Costs and consequences of chronic pain due to musculoskeletal disorders from a health system perspective in Chile

Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain. Background: Chronic pain is a prevalent and distressing condition caused by an unceasing pain lasting more than 3 months or a pain that persists beyond the normal healing time. There is evidence of inadequate management partly explained by the unawareness regarding the magnitude of the problem. Objectives: To estimate the annual expected costs and consequences of chronic pain caused by musculoskeletal diseases from the health system perspective in Chile. Methods: A Markov cohort model was built to represent chronic pain and estimate expected costs and consequences over 1-year time horizon. Transition probabilities were obtained through expert elicitation. Consequences examined were: years lost to disability (YLD), depression, anxiety, and productivity losses. Direct health care costs were estimated using local sources. Probabilistic sensitivity analysis was performed to characterize second-order uncertainty. Results: The annual expected cost due to musculoskeletal chronic pain was estimated in USD $1387.2 million, equivalent to 0.417$94 million (Bayesian credibility interval 95% $49.1-$156.26). Productivity losses were also important cost, although early retirement and presenteeism were not measured. Chronic pain causes 137,037 YLDs. Conclusion: Chronic pain is not only an important cause of disability but also responsible for high social and financial burden in Chile. Public health programs focused on managing chronic pain may decrease burden of disease and possibly reduce costs.

Polyembryony in Maize: A Complex, Elusive, and Potentially Agronomical Useful Trait

Polyembryony (PE) is a rare phenomenon in cultivated plant species. Since nineteenth century, several reports have been published on PE in maize. Reports of multiple seedlings developing at embryonic level in laboratory and studies under greenhouse and field conditions have demonstrated the presence of PE in cultivated maize (Zea mays L.). Nevertheless, there is a lack of knowledge about this phenomenon; diverse genetic mechanisms controlling PE in maize have been proposed: Mendelian inheritance of a single gene, interaction between two genes and multiple genes are some of the proposed mechanisms. On the other hand, the presence of two or more embryos per seed confers higher nutrimental quality because these grains have more crude fat and lysine than normal maize kernels. As mentioned above, there is a necessity for more studies about PE maize in order to establish the genetic mechanism responsible for this phenomenon; on the other hand, previous studies showed that PE has potential to generate specialized maize varieties with yield potential and grain quality

Period Change Rates of Large Magellanic Cloud Cepheids using MESA

Pulsating stars, such as Cepheids and RR Lyrae, offer us a window to measure and study changes due to stellar evolution. In this work, we study the former by calculating a set of evolutionary tracks of stars with an initial mass of 4 to 7 $M_\odot$, varying the initial rotation rate and metallicity, using the stellar evolution code Modules for Experiments in Stellar Astrophysics (MESA). Using Radial Stellar Pulsations (RSP), a recently added functionality of MESA, we obtained theoretical instability strip (IS) edges and linear periods for the radial fundamental mode. Period-age, period-age-temperature, period-luminosity, and period-luminosity-temperature relationships were derived for three rotation rates and metallicities, showing a dependence on crossing number, position in the IS, rotation, and metallicity. We calculated period change rates (PCRs) based on the linear periods from RSP. We compared our models with literature results using the Geneva code, and found large differences, as expected due to the different implementations of rotation between codes. In addition, we compared our theoretical PCRs with those measured in our recent work for Large Magellanic Cloud Cepheids. We found good overall agreement, even though our models do not reach the short-period regime exhibited by the empirical data. Implementations of physical processes not yet included in our models, such as pulsation-driven mass loss, an improved treatment of convection that may lead to a better description of the instability strip edges, as well as consideration of a wider initial mass range, could all help improve the agreement with the observed PCRs.Comment: 19 pages, 17 figures. Accepted by MNRA

Manejo quirúrgico de lesión quística.

La lesión periapical indica la propagación bacteriana en el sistema de conductos y la posible presencia de biofilm extraradicular

Performance of ALICE AD modules in the CERN PS test beam

Two modules of the AD detector have been studied with the test beam at the T10 facility at CERN. The AD detector is made of scintillator pads read out by wave-length shifters (WLS) coupled to clean fibres that carry the produced light to photo-multiplier tubes (PMTs). In ALICE the AD is used to trigger and study the physics of diffractive and ultra-peripheral collisions as well as for a variety of technical tasks like beam-gas background monitoring or as a luminometer. The position dependence of the modules' efficiency has been measured and the effect of hits on the WLS or PMTs has been evaluated. The charge deposited by pions and protons has been measured at different momenta of the test beam. The time resolution is determined as a function of the deposited charge. These results are important ingredients to better understand the AD detector, to benchmark the corresponding simulations, and very importantly they served as a baseline for a similar device, the Forward Diffractive Detector (FDD), being currently built and that will be in operation in ALICE during the LHC Runs 3 and 4.Peer reviewe

Dynamics, Patterns and Causes of Fires in Northwestern Amazonia

According to recent studies, two widespread droughts occurred in the Amazon basin, one during 2005 and one during 2010. The drought increased the prevalence of climate-driven fires over most of the basin. Given the importance of human-atmosphere-vegetation interactions in tropical rainforests, these events have generated concerns over the vulnerability of this area to climate change. This paper focuses on one of the wettest areas of the basin, Northwestern Amazonia, where the interactions between the climate and fires are much weaker and where little is known about the anthropogenic drivers of fires. We have assessed the response of fires to climate over a ten-year period, and analysed the socio-economic and demographic determinants of fire occurrence. The patterns of fires and climate and their linkages in Northwestern Amazonia differ from the enhanced fire response to climate variation observed in the rest of Amazonia. The highest number of recorded fires in Northwestern Amazonia occurred in 2004 and 2007, and this did not coincide with the periods of extreme drought experienced in Amazonia in 2005 and 2010. Rather, during those years, Northwestern Amazonia experienced a relatively small numbers of fire hotspots. We have shown that fire occurrence correlated well with deforestation and was determined by anthropogenic drivers, mainly small-scale agriculture, cattle ranching (i.e., pastures) and active agricultural frontiers (including illegal crops). Thus, the particular climatic conditions for air convergence and rainfall created by proximity to the Andes, coupled with the presence of one of the most active colonisation fronts in the region, make this region differently affected by the general drought-induced fire patterns experienced by the rest of the Amazon. Moreover, the results suggest that, even in this wet region, humans are able to modify the frequency of fires and impact these historically well preserved forests

The state of the Martian climate

60°N was +2.0°C, relative to the 1981–2010 average value (Fig. 5.1). This marks a new high for the record. The average annual surface air temperature (SAT) anomaly for 2016 for land stations north of starting in 1900, and is a significant increase over the previous highest value of +1.2°C, which was observed in 2007, 2011, and 2015. Average global annual temperatures also showed record values in 2015 and 2016. Currently, the Arctic is warming at more than twice the rate of lower latitudes

Assessment of ecosystem services of an urbanized tropical estuary with a focus on habitats and scenarios

Tropical estuaries are one of the most valuable ecosystems on the planet because of the number of ecosystem services they provide. The increasing anthropogenic pressure to which these estuaries are subject has caused a reduction in their natural capital stock. Therefore, the application of a pragmatic and rational ecosystem-based management approach to sustainably manage the multiple ecosystem services provided by this ecosystem is necessary. The aim of our study is to present an approach that combines prospective scenarios with habitat-based perspective to assess the supply capacity of ecosystem services, plus determine the impact of protected areas in an urbanized tropical estuary. The current situation and two scenarios were generated to evaluate the capacity of habitats to supply ecosystem services. This type of assessment will allow the decision makers to visualize the effect of their choices or the occurrence of events which might produce significant changes in the estuary. Thus, over time, measures can be taken to sustain the supply of ecosystem services. We determined that the establishment of protected areas have a positive impact; however, the effect is not the same for all of them. Consequently, indicating that actions such as community participation, research, education, management planning and infrastructure development must accompany the development of a protected area

K2-280b -- a low density warm sub-Saturn around a mildly evolved star

We present an independent discovery and detailed characterisation of K2-280b, a transiting low density warm sub-Saturn in a 19.9-day moderately eccentric orbit (e = 0.35_{-0.04}^{+0.05}) from K2 campaign 7. A joint analysis of high precision HARPS, HARPS-N, and FIES radial velocity measurements and K2 photometric data indicates that K2-280b has a radius of R_b = 7.50 +/- 0.44 R_Earth and a mass of M_b = 37.1 +/- 5.6 M_Earth, yielding a mean density of 0.48_{-0.10}^{+0.13} g/cm^3. The host star is a mildly evolved G7 star with an effective temperature of T_{eff} = 5500 +/- 100 K, a surface gravity of log(g) = 4.21 +/- 0.05 (cgs), and an iron abundance of [Fe/H] = 0.33 +/- 0.08 dex, and with an inferred mass of M_star = 1.03 +/- 0.03 M_sun and a radius of R_star = 1.28 +/- 0.07 R_sun. We discuss the importance of K2-280b for testing formation scenarios of sub-Saturn planets and the current sample of this intriguing group of planets that are absent in the Solar System

SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome

The aim was to assess the ability of nasopharyngeal SARS-CoV-2 viral load at first patient’s hospital evaluation to predict unfavorable outcomes. We conducted a prospective cohort study including 321 adult patients with confirmed COVID-19 through RT-PCR in nasopharyngeal swabs. Quantitative Synthetic SARS-CoV-2 RNA cycle threshold values were used to calculate the viral load in log10 copies/mL. Disease severity at the end of follow up was categorized into mild, moderate, and severe. Primary endpoint was a composite of intensive care unit (ICU) admission and/or death (n = 85, 26.4%). Univariable and multivariable logistic regression analyses were performed. Nasopharyngeal SARS-CoV-2 viral load over the second quartile (≥ 7.35 log10 copies/mL, p = 0.003) and second tertile (≥ 8.27 log10 copies/mL, p = 0.01) were associated to unfavorable outcome in the unadjusted logistic regression analysis. However, in the final multivariable analysis, viral load was not independently associated with an unfavorable outcome. Five predictors were independently associated with increased odds of ICU admission and/or death: age ≥ 70 years, SpO2, neutrophils > 7.5 × 103/µL, lactate dehydrogenase ≥ 300 U/L, and C-reactive protein ≥ 100 mg/L. In summary, nasopharyngeal SARS-CoV-2 viral load on admission is generally high in patients with COVID-19, regardless of illness severity, but it cannot be used as an independent predictor of unfavorable clinical outcome