Tranexamic acid attenuates inflammatory response in cardiopulmonary bypass surgery through blockade of fibrinolysis: a case control study followed by a randomized double-blind controlled trial

INTRODUCTION: Extracorporeal circulation induces hemostatic alterations that lead to inflammatory response (IR) and postoperative bleeding. Tranexamic acid (TA) reduces fibrinolysis and blood loss after cardiopulmonary bypass (CPB). However, its effects on IR and vasoplegic shock (VS) are not well known and elucidating these effects was the main objective of this study. METHODS: A case control study was carried out to determine factors associated with IR after CPB. Patients undergoing elective CPB surgery were randomly assigned to receive 2 g of TA or placebo (0.9% saline) before and after intervention. We performed an intention-to-treat analysis, comparing the incidence of IR and VS. We also analyzed several biological parameters related to inflammation, coagulation, and fibrinolysis systems. We used SPSS version 12.2 for statistical purposes. RESULTS: In the case control study, 165 patients were studied, 20.6% fulfilled IR criteria, and the use of TA proved to be an independent protective variable (odds ratio 0.38, 95% confidence interval 0.18 to 0.81; P < 0.01). The clinical trial was interrupted. Fifty patients were randomly assigned to receive TA (24) or placebo (26). Incidence of IR was 17% in the TA group versus 42% in the placebo group (P = 0.047). In the TA group, we observed a significant reduction in the incidence of VS (P = 0.003), the use of norepinephrine (P = 0.029), and time on mechanical ventilation (P = 0.018). These patients showed significantly lower D-dimer, plasminogen activator inhibitor 1, and creatine-kinase levels and a trend toward lower levels of soluble tumor necrosis factor receptor and interleukin-6 within the first 24 hours after CPB. CONCLUSION: The use of TA attenuates the development of IR and VS after CPB. TRIAL REGISTRATION NUMBER: ISRCTN05718824

Position control of a shape memory alloy actuator using a four-term bilinear PID controller

Shape memory alloy (SMA) actuators have a number of appealing features, such as their low weight or their high force-to-weight ratio, that make them a potential alternative to traditional actuation technologies in fields such as space applications, surgical devices or wearable robotics. In this paper, a type of bilinear controller consisting of a conventional PID controller cascaded with a bilinear compensator, known as BPID, is proposed. Bilinear controllers are a subset of nonlinear controllers, which is why the BPID may be a promising alternative to control the position of a SMA actuator. Nonlinear control techniques are commonly applied to control SMA actuators, because of their nonlinear behavior caused by thermal hysteresis. The BPID controller is simpler and easier to implement than other nonlinear control strategies, which makes it a very appealing candidate to control SMA actuators. The performance of the BPID controller has been compared with other two controllers, a conventional PID and a commuted feed-forward PIPD, controlling a real SMA actuator. To this end, a set of five tests has been defined, in which the controlled actuator must follow a series of position references. From these tests, the position and error of the actuator have been plotted, and a series of metrics has been computed to have quantitative measurements of the performance of the three controllers. It is shown that, in most of the experiments, the BPID has a better performance than the other two tested controllers, especially tracking step references. However, the power consumption is slightly higher when the actuator is controlled with this strategy, although-the difference is minimal. Also, the BPID imposes greater energy variations to the SMA actuator, which might affect its service life. Overall, the BPID controller has proved to be a viable alternative to control SMA actuators.The research leading to these results has received funding from the STAMAS (Smart technology for artificial muscle applications in space) project, funded by the European Union’s Seventh Framework Programme for Research (FP7) (grant number 312815), and from the RoboHealth (DPI2013-47944-C4-3-R) Spanish research project

Identification of MiRNAs as Viable Aggressiveness Biomarkers for Prostate Cancer

MiRNAs play a relevant role in PC (prostate cancer) by the regulation in the expression of several pathways’ AR (androgen receptor), cellular cycle, apoptosis, MET (mesenchymal epithelium transition), or metastasis. Here, we report the role of several miRNAs’ expression patterns, such as miR-miR-93-5p, miR-23c, miR-210-3p, miR-221-3p, miR-592, miR-141, miR-375, and miR-130b, with relevance in processes like cell proliferation and MET. Using Trizol® extraction protocol and TaqMan™ specific probes for amplification, we performed miRNAs’ analysis of 159 PC fresh tissues and 60 plasmas from peripheral blood samples. We had clinical data from all samples including PSA, Gleason, TNM, and D’Amico risk. Moreover, a bioinformatic analysis in TCGA (The Cancer Genome Atlas) was included to analyze the effect of the most relevant miRNAs according to aggressiveness in an extensive cohort (n = 531). We found that miR-210-3p, miR-23c, miR-592, and miR-93-5p are the most suitable biomarkers for PC aggressiveness and diagnosis, respectively. In fact, according with our results, miR93-5p seems the most promising non-invasive biomarker for PC. To sum up, miR-210-3p, miR-23c, miR-592, and miR93-5p miRNAs are suggested to be potential biomarkers for PC risk stratification that could be included in non-invasive strategies such as liquid biopsy in precision medicine for PC management.Regional Ministry of Health and Families of the Andalusian Government (ref: PI-0319-2018)FIBAO (Andalusian Public Foundation for Biomedical Research in Eastern Andalusia, “Alejandro Otero”

Reflexiones sobre el aprendizaje de la histología en biología y en ciencias de la salud

El conocimiento de la estructura, composición y función del organismo es fundamental en la formación de los graduados de Ciencias Biomédicas y de Ciencias de la Salud. Las células y los tejidos son los componentes básicos para comprender el normal funcionamiento del organismo y sus procesos patológicos. Por otra parte, la Histología es una de las disciplinas básicas con mayor cantidad de publicaciones sobre temas relacionados con su docencia. Sin embargo, a pesar de la abrumadora literatura existente, todavía no hay criterios claros sobre la pertinencia de los contenidos, los métodos en el aprendizaje y la evaluación de esta materia. En este trabajo; tras una revisión bibliográfica y a partir de la información aportada por profesores de Histología, se lo analizan las principales cuestiones que plantea el proceso de enseñanza aprendizaje de la Histología en el ámbito de Biomedicina (Biología, Medicina, Veterinaria, Enfermería, Nutrición, Fisioterapia, Biotecnología, etc.), a saber: su pertinencia, los contenidos a impartir, las estrategias y los medios didácticos a emplear y los métodos de evaluación. A partir de todos estos datos se describen los principales puntos fuertes y débiles de la Histología con las correspondientes sugerencias de cambio y adaptación al entorno actual

Application of Multi-core and GPU Architectures on Signal Processing: Case Studies

In this article part of the techniques and developments we are carrying out within the INCO2 group are reported. Results follow the interdisciplinary approach with which we tackle signal processing applications. Chosen case studies show different stages of development: We present algorithms already completed which are being used in practical applications as well as new ideas that may represent a starting point, and which are expected to deliver good results in a short and medium term

Reflexiones en torno a la evaluación de las actividades del proceso de enseñanza-aprendizaje

La evaluación es un proceso sistemático, continuo e integral destinado a determinar hasta qué punto han sido alcanzados los objetivos educativos. En ella se aúnan dos actividades fundamentales: medir y emitir juicios de valor a partir, de los datos. Sin embargo, a pesar de la claridad de estos conceptos la forma de evaluar a los alumnos todavía sigue plagada de importantes contradicciones entre los profesores, lo que manifiesta unas conductas didácticas alejadas de lo que debiera ser una pedagogía basada en la evidencia. El objetivo de este proyecto es evidenciar las citadas discrepancias, entre los agentes del proceso de enseñanza aprendizaje (alumnos y profesores), a la hora de elaborar, realizar y calificar las pruebas de evaluación (“exámenes”) de los alumnos de varias disciplinas relacionadas con la Biomedicina. La metodología empleada ha consistido en aplicar a los estudiantes un sencillo cuestionario con preguntas de elección múltiple. A partir de los resultados, se pretende reflexionar sobre conjunto de criterios sólidos que permitan realizar las evaluaciones de los alumnos con mayor validez, fiabilidad, objetividad y pertinencia, como recomienda la OMS en su Guía Pedagógica para el Personal de Salud

Evaluación del entorno de aprendizaje del laboratorio de Histología con el Spanish Abbreviated Science Laboratory Environment Inventory (SASLEI)

Dentro del área de Biología Celular se recoge e imparte, la docencia de varias asignaturas que estudian la estructura, función y composición molecular de las células y de los tejidos normales y patológicos. Todas ellas utilizan el microscopio y laboratorios para impartir prácticas biológicas y biomédicas. El “entorno del aprendizaje” es considerado como un componente más del proceso de enseñanza aprendizaje. El objetivo del estudio fue recabar la opinión de los estudiantes de Histología, del Grado de Biología de la Facultad de Ciencias, de la Universidad de Alicante, sobre la calidad del entorno de aprendizaje en las prácticas de laboratorio de dicha disciplina. Para ello se utilizó el "Science Laboratory Environment Inventory" (SLEI) de Fraser, abreviado por Lightburn y traducido y adaptado al español, por De Juan et al., bajo el acrónimo de SASLEI. El SASLEI consta de 24 preguntas reunidas en cuatro categorías: integración de contenidos teóricos y prácticos, reglas de funcionamiento en el laboratorio, cohesión entre los estudiantes y calidad de los materiales e infraestructuras. El cuestionario se aplicó a los grupos 1, 2 y 3 de la signatura de Histología del curso 2015-2016. Los resultados muestran que los alumnos valoran muy positivamente las cuatro categorías, en las prácticas de laboratorio de Histología, siendo la valoración de la categoría integración, del grupo 1, la que ha recibido una puntuación significativamente más baja respecto de los otros dos grupos. El resto de las categorías fueron muy similares en los tres grupos

On the performance of multi-GPU-based expert systems for acoustic localization involving massive microphone array

Sound source localization is an important topic in expert systems involving microphone arrays, such as automatic camera steering systems, human-machine interaction, video gaming or audio surveillance. The Steered Response Power with Phase Transform (SRP-PHAT) algorithm is a well-known approach for sound source localization due to its robust performance in noisy and reverberant environments. This algorithm analyzes the sound power captured by an acoustic beamformer on a defined spatial grid, estimating the source location as the point that maximizes the output power. Since localization accuracy can be improved by using high-resolution spatial grids and a high number of microphones, accurate acoustic localization systems require high computational power. Graphics Processing Units (GPUs) are highly parallel programmable co-processors that provide massive computation when the needed operations are properly parallelized. Emerging GPUs offer multiple parallelism levels; however, properly managing their computational resources becomes a very challenging task. In fact, management issues become even more difficult when multiple GPUs are involved, adding one more level of parallelism. In this paper, the performance of an acoustic source localization system using distributed microphones is analyzed over a massive multichannel processing framework in a multi-GPU system. The paper evaluates and points out the influence that the number of microphones and the available computational resources have in the overall system performance. Several acoustic environments are considered to show the impact that noise and reverberation have in the localization accuracy and how the use of massive microphone systems combined with parallelized GPU algorithms can help to mitigate substantially adverse acoustic effects. In this context, the proposed implementation is able to work in real time with high-resolution spatial grids and using up to 48 microphones. These results confirm the advantages of suitable GPU architectures in the development of real-time massive acoustic signal processing systems.This work has been partially funded by the Spanish Ministerio de Economia y Competitividad (TEC2009-13741, TEC2012-38142-C04-01, and TEC2012-37945-C02-02), Generalitat Valenciana PROMETEO 2009/2013, and Universitat Politecnica de Valencia through Programa de Apoyo a la Investigacion y Desarrollo (PAID-05-11 and PAID-05-12).Belloch Rodríguez, JA.; Gonzalez, A.; Vidal Maciá, AM.; Cobos Serrano, M. (2015). On the performance of multi-GPU-based expert systems for acoustic localization involving massive microphone array. Expert Systems with Applications. 42(13):5607-5620. https://doi.org/10.1016/j.eswa.2015.02.056S56075620421

Todo lo que siempre quiso saber sobre la evaluación, pero no se atrevió a preguntar: a propósito de una encuesta

La evaluación es un proceso sistemático, continuo e integral destinado a determinar hasta qué punto han sido alcanzados los objetivos educativos. En ella se aúnan dos actividades fundamentales: medir y emitir juicios de valor a partir, de los datos. Sin embargo, a pesar de la claridad de estos conceptos la forma de evaluar a los alumnos todavía sigue plagada de importantes contradicciones entre los profesores, lo que manifiesta unas conductas didácticas alejadas de lo que debiera ser una pedagogía basada en la evidencia. El objetivo de este trabajo es evidenciar las citadas discrepancias, entre los agentes del proceso de enseñanza aprendizaje (alumnos y profesores), a la hora de elaborar, realizar y calificar las pruebas de evaluación (“exámenes”) de los alumnos de varias disciplinas relacionadas con la Biomedicina. La metodología empleada ha consistido en aplicar a los estudiantes un sencillo cuestionario con preguntas de elección múltiple. A partir de los resultados, se pretende reflexionar sobre conjunto de criterios sólidos que permitan realizar las evaluaciones de los alumnos con mayor validez, fiabilidad, objetividad y pertinencia, como recomienda la OMS en su Guía Pedagógica para el Personal de Salud

Executive summary: Diagnosis and Treatment of Catheter-Related Bloodstream Infection: Clinical Guidelines of the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC) and the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC)

Catheter-related bloodstream infections (CRBSI) constitute an important cause of hospital-acquired infection associated with morbidity, mortality, and cost. The aim of these guidelines is to provide updated recommendations for the diagnosis and management of CRBSI in adults. Prevention of CRBSI is excluded. Experts in the field were designated by the two participating Societies (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica and the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias). Short-term peripheral venous catheters, non-tunneled and long-term central venous catheters, tunneled catheters and hemodialysis catheters are covered by these guidelines. The panel identified 39 key topics that were formulated in accordance with the PICO format. The strength of the recommendations and quality of the evidence were graded in accordance with ESCMID guidelines. Recommendations are made for the diagnosis of CRBSI with and without catheter removal and of tunnel infection. The document establishes the clinical situations in which a conservative diagnosis of CRBSI (diagnosis without catheter removal) is feasible. Recommendations are also made regarding empirical therapy, pathogen-specific treatment (coagulase-negative staphylococci, Sthaphylococcus aureus, Enterococcus spp, Gram-negative bacilli, and Candida spp), antibiotic lock therapy, diagnosis and management of suppurative thrombophlebitis and local complications