Telehealth-Based Music Therapy Versus Cognitive Behavioral Therapy for Anxiety in Cancer Survivors: Rationale and Protocol for a Comparative Effectiveness Trial

Background: Cancer survivors represent one of the fastest growing populations in the United States. Unfortunately, nearly 1 in 3 survivors experience anxiety symptoms as a long-term consequence of cancer and its treatment. Characterized by restlessness, muscle tension, and worry, anxiety worsens the quality of life; impairs daily functioning; and is associated with poor sleep, depressed mood, and fatigue. Although pharmacological treatment options are available, polypharmacy has become a growing concern for cancer survivors. Music therapy (MT) and cognitive behavioral therapy (CBT) are evidence-based, nonpharmacological treatments that have demonstrated effectiveness in treating anxiety symptoms in cancer populations and can be adapted for remote delivery to increase access to mental health treatments. However, the comparative effectiveness of these 2 interventions delivered via telehealth is unknown. Objective: The aims of the Music Therapy Versus Cognitive Behavioral Therapy for Cancer-related Anxiety (MELODY) study are to determine the comparative effectiveness of telehealth-based MT versus telehealth-based CBT for anxiety and comorbid symptoms in cancer survivors and to identify patient-level factors associated with greater anxiety symptom reduction for MT and CBT. Methods: The MELODY study is a 2-arm, parallel-group randomized clinical trial that aims to compare the effectiveness of MT versus CBT for anxiety and comorbid symptoms. The trial will enroll 300 English- or Spanish-speaking survivors of any cancer type or stage who have experienced anxiety symptoms for at least 1 month. Participants will receive 7 weekly sessions of MT or CBT delivered remotely via Zoom (Zoom Video Communications, Inc) over 7 weeks. Validated instruments to assess anxiety (primary outcome), comorbid symptoms (fatigue, depression, insomnia, pain, and cognitive dysfunction), and health-related quality of life will be administered at baseline and at weeks 4, 8 (end of treatment), 16, and 26. Semistructured interviews will be conducted at week 8 with a subsample of 60 participants (30 per treatment arm) to understand individual experiences with the treatment sessions and their impact. Results: The first study participant was enrolled in February 2022. As of January 2023, 151 participants have been enrolled. The trial is expected to be completed by September 2024. Conclusions: This study is the first and largest randomized clinical trial to compare the short- and long-term effectiveness of remotely delivered MT and CBT for anxiety in cancer survivors. Limitations include the lack of usual care or placebo control groups and the lack of formal diagnostic assessments for psychiatric disorders among trial participants. The study findings will help guide treatment decisions for 2 evidence-based, scalable, and accessible interventions to promote mental well-being during cancer survivorship. International registered report identifier (irrid): DERR1-10.2196/46281

Ultralight vector dark matter search using data from the KAGRA O3GK run

Among the various candidates for dark matter (DM), ultralight vector DM can be probed by laser interferometric gravitational wave detectors through the measurement of oscillating length changes in the arm cavities. In this context, KAGRA has a unique feature due to differing compositions of its mirrors, enhancing the signal of vector DM in the length change in the auxiliary channels. Here we present the result of a search for U(1)B−L gauge boson DM using the KAGRA data from auxiliary length channels during the first joint observation run together with GEO600. By applying our search pipeline, which takes into account the stochastic nature of ultralight DM, upper bounds on the coupling strength between the U(1)B−L gauge boson and ordinary matter are obtained for a range of DM masses. While our constraints are less stringent than those derived from previous experiments, this study demonstrates the applicability of our method to the lower-mass vector DM search, which is made difficult in this measurement by the short observation time compared to the auto-correlation time scale of DM

Search for eccentric black hole coalescences during the third observing run of LIGO and Virgo

Despite the growing number of confident binary black hole coalescences observed through gravitational waves so far, the astrophysical origin of these binaries remains uncertain. Orbital eccentricity is one of the clearest tracers of binary formation channels. Identifying binary eccentricity, however, remains challenging due to the limited availability of gravitational waveforms that include effects of eccentricity. Here, we present observational results for a waveform-independent search sensitive to eccentric black hole coalescences, covering the third observing run (O3) of the LIGO and Virgo detectors. We identified no new high-significance candidates beyond those that were already identified with searches focusing on quasi-circular binaries. We determine the sensitivity of our search to high-mass (total mass M>70 M⊙) binaries covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to compare model predictions to search results. Assuming all detections are indeed quasi-circular, for our fiducial population model, we place an upper limit for the merger rate density of high-mass binaries with eccentricities 0<e≤0.3 at 0.33 Gpc−3 yr−1 at 90\% confidence level

Search for gravitational-lensing signatures in the full third observing run of the LIGO-Virgo network

Gravitational lensing by massive objects along the line of sight to the source causes distortions of gravitational wave-signals; such distortions may reveal information about fundamental physics, cosmology and astrophysics. In this work, we have extended the search for lensing signatures to all binary black hole events from the third observing run of the LIGO--Virgo network. We search for repeated signals from strong lensing by 1) performing targeted searches for subthreshold signals, 2) calculating the degree of overlap amongst the intrinsic parameters and sky location of pairs of signals, 3) comparing the similarities of the spectrograms amongst pairs of signals, and 4) performing dual-signal Bayesian analysis that takes into account selection effects and astrophysical knowledge. We also search for distortions to the gravitational waveform caused by 1) frequency-independent phase shifts in strongly lensed images, and 2) frequency-dependent modulation of the amplitude and phase due to point masses. None of these searches yields significant evidence for lensing. Finally, we use the non-detection of gravitational-wave lensing to constrain the lensing rate based on the latest merger-rate estimates and the fraction of dark matter composed of compact objects

Trabajo de investigación presentado como requisito para optar al título de: Tecnología en Electromedicina

En este informe se presenta una situación real y objetiva, propia del E.S.E HOSPITAL SANTA MATILDE, centro hospitalario de Nivel I, situado en el municipio de Madrid, departamento de Cundinamarca, donde se ofrecen servicios generales y especializados incluyendo la utilización de equipos biomédicos para atender pacientes con diferentes patologías de nivel I, tanto del área urbana como rural. La investigación de este informe está fundamentada en la experiencia obtenida durante la realización de mis prácticas en el E.S.E HOSPITAL SAN MATILDE DE MADRID, relacionada con el uso y manejo del equipo biomédico existente, buscando el mejoramiento necesario para llegar a la excelencia al identificar dificultades que pueden superarse para ofrecer a los usuarios oportunidades tecnológicas acordes con la vida actual.Introducción 11 1.1 Descripción del problema 12 1.1.1 Formulación del problema 14 1.2 Justificación 14 1.3 Objetivos 15 1.3.1 Objetivo general. 15 1.3.2 Objetivos específicos. 16 2. Marco de referencia 17 2.1 Marco de estado actual 17 2.1.1 Misión 21 2.1.2 Visión 21 2.1.3 Lema 21 2.2 Marco Contextual 22 2.2.1 Informes institucionales 22 2.2.2 Organigrama 23 2.3 Marco conceptual 24 5 2.3.1 Hospital 26 2.3.2 Paciente 27 2.3.3 Términos especiales 27 2.3.3.1. POS, EPS, IPS, REPS, Telemedicina. 27 2.3.3.2 Dispositivo médico, Equipo biomédico, Servicio de soporte técnico 28 2.3.3.3. Equipo biomédico (original), Infraestructura, Dotación y Mantenimiento hospitalario 30 2.3.4 Niveles hospitalarios. Hospital de Nivel I 32 2.4 Marco legal 34 Metodología 37 3.1 Actividades desarrolladas durante la pasantía. 40 3.1.1 Investigación Cualitativa – descriptiva. Proceso Vivencial 40 3.2 Investigación Cuantitativa – Encuesta de Satisfacción. 45 3.2.1 Instrumento de medición – Encuesta. 45 3.2.2 Tipo de encuesta 45 3.2.3 Plan de análisis 46 3.2.4 Resultados 46 Conclusiones 56 Recomendaciones 58 Referencias 6

The truth behind the man-truck and other car-driven hybrids in Adriano Gonzalez Leon's El arco en el cielo (1967) and Pais portable (1969)

With the man-truck of the story The arch in the sky and the 'man-tire', as it will be nicknamed the protagonist of Portable country, Adriano Gonzalez Leon deepens a reflection started in his stories Asphalt-hell (1962) on the interaction between people and the means of mobility within the framework of the power relations that sustain these interactions. Following the postulate of Bruno Latour in his book The Hope of Pandora, which explores the intrinsic relationship between the human and the nonhuman, and that the works of Gonzalez Leon fictionalize, this paper explores the criticism within the metaphor of the man-vehicle in the face of the official discourse that accompanies the development and use of transport systems. Some of the relevant aspects to deal with in this context are the perception of time and space in the imaginary of these characters and how they articulate a cultural memory that differs from the progressive and linear version of power entities

La tentación del abismo en armonía Somers: Entre el expresionismo de vanguardia y el gótico postmoderno

Armonía Somers (Uruguay 1917 - 1994) ha sido clasificada dentro de la llamada Generación del 45 de Uruguay, sin embargo, muchos críticos aseguran que su obra difiere de la estética del período en que escribió. Mientras Ángel Rama sugiere que la narrativa de Somers pertenece a la tradición de los raros y malditos, que desciende del extraño linaje del Conde franco-uruguayo y poeta Lautréamont, otros la colocan en el ámbito de la narrativa imaginativa y de lo fantástico. La crítica contemporánea se aproxima a la obra de Somers a partir del concepto de lo extraño o Unheimlich , abordando las novelas de la autora desde una perspectiva freudiana, lacaniana o heideggeriana. No obstante, ninguna de estas investigaciones ha determinado a qué género u orientación literaria se aviene, ni han indagado en profundidad sobre su contribución a los estudios metaficcionales. En esta tesis propongo que las novelas de Armonía Somers, La mujer desnuda (1950), De miedo en miedo. Los manuscritos del río (1965), Un retrato para Dickens (1969), Viaje al corazón del día. Elegía por un amor secreto (1986), y Solo los elefantes encuentran mandrágora (1986), transgreden los géneros y tendencias literarias dominantes en su época por medio de una imaginación excesiva y de una trama anti-dramática, asociada primordialmente con la experiencia del terror sublime y la representación de lo inexpresable o irrepresentable, ambas nociones correspondientes a la poética expresionista de vanguardia y al gótico postmoderno. Las novelas analizadas en este trabajo presentan en su estructura una amplia gama de formas ambiguas e inorgánicas, cuya función desestabiliza los aspectos formales del realismo y subvierte los postulados epistemológicos e ideológicos en que se apoyan las culturas afirmativas, las cuales legitiman solo cierto concepto de realidad, desentendiéndose del resto de las experiencia humanas que no encajan en sus esquemas. La desacralización, la disolución moral, la muerte simbólica y la naturaleza fluida de la identidad junto con una marcada autorreflexividad, son algunos de los temas más relevantes de este conjunto de obras, que he categorizado como un ejemplo del expresionismo gótico postmoderno del siglo XX

Genomic Aberrations in Circulating Tumor DNAs from Palbociclib-Treated Metastatic Breast Cancer Patients Reveal a Novel Resistance Mechanism.

Previously undescribed molecular mechanisms of resistance will emerge with the increased use of cyclin-dependent kinase 4/6 inhibitors in clinical settings. To identify genomic aberrations in circulating tumor DNA associated with treatment resistance in palbociclib-treated metastatic breast cancer (MBC) patients, we collected 35 pre- and post-treatment blood samples from 16 patients with estrogen receptor-positive (E