Viabilidad de una estructura sumergida en el litoral catalán para la práctica del Surf

En este documento se estudian los parámetros que intervienen en el proceso de formación, propagación y rotura de ola. A partir de un repaso al estado del arte actual de arrecifes artificiales a nivel mundial y después de analizar el oleaje catalán, se establece una estructura modelo aplicable a la costa catalana

Viabilidad de una estructura sumergida en el litoral catalán para la práctica del Surf

En este documento se estudian los parámetros que intervienen en el proceso de formación, propagación y rotura de ola. A partir de un repaso al estado del arte actual de arrecifes artificiales a nivel mundial y después de analizar el oleaje catalán, se establece una estructura modelo aplicable a la costa catalana

Elaboración de un modelo de gestión del conocimiento basado en las sesiones clínicas de medicina

Hoy en día no existe un modelo conceptual y práctico sobre cómo aflorar el conocimiento tácito que se genera en las sesiones clínicas en los centros sanitarios, ni tampoco cómo se transforma este conocimiento en conocimiento explícito, y qué valor le aporta al profesional su adquisición, aprendizaje y aplicación. Por eso los objetivos que se han centrado en esta investigación han sido revisar los modelos de gestión de conocimiento más relevantes según nuestro estudio, analizarlos y realizar una propuesta que se adapte a las necesidades de estos profesionales y sus organizaciones. La propuesta de nuestro modelo se ha planteado en tres estratos y dos ejes fundamentales. Donde los estratos hacen referencia a la evidencia científica, el feedback que nos ha proporcionado el usuario para adaptar el diseño a sus necesidades reales, y el desarrollo tecnológico, que debería tener una aplicación o software que gestionará este tipo de conocimiento. El resultado del modelo “EFD” (evidencia, feedback y desarrollo) proporciona información de dos ejes principales: Modelo conceptual y las necesidades tecnológicas. Estos dos ejes conjuntamente con los estratos determinados anteriormente, facilitan en cada uno lo que se tiene que tener en cuenta y cómo se tiene que programar un modelo que gestione las sesiones clínicas de un servicio de medicina en un hospital, ya que el aprendizaje que se realiza y como se realiza es diferente a otros tipos de aprendizaje que podemos encontrar

Dosimetry with gafchromic films based on a new micro-opto-electro-mechanical system

This work presents the first tests performed with radiochromic films and a new Micro‒Opto‒Electro-Mechanical system (MOEMS) for in situ dosimetry evaluation in radiotherapy in real time. We present a new device and methodology that overcomes the traditional limitation of time-delay in radiochromic film analysis by turning a passive detector into an active sensor. The proposed system consists mainly of an optical sensor based on light emitting diodes and photodetectors controlled by both customized electronic circuit and graphical user interface, which enables optical measurements directly. We show the first trials performed in a low‒energy proton cyclotron with this MOEMS by using gafchromic EBT3 films. Results show the feasibility of using this system for in situ dose evaluations. Further adaptation is ongoing to develop a full real‒time active detector by integrating MOEM multi‒arrays and films in flexible printed circuits. Hence, we point to improve the clinical application of radiochromic films with the aim to optimize radiotherapy treatment verifications

Photodynamic Therapy for the Treatment of Complex Anal Fistula

Background and objectives: To validate and analyze the results of intralesional photodynamic therapy in the treatment of complex anal fistula. Study design/materials and methods: This prospective multicentric observational study enrolled patients treated for complex anal fistula who underwent intralesional photodynamic therapy (i-PDT). The included patients were treated from January 2016 to December 2018 with a minimum follow-up of 1 year to evaluate recurrence, continence and postoperative morbidity. Intralesional 5-aminolevulinic acid (ALA) gel (2%) was injected directly into the fistula. The internal and external orifices were closed. After an incubation period of 2 hours, the fistula was irradiated using an optical fiber connected to a red laser (Multidiode 630 PDT) operating at 1 W/cm for 3 minutes (180 J). Results: In total, 49 patients were included (61.2% male). The mean age was 48 years, and the mean duration of fistula was 13 months. Of the fistulas included, 75.5% were medium transphincteric, and 24.5% were high transphincteric. The median fistula length was 4 ± 1,14 cm (range: 3-5). A total of 41 patients (83.7%) had a previous history of fistula surgery. Preoperatively, some degree of anal incontinence was found in 5 patients (10.2%). No center reported any other procedure-related complications intraoperatively. Phototoxicity was found in one patient. In the first 48 hours after the procedure, fever was reported in 2 patients (4%). At the end of follow-up, total healing was observed in 32/49 patients (65.3%). No patient reported new incontinence postoperatively. Conclusion: i-PDT could be considered a good choice in patients with complex anal fistulas to avoid surgery and its complications. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc

Ingeniería y aspectos técnicos de la digestión anaeróbica

El presente volumen es la continuación natural del libro de la misma colección dedicado a los aspectos bioquímicos y microbiológicos del proceso de digestión anaerobia. En él se abordan los aspectos tecnológicos de los reactores en los que la producción de biogás tiene lugar. Después de un capítulo inicial sobre la evolución de la implantación de la digestión anaerobia se dedican dos capítulos a conceptos básicos y aplicados de bioreactores. La aplicación de las bases teóricas se abordan con un enfoque diferenciado por tipología de materia prima a tratar: deyecciones ganaderas, fracción orgánica de residuos municipales, lodos residuales de plantas depuradoras, cultivos energéticos, mezclas de los substratos anteriores con residuos orgánicos industriales (codigestión) y aguas residuales, para las cuales la digestión anaerobia presenta ventajas ambientales, energéticas y económicas respecto a los sistemas aerobios convencionales para una gran variedad de efluentes industriales. Asimismo se abordan aspectos de automatización y control de las instalaciones, y de transformación de biogás para adecuarlo a su aprovechamiento energético (cogeneración, automoción o inyección a redes de gas natural), así como los sistemas usuales de pretratamiento de los substratos, para mejorar el perfil del proceso y aumentar la productividad energética. En algunos capítulos se aborda la evaluación económica de los proyectos o los sistemas de transformación de los efluentes (digestato) para mejorar su gestión y aprovechamiento. El libro presenta un enfoque técnico y didáctico y se considera que puede ser un complemento bibliográfico básico para estudiantes de cursos de ingeniería ambiental de carreras científicas y técnicas, aparte de un manual para ingenieros de proyectos y operadores de plantas de biogás.Postprint (published version

Clinical performance evaluation of the Idylla (TM) EGFR Mutation Test on formalin-fixed paraffin-embedded tissue of non-small cell lung cancer

Background: Detection of epidermal growth factor receptor (EGFR) mutations in exons 18-21 is recommended in all patients with advanced Non-small-cell lung carcinoma due to the demonstrated efficiency of the standard therapy with tyrosine kinase inhibitors in EGFR-mutated patients. Therefore, choosing a suitable technique to test EGFR mutational status is crucial to warrant a valid result in a short turnaround time using the lowest possible amount of tissue material. The Idylla (TM) EGFR Mutation Test is a simple, fast and reliable method designed for the detection of EGFR mutations from formalin-fixed paraffin-embedded samples. The aim of this study was the Clinical Performace Evaluation of the Idylla (TM) EGFR Mutation Test on the Idylla (TM) System. Methods: EGFR mutational status was determined on 132 archived formalin-fixed paraffin-embedded tissue sections with Idylla (TM) technology. Results: were compared with the results previously obtained by routine method in the reference lab (Therascreen (R) EGFR RGQ PCR v2, Qiagen in Molecular Pathology lab, Hospital Universitario Virgen del Rocio de Sevilla). Results: The overall agreement between results obtained with the Idylla (TM) EGFR Mutation Test and the Comparator test method was 95.38% (with 1-sided 95% lower limit of 91.7%) showing Positive Diagnostic Agreement of 93.22% and Negative Diagnostic Agreement of 97.18%, with a Limit Of Detection <= 5%. Conclusions: The Idylla (TM) EGFR Mutation Test passed its clinical validity performance characteristics for accuracy

Clinical evaluation of antiseptic mouth rinses to reduce salivary load of SARS-CoV-2

Most public health measures to contain the COVID-19 pandemic are based on preventing the pathogen spread, and the use of oral antiseptics has been proposed as a strategy to reduce transmission risk. The aim of this manuscript is to test the efficacy of mouthwashes to reduce salivary viral load in vivo. This is a multi-centre, blinded, parallel-group, placebo-controlled randomised clinical trial that tests the effect of four mouthwashes (cetylpyridinium chloride, chlorhexidine, povidone-iodine and hydrogen peroxide) in SARS-CoV-2 salivary load measured by qPCR at baseline and 30, 60 and 120 min after the mouthrinse. A fifth group of patients used distilled water mouthrinse as a control. Eighty-four participants were recruited and divided into 12-15 per group. There were no statistically significant changes in salivary viral load after the use of the different mouthwashes. Although oral antiseptics have shown virucidal effects in vitro, our data show that salivary viral load in COVID-19 patients was not affected by the tested treatments. This could reflect that those mouthwashes are not effective in vivo, or that viral particles are not infective but viral RNA is still detected by PCR. Viral infectivity studies after the use of mouthwashes are therefore required

Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU

(1) Aims: Patients receiving antitumor necrosis factor (anti-TNF) therapy are at risk of developing tuberculosis (TB), usually due to the reactivation of a latent TB infection (LTBI). LTBI screening and treatment decreases the risk of TB. This study evaluated the diagnostic performance of different LTBI screening strategies in patients with inflammatory bowel disease (IBD). (2) Methods: Patients in the Spanish ENEIDA registry with IBD screened for LTBI between January 2003 and January 2018 were included. The diagnostic yield of different strategies (dual screening with tuberculin skin test [TST] and interferon-gamma-release assay [IGRA], two-step TST, and early screening performed at least 12 months before starting biological treatment) was analyzed. (3) Results: Out of 7594 screened patients, 1445 (19%; 95% CI 18-20%) had LTBI. Immunomodulator (IMM) treatment at screening decreased the probability of detecting LTBI (20% vs. 17%, p = 0.001). Regarding screening strategies, LTBI was more frequently diagnosed by dual screening than by a single screening strategy (IGRA, OR 0.60; 95% CI 0.50-0.73, p < 0.001; TST, OR 0.76; 95% CI 0.66-0.88, p < 0.001). Two-step TST increased the diagnostic yield of a single TST by 24%. More cases of LTBI were diagnosed by early screening than by routine screening before starting anti-TNF agents (21% [95% CI 20-22%] vs. 14% [95% CI 13-16%], p < 0.001). The highest diagnostic performance for LTBI (29%) was obtained by combining early and TST/IGRA dual screening strategies in patients without IMM. (4): Conclusions: Both early screening and TST/IGRA dual screening strategies significantly increased diagnostic performance for LTBI in patients with IBD, with optimal performance achieved when they are used together in the absence of IMM