Las interfaces urbano-forestales como territorios de riesgo frente a incendios: análisis y caracterización regional en España

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Filosofía y Letras, Departamento de Geografía, 15-07-201

Vinculación del género en la profesión de enfermería

Mediante una revisión bibliográfica se analiza la vinculación de género que ha existido y existe en la profesión de enfermería en España y cómo ha influido en la realización, planificación y gestión de los cuidados realizados. Se trata de una disciplina sanitaria ejercida por mujeres que durante mucho tiempo ha estado bajo el poder de la medicina dirigida y gestionada por hombres, siendo por tanto una profesión subordinada al poder de la medicina y sin una identidad propia, siendo identificados los cuidados como tareas del hogar, del ámbito doméstico, propias por la asignación social de género de la mujer. Se tratan los puntos de la Ley para la igualdad de hombres y mujeres que se han aplicado y que pueden conducir a mejoras en relación a la dirección, gestión, planificación y ejecución de las competencias, funciones y cuidados de la enfermería. Se finaliza examinando la visión que los medios de comunicación tienen de la enfermería y cómo esa condición del género continua existiendo en la actualidad

Todas las voces. La elaboración de mapas de actores para la salvaguarda del patrimonio cultural inmaterial

La participación social se ha erigido en un proceso clave en los procesos de patrimonialización contemporáneos. En la primera parte del capítulo se abordan tres metodologías diferentes para garantizar criterios de representatividad, equidad y accesibilidad (redes sociales, análisis de partes interesadas y mapas sociales). En la segunda parte, a partir de un estudio de caso de una investigación realizada en 2019 sobre patrimonialización marítima, se discute sobre las virtualidades y amenazas del discurso y la praxis de la participación.Ministerio de Cultura y Deport

New electrohysterogram-based estimators of intrauterine pressure signal, tonus and contraction peak for non-invasive labor monitoring

[EN] Background: Uterine activity monitoring is an essential part of managing the progress of pregnancy and labor. Although intrauterine pressure (IUP) is the only reliable method of estimating uterine mechanical activity, it is highly invasive. Since there is a direct relationship between the electrical and mechanical activity of uterine cells, surface electrohysterography (EHG) has become a noninvasive monitoring alternative. The Teager energy (TE) operator of the EHG signal has been used for IUP continuous pressure estimation, although its accuracy could be improved. We aimed to develop new optimized IUP estimation models for clinical application. Approach: We first considered enhancing the optimal estimation of IUP clinical features (maximum pressure and tonus) rather than optimizing the signal only (continuous pressure). An adaptive algorithm was also developed to deal with inter-patient variability. For each optimizing signal feature (continuous pressure, maximum pressure and tonus), individual (single patient), global (full database) and adaptive models were built to estimate the recorded IUP signal. The results were evaluated by computing the root mean square errors (RMSe): continuous pressure error (CPe), maximum pressure error (MPe) and tonus error (TOe). Main results: The continuous pressure global model yielded IUP estimates with Cpe = 14.61mm Hg, MPe = 29.17mm Hg and Toe = 7.8mm Hg. The adaptive models significantly reduced errors to CPe = 11.88, MPe = 16.02 and Toe = 5.61mm Hg. The EHG-based IUP estimates outperformed those from traditional tocographic recordings, which had significantly higher errors (CPe = 21.93, MPe = 26.97, and TOe = 13.96). Significance: Our results show that adaptive models yield better IUP estimates than the traditional approaches and provide the best balance of the different errors computed for a better assessment of the labor progress and maternal and fetal wellbeing.This research project was supported by the Spanish Ministry of Economy and Competitiveness, the European Regional Development Fund (DPI2015-68397-R), and by the projects UPV_ FE-2018-C03 and GV/2018/104.Benalcazar-Parra, C.; Garcia-Casado, J.; Ye Lin, Y.; Alberola-Rubio, J.; López-Corral, A.; Perales Marin, AJ.; Prats-Boluda, G. (2019). New electrohysterogram-based estimators of intrauterine pressure signal, tonus and contraction peak for non-invasive labor monitoring. Physiological Measurement. 40(8):1-12. https://doi.org/10.1088/1361-6579/ab37dbS11240

Robust Characterization of the Uterine Myoelectrical Activity in Different Obstetric Scenarios

[EN] Electrohysterography (EHG) has been shown to provide relevant information on uterine activity and could be used for predicting preterm labor and identifying other maternal fetal risks. The extraction of high-quality robust features is a key factor in achieving satisfactory prediction systems from EHG. Temporal, spectral, and non-linear EHG parameters have been computed to characterize EHG signals, sometimes obtaining controversial results, especially for non-linear parameters. The goal of this work was to assess the performance of EHG parameters in identifying those robust enough for uterine electrophysiological characterization. EHG signals were picked up in different obstetric scenarios: antepartum, including women who delivered on term, labor, and post-partum. The results revealed that the 10th and 90th percentiles, for parameters with falling and rising trends as labor approaches, respectively, differentiate between these obstetric scenarios better than median analysis window values. Root-mean-square amplitude, spectral decile 3, and spectral moment ratio showed consistent tendencies for the different obstetric scenarios as well as non-linear parameters: Lempel-Ziv, sample entropy, spectral entropy, and SD1/SD2 when computed in the fast wave high bandwidth. These findings would make it possible to extract high quality and robust EHG features to improve computer-aided assessment tools for pregnancy, labor, and postpartum progress and identify maternal fetal risks.This work was supported by the Spanish Ministry of Economy and Competitiveness, the European Regional Development Fund (MCIU/AEI/FEDER, UE RTI2018-094449-A-I00-AR) and the Generalitat Valenciana (AICO/2019/220 & GV/2018/104)Mas-Cabo, J.; Ye Lin, Y.; Garcia-Casado, J.; Díaz-Martínez, MDA.; Perales-Marin, A.; Monfort-Ortiz, R.; Roca-Prats, A.... (2020). Robust Characterization of the Uterine Myoelectrical Activity in Different Obstetric Scenarios. Entropy. 22(7):1-15. https://doi.org/10.3390/e22070743S115227Wagura, P., Wasunna, A., Laving, A., Wamalwa, D., & Ng’ang’a, P. (2018). Prevalence and factors associated with preterm birth at kenyatta national hospital. BMC Pregnancy and Childbirth, 18(1). doi:10.1186/s12884-018-1740-2Liu, L., Johnson, H. L., Cousens, S., Perin, J., Scott, S., Lawn, J. E., … Black, R. E. (2012). Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. The Lancet, 379(9832), 2151-2161. doi:10.1016/s0140-6736(12)60560-1Howson, C. P., Kinney, M. V., McDougall, L., & Lawn, J. E. (2013). Born Too Soon: Preterm birth matters. Reproductive Health, 10(S1). doi:10.1186/1742-4755-10-s1-s1Euliano, T. Y., Nguyen, M. T., Darmanjian, S., McGorray, S. P., Euliano, N., Onkala, A., & Gregg, A. R. (2013). Monitoring uterine activity during labor: a comparison of 3 methods. American Journal of Obstetrics and Gynecology, 208(1), 66.e1-66.e6. doi:10.1016/j.ajog.2012.10.873Devedeux, D., Marque, C., Mansour, S., Germain, G., & Duchêne, J. (1993). Uterine electromyography: A critical review. American Journal of Obstetrics and Gynecology, 169(6), 1636-1653. doi:10.1016/0002-9378(93)90456-sChkeir, A., Fleury, M.-J., Karlsson, B., Hassan, M., & Marque, C. (2013). Patterns of electrical activity synchronization in the pregnant rat uterus. BioMedicine, 3(3), 140-144. doi:10.1016/j.biomed.2013.04.007Fele-Žorž, G., Kavšek, G., Novak-Antolič, Ž., & Jager, F. (2008). A comparison of various linear and non-linear signal processing techniques to separate uterine EMG records of term and pre-term delivery groups. Medical & Biological Engineering & Computing, 46(9), 911-922. doi:10.1007/s11517-008-0350-yMas-Cabo, J., Prats-Boluda, G., Perales, A., Garcia-Casado, J., Alberola-Rubio, J., & Ye-Lin, Y. (2018). Uterine electromyography for discrimination of labor imminence in women with threatened preterm labor under tocolytic treatment. Medical & Biological Engineering & Computing, 57(2), 401-411. doi:10.1007/s11517-018-1888-yVinken, M. P. G. C., Rabotti, C., Mischi, M., & Oei, S. G. (2009). Accuracy of Frequency-Related Parameters of the Electrohysterogram for Predicting Preterm Delivery. Obstetrical & Gynecological Survey, 64(8), 529-541. doi:10.1097/ogx.0b013e3181a8c6b1Hassan, M., Terrien, J., Marque, C., & Karlsson, B. (2011). Comparison between approximate entropy, correntropy and time reversibility: Application to uterine electromyogram signals. Medical Engineering & Physics, 33(8), 980-986. doi:10.1016/j.medengphy.2011.03.010Lemancewicz, A., Borowska, M., Kuć, P., Jasińska, E., Laudański, P., Laudański, T., & Oczeretko, E. (2016). Early diagnosis of threatened premature labor by electrohysterographic recordings – The use of digital signal processing. Biocybernetics and Biomedical Engineering, 36(1), 302-307. doi:10.1016/j.bbe.2015.11.005Garcia-Casado, J., Ye-Lin, Y., Prats-Boluda, G., Mas-Cabo, J., Alberola-Rubio, J., & Perales, A. (2018). Electrohysterography in the diagnosis of preterm birth: a review. Physiological Measurement, 39(2), 02TR01. doi:10.1088/1361-6579/aaad56Most, O., Langer, O., Kerner, R., Ben David, G., & Calderon, I. (2008). Can myometrial electrical activity identify patients in preterm labor? American Journal of Obstetrics and Gynecology, 199(4), 378.e1-378.e6. doi:10.1016/j.ajog.2008.08.003Verdenik, I., Pajntar, M., & Leskošek, B. (2001). Uterine electrical activity as predictor of preterm birth in women with preterm contractions. European Journal of Obstetrics & Gynecology and Reproductive Biology, 95(2), 149-153. doi:10.1016/s0301-2115(00)00418-8Horoba, K., Jezewski, J., Matonia, A., Wrobel, J., Czabanski, R., & Jezewski, M. (2016). Early predicting a risk of preterm labour by analysis of antepartum electrohysterograhic signals. Biocybernetics and Biomedical Engineering, 36(4), 574-583. doi:10.1016/j.bbe.2016.06.004Lucovnik, M., Maner, W. L., Chambliss, L. R., Blumrick, R., Balducci, J., Novak-Antolic, Z., & Garfield, R. E. (2011). Noninvasive uterine electromyography for prediction of preterm delivery. American Journal of Obstetrics and Gynecology, 204(3), 228.e1-228.e10. doi:10.1016/j.ajog.2010.09.024Smrdel, A., & Jager, F. (2015). Separating sets of term and pre-term uterine EMG records. Physiological Measurement, 36(2), 341-355. doi:10.1088/0967-3334/36/2/341Maner, W. (2003). Predicting term and preterm delivery with transabdominal uterine electromyography. Obstetrics & Gynecology, 101(6), 1254-1260. doi:10.1016/s0029-7844(03)00341-7Leman, H., Marque, C., & Gondry, J. (1999). Use of the electrohysterogram signal for characterization of contractions during pregnancy. IEEE Transactions on Biomedical Engineering, 46(10), 1222-1229. doi:10.1109/10.790499Mischi, M., Chen, C., Ignatenko, T., de Lau, H., Ding, B., Oei, S. G. G., & Rabotti, C. (2018). Dedicated Entropy Measures for Early Assessment of Pregnancy Progression From Single-Channel Electrohysterography. IEEE Transactions on Biomedical Engineering, 65(4), 875-884. doi:10.1109/tbme.2017.2723933Garfield, R. E., Maner, W. L., MacKay, L. B., Schlembach, D., & Saade, G. R. (2005). Comparing uterine electromyography activity of antepartum patients versus term labor patients. American Journal of Obstetrics and Gynecology, 193(1), 23-29. doi:10.1016/j.ajog.2005.01.050Maner, W. L., & Garfield, R. E. (2007). Identification of Human Term and Preterm Labor using Artificial Neural Networks on Uterine Electromyography Data. Annals of Biomedical Engineering, 35(3), 465-473. doi:10.1007/s10439-006-9248-8DIMITROV, G. V., ARABADZHIEV, T. I., MILEVA, K. N., BOWTELL, J. L., CRICHTON, N., & DIMITROVA, N. A. (2006). Muscle Fatigue during Dynamic Contractions Assessed by New Spectral Indices. Medicine & Science in Sports & Exercise, 38(11), 1971-1979. doi:10.1249/01.mss.0000233794.31659.6dNagarajan, R., Eswaran, H., Wilson, J. D., Murphy, P., Lowery, C., & Preißl, H. (2003). Analysis of uterine contractions: a dynamical approach. The Journal of Maternal-Fetal & Neonatal Medicine, 14(1), 8-21. doi:10.1080/jmf.14.1.8.21Zhang, X.-S., Roy, R. J., & Jensen, E. W. (2001). EEG complexity as a measure of depth of anesthesia for patients. IEEE Transactions on Biomedical Engineering, 48(12), 1424-1433. doi:10.1109/10.966601Garfield, R. E., Maner, W. L., Maul, H., & Saade, G. R. (2005). Use of uterine EMG and cervical LIF in monitoring pregnant patients. BJOG: An International Journal of Obstetrics & Gynaecology, 112, 103-108. doi:10.1111/j.1471-0528.2005.00596.xGrotegut, C. A., Paglia, M. J., Johnson, L. N. C., Thames, B., & James, A. H. (2011). Oxytocin exposure during labor among women with postpartum hemorrhage secondary to uterine atony. American Journal of Obstetrics and Gynecology, 204(1), 56.e1-56.e6. doi:10.1016/j.ajog.2010.08.02

A Comparative Study of Vaginal Labor and Caesarean Section Postpartum Uterine Myoelectrical Activity

[EN] Postpartum hemorrhage (PPH) is one of the major causes of maternal mortality and morbidity worldwide, with uterine atony being the most common origin. Currently there are no obstetrical techniques available for monitoring postpartum uterine dynamics, as tocodynamometry is not able to detect weak uterine contractions. In this study, we explored the feasibility of monitoring postpartum uterine activity by non-invasive electrohysterography (EHG), which has been proven to outperform tocodynamometry in detecting uterine contractions during pregnancy. A comparison was made of the temporal, spectral, and non-linear parameters of postpartum EHG characteristics of vaginal deliveries and elective cesareans. In the vaginal delivery group, EHG obtained a significantly higher amplitude and lower kurtosis of the Hilbert envelope, and spectral content was shifted toward higher frequencies than in the cesarean group. In the non-linear parameters, higher values were found for the fractal dimension and lower values for Lempel-Ziv, sample entropy and spectral entropy in vaginal deliveries suggesting that the postpartum EHG signal is extremely non-linear but more regular and predictable than in a cesarean. The results obtained indicate that postpartum EHG recording could be a helpful tool for earlier detection of uterine atony and contribute to better management of prophylactic uterotonic treatment for PPH prevention.This work was supported by the Spanish Ministry of Economy and Competitiveness, the European Regional Development Fund (MCIU/AEI/FEDER, UE RTI2018-094449-A-I00-AR) and the Generalitat Valenciana (GV/2018/104 and AICO/2019/220).Díaz-Martínez, MDA.; Mas-Cabo, J.; Prats-Boluda, G.; Garcia-Casado, J.; Cardona-Urrego, K.; Monfort-Ortiz, R.; Lopez-Corral, A.... (2020). A Comparative Study of Vaginal Labor and Caesarean Section Postpartum Uterine Myoelectrical Activity. Sensors. 20(11):1-14. https://doi.org/10.3390/s20113023S1142011Ngwenya, S. (2016). Postpartum hemorrhage: incidence, risk factors, and outcomes in a low-resource setting. International Journal of Women’s Health, Volume 8, 647-650. doi:10.2147/ijwh.s119232Carroli, G., Cuesta, C., Abalos, E., & Gulmezoglu, A. M. (2008). Epidemiology of postpartum haemorrhage: a systematic review. Best Practice & Research Clinical Obstetrics & Gynaecology, 22(6), 999-1012. doi:10.1016/j.bpobgyn.2008.08.004Souza, J. P., Gülmezoglu, A. M., Carroli, G., Lumbiganon, P., & Qureshi, Z. (2011). The world health organization multicountry survey on maternal and newborn health: study protocol. BMC Health Services Research, 11(1). doi:10.1186/1472-6963-11-286Knight, M., Callaghan, W. M., Berg, C., Alexander, S., Bouvier-Colle, M.-H., Ford, J. B., … Walker, J. (2009). Trends in postpartum hemorrhage in high resource countries: a review and recommendations from the International Postpartum Hemorrhage Collaborative Group. BMC Pregnancy and Childbirth, 9(1). doi:10.1186/1471-2393-9-55Callaghan, W. M., Kuklina, E. V., & Berg, C. J. (2010). Trends in postpartum hemorrhage: United States, 1994–2006. American Journal of Obstetrics and Gynecology, 202(4), 353.e1-353.e6. doi:10.1016/j.ajog.2010.01.011Marshall, A. L., Durani, U., Bartley, A., Hagen, C. E., Ashrani, A., Rose, C., … Pruthi, R. K. (2017). The impact of postpartum hemorrhage on hospital length of stay and inpatient mortality: a National Inpatient Sample–based analysis. American Journal of Obstetrics and Gynecology, 217(3), 344.e1-344.e6. doi:10.1016/j.ajog.2017.05.004Prick, B. W., Duvekot, J. J., van der Moer, P. E., van Gemund, N., van der Salm, P. C. M., Jansen, A. J. G., … Uyl-de Groot, C. A. (2014). Cost-effectiveness of red blood cell transfusion vs. non-intervention in women with acute anaemia after postpartum haemorrhage. Vox Sanguinis, 107(4), 381-388. doi:10.1111/vox.12181Castiel, D., Bréchat, P.-H., Benoît, B., Nguon, B., Gayat, E., Soyer, P., … Barranger, E. (2008). Coût total des actes chirurgicaux dans la prise en charge des hémorragies de la délivrance. Gynécologie Obstétrique & Fertilité, 36(5), 507-515. doi:10.1016/j.gyobfe.2008.03.009Fukami, T., Koga, H., Goto, M., Ando, M., Matsuoka, S., Tohyama, A., … Tsujioka, H. (2019). Incidence and risk factors for postpartum hemorrhage among transvaginal deliveries at a tertiary perinatal medical facility in Japan. PLOS ONE, 14(1), e0208873. doi:10.1371/journal.pone.0208873Vogel, J. P., Williams, M., Gallos, I., Althabe, F., & Oladapo, O. T. (2019). WHO recommendations on uterotonics for postpartum haemorrhage prevention: what works, and which one? BMJ Global Health, 4(2), e001466. doi:10.1136/bmjgh-2019-001466Lutomski, J., Byrne, B., Devane, D., & Greene, R. (2012). Increasing trends in atonic postpartum haemorrhage in Ireland: an 11-year population-based cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 119(9), 1150-1151. doi:10.1111/j.1471-0528.2012.03370.xWilmink, F. A., Wilms, F. F., Heydanus, R., Mol, B. W. J., & Papatsonis, D. N. M. (2008). Fetal complications after placement of an intrauterine pressure catheter: A report of two cases and review of the literature. The Journal of Maternal-Fetal & Neonatal Medicine, 21(12), 880-883. doi:10.1080/14767050802220508Hadar, E., Biron-Shental, T., Gavish, O., Raban, O., & Yogev, Y. (2014). A comparison between electrical uterine monitor, tocodynamometer and intra uterine pressure catheter for uterine activity in labor. The Journal of Maternal-Fetal & Neonatal Medicine, 28(12), 1367-1374. doi:10.3109/14767058.2014.954539Alberola-Rubio, J., Prats-Boluda, G., Ye-Lin, Y., Valero, J., Perales, A., & Garcia-Casado, J. (2013). Comparison of non-invasive electrohysterographic recording techniques for monitoring uterine dynamics. Medical Engineering & Physics, 35(12), 1736-1743. doi:10.1016/j.medengphy.2013.07.008Euliano, T. Y., Nguyen, M. T., Darmanjian, S., McGorray, S. P., Euliano, N., Onkala, A., & Gregg, A. R. (2013). Monitoring uterine activity during labor: a comparison of 3 methods. American Journal of Obstetrics and Gynecology, 208(1), 66.e1-66.e6. doi:10.1016/j.ajog.2012.10.873Euliano, T. Y., Nguyen, M. T., Marossero, D., & Edwards, R. K. (2007). Monitoring Contractions in Obese Parturients. Obstetrics & Gynecology, 109(5), 1136-1140. doi:10.1097/01.aog.0000258799.24496.93Benalcazar Parra, C., Tendero, A. I., Ye-Lin, Y., Alberola-Rubio, J., Perales Marin, A., Garcia-Casado, J., & Prats-Boluda, G. (2018). Feasibility of Labor Induction Success Prediction based on Uterine Myoelectric Activity Spectral Analysis. Proceedings of the 11th International Joint Conference on Biomedical Engineering Systems and Technologies. doi:10.5220/0006649400700077Euliano, T., Skowronski, M., Marossero, D., Shuster, J., & Edwards, R. (2006). Prediction of intrauterine pressure waveform from transabdominal electrohysterography. The Journal of Maternal-Fetal & Neonatal Medicine, 19(12), 803-808. doi:10.1080/14767050601023657Benalcazar-Parra, C., Garcia-Casado, J., Ye-Lin, Y., Alberola-Rubio, J., Lopez, Á., Perales-Marin, A., & Prats-Boluda, G. (2019). New electrohysterogram-based estimators of intrauterine pressure signal, tonus and contraction peak for non-invasive labor monitoring. Physiological Measurement, 40(8), 085003. doi:10.1088/1361-6579/ab37dbRooijakkers, M. J., Rabotti, C., Oei, S. G., Aarts, R. M., & Mischi, M. (2014). Low-complexity intrauterine pressure estimation using the Teager energy operator on electrohysterographic recordings. Physiological Measurement, 35(7), 1215-1228. doi:10.1088/0967-3334/35/7/1215Schlembach, D., Maner, W. L., Garfield, R. E., & Maul, H. (2009). Monitoring the progress of pregnancy and labor using electromyography. European Journal of Obstetrics & Gynecology and Reproductive Biology, 144, S33-S39. doi:10.1016/j.ejogrb.2009.02.016Fele-Žorž, G., Kavšek, G., Novak-Antolič, Ž., & Jager, F. (2008). A comparison of various linear and non-linear signal processing techniques to separate uterine EMG records of term and pre-term delivery groups. Medical & Biological Engineering & Computing, 46(9), 911-922. doi:10.1007/s11517-008-0350-yHassan, M., Terrien, J., Marque, C., & Karlsson, B. (2011). Comparison between approximate entropy, correntropy and time reversibility: Application to uterine electromyogram signals. Medical Engineering & Physics, 33(8), 980-986. doi:10.1016/j.medengphy.2011.03.010Mas-Cabo, J., Prats-Boluda, G., Perales, A., Garcia-Casado, J., Alberola-Rubio, J., & Ye-Lin, Y. (2018). Uterine electromyography for discrimination of labor imminence in women with threatened preterm labor under tocolytic treatment. Medical & Biological Engineering & Computing, 57(2), 401-411. doi:10.1007/s11517-018-1888-yLemancewicz, A., Borowska, M., Kuć, P., Jasińska, E., Laudański, P., Laudański, T., & Oczeretko, E. (2016). Early diagnosis of threatened premature labor by electrohysterographic recordings – The use of digital signal processing. Biocybernetics and Biomedical Engineering, 36(1), 302-307. doi:10.1016/j.bbe.2015.11.005Mas-Cabo, J., Prats-Boluda, G., Garcia-Casado, J., Alberola-Rubio, J., Perales, A., & Ye-Lin, Y. (2019). Design and Assessment of a Robust and Generalizable ANN-Based Classifier for the Prediction of Premature Birth by means of Multichannel Electrohysterographic Records. Journal of Sensors, 2019, 1-13. doi:10.1155/2019/5373810Acharya, U. R., Sudarshan, V. K., Rong, S. Q., Tan, Z., Lim, C. M., Koh, J. E., … Bhandary, S. V. (2017). Automated detection of premature delivery using empirical mode and wavelet packet decomposition techniques with uterine electromyogram signals. Computers in Biology and Medicine, 85, 33-42. doi:10.1016/j.compbiomed.2017.04.013Fergus, P., Cheung, P., Hussain, A., Al-Jumeily, D., Dobbins, C., & Iram, S. (2013). Prediction of Preterm Deliveries from EHG Signals Using Machine Learning. PLoS ONE, 8(10), e77154. doi:10.1371/journal.pone.0077154Ren, P., Yao, S., Li, J., Valdes-Sosa, P. A., & Kendrick, K. M. (2015). Improved Prediction of Preterm Delivery Using Empirical Mode Decomposition Analysis of Uterine Electromyography Signals. PLOS ONE, 10(7), e0132116. doi:10.1371/journal.pone.0132116Benalcazar-Parra, C., Ye-Lin, Y., Garcia-Casado, J., Monfort-Ortiz, R., Alberola-Rubio, J., Perales, A., & Prats-Boluda, G. (2019). Prediction of Labor Induction Success from the Uterine Electrohysterogram. Journal of Sensors, 2019, 1-12. doi:10.1155/2019/6916251Sammali, F., Kuijsters, N. P. M., Schoot, B. C., Mischi, M., & Rabotti, C. (2018). Feasibility of Transabdominal Electrohysterography for Analysis of Uterine Activity in Nonpregnant Women. Reproductive Sciences, 25(7), 1124-1133. doi:10.1177/1933719118768700Ye-Lin, Y., Bueno-Barrachina, J. M., Prats-boluda, G., Rodriguez de Sanabria, R., & Garcia-Casado, J. (2017). Wireless sensor node for non-invasive high precision electrocardiographic signal acquisition based on a multi-ring electrode. Measurement, 97, 195-202. doi:10.1016/j.measurement.2016.11.009Maul, H., Maner, W., Olson, G., Saade, G., & Garfield, R. (2004). Non-invasive transabdominal uterine electromyography correlates with the strength of intrauterine pressure and is predictive of labor and delivery. The Journal of Maternal-Fetal & Neonatal Medicine, 15(5), 297-301. doi:10.1080/14767050410001695301Shukla, S., Singh, S. K., & Mitra, D. (2020). An efficient heart sound segmentation approach using kurtosis and zero frequency filter features. Biomedical Signal Processing and Control, 57, 101762. doi:10.1016/j.bspc.2019.101762Ye-Lin, Y., Alberola-Rubio, J., Prats-boluda, G., Perales, A., Desantes, D., & Garcia-Casado, J. (2014). Feasibility and Analysis of Bipolar Concentric Recording of Electrohysterogram with Flexible Active Electrode. Annals of Biomedical Engineering, 43(4), 968-976. doi:10.1007/s10439-014-1130-5Vrhovec, J., Macek-Lebar, A., & Rudel, D. (s. f.). Evaluating Uterine Electrohysterogram with Entropy. IFMBE Proceedings, 144-147. doi:10.1007/978-3-540-73044-6_36Zhang, X.-S., Roy, R. J., & Jensen, E. W. (2001). EEG complexity as a measure of depth of anesthesia for patients. 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Phase I study of plitidepsin in combination with bortezomib and dexamethasone in patients with relapsed/refractory multiple myeloma

Previous studies showed antitumor activity for plitidepsin plus dexamethasone (DXM) in relapsed/refractory multiple myeloma (r/r MM), and in vitro synergism with bortezomib (BTZ) or DXM against MM cells. This phase I trial evaluated plitidepsin (3-h intravenous infusion Day 1 and 15), BTZ (subcutaneous bolus Day 1, 4, 8, and 11), and DXM (orally Day 1, 8, 15, and 22), every 4 weeks in 36 r/r MM patients. Twenty-two patients were treated using a standard dose escalation design (10 at the recommended dose [RD] cohort), and 14 additional patients were treated to expand the RD cohort. No dose-limiting toxicities (DLTs) occurred during dose escalation. The highest dose level evaluated (plitidepsin 5.0 mg/m2 , BTZ 1.3 mg/m2 , DXM 40.0 mg) was the RD for phase II studies. Results shown herein are focused on this RD. Two patients had DLTs (grade 3 diarrhea, and grade 3 nausea/vomiting refractory to antiemetic therapy). Grade ? 3 hematological toxicity (thrombocytopenia 46%, anemia 33%, and neutropenia 17%) was manageable and did not result in treatment discontinuation. Transient and manageable grade 3 ALT increase (26%) was the most common biochemical abnormality. At the RD cohort, overall response rate was 22.2% (95%CI, 6.4%-47.6%), including one stringent complete response, one very good partial response, and two partial responses in r/r patients to BTZ and/or lenalidomide. The clinical benefit rate was 77.8% (95%CI, 52.4-93.6%). No major pharmacokinetic drug-drug interaction was found. In conclusion, the triple combination of plitidepsin, BTZ, and DXM showed an acceptable safety profile and had moderate activity in adult patients with r/r MM.FUNDING: The study was funded by Pharma Mar, S.A. ACKNOWLEDGMENTS: The authors thank the patients, their families, and investigators teams for their participation in this phase I clinical trial

Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19

Objective To describe the impact of different doses of corticosteroids on the evolution of patients with COVID-19 pneumonia, based on the potential benefit of the non-genomic mechanism of these drugs at higher doses. Methods Observational study using data collected from the SEMI-COVID-19 Registry. We evaluated the epidemiological, radiological and analytical scenario between patients treated with megadoses therapy of corticosteroids vs low-dose of corticosteroids and the development of complications. The primary endpoint was all-cause in-hospital mortality according to use of corticosteroids megadoses. Results Of a total of 14,921 patients, corticosteroids were used in 5,262 (35.3%). Of them, 2,216 (46%) specifically received megadoses. Age was a factor that differed between those who received megadoses therapy versus those who did not in a significant manner (69 years [IQR 59-79] vs 73 years [IQR 61-83]; p < .001). Radiological and analytical findings showed a higher use of megadoses therapy among patients with an interstitial infiltrate and elevated inflammatory markers associated with COVID-19. In the univariate study it appears that steroid use is associated with increased mortality (OR 2.07 95% CI 1.91-2.24 p < .001) and megadose use with increased survival (OR 0.84 95% CI 0.75-0.96, p 0.011), but when adjusting for possible confounding factors, it is observed that the use of megadoses is also associated with higher mortality (OR 1.54, 95% CI 1.32-1.80; p < .001). There is no difference between megadoses and low-dose (p.298). Although, there are differences in the use of megadoses versus low-dose in terms of complications, mainly infectious, with fewer pneumonias and sepsis in the megadoses group (OR 0.82 95% CI 0.71-0.95; p < .001 and OR 0.80 95% CI 0.65-0.97; p < .001) respectively. Conclusion There is no difference in mortality with megadoses versus low-dose, but there is a lower incidence of infectious complications with glucocorticoid megadoses

Microbiome definition re-visited: old concepts and new challenges

peer-reviewedAbstract The field of microbiome research has evolved rapidly over the past few decades and has become a topic of great scientific and public interest. As a result of this rapid growth in interest covering different fields, we are lacking a clear commonly agreed definition of the term “microbiome.” Moreover, a consensus on best practices in microbiome research is missing. Recently, a panel of international experts discussed the current gaps in the frame of the European-funded MicrobiomeSupport project. The meeting brought together about 40 leaders from diverse microbiome areas, while more than a hundred experts from all over the world took part in an online survey accompanying the workshop. This article excerpts the outcomes of the workshop and the corresponding online survey embedded in a short historical introduction and future outlook. We propose a definition of microbiome based on the compact, clear, and comprehensive description of the term provided by Whipps et al. in 1988, amended with a set of novel recommendations considering the latest technological developments and research findings. We clearly separate the terms microbiome and microbiota and provide a comprehensive discussion considering the composition of microbiota, the heterogeneity and dynamics of microbiomes in time and space, the stability and resilience of microbial networks, the definition of core microbiomes, and functionally relevant keystone species as well as co-evolutionary principles of microbe-host and inter-species interactions within the microbiome. These broad definitions together with the suggested unifying concepts will help to improve standardization of microbiome studies in the future, and could be the starting point for an integrated assessment of data resulting in a more rapid transfer of knowledge from basic science into practice. Furthermore, microbiome standards are important for solving new challenges associated with anthropogenic-driven changes in the field of planetary health, for which the understanding of microbiomes might play a key role. Video Abstrac

Dibujo para grabado: Pre-producción, lenguajes gráficos y técnicas experimentales de construcción de la imagen para el grabado, las técnicas de estampación e impresión y el libro-arte

Proyecto de innovación docente pensado para canalizar la elaboración diversa de material docente y recursos didácticos que faciliten la práctica autónoma del estudiante y su aprendizaje del grabado, las técnicas de estampación, la edición y la creación del libro-arte fuera del aula, en un escenario de enseñanza semi-presencial. Se trata de apostar por fomentar la práctica artística independiente del alumnado. Para ello se propone reforzar la fase de pre-producción o fase de planificación aprovechar las posibilidades expresivas que ofrece el dibujo pensado para grabado, explorar diferentes lenguajes gráficos, adquirir vocabulario visual y generar paletas o bibliotecas de recursos gráfico-plásticos. El proyecto se entiende como espacio de diálogo e intercambio de conocimiento