Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis.

BACKGROUND: Nonselective beta-adrenergic blockers decrease portal pressure and prevent variceal hemorrhage. Their effectiveness in preventing varices is unknown. METHODS: We randomly assigned 213 patients with cirrhosis and portal hypertension (minimal hepatic venous pressure gradient [HVPG] of 6 mm Hg) to receive timolol, a nonselective beta-blocker (108 patients), or placebo (105 patients). The primary end point was the development of gastroesophageal varices or variceal hemorrhage. Endoscopy and HVPG measurements were repeated yearly. RESULTS: During a median follow-up of 54.9 months, the rate of the primary end point did not differ significantly between the timolol group and the placebo group (39 percent and 40 percent, respectively; P=0.89), nor were there significant differences in the rates of ascites, encephalopathy, liver transplantation, or death. Serious adverse events were more common among patients in the timolol group than among those in the placebo group (18 percent vs. 6 percent, P=0.006). Varices developed less frequently among patients with a baseline HVPG of less than 10 mm Hg and among those in whom the HVPG decreased by more than 10 percent at one year and more frequently among those in whom the HVPG increased by more than 10 percent at one year. CONCLUSIONS: Nonselective beta-blockers are ineffective in preventing varices in unselected patients with cirrhosis and portal hypertension and are associated with an increased number of adverse events. (ClinicalTrials.gov number, NCT00006398.

Systematic study of constitutive cyclo-oxygenase-2 expression: role of NFκB and NFAT transcriptional pathways

Cyclooxygenase-2 (COX-2) is an inducible enzyme that drives inflammation and is the therapeutic target for widely used nonsteroidal antiinflammatory drugs (NSAIDs). However, COX-2 is also constitutively expressed, in the absence of overt inflammation, with a specific tissue distribution that includes the kidney, gastrointestinal tract, brain, and thymus. Constitutive COX-2 expression is therapeutically important because NSAIDs cause cardiovascular and renal side effects in otherwise healthy individuals. These side effects are now of major concern globally. However, the pathways driving constitutive COX-2 expression remain poorly understood. Here we show that in the kidney and other sites, constitutive COX-2 expression is a sterile response, independent of commensal microorganisms and not associated with activity of the inflammatory transcription factor NF-κB. Instead, COX-2 expression in the kidney but not other regions colocalized with nuclear factor of activated T cells (NFAT) transcription factor activity and was sensitive to inhibition of calcineurin-dependent NFAT activation. However, calcineurin/NFAT regulation did not contribute to constitutive expression elsewhere or to inflammatory COX-2 induction at any site. These data address the mechanisms driving constitutive COX-2 and suggest that by targeting transcription it may be possible to develop antiinflammatory therapies that spare the constitutive expression necessary for normal homeostatic functions, including those important to the cardiovascular-renal system

Estudio de la fracción de materia orgánica de mayor remoción en el proceso de coagulación-floculación usando agua superficial

pEn este trabajo, se realizó la separación de la materia orgánica natural (MON) presente en el agua cruda que abastece a dos plantas potabilizadoras, una de río (Boaco) y otra de lago (Juigalpa), en dos tipos: hidrofóbica, constituida por las fracciones muy hidrofóbica (MH) y ligeramente hidrofóbica (LH); y el tipo hidrofílica formada por las fracciones cargada (CHA) y neutral (NEU). Las aguas obtenidas de cada fracción fueron sometidas a un proceso de coagulación-floculación-sedimentación a escala de laboratorio usando sulfato de aluminio como coagulante; donde la fracción hidrofílica (CHA y NEU) fue poco removida (lt; 35 %) en comparación con la hidrofóbica (gt; 65 %). Se utilizaron parámetros sustitutos para caracterizar dicha MON como carbono orgánico disuelto (COD), color, absorbancia ultravioleta (UV254) y absorbancia especifica ultravioleta (SUVA). Se determinó que estas aguas cruda presentan una mezcla de materia orgánica hidrofóbica e hidrofílica ya que los valores de SUVA estaban entre 2-4 L/mg-m, sin embargo la fracción hidrofóbica (MH+LH) fue la predominante ya que representa 63.6 % y 65 % medidos como COD en época seca para Boaco y Juigalpa respectivamente, en época lluviosa los porcentajes fueron un poco más alto (71.2 % y 66.1 %). Finalmente se halló que el agua de río (Boaco) contiene mayor concentración de trihalometanos (89-166 μg/L) que el agua del lago (Juigalpa) (28-80 μg/L) después de ser clorada. Encontrándose que la fracción hidrofóbica fue la que más contribuyó a la formación de trihalometanos (THMs) en 68.5 % (Boaco) y 78.6 % (Juigalpa) en la época seca en ambas aguas tratadas. Para la época lluviosa, la formación de THMs fue un poco mayor./ppstrongPalabras claves:/strong Materia orgánica; Trihalometanos; Fraccionamiento; Agua superficial/p pDOI: a href="http://dx.doi.org/10.5377/nexo.v24i1.596"http://dx.doi.org/10.5377/nexo.v24i1.596/a/p pNexo, Vol. 24, No. 1, pp. 72-80, 2011/

Estudio de la fracción de materia orgánica de mayor remoción en el proceso de coagulación-floculación usando agua superficial

In this work, we performed the separation of natural organic matter (MON) present in the raw water that supplies two water treatment plants, one from river (Boaco) and one from lake (Juigalpa), in two types: hydrophobic, formed by the fractions very hydrophobic (MH) and slightly hydrophobic (LH); and the hydrophilic type constituted by the charged (CHA) and neutral (NEU) fractions. These waters obtained from each fraction were subjected to a process of coagulation-flocculation-sedimentation on a laboratory scale using aluminum sulfate as a coagulant, wherein the hydrophilic fraction (CHA and NEU) was poorly removed (< 35 %) in comparison with the hydrophobic one (> 65 %). Surrogate parameters were used to characterise this MON such as dissolved organic carbon (COD), colour, ultraviolet absorbance (UV254) and specific ultraviolet absorbance (SUVA). Determination of SUVA values indicates a mixture of hydrophobic and hydrophilic organic matter in both raw waters as their values of specific ultraviolet absorbance (SUVA) were between 2-4 L/mg-m; however the hydrophobic fraction (MH + LH) was the predominant one, 63.6 % and 65 % measured as COD in dry season for Boaco and Juigalpa respectively, in rainy season, the percentage were a little higher (71.2 % and 66.1 %). Finally, it was found that the river water (Boaco) contains higher concentrations of trihalomethanes (89-166 μg/L) than the water lake (Juigalpa) (28-80 μg/L) after being chlorinated. Found that the hydrophobic fraction was the major contributor in 68.5 % (Boaco) and 78.6 % (Juigalpa) to the formation of trihalomethanes for dry season in both treated water. In rainy season, the THMs formation were a little higher. Keywords: Organic matter; Trihalomethanes; Fractionation; Superficial water DOI: http://dx.doi.org/10.5377/nexo.v24i1.596   Nexo, Vol. 24, No. 1, pp. 72-80, 2011En este trabajo, se realizó la separación de la materia orgánica natural (MON) presente en el agua cruda que abastece a dos plantas potabilizadoras, una de río (Boaco) y otra de lago (Juigalpa), en dos tipos: hidrofóbica, constituida por las fracciones muy hidrofóbica (MH) y ligeramente hidrofóbica (LH); y el tipo hidrofílica formada por las fracciones cargada (CHA) y neutral (NEU). Las aguas obtenidas de cada fracción fueron sometidas a un proceso de coagulación-floculación-sedimentación a escala de laboratorio usando sulfato de aluminio como coagulante; donde la fracción hidrofílica (CHA y NEU) fue poco removida (< 35 %) en comparación con la hidrofóbica (> 65 %). Se utilizaron parámetros sustitutos para caracterizar dicha MON como carbono orgánico disuelto (COD), color, absorbancia ultravioleta (UV254) y absorbancia especifica ultravioleta (SUVA). Se determinó que estas aguas cruda presentan una mezcla de materia orgánica hidrofóbica e hidrofílica ya que los valores de SUVA estaban entre 2-4 L/mg-m, sin embargo la fracción hidrofóbica (MH+LH) fue la predominante ya que representa 63.6 % y 65 % medidos como COD en época seca para Boaco y Juigalpa respectivamente, en época lluviosa los porcentajes fueron un poco más alto (71.2 % y 66.1 %). Finalmente se halló que el agua de río (Boaco) contiene mayor concentración de trihalometanos (89-166 μg/L) que el agua del lago (Juigalpa) (28-80 μg/L) después de ser clorada. Encontrándose que la fracción hidrofóbica fue la que más contribuyó a la formación de trihalometanos (THMs) en 68.5 % (Boaco) y 78.6 % (Juigalpa) en la época seca en ambas aguas tratadas. Para la época lluviosa, la formación de THMs fue un poco mayor. Palabras claves: Materia orgánica; Trihalometanos; Fraccionamiento; Agua superficial DOI: http://dx.doi.org/10.5377/nexo.v24i1.596   Nexo, Vol. 24, No. 1, pp. 72-80, 201

Paving the Way for a Real-Time Context-Aware Predictive Architecture

Internet of Things society generates and needs to consume huge amounts of data in a demanding context-aware scenario. Such exponentially growing data sources require the use of novel processing methodologies, technologies and tools to facilitate data processing in order to detect and prevent situations of interest for the users in their particular context. To solve this issue, we propose an architecture which making use of emerging technologies and cloud platforms can process huge amounts of heterogeneous data and promptly alert users of relevant situations for a particular domain according to their context. Last, but not least, we will provide a graphical tool for domain experts to easily model, automatically generate code and deploy the situations to be detected and the actions to be taken in consequence. The proposal will be evaluated through a real case study related to air quality monitoring and lung diseases in collaboration with a doctor specialist on lung diseases of a public hospital

18F-Fluorodeoxyglucose PET/CT in a Patient with Esophageal and Genital Leiomyomatosis

Diffuse esophageal leiomyomatosis is a rare benign tumor, which can be associated with leiomyoma in female genital tracts involving the uterus, vagina, and vulva. Alport syndrome, an inherited disorder that includes the kidneys, eyes, and sensorineural hearing loss, is also rarely associated with these multiple leiomyomatosis. In our case, 18F-fluoroseoxyglucose positron emission tomography/computed tomography was used to distinguish esophageal and genital leiomyomatosis from malignant masses

Nonlinear damping in mechanical resonators based on graphene and carbon nanotubes

Carbon nanotubes and graphene allow fabricating outstanding nanomechanical resonators. They hold promise for various scientific and technological applications, including sensing of mass, force, and charge, as well as the study of quantum phenomena at the mesoscopic scale. Here, we have discovered that the dynamics of nanotube and graphene resonators is in fact highly exotic. We propose an unprecedented scenario where mechanical dissipation is entirely determined by nonlinear damping. As a striking consequence, the quality factor Q strongly depends on the amplitude of the motion. This scenario is radically different from that of other resonators, whose dissipation is dominated by a linear damping term. We believe that the difference stems from the reduced dimensionality of carbon nanotubes and graphene. Besides, we exploit the nonlinear nature of the damping to improve the figure of merit of nanotube/graphene resonators.Comment: main text with 4 figures, supplementary informatio

The long-term effects of CVDs on economic development: the case of Bangalore

The aim of this paper is to demonstrate the economic and health burden of Cardiovascular diseases (CVDs) in the context of Bangalore during the period 2010-2013. A data set containing in excess of 1 million historic records corresponding to all-cause mortality was obtained from the central repository data register. After a data quality assessment, a dataset of n=183,893 was obtained. Spatial analysis was carried out to highlight the hotspots of CVD. Potential Years of Life Lost due to CVD and Present Value of Lifetime Earnings were computed. CVDs were responsible for 25% of the total of potential years of life lost. The potential value of lifetime earnings highlighted a loss in excess of 8 billion INR over the four years. CVD poses a tremendous challenge for socio-economic development, and there is an urgent need for a strategic action to promote CVD prevention and enable a sustainable development for the economy

A ferroelectric memristor

Memristors are continuously tunable resistors that emulate synapses. Conceptualized in the 1970s, they traditionally operate by voltage-induced displacements of matter, but the mechanism remains controversial. Purely electronic memristors have recently emerged based on well-established physical phenomena with albeit modest resistance changes. Here we demonstrate that voltage-controlled domain configurations in ferroelectric tunnel barriers yield memristive behaviour with resistance variations exceeding two orders of magnitude and a 10 ns operation speed. Using models of ferroelectric-domain nucleation and growth we explain the quasi-continuous resistance variations and derive a simple analytical expression for the memristive effect. Our results suggest new opportunities for ferroelectrics as the hardware basis of future neuromorphic computational architectures

Long‐Term Variability and Tendencies in Middle Atmosphere Temperature and Zonal Wind From WACCM6 Simulations During 1850–2014

Long‐term variability of middle atmosphere temperature (T) and zonal wind (U) is investigated using a three‐member ensemble of historical simulations of NCAR's Whole Atmospheric Community Climate Model latest version 6 (WACCM6) for 1850–2014 (165 years). The model reproduces the climatological features of T and U. The contributions of Quasi Biennial Oscillation (QBO) at 10 and 30 hPa, solar cycle (SC), El Niño‐Southern Oscillation (ENSO), ozone depleting substances (ODS), carbon dioxide (CO2), and stratospheric sulfate aerosol (volcanic eruptions) to change in monthly zonal mean T and U are analyzed using multiple linear regression. The signal due to CO2 increase dominates as a predictor of the net multidecadal global annual mean temperature change at all levels in the middle atmosphere. Contributions from ODS also affect the net multidecadal global mean temperature trend in the stratosphere. Because of similarities in the time evolution of the emissions of CO2 and ODS, the analysis of existing model output cannot accurately separate the attributions of cooling to these two dominant forcing processes. On shorter time scales, solar flux variations are the largest source of variability in the mesosphere while volcanic eruptions are the largest in the stratosphere. In the stratosphere and mesosphere, both QBO and ENSO can significantly impact zonal mean temperature and zonal‐mean zonal wind depending on latitudes, but their impact on the multidecadal global mean temperature trend is very small