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En el presente trabajo se propone la identificación de una pieza singular hallada hace más de 30 años en el oppidum ibérico de El Turó del Montgròs (El Brull, Barcelona) como un cinturón sabélico-samnita. El contexto de aparición permite vincular la pieza con un ritual de exposición de spolia hostium. Su presencia en el oppidum ausetano se relaciona con la actividad mercenaria de las poblaciones iberas. The present paper puts forward the identification of a singular piece discovered more than 30 years ago at El Turó del Montgròs Iberian oppidum (El Brull, Barcelona). It corresponds to a Sabellic-samnite belt. The context of the finding suggests that it would be the final expression of a spolia hostium exhibition ritual. Its presence in an Ausetan oppidum would be related to the mercenary activity of the Iberian communities.

Exotic animals have become popular pets, but there is little information about abandonment. Records of a network of foster homes for abandoned rabbits and rodents in Madrid (Spain) between 2008 and 2021 were analyzed. Data of 1024 animals were included, 46.4% were rabbits, 19.7% hamsters, 15.3% guinea pigs, 5.8% rats, 5.4% gerbils, 4.8% mice, and 2.6% chinchillas. Half of the animals (51.2%) were admitted with health issues, 41.3% had been abandoned, mostly in urban areas, 46.8% came from a local shelter, and 8.1% were relinquished by the owner. Only 12 animals were neutered and 8 were microchipped. The network of foster homes took care of 1009 animals (98.5%), 686 of them were adopted in an average time of 9.2 months, regardless of their health status, 15 animals died before fostering, and 323 died before adoption. Numerous rabbits and rodents are abandoned in urban areas in Madrid (Spain), very few of them are microchipped or neutered. Associations based on networks of foster homes for the adoption of abandoned rabbits and rodents can be effective, preserving animal welfare as effectively as shelters.

Purpose To investigate the quantity and quality of sleep hours in young athletes in a professional football club, to study if there is a significant relationship with mood state and subjective well-being, and to identify the relationship between sleep and quarterly academic performance. We also explored the relationship between sleep and quarterly academic performance. Method the study included 261 players of the various age group categories from football at Barcelona Football Club (average age:13.04 +/- 3.16). Participants maintained a sleep diary and completed questionnaires on their mood state and the quantity and quality of their sleep. Results 70% of the athletes slept less hours than recommended by the American National Sleep Foundation. Athletes with worse quantity and quality of sleep showed negative effects on academic results. Conclusions The results show that the majority of young players sleep less than recommended and show that those who sleep more hours obtain better academic results.

It is usually believed that, in the macroscopic limit, coarse-graining of measurements leads to classical behavior and, in particular, that coarse-graining of quantum correlations leads to local realistic correlations, a principle known as macroscopic locality. We show that, in the most general case, the Hilbert space structure of quantum theory can be preserved in the macroscopic limit. This leads to a violation of a Bell inequality for coarse-grained collective measurements, thus breaking the principle of macroscopic locality.

El artículo busca encontrar evidencia empírica de los determinantes de la salud, como una medición de capital salud en un país en desarrollo después de una profunda reforma en el sector salud. Siguiendo el modelo de Grossman (1972) y tomando factores institucionales, además de las variables individuales y socioeconómicas. Se usaron las encuestas de 1997 y 2000 donde se responde subjetivamente sobre el estado de salud y tipo de afiliación al sistema de salud. El proceso de estimación usado es un probit ordenado. Los resultados muestran una importante conexión entre las variables individuales, institucionales y socioeconómicas con el estado de salud. El efecto de tipo de acceso al sistema de salud presiona las inequidades en salud.

Lipodystrophy is a major disturbance in people living with HIV-1 (PLWH). Several systemic alterations in PLWH are reminiscent of those that occur in ageing. It is unknown whether the lipodystrophy in PLWH is the consequence of accelerated ageing in adipose tissue. We compared systemic and adipose tissue disturbances in PLWH with those in healthy elderly individuals (similar to 80 y old). We observed similarly enhanced expression of inflammation-related genes and decreased autophagy in adipose tissues from elderly individuals and PLWH. Indications of repressed adipogenesis and mitochondrial dysfunction were found specifically in PLWH, whereas reduced telomere length and signs of senesce were specific to elderly individuals. We conclude that ageing of adipose tissue accounts only partially for the alterations in adipose tissues of PLWH.

Background Since 1993, Colombia has had a mandatory social health insurance scheme that aims to provide universal health coverage to all citizens. However, some contributory regime participants purchase voluntary private health insurance (VPHI) to access better quality health services (i. e., physicians and hospitals), shorter waiting times, and a more extensive providers’ network. This article aims to estimate the price elasticity of demand for the VPHI market in Colombia. Methods We use data from the 2016–2017 consumer expenditure national survey and apply a Heckman selection model to address the selection problem into purchasing private insurance. Using the estimation results to further estimate the price semi-elasticity for VPHI, we then calculate the price elasticity for the households’ health expenditure and acquisition of VHPI. Results Our main findings indicate that a 1% VPHI price increase reduces the proportion of households affiliated to a VPHI in the country by about 2.32% to 4.66%, with robust results across sample restrictions. There are relevant differences across age groups, with younger households’ heads being less responsive to VPHI price changes. Conclusions We conclude that the VPHI demand in Colombia is noticeably elastic, and therefore tax policy changes can have a significant impact on public health insurance expenditures. The government should estimate the optimal VPHI purchase in order to reduce any welfare loss that the current arrangement might be generating.

The effectiveness of command-and-control policies related to tobacco use has been studied in high-income countries. Still, there is limited evidence of their effects in low and middle-income countries. We explore the case of Colombia, a country that introduced a business-supported smoking ban in bars and restaurants and all public indoor spaces in 2010. This paper investigates the effect of smoking bans in bars and restaurants on smoking prevalence in Bogotá, Colombia. In this paper, we use the matching with triple-differences technique in analyzing household consumption data from the 2007 and 2011 quality of life surveys. This is done by exploiting their geographical proximity and variation in the density of commercial areas. We found that after the smoking ban implementation, smoking prevalence reduced in households near high-density commercial blocks compared to households near low-density commercial blocks (-10.8 pp.). The impact is larger for households with children and older household heads. Since households near high-density commercial blocks are more frequently exposed to smoking than households near low-density commercial blocks, the former would be more willing to internalize the smoking de-normalization process.

Introduction Long-term use of nebulized or oral antibiotics is common in the treatment of cystic fibrosis and non-cystic fibrosis bronchiectasis. To date, however, few studies have focused on the use of nebulized antibiotics in COPD patients. The aims of this study are: to establish whether a combination of nebulized colistin plus continuous cyclic azithromycin in severe COPD patients with chronic bronchial infection due to Pseudomonas aeruginosa reduces the frequency of exacerbations, and to assess the effect of this treatment on microbiological sputum isolates. Material and methods A retrospective cohort was created for the analysis of patients with severe COPD and chronic bronchial infection due to P. aeruginosa treated with nebulized colistin at the Respiratory Day Care Unit between 2005 and 2015. The number and characteristics of COPD exacerbations (ECOPD) before and up to two years after the introduction of nebulized colistin treatment were recorded. Results We analyzed 32 severe COPD patients who received nebulized colistin for at least three months (median 17 months [IQR 7-24]). All patients but one received combination therapy with continuous cyclic azithromycin (median 24 months [IQR 11-30]). A significant reduction in the number of ECOPD from baseline of 38.3% at two years of follow-up was observed, with a clear decrease in P. aeruginosa ECOPD (from 59.5% to 24.6%) and a P. aeruginosa eradication rate of 28% over the two-year follow-up. Conclusion In patients with severe COPD and chronic bronchial infection due to P. aeruginosa, combination therapy with nebulized colistin and continuous cyclic azithromycin significantly reduced the number of ECOPD, with a marked decrease in P. aeruginosa sputum isolates.

In this paper we explore the R and D–innovation–productivity linkage for the Colombian manufacturing industry, paying special attention to the role of human capital. Using data from two firm-level surveys, the Survey of Development and Technological Innovation (EDIT) and the Annual Manufacturing Survey (EAM), we extend the model of Crépon, Duguet, and Mairesse [1998. ‘Research, Innovation and Productivity: An Econometric Analysis at the Firm Level.’ Economics of Innovation and New Technology 7 (2): 115–158] (hereafter CDM) by including human capital at the investment decision stage. We implement an instrumental variable methodology to correct the potential endogeneity that may arise with the inclusion of human capital. Our results suggest that human capital has a causal effect on research and development (R and D) investment decisions, the innovation behavior of the firm, and increases the labor productivity of the firm. The conclusions highlight the relevance of human capital in the surrounding literature which stands in contrast to prior work that has not included this variable. © 2019, © 2019 Informa UK Limited, trading as Taylor and Francis Group.

It is usually believed that coarse-graining of quantum correlations leads to classical correlations in the macroscopic limit. Such a principle, known as macroscopic locality, has been proved for correlations arising from independent and identically distributed (IID) entangled pairs. In this letter we consider the generic (non-IID) scenario. We find that the Hilbert space structure of quantum theory can be preserved in the macroscopic limit. This leads directly to a Bell violation for coarse-grained collective measurements, thus breaking the principle of macroscopic locality., 12 pages, 1 figure

Background Naturally occurring kidney disease (KD) in pet rabbits has not been fully characterized. It has been previously suggested that proteinuria, especially when associated with isosthenuria, may be an early indicator of KD prior to azotaemia in rabbits. The aim of the current study was to assess the diagnostic utility of the urinary protein dipstick test (UPDT) for detecting proteinuria in rabbit urine samples as a useful diagnostic tool in clinical setting. Methods Three hundred urinalyses from 156 pet rabbits were retrospectively analysed by comparing the UPDT with the urine protein:creatinine ratio (UPC) to assess its diagnostic performance in detecting proteinuria, defined as UPC > 0.3. Sensitivity, specificity, positive and negative predictive values (NPVs) were determined. Results When urine-specific gravity (USG) was ≤1.024 and a UPDT result of >0 was considered proteinuric, the specificity and positive predictive value (PPV) were both 100%. Following the same criteria, specificity and PPV decreased to 92.1% and 92.5% when USG was ≤1.038. NPVs were poor. Conclusion In rabbits, a UPDT result > 0 is indicative of proteinuria (UPC > 0.3) when the USG is ≤1.024. In all other cases, proteinuria should be measured using the UPC.

Background: Aspiration community-acquired pneumonia (ACAP) and community-acquired pneumonia (CAP) in patients with aspiration risk factors (AspRFs) are infections associated with anaerobes, but limited evidence suggests their pathogenic role. Research Question: What are the aspiration risk factors, microbiology patterns, and empiric anti-anaerobic use in patients hospitalized with CAP? Study Design and Methods: This is a secondary analysis of GLIMP, an international, multicenter, point-prevalence study of adults hospitalized with CAP. Patients were stratified into three groups: (1) ACAP, (2) CAP/AspRF+ (CAP with AspRF), and (3) CAP/AspRF- (CAP without AspRF). Data on demographics, comorbidities, microbiological results, and anti-anaerobic antibiotics were analyzed in all groups. Patients were further stratified in severe and nonsevere CAP groups. Results: We enrolled 2,606 patients with CAP, of which 193 (7.4%) had ACAP. Risk factors independently associated with ACAP were male, bedridden, underweight, a nursing home resident, and having a history of stroke, dementia, mental illness, and enteral tube feeding. Among non-ACAP patients, 1,709 (70.8%) had CAP/AspRF+ and 704 (29.2%) had CAP/AspRF-. Microbiology patterns including anaerobes were similar between CAP/AspRF-, CAP/AspRF+ and ACAP (0.0% vs 1.03% vs 1.64%). Patients with severe ACAP had higher rates of total gram-negative bacteria (64.3% vs 44.3% vs 33.3%, P =.021) and lower rates of total gram-positive bacteria (7.1% vs 38.1% vs 50.0%, P 50% in all groups) independent of AspRFs or ACAP received specific or broad-spectrum anti-anaerobic coverage antibiotics. Interpretation: Hospitalized patients with ACAP or CAP/AspRF+ had similar anaerobic flora compared with patients without aspiration risk factors. Gram-negative bacteria were more prevalent in patients with severe ACAP. Despite having similar microbiological flora between groups, a large proportion of CAP patients received anti-anaerobic antibiotic coverage.

Background Inhaled antibiotics (IA) in non-cystic fibrosis bronchiectasis (NCFB) are recommended by some clinical practice guidelines for prevention or treatment of NCFB exacerbations. Methods We performed a systematic review and meta-analysis to evaluate the efficacy and safety of IA use for treatment of adults with NCFB and Pseudomonas aeruginosa chronic bronchial infection. The search was performed in the Cochrane Library, PubMed, and Web of Science databases from 2000 to 2019. Studies of IA for treatment of stable or exacerbated NCFB adults (≥18 years) with P. aeruginosa infection were considered eligible. PROSPERO Registration number: CRD42019136154. Results Twelve trials (2476 participants) were included. IA therapy increased P. aeruginosa eradication from sputum in patients with exacerbations (OR: 3.19, 95%CI: 1.70–5.99) with similar effects on stable patients (OR: 7.22, 95%CI: 2.81–18.59), and a trend to reduced emergence of new respiratory pathogens (OR: 0.58, 95%CI: 0.28–1.18). IA achieved significant reduced exacerbation rates (RR: 0.90; 95%CI: 0.82–0.98) in stable patients, with a number needed to treat (NNT) of 59, but no significant changes in FEV1, mortality, hospitalizations or quality of life were identified. In stable patients, IA use increased antimicrobial resistance (RR: 2.10, 95%CI: 1.35–3.27) at the end of therapy, with a number needed to treat of 6. Conclusions IA therapy achieved a statistically significant eradication of P. aeruginosa from sputum, with a 10% reduction of exacerbations in stable patients. This effect has to be balanced with significant increases in antimicrobial resistance. Our meta-analysis failed to show a significant benefit in terms of patient-centered outcomes.

COPD is a complex disorder characterized by frequent exacerbations causing respiratory failure, antibiotic consumption and the need for the hospital admission. Acute exacerbations of COPD (AE-COPD) are an important cause of hospitalization and death. We analyzed all AE-COPD recommendations issued by different societies in order to collect them in a single document and evaluate its quality. Clinical practice guidelines recommendations regarding AE-COPD were systematically collected from current versions of CPGs released by major international scientific societies (ESCMID, ERS/ATS and GOLD). For each recommendation associated level of evidence was also presented. Thirty-three recommendations were found concerning AE-COPD in studied guidelines: in ESCMID/ERS 2011 guideline 41,9% were based on MA, SR or RCT, in ERS/ATS 2016 guideline no recommendation was considered based on the high quality of evidence and in GOLD 2020 guideline 75% of performed recommendations were based on RCTs. Six recommendations regarding ventilation in AE-COPD were identified. From these, 33,3% were based on high-quality RCTs, 16,7% in RCTs with important limitations and 50% in evidence from observational studies. In conclusion, AE-COPD recommendations based on the high quality of evidence are small, which discloses the importance of increase high-quality research efforts.

Background Antipseudomonal antibiotics should be restricted to patients at risk of Pseudomonas aeruginosa infection. However, the indications in different guidelines on community-acquired pneumonia (CAP) are discordant. Our objectives were to assess the prevalence of antipseudomonal antibiotic prescriptions and to identify determinants of empirical antibiotic choices in the emergency department. Methods Observational, retrospective, one-year cohort study in hospitalized adults with pneumonia. Antibiotic choices and clinical and demographic data were recorded on a standardized form. Antibiotics with antipseudomonal activity were classified into two groups: a) β-lactam antipseudomonals (β-APS), including carbapenems, piperacillin / tazobactam or cefepime (in monotherapy or combination) and b) monotherapy with antipseudomonal quinolones. Results Data were recorded from 549 adults with pneumonia, with Pseudomonas aeruginosa being isolated in only nine (1.6%). Most (85%) prescriptions were compliant with SEPAR guidelines and 207 (37%) patients received antibiotics with antipseudomonal activity (14% β-APS and 23% levofloxacin). The use of β-APS was independently associated with ICU admission (OR 8.16 95% CI 3.69–18.06) and prior hospitalization (OR 6.76 95% CI 3.02–15.15), while levofloxacin was associated with negative pneumococcal urine antigen tests (OR 3.41 95% CI 1.70–6.85) but negatively associated with ICU admission (OR 0.26 95% CI 0.08–0.86). None of these factors were associated with P aeruginosa episodes. In univariate analysis, prior P aeruginosa infection/colonization (2/9 vs 6/372, p = 0.013), severe COPD (3/9 vs 26/372, p = 0.024), multilobar involvement (7/9 vs 119/372, p = 0.007) and prior antibiotic (6/9 vs 109/372, p = 0.025) were significantly associated with P aeruginosa episodes. Conclusions Antipseudomonal prescriptions were common, in spite of the very low incidence of Pseudomonas aeruginosa. The rationale for prescription was influenced by both severity-of-illness and pneumococcal urine antigen test (levofloxacin) and prior hospitalization and ICU admission (β-APS). However, these factors were not associated with P aeruginosa episodes. Only prior P aeruginosa infection/colonization and severe COPD seem to be reliable indicators in clinical practice.

Aim: To characterize the respiratory virome in moderate/severe chronic obstructive pulmonary disease (COPD) patients using metagenomics, with healthy subjects as the reference. Patients & Methods: Sputum COPD samples were collected during stability and exacerbations with negative usual-care microbiologic analysis. Results: Eukaryotic viruses from the Anelloviridae, Herpesviridae and Retroviridae families and phages from the Shiphoviridae family were commonly found in COPD, and the respiratory virome in stability and noninfectious exacerbations showed a substantial similarity. DNA viruses with the highest relative abundance in COPD are Anelloviridae. Conclusion: These results support a colonizing role for eukaryotic viruses in COPD and highlight the importance of analyzing both DNA and RNA viruses when focusing on the respiratory virome.

Of the pet rabbits presented at one private practice between August 2011 and August 2016 (n=1369), 5·6% presented with a traumatic orthopaedic injury. Of these, 7·8% (n=6) presented with traumatic coxofemoral luxation, the most frequently observed type of luxation. Three cases of non-traumatic coxofemoral luxation in pet rabbits are also discussed. Eight rabbits presented with craniodorsal luxation and one with caudoventral luxation. Five rabbits were initially treated using closed reduction and an Ehmer sling under sedation. Two rabbits responded satisfactorily to closed reduction; their bandages remained in place for 10 and 14 days, and movement was cage-limited for 1 month after bandage placement. The bandage did not prevent re-luxation in three cases. Therefore, two rabbits received iliofemoral nylon sutures, and three rabbits received a femoral neck and head ostectomy. One rabbit was treated directly using open reduction and an iliofemoral nylon suture due to fractures in the same limb. One rabbit was presented in shock, coxofemoral luxation was noticed as an incidental finding and euthanasia was elected by the owner. In conclusion, of the three rabbits treated via femoral neck and head ostectomy one rabbit had an unsatisfactory outcome and two rabbits have non-assessable outcomes. The three rabbits treated with iliofemoral sutures showed satisfactory long-term outcomes and the two rabbits treated with closed reduction and an Ehmer sling showed satisfactory medium and long-term outcomes.

La historia literaria ha valorado la obra dramática de Mira de Amescua de acuerdo con determinadas constantes críticas. Una de esas constantes, quizás la más extendida, aprecia la obra de Mira como defectuosa fuente de numerosos temas y personajes del teatro europeo del XVII. La polémica francesa en torno a la originalidad de Corneille y Calderón, en sus respectivas obras Héraclius y En esta vida todo es verdad y todo mentira, sirve para detectar los prejuicios con los que la historia literaria del XIX se enfrentó a La rueda de la Fortuna, una de las primeras piezas de Mira.

The development of small satellites, called CubeSats, at universities gave rise to another concept of ground station and its location site on building roofs. As a facility project, conditioned by urban regulations, the agreement between the ground station engineers and the facility managers is necessary in the site selection process. This paper proposes the application of reverse engineering techniques, such as the laser scanning, to provide them 3D spatial information by the 3D digital reconstruction of the scenario. The main result obtained in the case study at the Technical University of Madrid was the proposal of the re-designed ground station site increasing the antenna performance and considering the established facility constraints. In these building roofs scenarios, the virtual simulation process of telecommunications antennas sites based on the created 3D digital scenario is very useful to optimize the location before the installation process.

Background Exacerbations of COPD (ECOPD) are a major cause of mortality and morbidity. Continuous cyclic azithromycin (CC-A) reduces the exacerbation rate, but it is unknown whether it remains effective and safe beyond the first year. Methods This study was a retrospective analysis of patients with severe COPD (Global Initiative for Chronic Obstructive Lung Disease grade D) with ≥ 4 moderate to severe ECOPD who received CC-A (500 mg three times per week) as add-on therapy. Patients treated over 24 months were considered long-term continuous cyclic azithromycin (LT-CC-A) users, and ECOPD, hospitalizations, and length of hospital stays during the first, second, and third years were compared with the previous 12 months. Microbiologic monitoring, assessment of macrolide resistance, and analysis of side effects were maintained throughout the study period. Results A total of 109 patients with severe COPD treated with CC-A (39 for ≥ 24 months) comprised the LT-CC-A group (35.8%). This group presented average reductions in ECOPD from baseline of 56.2% at 12 months, 70% at 24 months, and 41% at 36 months, paralleled by respective reductions in hospitalizations of 62.6%, 75.8%, and 39.8%. ECOPD due to common microorganisms fell by 12.5% and 17.3% at 12 and 24 months of LT-CC-A, respectively, with a 50% increase in macrolide resistance. Pseudomonas aeruginosa ECOPD rose by 7.2% and 13.1% at these two time points. CC-A therapy was well tolerated with few side effects: digestive disorders in the short term (7.1%) and hearing loss in the long term (5.1%). Conclusions LT-CC-A therapy over a 24- to 36-month period in patients with COPD (Global Initiative for Chronic Obstructive Lung Disease grade D) achieved sustained reductions in ECOPD and hospitalizations of > 50% with few adverse events, although macrolide resistance increased.

Investigacion publicada como capitulo 2 del libro: Medellin, construccion de ciudad: un proyecto de todos / Alcaldia de Medellin; coordinacion proyecto, Universidad del Rosario. – Bogota: Editorial Universidad del Rosario, Alcaldia de Medellin, 2019. 210 paginas. Incluye referencias bibliograficas. Clasificado bajo la tematica: 1. Desarrollo economico – Medellin (Colombia) 2. Planes de desarrollo – Medellin (Colombia) 3. Desarrollo urbano – Medellin (Colombia) 4. Investigacion y desarrollo 5. Ciencia y tecnologia 6. Medio ambiente.

Background Urinary calcium excretion by rabbits is set proportionately higher than that of other species, giving the rabbit urine its characteristic cloudy appearance. During pregnancy, lactation and growth, or when metabolic disorders interfere in the renal excretion of calcium, it is reported that less calcium is excreted and the urine appears clear. The quantification of the calcium concentration in the urine of rabbits may be of importance in the management of diseases that affect calcium metabolism, especially in kidney disease; however, reference intervals for urinary calcium concentration (UC) are unreported in pet rabbits. Methods Prospective data from 63 healthy pet rabbits were evaluated. An inhouse modified Arsenazo III technique, without acidifying the urine, was used to determine the reference intervals for UC and UC:creatinine ratio. Urinary protein:creatinine ratio, UC, UC:creatinine ratio, urinary gamma-glutamyl transferase concentration (UG), UG:creatinine ratio, phosphorus, plasma total calcium, plasma creatinine, urea and ionised calcium were assessed according to age, sex, neutered status, urine collection method and Encephalitozoon cuniculi IgG status in healthy rabbits. Results The reference intervals for UC and UC:creatinine ratio were 4.2–31.1 mg/dl (1.03–7.78 mmol/l) and less than 0.3, respectively. The results showed that none of these variables was influenced by the parameters evaluated, except for the phosphorus value, which was higher in pet rabbits aged up to 3 years compared with those over 3 years, suggesting that published reference values for plasma phosphorus in rabbits should be adjusted according to age. Conclusion The modified Arsenazo III technique described in the present work and the established reference values for UC and UCC in pet rabbits could be useful in the management of kidney disease in rabbits. The results showed that E cuniculi IgG seropositivity has no influence on the variables of renal interest in otherwise healthy rabbits.

This paper estimates the short-term impact of a twofold increase of the tobacco excise tax on consumption of illicit cigarette trade in Colombia. Using data collected before and after the tax increase from a novel smoker survey (DEICS-Col), the impact is estimated as the change in the probability that a smoker has illicit cigarettes. The methodology follows a difference-in-differences strategy, measuring the year-to-year variation of the proportion of illicit cigarettes between smokers who report buying low-priced cigarettes (the highest treatment intensity) and those who bought high-priced cigarettes (lowest treatment intensity). Estimations of the impact show an average increase of 4-5 percentage points on the proportion of illicit cigarettes relative to an initial penetration of low-priced illicit cigarettes of nearly 5.1 %.

BackgroundTobacco prevalence in Colombia is small compared with other Latin America despite the nation’s tobacco taxes being among the lowest in the region. However, tobacco taxes have increased several times during the last decade, and large increases in 2010 and 2016 impacted consumer prices.ObjectiveThis paper aims to estimate the price smoking participation elasticity (PPE) in Colombia, with specific reference to regional increases in consumer prices after 2010 tax policy changes.MethodsThe PPE is computed using logistic regression based on individual-level data from the National Psychoactive Substances Consumption Survey for 2008 and 2013. Our specific focus is state-level variation in Colombian cigarette prices between 2008 and 2013 induced by the tax hike in 2010.ResultsThe estimated PPE in Colombia is around −0.66 (p value=0.046). We find almost no differences across socioeconomic level, but price sensitivity was greater for women than men, and for relatively older individuals (ages 51–64).ConclusionsPPE for Colombia is above estimates for comparable middle-income countries such as Mexico. As a result, current estimates for health gains of tax policies are likely to be underestimated. Moreover, in contrast with the literature, we find that the PPE for the youth (≤25 years) is lower than older age groups, and there is no evidence of a prominent socio-economic status (SES) gradient.

To study the characteristics and outcomes of patients in the ICU with severe community-acquired pneumonia (SCAP) over a 15-year surveillance period.We conducted a retrospective cohort study of episodes of SCAP, and assessed the epidemiology, etiology, treatment and outcomes of patients admitted to the ICU, comparing three periods (1999-2003, 2004-2008 and 2009-2013).A total of 458 patients were diagnosed with SCAP. The overall cumulative incidence was 37.4 episodes/1000 admissions, with a progressive increase over the three periods (P0.001). Patients fulfilling the two major IDSA/ATS criteria at admission increased from 64.2% in the first period to 82.5% in the last period (P=0.005). Streptococcus pneumoniae was the prevalent pathogen. The incidence of bacteremia was 23.1%, and a progressive significant reduction in overall incidence was observed over the three periods (P=0.02). Globally, 91% of the patients received appropriate empiric antibiotic treatment, increasing from 78.3% in the first period to 97.7% in the last period (P0.001). Combination antibiotic therapy (betalactam+macrolide or fluoroquinolone) increased significantly from the first period (61%) to the last period (81.3%) (P0.001). Global ICU mortality was 25.1%, and decreased over the three periods (P=0.001).Despite a progressively higher incidence and severity of SCAP in our ICU, crude ICU mortality decreased by 18%. The increased use of combined antibiotic therapy and the decreasing rates of bacteremia were associated to improved patient prognosis.

Realizando una evaluacion de la implementacion del programa de Energia Prepago de Empresas Publicas de Medellin, busco analizar el impacto que la vinculacion a este tipo de programas tiene sobre el consumo de energia electrica de los hogares, haciendo especial enfasis en aquellos que son mas vulnerables desde una perspectiva socioeconomica. Mis resultados sugieren que el nuevo esquema y la provision de informacion a traves de los medidores inteligentes generan una disminucion en el consumo de electricidad del 15.04 % a nivel agregado. No obstante, la magnitud y la direccion de este efecto dependera de si el usuario exhibio o no un consumo excesivo antes de su vinculacion al programa. Este esquema permite que los usuarios mejoren sus patrones de consumo, mientras que se garantiza su acceso al servicio de energia electrica, minimizando los riesgos de desconexion y los costos asociados.