Análisis del proyecto de Cooperación Phileos en Quezon City (Filipinas), Julio de 2017

Tras la segunda misión llevada a cabo por la asociación Phileos en la ciudad de Quezon City, la ONG continúa evolucionando con nuevos proyectos en otras ciudades de Filipinas y con nuevos estudiantes de la Universidad de Zaragoza. En la misión de 2017 se llevaron a cabo medidas organizativas y docentes adicionales que se recogen y analizan en este trabajo con el fin de consolidar los proyectos que allí se llevan a cabo. Este trabajo de fin de grado (TFG) realiza un análisis de la población atendida para conocer sus características y exponer las nuevas medidas docentes incorporadas en la misión. Para ello se ha llevado a cabo un análisis descriptivo de los datos recogidos durante la misión de Julio de 2017 mediante el programa de análisis estadístico SPSS en las tres áreas médicas, especialmente en el apartado de Medicina General. La consulta de Ginecología y Obstetricia asistió a 101 pacientes y en el ámbito quirúrgico se llevaron a cabo 15 cirugías mayores y 20 menores. En el apartado de Medicina General se atendieron a 1081 pacientes. De los pacientes recogidos, el 66,2% fueron mujeres y el 34% menores de 10 años. Las enfermedades más consultadas por segundo año consecutivo fueron las relativas al aparato respiratorio con un 45,3%, predominando la patología mayoritariamente aguda. Las pruebas más realizadas fueron los análisis de sangre y las radiografías, y de todas ellas el 79% resultaron útiles para el diagnóstico. Los tratamientos más frecuentes fueron las multivitaminas, las medidas higiénico-dietéticas, los antiinflamatorios no esteroideos (AINEs), los analgésicos y los antibióticos, con un porcentaje del 1,4% de tratamiento antituberculoso. Un año más la misión resultó exitosa, con más pacientes atendidos y nuevos programas de prevención y docencia. Aun así, es necesario continuar evolucionando hacia nuevos protocolos de acción en el ámbito de la pediatría y trasladar la asistencia al hospital de Lagonoy, en el sureste de la isla de Luzón.<br /

Appropriate use of red blood cell transfusion in emergency departments: A study in five emergency departments

BACKGROUND: Transfusion of blood components continues to be an important therapeutic resource into the 21st century. Between 5 and 58% of transfusions carried out are estimated to be unnecessary. According to several studies, at least 20% of packed red blood cell transfusions (RBCT) are administered in hospital emergency departments (ED), but few data are available about the appropriateness of RBCT in this setting. This multicentre, cross-sectional observational study aims to assess the appropriateness of RBCT indications and transfused volumes in patients who attend ED. MATERIALS AND METHODS: The study cohort is made up of consecutive consenting adult patients (≥18 years old) who received RBCT in ED over a 3-month period and for whom relevant clinical data were collected and analysed. RESULTS: Data from 908 RBCT episodes (2±1 units per transfused patient) were analysed. RBCT was considered appropriate in 21.4% (n=195), with significant differences according to RBCT indication (p<0.001), hospital level (p<0.001) and prescribing physician (p=0.002). Pre-transfusion haemoglobin level (Hb) negatively correlated with RBCT appropriateness (r=-0.616; p<0.01). Only 72.4% of appropriate RBCT had a post-transfusion Hb assessment (n=516). Of these, 45% were considered to be over-transfused (n=232), with significant differences according to RBCT indication (p=0.012) and prescribing physician (p=0.047). Overall, 584/1,433 (41%) of evaluable RBC units were unnecessarily transfused. DISCUSSION: The appropriateness of RBCT in ED is similar to other hospital departments, but the rate of over-transfusion was high. These data support the need for a reassessment after transfusion of each RBC unit before further units are prescribed. In view of these results, we recommend that physicians should be made more aware of the need to prescribe RBCT appropriately in order to reduce over-transfusionThis project has received funding from the Spanish Ministry of Health, Social Policy and Equality through the SAS/2377/2010 call for granting aid for the promotion of independent clinical research (Department of Pharmacy and Health Products), file n. EC10-21

Loxl3 Promotes Melanoma Progression and Dissemination Influencing Cell Plasticity and Survival

Malignant melanoma is the most lethal skin cancer due to its aggressive clinical behavior and therapeutic resistance. A comprehensive knowledge of the molecular mechanisms underlying melanoma progression is urgently needed to improve the survival of melanoma patients. Phenotypic plasticity of melanoma cells has emerged as a key process in melanomagenesis and therapy resistance. This phenotypic plasticity is sustained by an epithelial-to-mesenchymal (EMT)-like program that favors multiple intermediate states and allows adaptation to changing microenvironments along melanoma progression. Given the essential role of lysyl oxidase-like 3 (LOXL3) in human melanoma cell survival and its contribution to EMT, we generated mice with conditional melanocyte-specific targeting of Loxl3, concomitant to Braf activation and Pten deletion. Our results supported a key role of Loxl3 for melanoma progression, metastatic dissemination, and genomic stability, and supported its contribution to melanoma phenotypic plasticity by modulating the expression of several EMT transcription factors (EMT-TFs). Malignant melanoma is a highly aggressive tumor causing most skin cancer-related deaths. Understanding the fundamental mechanisms responsible for melanoma progression and therapeutic evasion is still an unmet need for melanoma patients. Progression of skin melanoma and its dissemination to local or distant organs relies on phenotypic plasticity of melanoma cells, orchestrated by EMT-TFs and microphthalmia-associated TF (MITF). Recently, melanoma phenotypic switching has been proposed to uphold context-dependent intermediate cell states benefitting malignancy. LOXL3 (lysyl oxidase-like 3) promotes EMT and has a key role in human melanoma cell survival and maintenance of genomic integrity. To further understand the role of Loxl3 in melanoma, we generated a conditional Loxl3-knockout (KO) melanoma mouse model in the context of BrafV600E-activating mutation and Pten loss. Melanocyte-Loxl3 deletion increased melanoma latency, decreased tumor growth, and reduced lymph node metastatic dissemination. Complementary in vitro and in vivo studies in mouse melanoma cells confirmed Loxl3's contribution to melanoma progression and metastasis, in part by modulating phenotypic switching through Snail1 and Prrx1 EMT-TFs. Importantly, a novel LOXL3-SNAIL1-PRRX1 axis was identified in human melanoma, plausibly relevant to melanoma cellular plasticity. These data reinforced the value of LOXL3 as a therapeutic target in melanoma

Acenocoumarol Pharmacogenetic Dosing Algorithm versus Usual Care in Patients with Venous Thromboembolism: A Randomised Clinical Trial

Patients with venous thromboembolism (VTE) require immediate treatment with anticoagulants such as acenocoumarol. This multicentre randomised clinical trial evaluated the effectiveness of a dosing pharmacogenetic algorithm versus a standard-of-care dose adjustment at the beginning of acenocoumarol treatment. We included 144 patients with VTE. On the day of recruitment, a blood sample was obtained for genotyping (CYP2C9*2, CYP2C9*3, VKORC1, CYP4F2, APOE). Dose adjustment was performed on day 3 or 4 after the start of treatment according to the assigned group and the follow-up was at 12 weeks. The principal variable was the percentage of patients with an international normalised ratio (INR) within the therapeutic range on day 7. Thirty-four (47.2%) patients had an INR within the therapeutic range at day 7 after the start of treatment in the genotype-guided group compared with 14 (21.9%) in the control group (p = 0.0023). There were no significant differences in the time to achieve a stable INR, the number of INRs within the range in the first 6 weeks and at the end of study. Our results suggest the use of a pharmacogenetic algorithm for patients with VTE could be useful in achieving target INR control in the first days of treatment

Traducción para voice-over del género stand-up comedy. El caso de ‘Adam Sandler: 100% Fresh’: humor, registro coloquial y canciones

Treball de fi de grau en Traducció i Interpretació. Tutora: Verònica LópezEl stand-up comedy es originalmente un género humorístico teatral, no audiovisual, algo que lo distingue del resto de formatos televisivos, y que supone un reto en la traducción para voice- over por su espontaneidad e interacción con el público, además del uso de un lenguaje muy coloquial y repleto de referentes culturales. El objetivo de este trabajo es analizar las dificultades que se presentan a la hora de traducir el stand-up comedy Adam Sandler: 100 % Fresh, y determinar las estrategias más eficientes para conseguir mantener la intención humorística en la lengua de llegada. Para ello, por un lado, se ha propuesto una traducción para algunos fragmentos del monólogo especialmente complejos por contener referentes culturales, expresiones coloquiales, juegos de palabras y otros elementos difíciles de adaptar. Por otro lado, se ha llevado a cabo un proceso de transcreación a través del análisis y la traducción de dos canciones. La conclusión principal de este trabajo es que mantener los elementos de la cultura de partida y la función humorística de un texto al mismo tiempo es prácticamente imposible. Generalmente, se ha optado por adaptar los referentes, aunque evitando una domesticación absoluta del texto. De este modo, se ha alcanzado el objetivo de mantener el humor teniendo en cuenta las particularidades de la modalidad de voice-over. Los ejemplos aportados y las estrategias empleadas pueden ser útiles para futuras traducciones del género stand-up comedy.L’stand-up comedy és originalment un gènere humorístic teatral, no audiovisual, i això el distingeix de la resta de formats televisius, i alhora suposa un repte en la traducció per a voice- over a causa de l’espontaneïtat i interacció amb el públic, així com l’ús d’un llenguatge molt col·loquial i ple de referents culturals. L’objectiu d’aquest treball és analitzar les dificultats que es presenten a l’hora de traduir l’stand-up comedy Adam Sandler: 100% Fresh, i determinar les estratègies més eficients per a aconseguir mantenir la intenció humorística en la llengua d’arribada. Per a fer-ho, d’una banda, s’ha proposat una traducció per a alguns fragments del monòleg especialment difícils, perquè contenen referents culturals, expressions col·loquials, jocs de paraules i altres elements difícils d’adaptar. D’altra banda, s’ha portat a terme un procés de transcreació a través de l'anàlisi i la traducció de dues cançons. La conclusió principal d’aquest treball és que mantenir els elements de la cultura de partida alhora que la funció humorística d’un text és pràcticament impossible. Generalment, s’ha optat per adaptar els referents, però evitant una domesticació absoluta del text. D’aquesta manera, s’ha assolit l’objectiu de mantenir l’humor tenint en compte les particularitats de la modalitat de voice-over. Els exemples aportats i les estratègies utilitzades poden ser útils per a futures traduccions del gènere stand-up comedy.Stand-up comedy is originally a theatrical comedy genre, not an audiovisual one, something that makes it stand out from the rest of television formats, and poses a challenge in translation for voice-over due to its spontaneity and interaction with the audience, as well as the use of a highly colloquial language full of cultural references. The aim of this paper is to analyse the difficulties that arise when translating the stand-up comedy Adam Sandler: 100% Fresh, and to determine the most efficient strategies for maintaining the humorous intention in the target language. To this end, on the one hand, a translation has been proposed for some passages of the monologue which are particularly challenging because they include cultural references, colloquial expressions, puns and other elements that are difficult to adapt. On the other hand, a transcreation process has been carried out through the analysis and translation of two songs. The main conclusion of this paper is that it is practically impossible to maintain the elements of the source culture and the humorous function at the same time. Generally, it has been decided to adapt the references, while avoiding an absolute domestication of the text. In this way, it has been possible to achieve the goal of maintaining the humour while taking into account the particularities of the voice-over modality. The examples given and the strategies employed may be useful for future translations of the stand-up comedy genre

Sensory Profile and Acceptability of Juices from Mandarin Varieties and Hybrids

12 pages, 12 tables, 4 figures.Fresh juices from mandarin varieties, from hybrids, and from blends of these raw materials were evaluated by 100 consumers to determine acceptability, and by 10 trained panelists to quantify sensory attributes. Trained panelists found the juice from Clemenules richer in both mandarin and fresh flavor (odor and taste) whereas Nova juice presented minimum scores for these attributes. These aspects obviously affected the evaluation of acceptability by consumers, who preferred the juice from Clemenules (a Clementine variety) either alone or blended in major proportions with less preferred varieties such as Marisol, Hernandina (Clementines), Ortanique or Nova (hybrids). Nova juice was rejected by most consumers, but accepted by a small group of them. These results are of great importance for the European citrus industry since Clemenules is the most abundant variety and will constitute the main source of raw material for processing plants.This work is part of the Project AGL 2006-05809/ALI financed by Ministerio de Educación y Ciencia (Spain). Authors thank to CSIC (Program I3P, granted by European Social Funds) for Sara Bayarri contract and to Generalitat Valenciana, Conselleria d’ Agricultura, Pesca i Alimentació (AGROALIMED) for additional financial supportPeer reviewe

Market Power and Joint Ownership: Evidence from Nuclear Plants in Sweden

This paper presents an empirical test of the anticompetitive effects of joint ownership, by examining the operation of three nuclear plants in Sweden. Since maintenance is the main conduit explaining the variation in output, I formulate a model of intertemporal choice in which firms choose how to allocate a given amount of maintenance within each year. Using data on production and bidding curves on the day-ahead market, I test the model against data given three behavioral assumptions: Unilateral profit maximization; joint profit maximization; and a social planner. Modeling for joint profit maximization best matches data, indicating that joint ownership has facilitated coordination of maintenance decisions. Terminating the joint ownership and modeling for unilateral profit maximization would lead to a 5 percent decrease in prices and a 6 percent decrease in system production costs. I identify positive supply shocks in the form of inflow to the hydro power reservoirs as important determinants of the incentives to exercise market power. Therefore, the mechanisms discussed in this paper should be of relevance also in other electricity markets where the share of intermittent production is increasing. As a motivation for the structural exercise, I use a difference-in-differences estimator to identify a shift in the allocation of maintenance towards the winter season (when demand and prices are peaking) at the time of the introduction of the joint ownership. This is in line with the results from the structural model, as the ability to influence the price is also higher during the winter season