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Introducción: El sueño es fundamental para la calidad de vida y puede afectar el bienestar y la salud mental de los individuos. Objetivo: Analizar la calidad del sueño y satisfacción laboral en enfermeras españolas tras la pandemia por COVID-19. Materiales y Métodos: Estudio transversal utilizando el Pittsburgh Sleep Quality Index (PSQI), el Cuestionario de Satisfacción Laboral Font Roja y variables sociodemográficas y laborales. Se empleó un muestreo en "bola de nieve" mediante divulgación en redes sociales. Resultados: La puntuación media del PSQI fue de 9,75 ± 4,36 puntos. La peor calidad del sueño se identificó en participantes sin personas a cargo (p=0,031;β=3,329;IC95%=0,035-6,354) y en aquellos con dependientes distintos de los hijos (p=0,022;β=4,121; IC95%= 0,575-7,667). Sin embargo, ser doctor (p=0,001; β=-3,406; IC95%=-5,503-1,309) o especialista (p=0,021; β=-1,639; IC95%=-3,031- -0,247) se asoció con una mayor calidad del sueño. La mejor satisfacción laboral se identificó en mujeres (p=0,034;β=0,104;IC95%=0,007-0,201), que no trabajaban con pacientes COVID (p=0,049;β=-0,085; IC95%=-0,174- -0,003). Discusión: Es crucial mejorar las condiciones laborales, como la ratio enfermera-paciente y la distribución de los turnos de trabajo, para mejorar la calidad del sueño de las enfermeras. Conclusiones: Las enfermeras españolas presentan una mala calidad del sueño. No tener personas a cargo y tener dependientes distintos de los hijos fueron factores de riesgo de mala calidad del sueño. La satisfacción laboral fue mayor en mujeres que no trabajaban con pacientes COVID-19. No se encontró relación entre la satisfacción laboral y la calidad del sueño de los trabajadores.

Objective High-dimensional databases make it difficult to apply traditional learning algorithms to biomedical applications. Recent developments in computer technology have introduced deep learning (DL) as a potential solution to these difficulties. This study presents a novel intelligent decision support system based on a novel interpretation of data formalisation from tabular data in DL techniques. Once defined, it is used to diagnose the severity of obstructive sleep apnoea, distinguishing between moderate to severe and mild/no cases. Methods The study uses a complete database extract from electronic health records of 2472 patients, including anthropometric data, habits, medications, comorbidities, and patient-reported symptoms. The novelty of this methodology lies in the initial processing of the patients’ data, which is formalised into images. These images are then used as input to train a convolutional neural network (CNN), which acts as the inference engine of the system. Results The initial tests of the system were performed on a set of 247 samples from the Pulmonary Department of the Álvaro Cunqueiro Hospital in Vigo (Galicia, Spain), with an AUC value of ≈ 0.8. Conclusions This study demonstrates the benefits of an intelligent decision support system based on a novel data formalisation approach that allows the use of advanced DL techniques starting from tabular data. In this way, the ability of CNNs to recognise complex patterns using visual elements such as gradients and contrasts can be exploited. This approach effectively addresses the challenges of analysing large amounts of tabular data and reduces common problems such as bias and variance, resulting in improved diagnostic accuracy.

Entre las experiencias con “bóvedas tabicadas” que, por escasez de acero y cemento, se realizaron en la España de postguerra, destacan las construidas por Luis Moya en el Museo de América de Madrid (1942-1963), obra en colaboración con Luis Martínez-Feduchi. Situado el edificio a la entrada de la Ciudad Universitaria, un lugar de singular simbolismo en ese momento, propició que la investigación con ese sistema adquiriera, aquí, un valor programático. Además de englobar gran variedad de soluciones, fue ocasión para que Moya presentara sus primeros y espectaculares ensayos con bóvedas de arcos cruzados de ladrillo. Éstas, conjugando razón técnica y resultado plástico, constituyeron un prototipo que Moya desarrollaría después, en distintas ciudades españolas: uno de los relevantes momentos de la historia de la construcción en el siglo XX. Este estudio, incorporando análisis, datos y material gráfico inéditos, viene a satisfacer una laguna de conocimiento en la historia de este innovador proceso constructivo.

Topic modeling is a prevalent task for discovering the latent structure of a corpus, identifying a set of topics that represent the underlying themes of the documents. Despite its popularity, issues with its evaluation metric, the coherence score, result in two common challenges: algorithm selection and determining the number of topics. To address these two issues, we propose the topic specificity metric, which captures the relative frequency of topic words in the corpus and is used as a proxy for the specificity of a word. In this work, we formulate the metric firstly. Secondly, we demonstrate that algorithms train topics at different specificity levels. This insight can be used to address algorithm selection as it allows users to distinguish and select algorithms with the desired specificity level. Lastly, we show a strictly positive monotonic correlation between the topic specificity and the number of topics for LDA, FLSA-W, NMF and LSI. This correlation can be used to address the selection of the number of topics, as it allows users to adjust the number of topics to their desired level. Moreover, our descriptive metric provides a new perspective to characterize topic models, allowing them to be understood better.

Abstract Intrahospital transfer (IHT), a routine in the management of neurocritical patients requiring imaging or interventions, might affect brain metabolism. Studies about IHT effects using microdialysis (MD) have produced conflicting results. In these studies, only the most damaged hemisphere was monitored, and those may not reflect the impact of IHT on overall brain metabolism, nor do they address differences between the hemispheres. Herein we aimed to quantify the effect of IHT on brain metabolism by monitoring both hemispheres with bilateral MD. In this study, 27 patients with severe brain injury (10 traumatic brain injury and 17 subarachnoid hemorrhage patients) were included, with a total of 67 IHT. Glucose, glycerol, pyruvate and lactate were measured by MD in both hemispheres for 10 h pre- and post-IHT. Alterations in metabolite levels after IHT were observed on both hemispheres; although these changes were more marked in hemisphere A (most damaged) than B (less damaged). Our results suggest that brain metabolism is altered after an IHT of neurocritical ill patients particularly but not limited to the damaged hemisphere. Bilateral monitorization may be more sensitive than unilateral monitorization for detecting metabolic disturbances not directly related to the course of the disease.

Immune checkpoint inhibitors in combination with tyrosine kinase inhibitors (TKIs) are improving the response rates of advanced renal cancer patients. However, many treated patients do not respond, making novel immune checkpoint-based immunotherapies potentially clinically beneficial only for specific groups of patients. We detected high expression of the immune checkpoint protein B7-H3 in clear cell renal cell carcinomas (ccRCCs) and evaluated B7-H3 immunohistochemistry staining in tissue microarray samples from two distinct renal cancer cohorts. B7-H3 was highly expressed in approximately 50% of primary tumors and in 30% of metastatic lesions. B7-H3 expression in primary tumors correlated with tumor necrosis, sarcomatoid transformation, disease-free survival, and synchronous metastasis, while B7-H3 expression in metastasis correlated with metastases to the lymph nodes. Gene expression analysis revealed the association of B7-H3 expression with gene expression scores involved in T cell exhaustion and myeloid immune evasion, as well as with PI3K/AKT and JAK/STAT pathways. Furthermore, knocking down B7-H3 expression in renal cancer cells by siRNA and CRISPR/Cas resulted in lower 2D and 3D cell proliferation and viability as well as increased sensitivity to TKI axitinib. Together, our findings suggest a pro-oncogenic and immune evasive role for B7-H3 in ccRCC and highlight B7-H3 as an actionable novel immune checkpoint protein in combination with TKI in advanced renal cancer.

The Cryogenic Underground Observatory for Rare Events (CUORE) is a 1-ton scale bolometric experiment devoted to the search of the neutrinoless double-beta decay (0νββ) in 130Te. The CUORE detector consists of an array of 988 TeO2 crystals operated at 10 mK. CUORE-0 is the CUORE demonstrator: it has been built to test the performance of the upcoming CUORE experiment and represents the largest 130Te bolometric setup ever operated. CUORE-0 has been running at Laboratori Nazionali del Gran Sasso (Italy) from 2013 to 2015. The final CUORE-0 analysis on 0νββ and the corresponding detector performance are presented. The present status of the CUORE experiment, now in its final construction and commissioning phase, are discussed. The results from assembly of the detector and the commissioning of the cryostat are reported.

A integridade na investigação é um valor incontornável para as universidades. São várias as instituições e organizações comprometidas com a pesquisa que oferecem pautas para garantir a integridade nas diferentes ações que implica toda atividade investigadora. O objetivo deste trabalho é conhecer a percepção do pessoal docente e pesquisador universitário sobre as condutas éticas que devem ser respeitadas nas pesquisas da área de conhecimento de Ciências Sociais e Jurídicas e de Ciências e evidenciar a possível existência de diferenças entre os dois ramos do conhecimento. Para dar conta destes objectivos realizou-se um estudo descritivo e aplicou-se a uma amostra de docentes universitários de três universidades públicas espanholas um questionário em linha, desenhado ad hoc para o estudo. Os resultados obtidos mostram a existência de certos comportamentos que violam a integridade na investigação científica e de diferenças significativas neste tipo de práticas entre os dois campos de conhecimento. Além disso, torna-se evidente a necessidade de acções que garantam a integridade científica nas instituições de ensino superior.

Brain death triggers a systemic inflammatory response. Whether systemic inflammation is different in lung donors after brain- (DBD) or circulatory-death (DCD) is unknown, but this may potentially increase the incidence of primary graft dysfunction (PGD) after lung transplantation. We compared the plasma levels of interleukin (IL)-6, IL-8, IL-10 and TNF-α in BDB and DCD and their respective recipients, as well as their relationship with PGD and mortality after LT. A prospective, observational, multicenter, comparative, cohort-nested study that included 40 DBD and 40 DCD lung donors matched and their respective recipients. Relevant clinical information and blood samples were collected before/during lung retrieval in donors and before/during/after (24, 48 and 72 h) LT in recipients. Incidence of PGD and short-term mortality after LT was recorded. Plasma levels of all determined cytokines were numerically higher in DBD than in DCD donors and reached statistical significance for IL-6, IL-10 and IL-8. In recipients with PGD the donor’s plasma levels of TNF-α were higher. The post-operative mortality rate was very low and similar in both groups. DBD is associated with higher systemic inflammation than DCD donors, and higher TNF-α plasma levels in donors are associated with a higher incidence of PGD.

Abstract Rationale In-stent reocclusion after endovascular therapy has a negative impact on outcomes in acute ischemic stroke (AIS) due to tandem lesions (TL). Optimal antiplatelet therapy approach in these patients to avoid in-stent reocclusion is yet to be elucidated. Aims To assess efficacy and safety of intravenous tirofiban versus intravenous aspirin in patients undergoing MT plus carotid stenting in the setting of AIS due to TL. Sample size estimates Two hundred forty patients will be enrolled, 120 in every treatment arm. Methods and design A multicenter, prospective, randomized, controlled (aspirin group), assessor-blinded clinical trial will be conducted. Patients fulfilling the inclusion criteria will be randomized at MT onset to the experimental or control group (1:1). Intravenous aspirin will be administered at a 500-mg single dose and tirofiban at a 500-mcg bolus followed by a 200-mcg/h infusion during the first 24 h. All patients will be followed for up to 3 months. Study outcomes Primary efficacy outcome will be the proportion of patients with carotid in-stent thrombosis within the first 24 h after MT. Primary safety outcome will be the rate of symptomatic intracranial hemorrhage. Discussion This will be the first clinical trial to assess the best antiplatelet therapy to avoid in-stent thrombosis after MT in patients with TL. Trial registration The trial is registered as NCT05225961. February, 7th, 2022.

Solar neutrinos have been pivotal to the discovery of neutrino flavour oscillations and are a unique tool to probe the reactions that keep the Sun shine. Although most of solar neutrino components have been directly measured, the neutrinos emitted by the keystone pp reaction, in which two protons fuse to make a deuteron, have so far eluded direct detection. The Borexino experiment, an ultra–pure liquid scintillator detector running at the Laboratori Nazionali del Gran Sasso in Italy, has now filled the gap, providing the first direct real time measurement of pp neutrinos and of the solar neutrino luminosity.

The Borexino experiment located in the Gran Sasso National Laboratory, is an organic liquid scintillator detector conceived for the real time spectroscopy of low energy solar neutrinos. The phase-I of the data taking campaign (2007 – 2010) has allowed the first independent measurements of 7Be and pep solar neutrino fluxes as well as the first measurement of anti-neutrinos from the Earth. After a purification of the scintillator, Borexino is now in phase-II since 2011. Thanks to the unprecedented background levels, we have performed the first flux measurement of neutrinos from the fundamental pp reaction which powers the Sun. We review this breakthrough result and other recent results, including the latest review of our terrestrial neutrino analysis. We also discuss the upcoming measurements on middle energy solar neutrino spectral components (pep, CNO) and the new project SOX devoted to the study of sterile neutrinos via the use of a neutrino source placed in close proximity of the detector’s active material.

BackgroundThe cavernous sinus (CS) is a demanding surgical territory, given its deep location and the involvement of multiple neurovascular structures. Subjected to recurrent discussion on the optimal surgical access, the endoscopic transorbital approach has been recently proposed as a feasible route for selected lesions in the lateral CS. Still, for this technique to safely evolve and consolidate, a comprehensive anatomical description of involved cranial nerves, dural ligaments, and arterial relations is needed.ObjectiveDetailed anatomical description of the CS, the course of III, IV, VI, and V cranial nerves, and C3-C7 segments of the carotid artery, all described from the ventrolateral endoscopic transorbital perspective.MethodsFive embalmed human cadaveric heads (10 sides) were dissected. An endoscopic transorbital approach with lateral orbital rim removal, anterior clinoidectomy, and petrosectomy was performed. The course of the upper cranial nerves was followed from their apparent origin in the brainstem, through the middle fossa or cavernous sinus, and up to their entrance to the orbit. Neuronavigation was used to follow the course of the nerves and to measure their length of surgical exposure.ResultsThe transorbital approach allowed us to visualize the lateral wall of the CS, with cranial nerves III, IV, V1-3, and VI. Anterior clinoidectomy and opening of the frontal dura and the oculomotor triangle revealed the complete course of the III nerve, an average of 37 (±2) mm in length. Opening the trigeminal pore and cutting the tentorium permitted to follow the IV nerve from its course around the cerebral peduncle up to the orbit, an average of 54 (±4) mm. Opening the infratrochlear triangle revealed the VI nerve intracavernously and under Gruber’s ligament, and the extended petrosectomy allowed us to see its cisternal portion (27 ± 6 mm). The trigeminal root was completely visible and so were its three branches (46 ± 2, 34 ± 3, and 31 ± 1 mm, respectively).ConclusionComprehensive anatomic knowledge and extensive surgical expertise are required when addressing the CS. The transorbital corridor exposes most of the cisternal and the complete cavernous course of involved cranial nerves. This anatomical article helps understanding relations of neural, vascular, and dural structures involved in the CS approach, essential to culminating the learning process of transorbital surgery.

Este artículo investiga los cambios estructurales en la volatilidad cíclica del crecimiento de las economías de Uruguay, Argentina y Brasil entre 1980 y 2018. Poniendo el foco en lo sucedido en Uruguay, se analiza la existencia de quiebres estructurales en la volatilidad cíclica del producto interno bruto (PIB) controlado por la volatilidad internacional. Los resultados evidencian que, luego de la crisis económica del 2002, Uruguay habría experimentado un cambio en la volatilidad cíclica del PIB que implicó una reducción de la volatilidad de más del 50%. Brasil presenta un quiebre en la volatilidad cíclica en forma más temprana (en 1994) y Argentina no presenta quiebres en su volatilidad. Los resultados obtenidos para Uruguay descartan que la reducción de volatilidad observada responda principalmente a un escenario de reducción de volatilidad externa, también conocido como “hipótesis de la buena suerte”.

ObjectivesPatients and caregivers are the primary stakeholders in ambulatory safety, given they perform daily chronic disease self-management, medication administration and outpatient follow-up. However, little attention has been given to their role in adverse events. We identified themes related to patient and caregiver factors and challenges in ambulatory safety incident reports from a Patient Safety Organization.MethodsWe conducted a mixed-methods analysis of ambulatory incident reports submitted to the Collaborative Healthcare Patient Safety Organization, including 450 hospitals or clinic members in 13 US states. We included events that had patient and/or caregiver behavioural, socioeconomic and clinical factors that may have contributed to the event. Two members of the team independently coded patient/caregiver factors, with dual coding of 20% of events. We then conducted a 'frequent item set' analysis to identify which factors most frequently co-occurred. We applied inductive analysis to the most frequent sets to interpret themes. Our team included a diverse stakeholder advisory council of patients, caregivers and healthcare staff.ResultsWe analysed 522 incident reports and excluded 73 for a final sample of 449 events. Our co-occurrence analysis found the following three themes: (1) clinical advice may conflict with patient priorities; (2) breakdowns in communication and patient education cause medication adverse events and (3) patients with disabilities are vulnerable to the external environment.ConclusionsAmbulatory safety reports capture both structural and behavioural factors contributing to adverse events. Actionable takeaways include the following: improving clinician counselling of patients to convey medical advice to elicit priorities, enhanced education regarding medication adverse events and expanding safety precautions for patients with disabilities at home. Ambulatory safety reporting must include patients in reporting and event review for better mitigation of future harm.

Introduction: Large and Giant intracranial aneurysms (LGIAs) have become the paradigm for which endovascular techniques do not provide satisfactory results. Yet, microsurgery is followed by non-negligible rates of morbimortality. This scenario may have changed since the introduction of flow-diversion devices. Research question: Contemporary and standardised revision on microsurgical and endovascular results, with emphasis on anterior circulation LGIAs. Materials and methods: A systematic literature search was conducted in two databases (PubMed and Embase) on treatment outcomes of LGIAs of the anterior circulation, after the introduction of flow-diverters 2008/01/01, till 2023/05/20. Small case series (15% of posterior circulation aneurysms, and studies not reporting clinical and/or angiographic outcomes were excluded. Results: 44 relevant studies (observational cohorts) were identified, including 2923 LGIAs predominantly from anterior circulation. Mean follow-up 22 (±20) months. 1494 (51%) LGIAs were treated endovascularly and 1427 (49%) microsurgically. According to the random effects model, pooled rates of favourable clinical outcomes were 85.8% (CI 95% 82.6–88.4), complete occlusion 69.4% (CI 95% 63.7–7.46), complications 19.6% (CI 95%16–23.9) and mortality 5.6% (CI 95% 4.4–7.1). Focusing on type of treatment, occlusion rates are higher with microsurgical (842/993, 85% vs 874/1,299, 67%), although good outcomes are slightly more frequent with endovascular (1045/1,135, 92% vs 1120/1,294, 87%). Discussion and conclusions: According to contemporary data about occlusion rates, functional outcomes, and complications, primary or secondary treatment of LGIAs of the anterior circulation seems justified. Microsurgical occlusion rates are higher in LGIAs. An expert consensus on reporting complications and management strategies is warranted.

Community health promotion activities are a useful tool for a proactive approach to healthy lifestyles. However, the implementation of these types of activities at health centers is not standardized. The aim of this review was to analyse the characteristics of community activities undertaken in the primary care setting and substantiate available evidence on their health impact. We conducted a bibliographic review until November 15th, 2023 in the TRIPDATABASE, MEDLINE, EMBASE, and DIALNET databases. We included original papers on interventions, community activities, and actions and/or social prescriptions which had been implemented in a Primary Care setting, included a group approach in at least one session, and described some type of evaluation of the intervention applied. Studies targeted at professionals and those without involvement of the primary care team were excluded. The search identified 1912 potential studies. We included a total of 30 studies, comprising 11 randomized clinical trials, 14 quasi-experimental studies, 1 cohort study, and 4 qualitative studies. The issues most frequently addressed in community activities were healthy habits, physical activity, cardiovascular diseases and diabetes. Community activities can improve the physical and psychological environment of their participants, as well as their level of knowledge about the issues addressed. That said, however, implementation of these types of interventions is not uniform. The existence of a professional community-activity liaison officer at health centers, who would help integrate the health system with the community sector, could serve to standardize implementation and maximize the health impact of these types of interventions.

Rhabdoid meningiomas (RM) are a rare meningioma subtype with a heterogeneous clinical course which is more frequently associated with recurrence, even among tumors undergoing-complete surgical removal. Here, we retrospectively analyzed the clinical-histopathological and cytogenetic features of 29 tumors, from patients with recurrent (seven primary and 14 recurrent tumors) vs. non-recurrent RM (n = 8). Recurrent RM showed one (29%), two (29%) or three (42%) recurrences. BAP1 loss of expression was found in one third of all RM at diagnosis and increased to 100% in subsequent tumor recurrences. Despite both recurrent and non-recurrent RM shared chromosome 22 losses, non-recurrent tumors more frequently displayed extensive losses of chromosome 19p (62%) and/or 19q (50%), together with gains of chromosomes 20 and 21 (38%, respectively), whereas recurrent RM (at diagnosis) displayed more complex genotypic profiles with extensive losses of chromosomes 1p, 14q, 18p, 18q (67% each) and 21p (50%), together with focal gains at chromosome 17q22 (67%). Compared to paired primary tumors, recurrent RM samples revealed additional losses at chromosomes 16q and 19p (50% each), together with gains at chromosomes 1q and 17q in most recurrent tumors (67%, each). All deceased recurrent RM patients corresponded to women with chromosome 17q gains, although no statistical significant differences were found vs. the other RM patients.

The widespread availability of open datasets in cities is transforming the way urban energy systems are planned, simulated, and visualized. In this paper, a cross-scale approach is pursued to better understand the reciprocal effects between building energy performance, the urban climate, and urban dwellers’ indoor and outdoor thermal comfort. On the one hand, monthly building electricity and gas demand data at the parcel level was collected, along with hourly weather station data at the urban scale. On the other hand, a longitudinal experiment was carried out in which 22 participants wore smartwatches for 4–6 weeks and filled out hourly micro surveys on their activities, location, and thermal comfort. In addition to survey responses, the smartwatches collected participants’ physiological data and location throughout the period of the study. The project was conducted in Seoul, South Korea, the highest-ranked Asian country in open data readiness, implementation, and impact. This paper reports on the data collection effort and provides some preliminary analysis of the results. The work carried out is expected to help develop methodologies for the convergence of district-scale and occupant-scale data in urban areas. A number of expected applications are proposed, including urban-scale studies on the impact of urban form on the local climate and building energy performance, district-to-building-scale building energy simulations accounting for occupant thermal comfort-related behaviors, and district-scale analyses of occupants’ outdoor thermal comfort and its relationship with location and wayfinding in urban areas.

Background: Subarachnoid hemorrhage (SAH) entails high morbidity and mortality rates. Convolutional neural networks (CNN) are capable of generating highly accurate predictions from imaging data. Our objective was to predict mortality in SAH patients by processing initial CT scans using a CNN-based algorithm. Methods: We conducted a retrospective multicentric study of a consecutive cohort of patients with SAH. Demographic, clinical and radiological variables were analyzed. Preprocessed baseline CT scan images were used as the input for training using the AUCMEDI framework. Our model’s architecture leveraged a DenseNet121 structure, employing transfer learning principles. The output variable was mortality in the first three months. Results: Images from 219 patients were processed; 175 for training and validation and 44 for the model’s evaluation. Of the patients, 52% (115/219) were female and the median age was 58 (SD = 13.06) years. In total, 18.5% (39/219) had idiopathic SAH. The mortality rate was 28.5% (63/219). The model showed good accuracy at predicting mortality in SAH patients when exclusively using the images of the initial CT scan (accuracy = 74%, F1 = 75% and AUC = 82%). Conclusion: Modern image processing techniques based on AI and CNN make it possible to predict mortality in SAH patients with high accuracy using CT scan images as the only input. These models might be optimized by including more data and patients, resulting in better training, development and performance on tasks that are beyond the skills of conventional clinical knowledge.

We report on a search for double beta decay of $^{130}$Te to the first$0^{+}$ excited state of $^{130}$Xe using a 9.8 kg$\cdot$yr exposure of$^{130}$Te collected with the CUORE-0 experiment. In this work we exploitdifferent topologies of coincident events to search for both the neutrinolessand two-neutrino double-decay modes. We find no evidence for either mode andplace lower bounds on the half-lives: $\tau^{0\nu}_{0^+}>7.9\cdot 10^{23}$ yrand $\tau^{2\nu}_{0^+}>2.4\cdot 10^{23}$ yr. Combining our results with thoseobtained by the CUORICINO experiment, we achieve the most stringent constraintsavailable for these processes: $\tau^{0\nu}_{0^+}>1.4\cdot 10^{24}$ yr and$\tau^{2\nu}_{0^+}>2.5\cdot 10^{23}$ yr.

We report on a search for double beta decay of 130Te to the first 0 + excited state of 130Xe using a 9.8kg·yr exposure of 130Te collected with the CUORE-0 experiment. In this work we exploit different topologies of coincident events to search for both the neutrinoless and two-neutrino double beta decay modes. We find no evidence for either mode and place lower bounds on the half-lives: T01+0ν>7.9·1023yr and T01+2ν>2.4·1023yr (90%CL). Combining our results with those obtained by the CUORICINO experiment, we achieve the most stringent constraints available for these processes: T01+0ν>1.4·1024yr and T01+2ν>2.5·1023yr (90%CL).