Traffic model in urban roads planning from surveys and counts. Application to the city of Badajoz (Spain)

Este artículo describe la metodología utilizada para la construcción de un modelo de tráfico en Badajoz (España) comenzando con la asignación de la matriz de viaje origen-destino derivada de encuestas y recuentos de tráfico realizados en los accesos sur y este de Badajoz. El modelo de tráfico describe la movilidad en las futuras relaciones de tráfico del sur potencialmente limitables y permite calcular los ahorros en la distancia recorrida y los tiempos de viaje en la situación actual. El modelo de tráfico permite conocer diferentes comportamientos de las posibles alternativas en la construcción de una nueva carretera de alta capacidad. El modelo puede seleccionar el que captura más tráfico y produce un mayor ahorro en el tiempo de viaje, es decir, el que produce una mejor mejora socioeconómica. La investigación concluye a favor del corredor más cercano al centro de la ciudad, siendo este el más concurrido y el que produce un mayor ahorro de tiempo. También es el corredor que permite darle al Bypass Sur un doble propósito de recolectar y distribuir en la ciudad de Badajoz.This paper describes the methodology used for the construction of a traffic model in Badajoz (Spain) starting with the allocation of the origin-destination travel matrix derived from surveys and traffic counts conducted in the southern and eastern accesses of Badajoz. The traffic model describes the mobility in potentially-captable future southern traffic relationships and allows the calculation of savings in travelled distance and travel times on the current situation. The traffic model allows to know different behaviours of the possible alternatives in the construction of a new high-capacity road. The model is able to select the one which captures more traffic and produces a bigger saving in travel time, meaning, the one which produces a better socioeconomic improvement. The research concludes in favour of the nearest corridor to the city centre, being this one the more crowded and the one that produces greater time savings. It is also the corridor that allows giving the Southern Bypass a dual purpose of collectingdistributing in the city of Badajoz.Gobierno de Extremadura: Financiación del Estudio Informativo de la Ronda Sur de Badajoz)peerReviewe

Sudden death in the first trimester of pregnancy

como es sabido, entre las primeras causas de mortalidad materna durante el embarazo se encuentran los episodios de tromboembolismo venoso. Varios estudios poblacionales ya han demostrado que dicho riesgo se encuentra aumentado de manera muy significativa en caso de embarazos logrados mediante técnicas de Fertilización in vitro (FIV). Sin embargo, apenas existen casos en la literatura que ilustren estas situaciones de emergencia. Presentamos el caso de una mujer de 40 años, embarazada de mellizos mediante FIV, en su 12ª semana de gestación, que fallece tras dos días con clínica de mareos, taquicardia y ahogos. La finalidad de su publicación es doble: por un lado llamar la atención ante uno de los riesgos que acompañan la gestación y, por otro, poner en valor la función del médico forense y el estudio autópsico como fuente de recogida de información de salud pública.The venous thromboembolism and thromboembolic events remain the leading cause of death during pregnancy and postpartum in developed countries. Recent investigations have provided an important evidence of significantly increased risk of venous thromboembolism after in vitro fertilization (IVF) pregnancies. Nevertheless, there are few case reports showing these emergency situations. We report the case of a 40 years old woman, in her twelve week of a twin after IVF pregnancy, who dies after two weeks with dizziness, tachycardia and respiratory distress. Our objective is double: to highlight the risks of the pregnancy even in developed countries and, on the other hand, to enhance the role of the forensic pathologist and the forensic studies as epidemiological information gatherers

Incidence, risk factors, and outcomes of second neoplasms in patients with acute promyelocytic leukemia: the PETHEMA-PALG experience

Acute promyelocytic leukemia; Risk factors; Second neoplasmsLeucemia promielocítica aguda; Factores de riesgo; Segundas neoplasiasLeucèmia promielocítica aguda; Factors de risc; Segones neoplàsiesThe most important challenges in acute promyelocytic leukemia (APL) is preventing early death and reducing long-term events, such as second neoplasms (s-NPLs). We performed a retrospective analysis of 2670 unselected APL patients, treated with PETHEMA “chemotherapy based” and “chemotherapy free” protocols. Only de novo APL patients who achieved complete remission (CR) and completed the three consolidation cycles were enrolled into the analysis. Out of 2670 APL patients, there were 118 (4.4%) who developed s-NPLs with the median latency period (between first CR and diagnosis of s-NPL) of 48.0 months (range 2.8–231.1): 43.3 (range: 2.8–113.9) for s-MDS/AML and 61.7 (range: 7.1–231.1) for solid tumour. The 5-year CI of all s-NPLs was of 4.43% and 10 years of 7.92%. Among s-NPLs, there were 58 cases of s-MDS/AML, 3 cases of other hematological neoplasms, 57 solid tumours and 1 non-identified neoplasm. The most frequent solid tumour was colorectal, lung and breast cancer. Overall, the 2-year OS from diagnosis of s-NPLs was 40.6%, with a median OS of 11.1 months. Multivariate analysis identified age of 35 years (hazard ratio = 0.2584; p < 0.0001) as an independent prognostic factor for s-NPLs. There were no significant differences in CI of s-NPLs at 5 years between chemotherapy-based vs chemotherapy-free regimens (hazard ratio = 1.09; p = 0.932). Larger series with longer follow-up are required to confirm the potential impact of ATO+ATRA regimens to reduce the incidence of s-NPLs after front-line therapy for APL.This work was partially financed with FEDER funds (CIBERONC (CB16/12/00284)) and with Instituto de Investigación Sanitaria La Fe funds (2016/0158)

Congruencia en conocimientos y educación afectivo-sexual en personas con DI

En la educación de las personas con diversidad funcional intelectual (DFI) es importante que los principales agentes implicados (usuarios/as, padres y profesionales que trabajan con ellos) posean criterios comunes acerca de los objetivos educativos en general, y especialmente, en el área de la sexualidad. Sin embargo, las tres perspectivas no siempre son coincidentes con las consecuencias que se derivan de ello. Teniendo en cuenta la importancia de la identificación de necesidades y metas comunes, planteamos este trabajo con el objetivo de conocer el grado de concordancia entre: 1) los conocimientos que los usuarios tienen sobre sexualidad y la que los padres y profesionales les atribuyen y 2) la opinión de padres, profesionales y usuarios/as sobre la necesidad de proveer/recibir educación afectivo-sexual. Para ello, 92 adultos con DI (45.6% mujeres, 54.4% hombres) con edades entre los 19 y 67 años (M=37.5) y sus padres y profesionales, completaron un instrumento donde se les preguntaba acerca del conocimiento sobre sexualidad y sobre el interés de recibir formación en educación afectivo-sexual. Los resultados señalan una concordancia respecto a los conocimientos sobre sexualidad del 36.7% entre padres y usuarios/as y del 58.4% entre profesionales y usuarios. En cuanto a la concordancia respecto a la necesidad de recibir formación en educación afectivo-sexual, ésta fue 75.5% entre padres y usuarios/as y del 88.5% entre profesionales y usuarios. La concordancia entre los tres respecto a esta cuestión resultó alta (74.7%). A partir de estos resultados podemos concluir que los profesionales son mejores conocedores de las necesidad, capacidades y conocimientos de los/as usuarios/as de lo que lo son sus propios padres pero que todos tienen en común el identificar la necesidad de introducir de forma normalizada la educación afectivo-sexual en este colectivo.In education of people with intellectual disability (ID) it is important that the main agents involved (users, parents and professionals working with them) have common criteria about educational objectives in general, and especially, in sexuality. However, the three perspectives do not always coincide with the consequences of it. Taking into account the importance of identifying common needs and goals, we propose this work with the objective of knowing the degree of agreement between: 1) the knowledge that users have about sexuality and the attribution their parents and professionals made about them and 2) the opinion of parents, professionals and users on the need to provide/receive affective-sexual education. For this, 92 adults with ID (45.6% women, 54.4% men) with ages between 19 and 67 year old (M=37.5) and their parents and professionals, completed an instrument where they were asked about knowledge about sexuality and the interest of receiving training in affective-sexual education. Results indicate agreement respect to sexuality knowledge of 36.7% between parents and users and 58.4% between professionals and users. Regarding the agreement of the need to receive training in affective-sexual education, this was 75.5% between parents and users and 88.5% between professionals and users. The agreement between the three regarding this issue was high (74.7%). From these results we can conclude that professionals are better aware of the needs, skills and knowledge of the users than their own parents are but, all have in common the identification of the need to introduce in a standardized way affective-sexual education in this group

Cancer treatment-induced oral mucositis: a critical review

Introduction.- Head and neck cancer represents actually one of the main oncological problems. In its treatment, radiotherapy and chemotherapy leads to mucositis, as well as other side effects. Objective.- To review the high-quality evidence published over the last twenty-five years on the treatment of cancer treatment-induced oral mucositis. Material and methods.- A search of double blind randomised controlled clinical trials between 1985 and 2010 was performed in the Medline database. Oral mucositis, radiotherapy, chemotherapy, head and neck were used as keywords. Results.- The different therapeutic approaches found for cancer treatment-induced oral mucositis included: intensive oral hygiene care, use of topical antiseptics and antimicrobial agents, use of anti inflammatory agents, cytokines and growth factors, locally applied non-pharmacological methods, antioxidants, immune modulators, anticholeric agents and homoeopathic agents. Discussion.- To date no intervention has been able to prevent and treat oral mucositis on its own. Therefore, it is necessary to combine interventions that act on the different phases of mucositis. Conclusions.- It is still unclear as to which strategies reduce oral mucositis, as there is not enough evidence that describes a treatment with a proven efficiency and better than the other treatments for this conditio

Differential Impact of Transient and Chronic Loneliness on Health Status. A Longitudinal Study

Loneliness is associated with worse health status out-comes. Yet, the present study is one of the first to identify howpatterns of loneliness (transient and chronic) are associated withhealth over time.Design:A total of 2,390 individuals were inter-viewed in 2011–2012 and 2014–2015 in a follow-up study con-ducted over a nationally representative sample of Spain. Afterconfirming a longitudinal relationship between loneliness andhealth status, a growth curve mixture modeling was used toexamine health trajectories.Main outcome measures:The three-item UCLA Loneliness Scale was used to assess loneliness. Healthstatus was measured with self-reported questions regarding tendomains (vision, mobility, and self-care, among others), and sevenmeasured tests (including grip strength, walking speed and imme-diate and delayed verbal recall).Results:A quarter of participantswere lonely at baseline. Both the group of transient and chronicloneliness showed a negative significant relationship with healthstatus at follow-up, (b¼ 0.063 andb¼ 0.075 respectively,p<0.001). Nevertheless, the health status did not change acrosstime in any group.Conclusion:People experiencing chronic lone-liness had the worst health status. Different patterns of lonelinesscould benefit from the appropriate interventionsThis work was supported by the EU Horizon 2020 Framework Programme for Research andInnovation [635316 (ATHLOS Project)], by the European Community’s Seventh FrameworkProgramme (FP7/2007-2013) under agreement number 223071 (COURAGE in Europe), by theSpanish Ministry of Science and Innovation ACI-Promociona (ACI2009-1010), and by the Institutode Salud Carlos III-FIS research grants [PS09/00295, PS09/01845, PI12/01490, PI13/00059, PI16/00218 and PI16/01073]. Projects PI12/01490, PI13/00059, PI16/00218 and PI16/01073 have beenco-funded by the European Union European Regional Development Fund (ERDF)‘A Way toBuild Europe’. The work was also supported by the Instituto de Salud Carlos III Centro deInvestigaci on Biom edica en Red de Salud Mental (CIBERSAM). ST is supported by theFoundation for Education and European Culture (IPEP), the Sara Borrell postdoctoral programme(reference no. CD15/00019 from the Instituto de Salud Carlos III (ISCIII–Spain) and the Fondo190N. MART IN-MAR IA ET AL.Europeo de Desarrollo Regional (FEDER). NMM is supported by the programme‘Contratos pre-doctorales para Formaci on de Personal Investigador, FPI-UAM’, Universidad Aut onoma deMadrid, Spai

Congruencia en conocimientos y educación afectivo-sexual en personas con DI

In education of people with intellectual disability (ID) it is important that the main agents involved (users, parents and professionals working with them) have common criteria about educational objectives in general, and especially, in sexuality. However, the three perspectives do not always coincide with the consequences of it. Taking into account the importance of identifying common needs and goals, we propose this work with the objective of knowing the degree of agreement between: 1) the knowledge that users have about sexuality and the attribution their parents and professionals made about them and 2) the opinion of parents, professionals and users on the need to provide/receive affective-sexual education. For this, 92 adults with ID (45.6% women, 54.4% men) with ages between 19 and 67 year old (M=37.5) and their parents and professionals, completed an instrument where they were asked about knowledge about sexuality and the interest of receiving training in affective-sexual education. Results indicate agreement respect to sexuality knowledge of 36.7% between parents and users and 58.4% between professionals and users. Regarding the agreement of the need to receive training in affective-sexual education, this was 75.5% between parents and users and 88.5% between professionals and users. The agreement between the three regarding this issue was high (74.7%). From these results we can conclude that professionals are better aware of the needs, skills and knowledge of the users than their own parents are but, all have in common the identification of the need to introduce in a standardized way affective-sexual education in this group.En la educación de las personas con diversidad funcional intelectual (DFI) es importante que los principales agentes implicados (usuarios/as, padres y profesionales que trabajan con ellos) posean criterios comunes acerca de los objetivos educativos en general, y especialmente, en el área de la sexualidad. Sin embargo, las tres perspectivas no siempre son coincidentes con las consecuencias que se derivan de ello. Teniendo en cuenta la importancia de la identificación de necesidades y metas comunes, planteamos este trabajo con el objetivo de conocer el grado de concordancia entre: 1) los conocimientos que los usuarios tienen sobre sexualidad y la que los padres y profesionales les atribuyen y 2) la opinión de padres, profesionales y usuarios/as sobre la necesidad de proveer/ recibir educación afectivo-sexual. Para ello, 92 adultos con DI (45.6% mujeres, 54.4% hombres) con edades entre los 19 y 67 años (M=37.5) y sus padres y profesionales, completaron un instrumento donde se les preguntaba acerca del conocimiento sobre sexualidad y sobre el interés de recibir formación en educación afectivo-sexual. Los resultados señalan una concordancia respecto a los conocimientos sobre sexualidad del 36.7% entre padres y usuarios/as y del 58.4% entre profesionales y usuarios. En cuanto a la concordancia respecto a la necesidad de recibir formación en educación afectivo-sexual, ésta fue 75.5% entre padres y usuarios/as y del 88.5% entre profesionales y usuarios. La concordancia entre los tres respecto a esta cuestión resultó alta (74.7%). A partir de estos resultados podemos concluir que los profesionales son mejores conocedores de las necesidad, capacidades y conocimientos de los/as usuarios/as de lo que lo son sus propios padres pero que todos tienen en común el identificar la necesidad de introducir de forma normalizada la educación afectivo-sexual en este colectivo

La organización de las poblaciones clave ligadas a la transmisión del VIH: una intervención para abatir el estigma; México, 2005-2009

A qualitative and quantitative approach forms the base of this analysis of the results of "Vida Digna," a project aimed at abating stigma and discrimination in the HIV transmission field with actions taken by civil society organizations from 2005 to 2009 in the Mexican region of El Bajío. The results were analyzed in 2009 and 2010. The organizations involved were made up of key populations, defined as groups vulnerable to infection but also capable of resisting and controlling the transmission of HIV and the stigma and discrimination that are important barriers in the seeking of care and the achievement of effective HIV control. We describe and analyze the actions taken and the strengthening of the participating organizations. The visibility of new social actors such as transgender women and injecting drug users, as well as informative activities directed at journalists, the police and the military to prevent the criminalization and persecution of these groups, are highlighted.Una aproximación cuali-cuantitativa es la base para el análisis de los resultados del proyecto "Vida Digna", cuyo objetivo fue abatir el estigma y la discriminación en el campo de la transmisión del VIH a partir de las acciones realizadas por organizaciones de la sociedad civil durante el período 2005 al 2009, en la región mexicana llamada El Bajío. Los resultados se analizaron en los años 2009 y 2010. Las organizaciones participantes estuvieron compuestas por y para las denominadas poblaciones clave, definidas como grupos vulnerables a infectarse pero también capaces de resistir y controlar la transmisión del VIH, el estigma y la discriminación, que se constituyen en barreras importantes para la búsqueda de atención y en el control efectivo del VIH. Se describen y analizan las acciones y el fortalecimiento de las organizaciones participantes. Resaltan la visibilización de nuevos actores sociales, como las mujeres transgénero y los usuarios de drogas inyectables, y las acciones informativas dirigidas a periodistas, policías y militares para evitar la criminalización y persecución de estos grupos

Automatic blood glucose classification for gestational diabetes with feature selection: decision trees vs neural networks

Automatic blood glucose classification may help specialists to provide a better interpretation of blood glucose data, downloaded directly from patients glucose meter and will contribute in the development of decision support systems for gestational diabetes. This paper presents an automatic blood glucose classifier for gestational diabetes that compares 6 different feature selection methods for two machine learning algorithms: neural networks and decision trees. Three searching algorithms, Greedy, Best First and Genetic, were combined with two different evaluators, CSF and Wrapper, for the feature selection. The study has been made with 6080 blood glucose measurements from 25 patients. Decision trees with a feature set selected with the Wrapper evaluator and the Best first search algorithm obtained the best accuracy: 95.92%

Knowledge representation tool for cognitiveprocesses modeling

In the last decades, neuropsychological theories tend to consider cognitive functions as a result of the whole brainwork and not as individual local areas of its cortex. Studies based on neuroimaging techniques have increased in the last years, promoting an exponential growth of the body of knowledge about relations between cognitive functions and brain structures [1]. However, so fast evolution make complicated to integrate them in verifiable theories and, even more, translated in to cognitive rehabilitation. The aim of this research work is to develop a cognitive process-modeling tool. The purpose of this system is, in the first term, to represent multidimensional data, from structural and functional connectivity, neuroimaging, data from lesion studies and derived data from clinical intervention [2][3]. This will allow to identify consolidated knowledge, hypothesis, experimental designs, new data from ongoing studies and emerging results from clinical interventions. In the second term, we pursuit to use Artificial Intelligence to assist in decision making allowing to advance towards evidence based and personalized treatments in cognitive rehabilitation. This work presents the knowledge base design of the knowledge representation tool. It is compound of two different taxonomies (structure and function) and a set of tags linking both taxonomies at different levels of structural and functional organization. The remainder of the abstract is organized as follows: Section 2 presents the web application used for gathering necessary information for generating the knowledge base, Section 3 describes knowledge base structure and finally Section 4 expounds reached conclusions