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Background Early diagnosis in psoriatic arthritis (PsA) is mandatory in order to initiate early therapy and prevent disability. Around 20% of patients with Psoriasis (PsO) routinely visited in Dermatology departments have PsA previously undiagnosed. Objectives The aim of this study is to evaluate the presence of inflammation by clinical examination and ultrasound in joints and enthesis of patients with PsO without musculoskeletal symptoms. Methods Patients with PsO under topic or PUVA therapy without musculoskeletal symptoms were referred to our Arhritis Unit. Clinical and demographic data were collected. The patients were evaluated for Body Surface Area (BSA), Swollen Joint Count (SJC) (66 joints), Tender Joint Count (TJC) (68 joints) and enthesis (MASES). Psoriatic Arthritis Impact of Disease tool questionnaire (PsAID) and Psoriasis Epidemiology Screening tool questionnaire (PEST) were used to assess the impact of the disease. A comprehensive ultrasound evaluation of 46 joints and 12 enthesis was made (ESAOTE MylabTwice, 12–18 Mhz probe). Enthesis score was calculated using the Madrid Sonographic Enthesis Index (MASEI) and a total score for synovitis (synovial hypertrophy and Power Doppler) was also calculated. Results 42 patients were included. 20 patients were female (48%), mean age (SD) was 48.3 y (14.6) and disease duration was 17.9 y (15.9). Mean BMI was 24.6 (5.2) and BSA 5 (8.7). 13 out of 42 (31%) had severe PsO (systemic treatment or BSA >10% at any time of evolution). 4 patients (9.5%) had Power Doppler signal and 2 (4.8%) fulfilled criteria for ultrasound-defined active synovitis (SH ≥2 + PD) despite no signs or symptoms of musculoskeletal disease. However, although structural alterations such as calcifications and enthesophytes were frequent, no PD was found at any enthesis. In the univariate analysis, higher BMI (p=0.013), weight (p=0.010), waist (p=0.033) and hip (p=0.014) circumferences were significantly associated with severe PsO. In the same way, CRP serum levels were also significantly higher in patients with severe PsO (p=0.027). A strong trend was found between higher MASEI scores and onycopathy (p=0.09). pan> Conclusions Patients with PsO under topic or PUVA therapy without musculoskeletal sympoms have a low prevalence of findings in the joints and enthesis ultrasound evaluation. Of note, 9.5% of PsO patients had subclinical synovitis defined as PD. No changes in those finding were found in a short follow-up (6 months) in these patients. A higher number of patients would be necessary to have strong results. These patients will be followed in order to confirm if they develop Psoriatic Arthritis. Acknowledgements This work was partially financed by Pfizer-Spain Disclosure of Interest None declared

There has been a strong interest in understanding hybrid precoding tradeoffs for millimeter wave (mmW) multi-input multi-output (MIMO) systems. A common assumption in most of these works is that the analog part of the hybrid precoder can only be designed with phase shifters. The consequent search for analog and digital precoding matrices is solved with different black box-type optimization algorithms. In contrast, this work motivates an analog precoding structure at the base-station end that can be realized with both phase shifters and gain controls. Such a structure is necessary for interference management in multi- user transmissions and is easily realized with low complexity and cost. We then propose a feedback framework of the top-P beams over a beam alignment phase from each user. This framework allows the base-station to reconstruct the channel matrix between it and each user, and to manage interference with a simple zeroforcing solution. Such a structured solution is implemented with the amplitude and phase control of the analog part of the hybrid precoder. We finally illustrate the performance improvement with the proposed solution over simpler constructions such as beam steering that can be implemented with phase shifters alone.

Author(s): Gaither, Thomas; Castellanos, Erick; Fergus, Kirkpatrick; Baradaran, Nima; Shindel, Alan; Breyer, Benjamin

Background Prevention of cervical cancer is based upon the accurate diagnosis and grading of cervical lesions identified during screening. The pathological classification of cervical intraepithelial neoplasia (CIN) is problematic, as it relies on subjective criteria and is known to have high interobserver variability and low reproducibility. These limitations can result in either over or under treatment of patients. Biomarkers to improve CIN diagnosis have not overcome all these challenges. Main body Here we review the use of a promising optical imaging method using eosin-based fluorescence spectroscopy. This technique is able to perform fluorescent analysis of cervical biopsies directly from hematoxylin and eosin (H&E) stained tissues. Eosin is a brominated derivative of fluorescein. Fluorescence characteristics of protein–eosin complexes can demonstrate tissue changes associated with dysplasia and cancer. In this article we review the progress made towards developing eosin-based fluorescence spectroscopy. We describe the various morphologies seen among the CIN grades with this optical method and highlight the progress made to quantitate the spectral image characteristics. Conclusion Eosin-based fluorescence spectroscopy can be used to directly examine H&E stained tissue slides. Relevant areas can be imaged and spectral analysis done to obtain objective data to identify and grade cervical lesions.

Posttranslational modification of cellular proteins by ubiquitin serves a variety of functions. Among the multitude of ubiquitin substrates, ubiquitin itself is the most prevalent. For many years, the direct detection of polyubiquitin chains attached to cellular substrates was not practical, with cell biologists relegated to indirect approaches involving site-directed mutagenesis or in vitro biochemistry. Recent advances in two technologies-polyubiquitin linkage-specific antibodies and mass spectrometry proteomics, have overcome that limitation. Using one or both of these, the direct analysis of polyubiquitin chain linkages on cellular substrate proteins may be performed. This paper describes the complimentary nature of linkage-specific antibodies and mass spectrometry proteomics for the characterization of complex ubiquitin signals using lessons learned in early development of both technologies.

Background Prolonged sitting is associated with cardiometabolic and vascular disease. Despite emerging evidence regarding the acute health benefits of interrupting prolonged sitting time, the effectiveness of different modalities in older adults (who sit the most) is unclear. Methods In preparation for a future randomized controlled trial, we enrolled 10 sedentary, overweight or obese, postmenopausal women (mean age 66 years ±9; mean body mass index 30.6 kg/m2 ±4.2) in a 4-condition, 4-period crossover feasibility pilot study in San Diego to test 3 different sitting interruption modalities designed to improve glucoregulatory and vascular outcomes compared to a prolonged sitting control condition. The interruption modalities included: a) 2 minutes standing every 20 minutes; b) 2 minutes walking every hour; and c) 10 minutes standing every hour. During each 5-hr condition, participants consumed two identical, standardized meals. Blood samples, blood pressure, and heart rate were collected every 30 minutes. Endothelial function of the superficial femoral artery was measured at baseline and end of each 5-hr condition using flow-mediated dilation (FMD). Participants completed each condition on separate days, in randomized order. This feasibility pilot study was not powered to detect statistically significant differences in the various outcomes, however, analytic methods (mixed models) were used to test statistical significance within the small sample size. Results Nine participants completed all 4 study visits, one participant completed 3 study visits and then was lost to follow up. Net incremental area under the curve (iAUC) values for postprandial plasma glucose and insulin during the 5-hr sitting interruption conditions were not significantly different compared to the control condition. Exploratory analyses revealed that the 2-minute standing every 20 minutes and the 2-minute walking every hour conditions were associated with a significantly lower glycemic response to the second meal compared to the first meal (i.e., condition-matched 2-hour post-lunch glucose iAUC was lower than 2-hour post-breakfast glucose iAUC) that withstood Bonferroni correction (p = 0.0024 and p = 0.0084, respectively). Using allometrically scaled data, the 10-minute standing every hour condition resulted in an improved FMD response, which was significantly greater than the control condition after Bonferroni correction (p = 0.0033). Conclusion This study suggests that brief interruptions in prolonged sitting time have modality-specific glucoregulatory and vascular benefits and are feasible in an older adult population. Larger laboratory and real-world intervention studies of pragmatic and effective methods to change sitting habits are needed. Trial registration ClinicalTrials.gov NCT02743286.

Resumen Introduccion Dado el deficit de higados para trasplante se esta potenciando la donacion de vivo hepatica (DVH) en el ambito de habla hispana. Para ello es fundamental que los profesionales de centros hospitalarios esten a favor de dicha donacion, dado que son una pieza clave en este tratamiento y son un grupo generador de opinion ante la poblacion. Objetivo Analizar la actitud hacia la donacion de vivo hepatica (DVH) entre el personal hospitalario de centros sanitarios de Espana y Latinoamerica Material y metodo Del «Proyecto Colaborativo Internacional Donante» se seleccionaron 10 centros hospitalarios, 3 de Espana, 5 de Mexico y 2 de Cuba. Muestra aleatoria y estratificada por tipo de servicio y categoria laboral. Se valora la actitud hacia la DVH a traves de un cuestionario validado de aspectos psicosociales. El cuestionario fue anonimo y autoadministrado. Estadistica: test de la t de Student, de la χ2 y analisis de regresion logistica. Resultados De los 2.618 profesionales encuestados, el 85% (n = 2.231) esta a favor de la DVH relacionada, y de ellos el 31% (n = 804) a favor de la DVH no relacionada. No se asocian con dicha actitud ni el pais del encuestado, ni las variables sociopersonales ni las laborales. Los factores que se asocian a la actitud favorable hacia la DVH relacionada son haber tenido experiencia personal con la donacion y el trasplante (p Conclusiones La actitud hacia la DVH referida entre el personal hospitalario de Espana y Latinoamerica es favorable, y esta asociada con factores relacionados directa e indirectamente con la donacion y el trasplante, factores familiares, religiosos y de actitud hacia el cuerpo.

In this paper, the effect of fuzzy logic-based robust power system stabilizers on the improvement of the dynamics of a large-scale power system is investigated. The study is particularly focused on the Mexican Interconnected System and on adding damping to two critical inter-area system oscillation modes: The north-south mode and the western-peninsular mode. The fuzzy power system stabilizers (FPSSs) applied here are based on a significantly reduced rule base, small number of tuning parameters, and simple control algorithm and architecture, which makes their design and implementation easier and suitable for practical applications. Non-linear time-domain simulations for a set of test cases and results from Prony Analysis verify the robustness of the designed FPSSs, as compared to conventional PSSs.

Background No established measure of concentric left ventricular wall hypertrophy (cLVH) on routine computed tomography (CT) of the adult chest currently exists. The objective of this study was to identify and test linear measures for the detection of cLVH using transthoracic echocardiography (TTE) as the reference standard. Methods Contrast-enhanced non-electrocardiogram-gated chest CTs acquired within two weeks of TTE were retrospectively evaluated. Two radiologists independently made trans-axial measurements in the proximal half of the left ventricle at its approximate widest internal diameter: maximum septal thickness (sept), maximum lateral wall thickness (lat), and inner (Id) and outer (Od) wall-wall diameters at the level of greatest combined myocardial thickness. The sum of sept and lat, hereafter Thmax, and modified cross-sectional area (Amod = Od2 - Id2) were calculated. Sept, lat, Thmax, and Amod were evaluated by receiver operating characteristic (ROC) curves using TTE as the reference standard. Thresholds were optimized for specificity and applied to a validation cohort. Inter-rater agreement was assessed by a simple unweighted Kappa statistic (κ). Results Sept and Amod were selected based on areas under the ROC curves of 0.75 and 0.71, respectively, using 100 CTs. Thresholds of 1.6 cm and 30 cm2, respectively, showed similar specificities of 98% with sensitivities of 27% and 30%, respectively. Applied to a validation cohort of 100 CTs, sept had higher combined positive predictive value (75%), inter-rater agreement (κ = 0.58), specificity (91%), and sensitivity (24%). Conclusion Linear measures demonstrate utility in the diagnosis of cLVH on routine contrast-enhanced chest CT.

The field of immunotherapy is a continually expanding niche in cancer biology research. In the last two decades, there has been significant progress in identifying better targets and creating more specific agents for therapy in the field. B7-H3 (CD276) is an immune checkpoint from the B7 family of molecules, many of whom interact with known checkpoint markers including CTLA4, PD-1, and CD28. This is an exciting molecule that is overexpressed in many cancers, although the receptor of B7-H3 has not been characterized. Initially, B7-H3 was thought to co-stimulate the immune response, but recent studies have shown that it has a co-inhibitory role on T-cells, contributing to tumor cell immune evasion. Therefore, its overexpression has been linked to poor prognosis in human patients and to invasive and metastatic potential of tumors in in vitro models. Moreover, recent evidence has shown that B7-H3 influences cancer progression beyond the immune regulatory roles. In this review, we aim to characterize the roles of B7-H3 in different cancers, its relationship with other immune checkpoints, and its non-immunological function in cancer progression. Targeting B7-H3 in cancer treatment can reduce cell proliferation, progression, and metastasis, which may ultimately lead to improved therapeutic options and better clinical outcomes.

The following article has been submitted to/accepted by Journal of Renewable and Sustainable Energy. After it is published, it will be found at http://dx.doi.org/10.1063/1.4976326., Blue energy or salinity difference energy takes advantage of the free energy released in the mixture of two solutions with different salinity concentrations as it happens continuously in river mouths. Among the large number of available techniques that aim to harness blue energy, capmix (or capacitive mixing) methods allow to directly extract electrical energy without the need of any electromechanical converter such as turbines or heat engines. The main goal of this article is to analyze the potential of blue energy by capmix methods in Central America. So far, blue energy studies have been principally carried out in countries from the global North. Therefore, we describe experimental results with real sea and river waters from the Gulf of Fonseca, an area of special interest due to its hydrographic richness, which is situated among Honduras, El Salvador and Nicaragua. An electrochemical cell, which consists of a pair of activated carbon electrodes coated with cationic and anionic polyelectrolyte layers respectively, is used in the experiments. The cell voltage in open circuit (OCV) is used as a measure of the performance of the capmix process. It is found that the OCV is larger when natural river water is used instead of low salinity NaCl solutions. The rainy season in which the experiments were performed reduced the ionic content of the river, increasing the salinity difference with ocean waters. The feasibility of capmix as a means of clean energy production is discussed., Eureka SD Project (agreement number 2013-2591), Erasmus Mundus programme of the European Union., Ministerio de Economía y Competitividad of Spain (Project FIS2013-47666-C3- 1-R), Junta de Andalucía (Spain) project PE-2012- FQM0694, EU FEDER FUNDS

Introduction Ancillary hospital personnel represent an important body of opinion because as they work in a hospital their opinion has more credibility for the general public as a result of their activity in hospitals. However, in most cases they do not have any health care training which means that their attitude could be based on a lack of knowledge or unfounded fears. Objective To analyze the attitude toward living kidney donation (LKD) among ancillary personnel in Spanish and Latin-American hospitals and to analyze the variables that might influence such attitude. Patients and method from “International Collaborative Donor Project” a random sample was taken among ancillary personnel in Spain, Mexico and Cuba hospitals. Attitude toward LKD was evaluated using a validated, anonymously filled and self-administered survey. Results 951 professionals were surveyed (Spain: 277, Mexico: 632, Cuba: 42). 89% ( n = 850) are in favor of related kidney donation, lowering to 31% ( n = 289) in non-related donation. Of the rest, 8% ( n = 78) are not in favor and the 3% ( n = 23) are unsure. By country, Cubans (98%) and Mexicans (91%) are more in favor than Spanish (84%) ( P = 0.001). The following variables are related to favorable attitude toward LKD: female sex ( P = 0.017), university degree ( P = 0.010), work in health services ( P = 0.035), labor stability ( P = 0.016), personal experience in donation and transplantation ( P = 0.001), positive attitude toward cadaveric donation ( P P P P P P P = 0.002) and not being concerned about possible mutilation after donation ( P Conclusions The attitude toward living related kidney donation is favorable among ancillary personnel in Spanish and Latin-American hospitals. Because living donation is a better source of organs than cadaveric ones, this favorable predisposition can be used as promoting agent of living donation in order to develop it in Spanish-speaking countries.

Resumen Introduccion Los profesionales hospitalarios son un colectivo generador de opinion para el resto de la poblacion en temas sanitarios. La actitud no favorable de dicho grupo es un obstaculo hacia el incremento de las tasas de donacion de organos propios de cadaver. Objetivo Analizar la actitud de los profesionales hospitalarios hacia la donacion de los organos propios en centros sanitarios espanoles y latinoamericanos y determinar los factores que condicionan dicha actitud. Material y metodo Del «Proyecto Colaborativo Internacional Donante» se seleccionaron 11 centros hospitalarios, 3 de Espana, 5 de Mexico, 2 de Cuba y uno de Costa Rica. Muestra aleatorizada y estratificada por tipo de servicio y categoria laboral. La actitud hacia la donacion y el trasplante se valoro mediante una encuesta validada. El cuestionario fue anonimo y autoadministrado. Estadistica: tests de la t de Student, de la χ2 y analisis de regresion logistica. Resultados De los 2.785 profesionales encuestados, 822 son de Espana, 1.595 de Mexico, 202 de Cuba y 166 de Costa Rica. El 79% (n = 2.191) esta a favor de la donacion de organos de cadaver. Por pais, estan a favor el 94% (n = 189) de los cubanos, el 82% (n = 1.313) de los mexicanos, el 73% (n = 121) de los costarricenses y el 69% (n = 568) de los espanoles (p En el analisis multivariante, las variables con mas peso especifico son: 1) pais, siendo mas favorable en Cuba (odds ratio= 8,196; p Conclusiones La actitud hacia la donacion entre el personal hospitalario de centros sanitarios espanoles y latinoamericanos es favorable, aunque un 21% no esta a favor de donar. Dicha actitud es mas favorable entre los profesionales latinoamericanos, y esta muy condicionada por factores laborales y psicosociales.

Current therapies for glioblastoma are largely palliative, involving surgical resection followed by chemotherapy and radiation therapy, which yield serious side effects and very rarely produce complete recovery. Curcumin, a food component, blocked brain tumor formation but failed to eliminate established brain tumors in vivo, probably because of its poor bioavailability. In the glioblastoma GL261 cells, it suppressed the tumor-promoting proteins NF-κB, P-Akt1, vascular endothelial growth factor, cyclin D1 and BClXL and triggered cell death. Expression of exogenous p50 and p65 subunits of NF-κB conferred partial protection on transfected GL261 cells against curcumin insult, indicating that NF-κB played a key role in protecting glioblastoma cells. To enhance delivery, we coupled curcumin to the glioblastoma-specific CD68 antibody in a releasable form. This resulted in a 120-fold increase in its efficacy to eliminate GL261 cells. A very similar dose response was also obtained with human glioblastoma lines T98G and U87MG. GL261-implanted mice receiving intratumor infusions of the curcumin-CD68 adduct followed by tail-vein injections of solubilized curcumin displayed a fourfold to fivefold reduction in brain tumor load, survived longer, and about 10% of them lived beyond 100 days. Hematoxylin-eosin staining of brain sections revealed a small scar tissue mass in the rescued mice, indicating adduct-mediated elimination of glioblastoma tumor. The tumor cells were strongly CD68+ and some cells in the tumor periphery were strongly positive for microglial Iba1, but weakly positive for CD68. This strategy of antibody targeting of curcumin to tumor comes with the promise of yielding a highly effective therapy for glioblastoma brain tumors.

Engineered silver nanoparticles (AgNPs) undergo profound chemical transformations in the environment. Upon exposure to biological systems, a protein corona forms to coat the NPs, altering NP bioavailability, toxicity and environmental fate. Although recent studies have explored the importance of the engineered properties of NPs in the formation of protein coronas, less is known about the impact of environmental conditions. In this work, protein corona populations are compared across AgNPs of varied sizes and surface coatings, as well as in aqueous solutions with additives that mimic environmentally relevant conditions. Bioinformatic analysis of the protein corona populations reveals that, in low buffer concentrations, the formation of the protein corona is dominated by electrostatic interactions between the proteins and NPs. The influence of electrostatics is attenuated by addition of solution additives such as sodium chloride and cysteine. Protein enrichment on the NPs is compared across 6 samples with varied AgNP engineered properties and solution conditions. Clustered results reveal that engineered surface coatings strongly mediate protein corona formation. However, under conditions that mimic varied biological and environmental systems, the protein affinities are similar. Indeed, the AgNP protein coronas characterized under environmentally relevant conditions share 70% of the protein corona population. Results provide insight into the relative importance of engineered NP properties and uncontrollable environmental variables, such as solution reaction conditions, in the formation of protein coronas.

The rapid growth of wireless technology worldwide has prompted interest in the underutilized millimeter-wave band from 30 to 100 GHz. Regulation agencies set limits on the amount of electromagnetic radiation absorbed by users, measuring dosimetric quantities such as specific absorption rate (SAR) to assess compliance. The increased rate of energy deposition in human tissue at high frequencies remains a growing concern as wireless cellular networks begin to incorporate millimeter wave technologies. In this paper, we present a baseband model for SAR-aware wireless communication and a strategy for optimal hybrid precoding in millimeter wave systems with SAR constraints.

Hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome of abnormal immune activation resulting in phagocytosis of host cells and cytokine storm. This leads to systemic manifestations, such as cytopenias, hepatitis and, in very rare cases, stress-induced (Takotsubo) cardiomyopathy. We present a

Resumen Introduccion Los profesionales hospitalarios son un grupo de opinion influyente sobre la poblacion. Objetivo El objetivo de este trabajo ha sido analizar la actitud hacia la donacion hepatica de vivo (DVH) de los profesionales no sanitarios de hospitales espanoles y latinoamericanos, y determinar las variables que influyen en dicha actitud. Material y metodo Del «Proyecto Colaborativo Internacional Donante» se selecciona una muestra aleatoria y estratificada por servicio entre el personal no sanitario: 3 en Espana, 5 en Mexico y 2 en Cuba. La actitud se valoro mediante encuesta validada, anonima y autoadministrada. Resultados Se encuestan 951 profesionales no sanitarios, 277 de Espana, 632 de Mexico y 42 de Cuba. El 86% (n = 818) esta a favor de la DVH si fuera relacionada y el 31% (n = 299) si no es relacionada. Se asocia a dicha actitud: pais (Mexico 88%, Cuba 83%, Espana 81%) (p = 0,016), ser mujer (p = 0,026), tener experiencia con la donacion y el trasplante (p = 0,001), tener una actitud a favor hacia la donacion (p Conclusiones La actitud hacia la DVH relacionada entre el personal no sanitario de varios hospitales espanoles, mexicanos y cubanos es favorable. En el 86% de los encuestados dicha actitud no esta condicionada por los factores psicosociales clasicos.

Eosinophilic inflammation and Th2 cytokine production are central to the pathogenesis of asthma. Agents that target either eosinophils or single Th2 cytokines have shown benefits in subsets of biomarker-positive patients. More broadly effective treatment or disease-modifying effects may be achieved by eliminating more than one inflammatory stimulator. Here we present a strategy to concomitantly deplete Th2 T cells, eosinophils, basophils, and type-2 innate lymphoid cells (ILC2s) by generating monoclonal antibodies with enhanced effector function (19A2) that target CRTh2 present on all 4 cell types. Using human CRTh2 (hCRTh2) transgenic mice that mimic the expression pattern of hCRTh2 on innate immune cells but not Th2 cells, we demonstrate that anti-hCRTh2 antibodies specifically eliminate hCRTh2+ basophils, eosinophils, and ILC2s from lung and lymphoid organs in models of asthma and Nippostrongylus brasiliensis infection. Innate cell depletion was accompanied by a decrease of several Th2 cytokines and chemokines. hCRTh2-specific antibodies were also active on human Th2 cells in vivo in a human Th2-PBMC-SCID mouse model. We developed humanized hCRTh2-specific antibodies that potently induce antibody-dependent cell cytotoxicity (ADCC) of primary human eosinophils and basophils and replicated the in vivo depletion capacity of their murine parent. Therefore, depletion of hCRTh2+ basophils, eosinophils, ILC2, and Th2 cells with h19A2 hCRTh2–specific antibodies may be a novel and more efficacious treatment for asthma.

The diagnosis of cervical intraepithelial neoplasia (CIN) has low interobserver reproducibility. The pathogenesis of human papillomavirus (HPV) from infection to high-grade CIN is well understood. In benign lesions, HPV-DNA is often packaged into virions, whereas malignant transformation disrupts virion assembly. It is conceivable that if cervical lesions were exposed to endonuclease digestion, HPV virions would alter nuclear susceptibility to DNA degradation. We propose that susceptibility to endonuclease digestion can serve as a simple marker to identify CIN grade. From paraffin-embedded tissue blocks, condyloma accuminata, CIN I-III, and cervical carcinoma cases were identified. Sections were placed in a bath containing DNAse I for DNA digestion. Residual DNA was stained by a Feulgen process. Endonuclease-resistant DNA (erDNA) staining was correlated to disease grade. In addition, 10 HPV (+) patients whose infection regressed and 8 whose infection progressed to CIN II or above had their initial HPV lesions stained for erDNA. erDNA was observed in 81% condylomas and 80% CIN I cases. All CIN II, III, and cancer cases were endonuclease sensitive with 100% of lesions showing no staining. Eighty percent of HPV lesions that regressed had erDNA staining, whereas 75% lesions that progressed had no erDNA staining. The spectrum of cervical disease caused by HPV has different susceptibilities to endonuclease digestion, which may aid in the diagnosis of CIN. Furthermore, in our small pilot study, erDNA status was associated with the clinical outcomes. Prospective studies are needed to confirm this observation. erDNA status is a promising novel biomarker.

In this paper, an online hierarchical clustering method based on pattern recognition techniques is proposed for the automated clustering of system motion trajectories. Using the concept of minimum average distance between machine oscillations exhibiting a common behavior, a hierarchical clustered structure of the system that can be used for online determination of multimachine dynamic equivalents is suggested. The proposed formulation accounts for complex intermachine oscillations and is suitable for a wide range of problems such as wide-area stability analysis and online dynamic security assessment and control. The technique developed is applied to a six-area 377-machine model of the Mexican interconnected system. In particular, the clustering procedure is applied to identify the coherent motion of system machines following critical contingencies. Numerical examples illustrate the method and demonstrate the ability of the clustering technique to isolate and extract temporal modal behavior. It is shown that automated trajectory segmentation correctly identifies system dynamic behavior, enabling coherency analysis to be performed on an automated fashion. The method is currently being extended to perform model reduction, directly in time-domain using a multimachine representation.

We study the thermopower, thermal conductance, electric conductance and the thermoelectric figure of merit for a gate-defined T-shaped single quantum dot (QD). The QD is solved in the limit of strong Coulombian repulsion U → ∞ , inside the dot, and the quantum wire is modeled on a tight-binding linear chain. We employ the X-boson approach for the Anderson impurity model to describe the localized level within the quantum dot. Our results are in qualitative agreement with recent experimental reports and other theoretical researches for the case of a quantum dot embedded into a conduction channel, employing analogies between the two systems. The results for the thermopower sign as a function of the gate voltage (associated with the quantum dot energy) are in agreement with a recent experimental result obtained for a suspended quantum dot. The thermoelectric figure of merit times temperature results indicates that, at low temperatures and in the crossover between the intermediate valence and Kondo regimes, the system might have practical applicability in the development of thermoelectric devices.

Investigation analysed the influences of MDT´s precision in the results of the hydraulic simulation of floodings. Four digitals models of soil surface were created from different sources: three starting from vectorial cartography by contour lines of few scales and one getting from GPS devices and total station measuring. The comparison to the estimated measured error due to the utilization of simple vectorial cartography paper for the representation of riverbed and flood valleys, with the last model utilized, may assume it influence in flood simulation results. One conclusion was probed; height differences in the representation of soil surface to the same point were very wide [2,88 to 18,82 m], then the estimated water level as well the simulation of flooding area depend of the obtained cartography method, due that were found errors from 1,6 to 2,6 m and from 0,039 to 0,283 km2, that demonstrates he precision of the MDT with that the plot of land is modeled determines the results of the simulation to a large extent.

Introduction. Xenotransplantation is far from becoming a clinical reality. However, in vital organs it could be used as a bridge until a human organ becomes available, in an emergency situation. We analyzed the attitude toward xenotransplantation among personnel in transplant-related services in several hospitals in Spain and Latin America. Methods. A random sample stratified by type of service and job category (n = 738), in transplant-related services (procurement units, transplant units, and transplant patient follow-up units) was examined in eight hospital centers from three different countries: Spain (n = 349), Mexico (n = 269), and Cuba (n = 120). A self-administered validated questionnaire was completed anonymously. Results. Based on the assumption that all the results of xenotransplantation were similar to those achieved with human donors, most respondents [66% (n = 484)] would be in favor. The employees from Cuban centers had the most favorable attitudes (72% in favor), followed by the Spanish (64%) and the Mexicans (61%; P = .013). However, the differences were mainly determined by job category: Physicians showed the most favorable attitudes and auxiliary staff the least (67% vs 40%; P = .010). Attitudes were significantly related to beliefs about different types of human donation [deceased (P < .001) and living (P < .001)], the possibility of needing a transplant for oneself (P < .001), and a favorable attitude toward donating the organs of a deceased family member (P = .004). Conclusions. Currently, a third of health care employees working in transplant-related services are not in favor of xenotransplantation. More information should be provided about the subject, especially in centers with preclinical xenotransplantation programs.

Living donor kidney (LKD) transplantation provides better results than deceased donor donation, involving minimum risk for the donor. However, LKD donation rates are low in most countries. We analyzed attitudes toward LKD in transplant hospitals in Spain, Mexico, and Cuba.Data were obtained from five transplant hospitals through the International Collaborative Program "Proyecto Donante Vivo, Murcia" in three countries: Spain (n = 1168), Mexico (n = 903), and Cuba (n = 202). The random sample (2273 employees) was stratified according to job category. The instrument used to evaluate attitude was a validated questionnaire. Statistical analysis included Student t test, the chi(2) test, and multivariate analysis.Eighty eight percent (n = 2002) of Spanish, Mexican, and Cuban transplant hospital personnel were in favor of related LKD and 24% nonrelated LKD (n = 555). Attitudes were more favorable among centers in Cuba 97% (n = 195), followed by Mexico 88% (n = 793) and by Spain 87% (n = 1014; P.001). According to job category, 91% (n = 617) of physicians were in favor, 88% (n = 543) of nurses, 85% (n = 198) of health care assistants, and 85% (n = 198) of auxiliary personnel. Attitudes were related to variables of: attitude toward deceased donation (P.001), discussion about organ donation and transplantation (P.001), concern about body mutilation after donation (P = .001), a possible need for a transplant in the future (P.001), and attitude toward living liver donation (P.001).Attitudes toward LKD in Hispanic/Latin Transplant Hospitals were favorable and could encourage an increase in LKD in the coming years assuming suitable sociopolitical and economic condition, as well as support from nephrologists.

To analyze the attitude of nursing personnel about organ donation and transplantation in hospitals in Spain and Latin America, and factors that affect this attitude.Data were selected from 12 hospitals and 32 primary care centers participating in an international study (Proyecto Donante, Murcia) in 4 countries including Spain (n = 650), Mexico (n = 428), Cuba (n = 89), and Costa Rica (n = 27). The sample was random and stratified by type of service among nursing personnel (n = 1194). Attitude was evaluated using a psychosocial questionnaire.Of nursing personnel surveyed, 77% (n = 922) were in favor of organ donation. No differences were found according to whether they were directly involved in transplantation-related services (P.05). Attitude in favor of organ donation varied between countries: 92% in Cuba, 85% in Costa Rica, 80% in Mexico, and 73% in Spain (P.001) This attitude was also related to donation of a family member's organs (P.001), having discussed organ donation and transplantation within the family (P.001), the concept of brain death (P.001), fear of body mutilation (P.001), and manipulation of the body after death (P = .001).Attitude toward deceased organ donation among nurses varies between countries. There is a discrepancy between those in favor vs actual donation rates in countries and work centers. These fears may become worse when donation is seen as common in daily clinical practice.

Posttranslational modification with ubiquitin chains controls cell fate in all eukaryotes. Depending on the connectivity between subunits, different ubiquitin chain types trigger distinct outputs, as seen with K48- and K63-linked conjugates that drive protein degradation or complex assembly, respectively. Recent biochemical analyses also suggested roles for mixed or branched ubiquitin chains, yet without a method to monitor endogenous conjugates, the physiological significance of heterotypic polymers remained poorly understood. Here, we engineered a bispecific antibody to detect K11/K48-linked chains and identified mitotic regulators, misfolded nascent polypeptides, and pathological Huntingtin variants as their endogenous substrates. We show that K11/K48-linked chains are synthesized and processed by essential ubiquitin ligases and effectors that are mutated across neurodegenerative diseases; accordingly, these conjugates promote rapid proteasomal clearance of aggregation-prone proteins. By revealing key roles of K11/K48-linked chains in cell-cycle and quality control, we establish heterotypic ubiquitin conjugates as important carriers of biological information.

Background Detection of heart failure (HF) in stable outpatients can be difficult until an overt event occurs. This study sought to determine whether the combination of B-type natriuretic peptide (BNP) and impedance cardiography (ICG) could be used in a nonacute clinical setting to risk stratify and predict HF-related events in stable outpatients. Methods and Results Patients undergoing routine outpatient echocardiography underwent ICG and BNP testing and were followed for one year for HF-related events (Emergency Department [ED] visit or hospitalization due to HF or all-cause death). A total of 524 patients were analyzed, resulting in 57 HF-related events; 16 ED visits, 17 hospitalizations, and 24 all-cause deaths. Using Cox regression analyses, BNP and systolic time ratio index (STRI) by ICG proved to be the strongest predictors of future HF-related events. Patients with a BNP >100 pg/ml and STRI >0.45 sec-1 had a significantly lower event-free survival rate than those with a high BNP and low STRI (67% versus 89%, P=.001). In patients with LV dysfunction only, if both BNP and STRI values were high, the relative risk of a HF-related event increased by 12.5 (95 % C.I. 4.2-36.7), when compared with patients with a low BNP and low STRI (P Conclusions In a nonacute clinical setting, both BNP and ICG testing can provide unique predictive power of long-term HF-related events in a stable cohort of patients with and without LV dysfunction.

This article reports a hospital's experience confronting a community crisis, stemming from local and national breast health access issues, and evaluates the subsequent effectiveness of the initiative to improve breast care service. An interdisciplinary Breast Care Facility was developed adjacent to a Community Hospital. Patients receiving breast cancer screening during the year prior to the Breast Center opening (2002) were compared with patients in subsequent years (2003-2005). Program effectiveness was evaluated by examining screening mammography volume, wait times and cancer detection rates. Screening volume increased by 29.6%. Wait times declined from 30 weeks to 3.5 weeks. Initially, patients with a suspicious screening mammography had a 2-3 week delay for diagnostic mammography and the subsequent evaluation took another 3-4 weeks. Both times improved to an average of 2-5 days. Screening cancer detection rates increased from 3.2 per 1,000, to 6.3 per 1,000. In addition, the number of cancers identified by screening increased from 40% to 58%, p = 0.002. Patient satisfaction measured by survey was over 95%, in areas of courtesy, counseling, and overall care. Our study demonstrates that a comprehensive breast center model can increase access to breast care services, improve patient satisfaction and address focal areas of shortage. Furthermore, in the years after the opening of the breast center the cancer detection rate during screening increased, an important observation that needs to be investigated with future studies.

In this article, a general approach based on structured singular value (μ) analysis techniques is proposed for robust stability assessment of large-scale power systems with respect to parameter variations. First, structured singular value theory is utilized to find a linear fractional transformation based uncertainty representation of the system that explicitly captures the effect of uncertain real-valued parameter variations on the linear power system model. Techniques to handle parametric uncertainties occurring simultaneously at several locations in the system are then given, and methods to characterize uncertainty are discussed. The performance robustness of the proposed method is tested on a 6-area, 377-machine model of the Mexican interconnected system. In particular, the developed technique is used to analyze the influence of variations in system operating conditions and uncertainty in the structure of the power system on the stability robustness of two major inter-area modes. Several case...

Introduction About half of patients with acute liver failure (ALF) show clinical signs of cerebral edema and intracranial hypertension. Neuroimaging diagnostics and electroencephalography have poor correlation with intracranial pressure measurement. Objective The objective of this study was to characterize the cerebral hemodynamics patterns with transcranial Doppler (TCD) sonography in patients with ALF. Method We studied 21 patients diagnosed with ALF, admitted to the intensive care unit (ICU) at the Centro de Investigaciones Medico Quirurgicas of Cuba. All of these patients had a TCD performed on arrival at ICU, evaluating the following: systolic (SV), diastolic (DV), and medium (MV) flows velocities and pulsatility index (PI) in right middle cerebral artery (RMCA) via temporal windows. Results The sonographic patterns of cerebral hemodynamics were as follows: low-flow, 12 patients (57.1%); high resistance, 5 patients (23.8%); and hyperemic, 4 patients (19%). Patients who died while waiting had lower MV RMCA (56.1 vs 58.1 cm/s) and higher PI (1.71 vs 1.41) than patients who could undergo transplantation (P = .800 and P = .787, respectively). Conclusions In patients diagnosed with ALF admitted to the ICU the predominating cerebral hemodynamic pattern was low-flow with resistance increase. The TCD was shown to be a useful tool in the initial evaluation for prognosis and treatment.

Background Pathological classification of cervical intraepithelial neoplasia (CIN) is problematic as it relies on subjective criteria. We developed an imaging method that uses spectroscopy to assess the fluorescent intensity of cervical biopsies derived directly from hematoxylin and eosin (H&E) stained tissues. Methods Archived H&E slides were identified containing normal cervical tissue, CIN I, and CIN III cases, from a Community Hospital and an Academic Medical Center. Cases were obtained by consensus review of at least 2 senior pathologists. Images from H&E slides were captured first with bright field illumination and then with fluorescent illumination. We used a Zeiss Axio Observer Z1 microscope and an AxioVision 4.6.3-AP1 camera at excitation wavelength of 450–490 nm with emission captured at 515–565 nm. The 32-bit grayscale fluorescence images were used for image analysis. Results We reviewed 108 slides: 46 normal, 33 CIN I and 29 CIN III. Fluorescent intensity increased progressively in normal epithelial tissue as cells matured and advanced from the basal to superficial regions of the epithelium. In CIN I cases this change was less prominent as compared to normal. In high grade CIN lesions, there was a slight or no increase in fluorescent intensity. All groups examined were statistically different. Conclusion Presently, there are no markers to help in classification of CIN I-III lesions. Our imaging method may complement standard H&E pathological review and provide objective criteria to support the CIN diagnosis.

This paper documents research conducted to investigate the use and tuning of power system stabilizers (PSSs) to improve small-signal dynamic performance of the Mexican interconnected system (MIS). The analysis focuses on the control of a critical inter-area mode associated with the interaction between the southeastern and western regions of the system and a critical local mode. Study results include the determination of critical system modes more controllable by existing PSSs and the use of supplementary control actions to damp low-frequency inter-area modes of oscillation. Results for both, small and large perturbations are presented to illustrate the placement and tuning of PSSs at several appropriate locations throughout the system.

This paper shows the application of methodologies used in the design of control schemes to improve the dynamic behavior of electric power systems. The proposed control schemes protect the electric grid against two instabilities: power oscillations and voltage collapse. In particular, one control scheme is used to protect the electric grid of adverse effects of a major inter area mode and the other control scheme is proposed to avoid voltage collapse on the power system. Time domain simulations are used to assess the protection schemes proposed on a complex power system.

This paper examines the application of structured singular value (SSV) theory to analyse robust stability of complex power systems with respect to a set of structured uncertainties. Based on SSV theory and the frequency sweep method, techniques for robust analysis of large-scale power systems are developed. The main interest is focused on determining robust stability for varying operating conditions and uncertainties in the structure of the power system. The applicability of the proposed techniques is verified through simulation studies on a large-scale power system. In particular, results for the system are considered for a wide range of uncertainties of operating conditions. Specifically, the developed technique is used to estimate the effect of variations in the parameters of a major system intertie on the nominal stability of a critical inter-area mode.

The effects of environment enrichment on motor activity, exploration, and cognitive performances were studied in aged rats. Both nonimpaired (NI) and impaired (I) rats were submitted to daily training in a complex-enriched environment (cEE) for 60 days. Animals were examined at spatial water maze task, passive avoidance test, open-field test, and sensorimotor coordination tasks (bridges test and Marshall scales). At the end of experiments, animals were killed for brain biochemical determinations (gluthatione content and specific-ChAT activity). Results after the first evaluation (before training) corroborate that the aged rat population showed a heterogeneity in behavioral patterns like that observed in humans. Also, cEE modified exploration activity, cognition, motor functions, and biochemical markers in both NI and I groups, but changes reached significant relevance for the last group. It is significant that neurotrophins, "novo" synthesis of neurotransmitters, and oxidative stress levels may mediate the observed changes, indicating that the aged brain still has appreciable plasticity in response to well-manipulated environmental stimulation. Finally, our results also support the novel concepts and programs in prevention/reduction both in incidence/severity and outcome of age-associated neurodegenerative conditions.

Salcedo-Meza, J.R., Castellanos-Molina, R. Garza-Flores, J.D., Tejada-Castaneda, Z.I., Segura-Correa, J.C., Rodriguez-Vazquez, R. and Ku-Vera, J.C. 2004. Effect of dehydrated pig faeces in the ration on rumen degradability, kinetics of passage and in vivo digestibility in Holstein steers. J. Appl. Anim. Res., 25: 109–116. To assess the effect of 20, 25, 30 and 35% dehydrated pig faeces (DPF) in rations based on sorghum and cane molasses four Holstein steers in a 4 x 4 Latin square design were fed 2.6 kg DM/100 kg LW/day. Rumen degradability for DM and OM of DPF among rations did not differ (P>0.05). Potential degradation of DM and CP of sorghum straw was improved (P