Human papillomavirus-like particles vaccine efficiently produced in a non-fermentative system based on insect larva

8 p., 3 figures, 1 table of contents and bibliographySexually transmitt ed human papillomavirus (HPV) infections cause most cervical cancers. The inability to propagate HPV in vitro has led to the development of alternative approaches to antigen production for vaccine development. In the present work we describe a l ow - cost eff icient production of HPV virus - like particles (VLPs) in a non - fermentative system based on baculovirus and Trichoplusia ni ( T. ni ) insects. The L1 protein from HPV 16 was expressed by a recombinant baculovirus in larva at levels that reached 18 to 21 mg pe r g of fresh insect biomass. It represents about 2.5 times the L1 production yields obtained per g of insect cells using the same recombinant baculovirus. Under electron microscopy, purified VLPs produced in larvae were indistinguishable from those produce d in Sf - 21 insect cell cultures, presenting identical shape and size . Immunization of mice with the insect - derived VLPs induced a potent immune response similar to that obtained with insect cells - derived VLPs. The use of live insect larvae as “mini bioreac tors” opens up the possibility of cost - effective production of a vaccine against cervical cancer produced by papillomavirus, with special application in human populations where production costs restrain their use.This work was partially supported by Grants BIO2005-00155 and CPE03-022-C5-2 from the Ministerio de Educación y Ciencia and INIA, respectively, and by funds from the company Alternative Gene Expression S.L. (ALGENEX).Peer reviewe

Detection of intimate partner violence in primary care and related factors

Objetivo: La violencia de compañero íntimo (VCI) contra las mujeres es un importante problema de salud pública y de derechos humanos. Los profesionales de atención primaria tienen un papel clave en su detección y abordaje. El objetivo de este estudio es determinar la frecuencia y los factores asociados a la realización de preguntas de detección de VCI en atención primaria, y describir las principales acciones desarrolladas en los casos identificados. Métodos: Estudio transversal en 15 centros de salud de cuatro comunidades autónomas, con 265 profesionales sanitarios. Recogida de información mediante el cuestionario PREMIS (Physician Readiness to Manage Intimate Partner Violence Survey) autocumplimentado, que incluye variables sobre realización de preguntas para detección, sociodemográficas, nivel de formación/conocimientos en VCI, percepciones y acciones. Se realizó un análisis descriptivo y analítico. Resultados: El 67,2% de los participantes señalan que preguntan sobre VCI en la consulta, siendo las acciones más frecuentes referir/derivar a otros servicios, consejo individual y entrega de información. Se asociaron a mayor probabilidad de indagar sobre VCI tener ≥21 de horas de formación, nivel formativo avanzado, conocer políticas y programas, y disponer de protocolo y recursos apropiados de referencia. La realización de preguntas aumenta a medida que los/las profesionales se sienten formados en VCI y provistos/as de un protocolo de manejo de casos. Conclusiones: Dos terceras partes de los/las profesionales sanitarios/as encuestados/as refirieron indagar sobre VCI. Dada la influencia de la formación en VCI y el conocimiento sobre los recursos para su abordaje, resulta imprescindible continuar invirtiendo en la formación en VCI del personal sanitario.Objective: Intimate partner violence (IPV) against women is a significant public health and human rights problem. Primary care professionals play a key role in detecting and addressing this issue. The aim of this study is to determine the frequency of IPV and its associated factors in primary care by means of a screening questionnaire and to describe the main actions taken in identified cases. Methods: Cross-sectional study in 15 health centres in four autonomous regions of Spain with a total of 265 health professionals. The information was collected through the self-administered PREMIS questionnaire (Physician Readiness to Manage Intimate Partner Violence Survey), which includes variables concerning screening questions, sociodemographic factors, level of training/knowledge about IPV, perceptions and actions. A descriptive and analytical study was conducted. Results: 67.2% of participants said they ask about IPV during consultations. The most frequent actions were: referring patients to other departments, individual counselling and information delivery. ≥21 hours of training, an advanced training level, knowledge of policies and programmes and the implementation of an appropriate protocol and reference resources were all factors that increased the likelihood of investigating IPV. The asking of questions increases in line with professionals’ perceived level of training in IPV and the provision of a case management protocol. Conclusions: Two thirds of health professional respondents said they inquire about IPV. Given the influence of training in IPV and awareness of the resources to address the issue, it is essential to continue investing in the IPV training of healthcare personnel.Este estudio forma parte del proyecto de investigación Violencia contra las mujeres en la pareja y respuestas de los profesionales de atención primaria de salud de España, financiado por el Ministerio de Economía y Competitividad, el Instituto Carlos III y Fondos FEDER (PI13/00874) para el periodo 2014-2016. También recibió el apoyo económico de COFAS (COFUND action within the Marie Curie Action People, in the Seventh Framework program and the Swedish Council for Working Life and Social Research/FAS-Forskningsradet för arbetsliv och socialvetenskap)

Influence of Tartrate Ligand Coordination over Luminescence Properties of Chiral Lanthanide-Based Metal–Organic Frameworks

The present work reports on a detailed discussion about the synthesis, characterization, and luminescence properties of three pairs of enantiopure 3D metal–organic frameworks (MOFs) with general formula {[Ln2(L/D-tart)3(H2O)2]·3H2O}n (3D_Ln-L/D, where Ln = Sm(III), Eu(III) or Gd(III), and L/D-tart = L- or D-tartrate), and ten pairs of enantiopure 2D coordination polymers (CPs) with general formula [Ln(L/D-Htart)2(OH)(H2O)2]n (2D_Ln-L/D, where Ln = Y(III), Sm(III), Eu(III), Gd(III), Tb(III), Dy(III), Ho(III), Er(III), Tm(III) or Yb(III), and L/D-Htart = hydrogen L- or D-tartrate) based on single-crystal X-ray structures. Enantiopure nature of the samples has been further corroborated by Root Mean Square Deviation (RMSD) as well as by circular dichroism (CD) spectra. Solid-state emission spectra of Eu(III), Tb(III), and Dy(III)-based compounds confirm the occurrence of ligand-to-metal charge transfers in view of the characteristic emissions for these lanthanide ions, and emission decay curves were also recorded to estimate the emission lifetimes for the reported compounds. A complete theoretical study was accomplished to better understand the energy transfers occurring in the Eu-based counterparts, which allows for explaining the different performances of 3D-MOFs and 2D-layered compounds. As inferred from the colorimetric diagrams, emission characteristics of Eu-based 2D CPs depend on the temperature, so their luminescent thermometry has been determined on the basis of a ratiometric analysis between the ligand-centered and Eu-centered emission. Finally, a detailed study of the polarized luminescence intensity emitted by the samples is also accomplished to support the occurrence of chiro-optical activity.This work has been funded by the University of the Basque Country (GIU20/028), Gobierno Vasco/Eusko Jaurlaritza (IT1755-22, IT1500-22), Junta de Andalucía (FQM-394, B-FQM-734-UGR20 and ProyExcel_00386), and the Spanish Ministry of Economy and Competitiveness (MCIU/AEI/FEDER, UE) (PGC2018-102052-A-C22, PGC2018-102052-B-C21)

Experiments with the NNMFPACK library: influence of beta parameter in the NNMF approximation error

[EN] NnmfPack is a numerical library designed to compute efficiently the Non-Negative Matrix Factorization (NNMF). It has been conceived for shared memory heterogeneous parallel systems, and it supports, from its conception, both conventional multi-core processors and many-core coprocessors. NnmfPack offers different algorithms which allow to handle different metrics options such as beta-divergence or Frobenius norm. In real applications the choice of the beta parameter presents a problem for the users of the NNMF that must decide which value to use to obtain the best approximation. In this paper, the influence of the parameter beta in the NNMF approximation error for different problems is empirically evaluated. Different datasets have been used in order to analyze and evaluate the dependency between the quality of the approximation provided by NnmfPack and the value of the beta parameter used.This work has been partially supported by Ministerio de Economía y Competitividad from Spain, under the projects TEC2012-38142-C04-01 and TEC2012-38142-C04-04 and by PROMETEO FASE II 2014/003 projects of Generalitat Valenciana.San Juan Sebastián, P.; Vidal Maciá, AM.; García Mollá, VM.; Martínez Zaldívar, FJ.; Ranilla, J.; Alonso, P.; Alonso-González, M.... (2015). Experiments with the NNMFPACK library: influence of beta parameter in the NNMF approximation error. CMMSE. http://hdl.handle.net/10251/75307

Health care and societal costs of the management of children and adolescents with attention-deficit/hyperactivity disorder in Spain: a descriptive analysis

Background: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition in childhood (5.3% to 7.1% worldwide prevalence), with substantial overall financial burden to children/adolescents, their families, and society. The aims of this study were to describe the clinical characteristics of children and adolescents with ADHD in Spain, estimate the associated direct/indirect costs of the disorder, and assess whether the characteristics and financial costs differed between children/adolescents adequately responding to currently available pharmacotherapies compared with children/adolescents for whom pharmacotherapies failed. Methods: This was a multicenter, cross-sectional, descriptive analysis conducted in 15 health units representative of the overall Spanish population. Data on demographic characteristics, socio-occupational status, social relationships, clinical variables of the disease, and pharmacological and non-pharmacological treatments received were collected in 321 children and adolescents with ADHD. Direct and indirect costs were estimated over one year from both a health care system and a societal perspective. Results: The estimated average cost of ADHD per year per child/adolescent was €5733 in 2012 prices; direct costs accounted for 60.2% of the total costs (€3450). Support from a psychologist/educational psychologist represented 45.2% of direct costs and 27.2% of total costs. Pharmacotherapy accounted for 25.8% of direct costs and 15.5% of total costs. Among indirect costs (€2283), 65.2% was due to caregiver expenses. The total annual costs were significantly higher for children/adolescents who responded poorly to pharmacological treatment (€7654 versus €5517; P = 0.024), the difference being mainly due to significantly higher direct costs, particularly with larger expenses for non-pharmacological treatment (P = 0.012). Conclusions: ADHD has a significant personal, familial, and financial impact on the Spanish health system and society. Successful pharmacological intervention was associated with lower overall expenses in the management of the disorde

Determinants of survival in adult HIV patients on antiretroviral therapy in Oromiyaa, Ethiopia

Background: The antiretroviral treatment (ART) scale-up service has been a recent development in Ethiopia, but its impact on mortality has not been well investigated. The aim of this study was to assess the early survival outcome of the scale-up service by utilizing routine hospital data. Methods: All adult HIV/AIDS patients who started on antiretroviral treatment in Shashemene and Assela hospitals from January 1, 2006 to May 31, 2006 were included and followed up for 2 years. Data were extracted from standard patient medical registrations. Kaplan-Meier curves were used to estimate survival probability and the Cox proportional hazard model was applied to determine predictors of mortality. Two alterative assumptions (real case and worst case) were made in determining predictors of mortality. Results: The median age of patients was 33 years and 57% were female. Eighty-five percent had CD4 <200 cells/mu L with a median CD4 count of 103 cells/mu L. The median survival time was 104.4 weeks. A total of 28 (10.3%) deaths were observed during the 2-year period and 48 patients (18%) were lost to follow up. The majority of deaths occurred in the first 4 months of treatment. In multivariate analysis, 2-year survival was significantly associated with the clinical stage of the disease, baseline hemoglobin, and cotrimoxazole prophylaxis therapy (CPT) at or before ART initiation in both assumptions. The median CD4 count and body weight showed a marked improvement during the first 6 months of treatment, followed by stagnation thereafter. Conclusion: The study has shown an overall low mortality but a high loss to follow-up rate of the cohort. Advanced clinical stage, anemia, low body weight, and lack of CPT initiation were independent predictors of mortality - but not gender. CPT initiation should be encouraged in routine HIV care services, and patient retention mechanisms have to be strengthened. Stagnation in immunological and weight recovery after the first 6 months should be further investigated. The utilization of routine data should be encouraged in order to facilitate appropriate decision making

Predictors of patient satisfaction with hospital health care

BACKGROUND: We used a validated inpatient satisfaction questionnaire to evaluate the health care received by patients admitted to several hospitals. This questionnaire was factored into distinct domains, creating a score for each to assist in the analysis. We evaluated possible predictors of patient satisfaction in relation to socio-demographic variables, history of admission, and survey logistics. METHODS: Cross-sectional study of patients discharged from four acute care general hospitals. Random sample of 650 discharged patients from the medical and surgical wards of each hospital during February and March 2002. A total of 1,910 patients responded to the questionnaire (73.5%). Patient satisfaction was measured by a validated questionnaire with six domains: information, human care, comfort, visiting, intimacy, and cleanliness. Each domain was scored from 0 to 100, with higher scores indicating higher levels of patient satisfaction. RESULTS: In the univariate analysis, age was related to all domains except visiting; gender to comfort, visiting, and intimacy; level of education to comfort and cleanliness; marital status to information, human care, intimacy, and cleanliness; length of hospital stay to visiting and cleanliness, and previous admissions to human care, comfort, and cleanliness. The timing of the response to the mailing and who completed the questionnaire were related to all variables except visiting and cleanliness. Multivariate analysis confirmed in most cases the previous findings and added additional correlations for level of education (visiting and intimacy) and marital status (comfort and visiting). CONCLUSION: These results confirm the varying importance of some socio-demographic variables and length of stay, previous admission, the timing of response to the questionnaire, and who completed the questionnaire on some aspects of patient satisfaction after hospitalization. All these variables should be considered when evaluating patient satisfaction

Multicentre, randomised, open-label, phase IV-III study to evaluate the efficacy of cloxacillin plus fosfomycin versus cloxacillin alone in adult patients with methicillin-susceptible Staphylococcus aureus bacteraemia: Study protocol for the SAFO trial

Introduction Methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia is a frequent condition, with high mortality rates. There is a growing interest in identifying new therapeutic regimens able to reduce therapeutic failure and mortality observed with the standard of care of beta-lactam monotherapy. In vitro and small-scale studies have found synergy between cloxacillin and fosfomycin against S. aureus. Our aim is to test the hypothesis that cloxacillin plus fosfomycin achieves higher treatment success than cloxacillin alone in patients with MSSA bacteraemia. Methods We will perform a superiority, randomised, open-label, phase IV-III, two-armed parallel group (1:1) clinical trial at 20 Spanish tertiary hospitals. Adults (=18 years) with isolation of MSSA from at least one blood culture =72 hours before inclusion with evidence of infection, will be randomly allocated to receive either cloxacillin 2 g/4-hour intravenous plus fosfomycin 3 g/6-hour intravenous or cloxacillin 2 g/4-hour intravenous alone for 7 days. After the first week, sequential treatment and total duration of antibiotic therapy will be determined according to clinical criteria by the attending physician. Primary endpoints: (1) Treatment success at day 7, a composite endpoint comprising all the following criteria: patient alive, stable or with improved quick-Sequential Organ Failure Assessment score, afebrile and with negative blood cultures for MSSA at day 7. (2) Treatment success at test of cure (TOC) visit: patient alive and no isolation of MSSA in blood culture or at another sterile site from day 8 until TOC (12 weeks after randomisation). We assume a rate of treatment success of 74% in the cloxacillin group. Accepting alpha risk of 0.05 and beta risk of 0.2 in a two-sided test, 183 subjects will be required in each of the control and experimental groups to obtain statistically significant difference of 12% (considered clinically significant). Ethics and dissemination Ethical approval has been obtained from the Ethics Committee of Bellvitge University Hospital (AC069/18) and from the Spanish Medicines and Healthcare Product Regulatory Agency (AEMPS, AC069/18), and is valid for all participating centres under existing Spanish legislation. The results will be presented at international meetings and will be made available to patients and funders. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ