Obstructive Sleep Apnoea Syndrome, Endothelial Function and Markers of Endothelialization. Changes after CPAP

STUDY OBJECTIVES: This study tries to assess the endothelial function in vivo using flow-mediated dilatation (FMD) and several biomarkers of endothelium formation/restoration and damage in patients with obstructive sleep apnoea (OSA) syndrome at baseline and after three months with CPAP therapy. DESIGN: Observational study, before and after CPAP therapy. SETTING AND PATIENTS: We studied 30 patients with apnoea/hypopnoea index (AHI) >15/h that were compared with themselves after three months of CPAP therapy. FMD was assessed non-invasively in vivo using the Laser-Doppler flowmetry. Circulating cell-free DNA (cf-DNA) and microparticles (MPs) were measured as markers of endothelial damage and the vascular endothelial growth factor (VEGF) was determined as a marker of endothelial restoration process. MEASUREMENTS AND RESULTS: After three month with CPAP, FMD significantly increased (1072.26 ± 483.21 vs. 1604.38 ± 915.69 PU, p< 0.005) cf-DNA and MPs significantly decreased (187.93 ± 115.81 vs. 121.28 ± 78.98 pg/ml, p<0.01, and 69.60 ± 62.60 vs. 39.82 ± 22.14 U/μL, p<0.05, respectively) and VEGF levels increased (585.02 ± 246.06 vs. 641.11 ± 212.69 pg/ml, p<0.05). These changes were higher in patients with more severe disease. There was a relationship between markers of damage (r = -0.53, p<0.005) but not between markers of damage and restoration, thus suggesting that both types of markers should be measured together. CONCLUSIONS: CPAP therapy improves FMD. This improvement may be related to an increase of endothelial restoration process and a decrease of endothelial damage

Alterations of antitumor and metabolic responses in L5178Y-R lymphoma-bearing mice after only 30-minute daily chronic stress exposure

Aim: In stress research, reducing times of stress induction may contribute to improving the well-being of experimental animals, especially in cancer models, already under physiological distress. To support this idea, we evaluated the effects of a short-timed stress protocol on endocrine, metabolic and immune indicators in mice bearing the L5178Y-R lymphoma. Materials and Methods: A 30-minute daily stress protocol was applied for 28 days to healthy and lymphoma-bearing BALB/c mice; body weight, plasma levels of corticosterone, norepinephrine, Th1/Th2 cytokines, insulin, and leptin, were measured. Results: We found a 12% significant decrease in body weight in non-tumor bearing mice under stress (p < 0.007). The disruption of weight evolution was accompanied by a stress induced 85% decrease in plasmatic leptin (p < 0.01) and total reduction of insulin. Tumor burden alone was associated to an increase in more than two-fold of plasmatic levels of norepinephrine (p < 0.008). Neither stress nor tumor or their combination, resulted in an elevation of systemic IL-6. IFN-γ levels were 20 times higher in lymphoma-bearing animals when compared with non-tumor bearing mice (p < 0.01); however, under stress, this response was reduced by half, indicating a suppressing effect of chronic stress on the antitumor immune response. Conclusion: A short-timed stress induction is enough to cause significant alterations in the metabolism and immunity of healthy and tumor-bearing mice, supporting the use of short-timed protocols as an efficient way to induce chronic stress that also considers concerns regarding the well-being of experimental animals in biomedical research

Modelado de Procesos de Neurorrehabilitación

La Neurorrehabilitación es un proceso clínico que se centra en el abordaje de la alteración del sistema nervioso. Existe una enorme variabilidad tanto en la tipología como en el grado de las lesiones neurológicas, lo que la convierte en un proceso extremadamente complejo de analizar y comprender. El presente trabajo se centra en el modelado de las principales actividades que se llevan a cabo en el contexto de la Neurorrehabilitación actual con el objetivo de detectar aquellos puntos en que puedan ser mejoradas, tanto a nivel organizativo como a nivel de ejecución. Por otra parte, se trata de comprenderlas en profundidad para tratar de transformarlas posteriormente en nuevas actividades automatizadas y monitorizadas que se ajusten al nuevo paradigma de rehabilitación ubicua, personalizada y basada en la evidencia

Visual thinking como habilidad potenciadora de la gerencia creativa en equipos innovadores

The research focused on designing a visual thinking-based competency model as an enhancer skill of creative management in innovative teams. It can be classified as part of the positivist paradigm with a quantitative focus; it is also explanatory with a non-experimental, cross-cutting, field design. The population was integrated by twelve (12) innovative team members. An 87-item survey was applied, with scale-like response alternatives. This instrument was validated by experts, reliability was determined by a pilot test applied to a fraction of reporting units. The results were analyzed with descriptive statistics building frequency tables, including arithmetic mean and standard deviation, as well as inferential statistics for calculating variance. To establish the degree of association between variables, the Pearson correlation coefficient was used. The results showed that there is an association between visual thinking and creative management, reflecting a considerable correlative coefficient. A management skills model was established based on an emerging theory, which is why we propose that innovative teams must La investigación se orientó a diseñar un modelo de competencias basado en el visual thinking como habilidad potenciadora de la gerencia creativa en equipos innovadores. La investigación se enmarca dentro del paradigma positivista con enfoque cuantitativo. Asimismo, es explicativa con un diseño no experimental, transversal, de campo. La población se integró con doce (12) miembros de equipos innovadores. Se aplicó una encuesta de 87 ítems, con alternativas de respuestas tipo escala. Dicho instrumento fue validado por expertos, la confiabilidad se determinó con una prueba piloto aplicada a una fracción de unidades informantes. Los resultados fueron analizados con estadística descriptiva construyendo tablas de frecuencia, incluyendo media aritmética y desviación estándar, asi como estadística inferencial para calcular la varianza. Para establecer el grado de asociación entre las variables, se utilizó el Coeficiente de Correlación de Pearson. Los resultados arrojaron que existe asociación entre el visual thinking y la gerencia creativa, reflejando un coeficiente correlativo considerable. Se estableció un modelo de competencias gerenciales en base a una teoría emergente, motivo por el cual los equipos innovadores deben trabajar en el fortalecimiento de ambas variables a fin de optimizar la toma de decisiones en los distintos niveles jerárquicos promoviendo la solución de problemas

CMS Monte Carlo production in the WLCG computing Grid

Monte Carlo production in CMS has received a major boost in performance and scale since the past CHEP06 conference. The production system has been re-engineered in order to incorporate the experience gained in running the previous system and to integrate production with the new CMS event data model, data management system and data processing framework. The system is interfaced to the two major computing Grids used by CMS, the LHC Computing Grid (LCG) and the Open Science Grid (OSG). Operational experience and integration aspects of the new CMS Monte Carlo production system is presented together with an analysis of production statistics. The new system automatically handles job submission, resource monitoring, job queuing, job distribution according to the available resources, data merging, registration of data into the data bookkeeping, data location, data transfer and placement systems. Compared to the previous production system automation, reliability and performance have been considerably improved. A more efficient use of computing resources and a better handling of the inherent Grid unreliability have resulted in an increase of production scale by about an order of magnitude, capable of running in parallel at the order of ten thousand jobs and yielding more than two million events per day

Identificación de Oportunidades de Mejora en Procesos de Neurorrehabilitación

El modelado de procesos es una técnica de gestión empresarial destinada a la mejora continua de los procesos de una organización, como base operativa y estructural de la misma. En el ámbito de la Neurorrehabilitación, crece el interés por los mapas de procesos como herramienta de comprensión, representación y análisis de los procesos clínicos. El presente trabajo se centra en la identificación de oportunidades de mejora de las actividades de rehabilitación, con el objetivo de definir nuevas estrategias de monitorización y automatización que permitan su evolución hacia el nuevo modelo de rehabilitación ubicua, personalizada y basada en la evidencia

Retrospective cohort analysis of Spanish national trends of coronary artery bypass grafting and percutaneous coronary intervention from 1998 to 2017

Introduction Spain is one of the countries with the lowest rates of revascularisation and highest ratio of percutaneous coronary intervention (PCI) to coronary artery bypass grafting (CABG). Objectives To investigate the changes and trends in the two revascularisation procedures between 1998 and 2017 in Spain. Design Retrospective cohort study. Analysis of in-hospital outcomes. Setting Minimum basic data set from the Spanish National Department of Health: mandatory database collecting information of patients who are attended in the Spanish public National Health System. Participants 603 976 patients who underwent isolated CABG or PCI in the Spanish National Health System. The study period was divided in four 5-year intervals. Patients with acute myocardial infarction on admission were excluded. Primary and secondary outcomes We investigated the volume of procedures nationwide, the changes of the risk profile of patients and in-hospital mortality of both techniques. Results We observed a 2.2-fold increase in the rate of any type of myocardial revascularisation per million inhabitants-year: 357 (1998) to 776 (2017). 93 682 (15.5%) had a coronary surgery. PCI to CABG ratio rose from 2.2 (1998-2002) to 8.1 (2013-2017). Charlson's index increased by 0.8 for CABG and 1 for PCI. The median annual volume of PCI/hospital augmented from 136 to 232, while the volume of CABG was reduced from 137 to 74. In the two decades, we detected a significant reduction of CABG in-hospital mortality (6.5% vs 2.6%, p&lt;0.001) and a small increase in PCI (1.2% vs 1.5%, p&lt;0.001). Risk adjusted mortality rate was reduced for both CABG (1.51 vs 0.48, p&lt;0.001), and PCI (1.42 vs 1.05, p&lt;0.001). Conclusion We detected a significant increase in the volume of revascularisations (particularly PCI) in Spain. Risk-adjusted in-hospital mortality was significantly reduce

Daily monitoring of TeV gamma-ray emission from Mrk 421, Mrk 501, and the Crab Nebula with HAWC

We present results from daily monitoring of gamma rays in the energy range $\sim0.5$ to $\sim100$ TeV with the first 17 months of data from the High Altitude Water Cherenkov (HAWC) Observatory. Its wide field of view of 2 steradians and duty cycle of $>95$% are unique features compared to other TeV observatories that allow us to observe every source that transits over HAWC for up to $\sim6$ hours each sidereal day. This regular sampling yields unprecedented light curves from unbiased measurements that are independent of seasons or weather conditions. For the Crab Nebula as a reference source we find no variability in the TeV band. Our main focus is the study of the TeV blazars Markarian (Mrk) 421 and Mrk 501. A spectral fit for Mrk 421 yields a power law index $\Gamma=2.21 \pm0.14_{\mathrm{stat}}\pm0.20_{\mathrm{sys}}$ and an exponential cut-off $E_0=5.4 \pm 1.1_{\mathrm{stat}}\pm 1.0_{\mathrm{sys}}$ TeV. For Mrk 501, we find an index $\Gamma=1.60\pm 0.30_{\mathrm{stat}} \pm 0.20_{\mathrm{sys}}$ and exponential cut-off $E_0=5.7\pm 1.6_{\mathrm{stat}} \pm 1.0_{\mathrm{sys}}$ TeV. The light curves for both sources show clear variability and a Bayesian analysis is applied to identify changes between flux states. The highest per-transit fluxes observed from Mrk 421 exceed the Crab Nebula flux by a factor of approximately five. For Mrk 501, several transits show fluxes in excess of three times the Crab Nebula flux. In a comparison to lower energy gamma-ray and X-ray monitoring data with comparable sampling we cannot identify clear counterparts for the most significant flaring features observed by HAWC.Comment: 18 pages, 10 figures, accepted for publication in The Astrophysical Journa