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There is currently a degree of divergence among the main clinical practice guidelines on the management of risk factors for peripheral arterial disease (PAD). This project aims to gain understanding of the management of PAD risk factors in clinical practice and to reach a multidisciplinary consensus on the strategies to be followed in order to optimize its identification, treatment, and follow-up.A multidisciplinary consensus following the Delphi methodology.Professionals (n = 130) with extensive experience in PAD participated in this consultation. The results suggest that in order to optimize the control of risk factors, efforts should be aimed at: (1) promoting the involvement and awareness of all specialists in the identification of and screening for the disease; (2) guaranteeing the possibility of evaluating the ankle-brachial index (ABI) in all the medical specialties involved; (3) promoting strategies for patients to quit smoking through the use of drugs, programs, or referrals to specialized units; (4) promoting an appropriate Mediterranean-based diet and the prescription of daily exercise; (5) raising awareness of the importance of ensuring LDL cholesterol values below 70 mg/dL, especially in symptomatic but also in asymptomatic patients (55 mg/dL following the publication of the ESC/EAS guide); (6) recommending the use of antiplatelet therapy in asymptomatic patients with diabetes mellitus (DM) and/or a pathological ABI; and (7) protocolizing the annual evaluation of ABI in high-risk patients.This document presents the 22 agreed-upon strategies which are intended to help professionals optimize multidisciplinary management of PAD risk factors.

Greater population life expectancy and consistent improvement in diagnostic techniques have increased the diagnosis of abdominal aortic aneurysms (AAAs) in the elderly population. The aim was to study the natural history of small (55 mm) incidental AAAs in octogenarian and nonagenarian patients to assess the need for follow up and/or invasive treatment.This was a retrospective analysis of a prospective registry. Patients ≥ 80 years old at the time of diagnosis of a55 mm AAA in 1988-2018 were selected. Clinical and anatomical characteristics were registered. Patients were divided in three groups: 30 - 39 mm, 40 - 49 mm, and 50 - 54 mm AAA. The outcome variables were aorto-iliac rupture, AAA reaching a surgical threshold (≥ 55 mm), and death. A descriptive statistical analysis was performed and life tables, Kaplan-Meier curves, and uni- and multivariable Cox regression were used.Three hundred and ten patients were included, 256 (82.6%) men, with mean index age of 84.5 years (standard deviation [SD] 3.5), and median follow up of 37.9 months (interquartile range [IQR] 18.2 - 65.4). Eighteen (5.8%) AAAs ruptured; four of these patients were operated on and only one survived. Sixty-two (20%) AAA reached a surgical size; eight were repaired electively, with 0% early mortality. The survival rates were 81%, 70%, and 38% at one, two, and five years. The rupture rates were 1%, 2%, and 6% and the AAAs reaching surgical threshold were 1%, 4%, and 19% for the same time periods. AAA size40 mm was an independent protective factor from rupture (0.13; 95% confidence interval [CI] 0.03 - 0.48), reaching surgical threshold (0.08; 95% CI 0.04 - 0.16) and death (0.63; 95% CI 0.42 - 0.95).The risk of late rupture of small incidental AAA diagnosed in octogenarian and nonagenarian patients is very small, especially when the AAA is40 mm in diameter. In contrast, global mortality is high. Conservative management seems sensible, with strict selection of the patients who would benefit from follow up and eventual repair.

A continuous solid-state process inside a roller furnace has been used to fabricate Bi-2212 powders. These powders were synthesized for their use as precursors to obtain textured monoliths by laser induced directional solidification. A thermal cycle has been defined, which depends on the length of the furnace, the prefixed temperature profile and the velocity of the sample inside the furnace. Powder properties have been studied as a function of the number of processing cycles. Phase evolution has been analyzed using X-ray diffraction, while other relevant properties of the powders, including grain size distribution, thermal behavior and temperature dependence of the AC susceptibility, have also been measured. These properties have been compared with those of commercial powders and precursors prepared using a standard solid-state protocol. Textured samples using these continuous solid-state precursors exhibit superconducting properties comparable to those similarly processed but prepared from commercial powders., This work was supported by the Spanish Ministerio de Economía y Competitividad and the European FEDER Program (project ENE2014-52105-R), and by the Gobierno de Aragón (research groups T12, T87 and T54_17R). The authors acknowledge the use of Servicio General de Apoyo a la Investigación-SAI, University of Zaragoza.

In this paper we introduce an equivalence between the category of the t-nilpotent quadratic Lie algebras with d generators and the category of some symmetric invariant bilinear forms on the t-nilpotent free Lie algebra with d generators. Taking into account this equivalence, t-nilpotent quadratic Lie algebras with d generators are classified (up to isometric isomorphism, and over any field of characteristic zero), in the following cases: d=2 and t, 32 pages

A new method for calculating the incoherent neutron scattering function for solids is introduced, based on the traditional phonon expansion, where the terms are calculated using the saddle point approximation for each term. The method is simple enough to be used in calculation systems of practical application. It provides very accurate results even for the tails of the scattering function, and is superior to the Gaussian approximation to the phonon terms. Numerical and experimental comparisons are presented in different types of magnitudes derived from the double differential cross section, using vanadium as a test case., This project has received funding from the EU H2020 research and innovation programme under grant agreement No 654000 SINE2020. Grants No PGC-2018-099024-B-I00-ChiMag from the Ministry of Science and Innovation of Spain, i-COOPB20524 from CSIC, Spain, DGA-M4 from the Diputación General de Aragón (Spain), and 06/C563 from Universidad Nacional de Cuyo (Argentina) are also acknowledged.

Although Parkinson's Disease (PD) is mostly considered a motor disorder, it can present at early stages as a non-motor pathology. Among the non-motor clinical manifestations, depression shows a high prevalence and can be one of the first clinical signs to appear, even a decade before the onset of motor symptoms. Here, we review the evidence of early dysfunction in neural circuitry associated with depression in the context of PD, focusing on pre-clinical, pre-motor and early motor phases of the disease. In the pre-clinical phase, structural and functional changes in the substantia nigra, basal ganglia and limbic structures are already observed. Some of these changes are linked to motor compensation mechanisms while others correspond to pathological processes common to PD and depression and thus could underlie the appearance of depressive symptoms during the pre-motor phase. Studies of the early motor phase (less than five years post diagnosis) reveal an association between the extent of damage in different monoaminergic systems and the appearance of emotional disorders. We propose that the limbic loop of the basal ganglia and the lateral habenula play key roles in the early genesis of depression in PD. Alterations in the neural circuitry linked with emotional control might be sensitive markers of the ongoing neurodegenerative process and thus may serve to facilitate an early diagnosis of this disease. To take advantage of this, we need to improve the clinical criteria and develop biomarkers to identify depression, which could be used to determine individuals at risk to develop PD.

We have developed a new component module for the BEAMnrc software package, called SMLC, which models the tongue-and-groove structure of the Siemens Optifocus multileaf collimator. The ultimate goal is to perform accurate Monte Carlo simulations of the IMRT treatments carried out with Optifocus. SMLC has been validated by direct geometry checks and by comparing quantitatively the results of simulations performed with it and with the component module VARMLC. Measurements and Monte Carlo simulations of absorbed dose distributions of radiation fields sensitive to the tongue-and-groove effect have been performed to tune the free parameters of SMLC. The measurements cannot be accurately reproduced with VARMLC. Finally, simulations of a typical IMRT field showed that SMLC improves the agreement with experimental measurements with respect to VARMLC in clinically relevant cases. PACS number 87.55. K

In this paper we investigate the Lie structure of the derived Lie superalgebra [K, K], with K the set of skew elements of a semiprime associative superalgebra A with superinvolution. We show that if U is a Lie ideal of [K, K], then either there exists an ideal J of A such that the Lie ideal [J \cap K,K] is nonzero and contained in U, or A is a subdirect sum of A', A'', where the image of U in A' is central, and A'' is a subdirect product of orders in simple superalgebras, each at most 16-dimensional over its center., arXiv admin note: substantial text overlap with arXiv:math/0701357

Objectives In this review, we will discuss the latest advances in our understanding of the relationship between the cellular DNA damage response and genomic instability in prostate cancer and the emerging possibilities to exploit these aberrations as prognostic biomarkers and guides for personalized patient management. Methods Important findings related to genomic instability in prostate cancer were retrieved from the literature and combined with our own results and a translational perspective. Results Prostate cancer is characterized by a highly altered genomic landscape with a wide spectrum of genomic alterations, including somatic mutations, copy number alterations (CNAs), gene fusions, complex chromosomal rearrangements, and aneuploidy. In addition, massive DNA damaging events, including chromothripsis and chromoplexy, which can lead to extensive genomic insults in a single step, have been identified. A number of these genomic aberrations have been found to provide prognostic information and can therefore help to identify high-risk patients. In addition, defects in the DNA damage checkpoint and repair machinery can potentially be harnessed for therapeutic purposes. Conclusions Genomic instability plays a crucial role in the malignant progression of prostate cancer and can be exploited for the development of novel prognostic biomarkers and innovative therapies.

PCAF and GCN5 acetylate cyclin A at specific lysine residues targeting it for degradation at mitosis. We report here that histone deacetylase 3 (HDAC3) directly interacts with and deacetylates cyclin A. HDAC3 interacts with a domain included in the first 171 aa of cyclin A, a region involved in the regulation of its stability. In cells, overexpression of HDAC3 reduced cyclin A acetylation whereas the knocking down of HDAC3 increased its acetylation. Moreover, reduction of HDAC3 levels induced a decrease of cyclin A that can be reversed by proteasome inhibitors. These results indicate that HDAC3 is able to regulate cyclin A degradation during mitosis via proteasome. Interestingly, HDAC3 is abruptly degraded at mitosis also via proteasome thus facilitating cyclin A acetylation by PCAF/GCN5, which will target cyclin A for degradation. Because cyclin A is crucial for S phase progression and mitosis entry, the knock down of HDAC3 affects cell cycle progression specifically at both, S phase and G2/M transition. In summary we propose here that HDAC3 regulates cyclin A stability by counteracting the action of the acetylases PCAF/GCN5., This work was supported by Grants SAF2009-07769 from the Ministerio de Ciencia e Innovación of Spain and Reticc RD06/0020/0010 from the Istituto de Salud Carlos III.

SummaryBackgroundIf carotid artery narrowing remains asymptomatic (ie, has caused no recent stroke or other neurological symptoms), successful carotid endarterectomy (CEA) reduces stroke incidence for some years. We assessed the long-term effects of successful CEA.MethodsBetween 1993 and 2003, 3120 asymptomatic patients from 126 centres in 30 countries were allocated equally, by blinded minimised randomisation, to immediate CEA (median delay 1 month, IQR 0·3–2·5) or to indefinite deferral of any carotid procedure, and were followed up until death or for a median among survivors of 9 years (IQR 6–11). The primary outcomes were perioperative mortality and morbidity (death or stroke within 30 days) and non-perioperative stroke. Kaplan-Meier percentages and logrank p values are from intention-to-treat analyses. This study is registered, number ISRCTN26156392.Findings1560 patients were allocated immediate CEA versus 1560 allocated deferral of any carotid procedure. The proportions operated on while still asymptomatic were 89·7% versus 4·8% at 1 year (and 92·1% vs 16·5% at 5 years). Perioperative risk of stroke or death within 30 days was 3·0% (95% CI 2·4–3·9; 26 non-disabling strokes plus 34 disabling or fatal perioperative events in 1979 CEAs). Excluding perioperative events and non-stroke mortality, stroke risks (immediate vs deferred CEA) were 4·1% versus 10·0% at 5 years (gain 5·9%, 95% CI 4·0–7·8) and 10·8% versus 16·9% at 10 years (gain 6·1%, 2·7–9·4); ratio of stroke incidence rates 0·54, 95% CI 0·43–0·68, p

In this work we propose and analyze numerical methods for the approximation of the solution of Helmholtz transmission problems in two or three dimensions. This kind of problems arises in many applications related to scattering of acoustic, thermal and electromagnetic waves. Formulations based on boundary integral methods are powerful tools to deal with transmission problems in unbounded media. Different formulations using boundary integral equations can be found in the literature. We propose here new symmetric formulations based on a paper by Martin Costabel and Ernst P. Stephan (1985), that uses the Calderon projector for the interior and exterior problems to develop closed expressions for the interior and exterior Dirichlet-to-Neumann operators. These operators are then matched to obtain an integral system that is equivalent to the Helmholtz transmission problem and uses Cauchy data on the transmission boundary as unknowns. We show how to simplify the aspect and analysis of the method by employing an additional mortar unknown with respect to the ones used in the original paper, writing it in an appropriate way to devise Krylov type iterations based on the separate Dirichlet-to-Neumann operators.

Resumen Objetivo Presentar nuestros resultados en la realizacion de accesos vasculares para hemodialisis (AVHD). Pacientes y metodo Durante los anos 2004 y 2005, se realizaron 119AVHD en 90 pacientes. Resultados El 64,4 % de los pacientes fueron varones, y la edad media fue de 67,5 anos (29-86). Las patologias asociadas mas frecuentes fueron la hipertension arterial (63,5 %), la diabetes (25,4 %) y las cardiopatias (30,4 %). A 25 pacientes (27,8 %) se les habia realizado previamente algun tipo de AVHD. Se realizaron en 57 fistulas arteriovenosas (FAV) humerocefalicas (H-C) (48,7 %). Se implantaron 9 protesis de PTFE (7,5 %). La extremidad superior izquierda se utilizo en 76 ocasiones (63,9 %). En 69 pacientes (76,7 %) se realizo un solo procedimiento. El 73,9 % fueron varones, y la edad media fue de 68,6 anos. La tasa de permeabilidad primaria a 24 meses fue del 76,7 %, con un seguimiento medio de 10,9 meses (1-24). En los 21 pacientes en que fallo el primer AVHD, se realizaron 50 procedimientos. Predominaron las mujeres (66,7 %), y la edad fue mayor (74,5 anos). De estos, a 16 pacientes (17,8 %) se les realizaron 2 AVHD, a 2 (2,2 %) 3 AVHD, y a 3 (3,3 %), 4 AVHD. El 42,9% de los AVHD que fracasaron lo hicieron en el primer mes. Hubo 4 complicaciones (3,4 %): 2 isquemias distales (1,7 %) y 2 infecciones protesicas (1,7 %). Conclusiones La FAV es el acceso vascular para HD mas utilizado. La edad, el sexo y la arteriosclerosis influyen en los fracasos de los AVHD. Las complicaciones en este tipo de procedimientos son escasas.

It is shown that the argument presented in astro-ph/0307318 against the proof that the diluted limit of a self-gravitating system is ill behaved [Nucl. Phys. B668, 409 (2003) (astro-ph/0303301)] is misleading.

It is shown that the diluted thermodynamical limit of a self-gravitating system proposed by de Vega and Sanchez suffers from the same problems as the usual thermodynamical limit and leads to divergent thermodynamical functions. This question is also discussed from the point of view of mean field theory., 11 pages. A typo corrected. Cosmetic changes in some equations. Version that appear in the journal

ICM P09-015-F FONDECYT 3150540 1161274 1151029 CONICYT PIA ACT1402 FONDAP 15150012

– Flujo arterial correcto: el calibre arterial minimo debe ser 2 mm. Un calibre menor conlleva el fracaso de la fistula. La arteriosclerosis puede suponer la aparicion de isquemia distal1. – Vena superficial con diametro > 3 mm y que no este flebitica o, en su defecto, una protesis de PTFE de 6 mm. – Retorno venoso adecuado: que no haya trombosis venosa profunda (TVP) en la extremidad ni estenosis en venas centrales (frecuente en pacientes con via central previa). La TVP contraindica la realizacion de FAVI, ya que daria lugar a un gran edema que pone en riesgo la viabilidad de la extremidad.

We present a detailed analysis, in the framework of the MFA approach, of the critical behaviour of the lattice Schwinger model with Wilson fermions on lattices up to 24 2 , through the study of the Lee-Yang zeros and the specific heat. We find compelling evidence for a critical line ending at κ = 0.25 at large β . Finite size scaling analysis on lattices 8 2 , 12 2 , 16 2 , 20 2 and 24 2 indicates a continuous transition. The hyperscaling relation is verified in the explored β region.

We proposed two different methods for simulating theta-vacuum systems. Both can be affected by systematic effects but these errors can be controlled by comparing the results of the two unrelated methods. This has been done for some analytically soluble models and here the same procedure is successfully applied to the interesting case of CP^9 in the scaling region., Lattice2003(topology); 3 pages, 3 figures

We apply a recently proposed numerical technique for simulation of systems with a θ term to the CP 3 model with standard action. The algorithm, successfully tested in the strong coupling limit, here is applied to the weak coupling region.

If the fermion mass is large enough, the phase of the fermion determinant of QCD at finite density is strongly correlated with the imaginary part of the Polyakov loop. This fact can be exploited to reduce the fluctuations of the phase significantly, making numerical simulations feasible in regions of parameters where the naive brute force method does not work., Comment: LATTICE99 (Finite Temperature and Density II)

espanolObjetivos: Evaluar a largo plazo los resultados tensionales de la trabeculectomia en pacientes sin factores de riesgo previo y comparacion segun tipo de glaucoma y tratamiento medico previo. Metodos: Se realizo un estudio retrospectivo de 965 casos intervenidos de trabeculectomia simple sin factores de riesgo previos. Seguimiento de 3 a 20 anos. Los datos se recogieron al dia siguiente, semana, al mes, 3, 6 meses y cada ano despues de la intervencion hasta la ultima exploracion realizada. Se incluyeron pacientes con glaucoma primario de angulo abierto (GPAA) (671 ojos), pseudoexfoliativo (GPSX) (156 ojos), y cronico de angulo cerrado (GCAC) (138 ojos). Definimos exito absoluto: presion intraocular (PIO) ≤ 21 mm Hg sin tratamiento medico y exito relativo: PIO ≤ 21 mm Hg sin tratamiento medico o con 1 o 2 colirios (principios activos). Resultados: La presion intraocular media se mantuvo entre 15 y 17 mm Hg. El descenso tensional medio se encontro entre 8,87 y 10,57 mm Hg. El porcentaje de descenso medio se cifro entre un 30,70% y un 37,40%. El exito relativo a los 10 anos fue mejor para el GPAA y el exito absoluto fue similar para el GPAA y GPSX en el mismo tiempo. El grupo de pacientes que menor numero de colirios se administraba antes de la cirugia fue el que presento un mayor exito relativo y absoluto. Conclusion: La trabeculectomia simple es una tecnica quirurgica eficaz en el control tensional a largo plazo, mostrando una mejor resultado en pacientes con GPAA y con menor tratamiento medico previo. EnglishObjectives: To evaluate long-term intraocular pressure results after trabeculectomy in low risk patients. Therefore differences among glaucoma type and previous medical treatment will be evaluated. Methods: A retrospective follow-up study, ranging between 3 and 20 years, was carried out on 965 trabeculectomy surgeries without any surgical- failure factor. Follow-up was carried-out one day, one week, one month, three months, six months and annually after surgery until the last visit. Primary open angle (POAG) (671eyes), pseudoexfoliative (PSXG) (156 eyes) and chronic closure angle glaucomas (CCAG) (138 eyes) were included. IOP under 21 Hg mm without medical treatment was considered absolute success, relative success included those eyes with pressures under 21 and one or two daily antiglaucomatous drops. Results: Mean IOP ranged between 15 and 17 Hg mm. Mean IOP decreased from 30.7 to 37.4%. Relative success ten years after surgery was better in POAG; whereas absolute success resulted to be similar in POAG and PSXG. The group of patients less treated before surgery showed greater rate of absolute and relative success. Conclusions: Trabeculectomy alone is an efficient technique in long-term tensional control for uncomplicated eyes. The group of patients less treated before surgery and POAG showed greater rate success.

The lattice of subalgebras of an alternative algebra can determine the algebraic structure of the algebra. Here it is shown that alternative algebras with a lattice of subalgebras isomorphic to nondivision semisimple alternative algebras are closely related to them.