Information-Communication Technologies as an Integrated Water Resources Management (IWRM) Tool for Sustainable Development

Sustainability is a crucial and at the same time vital approach for satisfying future generations’ rights on natural resources. Toward this direction, global policies, supported by international organizations such as UNESCO and its international science programs, foster sustainable development as principal concept for the management of various thematic areas including the environment. The present work promotes the integration of information-communication technologies (ICTs) in the water resources management field as a state of the art concept that sets the basis for sustainable development at global scale. The research focuses on the ICTs contribution to the evolution of scientific and technological disciplines, such as satellite earth observations, real time monitoring networks, geographic information systems, and cloud-based geo information systems and their interconnection to integrated water resources management. Moreover, selected international research programs and activities of UNESCO International Hydrology Programme (IHP) are synoptically but comprehensively being presented to demonstrate the integration of the technological advances in water resources management and their role toward sustainable development

Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Assessing Marginalized Communities in Mexico for Implementation of Rainwater Catchment Systems

Mexico contains a high percentage of marginalized communities, as well as geographic areas with high annual precipitation (approximately 2000 mm). This study uses regional water access and precipitation data to determine municipalities that would most benefit from the installation of Domestic Rain Water Harvesting Systems (DRWHS). The main objective was to find a relationship between local conditions (marginalization, expected level of service, and precipitation) and the physical components of DRWHS. First, monthly precipitation and the number of inhabitants per household were determined for each municipality. Catchment area and tank size were then calculated for a single dwelling by municipality using water demand, run-off coefficient, monthly precipitation, and number of inhabitants per household. In general, municipalities with very low access to municipal water and very high precipitation were found in the southern area of the country. A curve that estimates catchment area based on annual precipitation was developed using the selected municipalities, which produced an average catchment area of 113.3 m2 for a water demand of 100 L/capita/day. While any DRWHS must be designed specific to local conditions, this study has determined that a regional approximation can be used to select ideal communities for these systems, which can in turn facilitate national implementation

Valuing the subsurface pathogen treatment barrier in water recycling via aquifers for drinking supplies

A quantitative microbial risk assessment (QMRA) was performed at four managed aquifer recharge (MAR) sites (Australia, South Africa, Belgium, Mexico) where reclaimed wastewater and stormwater is recycled via aquifers for drinking water supplies, using the same risk-based approach that is used for public water supplies. For each of the sites, the aquifer treatment barrier was assessed for its log removal capacity much like for other water treatment technologies. This information was then integrated into a broader risk assessment to determine the human health burden from the four MAR sites. For the Australian and South African cases, managing the aquifer treatment barrier was found to be critical for the schemes to have low risk. For the Belgian case study, the large treatment trains both in terms of pre- and post-aquifer recharge ensures that the risk is always low. In the Mexico case study, the risk was high due to the lack of pre-treatment and the low residence times of the recharge water in the aquifer. A further sensitivity analysis demonstrated that human health risk can be managed if aquifers are integrated into a treatment train to attenuate pathogens. However, reduction in human health disease burden (as measured in disability adjusted life years, DALYs) varied depending upon the number of pathogens in the recharge source water. The beta-Poisson dose response curve used for translating rotavirus and Cryptosporidium numbers into DALYs coupled with their slow environmental decay rates means poor quality injectant leads to aquifers having reduced value to reduce DALYs. For these systems, like the Mexican case study, longer residence times are required to meet their DALYs guideline for drinking water. Nevertheless the results showed that the risks from pathogens can still be reduced and recharging via an aquifer is safer than discharging directly into surface water bodies

Estrategia general para el desarrollo de ontologías

Para diversas organizaciones, se ha vuelto parte fundamental de sus principios el tener que adaptarse a una era cognitiva que se basa en presentar estrategias apropiadas y efectivas para la resolución de problemas utilizando el conocimiento organizacional. Por ello, se suele utilizar estas herramientas para la toma de decisiones con base en la información que han ido obteniendo a través del tiempo en sus campos. Con el propósito de modelar y tener la posibilidad de consultar el conocimiento disponible de algún dominio de estructura informal, el presente documento introduce una estrategia general basada en un conjunto de actividades que sustentarán la creación de ontologías para este tipo de dominios, implementada en lenguaje OWL. Esta estrategia fue probada empleando dos casos de estudio distintos: la terapia electroconvulsiva y el estrés laboral, resultando favorable en ambos casos y demostrando su efectividad y posible implementación para cualquier otro dominio de este tipo