Raltegravir, tenofovir, and emtricitabine in an HIV-Infected patient with HCV chronic hepatitis, NNRTI intolerance and protease inhibitors-induced severe liver toxicity

<p>Abstract</p> <p>Background</p> <p>in HIV-infected patients with HCV-related chronic hepatitis, liver impairment and drug toxicity may substantially reduce the number of possible therapeutic options.</p> <p>Case Description</p> <p>we here describe the case of an HCV-HIV coinfected woman who had repeated severe episodes of drug-related liver toxicity with indinavir, saquinavir, fosamprenavir, and darunavir, with minimal further therapeutic options left in this class. Previous treatment-limiting side effects with efavirenz and nevirapine also precluded use of non-nucleoside reverse transcriptase inhibitors. Introduction of an integrase-inhibitor regimen based on raltegravir, tenofovir, and emtricitabine allowed a prompt achievement of undetectable viral load and a substantial rise of CD4 count to high levels, with no subsequent episodes of hepatic toxicity, and no other side effects.</p> <p>Conclusions</p> <p>given the relatively common prevalence of HCV-related chronic hepatitis among people with HIV, raltegravir might represent an important alternative option for a substantial number of patients who cannot be treated with protease inhibitors or NNRTI because of drug-related hepatic toxicity.</p

A lattice estimate of the g_{D^* D pi} coupling

We present the results of the first direct determination of the g_{D^* D pi} coupling using lattice QCD. From our simulations in the quenched approximation, we obtain g_{D^* D pi} = 18.8 +/- 2.3^{+1.1}_{-2.0} and hat(g) = 0.67 +/- 0.08^{+0.04}_{-0.06}. It is in agreement with a recent experimental result from CLEO.Comment: Lattice2002(heavyquark), 3 pages, 3 figure

Midday measurements of leaf water potential and stomatal conductance are highly correlated with daily water use of Thompson Seedless grapevines

A study was conducted to determine the relationship between midday measurements of vine water status and daily water use of grapevines measured with a weighing lysimeter. Water applications to the vines were terminated on August 24th for 9 days and again on September 14th for 22 days. Daily water use of the vines in the lysimeter (ETLYS) was approximately 40 L vine−1 (5.3 mm) prior to turning the pump off, and it decreased to 22.3 L vine−1 by September 2nd. Pre-dawn leaf water potential (ΨPD) and midday Ψl on August 24th were −0.075 and −0.76 MPa, respectively, with midday Ψl decreasing to −1.28 MPa on September 2nd. Leaf g s decreased from ~500 to ~200 mmol m−2 s−1 during the two dry-down periods. Midday measurements of g s and Ψl were significantly correlated with one another (r = 0.96) and both with ETLYS/ETo (r = ~0.9). The decreases in Ψl, g s, and ETLYS/ETo in this study were also a linear function of the decrease in volumetric soil water content. The results indicate that even modest water stress can greatly reduce grapevine water use and that short-term measures of vine water status taken at midday are a reflection of daily grapevine water us

Prolonged progressive hypermetabolism during COVID-19 hospitalization undetected by common predictive energy equations

Background & Aims: Indirect calorimetry (IC) is the gold-standard for determining measured resting energy expenditure (mREE) in critical illness. When IC is not available, predicted resting energy expenditure (pREE) equations are commonly utilized, which often inaccurately predict metabolic demands leading to over- or under-feeding. This study aims to longitudinally assess mREE via IC in critically ill patients with SARS-CoV-2 (COVID-19) infection throughout the entirety of, often prolonged, intensive care unit (ICU) stays and compare mREE to commonly utilized pREE equations. / Methods: This single-center prospective cohort study of 38 mechanically ventilated COVID-19 patients from April 1, 2020 to February 1, 2021. The Q-NRG® Metabolic Monitor was used to obtain IC data. The Harris-Benedict (HB), Mifflin St-Jeor (MSJ), Penn State University (PSU), and weight-based equations from the American Society of Parenteral and Enteral Nutrition – Society of Critical Care Medicine (ASPEN-SCCM) Clinical Guidelines were utilized to assess the accuracy of common pREE equations and their ability to predict hypo/hypermetabolism in COVID-19 ICU patients. / Results: The IC measures collected revealed a relatively normometabolic or minimally hypermetabolic mREE at 21.3 kcal/kg/d or 110% of predicted by the HB equation over the first week of mechanical ventilation (MV). This progressed to significant and uniquely prolonged hypermetabolism over successive weeks to 28.1 kcal/kg/d or 143% of HB predicted by MV week 3, with hypermetabolism persisting to MV week 7. Obese individuals displayed a more truncated response with significantly lower mREE versus non-obese patients in MV week 1 (19.5±1.0 kcal/kg/d vs 25.1±1.8 kcal/kg/d, respectively; p < 0.01), with little change in weeks 2-3 (19.5±1.5 kcal/kg/d vs 28.0±2.0 kcal/kg/d; p < 0.01). Both ASPEN-SCCM upper range and PSU pREE equations provided close approximations of mREE yet, like all pREE equations, occasionally over- and under-predicted energy needs and typically did not predict late hypermetabolism. / Conclusions: Study results show a truly unique metabolic response in COVID-19 ICU patients, characterized by significant and prolonged, progressive hypermetabolism peaking at 3 weeks’ post-intubation, persisting for up to 7 weeks in ICU. This pattern was more clearly demonstrated in non-obese versus obese patients. This response is unique and distinct from any previously described model of ICU stress response in its prolonged hypermetabolic nature. This data reaffirms the need for routine, longitudinal IC measures to provide accurate energy targets in COVID-19 ICU patients. The PSU and ASPEN-SCCM equations appear to yield the most reasonable estimation to IC-derived mREE in COVID-19 ICU patients, yet still often over-/under-predict energy needs. These findings provide a practical guide for caloric prescription in COVID-19 ICU patients in the absence of IC

An Instanton Picture O.P.E. <A^2> Condensate?

Gluon two- and three-point Green Functions computed in Landau gauge from the lattice show the existence of power corrections to the purely perturbative expressions, that can be explained through an Operator Product Expansion as the influence of a non gauge invariant mass dimension two condensate. The relationship of this condensate with topological properties of QCD, namely instantons, will be studied, giving a first estimate of the contribution of instantons to this condensate based in the direct lattice measure, after a cooling process, of the instanton liquid properties.Comment: Lattice2002(topology) contribution, 3 pages, 2 figure

The Influence of Physiological Status on age Prediction of Anopheles Arabiensis Using Near Infra-red spectroscopy

Determining the age of malaria vectors is essential for evaluating the impact of interventions that reduce the survival of wild mosquito populations and for estimating changes in vectorial capacity. Near infra-red spectroscopy (NIRS) is a simple and non-destructive method that has been used to determine the age and species of Anopheles gambiae s.l. by analyzing differences in absorption spectra. The spectra are affected by biochemical changes that occur during the life of a mosquito and could be influenced by senescence and also the life history of the mosquito, i.e., mating, blood feeding and egg-laying events. To better understand these changes, we evaluated the influence of mosquito physiological status on NIR energy absorption spectra. Mosquitoes were kept in individual cups to permit record keeping of each individual insect’s life history. Mosquitoes of the same chronological age, but at different physiological stages, were scanned and compared using cross-validations. We observed a slight trend within some physiological stages that suggest older insects tend to be predicted as being physiologically more mature. It was advantageous to include mosquitoes of different chronological ages and physiological stages in calibrations, as it increases the robustness of the model resulting in better age predictions. Progression through different physiological statuses of An. arabiensis influences the chronological age prediction by the NIRS. Entomologists that wish to use NIR technology to predict the age of field-caught An. gambiae s.l from their study area should use a calibration developed from their field strain using mosquitoes of diverse chronological ages and physiological stages to increase the robustness and accuracy of the predictions.\u

Smolyak's algorithm: A powerful black box for the acceleration of scientific computations

We provide a general discussion of Smolyak's algorithm for the acceleration of scientific computations. The algorithm first appeared in Smolyak's work on multidimensional integration and interpolation. Since then, it has been generalized in multiple directions and has been associated with the keywords: sparse grids, hyperbolic cross approximation, combination technique, and multilevel methods. Variants of Smolyak's algorithm have been employed in the computation of high-dimensional integrals in finance, chemistry, and physics, in the numerical solution of partial and stochastic differential equations, and in uncertainty quantification. Motivated by this broad and ever-increasing range of applications, we describe a general framework that summarizes fundamental results and assumptions in a concise application-independent manner

Electric-field controlled spin reversal in a quantum dot with ferromagnetic contacts

Manipulation of the spin-states of a quantum dot by purely electrical means is a highly desirable property of fundamental importance for the development of spintronic devices such as spin-filters, spin-transistors and single-spin memory as well as for solid-state qubits. An electrically gated quantum dot in the Coulomb blockade regime can be tuned to hold a single unpaired spin-1/2, which is routinely spin-polarized by an applied magnetic field. Using ferromagnetic electrodes, however, the properties of the quantum dot become directly spin-dependent and it has been demonstrated that the ferromagnetic electrodes induce a local exchange-field which polarizes the localized spin in the absence of any external fields. Here we report on the experimental realization of this tunneling-induced spin-splitting in a carbon nanotube quantum dot coupled to ferromagnetic nickel-electrodes. We study the intermediate coupling regime in which single-electron states remain well defined, but with sufficiently good tunnel-contacts to give rise to a sizable exchange-field. Since charge transport in this regime is dominated by the Kondo-effect, we can utilize this sharp many-body resonance to read off the local spin-polarization from the measured bias-spectroscopy. We show that the exchange-field can be compensated by an external magnetic field, thus restoring a zero-bias Kondo-resonance, and we demonstrate that the exchange-field itself, and hence the local spin-polarization, can be tuned and reversed merely by tuning the gate-voltage. This demonstrates a very direct electrical control over the spin-state of a quantum dot which, in contrast to an applied magnetic field, allows for rapid spin-reversal with a very localized addressing.Comment: 19 pages, 11 figure