Cut-offs and response criteria for the Hospital Universitario la Princesa Index (HUPI) and their comparison to widely-used indices of disease activity in rheumatoid arthritis

Objective To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Methods Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. Results The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if =2, low disease activity if >2 and =5), moderate if >5 and <9 and high if =9. HUPI''s AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28''s AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. Conclusions The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis

A global look at time: a 24-country study of the equivalence of the Zimbardo Time Perspective Inventory

In this article, we assess the structural equivalence of the Zimbardo Time Perspective Inventory (ZTPI) across 26 samples from 24 countries (N = 12,200). The ZTPI is proven to be a valid and reliable index of individual differences in time perspective across five temporal categories: Past Negative, Past Positive, Present Fatalistic, Present Hedonistic, and Future. We obtained evidence for invariance of 36 items (out of 56) and also the five-factor structure of ZTPI across 23 countries. The short ZTPI scales are reliable for country-level analysis, whereas we recommend the use of the full scales for individual-level analysis. The short version of ZTPI will further promote integration of research in the time perspective domain in relation to many different psycho-social processes

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

The use of scenarios and models to evaluate the future of nature values and ecosystem services in Mediterranean forests

Science and society are increasingly interested in predicting the effects of global change and socio-economic development on natural systems, to ensure maintenance of both ecosystems and human well-being. The Intergovernmental Platform on Biodiversity and Ecosystem Services has identified the combination of ecological modelling and scenario forecasting as key to improving our understanding of those effects, by evaluating the relationships and feedbacks between direct and indirect drivers of change, biodiversity, and ecosystem services. Using as case study the forests of the Mediterranean basin (complex socio-ecological systems of high social and conservation value), we reviewed the literature to assess (1) what are the modelling approaches most commonly used to predict the condition and trends of biodiversity and ecosystem services under future scenarios of global change, (2) what are the drivers of change considered in future scenarios and at what scales, and (3) what are the nature and ecosystem service indicators most commonly evaluated. Our review shows that forecasting studies make relatively little use of modelling approaches accounting for actual ecological processes and feedbacks between different socio-ecological sectors; predictions are generally made on the basis of a single (mainly climate) or a few drivers of change. In general, there is a bias in the set of nature and ecosystem service indicators assessed. In particular, cultural services and human well-being are greatly underrepresented in the literature. We argue that these shortfalls hamper our capacity to make the best use of predictive tools to inform decision-making in the context of global change.This work was supported by the Spanish Government through the INMODES project (grant number CGL2017-89999-C2-2-R), the ERA-NET FORESTERRA project INFORMED (grant number 29183), and the project Boscos Sans per a una Societat Saludable funded by Obra Social la Caixa (https://obrasociallacaixa.org/). AMO and AA were supported by Spanish Government through the “Juan de la Cierva” fellowship program (IJCI-2016-30349 and IJCI-2016-30049, respectively). JVRD was supported by the Government of Asturias and the FP7-Marie Curie-COFUND program of the European Commission (Grant “Clarín” ACA17-02)

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

The DUNE far detector vertical drift technology. Technical design report

DUNE is an international experiment dedicated to addressing some of the questions at the forefront of particle physics and astrophysics, including the mystifying preponderance of matter over antimatter in the early universe. The dual-site experiment will employ an intense neutrino beam focused on a near and a far detector as it aims to determine the neutrino mass hierarchy and to make high-precision measurements of the PMNS matrix parameters, including the CP-violating phase. It will also stand ready to observe supernova neutrino bursts, and seeks to observe nucleon decay as a signature of a grand unified theory underlying the standard model. The DUNE far detector implements liquid argon time-projection chamber (LArTPC) technology, and combines the many tens-of-kiloton fiducial mass necessary for rare event searches with the sub-centimeter spatial resolution required to image those events with high precision. The addition of a photon detection system enhances physics capabilities for all DUNE physics drivers and opens prospects for further physics explorations. Given its size, the far detector will be implemented as a set of modules, with LArTPC designs that differ from one another as newer technologies arise. In the vertical drift LArTPC design, a horizontal cathode bisects the detector, creating two stacked drift volumes in which ionization charges drift towards anodes at either the top or bottom. The anodes are composed of perforated PCB layers with conductive strips, enabling reconstruction in 3D. Light-trap-style photon detection modules are placed both on the cryostat's side walls and on the central cathode where they are optically powered. This Technical Design Report describes in detail the technical implementations of each subsystem of this LArTPC that, together with the other far detector modules and the near detector, will enable DUNE to achieve its physics goals

Proteomic and genomic approaches for the study of in-root interaction between nematode (Meloidogyne artiellia) and fungal (Fusarium oxysporum f. sp. ciceris race 5) chickpea pathogens

Trabajo presentado en la II Meeting Plant Proteomics in Europe, celebrada en Córdoba del 6 al 8 de febrero de 2008.Chickpea, the most important food legume in the Mediterranean Basin and the Indian subcontinent, can be severely affected by more than 50 diseases of diverse aetiology that occur worldwide. Fusarium wilt, caused by Fusarium oxysporum f. sp. ciceris (Foc), is the most important soil borne disease of chickpeas and ranks as the major yield-limiting factor for the crop. Control of the disease is primarily by the use of chickpea cultivars with resistance to specifi c races of the pathogen. However, valuable Foc-resistance can be annulled by joint infec-tions of resistant roots with Foc and the root-knot nema-tode Meloidogyne artiellia. Infections by the nematode begins with penetration of root tissues by second-stage juveniles (J2) at the zone of root elongation; thereafter, the J2s individuals establish a permanent feeding site and induce formation of several (usually 4-6) multinucleate giant cells that support growth and reproduction of the sedentary reproductive females.Peer reviewe

Sex-associated variations in coral skeletal oxygen and carbon isotopic composition of <i>Porites panamensis</i> in the southern Gulf of California

Coral δ18O variations are used as a proxy for changes in sea surface temperature (SST) and seawater isotope composition. Skeletal δ13C of coral is frequently used as a proxy for solar radiation because most of its variability is controlled by an interrelationship between three processes: photosynthesis, respiration, and feeding. Coral growth rate is known to influence the δ18O and δ13C isotope record to a lesser extent than environmental variables. Recent published data show differences in growth parameters between female and male coral in the gonochoric brooding coral Porites panamensis; thus, skeletal δ18O and δ13C are hypothesized to be different in each sex. To test this, this study describes changes in the skeletal δ18O and δ13C record of four female and six male Porites panamensis coral collected in Bahía de La Paz, Mexico, whose growth bands spanned 12 years. The isotopic data were compared to SST, precipitation, photosynthetically active radiation (PAR), chlorophyll a, and skeletal growth parameters. Porites panamensis is a known gonochoric brooder whose growth parameters are different in females and males. Splitting the data by sexes explained 81 and 93 % of the differences of δ18O, and of δ13C, respectively, in the isotope record between colonies. Both isotope records were different between sexes. δ18O was higher in female colonies than in male colonies, with a 0.31 ‰ difference; δ13C was lower in female colonies, with a 0.28 ‰ difference. A difference in the skeletal δ18O could introduce an error in SST estimates of  ≈  1.0 to  ≈  2.6 °C. The δ18O records showed a seasonal pattern that corresponded to SST, with low correlation coefficients (−0.45, −0.32), and gentle slopes (0.09, 0.10 ‰ °C−1) of the δ18O–SST relation. Seasonal variation in coral δ18O represents only 52.37 and 35.66 % of the SST cycle; 29.72 and 38.53 % can be attributed to δ18O variability in seawater. δ13C data did not correlate with any of the environmental variables; therefore, variations in skeletal δ13C appear to be driven mainly by metabolic effects. Our results support the hypothesis of a sex-associated difference in skeletal δ18O and δ13C signal, and suggest that environmental conditions and coral growth parameters affect skeletal isotopic signals differently in each sex. Although these findings relate to one gonochoric brooding species, they may have some implications for the more commonly used gonochoric spawning species such as Porites lutea and Porites lobata