Intervenciones para la adherencia al tratamiento de diabetes tipo 1: Revisión sistemática de la literatura

La adherencia al tratamiento de la diabetes tipo 1 es fundamental porque favorece la calidad de vida de las personas y disminuye el riesgo de desarrollar complicaciones agudas y/o crónicas, sin embargo, existe evidencia de que los pacientes no se adhieren eficazmente al tratamiento. Las intervenciones que buscan promover la adherencia terapéutica y que consideran la inclusión de componentes directos (específicos para el manejo de la enfermedad) e indirectos (procesos psicosociales), promueven un mayor control glucémico en jóvenes con diabetes tipo 1 (Hood, Rohan, Peterson y Drotar, 2010). Por lo tanto, el propósito del presente trabajo es realizar una revisión sistemática de la literatura sobre intervenciones orientadas a la promoción de adherencia terapéutica en personas con diabetes tipo 1, a fin de conocer su efectividad sobre factores directos e indirectos de la diabetes tipo 1. Se realizó una revisión sistemática de la literatura en las bases de datos PubMed, Redalyc y ScienceDirect. La búsqueda se realizó empleando términos relacionados con la diabetes tipo 1 combinados con indicadores de promoción de adherencia y de intervenciones, tanto en inglés como en español. La pesquisa de la información se limitó al título, resumen y palabras clave. La búsqueda comprendió artículos publicados entre enero de 2009 y julio de 2017. El análisis de los artículos se realizó con base en la agrupación de variables de Lipsey (1994) y otros criterios propuestos anteriormente para las revisiones de la literatura. Se identificaron seis estudios que cumplieron con los criterios de inclusión. La mayoría de las intervenciones fueron cognitvo-conductuales y tuvieron resultados favorables sobre factores directos e indirectos de la diabetes tipo 1. Palabras clave: dependencia a la insulina, control glucémico, a

Algoritmos de expansión de consulta basados en una nueva función discreta de relevancia

Se ha demostrado que el proceso de expansión de las consultas en el modelo espacio vectorial de representación dedocumentos en un sistema de recuperación de información, es una técnica útil para mejorar la relevancia medidapor la precisión de los resultados entregados a los usuarios. En este artículo se presenta un nuevo algoritmo y unavariación del mismo para realizar expansión de consultas en un sistema de recuperación de información. Estosalgoritmos se basan en una nueva función discreta que define la importancia relativa de un término en una colecciónde documentos. El algoritmo y su variación se evalúan frente a la búsqueda por similitud de cosenos y el algoritmode expansión propuesto por Rocchio, obteniendo excelentes resultados sobre la colección de datos CACM (artículospublicados en la revista Communications of the ACM).It has been shown that the query expansion process in the vector space model of document’s representation in aretrieval system, it is a useful technique for improving the relevance measured by precision of the results delivered tousers. This paper presents a new algorithm and a variation of itself used to perform query expansion in informationretrieval systems. These algorithms are based on a new discrete function that defines the relative importance of aterm in a document collection. The algorithm and its variation were evaluated against the cosine similarity searchand the query expansion algorithm proposed by Rocchio, with excellent results on data collection CACM (articlespublished in the Communications of the ACM journal)

Query expansion algorithms based on a new discrete relevance function

It has been shown that the query expansion process in the vector space model of document’s representation in aretrieval system, it is a useful technique for improving the relevance measured by precision of the results delivered tousers. This paper presents a new algorithm and a variation of itself used to perform query expansion in informationretrieval systems. These algorithms are based on a new discrete function that defines the relative importance of aterm in a document collection. The algorithm and its variation were evaluated against the cosine similarity searchand the query expansion algorithm proposed by Rocchio, with excellent results on data collection CACM (articlespublished in the Communications of the ACM journal).Se ha demostrado que el proceso de expansión de las consultas en el modelo espacio vectorial de representación dedocumentos en un sistema de recuperación de información, es una técnica útil para mejorar la relevancia medidapor la precisión de los resultados entregados a los usuarios. En este artículo se presenta un nuevo algoritmo y unavariación del mismo para realizar expansión de consultas en un sistema de recuperación de información. Estosalgoritmos se basan en una nueva función discreta que define la importancia relativa de un término en una colecciónde documentos. El algoritmo y su variación se evalúan frente a la búsqueda por similitud de cosenos y el algoritmode expansión propuesto por Rocchio, obteniendo excelentes resultados sobre la colección de datos CACM (artículospublicados en la revista Communications of the ACM)

Total absorption spectroscopy study of the beta decay of Br-86 and Rb-91

The beta decays of Br-86 and Rb-91 have been studied using the total absorption spectroscopy technique. The radioactive nuclei were produced at the Ion Guide Isotope Separator On-Line facility in Jyvaskyla and further purified using the JYFLTRAP. Br-86 and Rb-91 are considered to be major contributors to the decay heat in reactors. In addition, Rb-91 was used as a normalization point in direct measurements of mean gamma energies released in the beta decay of fission products by Rudstam et al. assuming that this decaywas well known from high-resolution measurements. Our results show that both decays were suffering from the Pandemonium effect and that the results of Rudstam et al. should be renormalized. The relative impact of the studied decays in the prediction of the decay heat and antineutrino spectrum from reactors has been evaluated.Peer reviewe

SETD2 loss-of-function promotes renal cancer branched evolution through replication stress and impaired DNA repair

The research leading to these results is supported by Cancer Research UK (XYG, RAB, EG, PM, PE, SG, C Santos, AJR, NM, PAB, AS and C Swanton), Breast Cancer Research Foundation (C Swanton and NK), Medical Research Council (ID: G0902275 to MG and C Santos; ID: G0701935/2 to AJR and C Swanton), the Danish Cancer Society (AMM, J Bartkova and J Bartek), the Lundbeck Foundation (R93-A8990 to J Bartek), the Ministry of the interior of the Czech Republic (grant VG20102014001 to MM and J Bartek), the National Program of Sustainability (grant LO1304 to MM and J Bartek), the Danish Council for Independent Research (grant DFF-1331-00262 to J Bartek), NIHR RMH/ICR Biomedical Research Centre for Cancer (JL), the EC Framework 7 (PREDICT 259303 to XYG, EG, PM, MG, TJ and C Swanton; DDResponse 259892 to J Bartek and J Bartkova and RESPONSIFY ID:259303 to C Swanton), UCL Overseas Research Scholarship (SG). C Swanton is also supported by the European Research Council, Rosetrees Trust and The Prostate Cancer Foundation. This research is supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Properties of the Binary Neutron Star Merger GW170817

On August 17, 2017, the Advanced LIGO and Advanced Virgo gravitational-wave detectors observed a low-mass compact binary inspiral. The initial sky localization of the source of the gravitational-wave signal, GW170817, allowed electromagnetic observatories to identify NGC 4993 as the host galaxy. In this work, we improve initial estimates of the binary's properties, including component masses, spins, and tidal parameters, using the known source location, improved modeling, and recalibrated Virgo data. We extend the range of gravitational-wave frequencies considered down to 23 Hz, compared to 30 Hz in the initial analysis. We also compare results inferred using several signal models, which are more accurate and incorporate additional physical effects as compared to the initial analysis. We improve the localization of the gravitational-wave source to a 90% credible region of 16  deg2. We find tighter constraints on the masses, spins, and tidal parameters, and continue to find no evidence for nonzero component spins. The component masses are inferred to lie between 1.00 and 1.89  M⊙ when allowing for large component spins, and to lie between 1.16 and 1.60  M⊙ (with a total mass 2.73−0.01+0.04  M⊙) when the spins are restricted to be within the range observed in Galactic binary neutron stars. Using a precessing model and allowing for large component spins, we constrain the dimensionless spins of the components to be less than 0.50 for the primary and 0.61 for the secondary. Under minimal assumptions about the nature of the compact objects, our constraints for the tidal deformability parameter Λ are (0,630) when we allow for large component spins, and 300−230+420 (using a 90% highest posterior density interval) when restricting the magnitude of the component spins, ruling out several equation-of-state models at the 90% credible level. Finally, with LIGO and GEO600 data, we use a Bayesian analysis to place upper limits on the amplitude and spectral energy density of a possible postmerger signal

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised