Factores Socioculturales y su influencia en un contexto intercultural de las actividades de salud en un contexto intercultural en tres barrios de Bilwi. RAAN 1999 - Mayo 2001

Estudio cualitativo con enfoque sociocultural en el que se tomó como universo a todos los y las pobladores del caso urbano de Bilwi de los barrios seleccionados (El Cocal, revolución y Arlen Siu

Giant cell tumor of talus: a case report

Giant cell tumor of talus is a rare entity. In contrast to GCT of long bones, most cases occur in a younger age group and tend to be multicentric. The authors report a case of GCT in a 19 year old boy which had led to extensive destruction of the talus. In view of the extensive involvement, total talectomy along with tibio – calcaneal arthrodesis was performed. At 6 months of followup, the patient had a painless and well arthrodesed ankle. There was no evidence of recurrence at 18 months of followup

Comorbid amyloid-β pathology affects clinical and imaging features in VCD

INTRODUCTION: To date, the clinical relevance of comorbid amyloid-β (Aβ) pathology in patients with vascular cognitive disorders (VCD) is largely unknown. METHODS: We included 218 VCD patients with available cerebrospinal fluid Aβ42 levels. Patients were divided into Aβ+ mild-VCD (n = 84), Aβ- mild-VCD (n = 68), Aβ+ major-VCD (n = 31), and Aβ- major-VCD (n = 35). We measured depression with the Geriatric Depression Scale, cognition with a neuropsychological test battery and derived white matter hyperintensities (WMH) and gray matter atrophy from MRI. RESULTS: Aβ- patients showed more depressive symptoms than Aβ+. In the major-VCD group, Aβ- patients performed worse on attention (P = .02) and executive functioning (P = .008) than Aβ+. We found no cognitive differences in patients with mild VCD. In the mild-VCD group, Aβ- patients had more WMH than Aβ+ patients, whereas conversely, in the major-VCD group, Aβ+ patients had more WMH. Atrophy patterns did not differ between Aβ+ and Aβ- VCD group. DISCUSSION: Comorbid Aβ pathology affects the manifestation of VCD, but effects differ by severity of VCD

Estudio de viabilidad y sostenibilidad de un plan de negocio para la producci?n y comercializaci?n de calzado femenino en la empresa negociaciones Fabio Vatelli EIRL

El presente plan de negocio analiza la viabilidad de una nueva l?nea de negocio que presenta un nuevo concepto de calzado femenino para el uso laboral, enfocado en la comodidad y confort, en la empresa Negociaciones Fabio Vatelli EIRL, empresa familiar en operaci?n, dedicada en la actualidad a la producci?n y comercializaci?n de calzado masculino. El objetivo principal es determinar si es viable esta nueva l?nea de negocio para Negociaciones Fabio Vatelli EIRL implementar la nueva l?nea de calzado femenino. Para tal efecto se plantean los siguientes objetivos espec?ficos: - Realizar el an?lisis de la situaci?n actual de la industria de calzado en el Per?. - Realizar una investigaci?n de mercado para determinar la demanda del producto. - Proponer una nueva l?nea de negocio, cuyo producto y servicio se define basado en el estudio de mercado y la competencia - Proponer la estrategia para la puesta en marcha y los planes funcionales de marketing, operaciones y recursos humanos. - Evaluar econ?mica y financieramente el negocio propuesto

Theoretical study of lepton events in the atmospheric neutrino experiments at SuperK

Super-Kamiokande has reported the results for the lepton events in the atmospheric neutrino experiment. These results have been presented for a 22.5kT water fiducial mass on an exposure of 1489 days, and the events are divided into sub-GeV, multi-GeV and PC events. We present a study of nuclear medium effects in the sub-GeV energy region of atmospheric neutrino events for the quasielastic scattering, incoherent and coherent pion production processes, as they give the most dominant contribution to the lepton events in this energy region. We have used the atmospheric neutrino flux given by Honda et al. These calculations have been done in the local density approximation. We take into account the effect of Pauli blocking, Fermi motion, Coulomb effect, renormalization of weak transition strengths in the nuclear medium in the case of the quasielastic reactions. The inelastic reactions leading to production of leptons along with pions is calculated in a $\Delta$- dominance model by taking into account the renormalization of $\Delta$ properties in the nuclear medium and the final state interaction effects of the outgoing pions with the residual nucleus. We present the results for the lepton events obtained in our model with and without nuclear medium effects, and compare them with the Monte Carlo predictions used in the simulation and the experimentally observed events reported by the Super-Kamiokande collaboration.Comment: 23 pages, 13 figure

High-dimensional detection of imaging response to treatment in multiple sclerosis

Changes on brain imaging may precede clinical manifestations or disclose disease progression opaque to conventional clinical measures. Where, as in multiple sclerosis, the pathological process has a complex anatomical distribution, such changes are not easily detected by low-dimensional models in common use. This hinders our ability to detect treatment effects, both in the management of individual patients and in interventional trials. Here we compared the ability of conventional models to detect an imaging response to treatment against high-dimensional models incorporating a wide multiplicity of imaging factors. We used fully-automated image analysis to extract 144 regional, longitudinal trajectories of pre- and post- treatment changes in brain volume and disconnection in a cohort of 124 natalizumab-treated patients. Low- and high-dimensional models of the relationship between treatment and the trajectories of change were built and evaluated with machine learning, quantifying performance with receiver operating characteristic curves. Simulations of randomised controlled trials enrolling varying numbers of patients were used to quantify the impact of dimensionality on statistical efficiency. Compared to existing methods, high-dimensional models were superior in treatment response detection (area under the receiver operating characteristic curve = 0.890 [95% CI = 0.885–0.895] vs. 0.686 [95% CI = 0.679–0.693], P < 0.01]) and in statistical efficiency (achieved statistical power = 0.806 [95% CI = 0.698–0.872] vs. 0.508 [95% CI = 0.403–0.593] with number of patients enrolled = 50, at α = 0.01). High-dimensional models based on routine, clinical imaging can substantially enhance the detection of the imaging response to treatment in multiple sclerosis, potentially enabling more accurate individual prediction and greater statistical efficiency of randomised controlled trials

Magnetisation transfer ratio abnormalities in primary and secondary progressive multiple sclerosis

Background: In relapse-onset multiple sclerosis (MS), tissue abnormality – as assessed with magnetisation transfer ratio (MTR) imaging - is greater in the outer cortical and inner periventricular layers. The cause of this remains unknown but meningeal inflammation has been implicated, particularly lymphoid follicles, which are seen in secondary progressive (SP) but not primary progressive (PP) MS. Cortical and periventricular MTR gradients might therefore differ in PPMS and SPMS if these follicles are responsible. / Objective: We assessed cortical and periventricular MTR gradients in PPMS; and compared gradients between people with PPMS and SPMS. / Methods: Using an optimised processing pipeline, periventricular normal-appearing white matter and cortical grey-matter MTR gradients were compared between 51 healthy controls and 63 people with progressive MS (28 PPMS, 35 SPMS). / Results: The periventricular gradient was significantly shallower in healthy controls (0.122 percentage units (pu)/band) compared to PPMS (0.952 pu/band, p<0.0001) and SPMS (1.360 pu/band, p<0.0001). The cortical gradient was also significantly shallower in healthy controls (-2.860 pu/band) compared to PPMS (-3.214 pu/band, p=0.038) and SPMS (-3.328 pu/band, p=0.016)). / Conclusion: Abnormal periventricular and cortical MTR gradients occur in both PPMS and SPMS suggesting comparable underlying pathological processes

Epidemiological risk factors for adult dengue in Singapore: an 8-year nested test negative case control study

10.1186/s12879-016-1662-4BMC Infectious Diseases16132