ScipionTomo: Towards cryo-electron tomography software integration, reproducibility, and validation.

Image processing in cryogenic electron tomography (cryoET) is currently at a similar state as Single Particle Analysis (SPA) in cryogenic electron microscopy (cryoEM) was a few years ago. Its data processing workflows are far from being well defined and the user experience is still not smooth. Moreover, file formats of different software packages and their associated metadata are not standardized, mainly since different packages are developed by different groups, focusing on different steps of the data processing pipeline. The Scipion framework, originally developed for SPA (de la Rosa-Trevín et al., 2016), has a generic python workflow engine that gives it the versatility to be extended to other fields, as demonstrated for model building (Martínez et al., 2020). In this article, we provide an extension of Scipion based on a set of tomography plugins (referred to as ScipionTomo hereafter), with a similar purpose: to allow users to be focused on the data processing and analysis instead of having to deal with multiple software installation issues and the inconvenience of switching from one to another, converting metadata files, managing possible incompatibilities, scripting (writing a simple program in a language that the computer must convert to machine language each time the program is run), etcetera. Additionally, having all the software available in an integrated platform allows comparing the results of different algorithms trying to solve the same problem. In this way, the commonalities and differences between estimated parameters shed light on which results can be more trusted than others. ScipionTomo is developed by a collaborative multidisciplinary team composed of Scipion team engineers, structural biologists, and in some cases, the developers whose software packages have been integrated. It is open to anyone in the field willing to contribute to this project. The result is a framework extension that combines the acquired knowledge of Scipion developers in close collaboration with third-party developers, and the on-demand design of functionalities requested by beta testers applying this solution to actual biological problems.

Escalas para predicción de resultados tras traumatismo grave / Scales for predicting outcome after severe trauma

En este artículo se ha hecho una revisión sobre el desarrollo de las escalas más utilizadas en los pacientes con traumatismo grave desde hace 40 años. Es sabido que, las escalas anatómicas son eficaces, tanto para medir la severidad de las lesiones, como para predecir resultados. Las escalas fisiológicas miden el componente dinámico tras el trauma, con gran influencia en el pronóstico de los traumatizados. Los índices metabólicos, tanto lactato como el déficit de base, son reflejo de un estado de hipoperfusión tisular, y por tanto de shock. Las escalas combinadas sirven para la predicción y comparación evaluativa de los resultados. La incorporación de factores que influyen en el pronóstico de los traumatizados ha conllevado al desarrollo de nuevas escalas. Sin embargo, carecen de estudios de validación externa para su uso generalizado. Hasta que estos estudios se lleven a cabo, estas escalas deben usarse con precaución (AU)

In this article we review the development of the most-used scales for severe trauma patients over the past 40 years. It is well known that anatomical scales are effective for measuring the severity of injuries and for predicting results. Physiological scales measure the dynamic component after trauma, with a great influence on the prognosis of injured patients. Metabolic scales, both lactate and base deficit, are reflections of tissue hypoperfusion states and therefore shock. The combined scales are used for prediction and comparative assessment of results. The inclusion of factors that influence the prognosis of trauma patients has led to the development of new scales. However, they lack external validation studies for their widespread use. Until these validation studies are conducted caution should be taken with the use of existing scales (AU)

[Scales for predicting outcome after severe trauma]. / Escalas para predicción de resultados tras traumatismo grave.

In this article we review the development of the most-used scales for severe trauma patients over the past 40 years. It is well known that anatomical scales are effective for measuring the severity of injuries and for predicting results. Physiological scales measure the dynamic component after trauma, with a great influence on the prognosis of injured patients. Metabolic scales, both lactate and base deficit, are reflections of tissue hypoperfusion states and therefore shock. The combined scales are used for prediction and comparative assessment of results. The inclusion of factors that influence the prognosis of trauma patients has led to the development of new scales. However, they lack external validation studies for their widespread use. Until these validation studies are conducted caution should be taken with the use of existing scales.

[Influence of prehospital response times in the survival of trauma patients in Navarre]. / Influencia de los tiempos de respuesta prehospitalarios en la supervivencia de los pacientes politraumatizados en Navarra.

The relation between response times and mortality of polytrauma patients in the so-called "golden hour" continues to be a subject of debate. The purpose of this study is to determine the variables related to mortality in these patients and the influence of response times of the Emergency Medical Services in this mortality. To this end, the data in the "Major Trauma of Navarre" Register (retrospective cohort of polytrauma patients attended to by the Navarre Health Service) were analyzed for the four year period between 2010 and 2013. Of the 217 trauma cases available for the analysis, 42 (19%) died. No significant association was found in the multi-variate analysis between the different response times and mortality: arrival at the scene (odds ratio (OR) 1.0; 95% confidence interval (CI) from 0.99 to 1.01), in the scenario (OR 1.00; 95% CI from 0.98 to 1.02) and total time (OR 1.00; 95% CI from 0.99 to 1.01). The variables that influenced mortality are patient age and severity of injuries measured by the prehospital Triage-Revised Trauma Score (T-RTS) and the New Injury Severity Score (NISS). The mortality of polytrauma patients attended to by the emergency system in our region is influenced by age and by the intensity of the aggression suffered, determined by the prehospital T-RTS and by the NISS. The response times of the hospital do not have a significant influence.

Influencia de los tiempos de respuesta prehospitalarios en la supervivencia de los pacientes politraumatizados en Navarra / Influence of prehospital response times in the survival of trauma patients in Navarre

La relación entre los tiempos de respuesta y la mortalidad de los pacientes politraumatizados en la denominada "hora de oro" sigue siendo tema de debate. El objetivo del presente estudio es determinar las variables relacionadas con la mortalidad en dichos pacientes y la influencia de los tiempos de respuesta de los Servicios Médicos de Emergencia en dicha mortalidad. Para ello se analizaron los datos del Registro "Major Trauma de Navarra" (cohorte retrospectiva de pacientes politraumatizados atendidos por el sistema sanitario de Navarra) durante los cuatro años comprendidos entre 2010 y 2013. De los 217 casos de trauma disponibles para el análisis, fallecieron 42 (19%). En el análisis multivariante no se encontró asociación significativa entre los diferentes tiempos de respuesta y la mortalidad: llegada a la escena (odds ratio (OR) 1,0; intervalo de confianza al 95% (IC) de 0,99 a 1,01), en el escenario (OR 1,00; IC 95% de 0,98 a 1,02) y tiempo total (OR 1,00; IC 95% de 0,99 a 1,01). Las variables que influyen en la mortalidad son la edad del paciente y la gravedad de las lesiones medidas por el Triage-Revised Trauma Score (T-RTS) prehospitalario y el New Injury Severity Score (NISS). La mortalidad de los pacientes politraumatizados atendidos por el sistema de emergencias en nuestra región está influida por la edad, y por la intensidad de la agresión sufrida determinada por el T-RTS prehospitalario y por el NISS. Los tiempos de respuesta prehospitalarios no influyen significativamente (AU)

The relation between response times and mortality of polytrauma patients in the so-called "golden hour" continues to be a subject of debate. The purpose of this study is to determine the variables related to mortality in these patients and the influence of response times of the Emergency Medical Services in this mortality. To this end, the data in the "Major Trauma of Navarre" Register (retrospective cohort of polytrauma patients attended to by the Navarre Health Service) were analyzed for the four year period between 2010 and 2013. Of the 217 trauma cases available for the analysis, 42 (19%) died. No significant association was found in the multivariate analysis between the different response times and mortality: arrival at the scene (odds ratio (OR) 1.0; 95% confidence interval (CI) from 0.99 to 1.01), in the scenario (OR 1.00; 95% CI from 0.98 to 1.02) and total time (OR 1.00; 95% CI from 0.99 to 1.01). The variables that influenced mortality are patient age and severity of injuries measured by the prehospital Triage-Revised Trauma Score (T-RTS) and the New Injury Severity Score (NISS). The mortality of polytrauma patients attended to by the emergency system in our region is influenced by age and by the intensity of the aggression suffered, determined by the prehospital T-RTS and by the NISS. The response times of the hospital do not have a significant influence (AU)

Arritmias y embarazo / Arrhythmias in pregnancy

Las modificaciones hemodinámicas y hormonales ligadas al embarazo, así como la presencia de una cardiopatía estructural subyacente son factores que pueden precipitar la aparición de arritmias. Generalmente son de fácil manejo y su presencia en gestantes no suele comportar consecuencias graves para el feto o para la madre. En otras ocasiones, sin embargo pueden acarrear un riesgo vital para ambos. Reconocer el tipo de arritmia y su repercusión hemodinámica es importante para plantear la estrategia terapéutica. Es fundamental conocer el perfil de seguridad de los antiarrítmicos disponibles y utilizarlos a las dosis adecuadas. El soporte vital avanzado implica una serie de peculiaridades que conviene recordar a la hora de someter a la embarazada a maniobras de resucitación. El objetivo de esta revisión es poner al día el conocimiento de esta patología con el fin de proporcionar los cuidados adecuados para la madre y el feto (AU)

The hemodynamic and hormonal changes of pregnancy and the presence of underlying structural heart disease are factors that can lead to arrhythmias. In general, such arrhythmias can be easily managed and have no serious consequences for mother or fetus. Occasionally, however, they can be life-threatening for both. It is important to be able to identify the type of arrhythmia present and understand its hemodynamic effects in order to plan a management approach. Knowledge of the safety profile of available antiarrhythmia agents and their appropriate dosages will also be required. A series of special circumstances must be taken into consideration when undertaking resuscitation maneuvers for advanced life support in pregnancy. Our aim is to review current knowledge that is necessary for providing adequate care for mother and fetus when arrhythmias develop (AU)

Implantado en Navarra el primer registro de politraumatizados de base poblacional en España / Implementation of the first Spanish population-based register for multiple-injury cases in Navarre

Se describen las características técnicas del primer registro de politraumatizados de base poblacional desarrollado en España (actualmente en fase de producción) así como la arquitectura informática, características técnicas, variables, estrategia de detección de casos, introducción y mantenimiento de los mismos y control de calidad de la base de datos. Entre el 1 de enero de 2010 y 31 de diciembre de 2011 se han recogido 243 casos. El sistema gestionado por un administrador ha soportado la entrada de 97 usuarios correspondientes a 7 servicios diferentes. El nivel de cumplimentación de las 63 variables fue del 90%. La mortalidad observada fue del 27%. Los tiempos de respuesta (llamada–entrada en el hospital, entrada en el hospital– realización de la primera tomografía computarizada, o primera intervención clave) son similares a los observados en otros registros europeos. En este momento tenemos operativo en Navarra el primer registro de politraumatizados español basado en el estilo Utstein. Su arquitectura informática nos permite introducir información de forma prospectiva y retrospectiva desde diferentes servicios con la participación de todos los escalones que atienden al paciente politraumatizado. Dicho registro nos ha permitido conocer las características de los politraumatizados, la calidad de la atención sanitaria, compararnos con otros sistemas y disponer de una base para que profesionales del Servicio Navarro de Salud dispongan de datos para sus investigaciones (AU)

To describe the technical features of the first population-based register for multiple-injury cases to be developed in Spain. Description of the system architecture and technical features of this population-based register, including the variables in the database, the case-finding strategy used, data inputting and maintenance, and quality control. Between January 1,2010 and December 31, 2011, we found 243 cases. The system was supervised by a database administrator and allowed97 users in 7 different departments to enter data. The level of reporting of 63 variables was 90%. Mortality was 27%.Response times (emergency call to hospital arrival and hospital arrival to first computed tomography scan or first key intervention) were similar to those recorded in other European registers. The first Utstein-style register for multipleinjuries in Spain is now being used in Navarre. The system architecture allows us to collect information prospectively and retrospectively from all who treat multiple-injury patients no matter their position on the staff of various hospital departments. This register has helped us determine the characteristics of multiple-injury patients and the quality of care they receive. We have been able to compare our setting with others’ and have provided a source of data for researchers in the Navarre health service (AU)

Respuesta de los autores: Suicidios violentos y fuentes forenses / No disponible

No disponible

Politraumatizados con intencionalidad suicida. Estudio epidemiológico de base poblacional en Navarra durante los años 2004-2005 / Severe multiple injuries after suicide attempts: population-based epidemiologic study in Navarre, Spain, between 2004 and 2005

Se estudia las características epidemiológicas de los politraumatizados atendidos por el Sistema de Emergencias de Navarra los años 2004 y 2005 cuya motivación fue el suicidio. Para ello, se incluyó pacientes con una o varias lesiones traumáticas graves, producidas por energía mecánica, que pueden comprometer su vida o provocar graves secuelas, y cuya intencionalidad fue el suicidio. Se incluyeron pacientes que en el momento de su atención presentaron un New Injury Severity Score (NISS) superior a 15 o fallecieron. La tasa de incidencia anual por 100.000 habitantes fue de 5,7. La relación hombres: mujeres fue de 3:1. El mecanismo más frecuentemente utilizado es la precipitación de altura, en segundo lugar el atropello por ferrocarril y las lesiones por arma de fuego en tercer lugar. Falleció el 80% de los pacientes, con una edad media de 50 años. La mujer utiliza preferentemente la precipitación de altura y el hombre también otros métodos. El NISS medio fue de 37 puntos. Se concluye que el suicidio por métodos violentos presenta bajas tasas de incidencia en Navarra. Es un método con una alta mortalidad por la gravedad de las lesiones es utilizado fundamentalmente por varones. Las mujeres utilizan preferentemente la precipitación de altura mientras que los hombres utilizan también otros métodos (AU)

We to study the epidemiologic characteristics of patients with multiple injuries after attempted suicide who were treated by the emergency health system of Navarre between 2004 and 2005. The patients that had 1 or more severe injuries from mechanical force after a suicide attempt were included. The injuries were life-threatening or could be the cause of severe complications or sequelae. An inclusion criterion was a New Injury Severity Score (NISS) of more than 15, or death. The annual incidence of such injuries was 5.7 per 100 000 population. The ratio of men to women was 3:1. In order of frequency, the most common methods were jumping from a high place, jumping in front of an oncoming train, and gunshot. Eighty percent of the patients died. The mean age was 50 years. Jumping from heights was chosen most often by both men and women, but men also chose the other methods (train and gunshot) more often than women. The mean NISS was 37 points. We conclude that the incidence of violent suicide is low in Navarre. Mortality is high because of the severity of injuries caused by the methods chosen mainly by men. Women mainly choose jumping from heights whereas men use additional methods (AU)

Prenylflavonoids and prenyl/alkyl-phloroacetophenones: synthesis and antitumour biological evaluation.

Several prenylflavonoids have been synthesised and tested against human tumour cell lines. The prenyl unit has been geranyl or a labdane diterpene. These labdane-flavonoids have been synthesised for the first time. The antitumour activity increase with the prenylation at C-8 position. Twenty-three C and O-prenylated acylphloroglucinols have been synthesised as well. In this case the C-alkylation products have resulted, in general, more active.