http://dugi-doc.udg.edu:443 El sistema de repositori digital DSpace captura, emmagatzema, indexa, conserva i distribueix material de recerca digital. Sun, 18 May 2025 09:02:12 GMT 2025-05-18T09:02:12Z http://hdl.handle.net/10256/26782 Germline mutations in advanced high-grade serous ovarian cancer: are they predictive of long-term survival? Juanhuix Guix, Cristina Background: High-grade serous ovarian cancers (HGSOC) are heterogeneous and aggressive malignancies, often diagnosed in advanced stages (FIGO III-IV) and associated with poor survival (OS, 39% at five years). Limited information exists regarding genetic prognostic factors for long-term survivors (≥ 5 years) of advanced HGSOC. Objective: This study aims to describe the differences in genetic characteristics of advanced HGSOC long-survivors in contrast with short-survivors (≤ 2 years) to improve outcomes for the latter group. Methods: A retrospective descriptive analysis of patients diagnosed with advanced HGSOC at Hospital Universitari Doctor Josep Trueta between 2009 and 2019 was conducted. Genetic studies were performed to detect germline mutations, focusing on BRCA1/2 and other relevant hereditary cancer-associated genes: BRIP1, MLH1, MSH2, MSH6, RAD51C and RAD51D. Results: The study analysed 126 patients with advanced HGSOC, split into 63 long-term (≥ 5 years) and 63 short-term (≤ 2 years) survivors. Genetic testing was available for 83 patients. Germline mutations were significantly more common in long-term survivors (32.73%) than in short-term survivors (7.14%). BRCA1 and BRCA2 mutations, found exclusively in long-term survivors, accounted for 30.91% of this group. Non-BRCA mutations, such as PALB2 and BRIP1, were identified in short-term survivors, though at lower frequencies. Variants of Uncertain Significance (VUS) were also identified in the short-term survival group, particularly in MMR-related genes (MSH6, MSH2) and HRR genes (CHEK2, ATM), suggesting potential but unconfirmed genetic contributions to prognosis. Conclusion: Long-term survivors have distinct genetic profiles compared to short-term survivors, including a higher prevalence of BRCA1/2 mutations. These findings highlight the potential of germline mutations as biomarkers for prognosis and treatment decisions in advanced HGSOC patients Wed, 01 Jan 2025 00:00:00 GMT http://hdl.handle.net/10256/26782 2025-01-01T00:00:00Z http://hdl.handle.net/10256/26781 Improving epilepsy management through education in the Smara refugee camp: a pre-post quasi experimental longitudinal study Grifell Reguant, Gisela BACKGROUND: Epilepsy affects approximately 50 million people globally, with 80% residing in low- and middle-income countries, where access to adequate healthcare is limited. Refugees in the Smara camp, Algeria, face additional challenges such as scarce medical resources, societal stigma, and a lack of epilepsy management knowledge among healthcare workers and patients. OBJECTIVES: The study aims to evaluate whether providing epilepsy education for healthcare personnel can reduce the frequency, severity, and complications of seizures among individuals with epilepsy in the Smara refugee camp. STUDY DESIGN AND PARTICIPANTS: This study is designed as a quasi-experimental prepost longitudinal study involving 102 participants diagnosed with epilepsy in the Smara refugee camp within the Saharawi Refugee Camps. Participants will be recruited through consecutive non-probabilistic sampling at Smara’s dispensaries and regional hospital, with a recruitment period of two months. METHODS: The study begins with a 6-month observation phase to establish baseline epilepsy characteristics among patients. This is followed by an intervention phase, comprising structured educational sessions for healthcare personnel, who will then educate patients. Data on seizure frequency, severity, and complications will be collected via the Epilepsy Journal app. Baseline covariates will be assessed through self-reported data, clinical criteria, and validated tools, including the ESMS, MMAS-8, OSSS-3, and HESPER scales at the start of the study. A second 6-month observation phase will analyze post-intervention changes in the condition's nature Wed, 01 Jan 2025 00:00:00 GMT http://hdl.handle.net/10256/26781 2025-01-01T00:00:00Z http://hdl.handle.net/10256/26780 Impact of personalized tracheostomy tubes using 3d models in polytrauma patients: a single center, randomized, prospective, controlled clinical trial González García, Adrián Background: Polytrauma is a leading cause of mortality and morbidity worldwide, frequently requiring tracheostomies for prolonged airway management, particularly those with severe injuries necessitating mechanical ventilation. Standard tracheostomy tubes (TT) often fail to adapt to individual anatomy, leading to complications such as tracheal stenosis, tracheomalacia or airway obstruction. Recent advancements in medical imaging and 3D printing technologies offer the possibility of customizing TTs to fit the unique anatomy of each patient, potentially reducing complications and improving outcomes. Utilizing high-resolution CT scans, 3D-printed TTs tailored to each patient’s specific anatomy could represent a paradigm shift in airway management for this highrisk population. Objectives: This study aims to evaluate whether customized TTs, designed from patient-specific 3D models based on routine CT scans, reduce complications compared to standard TTs. Secondary objectives include assessing the impact of these personalized TTs on hospitalization duration and the need for tube replacements. By leveraging routine imaging data, this approach seeks to streamline the integration of 3D printing into clinical practice without adding significant costs or additional diagnostic procedures. Design: A single center, randomized, prospective, controlled clinical trial will be conducted. Participants and Methods: 156 polytrauma patients requiring tracheostomy and meeting inclusion criteria will be randomized into two groups: one receiving customized TTs and the other receiving standard TTs. Patients will be followed from the immediate postoperative period during their hospital stay and up to six months post-surgical tracheostomy to monitor complications, hospital stay length, and the number of TT replacements. This comprehensive follow-up aims to capture both early and late complications, as well as assess recovery trajectories. Data will be analyzed using descriptive, bivariate, and multivariate methods to evaluate efficacy and potential confounders Wed, 01 Jan 2025 00:00:00 GMT http://hdl.handle.net/10256/26780 2025-01-01T00:00:00Z http://hdl.handle.net/10256/26779 Vision Based Reactive Navigation for Agricultural Robotics Operations Muhammad, Umar Given the lack of labour and the increasing demand of agriculture requiring a lot of manpower, agriculture is a sector that would greatly benefit from automation and robotics solutions. The technologies and algorithms developed in the robotics sector for localization and autonomous navigation have been intensively addressed in the last two decades, mainly in indoor environments (for example, logistics warehouses). In these cases, the scenario is usually quite structured, controlled, predictable and limited in size, and the terrain is usually quite flat and regular. Lidar based SLAM, for instance, has been intensively implemented and deployed with great results. These solutions, however, do not perform well in agricultural scenarios. The objective of this Thesis is to develop: ● A reactive navigation solution, based on vision and lidar sensors, in order to obtain a robust navigation solution. ● Overcome the problems associated with navigation derived from an erratic localization system, given the difficulty of the scenario.; Donada la manca de mà d'obra i la creixent demanda d'agricultura que requereix molta mà d'obra, l'agricultura és un sector que es beneficiaria enormement de solucions d'automatització i robòtica. Les tecnologies i algoritmes desenvolupats en el sector de la robòtica per a la localització i navegació autònoma s'han abordat intensament en les darreres dues dècades, principalment en entorns interiors (per exemple, magatzems logístics). En aquests casos, l'escenari sol ser força estructurat, controlat, previsible i limitat en mida, i el terreny sol ser força pla i regular. El SLAM basat en Lidar, per exemple, s'ha implementat i desplegat intensament amb grans resultats. No obstant això, aquestes solucions no funcionen bé en escenaris agrícoles. L'objectiu d'aquesta Tesi és desenvolupar: ● Una solució de navegació reactiva, basada en sensors de visió i lidar, per obtenir una solució de navegació robusta. ● Superar els problemes associats amb la navegació derivats d'un sistema de localització erràtic, donada la dificultat de l'escenari. Tue, 01 Jun 2021 00:00:00 GMT http://hdl.handle.net/10256/26779 2021-06-01T00:00:00Z