On the driver of relativistic effects strength in Seyfert galaxies

Spectroscopy of X-ray emission lines emitted in accretion discs around supermassive black holes is one of the most powerful probes of the accretion flow physics and geometry, while also providing in principle observational constraints on the black hole spin.[...] We aim at determining the ultimate physical driver of the strength of this relativistic reprocessing feature. We first extend the hard X-ray flux-limited sample of Seyfert galaxies studied so far (FERO, de la Calle Perez et al. 2010) to obscured objects up to a column density N_H=6x10^23 atoms/cm/cm. We verify that none of the line properties depends on the AGN optical classification, as expected from the Seyfert unification scenarios. There is also no correlation between the accretion disc inclination, as derived from formal fits of the line profiles, and the optical type or host galaxy aspect angle, suggesting that the innermost regions of the accretion disc and the host galaxy plane are not aligned. [...]. Data are not sensitive enough to the detailed ionisation state of the line-emitting disc. However, the lack of dependency of the line EW on either the luminosity or the rest-frame centroid energy rules out that disc ionisation plays an important role on the EW dynamical range in Seyferts. The dynamical range of the relativistically broadened K-alpha iron line EW in nearby Seyferts appears to be mainly determined by the properties of the innermost accretion flow. We discuss several mechanisms (disc ionisation, disc truncation, aberration due to a mildly relativistic outflowing corona) which can explain this. [...] Observational data are still not in contradiction with scenarios invoking different mechanisms for the spectral complexity around the iron line, most notably the "partial covering" absorption scenario. (abridged).Comment: Accepted for publication on Astronomy & Astrophysics. 14 pages, 9 figure

Report of the Eighth Interlaboratory Comparison organised by the Community Reference Laboratory for Heavy Metals in Feed and Food - Total Cd, Pb, As, Hg and Sn and extractable Cd and Pb in Feed of Plant Origin

The Institute for Reference Materials and Measurements (IRMM)of the Joint Research Centre, a Directorate General of the European Commission, operates the Community Reference Laboratory for Heavy Metals in Feed and Food (CRL-HM). One of its core tasks is to organise interlaboratory comparisons (ILCs) among appointed National Reference Laboratories (NRLs). This report presents the results of the eighth ILC of the CRL-HM which focused on the determination of total Cd, Pb, As, Hg and Sn and extractable amounts of Cd and Pb in feed of plant origin following Directive 2002/32/EC of the European Parliament and of the Council on undesirable substances in animal feed. The test material used in this exercise was a candidate reference material, the matrix being rye grass. The material was relabelled and dispatched to the participants on the second half of October 2009. Each participant received approximately 10 g of test material. Thirty participants from 25 member states registered to the exercise of which 27 reported results for total Cd, Pb and Hg, 23 for extractable Pb, 22 for extractable Cd and for total As and 16 for total Sn. One laboratory did not report results due to a breakdown of the instrumentation, and one laboratory reported results only for Hg for the same reason. The assigned values (Xref) for total Cd, Pb, As, Hg and Sn were the candidate certified values as obtained during the certification. The assigned values for extractable Cd and Pb were provided by IRMM using isotope dilution-inductively coupled plass-mass spectrometry (ID-ICP-MS). Participants were invited to report the uncertainty of their measurements, which was provided by the majority of them. The laboratory performance was evaluated using z- end zeta-scores in accordance with ISO 13528. The standard deviation for proficiency assessment (also called target standard deviation), was fixed to 15% of the assigned values for all measurands on the basis of the outcome of previous ILCs organis.JRC.DDG.D.6-Food Safety and Qualit

Comparative analysis of trueness between conventional and digital impression in dental-supported fixed dental prosthesis with vertical preparation

Biologically oriented preparation technique (BOPT) is a vertical preparation technique without a finish line to create a new anatomic crown with a prosthetic emergence profile. This case report describe the protocol realized digitally in a patient who required a new fixed partial denture (FPD) in the anterior esthetic zone. After time of temporary restoration, definitive conventional (CI) (double-cord retraction and vinyl polysiloxane material), and digital impression (DI) with three different intraoral scanner (IOS) (Trios®, True Definition® and iTero®) were taken. All digital impression were obtained through three different scans: temporary restoration in the mouth after healing period, prepared teeth, and temporary restoration out of the mouth. To establish which of the IOS was the most accurate, it was necessary to compare the STL files obtained from each of the IOS with the STL file of the conventional impression, which was digitized with a laboratory scanner (3Shape D800). All these STL were imported to a software (ExoCAD 2.4 Plovdiv®), and they were superimposed. To establish the difference in trueness with SC, 6 points were chosen, 3 points in teeth, and another 3 points in soft tissue. The mean measurement in terms of trueness in teeth were: STS (0,039 mm), SI (0,054 mm), STD (0,067 mm); and in soft tissue were: STS (0,051 mm), SI (0,09 mm), STD [0,236 mm]. The IOSs showed differences between them in terms of trueness, being the Trios the most accuracy IOS. Final restoration was fabricated and cemented. The patient was examined at 3, 6 and 12 months, without any type of biological or mechanical complications. Digital impression with an IOS seems to be a viable alternative to perform zirconia FPD in the BOPT tecbique

COVID-19’s impact on care practice for alpha-1-antitrypsin deficiency patients

Alpha-1-antitrypsin deficiency; COVID-19; Patient managementDeficiencia de alfa-1-antitripsina; COVID-19; Gestión del pacienteDeficiència d'alfa-1-antitripsina; COVID-19; Gestió del pacientBackground Patients with alpha-1 antitrypsin deficiency (AATD), commonly categorized as a rare disease, have been affected by the changes in healthcare management brought about by COVID-19. This study’s aim was to identify the changes that have taken place in AATD patient care as a result of the COVID-19 pandemic in Spain and to propose experts’ recommendations aimed at ensuring humanized and quality care for people with AATD in the post-pandemic situation. Methods A qualitative descriptive case study with a holistic single-case design was conducted, using focus groups with experts in AATD clinical management, including 15 health professionals with ties to the Spanish health system (12 pneumologists and 2 hospital pharmacists from 11 different hospitals in Spain) and 1 patient representative. Results COVID-19 has had a major impact on numerous aspects of AATD clinical patient management in Spain, including diagnostic, treatment, and follow-up phases. The experts concluded that there is a need to strengthen coordination between Primary Care and Hospital Care and improve the coordination processes across all the organizations and actors involved in the healthcare system. Regarding telemedicine and telecare, experts have concluded that it is necessary to promote this methodology and to develop protocols and training programs. Experts have recommended developing personalized and precision medicine, and patient participation in decision-making, promoting self-care and patient autonomy to optimize their healthcare and improve their quality of life. The possibility of monitoring and treating AATD patients from home has also been proposed by experts. Another result of the study was the recommendation of the need to ensure that plasma donations are made on a regular basis by a sufficient number of healthy individuals. Conclusion The study advances knowledge by highlighting the challenges faced by health professionals and changes in AATD patient management in the context of the COVID-19 pandemic. It also proposes experts’ recommendations aimed at ensuring humanized and quality care for people with AATD in the post-pandemic situation. This work could serve as a reference study for physicians on their daily clinical practice with AATD patients and may also provide guidance on the changes to be put in place for the post-pandemic situation.This study was funded by CSL Behring

Clinical Characteristics and Prognosis of COPD Patients Hospitalized with SARS-CoV-2

Objective To describe the characteristics and prognosis of patients with COPD admitted to the hospital due to SARS-CoV-2 infection. Methods The SEMI-COVID registry is an ongoing retrospective cohort comprising consecutive COVID-19 patients hospitalized in Spain since the beginning of the pandemic in March 2020. Data on demographics, clinical characteristics, comorbidities, laboratory tests, radiology, treatment, and progress are collected. Patients with COPD were selected and compared to patients without COPD. Factors associated with a poor prognosis were analyzed. Results Of the 10,420 patients included in the SEMI-COVID registry as of May 21, 2020, 746 (7.16%) had a diagnosis of COPD. Patients with COPD are older than those without COPD (77 years vs 68 years) and more frequently male. They have more comorbidities (hypertension, hyperlipidemia, diabetes mellitus, atrial fibrillation, heart failure, ischemic heart disease, peripheral vascular disease, kidney failure) and a higher Charlson Comorbidity Index (2 vs 1, p<0.001). The mortality rate in COPD patients was 38.3% compared to 19.2% in patients without COPD (p<0.001). Male sex, a history of hypertension, heart failure, moderate–severe chronic kidney disease, presence of cerebrovascular disease with sequelae, degenerative neurological disease, dementia, functional dependence, and a higher Charlson Comorbidity Index have been associated with increased mortality due to COVID-19 in COPD patients. Survival was higher among patients with COPD who were treated with hydroxychloroquine (87.1% vs 74.9%, p<0.001) and with macrolides (57.9% vs 50%, p<0.037). Neither prone positioning nor non-invasive mechanical ventilation, high-flow nasal cannula, or invasive mechanical ventilation were associated with a better prognosis. Conclusion COPD patients admitted to the hospital with SARS-CoV-2 infection have more severe disease and a worse prognosis than non-COPD patients

HERPES ZOSTER OFTÁLMICO. PRESENTACIÓN DE UN CASO

Se realizó una investigación explicativa, se desarrolló desde una perspectiva dialéctica materialista, sobre la infección por el virus de la varicela-zoster (VVZ). Los métodos y técnicas de investigación permitieron el análisis para procesar toda la información de la investigación, a través de medios automatizados, todos los datos obtenidos se compararon con la literatura nacional y extranjera actualizada. El caso que se analizó es el de una persona no inmune que persistió en estado latente, acantonado en los ganglios sensitivos, durante el transcurso de su vida, reactivándose dando lugar a una forma clínica Oftálmica del virus del Herpes Zoster. El objetivo principal es proporcionar habilidades necesarias para la prevención, diagnóstico y tratamiento del VVZ  en la práctica médica diaria. Los antecedentes de esteatosis hepática grado II, glaucoma, sinusitis crónica, absceso alveolar y otitis externa,  con lesiones eritemato- vesícula- postulosas, acompañado de escozor, edema palpebral inflamatorio severo, según el método clínico, indicó que los síntomas eran del virus de la varicela-zoster, forma clínica oftálmica. Al proporcionar habilidades necesarias para la prevención, diagnóstico y tratamiento del virus de la varicela-zoster (VVZ), forma clínica oftálmica, aumenta la calidad de vida y las consecuencias sociales que produc

Primary Angioplasty in a Catastrophic Presentation: Acute Left Main Coronary Total Occlusion—The ATOLMA Registry

Objectives. To determine the outcome predictors of in-hospital mortality in acute total occlusion of the left main coronary artery (ATOLMA) patients referred to emergent angioplasty and to describe the clinical presentation and the long-term outcome of these patients.Background. ATOLMA is an uncommon angiographic finding that usually leads to a catastrophic presentation. Limited and inconsistent data have been previously reported regarding true ATOLMA, yet comprehensive knowledge remains scarce.Methods. This is a multicenter retrospective cohort that includes patients presenting with myocardial infarction due to a confirmed ATOLMA who underwent emergency percutaneous coronary intervention (PCI).Results. In the period of the study, 7930 emergent PCI were performed in the five participating centers, and 46 of them had a true ATOLMA (0.58%). At admission, cardiogenic shock was present in 89% of patients, and cardiopulmonary resuscitation was required in 67.4%. All the patients had right dominance. Angiographic success was achieved in 80.4% of the procedures, 13 patients (28.2%) died during the catheterization, and the in-hospital mortality rate was 58.6% (27/46). At one-year and at the final follow-up, 18 patients (39%) were alive, including four cases successfully transplanted. Multivariate analysis showed that postprocedural TIMI flow was the only independent predictor of in-hospital mortality (OR 0.23, (95% CI 0.1-0.36),p<0.001).Conclusions. Our study confirms that the clinical presentation of ATOLMA is catastrophic, presenting a high in-hospital mortality rate; nevertheless, primary angioplasty in this setting is feasible. Postprocedural TIMI flow resulted as the only independent predictor of in-hospital mortality. In-hospital survivors presented an encouraging outcome. ATOLMA and left dominance could be incompatible with life

Propuesta de mejora del Sistema Interno de Garantía de Calidad de la Facultad de Medicina

La garantía de calidad en el ámbito universitario puede considerarse como la atención sistemática, estructurada y continua a las titulaciones ofertadas. La garantía de calidad se compromete a poner en marcha los medios que aseguren y demuestren la calidad de los programas formativos que se desarrollan en cada una de las titulaciones ofrecidas por la Universidad y así cumplir con la obligación que tiene con la sociedad. El presente proyecto nace como fruto de la responsabilidad adquirida para el cumplimiento de las funciones encomendadas y, con el objetivo de seguir adoptando una estrategia de mejora continua de la calidad de la docencia y satisfacción de los colectivos implicados en el proceso de enseñanza-aprendizaje (Profesorado, Estudiantes y PAS)

A Search for Dark Matter Annihilation with the Whipple 10m Telescope

We present observations of the dwarf galaxies Draco and Ursa Minor, the local group galaxies M32 and M33, and the globular cluster M15 conducted with the Whipple 10m gamma-ray telescope to search for the gamma-ray signature of self-annihilating weakly interacting massive particles (WIMPs) which may constitute astrophysical dark matter (DM). We review the motivations for selecting these sources based on their unique astrophysical environments and report the results of the data analysis which produced upper limits on excess rate of gamma rays for each source. We consider models for the DM distribution in each source based on the available observational constraints and discuss possible scenarios for the enhancement of the gamma-ray luminosity. Limits on the thermally averaged product of the total self-annihilation cross section and velocity of the WIMP, , are derived using conservative estimates for the magnitude of the astrophysical contribution to the gamma-ray flux. Although these limits do not constrain predictions from the currently favored theoretical models of supersymmetry (SUSY), future observations with VERITAS will probe a larger region of the WIMP parameter phase space, and WIMP particle mass (m_\chi).Comment: 33 pages, 12 figures, accepted for publication in the Astrophysical Journa