Nextmed: Automatic Imaging Segmentation, 3D Reconstruction, and 3D Model Visualization Platform Using Augmented and Virtual Reality

The visualization of medical images with advanced techniques, such as augmented reality and virtual reality, represent a breakthrough for medical professionals. In contrast to more traditional visualization tools lacking 3D capabilities, these systems use the three available dimensions. To visualize medical images in 3D, the anatomical areas of interest must be segmented. Currently, manual segmentation, which is the most commonly used technique, and semi-automatic approaches can be time consuming because a doctor is required, making segmentation for each individual case unfeasible. Using new technologies, such as computer vision and artificial intelligence for segmentation algorithms and augmented and virtual reality for visualization techniques implementation, we designed a complete platform to solve this problem and allow medical professionals to work more frequently with anatomical 3D models obtained from medical imaging. As a result, the Nextmed project, due to the different implemented software applications, permits the importation of digital imaging and communication on medicine (dicom) images on a secure cloud platform and the automatic segmentation of certain anatomical structures with new algorithms that improve upon the current research results. A 3D mesh of the segmented structure is then automatically generated that can be printed in 3D or visualized using both augmented and virtual reality, with the designed software systems. The Nextmed project is unique, as it covers the whole process from uploading dicom images to automatic segmentation, 3D reconstruction, 3D visualization, and manipulation using augmented and virtual reality. There are many researches about application of augmented and virtual reality for medical image 3D visualization; however, they are not automated platforms. Although some other anatomical structures can be studied, we focused on one case: a lung study. Analyzing the application of the platform to more than 1000 dicom images and studying the results with medical specialists, we concluded that the installation of this system in hospitals would provide a considerable improvement as a tool for medical image visualization

A new role for circulating T follicular helper cells in humoral response to anti-PD-1 therapy

Background Lung cancer is one of the most frequent malignancies in humans and is a major cause of death. A number of therapies aimed at reinforcing antitumor immune response, including antiprogrammed cell death protein 1 (anti-PD-1) antibodies, are successfully used to treat several neoplasias as non-small cell lung cancer (NSCLC). However, host immune mechanisms that participate in response to anti-PD-1 therapy are not completely understood. Methods We used a syngeneic immunocompetent mouse model of NSCLC to analyze host immune response to anti-PD-1 treatment in secondary lymphoid organs, peripheral blood and tumors, by flow cytometry, immunohistochemistry and quantitative real-time PCR (qRT-PCR). In addition, we also studied specific characteristics of selected immune subpopulations in ex vivo functional assays. Results We show that anti-PD-1 therapy induces a population of circulating T follicular helper cells (cTfh) with enhanced B activation capacity, which participates in tumor response to treatment. Anti-PD-1 increases the number of tertiary lymphoid structures (TLS), which correlates with impaired tumor growth. Of note, TLS support cTfh-associated local antibody production, which participates in host immune response against tumor. Conclusion These findings unveil a novel mechanism of action for anti-PD-1 therapy and provide new targets for optimization of current therapies against lung cancer.This work was supported by grants to AA: FIS PI15/01491 and CIBER CARDIOVASCULAR from the Instituto de Salud Carlos III (Fondo de Investigación Sanitaria del Instituto de Salud Carlos III with co-funding from the Fondo Europeo de Desarrollo Regional; FEDER

Factores de riesgo asociados a la seroprevalencia de lentivirus en rebaños ovinos y caprinos del noreste de México

A cross-sectional study was conducted with the purpose of determinate the risk factors associated with the serological frequency of small ruminant lentivirus (SRLV) in sheep and goats from northeastern Mexico. From 128 herds, 71 of goats, 32 of sheep and 25 mixed herds (goats + sheep), 768 individual sera were collected from animals ≥1 yr old. From each herd, 4 to 5 serum samples were mixed and analyzed by ELISA to identify antibodies against SRLV glycoprotein 135. Samples were obtained from randomly selected animals in 2019 and 2020. A questionnaire was applied to the producers and the data were analyzed to determine the risk factors associated with herd seropositivity by logistic regression. The proportion of seropositive herds, overall, was estimated at 50.6 %. According to the type of herd, seropositivity in goat herds was 62.0 %, in sheep herds 25.4 % and 50.2 % in mixed herds. The risk factors associated with the presence of antibodies against SRLV were the presence of animals with arthritis, veterinary care, reuse of needles, nerve alterations, low pregnancy rate, type of herd and mastitis. Serological frequency indicates a high endemicity of SRLV in small ruminant herds from northeastern Mexico.Se realizó un estudio transversal con el propósito de determinar los factores de riesgo asociados a la frecuencia serológica de Lentivirus de los pequeños rumiantes (LvPR) en ovinos y caprinos del noreste de México. De 128 rebaños, 71 de caprinos, 32 de ovinos y 25 mixtos (caprinos + ovinos), se recolectaron 768 sueros individuales de animales ≥1 año de edad. De cada rebaño 4 a 5 muestras de suero fueron mezcladas y analizadas por ELISA para identificar anticuerpos contra la glucoproteína 135 del LvPR. Las muestras se obtuvieron de animales seleccionados al azar en los años 2019 y 2020. Se aplicó un cuestionario a los productores y los datos se analizaron para determinar los factores de riesgo asociados a la seropositividad del rebaño mediante regresión logística. La proporción de rebaños seropositivos en general fue estimada en 50.6 %. Acorde al tipo de rebaño la seropositividad en rebaños caprinos fue de 62.0 %, en ovinos de 25.4 % y de 50.2 % en rebaños mixtos. Los factores de riesgo asociados a la presencia de anticuerpos contra el LvPR fueron presencia de animales con artritis, asistencia veterinaria, reutilizar agujas, alteraciones nerviosas, bajo índice de preñez, tipo de rebaño y mastitis. La frecuencia serológica indica una alta endemicidad del LvPR en rebaños de pequeños rumiantes del noreste de México

Temporal changes of NDVI for qualitative environmental assessment of mangroves: Shrimp farming impact on the health decline of the arid mangroves in the Gulf of California (1990-2010)

We assessed the temporal evolution of vegetation activity of mangroves in the Southeastern coastal of the Gulf of California (Mexico) through a multi-temporal analysis of Landsat TM images from 1990 to 2010 where time series of the Normalized Difference Vegetation Index (NDVI) were obtained. A multivariate regression analysis showed the presence of statistically significant negative trends of NDVI (low vegetation activity) in the coverage of mangrove forest, mangrove forest with pickleweed, and pickleweed; however, we did not found any meteorological variable (built time series of average minimum and maximum temperatures, and of accumulated rainfall) that controlled the observed trends. A pixel-by-pixel spatially distributed analysis of the temporal trends of NDVI, complemented by digitalization through photo interpretation of the shrimp farms present in the study area, showed a spatial relationship between the zones of greatest loss of vegetation activity (1990–2010) and the areas with greater proliferation of shrimp farms in the study area. Our study demonstrated the applicability of NDVI for the environmental assessment of mangroves. The relationship between changes in remote sensing indices and environmental variables allows for an efficient evaluation of the main environmental impacts, which can be used for coastal planning and management.The research was supported by the Mexican Secretary of Natural Resources and Environment (SEMARNAT-CONACYT; grant number SEMARNAT-2002-C01-0147). SM-B and RJM are students of Academic Program of Geoinformatics (UACJ).Peer Reviewe

Neumonía grave por infección con candida krusei: Reporte de caso

La neumonía por Candida Krusei es una patología rara, pero con reciente aumento de su incidencia. Se asocia a una alta mortalidad, y se presenta especialmente en pacientes inmunocomprometidos y pacientes geriátricos. El diagnóstico de esta entidad clínica es dificultoso debido a presentación clínica inespecífica. Presentamos el caso de un paciente de 90 años de edad, que debutó con cuadro respiratorio agudo, que no evolucionó de forma favorable tras la administración de antibióticos de amplio espectro, pero con remisión completa del cuadro clínico luego de la administración de voriconazol debido a la sospecha clínica de micosis pulmonar, y que posteriormente se llegó al diagnóstico definitivo de neumonía por Candida Krusei al confirmarse el crecimiento de este germen en cultivo de muestra de lavado broncoalveolar. El diagnóstico de neumonías por Candida se debe considerar en pacientes con sintomatología respiratoria especialmente en inmunocomprometidos y pacientes geriátricos. El tratamiento oportuno permitirá evitar complicaciones que pongan en riesgo la vida del paciente

Deletion of Wt1 during early gonadogenesis leads to differences of sex development in male and female adult mice

Assessing the role of the WT1 transcription factor (WT1) during early gonad differentiation and its impact on adult sex development has been difficult due to the complete gonadal agenesis and embryonic lethality exhibited by Wt1KO mouse models. Here, we generated Wt1LoxP/GFP;Wt1Cre mice, the first Wt1KO mouse model that reaches adulthood with a dramatically reduced Wt1 expression during early gonadogenesis. Wt1LoxP/GFP;Wt1Cre mice lacked mature gonads and displayed genital tracts containing both male and female genital structures and ambiguous genitalia. We found that WT1 is necessary for the activation of both male and female sex-determining pathways, as embryonic mutant gonads failed to upregulate the expression of the genes specific for each genetic programme. The gonads of Wt1LoxP/GFP;Wt1Cre mice showed a lack of production of Sertoli and pre-granulosa cells and a reduced number of germ cells. NR5A1 and the steroidogenic genes expression was modulated differently in XY and XX Wt1LoxP/GFP;Wt1Cre gonads, explaining the mutant phenotypes. Further studies of the XX Wt1LoxP/GFP;Wt1Cre gonads revealed that deletion of WT1 at an early stage impaired the differentiation of several cell types including somatic cells and the ovarian epithelium. Through the characterisation of this Wt1KO mouse model, we show that the deletion of Wt1 during early gonadogenesis produces dramatic defects in adult sex development

Perception about sexuality in university students

Sexuality is an essential aspect for human beings, its study includes terms such as: sex, gender identities and roles, eroticism, pleasure, intimacy, reproduction, and sexual orientation. This research was qualitative, descriptive, observational, and cross-sectional approach. The population was made up of 40 students over 18 years of age, who agreed to be part of the study and were enrolled in the Clinical Psychology major, Faculty of Health Sciences, National University of Chimborazo, Ecuador, in the year 2020. The data was collected through an interview. Among the participants, 67.5% belonged to the female gender, 92.5% declared themselves to be heterosexual sexual orientation, and 97.5% single. Most adequately conceptualized sexuality, with some confusion in its component categories. The environment marked by moral and religious myths generated repressed, discriminatory, and wrong thoughts and behaviors. Acceptance of sexuality was diffuse.La sexualidad es un aspecto esencial para los seres humanos, su estudio incluye términos tales como: sexo, identidades y papeles de género, erotismo, placer, intimidad, reproducción y orientación sexual. La investigación realizada tuvo un enfoque cualitativo, de tipo observacional descriptiva y corte transversal. La población estuvo conformada por 40 estudiantes mayores de 18 años, los que estuvieron emitieron su conformidad con ser parte del estudio y estaban matriculados en la carrera de Psicología Clínica, Facultad de Ciencias de la Salud, Universidad Nacional de Chimborazo, Ecuador, en el año 2020. La recolección de los datos fue mediante una entrevista. En los participantes, el 67,5% perteneció al género femenino, el 92,5% se declaró con orientación sexual heterosexual, 97,5% solteros/as. La mayoría conceptualizó adecuadamente la sexualidad, con algunas confusiones en categorías que lo componen. El ambiente marcado por mitos morales y religiosos generó pensamientos y conductas reprimidas, discriminatorias y equivocadas. La aceptación de la sexualidad se apreció difusa

Clinical follow-up of long nontapered sirolimus-eluting coronary stent in real-world patients with de novo lesions. The Billar registry

Introduction and objectives: Coronary lesions with stent overlapping are associated with higher neointimal proliferation that leads to more restenosis. Furthermore, the tapering of coronary arteries is a major challenge when treating long coronary lesions. This study attempted to assess the safety and clinical level of performance of long nontapered sirolimus-eluting coronary stent systems (> 36 mm) to treat long and diffused de novo coronary lesions in real-world scenarios. Methods: This was a prospective, non-randomized, multicentre study that included 696 consecutive patients treated with the long nontapered BioMime sirolimus-eluting coronary stent system in long and diffused de novo coronary lesions. The safety endpoint was major adverse cardiovascular events defined as a composite of cardiac death, myocardial infarction, clinically driven target lesion revascularization, stent thrombosis, and major bleeding at the 12-month follow-up. Results: Of a total of 696 patients, 38.79% were diabetic. The mean age of all the patients was 64.6 +/- 14 years, and 80% were males. The indication for revascularization was acute coronary syndrome in 63.1%. A total of 899 lesions were identified out of which 742 were successfully treated with long BioMime stents (37 mm, 40 mm, 44 mm, and 48 mm). The cumulative incidence of major adverse cardiovascular events was 8.1% at the 12-month follow-up including cardiac death (2.09%), myocardial infarction (1.34%), and total stent thrombosis (0.5%). Conclusions: This study confirms the safety and good performance of long nontapered BioMime coronary stents to treat de novo coronary stenosis. Therefore, it can be considered a safe and effective treatment for long and diffused de novo coronary lesions in the routine clinical practice

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

El reto de la inclusión de los Objetivos de Desarrollo Sostenible en la formación inicial de profesores de secundaria: creación del MOOC curso cero sobre educación y ODS, inclusión en asignaturas y en trabajos fin de máster

Memoria ID-041. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2021-2022