“CENTRO DE SIMULACION : UNA HERRAMIENTA PARA MEJORAR LA CALIDAD DE LA ENSEÑANZA DE MATERIAS CLINICAS EN MEDICINA.”

Las condiciones de la educación terciaria en las universidades publicas de Latinoamérica han ido empeorando a lo largo de los años. La elevada matricula, la falta de proyección de los países de sus necesidades de profesionales y los mermados presupuestos estatales han llevado a las instituciones a graves crisis. La Universidad de la Republica (Montevideo), no escapa a esta realidad que azota a la enseñanza terciaria en todo el continente. En este contexto la tradicional enseñanza de las materias clínicas en Medicina se ha resentido paulatinamente a medida que aumentan los problemas locativos, disminuyen las horas docentes y aumenta el numero de estudiantes. En Ginecosbtetricia los problemas consecuentes a la masificación se agravan debido al tipo de pacientes al que los estudiantes deben entrevistar. En este punto el tratar de mantener la ética en la atención médico paciente afectan el proceso de aprendizaje. El presente proyecto implementa la creación de un centro de simulación, e introduce el uso de simuladores al tradicional sistema de enseñanza. El utilizar nuevas estrategias tiene como objetivo generar un cambio de mentalidad en el proceso enseñanza aprendizaje. En el transcurso del siguiente curso del ciclo materno infantil, penúltimo año de la carrera de Doctor en Medicina se implementara la pasantía de los estudiantes por un centro de simulación ginecobstetrica donde se los entrenara en maniobras clínicas semiológicas. Se dividirán los estudiantes en forma aleatorizada en dos grupos, uno de ellos realizara su entrenamiento en el centro de simulación y el otro el curso normal. El entrenamiento del grupo se ejecutara en etapas y se utilizaran: guías clínicas estandarizadas y, los simuladores. Se realizara el seguimiento del aprendizaje por medio de planillas de verificación. Luego del entrenamiento los instructores habilitaran al estudiante a la practica con los pacientes. Mediante la aplicación del método de OSCE, se evaluará la adquisición de destrezas y el manejo clínico en ambos grupos de estudiantes. Esta evaluación inicial nos permitirá objetivar si realmente la implementación de este sistema mejora la calidad y adquisición de los conocimientos y destrezas

Development of a Digitally Controlled Inductive Power Transfer System with Post-Regulation for Variable Load Demand

none6noInductive Power Transfer (IPT) is an emerging technology enabling a contactless charging process in manifold applications such as electric vehicles, wearable and portable devices, or biomedical applications. Such technology can be profitably used to develop enhanced electronic solutions in the framework of smart cities, homes and smart workplaces. This paper presents the development and realization of a series–series compensated IPT System (IPTS) followed by a post-regulator implemented by means of a DC–DC converter. Such a system is modeled through a first harmonic approximation method, and a sensitivity analysis of the IPTS performance is carried out with respect to the variations of the primary inverter switching frequency and phase-shift angle. As an element of novelty of this work, the bias points are determined which allow the efficiency maximization while ensuring system controllability. An enhanced dynamic modeling of the system is then performed by means of a coupled mode theory, including the inverter phase-shift modulation and extending its validity to whatever operating frequency. A digital control of the post-regulator is implemented by means of a commercial low-cost microcontroller enabling the output voltage regulation under both fixed and variable load conditions through a voltage mode control technique. An IPTS prototype is eventually realized, which is able to correctly perform the output voltage regulation at the desired nominal value of 12 V for static resistive loads in the range [5, 24] W, yielding the output power in the range [6, 28.8]Wand the experimental efficiencies going from 72.1% (for 24 W) to 91.7% (for 5 W). The developed system can also be effectively used to deliver up to 35Woutput power to variable loads, as demonstrated during the battery charging test. Finally, an excellent output voltage regulation is ascertained for load transients between 5 W and 24 W, with limited over- and undershoot amplitudes (less than 3% of the nominal output voltage), thus enabling the use of the proposed system for both fixed and variable loads in the framework of smart homes and workplaces applications.openKateryna Stoyka, Antonio Vitale, Massimo Costarella, Alfonso Avella, Mario Pucciarelli, Paolo ViscontiStoyka, Kateryna; Vitale, Antonio; Costarella, Massimo; Avella, Alfonso; Pucciarelli, Mario; Visconti, Paol

The Platelet-derived Growth Factor Controls c-myc Expression through a JNK- and AP-1-dependent Signaling Pathway *

Pro-inflammatory cytokines, environmental stresses, as well as receptor tyrosine kinases regulate the activity of JNK. In turn, JNK phosphorylates Jun members of the AP-1 family of transcription factors, thereby controlling processes as different as cell growth, differentiation, and apoptosis. Still, very few targets of the JNK-Jun pathway have been identified. Here we show that JNK is required for the induction of c-myc expression by PDGF. Furthermore, we identify a phylogenetically conserved AP-1-responsive element in the promoter of the c-myc proto-oncogene that recruits in vivo the c-Jun and JunD AP-1 family members and controls the PDGF-dependent transactivation of the c-myc promoter. These findings suggest the existence of a novel biochemical route linking tyrosine kinase receptors, such as those for PDGF, and c-myc expression through JNK activation of AP-1 transcription factors. They also provide a novel potential mechanism by which both JNK and Jun proteins may exert either their proliferative or apoptotic potential by stimulating the expression of the c-myc proto-oncogene

Effects of liming on soil properties, leaf tissue cation composition and grape yield in a moderately acid vineyard soil. Influence on must and wine quality

[EN] Aims: Soil acidity decreases soil fertility and grapevine growth. Aluminum toxicity has been recognized as one of the most common causes of reduced grape yields in acid vineyard soils. The main aim of this study was to evaluate the effect of two liming materials, i.e. dolomitic lime and sugar foam, on a vineyard cultivated in an acid soil. Methods and results: The effects were studied in two soil layers (0-30 and 30-60 cm), as well as on leaf nutrient contents, grape yield, and must and wine quality properties, in a vineyard dedicated to Vitis vinifera L. cv. Mencía cultivation. The data management and analysis were carried out using ANOVA. Conclusion: Sugar foam was more efficient than dolomitic limestone as liming material since it induced the highest decrease in soil acidity properties at the same calcium carbonate equivalent dose. Effects of liming on leaf nutrient contents, grape yield, and must and wine quality properties were barely observed. Significance and impact of the study: Until recently, little was known about the effects of liming on both vine nutritional status and must/wine quality properties. Thus, this research fills an important knowledge gap.SIThis work was funded by the “Excelentísima Diputación Provincial de León”. We are specially grateful to “Losada Vinos de Finca, S.A.” for assistance in the research project

Indagini limnologiche nell\u27area antistante la foce del Torrente San Bernardino (sopralluogo del 14 giugno 2010)

No abstract availabl

Survival after Locoregional Treatments for Hepatocellular Carcinoma: A Cohort Study in Real-World Patients

Evidence of relative effectiveness of local treatments for hepatocellular carcinoma (HCC) is scanty. We investigated, in a retrospective cohort study, whether surgical resection, radiofrequency ablation (RFA), percutaneous ethanol injection (PEI), and transarterial embolization with (TACE) or without (TAE) chemotherapy resulted in different survival in clinical practice. All patients first diagnosed with HCC and treated with any locoregional therapy from 1998 to 2002 in twelve Italian hospitals were eligible. Overall survival (OS) was the unique endpoint. Three main comparisons were planned: RFA versus PEI, surgical resection versus RFA/PEI (combined), TACE/TAE versus RFA/PEI (combined). Propensity score method was used to minimize bias related to non random treatment assignment. Overall 425 subjects were analyzed, with 385 (91%) deaths after a median followup of 7.7 years. OS did not significantly differ between RFA and PEI (HR 1.11, 95% CI 0.79–1.57), between surgery and RFA/PEI (HR 0.95, 95% CI 0.64–1.41) and between TACE/TAE and RFA/PEI (HR 0.88, 95% CI 0.66–1.17). 5-year OS probabilities were 0.14 for RFA, 0.18 for PEI, 0.27 for surgery, and 0.15 for TACE/TAE. No locoregional treatment for HCC was found to be more effective than the comparator. Adequately powered randomized clinical trials are still needed to definitely assess relative effectiveness of locoregional HCC treatment

A reference map of potential determinants for the human serum metabolome

The serum metabolome contains a plethora of biomarkers and causative agents of various diseases, some of which are endogenously produced and some that have been taken up from the environment(1). The origins of specific compounds are known, including metabolites that are highly heritable(2,3), or those that are influenced by the gut microbiome(4), by lifestyle choices such as smoking(5), or by diet(6). However, the key determinants of most metabolites are still poorly understood. Here we measured the levels of 1,251 metabolites in serum samples from a unique and deeply phenotyped healthy human cohort of 491 individuals. We applied machine-learning algorithms to predict metabolite levels in held-out individuals on the basis of host genetics, gut microbiome, clinical parameters, diet, lifestyle and anthropometric measurements, and obtained statistically significant predictions for more than 76% of the profiled metabolites. Diet and microbiome had the strongest predictive power, and each explained hundreds of metabolites-in some cases, explaining more than 50% of the observed variance. We further validated microbiome-related predictions by showing a high replication rate in two geographically independent cohorts(7,8) that were not available to us when we trained the algorithms. We used feature attribution analysis(9) to reveal specific dietary and bacterial interactions. We further demonstrate that some of these interactions might be causal, as some metabolites that we predicted to be positively associated with bread were found to increase after a randomized clinical trial of bread intervention. Overall, our results reveal potential determinants of more than 800 metabolites, paving the way towards a mechanistic understanding of alterations in metabolites under different conditions and to designing interventions for manipulating the levels of circulating metabolites.The levels of 1,251 metabolites are measured in 475 phenotyped individuals, and machine-learning algorithms reveal that diet and the microbiome are the determinants with the strongest predictive power for the levels of these metabolites

Correction to:Yoghurt consumption is associated with changes in the composition of the human gut microbiome and metabolome (BMC Microbiology, (2022), 22, 1, (39), 10.1186/s12866-021-02364-2)

Following the publication of the original paper [1], there’s an error on the first name of one of the authors. Mureil Derrien should be Muriel Derrien. Correct name is shown in the author group section above. The original article has been corrected

Dysregulated Antibody, Natural Killer Cell and Immune Mediator Profiles in Autoimmune Thyroid Diseases.

Funder: FP7 Ideas: European Research Council; Grant(s): 278535, 305280, 324400, 315997The pathogenesis of autoimmune thyroid diseases (AITD) is poorly understood and the association between different immune features and the germline variants involved in AITD are yet unclear. We previously observed systemic depletion of IgG core fucosylation and antennary α1,2 fucosylation in peripheral blood mononuclear cells in AITD, correlated with anti-thyroid peroxidase antibody (TPOAb) levels. Fucose depletion is known to potentiate strong antibody-mediated NK cell activation and enhanced target antigen-expressing cell killing. In autoimmunity, this may translate to autoantibody-mediated immune cell recruitment and attack of self-antigen expressing normal tissues. Hence, we investigated the crosstalk between immune cell traits, secreted proteins, genetic variants and the glycosylation patterns of serum IgG, in a multi-omic and cross-sectional study of 622 individuals from the TwinsUK cohort, 172 of whom were diagnosed with AITD. We observed associations between two genetic variants (rs505922 and rs687621), AITD status, the secretion of Desmoglein-2 protein, and the profile of two IgG N-glycan traits in AITD, but further studies need to be performed to better understand their crosstalk in AITD. On the other side, enhanced afucosylated IgG was positively associated with activatory CD335- CD314+ CD158b+ NK cell subsets. Increased levels of the apoptosis and inflammation markers Caspase-2 and Interleukin-1α positively associated with AITD. Two genetic variants associated with AITD, rs1521 and rs3094228, were also associated with altered expression of the thyrocyte-expressed ligands known to recognize the NK cell immunoreceptors CD314 and CD158b. Our analyses reveal a combination of heightened Fc-active IgG antibodies, effector cells, cytokines and apoptotic signals in AITD, and AITD genetic variants associated with altered expression of thyrocyte-expressed ligands to NK cell immunoreceptors. Together, TPOAb responses, dysregulated immune features, germline variants associated with immunoactivity profiles, are consistent with a positive autoreactive antibody-dependent NK cell-mediated immune response likely drawn to the thyroid gland in AITD