Adhesió del President de la Generalitat al projecte de la jubilació de periodistes

Adhesió del President de la Generalitat al projecte de la jubilació de periodiste

Motivations and challenges of an engineering lecturer to implement EMI and innovative methodology

The objective: Explore the drivers for both EMI and teaching innovation.Find out the extent to which they influence each other: does EMI implementation lead to lecturers’ reappraisal of their courses on a level or are innovative lecturers more prone to engage in EMIPeer ReviewedPostprint (published version

Assessing the impact of early detection biases on breast cancer survival of Catalan women

Survival estimates for women with screen-detected breast cancer are affected by biases specific to early detection. Lead-time bias occurs due to the advance of diagnosis, and length-sampling bias because tumors detected on screening exams are more likely to have slower growth than tumors symptomatically detected. Methods proposed in the literature and simulation were used to assess the impact of these biases. If lead-time and length-sampling biases were not taken into account, the median survival time of screen-detected breast cancer cases may be overestimated by 5 years and the 5-year cumulative survival probability by between 2.5 to 5 percent units

Gestión de destinos familiares a través de la gamificación y personalización de viajes en familia en tiempo real

This paper presents a digital development designed specifically for family tourism with the creation of applications named Costa Daurada Trip&Kids and Terres de l’Ebre Trip&Kids. Its objectives are: 1) to facilitate, through an intelligent system, family tourism experiences to certain tourist attractions, especially beaches, cultural heritage and wine culture, and 2) to improve the experience of families during the visit to the attractions and increase their loyalty degree. These applications use intelligent systems to suggest to families the experiences that best suit their needs (such as children's age, interests, means of transport, etc.), considering the affluences, booking availability, parking options, opening hours or weather forecast, among others, in real time, of the attractions and their surroundings. The applications use gamification tools to enable the collection of user data, as well as to encourage visits to other areas with less popularity and help alleviate overcrowding in most frequented ones. Finally, indicators for tourism destination managers are generated through monitoring the behaviour of users with the applications.En este artículo se presenta un desarrollo tecnológico diseñado específicamente para el turismo familiar que se materializa en las aplicaciones Costa Daurada Trip&Kids y Terres de l’Ebre Trip&Kids. Sus objetivos son: 1) facilitar a través de un sistema de gestión inteligente las visitas de turismo familiar hacia determinados atractivos turísticos, en especial los relacionados con las playas, el patrimonio cultural y la cultura del vino, y 2) mejorar la experiencia de las familias durante la visita a los atractivos e incrementar su grado de fidelización. Las aplicaciones utilizan sistemas inteligentes para sugerir a las familias las experiencias que mejor se ajustan a sus necesidades (edad de los niños, intereses, medio de transporte, etc.), teniendo en cuenta la afluencia, la posibilidad de reservar, las opciones de aparcamiento, los horarios o la meteorología, entre otros, en tiempo real, de los atractivos y su entorno. Las aplicaciones utilizan herramientas de gamificación para posibilitar la recogida de datos de los usuarios, así como también para incentivar las visitas a otras zonas con menor afluencia y descongestionar las zonas más frecuentadas. Finalmente, se generan indicadores para los gestores de destinos turísticos a través de la monitorización del comportamiento de los usuarios con las aplicaciones

Multiple independent primary cancers do not adversely affect survival of the lung cancer patient §

Abstract Objective: Diagnosis of multiple independent primary cancers is increasing in many settings. Objectives of this study were to analyze clinical characteristics, organ location, and prognosis associated with the presentation of multiple independent primaries when a lung cancer is involved. Methods: We analyzed all patients with a histology-proven diagnosis of lung cancer registered from January 1990 to December 2004 at the Tumor Registry of the Hospital del Mar, Barcelona. We compared 1686 patients presenting a lung cancer as unique primary versus 228 patients presenting a lung cancer and another independent primary. Cofactors included age, sex, smoking habit, lung cancer histology and stage, type and intention of treatment, organ location of the other cancer, and survival from the date of lung cancer diagnosis. Results: Seventy percent of the other cancers were tobacco-related. Independent risk factors of cancer multiplicity were smoking (OR: 3.99; 95% CI: 1.4-11.2), lung cancer stages I (OR: 1.84; 95% CI: 1.2-2.9) and II (OR: 3.25; 95% CI: 1.7-6.3), and older age (OR: 3.11; 95% CI: 1.9-5.1). Once adjusted by age and sex, the main determinant of survival was lung cancer stage rather than cancer multiplicity. However, patients with multiple cancers presented a slightly better survival than patients with a lung cancer as unique primary. When analyzed by subgroups, survival was higher in patients with the lung cancer first (HR: 0.44; 95% CI: 0.24-0.80), and in patients with the other cancer first (HR: 0.80; 95% CI: 0.65-0.99), but it was not different in the patients with a lung cancer and a synchronous other cancer (HR: 0.80; 95% CI: 0.52-1.15). Conclusions: The risk of developing a second independent cancer was strongly associated with tobacco smoking. Cancer multiplicity was not associated with a worse prognosis. As a consequence, when a first primary tobacco-related cancer is treated with curative intention, patients should be closely followed up for an early diagnosis of a possible new independent cancer; and if diagnosed, treatment to cure should be considered as the first option.

A critical view of the restoration of dune systems in the Balearic Islands (2000-2017)

En las últimas décadas, se han aplicado a lo largo del litoral del estado español diferentes técnicas de gestión litoral con el fin de restaurar, mantener y proteger los sistemas playa-duna. Estas técnicas se han basado en la emulación artificial de los procesos naturales que favorecen la recuperación del sistema, mientras en otras se ha basado en la instalación de servicios que evitan la frecuentación y pisoteo de los sistemas dunares. La falta de criterios geomorfológicos en algunas actuaciones realizadas en las islas Baleares han generado y agravado procesos erosivos sobre aquellos que se pretendían recuperar, o bien se han fijado de forma artificial sistemas dinámicos. Este trabajo ejemplifica algunas técnicas aplicadas sin criterios geomorfológicos sobre sistemas dunares.In recent decades, different coastal management techniques have been used along the Spanish coast in order to restore, maintain and protect beach-dune systems. These techniques are based on the artificial emulation of natural processes that favour the recovery of the system, while others have been based on the setting up of services that avoid the frequenting and trampling of the dune systems. The lack of geomorphological criteria in some management activities carried out in the Balearic Islands, has caused and aggravated erosion on the systems that were supposed to be recovered, or they have artificially established those dynamic systems. This paper illustrates some techniques applied without geomorphological criteria on dune systems.Este artículo contribuye parcialmente al desarrollo del proyecto “Crisis y reestructuración de los espacios turísticos del litoral español” (CSO2015-64468-P) del Ministerio de Economía y Competitividad (MINECO) y del Fondo Europeo de Desarrollo Regional (FEDER)

La falta d’expressió de MICA en pacients amb càncer de bufeta significa un pitjor pronòstic

Antecedents: el càncer de bufeta urinària i de pulmó es troben entre els deu tipus de càncer més comuns en ambdós sexes. El receptor NKG2D i un dels seus lligants, MICA, s’associen amb el tabaquisme i la susceptibilitat de patir malaltia pulmonar obstructiva crònica i càncer de pulmó. Objectiu: esbrinar si el sistema NKG2D-MICA s’associa amb altres càncers epitelials relacionats amb l’hàbit de fumar com el càncer de bufeta. Disseny, Escenari i Participants: 70 casos primaris de càncer de bufeta no múscul invasiu van ser examinats per detectar l’expressió de MICA i CD8 +, CD4 + i la infiltració de cèl·lules NK. La majoria dels pacients (n = 55, 78,6%) eren fumadors actuals o anteriors. Metodologia: la tecnologia de microarrays (TMA) va ser triada per avaluar MICA i l’infiltració tumoral de limfòcits en les mostres de càncer de bufeta. Es varen utilitzar Curves de Kaplan-Meier i l’anàlisi univariant de Cox per avaluar la recaiguda, mortalitat total per càncer i la mortalitat específica per càncer de bufeta. Resultats i limitacions: MICA es va expressar en la majoria dels espècimens de càncer examinats (és a dir, 70%). La recaiguda del càncer de bufeta no es va associar amb l’estat d’expressió de MICA (log rank p = 0,1123). No obstant això, ha existit una associació significativa entre l’expressió de MICA i l’alta mortalitat per càncer de bufeta (HR = 0,25; IC95% = 0,06-0,97). Limfòcits CD4 + i CD8 + es van trobar a la majoria (64%) de les mostres de tumors infiltrants. Les cèl·lules que expressen el receptor NKG2D es van trobar només en el 3% de les mostres. No hi havia cap funció lineal entre les cèl·lules NKG2D +, el nombre o proporció de cèl·lules CD4 + i CD8 + TIL. Conclusions: MICA s’expressa només en una proporció significativa de carcinomes de bufeta. L’expressió de MICA s’associa amb avantatges significatius en la supervivència davant el càncer de bufeta. El sistema NKG2D-MICABackground: Bladder and lung cancer are among the ten most common cancers in both genders. The NKG2D receptor and one of its ligands, MICA, are associated with smoking and susceptibility to both chronic obstructive pulmonary disease and lung cancer. Objective: We hypothesized that NKG2D-MICA system was associated with other smok- ing-related epithelial cancers such as bladder cancer. Design, Setting, and Participants: 70 cases of primary non-muscle invasive bladder cancer were screened for the MICA expression and CD8+, CD4+ and NK cell infiltration. Most patients (n = 55, 78.6%) were current or former smokers. Measurements: Tissue microarray (TMA) technology was chosen to evaluate MICA and tumor infiltrating lymphocytes in samples with confirmed bladder cancer. Kaplan- Meier curves and univariate Cox analysis was used to assess relapse, all-cancer mortality and specific bladder cancer mortality. Results and Limitations: MICA was expressed in most cancer specimens examined (i.e., 70%). Relapse of bladder cancer was not associated with the status of MICA expression (log rank p = 0.1123). Nevertheless, a signifi- cant association existed between high MICA expression and bladder cancer mortality (HR = 0.25; CI95% = 0.06 - 0.97). Tumor infiltrating CD4+ and CD8+ lymphocytes were found in the majority (64%) of samples. Cells expressing the NKG2D receptor were found in only 3% of the samples. There was no linear function between NKG2D+ cells and number or ratio of CD4+ and CD8+ TIL. Conclusions: MICA is expressed in a significant proportion of bladder carci- nomas. MICA expression associates with significant survival advantages in the face of both all-cancer and bladder can- cer. The NKG2D-MICA system could represent a common mechanism involved in the immunopathology and natural history of bladder neoplasms

Estimación del coste hospitalario del cáncer colorrectal en Cataluña

Objetivo: Estimar el coste hospitalario del tratamiento del cáncer colorrectal (CCR) según estadio, tipo de coste y fase de evolución de la enfermedad en un hospital público. Métodos: Se realizó un estudio retrospectivo de costes de la atención hospitalaria del CCR de una cohorte de 699 pacientes con diagnóstico y tratamiento de CCR entre los a nos 2000 y 2006 en el Hospital del Mar, con seguimiento de hasta 5 a nos desde el diagnóstico de la enfermedad, a partir de bases de datos clínico-administrativas. Se analizó el coste medio por estadio, tipo de coste y fase de evolución de la enfermedad. Resultados: El coste medio por paciente en casos con diagnóstico in situ fue de 6573 D . Este coste aumentó en estadios más avanzados y llegó a los 36.894 D en el estadio III. Los principales componentes del coste fueron la cirugía-hospitalización (59,2%) y la quimioterapia (19,4%). En estadios más avanzados, el peso de la cirugía-hospitalización disminuyó, mientras que el de la quimioterapia aumentó. Conclusión: Este estudio proporciona el coste hospitalario del tratamiento del CCR calculado a partir de la práctica clínica habitual. La cirugía y el tratamiento quimioterápico son los principales componentes del coste. Los resultados obtenidos aportarán la información necesaria para los análisis de coste-efectividad de distintas iniciativas preventivas e innovaciones terapéuticas en nuestro entorno

Association between Radiologists' Experience and Accuracy in Interpreting Screening Mammograms

<p>Abstract</p> <p>Background</p> <p>Radiologists have been observed to differ, sometimes substantially, both in their interpretations of mammograms and in their recommendations for follow-up. The aim of this study was to determine how factors related to radiologists' experience affect the accuracy of mammogram readings.</p> <p>Methods</p> <p>We selected a random sample of screening mammograms from a population-based breast cancer screening program. The sample was composed of 30 women with histopathologically-confirmed breast cancer and 170 women without breast cancer after a 2-year follow-up (the proportion of cancers was oversampled). These 200 mammograms were read by 21 radiologists routinely interpreting mammograms, with different amount of experience, and by seven readers who did not routinely interpret mammograms. All readers were blinded to the results of the screening. A positive assessment was considered when a BI-RADS III, 0, IV, V was reported (additional evaluation required). Diagnostic accuracy was calculated through sensitivity and specificity.</p> <p>Results</p> <p>Average specificity was higher in radiologists routinely interpreting mammograms with regard to radiologists who did not (66% vs 56%; p < .001). Multivariate analysis based on routine readers alone showed that specificity was higher among radiologists who followed-up cases for which they recommended further workup (feedback) (OR 1.37; 95% CI 1.03 to 1.85), those spending less than 25% of the working day on breast radiology (OR 1.49; 95% CI 1.18 to 1.89), and those aged more than 45 years old (OR 1.33; 95% CI 1.12 to 1.59); the variable of average annual volume of mammograms interpreted by radiologists, classified as more or less than 5,000 mammograms per year, was not statistically significant (OR 1.06; 95% CI 0.90 to 1.25).</p> <p>Conclusion</p> <p>Among radiologists who read routinely, volume is not associated with better performance when interpreting screening mammograms, although specificity decreased in radiologists not routinely reading mammograms. Follow-up of cases for which further workup is recommended might reduce variability in mammogram readings and improve the quality of breast cancer screening programs.</p

Factors related with symptom duration until diagnosis and treatment of symptomatic colorectal cancer

BACKGROUND: Colorectal cancer (CRC) survival depends mostly on stage at the time of diagnosis. However, symptom duration at diagnosis or treatment have also been considered as predictors of stage and survival. This study was designed to: 1) establish the distinct time-symptom duration intervals; 2) identify factors associated with symptom duration until diagnosis and treatment. METHODS: This is a cross-sectional study of all incident cases of symptomatic CRC during 2006–2009 (795 incident cases) in 5 Spanish regions. Data were obtained from patients’ interviews and reviews of primary care and hospital clinical records. Measurements: CRC symptoms, symptom perception, trust in the general practitioner (GP), primary care and hospital examinations/visits before diagnosis, type of referral and tumor characteristics at diagnosis. Symptom Diagnosis Interval (SDI) was calculated as time from first CRC symptoms to date of diagnosis. Symptom Treatment Interval (STI) was defined as time from first CRC symptoms until start of treatment. Nonparametric tests were used to compare SDI and STI according to different variables. RESULTS: Symptom to diagnosis interval for CRC was 128 days and symptom treatment interval was 155. No statistically significant differences were observed between colon and rectum cancers. Women experienced longer intervals than men. Symptom presentation such as vomiting or abdominal pain and the presence of obstruction led to shorter diagnostic or treatment intervals. Time elapsed was also shorter in those patients that perceived their first symptom/s as serious, disclosed it to their acquaintances, contacted emergencies services or had trust in their GPs. Primary care and hospital doctor examinations and investigations appeared to be related to time elapsed to diagnosis or treatment. CONCLUSIONS: Results show that gender, symptom perception and help-seeking behaviour are the main patient factors related to interval duration. Health service performance also has a very important role in symptom to diagnosis and treatment interval. If time to diagnosis is to be reduced, interventions and guidelines must be developed to ensure appropriate examination and diagnosis during both primary and hospital care