Intraoperative use of IndoCyaninE Green fluorescence imaging to prevent anastomotic leakage in colorectal surgery : systematic Review, Meta-Analysis and Study Protocol for the ICEberG Trial

Intraoperative use of IndoCyaninE Green fluorescence imaging to prevent anastomotic leakage in colorectal surgery: systematic review, meta-analysis and study protocol for the ICEberG trial Aim: ICG fluorescence imaging has been increasingly considered as a potential tool to assess anastomosis perfusion. This study aims to validate its efficacy in reducing anastomotic leakage (AL) rate in colorectal surgery. Method:A systematic review and a meta-analysis of studies comparing fluorescence imaging with standard care were conducted. Furthermore, a prospective randomised controlled trial (RCT) was proposed. Results: 1302 patients from 5 studies were included. Fluorescence imaging significantly reduced AL risk in cancer surgery (OR:0.34; CI:0.16-0.74; P=0.006). Low AL rates were shown in rectal surgery (ICG:1.1% vs non-ICG:6.1%; P=0.02). There was no significant AL rate decrease when procedures for benign and malignant indication were combined. To date, there are no published RCTs, though 3 ongoing trials were identified. Conclusions: Fluorescence imaging seems to reduce AL rate following colorectal surgery for cancer. However, large well-design RCTs are needed to provide evidence for its routine use. The proposed ICEberG trial would address this need.Objectiu: L'ús d'imatges per fluorescència amb verd d'indocianina s'està considerant cada cop més com una potencial eina per l'avaluació de la perfusió de l'anastomosi. L'objectiu d'aquest estudi és validar la seva eficàcia en la reducció de la taxa de fuita anastomòtica en la cirurgia colorectal. Mètodes: S'ha realitzat una revisió sistemàtica i un meta-anàlisi dels estudis que comparaven l'ús d'imatges per fluorescència amb la pràctica habitual. A més, s'ha proposat un assaig controlat aleatori (ACA) prospectiu. Resultats: 1302 pacients de 5 estudis van ser inclosos a l'anàlisi. L'ús d'imatges per fluorescència va reduir significativament el risc de fuita en cirurgia per càncer (OR:0.34; CI:0.16-0.74; P=0.006). Es va veure una baixa taxa de fuita anastomòtica en cirurgia de recte (ICG:1.1% vs no-ICG:6.1%; P=0.02). No es va trobar un descens significatiu en la taxa de fuita anastomòtica quan es van combinar procediments amb indicació benigna i maligna. Actualment no existeixen ACA publicats, tot i que s'han identificat 3 assaigs en curs. Conclusions: L'ús d'imatges per fluorescència sembla reduir la taxa de fuita anastomòtica després de cirurgia colorectal per càncer. No obstant, es necessiten grans ACA que proporcionin evidència en l'ús d'aquesta tècnica a la pràctica habitual. El proposat ACA ICEberG abordaria aquesta necessitat

Acercamiento a la música tradicional zamorana en la Educación Primaria

Trabajo Fin de Grado-Universidad de Salamanca, 2014[ES] El estudio pretende analizar y evaluar el conocimiento sobre la música tradicional zamorana en los niños de la etapa primaria con el fin de determinar si existe una base para trabajar contenidos en el área de Educación Musical a través de ésta. Con la posibilidad de repetir el proyecto que Zoltán Kodály realizó en Hungría, esta investigación, siguiendo el método inductivo, aplica el muestreo en dos centros públicos de Educación Primaria de la provincia de Zamora. Y, se divide en dos fases: durante la primera fase, se realizan unas audiciones con canciones, seleccionadas en función de su representatividad, a los alumnos de la etapa. Posteriormente, en la segunda fase, se selecciona de cada centro un número de niños cuyas circunstancias sean representativas, para someter a los profesores de música de ambos centros a un cuestionario sobre el rendimiento individual del niño[EN] The study aims to analyze and evaluate knowledge about traditional music Zamora children of primary stage in order to determine whether there is a basis to work contents in the area of music education through it. With the possibility of repeating the project in Hungary Zoltan Kodaly he conducted this research, following the inductive method, applied sampling in two public Primary Schools in the province of Zamora. And it is divided into two phases: the first phase, some auditions with songs selected based on their representativeness, students stage are made. Later, in the second phase, a number of children whose circumstances are representative is selected from each center to subdue music teachers from both schools to a questionnaire on the individual performance of the child

Updated European guidelines for clinical management of familial adenomatous polyposis (FAP), MUTYH-associated polyposis (MAP), gastric adenocarcinoma, proximal polyposis of the stomach (GAPPS) and other rare adenomatous polyposis syndromes: a joint EHTG-ESCP revision

European guidelines; Familial adenomatous polyposis; Gastric adenocarcinomaDirectrices europeas; Poliposis adenomatosa familiar; Adenocarcinoma gástricoDirectrius europees; Poliposi adenomatosa familiar; Adenocarcinoma gàstricBackground: Hereditary adenomatous polyposis syndromes, including familial adenomatous polyposis and other rare adenomatous polyposis syndromes, increase the lifetime risk of colorectal and other cancers. Methods: A team of 38 experts convened to update the 2008 European recommendations for the clinical management of patients with adenomatous polyposis syndromes. Additionally, other rare monogenic adenomatous polyposis syndromes were reviewed and added. Eighty-nine clinically relevant questions were answered after a systematic review of the existing literature with grading of the evidence according to Grading of Recommendations, Assessment, Development, and Evaluation methodology. Two levels of consensus were identified: consensus threshold (≥67% of voting guideline committee members voting either 'Strongly agree' or 'Agree' during the Delphi rounds) and high threshold (consensus ≥ 80%). Results: One hundred and forty statements reached a high level of consensus concerning the management of hereditary adenomatous polyposis syndromes. Conclusion: These updated guidelines provide current, comprehensive, and evidence-based practical recommendations for the management of surveillance and treatment of familial adenomatous polyposis patients, encompassing additionally MUTYH-associated polyposis, gastric adenocarcinoma and proximal polyposis of the stomach and other recently identified polyposis syndromes based on pathogenic variants in other genes than APC or MUTYH. Due to the rarity of these diseases, patients should be managed at specialized centres.This research was supported financially by the British Journal of Medicine and by the ESCP (European Society of Coloproctology)

Performance and Operation of the CMS Electromagnetic Calorimeter

The operation and general performance of the CMS electromagnetic calorimeter using cosmic-ray muons are described. These muons were recorded after the closure of the CMS detector in late 2008. The calorimeter is made of lead tungstate crystals and the overall status of the 75848 channels corresponding to the barrel and endcap detectors is reported. The stability of crucial operational parameters, such as high voltage, temperature and electronic noise, is summarised and the performance of the light monitoring system is presented

A Risk-Based Screening Approach to Patients Needing Surgery During the De-Escalation Phase of COVID-19 Pandemic

Since the outbreak of COVID-19 pandemic, many national and international surgical societies have produced guidelines regarding the management of surgical patients. During the mitigation phase of the pandemic, most documents suggested to consider postponing elective procedures, unless this might have impacted the life expectancy of patients. As awareness and knowledge about COVID-19 are gradually increasing, and as we enter a phase when surgical services are resuming their activities, surgical strategies have to adapt to this rapidly evolving scenario. This is particularly relevant when considering screening policies and the associated findings. We herein describe a risk-based approach to the management of patients with surgical diseases, which might be useful in order to limit the risks for healthcare workers and patients, while allowing for resuming elective surgical practice safely

Transparency in surgical randomised controlled trials: cross-sectional, observational study

Objective To explore transparency in surgical randomised controlled trials with respect to trial registration, disclosure of funding sources, conflicts of interest, and data sharing.Design Cross sectional review of published randomised controlled trials.Setting Surgical randomised controlled trials involving human participants undergoing any kind of invasive surgery Data sources Ten high impact journals were systematically searched for randomised controlled trials, published in the years 2009, 2012, 2015, and 2018. Data was extracted following manual inspection of manuscripts. Main outcome measure Four domains of transparency were explored. These included trial registration on a public-accessible database, presence of a funding statement, presence of a conflict of interest statement, and presence of a statement relating to data sharing.Results Of 611 published trials, 475 were eligible for analysis. Three-hundred and ninety-seven (83.6%) were registered, of which 190 (47.9%) were done prospectively. Compliance to prospective registration increased over time (26.0% in 2009, 33.0% in 2012, 53.5% in 2015, and 72.7% in 2018). Funding statements were provided in 55%, 65%, 69.4%, and 75.4% of manuscripts, respectively. Conflicts of interest statements were provided in 49.5%, 89.1%, 94.6%, and 98.3% of manuscript, respectively. Data sharing statements were present in only 15 (3.2%) RCTs. Eleven of these were in studies published most recently in 2018. Conclusion Trial registration, presence of funding statements, and disclosure of personal conflicts in surgical RCTs have improved rapidly over the last 10 years. In contrast, disclosure of data sharing plans is exceptionally low. This may contribute to research waste and represents an essential target for improvement. Strengths and limitations of this studyStrengths:• Surgical RCTs published between 2008-2018 were considered in this study, which permitted an assessment of transparency over time. Limitations:• Included RCTs were from a sample of high impact surgical and general medical journals, which restricts the generalisability of findings across a broader population• The study considered author-reported statements of funding, conflicts, and data sharing, which may introduce bias or inaccuracies due to self-reporting.<br/

Gamificación como apoyo al aprendizaje en la enseñanza práctica en biología

Memoria ID2022-... Ayudas de la Universidad de Salamanca para la innovación docente, curso 2022-2023

Evolution of the maintainability of HPC facilities at CIEMAT headquarters

Desde su creación en 1951, el CIEMAT ha estado impulsando continuamente el uso de la computación como un método de investigación, desplegando plataformas de cómputo innovadoras. De esta manera, arquitecturas vectoriales, MPP, NUMA y otras completamente distribuidas han sido gestionadas en el CIEMAT, acumulando un extenso conocimiento sobre su sostenibilidad y sobre las necesidades de las comunidades científicas relacionadas con proyectos internacionales. Actualmente, la evolución del hardware y el software para HPC es cada vez más rápida e implica un desafío constante para aumentar su disponibilidad debido al número de iniciativas que el centro apoya. Para abordar esta tarea, el equipo TIC ha estado cambiando su gestión hacia un modelo flexible, con una mirada puesta en las adquisiciones futuras.Since its establishment in 1951, CIEMAT has been continuously boosting the use of computation as a research method, deploying innovative computing facilities. Hence, Vectorial, MPP, NUMA, and distributed architectures have been managed at CIEMAT, resulting in an extensive expertise on HPC maintainability as well as on the computational needs of the community related to international projects. Nowadays, the evolution of HPC hardware and software is progressively faster and implies a continuous challenge to increase their availability for the greater number of different initiatives supported. To address this task, the ICT team has been changing towards a flexible management model, with a look toward future acquisitions

Vertical raindrop size distribution in central Spain: a case study

[EN] A precipitation event that took place on 12 October 2008 in Madrid, Spain, is analyzed in detail. Three different devices were used to characterize the precipitation: a disdrometer, a rain gauge, and a Micro Rain Radar (MRR). These instruments determine precipitation intensity indirectly, based on measuring different parameters in different sampling points in the atmosphere. A comparative study was carried out based on the data provided by each of these devices, revealing that the disdrometer and the rain gauge measure similar precipitation intensity values, whereas the MRR measures different rain fall volumes. The distributions of drop sizes show that the mean diameter of the particles varied considerably depending on the altitude considered. The level at which saturation occurs in the atmosphere is decisive in the distribution of drop sizes between 2,700 m and 3,000 m. As time passes, the maximum precipitation intensities are registered at a lower height and are less intense. The maximum precipitation intensities occurred at altitudes above 1,000 m, while the maximum fall speeds are typically found at altitudes below 700 mSIThis study was partially supported by the Spanish MINECO (Grants TEC2014-57821-R and CGL2014-52556-R

Search for Evidence of the Type-III Seesaw Mechanism in Multilepton Final States in Proton-Proton Collisions at root s=13 TeV

Peer reviewe