Treatment strategy optimization for patients with non-small-cell lung cancer harboring EGFR mutation: a Delphi consensus

AIM: To stablish a consensus on the treatment strategy for advanced non-small-cell lung cancer (aNSCLC) with epidermal growth factor receptor mutation (EGFRm) in Spain. METHODS: After a systematic literature review, the scientific committee developed 33 statements in 4 fields: molecular diagnosis (10 items); histologic profile and patient clinical characteristics (7 items); first-line (1L) treatment in EGFRm aNSCLC (8 items); and subsequent-line treatment (8 items). A panel of 31 experts completed 2 Delphi online questionnaires rating their degree of agreement/disagreement for each statement through a 1-9 range scale (1-3 = disagree, 7-9 = agree). Consensus was reached if 2/3 of the participants are in the median range. RESULTS: In the first Delphi round consensus was achieved for 24/33 of the statements. One of the assertions was deleted, proceeding to a second round with the eight remaining questions with no consensus or in the range of indeterminacy. Determination of the EGFR status from tissue and analysis of the different biomarkers are two important variables that influenced treatment decision in patients with aNSCLC. 1L treatment should be the best therapeutic option, independently of the subsequent lines of treatment. For patients with the most common activating mutations osimertinib was considered the most efficient and safe 1L option. In case of disease progression, a new biopsy was needed. CONCLUSIONS: A consensus document is proposed to optimize the treatment strategy for untreated patients with a NSCLC with EGFR sensitizing mutations

New energy sources: Blue energy study in Central America

The following article has been submitted to/accepted by Journal of Renewable and Sustainable Energy. After it is published, it will be found at http://dx.doi.org/10.1063/1.4976326.Blue energy or salinity difference energy takes advantage of the free energy released in the mixture of two solutions with different salinity concentrations as it happens continuously in river mouths. Among the large number of available techniques that aim to harness blue energy, capmix (or capacitive mixing) methods allow to directly extract electrical energy without the need of any electromechanical converter such as turbines or heat engines. The main goal of this article is to analyze the potential of blue energy by capmix methods in Central America. So far, blue energy studies have been principally carried out in countries from the global North. Therefore, we describe experimental results with real sea and river waters from the Gulf of Fonseca, an area of special interest due to its hydrographic richness, which is situated among Honduras, El Salvador and Nicaragua. An electrochemical cell, which consists of a pair of activated carbon electrodes coated with cationic and anionic polyelectrolyte layers respectively, is used in the experiments. The cell voltage in open circuit (OCV) is used as a measure of the performance of the capmix process. It is found that the OCV is larger when natural river water is used instead of low salinity NaCl solutions. The rainy season in which the experiments were performed reduced the ionic content of the river, increasing the salinity difference with ocean waters. The feasibility of capmix as a means of clean energy production is discussed.Eureka SD Project (agreement number 2013-2591), Erasmus Mundus programme of the European Union.Ministerio de Economía y Competitividad of Spain (Project FIS2013-47666-C3- 1-R)Junta de Andalucía (Spain) project PE-2012- FQM0694EU FEDER FUND

Resultados en la prescripción electrónica de nutriciones parenterales tras la implantación de un programa informático. Análisis de costes y prescripción

Introduction. Increasingly hospitals that incorporate in its software technology computer capable ofdeveloping a nutrition effective, safe and adjusted to the needs of patients in order to minimize errors.However, these programs do not always have an intuitive, sometimes, may lead to difficulties makingthem to be underused and as a result, the number of prescriptions will be decreased.Objective. To evaluate the reduction in prescription of parenteral nutritions and the economic impactthat has been in our centre, the introduction of computer software for electronic prescription for parenteralnutritions.Material and method. A computer software of Fresenius-Kabi Spain (v. 1.8/2011) as the database, wasused to classify the NP prescribed during the past 24 months, taking into account the implementationof the computer tool. This procedure was used to determine the reduction in prescription of nutritions.Results. During the year 2013 were prescribed a total of 3.530 parenteral nutritions, while in the sameperiod in 2014, prescribed nutritions were 2.622. This difference of 908 prescriptions meant a savings of22.230,03 €.Introducción. Cada vez son más los hospitales que incorporan en su tecnología software informáticoscapaces de elaborar una nutrición eficaz, segura y ajustada a las necesidades de los pacientes con el fin deminimizar errores. Sin embargo, estos programas no siempre disponen de un manejo intuitivo, lo que enocasiones, pueden comportar diversas dificultades que los haga estar infrautilizados y en consecuencia,el número de prescripciones puede verse disminuido.Objetivo: Evaluar la reducción en la prescripción de nutriciones parenterales y el impacto económicoque ha supuesto en nuestro centro, tras la implantación de un software informático de prescripción electrónicapara nutriciones parenterales.Material y métodos. Se utilizó un software informático de Fresenius-Kabi España (v. 1.8/2011) comobase de datos, para clasificar las NP prescritas durante los últimos 24 meses, teniendo en cuenta la implantaciónde la herramienta informática. Este procedimiento se usó para determinar la disminución enla prescripción de nutriciones.Resultados. Durante el año 2013 se prescribieron un total de 3.530 nutriciones parenterales, mientras queen el mismo periodo de 2014, las nutriciones prescritas fueron 2.622. Esta diferencia de 908 prescripciones,supuso un ahorro económico de 22.230,03 €

Stability analysis for the background equations for inflation with dissipation and in a viscous radiation bath

The effects of bulk viscosity are examined for inflationary dynamics in which dissipation and thermalization are present. A complete stability analysis is done for the background inflaton evolution equations, which includes both inflaton dissipation and radiation bulk viscous effects. Three representative approaches of bulk viscous irreversible thermodynamics are analyzed: the Eckart noncausal theory, the linear and causal theory of Israel-Stewart and a more recent nonlinear and causal bulk viscous theory. It is found that the causal theories allow for larger bulk viscosities before encountering an instability in comparison to the noncausal Eckart theory. It is also shown that the causal theories tend to suppress the radiation production due to bulk viscous pressure, because of the presence of relaxation effects implicit in these theories. Bulk viscosity coefficients derived from quantum field theory are applied to warm inflation model building and an analysis is made of the effects to the duration of inflation. The treatment of bulk pressure would also be relevant to the reheating phase after inflation in cold inflation dynamics and during the radiation dominated regime, although very little work in both areas has been done, the methodology developed in this paper could be extended to apply to these other problems.Comment: 27 pages, 14 figures, Published version JCA

Results in the parenteral nutritions electronic prescription following implementation of a computer program. Cost analysis and prescription

Introducción. Cada vez son más los hospitales que incorporan en su tecnología software informáticos capaces de elaborar una nutrición eficaz, segura y ajustada a las necesidades de los pacientes con el fin de minimizar errores. Sin embargo, estos programas no siempre disponen de un manejo intuitivo, lo que en ocasiones, pueden comportar diversas dificultades que los haga estar infrautilizados y en consecuencia, el número de prescripciones puede verse disminuido. Objetivo: Evaluar la reducción en la prescripción de nutriciones parenterales y el impacto económico que ha supuesto en nuestro centro, tras la implantación de un software informático de prescripción electrónica para nutriciones parenterales. Material y métodos. Se utilizó un software informático de Fresenius-Kabi España (v. 1.8/2011) como base de datos, para clasificar las NP prescritas durante los últimos 24 meses, teniendo en cuenta la implantación de la herramienta informática. Este procedimiento se usó para determinar la disminución en la prescripción de nutriciones. Resultados. Durante el año 2013 se prescribieron un total de 3.530 nutriciones parenterales, mientras que en el mismo periodo de 2014, las nutriciones prescritas fueron 2.622. Esta diferencia de 908 prescripciones, supuso un ahorro económico de 22.230,03 €.Introduction. Increasingly hospitals that incorporate in its software technology computer capable of developing a nutrition effective, safe and adjusted to the needs of patients in order to minimize errors. However, these programs do not always have an intuitive, sometimes, may lead to difficulties making them to be underused and as a result, the number of prescriptions will be decreased. Objective. To evaluate the reduction in prescription of parenteral nutritions and the economic impact that has been in our centre, the introduction of computer software for electronic prescription for parenteral nutritions. Material and method. A computer software of Fresenius-Kabi Spain (v. 1.8/2011) as the database, was used to classify the NP prescribed during the past 24 months, taking into account the implementation of the computer tool. This procedure was used to determine the reduction in prescription of nutritions. Results. During the year 2013 were prescribed a total of 3.530 parenteral nutritions, while in the same period in 2014, prescribed nutritions were 2.622. This difference of 908 prescriptions meant a savings of 22.230,03 €

Plan de negocios para determinar la viabilidad del desarrollo de un asistente virtual de ventas (Chatbot) : caso Gamarra

El presente plan de negocios nace de identificar una carencia importante en el emporio comercial de Gamarra: la falta de implementaci?n de herramientas tecnol?gicas que favorezcan sus procesos de venta. As?, la introducci?n de un Asistente Virtual (Chatbot) se presenta como una oportunidad para los empresarios textiles de Gamarra. El an?lisis contextual arroj? que existen circunstancias favorables, a nivel de mercado, para el desarrollo y venta del Asistente Virtual. Sin embargo, tambi?n se destac? que la falta de conocimiento y las barreras de adopci?n tecnol?gica por parte de los empresarios de Gamarra es una barrera importante para el proyecto. Estos datos se consolidaron con los resultados de la investigaci?n de mercado. Empero, los resultados del estudio se?alaron que el empresario textil de Gamarra s? estar?a dispuesto a adquirir el Asistente Virtual, pues lo identifica como ?til para expandir las ventas de su negocio. Para lograr dicho objetivo se desarrollaron planes estrat?gicos, que conclu?an la necesidad de entrar en un mercado no penetrado, creando intimidad con el cliente, educ?ndolo en las bondades de la implantaci?n de tecnolog?a en sus empresas con un producto innovador. Finalmente, las proyecciones financieras se mostraron positivas, generando un VAN de S/259,937 y un TIR de 28%

POSICIONAMIENTO WEB EN ATRACTIVOS TURÍSTICOS DEL CANTÓN SUCRE, ECUADOR

La presente investigación realizó un análisis de posicionamiento web a partir del entorno de los canales publicitarios digitales, además la evaluación de la presencia online de los atractivos que posee el cantón Sucre, para determinar la calidad o grado de optimización de los medios publicitarios empleados para su promoción y la implementación de acciones que permitan la difusión de la oferta turística a través de motores de búsqueda mediante la utilización de estrategias Optimización para Motores de Búsqueda (SEO) y Marketing en Buscadores (SEM) que mejoren la visibilidad de sitios web orientados a la promoción turística; la mejora de visibilidad en medios sociales populares como Facebook, YouTube, Twitter e Instagram mediante la utilización de técnicas de Marketing en Medios Sociales (SMM) y Optimización en Medios Sociales (SMO). El uso de marketing móvil a través de aplicaciones destinadas a brindar información turística de los atractivos, la captación de emails para el desarrollo de marketing por correo electrónico y la ejecución de campañas de publicidad pagada en internet, destacando además las grandes ventajas competitivas y oportunidades de crecimiento sostenido que brinda la utilización de los medios digitales en relación con los medios publicitarios tradicionales en costos, alcance, usabilidad y medición de resultados.PALABRAS CLAVE: Posicionamiento web; atractivos; medios publicitarios; marketing digital; motores de búsquedas.WEB POSITIONING IN CANTON SUCRE TOURIST ATTRACTIONS, ECUADORABSTRACTThe present research carried out a web positioning analysis based on the environment of the digital advertising channels, besides the evaluation of the online presence of the attractions that has the canton Sucre, to determine the quality or degree of optimization of the publicity means employed for its Promotion and implementation of actions that allow the dissemination of tourism through search engines through the use of search engine optimization (SEO) and Search Engine Marketing (SEM) strategies that improve the visibility of web sites oriented to the Tourist promotion; Improving visibility on popular social media such as Facebook, YouTube, Twitter and Instagram through the use of Social Media Marketing (SMM) and Social Media Optimization (SMO) techniques. The use of mobile marketing through applications designed to provide tourist information about attractiveness, the capture of emails for the development of email marketing and the execution of paid advertising campaigns on the Internet, also highlighting the great competitive advantages and opportunities of Sustained growth in the use of digital media in relation to traditional advertising media in terms of costs, scope, usability and results measurement.KEYWORDS: Web positioning; Attractive; Advertising media; digital marketing; Search engines

Diseño de estrategias conjuntas UA-centros de secundaria para el fomento del conocimiento de disciplinas científico-técnicas

Continuando con la línea emprendida por el Instituto Universitario de Ingeniería de Procesos Químicos, para desarrollar actividades de fomento del conocimiento de disciplinas de ciencia y tecnología, se ha convocado el “VI Certamen de Proyectos Educativos de Ingeniería Química” durante el curso 2013-2014. Con dicha actividad se pretende promover el interés por estudios relacionados con las disciplinas científico-técnicas, entre los alumnos de ESO, con una mejor conceptualización, comprensión y caracterización de los temas. Para ello, se diseñan, planifican y desarrollan acciones entre profesorado de la UA y centros de secundaria, sobre el papel de la Química en la industria para mejorar la calidad de vida. En la presente edición del certamen se han inscrito 13 centros, que han presentado un total de 20 proyectos, relacionados con los siguientes temas: la Ingeniería Química y el medio ambiente, la Ingeniería Química y la industria alimentaria, la Ingeniería Química y el mundo de los plásticos, la Ingeniería Química y la energía y la Ingeniería Química «Verde» sostenible

Drought Sensitiveness on Forest Growth in Peninsular Spain and the Balearic Islands

Drought is one of the key natural hazards impacting net primary production and tree growth in forest ecosystems. Nonetheless, tree species show different responses to drought events, which make it difficult to adopt fixed tools for monitoring drought impacts under contrasting environmental and climatic conditions. In this study, we assess the response of forest growth and a satellite proxy of the net primary production (NPP) to drought in peninsular Spain and the Balearic Islands, a region characterized by complex climatological, topographical, and environmental characteristics. Herein, we employed three different indicators based on in situ measurements and satellite image-derived vegetation information (i.e., tree-ring width, maximum annual greenness, and an indicator of NPP). We used seven different climate drought indices to assess drought impacts on the tree variables analyzed. The selected drought indices include four versions of the Palmer Drought Severity Index (PDSI, Palmer Hydrological Drought Index (PHDI), Z-index, and Palmer Modified Drought Index (PMDI)) and three multi-scalar indices (Standardized Precipitation Evapotranspiration Index (SPEI), Standardized Precipitation Index (SPI), and Standardized Precipitation Drought Index (SPDI)). Our results suggest that—irrespective of drought index and tree species—tree-ring width shows a stronger response to interannual variability of drought, compared to the greenness and the NPP. In comparison to other drought indices (e.g., PDSI), and our results demonstrate that multi-scalar drought indices (e.g., SPI, SPEI) are more advantageous in monitoring drought impacts on tree-ring growth, maximum greenness, and NPP. This finding suggests that multi-scalar indices are more appropriate for monitoring and modelling forest drought in peninsular Spain and the Balearic Islands

Leigh syndrome is the main clinical characteristic of PTCD3 deficiency

Mitochondrial translation defects are a continuously growing group of disorders showing a large variety of clinical symptoms including a wide range of neurological abnormalities. To date, mutations in PTCD3, encoding a component of the mitochondrial ribosome, have only been reported in a single individual with clinical evidence of Leigh syndrome. Here, we describe three additional PTCD3 individuals from two unrelated families, broadening the genetic and phenotypic spectrum of this disorder, and provide definitive evidence that PTCD3 deficiency is associated with Leigh syndrome. The patients presented in the first months of life with psychomotor delay, respiratory insufficiency and feeding difficulties. The neurologic phenotype included dystonia, optic atrophy, nystagmus and tonic-clonic seizures. Brain MRI showed optic nerve atrophy and thalamic changes, consistent with Leigh syndrome. WES and RNA-seq identified compound heterozygous variants in PTCD3 in both families: c.[1453-1G>C];[1918C>G] and c.[710del];[902C>T]. The functional consequences of the identified variants were determined by a comprehensive characterization of the mitochondrial function. PTCD3 protein levels were significantly reduced in patient fibroblasts and, consistent with a mitochondrial translation defect, a severe reduction in the steady state levels of complexes I and IV subunits was detected. Accordingly, the activity of these complexes was also low, and high-resolution respirometry showed a significant decrease in the mitochondrial respiratory capacity. Functional complementation studies demonstrated the pathogenic effect of the identified variants since the expression of wild-type PTCD3 in immortalized fibroblasts restored the steady-state levels of complexes I and IV subunits as well as the mitochondrial respiratory capacity. Additionally, minigene assays demonstrated that three of the identified variants were pathogenic by altering PTCD3 mRNA processing. The fourth variant was a frameshift leading to a truncated protein. In summary, we provide evidence of PTCD3 involvement in human disease confirming that PTCD3 deficiency is definitively associated with Leigh syndrome.© 2022 The Authors. Brain Pathology published by John Wiley & Sons Ltd on behalf of International Society of Neuropathology