How do policy levers shape the quality of a national health system?

Poor quality of care may have a detrimental effect on access and take-up and can become a serious barrier to the universality of health services. This consideration is of particular interest in view of the fact that health systems in many countries must address a growing public-sector deficit and respond to increasing pressures due to COVID-19 and aging population, among other factors. In line with a rapidly emerging literature, we focus on patient satisfaction as a proxy for quality of health care. Drawing on rich longitudinal and cross-sectional data for Spain and multilevel estimation techniques, we show that in addition to individual level differences, policy levers (such as public health spending and the patient-doctor ratio, in particular) exert a considerable influence on the quality of a health care system. Our results suggest that policymakers seeking to enhance the quality of care should be cautious when compromising the level of health resources, and in particular, health personnel, as a response to economic downturns in a sector that traditionally had insufficient human resources in many countries, which have become even more evident in the light of the current health crisis. Additionally, we provide evidence that the increasing reliance on the private health sector may be indicative of inefficiencies in the public system and/or the existence of features of private insurance which are deemed important by patients.Ministerio de Economia Industria y Competitividad, y Ministerio de Ciencia Innovación y Universidades: PID2019-105688RB-I00 and ECO2015-66553-

Infection of Artemia sp. by Lymphocystis disease virus (LCDV)

In the present work, different developmental stages of Artemia sp. (metanauplius, juvenile and adult) were experimentally infected with LCDV by immersion. Results of viral quantification (both by qPCR and cell-culture viral titer determination) and expression showed that LCDV establishes a productive infection in Artemia, at least under experimental conditions, extending the host range of this virus to crustaceans.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Computational Solutions Based on Bayesian Networks to Hierarchize and to Predict Factors Influencing Gender Fairness in the Transport System: Four Use Cases

: Previous studies have highlighted inequalities and gender differences in the transport system. Some factors or fairness characteristics (FCs) strongly influence gender fairness in the transport system. The difference with previous studies, which focus on general concepts, is the incorporation of level 3 FCs, which are more detailed aspects or measures that can be implemented by companies or infrastructure managers and operators in order to increase fairness and inclusion in each use case. The aim of this paper is to find computational solutions, Bayesian networks, and analytic hierarchy processes capable of hierarchizing level 3 FCs and to predict by simulation their values in the case of applying some improvements. This methodology was applied to data from women in four use cases: railway transport, autonomous vehicles, bicycle sharing stations, and transport employment. The results showed that fairer railway transport requires increased personal space, hospitality rooms, help points, and helpline numbers. For autonomous vehicles, the perception of safety, security, and sustainability should be increased. The priorities for bicycle sharing stations are safer cycling paths avoiding hilly terrains and introducing electric bicycles, child seats, or trailers to carry cargo. In transport employment, the priorities are fair recruitment and promotion processes and the development of family-friendly policies

Fruit Composition of Eggplant Lines with Introgressions from the Wild Relative S. incanum: Interest for Breeding and Safety for Consumption

[EN] The wild species Solanum incanum has been used as a donor parent for the development of a set of eggplant introgression lines (ILs), which are of interest for breeding for stress tolerances and relevant morpho-agronomic traits but could also be useful for breeding for fruit quality, due to the generally higher content in health-promoting compounds of S. incanum. The use of eggplant ILs with introgressions from S. incanum requires ensuring that glycoalkaloids levels are below safety limits. We evaluated 25 fruit composition traits, including proximate composition, sugars, acids, phenolics, glycoalkaloids, and minerals in a set of 16 eggplant ILs with S. incanum, both parents and the F-1, grown under two environments (open field and screenhouse). The results demonstrated that the parents were significantly different regarding most fruit composition traits. Large variation was found among the 16 ILs for all traits analyzed and a strong influence of the environment accounted for the variation of 17 out of the 25 traits evaluated. Although the S. incanum parent produced fruits with high levels of glycoalkaloids, the 16 ILs showed mean values of total glycoalkaloids below the currently accepted safety limit for human consumption (200 mg kg(-1) fresh weight). Overall, the ILs produced fruits that are safe for consumption, with nutritional and functional quality similar to the recipient parent. Furthermore, six putative QTLs were detected spread over chromosomes 3 for crude protein, 5 for malic and total acids, and 7 for chlorogenic acid and solamargine, and potential candidate genes were spotted for most of them, which provide new relevant information for eggplant breeding.This work was undertaken as part of the initiative "Adapting Agriculture to Climate Change: Collecting, Protecting and Preparing Crop Wild Relatives", which is supported by the Government of Norway. The project is managed by the Global Crop Diversity Trust with the Millennium Seed Bank of the Royal Botanic Gardens, Kew, and implemented in partnership with national and international gene banks and plant breeding institutes around the world. For further information see the project website: http://www.cwrdiversity.org/.Funding was also received from grants AGL2015-64755-R funded by MCIN/AEI/10.13039/501100011033 and by "ERDF A way of making Europe" and RTI-2018-094592-B-100 funded by MCIN/AEI/10.13039/501100011033, and from the European Union's Horizon 2020 Research and Innovation Programme under grant agreement No. 677379 (G2P-SOL project: Linking genetic resources, genomes, and phenotypes of Solanaceous crops). M.P. is grateful to the Spanish Ministerio de Ciencia e Innovacion for a post-doctoral grant with the Juan de la Cierva program (grant number IJC2019-039091-I from MCIN/AEI/10.1309/501100011033). P.G. is grateful to the Japan Society for the Promotion of Science for a post-doctoral grant (P19105, FY2019 JSPS Postdoctoral Fellowship for Research in Japan). E.R.-M. is grateful to the Spanish Ministerio de Economia, Industria y Competitividad for a pre-doctoral grant (grant number BES-2016-077482 from MCIN/AEI/10.1309/501100011033).Rosa-Martínez, E.; Adalid-Martinez, AM.; García-Martínez, MD.; Mangino, G.; Raigón Jiménez, MD.; Plazas Ávila, MDLO.; Gramazio, P.... (2022). Fruit Composition of Eggplant Lines with Introgressions from the Wild Relative S. incanum: Interest for Breeding and Safety for Consumption. Agronomy. 12(2):1-12. https://doi.org/10.3390/agronomy1202026611212

Barreras percibidas para la actividad física de las mujeres mayores en España

En este artículo se recogen los principales resultados obtenidos en ese 12.5% de mujeres que constituyen la demanda latente (no practican ejercicio físico semanalmente pero les gustaría hacerlo) de servicios de actividad física (y que suponen en toda España 540.000 clientas potenciales de las entidades que las incorporen a su segmentación). Comenzando por un resumen de las actividades deseadas y las expectativas en las características de realización de dichas actividades, y posteriormente exponiendo las barreras que según declararon estas mujeres, les impedían realizar actividad física semanal y por tanto incorporarse como clientas a alguna de las entidades existentes de servicios de actividad física y wellness

Causas de incumplimiento de los pacientes que acuden a una farmacia comunitaria de Granada

Este trabajo fue presentado como comunicación- póster en el II Congreso Nacional de la SEFaC en A Coruña el 17-19 de noviembre de 2006.Objetivo: Determinar si los pacientes que acuden a una oficina de farmacia de Granada incumplen el tratamiento terapéutico e identificar su causa. Diseño: Estudio descriptivo, observacional, transversal. Emplazamiento: Farmacia comunitaria de Granada. Participantes: Pacientes mayores de 12 años y sin ninguna dificultad cognitiva, que acudieron a la farmacia en septiembre de 2005. Mediciones principales: Se midió el cumplimiento farmacoterapéutico mediante el cuestionario de Morisky-Green1. Se pasó un segundo cuestionario a los pacientes incumplidores preparado ad hoc para determinar las posibles causas de incumplimiento. Resultados: Participaron y concluyeron el estudio 139 pacientes. De ellos, 108 (77,7%) incumplían el tratamiento; el 62% eran mujeres y el resto, varones, con una mayoría en el rango de edad de 19-45 años (76%) y el 64,8% tenía un nivel cultural medio

Hormonal regulation of temperature-induced growth in Arabidopsis

[EN] Successful plant survival depends upon the proper integration of information from the environment with endogenous cues to regulate growth and development. We have investigated the interplay between ambient temperature and hormone action during the regulation of hypocotyl elongation, and we have found that gibberellins (GAs) and auxin are quickly and independently recruited by temperature to modulate growth rate, whereas activity of brassinosteroids (BRs) seems to be required later on. Impairment of GA biosynthesis blocked the increased elongation caused at higher temperatures, but hypocotyls of pentuple DELLA knockout mutants still reduced their response to higher temperatures when BR synthesis or auxin polar transport were blocked. The expression of several key genes involved in the biosynthesis of GAs and auxin was regulated by temperature, which indirectly resulted in coherent variations in the levels of accumulation of nuclear GFP-RGA (repressor of GA1) and in the activity of the DR5 reporter. DNA microarray and genetic analyses allowed the identification of the transcription factor PIF4 (phytochrome-interacting factor 4) as a major target in the promotion of growth at higher temperature. These results suggest that temperature regulates hypocotyl growth by individually impinging on several elements of a pre-existing network of signaling pathways involving auxin, BRs, GAs, and PIF4.We thank G. Choi (KAIST, Daejeon, South Korea), C. Fankhauser (University of Lausanne, Lausanne, Switzerland), T. Guilfoyle (Department of Biochemistry, University of Missouri, MO, USA), N. P. Harberd (Department of Plant Sciences, University of Oxford, Oxford, UK), E. Huq (University of Texas, Austin, TX, USA), T-p Sun (Department of Biology, Duke University, Durham, USA), S. G. Thomas (Rothamsted Research, Hertfordshire, UK), G. Vert (Institut de Biologie Integrative des Plantes, Montpellier, France), Z. Y. Wang (Department of Plant Biology, Carnegie Institution, Stanford, USA), Y. Yin (Plant Science Institute, Iowa State University, Ames, IA, USA), and the Arabidopsis Biological Resource Center for seeds; and X. W. Deng (Yale University, New Haven, CT, USA) for antibodies against RPT5. We also thank Dr Jorge Casal (Universidad de Buenos Aires, Buenos Aires, Argentina) for helpful suggestions on this work. Work in the authors' laboratories is funded by grant BIO2007-60923 from the Spanish Ministry of Science and Innovation and by grant 167890/110 from the Norwegian Research Council. JG-B was supported by a JAE pre-doctoral fellowship from CSIC.Stavang, JA.; Gallego-Bartolomé, J.; Gómez Jiménez, MD.; Yoshida, S.; Asami, T.; Olsen, JE.; García-Martínez, JL.... (2009). Hormonal regulation of temperature-induced growth in Arabidopsis. The Plant Journal. 60(4):589-601. https://doi.org/10.1111/j.1365-313X.2009.03983.x58960160

Fruit composition profile of pepper, tomato and eggplant varieties grown under uniform conditions

[EN] The study of the diversity within and between major Solanaceae crops (pepper, tomato, eggplant) is of interest for the selection and development of balanced diets. We have measured thirty-six major fruit composition traits, encompassing sugars, organic acids, antioxidants and minerals, in a set of 10 accessions per crop for pepper, tomato and eggplant, grown under the same cultivation conditions. The aim was to evaluate the diversity within species and to provide an accurate comparison of fruit composition among species by reducing to a minimum the environmental effect. Pepper, tomato and eggplant had a clearly distinct composition profile. Pepper showed the highest average content in total sugars and organic acids. Fructose and glucose were the major sugar compounds in the three species, although in pepper and tomato sucrose was present only in trace amounts. Citric acid was the major organic acid in pepper and tomato, while in eggplant it was malic acid. Pepper and eggplant had the highest total antioxidant activity. Vitamin C content was much higher in pepper than in tomato and eggplant, while eggplant accumulated high concentrations of chlorogenic acid. Furthermore, eggplant was the species with higher content in most minerals, particularly for K, Mg and Cu, while pepper was the richest in Fe. Due to their complementary nutritional profiles, a combined regular consumption of the three vegetables would supply more than 20% of the Dietary Reference Intake of several of the analysed phytochemicals. The large diversity within each species is of interest for selecting varieties with better nutritional and organoleptic profiles, as well as for breeding new cultivars.This work has been funded by the European Union's Horizon 2020 Research and Innovation Programme under grant agreement No. 677379 (Linking genetic resources, genomes and phenotypes of Sola-naceous crops; G2PSOL) . Elena RosaMartinez is grateful to the Spanish Ministerio de Economia, Industria y Competitividad for a pre-doctoral grant (BES2016077482)Rosa-Martínez, E.; García-Martínez, MD.; Adalid-Martinez, AM.; Pereira-Días, L.; Casanova-Calancha, C.; Soler-Calabuig, E.; Figás-Moreno, MDR.... (2021). Fruit composition profile of pepper, tomato and eggplant varieties grown under uniform conditions. Food Research International. 147:1-13. https://doi.org/10.1016/j.foodres.2021.110531S11314

High-resolution copy number analysis of paired normal-tumor samples from diffuse large B cell lymphoma

Copy number analysis can be useful for assessing prognosis in diffuse large B cell lymphoma (DLBCL). We analyzed copy number data from tumor samples of 60 patients diagnosed with DLBCL de novo and their matched normal samples. We detected 63 recurrent copy number alterations (CNAs), including 33 gains, 30 losses, and nine recurrent acquired copy number neutral loss of heterozygosity (CNN-LOH). Interestingly, 20 % of cases acquired CNN-LOH of 6p21 locus, which involves the HLA region. In normal cells, there were no CNAs but we observed CNN-LOH involving some key lymphoma regions such as 6p21 and 9p24.1 (5 %) and 17p13.1 (2.5 %) in DLBCL patients. Furthermore, a model with some specific CNA was able to predict the subtype of DLBCL, 1p36.32 and 10q23.31 losses being restricted to germinal center B cell-like (GCB) DLBCL. In contrast, 8p23.3 losses and 11q24.3 gains were strongly associated with the non-GCB subtype. A poor prognosis was associated with biallelic inactivation of TP53 or 18p11.32 losses, while prognosis was better in cases carrying 11q24.3 gains. In summary, CNA abnormalities identify specific DLBCL groups, and we describe CNN-LOH in germline cells from DLBCL patients that are associated with genes that probably play a key role in DLBCL development.This work was supported by research funding from the Health Council of Castilla y León (GRS265/A/08), the Health Research Program (PS09/01382), and the Red Temática de Investigación Cooperativa en Cáncer (RTICC) grant RD12/0036 (groups 0069, 0029, 0036, 0058, and 0060) included in the National Plan I+D+I supported by the Instituto Carlos III and the Fondo Europeo de Desarrollo Regional (FEDER), the Spanish Ministry of Economy and Competitiveness, and the European Regional Development Fund (ERDF) 'Una manera de hacer Europa' (Innocampus; CEI-2010-1-0010). ES was supported by CM10/00078-Río Hortega, an ISCIII contract, FEHH grant 2013–2014 and JR14/00025-Juan Rodés, an ISCIII contract. IS was supported by the Subprograma Juan de la Cierva (JCI-2011-10232) and a Miguel Servet contract (CP13/00159).Peer Reviewe

The EPICTER score: a bedside and easy tool to predict mortality at 6 months in acute heart failure

Aims: Estimating the prognosis in heart failure (HF) is important to decide when to refer to palliative care (PC). Our objective was to develop a tool to identify the probability of death within 6 months in patients admitted with acute HF. Methods and results: A total of 2848 patients admitted with HF in 74 Spanish hospitals were prospectively included and followed for 6 months. Each factor independently associated with death in the derivation cohort (60% of the sample) was assigned a prognostic weight, and a risk score was calculated. The accuracy of the score was verified in the validation cohort. The characteristics of the population were as follows: advanced age (mean 78 years), equal representation of men and women, significant comorbidity, and predominance of HF with preserved ejection fraction. During follow-up, 753 patients (26%) died. Seven independent predictors of mortality were identified: age, chronic obstructive pulmonary disease, cognitive impairment, New York Heart Association class III-IV, chronic kidney disease, estimated survival of the patient less than 6 months, and acceptance of a palliative approach by the family or the patient. The area under the ROC curve for 6 month death was 0.74 for the derivation and 0.68 for the validation cohort. The model showed good calibration (Hosmer and Lemeshow test, P value 0.11). The 6 month death rates in the score groups ranged from 6% (low risk) to 54% (very high risk). Conclusions: The EPICTER score, developed from a prospective and unselected cohort, is a bedside and easy-to-use tool that could help to identify high-risk patients requiring PC