7 research outputs found
AdquisiciĂłn, entrenamiento y prĂĄctica de competencias y destrezas digitales para estudiar Historia ContemporĂĄnea del primer curso de los grados de AntropologĂa Social y Cultural y de la AdministraciĂłn PĂșblica en las Facultades de PolĂticas y SociologĂa
Depto. de Historia, TeorĂas y GeografĂas PolĂticasFac. de Ciencias PolĂticas y SociologĂaFALSEsubmitte
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and lowâmiddle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of âsingle-useâ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for lowâmiddle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both highâ and lowâmiddleâincome countries
Intratumoral BO-112 in combination with radiotherapy synergizes to achieve CD8 T-cell-mediated local tumor control
BackgroundRadioimmunotherapy combines irradiation of tumor lesions with immunotherapy to achieve local and abscopal control of cancer. Most immunotherapy agents are given systemically, but strategies for delivering immunotherapy locally are under clinical scrutiny to maximize efficacy and avoid toxicity. Local immunotherapy, by injecting various pathogen-associated molecular patterns, has shown efficacy both preclinically and clinically. BO-112 is a viral mimetic based on nanoplexed double-stranded RNA (poly I:C) which exerts immune-mediated antitumor effects in mice and humans on intratumoral delivery. BO-112 and focal irradiation were used to make the proof-of-concept for local immunotherapy plus radiation therapy combinations.MethodsMurine transplantable tumor cell lines (TS/A, MC38 and B16-OVA) were used to show increased immunogenic features under irradiation, as well as in bilateral tumor models in which only one of the lesions was irradiated or/and injected with BO-112. Flow cytometry and multiplex tissue immunofluorescence were used to determine the effects on antitumor immunity. Depletions of immune cell populations and knockout mice for the IFNAR and BATF-3 genes were used to delineate the immune system requirements for efficacy.ResultsIn cultures of TS/A breast cancer cells, the combination of irradiation and BO-112 showed more prominent features of immunogenic tumor cell death in terms of calreticulin exposure. Injection of BO-112 into the tumor lesion receiving radiation achieved excellent control of the treated tumor and modest delays in contralateral tumor progression. Local effects were associated with more prominent infiltrates of antitumor cytotoxic tumor lymphocytes (CTLs). Importantly, local irradiation plus BO-112 in one of the tumor lesions that enhanced the therapeutic effects of radiotherapy on distant irradiated lesions that were not injected with BO-112. Hence, this beneficial effect of local irradiation plus BO-112 on a tumor lesion enhanced the therapeutic response to radiotherapy on distant non-injected lesions.ConclusionThis study demonstrates that local BO-112 immunotherapy and focal irradiation may act in synergy to achieve local tumor control. Irradiation plus BO-112 in one of the tumor lesions enhanced the therapeutic effects on distant irradiated lesions that were not injected with BO-112, suggesting strategies to treat oligometastatic patients with lesions susceptible to radiotherapy and with at least one tumor accessible for repeated BO-112 intratumoral injections
Abnormal functional connectivity in radiologically isolated syndrome: A resting-state fMRI study
Radiologically isolated syndrome (RIS) patients might have psychiatric and cognitive deficits, which suggests an involvement of major resting-state functional networks. Notwithstanding, very little is known about the neural networks involved in RIS.
Objective: To examine functional connectivity differences between RIS and healthy controls using resting-state functional magnetic resonance imaging (fMRI).
Methods: Resting-state fMRI data in 25 RIS patients and 28 healthy controls were analyzed using an independent component analysis; in addition, seed-based correlation analysis was used to obtain more information about specific differences in the functional connectivity of resting-state networks. Participants also underwent neuropsychological testing.
Results: RIS patients did not differ from the healthy controls regarding age, sex, and years of education. However, in memory (verbal and visuospatial) and executive functions, RIS patientsâ cognitive performance was significantly worse than the healthy controls. In addition, fluid intelligence was also affected. Twelve out of 25 (48%) RIS patients failed at least one cognitive test, and six (24.0%) had cognitive impairment. Compared to healthy controls, RIS patients showed higher functional connectivity between the default mode network and the right middle and superior frontal gyri and between the central executive network and the right thalamus (pFDR < 0.05; corrected). In addition, the seed-based correlation analysis revealed that RIS patients presented higher functional connectivity between the posterior cingulate cortex, an important hub in neural networks, and the right precuneus.
Conclusion: RIS patients had abnormal brain connectivity in major resting-state neural networks and worse performance in neurocognitive tests. This entity should be considered not an âincidental findingâ but an exclusively non-motor (neurocognitive) variant of multiple sclerosis.Depto. de PsicobiologĂa y MetodologĂa en Ciencias del ComportamientoFac. de PsicologĂaTRUEpu
Abnormal functional connectivity in radiologically isolated syndrome: A resting-state fMRI study
Background: Radiologically isolated syndrome (RIS) patients might have psychiatric and cognitive deficits, which suggests an involvement of major resting-state functional networks. Notwithstanding, very little is known about the neural networks involved in RIS. Objective: To examine functional connectivity differences between RIS and healthy controls using resting-state functional magnetic resonance imaging (fMRI). Methods: Resting-state fMRI data in 25 RIS patients and 28 healthy controls were analyzed using an independent component analysis; in addition, seed-based correlation analysis was used to obtain more information about specific differences in the functional connectivity of resting-state networks. Participants also underwent neuropsychological testing. Results: RIS patients did not differ from the healthy controls regarding age, sex, and years of education. However, in memory (verbal and visuospatial) and executive functions, RIS patientsâ cognitive performance was significantly worse than the healthy controls. In addition, fluid intelligence was also affected. Twelve out of 25 (48%) RIS patients failed at least one cognitive test, and six (24.0%) had cognitive impairment. Compared to healthy controls, RIS patients showed higher functional connectivity between the default mode network and the right middle and superior frontal gyri and between the central executive network and the right thalamus ( pFDR < 0.05; corrected). In addition, the seed-based correlation analysis revealed that RIS patients presented higher functional connectivity between the posterior cingulate cortex, an important hub in neural networks, and the right precuneus. Conclusion: RIS patients had abnormal brain connectivity in major resting-state neural networks and worse performance in neurocognitive tests. This entity should be considered not an âincidental findingâ but an exclusively non-motor (neurocognitive) variant of multiple sclerosis.National Institutes of Health (EEUU)European CommissionMinisterio de EconomĂa y Competitividad (España)Ministerio de Ciencia e InnovaciĂłn (España)Depto. de PsicobiologĂa y MetodologĂa en Ciencias del ComportamientoDepto. de PsicologĂa Experimental, Procesos Cognitivos y LogopediaDepto. de MedicinaFac. de PsicologĂaFac. de MedicinaTRUEpu
Jornadas Nacionales de RobĂłtica y BioingenierĂa 2023: Libro de actas
Las Jornadas de RobĂłtica y BioingenierĂa de 2023 tienen lugar en la Escuela TĂ©cnica Superior de IngenierĂa Industrial de la Universidad PolitĂ©cnica de IVIadrid, entre los dĂas 14 y 16 de junio de 2023. En este evento propiciado por el ComitĂ© Español de AutomĂĄtica (CEA) tiene lugar la celebraciĂłn conjunta de las XII Jornadas Nacionales de RobĂłtica y el XIV Simposio CEA de BioingenierĂa.
Las Jornadas Nacionales de RobĂłtica es un evento promovido por el Grupo TemĂĄtico de RobĂłtica (GTRob) de CEA para dar visibilidad y mostrar las actividades desarrolladas en el ĂĄmbito de la investigaciĂłn y transferencia tecnolĂłgica en robĂłtica. Asimismo, el propĂłsito de Simposio de BioingenierĂa, que cumple ahora su decimocuarta dicciĂłn, es el de proporcionar un espacio de encuentro entre investigadores, desabolladores, personal clĂnico, alumnos, industriales, profesionales en general e incluso usuarios que realicen su actividad en el ĂĄmbito de la bioingenierĂa. Estos eventos se han celebrado de forma conjunta en la anualidad 2023.
Esto ha permitido aunar y congregar un elevado nĂșmero de participantes tanto de la temĂĄtica robĂłtica como de bioingenierĂa (investigadores, profesores, desabolladores y profesionales en general), que ha posibilitado establecer puntos de encuentro, sinergias y colaboraciones entre ambos.
El programa de las jornadas aĂșna comunicaciones cientĂficas de los Ășltimos resultados de investigaciĂłn obtenidos, por los grupos a nivel español mĂĄs representativos dentro de la temĂĄtica de robĂłtica y bioingenierĂa, asĂ como mesas redondas y conferencias en las que se debatirĂĄn los temas de mayor interĂ©s en la actualidad.
En relaciĂłn con las comunicaciones cientĂficas presentadas al evento, se ha recibido un total de 46 ponencias, lo que sin duda alguna refleja el alto interĂ©s de la comunidad cientĂfica en las Jornadas de RobĂłtica y BioingenierĂa. Estos trabajos serĂĄn expuestos y presentados a lo largo de un total de 10 sesiones, distribuidas durante los diferentes dĂas de las Jornadas. Las temĂĄticas de los trabajos cubren los principales retos cientĂficos relacionados con la robĂłtica y la bioingenierĂa: robĂłtica aĂ©rea, submarina, terrestre, percepciĂłn del entorno, manipulaciĂłn, robĂłtica social, robĂłtica mĂ©dica, teleoperaciĂłn, procesamiento de señales biolĂłgicos, neurorehabilitaciĂłn etc.
Confiamos, y estamos seguros de ello, que el desarrollo de las jornadas sea completamente productivo no solo para los participantes en las Jornadas que podrĂĄn establecer nuevos lazos y relaciones fructĂferas entre los diferentes grupos, sino tambiĂ©n aquellos investigadores que no hayan podido asistir. Este documento que integra y recoge todas las comunicaciones cientĂficas permitirĂĄ un anĂĄlisis mĂĄs detallado de cada una de las mismas
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
Background
Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks.
Methods
The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned.
Results
A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31).
Conclusion
Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)