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We performed a retrospective analysis of the patients assessed at our memory unit for whom Alzheimer disease (AD) cerebrospinal fluid biomarker results were available. We selected patients diagnosed with mild cognitive impairment due to AD (National Institute on Aging-Alzheimer's Association clinical criteria), confirmed neuropsychological deficit, a Global Deterioration Scale score of 3, and an abnormal profile of cerebrospinal fluid biomarkers. Of the 588 cases reviewed, 110 met the inclusion criteria. During follow-up, 50 cases (45.45%) progressed to dementia due to AD. Baseline levels of total and phosphorylated tau were higher in the group of patients that progressed to dementia than in those remaining with mild cognitive impairment. After adjusting for age, sex, history of hypertension, diabetes, and educational level, a 10% increase in total tau protein values was associated with a 7.60% increase in the risk of progression to dementia (hazard ratio: 2.22; 95% confidence interval, 1.28-3.84]; P = .004). Among patients with mild cognitive impairment due to AD and abnormal cerebrospinal fluid biomarker profiles, progressively higher concentrations of total or phosphorylated tau were associated with increased risk of progression to dementia.

Food waste (FW) accounting methodology is of paramount importance in Europe. The European Commission established a common methodology and minimum quality requirements for its measurement. Although these guidelines represents a great advance, important questions as the definition of flows, the Food Supply Chain (FSC) stages considered or the measurement methodology depending on the availability of resources remain open. The study aim is to analyze the implications of these approaches on the FW ratios, based on 109 ratios from different European frameworks obtained by literature review. Among these aspects, the considered FSC stages and the measurement methodology stand out as factors that influence the results; while the direct methods give more accurate values, the indirect methods tend to overestimate the generation. Highlight as significant result, the creation of a superstructure that collects the different approaches used in FW generation ratios and it serves as a tool for benchmarking. This work has been financially supported by the Government of Cantabria R&D project entitled “Obtaining, treatment and dissemination of data related to production and management of waste, and adjustment of the existing indicators system to the valid waste plan of Cantabria”.

Las enfermedades cardiovasculares son la principal causa mundial de mortalidad y México no es la excepción. Los datos epidemiológicos obtenidos en 1990 mostraron que los padecimientos cardiovasculares representaron el 19.8% de todas las causas de muerte en nuestro país; esta cifra se incrementó de manera significativa a un 25.5% para 2015. Diversas encuestas nacionales sugieren que más del 60% de la población adulta tiene al menos un factor de riesgo para padecer enfermedades cardiovasculares (obesidad o sobrepeso, hipertensión, tabaquismo, diabetes, dislipidemias). Por otro lado, datos de la Organización Panamericana de la Salud han relacionado el proceso de aterosclerosis como la primer causa de muerte prematura, reduciendo la expectativa de vida de manera sensible, lo que tiene una enorme repercusión social.Este documento constituye la guía de práctica clínica (GPC) elaborada por iniciativa de la Sociedad Mexicana de Cardiología en colaboración con la Sociedad Mexicana de Nutrición y Endocrinología, A.C., Asociación Nacional de Cardiólogos de México, A.C., Asociación Mexicana para la Prevención de la Aterosclerosis y sus Complicaciones, A.C., Comité Normativo Nacional de Medicina General, A.C., Colegio Nacional de Medicina Geriátrica, A.C., Colegio de Medicina Interna de México, A.C., Sociedad Mexicana de Angiología y Cirugía Vascular y Endovenosa, A.C., Instituto Mexicano de Investigaciones Nefrológicas, A.C. y la Academia Mexicana de Neurología, A.C.; con el apoyo metodológico de la Agencia Iberoamericana de Desarrollo y Evaluación de Tecnologías en Salud, con la finalidad de establecer recomendaciones basadas en la mejor evidencia disponible y consensuadas por un grupo interdisciplinario de expertos. El objetivo de este documento es el de brindar recomendaciones basadas en evidencia para ayudar a los tomadores de decisión en el diagnóstico y tratamiento de las dislipidemias en nuestro país.Este documento cumple con estándares internacionales de calidad, como los descritos por el Instituto de Medicina de EE.UU., el Instituto de Excelencia Clínica de Gran Bretaña, la Red Colegiada para el Desarrollo de Guías de Escocia y la Red Internacional de Guías de Práctica Clínica. Se integró un grupo multidisciplinario de expertos clínicos y metodólogos con experiencia en revisiones sistemáticas de la literatura y el desarrollo de guías de práctica clínica. Se consensuó un documento de alcances, se establecieron las preguntas clínicas relevantes, se identificó de manera exhaustiva la mejor evidencia disponible evaluada críticamente en revisiones sistemáticas de la literatura y se desarrollaron las recomendaciones clínicas. Se utilizó la metodología de Panel Delphi modificado para lograr un nivel de consenso adecuado en cada una de las recomendaciones contenidas en esta GPC.Se consensuaron 23 preguntas clínicas que dieron origen a sus respectivas recomendaciones clínicas.Esperamos que este documento contribuya a la mejor toma de decisiones clínicas y se convierta en un punto de referencia para los clínicos y pacientes en el manejo de las dislipidemias y esto contribuya a disminuir la morbilidad y mortalidad derivada de los eventos cardiovasculares ateroscleróticos en nuestro país.Cardiovascular diseases are the leading cause of mortality worldwide and Mexico is no exception. The epidemiological data obtained in 1990 showed that cardiovascular diseases represented 19.8% of all causes of death in our country. This figure increased significantly to 25.5% for 2015. Some national surveys suggest that more than 60% of the adult population has at least one risk factor for cardiovascular disease (obesity or overweight, hypertension, smoking, diabetes, dyslipidemias). On the other hand, data from the Pan American Health Organization have linked the process of atherosclerosis as the first cause of premature death, significantly reducing life expectancy, which has enormous social repercussions.This document constitutes the Clinical Practice Guide (CPG) prepared at the initiative of the Mexican Society of Cardiology in collaboration with the Mexican Society of Nutrition and Endocrinology, AC, National Association of Cardiologists of Mexico, AC, Mexican Association for the Prevention of Atherosclerosis and its Complications, AC, National Normative Committee of General Medicine, AC, National College of Geriatric Medicine, AC, College of Internal Medicine of Mexico, AC, Mexican Society of Angiology and Vascular and Endovenous Surgery, AC, Mexican Institute of Research Nephrological, AC and the Mexican Academy of Neurology, A.C.; with the methodological support of the Ibero-American Agency for the Development and Evaluation of Health Technologies, in order to establish recommendations based on the best available evidence and agreed upon by an interdisciplinary group of experts. The objective of this document is to provide evidence-based recommendations to help decision makers in the diagnosis and treatment of dyslipidemias in our country.This document complies with international quality standards, such as those described by the Institute of Medicine of the USA, the Institute of Clinical Excellence of Great Britain, the Scottish Intercollegiate Guideline Network and the Guidelines International Network. A multidisciplinary group of clinical experts and methodologists with experience in systematic reviews of the literature and the development of clinical practice guidelines was formed. A scope document was agreed upon, relevant clinical questions were established, the best available evidence critically evaluated in systematic literature reviews was exhaustively identified, and clinical recommendations were developed. The modified Delphi Panel methodology was used to achieve an adequate level of consensus in each of the recommendations contained in this CPG.23 clinical questions were agreed upon which gave rise to their respective clinical recommendations.We consider that this document contributes to better clinical decision-making and becomes a point of reference for clinicians and patients in the management of dyslipidemias and this contributes to reducing the morbidity and mortality derived from atherosclerotic cardiovascular events in our country.

Resumen: Introducción: Apenas conocemos cómo es la asistencia de los recién nacidos (RN) con encefalopatía hipóxico-isquémica (EHI) en hipotermia terapéutica (HT), especialmente si existen protocolos asistenciales, la neuromonitorización que se realiza o cómo es la aproximación al pronóstico neurológico. Este conocimiento permite detectar e implementar áreas de mejora asistencial. Método: Estudio transversal de los 57 hospitales españoles que realizaban HT en 2015, mediante cuestionario sobre: 1) la disponibilidad de protocolos y de recursos tecnológicos; 2) el uso de herramientas de neuromonitorización; 3) los conocimientos de los profesionales; 4) la información pronóstica que se da los padres, y 5) el informe al alta y del plan de seguimiento. Resultados: El 95% utiliza enfriamiento corporal-total servocontrolado y dispone de protocolos específicos de actuación. El 70% utiliza sedación y el 68% deja al paciente a dieta absoluta. La monitorización con electroencefalografía integrada por amplitud se utiliza en más del 80% de los centros, aunque solo en el 50% la enfermera es capaz de interpretarlo. La saturación de oxígeno cerebral es escasamente monitorizada (16%). Entre los estudios diagnóstico-pronósticos, la neuroimagen es universal, pero los neurobiomarcadores apenas se utilizan (29%). Solo el 21% ofrece información pronóstica antes de las 72 h de vida; sin presencia de la enfermera en el 70%. El seguimiento lo realiza el neuropediatra (84%), con una duración desigual entre centros. Conclusiones: La asistencia del RN con EHI en España es adecuada, con áreas de mejora en: neuromonitorización, sedación, marco temporal de la información pronóstica, trabajo en equipo y estandarización de la duración del seguimiento. Abstract: Introduction: There is not much information about the care of infants with hypoxic-ischaemic encephalopathy (HIE) treated with therapeutic hypothermia (TH) in Spain. This includes whether protocols are routinely used, the type of neuro-monitoring performed, and how information on the neurological prognosis is presented to families. The answers to these would allow to detect and implement areas of improvement. Method: A cross-sectional analysis was performed on the responses to structured questionnaires sent to all the Spanish neonatal units that were performing TH in June 2015. Questions were divided into 5 sections: 1) the availability of protocols and technological resources, 2) the use of neuro-monitoring tools, 3) the knowledge and training of the professionals; 4) the prognostic information given to the parents; and 5) the discharge report and the follow-up plan. Results: Most centres (95%) use servo controlled whole-body cooling methods and have specific management protocols. Sedation is used in 70% of centres, and in 68% of them the onset of enteral feeding is delayed until the end of the cooling period. Amplitude-integrated electroencephalography monitoring is used in more than 80% of the centres, although only in 50% are nurses able to interpret it. Cerebral oxygen saturation is not often monitored (16%). As regards diagnostic-prognostic studies, neuroimaging is universal, but brain damage biomarkers are hardly used (29%). Prognostic information is offered within the first 72 posnatal hours in 21% of the centres, and is given without the presence of the nurse in 70% of the centres. Follow-up is performed by a neuro-paediatrician (84%), with an uneven duration between centres. Conclusions: The care of infants with HIE treated with TH in Spain is generally adequate, although there are areas for improvement in neuromonitoring, sedation, prognostic information, teamwork, and duration of follow-up.

The tokamak à configuration variable (TCV) continues to leverage its unique shaping capabilities, flexible heating systems and modern control system to address critical issues in preparation for ITER and a fusion power plant. For the 2019–20 campaign its configurational flexibility has been enhanced with the installation of removable divertor gas baffles, its diagnostic capabilities with an extensive set of upgrades and its heating systems with new dual frequency gyrotrons. The gas baffles reduce coupling between the divertor and the main chamber and allow for detailed investigations on the role of fuelling in general and, together with upgraded boundary diagnostics, test divertor and edge models in particular. The increased heating capabilities broaden the operational regime to include T e/T i ∼ 1 and have stimulated refocussing studies from L-mode to H-mode across a range of research topics. ITER baseline parameters were reached in type-I ELMy H-modes and alternative regimes with ‘small’ (or no) ELMs explored. Most prominently, negative triangularity was investigated in detail and confirmed as an attractive scenario with H-mode level core confinement but an L-mode edge. Emphasis was also placed on control, where an increased number of observers, actuators and control solutions became available and are now integrated into a generic control framework as will be needed in future devices. The quantity and quality of results of the 2019–20 TCV campaign are a testament to its successful integration within the European research effort alongside a vibrant domestic programme and international collaborations.

Transport processes around the magnetic X-point of tokamaks, such as turbulence and mean-field drifts, are scarcely understood. The assessment of the capability of turbulence codes to quantitatively reproduce these dynamics has been hampered by limitations in computational power and available experimental data. In this paper, we present a rigorous validation of full-scale simulations of a newly developed X-point scenario in the basic toroidal plasma device TORPEX, performed with the four state-of-the-art codes FELTOR, GBS, GRILLIX, and STORM. High-resolution Langmuir probe array measurements of various time-averaged and fluctuating quantities and across the entire cross section of TORPEX show that this X-point scenario features the key ingredients of X-point dynamics, such as small-scale fluctuations and background drifts. The codes are able to qualitatively reproduce some characteristics of the time-averaged fields, such as the ion saturation current profiles at mid-height, the plasma up-down asymmetry, and the blob trajectories. A quantitative agreement is found for the background E × B velocity pattern, while the fluctuation levels are generally underestimated typically by factors of 2 or more, and thus, background fluxes are found to dominate over turbulent ones in simulations. The sensitivity of the simulation results on the plasma collisionality and on the position of the sources is tested in GBS, showing a mild effect on the overall quantitative agreement with the experiment. Overall, this validation reveals the challenges to reproduce the plasma dynamics near an X-point and provides a clear path to a quantitative and computationally relatively inexpensive assessment of future developments in turbulence codes.

The separated collection and management of biowaste (BW) must be implemented in next years in the European countries. In order to define a proper BW strategy, it is necessary to estimate the generation at a municipal level, since depending on the amount to be treated, the strategy may notably vary. The aim of this study is to develop a methodology to estimate BW generation at municipal level taking into account the characteristics of the region, the Municipal Solid Waste management applied, and diferent socio-economic variables that defne the level of rurality of a municipality. A model to estimate the BW generation for each type of municipality has been developed using Multiple Linear Regression Analysis. As input data, results from a Waste Compositional Analysis executed by the regional government to samples collected on 38 municipalities and data related to infuential socio-economic variables have been used. Signifcant infuence of socio-economic variables on BW generation is observed for the rural municipalities. The evolution of these characteristics, as well as the greater awareness of society with food waste, have change the consumption patterns. Therefore, it is not recommended to use static ratios, but models that allow including socio-economic changes in the estimation of waste generation. This work has been financially supported by the Government of Cantabria R&D project entitled “Obtention, treatment and dissemination of data related to production and management of waste, and adjustment of the existing indicators system to the valid waste plan of Cantabria”. The public company MARE S.A. has provided the MSW generation data, as well as the WCA characterisations used to develop the statistical modelling

Inflammation in the respiratory tract is thought to worsen the disease response to Mycoplasma bovis infection. This study investigated the cells involved in this response with a focus on proteases and cytokines as harmful effector mechanisms. By immunohistochemistry, Mac387-positive macrophages were the main cell type comprising the foci of caseous necrosis in cattle with M. bovis pneumonia. Thus, the study evaluated how priming of different types of macrophages with bacterial lysate (or pro-inflammatory cytokines induced by the bacterial lysate) affected their responses to M. bovis infection. Inducible responses were detected in monocyte-derived macrophages (M1-MDMs and M2-MDMs), whereas pulmonary alveolar macrophages (PAMs) were minimally affected by priming or infection. M. bovis-infected MDMs secreted MMP-12 and SPLA2, and priming with pro-inflammatory cytokines increased the secretion of cathepsin B in response to M. bovis infection. Of these, there were higher concentrations of cathepsin B and SPLA2 in lungs with M. bovis pneumonia compared to healthy lungs, and these are potential mechanisms for macrophage-induced lung damage in M. bovis infection. Priming of MDMs with either bacterial lysate or with pro-inflammatory cytokines caused an enhanced response to M. bovis infection with respect to IL-8 and IL-1β secretion. The findings of this study suggest proteases, lipases and cytokines derived from monocyte-derived macrophages as possible mediators by which prior inflammation in the respiratory tract worsen disease outcomes from M. bovis infection.

As part of an ongoing divertor upgrade of the TCV tokamak it is planned to add gas baffles to form a divertor chamber of variable closure. The baffles promise to increase the compression of neutral particles in the divertor and, thereby, extend the research on the TCV divertor towards more reactor relevant, highly dissipative divertor regimes. It is foreseen to construct the baffles entirely of polycrystalline graphite that was used for the existing TCV protection tiles. The thermal considerations of the baffle design are based on the heat loads expected during normal operation, where even an extremely large increase in the power carrying plasma channel towards the baffle over the entire 2 seconds duration of a TCV discharge gives no cause for concern. An electromagnetic analysis considers halo currents flowing through the baffles, which can occur during disruptions, as a worst-case scenario. It is found that a halo current of 250 kA results in an average vertical force in the baffles of up to 950 kN/m3. The fixture of the baffle tiles to the vacuum vessel is designed for a maximum tensile stress of 31 MPa and maximum compressive stress of 60 MPa that remains a factor of two below their respective material limits. The obtained results of the thermal, electromagnetic and structural analysis thus validate the proposed baffle design.

Resumen La trascendencia de la museologia relacionada con la anatomia y la anatomia patologica radica tanto en la conservacion de piezas anatomicas naturales o de sus reproducciones, como en la posibilidad de ofrecer un valioso material para fines didacticos e investigadores. Los primeros fundamentos para la ensenanza anatomica fueron los theatrum anatomicum y los «gabinetes anatomicos» de las catedras de anatomia de la facultades de medicina europeas, a los que sucedieron en siglos posteriores los museos anatomicos y anatomopatologicos. Tras una epoca de auge durante el siglo xviii , la mayor parte de ellos sufrieron un proceso de decadencia progresiva que llevo a la perdida de muchos de ellos. En la actualidad se observa un interes creciente en la recuperacion y puesta en valor de estas colecciones. Este trabajo muestra una aproximacion historica de su desarrollo y una revision de la situacion actual de los principales museos de Espana y de Europa.

Resumen El ácido acetilsalicílico (Aspirina) es un inhibidor irreversible de la acetil ciclooxigenasa (COX) y su actividad no es restaurada hasta la formación de nuevas plaquetas. Sus efectos benéficos terapéuticos cardiovasculares lo han convertido en la piedra angular del tratamiento del paciente con enfermedad arterial coronaria. Existe una población de pacientes con indicación absoluta para su uso; sin embargo, la presencia o antecedente de hipersensibilidad a esta molécula conlleva un alto riesgo de complicaciones no relacionadas con enfermedad cardiovascular. En algunos de estos pacientes es crucial conocer e implementar protocolos de desensibilización para el ácido acetilsalicílico y, de esta manera, continuar con el uso de esta estrategia terapéutica necesaria e idónea en esta población. Abstract Acetylsalicylic acid (Aspirin) is an irreversible inhibitor of acetyl cyclooxygenase (COX) and its activity is not restored until new platelets are formed. Its beneficial therapeutic cardiovascular effects have made it the cornerstone of the treatment of patients with coronary artery disease. There is a population of patients with absolute indication for its use, however, the presence or history of hypersensitivity to this molecule leads to a high risk of complications unrelated to their cardiovascular disease. It is vital to know and implement in some of these patients, desensitization protocols for acetyl salicylic acid and in this way to continue the use of this therapeutic strategy necessary and appropriate in this population.

BackgroundIn contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity.Methods and resultsCLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure.Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox proportional hazards model, diabetes was associated with increased risks for the primary outcome (cardiovascular death, myocardial infarction, or stroke) with an adjusted hazard ratio of 1.28 (95% confidence interval 1.18, 1.39) and for all secondary outcomes (all-cause and cardiovascular mortality, myocardial infarction, stroke, heart failure, and coronary revascularization). Differences on outcomes according to geography and ethnicity were modest.ConclusionIn patients with chronic coronary syndromes, diabetes is independently associated with mortality and cardiovascular events, including heart failure, which is not accounted by demographics, prior medical history, left ventricular ejection fraction, or use of secondary prevention medication. This is observed across multiple geographic regions and ethnicities, despite marked disparities in the prevalence of diabetes.ClinicalTrials identifierISRCTN43070564

[EN] In this paper we describe several alternative inline implementations for combline filters with transmission zeros located both below and above the pass-band. A systematic design procedure is also presented using a lumped-element equivalent circuit. Following the design procedure that we propose, up to N+1 transmission zeros can be implemented with an inline filter of order N. The generation of the transmission zeros is explained physically in terms of mixed inductive and capacitive couplings. Several filters are also manufactured and tested. Good agreement between measured and simulated results is demonstrated thereby fully validating the new filter concepts., This work was supported by the Ministerio de Ciencia e Innovacion under Coordinated Project PID2019-103982RB-C41.

The Tokamak à Configuration Variable (TCV) tokamak is in the midst of an upgrade to further its capability to investigate conventional and alternative divertor configurations. To that end, modular and removable gas baffles have been installed to decrease the coupling between the divertor and the plasma core. The baffles primarily seek to suppress the transit of recycling neutrals to closed flux surfaces. A first experimental campaign with the gas baffles has shown that the baffled divertor remains compatible with a wide range of configurations including snowflake and super-X divertors. Plasma density ramp experiments reveal an increase of the neutral pressure in the divertor by up to a factor ×5 compared to the unbaffled divertor and thereby qualitatively confirm simulations with the SOLPS-ITER code that were used to guide the baffle design. Together with a range of new and upgraded divertor diagnostics, the baffled TCV divertor is now used to validate divertor models for ITER and next step devices with particular emphasis on geometric variations.

espanolSegun la prevalencia y el impacto en la salud publica, la toxocariasis es una zoonosis subestimada en los paises en desarrollo y desarrollados. La transmision de Toxocara spp. involucra animales de compania caninos y felinos, como tambien perros y gatos sin hogar (Canis familiaris y Felis catus, respectivamente), que diseminan los huevos del parasito en sus heces al medio ambiente. Uno de los principales factores de riesgo para la infeccion y el desarrollo de la toxocariasis humana es convivir con cachorros felinos y caninos. Durante mucho tiempo, la estrategia preventiva para esta infeccion parasitaria ha sido el uso regular de medicamentos antiparasitarios para reducir la carga parasitaria a corto plazo. Se puede lograr una proteccion inmunologica duradera con la vacunacion, sin embargo, todavia no se dispone de una vacuna. Por lo tanto, es fundamental conocer y comprender el estado del arte del desarrollo de vacunas para el control efectivo de esta zoonosis. Este articulo revisa los estudios experimentales centrados en el desarrollo de vacunas para el control de la toxocariasis, y se presta especial atencion a los estudios epidemiologicos relevantes sobre la importancia de los caninos domesticos en la toxocariasis humana. EnglishBased on prevalence and impact on public health, toxocariasis is an underestimated zoonosis in developing and developed countries. The transmission of Toxocara spp. involves pets, stray dogs and cats (Canis familiaris and Felis catus, respectively), which spread the parasite’s eggs in their feces to the environment. One of the main risk factors for the infection and development of human toxocariasis, is to cohabit with puppies and kittens. For a long time, the preventive strategy for this parasitic infection has been the regular use of antiparasitic drugs to reduce parasite burden in the short term. A long lasting immunological protection can be achieved with vaccination, however, a vaccine is not yet available. Therefore, it is fundamental to know and to understand the state of the art of vaccine development for effective control of this zoonosis. This paper reviews the experimental studies focused on vaccine development for toxocariasis control, and special attention is given to relevant epidemiological studies on the importance of dogs in human toxocariasis. portuguesCom base na prevalencia e no impacto na saude publica, a toxocariase e uma zoonose subestimada nos paises em desenvolvimento e desenvolvidos. A transmissao de Toxocara spp. envolve animais caes e gatos de estimacao e vadios (Canis familiaris e Felis catus, respectivamente), que espalham os ovos do parasita nas fezes para o meio ambiente. Um dos principais fatores de risco para a infeccao e desenvolvimento da toxocariase humana e coabitar com filhotes de cachorros e gatos. Por um longo tempo, a estrategia preventiva para essa infeccao parasitaria tem sido o uso regular de medicamentos antiparasitarios para reduzir a carga parasitaria a curto prazo. Uma protecao imunologica duradoura pode ser alcancada com a vacinacao, no entanto, uma vacina ainda nao esta disponivel. Portanto, e fundamental conhecer e entender o estado da arte do desenvolvimento de vacinas para o controle efetivo dessa zoonose. Este artigo revisa os estudos experimentais focados no desenvolvimento de vacinas para o controle da toxocariase, e atencao especial e dada a estudos epidemiologicos relevantes sobre a importância dos caes na toxocariase humana.

Fast-particle driven Alfvén Eigenmodes have been observed in low-collisionality discharges with off-axis neutral beam injection (NBI), electron cyclotron resonance heating (ECRH) and a reduced toroidal magnetic field. During NBI and ECRH, toroidicity induced Alfvén Eigenmodes (TAEs) appear in frequency bands close to 200 kHz and energetic-particle-induced geodesic acoustic modes (EGAMs) are observed at about 40 and 80 kHz. When turning off ECRH in the experiment, those beam-driven modes disappear which can be explained by a modification of the fast-ion slowing down distribution. In contrast, coherent fluctuations close to the frequency of the beam-driven TAEs are present throughout the experiment. The modes are even observed during ohmic plasma conditions, which clearly demonstrates that they are not caused by fast particles and suggests an alternative drive, such as turbulence. The mode-induced fast-ion transport has been found to be weak and marginal in terms of the fast-ion diagnostic sensitivities. Measurements of the plasma stored energy, neutron rates, neutral particle fluxes and fast-ion D-alpha spectroscopy show good agreement with neoclassical modelling results from TRANSP. This is further supported by a similarly good agreement between measurement and modelling in cases with and without ECRH and therefore with and without the modes. Instead, a significant level of charge exchange losses are predicted and observed which generate a bump-on-tail fast-ion distribution function that can provide the necessary free energy to EGAMs. European Commission 633053

En este articulo se han presentado varios tipos de redes conformadoras de haz, estas propuestas pueden ser utilizadas para una agrupacion de antenas utiles en diversos tipos aplicaciones. El primer diseno corresponde a una Matriz de Butler de 4X4 para una frecuencia de resonancia de 2.45 GHz, dependiendo del puerto por la cual la senal sea excitada, se podra obtener diversas variaciones en fase en los puertos de salida (45°, 135°, -45° y -135°), la matriz de Butler propuesta ha sido optimizada a partir de un esquema de matriz generalizada, reduciendo el tamano a traves de una simple superposicion de multiples lineas de transmision a l/4. El segundo diseno corresponde a una lente de Rotman con una frecuencia de resonancia caracteristica de 5.8 GHz, con un maximo angulo focal de 30°, para este diseno se ha utilizado el concepto de la optica geometrica, y el ultimo diseno ha sido realizado para una frecuencia de 5.8 GHz usando una agrupacion de ranuras disenadas con tecnologia Substrate Integrated Waveguide.

Congenital oculomotor apraxia, also known as Cogan´s syndrome [Cogan-type congenital ocular motor apraxia (COMA, OMIM 257550)], is a rare hereditary disease that affects the eye insofar as it cannot make horizontal movements voluntary. Of unknown etiology, it was described by Cogan in 1952 and, classically considered as a sporadic disease with autosomal dominant inheritance in some cases, and as an indicator of partial metabolic alterations or defects of neurological development in others. We present a newborn with 6q21q22.1 microdeletion, result of gestation after in vitro fertilization, which clinically manifests movement disorders including ataxia and characteristic clinical picture of Cogan´s syndrome (oculomotor apraxia); highlighting microcephaly and peculiar phenotype characterized by small eyes, sparse hair, broad nasal root with epicanthus and hypoplasia of nasal wings. Cerebral ultrasound showed Cysts of the Subependymal. Germinal Matrix. The 6q deletions are infrequent, with around 100 cases described, associated with variable phenotypes, including dysmorphic features, growth retardation, upper limb malformations, and Prader-Willi (PW)-like features; and few of them studied with high resolution cytogenetic techniques. Recently, in the study of three patients (one with ataxia and two with movement disorders), the 6q22.1 region has been proposed as critical (including the MARCKS, HDAC2, and HS3ST5 genes), a region that is also affected in our patient, and correlated with the ataxia phenotype, as the most outstanding data. So, from these results, the genetic heterogeneity of Cogan syndrome is inferred. In this article we also review the bibliography related to oculomotor apraxia associated with other movement disorders such as ataxia.

Resumen Objetivo Conocer la fiabilidad en la interpretacion del electrocardiograma (ECG) por medicos de familia en ejercicio y medicos residentes en periodo de formacion, utilizando para ello la comparacion con la interpretacion realizada por el cardiologo. Material y metodos Estudio observacional. Se incluyeron medicos de familia en ejercicio del Area de Salud de Toledo, medicos internos residentes de Medicina Familiar y Comunitaria y los medicos internos residentes de Cardiologia de los 3 anos iniciales del periodo formativo (R1-R3). Se utilizo un cuestionario con 13 ECG sin datos clinicos del paciente. Los 13 ECG fueron seleccionados y sus diagnosticos consensuados por 2 cardiologos del Complejo Hospitalario de Toledo. Resultados El porcentaje de respuestas correctas mas alto (82,3%) correspondio al ECG 5 (fibrilacion auricular), y el mas bajo (26,5%), al ECG 11 (ritmo de la union). La competencia diagnostica mas alta fue alcanzada por los medicos residentes de Cardiologia, los medicos de familia en ejercicio, los tutores de residentes y los medicos con trabajo en el Servicio de Urgencias del hospital. Los valores mas altos de odds ratio para una mayor competencia diagnostica fueron trabajar en el Servicio de Urgencias y ser medico de familia en ejercicio, ambas con resultados casi significativos (p Conclusiones Los medicos de familia y los medicos residentes tienen un grado de fiabilidad medio en la interpretacion del ECG con relacion al cardiologo.

Resumen Introduccion El IAM es una de las principales causas de muerte en los paises desarrollados. Complicaciones La elevada mortalidad de esta patologia, a su vez, se debe a la frecuente aparicion de complicaciones. Las arritmias en general son las mas frecuentes en la fase aguda, siendo las ventriculares la principal causa de muerte en la fase prehospitalaria. Durante la hospitalizacion y despues de ella, sera sobre todo el grado de disfuncion ventricular y sus consecuencias las que condicionen el pronostico del paciente. Las complicaciones mecanicas, al igual que las anteriores mucho menos frecuentes en la era de la reperfusion precoz, tienen una alta letalidad pero son potencialmente corregibles, por lo que siempre hay que tenerlas en mente ante un paciente que se deteriora hemodinamicamente de forma brusca.

Resumen Objetivo Valorar la contribucion de la PET con 11C-metionina en la diferenciacion precoz entre recurrencia tumoral y radionecrosis en pacientes tratados de gliomas de alto grado. Metodo Treinta pacientes tratados de glioma (grado iii / iv ) con cirugia/radioterapia/quimioterapia (5-18 meses) con RM indeterminada. A todos se les realizo estudio de PET con 11C-metionina ( El manejo de los pacientes se decidio en el comite de neurooncologia: seguimiento clinico-imagen, tratamiento de segunda linea o cirugia. Resultados Veintitres estudios de PET con 11C-metionina fueron visualmente positivos. La morfologia fue: 15 focales, 4 difusos y 4 anulares. Tres de los focales fueron resecados (AP+). En 16 se realizo terapia de segunda linea (11 respuesta, 5 progresion). En los 4 de morfologia anular se decidio seguimiento, con progresion en 2 (verdaderos positivos) y libres de enfermedad en 2 (6 y 7 meses despues) (falsos positivos). Siete estudios de PET con 11C-metionina fueron visualmente negativos, todos ellos libres de enfermedad (3-12 meses). La relacion SUV lesion/fondo en la recurrencia tumoral fue de 2,79 ± 1,35 mientras que en la radionecrosis fue de 1,53 ± 0,39 (p Con umbral de corte SUV lesion/fondo de 2,35 se obtuvo una sensibilidad y especificidad del 90,5 y 100%. Conclusion La valoracion de la PET con 11C-metionina, con analisis visual, cuantitativo y corregistro PET/RM muestra un papel complementario en los pacientes con RM no concluyente, permitiendo una diferenciacion precoz entre recurrencia tumoral y radionecrosis, que ayuda a la individualizacion de la terapia.

Objective To evaluate the contribution of 11 C-Methionine PET in the early differentiation between tumor recurrence and radionecrosis in patients treated for a high grade glioma. Method The study included 30 patients with glioma (III/IV grade) treated with surgery/radiotherapy/chemotherapy (5–8 months) and with an indeterminate MRI. All patients underwent a 11 C-Methione PET (within 15 days of MRI) and studies were visually analyzed (intensity and morphology of uptake), quantified (SUV max/SUV mean background), and coregistered to MRI (3D-Flair). Patient management was decided by the neuro-oncology committee to clinical and imaging follow-up, second-line treatment, or surgery. Results There were 23 11 C-Methionine PET studies visually positive. Morphology of uptake was focal in 15, diffuse in 4, and ring-shaped in 4. Three out of the focal uptake cases underwent resection (Histopathology +). Sixteen underwent second-line therapy (11 responded; 5 progressed). The 4 cases with ring-shaped uptake were followed-up, and progression was found in 2 (true-positive), and disease-free in 2 (follow-up of 6 and 7 months, respectively) (false-positive). Seven out of 11 C-Methionine PET studies were visually negative, and all of them were disease-free (follow-up of 3–12 months). SUV lesion/background was 2.79 ± 1.35 in tumor recurrence, and 1.53 ± 0.39 in radionecrosis ( P Taking into account a SUV lesion/background threshold of 2.35, the sensitivity and specificity values were 90.5% and 100%, respectively. Conclusion Visual analysis, quantitative and PET/MRI coregistration of 11 C-Methionine PET showed their complementary role in patients with indeterminate MRI results, thus allowing early differentiation between tumor recurrence and radionecrosis, and helping in the individual therapy approach.

This paper shows a project that develop a complete system of dielectric property measurements. This system ought to be simple, intuitive, fast, cheap and complete. Moreover, it must show a disruptive value compared to the conventional systems. The system basically consists of two different elements. Firstly, a low-cost vector network analyzer. Secondly, two optimized coaxial probes. Measuring the scattering parameters with a thin sample located between the probes, the dielectric properties of the sample can be calculated. This system has been designed and manufactured, with very promising results. Furthermore, it offers a future line of research. This prototype may become a marketable product.

Currently, companies seek to increase customer satisfaction by offering new interactions with their clients. Among different interactions, retail delivery services, like home delivery or door-to-door delivery, have gained importance in recent years, being now a competitive advantage. However, this interaction is expensive because of the distances that must be traveled, and it could incur in low service levels due to the large number of orders that might not be covered completely. The use of mobile warehouses constitutes a good approach to solve retail delivery logistics problems. Mobile warehouses are vehicles that drive around the city, perform the delivery to the final customer and manage the administrative tasks such as billing and collecting money. This delivery strategy requires to know the number of products that the vehicle should carry in order to satisfy the demand without returning to the distribution center. This study presents a methodology for demand forecasting and inventory management in a mobile warehouse. Different forecasting methods were used, but artificial neural networks showed the best performance to forecast demand using mobile warehouses. Once the demand forecast is determined, a linear programing optimization model is proposed for inventory management with the aim to reduce the total cost of stock out occurrences in terms of traveling distance to the distribution center, time expended, and lost cost sale. A case study from an Ecuadorian company in Quito is presented, in which the number of products that the vehicle should carry is determined minimizing the stock out occurrences.

Conventional assays of polymorphonuclear cell (PMN, neutrophil) function such as oxidative burst (OB) and phagocytosis (PC) are widely used to evaluate innate immunity in the transition period of dairy cows. Oxidative burst is commonly evaluated by measuring PMN median fluorescence intensity (MFI) involving the release of reactive oxygen species after in vitro stimulation. Phagocytosis can be measured by engulfment of fluorescent beads by PMN. DQ-ovalbumin (DQ-OVA) is a molecule suitable for the assessment of intracellular proteolytic degradation, so it might be informative about an additional pathway of pathogen handling by PMN. In this study, we evaluated the use of the DQ-OVA assay for the assessment of PMN function and the relationships among OB, PC, and DQ-OVA results in PMN isolated from blood of dairy cows between 5 and 21 d post partum. Results of the DQ-OVA validation assay were assessed with mixed linear regression models. Pearson correlation tests and kappa values for agreement were used to associate the MFI between each PMN function assay (OB, PC, and DQ-OVA). For the validation assay (9 cows in 3 replicates), PMN incubated with DQ-OVA were stimulated with IFN-gamma or inhibited with cytochalasin D, and fluorescence was compared with untreated PMN. Stimulated and inhibited PMN had greater (970 +/- 160 units) and lesser (593 +/- 55 units) MFI relative to untreated PMN (791 +/- 154 units), respectively, indicating that DQ-OVA fluorescence reflected enhanced or reduced endocytic and proteolytic function. To associate the MFI outcomes among OB, PC, and DQ-OVA, 153 samples from 40 cows were analyzed. Results showed significant, although weak association between DQ-OVA and PC MFI (Pearson r = 0.16). When values of MP! were categorized according to the first ("high" PMN functionality), second and third ("moderate" PMN functionality), or fourth ("low" PMN functionality) quartiles, agreement beyond chance (kappa) was moderate: kappa = 0.38 for DQ-OVA and OB, kappa = 0.43 for DQ-OVA and PC, and kappa = 0.43 for OB and PC. The DQ-OVA assay may complement traditional PMN functional assays because it provides additional information regarding the combination of endocytosis and proteolytic degradation, but it is not a substitute for assessment of OB or PC.

The different types of viral meningitis constitute a condition that is relatively frequent in newborn infants, although in many cases they are underdiagnosed due to the absence of pleocytosis in the cerebrospinal fluid (CSF).To describe the clinical features and laboratory findings of newborn infants with viral meningitis and to highlight the importance of the polymerase chain reaction (PCR) in the CSF to diagnose this condition.A retrospective review of the medical records of newborn infants hospitalised in the neonatology section who had been diagnosed with viral meningitis between May 2014 and May 2017.Altogether 17 cases of viral meningitis were registered (15 caused by enterovirus and two due to parechovirus), which accounts for 14.8% of all newborns hospitalised owing to febrile symptoms. All of them had fever (100%), and other notable symptoms were irritability (76%) and rejection of feeding (65%). Normal cellularity was found in the CSF without high protein levels in 88% of them, and without hypoglycorrhachia in all of them (100%), which meant that many of these children had previously been left with a diagnosis of a febrile syndrome with no focus. These data stress the need to perform the PCR in the CSF of newborn infants who have a fever without a focus, due to the normal status of the results of the complementary tests in most cases. Subsequent neurological follow-up was performed in 64.7% of the children in the neurology service, without any neurological sequelae being found, except in one case.Multiple PCR in the CSF has become an essential diagnostic technique in cases of newborn infants with a suspected infection, and replaces viral culture as the reference test due its being quicker and more sensitive.Meningitis viricas neonatales. Importancia de la reaccion en cadena de la polimerasa en su diagnostico.Introduccion. Las meningitis viricas representan una entidad relativamente frecuente en los recien nacidos, aunque en muchos casos infradiagnosticadas, ante la ausencia de pleocitosis en el liquido cefalorraquideo (LCR). Objetivos. Describir las caracteristicas clinicas y los hallazgos de laboratorio de neonatos con meningitis viricas y destacar la importancia de la reaccion en cadena de la polimerasa (PCR) en el LCR para diagnosticar esta patologia. Pacientes y metodos. Revision retrospectiva de historias clinicas de neonatos ingresados en la seccion de neonatologia diagnosticados de meningitis virica entre mayo de 2014 y mayo de 2017. Resultados. Se registraron 17 casos de meningitis virica (15 causadas por enterovirus y dos por parechovirus), que constituyen el 14,8% de los neonatos ingresados por sindrome febril. Todos manifestaron fiebre (100%), y otros sintomas destacados fueron irritabilidad (76%) y rechazo de la ingesta (65%). El 88% curso con celularidad normal en el LCR y sin hiperproteinorraquia, y el 100%, sin hipoglucorraquia, por lo que previamente muchos de estos niños quedaban con el diagnostico de sindrome febril sin foco. Estos datos resaltan la necesidad de realizar la PCR en el LCR a neonatos con fiebre sin foco, debido a la normalidad de las pruebas complementarias en la mayoria de los casos. El 64,7% de los niños recibio seguimiento neurologico posterior en consulta de neurologia, sin objetivarse secuelas neurologicas, salvo en uno de ellos. Conclusiones. La PCR multiple en el LCR se ha convertido en una tecnica diagnostica imprescindible en el recien nacido con sospecha de infeccion y sustituye al cultivo viral como prueba de referencia por su mayor rapidez y sensibilidad.

Resumen Introduccion La correcta peticion e interpretacion de pruebas diagnosticas en pacientes con sindrome coronario agudo (SCA) es vital para establecer un diagnostico rapido y certero, asi como para obtener informacion pronostica del mismo. Pruebas El electrocardiograma (ECG) de 12 derivaciones es la primera y principal prueba diagnostica que tenemos que realizar, dentro de los 10 primeros minutos desde el contacto con el paciente, ya que nos aportara la informacion mas relevante y la estrategia inmediata a seguir; asi mismo, la determinacion de marcadores de necrosis miocardica nos ayudara en el diagnostico y en la estratificacion pronostica, facilitandonos la toma de decisiones.

Osteoarthritis (OA) is a chronic joint disease afflicting a substantial portion of the world's population with no currently available cure. Mesenchymal stem cell (MSC)-based therapies have been observed to have a mild beneficial effect in OA but the mechanism behind their action remains unclear. This study aimed to identify the lymphocytic response to a xenogeneic human umbilical cord-derived MSC-based cell therapy. A unilateral medial meniscal release model was employed in an ovine model of post-traumatic OA, with the contralateral limb employed as the control. A dose of 1.0 × 107 MSCs was administered to a subset of the OA group as well as to a normal sham-operated group. Synovial fluid was aspirated periodically for 13 weeks for flow cytometry analysis. At the termination of the study the stifle joints were collected and analyzed for potential pathologic changes. Cell therapy induced a transient influx of CD4+ leukocytes; there was a similar significant increase in the proportion of CD4+CD25+ and CD4+CD25hi leukocytes in response to cell therapy, the latter being a subset that may be composed of regulatory T cells. There was no significant effect of the cell therapy treatment on the proportion of synovial fluid-derived CD8+ cells or BAQ44A+ B cells. iNOS expression of intimal lining macrophages was evident but reduced in the cell therapy OA group suggesting macrophage phenotype transformation. There were no inflammatory or histological changes that could be attributed to the cell therapy. Cell therapy induced chemotaxis of CD4+ cells to the joint but these cells were not associated with pathological changes, despite their expression of activation markers (CD25+).