382 research outputs found

    Registro nacional de pacientes intervenidos de cirugía cardiovascular («QUIP-ESPAÑA»)

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    Exploiting Heterogeneous Parallelism on Hybrid Metaheuristics for Vector Autoregression Models

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    In the last years, the huge amount of data available in many disciplines makes the mathematical modeling, and, more concretely, econometric models, a very important technique to explain those data. One of the most used of those econometric techniques is the Vector Autoregression Models (VAR) which are multi-equation models that linearly describe the interactions and behavior of a group of variables by using their past. Traditionally, Ordinary Least Squares and Maximum likelihood estimators have been used in the estimation of VAR models. These techniques are consistent and asymptotically efficient under ideal conditions of the data and the identification problem. Otherwise, these techniques would yield inconsistent parameter estimations. This paper considers the estimation of a VAR model by minimizing the difference between the dependent variables in a certain time, and the expression of their own past and the exogenous variables of the model (in this case denoted as VARX model). The solution of this optimization problem is approached through hybrid metaheuristics. The high computational cost due to the huge amount of data makes it necessary to exploit High-Performance Computing for the acceleration of methods to obtain the models. The parameterized, parallel implementation of the metaheuristics and the matrix formulation ease the simultaneous exploitation of parallelism for groups of hybrid metaheuristics. Multilevel and heterogeneous parallelism are exploited in multicore CPU plus multiGPU nodes, with the optimum combination of the different parallelism parameters depending on the particular metaheuristic and the problem it is applied to.This work was supported by the Spanish MICINN and AEI, as well as European Commission FEDER funds, under grant RTI2018-098156-B-C53 and grant TIN2016-80565-R

    Plan de acogida para los alumnos de nuevo ingreso en el grado de Ingeniería Informática en la ESII (UCLM)

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    Con el propósito de facilitar la adaptación de los nuevos estudiantes a la Universidad, se ha diseñado en la Escuela Superior de Ingeniería Informática de Albacete (ESII) de la Universidad de Castilla-La Mancha (UCLM) un plan de acogida. Este plan consiste en un conjunto de actividades concebidas para asentar las bases del aprendizaje en la Educación Superior, en especial en los estudios de Informática. Durante la primera semana del curso se realizan unas jornadas de acogida, con charlas de presentación de todos los servicios que ofrecen tanto el centro como la Universidad. También se imparten diversos talleres y seminarios. Además de estas jornadas, durante todo el curso se ofrecen actividades de apoyo y refuerzo, así como un plan de tutorías personalizadas que les acompañará durante sus estudios universitarios en este centro.SUMMARY: In order to facilitate the adaptation of new students to the University, a welcome plan is designed by our institution. This plan consists of a set of activities designed to lay the foundations for learning in Higher Education, specifically in Computer Science. During the first week of the first semester, introductory talks on the services of the School and the University are given, and several workshops and seminars are held too. In addition to these sessions, and throughout the two semesters, some support and reinforcement activities are also offered to students, and a personalized tutoring plan that will accompany them during their studies at this center.Peer Reviewe

    Aortic injuries in crush trauma patients: different mechanism, different management

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    [Abstract] Background. The objective of this study is to report the clinical and radiological characteristics and early and long-term survival of a series of acute traumatic aortic injuries (ATAI) in crush trauma patients, and to compare such data with our last 30 years experience managing ATAI in deceleration non-crush trauma patients. Methods. From January 1980 to December 2010, 5 consecutive ATAI in crush trauma and 69 in non-crush trauma patients were admitted at our institution. ISS, RTS and TRISS scores were similar in both groups. Results. Overall in-hospital mortality was 24.3%. There was no in-hospital mortality in crush patients and 26.1% in non-crush patients (p = 0.32). All aortic-related complications occurred in non-crush patients. Median follow-up was 129 months (range 3–350 months). Non-crush group survival was 76.8% at 1 year, 73.6% at 5 years, and 71.2%% at 10 years. There was no mortality during follow-up in the crush group. Mean (SD) peak creatine phosphokinase was significantly higher in crush group than in non-crush group: 7598 (3690) IU/L vs. 3645 (2506) IU/L; p = 0.041. Incidence of acute renal injury was higher in crush trauma patients (100% vs. 36.2%; p = 0.018). Low-severity injuries were more common in crush trauma patients (100% in crush patients vs. 43.5% in non-crush patients, p = 0.04). Conclusions. Aortic injuries in crush thoracic trauma patients seem to present in a different clinical scenario from aortic injuries in high-speed thoracic trauma thus requiring distinct considerations. When planning the initial management of aortic injuries in crush trauma, the increased risk of rhabdomiolysis and subsequent acute renal failure, as well as a tendency to develop lower-risk aortic wall injuries, must be considered

    Role of conservative management in traumatic aortic injury: comparison of long-term results of conservative, surgical, and endovascular treatment

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    [Abstract] Objective. The purpose of this study is to compare early and long-term results in terms of survival and cardiovascular complications of patients with acute traumatic aortic injury who were conservatively managed with patients who underwent surgical or endovascular repair. Methods. From January 1980 to December 2009, 66 patients with acute traumatic aortic injury were divided into 3 groups according to treatment intention at admission: 37 patients in a conservative group, 22 patients in a surgical group, and 7 patients in an endovascular group. Groups were similar with regard to gender, age, Injury Severity Score, Revised Trauma Score, and Trauma Injury Severity Score. Results. In-hospital mortality was 21.6% in the conservative group, 22.7% in the surgical group, and 14.3% in the endovascular group (P = .57). In-hospital aortic-related complications occurred only in the conservative group. Median follow-up time was 75 months (range, 5–327 months). Conservative group survival was 75.6% at 1 year, 72.3% at 5 years, and 66.7% at 10 years. Surgical group survival remained at 77.2% at 1, 5, and 10 years, whereas survival in the endovascular group was 85.7% at 1 and 5 years (P = .18). No patient in the surgical or endovascular group required reintervention because of aortic-related complications, whereas 37.9% of the conservative group had an aortic-related complication that required surgery or caused the patient’s death during the follow-up period. Cumulative survival free from aortic-related complications in the conservative group was 93% at 1 year, 88.5% at 5 years, and 51.2% at 10 years. Cox regression confirmed the initial type of aortic lesion (hazard ratio, 2.94; P = .002) and a Trauma Score-Injury Severity Score greater than 50% on admission (hazard ratio, 1.49; P = .042) as risk factors for the appearance of aortic-related complications. Two peaks in the complication rate of the conservative group were detected in the first week and between the first and third months after blunt thoracic trauma. Conclusions. The advent of thoracic aortic endografting has enabled a revolution in the management of acute traumatic aortic injury in patients with multisystem trauma with a low in-hospital morbimortality. Nonoperative management may be only a therapeutic option with acceptable survival in carefully selected patients. The natural history of these patients has revealed a marked trend of late aortic-related complications developing, which may justify an endovascular repair even in some low-risk patients

    Loss of Melanopsin-Expressing Ganglion Cell Subtypes and Dendritic Degeneration in the Aging Human Retina

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    In mammals, melanopsin-expressing retinal ganglion cells (mRGCs) are, among other things, involved in several non-image-forming visual functions, including light entrainment of circadian rhythms. Considering the profound impact of aging on visual function and ophthalmic diseases, here we evaluate changes in mRGCs throughout the life span in humans. In 24 post-mortem retinas from anonymous human donors aged 10–81 years, we assessed the distribution, number and morphology of mRGCs by immunostaining vertical retinal sections and whole-mount retinas with antibodies against melanopsin. Human retinas showed melanopsin immunoreactivity in the cell body, axon and dendrites of a subset of ganglion cells at all ages tested. Nearly half of the mRGCs (51%) were located within the ganglion cell layer (GCL), and stratified in the outer (M1, 12%) or inner (M2, 16%) margin of the inner plexiform layer (IPL) or in both plexuses (M3, 23%). M1 and M2 cells conformed fairly irregular mosaics, while M3 cell distribution was slightly more regular. The rest of the mRGCs were more regularly arranged in the inner nuclear layer (INL) and stratified in the outer margin of the IPL (M1d, 49%). The quantity of each cell type decrease after age 70, when the total number of mRGCs was 31% lower than in donors aged 30–50 years. Moreover, in retinas with an age greater than 50 years, mRGCs evidenced a decrease in the dendritic area that was both progressive and age-dependent, as well as fewer branch points and terminal neurite tips per cell and a smaller Sholl area. After 70 years of age, the distribution profile of the mRGCs was closer to a random pattern than was observed in younger retinas. We conclude that advanced age is associated with a loss in density and dendritic arborization of the mRGCs in human retinas, possibly accounting for the more frequent occurrence of circadian rhythm disorders in elderly persons.This research was supported by grants from the Spanish Ministry of Economy and Competitiveness (MINECO-FEDER BFU2015-67139-R), Instituto de Salud Carlos III (RETICS-FEDER RD16/0008/0016) and Generalitat Valenciana (PROMETEO/2016/158)

    Valoración de los beneficios de la movilización continua pasiva tras artroplastia total de rodilla

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    Se realiza un estudio restrospetivo y randomizado en 43 pacientes (43 rodillas), afectados de gonartrosis grado III de Ahlbäck intervenidos mediante artroplastia total de rodilla (ATR) tipo Press-fit Condylar (PFC) para la valoración de los posibles beneficios de la Movilización Continua Pasiva (MPC) en el proceso de rehabilitación tras la ATR. Se crearon aleatoriamente tres grupos de pacientes: Grupo I (no MPC), Grupo II (MPC 0º- 40º) y Grupo III (MPC 0º-70º). Se cuantificaron las siguientes variables: días de hospitalización, rango de movimiento (ROM) a los 7 días y a los 6 meses postoperatorios, sangrado a través del drenaje tipo redón y requerimientos analgésicos. Únicamente hallamos diferencias estadísticamente significativas en el sangrado a través del drenaje, siendo este mayor en los pacientes sometidos a MPC. No hubo diferencias estadísticamente significativas en cuanto al ROM en ninguno de los momentos estudiados, entre los tres grupos..A prospective and randomize study was performed in 43 patients (43 knee joints) with gonarthrosis grade III of Ahlbäck who underwent a total knee arthroplasty (TKA) type Press-fit Condylar (PFC), in order to evaluate the possible advantages of the continuous passive motion (CPM) in the process of rehabilitation after TKA. Patients were randomly assigned to three groups: Group I (no CPM), group II (CPM 0-40º) and group III (CPM 0-70º). The following variable parameters were quantified: hospitalisation days, range of motion (ROM) after 7 days and 6 months postoperation, bleeding through the aspirative significant differences in the bleeding through the drainage, being larger in patients who received CPM. There were statistically differences in the ROM in any of the studied moments and in neither of the groups

    Long-Term outcomes and durability of the mitroflow aortic bioprosthesis

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    [Abstract] Background. This study aims to determine the incidence and causes of structural valve deterioration (SVD) among all models of Mitroflow bioprostheses (A12/LX/DL), as well as to define their long-term clinical and hemodynamic performance. Methods and Results. We retrospectively reviewed a series of 1023 patients who underwent aortic valve replacement with Mitroflow bioprostheses between 2001 and 2014. A small aortic root was found in 22.4% of patients. There were two cases of severe patient-prosthesis mismatch. Only 31 patients developed SVD. The rate of incidence was 8.1 cases per 1000 patient-years. Cumulative incidence of SVD was 1.4% and 3% at five and 10 years, respectively. Freedom from SVD was 97.4% and 88.2% at five and 10 years, respectively. Anticalcification phospholipid reduction treatment (PRT) for model DL was a protective factor for SVD. Multivariable analysis confirmed age <70 years and use of 19 mm valve as independent predictors of SVD. Cumulative survival was 76.6% at five years and 42.3% at 10 years (mean follow-up 3.8 ± 3.1 years). In multivariable analysis, neither the use of small aortic prosthesis (p = 0.18) nor the occurrence of SVD (p = 0.85) was found to be independent predictors of long-term survival. Conclusions. Mitroflow valves demonstrate an acceptable rate of SVD and satisfactory long-term hemodynamic performance, particularly in patients with small aortic roots, age >70 years, and cases with severe left ventricular hypertrophy. PRT might contribute to improved long-term durability
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