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Abstract: Objective: The objective of this study was to compare the pharmacokinetic profiles of a generic formulation with the innovator mycophenolate mofetil (MMF). Methods and Patients: Thirteen patients with stable renal grafts received MMF posttransplantation (mean, 32 months; confidence interval 95%: 51, 9–12, 36). Graft function improved significantly (serum creatinine levels 2.72 ± 1.75 mg/dL to 1.9 ± 0.66 and 1.79 ± 0.86 mg/dL at 12 and 30 months, respectively; P < .05). Three point (basal, 2, and 6 hours) profiles were performed. Five patients were switched 1:1 to a generic formulation for 60 days and repeating the pharmacokinetics were repeated. Afterwards, they returned to the innovator MMF for 45 days. Finally, all patients received generic MMF, repeating the pharmacokinetics between 15 days and 6 months later. Results: The area under the curve (AUC 0–6) of MPA was 52.68 ± 17.5 μg/mL*hr, with 61.5% of basal determinations (Co) under 5 μg/mL (4.08 ± 0.74). The Pearson correlation coefficient was high between both MMF formulations regarding FMPA AUC 0.768 (P < .005), Co (0.774; P < 0.05), and C6 (0.996; P < .005). GMPA AUC were similar (Pearson) 0.7 (P < .01), Co 0.99 (P < .01), and C6 0.86 (P < .01). C2 MMF levels were variable and showed poor correlation. FMPA AUC of generic and original formulations after 60 days had tight correlation. (Pearson 0.883; P < .025) and comparing 15 and 60 days postconversion with generic drug in the same patients were similar (Pearson 0.58; P < .025). Renal function at 12 months remained stable postconversion. Conclusions: Conversion to generic MMF in stable renal transplant recipients showed good clinical results. [Copyright &y& Elsevier]

National and overseas reports clearly show that a significant proportion of concrete construction problems are associated with drying shrinkage. These results could be a result of few available long-term drying shrinkage data and changes of the behaviour of concrete mixes used nowadays. Therefore, poor estimates of drying shrinkage strains from prediction models could impair the performance and service life of concrete structures. The objective of the current research was to analyse the effect of mix design parameters on drying shrinkage of concretes made with Portland and blended Portland cements, considering 30 mixes that are commonly used in local construction, tested up to 1350 days of drying. It was concluded that, when using rapid-hardening cement of any type, a larger maximum aggregate size and lower water content reduces drying shrinkage. Cement and aggregate type are shown to have a significant effect on drying shrinkage time function and magnitude. Experimental results were compared with calculated drying shrinkage strains estimated by ACI 209, CEB MC90, B3, GL 2000, Sakata 1993 and Sakata 2001 models. It was concluded that none of the shrinkage prediction models adequately reproduced the observed shrinkage behaviour of concrete made with Chilean Portland and blended Portland cements, underestimating the actual long-term drying shrinkage strains. [ABSTRACT FROM AUTHOR]

Abstract: Following the change, in the way we monitored cyclosporine (CsA) levels in January 2000 namely from C0 to C2 concentrations, in renal ¿de novo¿ allograft recipients, some patients treated with concomitant ketoconazole experienced liver toxicity, a complication that had not been previously seen with CsA monitoring using C0. Therefore, we decided to compare the outcomes of patients transplanted using CsA levels monitored by C0 (1998 to 1999) who also had simultaneous C2 determinations (group A) with those of recipients transplanted after 2000 (group B). All received steroids, azathioprine, and CsA plus ketoconazole. Recipients were followed for at least a year after transplantation. Patients in group B showed higher CsA C2 levels, AUC concentrations, and drug doses during the immediate postsurgical period, and at 2 weeks as well as 4 and 6 months posttransplantation. Six group B patients (26%) but no group A recipients displayed, severe liver toxicity characterized by jaundice, elevated liver enzymes, with negative serological tests for CMV, HVC, and HVB. There was a correlation between the GOT and the C2 CsA levels; both normalized 15 to 55 days after CsA dose reduction. High C2 CsA levels, which have been recommended when the drug is used alone in renal transplantation, cannot be used in patients taking ketoconazole, because C2 neither represents nor correlates with AUC drug exposure. Thus high C2 levels may produce liver toxicity. [Copyright &y& Elsevier]

Understanding the drivers of greenhouse gas (GHG) emissions is one of the most critical global environmental challenges to mitigate the increasing global temperature. Nitrous oxide (N2O) emissions are highly variable in space and time and are controlled by multiple proximal drivers, that is, those that affect N2O emissions directly and in short timescales, and distal or indirect drivers that influence emissions over long timescales. Here we present a quantification of N2O emissions in grasslands and forests throughout the Pampas and the Semiarid Chaco in Argentina and reveal distal and proximal drivers, analyzing them in both spatial and temporal models. We measured N2O emissions, soil and climate variables monthly in nine sites over two years. Mean annual temperature and the following soil properties: phosphorous availability, carbon:nitrogen ratio, clay and sand percentages were the main distal drivers controlling N2O emissions in the spatial model, while among proximal drivers, only soil nitrate contents were positively related to N2O emissions. When considering the seasonal variability of N2O emissions (temporal model), we found that emissions were positively related to proximal drivers, such as soil nitrate and soil temperature. Our results show that soil N2O emission drivers differ between spatial and temporal models in natural grasslands and forests, explaining up to 85 and 56% of variations in N2O emissions, respectively. Temperature increased N2O emissions in both spatial and temporal models; therefore, future global warming may increase background emissions from natural ecosystems with important positive feedbacks on the earth system warming. [ABSTRACT FROM AUTHOR]

Highlights • Diagnosis with FilmArray-RP was associated with changes in medical management. • Accurate and rapid diagnosis decreased antibiotic use and complementary studies, and improved oseltamivir use. • The multiplex PCR respiratory panel permitted a high viral detection rate not only in children but in adults. Abstract Background Acute respiratory infections (ARI) are a leading cause of morbidity and mortality worldwide. There is a need to demonstrate the clinical impact of using the new, rapid and sensitive molecular assays in prospectively designed studies. Objectives To study the impact on medical management of a rapid molecular assay in patients with respiratory infections. Study design A prospective, randomized, non-blinded study was performed in patients presenting to the Emergency Department during two respiratory seasons (2016–2017). Diagnosis was performed by FilmArray Respiratory Panel (FilmArray-RP) or by immunofluorescence assay (IFA). Results A total of 432 patients (156 children and 276 adults) were analyzed. Diagnosis with FilmArray-RP was associated with significant changes in medical management including withholding antibiotic prescriptions (OR:15.52, 95%CI:1.99–120.83 in adults and OR:12.23, 95%CI:1.56–96.09 in children), and reduction in complementary studies in children (OR:9.64, 95%CI:2.13–43.63) compared to IFA. Decrease in oseltamivir prescriptions was significantly higher in adults in the FilmArray-RP group (p = 0.042; OR:1.19, 95%CI:0.51-2.79) compared to adults managed with IFA. Diagnostic yield was significantly higher by FilmArray-RP (81%) than by IFA (31%)(p < 0.001). The median time from sample collection to reporting was 1 h 52 min by FilmArray-RP and 26 h by IFA (p < 0.001). Conclusions The high respiratory viruses' detection rate and availability of results within two hours when using FilmArray-RP were associated with decreases in antibiotic prescriptions and complementary studies and more accurate use of oseltamivir. [ABSTRACT FROM AUTHOR]