Quality of care assessment for non-small cell lung cancer patients: transforming routine care data into a continuous improvement system.

PURPOSE: The complexity of cancer care requires planning and analysis to achieve the highest level of quality. We aim to measure the quality of care provided to patients with non-small cell lung cancer (NSCLC) using the data contained in the hospital's information systems, in order to establish a system of continuous quality improvement. METHODS/PATIENTS: Retrospective observational cohort study conducted in a university hospital in Spain, consecutively including all patients with NSCLC treated between 2016 and 2020. A total of 34 quality indicators were selected based on a literature review and clinical practice guideline recommendations, covering care processes, timeliness, and outcomes. Applying data science methods, an analysis algorithm, based on clinical guideline recommendations, was set up to integrate activity and administrative data extracted from the Electronic Patient Record along with clinical data from a lung cancer registry. RESULTS: Through data generated in routine practice, it has been feasible to reconstruct the therapeutic trajectory and automatically calculate quality indicators using an algorithm based on clinical practice guidelines. Process indicators revealed high adherence to guideline recommendations, and outcome indicators showed favorable survival rates compared to previous data. CONCLUSIONS: Our study proposes a methodology to take advantage of the data contained in hospital information sources, allowing feedback and repeated measurement over time, developing a tool to understand quality metrics in accordance with evidence-based recommendations, ultimately seeking a system of continuous improvement of the quality of health care.

Eco-Friendly Natural Rubber-Jute Composites for the Footwear Industry.

Nowadays, biocomposites represent a new generation of materials that are environmentally friendly, cost-effective, low-density, and not derived from petroleum. They have been widely used to protect the environment and generate new alternatives in the polymer industry. In this study, we incorporated untreated jute fibers (UJFs) and alkaline-treated jute fibers (TJFs) at 1-5 and 10 phr into TSR 10 natural rubber as reinforcement fillers. These composites were produced to be used in countersole shoes manufacturing. Untreated fibers were compared to those treated with 10% sodium hydroxide. The alkali treatment allowed the incorporation of fibers without compromising their mechanical properties. The TJF samples exhibited 8% less hardness, 70% more tensile strength, and the same flexibility compared to their pure rubber counterparts. Thanks to their properties and ergonomic appearance, the composites obtained here can be useful in many applications: construction materials (sound insulating boards, and flooring materials), the automotive industry (interior moldings), the footwear industry (shoe soles), and anti-static moldings. These new compounds can be employed in innovative processes to reduce their carbon footprint and negative impact on our planet. Using the Lorenz-Park equation, the loaded composites examined in this study exhibited values above 0.7, which means a competitive load-rubber interaction. Scanning electron microscopy (SEM) was used to investigate the morphology of the composites in detail.

A Real-Time FPGA-Based Metaheuristic Processor to Efficiently Simulate a New Variant of the PSO Algorithm.

Nowadays, high-performance audio communication devices demand superior audio quality. To improve the audio quality, several authors have developed acoustic echo cancellers based on particle swarm optimization algorithms (PSO). However, its performance is reduced significantly since the PSO algorithm suffers from premature convergence. To overcome this issue, we propose a new variant of the PSO algorithm based on the Markovian switching technique. Furthermore, the proposed algorithm has a mechanism to dynamically adjust the population size over the filtering process. In this way, the proposed algorithm exhibits great performance by reducing its computational cost significantly. To adequately implement the proposed algorithm in a Stratix IV GX EP4SGX530 FPGA, we present for the first time, the development of a parallel metaheuristic processor, in which each processing core simulates the different number of particles by using the time-multiplexing technique. In this way, the variation of the size of the population can be effective. Therefore, the properties of the proposed algorithm along with the proposed parallel hardware architecture potentially allow the development of high-performance acoustic echo canceller (AEC) systems.

Vegetable Cellulose Fibers in Natural Rubber Composites.

In the last decade, natural fibers have had a significant impact on the research and development of innovative composites made with natural rubber, improving their properties over those of their counterparts that incorporate polluting synthetic fibers. In recent years, this fact has stimulated the research into several modified natural rubber composites reinforced with vegetable fibers. This paper reviews the scientific literature published in the last decade about the properties and characteristics of natural vegetable fibers and natural rubber used in composites. Nowadays the use of alternative materials has become necessary, considering that synthetic materials have caused irreversible damage to the environment, being associated with global warming, for this reason research and development with materials that print a lower carbon footprint during the manufacturing process and subsequent product manufacturing. This review is an invitation to the use of vegetable fibers, as well as vegetable-type matrices, in this case natural rubber as a binder system, it is fantastic to know the different works carried out by other scientists and engineers, in this way to project new compounds linked to innovation in processes that reduce the carbon footprint and its negative impact on our planet.

Advances in the development of tailor-made color alcoholic beverages based on an accelerated maturation process.

The study of the evolution of color of alcoholic beverages subjected to accelerate maturation process using heat-treated French oak wood fragments is presented. The results show that it is possible to obtain tonalities like aged beverages in 4 weeks. In this sense, the fragments conditioned at 150 °C (light toasted) proportionated colors like white wine, pale straw, and pale gold. On the other hand, the fragments that received a heat treatment at 200 °C (medium toasted) present yellow tones such as old gold, amber, and deep gold. Finally, the fragments treated at 250 °C (heavily toasted) are those with the most intense yellow tones, classified as sweet chestnut, sherry, russet, muscat, and tawny. The studies of kinetic maturation concluded that the mathematical model of parabolic diffusion could correctly describe the process. Based on this, it is concluded that the heat treatment increases the cavities of the most exposed surface of the wood, increasing the maximum humidity of the materials by 20 %; in such a way that during the first two weeks, there is a diffusion of the solution to the active sites. Wood bioactive compounds on the outer surface achieve a rapid extraction, such as flavonoids, which oxidize rapidly within the solution, generating an increase in yellow color. The previous results were corroborated in a real case analysis using Tequila which can be concluded that the proposed process can give the beverage similar colors to an aged, extra-aged, and ultra-aged class in less than 4 weeks.

Evaluación de cultivares de caña de azúcar (Saccharum spp.) para producción de panela en el departamento de Boyacá, Colombia / Evaluation of sugarcane cultivars (Saccharum spp.) for panela production in the department of Boyacá, Colombia

RESUMEN En Colombia, el departamento de Boyacá tiene uno de los mayores rendimientos de caña de azúcar (Saccharum spp.), para la producción de panela; sin embargo, los productores demandan constantemente la evaluación de material genético, que pueda aumentar los rendimientos por unidad de área y las características agroindustriales de los materiales tradicionales, de mayor dominio en la región. Con la finalidad de estimar los rendimientos de caña y de panela por hectárea, se evaluaron, a nivel experimental, los cultivares CC 01-1940, CC 99-2282, CC 05-940, CC 03-469, CC 06-791, en el municipio de Moniquirá, Boyacá. Posteriormente, se realizaron pruebas comerciales de molienda, con el mejor cultivar en Moniquirá y en San José de Pare, Boyacá, junto a los testigos de cada zona Caña Buena y RD 75-11, respectivamente. Experimentalmente, se destacó el cultivar CC 01-1940, con una producción de 183,3t/ha de caña (TCH), 24,2 toneladas de panela por hectárea (TPH), así como una conversión de 13,2% de panela (CP). En prueba comercial de molienda en San José de Pare, se encontró que CC 01-1940 alcanzó una producción de 221,9 TCH y 26,1 TPH, superando por más de 30 toneladas de caña y 5,2 toneladas de panela, al reporte alcanzado por RD 75-11. Para el municipio de Moniquirá, CC 01-1940 obtuvo 158,5 TCH, 18,5 TPH y 11,6% CP, superando al cultivar testigo Caña Buena.

ABSTRACT In Colombia, the department of Boyacá has one of the highest yields of sugar cane (Saccharum spp.) for panela production. However, producers constantly demand the evaluation of genetic material that could increase the yields per area and the agro-industrial characteristics of the traditional material of greater dominance in the region. In order to estimate cane and panela yields per hectare, cultivars CC 01-1940, CC 99-2282, CC 05-940, CC 03-469, CC 06-791 were evaluated experimentally in the municipality of Moniquirá, Boyacá. Subsequently, commercial milling tests were carried out with the best cultivar in Moniquirá and San José de Pare, Boyacá, together with the control materials from each zone, Caña Buena and RD 75-11, respectively. Experimentally, the cultivar CC 01-1940 stood out with a production of 183.3t/ha of sugarcane (TCH), 24.2 tons of panela per hectare (TPH), as well as a conversion of 13.2% of panela (CP). In a commercial milling test in San José de Pare, it was found that the cultivar CC 01-1940 had a production of 221.9 TCH and 26.1 TPH, surpassing by more than 30 tons of cane and 5.2 tons of panela, for what was reported by RD 75-11. For the municipality of Moniquirá, the cultivar CC 01-1940 obtained 158.5 TCH, 18.5 TPH and 11.6% CP, surpassing the cultivar Caña Buena.

A novel online fluorescence method for in-vivo measurement of hydrogen peroxide during oxidative stress produced in a temporal lobe epilepsy model.

Status epilepticus (SE) can result in an overproduction of hydrogen peroxide (H2O2), which contributes to oxidative stress and brain injury during different phases of epileptogenesis and seizures. In this study, we measured the extracellular H2O2 concentration in the rat hippocampus in a temporal lobe epilepsy model. A new fluorescent technique for measuring H2O2 in vivo simultaneously with electroencephalography recording was tested. The method consists of mixing microdialysate with an enzymatic reactor to produce a fluorescent compound. The fluorescence intensity was measured every second and was proportional to the H2O2 concentration. The results showed that H2O2 was released during SE; we detected a significant increase of up to five times over the baseline value that correlated with changes in electrical activity. We also observed that H2O2 was produced for days after SE and was associated with continuous neuronal death and seizure generation. Therefore, we monitored H2O2 48 h and 15 days after SE, observing increases of up to 96 and 124%, respectively, accompanied by changes in electrical activity with spontaneous discharges of large amplitude. These changes may reflect the oxidative stress generated during epileptogenesis that remains during the chronic period (458% increased) with the presence of large spikes, indicating that the H2O2 could also participate in the generation and maintenance of spontaneous recurrent seizures. There are no previous reports on the detection of H2O2 at this temporal resolution; thus, this study contributes a novel technique for studying and understanding epileptogenesis to develop new antioxidant strategies for the treatment of temporal lobe epilepsy.

Management of malignant insulinoma.

AIM: Malignant insulinoma is an infrequent functional endocrine tumor of the pancreas. Adequate therapy is a demanding challenge for oncologists and endocrinologists. OBJECTIVE: To evaluate the results of multidisciplinary management of malignant insulinoma. MATERIALS AND METHODS: Retrospective review of patients with malignant insulinoma treated from 1995 to 2011. RESULTS: Seven patients with malignant insulinoma were included: four males and three females; median age was 61.8 years (range 37-78). Six tumors were sporadic and one was diagnosed in a patient with a type 1 multiple endocrine neoplasia (MEN-1). Surgery was performed in six cases and one patient was considered unresectable. Hypoglycemias persisted in all cases and somatostatin analogs, glucocorticoids and diazoxide were used. Two patients received everolimus. Other techniques were chemoembolization and internal radiation therapy with yttrium-90. Successful liver transplant was done in the patient with MEN-1. CONCLUSION: Hypoglycemia management is complex and requires multiple therapies. Further evaluations will be necessary to determine the best treatment.

Immunoexpression of p53, Ki-67 and E-cadherin in basaloid squamous cell carcinoma of the larynx.

INTRODUCTION: Basaloid is a rare and poorly-differentiated variant of squamous cell carcinoma of the larynx, with an invasive solid growth of cells in a lobular configuration. Different molecular markers, such as p53, Ki-67 and E-cadherin, have been shown to be prognostic factors in head and neck cancer. OBJECTIVE: To evaluate the relationship between the immunoexpression of p53, Ki-67 and E-cadherin in relation to prognosis in basaloid squamous cell carcinoma of the larynx (BSCCL). PATIENTS AND METHODS: We retrospectively studied 11 cases of BSCCL, all male with a mean age of 62.4 years. Immunohistochemical analyses were performed on paraffin-embedded tissues using p53 (DO- 7), Ki-67 (MIB-1) and E-cadherin (36B5) antibodies. Quantitative assessments of the expression and descriptive statistical analyses were performed. RESULTS: In 72.7% of the cases, clinically advanced stages III-IV were diagnosed. Average survival time was 56.09 months, and 72.7% of patients died as a consequence of the tumour. Immunoreactivity of p53 (>10% of cells) was detected in the 81.8% of the cases. The 72.7% of the cases showed overexpression of Ki-67 (>50% of cells). The cases with low immunoexpression of Ki-67 and p53 had the best clinicopathological data. All cases showed a decreased expression of E-cadherin. CONCLUSIONS: BSCCL is an aggressive variant of the squamous cell carcinoma and has a high expression of p53 and Ki-67 with a low expression of Ecadherin. These results could be related to the aggressiveness of the disease and its poor prognosis.