Las comunidades rurales, periféricas o urbanas se han incorporado en este milenio como actores vivos de las soluciones a la crisis. Unas con más creatividad, otras más efectivas en resultados y ...algunas fuertes en impacto. En su mayoría, han echado mano a su pasión para encontrar soluciones alternativas incidiendo directamente en los procesos productivos que las organizaciones con y sin fines de lucro han implementado o quisieran implementar. Sin embargo, todas disponen de la tecnología, cualquiera que sea el avance en su entorno, para diseñar y emprender esas ansiadas soluciones. Como resultado primario se logra que la pasión unida a la tecnología sea el común denominador de la innovación y creatividad; por ello las ideas y los valores de quienes emprenden estas soluciones son fundamentales para cambiar el modo de hacer las cosas y los resultados e impacto que necesitan esas comunidades. A las comunidades que emprenden de esta forma se les conoce como nuevas, modernas y proactivas en la búsqueda de caminos más efectivos y más eficientes para satisfacer las necesidades. Desde el siglo pasado, la modernización ha tenido importancia, pero ahora cobran mayor relevancia la invención y el desarrollo de modos distintos de hacer las cosas gracias a velocidad tan vertiginosa con la que se ejecutan.
We propose an experimental arrangement to increase pulse energy in the array of erbium-doped fiber lasers (EDFLs). The experimental setup consists of three coupled periodically modulated multistable ...EDFLs; one master laser and two slave lasers. The master laser is tuned to the coexisting attractor with the largest peak amplitude and synchronizes the slave lasers to maintain them in the same attractor as the master laser. Summing the outputs of the slave lasers we obtain laser pulsations with a double peak intensity. The number of slave lasers can be augmented to further increase the sum peak power.
•A new method for increasing laser pulse energy is proposed.•The method is based on controlling multistability in the array of erbium-doped fiber lasers.•In our experiment with two slave lasers, the pulse energy was amplified by a factor of 40.•Higher amplification can be achieved by increasing the number of slave lasers.
Hydroxychloroquine, a drug commonly used in the treatment of rheumatoid arthritis, has received much negative publicity for adverse events associated with its authorisation for emergency use to treat ...patients with COVID-19 pneumonia. We studied the safety of hydroxychloroquine, alone and in combination with azithromycin, to determine the risk associated with its use in routine care in patients with rheumatoid arthritis.
In this multinational, retrospective study, new user cohort studies in patients with rheumatoid arthritis aged 18 years or older and initiating hydroxychloroquine were compared with those initiating sulfasalazine and followed up over 30 days, with 16 severe adverse events studied. Self-controlled case series were done to further establish safety in wider populations, and included all users of hydroxychloroquine regardless of rheumatoid arthritis status or indication. Separately, severe adverse events associated with hydroxychloroquine plus azithromycin (compared with hydroxychloroquine plus amoxicillin) were studied. Data comprised 14 sources of claims data or electronic medical records from Germany, Japan, the Netherlands, Spain, the UK, and the USA. Propensity score stratification and calibration using negative control outcomes were used to address confounding. Cox models were fitted to estimate calibrated hazard ratios (HRs) according to drug use. Estimates were pooled where the I2 value was less than 0·4.
The study included 956 374 users of hydroxychloroquine, 310 350 users of sulfasalazine, 323 122 users of hydroxychloroquine plus azithromycin, and 351 956 users of hydroxychloroquine plus amoxicillin. No excess risk of severe adverse events was identified when 30-day hydroxychloroquine and sulfasalazine use were compared. Self-controlled case series confirmed these findings. However, long-term use of hydroxychloroquine appeared to be associated with increased cardiovascular mortality (calibrated HR 1·65 95% CI 1·12–2·44). Addition of azithromycin appeared to be associated with an increased risk of 30-day cardiovascular mortality (calibrated HR 2·19 95% CI 1·22–3·95), chest pain or angina (1·15 1·05–1·26), and heart failure (1·22 1·02–1·45).
Hydroxychloroquine treatment appears to have no increased risk in the short term among patients with rheumatoid arthritis, but in the long term it appears to be associated with excess cardiovascular mortality. The addition of azithromycin increases the risk of heart failure and cardiovascular mortality even in the short term. We call for careful consideration of the benefit–risk trade-off when counselling those on hydroxychloroquine treatment.
National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, NIHR Senior Research Fellowship programme, US National Institutes of Health, US Department of Veterans Affairs, Janssen Research and Development, IQVIA, Korea Health Industry Development Institute through the Ministry of Health and Welfare Republic of Korea, Versus Arthritis, UK Medical Research Council Doctoral Training Partnership, Foundation Alfonso Martin Escudero, Innovation Fund Denmark, Novo Nordisk Foundation, Singapore Ministry of Health's National Medical Research Council Open Fund Large Collaborative Grant, VINCI, Innovative Medicines Initiative 2 Joint Undertaking, EU's Horizon 2020 research and innovation programme, and European Federation of Pharmaceutical Industries and Associations.
Several reports have linked, among other aspects, the role of an opioid system in respiratory physiology with underlying mechanisms of panic attacks. The involvement of the opioid system in ...experimental panic is to be further probed. This study aimed to determine whether opioid blockade would increase panic-related symptomatology on provocation with 35% CO2 inhaled by healthy volunteers. Participants in a double-blind, randomised crossover design orally received either 50 mg of naltrexone or placebo. Most subjects undertook a double inhalation of 35% CO2 one hour after pre-medication, and a separate group did so after five hours. The reactivity to CO2 and the symptoms elicited by naltrexone alone were measured. Among other findings, naltrexone pre-medication alone elicited significant increments in panic-related symptoms. Responses to CO2 were not significantly different between conditions in either group. These preliminary findings suggest that exposure to opioid blockade alone can potentially elicit symptoms that resemble panic, however, without modifying the response to experimental panic provocation with 35% CO2.
Several reports have linked, among other aspects, the role of an opioid system in respiratory physiology with underlying mechanisms of panic attacks. The involvement of the opioid system in ...experimental panic is to be further probed. This study aimed to determine whether opioid blockade would increase panic-related symptomatology on provocation with 35% CO2 inhaled by healthy volunteers. Participants in a double-blind, randomised crossover design orally received either 50 mg of naltrexone or placebo. Most subjects undertook a double inhalation of 35% CO2 one hour after pre-medication, and a separate group did so after five hours. The reactivity to CO2 and the symptoms elicited by naltrexone alone were measured. Among other findings, naltrexone pre-medication alone elicited significant increments in panic-related symptoms. Responses to CO2 were not significantly different between conditions in either group. These preliminary findings suggest that exposure to opioid blockade alone can potentially elicit symptoms that resemble panic, however, without modifying the response to experimental panic provocation with 35% CO2.
Summary Background Exhaled NO (FENO ) is a useful biomarker for the monitoring of asthma control and response to therapy. However, there is a lack of data on FENO levels and their interpretation in ...Primary Care asthma population depending on their treatment and smoking habit. Besides, the majority of current FENO tests have been done by stationary chemiluminescence analysers whose use is limited to research laboratories. Methods FENO measurements by the novel hand-held NO monitoring device (NIOX MINO® ) were made in 96 asthma patients (32 males, mean age 53 ± 12) at five local General Practices during their scheduled 15–20 min visits for lung function assessment. Results Success rate was 78% and the intra-subject coefficient of variation was 8.7%. Inhaled corticosteroid treatment had an overall reducing effect on the FENO value (30.5 19.8–49.8) vs. patients not on the ICS (26.5 19–94) ( p < 0.044). FENO levels in the ICS treated current or ex-smokers group of patients were still significantly above the normal values ( p < 0.0001). FENO levels were similar in patients receiving ICS whether there were current, ex-smokers or non-smokers. The highest FENO levels (94 15.8–151) were found in asthmatic current smokers and not receiving treatment with ICS. The most “normalised” FENO levels (35.3 13.5–35.3) were seen in ex-smokers. Conclusions FENO measurements performed with a new hand-held monitoring device are reproducible and feasible in General Practice in the majority of patients of different ages and asthma severities. A high percentage of patients with different severities of asthma and regardless of their treatment with ICS and current smoking habit (current and/or ex-smokers) had highly elevated FENO values, suggesting that their current therapy was possibly insufficient to control the underlying degree of airway inflammation and asthma symptoms.
A monitoring network developed to diagnose early faults in power generators is described. Nowadays, the appropriate operation of generators resides in the information provided by the online ...monitoring system, which is used to implement predictive maintenance for these machines and to provide early warning of potential failures.
In this paper, the configuration of the monitoring system and a detailed study of the measured variables related to their physical behaviour within the generators’ operation are presented. The sensors used and the waveform analysis procedures are explained. Additionally, the architecture that constitutes the application programs and their characteristics as a data network is also described. Finally, some results recorded by the system are shown and discussed.
A new enzymatic process is described. Different preparations of lipase B from Candida antarctica are able to catalyse Michael-type addition of secondary amines to acrylonitrile. This new reaction ...widens the applicability of these biocatalysts in organic synthesis.
The detection of continuous gravitational waves has to deal with the Doppler effect induced by the Earth motion with respect to the source. This frequency shift must be taken into account to recover ...the signal energy as a monochromatic peak with a high signal-to-noise ratio. The correction to be applied to the antenna output depends on the source sky direction, on the source spin and also on the spin-down rate. Since they are, in general, unknown parameters a large computational effort is necessary to correct for any possible value. A correction technique independent of the source frequency is discussed here. The method consists to anticipate or delay the antenna clock by removing or doubling one of its digital signal sample, in order to mantain the clock of the moving observer well locked to the rest one. The method, which requires just a little computational effort, appears to be very effective for "semi-targeted" searches, where the source direction is known but the emission frequency is not.
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