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Braquiterapia adyuvante de alta tasa de dosis en el tratamiento de pacientes con carcinoma de cabeza y cuello: aplicabilidad de los datos dosimétricos
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[Noticia] «Celebrado en Santillana del Mar (Cantabria) el “Congreso Y los sueños, sueños son... Calderón de la Barca y el Siglo de Oro”»
No full textAggregation of T -subgroups
No full textWe study when an aggregation function acting on an n-tuple of T-subgroups preserves the structure of T-subgroup. First we need to consider that there are two known definitions applicable to the aggregation of structures on fuzzy sets. These two notions differ in the domain of the aggregated structure. It is known that for indistinguishability operators, pseudometrics, quasi-pseudometrics among others, the aggregation functions that preserve these structures are the same with both definitions. However this is not the case for quasi-metrics. In this line we study the aggregation of T-subgroups with both definitions and their implications. We see that aggregation functions may preserve the structure of T-subgroups with one definition but not with the other. However, under adequate restrictions, the aggregation functions preserving the structure of T-subgroups are the same with either definition. We also show that the results depend on the structure of the subgroup lattice of the ambient group, the particular T-subgroups being aggregated, or the aggregation function
La presencia de la Fortuna en Mira de Amescua y Shakespeare: el caso de La adversa Fortuna de don Álvaro de Luna y El rey Lear
No full textLa Fortuna es un tema fundamental durante el Barroco español y el periodo isabelino, múltiples autores la presentan en sus obras como causa de los cambios de suerte en los personajes de sus obras. En este caso, se busca analizar su presencia en dos obras específicas de este periodo, por un lado, La adversa Fortuna de don Álvaro de Luna de Mira de Amescua y, por otro, El rey Lear de Shakespeare. En ambos casos, la presencia de la Fortuna se relaciona con las figuras de poder y, especialmente, con la del privado del rey. El análisis se centra, en primer lugar, en mostrar un breve recorrido por las representaciones de la Fortuna hasta llegar a los tópicos específicos que estos autores utilizan. En segundo lugar, se hace un análisis literario-dramático de la configuración de los personajes por medio de la presencia de la Fortuna.Fortune is a fundamental theme during the Spanish Baroque and the Elizabethan period, multiple authors present it in their works as the cause of changes of luck in the characters of their plays. In this case, it’s going to be analized its presence in two specific works of this period, on the one hand, La adversa Fortuna de don Álvaro de Luna by Mira de Amescua and, on the other, King Lear by Shakespeare. In both cases, the presence of Fortune is related to figures of power and, especially, to the king’s favourite. The analysis focuses, first of all, on showing a brief tour of the representations of Fortune until reaching the specific topics that these authors use. Secondly, a literary-dramatic analysis of the configuration of the characters is made through the presence of Fortune
Aquinas and the Multiverse. An Approach
No full textGradually, the multiverse hypothesis has been gaining popularity, not only in the scientific and academic sphere, but also in popular culture. This hypothesis, however, is not recent; Thomas Aquinas himself had to respond to a version of it. Although the problem is broad and must be approached in an interdisciplinary dialogue, the Thomistic approach is very interesting, since he accepts the plurality of worlds as something possible but denies that it is a possibility made real. His answer, which is the subject of this article, is an opportunity to think about our representation of God and his causal activity
Illuminating the Neuroscience of Decision-making Through the Dark Night of John of the Cross
No full textIn this publication, we will use the principal concepts of John of the Cross, the famous mystic of the XVIth century, as a framework to go over, in a non-reductionist way, three challenges in contemporary neuroscience of decision-making. Firstly, the dark night and the purgative paths will be related to discontinuity in decision-making. Secondly, the passive and active paths will be associated to brain plasticity, architecture, and levels of decision. Thirdly, the illumination, which can be felt when a solution is reached, has to do with positive emotions and can be inspired by the science of love of John of the Cross. We shall lastly conclude by emphasizing the usefulness of his work to illuminate the neuroscience of decision-making
Safety and effectiveness of sucroferric oxyhydroxide in Spanish patients on dialysis: sub-analysis of the VERIFIE study
No full textBackground and aims: In this study, we show the results of the subset of Spanish patients
of the VERIFIE study, the first post-marketing study assessing the long-term safety and
effectiveness of sucroferric oxyhydroxide (SFOH) in patients with hyperphosphatemia
undergoing dialysis during clinical practice.
Patients and methods: Patients undergoing hemodialysis and peritoneal dialysis with indication of SFOH treatment were included. Follow-up duration was 12–36 months after SFOH
initiation. Primary safety variables were the incidence of adverse drug reactions (ADRs),
medical events of special interest (MESIs), and variations in iron-related parameters. SFOH
effectiveness was evaluated by the change in serum phosphorus levels.
Results: A total of 286 patients were recruited and data from 282 were analyzed. Among
those 282 patients, 161 (57.1%) withdrew the study prematurely and 52.5% received concomitant treatment with other phosphate binders. ADRs were observed in 35.1% of patients,
the most common of which were gastrointestinal disorders (77.1%) and mild/moderate in
severity (83.7%). MESIs were reported in 14.2% of patients, and 93.7% were mild/moderate.
An increase in ferritin (386.66ng/mL vs 447.55ng/mL; p = 0.0013) and transferrin saturation
(28.07% vs 30.34%; p = 0.043) was observed from baseline to the last visit (p = 0.0013). Serum
phosphorus levels progressively decreased from 5.69mg/dL at baseline to 4.84mg/dL at the
last visit (p < 0.0001), increasing by 32.2% the proportion of patients who achieved serum
phosphorus levels ≤5.5mg/dL, with a mean daily SFOH dose of 1.98 pills/day.
Conclusions: SFOH showed a favorable effectiveness profile, a similar safety profile to that
observed in the international study with most adverse events of mild/moderate severity,
and a low daily pill burden in Spanish patients in dialysis.Antecedentes y objetivo: En este estudio presentamos los resultados del subgrupo de pacientes
espanoles ˜ del estudio VERIFIE, primer estudio post-autorización prospectivo que evalúa la
seguridad y efectividad a largo plazo del oxihidróxido sucroférrico (OHS) en pacientes en
diálisis con hiperfosfatemia durante la práctica clínica habitual.
Pacientes y métodos: Se incluyeron pacientes en hemodiálisis y diálisis peritoneal con indicación de tratamiento con OHS. La duración del seguimiento fue de 12 a 36 meses desde el
inicio del tratamiento con OHS. Las variables primarias de seguridad fueron la incidencia de
reacciones adversas a medicamentos (RAMs), eventos médicos de interés especial (EMIEs)
y variaciones en los parámetros del hierro. La efectividad del OHS se evaluó mediante el
cambio en los niveles de fósforo sérico.
Resultados: Se reclutaron 286 pacientes y se analizaron los datos de 282. De estos 282
pacientes, 161 (57,1%) abandonaron el estudio de manera prematura y un 52,5% recibieron
tratamiento concomitante con otros captores de fósforo. Un 35,1% reportaron RAMs y la
mayoría fueron de tipo gastrointestinal (77,1%) y de intensidad leve/moderada (83,7%). Un
14,2% de los pacientes presentaron EMIEs, de los que el 93,7% fueron leves/moderados.
Se observó un incremento de la ferritina (386,66ng/mL vs 447,55ng/mL; p = 0,0013) y saturación de la transferrina (28,07% vs 30,34%; p = 0,043) desde el inicio hasta la última visita.
Los niveles de fósforo sérico disminuyeron progresivamente desde 5,69mg/dL al inicio hasta
4,84 mg/dL en la última visita (p < 0,0001), aumentando la proporción de pacientes con niveles de fósforo ≤5,5mg/dL un 32,2%, y con una dosis diaria media de 1,98 comprimidos/día.
Conclusiones: OHS presentó un perfil de efectividad favorable, un perfil de seguridad similar
al observado en el estudio internacional con una mayoría de efectos adversos de severidad
leve/moderada, y un número reducido de comprimidos diarios en pacientes espanoles ˜ en
diálisis
Single cell spatial analysis reveals inflammatory foci of immature neutrophil and CD8 T cells in COVID-19 lungs
No full textSingle cell spatial interrogation of the immune-structural interactions in COVID -19 lungs is challenging, mainly because of the marked cellular infiltrate and architecturally distorted microstructure. To address this, we develop a suite of mathematical tools to search for statistically significant co-locations amongst immune and structural cells identified using 37-plex imaging mass cytometry. This unbiased method reveals a cellular map interleaved with an inflammatory network of immature neutrophils, cytotoxic CD8 T cells, megakaryocytes and monocytes co-located with regenerating alveolar progenitors and endothelium. Of note, a highly active cluster of immature neutrophils and CD8 T cells, is found spatially linked with alveolar progenitor cells, and temporally with the diffuse alveolar damage stage. These findings offer further insights into how immune cells interact in the lungs of severe COVID-19 disease. We provide our pipeline [Spatial Omics Oxford Pipeline (SpOOx)] and visual-analytical tool, Multi-Dimensional Viewer (MDV) software, as a resource for spatial analysis.
Mathematical tools can be used to help identify pathological features from images of diseased lungs. Here, the authors used mathematical tools combined with high resolution multiplex imaging mass cytometry to show an association between immature neutrophils, CD8 T cells and proliferating alveolar epithelial cells in areas of maximal alveolar damage in COVID-19 lungs
Financial toxicity in the clinical encounter: a paired survey of patient and clinician perceptions
No full textObjective: To compare the agreement between patient and clinician perceptions of care-related financial issues.Patients and Methods: We surveyed patient-clinician dyads immediately after an outpatient medical encounter between September 2019 and May 2021. They were asked to separately rate (1-10) patient's level of difficulty in paying medical bills and the importance of discussing cost issues with that patient during clinical encounters. We calculated agreement between patient-clinician ratings using the intraclass correlation coefficient and used random effects regression models to identify patient predictors of paired score differences in difficulty and importance of ratings.Results: 58 pairs of patients (n=58) and clinicians (n=40) completed the survey. Patient-clinician agreement was poor for both measures, but higher for difficulty in paying medical bills (intraclass correlation coefficient=0.375; 95% CI, 0.13-0.57) than for the importance of discussing cost (-0.051; 95% CI,-0.31 to 0.21). Agreement on difficulty in paying medical bills was not lower in encounters with conversations about the cost of care. In adjusted models, poor patient-clinician agreement on difficulty in paying medical bills was associated with lower patient socioeconomic status and education level, whereas poor agreement on patient-perceived importance of discussing cost was significant for patients who were White, married, reported 1 or more long-term conditions, and had higher education and income levels.Conclusion: Even in encounters where cost conversations occurred, there was poor patient-clinician agreement on ratings of the patient's difficulty in paying medical bills and perceived importance of discussing cost issues. Clinicians need more training and support in detecting the level of financial burden and tailoring cost conversations to the needs of individual patients
Verdad, bien y virtud. Un análisis antropológico de la virtud en el conocimiento humano según Santo Tomás de Aquino
Get PDFLa definición de verdad en el pensamiento de Santo Tomás lleva implícito una comprensión y estructuración de elementos que traslucen una posible conexión entre gnoseología y moral. A este respecto podemos decir que la definición de verdad para el Aquinate engloba tres aspectos que se pueden extraer de la noción de adaequatio, a saber, los aspectos cognoscitivo, manifestativo y teleológico. Se plantea entonces desde aquí una relación de complementariedad entre virtudes desde las nociones gnoseológicas mensura y adaequatio, nociones que de hecho reconducen la verdad del plano gnoseológico al plano moral de la virtud (status virtus). De este modo, la relación entre virtudes abre paso a comprender su interacción mutua desde el concepto de interhabitualidad propuesto en este trabajo. La interhabitualidad se comprende desde dos niveles: el primer nivel de interhabitualidad tiene que ver con la génesis u origen de las virtudes (semina virtutum). Esta primera relación interhabitual se fundamenta en tres virtudes: el intellectus, la sindéresis y la prudencia. Esta última hace de puente entre virtudes debido a que en ella se realiza plenamente la noción de mensura. Desde aquí se abre paso a un segundo nivel de interhabitualidad, el que concierne al uso (usus) del acto de la virtud. Para el Aquinate el buen uso del acto de la virtud intelectual depende de la virtud moral y deja abierta la cuestión sobre qué virtudes intervienen. De ahí que se proponga en este trabajo tres virtudes synergéticas para este cometido: La prudencia, la studiositas y la veracidad.The definition of truth in the thought of Saint Thomas implies an understanding and structuring of elements that reveal a possible connection between epistemology and morality. In this regard we can say that the definition of truth for Aquinas encompasses three aspects that can be extracted from the notion of adaequatio, namely, the cognitive, manifestive and teleological aspects. From here, then, a complementary relationship between virtues arises from the epistemological notions mensura and adaequatio, notions that in fact redirect the truth from the epistemological plane to the moral plane of virtue (status virtus). In this way, the relationship between virtues opens the way in understanding their mutual interaction from the concept of interhabituality proposed in this work. Interhabituality is understood from two levels: the first level of interhabituality has to do with the genesis or origin of virtues (semina virtutum). This first interhabitual relationship is based on three virtues: the intellectus, synderesis and prudence. The latter acts as a bridge between virtues because the notion of mensura is fully realized in it. From here, the way is opened to a second level of interhabituality, the one that concerns the use (usus) of the act of virtue. For Aquinas, the proper use of the act of intellectual virtue depends on moral virtue and leaves open the question of what virtues intervene. Hence, three synergistic virtues are proposed in this work for this purpose: Prudence, the studiositas and veracity