Using a system thinking approach to assess the contribution of nature based solutions to sustainable development goals

Abstract Climate change and the overexploitation of natural resources increase the need to integrate sustainable development policies at both national and international levels to fit the demands of a growing population. In 2015 the United Nations (UN) established the 2030 Agenda for sustainable development with the aim of eradicating extreme poverty, reducing inequality and protecting the planet. The Agenda 2030 highlights the importance of biodiversity and the functioning of ecosystems to maintain economic activities and the well-being of local communities. Nature Based Solutions (NBS) support biodiversity conservation and the functioning of ecosystems. NBS are increasingly seen as innovative solutions to manage water-related risks while transforming natural capital into a source of green growth and sustainable development. In this context, NBS could potentially contribute to the achievement of several Sustainable Development Goals (SDGs) by promoting the delivery of bundles of ecosystem services together generating various social, economic and environmental co-benefits. However, to achieve the full potential of NBS, it is necessary to recognize the trade-offs and synergies of the co-benefits associated with their implementation. To this aim, we have adopted a system perspective and a multi-sectoral approach to analyse the potential of NBS to deliver co-benefits while at the same time reducing the negative effects of water-related hazards. Using the case study of Copenhagen, we have analysed the relationships between the co-benefits associated with the scenario of the restoration of the Ladegaardsaa urban river. Our hypothesis is that enhancing the understanding of the social, economic and environmental factors of the system, including mutual influences and trade-offs, could improve the decision-making process and thereby enhance the capability of NBS to contribute to the achievement of the SDGs

Adherence to healthy diet and physical activity in clinical patients

Antecedentes: el objetivo de este estudio ha sido explorar las propiedades psicométricas del cuestionario Motiva.Diaf, diseñado para medir la adherencia a las características de la dieta saludable y realización de actividad física en personas enfermas. Método: participaron 230 pacientes, que asistieron a consultas hospitalarias, con una edad media de 49,28 años (SD = 12,34), siendo un 55,7 % mujeres. Dos semanas tras la administración inicial, se seleccionaron al azar 40 participantes, de los que tenían otra cita hospitalaria, para completar nuevamente el cuestionario con el fin de evaluar la fiabilidad test-retest. Resultados: la precisión de las puntuaciones es adecuada en términos de consistencia interna (α = .802; Ω = .776) y de estabilidad temporal (r =.786). La estructura del test es esencialmente unidimensional y las puntuaciones en esta dimensión convergen con las medidas de necesidades psicológicas básicas (r Diet = .294; r Physical Activity= .359) y salud percibida (r = .266). También se encontró una relación moderada con IMC (r = - .129). Conclusiones: Motiva.Diaf ha demostrado una fiabilidad y validez. La disponibilidad de un instrumento de estas características tiene implicaciones significativas en la evaluación de las conductas, diseño e implementación de intervenciones conductuales

Impaired expression of ectonucleotidases in ectopic and eutopic endometrial tissue is in favor of ATP accumulation in the tissue microenvironment in endometriosis

Endometriosis is a prevalent disease defined by the presence of endometrial tissue outside the uterus. Adenosine triphosphate (ATP), as a proinflammatory molecule, promotes and helps maintain the inflammatory state of endometriosis. Moreover, ATP has a direct influence on the two main symptoms of endometriosis: infertility and pain. Purinergic signaling, the group of biological responses to extracellular nucleotides such as ATP and nucleosides such as adenosine, is involved in the biology of reproduction and is impaired in pathologies with an inflammatory component such as endometriosis. We have previously demonstrated that ectonucleotidases, the enzymes regulating extracellular ATP levels, are active in non-pathological endometria, with hormone-dependent changes in expression throughout the cycle. In the present study we have focused on the expression of ectonucleotidases by means of immunohistochemistry and in situ activity in eutopic and ectopic endometrial tissue of women with endometriosis, and we compared the results with endometria of women without the disease. We have demonstrated that the axis CD39-CD73 is altered in endometriosis, with loss of CD39 and CD73 expression in deep infiltrating endometriosis, the most severe, and most recurring, endometriosis subtype. Our results indicate that this altered expression of ectonucleotidases in endometriosis boosts ATP accumulation in the tissue microenvironment. An important finding is the identification of the nucleotide pyrophophatase/phosphodiesterase 3 (NPP3) as a new histopathological marker of the disease since we have demonstrated its expression in the stroma only in endometriosis, in both eutopic and ectopic tissue. Therefore, targeting the proteins directly involved in ATP breakdown could be an appropriate approach to consider in the treatment of endometriosis

COVIDGR Dataset and COVID-SDNet Methodology for Predicting COVID-19 Based on Chest X-Ray Images

Currently, Coronavirus disease (COVID-19), one of the most infectious diseases in the 21st century, is diagnosed using RT-PCR testing, CT scans and/or Chest X-Ray (CXR) images. CT (Computed Tomography) scanners and RT-PCR testing are not available in most medical centers and hence in many cases CXR images become the most time/cost effective tool for assisting clinicians in making decisions. Deep learning neural networks have a great potential for building COVID-19 triage systems and detecting COVID-19 patients, especially patients with low severity. Unfortunately, current databases do not allow building such systems as they are highly heterogeneous and biased towards severe cases. This article is three-fold: (i) we demystify the high sensitivities achieved by most recent COVID-19 classification models, (ii) under a close collaboration with Hospital Universitario Clínico San Cecilio, Granada, Spain, we built COVIDGR-1.0, a homogeneous and balanced database that includes all levels of severity, from normal with Positive RT-PCR, Mild, Moderate to Severe. COVIDGR-1.0 contains 426 positive and 426 negative PA (PosteroAnterior) CXR views and (iii) we propose COVID Smart Data based Network (COVID-SDNet) methodology for improving the generalization capacity of COVID-classification models. Our approach reaches good and stable results with an accuracy of 97.72%±0.95% , 86.90%±3.20% , 61.80%±5.49% in severe, moderate and mild COVID-19 severity levels. Our approach could help in the early detection of COVID-19. COVIDGR-1.0 along with the severity level labels are available to the scientific community through this link https://dasci.es/es/transferencia/open-data/covidgr/This work was supported by the project DeepSCOP-Ayudas Fundación BBVA a Equipos de Investigación Científica en Big Data 2018, COVID19_RX-Ayudas Fundación BBVA a Equipos de Investigación Científica SARS-CoV-2 y COVID-19 2020, and the Spanish Ministry of Science and Technology under the project TIN2017-89517-P. S. Tabik was supported by the Ramon y Cajal Programme (RYC-2015-18136). A. Gómez-Ríos was supported by the FPU Programme FPU16/04765. D. Charte was supported by the FPU Programme FPU17/04069. J. Suárez was supported by the FPU Programme FPU18/05989. E.G was supported by the European Research Council (ERC Grant agreement 647038 [BIODESERT])

Prevalencia de patrones electrocardiográficos asociados a muerte súbita en la población española de 40 años o más. Resultados del estudio OFRECE

[Abstract] Introduction and objectives. Some electrocardiographic patterns are associated with an increased risk of sudden cardiac death due to ventricular arrhythmias. There is no information on the prevalence of these patterns in the general population in Spain. The objective of this study was to analyze the prevalence of these patterns and associated clinical and epidemiological factors. Methods. This subanalysis of the OFRECE study selected a representative sample of the Spanish population aged ≥ 40 years. We studied the presence or absence of electrocardiographic patterns of Brugada syndrome and QT interval abnormalities. Clinical data and electrocardiograms were available in all participants. Electrocardiograms were evaluated by 2 cardiologists and a third cardiologist was consulted if there was disagreement in the diagnosis. We calculated the weighted prevalence and clinical factors associated with the presence of Brugada-type patterns or QT segment abnormalities. Results. Overall, 8343 individuals were evaluated (59.2 years, 52.4% female). There were 12 Brugada cases (type 1, 2 cases; type 2, 10 cases; weighted prevalence, 0.13%). For corrected QT (QTc) analysis, we excluded participants with left bundle branch block or without sinus rhythm. Weighted prevalences were as follows: short QTc (< 340 ms) 0.18%, borderline QTc (441-469 ms) 8.33%, long QTc (≥ 470 ms criterion) 1.01% and long QTc (≥ 480 criterion) 0.42%. Conclusions. A total of 0.6% to 1.1% of the Spanish population aged ≥ 40 years has an electrocardiographic pattern associated with a higher risk of sudden death (Brugada syndrome, long QT, or short QT).[Resumen] Introducción y objetivos. Hay patrones electrocardiográficos asociados a mayor riesgo de muerte súbita por arritmias ventriculares. En España no existe información acerca de su prevalencia en la población. El objetivo es estudiar la prevalencia de estos patrones, así como los factores clinicoepidemiológicos asociados a su presencia. Métodos. Subanálisis del estudio OFRECE en el que se estudió la prevalencia de patrones electrocardiográficos de síndrome de Brugada o anomalías del intervalo QT en una muestra representativa de la población española ≥ 40 años. Se dispuso de datos clínicos y electrocardiogramas de todos los participantes. Los electrocardiogramas fueron evaluados de forma independiente por 2 cardiólogos y, en caso de desacuerdo, se consultó con un tercero. Se analizaron las prevalencias ponderadas y los factores clínicos asociados a patrones tipo Brugada o a anomalías del segmento QT. Resultados. Se evaluó a 8.343 individuos (59,2 años, 52,4% mujeres) y se detectaron 12 casos de patrón Brugada (tipo 1, 2 casos; tipo 2, 10 casos; prevalencia ponderada, 0,13%). Para el análisis del QT corregido (QTc) se excluyó a los participantes con bloqueo de rama izquierda o ritmos no sinusales. Las prevalencias ponderadas fueron: QTc corto (< 340 ms) 0,18%, QTc borderline (441-469 ms) 8,33%, QTc largo (criterio ≥ 470 ms) 1,01% y QTc largo (criterio ≥ 480 ms) 0,42%. Conclusiones. El 0,6-1,1% de la población española de edad ≥ 40 años presenta un patrón electrocardiográfico de riesgo de muerte súbita (síndrome de Brugada, QT largo o QT corto)

Cuerpos y prácticas: una década de estudios ctg

Resumen En este trabajo presentamos algunas investigaciones realizadas en el área de estudios sociales de la ciencia bajo el enfoque denominado Ciencia, Tecnología y Género (CTG). La intersección de los estudios sociales de la ciencia con la teoría feminista y los estudios de género ha dado lugar a este campo de estudio interdisciplinar. En el Estado español, se han llevado a cabo múltiples trabajos en esta línea, de los que exponemos algunos de los realizados por nuestro grupo de investigación al menos en los últimos diez años. Se centran en estudios de caso, que implican diferentes tecnologías biomédicas, y en los que los cuerpos juegan un papel fundamental estableciendo alianzas, resistencias o cuestionando los marcos normativos en los que cuerpos y tecnologías se hayan inmersos

La Biblioteca Universitaria de Granada y su compromiso con la sociedad

Se describen las actividades que lleva a cabo la Biblioteca Universitaria de Granada enfocadas al conjunto de la sociedad, y que constituyen una extensión de sus funciones tradicionales de servicio al estudio, la docencia y la investigación desarrolladas en la institución en que se encuentran. Acciones dirigidas siguiendo varias líneas de trabajo: el acceso abierto a recursos de conocimiento y formación y la realización de actividades culturales abiertas a toda la ciudadanía; el servicio a los usuarios con necesidades especiales o en riesgo de exclusión social, incluyendo la participación en acciones solidarias; la formación de una conciencia ecológica mediante la realización de campañas de concienciación en este sentido; y, mediante la contribución a la economía de la comunidad a través de la elección de proveedores locales para invertir su presupuesto. Todo ello en aras de construir un modelo de biblioteca abierto y dinamizador dentro del conjunto de la sociedad

DUbbing language-therapy CINEma-based in aphasia post-stroke (DULCINEA): study protocol for a randomized crossover pilot trial

Communication is one of the most important predictors of social reintegration after stroke. Approximately 15–42% of stroke survivors experience post-stroke aphasia. Helping people recover from aphasia is one of the research priorities after a stroke. Our aim is to develop and validate a new therapy integrating dubbing techniques to improve functional communication. Methods: The research project is structured as three work packages (WP). WP1: development of the dubbed language cinema-based therapy: Two research assistants (a speech therapist and a dubbing actor) will select the clips, mute specific words/sentences in progressive speech difficulty, and guide patients to dub them across sessions. Words to be dubbed will be those considered to be functionally meaningful by a representative sample of aphasic patients and relatives through an online survey. WP2: a randomized, crossover, interventional pilot study with the inclusion of 54 patients with post-stroke non-fluent aphasia. Patients will be treated individually in 40-min sessions twice per week for 8 weeks. Primary outcomes will be significant pre/post differences in scores in the Communicative Activity Log (CAL) questionnaire and Boston Diagnostic Aphasia Examination (BDAE) administered by a psychologist blinded to the patients’ clinical characteristics. Secondary outcomes: General Health Questionnaire (GHQ)-12, Stroke Aphasia Quality of Life Scale (SAQOL-39), Western Aphasia Battery Revised (WAB-R), and the Stroke Aphasic Depression Questionnaire (SADQ10). WP3: educational activities and dissemination of results. WP3 includes educational activities to improve public knowledge of aphasia and dissemination of the results, with the participation of the Spanish patients’ association Afasia Activa. Discussion: This pilot clinical trial will explore the efficacy of a new therapeutic tool based on dubbing techniques and computer technology to improve functional communication of patients suffering from post-stroke aphasia with the use of standardized test assessmentThis study is promoted by Blanca Fuentes and the Research Foundation of La Paz University Hospital, which hosts a research consortium joined by the Department of Neurology at La Paz University Hospital, the Department of Psychology at Comillas Pontifical University, and the patients’ association Afasia Activa. This project has received funding from “la Caixa” Banking Foundation under the project code HR18-00026. Funder is not involved in any of the following processes: design of the trial, data collection, analysis, or interpretation of data nor than in writing the manuscrip

Dyslipidemias and stroke prevention: recommendations of the Study Group of Cerebrovascular Diseases of the Spanish Society of Neurology

Objetivo: Actualizar las recomendaciones de la Sociedad Española de Neurología para la prevención del ictus, tanto primaria como secundaria, en pacientes con dislipidemia. Desarrollo: Se ha realizado una revisión sistemática en Pubmed evaluando los principales aspectos relacionados con el manejo de las dislipidemias en la prevención primaria y secundaria del ictus, elaborándose una serie de recomendaciones relacionadas con los mismos. Conclusiones: En prevención primaria se recomienda determinar el riesgo vascular del paciente con el fin de definir los objetivos de LDLc. En prevención secundaria tras un ictus de origen aterotrombótico se recomienda un objetivo de LDLc < 55 mg/dl, mientras que en ictus isquémicos de origen no aterotrombótico, dado que su relación con dislipidemias es incierta, se establecerán los objetivos en función del grupo de riesgo vascular de cada paciente. Tanto en prevención primaria como secundaria las estatinas son los fármacos de primera elección, pudiendo asociarse ezetimiba y/o inhibidores de PCSK9 en aquellos casos que no alcancen los objetivos terapéuticosObjective We present an update of the Spanish Society of Neurology's recommendations for prevention of both primary and secondary stroke in patients with dyslipidaemia. Development We performed a systematic review to evaluate the main aspects of the management of dyslipidaemias in primary and secondary stroke prevention and establish a series of recommendations. Conclusions In primary prevention, the patient's vascular risk should be determined in order to define target values for low-density lipoprotein cholesterol. In secondary prevention after an atherothrombotic stroke, a target value < 55 mg/dL is recommended; in non-atherothombotic ischaemic strokes, given the unclear relationship with dyslipidaemia, target value should be established according to the vascular risk group of each patient. In both primary and secondary prevention, statins are the drugs of first choice, and ezetimibe and/or PCSK9 inhibitors may be added in patients not achieving the target valu