Foreign Tourists in World Heritage Sites: A Motivation-Based Segmentation

The inclusion on the lists published by the United Nations Educational, Scientific, and Cultural Organization (UNESCO)—World Heritage Site (WHS), Intangible Cultural Heritage (ICH), and World Heritage Sites in Danger—suggests, first of all, the acknowledgement of something worth protecting and, secondly, an increase in the strength of tourist attraction to the affected destination, especially among specific visitors. The identification and classification of tourists that are seen to be more interested in heritage is the stated aim of this work, based on models already proposed in the scientific literature. For this purpose, a survey was conducted that interviewed a representative sample of international tourists visiting the city of Córdoba. A multi-variant technique of case-cluster was applied. In addition, a discriminant analysis was used to validate the clusters of the cases obtained. For analyzing the differences between the different groups obtained, some non-parametrical statistical procedures were applied. The results obtained allowed for the visualization of a model that shows the empirical evidence regarding the presence of four types of foreign tourists that are considered valid for segmentation in the city of Córdoba as a WHS tourist destination: the alternative tourist, emotional tourist, cultural tourist, and heritage tourist. These results allow public and private managers to design specific strategies to increase visitor satisfaction

Aplicaciones del SiC biomórfico como reforzante estructural en hormigones refractarios

Una posible aplicación del SiC biomórfico (bioSiC) son los reforzante estructural en hormigones refractarios. En este caso se han fabricado piezas de bioSiC con forma de cilindros alargados, 3-4 mm de diámetro y 30-35 mm de longitud, mediante infiltración reactiva de Si líquido en piezas de carbón obtenidas por pirolización de madera de haya de calidad comercial. Hemos estudiado las características microestructurales y las propiedades mecánicas de los reforzantes, como paso previo al estudio de la aplicación mencionada, de la que se ofrece un avance en este trabajo. Para caracterizar la calidad del material y del proceso de fabricación, la microestructura de las piezas se ha estudiado mediante microscopía electrónica de barrido. Los reforzantes de bioSiC fueron ensayados a compresión uniaxial y flexión en cuatro puntos a temperatura ambiente y a alta temperatura (1250-1400ºC) para la determinación de sus propiedades mecánicas, y se realizaron estudios fractográficos en el segundo tipo de ensayos. Subsecuentemente, se prepararon ladrillos refractarios con un 3% en peso de reforzantes de bioSiC, que fueron curados a diferentes temperaturas (máx. 1600ºC). Estos ladrillos se han ensayado en compresión y flexión en tres puntos, a temperatura ambiente, comparándose los resultados con los obtenidos en ladrillos sin reforzantes y reforzados con agujas metálicas de calidad comercial (acero refractario 306 ó 310), con la misma formulación y condiciones de curado.This work is devoted to the study of the time and temperature dependence of the static grain growth in YTZP 4 mol %, with an average grain size within the submicrometric range ( > 0.1 µm). Also, the mechanical response in the temperature interval between 1200 ºC and 1500 ºC is analysed. The grain growth is controlled by the yttria segregation at the grain boundaries, which plays a key role in the cationic diffusion processes. Microstructural characterization of both as-received and deformed samples allows to conclude that plastic deformation is due to grain boundary sliding (GBS), with stress exponents increasing with the flow stress, but in all cases they are lower than n = 2

Tocilizumab in refractory Caucasian Takayasu’s arteritis: a multicenter study of 54 patients and literature review

Arteritis de Takayasu; Tocilizumab; Teràpia biològicaArteritis de Takayasu; Tocilizumab; Terapia biológicaTakayasu’s arteritis; Tocilizumab; Biological therapyObjective: To assess the efficacy and safety of tocilizumab (TCZ) in Caucasian patients with refractory Takayasu’s arteritis (TAK) in clinical practice. Methods: A multicenter study of Caucasian patients with refractory TAK who received TCZ. The outcome variables were remission, glucocorticoid-sparing effect, improvement in imaging techniques, and adverse events. A comparative study between patients who received TCZ as monotherapy (TCZMONO) and combined with conventional disease modifying anti-rheumatic drugs (cDMARDs) (TCZCOMBO) was performed. Results: The study comprised 54 patients (46 women/8 men) with a median [interquartile range (IQR)] age of 42.0 (32.5–50.5) years. TCZ was started after a median (IQR) of 12.0 (3.0–31.5) months since TAK diagnosis. Remission was achieved in 12/54 (22.2%), 19/49 (38.8%), 23/44 (52.3%), and 27/36 (75%) patients at 1, 3, 6, and 12 months, respectively. The prednisone dose was reduced from 30.0 mg/day (12.5–50.0) to 5.0 (0.0–5.6) mg/day at 12 months. An improvement in imaging findings was reported in 28 (73.7%) patients after a median (IQR) of 9.0 (6.0–14.0) months. Twenty-three (42.6%) patients were on TCZMONO and 31 (57.4%) on TCZCOMBO: MTX (n = 28), cyclosporine A (n = 2), azathioprine (n = 1). Patients on TCZCOMBO were younger [38.0 (27.0–46.0) versus 45.0 (38.0–57.0)] years; difference (diff) [95% confidence interval (CI) = -7.0 (-17.9, -0.56] with a trend to longer TAK duration [21.0 (6.0–38.0) versus 6.0 (1.0–23.0)] months; diff 95% CI = 15 (-8.9, 35.5), and higher c-reactive protein [2.4 (0.7–5.6) versus 1.3 (0.3–3.3)] mg/dl; diff 95% CI = 1.1 (-0.26, 2.99). Despite these differences, similar outcomes were observed in both groups (log rank p = 0.862). Relevant adverse events were reported in six (11.1%) patients, but only three developed severe events that required TCZ withdrawal. Conclusion: TCZ in monotherapy, or combined with cDMARDs, is effective and safe in patients with refractory TAK of Caucasian origin.The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was partially supported by RETICS Programs, RD08/0075 (RIER), RD12/0009/0013 and RD16/0012 from “Instituto de Salud Carlos III” (ISCIII) (Spain). However, this research did not receive any specific grant from funding agencies in the commercial or not-for-profit sectors

Phthalates, organotin compounds and per-polyfluoroalkyl substances in semiconfined areas of the Spanish coast: occurrence, sources and risk assessment

Postprint3,25

Clinical Implications of (Pro)renin Receptor (PRR) Expression in Renal Tumours

(1) Background: Renal cancer is one of the most frequent malignancies in Western countries, with an unpredictable clinical outcome, partly due to its high heterogeneity and the scarcity of reliable biomarkers of tumour progression. (Pro)renin receptor (PRR) is a novel receptor of the renin–angiotensin system (RAS) that has been associated with the development and progression of some solid tumours by RAS-dependent and -independent mechanisms. (2) Methods: In this study, we analysed the immunohistochemical expression of PRR at the centre and border in a series of 83 clear-cell renal cell (CCRCCs), 19 papillary (PRCC) and 7 chromophobe (ChRCC) renal cell carcinomas, and the benign tumour renal oncocytoma (RO, n = 11). (3) Results: PRR is expressed in all the tumour subtypes, with higher mean staining intensity in ChRCCs and ROs. A high expression of PRR at the tumour centre and at the infiltrative front of CCRCC tissues is significantly associated with high grade, tumour diameter, local invasion and stage, and with high mortality risk by UCLA integrated staging system (UISS) scale. (4) Conclusions: These findings indicate that PRR is associated with the development and progression of renal tumours. Its potential as a novel biomarker for RCC diagnosis/prognosis and as a promising therapeutic target should be taken into account in the future.The work was funded by the Basque Government (ELKARTEK KK2018-00090 and KK-2020/00069)

Early Stepdown From Echinocandin to Fluconazole Treatment in Candidemia: A Post Hoc Analysis of Three Cohort Studies

Antifúngic; Candidèmia; DesescaladaAntifúngico; Candidemia; DesescaladaAntifungal; Candidemia; De-escalationBackground There are no clear criteria for antifungal de-escalation after initial empirical treatments. We hypothesized that early de-escalation (ED) (within 5 days) to fluconazole is safe in fluconazole-susceptible candidemia with controlled source of infection. Methods This is a multicenter post hoc study that included consecutive patients from 3 prospective candidemia cohorts (2007–2016). The impact of ED and factors associated with mortality were assessed. Results Of 1023 candidemia episodes, 235 met inclusion criteria. Of these, 54 (23%) were classified as the ED group and 181 (77%) were classified as the non-ED group. ED was more common in catheter-related candidemia (51.9% vs 31.5%; P = .006) and episodes caused by Candida parapsilosis, yet it was less frequent in patients in the intensive care unit (24.1% vs 39.2%; P = .043), infections caused by Nakaseomyces glabrata (0% vs 9.9%; P = .016), and candidemia from an unknown source (24.1% vs 47%; P = .003). In the ED and non-ED groups, 30-day mortality was 11.1% and 29.8% (P = .006), respectively. Chronic obstructive pulmonary disease (odds ratio [OR], 3.97; 95% confidence interval [CI], 1.48–10.61), Pitt score > 2 (OR, 4.39; 95% CI, 1.94–9.20), unknown source of candidemia (OR, 2.59; 95% CI, 1.14–5.86), candidemia caused by Candida albicans (OR, 3.92; 95% CI, 1.48–10.61), and prior surgery (OR, 0.29; 95% CI, 0.08–0.97) were independent predictors of mortality. Similar results were found when a propensity score for receiving ED was incorporated into the model. ED had no significant impact on mortality (OR, 0.50; 95% CI, 0.16–1.53). Conclusions Early de-escalation is a safe strategy in patients with candidemia caused by fluconazole-susceptible strains with controlled source of bloodstream infection and hemodynamic stability. These results are important to apply antifungal stewardship strategies.This research forms part of an activity that has received funding from EIT Health. EIT Health is supported by the European Institute of Innovation and Technology (EIT), a body of the European Union that receives support from the European Union´s Horizon 2020 Research and Innovation Program. This study has been cofunded by the European Regional Development Fund. E. M.-G. (PI18/01061), P. P.-A. (“Rio Hortega” contract CM18/00132), M. F.-R. (“Miguel Servet” contract CP18/00073), and C. G.-V. (FIS PI18/01061) have received research grants from the Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III

Legged locomotion over irregular terrains: State of the art of human and robot performance

Legged robotic technologies have moved out of the lab to operate in real environments, characterized by a wide variety of unpredictable irregularities and disturbances, all this in close proximity with humans. Demonstrating the ability of current robots to move robustly and reliably in these conditions is becoming essential to prove their safe operation. Here, we report an in-depth literature review aimed at verifying the existence of common or agreed protocols and metrics to test the performance of legged system in realistic environments. We primarily focused on three types of robotic technologies, i.e., hexapods, quadrupeds and bipeds. We also included a comprehensive overview on human locomotion studies, being it often considered the gold standard for performance, and one of the most important sources of bioinspiration for legged machines. We discovered that very few papers have rigorously studied robotic locomotion under irregular terrain conditions. On the contrary, numerous studies have addressed this problem on human gait, being nonetheless of highly heterogeneous nature in terms of experimental design. This lack of agreed methodology makes it challenging for the community to properly assess, compare and predict the performance of existing legged systems in real environments. On the one hand, this work provides a library of methods, metrics and experimental protocols, with a critical analysis on the limitations of the current approaches and future promising directions. On the other hand, it demonstrates the existence of an important lack of benchmarks in the literature, and the possibility of bridging different disciplines, e.g., the human and robotic, towards the definition of standardized procedure that will boost not only the scientific development of better bioinspired solutions, but also their market uptake

Superficial Characteristics and Functionalization Effectiveness of Non-Toxic Glutathione-Capped Magnetic, Fluorescent, Metallic and Hybrid Nanoparticles for Biomedical Applications

An optimal design of nanoparticles suitable for biomedical applications requires proper functionalization, a key step in the synthesis of such nanoparticles, not only for subsequent crosslinking to biological targets and to avoid cytotoxicity, but also to endow these materials with colloidal stability. In this sense, a reliable characterization of the effectiveness of the functionalization process would, therefore, be crucial for subsequent bioconjugations. In this work, we have analyzed glutathione as a means to functionalize four of the most widely used nanoparticles in biomedicine, one of which is a hybrid gold-magnetic-iron-oxide nanoparticle synthetized by a simple and novel method that we propose in this article. We have analyzed the colloidal characteristics that the glutathione capping provides to the different nanoparticles and, using information on the Z-potential, we have deduced the chemical group used by glutathione to link to the nanoparticle core. We have used electron microscopy for further structural and chemical characterization of the nanoparticles. Finally, we have evaluated nanoparticle cytotoxicity, studying cell viability after incubation with different concentrations of nanoparticles, showing their suitability for biomedical applications

Evaluacion por western blot, inmunofluorescencia indirecta y elisa de perros infectados con leishmania (leishmania) infantum

Objetivo Evaluar el desempeño de las pruebas empleadas en Colombia para el diagnóstico de la leishmaniasis visceral canina y adaptar una técnica de Western blot empleando animales experimental y naturalmente infectados.  Metodología Se obtuvieron sueros de 10 perros infectados experimentalmente con L. infantum, 5 perros infectados naturalmente, 16 perros sanos, 26 de reacción cruzada (infectados con Babesia canis, Erhlichia canis, Dirofilaria immitis, Trypanosoma cruzi, Leishmania (Viannia) spp.), 40 de zonas no endémicas y 150 de zona endémica.  Todos fueron evaluados mediante las pruebas de inmunofluorescencia indirecta (IFI), ELISA y Western blot (WB).  Resultados Se encontró que IFI tuvo el mayor porcentaje de positividad en los perros infectados (73 %) mientras que el menor porcentaje de falsos positivos se obtuvo por WB (2,5 %).  La prueba de ELISA fue la menos eficiente. Fueron reconocidas 24 fracciones antigénicas, las bandas de 29, 34, 50, 69, 75, 86, 99 y 123 kDa fueron responsables de reacciones inespecíficas en los sueros de perros sanos, de zona no endémica y de reacción cruzada.  Las bandas por debajo de 29 kDa mostraron ser potencialmente diagnósticas, especialmente la fracción de 13 kDa.  Conclusiones Los métodos directos y serológicos pueden subdiagnosticar la infección por Leishmania, solamente un constructo que combine tanto pruebas directas como indirectas sería la forma más eficiente de diagnóstic