Aportaciones al proceso de creación de contenidos de realidad aumentada, orientados a formación, industria y construcción

La Realidad Aumentada (AR) consiste en aumentar la percepción que el usuario tiene del mundo real con información virtual que lo complementa. Esta característica de aumentar los sentidos, es deseable en muchos campos de aplicación, por lo que aunque es un campo de investigación relativamente joven, ha experimentado un gran auge en los últimos años. La evolución de cada uno de los procesos que componen un sistema AR, ha permitido que está tecnología traspase las puertas de los laboratorios, y pueda ser utilizada por cualquier usuario que disponga, por ejemplo, de un Smartphone. Sin embargo, todavía existe una gran limitación y es la creación de contenidos (authoring). En la actualidad existen un pequeño número de herramientas de authoring que permiten crear contenidos AR, y en la mayoría de casos son herramientas propietarias que se limitan al uso de su propia tecnología. En este trabajo se presentan las aportaciones al proceso de authoring de contenidos AR orientados a formación, industria y construcción. Estas aportaciones se engloban en dos campos principales: la creación de contenidos para ayudas visuales, y la creación de información durante la revisión del proceso constructivo por medio de AR (denominada información As-Built). Para la creación de ayudas visuales AR se define un nuevo modelo de authoring, a partir del modelo de presentaciones de diapositivas digitales, en el que se incluyen los mecanismos necesarios para crear los contenidos aumentados. Para la creación de la información As-Built, se han desarrollado, tanto una metodología, como el sistema que permite llevarla a cabo. Todas las aportaciones presentadas en este trabajo tienen la finalidad de permitir a usuarios no expertos crear contenidos AR, abstrayéndoles del funcionamiento a bajo nivel de los sistemas AR. En los resultados presentados a lo largo de este trabajo se muestra cómo los sistemas desarrollados logran dicho objetivo, permitiendo a los usuarios no expertos, crear contenidos AR tanto en ayudas visuales, como para documentar el proceso constructivo.Augmented Reality (AR) consists in augmenting the user’s perception of the real world adding virtual information that complements it. This capability of augment the senses, it is desirable in many applications, so although it is a relatively young field of research, has experienced a boom in recent years. The evolution of each of the processes involved in AR systems (computer vision, 3d rendering, etc.), it is making possible that this technology goes out from laboratories, to be used by anyone who own, for example, a Smartphone. However, there is still a major constraint, the AR content creation (denominated authoring). Nowadays, there are a small number of authoring tools for creating AR content, and in most cases are proprietary systems that are limited to using its own technology. In this thesis, the contributions to the process of authoring of AR content oriented to training, construction and industry are presented. These contributions are focused on two main areas: creating AR content for visual aids, and the creation of information during the review of the construction process through AR (As-Built information). To create AR visual aids, a new authoring model is defined extending the digital slide presentations, which include the necessary mechanisms to create the augmented content. To create the As-Built information, during the revision of the construction process, a methodology and the system that allows carrying it out are proposed. All contributions presented in this paper are intended to allow non-expert users to create AR content, by abstracting them from the low level technical details of AR applications. The results presented will show how the proposed systems achieved this objective; allowing non-expert users to create AR content both AR visual aids and As-Built information to document the construction process

El rol del orientador educativo como pieza clave en el aprendizaje:técnicas de estudio en educación para adultos

Este trabajo se centra en el análisis y desarrollo del aprendizaje en el aula y en los diferentes elementos que componen este proceso. Además, se realizan algunas propuestas estratégicas utilizando las técnicas de estudio como herramienta principal. Asimismo, se considera la función asesora del orientador educativo y su labor de apoyo al profesorado y alumnado en las instituciones educativas como pieza clave en el desarrollo de las mismas. Este trabajo pone especial atención en la aplicación de las técnicas de estudio en los centros de adultos teniendo en cuenta sus características personales.<br /

Computer Animation to teach interpolation

While mathematics courses are a basic topic in engineering studies, they are often considered as a dif- cult subject by students. In this work we present a learning experience based on computer animation and using the perspective of mathematical modelling. Our goal is to provide the students with a context that motivates the study of function interpolation. We present a problem statement that is intended to be solved by means of the Modeling Cycle. The development of the activity and the strategies identi ed during the process are presented and discussed

MIME: A mixed-space collaborative system with three immersion levels and multiple users

Shared spaces for remote collaboration are nowadays possible by considering a variety of users, devices, immersion systems, interaction capabilities, navigation paradigms, etc. There is a substantial amount of research done in this line, proposing different solutions. However, still a more general solution that considers the heterogeneity of the involved actors/items is lacking. In this paper, we present MIME, a mixed-space tri-collaborative system. Differently from other mixed-space systems, MIME considers three different types of users (in different locations) according to the level of immersion in the system, who can interact simultaneously – what we call a tri-collaboration. For the three types, we provide a solution to navigate, point at objects/locations and make annotations, while users are able to see a virtual representation of the rest of users. Additionally, the total number of users that can simultaneously interact with the system is only restricted by the available hardware, i.e., various users of the same type can be simultaneously connected to the system. We have conducted a preliminary study at the laboratory level, showing that MIME is a promising tool that can be used in many real cases for different purposes.Shared spaces for remote collaboration are nowadays possible by considering a variety of users, devices, immersion systems, interaction capabilities, navigation paradigms, etc. There is a substantial amount of research done in this line, proposing different solutions. However, still a more general solution that considers the heterogeneity of the involved actors/items is lacking. In this paper, we present MIME, a mixed-space tri-collaborative system. Differently from other mixed-space systems, MIME considers three different types of users (in different locations) according to the level of immersion in the system, who can interact simultaneously – what we call a tri-collaboration. For the three types, we provide a solution to navigate, point at objects/locations and make annotations, while users are able to see a virtual representation of the rest of users. Additionally, the total number of users that can simultaneously interact with the system is only restricted by the available hardware, i.e., various users of the same type can be simultaneously connected to the system. We have conducted a preliminary study at the laboratory level, showing that MIME is a promising tool that can be used in many real cases for different purposes

Selective delivery of photothermal nanoparticles to tumors using mesenchymal stem cells as Trojan horses

The main challenge of cancer treatment is to avoid or minimize systemic side effects in off-target tissues. Mesenchymal stem cells (MSCs) can be used as therapeutical carriers because of their ability to migrate and incorporate into inflammation areas including tumors. Here, this homing ability is exploited by carrying therapeutic nanoparticles (Hollow Gold Nanoparticles (HGNs)) following a “Trojan-horse” strategy. Amongst the different nanoparticles to be employed, HGNs have the capacity to resonate in the near infrared region when irradiated by an appropriated laser (808 nm). By transforming this absorbed energy into heat, they are capable to produce locally induced hyperthermia. At this wavelength healthy tissues have a minimal light absorption being the effect restricted to the tissues containing HGNs. By placing HGNs inside MSCs, the recognition, excretion and immune response are minimized. We demonstrate that MSCs internalize HGNs and reach the tumors still containing HGNs. After laser treatment this loaded cells are able to eradicate tumoral cells in vitro and in vivo without significant toxicity. Also Ki67 expression, which is usually correlated with proliferation, is reduced after treatment. This approach enhances the effectiveness of the treatment when compared to just the enhanced permeation and retention effect (EPR) of the HGNs by themselves

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

R-COMP versus R-CHOP as first-line therapy for diffuse large B-cell lymphoma in patients ≥60 years: Results of a randomized phase 2 study from the Spanish GELTAMO group

The use of non-pegylated liposomal doxorubicin (Myocet® ) in diffuse large B-cell lymphoma (DLBCL) has been investigated in retrospective and single-arm prospective studies. This was a prospective phase 2 trial of DLBCL patients ≥60 years old with left ventricular ejection fraction (LVEF) ≥55% randomized to standard R-CHOP or investigational R-COMP (with Myocet® instead of conventional doxorubicin). The primary end point was to evaluate the differences in subclinical cardiotoxicity, defined as decrease in LVEF to <55% at the end of treatment. Secondary objectives were efficacy, safety, and variations of troponin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) and LVEF along follow-up. Ninety patients were included, 45 in each group. No differences were observed in the percentage of patients with LVEF <55% at end of treatment (11% in R-CHOP arm vs. 7% in R-COMP arm, p = 0.697) or at 4 months (10% vs. 6%, respectively, p = 0.667) and 12 months (8% vs. 7%, respectively, p = 1). However, a higher percentage of R-CHOP compared with R-COMP patients showed increased troponin levels in cycle 6 (100% vs. 63%, p = 0.001) and at 1 month after treatment (88% vs. 56%, respectively, p = 0.015). Cardiovascular adverse events were seen in five R-CHOP patients (nine episodes, four grade ≥3) and in four R-COMP patients (five episodes, all grade 1-2). No significant differences in efficacy were observed. In conclusion, R-COMP is a feasible immunochemotherapy schedule for DLBCL patients ≥60 years, with similar efficacy to R-CHOP. However, the use of non-pegylated doxorubicin instead of conventional doxorubicin was not associated with less early cardiotoxicity, although some reduced cardiac safety signals were observed. Trial registration: ClinicalTrials.gov Identifier: NCT02012088

Rare predicted loss-of-function variants of type I IFN immunity genes are associated with life-threatening COVID-19

BackgroundWe previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15-20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in similar to 80% of cases.MethodsWe report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded.ResultsNo gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5-528.7, P=1.1x10(-4)) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR=3.70[95%CI 1.3-8.2], P=2.1x10(-4)). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR=19.65[95%CI 2.1-2635.4], P=3.4x10(-3)), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR=4.40[9%CI 2.3-8.4], P=7.7x10(-8)). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD]=43.3 [20.3] years) than the other patients (56.0 [17.3] years; P=1.68x10(-5)).ConclusionsRare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care