Prediction of improvement in skin fibrosis in diffuse cutaneous systemic sclerosis: a EUSTAR analysis

OBJECTIVES Improvement of skin fibrosis is part of the natural course of diffuse cutaneous systemic sclerosis (dcSSc). Recognising those patients most likely to improve could help tailoring clinical management and cohort enrichment for clinical trials. In this study, we aimed to identify predictors for improvement of skin fibrosis in patients with dcSSc. METHODS We performed a longitudinal analysis of the European Scleroderma Trials And Research (EUSTAR) registry including patients with dcSSc, fulfilling American College of Rheumatology criteria, baseline modified Rodnan skin score (mRSS) ≥7 and follow-up mRSS at 12±2 months. The primary outcome was skin improvement (decrease in mRSS of >5 points and ≥25%) at 1 year follow-up. A respective increase in mRSS was considered progression. Candidate predictors for skin improvement were selected by expert opinion and logistic regression with bootstrap validation was applied. RESULTS From the 919 patients included, 218 (24%) improved and 95 (10%) progressed. Eleven candidate predictors for skin improvement were analysed. The final model identified high baseline mRSS and absence of tendon friction rubs as independent predictors of skin improvement. The baseline mRSS was the strongest predictor of skin improvement, independent of disease duration. An upper threshold between 18 and 25 performed best in enriching for progressors over regressors. CONCLUSIONS Patients with advanced skin fibrosis at baseline and absence of tendon friction rubs are more likely to regress in the next year than patients with milder skin fibrosis. These evidence-based data can be implemented in clinical trial design to minimise the inclusion of patients who would regress under standard of care.

Donald Mowbray, Pain and suffering in medieval theology: Academic Debates at the University of Paris in the Thirteenth Century, Boydel and Brewer, Woodbridge, 2009; 192 p, ISBN 9781843834618.

Fil: Peretó Rivas, Rubén.

Photosynthetic parameters, chlorophyll concentration, and diffuse attenuation coefficients in the Rhode River, Maryland (USA), 1990-2009

Parameters in the photosynthesis-irradiance (P-E) relationship of phytoplankton were measured at weekly to bi-weekly intervals for 20 yr at 6 stations on the Rhode River, Maryland (USA). Variability in the light-saturated photosynthetic rate, PBmax, was partitioned into interannual, seasonal, and spatial components. The seasonal component of the variance was greatest, followed by interannual and then spatial. Physiological models of PBmax based on balanced growth or photoacclimation predicted the overall mean and most of the range, but not individual observations, and failed to capture important features of the seasonal and interannual variability. PBmax correlated most strongly with temperature and the concentration of dissolved inorganic carbon (IC), with lesser correlations with chlorophyll a, diffuse attenuation coefficient, and a principal component of the species composition. In statistical models, temperature and IC correlated best with the seasonal pattern, but temperature peaked in late July, out of phase with PBmax, which peaked in September, coincident with the maximum in monthly averaged IC concentration. In contrast with the seasonal pattern, temperature did not contribute to interannual variation, which instead was governed by IC and the additional lesser correlates. Spatial variation was relatively weak and uncorrelated with ancillary measurements. The results demonstrate that both the overall distribution of PBmax and its relationship with environmental correlates may vary from year to year. Coefficients in empirical statistical models became stable after including 7 to 10 yr of data. The main correlates of PBmax are amenable to automated monitoring, so that future estimates of primary production might be made without labor-intensive incubations.

Diffuse Soil Co2 Flux To Assess The Reliability Of Co2 Storage In The Mazarrón-Gañuelas Tertiary Basin (Spain)

Geological storage of CO2 is nowadays internationally considered as the most effective method for greenhouse gas emission mitigation, in order to minimize its effects on the global climatology. One of the main options is to store the CO2 in deep saline aquifers at more than 800 m depth, because it achieves its supercritical state. Among the most important aspects concerning the performance assessment of a deep CO2 geological repository is the evaluation of the CO2 leakage rate from the chosen storage geological formation. Therefore, it is absolutely necessary to increase the knowledge on the interaction among CO2, storage and sealing formations, as well as on the flow paths for CO2 and the physico-mechanical resistance of the sealing formation. Furthermore, the quantification of the CO2 leakage rate is essential to evaluate its effects on the environment. One way to achieve this objective is to study of CO2 leakage on natural analogue systems, because they can provide useful information about the natural performance of the CO2, which can be applied to an artificial CO2 geological storage. This work is focused on the retention capacity of the cap-rock by measuring the diffuse soil CO2 flux in a site selected based on: i) the presence of a natural and deep CO2 accumulation; ii) its structural geological characteristics; and iii) the nature of the cap-rocks. This site is located in the so-called Mazarrón-Gañuelas Tertiary Basin, in the Guadalentin Valley, province of Murcia (Spain) Therefore the main objective of this investigation has been to detect the possible leakages of CO2 from a deep saline aquifer to the surface in order to understand the capability of this area as a natural analogue for Carbon Capture and Sequestration (CCS). The results obtained allow to conclude that the geological sealing formation of the basin seems to be appropriate to avoid CO2 leakages from the storage formation.

Diffuse illuminance availability on horizontal and vertical surfaces at Madrid, Spain

The overall objective of this work is to provide diffuse illuminance availability at Madrid (Spain) through a statistical analysis of illuminance values corresponding to a long-term data series. The illuminance values are obtained from irradiance measurements by means of different empirical models for luminous efficacy. The values of diffuse illuminance on a horizontal and on vertical surfaces facing the four cardinal points are estimated and the different aspects related to daylight availability in an area with specific climatic conditions are analyzed. The experimental data consist of global and diffuse irradiance measurements on a horizontal surface provided by the National Meteorological Agency in Spain (AEMET) for Madrid. These data consist of hourly values measured in the period of 1980–2005. The statistical results derived correspond to a daylight typical year for the five surfaces considered. This information will be useful to building experts to estimate natural illumination availability when daylighting techniques are applied in building design with the main aim of electric energy savings.

Doctrinale mortis / venerandi patris artiu[m] ac sacre pagine p[ro]fessoris Parisien[sis] Ioa[n]nis Raulin ordinis Cluniacen[sis] ; opus egregium corporalis mortis doctrinas leges et co[n]comita[n]tia ; ac detestabilis culpe mirabilia ; necno[n] gehenne docume[n]ta vías horribiles et tormenta diffuse complecte[n]s ... ; iamiam diligenti accuratione recognitum et a multis me[n]dis castigatu[m]

Pie de imp. tomado del colofón

Clustering techniques for patients suffering acquired brain injury inneuro personal trainer

The study of the effectiveness of the cognitive rehabilitation processes and the identification of cognitive profiles, in order to define comparable populations, is a controversial area, but concurrently it is strongly needed in order to improve therapies. There is limited evidence about cognitive rehabilitation efficacy. Many of the trials conclude that in spite of an apparent clinical good response, differences do not show statistical significance. The common feature in all these trials is heterogeneity among populations. In this situation, observational studies on very well controlled cohort of studies, together with innovative methods in knowledge extraction, could provide methodological insights for the design of more accurate comparative trials. Some correlation studies between neuropsychological tests and patients capacities have been carried out -1---2- and also correlation between tests and morphological changes in the brain -3-. The procedures efficacy depends on three main factors: the affectation profile, the scheduled tasks and the execution results. The relationship between them makes up the cognitive rehabilitation as a discipline, but its structure is not properly defined. In this work we present a clustering method used in Neuro Personal Trainer (NPT) to group patients into cognitive profiles using data mining techniques. The system uses these clusters to personalize treatments, using the patients assigned cluster to select which tasks are more suitable for its concrete needs, by comparing the results obtained in the past by patients with the same profile.

Diffuse soil CO2 flux to assess the reliability of CO2 storage the reliability of CO2 storage in the Mazarrón-Gañuelas Tertiary Basin (Spain)

In the framework of a global investigation of the Spanish natural analogues of CO2 storage and leakage, four selected sites from the Mazarrón?Gañuelas Tertiary Basin (Murcia, Spain) were studied for computing the diffuse soil CO2 flux, by using the accumulation chamber method. The Basin is characterized by the presence of a deep, saline, thermal (?47 ?C) CO2-rich aquifer intersected by two deep geothermal exploration wells named ?El Saladillo? (535 m) and ?El Reventón? (710 m). The CO2 flux data were processed by means of a graphical?statistical method, kriging estimation and sequential Gaussian simulation algorithms. The results have allowed concluding that the Tertiary marly cap-rock of this CO2-rich aquifer acts as a very effective sealing, preventing any CO2 leak from this natural CO2 storage site, being therefore an excellent scenario to guarantee, by analogy, the safety of a CO2 storage.

Vocal tract settings in speakers suffering from obstructive sleep apnea síndrome

Automatic systems based on speech signal analysis for the early dete ction of obstructive sleep apnea (OSA) have achieved fairly high performance rates in recent years. However, a satisfactory explanation of these results has not been available. This presentation aims at explaining via an examination of the long-term spectra of OSA patients and normal control speakers these systems’ ability to discover OSA speakers on the base of all-purpose cepstral coefficients. An in terpretation of the long- term spectra in terms of the underlying tract settings suggests that the speech of OSA patients is characterized by a pharyngeal narrowing that may be captured by acoustic cues of the spectral contour of windowed speech frames. A novel interpretation of long-term spectra in terms of the first principal component of the temporal sequence of short-term amplitude-spectra is also discussed.

Bifurcation diagrams for polymer blends with diffuse interfaces in confined and adaptive geometries

Dynamics of binary mixtures such as polymer blends, and fluids near the critical point, is described by the model-H, which couples momentum transport and diffusion of the components [1]. We present an extended version of the model-H that allows to study the combined effect of phase separation in a polymer blend and surface structuring of the film itself [2]. We apply it to analyze the stability of vertically stratified base states on extended films of polymer blends and show that convective transport leads to new mechanisms of instability as compared to the simpler diffusive case described by the Cahn- Hilliard model [3, 4]. We carry out this analysis for realistic parameters of polymer blends used in experimental setups such as PS/PVME. However, geometrically more complicated states involving lateral structuring, strong deflections of the free surface, oblique diffuse interfaces, checkerboard modes, or droplets of a component above of the other are possible at critical composition solving the Cahn Hilliard equation in the static limit for rectangular domains [5, 6] or with deformable free surfaces [6]. We extend these results for off-critical compositions, since balanced overall composition in experiments are unusual. In particular, we study steady nonlinear solutions of the Cahn-Hilliard equation for bidimensional layers with fixed geometry and deformable free surface. Furthermore we distinguished the cases with and without energetic bias at the free surface. We present bifurcation diagrams for off-critical films of polymer blends with free surfaces, showing their free energy, and the L2-norms of surface deflection and the concentration field, as a function of lateral domain size and mean composition. Simultaneously, we look at spatial dependent profiles of the height and concentration. To treat the problem of films with arbitrary surface deflections our calculations are based on minimizing the free energy functional at given composition and geometric constraints using a variational approach based on the Cahn-Hilliard equation. The problem is solved numerically using the finite element method (FEM).

Higher levels of physical fitness are associated with a reduced risk of suffering sarcopenic obesity and better perceived health among elderly. The EXERNET multi-center study

Evaluar la asociación entre los niveles físicos de la aptitud, de calidad relacionada con la salud de la vida (CVRS) y la obesidad sarcopénica