The COPD control panel: towards personalised medicine in COPD

Background Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease whose assessment and management have traditionally been based on the severity of airflow limitation (forced expiratory volume in 1 s (FEV1)). Yet, it is now clear that FEV1 alone cannot describe the complexity of the disease. In fact, the recently released Global Initiative for Chronic Obstructive Lung Disease (GOLD), 2011 revision has proposed a new combined assessment method using three variables (symptoms, airflow limitation and exacerbations). Methods Here, we go one step further and propose that in the near future physicians will need a"control panel" for the assessment and optimal management of individual patients with complex diseases, including COPD, that provides a path towards personalised medicine. Results We propose that such a"COPD control panel" should include at least three different domains of the disease: severity, activity and impact. Each of these domains presents information on different"elements" of the disease with potential prognostic value and/or with specific therapeutic requirements. All this information can be easily incorporated into an"app" for daily use in clinical practice. Conclusion We recognise that this preliminary proposal needs debate, validation and evolution (eg, including"omics" and molecular imaging information in the future), but we hope that it may stimulate debate and research in the field.

Identification and prospective validation of clinically relevant chronic obstructive pulmonary disease (COPD) subtypes.

Background Chronic obstructive pulmonary disease (COPD) is increasingly considered a heterogeneous condition. It was hypothesised that COPD, as currently defined, includes different clinically relevant subtypes. Methods To identify and validate COPD subtypes, 342 subjects hospitalised for the first time because of a COPD exacerbation were recruited. Three months after discharge, when clinically stable, symptoms and quality of life, lung function, exercise capacity, nutritional status, biomarkers of systemic and bronchial inflammation, sputum microbiology, CT of the thorax and echocardiography were assessed. COPD groups were identified by partitioning cluster analysis and validated prospectively against cause-specific hospitalisations and all-cause mortality during a 4 year follow-up. Results Three COPD groups were identified: group 1 (n ¼ 126, 67 years) was characterised by severe airflow limitation (postbronchodilator forced expiratory volume in 1 s (FEV 1 ) 38% predicted) and worse performance in most of the respiratory domains of the disease; group 2 (n ¼ 125, 69 years) showed milder airflow limitation (FEV 1 63% predicted); and group 3 (n ¼ 91, 67 years) combined a similarly milder airflow limitation (FEV 1 58% predicted) with a high proportion of obesity, cardiovascular disorders, iabetes and systemic inflammation. During follow-up, group 1 had more frequent hospitalisations due to COPD (HR 3.28, p < 0.001) and higher all-cause mortality (HR 2.36, p ¼ 0.018) than the other two groups, whereas group 3 had more admissions due to cardiovascular disease (HR 2.87, p ¼ 0.014). Conclusions In patients with COPD recruited at their first hospitalisation, three different COPD subtypes were identified and prospectively validated:"severe respiratory COPD","moderate respiratory COPD", and"systemic COPD'

Study of Johnsons Glacier (Livingston Island, Antarctica) by means of shallow ice cores and their tephra and by analysis of 137Cs content

With the aim of monitoring the dynamics of the Livingston Island ice cap, the Departament de Geodinàmica i Geofísica of the Universitat de Barcelona began ye a r ly surveys in the austral summer of 1994-95 on Johnsons Glacier. During this field campaign 10 shallow ice cores were sampled with a manual ve rtical ice-core drilling machine. The objectives were: i) to detect the tephra layer accumulated on the glacier surface, attributed to the 1970 Deception Island pyroclastic eruption, today interstratified; ii) to verify wheter this layer might serve as a reference level; iii) to measure the 1 3 7Cs radio-isotope concentration accumulated in the 1965 snow stratum; iv) to use the isochrone layer as a mean of verifying the age of the 1970 tephra layer; and, v) to calculate both the equilibrium line of the glacier and average mass balance over the last 28 years (1965-1993). The stratigr a p hy of the cores, their cumulative density curves and the isothermal ice temperatures recorded confi rm that Johnsons Glacier is a temperate glacier. Wi n d, solar radiation heating and liquid water are the main agents controlling the ve rtical and horizontal redistribution of the volcanic and cryoclastic particles that are sedimented and remain interstratified within the g l a c i e r. It is because of this redistribution that the 1970 tephra layer does not always serve as a ve ry good reference level. The position of the equilibrium line altitude (ELA) in 1993, obtained by the 1 3 7Cs spectrometric analysis, varies from about 200 m a.s.l. to 250 m a.s.l. This indicates a rising trend in the equilibrium line altitude from the beginning of the 1970s to the present day. The va rying slope orientation of Johnsons Glacier relative to the prevailing NE wind gives rise to large local differences in snow accumulation, which locally modifies the equilibrium line altitude. In the cores studied, 1 3 7Cs appears to be associated with the 1970 tephra laye r. This indicates an intense ablation episode throughout the sampled area (at least up to 330 m a.s.l), which probably occurred synchronically to the 1970 tephra deposition or later. A rough estimate of the specific mass balance reveals a considerable accumulation gradient related to the increase with altitude.

Repeated doses of methylone, a new drug of abuse, induce changes in serotonin and dopamine systems in the mouse

Rationale Methylone, a new drug of abuse sold as"bath salts' has similar effects to ecstasy or cocaine. Objective We have investigated changes in dopaminergic and serotoninergic markers, indicative of neuronal damage, induced by methylone in the frontal cortex, hippocampus and striatum of mice and according two different treatment schedules. Methods Methylone was given subcutaneously to male Swiss CD1 mice and at an ambient temperature of 26ºC. Treatment A: three doses of 25 mg/Kg at 3.5 h interval between doses for two consecutive days. Treatment B: four doses of 25 mg/Kg at 3 h interval in one day. Results Repeated methylone administration induced hyperthermia and a significant loss in body weight. Following treatment A, methylone induced transient dopaminergic (frontal cortex) and serotoninergic (hippocampus) impairment. Following treatment B, transient dopaminergic (frontal cortex) and serotonergic (frontal cortex and hippocampus) changes 7 days after treatment were found. We found evidence of astrogliosis in the CA1 and the dentate gyrus of the hippocampus following treatment B. The animals also showed an increase in immobility time in the forced swim test, pointing to a depressive-like behavior. In cultured cortical neurons, methylone (for 24 and 48 h) did not induce a remarkable cytotoxic effect. Conclusions The neural effects of methylone differ depending upon the treatment schedule. Neurochemical changes elicited by methylone are apparent when administered at an elevated ambient temperature, four times per day at 3 h intervals, which is in accordance with its short half-life.

La voluntad del retorno: correspondencia desde el exilio catalán

[spa] El presente artículo ofrece una aproximación al complejo fenómeno del exilio provocado por la Guerra Civil española desde un punto de vista poco analizado hasta este momento: el estudio a través de los epistolarios existentes de los sentimientos personales que hizo aflorar este abandono forzado del país (miedos, deseos, esperanzas, incertidumbres, preocupaciones e inquietudes, ánimos, etc.). Para conseguir esta visión más personal hemos basado nuestra investigación en el análisis de unas fuentes que consideramos poco trabajadas hasta el momento como son los epistolarios. El estudio de éstos, ya sean fuentes primarias depositadas en fondos de archivos diversos de Catalunya como los epistolarios editados, nos ha permitido obtener un testimonio personal y de primera mano de un fenómeno, el del exilio, tratado principalmente hasta ahora desde un punto de vista colectivo. El análisis, centrado básicamente en personajes catalanes y en el periodo comprendido entre 1939 y 1946 (cuando se desvanece definitivamente la esperanza que la victoria aliada provoque el fin del régimen) pone de manifiesto una voluntad común: el ansia del retorno.

Exploring the link between flexible working and organizational performance

The expansion of flexible work experienced since the 1980s in developed economies is consistent with a more generic trend towards organizational flexibility, which many authors see as essential in order to compete in the dynamic global environment (Volberda, 1998). From this point of view, the changing demands of the environment have forced organizations to seek the ability to adapt rapidly and effectively as a means to be successful or even to survive. In the quest for flexibility, every area of the organization has been scrutinized in order to render it as ¿agile¿ as possible. In the human resources arena, this analysis has led to the definition of diverse ¿flexible working practices¿ (FWP) that describe a wide range of employment practices, which differ from the traditional full-time job with a fixed salary and a permanent contract. These practices have been described using other terms, such as ¿alternative¿ (Polivka, 1996; Powell & Mainiero, 1999), ¿non-standard¿ (Kalleberg, 2000), or ¿atypical¿ (De Grip, Hoevenberg, &m Willems, 1997), which coincide in denoting their divergence from the most traditional forms of employment. This article will show that quite different practices have been embraced by the common term ¿flexible working practices.¿ Subsequently, the results of empirical research regarding the implications for organizational performance of a number of flexible practices will be commented on.

Deep incision in an Aptian carbonate succession indicates major sea-level fall in the Cretaceous

Long-term relative sea-level cycles (0 5 to 6 Myr) have yet to be fully understood for the Cretaceous. During the Aptian, in the northern Maestrat Basin (Eastern Iberian Peninsula), fault-controlled subsidence created depositional space, but eustasy governed changes in depositional trends. Relative sea-level history was reconstructed by sequence stratigraphic analysis. Two forced regressive stages of relative sea-level were recognized within three depositional sequences. The first stage is late Early Aptian age (intra Dufrenoyia furcata Zone) and is characterized by foreshore to upper shoreface sedimentary wedges, which occur detached from a highstand carbonate platform, and were deposited above basin marls. The amplitude of relative sea-level drop was in the order of tens of metres, with a duration of <1 Myr. The second stage of relative sea-level fall occurred within the Late Aptian and is recorded by an incised valley that, when restored to its pre-contractional attitude, was >2 km wide and cut 115 m down into the underlying Aptian succession. With the subsequent transgression, the incision was back-filled with peritidal to shallow subtidal deposits. The changes in depositional trends, lithofacies evolution and geometric relation of the stratigraphic units characterized are similar to those observed in coeval rocks within the Maestrat Basin, as well as in other correlative basins elsewhere. The pace and magnitude of the two relative sea-level drops identified fall within the glacio-eustatic domain. In the Maestrat Basin, terrestrial palynological studies provide evidence that the late Early and Late Aptian climate was cooler than the earliest part of the Early Aptian and the Albian Stage, which were characterized by warmer environmental conditions. The outcrops documented here are significant because they preserve the results of Aptian long-term sea-level trends that are often only recognizable on larger scales (i.e. seismic) such as for the Arabian Plate.

Deep incision in an Aptian carbonate succession indicates major sea-level fall in the Cretaceous

Long-term relative sea-level cycles (0 5 to 6 Myr) have yet to be fully understood for the Cretaceous. During the Aptian, in the northern Maestrat Basin (Eastern Iberian Peninsula), fault-controlled subsidence created depositional space, but eustasy governed changes in depositional trends. Relative sea-level history was reconstructed by sequence stratigraphic analysis. Two forced regressive stages of relative sea-level were recognized within three depositional sequences. The first stage is late Early Aptian age (intra Dufrenoyia furcata Zone) and is characterized by foreshore to upper shoreface sedimentary wedges, which occur detached from a highstand carbonate platform, and were deposited above basin marls. The amplitude of relative sea-level drop was in the order of tens of metres, with a duration of <1 Myr. The second stage of relative sea-level fall occurred within the Late Aptian and is recorded by an incised valley that, when restored to its pre-contractional attitude, was >2 km wide and cut 115 m down into the underlying Aptian succession. With the subsequent transgression, the incision was back-filled with peritidal to shallow subtidal deposits. The changes in depositional trends, lithofacies evolution and geometric relation of the stratigraphic units characterized are similar to those observed in coeval rocks within the Maestrat Basin, as well as in other correlative basins elsewhere. The pace and magnitude of the two relative sea-level drops identified fall within the glacio-eustatic domain. In the Maestrat Basin, terrestrial palynological studies provide evidence that the late Early and Late Aptian climate was cooler than the earliest part of the Early Aptian and the Albian Stage, which were characterized by warmer environmental conditions. The outcrops documented here are significant because they preserve the results of Aptian long-term sea-level trends that are often only recognizable on larger scales (i.e. seismic) such as for the Arabian Plate.

Danza movimiento terapia y abuso sexual

L'organització mundial de la salut, assenyala que la major part de les agressions sexuals tenen com a víctimes a dones i nenes, i són perpetrades per homes i nens. En alguns països, gairebé una de cada quatre dones ha estat víctima de violència sexual per part de la seva parella i fins a una tercera part de les adolescents han sofert una iniciació sexual forçada. Estudis especialitzats fan referència al percentatge de dones que han sofert alguna forma d'abús sexual abans dels 18 anys. En el mateix sentit, enquestes mundials assenyalen que entre el 10% i el 69% de les dones diuen haver estat agredides físicament per una parella masculina en algun moment de la seva vida. La violència sexual infantil provoca a les seves víctimes una sèrie de repercussions i seqüeles, psicològiques, emocionals, socials; compromet el desenvolupament integral de l'individu, i provoca l'aparició d'una sèrie de patologies a l'edat adulta. La present investigació fa una revisió teòrica de la violència sexual, de la violència de gènere, i de les aportacions del procés de recuperació a través de la dansa moviment teràpia d'aquesta població. També es mostra el recorregut del marc d'actuació dels organismes d'ordre públic de la ciutat de Barcelona per a l'atenció i detecció en casos d'abús sexual

Equivalent representation form of oscillators with elastic and damping nonlinear terms

In this work we consider the nonlinear equivalent representation form of oscillators that exhibit nonlinearities in both the elastic and the damping terms. The nonlinear damping effects are considered to be described by fractional power velocity terms which provide better predictions of the dissipative effects observed in some physical systems. It is shown that their effects on the system dynamics response are equivalent to a shift in the coefficient of the linear damping term of a Duffing oscillator. Then, its numerical integration predictions, based on its equivalent representation form given by the well-known forced, damped Duffing equation, are compared to the numerical integration values of its original equations of motion. The applicability of the proposed procedure is evaluated by studying the dynamics response of four nonlinear oscillators that arise in some engineering applications such as nanoresonators, microresonators, human wrist movements, structural engineering design, and chain dynamics of polymeric materials at high extensibility, among others

Crassostrea patagonica (d'Orbigny, 1842) shell concentrations from the late Miocene Rio Negro province, NE Patagonia, Argentina

The Río Negro Formation (late Miocene-early Pliocene) mainly consists of continental deposits, but it contains a middle member of marine origin. It represents a transgressive-regressive sequence that can be seen at several outcrops along the N Patagonian coast. The taphonomical approach to the El Espigón marine deposits permits the identification of four main layers containing different kinds of skeletal accumulation, which mainly consist of oyster shells [Crassostrea patagonica (D'Orbigny, 1842)]. These concentrations display three different morphologies (pouches, pavements and bouquets) with a different taphonomic signature. These deposits were formed in shallow marine environments influenced by wave activity that produced valve concentrations of different entities. They contain several shell beds that represent event, composite, hiatal to lag skeletal concentrations. Traces of bioturbation in the sediment (Thalassinoides, Teichichnus) and bioerosion on the shells (Entobia, Gastrochaeonolites, Caulostrepsis), and encrusters (cirripeds, bryozoans), are also abundant in the outcrop and consititue common components of these Miocene materials. Layers 1 and 2 of the sequence were deposited in shoreface/foreshore environments at the beginning of a highstand systems tract, while layers 3 and 4 were deposited at the end, or at the beginning of a forced regression, in foreshore environments. A final erosional episode cut the top of the layer 4, which truncated the abundant bioturbaation developed there.

The age of the"Grande Coupure" mammal turnover: New constraints from the Eocene Oligocene record of the Eastern Ebro Basin (NE Spain.)

The Grande Coupure represents a major terrestrial faunal turnover recorded in Eurasia associated with the overall climate shift at the Eocene-Oligocene transition. During this event, a large number of European Eocene endemic mammals became extinct and new Asian immigrants appeared. The absolute age of the Grande Coupure, however, has remained controversial for decades. The Late Eocene-Oligocene continental record of the Eastern Ebro Basin (NE Spain) constitutes a unique opportunity to build a robust magnetostratigraphy- based chronostratigraphy which can contribute with independent age constraints for this important turnover. This study presents new magnetostratigraphic data of a 495-m-thick section (Moià-Santpedor) that ranges from 36.1 Ma to 33.3 Ma. The integration of the new results with previous litho- bio- and magnetostratigraphic records of the Ebro Basin yields accurate ages for the immediately pre- and post-Grand Coupure mammal fossil assemblages found in the study area, bracketing the Grande Coupure to an age embracing the Eocene-Oligocene transition, with a maximum allowable lag of 0.5 Myr with respect to this boundary. The shift to drier conditions that accompanied the global cooling at the Eocene-Oligocene transition probably determined the sedimentary trends in the Eastern Ebro Basin. The occurrence and expansion of an amalgamated-channel sandstone unit is interpreted as the forced response of the fluvial fan system to the transient retraction of the central-basin lake systems. The new results from the Ebro Basin allow us to revisit correlations for the controversial Eocene-Oligocene record of the Hampshire Basin (Isle of Wight, UK), and their implications for the calibration of the Mammal Palaeogene reference levels MP18 to MP21.

Software per al cronometratge de temps mitjançant sensors digitals

L’Slot, conegut per tots amb el nom d’Scalextric, s’ha implantat com a una forma d’oci habitual, la pràctica del qual no queda restringida als més petits, sinó que cada vegada crea més afició entre els grans. El fet que l’Slot s’hagi extès entre els adults n’ha revolucionat la pràctica. L’entrada al mercat de l’Slot de gent adulta, i amb poder adquisitiu molt superior als adolescents, ha provocat que les marques especialitzades vagin evolucionant els seus productes cada vegada més. Totes les marques s’han vist obligades a desenvolupar vehicles més competitius i alhora treure al mercat accessoris que augmentin la realitat del joc. Una de les necessitats que s’ha creat és la de competir entre jugadors. Aquesta competició tan pot ser en forma de carrera entre diversos participants, com de forma individual, cronometrant el temps de cada participant en un circuit. L’objectiu principal del projecte és crear un sistema capaç de realitzar cronometratges en temps real mitjançant sensors digitals ja existents en el mercat de l’Slot i poder controlar i visualitzar la informació des d’un PC. Per a poder captar els senyals dels sensors s’ha utilitzat un sistema microcontrolat, que garanteix gran velocitat d’adquisició, processament de dades i transmissió. La comunicació del Microcontrolador amb el PC s’ha realizat mitjançant el bus USB. El PC serà el controlador del sistema i donarà les ordres al Microcontrolador, podent així tenir control total sobre el funcionament del programa. També serà el PC el que tractarà els crocometratges enregistrats i els mostrarà per pantalla

Projecte P.I.T.O.S (Projecte d'informació telefònica d'orientació al S.A.T)

JCM és una empresa dedicada al disseny de sistemes de control d’accés. Disposa d’uns equips elèctrics amb molts paràmetres configurables, així es poden utilitzar en molts tipus d’instal•lació. Aquets paràmetres són configurables pels clients. JCM, disposa d’un servei d’atenció telefònica (SAT), que intenta donar solucions a tots els problemes que puguin sorgir als clients. Sovint, no poden donar suport als dubtes dels clients per culpa de la poca informació que reben a través del client. L'objectiu del projecte és resoldre el problema de falta d'informació i mala comunicació per millorar la qualitat del servei que ofereix el SAT. La solució, no ha d’alterar el cost de producció del producte. S’ha de tenir en compte també que els equips poden estar instal•lats en qualsevol part del món i que només es poden utilitzar recursos de fàcil accés per tots els clients. Per complir amb aquests objectius, emetrem un missatge, a través del brunzidor del equip, amb la informació de configuració de l'equip. Aquest missatge viatjarà a través de la xarxa telefònica fins al SAT. Un cop allà, el descodificarem i n'enviarem les dades a un PC perquè pugui presentar les dades sobre la configuració de una forma clara pel SAT.

Periodismo y dispositivos móviles de lecto-escritura. Introducción al diseño de contenidos para tabletas

El lanzamiento de las tabletas, especialmente la iPad de Apple en 2010, abrió la competencia entre las compañías de comunicación en el sentido de hacer disponible el contenido para este entorno de medios emergentes. La fuga de lectores de periódicos impresos y la consecuente caída en las ganancias por publicidad, forzó a las compañías periodísticas a que buscaran los otros medios de mantener sus negocios. La diversificación de productos y la penetración de los periódicos en dispositivos móviles constituyen un escenario prometedor para el medio. El vertiginoso volumen de ventas de las tabletas indica que en 2012 serán comercializadas más de 140 millones de unidades en el mundo. El diseño de los periódicos en tabletas está íntimamente ligado al diseño de la versión impresa por la fuerza de su metáfora. El desafío es encontrar un diseño de páginas propio, aprovechando el potencial multimedia sin interferir negativamente en la legibilidad y en el carácter intrínseco de informar.