Telemedicine Programs in Respiratory Diseases

Telemedicine programs are widely used in respiratory diseases, more often in patients with chronic obstructive pulmonary diseases (COPD). Telemedicine platforms use several devices to measure vital signs such as heart rate, respiratory rate, pulsioximetry or blood pressure between others. It is not unusual that patients could do questionnaires about clinical situation or communicate with their nurses via telephone, video-calling and/or Skype. The majority of results has been positive, with reduction in the number of emergency visits, hospitalizations and noninvasive ventilations. Despite their promising results, telemedicine programs/platforms are slow to implement. In this chapter, we reviewed some of the factors related to telemedicine implementation such as patients’ adherence, impact of telemedicine design and professionals\u27 resistance to change between others

All roads lead to Rome: Results of non-invasive respiratory therapies applied in a tertiary-care hospital without an Intermediate Care Unit during the COVID-19 pandemic

Documento escrito por un elevado número de autores/as, solo se referencia el/la que aparece en primer lugar y los/as autores/as pertenecientes a la UC3M.Introducción: Las terapias respiratorias no invasivas (TRNI) fueron ampliamente utilizadas en la primera ola de la pandemia de COVID-19, en escenarios distintos según los medios disponibles. El objetivo fue presentar la supervivencia a 90 días y los factores asociados a esta de los pacientes tratados con TRNI en un centro de tercer nivel sin Unidad de Cuidados Respiratorios Intermedios. Como objetivo secundario comparar los resultados obtenidos de las distintas terapias. Métodos: Estudio observacional de pacientes tratados con TRNI fuera de un ambiente de Cuidados Intensivos o Unidad de Cuidados Respiratorios Intermedios, diagnosticados de COVID-19 y con síndrome de distrés respiratorio agudo por criterios radiológicos y de ratio SpO2/FiO2. Se desarrolló un modelo multivariante de regresión logística para determinar las variables independientemente asociadas, y se compararon los resultados de la terapia de alto flujo con cánula nasal y la presión positiva continua en la vía aérea. Resultados: Se trataron 107 pacientes y sobrevivieron 85 (79,4%) a los 90 días. Antes de iniciar la TRNI el ratio medio de SpO2/FiO2 fue de 119,8 ± 59,4. Un mayor score de SOFA se asoció significativamente a la mortalidad (OR 2,09; IC95% 1,34 - 3,27), mientras que la autopronación fue un factor protector (OR 0,23; IC95% 0,06 - 0,91). La terapia de alto flujo con cánula nasal fue utilizada en 63 sujetos (58,9%), y la presión positiva continua en la vía aérea en 41 (38,3%). No se encontraron diferencias entre ellas. Conclusión: Aproximadamente cuatro de cada cinco pacientes tratados con TRNI sobrevivieron a los 90 días, y no se encontraron diferencias significativas entre la terapia de alto flujo con cánula nasal y la presión positiva continua en la vía aérea.Introduction: Non-invasive respiratory therapies (NRT) were widely used in the first wave of the COVID-19 pandemic in different settings, depending on availability. The objective of our study was to present 90-day survival and associated factors in patients treated with NRT in a tertiary hospital without an Intermediate Respiratory Care Unit. The secondary objective was to compare the outcomes of the different therapies. Methods: Observational study of patients treated with NRT outside of an intensive care or intermediate respiratory care unit setting, diagnosed with COVID-19 and acute respiratory distress syndrome by radiological criteria and SpO2/FiO2 ratio. A multivariate logistic regression model was developed to determine independently associated variables, and the outcomes of high flow nasal cannula and continuous positive airway pressure were compared. Results: In total, 107 patients were treated and 85 (79.4%) survived at 90 days. Before starting NRT, the mean SpO2/FiO2 ratio was 119.8 ± 59.4. A higher SOFA score was significantly associated with mortality (OR 2,09; 95% CI 1.34-3.27), while self-pronation was a protective factor (OR 0.23; 95% CI 0.06-0.91). High flow nasal cannula was used in 63 subjects (58.9%), and continuous positive airway pressure in 41 (38.3%), with no differences between them. Conclusion: Approximately 4 out of 5 patients treated with NRT survived to 90 days, and no significant differences were found between high flow nasal cannula and continuous positive airway pressure

Análisis Bibliométrico de Archivos De Bronconeumología: Evolución de los Indicadores Bibliométricos, Uso y Accesibilidad Estadistica, Redes de Colaboración, Adherencia a Iniciativas de Calidad y Métricas Alternativas

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Medicina. Fecha de lectura: 06-03-2020La presente tesis doctoral consistió en el análisis bibliométrico de la revista Archivos de Bronconeumología, el principal órgano de difusión de la patología del aparato respiratorio de las sociedades del campo en España y Latinoamérica. Como antecedente relevante, la revista fue penalizada en 2010 por el Journal Citation Reports, el encargado de publicar el factor de impacto año a año, por su exceso de autocitación, y que podía predecir tendencias de los indicadores a lo largo del tiempo. Se llevó a cabo un análisis integral de la evolución de la revista durante 17 años, que incluyó no solo los indicadores bibliométricos clásicos de productividad, consumo, colaboración y repercusión, sino también de sus redes de colaboración, la adherencia a iniciativas internacionales de calidad en la presentación de datos científicos y adaptándose a los tiempos modernos, el impacto mediático de sus trabajos en redes sociales y similares. Los resultados principales se resumen de la siguiente forma: aumento de la productividad en los últimos cinco años atribuible al incremento del material editorial; una internacionalización creciente; una inclusión de más ramas de la ciencia en comparación a años previos; una mayor profesionalización del proceso de aceptación pero no de la publicación de los trabajos; una feminización de sus autorías aunque no lo suficiente en cuanto a las posiciones de coordinación; una repercusión mayor y más rápida; redes de colaboración asociadas a los agentes más productivos y dependientes de la tipología documental; un aumento significativo de la calidad en la presentación de sus datos científicos, asociado a una mayor captación de citas; y un impacto mediático con métricas alternativas por encima del promedio. En conclusión, se observó una mejoría en la mayor parte de los parámetros analizados, aunque se han evidenciado áreas mejorablesThis doctoral thesis consisted in the bibliometrics analysis of Archivos de Bronconeumología, the leading diffusion mean of respiratory medicine societies of Spain and Latin America. As a remarkable record, the journal was penalized due to its excess of self-citation in 2010 by the Journal Citation Reports, the one in charge of publishing the impact factors of journals year by year, which might have predicted tendencies of indicators throughout time. A comprehensive analysis of the papers published in the journal for 17 years was carried out, including not only the classic bibliometrics indicators such as productivity, consumption, collaboration and repercussion, though also of its collaborative networks, adherence to international quality statements of scientific data communication, and, catching up with modern times, its impact on social media. The main results of the study are summarized as follows: productivity increase secondary to editorial material increment; a growing internationalization; a higher number of scientific fields participating; a faster acceptance time, although, a longer publication frame of time; a feminization of authorships, though insufficient in terms of coordinating positions; a greater and faster repercussion; a significative increment of quality in scientific data communication, accompanied by higher impact; and a altmetrics impact above the average. In conclusion, the journal developed greatly in the majority of analyzed areas, though there is still room for improvemen

Altmetrics analysis of Archivos de Bronconeumología from 2014 to 2018

Introduction: Alternative metrics or altmetrics are non-traditional measurements of scientific production that reflect a publication's influence in social networks and similar channels of dissemination. The aim of this study was to analyze the media impact of ARCHIVOS DE BRONCONEUMOLOGÍA according to 2 altmetric aggregators and website visits. Methods: This was an observational study of the original articles and review and consensus articles published in ARCHIVOS DE BRONCONEUMOLOGÍA during the period 2014-2018. Data from the PlumX Metrics and Altmetric aggregators and visits to the ARCHIVOS DE BRONCONEUMOLOGÍA website were analyzed. Five comparisons were made: by specialty area, by funding received, by number of participating centers, by document type, and by topic. In a subanalysis, altmetrics were correlated with the conventional citation system. Results: We analyzed 273 papers, of which 186 were original articles (68.1%). The papers that achieved greater media impact in the 2 aggregators analyzed, and in terms of website visits, were pulmonology papers and review and consensus articles. The mean Altmetric Attention Score was 1.9 ± 4.4 (range 0-59), which is above average for the date of publication of the paper. A statistically significant weak to moderate correlation was identified between altmetrics and conventional citations. Conclusions: Review articles, consensus documents, and pulmonology papers had a greater media impact. Mean Altmetric Attention Score was higher than the average based on the date of publication. A weak to moderate correlation between altmetrics and conventional citations was identified.Introducción: Las métricas alternativas o altmetrics son todas aquellas mediciones de la producción científica diferentes a los indicadores clásicos y recogen su influencia mediática en redes sociales y canales de difusión similares. El objetivo del estudio fue analizar el impacto mediático de Archivos de Bronconeumología en 2 agregadores de altmetrics y de las visitas a su página web. Métodos: Estudio observacional de los artículos originales, de revisión y de consenso de Archivos de Bronconeumología durante el periodo 2014-2018. Se analizaron los agregadores PlumX Metrics y Altmetric, y las visitas a la página web de Archivos de Bronconeumología. Se realizaron 5 comparaciones: por especialidad firmante, por financiación recibida, por número de centros participantes, por tipología documental y por área temática. Como subanálisis, se correlacionaron las altmetrics con las citaciones convencionales. Resultados: Se analizaron 273 publicaciones de las que 186 fueron artículos originales (68,1%). Las publicaciones de Neumología y las de revisión y consenso obtuvieron mayor impacto mediático en los 2 agregadores analizados, así como en las visitas a la página web. El score medio de atención de Altmetric fue de 1,9 ± 4,4 (rango 0-59), por encima del promedio para la antigüedad de la publicación. Se documentó una correlación estadísticamente significativa débil a moderada entre las altmetrics y las citaciones clásicas. Conclusiones: Las publicaciones de revisión, de consenso y las de Neumología tuvieron mayor impacto mediático. El score medio de atención de Altmetric fue superior al promedio en función de la antigüedad de las publicaciones. Se objetivó una correlación débil a moderada de las altmetrics con las citaciones convencionale

ESTADO, PAISAJE Y SOCIEDAD DURANTE EL PERIODO IBÉRICO ANTIGUO EN LAS CAMPIÑAS ORIENTALES DEL ALTO GUADALQUIVIR (SIGLOS VI – V A.C.)

The formation of Iberian society is the result of a combination of factors that took place over a long period of time, reaching its peak around the 7th to 6th centuries BC. In the case of the communities that inhabited the upper Guadalquivir, although with territorial peculiarities, the various studies carried out have served to establish settlement patterns that are fundamental for understanding the organisation of the territory during the Iberian Formative Period. This paper presents an updated analysis of this issue, thanks to recent fieldwork carried out in the municipality of Cazorla, which has made it possible to identify previously unexplored areas, and to the use of Geographic Information Systems (GIS). On the basis of the results obtained, it has been possible to postulate new approaches that complement those already established and reinforce the complexity of a population network that goes beyond the oppidum as the sole catalyst of the surrounding landscape.La formación de la sociedad ibera es el producto de una amalgama de factores acaecidos durante un largo periodo de tiempo, materializados alrededor de los siglos VII- VI a.C. En el caso de las comunidades que habitaron el alto Guadalquivir, aunque con particularidades territoriales, las diferentes investigaciones llevadas a cabo han servido para establecer unos patrones de asentamiento, fundamentales para comprender la ordenación del territorio durante el periodo formativo ibérico. En este trabajo se expone un análisis actualizado de este asunto gracias a los recientes trabajos de campo realizados en el término municipal de Cazorla, que ha permitido reconocer zonas no investigadas con anterioridad, y la aplicación de Sistemas de Información Geográfica (SIG). A partir de los resultados obtenidos, ha sido posible postular novedosos planteamientos que vienen a completar los establecidos con anterioridad, reforzando la complejidad de un entramado poblacional que va más allá del oppidum como único elemento catalizador del paisaje circundante

Construcción de clasificadores de malware para agencias de seguridad del Estado

Sandboxing has been used regularly to analyze software samples and determine if these contain suspicious properties or behaviors. Even if sandboxing is a powerful technique to perform malware analysis, it requires that a malware analyst performs a rigorous analysis of the results to determine the nature of the sample: goodware or malware. This paper proposes two machine learning models able to classify samples based on signatures and permissions obtained through Cuckoo sandbox, Androguard and VirusTotal. The developed models are also tested obtaining an acceptable percentage of correctly classified samples, being in this way useful tools for a malware analyst. A proposal of architecture for an IoT sentinel that uses one of the developed machine learning model is also showed. Finally, different approaches, perspectives, and challenges about the use of sandboxing and machine learning by security teams in State security agencies are also shared.El sandboxing ha sido usado de manera regular para analizar muestras de software y determinar si estas contienen propiedades o comportamientos sospechosos. A pesar de que el sandboxing es una técnica poderosa para desarrollar análisis de malware, esta requiere que un analista de malware desarrolle un análisis riguroso de los resultados para determinar la naturaleza de la muestra: goodware o malware. Este artículo propone dos modelos de aprendizaje automáticos capaces de clasificar muestras con base a un análisis de firmas o permisos extraídos por medio de Cuckoo sandbox, Androguard y VirusTotal. En este artículo también se presenta una propuesta de arquitectura de centinela IoT que protege dispositivos IoT, usando uno de los modelos de aprendizaje automáticos desarrollados anteriormente. Finalmente, diferentes enfoques y perspectivas acerca del uso de sandboxing y aprendizaje automático por parte de agencias de seguridad del Estado también son aportados

Peroxiredoxin 6 Down-Regulation Induces Metabolic Remodeling and Cell Cycle Arrest in HepG2 Cells

Peroxiredoxin 6 (Prdx6) is the only member of 1-Cys subfamily of peroxiredoxins in human cells. It is the only Prdx acting on phospholipid hydroperoxides possessing two additional sites with phospholipase A2 (PLA2) and lysophosphatidylcholine-acyl transferase (LPCAT) activities. There are contrasting reports on the roles and mechanisms of multifunctional Prdx6 in several pathologies and on its sensitivity to, and influence on, the redox environment. We have down-regulated Prdx6 with specific siRNA in hepatoblastoma HepG2 cells to study its role in cell proliferation, redox homeostasis, and metabolic programming. Cell proliferation and cell number decreased while cell volume increased; import of glucose and nucleotide biosynthesis also diminished while polyamines, phospholipids, and most glycolipids increased. A proteomic quantitative analysis suggested changes in membrane arrangement and vesicle trafficking as well as redox changes in enzymes of carbon and glutathione metabolism, pentose-phosphate pathway, citrate cycle, fatty acid metabolism, biosynthesis of aminoacids, and Glycolysis/Gluconeogenesis. Specific redox changes in Hexokinase-2 (HK2), Prdx6, intracellular chloride ion channel-1 (CLIC1), PEP-carboxykinase-2 (PCK2), and 3-phosphoglycerate dehydrogenase (PHGDH) are compatible with the metabolic remodeling toward a predominant gluconeogenic flow from aminoacids with diversion at 3-phospohglycerate toward serine and other biosynthetic pathways thereon and with cell cycle arrest at G1/S transition

Individual Tree Diameter and Height Growth Models for 30 Tree Species in Mixed-Species and Uneven-Aged Forests of Mexico

Lack of knowledge of individual tree growth in species-rich, mixed forest ecosystems impedes their sustainable management. In this study, species-specific models for predicting individual diameter at breast height (dbh) and total tree height (h) growth were developed for 30 tree species growing in mixed and uneven-aged forest stands in Durango, Mexico. Growth models were also developed for all pine, all oaks, and all other species of the genus Arbutus (strawberry trees). A database of 55,158 trees with remeasurements of dbh and h of a 5-year growth period was used to develop the models. The data were collected from 217 stem-mapped plots located in the Sierra Madre Occidental (Mexico). Weighted regression was used to remove heteroscedasticity from the species-specific dbh and h growth models using a power function of the tree size independent variables. The final models developed in the present study to predict dbh and total tree height growth included size variables, site factors, and competition variables in their formulation. The developed models fitted the data well and explained between 98 and 99% and of the observed variation of dbh, and between 77 and 98% of the observed variation of total tree height for the studied species and groups of species. The developed models can be used for estimating the individual dbh and h growth for the analyzed species and can be integrated in decision support tools for management planning in these mixed forest ecosystemsThis study was supported by the National Forestry Commission (CONAFOR) and the Mexican National Council for Science and Technology (CONACYT)S

The construction of infant and primary school teachers’ identity during their initial professional development and first years of work (Identidoc). Summary, main results and contributions

Podeu consultar el simposi sencer a: http://hdl.handle.net/2445/50680Podeu consultar la versió en català de la comunicació a: http://hdl.handle.net/2445/50728Educators who are currently beginning their professional career at any level of the educational system and who will likely have to work during the next thirty to forty years will be taking part in the education of individuals who, with the permission of prophets and doomsayers, will live part of their lives in the 22nd century. That long but simple statement causes a bit of vertigo as well as a good amount of reflection on the part of we educators who were trained in the 20th century, are working in the 21st century, and are responsible for preparing people to build a tomorrow that is already today (Millán and Sancho, 1995). This is the starting point of our research groups’ interest in exploring how men and women who have graduated from teacher education programs with specializations in infant and primary education learn to be teachers, and how they establish and position themselves as teachers during their university studies and the first years of their professional life..

A New Set of in Silico Tools to Support the Interpretation of ATM Missense Variants Using Graphical Analysis

Establishing the pathogenic nature of variants in ATM, a gene associated with breast cancer and other hereditary cancers, is crucial for providing patients with adequate care. Unfortunately, achieving good variant classification is still difficult. To address this challenge, we extended the range of in silico tools with a series of graphical tools devised for the analysis of computational evidence by health care professionals. We propose a family of fast and easy-to-use graphical representations in which the impact of a variant is considered relative to other pathogenic and benign variants. To illustrate their value, the representations are applied to three problems in variant interpretation. The assessment of computational pathogenicity predictions showed that the graphics provide an intuitive view of pre-diction reliability, complementing and extending conventional numerical reliability indexes. When applied to variant of unknown significance populations, the representations shed light on the nature of these variants and can be used to prioritize variants of unknown significance for further studies. In a third application, the graphics were used to compare the two versions of the ATM-adapted American College of Medical Genetics and Genomics and Association for Molecular Pathology guidelines, obtaining valuable information on their relative virtues and weaknesses. Finally, a server [ATMision (ATM missense in silico interpretation online)] was generated for users to apply these representations in their variant interpretation problems, to check the ATM-adapted guidelines' criteria for computational evidence on their variant(s) and access different sources of information. (J Mol Diagn 2024, 26: 17-28; https://doi.org/10.1016/j.jmoldx.2023.09.009