External validation of multidimensional prognostic indices (ADO, BODEx and DOSE) in a primary care international cohort (PROEPOC/COPD cohort)

Background: Due to the heterogeneous and systemic nature of the chronic obstructive pulmonary disease (COPD), the new guidelines are oriented toward individualized attention. Multidimensional scales could facilitate its proper clinical and prognostic assessment, but not all of them were validated in an international primary care cohort, different from the original ones used for model development. Therefore, our main aim is to assess the prognostic capacity of the ADO, BODEx and DOSE indices in primary care for predicting mortality in COPD patients and to validate the models obtained in subgroups of patients, classified by revised Global Initiative for Chronic Obstructive Lung Disease (2011) and updated Spanish Guideline (2014). Besides, we want to confirm that the prognostic capacity of all indices increases if the number of exacerbations is substituted by the interval between them and to assess the impact on health of the patient''s lifestyle, social network and adherence to treatment. Methods: Design: External validation of scales, open and prospective cohort study in primary care. Setting: 36 health centres in 6 European high, medium and low income countries. Subjects: 477 patients diagnosed with COPD, captured in clinical visit by their General Practitioner/Nurse. Predictors: Detailed patient history, exacerbations, lung function test and questionnaires at baseline. Outcomes: Exacerbations, all-cause mortality and specific mortality, within 5 years of recruitment. Analysis: Multivariate logistic regression and Cox regression will be used. Possible non-linear effect of the indices will be studied by using Structured Additive Regression models with penalised splines. Subsequently, we will assess different aspects of the regression models: discrimination, calibration and diagnostic precision. Clinical variables modulated in primary care and the interval between exacerbations will be considered and incorporated into the analysis. Discussion: The Research Agenda for General Practice/Family Medicine highlights that the evidence on predictive values of prognostic indices in primary care is scarce. A prospective cohort like that of PROEPOC/COPD provides good opportunities for research into COPD and make communication easier between family practitioners, nursing staff, pneumologists and other professionals, supporting a multi-disciplinary approach to the treatment of these patients. Trial registration:ISRCTN52402811. Date: 15/01/2015. Prospectively registered

Atención de la urgencia quirúrgica durante la pandemia COVID-19. Recomendaciones de la Asociación Española de Cirujanos

La infección por el nuevo coronavirus SARS-CoV-2 (enfermedad por coronavirus 2019 [COVID-19]) ha determinado la necesidad de la reorganización de muchos centros hospitalarios en el mundo. España, como uno de los epicentros de la enfermedad, ha debido asumir cambios en la práctica totalidad de su territorio. Sin embargo, y desde el inicio de la pandemia, en todos los centros que atienden urgencias quirúrgicas ha sido necesario el mantenimiento de su cobertura, aunque igualmente ha sido inevitable introducir directrices especiales de ajuste al nuevo escenario que permitan el mantenimiento de la excelencia en la calidad asistencial. Este documento desarrolla una serie de indicaciones generales para la cirugía de urgencias y la atención al politraumatizado desarrolladas desde la literatura disponible y consensuadas por un subgrupo de profesionales desde el grupo general Cirugía-AEC-COVID-19. Estas medidas van encaminadas a contemplar un riguroso control de la exposición en pacientes y profesionales, a tener en cuenta las implicaciones de la pandemia sobre diferentes escenarios perioperatorios relacionados con la urgencia y a una adaptación ajustada a la situación del centro en relación con la atención a pacientes infectados. New coronavirus SARS-CoV-2 infection (coronavirus disease 2019 [COVID-19]) has determined the necessity of reorganization in many centers all over the world. Spain, as an epicenter of the disease, has been forced to assume health policy changes in all the territory. However, and from the beginning of the pandemic, every center attending surgical urgencies had to guarantee the continuous coverage adopting correct measures to maintain the excellence of quality of care. This document resumes general guidelines for emergency surgery and trauma care, obtained from the available bibliography and evaluated by a subgroup of professionals designated from the general group of investigators Cirugía-AEC-COVID-19 from the Spanish Association of Surgeons, directed to minimize professional exposure, to contemplate pandemic implications over different urgent perioperative scenarios and to adjust decision making to the occupational pressure caused by COVID-19 patients

SCoCAN: un protocolo de comunicaciones de tiempo real para Sistemas Empotrados Distribuidos. Aplicación al control de robots

En este trabajo se describe el diseño y la implementación de una arquitectura distribuida para el control de robots móviles. En el desarrollo de esta arquitectura se han implementado tanto los nodos empotrados encargados del control del sistema, así como el protocolo de comunicaciones SCoCAN (Shared Channel on CAN). Este protocolo permite comunicaciones de tiempo real entre diferentes nodos distribuidos (sensores, actuadores y controladores). SCoCAN esta basado en un esquema de comunicaciones híbrido (Time Triggered-Event Triggered) que garantiza un jitter mínimo en el lazo sensor-control-actuador. Los nodos distribuidos utilizan RT-Linux como plataforma de gestión, control y planificación del sistema de tiempo real

Arácnidos prioritarios para la conservación en Uruguay

La lista de especies prioritarias para la conservación en Uruguay resulta un insumo imprescindible para la gestión de la biodiversidad a nivel nacional y regional. Actualmente esta lista contiene vertebrados, plantas vasculares y moluscos continentales, siendo estos últimos los únicos representantes de invertebrados. Los arácnidos son predadores “tope” y reflejan lo que sucede a otros niveles de la trama trófica. En Uruguay se han identificado algunos problemas en cuanto a la conservación de los arácnidos, de los cuales las principales amenazas son la modificación y fragmentación de hábitat y el comercio ilegal de especies. El objetivo fue elaborar una lista de especies de arácnidos prioritarias para la conservación en Uruguay. Se realizaron una serie de talleres con expertos aracnólogos donde se consensuaron 7 criterios para definir especies prioritarias y se conformó una lista en base a éstos. Se identificaron 42 especies de arácnidos prioritarias para la conservación en Uruguay, de las cuales 35 son arañas, 4 son escorpiones, 2 opiliones y 1 solífugo. La elaboración de esta lista contribuirá a mejorar el estado del conocimiento de la biodiversidad de invertebrados a nivel nacional.Arachnids with priority for conservation in Uruguay. The list of species with priorities for conservation in Uruguay is an essential input for biodiversity management. Currently the list includes vertebrates, vascular plants and continental mollusks, of which the last group is the only representative of invertebrates. Arachnids are top predators that reflect what is happening at the oth201er levels of the trophic web. Some problems about arachnids’ conservation have been identified in Uruguay, mostly related to habitat reduction and modification and traffic of species. The objective of the present study was to elaborate a list of arachnids with priority of conservation in Uruguay. We organized a series of workshops with arachnology experts, agreed in seven criteria to define priority species and created the list. We identified 42 arachnids with priority of conservation in Uruguay. Thirty-five are spiders, four are scorpions, two are harvestmen and one is a camel spider. The creation of this list generates an antecedent for these groups that will contribute to improve the knowledge of invertebrate biodiversity in our country and the region

An updated climatology of surface dimethylsufide concentrations and emission fluxes in the global ocean

The potentially significant role of the biogenic trace gas dimethylsulfide (DMS) in determining the Earth's radiation budget makes it necessary to accurately reproduce seawater DMS distribution and quantify its global flux across the sea/air interface. Following a threefold increase of data (from 15,000 to over 47,000) in the global surface ocean DMS database over the last decade, new global monthly climatologies of surface ocean DMS concentration and sea-to-air emission flux are presented as updates of those constructed 10 years ago. Interpolation/extrapolation techniques were applied to project the discrete concentration data onto a first guess field based on Longhurst's biogeographic provinces. Further objective analysis allowed us to obtain the final monthly maps. The new climatology projects DMS concentrations typically in the range of 1–7 nM, with higher levels occurring in the high latitudes, and with a general trend toward increasing concentration in summer. The increased size and distribution of the observations in the DMS database have produced in the new climatology substantially lower DMS concentrations in the polar latitudes and generally higher DMS concentrations in regions that were severely undersampled 10 years ago, such as the southern Indian Ocean. Using the new DMS concentration climatology in conjunction with state-of-the-art parameterizations for the sea/air gas transfer velocity and climatological wind fields, we estimate that 28.1 (17.6–34.4) Tg of sulfur are transferred from the oceans into the atmosphere annually in the form of DMS. This represents a global emission increase of 17% with respect to the equivalent calculation using the previous climatology. This new DMS climatology represents a valuable tool for atmospheric chemistry, climate, and Earth System models