Insuffisance corticosurrénalienne précipitée par un traitement de lévothyroxine [Adrenal insufficiency caused by treatment with levothyroxine]

Primary adrenal insufficiency is a rare disease. Its diagnosis remains a clinical challenge since the signs and symptoms of the disease are insidious in onset and non specific in nature. A case report of Addison's crisis induced by levothyroxine substitution therapy is described. This clinical case is discussed in details with a special emphasis to the published literature regarding the strategy of diagnosis and the specific therapy of primary adrenal insufficiency.

The great diversification and its undoing

We investigate the hypothesis that macroeconomic fluctuations are primitively theresults of many microeconomic shocks, and show that it has significant explanatorypower for the evolution of macroeconomic volatility. We define ?fundamental? volatilityas the volatility that would arise from an economy made entirely of idiosyncratic microeconomicshocks, occurring primitively at the level of sectors or firms. In its empiricalconstruction, motivated by a simple model, the sales share of different sectors vary overtime (in a way we directly measure), while the volatility of those sectors remains constant.We find that fundamental volatility accounts for the swings in macroeconomicvolatility in the US and the other major world economies in the past half century. Itaccounts for the ?great moderation? and its undoing. Controlling for our measure offundamental volatility, there is no break in output volatility. The initial great moderationis due to a decreasing share of manufacturing between 1975 and 1985. The recentrise of macroeconomic volatility is due to the increase of the size of the financial sector.We provide a model to think quantitatively about the large comovement generated byidiosyncratic shocks. As the origin of aggregate shocks can be traced to identifiablemicroeconomic shocks, we may better understand the origins of aggregate fluctuations.

Identidad territorial y promoción turística: la organización de eventos como estrategia de creación, consolidación y difusión de la imagen de marca del territorio

La organización de un evento resulta paradigmática en el proceso de construcción de imágenes territoriales vividas in situ. La fabricación de imágenes territoriales - turísticas o no- con motivo de la organización de un evento para su posterior consolidación en el imaginario colectivo de los asistentes, plantea una curiosa alternativa de promoción turística implícita en la propia estrategia de gestión del evento. En efecto, no cabe duda de que el evento, por sí mismo, representa una importante estrategia de promoción del territorio, pero hay más; también puede devenir a modo de catalizador de imágenes, de creador de imaginarios capaces de fijar una marca de ciudad en su conjunto. El presente artículo dará a conocer las posibilidades que se desprenden de la organización de un evento en relación al posicionamiento identitario y promocional de un territorio.

Sexual dimorphism in androdioecious Mercurialis annua, a wind-pollinated herb

Gender-dimorphic species often display a degree of sexual dimorphism in terms of life-history traits, yet little is known about dimorphism in androdioecious plants. Here we investigate sexual dimorphism in an androdioecious population of the wind-pollinated herb Mercurialis annua by comparing the resource allocation strategies of males and hermaphrodites grown under different nutrient-availability and competitive regimes. We found that males displayed smaller aboveground vegetative sizes than did hermaphrodites, but neither soil nutrient availability nor competition had a strong independent effect on their relative sizes. Plants adjusted their relative reproductive investment in response to nutrient availability. Specifically, hermaphrodites increased their reproductive allocation when growing in poor soils, whereas males displayed the opposite response. Finally, hermaphrodites were strongly female biased in their sex allocation, and this was more pronounced in nutrient-poor soils. To conclude, sexual dimorphism in androdioecious M. annua shares many features with dioecious and gynodioecious species, particularly wind-pollinated herbs. However, the direction of sex-allocation reaction norms displayed by hermaphrodites of M. annua differs from that documented for several insect-pollinated gynodioecious species, hinting at the importance of either the pollination mode or the sexual system as a context of selection shaping the reproductive strategy of plants with both male and female functions.

Business Sphere, Special Issue

Food products are a specialization, an industry of excellence, and thelargest sector of manufacturing employment in the state of Iowa. All ofthe top five food companies have operations in Iowa. According to Harris Info Source, manufacturing of foods and ingredients in Iowa employs 58,826 people at 775 plants. Processing and value adding enterprises are fed by nation-leading agriculture. Iowa is the top producer of corn, soybeans, hogs and eggs in the United States.

Algunes reflexions sobre la construcció d'indicadors indirectes pel seguiment de l'activitat industrial regional

En un gran nombre d'economies, l'evolució de la producció industrial s'analitza a partir de la informació sobre el Producte Industrial Brut i/o el Valor Afegit Brut que proporcionen les Comptabilitats Nacionals. A Espanya, la utilització d'aquestes dades presenta el problema que no estan disponibles tan ràpidament com seria desitjable. En conseqüència, no és possible realitzar un seguiment a curt termini de l'activitat industrial a partir dels mateixos. Per a solucionar aquest problema, l'Institut Nacional d'Estadística elabora un Índex de Producció Industrial mensual a partir de la informació obtinguda a través d'una enquesta dirigida a una mostra representativa de les empreses espanyoles. No obstant això, a nivell regional, les dificultats per a realitzar un seguiment de l'activitat industrial són majors a causa de l'escassesa d'informació estadística. Durant els últims anys, diferents institucions públiques i privades han començat a elaborar indicadors d'activitat per a algunes regions espanyoles, encara que a partir de metodologies no homogènies, de manera que aquests índexs no són directament comparables. Per a corregir aquesta situació, en diferents fòrums s'ha proposat emprar la metodologia utilitzada per l'Institut d'Estadística de Catalunya (IEC) per a la comunitat catalana com alternativa per a aquelles comunitats espanyoles que no disposen d'un indicador de l'activitat industrial, atès que per a Catalunya resulta una metodologia adequada. En aquest treball s'estudia la idoneïtat d'estendre aquesta metodologia a la resta de regions espanyoles. Per a això, es construeixen uns indicadors d'acord amb la metodologia del IEC i es comparen amb els índexs regionals obtinguts per mètodes directes per a tres de les quatre regions que existeixen: Andalusia, Astúries i Euskadi

DAI/ZBP1 recruits RIP1 and RIP3 through RIP homotypic interaction motifs to activate NF-kappaB.

Detection of viral nucleic acids is central to antiviral immunity. Recently, DAI/ZBP1 (DNA-dependent activator of IRFs/Z-DNA binding protein 1) was identified as a cytoplasmic DNA sensor and shown to activate the interferon regulatory factor (IRF) and nuclear factor-kappa B (NF-kappaB) transcription factors, leading to type-I interferon production. DAI-induced IRF activation depends on TANK-binding kinase 1 (TBK1), whereas signalling pathways and molecular components involved in NF-kappaB activation remain elusive. Here, we report the identification of two receptor-interacting protein (RIP) homotypic interaction motifs (RHIMs) in the DAI protein sequence, and show that these domains relay DAI-induced NF-kappaB signals through the recruitment of the RHIM-containing kinases RIP1 and RIP3. We show that knockdown of not only RIP1, but also RIP3 affects DAI-induced NF-kappaB activation. Importantly, RIP recruitment to DAI is inhibited by the RHIM-containing murine cytomegalovirus (MCMV) protein M45. These findings delineate the DAI signalling pathway to NF-kappaB and suggest a possible new immune modulation strategy of the MCMV.

Algunes reflexions sobre la construcció d'indicadors indirectes pel seguiment de l'activitat industrial regional

En un gran nombre d'economies, l'evolució de la producció industrial s'analitza a partir de la informació sobre el Producte Industrial Brut i/o el Valor Afegit Brut que proporcionen les Comptabilitats Nacionals. A Espanya, la utilització d'aquestes dades presenta el problema que no estan disponibles tan ràpidament com seria desitjable. En conseqüència, no és possible realitzar un seguiment a curt termini de l'activitat industrial a partir dels mateixos. Per a solucionar aquest problema, l'Institut Nacional d'Estadística elabora un Índex de Producció Industrial mensual a partir de la informació obtinguda a través d'una enquesta dirigida a una mostra representativa de les empreses espanyoles. No obstant això, a nivell regional, les dificultats per a realitzar un seguiment de l'activitat industrial són majors a causa de l'escassesa d'informació estadística. Durant els últims anys, diferents institucions públiques i privades han començat a elaborar indicadors d'activitat per a algunes regions espanyoles, encara que a partir de metodologies no homogènies, de manera que aquests índexs no són directament comparables. Per a corregir aquesta situació, en diferents fòrums s'ha proposat emprar la metodologia utilitzada per l'Institut d'Estadística de Catalunya (IEC) per a la comunitat catalana com alternativa per a aquelles comunitats espanyoles que no disposen d'un indicador de l'activitat industrial, atès que per a Catalunya resulta una metodologia adequada. En aquest treball s'estudia la idoneïtat d'estendre aquesta metodologia a la resta de regions espanyoles. Per a això, es construeixen uns indicadors d'acord amb la metodologia del IEC i es comparen amb els índexs regionals obtinguts per mètodes directes per a tres de les quatre regions que existeixen: Andalusia, Astúries i Euskadi

Optical crop sensor for variable-rate nitrogen fertilization in corn: i - plant nutrition and dry matter production

Variable-rate nitrogen fertilization (VRF) based on optical spectrometry sensors of crops is a technological innovation capable of improving the nutrient use efficiency (NUE) and mitigate environmental impacts. However, studies addressing fertilization based on crop sensors are still scarce in Brazilian agriculture. This study aims to evaluate the efficiency of an optical crop sensor to assess the nutritional status of corn and compare VRF with the standard strategy of traditional single-rate N fertilization (TSF) used by farmers. With this purpose, three experiments were conducted at different locations in Southern Brazil, in the growing seasons 2008/09 and 2010/11. The following crop properties were evaluated: above-ground dry matter production, nitrogen (N) content, N uptake, relative chlorophyll content (SPAD) reading, and a vegetation index measured by the optical sensor N-Sensor® ALS. The plants were evaluated in the stages V4, V6, V8, V10, V12 and at corn flowering. The experiments had a completely randomized design at three different sites that were analyzed separately. The vegetation index was directly related to above-ground dry matter production (R² = 0.91; p<0.0001), total N uptake (R² = 0.87; p<0.0001) and SPAD reading (R² = 0.63; p<0.0001) and inversely related to plant N content (R² = 0.53; p<0.0001). The efficiency of VRF for plant nutrition was influenced by the specific climatic conditions of each site. Therefore, the efficiency of the VRF strategy was similar to that of the standard farmer fertilizer strategy at sites 1 and 2. However, at site 3 where the climatic conditions were favorable for corn growth, the use of optical sensors to determine VRF resulted in a 12 % increase in N plant uptake in relation to the standard fertilization, indicating the potential of this technology to improve NUE.

Treating the individual hypertensive patient: considerations on dose, sequential monotherapy and drug combinations.

For the general practitioner to be able to prescribe optimal therapy to his individual hypertensive patients, he needs accurate information on the therapeutic agents he is going to administer and practical treatment strategies. The information on drugs and drug combinations has to be applicable to the treatment of individual patients and not just patient study groups. A basic requirement is knowledge of the dose-response relationship for each compound in order to choose the optimal therapeutic dose. Contrary to general assumption, this key information is difficult to obtain and often not available to the physician for many years after marketing of a drug. As a consequence, excessive doses are often used. Furthermore, the physician needs comparative data on the various antihypertensive drugs that are applicable to the treatment of individual patients. In order to minimize potential side effects due to unnecessary combinations of compounds, the strategy of sequential monotherapy is proposed, with the goal of treating as many patients as possible with monotherapy at optimal doses. More drug trials of a crossover design and more individualized analyses of the results are badly needed to provide the physician with information that he can use in his daily practice. In this time of continuous intensive development of new antihypertensive agents, much could be gained in enhanced efficacy and reduced incidence of side effects by taking a closer look at the drugs already available and using them more appropriately in individual patients.

Immune response to MMTV infection.

Mouse mammary tumor virus (MMTV) has developed a strategy of exploitation of the immune response. It infects dendritic cells and B cells and requires this infection to establish an efficient chronic infection. This allows transmission of infection to the mammary gland, production in milk and infection of the next generation via lactation. The elaborate strategy developed by MMTV utilizes several key elements of the normal immune response. Starting with the infection and activation of dendritic cells and B cells leading to the expression of a viral superantigen followed by professional superantigen-mediated priming of naive polyclonal T cells by dendritic cells and induction of superantigen-mediated T cell B cell collaboration results in long-lasting germinal center formation and production of long-lived B cells that can later carry the virus to the mammary gland epithelium. Later in life it can induce transformation of mammary gland epithelium by integrating close to proto-oncogenes leading to their overexpression. Genes encoding proteins of the Wnt-pathway are preferential targets. This review will put these effects in the context of a normal immune response and summarize important facts on MMTV biology.

Stratégies diagnostiques des diarrhées chroniques de l'adulte [Chronic diarrhea in adults: diagnostic strategies]

The presence of chronic diarrhea requires a prompt diagnostic strategy in order to avoid risks of malnutrition and electrolytic disturbances. Two different clinical situations, i.e. collagen colitis and secretory diarrhea, exemplify the diagnostic evaluation of a single symptom. This non exhaustive review should lead to a diagnostic strategy of chronic diarrhea.

A bioeconomic model for Mediterranean fisherires, the hake off Catalonia (western Mediterranean) as a case study

The theoretical aspects and the associated software of a bioeconomic model for Mediterranean fisheries are presented. The first objective of the model is to reproduce the bioeconomic conditions in which the fisheries occur. The model is, perforce, multispecies and multigear. The main management procedure is effort limitation. The model also incorporates the usual fishermen strategy of increasing efficiency to obtain increased fishing mortality while maintaining the nominal effort. This is modelled by means of a function relating the efficiency (or technological progress) with the capital invested in the fishery and time. A second objective is to simulate alternative management strategies. The model allows the operation of technical and economic management measures in the presence of different kind of events. Both deterministic and stochastic simulations can be performed. An application of this tool to the hake fishery off Catalonia is presented, considering the other species caught and the different gears used. Several alternative management measures are tested and their consequences for the stock and economy of fishermen are analysed.

Neoadjuvant chemotherapy and radiotherapy followed by surgery in selected patients with stage IIIB non-small-cell lung cancer: a multicentre phase II trial.

BACKGROUND: Stage IIIB non-small-cell lung cancer (NSCLC) is usually thought to be unresectable, and is managed with chemotherapy with or without radiotherapy. However, selected patients might benefit from surgical resection after neoadjuvant chemotherapy and radiotherapy. The aim of this multicentre, phase II trial was to assess the efficacy and toxicity of a neoadjuvant chemotherapy and radiotherapy followed by surgery in patients with technically operable stage IIIB NSCLC. METHODS: Between September, 2001, and May, 2006, patients with pathologically proven and technically resectable stage IIIB NSCLC were sequentially treated with three cycles of neoadjuvant chemotherapy (cisplatin with docetaxel), immediately followed by accelerated concomitant boost radiotherapy (44 Gy in 22 fractions) and definitive surgery. The primary endpoint was event-free survival at 12 months. Efficacy analyses were done by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00030810. FINDINGS: 46 patients were enrolled, with a median age of 60 years (range 28-70). 13 (28%) patients had N3 disease, 36 (78%) had T4 disease. All patients received chemotherapy; 35 (76%) patients received radiotherapy. The main toxicities during chemotherapy were neutropenia (25 patients [54%] at grade 3 or 4) and febrile neutropenia (nine [20%]); the main toxicity after radiotherapy was oesophagitis (ten patients [29%]; nine grade 2, one grade 3). 35 patients (76%) underwent surgery, with pneumonectomy in 17 patients. A complete (R0) resection was achieved in 27 patients. Peri-operative complications occurred in 14 patients, including two deaths (30-day mortality 5.7%). Seven patients required a second surgical intervention. Pathological mediastinal downstaging was seen in 11 of the 28 patients who had lymph-node involvement at enrolment, a complete pathological response was seen in six patients. Event-free survival at 12 months was 54% (95% CI 39-67). After a median follow-up of 58 months, the median overall survival was 29 months (95% CI 16.1-NA), with survival at 1, 3, and 5 years of 67% (95% CI 52-79), 47% (32-61), and 40% (24-55). INTERPRETATION: A treatment strategy of neoadjuvant chemotherapy and radiotherapy followed by surgery is feasible in selected patients. Toxicity is considerable, but manageable. Survival compares favourably with historical results of combined treatment for less advanced stage IIIA disease. FUNDING: Swiss Group for Clinical Cancer Research (SAKK) and an unrestricted educational grant by Sanofi-Aventis (Switzerland).

Transferència científica a l'Institut de Ciència i Tecnologia Ambientals : anàlisi de la vinculació universitat - societat

Aquest projecte ha estat impulsat per l’Observatori de la Divulgació de la Ciència (ODC) de la UAB i dut a terme a l’Institut de Ciència i Tecnologia Ambientals (ICTA). Està emmarcat dins el marc del nou Programa Europeu Horizon 2020 i més específicament dels conceptes establerts per la RRI. L’objectiu d’aquest projecte és analitzar la comunicació científica que duu a terme l’ICTA cap a al societat i conèixer la filosofia, els incentius i la motivació de l’ICTA i els seus investigadors per donar a conèixer la seva recerca a la ciutadania. L’anàlisi de la comunicació de l’ICTA consta d’un anàlisi del contingut de la pàgina web del centre de recerca, una entrevista feta a la directora de l’institut i un qüestionari realitzat a 14 investigadors Les formes de comunicació que més utilitzen són els articles científics en revistes dirigides a públic acadèmic. Respecte la comunicació no acadèmica, s’ha pogut observar que la majoria dels investigadors, tot i la manca de facilitats realitzaven activitats per interès personal, molts cops però, no comuniquen la seva recerca, principalment perquè tenen altres tasques de docència, de recerca i gestió per atendre. Hi ha una minoria que es refereix a la comunicació científica com un “estil essencialment vocacional”. Per tal d’impulsar i promoure una estratègia contínua i efectiva de comunicació científica cal definir un pla de comunicació a nivell institucional que contribueixi a millorar les capacitats divulgatives, comunicatives i educatives de l’ICTA per tal d’ajudar a les persones que hi fan recerca a apropar la seva tasca a la societat a la que pertanyen.