The magnetocaloric effect in materials with a second order phase transition: Are T C and T peak necessarily coincident?

Using the Arrott–Noakes equation of state it is shown that the Curie point TC and the temperature where the magnetic entropy change is maximum Tpeak coincide only in the mean field approximation, but the Heisenberg model implies that Tpeak TC even for homogeneous materials. The distance between Tpeak and TC increases with applied magnetic field following a power law. In both cases, TC corresponds to a singular point in the temperature dependence of the magnetic entropy change. The field dependence of the magnetic entropy change is exactly the same at the Curie temperature and at the temperature of the peak

Constraining the dark matter contribution of γ\gamma rays in Cluster of galaxies using Fermi-LAT data

Clusters of galaxies are the largest gravitationally-bound systems in the Universe. Their dynamics are dominated by dark matter (DM), which makes them among the best targets for indirect DM searches. We analyze 12 years of data collected by the Fermi Large Area Telescope (Fermi-LAT) in the direction of 49 clusters of galaxies selected for their proximity to the Earth and their high X-ray flux, which makes them the most promising targets. We first create physically motivated models for the DM density around each cluster considering different assumptions for the substructure distribution. Then we perform a combined search for a $\gamma$-ray signal in the {\it Fermi}-LAT data between 500 MeV and 1 TeV. We find a signal of $\gamma$ rays potentially associated with DM that is at a statistical significance of $2.5\sigma-3.0\sigma$ when considering a slope for the subhalo mass distribution $\alpha=1.9$ and minimum mass of $M_{\rm{min}}=10^{-6}$ $M_{\odot}$. The best-fit DM mass and annihilation cross-sections for a $b\bar{b}$ annihilation channel are $m_{\chi}=40-60$ GeV and $\langle \sigma v \rangle = (2-4) \times 10^{-25}$ cm$^3$/s. When we consider $\alpha=2.0$ and $M_{\rm{min}}=10^{-9}$ $M_{\odot}$, the best-fit of the cross section reduces to $\langle \sigma v \rangle = (4-10) \times 10^{-26}$ cm$^3$/s. For both DM substructure models there is a tension between the values of $\langle \sigma v \rangle$ that we find and the upper limits obtained with the non-detection of a $\gamma$-ray flux from Milky Way dwarf spheroidal galaxies. This signal is thus more likely associated with $\gamma$ rays produced in the intracluster region by cosmic rays colliding with gas and photon fields.Comment: 27 Pages, 13 Figures. Accepted for publication in the PRD journa

Exploring the independent association of employment status to cancer survivors’ health-related quality of life

Background: Having a job has been associated with better Health-Related Quality of Life (HRQOL) in cancer survivors. However, the sociodemographic and disease-related profiles characterizing the survivors being employed and those having better HRQOL largely overlap. The present study aims to discern the degree to which employment status is independently associated with cancer survivors' HRQOL or if it mainly reflects the impact of other sociodemographic and cancer-related variables. Methods: Cross-sectional study on a heterogeneous sample of 772 working-age survivors of adult-onset cancer. An instrument specifically designed to assess HRQOL in cancer survivors and Multivariate Variance Analysis (MANOVA) were used. Results: Survival phase, cancer type, and employment status showed the main effects on cancer survivors' HRQOL. In particular, being employed (vs unemployed) had the greatest positive association with HRQOL, affecting ten of the twelve HRQOL domains considered. Also, interaction effects highlighted the role of age (younger) and marital status (single) as risk factors for a greater negative impact of variables affecting the survivor's HRQOL. Conclusions: The application of a multivariate methodology sheds new light on two relevant issues for the cancer survivor's HRQOL: (i) the existence of differences between diagnostic groups that are not attributed to other variables such as sex, and (ii) the important and independent role that employment status plays. Comprehensive cancer survivorship care should focus more on high-risk groups and include having a job as an essential aspect to consider and prompt. The fact that the employment status is susceptible to change represents a valuable opportunity to care for the wellbeing of this population

HEMIC Project: Design of a Clinical Information Modelling Tool Based on ISO13972 Technical Specification

The Andalusian Health Service is the public healthcare provider for 8.302.923 inhabitants in the South Spain. This organization coordinates primary and specialized care with an IT infrastructure composed by multiple Electronic Health Record Systems. According to the large volume of healthcare professionals involved, there is a need for providing a consistent management of information through multiple locations and systems. The HEMIC project aims to address this need developing and validating a methodology based on a software tool for standardizing information contained within EHR systems. The developed tool has been designed for supporting the participation of healthcare professionals the establishment of mechanisms for information governance. This research presents the requirements and designs for of a software tool focused on the adoption of recognized best practice in clinical information modeling. The designed tool has a Service Oriented Architecture that will be able to integrate terminology servers and repositories of clinical information models as part of the modeling process. Moreover, the defined tool organizes clinicians, IT developers and terminology experts involved in the modeling process in three levels to promote their coordination in the definition, specialization and validation of clinical information models. In order to ensure the quality of the developed clinical information models, the defined tool is based on the requirements defined in the ISO13972 Technical Specification

Field dependence of the adiabatic temperature change in second order phase transition materials: Application to Gd

The field dependence of the adiabatic temperature change Tad of second order phase transition materials is studied, both theoretically and experimentally. Using scaling laws, it is demonstrated that, at the Curie temperature, the field dependence of Tad is characterized by H1/. Therefore, as the magnetic entropy change SM follows a H(1−)/ power law, these two dependencies coincide only in the case of a mean field model. A phenomenological construction of a universal curve for Tad is presented, and its theoretical justification is also given. This universal curve can be used to predict the response of materials in different conditions not available in the laboratory (extrapolations in field or temperature), for enhancing the resolution of the data and as a simple screening procedure for the characterization of materialsThis work was supported by the Spanish Ministry of Science and Innovation and EU FEDER (Grant No. MAT 2007-65227), and the PAI of the Regional Government of Andalucía Grant No. P06-FQM-01823 .Peer reviewe

Sensitivity of the Cherenkov Telescope Array to a dark matter signal from the Galactic centre

Full list of authors: Acharyya, A.; Adam, R.; Adams, C.; Agudo, I.; Aguirre-Santaella, A.; Alfaro, R.; Alfaro, J.; Alispach, C.; Aloisio, R.; Alves Batista, R.; Amati, L.; Ambrosi, G.; Angüner, E. O.; Antonelli, L. A.; Aramo, C.; Araudo, A.; Armstrong, T.; Arqueros, F.; Asano, K.; Ascasíbar, Y. Ashley, M.; Balazs, C.; Ballester, O.; Baquero Larriva, A.; Barbosa Martins, V.; Barkov, M.; Barres de Almeida, U.; Barrio, J. A.; Bastieri, D.; Becerra, J.; Beck, G.; Becker Tjus, J.; Benbow, W.; Benito, M.; Berge, D.; Bernardini, E.; Bernlöhr, K.; Berti, A.; Bertucci, B.; Beshley, V.; Biasuzzi, B.; Biland, A.; Bissaldi, E.; Biteau, J.; Blanch, O.; Blazek, J.; Bocchino, F.; Boisson, C.; Bonneau Arbeletche, L.; Bordas, P.; Bosnjak, Z.; Bottacini, E.; Bozhilov, V.; Bregeon, J.; Brill, A.; Bringmann, T.; Brown, A. M.; Brun, P.; Brun, F.; Bruno, P.; Bulgarelli, A.; Burton, M.; Burtovoi, A.; Buscemi, M.; Cameron, R.; Capasso, M.; Caproni, A.; Capuzzo-Dolcetta, R.; Caraveo, P.; Carosi, R.; Carosi, A.; Casanova, S.; Cascone, E.; Cassol, F.; Catalani, F.; Cauz, D.; Cerruti, M.; Chadwick, P.; Chaty, S.; Chen, A.; Chernyakova, M.; Chiaro, G.; Chiavassa, A.; Chikawa, M.; Chudoba, J.; Çolak, M.; Conforti, V.; Coniglione, R.; Conte, F.; Contreras, J. L.; Coronado-Blazquez, J.; Costa, A.; Costantini, H.; Cotter, G.; Cristofari, P.; D'Aimath, A.; D'Ammando, F.; Damone, L. A.; Daniel, M. K.; Dazzi, F.; De Angelis, A.; De Caprio, V.; de Cássia dos Anjos, R.; de Gouveia Dal Pino, E. M.; De Lotto, B.; De Martino, D.; de Oña Wilhelmi, E.; De Palma, F.; de Souza, V.; Delgado, C.; Delgado Giler, A. G.; della Volpe, D.; Depaoli, D.; Di Girolamo, T.; Di Pierro, F.; Di Venere, L.; Diebold, S.; Dmytriiev, A.; Domínguez, A.; Donini, A.; Doro, M.; Ebr, J.; Eckner, C.; Edwards, T. D. P.; Ekoume, T. R. N.; Elsässer, D.; Evoli, C.; Falceta-Goncalves, D.; Fedorova, E.; Fegan, S.; Feng, Q.; Ferrand, G.; Ferrara, G.; Fiandrini, E.; Fiasson, A.; Filipovic, M.; Fioretti, V.; Fiori, M.; Foffano, L.; Fontaine, G.; Fornieri, O.; Franco, F. J.; Fukami, S.; Fukui, Y.; Gaggero, D.; Galaz, G.; Gammaldi, V.; Garcia, E.; Garczarczyk, M.; Gascon, D.; Gent, A.; Ghalumyan, A.; Gianotti, F.; Giarrusso, M.; Giavitto, G.; Giglietto, N.; Giordano, F.; Giuliani, A.; Glicenstein, J.; Gnatyk, R.; Goldoni, P.; González, M. M.; Gourgouliatos, K.; Granot, J.; Grasso, D.; Green, J.; Grillo, A.; Gueta, O.; Gunji, S.; Halim, A.; Hassan, T.; Heller, M.; Hernández Cadena, S.; Hiroshima, N.; Hnatyk, B.; Hofmann, W.; Holder, J.; Horan, D.; Hörandel, J.; Horvath, P.; Hovatta, T.; Hrabovsky, M.; Hrupec, D.; Hughes, G.; Humensky, T. B.; Hütten, M.; Iarlori, M.; Inada, T.; Inoue, S.; Iocco, F.; Iori, M.; Jamrozy, M.; Janecek, P.; Jin, W.; Jouvin, L.; Jurysek, J.; Karukes, E.; Katarzyński, K.; Kazanas, D.; Kerszberg, D.; Kherlakian, M. C.; Kissmann, R.; Knödlseder, J.; Kobayashi, Y.; Kohri, K.; Komin, N.; Kubo, H.; Kushida, J.; Lamanna, G.; Lapington, J.; Laporte, P.; Leigui de Oliveira, M. A.; Lenain, J.; Leone, F.; Leto, G.; Lindfors, E.; Lohse, T.; Lombardi, S.; Longo, F.; Lopez, A.; López, M.; López-Coto, R.; Loporchio, S.; Luque-Escamilla, P. L.; Mach, E.; Maggio, C.; Maier, G.; Mallamaci, M.; Malta Nunes de Almeida, R.; Mandat, D.; Manganaro, M.; Mangano, S.; Manicò, G.; Marculewicz, M.; Mariotti, M.; Markoff, S.; Marquez, P.; Martí, J.; Martinez, O.; Martínez, M.; Martínez, G.; Martínez-Huerta, H.; Maurin, G.; Mazin, D.; Mbarubucyeye, J. D.; Medina Miranda, D.; Meyer, M.; Miceli, M.; Miener, T.; Minev, M.; Miranda, J. M.; Mirzoyan, R.; Mizuno, T.; Mode, B.; Moderski, R.; Mohrmann, L.; Molina, E.; Montaruli, T.; Moralejo, A.; Morcuende-Parrilla, D.; Morselli, A.; Mukherjee, R.; Mundell, C.; Nagai, A.; Nakamori, T.; Nemmen, R.; Niemiec, J.; Nieto, D.; Nikołajuk, M.; Ninci, D.; Noda, K.; Nosek, D.; Nozaki, S.; Ohira, Y.; Ohishi, M.; Ohtani, Y.; Oka, T.; Okumura, A.; Ong, R. A.; Orienti, M.; Orito, R.; Orlandini, M.; Orlando, S.; Orlando, E.; Ostrowski, M.; Oya, I.; Pagano, I.; Pagliaro, A.; Palatiello, M.; Pantaleo, F. R.; Paredes, J. M.; Pareschi, G.; Parmiggiani, N.; Patricelli, B.; Pavletić, L.; Pe'er, A.; Pecimotika, M.; Pérez-Romero, J.; Persic, M.; Petruk, O.; Pfrang, K.; Piano, G.; Piatteli, P.; Pietropaolo, E.; Pillera, R.; Pilszyk, B.; Pintore, F.; Pohl, M.; Poireau, V.; Prado, R. R.; Prandini, E.; Prast, J.; Principe, G.; Prokoph, H.; Prouza, M.; Przybilski, H.; Pühlhofer, G.; Pumo, M. L.; Queiroz, F.; Quirrenbach, A.; Rainò, S.; Rando, R.; Razzaque, S.; Recchia, S.; Reimer, O.; Reisenegger, A.; Renier, Y.; Rhode, W.; Ribeiro, D.; Ribó, M.; Richtler, T.; Rico, J.; Rieger, F.; Rinchiuso, L.; Rizi, V.; Rodriguez, J.; Rodriguez Fernandez, G.; Rodriguez Ramirez, J. C.; Rojas, G.; Romano, P.; Romeo, G.; Rosado, J.; Rowell, G.; Rudak, B.; Russo, F.; Sadeh, I.; Sæther Hatlen, E.; Safi-Harb, S.; Salesa Greus, F.; Salina, G.; Sanchez, D.; Sánchez-Conde, M.; Sangiorgi, P.; Sano, H.; Santander, M.; Santos, E. M.; Santos-Lima, R.; Sanuy, A.; Sarkar, S.; Saturni, F. G.; Sawangwit, U.; Schussler, F.; Schwanke, U.; Sciacca, E.; Scuderi, S.; Seglar-Arroyo, M.; Sergijenko, O.; Servillat, M.; Seweryn, K.; Shalchi, A.; Sharma, P.; Shellard, R. C.; Siejkowski, H.; Silk, J.; Siqueira, C.; Sliusar, V.; Słowikowska, A.; Sokolenko, A.; Sol, H.; Spencer, S.; Stamerra, A.; Stanič, S.; Starling, R.; Stolarczyk, T.; Straumann, U.; Strišković, J.; Suda, Y.; Suomijarvi, T.; Świerk, P.; Tavecchio, F.; Taylor, L.; Tejedor, L. A.; Teshima, M.; Testa, V.; Tibaldo, L.; Todero Peixoto, C. J.; Tokanai, F.; Tonev, D.; Tosti, G.; Tosti, L.; Tothill, N.; Truzzi, S.; Travnicek, P.; Vagelli, V.; Vallage, B.; Vallania, P.; van Eldik, C.; Vandenbroucke, J.; Varner, G. S.; Vassiliev, V.; Vázquez Acosta, M.; Vecchi, M.; Ventura, S.; Vercellone, S.; Vergani, S.; Verna, G.; Viana, A.; Vigorito, C. F.; Vink, J.; Vitale, V.; Vorobiov, S.; Vovk, I.; Vuillaume, T.; Wagner, S. J.; Walter, R.; Watson, J.; Weniger, C.; White, R.; White, M.; Wiemann, R.; Wierzcholska, A.; Will, M.; Williams, D. A.; Wischnewski, R.; Yanagita, S.; Yang, L.; Yoshikoshi, T.; Zacharias, M.; Zaharijas, G.; Zakaria, A. A.; Zampieri, L.; Zanin, R.; Zaric, D.; Zavrtanik, M.; Zavrtanik, D.; Zdziarski, A. A.; Zech, A.; Zechlin, H.; Zhdanov, V. I.; Živec, M.-- This is an open access article published by IOP Publishing Ltd on behalf of Sissa Medialab. Original content from this work may be used under the terms of the Creative Commons Attribution 4.0 licence. Any further distribution of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI.We provide an updated assessment of the power of the Cherenkov Telescope Array (CTA) to search for thermally produced dark matter at the TeV scale, via the associated gamma-ray signal from pair-annihilating dark matter particles in the region around the Galactic centre. We find that CTA will open a new window of discovery potential, significantly extending the range of robustly testable models given a standard cuspy profile of the dark matter density distribution. Importantly, even for a cored profile, the projected sensitivity of CTA will be sufficient to probe various well-motivated models of thermally produced dark matter at the TeV scale. This is due to CTA's unprecedented sensitivity, angular and energy resolutions, and the planned observational strategy. The survey of the inner Galaxy will cover a much larger region than corresponding previous observational campaigns with imaging atmospheric Cherenkov telescopes. CTA will map with unprecedented precision the large-scale diffuse emission in high-energy gamma rays, constituting a background for dark matter searches for which we adopt state-of-the-art models based on current data. Throughout our analysis, we use up-to-date event reconstruction Monte Carlo tools developed by the CTA consortium, and pay special attention to quantifying the level of instrumental systematic uncertainties, as well as background template systematic errors, required to probe thermally produced dark matter at these energies. © 2021 The Author(s).We gratefully acknowledge financial support from the following agencies and organisations: State Committee of Science of Armenia, Armenia; The Australian Research Council, Astronomy Australia Ltd, The University of Adelaide, Australian National University, Monash University, The University of New South Wales, The University of Sydney, Western Sydney University, Australia; Federal Ministry of Education, Science and Research, and Innsbruck University, Austria; Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq), Fundacao de Amparo a Pesquisa do Estado do Rio de Janeiro (FAPERJ), Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP), Ministry of Science, Technology, Innovations and Communications (MCTIC), and Instituto Serrapilheira, Brasil; Ministry of Education and Science, National RI Roadmap Project DO1-153/28.08.2018, Bulgaria; The Natural Sciences and Engineering Research Council of Canada and the Canadian Space Agency, Canada; CONICYT-Chile grants CATA AFB 170002, ANID PIA/APOYO AFB 180002, ACT 1406, FONDECYT-Chile grants, 1161463, 1170171, 1190886, 1171421, 1170345, 1201582, Gemini-ANID 32180007, Chile; Croatian Science Foundation, Rudjer Boskovic Institute, University of Osijek, University of Rijeka, University of Split, Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, University of Zagreb, Faculty of Electrical Engineering and Computing, Croatia; Ministry of Education, Youth and Sports, MEYS LM2015046, LM2018105, LTT17006, EU/MEYS CZ.02.1.01/0.0/0.0/16_013/0001403, CZ.02.1.01/0.0/0.0/18_046/0016007 and CZ.02.1.01/0.0/0.0/16_019/0000754, Czech Republic; Academy of Finland (grant nr.317636, 320045, 317383 and 320085), Finland; Ministry of Higher Education and Research, CNRS-INSU and CNRS-IN2P3, CEA-Irfu, ANR, Regional Council Ile de France, Labex ENIGMASS, OSUG2020, P2IO and OCEVU, France; Max Planck Society, BMBF, DESY, Helmholtz Association, Germany; Department of Atomic Energy, Department of Science and Technology, India; Istituto Nazionale di Astrofisica (INAF), Istituto Nazionale di Fisica Nucleare (INFN), MIUR, Istituto Nazionale di Astrofisica (INAF-OABRERA) Grant Fondazione Cariplo/Regione Lombardia ID 2014-1980/RST_ERC, Italy; ICRR, University of Tokyo, JSPS, MEXT, Japan; Netherlands Research School for Astronomy (NOVA), Netherlands Organization for Scientific Research (NWO), Netherlands; University of Oslo, Norway; Ministry of Science and Higher Education, DIR/WK/2017/12, the National Centre for Research and Development and the National Science Centre, UMO-2016/22/M/ST9/00583, Poland; Slovenian Research Agency, grants P1-0031, P1-0385, I0-0033, J1-9146, J1-1700, N1-0111, and the Young Researcher program, Slovenia; South African Department of Science and Technology and National Research Foundation through the South African Gamma-Ray Astronomy Programme, South Africa; The Spanish Ministry of Science and Innovation and the Spanish Research State Agency (AEI) through grants AYA2016-79724-C4-1-P, AYA2016-80889-P, AYA2016-76012-C3-1-P, BES-2016-076342, ESP2017-87055-C2-1-P, FPA2017-82729-C6-1-R, FPA2017-82729-C6-2-R, FPA2017-82729-C6-3-R, FPA2017-82729-C6-4-R, FPA2017-82729-C6-5-R, FPA2017-82729-C6-6-R, PGC2018-095161-B-I00, PGC2018-095512-B-I00; the \Centro de Excelencia Severo Ochoa"program through grants no. SEV-2015-0548, SEV-2016-0597, SEV-2016-0588, SEV-2017-0709; the "Unidad de Excelencia Maria de Maeztu" program through grant no. MDM-2015-0509; the "Ramon y Cajal" programme through grants RYC-2013-14511, RyC-2013-14660, RYC-2017-22665; and the MultiDark Consolider Network FPA2017-90566-REDC. Atraccion de Talento contract no. 2016-T1/TIC-1542 granted by the Comunidad de Madrid; the "Postdoctoral Junior Leader Fellowship" programme from La Caixa Banking Foundation, grants no. LCF/BQ/LI18/11630014 and LCF/BQ/PI18/11630012; the "Programa Operativo" FEDER2014-2020, Consejeria de Economia y Conocimiento de la Junta de Andalucia (ref. 1257737), PAIDI 2020 (ref. P18-FR-1580), and Universidad de Jaen; the Spanish AEI EQC2018-005094-P FEDER 2014-2020; the European Union's "Horizon 2020" research and innovation programme under Marie Sklodowska-Curie grant agreement no. 665919; and the ESCAPE project with grant no. GA:824064, Spain; Swedish Research Council, Royal Physiographic Society of Lund, Royal Swedish Academy of Sciences, The Swedish National Infrastructure for Computing (SNIC) at Lunarc (Lund), Sweden; State Secretariat for Education, Research and Innovation (SERI) and Swiss National Science Foundation (SNSF), Switzerland; Durham University, Leverhulme Trust, Liverpool University, University of Leicester, University of Oxford, Royal Society, Science and Technology Facilities Council, U.K.; U.S. National Science Foundation, U.S. Department of Energy, Argonne National Laboratory, Barnard College, University of California, University of Chicago, Columbia University, Georgia Institute of Technology, Institute for Nuclear and Particle Astrophysics (INPAC-MRPI program), Iowa State University, the Smithsonian Institution, Washington University McDonnell Center for the Space Sciences, The University of Wisconsin and the Wisconsin Alumni Research Foundation, U.S.A. The research leading to these results has received funding from the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreements No 262053 and No 317446. This project is receiving funding from the European Union's Horizon 2020 research and innovation programs under agreement No 676134.Peer reviewe

Modelo de negocio para el desarrollo de habilidades suaves en los colaboradores

Este proyecto tuvo el objetivo de atender la problemática encontrada en el desarrollo de habilidades suaves en colaboradores de pequeñas y medianas empresas a través de la metodología Lean Start Up

Prevalence estimation of significant fibrosis because of NASH in Spain combining transient elastography and histology

Acord transformatiu CRUE-CSICBackground & Aims: Non-alcoholic fatty liver disease (NAFLD) has become a major public health problem, but the prevalence of fibrosis associated with non-alcoholic steatohepatitis (NASH) is largely unknown in the general population. This study aimed to provide an updated estimation of the prevalence of NASH fibrosis in Spain. Methods: This was an observational, retrospective, cross-sectional, population-based study with merged data from two Spanish datasets: a large (N = 12 246) population-based cohort (ETHON), including transient elastography (TE) data, and a contemporary multi-centric biopsy-proven NASH cohort with paired TE data from tertiary centres (N = 501). Prevalence for each NASH fibrosis stage was estimated by crossing TE data from ETHON dataset with histology data from the biopsy-proven cohort. Results: From the patients with valid TE in ETHON dataset (N = 11 440), 5.61% (95% confidence interval [95% CI]: 2.53-11.97) had a liver stiffness measurement (LSM) ≥ 8 kPa. The proportion attributable to NAFLD (using clinical variables and Controlled Attenuation Parameter) was 57.3% and thus, the estimated prevalence of population with LSM ≥ 8 kPa because of NAFLD was 3.21% (95% CI 1.13-8.75). In the biopsy-proven NASH cohort, 389 patients had LSM ≥ 8 kPa. Among these, 37% did not have significant fibrosis (F2-4). The estimated prevalence of NASH F2-3 and cirrhosis in Spain's adult population were 1.33% (95% CI 0.29-5.98) and 0.70% (95% CI 0.10-4.95) respectively. Conclusions: These estimations provide an accurate picture of the current prevalence of NASH-related fibrosis in Spain and can serve as reference point for dimensioning the therapeutic efforts that will be required as NASH therapies become available

Vinorelbine alternating oral and intravenous plus epirubicin in first-line therapy of metastatic breast cancer: results of a multicentre phase II study

The combination of intravenous (i.v.) vinorelbine and epirubicin is highly active in the treatment of metastatic breast cancer (MBC). In an effort to improve patient convenience, we investigated a regimen alternating i.v. and oral vinorelbine in combination with epirubicin as first-line chemotherapy of patients with MBC. In all, 49 patients with MBC received, as first-line treatment, a combination regimen consisting of i.v. vinorelbine 25 mg m−2 plus epirubicin 90 mg m−2 given on day 1, and oral vinorelbine 60 mg m−2 on day 8 (or day 15 if neutrophils <1500 mm−3) every 3 weeks, in an open-label, multicentre phase II study. Treatment was to be repeated for a maximum of six cycles. The study population had a median age of 55 years, half of the patients had received prior adjuvant chemotherapy and 86% presented a visceral involvement. In all, 25 responses were documented and validated by an independent panel review, yielding response rates of 51% (95% CI: 36–66) in the 49 enrolled patients and 54.5% (95% CI: 39–70) in the 44 evaluable patients. Median durations of progression-free survival and survival were 8 and 20 months, respectively. Neutropenia was the main dose-limiting toxicity, but complications were uncommon, four patients having experienced febrile neutropenia and six having developed neutropenic infection. Other frequently reported adverse events included stomatitis, nausea and vomiting, which were rarely severe. No toxic death was reported. Among patients who received six cycles, global score of quality of life remained stable. This regimen alternating oral and i.v. vinorelbine in combination with epirubicin is effective and safe. Oral vinorelbine on day 8 offers greater convenience to the patient, and decreases the need for i.v. injection and reduces time spent in hospital. Therefore, oral vinorelbine is a convenient alternative to the i.v. form in combination regimens commonly used to treat MBC