Colaboración internacional y buenas prácticas en la gestión de enfermedades crónicas complejas a través de herramientas web 2.0: Observatorio de prácticas innovadoras en el manejo de enfermedades crónicas complejas OPIMEC

Ponencias de la Segunda Conferencia internacional sobre brecha digital e inclusión social, celebrada del 28 al 30 de octubre de 2009 en la Universidad Carlos III de MadridLas enfermedades crónicas (EC) constituyen un reto de salud mundial en el siglo XXI. La OMS las define como enfermedades de larga duración por lo general de progresión lenta y prevé que en 2020 serán responsables del 73% de las muertes y del 60% de la carga global de enfermedad (World Health Organization, 2002). Es primordial que la comunidad internacional de salud pública y de gestión sanitaria conozca y comparta información sobre los avances en las prácticas tecnológicas y organizativas más innovadoras en gestión de EC, con énfasis en las EC Complejas (ECC) asociadas a una mayor pérdida de autonomía y grado de dependencia y discapacidad. Con este propósito, a mediados de 2006, la Dirección General de Innovación Sanitaria, Sistemas y Tecnología de la Consejería de Salud de la Junta de Andalucía crea el «Observatorio de Prácticas Innovadoras para el Manejo de Enfermedades Crónicas Complejas» (OPIMEC) que impulsa la participación y generación de conocimiento en información sanitaria para profesionales y una Plataforma de Red en el ámbito de la gestión de ECC para el fomento de alianzas y colaboraciones desde Andalucía basadas en dar y recibir conocimiento abierto entre personas, equipos y organizaciones (Jadad AR, 1999, p. 761-764; Jadad AR, 2000, p.362-365). La Web del Observatorio de Prácticas Innovadoras en el Manejo de Enfermedades Crónicas Complejas (OPIMEC), http://www.opimec.org, va centrada en la creación de una plataforma basada en la Web 2.0. que permite el acceso y la edición colaborativa de contenidos para profesionales. El objetivo fundamental de esta plataforma es compartir y colaborar en la generación y difusión de conocimiento, todo ello facilitado con herramientas innovadoras de la Web 2.0. como son la publicación de contenidos, la votación, comentarios sobre los contenidos, la sindicación de contenidos y la creación de comunidades abiertas de trabajo colaborativo. El proyecto OPIMEC cuenta con una cadena de procesos de gestión de la información de los que podemos destacar su forma colaborativa de crear conocimiento por todas las personas usuarias de la plataforma, un equipo editorial encargado de asegurar la calidad de los contenidos y una evaluación por pares de las prácticas y organizaciones propuestas en la Web. Desde la edición, hasta la publicación y su distribución final el conocimiento es examinado metódicamente. Este proceso es automatizado a través de herramientas de software libre creadas para OPIMEC y asesorado por su Consejo Asesor Internacional. Así pues, la plataforma Web 2.0 que da soporte al observatorio OPIMEC está construida sobre tecnologías libres como: Framework Web Django (impulsado por Google Inc. entre otros), MySQL y GNU/Linux. La elección de esta combinación tecnológica se ha realizado tras un análisis exhaustivo sobre las tecnologías abiertas disponibles, en base a criterios de eficiencia, productividad y adaptabilidad a las necesidades actuales y futuras de OPIMEC. La Web OPIMEC tiene intención y vocación de convertirse en un destacado proyecto a nivel mundial con clara vertiente de cooperación internacional e innovación, mejorando la calidad de vida de la ciudadanía, aprovechando las herramientas que ofrece la difundida red global de Internet y promocionando la participación e iniciativa de los y las profesionales. Nuestra Web OPIMEC está estructurada en espacios que facilitan y propician la participación y consecución de los objetivos del proyecto, con el fin de que la asimilación de sus contenidos por parte de las personas usuarias sea eficiente y efectiva. Podemos encontrar en ella, herramientas existentes en las redes sociales así como algunas nuevas desarrolladas específicamente para OPIMEC, como son los “documentos colaborativos”, que facilitarán el trabajo, la conexión y la participación de profesionales desde cualquier parte del mundo, pudiendo así aprovechar los recursos al máximo, Se dispone por tanto de destacadas herramientas como una base de datos actualizada de eventos, noticias, recursos y documentos, directorios y mapas de organizaciones, prácticas y personas innovadoras, espacios de comunidad en las que los equipos de trabajo pueden desarrollarse, comunicarse y complementarse con otras personas usuarias, compartiendo buenas prácticas, innovación y contenidos novedosos en el manejo de enfermedades crónicas complejas. El aspecto importante de la plataforma es que las personas usuarias son de forma democrática, creadores, evaluadores y consumidores de los contenidos publicados, siendo así una herramienta de trabajo construida, ampliada, valorada y seguida por toda la comunidad de profesionales; facilitando la difusión del conocimiento construido por y para todos y todas los profesionales sanitarios, personal investigador, ciudadanos y ciudadanas en general en el manejo de enfermedades crónicas complejas. Un conocimiento ampliamente compartido es la clave para aumentar y mejorar el bienestar social y la calidad de vida

On the origins of American Criollo pigs: A common genetic background with a lasting Iberian signature

American Criollo pigs are thought to descend mainly from those imported from the Iberian Peninsula starting in the late 15th century. Criollo pigs subsequently expanded throughout the Americas, adapting to very diverse environments, and possibly receiving influences from other origins. With the intensification of agriculture in the mid-20th century, cosmopolitan breeds largely replaced Criollo pigs, and the few remaining are mostly maintained by rural communities in marginal areas where they still play an important socio-economic and cultural role. In this study, we used 24 microsatellite markers in samples from 1715 pigs representing 46 breeds with worldwide distribution, including 17 American Criollo breeds, with the major focus of investigating their genetic diversity, structure and breed relationships. We also included representatives of the Iberian, Local British, Hungarian, Chinese and Commercial breeds, as well as Wild Boar, in order to investigate their possible influence in the genetic composition of Criollos. Our results show that, when compared with the other breeds, Criollo pigs present higher levels of genetic diversity, both in terms of allelic diversity and expected heterozygosity. The various analyses indicate that breed differentiation overall explains nearly 21% of the total genetic diversity. Criollo breeds showed their own identity and shared a common genetic background, tending to cluster together in various analyses, even though they differ from each other. A close relationship of Criollos with Iberian breeds was revealed by all the different analyses, and the contribution of Iberian breeds, particularly of the Celtic breeds, is still present in various Criollo breeds. No influence of Chinese breeds was detected on Criollos, but a few were influenced by Commercial breeds or by wild pigs. Our results confirm the uniqueness of American Criollo pigs and the role that Iberian breeds have played in their development. © 2021 Revidatti et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Deficiency of Thioredoxin Binding Protein-2 (TBP-2) Enhances TGF-β Signaling and Promotes Epithelial to Mesenchymal Transition

Transforming growth factor beta (TGF-β) has critical roles in regulating cell growth, differentiation, apoptosis, invasion and epithelial-mesenchymal transition (EMT) of various cancer cells. TGF-β-induced EMT is an important step during carcinoma progression to invasion state. Thioredoxin binding protein-2 (TBP-2, also called Txnip or VDUP1) is downregulated in various types of human cancer, and its deficiency results in the earlier onset of cancer. However, it remains unclear how TBP-2 suppresses the invasion and metastasis of cancer.In this study, we demonstrated that TBP-2 deficiency increases the transcriptional activity in response to TGF-β and also enhances TGF-β-induced Smad2 phosphorylation levels. Knockdown of TBP-2 augmented the TGF-β-responsive expression of Snail and Slug, transcriptional factors related to TGF-β-mediated induction of EMT, and promoted TGF-β-induced spindle-like morphology consistent with the depletion of E-Cadherin in A549 cells.Our results indicate that TBP-2 deficiency enhances TGF-β signaling and promotes TGF-β-induced EMT. The control of TGF-β-induced EMT is critical for the inhibition of the invasion and metastasis. Thus TBP-2, as a novel regulatory molecule of TGF-β signaling, is likely to be a prognostic indicator or a potential therapeutic target for preventing tumor progression

Epithelial-Mesenchymal Transition in Cancer: Parallels Between Normal Development and Tumor Progression

From the earliest stages of embryonic development, cells of epithelial and mesenchymal origin contribute to the structure and function of developing organs. However, these phenotypes are not always permanent, and instead, under the appropriate conditions, epithelial and mesenchymal cells convert between these two phenotypes. These processes, termed Epithelial-Mesenchymal Transition (EMT), or the reverse Mesenchymal-Epithelial Transition (MET), are required for complex body patterning and morphogenesis. In addition, epithelial plasticity and the acquisition of invasive properties without the full commitment to a mesenchymal phenotype are critical in development, particularly during branching morphogenesis in the mammary gland. Recent work in cancer has identified an analogous plasticity of cellular phenotypes whereby epithelial cancer cells acquire mesenchymal features that permit escape from the primary tumor. Because local invasion is thought to be a necessary first step in metastatic dissemination, EMT and epithelial plasticity are hypothesized to contribute to tumor progression. Similarities between developmental and oncogenic EMT have led to the identification of common contributing pathways, suggesting that the reactivation of developmental pathways in breast and other cancers contributes to tumor progression. For example, developmental EMT regulators including Snail/Slug, Twist, Six1, and Cripto, along with developmental signaling pathways including TGF-β and Wnt/β-catenin, are misexpressed in breast cancer and correlate with poor clinical outcomes. This review focuses on the parallels between epithelial plasticity/EMT in the mammary gland and other organs during development, and on a selection of developmental EMT regulators that are misexpressed specifically during breast cancer

Breast cancer epithelial-to-mesenchymal transition: examining the functional consequences of plasticity

The epithelial-to-mesenchymal transition (EMT) is a critical developmental process that has recently come to the forefront of cancer biology. In breast carcinomas, acquisition of a mesenchymal-like phenotype that is reminiscent of an EMT, termed oncogenic EMT, is associated with pro-metastatic properties, including increased motility, invasion, anoikis resistance, immunosuppression and cancer stem cell characteristics. This oncogenic EMT is a consequence of cellular plasticity, which allows for interconversion between epithelial and mesenchymal-like states, and is thought to enable tumor cells not only to escape from the primary tumor, but also to colonize a secondary site. Indeed, the plasticity of cancer cells may explain the range of pro-metastatic traits conferred by oncogenic EMT, such as the recently described link between EMT and cancer stem cells and/or therapeutic resistance. Continued research into this relationship will be critical in developing drugs that block mechanisms of breast cancer progression, ultimately improving patient outcomes

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

© 2024 The Authors. Journal of Extracellular Vesicles, published by Wiley Periodicals, LLC on behalf of the International Society for Extracellular Vesicles. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly.Peer reviewe

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic