We consider the Newtonian four-body problem in the plane with a dominat mass
M
. We study the planar central configurations of this problem when the remaining masses are infinitesimal. We obtain two ...different classes of central configurations depending on the mutual distances between the infinitesimal masses. Both classes exhibit symmetric and non-symmetric configurations. And when two infinitesimal masses are equal, with the help of extended precision arithmetics, we provide evidence that the number of central configurations varies from five to seven.
Introduction
No controlled clinical trials had studied the role of maraviroc (MRV) in fully suppressed patients 1.
Materials and Methods
MRV‐cohort is an observational, retrospective, multicentric ...(27 sites) large cohort study of patients starting MRV in clinical practice under different circumstances, with at least 48 weeks of follow‐up. For the present analysis we selected all those patients starting with an HIV‐RNA<50 copies/mL. Demographics, baseline CD4 cell count, past history of antiretroviral treatment (ART), tropism, reasons for MRV use, MRV based therapy and change/end of MRV use were assessed. Paired analysis of lipid, hepatic and kidney profile changes and univariate and multivariate analyses of HIV‐RNA<50 copies/mL at 48 weeks were explored.
Results
We included 247 out of 667 subjects from the entire cohort. At study entry, their median age was 47 years, 23% were women, 31% MSM, 49% had CDC category C, median CD4+ counts were 468 cells/mm3, 46% were HCV+ and 4.5% AgHBs+. Tropism information was available in 197 (94% R5). Median length of prior ARTV was 10.7 years, with exposure to a median of three drug families. Main reasons for prescribing MRV were: toxicity 38%, inmunodiscordance 23%, simplification 19% and admission in a clinical trial 10.4%. MRV based therapies used were MRV+2NRTIs 9%, MRV+PI 46%, MRV+PI+other 40% and MRV+other 5%. At 48 weeks, 23% of patients had changed or finished MRV therapy due to toxicity 2.4%, virological failure 2%, immunological failure 1.2%, simplification 3,2%, trial requirement 9.7%, medical decision 2.8%, treatment suspension 1.2% and unknown 0.4%. At 48 weeks, no significant changes were observed in lipid, hepatic or kidney profiles, and 85% of patients remained with HIV‐RNA<50 copies/mL. Focusing on viral response univariate and multivariate models did not show any significant baseline variable explaining viral failure.
Conclusions
In clinical practice MRV was used, mostly in R5 positive patients, with adequate efficacy and tolerance, but important number of patients changed due to non‐clinical reasons. In this scenario neither reason for use of MRV nor MRV‐based therapy explained viral failure.
Trapezoid central configurations Corbera, Montserrat; Cors, Josep M.; Llibre, Jaume ...
Applied mathematics and computation,
04/2019, Letnik:
346
Journal Article, Publication
Recenzirano
Odprti dostop
We classify all planar four–body central configurations where two pairs of the bodies are on parallel lines. Using cartesian coordinates, we show that the set of four–body trapezoid central ...configurations with positive masses forms a two–dimensional surface where two symmetric families, the rhombus and isosceles trapezoid, are on its boundary. We also prove that, for a given position of the bodies, in some cases a specific order of the masses determines the geometry of the configuration, namely acute or obtuse trapezoid central configuration. We also prove the existence of non–symmetric trapezoid central configurations with two pairs of equal masses.
The involvement of genital women tract of chronic schistosomiasis among African migrant women in non-endemic countries might be more prevalent than expected. A gold standard diagnostic is most needed ...to determine the true prevalence of this condition and characterize the clinical presentation of female genital schistosomiasis among this particular population.
Schistosomiasis is highly endemic in sub-Saharan Africa and frequently imported to Europe. Male urogenital manifestations are often neglected. We aimed to ascertain the prevalence of genitourinary ...clinical signs and symptoms among long-term African migrants in a non-endemic European country using a serology test.
We carried out a prospective, community-based cross-sectional study of adult male migrants from sub-Saharan Africa living in Spain. Schistosoma serology tests and microscopic urine examinations were carried out, and clinical data were obtained from an electronic medical record search and a structured questionnaire.
We included 388 adult males, mean age 43.5 years Standard Deviation (SD) = 12.0, range: 18-76. The median time since migration to the European Union was 17 Interquartile range (IQR): 11-21 years. The most frequent country of origin was Senegal (N = 179, 46.1%). Of the 338, 147 (37.6%) tested positive for Schistosoma. Parasite eggs were present in the urine of only 1.3%. Nine genitourinary clinical items were significantly associated with positive Schistosoma serology results: pelvic pain (45.2%; OR = 1.57, 95% CI: 1.0-2.4), pain on ejaculation (14.5%; OR = 1.85, 95% CI: 1.0-3.5), dyspareunia (12.4%; OR = 2.45, 95% CI: 1.2-5.2), erectile dysfunction (9.5%; OR = 3.10, 95% CI: 1.3-7.6), self-reported episodes of infertility (32.1%; OR = 1.69, 95% CI: 1.0-2.8), haematuria (55.2%; OR = 2.37, 95% CI: 1.5-3.6), dysuria (52.1%; OR = 2.01, 95% CI: 1.3-3.1), undiagnosed syndromic STIs (5.4%), and orchitis (20.7%; OR = 1.81, 95% CI: 1.0-3.1). Clinical signs tended to cluster.
Urogenital clinical signs and symptoms are prevalent among male African long-term migrants with a positive Schistosoma serology results. Genital involvement can be frequent even among those with long periods of non-residence in their sub-Saharan African countries of origin. Further research is needed to develop diagnostic tools and validate therapeutic approaches to chronic schistosomiasis.
The approval of maraviroc (Selzentri®), the first CCR5 antagonist, with specific antiviral activity against CCR5 (R5)-tropic HIV variants, has promoted the determination of HIV coreceptor usage in ...the clinical setting. The phenotypic assay Trofile™, which is based on recombinant virus technology, has been the most widely used diagnostic test, given that it was the only assay which provided tropism information in the pivotal maraviroc clinical trials. However, this method displays logistical and technical limitations that make it far from convenient as a diagnostic test in clinical practice. Genotypic methods based on V3 genotyping represent a more feasible alternative and progressively are replacing phenotypic assays. Even though their sensitivity to detect X4-tropic variants is lower compared to Trofile™, recent studies have demonstrated that specific genotypic tools (geno2pheno and PSSM) are comparable to Trofile™ and ES-Trofile™ in predicting virologic response to maraviroc. This review summarizes clinical and methodological recommendations for the genotypic determination of HIV tropism to guide therapeutic decisions with CCR5 antagonists in HIV therapeutics.
There are few data about the immunovirological efficacy, safety/tolerability, and durability of maraviroc (MVC) addition to aging patients on suppressive antiretroviral therapy (cART) and ...undetectable viral load (<50 copies/ml). The aging population is underrepresented in most HIV clinical trials. This study included 80 patients aged ≥50 years and 161 aged <50 years and showed that after 48 weeks of treatment, there was no between-group differences in the median increase of CD4(+) T cells or the virological suppression rate. Safety and tolerability were also comparable. In multivariable analysis, the effect of age was not modified and was independent of the response to MVC. An immunological recovery of ≥100 CD4(+) T cells was significantly less common in those with a longer HIV history (≥15 years) (OR 0.43; p=0.016) or having <200/mm(3) CD4(+) T cells at MVC initiation (OR 0.27; p=0.004). Meanwhile, achieving a CD4/CD8 ratio ≥0.5 at week 48 was less likely in those with CD4(+) T cell counts <200 at MVC initiation (OR 0.09; p<0.0001) or with a previous AIDS event (OR 0.43; p=0.028). In summary, the immunovirological efficacy, safety/tolerability, and durability of MVC addition in patients virologically suppressed were independent of the patient's age at treatment onset.
Abstract
Plasma extracellular vesicle (EV)-associated cytokines were quantified in people with HIV (PWH) with different virological control status, including elite controllers (EC) who maintain ...persistent control (PC) or not (TC). Cytokine signatures and pathways were determined for each group. Median EV-associated cytokine levels were higher among PWH than HIV-uninfected. EC showed the highest levels of EV-associated cytokines among PWH with PC levels higher than TC levels. IL-18 levels best distinguished PWH from uninfected controls, and EC from ART-treated, and IL-3 distinguished PC from TC. The role of EV-cytokines in intercellular communication and endogenous control of HIV expression should be investigated further.
Elite controllers (EC) had higher plasma extracellular vesicle (EV)-associated cytokines than other people with HIV, and persistent controllers (PC) had higher levels than transient controllers (TC). EV-associated IL-18 distinguished EC from ART treated; EV-associated IL-3 and TRAIL distinguished PC from TC.
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