Thermodynamics of anisotropic branes

We study the thermodynamics of flavor D7-branes embedded in an anisotropic black brane solution of type IIB supergravity. The flavor branes undergo a phase transition between a `Minkowski embedding', in which they lie outside of the horizon, and a `black hole embedding', in which they fall into the horizon. This transition depends on the black hole temperature, its degree of anisotropy, and the mass of the flavor degrees of freedom. It happens either at a critical temperature or at a critical anisotropy. A general lesson we learn from this analysis is that the anisotropy, in this particular realization, induces similar effects as the temperature. In particular, increasing the anisotropy bends the branes more and more into the horizon. Moreover, we observe that the transition becomes smoother for higher anisotropies

Análisis financiero y percepción de los servicios ambientales de un sistema silvopastoril: un estudio de caso en los Tuxtlas, México

The aim is to demonstrate that a silvopastoral system is more cost effective than a traditional system for milk producers in the Biosphere Reserve of Los Tuxtlas, Veracruz, Mexico. A silvopastoral system is more profitable four years after and the initial investment is recovered after two or three years. Moreover, in the short term producers can increase their income. A silvopastoral system increases the production of marketable goods such as milk and generates other environmental goods and service that are identified by producers.A través de un análisis financiero, se verifica que la implementación de un sistema silvopastoril es más rentable económicamente que un sistema tradicional para productores de leche en la Reserva de la Biósfera de los Tuxtlas, Veracruz, México. Aproximadamente, deben pasar cuatro años para que un sistema silvopastoril sea más rentable y entre dos a tres años para recuperar la inversión económica inicial. Aunado a ello, en el corto plazo los productores indican un aumento de sus ingresos brutos derivados de la actividad. Un sistema silvopastoril, además de incrementar la producción de bienes mercadeables como la leche, genera otros bienes y servicios ambientales mismos que son identificados en este estudio por los productores

Análisis financiero y percepción de los servicios ambientales de un sistema silvopastoril: un estudio de caso en los Tuxtlas, México

A través de un análisis financiero, se verifica que la implementación de un sistema silvopastoril es más rentable económicamente que un sistema tradicional para productores de leche en la Reserva de la Biósfera de los Tuxtlas, Veracruz, México. Aproximadamente, deben pasar cuatro años para que un sistema silvopastoril sea más rentable y entre dos a tres años para recuperar la inversión económica inicial. Aunado a ello, en el corto plazo los productores indican un aumento de sus ingresos brutos derivados de la actividad. Un sistema silvopastoril, además de incrementar la producción de bienes mercadeables como la leche, genera otros bienes y servicios ambientales mismos que son identificados en este estudio por los productores.The aim is to demonstrate that a silvopastoral system is more cost effective than a traditional system for milk producers in the Biosphere Reserve of Los Tuxtlas, Veracruz, Mexico. A silvopastoral system is more profitable four years after and the initial investment is recovered after two or three years. Moreover, in the short term producers can increase their income. A silvopastoral system increases the production of marketable goods such as milk and generates other environmental goods and service that are identified by producers

Investigación clínica en la práctica de la reumatología en Colombia. Visión de un reumatólogo desde la óptica ética

En Colombia, la artritis reumatoide es considerada como una enfermedad de alto costo. Sin embargo, el sistema de salud colombiano indica que los pacientes con esta enfermedad pueden acceder a tratamientos costosos como las terapias biológicas, incluidas o de obligatoria cobertura en el Plan Obligatorio de Salud (POS). La industria farmacéutica, con el concurso de médicos e institutos de reumatología en varios países del mundo, incluyendo a Colombia, ha iniciado investigaciones mediante experimentos clínicos que buscan encontrar nuevas opciones terapéuticas para mejorar el control de la artritis reumatoide. El paciente con este tipo de enfermedad tendría que poder decidir si quiere ser parte de estos experimentos o ser tratado con los medicamentos y terapias cubiertas en el POS. El autor, en este artículo, expone y cuestiona el proceder del reumatólogo y de las instituciones de atención a la reumatología en Colombia ante la explicación objetiva al paciente y apoyo en la decisión de ser tratado con la terapia convencional o experimental. Un dilema ético que afronta día a día el médico reumatólogo que trabaja en atención de pacientes y en investigación.39-47The rheumatoid arthritis in Colombia is considered as a high cost disease. However, the Colombian healthcare system shows that the patients with this disease can access to high cost treatments as biological therapy is incorporated or mandatory whitin the coverage in the Mandatory Healthcare Plan (POS2). Nowadays, the pharmaceutic industry in collaboration with doctors and rheumatology institutes in Colombia, have begun researches that contribute to a future cure of this disease, through clinical experiments. The patient with this kind of disease would have to decide if they want to be part of this experiments or be treated by POS’s medicines and therapies. The author in this article exposes and disputes rheumatologists and institutions proceeding in face of support patient’s decision to be treated by experimental or conventional treatment. An ethical dilemma that rheumatologists have to face

Simulación clínica en reumatología : efecto de una intervención educativa basada en simulación clínica en el diagnóstico de artritis reumatoide y artrosis por parte de médicos generales, un experimento clínico aleatorizado

Objetivo: Evaluar la efectividad de una herramienta educativa para médicos generales basada en simulación clínica reumatológica, para el diagnóstico de artritis reumatoide y artrosis. Diseño: experimento clínico aleatorizado. Lugar: Bogotá, Colombia. Población: Médicos generales de consulta externa. Intervención: Los sujetos de investigación fueron asignados a uno de dos grupos: a) grupo experimental: intervención educativa en artritis reumatoide con simulación clínica, b) grupo control: intervención educativa sobre aspectos básicos de diagnóstico y tratamiento de osteoporosis. Medición: Cuatro semanas después de la intervención educativa, los integrantes de los dos grupos enfrentaron un proceso evaluativo que incluyó cuatro casos clínicos con pacientes reales (dos pacientes con artritis reumatoide y dos pacientes con artrosis), dos casos clínicos con dos modelos de simulación clínica (un caso de artritis reumatoide y un caso de artrosis) y seis casos clínicos virtuales (tres casos de artritis reumatoide y tres casos de artrosis), en los cuales los participantes anotaron los hallazgos semiológicos detectados, establecieron un diagnóstico y definieron los paraclínicos que solicitarían, si era el caso, para corroborar su diagnóstico Resultados: 160 médicos (80 para el grupo de intervención educativa activa en artritis reumatoide y 80 para el grupo control),89 eran mujeres (56%). Edad promedio 35,0 años (desviación estándar 7,7 años). Se definió como éxito cuando el médico diagnosticara en forma correcta a por lo menos 10 de los 12 casos que se le presentaron, se encontró una diferencia de 81,3% (Intervalo de Confianza del 95% 72-90%) en éxitos a favor del grupo activo (88,8% vs 7,5%) diferencia estadísticamente significativa (p=menor que 0,001). Se encontró un mayor número de aciertos en la detección de los hallazgos semiológicos en el grupo activo comparado con el control (valor de p menor que 0.001) Conclusiones: El presente estudio mostró la efectividad de una intervención educativa basada en simulación clínica para mejorar el abordaje diagnóstico en artritis reumatoide y artrosis, creándose un nuevo horizonte en la enseñanza de la reumatología moderna, lo cual redundará en un beneficio para los pacientes, y en una mejora de la calidad y el empleo de recursos del sistema de salud.Objective: To evaluate the effectiveness of an rheumatology educational tool based on clinical simulation for general practitioners, to improve the diagnosis of rheumatoid arthritis and osteoarthritis. Design: Randomized clinical trial Place: Bogotá, Colombia. Intervention: Research subjects were assigned to one of two groups: a) experimental group: educational intervention in rheumatoid arthritis based on clinical simulation, b) control group: educational intervention on basic aspects of diagnosis and treatment of osteoporosis Measurement: Four weeks after the educational intervention, members of the two groups faced an evaluation process that included four cases with real patients (two patients with rheumatoid arthritis and two patients with osteoarthritis), two cases with two clinical simulation models (a case of rheumatoid arthritis and an osteoarthritis case) and six virtual clinical cases (three rheumatoid arthrits cases and three osteoarthritis cases), in which participants noted the detected semiological findings, established a definitive diagnosis and paraclinical that would apply if it was the case, for corroborate the diagnosis. Results: 160 physicians (80 for the active group and 80 for the control group), 89 were women (56%). Average age 35.0 years (standard deviation 7.7 years). Success was defined as when the doctor diagnosed correctly at least 10 of the 12 cases submitted to it, a difference of 81.3% (confidence interval 95% 72-90%) was found in successes, and was statistically significant in favor of the active group (88.8% vs 7.5%) (p = menor que 0.001). A greater number of hits was found in the detection of the semiological findings in the active group compared with the control (valor de p menor que 0.001) Conclusions: The present study showed the effectiveness of an educational intervention based on clinical simulation to improve the diagnostic approach in rheumatoid arthritis and osteoarthritis, creating a new horizon in the teaching of modern rheumatology, which will result in a benefit for patients, and an improvement in the quality and use of health system resources.Magíster en Epidemiología ClínicaMaestrí

Troca plasmática terapêutica em doenças reumáticas : a experiência de um hospital universitário

Introdução: Diariamente acumulam-se evidências relacionadas com a utilização da troca plasmática terapêutica (TPT) em pacientes com doenças reumáticas. O Hospital Universitário San Ignacio registrou todas as sessões de TPT realizadas pelo grupo de aférese desta instituição. Objetivo: Descrever a experiência do Hospital Universitário San Ignacio na TPT em pacientes com doenças reumatológicas. Métodos: Trata-se de uma análise observacional, retrospectiva, descritiva. Este estudo incluiu análises das sessões de TPT realizadas em pacientes com doenças reumáticas de novembro de 2009 a novembro de 2013. Resultados: O grupo de aférese realizou 136 sessões em 27 pacientes. A idade média dos pacientes foi de 43 anos (DP 18,5) e 59,3% dos pacientes eram do sexo feminino. Quanto ao diagnóstico, os mais frequentes foram: vasculite associada ao ANCA seguida de lúpus eritematoso sistêmico e síndrome antifosfolipídica catastrófica. A quantidade média de sessões por paciente foi de 5 (DP 1,8) e a média de troca plasmática por paciente foi de 1,3 unidades de substituição do volume de plasma. A solução de substituição mais utilizada foi o plasma fresco congelado (PFC, 63,2% das sessões). De todas as sessões, 4,4% apresentaram complicações, a maioria delas relacionadas com o acesso vascular. Quinze pacientes necessitaram de terapia de substituição renal (TSR) secundária à mesma causa que levou à necessidade de TPT; três pacientes necessitaram de TSR em decorrência de outras causas além da intervenção diagnóstica de TPT e um paciente tinha sido submetido à diálise crônica. Conclusões: A TPT é uma alternativa terapêutica que é necessária para o manejo de pacientes com doenc¸as reumáticas com envolvimento renal e daqueles que são refratários ao tratamento convencional. Os resultados clínicos do presente estudo estão de acordo com o que é encontrado na literatura global.Q3Artículo original397-402Introduction: Each day, evidence accumulates related to the use of therapeutic plasma exchange (TPE) in patients with rheumatic diseases. San Ignacio University Hospital has recorded all of the TPE sessions performed by the institution’s apheresis group. Objective: To describe the TPE experience of patients with rheumatologic diseases in a hospital setting. Methods: Descriptive, observational, retrospective analysis. This study included analyses of the TPE sessions that were performed in patients with rheumatic diseases from November 2009 to November 2013. Results: The apheresis group performed 136 sessions in 27 patients. The mean patient age was 43 years (SD 18.5), and 59.3% of the patients were female. Regarding the diagnosis, the most frequents ones where: ANCA-associated vasculitis followed by systemic lupus erythematosus and catastrophic antiphospholipid syndrome. The average number of sessions per patient was 5 (SD 1.8), and the average plasma exchange per patient was 1.3 plasma volume replacement units. The most used replacement solution was frozen fresh plasma (FFP; 63.2% of the sessions). Of all the sessions, 4.4% presented complications, and the majority of the complications were related to vascular access. Fifteen patients required renal replacement therapy (RRT) secondary to the same cause that created the need for TPE, 3 patients required RRT due to causes other than the TPE diagnostic intervention and 1 patient had undergone chronic dialysis. Conclusions: TPE is a therapeutic alternative that is needed for the management of patients with rheumatic diseases with renal involvement and those who are refractory to conventional management. Our clinical results were in agreement with the global literatur

Telehealth and Telemedicine in Latin American Rheumatology, a New Era After COVID-19

Q3Q3Telemedicine is the delivery of health care services by health care professionals using information and communication technologies to exchange valid information for the diagnosis, treatment, and prevention of diseases. Telemedicine was further developed in Latin America during the COVID-19 (coronavirus disease 2019) pandemic, becoming the first line of defense for health professionals to stop the spread of infections and allow them to continue the care of their patients. During the pandemic, 79% of rheumatologists in Latin America reported the use of remote communication, the most frequent being the use of phone calls and WhatsApp voice messages. In contrast, 84% of the patients reported that telemedicine was appropriate for them during the pandemic, but only 54% considered telemedicine to be a valid option for rheumatic health care after the pandemic. Telemedicine and telehealth have advantages such as lower costs, improved access in rural areas, shortage of care providers, and reduction in waiting time for appointments. However, it also has some challenges, such as legal, technological, and organizational barriers. In this review, we explore the current state of telemedicine in Latin America and discuss its future.https://orcid.org/0000-0003-1490-1822Revista Internacional - IndexadaBN

New Tools to Study DNA Double-Strand Break Repair Pathway Choice

A broken DNA molecule is difficult to repair, highly mutagenic, and extremely cytotoxic. Such breaks can be repaired by homology-independent or homology-directed mechanisms. Little is known about the network that controls the repair pathway choice except that a licensing step for homology-mediated repair exists, called DNA-end resection. The choice between these two repair pathways is a key event for genomic stability maintenance, and an imbalance of the ratio is directly linked with human diseases, including cancer. Here we present novel reporters to study the balance between both repair options in human cells. In these systems, a double-strand break can be alternatively repaired by homology-independent or -dependent mechanisms, leading to the accumulation of distinct fluorescent proteins. These reporters thus allow the balance between both repair pathways to be analyzed in different experimental setups. We validated the reporters by analyzing the effect of protein downregulation of the DNA end resection and non-homologous end-joining pathways. Finally, we analyzed the role of the DNA damage response on double-strand break (DSB) repair mechanism selection. Our reporters could be used in the future to understand the roles of specific factors, whole pathways, or drugs in DSB repair pathway choice, or for genome-wide screening. Moreover, our findings can be applied to increase gene-targeting efficiency, making it a beneficial tool for a broad audience in the biological sciences. © 2013 Gomez-Cabello et al.This work has been funded by a R+D+I grant from the Spanish Ministry of Economy and Competitivity (SAF2010-14877) and an European Research Council (ERC) Starting Grant (DSBRECA).Peer Reviewe

New tools to study DNA double-strand break repair pathway choice

A broken DNA molecule is difficult to repair, highly mutagenic, and extremely cytotoxic. Such breaks can be repaired by homology-independent or homology-directed mechanisms. Little is known about the network that controls the repair pathway choice except that a licensing step for homology-mediated repair exists, called DNA-end resection. The choice between these two repair pathways is a key event for genomic stability maintenance, and an imbalance of the ratio is directly linked with human diseases, including cancer. Here we present novel reporters to study the balance between both repair options in human cells. In these systems, a double-strand break can be alternatively repaired by homology-independent or -dependent mechanisms, leading to the accumulation of distinct fluorescent proteins. These reporters thus allow the balance between both repair pathways to be analyzed in different experimental setups. We validated the reporters by analyzing the effect of protein downregulation of the DNA end resection and non-homologous end-joining pathways. Finally, we analyzed the role of the DNA damage response on double-strand break (DSB) repair mechanism selection. Our reporters could be used in the future to understand the roles of specific factors, whole pathways, or drugs in DSB repair pathway choice, or for genome-wide screening. Moreover, our findings can be applied to increase gene-targeting efficiency, making it a beneficial tool for a broad audience in the biological sciences

Social networks and traditional metrics of impact in pulmonary medicine journals: a correlation study

Introduction: The Scimago Journal Rank (SJR) impact factor is extensively used. However, as the Internet has become widely available, new metrics are coming into play. Our research aims to determine whether a correlation  between the SJR impact factor and metrics reflecting social media activity does exist.Materials and methods: We have used pulmonary medicine journals indexed in the SJR. Variables of social network usage have been extracted from verified accounts. Bivariate analyses have been performed with the Mann-Whitney U tests, the correlation between social media-derived variables and the SJR impact factor have been assessed with the Spearman correlation coefficient. Results are presented before and after adjustment for the years since the creation of the accounts.Results: From 130 journals, 38 had at least one social network account, Twitter being the most commonly used (22.85%). The H index was higher in journals with social network accounts (Median 60 vs 17; p < 0.01). The global correlation between the SJR and the number of followers on Twitter revealed moderate agreement (r = 0.46; p < 0.01), which was excellent in open access journals (rs = 0.90; p < 0.05).Conclusions: The use of social networks is directly correlated with traditional indicators of scientific impact. The joint use of alternative and traditional metrics may be useful for journals in order to generate strategies aiming to increase their audience, as well as for researchers when deciding about the best option of disseminating their articles