Analgesia epidural frente a analgesia endovenosa en cirugía ginecológica oncológica: Chen LM, Weinberg VK, Chen C, Powell CB, Chen LL, Chan JK, et al. Perioperative outcomes comparing patient controlled epidural versus intravenous analgesia in gynecologic oncology surgery. Gynecol Oncol 2009; 115: 357-61.

La cirugía ginecológica oncológica se asocia a dolor moderado-severo en el postoperatorio, así como a potenciales complicaciones como la pérdida sanguínea, eventos tromboembólicos e íleo paralítico, que incrementan la estancia hospitalaria. La analgesia epidural ha demostrado ser efectiva en el control del dolor tras cirugía mayor abdominal, sin embargo existen múltiples controversias con respecto a la combinación óptima de fármacos a emplear, el nivel neuroaxial en el que situar el catéter o su repercusión en el postoperatorio de la cirugía oncológica ginecológica

Eficacia de la infusión continua de levobupivacaína en la herida quirúrgica tras cesárea

Programa Oficial de Doutoramento en Ciencias da Saúde. 5007V01[Resumo] Algunhas pacientes aínda sofren dor tras unha cesárea. A infusión de anestésicos locais na ferida podería actuar sobre a sensibilización periférica e central. Avaliamos os beneficios da infusión continua de levobupivacaína tras cesárea na hiperalgesia secundaria e primaria, alivio da dor, dor persistente e resposta inflamatoria e metabólica de estrés. Setenta mulleres sas programadas para cesárea participaron neste ensaio prospectivo, aleatorizado, triplo-cego. As mulleres recibiron levobupivacaína 0,35%, 7 ml/ h durante 48h (Grupo L) ou solución salina (Grupo S). Recolléronse: hiperalgesia secundaria; hiperalgesia primaria; intensidade da dor posoperatorio; tempo ata o primeiro birlo de analgesia; dose acumulada de recate; dor persistente; parámetros bioquímicos; e eventos adversos. No Grupo L, a área de hiperalgesia secundaria reduciuse significativamente [43.4(18.5-80) fronte 68.4(39.0-136) cm2 e 45.1(0.9-89.8) fronte 67.3(31.3-175) cm2 ás 24 e 48 h, respectivamente; interacción grupo:tempo p< 0.001], o limiar de dor foi maior ás 24 h [633(441-802) fronte 417(300-572) g.mm-2, p=0.001], e o consumo de morfina foi menor ás 24 h [4(2-11) fronte 11(6-23), p= 0.003] fronte ao Grupo S. Os niveis de insulina foron significativamente máis baixos no Grupo L. A infusión de levobupivacaína na ferida podería ser un complemento antihiperalgésico eficaz.[Resumen] Algunas pacientes todavía sufren dolor tras una cesárea. La infusión de anestésicos locales en la herida podría actuar sobre la sensibilización periférica y central. Evaluamos los beneficios de la infusión continua de levobupivacaína tras cesárea en la hiperalgesia secundaria y primaria, alivio del dolor, dolor persistente y respuesta inflamatoria y metabólica de estrés. Setenta mujeres sanas programadas para cesárea participaron en este ensayo prospectivo, aleatorizado, triple-ciego. Las mujeres recibieron levobupivacaína 0,35%, 7 ml/h durante 48 h (Grupo L) o solución salina (Grupo S). Se recogieron: hiperalgesia secundaria; hiperalgesia primaria; intensidad del dolor posoperatorio; tiempo hasta el primer bolo de analgesia; dosis acumulada de rescate; dolor persistente; parámetros bioquímicos; y eventos adversos. En el Grupo L, el área de hiperalgesia secundaria se redujo significativamente [43.4(18.5-80) frente 68.4(39.0-136) cm2 y 45.1(0.9-89.8) frente 67.3(31.3-175) cm2 a las 24 y 48h, respectivamente; interacción grupo:tiempo p< 0.001], el umbral de dolor fue mayor a las 24h [633(441-802) frente 417(300-572) g.mm-2, p=0.001], y el consumo de morfina fue menor a las 24h [4(2-11) frente 11(6-23), p= 0.003] frente al Grupo S. Los niveles de insulina fueron significativamente más bajos en el Grupo L. La infusión de levobupivacaína en la herida podría ser un complemento antihiperalgésico eficaz.[Abstract] Some patients still report pain after cesarean delivery. Local anesthetic wound infusion might act on peripheral and central sensitization mechanisms. We evaluated the benefits of continuous wound infusion of levobupivacaine after cesarean delivery on secondary hyperalgesia and primary hyperalgesia, pain relief, persistent pain, and inflammatory and metabolic stress response. Seventy healthy women scheduled for cesarean delivery participated in this prospective, randomized, triple-blind trial. Women were randomized to receive continuous wound infusion (0.35% levobupivacaine 7 ml/h for 48 h; Group L) or saline (Group S). The following variables were collected: secondary hyperalgesia; primary hyperalgesia; intensity of postoperative pain; time to first bolus of patientcontrolled analgesia; cumulative dose of rescue morphine and acetaminophen; persistent postoperative pain; biochemical parameters; and adverse events. In Group L, the area of secondary hyperalgesia was significantly reduced [43.4(18.5-80) vs. 68.4(39.0-136) cm2 and 45.1(0.9-89.8) vs. 67.3(31.3-175) cm2 at 24 and 48 h, respectively; group:time interaction p-value < 0.001], the pain threshold was significantly higher at 24 hours [633(441-802) vs. 417(300-572) g.mm-2, p=0.001], and morphine consumption was significantly lower at 24 h [4(2-11) vs 11(6-23), p= 0.003] compared with Group S. Plasma insulin levels were significantly lower in Group L. Levobupivacaine wound infusion might be an effective antihyperalgesic adjunct

ED-Scorbot: A Robotic test-bed Framework for FPGA-based Neuromorphic systems

Neuromorphic engineering is a growing and promising discipline nowadays. Neuro-inspiration and brain understanding applied to solve engineering problems is boosting new architectures, solutions and products today. The biological brain and neural systems process information at relatively low speeds through small components, called neurons, and it is impressive how they connect each other to construct complex architectures to solve in a quasi-instantaneous way visual and audio processing tasks, object detection and tracking, target approximation, grasping…, etc., with very low power. Neuromorphs are beginning to be very promising for a new era in the development of new sensors, processors, robots and software systems that mimic these biological systems. The event-driven Scorbot (EDScorbot) is a robotic arm plus a set of FPGA / microcontroller’s boards and a library of FPGA logic joined in a completely event-based framework (spike-based) from the sensors to the actuators. It is located in Seville (University of Seville) and can be used remotely. Spike-based commands, through neuro-inspired motor controllers, can be sent to the robot after visual processing object detection and tracking for grasping or manipulation, after complex visual and audio-visual sensory fusion, or after performing a learning task. Thanks to the cascade FPGA architecture through the Address-Event-Representation (AER) bus, supported by specialized boards, resources for algorithms implementation are not limited.Ministerio de Economía y Competitividad TEC2012-37868-C04-02Junta de Andalucía P12-TIC-130

Sustainable Urban Race, una propuesta para el fomento de vocaciones científico-técnicas

Comunicación presentada a las XXXIX Jornadas de Automática, celebradas en Badajoz del 5 al 7 de Septiembre de 2018 y organizada por la Universidad de ExtremaduraEl objetivo fundamental del proyecto Competición de vehículos solares para el fomento de las vocaciones científico-técnicas mediante el aprendizaje basado en proyectos - SUR18 es aumentar el interés por la ciencia y la tecnología entre los estudiantes de ESO, Formación Profesional y Bachillerato. Para la consecución de este objetivo se ha planteado la participación de institutos y centros de formación en el diseño y construcción de un vehículo eléctrico eficiente para el transporte de al menos una persona en ambiente urbano, empleando la metodología de aprendizaje basado en proyectos. Además se han incluido una serie de retos o desafíos tecnológicos que los equipos debían superar. Los resultados se han presentado en una competición abierta al público, que ha tenido lugar en Huelva el día 1 de junio de 2018.The fundamental objective of the project Solar Vehicle Competition for the promotion of scientific-technical vocations through project-based learning - SUR18 is to increase interest in science and technology among pre-university students. To achieve this objective, the participation of pre-university centers in the design and construction of an efficient electric vehicle for the transport of at least one person in an urban environment has been proposed, using the project-based learning methodology. In addition, a series of technological challenges that the teams had to overcome have been included. The results have been presented in a competition open to the public, which took place in Huelva on June 1, 2018.Fundación Española para la Ciencia y la Tecnología (FECYT) del Ministerio de Economía, Industria y Competitividad. Proyecto “Competición de vehículos solares para el fomento de las vocaciones científico- técnicas mediante el aprendizaje basado en proyectos”- SUR1

Circulating carotenoids are associated with favorable lipid and fatty acid profiles in an older population at high cardiovascular risk

Carotenoid intake has been reported to be associated with improved cardiovascular health, but there is little information on actual plasma concentrations of these compounds as biomarkers of cardiometabolic risk. The objective was to investigate the association between circulating plasma carotenoids and different cardiometabolic risk factors and the plasma fatty acid profile. This is a cross-sectional evaluation of baseline data conducted in a subcohort (106 women and 124 men) of an ongoing multi-factorial lifestyle trial for primary cardiovascular prevention. Plasma concentrations of carotenoids were quantified by liquid chromatography coupled to mass spectrometry. The associations between carotenoid concentrations and cardiometabolic risk factors were assessed using regression models adapted for interval-censored variables. Carotenoid concentrations were cross-sectionally inversely associated with serum triglyceride concentrations [-2.79 mg/dl (95% CI: -4.25, -1.34) and -5.15 mg/dl (95% CI: -7.38, -2.93), p-values = 0.0002 and <0.00001 in women and men, respectively], lower levels of plasma saturated fatty acids [-0.09% (95% CI: -0.14, -0.03) and -0.15 % (95% CI: -0.23, -0.08), p-values = 0.001 and 0.0001 in women and men, respectively], and higher levels of plasma polyunsaturated fatty acids [(0.12 % (95% CI: -0.01, 0.25) and 0.39 % (95% CI: 0.19, 0.59), p-values = 0.065 and 0.0001 in women and men, respectively] in the whole population. Plasma carotenoid concentrations were also associated with higher plasma HDL-cholesterol in women [0.47 mg/dl (95% CI: 0.23, 0.72), p-value: 0.0002], and lower fasting plasma glucose in men [-1.35 mg/dl (95% CI: -2.12, -0.59), p-value: 0.001]. Keywords: Mediterranean diet; PREDIMED-plus study; cardiovascular health; liquid chromatography; mass spectrometry; plasma carotenoids

Exploring APOE genotype effects on Alzheimer's disease risk and amyloid β burden in individuals with subjective cognitive decline: The FundacioACE Healthy Brain Initiative (FACEHBI) study baseline results

Introduction: Subjective cognitive decline (SCD) has been proposed as a potential preclinical stage of Alzheimer's disease (AD). Nevertheless, the genetic and biomarker profiles of SCD individuals remain mostly unexplored. Methods: We evaluated apolipoprotein E (APOE) ε4's effect in the risk of presenting SCD, using the Fundacio ACE Healthy Brain Initiative (FACEHBI) SCD cohort and Spanish controls, and performed a meta-analysis addressing the same question. We assessed the relationship between APOE dosage and brain amyloid burden in the FACEHBI SCD and Alzheimer's Disease Neuroimaging Initiative cohorts. Results: Analysis of the FACEHBI cohort and the meta-analysis demonstrated SCD individuals presented higher allelic frequencies of APOE ε4 with respect to controls. APOE dosage explained 9% (FACEHBI cohort) and 11% (FACEHBI and Alzheimer's Disease Neuroimaging Initiative cohorts) of the variance of cerebral amyloid levels. Discussion: The FACEHBI sample presents APOE ε4 enrichment, suggesting that a pool of AD patients is nested in our sample. Cerebral amyloid levels are partially explained by the APOE allele dosage, suggesting that other genetic or epigenetic factors are involved in this AD endophenotype

Dietary diversity and depression: cross-sectional and longitudinal analyses in Spanish adult population with metabolic syndrome. Findings from PREDIMED-Plus trial

Objective: To examine the cross-sectional and longitudinal (2-year follow-up) associations between dietary diversity (DD) and depressive symptoms. Design: An energy-adjusted dietary diversity score (DDS) was assessed using a validated FFQ and was categorised into quartiles (Q). The variety in each food group was classified into four categories of diversity (C). Depressive symptoms were assessed with Beck Depression Inventory-II (Beck II) questionnaire and depression cases defined as physician-diagnosed or Beck II >= 18. Linear and logistic regression models were used. Setting: Spanish older adults with metabolic syndrome (MetS). Participants: A total of 6625 adults aged 55–75 years from the PREDIMED-Plus study with overweight or obesity and MetS. Results: Total DDS was inversely and statistically significantly associated with depression in the cross-sectional analysis conducted; OR Q4 v. Q1 = 0·76 (95 % CI (0·64, 0·90)). This was driven by high diversity compared to low diversity (C3 v. C1) of vegetables (OR = 0·75, 95 % CI (0·57, 0·93)), cereals (OR = 0·72 (95 % CI (0·56, 0·94)) and proteins (OR = 0·27, 95 % CI (0·11, 0·62)). In the longitudinal analysis, there was no significant association between the baseline DDS and changes in depressive symptoms after 2 years of follow-up, except for DD in vegetables C4 v. C1 = (β = 0·70, 95 % CI (0·05, 1·35)). Conclusions: According to our results, DD is inversely associated with depressive symptoms, but eating more diverse does not seem to reduce the risk of future depression. Additional longitudinal studies (with longer follow-up) are needed to confirm these findings.T The PREDIMED-Plus trial was supported by the European Research Council (Advanced Research Grant 2013-2018; 340918) grant to Miguel Angel Martinez-Gonzalez, and by the official funding agency for biomedical research of the Spanish Government, ISCIII through the Fondo de Investigacion para la Salud (FIS), which is cofunded by the European Regional Development Fund (four coordinated FIS projects led by Jordi Salas-Salvado and Josep Vidal), including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, The Especial Action Project entitled: 'Implementacion y Evaluacion de una intervencion intensiva sobre la actividad fisica Cohorte PREDIMED-Plus' grant to Jordi Salas-Salvado, the Recercaixa grant to Jordi Salas-Salvado (2013ACUP00194), grants from the Consejeria de Salud de la Junta de Andalucia (PI0458/2013; PS0358/2016; PI0137/2018), the PROMETEO/2017/017 grant from the Generalitat Valenciana, the SEMERGEN grant, and CIBEROBN and FEDER funds (CB06/03), ISCIII. International Nut&Dried Fruit Council-FESNAD N degrees 201302: Miguel Angel Martinez-Gonzalez (PI). None of the funding sources took part in the design, collection, analysis or interpretation of the data, or in the decision to submit the manuscript for publication. The corresponding author had full access to all the data in the study and had final responsibility to submit for publication

Contribution of cardio-vascular risk factors to depressive status in the PREDIMED-PLUS Trial. A cross-sectional and a 2-year longitudinal study

Background Cardio-vascular disease and depression are thought to be closely related, due to shared risk factors. The aim of the study was to determine the association between cardio-vascular risk (CVR) factors and depressive status in a population (55-75 years) with metabolic syndrome (MetS) from the PREDIMED-Plus trial. Methods and findings Participants were classified into three groups of CVR according to the Framingham-based REGICOR function: (1) low (LR), (2) medium (MR) or (3) high/very high (HR). The Beck Depression Inventory-II (BDI-II) was used to assess depressive symptoms at baseline and after 2 years. The association between CVR and depressive status at baseline (n = 6545), and their changes after 2 years (n = 4566) were evaluated through multivariable regression models (logistic and linear models). HR women showed higher odds of depressive status than LR [OR (95% CI) = 1.78 (1.26, 2.50)]. MR and HR participants with total cholesterol <160 mg/mL showed higher odds of depression than LR [OR (95% CI) = 1.77 (1.13, 2.77) and 2.83 (1.25, 6.42) respectively)] but those with total cholesterol ¿280 mg/mL showed lower odds of depression than LR [OR (95% CI) = 0.26 (0.07, 0.98) and 0.23 (0.05, 0.95), respectively]. All participants decreased their BDI-II score after 2 years, being the decrease smaller in MR and HR diabetic compared to LR [adjusted mean±SE = -0.52±0.20, -0.41 ±0.27 and -1.25±0.31 respectively). MR and HR participants with total cholesterol between 240-279 mg/mL showed greater decreases in the BDI-II score compared to LR (adjusted mean±SE = -0.83±0.37, -0.77±0.64 and 0.97±0.52 respectively). Conclusions Improving cardiovascular health could prevent the onset of depression in the elderly. Diabetes and total cholesterol in individuals at high CVR, may play a specific role in the precise response.The PREDIMED-Plus trial was supported by the European Research Council through a grant to MAM (Advanced Research Grant 2013-2018; 340918). The project was also supported by the official funding agency for biomedical research of the Spanish Government (ISCIII) through the Fondo de Investigación para la Salud (FIS), which is co-funded by the European Regional Development Fund (four coordinated FIS projects), who awarded grants to JS and JV (PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732 and PI17/00926). The International Nut&Dried Fruit Council-FESNAD also provided funding through a grant to MAM (201302), and Recercaixa also awarded a grant to JS (2013ACUP00194). The Department of Health, Generalitat de Cataluña by the calls 'Acció instrumental de programes de recerca orientats en lámbit de la recercaila innovació en salut' and 'Pla estrategic de recerca i innovació en salut (PERIS),' also awarded a grant to FF (SLT006/17/00246). This research was also partially funded by: Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, PI0137/2018); Generalitat Valenciana (PROMETEO/2017/017); SEMERGEN, CIBEROBN, FEDER and ISCIII (CB06/03); EU-H2020 Grants (Eat2beNICE/h2020-sfs-2016-2, ref.728018; PRIME/h2020-SC1-BHC-2018-2020, ref: 847879)