Andalusian Agency for Healthcare Quality

The mitotic spindle in the fission yeast Schizosaccharomyces pombe is a single bundle of microtubules that elongates to segregate the chromosomes during anaphase B. The mechanical properties of the spindle and the forces driving its elongation remain poorly defined. Here, we analyzed how spindles react to mechanical and genetic perturbations to uncover their mechanical properties. Treatment of cells with osmotic oscillations and blue light led to a consistent phenotype of spindle buckling and breakage in mid-anaphase. The stalling of pole separation and reduced rates of spindle elongation indicated that spindles elongate and buckle under increased mechanical load. The structural integrity of the bent spindles was dependent on Ase1 (PRC1), while the spindle elongation rate was dependent on motor proteins Klp9 (kinesin-6) and Cut7 (kinesin-5). Modeling of bent spindle shapes revealed that most spindles behave mechanically as a beam in which the midzone region is one to two times as rigid than the rest of the beam. Upon reaching a threshold size, bent spindles broke at a specific fragile site near the edge of the spindle midzone. Our findings in this simple fission yeast spindle are relevant to the mechanics of more complex metazoan spindles.

El artículo analiza la violencia institucional del Sistema de Protección de la Infancia desde la perspectiva de adolescentes y jóvenes en acogimiento residencial o familiar en España a través de una metodología cualitativa basada en entrevistas grupales y en un análisis de redes semánticas. Emergieron 6 supracategorías sobre malestares y reivindicaciones en el sistema de protección, vinculadas con los aspectos relacionales, la calidad de los cuidados y el protagonismo o la participación de adolescentes institucionalizados. Este texto concluye con una reflexión sobre la importancia del análisis de la violencia institucional en el sistema de protección, para corregir políticas públicas y diseñar estrategias que la minimicen.

Metastatic castration-resistant prostate cancer (mCRPC) is an aggressive, lethal state of prostate cancer, for which early progression is an indicator of poor prognosis. The ability to predict this progression is of paramount clinical importance for guiding personalized treatment strategies. We aimed to develop and validate a novel machine learning (ML) model to predict early progression (≤ 12 months) to mCRPC and compare its performance against standard ML algorithms. This was a retrospective analysis of 172 patients with mHSPC from the publicly available MSK-IMPACT cohort. Inclusion criteria specified patients with mHSPC who had undergone genomic profiling and progressed to mCRPC during follow-up. Patients with incomplete data were excluded. We collected 11 clinical, pathological, and genomic variables. The primary outcome was early progression (≤ 12 months) to mCRPC. Model performance was evaluated using a stratified fivefold cross-validation, with AUC as the primary metric. A novel Rivality Index (RINH)-based model, adapted from chemoinformatics, demonstrated significantly superior predictive performance (AUC: 0.86) compared to a panel of standard ML algorithms, none of which exceeded an AUC of 0.67. The model achieved an accuracy of 0.74, a sensitivity of 0.70, and a specificity of 0.77. Key limitations include the retrospective design and use of a single-institution data set. This novel RINH model offers a robust tool for risk stratification in mHSPC patients, capable of personalizing therapeutic strategies. However, external validation in multi-center, prospective cohorts is an essential next step before its consideration as a clinical decision support tool.

Se estudian las patentes en España del campo de la Industria 4.0. Se utiliza una metodología compleja y avanzada para la identificación del campo semántico, en base. A más de 326 campos de la Clasificación Común de Patentes (CPC) seleccionados por los revisores de la Oficina Europea de Patentes (EPO). Las patentes fueron recuperadas de la fuente Questel Intelligence (2010-2022). Los resultados indican que España tiene un desarrollo relativo alto en el campo de la producción de energía y vehículos. Al mismo tiempo presenta ciertas deficiencias em software e Inteligencia Artificial. En cuanto a los actores locales destacan empresas de telecomunicaciones como Telefónica y Vodafone, e instituciones como las universidades de Sevilla, Valladolid y el CSIC. Entre los actores externos destacan Qualcomm, Huawei, Ericsson, Samsung y Apple.

Objective: We analyzed the effect of implementing a flash glucose monitoring (FGM) technology in a public health care system with universal coverage on the rate of severe hypoglycemia requiring urgent care in adults with type 1 diabetes mellitus (T1DM). Methods: Using a comprehensive regional dataset, we extracted emergency care codes with hypoglycemia in individuals with T1DM who initiated the use of FGM in Andalucia, Spain, from January 1, 2020, to December 31, 2021. Severe hypoglycemia was defined as a confirmed blood glucose <70 mg/dL, which required the urgent dispatch of an emergency medical service (EMS) for onsite management. We compared hypoglycemic events reported in the 12 months before and after the initiation of FGM to determine the population incidence rates. Results: A total of 13,616 participants with a mean age of 43.7 ± 13.5 years were included. The follow-up periods were 23.4 and 24.8 months before and after FGM. There were 969 and 737 cases of hypoglycemia before and after the initiation of FGM. The baseline incidence rate was 358.58 episodes per 10,000 person-years, which decreased to 260.9 at the end of the follow-up (rate-ratio 0.72 [0.66; 0.80]). The reduction in hypoglycemia was significant in individuals aged ≥60 years (rate-ratio 0.40 [0.28; 0.55]) and males (0.64 [0.56; 0.72]). In addition, there was a reduction in the overall median HbA1c of -0.35% (95% CI [-0.38; -0.33], P < 0.001). Conclusion: The implementation of FGM systems in a public health care system as a provision for adults with T1DM was associated with significant reductions in the rate of severe hypoglycemic events that required urgent EMS care.

Situated in the administrative boundaries of West Java Province and DKI Jakarta Province, the Ciliwung River is a national river. Its river length is about 120 km, and its watershed area is about 425 km³ (DAS). The population of Depok City is growing at a pace of 1.79% annually, which leads to a rise in the demand for food, clothing, and housing, among other necessities. As a result of the growth of various industrial and community residential buildings to accommodate human needs, wastewater discharge into rivers will increase and the amount of pollution entering the Ciliwung River may surpass its carrying capacity if efforts are not made to control water pollution. As a result, research must be done to ascertain Segment IV Depok City's Ciliwung River Pollutant Load Capacity utilizing a simulation model and Qual2Kw software. Primary data samples of the Ciliwung River's water and pollution sources that enter it were collected for this study, in addition to firsthand field observations. Data calibration is carried out after entering hydraulic and quality data into worksheets. In order to ensure that river flow data still satisfies class II river water quality standards, modeling is done utilizing the following sources: (1) existing data; (2) upstream data of class II river water quality standards; and (3) current conditions of river flow and trial &amp; error pollutant source data. The findings indicated that the Ciliwung River section IV, Depok City, has a somewhat contaminated water quality. Pollutant loads for TSS and COD criteria can still be accommodated in Ciliwung River section IV, Depok City. In the meantime, the BOD criteria for carrying pollutant loads has been surpassed; therefore, to meet class II water quality regulations, the BOD pollutant load needs to be reduced by 22.58% to 37.50%.

Abstract Background Personalized medicine (PM) is a rapidly evolving field, and its implementation varies widely across different countries. Some countries have invested significantly in PM research and development, while others still need to adopt these approaches. Methods To create a visual map of the PM implementation current state between countries. A framework was applied to determine the PM implementation level. The necessary information was identified and gathered from various sources, including policy documents, national guidelines, websites of major governmental agencies, research organizations, and health technology assessment agencies such as NICE, CADTH, AHRQ, and RedETS. Results Our search retrieved 184 full-text documents to fulfill the framework, generating a PM implementation country map. The map reflects the variability between countries based on different factors, particularly social-economic development. Conclusions Our PM framework was applied in a multi-country context, ranking countries based on their implementation levels. Our findings can reflect the adoption of best practices to improve implementation efforts. Policymakers, healthcare professionals, and researchers can use our framework to assess PM implementation in their respective regions. Further research is needed to evaluate the framework's challenges, limitations, and performance in different contexts. Key messages • Our PM framework was applied in a multi-country context, ranking countries based on their implementation levels. • Policymakers, healthcare professionals, and researchers can use our framework to assess PM implementation in their respective regions.

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 2.913 (2021 JCR, received in June 2022)The IJIC 20th Anniversary Issue was published in 2021.