Outcome of treated anogenital intraepithelial neoplasia among human immunodeficiency virus-infected women

OBJECTIVE: To determine characteristics and clinical course of high-grade anogenital intraepithelial neoplasia (AIN) in human immunodeficiency virus (HIV)-infected women. STUDY DESIGN: HIV-positive women with biopsy-proven high-grade (II and III) vulvar (VIN), vaginal (VAIN) or perianal intraepithelial neoplasia (PAIN) were identified in the electronic databases of 2 colposcopy clinics. RESULTS: A total of 31 patients were identified from 1992 to 2007, of which 30 had a mean follow-up of 47.7 months (SD = 46.0; range, 2.6-166.2). Of the patients, 77.4% had VIN, 12.9% VAIN and 9.7% PAIN at first diagnosis. Age at diagnosis of IN was 36.2 years (SD +/- 5.2; range, 23.5-47.0). Ninety percent of patients received antiretroviral therapy at first diagnosis of IN; 65% (13 of 20) of patients with a follow-up of > 2 years required a second treatment, and 2 developed invasive vulvar cancer (10%). CONCLUSION: AIN among HIV-positive women shows a high relapse rate despite treatment modality used and a substantial invasive potential.

Antarctic Volcanic Flux Ratios from Law Dome Ice Cores

Explosive volcanic eruptions can inject large quantities of sulphur dioxide into the stratosphere. The aerosols that result from oxidation of the sulphur dioxide can produce significant cooling of the troposphere by reflecting or absorbing solar radiation. It is possible to obtain an estimate of the relative stratospheric sulphur aerosol concentration produced by different volcanoes by comparing sulphuric acid fluxes determined by analysis of polar ice cores. Here, we use a non-sea-salt sulphate time series derived from three well-dated Law Dome ice cores to investigate sulphuric acid flux ratios for major eruptions over the period AD 1301-1995. We use additional data from other cores to investigate systematic spatial variability in the ratios. Only for the Kuwae eruption (Law Dome ice date AD 1459.5) was the H2SO4 flux larger than that deposited by Tambora (Law Dome ice date AD 1816.7).

Solar Forcing of the Polar Atmosphere

We present highly resolved, annually dated, calibrated proxies for atmospheric circulation from several Antarctic ice cores (ITASE (International Trans-Antarctic Scientific Expedition), Siple Dome, Law Dome) that reveal decadal-scale associations with a South Pole ice-core Be-10 proxy for solar variability over the last 600 years and annual-scale associations with solar variability since AD 1720. We show that increased (decreased) solar irradiance is associated with increased (decreased) zonal wind strength near the edge of the Antarctic polar vortex. The association is particularly strong in the Indian and Pacific Oceans and as such may contribute to understanding climate forcing that controls drought in Australia and other Southern Hemisphere climate events. We also include evidence suggestive of solar forcing of atmospheric circulation near the edge of the Arctic polar vortex based on ice-core records from Mount Logan, Yukon Territory, Canada, and both central and south Greenland as enticement for future investigations. Our identification of solar forcing of the polar atmosphere and its impact on lower latitudes offers a mechanism for better understanding modern climate variability and potentially the initiation of abrupt climate-change events that operate on decadal and faster scales.

Post-Depositional Movement of Methanesulphonic Acid at Law Dome, Antarctica, and the Influence of Accumulation Rate

A series of ice cores from sites with different snow-accumulation rates across Law Dome, East Antarctica, was investigated for methanesulphonic acid (MSA) movement. The precipitation at these sites (up to 35 km apart) is influenced by the same air masses, the principal difference being the accumulation rate. At the low-accumulation-rate W20k site (0.17 in ice equivalent), MSA was completely relocated from the summer to winter layer. Moderate movement was observed at the intermediate-accumulation-rate site (0.7 in ice equivalent), Dome Summit South (DSS), while there was no evidence of movement at the high-accumulation-rate DE08 site (1.4 in ice equivalent). The main DSS record of MSA covered the epoch AD 1727-2000 and was used to investigate temporal post-depositional changes. Co-deposition of MSA and sea-salt ions was observed of the surface layers, outside of the main summer MSA peak, which complicates interpretation of these peaks as evidence of movement in deeper layers. A seasonal study of the 273 year DSS record revealed MSA migration predominantly from summer into autumn (in the up-core direction), but this migration was suppressed during the Tambora (1815) and unknown (1809) volcanic eruption period, and enhanced during an epoch (1770-1800) with high summer nitrate levels. A complex interaction between the gradients in nss-sulphate, nitrate and sea salts (which are influenced by accumulation rate) is believed to control the rate and extent of movement of MSA.

Between anxiety and hope: the experiences of women with vulval intraepithelial neoplasia during their illness trajectory - a qualitative approach

The vulvar intraepithelial neoplasia (VIN) is a rare chronic skin condition that may progress to an invasive carcinoma of the vulva. Major issues affecting women's health were occurring symptoms, negative influences on sexuality, uncertainty concerning the illness progression and changes in the body image. Despite this, there is little known about the lived experiences of the illness trajectory. Therefore, the aim of this study was to describe the experiences of women with VIN during the illness trajectory. In a secondary data analysis of the foregoing qualitative study we analysed eight narrative interviews with women with VIN by using thematic analysis in combination with critical hermeneutics. Central for these women during their course of illness was a sense of "Hope and Fear". This constitutive pattern reflects the fear of recurrence but also the trust in healing. The eight narratives showed women's experiences during their course of illness occurred in five phases: "there is something unknown"; "one knows, what IT is"; "IT is treated and should heal"; "IT has effects on daily life"; "meanwhile it works". Women's experiences were particularly influenced by the feeling of "embarrassment" and by "dealing with professionals". Current care seems to lack adequate support for women with VIN to manage these phases. We suggest, based on our study and the international literature, that new models of counselling and providing information need to be developed and evaluated.

Auffällige Erscheinungen in der Verbreitung von Land- und Süsswassermollusken am Niederrhein

Vin Heinr. Brockmeier

Efecto del tiempo de maceración sobre el color, la composición tánica y la astringencia de vinos Cabernet Sauvignon y Malbec

El objetivo del trabajo fue estudiar el efecto del tiempo de maceración sobre la composición tánica, el color y la astringencia de vinos Cabernet Sauvignon y Malbec, provenientes de la Zona Alta del Río Mendoza y saber qué tiempo de maceración permite una mayor expresión del color y del cuerpo del vino. A partir de dos vinificaciones industriales, se realizaron muestreos para determinar las curvas de extracción de los componentes fenólicos y del color. Además, se llevaron a cabo dos experimentos probando un tiempo de maceración corto, de 5 días, uno “clásico" en la región, de 10 días, y uno largo, de 20 días. En los vinos resultantes se determinó el perfil fenólico, discriminando los componentes tánicos y del color, durante el primer año de conservación en vasijas de vidrio. Se utilizaron técnicas de espectrometría VIS y UV y los vinos fueron evaluados por un panel de expertos degustadores. La variedad Cabernet S. siguió un patrón de extracción de antocianos y taninos durante la maceración acorde con lo que indica la bibliografía. La magnitud del color rojo alcanzó un máximo cerca del 10º día y luego sufrió una caída que, en la maceración de 20 días, significó una pérdida de alrededor de un 10%. Los taninos aumentaron rápidamente hasta el 10º día y luego continuaron creciendo muy lentamente. Los vinos Cabernet S. obtenidos con maceración de 10 días y de 20 días resultaron muy superiores en cuanto a los contenidos de antocianos, color polimérico y taninos. También provocaron sensaciones de concentración y untuosidad mayores. Además resultaron más ásperos, astringentes y secantes que los de 5 días, pero estas sensaciones fueron moderadas. Los vinos de 20 días fueron similares a los de 10 días salvo en que alcanzaron un contenido mayor de polifenoles totales y de taninos no astringentes. La variedad Malbec siguió un patrón de extracción de antocianos y taninos similar al Cabernet S. hasta el 10º día, pero luego ambos mostraron una caída pronunciada, como consecuencia de un deterioro oxidativo. La maceración de 10 días resultó óptima y los vinos se destacaron por su mayor contenido en polifenoles totales, antocianos, color polimérico y taninos. Estos atributos provocaron sensaciones de concentración y untuosidad destacadas y similares a las de los Cabernet S. de 10 y 20 días. Las sensaciones de secante, áspero y astringente fueron menores que en los Cabernet. Los Malbec de 5 días resultaron muy pobres en atributos y los de 20 días con característics intermedias entre los de 5 y los de 10 días. En ambas variedades la pérdida en los contenidos de antocianos copigmentados se acompañó de un aumento proporcional en los contenidos de antocianos polimerizados. Durante el estacionamiento todos los vinos Cabernet S. y Malbec sufrieron una degradación de polifenoles totales, antocianos y taninos. El ritmo de degradación de cada compuesto fue similar para los distintos vinos, sin importar las concentraciones iniciales del compuesto. En ambas variedades los polifenoles totales y los taninos se correlacionaron positivamente con la aspereza, la astringencia, lo secante, la untuosidad y la concentración. Lo secante se asoció negativamente con la proporción de taninos no precipitables con gelatina. La espectrometría VIS y UV, como método instrumental de análisis, resultó suficientemente potente como para permitir una la apreciación del perfil fenólico y diferenciar los vinos Cabernet S. de los Malbec, independientemente del tiempo de maceración con que fueron elaborados.

Carcinoma escamoso vulvar : revisión de la literatura

Fil: Parra, Viviana Gladys. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Cátedra de Dermatología

Manejo de suelo mediante coberturas vegetales establecidas

El objetivo de esta investigación fue determinar los efectos de las coberturas vegetales en el microclima de la planta de vid. Se compararon cinco coberturas de diferente ciclo vegetativo con respecto al manejo de suelo sin labranza mediante aplicación de herbicidas. El estudio se desarrolló en un viñedo cv. Malbec conducido en espaldera alta, situado en Agrelo, Luján de Cuyo, Mendoza, Argentina. Se determinaron parámetros microclimáticos, temperatura, humedad relativa y radiación a nivel de racimos, temperatura del suelo, cantidad y calidad de la radiación reflejada por la cobertura. También se midió la expresión vegetativa y de uvas y el potencial enológico. Se verificó una significativa disminución de la radiación fotosintéticamente activa (RFA) reflejada por las coberturas con una menor relación “Rojo/Rojo lejano" comparada con el suelo descubierto. Sin embargo, el efecto no se percibió dentro de la canopia debido a que las coberturas permanentes de trébol rojo (Trifolium pratensis) y agropiro alargado (Agropyron elongatum) restringieron el vigor de las cepas, disminuyendo el crecimiento de brotes y el tamaño de hojas, lo cual se tradujo en una mayor recepción directa de la RFA a nivel de racimos. No hubo una significativa variación en cuanto a temperatura máxima, mínima y amplitud térmica a nivel de racimos. No obstante ello, los tratamientos con mayor cobertura de suelo tendieron a reducir levemente la temperatura mínima a nivel de racimos. La humedad relativa en la canopia no fue significativamente afectada. El trébol rojo, el agropiro alargado, la mezcla centeno-cebadilla (Secale cereale-Bromus catharticus) y el sorgo del Sudán (Sorghum sudanensis) redujeron notablemente la amplitud térmica del suelo. El efecto fue determinado principalmente por la disminución de la temperatura máxima. Las coberturas vegetales con alguna dificultad para desarrollarse durante su ciclo vegetativo tuvieron un comportamiento intermedio o uno muy similar al de un suelo descubierto. La introducción de una cobertura permanente con buena invasión del sitio interfilar permitió modificar indirectamente las características microclimáticas de la canopia, a través del control del crecimiento vegetativo y de los rendimientos de la planta de vid, modificando el equilibrio vigor / producción del viñedo, y por lo tanto la composición de las uvas y del vino elaborado.

Novel Inductor‐less Conversion Strategy Based on Multiphase Transformer‐Coupled Converters: Analysis, Design and Applications

There are many the requirements that modern power converters should fulfill. Most of the applications where these converters are used, demand smaller converters with high efficiency, improved power density and a fast dynamic response. For instance, loads like microprocessors demand aggressive current steps with very high slew rates (100A/mus and higher); besides, during these load steps, the supply voltage of the microprocessor should be kept within tight limits in order to ensure its correct performance. The accomplishment of these requirements is not an easy task; complex solutions like advanced topologies - such as multiphase converters- as well as advanced control strategies are often needed. Besides, it is also necessary to operate the converter at high switching frequencies and to use capacitors with high capacitance and low ESR. Improving the dynamic response of power converters does not rely only on the control strategy but also the power topology should be suited to enable a fast dynamic response. Moreover, in later years, a fast dynamic response does not only mean accomplishing fast load steps but output voltage steps are gaining importance as well. At least, two applications that require fast voltage changes can be named: Low power microprocessors. In these devices, the voltage supply is changed according to the workload and the operating frequency of the microprocessor is changed at the same time. An important reduction in voltage dependent losses can be achieved with such changes. This technique is known as Dynamic Voltage Scaling (DVS). Another application where important energy savings can be achieved by means of changing the supply voltage are Radio Frequency Power Amplifiers. For example, RF architectures based on ‘Envelope Tracking’ and ‘Envelope Elimination and Restoration’ techniques can take advantage of voltage supply modulation and accomplish important energy savings in the power amplifier. However, in order to achieve these efficiency improvements, a power converter with high efficiency and high enough bandwidth (hundreds of kHz or even tens of MHz) is necessary in order to ensure an adequate supply voltage. The main objective of this Thesis is to improve the dynamic response of DC-DC converters from the point of view of the power topology. And the term dynamic response refers both to the load steps and the voltage steps; it is also interesting to modulate the output voltage of the converter with a specific bandwidth. In order to accomplish this, the question of what is it that limits the dynamic response of power converters should be answered. Analyzing this question leads to the conclusion that the dynamic response is limited by the power topology and specifically, by the filter inductance of the converter which is found in series between the input and the output of the converter. The series inductance is the one that determines the gain of the converter and provides the regulation capability. Although the energy stored in the filter inductance enables the regulation and the capability of filtering the output voltage, it imposes a limitation which is the concern of this Thesis. The series inductance stores energy and prevents the current from changing in a fast way, limiting the slew rate of the current through this inductor. Different solutions are proposed in the literature in order to reduce the limit imposed by the filter inductor. Many publications proposing new topologies and improvements to known topologies can be found in the literature. Also, complex control strategies are proposed with the objective of improving the dynamic response in power converters. In the proposed topologies, the energy stored in the series inductor is reduced; examples of these topologies are Multiphase converters, Buck converter operating at very high frequency or adding a low impedance path in parallel with the series inductance. Control techniques proposed in the literature, focus on adjusting the output voltage as fast as allowed by the power stage; examples of these control techniques are: hysteresis control, V 2 control, and minimum time control. In some of the proposed topologies, a reduction in the value of the series inductance is achieved and with this, the energy stored in this magnetic element is reduced; less stored energy means a faster dynamic response. However, in some cases (as in the high frequency Buck converter), the dynamic response is improved at the cost of worsening the efficiency. In this Thesis, a drastic solution is proposed: to completely eliminate the series inductance of the converter. This is a more radical solution when compared to those proposed in the literature. If the series inductance is eliminated, the regulation capability of the converter is limited which can make it difficult to use the topology in one-converter solutions; however, this topology is suitable for power architectures where the energy conversion is done by more than one converter. When the series inductor is eliminated from the converter, the current slew rate is no longer limited and it can be said that the dynamic response of the converter is independent from the switching frequency. This is the main advantage of eliminating the series inductor. The main objective, is to propose an energy conversion strategy that is done without series inductance. Without series inductance, no energy is stored between the input and the output of the converter and the dynamic response would be instantaneous if all the devices were ideal. If the energy transfer from the input to the output of the converter is done instantaneously when a load step occurs, conceptually it would not be necessary to store energy at the output of the converter (no output capacitor COUT would be needed) and if the input source is ideal, the input capacitor CIN would not be necessary. This last feature (no CIN with ideal VIN) is common to all power converters. However, when the concept is actually implemented, parasitic inductances such as leakage inductance of the transformer and the parasitic inductance of the PCB, cannot be avoided because they are inherent to the implementation of the converter. These parasitic elements do not affect significantly to the proposed concept. In this Thesis, it is proposed to operate the converter without series inductance in order to improve the dynamic response of the converter; however, on the other side, the continuous regulation capability of the converter is lost. It is said continuous because, as it will be explained throughout the Thesis, it is indeed possible to achieve discrete regulation; a converter without filter inductance and without energy stored in the magnetic element, is capable to achieve a limited number of output voltages. The changes between these output voltage levels are achieved in a fast way. The proposed energy conversion strategy is implemented by means of a multiphase converter where the coupling of the phases is done by discrete two-winding transformers instead of coupledinductors since transformers are, ideally, no energy storing elements. This idea is the main contribution of this Thesis. The feasibility of this energy conversion strategy is first analyzed and then verified by simulation and by the implementation of experimental prototypes. Once the strategy is proved valid, different options to implement the magnetic structure are analyzed. Three different discrete transformer arrangements are studied and implemented. A converter based on this energy conversion strategy would be designed with a different approach than the one used to design classic converters since an additional design degree of freedom is available. The switching frequency can be chosen according to the design specifications without penalizing the dynamic response or the efficiency. Low operating frequencies can be chosen in order to favor the efficiency; on the other hand, high operating frequencies (MHz) can be chosen in order to favor the size of the converter. For this reason, a particular design procedure is proposed for the ‘inductorless’ conversion strategy. Finally, applications where the features of the proposed conversion strategy (high efficiency with fast dynamic response) are advantageus, are proposed. For example, in two-stage power architectures where a high efficiency converter is needed as the first stage and there is a second stage that provides the fine regulation. Another example are RF power amplifiers where the voltage is modulated following an envelope reference in order to save power; in this application, a high efficiency converter, capable of achieving fast voltage steps is required. The main contributions of this Thesis are the following: The proposal of a conversion strategy that is done, ideally, without storing energy in the magnetic element. The validation and the implementation of the proposed energy conversion strategy. The study of different magnetic structures based on discrete transformers for the implementation of the proposed energy conversion strategy. To elaborate and validate a design procedure. To identify and validate applications for the proposed energy conversion strategy. It is important to remark that this work is done in collaboration with Intel. The particular features of the proposed conversion strategy enable the possibility of solving the problems related to microprocessor powering in a different way. For example, the high efficiency achieved with the proposed conversion strategy enables it as a good candidate to be used for power conditioning, as a first stage in a two-stage power architecture for powering microprocessors.

Fiestas seculares, con que la coronada ciudad de Valencia celebró el feliz cumplimiento del tercer siglo de la canonizacion de su esclarecido hijo, y angel protector S. Vicente Ferrer, Apostol de Europa

Contiene: Apolo Carretero, alias el Parnaso Triunfal : esto es, nueva coleccion de los ingeniosos versos que se tiraban al pueblo de los Carros Triunfales de los Oficios / su autor Domingo Pablo, enano de Santa Ana, 1761