Life extending control for rocket engines

The concept of life extending control is defined. A brief discussion of current fatigue life prediction methods is given and the need for an alternative life prediction model based on a continuous functional relationship is established. Two approaches to life extending control are considered: (1) the implicit approach which uses cyclic fatigue life prediction as a basis for control design; and (2) the continuous life prediction approach which requires a continuous damage law. Progress on an initial formulation of a continuous (in time) fatigue model is presented. Finally, nonlinear programming is used to develop initial results for life extension for a simplified rocket engine (model)

Osteoblastoma en calcáneo: caso clínico

Se presenta el caso clínico de una niña de 14 años que consultó por dolor en pie derecho. Como antecedentes de interés había sido intervenida de una artritis de tobillo en su país de origen. Tras las pruebas complementarias y la sospecha diagnóstica inicial de osteomielitis crónica (absceso de Brodie) se decidió tratamiento quirúrgico con curetaje de la lesión y cementación con antibiótico de la misma. En el acto quirúrgico se recogieron muestras para estudio microbiológico y anatomía patológica siendo el diagnóstico definitivo de osteoblastomaThe clinical case of a 14-year-old girl operated in her country of origin of ankle arthritis consulting her doctor because of pain in her right foot is presented. After complementary tests and an initial diagnosis of chronic osteomyelitis (Brodie's abscess) the patient was referred to surgical treatment with curettage and cementation plus systemic antibiotics. Surgical biopsies were collected for microbiological and pathological examination leading to a definitive diagnosis of osteoblastom

La variación concepcional en Twitter: análisis a partir del modelo de Koch y Oesterreicher

This contribution analyses the conceptional variation in Twitter communication based on the parameters described in Koch and Oesterreicher’s model ([1990] 2007). After outlining the foundations of variational linguistics and the position of conceptional variation within the chain of varieties, and after reviewing the presence of this model in studies of computer-mediated communication, the conceptional characteristics of Twitter communication are presented. The analysis focuses especially on the parameters of public/private communication, emotionality, referentiality and dialogicity, in which it is necessary to specify the distinctive characteristics of communication in social networks as opposed to prototypically immediate communication such as oral conversation.Este artículo analiza la variación concepcional que presenta la comunicación en Twitter a partir de los parámetros descritos en el modelo de Koch/Oesterreicher ([1990] 2007). Tras exponer los fundamentos de la lingüística de las variedades y la posición que tiene la variación concepcional dentro de la cadena de variedades y tras revisar la presencia que ha tenido este modelo en los estudios de comunicación mediada por ordenador, se exponen las características concepcionales de la comunicación en Twitter. El análisis se centra especialmente en los parámetros comunicación pública/privada, familiaridad, referencialización y dialogicidad, en los que es necesario matizar las características distintivas de la comunicación en redes sociales frente a una comunicación prototípicamente inmediata como la conversación oral

Working towards a consensus on the oncological approach of breakthrough pain: A Delphi survey of Spanish experts

Purpose: There is a lack of standards for the diagnosis, assessment and management of breakthrough cancer pain (BTcP). La Fundación ECO (the Foundation for Excellence and Quality in Oncology) commissioned a study to establish a consensus and lay the foundations for the appropriate management of BTcP in oncology patients. Patients and methods: A modified Delphi survey comprising two rounds was used to gather and analyze data, which was conducted over the Internet. Each statement that reached a consensus with the respondents was defined as a median consensus score (MED) of =7, and agreement among panelists as an interquartile range (IQR) of =3. Results: In total, 69 medical oncologists responded, with a broad consensus that BTcP implied exacerbations of high-intensity pain, as opposed to moderate pain. Furthermore, they concurred that appropriate diagnostic equipment is needed, and that rapid-onset fentanyl formulations should be the preferred treatment for BTcP management. The panelists agreed that a lack of appropriate information and training to attend to patients, as well as limited patient visitation rights, were barriers to effective BTcP management. Regarding gaps in detected knowledge, the panelists were unsure of the measures necessary to assess the burden of the disease on the patient’s quality of life and associated medication costs. Alongside this, there was a lack of awareness of the technical specifics of the different formulations of rapid-onset fentanyl. Conclusion: These results represent the current status of BTcP management. They may inform recommendations and provide a framework for future research

Pericardial Cyst in a Neonate

Pericardial cyst is a rare entity, often discovered incidentally on routine chest radiographs. Some studies reported an incidence of about 1:100.000. Symptomatic cysts presenting in the neonatal period are very rare. Most of the patients are asymptomatic, but can cause symptoms when they undergo complications or on account of their large size. We describe the case of a neonate presenting with tachypneau where a pericardial cyst was diagnosed with echocardiography and computer tomography, the cyst was successfully resected with open heart surgery

Análisis de las empresas de turismo rural en Cataluña y Galicia: rentabilidad económica y solvencia 2014 – 2018

We study rural tourism based on the accounting data obtained from the SABI database (Iberian Balance Sheet Analysis System). The study has been limited to two Spanish communities, specifically Catalonia and Galicia, during 2014 and 2018. We analyse the economic viability of the farms at an aggregate level, through financial ratios applying the CoDa methodology (Compositional Data), which solves the problems of asymmetry, nonlinearity and outliers present in traditional sectoral analysis through ratios. The data have been classified into three groups (clusters), which differ with respect to return on equity, decomposed into turnover, margin and leverage. The compositional biplot has also been used, which makes it possible to diagnose individual companies and trace their trajectories over time. We conclude that in all clusters, the industry presents mostly negative margins and returns, although the situation improves somewhat in 2018. We identify a cluster with major indebtedness problems located mostly in Galicia.El objeto de estudio es el turismo rural a partir de los datos contables que se obtienen de la base de datos SABI (Iberian Balance Sheet Analysis System). Se ha delimitado el estudio a dos comunidades españolas, en concreto Catalunya y Galicia, durante los años 2014 y 2018. Se ha analizado la viabilidad económica de las explotaciones a nivel agregado, a través de las ratios financieras aplicando la metodología CoDa (Datos Composicionales), que soluciona los problemas de asimetría, no linealidad y valores atípicos que presenta el análisis sectorial tradicional, a través de las ratios. Los datos se han clasificado en tres grupos (clústeres), analizando las divergencias que presentan respecto a la rentabilidad financiera, descomponiendo esta variable en rotación, margen y apalancamiento. También se ha utilizado el biplot composicional que permite hacer diagnósticos de empresas individuales y trazar sus trayectorias en el tiempo. Se concluye que, en todos los clústeres, el sector presenta márgenes y rentabilidades mayoritariamente negativos, aunque la situación mejora algo en 2018. Se identifica un grupo con grandes problemas de endeudamiento situado mayoritariamente en Galicia

Análisis de las empresas de turismo rural en Cataluña y Galicia: rentabilidad económica y solvencia 2014 – 2018

El objeto de estudio es el turismo rural a partir de los datos contables que se obtienen de la base de datos SABI (Iberian Balance Sheet Analysis System). Se ha delimitado el estudio a dos comunidades españolas, en concreto Catalunya y Galicia, durante los años 2014 y 2018. Se ha analizado la viabilidad económica de las explotaciones a nivel agregado, a través de las ratios financieras aplicando la metodología CoDa (Datos Composicionales), que soluciona los problemas de asimetría, no linealidad y valores atípicos que presenta el análisis sectorial tradicional, a través de las ratios. Los datos se han clasificado en tres grupos (clústeres), analizando las divergencias que presentan respecto a la rentabilidad financiera, descomponiendo esta variable en rotación, margen y apalancamiento. También se ha utilizado el biplot composicional que permite hacer diagnósticos de empresas individuales y trazar sus trayectorias en el tiempo. Se concluye que, en todos los clústeres, el sector presenta márgenes y rentabilidades mayoritariamente negativos, aunque la situación mejora algo en 2018. Se identifica un grupo con grandes problemas de endeudamiento situado mayoritariamente en Galicia

Active study: undetected prevalence and clinical inertia in the treatment of breakthrough cancer pain (BTcP)

Aims To prove if there is clinical inertia in the identification and treatment of episodes of breakthrough cancer pain (BTcP), comparing actual results from clinical practice with clinical oncologists’ prior perception. Design Observational and descriptive study, using information collected by practising medical oncologists, at three moments: (a) questionnaire regarding their professional judgement of the handling of patients with BTcP in their practice, (b) cross-sectional clinical screening, to detect possible existing cases of BTcP in a representative sample of their patients, (c) retrospective self-audit of clinical case histories of patients diagnosed with BTcP to find out about how it has been handled. Participants and study period A random sample on a state level of 108 specialists in medical oncology. 540 patients who suffer some type of cancer pain on the designated study date for each specialist (July–December 2016). Results The global prevalence of BTcP in the study sample covered 91.3% of the patients who were suffering some type of cancer pain. Barely 2% of the doctors surveyed suspected figures around this mark. 40.9% of the cases had not been previously detected as BTcP by their doctors. Although 90% of the patients who had previously been diagnosed with BTcP received a specific analgesic treatment for the symptoms, 42% of those patients with known BTcP were not able to control their episodes of pain. Conclusions Clinical inertia is a serious problem in the handling of BTcP in medical oncology services, where it is the subject of a significantly low level of detection and treatment, despite the contrasting perception of specialists.pre-print339 K

Oncologist’s knowledge and implementation of guidelines for breakthrough cancer pain in Spain: CONOCE study

[Purpose]: Breakthrough cancer pain (BTcP) has been shown to be a prevalent and poor prognostic factor for oncologic patients, which remain under diagnosed and undertreated. In 2012, the Spanish Society of Medical Oncology (SEOM) published a clinical practice guideline (CPG) for the treatment of cancer pain which specifically addressed the management of BTcP.[Methods]: Fundación ECO designed a qualitative study using an Internet-based survey to investigate the attitudes toward, compliance with, and use of SEOM Guideline.[Results]: A total of 83 oncologists with a mean experience of 13 years responded. Overall, 82% were aware of different guidelines to manage BTcP. Notably, attitudes toward guidelines were highly positive and there was nearly unanimous agreement that CPG provided the best scientific evidence available (99%), on the minimum information to be gathered for the medical history (100%), on the need for a specific treatment for BTcP (100%), and fentanyl as the first-choice drug (99%). Interestingly, there were discrepancies between what oncologists agreed with and what they do in clinical practice. In fact, 87.6% declare full compliance with SEOM guideline, although adherence to registration of BTcP data in medical records ranged from 30.1 to 91.6% (mean 64.5%); therapeutic management compliance was higher ranging from 75.9 to 91.6%. Main barriers identified were time pressure together with vague statements and limited dissemination of the guidelines.[Conclusion]: Despite oncologist’s clinical practice is increasingly guided by GPC, it suffers from limited compliance, at least in part due to suboptimal statements. Improved dissemination and education are needed to enhance guideline implementation.This study was funded by Kyowa Kirin Farmacéutica S. L.U. through Fundación ECO

Reprogramming human T cell function and specificity with non-viral genome targeting.

Decades of work have aimed to genetically reprogram T cells for therapeutic purposes1,2 using recombinant viral vectors, which do not target transgenes to specific genomic sites3,4. The need for viral vectors has slowed down research and clinical use as their manufacturing and testing is lengthy and expensive. Genome editing brought the promise of specific and efficient insertion of large transgenes into target cells using homology-directed repair5,6. Here we developed a CRISPR-Cas9 genome-targeting system that does not require viral vectors, allowing rapid and efficient insertion of large DNA sequences (greater than one kilobase) at specific sites in the genomes of primary human T cells, while preserving cell viability and function. This permits individual or multiplexed modification of endogenous genes. First, we applied this strategy to correct a pathogenic IL2RA mutation in cells from patients with monogenic autoimmune disease, and demonstrate improved signalling function. Second, we replaced the endogenous T cell receptor (TCR) locus with a new TCR that redirected T cells to a cancer antigen. The resulting TCR-engineered T cells specifically recognized tumour antigens and mounted productive anti-tumour cell responses in vitro and in vivo. Together, these studies provide preclinical evidence that non-viral genome targeting can enable rapid and flexible experimental manipulation and therapeutic engineering of primary human immune cells