Projeto de um aplicativo móvel para monitoramento domiciliar de bebês com cardiopatias congênitas complexas

Introducción: Las cardiopatías congénitas están relacionadas con defectos cardíacos que se desarrollan durante el embarazo y están presentes al nacer. El éxito de las intervenciones depende en gran medida de la educación de los padres/cuidadores sobre los signos y síntomas de alerta. Los cuidadores necesitan tener herramientas para hacer frente a las barreras del sistema de salud. Objetivo: crear un sistema como herramienta de seguimiento para los bebés con cardiopatías congénitas complejas que ayude a los padres/cuidadores y a los profesionales médicos a observar las variables fisiológicas del paciente y a brindar una retroalimentación oportuna y profesional a los padres/cuidadores desde la atención domiciliaria. Materiales y métodos:se presenta un sistema que proporciona apoyo a los pacientes que necesitan seguimiento de cardiopatías congénitas complejas mediante un programa de monitoreo en casa. El sistema consiste en una aplicación móvil que permite a los padres/cuidadores controlar las variables fisiológicas del paciente (peso, ingesta de alimento y oximetría). La información registrada en la aplicación se envía para ser evaluada en tiempo real por el equipo médico. Resultados: la aplicación proporciona un medio eficaz para enviar datos y comunicarse con el centro de control médico, además de ofrecer material educativo e informativo. De este modo, los padres/cuidadores reciben constantemente ayuda e información acerca del estado de su bebé. Conclusiones: la aplicación móvil podría ayudar a minimizar los costos de la atención médica y superar las limitaciones del seguimiento domiciliario, dando a los médicos la posibilidad de ver la evolución del paciente y dar recomendaciones oportunas. Como citar este artículo: Castro David, Pérez-Rivero Paula, Quintero-Lesmes Doris Cristina, Castro Javier. Design of a mobile application for home monitoring of babies with complex congenital heart disease. Revista Cuidarte. 2022;13(3):e2335. http://dx.doi.org/10.15649/cuidarte.2335       Introduction: Congenital heart diseases are related to heart defects that develop during pregnancy and are present at birth. Children must regularly attend specialized clinical centers for treatment, which includes medical check-ups, hemodynamic procedures, and surgery. Nevertheless, the success of interventions largely depends on the education of parents and caregivers about the symptoms and warning signs that babies with complex congenital heart disease may present during the period between stages. Likewise, it is necessary for caregivers to have tools to face the barriers of the health system, such as, obstacles or delays in obtaining healthcare services. This facilitates timely health care for patients and avoids fatal outcomes or deterioration in quality of life. Materials and Methods: This document presents a system that provides support to patients with complex congenital heart disease in follow-up by a home monitoring program. The system consists of a mobile application that allows parents/caregivers to monitor physiological variables of the patients (weight, intake, and oximetry). The information registered in the application is sent for real-time evaluation by the medical team. Results:The application provides an effective means for sending data and communicating with the medical control center, in addition to offering educational and informative material. In this way, parents/caregivers get constant help and feedback about their baby's condition. Conclusions: The mobile application could help mitigate the costs of medical care and overcome the limitations of follow-up at home, giving doctors the possibility to see the patient's evolution and give timely recommendations. How to cite this article: Castro David, Pérez-Rivero Paula, Quintero-Lesmes Doris Cristina, Castro Javier. Design of a mobile application for home monitoring of babies with complex congenital heart disease. Revista Cuidarte. 2022;13(3):e2335. http://dx.doi.org/10.15649/cuidarte.2335       Introdução: as doenças cardíacas congênitas estão relacionadas a defeitos cardíacos que se desenvolvem durante a gravidez e estão presentes no nascimento. O sucesso das intervenções depende em grande parte da educação dos pais/responsáveis sobre os sinais e sintomas de alerta. Os cuidadores precisam ter ferramentas para lidar com as barreiras do sistema de saúde. Objetivo: Criar uma ferramenta de sistema de monitoramento para bebês com doenças cardíacas congênitas complexas, que ajude pais/cuidadores e profissionais médicos a observar as variáveis fisiológicas do paciente e manter um feedback profissional e oportuno para os pais/cuidadores dos cuidados domiciliares. Materiais e Métodos: é apresentado um sistema que fornece suporte aos pacientes com cardiopatias congênitas complexas em acompanhamento através de um programa de monitoramento domiciliar. O sistema consiste em uma aplicação móvel que permite aos pais/responsáveis pelo acompanhamento das variáveis fisiológicas do paciente (peso, ingestão e oximetria). As informações registradas no aplicativo são enviadas para serem avaliadas em tempo real pela equipe médica. Resultados: a aplicação fornece um meio eficiente para enviar dados e se comunicar com o centro de controle médico, além de oferecer material educativo e informativo. Desta forma, os pais/responsáveis recebem ajuda constante e feedback sobre a condição de seu bebê. Conclusões: a aplicação móvel pode ajudar a minimizar os custos do atendimento médico e superar as limitações do acompanhamento domiciliar, dando aos médicos a possibilidade de ver a evolução do paciente e dar recomendações oportunas. Como citar este artigo: Castro David, Pérez-Rivero Paula, Quintero-Lesmes Doris Cristina, Castro Javier. Design of a mobile application for home monitoring of babies with complex congenital heart disease. Revista Cuidarte. 2022;13(3):e2335. http://dx.doi.org/10.15649/cuidarte.2335      &nbsp

Using machine learning methods to determine a typology of patients with HIV-HCV infection to be treated with antivirals

Several European countries have established criteria for prioritising initiation of treatment in patients infected with the hepatitis C virus (HCV) by grouping patients according to clinical characteristics. Based on neural network techniques, our objective was to identify those factors for HIV/HCV co-infected patients (to which clinicians have given careful consideration before treatment uptake) that have not being included among the prioritisation criteria. This study was based on the Spanish HERACLES cohort (NCT02511496) (April-September 2015, 2940 patients) and involved application of different neural network models with different basis functions (product-unit, sigmoid unit and radial basis function neural networks) for automatic classification of patients for treatment. An evolutionary algorithm was used to determine the architecture and estimate the coefficients of the model. This machine learning methodology found that radial basis neural networks provided a very simple model in terms of the number of patient characteristics to be considered by the classifier (in this case, six), returning a good overall classification accuracy of 0.767 and a minimum sensitivity (for the classification of the minority class, untreated patients) of 0.550. Finally, the area under the ROC curve was 0.802, which proved to be exceptional. The parsimony of the model makes it especially attractive, using just eight connections. The independent variable "recent PWID" is compulsory due to its importance. The simplicity of the model means that it is possible to analyse the relationship between patient characteristics and the probability of belonging to the treated group

Inteligência fluida e cristalizada no autismo de alto funcionamento e a síndrome de Asperger

Intelligence in autistic spectrum disorders, especially high functioning autism and Asperger’s syndrome has been the subject of numerous investigations that seek to establish intellectual ability observed in these subjects. Some of the most outstanding results indicate that fluid intelligence is one of the aspects of superior performance in this population compared to tests that measure crystallized intelligence such as the Wechsler scales, providing a reason for using in intelligence studies instruments that measure abstract reasoning and the analogical capacity, closely related to fluid intelligence function, one of this like the Raven progressive matrices. In the present research we evaluated 12 children with high functioning Autism and 6 with Asperger’s syndrome through the WISC-IV and the Raven test. The results showed there are no significant differences between both measures of intelligence. However, we found that there are differences in the intellectual profile of both groups and that Asperger’s syndrome appears to have a better intellectual level compared with high functioning Autism.La inteligencia en los trastornos del espectro autista, especialmente en el autismo de alto funcionamiento y el síndrome de Asperger, ha sido tema de numerosas investigaciones que pretenden establecer la capacidad intelectual que se observa en estos sujetos. Algunos de los resultados más sobresalientes señalan que la inteligencia fluida es uno de los aspectos de desempeño superior en esta población, en comparación con el desempeño en las pruebas que miden inteligencia cristalizada como la escala Wechsler, razón por la cual los estudios sobre inteligencia deberían utilizar instrumentos que midan el razonamiento abstracto y la capacidad analógica, funciones estrechamente relacionadas con la inteligencia fluida, como lo es el test de matrices progresivas de Raven. En la presente investigación se evaluaron 12 niños con autismo de alto funcionamiento y 6 con síndrome de Asperger, a través de la escala de Wechsler IV y el test de Raven. Los resultados arrojaron que no existen diferencias significativas entre ambas medidas de inteligencia. No obstante, sí se encontró que existen diferencias en el perfil intelectual de ambos grupos y que el síndrome de Asperger parece tener un nivel intelectual superior, en comparación con el autismo de alto funcionamiento. A inteligência nos transtornos do espectro autista, especialmente no autismo de alto funcionamento e a síndrome de Asperger, tem sido tema de numerosas pesquisas que pretendam estabelecer a capacidade intelectual que se observa nestes sujeitos. Alguns dos resultados mais sobressalientes assinalam que a inteligência fluida é um dos aspectos de desempenho superior nesta população, em comparação com o desempenho nas provas que medem inteligência cristalizada como as escalas Wechsler, razão pela qual os estudos sobre inteligência deveriam utilizar instrumentos que meçam o razoamento abstrato e a capacidade analógica, funções estreitamente relacionadas com a inteligência fluida, como é o teste de matrizes progressivas de Raven. Na presente pesquisa avaliaram-se 12 crianças com autismo de alto funcionamento e 6 com síndrome de Asperger, através do WISC-IV e o teste de Raven. Os resultados mostraram que não existem diferenças significativas entre ambas as medidas de inteligência. Não obstante, sim encontrou-se que existem diferenças no perfil intelectual de ambos os grupos e que a síndrome de Asperger parece ter um nível intelectual superior, em comparação com o autismo de alto funcionament

Terapia de aceptación y compromiso en un caso de tras¬torno mixto de ansiedad y depresión en una paciente con cáncer

This paper introduces the case of a woman with breast cancer who had developed a mixed depressive-anxiety disorder with avoidance behaviors. The patient presented depressive symptoms like listlessness, insomnia, weeping, food disorders and hopelessness though. Also, she exhibited physiological arousal and restlessness feelings. Additionally, the patient had an avoidance patron behavior in relation with all stimulus she believed could hurt her. Based on the Acceptance and Commitment Therapy (ACT) the intervention planted the following objectives: the patient will learn to accept her illness and the emotional distress that she was experiencing, also, the patient will recover the other areas of her life that she had abandoned. The treatment was developed in 14 sessions. The therapist used these techniques: creative hopelessness, disabling verbal functions, values clarification and loss of control over private events. In the results, it was observed a positive change in the behavior of the patient as well as a decrease in emotional distress that was his reason for initial consultatio

Evaluation of the efficacy and safety of text messages targeting adherence to cardiovascular medications in secondary prevention: the txt2heart Colombia randomised controlled trial protocol.

INTRODUCTION: Anti-platelet therapy, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, beta-blockers and statins are cost-effective in patients with atherosclerotic cardiovascular diseases (ASCVD) for reducing the risk of ASCVD events. Unfortunately, there is abundant evidence that adherence to these cardiovascular medications is far from ideal. A recent Cochrane review showed a potential beneficial effect of Short Message Service (SMS) interventions on adherence to medication in ASCVD patients. METHODS AND ANALYSIS: The txt2heart study is a pragmatic randomised single-blind controlled trial. The objective is to evaluate the efficacy and safety of an intervention with SMS messages delivered by mobile phones to improve adherence to cardiovascular medications in patients with ASCVD. The intervention consists of behavioural techniques delivered via SMS. The primary outcome is change in blood serum low-density lipoprotein cholesterol levels as an indicator of adherence to statins. Secondary outcomes will include systolic blood pressure as an indicator of adherence to blood-lowering therapies and heart rate as an indicator of adherence to beta-blockers, urine levels of 11-dehydrothromboxane B2, self-reported adherence to cardiovascular medications and rates of cardiovascular death or hospitalisation due to cardiovascular disease. ETHICS AND DISSEMINATION: The study will be performed in compliance with the protocol, regulatory requirements, Good Clinical Practice and ethical principles of the Declaration of Helsinki. The Ethics Committee of Fundación Cardiovascular de Colombia evaluated and approved the trial. The txt2heart Colombia trial aims to provide robust evidence to evaluate whether SMS messages delivered through mobile telephones change the behaviour of Colombian patients who have suffered a cardiovascular event. Trial results will be presented to the local health authorities, and if the intervention is effective and safe, we hope this strategy will be implemented quickly because of its low cost and wide-reaching impact on the population. TRIAL REGISTRATION NUMBER: NCT03098186

Anti-HIV-1 activity of a tripodal receptor that recognizes mannose oligomers

The glycoprotein gp120 of the HIV-1 viral envelope has a high content in mannose residues, particularly ¿-1,2-mannose oligomers. Compounds that interact with these high-mannose type glycans may disturb the interaction between gp120 and its (co)receptors and are considered potential anti-HIV agents. Previously, we demonstrated that a tripodal receptor (1), with a central scaffold of 1,3,5-triethylbenzene substituted with three 2,3,4-trihydroxybenzoyl groups, selectively recognizes ¿-1,2-mannose polysaccharides. Here we present additional studies to determine the anti-HIV-1 activity and the mechanism of antiviral activity of this compound. Our studies indicate that 1 shows anti-HIV-1 activity in the low micromolar range and has pronounced gp120 binding and HIV-1 integrase inhibitory capacity. However, gp120 binding rather than integrase inhibition seems to be the primary mechanism of antiviral activity of 1.The Spanish MICINN/MINECO (Project: SAF 201239760-C02-01, co-financed by the FEDER programme); Plan Nacional de Cooperación Público-Privada. Subprograma INNPACTO (IPT-2012-0213-060000, co-financed by the FEDER programme) and the Comunidad de Madrid (BIPEDD2-CM-S2010/BMD-2457) are acknowledged for fi nancial support. The Spanish ICINN/MINECCO is also acknowledged for a grant to E. Rivero-Buceta. We thank Leentje Persoons, Frieda De Meyer, Leen Ingels, Stijn Delmotte, Katrien Geerts, and Inge Vliegen for excellent technical assistance. Financial support of KU Leuven (GOA 10/14; PF 10/18) and the FWO (G-0528.12N) was provided for the antiviral experiments. The integrase studies were supported by the Center for Cancer Research, the Intramural Program of the National Cancer Institute,NIH (Z01-BC 007333).Peer Reviewe

Neurodegeneration, Mitochondria, and Antibiotics

Neurodegenerative diseases are characterized by the progressive loss of neurons, synapses, dendrites, and myelin in the central and/or peripheral nervous system. Actual therapeutic options for patients are scarce and merely palliative. Although they affect millions of patients worldwide, the molecular mechanisms underlying these conditions remain unclear. Mitochondrial dysfunction is generally found in neurodegenerative diseases and is believed to be involved in the pathomechanisms of these disorders. Therefore, therapies aiming to improve mitochondrial function are promising approaches for neurodegeneration. Although mitochondrial-targeted treatments are limited, new research findings have unraveled the therapeutic potential of several groups of antibiotics. These drugs possess pleiotropic effects beyond their anti-microbial activity, such as anti-inflammatory or mitochondrial enhancer function. In this review, we will discuss the controversial use of antibiotics as potential therapies in neurodegenerative diseases.This project was supported by FIS PI19/00377 (2019) and FIS PI22/00142 (2022) grants, Instituto de Salud Carlos III, Spain; and the Fondo Europeo de Desarrollo Regional (FEDER Unión Europea), Spanish Ministry of Education, Culture, and Sport. This activity was co-financed by the European Regional Development Fund (ERDF) and by the Regional Ministry of Economic Transformation, Industry, Knowledge, and Universities of the Junta de Andalucía, within the framework of the ERDF Andalusia operational program 2014–2020 Thematic objective “01—Reinforcement of research, technological development and innovation” through the reference research project CTS-5725 and PY18-850.Peer reviewe

Curso Sistema Político Español (formato power point)

Material elaborado en el marco del proyecto de tipo NOU-PID “Docencia adaptada a formato on line de la asignatura Sistema Político Español”, coordinado por el profesor Joaquín Martín Cubas, de las convocatorias del PID Programa de Innovación Docente de la Universitat de València (2020-21) con referencia UV-SFPIE_PID-1353413. El proyecto está enfocado a la elaboración de material y diseño de estrategias para la docencia virtual y la evaluación en línea. Entre sus objetivos se encuentra el diseño de materiales docentes innovadores y entornos de aprendizaje y evaluación en formato on line: audiovisuales, powers, enlaces, prácticas, autoevaluación y foros o webinars.Cada uno de los 22 temas en los que se ha dividido el temario de la asignatura Sistema Político Español se han depositado en abierto en el Repositorio de la Universitat de València en sus tres formatos: Texto, PowerPoint y Grabación audiovisual, siendo sus contenidos responsabilidad exclusiva de los autores firmantes de cada tema. El texto, además del desarrollo del contenido de cada tema, dispone de Bibliografía específica, Enlaces on line de interés, una Sugerencia de Práctica y un Test de autoevaluación con cinco o seis preguntas, cada una de las cuales tiene cuatro respuestas posibles de la cual solo una es correcta.Each of the 22 topics into which the syllabus of the subject Spanish Political System has been divided have been deposited openly in the Repository of the University of València in its three formats: Text, PowerPoint and Audiovisual recording, their contents being the sole responsibility of the signing authors of each topic. The text, in addition to the development of the content of each topic, it has specific Bibliography, on-line links of interest, a Practice Suggestion and a self-evaluation test with five or six questions, each of which has four possible answers from the which only one is correct

Efficacy and Safety of Text Messages Targeting Adherence to Cardiovascular Medications in Secondary Prevention: TXT2HEART Colombia Randomized Controlled Trial

BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality worldwide, with a prevalence of approximately 100 million patients. There is evidence that antiplatelet agents and antihypertensive medications could reduce the risk of new vascular events in this population; however, treatment adherence is very low. An SMS text messaging intervention was recently developed based on behavior change techniques to increase adherence to pharmacological treatment among patients with a history of ASCVD. OBJECTIVE: This study aims to evaluate the efficacy and safety of an SMS text messaging intervention to improve adherence to cardiovascular medications in patients with ASCVD. METHODS: A randomized controlled clinical trial for patients with a prior diagnosis of cardiovascular events, such as acute myocardial infarction, unstable angina, cerebrovascular disease, or peripheral artery disease, in one center in Colombia was conducted. Patients randomized to the intervention arm were assigned to receive SMS text messages daily for the first 4 weeks, 5 SMS text messages on week 5, 3 SMS text messages each in weeks 6 and 7, and 1 SMS text message weekly from week 8 until week 52. In contrast, patients in the control arm received a monthly SMS text message reminding them of the next study appointment and the importance of the study, requesting information about changes in their phone number, and thanking them for participating in the study. The primary endpoint was the change in low-density lipoprotein cholesterol (LDL-C) levels, whereas the secondary endpoints were the changes in thromboxane B2 levels, heart rate, systolic and diastolic blood pressure, medication adherence, cardiac and noncardiac mortality, and hospitalization. Linear regression analyses and bivariate tests were performed. RESULTS: Of the 930 randomized patients, 805 (86.5%) completed follow-up and were analyzed for the primary endpoint. There was no evidence that the intervention changed the primary outcome (LDL-C levels; P=.41) or any of the secondary outcomes evaluated (all P>.05). There was also no evidence that the intervention was associated with adverse events. CONCLUSIONS: In this study, there was no evidence that a behavior modification intervention delivered by SMS text messaging improved LDL-C levels, blood pressure levels, or adherence at 12 months. More research is needed to evaluate whether different SMS text messaging strategies, including personalized messages and different timings, are effective; future studies should include mixed methods to better understand why, for whom, and in which context (eg, health system or social environment) SMS text messaging interventions work (or not) to improve adherence in patients with ASCVD. TRIAL REGISTRATION: ClinicalTrials.gov NCT03098186; https://clinicaltrials.gov/ct2/show/NCT03098186. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2018-028017

Post-Franco Theatre

In the multiple realms and layers that comprise the contemporary Spanish theatrical landscape, “crisis” would seem to be the word that most often lingers in the air, as though it were a common mantra, ready to roll off the tongue of so many theatre professionals with such enormous ease, and even enthusiasm, that one is prompted to wonder whether it might indeed be a miracle that the contemporary technological revolution – coupled with perpetual quandaries concerning public and private funding for the arts – had not by now brought an end to the evolution of the oldest of live arts, or, at the very least, an end to drama as we know it