Search

IntroductionRegorafenib is indicated as treatment in third-line and beyond in patients with metastatic colorectal cancer.Methods This is a retrospective study of a cohort of patients with mCRC treated with regorafenib in Hospital Universitario Ramón y Cajal, in Madrid, Spain.ResultsWith the aim to assess the efficacy and safety of regorafenib, 91 patients treated between 2013 and 2023 were included. Only 1.1% of patients achieved disease control. Median progression free survival was 2.40 months and median overall survival was 4.76 months. The most frequent adverse events were fatigue and hand-foot skin reaction (59.34% and 28.57%, respectively).DiscussionOur results confirm the safety of regorafenib as treatment of mCRC in real clinical practice. Although our population is less pretreated than in the CORRECT trial, our disease control rate was inferior. This difference may be due to a worse baseline status and a high percentage of hepatic disease showed in our patients.

Introduction: Androgenic deprivation therapies have been linked to the development of metabolic syndrome (MS) and cardiovascular diseases, which may lead to a poorer survival in patients with metastatic Castration-Resistant Prostate Cancer (mCRPC). We aimed to analyze whether some cardiovascular or neurological disorders, together with other medical and urological complications, may have an effect on survival outcomes, at baseline and during treatment from patients treated with androgen pathway inhibitors (API). Material and Methods: A retrospective study of a consecutive series of patients diagnosed with mCRPC between 2010 and 2018 treated with API in the first line setting in a single center. Results: Seventy-three patients met the inclusion criteria. Baseline prognostic factors associated with worse survival were diabetes mellitus (DM) with insulin needs compared to patients without DM [hazard ratio (HR) = 0.19, p = 0.025], hypertension (HTN) (HR = 0.46, p = 0.035), and a history of stroke (HR = 0.16, p

A proposal is made to employ stochastic models, based on diffusion processes, to represent the evolution of the SARS-CoV-2 virus pandemic. Specifically, two diffusion processes are proposed whose mean functions obey multi-sigmoidal Gompertz and Weibull-type patterns. Both are constructed by introducing polynomial functions in the ordinary differential equations that originate the classical Gompertz and Weibull curves. The estimation of the parameters is approached by maximum likelihood. Various associated problems are analyzed, such as the determination of initial solutions for the necessary numerical methods in practical cases, as well as Bayesian methods to determine the degree of the polynomial. Additionally, strategies are suggested to determine the best model to fit specific data. A practical case is developed from data originating from several Spanish regions during the first two waves of the COVID-19 pandemic. The determination of the inflection time instants, which correspond to the peaks of infection and deaths, is given special attention. To deal with this particular issue, point estimation as well as first-passage times have been considered.

Introducción. La enfermedad de Graves es un desorden autoinmune que estimula la tiroides. Su síntoma extratiroidal más frecuente e importante es la oftalmopatía de Graves, la cuál se presenta con retracción del párpado superior, proptosis, quemosis, edema periorbital, sensación molesta en el ojo, dolor o presión retrobulbar, motilidad ocular alterada, demora en el cierre palpebral. Caso clínico. Paciente de 49 años de edad que acude a la clínica por problema de oftalmopatía de Graves con una evolución de 5 años. El tratamiento de elección es la descompresión orbitaria endoscópica. Discusión. El procedimiento quirúrgico se realizó siguiendo las mismas guías de otros casos reportados, lo que resulta en una reducción de la proptosis entre 3,2 y 4,7 mm. La complicación postoperatorio más común es la diplopia; presente en 15 - 63% de los pacientes. Conclusiones. La descompresión orbitaria quirúrgica es un tratamiento con excelentes resultados, aliviando la sensación de dolor y presión en el paciente, y resolviendo también sus problemas estéticos.

Introducción: La impactación de los terceros molares mandibulares se ha convertido en un fenómeno frecuente que se relaciona directamente por la falta de espacio en la arcada dental. Objetivo: Establecer la prevalencia de terceros molares mandibulares en base a la clasificación propuesta por Sandhu & Kaur. Metodología: Se observaron 400 radiografías panorámicas digitales obtenidas del Centro de Rayos X & Imagen, para lo cual se usó el software AutoCad 2016. Esto resultó en 688 terceros molares inferiores estudiados. Resultados La posición mesioangular tuvo una prevalencia de 57,6% en el grupo masculino y 48,7% en el grupo femenino. En cuanto a la edad, se encontró la posición mesioangular con una prevalencia de 68,5% para el grupo de 17 a 26 años, y la posición vertical con una prevalencia de 44,4% para el grupo de mayores de 26 años. De los 688 terceros molares mandibulares, el 53,1% se clasificaron como mesioangulares. Conclusiones: La posición mesioangular fue la más prevalente de la totalidad de terceros molares mandibulares evaluados, así como en ambos sexos y en el grupo etario de 17 a 26 años. La posición vertical fue la más prevalente en el grupo de mayores de 26 años. Estos datos pueden indicar cambios de angulación hasta los 26 años de edad.

Introducción: La presencia de fístulas colecistoentéricas ocurren de manera fortuita como complicación poco frecuente de la colecistolitiasis. Caso clínico: Paciente de 51 años de edad, con diagnóstico ecográfico de colecistolitiasis. Se realiza colecistectomía laparoscópica, se observa plastrón vesicular y adherencias. Se extraen dos litos de 3 cm de diámetro cada uno y ante la imposibilidad de extraer la vesícula se dejan dos drenes de Nelaton por los que salen gran cantidad de líquido sero-hemático y bilioso. Se realiza una radiografía contrastada, se confirma la presencia de dos fístulas simultáneas colecistoduodenal y colecistocolónica. Resultados: El paciente se encuentra en el día cien post-operatorio, asintomático y con una actividad física normal. Se solicitó colangioresonancia magnética que muestra una pequeña lesión residual cicatrizal en el sitio del absceso subfrénico derecho y una cantidad escasa de bilis subhepática en el lecho vesicular. Conclusiones: El diagnóstico se realiza en el acto operatorio, donde el cierre de la fístula es el tratamiento de elección. Las indicaciones para cirugía son la presencia de obstrucción o sepsis.

A central aspect of in vivo experiments with anticancer therapies is the comparison of the effect of different therapies, or doses of the same therapeutic agent, on tumor growth. One of the most popular clinical endpoints is tumor growth delay, which measures the effect of treatment on the time required for tumor volume to reach a specific value. This effect has been analyzed through a variety of statistical methods: conventional descriptive analysis, linear regression, Cox regression, etc. We propose a new approach based on stochastic modeling of tumor growth and the study of first-passage time variables. This approach allows us to prove that the time required for tumor volume to reach a specific value must be determined empirically as the average of the times required for the volume of individual tumors to reach said value instead of the time required for the average volume of the tumors to reach the value of interest. In addition, we define several measures in random environments to compare the time required for the tumor volume to multiply k times its initial volume in control, as well as treated groups, and the usefulness of these measures is illustrated by means of an application to real data.

This paper proposes and assesses an integrated solution to monitor and diagnose photovoltaic (PV) solar modules based on a decentralized wireless sensor acquisition system. Both DC electrical variables and environmental data are collected at PV module level using low-cost and high-energy efficiency node sensors. Data is real-time processed locally and compared with expected PV module performances obtained by a PV module model based on symmetrized-shifted Gompertz functions (as previously developed and assessed by the authors). Sensor nodes send data to a centralized sink-computing module using a multi-hop wireless sensor network architecture. Such integration thus provides extensive analysis of PV installations, and avoids off-line tests or post-processing processes. In comparison with previous approaches, this solution is enhanced with a low-cost system and non-critical performance constraints, and it is suitable for extensive deployment in PV power plants. Moreover, it is easily implemented in existing PV installations, since no additional wiring is required. The system has been implemented and assessed in a Spanish PV power plant connected to the grid. Results and estimations of PV module performances are also included in the paper.

The environment in livestock buildings must be controlled to ensure the health and welfare of both workers and animals, as well as to restrict the emission of pollutants to the atmosphere. Among the pollutants generated inside these premises, carbon dioxide (CO2) is of great interest in terms of animal welfare and ventilation control. The use of inexpensive sensors means that complete systems can be designed with a number of sensors located around the building. This paper describes a study of the suitability of multipoint simultaneous CO2 sensors operating in a wireless sensor network, which was found to operate satisfactorily under laboratory conditions and was found to be the best alternative for these applications. The sensors showed a highly linear response to CO2 concentrations, ranging from 500 to 5000 ppm. However, individual sensor response was found to differ, which made it necessary to calibrate each one separately. Sensor precision ranged between 80 and 110 ppm CO2, and sensor response to register a 95% change in concentration was estimated at around 5 min. These features mean this type of sensor network can be used to monitor animal welfare and also for environmental control in poorly ventilated livestock premises. According to the tests conducted in this study, a temporal drift may occur and therefore a regular calibration of sensors would be needed.

The behaviour of many dynamic real phenomena shows different phases, with each one following a sigmoidal type pattern. This requires studying sigmoidal curves with more than one inflection point. In this work, a diffusion process is introduced whose mean function is a curve of this type, concretely a transformation of the well-known Gompertz model after introducing in its expression a polynomial term. The maximum likelihood estimation of the parameters of the model is studied, and various criteria are provided for the selection of the degree of the polynomial when real situations are addressed. Finally, some simulated examples are presented.

Network simulators are useful for researching protocol performance, appraising new hardware capabilities and evaluating real application scenarios. However, these tasks can only be achieved when using accurate models and real parameters that enable the extraction of trustworthy results and conclusions. This paper presents an underwater wireless sensor network ecosystem for the ns-3 simulator. This ecosystem is composed of a new energy-harvesting model and a low-cost, low-power underwater wake-up modem model that, alongside existing models, enables the performance of accurate simulations by providing real weather and marine conditions from the location where the real application is to be deployed.

During the last two decades Red Palm Weevil (RPW, Rynchophorus Ferrugineus) has become one of the most dangerous threats to palm trees in many parts of the World. Its early detection is difficult, since palm trees do not show visual evidence of infection until it is too late for them to recover. For this reason the development of efficient early detection mechanisms is a critical element of RPW pest management systems. One of the early detection mechanisms proposed in the literature is based on acoustic monitoring, as the activity of RPW larvae inside the palm trunk is audible for human operators under acceptable environmental noise levels (rural areas, night periods, etc.). In this work we propose the design of an autonomous bioacoustic sensor that can be installed in every palm tree under study and is able to analyze the captured audio signal during large periods of time. The results of the audio analysis would be reported wirelessly to a control station, to be subsequently processed and conveniently stored. That control station is to be accessible via the Internet. It is programmed to send warning messages when predefined alarm thresholds are reached, thereby allowing supervisors to check on-line the status and evolution of the palm tree orchards. We have developed a bioacoustic sensor prototype and performed an extensive set of experiments to measure its detection capability, achieving average detection rates over 90%.

Este artículo rastrea la idea del estadio de fútbol como un espacio en el cual las personas impulsivamente se refieren al "Otro", naturalizando el uso de la violencia verbal hacia los adversarios, e incluso contra los mismos jugadores de la hinchada local. Para ello, se propone describir cómo se enmarcan las prácticas y discursos racistas en este escenario deportivo a partir de la observación participativa de seis partidos del América de Cali, tres de ellos jugando de visitante y tres de local.

Este artículo parte una revisión bibliográfica sobre el tema de la extradición, propone una visión y aporta una herramienta analítica que permite ampliar el debate alrededor de este tema, en el cual, de manera general se encuentran tres posiciones en donde se pueden ubicar a diferentes autores que han abordado esta temática. Se analizan los periodos presidenciales de Betancourt (1982-1986), Barco (1986-1990), Pastrana (1998-2002) y Uribe (2002-2010), se intentará establecer un dialogo entre los discursos que fundamenta la identidad del Estado colombiano.

This paper is focused on the description of the physical layer of a new acoustic modem called ITACA. The modem architecture includes as a major novelty an ultra-low power asynchronous wake-up system implementation for underwater acoustic transmission that is based on a low-cost off-the-shelf RFID peripheral integrated circuit. This feature enables a reduced power dissipation of 10 µW in stand-by mode and registers very low power values during reception and transmission. The modem also incorporates clear channel assessment (CCA) to support CSMA-based medium access control (MAC) layer protocols. The design is part of a compact platform for a long-life short/medium range underwater wireless sensor network.

The specific characteristics of underwater environments introduce new challenges for networking protocols. In this paper, a specialized architecture for underwater sensor networks (UWSNs) is proposed and evaluated. Experiments are conducted in order to analyze the suitability of this protocol for the subaquatic transmission medium. Moreover, different scheduling techniques are applied to the architecture in order to study their performance. In addition, given the harsh conditions of the underwater medium, different retransmission methods are combined with the scheduling techniques. Finally, simulation results illustrate the performance achievements of the proposed protocol in end-to-end delay, packet delivery ratio and energy consumption, showing that this protocol can be very suitable for the underwater medium.

Different versions of the lognormal diffusion process with exogenous factors have been used in recent years to model and study the behavior of phenomena following a given growth curve. In each case considered, the estimation of the model has been addressed, generally by maximum likelihood (ML), as has been the study of several characteristics associated with the type of curve considered. For this process, a unified version of the ML estimation problem is presented, including how to obtain estimation errors and asymptotic confidence intervals for parametric functions when no explicit expression is available for the estimators of the parameters of the model. The Gompertz-type diffusion process is used here to illustrate the application of the methodology.