Análisis crítico de la cirugía de la válvula tricúspide

ResuménLa insuficiencia tricúspide funcional significativa está presente en el 30% de los pacientes sometidos a cirugía valvular mitral. Se produce por dilatación del anillo y restricción de los velos secundaria a disfunción del ventrículo derecho. En la actualidad se sabe que la reparación tricúspide mejora la supervivencia y la clase funcional en los pacientes con insuficiencia significativa; sin embargo, continúa la controversia en aquellos pacientes con insuficiencia leve o moderada. En la presente revisión se comentan los actuales criterios para la reparación tricúspide concomitante con lesiones valvulares izquierdas. Se recomienda la realización de anuloplastia tricúspide en función de parámetros de dilatación anular y disfunción del ventrículo derecho independientemente del grado de insuficiencia.Abstractsignificant functional tricuspid regurgitation is present in 30% of patients submitted to mitral valve surgery. this is due to annular dilatation and leaflet tethering secondary to right ventricular dysfunction. Currently, there is evidence suggesting that tricuspid valve repair improves survival and functional class in patients with significant regurgitation. Nevertheless, there is still some controversy about the need for repair in those patients having mild or moderate insufficiency. In this review, we discuss the present criteria for concomitant tricuspid valve repair in left-sided valvular lesions. The practice of tricuspid valve repair is recommended according to criteria of annular dilatation and right ventricular dysfunction, regardless of the grade of regurgitation

Mes de nacimiento y éxito en el fútbol. Estudio del Efecto Relativo de la Edad en el fútbol guipuzcoano

Los niños nacidos más tarde dentro del año competicional sufren de menores posibilidades de promoción, debido a su menor grado de madurez física, mental y emocional. Este fenómeno, conocido como Efecto Relativo de la Edad o RAE, se estudia en el fútbol guipuzcoano y estatal, evaluando posibles los mecanismos físicos implicados. Se discuten las consecuencias del RAE, los posibles remedios y las nuevas líneas de investigación abiertas.Lehiaketa urtearen barnean beranduago jaiotako haurrek promozio aukera gutxiago izaten dute, beren gorputz, adimen eta emozio heldutasun maila txikiagoa dela eta. Fenomeno hori, Adinaren Eragin Erlatiboa (RAE) izenez ezagutzen dena, Gipuzkoako eta estatuko futbolean aztertzen ari da, tartean liratekeen mekanismo fisikoak ebaluatzen ari direlarik. RAEren ondorioak, litezkeen konponbideak eta zabalduriko ikerketa lerro berriak eztabaidatzen dira lan honetan.Les enfants nés plus tard dans l'année ont moins de possibilité de promotion, à cause de leur moindre maturité physique, mentale et émotionnelle. Ce phénomène, connu comme Effet Relatif de l'Age ou RAE, est étudié dans le football de Guipuzcoa et national, en évaluant les mécanismes physiques possibles impliqués. On parle des conséquences du RAE, les remèdes possibles et les nouvelles voies de recherche ouvertes.Children born later on during the competitional year have lesser possibilities of promotion, due to their lesser degree of physical, mental and emotional maturity. This phenomenon, better known as the Relative Age Effect or RAE, is studied in Gipuzkoan and Spanish soccer. In this context, the physical in mechanisms involved are evaluated. The consequences of RAE are discussed, as are the possible remedies and new lines of research

Uso y abuso de esteroides anabolizantes

Los esteroides anabolizantes son derivados sintéticos de la hormona testosterona, que se utilizan ampliamente, desde la primera juventud hasta la vejez, tanto con fines deportivos como con el ánimo de lograr una imagen corporal atlética. Su consumo se asocia con la aparición de efectos secundarios, en algunos casos graves e irreversibles, un riesgo que es desconocido por la mayor parte de los usuarios. Muchos suplementos deportivos están contaminados con estas substancias.Esteroide anabolizatzaile gehienak testosterona eta hazkunde hormonaren eratorri sintetikoak dira. Asko erabiltzen dira kirolean eta kiroletik kanpo, irudi atletikoa lortzeko. Bere kontsumoak albo ondorioak ekartzen ditu, askotan larriak eta atzeraezinak, baino jende gutxik identifikatu ditzake alboondorio hauek. Kirol gehigarri asko kutsatuta daude substantzia hauekin.Les steroides anaboliques sont dérivés synthétiques de la testosterone et de la hormone du croissance, qui sont très utilisés dans le milieu sportive et aussi pour obtenir une figure corporel athlétique. Sa consommation est associée á l'apparition des effets secondaires, souvent graves et irréversibles, pas du tout connues par le plus part des consommateurs. Beaucoup des suppléments sportifs sont contaminés avec ces substances.This article evaluates the relationship between the nutritional state, diet-related attitudes and behaviours, and the perception on body image in university students. There was a higher amount of cases of overweight in men than in women. However, the tendency to "go on a diet" was higher in women, which may be due to the existing social pressure to maintain a stylised image

Evaluación del acceso a la dirección escolar en los centros públicos del País Vasco

En el artículo se resume una investigación realizada en el País Vasco con los directores y directoras que van a acceder a la función directiva en el curso 2009-2010. Este estudio tiene como objetivo analizar el proceso de acceso a la dirección en los centros públicos de la comunidad autónoma. Los resultados de la investigación indican que, según los candidatos y candidatas, el procedimiento idóneo de acceso a la dirección pasa por la selección del Consejo Escolar, mediante un proceso eliminatorio, en función del Proyecto de Dirección presentado y valorando en menor medida los méritos acreditados por el candidato._______________________________________________The article summarises a piece of research carried out in the Basque Country involving headmasters and headmistresses who are going to apply for a management position in the 2009-2010 academic year. This study aims to analyse the process to access management in state schools in this region. The results from the research indicate that, depending on the candidates, the suitable management access procedure involves School Council selection, by process of elimination, depending on the Management Project presented and the academic merits accredited by the candidate to a lesser extent

A Novel Approach for the Shape Characterisation of Non-Melanoma Skin Lesions Using Elliptic Fourier Analyses and Clinical Images

[EN] The early detection of Non-Melanoma Skin Cancer (NMSC) is crucial to achieve the best treatment outcomes. Shape is considered one of the main parameters taken for the detection of some types of skin cancer such as melanoma. For NMSC, the importance of shape as a visual detection parameter is not well-studied. A dataset of 993 standard camera images containing different types of NMSC and benign skin lesions was analysed. For each image, the lesion boundaries were extracted. After an alignment and scaling, Elliptic Fourier Analysis (EFA) coefficients were calculated for the boundary of each lesion. The asymmetry of lesions was also calculated. Then, multivariate statistics were employed for dimensionality reduction and finally computational learning classification was employed to evaluate the separability of the classes. The separation between malignant and benign samples was successful in most cases. The best-performing approach was the combination of EFA coefficients and asymmetry. The combination of EFA and asymmetry resulted in a balanced accuracy of 0.786 and an Area Under Curve of 0.735. The combination of EFA and asymmetry for lesion classification resulted in notable success rates when distinguishing between benign and malignant lesions. In light of these results, skin lesions’ shape should be integrated as a fundamental part of future detection techniques in clinical screening.SIJunta de Castilla y Leó

An Evaluation of Landmark-Based Methods to Explore Tooth Score Morphology: A Case Study on Felids and Hyenids

Taphonomic studies aim to identify the modifying agents that intervene in bone assemblages found at archaeopaleontological sites. Carnivores may modify, accumulate, or scavenge skeletal parts inflicting tooth marks, including scores, on the cortical surface. Several works have studied tooth score morphology to discern which carnivore group modified the bone assemblages, achieving different results. In the present study, different methods based on the use of landmarks and semilandmarks have been tested to describe and analyze the score profile cross-sections of spotted and brown hyenas, leopards, and lions. According to our results, the already published seven-landmark method is useful in order to differentiate between carnivore species from different families (e.g., felids and hyenids). Meanwhile, felid species (e.g., leopards and lions) cannot be consistently distinguished using any of the methods tested here. In contrast, hyenid species can be morphologically differentiated. On the other hand, the use of semilandmarks does not generally improve morphological characterization and distinction, but low numbers of landmarks and the inclusion of the score’s deepest point might provide the best results when semi-automatic semilandmark models are preferred to avoid sampling biases.The grant IJC2020-043576-I funded by MCIN/AEI/10.13039/501100011033 and the “European Union NextGenerationEU/PRTR” has been awarded to M.C.A. The grant RYC2021-034813-I funded by MCIN/AEI/10.13039/501100011033 and the European Union “NextGenerationEU”/PRTR has been awarded to M.Á.M.-G. During the development of the present work, J.A. was funded by the Euskal Herriko Unibertsitatea [ESPDOC21/05]. L.A.C. is funded by the Spanish Ministry of Science, Innovation and Universities by an FPI Predoctoral grant PRE2019-089411 associated with project RTI2018-099850-B-I0

Spilled ink blots the mind: A reply to Merrit et al. (2018) on subjectivity and bone surface modifications

Categorical variables identifying microscopic features of cut marks produce high accuracy in discrimination of bone surface modifications, but are vulnerable to variable degrees of inter-analyst subjectivity. Metric analyses of cut mark width and depth are presented by Merritt et al. (2018) as a more objective method of identifying cut marks. However, this uni(bi)variate method has shown very high rates of mark classification error when structurally similar marks are compared. Furthermore, within-sample comparison carried out via subsampling shows that different datasets of metric values, obtained with the same type of tool and raw material, are subject to such a high degree of variability that significant differences of homogeneous subsamples are repeatedly obtained, thus preventing any useful analogs to be made. Additionally, this much higher stochastic variability depends on limited knowledge of the contextual processes that intervene in cut mark metric properties, as well as on a mismatch between theoretical premises on the immanent-configurational process-trace dynamics and their confusion during experimental praxis. The selection of specific contextual variables and disregard of others, in addition to the combination of different tool types and raw materials, distorts the resulting cut mark properties. This indicates that even when attempting to use exclusively metric numeric variables, subjectivity is a conditioning factor in analyzing and interpreting cut marks

Geometric Morphometrics and Machine Learning Models Applied to the Study of Late Iron Age Cut Marks from Central Spain

Recently the incorporation of artificial intelligence has allowed the development of valuable methodological advances in taphonomy. Some studies have achieved great precision in identifying the carnivore that produced tooth marks. Additionally, other works focused on human activity have managed to specify what type of tool or raw material was used in the filleting processes identified at the sites. Through the use of geometric morphometrics and machine learning techniques, the present study intends to analyze the cut marks of the Ulaca oppidum (Solosancho, Ávila, Spain) in order to identify the type of tools used during carcass modification. Although the Ulaca oppidum is an Iron Age site, the results suggest that most of the cut marks were produced with flint tools.During the development of the present work J.A. was funded by the Euskal Herriko Unibertsitatea [ESPDOC21/05]. This work has been partially funded by the Ministerio de Ciencia e Innovación (project PID2021-123721OB-I00 funded by MCIN/AEI/10.13039/501100011033/FEDER, UE) and Fundación Española para la Ciencia y la Tecnología (FCT-21-17318). M.Á.M.-G. and C.S.B. acknowledges the grant RYC2021-034813-I and RYC2021-034720-I respectively, funded by MCIN/AEI/10.13039/501100011033 and by European Union “NextGenerationEU”/PRTR

Application of Entropy-Based Features to Predict Defibrillation Outcome in Cardiac Arrest

Prediction of defibrillation success is of vital importance to guide therapy and improve the survival of patients suffering out-of-hospital cardiac arrest (OHCA). Currently, the most efficient methods to predict shock success are based on the analysis of the electrocardiogram (ECG) during ventricular fibrillation (VF), and recent studies suggest the efficacy of waveform indices that characterize the underlying non-linear dynamics of VF. In this study we introduce, adapt and fully characterize six entropy indices for VF shock outcome prediction, based on the classical definitions of entropy to measure the regularity and predictability of a time series. Data from 163 OHCA patients comprising 419 shocks (107 successful) were used, and the performance of the entropy indices was characterized in terms of embedding dimension (m) and matching tolerance (r). Six classical predictors were also assessed as baseline prediction values. The best prediction results were obtained for fuzzy entropy (FuzzEn) with m = 3 and an amplitude-dependent tolerance of r = 80 μV. This resulted in a balanced sensitivity/specificity of 80.4%/76.9%, which improved by over five points the results obtained for the best classical predictor. These results suggest that a FuzzEn approach for a joint quantification of VF amplitude and its non-linear dynamics may be a promising tool to optimize OHCA treatment.This work received financial support from Spanish Ministerio de Economia y Competitividad, projects TEC2013-31928 and TEC2014-52250-R, and jointly with the Fondo Europeo de Desarrollo Regional (FEDER), project TEC2015-64678-R; from Junta de Comunidades de Castilla La Mancha, project PPII-2014-026-P; and from UPV/EHU through the grant PIF15/190 and through its research unit UFI11/16.Chicote, B.; Irusta, U.; Alcaraz, R.; Rieta, JJ.; Aramendi, E.; Isasi, I.; Alonso, D.... (2016). Application of Entropy-Based Features to Predict Defibrillation Outcome in Cardiac Arrest. Entropy. 18(9):1-17. https://doi.org/10.3390/e18090313S11718

Evaluating the Influence of Mood and Stress on GlycemicVariability in People with T1DM Using Glucose MonitoringSensors and Pools

Objective: Assess in a sample of people with type 1 diabetes mellitus whether mood andstress influence blood glucose levels and variability.Material and Methods: Continuous glucosemonitoring was performed on 10 patients with type 1 diabetes mellitus, where interstitial glucosevalues were recorded every 15 min. A daily survey was conducted through Google Forms, collectinginformation on mood and stress. The day was divided into six slots of 4-h each, asking the patientto assess each slot in relation to mood (sad, normal or happy) and stress (calm, normal or nervous).Different measures of glycemic control (arithmetic mean and percentage of time below/above thetarget range) and variability (standard deviation, percentage coefficient of variation, mean amplitudeof glycemic excursions and mean of daily differences) were calculated to relate the mood and stressperceived by patients with blood glucose levels and glycemic variability. A hypothesis test wascarried out to quantitatively compare the data groups of the different measures using the Student’st-test.Results: Statistically significant differences (p-value < 0.05) were found between differentlevels of stress. In general, average glucose and variability decrease when the patient is calm. Thereare statistically significant differences (p-value < 0.05) between different levels of mood. Variabilityincreases when the mood changes from sad to happy. However, the patient’s average glucosedecreases as the mood improves.Conclusions: Variations in mood and stress significantly influenceblood glucose levels, and glycemic variability in the patients analyzed with type 1 diabetes mellitus.Therefore, they are factors to consider for improving glycemic control. The mean of daily differencesdoes not seem to be a good indicator for variability.2021-2