Adaptive proton radiation therapy via fast Monte Carlo dose calculation to correct for inter- and intra-fraction motion and geometry changes

Intensity modulated proton therapy (IMPT) plans precisely balance thousands of proton beamlets, giving high dose to the tumor while trying to spare healthy tissues. However, plan quality is affected by factors including: 1) dose calculation inaccuracies, 2) underestimation of the biological effect of the dose in sensitive areas and geometrical changes like 3) patient movement or 4) changes in posture and anatomy. All these factors are addressed in the projects here presented. Project 1, in collaboration, introduces an upgraded version of a Monte Carlo package for graphics processing units (GPU-MC) to provide fast and accurate dose calculations. This package is extended to serve as the unique dose calculation engine in the following projects. Project 2, in collaboration, presents a prioritized optimization method to reduce the potential biological effect of the radiation in organs at risk near the tumor. Project 3 compares computationally efficient strategies to take into account the patient respiratory motion by defining planning target volumes based on a 4DCT of the patient. Density overwrites considering water-equivalent-path-length to voxels across the 4DCT targets works best. Project 4 demonstrates an online algorithm that maintains IMPT plan quality through treatment, adapting it to the daily patient posture and anatomy using GPU-MC calculations

Incidence and prognosis of late readmission after percutaneous coronary intervention

Background: Early readmission (< 30 days) after percutaneous coronary intervention (PCI) is associated with a worse prognosis, but little is known regarding the causes and consequences of late readmission. The aim of the present study was to determine the incidence, causes, and prognosis of patients readmitted > 1 < 12-months after PCI (late readmission). Methods: Single-center retrospective cohort study of 743 consecutive post-PCI patients. Patient characteristics and follow-up data were collected by reviewing their electronic medical records and from standardized telephone interviews performed at 1 year and at the end of follow-up. Results: Of the 743 patients, 224 (30.14%) were readmitted 1–12 months after PCI, 109 due to chest pain (48.66%), and 115 for other reasons (51.34%). Hospital readmission was associated with lower survival rates of 77.6% vs. 98.3% at 24 months and 73.5% vs. 97.6% at 36 months (p < 0.001). Univariate predictors for late readmission were hypertension, older age, chronic kidney disease, lower left ventricular ejection fraction, and lower baseline hemoglobin concentration. Only baseline hemoglobin concentration was an independent predictor of late readmission (odds ratio: 0.867, 95% confidence interval: 0.778–0.966, p = 0.01). Readmission for chest pain portrayed a lower mortality rate compared to other causes, with survival rates of 90.2% vs. 50% at 36 months (p < 0.001). Conclusions: Late hospital readmission after PCI is associated with a worse prognosis and is related to patient comorbidities. Readmission for chest pain is common and portrayed a more favorable prognosis, similar to patients not readmitted. A readily available parameter, baseline anemia, was the main predictor of late readmission

Co-creation Initiatives in Healthcare in Small Communities

The uses of technology in public spaces are not new, but now we find new forms of social interactions and practices, socio-spatial representations and relationships. The close relationship between real and virtual worlds also opens up new ways of advancing knowledge. In order to facilitate the implementation of Open Science, we explore different co-creation methods with multiple stakeholders. All groups are involved and have influence throughout the project lifecycle: from the beginning, to planning, to implementation, to dissemination. Research activities should involve a wide variety of stakeholders interested, including government, educators, nurses, charities, civil societies, patient groups and the publics, based in a way to (1) obtaining contributions by customers, (2) selecting the best of these contributions, and (3) incorporating these selected contributions into products, processes, or services. Interactions between Information and Communication Technologies (ICT), public spaces, and healthcare are considered as s a tool for connecting people in small communities (enhancing participation). A Platform (DXP - Digital eXperience Platform) through “headless” technologies may provide content management capabilities and easy integration with devices and various sources, driven by user needs and developed with the concept of “Community in mind” in order to create strong and active communities and transform our small communities into more human environments, rather than just more high-tech places, and to understand that “smartness” should be people-friendly. It was applies the Responsible Research and Innovation (RRI) principles on the scientific process and governance, identify drivers and barriers, interests and values for current and future societal challenges.This research was financially supported by the European Union’s Horizon 2020 research and innovation programme under the grant agreement No 741527 (project ORION).S

Persistent Pulmonary Hypertension in Corrected Valvular Heart Disease: Hemodynamic Insights and Long-Term Survival.

Background The determinants and consequences of pulmonary hypertension after successfully corrected valvular heart disease remain poorly understood. We aim to clarify the hemodynamic bases and risk factors for mortality in patients with this condition. Methods and Results We analyzed long-term follow-up data of 222 patients with pulmonary hypertension and valvular heart disease successfully corrected at least 1 year before enrollment who had undergone comprehensive hemodynamic and imaging characterization as per the SIOVAC (Sildenafil for Improving Outcomes After Valvular Correction) clinical trial. Median (interquartile range) mean pulmonary pressure was 37 mm Hg (32-44 mm Hg) and pulmonary artery wedge pressure was 23 mm Hg (18-26 mm Hg). Most patients were classified either as having combined precapillary and postcapillary or isolated postcapillary pulmonary hypertension. After a median follow-up of 4.5 years, 91 deaths accounted for 4.21 higher-than-expected mortality in the age-matched population. Risk factors for mortality were male sex, older age, diabetes mellitus, World Health Organization functional class III and higher pulmonary vascular resistance-either measured by catheterization or approximated from ultrasound data. Higher pulmonary vascular resistance was related to diabetes mellitus and smaller residual aortic and mitral valve areas. In turn, the latter correlated with prosthetic nominal size. Six-month changes in the composite clinical score and in the 6-minute walk test distance were related to survival. Conclusions Persistent valvular heart disease-pulmonary hypertension is an ominous disease that is almost universally associated with elevated pulmonary artery wedge pressure. Pulmonary vascular resistance is a major determinant of mortality in this condition and is related to diabetes mellitus and the residual effective area of the corrected valve. These findings have important implications for individualizing valve correction procedures. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT00862043.This study was funded by the Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Spain, the European Union–European Regional Development Fund (EC07/90772 and PI19/00649), and the Consorcio de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV).S

Interplay of Linker Functionalization and Hydrogen Adsorption in the Metal–Organic Framework MIL-101

Functionalization of metal–organic frameworks results in higher hydrogen uptakes owing to stronger hydrogen–host interactions. However, it has not been studied whether a given functional group acts on existing adsorption sites (linker or metal) or introduces new ones. In this work, the effect of two types of functional groups on MIL-101 (Cr) is analyzed. Thermal-desorption spectroscopy reveals that the −Br ligand increases the secondary building unit’s hydrogen affinity, while the −NH2 functional group introduces new hydrogen adsorption sites. In addition, a subsequent introduction of −Br and −NH2 ligands on the linker results in the highest hydrogen-store interaction energy on the cationic nodes. The latter is attributed to a push-and-pull effect of the linkers

Impact of operatoŕs experience on peri-procedural outcomes with Watchman FLX: Insights from the FLX-SPA registry

Background: The Watchman FLX is a device upgrade of the Watchman 2.5 that incorporates several design enhancements intended to simplify left atrial appendage occlusion (LAAO) and improve procedural outcomes. This study compares peri-procedural results of LAAO with Watchman FLX (Boston Scientific, Marlborough, Massachusetts) in centers with varying degrees of experience with the Watchman 2.5 and Watchman FLX. Methods: Prospective, multicenter, 'real-world' registry including consecutive patients undergoing LAAO with the Watchman FLX at 26 Spanish sites (FLX-SPA registry). Implanting centers were classified according to the center's prior experience with the Watchman 2.5. A further division of centers according to whether or not they had performed ≤ 10 or > 10Watchman FLX implants was prespecified at the beginning of the study. Procedural outcomes of institutions stratified according to their experience with the Watchman 2.5 and FLX devices were compared. Results: 359 patients [mean age 75.5 (SD8.1), CHA2DS2-VASc 4.4 (SD1.4), HAS-BLED 3.8(SD0.9)] were included. Global success rate was 98.6%, successful LAAO with the first selected device size was achieved in 95.5% patients and the device was implanted at first attempt in 78.6% cases. There were only 9(2.5%) major peri-procedural complications. No differences in efficacy or safety results according to the centeŕs previous experience with Watchman 2.5 and procedural volume with Watchman FLX existed. Conclusions: The Watchman FLX attains high procedural success rates with complete LAA sealing in unselected, real-world patients, along with a low incidence of peri-procedural complications, regardless of operatoŕs experience with its previous device iteration or the number of Watchman FLX devices implanted

The Human Phenotype Ontology in 2024: phenotypes around the world.

The Human Phenotype Ontology (HPO) is a widely used resource that comprehensively organizes and defines the phenotypic features of human disease, enabling computational inference and supporting genomic and phenotypic analyses through semantic similarity and machine learning algorithms. The HPO has widespread applications in clinical diagnostics and translational research, including genomic diagnostics, gene-disease discovery, and cohort analytics. In recent years, groups around the world have developed translations of the HPO from English to other languages, and the HPO browser has been internationalized, allowing users to view HPO term labels and in many cases synonyms and definitions in ten languages in addition to English. Since our last report, a total of 2239 new HPO terms and 49235 new HPO annotations were developed, many in collaboration with external groups in the fields of psychiatry, arthrogryposis, immunology and cardiology. The Medical Action Ontology (MAxO) is a new effort to model treatments and other measures taken for clinical management. Finally, the HPO consortium is contributing to efforts to integrate the HPO and the GA4GH Phenopacket Schema into electronic health records (EHRs) with the goal of more standardized and computable integration of rare disease data in EHRs

Universitarios y redes sociales: Estudio sobre la percepción de la privacidad y su gestión

The main objective of this article is to examine the trends in the use of social networks among university students and study the perception that users have about the use that companies make of their data on the Internet. After completing a questionnaire for a sample of students between 18 and 22 years old, the main results of the research show us how young people are aware that their activity in the network is being monitored. A large majority accept this fact, not without emphasizing that they try to control the content that goes up to the networks. In the correlation analysis of variables we observe that sex does not influence the results obtained, however, there are moderate relationships between the age variable, the activity of the users and the time they spend in the networks.El presente artículo tiene como principales objetivos examinar las tendencias en el uso del social media entre los estudiantes universitarios y estudiar la percepción que tienen los usuarios sobre el uso que, de sus datos, realizan las empresas en Internet. Tras la realización de un cuestionario a una muestra de alumnos entre 18 y 30 años, los principales resultados que arroja la investigación nos muestran cómo los jóvenes son conscientes de que su actividad en la Red está siendo monitorizada. Una gran mayoría acepta este hecho, no sin remarcar que procuran controlar los contenidos que suben a las redes. En el análisis de correlación de variables observamos que el sexo no influye sobre los resultados obtenidos, sin embargo, sí existen relaciones de manera moderada entre la variable edad, la actividad de los usuarios y el tiempo que pasan en redes

The image on social networks:suitability study for Human Resources Departments

La llegada del siglo XXI ha acelerado las posiciones que presentaba la irrupción de las redes sociales digitales en nuestra sociedad. Hoy podemos hablar de una identidad digital propia que puede ser trabajada como tal, o ser el resultado de nuestra actividad en la red. A través de internet, con las redes sociales y su adaptación a los smartphones, los jóvenes están en contacto contínuo y hacen que esta comunicación digital sea un rasgo de su existencia y la manera más común de gestionar sus relaciones. Las características de las redes sociales más usadas hoy, hacen que la imagen, bien fija a través de la fotografía o en movimiento a través del video, constituya uno de los pilares de comunicación social. Conscientes de esto, muchas de las empresas de recursos humanos han decidido incluir el análisis de la identidad digital a través de la imagen como parte de su proceso selectivo, siendo la foto de perfil uno de los elementos más tenidos en consideración en dicho proceso. Por ello, hemos elaborado un estudio entre 144 empresas de recursos humanos de España dónde buscamos saber hasta que punto es importante cuidar la imagen en redes sociales y cuáles son las imágenes que pueden ayudar o hacer que un candidato sea descartado en el proceso de selección.info:eu-repo/semantics/publishedVersio

Tailored graphene materials by chemical reduction of graphene oxides of different atomic structure

[EN] Graphene materials with different characteristics in terms of sheet size and defects (structural and/or functional groups) were obtained by the reduction with hydrazine of two graphene oxides with similar oxygen content, but with functional groups of different type and location. The oxides were prepared from two synthetic graphites with distinct crystalline structure. Our research has obtained experimental evidence of a greater reactivity of the oxygen functional groups located in the interior of the aromatic domains on the basal planes (mainly epoxy) and a lower reactivity of oxygen functional groups located at the edges (mainly carboxyl and OH). Furthermore, these edge-located groups were found to be responsible for hydrogen bonding lateral interactions between sheets (these occur through the residual OH groups), which cause a substantial increase in the size of the reduced graphene oxide with respect to that of the parent graphene oxide. These results offer a way to tailor the characteristics of graphene materials for diverse applications.The authors thank MICINN (CONSOLIDER CSD2009-00050; CSD2009 00013 IMAGINE; MAT2010-15138) and Generalitat de Catalunya (2009 SGR 770, NanoAraCat and XaRMAE) for financial support. Dr. P.A. thanks MICINN for her Ramon y Cajal contract. C.B. acknowledges a fellowship from FICYT. Authors also thank Dr. Pacheco for his assistance in the HR-TEM.Peer reviewe