L’hipogeu funerari de la Sagrera (Barcelona) Resultats preliminars

L’objectiu d’aquest estudi és presentar un avanç dels resultats obtinguts durant l’excavació arqueològica preventiva efectuada a l’hipogeu funerari de la Sagrera. Es tracta d’un hipogeu del neo- lític final que ha estat considerat com a excepcional dins l’àmbit de l’arqueologia catalana. Una excepcionalitat que ve donada tant pel seu estat de conservació com pel nombre d’individus enterrats (207 individus, a manca de l’estudi antropològic) com, sobretot, per la dinàmica de funcionament. A l’interior de la cambra sepulcral s’han pogut distingir dos grans moments d’ús. L’ús primigeni de l’hipogeu es caracteritza per una sèrie d’enterraments successius, reordenacions i arranjaments de l’espai que es tradueixen en acumulacions en posició secundària. En un moment donat, però, aquesta dinàmica d’ús es trenca sobtadament i és succeïda per un enterrament massiu i simultani. L’aparent absència de signes de violència així com la manca absoluta d’artefactes en aquest segon nivell ens porta a descartar el fet bèl·lic com a element explicatiu d’un enterrament d’aquestes característiques. Hipotetitzem, per tant, un fet traumàtic, tipus epidèmic, com a origen més probable d'aquest dipòsit

Sex as a Prognostic Factor in Systematic Reviews: Challenges and Lessons Learned

Sex is a common baseline factor collected in studies that has the potential to be a prognostic factor (PF) in several clinical areas. In recent years, research on sex as a PF has increased; however, this influx of new studies frequently shows conflicting results across the same treatment or disease state. Thus, systematic reviews (SRs) addressing sex as a PF may help us to better understand diseases and further personalize healthcare. We wrote this article to offer insights into the challenges we encountered when conducting SRs on sex as a PF and suggestions on how to overcome these obstacles, regardless of the clinical domain. When carrying out a PF SR with sex as the index factor, it is important to keep in mind the modifications that must be made in various SR stages, such as modifying the PF section of CHARMS-PF, adjusting certain sections of QUIPS and extracting data on the sex and gender terms used throughout the studies. In this paper, we provide an overview of the lessons learned from carrying out our reviews on sex as a PF in different disciplines and now call on researchers, funding agencies and journals to realize the importance of studying sex as a PF.Instituto de Salud Carlos III (Plan Estatal de I + D + i 2013–2016)European Development Regional Fund. “A way to achieve Europe” (ERDF) grant number PIE16/0005

Perturbaciones tropicales en el Atlántico norte suroriental. Estado de la cuestión y perspectivas de futuro

This study analyzes tropical disturbances in a region usually not affected by these events, the southeastern North Atlantic. This is an extensive area between Macaronesia and the coasts of northwest Africa and the southwest of the Iberian Peninsula. In the context of climate change, a statistical analysis has been conducted of the main database of the National Hurricane Center for the Atlantic basin, as well as a bibliographical compilation, in order to analyze the temporal and spatial evolution of these phenomena. The starting hypothesis is to verify the existence of an increase in the risk of these situations in the region of study, through research that characterizes and charts these phenomena. The results indicate that, although with long periods of recurrence, some events with notable impacts had occurred before the first systematic records were kept. In addition, over the last fifty years, a much more reliable period from a scientific perspective, there has been an increase in their number, especially in recent decades. Furthermore, an approximate estimate is made of the population likely to be affected by tropical disturbances, which estimates that more than twenty million people are at risk.Se presenta un estudio sobre las perturbaciones tropicales en una región habitualmente no afectada por estos eventos, el Atlántico norte suroriental. Se trata de una extensa área entre la Macaronesia y las costas del noroeste de África y suroeste de la península ibérica. En el contexto del cambio climático se hace un análisis estadístico de la principal base de datos del National Hurricane Center para la cuenca atlántica, así como una recopilación bibliográfica, con el fin de analizar la evolución temporal y espacial de estos fenómenos. La hipótesis de partida es comprobar la existencia de un incremento en el riesgo de estas situaciones en la región de análisis, para lo que se elabora un estudio que las caracteriza y contabiliza. Los resultados señalan que, aunque con periodos de recurrencia largos, se han dado algunos eventos con destacados impactos antes del comienzo sistemático de su registro. Además, en los últimos 50 años, periodo mucho más fiable desde una perspectiva científica, se constata un aumento en su número, especialmente en las últimas décadas. Asimismo, se hace una aproximación a la población susceptible de ser afectada por las perturbaciones tropicales, la cual se estima en más de 20 millones de personas en riesgo.This research is part of the research project “MYRIAD-EU: Multi-hazard and sYstemic framework for enhancing Risk-Informed mAnagement and Decision-making in the EU”

Lack of sex-related analysis and reporting in Cochrane Reviews : a cross-sectional study

Background: Sex-specific analysis and reporting may allow a better understanding of intervention effects and can support the decision-making process. Well-conducted systematic reviews (SRs), like those carried out by the Cochrane Collaboration, provide clinical responses transparently and stress gaps of knowledge. This study aimed to describe the extent to which sex is analysed and reported in a cross-section of Cochrane SRs of interventions, and assess the association with the gender of main authorships. Methods: We searched SRs published during 2018 within the Cochrane Database of Systematic Reviews. An investigator appraised the sex-related analysis and reporting across sections of SRs and collected data on gender and country of affiliation of the review first and last authors, and a second checked for accuracy. We conducted descriptive statistics and bivariate logistic regression to explore the association between the gender of the authors and sex-related analysis and reporting. Results: Six hundred and ten Cochrane SRs were identified. After removing those that met no eligibility criteria, 516 reviews of interventions were included. Fifty-six reviews included sex-related reporting in the abstract, 90 considered sex in their design, 380 provided sex-disaggregated descriptive data, 142 reported main outcomes or performed subgroup analyses by sex, and 76 discussed the potential impact of sex or the lack of such on the interpretations of findings. Women represented 53.1 and 42.2% of first and last authorships, respectively. Women authors (in first and last position) had a higher possibility to report sex in at least one of the review sections (OR 2.05; CI 95% 1.12-3.75, P=0.020) than having none. Conclusions: Sex consideration amongst Cochrane SRs was frequently missing. Structured guidance to sex-related analysis and reporting is needed to enhance the external validity of findings. Likewise, including gender diversity within the research workforce and relevant authorship positions may foster equity in the evidence generated

Improving social justice in COVID-19 health research: Interim guidelines for reporting health equity in observational studies

The COVID-19 pandemic has highlighted the global imperative to address health inequities. Observational studies are a valuable source of evidence for real-world effects and impacts of implementing COVID-19 policies on the redistribution of inequities. We assembled a diverse global multi-disciplinary team to develop interim guidance for improving transparency in reporting health equity in COVID-19 observational studies. We identified 14 areas in the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist that need additional detail to encourage transparent reporting of health equity. We searched for examples of COVID-19 observational studies that analysed and reported health equity analysis across one or more social determinants of health. We engaged with Indigenous stakeholders and others groups experiencing health inequities to co-produce this guidance and to bring an intersectional lens. Taking health equity and social determinants of health into account contributes to the clinical and epidemiological understanding of the disease, identifying specific needs and supporting decision-making processes. Stakeholders are encouraged to consider using this guidance on observational research to help provide evidence to close the inequitable gaps in health outcomes

Differences in job satisfaction and stress among self-employed people and employees

Recepción: 20 de mayo de 2016 | Revisión: 21 de mayo de 2016 | Aceptado: 30 de mayo de 2016Correspondencia: [email protected] esta investigación se ha pretendido buscar las posibles diferencias existentes en la satisfacción y el estrés laboral entre los trabajadores autónomos y los trabajadores por cuenta ajena. Para llevar esto a cabo se han utilizado dos cuestionarios a partir de los cuales se han obtenido los datos para su posterior análisis. A la vista de los resultados, se ha hallado una correlación negativa entre la satisfacción y el estrés laboral. Sin embargo, no se han encontrado evidencias de que los trabajadores autónomos tengan mayores niveles de satisfacción laboral y menores de estrés en el trabajo.The aim of this research study was to determine the possible existence of differences in job satisfaction and stress among self-employed people and employees. In order to do so two questionnaires were used from which we obtained all the data for the subsequent analysis. In the light of the results a negative correlation between the two aforementioned variables was found. However, no evidence was found concerning self-employed people having higher job satisfaction levels and lower levels of stress.Universidad de Granada. Departamento de Psicología Social. Proyecto de Innovación Docente ReiDoCre

Sex as a prognostic factor for mortality in critically ill adults with sepsis: a systematic review and meta-analysis.

Objective To assess the role of sex as an independent prognostic factor for mortality in patients with sepsis admitted to intensive care units (ICUs). Design Systematic review and meta-analysis. Data sources MEDLINE, Embase, Web of Science, ClinicalTrials. gov and the WHO Clinical Trials Registry from inception to 17 July 2020. Study selection Studies evaluating independent associations between sex and mortality in critically ill adults with sepsis controlling for at least one of five core covariate domains prespecified following a literature search and consensus among experts. Data extraction and synthesis Two authors independently extracted and assessed the risk of bias using Quality In Prognosis Studies tool. Meta-analysis was performed by pooling adjusted estimates. The Grades of Recommendations, Assessment, Development and Evaluation approach was used to rate the certainty of evidence. Results From 14 304 records, 13 studies (80 520 participants) were included. Meta-analysis did not find sex-based differences in all-cause hospital mortality (OR 1.02, 95% CI 0.79 to 1.32; very low-certainty evidence) and all-cause ICU mortality (OR 1.19, 95% CI 0.79 to 1.78; very low-certainty evidence). However, females presented higher 28-day all-cause mortality (OR 1.18, 95% CI 1.05 to 1.32; very low-certainty evidence) and lower 1-year all-cause mortality (OR 0.83, 95% CI 0.68 to 0.98; low-certainty evidence). There was a moderate risk of bias in the domain adjustment for other prognostic factors in six studies, and the certainty of evidence was further affected by inconsistency and imprecision. Conclusion The prognostic independent effect of sex on all-cause hospital mortality, 28-day all-cause mortality and all-cause ICU mortality for critically ill adults with sepsis was uncertain. Female sex may be associated with decreased 1-year all-cause mortality.post-print1281 K

Systemic Oncological Treatments versus Supportive Care for Patients with Advanced Hepatobiliary Cancers : An Overview of Systematic Reviews

Altres ajuts: This study is funded through a grant from Instituto de Salud Carlos III (PI18/00034), co-financed by funds from the European Regional Development Fund.Hepatobiliary cancers (that include hepatocellular carcinoma, intrahepatic or extrahepatic cholangiocarcinoma and gallbladder cancer) are usually treated with systemic oncological treatments (i.e., chemotherapy, immunotherapy and biological or targeted therapies) mainly due to their improvement in survival. However, the trade-off between these therapies and usual practice supportive care is not clear, and other outcomes beyond survival should be considered in advanced stages, such as quality of life or symptom control. The present study is part of a wider project aiming to conduct broad evidence syntheses assessing the effects of systemic oncological treatments versus usual practice supportive care for patients with advanced non-intestinal digestive cancers. We performed an overview of systematic reviews assessing the effects of systemic oncological treatments versus usual practice supportive care for patients with primary advanced hepatobiliary cancer. We found evidence that for these patients (specifically for advanced hepatocellular carcinoma), systemic oncological treatments tend to improve survival at the expense of greater toxicity. Much of systematic reviews included was of low quality and highly overlapped. Nevertheless, the evidence we found failed to report other important outcomes that could be critical for decision making, including quality of life or symptom control. Future research assessing these patient-important outcomes is needed. Background: The trade-off between systemic oncological treatments (SOTs) and UPSC in patients with primary advanced hepatobiliary cancers (HBCs) is not clear in terms of patient-centred outcomes beyond survival. This overview aims to assess the effectiveness of SOTs (chemotherapy, immunotherapy and targeted/biological therapies) versus UPSC in advanced HBCs. Methods: We searched for systematic reviews (SRs) in PubMed, EMBASE, the Cochrane Library, Epistemonikos and PROSPERO. Two authors assessed eligibility independently and performed data extraction. We estimated the quality of SRs and the overlap of primary studies, performed de novo meta-analyses and assessed the certainty of evidence for each outcome. Results: We included 18 SRs, most of which were of low quality and highly overlapped. For advanced hepatocellular carcinoma, SOTs showed better overall survival (HR = 0.62, 95% CI 0.55-0.77, high certainty for first-line therapy; HR = 0.85, 95% CI 0.79-0.92, moderate certainty for second-line therapy) with higher toxicity (RR = 1.18, 95% CI 0.87-1.60, very low certainty for first-line therapy; RR = 1.58, 95% CI 1.28-1.96, low certainty for second-line therapy). Survival was also better for SOTs in advanced gallbladder cancer. No outcomes beyond survival and toxicity could be meta-analysed. Conclusion: SOTs in advanced HBCs tend to improve survival at the expense of greater toxicity. Future research should inform other patient-important outcomes to guide clinical decision making

Improving Social Justice in COVID-19 Health Research: Interim guidelines for reporting health equity in observational studies

The COVID-19 pandemic has highlighted the global imperative to address health inequities. Observational studies are a valuable source of evidence for real-world effects and impacts of implementing COVID-19 policies on the redistribution of inequities. We assembled a diverse global multi-disciplinary team to develop interim guidance for improving transparency in reporting health equity in COVID-19 observational studies. We identified 14 areas in the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist that need additional detail to encourage transparent reporting of health equity. We searched for examples of COVID-19 observational studies that analysed and reported health equity analysis across one or more social determinants of health. We engaged with Indigenous stakeholders and others groups experiencing health inequities to co-produce this guidance and to bring an intersectional lens. Taking health equity and social determinants of health into account contributes to the clinical and epidemiological understanding of the disease, identifying specific needs and supporting decision-making processes. Stakeholders are encouraged to consider using this guidance on observational research to help provide evidence to close the inequitable gaps in health outcomes

Genome-wide association analysis of dementia and its clinical endophenotypes reveal novel loci associated with Alzheimer's disease and three causality networks : The GR@ACE project

Introduction: Large variability among Alzheimer's disease (AD) cases might impact genetic discoveries and complicate dissection of underlying biological pathways. Methods: Genome Research at Fundacio ACE (GR@ACE) is a genome-wide study of dementia and its clinical endophenotypes, defined based on AD's clinical certainty and vascular burden. We assessed the impact of known AD loci across endophenotypes to generate loci categories. We incorporated gene coexpression data and conducted pathway analysis per category. Finally, to evaluate the effect of heterogeneity in genetic studies, GR@ACE series were meta-analyzed with additional genome-wide association study data sets. Results: We classified known AD loci into three categories, which might reflect the disease clinical heterogeneity. Vascular processes were only detected as a causal mechanism in probable AD. The meta-analysis strategy revealed the ANKRD31-rs4704171 and NDUFAF6-rs10098778 and confirmed SCIMP-rs7225151 and CD33-rs3865444. Discussion: The regulation of vasculature is a prominent causal component of probable AD. GR@ACE meta-analysis revealed novel AD genetic signals, strongly driven by the presence of clinical heterogeneity in the AD series