A radio and infrared exploration of the Cygnus X-3 environments

To confirm, or rule out, the possible hot spot nature of two previously detected radio sources in the vicinity of the Cygnus X-3 microquasar. We present the results of a radio and near infrared exploration of the several arc-minute field around the well known galactic relativistic jet source Cygnus X-3 using the Very Large Array and the Calar Alto 3.5~m telescope. The data this paper is based on do not presently support the hot spot hypothesis. Instead, our new observations suggest that these sources are most likely background or foreground objects. Actually, none of them appears to be even barely extended as would be expected if they were part of a bow shock structure. Our near infrared observations also include a search for extended emission in the Bracket $\gamma$ (2.166 $\mu$m) and $H_{2}$ (2.122 $\mu$m) lines as possible tracers of shocked gas in the Cygnus X-3 surroundings. The results were similarly negative and the corresponding upper limits are reported.Comment: Accepted for publication in A&A; 5 pages, 4 figure

Chandra X-ray counterpart of KS 1741-293

We aim to investigate the nature of the high energy source KS 1741-293 by revisiting the radio and infrared associations proposed in the early 1990s. Our work is mostly based on the analysis of modern survey and archive data, including the NRAO, MSX, 2MASS and Chandra archives, and catalogues. We also have obtained deep CCD optical observations by ourselves. The coincidence of KS 1741-293 with an extended radio and far-infrared source, tentatively suggested in 1994, is no longer supported by modern observational data. Instead, a Chandra source is the only peculiar object found to be consistent with all high-energy error circles of KS 1741-293 and we propose it to be its most likely X-ray counterpart. We also report the existence of a non-thermal radio nebula in the vicinity of the KS 1741-293 position with the appearance of a supernova remnant. The possibility of being associated to this X-ray binary is discussed.Comment: 5 pages, 4 figures, 2 tables. Accepted for publication in Astronomy & Astrophysic

Evaluating an implementation programme for medication review with follow-up in community pharmacy using a hybrid effectiveness study design: translating evidence into practice.

OBJECTIVES: To evaluate an implementation programme of a community pharmacy medication review with follow-up (MRF) service using a hybrid effectiveness-implementation study design, and to compare the clinical and humanistic outcomes with those in a previously conducted cluster randomised controlled trial (cRCT). SETTING: Community pharmacies in Spain. PARTICIPANTS: 135 community pharmacies and 222 pharmacists providing MRF to polymedicated patients aged 65 or over. INTERVENTION: The intervention was an implementation programme for the MRF service. A national level group was established, mirrored with a provincial level group. A series of interventions were defined (1) to engage pharmacy owners with the implementation model and (2) to provide training to pharmacists consisting of clinical case studies, process of MRF, communication skills and data collection methods and (3) practice change facilitators. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcomes for the implementation programme were progress, reach, fidelity and integration. The secondary outcomes were number of medications, non-controlled health problems, emergency visits, hospitalisations and health-related quality of life, which were compared with a previous 6-month cluster RCT. RESULTS: 55% of pharmacies reached the implementation phase and 35.6% remained in the testing phase at 12 months. A reach of 89.3% (n=844) was achieved. Fidelity average score was 8.45 (min: 6.2, max: 9.3) out of 10. The integration mean score was 3.39 (SD: 0.72) out of 5. MRF service outcomes were similar to the cluster RCT study; however, the magnitude of the outcomes was delayed. CONCLUSIONS: The implementation of pharmacy services is a complex multifactorial process, conditioned by numerous implementation factors. In the absence of remuneration, the implementation of the MRF service is a slow process, taking at least 12 months to complete. TRIAL REGISTRATION NUMBER: CGFTRA-2017-01

An X-ray study of the SNR G344.7-0.1 and the central object CXOU J170357.8-414302

Aims. We report results of an X-ray study of the supernova remnant (SNR) G344.7-0.1 and the point-like X-ray source located at the geometrical center of the SNR radio structure. Methods. The morphology and spectral properties of the remnant and the central X-ray point-like source were studied using data from the XMM-Newton and Chandra satellites. Archival radio data and infrared Spitzer observations at 8 and 24 $\mu$m were used to compare and study its multi-band properties at different wavelengths. Results. The XMM-Newton and Chandra observations reveal that the overall X-ray emission of G344.7-0.1 is extended and correlates very well with regions of bright radio and infrared emission. The X-ray spectrum is dominated by prominent atomic emission lines. These characteristics suggest that the X-ray emission originated in a thin thermal plasma, whose radiation is represented well by a plane-parallel shock plasma model (PSHOCK). Our study favors the scenario in which G344.7-0.1 is a 6 x 10^3 year old SNR expanding in a medium with a high density gradient and is most likely encountering a molecular cloud on the western side. In addition, we report the discovery of a soft point-like X-ray source located at the geometrical center of the radio SNR structure. The object presents some characteristics of the so-called compact central objects (CCO). However, its neutral hydrogen absorption column (N_{H}) is inconsistent with that of the SNR. Coincident with the position of the source, we found infrared and optical objects with typical early-K star characteristics. The X-ray source may be a foreground star or the CCO associated with the SNR. If this latter possibility were confirmed, the point-like source would be the farthest CCO detected so far and the eighth member of the new population of isolated and weakly magnetized neutron stars.Comment: 9 pages, 8 figures, accepted for publication in Astronomy and Astrophysics. Higher resolution figures can be seen on A&

Apoptosis of peritoneal leucocytes during early stages of Fasciola hepatica infections in sheep

Several immunomodulatory properties have been described in Fasciola hepatica infections. Apoptosis has been shown to be an effective mechanism to avoid the immune response in helminth infections. The aim of the present work was to study apoptosis in peritoneal leucocytes of sheep experimentally infected with F. hepatica during the early stages of infection. Five groups (n = 5) of sheep were used. Groups 2–5 were orally infected with 200 metacercariae (mc) and sacrificed at 1, 3, 9 and 18 days post-infection (dpi), respectively. Group 1 was used as the uninfected control (UC). Apoptosis was detected using three different methods 1) immunocytochemistry (ICC) with a polyclonal antibody anti-active caspase-3; 2) an annexin V flow cytometry assay using the Annexin V-FITC/propidium iodide (PI); and 3) transmission electron microscopy (TEM). The differential leucocyte count revealed that the majority of peritoneal granulocytes were eosinophils, which increased significantly at 9 and 18 dpi with respect to the uninfected controls. The ICC study revealed that the percentage of caspase-3+ apoptotic peritoneal leucocytes increased significantly from 3 dpi onwards with respect to the uninfected controls. The flow cytometry annexin V assay detected a very significant (P < 0.001) increase of apoptotic peritoneal macrophages, lymphocytes and granulocytes, which remained higher than in the UC until 18 dpi. Transmission electron microscopy studies also confirmed the presence of apoptosis in peritoneal eosinophils at 18 dpi. This is the first report of apoptosis induced by F. hepatica in the peritoneal leucocytes of sheep in vivo. The results of this work suggest the importance of apoptosis induction for the survival of the juvenile parasites in the peritoneal migratory stages of infection.This work was supported by EU grants (H2020-635408-PARAGONE) and the Spanish Ministry of Science grant AGL2015-67023-C2-1-R. The TEM studies were carried out by the Central Research Services (SCAI) of the University of CórdobaAccepted manuscriptVeterinari

Comparative dynamics of peritoneal cell immunophenotypes in sheep during the early and late stages of the infection with Fasciola hepatica by flow cytometric analysis

Background: The peritoneal cell populations (PCP) are thought to play a crucial role during the early immune response in Fasciola hepatica infection while newly excysted juveniles (NEJ) are migrating in the peritoneal cavity (PC) towards the liver. In this study, we aimed to determine the immunophenotypes of the PCP and to analyse the dynamics of the recruitment of the PCP during the early and late stage of the infection in sheep infected with F. hepatica. Methods: Thirty-seven sheep were divided into three groups: Group 1 (n = 20) and 2 (n = 10) were challenged with F. hepatica, Group 3 (n = 7) was not infected and remained as uninfected control (UC). After the slaughtering, peritoneal lavages were carried out to isolate peritoneal cell populations at 1, 3, 9 and 18 days post-infection (dpi) for Group 1 and at 14 weeks post-infection (wpi) for Group 2 and 3. Flow cytometry was conducted to assess the dynamics of peritoneal cavity cell populations. Results: TCD4 cells showed a significant decrease at 1 and 18 dpi when compared to UC; no statistical differences were detected for TCD8 and WC1+ γδ during the early stage of the infection with respect to the UC. CD14 cells exhibited a decreasing trend, with a significant decrease at 9 and 18 dpi when compared to the UC. The dynamics of MHCII and CD83 cells showed a similar increasing pattern from 3 to 18 dpi. During the chronic stage, both TCD4 and TCD8 cells showed no significant differences when compared to the UC, although a slight but statistically significant higher level of WC1+ γδ cells was observed. A lower percentage of antigen-presenting cells (APCs) was detected with respect to the UC. Conclusions: The recruitment of the lymphocytes subsets did not show a significant increase during the course of the infection and only WC1+ γδ cells displayed a significant increase at the chronic stage. For the CD14, a decreasing trend was observed during the early stage, which was statistically significant at the chronic stage of the infection. Peritoneal CD83 and MHCII cells developed an increasing trend during the early stage of infection, and showed a significant decrease at the late stage of the infection.This study was funded by the European Union Grant H2020-635408- PARAGONE and by National Grant AGL2015-67023-C2-1-R. RPC was supported by an FPU grant of the Spanish Ministry of Education, Culture and Sport. Funding bodies were neither involved in the design of the study nor in analysis and interpretation of the dataVeterinari

Effectiveness of a medication adherence management intervention in a community pharmacy setting: a cluster randomised controlled trial

BackgroundNon-adherence to medications continues to be a burden worldwide, with significant negative consequences. Community pharmacist interventions seem to be effective at improving medication adherence. However, more evidence is needed regarding their impact on disease-specific outcomes. The aim was to evaluate the impact of a community pharmacist-led adherence management intervention on adherence and clinical outcomes in patients with hypertension, asthma and chronic obstructive pulmonary disease (COPD).MethodsA 6-month cluster randomised controlled trial was conducted in Spanish community pharmacies. Patients suffering from hypertension, asthma and COPD were recruited. Patients in the intervention group received a medication adherence management intervention and the control group received usual care. The intervention was based on theoretical frameworks for changing patient behaviour. Medication adherence, disease-specific outcomes (Asthma Control Questionnaire (ACQ) scores, Clinical COPD Questionnaire (CCQ) scores and blood pressure levels) and disease control were evaluated. A multilevel regression model was used to analyse the data.ResultsNinety-eight pharmacies and 1186 patients were recruited, with 1038 patients completing the study. Patients receiving the intervention had an OR of 5.12 (95% CI 3.20 to 8.20, pConclusionsA community pharmacist-led medication adherence intervention was effective at improving medication adherence and clinical outcomes in patients suffering from hypertension, asthma and COPD. Future research should explore the implementation of these interventions in routine practice.Trial registration numberACTRN12618000410257

Cost-Utility Analysis of a Medication Adherence Management Service Alongside a Cluster Randomized Control Trial in Community Pharmacy.

Background: It is necessary to determine the cost utility of adherence interventions in chronic diseases due to humanistic and economic burden of non-adherence. Purpose: To evaluate, alongside a cluster-randomized controlled trial, the cost-utility of a pharmacist-led medication adherence management service (MAMS) compared with usual care in community pharmacies. Materials and Methods: The trial was conducted over six months. Patients with treatments for hypertension, asthma or chronic obstructive pulmonary disease (COPD) were included. Patients in the intervention group (IG) received a MAMS based on a brief complex intervention, whilst patients in the control group (CG) received usual care. The cost–utility analysis adopted a health system perspective. Costs related to medications, healthcare resources and adherence intervention were included. The effectiveness was estimated as quality-adjusted life years (QALYs), using a multiple imputation missing data model. The incremental cost–utility ratio (ICUR) was calculated on the total sample of patients. Results: A total of 1186 patients were enrolled (IG: 633; CG: 553). The total intervention cost was estimated to be € 27.33 ± 0.43 per patient for six months. There was no statistically significant difference in total cost of medications and healthcare resources per patient between IG and CG. The values of EQ-5D-5L at 6 months were significantly higher in the IG [IG: 0.881 ± 0.005 vs CG: 0.833 ± 0.006; p = 0.000]. In the base case, the service was more expensive and more effective than usual care, resulting in an ICUR of € 1,494.82/QALY. In the complete case, the service resulted in an ICUR of € 2,086.30/QALY, positioned between the north-east and south-east quadrants of the cost–utility plane. Using a threshold value of € 20,000/QALY gained, there is a 99% probability that the intervention is cost-effective. Conclusion: The medication adherence management service resulted in an improvement in the quality of life of the population with chronic disease, with similar costs compared to usual care. The service is cost-effective