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Julia Sabin,1 Elisa Salas,2 Jesús Martín-Martínez,3 Antonio Candeliere-Merlicco,4 Francisco Javier Barrero Hernández,5 Ana María Alonso Torres,6 José Luis Sánchez-Menoyo,7 Laura Borrega,8 María Rodríguez-Rodríguez,9 Montserrat Gómez-Gutiérrez,10 Sara Eichau,11 Miguel Ángel Hernández-Pérez,12 Carmen Calles,13 Eva Fernandez-Diaz,14 Olga Carmona,15 Aida Orviz,16 Ana López-Real,17 Pablo López-Muñoz,18 Amelia Mendoza Rodríguez,19 Eduardo Aguera-Morales,20 Jorge Maurino2 1Department of Neurology, Hospital Universitario Puerta de Hierro, Madrid, Spain; 2Medical Department, Roche Farma, Madrid, Spain; 3Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, Spain; 4Department of Neurology, Hospital Rafael Méndez, Lorca, Spain; 5Department of Neurology, Hospital Clínico Universitario San Cecilio, Granada, Spain; 6Department of Neurology, Hospital Regional Universitario de Málaga, Málaga, Spain; 7Department of Neurology, Hospital de Galdakao-Usansolo, Galdakao, Spain; 8Department of Neurology, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain; 9Department of Neurology, Hospital Universitario Lucus Augusti, Lugo, Spain; 10Department of Neurology, Hospital San Pedro de Alcántara, Cáceres, Spain; 11Department of Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain; 12Department of Neurology, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain; 13Department of Neurology, Hospital Universitario Son Espases, Palma de Mallorca, Spain; 14Department of Neurology, Hospital Universitario de Albacete, Albacete, Spain; 15Department of Neurology, Fundació Salut Empordà, Figueres, Spain; 16Department of Neurology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; 17Department of Neurology, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; 18Department of Neurology, Hospital Arnau de Vilanova, Llíria, Spain; 19Department of Neurology, Complejo Asistencial de Segovia, Segovia, Spain; 20Department of Neurology, Hospital Universitario Reina Sofía, Córdoba, SpainCorrespondence: Jorge Maurino, Ribera del Loira 50, Madrid, 28042, Spain, Tel + 34 913 24 81 00, Email jorge.maurino@roche.comPurpose: Shared decision-making is critical in multiple sclerosis (MS) due to the uncertainty of the disease trajectory over time and the large number of treatment options with differing efficacy, safety and administration characteristics. The aim of this study was to assess patients’ decisional conflict regarding the choice of a disease-modifying therapy and its associated factors in patients with mid-stage relapsing-remitting multiple sclerosis (RRMS).Methods: A multicenter, non-interventional study was conducted. Adult patients with a diagnosis of RRMS (2017 revised McDonald criteria) and disease duration of 3 to 8 years were included. The level of uncertainty experienced by a patient when faced with making a treatment choice was assessed using the 4-item Decisional Conflict Scale. A battery of patient-reported and clinician-rated measures was administered to obtain information on symptom severity, illness perception, illness-related uncertainty, regret, MS knowledge, risk taking behavior, preferred role in the decision-making process, cognition, and self-management. Patients were recruited during routine follow-up visits and completed all questionnaires online using electronic tablets at the hospital. A multivariate logistic regression analysis was conducted.Results: A total of 201 patients were studied. Mean age (Standard deviation) was 38.7 (8.4) years and 74.1% were female. Median disease duration (Interquartile range) was 6.0 (4.0– 7.0) years. Median EDSS score was 1.0 (0– 2.0). Sixty-seven (33.3%) patients reported a decisional conflict. These patients had lower MS knowledge and more illness uncertainty, anxiety, depressive symptoms, fatigue, subjective symptom severity, a threatening illness perception, and poorer quality of life than their counterparts. Lack of decisional conflict was associated with MS knowledge (Odds ratio [OR]=1.195, 95% CI 1.045, 1.383, p=0.013), self-management (OR=1.049, 95% CI 1.013, 1.093, p=0.018), and regret after a healthcare decision (OR=0.860, 95% CI 0.756, 0.973, p=0.018) in the multivariate analysis.Conclusion: Decisional conflict regarding the selection of a disease-modifying therapy was a common phenomenon in patients with mid-stage RRMS. Identifying factors associated with decisional conflict may be useful to implement preventive strategies that help patients better understand their condition and strengthen their self-management resources.Keywords: multiple sclerosis, disease-modifying therapies, decision-making, decisional conflict, disease-related knowledge, self-management

The structure and properties of ethylene-co-vinyl acetate (EVA) and poly(3-hydroxybutyrate) (PHB) blends depended on their PHB content, i.e. PHB phase dominated the structure for amounts of PHB higher than 50 wt%, whereas EVA phase is dominant for PHB content lower than 50 wt%. EVA/PHB (70:30) blend showed unexpected different structure because of higher miscibility and the creation of new interfacial interactions between C=O and CH3 groups of PHB and CH3 and C=O groups of EVA, these interactions led changing of the phase structure of ethylene and vinyl acetate domains in EVA. As a consequence, improved thermal, viscoelastic and morphological properties were obtained. EVA+PHB blends containing 60 wt% or more PHB did not show tack and, interestingly, the addition of 20-30 wt% PHB enhanced the tack and displaced the maximum tack of pure EVA to lower temperature. The tack of EVA/PHB (70:30) blend was the highest among all blends because of its particular structure, fibrillation was also shown. Finally, the adhesion of EVA+PHB blends containing 20-30 wt% PHB to polypropylene (PP) substrate was higher than the one of pure EVA because of the interactions between the ethylene domains in EVA phase of the blend and PP substrate surface. [ABSTRACT FROM AUTHOR]

The curing process, wear behavior, and mechanical properties of an epoxy adhesive filled with boron carbide (B4C) were studied. Two different particle sizes and amount of reinforcing B4C were tested. One advantage of using B4C is its ability to absorb neutrons, a property of great importance in the nuclear industry. Gel time and degree of curing were measured to evaluate the effect of adding B4C to the epoxy resin. The chemical structure was studied by Fourier Transform Infrared Spectroscopy (FTIR) and the B4C distribution was analyzed by laser confocal microscopy. Dynamic Mechanical Thermal Analysis (DMTA) tests were also carried out to monitor the viscoelastic properties and the glass transition temperature (Tg) of the cured reinforced epoxy. The wear resistance against alumina was measured using a pin-on-disc test, evaluated as mass loss. The wear tracks were studied by Scanning Electron Microscopy (SEM). The bending strength was also studied to assess the degree of interaction between the B4C and the matrix. The results showed that the reinforced epoxy with B4C was very abrasive, wearing the alumina. The reinforced epoxy had excellent mechanical properties that increased with B4C content and with small particles. Moreover, the Tg value decreased slightly upon B4C addition. [ABSTRACT FROM AUTHOR]

To investigate the impact of gate oxide degradation and breakdown (BD) on complimentary metal-oxide-semiconductor circuit functionality, an accurate description of the electrical characteristics of the stressed devices, which can be included in circuit simulators, is needed. In this paper, a description of the stressed device performance that considers, on the one hand, the variation of the channel current and, on the other, the increase in the gate current due to the oxide degradation and BD is presented, which is able to account for different levels of oxide damage. The parameters extracted from device experimental data have been introduced in a circuit simulator to evaluate the effect of the oxide degradation and BD on simple analog (current mirror) and digital [reset set (RS) latches] circuits. The impact of the increase in the gate leakage current and the variation of the conduction along the metal-oxide-semiconductor field-effect transistor channel due to the oxide degradation on the circuit performances has been separately analyzed. [ABSTRACT FROM AUTHOR]

Introduction: Residual pleural cavities are pleural spaces caused by a lack of pulmonary reexpansion mainly secondary to pleural infections or thoracic surgeries. If they can not be solved with first line treatments (thoracic drainage, fibrinolytics or surgical decortication), these can become cronic and complicate. Material and Methods: Retrospective descriptive study of patients with complicated residual pleural cavities at the Thoracic Surgery Service of the “Complejo Hospitalario Universitario de Albacete” from November 2004 to May 2015. Results: Sixty-three patients were diagnosed, showing that incidence was more frequent in men (n=57; 90.5%). 16.27% of the surgeries treated within this period were secondary to this pathology. The infectious pathology was the most frequent (n = 35; 55.6%), whereas within the postoperative group, it was pneumonectomy (n = 8; 42.1%), with 190.7 days in average from surgical intervention to the diagnosis. In 43 patients (68.3%), the pleural fluid culture was positive. In 17 patients (27%), it was associated with a bronchopleural fistula. From the 63 patients, 16 (25.4%) received a single surgical treatment (25.4%), while 47 (74.6%) required more than one treatment. In 39 cases (61.9%), the complicated pleural cavity was resolved, whereas in 24 (38.1%) patients it wasn’t. Conclusions: Despite it being a rare pathology, it is still present today, mainly as a post-surgical or infectious complication. To date, the treatments described haven’t exhibited high efficacy.

Two ethylene vinyl acetate (EVA) copolymers (12 and 20 wt% of vinyl acetate,VA, content) have been treated with low pressure RF plasmas from non-oxidizing gases (Ar, N[sub 2]) and oxidizing gases (air, a mixture of 4N[sub 2]: 6O[sub 2] (v/v), O[sub 2] and CO[sub 2]). The formation of polar moieties on both EVAs was more noticeable by treatment with plasmas from non-oxidizing gases than from oxidizing ones (the higher the reactivity, the lower the difference with respect to untreated EVA surfaces). The surface etching with the non-oxidizing plasmas, giving rise to a high roughness, depends on the wt% of VA in the composition of the copolymer because of the different resistances of VA (low) and PE (high) to the non-oxidizing plasma particles bombardment. The adhesion properties obtained using a polyurethane adhesive (PU) showed high T-peel strength values and adhesion failure in EVAs treated with plasmas from oxidizing gases, due to roughness produced causing mechanical interlocking of the adhesive. Lower T-peel strength values were obtained with non-oxidizing plasmas: the values for EVA12 being, in general, lower than those obtained for EVA20. The durability of the treated EVAs/PU adhesive joints after ageing in humidity and temperature was quite good. [ABSTRACT FROM AUTHOR]