Infection causes childhood leukemia

This is an open-access article distributed under the terms of the Creative Commons Attribution License.-- Editorial.Peer Reviewe

Effect of the use of heuristics on diagnostic error in Primary Care: Scoping review

Evaluar la evidencia sobre el uso de heurísticos de representatividad, disponibilidad, anclaje y ajuste y exceso de confianza en la práctica clínica real, específicamente en el ámbito de la Atención Primaria. Se seleccionaron 48 estudios que analizaban heurísticos de disponibilidad (26), anclaje y ajuste (9), exceso de confianza (9) y representatividad (8). Resultados: La población de estudio incluía médicos (35,4%), pacientes (27%), residentes (20,8%), enfermeros (14,5%) y estudiantes (14,5%). Los estudios realizados en condiciones reales fueron 17 (35,4%). En 33 de los 48 estudios se observó el empleo del heurístico analizado en la población estudiada (68,7%). El uso de heurísticos durante el proceso diagnóstico fue analizado en 27 estudios (54,1%); en 5 de ellos, el estudio se realizó en escenarios reales (18%). De los 48 estudios, 6 se realizaron en Atención Primaria (12,5%), 3 de los cuales analizaban el proceso diagnóstico: solo en uno de los 3 se analizó el uso de heurístico en condiciones reales, sin demostrar la existencia de sesgo. La evidencia empírica disponible sobre la utilización de heurísticos y su papel en el error diagnóstico en condiciones reales es limitada. En particular, en el caso del proceso de decisión diagnóstica en Atención Primaria la evidencia es prácticamente inexistente.To assess the use of representativeness, availability, overconfidence, anchoring andadjustment heuristics in clinical practice, specifically in Primary Care setting. A total of 48 studies were selected that analyzed availability heuristics(26), anchoring and adjustment (9), overconfidence (9) and representativeness (8).Results: From the 48 studies selected, 26 analyzed availability heuristics, 9 anchoring andadjustment, 9 overconfidence; and 8 representativeness. The study population included physi-cians (35.4%), patients (27%), trainees (20.8%), nurses (14.5%) and students (14.5%). The studiesconducted in clinical practice setting were 17 (35.4%). In 33 of the 48 studies (68,7%) it wasobserved heuristic use in the population studied. Heuristics use on diagnostic process was foundin 27 studies (54.1%); 5 of them (18%) were carried out in clinical practice setting. Of the 48studies, 6 (12,5%) were performed in Primary Care, 3 of which studied diagnostic process: onlyone of them analyzed the use of heuristics in clinical practice setting, without demonstratingbias as consequence of the use of heuristic. The evidence about heuristic use in diagnostic process on clinical practice settingis limited, especially in Primary Care

Calculations of Some Doping Nanostructurations and Patterns Improving the Functionality of High-Temperature Superconductors for Bolometer Device Applications

We calculate the effects of doping nanostructuration and the patterning of thin films of high-temperature superconductors (HTS) with the aim of optimizing their functionality as sensing materials for resistive transition-edge bolometer devices (TES). We focus, in particular, on spatial variations of the carrier doping into the CuO2 layers due to oxygen off-stoichiometry, (that induce, in turn, critical temperature variations) and explore following two major cases of such structurations: First, the random nanoscale disorder intrinsically associated to doping levels that do not maximize the superconducting critical temperature; our studies suggest that this first simple structuration already improves some of the bolometric operational parameters with respect to the conventional, nonstructured HTS materials used until now. Secondly, we consider the imposition of regular arrangements of zones with different nominal doping levels (patterning); we find that such regular patterns may improve the bolometer performance even further. We find one design that improves, with respect to nonstructured HTS materials, both the saturation power and the operating temperature width by more than one order of magnitude. It also almost doubles the response of the sensor to radiationThis work was supported by projects FIS2016-79109-P (AEI/FEDER, UE) and AYA2016-78773-C2-2-P(AEI/FEDER,UE), by the Xunta de Galicia under grants ED431D 2017/06 and ED431C 2018/11, the Consellería de Educación Program for Development of a Strategic Grouping in Materials AeMAT under Grant No. ED431 2018/08, Xunta de Galicia, and by the CA16218 nanocohybri COST Action. JCV thanks the Spanish Ministry of Education for grant FPU14/00838S

Early epigenetic cancer decisions

A cancer dogma states that inactivation of oncogene(s) can cause cancer remission, implying that oncogenes are the Achilles' heel of cancers. This current model of cancer has kept oncogenes firmly in focus as therapeutic targets and is in agreement with the fact that in human cancers all cancerous cells, with independence of the cellular heterogeneity existing within the tumour, carry the same oncogenic genetic lesions. However, recent studies of the interactions between an oncogene and its target cell have shown that oncogenes contribute to cancer development via developmental reprogramming of the epigenome within the target cell. These results provide the first evidence that carcinogenesis can be initiated by epigenetic stem cell reprogramming, and uncover a new role for oncogenes in the origin of cancer. Here we analyse these evidences and discuss how this vision offers new avenues for developing novel anti-cancer interventions.Research in our group is partially supported by FEDER and by MICINN (SAF2012-32810), by NIH grant (R01 CA109335-04A1), by the ARIMMORA project (FP7-ENV-2011, European Union Seventh Framework Program), by Junta de Castilla y Leon (BIO/SA06/13), and by the Deutsche José Carreras Leukämie-Stiftung (DJCLS project 13/26). All Spanish funding is co-sponsored by the European Union FEDER program. ISG is an API lab of the EuroSyStem project and a partner within the Marie Curie Initial Training Network DECIDE (Decision-making within cells and differentiation entity therapies) funded by the European Union’s Seventh Programme under grant agreement n° 315902.Peer Reviewe

Sistemas de geolocalización para el mando y control en el combate en el subsuelo en el horizonte 2035

El objetivo de este trabajo es analizar posibles soluciones al problema que para el mando y control supone la geolocalización de unidades de infantería en el combate en subsuelo, siendo éste uno de los escenarios más habituales contemplados en el empleo de las fuerzas terrestres en el horizonte 2035. Para el cumplimiento de este objetivo es necesaria la consecución de una serie de objetivos parciales que se exponen a continuación:• Conocer el planteamiento que se tiene referente a combate subterráneo en el horizonte 2035 y determinar las necesidades de geolocalización que el mando y control de unidades tiene en este escenario. • Conocer los sistemas de geolocalización en ambiente cerrados que actualmente hay en el mercado. • Analizar las ventajas y limitaciones de los sistemas de geolocalización encontrados para su uso en el mando y control de unidades de infantería en combate en subsuelo. <br /

Effect of femtosecond laser treatment on effectiveness of resin-zirconia adhesive: an in vitro study.

Introduction: When aesthetics is compromised, dental ceramics are excellent materials for dental restorations; owing to their optical properties and biocompatibility, zirconia ceramics are particularly interesting. Self-adhesive resin cements are the most suitable for bonding to zirconia ceramics, but traditional adhesive chemistry is ineffective and surface treatments are required to improve the adhesive bonding between resin and zirconia. The aim of this study was to evaluate the effect of femtosecond laser treatment on the shear bond strength (SBS) of self-adhesive resin cement on zirconia surfaces and to contrast it with other different surface conditioning methods.Methods: Sixty square-shaped zirconia samples were divided randomly into four groups (n = 15) according to their surface conditioning method: the NT group - no surface treatment; the APA25 group - airborne abrasion with 25 μm alumina particles; the TSC group - tribochemical silica coating, and the FS group - femtosecond laser irradiation (800 nm, 4 mJ, 40 fs/pulse, 1 kHz). Self-adhesive resin cements were bonded at the centre of samples, and after 72 hours, they were tested for SBS with a universal testing machine at a crosshead speed of 0.5 mm/min, until fracture. Five zirconia surfaces for each group were subjected to a surface morphology analysis by scanning electron microscopy (SEM). The failure modes were noted and a third of the specimens were prepared to morphological analysis.Results: The NT group showed lower SBS values than the other groups. Femtosecond laser treatment demonstrated higher values than the control and APA25 groups and similar values to those of the TSC group. In the APA25 group, the surface conditioning method had values close to those of the TSC group, but lower than those obtained with femtosecond laser treatment.Conclusion: The treatment of zirconia with femtosecond laser irradiation created a consistent and profound surface roughness, improving the adhesive effectiveness of the zirconia-resin interface

Considerations About Pedagogical and Professional Oral Communicative Competence in English

En el artículo se abordó uno de los problemas más importantes y actuales para el proceso de enseñanza-aprendizaje del inglés como lengua extranjera: la formación y desarrollo de la competencia comunicativa oral profesional pedagógica. Para ello, los autores realizaron una sistematización de los elementos esenciales que han dado tratamiento al tema. Investigación descriptiva, desde una posición crítica y dialéctica permite revelar faltantes a resolver por vía científica que dieron lugar a los resultados de un proyecto de investigación orientado a la didáctica específica del Inglés como segunda lengua. Para la fase de diagnóstico-fáctico: observación científica, se encuestaron a 70 estudiantes seleccionados desde un muestreo aleatorio estratificado de la carrera de Licenciatura en Educación, especialidad Lengua Inglesa, que representa un 35,2% de la población. Una segunda encuesta, se aplicó a 10 profesores de Práctica Integral de la Lengua Ingles y se entrevistaron 20 docentes con experiencia en la Educación Superior Pedagógica El objetivo fundamental radica en el análisis de fundamentos teóricometodológicos sobre las principales categorías pedagógicas de la competencia comunicativa oral profesional pedagógica en inglés, con un enfoque sistémico-comunicativo. Todo lo anterior conforma la novedad de una investigación terminada en la Universidad de Ciencias Pedagógicas de Holguín, en especial en los profesores en formación de inglés.Abstract: The article dealt with one of the most important and updated problems of the teaching-learning process of English as a foreign language: the formation and development of the pedagogical and professional oral communicative competence. To do so, the authors carried out an analysis of different sources which have to do with this theme. Descriptive research, from a position critical and dialectic to reveal missing to resolve through the science that gave rise to the results of a research project aimed at the specific teaching of English as a second language. For the diagnostic - factice phase: scientific observation, surveyed 70 students selected from a random stratified sampling of the Bachelor’s degree in education, English language specialty race, representing 35.2% of the population. A second survey was applied to 10 teachers of comprehensive practice of the English language and interviewed 20 teachers with experience in teaching higher education.The main objective is aimed at the analysis of theoretic-methodological foundations about the main pedagogical categories of the pedagogical and professional oral communicative competence in English, with a systemic-communicative approach. Everything previously stated constitutes the novelty of an investigation concluded in the University of Pedagogical Sciences in Holguín, especially in teachers-to-be of English

Adverse events: an expensive and avoidable hospital problem

Introduction: Adverse healthcare-related events (AE) entail reduced patient safety. Estimating their frequency, characteristics, avoidability and impact is a means to identify targets for improvement in the quality of care. Methods: This was a descriptive observational study conducted within the Patient Safety Incident Study in Hospitals in the Community of Madrid (ESHMAD). The study was conducted in a high-complexity hospital in May 2019 through a two-phase electronic medical record review: (1) AE screening and epidemiological and clinical data collection and (2) AE review and classification and analysis of their impact, avoidability, and associated costs. Results: A total of 636 patients were studied. The prevalence of AE was 12.4%. Death during the stay was associated with the presence of AE (OR [CI95%]: 2.15 [1.07 to 4.52]) versus absence and emergency admission (OR [CI95%]: 17.11[6.63 to 46.26]) versus scheduled. A total of 70.2% of the AEs were avoidable. Avoidable AEs were associated with the presence of pressure ulcers (OR [CI95%]: 2.77 [1.39 to 5.51]), central venous catheter (OR [CI95%]: 2.58 [1.33 to 5.00]) and impaired mobility (OR [CI95%]: 2.24[1.35 to 3.71]), versus absences. They were associated too with the stays in the intensive care unit (OR [CI95%]: 2.75 [1.07 to 7.06]) versus medical service. AEs were responsible for additional costs of €909,716.8 for extra days of stay and €12,461.9 per patient with AE. Conclusions: The prevalence of AEs was similar to that found in other studies. AEs led to worse patient outcomes and were associated with the patient’s death. Although avoidable AEs were less severe, their higher frequency produced a greater impact on the patient and healthcare system.Key messages Adverse events are one of the main problems in healthcare delivery and patients who suffer from at least one AE are double as likely to die during hospitalization. Avoidable adverse events are the most frequent in health care and they are a good target where achieve improvement areas that allow getting optimal patient safety and quality of care levels. Patients hospitalized in the ICU, with the previous presence of pressure ulcers, central venous catheter, or impaired mobility were associated with the development of avoidable AE, so optimal management of these patients would reduce the impact of AE

Materials Science Toolkit for Carbon Footprint Assessment: A Case Study for Endoscopic Accessories of Common Use

[EN] Ironically, healthcare systems are key agents in respiratory-related diseases and estimated deaths because of the high impact of their greenhouse gas emissions, along with industry, transportation, and housing. Based on safety requirements, hospitals and related services use an extensive number of consumables, most of which end up incinerated at the end of their life cycle. A thorough assessment of the carbon footprint of such devices typically requires knowing precise information about the manufacturing process, rarely available in detail because of the many materials, pieces and steps involved during the fabrication. And yet, tools most often used for determining the environmental impact of consumer goods just require a bunch of parameters, mainly based on the material composition of the device. Here we report a basic set of analytical methods that provide the information required by the software OpenLCA to calculate the main outcome related to environmental impact, the greenhouse gas emissions. Through thermogravimetry, calorimetry, infrared spectroscopy and elemental analysis we proved that obtaining relevant data for the calculator in the exemplifying case of endoscopy tooling or accessories is possible. This routine procedure opens the door to a broader, more accurate analysis of the environmental impact of everyday work at hospital services, offering potential alternatives to minimize it.This study has been funded by Instituto de Salud Carlos III (ISCIII) through the project PI21/00193 and cofunded by the European Union. Funding: Instituto de Salud Carlos III (ISCIII), PI21/00193, cofunded by the European Union. And through the project PI2023-6 from UPV-LaFe innovation projects.Martín-Cabezuelo, R.; Vilariño-Feltrer, G.; Campillo Fernandez, AJ.; Lorenzo-Zúñiga, V.; Pons, V.; López-Muñoz, P.; Tort-Ausina, I. (2023). Materials Science Toolkit for Carbon Footprint Assessment: A Case Study for Endoscopic Accessories of Common Use. ACS Environmental Au. https://doi.org/10.1021/acsenvironau.3c0004