Members of the genus Sarcocystis are frequently found infecting members of the family Cervidae. Although Sarcocystis species are generally host specific for their intermediate hosts, species in ...cervids appear to be less host specific. Here, we report fallow deer (Dama dama) as a new host for Sarcocystis morae, originally described from the red deer (Cervus elaphus). Tongues of 69 legally hunted animals in Spain were tested for sarcocysts, and the species were characterized by light microscopy, ultrastructurally and molecularly. Sarcocysts were identified in 66.7% of D. dama. Sarcocysts had thin (<2 µm thick) cyst wall with hair-like villar protrusions bifurcated at their tips resembling type 8a. Genetic sequences obtained for 18S rRNA and COI reached 99.6–100% and 97.9–98.7% similarity, respectively, to those of S. morae from the red deer. The present study provides new data concerning lower level of host specificity within Sarcocystis genus for cervids.
The present study analyzes the determination of the applicable law to the license and the transfer of technology contracts, based on the Argentine private international law. The possibility to ...determine said law by means of the agreement between the parties themselves and the limits of said agreements is analyzed. The different solutions applicable in case of lack of choice- of-jurisdiction clauses of the applicable law, examining the items in common such as the place for the compliance of the contract, the address of the party that fulfills the services which are characteristic of the contract and the place where it is celebrated. The applicable solution is also analyzed using the most significant contacts of the contract’s core. The study of the applicable law is complemented by the examination of certain variants of the license and transfer of technology contracts such as the ones related to non-patented knowledges and those for the joint development of technologies which state specific questions in terms of the determination of the applicable law. The field of application of the contract is also analyzed making the distinction between the questions which are typical of the contract and those governed by other rules in conflict, for example those related to the effect of the rights of industrial property. The limits that the public order and the different mandatory rules impose for the application of the law of the contract with regards to the licenses and agreements for the transfer of technology are also studied. At the same time, a solution for these different questions under the Argentine law is proposed but using the existing records in the main, private international law systems from a comparative point of view.
O presente estudo examina a determinação da lei aplicável aos contratos de licença e transferência de tecnologia, sobre a base do direito internacional privado argentino. É analisada a possibilidade de determinar tal lei mediante o próprio acordo das partes e os limites para tais acordos. São estudadas as diferentes soluções aplicáveis em caso de falta de cláusulas de eleição da lei aplicável, examinando pontos de contato tais como o local de cumprimento do contrato, o endereço da parte que cumpre as prestações características do contrato e o local de celebração deste. Também é analisada a solução aplicável utilizando os contatos mais significativos ou o centro de gravidade do contrato. O estudo da lei aplicável é visto complementado pelo exame de certas variantes de contratos de licença e transferência de tecnologia, como os relativos a conhecimentos não patenteados e os dirigidos ao desenvolvimento conjunto de tecnologias, que propõem questões específicas quanto à determinação de lei aplicável. Também é analisado o âmbito de aplicação da lei do contrato, destacando-se entre as questões tipicamente contratuais das regidas por outras normas de conflito, como são as relativas aos efeitos dos direitos de propriedade industrial. São estudados os limites que a ordem pública e diversas normas imperativas propõem à aplicação da lei do contrato no âmbito das licenças e acordos de transferência de tecnologia. Adicionalmente, é proposta a solução para estas diferentes questões sob o direito argentino, mas utilizando os antecedentes existentes nos principais sistemas de direito internacional privado desde um ponto de vista comparativo.
El presente estudio examina la determinación de la ley aplicable a los contratos de licencia y transferencia de tecnología sobre la base del derecho internacional privado argentino. Se analiza la posibilidad de determinar tal ley mediante el propio acuerdo de las partes y los límites a tales acuerdos. Se estudian las distintas soluciones aplicables en caso de falta de cláusulas de elección de la ley aplicable, examinando puntos de contacto tales como el lugar de cumplimiento del contrato, el domicilio de la parte que cumple las prestaciones características del contrato y el lugar de celebración de este. También se analiza la solución aplicable utilizando los contactos más significativos o el centro de gravedad del contrato. El estudio de la ley aplicable se ve complementado por el examen de ciertas variantes de contratos de licencia y transferencia de tecnología, como los relativos a conocimientos no patentados y los dirigidos al desarrollo conjunto de tecnologías, que plantean cuestiones específicas en cuanto a la determinación de la ley aplicable. También se analiza el ámbito de aplicación de la ley del contrato, distinguiéndose entre las cuestiones típicamente contractuales de las regidas por otras normas de conflicto, como ser las relativas a los efectos de los derechos de propiedad industrial. Se estudian los límites que el orden público y diversas normas imperativas plantean a la aplicación de la ley del contrato en el ámbito de las licencias y acuerdos de transferencia de tecnología. Asimismo, se propone la solución para estas diferentes cuestiones bajo el derecho argentino, pero utilizando los antecedentes existentes en los principales sistemas de derecho internacional privado desde un punto de vista comparativo.
Barbary sheep (
Ammotragus lervia
) is a North African native wild Caprinae, introduced in the 1970s in new territories such as Spain, the USA, and Mexico. Here, we describe
Sarcocystis
species in ...Barbary sheep. Sarcocysts were found in 19 out of 56 adult
A. lervia
in Southern Spain and characterized morphologically and molecularly. By light microscopy, sarcocysts had thin (< 1 μm) or thick (> 2 μm) walls. By transmission electron microscopy, sarcocysts with thick walls had Type 14 villar protrusions corresponding to
S. tenella
/
S. capracanis
of domestic sheep (
Ovis aries
) or goats (
Capra hircus
). Sarcocysts with thin walls had Type 7b villar protrusions that corresponded to
S. arieticanis
/
S. hircicanis
of domestic sheep or goats. Molecular analyses allowed the identification of only thick-walled
Sarcocystis
species. Six sarcocysts were assigned to
S
.
tenella
(99.2–100% and 95.6–100% sequence similarity within 18S rRNA and COI, respectively) and 19 sarcocysts were assigned to
S
.
capracanis
(98.5–99.8% and 97.9–99.0% sequence similarity within 18S rRNA and COI, respectively). Further studies are needed for taxonomic identification of sarcocysts in Barbary sheep because
Sarcocystis
species in sheep and goats are not cross transmissible despite morphological similarities.
We present a 3‐patient case series that support the use of ultrasound guided minimally invasive autopsy (MIA). This technique has a high diagnostic accuracy in specific clinical settings. It makes ...easier to diagnose pathologies once the patient has died, avoiding body deformation, with a notable reduction in sample processing time compared to the open autopsy study and, therefore, a shorter overall diagnostic response time. MIA shows some similarities with point of care ultrasound (POCUS), like examination protocols or that they can be performed at the bedside.
Point of care rapid diagnostic tests (POC-RDT) for Hepatitis C virus (HCV), Human Immunodeficiency virus (HIV) and Hepatitis B virus (HBV), are ideal for screening in non-clinical outreach settings ...as they can provide immediate results and facilitate diagnosis, allowing high risk population screening. The aim of this study was to compare POC-RDT with laboratory conventional tests. A total of 301 vulnerable evaluable subjects (drug users, migrants and homeless population) were recruited at a mobile screening unit in outreach settings in Madrid. Fingerprick whole blood capillary samples were tested using the SD BIOLINE HCV POC-RDT, Determine HIV Early Detect and Determine HBsAg 2, and the results were assessed against the LIAISON XL HCV, HIV and Murex-HBsAg-Quant, reference assays, respectively. The feasibility and user satisfaction of the POC-RDT were evaluated through a questionnaire. The resolved sensitivity and resolved specificity and their 95% confidence intervals (95% CI) were as follows, respectively: SD-BIOLINE-HCV: 98.8% (95% CI 93.4, 100.0) and 100.0% (95% CI 98.3, 100.0); Determine HIV Early Detect: 100% (95% CI 85.2, 100.0) and 100% (95% CI 98.7, 100); and Determine HBsAg 2: 66.7% (95% CI 9.4, 99.2) and 100.0% (95% CI 98.7, 100.0). As expected, the number of subjects with a confirmed positive result for HBsAg was very low (n = 4). Therefore, the analytical sensitivity has been evaluated in addition: The Determine HBsAg 2 test demonstrated 100% sensitivity for standard concentrations ≥ 0.125 IU/mL. The subject questionnaire yielded positive feedback for most subjects. The POC-RDT fingerprick blood collection method was well received, and the tests demonstrated a comparable clinical performance with conventional tests in outreach settings and vulnerable high-risk populations.
Sexualized intravenous drug use, also known as slamsex, seems to be increasing among HIV-positive men who have sex with men (MSM). Physical and psychopathological symptoms have previously been ...reported in this population, although research on the subject of slamsex is scarce. The objectives of our study were to describe the psychopathological background of a sample of HIV-positive MSM who engaged in slamsex during the previous year and to compare physical, psychopathological, and drug-related symptoms between these participants and those who engaged in non-injecting sexualized drug use.
Participants (HIV-positive MSM) were recruited from the U-Sex study in 22 HIV clinics in Madrid during 2016-17. All participants completed an anonymous cross-sectional online survey on sexual behavior and recreational drug use. When participants met the inclusion criteria, physicians offered them the opportunity to participate and gave them a card with a unique code and a link to access the online survey. The present analysis is based on HIV-positive MSM who had engaged in slamsex and non-injecting sexualized drug use.
The survey sample comprised 742 participants. Of all the participants who completed the survey, 216 (29.1%) had engaged in chemsex, and of these, 34 (15.7%) had engaged in slamsex. Participants who engaged in slamsex were more likely to have current psychopathology (depression, anxiety, and drug-related disorders) than participants who engaged in non-injecting sexualized drug use. In addition, participants who engaged in slamsex more frequently reported high-risk sexual behaviors and polydrug use and were more often diagnosed with sexually transmitted infections (STIs) and hepatitis C than those who did not inject drugs. Compared with participants who did not inject drugs, participants who engaged in slamsex experienced more severe drug-related symptoms (withdrawal and dependence), symptoms of severe intoxication (loss of consciousness), and severe psychopathological symptoms during or after slamsex (eg, paranoid thoughts and suicidal behaviors).
Slamsex is closely associated with current psychiatric disorders and severe drug-related and psychiatric symptoms.
•We performed a prospective study in PWUDs from one of the largest shantytowns in Europe.•The prevalence of active HCV infection was high (23.1%), particularly in IDUs (40.2%).•The HCV care cascade ...was poor; only around 50% of HCV viremic patients began HCV therapy.•The prevalence of HBsAg was 4.3%, and only two individuals had anti-HDV antibodies.
The burden of hepatitis C virus (HCV) infection among people who use drugs (PWUDs) is considerable. We aimed to screen for HCV infection using the fingerstick dried blood spot (DBS) test and to describe the cascade of hepatitis C care among PWUDs in Madrid, Spain. We also evaluated the prevalence of hepatitis B virus (HBV) and hepatitis D virus (HDV) in this population.
We carried out a prospective study and collected samples and epidemiological data using a mobile unit. Viral infections were tested by immunoassay and RT-PCR assay. PWUDs with a positive result were contacted and referred to a specialized health center to confirm and treat the HCV infection.
We studied 529 PWUD samples; 49.7% were from persons who had previously used injection drugs (IDUs). Of these, 152 (28.7%) were positive for HCV antibodies, 122 (23.1%) for HCV RNA, 23 (4.3%) for HBsAg, and two (0.4%) for HDV antibodies (8.7% of those with hepatitis B). People who inject drugs (PWID) more frequently had positive HCV antibody titers (52% vs. 7.3%; p<0.001) and a positive HCV RNA test result (40.2% vs. 7.3%; p<0.001) than non-PWID. The time from sample collection to test results was 19 days. The next 104 individuals (85.2%) with active HCV infection were contacted to report their HCV test results. Of these, 63 (51.6%) had an appointment, 62 (50.8%) were evaluated in the hospital, and 56 (45.9%) started HCV therapy.
HCV screening using fingerstick DBS was an excellent tool for determining HCV prevalence and other chronic hepatitis viruses (HBV and HDV) in PWUDs. However, linkage to care was limited, mainly with respect to the initiation of HCV therapy.
Harm reduction strategies have been shown to decrease the incidence of human immunodeficiency virus (HIV) infection in people who inject drugs (PWID), but the results have been inconsistent when it ...comes to prevention of hepatitis C virus (HCV) infection. We aimed to examine the rate of HCV seroconversion among people who use drugs (PWUD) followed at a mobile harm reduction unit (MHRU) to evaluate if a low-threshold methadone substitution program (LTMSP) is associated with a low HCV seroconversion rate and subsequently identify barriers for elimination.
A cohort of PWUD have been followed at a MRHU in Madrid between 2013 and 2016. Individuals who were negative for HCV antibodies at baseline and who had at least one retest for HCV antibodies were eligible. Kaplan-Meier methods were employed to estimate the global incidence density.
During the study period, 946 PWUD were screened for HCV at least once. At baseline 127 PWUD were negative for HCV antibodies and had at least one follow-up HCV antibodies test. The baseline HCV prevalence was 33%. After a median 0.89 (IQR 0.3-1.5) years of follow-up and 135 person-years of risk for HCV infection, 28 subjects seroconverted. The incidence density for HCV seroconversion for this sample was 20.7 cases (95% CI: 14.3-29.7) per 100 person-years. Injecting drugs in the last year was strongly associated to HCV seroconversion (AHR 15.5, 95%CI 4.3-55.8, p < 0.001). Methadone status was not associated to HCV seroconversion.
A high incidence of HCV infection was found among PWUD at a MHRU in Madrid. In this setting opiate substitutive treatment (OST) as a LTMSP does not appear to protect against HCV seroconversion.
Abstract
Background
Although switching antiretroviral therapy (ART) in people with human immunodeficiency virus experiencing insomnia due to dolutegravir-related neurotoxicity is well founded upon ...evidence, there is a lack of proof in regard to the outcome of stopping dolutegravir-based ART in people without insomnia but reporting poor sleep quality.
Methods
This is a randomized, multicenter, open-label study to evaluate the reversibility of patient-reported sleep disturbances in patients on dolutegravir/lamivudine/abacavir without insomnia after switching to darunavir/cobicistat/emtricitabine/tenofovir alafenamide. The participants were randomized to switch ART at baseline or at week 4 and then completed 8 weeks of darunavir/cobicistat/emtricitabine/tenofovir alafenamide. Our primary objective was to compare changes in sleep quality between arms at week 4. Secondary objectives were to compare changes in mood and neuropsychiatric symptoms (NS) at week 4 and 4 and 8 weeks after switching to darunavir/cobicistat/emtricitabine/tenofovir alafenamide. The participants completed a survey, including the Pittsburgh Sleep Quality Index (PSQI), the Hospital Anxiety and Depression scale (HADS), and specific questions to explore NS, at each visit to assess those objectives.
Results
We included 72 participants. The results show that study arms were similar at baseline; however, at week 4, PSQI scores remained unchanged with dolutegravir/lamivudine/abacavir, whereas patients improved significantly after switching to darunavir/cobicistat/emtricitabine/tenofovir alafenamide. Similar differences between arms were also observed in HADS and NS changes. At weeks 4 and 8 after all participants switched to darunavir/cobicistat/emtricitabine/tenofovir alafenamide, we have observed significant improvements in PSQI and HAD scores and in NS.
Conclusions
In patients reporting subclinical sleep disturbances without insomnia, switching from dolutegravir/lamivudine/abacavir to darunavir/cobicistat/emtricitabine/tenofovir alafenamide was associated with better sleep quality and improvements in mood and NS.
This trial explores the subclinical neurotoxicity of DTG/3TC/ABC and its reversibility after switching to DRV/COBI/FTC/TAF in virologically suppressed HIV-infected individuals, a regimen known for its safety neuropsychiatric profile. Results will help to understand the neurotoxicity profile of dolutegravir-based therapies.
We aim to describe the safety and efficacy of sotrovimab in severe cases of COVID-19 in immunocompromised hosts.
We used a retrospective multicenter cohort including immunocompromised hospitalized ...patients with severe COVID-19 treated with sotrovimab between October 2021 and December 2021.
We included 32 patients. The main immunocompromising conditions were solid organ transplantation (46.9%) and hematological malignancy (37.5%). Seven patients (21.9%) had respiratory progression: 12.5% died and 9.4% required mechanical ventilation. Patients treated within the first 14 days of their symptoms had a lower progression rate: 12.0% vs. 57.1%,
= 0.029. No adverse event was attributed to sotrovimab.
Sotrovimab was safe and may be effective in its use for immunocompromised patients with severe COVID-19. More studies are needed to confirm these preliminary data.
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