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Agostino NIFO, Sobre la belleza y el amor

The prevalence of personality disorders (PDs) and sexual dysfunction in chronic pain patients is higher than in general population. Our main objective was to analyse the influence of PD in patients with erectile dysfunction and chronic non-cancer pain and their response to andrological treatment. One-hundred one patients were included along 30 months. Pain intensity, quality of life, sexual life quality, anxiety and depression were analysed together with opioid dose. Erectile functioning was measured with the International Index of Erectile Function (IIEF) and PDs with Millon Clinical Multiaxial Inventory (MCMI-III). The mean age was 57 +/- 12 years old, with moderate to severe pain, 70% were sexually active and presented moderate to severe ED. PDs were very frequent (31%, cut-off 85 and 84% cut-off 75 scores) mostly anxiety, compulsive, though disorder, somatoform and narcissistic. Self-defeating feature presence was significantly correlated (r = -0.4, 95% CI = -0.605 to -0.145, p = 0.002) with a more severe baseline ED and narcissistic, and a better response to andrological treatment (p = 0.010, d = 1.082). Patients with dysthymia features required significantly higher opioid doses vs. control (238 vs. 102 mg/day, respectively). These findings underline the importance of diagnosing PDs to rigorously treat patients with chronic pain and ED.

Purpose Human cornea substitutes generated by tissue engineering currently require limbal stem cells for the generation of orthotypical epithelial cell cultures. We recently reported that bioengineered corneas can be fabricatedin vitrofrom a heterotypical source obtained from Wharton's jelly in the human umbilical cord (HWJSC). Methods Here, we generated a partial thickness cornea model based on plastic compression nanostructured fibrin-agarose biomaterials with cornea epithelial cells on top, as an orthotypical model (HOC), or with HWJSC, as a heterotypical model (HHC), and determined their potentialin vivousefulness by implantation in an animal model. Results No major side effects were seen 3 and 12 months after implantation of either bioengineered partial cornea model in rabbit corneas. Clinical results determined by slit lamp and optical coherence tomography were positive after 12 months. Histological and immunohistochemical findings demonstrated thatin vitroHOC and HHC had moderate levels of stromal and epithelial cell marker expression, whereasin vivografted corneas were more similar to control corneas. Conclusion These results suggest that both models are potentially useful to treat diseases requiring anterior cornea replacement, and that HHC may be an efficient alternative to the use of HOC which circumvents the need to generate cornea epithelial cell cultures.

Background Our understanding of HIV-1 and antiretroviral treatment (ART) is strongly biased towards subtype B, the predominant subtype in North America and western Europe. Efforts to characterize the response to first-line treatments in other HIV-1 subtypes have been hindered by the availability of large study cohorts in resource-limited settings. To maximize our statistical power, we combined HIV-1 sequence and clinical data from every available study population associated with the Joint Clinical Research Centre (JCRC) in Uganda. These records were combined with contemporaneous ART-naive records from Uganda in the Stanford HIVdb database. Methods Treatment failures were defined by the presence of HIV genotype records with sample collection dates after the ART start dates in the JCRC database. Drug resistances were predicted by the Stanford HIVdb algorithm, and HIV subtype classification and recombination detection was performed with SCUEAL. We used Bayesian network analysis to evaluate associations between drug exposures and subtypes, and binomial regression for associations with recombination. Results This is the largest database of first-line treatment failures (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$n=1724$$\end{document}n=1724) in Uganda to date, with a predicted statistical power of 80% to detect subtype associations at an odds ratio of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\ge 1.2$$\end{document}≥1.2. In the subset where drug regimen data were available, we observed that use of 3TC was associated with a higher rate of first line treatment failure, whereas regimens containing AZT and TDF were associated with reduced rates of failure. In the complete database, we found limited evidence of associations between HIV-1 subtypes and treatment failure, with the exception of a significantly lower frequency of failures among A/D recombinants that comprised about 7% of the population. First-line treatment failure was significantly associated with reduced numbers of recombination breakpoints across subtypes. Conclusions Expanding access to first-line ART should confer the anticipated public health benefits in Uganda, despite known differences in the pathogenesis of HIV-1 subtypes. Furthermore, the impact of ART may actually be enhanced by frequent inter-subtype recombination in this region. Electronic supplementary material The online version of this article (10.1186/s12981-019-0218-2) contains supplementary material, which is available to authorized users.

To determine whether elevated intra-abdominal pressure (IAP) is associated with a higher rate of enteral nutrition-related gastrointestinal (GI) complications, to assess the value of IAP as a predictor of enteral nutrition (EN) intolerance. Intensive Care Unit (ICU) patients on mechanical ventilation requiring at least 5 days of EN were recruited for a prospective, observational, non-interventional, multicenter study. EN was performed and GI complications were managed with an established protocol. IAP was determined via a urinary catheter. Patients who developed any GI complications were considered as presenting EN intolerance. Variables related to EN, IAP and GI complications were monitored daily. Statistical analysis compared patients without GI complications (group A) vs. GI complications (group B). 247 patients were recruited from 28 participating ICUs (group A: 119, group B: 128). No differences between groups were recorded. Patients in group B (p &lt, 0.001) spent more days on EN (8.1 ± 8.4 vs. 18.1 ± 13.7), on mechanical ventilation (8.0 ± 7.7 vs. 19.3 ± 14.9) and in the ICU (12.3 ± 11.4 vs. 24.8 ± 17.5). IAP prior to the GI complication was (14.3 ± 3.1 vs. 15.8 ± 4.8) (p &lt, 0.003). The best IAP value identified for EN intolerance was 14 mmHg but it had low sensitivity and specificity. Although a higher IAP was associated with EN intolerance, IAP alone did not emerge as a good predictor of EN intolerance in critically ill patients.

In France in 2013, 19.5 million tons of waste were sent to ISDND. Waste storage centers are managed as "bioreactors", in order to facilitate the biodegradation and enhance as much biogas as possible. ISDND arriving at the end of operation are subject to regulations imposing long term (over than 30 years) monitoring, depending on the condition of stability of the waste mass. The managers of the waste mass need simple and effective methods to estimate the biodegradation and stability level. Current methods are expensive, intrusive and not really accurate (drilling, followed by effluent). Using geophysical methods allow them to obtain information spread throughout the waste mass in a non-destructive way. The Electrical Resistivity Tomography (ERT) method and the Induced Polarization (IP) method are being tested on-site at "Les Champs Jouault". Both of those methods require the same electrodes. The ERT method shows that the resistance decreases strongly over time. This decrease is accentuated by injections campaigns that take place on-site. The method of induced chargeability can be treated along 2 axis: it can be treated by calibrating the curve of decrease following 3 models or by analyzing the calculated total chargeability. The field data needs to be sorted before any analysis. The results of calibrations show that the mathematical model requires parameters, and that the modeled curve is close to reality. However, the 4-parameter model (M3) needs to apply a sort very important in measuring quadrupoles, since only 20% are retained. The M2 model, which requires 3 parameters of timing, seems to be the closest to reality while maintaining sufficient quadrupoles. The total chargeability analysis shows a big collapse over time. Same for the resistance where injection campaigns on the waste mass translates into a more significant collapse of the chargeability. The comparison between data of geophysics and physical parameters recorded on-site (settlements, temperature, biogas) shows that the chargeability is linked to the height of settlement. This is related to the fact that the chargeability depends on pores' shapes; En France, 19,5 millions de tonnes de déchets ont été envoyées vers des ISDND en 2013. Certains centres de stockage de déchets non dangereux sont gérés en mode « bioréacteurs », afin de favoriser la biodégradation et valoriser au maximum le biogaz produit. D'autre part, les ISDND arrivant en fin d'exploitation sont soumises à une règlementation imposant un suivi long terme d'une durée de 30 ans. Les gestionnaires de ces massifs ont besoin de méthodes simples et efficaces pour estimer l'état de biodégradation et de stabilité du massif. Actuellement, les méthodes utilisées sont couteuses, intrusives et peu précises (forages, suivi des effluents). L'utilisation de méthodes géophysiques permet d'obtenir des informations réparties sur l'ensemble du massif de façon non destructive. Les méthodes de tomographie de résistivité électrique et de Polarisation Provoquées sont testées sur le site de la SAS Les Champs Jouault, avec les mêmes dispositifs d'électrodes. La méthode ERT montre que la résistivité diminue fortement dans le temps. Cette diminution est accentuée par les campagnes d'injections qui sont menées sur le site. La méthode de la polarisation provoquée peut être traitée suivant 2 axes : le calage de la courbe de décroissance suivant 3 modèles et l'analyse de la chargeabilité totale calculée. Un tri des données de terrain est nécessaire avant toute analyse. Le calage des courbes est testé à partir de 3 modèles mathématiques : à une exponentielle (M1), deux exponentielles (M2) ou une fonction de puissance (M3). Les résultats des calages montrent que plus le modèle nécessite de paramètres, et plus la courbe modélisée est proche de la réalité. Cependant, le modèle à 4 paramètres (M3) nécessite d'appliquer un tri très important dans les quadripôles de mesure, puisque seuls 20% sont conservés. Le modèle M2, qui nécessite 3 paramètres de calage, semble être le plus proche de la réalité tout en conservant une quantité de quadripôles suffisante. L'analyse de la chargeabilité totale montre une forte chute dans le temps. De même que pour la résistivité, les campagnes d'injection menées sur le massif se traduisent par une chute plus importante de la chargeabilité. La comparaison des données de géophysique avec les paramètres physiques enregistrés sur le site (tassements, température, biogaz) montre que la chargeabilité est liée à la hauteur de tassement. Ceci est lié au fait que la chargeabilité dépend de la forme des pores.

A composite end point is often used as the primary end point to assess the efficacy of a new treatment in randomized clinical trials. In cardiovascular trials, the often rare event of the relevant primary end point (individual or composite), such as cardiovascular death, myocardial infarction, or both, is combined with a more common secondary end point, such as target lesion revascularization, with the aim to increase the statistical power of the study. Gómez and Lagakos developed statistical methodology to be used at the design stage of a randomized clinical trial for deciding whether to expand a study-relevant primary end point to the composite of the relevant end point and a secondary end point. The method uses the asymptotic relative efficiency of the logrank test for comparing treatment groups based on the relevant end point versus the logrank test based on the composite end point. The method is used to assess, in the cardiovascular research area, the characteristicsof the candidate individual end points that should govern the choice of using a composite end point as the primary end point in a clinical trial. A set of recommendations is provided based on the reported values of the frequencies of observing each candidate end point and on the magnitude of the effect of treatment as expressed by the hazard ratio, supported by cardiovascular randomized clinical trials published in 2008. © 2014 American Heart Association, Inc.