Supporting Treatment Adherence Readiness through Training (START) for patients with HIV on antiretroviral therapy: study protocol for a randomized controlled trial.

BackgroundFew HIV antiretroviral adherence interventions target patients before they start treatment, assess adherence readiness to determine the timing of treatment initiation, or tailor the amount of adherence support. The Supporting Treatment Adherence Readiness through Training (START) intervention, based on the information-motivation-behavioral skills model of behavior change, is designed to address these gaps with the inclusion of (1) brief pill-taking practice trials for enhancing pretreatment adherence counseling and providing a behavioral criterion for determining adherence readiness and the timing of treatment initiation and (2) a performance-driven dose regulation mechanism to tailor the amount of counseling to the individual needs of the patient and conserve resources. The primary aim of this randomized controlled trial is to examine the effects of START on antiretroviral adherence and HIV virologic suppression.Methods/designA sample of 240 patients will be randomized to receive START or usual care at one of two HIV clinics. Primary outcomes will be optimal dose-taking adherence (>85 % prescribed doses taken), as measured with electronic monitoring caps, and undetectable HIV viral load. Secondary outcomes will include dose-timing adherence (>85 % prescribed doses taken on time) and CD4 count. Primary endpoints will be month 6 (short-term effect) and month 24 (to test durability of effect), though electronic monitoring will be continuous and a fully battery of assessments will be administered every 6 months for 24 months.DiscussionIf efficacious and cost-effective, START will provide clinicians with a model for assessing patient adherence readiness and helping patients to achieve and sustain readiness and optimal treatment benefits.Trial registrationClinicalTrials.gov identifier NCT02329782 . Registered on 22 December 2014

Comparative evaluation of instrument segmentation and tracking methods in minimally invasive surgery

Intraoperative segmentation and tracking of minimally invasive instruments is a prerequisite for computer- and robotic-assisted surgery. Since additional hardware like tracking systems or the robot encoders are cumbersome and lack accuracy, surgical vision is evolving as promising techniques to segment and track the instruments using only the endoscopic images. However, what is missing so far are common image data sets for consistent evaluation and benchmarking of algorithms against each other. The paper presents a comparative validation study of different vision-based methods for instrument segmentation and tracking in the context of robotic as well as conventional laparoscopic surgery. The contribution of the paper is twofold: we introduce a comprehensive validation data set that was provided to the study participants and present the results of the comparative validation study. Based on the results of the validation study, we arrive at the conclusion that modern deep learning approaches outperform other methods in instrument segmentation tasks, but the results are still not perfect. Furthermore, we show that merging results from different methods actually significantly increases accuracy in comparison to the best stand-alone method. On the other hand, the results of the instrument tracking task show that this is still an open challenge, especially during challenging scenarios in conventional laparoscopic surgery

Fucino palaeo-lake: Towards the Palaeoenvironmental history of the last 430 Ka

© 2010 AIQUA - Associazione Italiana per lo Studio del Quaternario e EMMEVI - Servizio Congressi SPA. The sedimentary succession deposited in Fucino palaeo-lake potentially records the environmental history of the Central Mediterranean Region continuously since the early Pleistocene and up to recent historical times. Fucino palaeo-lake sediments are interbedded with numerous volcanic ash layers which allow the reconstruction a robust and independent chronological framework of past environment changes. This framework is a fundamental tool to synchronise different archives at a regional and extra-regional scale and to better understand the spatio-temporal climate variability in the Quaternary at the orbital and millennial-scales. Here we present new preliminary data for the last five glacial to interglacial cycles

The Lake Ohrid SCOPSCO project

The ICDP SCOPSCO project at Lake Ohrid in Macedonia and Albania was one of the most successful lake drilling campaigns worldwide. Drilling took place from April to June 2013 and yielded more than 2000 m of sediments from four different sites in the lake. The maximum penetration was 569 m below lake floor and the overall recovery at all drill sites was > 95 %. Almost two years after the drilling operation, core opening and processing as well as biological and geological analyses are still ongoing

Images of Embedded Jovian Planet Formation At A Wide Separation Around AB Aurigae

Direct images of protoplanets embedded in disks around infant stars provide the key to understanding the formation of gas giant planets like Jupiter. Using the Subaru Telescope and Hubble Space Telescope, we find evidence for a jovian protoplanet around AB Aurigae orbiting at a wide projected separation (93 au), likely responsible for multiple planet-induced features in the disk. Its emission is reproducible as reprocessed radiation from an embedded protoplanet. We also identify two structures located at 430-580 au that are candidate sites of planet formation. These data reveal planet formation in the embedded phase and a protoplanet discovery at wide, > 50 au separations characteristic of most imaged exoplanets. With at least one clump-like protoplanet and multiple spiral arms, the AB Aur system may also provide the evidence for a long-considered alternative to the canonical model for Jupiter's formation: disk (gravitational) instability.Comment: Author's personal version: 19 pages, 5 Figures, 1 Table; 32 Supplementary pages, 18 Supplementary Figures, 1 Supplementary Table; Accepted for Publication in Nature Astronomy. Published version: https://www.nature.com/articles/s41550-022-01634-

Direct Imaging Discovery and Dynamical Mass of a Substellar Companion Orbiting an Accelerating Hyades Sun-like Star with SCExAO/CHARIS

We present the direct-imaging discovery of a substellar companion in orbit around a Sun-like star member of the Hyades open cluster. So far, no other substellar companions have been unambiguously confirmed via direct imaging around main-sequence stars in Hyades. The star HIP 21152 is an accelerating star as identified by the astrometry from the Gaia and Hipparcos satellites. We have detected the companion, HIP 21152 B, in multi-epoch using the high-contrast imaging from SCExAO/CHARIS and Keck/NIRC2. We have also obtained the stellar radial-velocity data from the Okayama 188cm telescope. The CHARIS spectroscopy reveals that HIP 21152 B's spectrum is consistent with the L/T transition, best fit by an early T dwarf. Our orbit modeling determines the semi-major axis and the dynamical mass of HIP 21152 B to be 17.5$^{+7.2}_{-3.8}$ au and 27.8$^{+8.4}_{-5.4}$ $M_{\rm{Jup}}$, respectively. The mass ratio of HIP 21152 B relative to its host is $\approx$2\%, near the planet/brown dwarf boundary suggested from recent surveys. Mass estimates inferred from luminosity evolution models are slightly higher (33--42 $M_{\rm{Jup}}$). With a dynamical mass and a well-constrained age due to the system's Hyades membership, HIP 21152 B will become a critical benchmark in understanding the formation, evolution, and atmosphere of a substellar object as a function of mass and age. Our discovery is yet another key proof-of-concept for using precision astrometry to select direct imaging targets.Comment: 21 pages (11 pages in main body), 8 figures (4 figures in main body). Accepted for Publication in ApJL at July 9, 2022 (UT

European guideline (EuroGuiDerm) on atopic eczema - part II: non-systemic treatments and treatment recommendations for special AE patient populations.

The evidence- and consensus-based guideline on atopic eczema was developed in accordance with the EuroGuiDerm Guideline and Consensus Statement Development Manual. Four consensus conferences were held between December 2020 and July 2021. Twenty-nine experts (including clinicians and patient representatives) from 12 European countries participated. This second part of the guideline includes recommendations and detailed information on basic therapy with emollients and moisturizers, topical anti-inflammatory treatment, antimicrobial and antipruritic treatment and UV phototherapy. Furthermore, this part of the guideline covers techniques for avoiding provocation factors, as well as dietary interventions, immunotherapy, complementary medicine and educational interventions for patients with atopic eczema and deals with occupational and psychodermatological aspects of the disease. It also contains guidance on treatment for paediatric and adolescent patients and pregnant or breastfeeding women, as well as considerations for patients who want to have a child. A chapter on the patient perspective is also provided. The first part of the guideline, published separately, contains recommendations and guidance on systemic treatment with conventional immunosuppressive drugs, biologics and janus kinase (JAK) inhibitors, as well as information on the scope and purpose of the guideline, and a section on guideline methodology

Mediterranean winter rainfall in phase with African monsoons during the past 1.36 million years

Mediterranean climates are characterized by strong seasonal contrasts between dry summers and wet winters. Changes in winter rainfall are critical for regional socioeconomic development, but are difficult to simulate accurately1 and reconstruct on Quaternary timescales. This is partly because regional hydroclimate records that cover multiple glacial–interglacial cycles2,3 with different orbital geometries, global ice volume and atmospheric greenhouse gas concentrations are scarce. Moreover, the underlying mechanisms of change and their persistence remain unexplored. Here we show that, over the past 1.36 million years, wet winters in the northcentral Mediterranean tend to occur with high contrasts in local, seasonal insolation and a vigorous African summer monsoon. Our proxy time series from Lake Ohrid on the Balkan Peninsula, together with a 784,000-year transient climate model hindcast, suggest that increased sea surface temperatures amplify local cyclone development and refuel North Atlantic low-pressure systems that enter the Mediterranean during phases of low continental ice volume and high concentrations of atmospheric greenhouse gases. A comparison with modern reanalysis data shows that current drivers of the amount of rainfall in the Mediterranean share some similarities to those that drive the reconstructed increases in precipitation. Our data cover multiple insolation maxima and are therefore an important benchmark for testing climate model performance

Genotypic diversity and phenotypic spectrum of infantile liver failure syndrome type 1 due to variants inLARS1

Purpose: Biallelic variants in LARS1, coding for the cytosolic leucyl-tRNA synthetase, cause infantile liver failure syndrome 1 (ILFS1). Since its description in 2012, there has been no systematic analysis of the clinical spectrum and genetic findings. Methods: Individuals with biallelic variants in LARS1 were included through an international, multicenter collaboration including novel and previously published patients. Clinical variables were analyzed and functional studies were performed in patient-derived fibroblasts. Results: Twenty-five individuals from 15 families were ascertained including 12 novel patients with eight previously unreported variants. The most prominent clinical findings are recurrent elevation of liver transaminases up to liver failure and encephalopathic episodes, both triggered by febrile illness. Magnetic resonance image (MRI) changes during an encephalopathic episode can be consistent with metabolic stroke. Furthermore, growth retardation, microcytic anemia, neurodevelopmental delay, muscular hypotonia, and infection-related seizures are prevalent. Aminoacylation activity is significantly decreased in all patient cells studied upon temperature elevation in vitro. Conclusion: ILFS1 is characterized by recurrent elevation of liver transaminases up to liver failure in conjunction with abnormalities of growth, blood, nervous system, and musculature. Encephalopathic episodes with seizures can occur independently from liver crises and may present with metabolic stroke

Optical properties of ZnO deposited by atomic layer deposition (ALD) on Si nanowires

International audienceIn this work, we report proof-of-concept results on the synthesis of Si core/ ZnO shell nanowires (SiNWs/ZnO) by combining nanosphere lithography (NSL), metal assisted chemical etching (MACE) and atomic layer deposition (ALD). The structural properties of the SiNWs/ZnO nanostructures prepared were investigated by X-ray diffraction, Raman spectroscopy, scanning and transmission electron microscopies. The X-ray diffraction analysis revealed that all samples have a hexagonal wurtzite structure. The grain sizes are found to be in the range of 7-14 nm. The optical properties of the samples were investigated using reflectance and photoluminescence spectroscopy. The study of photoluminescence (PL) spectra of SiNWs/ZnO samples showed the domination of defect emission bands, pointing to deviations of the stoichiometry of the prepared 3D ZnO nanostructures. Reduction of the PL intensity of the SiNWs/ZnO with the increase of SiNWs etching time was observed, depicting an advanced light scattering with the increase of the nanowire length. These results open up new prospects for the design of electronic and sensing devices