Repair of Mitral Prolapse: Comparison of Thoracoscopic Minimally-invasive and Conventional Approaches

Objectives: Surgical repair remains the best treatment for severe primary mitral regurgitation (MR). Minimally invasive mitral valve surgery is being increasingly performed, but there is a lack of solid evidence comparing thoracoscopic with conventional surgery. Our objective was to compare outcomes of both approaches for repair of leaflet prolapse. Methods: All consecutive patients undergoing surgery for severe MR due to mitral prolapse from 2012 to 2020 were evaluated according to the approach used. Freedom from mortality, reoperation and recurrent severe MR were evaluated by Kaplan-Meier method. Differences in baseline characteristics were adjusted with propensity score-matched analysis (1:1, nearest neighbour). Results: Three hundred patients met inclusion criteria and were divided into thoracoscopic (N = 188) and conventional (sternotomy; N = 112) groups. Unmatched patients in the thoracoscopic group were younger and had lower body mass index, New York Heart Association class and EuroSCORE II preoperatively. After matching, thoracoscopic group presented significantly shorter mechanical ventilation (9 vs 15 h), shorter intensive care unit stay (41 vs 65 h) and higher postoperative haemoglobin levels (11 vs 10.2 mg/dl) despite longer bypass and cross-clamp times (+30 and +17 min). There were no differences in mortality or MR grade at discharge between groups nor differences in survival, repair failures and reinterventions during follow-up. Conclusions: Minimally invasive mitral repair can be performed in the majority of patients with mitral prolapse, without compromising outcomes, repair rate or durability, while providing shorter mechanical ventilation and intensive care unit stay and less blood loss

COVID-19 Associated Pulmonary Aspergillosis (CAPA): Hospital or Home Environment as a Source of Life-Threatening Aspergillus fumigatus Infection?

Most cases of invasive aspergillosis are caused by Aspergillus fumigatus, whose conidia are ubiquitous in the environment. Additionally, in indoor environments, such as houses or hospitals, conidia are frequently detected too. Hospital-acquired aspergillosis is usually associated with airborne fungal contamination of the hospital air, especially after building construction events. A. fumigatus strain typing can fulfill many needs both in clinical settings and otherwise. The high incidence of aspergillosis in COVID patients from our hospital, made us wonder if they were hospital-acquired aspergillosis. The purpose of this study was to evaluate whether the hospital environment was the source of aspergillosis infection in CAPA patients, admitted to the Hospital Universitario Central de Asturias, during the first and second wave of the COVID-19 pandemic, or whether it was community-acquired aspergillosis before admission. During 2020, sixty-nine A. fumigatus strains were collected for this study: 59 were clinical isolates from 28 COVID-19 patients, and 10 strains were environmentally isolated from seven hospital rooms and intensive care units. A diagnosis of pulmonary aspergillosis was based on the ECCM/ISHAM criteria. Strains were genotyped by PCR amplification and sequencing of a panel of four hypervariable tandem repeats within exons of surface protein coding genes (TRESPERG). A total of seven genotypes among the 10 environmental strains and 28 genotypes among the 59 clinical strains were identified. Genotyping revealed that only one environmental A. fumigatus from UCI 5 (box 54) isolated in October (30 October 2020) and one A. fumigatus isolated from a COVID-19 patient admitted in Pneumology (Room 532-B) in November (24 November 2020) had the same genotype, but there was a significant difference in time and location. There was also no relationship in time and location between similar A. fumigatus genotypes of patients. The global A. fumigatus, environmental and clinical isolates, showed a wide diversity of genotypes. To our knowledge, this is the first study monitoring and genotyping A. fumigatus isolates obtained from hospital air and COVID-19 patients, admitted with aspergillosis, during one year. Our work shows that patients do not acquire A. fumigatus in the hospital. This proves that COVID-associated aspergillosis in our hospital is not a nosocomial infection, but supports the hypothesis of "community aspergillosis" acquisition outside the hospital, having the home environment (pandemic period at home) as the main suspected focus of infection.S

Proyectos de emprendimiento para la empleabilidad de titulados en periodismo

Objetivo principal: poner a disposición de los alumnos de segundo ciclo del Grado de Periodismo un espacio de coworking en condiciones adecuadas así como docentes que les tutelen para que puedan afrontar sus ideas y proyectarlas hacia el mercado de la Comunicación, en el que puedan desarrollar sus proyectos periodísticos y lograr la creación de una micro-pyme informativa y/o de comunicación. Objetivos específicos: a) Diseñar un marco integral de conocimientos a partir de las competencias periodísticas aprendidos en la titulación de periodismo: la empresa informativa, la estructura, la tecnología, la dirección y gestión periodística y de medios, para acercar a los estudiantes al mundo empresarial. b) Facilitar la salida al mercado laboral, empresarial y en Comunicación a cuantas ideas de negocio se valoren como posibles y se puedan gestionar desde estos espacios de trabajo colaborativo, mediante la tutorización y la mentoría. En cuanto a la metodología aplicada, se trata de evaluar y proyectar ideas creativas previas a su lanzamiento al mercado, a partir de una personalidad jurídica concreta y presumible (viabilidad societaria), durante el cuatrimestre de trabajo (fase de recuperación de datos) a partir de dos grupos (muestra total de unos 132 alumnos) divididos en 18 equipos (17 presenciales y uno virtual) organizados a partir de un proyecto de innovación docente. Se les explica el contenido del proyecto y las razones de llevarlo a cabo, tras lo cual sólo 16 alumnos han decidido no participar, por lo que el total de alumnos participantes ha sido de 116. Los espacios de desarrollo metodológico se sitúan en el marco de las clases de 4º curso del Grado de Periodismo, asignatura de “Dirección y Gestión de Empresas Periodísticas”, grupos A y C, durante el 2ª Cuatrimestre del curso 2017-2018 (enero-mayo) y termina con una presentación de cada proyecto a la finalización del periodo lectivo. Destacar como resultados más notables que de los 18 equipos que todos son proyectos nativos digitales y que internet es la red por excelencia que les acoge y les permite distribuir sus productos a partir de contenidos periodísticos de información, bien generalista o de diferentes temáticas que a su vez se van especializando. Seis de estos proyectos se basan en la información general y otros cuatro establecen la información cultural como el valor fundamental sobre el que descansa su idea emprendedora. Ocho proyectos se distinguen por ser considerados temáticos con especializaciones muy diversas: el fútbol sala y la hípica (en el marco deportivo); la arquitectura; la información universitaria; videojuegos y tecnología; los productos lácteos (alimentación); sobre la tercera edad, y sobre el negocio de las “bodas… y divorcios”. Se observa una clara tendencia para su oportunidad de negocio y encuentran razones de mercado para un lanzamiento a corto – medio plazo. Uno de estos proyectos está residente en Tetuán Valley

El sector de automoción en Castilla y León: componentes e industria auxiliar

[ES] Este trabajo de investigación tiene por objeto principal determinar la relevancia del espacio en las nuevas formas de organización productiva que se han ido implantado en la industria de automoción de Castilla y León a partir de la adhesión española a las Comunidades Europeas, con ánimo de exhaustividad. Exploraremos la capacidad del territorio castellano y leonés para explicar la localización de las actividades productivas existentes; para reforzar la localización de las empresas que conforman el tejido del sector; para atraer nuevas implantaciones empresariales; para evitar la deslocalización de plantas productivas

Modelado de las pérdidas de propagación en un escenario de oficinas en bandas de milimétricas

[EN] In this conference contribution, we present millimeter-wave (mmWave) propagation measurements for an office environment from 25 to 40 GHz and investigate the path loss using the most common empirical models proposed in WINNER-II and adopted by the 3GPP: the single-frequency floating-intercept (FI) model, the single-frequency close-in (CI) free space reference distance model, the multi-frequency alphabeta-gamma (ABG) model and the close-in free space reference distance with frequency path loss exponent (CIF). Both line-ofsight (LOS) and obstructed-LOS (OLOS) propagation conditions have been considered. The mean value of the model parameters, and their 95 % confidence intervals, have been derived using regression and optimization techniques.Este trabajo ha sido financiado en parte por el Ministerio de Economia, Industria y Competitividad a traves de los proyectos TEC2016-78028-C3-2-P, TEC2017-86779-C2-1-R y TEC2017-86779-C2-2-R, a traves de la Agencia Estatal de Investigacion (AEI) y el Fondo Europeo de Desarrollo Regional (FEDER) y por COLCIENCIAS en Colombia.Rubio Arjona, L.; Bernardo-Clemente, B.; Rodrigo Peñarrocha, VM.; Reig, J.; Molina-García-Pardo, JM.; Pérez, JR.; Torres, RP.... (2020). Modelado de las pérdidas de propagación en un escenario de oficinas en bandas de milimétricas. Universidad de Málaga. 1-4. http://hdl.handle.net/10251/178596S1

The effect of cross-linking on the molecular dynamics of the segmental and β Johari–Goldstein processes in polyvinylpyrrolidone-based copolymers

The effect of the cross-link density on the molecular dynamics of copolymers composed of vinylpyrrolidone (VP) and butyl acrylate (BA) was studied using differential scanning calorimetry (DSC) and dielectric relaxation spectroscopy (DRS). A single glass transition was detected by DSC measurements. The dielectric spectra exhibit conductive processes and three dipolar relaxations labeled as a, b and g in the decreasing order of temperatures. The cross-linker content affects both a and b processes, but the fastest g process is relatively unaffected. An increase of cross-linking produces a typical effect on the a process dynamics: (i) the glass transition temperature is increased, (ii) the dispersion is broadened, (iii) its strength is decreased and (iv) the relaxation times are increased. However, the b process, which possesses typical features of a pure Johari Goldstein relaxation, unexpectedly loses the intermolecular character for the highest cross-linker content.B.R.F., M.J.S., P.O.S. and M.C. gratefully acknowledge CICYT for grant MAT2012-33483. F.G. and J.M.G. acknowledge the Spanish Ministerio de Economia y Competitividad-FEDER (MAT2014-54137-R) and the Junta de Castilla y Leon (BU232U13).Redondo Foj, MB.; Sanchis Sánchez, MJ.; Ortiz Serna, MP.; Carsí Rosique, M.; García, JM.; García, FC. (2015). The effect of cross-linking on the molecular dynamics of the segmental and β Johari–Goldstein processes in polyvinylpyrrolidone-based copolymers. Soft Matter. 11:7171-7180. https://doi.org/10.1039/c5sm00714cS7171718011V. Bühler , Polyvinylpyrrolidone Excipients for Pharmaceuticals: Povidone, Crospovidone and Copovidone , Springer , Berlin , 2005Haaf, F., Sanner, A., & Straub, F. (1985). Polymers of N-Vinylpyrrolidone: Synthesis, Characterization and Uses. 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Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio