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Colorectal cancer is the second-leading oncological cause of death worldwide1. Despite advances in treatment, there is still a risk of local and distant recurrence, which impacts on long-term outcomes This study was awarded a grant by the ‘Asociación Española de Coloproctolgía’ and ‘Col·legi Oficial de Metges de Girona—Joan Bruguera Grant’ in 2021.

Pràctiques d'higiene; Espigolament; Productes hortofructícoles Prácticas de higiene; Espigado; Productos hortofrutícolas Hygiene practices; Spiked; Horticultural products Aquesta guia aborda la pràctica de l’espigolament, una acció tradicional actualment revaloritzada, que es du a terme en els camps de conreu sempre amb el permís del productor. Consisteix en la collita a camp del producte excedentari, sembrat totalment o parcialment no collit, així com del producte que no compleix els requisits estètics demandats pel mercat però que és apte per al consum humà i que compleix totes les mesures sanitàries. Aquesta guia pretén impulsar aquesta pràctica i que es dugui a terme amb garanties per a totes les parts implicades. Esta guía aborda la práctica del espigado, una acción tradicional actualmente revalorizada que se lleva a cabo en los campos de cultivo siempre con el permiso del productor. Consiste en la cosecha en campo del producto excedentario, sembrado totalmente o parcialmente no recogido, así como del producto que no cumple los requisitos estéticos demandados por el mercado pero que es apto para el consumo humano y que cumple todas las medidas sanitarias. Esta guía pretende dar un impulso a esta práctica y que se lleve a cabo con garantías para todas las partes implicadas.

Aldehyde dehydrogenases (ALDHs) are overexpressed in various tumor types including prostate cancer and considered a potential target for therapeutic intervention. 4-(Diethylamino)benzaldehyde (DEAB) has been extensively reported as a pan-inhibitor of ALDH isoforms, and here, we report on the synthesis, ALDH isoform selectivity, and cellular potencies in prostate cancer cells of 40 DEAB analogues; three analogues (14, 15, and 16) showed potent inhibitory activity against ALDH1A3, and two analogues (18 and 19) showed potent inhibitory activity against ALDH3A1. Significantly, 16 analogues displayed increased cytotoxicity (IC50 = 10-200 μM) compared with DEAB (>200 μM) against three different prostate cancer cell lines. Analogues 14 and 18 were more potent than DEAB against patient-derived primary prostate tumor epithelial cells, as single agents or in combination treatment with docetaxel. In conclusion, our study supports the use of DEAB as an ALDH inhibitor but also reveals closely related analogues with increased selectivity and potency.

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Background The age, multimorbidity, immunodeficiency and frailty of older people living in nursing homes make them vulnerable to COVID-19 and to mortality in general. For this reason, our objective is to verify the incidence of general and COVID-19 mortality and to analyse its predictive factors in older people living in nursing homes over a 2-year period. Methods A two-year prospective longitudinal multicenter study was carried out in 5 nursing homes in Central Catalonia (Spain) between 2020 and 2022. Date and causes of deaths were recorded. In addition, sociodemographic and health data were collected. For the effect of mortality, survival curves were performed using the Kaplan-Meier method and multivariate analysis using Cox regression. Results The total sample of 125 subjects had a mean age of 85.10 years (standard deviation = 7.3). A total of 59 (47.2%) deaths were recorded at 24 months (95% confidence interval [CI], 38.6–55.9) and 25 (20.0%) were due to COVID-19 most in first 3 months. In the multivariate analysis, functional impairment (hazard ratio [HR]: 2.40, 95% CI: 1.33–4.32, p = 0.003) was a significant risk factor for mortality independently of age (HR: 1.17, 95% CI: 0.69-2.00, p = 0.549) and risk of sarcopenia (HR: 1.40, 95% CI, 0.63–3.12, p = 0.403). Conclusions Nearly half of this sample of nursing home residents died within the 2-year period, and 20% were attributed to COVID-19. Functional impairment was a risk factor for overall mortality and COVID-19 mortality, independent of age and risk of sarcopenia.

Additional file 1. SPIRITpirit checklist.

Efforts to determine whether metformin can increase the effectiveness of neoadjuvant chemoradiotherapy in rectal cancer have increased in recent years. However, retrospective studies have yielded inconclusive results. Objectives The aim of this study was to compare oncological outcomes and survival after neoadjuvant chemoradiotherapy in patients with rectal cancer taking metformin versus in those not taking metformin. Methods This study analyzed 423 consecutive patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiotherapy and curative surgery between January 2010 and May 2020; of these, 59 were taking metformin and 364 were not taking metformin. Results Patients taking metformin had a lower proportion of tumor regression (6.8% versus 22.0%, P = 0.012) as well as a lower proportion of patients achieving a pathological complete response (6.8% versus 20.6%, P = 0.011). In the multivariate analysis, independent predictors of pathologic complete response were not taking metformin (OR: 5.26, 95% CI: 1.12-24.85, P= 0.035) and cT2 stage (OR: 3.49, 95% CI: 1.10-11.07, P= 0.034); the interval was also an independent predictor of tumor regression (OR: 1.78, 95% CI: 1.06-2.96, P= 0.028). No differences were observed in survival between groups. Conclusion Metformin was not associated with better tumor responses or survival after neoadjuvant treatment.

Introduction In Spain over the last two decades, cesarean section (CS) rates have increased from 15 to 25% in the Public Health Sector and from 28 to 38% in the private sector. There are multiples causes for this rise, which are often unclear. The aim of our study is to collect and analyze all the CS rates data from a hospital network of the 42 Quironsalud Hospitals (private sector) and to assess its distribution regarding the different types of hospitals and patient characteristics. Material and methods An observational retrospective study between 2017 and 2018 was performed. Hospitals are classified into three groups: large hospitals (11), medium hospitals (17) and small hospitals (14). The cesarean section rate was measured by patient categorization into three groups: total deliveries, low risk cesarean sections and low risk cesarean sections without previous cesarean delivery. Results We analyzed 62,685 deliveries: 42,987 were vaginal deliveries (68.6%) and 19,698 CS (31.4%). The mean age for the total number of deliveries was 34.18 years old, whilst the mean age for the low-risk group was 34.12. Of the 19,698 CS, 18.36% (3618) were in high-risk population and 81.63% (16,080) in low risk population. 69.54% (11,183) of the low-risk CS were in patients without a previous CS. Conclusions The overall rate of CS in the Quironsalud group is slightly higher than the one from the Public Healthcare. The older maternal age as well as the hospital resources involved in the delivery attendance can explain this difference.

Objective Previous imaging studies in patients with borderline personality disorder (BPD) have detected functional brain dysfunctions. Mindfulness training may improve the symptoms of BPD, although the neural mechanisms involved remain poorly understood. This study had several key aims: a) to investigate the role of right anterior insula (rAI) functional connectivity in modulating baseline emotional status in BPD, b) to compare differences in connectivity changes after mindfulness training versus interpersonal effectiveness intervention, and c) to explore the correlation between longitudinal changes in imaging data and clinical indicators. Methods Thirty-eight patients with BPD underwent resting-state functional magnetic resonance imaging. Participants completed self-report clinical scales and participated in a dialectical-behavioral therapy (mindfulness versus interpersonal effectiveness modules). Changes in clinical and imaging variables were evaluated longitudinally after completion of the first 10-week sessions of psychotherapeutic intervention. Results At baseline, the rAI was strongly connected with the other salience network nodes and anticorrelated with most core nodes of the default mode network (p < .05, corrected). The functional connectivity of the rAI correlated with emotional dysregulation and deficits in mindfulness capacities (p < .05, corrected). After completion of psychotherapeutic intervention, both groups (mindfulness and interpersonal effectiveness) showed divergent posttherapy functional connectivity changes, which were in turn associated with the clinical response. Conclusions The functional connectivity of the rAI seems to play an important role in emotion dysregulation and deficits in mindfulness capacities in individuals with BPD. Psychotherapy seems to modulate this functional connectivity, leading to beneficial changes in clinical variables.

El objetivo del presente artículo es doble. Por un lado, se pretende defender la tradición retórica que impregna el humanismo cívico en términos de su potencial utilidad con vistas a la educación para la ciudadanía. Por otro lado, mediante un ejercicio de “rational reconstruction” (Richard Rorty) o “rewriting” (Stanley Fish), se propone rastrear el papel de la solidaridad cívica en la Laudatio Florentinae urbis de Leonardo Bruni para realizar una “apropiación” de sus elementos en el contexto de los debates actuales en filosofía política. La metáfora del “florecimiento” de la comunidad política, recurrente en el humanismo cívico, implica siempre una exhortación a la práctica de las virtudes cívicas por parte de los ciudadanos, es decir, una subordinación de los intereses particulares al bien común y, en consecuencia, una base de solidaridad en el cuerpo civil. Para ello, se partirá de la distinción rawlsiana entre “republicanismo clásico” y “humanismo cívico” que se halla en El liberalismo político (V, §7, 5). El argumento por disociación de Rawls será problematizado para sostener que el papel de las virtudes ciudadanas, como virtudes propiamente humanas, debe ser más importante y más exigente que el que el liberalismo le reserva si queremos una sociedad verdaderamente floreciente.

This deliverable aims to describe the evaluation activities of the SIMBAD project. The document contains the results of WP6, whose objective is to demonstrate and evaluate the SIMBAD performance modelling network. This involves the evaluation of the three main technical WPs of the project; namely WP3, WP4 and WP5. The document is divided in three main parts, one for each WP. In each section, the methodological approach and the evaluation results are described. References to previous deliverables of the project are present along the document, since those documents are an important source of information, both for the methodology description and for the results of each WP. The evaluation activities have been successfully accomplished. For each WP, the results obtained have been compared with the results obtained by the simulation tools or the ATM experts. The validation results confirm that the proposed machine learning techniques are able to accurately capture the behaviour of the air traffic system, while reducing the computational cost. Even considering the training costs, one can realize that the computational costs are considerably reduced, but if only the execution costs are considered, the costs are further reduced. This document is part of a project that has received funding from the SESAR Joint Undertaking under grant agreement No 894241 under European Union’s Horizon 2020 research and innovation programme.

We present a framework to generate, in a multi-aircraft environment, 4D optimized trajectories in a scenario with several weather constraints obtained with advanced weather prediction models. We focus on the trajectory optimization module of this framework, which is based on a point-mass representation of the aircraft. By tuning some of the parameters of this module, we compute several alternative trajectories avoiding these constraints both laterally and vertically. The experiment conducted involves flights crossing the North Atlantic region, while in the en-route phase. This preliminary framework is also used to run the experiments in multiple cycles or consecutive time periods, assuming different update times for the weather constraints, and choosing the best trajectory per flight and per cycle. The ultimate goal of the framework is to develop innovative procedures in the air traffic management system to reduce the climate and environmental impact of aviation, while increasing the resilience of air operations to weather phenomena.

IntroductionRandomized clinical trials (RCT) are limited in reflecting observable results out of controlled settings, which requires the execution of further lengthy observational studies. The usage of real-world data (RWD) has been recently considered to be a viable alternative to overcome these issues and complement certain clinical conclusions. Transcriptomics and other high-throughput data contain a molecular description of medical conditions and disease states. When linked to RWD, including demographical information, transcriptomics data is capable of elucidating nuances in disease pathways in specific patient populations. This work focuses on the construction of a patient repository database with clinical information resulting from the integration of publicly available transcriptomics datasets.ResultsSamples from patient data were integrated into the patient repository by using a new post-processing technique allowing for the combined usage of samples originating from Gene Expression Omnibus (GEO) datasets. RWD was mined from GEO samples’ metadata, and a clinical and demographical characterization of the database was obtained. Our post-processing technique, that we’ve called MACAROON, aims to uniformize, and integrate transcriptomics data (considering batch effects and possible processing-originated artefacts). This process was able to better reproduce the down streaming biological conclusions in a 10% enhancement (compared to other methods available). RWD mining was done through a manually curated synonym dictionary allowing for the correct assignment (95.33% median accuracy) of medical conditions.ConclusionOur strategy produced a RWD repository, including molecular information and clinical and demographical RWD. The exploration of these data facilitates shedding light on clinical outcomes and pathways specific to predetermined populations of patients by integrating multiple public datasets.

Toda formación tiene que ser sencillamente “investigativa”, la capacidad de asombro innata de los seres humanos se está perdiendo y debe ser recuperada, incluso, o sobre todo “para la comprensión, para el mundo de la vida cotidiana, para la construcción de la disposición al pensamiento crítico”, porque la investigación es realmente “una función inherente y fundamental del ser humano” All training has to be simply "investigative", the innate capacity for astonishment of human beings is being lost and must be recovered, even, or especially "for understanding, for the world of daily life, for the construction of the disposition to critical thinking”, because research is really “an inherent and fundamental function of the human being”

Objectives: To analyze cumulative incidence and mortality by COVID-19 in the different types of nursing homes, in the first and second wave.Methods: Data source: Transparency portal of the Generalitat de Catalunya, official COVID-19 register of all Catalan nursing homes (from March to December 10, 2020). Variables: Affectation of disease and mortality by COVID-19 in geriatric centers in Catalonia, stratified by size of center and type of management. Univariate, bivariate and multivariate linear regression analysis, IBMTMSPSS® v.20.Results:N = 1,057 residences (63,682 beds, average = 60.48). 52% have 150 beds. COVID-19: Cumulative incidence: 21,370 (confirmed + suspicious); mortality: 5,010 (confirmed + suspicious).233 residences did not register COVID-19 patients (22%) and 636 did not register COVID-19 deaths (60.2%).According to the type of supplier, the lowest incidence of COVID-19 was in non-accredited (36.2% without cases), then concerted / collaborators (19.3%) and own of the Generalitat de Catalunya (7.9 %, p = 0.000). The centers with the fewest deaths were the non-accredited (78% without deaths), followed by contracted / collaborators (56.8%) and those of the Generalitat de Catalunya (41.3%, p = 0.000).Depending on the size, no COVID-19 patients were registered: 168 centers 150 beds (1.9%) (p = 0.000). 395 of the 150 beds (17%) (p = 0.000).Discussion:Of the 1,057 centers analyzed, 22% did not register cases and in 60% there were no deaths from COVID-19.Residences without concert / collaboration with the Generalitat and with fewer beds showed a lower cumulative incidence and mortality due to COVID-19 during the first wave.

New techniques are being developed to improve the results of laparoscopic surgery for rectal cancer. This paper analyzes the learning curves for transanal total mesorectal excision (taTME) and robot-assisted surgery in our colorectal surgery department. We analyzed retrospectively data from patients undergoing curative and elective surgery for rectal cancer ≤12 cm from the anal verge. We excluded extended surgeries. We used cumulative sum (CUSUM) curve analysis to identify inflection points. Between 2015 and 2021, 588 patients underwent surgery for rectal cancer at our center: 67 taTME and 79 robot-assisted surgeries. To overcome the operative time learning curve, 14 cases were needed for taTME and 53 for robot-assisted surgery. The morbidity rate started to decrease after the 17th case in taTME and after the 49th case in robot-assisted surgery, but it is much less abrupt in robot-assisted group. During the initial learning phase, the rate of anastomotic leakage was higher in taTME (35.7% vs. 5.7%). Two Urological lesions occurred in taTME but not in robot-assisted surgery. The conversion rate was higher in robot-assisted surgery (1.5% vs. 10.1%). Incorporating new techniques is complex and entails a transition period. In our experience, taTME involved a higher rate of serious complications than robot-assisted surgery during initial learning period but required a shorter learning curve.