Adherencia al tratamiento con fármacos moduladores de la enfermedad sintéticos en la artritis reumatoide. Resultados del estudio OBSERVAR

[Abstract] Background: Treatment compliance with disease-modifying antirheumatic drugs (DMARD) is essential to achieve the therapeutic goals in rheumatoid arthritis (RA). However, despite the need for good compliance, there is evidence that patients with RA frequently fail to use DMARD for the control of RA. Thus, the main objective of the OBSERVAR study is to evaluate the reasons for the lack of therapeutic adherence to synthetic DMARD in these patients. Patients and methods: A Delphi process involving 18 randomly selected Spanish rheumatologists determined the level of agreement with 66 causes of noncompliance selected from the literature in relation to synthetic DMARD in RA. Results: The reasons for noncompliance were consistent in 75.7%, although 3 reasons (4.5%) were highly consistent: 1) not knowing what to do in the case of an adverse event with DMARD; 2) not having undergone adherence screening by health personnel for early detection of "noncompliant patients"; and 3) not having undergone interventions or strategies that improve adherence. Conclusion: In order to improve adherence to RA treatment with synthetic DMARD, the patient should be adequately informed of each new treatment introduced, the patient's compliance profile should be incorporated into the clinical routine and the patient's motivation for therapeutic compliance be reinforced through the methods available to us.[Resumen] Introducción. La cumplimentación del tratamiento modificador de la enfermedad es esencial para alcanzar los objetivos terapéuticos en la artritis reumatoide (AR). Sin embargo, y a pesar de la necesidad de una buena adherencia, existe evidencia de que muchos pacientes con AR no cumplen adecuadamente con la prescripción del tratamiento indicado con fármacos moduladores de la enfermedad de acción lenta (FAME) sintéticos o convencionales. Conscientes de la importancia de este hecho, el estudio sobre observancia terapéutica en AR (estudio OBSERVAR) tiene como objetivo principal valorar los motivos de la falta de adherencia terapéutica a los FAME sintéticos en estos pacientes. Pacientes y métodos. Mediante un proceso Delphi entre 18 reumatólogos españoles seleccionados aleatoriamente se determinó el grado de acuerdo con 66 causas de incumplimiento seleccionadas de la bibliografía, en relación con los FAME sintéticos en la AR. Resultados. Los motivos de incumplimiento fueron consistentes en el 75,7%, si bien 3 razones (4,5%) destacaron como muy consistentes: 1) desconocer qué hacer cuando se sufre un acontecimiento adverso con el FAME; 2) no llevar a cabo métodos de cribado de la adherencia por el personal sanitario para detectar a los «pacientes incumplidores» de forma temprana y 3) no aplicar intervenciones o estrategias que mejoren la adherencia terapéutica. Conclusión. Para mejorar la adherencia al tratamiento de la AR con FAME sintéticos se debe informar al paciente de cada tratamiento nuevo introducido, incorporar el perfil de cumplimiento del paciente en la rutina clínica, y reforzar la motivación del paciente al cumplimiento terapéutico mediante los métodos a nuestro alcance

Teaching the mean-field approximation

[ENG] Many University subjects that we teach in engineering degrees (e.g. Control Theory, Operations Research, Game Theory, Physics, Fluid Dynamics, Modelling and Control of Queuing and Production Systems, Stochastic Processes, and Network Theory) make extensive use of the so-called mean-field analysis. In these subjects, the mean-field analysis often appears as an approximation of a discrete time stochastic process where a) the inherent stochasticity of the original process is replaced with determinism, and b) the time discreteness of the original process is replaced with time continuity. Thus, the mean-field approximation is presented as a continuous time differential equation that can approximate the dynamics of the discrete time stochastic process under investigation. In this paper we present a teaching methodology that we have found useful for introducing students to the mean-field analysis, and we provide some accompanying teaching material –in the form of computer models– that other academics may want to use in their own lecturesThe authors gratefully acknowledge financial support from the Spanish JCyL (VA006B09, GR251/2009), MICINN (SICOSSYS: TIN2008-06464-C03-02; CONSOLIDER-INGENIO 2010: CSD2010-00034; DPI2010-16920) and L.R.I. from the Spanish Ministry of Education (JC2009-00263)

Invirtiendo en capital natural: un marco para integrar la sostenibilidad ambiental en las políticas de cooperación

Tomando en cuenta la magnitud de la crisis ambiental que afecta al planeta y los estrechos vínculos existentes entre la conservación de los ecosistemas y la lucha contra la pobreza, cabría preguntarse por qué los temas de protección del medio ambiente continúan teniendo un peso relativo tan bajo en las agendas y prioridades de las agencias de cooperación internacional. En este artículo, se analizan las razones de este desequilibrio y se propone un marco conceptual con base socio-ecológica para facilitar una verdadera integración de la sostenibilidad ambiental como prioridad estratégica en las políticas y herramientas de ayuda oficial al desarrollo. Varios paradigmas y principios fundamentales emanan de este nuevo marco conceptual, que considera a los ecosistemas funcionales como un capital natural que, adecuadamente gestionado, es capaz de producir un rico y variado flujo de servicios sobre los cuales es posible construir un proceso de desarrollo social, económica y ambientalmente sostenible, además de justo en términos de equidad intra e intergeneracional

Tamoxifen and estradiol interact with the flavin mononucleotide site of complex I leading to mitochondrial failure

This study evaluated the action of tamoxifen and estradiol on the function of isolated liver mitochondria. We observed that although tamoxifen and estradiol per se did not affect mitochondrial complexes II, III, or IV, complex I is affected, this effect being more drastic (except for state 4 of respiration) when mitochondria were coincubated with both drugs. Furthermore, using two respiratory chain inhibitors, rotenone and diphenyliodonium chloride, we identified the flavin mononucleotide site of complex I as the target of tamoxifen and/or estradiol action(s). Tamoxifen (25 microm) per se induced a significant increase in hydrogen peroxide production and state 4 of respiration. Additionally, a significant decrease in respiratory control ratio, transmembrane, and depolarization potentials were observed. Estradiol per se decreased carbonyl cyanide p-trifluoromethoxyphenylhydrazone (FCCP)-stimulated respiration, state 3 of respiration, and respiratory control ratio and increased lag phase of repolarization. With the exception of state 4 of respiration whose increase induced by tamoxifen was reversed by the presence of estradiol, the effects of tamoxifen were highly exacerbated when estradiol was present. We observed that 10 microm tamoxifen in the presence of estradiol affected mitochondria significantly by decreasing FCCP-stimulated respiration, state 3 of respiration, respiratory control ratio, and ADP depolarization and increasing the lag phase of repolarization. All of the deleterious effects induced by 25 microm tamoxifen were highly exacerbated in the presence of estradiol. Furthermore, we observed that the effects of both compounds were independent of estrogen receptors because the pure estrogen antagonist ICI 182,780 did not interfere with tamoxifen and/or estradiol detrimental effects. Altogether, our data provide a mechanistic explanation for the multiple cytotoxic effects of tamoxifen including its capacity to destroy tamoxifen-resistant breast cancer cells in the presence of estradiol. This new piece of information provides a basis for the development of new and promising anticancer therapeutic strategie

Solar irradiance dictates settlement timing and intensity of marine mussels

11 páginas, 4 figuras, 2 tablas.-- This work is licensed under a Creative Commons Attribution 4.0 International LicenseIdentifying the environmental factors driving larval settlement processes is crucial to understand the population dynamics of marine invertebrates. This work aims to go a step ahead and predict larval presence and intensity. For this purpose we consider the influence of solar irradiance, wind regime and continental runoff on the settlement processes. For the first time, we conducted a 5-years weekly monitoring of Mytilus galloprovincialis settlement on artificial suspended substrates, which allowed us to search for interannual variability in the settlement patterns. Comparison between the seasonal pattern of larval settlement and solar irradiance, as well as the well-known effect of solar irradiance on water temperature and food availability, suggest that solar irradiance indirectly influences the settlement process, and support the use of this meteorological variable to predict settlement occurrence. Our results show that solar irradiance allows predicting the beginning and end of the settlement cycle a month in advance: Particularly we have observed that solar irradiance during late winter indirectly drives the timing and intensity of the settlement onset, Finally, a functional generalise additive model, which considers the influence of solar irradiance and continental runoff on the settlement process, provides an accurate prediction of settlement intensity a fortnight in advanceThis study was funded by PROINSA-CSIC contract-project (CSIC0704101100001), CSIC- PIE project (CSIC 201540E107) and EU H2020 project ClimeFish (EU 677039).Peer reviewe

Methane Emission Estimated from Different Cattle Intake Data in Heifers Grazing a Tropical Pasture

The quantification of methane (CH4) from enteric fermentation related to cattle diet is a useful tool to identify strategies to mitigate greenhouse gas emissions. This is even important in tropical and subtropical regions due to the lack of CH4 estimations in beef cattle, particularly from Bos Indicus breeds grazing tropical grasses (Kurihara et al., 1999). Several modelling approaches have been developed in order to predict CH4 emission. However, the use of these models has limitations associated with uncertainty information required such as feed intake (FI), composition of the selected diet and animal responses (Gonzalez et al., 2014). FI is the main factor influencing CH4 emission. Individual FI measurements are not easy to achieve accurately in grazing animals rather than those located in pens, particularly under deferred tropical pastures at the end of the dry season, due to the large proportion of death forage. In this case, cattle supplementation with energetic and proteins concentrates, is a viable practice in order to improve animal FI and reduce CH4 emissions. The main objectives of this study was estimate and compare CH4 emission using data collected from experimental trials and predicted by a model (UNFCCC, 2014) in supplemented heifers grazing low quality Chloris gayana pasture in northwestern Argentina (Semiarid Chaco Region)

Effect of Supplementation Frequency on Forage Utilization by Heifers Grazing a Tropical Pasture during the Dry Season

In tropical pasture, low quality and availability forage during the dry season can limit the cattle intake. Energetic and protein supplementation is a viable practice to improve feed intake and animal performance. Previous studies have shown that infrequent protein supplementation decreases feeding cost achieving similar performance compared with every day supplementation (Farmer et al., 2004). Even though infrequent protein supplementation has been widely studied, little research has been carried out on infrequent energetic supplementation, especially its effect on pasture utilization. Some evidence indicates that negative effects on forage use at low levels of infrequent supplementation (Beaty et al., 1994). However, high levels of energetic supplementation can result in a substitution effect of forage for concentrate, reducing pasture utilization, even more when forage quality decreases as dry season progresses. Thus, the aim of this study was to evaluate the effect of supplementation frequency (continuous or discontinuous, based on energetic concentrate) on forage utilization by heifers grazing a Chloris gayana pasture during the dry season in the Semiarid Chaco Region (Northwestern Argentine)

Robustness of cooperation to movement patterns in a hunter-fisher-gatherer model

Most societies often face social dilemmas in which there can be contradictions between individual interests versus those of the community as a whole. Hunter-fisher-gatherer societies can be considered as paradigmatic examples of these phenomena. The fact that many of these societies tend to live permanently disaggregated produces a specific need for maintaining the social tissue as well as for reproducing social and economic knowledge and values that depend on individual behaviour. Therefore, aggregation events are of special relevance as they represent the optimal occasion to deal with specific social aspects that in these cases need extraordinary circumstances to be held. Our case of study is focused on cooperative processes developed by historical hunterfisher- gatherer-societies from the Beagle channel (Tierra del Fuego), that developed their existence mainly through an economy focused on the exploitation of coastal and maritime resources. Yamana households moved across the territory in their canoes in search for needed resources. In spite of this, Yamana society has different ways to strength social cohesion: visiting each other or because of the celebration of different types of ceremonies. Initiation ceremonies were of special relevance, and the need for maintaining the group meanwhile these rituals were being developed became essential. The finding of a beached whale, and the subsequent aggregation event that took place through a public call, created the ideal context for the development of economic and social processes in a cooperative way

Estudos preliminares para consolidação de suportes com pintura mural: síntese e caracterização de nanocais

-Resumo Neste trabalho apresentam-se os resultados da síntese e da caracterização de nano-materiais de hidróxido de cálcio e de hidróxido de magnésio visando a sua aplicação como consolidantes de suportes com pintura mural. Este estudo preliminar constitui a etapa inicial de um projeto em curso e que tem como principal objetivo o desenvolvimento de novas estratégias de síntese de nano-materiais inovadores para conservação e restauro de revestimentos antigos. - Abstract In this publication, we report the synthesis and characterization of calcium and magnesium hydroxides nanoparticles for consolidation of mural paintings. Some preliminary results are discussed. This research is the initial part of our ongoing project which aims to develop new synthetic strategies towards novel and innovative materials for preservation and restoration of old rend