Design of a case management model for people with chronic disease (Heart Failure and COPD). Phase I: modeling and identification of the main components of the intervention through their actors: patients and professionals (DELTA-ICE-PRO Study

Background Chronic diseases account for nearly 60% of deaths around the world. The extent of this silent epidemic has not met determined responses in governments, policies or professionals in order to transform old Health Care Systems, configured for acute diseases. There is a large list of research about alternative models for people with chronic conditions, many of them with an advanced practice nurse as a key provider, as case management. But some methodological concerns raise, above all, the design of the intervention (intensity, frequency, components, etc). Methods/Design Objectives: General: To develop the first and second phases (theorization and modeling) for designing a multifaceted case-management intervention in people with chronic conditions (COPD and heart failure) and their caregivers. Specific aims: 1) To identify key events in people living with chronic disease and their relation with the Health Care System, from their point of view. 2) To know the coping mechanisms developed by patients and their caregivers along the story with the disease. 3) To know the information processing and its utilization in their interactions with health care providers. 4) To detect potential unmet needs and the ways deployed by patients and their caregivers to resolve them. 5) To obtain a description from patients and caregivers, about their itineraries along the Health Care System, in terms of continuity, accessibility and comprehensiveness of care. 6) To build up a list of promising case-management interventions in patients with Heart Failure and COPD with this information in order to frame it into theoretical models for its reproducibility and conceptualization. 7) To undergo this list to expert judgment to assess its feasibility and pertinence in the Andalusian Health Care. Design: Qualitative research with two phases: For the first five objectives, a qualitative technique with biographic stories will be developed and, for the remaining objectives, an expert consensus through Delphi technique, on the possible interventions yielded from the first phase. The study will be developed in the provinces of Almería, Málaga and Granada in the Southern Spain, from patients included in the Andalusian Health Care Service database with the diagnosis of COPD or Heart Failure, with the collaboration of case manager nurses and general practitioners for the assessment of their suitability to inclusion criteria. Patients and caregivers will be interviewed in their homes or their Health Centers, with their family or their case manager nurse as mediator. Discussion First of a series of studies intended to design a case-management service for people with heart failure and COPD, in the Andalusian Health Care System, where case management has been implemented since 2002. Accordingly with the steps of a theoretical model for complex interventions, in this study, theorization and intervention modeling phases will be developed.This research was carried out with the support of one research grant, awarded by the Regional Health Ministry of Andalusia (Exp. 0222/2008

Prevalence of anti-sperm antibodies, risk factors associated and their impact on spermatobioscopy in infertile men

Background: The first immunological correlation with male infertility was reported in 1954 by Wilson and Rumke with the identification of anti-sperm antibodies. The prevalence of anti-sperm antibodies in infertile men varies from 9%-36%, the main cause being the loss of the blood-testicular barrier and otherwise the association with chronic inflammation. It has been shown that immune infertility is found in 15% of patients with varicocele.Methods: A transversal comparative study was carried out with 360 infertile men who were tested for anti-sperm antibodies between January 2011 and July 2018. Two groups were integrated; Group 1, infertile men with positive anti-sperm antibodies >50%, group 2, infertile men with negative anti-sperm <50%. Seminogram parameters were evaluated according to the WHO 5th edition and associated risk factors with anti-sperm antibodies.Results: 360 infertile men were evaluated during the study, 42 were excluded because they did not meet the inclusion criteria, the prevalence of anti-sperm antibodies was 14.5%. Group 1; n=46 (14.5%) and group 2, n=272 (85.5%), the clinical characteristics and the hormonal profile were compared at study admission without significant difference. There was a significant decrease in progressive motility in group 1 (38.7±23.8) vs group 2 (50.1±18.9) p=0.03. Analyzing the risk factors, varicocele was found to be significant 23.7%, OR 2.14 (1.27-3.61) p=0.004 as well as retractable testicle 26.4%, OR 2.13 (1.23-3.70) p= 0.008.Conclusions: The affectation of motility was confirmed, which leads to the suspect varicocele and retractable testicle as risk factors

Comparative evaluation of R1234yf, R1234ze(E) and R450A as alternatives to R134a in a variable speed reciprocating compressor

A comparative energetic evaluation of R1234yf, R1234ze(E) and R450A as alternatives to R134a in a variable speed compressor is carried out. A compressor model based on dimensionless numbers was obtained using the Buckingham p -theorem, which was validated with experimental data; showing that the prediction error of the model is lower than ± 10% and ± 2 K for temperature. The experimental data were obtained by testing R134a, R1234yf, R1234ze(E) and R450A for a wide range of operating condi- tions. Results obtained with the validated model, show that the dimensionless approach provides a similar estimation of energy parameters compared with the experimental results, such as power con- sumption, refrigerant mass fl ow rate, cooling capacity, COP, discharge temperature and compressor ef- fi ciencies for each refrigerant tested using the dimensionless approach proposed. The comparative evaluation of the compressor predictions shows a reduction in the cooling capacity obtained with R1234yf, R450A and R1234ze(E), in comparison with R134a. Also, COP values for R1234yf, R450A, and R1234ze(E) are lower than those obtained from R134a. Finally, results shows that the dimensionless correlation compressor model can be used to predict the performance of other reciprocating compres- sors, at similar operating conditions for a wide range of compressor rotation speed, with a reasonable accuracy.The authors thankfully acknowledge to the "Consejo Nacional deCiencia y Tecnología (CONACYT)” for their support to this study, and to the “Ministerio de Educación, Cultura y Deporte” (Grant number FPU12/02841) for sponsoring this work through “Becas y Contratosde Formación de Profesorado Universitario del Programa Nacional de Formación de Recursos Humanos de Investigación del ejercicio 2012”

Critical Behavior of Three-Dimensional Disordered Potts Models with Many States

We study the 3D Disordered Potts Model with p=5 and p=6. Our numerical simulations (that severely slow down for increasing p) detect a very clear spin glass phase transition. We evaluate the critical exponents and the critical value of the temperature, and we use known results at lower $p$ values to discuss how they evolve for increasing p. We do not find any sign of the presence of a transition to a ferromagnetic regime.Comment: 9 pages and 9 Postscript figures. Final version published in J. Stat. Mec

Room temperature vacuum-deposition of CsPbI2Br perovskite films from multiple-sources and mixed halide precursors

Fully inorganic cesium lead halide perovskites, such as CsPbI2Br, show enhanced thermal stability compared to hybrid ones and are being widely investigated as wide bandgap absorbers for tandem applications. Despite their simple stoichiometry, the preparation of highly crystalline and stable cesium lead halide thin films is not trivial. In general, high-efficiency solar cells based on solution-processed CsPbI2Br thin films are prepared by hightemperature annealing or the use of chemical additives. In this work, we use solvent-free synthesis to investigate the formation of CsPbI2Br in bulk or in thin films via mechanochemical synthesis and multiple-source vacuum deposition, respectively. We demonstrate the importance of fostering halide alloying in the vacuum processing of inorganic lead halide perovskites, which can be attained either by using mixed halide precursors or by increasing the number of precursors (and hence deposition sources). These strategies lead to highly oriented perovskite films even at room temperature, with improved optoelectronic properties. We obtained promising power conversion efficiencies of 8.3% for solar cells employing asdeposited perovskites (without any annealing) and 10.0% for devices based on CsPbI2Br annealed at low temperatures (150 °C). This study allowed us to highlight the most promising processes and strategies to further optimize the material deposition as well as the solar cell architecture

Lack of a synergistic effect of a non-viral ALS gene therapy based on BDNF and a TTC fusion molecule

Significant improvements in behavioral and electrophysiological results, motoneuron survival and anti-apoptotic/survival-activated pathways were observed with BDNF-TTC treatment. However, no synergistic effect was found for this fusion molecule. Although BDNF in the fusion molecule is capable of activating autocrine and neuroprotective pathways, TTC treatment alone yielded similar neuroprotection. Therefore, an accurate study of the neuroprotective effects of TTC fusion molecules should be performed to obtain a better understanding of its effect

Turbidity and Other Effects Resulting from Trafalgar Sandbank Dredging and Palmar Beach Nourishment

Beach-nourishment requirements on the southwestern Spanish coast have led to a significant increase in offshore dredging. Following a new research line, assessment of changes recorded in physicochemical and biological parameters due to dredging and dumping operations was performed at the Cape of Trafalgar and Palmar Beach during June and July 2008. Turbidity, salinity, pH, dissolved oxygen, temperature, and suspended-sediment data were collected at 10 stations. At the end of the study, a three-campaign monitoring program was implemented for 1 year to assess the possible effects on biological communities and sediment properties. The relevant results, such as the average extent of the sediment plume (< 400 m) and its persistence in the environment (< 10 min), are discussed in this paper. A precise correlation between turbidity and suspended sediments and the recovery time of ecological balance were also established. Furthermore, minimal and reversible effects caused by dredging and dumping operations in this type of marine environment were identified

Altered innate immune profile in blood of systemic mastocytosis patients

[Background]: Mast cells (MC) from systemic mastocytosis (SM) patients release MC mediators that lead to an altered microenvironment with potential consequences on innate immune cells, such as monocytes and dendritic cells (DC). Here we investigated the distribution and functional behaviour of different populations of blood monocytes and DC among distinct diagnostic subtypes of SM. [Methods]: Overall, we studied 115 SM patients - 45 bone marrow mastocytosis (BMM), 61 indolent SM (ISM), 9 aggressive SM (ASM)- and 32 healthy donors (HD). Spontaneous and in vitro-stimulated cytokine production by blood monocytes, and their plasma levels, together with the distribution of different subsets of blood monocytes and DCs, were investigated. [Results]: SM patients showed increased plasma levels and spontaneous production by blood monocytes of IL1β, IL6, IL8, TNFα and IL10, associated with an exhausted ability of LPS + IFNγ-stimulated blood monocytes to produce IL1β and TGFβ. SM (particularly ISM) patients also showed decreased counts of total monocytes, at the expense of intermediate monocytes and non-classical monocytes. Interestingly, while ISM and ASM patients had decreased numbers of plasmacytoid DC and myeloid DC (and their major subsets) in blood, an expansion of AXL+ DC was specifically encountered in BMM cases. [Conclusion]: These results demonstrate an altered distribution of blood monocytes and DC subsets in SM associated with constitutive activation of functionally impaired blood monocytes and increased plasma levels of a wide variety of inflammatory cytokines, reflecting broad activation of the innate immune response in mastocytosis.This study has been funded by Instituto de Salud Carlos III (ISCIII) (grant number PI19/01166; and Centro de Investigación Biomédica en Red de Cáncer [CIBERONC] programme, grant number CB16/12/00400) and co-funded by the European Union (EU). We thank the support of the Spanish National DNA Bank Carlos III (www.bancoadn.org; biobank ID B.0000716; supported by ISCIII and co-founded by EU [grant number PT20/00085]) for providing plasma samples. APP was supported by a grant of the Government of Castilla y León (Orden EDU/556/2019), Spain; co-financed with the “European Regional Development Fund” (BDNS, Identif.:422058). We thank the support of the Spanish Association of Mastocytosis and Related Diseases

Vortex dynamics controlled by local superconducting enhancement

A controlled local enhancement of superconductivity yields unexpected modifications in the vortex dynamics. This local enhancement has been achieved by designing an array of superconducting Nb nanostructures embedded in a V superconducting film. The most remarkable findings are: (i) vanishing of the main commensurability effect between the vortex lattice and the array unit cell, (ii) hysteretic behavior in the vortex dynamics, (iii) broadening of the vortex liquid phase and (iv) strong softening of the vortex lattice. These effects can be controlled and they can be quenched by reducing the Nb array superconducting performance applying an in-plane magnetic field. These results can be explained by taking into account the repulsive potential landscape created by the superconducting Nb nanostructures on which vortices move