Search

The past 10 years have seen a major shift in English and English as a Second Language (ESL) placement and pedagogy in California's Community Colleges (CCC), driven by a developmental education reform movement known as acceleration. Popularized by the faculty-led California Acceleration Project (CAP), the acceleration movement focused on reducing or eliminating prerequisite pathways in English and math due to a decade's worth of state-wide data showing that each level of remediation statistically reduced a student's chances of ever reaching or completing the first transfer-level course in the respective discipline (Hern & Snell, 2010). Faculty from many of the state's 117 community colleges participated in CAP's communities of practice, starting with the first cohort in the academic year 2011-2012, and returned to develop accelerated pathways at their own colleges. As these models proved successful and the data supporting acceleration mounted, CAP leaders joined forces with the College Futures Foundation and other partners to lobby for legislative action to compel a system-wide change. The resulting legislation, Assembly Bill 705 (Cal. Assemb., 2017), was signed into law in October 2017 and implemented as of January 1, 2018. This law required that all state community college districts maximize the probability that incoming students would access and complete their first transfer-level English and math class within a year of first enrolling and that students who enrolled in ESL courses would access and complete their first transfer-level English class within three years of first enrollment (Rodriguez et al., 2022).

Abstract Cryotherapy is an ablative therapy that can be used to treat localized prostate cancer. In case of recurrence, treatment options are not well-defined, and their outcomes are unknown. We therefore collected all patients treated with radiotherapy after cryotherapy for prostate cancer recurrence in Nantes (France) between 2012 and 2019. We identified ten patients. After a median follow-up of 5 years, two patients presented late grade 3 toxicities; one patient presented a grade 3 rectal hemorrhage, and one had a grade 3 hematuria. Two patients relapsed at 61 and 62 months, and three patients died of other causes. Radiotherapy to treat local prostate cancer recurrence after cryotherapy seems feasible and effective in local control. These results do not allow us to recommend this technique in current practice but are encouraging for the conduct of prospective trials.

AbstractBackground Some patients with severe asthma may benefit from treatment with biologics, but evidence has been mostly collected from randomized controlled trials (RCTs), in which patients’ characteristics are different from those encountered in asthma patients in the real-world setting. The aim of this study was to describe the clinical features of complete responders versus non-complete responders to long-term treatment with biologics in patients with severe asthma attended in routine daily practice.Methods Data of a cohort of 90 patients with severe asthma who were treated with biologics (omalizumab, benralizumab, and mepolizumab) for at least 12 months and were followed up to March 2022. Data recorded included clinical characteristics and effectiveness of treatment (exacerbation, Asthma Control Test [ACT] score, lung function, use of maintenance oral corticosteroids [mOCS]), FeNO, and blood eosinophils at baseline, at 12 months, and at the end of follow-up. Complete response is considered if, in addition to not presenting exacerbations or the use of mOCS, the ACT score was >20 and, the FEV1 >80% predicted.Results An improvement in all asthma control parameters was observed after 12 months of treatment and a mean follow-up of 55 months. After 12 months of treatment 27.2% of patients met the criteria of complete response and this percentage even increased to 35.3% at the end of follow-up. Long-term complete response was associated to better lung function with mepolizumab and omalizumab treatment and to less previous exacerbations in the benralizumab group. The main cause of not achieving a complete response was the persistence of an airflow obstructive pattern.Conclusions This study shows that omalizumab, benralizumab, and mepolizumab improved the clinical outcomes of patients with severe asthma in a clinic environment with similar effect sizes to RCTs in the long term follow-up. Airflow obstruction, however, was a predictor of a non-complete response to biologics.

Dead bodies – and the graves in which they are interred – are often highly contested within Holocaust campscapes. Although photographs of bodies at places like Bergen-Belsen, Dachau, and Ohrdruf emerged in the immediate aftermath of the Second World War, the exhumation of mass graves of Holocaust victims for either judicial or humanitarian reasons has become something of a taboo subject. Whilst some see dead bodies in these environments as evidence of a crime, others view them as relatives, friends, and loved ones who require a proper burial, a marked burial site, or should be left undisturbed. Disputes arise between governments, communities, individuals, and religious groups when accounting for Halacha (Jewish Law) and the dead. This paper highlights how a non-invasive methodology, derived from archaeology and other disciplines, offers one way of locating and classifying graves whilst respecting the ethical sensitivities involved in their investigation. This is a growing field of research and one which has proven ability and future potential to shed new light on the crimes perpetrated across the European Holocaust landscape.

This article recounts some of the motivations, hurdles, and successes the Cuyamaca ESL Department in San Diego encountered while transforming its curriculum to an accelerated model. The college discovered that the new program, while challenging, increased the success and rate of passing among its language learners and improved the quality of their writing in ways even the implementers did not expect. The concerns, philosophy, and results behind Cuyamaca's move away from traditional ESL classes are examined.

Background: despite the importance of calculating global cardiovascular risk in hypertensive patients and the benefits of its implementation in Primary Health Care, studies on its estimation are insufficient at the University of Medical Sciences of Cienfuegos. Objective: to determine the global cardiovascular risk in hypertensive patients at the University of Medical Sciences of Cienfuegos in the year 2021. Methods: a descriptive, cross-sectional and correlational study was carried out. The sample consisted of 105 hypertensive patients between 40-80 years of age from the University of Medical Sciences of Cienfuegos in 2021. The variables studied were: age, gender, total cholesterol, smoking, systolic blood pressure, diagnosed diabetes mellitus, and global cardiovascular risk. The absolute and relative frequency of the variables were calculated and Pearson's Chi square was applied in the association of the variables and low cardiovascular risk with a significance level of p=0.05. The results were presented in tables. Results: the female gender, the age group of 50-69 years, non-diabetics and non-smokers, with normal cholesterol and prehypertensive predominated. 93.3 % presented low overall cardiovascular risk and 6.7 % moderate to critical. Non-diabetic patients with normal systolic blood pressure presented a significant association with low cardiovascular risk. Conclusions: hypertensive patients at the University of Medical Sciences of Cienfuegos have a low overall cardiovascular risk, a correlation was shown between low cardiovascular risk and normal systolic blood pressure and a history of non-diabetes, which would determine protection against cardiovascular and cerebrovascular events in the future

River ecosystems host a large biodiversity and provide essential ecosystem services but are threatened by multiple anthropogenic activities that degrade their structure and functioning. Although both structure and functioning are key components of ecological status, river monitoring programmes rely almost exclusively on structural indicators, such as community structure, or water quality, neglecting functional attributes. Scientists have pointed towards some promising functions, such as organic matter decomposition, as potential indicators of river functional status. However, it may not be the best indicator to assess the ecosystem functioning of river ecosystem subjected to certain impacts, such as nutrient inputs. Additionally, managers have seldom used functional indicators, probably because of the lack of simple, routine protocols. Here we present the nutrient uptake bioassay (NUB), a simple and straightforward method to measure nutrient uptake by river biofilm that could be developed as a functional indicator of river ecological status. The NUB consists in deploying biofilm carriers in the river for a specific period, allowing biofilm colonization. Biofilm carriers are then incubated in the field in a nutrient-enriched standard solution for one hour and finally the remaining nutrient concentration in the standard medium is measured. Nutrient uptake is calculated from the difference between the initial and final nutrient concentrations. Chlorophyll in the biofilm carriers can also be measured to calculate biofilm accrual rates. The NUB has been developed based on a mesocosm and a field experiments, which showed that the NUB provides additional, non-redundant information to current biomonitoring techniques. Overall, the NUB is a cheap, robust and reliable method that can be applied by most river monitoring practitioners and can be adapted to most river types and situations. As nutrient uptake is linked to the self-purification capacity of rivers, the NUB results provide information about an important ecosystem service. Therefore, we suggest that the NUB can be developed as part of the monitoring toolbox available for managers to improve the assessment of river ecological status and to diagnose the causes of ecosystem impairment.

In 1985, the World Heritage Committee inscribed the site “Painted Churches in the Troodos Region” of the Republic of Cyprus on the UNESCO World Heritage List. The latter included nine Byzantine and Post Byzantine Churches to which a tenth church was added in 2001. In the framework of the IH-AT project, all the churches and the premises in their proximities were analysed using a wide array of non-destructive digital methodologies coupled with more traditional art-historical studies. Image- and Range-based techniques were used to document all the morphological features of the buildings with the final goal of understanding their humble architecture. Additionally, a Ground Penetrating Radar (GPR) was performed to investigate the presence of buried structures that, according to historical sources, were once surrounding the religious sites.For the exploitation and visualization of the extensive database by the scientific community and the public at large, a web portal comprised of reliable and efficient technology-ready tools have been developed.The proposed methodology was implemented to provide new insights on the churches’ architectural features; confirm the presence or absence of buried remains of archaeological interest; and help heritage professionals, with lack or minimal programming skills, to customize online visualizations of 3D interactive models.

Introduction: The Covid-19 pandemic soon became an international health emergency raising concern about its impact not only on physical health but also on quality of life and mental health. Rare diseases are chronically debilitating conditions with challenging patient care needs. We aimed to assess the quality of life and mental health of patients with rare diseases in Spain, with a special focus on inherited metabolic disorders (IMD). Methods: A prospective case-control study was designed, comparing 459 patients suffering from a rare disease (including 53 patients with IMD) and 446 healthy controls. Quality of life (QoL) and mental health were assessed using validated scales according to age: KINDL-R and the Pediatric Symptom Checklist (PSC) for children and the WhoQoL-Bref questionnaire, GAD and PHQ-9 in adults. Results: First, children and adults (but not adolescents) with IMD showed greater psychological effects than controls (p = 0.022, p = 0.026 respectively). Second, when comparing QoL, only adult patients with IMD showed worse score than controls (66/100 vs 74,6/100 respectively, p = 0.017). Finally, IMD had better quality of life than other rare neurological and genetic diseases (p = 0.008) or other rare diseases (p

In the framework of the IH-AT (Invisible Heritage Analysis and Technology) project, a cluster of churches ranging from the 11th to the 16th centuries, located in the Troodos Mountain range of Cyprus, designated by UNESCO as World Heritage monuments, were investigated using Non-Destructive-Techniques (NDT) (geophysical and topographic survey), 3D modelling and visualisation methods, contextualised and interpreted by art-historical and archaeological research. A geophysical survey, performed using a Ground Penetrating Radar (GPR), specifically aimed to confirm the presence or absence of buried features of archaeological interest at each of these sites, in particular, evidence of monastic complexes and buildings that used to surround preserved churches. This paper describes the preliminary results of this survey and some initial interpretations concerning what new information can be discerned about the now lost monastery complexes, in advance of future excavation.

We present the anaesthetic management of a parturient with myogenic differentiation-1 gene-related congenital myopathy who presented for urgent caesarean section due to pre-eclampsia and respiratory failure. The challenges we faced include chronic respiratory failure with diaphragmatic dysfunction, difficulties with neuraxial anaesthesia, potential risk of triggering malignant hyperthermia in an unknown myopathy, and the complexities of multidisciplinary team involvement. As there is limited medical literature regarding this condition, we believe this is the first case report describing the anaesthetic care of a pregnant patient with this rare congenital myopathy.

Background Infliximab (IFX) trough concentrations (Cmin) have been linked to treatment efficacy in psoriatic patients. Inter-individual IFX Cmin variability and factors influencing IFX pharmacokinetics could explain differences in treatment response. Objective To evaluate the association between IFX Cmin and clinical outcomes in psoriatic patients. Methods Prospective study of 33 patients with moderate to severe psoriasis receiving IFX at Bellvitge University Hospital, between October 2013 and November 2016. IFX Cmin and antibodies toward infliximab (ATI) were measured. Results We collected 155 IFX Cmin and ATI values (mean age, 46 (14) years; 11 (33.3%) women). Mean IFX Cmin was 2.5 (2.4) mg/L and ATIs were detected in six patients, resulting in undetectable IFX Cmin. IFX Cmin was significantly associated with ATI and body mass index (BMI) (β −2.51, 95% CI −3.56 to −1.4 and β −0.05, 95% CI −0.09 to −0.01). PASI score and PASI 90/100 response were significantly associated with IFX Cmin (IRR 0.80, 95% CI 0.70 to 0.92; OR 1.79, 95% CI 1.18 to 2.71 and OR 1.79, 95% CI 1.14 to 2.81). Conclusion IFX Cmin significantly influences PASI 90/100 response rates. IFX Cmin wa significantly associated with ATI and BMI. The observed inter-individual variability in IFX Cmin supports the need for IFX drug monitoring.

Objective Low‐dose methotrexate (LD‐MTX), a cornerstone in the treatment of rheumatoid arthritis, is associated with a moderately increased risk of anemia, leukopenia, and skin cancers, but the risks of myelosuppression and malignancy during LD‐MTX use remain incompletely described. We examined the risks of cytopenias and skin cancers among patients taking LD‐MTX versus placebo in a large randomized controlled trial (RCT). Methods We prespecified secondary analyses of a double‐blind, placebo‐controlled RCT that included adults with known cardiovascular disease and diabetes or metabolic syndrome in the United States and Canada. Subjects were randomly allocated to LD‐MTX (20 mg/week maximum) or placebo. All subjects received folic acid (1 mg daily for 6days/week). We assessed the frequency of blindly adjudicated hematologic and malignant adverse events (AEs). Results A total of 2391 subjects were randomized to LD‐MTX (mean dosage 14.9 mg/week), and 2395 were randomized to placebo. During follow‐up, in the LD‐MTX arm, simultaneous two‐line cytopenias (n = 92 [3.9%]) or pancytopenia (n = 13 [0.54%]) were infrequent. Pancytopenia developed as soon as 4 months and as late as 3.5 years after beginning LD‐MTX, though the latter subject had been recently diagnosed with multiple myeloma. Overall skin cancer risk was increased in users of LD‐MTX compared with users of placebo, which driven largely by a statistically significant increased risk of squamous cell skin cancer (hazard ratio [HR] 3.31; 95% confidence interval [CI] 1.63‐6.71). Melanoma was increased in LD‐MTX, but this was not statistically significant (HR 2.33; 95% CI 0.60‐9.01). Conclusions Among subjects using LD‐MTX, simultaneous two‐line cytopenias and pancytopenia were uncommon. We found more cases of skin cancer, particularly squamous cell carcinomas, in the LD‐MTX arm than the placebo arm.

Resumen: Objetivo: Construir un índice de privación para la asignación del presupuesto de los equipos de atención primaria de Cataluña, válido tanto para entornos urbanos como rurales y actualizable con más frecuencia que los índices construidos con las variables censales. Método: A partir de la revisión de los índices de privación más comunes se seleccionaron las variables existentes de fuentes que permiten una actualización frecuente y que son representativas del ámbito territorial de las áreas básicas de salud. Se calcularon las correlaciones entre las variables escogidas y las variables de utilización de atención sanitaria y morbilidad. Se aplicó el análisis de componentes principales. Finalmente, se calcularon las correlaciones entre el índice construido y el índice MEDEA, y con variables de utilización de recursos y morbilidad para diferentes tramos de dispersión poblacional. Resultados: Las variables de renta, ocupación y nivel de estudios son las que tienen más correlación con la utilización de atención sanitaria y la morbilidad. El índice socioeconómico compuesto (ISC) tiene un rango de −0,01 a 5,68, una media de 2,60 y una desviación estándar de 0,91. La correlación entre el ISC y el MEDEA es de 0,89. El ISC se correlaciona con la utilización de atención sanitaria tanto en los entornos urbanos como en los rurales, aunque en estos últimos la asociación es menor. Conclusiones: El ISC se ha construido con datos que permiten una actualización frecuente, y se ha integrado en el modelo de asignación de recursos de la atención primaria a partir de 2017. Abstract: Objective: To build a deprivation index for the assignation of the budgets of the primary healthcare teams in Catalonia (Spain) valid for both urban and rural environments and updatable with greater frequency than indices built from census variables. Method: Starting from a review of the most common deprivation indices, variables were selected from sources that allow frequent updating and are representative at the territorial level of primary care. The correlations were calculated between the chosen variables and variables of need for healthcare and morbidity. principal components analysis was applied. Finally, the correlations of the index built with the MEDEA index and with variables of use of healthcare resources and morbidity was calculated stratifying by geographical dispersion. Results: The variables of income, occupation and education are the ones with the highest correlation with the need for healthcare and morbidity. The composed socioeconomic index (CSI) ranges from −.01 to 5.68, with an average value of 2.60 and a standard deviation of .91. The correlation between the CSI and the MEDEA index is .89. The CSI correlates with use for healthcare in both urban and rural environments, although in rural environments the association is lower. Conclusions: The CSI was built with data that allow frequent updating and was integrated in the model for allocating resources to primary healthcare starting in 2017. Palabras clave: Índice de privación, Desigualdades en salud, Datos administrativos, Análisis de componentes principales, Financiación de la atención primaria, Keywords: Deprivation index, Health inequalities, Administrative data, Principal components analysis, Primary care financing

Efforts to locate missing persons resulting from conflict often centre of excavation. Although this approach is the only way to definitively confirm the presence of human remains, it can be costly and labour-intensive, particularly when large areas need to be searched. This paper discusses a wide range of emerging non-invasive digital methods implemented with a view to locating burials and mass graves and increase the excavation recovery rate of the Committee on Missing Persons in Cyprus (CMP). Aerial and terrestrial survey and subsequent 3D modelling were combined with geophysical survey in order to record sites, two of which were excavated to ground-truth the findings. The results demonstrated the effectiveness of these techniques in defining the search parameters of potential burial sites and prioritizing features for investigation. The nature of the collaboration between archaeologists, digital technologists, and forensic experts allowed mutual trust to be built between all parties, whilst also testing the effectiveness of the methods employed. Keywords: Forensic archaeology, Digital technologies, Geophysics, Missing persons, Ground penetrating radar, Photogrammetry

Introduction Suicide attempts represent an important public health burden. Centralised electronic health record (EHR) systems have high potential to provide suicide attempt surveillance, to inform public health action aimed at reducing risk for suicide attempt in the population, and to provide data-driven clinical decision support for suicide risk assessment across healthcare settings. To exploit this potential, we designed the Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study. Using centralised EHR data from the entire public healthcare system of Catalonia, Spain, the CSRC-Epi study aims to estimate reliable suicide attempt incidence rates, identify suicide attempt risk factors and develop validated suicide attempt risk prediction tools.Methods and analysis The CSRC-Epi study is registry-based study, specifically, a two-stage exposure-enriched nested case–control study of suicide attempts during the period 2014–2019 in Catalonia, Spain. The primary study outcome consists of first and repeat attempts during the observation period. Cases will come from a case register linked to a suicide attempt surveillance programme, which offers in-depth psychiatric evaluations to all Catalan residents who present to clinical care with any suspected risk for suicide. Predictor variables will come from centralised EHR systems representing all relevant healthcare settings. The study’s sampling frame will be constructed using population-representative administrative lists of Catalan residents. Inverse probability weights will restore representativeness of the original population. Analysis will include the calculation of age-standardised and sex-standardised suicide attempt incidence rates. Logistic regression will identify suicide attempt risk factors on the individual level (ie, relative risk) and the population level (ie, population attributable risk proportions). Machine learning techniques will be used to develop suicide attempt risk prediction tools.Ethics and dissemination This protocol is approved by the Parc de Salut Mar Clinical Research Ethics Committee (2017/7431/I). Dissemination will include peer-reviewed scientific publications, scientific reports for hospital and government authorities, and updated clinical guidelines.Trial registration number NCT04235127.

El presente artículo persigue mostrar cómo en la comunidad indígena perteneciente a la etnia timote, localizadaen el sitio conocido como Paramito Alto en el municipio Miranda del Estado Mérida, Venezuela, se mantienen patrones de comportamiento provenientes de su condición indígena que se verifican en sus creencias, en la forma en cómo viven sus espacios y los valores que les asignan como individuos, como familia y como comunidad. Es parte de un trabajo deinvestigación-acción-participación, interdisciplinario,que se desarrolló en el período 2002-2005 en el Centro de Investigaciones de la Vivienda de la Facultad de Arquitectura y Arte, de manera conjunta con las facultades del área de la Salud y Humanidades. El resultado de esta investigación permitió determinar los valores intangibles que subyacen en la comunidad, que se verifican en los principales aspectos de su vida cotidiana y su hábitat. Estudios recientes (2017) han corroborado la permanencia de estos valores.

This paper aims to propose and validate a methodology which can support forensic technicians while documenting a crime scene, after a contamination event (either accidental or deliberate) has changed its original appearance. Indeed, investigators need fast and automated tools to detect changes that occurred at a scene over time, and solutions to this problem are still an open issue. The contribution of the paper for addressing this need is twofold. First, a new methodology is introduced, that exploits panoramic images acquired with the Ricoh Theta SC camera, and 2D feature-based methods. The core idea is that SIFT features inherently contain scene information and, thanks to their good stability and invariance, can be exploited to detect possible changes that occurred at a scene surveyed with multi-temporal images. Second, in order to evaluate the performance of the proposed methodology, a reference approach is applied, based on state-of-the-art change detection algorithms (MAF/MAD), originally developed for remote sensing applications. Both methods are tested by simulating a typical crime scene, and a contamination event at the Crime Scene House (UK).

Crime scene documentation is a fundamental task which has to be undertaken in a fast, accurate and reliable way, highlighting evidence which can be further used for ensuring justice for victims and for guaranteeing the successful prosecution of perpetrators. The main focus of this paper is on the documentation of a typical crime scene and on the rapid recording of any possible contamination that could have influenced its original appearance. A 3D reconstruction of the environment is first generated by processing panoramas acquired with the low-cost Ricoh Theta 360 camera, and further analysed to highlight potentials and limits of this emerging and consumer-grade technology. Then, a methodology is proposed for the rapid recording of changes occurring between the original and the contaminated crime scene. The approach is based on an automatic 3D feature-based data registration, followed by a cloud-to-cloud distance computation, given as input the 3D point clouds generated before and after e.g. the misplacement of evidence. All the algorithms adopted for panoramas pre-processing, photogrammetric 3D reconstruction, 3D geometry registration and analysis, are presented and currently available in open-source or low-cost software solutions.

Fundamento: La medida del perímetro de la cintura como valoración indirecta de obesidad abdominal se presenta como un elemento esencial en la valoración clínica de la obesidad. El vínculo entre obesidad abdominal e insulinoresistencia se propone como el eje central de la fisiopatología del síndrome metabólico y sus complicaciones. Objetivo: Determinar si los individuos con obesidad abdominal presentan cambios relacionados con los factores que forman parte del síndrome metabólico superiores a los observados en individuos sin obesidad abdominal. Métodos: Se realizó un estudio analítico comparativo con diseño de casos y controles con dos grupos, organizados a partir de una muestra de 98 personas de ambos sexos extraída al azar del universo constituido por una población de 510 trabajadores de la Universidad de Ciencias Médicas de Cienfuegos, de septiembre a diciembre de 2005. A todos se le realizaron mediciones de la presión arterial, colesterol, HDL colesterol, glucemia en ayunas y triglicéridos. Resultados: El 30,6 % de los individuos presentó obesidad abdominal, predominando esta por encima de los 40 años y en féminas (83,3 %). El 53,3 %.de los obesos fueron hipertensos, igual porcentaje tuvo bajos valores de HDL y el 16,7 % mostró alteración de la glucemia. Conclusiones: La obesidad abdominal constituye un problema de salud en la población estudiada, incrementándose con la edad. Los individuos que presentan obesidad abdominal tienen un riesgo mayor de presentar alteraciones metabólicas, tales como bajos niveles de HDL colesterol, altos valores de triacilglicéridos y de colesterol total, así como alteraciones de la glucemia e hipertensión

El Catálogo de Acceso Público en Línea (OPAC) es un módulo del Sistema Gestor de Bibliotecas de los Servicios Bibliotecarios de la Universida d de Los Andes (Serbiula) para la consulta del fondo documental. En la medida que evolucionan las TIC, se adaptan los recursos de información ofrecidos por el OPAC: incorporando servicios para proveer fácil manejo y comprensión. Se analizaron los aspectos estructurales del OPAC de Serbiula con la finalidad de hacer mejoras en su diseño con base en indicadores en la estructura externa, el sistema de búsqueda, resultados y visualización de la búsqueda, y la gestión de los resultados; todo esto, basado en una metodología de benchmarking , utilizando un instrumento de evaluación denominado FORM50. Se obtuvo como resultado las fortalezas, (plataforma tecnológica, desarrolladores) y debilidades (búsqueda limitada, descargas, exportación, entre otras) del OPAC, lo q ue lleva a proponer la ejecución de un proyecto para las mejoras viables.

Primary ciliary dyskinesia (PCD) is an autosomal recessive rare disease caused by an alteration of ciliary structure. Immunofluorescence, consisting in the detection of the presence and distribution of cilia proteins in human respiratory cells by fluorescence, has been recently proposed as a technique to improve understanding of disease-causing genes and diagnosis rate in PCD. The objective of this study is to determine the accuracy of a panel of four fluorescently labeled antibodies (DNAH5, DNALI1, GAS8 and RSPH4A or RSPH9) as a PCD diagnostic tool in the absence of transmission electron microscopy analysis. The panel was tested in nasal brushing samples of 74 patients with clinical suspicion of PCD. Sixty-eight (91.9%) patients were evaluable for all tested antibodies. Thirty-three cases (44.6%) presented an absence or mislocation of protein in the ciliary axoneme (15 absent and 3 proximal distribution of DNAH5 in the ciliary axoneme, 3 absent DNAH5 and DNALI1, 7 absent DNALI1 and cytoplasmatic localization of GAS8, 1 absent GAS8, 3 absent RSPH9 and 1 absent RSPH4A). Fifteen patients had confirmed or highly likely PCD but normal immunofluorescence results (68.8% sensitivity and 100% specificity). In conclusion, immunofluorescence analysis is a quick, available, low-cost and reliable diagnostic test for PCD, although it cannot be used as a standalone test.

Oil spill accidents during port operations are one of the main hydrocarbon pollution threats for coastal waters. Appropriate environmental risk assessment and pollution events management tools are needed to achieve sustainability and environmental protection in port activity. Recent developments in monitoring techniques and accurate meteo-oceanographic prediction systems have been implemented in many ports, providing tools for environmental management. A novel method based on meteo-oceanographic operational services, in conjunction with Monte Carlo experiments using an oil spill model, is implemented to perform probabilistic maps of potential pollution events. Tarragona port area was chosen as the study case for three reasons: it accommodates a hub of petrochemical industry, the availability of high-resolution wind and water current data, and previous studies at the area offer the possibility to check the results’ accuracy. The interpretation of the impact probability maps reveals a specific pattern explained by the mean hydrodynamic conditions and the energetic north-westerly wind conditions. The impact probability maps may enhance efficiency in the environmental management of port waters and nearby coastal areas, reducing the negative impact of pollutant discharges.

Most drugs that act on the central nervous system (CNS) require dose titration to avoid withdrawal syndrome. Tizanidine withdrawal syndrome is caused by adrenergic discharge due to its α 2 -agonist mechanism and is characterized by hypertension, reflex tachycardia, hypertonicity, and anxiety. Although tizanidine withdrawal syndrome is mentioned as a potential side effect of cessation, it is not common and there have been few reports. We present the case of a 31-year-old woman with tizanidine withdrawal syndrome after discontinuing medication prescribed for a muscle contracture (tizanidine). She showed high adrenergic activity with nausea, vomiting, generalized tremor, dysthermia, hypertension, and tachycardia. Symptoms were reversed and successful reweaning was achieved by restarting tizanidine followed by slow downward titration. Withdrawal syndrome should be considered when drugs targeting the CNS are suddenly stopped. Weaning regimens should be closely monitored for acute withdrawal reactions.

There are different phenotypes of obstructive sleep apnoea (OSA), many of which have not been characterised. Identification of these different phenotypes is important in defining prognosis and guiding the therapeutic strategy. The aim of this study was to characterise the entire population of continuous positive airway pressure (CPAP)-treated patients in Catalonia and identify specific patient profiles using cluster analysis. A total of 72,217 CPAP-treated patients who contacted the Catalan Health System (CatSalut) during the years 2012 and 2013 were included. Six clusters were identified, classified as "Neoplastic patients" (Cluster 1, 10.4%), "Metabolic syndrome patients" (Cluster 2, 27.7%), "Asthmatic patients" (Cluster 3, 5.8%), "Musculoskeletal and joint disorder patients" (Cluster 4, 10.3%), "Patients with few comorbidities" (Cluster 5, 35.6%) and "Oldest and cardiac disease patients" (Cluster 6, 10.2%). Healthcare facility use and mortality were highest in patients from Cluster 1 and 6. Conversely, patients in Clusters 2 and 4 had low morbidity, mortality and healthcare resource use. Our findings highlight the heterogeneity of CPAP-treated patients, and suggest that OSA is associated with a different prognosis in the clusters identified. These results suggest the need for a comprehensive and individualised approach to CPAP treatment of OSA.

Recent work in human geography has begun to explore the fluidity of bodily boundaries and to foreground the connectedness of bodies to other bodies/objects/places. Across multiple subdisciplinary areas, including health, children's and feminist geographies, geographers have begun to challenge the notion of a singular, bounded body by highlighting the importance of, for example, relations of care and intergenerationality to everyday embodied experiences; remembered past/anticipated future bodies to self-perception and body image; affect/emotion to the production of embodied collectives; and connections to distant and proximate others to understandings of embodied rights and responsibility. In this paper we will review these areas of work in order to explore the ways in which this geographical work on embodied connections might contribute to recent debates concerning public health pedagogy and the production of embodied and emotional collectives in education. This will involve an analysis of the recent anti-obesity Change4Life campaign in the UK; used in this context as a way to explore how the campaign attempts to produce healthy bodies through a form of pedagogy which is centred upon notions of embodied connectivities and collectives. (Contains 1 note.)

The aims of the present study are to investigate whether and how teachers change in their observed classroom quality (emotional and instructional support, classroom organization, and students' engagement; measured with the Classroom Assessment Scoring System observation measure for secondary school [CLASS-S]; Pianta, La Paro, & Hamre, 2006) during their teacher education year and the first 2 years of professional practice, as well as the effects of personal characteristics and contextual factors on observed classroom quality. Confirmatory factor analyses (CFAs) with a reduced number of indicators per a priori construct fitted the data well. Using factor scores in 3-level multilevel models for change (376 lesson segments 20 min in duration nested within 10 time points, within 17 teachers), we found more variability over time than within lessons and the least variability between teachers. Emotional support showed an inverted U-shaped change over time, whereas classroom organization increased linearly over time. Emotional support was lower for older students, and students were more engaged in larger classes. A higher level of classroom organization during lessons was related to less variability in student engagement, but variability of instructional support was unrelated to variability of student engagement within each lesson. The findings are discussed within the context of teachers' supported transitions into professional practice. (Contains 6 tables and 2 figures.)

Fundamento: La medida del perímetro de la cintura como valoración indirecta de obesidad abdominal se presenta como un elemento esencial en la valoración clínica de la obesidad. El vínculo entre obesidad abdominal e insulinoresistencia se propone como el eje central de la fisiopatología del síndrome metabólico y sus complicaciones. Objetivo: Determinar si los individuos con obesidad abdominal presentan cambios relacionados con los factores que forman parte del síndrome metabólico superiores a los observados en individuos sin obesidad abdominal. Métodos: Se realizó un estudio analítico comparativo con diseño de casos y controles con dos grupos, organizados a partir de una muestra de 98 personas de ambos sexos extraída al azar del universo constituido por una población de 510 trabajadores de la Universidad de Ciencias Médicas de Cienfuegos, de septiembre a diciembre de 2005. A todos se le realizaron mediciones de la presión arterial, colesterol, HDL colesterol, glucemia en ayunas y triglicéridos. Resultados: El 30,6 % de los individuos presentó obesidad abdominal, predominando esta por encima de los 40 años y en féminas (83,3 %). El 53,3 %.de los obesos fueron hipertensos, igual porcentaje tuvo bajos valores de HDL y el 16,7 % mostró alteración de la glucemia. Conclusiones: La obesidad abdominal constituye un problema de salud en la población estudiada, incrementándose con la edad. Los individuos que presentan obesidad abdominal tienen un riesgo mayor de presentar alteraciones metabólicas, tales como bajos niveles de HDL colesterol, altos valores de triacilglicéridos y de colesterol total, así como alteraciones de la glucemia e hipertensión

Nuestra investigación esta dirigida a ocupar de forma sana el tiempo libre de los adolescentes de 11 a 17 años del CDR-2-Abel Santamaría ubicado en el Consejo Popular -Villa-2 ,Municipio Consolación del Sur. Se ha incrementado la disminución de esta población en actividades deportivas recreativas al surgir el periodo especial , sucedieron cambios en la vida política, económica y social de la población cubana, se hizo necesario, mantener los valores éticos de la revolución, los logros alcanzados en el deporte y la ,recreación ,están en peligro así como la pirámide deportiva ,recreativa desde la base hasta el alto rendimiento, nos dirigimos a esta localidad para localizar la muestra a investigar ejecutamos un censo de población, se aplico una observación encubierta obteniendo información de la situación actual de este problema, preferencias de actividades , relaciones sociales etc , una entrevista aplicada a los mismos, así como a sus padres facilito conocer sus criterios sobre la ocupación del tiempo libre en actividades relacionadas con el deporte y la recreación, la situación socio política ,económica, este proceso lo ejecuto un equipo de 5 investigadores se procesaron estos datos permitiendo establecer criterios de las posibles causas que pudieran dar lugar a esta situación ,así como posibilidades de seleccionar actividades que se relacionaran con el deporte y la recreación ,logrando el objetivo fundamental de nuestra revolución el bienestar de nuestra sociedad ,se diseño un conjunto de actividades deportivas recreativas para ocupar el tiempo libre que fueran preferencia de los adolescentes, lográndose con su aplicación el objetivo propuesto.

La medida del desempeño de los servicios sanitarios está recibiendo una mayor atención debido al aumento del gasto sanitario y de las expectativas de la población, y a la necesidad de obtener el máximo rendimiento de los recursos invertidos. En Cataluña, en el año 2005, aprovechando la experiencia previa de la Agència de Salut Pública de Barcelona y del Consorci Sanitari de Barcelona comparando los servicios sanitarios de Barcelona y Montreal, una beca de investigación de la Agència d'Avaluació de Tecnologia i Recerca Mèdiques, y el interés de planificación sanitaria del Departament de Salut, se puso en marcha el proyecto de análisis del desempeño de los servicios sanitarios de Cataluña. El objetivo de este artículo es presentar el desarrollo del proyecto, mostrar algunos ejemplos que ilustran el tipo de información que se ha podido obtener y el tipo de análisis que esta información permite, exponer posibles explicaciones de los resultados presentados y discutir algunas limitaciones e implicaciones. De hecho, el valor añadido de este proyecto es que permite conocer el desempeño del sistema sanitario en la consecución de sus objetivos, establecer un conjunto de indicadores homogeneizados de referencia y ser una pieza clave en el desarrollo de la Central de Resultats del Departament de Salut de la Generalitat de Catalunya.Performance assessment of healthcare services is receiving greater attention due to increasing health care expenditures, greater expectations among the population, and the need to obtain results from the invested resources. Taking advantage of the existing experience of the Agència de Salut Pública de Barcelona and the Consorci Sanitari de Barcelona, which compared the healthcare services of Barcelona and Montreal, a grant from the Agència d'Avaluació de Tecnologia i Recerca Mèdiques, and the health planning interest of the Departament de Salut, the performance assessment of the Catalan healthcare service project was started in Catalonia in 2005. This article aims to present the development of the project, to provide some examples that illustrate the kind of numerical and graphical information that could be obtained and the kind of analysis that could be performed, to provide possible explanations for the results shown, and to discuss some limitations and implications. Currently, the added value of this project is that it identifies the extent to which the healthcare system is achieving its objectives, establishes a set of homogeneous indicators that could be used in the future, and is a key tool in the development of the Central de Resultats del Departament de Salut de la Generalitat de Catalunya.

• International academia-industry teams can advance missing persons investigations. • This innovative model actively supports knowledge exchange between all involved. • Students develop key skills through an authentic learning environment. • New investigative leads are initiated, and police resources optimised. • Recommendations are made to support others seeking to adopt a similar model. In recent years, students in police academies and higher education institutions around the world have worked together to analyse cold cases including long-term missing persons cases in collaboration with investigators and prosecutors. In 2020, three European organisations, the Police Expert Network on Missing Persons (PEN-MP), AMBER Alert Europe and Locate International, succeeded in connecting these educational organisations enabling them to work collectively on cases and conduct cold case analyses (CCA) across international borders. The International Cold Case Analysis Project (ICCAP) learning objectives were to 1) collect the necessary information about the victim, 2) reconstruct the crime, and 3) investigate trace control. In a learning objective-based evaluation using Computer-Assisted Web Interviewing, 76 participating students from the German and International ICCAP teams were asked to complete a pre- and post-review questionnaire to self-assess their personal competence development. Participants reported significant increases in competence in all evaluated areas, thus demonstrating that authentic and relevant collaborations can enrich the learning environment, promote the use of professional skills, and provide significant knowledge exchange opportunities between academia and industry. Drawing on case studies of cold case missing persons' investigations and unidentified found remains, this article shares how university academics, students and community volunteers can work together nationally and internationally to find out what has happened to missing people and how we can more effectively identify the previously unidentified. In so doing, we share the expertise required to progress these cold cases and provide recommendations to support other institutions and organisations in adopting this innovative approach. [ABSTRACT FROM AUTHOR]

Como miembro del equipo de la investigación sobre Comunicación, discurso y ciudadanía, dirigida por la Dra. Sonia Luz Carrillo, en la Facultad de Letras y Ciencias Humanas de la UNMSM, indagué sobre el valor etimológico y semántico de una serie de términos, usados comúnmente en el discurso oral o escrito, en estudios o tratados sociológicos referidos a la comprensión y desarrollo de la participación ciudadana en nuestra sociedad actual. Presento a continuación, a modo de fichas de trabajo, algunos de estos vocablos cuyo significado ha pasado por un proceso de cambios, modificando -por enriquecimiento o contracción- el sentido primigenio.

El presente estudio trata de formular en forma clara las nociones sintácticas necesarias para poder comprender e interpretar textos clásicos latinos, filosóficos, históricos o literarios, indispensables en los estudios universitarios humanísticos. El estudio de la lengua latina supone la conjunción de los dos aspectos esenciales del lenguaje: su morfología (en el caso de la lengua latina, con sus declinaciones nominales, adjetivales y pronominales, así como los paradigmas de las conjugaciones verbales) y la sintaxis, es decir, las reglas características de su estructura, sus giros y sus posibilidades. En este estudio obviamos lo referente a las reglas morfológicas por considerarlas ya conocidas, y formulamos las combinaciones sintácticas de las cuatro categorías gramaticales esenciales: sustantivo, adjetivo, verbo y adverbio. Profundizamos en la función peculiar de cada una de ellas, así como sobre otras modalidades sintácticas que pueden también cumplir dichas funciones.