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Background: Persistence of a low CD4/CD8 ratio is associated with an increased morbimortality in people living with HIV (PLWH) under effective antiretroviral therapy. We aimed to explore the immunological significance of a persistently low CD4/CD8 ratio, even despite normal CD4 levels, and assess whether these features vary from those associated to a low nadir-CD4, another well-established predictor of disease progression. Methods: CD4-recovered PLWH were classified by CD4/CD8 ratio after three-years of ART (viral suppression, CD4≥500; R 1.2, n = 28). sj/β-TRECs ratio and inflammatory-related markers were quantified. PBMCs were immunophenotyped by CyTOF and functionally characterized by ELISPOT. Subjects were also reclassified depending on nadir-CD4 (N ≤ 350/N > 350). Results: R 1.2 (increased β2-microglobulin, D-dimers and IP-10 before ART). R 350, the main features were altered functional markers in CD4 T-cells, despite no differences in maturational subsets, together with a restricted T-cell cytokine secretion pattern. Conclusion: Persistence of low CD4/CD8 ratio in successfully-treated PLWH, with normal CD4 counts, is associated with baseline inflammation and low thymic function, and it features post-therapy alterations specific to CD8 T-cells. Differently, subjects recovered from low nadir-CD4 in this setting feature post-therapy alterations on CD4 T-cells. Hence, different mechanisms of disease progression could underlie these biomarkers, potentially requiring different clinical approaches.

Introducción: El tratamiento inicial de la tenosinovitis estenosante suele ser conservador. Cuando no hay buena respuesta debe resolverse liberando quirúrgicamente la polea A1, tradicionalmente con liberación abierta (LA), sin embargo, existe la alternativa de la liberación percutánea de la polea A1 guiada por ultrasonido (LPAUS), que ha mostrado similares resultados. Objetivo: Evaluar la eficacia y costos de LPAUS en comparación con la LA en nuestro centro. Método: Se llevó a cabo un estudio retrospectivo en pacientes sometidos a LPAUS. Se obtuvo información sobre escala del dolor, síntomas mecánicos (grados de Quinnell) y discapacidad (QuickDASH) antes y después del procedimiento. Se evaluaron los costos de este y las alternativas de LA. Resultados: Se observó una mejora estadísticamente significativa en dolor, síntomas mecánicos y discapacidad después del procedimiento. No se informaron complicaciones. La LPAUS resultó ser un 63% menos costosa que la alternativa de LA más económica. Conclusión: La LPAUS es una alternativa segura y efectiva para tratar el «dedo opulgar en gatillo», con bajos costos y un periodo de recuperación más corto en comparación con la LA. La LPAUS sedebe considerar como tratamiento inicial cuando otras opciones no han tenido éxito.

Resumen: Objetivos: Conocer las características, indicaciones, mortalidad, tasa de reingresos e identificar factores de riesgo. Material y método: Estudio de cohortes retrospectivo de los pacientes congénitos adultos intervenidos desde 2012 a 2020. Análisis multivariante mediante regresión logística binario. Resultados: Se intervinieron 137 pacientes. Edad media 32 (14-73) años; 39,4% mujeres. Tiempo de circulación extracorpórea de 119,28±67 minutos. Clampaje 78±46,76 minutos. Tasa de mortalidad de 5,8% y de reingreso del 9.95%, siendo las causas: fibrilación auricular, insuficiencia cardiaca e infecciosas. Las indicaciones son: defectos septales (20%), patología aórtica/TSVI (21%), patología del tracto de salida derecho (34%) y afectación de válvulas AV (12%).Según análisis multivariante se asocia a mayor mortalidad la hipertensión pulmonar severa, dos o más intervenciones previas y escala RACHS-1 de 4 (p < 0,05). Mayor probabilidad de reingresos: fibrilación auricular (p = 0,047). Conclusiones: La mortalidad de estos pacientes es baja a pesar de tiempos quirúrgicos altos, mayor complejidad y elevada tasa de reintervención. Hay un porcentaje de reingresos no previstos y complicaciones. Debería validarse una escala de riesgo específica. En general, la información de que se dispone es aún insuficiente. Abstract: Objective: To evaluate surgical results, mortality, readmission rates and identify risk factors. Methods: Retrospective study of all cases from 2012 to 2020. Risk factors were assessed fitting regression logistic models. Results: 137 patients were operated, mean age 37 (14-73), 39,4% female. Mean cardiopulmonary bypass time 119,28±67; aortic cross-clamp time 78±46,76. Mortality was 5.8% and readmission rate 9.95% mainly due to atrial fibrillation, congestive heart failure and infections. Indications were septal defects (20%), aortic and LVOT indications (21%), RVOT procedures (34%) and AV valves disease (12%). Mortality was associated to severe pulmonary hypertension, 2 or more previous cardiac surgery and RASCH-1 score 4. Readmission rate was associated to atrial fibrillation. Conclussions: Although these patients have high complexity, long cardiopulmonary bypass time and high rate of reinterventions, mortality is low. There is a number of readmissions and complications. Specific risk models should be validated. There is still a lack of information.

The advancement of novel water treatment technologies requires the implementation of both accurate data measurement and recording processes. These procedures are essential for acquiring results and conducting thorough analyses to enhance operational efficiency. In addition, accurate sensor data facilitate precise control over chemical treatment dosages, ensuring optimal water quality and corrosion inhibition while minimizing chemical usage and associated costs. Under this framework, this paper describes the sensoring and monitoring solution for a hybrid system based on a cooling tower (CT) connected to mechanical vapor compression (MVC) equipment for desalination and brine concentration purposes. Sensors connected to the data commercial logger solution, Almemo 2890-9, are also discussed in detail such as temperature, relative humidity, pressure, flow rate, etc. The monitoring system allows remote control of the MVC based on a server, GateManager, and TightVNC. In this way, the proposed solution provides remote access to the hybrid system, being able to visualize gathered data in real time. A case study located in Cartagena (Spain) is used to assess the proposed solution. Collected data from temperature transmitters, pneumatic valves, level sensors, and power demand are included and discussed in the paper. These variables allow a subsequent forecasting process to estimate brine concentration values. Different sample times are included in this paper to minimize the collected data from the hybrid system within suitable operation conditions. This solution is suitable to be applied to other desalination processes and locations.

Resumen: Introducción y objetivos: El canal auriculoventricular completo supone el 3% de las cardiopatías congénitas. Su pronóstico depende del estado de la válvula auriculoventricular izquierda post-reparación. Analizaremos nuestros resultados de morbimortalidad y necesidad de reintervención. Métodos: Estudio observacional retrospectivo, incluyendo a los pacientes con canal auriculoventricular completo intervenidos en nuestro centro entre enero de 2008 y julio de 2021. Resultados: Fueron intervenidos 57 pacientes. La mediana de edad y de peso fueron 6 meses y 5,8 kg, respectivamente (rango intercuartil 4-7 meses y 4,8-6,7 kg). La mortalidad hospitalaria fue de 3 pacientes (5,3%). El 7,2% de los pacientes necesitaron reintervención precoz sobre la válvula auriculoventricular izquierda. La supervivencia global fue del 88,6% (seguimiento mediano de 4,7 años [rango intercuartílico: 1,5-10,9]; seguimiento completo en el 93% de los pacientes). La libertad de reintervención sobre la válvula auriculoventricular izquierda fue del 83,7%. La válvula auriculoventricular izquierda presentaba regurgitación menor de III/IV en el 90,2% de los pacientes al final del seguimiento.La intervención antes de 3 meses (p = 0,001), la hipertensión pulmonar preoperatoria (p = 0,007) y la estenosis valvular auriculoventricular izquierda postoperatoria (p = 0,001) fueron factores de riesgo de mortalidad. El peso inferior a 4 kg (p

Los sonidos han jugado un papel importante dentro de la narrativa de las crónicas. Sin embargo, los elementos sonoros a penas y son tomados en cuenta por los historiadores, a pesar de la importancia sensorial que pueden transmitir sobre el paisaje sonoro del campo de batalla. En este sentido, el estudio de caso de la batalla de Crécy (1346) permitirá resaltar la importancia de los elementos sonoros que marcan los tiempos del enfrentamiento.

La trombosis venosa plantar subcutánea (TVPS) es una entidad escasamente descrita y no sospechada clínicamente en los casos reportados. Hasta la fecha la mejor caracterización ha sido descrita en estudios por ultrasonido (US), lo que le confiere a esta herramienta un rol fundamental. Describir la apariencia en US de la TVPS en una serie de casos. Se realizó una revisión retrospectiva para recolectar todos los casos diagnosticados de TVPS en nuestro Picture Archiving Communication System (PACS). Se recabó información por medio del registro clínico y encuesta telefónica. Se realizó además revisión bibliográfica de los casos reportados en PubMed. La serie estuvo compuesta por 5 pacientes de entre 37 y 75 años. Los tamaños de las lesiones fluctuaron entre 3 y 11 mm y todos los casos se presentaron como un nódulo plantar palpable y doloroso. En ningún caso el diagnostico de TVPS fue sospechado antes de la realización del US. La TVPS es una patología no sospechada clínicamente, que se presenta como nódulos plantares palpables habitualmente dolorosos, y cuyos hallazgos al US son característicos, haciéndolo el método de elección para su diagnóstico.

Background: Chronic obstructive pulmonary disease (COPD), usually caused by long-term tobacco smoking, is independently associated with systemic inflammation. However, little is known about the systemic inflammatory status of patients with early-stage COPD (classified as GOLD 1) and long-term smokers with normal lung function (LF). Here, we characterised the early changes in the associated inflammatory state in patients with GOLD 1 and in long-term smokers with normal LF. Methods: Fresh blood samples from 27 patients with GOLD 1, 27 long-term smokers and 14 non-smokers were analysed. Results: Ex vivo blood analysis revealed greater leucocyte-platelet adhesion to TNFα-stimulated pulmonary endothelium in patients with GOLD 1 than in smokers and non-smokers. In addition, platelet reactivity (platelet count and activation, and fibrinogen levels) and the frequency of leucocyte-platelet aggregates were higher in the GOLD 1 group than in the other groups. Some of these findings correlated with the severity of lung dysfunction, while platelet hyperactivity correlated positively with leucocyte-platelet adhesion. The GOLD 1 group also had a higher Th17/Treg ratio and higher circulating levels of IL-17C and C-reactive protein than the other groups. However, long-term smokers also had higher leucocyte counts and activation, and higher plasma levels of TNFα and IL-6 than non-smokers. Conclusion: Our data suggest that the altered inflammatory parameters in longterm smokers may represent early biomarkers of COPD. Accordingly, peripheral immune monitoring based on the above parameters may be useful to prevent disease progression in long-term smokers with normal LF and early COPD. [ABSTRACT FROM AUTHOR]

High‐risk neuroblastoma (NB) patients with 11q deletion frequently undergo late but consecutive relapse cycles with fatal outcome. To date, no actionable targets to improve current multimodal treatment have been identified. We analyzed immune microenvironment and genetic profiles of high‐risk NB correlating with 11q immune status. We show in two independent cohorts that 11q‐deleted NB exhibits various immune inhibitory mechanisms, including increased CD4+ resting T cells and M2 macrophages, higher expression of programmed death‐ligand 1, interleukin‐10, transforming growth factor‐beta‐1, and indoleamine 2,3‐dioxygenase 1 (P

In this paper, we highlight the basic techniques of multivariate statistical process control (MSPC) under the dimensionality criteria, such as Multiway Principal Component Analysis, Multiway Partial Squares, Structuration à Trois Indices de la Statistique, Tucker3, Parallel Factors, Multiway Independent Component Analysis, Multiset Canonical Correlation Analysis, Slow Features Analysis, and Parallel Coordinates. Furthermore, we summarize the procedures of each statistical technique and the usage of multivariate control charts. In addition, we review the most significant proposals and applications in practical cases. Finally, we compare and discuss the benefits and limitations within methods.

Resumen: Introducción y objetivos: La transposición de grandes arterias (D-TGA) es una de las cardiopatías congénitas más frecuentes. La aparición del switch arterial supuso un antes y un después en el manejo de esta patología. Hoy en día es una técnica estandarizada y con excelentes resultados. En este estudio buscamos analizar el estado actual de la cirugía de D-TGA en periodo neonatal mediante revisión de nuestra experiencia. Métodos: Estudio observacional retrospectivo. Se incluyó a los pacientes intervenidos mediante switch arterial en nuestro centro entre enero de 2007 y septiembre de 2020. Resultados: Setenta y cuatro pacientes intervenidos. La mortalidad global fue del 10,8% (15,6% en 2007-2012 y 7,1% en 2013-2020). El 44,6% de los pacientes presentaban D-TGA compleja. La presencia de patrones coronarios anómalos, lesiones asociadas o cirugía tardía no elevó significativamente la mortalidad. El tiempo de estancia en cuidados intensivos y hospitalario (mediana + rango intercuartílico) fue de 10 (7-17) y 20 (14-30) días, respectivamente.Con un seguimiento medio de 5,3 ± 3,75 años, la supervivencia fue del 100%. La supervivencia libre de reintervención fue de 87,6% a 10 años. La tasa de reintervención fue mayor (p < 0,01) en los pacientes con anomalía de Taussig-Bing o coartación de aorta. Conclusiones: El switch arterial se considera de elección para el tratamiento de la D-TGA en periodo neonatal, por sus buenos resultados perioperatorios y a largo plazo. Los pacientes sometidos a esta técnica pueden requerir reintervenciones, fundamentalmente por obstrucción del tracto de salida de ventrículo derecho o patología de la válvula y la raíz neoaórtica. Abstract: Introduction: Transposition of the great arteries (D-TGA) is one of the most common congenital heart diseases. The development of the arterial switch operation supposed a great achivement in the management of this pathology. Today it is a standardized technique with excellent results. In this study we seek to analyze the current status of the surgery for D-TGA in the neonatal period by reviewing our experience. Methods: Retrospective observational study. We included all patients who underwent arterial switch operation in our center between January 2007 and September 2020. Results: 74 patients underwent arterial switch operation. Overall mortality was 10.8% (15.6% in 2007-2012 and 7.1% in 2013-2020). 44.6% of the patients presented complex D-TGA. The presence of abnormal coronary patterns, associated malformations, or late surgery did not significantly increase mortality. The length of stay in ICU and hospital (median + interquartile range) was 10 (7-17) and 20 (14-30) days respectively.During the follow up period (mean follow-up of 5.3 ± 3.75 years) survival rate was 100%. Reoperation-free survival was 87.6% at 10 years. Reoperation rate was higher (p < 0.01) in patients with Taussig-Bing anomaly or coarctation of the aorta. Conclusions: The arterial switch operation is considered of choice for the treatment of D-TGA in the neonatal period, due to its good perioperative and long-term results. These patients may require reinterventions, mainly due to right ventricular outflow tract obstruction and pathology of the neo-aortic valve and root.

Los trastornos pancreáticos, las pancreatitis agudas de etiología biliar son infrecuentes en pediatría y más aún los pseudoquistes pancreáticos, los cuales son colecciones líquidas rodeadas por una cápsula fibrosa sin epitelio, generalmente secundario a una pancreatitis aguda. Presentamos el caso de una paciente femenina de 14 años, con antecedente de pancreatitis aguda de origen biliar hace 10 meses, que presenta dolor abdominal y una masa palpable en epigastrio. Se realizaron estudios imagenológicos, confirmando el diagnóstico de pseudoquiste pancreático y colelitiasis. Se optó por las bondades técnicas y estéticas de la laparoscopía, para esta población. Por lo cual, se realizó una cistogastroanastomosis y colecistectomía laparoscópica, con una evolución favorable. Nosotros reafirmamos que esta técnica, es un método seguro y efectivo, para el manejo de esta patología en pacientes pediátricos, y debería considerarse como primera opción, al no contar con procedimientos endoscópicos. Siendo este, el primer reporte en nuestro medio.

El control estadístico multivariante de procesos para la producción por lotes generalmente toma en consideración características correlacionadas para la inspección del desempeño del proceso. En la literatura, los investigadores han utilizado varias técnicas estadísticas de forma individual para abordar esta inspección durante las fases de control y seguimiento. Nuevas estrategias han explorado la posibilidad de combinar dos técnicas con el fin de optimizar el control y el monitoreo del proceso por lotes, como el enfoque DS-PC. Este enfoque novedoso se refiere al uso de Statis Dual y Coordenadas Paralelas e implica una serie de varios pasos de protocolos y aplicaciones de fórmulas que son propensas a errores y consumen mucho tiempo. Utilizando la metodología que se encuentra en la literatura, el paquete DSPC para R se desarrolló con el objetivo de ofrecer una herramienta simple para realizar el cómputo de Statis Dual rápidamente para las fases de control y seguimiento. Las salidas del paquete ofrecen visualizaciones gráficas para detectar comportamientos inusuales durante la producción a través de gráficos de control IS (Interestructura) y CO (Intraestructura). La salida también incluye el gráfico de coordenadas paralelas. Este paquete será útil para los profesionales interesados en la aplicación del enfoque DS-PC a cualquier industria de proceso por lotes a través de la automatización sugerida por defecto o la opción personalizada. Para familiarizar a los usuarios con esta estrategia, el paquete proporciona un conjunto de datos simulado de fabricación de bolsas de plástico industriales.

The present work describes the effects on iron homeostasis when copper transport was deregulated in Arabidopsis thaliana by overexpressing high affinity copper transporters COPT1 and COPT3 (COPTOE). A genome-wide analysis conducted on COPT1OE plants, highlighted that iron homeostasis gene expression was affected under both copper deficiency and excess. Among the altered genes were those encoding the iron uptake machinery and their transcriptional regulators. Subsequently, COPTOE seedlings contained less iron and were more sensitive than controls to iron deficiency. The deregulation of copper (I) uptake hindered the transcriptional activation of the subgroup Ib of basic helix-loop-helix (bHLH-Ib) factors under copper deficiency. Oppositely, copper excess inhibited the expression of the master regulator FIT but activated bHLH-Ib expression in COPTOE plants, in both cases leading to the lack of an adequate iron uptake response. As copper increased in the media, iron (III) was accumulated in roots, and the ratio iron (III)/iron (II) was increased in COPTOE plants. Thus, iron (III) overloading in COPTOE roots inhibited local iron deficiency responses, aimed to metal uptake from soil, leading to a general lower iron content in the COPTOE seedlings. These results emphasized the importance of appropriate spatiotemporal copper uptake for iron homeostasis under non-optimal copper supply. The understanding of the role of copper uptake in iron metabolism could be applied for increasing crops resistance to iron deficiency.

Abstract Background The role of human papillomavirus (HPV) in orthokeratinized odontogenic cysts (OOCs) has rarely been studied. The objective is to describe the clinicopathological findings in a series of OOCs from a Spanish population that were investigated in relation to the possible presence of HPV. Methods A clinicopathological retrospective analysis followed by a molecular analysis of 28 high- and low-risk HPV genotypes was performed in OOC samples of patients seen during the last 15-years in a Spanish tertiary care center. Results Of 115 odontogenic cysts with keratinization, 16 cases of OOCs were confirmed and evaluated. OOCs occurred predominantly in the mandible of males (mean age 36.06 ± 13.16 years). Swelling of the jaw followed by pain were the most common clinical symptoms, and 56.5% of the OOC cases were associated with an unerupted tooth. After a mean post-cystectomy follow-up of 3.8 years, only one recurrent case was observed, resulting in a verrucous cystic lesion that was considered premalignant after immunohistological examination. DNA extraction was successful from 14 of the 16 OOC cases. None of the primary OCCs or the single recurrent OOC were positive for HPV in the molecular analysis. Conclusions OOCs show a very limited potential for recurrence. Our results suggest that neither high- or low-risk HPV subtypes are likely to play a role in the etiology or neoplastic transformation of OOC, at least in the Spanish population.

Diagnosis testing for primary ciliary dyskinesia (PCD) requires a combination of investigations that includes study of ciliary beat pattern by high-speed video-microscopy, genetic testing and assessment of the ciliary ultrastructure by transmission electron microscopy (TEM). Historically, TEM was considered to be the “gold standard” for the diagnosis of PCD. However, with the advances in molecular genetic techniques, an increasing number of PCD variants show normal ultrastructure and cannot be diagnosed by TEM. During ultrastructural assessment of ciliary biopsies of patients with suspicion of PCD, we observed an axonemal defect not previously described that affects peripheral doublets tilting. To further characterize this defect of unknown significance, we studied the ciliary axonemes by TEM from both PCD-confirmed patients and patients with other sino-pulmonary diseases. We detected peripheral doublets tilting in all the PCD patients, without any significant difference in the distribution of ciliary beat pattern or mutated gene. This defect was also present in those patients with normal ultrastructure PCD subtypes. We believe that the performance of axonemal asymmetry analysis would be helpful to enhance diagnosis of PCD.

Multivariate data collected from batches is usually monitored via control charts (CCs) based on MPCA and MPLS for batch to batch comparison. In addition, distribution free approaches include other dimensionality reduction methods for batch and time-wise analysis. However, techniques for multivariate data focused on variable-wise analysis haven’t been widely developed. Here, we propose a nonparametric quality control strategy for off-line monitoring of batches and variables, besides visual clustering of observations within batches. In our approach, CCs based on Dual STATIS are created using robust bagplots to enhance signal detection in batch and variable-wise analysis, while parallel coordinate plots are used in identification of unusual observations’ behavior per variable, regardless distributional assumptions. This proposed strategy poses the main advantage of detecting different type of changes through meaningful visualization tools, allowing easier interpretation of results in industrial settings.

En este trabajo discutiremos la construcción, uso y funcionamiento de un detector de polaridad electrostática que fue diseñado con el propósito de hacer interesante y entretenida una clase introductoria acerca de la existencia de cargas eléctricas y sus interacciones. El detector de polaridad usa un circuito simple y un diseño que puede imprimirse en una impresora 3D. Así el lector puede armar su propio detector luego de comprar y ensamblar de manera fácil algunos componentes electrónicos de bajo costo. El cuerpo del detector tiene la forma de un tiburón martillo cuyos ojos se encienden de acuerdo al signo de la carga del objeto que se quiere medir. Esta forma divertida de tiburón permite construir actividades entretenidas en donde los estudiantes puedan investigar las propiedades fundamentales de las interacciones entre objetos cargados eléctricamente.

This paper proposes a methodology aiming at determining the most influent working variables and geometrical parameters over the pressure drop and heat transfer during the condensation process of several refrigerant gases using heat exchangers with pipes mini channels technology. A multi-criteria decision making (MCDM) methodology was used; this MCDM includes a mathematical method called SIMUS (Sequential Interactive Modelling for Urban Systems) that was applied to the results of 2543 tests obtained by using a designed refrigeration rig in which five different refrigerants (R32, R134a, R290, R410A and R1234yf) and two different tube geometries were tested. This methodology allows us to reduce the computational cost compared to the use of neural networks or other model development systems. This research shows six variables out of 39 that better define simultaneously the minimum pressure drop, as well as the maximum heat transfer, saturation pressure fluid entering the condenser being the most important one. Another aim of this research was to highlight a new methodology based on operation research for their application to improve the heat transfer energy efficiency and reduce the CO2 footprint derived of the use of heat exchangers with minichannels.

The organic Rankine cycle (ORC) is widely accepted to produce electricity from low-grade thermal heat sources. In fact, it is a developed technology for waste-heat to electricity conversions. In this paper, an ORC made up of super-heater, turbine, regenerator, condenser, pump, economizer and evaporator is considered. An optimization model to obtain the maximum performance of such ORC, depending on the super-heater pressure, is proposed and assessed, in order to find possible new working fluids that are less pollutant with similar behavior to those traditionally used. The different super-heater pressures under analysis lie in between the condenser pressure and 80% of the critical pressure of each working fluid, taking 100 values uniformly distributed. The system and optimization algorithm have been simulated in Matlab with the CoolProp library. Results show that the twelve working fluids can be categorized into four main groups, depending on the saturation pressure at ambient conditions (condenser pressure), observing that the fluids belonging to Group 1, which corresponds with the lower condensing pressure (around 100 kPa), provide the highest thermal efficiency, with values around η=23−25%. Moreover, it is also seen that R123 can be a good candidate to substitute R141B and R11; R114 can replace R236EA and R245FA; and both R1234ZE and R1234YF have similar behavior to R134A.