El carbunco es una zoonosis que afecta a animales herbívoros, causada por el microorganismo Bacillus anthracis; que se encuentra en su forma vegetativa en el organismo infectado, y una vez en ...contacto con el aire forma esporas que infectan al huésped, liberando toxinas que inducen edema, septicemia y necrosis tisular. En humanos, la transmisión se produce por cortes, pinchazos o contacto directo de piel lesionada con esporas o tejidos de animales infectados. En Perú, para la década de 1980, se reportaron 400 casos anuales en áreas rurales agrícolas, adquiridos por manipulación del ganado vacuno, muerto por ántrax. Es por ello, que la piel y el cuero procedente de animales infectados representa un riesgo de infección para los trabajadores de industrias curtiembres. Se realizó un estudio transversal para evaluar el riesgo biológico ocupacional y las medidas de bioseguridad relacionadas con el Bacillus anthracis en pequeñas, medianas y grandes empresas curtiembres peruanas. Se aplicó un instrumento a los trabajadores para cuantificar las variables, componentes de riesgo biológico y conocer las medidas higiénicas adoptadas. Posteriormente se calculó e interpretó el nivel de riesgo biológico. Se encontró que el nivel de riesgo supera el límite de exposición biológica para el Bacillus anthracis en todas las empresas evaluadas y los trabajadores de las pequeñas empresas tienen poco conocimiento acerca del riesgo biológico al que están expuestos, siendo necesaria la capacitación de los trabajadores acerca del Bacillus anthracis y adopción de medidas de bioseguridad en empresas curtiembres, que garanticen la salud de los trabajadores.
En los últimos años, numerosos han sido los estudios sobre las competencias y las estrategias que los jóvenes desarrollan en los entornos digitales y en su relación con las franquicias culturales en ...el seno de sus universos transmedia. Este artículo, de tipo eminentemente teórico, tiene como objetivo ofrecer un análisis crítico sobre la mercantilización de la creatividad que los jóvenes despliegan en la Red. Los entornos digitales ofrecen escasas posibilidades de democratización del discurso público. La producción mediática de los jóvenes online suele estar basada en actos de falsa participación, ya que sus posibilidades de influencia son muy limitadas. A la vez, sus acciones en estos entornos digitales sirven para el sustento del capitalismo cognitivo a través de procesos de alienación y trabajo gratis que tienen como resultado la aparición de un feudalismo informacional que transfiere los bienes generados por la cultura juvenil desde el intelecto colectivo a las manos privadas.
OBJECTIVE:To develop guidelines for Musculoskeletal Ultrasound (MSKUS) training for rheumatologists in the Americas.
METHODS:A total of 25 Rheumatologists from 19 countries of the American Continent ...participated in a consensus-based interactive process (Delphi method) using 2 consecutive electronic questionnaires. The first questionnaire included the followingthe relevance of organizing courses to teach MSKUS to Rheumatologists, the determination of the most effective educational course models, the trainee levels, the educational objectives, the requirements for passing the course(s), the course venues, the number of course participants per instructor, and the percentage of time spent in hands-on sessions. The second questionnaire consisted of questions that did not achieve consensus (>65%) in the first questionnaire, topics, and pathologies to be covered at each course MSKUS level.
RESULTS:General consensus was obtained for MSKUS courses to be divided into 3 educational levelsbasic, intermediate, and advanced. These courses should be taught using a theoretical-didactic and hands-on model. In addition, the group established the minimum requirements for attending and passing each MSKUS course level, the ideal number of course participants per instructor (4 participants/instructor), and the specific topics and musculoskeletal pathologies to be covered. In the same manner, the group concluded that 60% to 70% of course time should be focused on hands-on sessions.
CONCLUSION:A multinational group of MSKUS sonographers using a consensus-based questionnaire (Delphi method) established the first recommendations and guidelines for MSKUS course training in the Americas. Pan-American League of Associations for Rheumatology urges that these guidelines and recommendations be adopted in the future by both national and regional institutions in the American continent involved in the training of Rheumatologists for the performance of MSKUS.
Purpose: To report a case of Coats’ disease managed with the dexamethasone intravitreal implant Ozurdex® (Allergan, Inc., Irvine, Calif., USA) combined with retinal photocoagulation. Methods: A ...46-year-old female with 20/200 visual acuity was diagnosed with Coats’ disease with secondary retinal vasoproliferative tumor. An initial approach was performed with an intravitreal injection of the sustained-release dexamethasone implant Ozurdex. After reattachment of the retina, the telangiectatic vessels were treated with laser photocoagulation. Results: The patient’s visual acuity improved to 20/25 after the intravitreal Ozurdex. No further recurrences of exudation were evident through the 12-month follow-up. Conclusions: Ozurdex may be an effective initial therapeutic approach for Coats’ disease with immediate anatomical response and visual improvement.
Abstract
Various constraints of Static Random Access Memory (SRAM) are leading to consider new memory technologies as candidates for building on-chip shared last-level caches (SLLCs). Spin-Transfer ...Torque RAM (STT-RAM) is currently postulated as the prime contender due to its better energy efficiency, smaller die footprint and higher scalability. However, STT-RAM also exhibits some drawbacks, like slow and energy-hungry write operations that need to be mitigated before it can be used in SLLCs for the next generation of computers. In this work, we address these shortcomings by leveraging a new management mechanism for STT-RAM SLLCs. This approach is based on the previous observation that although the stream of references arriving at the SLLC of a Chip MultiProcessor (CMP) exhibits limited temporal locality, it does exhibit reuse locality, i.e. those blocks referenced several times manifest high probability of forthcoming reuse. As such, conventional STT-RAM SLLC management mechanisms, mainly focused on exploiting temporal locality, result in low efficient behavior. In this paper, we employ a cache management mechanism that selects the contents of the SLLC aimed to exploit reuse locality instead of temporal locality. Specifically, our proposal consists in the inclusion of a Reuse Detector (RD) between private cache levels and the STT-RAM SLLC. Its mission is to detect blocks that do not exhibit reuse, in order to avoid their insertion in the SLLC, hence reducing the number of write operations and the energy consumption in the STT-RAM. Our evaluation, using multiprogrammed workloads in quad-core, eight-core and 16-core systems, reveals that our scheme reports on average, energy reductions in the SLLC in the range of 37–30%, additional energy savings in the main memory in the range of 6–8% and performance improvements of 3% (quad-core), 7% (eight-core) and 14% (16-core) compared with an STT-RAM SLLC baseline where no RD is employed. More importantly, our approach outperforms DASCA, the state-of-the-art STT-RAM SLLC management, reporting—depending on the specific scenario and the kind of applications used—SLLC energy savings in the range of 4–11% higher than those of DASCA, delivering higher performance in the range of 1.5–14% and additional improvements in DRAM energy consumption in the range of 2–9% higher than DASCA.
The knowledge of the mechanisms underlying the adhesive processes that lead to homing and/or mobilization of hematopoietic progenitor cells, and the influence of blood rheology, is still limited. We ...analyzed the impact of flow conditions on the adhesion of CD34
+ peripheral blood progenitor cell (PBPC) to the adhesive proteins fibronectin, laminin, and collagen, and to stromal cells.
Under static conditions, all the adhesive substrata assayed promoted adhesion of CD34
+ PBPC, being higher on the stromal cells. Under flow conditions, adhesion of CD34
+ PBPC was remarkable on stromal cells while insignificant onto the purified proteins. Exposure of stromal cell monolayers to granulocyte colony-stimulating factor (G-CSF) further enhanced PBPC adhesion. This effect correlated with the activation of p38 MAPK and with an increase in the expression of VCAM-1 on stromal cells exposed to G-CSF. In inhibitory assays, both an antibody to the G-CSFR and a specific inhibitor of the p38 MAPK blocked the effects induced by the cytokine.
Our results provide direct evidence that in stromal cells G-CSF activates the signaling protein p38 MAPK, inducing expression of the adhesion receptor VCAM-1. This mechanism seems to promote adhesion of CD34
+ cells on stromal cells and could play a potential role in homing events.
In recent years, several studies have analysed the skills and strategies that young people develop in digital environments and their relationship with cultural franchises within their transmedia ...universes. This article, clearly theoretical, aims to offer a critical analysis of the commodification of the creative work that young people produce on the web. Digital environments offer few possibilities for democratising public discourse. The online media production of teenagers is usually based on acts of false participation, since their possibilities of influence are very limited. At the same time, their actions in these digital environments are used to sustain a model of cognitive capitalism through processes of alienation and free labour that result in the advent of an information feudalism that transfers the goods of youth culture from the collective intellect into private hands. Keywords Youth culture; empowerment; commodification; fans; participatory culture; transliteracy.
The idiopathic retinitis, vasculitis, aneurysms and neuroretinitis syndrome is a rare retinal vascular disorder characterized by multiple leaking aneurysmal dilations, retinal vasculitis, ...neuroretinitis and peripheral vascular ischemia. Visual loss mainly occurs due to the development of retinal neovascularization and/or exudative maculopathy. Although the treatment of choice has not yet been established, retinal photocoagulation seems to be the best option to control the disease and to prevent its progression. Herein, we report a case of idiopathic retinitis, vasculitis, aneurysms and neuroretinitis syndrome with both retinal neovascularization and macular exudation successfully managed with intravitreal ranibizumab (Lucentis®) as adjunctive therapy to retinal photocoagulation.
Background
To study the visual outcomes of neovascular AMD (nAMD) treated with anti‐vascular endothelial growth factor (VEGF) drugs at national level.
Methods
Multicenter national database of nAMD ...eyes treated with anti‐VEGF intravitreal injections (ranibizumab, aflibercept, bevacizumab) in fixed bimonthly (FB) or treat‐and‐extend (TAE) regimens. Demographics, visual acuity (VA) in logarithm of the minimum angle of resolution (logMAR) ETDRS letters at baseline and subsequent visits, number of injections and visits data were collected using a validated web‐based tool (Fight Retinal Blindness!).
Results
1273 eyes (1014 patients) were included, 971 treatment naïve (TN) and 302 previously treated (PT). Baseline VA (mean ± SD) was 57.5 (±19.5) and 62.2 (±17) (p > 0.001), and 24 months final VA was 60.4 (±21.2) and 58.8 (±21.1) (p = 0.326), respectively. Mean VA change at 12/24 months was +4.2/+2.9 letters in TN eyes and +0.1/−3.4 letters in PT eyes (p < 0.001/p < 0.001). The percentage of ≥15 letters gainers/losers at 24 months was 24.8%/14.5% in TN, and 10.3%/15.7% in PT eyes. The median number of injections/visits at 12 months was 7/9 in TN and 6/8 in PT (p = 0.002/p < 0.001) and at 24 months was 11/16 in TN and 11/14 in PT (p = 0.329/p < 0.001). Study drugs included ranibizumab (39.5%), aflibercept (41.2%) and bevacizumab (19.3%).
Conclusion
Independent, large‐scale national audits are feasible if committed health care professionals are provided with efficient information technology systems to do them. The results described here represent an adequate measurement of the quality of care delivered nationwide and benchmark the clinical management of nAMD at a country level compared to other real‐world international cohorts.
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