Predicting optimal anesthesia level from propofol and remifentanil concentration: analysis of covariate factors for individualization

Treballs Finals de Grau d'Enginyeria Biomèdica. Facultat de Medicina i Ciències de la Salut. Universitat de Barcelona. Curs: 2020-2021. Tutor: Pedro Gambús Cerrillo. Tutor Extern: Sebastián Jaramillo SelmanGeneral anesthesia involves some targeting effects which aim to prevent the patient from suffering against the therapeutic aggression. These effects are hypnosis, analgesia, amnesia and immobility and to achieve them a combination of drugs is delivered into the patient, from which propofol and remifentanil are highlighted. In the operating room, monitoring systems are used to assess the depth of anesthesia in real time. This monitoring includes basic systems such as arterial blood pressure, oxygenation or electrocardiogram and electroencephalogram derived measures, which are more complex; from this last group, BIS index is a good indicator. Being able to predict the anesthetic depth from a set of input variables could be valuable during the surgery, as it would help the anesthesiologists to prevent adverse effects, and it would help the post-operative recovery. Knowing this, the aim of this project is to predict the probability to be in the optimal level of anesthesia, which is related to the BIS index. This probability is obtained from the input concentration of propofol and remifentanil, a hypnotic and an analgesic drug respectively, and from the demographic variables such as age, height or gender. To do so, a Logistic Regression model will be built with data from patients undergoing general anesthesia in Cirurgia Major Ambulatòria (CMA) in Hospital Clínic

Inertial sensors for gait monitoring and design of adaptive controllers for exoskeletons after stroke: a feasibility study

Introduction: Tuning the control parameters is one of the main challenges in robotic gait therapy. Control strategies that vary the control parameters based on the user’s performance are still scarce and do not exploit the potential of using spatiotemporal metrics. The goal of this study was to validate the feasibility of using shank-worn Inertial Measurement Units (IMUs) for clinical gait analysis after stroke and evaluate their preliminary applicability in designing an automatic and adaptive controller for a knee exoskeleton (ABLE-KS). Methods: First, we estimated the temporal (i.e., stride time, stance, and swing duration) and spatial (i.e., stride length, maximum vertical displacement, foot clearance, and circumduction) metrics in six post-stroke participants while walking on a treadmill and overground and compared these estimates with data from an optical motion tracking system. Next, we analyzed the relationships between the IMU-estimated metrics and an exoskeleton control parameter related to the peak knee flexion torque. Finally, we trained two machine learning algorithms, i.e., linear regression and neural network, to model the relationship between the exoskeleton torque and maximum vertical displacement, which was the metric that showed the strongest correlations with the data from the optical system [r = 0.84; ICC(A,1) = 0.73; ICC(C,1) = 0.81] and peak knee flexion torque (r = 0.957). Results: Offline validation of both neural network and linear regression models showed good predictions (R2 = 0.70–0.80; MAE = 0.48–0.58 Nm) of the peak torque based on the maximum vertical displacement metric for the participants with better gait function, i.e., gait speed > 0.7 m/s. For the participants with worse gait function, both models failed to provide good predictions (R2 = 0.00–0.19; MAE = 1.15–1.29 Nm) of the peak torque despite having a moderate-to-strong correlation between the spatiotemporal metric and control parameter. Discussion: Our preliminary results indicate that the stride-by-stride estimations of shank-worn IMUs show potential to design automatic and adaptive exoskeleton control strategies for people with moderate impairments in gait function due to stroke.Peer ReviewedPostprint (published version

Inertial sensors for gait monitoring and design of adaptive controllers for exoskeletons after stroke: a feasibility study

Introduction: Tuning the control parameters is one of the main challenges in robotic gait therapy. Control strategies that vary the control parameters based on the user’s performance are still scarce and do not exploit the potential of using spatiotemporal metrics. The goal of this study was to validate the feasibility of using shank-worn Inertial Measurement Units (IMUs) for clinical gait analysis after stroke and evaluate their preliminary applicability in designing an automatic and adaptive controller for a knee exoskeleton (ABLE-KS).Methods: First, we estimated the temporal (i.e., stride time, stance, and swing duration) and spatial (i.e., stride length, maximum vertical displacement, foot clearance, and circumduction) metrics in six post-stroke participants while walking on a treadmill and overground and compared these estimates with data from an optical motion tracking system. Next, we analyzed the relationships between the IMU-estimated metrics and an exoskeleton control parameter related to the peak knee flexion torque. Finally, we trained two machine learning algorithms, i.e., linear regression and neural network, to model the relationship between the exoskeleton torque and maximum vertical displacement, which was the metric that showed the strongest correlations with the data from the optical system [r = 0.84; ICC(A,1) = 0.73; ICC(C,1) = 0.81] and peak knee flexion torque (r = 0.957).Results: Offline validation of both neural network and linear regression models showed good predictions (R2 = 0.70–0.80; MAE = 0.48–0.58 Nm) of the peak torque based on the maximum vertical displacement metric for the participants with better gait function, i.e., gait speed > 0.7 m/s. For the participants with worse gait function, both models failed to provide good predictions (R2 = 0.00–0.19; MAE = 1.15–1.29 Nm) of the peak torque despite having a moderate-to-strong correlation between the spatiotemporal metric and control parameter.Discussion: Our preliminary results indicate that the stride-by-stride estimations of shank-worn IMUs show potential to design automatic and adaptive exoskeleton control strategies for people with moderate impairments in gait function due to stroke

Arqueología en la ACEGA 2: el área arqueológica de O Peto (Vedra, A Coruña)

Cadernos de Arqueoloxía e Patrimonio (CAPA)[EN] The archaeological area of O Peto was discovered during the construction of the highway Santiago-Alto de Santo de Domingo. This site shows the existence of archaeological structures near of the galician Iron Age hillforts. In fact O Peto is an artificialized space (where a set of several structures was exhumed) that belongs to a prerroman iron mining complex that suffered several changes in the beginning of Romanization.[ES] El área arqueológica de O Peto se descubrió durante el control arqueológico de la construcción de la Autopista Santiago-Alto de Santo Domingo. Se trata de un ejemplo significativo de la existencia de estructuras anejas en el entorno inmediato del recinto habitacional de los castros de la Edad del Hierro. Constituye un espacio claramente artificializado en el que se superponen estructuras excavadas en la roca, de naturaleza y finalidad diferentes. A este respecto se configura un espacio construido –aparentemente multifuncional- que experimentó sucesivos procesos de ampliación, redefinición, sellado intencionado y abandono entre la Edad del Hierro y Época Romana. La información aportada por la excavación indica que este yacimiento albergó un complejo minerometalúrgico caracterizado tecnológicamente por la utilización de hornos bajos prerromanos sin sangrado de escoria que procesarían el mineral extraído en el propio yacimiento.Proyecto financiado por la Dirección Xeral de Investigación e Desenvolvemento da Consellería de Innovación, Industria e Comercio (Xunta de Galicia) con cargo a la convocatoria Programa de Tecnoloxías para a Innovación- Tecnoloxías da Construcción e da Conservación do Patrimonio do ano 2004. Código de Proxecto: PGIDIT04CCP606003PRPeer reviewe

The evolution, form and function of the human respiratory system

This paper presents an updated view on the morphological and functional significance of the human respiratory system in the context of human evolutionary anatomy. While usually the respiratory system is treated either from a craniofacial perspective, mostly in the context of nasal evolution and air-conditioning, or from a postcranial perspective featuring on overall thoracic shape changes, here we pursue a holistic perspective on the form, function, integration, and evolutionary change of the entire organismal system in hominins. We first present a brief review of the most important morphological structures, their function, and its potential integration and interaction with the nasal cavity and thoracic skeleton. This is followed by an overview of the most important improvements in methods for the comparative study in recent humans and fossil hominins. We then overview and list a compendium of hominin fossil material currently available for the study. We propose four functional categories of hominin respiratory system configurations that differ potentially with respect to size, shape, biomechanics and/or bioenergetics. Finally, we discuss these and speculate on possible ways for future research into an anatomical system that, despite its under-investigated status, is central to the understanding of the form and functions of the hominin organism and its paleobiology.Grant PID2020-115854GB-I00 to MB is funded by MCIN/AEI/10.13039/501100011033 of the Spanish Ministry of Science and Innovation and the European Union and is linked to PRE2021- 097584 FPI dissertation grant to JMLRP. Grants PID2019-105097RB I00/AEI/10.13039/501100011033) and PDC2022-133532-I00 are funded to MAB. MLC is funded by a FPU21/02087 Dissertation grant. Grant IIPPITD-2021 is funded to APR for stays of UMA researchers in quality research centers.Peer reviewe

Arqueología en la ACEGA 2: el área arqueológica de O Peto (Vedra, A Coruña)

Cadernos de Arqueoloxía e Patrimonio (CAPA)[EN] The archaeological area of O Peto was discovered during the construction of the highway Santiago-Alto de Santo de Domingo. This site shows the existence of archaeological structures near of the galician Iron Age hillforts. In fact O Peto is an artificialized space (where a set of several structures was exhumed) that belongs to a prerroman iron mining complex that suffered several changes in the beginning of Romanization.[ES] El área arqueológica de O Peto se descubrió durante el control arqueológico de la construcción de la Autopista Santiago-Alto de Santo Domingo. Se trata de un ejemplo significativo de la existencia de estructuras anejas en el entorno inmediato del recinto habitacional de los castros de la Edad del Hierro. Constituye un espacio claramente artificializado en el que se superponen estructuras excavadas en la roca, de naturaleza y finalidad diferentes. A este respecto se configura un espacio construido –aparentemente multifuncional- que experimentó sucesivos procesos de ampliación, redefinición, sellado intencionado y abandono entre la Edad del Hierro y Época Romana. La información aportada por la excavación indica que este yacimiento albergó un complejo minerometalúrgico caracterizado tecnológicamente por la utilización de hornos bajos prerromanos sin sangrado de escoria que procesarían el mineral extraído en el propio yacimiento.Proyecto financiado por la Dirección Xeral de Investigación e Desenvolvemento da Consellería de Innovación, Industria e Comercio (Xunta de Galicia) con cargo a la convocatoria Programa de Tecnoloxías para a Innovación- Tecnoloxías da Construcción e da Conservación do Patrimonio do ano 2004. Código de Proxecto: PGIDIT04CCP606003PRPeer reviewe

Methionine adenosyltransferase 1a antisense oligonucleotides activate the liver-brown adipose tissue axis preventing obesity and associated hepatosteatosis

Altered methionine metabolism is associated with weight gain in obesity. The methionine adenosyltransferase (MAT), catalyzing the first reaction of the methionine cycle, plays an important role regulating lipid metabolism. However, its role in obesity, when a plethora of metabolic diseases occurs, is still unknown. By using antisense oligonucleotides (ASO) and genetic depletion of Mat1a, here, we demonstrate that Mat1a deficiency in diet-induce obese or genetically obese mice prevented and reversed obesity and obesity-associated insulin resistance and hepatosteatosis by increasing energy expenditure in a hepatocyte FGF21 dependent fashion. The increased NRF2-mediated FGF21 secretion induced by targeting Mat1a, mobilized plasma lipids towards the BAT to be catabolized, induced thermogenesis and reduced body weight, inhibiting hepatic de novo lipogenesis. The beneficial effects of Mat1a ASO were abolished following FGF21 depletion in hepatocytes. Thus, targeting Mat1a activates the liver-BAT axis by increasing NRF2-mediated FGF21 secretion, which prevents obesity, insulin resistance and hepatosteatosis. High methionine and S-adenosylmethionine serum levels are related with obesity. Here the authors show that knockdown of methionine adenosyltransferase by using antisense oligonucleotides provides beneficial effects in obesity and comorbidities.This work was supported by Ayudas para apoyar grupos de investigacion del sistema Universitario Vasco (IT971-16) and MCIU/AEI/FEDER, UE (RTI2018-095134-B-100) (to P.A.), (RTI2018-099413-B-I00 and RED2018-102379-T) (to R.N.), PID2020119486RB-100 (to M.V.R.) and (RTI2018-096759-A-100) (to T.C.D). EFSD/Lilly European Diabetes Research Program, MICIU (PID2019-104399RB-I00), Fundacion AECC PROYE19047SABI, and Comunidad de Madrid IMMUNOTHERCAN-CM B2017/BMD-3733 (to G.S.). La CAIXA Foundation LCF/PR/HP17/52190004, MINECO-FEDER SAF2017-87301-R, AYUDAS FUNDACION BBVA A EQUIPOS DE INVESTIGACION CIENTIFICA UMBRELLA 2018 and AECC Scientific Foundation, grant name: Rare Cancers 2017 (to M.L.M.-C.). AECC Scientific Foundation (to T.C.D.). Xunta de Galicia 2020-PG015 (to R.N.) Gilead Sciences International Research Scholars Program in Liver Disease (to M.V.R.). Personal fellows: E.P.F. was awarded with Juan de la Cierva-Formacion, FJC2018-035449-I. C.F. was awarded with Sara Borrell (CD19/00078). CIC bioGUNE thanks MCIU for the Severo Ochoa Excellence Accreditation (SEV-2016-0644). The authors thank Dr. Manuel Lafitas laboratory (Getxo, Bizkaia, Spain) for his valuable help in the analysis of biochemical parameters

Acceptability and feasibility of a virtual community of practice to primary care professionals regarding patient empowerment: A qualitative pilot study

Background: Virtual communities of practice (vCoPs) facilitate online learning via the exchange of experiences and knowledge between interested participants. Compared to other communities, vCoPs need to overcome technological structures and specific barriers. Our objective was to pilot the acceptability and feasibility of a vCoP aimed at improving the attitudes of primary care professionals to the empowerment of patients with chronic conditions. Methods: We used a qualitative approach based on 2 focus groups: one composed of 6 general practitioners and the other of 6 practice nurses. Discussion guidelines on the topics to be investigated were provided to the moderator. Sessions were audio-recorded and transcribed verbatim. Thematic analysis was performed using the ATLAS-ti software. Results: The available operating systems and browsers and the lack of suitable spaces and time were reported as the main difficulties with the vCoP. The vCoP was perceived to be a flexible learning mode that provided up-to-date resources applicable to routine practice and offered a space for the exchange of experiences and approaches. Conclusions: The results from this pilot study show that the vCoP was considered useful for learning how to empower patients. However, while vCoPs have the potential to facilitate learning and as shown create professional awareness regarding patient empowerment, attention needs to be paid to technological and access issues and the time demands on professionals. We collected relevant inputs to improve the features, content and educational methods to be included in further vCoP implementation. Trial registration: ClinicalTrials.gov, NCT02757781. Registered on 25 April 2016.This study was financed by Instituto de Salud Carlos III and Cofinanced by Fondo Europeo de Desarrollo Regional (FEDER). Ministerio de Economía y Competitividad. Gobierno de España. (PI15/00164, PI15/00586, PI15/00566

Artistas sobre outras obras

Ouvir os criadores, os artistas, pode ter uma pertinência resistente. Pertinência, se for um exercício continuado. Resistente se se propiciarem discursos alternativos, fora dos circuitos de legitimação, descentrados, e verdadeiramente críticos, sem interesses no teatro da arte contemporânea. É possível descolonizar a arte? Entre a arte o poder estabelece-se ora oposições ora alianças, ambas construtoras de identidades e de discursos, no contexto da crise de descentramento em torno do etnocentrismo, do género, do pós-colonialismo. As imagens tornaram-se hoje mais letalmente políticas (as fakenews, os memes, as redes): são as ‘imagens armadilha,’ ou as ‘imagens ofensivas.’ Ao museu, tingido de hibridação, sobra a desconfiança da sua génese colonial: afinal o oriente foi lá imaginado primeiro.info:eu-repo/semantics/publishedVersio