HELP: Optimizing Treatment of Parkinson’s Disease Patients

3rd International Conference on the Elderly and New Technologies. III Jornadas Internacionales de Mayores y Nuevas Tecnologías.This paper presents a novel health monitoring system for Parkinson’s disease (pd) patients called help (Home-based Empowered Living for Parkinson’s disease patients). The help system has been specifically designed and implemented as a health monitoring system in order to optimize treatment and improve quality of life of people with Parkinson’s. This is a challenging goal due to the difficulty in establishing a closed-loop system that is able to detect the outcomes of treatment and react accordingly. In a similar way to diabetes treatment where the plasma glucose level can be measured and can be used to regulate drug doses, the help system’s approach aims to estimate pd symptoms and to adjust the dose of medication in order to reduce symptoms. The proposed health monitoring system is composed of several components: a body sensor & actuator network managed by a smartphone, a remote monitoring platform for doctors and clinical professionals as well as a telecommunication and service infrastructure. The real advantage derives from having constant medical control without dramatically modifying daily life. The help system is going to be evaluated in several cities during the first part of 2012 under daily living conditions with pd patients.En este trabajo se presenta un nuevo sistema de vigilancia de la salud para pacientes con la enfermedad de Parkinson (ep), pacientes llamados help (Fortaleciendo la vida en el hogar de pacientes con la enfermedad Parkinson). El sistema de ayuda ha sido específicamente diseñado e implementado como un sistema de vigilancia de la salud con el fin de optimizar el tratamiento y mejorar la calidad de vida de las personas con Parkinson. Este es un objetivo difícil debido a la dificultad del establecimiento de un sistema de circuito cerrado que es capaz de detectar los resultados del tratamiento y reaccionar en consecuencia. Es una manera similar al tratamiento de la diabetes donde el nivel de glucosa en plasma se puede medir y se puede utilizar para regular las dosis de medicamentos; el enfoque del sistema de ayuda tiene por objeto estimar los síntomas de la ep y ajustar la dosis de la medicación con el fin de reducir los síntomas. El sistema de vigilancia de la salud propuesto se compone de varios componentes: un sensor corporal y un actuador de red gestionado por un smartphone, una plataforma de monitorización remota para los médicos y clínicos profesionales, así como el uso de telecomunicaciones y servicios de infraestructura. La verdadera ventaja deriva de que tiene un constante control médico sin modificar drásticamente la vida cotidiana. El sistema help va a ser evaluado en varias ciudades durante la primera parte del año 2012 en condiciones de vida diaria con pacientes con ep

Clinical relevance of the first domomedicine platform securing multidrug chronotherapy delivery in metastatic cancer patients at home : the inCASA European project

Background: Telehealth solutions can improve the safety of ambulatory chemotherapy, contributing to the maintenance of patients at their home, hence improving their well-being, all the while reducing health care costs. There is, however, need for a practicable multilevel monitoring solution, encompassing relevant outputs involved in the pathophysiology of chemotherapy-induced toxicity. Domomedicine embraces the delivery of complex care and medical procedures at the patient’s home based on modern technologies, and thus it offers an integrated approach for increasing the safety of cancer patients on chemotherapy. Objective: The objective was to evaluate patient compliance and clinical relevance of a novel integrated multiparametric telemonitoring domomedicine platform in cancer patients receiving multidrug chemotherapy at home. Methods: Self-measured body weight, self-rated symptoms using the 19-item MD Anderson Symptom Inventory (MDASI), and circadian rest-activity rhythm recording with a wrist accelerometer (actigraph) were transmitted daily by patients to a server via the Internet, using a dedicated platform installed at home. Daily body weight changes, individual MDASI scores, and relative percentage of activity in-bed versus out-of-bed (I<O) were computed. Chemotherapy was administered according to the patient medical condition. Compliance was evaluated according to the proportions of (1) patient-days with all data available (full) and (2) patient-days with at least one parameter available (minimal). Acceptability was assessed using the Whole Systems Demonstrator Service User Technology Acceptability Questionnaire. Linear discriminant analysis was used to identify the combination of parameters associated with subsequent unplanned hospitalization. Results: A total of 31 patients (males: 55% [17/31]; World Health Organization Performance Status=0: 29% (9/31); age range: 35-91 years) participated for a median of 58 days (38-313). They received a total of 102 chemotherapy courses (64.7% as outpatients). Overall full compliance was 59.7% (522/874), with at least one data available for 830/874 patient-days (95.0%), during the 30-day per-protocol span. Missing data rates were similar for each parameter. Patients were altogether satisfied with the use of the platform. Ten toxicity-related hospitalizations occurred in 6 patients. The combination of weighted circadian function (actigraphy parameter I<O), body weight change, and MDASI scores predicted for ensuing emergency hospitalization within 3 days, with an accuracy of 94%. Conclusions: Multidimensional daily telemonitoring of body weight, circadian rest-activity rhythm, and patient-reported symptoms was feasible, satisfactory, and clinically relevant in patients on chemotherapy. This domomedicine platform constitutes a unique tool for the further development of safe home-based chemotherapy administration

Neurofilament light chain level is a weak risk factor for the development of MS

Altres ajuts: T Jens Kuhle was supported by an ECTRIMS Research Fellowship Programme and by the Forschungsfonds of the University of Basel, Switzerland.To determine the prognostic value of selected biomarkers in clinically isolated syndromes (CIS) for conversion to multiple sclerosis (MS) and disability accrual. Data were acquired from 2 CIS cohorts. The screening phase evaluated patients developing clinically definite MS (CIS-CDMS) and patients who remained as CIS during a 2-year minimum follow-up (CIS-CIS). We determined levels of neurofascin, semaphorin 3A, fetuin A, glial fibrillary acidic protein, and neurofilament light (NfL) and heavy chains in CSF (estimated mean [95% confidence interval; CI]). We evaluated associations between biomarker levels, conversion, disability, and magnetic resonance parameters. In the replication phase, we determined NfL levels (n = 155) using a 900 ng/L cutoff. Primary endpoints in uni- and multivariate analyses were CDMS and 2010 McDonald MS. The only biomarker showing significant differences in the screening was NfL (CIS-CDMS 1,553.1 [1,208.7-1,897.5] ng/L and CIS-CIS 499.0 [168.8-829.2] ng/L, p < 0.0001). The strongest associations were with brain parenchymal fraction change (r = −0.892) and percentage brain volume change (r = −0.842) at 5 years. NfL did not correlate with disability. In the replication phase, more NfL-positive patients, according to the cutoff, evolved to MS. Every 100-ng/L increase in NfL predicted CDMS (hazard ratio [HR] = 1.009, 95% CI 1.005-1.014) and McDonald MS (HR = 1.009, 95% CI 1.005-1.013), remaining significant for CDMS in the multivariate analysis (adjusted HR = 1.005, 95% CI 1.000-1.011). This risk was lower than the presence of oligoclonal bands or T2 lesions. NfL is a weak independent risk factor for MS. Its role as an axonal damage biomarker may be more relevant as suggested by its association with medium-term brain volume changes

Estructura i diversitat genètica de les poblacions pirinenques de Dichoropetalum schottii (Bess.) Pimenov & Kljuykov (Apiaceae): avaluació per a l’establiment de prioritats en conservació.

12 p., gráf., fot. -- Comunicación presentada al IX Col·loqui International de Botànica Pirenaico-cantàbrica celebrado en Ordino (Andorra) en 2010.[EN]Dichoropetalum schottii is a taxon of S. European mountains reaching its western distribution limit at the Pyrenees. A single Iberian location is known, hosting c. 250 individuals (CR according to IUCN 2001 categories). It is also known in France from some ten localities in the Eastern Pyrenees and protected by law in Catalonia and Languedoc-Roussillon. Allozyme variation of Pyrenean populations has been studied. Parameters of genetic variation (P99, A, He) for eight loci show lower values for the Catalan population (25.0; 1.37; 0.100, respectively) than for the remaining Pyrenean populations (37.5-50; 1.50; 0.112-0.134), in congruence with small population size and marginal excentric situation in relation with the total distribution area. By comparing the obtained data with those of populations of the whole distribution area, we conclude that the Pyrenean populations set can be distinguished as a significant portion of genetic variation, characterized by private alleles and by a relatively recent origin, coming from an E. Mediterranean mountain stock. The set of Pyrenean populations can be identified as a functional conservation unit for which conservation measures are proposed.[CAT]Dichoropetalum schottii és un tàxon de les muntanyes del S. d’Europa que ateny el seu extrem occidental de distribució als Pirineus. Se’n coneix una única localitat ibèrica amb vora 250 individus (CR segons categories UICN 2001). A l’estat francès és conegut d’una desena de localitats dels Pirineus Orientals. Aquest tàxon és protegit legalment tant a la Catalunya autònoma com a la regió del Llenguadoc-Rosselló. S’ha estudiat la variació al·loenzimàtica de les poblacions pirinenques. Els paràmetres de variació genètica (P99, A, He) per a vuit loci indiquen valors més baixos a la població catalana (25,0; 1,37; 0,100, respectivament) que no pas a la resta de poblacions dels Pirineus (37,5-50; 1,50;0,112-0,134), congruents amb la petita mida poblacional i amb la situació marginal excèntrica respecte a l’àrea de distribució total. Comparant les dades obtingudes amb les de poblacions de tota l’àrea de distribució es conclou que el nucli pirinenc en conjunt pot ser distingit com una fracció significativa de la variació genètica caracteritzada per la presència d’al·lels privats i per un origen relativament recent, a partir d’una estirp procedent de les muntanyes mediterrànies orientals. El conjunt de poblacions pirinenques és identificable com a unitat funcional de conservació, per a la qual es proposen mesures de conservació.Aquest treball ha estat finançat pel Ministerio de Educación y Ciencia [CGL2007-60475/BOS], i mitjançant la concessió d’una beca BRD (Universitat de Barcelona) a M.C. Martinell i d’un contracte postdoctoral Jae-Doc (CSIC) a J. López-Pujol.Peer reviewe

Caracterització biològica i citogenètica de la població retrobada de l'esperó de Bolòs (Delphinium bolosii) al Parc Natural de Sant Llorenç del Munt i l'Obac

Peer reviewe

Estudi preliminar de variabilitat isoenzimàtica de Delphinium bolosii al Parc Natural de Sant Llorenç del Munt i l’Obac

Peer reviewe

Demographic Monitoring and Verification of Chromosomal Variability of the Bolòs Larkspur (Delphinium Bolosii) in the Sant Llorenç del Munt i l’Obac Nature Park

Trabajo presentado en la IX Trobada d’Estudiosos de Sant Llorenç del Munt i l’Obac, celebrada en Castellar del Vallès el 21 y 22 de noviembre de 2017.[CA] Des del retrobament de l’esperó de Bolòs al Parc Natural de Sant Llorenç del Munt i l’Obac, se li ha fet un seguiment anual (2014-2017) per valorar-ne la dinàmica demogràfica i la possible evolució, comptant individus juvenils i reproductors emergits cada any, l’alçada de les tiges floríferes i la producció de flors i fruits. Aquesta informació s’incorporarà a la base de dades SEFA (Programa de seguiment de flora amenaçada). A més, s’ha ampliat l’estudi de germinació amb més individus per obtenir material per confirmar el nombre cromosòmic, atès que en l’únic individu estudiat va ser diferent (2n = 16) de les altres poblacions reportades (2n = 18), aquest darrer nombre força rar en la tribu Delphinieae. Es confirma 2n = 16 en tots els individus analitzats.[ES] Desde el reencuentro de la espuela de Bolòs en el Parque Natural de Sant Llorenç del Munt i l’Obac, se le ha realizado un seguimiento anual (2014-2017) para valorar su dinámica demográfica y su posible evolución, contabilizando individuos juveniles y reproductores emergidos cada año, la altura de los tallos floríferos y la producción de flores y frutos. Esta información se incorporará a la base de datos SEFA (Programa de seguimiento de flora amenazada). Además, se ha ampliado el estudio de germinación con más individuos para obtener material para confirmar el número cromosómico, dado que en el único individuo estudiado fue distinto (2n = 16) de las otras poblaciones reportadas (2n = 18), número este último bastante raro en la tribu Delphinieae. Se confirma 2n = 16 en todos los individuos analizados.[EN] After the Bolòs larkspur was rediscovered in Sant Llorenç del Munt i l’Obac Nature Park, annual monitoring (2014-2017) was conducted to assess its demographic dynamics and possible evolution, including counting young and reproductive individuals emerging every year, the height of the flower stems and flower and fruit production. This information will be added to the Standardised Programme for Monitoring Endangered Flora (SEFA) database. In addition, the germination study has been extended with more individuals to obtain material to confirm the chromosome number, since in the only individual studied it was different (2n = 16) from the other reported populations (2n = 18); this latter number is rare in the Delphinieae tribe. 2n = 16 is confirmed in all the individuals analysed.Aquest estudi forma part d’un conveni entre la Gerència de Serveis d’Espais Naturals de la Diputació de Barcelona i la Fundació Bosch i Gimpera de la UB (FBG 307801).Peer reviewe

Neurofilament light chain level is a weak risk factor for the development of MS

Objective: To determine the prognostic value of selected biomarkers in clinically isolated syndromes (CIS) for conversion to multiple sclerosis (MS) and disability accrual. Methods: Data were acquired from 2 CIS cohorts. The screening phase evaluated patients developing clinically definite MS (CIS-CDMS) and patients who remained as CIS during a 2-year minimum follow-up (CIS-CIS). We determined levels of neurofascin, semaphorin 3A, fetuin A, glial fibrillary acidic protein, and neurofilament light (NfL) and heavy chains in CSF (estimated mean [95% confidence interval; CI]). We evaluated associations between biomarker levels, conversion, disability, and magnetic resonance parameters. In the replication phase, we determined NfL levels (n = 155) using a 900 ng/L cutoff. Primary endpoints in uni- and multivariate analyses were CDMS and 2010 McDonald MS. Results: The only biomarker showing significant differences in the screening was NfL (CIS-CDMS 1,553.1 [1,208.7–1,897.5] ng/L and CIS-CIS 499.0 [168.8–829.2] ng/L, p < 0.0001). The strongest associations were with brain parenchymal fraction change (rs = −0.892) and percentage brain volume change (rs = −0.842) at 5 years. NfL did not correlate with disability. In the replication phase, more NfL-positive patients, according to the cutoff, evolved to MS. Every 100-ng/L increase in NfL predicted CDMS (hazard ratio [HR] = 1.009, 95% CI 1.005–1.014) and McDonald MS (HR = 1.009, 95% CI 1.005–1.013), remaining significant for CDMS in the multivariate analysis (adjusted HR = 1.005, 95% CI 1.000–1.011). This risk was lower than the presence of oligoclonal bands or T2 lesions. Conclusions: NfL is a weak independent risk factor for MS. Its role as an axonal damage biomarker may be more relevant as suggested by its association with medium-term brain volume changes

Neurofilament light chain level is a weak risk factor for the development of MS

Altres ajuts: T Jens Kuhle was supported by an ECTRIMS Research Fellowship Programme and by the Forschungsfonds of the University of Basel, Switzerland.To determine the prognostic value of selected biomarkers in clinically isolated syndromes (CIS) for conversion to multiple sclerosis (MS) and disability accrual. Data were acquired from 2 CIS cohorts. The screening phase evaluated patients developing clinically definite MS (CIS-CDMS) and patients who remained as CIS during a 2-year minimum follow-up (CIS-CIS). We determined levels of neurofascin, semaphorin 3A, fetuin A, glial fibrillary acidic protein, and neurofilament light (NfL) and heavy chains in CSF (estimated mean [95% confidence interval; CI]). We evaluated associations between biomarker levels, conversion, disability, and magnetic resonance parameters. In the replication phase, we determined NfL levels (n = 155) using a 900 ng/L cutoff. Primary endpoints in uni- and multivariate analyses were CDMS and 2010 McDonald MS. The only biomarker showing significant differences in the screening was NfL (CIS-CDMS 1,553.1 [1,208.7-1,897.5] ng/L and CIS-CIS 499.0 [168.8-829.2] ng/L, p < 0.0001). The strongest associations were with brain parenchymal fraction change (r = −0.892) and percentage brain volume change (r = −0.842) at 5 years. NfL did not correlate with disability. In the replication phase, more NfL-positive patients, according to the cutoff, evolved to MS. Every 100-ng/L increase in NfL predicted CDMS (hazard ratio [HR] = 1.009, 95% CI 1.005-1.014) and McDonald MS (HR = 1.009, 95% CI 1.005-1.013), remaining significant for CDMS in the multivariate analysis (adjusted HR = 1.005, 95% CI 1.000-1.011). This risk was lower than the presence of oligoclonal bands or T2 lesions. NfL is a weak independent risk factor for MS. Its role as an axonal damage biomarker may be more relevant as suggested by its association with medium-term brain volume changes

Experiencias de evaluación continuada en la Universidad

El Grupo Transversal de Innovación Docente sobre Aprendizaje Autónomo (TRANS.EDU) de la Universidad de Barcelona lleva unos años innovando e investigando sobre cómo mejorar la evaluación continuada en la educación superior. Fruto de su trabajo junto con el de otros docentes, son las experiencias que se incluyen en este libro. Se ha tratado de recoger ejemplos de prácticas de evaluación continuada que se están desarrollando en titulaciones muy diversas y de distintas ramas de conocimiento. El contenido de las experiencias es también variado, y se refieren a distintas fases de la secuencia formativa, pero se presentan siguiendo el mismo formato para facilitar su lectura