The controllability of a monetary aggregate in EMU

La consideracion de un agregado monetario como objetivo intermedio de la politica monetaria exige que esa definicion de liquidez mantenga una relacion de estabilidad con el objetivo final y que su evolucion pueda ser controlada por parte del banco central. Este documento analiza esta segunda cuestion, centrandose en las posibilidades que tendria el Banco Central Europeo de controlar efectivamente un agregado monetario si decidiera considerarlo como objetivo intermedio. En el trabajo se revisan los mecanismos a traves de los cuales la politica monetaria puede controlar la evolucion de la cantidad de dinero, y se examinan las propiedades empiricas de la demanda de dinero en la Union Monetaria Europea (UME) y en un pais, como Alemania, en el que se han venido fijando objetivos en terminos de un agregado monetario. El documento pone de manifiesto que las condiciones para ejercer un control adecuado de la cantidad de dinero en la UME son notablemente mas desfavorables de lo que resultan en Alemania. (ac) (jle) (em) (jp) (mac

Magnetic resonance spectroscopy of normal appearing white matter in early relapsing-remitting multiple sclerosis: correlations between disability and spectroscopy

BACKGROUND: What currently appears to be irreversible axonal loss in normal appearing white matter, measured by proton magnetic resonance spectroscopy is of great interest in the study of Multiple Sclerosis. Our aim is to determine the axonal damage in normal appearing white matter measured by magnetic resonance spectroscopy and to correlate this with the functional disability measured by Multiple Sclerosis Functional Composite scale, Neurological Rating Scale, Ambulation Index scale, and Expanded Disability Scale Score. METHODS: Thirty one patients (9 male and 22 female) with relapsing remitting Multiple Sclerosis and a Kurtzke Expanded Disability Scale Score of 0–5.5 were recruited from four hospitals in Andalusia, Spain and included in the study. Magnetic resonance spectroscopy scans and neurological disability assessments were performed the same day. RESULTS: A statistically significant correlation was found (r = -0.38 p < 0.05) between disability (measured by Expanded Disability Scale Score) and N-Acetyl Aspartate (NAA/Cr ratio) levels in normal appearing white matter in these patients. No correlation was found between the NAA/Cr ratio and disability measured by any of the other disability assessment scales. CONCLUSIONS: There is correlation between disability (measured by Expanded Disability Scale Score) and the NAA/Cr ratio in normal appearing white matter. The lack of correlation between the NAA/Cr ratio and the Multiple Sclerosis Functional Composite score indicates that the Multiple Sclerosis Functional Composite is not able to measure irreversible disability and would be more useful as a marker in stages where axonal damage is not a predominant factor

Muskuilu-maskorren hauskortasuna urratzaile gisa

The spread of raft-farming of mussels in river estuaries around the world produces millions of tons of shell waste which mainly ends up in landfills. In addition, the United Nations and the European Union promote the sustainable development goals (SDG) for sustainable food production, requiring adequate waste management to analyse the life cycle and reuse of goods and materials. This work proposes to use mussels shells by-products created by the canning industry as abrasive in the sandblasting process. One of the main characteristics of abrasive grains is the friability, which determines the behaviour of the abrasive in the sandblasting process. Shells need to be prepared before using in sandblasting, a conditioning that involves the cleaning, grinding and sieving of shells. The purpose of this work is to examine the friability of mussel shells from two points of view, the effect of the cleaning process and a comparison with a common abrasive material (garnet). The characterization of the friability of mussel shells allows to foresee and define adequate applications according to their behaviour as abrasive. It is noticeable on the results that garnet is four times more friable than shells. This interesting feature enlarges the life of sand in close cycles and foresees a promising future to the new application.; Munduan zehar ibaien estuarioetan muskuilu-haztegiek izandako zabalkuntzak irtenbide zaila duen milioika tona maskor hondakin sortzen ditu. Bestalde, Nazio Batuek eta Europar Batasunak bultzatutako garapen iraunkorrerako helburuek (GIH) elikagaien ekoizpen jasangarria bultzatzeaz gain, hondakinen kudeaketa egokia exijitzen du, material eta produktuen bizitza zikloa aztertzera behartuz eta berrerabilpena lehenetsiz. Lan honek kontserba-industriak sortutako muskuilu-maskor azpi-produktua granailaketan eta hondar-zurrustako garbiketa-prozesuetan urratzaile gisa erabiltzea proposatzen da. Urratzaileen ezaugarri nagusietako bat hauskortasuna da, horrek baldintzatzen baitu urratzailearen portaera hondar-zurrusta prozesuan. Maskor-hondarra lortzeko pausoak maskorren garbiketa, ehoketa eta baheketa prozesuek osatzen dute. Lan honen helburua muskuilu-maskorren hauskortasuna bi ikuspuntutatik aztertzea da: garbiketa-prozesuaren eragina eta ohiko urratzaile batekin (granatea) hauskortasunaren konparaketa. Muskuilu-maskorren hauskortasunaren karakterizazioak urratzaile gisa duten portaera aurreikusi eta aplikazio egokiak definitzea ahalbidetzen du. Emaitzek nabarmenki erakutsi dute maskorrek granateak baino lau aldiz hauskortasun txikiagoa duela. Ezaugarri interesgarri horrek ziklo itxian lan egiten duen hondarraren bizitza luzatzea dakar eta aplikazio berriari hondar-zurrustan etorkizun oparoa aurreikusten dio

Assessment of the appropriateness criteria for the indication of stress echocardiography in a cardiovascular reference center

Reseña El propósito de este estudio es evaluar la aplicación clínica e indicación de los criterios apropiados para la ecocardiografía de estrés de acuerdo a la Fundación del Colegio Americano de Cardiología/Sociedad Americana de Ecocardiografía, en la práctica diaria de un centro cardiovascular de referencia. Materiales y métodos Fueron incluidos los estudios consecutivos realizados entre enero de 2012 y julio de 2013. Los datos fueron revisados, analizados y clasificados por cuatro cardiólogos expertos teniendo en cuenta: la demografía, la especialidad que refiere, la indicación primaria y su clasificación final como apropiados, inapropiados o inciertos. Resultados Un total de 1.556 estudios fueron incluidos inicialmente, 450 fueron excluidos por estar relacionados con programas de trasplante de órgano sólido y en 170 no se pudo determinar una indicación clara para el estudio. Los 936 estudios restantes (85%) fueron analizados para la determinación de criterios apropiados. De estos 679 (73%) tenían una indicación apropiada, 70 (7%) eran inciertos y 187 (20%) fueron inapropiados. Cuatrocientos veintiocho (46%) fueron referidos por medicina interna, 375 (40%) por cardiología, 51 (5%) por anestesiología y 82 (10%) por medicina general y otras especialidades. Un total de 159 (17%) estudios arrojaron un resultado anormal, todos ellos estaban apropiadamente indicados, ninguno fue anormal en los inapropiadamente indicados. Conclusiones La revisión de la aplicación de los criterios apropiados para la ecocardiografía de estrés no solo permite una implementación clínica efectiva en un centro cardiovascular de referencia, sino que también estratifica razonablemente la posibilidad de tener un resultado anormal en aquellos con una indicación apropiada. Sin embargo, esto debería validarse extensamente en una cohorte multicéntrica.Q4Artículo original77-81Background The purpose of this study is to evaluate the clinical application and assessment of appropriate criteria for the indication of stress echocardiograms according to the American College of Cardiology Foundation/American Society of Echocardiography in daily clinical practice at a cardiovascular reference center. Materials and methods All consecutive studies carried out between January 2012 and July 2013 were included. The data was reviewed, analyzed and classified by four expert cardiologists regarding issues such as demography, referred specialty, primary indication and its final classification as appropriate, inappropriate or uncertain. Results A total of 1,556 studies were initially included, 450 which were excluded as being related to program of solid organ transplantation and 170 as no clear indication of the study could be determined. Therefore, the remaining 936 were analyzed for the evaluation of appropriateness criteria. Of these 679 (73%) had appropriate indication, 70 (7%) were uncertain and 187 (20%) inappropriate. 428 (46%) were referred by internal medicine, 375 (40%) by cardiology, 51 (5%) by anesthesiology and 82 (10%) by general medicine and other specialties. A total of 159 (17%) studies rendered an abnormal result, all of them which were properly indicated, and no one was abnormal in the inappropriately indicated. Conclusions Reviewing appropriateness criteria for SE not only allows an effective characterization and clinical performance in a single center, but also reasonably stratifies the possibility of having an abnormal result in those with an appropriate indication. However, this should be validated extensively in a multicenter cohort

Randomized controlled trial evaluating the benefit of a novel clinical decision support system for the management of COVID-19 patients in home quarantine: A study protocol

Producción Científica(1) Background: We present the protocol of a randomized controlled trial designed to evaluate the benefit of a novel clinical decision support system for the management of patients with COVID-19. (2) Methods: The study will recruit up to 500 participants (250 cases and 250 controls). Both groups will receive the conventional telephone follow-up protocol by primary care and will also be provided with access to a mobile application, in which they will be able to report their symptoms three times a day. In addition, patients in the active group will receive a wearable smartwatch and a pulse oximeter at home for real-time monitoring. The measured data will be visualized by primary care and emergency health service professionals, allowing them to detect in real time the progression and complications of the disease in order to promote early therapeutic interventions based on their clinical judgement. (3) Results: Ethical approval for this study was obtained from the Drug Research Ethics Committee of the Valladolid East Health Area (CASVE-NM-21-516). The results obtained from this study will form part of the thesis of two PhD students and will be disseminated through publication in a peer-reviewed journal. (4) Conclusions: The implementation of this telemonitoring system can be extrapolated to patients with other similar diseases, such as chronic diseases, with a high prevalence and need for close monitoring.Junta de Castilla y León e Instituto de Salud Carlos III - (grant COV20/00539

Public healthcare costs associated with long-term exposure to mixtures of persistent organic pollutants in two areas of Southern Spain: A longitudinal analysis

Background: Polychlorinated biphenyls and organochlorine pesticides are persistent organic pollutants (POPs) that had been banned or restricted in many countries, including Spain. However, their ubiquity still poses environmental and human health threats. Objective: To longitudinally explore public healthcare costs associated with long-term exposure to a mixture of 8 POPs in a cohort of residents of two areas of Granada Province, Southern Spain. Methods: Longitudinal study in a subsample (n = 385) of GraMo adult cohort. Exposure assessment was performed by analyzing adipose tissue POP concentrations at recruitment. Average primary care (APC) and average hospital care (AHC) expenditures of each participant over 14 years were estimated using the data from their medical records. Data analyses were performed by robust MM regression, weighted quantile sum regression (WQS) and G-computation analysis. Results: In the adjusted robust MM models for APC, most POPs showed positive beta coefficients, being Hexachlorobenzene (HCB) significantly associated (beta 1.87; 95% Confidence interval (95%CI): 0.17, 3.57). The magnitude of this association increased (beta: 3.72; 95%CI: 0.80, 6.64) when the analyses were restricted to semirural residents, where p-HCH was also marginally-significantly associated to APC (beta: 3.40; 95%CI: -0.10, 6.90). WQS revealed a positive but non-significant mixture association with APC (beta: 0.14; 95%CI: -0.06, 0.34), mainly accounted for by p-HCH (54%) and HCB (43%), that was borderline-significant in the semi-rural residents (beta: 0.23; 95%CI: -0.01, 0.48). No significant results were observed in G-Computation analyses. Conclusion: Long-term exposure to POP mixtures might represent a modifiable factor increasing healthcare costs, thus affecting the efficiency of the healthcare systems. However, and owing the complexity of the potential causal pathways and the limitations of the present study, further research is warranted to fully elucidate ascertain whether interventions to reduce human exposure should be considered in healthcare policies.CIBER de Epidemiologia y Salud Publica (CIBERESP), Instituto de Salud Carlos III, Spain PI16/01858 PI18/01573 PI20/01568European CommissionRamon y Cajal Program (Ministerio de Economia, Industria y Competitividad, Spain) RYC-2016-20,155PFIS (Instituto de Salud Carlos III, Spain) FI17/00310Universidad de Granada/CBU

Las conferencias sectoriales (2001-2012): Dinámica de funcionamiento y valores y percepciones de los agentes políticos y técnicos

The territorial organization established in Spain since 1978 is located at an intermediate point between unitary and federal models. In this institutional framework, coordination of sectoral policies has been channeled through intergovernmental organizations such as the Sectorial Conferences, which aim to integrate the Autonomous Regions in the decision making processes of the State. Similarly, these conferences are channels to establish a horizontal coordination between Autonomous Regions in a context such as Spanish, where they have just had enough other development tools designed specifically for this purpose. In this article are presented the main findings of a research project funded by the National Institute of Public Administration (INAP) in 2013. This project aims to analyze the functioning, dynamics and the results of work of the Sectorial Conferences, as well as their role as instruments of shared governance. To do this, there has been an empirical analysis that besides the formal study of these organisms, pay attention to elements such as the human factor, leadership, ideology or the nature of the issues.La organización territorial establecida en España desde 1978 se ubica en un punto intermedio entre los modelos unitarios y federales. En este marco institucional, la coordinación de las políticas sectoriales se ha canalizado a través de organismos intergubernamentales como las Conferencias Sectoriales, que pretenden integrar a las Comunidades Autónomas en los procesos de toma de decisión del Estado. De la misma manera, estas Conferencias son canales para establecer una coordinación horizontal entre las Comunidades Autónomas en un contexto como el español, donde apenas han tenido desarrollo suficiente otras herramientas diseñadas específicamente a este fin. En este artículo se presentan las principales conclusiones de un proyecto de investigación financiado por el Instituto Nacional de Administración Pública (INAP) en 2013 Este proyecto se orienta al análisis del funcionamiento, la dinámica y los resultados del trabajo de las Conferencias Sectoriales, así como a su papel como instrumentos de gobierno compartido. Para ello, se ha realizado un análisis empírico que, además del estudio formal de estos organismos, presta atención a elementos como el factor humano, el liderazgo, la ideología o la propia naturaleza de los temas tratados

Plurilingüismo y aprendizaje cooperativo en el diseño de prácticas de Lingüística

Este artículo presenta el trabajo realizado desde el área de Lingüística General de la Universidad de Alicante para ofertar sus prácticas de la asignatura “Lingüística General II”, común a todas las especialidades de lenguas modernas de la Facultad de Filosofía y Letras, en los tres idiomas en que tiene lugar la docencia de dichas clases: castellano, valenciano e inglés. A fin de armonizar los contenidos prácticos de una enseñanza trilingüe, por un lado, y de fomentar la implicación del alumnado en las actividades prácticas y contribuir al desarrollo del aprendizaje colaborativo en el aula, por otro, los profesores de este área de conocimiento, junto con la participación de dos estudiantes, han diseñado veinte prácticas que van desde el análisis del signo lingüístico hasta la Pragmática, pasando por la Fonética, la Morfología, la Sintaxis y el Análisis del Discurso

Novel non-resorbable polymeric-nanostructured scaffolds for guided bone regeneration

Objective The aim of this study was to evaluate the bone-regeneration efficiency of novel polymeric nanostructured membranes and the effect of zinc, calcium, titanium and bone morpho-protein loading on membranes, through an in vivo rabbit model. Material and Methods Nanostructured membranes of methylmethacrylate were loaded with zinc, calcium, TiO2 nanoparticles and bone-morphogenetic protein (BMP). These membranes covered the bone defects prepared on the skulls of six rabbits. Animals were sacrificed six weeks after surgery. Micro computed tomography was used to evaluate bone architecture through BoneJ pluging and ImageJ script. Three histological processing of samples, including von Kossa silver nitrate, toluidine blue and fluorescence by the deposition of calcein were utilized. Results Zn-Membranes (Zn-Ms) promoted the highest amount of new bone and higher bone perimeter than both unloaded and Ti-Membranes (Ti-Ms). Ca-Membranes (Ca-Ms) attained higher osteoid perimeter and bone perimeter than Zn-Ms. The skeleton analysis showed that Zn-Ms produced more branches and junctions at the trabecular bone than BMP-loaded membranes (BMP-Ms). Samples treated with Ti-Ms showed less bone formation and bony bridging processes. Both Zn-Ms and Ca-Ms achieved higher number of osteoblasts than the control group. BMP-Ms and Ca-Ms originated higher number of blood vessels than Ti-Ms and control group. Conclusions Zn incorporation in novel nanostructured membranes provided the highest regenerative efficiency for bone healing at the rabbit calvarial defects. Clinical relevance Zn-Ms promoted osteogenesis and enhanced biological activity, as mineralized and osteoid new bone with multiple interconnected ossified trabeculae appeared in close contact with the membrane.Project MAT2017-85999-P MINECO/AEI/FEDER/UE supported by the Ministry of Economy and Competitiveness and European Regional Development Fund