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La incorporación de actividades de trabajo en equipo en los programas de formación universitaria es esencial, ya que es una de las habilidades más valoradas para los profesionales en el campo de la ingeniería. La selección de los grupos de trabajo por parte del profesor es una estrategia que puede conducir a un mejor desempeño en las tareas colaborativas. Este estudio presenta los resultados de una investigación sobre los criterios conscientes para la selección de grupos de trabajo basados en los roles de los estudiantes. La investigación tuvo como objetivo analizar las dinámicas de trabajo en equipo entre estudiantes de diversas disciplinas dentro de los cursos de ingeniería. Se examinaron las opiniones de más de 600 estudiantes matriculados en 10 programas de grado y posgrado. Los resultados indican que los estudiantes de cursos avanzados se sienten más cómodos asumiendo el papel de líder, mientras que los estudiantes de primer año no tienen un perfil claramente definido. La evaluación de los estudiantes con esta metodología también muestra ciertas variaciones dependiendo del año y el tipo de actividad. En general, en los grupos con mejor rendimiento, la mayoría de los miembros reciben evaluaciones similares de sus compañeros. Abstract The incorporation of teamwork activities in university training programs is essential, as it is one of the most valued skills for professionals in the field of engineering. The selection of working groups by the teacher is a strategy that can lead to better performance in collaborative tasks. This study presents the results of research on the conscious selection criteria for group work based on students’ roles. The research aimed to analyze teamwork dynamics among students from various disciplines within engineering courses. The opinions of over 600 students enrolled in 10 undergraduate and postgraduate programs were examined. The results indicate that students in advanced courses feel more comfortable taking on the role of leader, while first-year students do not have a well-defined profile. The evaluation of students using this methodology also shows certain variations depending on the year and type of activity. Overall, in the highest-performing groups, most members receive similar evaluations from their peers.

Background Increased vascular CaV1.2 channel function causes enhanced arterial tone during hypertension. This is mediated by elevations in angiotensin II/protein kinase C signaling. Yet, the mechanisms underlying these changes are unclear. We hypothesize that α1C phosphorylation at serine 1928 (S1928) is a key event mediating increased CaV1.2 channel function and vascular reactivity during angiotensin II signaling and hypertension. Methods and Results The hypothesis was examined in freshly isolated mesenteric arteries and arterial myocytes from control and angiotensin II‐infused mice. Specific techniques include superresolution imaging, proximity ligation assay, patch‐clamp electrophysiology, Ca2+ imaging, pressure myography, laser speckle imaging, and blood pressure telemetry. Hierarchical “nested” and appropriate parametric or nonparametric t test and ANOVAs were used to assess statistical differences. We found that angiotensin II redistributed the CaV1.2 pore‐forming α1C subunit into larger clusters. This was correlated with elevated CaV1.2 channel activity and cooperativity, global intracellular Ca2+ and contraction of arterial myocytes, enhanced myogenic tone, and altered blood flow in wild‐type mice. These angiotensin II‐induced changes were prevented/ameliorated in cells/arteries from S1928 mutated to alanine knockin mice, which contain a negative modulation of the α1C S1928 phosphorylation site. In angiotensin II‐induced hypertension, increased α1C clustering, CaV1.2 activity and cooperativity, myogenic tone, and blood pressure in wild‐type cells/tissue/mice were averted/reduced in S1928 mutated to alanine samples. Conclusions Results suggest an essential role for α1C S1928 phosphorylation in regulating channel distribution, activity and gating modality, and vascular function during angiotensin II signaling and hypertension. Phosphorylation of this single vascular α1C amino acid could be a risk factor for hypertension that may be targeted for therapeutic intervention.

Objectives: Adherence to healthy lifestyle recommendations has been reported to improve health-related quality of life (HRQL) in breast cancer (BC) patients, but the influence of long-term behavioral changes remains unknown. We evaluated the association between adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations and HRQL both, at BC diagnosis and the change 7−12 years later. Design: Prospective cohort study. Settings and participants: A total of 406 breast cancer survivors, from the EpiGEICAM study, were recruited in 16 Spanish hospitals. Measurements: Epidemiological, clinical, dietary, physical activity and HRQL information was collected both at recruitment and 7−12 years later. A 7-item score to measure compliance with recommendations was assessed according to the 2018 WCRF/AICR scoring criteria. HRQL was evaluated using SF-36 questionnaire. Linear mixed models for longitudinal data were used to assess the cross-sectional and longitudinal association between adherence score and the physical and mental component summary scores. Results: At diagnosis, for each unit increase in WCRF/AICR score adherence, the HRQL physical domain increased 0.78 points (95%CI: −0.04 to 1.60; P trend:0.06). The mean change in physical HRQL from diagnosis to follow-up per unit increase in within-subject adherence score was 0.73 points (95%CI: −0.18 to 1.65; P trend: 0.12). For the mental domain, no association was observed with compliance with the recommendations at diagnosis, nor with changes in adherence over time. Conclusions: Our results suggest that Increased adherence to WCRF/AICR cancer prevention recommendations over time could contribute to slightly improved long-term physical HRQoL in BC survivors.

Summary: Background: Mobile health (mHealth) systems are a promising alternative for rehabilitation of hip fracture, addressing constrained healthcare resources. Half of older adults fails to recover their pre-fracture routines, which imposes a burden on caregivers. We aimed to test the effectiveness of the 3-month ActiveHip + mHealth intervention on physical and psychological outcomes of older adults with hip fracture and their family caregivers. Methods: In a multicentre open-label randomised controlled trial conducted across 3 hospitals in Andalusia (Spain), patients older than 65 with a hip fracture, who were previously independent and lacked cognitive impairment were recruited alongside with their caregivers. Participants were randomly allocated (1:1) to the intervention group (ActiveHip+) or control (usual care) group. The intervention group underwent a 12-week health education and tele-rehabilitation programme through the ActiveHip + mHealth intervention. The primary outcome, physical performance, was assessed using the Short Physical Performance Battery at three time points: at hospital discharge (baseline), 3-month after surgery (post intervention) and 1-year after surgery follow-up. Primary analyses of primary outcomes and safety data followed an intention-to-treat approach. This study is registered at ClinicalTrials.gov, NCT04859309. Findings: Between June 1st, 2021 and June 30th, 2022 data from 105 patients and their caregivers were analysed. Patients engaged in the ActiveHip + mHealth intervention (mean 7.11 points, SE 0.33) showed higher physical performance compared with patients allocated in the control group (mean 5.71 points, SE 0.32) at 3 months after surgery (mean difference in change from baseline 1.40 points, SE 0.36; puncorrected = 0.00011). These benefits were not maintained at 1-year after surgery follow-up (mean difference in change from baseline 0.19 points, SE 0.47; puncorrected = 0.68). No adverse events, including falls and refractures, were reported during the tele-rehabilitation sessions. At 3-months, the intervention group had 2 falls, compared to 4 in the control group, with no observed refractures. At the 1-year follow-up, the intervention group experienced 7 falls and 1 refracture, while the control group had 13 falls and 2 refractures. Interpretation: This study suggests that the ActiveHip + mHealth intervention may be effective for recovering physical performance in older adults with hip fracture. Importantly, the implementation of ActiveHip + into daily clinical practice may be feasible and has already been adopted in 18 hospitals, mostly in Spain but also in Belgium and Portugal. Thus, ActiveHip + could offer a promising solution when rehabilitation resources are limited. However, its dependence on caregiver support and the exclusion of participants with cognitive impairment makes it necessary to be cautious about its applicability. In addition, the non-maintenance of the effectiveness at 1-year follow-up highlights the need of refinement the ActiveHip + intervention to promote long-lasting behavioural changes. Funding: EIT Health and the Ramón y Cajal 2021 Excellence Research Grant action from the Spanish Ministry of Science and Innovation.

The crisis of neoliberalism is the crisis of the West, unable to redirect its course and threatened by internal and external contradictions. The emergence of the postmodernism has generated a new uncritical ethos that relativises Western rights and freedoms. The invasion of capitalist mercantile logic into the school, under the neoliberal paradigm, has displaced any political training from the school, contributing to contemporary cultural relativity. In the present work we will review the course of neoliberalism from its origins to the present day, and we will analyse its impact on the Western school. This journey is carried out from a critical approach. Two main consequences are detected: the substitution of knowledge by labour competences, and the promotion of a homogeneity that benefits competitiveness, but deteriorates democratic culture. We conclude with the requirement for schools to abandon relative narratives and embrace democratic values in order to improve the coexistence and the political participation.

ObjectiveTo estimate the incidence rate of tuberculosis (TB) in the Highlands (Tsotsil-Tseltal) region of Chiapas and to analyze sociodemographic factors that might influence the success of anti-TB treatment from the period of January 2019 to June 2022.MethodsRetrospective study in which the TB databases of the National Epidemiological Surveillance System (SINAVE) were analyzed. TB incidence rates were calculated based on the number of registered TB cases and estimated annual populations. The success-failure of anti-TB treatment was analyzed according to sociodemographic indicators, degree of concentration of indigenous population of the municipality of residence and admission to SINAVE.ResultsTwo hundred thirty-three cases were analyzed. The variables associated to a lower success rate of treatment against TB were: living in a municipality with high-very high concentration of indigenous population, being indigenous, having a primary school education or lower, and agricultural occupation. The number of TB diagnosed from 2020-2022 and the incidence rates from 2020-2021 decreased significantly compared to 2019.ConclusionsIt is necessary to strengthen the follow-up of TB cases in the region, mainly in areas with high-very high indigenous concentration, in people with low levels of education and engaged in agricultural work.

The past decade's development of UV LEDs has fueled significant research in water disinfection, with widespread debate surrounding the potential synergies of multiple UV wavelengths. This study analyses the use of three UV sources (265, 275, and 310 nm) on the inactivation of Escherichia coli bacteria in two water matrixes. At maximum intensity in wastewater, individual inactivation experiments in a single pass set-up (Flow rate = 2 L min−1, Residence time = 0.75 s) confirmed the 265 nm light source to be the most effective (2.2 ± 0.2 log units), while the 310 nm led to the lowest inactivation rate (0.0003 ± 7.03×10−5 log units). When a combination of the three wavelengths was used, an average log reduction of 4.4 ± 0.2 was observed in wastewater. For combinations of 265 and 275 nm, the average log reductions were similar to the sum of individual log reductions. For combinations involving the use of 310 nm, a potential synergistic effect was investigated by the use of robust statistical analysis techniques. It is concluded that combinations of 310 nm with 265 nm or 275 nm devices, in sequential and simultaneous mode, present a significant synergy at both intensities due to the emission spectra of the selected LEDs, ensuring the possibility of two inactivation mechanisms. Finally, the electrical energy per order of inactivation found the three-wavelength combination to be the most energy efficient (0.39 ± 0.05, 0.36 ± 0.01 kWh m−3, at 50% and 100% dose, respectively, in wastewater) among the synergistic combinations.

The sustainable use and protection of water resources are urgently needed. Human activity and climate change are exacerbating water-related problems and worsening the quality of riparian and wetland ecosystems, rendering them unable to provide services which are basic to human well-being and socioeconomic development. The most affected communities are those that rely on natural aquatic environments, thus suffering the worst consequences of its degradation.This is the case of the Colombian Embera indigenous people, whose populations have been forced to migrate, due to armed conflicts, to peripheral urban areas without access to safe water and sanitation. For this reason, the international cooperation project ''Baña Do Bari'' was set up to design and implement treatment wetlands (TWs) for the treatment of wastewater mainly produced in sanitary infrastructure, with the purpose of guaranteeing adequate living conditions and improved basic hygiene to indigenous communities. The sanitary infrastructure was designed collectively with the participation of the community.In this paper, the above-mentioned project is analyzed to determine if its actions can be considered Nature-based Solutions (NBS) and to identify opportunities for improvement. To this end, the IUCN Global Standard for NBS and other technical criteria were used. The main results indicate that TWs built within the ''Baña Do Bari'' project can be considered a NBS according to the technical criteria used for self-assessment. Regarding the Standard, the project strongly resolves social challenges. The criteria that could be improved are mainly related to the collection of environmental data on the biodiversity conservation status in the area.

Objective @ctivehip is a home-based multidisciplinary telerehabilitation programme for older adults with hip fracture, conducted with the assistance of their family caregivers. This programme was useful in improving their functional recovery. Nevertheless, we were concerned about how the programme might have affected caregivers, whose assistance was essential for supporting older adults in using new technologies and ensuring their safety during the exercises and activities at home. The aim of the present study was to compare the burden, psychological factors and physical fitness of the family caregivers of older adults who opted the @ctivehip telerehabilitation programme versus those family caregivers of older adults who received the face-to-face rehabilitation provided by the Andalusian Public Healthcare System (in Spain). Methods In this single-blinded, non-randomized clinical trial, participants were older adults with hip fracture and their family caregivers. The telerehabilitation group (n = 30) underwent a 12-week multidisciplinary telerehabilitation programme, and the comparative group (n = 32) received face-to-face rehabilitation. Caregivers outcomes measured were (i) the burden using the Zarit Burden Interview, (ii) the anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and (iii) the Physical Fitness with the International Fitness Scale (IFIS). Results There were not statistically significant differences on caregiver burden between family caregivers in the @ctivehip and the comparative group, although there was a trend towards lower values [[Mean (95%CI); 14.73 (9.09 to 20.37) vs 16.03 (10.63 to 21.43); p = 0.771] as well as for anxiety and depression [5.66 (3.21 to 8.78) vs 11.19 (8.52 to 13.86); p = 0.022]. Likewise achieved better, though not statistically significant, scores in physical fitness [19.37 (17.94 to 20.81) vs 17.15 (15.77 to 18.53); p = 0.055]. Conclusion Caregiver burden is not associated with telerehabilitation. In addition, telerehabilitation is associated with lower anxiety and depression levels among family caregivers who opt for this programme. Physical fitness is not related with telerehabilitation.

Reading, as complex cognitive activity, has become the focus of numerous national and international studies from a comparative perspective. This research analyses the Programme for International Student Assessment (PISA) over the last few years due to, according to the results, the low performance presented by Spanish students in reading skills. This low result is shown in the different stages analysed and it is even worse if it is considered the 2006 and 2018 reports since in those years worst results were achieved (461 and 477 points respectively). In order to do this, different factors that have an influence on reading skills are analysed. It is done a comparative and longitudinal research from 2000 to 2018 that considers all the results provided by OECD. With that data in mind and the purpose of understanding them and contextualize those factors that could rise to them, other elements are studied, such as the presence of the reading skills in the Spanish legislation, the investment made in Secondary Education, the rate of students who finish Compulsory Secondary School, as well as the evolution that school libraries have had in terms of number, uses or the participation of families and the environment in them. These aspects are analysed in a way that is compared with the reading performance obtained throughout the PISA studies. Finally, the approach of the PISA reports justifies its use as a reference for a qualitative and global understanding of the aspects that interfere with appropriate reading skills in fifteen-year-old students. This goes beyond numerical results.

Abstract Peripheral inflammatory immune responses are thought to play a major role in the pathogenesis of Parkinson’s disease (PD). The neutrophil-to-lymphocyte ratio (NLR), a biomarker of systemic inflammation, has been reported to be higher in patients with PD than in healthy controls (HCs). The present study was aimed at determining if the peripheral inflammatory immune response could be influenced by the genetic background of patients with PD. We included a discovery cohort with 222 patients with PD (132 sporadic PD, 44 LRRK2-associated PD (with p.G2019S and p.R1441G variants), and 46 GBA-associated PD), as well as 299 HCs. Demographic and clinical data were recorded. Leukocytes and their subpopulations, and the NLR were measured in peripheral blood. Multivariate lineal regression and post-hoc tests were applied to determine the differences among the groups. Subsequently, a replication study using the Parkinson’s Progression Markers Initiative cohort was performed which included 401 patients with PD (281 sPD patients, 66 LRRK2-PD patients, 54 GBA-PD patients) and a group of 174 HCs. Patients with sporadic PD and GBA-associated PD showed a significantly lower lymphocyte count, a non-significantly higher neutrophil count and a significantly higher NLR than HCs. The peripheral inflammatory immune response of patients with LRRK2-associated PD did not differ from HCs. Our study supports the involvement of a peripheral inflammatory immune response in the pathophysiology of sPD and GBA-associated PD. However, this inflammatory response was not found in LRRK2-associated PD, probably reflecting different pathogenic inflammatory mechanisms.

Abstract Background Depression is a common condition among cancer patients, across several points in the disease trajectory. Although presenting higher prevalence rates than the general population, it is often not reported or remains unnoticed. Moreover, somatic symptoms of depression are common in the oncological context and should not be dismissed as a general symptom of cancer. It becomes even more challenging to track psychological distress in the period after the treatment, where connection with the healthcare system typically becomes sporadic. The main goal of the FAITH project is to remotely identify and predict depressive symptoms in cancer survivors, based on a federated machine learning (ML) approach, towards optimization of privacy. Methods FAITH will remotely analyse depression markers, predicting their negative trends. These markers will be treated in distinct categories, namely nutrition, sleep, activity and voice, assessed in part through wearable technologies. The study will include 300 patients who have had a previous diagnosis of breast or lung cancer and will be recruited 1 to 5 years after the end of primary cancer. The study will be organized as a 12-month longitudinal prospective observational cohort study, with monthly assessments to evaluate depression symptoms and quality of life among cancer survivors. The primary endpoint is the severity of depressive symptoms as measured by the Hamilton Depression Rating Scale (Ham-D) at months 3, 6, 9 and 12. Secondary outcomes include self-reported anxiety and depression symptoms (HADS scale), and perceived quality of life (EORTC questionnaires), at baseline and monthly. Based on the predictive models gathered during the study, FAITH will also aim at further developing a conceptual federated learning framework, enabling to build machine learning models for the prediction and monitoring of depression without direct access to user’s personal data. Discussion Improvements in the objectivity of psychiatric assessment are necessary. Wearable technologies can provide potential indicators of depression and anxiety and be used for biofeedback. If the FAITH application is effective, it will provide healthcare systems with a novel and innovative method to screen depressive symptoms in oncological settings. Trial registration Trial ID: ISRCTN10423782 . Date registered: 21/03/2022.

Los sistemas de pavimento permeable son una de las técnicas de drenaje urbano sostenible mejor consideradas para la gestión sostenible de las aguas pluviales. El presente trabajo tiene como objetivos destacar y analizar las referencias internacionales y nacionales más importantes para el diseño de sistemas de pavimento permeable, llevándose a cabo una exhaustiva revisión del estado del arte de los criterios de diseño hidrológico e hidráulico, ambiental y estructural de estas estructuras, así como de las recomendaciones para su operación y mantenimiento, propuestos en las guías españolas. Innovaciones recientes desarrolladas en España, reflejan que el ajuste y la mejora del diseño de los sistemas de pavimento permeable puede ayudar a optimizar su funcionamiento. Por ejemplo, la consideración de volúmenes de gestión de lluvia adaptados a las condiciones climatológicas del lugar de instalación, la incorporación de materiales reactivos para el control de contaminantes, la elección de superficies permeables más apropiadas o la ejecución de un proceso de mantenimiento mejorado. El conocimiento generado por la investigación, apoyado con información gráfica adaptada a la normativa municipal, debe promover el desarrollo de manuales y guías de diseño, exclusivas de sistemas de pavimento permeable, adaptadas a las singularidades de cada municipio.

IntroductionHemolytic uremic syndrome (HUS) is a condition that results in acute kidney failure mainly in children, which is caused by Shiga toxin–producing Escherichia coli and inflammatory response. Although anti-inflammatory mechanisms are triggered, studies on the implication in HUS are scarce. Interleukin-10 (IL-10) regulates inflammation in vivo, and the interindividual differences in its expression are related to genetic variants. Notably, the single nucleotide polymorphism (SNP) rs1800896 −1082 (A/G), located in the IL-10 promoter, regulates cytokine expression.MethodsPlasma and peripheral blood mononuclear cells (PBMC) were collected from healthy children and HUS patients exhibiting hemolytic anemia, thrombocytopenia, and kidney damage. Monocytes identified as CD14+ cells were analyzed within PBMC by flow cytometry. IL-10 levels were quantified by ELISA, and SNP −1082 (A/G) was analyzed by allele-specific PCR.ResultsCirculating IL-10 levels were increased in HUS patients, but PBMC from these patients exhibited a lower capacity to secrete this cytokine compared with those from healthy children. Interestingly, there was a negative association between the circulating levels of IL-10 and inflammatory cytokine IL-8. We observed that circulating IL-10 levels were threefold higher in HUS patients with −1082G allele in comparison to AA genotype. Moreover, there was relative enrichment of GG/AG genotypes in HUS patients with severe kidney failure.DiscussionOur results suggest a possible contribution of SNP −1082 (A/G) to the severity of kidney failure in HUS patients that should be further evaluated in a larger cohort.

Background: Ribociclib has demonstrated a statistically significant overall survival benefit in pre- and postmenopausal patients with hormone receptor positive/human epidermal growth factor receptor 2 negative (HR+/HER2−) advanced breast cancer. New Adjuvant Trial with Ribociclib [LEE011] (NATALEE) is a trial evaluating the efficacy and safety of adjuvant ribociclib plus endocrine therapy (ET) versus ET alone in patients with HR+/HER2− early nonmetastatic breast cancer (EBC). Methods/design: NATALEE is a multicenter, randomized, open-label, Phase III trial in patients with HR+/HER2− EBC. Eligible patients include women, regardless of menopausal status, and men aged ⩾18 years. Select patients with stage IIA, stage IIB, or stage III disease (per the anatomic classification in the AJCC Cancer Staging Manual , 8th edition) with an initial diagnosis ⩽18 months prior to randomization are eligible. Patients receiving standard (neo)adjuvant ET are eligible if treatment was initiated ⩽12 months before randomization. Patients undergo 1:1 randomization to ribociclib 400 mg/day (3 weeks on/1 week off) +ET (letrozole 2.5 mg/day or anastrozole 1 mg/day [investigator’s discretion] plus goserelin [men or premenopausal women]) or ET alone. Ribociclib treatment duration is 36 months; ET treatment duration is ⩾60 months. The primary end point is invasive disease-free survival. Discussion: The 36-month treatment duration of ribociclib in NATALEE is extended compared with that in other adjuvant cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitor trials and is intended to maximize efficacy due to longer duration of CDK4/6 inhibition. Compared with the 600-mg/day dose used in advanced breast cancer, the reduced ribociclib dose used in NATALEE may improve tolerability while maintaining efficacy. NATALEE includes the broadest population of patients with HR+/HER2− EBC of any Phase III trial currently evaluating adjuvant CDK4/6 inhibitor treatment. Trial registration: ClinicalTrials.gov identifier: NCT03701334 ( https://clinicaltrials.gov/ct2/show/NCT03701334 )

Background: The phase IIIb CompLEEment-1 study evaluated ribociclib plus letrozole in patients with hormone receptor–positive (HR+), human epidermal growth factor receptor 2–negative (HER2–) advanced breast cancer (ABC). Outcomes were investigated in the following subgroups: central nervous system (CNS) metastases, prior chemotherapy for advanced disease, Eastern Cooperative Oncology Group (ECOG) performance status (PS) 2, and visceral metastases plus prior chemotherapy for advanced disease or ECOG PS 2. Patients and methods: Patients with HR+, HER2– ABC without prior hormonal treatment for advanced disease received oral ribociclib (600 mg once daily, 3 weeks on/1 week off) plus letrozole (2.5 mg once daily, continuous). Primary endpoint was safety/tolerability, assessed via occurrence of adverse events (AEs); key secondary endpoints included time to progression (TTP), overall response rate, and clinical benefit rate. Results: 51 patients had CNS metastases, 194 received prior chemotherapy for advanced disease, 112 had ECOG PS 2, 146 had visceral metastases plus prior chemotherapy, and 77 had visceral metastases plus ECOG PS 2. Safety results were consistent with those in the overall CompLEEment-1 population; no new safety concerns were identified. The AE profile was manageable with low rates of discontinuations due to AEs. TTP in patients with CNS metastases was consistent with the overall study population and shorter for other patient subgroups. Each patient subgroup achieved meaningful clinical benefit from treatment, consistent with the overall population. Conclusion: These findings confirm the clinical benefit of ribociclib plus endocrine therapy in high-risk patient subgroups of clinical interest commonly underrepresented in clinical trials.

The use of underwater recording is widely implemented across different marine ecology studies as a substitute for more invasive techniques. This is the case of the Deep Scattering Layer (DSL), a biomass-rich layer in the ocean located between 400 and 600 m deep. The data processing of underwater videos has usually been carried out manually or targets organisms above a certain size. Marine snow, or macroscopic amorphous aggregates, plays a major role in nutrient cycles and in the supply of organic material for organisms living in the deeper layers of the ocean. Marine snow, therefore, should be taken into account when estimating biomass abundance in the water column. The main objective of this project is to develop a new software application for the automatic detection and analysis of biomass abundance relative to time in underwater videos, taking into consideration small items. The application software is based on a pipeline and client-server architecture, developed in Python and using open source libraries. The software was trained with underwater videos of the DSL recorded with low-cost equipment. A usability study carried out with end-users shows satisfaction with the user-friendly interface and the expected results. The software application developed is capable of automatically detecting small items captured by underwater videos. In addition, it can be easily adapted to a web application.

The genetic variation of the European population at a macro-geographic scale follows genetic gradients which reflect main migration events. However, less is known about factors affecting mating patterns at a micro-geographic scale. In this study we have analyzed 726,718 autosomal single nucleotide variants in 435 individuals from the catalan Pyrenees covering around 200 km of a vast and abrupt region in the north of the Iberian Peninsula, for which we have information about the geographic origin of all grand-parents and parents. At a macro-geographic scale, our analyses recapitulate the genetic gradient observed in Spain. However, we also identified the presence of micro-population substructure among the sampled individuals. Such micro-population substructure does not correlate with geographic barriers such as the expected by the orography of the considered region, but by the bishoprics present in the covered geographic area. These results support that, on top of main human migrations, long ongoing socio-cultural factors have also shaped the genetic diversity observed at rural populations.

En el año 2019 se cumplieron 300 años del fallecimiento de San Juan Bautista de La Salle. Ello evoca la necesidad de revisar y valorar la trascendencia de una de las figuras de la pedagogía socio-cristiana más significativas de la historia de la educación. Este trabajo tiene como objetivo analizar la obra pedagógica y social de San Juan Bautista de la Salle, así como exponer las características que definieron la supervivencia y expansión de todo un movimiento educativo, el lasallismo, por todo el mundo. Se ha llevado a cabo una hermenéutica pedagógica de las obras primas del fundador como método de investigación, tomando también en consideración a autores destacados en el estudio del lasallismo para entender el desarrollo y presencia de la pedagogía y formas de vivir el hecho religioso de los Hermanos de las Escuelas Cristianas desde el siglo XVII hasta la actualidad. Como consecuencia de ello, asistimos a toda una obra viva en los cinco continentes que combina rasgos educativos originarios con innovaciones didácticas que representan su adaptabilidad y alcance social ante las demandas de la ciudadanía del siglo XXI.

Cardiotoxicity due to anthracyclines (CDA) affects cancer patients, but we cannot predict who may suffer from this complication. CDA is a complex trait with a polygenic component that is mainly unidentified. We propose that levels of intermediate molecular phenotypes (IMPs) in the myocardium associated with histopathological damage could explain CDA susceptibility, so variants of genes encoding these IMPs could identify patients susceptible to this complication. Thus, a genetically heterogeneous cohort of mice (n = 165) generated by backcrossing were treated with doxorubicin and docetaxel. We quantified heart fibrosis using an Ariol slide scanner and intramyocardial levels of IMPs using multiplex bead arrays and QPCR. We identified quantitative trait loci linked to IMPs (ipQTLs) and cdaQTLs via linkage analysis. In three cancer patient cohorts, CDA was quantified using echocardiography or Cardiac Magnetic Resonance. CDA behaves as a complex trait in the mouse cohort. IMP levels in the myocardium were associated with CDA. ipQTLs integrated into genetic models with cdaQTLs account for more CDA phenotypic variation than that explained by cda-QTLs alone. Allelic forms of genes encoding IMPs associated with CDA in mice, including AKT1, MAPK14, MAPK8, STAT3, CAS3, and TP53, are genetic determinants of CDA in patients. Two genetic risk scores for pediatric patients (n = 71) and women with breast cancer (n = 420) were generated using machine-learning Least Absolute Shrinkage and Selection Operator (LASSO) regression. Thus, IMPs associated with heart damage identify genetic markers of CDA risk, thereby allowing more personalized patient management.

Resumen: Objetivo: Caracterizar el tiempo en rango terapéutico (TTR) y estimar la tasa de incidencia de complicaciones (PTIRc) en adultos con protocolo de warfarina. Diseño: Cohorte retrospectiva basada en registros médicos de pacientes mayores de 18 años entre 1996 a 2016 y seguidos al menos tres meses. Emplazamiento: Unidad de Hematología de un centro especializado cardiovascular venezolano. Participantes: Registros médicos electrónicos. Mediciones principales: TTR y PTIRc. Las variables fueron: sexo, analfabetismo funcional, ocupación, international normalized ratio (INR) y tiempo de seguimiento, que fueron analizados con TTR and PTIRc mediante modelos de logística binomial y regresión de Poisson, respectivamente. Resultados: Un total de 2.770 pacientes fueron seguidos durante 1.201.380 días; el 42,3% tuvieron un TTR

Ion channels that influence membrane potential and intracellular calcium concentration control vascular smooth muscle excitability. Voltage-gated calcium channels (VGCC), transient receptor potential (TRP) channels, voltage (KV), and Ca2+-activated K+ (BK) channels are key regulators of vascular smooth muscle excitability and contractility. These channels are regulated by various signaling cues, including protein kinases and phosphatases. The effects of these ubiquitous signaling molecules often depend on the formation of macromolecular complexes that provide a platform for targeting and compartmentalizing signaling events to specific substrates. This manuscript summarizes our current understanding of specific molecular complexes involving VGCC, TRP, and KV and BK channels and their contribution to regulating vascular physiology.

Tumor interface dynamics is a complex process determined by cell proliferation and invasion to neighboring tissues. Parameters extracted from the tumor interface fluctuations allow for the characterization of the particular growth model, which could be relevant for an appropriate diagnosis and the correspondent therapeutic strategy. Previous work, based on scaling analysis of the tumor interface, demonstrated that gliomas strictly behave as it is proposed by the Family-Vicsek ansatz, which corresponds to a proliferative-invasive growth model, while for meningiomas and acoustic schwannomas, a proliferative growth model is more suitable. In the present work, other morphological and dynamical descriptors are used as a complementary view, such as surface regularity, one-dimensional fluctuations represented as ordered series and bi-dimensional fluctuations of the tumor interface. These fluctuations were analyzed by Detrended Fluctuation Analysis to determine generalized fractal dimensions. Results indicate that tumor interface fractal dimension, local roughness exponent and surface regularity are parameters that discriminate between gliomas and meningiomas/schwannomas.

BackgroundOncology clinical trials can lead to relevant financial savings in drug acquisition for healthcare providers. Considerable methodological heterogeneity is observed among previous studies estimating these savings.MethodsWe developed a methodology to estimate the economic benefit obtained from the enrollment of patients into clinical trials through the analysis of drug cost avoidance. We designed a decision algorithm to determine if a clinical trial is associated with drug cost avoidance. This algorithm is based on five scenarios according to the availability or not of standard treatment, the presence or absence of a control arm (placebo or active treatment), and the provider of the medication. We considered as reference the cost of the standard treatment that the patient would have received in routine clinical practice. We standardized drug doses and treatment durations according to the literature. Costs were considered from a National Health System perspective. We applied this methodology at a single, research-active University Hospital in 2019. A cost avoidance analysis per trial and patient was carried out on cancer patients.ResultsWe analyzed 140 trials in which 198 patients were recruited. Drug cost avoidance was found in 120 trials (85.7%). The estimated total drug cost avoidance amounted to over €3,200,000. Melanoma and genitourinary tumors were the tumor types associated with the highest cost avoidance. The average drug cost avoidance per patient was €16,245.ConclusionWe describe a standardized method to estimate drug cost avoidance in clinical trials. We have applied it to all ongoing oncology clinical trials in our center. This methodology could be valuable for other centers to analyze the potential saving of clinical trials.

Regarding human identification in armed conflicts, various complications can be observed. Usually, such difficulties can be social-related, which can include the lack of access to the relative’s genetic material, or the unwillingness of administrative and judicial authorities to participate in the process of identification. In the case of genetics, the analysis allows identifying the individual from a blood sample, a part of an organ, or from skeletal remains, which is why it is considered a much more extensive and effective method when compared with fingerprint techniques or odontology. However, several factors can prevent this identification, such as considerably degraded genetic material. For successful identification, it is mandatory to have access to antemortem biological samples unequivocally attributed to the individual in question, using recombinant nuclear markers, as well as using biological samples from close relatives, whether parents or sons. Nevertheless, the problems associated with armed conflicts make this type of study very difficult. In this article, we focus on the main difficulties encountered when identifying an individual victim of an armed conflict, as well as on the possibilities that exist and on viable measures that could be required to improve the identification of these victims.

Abstract Novel antibody-drug conjugates against HER2 are showing high activity in HER2-negative breast cancer (BC) with low HER2 expression (i.e., 1+ or 2+ and lack of ERBB2 amplification). However, the clinical and molecular features of HER2-low BC are yet to be elucidated. Here, we collected retrospective clinicopathological and PAM50 data from 3,689 patients with HER2-negative disease and made the following observations. First, the proportion of HER2-low was higher in HR-positive disease (65.4%) than triple-negative BC (TNBC, 36.6%). Second, within HR-positive disease, ERBB2 and luminal-related genes were more expressed in HER2-low than HER2 0. In contrast, no gene was found differentially expressed in TNBC according to HER2 expression. Third, within HER2-low, ERBB2 levels were higher in HR-positive disease than TNBC. Fourth, HER2-low was not associated with overall survival in HR-positive disease and TNBC. Finally, the reproducibility of HER2-low among pathologists was suboptimal. This study emphasizes the large biological heterogeneity of HER2-low BC, and the need to implement reproducible and sensitive assays to measure low HER2 expression.

Molecular mechanisms by which glucose modulates L-type Ca2+ channel activity and vascular reactivity are unclear. Here the authors report a nanocomplex orchestrated by AKAP5 that facilitates local purinergic stimulation of L-type Ca2+ channels and vasoconstriction during diabetic hyperglycemia.

La pandemia del Covid-19, causada por el virus SARS-CoV-2, ha cambiado el modus vivendi de miles de personas en todo el mundo. La excepcionalidad y la emergencia ha influido en diversos sectores y ámbitos de la vida social e institucional de los seres humanos como el sanitario, económico, político o educativo. El objetivo de este estudio es ofrecer una perspectiva internacional sobre el proceso de cierre de escuelas y sus consecuencias educativo-sociales a través de las percepciones de informantes clave. Con una muestra que alcanza 23 países y 4 continentes distintos, las percepciones se han analizado en base a siete categorías: Tiempos en la ejecución, anticipación o demora de medidas. Carácter democrático-participativo de las medidas educativas tomadas. Adaptación curricular, didáctica y metodológica. Infraestructura y recursos para una adecuada formación a distancia. Percepciones acerca del profesorado. Percepciones sobre el entorno familiar. Propuestas alternativas. Los resultados muestran una elevada diversidad de maneras de afrontar esta situación, pero con similares consecuencias para la población más vulnerable. Ello implica una llamada de atención a responsables y agentes del ámbito educativo para frenar la desigualdad educativa y social que el Covid-19 puede estar generando.

Abstract This study evaluates the impact of breast cancer (BC) in health related quality of life (HRQL) and in psychological distress (PD) during the initial phases of the disease and looks for contributing factors. A multicentric case-control study, EpiGEICAM, was carried out. Incident BC cases and age- and residence- matched controls were included. Clinical, epidemiological, HRQL (SF-36) and PD information (GHQ-28) was collected. We used multivariable logistic regression models to estimate OR of low HRQL and of PD in cases compared to controls, and to identify factors associated with low HRQL and with PD. Among 896 BC cases and 890 control women, cases had poorer scores than both, the reference population and the control group, in all SF-36 scales. BC women with lower education, younger, active workers, never smokers, those with comorbidities, in stage IV and with surgical treatment had lower physical HRQL; factors associated with low mental HRQL were dissatisfaction with social support, being current smoker and having children. Cases had a fivefold increased odds of PD compared to controls. Managing comorbidities and trying to promote social support, especially in younger and less educated women, could improve well-being of BC patients.

BackgroundCorticosteroids are the cornerstone of the treatment of patients with COVID-19 admitted to hospital. However, whether corticosteroids can prevent respiratory worsening in hospitalized COVID-19 patients without oxygen requirements is currently unknown.AimsTo assess the efficacy of methylprednisolone pulses (MPP) in hospitalized COVID-19 patients with increased levels of inflammatory markers not requiring oxygen at baseline.MethodsMulticenter, parallel, randomized, double-blind, placebo-controlled trial conducted in Spain. Patients admitted for confirmed SARS-CoV-2 pneumonia with raised inflammatory markers (C-reactive protein >60 mg/L, interleukin-6 >40 pg/ml, or ferritin >1,000 μg/L) but without respiratory failure after the first week of symptom onset were randomized to receive a 3-day course of intravenous MPP (120 mg/day) or placebo. The primary outcome was treatment failure at 14 days, a composite variable including mortality, the need for ICU admission or mechanical ventilation, and clinical worsening, this last parameter defined as a PaO2/FiO2 ratio below 300; or a 15% decrease in the PaO2 from baseline, together with an increase in inflammatory markers or radiological progression. If clinical worsening occurred, patients received tocilizumab and unmasked corticosteroids. The secondary outcomes were 28-day mortality, adverse events, need for ICU admission or high-flow oxygen, length of hospital stay, SARS-CoV-2 clearance, and changes in laboratory parameters.ResultsA total of 72 patients were randomized and 71 patients were analyzed (34 in the MPP group and 37 in the placebo group). Twenty patients presented with treatment failure (29.4 in the MPP group vs. 27.0% in the placebo group, p = 0.82), with no differences regarding the time to treatment failure between groups. There were no cases of death or mechanical ventilation requirements at 14 days post-randomization. The secondary outcomes were similar in MPP and placebo groups.ConclusionsA 3-day course of MPP after the first week of disease onset did not prevent respiratory deterioration in hospitalized COVID-19 patients with an inflammatory phenotype who did not require oxygen.

Objective To determine the health status and exercise capacity of COVID-19 survivors one year after hospital discharge. Methods This multicenter prospective study included COVID-19 survivors 12 months after hospital discharge. Participants were randomly selected from a large cohort of COVID-19 patients who had been hospitalized until 15th April 2020. They were interviewed about persistent symptoms, underwent a physical examination, chest X-ray, and a 6-minute walk test (6MWT). A multivariate analysis was performed to determine the risk factors for persistent dyspnea. Results Of the 150 patients included, 58% were male and the median age was 63 (IQR 54–72) years. About 82% reported ≥1 symptoms and 45% had not recovered their physical health. The multivariate regression analysis revealed that the female sex, chronic obstructive pulmonary disease, and smoking were independent risk factors for persistent dyspnea. Approximately 50% completed less than 80% of the theoretical distance on the 6MWT. Only 14% had an abnormal X-ray, showing mainly interstitial infiltrates. A third of them had been followed up in outpatient clinics and 6% had undergone physical rehabilitation. Conclusion Despite the high rate of survivors of the first wave of the COVID-19 pandemic with persistent symptomatology at 12 months, the follow-up and rehabilitation of these patients has been really poor. Studies focusing on the role of smoking in the persistence of COVID-19 symptoms are lacking.

Resumen: Introducción: La supervivencia de los pacientes infectados por VIH ha supuesto un aumento de las enfermedades no definitorias de sida. El objetivo de este artículo es valorar la relación entre niveles bajos de albumina al diagnóstico de la infección con la aparición de estas enfermedades. Material y método: Estudio observacional descriptivo y transversal en el que se incluye a pacientes con VIH en tratamiento. Se recogen variables demográficas, de enfermedad y presencia de enfermedades no definitorias de sida. Resultados: Se incluyó en el estudio a 382 pacientes, mayoritariamente varones (79,3%), con una edad media de 47,09 años. La enfermedad no definitoria de sida más frecuente fue la neoplasia. La presencia de hipoalbuminemia al diagnóstico se asoció con la aparición de enfermedades no definitorias de sida (p < 0,001), especialmente neoplasias y enfermedades cardiovasculares. Discusión: La albumina sérica tiene la capacidad de predecir enfermedades no relacionadas con el sida a corto y medio plazo. La presencia de hipoalbuminemia al diagnóstico se asocia con la aparición de neoplasias y enfermedades cardiovasculares. Abstract: Introduction: The survival of patients infected with HIV has increased non-AIDS-defining diseases. The aim of this article is to assess the presence of low levels of albumin at the diagnosis of infection with the onset of these diseases. Material and method: Descriptive and cross-sectional observational study in which HIV patients are included in treatment. Demographic, disease and presence of non-AIDS-defining diseases are collected. Results: The study included 382 patients, mostly males (79.3%), with an average age of 47.09 years. The most common non-defining AIDS disease is neoplasms. The presence of hypoalbuminemia at diagnosis was associated with the appearance of non-AIDS-defining diseases (P

En su estilo tardío (especialmente en las fiestas palaciegas) Calderón desarrolla un abanico de registros que alterna y entreteje para lograr que las redundancias, necesarias para el adecuado seguimiento de la trama, no provoquen el tedio. Para ejemplificar esta técnica, proponemos un análisis del inicio de Auristela y Lisidante, así como de la textura de registros con que se expresan dos acontecimientos que el autor toma de una comedia de juventud, El alcaide de sí mismo, de una factura mucho más sencilla.

Resumen La educación para el consumo desde una perspectiva crítica es un tema serio que necesita ser estudiado y trabajado por todos los miembros de la sociedad educativa. Este trabajo plantea dos objetivos. Por un lado, realizar un análisis de la sociedad actual en clave de consumo. En la actual sociedad occidental el consumo de bienes se ha convertido en un factor de integración en la sociedad y se ha consagrado como la llave para acceder al mundo de primer orden. Las lógicas del mercado de consumo se han instaurado en la educación occidental creando una pedagogía consumista. Por otro lado, se pretende justificar la necesidad de una pedagogía crítica para el consumo como modelo pedagógico dirigido a alfabetizar económicamente a niños y jóvenes mediante el fomento del pensamiento crítico y el fortalecimiento del sistema educativo público para un adecuado y equitativo desarrollo individual y social. En cuanto al método, este trabajo se ha llevado a cabo desde una perspectiva y análisis crítico de las teorías educativas y sociales que abordan el consumo y sus consecuencias para la sociedad del siglo XXI. Como resultado se presenta el planteamiento de construir y defender críticamente la escuela y la educación a través de acciones coordinadas entre el alumnado y el profesorado que logre el empoderamiento para ser críticos, reflexivos y socialmente responsables. Se concluye que educar para el consumo responsable implica el compromiso de toda la comunidad educativa para lograr un cambio social.

Entre 2014 y 2017, El Estado Islámico (Daesh) asesinó a más de 800 personas ante sus cámaras. La mayoría de los asesinados eran sirios e iraquíes de fe musulmana condenados a morir públicamente. De todas estas ejecuciones, más de la mitad contenían referencias a la cultura audiovisual occidental. Sin embargo, el éxito de la producción propagandística de la organización no sólo se reflejó en la popularidad que alcanzaron sus vídeos a escala mundial, sino también en su “eficacia icónica”, ya que a través de ella la organización fue capaz de transformar semánticamente el terrorismo y convertirlo no sólo en algo amenazante, sino también en un producto de consumo masivo que además inspiró a quienes lo consumen a crear nuevos contenidos relacionados con el Estado Islámico. De este modo, el ISIS ha conseguido configurar un eficaz discurso visual en torno a la violencia, capaz de despertar simultáneamente pasiones como el miedo o la fascinación. Entre las principales estrategias utilizadas se encuentran los recursos relacionados con la ficción, así como las técnicas para producir un “efecto de realidad”. También destaca la forma particular de representar la muerte, en la que predomina una “somática del ver morir” sobre una “somática del morir”.

Este trabajo presenta un análisis del impacto/dependencia que la prensa pedagógica ha tenido en Extremadura. Desde un marco metodológico de corte cualitativo, se ha utilizado el método histórico-pedagógico y la técnica de fichado para llevar a cabo un vaciado de diversas fuentes que ha permitido construir una imagen completa de la prensa pedagógica en Extremadura, desde sus inicios en 1858 hasta finales del siglo XX. Ello ha dado como resultado un conocimiento del número, tipología, distribución, alcance, longevidad, agentes y fines de los diferentes periódicos, boletines y revistas; así como un análisis de los factores de impacto educativo, cultural y social y las cotas de dependencia de la prensa con el contexto extremeño. Se concluye que la prensa pedagógica sirvió de canal para hacer visible múltiples demandas de actores educativos, de instrumento de renovación pedagógica y de vehículo de cohesión comunitaria. Sin embargo, también estuvo moldeada por condicionantes económicos, ideológicos, y políticos que determinaron su esencia, cambios y supervivencia a lo largo de las décadas.

Abstract Background Major mental disorders in prison populations have been recognised as a long-term problem with an important impact on public health. Despite this, screening activities in prisons are still weak in Latin America. We proposed to estimate the prevalence of depression and psychosis and associated factors in the largest Ecuadorian prison for male inmates. Methods Cross-sectional study with 309 prisoners chosen at random between January and February 2017, who were administered two structured questionnaires. The first examined socio-demographic and occupational characteristics prior to incarceration and presence of social support networks; the second was the Mini International Neuropsychiatric Interview version in Spanish 5.0.0. We used maximum likelihood tests and multiple logistic regression to assess associations between depression, psychosis and study factors. Results The prevalence of depression and psychosis were 50.2% (95% CI 44.6–55.8) and 25.9% (95% CI 21.0–30.8), respectively. The two conditions occurred together in 22.0% of the cases (95% CI 14.8–29.2), and depression or psychosis (D/P) was found in 54.0% (95% CI 48.4–59.6). Consuming drugs while in prison was found in 41.4% (95% CI 35.9–46.9). When age was considered among those consuming drugs, the prevalence of D/P were 72.2, 88.0, and 92.3%, respectively for the age-groups 18–29, 30–39 and 40 years or over (p-value

We investigated which determinants (socioeconomic, early life factors, body composition changes, fitness changes and/or physical activity changes) best predicted longitudinal outcomes in cardiometabolic risk profile (Z-score change) in adolescents with OW/OB who underwent a 13-month multidisciplinary lifestyle intervention. A total of 165 adolescents (13–16 y; 46% boys) from the EVASYON study were included. Socioeconomic variables and early life factors were obtained from the medical records. Body composition was assessed using anthropometry. Fitness and physical activity were measured with field-based tests and questionnaires. Cardiometabolic risk factors (fasting glucose, HDL cholesterol, triglycerides, blood pressure and waist circumference) were derived from standard methods in the hospital. Body weight changes, sex and mother’s education were selected in the stepwise process as the most important determinants of changes in cardiometabolic risk profile (R2 = 0.26, p = 0.002; R2 = 0.14, p = 0.013; and R2 = 0.14, p = 0.017, respectively). Both boys and girls showed a lower cardiometabolic risk score with the reduction in body weight (r = 0.535, p = 0.009 and r = 0.506, p = 0.005, respectively). There was no interaction between sex and body weight change (p = 0.614). In conclusion, the simple measure of changes in body weight should be considered to track changes in cardiometabolic risk profile in adolescents with OW/OB.

Resumen: La cetoacidosis diabética es una complicación de la diabetes mellitus que se da con más frecuencia en pacientescon DM tipo 1. Los factores desencadenantes pueden ser desde falta de adherencia al tratamiento a infecciones,siendo estas últimas las más frecuentes. Sin embargo, en ocasiones, detrás de esta situación subyacen problemasneoplásicos. La DM se asocia con diversas neoplasias, entre las que destaca, la neoplasia de páncreas. Abstract: Diabetic ketoacidosis is a complication of diabetes mellitus that occurs more frequently in patients with Type1 Diabetes Mellitus. The triggers can be from lack of adherence to treatment to infections, the latter beingthe most frequent. However, sometimes behind this situation lie neoplastic problems. DM is associated withvarious neoplasms, among which, the pancreatic neoplasm stands out. Palabras clave: Cetoacidosis diabética, Cáncer de páncreas, Keywords: Diabetic ketoacidosis: Pancreatic cancer

BackgroundThere are limited published data on factors related to risky sexual practices (RSP) affecting sexually transmitted infections (STIs) among female sex workers (FSWs) in Ecuador.MethodsCross-sectional study of FSWs presenting for a consultation in a primary health care centre during 2017. A questionnaire was administered to collect information on RSP and potential risk factors including age, membership of an FSW association, self-report of previous STI diagnosis, previous treatment for suspected STI and temporary migration for sex work. Associations between RSP and potential risk factors were estimated by logistic regression. The proportion of STI was estimated from vaginal swabs by real-time PCR for four sexually transmitted pathogens (Neisseria gonorrhoeae, Trichomonas vaginalis, Chlamydia trachomatis, and Mycoplasma genitalium).ResultsOf 249 FSWs recruited, 22.5% had reported RSPs at least once during sex work. Among FSWs reporting unprotected vaginal sex in the previous three months, 25.5% had at least one other RSP type. 17.6% (95%CI 13.3-22.8) had at least one active STI. Prevalence of co-infections was 2.4% (95%CI 1.1-5.2). In multivariable analysis, RSP was associated with age (adjusted OR 1.06; 95%CI 1.02-1.10), membership of an FSWs association (aOR 3.51; 95%CI 1.60-7.72) and self-reported previous STI (aOR 3.43; 95%CI 1.28-9.17).ConclusionsAmong a population of female sex workers with high proportion of STIs, increasing age and belonging to an FSWs association was associated with a higher likelihood of engaging in RSP with clients. Engaging with FSWs organisations may reduce the burden of STI among sex workers.

Aim of study: To evaluate the changes in Spanish agricultural production since 1950s in a context of intense transformations in terms of the regional and crop composition. Area of study: Spanish provinces during the second half of the twentieth century. Material and methods: We use index decomposition analysis to evaluate the changes in the value and volume of crop production, as well as the role of product composition and the regional distribution of production. Main results: Spanish agriculture have focused on certain regions in the south or in the east of Spain. Some products like vegetables or fruits have a positive prices and composition effects, encouraging the production in these provinces. Research highlights: We found a ‘double concentration’: Spanish agriculture has increasingly tended to produce high value-added products, such as vegetables, fruit and olive oil. On the other hand, crop production is concentrated in the southern and eastern provinces of Spain.

Background: Cancer patients represent a vulnerable population for COVID-19 illness. We aimed to analyze outcomes of lung cancer patients affected by COVID-19 in a tertiary hospital of a high-incidence region during the pandemic.Methods: We annotated 23 lung cancer patients consecutively diagnosed with COVID-19 at our institution (HGUGM; Madrid, Spain) between March 4th, 2020 and May 12th, 2020. Only patients with a confirmatory SARS-CoV-2 RT-PCR were included in the study.Results: All patients had at least 1 COVID-19 related symptom; cough (48%), shortness of breath (48%), fever (39%), and low-grade fever (30%) were the most common. Time from symptoms onset to first positive SARS-CoV-2 PCR was 5.5 days (range 1–17), with 13% of cases needed from a 2nd PCR to confirm diagnosis. There was a high variability on thoracic imaging findings, with multilobar pneumonia as the most commonly found pattern (74%). Main lab test abnormalities were low lymphocytes count (87%), high neutrophil to lymphocyte ratio -NLR- (78%), and elevated inflammatory markers: fibrinogen (91%), c-reactive protein -CRP- (87%), and D-dimer (70%). In our series, hospitalization rate was 74%, 39% of patients developed acute respiratory distress syndrome (ARDS), and the case-fatality rate was 35% (8/23). 87% of patients received anti-viral treatment (87% hydroxychloroquine, 74% lopinavir/ritonavir, 13% azithromycin), 43% corticosteroids, 26% interferon-β, 4% tocilizumab, and 82% of hospitalized patients received anticoagulation. High-oxygen requirements were needed in 39% of patients, but only 1 pt was admitted for invasive MV and was discharged 42 days after admission. Multiple variables related to tumor status, clinical baseline conditions, and inflammation markers were associated with mortality but did not remain statistically significant in a multivariate model. In patients with lung cancer receiving systemic therapy (n = 242) incidence and mortality from COVID-19 were 4.5, and 2.1%, respectively, with no differences found by type of treatment.Conclusions: Lung cancer patients represent a vulnerable population for COVID-19, according to the high rate of hospitalization, onset of ARDS, and high mortality rate. Although larger series are needed, no differences in mortality were found by type of cancer treatment. Measures to minimize the risk of SARS-CoV-2 infection remain key to protect lung cancer patients.

Objetivo: Estimar la probabilidad de hallazgo de hígado graso (PHG) en reportes de ecografía clínica abdominal (ECA), global y estratificado por motivo ecográfico en función del sexo y edad en pacientes que requirieron esta prueba. Métodos: Diseño transversal efectuado en registros ecográficos de pacientes mayores de 18 años con indicación de ecografía de abdomen, efectuado en 2016. Los reportes proceden de un centro ecuatoriano de Imagenología en un hospital docente de segundo nivel. A través de regresión logística se calculó la PHG en función de los motivos del examen, tanto en el global como estratificado por sexo. Resultados: Se incluyeron 774 registros. La edad estuvo entre 18 y 98 años (promedio 48 años; DT16,6). La PHG global fue 33.6% (95% CI 30.3-36.9), en hombres que tuvieron una ECA por control rutinario fue 15,4% y en mujeres por neoplasias fue 10,7%. En todos los casos hubo un incremento de la PHG conforme incrementa la edad. Conclusiones: La PHG en ECA descrita por motivo de realización del examen, sexo y edad aporta nueva información a los equipos médicos multidisciplinarios, así como para los estudios epidemiológicos – radiológicos.

Despite its reduced sensitivity, sputum smear microscopy (SSM) remains the main diagnostic test for detecting tuberculosis in many parts of the world. A new diagnostic technique, the magnetic nanoparticle-based colorimetric biosensing assay (NCBA) was optimized by evaluating different concentrations of glycan-functionalized magnetic nanoparticles (GMNP) and Tween 80 to improve the acid-fast bacilli (AFB) count. Comparative analysis was performed on 225 sputum smears: 30 with SSM, 107 with NCBA at different GMNP concentrations, and 88 with NCBA-Tween 80 at various concentrations and incubation times. AFB quantification was performed by adding the total number of AFB in all fields per smear and classified according to standard guidelines (scanty, 1+, 2+ and 3+). Smears by NCBA with low GMNP concentrations (≤1.5 mg/mL) showed higher AFB quantification compared to SSM. Cell enrichment of sputum samples by combining NCBA-GMNP, incubated with Tween 80 (5%) for three minutes, improved capture efficiency and increased AFB detection up to 445% over SSM. NCBA with Tween 80 offers the opportunity to improve TB diagnostics, mainly in paucibacillary cases. As this method provides biosafety with a simple and inexpensive methodology that obtains results in a short time, it might be considered as a point-of-care TB diagnostic method in regions where resources are limited.

Stromal cell recruitment, activation and crosstalk with cancer cells is poorly understood. Here, the authors demonstrate that cancer cell-derived Hedgehog ligand triggers stromal remodeling that in turn induces a cancer-stem-cell like, drug-resistant phenotype of nearby cancer cells while treatment with smoothened inhibitors reverses these phenotypes.

Algunas de las colecciones que custodia el actual Museo Arqueológico Municipal de Cartagena derivan del siglo xvi, fecha en la que algunos eruditos mostraron fascinación por custodiar las antigüedades de la ciudad, un encanto que se mantuvo durante siglos siguientes. Estos hechos nos sirven de marco para este trabajo donde queremos esbozar una breve historia del Museo.

Toda obra de arte cuya recepción tenga lugar en el tiempo (la música, la literatura, el cine, etc.) experimenta la exigencia de ordenar de algún modo ciertos elementos en él: es posible analizar esa disposición (y no necesariamente atendiendo a su relación con el otro tiempo, virtual, de la ficción). Entre los géneros literarios, el teatro impone a las obras una limitada extensión y claridad en la expresión de las pretensiones, lo que facilita su detección. Proponemos ejemplificar con dos comedias de Calderón una propuesta metodológica para describir la distribución de conflictos en el tiempo escénico.

A/B testing is used in digital contexts both to offer a more personalized service and to optimize the e-commerce purchasing process. A personalized service provides customers with the fastest possible access to the contents that they are most likely to use. An optimized e-commerce purchasing process reduces customer effort during online purchasing and assures that the largest possible number of customers place their order. The most widespread A/B testing method is to implement the equivalent of RCT (randomized controlled trials). Recently, however, some companies and solutions have addressed this experimentation process as a multi-armed bandit (MAB). This is known in the A/B testing market as dynamic traffic distribution. A complementary technique used to optimize the performance of A/B testing is to improve the experiment stopping criterion. In this paper, we propose an adaptation of A/B testing to account for possibilistic reward (PR) methods, together with the definition of a new stopping criterion also based on PR methods to be used for both classical A/B testing and A/B testing based on MAB algorithms. A comparative numerical analysis based on the simulation of real scenarios is used to analyze the performance of the proposed adaptations in both Bernoulli and non-Bernoulli environments. In this analysis, we show that the possibilistic reward method PR3 produced the lowest mean cumulative regret in non-Bernoulli environments, which proved to have a high confidence level and be highly stable as demonstrated by low standard deviation measures. PR3 behaves exactly the same as Thompson sampling in Bernoulli environments. The conclusion is that PR3 can be used efficiently in both environments in combination with the value remaining stopping criterion in Bernoulli environments and the PR3 bounds stopping criterion for non-Bernoulli environments.