Adherencia al tratamiento con fármacos moduladores de la enfermedad sintéticos en la artritis reumatoide. Resultados del estudio OBSERVAR

[Abstract] Background: Treatment compliance with disease-modifying antirheumatic drugs (DMARD) is essential to achieve the therapeutic goals in rheumatoid arthritis (RA). However, despite the need for good compliance, there is evidence that patients with RA frequently fail to use DMARD for the control of RA. Thus, the main objective of the OBSERVAR study is to evaluate the reasons for the lack of therapeutic adherence to synthetic DMARD in these patients. Patients and methods: A Delphi process involving 18 randomly selected Spanish rheumatologists determined the level of agreement with 66 causes of noncompliance selected from the literature in relation to synthetic DMARD in RA. Results: The reasons for noncompliance were consistent in 75.7%, although 3 reasons (4.5%) were highly consistent: 1) not knowing what to do in the case of an adverse event with DMARD; 2) not having undergone adherence screening by health personnel for early detection of "noncompliant patients"; and 3) not having undergone interventions or strategies that improve adherence. Conclusion: In order to improve adherence to RA treatment with synthetic DMARD, the patient should be adequately informed of each new treatment introduced, the patient's compliance profile should be incorporated into the clinical routine and the patient's motivation for therapeutic compliance be reinforced through the methods available to us.[Resumen] Introducción. La cumplimentación del tratamiento modificador de la enfermedad es esencial para alcanzar los objetivos terapéuticos en la artritis reumatoide (AR). Sin embargo, y a pesar de la necesidad de una buena adherencia, existe evidencia de que muchos pacientes con AR no cumplen adecuadamente con la prescripción del tratamiento indicado con fármacos moduladores de la enfermedad de acción lenta (FAME) sintéticos o convencionales. Conscientes de la importancia de este hecho, el estudio sobre observancia terapéutica en AR (estudio OBSERVAR) tiene como objetivo principal valorar los motivos de la falta de adherencia terapéutica a los FAME sintéticos en estos pacientes. Pacientes y métodos. Mediante un proceso Delphi entre 18 reumatólogos españoles seleccionados aleatoriamente se determinó el grado de acuerdo con 66 causas de incumplimiento seleccionadas de la bibliografía, en relación con los FAME sintéticos en la AR. Resultados. Los motivos de incumplimiento fueron consistentes en el 75,7%, si bien 3 razones (4,5%) destacaron como muy consistentes: 1) desconocer qué hacer cuando se sufre un acontecimiento adverso con el FAME; 2) no llevar a cabo métodos de cribado de la adherencia por el personal sanitario para detectar a los «pacientes incumplidores» de forma temprana y 3) no aplicar intervenciones o estrategias que mejoren la adherencia terapéutica. Conclusión. Para mejorar la adherencia al tratamiento de la AR con FAME sintéticos se debe informar al paciente de cada tratamiento nuevo introducido, incorporar el perfil de cumplimiento del paciente en la rutina clínica, y reforzar la motivación del paciente al cumplimiento terapéutico mediante los métodos a nuestro alcance

Non-monotonic behavior of weak-polyelectrolytes adsorption on a cationic surface: A Monte Carlo simulation study

In this work, the weak polyelectrolyte (PE) adsorption on a strong cationic surface is studied with constant pH Monte Carlo simulations using a coarse-grained model. When a large number of PE chains is added to the system, the PE adsorbed amount vs pH curve exhibits a non-monotonic behavior, with the appearance of a maximum close to the intrinsic pKa0-value of the PE titratable groups. The apparent pKa-value of the PE chains shows a non-trivial tendency depending on the pH-value and the surface coverage degree. In increasing the pH-value, the small anions that accompany the cationic surface are replaced by PE chains and small cations. For pH>pKa0+1, an evident charge reversion of surface is observed. These results are explained analyzing the interplay between the attractive and repulsion electrostatic interactions between the different components of the system (inter- and intra-charged monomers of PE chains, the strong cationic surface and small ions) and their effects on the PE chain ionization.Fil: Narambuena, Claudio Fabian. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - San Luis. Instituto de Fisica Aplicada "dr. Jorge Andres Zgrablich". Grupo Vinculado Bionanotecnologia y Sistemas Complejos | Universidad Nacional de San Luis. Facultad de Cs.fisico Matematicas y Naturales. Instituto de Fisica Aplicada "dr. Jorge Andres Zgrablich". Grupo Vinculado Bionanotecnologia y Sistemas Complejos. - Universidad Tecnologica Nacional. Facultad Reg.san Rafael. Grupo Vinculado Bionanotecnologia y Sistemas Complejos.; ArgentinaFil: Blanco, Pablo M.. Universidad de Barcelona. Facultad de Quimica. Instituto de Quimica Teorica y Computacional.; EspañaFil: Rodriguez, Adrian. Universidad Tecnológica Nacional. Facultad Reg. Neuquen; ArgentinaFil: Rodríguez, Diego E.. Universidad Tecnológica Nacional. Facultad Reg. Neuquen; ArgentinaFil: Madurga, Sergio. Universidad de Barcelona. Facultad de Quimica. Instituto de Quimica Teorica y Computacional.; EspañaFil: Garcés, José L.. Universidad de Barcelona. Facultad de Quimica. Instituto de Quimica Teorica y Computacional.; EspañaFil: Mas Pujadas, Francesc. Universidad de Barcelona. Facultad de Quimica. Instituto de Quimica Teorica y Computacional.; Españ

Objectively measured physical activity and academic performance in school-aged youth: The UP&DOWN longitudinal study

To examine the longitudinal relationships between objectively measured total volume and specific intensities of physical activity (PA) with academic performance in a large sample of youth aged 6-18 years. A longitudinal study of 1046 youth (10.04 +/- 3.10 years) from Spain was followed over 2 years. PA (volume and intensity) was measured by accelerometry. Academic performance was assessed through grades reported on the transcript at the end of the academic year (Mathematics, Language, an average of these two core subjects, and grade point average [GPA]). Longitudinal relationships between PA and four indicators of academic performance were examined using covariance and regression analyses, adjusted for a variety of confounders. Youth Quartile 2 for PA volume at baseline obtained better scores than those who participated in Quartiles 1 or 4 volumes of PA in GPA 2 years later (p = 0.006). There were generally no longitudinal associations between specific PA intensities and any of the academic performance indicators (all p > 0.170). However, a change in light PA over 2 years was inversely associated with three academic indicators in youth (beta(range), -.103 to - 090; all P < 040). Findings suggest that participants in Quartile 2 volume of PA had a better GPA in comparison with Quartiles 1 and 4 volumes of PA during youth, but there was no association with changes in PA volume over time. PA intensity was generally unrelated to academic performance during youth. However, there was an inverted u-shape relationship between light PA changes and GPA.The authors gratefully acknowledge the youth, parents, and teachers who participated in this study. The UP&DOWN Study was supported by the DEP 2010-21662-C04-00 grant from the National Plan for Research, Development, and Innovation (R + D + i) MICINN. DM--G is supported by a 'Ramon y Cajal' contract (RYC--2016--20546). IE--C is supported by the Spanish Ministry of Economy and Competitiveness (RTI2018-095284-J-100). AM--M was a recipient of a Jose Castillejo Fellowship from the Spanish Ministry of Science, Innovation, and Universities (CAS19/00265). JS is supported by a Leadership Level 2 Fellowship, National Health and Medical Research Council Australia (APP 1176885). This research was partially funded by "Convocatoria extraordinaria de ayudas a la investigacion. Preparacion, ejecucion y transferencia de conocimiento (convocatoria 2020) de l'Institut de Recerca i Innovacio Educativa (IRIE)"

A knowledge based application for industrialization design

After being designed, a product has to be manufactured, which means converting concepts and information into a real, physical object. This requires a big amount of resources and a careful planning. The product manufacturing must be designed too, and that is called Industrialization Design. An accepted methodology for this activity is starting defining simple structures and then progressively increasing the detail degree of the manufacturing solution. The impact of decisions taken at first stages of Industrialization Design is remarkable, and software tools to assist designers are required. In this paper a Knowledge Based Application prototype for the Industrialization Design is presented. The application is implemented within the environment CATIA V5/DELMIA. A case study with a simple Product from aerospace sector illustrates the prototype development

Kerr-Schild Symmetries

We study continuous groups of generalized Kerr-Schild transformations and the vector fields that generate them in any n-dimensional manifold with a Lorentzian metric. We prove that all these vector fields can be intrinsically characterized and that they constitute a Lie algebra if the null deformation direction is fixed. The properties of these Lie algebras are briefly analyzed and we show that they are generically finite-dimensional but that they may have infinite dimension in some relevant situations. The most general vector fields of the above type are explicitly constructed for the following cases: any two-dimensional metric, the general spherically symmetric metric and deformation direction, and the flat metric with parallel or cylindrical deformation directions.Comment: 15 pages, no figures, LaTe

H2 oxidation versus organic substrate oxidation in non-heme iron mediated reactions with H2O2

Herein we show that species generated upon reaction of α-[Fe(CF3SO3)2(BPMCN)] (BPMCN = N,N′-bis(2-pyridylmethyl)-trans-1,2-diaminocyclohexane) with H2O2 (putatively [FeV(O)(OH)(BPMCN)]) is able to efficiently oxidize H2 to H2O even in the presence of organic substrates, while species formed in the presence of acetic acid (putatively [FeV(O)(OAc)(BPMCN)]) prefer organic substrate oxidation over H2 activation. Mechanistic implications have been analysed with the aid of computational methodsThis work was supported by Spanish Ministerio de Economia y Competitividad (CTQ2012-37420-C02-02 and 01) European Research Council (StG 239910), and Generalitat de Catalunya (2014 SGR 862 and ICREA Academia award to MC). J.Ll.-F. thanks the CELLEX foundation for the starting career program for financial suppor

Phases of dual superconductivity and confinement in softly broken N=2 supersymmetric Yang-Mills theories

We study the electric flux tubes that undertake color confinement in N=2 supersymmetric Yang-Mills theories softly broken down to N=1 by perturbing with the first two Casimir operators. The relevant Abelian Higgs model is not the standard one due to the presence of an off-diagonal coupling among different magnetic U(1) factors. We perform a preliminary study of this model at a qualitative level. BPS vortices are explicitely obtained for particular values of the soft breaking parameters. Generically however, even in the ultrastrong scaling limit, vortices are not critical but live in a "hybrid" type II phase. Also, ratios among string tensions are seen to follow no simple pattern. We examine the situation at the half Higgsed vacua and find evidence for solutions with the behaviour of superconducting strings. In some cases they are solutions to BPS equations.Comment: 15 pages, 1 figure, revtex; v2: typos corrected, final versio

Supernova Model Discrimination with Hyper-Kamiokande

[EN] Core-collapse supernovae are among the most magnificent events in the observable universe. They produce many of the chemical elements necessary for life to exist and their remnants-neutron stars and black holes-are interesting astrophysical objects in their own right. However, despite millennia of observations and almost a century of astrophysical study, the explosion mechanism of core-collapse supernovae is not yet well understood. Hyper-Kamiokande is a next-generation neutrino detector that will be able to observe the neutrino flux from the next galactic core-collapse supernova in unprecedented detail. We focus on the first 500 ms of the neutrino burst, corresponding to the accretion phase, and use a newly-developed, high-precision supernova event generator to simulate Hyper-Kamiokande's response to five different supernova models. We show that Hyper-Kamiokande will be able to distinguish between these models with high accuracy for a supernova at a distance of up to 100 kpc. Once the next galactic supernova happens, this ability will be a powerful tool for guiding simulations toward a precise reproduction of the explosion mechanism observed in nature.We thank MacKenzie Warren, Ken'ichiro Nakazato, Tomonori Totani, Adam Burrows, David Vartanyan, and Irene Tamborra for access to the supernova models used in this work and for answering various related questions. This work was supported by MEXT Grant-in-Aid for Scientific Research on Innovative Areas titled "Exploration of Particle Physics and Cosmology with Neutrinos" under grant No. 18H05535, 18H05536, and 18H5537. In addition, participation of individual researchers has been further supported by funds from JSPS, Japan; the European Union's Horizon 2020 Research and Innovation Programme H2020 grant Nos. RISE-GA822070-JENNIFER2 2020 and RISEGA872549-SK2HK; SSTF-BA1402-06, NRF grant Nos. 20090083526, NRF-2015R1A2A1A05001869, NRF-2016R1D1A 1A02936965, NRF-2016R1D1A3B02010606, NRF-2017R1 A2B4012757, and NRF-2018R1A6A1A06024970 funded by the Korean government (MSIP); JSPS-RFBR Grant #20-5250010/20 and the Ministry of Science and Higher Education under contract #075-15-2020-778, Russia; Brazilian Funding agencies, CNPq and CAPES; STFC ST/R00031X/2, ST/T002891/1, ST/V002872/1, Consolidated Grants, UKRI MR/S032843/1 and MR/S034102/1, UK. Software: BONSAI.(Smy 2007), sntools. (Migenda et al. 2021), WCSim, 124. matplotlib.(Hunter 2007), NumPy.(van der Walt et al. 2011), SciPy.(Virtanen et al. 2020)Abe, K.; Adrich, P.; Aihara, H.; Akutsu, R.; Alekseev, I.; Ali, A.; Ameli, F.... (2021). Supernova Model Discrimination with Hyper-Kamiokande. The Astrophysical Journal. 916(1):1-17. https://doi.org/10.3847/1538-4357/abf7c4117916