Prophylactic positive end-expiratory pressure: are good intentions enough?

This article is online a

Dependência da impedância de entrada com a posição da sonda de alimentação para antenas microstrip

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Prescribing patterns and economic costs of proton pump inhibitors in Colombia

To determine the prescribing patterns for proton pump inhibitors and to estimate the economic cost of their use in a group of patients affiliated with the Colombian Health System. This is a descriptive observational study. Data for analysis consisted of prescriptions dispensed between October 1st, 2010 and October 31st, 2010 and were collected from a systematic database of 4.2 million members. Socio-demographic variables were considered along with the defined daily dose,comedication, convenience of the indication for proton pump inhibitor use and costs. In this study, 113,560 prescriptions were dispensed in 89 cities, mostly to women (57.6%) with a mean age of 54.4 ± 18.7 years; the drugs were omeprazole (n= 111.294; 97.81%),esomeprazole (n= 1.378; 1.2%), lansoprazole (n= 524; 0.4%), pantoprazole and rabeprazole. The indication for 87.349 of the formulas (76.9%) was justified and statistically associated with the use of NSAIDs, antithrombotics, corticosteroids, anti-ulcer, antibiotics and prokinetics. No justification was found for 26.211 (23.1%) of the prescriptions, which were associated with antidiabetics, antihypertensives, hypolipidemics and others (p <0.001).The annual justified cost was estimated to be U

Curso modelado de nicho ecológico, version 1.0

The suite of ideas, protocols, and software tools that has come to be known as “Ecological Niche Modeling” (ENM) — as well as those for the related “Species Distribution Modeling” (SDM)—has seen intensive exploration and research attention in recent decades. In spite of at least four syntheses, the field has grown so much in complexity that it is rather difficult to access for newcomers. Until now, accessibility to this field was achieved by in-person courses organized by universities or research centers, in some of which we have participated as instructors. However, the access to these specialized courses is limited, on one hand because they are not offered in all universities, and on the other because normally they are taught in English. To expand the access to a wider community of Spanish-speaking researchers, here we offer an entirely digital and free-of-charge course in Spanish, which was presented over 23 weeks via Internet in 2018. Although intrinsic Internet-related barriers may limit access to course materials, we have made them available in diverse formats (video, audio, pdf) in order to eliminate most of these problems.El conjunto de ideas, métodos y programas informáticos que se conoce como “Modelado de Nicho Ecológico” (MNE)—y el relacionado “Modelado de Distribución de Especies” (MDS)—han sido objeto de intensa exploración e investigación en las últimas décadas. A pesar de existir al menos cuatro síntesis publicadas, este campo ha crecido tanto en complejidad, que la formación de nuevos investigadores es difícil. Hasta ahora, dicha formación se ha hecho de manera presencial en cursos organizados por universidades o centros de investigación, de los que hemos formado parte como instructores. Sin embargo, el acceso a este tipo de cursos especializados es restringido, por un lado, porque los cursos no se ofrecen en todas las universidades, y por otro, porque normalmente se imparten en inglés. Para facilitar el acceso a una mayor comunidad de científicos de habla hispana, presentamos un curso en español, completamente digital y de acceso gratuito, que se realizó vía Internet durante 23 semanas consecutivas en 2018. Aunque las barreras intrínsecas al uso de Internet pueden dificultar la accesibilidad a los materiales del curso, hemos usado diversos formatos para la divulgación de los contenidos académicos (video, audio, pdf) con el objetivo de eliminar la mayor parte de estos problemas

Boletín NUESTRA AMÉRICA XXI - Desafíos y alternativas, num.42, Marzo 2020

Una excelente iniciativa del Grupo de Trabajo Crisis y economía mundial, coordinado por María Josefina Morales, Julio Gambina y Gabriela Roffinelli

Nuclear astrophysics with radioactive ions at FAIR

R. Reifarth et al: ; 12 págs.; 9 figs.; Open Access funded by Creative Commons Atribution Licence 3.0 ; Nuclear Physics in Astrophysics VI (NPA6)The nucleosynthesis of elements beyond iron is dominated by neutron captures in the s and r processes. However, 32 stable, proton-rich isotopes cannot be formed during those processes, because they are shielded from the s-process ow and r-process -decay chains. These nuclei are attributed to the p and rp process. For all those processes, current research in nuclear astrophysics addresses the need for more precise reaction data involving radioactive isotopes. Depending on the particular reaction, direct or inverse kinematics, forward or time-reversed direction are investigated to determine or at least to constrain the desired reaction cross sections. The Facility for Antiproton and Ion Research (FAIR) will oer unique, unprecedented opportunities to investigate many of the important reactions. The high yield of radioactive isotopes, even far away from the valley of stability, allows the investigation of isotopes involved in processes as exotic as the r or rp processes.This project was supported by the HGF Young Investigators Project VH-NG-327, EMMI, H4F, HGS-HIRe, JINA, NAVI, DFG and ATHENA.Peer Reviewe

Quasi-free neutron and proton knockout reactions from light nuclei in a wide neutron-to-proton asymmetry range

The quasi-free scattering reactions 11C(p,2p) and 10,11,12C(p,pn) have been studied in inverse kinematics at beam energies of 300–400 MeV/u at the R3B-LAND setup. The outgoing proton-proton and proton-neutron pairs were detected in coincidence with the reaction fragments in kinematically complete measurements. The efficiency to detect these pairs has been obtained from GEANT4 simulations which were tested using the 12C(p,2p) and 12C(p,pn) reactions. Experimental cross sections and momentum distributions have been obtained and compared to DWIA calculations based on eikonal theory. The new results reported here are combined with previously published cross sections for quasi-free scattering from oxygen and nitrogen isotopes and together they enable a systematic study of the reduction of single-particle strength compared to predictions of the shell model over a wide neutron-to-proton asymmetry range. The combined reduction factors show a weak or no dependence on isospin asymmetry, in contrast to the strong dependency reported in nucleon-removal reactions induced by nuclear targets at lower energies. However, the reduction factors for (p,2p) are found to be 'significantly smaller than for (p,pn) reactions for all investigated nuclei.German Federal Ministry of Education and Research | Ref. BMBF 05P2015RDFN1German Federal Ministry of Education and Research | Ref. 05P15WOFNAEuropean Commission | Ref. FP7, ENSAR, n. 262010Comisión Interministerial de Ciencia y Tecnología (CICYT) | Ref. FPA2012-32443Comisión Interministerial de Ciencia y Tecnología (CICYT) | Ref. FPA2015-64969-07387Comisión Interministerial de Ciencia y Tecnología (CICYT) | Ref. FPA2015-69640-C2-1-PSwedish Research Council | Ref. 621-2011-5324National Science Foundation, EE. UU. | Ref. n. 1415656Department of Energy, EE. UU. | Ref. n. DE-FG02-08ER41533Fundação para a Ciência e a Tecnologia | Ref. PTDC/FIS/ 103902/200

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Temperature Effects Explain Continental Scale Distribution of Cyanobacterial Toxins

Insight into how environmental change determines the production and distribution of cyanobacterial toxins is necessary for risk assessment. Management guidelines currently focus on hepatotoxins (microcystins). Increasing attention is given to other classes, such as neurotoxins (e.g., anatoxin-a) and cytotoxins (e.g., cylindrospermopsin) due to their potency. Most studies examine the relationship between individual toxin variants and environmental factors, such as nutrients, temperature and light. In summer 2015, we collected samples across Europe to investigate the effect of nutrient and temperature gradients on the variability of toxin production at a continental scale. Direct and indirect effects of temperature were the main drivers of the spatial distribution in the toxins produced by the cyanobacterial community, the toxin concentrations and toxin quota. Generalized linear models showed that a Toxin Diversity Index (TDI) increased with latitude, while it decreased with water stability. Increases in TDI were explained through a significant increase in toxin variants such as MC-YR, anatoxin and cylindrospermopsin, accompanied by a decreasing presence of MC-LR. While global warming continues, the direct and indirect effects of increased lake temperatures will drive changes in the distribution of cyanobacterial toxins in Europe, potentially promoting selection of a few highly toxic species or strains.Peer reviewe