Clinical management and acute exacerbations in patients with idiopathic pulmonary fibrosis in Spain: results from the OASIS study

Clinical management; Acute exacerbations; Early treatmentGestión clínica; Exacerbaciones agudas; Tratamiento precozGestió clínica; Exacerbacions agudes; Tractament precoçBackground Idiopathic pulmonary fibrosis (IPF) is a progressive disease associated with decline in lung function and poor prognosis entailing significant impairment in quality of life and high socioeconomic burden. The aim of this study was to characterize clinical management and resources utilization of patients with IPF in Spain, according to predicted forced vital capacity (FVC) % at baseline. Methods Prospective, non-interventional, multicentric real-world data study in patients with IPF in Spain with 12-months follow-up. Clinical management and resources utilization during study period were recorded and compared between groups. FVC decline and acute exacerbations occurrence and associated healthcare resource use were also analysed. FVC decline after 12 months was estimated as relative change. Results 204 consecutive patients with IPF were included and divided according to baseline FVC % predicted value. At baseline, patients with FVC  10% in the more preserved lung function groups than in the FVC < 50% group, because of their already deteriorated condition. Conclusions We observed a significantly higher annual IPF-related resource use in patients with more impaired lung function at baseline. Since FVC decreases irrespective of FVC% predicted at baseline, slowing IPF progression to maintain patients at early disease stages is relevant to improve IPF management and to optimize resource use.The study was supported and funded by Boehringer Ingelheim España

Six Collective Challenges for Sustainability of Almería Greenhouse Horticulture

Globally, current food consumption and trade are placing unprecedented demand on agricultural systems and increasing pressure on natural resources, requiring tradeoffs between food security and environmental impacts especially given the tension between market-driven agriculture and agro-ecological goals. In order to illustrate the wicked social, economic and environmental challenges and processes to find transformative solutions, we focus on the largest concentration of greenhouses in the world located in the semi-arid coastal plain of South-east Spain. Almería family farming, predominantly cooperative, greenhouse intensive production, commenced after the 1960s and has resulted in very significant social and economic benefits for the region, while also having important negative environmental and biodiversity impacts, as well as creating new social challenges. The system currently finds itself in a crisis of diminishing economic benefits and increasing environmental and social dilemmas. Here, we present the outcomes of multi-actor, transdisciplinary research to review and provide collective insights for solutions-oriented research on the sustainability of Almeria’s agricultural sector. The multi-actor, transdisciplinary process implemented collectively, and supported by scientific literature, identified six fundamental challenges to transitioning to an agricultural model that aims to ameliorate risks and avoid a systemic collapse, whilst balancing a concern for profitability with sustainability: (1) Governance based on a culture of shared responsibility for sustainability, (2) Sustainable and efficient use of water, (3) Biodiversity conservation, (4) Implementing a circular economy plan, (5) Technology and knowledge transfer, and (6) Image and identity. We conclude that the multi-actor transdisciplinary approach successfully facilitated the creation of a culture of shared responsibility among public, private, academic, and civil society actors. Notwithstanding plural values, challenges and solutions identified by consensus point to a nascent acknowledgement of the strategic necessity to locate agricultural economic activity within social and environmental spheres.This paper demonstrates the need to establish transdisciplinary multi-actor work-schemes to continue collaboration and research for the transition to an agro-ecological model as a means to remain competitive and to create value

Diseñar y establecer un proceso para la selección de personal de la empresa Financiera Comultrasan, cooperativa líder en el ahorro y crédito, en todas las sedes del departamento de Boyacá.”

En la actualidad las empresas se enfocan en la efectividad de los procesos del área de talento humano, siendo un componente de gran importancia la selección de personal. Por esta razón el presente estudio se centra en el proceso de selección de personal de la empresa financiera Comultrasan en todas las sedes del departamento de Boyacá. El objetivo principal del presente trabajo fue fortalecer el proceso de selección de personal con el diseño de un proceso estratégico confiable y de calidad donde se evalúen las necesidades y requerimientos de los puestos de trabajo a fin de mejorar el desempeño laboral. La investigación se basa en una investigación descriptiva con enfoque cuantitativo, apoyada en técnicas como la encuesta, la cual se instrumentó mediante un cuestionario de 13 preguntas dicotómicas cerradas (Si, No), aplicada a 15 trabajadores para recoger su impresión sobre las técnicas de reclutamiento, políticas formales para el reclutamiento de personal, criterios de selección, estilos de evaluación de cumplimiento de objetivos del colaborador participante en el proceso de selección del área de talento humano. Se presentan, interpretan los resultados y se resalta que no se viene dando cumplimiento a todos los requisitos contenidos en el proceso de reclutamiento de personal lo cual genera un desvió al cumplimiento del plan estratégico de la empresa, aumento en los costos y disminución de productividad. Dentro de las recomendaciones, se puede mencionar la utilización de las técnicas en el proceso de selección de personal que den total cumplimiento de los requisitos del diseño del proceso estratégico de selección y se pueda mitigar la falencia de recomendación de candidatos por parte de los empleados de la empresa. Así mismo de acuerdo a los análisis de resultados obtenidos en el proceso de investigación, la empresa cuenta con la área de talento humano y herramientas, donde toma como referencia al personal interno en la recomendación en la selección y reclutamiento del personal para las vacantes ofertadas, se apoya en la verificación de referencias, requisitos propios del puesto de trabajo vacante (nivel de estudio, experiencia laboral, certificaciones, antecedentes) de la hoja de vida como requisito primordial, la información sobre vacantes se desarrolla mediante publicaciones en la intranet y anuncios en carteleras institucionales.At present, companies focus on the effectiveness of the processes in the human talent area, with the selection of personnel being a very important component. For this reason, this study focuses on the recruitment process of the financial company Comultrasan in all the offices of the department of Boyacá. The main objective of this work was to strengthen the personnel selection process with the design of a reliable and quality strategic process where the needs and requirements of the jobs are evaluated in order to improve job performance. The research is based on a descriptive research with a quantitative approach, supported by techniques such as the survey, which was implemented through a questionnaire of 13 closed dichotomous questions (Yes, No), applied to 15 workers to collect their impression of the recruitment techniques , formal policies for the recruitment of personnel, selection criteria, styles of evaluation of compliance with the objectives of the collaborator participating in the selection process of the human talent area. The results are presented, interpreted and it is highlighted that all the requirements contained in the personnel recruitment process are not being fulfilled, which generates a deviation from the fulfillment of the company's strategic plan, increased costs and decreased productivity. Among the recommendations, it is possible to mention the use of techniques in the personnel selection process that fully comply with the requirements of the design of the strategic selection process and can mitigate the lack of recommendation of candidates by the employees of the company. Likewise, according to the analysis of the results obtained in the research process, the company has the area of human talent and tools, where it takes as a reference the internal personnel in the recommendation in the selection and recruitment of personnel for the vacancies offered, is supported by the verification of references, requirements of the vacant job (level of study, work experience, certifications, background) of the resume as a primary requirement, the information on vacancies is developed through publications on the intranet and advertisements on institutional billboard

PanDrugs2: prioritizing cancer therapies using integrated individual multi-omics data

Genomics studies routinely confront researchers with long lists of tumor alterations detected in patients. Such lists are difficult to interpret since only a minority of the alterations are relevant biomarkers for diagnosis and for designing therapeutic strategies. PanDrugs is a methodology that facilitates the interpretation of tumor molecular alterations and guides the selection of personalized treatments. To do so, PanDrugs scores gene actionability and drug feasibility to provide a prioritized evidence-based list of drugs. Here, we introduce PanDrugs2, a major upgrade of PanDrugs that, in addition to somatic variant analysis, supports a new integrated multi-omics analysis which simultaneously combines somatic and germline variants, copy number variation and gene expression data. Moreover, PanDrugs2 now considers cancer genetic dependencies to extend tumor vulnerabilities providing therapeutic options for untargetable genes. Importantly, a novel intuitive report to support clinical decision-making is generated. PanDrugs database has been updated, integrating 23 primary sources that support >74K drug–gene associations obtained from 4642 genes and 14 659 unique compounds. The database has also been reimplemented to allow semi-automatic updates to facilitate maintenance and release of future versions. PanDrugs2 does not require login and is freely available at https://www.pandrugs.org/.Instituto de Salud Carlos III | Ref. IMP/00019Agencia Estatal de Investigacion | Ref. PID2021-124188NB-I00Xunta de Galicia | Ref. | Ref. ED431C2018/55Xunta de Galicia | Ref. | Ref. ED431C2022/0

Society facing death and its implications for end-of-life care: a qualitative study with healthcare professionals (Research Project FFI2016-76927-P-AEI/FEDER, UE)

Background/aims: End-of-life care is conditioned by the social opinion towards disease, suffering, death, and life. In Western countries, the process of dying is often considered a taboo; however, the debate around the topic has led to attempts to dignify end-of-life care (regulation of the right to palliative care, advanced directives). The objective of this study was to understand how social patterns about death influence end-of-life palliative care from the perspective of healthcare professionals. Methods: A qualitative study based on grounded theory was designed and carried out between 2017 and 2019. Forty-six professionals (6 doctors, 5 clinical psychologists and 35 nurses) took part in the study, selected through theoretical and convenience sampling. Four focus groups, with a total of 20 participants, and 17 in-depth interviews were conducted. The data were analysed following Grounded Theory procedure with the assistance of ATLAS.ti software (constant comparative analysis, open, axial and selective coding). Results: Data analysis suggests that there may be two opposing social patterns of coping with death. One represents a “Positive way” that includes effort and internal work to make death a part of existence. The other is a “Negative way” that is dominated by a culture of concealment and stubbornness towards death. Participants also conceptualised “Endof-life and death as a care process”, which encompasses “The facilitating role of health professionals” and “Conflicts in decision-making.” Conclusions: Health professionals have identified that socio-cultural patterns towards death influence aspects of the process of end-of-life care such as emergency departments attendance, demand for hospitalisation or management of clinical information. Healthcare professionals take action to facilitate acceptance within the social and family circle, but are faced with conflicts in decision-making when the patient’s closest social and family network put pressure on the professionals or influence the patient’s own free will

Nursing education during the SARS-CoV-2 pandemic: assessment of students’ satisfaction with e-Learning environment

The disease caused by the SARS-CoV-2 coronavirus led to the disruption of normality with respect to education, public healthcare and new technologies. Education is a fundamental pillar to increase the knowledge and morale of people. However, due to the lockdown implemented to protect the population from an infection of unknown aetiology, the education system decided to switch from face-to-face education to virtual education. This modality has affected the teaching–learning process in the Degree of Nursing, since its competencies and knowledge demand in-presence learning. The aim of this study was to evaluate the impact that telematic education had on students of the Degree of Nursing who were studying in the final year of said degree, which involves their imminent entry into the labour market. We used the client satisfaction questionnaire of Bob Hayes to gather data and analyse the satisfaction level of the nursing students. As a result, a considerable amount of information was obtained about teaching, which shows the absence of practical activities and the lack of information about safety and protection measures related to the pandemic. Most educators themselves were struggling to understand the implications of the virus and implement appropriate safety measures, since there was quite a bit of conflicting information relating to the effectiveness of personal protective safety equipment and the lifespan of the virus on various media outside of the host. It is, therefore, not surprising that education for students in this regard was lacking. In general, most of the students showed dissatisfaction with the virtual education they received.info:eu-repo/semantics/publishedVersio

Reproductive traits of the round sardinella in the Canary Islands (Spain, NW Africa)

The present study aims to investigate the reproductive biology of the small pelagic Sardinella aurita Valenciennes, 1847 in the Canary Islands, to enable its reliable assessment and advise on appropriate management measures for a fishing resource showing a declining trend in landings. Reproductive biology and sexual patterns of round sardinella were examined from monthly random samples of commercial catches landed by the artisanal purse-seine fleet. The landings' length frequencies, ranging between 9–32 cm (based on the total lengths, TL), were recorded from 2013–2019. The overall mean value of TL was 20.9 cm, with annual mean values between 20–22 cm, except in 2016 (TL = 19 cm). The overall sex ratio M:F was 1:0.92, with males significantly predominant. Sex ratios fluctuated as a function of size and month: females were more abundant in the larger length classes, as well as before and after spawning, whereas males were more abundant in the smaller length classes and during spawning. Based on gonad maturity stages and gonadosomatic index, round sardinella spawns during almost all the year, with a peak in January–February and a resting period during October–November. The length at first maturity was estimated at TL of 18.2 cm, notably smaller than the value obtained for the NW African coastal waters where the demographic structure in round sardinellas' landings is totally different.Versión del edito

Ultrasound Muscle Evaluation for Predicting the Prognosis of Patients with Head and Neck Cancer: A Large-Scale and Multicenter Prospective Study

© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).Head and neck cancer (HNC) is a prevalent and aggressive form of cancer with high mortality rates and significant implications for nutritional status. Accurate assessment of malnutrition in patients with HNC is crucial for optimizing treatment outcomes and improving survival rates. This study aimed to evaluate the use of ultrasound techniques for predicting nutritional status, malnutrition, and cancer outcomes in patients with HNC. A total of 494 patients with HNC were included in this cross-sectional observational study. Various tools and body composition measurements, including muscle mass and adipose tissue ultrasound evaluations, were implemented. Using regression models, we mainly found that high levels of RF-CSA (rectus femoris cross-sectional area) were associated with a decreased risk of malnutrition (as defined with GLIM criteria (OR = 0.81, 95% CI: 0.68–0.98); as defined with PG-SGA (OR = 0.78, 95% CI: 0.62–0.98)) and sarcopenia (OR = 0.64, 95% CI: 0.49–0.82) after being adjusted for age, sex, and BMI. To predict the importance of muscle mass ultrasound variables on the risk of mortality, a nomogram, a random forest, and decision tree models were conducted. RF-CSA was the most important variable under the random forest model. The obtained C-index for the nomogram was 0.704, and the Brier score was 16.8. With an RF-CSA < 2.7 (AUC of 0.653 (0.59–0.77)) as a split, the decision tree model classified up to 68% of patients as possessing a high probability of survival. According to the cut-off value of 2.7 cm2, patients with a low RF-CSA value lower than 2.7 cm2 had worse survival rates (p < 0.001). The findings of this study highlight the importance of implementing ultrasound tools, for accurate diagnoses and monitoring of malnutrition in patients with HNC. Adipose tissue ultrasound measurements were only weakly associated with malnutrition and not with sarcopenia, indicating that muscle mass is a more important indicator of overall health and nutritional status. These results have the potential to improve survival rates and quality of life by enabling early intervention and personalized nutritional management.H.B. is supported by a predoctoral fellowship (“Plan Propio IBIMA 2020 A.1 Contratos predoctorales”, Ref.: predoc20_002) and by a “Sara Borrell” postdoctoral contract (CD22/00053) from the Instituto de Salud Carlos III—Madrid (Spain), “Financiado por la Unión Europea—NextGenerationEU” y mediante el Plan de Recuperación, Transformación y Resiliencia. This research was funded by FRESENEIUS KABI. The APC was funded by FRESENIUS KABI.Peer reviewe

Machine learning and natural language processing (NLP) approach to predict early progression to first-line treatment in real-world hormone receptor-positive (HRþ)/HER2-negative advanced breast cancer patients.

Este artículo ha sido publicado en la revista European Journal of Cancer. Esta versión tiene Licencia Creative Commons CC-BY-NC-NDBackground: CDK4/6 inhibitors plus endocrine therapies are the current standard of care in the first-line treatment of HRþ/HER2-negative metastatic breast cancer, but there are no well-established clinical or molecular predictive factors for patient response. In the era of personalised oncology, new approaches for developing predictive models of response are needed. Materials and methods: Data derived from the electronic health records (EHRs) of real-world patients with HRþ/HER2-negative advanced breast cancer were used to develop predictive models for early and late progression to first-line treatment. Two machine learning approaches were used: a classic approach using a data set of manually extracted features from reviewed (EHR) patients, and a second approach using natural language processing (NLP) of freetext clinical notes recorded during medical visits. Results: Of the 610 patients included, there were 473 (77.5%) progressions to first-line treatment, of which 126 (20.6%) occurred within the first 6 months. There were 152 patients (24.9%) who showed no disease progression before 28 months from the onset of first-line treatment. The best predictive model for early progression using the manually extracted dataset achieved an area under the curve (AUC) of 0.734 (95% CI 0.687e0.782). Using the NLP free-text processing approach, the best model obtained an AUC of 0.758 (95% CI 0.714 e0.800). The best model to predict long responders using manually extracted data obtained an AUC of 0.669 (95% CI 0.608e0.730). With NLP free-text processing, the best model attained an AUC of 0.752 (95% CI 0.705e0.799). Conclusions: Using machine learning methods, we developed predictive models for early and late progression to first-line treatment of HRþ/HER2-negative metastatic breast cancer, also finding that NLP-based machine learning models are slightly better than predictive models based on manually obtained data