176 research outputs found

    Nitrate pollution of groundwater, all right... but nothing else?

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    Contamination from agricultural sources and, in particular, nitrate pollution, is one of the main concerns in groundwater management. However, this type of pollution entails the entrance of other substances into the aquifer, as well as it may promote other processes. In this study, we deal with hydrochemical and isotopic analysis of groundwater samples from four distinct zones in Catalonia (NE Spain), which include different lithological units, to investigate the influence of manure fertilization on the overall hydrochemical composition of groundwater. Results indicate that high nitrate concentrations, resulting from intense manure application, homogenize the contents of the major dissolved ions (i.e.; Cl-, SO42-, Ca2+, Na+, K+, and Mg2+). Moreover, positive linear relationships between nitrate and some ions are found indicating the magnitude of the fertilization impact on groundwater hydrochemistry. Nevertheless, the increasing concentration of specific ions is not only attributed to the manure input, but to the enhancing effect of manure and slurry upon the biogeochemical processes that control water-rock interactions. Such results raise awareness that such processes should be evaluated in advance in order to assess adequate groundwater resources assessmen

    Integrating magnetic capabilities to intracellular chips for cell trapping

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    Current microtechnologies have shown plenty of room inside a living cell for silicon chips. Microchips as barcodes, biochemical sensors, mechanical sensors and even electrical devices have been internalized into living cells without interfering their cell viability. However, these technologies lack from the ability to trap and preconcentrate cells in a specific region, which are prerequisites for cell separation, purification and posterior studies with enhanced sensitivity. Magnetic manipulation of microobjects, which allows a non-contacting method, has become an attractive and promising technique at small scales. Here, we show intracellular Ni-based chips with magnetic capabilities to allow cell enrichment. As a proof of concept of the potential to integrate multiple functionalities on a single device of this technique, we combine coding and magnetic manipulation capabilities in a single device. Devices were found to be internalized by HeLa cells without interfering in their viability. We demonstrated the tagging of a subpopulation of cells and their subsequent magnetic trapping with internalized barcodes subjected to a force up to 2.57 pN (for magnet-cells distance of 4.9 mm). The work opens the venue for future intracellular chips that integrate multiple functionalities with the magnetic manipulation of cells

    Nuevas tendencias en el derecho de la competencia y de la propiedad industrial

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    Divulgação dos SUMÁRIOS das obras recentemente incorporadas ao acervo da Biblioteca Ministro Oscar Saraiva do STJ. Em respeito à Lei de Direitos Autorais, não disponibilizamos a obra na íntegra.Localização na estante: 347.77 N964tOrganizado por: Anxo Tato Plaza, Julio Costas Comesaña, Pablo I. Fernández Carballo-Calero, Francisco J. Torres Pérez e Sara Louredo Casad

    Memoria remota: la previvencia del romanticismo historiográfico en los videojuegos

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    El romanticismo historiográfico ha sido tradicionalmente categorizado como una tendencia obsoleta, cuyas aportaciones no deben ser tenidas en consideración al ser estas producto de un contexto determinado como lo fue el siglo XIX. Sin embargo, se advierte su presencia en los videojuegos, uno de los medios culturales por excelencia en la actualidad, cuyas singularidades determinadas por su inherente componente interactivo requieren de una profunda investigación por parte de la academia. Por ende, el presente escrito tiene como objetivo determinar si los ecos del romanticismo tienen cabida en los medios videolúdicos, de qué manera persisten y cómo son representados.El romanticisme historiogràfic ha sigut tradicionalment categoritzat com una tendència obsoleta, les aportacions de la qual no han de ser tingudes en consideració al ser aquestes producte d'un context determinat com ho va ser el segle XIX. Tot i així, s'adverteix la seva presència als videojocs, un dels mitjans culturals per excel·lència en l'actualitat, les singularitats dels quals, en venir determinades pel seu inherent component interactiu, requereixen d'una profunda recerca per part de l'acadèmia. En conseqüència, el present escrit té com a objectiu determinar si els ressons del romanticisme tenen cabuda en els mitjans videolúdics, de quina manera persisteixen i com són representats.Historiographical Romanticism has traditionally been categorised as an obsolete trend, whose contributions should not be taken into consideration as they are the product of a specific context such as the 19th century. However, its presence can be seen in video games, one of today's cultural media par excellence, whose singularities determined by their inherent interactive component require of a deep research by the academy. Therefore, the aim of this paper is to determine whether the echoes of Romanticism have a place in video games, how they persist and how they are represented

    Association of breast and gut microbiota dysbiosis and the risk of breast cancer: a case-control clinical study

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    We would like to thank M Luisa Puertas-Martin and Isabel Manzano-Jimenez, nurses at the Unit of Mammary Pathology, General Surgery Service, San Cecilio University Hospital (Granada), without whose enthusiasm the enrolment of participants in Granada would still be stalled. We are indebted to all the women taking part in the study.The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Trial registration ClinicalTrials.gov NCT03885648, 03/25/2019. Retrospectively registered.Background Breast cancer ranks first in women, and is the second cause of death in this gender. In addition to genetics, the environment contributes to the development of the disease, although the factors involved are not well known. Among the latter is the influence of microorganisms and, therefore, attention is recently being paid to the mammary microbiota. We hypothesize that the risk of breast cancer could be associated with the composition and functionality of the mammary/gut microbiota, and that exposure to environmental contaminants (endocrine disruptors, EDCs) might contribute to alter these microbiota. Methods We describe a case-control clinical study that will be performed in women between 25 and 70 years of age. Cases will be women diagnosed and surgically intervened of breast cancer (stages I and II). Women with antecedents of cancer or advanced tumor stage (metastasis), or who have received antibiotic treatment within a period of 3 months prior to recruitment, or any neoadjuvant therapy, will be excluded. Controls will be women surgically intervened of breast augmentation or reduction. Women with oncological, gynecological or endocrine history, and those who have received antibiotic treatment within a period of 3 months prior to recruitment will also be excluded. Blood, urine, breast tissue and stool samples will be collected. Data regarding anthropometric, sociodemographic, reproductive history, tumor features and dietary habits will be gathered. Metabolomic studies will be carried out in stool and breast tissue samples. Metagenomic studies will also be performed in stool and breast tissue samples to ascertain the viral, fungal, bacterial and archaea populations of the microbiota. Quantitation of estrogens, estrogen metabolites and EDCs in samples of serum, urine and breast tissue will also be performed. Discussion: This is the first time that the contribution of bacteria, archaea, viruses and fungi together with their alteration by environmental contaminants to the risk of breast cancer will be evaluated in the same study. Results obtained could contribute to elucidate risk factors, improve the prognosis, as well as to propose novel intervention studies in this disease.This work is funded by grants PI-0538-2017 (Junta de Andalucía, Spain, to LF) and Biomedical Research Networking Center-CIBER de Epidemiología y Salud Pública (CIBERESP) of the Institute of Health Carlos III -supported by European Regional Development Fund/FEDER (FIS-PI16/01812) (to MFF)

    Sistemas de apoyo clínico en Atención primaria: uso de e-learning e ilustraciones médicas en la toma de decisiones compartidas

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    Comunicación oral presentada en la Segunda Conferencia Internacional de Comunicación en Salud, celebrada el 23 de octubre de 2015 en la Universidad Carlos III de MadridIntroducción: La digitalización de la historia clínica supone un nuevo paradigma en la consulta de atención primaria permitiendo la continuidad asistencial y una gran accesibilidad a la información. Incorporar la participación del paciente aumenta su confianza y satisfacción hacia el profesional disminuyendo la iatrogenia y el coste sanitario. Esta visita personalizada requiere más tiempo, pero el aprendizaje electrónico mutuo (e-learning) aumenta la precisión diagnóstica y terapéutica, minimizando errores y efectos secundarios. Objetivos: evaluar el uso del e-learning e ilustraciones médicas en la toma de decisiones compartidas en el Centro de Atención Primaria Raval Sud de Barcelona; valorar la efectividad en la utilización de imágenes y gráficos para empoderar a la población atendida para comprender y participar en la toma de decisiones referentes a su salud; conocer la satisfacción y preferencias de uso del paciente y del profesional. Metodología: Diseño: Estudio cualitativo fenomenológico. Ámbito de estudio: Centro de Atención Primaria Raval Sud de Barcelona (zona urbana socialmente deprimida, 60% población inmigrada). Población de estudio: Pacientes atendidos por cualquier motivo (muestreo por bola de nieve) que accedan a participar en nuestro estudio. Técnicas de recogida de información: Observaciones y entrevistas individuales semiestructuradas. Durante la visita se observa la comunicación médico-paciente mediante la utilización del soporte visual electrónico, posteriormente se entrevista al paciente y al profesional para conocer su opinión. Análisis: Las observaciones y entrevistas son grabadas (grabadora de sonido) con posterior transcripción literal del texto y marcaje de citas, códigos y categorías. Análisis de contenido temático y categorización a posteriori. Resultados: Tras una prueba piloto se observa mayor facilitación y comprensión tras la visita, el paciente se muestra satisfecho y prefiere el uso del e-learning e ilustraciones médicas a la visita tradicional

    Impact of biological agents on postsurgical complications in inflammatory bowel disease: A multicentre study of Geteccu

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    Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered “exposed”. The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2–2.0), urgent surgery (OR: 1.6; 95% CI: 1.2–2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1–1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3–2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97–1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03–2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections

    Identification of high-risk patients for referral through machine learning assisting the decision making to manage minor ailments in community pharmacies

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    Background: Data analysis techniques such as machine learning have been used for assisting in triage and the diagnosis of health problems. Nevertheless, it has not been used yet to assist community pharmacists with services such as the Minor Ailment Services These services have been implemented to reduce the burden of primary care consultations in general medical practitioners (GPs) and to allow a better utilization of community pharmacists’ skills. However, there is a need to refer high-risk patients to GPs.Aim: To develop a predictive model for high-risk patients that need referral assisting community pharmacists’ triage through a minor ailment service.Method: An ongoing pragmatic type 3 effectiveness-implementation hybrid study was undertaken at a national level in Spanish community pharmacies since October 2020. Pharmacists recruited patients presenting with minor ailments and followed them 10 days after the consultation. The main outcome measured was appropriate medical referral (in accordance with previously co-designed protocols). Nine machine learning models were tested (three statistical, three black box and three tree models) to assist pharmacists in the detection of high-risk individuals in need of referral.Results: Over 14′000 patients were included in the study. Most patients were female (68.1%). With no previous treatment for the specific minor ailment (68.0%) presented. A percentage of patients had referral criteria (13.8%) however, not all of these patients were referred by the pharmacist to the GP (8.5%). The pharmacists were using their clinical expertise not to refer these patients. The primary prediction model was the radial support vector machine (RSVM) with an accuracy of 0.934 (CI95 = [0.926,0.942]), Cohen’s kappa of 0.630, recall equal to 0.975 and an area under the curve of 0.897. Twenty variables (out of 61 evaluated) were included in the model. radial support vector machine could predict 95.2% of the true negatives and 74.8% of the true positives. When evaluating the performance for the 25 patient’s profiles most frequent in the study, the model was considered appropriate for 56% of them.Conclusion: A RSVM model was obtained to assist in the differentiation of patients that can be managed in community pharmacy from those who are at risk and should be evaluated by GPs. This tool potentially increases patients’ safety by increasing pharmacists’ ability to differentiate minor ailments from other medical conditions

    Barreras para la implantación de servicios cognitivos en la farmacia comunitaria española

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    Objetivo: Identificar y analizar los elementos que dificultan la diseminación, la implantación y la sostenibilidad de distintos servicios cognitivos orientados a los pacientes en la farmacia comunitaria española. Diseño: Estudio cualitativo en el que se han utilizado entrevistas semiestructuradas, con el fin de realizar un análisis descriptivo. Métodos: Se eligieron dos conjuntos de expertos relacionados con la farmacia comunitaria española. El primero estaba compuesto de 15 farmacéuticos comunitarios que se habían destacado por sus actividades profesionales y el segundo, por 18 estrategas de la farmacia. Resultados: La falta de orientación clínica de la formación universitaria, la falta de actitud ante el cambio y la incertidumbre sobre su futuro profesional se identificaron como barreras del farmacéutico individual. Para la farmacia como empresa, se identificaron como barreras la falta de pago por los servicios, la ausencia de mensajes claros y el reducido volumen de la farmacia española. En la categoría profesión farmacéutica, el actual sistema de remuneración, la falta de formación universitaria clínica y la falta de liderazgo de las instituciones representantes fueron las barreras encontradas. En cuanto a los otros colectivos, se encontró que la falta de apoyo real de las administraciones sanitarias, el desconocimiento de los médicos de los objetivos de los servicios cognitivos farmacéuticos, y la falta de demanda de estos servicios por los pacientes fueron las barreras identificadas. Conclusiones: Se han encontrado 12 barreras que se han agrupado en 6 categorías. Estas barreras coinciden con las comunicadas en otros países.Objective: To identify and assess barriers for dissemination, implementation, and sustainability of different cognitive services in Spanish community pharmacies. Design: Qualitative study through semistructured interviews followed by a descriptive analysis. Method: Two groups of experts related to Spanish community pharmacy were chosen. One with 15 community pharmacists with a relevant professional activity, while the other group (n=18) was related to pharmacy strategists. Results: The lack of university clinical oriented learning, lack of pharmacists’ attitude towards change and some uncertainty over their professional future were identified as barriers at the pharmacists’ level. In relation to pharmacy as an organization the lack of clear messages by their leaders and the small volume of Spanish pharmacies were identified as barriers. In the category of pharmacy profession, the current reimbursement system, the lack of university clinical education, and the lack of leadership by current representative organizations were the barriers found. The lack of real involvement by health authorities, the lack of knowledge about the objectives of pharmacy cognitive services, and the lack of demand of these services by patients where also identified as barriers. Conclusions: Finally, 12 barriers were identified and grouped into 6 categories. These barriers fit in with the barriers identified in other countries
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