12 item Allodynia Symptom Checklist/Brasil: cross-cultural adaptation, internal consistency and reproducibility

Since there was no Portuguese questionnaire to evaluate cutaneous allodynia, which has been pointed out as a risk factor of migraine, we aimed to perform the cross-cultural adaptation of the 12 item Allodynia Symptom Checklist for the Brazilian population and to test its measurement properties. It consisted in six stages: translation, synthesis, back translation, revision by a specialist committee, pretest and submission the documents to the committee. In the pretest stage, the questionnaire was applied to 30 migraineurs of both sexes, who had some difficulty in understanding it. Thus, a second version was applied to 30 additional subjects, with no difficulties being reported. The mean filling out time was 3'36", and the internal consistency was 0.76. To test reproducibility, 15 other subjects filled out the questionnaire at two different times, it was classified as moderate (weighted kappa=0.58). We made available to Brazilian population an easy, quick and reliable questionnaire.

Metal binding selectivity of oxa-aza macrocyclic ligand: a DFT study of first- and second-row transition metal for four coordination systems

A detailed theoretical study of the 1,7,1l,17-tetraoxa-2,6,12,16-tetraaza-cycloeicosane ligand ([20]AneN(4)O(4)) coordinated to Fe2+, Co2+, Ni2+, Ru2+, Rh2+, and Pd2+ transition metal ions was carried out with the B3LYP method. Two different cases were performed: when nitrogen is the donor atom (1a (q) ) and also with the oxygen as the donor atom (1b (q) ). For all the cases performed in this study 1a (q) structures were always more stable than the 1b (q) ones. Considering each row is possible to see that the energy increases with the increase of the atomic number. The M2+ cation binding energies for the 1a (q) complexes increase with the following order: Fe2+ < Ru2+ < Co2+ < Ni2+ < Rh2+ < Pd2+.

Prediction of the rate of decline in fetal hemoglobin levels between first and second transfusions in red cell alloimmune disease

Objective To determine variables that predict the rate of decline in fetal hemoglobin levels in alloimmune disease. Method Retrospective review of singleton pregnancies that underwent first and second intrauterine transfusions for treatment of fetal anemia because of maternal Rh alloimmunization in a tertiary referral center. Results Forty-one first intrauterine transfusions were performed at 26.1?weeks (standard deviation, SD, 4.6), mean volume of blood transfused was 44.4?mL (SD 23.5) and estimated feto-placental volume expansion was 51.3% (SD 14.5%). Between first and second transfusion, hemoglobin levels reduced on average 0.40?g/dl/day (SD 0.25). Stepwise multiple regression analysis demonstrated that this rate significantly correlated with hemoglobin levels after the first transfusion, the interval between both procedures, and middle cerebral artery systolic velocity before the second transfusion. Conclusion The rate of decline in fetal hemoglobin levels between first and second transfusions in alloimmune disease can be predicted by a combination of hemoglobin levels after the first transfusion, interval between both procedures, and middle cerebral artery systolic velocity before the second transfusion. (C) 2012 John Wiley & Sons, Ltd.

First- and second-row transition metal oxa-aza macrocyclic complexes: a DFT study of an octahedral conformation

A theoretical study of structures of the 1,7,1 l,17-tetraoxa-2,6,12,16-tetraaza-cycloeicosane ligand ([20]AneN(4)O(4)) coordinated to Fe2+, Co2+, Ni2+, Ru2+, Rh2+, and Pd2+ transition metals ions was carried out with the DFT/B3LYP method. Complexes were fully optimized in C-s symmetry with the metal ions coordinated either to nitrogen (1a) or oxygen atoms (1b). For all the cases performed in this work, 1a was always more stable than 1b. Considering each row it is possible to see that the binding energy increases with the atomic number. The M2+ cation binding energies increase in the following order: Fe2+ < Ru2+ < Co2+ < Ni2+ < Rh2+ < Pd2+. In addition, it was observed the preference of Pd2+ and Rh2+ complexes for a tetrahedral arrangement, while Fe2+, Ru2+, Co2+, Ni2+ complexes had a preference for the octahedral arrangement. From the orbital representation results, it was seen that 1b unsymmetrical orbitals may influence the susceptibility over metal ions orientation toward heteroatoms orbitals.

Odd homoclinic orbits for a second order Hamiltonian system

The aim of this paper is to find an odd homoclinic orbit for a class of reversible Hamiltonian systems. The proof is variational and it employs a version of the concentration compactness principle of P. L. Lions in a lemma due to Struwe.

Dental caries associated factors in 12 year-old schoolchildren from a municipality in the state of São Paulo, Brazil

Objective To analyze the possible association between dental caries, fluorosis and the need for treatment in 12 year-old schoolchildren and the socioeconomic conditions of parents/guardians in the city of Franca, in the state of São Paulo. Methods A random sample of schoolchildren aged 12 was obtained from the school records in Franca, using a systematic random technique. The epidemiological survey was carried out by a single calibrated examiner, on 258 public and private schoolchildren in order to obtain the prevalence of dental caries, the need for treatment and the severity of dental fluorosis. Parents/guardians were also interviewed to assess their socioeconomic conditions (education and per capita income). We used multiple correlation analysis to investigate associations between category variables. Results It was possible to identify two distinct groups, with associations between the variables: the first group, represented by schoolchildren with average prevalence of caries, need for treatment, low level of parental education and income; and a second group represented by schoolchildren with low prevalence of caries, no need for treatment, high parental education and income. The two dimensions explained approximately 35% of total inertia. The factors within each group are related. Conclusion High income and parental education are associated with the low prevalence of dental caries but there is no association with dental fluorosis.

Contractive-like mapping principles in ordered metric spaces and application to ordinary differential equations

[EN] The purpose of this paper is to present a fixed point theorem for generalized contractions in partially ordered complete metric spaces. We also present an application to first-order ordinary differential equations.

Bioremediation of PAHs - Limitations and soultions

Introduction 1.1 Occurrence of polycyclic aromatic hydrocarbons (PAH) in the environment Worldwide industrial and agricultural developments have released a large number of natural and synthetic hazardous compounds into the environment due to careless waste disposal, illegal waste dumping and accidental spills. As a result, there are numerous sites in the world that require cleanup of soils and groundwater. Polycyclic aromatic hydrocarbons (PAHs) are one of the major groups of these contaminants (Da Silva et al., 2003). PAHs constitute a diverse class of organic compounds consisting of two or more aromatic rings with various structural configurations (Prabhu and Phale, 2003). Being a derivative of benzene, PAHs are thermodynamically stable. In addition, these chemicals tend to adhere to particle surfaces, such as soils, because of their low water solubility and strong hydrophobicity, and this results in greater persistence under natural conditions. This persistence coupled with their potential carcinogenicity makes PAHs problematic environmental contaminants (Cerniglia, 1992; Sutherland, 1992). PAHs are widely found in high concentrations at many industrial sites, particularly those associated with petroleum, gas production and wood preserving industries (Wilson and Jones, 1993). 1.2 Remediation technologies Conventional techniques used for the remediation of soil polluted with organic contaminants include excavation of the contaminated soil and disposal to a landfill or capping - containment - of the contaminated areas of a site. These methods have some drawbacks. The first method simply moves the contamination elsewhere and may create significant risks in the excavation, handling and transport of hazardous material. Additionally, it is very difficult and increasingly expensive to find new landfill sites for the final disposal of the material. The cap and containment method is only an interim solution since the contamination remains on site, requiring monitoring and maintenance of the isolation barriers long into the future, with all the associated costs and potential liability. A better approach than these traditional methods is to completely destroy the pollutants, if possible, or transform them into harmless substances. Some technologies that have been used are high-temperature incineration and various types of chemical decomposition (for example, base-catalyzed dechlorination, UV oxidation). However, these methods have significant disadvantages, principally their technological complexity, high cost , and the lack of public acceptance. Bioremediation, on the contrast, is a promising option for the complete removal and destruction of contaminants. 1.3 Bioremediation of PAH contaminated soil & groundwater Bioremediation is the use of living organisms, primarily microorganisms, to degrade or detoxify hazardous wastes into harmless substances such as carbon dioxide, water and cell biomass Most PAHs are biodegradable unter natural conditions (Da Silva et al., 2003; Meysami and Baheri, 2003) and bioremediation for cleanup of PAH wastes has been extensively studied at both laboratory and commercial levels- It has been implemented at a number of contaminated sites, including the cleanup of the Exxon Valdez oil spill in Prince William Sound, Alaska in 1989, the Mega Borg spill off the Texas coast in 1990 and the Burgan Oil Field, Kuwait in 1994 (Purwaningsih, 2002). Different strategies for PAH bioremediation, such as in situ , ex situ or on site bioremediation were developed in recent years. In situ bioremediation is a technique that is applied to soil and groundwater at the site without removing the contaminated soil or groundwater, based on the provision of optimum conditions for microbiological contaminant breakdown.. Ex situ bioremediation of PAHs, on the other hand, is a technique applied to soil and groundwater which has been removed from the site via excavation (soil) or pumping (water). Hazardous contaminants are converted in controlled bioreactors into harmless compounds in an efficient manner. 1.4 Bioavailability of PAH in the subsurface Frequently, PAH contamination in the environment is occurs as contaminants that are sorbed onto soilparticles rather than in phase (NAPL, non aqueous phase liquids). It is known that the biodegradation rate of most PAHs sorbed onto soil is far lower than rates measured in solution cultures of microorganisms with pure solid pollutants (Alexander and Scow, 1989; Hamaker, 1972). It is generally believed that only that fraction of PAHs dissolved in the solution can be metabolized by microorganisms in soil. The amount of contaminant that can be readily taken up and degraded by microorganisms is defined as bioavailability (Bosma et al., 1997; Maier, 2000). Two phenomena have been suggested to cause the low bioavailability of PAHs in soil (Danielsson, 2000). The first one is strong adsorption of the contaminants to the soil constituents which then leads to very slow release rates of contaminants to the aqueous phase. Sorption is often well correlated with soil organic matter content (Means, 1980) and significantly reduces biodegradation (Manilal and Alexander, 1991). The second phenomenon is slow mass transfer of pollutants, such as pore diffusion in the soil aggregates or diffusion in the organic matter in the soil. The complex set of these physical, chemical and biological processes is schematically illustrated in Figure 1. As shown in Figure 1, biodegradation processes are taking place in the soil solution while diffusion processes occur in the narrow pores in and between soil aggregates (Danielsson, 2000). Seemingly contradictory studies can be found in the literature that indicate the rate and final extent of metabolism may be either lower or higher for sorbed PAHs by soil than those for pure PAHs (Van Loosdrecht et al., 1990). These contrasting results demonstrate that the bioavailability of organic contaminants sorbed onto soil is far from being well understood. Besides bioavailability, there are several other factors influencing the rate and extent of biodegradation of PAHs in soil including microbial population characteristics, physical and chemical properties of PAHs and environmental factors (temperature, moisture, pH, degree of contamination). Figure 1: Schematic diagram showing possible rate-limiting processes during bioremediation of hydrophobic organic contaminants in a contaminated soil-water system (not to scale) (Danielsson, 2000). 1.5 Increasing the bioavailability of PAH in soil Attempts to improve the biodegradation of PAHs in soil by increasing their bioavailability include the use of surfactants , solvents or solubility enhancers.. However, introduction of synthetic surfactant may result in the addition of one more pollutant. (Wang and Brusseau, 1993).A study conducted by Mulder et al. showed that the introduction of hydropropyl-ß-cyclodextrin (HPCD), a well-known PAH solubility enhancer, significantly increased the solubilization of PAHs although it did not improve the biodegradation rate of PAHs (Mulder et al., 1998), indicating that further research is required in order to develop a feasible and efficient remediation method. Enhancing the extent of PAHs mass transfer from the soil phase to the liquid might prove an efficient and environmentally low-risk alternative way of addressing the problem of slow PAH biodegradation in soil.

Quantum effects and dynamics in hydrogen-bonded systems: a first-principles approach to spectroscopic experiments

Computer simulations have become an important tool in physics. Especially systems in the solid state have been investigated extensively with the help of modern computational methods. This thesis focuses on the simulation of hydrogen-bonded systems, using quantum chemical methods combined with molecular dynamics (MD) simulations. MD simulations are carried out for investigating the energetics and structure of a system under conditions that include physical parameters such as temperature and pressure. Ab initio quantum chemical methods have proven to be capable of predicting spectroscopic quantities. The combination of these two features still represents a methodological challenge. Furthermore, conventional MD simulations consider the nuclei as classical particles. Not only motional effects, but also the quantum nature of the nuclei are expected to influence the properties of a molecular system. This work aims at a more realistic description of properties that are accessible via NMR experiments. With the help of the path integral formalism the quantum nature of the nuclei has been incorporated and its influence on the NMR parameters explored. The effect on both the NMR chemical shift and the Nuclear Quadrupole Coupling Constants (NQCC) is presented for intra- and intermolecular hydrogen bonds. The second part of this thesis presents the computation of electric field gradients within the Gaussian and Augmented Plane Waves (GAPW) framework, that allows for all-electron calculations in periodic systems. This recent development improves the accuracy of many calculations compared to the pseudopotential approximation, which treats the core electrons as part of an effective potential. In combination with MD simulations of water, the NMR longitudinal relaxation times for 17O and 2H have been obtained. The results show a considerable agreement with the experiment. Finally, an implementation of the calculation of the stress tensor into the quantum chemical program suite CP2K is presented. This enables MD simulations under constant pressure conditions, which is demonstrated with a series of liquid water simulations, that sheds light on the influence of the exchange-correlation functional used on the density of the simulated liquid.

Synthesis of Hand Exoskeletons for the Rehabilitation of Post-Stroke Patients

This dissertation presents the synthesis of a hand exoskeleton (HE) for the rehabilitation of post-stroke patients. Through the analysis of state-of-the-art, a topological classification was proposed. Based on the proposed classification principles, the rehabilitation HEs were systematically analyzed and classified. This classification is helpful to both understand the reason of proposing certain solutions for specific applications and provide some useful guidelines for the design of a new HE, that was actually the primary motivation of this study. Further to this classification, a novel rehabilitation HE was designed to support patients in cylindrical shape grasping tasks with the aim of recovering the basic functions of manipulation. The proposed device comprises five planar mechanisms, one per finger, globally actuated by two electric motors. Indeed, the thumb flexion/extension movement is controlled by one actuator whereas a second actuator is devoted to the control of the flexion/extension of the other four fingers. By focusing on the single finger mechanism, intended as the basic model of the targeted HE, the feasibility study of three different 1 DOF mechanisms are analyzed: a 6-link mechanism, that is connected to the human finger only at its tip, an 8-link and a 12-link mechanisms where phalanges and articulations are part of the kinematic chain. The advantages and drawbacks of each mechanism are deeply analyzed with respect to targeted requirements: the 12-link mechanism was selected as the most suitable solution. The dimensional synthesis based on the Burmester theory as well as kinematic and static analyses were separately done for all fingers in order to satisfy the desired specifications. The HE was finally designed and a prototype was built. The experimental results of the first tests are promising and demonstrate the potential for clinical applications of the proposed device in robot-assisted training of the human hand for grasping functions.

Schriftlicher Text im Film und seine Übersetzung : die Inserts der BBC-Serie Sherlock (2010-12) ; aus der Perspektive von Untertiteltheorie, Comictheorie und Translationspraxis

Die BBC-Serie SHERLOCK war 2011 eine der meistexportierten Fernsehproduktionen Großbritanniens und wurde weltweit in viele Sprachen übersetzt. Eine der Herausforderungen bei der Übersetzung stellen die Schrifteinblendungen der Serie (kurz: Inserts) dar. Die Inserts versprachlichen die Gedanken des Protagonisten, bilden schriftliche und digitale Kommunikation ab und zeichnen sich dabei durch ihre visuelle Auffälligkeit und teilweise als einzige Träger sprachlicher Kommunikation aus, womit sie zum wichtigen ästhetischen und narrativen Mittel in der Serie werden. Interessanterweise sind in der Übersetztung alle stilistischen Eigenschaften der Original-Inserts erhalten. In dieser Arbeit wird einerseits untersucht, wie Schrifteinblendungen im Film theoretisch beschrieben werden können, und andererseits, was sie in der Praxis so übersetzt werden können, wie es in der deutschen Version von Sherlock geschah. Zur theoretischen Beschreibung werden zunächst die Schrifteinblendungen in Sherlock Untertitelungsnormen anhand relevanter grundlegender semiotischer Dimensionen gegenübergestellt. Weiterhin wird das Verhältnis zwischen Schrifteinblendungen und Filmbild erkundet. Dazu wird geprüft, wie gut verschiedene Beschreibungsansätze zu Text-Bild-Verhältnissen aus der Sprachwissenschaft, Comicforschung, Übersetzungswissenschaft und Typografie die Einblendungen in Sherlock erklären können. Im praktischen Teil wird die Übersetzung der Einblendungen beleuchtet. Der Übersetzungsprozess bei der deutschen Version wird auf Grundlage eines Experteninterviews mit dem Synchronautor der Serie rekonstruiert, der auch für die Formulierung der Inserts zuständig war. Abschließend werden spezifische Übersetzungsprobleme der Inserts aus der zweiten Staffel von SHERLOCK diskutiert. Es zeigt sich, dass Untertitelungsnormen zur Beschreibung von Inserts nicht geeignet sind, da sie in Dimensionen wie Position, grafische Gestaltung, Animation, Soundeffekte, aber auch Timing stark eingeschränkt sind. Dies lässt sich durch das historisch geprägte Verständnis von Untertiteln erklären, die als möglichst wenig störendes Beiwerk zum fertigen Filmbild und -ablauf (notgedrungen) hinzugefügt werden, wohingegen für die Inserts in SHERLOCK teilweise sogar ein zentraler Platz in der Bild- und Szenenkomposition bereits bei den Dreharbeiten vorgesehen wurde. In Bezug auf Text-Bild-Verhältnisse zeigen sich die größten Parallelen zu Ansätzen aus der Comicforschung, da auch dort schriftliche Texte im Bild eingebettet sind anstatt andersherum. Allerdings sind auch diese Ansätze zur Beschreibung von Bewegung und Ton unzureichend. Die Erkundung der Erklärungsreichweite weiterer vielversprechender Konzepte, wie Interface und Usability, bleibt ein Ziel für künftige Studien. Aus dem Experteninterview lässt sich schließen, dass die Übersetzung von Inserts ein neues, noch unstandardisiertes Verfahren ist, in dem idiosynkratische praktische Lösungen zur sprachübergreifenden Kommunikation zwischen verschiedenen Prozessbeteiligten zum Einsatz kommen. Bei hochqualitative Produktionen zeigt ist auch für die ersetzende Insertübersetzung der Einsatz von Grafikern unerlässlich, zumindest für die Erstellung neuer Inserts als Übersetzungen von gefilmtem Text (Display). Hierbei sind die theoretisch möglichen Synergien zwischen Sprach- und Bildexperten noch nicht voll ausgeschöpft. Zudem zeigt sich Optimierungspotential mit Blick auf die Bereitstellung von sorgfältiger Dokumentation zur ausgangssprachlichen Version. Diese wäre als Referenzmaterial für die Übersetzung insbesondere auch für Zwecke der internationalen Qualitätssicherung relevant. Die übersetzten Inserts in der deutschen Version weisen insgesamt eine sehr hohe Qualität auf. Übersetzungsprobleme ergeben sich für das genretypische Element der Codes, die wegen ihrer Kompaktheit und multiplen Bezügen zum Film eine Herausforderung darstellen. Neben weiteren bekannten Übersetzungsproblemen wie intertextuellen Bezügen und Realia stellt sich immer wieder die Frage, wieviel der im Original dargestellten Insert- und Displaytexte übersetzt werden müssen. Aus Gründen der visuellen Konsistenz wurden neue Inserts zur Übersetzung von Displays notwendig. Außerdem stellt sich die Frage insbesondere bei Fülltexten. Sie dienen der Repräsentation von Text und der Erweiterung der Grenzen der fiktiv dargestellten Welt, sind allerdings mit hohem Übersetzungsaufwand bei minimaler Bedeutung für die Handlung verbunden.

Il linguaggio valutativo nel bilancio di sostenibilità: analisi trilingue basata su corpora

The aim of this dissertation is to analyze the language of evaluation in Italian, English and French sustainability reports in order to observe how firms build their corporate image and to investigate the kind of relationship they develop with their stakeholders. The analysis is carried out by applying Martin & White's Appraisal theory and corpus linguistics methods. For the purposes of this research, a multilingual specialized corpus of sustainability reports has been created, which is the result of two different levels of compilation. At the first level, three sub-corpora have been created with the aim of representing three different languages (Italian, English and French): at this level, the research on evaluative language will show that a standardization process of sustainability reports is underway. At the second level of compilation, each of the three sub-corpora has been split in two further sub-corpora, representative of two different business sectors: at this level, the research will show how the sector where firms operate directly influences the choice of the topics to be discussed. The first chapter of this dissertation introduces the concept of evaluative language, with a particular focus on the framework of Appraisal theory. The second chapter deals with corpus linguistics and describes different types of corpora, the search methods and the criteria for the compilation of corpora. The third chapter discusses the concepts of Corporate Social Responsibility and sustainability reports, focusing mainly on the reporting principles and the linguistic patterns of this genre, and provides an overview of the main guidelines and certifications for the reporting of sustainability actions. Chapter four is dedicated to the description of the methodology used for this research, while the last chapter presents and discusses the results of the analysis, in an attempt to draw generalizations on the use of evaluative language in this emerging genre.

Estrazione terminologica automatica: sistemi a confronto

In any terminological study, candidate term extraction is a very time-consuming task. Corpus analysis tools have automatized some processes allowing the detection of relevant data within the texts, facilitating term candidate selection as well. Nevertheless, these tools are (normally) not specific for terminology research; therefore, the units which are automatically extracted need manual evaluation. Over the last few years some software products have been specifically developed for automatic term extraction. They are based on corpus analysis, but use linguistic and statistical information to filter data more precisely. As a result, the time needed for manual evaluation is reduced. In this framework, we tried to understand if and how these new tools can really be an advantage. In order to develop our project, we simulated a terminology study: we chose a domain (i.e. legal framework for medicinal products for human use) and compiled a corpus from which we extracted terms and phraseologisms using AntConc, a corpus analysis tool. Afterwards, we compared our list with the lists extracted automatically from three different tools (TermoStat Web, TaaS e Sketch Engine) in order to evaluate their performance. In the first chapter we describe some principles relating to terminology and phraseology in language for special purposes and show the advantages offered by corpus linguistics. In the second chapter we illustrate some of the main concepts of the domain selected, as well as some of the main features of legal texts. In the third chapter we describe automatic term extraction and the main criteria to evaluate it; moreover, we introduce the term-extraction tools used for this project. In the fourth chapter we describe our research method and, in the fifth chapter, we show our results and draw some preliminary conclusions on the performance and usefulness of term-extraction tools.

Treatment failure and mortality factors in patients receiving second-line HIV therapy in resource-limited countries

Context Long-term antiretroviral therapy (ART) use in resource-limited countries leads to increasing numbers of patients with HIV taking second-line therapy. Limited access to further therapeutic options makes essential the evaluation of second-line regimen efficacy in these settings. Objectives To investigate failure rates in patients receiving second-line therapy and factors associated with failure and death. Design, Setting, and Participants Multicohort study of 632 patients >14 years old receiving second-line therapy for more than 6 months in 27 ART programs in Africa and Asia between January 2001 and October 2008. Main Outcome Measures Clinical, immunological, virological, and immunovirological failure (first diagnosed episode of immunological or virological failure) rates, and mortality after 6 months of second-line therapy use. Sensitivity analyses were performed using alternative CD4 cell count thresholds for immunological and immunovirological definitions of failure and for cohort attrition instead of death. Results The 632 patients provided 740.7 person-years of follow-up; 119 (18.8%) met World Health Organization failure criteria after a median 11.9 months following the start of second-line therapy (interquartile range [IQR], 8.7-17.0 months), and 34 (5.4%) died after a median 15.1 months (IQR, 11.9-25.7 months). Failure rates were lower in those who changed 2 nucleoside reverse transcriptase inhibitors (NRTIs) instead of 1 (179.2 vs 251.6 per 1000 person-years; incidence rate ratio [IRR], 0.64; 95% confidence interval [CI], 0.42-0.96), and higher in those with lowest adherence index (383.5 vs 176.0 per 1000 person-years; IRR, 3.14; 95% CI, 1.67-5.90 for <80% vs ≥95% [percentage adherent, as represented by percentage of appointments attended with no delay]). Failure rates increased with lower CD4 cell counts when second-line therapy was started, from 156.3 vs 96.2 per 1000 person-years; IRR, 1.59 (95% CI, 0.78-3.25) for 100 to 199/μL to 336.8 per 1000 person-years; IRR, 3.32 (95% CI, 1.81-6.08) for less than 50/μL vs 200/μL or higher; and decreased with time using second-line therapy, from 250.0 vs 123.2 per 1000 person-years; IRR, 1.90 (95% CI, 1.19-3.02) for 6 to 11 months to 212.0 per 1000 person-years; 1.71 (95% CI, 1.01-2.88) for 12 to 17 months vs 18 or more months. Mortality for those taking second-line therapy was lower in women (32.4 vs 68.3 per 1000 person-years; hazard ratio [HR], 0.45; 95% CI, 0.23-0.91); and higher in patients with treatment failure of any type (91.9 vs 28.1 per 1000 person-years; HR, 2.83; 95% CI, 1.38-5.80). Sensitivity analyses showed similar results. Conclusions Among patients in Africa and Asia receiving second-line therapy for HIV, treatment failure was associated with low CD4 cell counts at second-line therapy start, use of suboptimal second-line regimens, and poor adherence. Mortality was associated with diagnosed treatment failure.

Evaluation of the second generation of a bioresorbable everolimus drug-eluting vascular scaffold for treatment of de novo coronary artery stenosis: six-month clinical and imaging outcomes

The first generation of the bioresorbable everolimus drug-eluting vascular scaffold showed signs of shrinkage at 6 months, which largely contributed to late luminal loss. Nevertheless, late luminal loss was less than that observed with bare metal stents. To maintain the mechanical integrity of the device up to 6 months, the scaffold design and manufacturing process of its polymer were modified.