Persistent Tracheostomy after Organ Preservation Protocol in Patients Treated for Larynx and Hypopharynx Cancer

Introduction  Squamous cell carcinoma of the larynx is currently the second most common malignancy of the airway after lung cancer, and hypopharyngeal cancer accounts for fewer than 5% of head and neck cancers. The nonsurgical options for patients with this disease are related to significant long-term toxicities and the need for persistent tracheostomy, which adversely affects the quality of life of these patients. Objective  To evaluate the need for tracheostomy, and the influence of this in the overall and specific survival rates of patients diagnosed with all stages of laryngeal carcinoma treated by chemoradiotherapy. Methods  A retrospective study of patients diagnosed with laryngeal carcinoma was performed according to the criteria of the Union for International Cancer Control (UICC) and the American Joint Committee on Cancer (AJCC) 7th edition, in a tertiary hospital. Results  A total of 21 patients were evaluated, 8 patients required a tracheotomy (31%) during the treatment protocol, 7 (35%) men and 1 (100%) women. According to subsite 4/4 patient with glottis cancer (p ≤ 0.001), 2/10 patients with supra glottis cancer and 2/7 patients with hypopharyngeal cancer. During follow up, just in 1 patient was possible to close the tracheostomy. Conclusion  Persistent tracheostomy dependence after primary chemoradiation increases significantly the morbidity, and decreases the quality of life of those patients. Patients with glottis cancer are prone to need a tracheostomy, but no statistical difference regarding the oncological stage and the need for a tracheostomy were detected. A more thorough selection of the patients is needed to improve the quality of life and reduce permanent tracheostomy dependence

Accessibility Indicators for the Assessment of Cultural Heritage as a Resource for Development in Rural Areas of Huelva

La recent reconceptualització del patrimoni cultural com a instrument i mig per al desenvolupament sostenible comporta la necessitat d'implementar eines capaces de mesurar, en termes qualitatius i quantitatius, diversos aspectes sobre la gestió dels béns i elements patrimonials de caràcter territorial. L'objectiu fonamental d'aquest treball és el de desenvolupar una eina que permeti, a través d'aplicacions de sistemes d'informació geogràfica, contribuir a la identificació del patrimoni cultural com a recurs de desenvolupament en un context d'equilibri territorial. Així, es defensa que, a major accessibilitat, entesa en totes les formes contemplades en el disseny metodològic que es presenta, major contribució permeten els béns culturals al desenvolupament sostenible d'àmbits rurals. Per a això, s'han dissenyat i desenvolupat indicadors específics sobre accessibilitat geogràfica (travel cost), accés territorial (propietat i ús del sòl), patrimoni en xarxa i accés digital, per a cadascun dels quals s'han distingit quatre nivells. Posteriorment, han estat aplicats a un conjunt d'elements del patrimoni immoble i immaterial de dues àrees rurals d'Andalusia, Espanya: Andévalo occidental i Sierra de Huelva. Els resultats obtinguts ofereixen conclusions útils com a suport per als processos de presa de decisions sobre patrimoni territorial en aquesta mena d'àmbits, extrapolables a altres estudis amb característiques similars.The recent reconceptualization of cultural heritage as an instrument and means for sustainable development entails the need for implementing tools capable of measuring, in qualitative and quantitative terms, various aspects of the management of heritage assets and elements in the territory. The main objective of this work is to develop a tool that allows, through Geographic Information Systems applications, to contribute to the identification of cultural heritage as a development resource in a context of territorial balance. Thus, it is argued that the greater the accessibility, understood in all the forms contemplated in the methodological design presented, the greater the contribution of cultural assets to the sustainable development of rural areas. To this end, specific indicators have been designed and developed on geographical accessibility (travel cost), territorial access (land ownership and use), networked heritage, and digital access). For each one of these, four levels have been distinguished. Subsequently, they have been applied to a set of elements of the immovable and intangible heritage of two rural areas in Andalusia, Spain: western Andévalo and Sierra de Huelva. The results obtained offer useful conclusions as support for decision-making processes on territorial heritage in this type of area, which can be extrapolated to other studies with similar characteristics.La reciente reconceptualización del patrimonio cultural como instrumento y medio para el desarrollo sostenible conlleva la necesidad de implementar herramientas capaces de medir, en términos cualitativos y cuantitativos, diversos aspectos sobre la gestión de los bienes y elementos patrimoniales de carácter territorial. El objetivo fundamental de este trabajo es el de desarrollar una herramienta que permita, a través de aplicaciones de sistemas de información geográfica, contribuir a la identificación del patrimonio cultural como recurso de desarrollo en un contexto de equilibrio territorial. Así, se defiende que, a mayor accesibilidad, entendida en todas las formas contempladas en el diseño metodológico que se presenta, mayor contribución permiten los bienes culturales al desarrollo sostenible de ámbitos rurales. Para ello, se han diseñado y desarrollado indicadores específicos sobre accesibilidad geográfica (travel cost), acceso territorial (propiedad y uso del suelo), patrimonio en red y acceso digital, para cada uno de los cuales se han distinguido cuatro niveles. Posteriormente, han sido aplicados a un conjunto de elementos del patrimonio inmueble e inmaterial de dos áreas rurales de Andalucía, España: Andévalo occidental y Sierra de Huelva. Los resultados obtenidos ofrecen conclusiones útiles como soporte para los procesos de toma de decisiones sobre patrimonio territorial en este tipo de ámbitos, extrapolables a otros estudios con características similares.Peer Reviewe

Optimization of NIR Spectral Data Management for Quality Control of Grape Bunches during On-Vine Ripening

NIR spectroscopy was used as a non-destructive technique for the assessment of chemical changes in the main internal quality properties of wine grapes (Vitis vinifera L.) during on-vine ripening and at harvest. A total of 363 samples from 25 white and red grape varieties were used to construct quality-prediction models based on reference data and on NIR spectral data obtained using a commercially-available diode-array spectrophotometer (380–1,700 nm). The feasibility of testing bunches of intact grapes was investigated and compared with the more traditional must-based method. Two regression approaches (MPLS and LOCAL algorithms) were tested for the quantification of changes in soluble solid content (SSC), reducing sugar content, pH-value, titratable acidity, tartaric acid, malic acid and potassium content. Cross-validation results indicated that NIRS technology provided excellent precision for sugar-related parameters (r2 = 0.94 for SSC and reducing sugar content) and good precision for acidity-related parameters (r2 ranging between 0.73 and 0.87) for the bunch-analysis mode assayed using MPLS regression. At validation level, comparison of LOCAL and MPLS algorithms showed that the non-linear strategy improved the predictive capacity of the models for all study parameters, with particularly good results for acidity-related parameters and potassium content

Las unidades del discurso oral. La propuesta Val.Es.Co. de segmentación de la conversación (coloquial)

El presente artículo resume y examina críticamente la propuesta de segmentación del discurso realizada en Briz y Grupo Val.Es.Co (2003). El modelo Val.Es.Co. consta de ocho unidades (discurso, diálogo, intercambio/ alternancia de turnos, intervención/turno, acto y subacto), tres órdenes (social, estructural e informativo) y cuatro posiciones (inicial, media, final e independiente); se caracteriza, además, por ser jerárquico y recursivo. La aplicación del modelo Val.Es.Co. permite la segmentación de una conversación coloquial sin residuos, así como un adecuado tratamiento de diversos fenómenos conversacionales (actos truncados, solapamientos, elementos suprasegmentales o marcadores discursivos)This paper summarizes and critically reviews the model of discourse segmentation made by Briz and Grupo Val.Es.Co (2003). This model is made up of eight units (discourse, dialogue, exchange/ turn taking, intervention/turn, act and subact), three orders (social, structural and informative) and four positions (initial, medial, final and independent). The Val.Es.Co model is also hyerarchical and recursive. By applying the Val.Es.Co model, a conversation can be divided into parts and subparts without any element remaining unanalyzed. Also, some specific features occurring in conversations such as false starts, overlappings, the segmentation value of prosodic features or discourse markers, can be successfully analyze

The Antimicrobials Anacardic Acid and Curcumin Are Not-Competitive Inhibitors of Gram-Positive Bacterial Pathogenic Glyceraldehyde-3-Phosphate Dehydrogenase by a Mechanism Unrelated to Human C5a Anaphylatoxin Binding

The ubiquitous and highly abundant glycolytic enzyme D-glyceraldehyde-3-phosphate dehydrogenase (GAPDH) is pivotal for the energy and carbon metabolism of most organisms, including human pathogenic bacteria. For bacteria that depend mostly on glycolysis for survival, GAPDH is an attractive target for inhibitor discovery. The availability of high-resolution structures of GAPDH from various pathogenic bacteria is central to the discovery of new antibacterial compounds. We have determined the X-ray crystal structures of two new GAPDH enzymes from Gram-positive bacterial pathogens, Streptococcus pyogenes and Clostridium perfringens. These two structures, and the recent structure of Atopobium vaginae GAPDH, reveal details in the active site that can be exploited for the design of novel inhibitors based on naturally occurring molecules. Two such molecules, anacardic acid and curcumin, have been found to counter bacterial infection in clinical settings, although the cellular targets responsible for their antimicrobial properties remain unknown. We show that both anacardic acid and curcumin inhibit GAPDH from two bacterial pathogens through uncompetitive and non-competitive mechanisms, suggesting GAPDH as a relevant pharmaceutical target for antibacterial development. Inhibition of GAPDH by anacardic acid and curcumin seems to be unrelated to the immune evasion function of pathogenic bacterial GAPDH, since neither natural compound interfere with binding to the human C5a anaphylatoxin

Osimertinib in advanced EGFR-T790M mutation-positive non-small cell lung cancer patients treated within the Special Use Medication Program in Spain : OSIREX-Spanish Lung Cancer Group

AURA study reported 61% objective response rate and progression-free survival of 9.6 months with osimertinib in patients with EGFR/T790M+ non-small cell lung cancer. Due to lack of real-world data, we proposed this study to describe the experience with osimertinib in Spain. Post-authorization, non-interventional Special Use Medication Program, multicenter, retrospective study in advanced EGFR/T790M+ non-small cell lung cancer. One hundred-fifty five patients were enrolled (August 2016-December 2018) from 30 sites. Primary objective: progression-free survival. Secondary objectives: toxicity profile, objective response rate, and use of health service resources. 70% women, median age 66. 63.9% were non-smokers and 99% had adenocarcinoma. Most patients had received at least one prior treatment (97%), 91.7% had received previous EGFR-tyrosine kinase inhibitors and 2.8% osimertinib as first-line treatment. At data cutoff, median follow-up was 11.8 months. One hundred-fifty five patients were evaluable for response, 1.3% complete response, 40.6% partial response, 31% stable disease and 11.6% disease progression. Objective response rate was 42%. Median progression-free survival was 9.4 months. Of the 155 patients who received treatment, 76 (49%) did not reported any adverse event, 51% presented some adverse event, most of which were grade 1 or 2. The resource cost study indicates early use is warranted. This study to assess the real-world clinical impact of osimertinib showed high drug activity in pretreated advanced EGFR/T790M+ non-small cell lung cancer, with manageable adverse events. Clinical trial registration number : NCT03790397

Accuracy and Survival Outcomes after National Implementation of Sentinel Lymph Node Biopsy in Early Stage Endometrial Cancer

Background. Sentinel lymph node (SLN) biopsy has recently been accepted to evaluate nodal status in endometrial cancer at early stage, which is key to tailoring adjuvant treatments. Our aim was to evaluate the national implementation of SLN biopsy in terms of accuracy to detect nodal disease in a clinical setting and oncologic outcomes according to the volume of nodal disease. Patients and Methods. A total of 29 Spanish centers participated in this retrospective, multicenter registry including patients with endometrial adenocarcinoma at preoperative early stage who had undergone SLN biopsy between 2015 and 2021. Each center collected data regarding demographic, clinical, histologic, therapeutic, and survival characteristics. Results. A total of 892 patients were enrolled. After the surgery, 12.9% were suprastaged to FIGO 2009 stages III-IV and 108 patients (12.1%) had nodal involvement: 54.6% macrometastasis, 22.2% micrometastases, and 23.1% isolated tumor cells (ITC). Sensitivity of SLN biopsy was 93.7% and false negative rate was 6.2%. After a median follow up of 1.81 years, overall surivial and disease-free survival were significantly lower in patients who had macrometastases when compared with patients with negative nodes, micrometastases or ITC. Conclusions. In our nationwide cohort we obtained high sensitivity of SLN biopsy to detect nodal disease. The oncologic outcomes of patients with negative nodes and low-volume disease were similar after tailoring adjuvant treatments. In total, 22% of patients with macrometastasis and 50% of patients with micrometastasis were at low risk of nodal metastasis according to their preoperative risk factors, revealing the importance of SLN biopsy in the surgical management of patients with early stage EC

Detectives de alimentos: un trabajo en equipo para la investigación de toxiinfecciones alimentarias

Proyecto de Innovación Docente en el que los estudiantes realizan un trabajo cooperativo mediante el método del puzle para diseñar fichas descriptivas de patógenos de transmisión alimentaria y resolver un caso de toxiinfección alimentari

re-habitar El Carmen : Un proyecto sobre patrimonio contemporáneo

El proyecto _re-HABITAR suponía para el propio proceder de la institución un avance más allá del reconocimiento, registro, inventario o protección patrimonial de la arquitectura del siglo XX y del Movimiento Moderno para posicionarse en la acción preventiva y conservativa de ese legado contemporáneo. Para ello, la praxis patrimonial se aferraba a un modelo: el de la vivienda social en España en la segunda mitad del siglo XX; a un caso concreto: el de la barriada de Nuestra Señora del Carmen (Recasens Méndez-Queipo de Llano, 1958); y a un requisito fundamental: analizar un objeto vivo y en uso, aún con la presencia de quienes lo vivieron y usaron desde su origen

A communal catalogue reveals Earth's multiscale microbial diversity

Our growing awareness of the microbial world's importance and diversity contrasts starkly with our limited understanding of its fundamental structure. Despite recent advances in DNA sequencing, a lack of standardized protocols and common analytical frameworks impedes comparisons among studies, hindering the development of global inferences about microbial life on Earth. Here we present a meta-analysis of microbial community samples collected by hundreds of researchers for the Earth Microbiome Project. Coordinated protocols and new analytical methods, particularly the use of exact sequences instead of clustered operational taxonomic units, enable bacterial and archaeal ribosomal RNA gene sequences to be followed across multiple studies and allow us to explore patterns of diversity at an unprecedented scale. The result is both a reference database giving global context to DNA sequence data and a framework for incorporating data from future studies, fostering increasingly complete characterization of Earth's microbial diversity.Peer reviewe