An institutional perspective on the impact of recent antibiotic exposure on length of stay and hospital costs for patients with gram-negative sepsis

Carta a Alfonso Sastre Pascual Serrano Pero ¿qué pasa con los intelectuales? (para mi amigo Pascual Serrano) Alfonso Sastre Una reflexión necesaria Pascual Serrano Carta a Alfonso Sastre y a Pascual Serrano, Octavio Rodríguez Araujo. La cobardía de los intelectuales, Carlo Frabetti. Los intelectuales y la apatía, Santiago Alba Ric

Algunos conceptos para la mejora de la rentabilidad en explotaciones cunícolas

La cunicultura no atraviesa por buenos momentos y la rentabilidad de muchas de las explotaciones españolas está cada vez más comprometida. En este trabajo se intenta conocer y razonar sobre algunas cuestiones generales que podrían contribuir a la mejora de la rentabilidad de las explotaciones cunícolas. El conocimiento sobre el origen de los ingresos y costes de nuestra explotación tanto fijos como variables es imprescindible a la hora de adoptar medidas adecuadas que contribuyan a mejorar la situación económica de nuestras explotaciones

Service for the pseudonymization of electronic healthcare records based on ISO/EN 13606 for the secondary use of information

The availability of electronic health data favors scientific advance through the creation of repositories for secondary use. Data anonymization is a mandatory step to comply with current legislation. A service for the pseudonymization of electronic healthcare record (EHR) extracts aimed at facilitating the exchange of clinical information for secondary use in compliance with legislation on data protection is presented. According to ISO/TS 25237, pseudonymization is a particular type of anonymization. This tool performs the anonymizations by maintaining three quasi-identifiers (gender, date of birth and place of residence) with a degree of specification selected by the user. The developed system is based on the ISO/EN 13606 norm using its characteristics specifically favorable for anonymization. The service is made up of two independent modules: the demographic server and the pseudonymizing module. The demographic server supports the permanent storage of the demographic entities and the management of the identifiers. The pseudonymizing module anonymizes the ISO/EN 13606 extracts. The pseudonymizing process consists of four phases: the storage of the demographic information included in the extract, the substitution of the identifiers, the elimination of the demographic information of the extract and the elimination of key data in free-text fields. The described pseudonymizing system was used in three Telemedicine research projects with satisfactory results. A problem was detected with the type of data in a demographic data field and a proposal for modification was prepared for the group in charge of the drawing up and revision of the ISO/EN 13606 norm

Enhanced optical frequency comb generation by pulsed gain-switching of optically injected semiconductor lasers

We report on the experimental generation of broad and flat optical frequency combs (OFC) in a 1550 nm laser diode using gain switching with pulsed electrical excitation together with optical injection. The combination of both techniques allows the generation of high-quality OFCs at a repetition frequency of 500 MHz, showing a low-noise optical spectrum with unprecedent features in terms of width (108 tones within 10 dB) and flatness (56 tones within 3 dB) in comparison with those previously reported for this modulation frequency. The influence of the injection conditions on the OFC quality is studied. Using these two techniques, it has been possible to reduce the separation between tones, generating high spectral performance OFCs with a repetition rateof 100 MHz.Ministerio de Economia y Competitividad of Spain (TEC201565212-C3-1-P, TEC201565212- C3-2-P)

Service Orchestration and Federation for Verticals

The next generation mobile transport networks shall transform into flexible and agile SDN/NFV-based transport and computing platforms, capable of simultaneously supporting the needs of different vertical industries, e.g., automotive, e-health and media, by meeting a diverse range of networking and computing requirements. Network slicing, has emerged as the most promising approach to address this challenge by enabling per-slice management of virtualized resources and provisioning and managing slices tailored to the needs of different vertical industries. Service orchestration is the key enabler for slicing that allows efficient placement of virtual network functions over the infrastructure as well as optimal allocation of virtual resources among all network slices to deliver guaranteed, reliable and scalable services of different verticals. Besides, due to the limited footprint of infrastructure operators, it is also required to enable the interconnection and federation of multiple administrative domains, to effectively allow services to span across several providers. This paper presents the design of Service Orchestrator (SO) in the 5G- TRANSFORMER system, which deals with service orchestration and federation across multiple domains.This work has been partially funded by the EU H2020 5G-TRANSFORMER Project (grant no. 761536

Supervivencia del injerto tras trasplante hepático: aproximación a un nuevo índice de riesgo español

Introducción: existen diversos indicadores para la valoración de la supervivencia del injerto hepático (DRI americano y ET-DRI europeo, entre otros), pero existen diferencias importantes entre los programas de trasplante de los diferentes países y podría ser que dichos indicadores no sean válidos en nuestro medio. Objetivos: el objetivo de este estudio es describir un nuevo indicador nacional de riesgo del injerto hepático a partir de los resultados del Registro Español de Trasplante Hepático (RETH) y validar el DRI y el ET-DRI. Metodología: el RETH incluye un análisis de Cox de los factores relacionados con la supervivencia del injerto. En base a sus resultados se define el indicador graft risk index (GRI). Las variables que contempla dependen del proceso de donación: edad, causa de muerte, compatibilidad sanguínea y tiempo de isquemia fría; y del receptor: edad, enfermedad de base, virus C, número de trasplante, estado UNOS y técnica quirúrgica. Se obtuvo la curva de la regresión logística y se calcularon las curvas de supervivencia del injerto por estratificación. La precisión se evaluó mediante el área ROC. Resultados: un GRI de 1 se corresponde con una probabilidad de pérdida del injerto del 23, 25%; cada punto de aumento del GRI supone que la probabilidad se multiplica por 1, 33. El GRI mostró la mejor discriminación por estratificación. El área ROC del DRI fue 0, 54 (95% IC, 0, 50-0, 59) y del ET-DRI, 0, 56 (95% IC, 0, 51-0, 61), frente al GRI 0, 70 (95% IC, 0, 65-0, 73) (p < 0, 0001). Conclusiones: el DRI y el ET-DRI no parecen útiles en nuestro medio y sería necesario disponer de un indicador propio. El GRI requiere un estudio nacional que perfile más el indicador y realice una validación más amplia. Introduction: several indicators are available to assess liver graft survival, including the American DRI and the European ET-DRI. However, there are significant differences between transplant programs of different countries, and the previously mentioned indicators might be not valid in our setting. Objectives: the aim of the study was to describe a new national liver graft risk indicator based on the results obtained from the Registro Espanol de Trasplante Hepatico (RETH) and to validate the DRI and ET-DRI indicators. Methods: the RETH includes a Cox analysis of factors associated with graft survival; the graft risk index (GRI) indicator was defined based on these results. The variables considered are dependent upon the donation conditions (age, cause of death, blood compatibility and cold ischemia time) and the transplant recipient (age, underlying disease, hepatitis C virus, transplant number, UNOS status and surgical technique). A logistic regression curve was obtained and graft survival curves were calculated by stratification. Precision was assessed using the ROC analysis. Results: a GRI of 1 represents a probability of graft loss of 23.25%; each point increase in the GRI score multiplies this probability by 1.33. The best discrimination of GRI was obtained by stratification.The DRI ROC area was 0.54 (95% CI, 0.50-0.59) and the ET-DRI ROC area was 0.56 (95% CI, 0.51-0.61), compared to 0.70 (95% CI, 0.65-0.73) (p < 0.0001) for the GRI. Conclusions: both the DRI and ET-DRI do not seem to be useful in our setting. Hence a national indicator is more desirable.The GRI requires a national study in order to further streamline and assess this indicator

Exploiting the potential of autophagy in cisplatin therapy: a new strategy to overcome resistance

Resistance to cisplatin is a major challenge in the current cancer therapy. In order to explore new therapeutic strategies to cisplatin resistance, we evaluated, in a model of lung cancer (H1299 and H460 cell lines), the nature of the pathways leading to cell death. We observed that H1299 displayed a natural resistance to cisplatin due to an inability to trigger an apoptotic response that correlates with the induction of autophagy. However, pharmacological and genetic approaches showed how autophagy was a mechanism associated to cell death rather than to resistance. Indeed, pro-autophagic stimuli such as mTOR or Akt inhibition mediate cell death in both cell lines to a similar extent. We next evaluated the response to a novel platinum compound, monoplatin, able to promote cell death in an exclusive autophagy-dependent manner. In this case, no differences were observed between both cell lines. Furthermore, in response to monoplatin, two molecular hallmarks of cisplatin response (p53 and MAPKs) were not implicated, indicating the ability of this pro-autophagic compound to overcome cisplatin resistance. In summary, our data highlight how induction of autophagy could be used in cisplatin resistant tumours and an alternative treatment for p53 mutated patient in a synthetic lethally approach