Could the Recent Zika Epidemic Have Been Predicted?

Given knowledge at the time, the recent 2015–2016 zika virus (ZIKV) epidemic probably could not have been predicted. Without the prior knowledge of ZIKV being already present in South America, and given the lack of understanding of key epidemiologic processes and long-term records of ZIKV cases in the continent, the best related prediction could be carried out for the potential risk of a generic Aedes-borne disease epidemic. Here we use a recently published two-vector basic reproduction number model to assess the predictability of the conditions conducive to epidemics of diseases like zika, chikungunya, or dengue, transmitted by the independent or concurrent presence of Aedes aegypti and Aedes albopictus. We compare the potential risk of transmission forcing the model with the observed climate and with state-of-the-art operational forecasts from the North American Multi Model Ensemble (NMME), finding that the predictive skill of this new seasonal forecast system is highest for multiple countries in Latin America and the Caribbean during the December-February and March-May seasons, and slightly lower—but still of potential use to decision-makers—for the rest of the year. In particular, we find that above-normal suitable conditions for the occurrence of the zika epidemic at the beginning of 2015 could have been successfully predicted at least 1 month in advance for several zika hotspots, and in particular for Northeast Brazil: the heart of the epidemic. Nonetheless, the initiation and spread of an epidemic depends on the effect of multiple factors beyond climate conditions, and thus this type of approach must be considered as a guide and not as a formal predictive tool of vector-borne epidemics

Herramienta de coordinación de titulaciones en la E.P.S. Linares

En este trabajo se presenta una plataforma de coordinación de actividades vinculadas con la docencia de todas las asignaturas de las titulaciones de grado y máster impartidas en el centro, organizadas por cursos y títulos, de manera que el profesorado de cada asignatura cuente, para la programación sus tareas (pruebas, entregas de prácticas o relaciones de problemas, visitas, conferencias, seminarios, etc.), de toda la información sobre el resto de asignaturas del título. En este sentido, la plataforma se nutre de la información que el profesorado, usuario principal de la misma, introduce en ella. Debe contener las actividades del trabajo y recursos utilizados: es decir, metodologías, técnicas y tecnología

Impact of biological agents on postsurgical complications in inflammatory bowel disease: A multicentre study of Geteccu

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered “exposed”. The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2–2.0), urgent surgery (OR: 1.6; 95% CI: 1.2–2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1–1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3–2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97–1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03–2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections

Parametric Methodology to Optimize the Sizing of Solar Collector Fields in Series-Parallel Arrays

The analysis of solar thermal systems through numerical simulation is of great importance, since it allows predicting the performance of many configurations in any location and under different climatic conditions. Most of the simulation tools are commercial and require different degrees of training; therefore, it is important to develop simple and reliable methodologies to obtain similar results. This study presents a parametric methodology to size stationary solar collector fields, with operating temperatures up to 150 °C. The costs of the collector loop piping and the pumping power of different series−parallel arrays is considered. The proposed tool was validated with experimental data and through simulations using commercial software. The tool allows establishing series−parallel arrays and calculates the volume of the storage tank according to the thermal load. The calculation is based on the system energy balance, where the mass flow and the heat losses in the interconnections of the collectors are taken into account. The number of collectors and the optimal series−parallel array were determined. The results show deviations lower than 7% in the relative error of the temperature profiles and in the solar fraction, with respect to the results obtained by dynamic simulations

Pre-Feasibility Assessment Tool for Solar Industrial Process Heating

The industrial sector demands 25% of global energy as heat, where one-third is used at temperatures below 150 °C. Nevertheless, the installed solar heating capacity in the industry is only 0.02%, even though the integration of solar heating systems into production processes could significantly reduce fossil fuel consumption at a competitive cost. Among other reasons, this low penetration is due to the final users’ lack of knowledge of solar heating technologies. As a result, a free pre-feasibility assessment tool was developed for non-specialised users to evaluate the possibility of integrating solar heat into their processes using basic information. This tool uses transient simulation to estimate a feasible solar heating system through the parametric optimisation of the solar collection area, thermal storage volume, heat exchange capacity, and solar integration schemes at the supply level and costs. A commercial facility in Mexico was analysed using the developed tool as a case study. However, even when this is not a design tool, the calculated solar collector area, storage tank volume, and investment were only 2.1%, 9.0%, and 2.3% higher than reported by the solar designer. Pre-feasibility assessment tools are essential to overcome the certainty gap between end users and solar designers, thus enhancing the possibility of implementing solar heating systems in various commercial and industrial processes

Efficacy and safety of bromfenac 0.09% and sodium hyaluronate 0.4% combination therapy, versus placebo in patients with pterygium I–III for clinical signs on ocular inflammation

Eduardo Chávez-Mondragón,1 Claudia Palacio,2 Abraham Soto-Gómez,3 Miguel Villanueva-Nájera,4 Guillermo De Wit-Carter,5 Ruben Suárez-Velasco,6 Leopoldo Baiza-Duran,7 Oscar Olvera-Montaño,7 Patricia Muñoz-Villegas71Fundación de Asistencia Privada Conde de Valenciana, IAP, CDMX, Mexico; 2Fundación Hospital Nuestra Señora de la Luz, IAP, CDMX, Mexico; 3Catarata y Glaucoma de Occidente, SA de CV, Guadalajara, Jalisco, Mexico; 4Private Office, CDMX, Mexico; 5Asociación para Evitar la Ceguera en Mexico IAP, CDMX, Mexico; 6Novam y Vita, Guadalajara, Jalisco, Mexico; 7Clinical Research Department, Laboratorios Sophia, SA de CV, Zapopan, Jalisco, MexicoPurpose: This study evaluated the clinical efficacy and safety of bromfenac 0.09%, sodium hyaluronate 0.4% (SH) combination therapy, versus placebo and SH in a clinical model of pterygium I–III.Methods: A total of 166 eyes (99 patients) with pterygium grade I–III were randomized to bromfenac 0.09% ophthalmic solution+SH 0.4% or placebo+SH 0.4%. This was a Phase IV, prospective, parallel, double-masked, multicenter clinical trial. One drop of bromfenac or placebo was instilled two times a day (BID) for 20 days, both groups accompanied treatments with one drop of SH three times a day (TID). The primary efficacy endpoints were the conjunctival hyperemia and the Ocular Surface Disease Index (OSDI) score. Other results measured included burning, foreign body sensation, and photophobia. The safety was assessed by the tear break-up time (TBUT), visual acuity (VA), IOP, lissamine green, fluorescein stains, and the incidence of adverse events (AEs).Results: Compared with baseline, there was a significant reduction in the conjunctival hyperemia (p=0.0001) and OSDI score in both groups (p=0.0001). There was a significant improvement in ocular symptomatology for both, placebo/SH and bromfenac/SH groups (p=0.0001), the decrement in the ocular burning was 41.1% vs 24.6%, the foreign body sensation was 31.5% vs 36.2% and, for photophobia was 23.3% vs 30.5%, respectively. A statistically significant difference was observed in TBUT for bromfenac/SH (p=0.045), at day 20. There were no significant alterations in IOP (p=0.068) or VA (p=0.632). Similar improvements were observed in the fluorescein and green lissamine staining. Finally, the incidence of AE was similar between groups.Conclusion: The treatment with bromfenac 0.09% ophthalmic solution and SH 0.4% combination therapy for 3 weeks reduced clinical signs, in patients with pterygium I–III. The results suggest that bromfenac 0.09% can improve the symptomatology, reduce the presentation of clinical signs associated with superficial ocular inflammation.Keywords: nonsteroidal anti-inflammatory drug, Ocular Surface Disease Index, conjunctival hyperemia, ocular lubrican

Contenidos virtuales para neurorrehabilitación funcional de la extremidad superior

La utilización de entornos virtuales de rehabilitación que hacen uso de dispositivos comerciales para el entretenimiento ha adquirido un gran interés en el área de neurorrehabilitación. El objetivo del presente trabajo es diseñar y desarrollar contenidos virtuales (CVs) para rehabilitación funcional en pacientes con Traumatismo Craneoencefálico (TCE). Para ello se han diseñado dos actividades de rehabilitación que hacen uso del sensor de profundidad de bajo coste Microsoft Kinect junto con dispositivos de control, especialmente diseñados para los CVs de rehabilitación, que sirvan como herramienta de monitorización e interacción. Los CVs desarrollados se han basado en actividad

Battle of Thermopylae: 300 Spartans (natural killer cells plus obinutuzumab) versus the immortal warriors (chronic lymphocytic leukemia cells) of Xerxes’ army

Aim: To analyze the effects of subcutaneous or intravenous rituximab + lymphokine-activated killer cells, obinutuzumab or ibrutinib on natural killer (NK) cell levels in chronic lymphocytic leukemia and follicular lymphoma patients. Patients & methods: The distribution of peripheral blood NK cells of 31 patients was analyzed by flow cytometry. Results: We detected a decrease of NK cells in peripheral blood below normal range after obinutuzumab treatment. During maintenance treatment with subcutaneous rituximab, an NK cell reduction was less pronounced than after intravenous rituximab treatment, despite lymphokineactivated killer cell infusions. Conclusion: After one dose of obinutuzumab, each NK cell in peripheral blood destroys 25 leukemic cells. Lay abstract: The standard treatment of chronic lymphocytic leukemia and follicular lymphoma is chemotherapy in combination with anti-CD20 monoclonal antibodies, resulting in the destruction of the immune system, or a ‘Kamikaze effect’. Unfortunately, immunotherapy with rituximab or obinutuzumab may be of limited efficacy when the immunological system is overwhelmed by abundant tumor cells or is diminished by chemotherapy, which eliminates effector immune cells such as natural killer cells before they would be able to kill the whole tumor. Hence, it is important to measure the number of immune cells to ensure that during the encounter of effector cells with tumor cells, sufficient ‘warriors’ can win the battle against the tumor. Otherwise, something akin to the Battle of Thermopylae can happen where a limited number of Spartan warriors faced a huge army and were defeated in the end

Battle of Thermopylae: 300 Spartans (natural killer cells plus obinutuzumab) versus the immortal warriors (chronic lymphocytic leukemia cells) of Xerxes’ army

Aim: To analyze the effects of subcutaneous or intravenous rituximab + lymphokine-activated killer cells, obinutuzumab or ibrutinib on natural killer (NK) cell levels in chronic lymphocytic leukemia and follicular lymphoma patients. Patients & methods: The distribution of peripheral blood NK cells of 31 patients was analyzed by flow cytometry. Results: We detected a decrease of NK cells in peripheral blood below normal range after obinutuzumab treatment. During maintenance treatment with subcutaneous rituximab, an NK cell reduction was less pronounced than after intravenous rituximab treatment, despite lymphokineactivated killer cell infusions. Conclusion: After one dose of obinutuzumab, each NK cell in peripheral blood destroys 25 leukemic cells. Lay abstract: The standard treatment of chronic lymphocytic leukemia and follicular lymphoma is chemotherapy in combination with anti-CD20 monoclonal antibodies, resulting in the destruction of the immune system, or a ‘Kamikaze effect’. Unfortunately, immunotherapy with rituximab or obinutuzumab may be of limited efficacy when the immunological system is overwhelmed by abundant tumor cells or is diminished by chemotherapy, which eliminates effector immune cells such as natural killer cells before they would be able to kill the whole tumor. Hence, it is important to measure the number of immune cells to ensure that during the encounter of effector cells with tumor cells, sufficient ‘warriors’ can win the battle against the tumor. Otherwise, something akin to the Battle of Thermopylae can happen where a limited number of Spartan warriors faced a huge army and were defeated in the end