81 research outputs found
Self-modulation of nonlinear waves in a weakly magnetized relativistic electron-positron plasma with temperature
We develop a nonlinear theory for self-modulation of a circularly polarized electromagnetic wave in a relativistic hot weakly magnetized electron-positron plasma. The case of parallel propagation along an ambient magnetic field is considered. A nonlinear Schrodinger equation is derived for the complex wave amplitude of a self-modulated wave packet. We show that the maximum growth rate of the modulational instability decreases as the temperature of the pair plasma increases. Depending on the initial conditions, the unstable wave envelope can evolve nonlinearly to either periodic wave trains or solitary waves. This theory has application to high-energy astrophysics and high-power laser physics.CONICyTFONDECyT 1110135 1080658Brazilian agency CNPqBrazilian agency FAPESPMarie Curie International Incoming Fellowshiphospitality of Paris ObservatoryInstitute for Fusion Studie
Vagus nerve stimulation in patients with migraine
ntroducción. La estimulación del nervio vago (ENV) está aprobada para el tratamiento de la epilepsia refractaria cuando
no es posible cirugía resectiva, con una eficacia bien establecida. Series publicadas sugieren un efecto beneficioso de la
ENV en la migraña.
Objetivos. Determinar el grado de mejoría de la cefalea en pacientes migrañosos a los que se les había implantado una
ENV para tratamiento de la epilepsia refractaria y evaluar qué variables se asocian a mayor posibilidad de éxito con esta
medida.
Pacientes y métodos. Estudio observacional y retrospectivo desde el 1 de enero de 1999 hasta el 31 de diciembre de 2010.
Se contactó telefónicamente con los pacientes con ENV para epilepsia refractaria, seleccionando a aquéllos que cumplían
los criterios de la Sociedad Internacional de Cefaleas para la migraña. Se recogieron edad, género, año de implantación,
edad de inicio de la epilepsia y la migraña, mejoría de crisis y de migraña, presencia de aura migrañosa y coexistencia de
síndrome ansiosodepresivo. Se contactó con 94 pacientes con ENV y se seleccionó a 13 pacientes migrañosos.
Resultados. Tras la implantación de la ENV, se observó una disminución de al menos el 50% de los episodios de migraña
en nueve pacientes (69%) (p = 0,004), así como una disminución del número de episodios de migraña en aquellos pacientes
que también habían reducido sus crisis epilépticas (p = 0,012). No se observaron asociaciones estadísticamente
significativas en cuanto al sexo, edad, tiempo de evolución, existencia de aura migrañosa o coexistencia de síndrome
ansiosodepresivo.
Conclusiones. La ENV podría resultar beneficiosa en pacientes con migraña, especialmente en casos de difícil control.
Debido al tipo estudio, hay que tomar estas conclusiones con precaución. Serán necesarios estudios clínicos prospectivos
antes de llevarse a la práctica clínica habitualIntroduction. Vagus nerve stimulation (VNS) has been approved for the treatment of refractory epilepsy when resective
surgery is not possible, and has proved to be highly effective. Series published in the literature suggest a beneficial effect
of VNS in the treatment of migraine.
Aims. To determine the degree to which headaches improve in patients with migraine after the placement of VNS to treat
refractory epilepsy, and to evaluate what variables are associated with an increased chance of success with this measure.
Patients and methods. An observation-based retrospective study was conducted from 1st January 1999 until 31st December
2010. Patients with VNS for refractory epilepsy were contacted by telephone, after selecting those who fulfilled International
Headache Society criteria for migraine. Data collected included age, gender, year of placement, age at onset of epilepsy
and migraine, improvement of seizures and migraine, presence of migraine with aura and coexistence of anxious-depressive
syndrome. Ninety-four patients with VNS were contacted and 13 patients with migraine were selected.
Results. Following placement of the VNS, the number of episodes of migraine was seen to decrease by at least 50% in
nine patients (69%) (p = 0.004) and there was a drop in the number of episodes of migraine in those patients who had
also reduced their epileptic seizures (p = 0.012). No statistically significant associations were observed as regards sex, age,
length of disease history, existence of migraine with aura or coexistence of anxious-depressive syndrome.
Conclusions. VNS could have beneficial effects for patients with migraine, especially in cases that are difficult to control.
Due to the type of study, these conclusions must be taken with caution. Prospective clinical studies are needed before
introducing the technique into daily clinical practic
An instrumental puzzle: the modular integration of AOLI
The Adaptive Optics Lucky Imager, AOLI, is an instrument developed to deliver
the highest spatial resolution ever obtained in the visible, 20 mas, from
ground-based telescopes. In AOLI a new philosophy of instrumental prototyping
has been applied, based on the modularization of the subsystems. This modular
concept offers maximum flexibility regarding the instrument, telescope or the
addition of future developments.Comment: 10 pages, 8 figures, Proc. SPIE 9908, Ground-based and Airborne
Instrumentation for Astronomy VI, 99082Z (August 9, 2016
AOLI: Near-diffraction limited imaging in the visible on large ground -based telescopes
The combination of Lucky Imaging with a low order adaptive optics system was demonstrated very successfully on the Palomar 5m telescope nearly 10 years ago. It is still the only system to give such high-resolution images in the visible or near infrared on ground-based telescope of faint astronomical targets. The development of AOLI for deployment initially on the WHT 4.2 m telescope in La Palma, Canary Islands, will be described in this paper. In particular, we will look at the design and status of our low order curvature wavefront sensor which has been somewhat simplified to make it more efficient, ensuring coverage over much of the sky with natural guide stars as reference object. AOLI uses optically butted electron multiplying CCDs to give an imaging array of 2000 x 2000 pixels.Science and Technology Facilities CouncilThis is the author accepted manuscript. The final version is available from SPIE via http://dx.doi.org/10.1117/12.223090
Challenges of design, implementation, acceptability, and potential for, biomedical technologies in the Peruvian Amazon.
BACKGROUND: Biomedical technologies have the potential to be advantageous in remote communities. However, information about barriers faced by users of technology in general and in remote Indigenous communities is scarce. The purpose of this study was to characterize the leading challenges faced by researchers who have used biomedical technologies in the Peruvian Amazon. METHODS: This exploratory, qualitative study with a phenomenological approach depicts the lived experience of participants who were researchers with experience working with biomedical technologies in the Peruvian Amazon in the past five years. Analysis was based on three core themes: design, implementation, and acceptability. Sub-themes included environment, community, and culture. Of the 24 potential participants identified and contacted, 14 agreed to participate, and 13 met inclusion criteria and completed semi-structured interviews. Results were sent to each participant with the opportunity to provide feedback and partake in a 30-minute validation meeting. Five participants consented to a follow-up meeting to validate the results and provide further understanding. RESULTS: Participants recognized significant challenges, including technologies designed out-of-context, difficulty transporting the technologies through the Amazon, the impact of the physical environment (e.g., humidity, flooding), and limited existing infrastructure, such as electricity and appropriately trained health personnel. Participants also identified cultural factors, including the need to address past experiences with technology and health interventions, understand and appropriately communicate community benefits, and understand the effect of demographics (e.g., age, education) on the acceptance and uptake of technology. Complementary challenges, such as corruption in authority and waste disposal, and recommendations for technological and health interventions such as co-design were also identified. CONCLUSIONS: This study proposes that technological and health interventions without efforts to respect local cultures and health priorities, or understand and anticipate contextual challenges, will not meet its goal of improving access to healthcare in remote Amazon communities. Furthermore, the implications of corruption on health services, and improper waste disposal on the environment may lead to more detrimental health inequities
Effect of viral storm in patients admitted to intensive care units with severe COVID-19 in Spain: a multicentre, prospective, cohort study
Background: The contribution of the virus to the pathogenesis of severe COVID-19 is still unclear. We aimed to evaluate associations between viral RNA load in plasma and host response, complications, and deaths in critically ill patients with COVID-19. Methods: We did a prospective cohort study across 23 hospitals in Spain. We included patients aged 18 years or older with laboratory-confirmed SARS-CoV-2 infection who were admitted to an intensive care unit between March 16, 2020, and Feb 27, 2021. RNA of the SARS-CoV-2 nucleocapsid region 1 (N1) was quantified in plasma samples collected from patients in the first 48 h following admission, using digital PCR. Patients were grouped on the basis of N1 quantity: VIR-N1-Zero (2747 N1 copies per mL). The primary outcome was all-cause death within 90 days after admission. We evaluated odds ratios (ORs) for the primary outcome between groups using a logistic regression analysis. Findings: 1068 patients met the inclusion criteria, of whom 117 had insufficient plasma samples and 115 had key information missing. 836 patients were included in the analysis, of whom 403 (48%) were in the VIR-N1-Low group, 283 (34%) were in the VIR-N1-Storm group, and 150 (18%) were in the VIR-N1-Zero group. Overall, patients in the VIR-N1-Storm group had the most severe disease: 266 (94%) of 283 patients received invasive mechanical ventilation (IMV), 116 (41%) developed acute kidney injury, 180 (65%) had secondary infections, and 148 (52%) died within 90 days. Patients in the VIR-N1-Zero group had the least severe disease: 81 (54%) of 150 received IMV, 34 (23%) developed acute kidney injury, 47 (32%) had secondary infections, and 26 (17%) died within 90 days (OR for death 0·30, 95% CI 0·16-0·55; p<0·0001, compared with the VIR-N1-Storm group). 106 (26%) of 403 patients in the VIR-N1-Low group died within 90 days (OR for death 0·39, 95% CI 0·26-0·57; p<0·0001, compared with the VIR-N1-Storm group). Interpretation: The presence of a so-called viral storm is associated with increased all-cause death in patients admitted to the intensive care unit with severe COVID-19. Preventing this viral storm could help to reduce poor outcomes. Viral storm could be an enrichment marker for treatment with antivirals or purification devices to remove viral components from the blood.This work was supported by grants from the Instituto de Salud Carlos III (FONDO-COVID19, COV20/00110, CIBERES, 06/06/0028; AT), Proyectos de Investigación en Salud (PI19/00590; JFB-M), Miguel Servet (CP20/00041; DdG-C), Sara Borrell (CD018/0123; APT), and Predoctorales de Formación en Investigación en Salud (FI20/00278; AdF). We also received funds from Programa de Donaciones Estar Preparados, UNESPA (Madrid, Spain), and from the Canadian Institutes of Health Research (CIHR OV2–170357; DJK and JFB-M), Research Nova Scotia, Li-Ka Shing Foundation (DJK), and finally by a Research Grant 2020 from ESCMID (APT). COV20/00110, PI19/00590, CP20/00041, CD018/0123, FI20/00278 were co-funded by European Regional Development Fund and European Social Fund (A way to make Europe, and Investing in your future). We thank the IRB-Lleida Biobank 119 (B.0000682) and Plataforma Biobancos PT17/0015/0027 in Lleida, the Hospital Clinic Barcelona (HCB)-IDIBAPS biobank in Barcelona, and the National DNA Bank and the Hospital Universitario de Salamanca biobank (both in Salamanca) for their logistical support with sample processing and storage. We are indebted to the Fundació Glòria Soler for its contribution and support to the COVIDBANK of HCBIDIBAPS Biobank. This work was not supported by any pharmaceutical company or other agency.S
Human papillomavirus and Epstein-Barr virus infections in breast cancer from chile
<p>Abstract</p> <p>Background</p> <p>Human papillomavirus (HPV) and Epstein Barr virus (EBV) have been found in breast carcinomas (BCs) around the world. In this study, fifty-five BCs from Chile were analyzed for HPV and EBV presence. In addition, HPV-16 viral load/physical status and E6/E7 expressions were determined.</p> <p>Results</p> <p>The amplification of a housekeeping gene showed that 46/55 samples (84%) had amplifiable DNA. HPV-16 was detected in 4/46 BCs (8.7%) and EBV was detected in 3/46 (6.5%) BCs. The analysis of HPV-16 physical status showed that this virus was integrated in all of the tumors with a relatively low viral load (range: 0.14 to 33.8 copies/cell). E6 and E7 transcripts, however, were not detected in any HPV-16 positive specimens. Using a Cox-regression model, we found a statistically significant association between EBV presence and poor survival (p = 0.013).</p> <p>Conclusions</p> <p>The findings in this study suggest that it is unlikely that HPV and/or EBV play a direct role in the etiology of BC.</p
Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients
Introduction: Critical COVID-19 survivors have a high risk of respiratory sequelae. Therefore, we aimed to identify key factors associated with altered lung function and CT scan abnormalities at a follow-up visit in a cohort of critical COVID-19 survivors. Methods: Multicenter ambispective observational study in 52 Spanish intensive care units. Up to 1327 PCR-confirmed critical COVID-19 patients had sociodemographic, anthropometric, comorbidity and lifestyle characteristics collected at hospital admission; clinical and biological parameters throughout hospital stay; and, lung function and CT scan at a follow-up visit. Results: The median [p25–p75] time from discharge to follow-up was 3.57 [2.77–4.92] months. Median age was 60 [53–67] years, 27.8% women. The mean (SD) percentage of predicted diffusing lung capacity for carbon monoxide (DLCO) at follow-up was 72.02 (18.33)% predicted, with 66% of patients having DLCO < 80% and 24% having DLCO < 60%. CT scan showed persistent pulmonary infiltrates, fibrotic lesions, and emphysema in 33%, 25% and 6% of patients, respectively. Key variables associated with DLCO < 60% were chronic lung disease (CLD) (OR: 1.86 (1.18–2.92)), duration of invasive mechanical ventilation (IMV) (OR: 1.56 (1.37–1.77)), age (OR [per-1-SD] (95%CI): 1.39 (1.18–1.63)), urea (OR: 1.16 (0.97–1.39)) and estimated glomerular filtration rate at ICU admission (OR: 0.88 (0.73–1.06)). Bacterial pneumonia (1.62 (1.11–2.35)) and duration of ventilation (NIMV (1.23 (1.06–1.42), IMV (1.21 (1.01–1.45)) and prone positioning (1.17 (0.98–1.39)) were associated with fibrotic lesions. Conclusion: Age and CLD, reflecting patients’ baseline vulnerability, and markers of COVID-19 severity, such as duration of IMV and renal failure, were key factors associated with impaired DLCO and CT abnormalities
Effect of viral storm in patients admitted to intensive care units with severe COVID-19 in Spain: a multicentre, prospective, cohort study
Background: The contribution of the virus to the pathogenesis of severe COVID-19 is still unclear. We aimed to evaluate associations between viral RNA load in plasma and host response, complications, and deaths in critically ill patients with COVID-19. Methods: We did a prospective cohort study across 23 hospitals in Spain. We included patients aged 18 years or older with laboratory-confirmed SARS-CoV-2 infection who were admitted to an intensive care unit between March 16, 2020, and Feb 27, 2021. RNA of the SARS-CoV-2 nucleocapsid region 1 (N1) was quantified in plasma samples collected from patients in the first 48 h following admission, using digital PCR. Patients were grouped on the basis of N1 quantity: VIR-N1-Zero ([removed]2747 N1 copies per mL). The primary outcome was all-cause death within 90 days after admission. We evaluated odds ratios (ORs) for the primary outcome between groups using a logistic regression analysis. Findings: 1068 patients met the inclusion criteria, of whom 117 had insufficient plasma samples and 115 had key information missing. 836 patients were included in the analysis, of whom 403 (48%) were in the VIR-N1-Low group, 283 (34%) were in the VIR-N1-Storm group, and 150 (18%) were in the VIR-N1-Zero group. Overall, patients in the VIR-N1-Storm group had the most severe disease: 266 (94%) of 283 patients received invasive mechanical ventilation (IMV), 116 (41%) developed acute kidney injury, 180 (65%) had secondary infections, and 148 (52%) died within 90 days. Patients in the VIR-N1-Zero group had the least severe disease: 81 (54%) of 150 received IMV, 34 (23%) developed acute kidney injury, 47 (32%) had secondary infections, and 26 (17%) died within 90 days (OR for death 0·30, 95% CI 0·16–0·55; p<0·0001, compared with the VIR-N1-Storm group). 106 (26%) of 403 patients in the VIR-N1-Low group died within 90 days (OR for death 0·39, 95% CI 0·26–0·57; p[removed]11 página
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