Initiation of rilpivirine, tenofovir and emtricitabine (RPV/TDF/FTC) regimen in 363 patients with virological vigilance assessment in 'real life'.

OBJECTIVES: To study the single-tablet regimen (STR) combination rilpivirine/tenofovir/emtricitabine (RPV/TDF/FTC) as soon as it became available. We describe a 14 month follow-up in a real clinical setting with a focus on resistance to RPV/TDF/FTC and polymorphisms associated with these drugs. METHODS: We estimated drug resistance at STR baseline by combining all available resistance tests, resulting in a cumulative virtual genotype. Physicians were advised of current or archived resistance mutations for the three drugs. Virological response was analysed according to resistance genotype at baseline. RESULTS: Three hundred and sixty-three patients received RPV/TDF/FTC; 79% had received previous treatment and RPV/TDF/FTC was the result of a switch of one drug to rilpivirine in two-thirds of cases. The cumulative genotype showed 4% of rilpivirine resistance mutations at baseline and 16% of polymorphisms concerning non-nucleoside reverse transcriptase inhibitors (NNRTIs). With a median duration of STR of 8 months, 78% of patients with these polymorphisms were virologically suppressed compared with 96% with wild-type genotypes. Five genotypes were determined during the follow-up, revealing three rilpivirine resistance-associated mutations: E138Q/Y181I, M230L and K101P (potentially with a K101Q intermediate). CONCLUSIONS: This observational study reflects routine clinical practice and the relevance of virological advice. It also confirms the efficacy of this STR (RPV/TDF/FTC) for naive and virologically suppressed pretreated patients with a low prevalence of virological failure and resistance if the cumulative baseline genotype is free of resistance to NNRTIs and/or polymorphisms associated with NNRTIs.

Assessing number and quality of urology open access journals: 2011 to 2018.

BACKGROUND/AIMS: There is clear evidence that publishing research in an open access (OA) journal or as an OA model is associated with higher impact, in terms of number of reads and citation rates. The development of OA journals and their quality are poorly studied in the field of urology. In this study, we aim to assess the number of OA journals, their quality in terms of CiteScore, percent cited and quartiles, and their scholarly production during the period from 2011 to 2018. METHODS: We obtained data about journals from www.scopus.com, and we filtered the list for urology journals. We obtained data for all Scopus indexed journals during the period from 2011 to 2018. For each journal, we extracted the following indices: CiteScore, Citations, scholarly output, and SCImago quartiles. We analyzed the difference in quality indices between OA and non-OA urology journals. RESULTS: Urology journals have increased from 66 journals in 2011 to 99 journals in 2018. The number of OA urology journals has increased from only 10 (15.2%) journals in 2011 to 33 (33.3%) journals in 2018. The number of quartile 1 (the top 25%) journals has increased from only 1 journal in 2011 to 5 journals in 2018. Non-OA urology journals had significantly higher CiteScore compared with OA journals till the year 2015, after which the mean difference in CiteScore became smaller with insignificant p-value. CONCLUSION: Number and quality of OA journals in the field of urology have increased throughout the last few years. Despite this increase, non-OA urology journals still have higher quality and output.

Pyogenic lung abscess in an infectious disease unit: a 20-year retrospective study.

BACKGROUND: Pyogenic lung abscesses are rare and poorly described infections. This study aimed to describe their prognostic factors. METHODS: We retrospectively included all patients hospitalized between 1 January 1998 and 1 June 2018, with an International Classification of Diseases, version 10 (IDC-10) diagnosis of pyogenic lung abscess, from the Diamm based medical records (Micro6, Nancy, France). Parasitic, fungal, or mycobacterial lung abscesses were excluded. RESULTS: A total of 64 patients were included. Abscesses were associated with immunosuppression in 28 patients, including HIV infection and immunosuppressive therapy for eight and 12 patients, respectively. Bacterial identification was obtained for 36 patients. Nine patients (14%) developed lung abscesses after hematogenous dissemination. They differed from bronchogenic abscesses by their younger age (p = 0.03), the absence of smoking or emphysema (p = 0.05), Staphylococcus aureus (p = 0.001) or Streptococcus spp. (p = 0.05) isolation, and the smaller size of their abscess (p = 0.02). Overall, evolution was marked by radiological sequelae (46.9%), relapse (12.5%), and death (4.8%). Radiological sequelae occurred more frequently during the course of bronchogenic abscesses (p = 0.02), particularly when they spontaneously discharged (p = 0.04). Relapses were more frequent in patients with emphysema (p = 0.04) and when Haemophilus influenzae was isolated (p = 0.04). In multivariate analysis, poor outcomes, including death, sequelae, and relapse occurred more frequently in patients who had bronchogenic abscess (p = 0.02), and in those who received antibiotics during less than 6 weeks (p = 0.05). CONCLUSION: A duration of antibiotic treatment of less than 6 weeks and bronchogenic presentation were globally associated with poor outcome of pyogenic lung abscesses. These data should be considered when proposing guidelines for the care of pyogenic lung abscesses.The reviews of this paper are available via the supplemental material section.

Long-term AIDS-related PCNSL outcomes with HD-MTX and combined antiretroviral therapy.

OBJECTIVE: To assess the characteristics and outcomes of patients with AIDS-related primary CNS lymphoma (AR-PCNSL) in the combined antiretroviral therapy (cART) era systematically treated with high-dose methotrexate (HD-MTX). METHODS: We retrospectively analyzed (intention-to-treat analysis) 51 consecutive patients with AR-PCNSL (median age 39 years) who were diagnosed from 1996 to 2014 and treated with a median of 6 (range 1-15) infusions of HD-MTX (3 g/m2) combined with cART. RESULTS: Median all-patients' and survivors' follow-up lasted 23 (range 0-186) and 76 (range 23-186) months, respectively. At PCNSL diagnosis, 83% of the patients were on cART, median plasma HIV load was 175,600 copies/mL, and median CD4+ T-cell count was 24/µL. Median Eastern Cooperative Oncology Group performance status was 2 (range 1-4). Median overall survival (OS) was 5.7 years, with 5- and 10-year rates of 48% and 41%. Median time to progression was not reached (69% at 10 months). PCNSL was the direct cause of 14 deaths, all observed within the 10 months after its diagnosis: 6 patients died before HD-MTX could be administered, 4 had refractory disease, and 4 relapsed. Multivariate analyses retained time interval between AIDS diagnosis and PCNSL diagnosis, age at AR-PCNSL diagnosis, and deep brain structure involvement as independent OS-predictive factors. To restore effective immune function, cART tailored to HIV genotypes was started and combined with HD-MTX; no interactions and no immune reconstitution inflammatory syndrome occurred. No patient died of acute treatment-related toxicity, and 21 of 51 (41%) patients experienced grade 3/4 toxicity. CONCLUSIONS: Combined short-term HD-MTX monochemotherapy and optimal cART simply and effectively treat AR-PCNSL, achieving long-term survival with few relapses. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that short-term HD-MTX monochemotherapy improves long-term survival of patients with AIDS with primary CNS lymphoma receiving cARTs.

DFT and TD-DFT calculation of new thienopyrazine-based small molecules for organic solar cells.

BACKGROUND: Novel six organic donor-π-acceptor molecules (D-π-A) used for Bulk Heterojunction organic solar cells (BHJ), based on thienopyrazine were studied by density functional theory (DFT) and time-dependent DFT (TD-DFT) approaches, to shed light on how the π-conjugation order influence the performance of the solar cells. The electron acceptor group was 2-cyanoacrylic for all compounds, whereas the electron donor unit was varied and the influence was investigated. METHODS: The TD-DFT method, combined with a hybrid exchange-correlation functional using the Coulomb-attenuating method (CAM-B3LYP) in conjunction with a polarizable continuum model of salvation (PCM) together with a 6-31G(d,p) basis set, was used to predict the excitation energies, the absorption and the emission spectra of all molecules. RESULTS: The trend of the calculated HOMO-LUMO gaps nicely compares with the spectral data. In addition, the estimated values of the open-circuit photovoltage (Voc) for these compounds were presented in two cases/PC60BM and/PC71BM. CONCLUSION: The study of structural, electronics and optical properties for these compounds could help to design more efficient functional photovoltaic organic materials.

Theoretical investigation of new thiazolothiazole-based D-π-A organic dyes for efficient dye-sensitized solar cell.

Novel ten organic donor-π-acceptor dyes (D-π-A), used for dye-sensitized solar cells (DSSCs), based on thiazolothiazole were studied by density functional theory (DFT) and time dependant DFT (TDDFT) approaches to shed light on how the π-conjugation order influence the performance of the dyes. The electron acceptor (anchoring) group was 2-cyanoacrylic for all dyes whereas the electron-donor unit varied and the influence was investigated. The theoretical results have shown that TDDFT calculations using the Coulomb attenuating method CAM-B3LYP with the polarized split-valence 6-31G (d,p) basis sets and the polarizable continuum model (PCM) were reasonably capable of predicting the excitation energies, the absorption and the emission spectra of the molecules. The LUMO and HOMO energy levels of these dyes can ensure a positive effect on the process of electron injection and dye regeneration. The trend of the calculated HOMO-LUMO gaps nicely compares with the spectral data. Key parameters in close connection with the short-circuit current density (Jsc), including light-harvesting efficiency (LHE), injection driving force (ΔG(inject)) and total reorganization energy (λtotal), were discussed. In addition, the estimated values of open-circuit photovoltage (Voc) for these dyes were presented. The calculated results of these dyes reveal that the D6 dye can be used as a potential sensitizer for TiO2 nanocrystalline solar cells due to its best electronic and optical properties and good photovoltaic parameters.

Theoretical design of thiazolothiazole-based organic dyes with different electron donors for dye-sensitized solar cells.

In this study, we have designed four novel organic donor-π-acceptor dyes (D1, D2, D3, D4), used for dye sensitized solar cells (DSSCs). The electron acceptor (anchoring) group was 2-cyanoacrylic for all dyes whereas the electron donor unit varied (coumarin, indoline, carbazole, triphenylamine) and the influence was investigated. These dyes, based on thiazolothiazole as π-spacer, were studied by density functional theory (DFT) and its extensible time dependant DFT (TDDFT) approaches to shed light on how the π-conjugation order influence the performance of the dyes in the DSSCs. The theoretical results have shown that the LUMO and HOMO energy levels of these dyes can be ensuring positive effect on the process of electron injection and dye regeneration. The trend of the calculated HOMO-LUMO gaps nicely compares with the spectral data. Key parameters in close connection with the short-circuit current density (Jsc), including light harvesting efficiency (LHE), injection driving force (ΔGinject.) and total reorganization energy (λtotal), were discussed. The calculated results of these dyes reveal that dye D2, with indoline as electron donor group, can be used as a potential sensitizer for TiO2 nanocrystalline solar cells due to its best electronic and optical properties and good photovoltaic parameters.

Structure-olfactive threshold relationships for pyrazine derivatives.

Structure-olfactive threshold relationships for 40 pyrazine derivatives have been studied by multivariate statistical analysis. Variable descriptors used to describe the molecules studied were obtained using molecular-mechanics software. A correlation coefficient of 0.82 was obtained when all the molecules were included in the model. When the model was established for closely related subsets of molecules, the correlation coefficients obtained were higher and the established models were bilinear. Such models allow the identification of optimal structures corresponding to low olfactive thresholds for the subsets studied. Surprisingly, we find that the optimum structures are included in the set of 40 molecules. The efficiency of the models was supported by the cross-validation technique, where the correlation coefficients were found to be good with respect to the precision of the values of the olfactive thresholds.