Lipidomics Reveals Reduced Inflammatory Lipid Species and Storage Lipids after Switching from EFV/FTC/TDF to RPV/FTC/TDF: A Randomized Open-Label Trial

HIV and antiretroviral therapy affect lipid metabolism. Lipidomics quantifies several individual species that are overlooked using conventional biochemical analyses, outperforming traditional risk equations. We aimed to compare the plasma lipidomic profile of HIV patients taking efavirenz (EFV) or rilpivirine (RPV). Patients >/= 18 years old on EFV co-formulated with emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) with HIV-RNA /=6 months were randomized to continue EFV/FTC/TDF (n = 14) or switch to RPV/FTC/TDF (n =15). Lipidomic analyses conducted by mass spectrometry (MS) were performed at baseline and after 12 and 24 weeks. OWLiver((R)) Care and OWLiver((R)) tests were performed to estimate the presence of fatty liver disease (NAFLD). No significant differences (83% male, median age 44 years, 6 years receiving EFV/FTC/TDF, CD4(+) count 740 cells/mm(3), TC 207 [57 HDL-C/133 LDL-C] mg/dL, TG 117 mg/dL) were observed between the groups at baseline. Significant reductions in plasma lipids and lipoproteins but increased circulating bilirubin concentrations were observed in patients who switched to RPV/FTC/TDF. Patients on RPV/FTC/TDF showed a decrease in the global amount of storage lipids (-0.137 log2 [fold-change] EFV vs. 0.059 log2 [fold-change] RPV) but an increase in lysophosphatidylcholines (LPCs) and total steroids. Compared with EFV, RPV increased metabolites with anti-inflammatory properties and reduced the repository of specific lipotoxic lipids

Constraining nuclear star cluster formation using MUSE-AO observations of the early-type galaxy FCC 47

Context. Nuclear star clusters (NSCs) are found in at least 70% of all galaxies, but their formation path is still unclear. In the most common scenarios, NSCs form in-situ from the galaxy's central gas reservoir, through the merging of globular clusters (GCs), or through a combination of both. Aims: As the scenarios pose different expectations for angular momentum and stellar population properties of the NSC in comparison to the host galaxy and the GC system, it is necessary to characterise the stellar light, NSC, and GCs simultaneously. The large NSC (r_eff = 66 pc) and rich GC system of the early-type Fornax cluster galaxy FCC 47 (NGC 1336) render this galaxy an ideal laboratory to constrain NSC formation. Methods: Using Multi Unit Spectroscopic Explorer science verification data assisted by adaptive optics, we obtained maps for the stellar kinematics and stellar-population properties of FCC 47. We extracted the spectra of the central NSC and determined line-of-sight velocities of 24 GCs and metallicities of five. Results: The galaxy shows the following kinematically decoupled components (KDCs): a disk and a NSC. Our orbit-based dynamical Schwarzschild model revealed that the NSC is a distinct kinematic feature and it constitutes the peak of metallicity and old ages in FCC 47. The main body consists of two counter-rotating populations and is dominated by a more metal-poor population. The GC system is bimodal with a dominant metal-poor population and the total GC system mass is \u30317% of the NSC mass (\u3037 7 10^8 M_sun). Conclusions: The rotation, high metallicity, and high mass of the NSC cannot be explained by GC-inspiral alone. It most likely requires additional, quickly quenched, in-situ formation. The presence of two KDCs likely are evidence of a major merger that has significantly altered the structure of FCC 47, indicating the important role of galaxy mergers in forming the complex kinematics in the galaxy-NSC system

Ivermectin, ‘Wonder drug’ from Japan: the human use perspective

Discovered in the late-1970s, the pioneering drug ivermectin, a dihydro derivative of avermectin—originating solely from a single microorganism isolated at the Kitasato Intitute, Tokyo, Japan from Japanese soil—has had an immeasurably beneficial impact in improving the lives and welfare of billions of people throughout the world. Originally introduced as a veterinary drug, it kills a wide range of internal and external parasites in commercial livestock and companion animals. It was quickly discovered to be ideal in combating two of the world’s most devastating and disfiguring diseases which have plagued the world’s poor throughout the tropics for centuries. It is now being used free-of-charge as the sole tool in campaigns to eliminate both diseases globally. It has also been used to successfully overcome several other human diseases and new uses for it are continually being found. This paper looks in depth at the events surrounding ivermectin’s passage from being a huge success in Animal Health into its widespread use in humans, a development which has led many to describe it as a “wonder” drug

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): study protocol for a randomized controlled trial

BACKGROUND: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). METHODS/DESIGN: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH2O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure 6430 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. DISCUSSION: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration metho

Gaia Data Release 2 Mapping the Milky Way disc kinematics

Context. The second Gaia data release (Gaia DR2) contains high-precision positions, parallaxes, and proper motions for 1.3 billion sources as well as line-of-sight velocities for 7.2 million stars brighter than G(RVS) = 12 mag. Both samples provide a full sky coverage. Aims. To illustrate the potential of Gaia DR2, we provide a first look at the kinematics of the Milky Way disc, within a radius of several kiloparsecs around the Sun. Methods. We benefit for the first time from a sample of 6.4 million F-G-K stars with full 6D phase-space coordinates, precise parallaxes (sigma((omega) over bar)/(omega) over bar Results. Gaia DR2 allows us to draw 3D maps of the Galactocentric median velocities and velocity dispersions with unprecedented accuracy, precision, and spatial resolution. The maps show the complexity and richness of the velocity field of the galactic disc. We observe streaming motions in all the components of the velocities as well as patterns in the velocity dispersions. For example, we confirm the previously reported negative and positive galactocentric radial velocity gradients in the inner and outer disc, respectively. Here, we see them as part of a non-axisymmetric kinematic oscillation, and we map its azimuthal and vertical behaviour. We also witness a new global arrangement of stars in the velocity plane of the solar neighbourhood and in distant regions in which stars are organised in thin substructures with the shape of circular arches that are oriented approximately along the horizontal direction in the U - V plane. Moreover, in distant regions, we see variations in the velocity substructures more clearly than ever before, in particular, variations in the velocity of the Hercules stream. Conclusions. Gaia DR2 provides the largest existing full 6D phase-space coordinates catalogue. It also vastly increases the number of available distances and transverse velocities with respect to Gaia DR1. Gaia DR2 offers a great wealth of information on the Milky Way and reveals clear non-axisymmetric kinematic signatures within the Galactic disc, for instance. It is now up to the astronomical community to explore its full potential.Peer reviewe

Many Labs 5:Testing pre-data collection peer review as an intervention to increase replicability

Replication studies in psychological science sometimes fail to reproduce prior findings. If these studies use methods that are unfaithful to the original study or ineffective in eliciting the phenomenon of interest, then a failure to replicate may be a failure of the protocol rather than a challenge to the original finding. Formal pre-data-collection peer review by experts may address shortcomings and increase replicability rates. We selected 10 replication studies from the Reproducibility Project: Psychology (RP:P; Open Science Collaboration, 2015) for which the original authors had expressed concerns about the replication designs before data collection; only one of these studies had yielded a statistically significant effect (p < .05). Commenters suggested that lack of adherence to expert review and low-powered tests were the reasons that most of these RP:P studies failed to replicate the original effects. We revised the replication protocols and received formal peer review prior to conducting new replication studies. We administered the RP:P and revised protocols in multiple laboratories (median number of laboratories per original study = 6.5, range = 3?9; median total sample = 1,279.5, range = 276?3,512) for high-powered tests of each original finding with both protocols. Overall, following the preregistered analysis plan, we found that the revised protocols produced effect sizes similar to those of the RP:P protocols (?r = .002 or .014, depending on analytic approach). The median effect size for the revised protocols (r = .05) was similar to that of the RP:P protocols (r = .04) and the original RP:P replications (r = .11), and smaller than that of the original studies (r = .37). Analysis of the cumulative evidence across the original studies and the corresponding three replication attempts provided very precise estimates of the 10 tested effects and indicated that their effect sizes (median r = .07, range = .00?.15) were 78% smaller, on average, than the original effect sizes (median r = .37, range = .19?.50)

Multirambles - BCN 6T

Strategie Urbane e Turismo in la citt\ue

Evaluaci\uf3n de la cobertura de toxoide tet\ue1nico en mujeres embarazadas y algunos factores condicionantes. Area de influencia del Ambulatorio Urbano tipo II "Dr. Rafael Pereira" Barrio Uni\uf3n. Octubre 1995. Barquisimeto

Con el objeto de evaluar la cobertura del Toxoide Tet\ue1nico en mujeres embarazadas y algunos factores que pueden influir en el cumplimiento de la misma se realiz\uf3 un estudio descrptivo transversal y explicativo no experimental en gestantes del \ue1rea de influencia del Ambulatorio Urbano Tipo II "Dr. Rafael Pereira" en Octubre de 1995. Se incluyeron un total de 210 gestantes; 77 primigestas entre su octavo y noveno mes de embarazo y 133 embarazadas con 2 o m\ue1s gestas. Los resultados arrojaron una cobertura total del 48,57%. As\ued tenemos que segun la edad la cobertura fue mayor en el grupo de 32 a\uf1os o m\ue1s con 55% y menor en el grupo de 12 a 21 a\uf1os con 46,5%. En relaci\uf3n al n\ufamero de gestas hubo mayor cobertura en embarazadas con m\ue1s de una gesta, con 56,32% y menor en las primigestas con 42,81%. De acuerdo al estrato social al cual pertenecen la mayor cobertura se apreci\uf3 en el grupo marginal con 50% y la menor en el grupo obrero con 47,66%. Seg\ufan el n\ufamero de embarazadas con control pre-natal adecuado, que represent\uf3 el 42,85% la cobertura fu\ue9 del 74,54%. En cuanto al grado de instrucci\uf3n de las gestantes el mayor porcentaje de cobertura lo present\uf3 el grupo analfabeta con 60%, seguido del universitario con 59,61% y la menor cobertura para el grupo de t\ue9cnico inferior o con secundaria incompleta con 39,75%. Al comparar el nivel de conocimiento sobre T\ue9tanos y Toxoide Tet\ue1nico con el nivel de cobertura encontramos que la misma fu\ue9 mayor en el grupo con el nivel de conocimiento BUENO con el 62,06% y menor en el grupo con nivel de conocimiento MALO con 42,25%. Los resultados obtenidos se consideran muestras no representativas, a excepci\uf3n de los relacionados con cobertura y control pre-natal

Manual de Normas y Procedimientos Administrativos de la Asociaci\uf3n Cardiovascular Centroccidental (ASCARDIO)

Para las Instituciones cada d\ueda se hace mas necesario contar con Manuales de Procedimientos Administrativos que les permita instrumentar controles y que sean mas efectivas las funciones de supervisi\uf3n y evaluaci\uf3n de los procesos operativos que cumplen, lo antes expuesto justifica el objetivo de \ue9sta investigaci\uf3n que pretende el Dise\uf1o del Manual de Normas y Procedimientos Administrativos para la Asociaci\uf3n Cardiovascular Ascardio, despu\ue9s de haber revisado investigaciones referidas al tema as\ued como consultar bibliograf\ueda sobre el \ue1rea de estudio, se aplicaron entrevistas y encuestas al personal seleccionado como muestra en la instituci\uf3n Ascardio, recolectada la informaci\uf3n \ue9sta fue analizada y sistematizada para obtener conclusiones y recomendaciones lo que finalmente llevo al logro del objetivo como fue el Dise\uf1o de los Procedimientos Administrativos para las Compras, Cuentas por Pagar y Cuentas por Cobrar de la organizaci\uf3n objeto de esta investigaci\uf3n