Sobre el gobierno de la máquina: dioses, reyes y sabios

La pregunta por los límites éticos de las neurociencias remite a su vez a la pregunta por los fundamentos de la condición moral. Diversos discursos (religiosos, históricos, biológicos) pretenden responder en exclusiva a esa pregunta, pero la realidad del hombre no es unívoca ni se explica por una sola razón. Y como no existe una idea universal del hombre, no puede existir una ética universal, aunque sí una razón jurídica supranacional y supracultural. Los límites de las neurociencias deben quedar fijados en el único marco posible, que no es otro que el de su estatuto epistemológico: la tecnología médica y la salud física y psíquica de los pacientes voluntariamente sometidos a su control y cuidado.La pregunta por los límites éticos de las neurociencias remite a su vez a la pregunta por los fundamentos de la condición moral. Diversos discursos (religiosos, históricos, biológicos) pretenden responder en exclusiva a esa pregunta, pero la realidad del hombre no es unívoca ni se explica por una sola razón. Y como no existe una idea universal del hombre, no puede existir una ética universal, aunque sí una razón jurídica supranacional y supracultural. Los límites de las neurociencias deben quedar fijados en el único marco posible, que no es otro que el de su estatuto epistemológico: la tecnología médica y la salud física y psíquica de los pacientes voluntariamente sometidos a su control y cuidado

Sobre el gobierno de la máquina: dioses, reyes y sabios

La pregunta por los límites éticos de las neurociencias remite a su vez a la pregunta por los fundamentos de la condición moral. Diversos discursos (religiosos, históricos, biológicos) pretenden responder en exclusiva a esa pregunta, pero la realidad del hombre no es unívoca ni se explica por una sola razón. Y como no existe una idea universal del hombre, no puede existir una ética universal, aunque sí una razón jurídica supranacional y supracultural. Los límites de las neurociencias deben quedar fijados en el único marco posible, que no es otro que el de su estatuto epistemológico: la tecnología médica y la salud física y psíquica de los pacientes voluntariamente sometidos a su control y cuidado

The Efficacy and Effectiveness of Education for Preventing and Treating Non-Specific Low Back Pain in the Hispanic Cultural Setting: A Systematic Review

[EN] A systematic review was conducted to assess the efficacy and effectiveness of education programs to prevent and treat low back pain (LBP) in the Hispanic cultural setting. Electronic and manual searches identified 1148 unique references. Nine randomized clinical trials (RCTs) were included in this review. Methodological quality assessment and data extraction followed the recommendations from the Cochrane Back Pain Review Group. Education programs which were assessed focused on active management (3 studies), postural hygiene (7), exercise (4) and pain neurophysiology (1). Comparators were no intervention, usual care, exercise, other types of education, and different combinations of these procedures. Five RCTs had a low risk of bias. Results show that: (a) education programs in the school setting can transmit potentially useful knowledge for LBP prevention and (b) education programs for patients with LBP improve the outcomes of usual care, especially in terms of disability. Education on pain neurophysiology improves the results of education on exercise, and education on active management is more effective than “sham” education and education on postural hygiene. Future studies should assess the comparative or summatory effects of education on exercise, education on pain neurophysiology and education on active management, as well as explore their efficiency.S

The Efficacy and Effectiveness of Education for Preventing and Treating Non-Specific Low Back Pain in the Hispanic Cultural Setting: A Systematic Review

A systematic review was conducted to assess the efficacy and effectiveness of education programs to prevent and treat low back pain (LBP) in the Hispanic cultural setting. Electronic and manual searches identified 1148 unique references. Nine randomized clinical trials (RCTs) were included in this review. Methodological quality assessment and data extraction followed the recommendations from the Cochrane Back Pain Review Group. Education programs which were assessed focused on active management (3 studies), postural hygiene (7), exercise (4) and pain neurophysiology (1). Comparators were no intervention, usual care, exercise, other types of education, and different combinations of these procedures. Five RCTs had a low risk of bias. Results show that: (a) education programs in the school setting can transmit potentially useful knowledge for LBP prevention and (b) education programs for patients with LBP improve the outcomes of usual care, especially in terms of disability. Education on pain neurophysiology improves the results of education on exercise, and education on active management is more effective than “sham” education and education on postural hygiene. Future studies should assess the comparative or summatory effects of education on exercise, education on pain neurophysiology and education on active management, as well as explore their efficiency

Effects of a N-Maleimide-derivatized Phosphatidylethanolamine on the Architecture and Properties of Lipid Bilayers

N-maleimide-derivatized phospholipids are often used to facilitate protein anchoring to membranes. In autophagy studies, this is applied to the covalent binding of Atg8, an autophagy protein, to a phosphatidylethanolamine (PE) in the nascent autophagosome. However, the question remains on how closely the N-maleimide PE derivative (PE-mal) mimicks the native PE in the bilayer. In the present paper, spectroscopic and calorimetric techniques have been applied to vesicles containing either PE or PE-mal (together with other phospholipids) to compare the properties of the native and derivatized forms of PE. According to differential scanning calorimetry, and to infrared spectroscopy, the presence of PE-mal did not perturb the fatty acyl chains in the bilayer. Fluorescence spectroscopy and microscopy showed that PE-mal did not alter the bilayer permeability either. However, fluorescence emission polarization of the Laurdan and DPH probes indicated an increased order, or decreased fluidity, in the bilayers containing PE-mal. In addition, the infrared spectral data from the phospholipid phosphate region revealed a PE-mal-induced conformational change in the polar heads, accompanied by increased hydration. Globally considered, the results suggest that PE-mal would be a reasonable substitute for PE in model membranes containing reconstituted proteins.This work was funded in part by the Spanish Ministry of Science, Innovation, and Universities (MCIU), Agencia Estatal de Investigación (AEI), Fondo Europeo de Desarrollo Regional (FEDER) (grant No. PID2021-124461NB-I00), the Basque Government (grant No. IT1625-22), Fundación Ramón Areces (CIVP20A6619), Fundación Biofísica Bizkaia and the Basque Excellence Research Centre (BERC) program of the Basque Government. E.J.G.-R. was supported by Fundación Ramón Areces. Y.R.V. was a recipient of a pre-doctoral FPU fellowship from the Spanish Ministry of Science, Innovation, and Universities (FPU18/00799). U.B. thanks the University of the Basque Country for a pre-doctoral contract

Identifying analogues for data-limited volcanoes using hierarchical clustering and expert knowledge: a case study of Melimoyu (Chile)

Determining the eruption frequency-Magnitude (f-M) relationship for data-limited volcanoes is challenging since it requires a comprehensive eruption record of the past eruptive activity. This is the case for Melimoyu, a long-dormant and data-limited volcano in the Southern Volcanic Zone (SVZ) in Chile with only two confirmed Holocene eruptions (VEI 5). To supplement the eruption records, we identified analogue volcanoes for Melimoyu (i.e., volcanoes that behave similarly and are identified through shared characteristics) using a quantitative and objective approach. Firstly, we compiled a global database containing 181 variables describing the eruptive history, tectonic setting, rock composition, and morphology of 1,428 volcanoes. This database was filtered primarily based on data availability into an input dataset comprising 37 numerical variables for 438 subduction zone volcanoes. Then, we applied Agglomerative Nesting, a bottom-up hierarchical clustering algorithm on three datasets derived from the input dataset: 1) raw data, 2) output from a Principal Component Analysis, and 3) weighted data tuned to minimise the dispersion in the absolute probability per VEI. Lastly, we identified the best set of analogues by analysing the dispersion in the absolute probability per VEI and applying a set of criteria deemed important by the local geological service, SERNAGEOMIN, and VB. Our analysis shows that the raw data generate a low dispersion and the highest number of analogues (n = 20). More than half of these analogues are in the SVZ, suggesting that the tectonic setting plays a key role in the clustering analysis. The eruption f-M relationship modelled from the analogue’s eruption data shows that if Melimoyu has an eruption, there is a 49% probability (50th percentile) of it being VEI≥4. Meanwhile, the annual absolute probability of a VEI≤1, VEI 2, VEI 3, VEI 4, and VEI≥5 eruption at Melimoyu is 4.82 × 10−4, 1.2 × 10−3, 1.45 × 10−4, 9.77 × 10−4, and 8.3 × 10−4 (50th percentile), respectively. Our work shows the importance of using numerical variables to capture the variability across volcanoes and combining quantitative approaches with expert knowledge to assess the suitability of potential analogues. Additionally, this approach allows identifying groups of analogues and can be easily applied to other cases using numerical variables from the global database. Future work will use the analogues to populate an event tree and define eruption source parameters for modelling volcanic hazards at Melimoyu

Neumatosis intestinal y gas portomesentérico: a propósito de un caso

La neumatosis intestinal (presencia de gas en el interior de la pared intestinal y en el complejo venoso portomesentérico) es una situación clínica poco frecuente que ha sido característicamente relacionada con la isquemia intestinal y con un desenlace fatal. Existen otras causas que pueden justifi car estos hallazgos y cuya repercusión para el paciente no es inevitablemente trágica. Los avances recientes en técnicas de imagen, sobre todo en tomografía computarizada multicorte (TCMC), permiten un diagnóstico preciso fi able y precoz de estos hallazgos. En este artículo, repasamos las manifestaciones radiológicas de la neumatosis intestinal en TC así como las distintas causas relacionadas con esta entidad, en relación con los hallazgos presentes en un paciente diagnosticado de carcinoma de esófago y en tratamiento quimioterápico. INGLÉS: Intestinal pneumatosis (presence of gas in the intestinal wall and in the portomeseteric veins) is an infrequent clinical situation that has been associated with extended bowel necrosis and fatal outcome. However, there are other reasons that can justify these findings without such an outcome. Recent advances in diagnostic imaging techniques, especially multislice computerized tomography (MSCT), have allowed precise and quick diagnosis of these entities. In this article, we review the MSCT radiological manifestations of intestinal pneumatosis, as well as the different diagnoses related with the findings observed in a patient diagnosed with esophageal carcinoma under chemotherapy treatment

Evaluation of two treatment strategies for the prevention of preterm birth in women identified as at risk by ultrasound (PESAPRO Trial): Study protocol for a randomized controlled trial

Background: Premature birth is considered one of the main problems in modern Obstetrics. It causes more than 50 % of neonatal mortality; it is responsible for a large proportion of infant morbidity and incurs very high economic costs. Cervical length, which can be accurately measured by ultrasound, has an inverse relationship with the risk of preterm birth. As a result, having an effective intervention for asymptomatic patients with short cervix could reduce the prematurity. Although recently published data demonstrates the effectiveness of vaginal progesterone and cervical pessary, these treatments have never been compared to one another. Methods/Design: The PESAPRO study is a noncommercial, multicenter, open-label, randomized clinical trial (RCT) in pregnant women with a short cervix as identified by transvaginal ultrasonography at 19 to 22 weeks of gestation. Patients are randomized (1:1) to either daily vaginal progesterone or cervical pessary until the 37th week of gestation or delivery; whichever comes first. During the trial, women visit every 4 weeks for routine questions and tests. The primary outcome is the proportion of spontaneous preterm deliveries before 34 weeks of gestation. A sample size of 254 pregnant women will be included at 29 participating hospitals in order to demonstrate noninferiority of placing a pessary versus vaginal progesterone. The first patient was randomized in August 2012, and recruitment of study subjects will continue until the end of December 2015. Discussion: This trial assesses the comparative efficacy and safety between two accepted treatments, cervical pessary versus vaginal progesterone, and it will provide evidence in order to establish clinical recommendationsThe study has been funded by two national grants from the Spanish Ministry of Health and ISCIII

Recomendaciones –guía– en la lesión aguda medular intraoperatoria en cirugía correctora del raquis

Producción CientíficaEl objetivo del tratamiento quirúrgico para la escoliosis, cifosis y otro tipo de deformidades del raquis es la fusión de las vértebras para que la columna vertebral no pueda curvarse. Se colocan implantes metálicos (barras, tornillos, alambres, placas, etc.), para mantener el raquis mientras las vértebras se fusionan. La artrodesis vertebral se potencia con injerto (autogénico y/o alogénico) de hueso. El abordaje quirúrgico puede ser posterior, anterior o combinación de ambos. La cirugía toracoscópica se puede utilizar en el abordaje anterior del raquis dorsal. La cirugía correctora del raquis en pediatría y adultos es un procedimiento prolongado (en general más de 4 horas), tiene las complicaciones potenciales de la cirugía mayor (hemorragia grave, hipotermia, infección, embolismo graso o aéreo, hipotensión arterial, etc.)1,2 y entre las patrimoniales, las neurológicas (plejia, paresia) son las más catastróficas3,