Unificación de comunicaciones entre el vehículo y la central empleando el protocolo IPv6

Las arquitecturas de comunicación presentes actualmente en el campo de la gestión de flotas, hacen uso de diversas conexiones para tratar con los diferentes tipos de comunicaciones que se establecen entre los vehículos y la central, ya sea para transmitir voz, datos o para enviar y recibir faxes. En un intento de solucionar esta situación, el proyecto DAMA estudia la mejor manera de centralizar todas estas comunicaciones en un dispositivo de bajo coste, que actúe como único punto de acceso entre el mundo exterior y el vehículo, utilizando en cada momento la mejor red de acceso disponible. La utilización del protocolo IPV6, y más concretamente el servicio de movilidad a nivel de red que éste proporciona (MIPv6), junto con las técnicas de movilidad a nivel de aplicación proporcionadas por el protocolo de señalización SIP, son los pilares básicos en los que se basa la solución propuesta por DAMA

Study on child welfare of adopted chinese children at schools in Castilla y León

[ES] nuevos desafíos sociales que deben ser abordados. Más allá de los procesos de aprendizaje propios de los centros escolares, se percibe a la escuela como el espacio idóneo para que niños, niñas y adolescentes desarrollen habilidades y comportamientos que les permitan vivir en sociedad y como un escenario de confluencia para culturas totalmente diferenciadas. En el caso de España, la llegada de los niños adoptados de origen chino contribuyó a aumentar la diversidad étnica de la población española en las aulas, y con ello los desafíos para la institución educativa. El objetivo principal de esta investigación estriba en conocer el bienestar social de los niños y niñas adoptados en la R.P. China que cursan la Educación Secundaria en Castilla y León, dado que se presenta como un grupo potencialmente expuesto a las tensiones que se generan en contextos educativos heterogéneos. Para alcanzar el objetivo se han realizado 10 entrevistas semiestructuradas. La estrategia analítica seguida se asienta en la teoría fundamentada. Los resultados muestran que es un grupo objeto de burla por sus rasgos fenotípicos asiáticos, pero no por su condición de adoptados. [EN] The increasing diversity in schools as a result of international adoption has created new social challenges that need to be addressed. Beyond the learning processes of schools, the school is perceived as the ideal space for children and adolescents to develop skills and behaviours that allow them to live in society and it is considered a meeting point of different cultures. In the case of Spain, adopted Chinese children contributed to ethnic diversity in the classrooms, and the schools had to face this challenge. The main objective of this study is to know the social well-being of children adopted in the Republic of China who attend Secondary Education in Castile and Leon since it presents itself as a group potentially exposed to the tensions that arise in heterogeneous groups in educational settings. Ten semi-structured interviews were conducted to meet the objective. The analytical strategy mfollowed is based on well-founded theory. The results show that it is a group mocked for its Asian phenotypic features, but not for its adopted status

Surgical treatment for colorectal cancer: Analysis of the influence of an enhanced recovery programme on long-term oncological outcomes-a study protocol for a prospective, multicentre, observational cohort study

Introduction The evidence currently available from enhanced recovery after surgery (ERAS) programmes concerns their benefits in the immediate postoperative period, but there is still very little evidence as to whether their correct implementation benefits patients in the long term. The working hypothesis here is that, due to the lower response to surgical aggression and lower rates of postoperative complications, ERAS protocols can reduce colorectal cancer-related mortality. The main objective of this study is to analyse the impact of an ERAS programme for colorectal cancer on 5-year survival. As secondary objectives, we propose to analyse the weight of each of the predefined items in the oncological results as well as the quality of life. Methods and analysis A multicentre prospective cohort study was conducted in patients older than 18 years of age who are scheduled to undergo surgery for colorectal cancer. The study involved 12 hospitals with an implemented enhanced recovery protocol according to the guidelines published by the Spanish National Health Service. The intervention group includes patients with a minimum implementation level of 70%, and the control group includes those who fail to reach this level. Compliance will be studied using 18 key performance indicators, and the results will be analysed using cancer survival indicators, including overall survival, cancer-specific survival and relapse-free survival. The time to recurrence, perioperative morbidity and mortality, hospital stay and quality of life will also be studied, the latter using the validated EuroQol Five questionnaire. The propensity index method will be used to create comparable treatment and control groups, and a multivariate regression will be used to study each variable. The Kaplan-Meier estimator will be used to estimate survival and the log-rank test to make comparisons. A p value of less than 0.05 (two-tailed) will be considered to be significant. Ethics and dissemination Ethical approval for this study was obtained from the Aragon Ethical Committee (C.P.-C.I. PI20/086) on 4 March 2020. The findings of this study will be submitted to peer-reviewed journals (BMJ Open, JAMA Surgery, Annals of Surgery, British Journal of Surgery). Abstracts will be submitted to relevant national and international meetings.The present research study was awarded a Ministerio de Ciencia e Innovación health research project grant (PI19/00291) from the Carlos III Institute of the Spanish National Health Service as part of the 2019 call for Strategic Action in Health

Endothelial dysfunction is an early indicator of sepsis and neutrophil degranulation of septic shock in surgical patients

Producción CientíficaBackground: Stratification of the severity of infection is currently based on the Sequential Organ Failure Assessment (SOFA) score, which is difficult to calculate outside the ICU. Biomarkers could help to stratify the severity of infection in surgical patients. Methods: Levels of ten biomarkers indicating endothelial dysfunction, 22 indicating emergency granulopoiesis, and six denoting neutrophil degranulation were compared in three groups of patients in the first 12 h after diagnosis at three Spanish hospitals. Results: There were 100 patients with infection, 95 with sepsis and 57 with septic shock. Seven biomarkers indicating endothelial dysfunction (mid-regional proadrenomedullin (MR-ProADM), syndecan 1, thrombomodulin, angiopoietin 2, endothelial cell-specific molecule 1, vascular cell adhesion molecule 1 and E-selectin) had stronger associations with sepsis than infection alone. MR-ProADM had the highest odds ratio (OR) in multivariable analysis (OR 11·53, 95 per cent c.i. 4·15 to 32·08; P = 0·006) and the best area under the curve (AUC) for detecting sepsis (0·86, 95 per cent c.i. 0·80 to 0·91; P < 0·001). In a comparison of sepsis with septic shock, two biomarkers of neutrophil degranulation, proteinase 3 (OR 8·09, 1·34 to 48·91; P = 0·028) and lipocalin 2 (OR 6·62, 2·47 to 17·77; P = 0·002), had the strongest association with septic shock, but lipocalin 2 exhibited the highest AUC (0·81, 0·73 to 0·90; P < 0·001). Conclusion: MR-ProADM and lipocalin 2 could be alternatives to the SOFA score in the detection of sepsis and septic shock respectively in surgical patients with infection.Instituto de Salud Carlos III (grants PI15/01959, PI15/01451 and PI16/01156

Punto de corte de circunferencia braquial media: importancia obstétrica y neonatal

Introducción: La preeclampsia es un trastorno multisis- témico que se encuentra entre las principales causas de morbi-mortalidad materna durante la gestación, la obe- sidad es uno de los factores que interviene en la siopa- tología de esta alteración vascular. Por lo cual el objetivo de este estudio es evaluar el comportamiento del Índice de Masa Corporal (IMC) y la Circunferencia Braquial Me- dia (CBM) en pacientes preclámpticas ingresadas en la Maternidad Enrique C. Sotomayor de la ciudad de Guaya- quil, así como establecer un punto de corte del parámetro más relacionado con la preeclampsia. Materiales y Métodos: Se realizó un estudio caso-con- trol, aleatorio, en 30 mujeres sin preeclampsia y 30 con preeclampsia ingresadas en la Maternidad Enrique C. So- tomayor de la ciudad de Guayaquil, Ecuador, 2010. Se realizó una Curva COR para determinar el punto de corte de CBM para preeclampsia. Asimismo se realizó un mod- elo de regresión logística múltiple para factores asociados a complicación neonatal. Resultados: Las mujeres preeclámpticas presentaron va- lores más altos de CBM (30,3cm); p&lt;0.0001. El punto de corte seleccionado para el diagnóstico de preeclampsia fue 27,5cm con un ABC=0,898 (sensibilidad: 90%; espe- ci cidad: 83,3%). La CBM alta fue el factor más asociado con la presencia de complicación neonatal (OR: 5,13; IC95%: 1,04-25,39; p=0,04). Conclusiones: Se sugiere medir la CBM en la paciente gestante para la valoración de obesidad, siendo 27,5cm el punto de corte a partir del cual hay una mayor relación con preeclampsia y complicaciones neonatales como bajo peso al nacer.&nbsp

Plan de comunicación interna y externa de la Facultad de Ciencias Sociales. Programa de Actividades Complementarias y de Difusión Cultural de la Facultad II

Memoria ID-0258. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2014-2015

Autoantibodies against type I IFNs in patients with critical influenza pneumonia

In an international cohort of 279 patients with hypoxemic influenza pneumonia, we identified 13 patients (4.6%) with autoantibodies neutralizing IFN-alpha and/or -omega, which were previously reported to underlie 15% cases of life-threatening COVID-19 pneumonia and one third of severe adverse reactions to live-attenuated yellow fever vaccine. Autoantibodies neutralizing type I interferons (IFNs) can underlie critical COVID-19 pneumonia and yellow fever vaccine disease. We report here on 13 patients harboring autoantibodies neutralizing IFN-alpha 2 alone (five patients) or with IFN-omega (eight patients) from a cohort of 279 patients (4.7%) aged 6-73 yr with critical influenza pneumonia. Nine and four patients had antibodies neutralizing high and low concentrations, respectively, of IFN-alpha 2, and six and two patients had antibodies neutralizing high and low concentrations, respectively, of IFN-omega. The patients' autoantibodies increased influenza A virus replication in both A549 cells and reconstituted human airway epithelia. The prevalence of these antibodies was significantly higher than that in the general population for patients 70 yr of age (3.1 vs. 4.4%, P = 0.68). The risk of critical influenza was highest in patients with antibodies neutralizing high concentrations of both IFN-alpha 2 and IFN-omega (OR = 11.7, P = 1.3 x 10(-5)), especially those <70 yr old (OR = 139.9, P = 3.1 x 10(-10)). We also identified 10 patients in additional influenza patient cohorts. Autoantibodies neutralizing type I IFNs account for similar to 5% of cases of life-threatening influenza pneumonia in patients <70 yr old

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Pedagogía social : revista interuniversitaria

Resumen basado en el de la publicaciónTítulo, resumen y palabras clave en español, inglés y portuguésMonográfico con el título: “Escuela y vulnerabilidad social”Título del monográfico en inglés: “School and social vulnerability”La creciente heterogeneidad en las escuelas, fruto de la adopción internacional, ha generado nuevos desafíos sociales que deben ser abordados. Más allá de los procesos de aprendizaje propios de los centros escolares, se percibe a la escuela como el espacio idóneo para que niños, niñas y adolescentes desarrollen habilidades y comportamientos que les permitan vivir en sociedad y como un escenario de confluencia para culturas totalmente diferenciadas. En el caso de España, la llegada de los niños adoptados de origen chino contribuyó a aumentar la diversidad étnica de la población española en las aulas, y con ello los desafíos para la institución educativa. Se busca conocer el bienestar social de los niños y niñas adoptados en la R.P. China que cursan la Educación Secundaria en Castilla y León, dado que se presenta como un grupo potencialmente expuesto a las tensiones que se generan en contextos educativos heterogéneos. Para alcanzar el objetivo se han realizado 10 entrevistas semiestructuradas. La estrategia analítica seguida se asienta en la teoría fundamentada. Los resultados muestran que es un grupo objeto de burla por sus rasgos fenotípicos asiáticos, pero no por su condición de adoptados.ES