Universities and RIS3: the case of Catalonia and the RIS3CAT Communities Smart Specialisation Policy Brief No. 18/2016

The study allows extrapolations relevant to other EU regions and to furthering the conceptual RIS3 framework. • The EDP must be intended as continuous process that goes from priority identification to the definition and implementation of policy instruments, aimed at pursuing innovative and collaborative projects. • As such, the EDP requires the government to act as or provide a platform for stakeholders’ interaction and RIS3 implementation. RIS3CAT Communities are a good example of this new role of government and one from which other regions can take inspiration. • In RIS3 is not sufficient to engage stakeholders at the planning level. It is beneficial to consult stakeholders in the actual definition of policy instruments, in order to be able to identify potential bottlenecks and ensure that each stakeholder is well positioned to take part and contribute to the process with its resources and capabilities. • In this respect, it is important to stress that universities, SMEs and large firms, have different strengths and financial regimes. Such heterogeneity should be better exploited, without limiting cash-short actors. • Whilst the road ahead is challenging for HEIs, which face a policy environment that is changing faster than their organizational culture, universities are showing both resilience and leadership in taking up the challenge of being a key actor for local development. The RIS3 approach builds coherently on this evolution and has the potential to leverage it for the benefit of regions and local communities.JRC.J.2-Knowledge for Growt

Cysteine and Folate metabolism are targetable vulnerabilities of metastatic colorectal cancer

With most cancer-related deaths resulting from metastasis, the development of new therapeutic approaches against metastatic colorectal cancer (mCRC) is essential to increasing patient survival. The metabolic adaptations that support mCRC remain undefined and their elucidation is crucial to identify potential therapeutic targets. Here, we employed a strategy for the rational identification of targetable metabolic vulnerabilities. This strategy involved first a thorough metabolic characterisation of same-patient-derived cell lines from primary colon adenocarcinoma (SW480), its lymph node metastasis (SW620) and a liver metastatic derivative (SW620-LiM2), and second, using a novel multi-omics integration workflow, identification of metabolic vulnerabilities specific to the metastatic cell lines. We discovered that the metastatic cell lines are selectively vulnerable to the inhibition of cystine import and folate metabolism, two key pathways in redox homeostasis. Specifically, we identified the system xCT and MTHFD1 genes as potential therapeutic targets, both individually and combined, for combating mCRC

Systematic Collaborative Reanalysis of Genomic Data Improves Diagnostic Yield in Neurologic Rare Diseases

Altres ajuts: Generalitat de Catalunya, Departament de Salut; Generalitat de Catalunya, Departament d'Empresa i Coneixement i CERCA Program; Ministerio de Ciencia e Innovación; Instituto Nacional de Bioinformática; ELIXIR Implementation Studies (CNAG-CRG); Centro de Investigaciones Biomédicas en Red de Enfermedades Raras; Centro de Excelencia Severo Ochoa; European Regional Development Fund (FEDER).Many patients experiencing a rare disease remain undiagnosed even after genomic testing. Reanalysis of existing genomic data has shown to increase diagnostic yield, although there are few systematic and comprehensive reanalysis efforts that enable collaborative interpretation and future reinterpretation. The Undiagnosed Rare Disease Program of Catalonia project collated previously inconclusive good quality genomic data (panels, exomes, and genomes) and standardized phenotypic profiles from 323 families (543 individuals) with a neurologic rare disease. The data were reanalyzed systematically to identify relatedness, runs of homozygosity, consanguinity, single-nucleotide variants, insertions and deletions, and copy number variants. Data were shared and collaboratively interpreted within the consortium through a customized Genome-Phenome Analysis Platform, which also enables future data reinterpretation. Reanalysis of existing genomic data provided a diagnosis for 20.7% of the patients, including 1.8% diagnosed after the generation of additional genomic data to identify a second pathogenic heterozygous variant. Diagnostic rate was significantly higher for family-based exome/genome reanalysis compared with singleton panels. Most new diagnoses were attributable to recent gene-disease associations (50.8%), additional or improved bioinformatic analysis (19.7%), and standardized phenotyping data integrated within the Undiagnosed Rare Disease Program of Catalonia Genome-Phenome Analysis Platform functionalities (18%)

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Competencia cívica y actitudes hacia el Estado del Bienestar: La opinión pública de los ciudadanos españoles

El concepto "competencia cívica" es utilizado en la literatura -de manera similar al compromiso cívico, la ciudadanía activa, el capital social o la alfabetización cívica-, para referirse al conjunto de conocimientos, habilidades, actitudes y valores de las personas que participan activamente en la vida política y comunitaria. La relación entre las políticas de bienestar y las desigualdades en el nivel de competencia cívica de la ciudadanía no ha sido objeto habitual de la investigación académica. En el presente estudio se ha pretendido analizar en qué medida la competencia cívica de un individuo está relacionada con el nivel educativo y el estado de salud, y en qué medida la competencia cívica influye en las actitudes y expectativas de futuro hacia el Estado del Bienestar (EB), así como identificar perfiles de ciudadanos en base las variables de estudio. El marco conceptual y analítico del estudio ha incluido cinco dimensiones relacionadas con la competencia cívica: la participación en organizaciones de voluntariado, los valores cívicos, la participación política, la implicación personal hacia la política y la confianza institucional. Las actitudes hacia el EB se han medido a través de una pregunta dirigida a conocer si los ciudadanos prefieren "más impuestos y mayor gasto social" o "menos impuestos y menor gasto social". Las expectativas de futuro hacia el EB se han analizado mediante la percepción subjetiva de inseguridad socioeconómica y riesgo. Se han utilizado los datos de una encuesta sobre alfabetización cívica y sanitaria realizada por la Fundación Josep Laporte (UAB) durante los años 2010 y 2011 a una muestra de 3.000 personas de la población española. Se han utilizado modelos de regresión logística multivariable para analizar el grado de asociación entre las variables, y un análisis de correspondencias múltiples y de clústers para identificar diferentes perfiles de ciudadanos. Los resultados obtenidos muestran que un mayor grado de competencia cívica está asociado a un mayor nivel educativo y -de manera parcial- a un mejor estado de salud. Por otro lado, la actitud favorable al aumento de impuestos y mayor gasto social está asociada a un mayor nivel educativo, un buen estado de salud y un mayor grado de competencia cívica. Finalmente, una mayor percepción de inseguridad socioeconómica y riesgo en el futuro está asociada a un peor estado de salud pero no se observa, en cambio, una asociación clara con el grado de competencia cívica ni con el nivel educativo. Los resultados también han permitido elaborar una tipología de 3 grupos de ciudadanos en la que se identifica un gradiente en función de su nivel de competencia cívica. Este estudio tiene varias implicaciones para las políticas públicas. En primer lugar, los resultados sugieren la pertinencia de estrategias dirigidas a promover el desarrollo de la competencia cívica. En segundo lugar, el amplio apoyo que los ciudadanos "cívicos", con un elevado nivel educativo y un buen estado de salud, otorgan al EB aporta un elemento de reflexión en un momento en el que se apela a la corresponsabilidad personal y en un contexto de crisis económica y amplios recortes en servicios públicos como la educación y la sanidad. Finalmente, se intuye la fuerte influencia que puede tener la desconfianza institucional en la configuración de las actitudes y expectativas de futuro hacia el EB. Esta investigación señala diferentes líneas de investigación para el futuro. Entre ellas, la posible relación entre la competencia cívica y las actitudes hacia el EB, desde una perspectiva comparada -por ejemplo, en distintos modelos de EB-, y la inclusión de otras formas de confianza -como la confianza social o la confianza en instituciones privadas- en el marco conceptual de la relación entre la confianza institucional y las actitudes y expectativas de futuro hacia el EB, se apuntan como especialmente relevantes.The term "civic competence" is used in the literature, similarly as civic engagement, active citizenship, social capital or civic literacy, as the knowledge, skills, attitudes and values of those people who are actively involved in community and political life. The relationship between welfare policies and civic competence inequalities has not been a common topic in the academic research. In this study we have tried to analyze how civic competence is related to educational level and health status, and to what extent civic competence influences Welfare State (WS) attitudes and future expectations, as well as identify patterns of citizens based on the study variables. The conceptual and analytic framework of the study included five dimensions related to civic competence: participation in volunteer organizations, civic values, political participation, personal involvement in politics, and institutional trust. WS attitudes were measured by asking citizens to choose between "increased taxes and more social spending" or "decreased taxes and less social spending." Future expectations towards WS were analyzed using self-perceived socio-economic insecurity and risk. Data were obtained from the "Health and Civic Literacy" survey conducted by Josep Laporte Foundation (UAB) during 2010 and 2011 in a sample of 3.000 Spanish adult citizens. We used multivariable regression models to analyze the relationship between study variables, and a cluster analysis to identify different patterns of citizens. The results show that higher civic competence is related to higher educational level and, partially, to better health. Support to increased taxes and more social spending is associated with higher education, good health and higher civic competence. Finally, higher self-perceived socio-economic insecurity and risk in the future is clearly related to poorer health status, but not with civic competence nor with educational level. The study also shows a three group typology of citizens with remarkable differences in the level of civic competence. This study has several implications for public policies. First, the results suggest the relevance of strategies addressed to promote the development of civic competence. Second, the high support to WS of "civic" citizens with high education and good health, provides an element of reflection in the current context of calls for individual responsibility, economic crisis and broad spending cuts in public services like education and health. Finally, it points to the strong influence of institutional distrust in shaping WS attitudes and future expectations. This research provides several lines of further research. Among them, the possible relationship between civic competence and WS attitudes, from a comparative perspective -i.e., different WS models-, and the incorporation of other forms of trust -such as social trust or trust in private institutions- in the framework of the relationship between institutional trust and WS attitudes and future expectations, are noted as particularly relevant

Transcutaneous Cervical Spinal Cord Stimulation Combined with Robotic Exoskeleton Rehabilitation for the Upper Limbs in Subjects with Cervical SCI: Clinical Trial

(1) Background: Restoring arm and hand function is a priority for individuals with cervical spinal cord injury (cSCI) for independence and quality of life. Transcutaneous spinal cord stimulation (tSCS) promotes the upper extremity (UE) motor function when applied at the cervical region. The aim of the study was to determine the effects of cervical tSCS, combined with an exoskeleton, on motor strength and functionality of UE in subjects with cSCI. (2) Methods: twenty-two subjects participated in the randomized mix of parallel-group and crossover clinical trial, consisting of an intervention group (n = 15; tSCS exoskeleton) and a control group (n = 14; exoskeleton). The assessment was carried out at baseline, after the last session, and two weeks after the last session. We assessed graded redefined assessment of strength, sensibility, and prehension (GRASSP), box and block test (BBT), spinal cord independence measure III (SCIM-III), maximal voluntary contraction (MVC), ASIA impairment scale (AIS), and WhoQol-Bref; (3) Results: GRASSP, BBT, SCIM III, cylindrical grip force and AIS motor score showed significant improvement in both groups (p ≤ 0.05), however, it was significantly higher in the intervention group than the control group for GRASSP strength, and GRASSP prehension ability (p ≤ 0.05); (4) Conclusion: our findings show potential advantages of the combination of cervical tSCS with an exoskeleton to optimize the outcome for UE