During the journey through Portugal by Hoffmannsegg and Link (1797–1801), these authors collected an appreciable number of specimens, most of which have been lost. Their collections are relevant ...since they were used by themselves or by other authors to describe numerous species. In the herbarium of the Real Jardín Botánico of Madrid, 70 specimens from this journey have been located. In the archive of this institution the letters that Hoffmannsegg and Link sent to Cavanilles accompanying these plants have also been located. The analysis of these letters, the herbarium labels and of the protologues has permitted to establish that 15 specimens are original material, four of which had already been proposed as lectotypes by other authors (Airochloa caudata Link, Silene fuscata Link ex Brot., Silene micrantha Link ex Otth and Silene pernoctans Link). The designation of a neotype for Stipa gigantea Link should be superseded, because an original material has been found. Thus, a lectotype for this taxon is proposed.
Two-drug regimens (2DRs) are emerging in clinical practice guidelines as treatment option for both naive and treatment-experienced people living with HIV (PLHIV).
To determine the real-life ...effectiveness of 2DR with 25 mg RPV plus 50 mg DTG in a single-tablet regimen (RPV/DTG
) and its impact on viral and immune status, lipid profile, and inflammatory markers.
This observational study included 291 treatment-experienced PLHIV, starting 2DR with RPV/DTG
between 29 January 2019 and 2 February 2022, who were followed up for at least six months. Participants gave verbal informed consent for the switch in antiretroviral therapy (ART) to RPV/DTG
.
The mean age of the 291 participants was 51.3 years; 77.7% were male; and 42.9% were in the AIDS stage with a CD4 nadir of 283.5 ± 204.6 cells/uL. The median time since HIV diagnosis was 19.7 years (IQR: 10.6-27). Before 2DR, patients received a median of five ART lines (IQR: 3-7) for 22.2 years (IQR: 14-26), with 34.4% (
= 100) receiving a three-drug regimen (3DR), 31.3% (
= 91) receiving monotherapy, and 34.4% (
= 100) receiving 2DR. The median time on RPV/DTG
was 14 months (IQR: 9.5-21); 1.4% were lost to the follow-up. Effectiveness was 96.2% by intention-to-treat (ITT) analysis, 97.5% by modified ITT, and 99.3% by per-protocol analysis. Virological failure was observed in 0.69%, blips in 3.5%, and switch to another ART in 1.4%. The mean lipid profile improved, with reductions in TC/HDLc ratio (3.9 ± 0.9 vs. 3.6 ± 0.9;
= 0.0001), LDLc (118.3 ± 32.2 mg/dL vs. 106.2 ± 29.8 mg/dL,
= 0.0001), TG (130.9 ± 73.9 mg/dL vs. 115.9 ± 68.5 mg/dL,
= 0.0001), and CD4/CD8 ratio increase (0.99 ± 0.58 vs. 1.01 ± 0.54;
= 0.0001). The cost-effectiveness of 2DR with RPV/DTG
was similar to that of DTG/3TC and superior to those of BIC/TAF/FTC and DRV/c/TAF/FTC, with higher virological suppression and lower annual costs.
The switch to RPV plus DTG in STR is a cost-effective, long-lasting, and robust strategy for PLHIV, with a very long experience of treatment, which improves the lipid profile without affecting inflammatory markers.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Virologic characterization of newly HIV-diagnosed adolescents could help to improve their specific needs. The objective was to describe the transmitted drug resistance mutations (TDR) and its ...transmission by clusters in this population in Spain.
TDR to retrotranscriptase and protease inhibitors included in the WHO TDR list 2009 implemented in the Calibrated Population Resistance tool v8.0 (Stanford) were studied in HIV pol sequences from all HIV-diagnosed adolescents (12-19-year-old) enrolled during 2004-2019 period in the Spanish pediatric and adult (CoRISpe-CoRIS) cohorts. The found TDR were compared with the provided by the Stanford algorithm v9.0 2021. HIV-1 variants and transmission clusters were also studied.
Among 410 HIV-1 adolescents diagnosed, 141 (34.4%) had available ART-naive sequences. They were mostly male (81.6%), Spanish (55.3%) and with behavioral risk (92.2%), mainly male-to-male sexual contact (63.1%). TDR prevalence was significantly higher by Stanford versus WHO list (18.4% vs. 7.1%; P = 0.004). The most prevalent TDR by the WHO list was K103N (3.6%) and by Stanford E138A (6.6%), both at retrotranscriptase. E138A, related to rilpivirine/etravirine resistance, was absent in the WHO list. One in 4 adolescents carried HIV-1 non-B variants. We described 5 transmission clusters, and 2 carried TDR mutations.
Our data suggest a high TDR prevalence in adolescents with a new HIV diagnosis in Spain, similar to adults, 2 active TDR transmission clusters, and the need for the WHO TDR list update. These findings could have implications for the options of the recently available rilpivirine-related long-acting treatment and in first-line regimen election.
Summary
Introduction
Candida species are the leading cause of invasive fungal infections in hospitalised patients and are the fourth most common isolates recovered from patients with bloodstream ...infection. Few data exist on risk factors for candidemia in non‐ICU patients. We performed a population‐based case‐control study to evaluate the main predictors for candidemia in non‐ICU patients.
Methods and findings
We included all non‐neutropenic, non‐critically ill and non‐surgical adult patients with candidemia between January 2010 and June 2014. Patients with positive, non‐candidal blood culture obtained at the same day (±2 days) were selected as controls. Cases and controls were matched according to hospital ward and clinical characteristics. Risk factors for candidemia were identified through a logistic regression. We included 56 candidemic and 512 bacteriemic non‐candidemic patients. Most of candidemic patients (52) had received antibiotics prior to candidemia. Among them, the 30‐day mortality rate was 34% (19/56). Multivariate analysis identified male sex, prior use of steroids, prior use of antibiotics, total parenteral nutrition and urinary catheterisation as independent predictors of candidemia. To develop the CaMed score, we rounded up weights of different risk factors as follows; total parenteral nutrition (+2), prior antibiotic therapy (+5), each of the other risk factors (+1). A score ≥ 7 identified patients at high risk of candidemia (P < 0.001; RR 29.805; CI 95% 10.652‐83.397; sensitivity 79.2, specificity 82.6%, Youden index 0,62).
Conclusions
Our set of easy independent predictors of candidemia in non‐neutropenic, non‐ICU, non‐surgical patients provide a rationale for early initiation of antifungals and could reduce candidemia‐related mortality.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Mycobacterium caprae, a member of the Mycobacterium tuberculosis complex, causes tuberculosis in humans and animals, but the incidence in humans is very low worldwide. Direct contact with animals and ...with unpasteurized dairy products is the most frequent source of contagion. Cutaneous tuberculosis supposes a diagnostic challenge due to its variety of clinical manifestations and the difficulty in demonstrating resistant acid‐alcohol bacilli in histological samples. In cases of high suspicion, the initiation of antituberculosis treatment should be considered empirically. Combined therapeutic regimens are necessary to prevent long‐term resistance and complications, although the duration of treatment has not been fully established.
Full text
Available for:
BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
BACKGROUNDPersistent controllers (PCs) maintain antiretroviral-free HIV-1 control indefinitely over time, while transient controllers (TCs) eventually lose virological control. It is essential to ...characterize the quality of the HIV reservoir in terms of these phenotypes in order to identify the factors that lead to HIV progression and to open new avenues toward an HIV cure.METHODSThe characterization of HIV-1 reservoir from peripheral blood mononuclear cells was performed using next-generation sequencing techniques, such as full-length individual and matched integration site proviral sequencing (FLIP-Seq; MIP-Seq).RESULTSPCs and TCs, before losing virological control, presented significantly lower total, intact, and defective proviruses compared with those of participants on antiretroviral therapy (ART). No differences were found in total and defective proviruses between PCs and TCs. However, intact provirus levels were lower in PCs compared with TCs; indeed the intact/defective HIV-DNA ratio was significantly higher in TCs. Clonally expanded intact proviruses were found only in PCs and located in centromeric satellite DNA or zinc-finger genes, both associated with heterochromatin features. In contrast, sampled intact proviruses were located in permissive genic euchromatic positions in TCs.CONCLUSIONSThese results suggest the need for, and can give guidance to, the design of future research to identify a distinct proviral landscape that may be associated with the persistent control of HIV-1 without ART.FUNDINGInstituto de Salud Carlos III (FI17/00186, FI19/00083, MV20/00057, PI18/01532, PI19/01127 and PI22/01796), Gilead Fellowships (GLD22/00147). NIH grants AI155171, AI116228, AI078799, HL134539, DA047034, MH134823, amfAR ARCHE and the Bill and Melinda Gates Foundation.
This study provides a systematic literature review of research in the field of teaching and learning mathematics through Content and Language Integrated Learning (CLIL), Content-Based Instruction ...(CBI), and English Medium Instruction (EMI). The review aims to examine the most relevant literature with a focus on mathematics and CLIL, CBI, or EMI in Scopus and Web of Science per the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Based on 151 sources, 52 papers were selected according to predefined selection criteria. The papers were analysed and coded according to the following categories: (1) geographical productivity, (2) diachronic productivity growth, (3) main objectives, (4) methodology, and research design, (5) variables and measurement instruments, (6) context and sample details, and (7) main findings. The results reveal that most of the research analysed has been carried out in the Asian continent, followed by Europe. The analysis of diachronic productivity shows that the study of the application of CLIL, CBI, and EMI programs in the teaching-learning process of mathematics has notably increased in recent years, especially in the last triennium (2020–2022). Regarding the objectives of the selected corpus, the majority aimed at teaching practices and learning processes, and outcomes in mathematics and language proficiency in CLIL, CBI, and/or EMI classrooms. The corpus analysed fits within one or more of the following categories: empirical, qualitative, descriptive, correlational, and cross-sectional. The samples utilized in different studies differ significantly, both in terms of quantity –ranging from one person to 700– and in the educational level being studied, which would be primary, secondary, or tertiary education. The main variables studied in the corpus focus on mathematical competence, language proficiency, teaching practices, teacher training, science competence, and teachers’ perceptions. The most widely used instruments have been objective tests, such as questionnaires, together with standardized tests to measure some aspects related to mathematical competence and language proficiency. They are followed by an analysis of documents (academic records, teaching materials, official documents...), participant or non-participant observation, interviews, and video and audio recordings. In summary, in the scientific literature analysed, a positive or neutral view predominates on the effects of the CLIL, CBI, and EMI approaches on the learning of mathematics and the L2. This can be due to methodological issues fundamentally related to the methodology, research design, sample, and measurement instruments. Thus, we must highlight that some of the results from the selected papers must be interpreted with caution. Taking this factor into consideration, further comparative studies on a wider scale are required to examine thoroughly the effects of CLIL, CBI, and EMI on the teaching and learning of mathematics in an L2. Besides, it is important to study in greater depth the different levels of language acquisition since the research analysed shows that these have not been sufficiently addressed in the mathematical field of knowledge.
PDF
