Bictegravir/Emtricitabine/Tenofovir Alafenamide in a Multicentre Cohort: Real-Life Experience From Spain.

BACKGROUND: The evaluation of bictegravir, emtricitabine, and tenofovir alafenamide (BIC/FTC/TAF) in clinical trials has shown high rates of virological suppression but information about its use in real-life settings is scarce. OBJECTIVE: To evaluate the effectiveness, safety, durability, and predictive variables of therapeutic failure of BIC/FTC/TAF in a real-life cohort. METHODS: This observational, retrospective, multicentered cohort study included treatment-naive (TN) and treatment-experienced (TE) adult patients living with HIV (PLWH) who started treatment with BIC/FTC/TAF from January 1, 2019, to January 31, 2022. Treatment effectiveness (based on intention-to-treat [ITT], modified ITT [mITT], and on-treatment [OT]), tolerability, and safety were evaluated in all patients who started BIC/FTC/TAF antiretroviral therapy. RESULTS: We included a total of 505 PLWH of whom 79 (16.6%) were TN and 426 (83.4%) were TE. Patients were followed up for a median (interquartile range [IQR]) of 19.6 (9.6-27.3) months, and 76% and 56% of PLWH reached month 6 and month 12 of treatment, respectively. Rates of TN PLWH with HIV-RNA <50 copies/mL in the OT, mITT, and ITT groups were 94%, 80%, and 62%, respectively, after 12 months of BIC/FTC/TAF treatment. Rates of TE PLWH with HIV-RNA <50 copies/mL were 91%, 88%, and 75% at month 12. The multivariate analysis revealed that neither age, sex, CD4 cell count <200 cells/µL, or viral load >100 000 copies/mL were associated with therapeutic failure. CONCLUSION AND RELEVANCE: Our real-life data showed that BIC/FTC/TAF is effective and safe for use in the treatment of both TN and TE patients in clinical practice.

The efficacy of nonpharmacological treatment for dementia-related apathy.

OBJECTIVE: To determine the usefulness of a formal, structured, nonpharmacological treatment for apathetic dementia patients. PATIENTS AND METHODS: A controlled, cross-over, randomized, simple-blind, multicentre clinical trial. A total of 146 institutionalized or day care dementia patients with a stage 1 or 2 Clinical Dementia Rating, with no significant motor or sensory problems, or with rapidly evolving dementia and in a clinically stable state were recruited. A cognitive mini examination, and functional, depression, and potential toxicity scales, Neuropsychiatric Inventory Questionnaire (NPI-Q), and Dementia Apathy Interview and Rating (DAIR) scales were applied at baseline. Patients were randomized to initial intervention (music and art therapy and psychomotor activity) or initial control (free activities in the day room) and changed over at 4 weeks. NPI-Q and DAIR scales were administered at the end of weeks 4 and 8. RESULTS: A significant difference between intervention and control periods, as measured using the DAIR scale, was observed, with a difference of 0.21 (95% confidence interval: 0.07-0.34, P<0.005). The difference was very important in the patients with moderated apathy. However, differences were not so important in the patients with severe apathy and there were no differences at all in the non-apathetic patients. No significant differences were found with the NPI-Q scale, although there was a clear improvement trend in the "apathy" question on this scale. This effect seems to extend beyond the therapeutic intervention period. CONCLUSIONS: A structured, nonpharmacological, short-term occupational therapy intervention is more useful than activities of the patients' own choice for improving apathy in patients with mild or moderate dementia.

Citizen science for predicting spatio-temporal patterns in seabird abundance during migration.

Pelagic seabirds are elusive species which are difficult to observe, thus determining their spatial distribution during the migration period is a difficult task. Here we undertook the first long-term study on the distribution of migrating shearwaters from data gathered within the framework of citizen science projects. Specifically, we collected daily abundance (only abundance given presence) of Balearic shearwaters from 2005 to 2017 from the online databases Trektellen and eBird. We applied machine-learning techniques, specifically Random Forest regression models, to predict shearwater abundance during migration using 15 environmental predictors. We built separated models for pre-breeding and post-breeding migration. When evaluated for the total data sample, the models explained more than 52% of the variation in shearwater abundance. The models also showed good ability to predict shearwater distributions for both migration periods (correlation between observed and predicted abundance was about 70%). However, relative variable importance and variation among the models built with different training data subsamples differed between migration periods. Our results showed that data gathered in citizen science initiatives together with recently available high-resolution satellite imagery, can be successfully applied to describe the migratory spatio-temporal patterns of seabird species accurately. We show that a predictive modelling approach may offer a powerful and cost-effective tool for the long-term monitoring of the migratory patterns in sensitive marine species, as well as to identify at sea areas relevant for their protection. Modelling approaches can also be essential tools to detect the impacts of climate and other global changes in this and other species within the range of the training data.

The effect of ischemic preconditioning on secondary ischemia in myocutaneous flaps.

We sought to determine the effect of ischemic preconditioning (IPC) on secondary ischemia in myocutaneous flaps in a rat model. Forty rectus abdominis myocutaneous flaps were elevated in 40 rats, and the animals were randomized into control or IPC groups (20 flaps each group). All flaps were then subject to primary ischemia for 2 hours via pedicle clamping. Twenty-four hours later, the control and IPC flaps were randomized to two groups each of 1 or 2 hours of secondary ischemia (4 groups, 10 flaps per group). Flap survival was evaluated on postoperative day 5 by measuring the percentage area of flap survival by a blinded observer. Mean flap survival area and total necrosis rates were compared between the groups. In the 1-hour secondary ischemia groups, IPC improved mean flap survival area from 11 +/- 7% to 36 +/- 22%, and the total necrosis rates from 40 to 0%. These differences were statistically significant (p < 0.006, p < 0.05, respectively). In the 2-hour secondary ischemia groups, differences were not statistically significant (p = 0.2, p = 0.4, respectively). IPC improves the survival of myocutaneous flaps subjected to secondary ischemia of 1 hour in this rat free flap model.

Células madre en odontología: nuevas perspectivas / Stem cells in dentistry: new perspectives

En el campo de la odontología, prevalecen actualmente alternativas terapéuticas con una filosofía conservadora. Sin embargo, con el advenimiento de los tratamientos con células madre (CM), se amplían las posibilidades terapéuticas, que buscan la combinación y el equilibrio entre la intervención tradicional y las posibilidades de reposición de estructuras anatómicas dañadas, a través de la regeneración de tejidos utilizando células madre o sus derivados (AU)

In the dentistry field, therapeutic alternatives with a conservative philosophy currently prevail. However, with the advent of stem cell (SC) treatments, therapeutic possibilities are expanding, seeking a combination and balance between traditional intervention and the pos- sibility of replacing damaged anatomical structures through tissue regeneration, using stem cells or their derivatives (AU)

Epidemiology of bovine brucellosis in Costa Rica: Lessons learned from failures in the control of the disease.

Brucellosis, caused by Brucella abortus is a major disease of cattle and a zoonosis. In order to estimate the bovine brucellosis prevalence in Costa Rica (CR), a total 765 herds (13078 bovines) from six regions of CR were randomly sampled during 2012-2013. A non-random sample of 7907 herds (532199 bovines) of the six regions, arriving for diagnoses during 2014-2016 to the Costa Rican Animal Health Service was also studied. The prevalence estimated by Rose Bengal test (RBT) ranged from 10.5%-11.4%; alternatively, the prevalence estimated by testing the RBT positives in iELISA, ranged from 4.1%-6.0%, respectively. However, cattle in CR are not vaccinated with B. abortus S19 but with RB51 (vaccination coverage close to 11%), and under these conditions the RBT displays 99% specificity and 99% sensitivity. Therefore, the RBT herd depicted in the random analysis stands as a feasible assessment and then, the recommended value in case of planning an eradication program in CR. Studies of three decades reveled that bovine brucellosis prevalence has increased in CR. B. abortus was identified by biochemical and molecular studies as the etiological agent of bovine brucellosis. Multiple locus variable-number tandem repeat analysis-16 revealed four B. abortus clusters. Cluster one and three are intertwined with isolates from other countries, while clusters two and four have only representatives from CR. Cluster one is widely distributed in all regions of the country and may be the primary B. abortus source. The other clusters seem to be restricted to specific areas in CR. The implications of our findings, in relation to the control of the disease in CR, are critically discussed.

Acute oral administration of low doses of methylphenidate targets calretinin neurons in the rat septal area.

Methylphenidate (MPD) is a commonly administered drug to treat children suffering from attention deficit hyperactivity disorder (ADHD). Alterations in septal driven hippocampal theta rhythm may underlie attention deficits observed in these patients. Amongst others, the septo-hippocampal connections have long been acknowledged to be important in preserving hippocampal function. Thus, we wanted to ascertain if MPD administration, which improves attention in patients, could affect septal areas connecting with hippocampus. We used low and orally administered MPD doses (1.3, 2.7 and 5 mg/Kg) to rats what mimics the dosage range in humans. In our model, we observed no effect when using 1.3 mg/Kg MPD; whereas 2.7 and 5 mg/Kg induced a significant increase in c-fos expression specifically in the medial septum (MS), an area intimately connected to the hippocampus. We analyzed dopaminergic areas such as nucleus accumbens and striatum, and found that only 5 mg/Kg induced c-fos levels increase. In these areas tyrosine hydroxylase correlated well with c-fos staining, whereas in the MS the sparse tyrosine hydroxylase fibers did not overlap with c-fos positive neurons. Double immunofluorescence of c-fos with neuronal markers in the septal area revealed that co-localization with choline acethyl transferase, parvalbumin, and calbindin with c-fos did not change with MPD treatment; whereas, calretinin and c-fos double labeled neurons increased after MPD administration. Altogether, these results suggest that low and acute doses of methylphenidate primary target specific populations of caltretinin medial septal neurons.

[Relationship between insight, violence and diagnoses in psychotic patients]. / Relación entre insight, violencia y diagnóstico en pacientes con psicosis.

INTRODUCTION: Lack of insight is a common clinical problem in psichiatric patients, but few times has been properly studied until recently. Patients with good insight tend to show a better treatment adherence with a better prognosis and swow less hostility. This study aims to investigate whether there is a relationship between the hostility degree and insight or not and to anlalyze if there are insight quantitative differences between the patients regarding their diagnoses. METHOD: 168 psychotic patients were studied (including 86 patients with schizophrenia and 43 with bipolar disorder). PANNS P7 (hostility) item and G14 (poor impulse control) were analized in order to assess patients' violence and G12 in order to assess insight. All these data was correlated. It was also analyzed the PANSS results of schizophrenic vs bipolar patients regarding insight and hostility separately looking for a more homogenic pull of patients. RESULTS: Patients with greater hostility showed a worse impulse control and poorer insight than the rest. Schizophrenic patients showed a greater hostility and lower insight than bipolar patients. DISCUSSION: Lack of insight may lead to a greater hostility and worse impulse control. Therapeutic interventions adressed to improve insight could indirectly lower hostility and gain a better impulse control for psychotic patients.

Efecto de la incorporacion de aditivos sobre el envejecimiento de geles de almidon de maiz y arepas / Effect of the incorporation of additives on the aging of corns starch gels and arepas

Se investigó el efecto de la incorporación de diferentes aditivos sobre el envejecimiento de los almidones de maíz y arepas. Los almidones fueron extraídos a partir de endospermo degerminado de maíz, aplicando un proceso de molienda húmeda, y su retrogradación, con o sin incorporación de aditivos, evaluada utilizando el amilógrato de Brabender, y mediante la medida de cambios en la viscosidad de los geles de almitivos que resultaron ser más efectivos en retardar la velocidad de envejecimiento de los geles se usaron en las arepas. Asimismo, para encontrar los niveles de incorporación en las mismas, se utilzó un páinel de catadores con el fin de establecer la concentración umbral para cada uno de los aditivos. Los cambios en la textura de las arepas - mantenidas a dos temperaturas de almacenaje, 9§ y 23§C - fueron evaluados utilizando un texturómetro Instron. Las pruebas preliminares con el almidón de maíz permitieron seleccionar los siguientes aditivos: monoglicéridos destilados, goma guar y aceite vegetal hidrogenado. Se estudió el efecto de 15 combinaciones diferentes de estos aditivos sobre la textura