Safety and effectiveness of propranolol in severely burned patients: systematic review and meta-analysis

Background The objective of this systematic review was to determine the effectiveness and safety of propranolol compared to placebo or usual care for improving clinical relevant outcomes in severely burned patients (TBSA \u3e20%). Methods Relevant articles from randomized controlled trials were identified by a literature search in MEDLINE, EMBASE, and CENTRAL. We included trials involving patients with a severe burn (\u3e20% of total body surface area affected). Trials were eligible if they evaluated propranolol and compared to usual care or placebo. Two investigators independently assessed articles for inclusion and exclusion criteria and selected studies for the final analysis. We conducted a meta-analysis using a random-effects model. Results We included ten studies in our systematic review. These studies randomized a total of 1236 participants. There were no significant differences between propranolol and placebo with respect to mortality (RD −0.02 [95% CI −0.06 to 0.02]), sepsis (RD −0.03 [95% CI −0.09 to 0.04]), and the overall hospital stay (MD −0.37 [−4.52 to 3.78]). Propranolol-treated adults had a decrease in requirements of blood transfusions (MD −185.64 [95% CI −331.06 to −40.43]) and a decreased heart rate (MD −26.85 [95% CI −39.95 to −13.75]). Conclusions Our analysis indicates that there were no differences in mortality or sepsis in severely burned patients treated with propranolol compared with those who had usual care or placebo. However, the use of propranolol in these patients resulted in lower requirements of blood transfusion and lower values of heart rate. The evidence synthesized in this systematic review is limited to conclude that propranolol reduces the length of hospital stay among severely burned patients. Future trials should assess the impact of propranolol on clinically relevant outcomes such as mortality and adverse events

Rampant Arch and Its Optimum Geometrical Generation

Gothic art was developed in western Europe from the second half of the 12th century to the end of the 15th century. The most characteristic Gothic building is the cathedral. Gothic architecture uses well-carved stone ashlars, and its essential elements include the arch. The thrust is transferred by means of external arches (flying buttresses) to external buttresses that end in pinnacles, which accentuates the verticality. The evolution of the flying buttresses should not only be considered as an aesthetic consideration, but also from a constructive point of view as an element of transmission of forces or loads. Thus, one evolves from a beam-type buttress to a simple arch, and finally to a rampant arch. In this work, we study the geometry of the rampant arch to determine which is the optimum from the constructive point of view. The optimum rampant arch obtained is the one with the common tangent to the two arches parallel to the slope line. A computer program was created to determine this optimal rampant arch by means of a numerical or graphical input. It was applied to several well-known and representative cases of Gothic art in France (church of Saint Urbain de Troyes) and Spain (Cathedral of Palma de Mallorca), establishing if they were designs of optimal rampant arches or not

El Atlas Geográfico de España de Tomás López: Análisis mediante SIG de las poblaciones del «Reyno de Jaén» (1787)

El catastro es el inventario de la riqueza de un país, los primeros avances en este sentido fueron identificar las poblaciones existentes y su ubicación geográfica. En este trabajo se analiza el trabajo del cartógrafo Tomás López, primero enmarcando su vida y obra, y posteriormente se analiza Atlas Geográfico de España (AGE) de Tomás López en su edición de 1804 y en concreto la hoja n.º 64 correspondiente al Reyno de Jaén y cuya elaboración data de 1787. Para ello se propone una metodología de análisis sistemático mediante Sistemas de Información Geográfica, basada en digitalizar todos los núcleos de población del AGE y compararlos con los actuales. Se aprecia por otro lado una falta de homogeneidad en la escala del plano siendo más preciso en la zona central, aumentando el error de forma radial. Este trabajo a la vez que aporta nueva información, también sirve para revalorizar el meritorio trabajo del maestro López y abre nuevas ventanas a la investigación de la cartografía histórica y al conocimiento de la realidad de cada territorio. Desde el punto de vista catastral, destaca que alrededor de la mitad de las poblaciones de la época o han desaparecido o han cambiado de nombre, pudiendo ser objeto de una investigación detallada de topónimos. Esto también puede ser indicativo a su vez del gran despoblamiento rural que ha existido en dos siglos, donde se han perdido la mitad de las poblaciones

Tomas Lopez's Geographic Atlas of Spain (1787) and its Hydrographic Network: GIS analysis of the Reyno de Jaen

Knowledge of the development of hydrographic networks can be useful for a number of research works in hydraulic engineering. We thus, intend to analyse the cartography regarding the first work that systematically encompasses the entire hydrographic network: Tomas Lopez’s Geographic Atlas of Spain (1787). In order to achieve this goal, we will first analyze –by way of the Geographic Information System (GIS) – both the present and referred historical cartographies. In comparing them, we will use the then-existing population centres that correspond to modern ones. The aim is to compare the following research variables in the hydrographic network: former toponyms, length of riverbeds and distance to population centres. The results of this study will show the variation in the riverbeds and the probable change in their denomination

GIS analysis of the accuracy of Tomas Lopez's historical cartography in the Canary Islands (1742 - 1746)

The accuracy of Tomás López´s historical cartography of the Canary Islands included in the “Atlas Particular” of the Kingdoms of Spain, Portugal and Adjacent Islands” is analyzed. For this purpose, we propose a methodology based on Geographic Information Systems (GIS), a comparison of digitized historical cartography population centres with current ones. This study shows that the lineal error value is small for the smaller islands: Lanzarote, El Hierro, La Palma and La Gomera. In the large islands of Tenerife, Fuerteventura and Gran Canaria, the error is smaller in central zones but increases towards the coast. This indicates that Tomás López began his cartography starting from central island zones, accumulating errors due to lack of geodetic references as he moved toward the coast

Tomas Lopez's Geographic Atlas of Spain in the Peninsular War: A methodology for determining errors

During the Peninsular War, Napoleon's and Wellington's armies were aware of the lack of precision in the maps of Spain and its provinces that appeared in Tomas Lopez \s Geographical Atlas of Spain. The errors were due to the non-topographical surveying method he used which he had learned from his teacher Jean Baptiste Bourguignon D 'Anville. To map all of the Spanish provinces, Tomas Lopez divided them into circles of three leagues in diameter (16,718 m), taking a particular town as the centre. He asked the town's priest to draw a map of the territory and to complete a questionnaire that Tomas Lopez sent to him. The priest was to return the two documents after he had completed them. Subsequently, at his desk, Tomas Lopez used the maps and reports as well as other graphic and written sources from various locations to make an outline of each map. Next, he made a mosaic that served as a pattern for drawing the final provincial map. We will see the way that this method was applied in two concrete cases: the villages ofChavaler and Monteagudo, situated in the Spanish province of Soria, and verify their degree of accuracy. We will use the maps drawn by the priests in 1767, the final map of the province which was published in 1804 by Tomás López, and a current map of the province showing the angular and linear errors in Lopez \s map

GIS analysis for the study of rural depopulation: the Kingdom of Valencia (Tomas Lopez 1789)

One of the more aspects that have shaped the landscape is the human impact. The human impact has the clearest indicator of the density of settlements in a particular geographic region. In this paper we study all settlements shown on the map of the Kingdom of Valencia, Spain Geographic Atlas (AGE) of Tomas Lopez (1788), and their correspondence with the current ones. To meet this goal we have developed a specific methodology, the systematic study of all existing settlements in historical cartography. This will determine which have disappeared and which have been renamed. The material used has been the historical cartography of Tomas Lopez, part of the AGE (1789), the Kingdom of Valencia (1789), sheets numbers (78, 79, 80 and 81); Current mapping of the provinces of Alicante, Valencia, Castellon, Teruel, Tattagona and Cuenca; As main software ArcGis V.9.3. The steps followed in the methodology are as follows: 1. Check the scale of the maps. Analyze the possible use of a spherical earth model. 2. Geo-reference of maps with latitude and longitude framework. Move the historical longitude origin to the origin longitude of modern cartography. 3 Digitize of all population settlements or cities. 4 Identify historic settlements or cities corresponding with current ones. 5. If the maps have the same orientation and scale, replace the coordinate transformation of historical settlements with a new one, by a translation in latitude and longitude equal to the calculated mean value of all ancient map points corresponding to the new. 6. Calculation of absolute accuracy of the two maps, i.e. the linear distance between the points of both maps. 7 draw in the GIS, the settlements without correspondence, in the current coordinates, and with a circle of mean error of the sheet, in order to locate their current location. If there are actual settlements exist within this circle, they are candidates to be the searched settlements. We analyzed more than 2000 settlements represented in the Atlas of Tomas Lopez of the Kingdom of Valencia (1789), of which almost 14.5% have no correspondence with the existing settlements. The rural landscape evolution of the Valencia, oldest kingdom of Valencia, one can say that can be severely affected by the anthropization suffered in the period from 1789 to the present, since 70% of existing settlements actually have appeared after Tomas Lopez¿s cartography, dated on 178

Tumor-associated stromal cells as key contributors to the tumor microenvironment.

The tumor microenvironment is a heterogeneous population of cells consisting of the tumor bulk plus supporting cells. It is becoming increasingly evident that these supporting cells are recruited by cancer cells from nearby endogenous host stroma and promote events such as tumor angiogenesis, proliferation, invasion, and metastasis, as well as mediate mechanisms of therapeutic resistance. In addition, recruited stromal cells range in type and include vascular endothelial cells, pericytes, adipocytes, fibroblasts, and bone-marrow mesenchymal stromal cells. During normal wound healing and inflammatory processes, local stromal cells change their phenotype to become that of reactive stroma. Under certain conditions, however, tumor cells can co-opt these reactive stromal cells and further transition them into tumor-associated stromal cells (TASCs). These TASCs express higher levels of proteins, including alpha-smooth muscle actin, fibroblast activating protein, and matrix metalloproteinases, compared with their normal, non-reactive counterparts. TASCs are also known to secrete many pro-tumorigenic factors, including IL-6, IL-8, stromal-derived factor-1 alpha, vascular endothelial growth factor, tenascin-C, and matrix metalloproteinases, among others, which recruit additional tumor and pro-tumorigenic cells to the developing microenvironment. Here, we review the current literature pertaining to the origins of recruited host stroma, contributions toward tumor progression, tumor-associated stromal cells, and mechanisms of crosstalk between endogenous host stroma and tumor cells

GIS for cartographic accuracy analysis of settlements in the province of Madrid (AGE Tomas Lopez 1804).

Purpose: In this paper we study all settlements shown on the map of the Province of Madrid, sheet number 1 of AGE (Atlas Geográfico de España of Tomas Lopez 1804) and their correspondence with the current ones. This map is divided in to zones: Madrid and Almonacid de Zorita. Method: The steps followed in the methodology are as follow: 1. Geo-reference of maps with latitude and longitude framework. Move the historical longitude origin to the origin longitude of modern cartography. 2 Digitize of all population settlements or cities (97 on Madrid and 42 on Almonacid de Zorita), 3 Identify historic settlements or cities corresponding with current ones. 4. If the maps have the same orientation and scale, replace the coordinate transformation of historical settlements with a new one, by a translation in latitude and longitude equal to the calculated mean value of all ancient map points corresponding to the new. 5. Calculation of absolute accuracy of the two maps. 6 draw in the GIS, the settlements accuracy. Result: It was found that all AGE settlements have good correspondence with current, ie only 27 settlements lost in Madrid and 2 in Almonacid. The average accuracy is 2.3 and 5.7 km to Madrid and Almonacid de Zorita respectively. Discussion & Conclusion: The final accuracy map obtained shows that there is less error in the middle of the map. This study highlights the great work done by Tomas Lopez in performing this mapping without fieldwork. This demonstrates the great value that has been the work of Tomas Lopez in the history of cartography

Las "Provincias Bascongadas" del Atlas Geográfico de España de Tomás López de 1804.

La obra cartográfica de Tomás López siempre despertó controversias y no le han faltado detractores que señalan la falta de exactitud de sus mapas. Aun así la obra de Tomás López tiene un gran reconocimiento por su carácter compilatorio de toda la información cartográfica disponible en hasta la época. En general es poco conocido el vínculo entre la obra de López con el ?laboriosísimo desarrollo? de los mapas de Polo y Catalina, que se responsabilizó de la organización de la información para el Censo de la riqueza territorial e industrial de España (1803). Para ello, planimetró por el método de los triángulos uno a uno los mapas de la serie de reinos y provincias peninsulares y las islas del Atlas Geográfico de España (AGE) de Tomás López de 1804. En este trabajo se muestra un ejemplo de la precisión del AGE y alto grado de correlación de toponímico con la cartografía actual en las tres ?Provincias Bascongadas? que comprendían el ?Señorío de Vizcaya?, la ?Provincia de Guipuzcua? y la ?Provincia de Alava?