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To review and update last protocols in hormone sensitive metastatic prostate cancer for improving clinical management in routine. Evidence analysis available about recent updates protocols in hormone sensitive metastatic prostate cancer according to expert panel of clinicians about this field. A nominal consensus group for unify and improve the recommendations to the management of sensitive metastatic prostate cancer patients is currently needed. This document unifies and improve the management of patients with hormone sensitive metastatic prostate cancer, with a methodology that combines data quantitative and qualitative and based on the participation of a broad scientific committee appointed by the Spanish Association of Urology.

In recent years, multidisciplinary programs have been implemented that include different actions during the pre, intra and postoperative period, aimed at reducing perioperative stress and therefore improving the results of patients undergoing surgical interventions. Initially, these programs were developed for colorectal surgery and from there they have been extended to other surgeries. Thoracic surgery, considered highly complex, like other surgeries with a high postoperative morbidity and mortality rate, may be one of the specialties that most benefit from the implementation of these programs. This review presents the recommendations made by different specialties involved in the perioperative care of patients who require resection of a lung tumor. Meta-analyses, systematic reviews, randomized and non-randomized controlled studies, and retrospective studies conducted in patients undergoing this type of intervention have been taken into account in preparing the recommendations presented in this guide. The GRADE scale has been used to classify the recommendations, assessing on the one hand the level of evidence published on each specific aspect and, on the other hand, the strength of the recommendation with which the authors propose its application. The recommendations considered most important for this type of surgery are those that refer to pre-habilitation, minimization of surgical aggression, excellence in the management of perioperative pain and postoperative care aimed at providing rapid postoperative rehabilitation.

La arquitectura muscular del miocardio del corazón está constituida fundamentalmente por células musculares de trabajo o cardiomiocitos responsables de la contracción miocárdica, y un espacio intersticial con un componente de células productoras de colágeno o fibroblastos, rodeados de una matriz extracelular de tejido conectivo. Pequeños grupos celulares de localización predominante en las aurículas contienen características neuroendocrinas. Para que se produzca la activación del miocardio de trabajo estriado y el acoplamiento excitación-contracción a través del potencial de acción transmembrana, es necesaria la presencia de las células especializadas del sistema específico de conducción. El proceso y la secuencia de activación de las cámaras cardíacas se realiza a través del sistema específico de conducción, modulado por las fibras simpáticas y parasimpáticas del sistema neurovegetativo, que ejercen un control autónomo del mismo. El sistema de conducción auriculoventricular está compuesto por miocitos especializados y consta de un componente auricular: el nodo sinoauricular y el nodo auriculoventricular, que están en contacto con el miocardio auricular. A continuación, el haz de His atraviesa el cuerpo fibroso central y termina dividiéndose en dos haces o ramas, una izquierda y otra derecha, las cuales se ramifican en los ventrículos formando las denominadas fibras de Purkinje. El haz de His y sus ramas se encuentran rodeados de una capa de tejido conectivo, la cual se pierde en las fibras de Purkinje, lo que permite a estas establecer contacto directo con el miocardio de trabajo ventricular. Es necesario el conocimiento detallado del tejido específico de conducción para entender el ritmo normal del corazón y los sustratos anatómicos y eléctricos que constituyen las arritmias cardíacas. The specialized electrical conduction system of the heart. The heart nodes and the His-Purkinje system. Anatomical underpinnings of the accessory pathways The muscular architecture of the heart myocardium is mainly composed of muscle cells, or cardiomyocytes, that are responsible for myocardial contraction as well as an interstitial space with a component of collagen-producing cells, or fibroblasts, surrounded by an extracellular matrix of connective tissue. Small cell groups predominantly located in the atria have neuroendocrine characteristics. In order to activate of the striated myocardium and excitation-contraction coupling through transmembrane action potential, the presence of specialized cells of the specific conduction system is necessary. The process and sequence of activation of the heart chambers occurs through the specific conduction system and is modulated by sympathetic and parasympathetic fibers of the neurovegetative system, which exercise autonomous control of it. The atrioventricular conduction system is composed of specialized myocytes and has an atrial component: the sinoatrial node and atrioventricular node, which are in contact with the atrial myocardium. Next, the bundle of His crosses the central fibrous body and divides into two bundles or branches—the left and the right—which branch into the ventricles, forming what is known as Purkinje fibers. The bundle of His and its branches are surrounded by a layer of connective tissue that is lost in the Purkinje fibers, allowing them to establish direct contact with the ventricular myocardium. Detailed knowledge of the specific conduction tissue is necessary to understand normal heart rhythm and the anatomical and electrical underpinnings that constitute heart arrhythmias. Sin financiación No data JCR 2021 0.107 SJR (2021) Q4, 2423/2489 Medicine (miscellaneous) No data IDR 2021 UEM

The design and location of solar energy technologies are based chiefly on the availability of solar resource. Specialized measurement equipment and solar resource assessment techniques are mandatory in order to identify appropriate locations for deploying solar systems while minimizing risk and increasing the return rate of the site. These needs have given the scientific community a motivation to design highly reliable and cost-competitive sensors. This work presents a novel methodology to estimate solar irradiance components using a low-cost sky-imager system. Captured images are processed to correct the spherical aberration of the dome and to achieve a pixel-radiance model, allowing each pixel of the image to be considered as an individual source of irradiation. The performance of the proposed model is analyzed and compared in four different weather scenarios against a secondary standard solarimetric station, obtaining a normalized mean bias error for direct normal irradiance, global horizontal irradiance and diffuse horizontal irradiance of 4.53%, −6.55% and 19.62% for a sunny day, 0.79%, −6.13% and 7.00% for a partially sunny day, 1.96%, −6.58% and −0.73% for a partially cloudy day, 100%, −10.48% and −0.65% for a cloudy day, respectively. According to the experimental results, the system stands out for its performance, easy setup, low-cost components and a robust estimation in all possible weather scenarios.

We propose a new concept of small animal X-ray irradiator based on a conventional imaging X-ray tube for preclinical research. In this work we assessed its feasibility to deliver FLASH dose rates. Our design puts the imaging X-ray tube into a shielded cabinet, which makes the system affordable and suitable to use without disruption in existing laboratories and with minimum regulatory burden. Two conventional 150 kVp X-ray tubes were characterized with Gafchromic films for dose rates and dose uniformity. Monte Carlo simulations were also performed to model the irradiator, and the efficiencies of the tube and dose rates (with and without additional filtration) were calculated and compared with measurements. The feasibility of achieving ultra-high dose rates was determined from the rating charts provided by the manufacturer and measurements. The small animal irradiator proposed in this work was able to deliver conventional dose rate irradiation (0.5-1 Gy/min) at 150 kVp at 20 cm distance with minimum amount of filtration. FLASH irradiations (a 10 Gy dose delivered at >40 Gy/s) were also possible at the maximum capabilities of the tubes by placing the samples at the closest possible distances from the sources. A first prototype has already been built and characterized.

Resumen Objetivo El objetivo de la presente revision fue analizar y comparar la efectividad de distintos tipos de ejercicio terapeutico en personas con dolor cronico del raquis. Metodo La busqueda de datos se realizo utilizando la base de datos electronica MEDLINE. Se incluyeron ensayos clinicos aleatorizados, realizados en pacientes entre 18 y 65 anos con dolor cronico en la region del raquis. Resultados Dos revisores independientes realizaron el analisis de la calidad metodologica utilizando la escala PEDro, siendo 13 los articulos finalmente seleccionados. Los diferentes tipos de ejercicio terapeutico tuvieron efectos significativos en la reduccion del dolor, disminucion de la discapacidad y mejora de la calidad de vida de los pacientes. Conclusiones Los resultados muestran que no hay una modalidad de ejercicio terapeutico superior a otras. La combinacion de diferentes modalidades de ejercicio terapeutico podria resultar una herramienta completa para el manejo del dolor cronico en la columna.

Background and aims: Emergency General Surgery (EGS) conditions account for millions of deaths worldwide, yet it is practiced without benchmarking-based quality improvement programs. The aim of this observational, prospective, multicenter, nationwide study was to determine the best benchmark cutoff points in EGS, as a reference to guide improvement measures. Methods: Over a 6-month period, 38 centers (5% of all public hospitals) attending EGS patients on a 24-h, 7-days a week basis, enrolled consecutive patients requiring an emergent/urgent surgical procedure. Patients were stratified into cohorts of low (i.e., expected morbidity risk = 40.9%, length of hospital stays

Introduction Cytoreductive surgery with hyperthermic intraoperative chemotherapy (HITHOC) is a therapeutic option for treatment of malignant pleural mesothelioma. Anaesthetic management might be challenging. Patients and methods A descriptive analysis of a case series is presented. Seven patients with malignant pleural mesothelioma diagnostic undergoing HITHOC surgery were studied. Combined general and epidural anaesthesia were administered. An intensive haemodynamic monitorization was implemented. Data regarding perioperative course was analyzed. Results Between May 2015 and October 2018 7 patients underwent HITHOC procedure. Blood transfusions were administered in all patients, and 5 of the 7 patients required vasoactive drug administration. Extubation at the end of the procedure was able in 6 of the 7 patients. The median length of stay in ICU was 4 days, and 29 days for the whole hospitalary stay. No significant postoperative pain was observed. Conclusions HITHOC surgery is a complex procedure in which several haemodynamic changes occur. An intensive intraoperative monitorization was useful for controlling complications.

Resumen Objetivos Describir las caracteristicas de las urgencias hipertensivas atendidas en un Servicio de Urgencias, asi como las variables asociadas a reconsulta precoz ( Metodos Se realizo un estudio descriptivo, retrospectivo de todos los pacientes atendidos en el Servicio de Urgencias de un hospital de tercer nivel durante el ano 2013. Posteriormente se realizo un analisis de casos-control para analizar el grupo de pacientes con reconsulta. Resultados Se analizaron un total de 398 urgencias hipertensivas (32,4% hombres, edad media 67,8 anos) lo que represento una incidencia de 3,28/1.000 visitas. Un 80,9% eran hipertensos previamente, siendo 2,23 la media de Indice de Charlson. La cefalea fue el sintoma mas frecuente (49,1%), seguida del mareo/inestabilidad (29,5%) y las nauseas/vomitos (17,1%). Un 80,7% de los pacientes recibieron tratamiento farmacologico. Las tasas de eventos cardiovasculares o mortalidad al mes fueron bajas (2,26% y 0,25% respectivamente). Pese a ello, un 7,53% y un 11,31% de los pacientes reingresaron antes de 7 dias o 30 dias, respectivamente. Las variables asociadas a reconsulta en el analisis multivariante fueron la presion arterial sistolica elevada en la primera determinacion, la hipertension arterial previa y la presencia de palpitaciones. Conclusiones Las urgencias hipertensivas son entidades de elevada incidencia en los Servicios de Urgencias. En nuestro estudio, los individuos con diagnostico previo de hipertension arterial y la presion arterial sistolica elevada en la primera determinacion tienen mayor riesgo de reconsulta y serian candidatos a un seguimiento mas estrecho al alta.

ZnO microstructures were synthesized by conventional and homogenous precipitation methods utilizing ammonium hydroxide and urea as precipitation agents, respectively. Maximum synthesis temperature was around 90 °C for 10 and 13 h. XRD indicates the presence of ZnO wurtzite hexagonal structure and FTIR results suggests that all samples possess similar functional groups whereas an increment in the calcination time increases the Zn-O band intensity at ∼550 cm−1 confirming the formation of ZnO. Morphological analysis evidences ZnO nuts and needle like morphologies for samples calcined at 13 h with urea and ammonia as precipitation agents, correspondingly. Growth mechanism of ZnO porous structures at different calcination temperatures and precipitation agents are reported in this work.

TiO2 thin films were deposited by DC Sputtering varying the deposit time. These films were characterized by XRD, AFM, photoluminescence, UV–Vis, ellipsometry and XPS. The optical properties of TiO2 thin films with different thickness, influenced their photocatalytic behavior in two photoinduced process. When TiO2 thin films were irradiated with a UV light, midgap states were generated and the electrons were placed in lower energies than its band gap, favoring the photocatalytic hydrogen production and CO2 photoreduction. From PL technique analyses it was observed that electrons occupied midgap states between the bands, with lower energies than the band gap. With these results it was possible to propose an energy diagram in order to correlate with photoinduced processes results. The presence of Ti3+ species was reconfirmed by means of XPS analyses. These species could be found in the midgap states, generated by the interaction between the UV irradiation and the film surface, which contributed to the photocatalytic activity of the films. The hydrogen production was similar for all the thin films studied (33–35 μmol) associated to the presence of similar energy midgap states. In the case of CO2 photoreduction, all films produced CH2O (8951 and 6252 μmol/g) and the films with a thickness of 330 and 420 nm generated CH3OH (970 and 292 μmol/g). The extinction coefficient confirmed the XRD results for the film with greatest deposited time, which exhibited the highest crystallinity. All photocatalytic results did not show any dependence with the thin film thickness.

Increased water scarcity can seriously threaten crop productivity worldwide. Therefore, the search for better adapted cultivars to water limitation is needed. Extensive sexual sterility of garlic limits traditional breeding programs and the study of physiological traits provides valuable information for crop selection to stressful conditions. Variability in the functional response of garlic to well-watered (WW) and water deficit (WD) conditions and its relationship with biomass components was analysed in five garlic cultivars (‘Fino de Chinchon’, ‘Gardacho’, ‘Purple from Las Pedroneras’, ‘Violet Spring’ and ‘White Spring’). Significant differences in bulb biomass were found between water treatments, among cultivars and the interaction of the two factors. The observed cultivar variability in yield components was reflected in the variability patterns of functional traits, especially when the plants endured the peak of water deficit. This variability conformed to different adaptive strategies with regards to the plant water economy (i.e. drought escape; drought avoidance through water saving; or water spenders). Inter-cultivar variability should be considered and further explored in garlic selection and future crop improvement.

A detection system composed of a CeBr3 scintillating crystal coupled with a photomultiplier tube and connected to a digital oscilloscope was installed in the control room of a Cyberknife™ clinical accelerator during normal irradiation in order to infer the temporal characteristics of the beam and spectral characteristics of the low-intensity scattered radiation present outside the treatment room. Three batches of 20,000 pulses were measured at three different gantry angles. After digitalization and post-processing of the signals, the time profile of the beam pulses was determined with an accuracy of 14 ns with respect to the gating signal, while the energy spectrum of the measured radiation field could be acquired with a resolution of 5.5%. The proposed device makes it possible, thanks to the increased sensitivity of the scintillating crystals and the digital signal processing techniques in place, to monitor the properties of the radiation present outside the bunker produced by the treatment beam, minimizing interference with patient treatment, QA or research activities.

We report the low-temperature (100 °C) processing and characteristics of PS TiO2 cross-linked hybrid films, obtained by a simple sol-gel route using titanium butoxide (TB) as the inorganic source, styrene (ST) as the organic source, and 3-trimetoxy-silyl-propyl- methacrylate (TMSPM) as the coupling agent. The films were characterized by FTIR to identify the characteristic chemical groups. TGA determined the content of the organic and inorganic components. AFM and SEM images revealed the homogeneous and smooth surface with very low roughness of the hybrid films. At macroscopic level, the hybrid films were homogeneous with high transparency and high refractive index, determined from optical spectroscopy. These characteristics support the formation of a cross-linked hybrid material with strong bonds between organic and inorganic phases. The hybrid films dielectric characteristics were studied by measuring capacitance-voltage (C V) and current-voltage (I V) curves in metal-insulator-metal (MIM) structures. The dielectric constant measured was 5.2 and leakage current around 10−6 A/cm2.

TiO2 nanorods were prepared by hydrothermal method over TiO2 seed layers deposited by DC Sputtering. From the XRD structural characterization, it has been stated that TiO2 seed layer present mainly the anatase phase with some contributions of rutile phase, while for TiO2 nanorods, the rutile phase is present. The thin film thickness were measured using a profilometer, resulting in a thickness of 310 nm for the seed layer and ∼400 nm for TiO2 nanorods. PL analysis for both films presented an indirect transitions Γ1b → Χ2a, as well as oxygen vacancies, defects and surface states. Photocatalytic H2 production for TiO2 seed layer film was around 38 μmol, while TiO2 nanorods produced 132 μmol. This is attributed to the increase to the midgap states present below the conduction band and near to the valence band, which help to improve the photocatalytic activity.

In this work, visible-active BaBiO3 perovskite photocatalysts were prepared by solid state and hydrothermal methods. The physicochemical characterization of the materials was carried out by XRD, SEM, UV–vis, PL and EIS analysis. It was found that the materials exhibit a base centered monoclinic structure with morphology of dense irregular particles and an absorption edge near to 620 nm (∼2 eV) in the visible region. In the photocatalytic tests, BaBiO3 efficiently performed the water splitting reaction and the degradation of rhodamine B (RhB) under visible light using a solar simulator with a Xe- lamp, obtaining attractive yields in both processes (61 μmol g−1 h−1 of H2 evolution and 80% of RhB degradation), which are higher than the reported in previous works for BaBiO3 and competitive with the activity of TiO2 under UV light. The dependence of the catalytic activity in the photoinduced processes from the physicochemical properties of BaBiO3 powders prepared by solid state and the hydrothermal route is studied. According to the results, the crystallinity played the main role in determining the photocatalytic performance of the materials. BaBiO3 synthesized by solid state reaction exhibited the highest crystallinity and presented the best performance compared to the materials synthesized by hydrothermal method. Also, BaBiO3 obtained by solid-state shows the lower resistance for the charge transfer. In summary, the suitable photoabsorption, crystalline structure, and electronic properties of BaBiO3 powders determined their effective application and high activity in the water splitting and degradation of rhodamine B processes. In addition, the potential properties of this compound as a visible-light-driven photocatalyst favored its application in both processes.

The amount of data generated in the laboratory increases constantly, where a common problem needed to be addressed during the data preparation stage is related to noise. The Savitzky-Golay method has been established as the common smoothing technique, where the process is based on two parameters: polynomial order and window size, which are commonly empirically determined. This work shows how the application of the Nyquist theorem allows to calculate the window size parameter of the Savitzky-Golay smoothing method, in order to process bio-optical signals. Like in the case of mid-IR glucose absorption and cervical spine X-ray images, from which a derivative based analysis allows to either confirm or determine regions of interest for further study.

In the present work, we report the electrophoretic deposition of lead molybdate nanoparticles which were synthesized by an ultrasonic-assisted method using Pb(NO3)2 and H2MoO4 as precursors. The PbMoO4 nanoparticles were characterized by X-ray diffraction, UV–vis diffuse reflectance spectroscopy, N2 adsorption-desorption as well as SEM and TEM microscopies. Subsequently, the as-prepared nanoparticles were dispersed in isopropyl alcohol and deposited after 15–45 min under 8, 10, 12 and 14 V on commercial aluminum plates. The results show that the electrophoretic deposition of the PbMoO4 follows a growth like the Volmer-Weber theory, which involves the formation of 3-D islands of particles and its later growth and coalescence. As consequence, the coatings present some cavities and therefore an increase of the surface area, which is important for photocatalytic applications. Finally, the prepared coatings were tested for the photocatalytic degradation of the tetracycline antibiotic under simulated solar irradiation, reaching a 55% of efficiency and a good stability after 4 consecutive degradation cycles.

12 pages, 10 figures, 1 table, In early summer (June 2010), we used zooplankton and hydrographic sampling to analyze relationships between larval fish habitats and converging water masses in the Pacific tropical-subtropical region off Mexico. Results showed an equatorward jet parallel to the Baja California Peninsula (the Tropical Branch of California Current) which was located northward of 25oC surface isotherm. In this area, a larval fish habitat indicated by Triphoturus mexicanus larvae was identified. The habitat had low larval abundance (17 larvae per 10 m2) with major larval concentration below the thermocline (∼ 20 Co and oligotrophic conditions, < 0.3 mg m-3). Two larval fish habitats were defined south of the 25oC surface isotherm. One larval fish habitat was located in a coastal jet and cyclonic field immersed in the Transitional Waters, with the highest larval fish abundance (49 larvae 10 per m2). The indicator species were Vinciguerria lucetia and Diogenichthys laternatus. Both species had the greatest abundance in the warm (∼25 oC) and mesotrophic (>1 mg m-3) waters of the shallow thermocline (∼30 m depth). The other larval fish habitat occupied an area of anticyclonic circulation in the offshore California Current Water, where the thermocline was depressed ∼ 70 m depth. Oligotrophic conditions (0.3 mg m-3) corresponded with the lowest mean larval abundance (14 larvae per 10 m2) of the study. The distribution of the larval fish habitats and their indicator species correspond with the water masses distributions in the Tropical-Subtropical convergence, which are modulated by mesoscale structures affecting the thermocline depth and the larval life-history, The study was funded by the CONACyT Project no. 236864 (LSV, Influencia de remolinos de mesoscala sobre hábitats de larvas de peces en la zona de mínimo de oxígeno frente a México) and IPN-CICIMAR Project no. 20210789 (LSV, Grupos del zooplancton, con énfasis en larvas de peces, en relación a gradientes de oxígeno)

Resumen Objetivo Estimar la tasa de adherencia al tratamiento antiasmatico con corticoide inhalado en condiciones de practica clinica habitual, asi como su relacion con las exacerbaciones, el uso de recursos y los costes. Material y metodos Estudio observacional retrospectivo realizado en el ambito de Badalona Serveis Assistencials. Se incluyeron pacientes ≥ 15 anos con diagnostico confirmado de asma que iniciaron tratamiento con corticoide inhalado entre enero 2010-diciembre 2011. El periodo de seguimiento fue de 24 meses. La adherencia al tratamiento se midio con la tasa de posesion de medicacion, estableciendose 2 grupos: pacientes adherentes (ADH; tasa de posesion de medicacion ≥ 80%) y no adherentes (no-ADH; tasa de posesion de medicacion Resultados Se incluyeron 2.303 pacientes, con una edad media de 48,6 anos, un 64,3% fueron mujeres y un 52,6% presentaban asma persistente moderada. Un 51,0% eran ADH al tratamiento. De los pacientes no-ADH, un 63,4% presento exacerbaciones durante el periodo de estudio frente al 37,4% de los pacientes ADH (p Conclusion La falta de adherencia se relaciono con un aumento de la tasa de exacerbaciones, asi como del consumo de recursos sanitarios y costes.

This paper reports the luminescent response upconversion of zirconium oxide (ZrO 2 ) nanoparticles doped with erbium (Er 3+ ) and ytterbium (Yb 3+ ) ions, synthesized by hydrothermal route. X ray diffraction (DRX) showed that the synthesized material presents the face centered cubic (FCC) structure. High resolution transmission electron microscopy (HRTEM) showed the presence of crystals size smaller than 10 nm. The photoluminescent analysis allowed to observe an intense upconversion luminescence emission of the samples doped with both ions Er 3+ and Yb 3+ , when these are excited with 910 nm laser source, showing the electronic transitions 4 F 9/2 → 4 I 5/2 ; 2 H 11/2 → 4 I 5/2 ; 4 S 3/2 → 4 I 15/2 of Er 3+ . Two decay times were observed, whose behavior can be associated to the average distance between erbium ions within the nanocrystals.

This paper describes an experimental and numerical investigation of the Iberdrola TLP wind turbine concept, TLPWIND, in realistic wind and wave conditions. The TLP was coupled to the NREL 5 MW reference turbine and was designed to operate in a water depth of 70 m. The test campaign included free oscillation tests, tests in regular and irregular waves and simulated wind conditions. A Software-in-the-loop approach was adopted to account for the time-varying aerodynamic forces produced by the turbine during the physical experiments. The effect of wind was found to have a significant contribution to the overall response of the platform whilst variation in wave conditions was found to have a relatively small effect on the platform response. A comparison of results from physical and numerical simulations show that, the numerical predictions from FAST were very close to the results obtained from the experiments in some cases, but in other cases the numerical model failed to accurately predict the platform response. The results from both studies show the benefits of such TLP structures in terms of motions which are vital to obtain a high power output from a floating offshore wind turbine.

We describe a case of fat droplets and blood in the cerebral subarachnoid space secondary in a patient with a complex sacral fracture without associated cranial trauma, a few days after admission. To our knowledge, there is only one published case with similar findings and without any other underlying lesion as cause. We explain the differences in the mechanism of production between this direct fat embolism and brain fat embolism syndrome, which is an intravascular embolism with different radiological appearance. The most important features of sacral fracture with spondylopelvic dissociation are described. Finally, this entity should be taken into account in the differential diagnosis of the few causes of fat in the subarachnoid space. In the context of high-energy trauma fractures of the sacrum or spine must be ruled out as a potential cause of this uncommon intracranial finding.