Reflexiones a la técnica de instrumentación rotatoria y aplicación clínica del HERO 642

El auge de las técnicas mecánicas, mediante rotación continua, en la preparación del sistema de conductos radiculares obliga a realizar una serie de reflexiones respecto a las ventajas e inconvenientes de las mismas según los diferentes objetivos que se persiguen en esta fase de la terapéutica. Se describe el sistema de instrumentación HERO 642 comparado con otras marcas y se expone la técnica propugnada por los diseñadores, Vulcain JM y Calas P, junto con las modificaciones propuestas por los autores del artículo. Finalmente, se establecen unas premisas fundamentales para el correcto empleo de la instrumentación rotatoria como técnica habitual en el tratamiento de conductos radiculares, en comparación con otros sistemas.

ESTRO-HERO survey: Guidelines for equipment and staffing of radiotherapy facilities in the European countries: Final results of the ESTRO-HERO survey

Background and purpose: In planning to meet evidence based needs for radiotherapy, guidelines for the provision of capital and human resources are central if access, quality and safety are not to be compromised. A component of the ESTRO-HERO (Health Economics in Radiation Oncology) project is to document the current availability and content of guidelines for radiotherapy in Europe. Materials and methods: An 84 part questionnaire was distributed to the European countries through their national scientific and professional radiotherapy societies with 30 items relating to the availability of guidelines for equipment and staffing and selected operational issues. Twenty-nine countries provided full or partial evaluable responses. Results: The availability of guidelines across Europe is far from uniform. The metrics used for capital and human resources are variable. There seem to have been no major changes in the availability or specifics of guidelines over the ten-year period since the QUARTS study with the exception of the recent expansion of RTT staffing models. Where comparison is possible it appears that staffing for radiation oncologists, medical physicists and particularly RTTs tend to exceed guidelines suggesting developments in clinical radiotherapy are moving faster than guideline updating. Conclusion: The efficient provision of safe, high quality radiotherapy services would benefit from the availability of well-structured guidelines for capital and human resources, based on agreed upon metrics, which could be linked to detailed estimates of need

ESTRO-HERO survey: Radiotherapy equipment and departments in the European countries: Final results from the ESTRO-HERO survey

Background: Documenting the distribution of radiotherapy departments and the availability of radiotherapy equipment in the European countries is an important part of HERO the ESTRO Health Economics in Radiation Oncology project. HERO has the overall aim to develop a knowledge base of the provision of radiotherapy in Europe and build a model for health economic evaluation of radiation treatments at the European level. The aim of the current report is to describe the distribution of radiotherapy equipment in European countries. Methods: An 84-item questionnaire was sent out to European countries, principally through their national societies. The current report includes a detailed analysis of radiotherapy departments and equipment (questionnaire items 2629), analyzed in relation to the annual number of treatment courses and the socio-economic status of the countries. The analysis is based on validated responses from 28 of the 40 European countries defined by the European Cancer Observatory (ECO). Results: A large variation between countries was found for most parameters studied. There were 2192 linear accelerators, 96 dedicated stereotactic machines, and 77 cobalt machines reported in the 27 countries where this information was available. A total of 12 countries had at least one cobalt machine in use. There was a median of 0.5 simulator per MV unit (range 0.31.5) and 1.4 (range 0.44.4) simulators per department. Of the 874 simulators, a total of 654 (75%) were capable of 3D imaging (CT-scanner or CBCToption). The number of MV machines (cobalt, linear accelerators, and dedicated stereotactic machines) per million inhabitants ranged from 1.4 to 9.5 (median 5.3) and the average number of MV machines per department from 0.9 to 8.2 (median 2.6). The average number of treatment courses per year per MV machine varied from 262 to 1061 (median 419). While 69% of MV units were capable of IMRT only 49% were equipped for image guidance (IGRT). There was a clear relation between socio-economic status, as measured by GNI per capita, and availability of radiotherapy equipment in the countries. In many low income countries in Southern and Central-Eastern Europe there was very limited access to radiotherapy and especially to equipment for IMRT or IGRT. Conclusions: The European average number of MV machines per million inhabitants and per department is now better in line with QUARTS recommendations from 2005, but the survey also showed a significant heterogeneity in the access to modern radiotherapy equipment in Europe. High income countries especially in Northern-Western Europe are well-served with radiotherapy resources, other countries are facing important shortages of both equipment in general and especially machines capable of delivering high precision conformal treatments (IMRT, IGRT)

ESTRO-HERO survey: Radiotherapy staffing in the European countries: Final results from the ESTRO-HERO survey

Background: The ESTRO Health Economics in Radiation Oncology (HERO) project has the overall aim to develop a knowledge base of the provision of radiotherapy in Europe and build a model for health economic evaluation of radiation treatments at the European level. The first milestone was to assess the availability of radiotherapy resources within Europe. This paper presents the personnel data collected in the ESTRO HERO database. Materials and methods: An 84-item questionnaire was sent out to European countries, through their national scientific and professional radiotherapy societies. The current report includes a detailed analysis of radiotherapy staffing (questionnaire items 4760), analysed in relation to the annual number of treatment courses and the socio-economic status of the countries. The analysis was conducted between February and July 2014, and is based on validated responses from 24 of the 40 European countries defined by the European Cancer Observatory (ECO). Results: A large variation between countries was found for most parameters studied. Averages and ranges for personnel numbers per million inhabitants are 12.8 (2.530.9) for radiation oncologists, 7.6 (019.7) for medical physicists, 3.5 (012.6) for dosimetrists, 26.6 (1.978) for RTTs and 14.8 (0.461.0) for radiotherapy nurses. The combined average for physicists and dosimetrists is 9.8 per million inhabitants and 36.9 for RTT and nurses. Radiation oncologists on average treat 208.9 courses per year (range: 99.9348.8), physicists and dosimetrists conjointly treat 303.3 courses (range: 85757.7) and RTT and nurses 76.8 (range: 25.7156.8). In countries with higher GNI per capita, all personnel categories treat fewer courses per annum than in less affluent countries. This relationship is most evident for RTTs and nurses. Different clusters of countries can be distinguished on the basis of available personnel resources and socio-economic status. Conclusions: The average personnel figures in Europe are now consistent with, or even more favourable than the QUARTS recommendations, probably reflecting a combination of better availability as such, in parallel with the current use of more complex treatments than a decade ago. A considerable variation in available personnel and delivered courses per year however persists among the highest and lowest staffing levels. This not only reflects the variation in cancer incidence and socio-economic determinants, but also the stage in technology adoption along with treatment complexity and the different professional roles and responsibilities within each country. Our data underpin the need for accurate prediction models and long-term education and training programmes

L' univers femení del Jaufré : les dames, motor de l'acció cavalleresca

Els models literaris analitzats se centren quasi exclusivament en les obres de Chrétien de Troyes i en els lais de Maria de França. S'ha pretés en tot moment fer una lectura de la novel·la en clau femenina per tal de demostrar que la figura central de l'heroi actua i evoluciona generalment gràcies a o a causa de la voluntat, les decisions o les accions de les dones que troba en la seua aventura. No hi pot haver cavalleria sense amor; tot cavaller ha de lluitar per la seua dama tant al camp de batalla com a la cort.

El héroe lleva tacones: sobre la aventura mítica en La mujer habitada de Gioconda Belli

En el presente trabajo se analiza la primera novela de Gioconda Belli La mujer habitada desde la perspectiva de la aventura mítica del héroe analizada en el libro The hero with a thousand faces de Joseph Campbell. Se estudia la trayectoria arriesgada de la protagonista, una joven hero��na contemporánea que, sin embargo, no se diferencia mucho de las andanzas peligrosas de héroes míticos. El trabajo consta de tres capítulos dedicados al estudio de la protagonista y su semejanza con la figura del héro mítico, de su aventura, y de las funciones de algunos personajes secundarios dentro de esta, respectivamente

La cuestión de la mímesis (de Platón a la Odisea)

Proyecto de investigación realizado en la Freie Universität Berlin, Alemania, entre 2010 y 2012 desarrollando el proyecto titulado "El problema ontológico de la mímesis", el cual continuaba y desarrollaba planteamientos esbozados en mi tesis doctoral ("Problemas hermenéuticos en la lectura de la Ilíada"). Se pretendía examinar la noción de «mímesis» que se critica en el libro décimo de "La república". Se observó que 1. la actividad de Homero y los «poetas» era analizada en términos de pretensión de «saber»; 2. la noción de «saber» que operaba en la base del análisis filosófico era la de «saber habérselas con» (quien sabe de riendas es el jinete, etc.); 3. la problematicidad de la actividad de los «poetas» radicaba en que su pericia no tenía ámbito de referencia delimitado alguno; en este sentido, el poeta era un imitador, o sea, se le disputaba la posesión de auténtico saber. Partiendo del análisis platónico la investigación pasó a centrarse en ciertos aspectos cruciales para una interpretación de la Odisea. Nos interesaba especialmente observar que Ulises era un héroe esencialmente atípico en cuanto que era extraordinariamente «sabio» (astuto, capaz, perspicaz), lo cual daba cuenta tanto de la anticotidianidad del aprendizaje realizado (las llamadas «aventuras») como de su condición de héroe-poeta, o sea, de experto «decir». El reverso de esta especialísima capacidad era nada más y nada menos que su dudosa y problemática aptitud para actuar y decir como si fuera otro, es decir, su capacidad para lo que en Platón se llama «mímesis».

Reactable Role Gaming (RRG): disseny, implementació i avaluació d'un entorn pel desenvolupament de jocs de rol per a taules interactives

En aquest projecte s’ha implentat un framework per crear jocs de rol per ainterfícies tangibles. S’ha intentat arribar a un nivell d’abstracció prou elevat com perquè l'usuari del framework no necessiti tenir coneixements de programació gaire avançats per utilitzar-lo.El projecte va néixer de la idea d’utilitzar miniatures dels jocs de rol convencionalssobre una interfície tangible, intentant fusionar realitat amb ficció. Agafant com a influència principal un joc de taula ja existent, el Hero Quest™. D’aquesta manera s’ha pogut fer un anàlisi complert del joc i intentar solucionar possibles defectes que les interfícies tangibles ens ajudessin a solucionar.Gracies al equip reacTable, que forma part del Grup de Tecnologia Musical de laUniversitat Pompeu Fabra, qui va desenvolupar una interfície tabletop d’aquestes característiques com a instrument musical, s’ha pogut realitzar aquest experiment i barrejar els jocs de rol sobre taula amb els videojocs.

La caverna de Josep Palau i Fabre (1952-1969): teatre versus al·legoria filosòfica per a representar i impedir el final tràgic i fosc del lluminós art de pensar.

What is the use of performing the myth of the cave from book VII of the Republic by Plato? Josep Palau i Fabre, considers that, in Plato's dialogues, the speakers are mere instruments at the service of his dialectical goal. The aim of this article is to show how, by turning the myth into a tragedy and also by relying on Heraclitus's conflict or war of opposites, the playwright succeeds in favoring a sort of thought which is not one-sided or univocal. On the contrary, in Palau i Fabre's La Caverna, the tragic hero, that is, the released prisoner transformed by the light of Reality and finally killed by his "cavemates" -after having been imprisoned again and having tried to rescue them from their ignorance or shadows-, still leaves to them his powerful experience of the agonistikos thought, which might bear fruit in their life to come.

La caverna de Josep Palau i Fabre (1952-1969): teatro versus alegoría filosófica para representar e impedir el final trágico y sombrío del luminoso arte de pensar.

What is the use of performing the myth of the cave from book VII of the Republic by Plato? Josep Palau i Fabre, considers that, in Plato's dialogues, the speakers are mere instruments at the service of his dialectical goal. The aim of this article is to show how, by turning the myth into a tragedy and also by relying on Heraclitus's conflict or war of opposites, the playwright succeeds in favoring a sort of thought which is not one-sided or univocal. On the contrary, in Palau i Fabre's La Caverna, the tragic hero, that is, the released prisoner transformed by the light of Reality and finally killed by his "cavemates" -after having been imprisoned again and having tried to rescue them from their ignorance or shadows-, still leaves to them his powerful experience of the agonistikos thought, which might bear fruit in their life to come.

A favor dels clàssics d'aventures de la literatura juvenil

No entengueu aquest article com un clam nostalgic als herois i hero'ines de tots els temps. No el vegeu tampoc com una manca de reconeixement al gran esforç realitzat per escriptors i escriptores, món educatiu i editorial per ampliar l'oferta de literatura infantil i juvenil i posar a l'abast deis adolescents un ventall de títols i col-leccions que els motivin per a la lectura. Aquestes pagines ni tan sois pretenen entrar en la polemica sobre la funció literaria i pedagógica del corrent anomenat "realisme crític", amb reflexió psicológica, on s'hi tracten temes que permeten als adolescents identificar-se, de manera explícita, amb els infortunis que succeeixen als joves protagonistes. Adhuc, en aquest escrit es vol deixar al marge la qüestió deis límits entre literatura per a nens i joves i literatura per a adults.

The cave (La caverna -1952-1969) by Josep Palau i Fabre: theatre versus philosophical allegory in order both to perform and stop the tragic and dark end of the bright art of thinking

What is the use of representing in performance the image of the cave from book VII of Plato’s Republic? Josep Palau i Fabre considers that in Plato’s dialogues the speakers are mere instruments at the service of his dialectical purpose. The aim of this article is to show how, by turning the myth into a tragedy and relying on Heraclitus’s conflict or war of opposites, the playwright succeeds in favouring a sort of thought which is not one-sided or univocal. On the contrary, in Palau i Fabre’s La Caverna, the tragic hero, the released prisoner transformed by the light of Reality and finally killed by his “cavemates” –after having been imprisoned again and having tried to rescue them from their ignorance or shadows– still leaves them his powerful experience of the agonistikós thought, which might bear fruit in their life to come.

Patriarchal Hauntings: Re-reading Villainy and Gender in Daphne du Maurier's Rebecca

Criticism of Daphne du Maurier’s popular classic Rebecca (1938) can be divided into two mainstream interpretations. On the one hand, it was traditionally marketed as a gothic romance where the hero and the heroine conquered the evil women that separated them. On the other, certain feminist critics have recently provided a very diff erent view of the story, aligning it with gothic narratives that deal with the dangers women suff er under the patriarchal control of their husbands. Th is would imply that du Maurier’s novel should not be read as a traditional romance that promotes patriarchy, as the former interpretation suggested. In this article, I propose, through a Gothic Studies and a Gender Studies reading, that villainy in this novel is not exclusively linked to gender and, therefore, the victim and abuser statuses cannot be equated to femininity and masculinity, respectively. Instead, I argue that villainy in the novel is inextricably connected to being in a powerful position within patriarchy, and that it is the desire to maintain this position and perpetuate the patriarchal system that leads the main characters (men and women) to commit acts of villainy.

Cardiac motion estimation by joint alignment of tagged MRI sequences

Image registration has been proposed as an automatic method for recovering cardiac displacement fields from Tagged Magnetic Resonance Imaging (tMRI) sequences. Initially performed as a set of pairwise registrations, these techniques have evolved to the use of 3D+t deformation models, requiring metrics of joint image alignment (JA). However, only linear combinations of cost functions defined with respect to the first frame have been used. In this paper, we have applied k-Nearest Neighbors Graphs (kNNG) estimators of the -entropy (H ) to measure the joint similarity between frames, and to combine the information provided by different cardiac views in an unified metric. Experiments performed on six subjects showed a significantly higher accuracy (p < 0.05) with respect to a standard pairwise alignment (PA) approach in terms of mean positional error and variance with respect to manually placed landmarks. The developed method was used to study strains in patients with myocardial infarction, showing a consistency between strain, infarction location, and coronary occlusion. This paper also presentsan interesting clinical application of graph-based metric estimators, showing their value for solving practical problems found in medical imaging.

Bach després de Bach : ressonàncies bachianes en obres posteriors de Mozart, Schumann, Brahms, Britten i Villa-Lobos

L’objectiu d’aquest projecte és estudiar la recepció de l’obra de Bach des de la seva vida fins l’actualitat. Es pretén, d’una banda, esbrinar quins són els motius que van produir que cada època històrica jutjés l’obra de Bach de diferent manera, quins van ser els mitjans de conservació de la seva obra així com quins canvis va patir la seva obra per tal d’encaixar amb cada època. D’altra banda pretén exemplificar aquesta diferència en la posició que cada època va atorgar a l’obra de Bach mitjançant obres de compositors posteriors (Mozart, Schumann, Brahms, Britten i Villa-Lobos) que, cadascuna de manera diferent, contenen alguna reminiscència de Bach. La metodologia utilitzada ha consistit en la seva major part en la recerca bibliogràfica però també en la comparació de versions d’obres musicals en partitures i gravacions. La conclusió principal que es pot extreure d’aquest treball és que cadascú és producte de la seva època amb el seu context particular i per tant, qualsevol interpretació que pugui fer d’una obra musical amb el seu estil compositiu ve fortament determinat per la ideologia del context que l’envolta. És normal, doncs, que el segle XVIII la decadència del pensament religiós comportés un rebuig per l’obra de Bach la qual és majoritàriament de caràcter religiós, mentre que el segle XIX amb l’emergència de la burgesia i els seus valors romàntics s’elevés la figura de Bach com l’heroi del poble alemany.