Hepatocellular carcinoma: Review of disease and tumor biomarkers.

© The Author(s) 2016.Hepatocellular carcinoma (HCC) is a common malignancy and now the second commonest global cause of cancer death. HCC tumorigenesis is relatively silent and patients experience late symptomatic presentation. As the option for curative treatments is limited to early stage cancers, diagnosis in non-symptomatic individuals is crucial. International guidelines advise regular surveillance of high-risk populations but the current tools lack sufficient sensitivity for early stage tumors on the background of a cirrhotic nodular liver. A number of novel biomarkers have now been suggested in the literature, which may reinforce the current surveillance methods. In addition, recent metabonomic and proteomic discoveries have established specific metabolite expressions in HCC, according to Warburgs phenomenon of altered energy metabolism. With clinical validation, a simple and non-invasive test from the serum or urine may be performed to diagnose HCC, particularly benefiting low resource regions where the burden of HCC is highest

Differences in Current Hookah and Cigarette Smoking Status Attitudes and Beliefs at a Florida University: A Discriminant Analysis

Rising college hookah use, in the absence of cigarettes, suggests attitudinal differences among both forms of tobacco consumption. This study examines which smoking attitudes/beliefs are most distinguishing across current non-smokers, cigarette smokers, hookah smokers, and dual (cigarette and hookah-only) smokers at a Florida university. Self- administered questionnaire data from 373 university students were categorized into four groups based on self-reported 30-day smoking status. Discriminant analysis was used to examine maximal differences between groups across perceived peer acceptability of cigarette smoking, peer acceptability of hookah smoking, hookah smoking harmfulness, and attitude toward peer hookah smoking. Descriptive analyses indicated an overall awareness of hookah smoking harmfulness across all four groups. Discriminant analysis findings indicated peer acceptability of cigarette smoking (r = .75) contributed the most to attitude/belief differences across all four groups. Pairwise group comparisons showed a significant attitudinal mean difference in peer acceptability to cigarettes for cigarette smokers vs hookah smokers (T=3.9, p=.001). Study findings underscore the need for campus-based anti-smoking social norm approaches targeting positive hookah smoking peer use attitudes. Programming efforts are recommended to implement the use of self-reported perceived peer acceptability to cigarette smoking as a potential risk indicator for students at-risk for cigarette or dual use

NIRS potential use for the determination of natural resources quality from dehesa (acorn and grass) in Montanera system for Iberian pigs.

NIRS technology has been used as an alternative to conventional methods to determinate the content of nutrients of acorns and grass from dehesa ecosystem. Dry matter (DM), crude fat (CF), crude protein (CP), starch, total phenolic compounds (TP), α-tocopherol, γ-tocopherol, fatty acids, neutral detergent fiber (NDF), total antioxidant activity (TAA) and total energy (TE) were determined by conventional methods for later development of NIRS predictive equations. The NIR spectrum of each sample was collected and for all studied parameters, a predictive model was obtained and external validated. Good prediction equations were obtained for moisture, crude fat, crude protein, total energy and γ-tocopherol in acorns samples, with high coefficients of correlation (1-VR) and low standard error of prediction (SEP) (1-VR=0.81, SEP=2.62; 1-VR=0.92, SEP=0.54; 1-VR=0.86, SEP=0.47; 1-VR=0.84, SEP=0.2; 1-VR=0.88, SEP=5.4, respectively) and crude protein, NDF, α-tocopherol and linolenic acid content in grass samples (1-VR=0.9, SEP=1.99; 1-VR=0.87, SEP=4.13; 1-VR=0.76, SEP=10.9; 1-VR=0.82, SEP=0.6, respectively). Therefore, these prediction models could be used to determinate the nutritional composition of Montanera natural resources

Construction and Validation of the 21 Item Fitness-to-Drive Screening Measure Short-Form

Introduction: The Fitness-to-Drive Screening Measure is a free online screening tool that detects at-risk older drivers, however, it's 20 min administration time may render the 54-item tool less than optimal for clinical use. Thus, this study constructed and validated a 21-item FTDS Short-Form (FTDS-SF).Method: This mixed methods study used 200 proxy rater responses and older driver on-road assessments. We conducted a Rasch analysis to examine information at the level of the item and used content validity index scores to select items. Using a receiver operator characteristics curve we determined the concurrent validity of the FTDS-SF to on-road outcomes.Results: Twenty-one items were selected for the FTDS-SF. The area under the curve = 0.72, indicated the FTDS-SF predicted on-road outcomes with acceptable accuracy. Still, 68 drivers were misclassified.Conclusion: The FTDS-SF may reduce administration time, while still yielding acceptable psychometric properties. Yet, caution needs to be executed in clinical decision making as the measure is overly specific

Caso clínico de seguimiento farmacoterapéutico: paciente hipertensa no controlada

Paciente habitual de la farmacia que acude a retirar su medicación durante un episodio claro de crisis hipertensiva.HT

Caso clínico de seguimiento farmacoterapéutico: paciente hipertensa no controlada

Paciente habitual de la farmacia que acude a retirar su medicación durante un episodio claro de crisis hipertensiva.HT

Dynamic modeling of a dual active bridge DC to DC converter with average current control and load-current feed-forward

Bidirectional power flow is needed in many power conversion systems like energy storage systems, regeneration systems, power converters for improvement of the power quality and some DC-DC applications where bidirectional high power conversion and galvanic isolation are required. The dual active bridge (DAB) is an isolated, high voltage ratio DC-DC converter suitable for high power density and high power applications, being a key interface between renewable energy sources and energy storage devices. This paper is focused on the modeling and control design of a DC-DC system with battery storage based on a DAB converter with average current mode control of the output current and output voltage control. The dynamic response of the output voltage to load steps is improved by means of an additional load-current feed-forward control loop. An analytical study of the load-current feed-forward is presented and validated by means of both simulations and experimental results.This work was supported by the Spanish Ministry of Economy and Competitiveness under grant ENE2012-37667-C02-01.Guacaneme Moreno, JA.; Gabriel Garcerá; Figueres Amorós, E.; Patrao Herrero, I.; González Medina, R. (2015). Dynamic modeling of a dual active bridge DC to DC converter with average current control and load-current feed-forward. International Journal of Circuit Theory and Applications. 43(10):1311-1332. https://doi.org/10.1002/cta.2012S131113324310Vazquez, S., Lukic, S. M., Galvan, E., Franquelo, L. G., & Carrasco, J. M. (2010). Energy Storage Systems for Transport and Grid Applications. IEEE Transactions on Industrial Electronics, 57(12), 3881-3895. doi:10.1109/tie.2010.2076414De Doncker, R. W. A. A., Divan, D. M., & Kheraluwala, M. H. (1991). A three-phase soft-switched high-power-density DC/DC converter for high-power applications. IEEE Transactions on Industry Applications, 27(1), 63-73. doi:10.1109/28.67533Kheraluwala, M. N., Gascoigne, R. W., Divan, D. M., & Baumann, E. D. (1992). Performance characterization of a high-power dual active bridge DC-to-DC converter. IEEE Transactions on Industry Applications, 28(6), 1294-1301. doi:10.1109/28.175280Chang, Y.-H., & Wu, K.-W. (2012). A gain/efficiency-enhanced bidirectional switched-capacitor DC-DC converter. International Journal of Circuit Theory and Applications, 42(5), 468-493. doi:10.1002/cta.1863Li H Liu D Peng FZ Gui-Jia S Small Signal Analysis of A Dual Half Bridge Isolated ZVS Bi-directional DC-DC converter for Electrical Vehicle Applicat 36th IEEE Power Electronics Specialists Conference 2005 2777 2782Chiu, H.-J., Yao, C.-J., & Lo, Y.-K. (2009). A DC/DC converter topology for renewable energy systems. International Journal of Circuit Theory and Applications, 37(3), 485-495. doi:10.1002/cta.475Doishita K Hashiwaki M Aoki T Kawagoe Y Murakami N Highly reliable uninterruptible power supply using a bi-directional converter The 21st International Telecommunication Energy Conference (INTELEC '99), Copenhagen 1999 10.1109/INTLEC.1999.794066Krismer F Biela J Kolar JW A comparative evaluation of isolated bi-directional DC/DC converters with wide input and output voltage range 40th IAS Annual Meeting Industry Applications Conference 2005 1 599 606Aggeler D Biela J Inoue S Akagi H Kolar JW Bi-Directional Isolated DC-DC Converter for Next-Generation Power Distribution - Comparison of Converters using Si and SiC Devices Power Conversion Conference-Nago 2007 510 517Krishnamurthy HK Ayyanar R Building Block Converter Module for Universal (AC-DC, DC-AC, DC-DC) Fully Modular Power Conversion Architecture IEEE Power Electronics Specialists Conference 2007 483 489Romero-Cadaval, E., Spagnuolo, G., Franquelo, L. G., Ramos-Paja, C. A., Suntio, T., & Xiao, W. M. (2013). Grid-Connected Photovoltaic Generation Plants: Components and Operation. IEEE Industrial Electronics Magazine, 7(3), 6-20. doi:10.1109/mie.2013.2264540Yu, X., She, X., Ni, X., & Huang, A. Q. (2014). System Integration and Hierarchical Power Management Strategy for a Solid-State Transformer Interfaced Microgrid System. IEEE Transactions on Power Electronics, 29(8), 4414-4425. doi:10.1109/tpel.2013.2289374Liserre, M., Sauter, T., & Hung, J. (2010). Future Energy Systems: Integrating Renewable Energy Sources into the Smart Power Grid Through Industrial Electronics. IEEE Industrial Electronics Magazine, 4(1), 18-37. doi:10.1109/mie.2010.935861Mi, C., Bai, H., Wang, C., & Gargies, S. (2008). Operation, design and control of dual H-bridge-based isolated bidirectional DC–DC converter. IET Power Electronics, 1(4), 507. doi:10.1049/iet-pel:20080004Friedemann A Krismer F Kolar JW Design of a Minimum Weight Dual Active Bridge Converter for an Airborne Wind Turbine System Proceedings of the 27th Applied Power Electronics Conference and Exposition (APEC) 2012Krismer, F., & Kolar, J. W. (2010). Accurate Power Loss Model Derivation of a High-Current Dual Active Bridge Converter for an Automotive Application. IEEE Transactions on Industrial Electronics, 57(3), 881-891. doi:10.1109/tie.2009.2025284Hengsi Qin, & Kimball, J. W. (2012). Generalized Average Modeling of Dual Active Bridge DC–DC Converter. IEEE Transactions on Power Electronics, 27(4), 2078-2084. doi:10.1109/tpel.2011.2165734Segaran D McGrath B Holmes DG Adaptive dynamic control of a Bidirectional DC-DC converter IEEE Proceedings Energy Conversion Congress 2010 1442 1449Bai H Mi C Wang C Gargies S The dynamic model and hybrid phase-shift control of a dual-active-bridge converter Proceedings IECON 2008 2840 2845Segaran, D., Holmes, D. G., & McGrath, B. P. (2013). Enhanced Load Step Response for a Bidirectional DC–DC Converter. IEEE Transactions on Power Electronics, 28(1), 371-379. doi:10.1109/tpel.2012.2200505Tang W Lee FC Ridley RB Small-signal modeling of average current-mode control APEC'92. Seventh Annual Conference Proceedings 1992 747 755Kheraluwala MH High-Power High frequency DC-DC converters PhD thesis 1991Fang, C.-C. (2011). Sampled-data poles, zeros, and modeling for current-mode control. International Journal of Circuit Theory and Applications, 41(2), 111-127. doi:10.1002/cta.790Redl, R., & Sokal, N. O. (1986). Near-Optimum Dynamic Regulation of DC-DC Converters Using Feed-Forward of Output Current and Input Voltage with Current-Mode Control. IEEE Transactions on Power Electronics, PE-1(3), 181-192. doi:10.1109/tpel.1986.4766303Qin H Kimball JW Closed-loop control of DC-DC dual active bridge converters driving single-phase inverters IEEE Energy Conversion Congress and Exposition (ECCE) 2012 173 17

Tumor Size Matters-Understanding Concomitant Tumor Immunity in the Context of Hypofractionated Radiotherapy with Immunotherapy.

The purpose of this study was to determine the dynamic contributions of different immune cell subsets to primary and abscopal tumor regression after hypofractionated radiation therapy (hRT) and the impact of anti-PD-1 therapy. A bilateral syngeneic FSA1 fibrosarcoma model was used in immunocompetent C3H mice, with delayed inoculation to mimic primary and microscopic disease. The effect of tumor burden on intratumoral and splenic immune cell content was delineated as a prelude to hRT on macroscopic T1 tumors with 3 fractions of 8 Gy while microscopic T2 tumors were left untreated. This was performed with and without systemic anti-PD-1. Immune profiles within T1 and T2 tumors and in spleen changed drastically with tumor burden in untreated mice with infiltrating CD4+ content declining, while the proportion of CD4+ Tregs rose. Myeloid cell representation escalated in larger tumors, resulting in major decreases in the lymphoid:myeloid ratios. In general, activation of Tregs and myeloid-derived suppressor cells allow immunogenic tumors to grow, although their relative contributions change with time. The evidence suggests that primary T1 tumors self-regulate their immune content depending on their size and this can influence the lymphoid compartment of T2 tumors, especially with respect to Tregs. Tumor burden is a major confounding factor in immune analysis that has to be taken into consideration in experimental models and in the clinic. hRT caused complete local regression of primary tumors, which was accompanied by heavy infiltration of CD8+ T cells activated to express IFN-γ and PD-1; while certain myeloid populations diminished. In spite of this active infiltrate, primary hRT failed to generate the systemic conditions required to cause abscopal regression of unirradiated microscopic tumors unless PD-1 blockade, which on its own was ineffective, was added to the RT regimen. The combination further increased local and systemically activated CD8+ T cells, but few other changes. This study emphasizes the subtle interplay between the immune system and tumors as they grow and how difficult it is for local RT, which can generate a local immune response that may help with primary tumor regression, to overcome the systemic barriers that are generated so as to effect immune regression of even small abscopal lesions