Supervivencia a dos años en pacientes con cáncer gástrico localmente avanzado en una institución de Popayán entre 2018 y 2020

Introducción. El tratamiento oncológico perioperatorio en pacientes con cáncer gástrico localmente avanzado está indicado; aun así, no siempre es posible. El objetivo de este estudio fue evaluar la supervivencia de los pacientes según la administración de quimioterapia perioperatoria. Métodos. Estudio observacional, tipo cohorte ambispectivo, incluyendo pacientes con cáncer gástrico localmente avanzado quienes recibieron o no quimioterapia perioperatoria. Resultados. Se incluyeron 33 pacientes, 90,9 % pertenecían al régimen subsidiado de salud y el 78,8 % en estadio T4. El grupo que recibió quimioterapia perioperatoria, que solo tuvo 5 pacientes (15,1 %), presentó mayor supervivencia global a 2 años (100 %), seguido del grupo de quimioterapia postoperatoria (58,8 %) y del grupo sin quimioterapia, que alcanzó una supervivencia global a 2 años de 54,5 %. Discusión. La supervivencia global fue mayor en el grupo de quimioterapia perioperatoria, consonante a lo descrito a nivel internacional, aunque los pacientes se encontraban en un estadío localmente más avanzado, la mayoría con T4 y N+ según AJCC VIII edición. Conclusiones. El estadío clínico es un factor pronóstico importante y, en nuestro medio, la mayoría de los pacientes consultan en estadíos localmente más avanzados. A eso se suman las dificultades en el acceso a la atención en salud. Aun así, la quimioterapia perioperatoria mostró una supervivencia mayor en pacientes con cáncer gástrico localmente avanzado

Enhancement of nerve structure segmentation by a correntropy-based pre-image approach

El bloqueo de nervios periféricos (PNB) es una técnica ampliamente usada para llevar a cabo anestesia regional en el manejo del dolor. El PNB aplica una sustancia anestésica en el área que rodea el nervio que se quiere intervenir, y su éxito depende de la localización exacta del mismo. Recientemente, las imágenes de ultrasonido (UI) se han utilizado para la localización de nervios periféricos en PNB ya que permiten una visualización no invasiva y directa del nervio y de las estructuras anatómicas alrededor de él; sin embargo, este tipo de imágenes están afectadas por ruido speckle, dificultando su delimitación exacta. De esta manera, es pertinente una etapa de filtrado para atenuar el ruido sin remover información anatómica importante para la segmentación. En este artículo se propone una estrategia para el mejoramiento de UI usando filtrado basado en pre-imágenes. En particular, las imágenes se mapean a un espacio de alta dimensionalidad a través de una función kernel. Específicamente, se emplea un mapeo basado en Correntropía con el fin de codificar estadísticos de orden superior de las imágenes bajo condiciones no-lineales y no-Gaussianas. El enfoque propuesto se valida en la segmentación de nervios para PNB. El enfoque de filtrado basado en pre-imágenes con Correntropía (CPIF) es usado como pre-procesamiento en tareas de segmentación de nervios sobre UI. El rendimiento de la segmentación es medida en términos del coeficiente Dice. De acuerdo con los resultados, CPIF encuentra una aproximación adecuada para las UI al asegurar la identificación de patrones discriminativos de estructuras nerviosas.Peripheral Nerve Blocking (PNB) is a commonly used technique for performing regional anesthesia and managing pain. PNB comprises the administration of anesthetics in the proximity of a nerve. In this sense, the success of PNB procedures depends on an accurate location of the target nerve. Recently, ultrasound images (UI) have been widely used to locate nerve structures for PNB, since they enable a non-invasive visualization of the target nerve and the anatomical structures around it. However, UI are affected by speckle noise, which makes it difficult to accurately locate a given nerve. Thus, it is necessary to perform a filtering step to attenuate the speckle noise without eliminating relevant anatomical details that are required for high-level tasks, such as segmentation of nerve structures. In this paper, we propose an UI improvement strategy with the use of a pre-image-based filter. In particular, we map the input images by a nonlinear function (kernel). Specifically, we employ a correntropy-based mapping as kernel functional to code higher-order statistics of the input data under both nonlinear and non-Gaussian conditions. We validate our approach against an UI dataset focused on nerve segmentation for PNB. Likewise, our Correntropy-based Pre-Image Filtering (CPIF) is applied as a pre-processing stage to segment nerve structures in a UI. The segmentation performance is measured in terms of the Dice coefficient. According to the results, we observe that CPIF finds a suitable approximation for UI by highlighting discriminative nerve patterns

Oral Anticoagulation and Risk of Symptomatic Hemorrhagic Transformation in Stroke Patients Treated With Mechanical Thrombectomy: Data From the Nordictus Registry

Introduction: We aimed to evaluate if prior oral anticoagulation (OAC) and its type determines a greater risk of symptomatic hemorrhagic transformation in patients with acute ischemic stroke (AIS) subjected to mechanical thrombectomy. Materials and Methods: Consecutive patients with AIS included in the prospective reperfusion registry NORDICTUS, a network of tertiary stroke centers in Northern Spain, from January 2017 to December 2019 were included. Prior use of oral anticoagulants, baseline variables, and international normalized ratio (INR) on admission were recorded. Symptomatic intracranial hemorrhage (sICH) was the primary outcome measure. Secondary outcome was the relation between INR and sICH, and we evaluated mortality and functional outcome at 3 months by modified Rankin scale. We compared patients with and without previous OAC and also considered the type of oral anticoagulants. Results: About 1.455 AIS patients were included, of whom 274 (19%) were on OAC, 193 (70%) on vitamin K antagonists (VKA), and 81 (30%) on direct oral anticoagulants (DOACs). Anticoagulated patients were older and had more comorbidities. Eighty-one (5.6%) developed sICH, which was more frequent in the VKA group, but not in DOAC group. OAC with VKA emerged as a predictor of sICH in a multivariate regression model (OR, 1.89 [95% CI, 1.01–3.51], p = 0.04) and was not related to INR level on admission. Prior VKA use was not associated with worse outcome in the multivariate regression model nor with mortality at 3 months. Conclusions: OAC with VKA, but not with DOACs, was an independent predictor of sICH after mechanical thrombectomy. This excess risk was associated neither with INR value by the time thrombectomy was performed, nor with a worse functional outcome or mortality at 3 months

Diseño de un prototipo funcional para producción de alimentos mediante agricultura vertical

Proyecto de Aplicación Profesional en el que se construyó un prototipo demostrativo-experimental para el desarrollo de cultivos hidropónicos con el concepto de agricultura vertical y nivel básico de automatización para la producción sustentable de alimentos del campo sin el uso de suelo. La metodología del proyecto se basó en la producción de hortalizas mediante cultivos hidropónicos en arreglo vertical para maximizar el uso de espacio dentro de un invernadero. En esta etapa de desarrollo del proyecto se investigó la posibilidad de probar el sistema de producción hidropónica con plantas medicinales y hortalizas como arúgula, albahaca y espinacas. Esta idea fue el resultado de un requerimiento del Banco Diocesano de Alimentos de Guadalajara

Enhancement of nerve structure segmentation by a correntropy-based pre-image approach

Peripheral Nerve Blocking (PNB) is a commonly used technique for performing regional anesthesia and managing pain. PNB comprises the administration of anesthetics in the proximity of a nerve. In this sense, the success of PNB procedures depends on an accurate location of the target nerve. Recently, ultrasound images (UI) have been widely used to locate nerve structures for PNB, since they enable a non-invasive visualization of the target nerve and the anatomical structures around it. However, UI are affected by speckle noise, which makes it difficult to accurately locate a given nerve. Thus, it is necessary to perform a filtering step to attenuate the speckle noise without eliminating relevant anatomical details that are required for high-level tasks, such as segmentation of nerve structures. In this paper, we propose an UI improvement strategy with the use of a pre-image-based filter. In particular, we map the input images by a nonlinear function (kernel). Specifically, we employ a correntropy-based mapping as kernel functional to code higher-order statistics of the input data under both nonlinear and non-Gaussian conditions. We validate our approach against an UI dataset focused on nerve segmentation for PNB. Likewise, our Correntropy-based Pre-Image Filtering (CPIF) is applied as a pre-processing stage to segment nerve structures in a UI. The segmentation performance is measured in terms of the Dice coefficient. According to the results, we observe that CPIF finds a suitable approximation for UI by highlighting discriminative nerve patterns.El bloqueo de nervios periféricos (PNB) es una técnica ampliamente usada para llevar a cabo anestesia regional en el manejo del dolor. El PNB aplica una sustancia anestésica en el área que rodea el nervio que se quiere intervenir, y su éxito depende de la localización exacta del mismo. Recientemente, las imágenes de ultrasonido (UI) se han utilizado para la localización de nervios periféricos en PNB ya que permiten una visualización no invasiva y directa del nervio y de las estructuras anatómicas alrededor de él; sin embargo, este tipo de imágenes están afectadas por ruido speckle, dificultando su delimitación exacta. De esta manera, es pertinente una etapa de filtrado para atenuar el ruido sin remover información anatómica importante para la segmentación. En este artículo se propone una estrategia para el mejoramiento de UI usando filtrado basado en pre-imágenes. En particular, las imágenes se mapean a un espacio de alta dimensionalidad a través de una función kernel. Específicamente, se emplea un mapeo basado en Correntropía con el fin de codificar estadísticos de orden superior de las imágenes bajo condiciones no-lineales y no-Gaussianas. El enfoque propuesto se valida en la segmentación de nervios para PNB. El enfoque de filtrado basado en pre-imágenes con Correntropía (CPIF) es usado como pre-procesamiento en tareas de segmentación de nervios sobre UI. El rendimiento de la segmentación es medida en términos del coeficiente Dice. De acuerdo con los resultados, CPIF encuentra una aproximación adecuada para las UI al asegurar la identificación de patrones discriminativos de estructuras nerviosas

Potential of Calabash tree (Crescentia cujete) as a local resource to enhance sustainable livestock farming in the dry Caribbean region

International audienceA multidisciplinary and participative project (i.e. including farmers, technician, researchers and other local actors) is being carried out under the dry Caribbean region of Colombia. The aim is to get new and deep insights in the actual potential of Calabash tree (CT; Crescentia cujete) for contributing to the sustainable development goals of livestock production in the local context, with native and well-adapted resources. For this, a series of protocols have been placed under real-farm conditions (Farm El Porvenir-10°05'57" N 73°23'53" W). A previously established CT plantation (field layout: 4 m × 4 m) was used. A two-year monitoring protocol was settled (2022-2023) to follow how forage and fruit production and quality are affected by year season, sun exposure (total sun or penumbra) and pruning. Four treatments were allocated 1) Sun-Intact, SI; 2) Sun-Pruned, SP; 3) Penumbra-Intact, PI; 4) Penumbra-Pruned, PP). Representative samples were collected (almost bimonthly) in previously selected adult trees (n= 50 per treatment). The agronomic parameters include number of branches (young, medium and adult), forage production (fresh and dry matter per tree and hectare, ha), fruit production (i.e. per tree and per ha, number and weight of fruits, green or ripe). The kinetic of production and nutritive value are followed for each plant component. The meteorological local conditions are permanently monitored (i.e. T°C, relative humidity, rainfall, etc.). Thereafter, and considering the great potential of the CT fruit, the project includes the evaluation of different conservation strategies for using this resource in the ruminant feeding systems mainly during the dry season. First of all, the saline silage alternative is considered, as this is a common practice established by local farmers in their herds (i.e. other conservation methods are included, such as: fruit dehydration, natural conservation and mixing fruit pulp with fodder-CT leaves and grasses and/or with hay). Furthermore, a key component of the project is related to assessing the role of CT in the feeding, nutrition and metabolism, as well as anti-parasitic and enteric methane mitigation potentials when local ruminants (crossed Bos indicus cattle) are fed diets composed by CT forage, fresh and/or conserved pulp mixed with other local on-farm produced resources (e.g. Megathyrsus maximus cv. Tanzania). Protocols combine in vitro (Theodorou, 1994; Tilley and Terry, 1963; Bambou, et al., 2009 and RUSITEC ® technics), in situ (Orskov and McDonald, 1979) and in vivo methods (palatability, acceptability, voluntary intake and digestibility trials). Key physiological stages are considered in the in vivo trials under silvopastoral conditions of the farm (e.g. around calving) as well as feeding practices during dry season. Datasets are built for each variable, and multivariate analyses, multiple regression and other sound statistical procedures are carried out. The R software is used. Preliminary results until now demonstrate significant (P< 0.05) seasonal effects on forage and fruit production, as well as a significant effects (P< 0.05) of sunshine gradient and pruning on fruit production. Interpretation of results will be carried with a holistic, systemic, participatory approach, thus considering priorities of local farmers for their final adoption of results on their practical and day-today contexts

Using simple models to describe the kinetics of growth, glucose consumption, and monoclonal antibody formation in naive and infliximab producer CHO cells

Despite their practical and commercial relevance, there are few reports on the kinetics of growth and production of Chinese hamster ovary (CHO) cells—the most frequently used host for the industrial production of therapeutic proteins. We characterize the kinetics of cell growth, substrate consumption, and product formation in naive and monoclonal antibody (mAb) producing recombinant CHO cells. Culture experiments were performed in 125 mL shake flasks on commercial culture medium (CD Opti CHO™ Invitrogen, Carlsbad, CA, USA) diluted to different glucose concentrations (1.2–4.8 g/L). The time evolution of cell, glucose, lactic acid concentration and monoclonal antibody concentrations was monitored on a daily basis for mAb-producing cultures and their naive counterparts. The time series were differentiated to calculate the corresponding kinetic rates (rx = d[X]/dt; rs = d[S]/dt; rp = d[mAb]/dt). Results showed that these cell lines could be modeled by Monod-like kinetics if a threshold substrate concentration value of [S]t = 0.58 g/L (for recombinant cells) and [S]t = 0.96 g/L (for naïve cells), below which growth is not observed, was considered. A set of values for μmax, and Ks was determined for naive and recombinant cell cultures cultured at 33 and 37 °C. The yield coefficient (Yx/s) was observed to be a function of substrate concentration, with values in the range of 0.27–1.08 × 107 cell/mL and 0.72–2.79 × 106 cells/mL for naive and recombinant cultures, respectively. The kinetics of mAb production can be described by a Luedeking–Piret model (d[mAb]/dt = αd[X]/dt + β[X]) with values of α = 7.65 × 10−7 µg/cell and β = 7.68 × 10−8 µg/cell/h for cultures conducted in batch-agitated flasks and batch and instrumented bioreactors operated in batch and fed-batch mode