Agent Programming in Ciao Prolog

The agent programming landscape has been revealed as a natural framework for developing “intelligence” in AI. This can be seen from the extensive use of the agent concept in presenting (and developing) AI systems, the proliferation of agent theories, and the evolution of concepts such as agent societies (social intelligence) and coordination

Evaluation of a mindfulness-based intervention with and without virtual reality dialectical behavior therapy® mindfulness skills training for the treatment of generalized anxiety disorder in primary care: A pilot study

Generalized Anxiety Disorder (GAD) is a very prevalent disorder in primary care (PC). Most patients with GAD never seek treatment, and those who do seek treatment often drop out before completing treatment. Although it is an understudied treatment, Mindfulness-Based Interventions (MBIs) indicate preliminary efficacy for the treatment of GAD symptoms, but many patients with GAD present other associated symptoms (e.g., attention deficits) that complicate the treatment. Virtual Reality DBT® Mindfulness Skills learning has recently been developed to make learning mindfulness easier for patients with emotion dysregulation who have trouble concentrating. Virtual Reality (VR) might serve as a visual guide for practicing mindfulness as it gives patients the illusion of "being there" in the 3D computer generated world. The main goal of this study was to evaluate the effect of two MBIs (a MBI in a group setting alone and the same MBI plus 10 min VR DBT® Mindfulness skills training) to reduce GAD symptoms. A secondary aim was to explore the effect in depression, emotion regulation, mindfulness, and interoceptive awareness. Other exploratory aims regarding the use of VR DBT® Mindfulness skills were also carried out. The sample was composed of 42 patients (roughly half in each group) with GAD attending PC visits. After treatment, both groups of patients showed significant improvements in General Anxiety Disorder measured by the GAD-7 using mixed regression models [MBI alone (B = -5.70; p < 0.001; d = -1.36), MBI+VR DBT® Mindfulness skills (B = -4.38; p < 0.001; d = -1.33)]. Both groups also showed significant improvements in anxiety, depression, difficulties of emotion regulation and several aspects of mindfulness and interoceptive awareness. Patients in the group that received additional 10 min VR DBT Mindfulness Skills training were significantly more adherent to the treatment than those receiving only standard MBI (100% completion rate in MBI + VR vs. 70% completion rate in MBI alone; Fisher = 0.020). Although randomized controlled studies with larger samples are needed, this pilot study shows preliminary effectiveness of MBI to treat GAD, and preliminary evidence that adjunctive VR DBT® Mindfulness Skills may reduce dropouts

Comparative Analysis of Chromatin-Delivered Biomarkers in the Monitoring of Sepsis and Septic Shock: A Pilot Study

[EN] Sepsis management remains one of the most important challenges in modern clinical practice. Rapid progression from sepsis to septic shock is practically unpredictable, hence the critical need for sepsis biomarkers that can help clinicians in the management of patients to reduce the proba-bility of a fatal outcome. Circulating nucleoproteins released during the inflammatory response to infection, including neutrophil extracellular traps, nucleosomes, and histones, and nuclear pro-teins like HMGB1, have been proposed as markers of disease progression since they are related to inflammation, oxidative stress, endothelial damage, and impairment of the coagulation response, among other pathological features. The aim of this work was to evaluate the actual potential for decision making/outcome prediction of the most commonly proposed chromatin-related bi-omarkers (i.e., nucleosomes, citrullinated H3, and HMGB1). To do this, we compared different ELISA measuring methods for quantifying plasma nucleoproteins in a cohort of critically ill pa-tients diagnosed with sepsis or septic shock compared to nonseptic patients admitted to the inten-sive care unit (ICU), as well as to healthy subjects. Our results show that all studied biomarkers can be used to monitor sepsis progression, although they vary in their effectiveness to separate sepsis and septic shock patients. Our data suggest that HMGB1/citrullinated H3 determination in plasma is potentially the most promising clinical tool for the monitoring and stratification of septic patients.This activity received funding from the European Institute of Innovation and Technology (EIT). This body of the European Union receives support from the European Union's Horizon 2020 research and innovation program. C.R-M. thanks GVA for starting grant (GV/2018/127) and Spanish Ministry of Science and Innovation for research project (PID2020-119127RA-I00); J.B-G thanks ISCIII, AES2018 for iPFIS fellowship (IFI18/00015) and GVA for APOTI fellowship (APOTIP/2017/012); CG thanks Spanish Ministry of Universities for fellowship FPU18/03969; J.L.G-G and F.V.P thank INCLIVA, GVA and AES2016 and AES2019 (ISCIII) for starting grant (GV/2014/132), project PI16/01036 and PI19/00994 and project DTS17/00132 (co-financed by the ERDF). The project leading to these results has received funding from "la Caixa" Foundation (ID 100010434), under agreement CI18-0009. C.R-M., F.V.P. and A.M. thank Grand Challenges Canada. : We want to particularly acknowledge the patients and the INCLIVA Biobank (PT17/0015/0049; B.000768 ISCIII) integrated in the Valencian Biobanking Network and the Spanish National Biobanks Network for their collaboration.Beltrán-García, J.; Manclus Ciscar, JJ.; García-López, EM.; Carbonell, N.; Ferreres, J.; Rodríguez-Gimillo, M.; Garcés, C.... (2021). Comparative Analysis of Chromatin-Delivered Biomarkers in the Monitoring of Sepsis and Septic Shock: A Pilot Study. International Journal of Molecular Sciences. 22(18):1-15. https://doi.org/10.3390/ijms22189935115221

Short-course versus long-course therapy of the same antibiotic for community-acquired pneumonia in adolescent and adult outpatients.

Background Community-acquired pneumonia (CAP) is a lung infection that can be acquired during day-to-day activities in the community (not while receiving care in a hospital). Community-acquired pneumonia poses a significant public health burden in terms of mortality, morbidity, and costs. Shorter antibiotic courses for CAP may limit treatment costs and adverse effects, but the optimal duration of antibiotic treatment is uncertain. Objectives To evaluate the efficacy and safety of short-course versus longer-course treatment with the same antibiotic at the same daily dosage for CAP in non-hospitalised adolescents and adults (outpatients). We planned to investigate non-inferiority of short-course versus longerterm course treatment for efficacy outcomes, and superiority of short-course treatment for safety outcomes. Search methods We searched CENTRAL, which contains the Cochrane Acute Respiratory Infections Group Specialised Register,MEDLINE, Embase, five other databases, and three trials registers on 28 September 2017 together with conference proceedings, reference checking, and contact with experts and pharmaceutical companies.SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing short- and long-courses of the same antibiotic for CAP in adolescent and adult outpatients. DATA COLLECTION AND ANALYSIS: We planned to use standard Cochrane methods. MAIN RESULTS: Our searches identified 5260 records. We did not identify any RCTs that compared short- and longer-courses of the same antibiotic for the treatment of adolescents and adult outpatients with CAP.We excluded two RCTs that compared short courses (five compared to seven days) of the same antibiotic at the same daily dose because they evaluated antibiotics (gemifloxacin and telithromycin) not commonly used in practice for the treatment of CAP. In particular, gemifloxacin is no longer approved for the treatment of mild-to-moderate CAP due to its questionable risk-benefit balance, and reported adverse effects. Moreover, the safety profile of telithromycin is also cause for concern.We found one ongoing study that we will assess for inclusion in future updates of the review. AUTHORS' CONCLUSIONS: We found no eligible RCTs that studied a short-course of antibiotic compared to a longer-course (with the same antibiotic at the same daily dosage) for CAP in adolescent and adult outpatients. The effects of antibiotic therapy duration for CAP in adolescent and adult outpatients remains unclear.pre-print547 K

Alterations in leukocyte DNA methylome are associated to immunosuppression in severe clinical phenotypes of septic patients

IntroductionSepsis patients experience a complex interplay of host pro- and anti-inflammatory processes which compromise the clinical outcome. Despite considering the latest clinical and scientific research, our comprehension of the immunosuppressive events in septic episodes remains incomplete. Additionally, a lack of data exists regarding the role of epigenetics in modulating immunosuppression, subsequently impacting patient survival.MethodsTo advance the current understanding of the mechanisms underlying immunosuppression, in this study we explored the dynamics of DNA methylation using the Infinium Methylation EPIC v1.0 BeadChip Kit in leukocytes from patients suffering from sepsis, septic shock, and critically ill patients as controls, within the first 24 h after admission in the Intensive Care Unit of a tertiary hospital.Results and discussionEmploying two distinct analysis approaches (DMRcate and mCSEA) in comparing septic shock and critically ill patients, we identified 1,256 differentially methylated regions (DMRs) intricately linked to critical immune system pathways. The examination of the top 100 differentially methylated positions (DMPs) between septic shock and critically ill patients facilitated a clear demarcation among the three patient groups. Notably, the top 6,657 DMPs exhibited associations with organ dysfunction and lactate levels. Among the individual genes displaying significant differential methylation, IL10, TREM1, IL1B, and TNFAIP8 emerged with the most pronounced methylation alterations across the diverse patient groups when subjected to DNA bisulfite pyrosequencing analysis. These findings underscore the dynamic nature of DNA methylation profiles, highlighting the most pronounced alterations in patients with septic shock, and revealing their close association with the disease

Reappraisal of the outcome of healthcare-associated and community-acquired bacteramia: a prospective cohort study

Background: Healthcare-associated (HCA) bloodstream infections (BSI) have been associated with worse outcomes, in terms of higher frequencies of antibiotic-resistant microorganisms and inappropriate therapy than strict community-acquired (CA) BSI. Recent changes in the epidemiology of community (CO)-BSI and treatment protocols may have modified this association. The objective of this study was to analyse the etiology, therapy and outcomes for CA and HCA BSI in our area. Methods: A prospective multicentre cohort including all CO-BSI episodes in adult patients was performed over a 3-month period in 2006–2007. Outcome variables were mortality and inappropriate empirical therapy. Adjusted analyses were performed by logistic regression. Results: 341 episodes of CO-BSI were included in the study. Acquisition was HCA in 56% (192 episodes) of them. Inappropriate empirical therapy was administered in 16.7% (57 episodes). All-cause mortality was 16.4% (56 patients) at day 14 and 20% (71 patients) at day 30. After controlling for age, Charlson index, source, etiology, presentation with severe sepsis or shock and inappropriate empirical treatment, acquisition type was not associated with an increase in 14-day or 30-day mortality. Only an stratified analysis of 14th-day mortality for Gram negatives BSI showed a statically significant difference (7% in CA vs 17% in HCA, p = 0,05). Factors independently related to inadequate empirical treatment in the community were: catheter source, cancer, and previous antimicrobial use; no association with HCA acquisition was found. Conclusion: HCA acquisition in our cohort was not a predictor for either inappropriate empirical treatment or increased mortality. These results might reflect recent changes in therapeutic protocols and epidemiological changes in community pathogens. Further studies should focus on recognising CA BSI due to resistant organisms facilitating an early and adequate treatment in patients with CA resistant BSI

Cost-Utility of Attachment-Based Compassion Therapy (ABCT) and Mindfulness-Based Stress Reduction (MBSR) in the Management of Depressive, Anxious, and Adjustment Disorders in Mental Health Settings: Economic Evaluation Alongside a Randomized Controlled Trial

ObjectivesThe main objective of this paper was to examine the cost-utility of attachment-based compassion therapy (ABCT) compared to Mindfulness-Based Stress Reduction (MBSR) and treatment-as-usual (TAU) on patients with depressive and/or anxious disorder, or adjustment disorder with depressive and/or anxious symptomatology in terms of effects on quality-adjusted life years (QALYs) as well as healthcare costs from a public healthcare system perspective.MethodA 6-month randomized controlled trial was conducted. Ninety Spanish patients with mental disorders (depressive, anxious, or adjustment disorders) received 8 weekly group sessions of TAU + ABCT, TAU + MBSR, or TAU alone. Data collection took place at pre- and 6-month follow-up. Cost-utility of the two treatment groups (ABCT vs MBSR vs TAU) was compared by examining treatment outcomes in terms of QALYs (obtained with the EQ-5D-3L) and healthcare costs (data about service use obtained with the Client Service Receipt Inventory).ResultsBoth MBSR and ABCT were more efficient than TAU alone, although the results did not reach statistical significance. Compared to ABCT, MBSR produced an increase both in terms of costs (euro53.69, 95% CI [- 571.27 to 513.14]) and effects (0.004 QALYs, 95% CI [- 0.031 to 0.049]); ICUR = euro13,422.50/QALY). Both interventions significantly reduced the number of visits to general practice compared to TAU.ConclusionsThis study has contributed to the evidence base of mindfulness- and compassion-based programs and provided promising information about the cost-utility of MBSR for patients with emotional disorders. However, the small sample size and short follow-up period limit the generalizability of the findings.PreregistrationClinicaltrials.gov; NCT03425487

Cost-utility of attachment-based compassion therapy (ABCT) and Mindfulness-Based Stress Reduction (MBSR) in the management of depressive, anxious, and adjustment disorders in mental health settings: economic evaluation alongside a randomized controlled trial

Objectives: The main objective of this paper was to examine the cost-utility of attachment-based compassion therapy (ABCT) compared to Mindfulness-Based Stress Reduction (MBSR) and treatment-as-usual (TAU) on patients with depressive and/or anxious disorder, or adjustment disorder with depressive and/or anxious symptomatology in terms of effects on quality-adjusted life years (QALYs) as well as healthcare costs from a public healthcare system perspective. Method: A 6-month randomized controlled trial was conducted. Ninety Spanish patients with mental disorders (depressive, anxious, or adjustment disorders) received 8 weekly group sessions of TAU + ABCT, TAU + MBSR, or TAU alone. Data collection took place at pre- and 6-month follow-up. Cost-utility of the two treatment groups (ABCT vs MBSR vs TAU) was compared by examining treatment outcomes in terms of QALYs (obtained with the EQ-5D-3L) and healthcare costs (data about service use obtained with the Client Service Receipt Inventory). Results: Both MBSR and ABCT were more efficient than TAU alone, although the results did not reach statistical significance. Compared to ABCT, MBSR produced an increase both in terms of costs (€53.69, 95% CI [− 571.27 to 513.14]) and effects (0.004 QALYs, 95% CI [− 0.031 to 0.049]); ICUR = €13,422.50/QALY). Both interventions significantly reduced the number of visits to general practice compared to TAU. Conclusions: This study has contributed to the evidence base of mindfulness- and compassion-based programs and provided promising information about the cost-utility of MBSR for patients with emotional disorders. However, the small sample size and short follow-up period limit the generalizability of the findings. Preregistration: Clinicaltrials.gov; NCT03425487

Comparative analysis of the deposits left by the tsunami that followed to the Lisbon Earthquake (1755 AD), on the Castilnovo beach and the Old Tuna Factory of La Chança (Conil de la Frontera, SW Spain)

On coasts of tectonically active areas, where old tsunami deposits are in a fragmentary state, the study of paleo-tsunamis provides data for interpreting facies and processes. In order to recognize facies, a study has been carried out on a sector of the SW coast of Spain, where some historical tsunamis are documented, such as that caused by the Lisbon earthquake (November 1, 1755 AD). This study is focused on a sector between the Salado River Mouth and Castilnovo Beach (Conil de la Frontera), where depositional morphologies attributed to this event can still be observed. It includes a comparative analysis with well-preserved deposits found inside an old tuna salting factory, La Chança which, albeit severely damaged, survived the tsunami. The sediments deposited by the 1755 AD tsunami record a mixture of older coastal deposits, including sands and muddy-sands, pebbles, mollusc shells, foraminifers, terrestrial gastropods, root features, and archaeological remains. After the tsunami, a part of the deposits were remobilized and mixed with normal coastal sediments, becaming unrecognizable as tsunamites. Several stratigraphic units have been distinguished, corresponding to different sedimentary stages. The results suggest that some depositional features were caused not by this event, but rather are a consequence of the interaction of other factors. Shelly beds intercalated within the deposits have provided a 14C age older than 1755 AD, which have been interpreted as records of other older events or erosion of older deposits followed by deposition during the tsunami event.En costas de regiones tectónicamente activas, donde depósitos de antiguos tsunamis se encuentran en estado fragmentario, el estudio de paleo-tsunamis proporciona datos para la interpretación de facies y la reconstrucción de los procesos. Con objeto de reconocer las facies y los procesos involucrados, se ha realizado un estudio sedimentológico en un sector de la costa SO de España, donde están documentados varios tsunamis históricos, como el causado por el terremoto de Lisboa del 1 de Noviembre de 1755. El estudio se centra en un sector comprendido entre la desembocadura del río Salado y la Playa de Castilnovo (Conil de la Frontera), donde aún se pueden observar morfologías y depósitos atribuidos a este evento. El estudio incluye el análisis comparativo con los sedimentos depositados en la antigua factoría de salazón de La Chança que, aunque seriamente dañada, sobrevivió al tsunami. Los sedimentos depositados por el tsunami de 1755 se combinaron con depósitos costeros más antiguos, resultando una mezcla de arenas, fango, clastos, conchas de moluscos, foraminíferos, gasterópodos terrestres, raíces y restos arqueológicos de la época. Tras el evento, estos sedimentos fueron redepositados en medios costeros, resultando unos depósitos irreconocibles, aunque algunos han sido interpretados como tsunamitas. Se han diferenciado varias unidades sedimentarias correspondientes a diferentes etapas, incluyendo la acción de este evento. Los resultados sugieren que algunos rasgos deposicionales presentes en los depósitos no fueron totalmente causados por el tsunami de 1755, sino que son una consecuencia de la interacción de varios factores. Además, algunas capas bioclásticas intercaladas en los depósitos han proporcionado una edad 14C mayor de 1.755 dC, lo que ha sido interpretado como el registro de eventos más antiguos

Calidad de carne de 7 razas españolas de ganado bovino vinculadas a su sistema de producción

En España, de modo general, el consumidor de carne de vacuno le da poca importancia a la raza en comparación con otros países Europeos, a pesar de que la misma influye en otras características que sí considera relevantes como el aspecto (color, grasa intramuscular) o la terneza. Las razas bovinas rústicas y locales españolas están ligadas a una región geográfica particular y a un sistema de erra tradicional, donde varios factores como la edad y peso al sacrificio, el sexo, el grado de engrasamiento, el manejo, la alimentación y el tratamiento post-sacrificio intervienen conjuntamente en la definición de cada producto. Estos productos suelen promocionarse a través de denominaciones de origen o marcas de calidad que, por otro lado, permiten al consumidor reducir la incertidumbre cuando compran alimentos, ya que están asociadas a ciertas características sensoriales y/o procesos productivos distintivos. Algunos autores han descrito la calidad de canal (Piedraflta et al., 2003) y las características bioquímicas (Gil et al., 2001) y sensoriales (Serra et al., 2008) de varias razas españolas vinculadas al sistema de producción, de modo que este trabajo se centra en la textura de la carne evaluada instrumentalmente y en algunas de sus características químicas. En: https://calidadcarnecita.wordpress.com/2016/02/12/calidad-de-la-carne-de-7-razas-espanolas-vinculadas-a-sus-sistema-de-produccion