Deep gray matter atrophy in multiple sclerosis: a tensor based morphometry.

Tensor based morphometry (TBM) was applied to determine the atrophy of deep gray matter (DGM) structures in 88 relapsing multiple sclerosis (MS) patients. For group analysis of atrophy, an unbiased atlas was constructed from 20 normal brains. The MS brain images were co-registered with the unbiased atlas using a symmetric inverse consistent nonlinear registration. These studies demonstrate significant atrophy of thalamus, caudate nucleus, and putamen even at a modest clinical disability, as assessed by the expanded disability status score (EDSS). A significant correlation between atrophy and EDSS was observed for different DGM structures: (thalamus: r=-0.51, p=3.85 x 10(-7); caudate nucleus: r=-0.43, p=2.35 x 10(-5); putamen: r=-0.36, p=6.12 x 10(-6)). Atrophy of these structures also correlated with 1) T2 hyperintense lesion volumes (thalamus: r=-0.56, p=9.96 x 10(-9); caudate nucleus: r=-0.31, p=3.10 x 10(-3); putamen: r=-0.50, p=6.06 x 10(-7)), 2) T1 hypointense lesion volumes (thalamus: r=-0.61, p=2.29 x 10(-10); caudate nucleus: r=-0.35, p=9.51 x 10(-4); putamen: r=-0.43, p=3.51 x 10(-5)), and 3) normalized CSF volume (thalamus: r=-0.66, p=3.55 x 10(-12); caudate nucleus: r=-0.52, p=2.31 x 10(-7), and putamen: r=-0.66, r=2.13 x 10(-12)). More severe atrophy was observed mainly in thalamus at higher EDSS. These studies appear to suggest a link between the white matter damage and DGM atrophy in MS

Plataformas educativas implementadas con Cloud Computing

Este trabajo plantea el uso del modelo de Cloud Computing como alternativa que permita impulsar la creación y el funcionamiento de plataformas educativas gracias a sus características de funcionamiento y bajo costo de inversión. Este modelo permite la virtualización de software y hardware al encontrarse disponibles como un servicio. Si bien se está hablando de una filosofía de trabajo emergente, es importante señalar sus aplicaciones en educación como un instrumento facilitador y mediador en el acceso y construcción al conocimiento por parte de los actores del proceso educativo. El objetivo del presente estudio es sentar las bases conceptuales para abordar la construcción de plataformas educativas basadas en este modelo. La forma de representación no solo sirve como vehículo para trasmitir conocimiento, sino una forma de generar concepciones de acceso a educación más abierta y democrática.Presentado en el IX Workshop Tecnología Informática aplicada en Educación (WTIAE)Red de Universidades con Carreras en Informática (RedUNCI

Desarrollo de aplicaciones para Cloud Computing

La cloud computing es vista por algunos autores como la Cuarta Generación de aplicaciones y se espera que sea la forma en que en estos próximos años se consumirán los recursos informáticos. Lograr un Cloud abierto, que soporte la diversidad de equipos y que funciones adecuadamente además para plataformas heterogéneas es el desafío más importante que se presenta para los diseñadores de sistemas. El objetivo que se pretende alcanzar con este trabajo de investigación es la construcción de una plataforma para construir Cloud Públicas y Abiertas, que sean accedidas desde cualquier tipo de dispositivo y se comporte conforme a las características del cliente.Presentado en el II Workshop Innovación en Sistemas de Software (WISS)Red de Universidades con Carreras en Informática (RedUNCI

Desarrollo de aplicaciones para Cloud Computing

La cloud computing es vista por algunos autores como la Cuarta Generación de aplicaciones y se espera que sea la forma en que en estos próximos años se consumirán los recursos informáticos. Lograr un Cloud abierto, que soporte la diversidad de equipos y que funciones adecuadamente además para plataformas heterogéneas es el desafío más importante que se presenta para los diseñadores de sistemas. El objetivo que se pretende alcanzar con este trabajo de investigación es la construcción de una plataforma para construir Cloud Públicas y Abiertas, que sean accedidas desde cualquier tipo de dispositivo y se comporte conforme a las características del cliente.Presentado en el II Workshop Innovación en Sistemas de Software (WISS)Red de Universidades con Carreras en Informática (RedUNCI

Desarrollo de aplicaciones para Cloud Computing

La cloud computing es vista por algunos autores como la Cuarta Generación de aplicaciones y se espera que sea la forma en que en estos próximos años se consumirán los recursos informáticos. Lograr un Cloud abierto, que soporte la diversidad de equipos y que funciones adecuadamente además para plataformas heterogéneas es el desafío más importante que se presenta para los diseñadores de sistemas. El objetivo que se pretende alcanzar con este trabajo de investigación es la construcción de una plataforma para construir Cloud Públicas y Abiertas, que sean accedidas desde cualquier tipo de dispositivo y se comporte conforme a las características del cliente.Presentado en el II Workshop Innovación en Sistemas de Software (WISS)Red de Universidades con Carreras en Informática (RedUNCI

Magnetic resonance imaging outcomes from a phase III trial of teriflunomide

Objective: The purpose of this study was to determine the effects of oral teriflunomide on multiple sclerosis (MS) pathology inferred by magnetic resonance imaging (MRI). Methods: Patients ( n=1088) with relapsing MS were randomized to once-daily teriflunomide 7 mg or 14 mg, or placebo, for 108 weeks. MRI was recorded at baseline, 24, 48, 72 and 108 weeks. Annualized relapse rate and confirmed progression of disability (sustained ≥12 weeks) were the primary and key secondary outcomes. The principal MRI outcome was change in total lesion volume. Results: After 108 weeks, increase in total lesion volume was 67.4% ( p=0.0003) and 39.4% ( p=0.0317) lower in the 14 and 7 mg dose groups versus placebo. Other measures favoring teriflunomide were accumulated enhanced lesions, combined unique activity, T2-hyperintense and T1-hypointense component lesion volumes, white matter volume, and a composite MRI score; all were significant for teriflunomide 14 mg and most significant for 7 mg versus placebo. Conclusions: Teriflunomide provided benefits on brain MRI activity across multiple measures, with a dose effect evident on several markers. These effects were also consistent across selected subgroups of the study population. These findings complement clinical data showing significant teriflunomide-related reductions in relapse rate and disease progression, and demonstrate containment of MRI-defined disease progression

Barriers to and Facilitators of a Career as a Physician‐Scientist Among Rheumatologists in the US

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/113102/1/acr22569.pd

Environmental factors can influence dengue reported cases

Introduction: Global climate changes directly affect the natural environment and contribute to an increase in the transmission of diseases by vectors. Among these diseases, dengue is at the top of the list. The aim of our study was to understand the consequences of temporal variability of air temperature in the occurrence of dengue in an area comprising seven municipalities of the Greater Sao Paulo. Method: Characterization of a temporal trend of the disease in the region between 2010 and 2013 was performed through analysis of the notified number of dengue cases over this period. Our analysis was complemented with meteorological (temperature) and pollutant concentration data (PM10). Results: We observed that the months of January, February, March, April and May (from 2010 to 2013) were the ones with the highest number of notified cases. We also found that there is a statistical association of moisture and PM10 with the reported cases of dengue. Conclusion: Although the temperature does not statistically display an association with recorded cases of dengue, we were able to verify that temperature peaks coincide with dengue outbreak peaks. Future studies on environmental pollution and its influence on the development of Aedes aegypti mosquito during all stages of its life cycle, and the definition of strategies for better monitoring, including campaigns and surveillance, would be compelling.ABC, FM, Santo Andre, SP, BrazilCoimbra Hlth Sch, Environm Hlth IPC, EsTesC, Coimbra, PortugalEsTesC, Coimbra Hlth Sch, Dept Ciencias Complementares IPC, Coimbra, PortugalFMABC, Gestao Saude Ambiental, Santo Andre, SP, BrazilUniv Fed Sao Paulo Unifesp, Biol Sci Dept, Diadema, SP, BrazilUniv Fed Sao Paulo Unifesp, Biol Sci Dept, Diadema, SP, BrazilWeb of Scienc

HIDDen: Hospice Inpatient Deep vein thrombosis Detection prospective longitudinal observational study to explore the prevalence, symptom burden and natural history of venous thromboembolism in people with advanced cancer

BACKGROUND: The prevalence of deep venous thrombosis in patients with advanced cancer is unconfirmed and it is unknown whether current international thromboprophylaxis guidance is applicable to this population. We aimed to determine prevalence and predictors of femoral deep vein thrombosis in patients admitted to specialist palliative care units (SPCUs). METHODS: We did this prospective longitudinal observational study in five SPCUs in England, Wales, and Northern Ireland (four hospices and one palliative care unit). Consecutive adults with cancer underwent bilateral femoral vein ultrasonography on admission and weekly until death or discharge for a maximum of 3 weeks. Data were collected on performance status, attributable symptoms, and variables known to be associated with venous thromboembolism. Patients with a short estimated prognosis (<5 days) were ineligible. The primary endpoint of the study was the prevalence of femoral deep vein thrombosis within 48 h of SPCU admission, analysed by intention to treat. This study is registered with the ISRCTN registry, number ISRCTN97567719. FINDINGS: Between June 20, 2016, and Oct 16, 2017, 343 participants were enrolled (mean age 68·2 years [SD 12·8; range 25-102]; 179 [52%] male; mean Australian-modified Karnofsky performance status 49 [SD 16·6; range 20-90]). Of 273 patients with evaluable scans, 92 (34%, 95% CI 28-40) had femoral deep vein thrombosis. Four participants with a scan showing no deep vein thrombosis on admission developed a deep vein thrombosis on repeat scanning over 21 days. Previous venous thromboembolism (p=0·014), being bedbound in the past 12 weeks for any reason (p=0·003), and lower limb oedema (p=0·009) independently predicted deep vein thrombosis. Serum albumin concentration (p=0·43), thromboprophylaxis (p=0·17), and survival (p=0·45) were unrelated to deep vein thrombosis. INTERPRETATION: About a third of patients with advanced cancer admitted to SPCUs had a femoral deep vein thrombosis. Deep vein thrombosis was not associated with thromboprophylaxis, survival, or symptoms other than leg oedema. These findings are consistent with venous thromboembolism being a manifestation of advanced disease rather than a cause of premature death. Thromboprophylaxis for SPCU inpatients with poor performance status seems to be of little benefit. FUNDING: National Institute for Health Research (Research for Patient Benefit programme)

Barriers to and Facilitators of a Career as a Physician-Scientist Among Rheumatologists in the US: Career as a Rheumatology Physician-Scientist

To determine perceived barriers and facilitators to a career in rheumatology research, examine factors leading rheumatologists to leave an academic research career, and solicit ways to best support young physician-scientists