Spatio-temporal analysis of oak decline process in open woodlands: A case study in SW Spain

This study aims to characterize at landscape level the spatio-temporal dynamics of a massive oak decline that is occurring in dehesas ecosystems. We are looking at possibilities of matching with Phytophthora disease behavior, a harmful disease detected in the studied area, in order to interpret its implications within the context of the disease management. Spatial locations of affected trees from 2001, 2009 and 2016 identified through photointerpretation were analyzed with the inhomogeneous Ripley's K-function to assess their spatial pattern. Multivariate Adaptive Regression Splines (MARS), a non-parametric data mining method, was used to investigate the influence of a range of landscape descriptors of different nature on the proneness to oak decline, using the location of affected trees in comparison with that of healthy spots (points randomly extracted from areas covered by healthy trees). Affected trees showed a strong clustering pattern that decreased over time. The reported spatial patterns align with the hypothesis of Phytophthora cinnamomi Rands. being the main cause of oak decline in Mediterranean forests. Location of affected trees detected in different years was found to be spatially related, suggesting the implication of a contagion process. MARS models from 2001, 2009 and 2016 reported Area Under the Curve (AUC) values of 0.707, 0.671 and 0.651, respectively. Slope was the most influential landscape descriptor across the three years, with distance to afforestations being the second for 2001 and 2009. Landscape descriptors linked to human factors and soil water content seem to influence oak decline caused by Phytophthora cinnamomi at landscape level. Afforestations carried out as part of the afforestation subsidy program promoted by the European Commission in 1992 could have acted as an initial source of Phytophthora cinnamomi infection. These findings together with the consideration of the spatial and temporal scale of the spreading are essential when planning the management of oak decline in open woodlands

Contabilidad ambiental. antecedentes internacionales

La Contabilidad Nacional trata de establecer una medida aproximada del bienestar que disfruta la población sin considerar el papel que desempeña el medio ambiente en la calidad de vida de la sociedad. Un grupo de organizaciones de ámbito supranacional y de países se hicieron eco de esta deficiencia y desarrollaron una serie de propuestas operativas para recoger información sobre el estado del medio ambiente y sus vínculos con el sistema económico. Los sistemas propuestos difieren en cada caso pudiendo diferenciarse cinco categorías: los sistemas de indicadores, los indicadores agregados, las cuentas de recursos naturales, las cuentas satélite y los sistemas de contabilidad integrada. Siguiendo esta clasificación, en el artículo se presentan algunas de las experiencias desarrolladas fundamentalmente a escala nacional. La inclusión de un país en alguna de las categorías no implica que se desarrolle de forma exclusiva un único sistema, siendo posible la coexistencia de sistemas complementarios

Development and validation of an HIV risk exposure and indicator conditions questionnaire to support targeted HIV screening

The aim of our study was to develop a Spanish-structured HIV risk of exposure and indicator conditions (RE&IC) questionnaire. People attending to an emergency room or to a primary clinical care center were offered to participate in a prospective, 1 arm, open label study, in which all enrolled patients filled out our developed questionnaire and were HIV tested. Questionnaire accuracy, feasibility, and reliability were evaluated. Valid paired 5329 HIV RE&IC questionnaire and rapid HIV tests were performed, 69.3% in the primary clinical care center, 49.6% women, median age 37 years old, 74.9% Spaniards, 20.1% Latin-Americans. Confirmed hidden HIV infection was detected in 4.1%, while HIV RE&IC questionnaire was positive in 51.2%. HIV RE&IC questionnaire sensitivity was 100% to predict HIV infection, with a 100% negative predictive value. When considered separately, RE or IC items sensitivity decreases to 86.4% or 91%, and similarly their negative predictive value to 99.9% for both of them. The majority of people studied, 90.8% self-completed HIV RE&IC questionnaire. Median time to complete was 3 minutes. Overall HIV RE&IC questionnaire test-retest Kappa agreement was 0.82 (almost perfect), likewise for IC items 0.89, while for RE items was lower 0.78 (substantial). A feasible and reliable Spanish HIV RE&IC self questionnaire accurately discriminated all non–HIV-infected people without missing any HIV diagnoses, in a low prevalence HIV infection area. The best accuracy and reliability were obtained when combining HIV RE&IC items

El análisis económico de los movimientos migratorios internacionales: ampliación y nuevas propuestas

Los movimientos migratorios constituyen uno de los mayores retos a los que se va a enfrentar el Mundo en los próximos años, tanto desde el punto de vista del país receptor, en el que pueden aparecer tensiones en los mercados laborales que deriven en problemas sociológicos y políticos, como para el país de salida, que puede registrar efectos positivos o negativos según sea la composición del flujo. En un trabajo anterior, presentado en la Reunión de Economía Mundial celebrada en La Coruña en abril de 2002, consideramos el fenómeno desde un punto de vista estrictamente económico, esto es, como la movilidad del factor de producción trabajo (o, si se prefiere, de capital humano), entre regiones (en el caso de los movimientos internacionales, entre países). Allí se examinaron las condiciones teóricas que llevan a que estos movimientos se produzcan, así como las consecuencias para los países receptores. Partiendo del sistema imperante de regulación de los flujos, se examinaron de manera muy sencilla las pérdidas de eficiencia a las que daría lugar, y se analizaron las consecuencias sobre el bienestar de su sustitución por modelos económicamente más racionales. En el presente trabajo avanzamos en la línea del anterior, examinando, en primer lugar, las grandes cifras de la emigración en España, con objeto de presentar una idea de la magnitud del objeto de estudio, para pasar, posteriormente, a discernir los posibles determinantes, a nivel empírico, de las salidas y llegadas de trabajadores a nuestro país. Finalmente, se discuten los efectos teóricos de la llegada de emigrantes, y se propone una regulación alternativa a la actual, en línea con la esbozada en el trabajo presentado en A Coruña, discutiendo su aplicabilidad

Activating transcription factor 6 derepression mediates neuroprotection in Huntington disease

Deregulated protein and Ca2+ homeostasis underlie synaptic dysfunction and neurodegeneration in Huntington disease (HD); however, the factors that disrupt homeostasis are not fully understood. Here, we determined that expression of downstream regulatory element antagonist modulator (DREAM), a multifunctional Ca2+-binding protein, is reduced in murine in vivo and in vitro HD models and in HD patients. DREAM downregulation was observed early after birth and was associated with endogenous neuroprotection. In the R6/2 mouse HD model, induced DREAM haplodeficiency or blockade of DREAM activity by chronic administration of the drug repaglinide delayed onset of motor dysfunction, reduced striatal atrophy, and prolonged life span. DREAM-related neuroprotection was linked to an interaction between DREAM and the unfolded protein response (UPR) sensor activating transcription factor 6 (ATF6). Repaglinide blocked this interaction and enhanced ATF6 processing and nuclear accumulation of transcriptionally active ATF6, improving prosurvival UPR function in striatal neurons. Together, our results identify a role for DREAM silencing in the activation of ATF6 signaling, which promotes early neuroprotection in HDThis work was funded by the Instituto de Salud Carlos III/CIBERNED (to J.R. Naranjo, B. Mellström, and A. Rábano), FISS-RIC RD12/0042/0019 (to C. Valenzuela), Madrid regional government/Neurodegmodels (to J.R. Naranjo), MINECO grants SAF2010-21784 and SAF2014-53412-R (to J.R. Naranjo), SAF2012-32209 (to M. Gutierrez-Rodriguez), SAF2010-14916 and SAF2013-45800-R (to C. Valenzuela), and a grant from the Swedish Research Council (J.Y. Li

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Falls Predict Acute Hospitalization in Parkinson's Disease

[Background] There is a need for identifying risk factors for hospitalization in Parkinson’s disease (PD) and also interventions to reduce acute hospital admission.[Objective] To analyze the frequency, causes, and predictors of acute hospitalization (AH) in PD patients from a Spanish cohort.[Methods] PD patients recruited from 35 centers of Spain from the COPPADIS-2015 (COhort of Patients with PArkinson’s DIsease in Spain, 2015) cohort from January 2016 to November 2017, were included in the study. In order to identify predictors of AH, Kaplan-Meier estimates of factors considered as potential predictors were obtained and Cox regression performed on time to hospital encounter 1-year after the baseline visit.[Results] Thirty-five out of 605 (5.8%) PD patients (62.5±8.9 years old; 59.8% males) presented an AH during the 1-year follow-up after the baseline visit. Traumatic falls represented the most frequent cause of admission, being 23.7% of all acute hospitalizations. To suffer from motor fluctuations (HR [hazard ratio] 2.461; 95% CI, 1.065–5.678; p = 0.035), a very severe non-motor symptoms burden (HR [hazard ratio] 2.828; 95% CI, 1.319–6.063; p = 0.008), falls (HR 3.966; 95% CI 1.757–8.470; p = 0.001), and dysphagia (HR 2.356; 95% CI 1.124–4.941; p = 0.023) was associated with AH after adjustment to age, gender, disease duration, levodopa equivalent daily dose, total number of non-antiparkinsonian drugs, and UPDRS-IIIOFF. Of the previous variables, only falls (HR 2.998; 95% CI 1.080–8.322; p = 0.035) was an independent predictor of AH.[Conclusion] Falls is an independent predictor of AH in PD patients.Peer reviewe

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Diseño óptico de nuevos elementos para la compensación de defectos refractivos

En la actualidad, la mayoría de defectos refractivos son compensados con lentes esféricas, tóricas y cónicas. El problema surge cuando el defecto refractivo no está compuesto únicamente por aberraciones de bajo orden. En este proyecto se va a desarrollar una herramienta de software capaz de diseñar lentes para compensar las aberraciones de alto orden y axicones compensadores de la presbicia