2,534 research outputs found
Las galerías filtrantes del Alto Lerma: usos y manejos sociales
La ubicación y estudio del manejo social del agua de las galerías filtrantes en el Estado de México no se ha realizado porque se ignora la existencia de este sistema hidráulico. En el presente artículo se informa por primera vez la georreferenciación y descripción del uso y manejo social del agua de las galerías filtrantes del Alto Lerma. Con base en trabajo de campo, revisión de archivos y etnografía, se verifica y describe la existencia de dicho sistema en esta región. El desarrollo de este trabajo es parte de una investigación más amplia, denominada "Caracterización del uso y manejo social del agua de las galerías filtrantes en el Estado de México", bajo la supervisión de Tonatiuh Romero
Is the liver kinetic growth rate in ALPPS unprecedented when compared with PVE and living donor liver transplant? A multicentre analysis
AbstractBackgroundThe clinical perspective on hepatic growth is limited. The goal of the present study was to compare hepatic hypertrophy and the kinetic growth rate(KGR) in patients after the ALPPS (Associating Liver Partition with Portal Vein Ligation for Staged Hepatectomy) procedure, portal vein embolization (PVE) and living donor liver transplantation.MethodsVolumetry and KGR of the future liver remnant (FLR) were compared from (15) patients undergoing ALPPS, (53) patients undergoing PVE, (90) recipients of living donor liver grafts and (93) donors of living donor liver grafts.ResultsThe degree of hypertrophy was significantly greater after ALPPS (84.3 ± 7.8%) than after PVE (36.0 ± 27.2%) (P < 0.001). The KGR was also significantly greater for ALPPS [32.7 ± 13.6 cubic centimetres (cc)/day] (10.8 ± 4.5%/day) compared with PVE (4.4 ± 3.2 cc/day) (0.98 ± 0.75%/day) (P < 0.001). The FLR of living donor donors had the greatest degree of hypertrophy (107.5 ± 39.2%) and was greater than after ALPPS (P = 0.02), PVE (P < 0.001) and in living donor‐recipient grafts (P < 0.001). KGR (cc/day) was greater in FLR of living donor donors compared with both ALPPS (P < 0.001) and PVE (P < 0.001). The KGR in patients undergoing ALPPS and living donor liver transplantation had a linear relationship with the size of FLR.ConclusionFLR hypertrophy and KGR were greater after ALPPS than PVE. However, the degree of hypertrophy after ALPPS is not unprecedented, as KGR in the FLR from living donor donors is equal to or greater than after ALPPS. The KGR of the FLR in patients after ALPPS and living donor donors correlates directly with the size of the FLR
Cluster Analysis of Finger-to-nose Test for Spinocerebellar Ataxia Assessment
El test Finger-to-nose test (FNT) es una evaluación neurológica para estudiar la coordinación. Se presenta una metodología de análisis de datos de FNT, que permite evaluar la evolución del estado de enfermos de Ataxia Espinocerebral de tipo 2 (SCA2), mediante técnicas de aprendizaje computacional.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech
History-sensitive versus future-sensitive approaches to security in distributed systems
We consider the use of aspect-oriented techniques as a flexible way to deal
with security policies in distributed systems. Recent work suggests to use
aspects for analysing the future behaviour of programs and to make access
control decisions based on this; this gives the flavour of dealing with
information flow rather than mere access control. We show in this paper that it
is beneficial to augment this approach with history-based components as is the
traditional approach in reference monitor-based approaches to mandatory access
control. Our developments are performed in an aspect-oriented coordination
language aiming to describe the Bell-LaPadula policy as elegantly as possible.
Furthermore, the resulting language has the capability of combining both
history- and future-sensitive policies, providing even more flexibility and
power.Comment: In Proceedings ICE 2010, arXiv:1010.530
The prognostic impact of SIGLEC5-induced impairment of CD8+ T cell activation in sepsis
Immune checkpoint; Sepsis; T-cell exhaustionPunto de control inmunológico; Septicemia; Agotamiento de células TPunt de control immunitari; Sèpsia; Esgotament de cèl·lules TBackground
Sepsis is associated with T-cell exhaustion, which significantly reduces patient outcomes. Therefore, targeting of immune checkpoints (ICs) is deemed necessary for effective sepsis management. Here, we evaluated the role of SIGLEC5 as an IC ligand and explored its potential as a biomarker for sepsis.
Methods
In vitro and in vivo assays were conducted to both analyse SIGLEC5's role as an IC ligand, as well as assess its impact on survival in sepsis. A multicentre prospective cohort study was conducted to evaluate the plasmatic soluble SIGLEC5 (sSIGLEC5) as a mortality predictor in the first 60 days after admission in sepsis patients. Recruitment included sepsis patients (n = 346), controls with systemic inflammatory response syndrome (n = 80), aneurism (n = 11), stroke (n = 16), and healthy volunteers (HVs, n = 100).
Findings
SIGLEC5 expression on monocytes was increased by HIF1α and was higher in septic patients than in healthy volunteers after ex vivo LPS challenge. Furthermore, SIGLEC5-PSGL1 interaction inhibited CD8+ T-cell proliferation. Administration of sSIGLEC5r (0.8 mg/kg) had adverse effects in mouse endotoxemia models. Additionally, plasma sSIGLEC5 levels of septic patients were higher than HVs and ROC analysis revealed it as a mortality marker with an AUC of 0.713 (95% CI, 0.656–0.769; p < 0.0001). Kaplan–Meier survival curve showed a significant decrease in survival above the calculated cut-off (HR of 3.418, 95% CI, 2.380–4.907, p < 0.0001 by log-rank test) estimated by Youden Index (523.6 ng/mL).
Interpretation
SIGLEC5 displays the hallmarks of an IC ligand, and plasma levels of sSIGLEC5 have been linked with increased mortality in septic patients.This work was supported by grants from Instituto de Salud Carlos III (ISCIII) and “Fondos FEDER” to ELC (PIE15/00065, PI18/00148, PI14/01234, PI21/00869), to PP (20859/PI/18) and to CdF (PI21/01178), and received funding from the European Union's Horizon 2020 research and innovation program under the Marie Sklodowaska-Curie grant agreement to KMH (No. 713673; “laCaixa”). R.L.-R. was supported by “Predoctotales de formación en Investigación” (PFIS) grant FI19/00334 and J.A.-O. by Sara Borrell grant CD21/00059 from ISCIII. The Vall d'Hebron University Hospital and Vall d’Hebron Research Institute were supported by Plan Nacional de I+D+i 2013–2016, the ISCIII and Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0003)—co-financed by European Development Regional Fund “A way to achieve Europe”, and by the European Union’s Horizon 2020 Research and Innovation Program (JCRR, RF, JJGL, AF). Authors thank Emilio Llanos for his technical assistance
Chronic alcohol consumption alters extracellular space geometry and transmitter diffusion in the brain
[EN] Already moderate alcohol consumption has detrimental long-term effects on brain function. However, how alcohol produces its potent addictive effects despite being a weak reinforcer is a poorly understood conundrum that likely hampers the development of successful interventions to limit heavy drinking. In this translational study, we demonstrate widespread increased mean diffusivity in the brain gray matter of chronically drinking humans and rats. These alterations appear soon after drinking initiation in rats, persist into early abstinence in both species, and are associated with a robust decrease in extracellular space tortuosity explained by a microglial reaction. Mathematical modeling of the diffusivity changes unveils an increased spatial reach of extrasynaptically released transmitters like dopamine that may contribute to alcohol's progressively enhanced addictive potencyThis work was supported by the European Union's Horizon 2020 research and innovation program (668863-SyBil-AA) and the ERA-NET NEURON program (FKZ 01EW1112-TRANSALC and PIM2010ERN-00679), as well as the Spanish State Research Agency through the Severo Ochoa Program for Centres of Excellence in R&D (SEV-2017-0723), the Deutsche Forschungsgemeinschaft (center grant TRR265-B08), and the Czech Science Foundation (GACR; grant no. 16-10214S to L.V.). S.C. and D.M. further acknowledge financial support from the Ministerio de Economia y Competitividad (MINECO) and FEDER funds under grant nos. BFU2015-64380-C2-1-R, BFU2015-64380-C2-2-R, and PGC2018-101055-B-I00 and the Generalitat Valenciana through the Prometeo Program (PROMETEO/2019/015). S.C. also acknowledges support of the Ministerio de Sanidad, Servicios Sociales e Igualdad (#2017I065). E.S. acknowledges financial support from the Slovak Research and Development Agency (APVV-17-0642). S.D.S. is supported by a NARSAD Young Investigator Grant (grant no. 25104), by the European Research Council through a Marie Sklodowska-Curie Individual Fellowship (grant no. 749506), and by the Generalitat Valenciana grant SEJI/2019/038. R.C. is supported by the NIAAA grant AA017447. W.H.S acknowledges support from the Bundesministerium fur Bildung und Forschung (BMBF; FKZ: 031L0190A, 01ZX1909CA).De Santis, S.; Cosa-Liñán, A.; Garcia-Hernandez, R.; Dmytrenko, L.; Vargova, L.; Vorisek, I.; Stopponi, S.... (2020). Chronic alcohol consumption alters extracellular space geometry and transmitter diffusion in the brain. Science Advances. 6(26):1-12. https://doi.org/10.1126/sciadv.aba0154S11262
ALPPS Offers a Better Chance of Complete Resection in Patients with Primarily Unresectable Liver Tumors Compared with Conventional-Staged Hepatectomies: Results of a Multicenter Analysis
Background: Portal vein occlusion to increase the size of the future liver remnant (FLR) is well established, using portal vein ligation (PVL) or embolization (PVE) followed by resection 4-8weeks later. Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) combines PVL and complete parenchymal transection, followed by hepatectomy within 1-2weeks. ALPPS has been recently introduced but remains controversial. We compare the ability of ALPPS versus PVE or PVL for complete tumor resection. Methods: A retrospective review of all patients undergoing ALPPS or conventional staged hepatectomies using PVL or PVE at four high-volume HPB centres between 2003 and 2012 was performed. Patients with primary liver tumors and liver metastases were included. Primary endpoint was complete tumor resection. Secondary endpoints include 90-day mortality, complications, FLR increase, time to resection, and tumor recurrence. Results: Forty-eight patients with ALPPS were compared with 83 patients with conventional-staged hepatectomies. Eighty-three percent (40/48 patients) of ALPPS patients achieved complete resection compared with 66% (55/83 patients) in PVE/PVL (odds ratio 3.34, p=0.027). Ninety-day mortality in ALPPS and PVE/PVL was 15 and 6%, respectively (p=0.2). Extrapolated growth rate was 11 times higher in ALPPS (34.8cc/day; interquartile range (IQR) 26-49) compared with PVE/PVL (3cc/day; IQR2-6; p=0.001). Tumor recurrence at 1year was 54 versus 52% for ALPPS and PVE/PVL, respectively (p=0.7). Conclusions: This study provides evidence that ALPPS offers a better chance of complete resection in patients with primarily unresectable liver tumors at the cost of a high mortality. The technique is promising but should currently not be used outside of studies and registries
ALPPS offers a better chance of complete resection in patients with primarily unresectable liver tumors compared with conventional-staged hepatectomies: results of a multicenter analysis
BACKGROUND: Portal vein occlusion to increase the size of the future liver remnant (FLR) is well established, using portal vein ligation (PVL) or embolization (PVE) followed by resection 4-8 weeks later. Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) combines PVL and complete parenchymal transection, followed by hepatectomy within 1-2 weeks. ALPPS has been recently introduced but remains controversial. We compare the ability of ALPPS versus PVE or PVL for complete tumor resection.
METHODS: A retrospective review of all patients undergoing ALPPS or conventional staged hepatectomies using PVL or PVE at four high-volume HPB centres between 2003 and 2012 was performed. Patients with primary liver tumors and liver metastases were included. Primary endpoint was complete tumor resection. Secondary endpoints include 90-day mortality, complications, FLR increase, time to resection, and tumor recurrence.
RESULTS: Forty-eight patients with ALPPS were compared with 83 patients with conventional-staged hepatectomies. Eighty-three percent (40/48 patients) of ALPPS patients achieved complete resection compared with 66 % (55/83 patients) in PVE/PVL (odds ratio 3.34, p = 0.027). Ninety-day mortality in ALPPS and PVE/PVL was 15 and 6 %, respectively (p = 0.2). Extrapolated growth rate was 11 times higher in ALPPS (34.8 cc/day; interquartile range (IQR) 26-49) compared with PVE/PVL (3 cc/day; IQR2-6; p = 0.001). Tumor recurrence at 1 year was 54 versus 52 % for ALPPS and PVE/PVL, respectively (p = 0.7).
CONCLUSIONS: This study provides evidence that ALPPS offers a better chance of complete resection in patients with primarily unresectable liver tumors at the cost of a high mortality. The technique is promising but should currently not be used outside of studies and registries
The U.S.-Mexico Border Infectious Disease Surveillance Project: Establishing Binational Border Surveillance
In 1997, the Centers for Disease Control and Prevention, the Mexican Secretariat of Health, and border health officials began the development of the Border Infectious Disease Surveillance (BIDS) project, a surveillance system for infectious diseases along the U.S.-Mexico border. During a 3-year period, a binational team implemented an active, sentinel surveillance system for hepatitis and febrile exanthems at 13 clinical sites. The network developed surveillance protocols, trained nine surveillance coordinators, established serologic testing at four Mexican border laboratories, and created agreements for data sharing and notification of selected diseases and outbreaks. BIDS facilitated investigations of dengue fever in Texas-Tamaulipas and measles in California–Baja California. BIDS demonstrates that a binational effort with local, state, and federal participation can create a regional surveillance system that crosses an international border. Reducing administrative, infrastructure, and political barriers to cross-border public health collaboration will enhance the effectiveness of disease prevention projects such as BIDS
Repensando el turismo sustentable
El libro aborda la problemática del turismo sustentable que, por un lado, al compartir contornos nebulosos con la sustentabilidad, funciona como un nuevo circuito de acumulación fundamentado en un discurso retórico de desarrollo local; por el otro, se nos presenta como una alternativa potencial para la formulación de vías comunitarias de desarrollo local, que permitirían la prosperidad o al menos la sobrevivencia de culturas y territorios partucularizados.Universidad Autónoma del Estado de Méxic
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