Landslide Risk: Economic Valuation in the North-Eastern Zone of Medellin City

Natural disasters of a geodynamic nature can cause enormous economic and human losses. The economic costs of a landslide disaster include relocation of communities and physical repair of urban infrastructure. However, when performing a quantitative risk analysis, generally, the indirect economic consequences of such an event are not taken into account. A probabilistic approach methodology that considers several scenarios of hazard and vulnerability to measure the magnitude of the landslide and to quantify the economic costs is proposed. With this approach, it is possible to carry out a quantitative evaluation of the risk by landslides, allowing the calculation of the economic losses before a potential disaster in an objective, standardized and reproducible way, taking into account the uncertainty of the building costs in the study zone. The possibility of comparing different scenarios facilitates the urban planning process, the optimization of interventions to reduce risk to acceptable levels and an assessment of economic losses according to the magnitude of the damage. For the development and explanation of the proposed methodology, a simple case study is presented, located in north-eastern zone of the city of Medellín. This area has particular geomorphological characteristics, and it is also characterized by the presence of several buildings in bad structural conditions. The proposed methodology permits to obtain an estimative of the probable economic losses by earthquake-induced landslides, taking into account the uncertainty of the building costs in the study zone. The obtained estimative shows that the structural intervention of the buildings produces a reduction the order of 21 % in the total landslide risk. © Published under licence by IOP Publishing Ltd

Quality of Work Life and Mental Health in Primary Care Physicians

AbstractThe aim of this study was to find the relationship between the perception of Quality of Work Life (QWL) and the mental health of primary care physicians of a public health institution in Guadalajara, Mexico. The study was analytical and was carried out with a universe of 818 doctors from 92 health units and the probability sample of 154 people. In all of them, CVT-GOHISALO and Goldberg GHQ-28 questionnaires were applied in order to measure their perception of QWL and the risk of mental illness respectively. Both instruments were selected because of their high reliability. We measured the satisfaction of the people interviewed for each one of the seven dimensions of CVT-GOHISALO and related to the points assigned to GHQ-28 case or not to consider the case of mental illness. The percentages of dissatisfaction with the QWL were greater than 12% in all dimensions of the instrument, being the highest value of 20.5% dissatisfaction for the job satisfaction dimension. In the classification of the case or not according to the GHQ-28, 22% were considered cases and 78% non-cases. We sought correspondence of satisfaction with the QWL by dimensions and non-case of Goldberg's, as well as dissatisfaction with the QWL and Goldberg's case, finding a clear link between being satisfied and having mental health. All dimensions have a correspondence that goes from 79.7% to 82.3% between satisfaction and non-case, being in all the statistical significance value less than 0.05 For primary care physicians in the studied institution, there is a clear relationship between being satisfied with the QWL and present less risk of mental illness. It is alarming that the medical staff presents high rates of dissatisfaction with the QWL and risk of mental illness. It is necessary to provide preventive programs among health care workers in order to improve their QWL and mental health

New biotechnological perspectives of a NADH oxidase variant from Thermus thermophilus HB27 as NAD+-recycling enzyme

<p>Abstract</p> <p>Background</p> <p>The number of biotransformations that use nicotinamide recycling systems is exponentially growing. For this reason one of the current challenges in biocatalysis is to develop and optimize more simple and efficient cofactor recycling systems. One promising approach to regenerate NAD⁺pools is the use of NADH-oxidases that reduce oxygen to hydrogen peroxide while oxidizing NADH to NAD⁺. This class of enzymes may be applied to asymmetric reduction of prochiral substrates in order to obtain enantiopure compounds.</p> <p>Results</p> <p>The NADH-oxidase (NOX) presented here is a flavoenzyme which needs exogenous FAD or FMN to reach its maximum velocity. Interestingly, this enzyme is 6-fold hyperactivated by incubation at high temperatures (80°C) under limiting concentrations of flavin cofactor, a change that remains stable even at low temperatures (37°C). The hyperactivated form presented a high specific activity (37.5 U/mg) at low temperatures despite isolation from a thermophile source. Immobilization of NOX onto agarose activated with glyoxyl groups yielded the most stable enzyme preparation (6-fold more stable than the hyperactivated soluble enzyme). The immobilized derivative was able to be reactivated under physiological conditions after inactivation by high solvent concentrations. The inactivation/reactivation cycle could be repeated at least three times, recovering full NOX activity in all cases after the reactivation step. This immobilized catalyst is presented as a recycling partner for a thermophile alcohol dehydrogenase in order to perform the kinetic resolution secondary alcohols.</p> <p>Conclusion</p> <p>We have designed, developed and characterized a heterogeneous and robust biocatalyst which has been used as recycling partner in the kinetic resolution of <it>rac</it>-1-phenylethanol. The high stability along with its capability to be reactivated makes this biocatalyst highly re-useable for cofactor recycling in redox biotransformations.</p

The social return on investment of a new approach to heart failure in the Spanish National Health System

AIMS: We aim to agree on a set of proposals to improve the current management of heart failure (HF) within the Spanish National Health System (SNHS) and apply the social return on investment (SROI) method to measure the social impact that these proposals would generate. METHODS AND RESULTS: A multidisciplinary working team of 16 experts was set up, with representation from the main stakeholders regarding HF: medical specialists (cardiologists, internal medicine physicians, general practitioners, and geriatric physicians), nursing professionals, health management professionals, patients, and informal caregivers. This team established a set of proposals to improve the management of HF according to the main areas of HF care: emergency and hospitalization, primary care, cardiology, and internal medicine. A forecast-type SROI method, with a 1-year time frame, was applied to measure the social impact resulting from the implementation of these proposals. The required investment and social return were estimated and summarized into a ratio indicating how much social return could be generated for each euro invested. Intangible returns were included and quantified through financial proxies. The approach to improve the management of HF consisted of 28 proposals, including the implementation of a case management nurse network, standardization of operational protocols, psychological support, availability of echocardiography machines at emergency departments, stationary units and primary care, early specialist visits after hospital discharge, and cardiac rehabilitation units, among others. These proposals would benefit not only patients and their informal caregivers but also the SNHS. Regarding patients, proposals would increase their autonomy in everyday activities, decrease anxiety, increase psychological and physical well-being, improve pharmacological adherence and self-care, enhance understanding of the disease, delay disease progression, expedite medical assessment, and prevent the decrease in work productivity associated with HF management. Regarding informal caregivers, proposals would increase their quality of life; improve their social, economic, and emotional well-being; and reduce their care burden. The SNHS would benefit from shorter stays of HF patients at intensive care units and reduction of hospitalizations and admissions to emergency departments. The investment needed to implement these proposals would amount to euro548m and yield a social return of euro1932m, that is, euro3.52 for each euro invested. CONCLUSIONS: The current management of HF could be improved by a set of proposals that resulted in an overall positive social return, varying between areas of analysis. This may guide the allocation of healthcare resources and improve the quality of life of patients with HF

Sistema de registro de dosis radiológica a pacientes en la historia clínica digital.

Este trabajo fue premiado en el Congreso con el 3º mejor póster de más de 400 trabajos presentados.La importancia del registro de la dosis radiológica recibida por un paciente tras una exposición a una exploración de radiodiagnóstico en la historia clínica es uno de los procesos claves dentro de la seguridad del paciente, como pone de manifiesto la Directiva Europea 2013/59 EURATOM, que obliga a la adaptación de los sistemas de información hospitalaria para gestionar la medición y evaluación de las dosis así como la evaluación del riesgo asociado a las mismas. El objetivo de este trabajo es exponer los procesos a desarrollar para la inclusión de esta información en la historia médica electrónica. Para ello, se ha analizado la información de dosis de los sistemas radiológicos y su forma de registro, cálculo y extracción de 33 hospitales españoles participantes en el proyecto DOPOES I (Dosis a la población derivadas de exploraciones de radiodiagnóstico en España). Dicha base de datos recoge información de 9 millones de procedimientos radiológicos. Como resultado, se ha obtenido un sistema de codificación unificado (codRis_DOPOES v.19) para 500 procedimientos radiológicos, así como el establecimiento de las bases para el diseño e implementación de un sistema de registro de dosis hospitalario. De esta manera que se pueda integrar en el historial médico del paciente permitiendo conocer tanto las dosis recibidas en cada procedimiento, facilitando el trabajo de los profesionales sanitarios y valorando mejor el riesgo asociado al uso de las radiaciones ionizantes

A strategic reflection for the management and implementation of CAR-T therapy in Spain: an expert consensus paper

CAR-T cell therapy represents a therapeutic revolution in the prognosis and treatment of patients with certain types of hematological cancer. However, they also pose new challenges in the healthcare, regulatory and financial fields. The aim of the RET-A project was to undertake a strategic reflection on the management of CAR-T therapies within the Spanish National Health System, to agree on recommendations that will help to better deal with the new context introduced by these cell therapies in the present and in the future. This think tank involved 40 key agents and opinion leaders. The experts identified three great challenges for implementing advanced therapies in Spain: therapeutic individualisation, with a multidisciplinary approach; acceleration of access times, by minimizing bureaucracy; and increase in the number of centers qualified to manage the CAR-T therapies in the NHS. The experts agreed on the ideal criteria for designating those qualified centers. They also agreed on a comprehensive CAR-T care pathway with the timings and roles which would ideally be involved in each part of the process.This study was funded by Gilead Sciences, Inc.Peer reviewe

Predicting aging-related decline in physical performance with sparse electrophysiological source imaging

Objective: We introduce a methodology for selecting biomarkers from activation and connectivity derived from Electrophysiological Source Imaging (ESI). Specifically, we pursue the selection of stable biomarkers associated with cognitive decline based on source activation and connectivity patterns of resting-state EEG theta rhythm, used as predictors of physical performance decline in aging individuals measured by a Gait Speed (GS) slowing. Methods: Our two-step methodology involves estimating ESI using flexible sparse-smooth-nonnegative models, from which activation ESI (aESI) and connectivity ESI (cESI) features are derived. The Stable Sparse Classifier method then selects potential biomarkers related to GS changes. Results and Conclusions: Our predictive models using aESI outperform traditional methods such as the LORETA family. The models combining aESI and cESI features provide the best prediction of GS changes. Potential biomarkers from activation/connectivity patterns involve orbitofrontal and temporal cortical regions. Significance: The proposed methodology contributes to the understanding of activation and connectivity of GS-related ESI and provides features that are potential biomarkers of GS slowing. Given the known relationship between GS decline and cognitive impairment, this preliminary work opens novel paths to predict the progression of healthy and pathological aging and might allow an ESI-based evaluation of rehabilitation programs

The Radiative Corrections to the Mass of the Kink Using an Alternative Renormalization Program

In this paper we compute the radiative correction to the mass of the kink in $\phi^4$ theory in 1+1 dimensions, using an alternative renormalization program. In this newly proposed renormalization program the breaking of the translational invariance and the topological nature of the problem, due to the presence of the kink, is automatically taken into account. This will naturally lead to uniquely defined position dependent counterterms. We use the mode number cutoff in conjunction with the above program to compute the mass of the kink up to and including the next to the leading order quantum correction. We discuss the differences between the results of this procedure and the previously reported ones.Comment: 8 pages, 2 figures. arXiv admin note: substantial text overlap with arXiv:0806.036

Análisis genético y molecular de propiedades fisicoquímicas del almidón y su asociación con la modificación del endospermo en maíz de calidad proteínica

Quality protein maize (QPM) was created converting the soft opaque-2 endosperm into a vitreous phenotype, but the mechanisms involved in this modification are not completely understood. Recombinant inbred lines (RILs) derived from K0326Y QPM and W64Ao2 were used to identify quantitative trait loci (QTL) associated with starch physicochemical properties. RILs contrasting in vitreousness were also used to evaluate the expression of starch biosynthesis genes. Mapping identified 5-6 QTLs for each trait that explained 66 % of the phenotypic variation. Three QTLs on bins 4.05, 5.04, and 9.03 were found close to the starch biosynthesis genes Brittle-2 (Bt2), Amylose extender-1 (Ae1), and Waxy-1 (Wx1), respectively. The expression of Wx1 was three-fold greater in K0326Y QPM than W64Ao2 and eight-fold higher in vitreous than opaque RILs, which corresponded with the greater accumulation of granule bound starch synthase I (GBSSI) and the higher amylose content observed in the vitreous lines. The increased synthesis of amylose may result in starch granules with more amorphous regions that favor their compaction. These results suggest that endosperm modification in QPM is associated with the synthesis of starch containing more amylose during kernel development, which may facilitate the packing of the starch granules resulting in the vitreous phenotype.El maíz de calidad proteínica (QPM) fue creado convirtiendo el endospermo suave opaco-2 en un fenotipo vítreo, pero los mecanismos involucrados en esta modificación no se conocen por completo. Se utilizaron líneas recombinantes puras derivadas de las líneas K0326Y QPM y W64Ao2 para identificar loci de características cuantitativas (QTL) asociados con propiedades fisicoquímicas del almidón. También se usaron RILs contrastantes en vitrosidad para evaluar la expresión de genes de biosíntesis de almidón. El mapeo identificó 5 o 6 QTL para cada característica que explicaron en promedio el 66 % de la variación fenotípica. Tres de los QTLs en los bins 4.05, 5.04 y 9.03 se encontraron cerca de los genes de síntesis de almidón Brittle 2 (Bt2), Amylose extender 1 (Ae1), y Waxy 1 (Wx1), respectivamente. La expresión de Wx1 fue tres veces mayor en K0326Y QPM que en W64Ao2 y ocho veces mayor en líneas vítreas en comparación con las opacas, lo que correspondió con la mayor acumulación de la enzima almidón sintasa unida al gránulo I (GBSSI) y el mayor contenido de amilosa observado en las líneas vítreas. El incremento en la síntesis de amilosa podría resultar en gránulos de almidón con más regiones amorfas que favorecen su compactación. Estos resultados sugieren que la modificación del endospermo en QPM está asociada con la síntesis de almidón conteniendo más amilosa durante el desarrollo del grano, lo cual podría facilitar el empaquetamiento de los gránulos de almidón resultando en el fenotipo vítreo