Al-Bustān. Las fincas aristocráticas y la construcción de los paisajes periurbanos de al-Ándalus y Sicilia

Navarro Palazón, Julio, editorLa presente publicación se enmarca en el Proyecto I+D+i «Almunias medievales en el Mediterráneo: Historia y conservación de los paisajes culturales periurbanos» (PID2019-111508GB-I00, dirigido por Julio Navarro Palazón), del Ministerio de Ciencia e Innovación. Agencia Estatal de Investigación. Proyectos de I+D+i, de los Programas Estatales de Generación de Conocimiento y fortalecimiento Científico y Tecnológico del Sistema de I+D+i y de I+D+i Orientada a los Retos de la Sociedad, del Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020. Esta obra es también un fruto destacado del trabajo realizado en el marco de la Unidad Asociada de I+D+i Patrimonio Cultural Árabe e Islámico, Consejo Superior de Investigaciones Científicas-Universidad de Granada, a través de la Escuela de Estudios Árabes de Granad

Memorias de investigación: Feria de Semilleros y Jornadas de Investigación de uniminuto, Seccional Antioquia - Chocó.

Feria de Semilleros y Jornadas de Investigación de uniminuto, Seccional Antioquia - Chocó.Esta publicación busca divulgar investigaciones y producción académica en diferentes disciplinas, realizadas por estudiantes y docentes de UNIMINUTO Seccional Antioquia – Chocó, así como dar a conocer los semilleros de investigación que participaron en la V Feria de Semilleros, con el fin de visibilizar el trabajo que realiza el Centro de Investigación para el Desarrollo de UNIMINUTO Bello —CIDUB—, con respecto a debates académicos y espacios de interlocución. Igualmente, permite que la comunidad educativa conozca los temas de investigación y las discusiones que se están dando entre los semilleros y grupos de investigación, para así buscar puntos de encuentro y sinergias entre los investigadores. Adicionalmente, el texto se convierte en una invitación para que se vinculen otros investigadores, docentes, estudiantes e incluso otras instituciones a los procesos investigativos coordinados desde el CIDUB

Memorias de investigación: Feria de Semilleros y Jornadas de Investigación de uniminuto, Seccional Antioquia - Chocó.

Feria de Semilleros y Jornadas de Investigación de uniminuto, Seccional Antioquia - Chocó.Esta publicación busca divulgar investigaciones y producción académica en diferentes disciplinas, realizadas por estudiantes y docentes de UNIMINUTO Seccional Antioquia – Chocó, así como dar a conocer los semilleros de investigación que participaron en la V Feria de Semilleros, con el fin de visibilizar el trabajo que realiza el Centro de Investigación para el Desarrollo de UNIMINUTO Bello —CIDUB—, con respecto a debates académicos y espacios de interlocución. Igualmente, permite que la comunidad educativa conozca los temas de investigación y las discusiones que se están dando entre los semilleros y grupos de investigación, para así buscar puntos de encuentro y sinergias entre los investigadores. Adicionalmente, el texto se convierte en una invitación para que se vinculen otros investigadores, docentes, estudiantes e incluso otras instituciones a los procesos investigativos coordinados desde el CIDUB

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

COVID-19 in hospitalized HIV-positive and HIV-negative patients : A matched study

CatedresObjectives: We compared the characteristics and clinical outcomes of hospitalized individuals with COVID-19 with [people with HIV (PWH)] and without (non-PWH) HIV co-infection in Spain during the first wave of the pandemic. Methods: This was a retrospective matched cohort study. People with HIV were identified by reviewing clinical records and laboratory registries of 10 922 patients in active-follow-up within the Spanish HIV Research Network (CoRIS) up to 30 June 2020. Each hospitalized PWH was matched with five non-PWH of the same age and sex randomly selected from COVID-19@Spain, a multicentre cohort of 4035 patients hospitalized with confirmed COVID-19. The main outcome was all-cause in-hospital mortality. Results: Forty-five PWH with PCR-confirmed COVID-19 were identified in CoRIS, 21 of whom were hospitalized. A total of 105 age/sex-matched controls were selected from the COVID-19@Spain cohort. The median age in both groups was 53 (Q1-Q3, 46-56) years, and 90.5% were men. In PWH, 19.1% were injecting drug users, 95.2% were on antiretroviral therapy, 94.4% had HIV-RNA < 50 copies/mL, and the median (Q1-Q3) CD4 count was 595 (349-798) cells/μL. No statistically significant differences were found between PWH and non-PWH in number of comorbidities, presenting signs and symptoms, laboratory parameters, radiology findings and severity scores on admission. Corticosteroids were administered to 33.3% and 27.4% of PWH and non-PWH, respectively (P = 0.580). Deaths during admission were documented in two (9.5%) PWH and 12 (11.4%) non-PWH (P = 0.800). Conclusions: Our findings suggest that well-controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes of COVID-19 hospitalization

How do women living with HIV experience menopause? Menopausal symptoms, anxiety and depression according to reproductive age in a multicenter cohort

CatedresBackground: To estimate the prevalence and severity of menopausal symptoms and anxiety/depression and to assess the differences according to menopausal status among women living with HIV aged 45-60 years from the cohort of Spanish HIV/AIDS Research Network (CoRIS). Methods: Women were interviewed by phone between September 2017 and December 2018 to determine whether they had experienced menopausal symptoms and anxiety/depression. The Menopause Rating Scale was used to evaluate the prevalence and severity of symptoms related to menopause in three subscales: somatic, psychologic and urogenital; and the 4-item Patient Health Questionnaire was used for anxiety/depression. Logistic regression models were used to estimate odds ratios (ORs) of association between menopausal status, and other potential risk factors, the presence and severity of somatic, psychological and urogenital symptoms and of anxiety/depression. Results: Of 251 women included, 137 (54.6%) were post-, 70 (27.9%) peri- and 44 (17.5%) pre-menopausal, respectively. Median age of onset menopause was 48 years (IQR 45-50). The proportions of pre-, peri- and post-menopausal women who had experienced any menopausal symptoms were 45.5%, 60.0% and 66.4%, respectively. Both peri- and post-menopause were associated with a higher likelihood of having somatic symptoms (aOR 3.01; 95% CI 1.38-6.55 and 2.63; 1.44-4.81, respectively), while post-menopause increased the likelihood of having psychological (2.16; 1.13-4.14) and urogenital symptoms (2.54; 1.42-4.85). By other hand, post-menopausal women had a statistically significant five-fold increase in the likelihood of presenting severe urogenital symptoms than pre-menopausal women (4.90; 1.74-13.84). No significant differences by menopausal status were found for anxiety/depression. Joint/muscle problems, exhaustion and sleeping disorders were the most commonly reported symptoms among all women. Differences in the prevalences of vaginal dryness (p = 0.002), joint/muscle complaints (p = 0.032), and sweating/flush (p = 0.032) were found among the three groups. Conclusions: Women living with HIV experienced a wide variety of menopausal symptoms, some of them initiated before women had any menstrual irregularity. We found a higher likelihood of somatic symptoms in peri- and post-menopausal women, while a higher likelihood of psychological and urogenital symptoms was found in post-menopausal women. Most somatic symptoms were of low or moderate severity, probably due to the good clinical and immunological situation of these women

Naturaleza urbana. Plataforma de experiencias

Naturaleza Urbana presenta experiencias autogestionadas que, con el tiempo, se han posicionado como ejercicios alternativos de identificación, monitoreo y recuperación de la biodiversidad urbana. En otros casos, el modelo comunidad-gobierno ha permitido desarrollar diagnósticos y propuestas de gestión corresponsables y sistémicas, entendiendo por esto último iniciativas que nacen desde los valores mismos que cada comunidad le atribuye a su biodiversidad. Del mismo modo, se presentan esfuerzos gubernamentales que han enriquecido la visión ambiental de los principales instrumentos de planificación urbana, por ejemplo, integrando la condición propiamente urbana como oportunidad para aumentar la oferta ambiental de la ciudad, fortaleciendo las funciones y procesos de la biodiversidad y revitalizando, con ello, la calidad de vida del entorno urbano. Por su parte, las universidades y los centros de investigación se han sumado a la ola emergente de generación de conocimiento en biodiversidad urbana (fenómeno nacional e internacional), han brindado evidencia científica de su valor para el bienestar humano y han propuesto reflexiones y lineamientos cualitativos de biodiversidad, con miras a hacer del ordenamiento un ejercicio más coherente con cada contexto territorial en particular.Bogotá, D. C., ColombiaInstituto de Investigación de Recursos Biológicos Alexander von Humbold

Urban Nature

Preservation, restoration, monitoring of biodiversity and promotion of native species, in their strict and classical sense, could be unviable strategies in the cities. Management systems such as the protected areas acquire profoundly different connotations and objectives from the traditional ones when thought of in the context of a city. Similarly, although ecological restoration seeks to return to a baseline ecosystem, there is little that we know about the vegetation present on the urban borders of the main Colombian cities prior to the 20th century. Finally, the models for potential distribution of species could produce unreliable results, because their methodological bases were not conceived based on urban dynamics. In this context, to de ne urban biodiversity and what strategy must be applied for its conservation implies a challenge that, beyond being scienti c, is necessarily social and cultural and involves planning and design. Innovation is inevitable.Bogotá, D. C

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)