Limitations of Algebraic Approaches to Graph Isomorphism Testing

We investigate the power of graph isomorphism algorithms based on algebraic reasoning techniques like Gr\"obner basis computation. The idea of these algorithms is to encode two graphs into a system of equations that are satisfiable if and only if if the graphs are isomorphic, and then to (try to) decide satisfiability of the system using, for example, the Gr\"obner basis algorithm. In some cases this can be done in polynomial time, in particular, if the equations admit a bounded degree refutation in an algebraic proof systems such as Nullstellensatz or polynomial calculus. We prove linear lower bounds on the polynomial calculus degree over all fields of characteristic different from 2 and also linear lower bounds for the degree of Positivstellensatz calculus derivations. We compare this approach to recently studied linear and semidefinite programming approaches to isomorphism testing, which are known to be related to the combinatorial Weisfeiler-Lehman algorithm. We exactly characterise the power of the Weisfeiler-Lehman algorithm in terms of an algebraic proof system that lies between degree-k Nullstellensatz and degree-k polynomial calculus

Rotura bilateral y simultánea del tendón de Aquiles

La rotura bilateral y simultánea del tendón de Aquiles es un hecho excepcional. La producción de esta lesión en una persona joven, sin antecedentes patológicos ni de administración de ciertos medicamentos es aún más excepcional. El tratamiento quirúrgico y un adecuado proceso de seguimiento y rehabilitación contribuyen a una buena recuperación y pronóstico en los individuos jóvenes y activos con roturas del tendón de Aquiles. Se presenta un caso clínico de una mujer de 21 años tratada quirúrgicamente con buen resultado.The bilateral and simultaneous rupture of Achilles tendon is an excepcional situation. The production of this injury in a young person, without history pathological or administration of certain drugs is even more exceptional. The surgical treatment and a proper process of following-up and rehabilitation help to a good recovery and prognosis in young and active people with Achilles tendon ruptures

Notch-mediated induction of N-cadherin and α 9-integrin confers higher invasive phenotype on rhabdomyosarcoma cells

Altres ajuts: This work was supported by grants from Institut Català d'Oncologia (ICO), Instituto de Salud Carlos III (RD06/0020/1021 and PI11/00740), Fundació la Marató de TV3, Asociación Española Contra el Cáncer, Fundació SMALL and Fundació A. BOSCH.Rhabdomyosarcoma (RMS) is the commonest type of soft-tissue sarcoma in children. Patients with metastatic RMS continue to have very poor prognosis. Recently, several works have demonstrated a connection between Notch pathway activation and the regulation of cell motility and invasiveness. However, the molecular mechanisms of this possible relationship remain unclear. The Notch pathway was manipulated pharmacologically and genetically. The mRNA changes were analysed by quantitative PCR and protein variations by western blot and immunofluorescence. Finally, the capabilities of RMS cells to adhere, heal a wound and invade were assessed in the presence of neuronal cadherin (N-cadherin)- and α 9-integrin-blocking antibodies. Cells treated with γ -secretase inhibitor showed lower adhesion capability and downregulation of N-cadherin and α 9-integrin. Genetic manipulation of the Notch pathway led to concomitant variations in N-cadherin and α 9-integrin. Treatment with anti-N-cadherin-blocking antibody rendered marked inhibition of cell adhesion and motility, while anti- α 9-integrin-blocking antibody exerted a remarkable effect on cell adhesion and invasiveness. Neuronal cadherin and α 9-integrin are postulated as leading actors in the association between the Notch pathway and promotion of cell adhesion, motility and invasion, pointing to these proteins and the Notch pathway itself as interesting putative targets for new molecular therapies against metastases in RMS

Effectiveness and safety of a microcrystalline tyrosine‐adjuvanted <i>Dermatophagoides pteronyssinus</i> allergoid immunotherapy in adult patients with allergic asthma and rhinitis: A real‐life prospective observational study

Introduction: Although clinical trials have shown the efficacy and safety of allergen-specific immunotherapy (AIT) in the treatment of allergic asthma, there is a need for real-life studies. We aimed to assess the effectiveness and safety of a microcrystalline tyrosine-adjuvanted Dermatophagoides pteronyssinus allergoid (Acarovac Plus (R)) in patients with house dust mite (HDM)-induced allergic asthma in a real-life study. Methods: A subanalysis of a multicenter, prospective, observational, real-life study. Patients with rhinitis and allergic asthma caused by HDMs were assessed before AIT with Acarovac Plus (R) and at 6 and 12 months after this treatment. Assessment parameters were percentage of days with asthma symptoms, percentage of days on asthma medication, classification of asthma according to Spanish guidelines for the management of asthma, asthma-related quality of life (quality of life in adults with asthma questionnaire [QLAAQ]), perception of symptoms (visual analog scale [VAS]), and treatment satisfaction (treatment satisfaction questionnaire for medication [TSQM]). Safety was assessed by the number and severity of adverse reactions. Results: This subanalysis included 55 patients. Treatment with Acarovac Plus (R) showed significant differences in the analyzed variables when the baseline visit was compared with the 12-month visit: reduction of the mean (SD) percentage of days with asthma symptoms (23.9 [9.2] vs. 5.1 [12.8]; p = .002), of the mean [SD] percentage of days on asthma medication (67.6 [42.9] vs. 45.1 [46.8]; p = .002), and of the percentage of patients with persistent asthma (78.2% vs. 38.9%; p = .009). Acarovac Plus (R) significantly improved asthma-related quality of life, as shown by a decrease of 1.39 points in QLAAQ score at 12 months (p < .001), and in the subjective perception of symptoms on the VAS (-3.50, p < .0001). Patients showed high treatment satisfaction according to the TSQM, and it was well tolerated. No serious adverse events were reported. Conclusions: Acarovac Plus (R) was effective and safe for the treatment of patients with HDM-induced allergic asthma in a real-life study

Asistencia urgente a pacientes con infección por el virus de la inmunodeficiencia humana: un problema que crece

La asistencia médica a pacientes con infección por el virus de la inmunodeficiencia humana (VIH) es habitualmente compleja debido a las características peculiares de esta enfermedad y al gran número de complicaciones infecciosas, metabólicas, neurológicas y en general, de todo tipo que presentan 1.3. Estos factores y la potencial gravedad que pueden representar, hace que con frecuencia estos pacientes soliciten asistencia médica en régimen urgente. La atención urgente a este colectivo de pacientes está poco organizada a nivel sanitario en nuestro país, ya que no se ha creado un dispositivo de asistencia sanitaria específica y la atención ambulatoria que reciben es claramente insuficiente

Understanding the discriminant factors that influence the adoption and use of clinical communities of practice : the ECOPIH case

The aim of the study presented in this article is to analyse the discriminant factors that have an influence on the use of communities of practice by primary and specialist healthcare professionals (physicians and nurses) for information sharing. Obtaining evidence from an ex-ante analysis to determine what factors explain healthcare professionals' clinical community of practice use allows aspects of its use to be identified. A theoretical model based on a modified technology acceptance model was used as the analysis tool, and a discriminant analysis was performed. An ad-hoc questionnaire was designed and sent to a study population of 357 professionals from the Badalona-Sant Adrià de Besòs Primary Care Service in Catalonia, Spain, which includes nine primary care centres and three specialist care centres. The study sample was formed by the 166 healthcare professionals who responded. The results revealed three main drivers for engagement in a CoP: First, for the whole sample, perceived usefulness for reducing costs associated with clinical practice was the factor with the greatest discriminant power that distinguished between users and non-users, followed by perceived usefulness for improving clinical practice quality, and lastly habitual social media website and application use. Turning to the two sub-samples of healthcare professions (physicians and nurses, respectively), we saw that the usefulness stemming from community of practice use changed. There were differences in the levels of motivation of healthcare professionals with regards to their engagement with CoP. While perceived usefulness for reducing costs associated with clinical practice was the main factor for the physicians, perceived usefulness of the Web 2.0 platform use for communication for improving clinical practice quality and perceived ease of use were the main factors for the nurses. In the context of communities of practice, the perception of usefulness of Web 2.0 platform use for communication is determined by organisational, technological and social factors. Specifically, the position that professionals have within the healthcare structure and particularly the closer healthcare professionals' activity is to patients and their professional experience of using social networks and ICTs are crucial to explaining the use of such platforms. Public policies promoting Web 2.0 platform use for communication should therefore go beyond the purely technological dimension and consider other professional and social determinants

Unified characterisations of resolution hardness measures

Various "hardness" measures have been studied for resolution, providing theoretical insight into the proof complexity of resolution and its fragments, as well as explanations for the hardness of instances in SAT solving. In this paper we aim at a unified view of a number of hardness measures, including different measures of width, space and size of resolution proofs. Our main contribution is a unified game-theoretic characterisation of these measures. As consequences we obtain new relations between the different hardness measures. In particular, we prove a generalised version of Atserias and Dalmau's result on the relation between resolution width and space from [5]

Immunological parameters as biomarkers of response to MicroCrystalline Tyrosine-adjuvanted mite immunotherapy

Despite the effectiveness of allergen immunotherapy (AIT), some patients are unresponsive for reasons still unknown; yet validated response biomarkers remain unavailable. To analyze immunological parameters as biomarkers to monitor and predict clinical response to a MicroCrystalline Tyrosine-adjuvanted house dust mite (HDM) AIT in patients with allergic rhinitis (AR). Observational, prospective, multicenter study including adult patients (aged 18-65 years) with AR, with and without asthma, sensitized to the HDM Dermatophagoides pteronyssinus (DP) and prescribed Acarovac Plus® DP 100% in the routine practice. Serum concentrations of total IgE, specific IgE, specific IgG4, IL-4, IL-5, IL-10, IL-13, and IFN-γ were compared between baseline and 12 months after AIT. The relationship between patients' baseline immunological profiles and classification as low, high, and non-responders and between their sensitization profile to DP allergens and effectiveness were analyzed. Of 141 patients recruited, 118 (mean [SD] age of 33.6 [9.5] years) were evaluable. One year after treatment, Der p 1-specific IgE, DP-specific IgG4, and IL-10 increased by a mean (SD) of 3.4 (13.6) kU/L (p = 0.016), 0.43 (0.55) mg/L (p < 0.0001), and 1.35 (7.56) pg/mL (p = 0.033), respectively. Non-responders showed increased baseline levels of IL-13 compared to high responders (p = 0.037). Changes in effectiveness variables between baseline and after AIT were similar regardless of the sensitization profile. Non-responsive patients to AIT showed increased baseline IL-13 concentrations, suggesting its value as prognostic biomarker. DP-specific AIT increased Der p 1-specific IgE, DP-specific IgG4, and IL-10 concentrations in patients with AR. All patients benefited from treatment regardless of their sensitization profile to major DP allergens

Low levels of few micronutrients may impact COVID-19 disease progression : an observational study on the first wave

We report an observational study performed between March and May 2020 in a Spanish university hospital during the SARS-CoV-2 pandemic. The main objective was to analyse the association between the levels of micronutrients in severe Covid-19 patients and their outcome. Adult patients with a positive polymerase-chain-reaction (PCR) for SARS-CoV-2 in the nasopharyngeal swab or in tracheal aspirate culture in the case of intubation were included. Micronutrient data were obtained from plasma analysis of a standard nutritional assessment performed within the first 24 h of hospital admission. Vitamins A, B6, C and E were analysed with HPLC methods; 25-OH-vitamin D by immunoassay and zinc by colorimetric measurements. One hundred and twenty patients were included. We found that 74.2% patients had low levels of zinc (normal levels >84 µg/dL) with a mean value of 63.5 (SD 13.5); 71.7% patients had low levels of vitamin A (normal levels >0.3 mg/L) with a mean value of 0.17 (SD 0.06); 42.5% patients had low levels of vitamin B6 (normal levels >3.6 ng/mL) with a mean value of 2.2 (SD 0.9); 100% patients had low levels of vitamin C (normal levels >0.4 mg/dL) with a mean value of 0.14 (SD 0.05); 74.3% patients had low values of vitamin D (normal levels >20 ng/mL) with mean value of 11.4 (SD 4.3); but only 5.8% of patients had low levels of vitamin E (normal levels >5 mg/L) with a mean value of 3.95 (SD 0.87). The variables associated with the need for ICU admission were low levels of zinc (standard error 0.566, 95% CI 0.086 to 0.790, p = 0.017), low levels of vitamin A (standard error 0.582, 95% CI 0.061 to 0.594, p = 0.004), age over 65 (standard error 0.018, 95% CI 0.917 to 0.985, p = 0.005) and male gender (standard error 0.458, 95% CI 1.004 to 6.040, p = 0.049). The only variable that was independently associated with the need for orotracheal intubation was low levels of vitamin A (standard error 0.58, 95% CI 0.042 to 0.405, p = 0.000). Conclusions: Low levels of vitamin A and zinc are associated with a greater need for admission to the ICU and orotracheal intubation. Patients older than 65 years had higher mortality. Randomized clinical trials are needed to examine whether micronutrient supplementation could be beneficial as an adjunctive treatment in COVID-19

Influenza and Pertussis Maternal Vaccination Coverage and Influencing Factors in Spain : a Study Based on Primary Care Records Registry

The purpose was to determine the coverage of maternal vaccination against influenza and pertussis, and the characteristics associated with being vaccinated, in a health area of Catalonia, Spain. Some 36,032 anonymized and computerized clinical records registries of pregnant women from Primary Care Centres (e-CAP database) were analysed, from between 2015 and 2018. Vaccination coverage and the association with sociodemographic variables and clinical conditions were estimated using a Poisson regression model. Maternal vaccination coverage against influenza ranged between 11.9% in 2015 and 6.8% in 2018, following a decreasing trend (p < 0.001). Coverage with the tetanus toxoid, diphtheria toxoid, and acellular pertussis vaccine varied between 49.8% in 2016 and 79.4% in 2018, following an increasing trend (p < 0.001). Having living children and suffering from obesity were factors associated with not being vaccinated against both infections. The predictive variables of vaccination against influenza were diabetes (IRR: 2.17, 95% CI: 1.42-3.30) and asthma (IRR: 2.05, 95% CI: 1.76-2.38); and for pertussis, it was asthma (IRR: 1.10, 95% CI: 1.03-1.17). Different socio-demographic factors and chronic conditions in pregnant women were associated with maternal vaccination, and which will have to be taken into account in clinical practice when implementing strategies to improve the coverage of the programme