Weighted convergence and regional clusters across China

We analyse per capita GDP convergence among 28 Chinese provinces between 1952 and 2005 using the distribution dynamics approach. Compared with previous studies, we provide a more complete view by including some additional information such as the asymptotic half-life of convergence, mobility indices and the continuous version of the ergodic distributions. In addition, we also extend the analysis to evaluate whether patterns could differ if weighted by either the population living in each province or their economic sizes, together with the existence and magnitude of spatial spillovers. The unweighted, unconditional analysis corroborates and supplements previous findings, especially those indicating that convergence patterns differ strongly under either pre- or post-reform trends. Both the weighted and space-conditioned analyses indicate that convergence could be much faster when these factors are introduced in the analysis. Implications are especially relevant when weighting by population, since results indicate that the number of people escaping from relative poverty would be much higher than the figure predicted by the unweighted analysis.Analizamos aquí la convergencia del PIB per cápita entre 28 provincias de China entre 1952 y 2005, utilizando el enfoque de evolución dinámica de distribuciones. En comparación con estudios previos, proporcionamos una visión más completa mediante la incorporación de información adicional como la semivida (half-life) asintótica de la convergencia, índices de movilidad y la versión continua de las distribuciones ergódicas. Además, ampliamos nuestro análisis a evaluar si pudiera haber diferencias en los patrones si se hiciera una ponderación basada en la población que vive en cada provincia o en sus tamaños económicos, junto con la existencia y magnitud de spillovers espaciales. El análisis incondicional, no ponderado, corrobora y complementa resultados de estudios anteriores, especialmente aquellos que indican que los patrones de convergencia difieren en gran medida bajo tendencias pre o post reforma económica. Tanto los análisis de naturaleza espacial como los ponderados indican que la convergencia podría suceder mucho más rápidamente si en el análisis se introdujesen estos factores . Las implicaciones son especialmente relevantes para la ponderación por población, ya que los resultados indican que el número de personas que podrían lograr salir de la una pobreza relativa podría ser mucho mayor que la cifra pronosticada por el análisis no ponderado

Value of procalcitonin, C-reactive protein, and neopterin in exacerbations of chronic obstructive pulmonary disease

The identification of biological markers in order to assess different aspects of COPD is an area of growing interest. The objective of this study was to investigate whether levels of procalcitonin (PCT), C-reactive protein (CRP), and neopterin in COPD patients could be useful in identifying the etiological origin of the exacerbation and assessing its prognosis. We included 318 consecutive COPD patients: 46 in a stable phase, 217 undergoing an exacerbation, and 55 with pneumonia. A serum sample was collected from each patient at the time of being included in the study. A second sample was also collected 1 month later from 23 patients in the exacerbation group. We compared the characteristics, biomarker levels, microbiological findings, and prognosis in each patient group. PCT and CRP were measured using an immunofluorescence assay. Neopterin levels were measured using a competitive immunoassay. PCT and CRP showed significant differences among the three patient groups, being higher in patients with pneumonia, followed by patients with exacerbation (P < 0.0001). For the 23 patients with paired samples, PCT and CRP levels decreased 1 month after the exacerbation episode, while neopterin increased. Neopterin showed significantly lower levels in exacerbations with isolation of pathogenic bacteria, but no differences were found for PCT and CRP. No significant differences were found when comparing biomarker levels according to the Gram result: PCT (P = 0.191), CRP (P = 0.080), and neopterin (P = 0.109). However, median values of PCT and CRP were high for Streptococcus pneumoniae, Staphylococcus aureus, and enterobacteria. All biomarkers were higher in patients who died within 1 month after the sample collection than in patients who died later on. According to our results, biomarker levels vary depending on the clinical status. However, the identification of the etiology of infectious exacerbation by means of circulating biomarkers is encouraging, but its main disadvantage is the absence of a microbiological gold standard, to definitively demonstrate their value. High biomarker levels during an exacerbation episode correlate with the short-term prognosis, and therefore their measurement can be useful for COPD management

Materials Science Toolkit for Carbon Footprint Assessment: A Case Study for Endoscopic Accessories of Common Use

[EN] Ironically, healthcare systems are key agents in respiratory-related diseases and estimated deaths because of the high impact of their greenhouse gas emissions, along with industry, transportation, and housing. Based on safety requirements, hospitals and related services use an extensive number of consumables, most of which end up incinerated at the end of their life cycle. A thorough assessment of the carbon footprint of such devices typically requires knowing precise information about the manufacturing process, rarely available in detail because of the many materials, pieces and steps involved during the fabrication. And yet, tools most often used for determining the environmental impact of consumer goods just require a bunch of parameters, mainly based on the material composition of the device. Here we report a basic set of analytical methods that provide the information required by the software OpenLCA to calculate the main outcome related to environmental impact, the greenhouse gas emissions. Through thermogravimetry, calorimetry, infrared spectroscopy and elemental analysis we proved that obtaining relevant data for the calculator in the exemplifying case of endoscopy tooling or accessories is possible. This routine procedure opens the door to a broader, more accurate analysis of the environmental impact of everyday work at hospital services, offering potential alternatives to minimize it.This study has been funded by Instituto de Salud Carlos III (ISCIII) through the project PI21/00193 and cofunded by the European Union. Funding: Instituto de Salud Carlos III (ISCIII), PI21/00193, cofunded by the European Union. And through the project PI2023-6 from UPV-LaFe innovation projects.Martín-Cabezuelo, R.; Vilariño-Feltrer, G.; Campillo Fernandez, AJ.; Lorenzo-Zúñiga, V.; Pons, V.; López-Muñoz, P.; Tort-Ausina, I. (2023). Materials Science Toolkit for Carbon Footprint Assessment: A Case Study for Endoscopic Accessories of Common Use. ACS Environmental Au. https://doi.org/10.1021/acsenvironau.3c0004

Improving the Diagnosis of Bloodstream Infections : PCR Coupled with Mass Spectrometry

The reference method for the diagnosis of bloodstream infections is blood culture followed by biochemical identification and antibiotic susceptibility testing of the isolated pathogen. This process requires 48 to 72 hours. The rapid administration of the most appropriate antimicrobial treatment is crucial for the survival of septic patients; therefore, a rapid method that enables diagnosis directly from analysis of a blood sample without culture is needed. A recently developed platform that couples broad-range PCR amplification of pathogen DNA with electrospray ionization mass spectrometry (PCR/ESI-MS) has the ability to identify virtually any microorganism from direct clinical specimens. To date, two clinical evaluations of the PCR/ESI-MS technology for the diagnosis of bloodstream infections from whole blood have been published. Here we discuss them and describe recent improvements that result in an enhanced sensitivity. Other commercially available assays for the molecular diagnosis of bloodstream infections from whole blood are also reviewed. The use of highly sensitive molecular diagnostic methods in combination with conventional procedures could substantially improve the management of septic patients

Procedimientos de Auditoría.

Este trabajo está basado en las prácticas de auditoría realizadas durante el máster en auditoría de la Universidad de Zaragoza. El objetivo del trabajo es documentar parte del trabajo realizado y explicar el proceso de auditoría. El trabajo está estructurado en dos bloques, en el primero se analizará la auditoría desde un punto de vista teórico, analizando las fuentes de regulación de la auditoría de cuentas en España, así como las diferentes fases en las que está estructurada. Debido a los cambios en el informe de auditoría se dedicará un apartado al análisis de los cambios y efectos a la labor del auditor. El segundo bloque se centra en los procedimientos de auditoría en las áreas de Clientes, Proveedores, Impuestos, Gastos de personal e Inmovilizado material. Se incluyen los papeles de trabajo para cada área, así como un análisis y explicación del procedimiento contenido y evidencia que proporcionan. This final Project is based on my audit internship during the audit master in Universidad de Zaragoza. The main goal of this project is to document part of the auditing procedures and explain the audit process. This project is divided in two parts, the first one focus on the auditing process from a theoretical point of view, analyzing sources of audit regulation in Spain, and the phases of an auditing process. Due to the recent changes on the audit report regulation, one part of the project will analyze the differences of the new report and the effect of those changes to the audit work. The second part will focus on the auditing process of the Customers, Suppliers, Taxes, Personal expenses and the tangible assets. This section includes paper works of all those areas, an analysis and explanation of the procedure and the proofs that provides

Evaluation of the automatic ELISA Triturus analyser

The objective was to evaluate the automatic ELISA Triturus analyser in order to assess its practicability and imprecision. The analyser was evaluated according to the guidelines of the Spanish Society of Clinical Chemistry. The evaluation was performed in two steps: evaluation of the imprecision and the inaccuracy of a semiquantitative and qualitative technique, and study of the practicability. The within-run imprecision rate ranged from 8.9 (VC) to 10.2% (VC) for the semiquantitative test, and from 11 (VC) to 17.2% (VC) for the qualitative one. The between-run imprecision rate ranged from 6 (VC) to 9.7% (VC) for the semiquantitative test, and from 8.8 (VC) to 18%(VC) for the qualitative technique. No sample-related carryover was detected in negative samples. The relative inaccuracy was correct for both techniques. Non-specific binding caused by waste products from the analysed circuits was not detected. The Triturus analyser is a reliable open analytical system with a considerable working capability, rendering this apparatus adequate for conventional laboratories with a medium-to-high work charge

Baseline Prediction of Combination Therapy Outcome in Hepatitis C Virus 1b Infected Patients by Discriminant Analysis Using Viral and Host Factors

Current treatment of chronic hepatitis C virus (HCV) infection has limited efficacy -especially among genotype 1 infected patients-, is costly, and involves severe side effects. Thus, predicting non-response is of major interest for both patient wellbeing and health care expense. At present, treatment cannot be individualized on the basis of any baseline predictor of response. We aimed to identify pre-treatment clinical and virological parameters associated with treatment failure, as well as to assess whether therapy outcome could be predicted at baseline.Forty-three HCV subtype 1b (HCV-1b) chronically infected patients treated with pegylated-interferon alpha plus ribavirin were retrospectively studied (21 responders and 22 non-responders). Host (gender, age, weight, transaminase levels, fibrosis stage, and source of infection) and viral-related factors (viral load, and genetic variability in the E1-E2 and Core regions) were assessed. Logistic regression and discriminant analyses were used to develop predictive models. A "leave-one-out" cross-validation method was used to assess the reliability of the discriminant models.Lower alanine transaminase levels (ALT, p=0.009), a higher number of quasispecies variants in the E1-E2 region (number of haplotypes, nHap_E1-E2) (p=0.003), and the absence of both amino acid arginine at position 70 and leucine at position 91 in the Core region (p=0.039) were significantly associated with treatment failure. Therapy outcome was most accurately predicted by discriminant analysis (90.5% sensitivity and 95.5% specificity, 85.7% sensitivity and 81.8% specificity after cross-validation); the most significant variables included in the predictive model were the Core amino acid pattern, the nHap_E1-E2, and gamma-glutamyl transferase and ALT levels.Discriminant analysis has been shown as a useful tool to predict treatment outcome using baseline HCV genetic variability and host characteristics. The discriminant models obtained in this study led to accurate predictions in our population of Spanish HCV-1b treatment naïve patients

Nova estratègia diagnòstica per la Tuberculosi : sí, però amb matisos

La realització de nous tests per diagnosticar la Infecció Latent per M.tuberculosi (ITBL), els TIGRAs, basats en la detecció d'una citosina relacionada amb la Resposta Immunològica Cel·lular que es desencadena contra el bacil tuberculós, sembla aportar noves llums al tractament de la infecció: són més sensibles i específics que el tractament estàndard de la Tuberculina (TST). Tot i així, encara es desconeix si la seva utilització posterior a un TST influeix en els resultats finals. Per això, i per ampliar aquesta línia d'investigació, un estudi de seguiment immunològic, dut a terme a la Unitat de Tuberculosi Experimental de l'hospital "Germans Trias i Pujol", ha obtingut uns resultats que demostren la necessitat d'aprofundir sobre aquest tema, malgrat alguns països valoren la possibilitat d'utilitzar-los seqüencialment

Relevance of Baseline Viral Genetic Heterogeneity and Host Factors for Treatment Outcome Prediction in Hepatitis C Virus 1b-Infected Patients

Only about 50% of patients chronically infected with HCV genotype 1 (HCV-1) respond to treatment with pegylated interferon-alfa and ribavirin (dual therapy), and protease inhibitors have to be administered together with these drugs increasing costs and side-effects. We aimed to develop a predictive model of treatment response based on a combination of baseline clinical and viral parameters. Seventy-four patients chronically infected with HCV-1b and treated with dual therapy were studied (53 retrospectively −training group−, and 21 prospectively −validation group−). Host and viral-related factors (viral load, and genetic variability in the E1-E2, core and Interferon Sensitivity Determining Region) were assessed. Multivariate discriminant analysis and decision tree analysis were used to develop predictive models on the training group, which were then validated in the validation group. A multivariate discriminant predictive model was generated including the following variables in decreasing order of significance: the number of viral variants in the E1-E2 region, an amino acid substitution pattern in the viral core region, the IL28B polymorphism, serum GGT and ALT levels, and viral load. Using this model treatment outcome was accurately predicted in the training group (AUROC = 0.9444; 96.3% specificity, 94.7% PPV, 75% sensitivity, 81% NPV), and the accuracy remained high in the validation group (AUROC = 0.8148, 88.9% specificity, 90.0% PPV, 75.0% sensitivity, 72.7% NPV). A second model was obtained by a decision tree analysis and showed a similarly high accuracy in the training group but a worse reproducibility in the validation group (AUROC = 0.9072 vs. 0.7361, respectively). The baseline predictive models obtained including both host and viral variables had a high positive predictive value in our population of Spanish HCV-1b treatment naïve patients. Accurately identifying those patients that would respond to the dual therapy could help reducing implementation costs and additional side effects of new treatment regimens

Spanish Paediatricians’ Knowledge, Attitudes and Practices Regarding Oral Health of Children under 6 Years of Age: A Cross-Sectional Study

Background: Early Childhood Caries (ECC) is a prevalent chronic pathology, and it has a negative impact on the oral and general health of the child patient. Aim: To evaluate the knowledge, attitudes and practices of Spanish paediatricians regarding early childhood caries according to the professional’s years of experience. Material and Methods: A cross-sectional questionnaire was conducted by Spanish paediatricians via WhatsApp and e-mails from January to April 2021. Data were analysed using Chi-squared test, Fisher’s exact test and Cramer’s V test. Results: There were a total of 359 participants. Most respondents were women (81.3%) with up to 10 years of professional experience (31.2%) in primary health care and public health. In most cases, participants had an excellent knowledge of primary dentition (90.8%), but they ignored (56%) when the first visit to the dentist should occur. Regarding the aetiological factors of caries, oral hygiene and prevention, a lower rate of knowledge was observed. The majority of participants (80.8%) were not able to identify white spot lesions and enamel defects (76%). They considered that their knowledge in oral health was deficient, highlighting the need to increase their training. Less experienced paediatricians were found to have higher success rates. Conclusions: The level of knowledge and attitudes regarding early childhood caries of the evaluated paediatricians should be improved. Paediatricians had difficulties in identifying early caries lesions and enamel defects. Nevertheless, a higher level of knowledge and positive attitudes towards dental caries has been detected among paediatricians with fewer years of professional experience