The complex globular cluster system of the S0 galaxy NGC 4382 in the outskirts of the Virgo Cluster

NGC 4382 is a merger-remnant galaxy that has been classified as morphological type E2, S0, and even Sa. In this work, we performed a photometric and spectroscopic analysis of the globular cluster (GC) system of this peculiar galaxy in order to provide additional information about its history. We used a combination of photometric data in different filters, and multiobject and long-slit spectroscopic data obtained using the Gemini/GMOS instrument. The photometric analysis of the GC system, using the Gaussian Mixture Model algorithm in the colour plane, reveals a complex colour distribution within Rgal < 5 arcmin (26.1 kpc), showing four different groups: the typical blue and red subpopulations, a group with intermediate colours, and the fourth group towards even redder colours. From the spectroscopic analysis of 47 GCs, confirmed members of NGC 4382 based on radial velocities, we verified 3 of the 4 photometric groups from the analysis of their stellar populations using the ULySS code. NGC 4382 presents the classic blue (10.4 ± 2.8 Gyr, [Fe/H] = −1.48 ± 0.18 dex), and red (12.1 ± 2.3 Gyr, [Fe/H] = −0.64 ± 0.26 dex) GCs formed earlier in the lifetime of the galaxy, and a third group of young GCs (2.2 ± 0.9 Gyr; [Fe/H] = −0.05 ± 0.28 dex). Finally, analysis of long-slit data of the galaxy reveals a luminosity-weighted mean age for the stellar population of ∼2.7 Gyr, and an increasing metallicity from [Fe/H] = −0.1 to +0.2 dex in Rgal < 10 arcsec (0.87 kpc). These values, and other morphological signatures in the galaxy, are in good agreement with the younger group of GCs, indicating a common origin as a result of a recent merger

Uptake, Retention, and Adherence to Pre-exposure Prophylaxis (PrEP) in TRIUMPH: A Peer-Led PrEP Demonstration Project for Transgender Communities in Oakland and Sacramento, California.

BackgroundTRIUMPH (Trans Research-Informed communities United in Mobilization for the Prevention of HIV) was a community-led, transgender-specific pre-exposure prophylaxis (PrEP) demonstration project at 2 community-based clinical sites in California. TRIUMPH used peer health education, community mobilization, and clinical integration of PrEP with hormone therapy to promote PrEP knowledge and acceptability. The goal of this study was to evaluate PrEP uptake, retention, and adherence among TRIUMPH participants and examine site-based differences.MethodsEligible participants were adult transgender and gender diverse people interested in PrEP. Participants were seen at baseline and at 1, 3, 6, 9, and 12 months for PrEP provision, clinical visits, and HIV testing. PrEP uptake was defined as dispensation of PrEP, PrEP retention was defined as proportion of expected visits completed among those who initiated PrEP, and PrEP adherence was assessed by measuring tenofovir diphosphate concentrations in dried blood spots. Logistic regression models quantified the association of variables with PrEP outcomes.ResultsTRIUMPH enrolled 185 participants; the median age was 28 years (interquartile range: 23-35), 7% was Black, and 58% was Latinx. PrEP uptake was as follows: 78% in Oakland and 98% in Sacramento; 91% among trans women, 96% among trans men, and 70% among nonbinary participants. Almost half (47%) rarely/never believed about HIV, and 42% reported condomless sex act in the past 3 months. Participants who reported higher numbers of sex partners were more likely to be retained and adherent; other predictors of adherence included not having a primary partner and not experiencing violence in the past 3 months.ConclusionsThis community-led, trans-specific PrEP demonstration project documents high levels of PrEP initiation in a young transgender and gender diverse cohort at risk of HIV acquisition

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p &lt; 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p &lt; 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p &lt; 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease