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Intrahepatic cholangiocarcinoma (iCCA) primarily arises from the transformation of cholangiocytes (epithelial cells of the bile ducts), is diagnosed at late stage and has a dismal prognosis (average 5-year survival after resection is 32%). An alarming increase in its incidence over the past decades and the scarce treatment options available urges for the development of novel therapeutic strategies to tackle this malignancy. Immunotherapy has had limited success in iCCA. Possible explanations are that iCCA immune microenvironment is poor in CD8+ T cells and rich in immunosuppressive innate immune cells. The immune landscape of iCCA is determined by the aetiology of the liver insult (e.g. viral, cholestatic) and these different iCCA immune landscapes have not yet been characterized. Therefore, in depth studies on the immunobiology of iCCA are essential to develop new immunotherapy strategies where innate immune cells play a prominent role. We hypothesized that bile acids (BA) are a potential, valid therapeutic target for iCCA, as they strongly influence liver immune microenvironment and proliferation. This idea is supported by the fact that BA have an immunomodulatory role through inhibition of NF-KB and reduction of macrophage production of pro-inflammatory cytokines, suppressing cholangiocyte transformation in iCCA. Since BA and derivatives have recently been approved for the treatment of human chronic cholestatic diseases and primary sclerosis cholangitis, but have not yet been tested to treat iCCA, the proposed project might directly offer evidence for a second use of these drugs in patients with iCCA. Using novel preclinical mouse models of iCCA and human iCCA samples, our objective is to develop new therapeutic strategies for iCCA treatment based on BA signalling, that would impair tumour growth and foster the immune response against the tumour. In order to investigate the effects that BA can exert in tumour initiation and development, we adopted a iCCA mouse model based on the hydrodynamic tail-vein delivery of genetic elements specifically in hepatocytes, which differentiate into cholangiocytes and ultimately leads to the development of iCCA, while conserving a competent immune system. We found that by feeding the animals with an endogenous BA-enriched diet (BA diet), we reduced the overall tumor burden and strikingly increased overall survival. The positive response to the BA diet was associated to an inhibition of tumor proliferation and a robust increase in the abundance and activation of inflammatory monocytes and T cells. Our preliminary results indicate that mimicking the effect of BA could represent a novel immunotherapeutic strategy for iCCA. We will present these data as well as ongoing studies including fluorescence-activated cell sorting and single-cell RNA seq sequencing, focused on understanding the cooperation between different immune cell types that foster response against the tumor. Citation Format: María García-Beccaria, Mirian Fernández-Vaquero, Maria Reich, Dominik Pfister, Diran Herebian, Benjamin Goeppert, Darjus Felix Tschaharganeh, Verena Keitel, Mathias Heikenwälder. Bile acid signaling remodels the iCCA immune microenvironment [abstract]. In: Proceedings of the AACR Special Conference: Advances in the Pathogenesis and Molecular Therapies of Liver Cancer; 2022 May 5-8; Boston, MA. Philadelphia (PA): AACR; Clin Cancer Res 2022;28(17_Suppl):Abstract nr PO026.

European Conference on Antennas and Propagation (15th. Online. 2021), In this work, a dual-reflector antenna based on a Cassegrain optics with a compact self-supported subreflector is presented to operate at X-band. The feeding subsystem is composed of a subreflector surface, the primary feed and a supporting structure in a single dielectric piece, providing a smart solution. The antenna is fed by a metallic rectangular waveguide with a H-plane transition to a Dielectric Rectangular Waveguide (DRW) finished on a hyperboloid. The designing process presented is based on optical geometrics and it is validated through the manufacture of the Cassegrain antenna. The prototype is fabricated using a 3-D printed technique and the subreflector and main parabolic reflector are metalized by a coating technique. The antenna is simulated and measured obtaining a high agreement on both. The prototype shows good performances in the whole band, validating both the designing technique and the proposed subreflector., This work was supported in part by the Ministerio de Ciencia, Innovación y Universidades under Project TEC2017-86619-R (ARTEINE), the European Space Agency under Contract ESTEC/AO/1-7064/12/NL/MH, and by Gobierno del Principado de Asturias/FEDER under Project GRUPIN-IDI/2018/0001991.

The failure of intubation in a patient with Difficult Airway (VAD) is not yet uncommon, which is why the wide use of rescue devices for direct laryngoscopy is still booming. It is in this area where videolaryngoscopy gain strength, offering indirect laryngoscopy through a multivariate assembly of lenses and optics. In this study, it is expected to evaluate the success rate with a videolaryngoscope using a traditional preformed stylet-guide with a certain angle of anteroposterior mobility vs. flexible guidance that allows anteroposterior and lateral mobility such as a fiberscope with the optical fiber turned off. The results experienced a better success rate in intubation on the first attempt and a lower rate of complications in airway management with glidescope+fiberscope., El fracaso de intubación en un paciente con Vía Aérea Difícil (VAD) todavía no es infrecuente, es por ello que la amplia utilización de dispositivos de rescate de la laringoscopia directa sigue en auge. Es en este ámbito donde cobran fuerza los videolaringoscopios, que ofrecen una laringoscopia indirecta a través de un montaje multivariado de lentes y ópticas. En este estudio se pretende evaluar la tasa de éxito con un videolaringoscopio usando una guía tradicional preformada con cierto ángulo de movilidad anteroposterior vs guía flexible que permite movilidad anteroposterior y lateral como es un fibrobroncospio con la fibra óptica apagada. Los resultados muestran una mejor tasa éxito en la intubación en el primer intento y menor tasa de complicaciones en el manejo de las vías respiratorias.

The indications for the use of supraglottic devices have been extended over time and today they have taken a prominent role in the management of the difficult airway within the different algorithms of scientific societies. This study tries to evaluate if these algorithms are really being put into practice (and therefore the use of these devices as a rescue) in our normal practice everyday. We have a retrospective cohort study of the Danish database on anesthetic acts comprising an extended period from 2008 to 2012 , analyzing 658,104 general anesthesia of adult patients. Special attention is given to patients who presented difficult airway, and the management to ensure oxygenation and airway. After statistical analysis, it is concluded that supraglottic devices are not widely used as rescue devices in patients with difficult airway, despite their relevant role in the management algorithms of this., Las indicaciones para el uso de dispositivos supraglóticos se han ido ampliando con el tiempo y hoy en día han tomado un papel destacado en el manejo de la vía aérea difícil dentro de los diferentes algoritmos de las sociedades científicas. Este estudio trata de evaluar si realmente se están poniendo en practica estos algoritmos(y por tanto el uso de estos dispositivos como rescate) en el día a día médico. Para ello se evalúa un estudio de cohorte retrospectivo de la base de datos danesa, sobre actos anestésicos que comprende un periodo extendido de 2008 a 2012 analizando 658104 anestesias generales de pacientes adultos. Se presta especial atención a los pacientes que presentaron vía aérea difícil, y el manejo que se realiza para asegurar la oxigenación y la vía aérea. Tras análisis estadísticos se concluye que, los dispositivos supragloticos no son ampliamente utilizados como dispositivos de rescate en pacientes con vía aérea difícil, a pesar de su relevante papel en los algoritmos de manejo de esta.

Simposium Nacional de la Unión Científica Internacional de Radio (URSI) (35º. Málaga. 2020), In this work, a reflectarray is proposed to be used as a plane wave generator (PWG).The reflectarray works at 28 GHz and produces a uniform plane wave in a certain region of the Fresnel region of the antenna, reaching an ultra-compact structure. In a first approach, a far-field focused reflectarray is analyzedto create the plane wave. However, the size where the plane wave is considered uniform is not large enough for its use in compact antenna test ranges (CATR). The desired wave must satisfy tight requirements, both in amplitude and phase, to be considered as auniform plane wave. The generalized Intersection Approach is used to improve the plane wave performances by doing a Phase-Only synthesis (POS)on the phase of the reflectarray elements. Simulations of the plane wave generated by the antenna before and after the optimization process are compared, showing an important enhancement on the uniformity of thewave. The obtained phase distribution is used to design and manufacture a reflectarray based on a three-parallel-dipoles cell. The prototype is measured in a planar range facility to evaluate the quality of the radiated plane wave. Measurements show a low ripple in both amplitude and phase, thus promising results are obtained., This work was supported in part by the Ministerio de Ciencia, Innovación y Universidades under project TEC2017-86619-R (ARTEINE), by Ministerio de Economía, Industria y Competividad under project TEC2016-75103-C2-1-R (MYRADA), and by Gobierno del Principado de Asturias/FEDER under project GRUPIN-IDI/2018/000191.

IEEE International Symposium on Antennas and Propagation and Noth American Radio Science Meeting- Proocedings (Montréal, Canada. 2020), In this work a reflectarray is proposed to be used as a plane wave generator (PWG). The reflectarray works at 𝟐𝟖 𝐆𝐇𝐳 and produces a plane wave in the Fresnel region of the antenna in order to obtain a compact structure. The generated wave front must satisfy tight requirement both in amplitude and phase in order to be considered as an uniform plane wave. The designed reflectarray based on a three-parallel-dipole cell has been manufactured. The prototype is measured in a planar range facility to evaluate the performances of the plane wave generated. The antenna satisfies the tight requirements and shows low ripple both in phase and amplitude and, therefore, promising results are obtained., This work was supported in part by the Ministerio de Ciencia, Innovación y Universidades under project TEC2017-86619-R (ARTEINE), by Ministerio de Economía, Industria y Competitividad under project TEC2016-75103-C2-1-R (MYRADA), and by Gobierno del Principado de Asturias/FEDER under project GRUPIN-IDI/2018/000191.

International Conference on Electromagnetics in Advanced Applications (ICEAA) (21st. 2019. Granada, Spain), A transmitarray antenna working at 28 GHz is proposed as a base station for novel indoor communications, including 5-G, Internet of Things (IoT) and wireless power transfer. This antenna produces a near-field coverage area in a desire area wherein the device should be found, giving them a total connectivity with external but also internal networks. Concerning the feeder, instead of using a single feeder configuration a cluster of them is selected. This cluster works in the 28 GHz band but using different channel which improves the capacity of the base station. In addition, a Phase-Only Synthesis (POS) is carried out in order to improve the features of the near-field coverage but only for the central feed and the final performances are evaluated for all the spots., This work was supported in part by the Ministerio de Ciencia, Innovacion y Universidades under project TEC2017-86619-R (ARTEINE) and by the Gobierno del Principado de Asturias/FEDER under Project GRUPINIDI/ 2018/000191.

​Annual​ ​Meeting​ ​and​ ​Symposium​ ​of​ ​the​ ​Antenna​ ​Measurement​ ​Techniques Association (41st​. 2019. San Diego​, ​USA), A reflectarray antenna working at 28 GHz is proposed to replace the reflector antenna of a Compact Antenna Test Range (CATR) system. As a first approach, the quiet zone obtained using a far-field collimated reflectarray is analysed. Due to the size of this area is not large enough, the generalized Intersection Approach is employed to carry out an optimization of the near-field for both phase and amplitude in order to maximize the size of the quiet zone at one plane. Simulations are compared for the near-field before and after the optimization process, showing an important enhancement of the size of the quiet zone, especially in the main cuts. From the obtained phase distribution a design is carried out. The unit cell chosen is based on a two-layer stacked patch, having good agreement between optimization and design results. Finally, the bandwidth response of the designed reflectarray is analysed, in order to assess its performances as probe in a CATR system., This work was supported in part by the Ministerio de Ciencia, Innovacion y Universidades under project TEC2017-86619-R (ARTEINE) and by the Gobierno del Principado de Asturias/FEDER under Project GRUPIN-IDI/2018/000191

​Annual​ ​Meeting​ ​and​ ​Symposium​ ​of​ ​the​ ​Antenna​ ​Measurement​ ​Techniques Association (41st​. 2019. San Diego​, ​USA), A transmitarray antenna is proposed as a multifocusing antenna in the near-field region with capability for focus scanning and/or simultaneous and independent focus spots generation at 28 GHz. The transmitarray optics is defined for a centred configuration and the elements are designed to focus the radiated near-field at a given point. Then, a number of feeds is placed along arcs in the principal planes and the near-field generated by the transmitarray when its illuminated by each one is obtained, demonstrating the capability to generate multiple independent near-field spots. The focusing performance is improved for the centered feed through a Phase-Only synthesis technique based on the generalized Intersection Approach in near-field. Finally, the spots produced by the whole cluster are calculated, demonstrating the overall improvement and validating the designing process. This configuration can be applied in near-field systems as radar for surface inspection, measurement systems or wireless power transfer among others., This work was supported in part by the Ministerio de Ciencia, Innovacion y Universidades under project TEC2017-86619-R (ARTEINE) and by the Gobierno del Principado de Asturias/FEDER under Project GRUPIN-IDI/2018/000191.

Abarcaremos el desarrollo de una de las técnicas decorativas más destacadas del territorio granadino, poniendo en manifiesto todos los elementos que hacen de ella única. Con el auge de las falsificaciones en el arte, principalmente en el siglo XIX, y con la pervivencia en la actualidad de talleres que desarrollan esta técnica con los conocimientos transmitidos del pasado a través de las generaciones que han ido transcurriendo, trataremos también las falsificaciones que se producen consiguiendo llegar incluso a museos de conocido nombre haciéndose pasar por originales., Departamento de Historia del Arte, Grado en Historia del Arte

European Conference in Antennas and Propagation (13th, 2019, Krakow, Poland), This work has been supported in part by the Ministerio de Ciencia, Innovación y Universidades under project TEC2017-86619-R (ARTEINE); by the Ministerio de Economía, Industria y Competitividad under project TEC2016-75103-C2-1-R (MYRADA); and by the Gobierno del Principado de Asturias under project GRUPIN-IDI-2018-000191 and through Programa “Clarín” de Ayudas Postdoctorales / Marie Courie-Cofund under project ACA17-09.

The study of weather extremes is critical because of their great impact on the environment, economy and society. The identification of areas at greater risk of extreme conditions, and of meteorological situations that give rise to such conditions, enhances the understanding of climate risks and helps establish measures to reduce adverse impacts. In the current paper, precipitation extreme events (PEEs) in Spain between 1960 and 2011 were analysed. Thresholds for determining event severity were defined using 99th percentiles. First, regions of extreme weather risk were identified and then trends of extreme precipitation index were analysed using the Mann–Kendall test. To better understand atmospheric processes associated with extreme weather events in each season, synoptic-scale fields of events exceeding the 99th percentile were analysed. By applying non-hierarchical K-means clustering, we defined six large-scale atmospheric patterns that largely explain the spatiotemporal distribution of PEEs in the study area. PEEs on the western Iberian Peninsula mainly occurred with zonal flow, with a long Atlantic fetch generating moisture advection towards that area. On the eastern peninsula, the most important pattern for PEE production is characterized by a cutoff low at mid-levels together with easterly moisture flow. The relationship of PEEs with teleconnection patterns, such as the North Atlantic Oscillation (NAO), Mediterranean Oscillation (MO) and Western Mediterranean Oscillation (WeMO), showed that nearly all the events over the southwestern peninsula were during the NAO- and MO-negative phases. However, on the Mediterranean coast, the negative WeMO phase had greater influence. By contrast, the northwestern peninsula and eastern Cantabrian coast showed weaker relationships between these indices and PEEs. The results show a clear ability to identify regions exposed to extreme precipitation hazards. The correct identification of synoptic patterns associated with each type of weather extreme will assist the prediction of such events, thereby providing useful information for decision making and warning systems.

El fracaso de intubación en un paciente con Vía Aérea Difícil (VAD) todavía no es infrecuente, es por ello que la amplia utilización de dispositivos de rescate de la laringoscopia directa sigue en auge. Es en este ámbito donde cobran fuerza los videolaringoscopios, que ofrecen una laringoscopia indirecta a través de un montaje multivariado de lentes y ópticas. Los videolaringoscopios nos han aportado en la especialidad de Anestesiología una visión enormemente nítida en muchos casos de glotis prácticamente imposibles, mejorando por tanto el grado de visibilidad ( clasificado en la Escala de Cormack-Lehane), pero esta ventaja no siempre conduce a un aumento en la tasa de éxito de intubación traqueal, debido a que la adecuada inserción del tubo a través de las cuerdas vocales es un factor limitante. Por ello se precisa de guías que permitan dar al tubo endotraqueal una forma adecuada para una correcta intubación. En este estudio se pretende evaluar la tasa de éxito con un videolaringoscopio usando una guía tradicional preformada con cierto ángulo de movilidad anteroposterior vs guía flexible que permite movilidad anteroposterior y lateral como es un fibrobroncospio con la fibra óptica apagada. Los resultados muestran una mejor tasa éxito en la intubación en el primer intento y menor tasa de complicaciones en el manejo de las vías respiratorias. ABSTRACT Better vision makes better intubation? The failure of intubation in a patient with Difficult Airway (VAD) is not yet uncommon, which is why the wide use of rescue devices for direct laryngoscopy is still booming. It is in this area where videolaryngoscopy gain strength, offering indirect laryngoscopy through a multivariate assembly of lenses and optics. Videolaryngoscopy have given us in Anesthesiology an enormously clear vision in many cases of practically impossible glottis, thus improving the degree of visibility (classified in the Cormack-Lehane Scale), but this advantage does not always lead to an increase in the success rate of tracheal intubation, due to the proper insertion of the tube through the vocal cords is a limiting factor. Therefore, stylet-guides are required that need to give the endotracheal tube a suitable form for proper intubation. In this study, it is expected to evaluate the success rate with a videolaryngoscope using a traditional preformed stylet-guide with a certain angle of anteroposterior mobility vs. flexible guidance that allows anteroposterior and lateral mobility such as a fiberscope with the optical fiber turned off. The results experienced a better success rate in intubation on the first attempt and a lower rate of complications in airway management with glidescope+fiberscope.

IEEE International Symposium on Antennas and Propagation and USNC-URSI Radio Science Meeting (2018, Boston), This work was supported in part by COST Action TD1301, MiMed; and by the Ministerio de Economía y Competividad (Spanish Government), under the projects TEC2017-86619-R (ARTEINE) and TEC2016-75103-C2-1-R (MYRADA).

The effect conjugated linoleic acid (CLA) accumulation in fish fillet on sensory and texture attributes has been evaluated. Fish were fed diets with graded levels of CLA, which were administered for different durations prior to harvest. Fish were sampled for fillet proximate composition and fatty acid profile for sensory and texture parameters at the end of the trial. Growth performance, feed conversion ratio and muscle proximate composition were not affected by dietary treatments. Muscle fatty acid profile was not affected by dietary treatments despite the increase in saturated fatty acids in fish fed diet with 10 g kg−1 of CLA for 16 weeks before harvest. Besides, the deposition levels of CLA isomers increased gradually depending on the CLA treatment, reaching its maximum level in fish fed 10 g kg−1 CLA diet for 20 weeks before harvest. Fish fed 10 g kg−1 were juicier (P

Resumen de comunicaciones de las III Jornadas Doctorales de la Universidad de Castilla-La Mancha

FisioUpdate is a project developed by some Lecturers teaching in courses related with Physiology at Universidad Europea de Madrid. The aim of this project is to be updated in the most recent discoveries in Physiology, and to approach this knowledge to our students in class. Since its beginning, 5 years ago, the Lecturers have attended weekly meetings, presenting and discussing 3–4 papers in each session. To date, almost 15 teachers, from 2 different Departments and different professional backgrounds, have attended permanent or occasionally, these meetings. The articles analyzed (more than 170) have dealt with varied topics, such as skeletal muscle (types of fibers, satellite cells, fatigue, exercise adaptation, hyperemia…), membrane physiology (gas transport, ionic channels…), neuromuscular junction (proteins involved, medical therapies…), brown, beige and white adipose tissue (leptin, anorexigenic hormones..) The knowledge acquired from these meetings was included and applied in subjects related to Physiology in 1st and 2nd years of many Health Sciences Degrees, such as Medicine, Sports, Physical Therapy, Psychology… Additionally, every year we have included new tools for spreading the existence of the project to other Lecturers and Departments in our University. In this sense, we have published a compendium with the summaries of the articles reviewed, and we have circulated it to our colleagues via mail. Besides, we have created a wiki space, with restricted access to the components of the FisioUpdate project, to function as a database of all the papers reviewed and a short summary of them. When appropriate, we also have uploaded to the wiki supplementary resources, such as graphs, schema, pictures or any other relevant information for a better understanding of the articles analyzed. Based on all these results, we consider that these kinds of activities are highly recommended for Lecturers, as a way to be updated in the most recent contents in a determined area. Currently, the participants on this project are highly motivated to continue with it, and working on the incorporation of new Lecturer for next years. Sin financiación 2.444 JCR (2016) Q2, 37/84 Physiology; Q3, 166/290 Biochemistry & Molecular Biology UEM

In the present study, the effects of long term feeding dietary conjugated linoleic acid (CLA) on growth, liver and perivisceral fat morphology, lipid metabolism enzymes and prostaglandin production potential were assessed. Two hundred and forty-three European sea bass (152.4 ± 1.96 g) were randomly allocated in 9 indoor 1 m 3 fiberglass tanks (4.1 kg/m 3 ) and assigned three diets containing graded amounts of CLA (0, 0.5 and 1%) for 20 weeks. Dietary CLA did not affect growth performance or tissue proximate composition although increased the saturated fatty acid fraction in fish fed with 1% CLA in muscle. Muscle and liver fatty acid profiles were slightly altered by CLA inclusion, mainly by the increase of the CLA isomers and by the increase of 18:0 and the decrease of 16:1n-7. Liver lipogenic and lipolytic enzymes were not affected by dietary CLA. Hepatocyte area was reduced in fish fed with 1% of CLA, as well as adipocyte area in fish fed with 0.5% of CLA where adipocyte number by unit of area also increased. Head kidney prostaglandins' production potential was reduced in fish fed with 1% of CLA, having also a negative correlation with dietary CLA level of inclusion. The present results suggest that CLA can be incorporated up to 1% in 150 g European sea bass for 20 weeks without affecting fish performance or enzyme activities and at the time improves liver and adipose tissue morphology.

The physiological response to stressors in fish, including hormonal profiles and associated tissue responsiveness, is less documented. The aim of this study was to evaluate feeding gilthead sea bream ( Sparus aurata ) with diets containing linseed oil (LO) and soybean oil (SO) as substitutes to fish oil (FO) and their effect on fatty acid profile of head kidney and the consequent effect on stress response to a crowding challenge. Fish were fed 8 experimental diets with different levels of substitution 0% (FO), 70% (70LO, 70SO, 20LO50SO and 50LO20SO) and 100% (100LO, 100SO and 50LO50SO) over a period of 8 months. At the end of the feeding trial, samples of head kidney were collected for biochemical analysis and the fish were challenged by a crowding test. During the challenge, samples of plasma for cortisol analysis were collected at 0 h, 2 h, 5 h, 24 h, 48 h and 1 week in order to study acute and chronic stress responses. Results showed that fish fed vegetable oils (VO) had significantly decreased ARA, EPA, DHA and n-3 HUFA, while LA, LNA and total C18 PUFAs were significantly increased. The basal cortisol levels were significantly increased in fish fed 70LO, 100LO, 50LO20SO and 50LO50SO. The physiological response to crowding was significantly affected by the diet. After 2 h of crowding, all the treatments showed higher cortisol, with fish fed 100LO had significantly the highest response registering 131.38 pg/ml. After 5 h and 24 h, plasma cortisol was reduced in all treatments except in 50LO20SO. After 48 h of crowding, the plasma cortisol was increased in all treatments with the maximum value seen in fish fed 100LO (72.12 pg/ml). These levels were decreased in fish fed FO, 70LO, 100LO and 50L050SO after 1 week of crowding, but remained higher in fish fed 70SO, 100SO, 20LO50SO and 50LO20SO. In conclusion, fish fed LO diets showed the same response pattern as the control but with higher intensity regaining the basal levels after 1 week as the control, while fish fed SO had a slow response but changed the pattern characterized by a lower response at the beginning and longer recuperation without regaining the control value even after 1 week.

Introduction: Ergospirometry objectively quantifies exercise capacity. Up until now, the response to exercise evaluated by ergospirometry in patients with pulmonary arterial hypertension has only been described in recently diagnosed.patients.

Increased energy content in fish feeds has led to an enhanced fat deposition, particularly in European sea bass, concerning fish farmers. Inclusion of conjugated linoleic acid (CLA) could reduce fat deposition as in other vertebrates. To determine if dietary CLA affects fat deposition, lipid metabolism, lipid composition and morphology of different tissues, growth and selected immune parameters, European sea bass juveniles were fed 4 graded levels of CLA (0, 0.5, 1 and 2%). Growth and feed conversion were not affected by CLA, whereas feed intake was reduced (P

La estenosis traqueal tras la intubación es una situación de gran importancia clínica. Se calcula que se produce aproximadamente en el 5-20% de los pacientes intubados o traqueostomizados. Un 1% de los casos conllevan disfunción respiratoria severa. Se presenta a un paciente de 45 años que sufre una enfermedad coronaria aguda grave resuelta en quirófano bajo anestesia general (primera intubación-ocasión). El paciente ingresa en la unidad de cuidados intensivos conectado a ventilación mecánica mantenida hasta el noveno día en que se desteta y extuba. Presenta entonces un cuadro de insuficiencia respiratoria que requiere reintubación (segunda ocasión) y reconexión al ventilador mecánico. Evoluciona favorablemente y permite su destete y extubación definitiva el día 12. A los 28 días presenta un cuadro de disnea, estridor, tiraje y taquipnea. Una exploración con fibrobroncoscopio muestra una estenosis traqueal en la región subglótica. Se realiza laserterapia y colocación de prótesis traqueal con buena evolución.

El departamento de Ciencias Biomédicas Básicas de la Universidad Europea de Madrid UEM se ha volcado en el uso de nuevas tecnologías de enseñanza aplicadas a las Ciencias Biomédicas. Algunas de estas metodologías se han aplicado con éxito durante los últimos cursos en el grado de Medicina, y en particular en la asignatura “Metodología, Estructura y Función (MEF)”, que integra las asignaturas de Anatomía, Histología y Fisiología del 2º curso del grado en medicina. La “flipped classroom” o clase invertida es un nuevo método didáctico que recurre a vídeos y otras fuentes fuera de la clase tradicional para que los mismos alumnos las usen desarrollando un aprendizaje autónomo de la materia. En este estudio, nuestro objetivo ha sido analizar la percepción real que tienen los propios alumnos de la clase invertida. Por ese motivo hemos pedido que un grupo de alumnos valore una clase invertida adaptada al currículo de la asignatura MEF. A través de un cuestionario, los alumnos han podido valorar la clase invertida frente al método tradicional y el uso de las nuevas tecnologías como recurso didáctico. SIN FINANCIACIÓN No data 2015 UEM

Uno de los retos más importantes de la enseñanza de ciencias básicas es la aplicación de métodos docentes innovadores cumpliendo los objetivos curriculares, en los que prima la adquisición de conocimientos sólidos. La Flipped Classroom es un método innovador que permite flexibilizar las clases transformando al alumno en un participante proactivo con capacidad autoevaluadora. En nuestro proyecto de Flipped Classroom para primeros cursos de Medicina hemos diseñado una actividad en la que proponemos al alumno un trabajo autónomo con dos objetivos: el aprendizaje de conceptos integrados en el currículum de la asignatura y el diseño por parte del propio alumno de herramientas que puede utilizar para estudiar individualmente, y que le facilitan el desarrollo de competencias. Las herramientas sobre las que se trabajó fueron el diseño de “Worksheets” y “Flash Cards”, que se han usado como apoyo en las tareas del alumno. Este método de Flipped Classroom es innovador en su diseño sencillo, puesto que los docentes de ciencias básicas no necesitan usar recursos multimedia sofisticados para utilizarla, aunque es lo suficientemente interactivo para que el alumno lo encuentre atractivo. Al mismo tiempo, el diseño de la actividad admite múltiples variantes que ofrece grandes posibilidades para su aplicación en el aula. SIN FINANCIACIÓN No data 2014 UEM

[Resumen] Los sistemas de gestión de la calidad en las Organizaciones Públicas atienden de manera irregular los diferentes procesos que se desarrollan en una obra de construcción. Mientras que los procesos productivos, financieros y de plazos forman parte de su gestión, no así otros procesos técnicos, también susceptibles de asegurar la eficiencia y eficacia de la misma. Uno de los procesos que adolece de ser medido y, por lo tanto, integrado en los sistemas de gestión empresarial, es el control de calidad. Aunque existe metodología para realizar el control y algún acercamiento a la gestión por parte del control de materiales, nunca se ha demostrado que la gestión del control de calidad sea útil para las Organizaciones Públicas, ni mucho menos, que pueda proveerlas de valor añadido. De acuerdo con lo anteriormente expuesto, esta tesis propone dotar a las obras de construcción promovidas por las Organizaciones Públicas de un índice que las califique en función de la calidad alcanzada durante el proceso constructivo. Este índice, denominado Índice de Calidad, proporcionará a los gestores la información necesaria para conseguir la eficiencia y eficacia de su gestión. También se propone dotar a las construcciones de una Etiqueta de Calidad, que será el certificado de la calidad obtenida al final del proceso. Para ello se diseña una herramienta informática basada en el análisis de valor que va a proporcionar el mencionado Índice de Calidad de las construcciones. Además la herramienta proporcionará información útil para elaborar un Cuadro de Mando en el momento en el que se adapte a cada caso concreto. Por último, se ha estudiado el comportamiento de la herramienta en tres aspectos. El primero permite comprobar cómo variaciones puntuales de los parámetros definidos no alteran el resultado final. El segundo permite comprobar que el Índice de Calidad se corresponde con el tipo de datos introducidos y el tercero ratifica el comportamiento coherente en un caso real., [Abstract] The quality management systems used by public organizations deal in an irregular way with the different processes that happen in construction sites. They work with productive, financing and expiry dates, but not with technical processes, which are also involved in ensuring the efficiency and efficacy of construction sites. One of the processes that is not measured, and, because of that, not taken into account in Business Management Systems, is the quality control. Although there is a methodology to apply the control and also some approach to the management concerning the materials control, it has never been shown that the quality control management is useful for the public administration, and far from it, that it can provide an added value. According to the previously said, this thesis proposes giving construction sites promoted by public administrations an index that classifies them in relation to the quality reached during the construction process. This index, named Quality Index, will provide the managers the necessary information to achieve the efficiency and effectiveness required to their management. It is also proposed to provide the constructions a Quality Brand that will be the certification of the reached quality obtained at the end of the process. In order to do so, it has been designed a software tool based on the value analysis that is going to provide the aforementioned Quality Index for construction sites. Apart from that, this tool will provide important information for the management, as it can be used as an instrument panel when adapted to each particular case. Finally, three aspects of the tool have been tested. The first one allows to check how occasional variations of the defined parameters do not change the final output. The second allows to check that the Quality Index correlates with the type of inserted data and the third confirms a coherent behaviour in an actual case., [Resumo] Os sistemas de xestión da calidade nas organizacións públicas atenden de maneira irregular os diferentes procesos que se desenvolven nunha obra de construción. Mentres os procesos produtivos, financeiros e de prazos forman parte da súa xestión, non así outros procesos técnicos, tamén susceptibles de asegurar a eficiencia e eficacia da mesma. Un dos procesos que pode ser medido e, polo tanto, integrado nos sistemas de xestión empresarial, e o control de calidade. Aínda que existe metodoloxía para realizalo e algún achegamento á xestión por parte do control de materiais, nunca se demostrou que a xestión do control de calidade sexa útil para as organizacións públicas, nin que poida provelas de valor engadido. De acordo co anteriormente exposto, esta tese propón dotar as obras de construción promovidas polas organizacións públicas, dun índice que as califique en función da calidade alcanzada durante o proceso construtivo. Este índice, denominado Índice de Calidade, proporcionará os xestores a información necesaria para conseguir a eficiencia e eficacia da súa xestión. Tamén proponse dotar as construcións dunha Etiqueta de Calidade que será o certificado da calidade obtida o fin do proceso. Para iso deséñase unha ferramenta informática baseada na análise de valor que vai proporcionar o mencionado Índice de Calidade das construcións. Ademais, a ferramenta proporcionará información útil para a xestión, podendo constituír un Cadro de Mando no momento no que se adapte a cada caso concreto. Por último, estudouse o comportamento da ferramenta en tres aspectos. O primeiro permite comprobar como variacións puntuais dos parámetros definidos non alteran o resultado final. O segundo permite comprobar que o Índice de Calidade correspóndese co tipo de datos introducidos e o terceiro ratifica o comportamento coherente da ferramenta nun caso real.

SIN FINANCIACIÓN No data 2013

SIN FINANCIACIÓN No data 2013

The purpose of this investigation was to study the relationship between both blood ammonia thresholds (AmT) and lactate thresholds (LT) during dynamic exercise in cardiac transplant patients (CTPs). Eleven male patients who had undergone orthotopic cardiac transplantation (age: 54 +/- 11 years, mean +/- SD; height: 165.1 +/- 6.6 cm; body mass: 78.3 +/- 16.1 kg) participated in this study. Each of them performed a bicycle ergometer test (ramp protocol) until volitional fatigue. During each test, gas exchange parameters and ECG responses were determined continuously. In addition, blood lactate and ammonia concentrations were measured every 2 min for determination of both LT and AmT, respectively. Peak values of oxygen uptake (Vo2), respiratory exchange ratio, ventilation, and heart rate averaged 15.9 +/- 3.03 mL.Kg-1.min-1, 1.02 +/- 0.06, 46.69 +/- 5.69 L.min-1, and 124 +/- 16 beats per minute, respectively. However, blood concentrations of lactate and ammonia at peak exercise were 3.7 +/- 0.4 mmol.L-1 and 85.6 +/- 31.7 micrograms.dL-1, respectively. LT and AmT were detected in 8 (72.7% of total) and 9 (81.8% of total) of 11 subjects, respectively. No significant differences were found between mean values of LT and AmT, when both were expressed either as Vo2 (10.01 +/- 1.19 vs 10.5 +/- 2.38 mL.kg-1.min-1, respectively) or as percent Vo2 peak (64.62 +/- 11.362 vs 66.48 +/- 9.19%, respectively). In addition, LT and AmT were significantly correlated (p < 0.05) when both were expressed either as Vo2 (mL.kg-1.min-1) or as percent Vo2 peak (r = 0.70 and r = 0.68, respectively). Our findings suggest that in CTPs, both LT and AmT occur at similar workloads, probably as a result of skeletal muscle alterations associated with chronic deconditioning and immunosuppressive therapy.

Como docentes investigadores, sentimos la necesidad de tener a nuestro alcance herramientas que nos permitan actualizarnos en las áreas específicas de la ciencia. En el departamento de Ciencias Biomédicas Básicas, hemos puesto en marcha un proyecto piloto Fisio-update para tratar de ofrecer una herramienta de este tipo a todos los docentes UEM. El proyecto tiene como objetivo incentivar la lectura de artículos científicos actuales a los profesores cuya actividad en la UEM es fundamentalmente docente, así como incentivar a los profesores investigadores a realizar un seguimiento de la investigación en áreas diferentes a las suyas. El cumplimiento de este objetivo se traducirá en una formación actualizada del docente que permitirá transmitir en el aula las líneas de investigación actuales en cada materia. Participan en el proyecto de forma voluntaria todos aquellos profesores del departamento que imparten asignaturas afines a los contenidos propuestos. Inicialmente proponemos una frecuencia quincenal para la celebración de las sesiones SIN FINANCIACIÓN No data 2012 UEM