SEOM–GEICAM–SOLTI clinical guidelines in advanced breast cancer (2022)

Advanced breast cancer; Anti-HER2 therapy; Endocrine therapyCàncer de mama avançat; Teràpia anti-HER2; Teràpia endocrinaCáncer de mama avanzado; Terapia anti-HER2; Terapia endocrinaAdvanced breast cancer represents a challenge for patients and for physicians due its dynamic genomic changes yielding to a resistance to treatments. The main goal is to improve quality of live and survival of the patients through the most appropriate subsequent therapies based on the knowledge of the natural history of the disease. In these guidelines, we summarize current evidence and available therapies for the medical management of advanced breast cancer

Scientific Performance and Mapping of the Term STEM in Education on the Web of Science

Technological progress is causing terms such as “STEM”, an acronym for Science, Technology, Engineering and Mathematics, to burst into the educational arena, marking a new era in the application of innovative and motivating teaching and learning processes. The objective of this research is to analyze the trajectory and the transcendence of the “STEM” concept in the educational field, having as reference the reported literature of Web of Science. The methodology applied in this research is based on bibliometrics, analyzing both the performance and the structural and dynamic development of the concept through a co-word analysis. The total number of documents analyzed is 4390. The results show that the scientific community mainly uses English and research papers to present their results. From 2015 onwards, the main lines of research are beginning to be established, which focus on “women” and “science”. It can be concluded that the term “STEM” in education is beginning to have a greater incidence and impact on the processes of teaching and learning, especially in the field of science, although there are currently discrepancies between men and women in its use

Educational applications of a pico-processor design

Knowledge of the internal structure and operating mechanism of microprocessors is a very important part in for engineers in electronics and computer science. This knowledge can be deepened with experiences of processor design, which also meet many aspects linked to other basic skills. However, due to its complexity, the design of commercial processors is not effective from an educational point of view. In this communication we present a VHDL design experience of a very simple processor that shows multiple learning posed to the student

Measuring Resilience in Women with Endometriosis

Endometriosis is a multifactorial disease with pathophysiological factors not yet well known; it also presents a wide symptomatic range that makes us think about the need for multidisciplinary management. It is a chronic disease in which there is no definitive treatment, and is associated in a large majority of cases with psychological pathology. Connecting comorbidities and multimorbidities on a neurobiological, neuropsychological, and pathophysiological level could significantly contribute to their more successful prevention and treatment. In our study, resilience is analyzed as an adjunctive measure in the management of endometriosis. Methods: A multi-centre, cross-sectional study was performed to analyse resilience levels in a sample of Spanish women suffering from endometriosis. CDRIS-25, CDRIS-10, BDI, the STAI, and the SF-36 Health Questionnaire were used for assessments. A representative group of 202 women with endometriosis was recruited by consecutive sampling. Exploratory and confirmatory factor analyses were performed for both resilience scales. Results: Mean CDRIS-25 and CDRIS-10 scores were 69.58 (SD 15.1) and 29.37 (SD 7.2), respectively. Women with adenomyosis and without signs of deep endometriosis showed the lowest scores. The best predictive model included women's age, years of endometriosis evolution, number of pregnancies, and history of fertility problems as the best predictive factors. Conclusions: Women build resilience as the number of years of evolution of the disease increases. Symptoms such as dyspareunia and continued abdominal pain were more prevalent among less resilient women

Uso del marketing digital innovando la oferta formativa y demanda educativa para el nivel superior, en los colegios públicos de la provincia de Satipo 2020-2021

The purpose is to determine the relationship between "use of digital marketing and the educational offer and educational demand for the higher level, of the public schools of the province of Satipo 2020 - 2021".The research obeys the quantitative approach, non-experimental design, applied type, descriptive level, due to its correlational nature, quantitative nature, according to the transverse temporal scope. A non-probabilistic census-type sample of 68 students was considered, using the virtual survey technique and the digital questionnaire as an instrument.The results obtained indicate a correlation of 0.409, which means a moderate correlation, they also indicated that 1.5% never carry out digital promotion, and that 86.6% state that they sometimes carry out digital promotion, finally on 17, 9% always carry out digital promotion. In this way, influence the use of virtual studies at the university level of teachers and students, to respond to changes in the educational systemEl propósito es determinar la relación entre “uso del marketing digital y la Oferta formativa y demanda educativa para el nivel superior, de los colegios públicos de la provincia de Satipo 2020 – 2021”. La investigación obedece al enfoque cuantitativo, de diseño no experimental, de tipo aplicada, en un nivel descriptivo, por su carácter correlacional, por naturaleza cuantitativa, según el alcance temporal transversal. Se consideró una muestra de tipo censal de forma no probabilístico, de 68 alumnos, utilizando la técnica de encuesta virtual y como instrumento el cuestionario digital. Los resultados obtenidos indica una correlación del 0.409, que significa una correlación moderada, asimismo señalaron que el 1,5 % nunca realizan promoción digital, y que el 86,6 % manifiesta, que a veces realizan promoción digital, por último, el 17,9% siempre realizan la promoción digital. De tal manera incidir en el empleo de estudios virtuales a nivel universitario de docentes y educandos, para responder a los cambios en el sistema educativo

An online home-based exercise program improves autonomic dysfunction in breast cancer survivors

Introduction: Exercise interventions for breast cancer survivors have proved their potential to improve clinical, physical, and psychosocial outcomes. However, limited studies have explored exercise effects on autonomic dysfunction and the measurement of exercise tolerance and progression through daily heart rate variability (HRV). Purpose: To analyze the effects of a 16-wk exercise intervention on the autonomic modulation of breast cancer survivors, as well as to examine the evolution of daily measured HRV and its interaction with exercise sessions in this population. Methods: A total of 29 patients who had undergone chemotherapy and radiotherapy were randomly assigned to the exercise group or to the control group. The exercise intervention was delivered remotely through online meetings and consisted of supervised training resistance and cardiovascular exercise 3 times per week. During the intervention all patients measured their HRV daily obtaining the napierian logarithm of the root mean square of successive differences between normal heartbeats (lnrMSSD) and the napierian logarithm of the standard deviation of the interbeat interval of normal sinus beats (lnSDNN) values at four moments: day 0 (the morning of the training sessions), 24, 48, and 72 h after exercise. Results: The results revealed a significant interaction between group and months during the intervention period for lnrMSSD and lnSDNN (p < 0.001). Additionally, there were significant differences in lnSDNN recovery time between months (p < 0.05), while differences in lnrMSSD become apparent only 24 h after exercise (p = 0.019). The control group experienced a significant decrease in both variables monthly (p < 0.05) while exercise group experienced a significant increment (p < 0.05). Conclusion: HRV is daily affected by exercise training sessions in cancer patients. Although results strongly support the role of exercise as a post-chemotherapy and radiotherapy rehabilitation strategy for breast cancer survivors to improve autonomic imbalance, further research is necessary to validate these initial findings

Diagnóstico y Caracterización de los Brezales Húmedos (Nat-2000 4020*) de las Sierras Septentrionales de Galicia a partir de Criterios Científicos: Importancia para su Conservación

En el trabajo se realiza una caracterización de las variaciones estacionales de la humedad del sustrato de los brezales húmedos de la Serra do Xistral (Lugo, Galicia), y se compara con la humedad de los diferentes ecosistemas que forman la catena vegetacional en la que se enmarcan, así como con la de otros tipos de humedales estacionales. La representatividad de este territorio ha conllevado su inclusión en la Red Natura 2000, mediante la designación del Lugar de Importancia Comunitaria (LIC) Serra do Xistral (ES1120015). Los datos presentados ponen de manifiesto un funcionamiento ecológico homogéneo de los brezales húmedos en relación al resto del complejo húmedo, así como su funcionamiento inequívoco como ecosistemas húmedos. Por tanto, se confirma el diagnóstico de los brezales húmedos de las Sierras Septentrionales gallegas, vinculados al tipo prioritario Nat-2000 4020*, incluido en el Anexo I de la Directiva Comunitaria 92/43/CEE. El diagnóstico y caracterización de los tipos de hábitat debe considerar la estructura, composición y funcionalidad ecológica, mediante el empleo de conocimientos científicos y técnicos. Esto resulta de vital importancia, sobre todo para la conservación de los tipos prioritarios, evitando la puesta en marcha de planes y proyectos sin una adecuada evaluación de sus repercusionesIn this paper we have performed a characterization of the soil moisture in several wet heaths from Serra do Xistral (Lugo, Galicia), to be compared with that in the different ecosystems existing at the same vegetation catena, as well as other seasonal wetlands in the region. The representativeness of this territory has led to its inclusion in the Natura 2000 network, by designating the Site of Community Importance (SCI) Serra do Xistral (ES1120015). The data presented show a homogeneous ecological functioning of wet heaths in relation to the rest of the wet complex, and sustain their unambiguous operation as wet ecosystems. Therefore, it confirms the diagnosis of wet heaths in the northern mountains of Galicia, linked to priority type Nat-2000 4020*, included in Annex I of the EU Directive 92/43/EEC. The diagnosis and characterization of habitat types should consider the structure, composition and ecological functionality through the use of scientific and technical knowledge. This is of vital importance, particularly for the conservation of priority types, avoiding the implementation of plans and projects without a proper impact assessmentS

An online home-based exercise program improves autonomic dysfunction in breast cancer survivors

Introduction: Exercise interventions for breast cancer survivors have proved their potential to improve clinical, physical, and psychosocial outcomes. However, limited studies have explored exercise effects on autonomic dysfunction and the measurement of exercise tolerance and progression through daily heart rate variability (HRV).Purpose: To analyze the effects of a 16-wk exercise intervention on the autonomic modulation of breast cancer survivors, as well as to examine the evolution of daily measured HRV and its interaction with exercise sessions in this population.Methods: A total of 29 patients who had undergone chemotherapy and radiotherapy were randomly assigned to the exercise group or to the control group. The exercise intervention was delivered remotely through online meetings and consisted of supervised training resistance and cardiovascular exercise 3 times per week. During the intervention all patients measured their HRV daily obtaining the napierian logarithm of the root mean square of successive differences between normal heartbeats (lnrMSSD) and the napierian logarithm of the standard deviation of the interbeat interval of normal sinus beats (lnSDNN) values at four moments: day 0 (the morning of the training sessions), 24, 48, and 72 h after exercise.Results: The results revealed a significant interaction between group and months during the intervention period for lnrMSSD and lnSDNN (p &lt; 0.001). Additionally, there were significant differences in lnSDNN recovery time between months (p &lt; 0.05), while differences in lnrMSSD become apparent only 24 h after exercise (p = 0.019). The control group experienced a significant decrease in both variables monthly (p &lt; 0.05) while exercise group experienced a significant increment (p &lt; 0.05).Conclusion: HRV is daily affected by exercise training sessions in cancer patients. Although results strongly support the role of exercise as a post-chemotherapy and radiotherapy rehabilitation strategy for breast cancer survivors to improve autonomic imbalance, further research is necessary to validate these initial findings

An UAV and Satellite Multispectral Data Approach to Monitor Water Quality in Small Reservoirs

A multi-sensor and multi-scale monitoring tool for the spatially explicit and periodic monitoring of eutrophication in a small drinking water reservoir is presented. The tool was built with freely available satellite and in situ data combined with Unmanned Aerial Vehicle (UAV)-based technology. The goal is to evaluate the performance of a multi-platform approach for the trophic state monitoring with images obtained with MultiSpectral Sensors on board satellites Sentinel 2 (S2A and S2B), Landsat 8 (L8) and UAV. We assessed the performance of three different sensors (MultiSpectral Instrument (MSI), Operational Land Imager (OLI) and Rededge Micasense) for retrieving the pigment chlorophyll-a (chl-a), as a quantitative descriptor of phytoplankton biomass and trophic level. The study was conducted in a waterbody affected by cyanobacterial blooms, one of the most important eutrophication-derived risks for human health. Different empirical models and band indices were evaluated. Spectral band combinations using red and near-infrared (NIR) bands were the most suitable for retrieving chl-a concentration (especially 2 band algorithm (2BDA), the Surface Algal Bloom Index (SABI) and 3 band algorithm (3BDA)) even though blue and green bands were useful to classify UAV images into two chl-a ranges. The results show a moderately good agreement among the three sensors at different spatial resolutions (10 m., 30 m. and 8 cm.), indicating a high potential for the development of a multi-platform and multi-sensor approach for the eutrophication monitoring of small reservoirsThis research was co-funded by the Spanish Ministry of Research, Innovation and Universities through the Torres Quevedo Sub-Program, grant number PTQ-15-07685S

Estudio multicéntrico en el seguimiento de las complicaciones de los catéteres venosos centrales en pacientes hematológicos.

Most hematological patients suffer a significant venous damage related to different administrated intravenous therapy, being necessary to place central venous catheters (CVC). CVC is associated with various complications. The most common catheter-related complications are occlusion and infection. To avoid such of them, the development of protocols for insertion and care are needed, as well as recording and following up complications. To this end, we propose a cross-sectional carried out during 13 months whose main goal is to know the incidence of CVC- related complications (mainly occlusion and infection) in hematological patients. Population included all the =14 ages patients admitted to different hematological units at Ramon y Cajal and Gregorio Marañón hospitals in Madrid and who signed informed consent. Socio-demographic, clinical characteristics and complications were entered into a log which included a pursuit of care protocol.La mayoría de los enfermos hematológicos sufren un gran deterioro venoso, por lo que necesitan la implantación de catéteres venosos centrales (CVC) que aportan al paciente comodidad y seguridad. La portabilidad del CVC conlleva poder padecer alguna complicación. Las más frecuentes son la oclusión e infección asociadas al catéter. Para evitar dichas complicaciones hay varias estrategias como los protocolos de inserción, mantenimiento y heparinización de forma profiláctica. Nuestro objetivo será conocer la incidencia de complicaciones (esencialmente oclusiones e infecciones) asociadas a CVC (Tunelizado, Reservorio y PICC) en pacientes hematológicos. Proponemos un estudio descriptivo transversal multicéntrico en los Hospitales Universitarios Ramón y Cajal y Gregorio Marañón en Madrid. La muestra estará compuesta por todos los pacientes hematológicos =14 años ingresados en las Unidades del estudio y portadores de CVC descrito. Se elaborará un formulario para el registro detallado de los datos socio-demográficos, clínicos, complicaciones de los CVC y seguimiento del protocolo de cuidados de los mismos