Masa intraoral de rápido crecimiento: a propósito de un caso

La aparición de una masa intraoral supone un motivo de consulta frecuente en nuestra especialidad. La mayoría de los casos corresponden a lesiones benignas y, dentro de las malignas, a tumores primarios intraorales. Las metástasis suponen menos del 1 % de las lesiones malignas. Presentamos el caso de una mujer de 86 años de edad, sin antecedentes oncológicos, que acudió a nuestro servicio presentando una masa intraoral asintomática, de crecimiento rápido y volumen considerable, sin otros hallazgos de interés a la exploración. La lesión se acompañaba de erosión ósea subyacente. El resultado de la biopsia fue de adenocarcinoma metastático de probable origen abdominal, si bien el tumor primario no pudo ser identificado con las técnicas diagnósticas no invasivas que se llevaron a cabo. Valorando el estado deteriorado de la paciente, así como el mal pronóstico de dichas lesiones, se optó por un tratamiento únicamente sintomático, consiguiendo una adecuada calidad de vida y sin aparición de recidivas locales en el momento actual.The appearance of an intraoral mass is common in our speciality. Most are benign lesions, but some are primary malignancies. Metastases account for less than 1% of all oral malignances. An 86 year old woman was referred to our department with a large, asymptomatic, intraoral, fast-growing mass. She had no previous cancer history or other relevant physical findings. The radiology studies showed underlying bone erosion. The histological study showed a metastatic adenocarcinoma with a suspected origin in the abdomen. We were unable to identify it by non invasive diagnostic procedures. Given the patient's general status and despite the ominous prognosis of such lesions, we decided not to perform any aggressive therapy beyond removing the oral mass, in order to maintain her quality of life. There have been no local recurrences until this time

Detection of hepatitis C virus (HCV) core-specific antibody suggests occult HCV infection among blood donors

Background: Blood transfusion safety is based on reliable donor screening for transmissible infections such as the hepatitis C virus (HCV) infection. Study design and methods: A novel HCV core-specific antibody was assayed on random single donations from 2007 first-time blood donors who tested negative for anti-HCV and HCV RNA on routine screening. Sample collection broke the code between donations and donors for ethical reasons. Results: Forty-two donations (2.1%) displayed reactivity in the novel test. The specificity of the reactivity was evaluated by a peptide inhibition assay, and testing against additional nonoverlapping HCV core peptide epitopes and other HCV antigens was performed on these samples. Six donations (14.3%; 0.30% from the total) were considered to contain anti-HCV after such supplemental testing. HCV RNA detection was also performed in peripheral blood mononuclear cells (PBMNCs) and serum or plasma samples from reactive donors after virus concentration by ultracentrifugation. HCV RNA tested negative in all PBMNCs samples, and a very low amount of viral genome was detected in serum or plasma concentrates from three anti-HCV core-reactive donors (7.1%) but not among concentrates from 100 randomly selected nonreactive donors. Sequencing of these polymerase chain reaction products revealed differences between the isolates that excluded partially sample contamination from a common source. Conclusion: These findings argue in favor of an ongoing occult HCV infection among these blood donors and account for some rather low, but perhaps not negligible, infection risk for such donations. Future studies involving larger samples of donations from traceable donors would enlighten the significance of these findings for the viral safety of the blood supply.This work was supported by research grants from DIATERS.A., Madrid, Spain.S

Intrapartum ultrasound in maternal lateral versus semi-recumbent posture. A repeated measures study

Objective: This study aimed to assess whether intrapartum ultrasound (ITU) measurements in maternal lateral posture are superimposable to ITU measurements in semi-recumbent position. Study design: A single-center, repeated measures design was used. Women in the second stage of labor were randomized to ITU first in semi-recumbent followed by ITU in side-lying posture without and with contraction, or inversely. The angle of progression (AOP) and the head-perineum distance (HPD) between contractions (AOP1 and HPD1) and with contraction (AOP2 and HPD2) were measured in each maternal posture. The differences between AOP1 and AOP2 (dAOP), and between HPD1 and HPD2 (dHPD) were calculated. Results and conclusions: Forty-two women participated in the study. A generalized estimating equation model showed that AOP1 (-3.00°; 95 % CI −5.77 to −0.23; p = 0.03) and AOP2 (-4.14°; 95 % CI −7.20 to −1.08; p = 0.008) were lower in semi-recumbent compared to maternal lateral posture. HPD1 (+1.43 mm; 95 % CI 0.05–2.81; p = 0.042) and HPD2 (+1.53 mm; 95 % CI 0.17–2.89; p = 0.03) were higher in semi-recumbent position. Differences in the ITU measurements in maternal lateral posture compared to semi-recumbent position are small. Monitoring the second stage of labor with ITU in lateral maternal posture is possibl

The AMASS approach for assurance and certification of critical systems

Safety-critical systems are subject to rigorous assurance and certification processes to guarantee that they do not pose unreasonable risks to people, property, or the environment. The associated activities are usually complex and time-consuming, thus they need adequate support for their execution. The activities are further becoming more challenging as the systems are evolving towards open, interconnected systems with new features, e.g. Internet connectivity, and new assurance needs, e.g. compliance with several assurance standards for different dependability attributes. This requires the development of novel approaches for cost-effective assurance and certification. With the overall goal of lowering assurance and certification costs in face of rapidly changing features and market needs, the AMASS project has created and consolidated the de-facto European-wide open solution for assurance and certification of critical systems. This has been achieved by establishing a novel holistic and reuse-oriented approach for architecture-driven assurance, multi-concern assurance, and for seamless interoperability between assurance and engineering activities along with third-party activities. This paper introduces the main elements of the AMASS approach and how to use them and benefit from them.The work leading to this paper has received funding from the AMASS project (H2020-ECSEL grant agreement no 692474; Spain’s MINECO ref. PCIN-2015-262)

Magnetic instabilities along the superconducting phase boundary of Nb/Ni multilayers

We report vibrating reed and superconducting quantum interference device magnetometer data that exhibit prominent dips or oscillations of the superconducting (SC) onset temperature, Delta T(C)(H)approximate to 0.01-0.7 K, for a [Nb(23 nm)/Ni(5 nm)](5) multilayer (ML) in dc magnetic fields applied nearly parallel to the ML plane. The vibrating reed data exhibit reproducible structures below T(C) that may reflect multiple SC transitions, but they are sensitive to ac field amplitude and dc field orientation. This striking behavior poses challenges for theoretical and experimental investigations of interfaces between SC and ferromagnetic layers that involve magnetic pair breaking effects, "pi phase shifts" of the SC order parameter, and exotic ("LOFF") pairing states. Alternatively, the anomalies may mark dynamical instabilities within a confined, strongly anisotropic Abrikosov vortex lattice

Thermal emissivity spectra and structural phase transitions of the eutectic Mg-51%Zn alloy: A candidate for thermal energy storage

The thermal emissivity spectrum in the mid infrared range (3 to 21 $\mu$m) as well as its dependence on temperature between 225 and 320 $^{\circ}$C has been obtained for the Mg-51%Zn (weight %) eutectic alloy, a candidate for thermal storage. The spectral curves show the typical behaviour of metals and alloys, with emissivity values between 0.05 and 0.2. It was also found that the emissivity spectrum shows variations in each heating cycle during the first few cycles. These changes are associated with the presence of metastable phases in the solid solid phase transition, present in the alloy below the melting point. The absence of signs of oxidation in air is very favourable for the use of this alloy in thermal energy storage systems. Moreover, the total normal emissivity curves obtained from dynamic spectral measurements have allowed analysing the behaviour phase transition sequence present in this alloy. These experimental results indicate that accurate emissivity measurements can be sensitive enough to account for the structural phase transitions in metals and alloys

Novos desafios para a educação ambiental: vulnerabilidade e resiliência social em face dos estragos da mudança climática. Um projeto em municípios de alto risco no estado de Veracruz, México.

El artículo presenta una síntesis del protocolo de investigación de un proyecto de investigación sobre vulnerabilidad y resiliencia social dirigido a evaluar la vulnerabilidad física, social y motivacional-actitudinal de tres municipios de la zona costera del estado de Veracruz en México, susceptibles de sufrir impactos periódicos de fenómenos climáticos extremos, mediante estrategias participativas con diferentes actores comunitarios, específicamente jóvenes de bachillerato, y con un enfoque de género. El estudio da continuidad a otro estudio previo sobre representaciones sociales de cambio climático y pretende forrmular criterios y pautas de acción mediante diversas estrategias inter e intracomunitarias que contribuyan a reducir riesgos de las comunidades vulnerables estudiadas y los de otras comunidades en condiciones equivalentes, para incrementar su resiliencia social

The upper-airway microbiome as a biomarker of asthma exacerbations despite inhaled corticosteroid treatment.

BACKGROUND: The response to inhaled corticosteroids (ICS) in asthma is affected by the interplay of several factors. Among these, the role of the upper-airway microbiome has been scarcely investigated. We aimed to evaluate the association between the salivary, pharyngeal, and nasal microbiome with asthma exacerbations despite receipt of ICS. METHODS: Samples from 250 asthma patients from the Genomics and Metagenomics of Asthma Severity (GEMAS) study treated with ICS were analyzed. Control/case subjects were defined by the absence/presence of asthma exacerbations in the past 6 months despite being treated with ICS. The bacterial microbiota was profiled by sequencing the V3-V4 region of the 16S rRNA gene. Differences between groups were assessed by PERMANOVA and regression models adjusted for potential confounders. Afalse discovery rate (FDR) of 5% was used to correct for multiple comparisons. Classification models of asthma exacerbations despite ICS treatment were built with machine learning approaches based on clinical, genetic, and microbiome data. RESULTS: In nasal and saliva samples, case subjects had lower bacterial diversity (Richness, Shannon, and Faith indices) than control subjects (.007≤ P≤ .037). Asthma exacerbations accounted for 8% to 9% of the interindividual variation of the salivary and nasal microbiomes (.003≤ P≤ .046). Three, 4, and 11 bacterial genera from the salivary, pharyngeal, and nasal microbiomes were differentially abundant between groups (4.09*10-12≤ FDR≤ 0.047). Integrating clinical, genetic, and microbiome data showed good discrimination for the development of asthma exacerbations despite receipt of ICS (AUCtraining: 0.82 and AUCvalidation: 0.77). CONCLUSION: The diversity and composition of the upper-airway microbiome are associated with asthma exacerbations despite ICS treatment. The salivary microbiome has a potential application as a biomarker of asthma exacerbations despite receipt of ICS

Cu fractionation, isotopic analysis, and data processing <i>via</i> machine learning: new approaches for the diagnosis and follow up of Wilson's disease <i>via</i> ICP-MS

Information about Cu fractionation and Cu isotopic composition can be paramount when investigating Wilson's disease (WD). This information can provide a better understanding of the metabolism of Cu. Most importantly, it may provide an easy way to diagnose and to follow the evolution of WD patients. For such purposes, protocols for Cu determination and Cu isotopic analysis via inductively coupled plasma mass spectrometry were investigated in this work, both in bulk serum and in the exchangeable copper (CuEXC) fractions. The CuEXC protocol provided satisfactory recovery values. Also, no significant mass fractionation during the whole analytical procedure (CuEXC production and/or Cu isolation) was detected. Analyses were carried out in controls (healthy persons), newborns, patients with hepatic disorders, and WD patients. While the results for Cu isotopic analysis are relevant (e.g., δ65Cu values were lower for both WD patients under chelating treatment and patients with hepatic problems in comparison with those values obtained for WD patients under Zn treatments, controls, and newborns) to comprehend Cu metabolism and to follow up the disease, the parameter that can help to better discern between WD patients and the rest of the patients tested (non-WD) was found to be the REC (relative exchangeable Cu). In this study, all the WD patients showed a REC higher than 17%, while the rest showed lower values. However, since establishing a universal threshold is complicated, machine learning was investigated to produce a model that can differentiate between WD and non-WD samples with excellent results (100% accuracy, albeit for a limited sample set). Most importantly, unlike other ML approaches, our model can also provide an uncertainty metric to indicate the reliability of the prediction, overall opening new ways to diagnose WD

Coping strategies used by health-care workers during the SARS-COV2 crisis. A real-world analysis.

El artículo ha sido publicado en la revista Psychiatry Research [Elsevier]. Está disponible en: https://www.sciencedirect.com/science/article/pii/S0165178122005066?via%3Dihub[EN]The aim of this paper is to analyze the main coping strategies used by frontline teams during the first days of the COVID pandemic confinement in Spain. This information could be necessary in order to carry out training programs that allow a better handling of future emergency situations, as well as acting more effectively and with less negative emotional impact. A questionnaire was used to identify different psychological profiles for coping, and in turn, other relevant variables were analyzed. The most used strategies by health professionals were problem solving, desiderative thinking and social support. Emotional expression and social support were used more by women. Significantly different behaviors were found in desiderative thinking (lower in people of 35-50 years old, and social support, higher in people 35 years old). The symptoms most commonly experienced by medical personnel were: sleep disorders, anxiety, tension, depressive symptoms, gastrointestinal symptoms and general somatic muscular symptoms. A relationship could be determined between the age/gender of the workers and the participants' overall assessment of their ability to cope with the COVID-19 stress situation they had experienced (men 50 years old and women between 35 and 50 years old, who felt able or very able to cope with the stress caused by the health emergency. However, women 50 years old believed they were able to cope poorly with the circumstances. The advantage of specific training plans in order to help with some stress symptoms could be suggested, aimed at the acquisition of tools based on problem solving, and emotional management in stressful and emergency situations