Menopausia y Terapia Hormonal de la Menopausia Las recomendaciones 2018 de la Unidad de Endocrinología Ginecológica de Clínica Alemana de Santiago -Sociedad Italiana de la Menopausia y la Sociedad Chilena de Endocrinología Ginecológica

ABSTRACT In the last decade, the risk benefits ratio of MHT has been evaluated mainly in terms of cardiovascular risk. Present Consensus Statement is largely inspired by the Global Consensus on Menopausal Hormone Therapy in 2013 and 2016 by leading global menopause societies (The American Society for Reproductive Medicine, The Asia Pacific Menopause Federation, The Endocrine Society, The European Menopause and Andropause Society, The International Menopause Society, The International Osteoporosis Foundation and The North American Menopause Society). The aim of these Recommendations is to provide a simple and updated reference on postmenopausal MHT. The term MHT typically includes estrogen replacement therapy (ERT) and estrogen-progestogen therapy (EPT). EPT can be sequential (Seq) when progestogen is added to ERT for 10-14 days a month, or continuous combined (CC) when progestogen is administered continuously every day along with a fixed amount of estrogen. MHT also includes Tibolone and the Tissue Selective Estrogen Complex (TSEC)

Coisotropic D-branes on AdS4 x CP3 and massive deformations

We scan for massive type IIA SU(3)-structure compactifications of the type AdS4 x CP3 with internal symmetry group SO(4). This group acts on CP3 with cohomogeneity one, so that one would expect new non-homogeneous solutions. We find however that all such solutions enhance their symmetry group to Sp(2) and form, in fact, the homogeneous family first described in arXiv:0712.1396. This is in accordance with arXiv:0901.0969, which argues from the CFT-side that although new vacua with SO(4) symmetry group and N=2 supersymmetry should exist, they fall outside our ansatz of strict SU(3)-structure, and instead have genuine SU(3)x SU(3)-structure. We do find that the SO(4)-invariant description, which singles out one preferential direction in the internal space, is well-adapted for describing the embedding of AdS4-filling supersymmetric D8-branes on both the original ABJM configuration as its massive Sp(2)-symmetric deformations.Supersymmetry requires these D-branes to be of the coisotropic type, which means in particular that their world-volume gauge field must be non-trivial.Comment: 24 pages, 1 figure, v2: due to a serious mistake the claims of the paper had to be correcte

Developmental subtypes assessed by DNA methylation-iPLEX forecast the natural history of chronic lymphocytic leukemia

© 2019 by The American Society of Hematology Alterations in global DNA methylation patterns are a major hallmark of cancer and represent attractive biomarkers for personalized risk stratification. Chronic lymphocytic leukemia (CLL) risk stratification studies typically focus on time to first treatment (TTFT), time to progression (TTP) after treatment, and overall survival (OS). Whereas TTFT risk stratification remains similar over time, TTP and OS have changed dramatically with the introduction of targeted therapies, such as the Bruton tyrosine kinase inhibitor ibrutinib. We have shown that genome-wide DNA methylation patterns in CLL are strongly associated with phenotypic differentiation and patient outcomes. Here, we developed a novel assay, termed methylation-iPLEX (Me-iPLEX), for high-throughput quantification of targeted panels of single cytosine guanine dinucleotides from multiple independent loci. Me-iPLEX was used to classify CLL samples into 1 of 3 known epigenetic subtypes (epitypes). We examined the impact of epitype in 1286 CLL patients from 4 independent cohorts representing a comprehensive view of CLL disease course and therapies. We found that epitype significantly predicted TTFT and OS among newly diagnosed CLL patients. Additionally, epitype predicted TTP and OS with 2 common CLL therapies: chemoimmunotherapy and ibrutinib. Epitype retained significance after stratifying by biologically related biomarkers, immunoglobulin heavy chain mutational status, and ZAP70 expression, as well as other common prognostic markers. Furthermore, among several biological traits enriched between epitypes, we found highly biased immunogenetic features, including IGLV3-21 usage in the poorly characterized intermediate-programmed CLL epitype. In summary, Me-iPLEX is an elegant method to assess epigenetic signatures, including robust classification of CLL epitypes that independently stratify patient risk at diagnosis and time of treatment

On the identification of earlywood and latewood radial elastic modulus of Pinus pinaster by digital image correlation: a parametric analysis

This work addresses the reconstruction of strain gradient fields at the wood growth ring scale from full-field deformation measurements provided by digital image correlation. Moreover, the spatial distribution of the earlywood and latewood radial modulus of elasticity is assessed. Meso-scale tensile tests are carried out on Pinus pinaster Ait. Wooden specimens oriented in the radial–tangential plane under quasi-static loading conditions. A parametric analysis of the twodimensional digital image correlation extrinsic and intrinsic setting parameters is performed, in a balance between spatial resolution and resolution. It is shown that the parametric module is an effective way to quantitatively support the choice of digital image correlation parameters in the presence of the high deformation gradient fields generated by the structure–property relationships at the scale of observation. Under the assumption of a uniaxial tensile stress state, the spatial distribution of the radial elastic modulus across the growth rings is obtained. It is observed that the ratio of the radial modulus of elasticity between latewood and earlywood tissues can vary significantly as a function of the digital image correlation parameters. It is pointed out, however, that a convergence value can be systematically established. Effectively, earlywood and latewood stress–strain curves are obtained and elastic properties are determined assuming the converged digital image correlation setting parameters

Identification of the TeV Gamma-ray Source ARGO J2031+4157 with the Cygnus Cocoon

The extended TeV gamma-ray source ARGO J2031+4157 (or MGRO J2031+41) is positionally consistent with the Cygnus Cocoon discovered by $Fermi$-LAT at GeV energies in the Cygnus superbubble. Reanalyzing the ARGO-YBJ data collected from November 2007 to January 2013, the angular extension and energy spectrum of ARGO J2031+4157 are evaluated. After subtracting the contribution of the overlapping TeV sources, the ARGO-YBJ excess map is fitted with a two-dimensional Gaussian function in a square region of $10^{\circ}\times 10^{\circ}$, finding a source extension $\sigma_{ext}$= 1$^{\circ}$.8$\pm$0$^{\circ}$.5. The observed differential energy spectrum is $dN/dE =(2.5\pm0.4) \times 10^{-11}(E/1 TeV)^{-2.6\pm0.3}$ photons cm$^{-2}$ s$^{-1}$ TeV$^{-1}$, in the energy range 0.2-10 TeV. The angular extension is consistent with that of the Cygnus Cocoon as measured by $Fermi$-LAT, and the spectrum also shows a good connection with the one measured in the 1-100 GeV energy range. These features suggest to identify ARGO J2031+4157 as the counterpart of the Cygnus Cocoon at TeV energies. The Cygnus Cocoon, located in the star-forming region of Cygnus X, is interpreted as a cocoon of freshly accelerated cosmic rays related to the Cygnus superbubble. The spectral similarity with Supernova Remnants indicates that the particle acceleration inside a superbubble is similar to that in a SNR. The spectral measurements from 1 GeV to 10 TeV allows for the first time to determine the possible spectrum slope of the underlying particle distribution. A hadronic model is adopted to explain the spectral energy distribution.Comment: 16 pages, 3 figures, has been accepted by ApJ for publicatio

Identification of anthropogenic parameters for a regional nitrogen balance model via field investigation of six ecosystems in China

To evaluate the impact of human behavior (with regard food consumption, waste disposal and farming method) on nitrogen flow, a field investigation was conducted in six typical ecosystems in China. A number of parameters for regional nitrogen balance models were identified during the investigation. The results show that the average per-capita daily protein intake is 107 g. While there is an insignificant difference in total protein intake among the different ecosystems, protein intake from all food groups, except for eggs, is significantly different (P a parts per thousand currency sign 0.05). Differences in diet, along with those in socio-economic conditions, reflect differences in the characteristics of the ecosystems. Regarding per-capita annual potential nitrogen loading from human excrement, a considerable difference exists between the urban rich and the rural poor. In urban areas, approximately 1.02 kg N is returned to farmlands and 5.49 kg N is directly discharged into rivers. In rural regions, on the other hand, approximately 4.33 kg N is returned to farmlands and 1.60 kg N is directly discharged into rivers. Furthermore, urea and mixed fertilizers constitute the most common chemical fertilizers in the study area. Fertilizer diversification is practiced in a range of agricultural lands, paddy-fields and irrigated plains. In the oasis and paddy-field agricultural systems, many of the agricultural by-products (e.g., straw) are burned or mixed with base-fertilizers and plowed into the soil. In irrigated agricultural systems, over 70% of agricultural by-products are recycled as livestock feed. In most instances, livestock excrement is directly reduced in the pasturelands or reused in the fields as manure. Occasionally, as in the case of large-scale breeding, excrements are usually abandoned