Learning and Teaching after 50 Years of THORAX Surgery

Surgeries are practiced in different areas, and specifically in the thorax described in this chapter, the medical doctors must know in detail the biological structures in which they perform such surgical procedures. Therefore, in this chapter, we refer to the descriptive and topographical anatomy written by French doctors L. Testut and A. Latarjet. In earlier times, for several reasons, the medical surgeon operated all body organs and was involved in resolving the pathology of different areas. Currently and in the future, medical knowledge in thoracic surgery will cover subspecialties specifically divided, for example: assisted video surgery, interventional bronchoscopy, and mediastinoscopies to take mediastinal biopsies using robotic surgery of pulmonary exeresis to shorten the hospitalization period and even the days spent in the intensive care unit

Effect of oregano oil dietary supplementation on production parameters, height of intestinal villi and the antioxidant capacity in the breast of broiler

Oregano additives could contain growth stimulating compounds for poultry, however, a great variation attributed to their main components is observed. The aim of the present study was to investigate the effect of oregano oil dietary supplementationon the productive variables, the height of the intestinal villi and the accumulation of antioxidant compounds in the breast of broilers. In total, 480 broilers were reared from 1 to 42 d of age and since the first day of life were allocated into four treatments, each with four replications of 30 birds. The formulated diet was based on corn and soybean meal and 0, 100, 200 or 400 mg of oregano oilper kg of feed were incorporated in the diets of treatment 1, 2, 3 and 4, respectively. Feed intake, weight gain, feed conversion andmortality rates were weekly recorded. At 21 and 42 days of age the intestinal villi height and antioxidant capacity in the chicken breast were measured. Oregano oil used contained 43.17% and 29.16% of thymol and carvacrol, respectively. Feed intake, weight gain, feed conversion rate and mortality were not affected by oregano oil dietary supplementation. The height of intestinal villi increased with the level of oregano oil supplementation (P<0.05). However, the size of the intestinal villi was greater in the duodenum compared to the other parts (P<0.05), and jejunum and ileum had the same height. Antioxidant capacity of chicken breast at the 6th week was increased in the group that was dietary supplemented with 400 mg of oregano oil per kg of feed

LA MODELACIÓN MATEMÁTICA EN SU ESTRUCTURACIÓN DE UN SISTEMA DE HABILIDADES (Original)

The mathematical modeling is one of the fundamental tools that it allows to the engineer to correctly interpret of  the reality and transform it in order to perfect the different processes of the economy. The present paper aims to offer a methodology to improve the teaching of the mathematical modeling through differential equations in the Engineering careers of the Faculty of Technical Sciences of Granma's University. A thorough analysis of the curricula of these careers and the preparation of teachers and students identified the main inadequacies in this subject. The proposed methodology is based in the structuring of the mathematical basic abilities and its influence for the formation and develops of the ability to model through differential equations and in the contextualization of the teaching problems so that they motivate the students to the efficient study of this content.La modelación matemática es una de las herramientas fundamentales que le permite al ingeniero interpretar de forma correcta la realidad y transformarla en aras de perfeccionar los distintos procesos de la economía. El presente trabajo tiene como objetivo ofrecer una metodología para contribuir al perfeccionamiento de la enseñanza de la modelación matemática, vía ecuaciones diferenciales en las carreras de Ingeniería de la facultad de Ciencias Técnicas de la Universidad de Granma. Mediante un análisis minucioso de los planes y programas de estudio de estas carreras, de la preparación de los docentes y de los estudiantes se determinaron las principales insuficiencias en esta temática. La metodología propuesta se sustenta en la estructuración de las habilidades matemáticas básicas y su influencia para la formación y desarrollo de la habilidad modelar vía ecuaciones diferenciales y en la contextualización de los problemas docentes de manera que motiven a los estudiantes al estudio eficiente de este contenido

DISEÑO E IMPLEMENTACIÓN DE UN ROUTER CNC (DESIGN AND IMPLEMENTATION OF A CNC ROUTER)

En el presente trabajo se describe la implementación del mecanismo denominado Router CNC, mediante el cual se pueden realizar diseño y ejecución de piezas, de distinto ámbito, en materiales tales como: aluminio, madera, acrílico, entre otros. El maquinado de elementos en 3D forma parte de las funciones del mismo. Gracias a los sistemas que integran al Router CNC: sistema de movimientos de direcciones responsable de los desplazamientos de la cabeza de corte, el sistema electrónico es el cableado y conjunto de tarjetas electrónicas encargadas del control y comunicaciones entre los sistemas. Se utilizó el software Universal Gcode Sender como interface entre el usuario y Router, el cual permitió la operación manual. Todo este embalaje hacen del Router CNC un mecanismo útil y versátil de acuerdo con el enfoque que se asigne: empresa, comercio, educación. Dirigido a los estudiantes del instituto Tecnológico de Tláhuac como una herramienta para el diseño y ejecución de sus proyectos en electrónica, control, programación, diseño entre otras, que les dé la oportunidad de materializarlos y fortalecer los conocimientos de manera práctica y despertar su interés para crear más proyectos útiles en su aprendizaje.Palabras clave: CNC, motor paso a paso, automatización. AbstractThis paper describes the implementation of the mechanism called CNC Router, through which you can perform design and execution of parts, of different scope, in materials such as: aluminum, wood, acrylic, among others. The machining of 3D elements is part of the functions of it. Thanks to the systems that integrate the CNC Router: system of movement of directions responsible for the displacements of the cutting head, the electronic system is the wiring and set of electronic boards responsible for control and communications between systems. The Universal Gcode Sender software was used as an interface between the user and the Router, which allowed manual operation. All this packaging make the CNC Router a useful and versatile mechanism according to the approach that is assigned: business, commerce, education. Directed to the students of the Technological Institute of Tláhuac as a tool for the design and execution of their projects in electronics, control, programming, design, among others, which gives them the opportunity to materialize them and strengthen knowledge in a practical way and arouse their interest to create more useful projects in their learning.Keywords: CNC, stepper motor, automation

Activated Lymphocytes and Increased Risk of Dermatologic Adverse Events during Sorafenib Therapy for Hepatocellular Carcinoma

Altres ajuts: Asociación Española Contra el Cáncer PI044031Hepatocellular carcinoma is the second cause of cancer-related death worldwide. Of those advanced-stage patients who are treated with sorafenib, those who develop early dermatologic adverse events have a better prognosis. These events are possibly immune-related. Therefore, we analyzed the phenotype of 52 sorafenib-treated patients' circulating lymphocytes throughout treatment. We found that different co-stimulatory and immune exhaustion markers, such as Programmed cell death protein 1 (PD-1) and DNAX accessory molecule 1 (DNAM-1) amongst others, correlate with the probability of developing these adverse events, both before and during the treatment. We also compared the phenotype of those lymphocytes expressing DNAM-1 with those that do not, and while NK DNAM-1-expressing cells have a co-stimulatory phenotype, T DNAM-1-expressing cells are immune-suppressors. Overall, we set a rationale for the combination of sorafenib and immune-targeted therapies; and for the use of immune markers (such as DNAM-1) for patients' prognosis evaluation. Advanced hepatocellular carcinoma patients treated with sorafenib who develop early dermatologic adverse events (eDAEs) have a better prognosis. This may be linked to immune mechanisms, and thus, it is relevant to assess the association between peripheral immunity and the probability of developing eDAEs. Peripheral blood mononuclear cells of 52 HCC patients treated with sorafenib were analyzed at baseline and throughout the first eight weeks of therapy. T, B, Natural Killer cells, and their immune checkpoints expression data were characterized by flow cytometry. Cytokine release and immune-suppression assays were carried out ex vivo. Cox baseline and time-dependent regression models were applied to evaluate the probability of increased risk of eDAEs. DNAM-1, PD-1, CD69, and LAG-3 in T cells, plus CD16 and LAG-3 in NK cells, are significantly associated with the probability of developing eDAEs. While NK DNAM-1 + cells express activation markers, T DNAM-1 + cells induce immune suppression and show immune exhaustion. This is the first study to report an association between immune checkpoints expression in circulating immune cells and the increased incidence of eDAEs. Our results support the hypothesis for an off-target role of sorafenib in immune modulation. We also describe a novel association between DNAM-1 and immune exhaustion in T cells

Early diarrhoea under sorafenib as a marker to consider the early migration to second-line drugs

Despite atezolizumab and bevacizumab (A + B) is currently the first-line treatment for hepatocellular carcinoma (HCC) patients, some patients will not be adequate for this combination. In the setting of sorafenib some adverse events have been proposed as prognostic factors. To characterize the early diarrhoea development as prognostic factor in 344 HCC patients. The development of early diarrhoea in sorafenib treatment defined as patients who developed diarrhoea and needed dose modification within the first 60 days of treatment (e-diarrhoea) and 3-grouping variables were analysed: Patients with e-diarrhoea, patients who developed diarrhoea after the first 60 days of treatment (L-diarrhoea) and patients that never developed diarrhoea (never diarrhoea). The median overall survival in sorafenib treated patients was significantly different across groups (6.8 months for e-diarrhoea, 26.7 months for L-diarrhoea and 13.3 months for never-diarrhoea). The emergence of e-diarrhoea was associated with poor outcomes (hazard ratio [HR] 1.84 [95%CI 1.15-2.95]), while there was no increased/decreased risk of dismal evolution in patients with L-diarrhoea (HR 0.66 [95%CI 0.42-1.03]). The emergence of e-diarrhoea in HCC patients treated with sorafenib is an early predictor of dismal evolution under this therapy. Thus, prompt identification of these non-responders may be useful for an early switch to second-line therapies. Established knowledge on this subject What are the significant and/or new findings of this study

Early diarrhoea under sorafenib as a marker to consider the early migration to second-line drugs

Background: Despite atezolizumab and bevacizumab (A + B) is currently the first-line treatment for hepatocellular carcinoma (HCC) patients, some patients will not be adequate for this combination. In the setting of sorafenib some adverse events have been proposed as prognostic factors. Objective: To characterize the early diarrhoea development as prognostic factor in 344 HCC patients. Methods: The development of early diarrhoea in sorafenib treatment defined as patients who developed diarrhoea and needed dose modification within the first 60 days of treatment (e-diarrhoea) and 3-grouping variables were analysed: Patients with e-diarrhoea, patients who developed diarrhoea after the first 60 days of treatment (L-diarrhoea) and patients that never developed diarrhoea (never diarrhoea). Results: The median overall survival in sorafenib treated patients was significantly different across groups (6.8 months for e-diarrhoea, 26.7 months for L-diarrhoea and 13.3 months for never-diarrhoea). The emergence of e-diarrhoea was associated with poor outcomes (hazard ratio [HR] 1.84 [95%CI 1.15-2.95]), while there was no increased/decreased risk of dismal evolution in patients with L-diarrhoea (HR 0.66 [95%CI 0.42-1.03]). Conclusion: The emergence of e-diarrhoea in HCC patients treated with sorafenib is an early predictor of dismal evolution under this therapy. Thus, prompt identification of these non-responders may be useful for an early switch to second-line therapies

IgG4-related disease: results from a multicenter Spanish registry

IgG4-related disease (IgG4-RD) is a rare entity consisting of inflammation and fibrosis that has been described in multiple organs. Concrete diagnostic criteria have been established recently and there is a lack of large series of patients.To describe the clinical presentation, histopathological characteristics, treatment and evolution of a series of IgG4-RD Spanish patients.A retrospective multicenter study was performed. Twelve hospitals across Spain included patients meeting the current 2012 consensus criteria on IgG4-RD diagnosis.Fifty-five patients were included in the study, 38 of whom (69.1%) were male. Median age at diagnosis was 53 years. Thirty (54.5%) patients were included in the Histologically Highly Suggestive IgG4-RD group and 25 (45.5%) in the probable IgG4-RD group. Twenty-six (47.3%) patients had more than 1 organ affected at presentation. The most frequently affected organs were: retroperitoneum, orbital pseudotumor, pancreas, salivary and lachrymal glands, and maxillary sinuses.Corticosteroids were the mainstay of treatment (46 patients, 83.6%). Eighteen patients (32.7%) required additional immunosuppressive agents. Twenty-four (43.6%) patients achieved a complete response and 26 (43.7%) presented a partial response (<50% of regression) after 22 months of follow-up. No deaths were attributed directly to IgG4-RD and malignancy was infrequent.This is the largest IgG4-RD series reported in Europe. Patients were middle-aged males, with histologically probable IgG4-RD. The systemic form of the disease was frequent, involving mainly sites of the head and abdomen. Corticosteroids were an effective first line treatment, sometimes combined with immunosuppressive agents. Neither fatalities nor malignancies were attributed to IgG4-RD

Physical programming for preference driven evolutionary multi-objective optimization

Preference articulation in multi-objective optimization could be used to improve the pertinency of solutions in an approximated Pareto front. That is, computing the most interesting solutions from the designer's point of view in order to facilitate the Pareto front analysis and the selection of a design alternative. This articulation can be achieved in an a priori, progressive, or a posteriori manner. If it is used within an a priori frame, it could focus the optimization process toward the most promising areas of the Pareto front, saving computational resources and assuring a useful Pareto front approximation for the designer. In this work, a physical programming approach embedded in an evolutionary multi-objective optimization is presented as a tool for preference inclusion. The results presented and the algorithm developed validate the proposal as a potential tool for engineering design by means of evolutionary multi-objective optimization.This work was partially supported by the FPI-2010/19 grant and the PAID-2011/2732 project from the Universitat Polittccnica de Valencia and the projects TIN2011-28082 and ENE2011-25900 from the Spanish Ministry of Economy and Competitiveness.Reynoso Meza, G.; Sanchís Saez, J.; Blasco Ferragud, FX.; Garcia Nieto, S. (2014). Physical programming for preference driven evolutionary multi-objective optimization. Applied Soft Computing. 24:341-362. https://doi.org/10.1016/j.asoc.2014.07.009S3413622

Ética profesional en educación superior : finalidades, estrategias y desafíos de la formación

Todo proyecto educativo que no responde a su época se expone a problemas de legitimidad y al duro escrutinio y sanción de los usuarios. Las instituciones de educación superior no son la excepción de esta premisa clásica, incluso más validada por eldinamismos, la versatilidad y ojo crítico en el mundo contemporáneo. La ética se ha convertido en el baremo principal para someter a juicio a las instituciones y a las personas que ahí actuan, como a las finalidades que se pretenden en sus acciones. En esta perspectiva, debe examinarse la función de las instituciones de educación superior.Este libro es el esfuerzo colectivo por acercarnos a esa problemática, en especial a las finalidades, estrategias y relaciones en juego para cumplir la tarea de la formación y sus nexos inevitables con la ética profesional