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SBRT-Spanish Group-05 (ClinicalTrials.gov.Identifier: NCT02192788) is a collaborative (SBRT-SG, Grupo de Investigación Clínica en Oncología Radioterápica, and Sociedad Española de Oncología Radioterápica) prospective multicenter phase II trial testing stereotactic body radiation therapy (SBRT) and androgen deprivation therapy (ADT) in patients with oligorecurrent prostate cancer. Two cohorts of patients with prostate cancer in an oligorecurrent stage (hormone-sensitive in the principal cohort and castration-resistant in the exploratory cohort) were assigned to receive ADT and SBRT for at least 24 months from the time of the enrollment. Concomitant treatment with chemotherapy, abiraterone, or enzalutamide was not allowed. Oncologic outcomes were assessed in both cohorts. Toxicity was prospectively analyzed. From 2014 to 2019, 81 patients with a total of 126 lesions from 14 centers met the inclusion criteria, 14 of whom were castration-resistant. With a median follow-up of 40 months (12-58 months), 3-year local recurrence-free survival was 92.5% (95% CI, 79.9%-96.3%) and 85.7% (95% CI, 48.2%-95.6%) in the principal and exploratory cohorts, respectively. In the principal cohort, biochemical relapse-free survival and metastasis progression-free survival at 1, 2, and 3 years were 91% (95% CI, 81%-95.8%), 73.7% (95% CI, 61.1%-82.8%), 50.6% (95% CI, 36.2%-63.3%), and 92% (95% CI, 83%-97%), 81% (95% CI, 70%-89%), and 67% (95% CI, 53%-77%), respectively. In the exploratory cohort, metastasis progression-free survival at 1, 2, and 3 years was 64% (95% CI, 34%-83%), 43% (95% CI, 18%-66%), and 26% (95% CI, 7%-51%), respectively. None of the patients developed grade III or higher toxicity or symptoms related to local progression, and only 2 (2.4%) patients developed grade II toxicity. The combination of SBRT and ADT is safe and shows favorable clinical outcomes in patients with hormone-sensitive and castration-resistant prostate cancer. Validation studies are needed in patients with castration-resistant prostate cancer. [ABSTRACT FROM AUTHOR]

Currently there is no treatment capable of significantly alleviating all the symptoms of fibromyalgia (FM), even though it is a complex syndrome with a high prevalence in the population. Experimental study using a single-blind, randomised, clinical trial. To analyse the efficacy of manual lymphatic drainage (MLD) as an alternative to traditional treatment of fibromyalgia (FM) in women. This was an experimental study using a single-blind, randomised, clinical trial of 20 women between 30 and 55 years old with FM. Patients were divided into an experimental group (n = 10) and a control group (n = 10). During the study, 3 measurements of pain (visual analogue scale and algometry), FM impact (Fibromyalgia Impact Questionnaire), sleep quality (Index Pittsburgh), anxiety and depression (Hospital Anxiety and Depression Scale) were recorded. Treatment of the experimental group consisted of 2 weekly MLD sessions for 6 weeks. The effect of the interaction of MLD showed statistically significant results in Right intercostal space (F 2,36 = 3.54; p = 0.04; n2p = 0.16). The sleep quality was significantly better favour of the treatment (F 2,36 = 4.16; p = 0.01; n2p = 0.20). MLD therapy demonstrated effects in the experimental group in contrast to the control group across the intervention period concerning the right intercostal space and sleep-related factors. However, MLD did not result in observable alterations in pain perception. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• Critical illness-associated cerebral microbleeds have typical locations such as juxtacortical white matter and corpus callosum. • Most cases present respiratory failure with prolonged mechanical ventilation and ICU stay, indistinctly between COVID-19 and non-COVID-19 patients. • The location of microbleeds were similar between COVID-19 and non-COVID-19 individuals but for a higher brainstem involvement in non-COVID-19 patients. Cerebral microbleeds in critically ill patients have been a reported complication of COVID-19. However, they have also been described in patients with other respiratory infections and conditions requiring intensive care unit (ICU) admission. Here, we aim to describe the clinical characteristics of critical illness-associated cerebral microbleeds and compare COVID-19 cases with those related to other conditions. We performed a systematic literature review in PubMed and Embase for Critical Illness–Associated Cerebral Microbleeds to describe the clinical characteristics of this entity, in both COVID-19 and non-COVID-19 patients. Of 157 manuscripts screened, 23 were included, totalling 143 cases (median age 61, interquartile range [IQR] 54–66), 104 (73 %) men. SARS-CoV2-associated pneumonia was found in 105 (73 %) cases. The median ICU stay was 34 (IQR 26–42) days and the median mechanical ventilation time was 24 (IQR 14–35) days. Cerebral microbleeds were more frequently juxtacortical (79 %) or located in the corpus callosum (75 %) and deep white matter (71 %) for both COVID-19 and non-COVID-19 individuals, whilst brainstem location was more frequent in non-COVID-19 patients (37 % vs 13 %; p = 0.02). Non-COVID-19 patients were younger (median age 42, IQR 30–54 years) than COVID-19 patients (median age 62, IQR 57–67 years; p < 0.001), and the median platelet count was significantly higher (200,000; IQR 116,000–284,000 ng/dL) in COVID-19 patients than non-COVID-19 patients (50,000; IQR 39,000–61,000 ng/mL; (p < 0.001). In this systematic review, most patients presented respiratory failure with prolonged mechanical ventilation and ICU stay. Juxtacortical white matter and corpus callosum are characteristic locations of critical illness-associated microbleeds. [ABSTRACT FROM AUTHOR]

Locally advanced colon cancer is a high-risk condition for tumour recurrence with poor survival. The current treatment is surgery followed by adjuvant chemotherapy based on fluoropyrimidines and oxaliplatin. This approach has improved the oncological outcomes on this population, however the mucinous condition has not been studied in depth and although the evidence is weak, it is thought to have a worse response to systemic chemotherapy. The CHEMUCCA study aims to answer this question. To evaluate the effectiveness of adjuvant systemic chemotherapy using the disease-free survival for stage II and III mucinous colon cancer who underwent surgical resection plus systemic adjuvant chemotherapy vs. surgery alone. Retrospective analytical study including patients diagnosed with high-risk stage II and stage III colon cancer, treated between 2010 and 2021, with a minimum follow-up of 3 years. Demographic variables and tumour features were analysed. The primary endpoint was disease-free survival. Log rank test and Cox regression were used. Of 1134 patients with high-risk stage II and III colon cancer disease, 206 (18,17 %) had mucinous histology and 928 (81,83 %) had non-mucinous histology. 708 patients who received adjuvant chemotherapy, 129 (62,62 %) in mucinous group and 579 (62,39 %) in the non-mucinous group. Adjuvant systemic chemotherapy in stage II and III mucinous colon cancer improved the DFS (HR = 0.58 [95 % CI 0.37−0.91]; p = 0,017). However, in a stratified analysis, patients with high-risk stage II mucinous colon cancer showed no benefit with this approach (HR = 0.4541 [95 % CI 0.19−1.03]; p = 0.06). Adjuvant chemotherapy has demonstrated to be effective in locally advanced mucinous colorectal cancer improving the oncological outcomes. However, this benefit could be diminished in high-risk stage II mucinous colon cancer patients. The administration of adjuvant chemotherapy on this patient's sub-group must be balanced according to risk versus benefits. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• ID3 remains a transcription factor that cannot be targeted for the prevention or treatment of cancer metastasis. • Milk thistle flavonolignan silibinin blocks the inducible activation of ID3 in brain endothelial cells. • Silibinin prevents the constitutive, acquired, and adaptive expression of ID3 in lung cancer cells. • Silibinin blocks ID3 transcription through BMP-responsive regulatory elements in ID3 gene enhancers. • Silibinin directly inhibits the kinase activity of the BMP receptors ACVRL1/ALK1 and BMPR2. • Silibinin suppresses ID3 overexpression in vivo at clinically relevant concentrations. ID3 (inhibitor of DNA binding/differentiation-3) is a transcription factor that enables metastasis by promoting stem cell-like properties in endothelial and tumor cells. The milk thistle flavonolignan silibinin is a phytochemical with anti-metastatic potential through largely unknown mechanisms. We have mechanistically investigated the ability of silibinin to inhibit the aberrant activation of ID3 in brain endothelium and non-small cell lung cancer (NSCLC) models. Bioinformatic analyses were performed to investigate the co-expression correlation between ID3 and bone morphogenic protein (BMP) ligands/BMP receptors (BMPRs) genes in NSCLC patient datasets. ID3 expression was assessed by immunoblotting and qRT-PCR. Luciferase reporter assays were used to evaluate the gene sequences targeted by silibinin to regulate ID3 transcription. In silico computational modeling and LanthaScreen TR-FRET kinase assays were used to characterize and validate the BMPR inhibitory activity of silibinin. Tumor tissues from NSCLC xenograft models treated with oral silibinin were used to evaluate the in vivo anti-ID3 effects of silibinin. Analysis of lung cancer patient datasets revealed a top-ranked positive association of ID3 with the BMP9 endothelial receptor ACVRL1/ALK1 and the BMP ligand BMP6. Silibinin treatment blocked the BMP9-induced activation of the ALK1-phospho-SMAD1/5-ID3 axis in brain endothelial cells. Constitutive, acquired, and adaptive expression of ID3 in NSCLC cells were all significantly downregulated in response to silibinin. Silibinin blocked ID3 transcription via BMP-responsive elements in ID3 gene enhancers. Silibinin inhibited the kinase activities of BMPRs in the micromolar range, with the lower IC 50 values occurring against ACVRL1/ALK1 and BMPR2. In an in vivo NSCLC xenograft model, tumoral overexpression of ID3 was completely suppressed by systematically achievable oral doses of silibinin. ID3 is a largely undruggable metastasis-promoting transcription factor. Silibinin is a novel suppressor of ID3 that may be explored as a novel therapeutic approach to interfere with the metastatic dissemination capacity of NSCLC. [Display omitted] [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To evaluate the therapeutic efficacy of irreversible electroporation (IRE) combined with the intratumoral injection of the immunogenic adjuvant poly-ICLC (polyinosinic-polycytidylic acid and poly-L-lysine, a dsRNA analog mimicking viral RNA) inmediately before IRE.Materials and Methods: Mice and rabbits bearing hepatocellular carcinoma tumors (Hepa.129 and VX2 tumor models, respectively) were treated with IRE (2 pulses of 2500V), with poly-ICLC, or with IRE + poly-ICLC combination therapy. Tumor growth in mice was monitored using a digital caliper and by computed tomography in rabbits.Results: Intratumoral administration of poly-ICLC immediately before IRE elicited shrinkage of Hepa.129 cell-derived tumors in 70% of mice, compared to 30% and 26% by poly-ICLC or IRE alone, respectively (P = .0004). This combined therapy induced the shrinkage of VX-2-based hepatocellular carcinoma tumors in 40% of rabbits, whereas no response was achieved by either individual treatment (P = .045). The combined therapy activated a systemic antitumor response able to inhibit the growth of other untreated tumors.Conclusions: IRE treatment, immediately preceded by the intratumoral administration of an immunogenic adjuvant such as poly-ICLC, might enhance the antitumor effect of the IRE procedure. This combination might facilitate the induction of a long-term systemic response to prevent tumor relapses and the appearance of metastases. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Previous studies indicate a role of CDKN2A/2B/2BAS genes in atherosclerosis and type 2 diabetes mellitus (T2DM). Progression of these diseases is accompanied by T-cell imbalance and chronic inflammation. Our main objective was to investigate a potential association between CDKN2A/2B/2BAS gene expression and T cell phenotype in T2DM and coronary artery disease (CAD) in humans, and to explore the therapeutic potential of these genes to restore immune cell homeostasis and disease progression. Reduced mRNA levels of CDKN2A (p16Ink4a), CDKN2B (p15Ink4b), and CDKN2BAS were observed in human T2DM and T2DM-CAD subjects compared with controls. Protein levels of p16Ink4a and p15Ink4b were also diminished in T2DM-CAD patients while CDK4 levels, the main target of p16Ink4a and p15Ink4b, were augmented in T2DM and T2DM-CAD subjects. Both patient groups displayed higher activated CD3+CD69+ T cells and proatherogenic CD14++CD16+ monocytes, while CD4+CD25+CD127 regulatory T (Treg cells) cells were decreased. Treatment of primary human lymphocytes with PD0332991, a p16Ink4a/p15Ink4b mimetic drug and a proven CDK4 inhibitor, increased Treg cells and the levels of activated transcription factor phosphoSTAT5. In vivo PD0332991 treatment of atherosclerotic apoE-/- mice and insulin resistant apoE-/-Irs2+/- mice augmented Foxp3-expressing Treg cells and decreased lesion size. Thus, atherosclerosis complications in T2DM associate with altered immune cell homeostasis, diminished CDKN2A/2B/2BAS expression, and increased CDK4 levels. The present study also suggests that the treatment with drugs that mimic CDKN2A/2B genes could potential be considered as a promising therapy to delay atherosclerosis. [ABSTRACT FROM AUTHOR]

Abstract Background Patients with hepatocellular carcinoma (HCC) are a growing population of the transplantation waiting list (WL) for orthotopic liver transplantation (OLT). There is no consensus to prioritize these patients while on the WL. Aims To assess whether patients with HCC were more prioritized than non-HCC patients based on their WL survival as primary outcome. Methods Restrospective cohort study including patients listed for elective OLT from January 2013 to January 2016. Results 165 patients with cirrhosis were listed for OLT: 64 in the HCC group (38.78%) and 101 in the non-HCC group (61.22%). Outcomes (HCC vs. non-HCC) were: OLT in 75.51% vs. 64.37%; death or dropout due to worsening in 20.41% vs. 27.59%, and delisting because of improvement in 4.08% vs. 8.05%. HCC patients had a significantly higher WL survival rate (HR = 0.45; 95% CI: 0.21–0.96); lower MELD score at transplantation (21 [20–24] vs. 24 [20–30]; p = 0.021); higher delta-MELD – the difference between MELD at transplantation and MELD at listing time – (3 [2–6] vs. 0 [0–5]; p = 0.024) and longer waiting time until OLT (143 [70–233] vs. 67 [21–164] days; p = 0.008). Conclusion Despite having to wait longer, patients with HCC showed higher WL survival than non-HCC patients. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Fog prediction in airports. • Multi-objective Evolutionary Artificial Neural Networks (MOEANN). • Nonlinear AutoRegressive network with eXogenous Multidimensional inputs (NARXM). • Global accuracy and minimum sensitivity optimisation. • Experimental validation in a real dataset from Valladolid airport. Abstract This paper proposes the application of novel artificial neural networks with evolutionary training and different basic functions (sigmoidal, product and radial), for a real problem of fog events classification from meteorological input variables. Specifically, a Multiobjective Evolutionary Algorithm is considered as artificial neural network training mechanism in order to obtain a binary classification model for the detection of fog events at Valladolid airport (Spain). The evolutionary neural models developed are based on two-dimensional performance measures: traditional accuracy and the minimum sensitivity, as the lowest percentage of examples correctly predicted as belonging to each class with respect to the total number of examples in the corresponding class. These performance measures are directly related to features associated with any classifier: its global performance and the rate of the worst classified class. These two objectives are usually in conflict when the optimization process tries to construct models with a high classification rate level in the generalization dataset, and also with a good classification level for each class or minimum sensitivity. A sensitivity analysis of the proposed models is carried out, and thus the subjacent relations between the input variables and the output classification target can be better understood. [ABSTRACT FROM AUTHOR]

Melanoma is a type of cancer that develops from the pigment-containing cells known as melanocytes. Usually occurring on the skin, early detection and diagnosis is strongly related to survival rates. Melanoma recognition is a challenging task that nowadays is performed by well trained dermatologists who may produce varying diagnosis due to the task complexity. This motivates the development of automated diagnosis tools, in spite of the inherent difficulties (intra-class variation, visual similarity between melanoma and non-melanoma lesions, among others). In the present work, we propose a system combining image analysis and machine learning to detect melanoma presence and severity. The severity is assessed in terms of melanoma thickness, which is measured by the Breslow index. Previous works mainly focus on the binary problem of detecting the presence of the melanoma. However, the system proposed in this paper goes a step further by also considering the stage of the lesion in the classification task. To do so, we extract 100 features that consider the shape, colour, pigment network and texture of the benign and malignant lesions. The problem is tackled as a five-class classification problem, where the first class represents benign lesions, and the remaining four classes represent the different stages of the melanoma (via the Breslow index). Based on the problem definition, we identify the learning setting as a partial order problem, in which the patterns belonging to the different melanoma stages present an order relationship, but where there is no order arrangement with respect to the benign lesions. Under this assumption about the class topology, we design several proposals to exploit this structure and improve data preprocessing. In this sense, we experimentally demonstrate that those proposals exploiting the partial order assumption achieve better performance than 12 baseline nominal and ordinal classifiers (including a deep learning model) which do not consider this partial order. To deal with class imbalance, we additionally propose specific over-sampling techniques that consider the structure of the problem for the creation of synthetic patterns. The experimental study is carried out with clinician-curated images from the Interactive Atlas of Dermoscopy, which eases reproducibility of experiments. Concerning the results obtained, in spite of having augmented the complexity of the classification problem with more classes, the performance of our proposals in the binary problem is similar to the one reported in the literature. [ABSTRACT FROM AUTHOR]

This paper is focused on reducing the number of elements in time series with minimum information loss, with specific applications on time series segmentation. A modification of the coral reefs optimization metaheuristic (CRO) is proposed for this purpose, which is called statistical CRO (SCRO), where the main parameters of the algorithm are adjusted based on the mean and standard deviation associated with the fitness distribution. Moreover, the algorithm is combined with the Bottom-Up and Top-Down methodologies (traditional local search methods for time series segmentation), resulting in a hybrid methodology (HSCRO). We evaluate the performance of these algorithms using 16 time series from different application areas. The statistically-driven version of CRO is shown to improve the results of the standard CRO, eliminating the necessity of manually adjusting the main parameters of the algorithm and dynamically adjusting these parameters throughout the evolution. Moreover, when compared with other local search methods and metaheuristics from the state of the art, HSCRO shows robust segmentation results, consistently obtaining lower approximation errors. [ABSTRACT FROM AUTHOR]

According to European Directive 2012/27/EU energy retrofitting of the current housing stock is being promoted. However, few studies have been carried outcharacterizing housing stock energy performance in order to incorporate energy retrofittingin cities in the southern Mediterranean area. The aim of this paper is to propose an energy assessment methodology on urban scale and to apply it to the southern Spanish province of Cadiz. This is followed by the generation of a predictive model for energy assessment in Mediterranean cities which could be further developed and used in the future to estimate overall energy efficiency on an urban scale. [ABSTRACT FROM AUTHOR]

Ordinal problems are those where the label to be predicted from the input data is selected from a group of categories which are naturally ordered. The underlying order is determined by the implicit characteristics of the real problem. They share some characteristics with nominal or standard classification problems but also with regression ones. In the real world, there are many problems of this type in different knowledge areas, such as medical diagnosis, risk prediction or quality control. The latter has gained an increasing interest in the Industry 4.0 scenario. Some weapons manufacturer follow an aesthetic quality control process to determine the quality of the wood used to produce the stock of the weapons they manufacture. This process is an ordinal classification problem that can be automatised using machine learning techniques. Deep learning methods have been widely used for multiples types of tasks including image aesthetic quality control, where convolutional neural networks are the most common alternative, given that they are focused on solving problems where the input data are images. In this work, we propose a new exponential regularised loss function that is usedto improve the classification performance for ordinal problems when using deep neural networks. The proposed methodology is applied to a real-world aesthetic quality control problem. The results and statistical analysis prove that the proposed methodology outperforms other state-of-the-art methods, obtaining very robust results. • Unimodal regularisation for cross-entropy loss using a distribution based on the proposed Lp exponential function. • Comparison with other regularisation methods based on other distributions and the standard nominal method. • Ordinal output scheme based on the cumulative link models with different link functions. • Combined with convolutional neural networks and applied to the aesthetic quality control process to determine the quality of the wood used to manufacture shotgun stocks. [ABSTRACT FROM AUTHOR]

This paper presents a system for weed mapping, using imagery provided by unmanned aerial vehicles (UAVs). Weed control in precision agriculture is based on the design of site-specific control treatments according to weed coverage. A key component is precise and timely weed maps, and one of the crucial steps is weed monitoring, by ground sampling or remote detection. Traditional remote platforms, such as piloted planes and satellites, are not suitable for early weed mapping, given their low spatial and temporal resolutions. Nonetheless, the ultra-high spatial resolution provided by UAVs can be an efficient alternative. The proposed method for weed mapping partitions the image and complements the spectral information with other sources of information. Apart from the well-known vegetation indexes, which are commonly used in precision agriculture, a method for crop row detection is proposed. Given that crops are always organised in rows, this kind of information simplifies the separation between weeds and crops. Finally, the system incorporates classification techniques for the characterisation of pixels as crop, soil and weed. Different machine learning paradigms are compared to identify the best performing strategies, including unsupervised, semi-supervised and supervised techniques. The experiments study the effect of the flight altitude and the sensor used. Our results show that an excellent performance is obtained using very few labelled data complemented with unlabelled data (semi-supervised approach), which motivates the use of weed maps to design site-specific weed control strategies just when farmers implement the early post-emergence weed control. [ABSTRACT FROM AUTHOR]

Objective Surgical treatment of popliteal artery aneurysms (PAAs) has advanced over time. Constant development of new endovascular techniques has converted these into the most attractive methods available today. However, results for each endovascular procedure are still limited, and available data have emerged from studies examining only a small number of cases. The present retrospective review was designed to examine early and late results for PAA treatment and to identify possible factors associated with graft patency. Methods This was a retrospective review of all PAAs treated from January 1993 to December 2013. Symptomatic and asymptomatic PAAs >2 cm treated using open surgery or an endovascular procedure were included. Kaplan-Meier curves and the Breslow test were used to analyze data. Results A total of 171 aneurysms were treated in 142 men (mean age, 69.3 years); of these, 53.3% were asymptomatic and 18.7% presented as acute ischemia. Saphenous vein was used for bypass in 57.9% of the patients, expanded polytetrafluoroethylene (ePTFE) in 23.4%, and a stent graft in 18.7%. In the open surgical group, a popliteal-popliteal bypass was performed in 37.4% and a distal anastomosis to a tibial vessel was required in 14.4%. Good runoff (two to three vessels) was present in 69%. Perioperative mortality (30 days) was 1.8%. Of eight early occlusions recorded, five (2.9%) underwent reoperations. Major amputations were needed in five patients (all with previous acute ischemia). Median follow-up for the entire cohort was 49 months (range, 1-228 months). Primary and secondary patency rates at 24, 36, and 60 months were 76.3% and 89.5%, 73.4% and 87.4%, and 68.3% and 80.9%, respectively. Popliteal-popliteal bypasses showed better primary patency at 24 months when saphenous vein was used vs ePTFE (94.9% vs 79%; P = .04); however, similar patency rates were recorded for short ePTFE bypasses and stent grafts (79% vs 79.7%). On multivariate analysis, only poor runoff emerged as an independent factor for worse primary patency (hazard ratio, 3.5; 95% confidence interval, 1.7-7.2; P = .001). Conclusions The open repair of PAA offers good long-term results, especially in asymptomatic patients, those undergoing elective surgery, and those showing good runoff. Given the also good midterm outcomes of endovascular treatment, this may be a feasible option in selected patients. [ABSTRACT FROM AUTHOR]

Sovereign rating has had an increasing importance since the beginning of the financial crisis. However, credit rating agencies opacity has been criticised by several authors highlighting the suitability of designing more objective alternative methods. This paper tackles the sovereign credit rating classification problem within an ordinal classification perspective by employing a pairwise class distances projection to build a classification model based on standard regression techniques. In this work the ϵ -SVR is selected as the regressor tool. The quality of the projection is validated through the classification results obtained for four performance metrics when applied to Standard & Poors, Moody's and Fitch sovereign rating data of U27 countries during the period 2007–2010. This validated projection is later used for ranking visualization which might be suitable to build a decision support system. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Patología is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Highlights: [•] The problem of constructing an organ allocation model via machine learning techniques is assessed. [•] The combination of donor, recipient, and surgery characteristics helps the prediction of graft survival after transplantation. [•] An ordinal classifier has been proved to perform well for the 4-category classification problem assessed. [•] An extended supranational experimental design for liver transplantation allocation could be feasible considering more countries. [Copyright &y& Elsevier]

Abstract: Nowadays, with the rapid development of new technologies, it is very difficult to be an active member of the society unless one is proficient in reading. Unfortunately, there are a lot of people who experience reading or writing problems. Experts who create materials for these groups of people have few user-friendly tools at their disposal in order to prepare easy-to- read texts. The present work has been done with the aim of providing support for text simplification experts who prepare easy-to-read texts in English, which is why different Natural Language Processing tools have been integrated in an already existing text editor. [Copyright &y& Elsevier]

Summary: Aim: To validate the Spanish version of the Emotional Labour Scale (ELS), an instrument widely used to understand how professionals working with people face emotional labor in their daily job. Method: An observational, cross-sectional and multicenter survey was used. Nursing students and their clinical tutors (n=211) completed the self-reported ELS when the clinical practice period was over. First order and second order Confirmatory Factor Analyses (CFA) were estimated in order to test the factor structure of the scale. Conclusions: The results of the CFA confirm a factor structure of the scale with six first order factors (duration, frequency, intensity, variety, surface acting and deep acting) and two larger second order factors named Demands (duration, frequency, intensity and variety) and Acting (surface acting and deep acting) establishing the validity of the Spanish version of the ELS. [Copyright &y& Elsevier]

Summary: The aim of the study was to identify the differences in functionality of the upper limb in subjects suffering from shoulder impingement syndrome after intervention by two manual therapy protocols. Randomized, single-blind study with a sample of 22 subjects (58 ± 10.86 years old) divided into two groups. The conventional-group (n = 11) received mobilizations of the shoulder and the experimental-group (n = 11) was treated with soft tissue techniques in the cervical and upper thoracic regions. These two groups received electrotherapy and postural advices. The treatment lasted three weeks (15 daily sessions of 1 h and 30 min). Both active and passive range of motion (ROM) and self-perceived functionality of the upper limb (DASH questionnaire) were measured. The experimental group showed a significant improvement in the DASH scores and both groups improved mobility in the intra-group comparison pre-intervention versus post-intervention (p < .05), but not statistically significant differences were found in the between-group comparison (p > .05). Our results suggest that a combined treatment with electrotherapy, postural hygiene and manual therapy, regardless of the protocol, improves shoulder mobility and functionality. [Copyright &y& Elsevier]

Abstract: This paper deals with one of the most important keys for economic growth: scientific knowledge and innovation, following the linear Research and Development (R&D) model. Patents, scientific publications and expenditure in R&D as well as the personnel involved in these activities are taken into account as proxy indicators, together with variables related to education and economy in order to classify R&D performance in 25 European Union (EU) Member States. This study classifies these countries using a set of variables which characterize them from 2005 to 2008 and analyses the most relevant ones for this classification. The Multilayer Perceptron Model (MLP) and the Product-Unit Neural Network (EPUNN) models, both trained by evolutionary algorithms (EA), were used to classify yearly country observations in clusters previously defined by employing unsupervised algorithm k-means clustering, obtaining four different classes of national R&D performance: low, moderate, high and innovation driven economies. Finally, our methodology is compared to other classification methods normally used in machine learning. The results show that while various methods of classification exist, our methodology obtains models with a significantly lower number of coefficients without decreasing their accuracy in predicting the classification of other European countries or in these countries in the following years. [Copyright &y& Elsevier]

Abstract: Radial Basis Function Neural Networks (RBFNNs) have been successfully employed in several function approximation and pattern recognition problems. The use of different RBFs in RBFNN has been reported in the literature and here the study centres on the use of the Generalized Radial Basis Function Neural Networks (GRBFNNs). An interesting property of the GRBF is that it can continuously and smoothly reproduce different RBFs by changing a real parameter τ. In addition, the mixed use of different RBF shapes in only one RBFNN is allowed. Generalized Radial Basis Function (GRBF) is based on Generalized Gaussian Distribution (GGD), which adds a shape parameter, τ, to standard Gaussian Distribution. Moreover, this paper describes a hybrid approach, Hybrid Algorithm (HA), which combines evolutionary and gradient-based learning methods to estimate the architecture, weights and node topology of GRBFNN classifiers. The feasibility and benefits of the approach are demonstrated by means of six gene microarray classification problems taken from bioinformatic and biomedical domains. Three filters were applied: Fast Correlation-Based Filter (FCBF), Best Incremental Ranked Subset (BIRS), and Best Agglomerative Ranked Subset (BARS); this was done in order to identify salient expression genes from among the thousands of genes in microarray data that can directly contribute to determining the class membership of each pattern. After different gene subsets were obtained, the proposed methodology was performed using the selected gene subsets as new input variables. The results confirm that the GRBFNN classifier leads to a promising improvement in accuracy. [Copyright &y& Elsevier]

Abstract: In this paper, q-Gaussian Radial Basis Functions are presented as an alternative to Gaussian Radial Basis Function. This model is based on q-Gaussian distribution, which parametrizes the Gaussian distribution by adding a new parameter q. The q-Gaussian Radial Basis Function allows different Radial Basis Functions to be represented by updating the new parameter q. For example, when the q-Gaussian function takes a value of q →1, it represents the standard Gaussian Radial Basis Function. The model parameters are optimized through a Memetic Algorithm that evolves both its structure and connections. To evaluate the effectiveness of the model, it is tested with a real problem of predictive microbiology. The problem consists of determining the growth boundaries of Staphylococcus aureus, a food borne pathogen responsible for several outbreaks. The data from the study of belongs to growth/no growth conditions of S. aureus whose temperature, pH and water activity () has been divided into three categorical classes: growth (G), growth transition (GT) and no growth (NG). Due to the imbalanced nature of the problem, it has been necessary to apply an over-sampling algorithm. The over-sampling procedure selected was the Synthetic Minority Over-Sampling Technique (SMOTE) algorithm. This algorithm has been applied to the patterns in the minority class in order for the performance of the classifier in this class to be acceptable (the minority class in this problem is of vital interest). [Copyright &y& Elsevier]

Abstract: The main objective of this work is to automatically design neural network models with sigmoid basis units for binary classification tasks. The classifiers that are obtained achieve a double objective: a high classification level in the dataset and a high classification level for each class. We present MPENSGA2, a Memetic Pareto Evolutionary approach based on the NSGA2 multiobjective evolutionary algorithm which has been adapted to design Artificial Neural Network models, where the NSGA2 algorithm is augmented with a local search that uses the improved Resilient Backpropagation with backtracking—IRprop+ algorithm. To analyze the robustness of this methodology, it was applied to four complex classification problems in predictive microbiology to describe the growth/no-growth interface of food-borne microorganisms such as Listeria monocytogenes, Escherichia coli R31, Staphylococcus aureus and Shigella flexneri. The results obtained in Correct Classification Rate (CCR), Sensitivity (S) as the minimum of sensitivities for each class, Area Under the receiver operating characteristic Curve (AUC), and Root Mean Squared Error (RMSE), show that the generalization ability and the classification rate in each class can be more efficiently improved within a multiobjective framework than within a single-objective framework. [Copyright &y& Elsevier]

Abstract: Familial hypercholesterolemia (FH) is a clinical condition with high risk for developing atherosclerosis. Increased oxidative stress (OS) and FH have been related to atherosclerosis, but no data are available on levels of OS and antioxidant enzyme activity in circulating mononuclear cells (CMCs) from FH patients. Circulating mononuclear cells are important mediators in atherosclerosis development, and chronically increased blood OS present in FH can induce modification in CMC activity. The objective of the study was to analyze the OS levels in CMCs from FH patients and controls. We have selected 30 nonrelated FH index patients and 30 normoglycemic and normocholesterolemic controls matched by age, sex, body mass index, abdominal circumference, and homeostasis model assessment index. Production of free radicals was analyzed by measurement of xanthine oxidase activity in plasma, reduced and oxidized glutathione (GSH and GSSG, respectively), and malonyldialdehyde in levels CMCs. Antioxidant status was analyzed by measuring antioxidant enzyme activity as superoxide dismutase, catalase, and glutathione peroxidase. We have found that FH patients showed significantly higher xanthine oxidase and malonyldialdehyde enzyme activities, as well as increased GSSG and lower GSH values resulting in a higher GSSG/GSH ratio. These data indicate a higher free radical production in plasma and increased OS levels in CMCs from patients than from controls. No significant differences were found in superoxide dismutase, catalase, and glutathione peroxidase activities between both groups. These data show an important alteration of OS regulation in FH and the absence of antioxidant response in CMCs mediated by some of the major antioxidant enzymes. [Copyright &y& Elsevier]

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Abstract: Objectives: To establish the incidence of restenosis (RES) following carotid endarterectomy (CEA) and evaluate clinical and technical factors related to its development. Design: Prospective non-randomised cohort study. Patients and methods: Two hundred and twenty-four patients with 243 CEA between May 1998 and December 2002, were subjected to clinical and haemodynamic follow-up, median follow-up 23 months (1–56). There was selective use of a shunt (17.3%) and patch (61.7%). RES (≥50%) and severe restenosis, ≥70%, (sRES) were defined as peak systolic velocities of ≥150 and ≥300cm/s (or ≥250cm/s with diastolic velocity >100cm/s), respectively. Rates of RES, symptom development and mortality were analysed using Kaplan–Meier curves. Cox''s regression model (hazards ratio/95% CI) was used to evaluate prognostic factors. Results: We detected 13 sRES (5.3%) (median time 6.1 months) and 30 (12.3%) moderate stenosis (mRES) (median time 3.7 months). Cumulative freedom from sRES at 23 months was 94.2%. Five sRES detected in the first 45 days after the procedure were deemed to be residual restenosis (rRES). Five (38.4%) sRES were symptomatic, 15.3% progressed to occlusion. Patient survival was 98.0 and 96.4% at 12 and 24 months, respectively. Independent risk factors for sRES: female sex (HR: 3.3, 95% CI 1.1–10 p=0.04) and diabetes (HR: 4.5, 95% CI 1.4–13.9 p=0.008). Conclusions: Carotid restenosis appears early, is usually low-grade and mostly asymptomatic. Although few stenoses progress to occlusion, women and diabetic patients were at highest risk. [Copyright &y& Elsevier]

• Study of generalisability for estimating cognitive load along with contexts and subjects. • Proved methods and features for studying cognitive load determined with EEG. • Low generalisability while comparing models from different people (inter-subject). • High generalisability while comparing models from different cognitive load tests (inter-context). Cognitive load is defined as the information the working memory is holding at specific moment. It has been studied not only in education but also in medicine, particularly regarding the diagnosis of disorders such as mild cognitive impairment. In our study, we examined the generalisability of cognitive load metrics obtained with electroencephalography (EEG) across various participants and contexts in four combinations: (a) inter-subject and intra-context, (b) inter-subject and inter-context, (c) intra-subject and intra-context, and (d) intra-subject and inter-context. EEG signals were recorded from 19 participants as they completed two cognitive assessment tests with differentiable levels of cognitive load: the n -back test and Stroop test. The data obtained were processed to extract numerous features that were later reduced following a forward feature selection and used to train different models for the various combinations of generalisability. Analysing the performance of trained models revealed that classification in (a) showed results close to random classification, in (b) showed significative differences between Stroop levels, in (c) revealed a classifier able to find patterns associated with the various levels of cognitive load for both tests, and in (d) indicated that Stroop levels were differentiable. Although the methods analysed can be used to determine patterns for each participant in a particular context and applied to different contexts, they cannot establish generalisable models among participants in a single context. Our analysis of the feature selection captured a group of powerful algorithms and parameters potentially usable for extracting features in cognitive load analysis. [ABSTRACT FROM AUTHOR]

• Brand congruence and brand credibility affect perceived value and future intentions of spectators. • Brand credibility predicts spectators' satisfaction and moderates the effect of perceived value on future intentions. • Brand congruence moderates the effect of satisfaction on future intentions. • Satisfaction is a necessary condition of high future intentions. • The lack of congruence is a necessary condition of low future intentions. This research aims to determine the effects of brand credibility and brand congruence on future intentions, perceived value, and spectators' satisfaction among the fans of a first division football team by combining two complementary methodological approaches, lineal models (the PROCESS macro) and fuzzy set qualitative comparative analysis (fsQCA). The effects of brand credibility and brand congruence were tested in a sample of 536 fans of a first division Spanish football club aged from 18 to 70 (70.2% men). The results suggest direct, positive, and significant effects of brand congruence and brand credibility on perceived value and future intentions. In contrast, in predicting spectators' satisfaction, only brand credibility was a significant positive predictor. Brand credibility significantly predicts spectators' satisfaction. A moderating effect of brand credibility in the effect of perceived value on future intentions was observed, and a moderating effect of brand congruence in the effect of satisfaction on future intentions was observed. Spectators' satisfaction seems to be a necessary condition of high future intentions while a lack of congruence seems to be a necessary condition of low future intentions. The findings contribute to understanding how brand credibility and brand congruence relate to service evaluations in professional football [ABSTRACT FROM AUTHOR]

Convolutional Neural Networks stands at the front of many solutions which deal with computer vision related tasks. The use and the applications of these models are growing unceasingly, as well as the complexity required to deal with bigger and highly complex problems. However, hitting the most suitable model for solving a specific task is not trivial. A very manually intensive and time consuming trial-and-error experimentation is needed in order to find an architecture, hyperparameters and parameters which reach a certain level of performance. Moreover, this process leads to oversized models, diminishing their generalisation capacity. In this paper, we leverage a metaheuristic and a hybridisation process to optimise the reasoning block of CNN models, composed by fully connected and dropout layers, conducting a full reconstruction that leads to lighter models with better performance. Our approach is architecture-independent and operates at the topology, hyperparameters and parameters (connection weights) levels. For that purpose, we have implemented the Hybrid Statistically-driven Coral Reef Optimisation (HSCRO) algorithm as an extension of SCRO, a metaheuristic which does not require to adjust any parameter since they are automatically and dynamically chosen based on the statistical characteristics of the evolution. In addition, a hybridisation process employs the backpropagation algorithm to make a final fine-grained weights adjustment. In the experiments, the VGG-16 model is successfully optimised in two different scenarios (the CIFAR-10 and the CINIC-10 datasets), resulting in a lighter architecture, with an 88% reduction of the connection weights, but without losing its generalisation performance. • Hybrid Statistically-Driven Coral Reef Optimisation algorithm. • Convolutional Neural Networks optimisation. • Fully connected layers of CNN models reduction. • Evolution of parameters, hyperparameters and architecture in CNN. • Hyperparameters and network architecture configuration in deep learning models. [ABSTRACT FROM AUTHOR]

• A full-body videogame elicited more social initiation conducts than free play in ASD children when they were playing alone or with a peer. • The videogame was also effective in reducing repetitive behaviors and increasing gestures. • The videogame could be considered as an appropriate tool to foster social behaviors but future work is needed to support this hypothesis. • Finding new attractive types of treatment would be useful to complement more traditional therapies. Game-based interventions that involve the use of technology have shown to facilitate motivation and learning processes in children with Autism Spectrum Disorders (ASD). The purpose of this observational study project was to conduct a feasibility study to compare the amount of social initiation conducts performed during a full-body interaction videogame versus the amount of social initiation conducts occurred during a free-play activity in children with ASD. We hypothesized that the videogame could elicit a higher number of these conducts and therefore could be proposed as a tool to promote social initiation skills. A total of 15 children (ages 4–6) participated in four sessions with two sections: playing with the videogame Pico's Adventure and free play time. Social skills conducts were codified according to an observational scale. Results show that the videogame elicited more social initiation conducts than free play in children with ASD when they were playing alone or playing with a peer. Furthermore, it showed to be as effective as free play in promoting social initiation while playing with parents. The videogame was also effective in reducing repetitive behaviors and increasing gestures. Considering all these results, the videogame could be considered as an appropriate tool to foster social behaviors but future work is needed in order to obtain further data that supports this hypothesis. Finding new attractive types of treatment would be useful to complement more traditional therapies. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether the amount of oxygen provided during postnatal stabilization changes the DNA methylome in preterm infants.Study Design: This prospective, observational study included 32 preterm infants ≤32 weeks of gestation who received oxygen in the delivery room. Patients were monitored using a respiratory function monitor to determine the amount of oxygen received upon stabilization. Blood samples were processed for comparison of DNA methylation before and after resuscitation using a DNA methylation high-resolution microarray Infinium Human DNA methylation EPIC 850K BeadChip.Results: The median amount oxygen provided to preterm infants during stabilization was 644 mLO2/kg. Male sex and vaginal delivery were associated with increased oxygen needs. There were 2626 differentially methylated CpGs representing 1567 genes that showed an association with oxygen load selected and, of these, 85% were hypomethylated. We found that oxygen loads of >500 mLO2/kg changed the methylation pattern of the selected CpGs. Genes associated with these CpGs were "enriched" in KEGG pathways involved in cell cycle progression, DNA repair, and oxidative stress.Conclusions: The oxygen load provided upon resuscitation modified the DNA methylome. Differential methylation may lead to altered expression of genes related to cell cycle progression, oxidative stress, and DNA repair. The reversibility of these early epigenetic changes is unknown but merits further study. [ABSTRACT FROM AUTHOR]

Summary: In this article we address concerns raised by Brumit and Glenn (2013) regarding the validity of the Spanish version of the Emotional Labour Scale (ELS). We respond to requests in relation to the translated version of the scale and the eigenvalue series. We also give an explanation of the differences in results between the original version and the Spanish version of the scale. [Copyright &y& Elsevier]

Cowden syndrome is a rare autosomal dominant disease. It is characterized by multiple noncancerous tumorlike growths called hamartomas, which typically are found in the skin, oral mucosa, thyroid, breast, and gastrointestinal tract. It carries with it a potential risk of malignant transformation, especially of the breast and thyroid. In 80% of the cases, the human tumor suppressor gene, phosphatase and tensin homolog (PTEN), is mutated in the germ line. We report a patient with Cowden syndrome who presented with generalized seizure and left anterior temporal hemorrhage and a nontraumatic subarachnoid hemorrhage due to multiple intracranial arteriovenous fistulas (AVFs). We discuss previous reports about vascular malformations in patients with Cowden syndrome and PTEN mutations. Importantly, we hypothesize that the production of multiple AVFs in our patient was associated with PTEN mutation. [ABSTRACT FROM AUTHOR]