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We analyze the role of nature and geography in determining economic and social outcomes. We propose a theoretical model relating geography and nature to economic growth, and examine that model using data from NUTS 2 European regions. By doing this, we identify the predictive power of first-nature variables to explain regional population distribution. Then we analyze the effects of misadjustment between the actual and predicted distribution of populations on economic performance. Our results indicate that deviating from first-nature outcomes has a significant negative effect on economic growth. Furthermore, we find that departing from natural endowment has a negative effect on social cohesion. The main policy implication emerging from our analysis is that strategies that harmonize with nature and geography yield better social welfare and human well-being than those policies that conflict with them.

In July 2015 the newly elected City Council of Barcelona approved a moratorium on the building of hotels. This study empirically evaluates its effect on hotel prices, using 202,019 daily observations on hotel prices between 2011 and 2017. While the inflow of tourists continued to rise after the moratorium, our synthetic control method finds that hotel prices increased significantly above pre-intervention trends. This suggests that the actual outcome of the moratorium was the protection and promotion of the interests of local industry incumbents.

Objective: To describe the capacity of a broad spectrum of cytokines and growth factors to predict ICU admission and/or death in patients with severe COVID-19. Design: An observational, analytical, retrospective cohort study with longitudinal follow-up. Setting: Hospital Universitario Príncipe de Asturias (HUPA). Participants: 287 patients diagnosed with COVID-19 admitted to our hospital from 24 March to 8 May 2020, followed until 31 August 2020. Main outcome measures: Profiles of immune response (IR) mediators were determined using the Luminex Multiplex technique in hospitalized patients within six days of admission by examining serum levels of 62 soluble molecules classified into the three groups: adaptive IR-related cytokines (n = 19), innate inflammatory IR-related cytokines (n = 27), and growth factors (n = 16). Results: A statistically robust link with ICU admission and/or death was detected for increased serum levels of interleukin (IL)-6, IL-15, soluble (s) RAGE, IP10, MCP3, sIL1RII, IL-8, GCSF and MCSF and IL-10. The greatest prognostic value was observed for the marker combination IL-10, IL-6 and GCSF. Conclusions: When severe COVID-19 progresses to ICU admission and/or death there is a marked increase in serum levels of several cytokines and chemokines, mainly related to the patient’s inflammatory IR. Serum levels of IL-10, IL-6 and GCSF were most prognostic of the outcome measure., This research was coordinated by ProA Capital and Startlite Foundation, Programa de Actividades de I+D de la Comunidad de Madrid en Biomedicina (B2020/MITICAD-CM).

Cocaine use disorder; Craving; Non-invasive brain stimulation Trastorn per consum de cocaïna; Ànsia; Estimulació cerebral no invasiva Trastorno por consumo de cocaína; Ansia; Estimulación cerebral no invasiva Long-term cocaine use is associated with cognitive deficits and neuro-psychiatric pathologies. Repetitive transcranial magnetic stimulation (rTMS) is an emerging therapeutic strategy relating to changes in brain activity. It stimulates the prefrontal cortex and is involved in inhibitory cognitive control, decision making and care. This systematic review aims to evaluate and synthesize the evidence on the safety, effectiveness, and cost-effectiveness of rTMS for the treatment of cocaine addiction. A systematic review of the literature was carried out. The following electronic databases were consulted from inception to October 2020: MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials and Web of Science. Randomised controlled trials, non-randomised controlled trials and case-series and full economic evaluations were included. Twelve studies were included. No identified study reported data on cost-effectiveness. Significant results of the efficacy of TMS have been observed in terms of the reduction of craving to consume and the number of doses consumed. No serious adverse effects have been observed. Despite the low quality of the studies, the first results were observed in terms of reduction of cocaine use and craving. In any case, this effect is considered moderate. Studies with larger sample sizes and longer follow-ups are required.

In the last 15 years, there has been a growing interest in the small modular nuclear reactors (SMR) and their applications. SMRs offer numerous benefits, including inherent safety features. SMRs are under development for all main reactor lines, but an important role for its outstanding safety features will be played by the so-called integral pressurized water nuclear reactors (iPWR). To achieve high proliferation resistance, extended fuel cycles for iPWR have been proposed. Obtaining such a large cycle length, using low fuel enrichment, without shuffle, and with a relatively small core size is a challenge for the neutronic design of the reactor core. In this work, a full-core neutronic computational model based in Serpent code was developed, it permitted to simulate the performance of the proposed reactor core configurations. Different variants of use of integral burnable absorbents in 48-months fuel cycle were studied, and the reactivity worth of the control rod groups was estimated. A fuel cycle extended of more than 1400 EFPDs is reached, and a minimal reactivity penalty was obtained.

The nuclear energy is a good alternative to meet the continuous increase in world energy demand. In this pers-pective, VHTRs (Very High Temperature Reactors) are serious candidates for energy generation due to its inherently safe performance, low power density and high conversion efficiency. However, the viability of these reactors depends on an efficient safety system in the operation of nuclear plants. The HTR (High Temperature Reactor)-10 model, an experimental reactor of the pebble bed type, is used as a case study in this work to perform the thermohydraulic simulation. Due to the complex patterns flow that appear in the pebble bed reactor core CFD (Computational Fluid Dynamics) techniques are used to simulate these reactors. A realistic approach is adopted to simulate the central annular column of the reactor core. As geometrical model of the fuel elements was selected the BCC (Body Centered Cubic) arrangement. Parameters considered for reactor design are available in the technical report of benchmark issues by IAEA (TECDOC-1694). We obtain the temperature profile distribution in the core for regimes where the coolant flow rate is smaller than recommended in a normal operation. In general, the temperature distributions calculated are consistent with phenomenological behavior. Even without considering the reactivity changes to reduce the reactor power or other safety mechanisms, the maximum temperatures do not exceed the recommended limits for TRISO fuel elements.

The COVID‐19 pandemic has become an unprecedented health, economic, and social crisis. The present study has built a theoretical model and used it to develop an empirical strategy, analyzing the drivers of policy‐response agility during the outbreak. Our empirical results show that national policy responses were delayed, both by government expectations of the healthcare system capacity and by expectations that any hard measures used to manage the crisis would entail severe economic costs. With decision‐making based on incomplete information, the agility of national policy responses increased as knowledge increased and uncertainty decreased in relation to the epidemic's evolution and the policy responses of other countries.

The Very High Temperature Reactor (VHTR) is one of the candidates of next generation of the nuclear reactors according to IAEA. Predicting the thermohydraulic behavior of High Temperature Reactors (HTR) is an important contribution to the development of this technology. Evaluation of thermohydraulic performance and a comparison with experimental data were proposed to the international research community. The impact of porosity of pebble beds in the thermohydraulic performance in normal operation and under accident condition is the goal of many kinds of research. In this sense, the three-dimensional CFD thermohydraulic simulation of a HTR using ANSYS CFX has been done. The full-scale approach is used to study the influence of different porosity scheme in the main structural materials of the HTR-10 reactor. The porous medium model was used to simulate the pebble bed core zone and the discharge system of pebbles. A comparison with experimental data was made. The steady-state thermohydraulic performance of the HTR-10 reactor at normal operation and anticipated transients without scram (ATWS) tests result, were used. In this work, was possible to estimate the effect of the porosity in the interior regions of the reactor and the impact on the temperature distribution. Finally, the study broadens the knowledge about the impact that the use of variable porosity has on safety analyses in pebble beds reactors.

In an iPWR (integral pressurized water reactor), the pressurizer is located at the top of the reactor vessel; this configuration requires the investigation of the mechanisms adopted for the homogenization of boron. In previous work, three representative experiments were conducted in an experimental installation made of stainless steel with a volumetric scale equal to 1:200, representing one-fourth of the pressurizer of an iPWR. The test facility layout was mounted so that the test section was fed with water or saline solutions with different concentrations, representing scenarios of boration or deboration. To determine the concentration at the inlet and outlet of the test section, samples have been collected every 10 min during the experiments representing some scenarios. The main goal in this work was to investigate how well mixing during boron dilution transients in the pressurizer of a small modular reactor can be modelled accurately by CFD (Computational Fluid Dynamics) codes. Two CFD codes were used, the commercial ANSYS CFX and the open source CFD code OpenFOAM. The use of open source software such as OpenFOAM offers a way to CFD gain acceptance in the licensing. The results of the comparison of simulations with an experiment at the test section were presented and showed a very good agreement. It was verified that deviations are less than 4%, both codes can be used to accurately represent this phenomenon. In order to improve future experiments, the dispersion of the solution inside the test section is studied with the aim to propose positions for sensors. A first simple configuration is proposed, but some further simulations will be done to find an optimum configuration.

This study aimed to create an individualized analysis model of the risk of intensive care unit (ICU) admission or death for coronavirus disease 2019 (COVID-19) patients as a tool for the rapid clinical management of hospitalized patients in order to achieve a resilience of medical resources. This is an observational, analytical, retrospective cohort study with longitudinal follow-up. Data were collected from the medical records of 3489 patients diagnosed with COVID-19 using RT-qPCR in the period of highest community transmission recorded in Europe to date: February&ndash, June 2020. The study was carried out in in two health areas of hospital care in the Madrid region: the central area of the Madrid capital (Hospitales de Madrid del Grupo HM Hospitales (CH-HM), n = 1931) and the metropolitan area of Madrid (Hospital Universitario Pr&iacute, ncipe de Asturias (MH-HUPA) n = 1558). By using a regression model, we observed how the different patient variables had unequal importance. Among all the analyzed variables, basal oxygen saturation was found to have the highest relative importance with a value of 20.3%, followed by age (17.7%), lymphocyte/leukocyte ratio (14.4%), CRP value (12.5%), comorbidities (12.5%), and leukocyte count (8.9%). Three levels of risk of ICU/death were established: low-risk level (&lt, 5%), medium-risk level (5&ndash, 20%), and high-risk level (&gt, 20%). At the high-risk level, 13% needed ICU admission, 29% died, and 37% had an ICU&ndash, death outcome. This predictive model allowed us to individualize the risk for worse outcome for hospitalized patients affected by COVID-19.

The annular flow two-phase regime appears in nuclear power plants cooling by water. On accidents with lost of cooling this regime determine the heat extraction conditions from the core. The experimental facility Gerador de Película Ondulatoria (GEPELON) was constructed at Universitat Politècnica de València to study this phenomenon. In this work, we use computational fluid dynamics techniques to simulate an air-water regime, specifically a gravity-driven falling liquid film in the GEPELON experimental facility. We consider a multibody geometry where the porous sintered of the input device is simulated in a realistic way. The Volume of Fluid (VOF) model was used in the resolution of the constitutive equations. We propose three geometric approximations to estimate film thickness, and simulation results were compared with experimental values. The simulation results show a good agreement with experimental measurements. Besides, no significant differences were observed between geometrical approximations for film thickness calculations.

Objetivo: Implementar y evaluar un programa de identificación terapéutica de depresión en adolescentes desarrollado en el Reino Unido (TIDY), entre adolescentes de 13-16 años que acuden a centros de Atención Primaria (AP) del área de Santiago de Compostela. Material y métodos: Se reclutaron profesionales de AP (PAP) que voluntariamente quisieron participar en el estudio, cuasi-experimental, de diseño antes-después. Se compararon estadísticamente los cambios en sus conocimientos y actitudes hacia la depresión adolescente y las tasas de cribado e identificación de la misma en los 80 días laborables antes y después de un periodo de formación. Se estudiaron también detalles específicos de la consulta de AP. Resultados: A pesar de la baja tasa de participación (23,19%), se observó una mejoría en los conocimientos y actitudes hacia la depresión adolescente, siendo sólo significativa en una de las características que se incluye en el diagnóstico de depresión (p

Brief report [Abstract] Bayesian techniques, as an alternative method of statistical analysis in rehabilitation studies, have some advantages such as handling small sample sizes, allowing incorporation of previous experience of the researchers or clinicians, being suitable for different kinds of studies, and managing highly complex models. These characteristics are important in rehabilitation research. In the present article, the Bayesian approach is displayed through three examples in previously analyzed data with traditional or frequentist methods. The studies used as examples have small sample sizes and show that the Bayesian procedures enhance the statistical information of the results. The Bayesian credibility interval includes the true value of the corresponding parameter diminishing uncertainty about the treatment effect. In addition, the Bayes factor value quantifies the evidence provided by the data in favor of the alternative hypothesis as opposed to the null hypothesis. Bayesian inference could be an interesting and adaptable alternative statistical method for physical medicine and rehabilitation applications.

The Very High Temperature Reactor (VHTR) is one of the next generation candidates for nuclear reactors, according to the IAEA. Predicting the thermohydraulic performance of high temperature reactors is an important contribution to technology development. The evaluation of the thermohydraulic behavior of the steady-state of the HTR-10 gas-cooled pebble bed high temperature test reactor was a challenge proposed to the international scientific community by the IAEA. This paper proposes a methodology for the thermohydraulic study of steady-states of high temperature gas-cooled pebble bed nuclear reactors, using real scale three-dimensional computational thermohydraulic modeling. The focus of this paper is to discuss the methodology that was improved. Analyses were carried out from comparative studies with experimental data and data obtained by other computational codes. A CFD method was developed to analyzes the main thermohydraulic parameters. The ANSYS CFX's full porous media approach was used to model the pebble bed reactor core. A variable porosity model was implemented in the pebble bed simulation to consider the closeness of the walls. The effect of the Reactor Core Cooling System was modeled from variable boundary conditions in the reactor pressure vessel surfaces. The temperature values obtained in the pebbles, the coolant, and the structural elements were confirmed to be under the normal operating limits. Also were obtained the threedimensional coolant velocities and pressures drop profiles which are important information to understand the thermohydraulic behavior of the reactor. Additionally, was evidenced the presence of thermohydraulic three-dimensional effects showing the important role of the 3D thermohydraulic modeling. With this paper was bear out that use of CFD applied to nuclear thermohydraulic modeling of HTR-10 increase the understanding of the phenomena occurring in high temperature gas-cooled pebble bed nuclear reactors.

La estimulación magnética transcraneal (EMT) es una técnica novedosa, no invasiva, que utiliza la fuerza electromagnética para alterar la excitabilidad neuronal. De manera que al contrario que el TEC (terapia electroconvulsiva) no requiere anestesia y el paciente permanece despierto y monitorizado clínicamente; y al contrario que en la estimulación del nervio vago o que en la estimulación cerebral profunda los electrodos no se insertan en el cerebro. Hasta la fecha se ha utilizado en el tratamiento de distintos trastornos neuropsiquiátricos y desde el 2008 ha sido aprobada por la FDA para el tratamiento de la depresión resistente sin síntomas psicóticos. La experiencia en esquizofrenia y otras psicosis es menor y como siempre hay muchos menos estudios en la población infantil y juvenil, pero como clínicos sabemos que el inicio de la patología psiquiátrica más grave ocurre en la infancia y la adolescencia y que la mitad de todos los trastornos mentales se inician antes de la mitad de la adolescencia. En pacientes tan jóvenes es especialmente importante encontrar tratamientos más efectivos y menos dañinos. La EMT representaría una alternativa interesante, ya que puede activar algunas regiones mientras que al mismo tiempo inhibe otras; de manera que hay estudios que explican mejoría de la sintomatología negativa de la esquizofrenia mediante la estimulación del córtex frontal dorsolateral. La eficacia en el tratamiento de las alucinaciones auditivas mediante la inhibición del córtex temporal izquierdo será revisada en este artículo.

In the last few decades, in both mining and civil engineering projects, deeper excavations have been carried out than in the past. With this increase in depth, rocks may overstress and rock failures can occur during excavation. When competent rock strata are encountered under high stress conditions, these failures can vary from superficial spalling to explosive rockburst. Intense rockbursts may cause fatal injuries to workers and significant loss of equipment and time. The occurrence of rockbursts is always difficult to predict and special steps and measures must be taken to control them. First, burst-prone zones must be predicted by an early exhaustive geological study and by the assessment of in situ stress level and orientation. Second, basic design parameters, e.g., shape, size, and excavation method, should be modified and adapted to the expected conditions to minimize rockburst risk. Third, in situ pre-conditioning methods, e.g., destress blasting, can be applied to decrease the capacity of the rock mass to store energy. Finally, special rock support and reinforcement systems, i.e., yielding systems, must be installed after excavation to ensure total stability of the opening. This paper reviews the geological and geomechanical factors that provoke and influence rockbursts in overstressed rock masses and the engineering measures taken to control them.

En el contexto del enfrentamiento político y mediático de las últimas elecciones presidenciales de los Estados Unidos de América, esta investigación compara el impacto y alcance de la opinión política de los medios tradicionales de referencia (The New York Times y The Washington Post), frente a dos medios nativos digitales (The Huffington Post y Politico.com), a través del análisis de un total de 162 editoriales y artículos de opinión publicados en sus respectivos espacios digitales y en las redes sociales. El resultado muestra que los medios nativos digitales analizados no amenazan el liderazgo de los medios tradicionales en la red, aunque el impacto y alcance de los editoriales de ambos es bajo y se observa la ausencia de una estrategia y criterio a la hora de posicionarse en la red, donde no consiguen ganar espacio, además de un escaso interés de los lectores online por la opinión política In the context of the political and media confrontation of the last presidential elections of the United States of America, this research compares the impact and scope of the traditional media's political opinion (The New York Times and The Washington Post) against two digital native media (The Huffington Post and Politico.com), through the analysis of a total of 162 publishers and opinion pieces published in their respective digital spaces and social networks. The result shows that the digital native media analyzed do not threaten the leadership of the traditional media on the net, although the impact and scope of the publishers of both are low and it is observed the absence of a strategy and criterion when it is positioned on the net, where they do not manage to gain space, and also it is proved a little interest of the online readers in the political opinion SI

The dramatic impact of neurological degenerative pathologies in life quality is a growing concern nowadays. Many techniques have been designed for the detection, diagnosis, and monitoring of the neurological disease. Most of them are too expensive or complex for being used by primary attention medical services. On the other hand, it is well known that many neurological diseases leave a signature in voice and speech. Through the present paper, a new method to trace some neurological diseases at the level of phonation will be shown. In this way, the detection and grading of the neurological disease could be based on a simple voice test. This methodology is benefiting from the advances achieved during the last years in detecting and grading organic pathologies in phonation. The paper hypothesizes that some of the underlying neurological mechanisms affecting phonation produce observable correlates in vocal fold biomechanics and that these correlates behave differentially in neurological diseases than in organic pathologies. A general description about the main hypotheses involved and their validation by acoustic voice analysis based on biomechanical correlates of the neurological disease is given. The validation is carried out on a balanced database of normal and organic dysphonic patients of both genders. Selected study cases will be presented to illustrate the possibilities offered by this methodology.

Phrenic nerve pacing is a method of respiratory support that can replace mechanical ventilation in high-level cervical spinal cord injury patients with diaphragmatic paralysis. Our objective was to evaluate survival and long-term quality of life in patients with external respiratory support by PNP vs volumetric respirator in patients with severe respiratory insufficiency due to a high-level spinal cord injury. This is a retrospective review study of a prospectively collected database for evaluate the survival and a questionnaire for quality of life has been collected face-to-face or by telephone at present. Cervical SCI patients with permanent respiratory support (PNP or MV). Long-term evaluation of a cohort of PNP-supported patients. We performed a comparison between these patients and volumetric respirator-supported patients. For survival analysis, we used the Kaplan–Meier method and Cox proportional hazards model. The health-related quality of life was assessed with SF-36 questionnaire, a general HRQL evaluation. One hundred twenty six patients on permanent respiratory support were evaluated during the study period. Of these, 38 were on PNP and 88 were mechanically ventilated. Paced patients were younger and had a longer survival, but in a multivariate analysis adjusted for age using a multiple logistic correlation we found that length of survival was greater for PNP patients. In terms of HRQL, the PNP-supported patients showed better results in terms of social functioning. PNP is a stable and effective method of long-term respiratory support in this type of patients (SCI patients dependent on external respiratory support). In these patients it improves the length of survival and some social issues by quality of life when compared with patients under MV.

Objetivo: Comprobar que el marcapasos diafragmático es una forma de soporte respiratorio que puede usarse para facilitar la retirada del respirador volumétrico en pacientes con lesión medular cervical y parálisis diafragmática, mediante su comparación con el respirador volumétrico tradicional. Diseño: Análisis retrospectivo de una base de datos prospectiva y de tipo caso-control apareado por edad. Ámbito: Unidad de Cuidados Intensivos y Unidad de Cuidados Intermedios Respiratorios del Hospital Nacional de Parapléjicos de Toledo. Pacientes: Se han recogido los datos de todos los pacientes dados de alta del hospital con soporte respiratorio permanente mediante respirador volumétrico o marcapasos diafragmático con un periodo de seguimiento de 25 años y se han realizado entrevistas personales para valorar la calidad de vida relacionada con la salud. Para las comparaciones estadísticas se han usado tests de comparaciones y de supervivencia. Intervenciones: Cuestionario de calidad de vida. Variables de interés: Datos demográficos y clínicos, estancia hospitalaria, mortalidad, readaptación familiar y calidad de vida relacionada con la salud. Resultados: Hemos examinado las historias clínicas de 101 pacientes, 37 con marcapasos y 64 con un respirador volumétrico. Nuestros resultados muestran tanto una duración del ingreso en UCI y de la hospitalización como una reintegración familiar sin diferencias significativas, con tendencia a una mayor supervivencia en los pacientes con marcapasos (18,18 frente a 9,67 años por el método de Kaplan-Meier, p

Background During the last decades, the progressive ageing of the population has resulted in a rising skin cancer incidence. Although previous studies detected no higher morbidity for dermatological surgery in senior patients, their exclusion from optimal surgical treatment remains as a common clinical practice. Objective The aim of this study was to determine the diseases treated with ambulatory major dermatological surgery, the surgical morbidity and the associated variables in ≥85 year-old patients. Patients/methods This is an observational study on 247 successive patients older than 85 years of age who underwent dermatological surgery in a single Ambulatory Mayor Surgery unit. Studied variables were age, gender, tobacco-alcohol exposure, co-morbid medical conditions, blood-thinning medication, antibiotic prophylaxis, number of lesions, location, histopathological diagnosis, area of skin removed, surgical technique, type of flap, length of surgery, entrance order, suture thread, surgical complications and need of post-operative admission. Results The most common site was head and neck (82.7%). The most frequent tumour was basal cell carcinoma (45.1%), followed by squamous cell carcinoma (38.7%) and melanoma (8.3%). Direct closure was the most frequent procedure (55.6%). Of the total number of patients, 7.9% of patients suffered complications; necrosis followed by cellulitis were the most frequent. Length of surgical procedure, area of skin removed and reconstruction with skin-graft were significantly related to higher risk of post-operative complications. Conclusions No intra or post-surgical mortality or life-threatening local complications were detected. Most post-surgical local complications appeared after wide excisions and complex reconstruction techniques that prolonged the length of the surgery.

Resumen Introduccion En los ultimos anos se ha incrementado la incidencia de sifilis en Espana. En un porcentaje importante existe coinfeccion con el virus de la inmunodeficiencia humana (VIH). Dado que estos pacientes tienen mayor riesgo de complicaciones neurologicas y de fracaso del tratamiento, hay que seguirlos cuidadosamente por el riesgo de desarrollar neurosifilis. En los pacientes coinfectados por el VIH –si bien las guias coinciden en realizar puncion lumbar en aquellos con sifilis latente tardia o de duracion incierta– la indicacion en pacientes con sifilis precoz activa es controvertida. Recientemente se han realizado estudios para determinar parametros clinicos o analiticos que identifiquen a aquellos pacientes que se beneficiarian de la puncion lumbar. Exponemos las diversas opiniones y aportamos la experiencia en nuestro servicio. Material y metodo Hemos realizado puncion lumbar de forma sistematica a todos los pacientes con sifilis precoz activa coinfectados por el VIH en el periodo 2003-2006. Resultados En el 100 % no se objetivo neurosifilis en LCR, y los parametros entraban dentro de la normalidad o eran compatibles con la infeccion por el VIH. Un 38 % presento un recuento de linfocitos CD4 + ≤ 350 y un 87,5 % tenia una titulacion en suero RPR ≥ 1:32. Conclusion Es posible que en la practica clinica se abuse de la realizacion de PL en estos pacientes, debido a la ausencia de criterios bien definidos. Nuestros datos estan en correlacion con los criterios actuales que apoyan la idea de restringir la realizacion de PL a determinados grupos.

It is known that the amount of characteristics may be the bottleneck of a digital processing system. Finding a good method to detect which characteristics are the most important to identify a speaker would get better results with less characteristics. The classification of an adult speaker by their age is a big challenge since the adulthood is a long period without significant changes in voice. This study proposes a new method based on F-ratio, dispersion metric and also correlation between parameters to find a rank of features. A bootstrapping procedure determines the optimum number of characteristics within a feature vector to characterize a speaker. The results are compared with other non linear ranking methods. The proposed algorithm achieves a better performance in most cases.

Person identification, especially in critical environments, has always been a subject of great interest. However, it has gained a new dimension in a world threatened by a new kind of terrorism that uses social networks (e.g. YouTube) to broadcast its message. In this new scenario, classical identification methods (such fingerprints or face recognition) have been forcedly replaced by alternative biometric characteristics such as voice, as sometimes this is the only feature available. Through the present paper, a new methodology to characterize speakers will be shown. This methodology is benefiting from the advances achieved during the last years in understanding and modelling voice production. The paper hypothesizes that a gender dependent characterization of speakers combined with the use of a new set of biometric parameters extracted from the components resulting from the deconstruction of the voice into its glottal source and vocal tract estimates, will enhance recognition rates when compared to classical approaches. A general description about the main hypothesis and the methodology followed to extract gender-dependent extended biometric parameters are given. Experimental validation is carried out both on a highly controlled acoustic condition database, and on a mobile phone network recorded under non-controlled acoustic conditions.

This paper has been developed as a part of research seeking to verify the effects of organisational culture in general, and market orientation in particular, on the behaviour and results of managerial organisations. The difference with other existing work on the same subject is that this work uses the case method to bring managerial reality into closer contact with the university environment. This report contains the first of the case studies carried out in the context of this research, and examines Zara, a strategic unit in the Inditex group, which is shown to be a paradigmatic example of the development of market orientation in a company, as a basis for the company’s performance and competitive advantages.

Reports of epidemiological surveys do not always provide adequate careful descriptions of the methodology used and the sociocultural context involved. Galicia, a natural region in south-west Europe, possesses certain characteristics that differ from those in other communities within the Spanish state. Galician is a Romance language, which is, in fact, closer to Portuguese than it is to Spanish. The population (2.7 million inhabitants) is widely dispersed, with two-thirds of them living in the countryside. More than 18% are older than 65, and the educational level of this elderly population is low. A total of 681 persons over 60 years of age were interviewed in their homes using the DIS-III as the main diagnostic instrument during the second phase of the Galicia Study of Mental Health of the Elderly. This paper analyses some methodological implications of this epidemiological study, focusing on the translation of the DIS into Galician and its performance and acceptability in this community. The possible cultural bias that can affect the rates of prevalence in some specific disorders, the limitations of lifetime prevalence and the advantages of using six-month prevalence rates is discussed. Besides some interesting anecdotes, which are described in the article, the main result is the very high acceptance of DIS-III in this elderly population. Copyright © 2000 Whurr Publishers Ltd.

Cochlear implantation is a surgical procedure that can restore the hearing capabilities to patients with severe or complete functional loss. However, the level of restoration varies highly between subjects and depends on patient-specific factors. This paper presents a software application for planning cochlear implantation procedures that includes patient-specific anatomy estimation using high resolution models, implant optimization for patient-specific implant selection, simulation of mechanical and electrical properties of the implant as well as clinical reporting.

Acute acalculous cholecystitis (AAC) is a very serious complication which can be found in patients with multiple serious traumatic lesions ('polytrauma'). Very few patients have been reported in the literature with an acute spinal injury and associated AAC. We report seven patients with polytrauma and acute spinal cord injury who developed AAC. All had no complaint of the principal warning symptom: right upper quadrant abdominal pain. All presented with a palpable mass in this site and the laboratory results were compatible with cholestasis. The diagnosis of AAC was confirmed both by ultra sound and CT scanning. We discuss the possible precipitating factors and the treatment. One hundred and ninety one patients were admitted to the Intensive Care Unit in our Hospital with SCI over a period of 2 years, all of these in the acute stage. AAC was diagnosed in seven patients among them. Our purpose is to call attention to this clinical condition which can complicate the outcome of patients with multiple trauma and acute spinal cord injury. To date AAC in this group of patients has been infrequently described in the available literature.

BACKGROUND: Electrophrenic pacing can be used in the management of ventilatory failure in quadriplegic patients. A study was undertaken to determine the pattern of transdiaphragmatic pressure (PDI) during the conditioning phase of electrophrenic pacing to see if it had a possible role in optimising the process of conditioning. METHODS: The tidal volume (TV) and PDI were measured in a group of six quadriplegic patients commencing ventilation by low frequency pulse stimulation (7-10 Hz) and low respiratory rate stimulation (< 10 breaths/min). RESULTS: Tidal volume increased between baseline and month 1 (4.33 ml/kg, p < 0.001) and between months 1 and 2 (3.00 ml/kg, p < 0.05) and then stabilised. PDI was higher during bilateral diaphragmatic pacing (mean (SD) 1.73 (0.30) kPa) than with either left (1.15 (0.34) kPa) or right (0.86 (0.37) kPa) unilateral pacing. PDI varied throughout the observation period, probably by interaction between recovery of the diaphragmatic fibres and the pacing regimen. CONCLUSIONS: Patients with quadriplegia due to high spinal injury can be maintained with ventilation by continuous electrophrenic pacing. The control criteria used in this study for pacing were tidal volume and the patient's tolerance, and the PDI measurement did not contribute any additional information to help with managing the conditioning process.

Neurological Diseases (ND) are affecting larger segments of aging population every year. Treatment is dependent on expensive accurate and frequent monitoring. It is well known that ND leave correlates in speech and phonation. The present work shows a method to detect alterations in vocal fold tension during phonation. These may appear either as hypertension or as cyclical tremor. Estimations of tremor may be produced by auto-regressive modeling of the vocal fold tension series in sustained phonation. The correlates obtained are a set of cyclicality coefficients, the frequency and the root mean square amplitude of the tremor. Statistical distributions of these correlates obtained from a set of male and female subjects are presented. Results from five study cases of female voice are also given.

Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works. E. Khoury , B. Vesnicer, J. Franco-Pedroso, R. Violato, Z. Boulkenafet, L.M. Mazaira Fernández, M. Díez, J. Kosmala, H. Khemiri, T. Cipr, R. Saeidi, M. Gunther, J. Zganec-Gros, R. Zazo Candil, F. Simöes, M. Bengherabi, A. Álvarez Marquina, M. Penagarikano, A. Abad, M. Boulayemen, P. Schwarz,, D. Van Leeuwen, J. González-Domínguez, M. Uliani Neto, E. Boutellaa, P. Gómez Vilda, A. Varona, D. Petrovska-Delacretaz, P. Matejka, J. González-Rodríguez, T. Pereira, F. Harizi, L. J. Rodríguez-Fuentes, L. El Shafey, M. Angeloni, G. Bordel, G. Chollet, S. Marcel, "The 2013 speaker recognition evaluation in mobile environment" in International Conference on Biometrics (ICB), Madrid (Spain), 2013, 1-8, This paper evaluates the performance of the twelve primary systems submitted to the evaluation on speaker verification in the context of a mobile environment using the MOBIO database. The mobile environment provides a challenging and realistic test-bed for current state-of-the-art speaker verification techniques. Results in terms of equal error rate (EER), half total error rate (HTER) and detection error trade-off (DET) confirm that the best performing systems are based on total variability modeling, and are the fusion of several sub-systems. Nevertheless, the good old UBM-GMM based systems are still competitive. The results also show that the use of additional data for training as well as gender-dependent features can be helpful., This evaluation was supported by the European Union under the project BEAT contract no. FP7-284989 , as well as the Swiss National Science Foundation under the LOBI project.

We have made a retrospective comparative study of patients with spinal cord injury, nine with a diaphragmatic pacemaker and 13 with mechanical ventilation. Clinical outcome, cost and subjective satisfaction with both modalities have been evaluated. The functional status was the same with both types of treatment. Proper management of an electric wheelchair and optimal phonation were attained, respectively, in 100% and 89% of pacers and in 77% and 77% of mechanically ventilated. The rate of hospital discharge and satisfaction with the treatment were significantly better for pacers. The time devoted to ventilatory assistance and cost were also more favourable in this group.

Vowels are important clues supporting speech perception. Nevertheless there are not good definitions for the vowel under the perceptual and computational points of view, among others. The purpose of the present paper is to give an explanation on how the concept of vowel may be defined under the perceptual point of view as those patterns assigned to a specific and categorical representation space which is competitively instantiated in the cortical structures, depending on the specific phonological framework of the listener's language. An experiment is designed to test this definition on a neuromorphic speech processor. Results are presented and discussed.

Kernel-PCA and PCA techniques are compared in the task of age and gender separation. A feature extraction process that discriminates between vocal tract and glottal source is implemented. The reason why speech is processed in that way is because vocal tract length and resonant characteristics are related to gender and age and there is also a great relationship between glottal source and age and gender. The obtained features are then processed with PCA and kernel-PCA techniques. The results show that gender and age separation is possible and that kernel-PCA (especially with RBF kernel) clearly outperforms classical PCA or no preprocessing features.

Voice biometry is classically based on the parameterization and patterning of speech features mainly. The present approach is based on the characterization of phonation features instead (glottal features). The intention is to reduce intra-speaker variability due to the ‘text’. Through the study of larynx biomechanics it may be seen that the glottal correlates constitute a family of 2-nd order gaussian wavelets. The methodology relies in the extraction of glottal correlates (the glottal source) which are parameterized using wavelet techniques. Classification and pattern matching was carried out using Gaussian Mixture Models. Data of speakers from a balanced database and NIST SRE HASR2 were used in verification experiments. Preliminary results are given and discussed.

The dramatic impact of neurological degenerative pathologies in life quality is a growing concern. It is well known that many neurological diseases leave a fingerprint in voice and speech production. Many techniques have been designed for the detection, diagnose and monitoring the neurological disease. Most of them are costly or difficult to extend to primary attention medical services. Through the present paper it will be shown how some neurological diseases can be traced at the level of phonation. The detection procedure would be based on a simple voice test. The availability of advanced tools and methodologies to monitor the organic pathology of voice would facilitate the implantation of these tests. The paper hypothesizes that some of the underlying mechanisms affecting the production of voice produce measurable correlates in vocal fold biomechanics. A general description of the methodological foundations for the voice analysis system which can estimate correlates to the neurological disease is shown. Some study cases will be presented to illustrate the possibilities of the methodology to monitor neurological diseases by voice.

The unveiling of neocortical short-time circuits to detect specific formant associations in Speech Processing is reviewed. The use of these specific structures to capture and parse dynamic changes taking place in the syllabic structure of speech is also presented. Results from computer simulations supporting physiological evidence are presented.

Summary Treatment of eruptive vellus hair cysts (EVHC) is often unsatisfactory. Laser treatment has been described as an adequate treatment in a few reports. Pulsed carbon dioxide (CO2) laser has been used effectively for facial EVHC and erbium:yttrium–aluminium–garnet laser has been used to treat truncal EVHC with variable outcomes. We report our experience with CO2 laser and lateral manual pressure to extract the cysts as an effective treatment in two cases of EVHC. Good cosmetic results were obtained in both cases. No lesion recurrence was observed after a follow-up of 10 years in the first case and 3 years in the second one. CO2 laser vaporization and further extraction of cysts by manual lateral pressure might be an effective method to treat EVHC, achieving good cosmetic results and no recurrence.

Actinic cheilitis (AC) is a precancerous lesion of the lip. Treatment of AC is indicated for prevention of squamous cell carcinoma (SCC), although the exact transition rate of AC to SCC is unknown. Carbon dioxide (CO(2)) laser vaporization seems to be an adequate therapy for AC, but there are no references about the evolution rate of AC to SCC after this treatment.To evaluate the results obtained after treatment of AC by CO(2) laser vaporization in comparison with other treatment modalities and the evolution rate of AC to SCC after CO(2) laser treatment.A retrospective review identified 43 patients with AC treated with CO(2) laser vaporization at our hospital from 2002 to 2006. Clinical and therapeutic information was evaluated. All patients were followed for more than 15 months after treatment.After a mean follow-up period of 29.4 months, 3/43 treated AC showed local recurrence. Another two patients developed SCC in the treated field. A residual scar was clinically evident in two patients.CO(2) laser vaporization with an adequate postoperative follow-up is an effective treatment for chronic AC. Nevertheless, some patients (4,6%) went on to develop lip SCC. The follow-up of these patients is mandatory.

Speech and voice technologies are experiencing a profound review as new paradigms are sought to overcome some specific problems which can not be completely solved by classical approaches. Neuromorphic Speech Processing is an emerging area in which research is turning the face to understand the natural neural processing of speech by the Human Auditory System in order to capture the basic mechanisms solving difficult tasks in an efficient way. In the present paper a further step ahead is presented in the approach to mimic basic neural speech processing by simple neuromorphic units standing on previous work to show how formant dynamics -and henceforth consonantal features-, can be detected by using a general neuromorphic unit which can mimic the functionality of certain neurons found in the Upper Auditory Pathways. Using these simple building blocks a General Speech Processing Architecture can be synthesized as a layered structure. Results from different simulation stages are provided as well as a discussion on implementation details. Conclusions and future work are oriented to describe the functionality to be covered in the next research steps.

Introduction: In the last years, the incidence of syphilis has incremented in Spain and coinfection with HIV occurs in a high percentage. In HIV-infected patients with syphilis, neurological complications, treatment failure and relapse appear to be slightly raised. Therefore, careful follow-up must be carried out because of the risk of developing neurosyphilis. According to the guidelines, lumbar puncture (LP) is indicated in HIV-infected patients with late latent syphilis or syphilis of unknown duration, but it is discussed in HIV-infected patients with early active syphilis. Recent research has been developed in order to determine clinical and analytical findings for identification of patients with high neurosyphilis risk. We review different opinions about this topic and report our experience. Methods. We have performed LP in all HIV-infected patients with early active syphilis during 2003-2006. Results. Of the eight studied patients, none met criteria for neurosyphilis. Three of eight (38 %) had a peripheral blood CD4 cell count CD4 + 350 cells/L. Seven of eight (87'5 %) had RPR 1:32. Conclusion. In these patients, performance of LP could be over indicated because of lack of well-established criterion. Our results are in agreement over to recent studies which restrict indication of LP to specific groups.