Clinical and ultrasound thyroid nodule characteristics and their association with cytological and histopathological outcomes: A retrospective multicenter study in high-resolution thyroid nodule clinics

Introduction: Thyroid nodules are a common finding. A high-resolution thyroid nodule clinic (HR-TNC) condenses all tests required for the evaluation of thyroid nodules into a single appointment. We aimed to evaluate the clinical outcomes at HR-TNCs. Design and Methods: A retrospective cross-sectional multicenter study including data from four HR-TNCs in Spain. We evaluated fine-needle aspiration (FNA) indications and the association between clinical and ultrasound characteristics with cytological and histopathological outcomes. Results: A total of 2809 thyroid nodules were included; FNA was performed in 82.1%. Thyroid nodules that underwent FNA were more likely larger, isoechoic, with microcalcifications, and in younger subjects. The rate of nondiagnostic FNA was 4.3%. A solid component, irregular margins or microcalcifications, significantly increased the odds of Bethesda IV-V-VI (vs. Bethesda II). Irregular margins and a solid component were independently associated with increased odds of malignancy. Thyroid nodules <20 mm and ≥20–<40 mm had a 6.5-fold and 3.3-fold increased risk for malignancy respectively in comparison with those ≥40 mm. Conclusion: In this large multicenter study, we found that the presence of a solid component and irregular margins are factors independently related to malignancy in thyroid nodules. Since nodule size ≥40 mm was associated with the lowest odds of malignancy, this cut-off should not be a factor leading to indicate thyroid surgery. HR-TNCs were associated with a low rate of nondiagnostic FNA

The massive stellar content in NGC604 and its evolutionary state

The ultraviolet resonance wind stellar lines, the nebular optical emission lines and the higher order terms of the Balmer series and HeI absorption lines detected in the spectra of NGC 604 are interpreted using evolutionary models optimized for young star forming regions. The evolutionary state and the massive stellar content of the region is derived in a self-consistent way. The three techniques applied suggest that the central ionizing cluster in NGC 604 is very young, 3 Myr old, and that the stars in the cluster were formed in an instantaneous burst following a Salpeter or flatter IMF, having stars more massive that 80 Msol. The stellar cluster is able to provide most of the ionizing photons needed to photoionize the whole nebula, and the wind power to form the central shell structure where the cluster core is located. The stellar cluster is affected by an extinction similar to the average extinction that affects the ionized gas. The estimated number of massive stars in the cluster is also in agreement with that derived from previous studies based on the detection of individual stars. The results that we present here support the use of these techniques for the interpretation of the integrated light of more distant star forming regionsComment: To be published in MNRAS. 17 pages and 17 figure

A study of the interplay between ionized gas and star clusters in the central region of NGC 5253 with 2D spectroscopy

ABRIDGED: A detailed 2D study of the central region of NGC5253 has been performed to characterize the stellar and ionized gas structure as well as the extinction distribution, physical properties and kinematics of the ionized gas in the central ~210pc x 130pc. We utilized optical integral field spectroscopy (IFS) data obtained with FLAMES. A detailed extinction map for the ionized gas in NGC5253 shows that the largest extinction is associated with the prominent Giant HII region. There is an offset of ~0.5" between the peak of the optical continuum and the extinction peak in agreement with findings in the infrared. We found that stars suffer less extinction than gas by a factor of 0.33. The [SII]l6717/[SII]l6731 map shows an electron density (N_e) gradient declining from the peak of emission in Ha (790cm^-3) outwards, while the argon line ratio traces areas with $N_e~4200 - 6200cm^(-3). The area polluted with extra nitrogen, as deduced from the excess [NII]/Ha, extends up to distances of 3.3" (~60pc) from the maximum pollution, which is offset by ~1.5" from the peak of continuum emission. Wolf-Rayet features are distributed in an irregular pattern over a larger area (~100pc x 100pc) and associated with young stellar clusters. We measured He^+ abundances over most of the field of view and values of He^++/H^+<~0.0005 in localized areas which do not coincide, in general, with the areas presenting W-R emission or extra nitrogen. The line profiles are complex. Up to three emission components were needed to reproduce them. One of them, associated with the giant HII region, presents supersonic widths and [NII] and [SII] emission lines shifted up to 40km/s with respect to Ha. Similarly, one of the narrow components presents offsets in the [NII] line of <~20km/s. This is the first time that maps with such velocity offsets for a starburst galaxy have been presented.Comment: accepted in Astronomy & Astrophysics. 21 pages, 22 figure

On the importance of the few most massive stars: the ionizing cluster of NGC 588

We present the results of a double analysis of the ionizing cluster in NGC 588, a giant HII region (GHR) in the outskirts of the nearby galaxy M33. For this purpose, we obtained ground based long-slit spectroscopy and combined it with archival ground based and space borne imaging and spectroscopy, in the wavelength range 1100-9800 A. A first modeling of the cluster was performed using integrated properties, such as the spectral energy distribution (SED), broad band colors, nebular emission Hbeta equivalent width, the main ultraviolet resonance lines, and the presence of Wolf-Rayet star features. By applying standard assumptions about the initial mass function (IMF), we were unable to fit satisfactorily these observational data. This contradictory result led us to carry out a second modeling, based on a resolved photometric analysis of individual stars in Hubble Space Telescope (HST) images, by means of finding the best fit isochrone in color-magnitude diagrams (CMD), and assigning a theoretical SED to each individual star. The overall SED of the cluster, obtained by integrating the individual stellar SEDs, is found to fit better the observed SED than the best solution found through the integrated first analysis, but at a significantly later stage of evolution of the cluster of 4.2 Myr, as obtained from the best fit to the CMD. A comparative analysis of both methods traces the different results to the effects of statistical fluctuations in the upper end of the IMF, which are significant in NGC 588, with a computed cluster mass of 5600 Msun, as predicted by Cervino et al (2002). We discuss the results in terms of the strong influence of the few most massive stars, six in the case of NGC 588, that dominate the overall SED and, in particular, the ionizing far ultraviolet range beyond the Lyman limit

Planck Intermediate Results. IV. The XMM-Newton validation programme for new Planck galaxy clusters

We present the final results from the XMM-Newton validation follow-up of new Planck galaxy cluster candidates. We observed 15 new candidates, detected with signal-to-noise ratios between 4.0 and 6.1 in the 15.5-month nominal Planck survey. The candidates were selected using ancillary data flags derived from the ROSAT All Sky Survey (RASS) and Digitized Sky Survey all-sky maps, with the aim of pushing into the low SZ flux, high-z regime and testing RASS flags as indicators of candidate reliability. 14 new clusters were detected by XMM, including 2 double systems. Redshifts lie in the range 0.2 to 0.9, with 6 clusters at z>0.5. Estimated M500 range from 2.5 10^14 to 8 10^14 Msun. We discuss our results in the context of the full XMM validation programme, in which 51 new clusters have been detected. This includes 4 double and 2 triple systems, some of which are chance projections on the sky of clusters at different z. We find that association with a RASS-BSC source is a robust indicator of the reliability of a candidate, whereas association with a FSC source does not guarantee that the SZ candidate is a bona fide cluster. Nevertheless, most Planck clusters appear in RASS maps, with a significance greater than 2 sigma being a good indication that the candidate is a real cluster. The full sample gives a Planck sensitivity threshold of Y500 ~ 4 10^-4 arcmin^2, with indication for Malmquist bias in the YX-Y500 relation below this level. The corresponding mass threshold depends on z. Systems with M500 > 5 10^14 Msun at z > 0.5 are easily detectable with Planck. The newly-detected clusters follow the YX-Y500 relation derived from X-ray selected samples. Compared to X-ray selected clusters, the new SZ clusters have a lower X-ray luminosity on average for their mass. There is no indication of departure from standard self-similar evolution in the X-ray versus SZ scaling properties. (abridged)Comment: accepted by A&

Uncovering multiple Wolf-Rayet star clusters and the ionized ISM in Mrk 178: the closest metal-poor Wolf-Rayet H ii galaxy

New integral field spectroscopy (IFS) has been obtained for the nearby metal-poor Wolf–Rayet (WR) galaxy Mrk 178 to examine the spatial correlation between its WR stars and the neighbouring ionized interstellar medium (ISM). The strength of the broad WR features and its low metallicity make Mrk 178 an intriguing object. We have detected the blue and red WR bumps in different locations across the field of view (∼300 pc × 230 pc) in Mrk 178. The study of the WR content has been extended, for the first time, beyond its brightest star-forming knot uncovering new WR star clusters. Using Large/Small Magellanic Cloud-template WR stars, we empirically estimate a minimum of ∼20 WR stars within the region sampled. Maps of the spatial distribution of the emission lines and of the physical–chemical properties of the ionized ISM have been created and analysed. Here, we refine the statistical methodology by Pérez-Montero et al. (2011) to probe the presence of variations in the ISM properties. An error-weighted mean of 12+log(O/H) = 7.72 ± 0.01 is taken as the representative oxygen abundance for Mrk 178. A localized N and He enrichment, spatially correlated with WR stars, is suggested by this analysis. Nebular He II λ4686 emission is shown to be spatially extended reaching well beyond the location of the WR stars. This spatial offset between WRs and He II emission can be explained based on the mechanical energy input into the ISM by the WR star winds, and does not rule out WR stars as the He II ionization source. We study systematic aperture effects on the detection and measurement of the WR features, using Sloan Digital Sky Survey spectra combined with the power of IFS. In this regard, the importance of targeting low metallicity nearby systems is discussed

Veränderungen im Leukozytenprofil der Dupontlerche ( Chersophilus duponti ) in Spanien und Marokko

[EN] Stress in birds has been widely studied through the measurement of heterophil-to-lymphocyte ratio (H/L ratio). In this study we aimed to assess for the first time the potential variation of stress, measured as H/L ratio, associated to geography (between-country variation) and seasonality (between seasons and within the breeding season), as well as the leukocyte profiles, in the threatened Dupont’s Lark (Chersophilus duponti), using samples from Spain and Morocco. Furthermore, we tested whether variation in H/L ratio was associated with variables such as population density, presence of blood parasites and individual body condition. We found that H/L ratio did not vary between countries, but individuals captured during the breeding season showed higher values of H/L compared to non-breeding ones. Neither male density, nor date within the breeding season had an effect on the H/L ratio. In Spain, individuals with higher body condition showed lower H/L ratio regardless of whether they were malaria-infected. In Morocco, malaria-infected individuals showed higher values of H/L ratio than the non-infected birds. Moreover, we found that our average values of H/L ratio in Morocco were within the ranges of other passerines, but not in Spain. Individuals with higher H/L ratios may be more stressed or present higher capability to face stressful situations. Although H/L ratio is a useful and relatively easy way to obtain measure of stress, the impact that the environment might have on stress and the way it is explained by H/L ratio must be addressed carefully. This study provides new insight for this species’ biology and provides useful reference information to test the status and survival of other populations.[DE] Stress bei Vögeln ist durch die Messung des Verhältnisses von Heterophilen zu T-Lymphozyten (H/L-Verhältnis) umfassend untersucht worden. In dieser Studie wollten wir zum ersten Mal die potentiellen Veränderungen des Stresses in Verbindung mit der Geografie (Unterschiede zwischen einzelnen Ländern) und der Saisonalität (zwischen den Jahreszeiten und innerhalb der Brutsaison), gemessen als H/L-Verhältnis, sowie die Leukozytenprofile bei der bedrohten Dupontlerche (Chersophilus duponti) anhand von Proben aus Spanien und Marokko bewerten. Darüber hinaus haben wir untersucht, ob das H/L-Verhältnis mit Variablen wie der Populationsdichte, dem Vorhandensein von Blutparasiten und der individuellen physischen Verfassung zusammenhängt. Wir stellten fest, dass das H/L-Verhältnis zwischen den einzelnen Ländern nicht variierte, aber die während der Brutzeit gefangenen Tiere höhere H/L-Werte aufwiesen als nicht brütende Tiere. Weder die Dichte an Männchen, noch der Zeitpunkt innerhalb der Brutsaison hatten einen Einfluss auf das H/L-Verhältnis. In Spanien wiesen Tiere mit einer besseren physischen Verfassung ein niedrigeres H/L-Verhältnis auf, unabhängig davon, ob sie mit Malaria infiziert waren. In Marokko zeigten malariainfizierte Vögel höhere Werte des H/L-Verhältnisses als nicht infizierte. Außerdem stellten wir fest, dass unsere Durchschnittswerte für das H/L-Verhältnis in Marokko innerhalb der Werte für andere Sperlingsvögel lagen, nicht aber in Spanien. Tiere mit einem höheren H/L-Verhältnis sind möglicherweise gestresster oder besser in der Lage, mit Stresssituationen umzugehen. Obwohl das H/L-Verhältnis ein nützliches und relativ einfach zu beschaffendes Maß für Stress ist, muss der eventuelle Einfluss der Umwelt auf Stress und die Möglichkeiten, diesen durch das H/L-Verhältnis zu erklären, sorgfältig untersucht werden. Diese Untersuchung bietet neue Einblicke in die Biologie dieser Art und liefert nützliche Referenzinformationen für die Bestimmung des aktuellen Status und für das Überleben anderer Populationen.Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature.This study was partially funded by the authors, the Spanish Ministry of Environment (MMA; J.J. Areces and B. Heredia), the Spanish Agency for International Cooperation (AECI), and the LIFE Ricoti (LIFE15-NAT-ES-000802), supported by the European Comisison. D.B.R. was supported by FPI-UAM fellowship from the Universidad Autónoma de Madrid (UAM), and the collaboration of the Instituto de Investigación en Recursos Cinegéticos (IREC-CSIC-UCLM). We wish to thank the Servicio de Vida Silvestre of Conselleria D’infraestructures, Territori i Medi Ambient (Generalitat Valenciana) and the Moroccan government for ringing permits and supporting our work. We thank V. Garza, A. Ramírez, R. del pozo, E. Juarez, E.L. García de la Morena, F. Suárez, M. Radi, M. Znari and M. Alouí, and the Colectivo Ornitológico Cigüeña Negra for their help during fieldtrips and arrangements. We also thank two anonymous referees whose helpful comments contributed to improve the paper. This work was approved by the Local Ethical Committee for Animal Experiments of the Autónoma University of Madrid (CEI80-1468-A229).Peer reviewe

Effectiveness and Safety of the Sequential Use of a Second and Third Anti-TNF Agent in Patients with Inflammatory Bowel Disease: Results from the Eneida Registry

Background: The effectiveness of the switch to another anti-tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients. Methods: We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent. Results: A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8-3; P < 0.0001) and ulcerative colitis vs Crohn''s disease (HR, 1.6; 95% CI, 1.1-2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug. Conclusions: Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response

La renovación de la palabra en el bicentenario de la Argentina : los colores de la mirada lingüística

El libro reúne trabajos en los que se exponen resultados de investigaciones presentadas por investigadores de Argentina, Chile, Brasil, España, Italia y Alemania en el XII Congreso de la Sociedad Argentina de Lingüística (SAL), Bicentenario: la renovación de la palabra, realizado en Mendoza, Argentina, entre el 6 y el 9 de abril de 2010. Las temáticas abordadas en los 167 capítulos muestran las grandes líneas de investigación que se desarrollan fundamentalmente en nuestro país, pero también en los otros países mencionados arriba, y señalan además las áreas que recién se inician, con poca tradición en nuestro país y que deberían fomentarse. Los trabajos aquí publicados se enmarcan dentro de las siguientes disciplinas y/o campos de investigación: Fonología, Sintaxis, Semántica y Pragmática, Lingüística Cognitiva, Análisis del Discurso, Psicolingüística, Adquisición de la Lengua, Sociolingüística y Dialectología, Didáctica de la lengua, Lingüística Aplicada, Lingüística Computacional, Historia de la Lengua y la Lingüística, Lenguas Aborígenes, Filosofía del Lenguaje, Lexicología y Terminología

Cooperativismo en Puerto Rico análisis de las cooperativas de trabajo asociado sector industrial

La idea fundamental de la tesis consiste en el planteamiento del surgimiento y evolución del cooperativismo y las aportaciones de este movimiento mundial, enfatizando en el cooperativismo puertorriqueño y en las cooperativas industriales como propuesta para el desarrollo empresarial y comunitario de Puerto Rico. La autora expone la importancia que representa el modelo cooperativo y sus posibilidades para la solución de problemas que afectan el desarrollo sostenible del país. El primer capítulo presenta un panorama general del surgimiento del cooperativismo, aportaciones de sus principales precursores, modelos sobresalientes cooperativos que les sucedieron y un ligero esbozo de su desarrollo en otros países. El segundo capítulo discute consideraciones generales en torno a la identidad cooperativa. El tercer capítulo se centra en el desarrollo del cooperativismo en Puerto Rico, desde sus inicios en el siglo XIX hasta los primeros años del siglo XXI. El cuarto capítulo analiza el marco jurídico que aplica a las cooperativas de trabajo asociado del sector industrial, los procesos para la organización e incorporación de estas y el análisis de cada cooperativa industrial existente en Puerto Rico. El quinto capítulo presenta el perfil del sector industrial con la interpretación de datos obtenidos, aspectos positivos, necesidades y líneas de acción sugeridas. Finaliza con las conclusiones generales de la investigación. En los anexos se incluye el cuestionario de entrevistas, organigramas de instituciones cooperativas y correspondencia con instituciones gubernamentales y cooperativas.Este trabajo provee una innovadora integración de una perspectiva histórica del cooperativismo a nivel internacional y nacional, así como aspectos conceptuales y el primer análisis de las cooperativas industriales existentes en Puerto Rico