Study protocol on social return on investment (SROI) project of the surgical waiting list management system

In Andalusia, the right to maximum waiting times for healthcare clashes with the available supply, leading to an increase in demand in the form of waiting lists. To address this situation, the activity of private centers has been created for certain diagnostic tests. The Social Return on Investment (SROI) model evaluates an intervention from an economic and stakeholder perspective. However, there are no studies on the suitability of waiting lists using SROI, which is why it is intended to be studied as a decision-making tool for the clinical and healthcare management of waiting lists. This research protocol is designed to determine the quality of life gained, with the EuroQol-5D-5L questionnaire, and its social assessment, with the specific survey of the SROI method, and, thus, analyze the social return on investment and determine the suitability of the intervention (diagnostic endoscopy activity arranged in a contracted center). After the study, we will know the economic (cost in public health centers and the incremental cost of extraordinary health resources), social (quality of life with health), and environmental scenarios of the concerted activity intervention in order to adjust waiting list timesPartial funding for open access charge: Universidad de Málag

Clinical impact of acute kidney injury on short- and long-term outcomes after transcatheter aortic valve implantation with the CoreValve prosthesis

AbstractBackgroundAcute kidney injury (AKI) after cardiac surgery is associated with increased mortality, but few data exist on the occurrence and clinical impact of AKI associated with transcatheter aortic valve implantation (TAVI). The objective of this study was to determine the incidence and prognosis of AKI after percutaneous implantation of the CoreValve® (Medtronic, Minneapolis, MN, USA) prosthesis.MethodsA total of 357 patients with severe aortic stenosis and 9 patients with pure native aortic regurgitation were treated with the CoreValve prosthesis. AKI was defined according to Valve Academic Research Consortium criteria as the absolute increase in serum creatinine ≥0.3mg/dl at 72h post percutaneous procedure.ResultsAKI was identified in 58 patients (15.8%), none of whom required renal replacement therapy. In patients with AKI, the mortality at 30 days was 13.5% compared with 1.6% of patients without AKI, [odds ratio (OR)=12.2 (95% CI 3.53–41.9); p<0.001] and total mortality after a mean of 26.2±17 months was 29.3% vs. 14.9% [OR=2.36 (95% CI 1.23–4.51), p=0.008]. In the multivariate analysis, AKI was an independent predictor of cumulative total mortality [hazard ratio=2.151, (95% CI from 1.169 to 3.957), p=0.014].ConclusionsThe deterioration of renal function in patients undergoing TAVI with the CoreValve prosthesis is a serious and frequent complication. The occurrence of AKI was associated with increased early mortality and was also a predictor of worse outcomes in follow-up

Regular generalized sampling in T-invariant subspaces of a Hilbert space

A regular generalized sampling theory in some structured T-invariant subspaces of a Hilbert space H, where T denotes a bounded invertible operator in H, is established in this paper. This is done by walking through the most important cases which generalize the usual sampling settings.Comment: 23 page

Neocortical tissue recovery in severe congenital obstructive hydrocephalus after intraventricular administration of bone marrow-derived mesenchymal stem cells

BACKGROUND: In obstructive congenital hydrocephalus, cerebrospinal fluid accumulation is associated with high intracranial pressure and the presence of periventricular edema, ischemia/hypoxia, damage of the white matter, and glial reactions in the neocortex. The viability and short time effects of a therapy based on bone marrow-derived mesenchymal stem cells (BM-MSC) have been evaluated in such pathological conditions in the hyh mouse model. METHODS: BM-MSC obtained from mice expressing fluorescent mRFP1 protein were injected into the lateral ventricle of hydrocephalic hyh mice at the moment they present a very severe form of the disease. The effect of transplantation in the neocortex was compared with hydrocephalic hyh mice injected with the vehicle and non-hydrocephalic littermates. Neural cell populations and the possibility of transdifferentiation were analyzed. The possibility of a tissue recovering was investigated using 1H High-Resolution Magic Angle Spinning Nuclear Magnetic Resonance (1H HR-MAS NMR) spectroscopy, thus allowing the detection of metabolites/osmolytes related with hydrocephalus severity and outcome in the neocortex. An in vitro assay to simulate the periventricular astrocyte reaction conditions was performed using BM-MSC under high TNFα level condition. The secretome in the culture medium was analyzed in this assay. RESULTS: Four days after transplantation, BM-MSC were found undifferentiated and scattered into the astrocyte reaction present in the damaged neocortex white matter. Tissue rejection to the integrated BM-MSC was not detected 4 days after transplantation. Hyh mice transplanted with BM-MSC showed a reduction in the apoptosis in the periventricular neocortex walls, suggesting a neuroprotector effect of the BM-MSC in these conditions. A decrease in the levels of metabolites/osmolytes in the neocortex, such as taurine and neuroexcytotoxic glutamate, also indicated a tissue recovering. Under high TNFα level condition in vitro, BM-MSC showed an upregulation of cytokine and protein secretion that may explain homing, immunomodulation, and vascular permeability, and therefore the tissue recovering. CONCLUSIONS: BM-MSC treatment in severe congenital hydrocephalus is viable and leads to the recovery of the severe neurodegenerative conditions in the neocortex. NMR spectroscopy allows to follow-up the effects of stem cell therapy in hydrocephalus.España Instituto Carlos III , PI15/00619 (to AJJ), PI19/00778 (to AJJ and PPG), PI15/00796, and PI18/01557España Ministerio de Educación, Cultura y Deporte FPU13/02906España, Ministerio de Economía y Competitividad RYC-2014-16980España, FEDER Andalucía y Universidad de Málaga UMA18-FEDERJA-27

Medidas multi-influencia como medio para caracterizar la firma global de un buque y proteger el entorno marino

The overall signature of a vessel comprises acoustic, magnetic, electric-field, pressure, and seismic radiations. Over the past years, the international community’s efforts have mainly centered on reducing the acoustic influence with the dual aim of decreasing the vessel’s detectability and reducing the levels of acoustic pollution generated in the marine environment. Nowadays, the need to act not only on the acoustic radiation but against the overall set of the vessel’s radiations is becoming increasingly clear, both in the military and the civilian fields, based on aspects like vessel stealthiness, security of harbor and critical infrastructures, and environmental protection. As a key element to achieve this goal, it is greatly important to have at our disposal highly modular and adaptable measurement systems covering the overall set of the vessel’s radiations, with a high capacity of data transmission to base centers to have the capacity to make measurements in all kinds of marine environments.La firma global de un buque está compuesta por radiaciones: acústica, magnética, de campo eléctrico, de presión y sísmica. A lo largo de los últimos años, los esfuerzos de la comunidad internacional se han centrado principalmente en reducir la influencia acústica, con el doble objetivo de disminuir la detectabilidad del buque y reducir el nivel de contaminación acústica generada en el entorno marino. En la actualidad, se está constatando con claridad la necesidad de actuar no sólo sobre la radiación acústica, sino sobre el conjunto global de las radiaciones del buque, tanto en el ámbito militar como en el ámbito civil, basado en aspectos como: la discreción de los buques, la seguridad en puertos e infraestructuras críticas y la protección ambiental. Como elemento clave para alcanzar esta meta, es de gran importancia tener a nuestra disposición sistemas de medida adaptables y altamente modulares que cubran el conjunto total de las radiaciones de los buques, con alta capacidad de transmisión de datos a centros base, con el objeto de tener la capacidad de realizar medidas en toda clase de entornos marinos

Fabrication and characterization of superficially modified porous dental implants

Stress-shielding and loosening compromise the success of dental implants under real-life service conditions. This work evaluates the mechanical behavior of superficially modified porous titanium dental implants fabricated by two different routes: conventional powder metallurgy and space-holder techniques. A novel, feasible and repetitive protocol of micro-milling of the implant thread (before sintering), as well as surface modification treatments (after sintering) are also implemented. The discussion is conducted in terms of the influence of porosity and surface roughness on the stiffness and yield strength of implants. The macro-pores concentrate stress locally, and, at the same time, they could act as a barrier to the propagation of micro-cracks. Higher rugosity was observed for virgin implants obtained with spacer particles. Concerning superficially modified implants, while bioglass 1393 was the most effective coating due to its greater infiltration and adhesion capacity, chemical etching could improve osteoblast adhesion because modifies the roughness of the implant surface.Ministry of Science and Innovation of Spain PID2019-109371GB-I00Junta de Andalucía–FEDER (Spain) US-125977

Sensitivity of combustion noise and NOx and soot emissions to pilot injection in PCCI Diesel engines

Diesel engines are the most commonly used internal combustion engines nowadays, especially in European transportation. This preference is due to their low consumption and acceptable driveability and comfort. However, the main disadvantages of traditional direct injection Diesel engines are their high levels of noise, nitrogen oxides (NO x) and soot emissions, and the usage of fossil fuels. In order to tackle the problem of high emission levels, new combustion concepts have been recently developed. A good example is the premixed charge compression ignition (PCCI) combustion, a strategy in which early injections are used, causing a burning process in which more fuel is burned in premixed conditions, which affects combustion noise. The use of a pilot injection has become an effective tool for reducing combustion noise. The main objective of this paper is to analyze experimentally the pollutant emissions, combustion noise, and performance of a Diesel engine operating under PCCI combustion with the use of a pilot injection. In addition, a novel methodology, based on the decomposition of the in-cylinder pressure signal, was used for combustion noise analysis. The results show that while the PCCI combustion has potential to reduce significantly the NO x and soot emission levels, compared to conventional Diesel combustion strategy, combustion noise continues to be a critical issue for the implementation of this new combustion concept in passenger cars.This work has been partially supported by Ministerio de Educacin y Ciencia through Grant No. TRA2006-13782. L.F. Monico holds the Grant 2009/003 from Santiago Grisolia Program of Generalitat Valenciana.Torregrosa, AJ.; Broatch Jacobi, JA.; García Martínez, A.; Mónico Muñoz, LF. (2013). Sensitivity of combustion noise and NOx and soot emissions to pilot injection in PCCI Diesel engines. Applied Energy. 104:149-157. https://doi.org/10.1016/j.apenergy.2012.11.040S14915710

Determining the impact of seasoning on the volatile chemical composition of the oak wood of different Sherry Casks® by DTD–GC–MS

The casks that have contained for a certain time Sherry wines are known as Sherry Casks® and their use and value have increased in recent years, as they confer unique organoleptic properties to the distillates and beverages that are aged inside them. During their seasoning, these casks yield certain compounds from wood into the wines, and at the same time, they retain some compounds from these Sherry wines which, in turn, are transferred to the distillates that are aged inside the casks, so that wood acts as a transfer vector between the two alcoholic beverages. A characterization of seasoned staves with three Sherry wines, Fino, Oloroso, and Pedro Ximénez, by DTD–GC–MS has been carried out in this study. Different tendencies regarding the compounds present in the wood have been observed as follows: in general, certain compounds from wood either disappeared or decreased during its seasoning, while other compounds that come from the seasoning wine either increased or appeared in the wood during the seasoning process. This fact demonstrates that during the ageing of Sherry wines these transfer certain interesting compounds into the casks wood, which are in turn transferred to the distillates