Data Reduction Techniques for High Contrast Imaging Polarimetry. Applications to ExPo

Imaging polarimetry is a powerful tool for detecting and characterizing exoplanets and circumstellar environments. Polarimetry allows a separation of the light coming from an unpolarized source such as a star and the polarized source such as a planet or a protoplanetary disk. Future facilities like SPHERE at the VLT or EPICS at the E-ELT will incorporate imaging polarimetry to detect exoplanets. The Extreme Polarimeter (ExPo) is a dual-beam imaging polarimeter that currently can reach contrast ratios of 10^5, enough to characterize circumstellar environments. We present the data reduction steps for a dual-beam imaging polarimeter that can reach contrast ratios of 10^5. The data obtained with ExPo at the William Herschel Telescope (WHT) are analyzed. Instrumental artifacts and noise sources are discussed for an unpolarized star and for a protoplanetary disk (AB Aurigae). The combination of fast modulation and dual-beam techniques allow us to minimize instrumental artifacts. A proper data processing and alignment of the images is fundamental when dealing with large contrasts. Imaging polarimetry proves to be a powerful method to resolve circumstellar environments even without a coronagraph mask or an Adaptive Optics system.Comment: 9 pages, 12 Figures, Accepted for publication in A&

Quality of life and cost-effectiveness analysis of topical tranexamic acid and fibrin glue in femur fracture surgery

Altres ajuts: European Regional Development Fund (FEDER); MAPFRE Foundation (grant code SA/12/AYU/456).Background: We assessed quality of life (QoL) of patients undergoing surgery for proximal femur fracture and performed a cost-effectiveness analysis of haemostatic drugs for reducing postoperative bleeding. Methods: We analysed data from an open, multicentre, parallel, randomized controlled clinical trial (RCT) that assessed the efficacy and safety of tranexamic acid (TXA group) and fibrin glue (FG group) administered topically prior to surgical closure, compared with usual haemostasis methods (control group). For this study we conducted a cost-effectiveness analysis of these interventions from the Spanish Health System perspective, using a time horizon of 12 months. The cost was reported i

Data preprocessing workflow for exhaled breath analysis by GC/MS using open sources

© 2020 The Authors. This document is made available under the CC-BY 4.0 license. http://creativecommons.org/licenses/by /4.0/ This document is the Accepted version of a Published Work that appeared in final form in Scientifc Reports. To access the final edited and published work see https://doi.org/10.1038/s41598-020-79014-

El correo electrónico en la consulta de Parkinson: ¿soluciones a un clic? // Use of e-mail for Parkinson's disease consultations: Are answers just a clic away?

INTRODUCCION: La problemática de los trastornos del movimiento (TM) es compleja y la duración y frecuencia de las consultas presenciales puede estar limitada por problemas de espacio y tiempo. Analizamos el funcionamiento de un servicio de atención por correo electrónico institucional para médicos de Atención Primaria (MAP) y pacientes en la Unidad de Trastornos del Movimiento (UTM). METODOS: Se revisaron retrospectivamente los correos electrónicos enviados y recibidos en un periodo de 4 meses, un año tras su implantación. La dirección se proporcionaba en consulta y mediante sesiones informativas a los MAP del área. Se analizaron datos clínicos y demográficos de los pacientes, tipo de interlocutor, número de consultas, motivo y actuaciones derivadas de ellas. RESULTADOS: Del 1 de enero al 30 de abril de 2015 se recibieron 137 correos de 63 pacientes (43% varones; edad 71 ± 10,5 años) diagnosticados de enfermedad de Parkinson (76%), parkinsonismos atípicos (10%) y otros (14%), y se enviaron 116 respuestas. En 20 casos (32%) fueron redactados por el paciente, en 38 (60%) por sus familiares y en 5 (8%) por MAP. Los motivos de consulta fueron clínicos en 50 casos (80%): deterioro clínico (16; 32%), nuevos síntomas (14; 28%), efectos secundarios o dudas sobre medicación (20; 40%). Como consecuencia, se adelantó una cita programada en 9 casos (14%), mientras que el resto se solucionaron por correo electrónico. En 13 (20%), el motivo de consulta fue burocrático: relacionado con citas (11, 85%) y solicitud de informe (2, 15%). La satisfacción fue generalizada, sin constituir una sobrecarga asistencial excesiva para los facultativos responsables. CONCLUSIONES: La implantación de una consulta por correo electrónico es factible en UTM, facilita la comunicación médico-paciente y la continuidad asistencial con Atención Primaria. // INTRODUCTION: The clinical problems of patients with movement disorders (MD) are complex, and the duration and frequency of face-to-face consultations may be insufficient to meet their needs. We analysed the implementation of an e-mail-based query service for our MD unit's patients and their primary care physicians (PCPs). METHODS: We retrospectively reviewed all consecutive emails sent and received over a period of 4 months, one year after implementation of the e-mail inquiry system. All patients received the during consultations, and PCPs, during scheduled informative meetings. We recorded and later analysed the profile of the questioner, patients’ demographic and clinical data, number of queries, reason for consultation, and actions taken. RESULTS: From 1 January 2015 to 30 April 2015, the service received 137 emails from 63 patients (43% male, mean age 71 ± 10.5) diagnosed with Parkinson's disease (76%), atypical parkinsonism (10%), and others (14%); 116 responses were sent. Twenty (32%) emails were written by patients, 38 (60%) by their caregivers, and 5 (8%) by their PCPs. The reasons for consultation were clinical in 50 cases (80%): 16 (32%) described clinical deterioration, 14 (28%) onset of new symptoms, and 20 (40%) side effects or concerns about medications. In 13 cases (20%), the query was bureaucratic: 11 were related to appointments (85%) and 2 were requests for clinical reports (15%). In response, new appointments were scheduled in 9 cases (14%), while the rest of the questions were answered by email. Patients were satisfied overall and the additional care burden on specialists was not excessive. CONCLUSIONS: Implementing an e-mail-based consultation system is feasible in MD units. It facilitates both communication between neurologists and patients and continued care in the primary care setting

Surgical checklist: seeking the involvement of professionals and patients

Objetivos: Los objetivos fueron mejorar la adherencia al listado de verificación quirúrgica (LVQ), identificar barreras y reclamar el apoyo de profesionales y pacientes. Material y Métodos: Se registró la participación en el proyecto PaSQ-WP5/ LVQ entre 2013 y 2015: Plan de Acción con dos líneas de trabajo, dirigidas a profesionales y pacientes, que contemplaban rondas de evaluación, análisis de barreras, evaluación de percepción del listado mediante cuestionarios de la Hauté Autorité de Santé, formación en seguridad y diseño del folleto Cirugía Segura Salva Vidas. Resultados: Los datos de presencia del LVQ en la historia clínica reflejaron una mejora estadísticamente significativa respecto a los iniciales. En 68,2% de las rondas se cumplimentó el listado correctamente. La opinión del profesional sobre la utilidad del listado fue positiva en 79,8% y consideró que había ayudado a identificar e interceptar incidentes de seguridad en 25,6%. Sin embargo, resultó difícil de aplicar durante urgencias quirúrgicas (51,8%), al enfermero le costó gestionar el listado (59,5%) y el intercambio de información en voz alta se interrumpió con frecuencia (51,2%). Del análisis de barreras destacaron el sobre-registro, falta de liderazgo del gestor del listado, escasa implicación de facultativos y ausencia de trabajo en equipo. Conclusiones: La implantación del LVQ fue laboriosa pero la implicación de profesionales y pacientes ayudó a avanzar en la cultura de seguridad. La actitud general de los sanitarios es positiva y por tanto no se trata de imponer el uso obligatorio del LVQ, sino de convencer de que su cumplimiento reduce los eventos adversos evitables.Objectives: To improve the adhesion to the surgical safety checklist (SSC), identify barriers and claim the support of professionals and patients. Methods: The experience includes our participation in the Pasq-WP5 / SSC project, directed to surgical professionals and patients. An Action Plan was developed from 2013 to 2015 with two lines of work, one for professionals and other for patients; whose activities are: evaluation rounds, barrier analysis, evaluation SSC perception (using Hauté Autorité de Santé questionnaires), safety training and brochure design Safe Surgery Saves Lives. Results: Data of SSC in the medical record reflect a statistically significant improvement. In 68.2% of the rounds, SSC was filled in correctly. Professional opinion on the usefulness of SSC is positive in 79.8%; consider that it is difficult to apply in emergency in 51.8%, it is difficult for a nurse to manage the SSC in 59.5%, the exchange of information aloud is difficult to obtain in 51.2% and the SSC has helped identify and intercept security incidents 25.6%. Analysis of barriers includes the over-registration, lack of leadership SSC manager, limited involvement of doctors and lack of teamwork. Conclusions: The involvement of professionals and patients will help further progress in safety culture. The goal is not to impose the SSC, but convinced that compliance reduce preventable adverse events

Current professional standing of young medical oncologists in Spain : a nationwide survey by the Spanish Society of Medical Oncology + MIR section

There is a lack of knowledge about the career paths and employment situation of young medical oncologists. The aim of our study was to evaluate the current professional standing of these professionals in Spain. The Spanish Society of Medical Oncology + MIR section conducted a national online survey in May 2021 of young medical oncology consultants (< 6 years of expertise) and final year medical oncology residents. A total of 162 responses were eligible for analysis and included participants from 16 autonomous communities; 64% were women, 80% were consultants, and 20% were residents. More than half of the participants performed routine healthcare activity and only 7% research activity. Almost three quarters (73%) were subspecialized in a main area of interest and almost half of these chose this area because it was the only option available after residency. Half of the respondents (51%) considered working abroad and 81% believed the professional standing in Spain was worse than in other countries. After finishing their residency, only 22 were offered a job at their training hospital. Just 16% of participants had a permanent employment contract and 87% were concerned (score of ≥ 5 on a scale of 1-10) about their job stability. In addition, one quarter of the participants in our study showed an interest in increasing their research activity. The choice of subspecialty in medical oncology may depend on job opportunities after residency rather than personal interest. The abundance of temporary contracts may have influenced the job stability concerns observed. Future mentoring strategies should engage in building a long-term career path for young medical oncologists. The online version contains supplementary material available at 10.1007/s12094-022-02989-3

Are the minimally invasive techniques the new gold standard in thymus surgery for myasthenia gravis? Experience of a reference single-site in VATS thymectomy

The thymus is the primary lymphoid organ responsible for the maturation and proliferation of T lymphocytes. During the first years of our lives, the activation and inactivation of T lymphocytes occur within the thymus, facilitating the correct maturation of central immunity. Alterations in the positive and negative selection of T lymphocytes have been studied as the possible origins of autoimmune diseases, with Myasthenia Gravis (MG) being the most representative example. Structural alterations in the thymus appear to be involved in the initial autoimmune response observed in MG, leading to the consideration of thymectomy as part of the treatment for the disease. However, the role of thymectomy in MG has been a subject of controversy for many years. Several publications raised doubts about the lack of evidence justifying thymectomy’s role in MG until 2016 when a randomized study comparing thymectomy via sternotomy plus prednisone versus prednisone alone was published in the New England Journal of Medicine (NEJM). The results clearly favored the group of patients who underwent surgery, showing improvements in symptoms, reduced corticosteroid requirements, and fewer recurrences over 3 years of follow-up. In recent years, the emergence of less invasive surgical techniques has made video-assisted or robotic-assisted thoracoscopic (VATS/RATS) thymectomy more common, replacing the traditional sternotomy approach. Despite the increasing use of VATS, it has not been validated as a technique with lower morbidity compared to sternotomy in the treatment of MG. The results of the 2016 trial highlighted the benefits of thymectomy, but all the patients underwent surgery via sternotomy. Our hypothesis is that VATS thymectomy is a technique with lower morbidity, reduced postoperative pain, and shorter postoperative hospital stays than sternotomy. Additionally, VATS offers better clinical improvement in patients with MG. The primary objective of this study is to validate the VATS technique as the preferred approach for thymectomy. Furthermore, we aim to analyze the impact of VATS thymectomy on symptoms and corticosteroid dosage in patients with MG, identifying factors that may predict a better response to surgery

Bladder cancer index: cross-cultural adaptation into Spanish and psychometric evaluation

BACKGROUND: The Bladder Cancer Index (BCI) is so far the only instrument applicable across all bladder cancer patients, independent of tumor infiltration or treatment applied. We developed a Spanish version of the BCI, and assessed its acceptability and metric properties. METHODS: For the adaptation into Spanish we used the forward and back-translation method, expert panels, and cognitive debriefing patient interviews. For the assessment of metric properties we used data from 197 bladder cancer patients from a multi-center prospective study. The Spanish BCI and the SF-36 Health Survey were self-administered before and 12 months after treatment. Reliability was estimated by Cronbach's alpha. Construct validity was assessed through the multi-trait multi-method matrix. The magnitude of change was quantified by effect sizes to assess responsiveness. RESULTS: Reliability coefficients ranged 0.75-0.97. The validity analysis confirmed moderate associations between the BCI function and bother subscales for urinary (r = 0.61) and bowel (r = 0.53) domains; conceptual independence among all BCI domains (r ≤ 0.3); and low correlation coefficients with the SF-36 scores, ranging 0.14-0.48. Among patients reporting global improvement at follow-up, pre-post treatment changes were statistically significant for the urinary domain and urinary bother subscale, with effect sizes of 0.38 and 0.53. CONCLUSIONS: The Spanish BCI is well accepted, reliable, valid, responsive, and similar in performance compared to the original instrument. These findings support its use, both in Spanish and international studies, as a valuable and comprehensive tool for assessing quality of life across a wide range of bladder cancer patients

Expansion of Signal Transduction Pathways in Fungi by Extensive Genome Duplication

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