Grado de pérdida de capacidad laboral asociada a la comorbilidad de los desórdenes músculo esqueléticos en la junta de calificación de invalidez regional Huila, 2009-2012

Resumen: Los desórdenes músculo esqueléticos son entidades que generan un efecto en la salud relacionados con la calidad de vida, dado al impacto global en la condición física, el bienestar psicológico y funcional. Estas entidades generan un gran número de indemnizaciones y en algunas oportunidades según el grado de pérdida de capacidad laboral la invalidez. Objetivo: Determinar la asociación del grado de perdida de la capacidad laboral con la comorbilidad de los desórdenes músculo esqueléticos y otros factores asociados. Materiales y métodos: Se realizó un estudio de corte transversal, basado en registros e historias clínicas. Los registros iniciales fueron 1427 casos, de los cuales 513 presentaban diagnóstico de DME y de estos 240 solicitaron la pérdida de capacidad laboral a la junta de invalidez regional Huila en el periodo comprendido del 2009 al 2012. Resultados: La distribución del grado de la pérdida de capacidad laboral generada de los DME por incapacidad permanente parcial fue del 73,3% y por invalidez el 26,7%. Se encontró una asociación significativa con respecto a la edad (p=0,002), donde el rango de 50-65 años presento mayor pérdida de capacidad laboral; con el género (p=0,047), siendo el femenino más prevalente la invalidez (34,7%) que en el masculino (23,2%) y la comorbilidad (p=0,019), donde los desórdenes músculo esqueléticos y los trastornos depresivos generaron mayor pérdida de capacidad laboral. No se encontró asociación significativa con la escolaridad (p=0,167), oficio (p=0,442) y actividad económica (p=0,118). En el análisis multivariado se encontró asociación significativa con el origen común (OR=4.028, IC 95%: 2.010, 8.072), el sexo femenino (OR=2.565, IC 95%: 1.140, 5.771), y el nivel de escolaridad técnico (OR=12.208, IC 95%: 1.372, 108.634). Conclusiones: La comorbilidad generó mayor pérdida de capacidad laboral, aunque los factores que en conjunto mostraron asociación fueron la edad avanzada, el género femenino, el origen común y el menor nivel educativo.

Data analysis and simulations of VIRTIS venus spectra

VIRTIS, a bordo di Venus Express, è uno spettrometro in grado di operare da 0.25 a 5 µm. Nel periodo 2006-2011 ha ricavato un'enorme mole di dati ma a tutt'oggi le osservazioni al lembo sono poco utilizzate per lo studio delle nubi e delle hazes, specialmente di notte. Gli spettri al lembo a quote mesosferiche sono dominati dalla radianza proveniente dalle nubi e scatterata in direzione dello strumento dalle hazes. L'interpretazione degli spettri al lembo non può quindi prescindere dalla caratterizzazione dell'intera colonna atmosferica. L'obiettivo della tesi è di effettuare un’analisi statistica sulle osservazioni al nadir e proporre una metodologia per ricavare una caratterizzazione delle hazes combinando osservazioni al nadir e al lembo. La caratterizzazione delle nubi è avvenuta su un campione di oltre 3700 osservazioni al nadir. È stato creato un ampio dataset di spettri sintetici modificando, in un modello iniziale, vari parametri di nube quali composizione chimica, numero e dimensione delle particelle. Un processo di fit è stato applicato alle osservazioni per stabilire quale modello potesse descrivere gli spettri osservati. Si è poi effettuata una analisi statistica sui risultati del campione. Si è ricavata una concentrazione di acido solforico molto elevata nelle nubi basse, pari al 96% in massa, che si discosta dal valore generalmente utilizzato del 75%. Si sono poi integrati i risultati al nadir con uno studio mirato su poche osservazioni al lembo, selezionate in modo da intercettare nel punto di tangenza la colonna atmosferica osservata al nadir, per ricavare informazioni sulle hazes. I risultati di un modello Monte Carlo indicano che il numero e le dimensioni delle particelle previste dal modello base devono essere ridotte in maniera significativa. In particolare si osserva un abbassamento della quota massima delle hazes rispetto ad osservazioni diurne.

On the formation of nitrogen oxides in the combustion processes of hydrogen in air

A research programme is being carried out at the Institute Nacional de Tecnica Aeroespacial of Spain, on several aspects of the formation of nitrogen oxides in continuous flow combustion systems, considering hydrogen and hydrocarbons as fuels. The research programme is fundamentally oriented on the basic aspects of the problem, although it also includes the study of the influence on the formation process of several operational and design variables of the combusters, such as type of fuels, fuel/air ratio, degree of mixing in premixed type flames, existence of droplets as compared with homogeneous combustion.This problem of nitrogen oxides formation is receiving lately great attention, specially in connection with automobile reciprocating engines and aircraft gas turbines. This is due to the fact of the increasing frequency and intensity of photochemical hazes or smog, typical of urban areas submitted to strong solar radiation, which are originated by the action on organic compounds of the oxidants resulting from the photochemical decomposition of nitrogen dioxide N02. In the combustion process almost all nitrogen oxides are in form of NO. This nitric oxide reacts with the oxygen of the air and forms N02, this reaction only taking place in or near the exhaust of tne motors, since the N0-02 reaction becomes frozen for the concentration existing in the atmosphere.

Inactive conformation of the serpin α1-antichymotrypsin indicates two-stage insertion of the reactive loop: Implications for inhibitory function and conformational disease

The serpins are a family of proteinase inhibitors that play a central role in the control of proteolytic cascades. Their inhibitory mechanism depends on the intramolecular insertion of the reactive loop into β-sheet A after cleavage by the target proteinase. Point mutations within the protein can allow aberrant conformational transitions characterized by β-strand exchange between the reactive loop of one molecule and β-sheet A of another. These loop-sheet polymers result in diseases as varied as cirrhosis, emphysema, angio-oedema, and thrombosis, and we recently have shown that they underlie an early-onset dementia. We report here the biochemical characteristics and crystal structure of a naturally occurring variant (Leu-55–Pro) of the plasma serpin α1-antichymotrypsin trapped as an inactive intermediate. The structure demonstrates a serpin configuration with partial insertion of the reactive loop into β-sheet A. The lower part of the sheet is filled by the last turn of F-helix and the loop that links it to s3A. This conformation matches that of proposed intermediates on the pathway to complex and polymer formation in the serpins. In particular, this intermediate, along with the latent and polymerized conformations, explains the loss of activity of plasma α1-antichymotrypsin associated with chronic obstructive pulmonary disease in patients with the Leu-55–Pro mutation.

Minimal disease activity for rheumatoid arthritis: A preliminary definition

Agreement on response criteria in rheumatoid arthritis (RA) has allowed better standardization and interpretation of clinical trial reports. With recent advances in therapy, the proportion of patients achieving a satisfactory state of minimal disease activity (MDA) is becoming a more important measure with which to compare different treatment strategies. The threshold for MDA is between high disease activity and remission and, by definition, anyone in remission will also be in MDA. True remission is still rare in RA; in addition, the American College of Rheumatology definition is difficult to apply in the context of trials. Participants at OMERACT 6 in 2002 agreed on a conceptual definition of minimal disease activity (MDA): "that state of disease activity deemed a useful target of treatment by both the patient and the physician, given current treatment possibilities and limitations." To prepare for a preliminary operational definition of MDA for use in clinical trials, we asked rheumatologists to assess 60 patient profiles describing real RA patients seen in routine clinical practice. Based on their responses, several candidate definitions for MDA were designed and discussed at the OMERACT 7 in 2004. Feedback from participants and additional on-site analyses in a cross-sectional database allowed the formulation of 2 preliminary, equivalent definitions of MDA: one based on the Disease Activity Score 28 (DAS28) index, and one based on meeting cutpoints in 5 out the 7 WHO/ILAR core set measures. Researchers applying these definitions first need to choose whether to use the DAS28 or the core set definition, because although each selects a similar proportion in a population, these are not always the same patients. In both MDA definitions, an initial decision node places all patients in MDA who have a tender joint count of 0 and a swollen joint count of 0, and an erythrocyte sedimentation rate (ESR) no greater than 10 mm. If this condition is not met: center dot The DAS28 definition places patients in MDA when DAS28

Transiting Exoplanet Studies and Community Targets for JWST's Early Release Science Program

The James Webb Space Telescope (JWST) will likely revolutionize transiting exoplanet atmospheric science, due to a combination of its capability for continuous, long duration observations and its larger collecting area, spectral coverage, and spectral resolution compared to existing space-based facilities. However, it is unclear precisely how well JWST will perform and which of its myriad instruments and observing modes will be best suited for transiting exoplanet studies. In this article, we describe a prefatory JWST Early Release Science (ERS) Cycle 1 program that focuses on testing specific observing modes to quickly give the community the data and experience it needs to plan more efficient and successful transiting exoplanet characterization programs in later cycles. We propose a multi-pronged approach wherein one aspect of the program focuses on observing transits of a single target with all of the recommended observing modes to identify and understand potential systematics, compare transmission spectra at overlapping and neighboring wavelength regions, confirm throughputs, and determine overall performances. In our search for transiting exoplanets that are well suited to achieving these goals, we identify 12 objects (dubbed “community targets”) that meet our defined criteria. Currently, the most favorable target is WASP-62b because of its large predicted signal size, relatively bright host star, and location in JWST's continuous viewing zone. Since most of the community targets do not have well-characterized atmospheres, we recommend initiating preparatory observing programs to determine the presence of obscuring clouds/hazes within their atmospheres. Measurable spectroscopic features are needed to establish the optimal resolution and wavelength regions for exoplanet characterization. Other initiatives from our proposed ERS program include testing the instrument brightness limits and performing phase-curve observations. The latter are a unique challenge compared to transit observations because of their significantly longer durations. Using only a single mode, we propose to observe a full-orbit phase curve of one of the previously characterized, short-orbital-period planets to evaluate the facility-level aspects of long, uninterrupted time-series observations.

Pulling Back the Veil: The Characterization and Habitability of Enshrouded Worlds

Thesis (Ph.D.)--University of Washington, 2016-08