Simulador cardiovascular para ensayo de robots de navegación autónoma

[Resumen] Este artículo presenta un modelo de simulación del sistema cardiovascular en el entorno de Matlab/Simulink, más concretamente de la zona de mayor riesgo cardiovascular, la arteria carótida. Está basado en un modelo eléctrico del sistema que describe la dinámica de contracción del corazón, así como su carácter cíclico y autónomo. Como primer paso, este modelo se generaliza para contemplar también la dinámica de la arteria carótida izquierda. A partir de él, y haciendo una serie de equivalencias entre dominios, se obtiene un modelo hidráulico que emula el comportamiento del sistema cardiovascular en esa zona y que, a diferencia del anterior, no presenta carácter autónomo. Para el diseño del control, se hace uso de la estrategia de linealización por realimentaón. Se incluyen simulaciones, tanto del modelo eléctrico completo como del hidráulico propuesto, para demostrar el correcto funcionamiento del simulador desarrollado. El objetivo final de este trabajo es la construcción de una plataforma de ensayo para robots nadadores tipo flagelo eucariótico y bacteriano de pequeñas dimensiones a partir del modelo hidráulico desarrollado que permita emular las condiciones en las que se encontrarían estos robots navegando por el sistema circulatorio humano.Junta de Extremadura; GR15178Ministerio de Economía y Competitividad; DPI2016-80547-

El Historiador del Arte en la sociedad actual: profesionalización en los Museos y la Curaduría de Exposiciones

Accésit 2018[ES] Impacto de su desarrollo y resultados con la mejora de la calidad de la educación superior en cuanto a su aplicación práctica, generalización a otros centros, disciplinas, coordinación entre docentes, coordinación entre titulaciones e implicación de la comunidad universitaria

Gene Expression Patterns Distinguish Mortality Risk in Patients with Postsurgical Shock

Producción CientíficaNowadays, mortality rates in intensive care units are the highest of all hospital units. However, there is not a reliable prognostic system to predict the likelihood of death in patients with postsurgical shock. Thus, the aim of the present work is to obtain a gene expression signature to distinguish the low and high risk of death in postsurgical shock patients. In this sense, mRNA levels were evaluated by microarray on a discovery cohort to select the most differentially expressed genes between surviving and non-surviving groups 30 days after the operation. Selected genes were evaluated by quantitative real-time polymerase chain reaction (qPCR) in a validation cohort to validate the reliability of data. A receiver-operating characteristic analysis with the area under the curve was performed to quantify the sensitivity and specificity for gene expression levels, which were compared with predictions by established risk scales, such as acute physiology and chronic health evaluation (APACHE) and sequential organ failure assessment (SOFA). IL1R2, CD177, RETN, and OLFM4 genes were upregulated in the non-surviving group of the discovery cohort, and their predictive power was confirmed in the validation cohort. This work offers new biomarkers based on transcriptional patterns to classify the postsurgical shock patients according to low and high risk of death. The results present more accuracy than other mortality risk scores.Instituto de Salud Carlos III (grant PI15/01451)Junta de Castilla y León (grant 1255/A/16)Universidad de Valladolid - Fondo Europeo de Desarrollo Regional (grant VA321P18

Cardiovascular Circulatory System and Left Carotid Model: A Fractional Approach to Disease Modeling

Cardiovascular diseases (CVDs) remain the leading cause of death worldwide, according to recent reports from the World Health Organization (WHO). This fact encourages research into the cardiovascular system (CVS) from multiple and different points of view than those given by the medical perspective, highlighting among them the computational and mathematical models that involve experiments much simpler and less expensive to be performed in comparison with in vivo or in vitro heart experiments. However, the CVS is a complex system that needs multidisciplinary knowledge to describe its dynamic models, which help to predict cardiovascular events in patients with heart failure, myocardial or valvular heart disease, so it remains an active area of research. Firstly, this paper presents a novel electrical model of the CVS that extends the classic Windkessel models to the left common carotid artery motivated by the need to have a more complete model from a medical point of view for validation purposes, as well as to describe other cardiovascular phenomena in this area, such as atherosclerosis, one of the main risk factors for CVDs. The model is validated by clinical indices and experimental data obtained from clinical trials performed on a pig. Secondly, as a first step, the goodness of a fractional-order behavior of this model is discussed to characterize different heart diseases through pressure–volume (PV) loops. Unlike other models, it allows us to modify not only the topology, parameters or number of model elements, but also the dynamic by tuning a single parameter, the characteristic differentiation order; consequently, it is expected to provide a valuable insight into this complex system and to support the development of clinical decision systems for CVDs

El Historiador del Arte en la sociedad actual: profesionalización en los museos y la curaduría de exposiciones

p. 38-58El ámbito de la experiencia que aquí se trata es el impacto de su desarrollo y resultados con la mejora de la calidad de la educación superior en cuanto a su aplicación práctica, generalización a otros centros, disciplinas, coordinación entre docentes, coordinación entre titulaciones e implicación de la comunidad universitaria.S

Impact on clinical practice of the implementation of guidelines for the toxicity management of targeted therapies in kidney cancer. The protect-2 study.

Journal Article;BACKGROUND The impact of such recommendations after their implementation of guidelines has not usually been evaluated. Herein, we assessed the impact and compliance with the Spanish Oncology Genitourinary Group (SOGUG) Guidelines for toxicity management of targeted therapies in metastatic renal cell carcinoma (mRCC) in daily clinical practice. METHODS Data on 407 mRCC patients who initiated first-line targeted therapy during the year before and the year after publication and implementation of the SOGUG guideline program were available from 34 Spanish Hospitals. Adherence to SOGUG Guidelines was assessed in every cycle. RESULTS Adverse event (AE) management was consistent with the Guidelines as a whole for 28.7 % out of 966 post-implementation cycles compared with 23.1 % out of 892 pre-implementation cycles (p = 0.006). Analysis of adherence by AE in non-compliant cycles showed significant changes in appropriate management of hypertension (33 % pre-implementation vs. 44.5 % post-implementation cycles; p < 0.0001), diarrhea (74.0 % vs. 80.5 %; p = 0.011) and dyslipemia (25.0 % vs. 44.6 %; p < 0.001). CONCLUSIONS Slight but significant improvements in AE management were detected following the implementation of SOGUG recommendations. However, room for improvement in the management of AEs due to targeted agents still remains and could be the focus for further programs in this direction.This study was funded by Pfizer, S.L.U. Medical writing assistance was provided by Esther Tapia, PhD and was founded by Pfizer.Ye

Promoción turística sostenible de la reserva de la biosfera Tajo-Tejo Internacional

Convocatoria proyectos de innovación de Extremadura 2020/2021Se describe un proyecto llevado acabo por varios centros educativos ubicados en la zona de la Reserva de la Biosfera Tajo-Tejo Internacional (RBTTI) que pretendía contribuir a la transformación sostenible del entorno mediante su conocimiento y promoción, implementando las competencias digital, social y ciudadana y la cultura emprendedora mediante metodologías activas como el aprendizaje servicio. Entre los objetivos principales del proyecto destacan: dar a conocer las implicaciones de la RBTTI; diseñar una campaña de promoción de la RBTTI mediante trípticos y vídeos promocionales; conocer la Reserva a través de las principales vías pecuarias y caminos que comunican los pueblos; descubrir los principales elementos socioculturales, históricos y tradicionales de la Reserva; valorar la importancia del territorio para conservar la biodiversidad: paisajes, ecosistemas, fauna y flora representativa; relacionar la trashumancia y las vías pecuarias como rasgos identificativos de la Reserva, vinculándolo con la historia y rasgos culturales de los pueblos y valorar el emprendimiento y la iniciativa personal, el asosiacionismo y creación de redes de cooperación en y entre pueblos como motor de desarrolloExtremaduraES

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective