Fecal occult blood and calprotectin testing to prioritize primary care patients for colonoscopy referral: The advantage study

AbstractColonoscopy is the gold standard for colorectal cancer (CRC) diagnosis and screening, but endoscopy services are usually overburdened. This study aims to investigate the usefulness of fecal hemoglobin (fHb) and calprotectin (FC) for the identification of patients with high probability of CRC who need urgent referral.MethodsIn a multicenter prospective study, we enrolled symptomatic patients referred from primary care for colonoscopy. Prior to bowel preparation, fHb and FC quantitative tests were performed. The diagnostic performance was estimated for each biomarker/combination. We built a multivariable predictive model based on logistic regression, translated to a nomogram and a risk calculator to assist clinicians in the decision‐making process.ResultsThe study included 1224 patients, of whom 69 (5.6%) had CRC. At the fHb cut‐offs of >0 and 10 μg/g, the negative predictive values for CRC were 98.8% (95% confidence interval 97.8%–99.3%) and 98.6% (95%CI 97.7%–99.1%), and the sensitivities were 85.5% (95%CI 75.0%–92.8%) and 79.7% (95%CI 68.3%–88.4%), respectively. When we added the cut‐off of 150 μg/g of FC to both fHb thresholds, the sensitivity of fecal tests improved. In the multivariate logistic regression model, the concentration of fHb was an independent predictor for CRC; age and gender were also independently associated with CRC.ConclusionsfHb and FC are useful as part of a triage tool to identify those symptomatic patients with high probability of CRC. This can be easily applied by physicians to prioritize high‐risk patients for urgent colonoscopy

Saliendo de la zona de confort para mejorar las competencias y empleabilidad del alumnado

[EN] The teaching innovation project under the title "Business simulation to bring management decision-making to the classroom" developed by students and lecturer of the Faculty of Economics and Business of the University of Zaragoza, has pursued three objectives since its inception: to apply and integrate the theoretical knowledge of the degree, improve the employability of participating students and complete the development of transversal and specific competencies of students by leaving their comfort zone. With the support of the Global Management Challenge competition, we offer comprehensive support to participants where the role of the lecturer with the use of active learning methodologies generates a real involvement in the student becoming an active part of their learning. On the other hand, students develop their skills by consolidating gamification as a methodology that allows them to face new scenarios for decision-making in a playful and experiential way. The new social networks have played a fundamental role because they have allowed the dissemination of the achievements obtained by the participants, which facilitates their access and visibility in the world of work.[ES] El proyecto de innovación docente bajo el titulo “Simulación empresarial para acercar la toma de decisiones de los directivos al aula” desarrollado por alumnado y profesorado de la Facultad de Economía y Empresa de la Universidad de Zaragoza, ha perseguido desde su creación tres objetivos: aplicar e integrar los conocimientos teóricos del grado, mejorar la empleabilidad de los alumnos participantes y completar el desarrollo de competencias transversales y específicas del alumnado al salir de su zona de confort.Apoyándonos en la competición Global Management Challenge ofrecemos un acompañamiento integral a los participantes donde, el papel del docente, con el uso de metodologías activas de aprendizaje genera una implicación real en el estudiante pasando a ser parte activa de su aprendizaje. Por otro lado, el estudiantado desarrolla sus competencias consolidando la gamificación como una metodología que permite enfrentarse a nuevos escenarios para la toma de decisiones de una forma lúdica y vivencial.Las nuevas redes sociales han jugado un papel fundamental porque han permitido la difusión de los logros obtenidos por los participantes lo que les facilita su acceso y visibilización al mundo laboral.A la Universidad de Zaragoza por la concesión del Proyecto de Innovación Docente titulado “Simulación empresarial para acercar la toma de decisiones de los directivos al aula” (PIIDUZ_19_451).Cabanés-Cacho, B.; Reina López, E.; Quilez Calavia, G.; Montañés Gómez, A.; Rutkevicius Remondini, F.; Ramos Sevillano, J.; Magreñán Ovejas, M.... (2021). Saliendo de la zona de confort para mejorar las competencias y empleabilidad del alumnado. En IN-RED 2021: VII Congreso de Innovación Edicativa y Docencia en Red. Editorial Universitat Politècnica de València. 1021-1030. https://doi.org/10.4995/INRED2021.2021.13791OCS1021103

Contourite stratigraphic models linked to the light intermediate versus dense deep Mediterranean water flow regime variations (Alboran Sea, SW Mediterranean)

21 pages, 16 figures, 3 tables.-- Data availability: Data supporting this study are openly available from DIGITAL.CSIC at doi: 10.20350/digitalCSIC/15507Several water masses are involved in the circulation of oceans, their bottom layers impacting on sedimentation through contourites. The majority of palaeoceanographic studies on regional contourites are performed for one water mass despite that their joint study would offer relevant clues to understand past ocean and climate interaction. This works presents for the first time a an analysis about the impact of the Light Intermediate Mediterranean (LMW) and Dense Deep Mediterranean (DMW) bottom currents on the sedimentation in the Alboran Sea (SW Mediterranean) and its paleoceanographic significance in response to climatic oscillations from the last glacial period to the Holocene. To do this, an integration of chronostratigraphical, sedimentological, and compositional data is carried out from contourites formed by those water masses. That integration enable us to define three distinct contourite stratigraphic models. (I) The contourite terrace model, characterized by coarse-grained contourites, which is an archive of the interplay between the high-energy Atlantic Water-LMW interface and glacioeustasy from the Younger Dryas (YD) to the Holocene. (II) The contourite drift models, which are archives of rapid ocean-climate coupled fluctuations since 29.5 kyr. They comprise coarse-grained contourites formed by a relatively fast LMW and fine-grained contourites formed by a relatively weak DMW, except for the Heinrich Stadials HS3 to HS1 and YD when coarse-grained contourites were deposited. (III) The contourite/turbidite mixed model represents another archive of DMW and glacioeustasy interplay from the end of the late Pleistocene to Holocene. That contourite stratigraphy allows us to infer for the first time the relative variability of the LMW versus DMW flow regimes, which records differences and similarities. The similarities indicate that the LMW and DMW fluctuations occur in parallel at millennial and centennial time scales. The differences refer to the overall higher velocity of LMW versus DMW; the magnitude changes in velocities that are lower for LMW and higher for DMW; the recognition of three short ventilation events (a, b, c) during HS1 and HS2 for only DMW; and the distinct LMW and DMW responses to the onset of glacial conditions and return to interglacial conditions during the HSs, YD and Holocene cold periods. The proposed contourite stratigraphic models can be applied for other areas in the Mediterranean margins to identify and correlate the LMW and DMW palaeoceanographic events throughout this sea. The findings suggest that the different water masses that make up the water column must be seriously considered to fully understand palaeoceanographic and palaeoclimatic studies based on contourites. This is because their distinct impact on sedimentation may provide new insights into their different palaeoceanographic responses to rapid climatic oscillations and their triggering mechanismsWe are also grateful for the ‘Severo Ochoa Centre of Excellence’ accreditation of ICM-CSIC (CEX2019-000928-S)Peer reviewe

Papel del endotelio en la regulación del tono vascular en pacientes con cirrosis hepática y en pacientes con trasplante hepático

Tesis doctoral inédita de la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Medicina. Fecha de lectura: 18-4-9

Papel del endotelio en la regulacion del tono vascular en pacientes con cirrosis hepatica y en pacientes con trasplante hepatico

Centro de Informacion y Documentacion Cientifica (CINDOC). C/Joaquin Costa, 22. 28002 Madrid. SPAIN / CINDOC - Centro de Informaciòn y Documentaciòn CientìficaSIGLEESSpai

MOF-polymer enhanced compatibility: post-annealed zeolite imidazolate framework membranes inside polyimide hollow fibers

Thermal annealing, a commonly used procedure for improving the performance of polymeric membranes, is in this work exploited in the presence of a metal-organic framework (MOF) supported layer. MOFs and polymers are materials with a common organic character, suggesting an enhanced affinity between them when used together in membrane separation. Zeolite-like imidazolate frameworks (ZIFs) ZIF-8 and ZIF-93 with sod and rho structures and pore apertures of 0.34 and 0.36 nm, respectively, have been grown inside 356 mm OD co-polyimide P84 hollow fibers by microfluidics, leading to continuous supported membranes. When these membranes were thermally in situ annealed below the glass transition temperature, while monitoring both H-2 and CH4 permeances, the MOF-polymer adhesion was enhanced. Thus the gas separation selectivity increased without any significant reduction in the gas permeance, and H-2/CH4 and CO2/CH4 maximum selectivities of 103 and 18 (ZIF-8) and 101 and 20 (ZIF93) were respectively measured. The good compatibility between MOF and polymer made improvements possible in the annealing of the membrane once it was prepared. If the annealing of the polymer was carried out before the MOF synthesis, the polymer chain rearrangement and surface smoothing prevented an optimum MOF-polymer interaction and the separation performance worsened. These results proved the compatibility between both materials and their synergistic contribution to gas selective transportSpanish MINECO MAT2013-40556-R, Aragon Government (DGA), European Social Fund, DGA fellowshi

High selectivity ZIF-93 hollow fiber membranes for gas separation

Zeolitic imidazolate framework-93 (ZIF-93) continuous membranes were synthesized on the inner side of P84 co-polyimide hollow fiber supports by microfluidics. MOFs and polymers showed high compatibility and the membrane exhibited H-2-CH4 and CO2-CH4 separation selectivities of 97 (100 degrees C) and 17 (35 degrees C), respectively.Spanish MINECO, MAT2013-40556-

Experiencias con Bombas de Mecate en tres escuelas del Subdepartamento de Bengbis, Provincia del Sur, Camerún

ResumenLa ONGD Zerca y Lejos ha implementado e introducido la tecnología Bomba de Mecate en los pozos de tres escuelas del Subdepartamento de Bengbis, en la Provincia del Sur de Camerún, frente a tecnologías más inaccesibles y más extendidas en la zona, como es la bomba de embolo, India Mark, que dificultan que la población tenga acceso continuo al agua segura, por falta de recursos, principalmente económicos. La sencillez de su fabricación ha permitido al equipo construirla en terreno con la colaboración de técnicos locales, utilizando fundamentalmente materiales locales y tratando de transmitir esta nueva tecnología a las comunidades beneficiarias. Tras más de tres años de trabajo con esta tecnología apropiada al contexto, se ha podido detectar una serie de problemas técnicos, sociales y económicos. Además de hacer frente a dichos problemas implementando mejoras en los diseños, se ha impartido formación técnica sobre el mantenimiento y construcción de las bombas y se ha fomentando la participación comunitaria, todo ello con el fin de asumir y garantizar el buen estado y la continuidad de las infraestructuras. Resumo A ONG Zerca y Lejos implementou e introduziu a tecnologia Bomba de mecate nos poços de três escolas do Subdepartamento de Bengbis, na província do sul de Camarões, à frente das tecnologias mais inacessíveis e difundidas na área, tais como a bomba de pistão, India Mark, que dificulta o acesso permanente da população à água potável, por falta de recursos, principalmente econômicos. A simplicidade da sua fabricação permitiu à equipe construir-laem terreno com a ajuda de técnicos locais, utilizando principalmente materiais locais, e tentando transmitir essa nova tecnologia para as comunidades beneficiárias. Depois de mais de três anos de trabalho com essa tecnologia apropriada ao contexto, foi possível detectar uma série de problemas técnicos , sociais e econômicos. Além de fazer frente a esses problemas implementando melhorias no design, estão sendo ministrados cursos de formação técnica para manutenção e construção das bombas, estimulando a participação da comunidade, com o intuito de assumir e garantir o bom estado e amanutenção das infraestruturas.