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A superelliptic curve over a discrete valuation ring $\mathscr{O}$ of residual characteristic p is a curve given by an equation $\mathscr{C}\;:\; y^n=\,f(x)$ , with $\textrm{Disc}(\,f)\neq 0$ . The purpose of this article is to describe the Galois representation attached to such a curve under the hypothesis that f(x) has all its roots in the fraction field of $\mathscr{O}$ and that $p \nmid n$ . Our results are inspired on the algorithm given in Bouw and WewersGlasg (Math. J.59(1) (2017), 77–108.) but our description is given in terms of a cluster picture as defined in Dokchitser et al. (Algebraic curves and their applications, Contemporary Mathematics, vol. 724 (American Mathematical Society, Providence, RI, 2019), 73–135.).

Objective There is controversy regarding the significance of radiological consolidation in the context of COPD exacerbation (eCOPD). While some studies into eCOPD exclude these cases, consolidation is a common feature of eCOPD admissions in real practice. This study aims to address the question of whether consolidation in eCOPD is a distinct clinical phenotype with implications for management decisions and outcomes. Patients and Methods The European COPD Audit was carried out in 384 hospitals from 13 European countries between 2010 and 2011 to analyze guideline adherence in eCOPD. In this analysis, admissions were split according to the presence or not of consolidation on the admission chest radiograph. Groups were compared in terms of clinical and epidemiological features, existing treatment, clinical care utilized and mortality. Results 14,111 cases were included comprising 2,714 (19.2%) with consolidation and 11,397 (80.8%) without. The risk of radiographic consolidation increased with age, female gender, cardiovascular diseases, having had two or more admissions in the previous year, and sputum color change. Previous treatment with inhaled steroids was not associated. Patients with radiographic consolidation were significantly more likely to receive antibiotics, oxygen and non-invasive ventilation during the admission and had a lower survival from admission to 90-day follow-up. Conclusions Patients admitted for COPD exacerbation who have radiological consolidation have a more severe illness course, are treated more intensively by clinicians and have a poorer prognosis. We recommend that these patients be considered a distinct subset in COPD exacerbation.

Even for modern robot attached gripping solutions, surface-sensitive object handling remains a challenge. A minimal gripping force is required to grip and handle a surface-sensitive object safely. At the same time, this gripping force should not exceed a certain level to avoid damaging the sensitive surface of the object. Because of this, it is necessary to determine the mostly small range of optimal gripping forces to ensure a safe handling. Therefore, this paper describes an approach to evaluate this range of gripping forces for surface-sensitive objects using by means of chocolate covered marshmallows. For this purpose, a test bench with the same characteristics as a planned gripper is developed. Throughout the project, this planned gripper will be controlled with the help of the detected range of gripping forces. In addition to these static measurements, it is planned, that the gripper will calculate the handling speeds, accomplished by a six-axis industrial robot, with its acceleration forces. The achieved results of this paper will be the starting point for the upcoming measurements with the robot. Furthermore, the influence of the temperature on the range of gripping forces was evaluated, to show the relevance of consistent environmental conditions for the handling of surface-sensitive objects.

Even for modern robot attached gripping solutions, sensitive object handling remains a challenge. Available gripping devices tend to only focus on the gripping process consisting of grasping and releasing. This approach neglects the forces that are applied to the product during transit. This yields the problem of damaging the product by the robot’s acceleration. In order to automate those processes, or reduce cycle time, it is necessary to develop a sensitive gripping system. It has to be capable of adjusting to the circumstances of the process and the object by reducing the total force applied to the object-specific maximum. Therefore, this paper describes an approach for the flexible and continuously controlled handling of sensitive objects via cyberphysical gripping system.

Resumen Introduccion Las normativas internacionales y espanolas recomiendan el tratamiento intensivo de la tuberculosis (TB) con cuatro farmacos. El objetivo es determinar si en Espana se sigue esta recomendacion y los factores asociados a utilizar tres farmacos (pauta estandar sin etambutol). Metodologia Estudio multicentrico descriptivo, retrospectivo, en el que se analizaron los datos de los pacientes diagnosticados de TB en practicamente todas las Comunidades Autonomas espanolas entre 2007 y 2012. El estudio de factores asociados a prescribir tres farmacos se baso en regresion logistica, calculandose las odds ratio (OR) y sus correspondientes intervalos de confianza del 95% (IC). Resultados Se incluyeron 3.189 pacientes, de los que 1.413 (44,3%) fueron tratados con tres farmacos. Este porcentaje fue del 41,2% en los pacientes con baciloscopia positiva, del 36,1% en los que tenian al menos resistencia a un farmaco, del 31,4% en los que tenian infeccion por VIH y del 24,8% en los inmigrantes. Los factores asociados al uso de tres farmacos fueron: ser mujer (OR = 1,18; IC: 1,00-1,39); ser autoctono (OR = 3,09; IC: 2,58-3,70); estar jubilado (OR = 1,42; IC: 1,14-1,77); vivir sin techo (OR = 3,10; IC: 1,52-6,43), vivir solo (OR = 1,62; IC: 1,11-2,36) o en familia (OR = 1,97; IC: 1,48-2,65); ser atendido por especialistas de zona (OR = 1,37; IC: 1,10;1,70); no estar infectado por el VIH (OR = 1,63; IC: 1,09-2,48) y tener baciloscopia negativa con cultivo positivo (OR = 1,59; IC: 1,25-2,02). Conclusiones Existe una proporcion importante de tratamiento intensivo con tres farmacos. Se deben seguir las recomendaciones del tratamiento de la TB, tanto en la practica clinica habitual como por parte del Plan para la Prevencion y Control de la TB en Espana.

There is a high demand for the automated handling of sensitive objects, e.g. pressure-sensitive pastries, fruit or sensitive cell material. However, easy-touse and flexible solutions for an automated handling of such objects are not available yet. Furthermore, the forces and torques are only considered during the grab or release process. Current methods do not support a complete monitoring of the forces and torques nor the dynamic behavior of the object during the entire handling process. The paper describes an approach for a continuously controlled handling of sensitive objects. It introduces a concept for an overall control of the handling device as well as a concept for the design of a gripping module.

La globalización financiera ha exigido la implementación de estándares de información promovidos desde las organizaciones internacionales reguladoras, tales como el IASC, que inicialmente emitió las normas internacionales de contabilidad (NIC) y, luego se reconfiguro como el IASB, pasando a emitir las Normas Internacionales de Información Financiera (NIIF). A pesar de que estas normas rigen, en gran parte, a las empresas cuyas acciones se transan en la bolsa de valores; el IASB estableció una versión simplificada para las pequeñas y medianas empresas (Pymes), las cuales predominan en el universo empresarial colombiano y exhiben una dinámica distinta a las grandes firmas y a aquellas empresas que fueron clasificadas dentro del Grupo 2. En las empresas de Tunja el proceso de adopción ha sido lento. Situación que se atribuye a la poca importancia que se le otorga a la estandarización financiera para el buen funcionamiento en la PYMEs. Por ello, los diversos actores involucrados en este proceso, en particular, las instituciones académicas, deben proporcionar el conocimiento pertinente para definir e implantar una estrategia global viable y exitosa, integrada por tres etapas (sensibilización, aprendizaje compartido, e implementación compartida), que contribuya a consolidar estas empresas como entes competitivos en el medio local.

Objective: To analyse direct and indirect costs of tuberculosis (TB) diagnosis and treatment and factors associated with those costs. Methods: All TB patients diagnosed and registered in a database at national level within the Integrated Research Project on Tuberculosis of the Spanish Society of Pneumology and Thoracic Surgery between September 2014 and September 2015 were included. We calculated direct costs (hospital stays, visits, diagnostic tests, treatment), and the resulting indirect costs of absenteeism and lost of productivity, contact tracing and rehabilitation measures. All costs were compared according to the following variables: age, gender, immigration, microbiological results, treatment, directed observed therapy (DOT), place where the process started (inpatient or outpatient) and days of absenteeism. For the statistical analysis, chi square test and logistic regression analysis were used. Results: 319 patients were included with a mean age of 56.72 ± 20.79 years. The average cost per patient was 10.262,62 ± 14,961,66 €., and increased significantly in the presence of hospital admission, thoracic CT, pleural biopsy, drug treatment extended over nine months, DOT and absenteeism. In multivariate analysis hospitalization: OR= 9,68 (CI 2,9-47,2) p Conclusion: Tuberculosis carries significant health spending, and it would be advisable to prevent the disease and to reduce hospitalizations trying to reduce costs. Supported by Grant SEPAR 136/2013.

Background: To validate the Test of Adherence to Inhalers' (TAI), a 12-item questionnaire designed to assess the adherence to inhalers in patients with COPD or asthma. Methods: A total of 1009 patients with asthma or COPD participated in a cross-sectional multicenter study. Patients with electronic adherence 80% were defined as adherents. Construct validity, internal validity, and criterion validity were evaluated. Self-reported adherence was compared with the Morisky-Green questionnaire. Results: Factor analysis study demonstrated two factors, factor 1 was coincident with TAI patient domain (items 1 to 10) and factor 2 with TAI health-care professional domain (items 11 and 12). The Cronbach's alpha was 0.860 and the test-retest reliability 0.883. TAI scores correlated with electronic adherence (=0.293, p=0.01). According to the best cut-off for 10 items (score 50, area under the ROC curve 0.7), 569 (62.5%) patients were classified as non-adherents. The non-adherence behavior pattern was: erratic 527 (57.9%), deliberate 375 (41.2%), and unwitting 242 (26.6%) patients. As compared to Morisky-Green test, TAI showed better psychometric properties. Conclusions: The TAI is a reliable and homogeneous questionnaire to identify easily non-adherence and to classify from a clinical perspective the barriers related to the use of inhalers in asthma and COPD., This study was funded by the Integrated Research Asthma Program (PII Asthma) together with the Integrated Research COPD Program (PII COPD) of the Spanish Respiratory Society (SEPAR). Unconditional funding was provided by Chiesi, who did not participate in data collection, interpretation of the results, or writing of the manuscript.

Latent infection with Mycobacterium tuberculosis is defined by a positive IFN-γ release assay (IGRA) result in the absence of active tuberculosis. Only few, mostly monocentric studies have evaluated the role of IGRAs to predict the development of tuberculosis in recent contacts in low-incidence countries of tuberculosis.To analyze IGRA results and the effect of preventive chemotherapy on tuberculosis progression rates among recent contacts.Results from contact investigations at 26 centers in 10 European countries including testing for latent infection with M. tuberculosis by the QuantiFERON-TB Gold In-Tube (QFT) test or the T-SPOT.TB (TSPOT) were prospectively collected and analyzed.Among 5,020 contacts of 1,023 index cases, 25 prevalent secondary cases were identified at screening. Twenty-four incident cases occurred among 4,513 contacts during 12,326 years of cumulative follow-up. In those with a positive IGRA result, tuberculosis incidence was 0.2 (QFT) and 0 (TSPOT) per 100 patient-years when contacts received preventive chemotherapy versus 1.2 (QFT) and 0.8 (TSPOT) per 100 patient-years in those not treated (38 and 37 patients needed to be treated to prevent one case, respectively). Positive and negative predictive values were 1.9% (95% confidence interval [CI], 1.1-3.0) and 99.9% (95% CI, 99.7-100) for the QFT and 0.7% (95% CI, 0.1-2.6) and 99.7% (95% CI, 99.1-99.9) for the TSPOT.Tuberculosis rarely developed among contacts, and preventive chemotherapy effectively reduced the tuberculosis risk among IGRA-positive contacts. Although the negative predictive value of IGRAs is high, the risk for the development of tuberculosis is poorly predicted by these assays.

Background The objectives of this study were to characterize blood pressure (BP) in acute ischemic stroke and to determine its relationship with short-term functional outcome. Methods We examined 24-h BP recordings in 434 patients with ischemic stroke (lacunar stroke [LS], n = 205; non-lacunar stroke [NLS], n = 229) and in 178 normotensive subjects. Stroke severity was evaluated by the National Institutes of Health Stroke Scale (NIHSS). Patients found to be hypertensive on BP recordings on day 1 were given captopril or amlodipine. The primary outcome was both moderate-to-severe disability (Rankin scale scores 4 to 6) on day 7 or death during hospital stay. Results Patients with LS and NLS had significantly higher systolic BP (SBP) and diastolic BP levels than control subjects. On day 1, patients with NLS showed significantly higher NIHSS scores, SBP, and heart rate (HR) levels than LS patients. In the multivariate analysis, combined death or dependency was associated with NIHSS score (odds ratio [OR] = 1.08 per 1-point increase, 95% confidence interval [CI] = 1.04 to 1.13), 24-h SBP >160 mm Hg (OR = 2.35, 95% CI = 1.10 to 5.52), and plasma glucose levels >125 mg/dL on admission (OR = 1.88, 95% CI =1.03 to 3.57), whereas a decrease in SBP on day 7 (OR = 0.46, 95% CI = 0.24 to 0.88) was associated with better short-term outcome. Conclusions At presentation, NLS patients showed higher BP levels than LS patients. Moderate reductions in BP during the first week after admission were associated with short-term functional improvement in patients with acute ischemic stroke.

A set of topological descriptors has been used to discriminate between antibacterial and nonantibacterial drugs. Topological descriptors are simple integers calculated from the molecular structure represented in SMILES format. The methods used for antibacterial activity discrimination were linear discriminant analysis (LDA) and artificial neural networks of a multilayer perceptron (MLP) type. The following plot frequency distribution diagrams were used: a function of the number of drugs within a value interval of the discriminant function and the output value of the neural network versus these values. Pharmacological distribution diagrams (PDD) were used as a visualizing technique for the identification of antibacterial agents. The results confirmed the discriminative capacity of the topological descriptors proposed. The combined use of LDA and MLP in the guided search and the selection of new structures with theoretical antibacterial activity proved highly effective, as shown by the in vitro activity and toxicity assays conducted.

We report the case of a woman, with severe respiratory impairment as a debut of acute myeloid leukemia who suspecting a pulmonary leukostasis, leukoapheresis was applied.

To determine if gender and age are associated with differences in mortality in patients requiring critical care.Retrospective analysis of prospectively collected data over 6 consecutive years.Polyvalent intensive care unit (ICU) of a tertiary hospital in the Canary Islands.Adult patients who were hospitalized in the ICU, divided on the basis of gender and age (oror=65 years).Demographic and clinical diagnosis data on ICU admission, APACHE II, days of mechanical ventilation, days of renal replacement therapy (RRT) and the mortality were collected.During the study period, 3786 patients were admitted to the ICU, 66.7% male and 2469 (65.2%)65 years. Mortality in the ICU of the coronary group was greater in women (11.1% vs 6.7%; p=0.02), even though there were no significant differences between both genders in the APACHE II (p=0.56). No statistically significant differences were found according to gender in age (oror=65 years), in the APACHE II, or in the need for mechanical ventilation or renal replacement therapy as well as in the ICU mortality. We also found no differences in the mortality between the diagnostic groups and gender even when the APACHE II was significantly greater on admission, as occurred for the women65 years of the coronary and traumas group and for women with surgeryor=65 years.No significant differences were demonstrated in the outcome in relationship with gender except for in the coronary group in which mortality was greater in women. Age above or below 65 years had no influence on mortality in our patients.

Objetivo. Determinar si la edad y el sexo tienen relación con diferencias en la mortalidad de los pacientes ingresados en la unidad de cuidados intensivos (UCI). Diseño. Estudio retrospectivo de datos recogidos prospectivamente durante 6 años consecutivos. Ámbito. UCI polivalente del Hospital Universitario Insular de Gran Canaria. Pacientes. Todos los pacientes ingresados en la UCI, diferenciados según el sexo y la edad < o ≥ 65 años. Principales variables de interés. Se recogieron datos demográficos y diagnósticos de los pacientes al ingreso, el APACHE II, los días que precisaron de ventilación mecánica y depuración extrarrenal y la mortalidad. Resultados. Durante el período de estudio ingresaron 3.786 pacientes en la UCI, de éstos. 2.526 (66,7%) eran varones y 2.469 (65,2%), menores de 65 años. La mortalidad en UCI del grupo con trastornos coronarios fue mayor en las mujeres (el 11,1 frente al 6,7%; p = 0,02), a pesar de que no había diferencias significativas entre ambos sexos en el índice de gravedad APACHE II (p = 0,56). No encontramos diferencias significativas entre los sexos, según la edad < o > 65 años, en el APACHE II, la necesidad de ventilación mecánica o depuración extrarrenal ni en la mortalidad en la UCI. Tampoco encontramos diferencias en la mortalidad entre los grupos diagnósticos y el sexo, a pesar de tener incluso un APACHE II al ingreso significativamente mayor, como era el caso de las mujeres menores de 65 años del grupo con trastornos coronarios y traumatismos, y las mujeres del grupo quirúrgico de 65 años o más. Conclusiones. No hemos demostrado diferencias en el pronóstico relacionadas con el sexo, salvo en el grupo de trastornos coronarios, donde la mortalidad es mayor en las mujeres. La edad mayor o menor de 65 años no ha influido en la mortalidad de nuestros pacientes.

To analize results and late complications in patients with vesicoureteral reflux, treated by endoscopic treatment and with several substances.In a long bibliographic review we analize results, recurrences and late complications with this treatment using different substances.In spite of the prescribed substance, VUR may recur several years after treatment. These cases are of low grade and most disappear after a new session of ET VUR can also appear in the other side, not knowing in fact why this happens. Grade IV -V reflux, and also VUR secondary to organic and functional pathology, can be resolved by endoscopic treatment, although the percentage of good results is lower. Parents have to be informed, in detail, of the three therapeutic options for reflux, (medical, endoscopic, and open surgery), and participate in the final decision. Parents use to prefer ET. According to the number of patients treated by ET and the number of follow-up years that possible side effects have been observed, most authors consider that ET is a safe treatment, and it is currently the treatment of choice for patients with reflux.

Amiodarone is an effective anti-arrhythmic agent. However, during long-term therapy, patients can develop severe adverse pulmonary reactions that are potentially life-threatening. A case of amiodarone-induced pulmonary toxicity is presented in a 78-year-old woman. She developed dyspnea and a pulmonary mass with associated multiple lung nodules mimicking a lung cancer following 5 years of treatment with amiodarone for atrial fibrillation. After drug withdrawal, and without any additional treatment, clinical and radiological improvement was observed, and radiological findings resolved completely within 6 months.

Duhamel's dorsal preputioplasty is frequently performed for the treatment of phimosis in infants because it prevents preputial resection. However, its simplicity does not exempt it from complications. An excessive ventral foreskin observed in some cases leads to esthetically unsatisfactory results. This can be corrected by Lemahud's (the converse of Duhamel) technique for preputial repair or by circumcision with excision of the redundant skin. Lemahud's foreskinplasty is indicated in those cases in which partial coverage of the glans is desired.

The creation of a surveillance system allowing the study of the evolution of the tendency of influenza and act as an alert system for undertaking control measures is necessary due to the great variability characteristic of the circulation of influenza virus. The Madrid Influenza Surveillance Group was therefore designed. The activity carried out during its first five years of existence is evaluated.The field work of the Group is based on the clinical study of patients with influenza, among which some are selected for virologic study with the aim to isolate and characterize the circulating virus. The data obtained by the work group itself are used as the dates of the System of Obligatory Disease Declaration and the System of Microbiologic Information as epidemiologic support to define the outbreaks observed.All the virus isolated were similar to those recommended by the World Health Organization for their inclusion in anti-influenza vaccination, with their circulation being largely reproduced throughout Europe. In three of the five seasons studied the type A virus prevailed leading to earlier outbreaks and a greater number of cases than in the two seasons with type B prevalence.The circulation of the influenza virus in Madrid coincides with that of the rest of Spain at both the maximum peak and relative incidence as well as the type of prevailing virus. The minor circulation detected by the Madrid Group is in concordance with the data provided by the other autonomic communities.

Backgrounds: AUDIPOC is a nationwide clinical audit that describes the characteristics, interventions and outcomes of patients admitted to Spanish hospitals because of an exacerbation of chronic obstructive pulmonary disease (ECOPD), assessing the compliance of these parameters with current international guidelines. The present study describes hospital resources, hospital factors related to case recruitment variability, patients' characteristics, and adherence to guidelines. Methodology/Principal Findings: An organisational database was completed by all participant hospitals recording resources and organisation. Over an 8-week period 11,564 consecutive ECOPD admissions to 129 Spanish hospitals covering 70% of the Spanish population were prospectively identified. At hospital discharge, 5,178 patients (45% of eligible) were finally included, and thus constituted the audited population. Audited patients were reassessed 90 days after admission for survival and readmission rates. A wide variability was observed in relation to most variables, hospital adherence to guidelines, and readmissions and death. Median inpatient mortality was 5% (across-hospital range 0-35%). Among discharged patients, 37% required readmission (0-62%) and 6.5% died (0-35%). The overall mortality rate was 11.6% (0-50%). Hospital size and complexity and aspects related to hospital COPD awareness were significantly associated with case recruitment. Clinical management most often complied with diagnosis and treatment recommendations but rarely (, This work was supported by Fondo de Investigacion Sanitaria (FIS), Instituto de Salud Carlos III, Ministerio de Ciencia e Innovacion (PI 08/90129, PI 90486, PI08/90578, PI 07/90503, PI 08/90251, PI 07/90516, PI 08/90529, PI 07/90309, PI 08/90457, PI 08/90129, PI 07/90721, PI 08/90550, PI08/90447, PI07/90403, PI 08/90486), Spanish Respiratory Society (SEPAR) and CIBER de Enfermedades Respiratorias (CIBERES). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.