Late vacuum choice and slow roll approximation in gravitational particle production during reheating

In the transition between inflation and reheating, the curvature scalar typically undergoes oscillations which have significant impact on the density of gravitationally produced particles. The commonly used adiabatic vacuum prescription for the extraction of produced particle spectra becomes a non-reliable definition of vacuum in the regimes for which this oscillatory behavior is important. In this work, we study particle production for a scalar field non-minimally coupled to gravity, taking into account the complete dynamics of spacetime during inflation and reheating. We derive an approximation for the solution to the mode equation during the slow-roll of the inflaton and analyze the importance of Ricci scalar oscillations in the resulting spectra. Additionally, we propose a prescription for the vacuum that allows to safely extrapolate the result to the present, given that the test field interacts only gravitationally. Lastly, we calculate the abundance of dark matter this mechanism yields and compare it to observations.Comment: 24 pages, 11 figure

Derivative couplings in gravitational production in the early universe

Gravitational particle production in the early universe is due to the coupling of matter fields to curvature. This coupling may include derivative terms that modify the kinetic term. The most general first order action contains derivative couplings to the curvature scalar and to the traceless Ricci tensor, which can be dominant in the case of (pseudo-)Nambu-Goldstone bosons or disformal scalars, such as branons. In the presence of these derivative couplings, the density of produced particles for the adiabatic regime in the de Sitter phase (which mimics inflation) is constant in time and decays with the inverse effective mass (which in turn depends on the coupling to the curvature scalar). In the reheating phase following inflation, the presence of derivative couplings to the background curvature modifies in a nontrivial way the gravitational production even in the perturbative regime. We also show that the two couplings -- to the curvature scalar and to the traceless Ricci tensor -- are drastically different, specially for large masses. In this regime, the production becomes highly sensitive to the former coupling while it becomes independent of the latter.Comment: 24 pages, 6 figure

Documento de consenso interdisciplinar de expertos en el manejo de la disección aórtica tipo B: comentarios y novedades a la luz del INSTEAD-XL

ResumenAnte la ausencia de evidencia científica sólida, un comité de expertos europeos ha publicado en la revista Journal of the American College of Cardiology un documento de consenso sobre el manejo de los diferentes subgrupos de pacientes con disección aórtica tipo B. Este documento está basado en un metaanálisis que recopila toda la experiencia publicada en los últimos años sobre disección aórtica tipo B, incluyendo a más de 6.700 pacientes.A pesar de su mejor pronóstico en fase aguda que la disección aórtica tipo A, la disección aórtica tipo B presenta un mal pronóstico a medio y largo plazo. El manejo limitado al tratamiento médico con control estricto de la presión arterial y el tratamiento de los casos complicados mediante cirugía abierta o técnicas endovasculares está sometido a controversia, especialmente por la disponibilidad y los buenos resultados de las técnicas endovasculares. Este documento pretende apoyar a los cirujanos o médicos que tratan la disección aórtica tipo B, estableciendo algunos algoritmos de manejo.Recogemos en este artículo las conclusiones y los datos fundamentales de este documento de consenso.La aparición posterior de los resultados a 5 años del estudio INSTEAD añaden una fuerte evidencia científica en contra de alguna de las principales conclusiones alcanzadas en este consenso y retan este consenso logrado solamente un año antes.AbstractDue to a lack of solid scientific evidence, an european experts committee have published in Journal of the American College of Cardiology an consensus document about the management of different subgroups of patients with type B aortic dissection. This document is based on a meta-analisys including the recent published experience that includes more than 6700 patients with type B aortic dissection.In spite of the better prognosis compared to type A dissection in the short term, type B dissection has a bad long term prognosis. The conservative management limited to tight blood pressure control and close surveillance to treat complicated cases with open surgery or endovascular therapy is under discussion, specially due to the feasibility and good results of endovascular technique. This consensus intends to support surgeons or doctors who deal with type B dissection and stablishs some management algorithm.We present in this article the conclusions and main data from this consensus document.The posterior publication of 5 years results of INSTEAD study adds an strong scientific evidence against some of this consensus principal conclusions and challenge the consensus just one year later

Transparent Glass-Ceramics Produced by Sol-Gel: A Suitable Alternative for Photonic Materials

Transparent glass-ceramics have shown interesting optical properties for several photonic applications. In particular, compositions based on oxide glass matrices with fluoride crystals embedded inside, known as oxyfluoride glass-ceramics, have gained increasing interest in the last few decades. Melt-quenching is still the most used method to prepare these materials but sol-gel has been indicated as a suitable alternative. Many papers have been published since the end of the 1990s, when these materials were prepared by sol-gel for the first time, thus a review of the achievements obtained so far is necessary. In the first part of this paper, a review of transparent sol-gel glass-ceramics is made focusing mainly on oxyfluoride compositions. Many interesting optical results have been obtained but very little innovation of synthesis and processing is found with respect to pioneering papers published 20 years ago. In the second part we describe the improvements in synthesis and processing obtained by the authors during the last five years. The main achievements are the preparation of oxyfluoride glass-ceramics with a much higher fluoride crystal fraction, at least double that reported up to now, and the first synthesis of NaGdF4 glass-ceramics. Moreover, a new SiO2 precursor was introduced in the synthesis, allowing for a reduction in the treatment temperature and favoring hydroxyl group removal. Interesting optical properties demonstrated the incorporation of dopant ions in the fluoride crystals, thus obtaining crystal-like spectra along with higher efficiencies with respect to xerogels, and hence demonstrating that these materials are a suitable alternative for photonic applications.This work was supported by MINECO under projects MAT2013-48246-C2-1-P, MAT2013-48246-C2-2-P, and MAT2017-87035-C2-1-P/-2-P (AEI/FEDER, UE) and Basque Country Government IT-943-16 and PPG17/07. The authors are grateful for access to the Spanish Beamline (SpLine) at the ESRF facilities in Grenoble to perform experiments MA-3350 and 25-01-1014. Jose Joaquin Velazquez also acknowledges MINECO for Grant FPDI-2013-16895

Operational realization of quantum vacuum ambiguities

We provide a reinterpretation of the quantum vacuum ambiguities that one encounters when studying particle creation phenomena due to an external and time-dependent agent. We propose a measurement-motivated understanding: Each way of measuring the number of created particles selects a particular vacuum. This point of view gives a clear and physical meaning to the time evolution of the number of particles produced by the agent as the counts in a specific detector and, at the same time relates commonly used quantization prescriptions to particular measurement setups.Comment: 6 pages, 3 figure

Statistical study of user perception of smart homes during vital signal monitoring with an energy saving algorithm

Sensor networks are deployed in people’s homes to make life easier and more comfortable and secure. They might represent an interesting approach for elderly care as well. This work highlights the benefits of a sensor network implemented in the homes of a group of users between 55 and 75 years old, which encompasses a simple home energy optimization algorithm based on user behavior. We analyze variables related to vital signs to establish users’ comfort and tranquility thresholds. We statistically study the perception of security that users exhibit, differentiating between men and women, examining how it affects the person’s development at home, as well as the reactivity of the sensor algorithm, to optimize its performance. The proposed algorithm is analyzed under certain performance metrics, showing an improvement of 15% over a sensor network under the same conditions. We look at and quantify the usefulness of accurate alerts on each sensor and how it reflects in the users’ perceptions (for men and women separately). This study analyzes a simple, low-cost, and easy-to-implement home-based sensor network optimized with an adaptive energy optimization algorithm to improve the lives of older adults, which is capable of sending alerts of possible accidents or intruders with the highest efficiency

Star formation in bright-rimmed clouds and cluster associated with W5 E H{\sc ii} region

The aim of this paper is to present the results of photometric investigations of the central cluster of the W5 E region as well as a follow-up study of the triggered star formation in and around bright-rimmed clouds (BRCs). We have carried out wide field $UBVI_c$ and deep $VI_c$ photometry of the W5 E H{\sc ii} region. A distance of $\sim$2.1 kpc and a mean age of $\sim$1.3 Myr have been obtained for the central cluster. The young stellar objects (YSOs) associated with the region are identified on the basis of near-infrared and mid-infrared observations. We confirmed our earlier results that the average age of the YSOs lying on/inside the rim are younger than those lying outside the rim. The global distribution of the YSOs shows an aligned distribution from the ionising source to the BRCs. These facts indicate that a series of radiation driven implosion processes proceeded from near the central ionising source towards the periphery of the W5 E H{\sc ii} region. We found that, in general, the age distributions of the Class II and Class III sources are the same. This result is apparently in contradiction with the conclusion by Bertout, Siess & Cabrit (2007) and Chauhan et al. (2009) that classical T Tauri stars evolve to weak-line T Tauri stars. The initial mass function of the central cluster region in the mass range $0.4 \le M/M_\odot \le 30$ can be represented by $\Gamma = -1.29 \pm 0.03$. The cumulative mass functions indicate that in the mass range $0.2 \le M/M_\odot \le 0.8$, the cluster region and BRC NW have more low mass YSOs in comparison to BRCs 13 and 14.Comment: 43 pages, 17 figures, accepted for publication in MNRA

Response to Novel Drugs before and after Allogeneic Stem Cell Transplantation in Patients with Relapsed Multiple Myeloma

Multiple myeloma (MM) remains as an incurable disease and, although allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative approach, most patients ultimately relapse, and their treatment remains challenging. Because allo-HSCT can modify not only the biology of the disease, but also the immune system and the microenvironment, it can potentially enhance the response to rescue therapies. Information on the efficacy and safety of novel drugs in patients relapsing after allo-HSCT is lacking, however. The objectives of this study were to evaluate the efficacy and toxicity of rescue therapies in patients with MM who relapsed after allo-HSCT, as well as to compare their efficacy before and after allo-HSCT. This retrospective multicenter study included 126 consecutive patients with MM who underwent allo-HSCT between 2000 and 2013 at 8 Spanish centers. All patients engrafted. The incidence of grade II-IV acute graft-versus-host disease (GVHD) was 47%, and nonrelapse mortality within the first 100 days post-transplantation was 13%. After a median follow-up of 92 months, overall survival (OS) was 51% at 2 years and 43% at 5 years. The median progression-free survival after allo-HSCT was 7 months, whereas the median OS after relapse was 33 months. Patients relapsing in the first 6 months after transplantation had a dismal prognosis compared with those who relapsed later (median OS, 11 months versus 120 months; P <.001). The absence of chronic GVHD was associated with reduced OS after relapse (hazard ratio, 3.44; P <.001). Most patients responded to rescue therapies, including proteasome inhibitors (PIs; 62%) and immunomodulatory drugs (IMiDs; 77%), with a good toxicity profile. An in-depth evaluation, including the type and intensity of PI- and IMiD-based combinations used before and after allo-HSCT, showed that the overall response rate and duration of response after allo-HSCT were similar to those seen in the pretransplantation period. Patients with MM who relapse after allo-HSCT should be considered candidates for therapy with new drugs, which can achieve similar response rates with similar durability as seen in the pretransplantation period. This pattern does not follow the usual course of the disease outside the transplantation setting, where response rates and time to progression decreases with each consecutive line of treatment

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Manual de simulación clínica en especialidades médicas

Manual sobre técnicas y modos de simulación clínica en diversas especialidades médicas.La enseñanza y formación en medicina necesita el uso de la simulación. Existen evidencias de su uso desde hace cientos de años, pero, en los últimos años se ha incrementado y diseminado. La simulación clínica está validada científicamente en múltiples contextos médicos y de otras áreas profesionales de la salud. Y es considerada de gran importancia como proceso de entrenamiento y de mejora de las competencias y adquisición de habilidades médicas en campos que incluye desde la historia clínica, comunicación con el paciente, exploración, diagnóstico terapéutica médica-farmacológica y quirúrgica y seguridad al tratar al paciente. Hoy en día, para muchas técnicas y situaciones clínicas es inaceptable llegar junto a los pacientes sin un dominio adquirido en simulación. La simulación puede ocurrir sin el uso de recursos adicionales, solo las personas, o utilizando pocos o muchos recursos de baja hasta alta tecnología y se puede adaptar a los recursos disponibles, abarcando todas las áreas de conocimiento, y dentro de ellas competencias técnicas o actitudes, solas o en conjunto. El uso racional y basado en evidencia de la simulación es de la mayor importancia por la necesidad de una mayor efectividad y eficiencia en la transformación de los profesionales de la salud para que puedan mejorar su capacidad de atender a los pacientes. La simulación es también una buena herramienta de evaluación de competencias y habilidades en Medicina y otras disciplinas de las Ciencias de la Salud Este manual incluye técnicas y modos de simulación clínica en diversas especialidades médicas, útiles, para quien busque un manual práctico y actualizado.Cátedra de Mecenazgo de la Universidad de Málaga. Cátedra de Terapias Avanzadas en Patología Cardiovascular Cátedra de Mecenazgo de la Universidad de Málaga. Cátedra de Investigación Biomédica Quirón Salu