Contributors:Paula Awamleh, Raquel Casado, Rebeca Mata
Se presenta un caso de manejo complicado y decisiones difíciles. Un paciente con antecedente de disección aórtica tipo A y dilatación residual de la aorta descendente de hasta 60mm es ingresado por un síndrome coronario agudo sin elevación del ST. La coronariografía pone de manifiesto una marcada ectasia coronaria y unos defectos de perfusión de dudoso origen. ¿Trombos o falsas imágenes por flujo muy lentificado? Asumiendo que pudiera tratarse de trombos, el paciente es tratado con anticoagulación repitiéndose la coronariografía al cabo de dos meses. En este segundo estudio se observa la completa desaparición de las imágenes, confirmándose el origen trombótico de las mismas. En este momento se plantea ¿cuál debe ser el tratamiento crónico del paciente? No hay evidencia científica disponible acerca del tratamiento de la ectasia coronaria y se trata de un paciente de alto riesgo por su antecedente de disección aórtica. Finalmente se decide, de forma empírica, mantener la anticoagulación de forma indefinida. Tras dos años y seis meses de seguimiento no ha habido incidencias clínicas.
Contributors:Manuel Alcaraz-Castaño, Mario López-Recio, Fernando Tapias, Felipe Cuartero, Javier Baena, Blanca Ruiz-Zapata, Jorge Morín, Alfredo Pérez-González, Manuel Santonja
The recent excavations (2008–2009) conducted at the open-air site of Las Delicias, located in the Manzanares River valley (Madrid), have revealed new important data for the understanding of the human settlement of Central Iberia during Solutrean times. In this paper, we present a geomorphological and taphonomic study of the Pleistocene deposits of Las Delicias, a technological analysis focused on the bifacial lithic reduction processes documented at the site, new Optically Stimulated Luminescence dates, and new palynological data. Together with the existence of numerous Solutrean lithic assemblages from the early 20th century excavations of the Manzanares terraces, these new data highlight the importance of the Manzanares valley as a focus of Solutrean settlement, not only related to flint procurement but also to foraging activities. Moreover, they require reconsideration of Central Iberia as a virtually unpopulated region during the Late Pleniglacial (MIS 2), and of the associated idea of its cultural dependence on the coastal areas of the Iberian Peninsula. We propose new avenues of research aimed at approaching the central region of Iberia in its own cultural and ecological terms.
Contributors:S. Wade Taylor, Christina Psaros, David W. Pantalone, Jake Tinsley, Steven A. Elsesser, Kenneth H. Mayer, Steven A. Safren
One dramatic advance in human immunodeficiency virus (HIV) prevention efforts has been the prescription of medications typically used for HIV treatment as prophylaxis against acquiring HIV. As a preventative agent, this practice is referred to as “preexposure prophylaxis” (PrEP). The U.S. Federal Drug Administration approved daily PrEP for adults at risk for HIV who do not consistently use condoms during sex with HIV-infected or unknown-status partners. In this paper, we describe a cognitive-behavioral therapy (CBT) PrEP adherence intervention developed for use in high-risk sexual-minority men in the United States, adapted from “Life-Steps,” an evidence-based CBT intervention to promote adherence to HIV treatment. Modules include creating a PrEP dosing schedule, adhering to daily PrEP, problem solving barriers to adherence, and sexual risk-reduction techniques. Supplemented with practical video vignettes, this novel intervention may help to enhance the clinical practice of health care providers in outpatient settings to increase PrEP adherence in sexual-minority men.
Contributors:S. Martínez-Fernández, X. Franch, J. Bisbal
Nowadays, lots of service providers offer predictive services that show in advance a condition or occurrence about the future. As a consequence, it becomes necessary for service customers to select the predictive service that best satisfies their needs. The QuPreSS reference model provides a standard solution for the selection of predictive services based on the quality of their predictions. QuPreSS has been designed to be applicable in any predictive domain (e.g., weather forecasting, economics, and medicine). This paper presents Mercury, a tool based on the QuPreSS reference model and customized to the weather forecast domain. Mercury measures weather predictive services' quality, and automates the context-dependent selection of the most accurate predictive service to satisfy a customer query. To do so, candidate predictive services are monitored so that their predictions can be eventually compared to real observations obtained from a trusted source. Mercury is a proof-of-concept of QuPreSS that aims to show that the selection of predictive services can be driven by the quality of their predictions. Throughout the paper, we show how Mercury was built from the QuPreSS reference model and how it can be installed and used.
Contributors:Kyle L. Gobrogge, Xixi Jia, Yan Liu, Zuoxin Wang
The neuropeptides vasopressin and corticotropin-releasing hormone facilitate, while serotonin inhibits, aggression. How the brain is wired to coordinate interactions between these functionally opposed neurotransmitters to control behavioral states is poorly understood.
The effects of cannabinoids in brain areas expressing cannabinoid receptors, such as hypothalamic nuclei, are not yet well known. Several studies have demonstrated the role of hypothalamic nuclei in the organisation of behavioural responses induced through innate fear and panic attacks. Panic-prone states are experimentally induced in laboratory animals through a reduction in the GABAergic activity. The aim of the present study was to examine panic-like elaborated defensive behaviour evoked through GABAA receptor blockade with bicuculline (BIC) in the dorsomedial division of the ventromedial hypothalamus (VMHdm). We also aimed to characterise the involvement of endocannabinoids and the CB1 cannabinoid receptor in the modulation of elaborated defence behavioural responses organised through the VMHdm. The guide-cannula was stereotaxicaly implanted in VMHdm and the animals were treated with anandamide (AEA) at different doses, and the effective dose was used after the pre-treatment with the CB1 receptor antagonist AM251, followed by GABAA receptor blockade in VMHdm. The results showed that the intra-hypothalamic administration of AEA at an intermediate dose (5 pmol) attenuated defence responses induced through the intra-VMHdm microinjection of bicuculline (40 ng). This effect, however, was prevented through the pre-treatment of the VMHdm with the CB1 receptor antagonist AM251. Moreover, AM251 potentiates de non-oriented escape induced by bicuculline, effect blocked by pre-treatment with the TRPV1 channel antagonist 6-I-CPS. These results indicate that AEA modulates the pro-aversive effects of intra-VMHdm-bicuculline treatment, recruiting CB1 cannabinoid receptors and the TRPV1 channel is involved in the AM251-related potentiation of bicuculline effects on non-oriented escape behaviour.
Contributors:T. Felgentreff, M. Perscheid, R. Hirschfeld
Distributed applications are hard to debug because timing-dependent network communication is a source of non-deterministic behavior. Current approaches to debug non-deterministic failures include post-mortem debugging as well as record and replay. However, the first impairs system performance to gather data, whereas the latter requires developers to understand the timing-dependent communication at a lower level of abstraction than they develop at. Furthermore, both approaches require intrusive core library modifications to gather data from live systems.
Surface-tension-driven capillary systems (CSs) enable self-powered delivery of samples and reagents for bioassays and thus are especially suitable for point-of-care applications. Current silicon and polymer based CSs require extensive work in professional cleanroom for the fabrication of either the silicon device itself or the micromold for polymer processing. In this work, we fabricated a PEG-based CS in a one-step photopolymerization process without the requirement of any cleanroom work. Water, buffer and serum can flow autonomously in this CS and the liquid flow rate can be tuned by modification with surfactant solution of different concentrations. We further integrated an antibody-coated microbead array into this CS for the autonomous immunoassay of two tumor markers, prostate specific antigen (PSA) and human chorionic gonadotropin (hCG), in serum samples with a total assay time of less than 10min. The detection limits for the two tumor markers were at sub-nanogram per milliliter range which is lower than their clinical threshold concentrations for cancer diagnosis. Moreover, simultaneous and multiplex detection of the two tumor markers was also achieved by using spatially encoded microbeads. This low cost and easy-fabricated CS enables fast, multiplex and autonomous immunoassay for protein markers and has the potential to be applied for point-of-care diagnostics on real clinical samples.
Contributors:Aref Yadollahi, Nima Shamsaei, Scott M. Thompson, Alaa Elwany, Linkan Bian
The effects of building orientation and post-fabrication heat treatment (solution annealing plus peak-aging) on fully-reversed strain-controlled fatigue behavior of 17-4 precipitation hardening (PH) stainless steel (SS) fabricated via Selective Laser Melting (SLM) is investigated. For this particular alloy, post-SLM heat treatment was found to be necessary in order to improve its tensile strength and fatigue behavior in low cycle fatigue (LCF), where the effects of microstructural impurities are less pronounced. However, the selected heat treatment was found to have detrimental influence on the SLM 17-4 PH SS high cycle fatigue (HCF) performance. The heat treatment resulted in precipitation hardening, allowing the SLM parts to become more sensitive to impurities in HCF, where the crack initiation stage dominates the total fatigue lifetime. Building orientation played a significant role on fatigue behavior in both LCF and HCF, owing to the relative orientation of deposited layers with respect to applied load. Un-melted regions (i.e. inter-layer cavities/voids), resulting from insufficient fusion or low laser penetration depth, were found to be the most detrimental type of defects on fatigue strength of SLM 17-4 PH SS due to their relatively large size and irregular shape. These specific regions that formed during fabrication of vertically-orientated samples were more detrimental than those of horizontally-built ones as they provided more stress concentration under loading, leading to lower fatigue strength. Although the process parameters were optimized based on maximizing density, the results of this study imply that this criterion is not sufficient for improving fatigue behavior, as the split-shaped un-melted regions, containing a large area with small volume, cannot be taken into account through conventional density measurements.
The reconfigurable cube mechanism (RCM) is a puzzle linkage made by eight connected sub-cubes. It is equivalent to a single-loop 8R spatial linkage with eight different topological configurations and changeable mobility. Unlike other common reconfigurable mechanisms, the topological configuration of the RCM is featured not only by its “relative joint orientations” but also the “relative joint distances.” These two topological properties, namely “orientation isomorphism” and “distance isomorphism” in this study, completely define the configuration isomorphism of the RCM. We will present a unified screw-based approach for the mobility analysis and the configuration isomorphism identification of the RCM. Two illustrative examples are provided for demonstrating the isomorphism identification of this special mechanism. The first example will show that two topologically identical RCMs may be seemingly significantly different in their appearance. Oppositely, the second example will demonstrate that two plausibly identical RCMs may have identical relative joint orientations but their relative joint distances are completely distinct.