Analysis of HIV quasispecies and virological outcome of an HIV D+/R+ kidney–liver transplantation

Introduction: Transplantation among HIV positive patients may be a valuable therapeutic intervention. This study involves an HIV D+/R+ kidney–liver transplantation, where PBMC-associated HIV quasispecies were analyzed in donor and transplant recipients (TR) prior to transplantation and thereafter, together with standard viral monitoring. Methods: The donor was a 54 year of age HIV infected woman: kidney and liver recipients were two HIV infected men, aged 49 and 61. HIV quasispecies in PBMC was analyzed by ultra-deep sequencing of V3 env region. During TR follow-up, plasma HIV-1 RNA, HIV-1 DNA in PBMC, analysis of proviral integration sites and drug-resistance genotyping were performed. Other virological and immunological monitoring included CMV and EBV DNA quantification in blood and CD4 T cell counts. Results: Donor and TR were all ART-HIV suppressed at transplantation. Thereafter, TR maintained a nearly suppressed HIV-1 viremia, but HIV-1 RNA blips and the increase of proviral integration sites in PBMC attested some residual HIV replication. A transient peak in HIV-1 DNA occurred in the liver recipient. No major changes of drug-resistance genotype were detected after transplantation. CMV and EBV transient reactivations were observed only in the kidney recipient, but did not require specific treatment. CD4 counts remained stable. No intermixed quasispecies between donor and TR was observed at transplantation or thereafter. Despite signs of viral evolution in TR, HIV genetic heterogeneity did not increase over the course of the months of follow up. Conclusions: No evidence of HIV superinfection was observed in the donor nor in the recipients. The immunosuppressive treatment administrated to TR did not result in clinical relevant viral reactivations

Clinical features of benign infantile convulsions: familial and sporadic cases.

Objective: To give a contribution about the existence of non familial benign infantile convulsions during the first two years of life. Patients and Methods: We evaluated 58 patients (29 females and 29 males) with seizure onset ranging between 4 and 24 months of life, regular psychomotor development, unremarkable neuro-imaging studies and interictal electroencephalogram. We analyzed gender, age at onset, duration, manifestations and frequency of seizures, family history of febrile or infantile convulsions. Results: 17 patients had a family history of benign epilepsy, while 41 had not. Among the latter, 12 showed a family history of febrile seizures and the remaining 29 had an uncertain or fully negative familiarity with it. No clinical differences have been observed between the familial and the non familial groups. Nobody experienced seizures after the age of two and the psychomotor development remained normal in all patients, during follow-up. Conclusions: This study confirms the existence of non familial benign infantile convulsions and the benign outcome of this type of seizures either familial or non-familial. In addition to this, we also discuss the possibility to avoid anti-epileptic treatment

A Systematic Mapping Study of Italian Research on Workflows

An entire ecosystem of methodologies and tools revolves around scientific workflow management. They cover crucial non-functional requirements that standard workflow models fail to target, such as interactive execution, energy efficiency, performance portability, Big Data management, and intelligent orchestration in the Computing Continuum. Characterizing and monitoring this ecosystem is crucial to developing an informed view of current and future research directions. This work conducts a systematic mapping study of the Italian workflow research community, analyzing 25 tools and 10 applications from several scientific domains in the context of the "National Research Centre for HPC, Big Data, and Quantum Computing"(ICSC). The study aims to outline the main current research directions and determine how they address the critical needs of modern scientific applications. The findings highlight a variegated research ecosystem of tools, with a prominent interest in advanced workflow orchestration and still immature but promising efforts toward energy efficiency

Benefit of Extended Dual Antiplatelet Therapy Duration in Acute Coronary Syndrome Patients Treated with Drug Eluting Stents for Coronary Bifurcation Lesions (from the BIFURCAT Registry)

Optimal dual antiplatelet therapy (DAPT) duration for patients undergoing percutaneous coronary intervention (PCI) for coronary bifurcations is an unmet issue. The BIFURCAT registry was obtained by merging two registries on coronary bifurcations. Three groups were compared in a two-by-two fashion: short-term DAPT ( 64 6 months), intermediate-term DAPT (6-12 months) and extended DAPT (>12 months). Major adverse cardiac events (MACE) (a composite of all-cause death, myocardial infarction (MI), target-lesion revascularization and stent thrombosis) were the primary endpoint. Single components of MACE were the secondary endpoints. Events were appraised according to the clinical presentation: chronic coronary syndrome (CCS) versus acute coronary syndrome (ACS). 5537 patients (3231 ACS, 2306 CCS) were included. After a median follow-up of 2.1 years (IQR 0.9-2.2), extended DAPT was associated with a lower incidence of MACE compared with intermediate-term DAPT (2.8% versus 3.4%, adjusted HR 0.23 [0.1-0.54], p <0.001), driven by a reduction of all-cause death in the ACS cohort. In the CCS cohort, an extended DAPT strategy was not associated with a reduced risk of MACE. In conclusion, among real-world patients receiving PCI for coronary bifurcation, an extended DAPT strategy was associated with a reduction of MACE in ACS but not in CCS patients