Desarrollo de un chatbot para la evaluación de la usabilidad y la experiencia de usuario de una plataforma web de ayuda a la decisión médica

[ES] Aleph es un sistema de ayuda a la decisión médica web desarrollado en Django, el cual ofrece herramientas de manejo de enfermedades, apoyo a la toma de decisiones clínicas y apoyo al tratamiento. Para mejorar dicho sistema queremos evaluar su usabilidad y la experiencia del usuario. Para llevar a cabo este trabajo hemos diseñado y desarrollado Alf, un chatbot que realiza un test usabilidad y la experiencia de usuario de Aleph de manera interactiva, en el que se adaptan dos de los cuestionarios más usados para evaluar dichas cualidades junto con tres tareas sencillas para familiarizar al usuario con Aleph. Los cuestionarios que hemos adaptado son el System Usabity Scale (SUS) y el User Experience Questionnaire (UEQ-S). Adicionalmente en las tareas evaluamos su dificultad, el tiempo empleado, su eficacia y la satisfacción del usuario. Este chatbot está compuesto de dos módulos, un Frontend, desarrollado en Django, y un Backend compuesto por una API de REST, una Object-Relational Mapping (ORM), una base de datos y una máquina de estados creada en Python 3.[EN] Aleph is a web-based medical decision support system developed in Django, which offers disease management tools, clinical decision support, and treatment support. To improve this system we want to evaluate its usability and user experience. To carry out this work we have designed and developed Alf, a chatbot that performs a usability test and the Aleph user experience in an interactive way, in which two of the most used questionnaires are adapted to evaluate these qualities together with three simple tasks to familiarize the user with Aleph. The questionnaires that we have adapted are the System Usabity Scale (SUS) and the User Experience Questionnaire (UEQ-S). Additionally, in the tasks we evaluate their difficulty, the time spent, their effectiveness and user satisfaction. This chatbot is made up of two modules, a Frontend, developed in Django, and a Backend made up of a REST API, an Object-Relational Mapping (ORM), a database, and a state machine created in Python 3.[CA] Aleph és un sistema d’ajuda a la decisió mèdica web desenvolupat en Django, el qual ofereix eines de maneig de malalties, suport a la presa de decisions clíniques i suport al tractament. Per a millorar aquest sistema volem avaluar la seua usabilitat i l’experiència d’usuari. Per dur a terme aquest treball hem dissenyat i desenvolupat Alf, un xatbot que realitza un test usabilitat i l’experiència d’usuari d’Aleph de manera interactiva al que s’adapten dos dels qüestionaris més usats per avaluar aquestes qualitats juntament amb tres tasques senzilles per familiaritzar l’usuari amb Aleph. Els qüestionaris que hem adaptat són el System Usabity Scale (SUS) i el User Experience Questionnaire (UEQ-S). A més en les tasques avaluem la seua dificultat, el temps emprat, la seua eficàcia i la satisfacció de l’usuari. Aquest xatbot està compost per dos mòduls, un Frontend desenvolupat en Django, un Backend compost per una API de REST, un Object-Relational Mapping (ORM), una base de dades i una màquina d’estats creada en Python 3.Mora Blasco, D. (2021). Desarrollo de un chatbot para la evaluación de la usabilidad y la experiencia de usuario de una plataforma web de ayuda a la decisión médica. Universitat Politècnica de València. http://hdl.handle.net/10251/173958TFG

p38γ and p38δ regulate postnatal cardiac metabolism through glycogen synthase 1

During the first weeks of postnatal heart development, cardiomyocytes undergo a major adaptive metabolic shift from glycolytic energy production to fatty acid oxidation. This metabolic change is contemporaneous to the up-regulation and activation of the p38γ and p38δ stress-activated protein kinases in the heart. We demonstrate that p38γ/δ contribute to the early postnatal cardiac metabolic switch through inhibitory phosphorylation of glycogen synthase 1 (GYS1) and glycogen metabolism inactivation. Premature induction of p38γ/δ activation in cardiomyocytes of newborn mice results in an early GYS1 phosphorylation and inhibition of cardiac glycogen production, triggering an early metabolic shift that induces a deficit in cardiomyocyte fuel supply, leading to whole-body metabolic deregulation and maladaptive cardiac pathogenesis. Notably, the adverse effects of forced premature cardiac p38γ/δ activation in neonate mice are prevented by maternal diet supplementation of fatty acids during pregnancy and lactation. These results suggest that diet interventions have a potential for treating human cardiac genetic diseases that affect heart metabolism.G.S. is a YIP EMBO member. B.G.T. was a fellow of the FPI Severo Ochoa CNIC program (SVP-2013-067639) and currently is funded by the AHA-CHF (AHA award number: 818798). V.M.R. is a FPI fellow (BES-2014-069332) and A.M.S. is a fellow of the FPI Severo Ochoa CNIC program (BES-2016-077635). This work was funded by the following grants: to G.S.: funding from the EFSD/Lilly European Diabetes Research Programme Dr Sabio, from Spanish Ministry of Science, Innovation and Universities (MINECO-FEDER SAF2016-79126-R and PID2019-104399RB-I00), Comunidad de Madrid (IMMUNOTHERCAN-CM S2010/BMD-2326 and B2017/BMD-3733) and Fundación Jesús Serra; to P.A.: Ayudas para apoyar grupos de investigación del sistema Universitario Vasco (IT971-16 to P.A.), MCIU/AEI/FEDER, funding from Spanish Ministry of Science, Innovation and Universities (RTI2018-095134-B-100); Excellence Network Grant from MICIU/AEI (SAF2016-81975-REDT and 2018-PN188) to PA and GS; to J.V.: funding from Spanish Ministry of Science, Innovation and Universities (PGC2018-097019-B-I00), the Instituto de Salud Carlos III (Fondo de Investigación Sanitaria grant PRB3 (PT17/0019/0003- ISCIII-SGEFI / ERDF, ProteoRed), and “la Caixa” Banking Foundation (project code HR17-00247); to J.P.B.: funding from Spanish Ministry of Science, Innovation and Universities (PID2019-105699RB-I00, RED2018‐102576‐T) and Escalera de Excelencia (CLU-2017-03); to J.A.E.: funding from Spanish Ministry of Science, Innovation and Universities MINECO (RED2018-102576-T, RTI2018-099357-B-I00), CIBERFES (CB16/10/00282), and HFSP (RGP0016/2018). RAP (XPC/BBV1602 and MIN/RYC1102). The CNIC is supported by the Ministry of Science, Innovation and Universities and the Pro CNIC Foundation, and is a Severo Ochoa Center of Excellence (SEV-2015-0505). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

La enseñanza del derecho en el siglo XX: Homenaje a Mariano Peset

Este libro cierra el tracto que se inició, en octubre de 2002 con la investidura como doctor honoris causa del profesor Mariano Peset. El hecho de que la historia de las universidades haya sido una línea ininterrumpida a lo largo de su investigación y el que hayamos tratado de materializar sus enseñanzas de tantos años en el Instituto Antonio de Nebrija de Estudios sobre la Universidad explican que le hayamos dedicado este homenaje científico en un seminario que tuvo lugar en el campus de Colmenarejo de la Universidad Carlos III durante los días 22 y 23 de septiembre de 2003. Quisimos que el encuentro científico tuviera carácter monográfico, para centrar el interés de nuestro encuentro y evitar la dispersión de los discursos. Y pensamos que tratar de la enseñanza del derecho en el siglo XX era un buen tema por varias razones, entre las que subrayo dos: porque la centuria pasada ya puede ser tratada históricamente y, sobre todo, para continuar la labor de Mariano Peset que, en su día, hizo lo propio para el siglo XIX, con incursiones también en el que nos ocupa en este libro.Prólogo / Adela Mora Cañada. -- La enseñanza de la historia del derecho y la LRU / Ramon Aznar i Garcia y Manuel Martínez Neira. -- Vicente Santamaría de Paredes, político y administrativista / Yolanda Blasco Gil. -- La enseñanza del Derecho en Valencia durante la autonomía de César Silió (1919-1921) / Daniel Comas Caraballo. -- Críticas a la codificación foral prevista en el código civil a la luz de la doctrina jurídico-civil contemporánea / Manuel Vicente Febrer Romaguera. -- La Facultad de Derecho de Valencia en el primer tercio del siglo xx (1900-1938) / Jorge Correa y Fco. Javier Palao. -- La política desde una asignatura: el Derecho Natural / Eusebio Fernández García. -- La institución del Senado en los catedráticos de Derecho Político (1900-1940) / Pilar García Trobat. -- Catedráticos de derecho en la Asamblea Nacional Consultiva de 1927 / María Pilar Hernando Serra. -- El Derecho político en Valencia, con especial referencia a Mariano Gómez González (1915-1932) / M.ª Fernanda Mancebo. -- Fe católica y razón liberal en el Derecho político. La anónima relevancia de Juan de Dios Vico y Brabo (1845-1908) / Sebastián Martín. -- Una polémica profesional: catedráticos y magistrados durante la II República / Pascual Marzal Rodríguez. -- Centro y periferia: el Doctorado en Derecho durante el siglo XX / Antonio Merchán. -- La irrupción de nuevos sectores: el Derecho Laboral / Miguel C. Rodríguez-Piñero Royo. -- El trabajo de cátedra de Adolfo Posada / Mónica Soria. -- Sobre los inicios en la enseñanza del Derecho del Trabajo / Carlos Tormo Camallonga. -- La enseñanza del mercantil a principios del siglo XX. El manual de Lorenzo Benito y Endara / Sergio Villamarín Gómez. – Clausura / Mariano Pese

Barriers of mental health treatment utilization among first-year college students: First cross-national results from the WHO World Mental Health International College Student Initiative.

BACKGROUND: Although mental disorders and suicidal thoughts-behaviors (suicidal thoughts and behaviors) are common among university students, the majority of students with these problems remain untreated. It is unclear what the barriers are to these students seeking treatment. AIMS: The aim of this study is to examine the barriers to future help-seeking and the associations of clinical characteristics with these barriers in a cross-national sample of first-year college students. METHOD: As part of the World Mental Health International College Student (WMH-ICS) initiative, web-based self-report surveys were obtained from 13,984 first-year students in eight countries across the world. Clinical characteristics examined included screens for common mental disorders and reports about suicidal thoughts and behaviors. Multivariate regression models adjusted for socio-demographic, college-, and treatment-related variables were used to examine correlates of help-seeking intention and barriers to seeking treatment. RESULTS: Only 24.6% of students reported that they would definitely seek treatment if they had a future emotional problem. The most commonly reported reasons not to seek treatment among students who failed to report that they would definitely seek help were the preference to handle the problem alone (56.4%) and wanting to talk with friends or relatives instead (48.0%). Preference to handle the problem alone and feeling too embarrassed were also associated with significantly reduced odds of having at least some intention to seek help among students who failed to report that they would definitely seek help. Having 12-month major depression, alcohol use disorder, and suicidal thoughts and behaviors were also associated with significantly reduced reported odds of the latter outcome. CONCLUSIONS: The majority of first-year college students in the WMH-ICS surveys report that they would be hesitant to seek help in case of future emotional problems. Attitudinal barriers and not structural barriers were found to be the most important reported reasons for this hesitation. Experimental research is needed to determine whether intention to seek help and, more importantly, actual help-seeking behavior could be increased with the extent to which intervention strategies need to be tailored to particular student characteristics. Given that the preference to handle problems alone and stigma and appear to be critical, there could be value in determining if internet-based psychological treatments, which can be accessed privately and are often build as self-help approaches, would be more acceptable than other types of treatments to student who report hesitation about seeking treatment.status: publishe

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Les guêpes parasitoïdes Melittobia (Hymenoptera : Eulophidae) dans la péninsule Ibérique : nouvelles données sur la distribution, la biologie et la morphologie

[EN]: Most data about parasitoids of the genus Melittobia (Hymenoptera: Eulophidae) in Europe, where only the native M. acasta (Walker, 1839) and the alien M. australica Girault, 1912 occur, come from studies carried out in the central-northern part of the continent. In the present study, we provide new information on both species in the Iberian Peninsula. We obtained M. acasta from mud nests of Sceliphron destillatorium (Illiger, 1807) (Hymenoptera: Sphecidae) and both M. australica and M. acasta from nests of Sceliphron spirifex (Linnaeus, 1758). Melittobia australica records are the first for this allochthonous species in the Iberian Peninsula, which is the second record in Europe. Rate of parasitism (number of parasitized nests/total number of collected nests) reached almost 50% of nests for M. australica and was much lower for M. acasta (up to 6%). The probability of M. australica to be found in a host nest did not depend on the number of brood cells in the nest, suggesting that nest size does not affect parasitism. Scanning electron microscope (SEM) images provided new information about the morphology of the antennal sensory system of both species. Energy-dispersive X-ray spectroscopy (EDS) revealed the presence of Zn in the mandibles of both species and sexes, suggesting an adaptation to egress from host nests.[FR]: La plupart des données sur les parasitoïdes du genre Melittobia (Hymenoptera : Eulophidae) en Europe, où seule l’espèce indigène M. acasta (Walker, 1839) et l’espèce exogène M. australica Girault, 1912 sont présentes, proviennent d’études menées dans les parties centrales et septentrionales du continent. Dans la présente étude, nous fournissons de nouvelles informations sur les deux espèces dans la péninsule Ibérique. Nous avons obtenu M. acasta dans des nids de boue de Sceliphron destillatorium (Illiger, 1807) (Hymenoptera : Sphecidae), et à la fois M. australica et M. acasta dans des nids de Sceliphron spirifex (Linnaeus, 1758). Les signalements de Melittobia australica sont les premiers pour cette espèce allochtone dans la péninsule Ibérique, et le deuxième en Europe. Le taux de parasitisme (nombre de nids parasités/nombre total de nids collectés) a atteint près de 50% des nids pour M. australica et était beaucoup plus faible pour M. acasta (jusqu’à 6%). La probabilité de trouver M. australica dans un nid-hôte ne dépendait pas du nombre de cellules de couvain dans le nid, ce qui suggère que la taille du nid n’affecte pas le parasitisme. Les images au microscope électronique à balayage ont fourni de nouvelles informations sur la morphologie du système sensoriel antennaire des deux espèces. La spectroscopie à rayons X à dispersion d’énergie a révélé la présence de zinc dans les mandibules des deux espèces et chez les deux sexes, suggérant une adaptation à la sortie des nids des hôtes.The study was funded by a SECTI post-doctoral contract from the Universidad de Castilla-La Mancha (to CP) and a project from Ministerio de Economía, Industria y Competitividad (España) [CGL2017- 83046-P] (to CP).Peer reviewe

Multidisciplinary study on the hydrogelation of the digold(i) complex [{Au(9N-adeninate)}2(μ-dmpe)]: optical, rheological, and quasi-elastic neutron scattering perspectives

Herein, the syntheses of [{Au(9N-adeninate)}2(μ-dmpe)] (2, dmpe = 1,2-bis(dimethylphosphino)ethane) and its chloride precursor [(AuCl)2(μ-dmpe)] (1) are described. X-ray diffraction of 2 reveals a short intramolecular aurophilic interaction (2.9921(7) Å), which is present even when 2 crystallizes from its own hydrometallogel (3.0512(3) Å). This interaction is demonstrated by TD-DFT calculations to be participating in the intense blue phosphorescence that 2 displays in the solid state and, presumably, also in the hydrogel one. Finally, as complex 2 could be understood as a formal dimer of LMWG [Au(9N-adeninate)(PMe3)] (3), the hydrogelation of the former is examined, with special regard to its optical, rheological and quasi-elastic neutron scattering properties, which are compared to those of 3.We gratefully acknowledge the DGI MICINN/FEDER (project number PID2019-104379RB-C22 (AEI/FEDER, UE)) and MCIU/FEDER (project number ECQ2018-004082 (AEI/FEDER, UE)) for financial support, and Laboratorio de Microscopías Avanzadas, Instituto de Nanociencia de Aragón for cryo-STEM facilities. D. Blasco acknowledges MIU (former MECD) for the concession of a FPU grant. J.A. Martínez-González acknowledges funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No. 665593 awarded to the Science and Technology Facilities Council. Neutron beamtime was awarded and data can be found in https://doi.org/10.5286/ISIS.E.RB1920572.Peer reviewe