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Background Chronic Obstructive Pulmonary Disease (COPD) is a treatable disease with a high prevalence, and high morbidity associated with significant socioeconomic costs. Objective To carry out a systematic review of the literature to analyze the main cost studies associated with COPD, in order to determine the main factors that influence the costs of the disease. Methods Searches were conducted in PubMed, SCOPUS and Web of Science databases for cost studies on COPD published in English, between the years 2015 and 2020. The search terms were “COPD” OR “pulmonary disease, chronic obstructive”, “cost*” OR “cost of illness”, “economic impact” AND “burden of disease”. The inclusion criteria included the identification of reported cost of the disease, economic burden, medical care expenses or use resources for COPD, the methodology used, data sources, and variables studied. Results 18 publications were analyzed: 17 included direct health costs, 6 included direct non-medical costs, 12 analyzed indirect costs and two reported intangible costs. Most of the studies reported data for developed and European countries, with direct costs being the most studied. Trends were observed in multiple studies of direct and healthcare costs for European countries measured by patient and year, where the higher costs were associated with more severe COPD and a frequent history of exacerbations. The highest costs reported corresponded to hospitalizations and the associated pharmacological treatment. The importance of the loss of productivity and premature retirement within the profile of the COPD patient was also highlighted as the main generator of indirect costs of the disease. Conclusion COPD generates substantial costs for the health system, mainly related to moderate to severe stages and the exacerbations and complications entailed. It is important to strengthen health systems with monitoring, evaluation and health education models that allow these patients to remain stable to avoid decompensation and subsequent hospitalizations.

Learning additional languages is considered to be something positive and stimulating for a lot of people. Such is its significance or value that almost every citizen knows more than one language. The purpose of this study relies on showing how English language is acquired in a society where there is a language contact between Catalan language and Spanish language, focusing particularly on the kind of communication and interaction within the educational system. Its main objective is to find out the attitudes learners have towards this topic and indicate the ways in which they make use of the language, so as to mention the major obstacles they may face in the acquisition process. Additionally, it tries to highlight which are the most relevant aspects to carefully bear in mind when developing oral communication within the classrooms.

During 2015 and 2016, two experiments were conducted under contrasting climatic conditions (rainy and dry seasons, respectively) in Campeche, Mexico, to test various thresholds (treatments) of soil moisture tension for the beginning of irrigation, and their effect on the yield and quality of Habanero Chilies, and also on the efficiency of water use, the virtual water content and its blue and green components. In both experiments, irrigation was initiated when the soil moisture tension, measured at 30 cm depth, took the values −10, −40 and −70 kPa, considered as treatments, using producer irrigation management as a control. The number of fruits per plant (NFP), fruit weight per plant (FWP), fruit diameter (FD), fruit length (FL), yield (Y), total water use efficiency (TWUE), irrigation water use efficiency (IWUE), virtual water (VW), green virtual water (GVW), and blue virtual water (BVW) were determined and statistically analyzed. During 2015, rains masked treatment effects, although significant effects were detected for FL, IWUE, VW and BVW. In 2016, the different irrigation treatments during the dry season had significant effects on the variables NFP, FWP and Y, with statistically higher values in the −10 kPa treatment; and also in IWUE, GVW and BVW with statistically higher values in the −70 kPa, −40 kPa and the control treatments, respectively. Nearly all crop growth and yield related variables had higher values with lower soil moisture tension. In both production cycles, significantly lowest values for IWUE and significantly highest values for BVW were obtained under producer irrigation management (controls); whereas significantly highest values were recorded for IWUE and significantly lowest for BVW in the −40 and −70 kPa treatments. It was concluded that the use of tensiometers to define the beginning of irrigation allows for improving irrigation sustainability.

Learning additional languages is considered to be something positive and stimulating for a lot of people. Such is its significance or value that almost every citizen knows more than one language. The purpose of this study relies on showing how English language is acquired in a society where there is a language contact between Catalan language and Spanish language, focusing particularly on the kind of communication and interaction within the educational system. Its main objective is to find out the attitudes learners have towards this topic and indicate the ways in which they make use of the language, so as to mention the major obstacles they may face in the acquisition process. Additionally, it tries to highlight which are the most relevant aspects to carefully bear in mind when developing oral communication within the classrooms.

The management of crisis situations has been a challenging problem from different points of views, such as communication efficiency and avoiding casualties. This paper presents a novel approach that includes an interaction organization pattern for Multi-agent Systems (MASs) in crisis management, abstracted from several existing case studies in which the agents follow a sequence of interactions and the organization must optimize the use of human resources. The pattern considers an emergent organization of peers that adopt different roles according to the circumstances. The key features of the organization are its robustness, scalability (in terms of both agents and roles), flexibility to deal with a changing environment, and the efficient use of resources. In order to validate the organization, the paper presents its modeling and development with the Ingenias methodology, conforming the corresponding MAS. This development follows a model-driven approach, which allows a smooth transition from the specification to the code, and a low-cost testing of the system with different settings. Another key aspect is the application of metrics for validating and improving the MAS in terms of response time. The MAS has been tested with 600 agents representing 200 citizens, showing its performance.

The definition of protocols between agents is not enough for guaranteeing the absence of undesirable communication in organizations and the presence of desirable ones in large multi-agent systems (MASs). This is a consequence of the complex system nature of MASs, which cause sophisticated behaviors to arise out of a multiplicity of relatively simple interactions among the independent agents composing them. With this motivation, this paper presents an approach for testing communication in MAS architectures. In this approach, designers are not only recommended to specify the desired communication protocols, but also the undesired patterns and organization structures in the agents' communications, allowing designers to define robust communication structures. For this purpose, this work presents (1) a language to define such patterns; (2) a set of already defined desired and undesired patterns which usually appear in general MASs; (3) a tool that allows developers to automatically detect these patterns in logs of MAS executions; and (4) a guideline that takes developers through the testing of the communications in MASs. The current approach is experienced with a case study, and the results show that the application of the current approach and the suppression of detected undesired patterns improve the effectiveness and efficiency of the corresponding MAS.

Multi-agent systems communication is arguably difficult to be designed. An equal balance of communication among agents is usually desirable. When this does not happen, it affects the quality of service, causing poor performances in terms of response times. The aim of this work is to detect undesirable patterns of communication in these types of systems, using the metaphor of bullying. Though observed in social environments, it can also be applied to a multi-agent system scenario: it consists of some agents' continuous communications toward the same agents. This causes an unbalanced communication, overloading the receiver, which results in higher response times. Some metrics have been designed to measure the agents' communication, and some rules classify agents accordingly into several patterns regarding the bullying metaphor. Furthermore, the experimental results prove that the metrics based on the bullying metaphor are strongly related with the quality of service of multi-agent systems. The experimental results also show that the causes of a bad quality of service can be figured out by means of this bullying metaphor and their metrics and classification rules.

The aim of the job-shop scheduling problem is to optimize the task planning in an industrial plant satisfying time and technological constraints. The existing algorithmic and mathematical methods for solving this problem usually have high computational complexities making them intractable. Flexible job-shop scheduling becomes even more complex, since it allows one to assign each operation to a resource from a set of suitable ones. Alternative heuristic methods are only able to satisfy part of the constraints applicable to the problem. Moreover, these solutions usually offer little flexibility to adapt them to new requirements. This paper describes research within heuristic methods that combines genetic algorithms with repair heuristics. Firstly, it uses a genetic algorithm to provide a non-optimal solution for the problem, which does not satisfy all its constraints. Then, it applies repair heuristics to refine this solution. There are different types of heuristics, which correspond to the different types of constraints. A heuristic is intended to evaluate and slightly modify a solution that violates a constraint in a way that avoids or mitigates such violation. This approach improves the adaptability of the solution to a problem, as some changes can be addressed just modifying the considered chromosome or heuristics. The proposed solution has been tested in order to analyse its level of constraint satisfaction and its makespan, which are two of the main parameters considered in these types of problems. The paper discusses this experimentation showing the improvements over existing methods.

Communication design is usually complex in Multi-Agent Systems (MAS) because of dynamic emergent behaviours. The lack of proper quantitative measures to assess alternative solutions and guide an iterative development makes this design even harder. The aim of this work is to efficiently find and describe communication patterns that should be avoided in these systems and identify the agents involved in these patterns. For this purpose, this research presents a suite of novel metrics and classification rules that, respectively, measure agents' communication and classify their results to describe patterns. This work also provides tools for automatically measuring the metrics and applying the classification rules. In order to evaluate this work, the results of applying these metrics and classification rules have been compared with the quality attribute of performance in several MAS. Performance is measured as the time between a user's request and the MAS response, and partially represents the factor of the quality of service. The experiments gather four agent-oriented communication designs that belong to two different domains: Crisis-management and Cinema ticket selling. The study reveals that the detected communication patterns are related with performance, and that the proposed metrics can arguably guide the design of communications improving the overall performance of systems.

Multi-agent executions become a difficult to follow task when there are lots of agents working concurrently. Programmers need to know if the system is working according to their expectations. In such situations, debugging tools are useful to follow the execution traces, but are not enough for such complex systems. An alternative solution is to save the execution traces (logs) in data warehouses, where they will be analysed through data mining techniques and queries. These techniques offer the programmer a summary of the execution parameters and even the discovery of unexpected patterns.

"Medicina Paliativa" is the official journal of the Spanish Society of Palliative Care ("Sociedad Española de Cuidados Paliativos"; SECPAL) and it reflects the interests, also on bioethics, of the professionals caring terminal people. We want to know what the bioethical questions they discuss and their approaches are.From all the published articles in "Medicina Paliativa" from 1994 to 2013 we selected those referred to bioethics topics. We analysed: number of publications, author, subtype of article, year of publication, topic, philosophic approach, and the presence of answers and discussion. Qualitative topics were reviewed and agreed by at least two authors.There were 60 (9%) publications with bioethics profile from a total of 672 analyzed articles. A majority were signed by only one author. 31 (51%) were published as letter. The most relevant topics were: euthanasia, dignity, proportionality of treatment and care, sedation, principles of bioethics, and information. The orientation of these papers was, in a majority, according to principles of palliative care. Most bioethics topics have been answered and even answered back.Bioethics is an interesting topic in palliative care. The arguments usually fit the principles of palliative care.

Different cultural groups may have different conceptions of what leadership should entail, i.e. different leadership prototypes. Several earlier studies revealed that within Europe various cultural clusters can be distinguished (Hofstede, 1991; Ronen & Shenkar, 1985). Using recent data from the GLOBE project, this article discusses similarities and differences on culture and leadership dimensions among 21 European countries. The results show that two broad clusters or patterns of cultural values can be distinguished, contrasting the North-Western and South-Eastern part of Europe. Within these clusters, differences in leadership prototypes to a certain extent mirror differences in culture. On the basis of these results it is hardly possible to speak of a single typically European culture or one distinct European management style. However, on some dimensions European scores are different from at least some other regions in the world.

This study focuses on culturally endorsed implicit theories of leadership (CLTs). Although cross-cultural research emphasizes that different cultural groups likely have different conceptions of what leadership should entail, a controversial position is argued here: namely that attributes associated with charismatic/transformational leadership will be universally endorsed as contributing to outstanding leadership. This hypothesis was tested in 62 cultures as part of the Global Leadership and Organizational Behavior Effectiveness (GLOBE) Research Program. Universally endorsed leader attributes, as well as attributes that are universally seen as impediments to outstanding leadership and culturally contingent attributes are presented here. The results support the hypothesis that specific aspects of charismatic/transformational leadership are strongly and universally endorsed across cultures.

In large multi-agent system (MAS), the definition of protocols between pairs of agents is not enough for guaranteeing the absence of undesirable communication organizations and the presence of desirable ones. This paper presents a technique and a tool for designing robust MAS communication architectures. In particular, in the proposed technique, designers are not only recommended to design the desired communication protocols, but also the undesired ones and the organization structures. The proposed tool performs data mining and on-line analytical processing (OLAP) on the logs of execution of MAS that use the Foundation for Intelligent Physical Agents (FIPA) protocol, in order to debug MAS communication architectures. The experimental results advocate that this approach is useful for MAS debugging and testing.

The Digital Home is the result of the convergence of technologies of different nature that interact with each other in the Home environment. It is a realization of the Ambient Intelligence concept. The final objective of the Ambient Intelligence is that sensors, devices and networks that compose this environment can co-exist with human users, to improve their quality of live. The relevant characteristic of the Digital Home as a main scenario of Ambient Intelligence is its pervasive nature. This paper describes these technologies and their harmonization, based on the work done in the INREDIS project, which deals with accessibility and new technologies.

Multi-agent systems are composed of autonomous entities that cooperate forming emergent behaviors. The communication between agents is sometimes unpredictable, and the resulting communication patterns can become crucial in their performance. This paper presents a metrics suite for evaluating the communication of the multi-agent systems. These metrics assist designers in detecting undesirable communication patterns in multi-agent systems, in order to improve their cooperative behavior. At the same time, we provide a demonstration that a well balanced communication is related to high levels of Quality of Service measured by response times. Project Agent-based Modelling and Simulation of Complex Social Systems (SiCoSSys), supported by Spanish Council for Science and Innovation, with grant TIN2008-06464-C03-01.

Accessibility is a growing interesting area for research as elderly or disabled population is increasing in developed countries. INREDIS is a project to make research in emergent technologies to provide solutions to different disabilities in several environments. Objectives of the project have been achieved by the analysis of the state of art of the current technologies. At this stage, context-aware technologies will play an important role. Position services are part of these technologies, so a full description of it, their applications in several contexts and the accessibility solutions they provide are explained in this paper. Special interest is focused on positional commerce.