Gobernanza, infraestructuras y desarrollo territorial : análisis a través de una estación de tren de alta velocidad

En las últimas décadas se han producido cambios en los modos de gobernanza local, con importantes consecuencias para la ejecución de las políticas de desarrollo local. El presente artículo analiza el proceso y las características de los agentes involucrados en el lobby de una estación del tav en Segovia y concluye que los estudios sobre desarrollo local deben considerar la creciente sofisticación de la sociedad civil local,que, organizada en redes socio-institucionales y a través de estrategias de participación complejas, incluye grupos e intereses plurales.Au cours des dernières décennies il ya eu des changements dans la gouvernance locale, avec des conséquences importantes pour la mise en oeuvre des politiques de développement local. Cet article analyse les processus et les caractéristiques des agents impliqués dans le lobby d'une gare de tgv à Segovia et conclut que les études de développement local devrait donc envisager la sophistication croissante de la société civile, qui, organisée en réseaux socio-institutionnels et à travers des stratégies de participation complexes, inclut groupes et intérêts pluriels.In the last decades there have been important changes in governance at local scale, with implications with regard to the execution of development policies. This article analyzes the process and characteristics of agents involve in the lobby of a high-speed train station in Segovia and conclude that research on local development should pay attention to the growing powers of local civil society, which, organized through socio-institutional networks and with complex participation strategies,includes plural groups and interests

La integración del ferrocarril de alta velocidad en el medio urbano. El caso de Segovia-Guiomar

La llegada del tren de alta velocidad genera oportunidades de dinamización que deben de ser ante todo concretadas a escala local. Los lugares suelen reaccionar desplegando medidas de planificación y gestión para garantizar la mejor integración de la nueva infraestructura, procurar su coherencia con el modelo territorial y el mejor aprovechamiento de la accesibilidad que genera el nuevo tren. En este artículo se estudian las medidas desarrolladas en Segovia a raíz de la implantación del tren de alta velocidad con una estación localizada en la periferia, por lo que tuvieron que desplegarse un buen número de acciones de planificación territorial y gestión de la movilidad. A través del planeamiento municipal se trata de integrar la estación y su entorno al conjunto urbano, con el desarrollo de suelo urbanizable y nueva infraestructura viaria. La gestión de la movilidad pasa inicialmente por la articulación de la estación con el centro urbano a través de servicios de autobuses coordinados con los horarios de los trenes.The arrival of the high-speed train service generates opportunities for dynamisation that particularly affects the local scale. Local scale authorities usually react by deploying planning and management resources to guarantee the best possible integration of new infrastructure in the local environment, striving to make sure that these new elements are coherent with the existing urban fabric and to maximise the level of accessibility generated by its presence. In this article, we examine the measures undertaken in Segovia and associated with the establishment of its new high-speed train station. The fact that the station was located in a peripheral area implies the need to undertake a wide range of measures to manage physical planning and maximise mobility. Municipal and territorial planning highlights the importance of infrastructure and of integrating a station and its immediate surroundings within the wider urban area. This normally entails the development of land through urban planning and additional transport infrastructure. For the present, managing mobility implies structuring the interaction between the railway station and the urban centre by coordinating bus services with train schedules.L'arrivée du train à grande vitesse crée des opportunités de dynamisation devant être concrétisées à l'échelle locale. Afin de garantir une meilleure intégration de la nouvelle infrastructure dans le milieu, cohérente avec le modèle urbain, et afin de garantir également une meilleure utilisation de l'accessibilité qui en découlera, l'environnement local a tendance à réagir avec des mesures de planification et de gestion. Dans cet article nous présentons les mesures mises en place à Ségovie. S'agissant d'un emplacement périphérique de la nouvelle gare, il a fallu mettre en place bon nombre d'actions non seulement de planification physique mais aussi de gestion de la mobilité qui sont détaillées dans le texte. L'aménagement municipal et territorial met en évidence l'importance de l'infrastructure et ce, en essayant, dans l'avenir, d'intégrer la gare dans l'ensemble urbain à travers le développement du sol urbanisable et de la construction d'une infrastructure viaire. Pour l'instant, la gestion de la mobilité passe par l'articulation de la gare avec le centre urbain grâce à un service de bus en correspondance avec les horaires des trains

Infraestructuras de transporte y territorio : los efectos estructurantes de la llegada del tren de alta velocidad en España

En los últimos años, la ampliación de la red del tren de alta velocidad en España ha generado un creciente interés tanto en el ámbito de las políticas de desarrollo urbano y territorial, como en el ámbito académico. El presente artículo se suma a estos estudios haciendo un esfuerzo por identificar elementos de reflexión que informen a las políticas públicas para maximizar las oportunidades que la infraestructura introduce. Para ello se identifican las oportunidades de dinamización, los efectos de la implantación y servicio, y finalmente, las políticas y acciones que a escala local suelen desplegarse para su máximo aprovechamiento.In recent years, the expansion of the high-speed rail network in Spain has generated a growing interest in urban and territorial development policies and in how they are analysed by academia. The present article adds to these studies by making an effort to identify policy issues that may help public bodies to maximize the opportunities that this infrastructure creates. Along these lines, the article identifies: development opportunities; the effects of providing this type of infrastructure and the services that it offers; and the policies and actions that can be implemented at the local scale in order to take the fullest advantage of the opportunities available

Genomic differentiation among varieties of Iberian pig

[EN] Aim of study: The objective of this study was to identify the autosomal genomic regions associated with genetic differentiation between three commercial strains of Iberian pig. Area of study: Extremadura (Spain). Material and methods: We used the Porcine v2 BeadChip to genotype 349 individuals from three varieties of Iberian pig (EE, Entrepelado; RR, Retinto; and TT, Torbiscal) and their crosses. After standard filtering of the Single Nucleotide Polymorphism (SNP) markers, 47, 67, and 123 haplotypic phases from EE, RR, and TT origins were identified. The allelic frequencies of 31,180 SNP markers were used to calculate the fixation index (FST) that were averaged in sliding windows of 2Mb. Main results: The results confirmed the greater genetic closeness of the EE and RR varieties, and we were able to identify several genomic regions with a divergence greater than expected. The genes present in those genomic regions were used to perform an Overrepresentation Enrichment Analysis (ORA) for the Gene Ontology (GO) terms for biological process. The ORA indicated that several groups of biological processes were overrepresented: a large group involving morphogenesis and development, and others associated with neurogenesis, cellular responses, or metabolic processes. These results were reinforced by the presence of some genes within the genomic regions that had the highest genomic differentiation. Research highlights: The genomic differentiation among varieties of the Iberian pig is heterogeneous along the genome. 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Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco region

Chagas disease, caused by the parasite Trypanosoma cruzi, is the neglected tropical disease with a highest burden in Latin America. Its acute stage is mostly asymptomatic and goes unnoticed. Symptoms appear at the chronic stage, which is when diagnosis is usually made. This is based on the agreement of two conventional serological tests such as Enzyme-Linked Immunosorbent Assays (ELISAs). There are commercial kits with good sensitivity and specificity but their use is impractical in many highly endemic regions with poorly equipped laboratories. Luckily, several rapid diagnostic tests (RDTs) are available for the detection of anti-T. cruzi immunoglobulins. They are easy to operate, require no cold storage, provide fast turnaround of results, and some can work with a tiny volume of whole blood as sample. With the aim to field validate their use we compared an alternative algorithm based on a combination of RDTs with the standard based on ELISAs. In both cases a third test was available in case of discordance. RDTs were implemented by mobile teams in field campaigns to detect chronic T. cruzi-infections in the Chaco region of Bolivia. ELISAs were made in the reference laboratories located in the main hospitals of Yacuiba and Villa Montes, two major cities of the region. We enrolled 685 subjects who voluntarily participated in the study and had not been treated against the disease before. The agreement between the two main RDTs was 93.1% (638/685) (kappa index = 0.86; CI 95% 0.83-0.90). In comparison to the ELISAs algorithm, the combined use of the RDTs provided a sensitivity of 97.7% and a specificity of 96.1%. These results support the use of RDTs for the diagnosis of chronic Chagas disease in the studied region, and encourage their evaluation in other regions of Bolivia and other endemic countries

Host age and expression of genes involved in red blood cell invasion in Plasmodium falciparum field isolates

Plasmodium falciparum proteins involved in erythrocyte invasion are main targets of acquired immunity and important vaccine candidates. We hypothesized that anti-parasite immunity acquired upon exposure would limit invasion-related gene (IRG) expression and affect the clinical impact of the infection. 11 IRG transcript levels were measured in P. falciparum isolates by RT-PCR, and IgG/IgM against invasion ligands by Luminex(R), in 50 Mozambican adults, 25 children with severe malaria (SM) and 25 with uncomplicated malaria (UM). IRG expression differences among groups and associations between IRG expression and clinical/immunologic parameters were assessed. IRG expression diversity was higher in parasites infecting children than adults (p = 0.022). eba140 and ptramp expression decreased with age (p = 0.003 and 0.007, respectively) whereas p41 expression increased (p = 0.022). pfrh5 reduction in expression was abrupt early in life. Parasite density decreased with increasing pfrh5 expression (p < 0.001) and, only in children, parasite density increased with p41 expression (p = 0.007), and decreased with eba175 (p = 0.013). Antibody responses and IRG expression were not associated. In conclusion, IRG expression is associated with age and parasite density, but not with specific antibody responses in the acute phase of infection. Our results confirm the importance of multi-antigen vaccines development to avoid parasite immune escape when tested in malaria-exposed individuals

The effects of thiopurine therapy on health-related quality of life in Inflammatory Bowel Disease patients

<p>Abstract</p> <p>Background</p> <p>The effect of thiopurine immunomodulators on health-related quality of life (HRQoL) in patients with inflammatory bowel disease (IBD) has been controversial. The aims were to evaluate the HRQoL in patients with IBD treated with thiopurines and assess the short- and long-term impacts of the treatment on HRQoL.</p> <p>Methods</p> <p>Ninety-two consecutive patients who started treatment with thiopurines were prospectively included. Evaluation of HRQoL was performed at months 0, 6, and 12 using two questionnaires, the Short-Form Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ).</p> <p>Results</p> <p>Baseline score of IBDQ was 4,6, range (2,31-6,84), with an impairment of the five dimensions of HRQoL compared with inactive patients. Results obtained in 8 dimensions of SF-36 showed worse HRQoL than Spanish general population. At 6 months patients had a significant improvement in overall IBDQ score -5,8 (1,58 -6,97)- and also in all IBDQ dimensions. All the 8 dimensions of SF-36 obtained a significant improvement. At twelve months score of IBDQ was 6,1, range (2,7-6,98), with improvement in all dimensions compared with baseline and 6 months. SF-36 showed a similar significant improvement in all subscales.</p> <p>Conclusions</p> <p>Thiopurine immunomodulators alone or with other treatments have a positive and long lasting impact on HRQoL of IBD patients.</p

Multicenter prospective clinical study to evaluate children short-term neurodevelopmental outcome in congenital heart disease (children NEURO-HEART): study protocol

Congenital heart disease; Neurodevelopment; Predictive markersCardiopatía congénita; Desarrollo neurológico; Marcadores predictivosCardiopaties congènites; Neurodesenvolupament; Marcadors predictiusBackground: Congenital heart disease (CHD) is the most prevalent congenital malformation affecting 1 in 100 newborns. While advances in early diagnosis and postnatal management have increased survival in CHD children, worrying long-term outcomes, particularly neurodevelopmental disability, have emerged as a key prognostic factor in the counseling of these pregnancies. Methods: Eligible participants are women presenting at 20 to < 37 weeks of gestation carrying a fetus with CHD. Maternal/neonatal recordings are performed at regular intervals, from the fetal period to 24 months of age, and include: placental and fetal hemodynamics, fetal brain magnetic resonance imaging (MRI), functional echocardiography, cerebral oxymetry, electroencephalography and serum neurological and cardiac biomarkers. Neurodevelopmental assessment is planned at 12 months of age using the ages and stages questionnaire (ASQ) and at 24months of age with the Bayley-III test. Target recruitment is at least 150 cases classified in three groups according to three main severe CHD groups: transposition of great arteries (TGA), Tetralogy of Fallot (TOF) and Left Ventricular Outflow Tract Obstruction (LVOTO). Discussion: The results of NEURO-HEART study will provide themost comprehensive knowledge until date of children’s neurologic prognosis in CHD and will have the potential for developing future clinical decisive tools and improving preventive strategies in CHD.RETICS funded by the PN 2018-2021 (Spain), ISCIII- Sub-Directorate General for Research Assessment and Promotion and the European Regional Development Fund (FEDER), reference RD16/002

The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe COVID-19: A pilot, double-blind, placebo-controlled, randomized clinical trial.

Background Ivermectin inhibits the replication of SARS-CoV-2 in vitro at concentrations not readily achievable with currently approved doses. There is limited evidence to support its clinical use in COVID-19 patients. We conducted a Pilot, randomized, double-blind, placebo-controlled trial to evaluate the efficacy of a single dose of ivermectin reduce the transmission of SARS-CoV-2 when administered early after disease onset. Methods Consecutive patients with non-severe COVID-19 and no risk factors for complicated disease attending the emergency room of the Clínica Universidad de Navarra between July 31, 2020 and September 11, 2020 were enrolled. All enrollments occurred within 72 h of onset of fever or cough. Patients were randomized 1:1 to receive ivermectin, 400 mcg/kg, single dose (n = 12) or placebo (n = 12). The primary outcome measure was the proportion of patients with detectable SARS-CoV-2 RNA by PCR from nasopharyngeal swab at day 7 post-treatment. The primary outcome was supported by determination of the viral load and infectivity of each sample. The differences between ivermectin and placebo were calculated using Fisher's exact test and presented as a relative risk ratio. This study is registered at ClinicalTrials.gov: NCT04390022. Findings All patients recruited completed the trial (median age, 26 [IQR 19-36 in the ivermectin and 21-44 in the controls] years; 12 [50%] women; 100% had symptoms at recruitment, 70% reported headache, 62% reported fever, 50% reported general malaise and 25% reported cough). At day 7, there was no difference in the proportion of PCR positive patients (RR 0·92, 95% CI: 0·77-1·09, p = 1·0). The ivermectin group had non-statistically significant lower viral loads at day 4 (p = 0·24 for gene E; p = 0·18 for gene N) and day 7 (p = 0·16 for gene E; p = 0·18 for gene N) post treatment as well as lower IgG titers at day 21 post treatment (p = 0·24). Patients in the ivermectin group recovered earlier from hyposmia/anosmia (76 vs 158 patient-days; p < 0.001). Interpretation Among patients with non-severe COVID-19 and no risk factors for severe disease receiving a single 400 mcg/kg dose of ivermectin within 72 h of fever or cough onset there was no difference in the proportion of PCR positives. There was however a marked reduction of self-reported anosmia/hyposmia, a reduction of cough and a tendency to lower viral loads and lower IgG titers which warrants assessment in larger trials. Funding ISGlobal, Barcelona Institute for Global Health and Clínica Universidad de Navarra