Validation of a 3D Local-Scale Adaptive Solar Radiation Model by Using Pyranometer Measurements and a High-Resolution Digital Elevation Model.

The result of the multidisciplinary collaboration of researchers from different areas of knowledge to validate a solar radiation model is presented. The MAPsol is a 3D local-scale adaptive solar radiation model that allows us to estimate direct, diffuse, and reflected irradiance for clear sky conditions. The model includes the adaptation of the mesh to complex orography and albedo, and considers the shadows cast by the terrain and buildings. The surface mesh generation is based on surface refinement, smoothing and parameterization techniques and allows the generation of high-quality adapted meshes with a reasonable number of elements. Another key aspect of the paper is the generation of a high-resolution digital elevation model (DEM). This high-resolution DEM is constructed from LiDAR data, and its resolution is two times more accurate than the publicly available DEMs. The validation process uses direct and global solar irradiance data obtained from pyranometers at the University of Salamanca located in an urban area affected by systematic shading from nearby buildings. This work provides an efficient protocol for studying solar resources, with particular emphasis on areas of complex orography and dense buildings where shadows can potentially make solar energy production facilities less efficient.

Harmonic Extraction in Graphene: Monte Carlo Analysis of the Substrate Influence.

Graphene on different substrates, such as SiO2, h-BN and Al2O3, has been subjected to oscillatory electric fields to analyse the response of the carriers in order to explore the generation of terahertz radiation by means of high-order harmonic extraction. The properties of the ensemble Monte Carlo simulator employed for such study have allowed us to evaluate the high-order harmonic intensity and the spectral density of velocity fluctuations under different amplitudes of the periodic electric field, proving that strong field conditions are preferable for the established goal. Furthermore, by comparison of both harmonic intensity and noise level, the threshold bandwidth for harmonic extraction has been determined. The results have shown that graphene on h-BN presents the best featuring of the cases under analysis and that in comparison to III-V semiconductors, it is a very good option for high-order harmonic extraction under AC electric fields with large amplitudes.

Blood culture-negative infective endocarditis: a worse outcome? Results from a large multicentre retrospective Spanish cohort study.

BACKGROUND: To assess the impact of blood cultures negative infective endocarditis (BCNIE) on in-hospital mortality. METHODS: Prospective multicentre study with retrospective analysis of a Spanish cohort including adult patients with definite IE. Cardiac implantable devices infection were excluded. Comparisons between blood cultures positive and BCNIE groups were performed to analyse in-hospital mortality. RESULTS: 1001 cases were included of which 83 (8.3%) had BCNIE. Alternative microbiological diagnosis was achieved for 39 (47%) out 83 cases. The most frequent identifications were: Coxiella burnetii (11; 28.2%), Tropheryma whipplei (4; 10.3%), Streptococcus gallolyticus (4;10.3%) and Staphylococcus epidermidis (3; 7.7%). Surgery was performed more frequently in BCNIE group (57.8 vs. 36.9%, p < .001). All-cause in-hospital mortality rate was 26.7% without statistical difference between compared groups. BCNIE was not associated to worse mortality rate in Cox regression model (aHR = 1.37, 95% CI 0.90-2.07, p = .14). Absence of microbiological diagnosis was also not associated to worse in-hospital prognosis (aHR = 1.62, 95% CI 0.99-2.64, p = .06). CONCLUSIONS: In our cohort, BCNIE was not associated to greater in-hospital mortality based in multivariate Cox regression models. The variables most frequently associated with mortality were indicated but not performed surgery (aHR = 2.48, 95% CI 1.73-3.56, p < .001), septic shock (aHR = 2.24, 95% CI 1.68-2.99, p < .001), age over 65 years (aHR = 1.88, 95% CI 1.40-2.52, p < .001) and complicated endocarditis (aHR = 1.79, 95% CI 1.36-2.37, p < .001).

Outpatient Parenteral Antibiotic Treatment for Infective Endocarditis: A Prospective Cohort Study From the GAMES Cohort.

BACKGROUND: Outpatient parenteral antibiotic treatment (OPAT) has proven efficacious for treating infective endocarditis (IE). However, the 2001 Infectious Diseases Society of America (IDSA) criteria for OPAT in IE are very restrictive. We aimed to compare the outcomes of OPAT with those of hospital-based antibiotic treatment (HBAT). METHODS: Retrospective analysis of data from a multicenter, prospective cohort study of 2000 consecutive IE patients in 25 Spanish hospitals (2008-2012) was performed. RESULTS: A total of 429 patients (21.5%) received OPAT, and only 21.7% fulfilled IDSA criteria. Males accounted for 70.5%, median age was 68 years (interquartile range [IQR], 56-76), and 57% had native-valve IE. The most frequent causal microorganisms were viridans group streptococci (18.6%), Staphylococcus aureus (15.6%), and coagulase-negative staphylococci (14.5%). Median length of antibiotic treatment was 42 days (IQR, 32-54), and 44% of patients underwent cardiac surgery. One-year mortality was 8% (42% for HBAT; P < .001), 1.4% of patients relapsed, and 10.9% were readmitted during the first 3 months after discharge (no significant differences compared with HBAT). Charlson score (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.04-1.42; P = .01) and cardiac surgery (OR, 0.24; 95% CI, .09-.63; P = .04) were associated with 1-year mortality, whereas aortic valve involvement (OR, 0.47; 95% CI, .22-.98; P = .007) was the only predictor of 1-year readmission. Failing to fulfill IDSA criteria was not a risk factor for mortality or readmission. CONCLUSIONS: OPAT provided excellent results despite the use of broader criteria than those recommended by IDSA. OPAT criteria should therefore be expanded.

Pharmacokinetic Evaluation of Nimotuzumab in Patients With Autosomal Dominant Polycystic Kidney Disease.

Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disease characterized by an overexpression and mislocalization of epidermal growth factor receptor (EGFR) to the apical membranes of cystic epithelial cells. Nimotuzumab is a humanized antibody that recognizes an extracellular domain III of human EGFR. The aim of this study was to assess the pharmacokinetic behavior of nimotuzumab in patients with ADPKD given as a single dose. A phase I, single-center, and noncontrolled open clinical study was conducted. Five patients were enrolled at each of the following fixed-dose levels: 50, 100, 200, and 400 mg. Intravenous continuous infusions of nimotuzumab were administered every 14 days during a year, except the first administration, when blood samples were drawn during 28 days for pharmacokinetic assessments. Subjects were closely monitored during the trial and at completion of the administration of nimotuzumab, including the anti-idiotypic response. For the first time, nimotuzumab was used for treating a nononcological disease. The administration of nimotuzumab showed dose-dependent kinetics. Nimotuzumab does not develop anti-idiotypic response against the murine portion present in the hypervariable region of the antibody present in the serum of the patients treated. No significant differences were found in the systemic clearance between the 100- and 400-mg dose, which indicates that the optimal biological dose is in this range of dose.

Scaling of graphene field-effect transistors supported on hexagonal boron nitride: radio-frequency stability as a limiting factor.

The quality of graphene in nanodevices has increased hugely thanks to the use of hexagonal boron nitride as a supporting layer. This paper studies to which extent hBN together with channel length scaling can be exploited in graphene field-effect transistors (GFETs) to get a competitive radio-frequency (RF) performance. Carrier mobility and saturation velocity were obtained from an ensemble Monte Carlo simulator that accounted for the relevant scattering mechanisms (intrinsic phonons, scattering with impurities and defects, etc). This information is fed into a self-consistent simulator, which solves the drift-diffusion equation coupled with the two-dimensional Poisson's equation to take full account of short channel effects. Simulated GFET characteristics were benchmarked against experimental data from our fabricated devices. Our simulations show that scalability is supposed to bring to RF performance an improvement that is, however, highly limited by instability. Despite the possibility of a lower performance, a careful choice of the bias point can avoid instability. Nevertheless, maximum oscillation frequencies are still achievable in the THz region for channel lengths of a few hundreds of nanometers.

Low positive rate of serum autoantibodies in colorectal cancer patients without systemic rheumatic diseases.

BACKGROUND: Antinuclear antibody (ANA) testing is useful for screening, diagnosis and follow-up of patients with systemic rheumatic diseases. Indirect immunofluorescence (IIF) on HEp-2 cells is the gold standard for ANA testing. However, ANA have also been detected in patients with different cancer types but without any autoimmune disease. To overcome these shortcomings, different automated solid-phase assays have been developed. AIM: To determine the positive rate of a new ANA detection method (EliA CTD Screen, Phadia, Germany), in CRC patients without systemic rheumatic diseases. Additionally, we compare this method with IIF. MATERIALS AND METHODS: Serum samples were obtained before a colonoscopy procedure in a patient cohort (n = 186) with a high clinical suspicion of CRC. Samples for ANA detection in CRC patients were processed in parallel by IIF on HEp-2 and the solid-phase fluoroenzymeimmunoassay EliA CTD Screen (Phadia, Germany) on the Phadia 250 instrument (Phadia GmbH, Freiburg, Germany). Positive samples by IIF and/or CTD were tested with EliA single ANA assays (Phadia, Germany) on the Phadia 250 instrument (Phadia GmbH, Freiburg, Germany). RESULTS: Forty-five patients diagnosed with CRC were included. Four cases were positive by CTD and 23 by IIF. Of the four positive patients by CTD, two were positive and one indeterminate for anti-dsDNA antibodies. Of the 23 positive by IIF, one patient was positive and another indeterminate for anti-dsDNA antibodies, and a third patient was positive for anti-U1RNP antibodies. CONCLUSIONS: The CTD assay shows a low false positive rate for detecting autoantibodies in a clinical context of CRC.

Plasma Tumor M2-Pyruvate Kinase Levels in Different Cancer Types.

BACKGROUND/AIM: Tumor M2-pyruvate kinase (M2-PK) is up-regulated in proliferating tissues. It has been shown that tumor M2-PK is detectable and quantifiable in the stool and plasma of patients with colorectal cancer (CRC). Tumor M2-PK has been extensively studied in gastrointestinal tumors but its role in other cancer types has not yet been deeply evaluated. The aim of the study was to determine and compare plasma tumor M2-PK levels in different cancer types. MATERIALS AND METHODS: All patients undergoing diagnostics for cancer at our Hospital during 2011 were included in the study (n=139). Plasma tumor M2-PK concentration was analyzed by an enzyme-linked immunosorbent assay. RESULTS: The different cancer types found in the study were: 60 colorectal, 43 breast, 8 lung, 5 prostatic, 4 ovarian and the remaining 19 cases were other uncommon tumor types. Most tumors had high concentrations of tumor M2-PK; prostatic, pharyngeal and testicular tumors had levels lower than or near the cut-off. Plasma tumor M2-PK levels were significantly higher in patients with distant metastases and stage IV by TNM. CONCLUSION: Plasma tumor M2-PK is not a specific marker for CRC and is elevated in many other types of cancers, including breast, lung, ovarian, and thyroid. Small amounts are found in prostatic, pharyngeal and testicular tumors.

Fisiopatología de la enfermedad renal poliquística / Physiopathology of the polycystic renal disease

La enfermedad renal poliquística es una de las condiciones genéticas con peligro para la vida más frecuentes en las poblaciones humanas. Se produce por mutaciones en los genes de algunas proteínas de las estructuras ciliares que modifica varias de las vías claves para la señalización celular, e induce un fenotipo hiperproliferativo que genera la aparición de neoplasmas benignos, localizados principalmente en el riñón, donde provocan la formación de quistes y la destrucción progresiva del tejido activo, hasta llegar a la enfermedad renal crónica. En los últimos años se ha acumulado una gran cantidad de información sobre la fisiopatología de la enfermedad y se ha hecho posible el surgimiento de estrategias nuevas para el tratamiento, que se encuentran en ensayos clínicos en todo el mundo(AU)

Polycystic Kidney Disease is one the most frequent life threatening genetic disease in the human population. The etiology is the defect on the genes coding for several proteins on the cell cilia, modifying key signaling pathways to induce a hyperproliferative phenotype and the development of benign neoplasms localized mainly on the kidneys, provoking the progressive destruction of the active tissue and the end stage renal disease. In the recent years many information has been gathered on the pathophysiology of the disease, making possible the devise of new treatment strategies in clinical trials through the world(AU)

Caracterización Clínica, Genética y Epidemiológica de las Enfermedades Quísticas Renales en el Municipio Quivicán / Clinical, genetic and epidemiologic characterization of renal cystic diseases in Quivicán municipality

Se realizó un estudio observacional, transversal, que incluyó a 44 individuos del municipio Quivicán, Provincia La Habana, con diagnóstico de quiste renal o de enfermedad genética que cursa con ellos, y a sus familiares de primer grado. Se realizó ultrasonido abdominal a 208 individuos, se confirmó la presencia de quistes renales en 54 casos, a los cuales se les realizó examen físico general y se les indicó estudios complementarios de sangre y orina. La investigación permitió estudiar al 58,1 por ciento de los familiares en riesgo; identificar 10 familias con alto riesgo de recurrencia de quistes renales, todas con diagnóstico de enfermedad poliquística renal y en una de ellas coincidiendo el diagnóstico de enfermedad renal quística medular, ambas con herencia autosómica dominante; así como, describir las principales características clínicas, genéticas y epidemiológicas de las enfermedades quísticas renales en el municipio Quivicán. Se detectaron además 18 nuevos casos, de ellos 11 con algún grado de afectación de la función renal(AU)

An observational, descriptive, transverse study was carried out; which included 44 individuals of the Quivicán municipality with diagnosis of renal cyst or a genetic disease associated with them and their first degree relatives. Abdominal ultrasound was done to 208 individuals, confirming the presence of renal cysts in 54 cases that received a general physical exam and were indicated blood and urine complementary studies.The investigation allowed to study 58,1 percent of the relatives in risk and identifying 10 families with high risk of renal cysts recurrence, all of them with diagnosis of polycystic kidney disease and in one of them coinciding with the diagnosis of medullar polycystic renal disease, both with dominant autosomic inheritance. It was also possible to describe the main clinical, genetic and epidemiologic characteristics of the renal cystic disease in the Quivicán municipality detecting 18 new cases, 11 of them having some degree of influence on the renal function(AU)

Successful treatment of propofol-induced priapism with distal glans to corporal cavernosal shunt.

We report a case of postoperative pediatric priapism in a boy without a hematologic disorder after a propofol-based general anesthetic. Our case underscores the importance of the early diagnosis and treatment to lessen the risk of complications. Given the wide use of propofol for sedation and anesthesia, clinicians should be cognizant of this rare, but serious, adverse effect that requires emergent attention.

Impact of a primary care intervention on smoking, drinking, diet, weight, sun exposure, and work risk in families with cancer experience.

BACKGROUND: Modifying multiple behavior risks is a promising approach to reduce cancer risk. Primary prevention advices of the European Code against Cancer were included in an educational intervention (EI) using social cognitive theories for motivating families with cancer experiences to adopt six cancer prevention behaviors. METHODS: A randomized clinical controlled trial recruited 3,031 patients from Primary Care among cancer patients' relatives. The experimental group (EG) received four EI, one EI every six months, focused on tobacco, alcohol, diet, weight, sun and work, and based on social cognitive models. The impact of the first three EI was calculated measuring at baseline and 18 months later: (a) The percentage of people with each risk behavior; (b) The score reached in a Total Cancer Behavioral Risk (TCBR) indicator; (c) The Odds Ratios at the post-test. RESULTS: Five risk behaviors decreased significantly more (p<0.01) in the EG than in the CG: Smoking (OR=0.662), drinking (OR=0.504), diet (OR=0.542), weight (OR=0.698), and sun (OR=0.389). The TCBR indicator also decreased an average of nearly 5 points (28.42 vs. 23.82), significantly more (p<0.001) in the EG. CONCLUSION: Families with cancer experiences changed five cancer risk behaviors when approached in Primary Care with interventions based on social cognitive models.

Registro genético preventivo automatizado de la enfermedad poliquística renal autosómica dominante

Se decidió crear un registro genético automatizado de la enfermedad poliquística renal autosómica dominante ya que es un fenómeno común y existe un programa nacional para su atención. Se empleó una metodología desarrollada por los autores para facilitar el estudio y seguimiento sistemático de muchas familias y su atención genética. Se logró en los primeros 3 años de funcionamiento, la caracterización clínica, genética y epidemiológica de 111 familias y se comprobó la factibilidad de la metodología desarrollada. Se les ofreció asesoramiento genético y seguimiento a 2 870 personas afectadas o con riesgo y se diseñaron varias investigaciones que contribuyeron a mejorar su atención y seguimiento.

It was decided to created an automated genetic registry of the autosomal dominant polycystio kidney disease, taking into account that it is a common phenomenon and that there is a national program for its attention. A methodology developed by the authors was used to enable the study and systematic follow-up of many families and their genetic attention. The clinical, genetic and epidemiological characterization of 111 families was attained during the first three years and the feasibility of the methodology was proved. 2 870 affected patients or at risk received genetic counseling and follow-up. Several investigations were designed to improve their attention and follow-up.

Registro genético preventivo automatizado de la enfermedad poliquística renal autosómica dominante / Automated preventive genetic registry of autosomal dominant polycystic kidney disease

Se decidió crear un registro genético automatizado de la enfermedad poliquística renal autosómica dominante ya que es un fenómeno común y existe un programa nacional para su atención. Se empleó una metodología desarrollada por los autores para facilitar el estudio y seguimiento sistemático de muchas familias y su atención genética. Se logró en los primeros 3 años de funcionamiento, la caracterización clínica, genética y epidemiológica de 111 familias y se comprobó la factibilidad de la metodología desarrollada. Se les ofreció asesoramiento genético y seguimiento a 2 870 personas afectadas o con riesgo y se diseñaron varias investigaciones que contribuyeron a mejorar su atención y seguimiento(AU)

Tratamiento de la hipertensión arterial sintomática con nifedipina / Treatment of symptomatic arterial hypertension with nifedipine

El bloqueador de canales de calcio, nifedipina, se mostró altamente efectivo en el tratamiento de la hipertensión arterial sintomática de 30 pacientes con diversas afecciones asociadas. Por sus escasos efectos secundarios, bajo costo, fácil administración, posible asociación con otros fármacos antihipertensivos, así como su posible uso en otros estados patológicos asociados, consideramos a la nifedipina, como la droga de elcción en el tratamiento de la hipertensión arterial sintomática

Tratamiento de la hipertensión arterial sintomática con nifedipina / Treatent of symptomatic arterial hypertension with nifedipine

El bloqueador de canales de calcio, nifedipina, se mostró altamente efectivo en el tratamiento de la hipertensión arterial sintomática de 30 pacientes con diversas afecciones asociadas. Por sus escasos efectos secundarios, bajo costo, fácil administración, posible asociación con otros fármacos antihipertensivos, así como su posible uso en otros estados patológicos asociados, consideramos a la nifedipina, como la droga de elcción en el tratamiento de la hipertensión arterial sintomática

Valoración de las dosis altas y estandares de esteroides en el trasplante renal primario de riñón de cadáver / Appraisal of standard and high dose steroid in primary cadaveric renal transplantation

Con el objetivo de analizar el efecto de las dosis de esteroides (mg/kg/día) sobre la supervivencia del injerto y de los pacientes, y sobre las complicaciones inmunológicas y sépticas, se estudiaron 54 trasplantes renales primarios (34 hombres y 20 mujeres) de donantes cadáveres. Los casos fueron divididos en 3 grupos de 13 casos y 1 de 15: grupo A (0,5 mg/kg/día y buena compatibilidad), grupo B (0,5 mg/kg/día y mala compatibilidad), grupo C (1,2 mg/kg/día y buena compatibilidad) y grupo D (1,2 mg/kg/día y mala compatibilidad). La supervivencia actuarial del total al año, fue del 66 % para la función renal y del 76 para la del paciente, no se encontraron diferencias significativas en estos 2 parámetros entre los 4 grupos analizados. Los grupos con dosis inicial baja (0,5 mg/kg) tuvieron mayor número de rechazos en los primeros 10 días y éstos fueron más precoces. La frecuencia de los pulsos esteroides hizo que al final del primer mes todos los pacientes recibieran dosis acumuladas altas de esteroides. No encontramos diferencias sobre las pérdidas de riñones por rechazo, pérdidas de pacientes, grado de función renal o complicaciones a los 30, 60 y 90 días