EEG-Based Tool for Prediction of University Students' Cognitive Performance in the Classroom.

This study presents a neuroengineering-based machine learning tool developed to predict students' performance under different learning modalities. Neuroengineering tools are used to predict the learning performance obtained through two different modalities: text and video. Electroencephalographic signals were recorded in the two groups during learning tasks, and performance was evaluated with tests. The results show the video group obtained a better performance than the text group. A correlation analysis was implemented to find the most relevant features to predict students' performance, and to design the machine learning tool. This analysis showed a negative correlation between students' performance and the (theta/alpha) ratio, and delta power, which are indicative of mental fatigue and drowsiness, respectively. These results indicate that users in a non-fatigued and well-rested state performed better during learning tasks. The designed tool obtained 85% precision at predicting learning performance, as well as correctly identifying the video group as the most efficient modality.

Chemical characterization (LC-MS-ESI), cytotoxic activity and intracellular localization of PAMAM G4 in leukemia cells.

Generation 4 of polyamidoamine dendrimer (G4-PAMAM) has several biological effects due to its tridimensional globular structure, repetitive branched amides, tertiary amines, and amino-terminal subunit groups liked to a common core. G4-PAMAM is cytotoxic due to its positive charges. However, its cytotoxicity could increase in cancer cells due to the excessive intracellular negative charges in these cells. Furthermore, this work reports G4-PAMAM chemical structural characterization using UHPLC-QTOF-MS/MS (LC-MS) by electrospray ionization to measure its population according to its positive charges. Additionally, the antiproliferative effects and intracellular localization were explored in the HMC-1 and K-562 cell lines by confocal microscopy. The LC-MS results show that G4-PAMAM generated multivalent mass spectrum values, and its protonated terminal amino groups produced numerous positive charges, which allowed us to determine its exact mass despite having a high molecular weight. Additionally, G4-PAMAM showed antiproliferative activity in the HMC-1 tumor cell line after 24 h (IC50 = 16.97 µM), 48 h (IC50 = 7.02 µM) and 72 h (IC50 = 5.98 µM) and in the K-562 cell line after 24 h (IC50 = 15.14 µM), 48 h (IC50 = 14.18 µM) and 72 h (IC50 = 9.91 µM). Finally, our results showed that the G4-PAMAM dendrimers were located in the cytoplasm and nucleus in both tumor cell lines studied.

Andean drought and glacial retreat tied to Greenland warming during the last glacial period.

Abrupt warming events recorded in Greenland ice cores known as Dansgaard-Oeschger (DO) interstadials are linked to changes in tropical circulation during the last glacial cycle. Corresponding variations in South American summer monsoon (SASM) strength are documented, most commonly, in isotopic records from speleothems, but less is known about how these changes affected precipitation and Andean glacier mass balance. Here we present a sediment record spanning the last ~50 ka from Lake Junín (Peru) in the tropical Andes that has sufficient chronologic precision to document abrupt climatic events on a centennial-millennial time scale. DO events involved the near-complete disappearance of glaciers below 4700 masl in the eastern Andean cordillera and major reductions in the level of Peru's second largest lake. Our results reveal the magnitude of the hydroclimatic disruptions in the highest reaches of the Amazon Basin that were caused by a weakening of the SASM during abrupt arctic warming. Accentuated warming in the Arctic could lead to significant reductions in the precipitation-evaporation balance of the southern tropical Andes with deleterious effects on this densely populated region of South America.

Nueva técnica para cirugía conservadora de nefronas en tumores polares. Una modificación de la técnica de Kim / New technique for nephron-sparing surgery in polar tumours. A modification of the Kim technique

Introducción y objetivos: La cirugía conservadora de nefronas (CCN) es la indicación siempre que sea factible y cumpla con las guías de tratamiento internacional. Una de las premisas a seguir al realizar una CCN es disminuir el tiempo de isquemia al mínimo posible. Proponemos una técnica quirúrgica para el tratamiento de los tumores renales polares y mayores de 4 cm basados en el principio de la técnica descrita por Kim en 1964. Método: La técnica realiza una sutura continua circular sobre la base del tumor, logrando compresión del polo renal sin clampaje vascular, facilitando la hemostasia y evitando la transfixión a ciegas que realiza la técnica original de Kim. Seleccionamos 28 pacientes para la realización de la técnica y reportamos los resultados obtenidos. Resultados: Los pacientes presentaban una edad media de 56 años (30-69). El resultado de RENAL score: 12 de baja complejidad, 12 de moderada y 4 de alta complejidad. Tiempo quirúrgico medio: 109 minutos (75-140); la media de pérdida estimada de sangre fue 120 ml (50-300ml); no se identificó margen positivo y no hubo ningún caso con necesidad de transfusión sanguínea. El tiempo medio de ingreso fue de 3,7 días (2-6). No se presentaron complicaciones grado 2 o mayor de Clavien. Hubo 3 complicaciones Clavien 1 (fiebre). La diferencia de tasa de filtración glomerular fue de -0,71 ml/min/m2. La anatomía patológica fue maligna en 26 casos, 19 de ellos carcinomas de células claras. Dos casos se informaron como oncocitomas. Conclusión: La técnica propuesta mostró resultados aceptables, con baja tasa de complicaciones en el grupo de pacientes presentados

Introduction and objectives: Nephron-sparing surgery (NSS) is the indication, provided it is feasible and meets the international treatment guidelines. One of the objectives of performing NSS is to reduce the ischemia time as much as possible. We propose a surgical technique for treating polar renal tumours and those larger than 4 cm based on the principle of the technique described by Kim in 1964. Method: The technique performs a continuous circular suture on the base of the tumour, achieving compression of the renal pole without vascular clamping, facilitating haemostasis and avoiding the blind transfixion performed in Kim's original technique. We selected 28 patients for the implementation of the technique. Results: The patients’ mean age was 56 years (30-69). The R.E.N.A.L. scores were as follows: 12 of low complexity, 12 of moderate complexity and 4 of high complexity. The mean surgical time was 109 minutes (75-140), and the mean estimated blood loss was 120 mL (50-300mL). No positive margins were identified, and no patients required blood transfusions. The mean stay was 3.7 days (2-6). There were no Clavien grade 2 or higher complications. There were 3 Clavien 1 complications (fever). The difference in glomerular filtration rate was -0.71 mL/min/m2. The pathology was malignant in 26 cases, 19 of them clear-cell carcinomas. Two cases were reported as oncocytomas. Conclusion: The proposed technique showed acceptable results, with a low rate of complications in the patient group

New technique for nephron-sparing surgery in polar tumours. A modification of the Kim technique. / Nueva técnica para cirugía conservadora de nefronas en tumores polares. Una modificación de la técnica de Kim.

INTRODUCTION AND OBJECTIVES: Nephron-sparing surgery (NSS) is the indication, provided it is feasible and meets the international treatment guidelines. One of the objectives of performing NSS is to reduce the ischemia time as much as possible. We propose a surgical technique for treating polar renal tumours and those larger than 4cm based on the principle of the technique described by Kim in 1964. METHOD: The technique performs a continuous circular suture on the base of the tumour, achieving compression of the renal pole without vascular clamping, facilitating haemostasis and avoiding the blind transfixion performed in Kim's original technique. We selected 28 patients for the implementation of the technique. RESULTS: The patients' mean age was 56 years (30-69). The R.E.N.A.L. scores were as follows: 12 of low complexity, 12 of moderate complexity and 4 of high complexity. The mean surgical time was 109minutes (75-140), and the mean estimated blood loss was 120mL (50-300mL). No positive margins were identified, and no patients required blood transfusions. The mean stay was 3.7 days (2-6). There were no Clavien grade 2 or higher complications. There were 3 Clavien 1 complications (fever). The difference in glomerular filtration rate was -0.71mL/min/m2. The pathology was malignant in 26 cases, 19 of them clear-cell carcinomas. Two cases were reported as oncocytomas. CONCLUSION: The proposed technique showed acceptable results, with a low rate of complications in the patient group.

[Appropriateness of emergency hospital admissions]. / Adecuación de los ingresos hospitalarios urgentes.

INTRODUCTION: The aim of this work is to know the proportion of inadequate urgent admissions in a general hospital. MATERIAL AND METHODS: A retrospective and descriptive study of patients admitted during 1,999 was performed. The Appropriatness Evaluation Protocol (AEP) was used in order to evaluate the appropriatness of the admissions. RESULTS: Eighteen admissions (4.5%) were inadecuated. There was a higher proportion of inappropriate admission (IA) when the physician responsible of the admission was a medical specialist (internal medicine, hematology or nephrology): odds ratio 5.3 in opposite to emergency physicians (p < 0.03). CONCLUSIONS: There was a low proportion of inadequate admissions (4.5%) and the risk of inappropriatness of the admission was major when it was ordered by a medical specialist.

Adecuación de los ingresos hospitalarios urgentes / Appropriateness of the emergent hospitalary admissions

Objetivo: Estudio realizado para conocer el porcentaje de ingresos inapropiados urgentes de un hospital general. Material y métodos: Estudio descriptivo retrospectivo de los pacientes ingresados durante 1.999 mediante aplicación del Appropriateness Evaluation Protocol (AEP) para valorar la adecuación del ingreso. Resultados: Dieciocho pacientes (4,5 per cent) ingresaron de forma inapropiada. Hubo mayor riesgo de ingreso inadecuado por los especialistas médicos (internista de guardia, hematólogo o nefrólogo): odds ratio frente a ingreso por médico de Urgencias de 5,3 (p<0,03). Conclusiones: Destaca una bajo porcentaje de ingresos inadecuados (4,5 per cent). Existe mayor riesgo cuando el médico responsable del ingreso pertenece a una especialidad médica. (AU)

Supervivencia tras parada cardíaca extrahospitalaria en un hospital general / Survival after and extrahospitalary cardiac arrest in a general Hospital

Objetivo: La supervivencia tras una parada cardíaca extrahospitalaria (PC) es baja. Se estudian las principales características y la supervivencia de las PC reanimadas, así como si la implantación de un Servicio de Emergencias extrahospitalario (SME) ha modificado estos resultados. Métodos: Se presenta un estudio retrospectivo de todas las PC reanimadas durante los últimos siete años, en el Servicio de Urgencias de un hospital general de una pequeña Comunidad que, durante la mayor parte del estudio, no disponía de SME. La recogida de datos se realizó de la historia clínica y de una hoja de registro específica "estilo Utstein". Las variables analizadas fueron la edad, el sexo, el tiempo desde la PC hasta el inicio de la Resucitación Cardiopulmonar (RCP), la etiología estimada de PC (cardíaca o no), el ritmo electrocardiográfico (ECG) basal y la supervivencia tras la RCP. Resultados: Se realizaron maniobras de RCP en 487 pacientes. Un 41 por ciento recuperó el pulso y el 20 por ciento fue dado de alta del hospital con vida, la mayoría (14 por ciento) con buena recuperación cerebral. Los supervivientes presentaron fibrilación ventricular (FV) como ritmo ECG basal más frecuente de PC, y un menor intervalo de tiempo entre la PC y el inicio de las maniobras de RCP. Conclusiones: En nuestra serie la supervivencia tras PC extrahospitalaria concuerda con la bibliografía, siendo los factores relacionados con la misma el ritmo ECG basal de FV y el tiempo en iniciar la RCP. No se registraron diferencias estadísticamente significativas tras la implantación de un SME en la Comunidad (AU)

Síndrome de Stokes-Adams por bloqueo aurículoventricular(A-V) de segundo grado tipo II / Stokes-Adams syndrome induced by type II, 2nd-degree atrio-ventricular (A-V) block

Presentamos un caso de bloqueo A-V de 2º grado tipo II que desemboca en una asistolia de más de 20 segundos de duración, con recuperación espontánea de pulso y que fue registrado por un equipo de unidad móvil de emergencias del 061. La paciente fue tratada con un marcapasos definitivo y está asintomática. En las urgencias hospitalarias vemos síncopes a menudo. En la mayoría de los casos les tenemos que dar el alta sin llegar a conocer la etiología del cuadro (AU)

Prevalencia de las intoxicaciones agudas en Urgencias de La Rioja / Prevalence Acute Intoxications in Emergency Room in La Rioja

Objetivo: Conocer la prevalencia de las intoxicaciones agudas atendidas en los servicios de urgencias de los hospitales de La Rioja, sus principales características y las medidas de tratamiento más empleadas. Métodos: Estudio prospectivo de las intoxicaciones agudas atendidas, durante 1998, en los servicios de urgencias del Complejo Hospitalario San Millán-San Pedro de Logroño y del Centro de Especialidades de Calahorra, que constituyen la red de atención urgente especializada del Insalud en La Rioja. Se realizó un análisis descriptivo de las variables: filiación, distribución temporal, tóxico ingerido, intencionalidad, antecedentes de episodios previos, síntomas, pruebas diagnósticas, tratamiento instaurado y destino de los intoxicados. Resultados: 618 casos registrados (0,67 por ciento del total de urgencias atendidas). La edad media fue de 32,4 años (DE 18,8). Las intoxicaciones fueron más frecuentes en varones (58,4 por ciento), en septiembre, en fin de semana, y con dos picos horarios de afluencia (de 20 a 22 y de 1 a 3 horas). La tasa de prevalencia fue de 230,42 por cien mil habitantes. Se registraron 747 tóxicos distribuidos en 6 grupos, las más frecuentes drogas de abuso (49,3 por ciento). Los más utilizados fueron el alcohol (38,4 por ciento) y las benzodiacepinas (11,8 por ciento). La intencionalidad fue fundamentalmente accidental (71,4 por ciento), siendo la suicida más frecuente en mujeres, intoxicados por psicofármacos y en enfermos psiquiátricos. Los tratamientos más utilizados fueron: lavado gástrico (15,2 por ciento), fluidos endovenosos (13,6 por ciento) y carbón activado (12,8 por ciento). Ingresaron 116 pacientes (18,8 por ciento), remitiéndose 50 (8,1 por ciento) para valoración urgente por Psiquiatría. La estancia media de ingreso fue de 3 días. Sólo falleció 1 paciente (0,16 por ciento). Conclusiones: La prevalencia de intoxicaciones agudas en urgencias en La Rioja fue de 230,42 casos por cien mil habitantes (0,67 por ciento de urgencias atendidas), la mayoría accidentales y de predominio en varones jóvenes. El alcohol y las benzodiacepinas originaron la mitad de los casos. El estudio revela la escasa repercusión de las intoxicaciones en las Urgencias hospitalarias de La Rioja (AU)

[Inappropiate visits to emergency department of a general hospital].

The proportion of inadequate attendances at emergency department (ED) is 20-80%. The suitability of attendances at ED was evaluated using an Hospital Emergency Suitability Protocol, which was validated. 37.9% of attendances were inappropriate and they are more frequent in children. Patients who were referred by a doctor, with trauma or surgical consulted more adequately. The suitability of attendances at ED are related with illness.

Attendance of patients with minor head injury in an emergency department observation ward.

A retrospective study was undertaken to compare the management of head injured patients in a short stay ward (SSW) with their management in other departments in the same hospital, where there is no neurosurgery department. Head injured patients were admitted to the general surgery department until November 1998, when the SSW was inaugurated. The following data were collected for all head injured patients admitted between 1997 and 1999: age, gender, diagnosis, outcome categories and length of stay. A total of 225, 238 and 340 head injured patients were admitted in 1997, 1998 and 1999 respectively. Patients in the neurology department were older (60 +/- 23 years) than in the SSW (41 +/- 23 years) and general surgery department (42 +/- 20 years). Patient diagnosis was similar in the SSW, paediatrics and general surgery departments but patients admitted to the neurology department had more skull fractures and intracranial injuries. The length of stay was longer in general surgery (3.5 +/- 3.9 days) and neurology departments (9.6 +/- 19.1 days) than in the SSW (1.4 +/- 0.8 days) and paediatrics department (1.5 +/- 1.5 days). Thirteen patients in the SSW required admission to another department in the hospital and only one was transferred to the neurosurgery department in another hospital. The results support the view that SSWs are suitable in the management of head injured patients.