Rancheros y sociedades rancheras

International audienc

Demographic and epidemiological characteristics of major regions, 1990-2001

In an era when most societies are coping with greater demand for health resources, choices will have to be made about the provision of health services. Strategic health planning must take into account the comparative burden of diseases and injuries, and the risk factors that cause them, and how this burden is likely to change under various policies and interventions. The Global Burden of Disease (GBD) framework is the principal, if not the only, framework for integrating and analyzing information on population health and making it more relevant for health policy and planning purposes. The comprehensive findings of the 2001 GBD study represent a major update of the effort launched with the 1990 GBD study. The 1990 GBD study was a major advance in the quantification of the impact of diseases, injuries, and risk factors on population health globally and by region. Government and nongovernmental agencies alike have used its results to argue for more strategic allocation of health resources to programs that are likely to yield the greatest gains in population health. Publication of the 1990 results led to improvements in analytical methods and mortality data in a number of countries. In addition, critiques of methodological approaches used in the 1990 study prompted a new framework for risk factor assessment along with systematic attempts to quantify some of the uncertainty in national and global assessments of disease burden. The 2001 GBD provides a new and improved baseline for measuring progress in global health

Terminus thinning drives recent acceleration of a Greenlandic lake-terminating outlet glacier

Ice-contact proglacial lakes affect ice dynamics and the transition of glacier termini from land- to lake-terminating has been shown to cause ice flow acceleration. In recent decades, the number and size of Greenlandic ice-marginal lakes has increased, highlighting the need to further understand these lake-terminating ice-margins as their influence on ice sheet mass balance increases. Here, time series of satellite-derived observations of ice velocity, surface elevation, and terminus position were generated at a lake-terminating outlet glacier, Isortuarsuup Sermia, and the nearby land-terminating Kangaasarsuup Sermia in south-west Greenland. At Isortuarsuup Sermia, annual surface velocity at the terminus increased by a factor of 2.5 to 214 ± 4 m yr ´1 (2013–2021), with the magnitude of this acceleration declining with distance up-glacier. Meanwhile, near-terminus surface elevation changed at a rate of -2.3 ± 1.1 m yr ´1 (2012–2021). Conversely, velocity change at Kangaasarsuup Sermia was minimal, while surface elevation change was approximately half at comparable elevations (-1.2 ± 0.3 m yr ´1). We attribute these dynamic differences to thinning at Isortuarsuup Sermia and subsequent retreat from a stabilising sublacustrine moraine, and emphasise the potential of proglacial lakes to enhance future rates of mass loss from the Greenland Ice Sheet.</p

Can we prevent drug related deaths by training opioid users to recognise and manage overdoses?

<p>Abstract</p> <p>Background</p> <p>Naloxone has been evidenced widely as a means of reducing mortality resulting from opiate overdose, yet its distribution to drug users remains limited. However, it is drug users who are most likely to be available to administer naloxone at the scene and who have been shown to be willing and motivated to deliver this intervention. The current study builds on a national training evaluation in England by assessing 6-month outcome data collected primarily in one of the participating centres.</p> <p>Methods</p> <p>Seventy patients with opioid dependence syndrome were trained in the recognition and management of overdoses in Birmingham (n = 66) and London (n = 4), and followed up six months after receiving naloxone. After successful completion of the training, participants received a supply of 400 micrograms of naloxone (in the form of a preloaded syringe) to take home. The study focused on whether participating users still had their naloxone, whether they retained the information, whether they had witnessed an overdose and whether they had naloxone available and were still willing to use it in the event of overdose.</p> <p>Results & Discussion</p> <p>The results were mixed - although the majority of drug users had retained the naloxone prescribed to them, and retention of knowledge was very strong in relation to overdose recognition and intervention, most participants did not carry the naloxone with them consistently and consequently it was generally not available if they witnessed an overdose. The paper discusses the reasons for the reluctance to carry naloxone and potential opportunities for how this might be overcome. Future issues around training and support around peer dissemination are also addressed.</p> <p>Conclusion</p> <p>Our findings confirm that training of drug users constitutes a valuable resource in the management of opiate overdoses and growth of peer interventions that may not otherwise be recognised or addressed. Obstacles have been identified at individual (transportability, stigma) and at a systems level (police involvement, prescription laws). Training individuals does not seem to be sufficient for these programmes to succeed and a coherent implementation model is necessary.</p

High-Luminosity Large Hadron Collider (HL-LHC): Technical Design Report

The Large Hadron Collider (LHC) is one of the largest scientific instruments ever built. Since opening up a new energy frontier for exploration in 2010, it has gathered a global user community of about 9000 scientists working in fundamental particle physics and the physics of hadronic matter at extreme temperature and density. To sustain and extend its discovery potential, the LHC will need a major upgrade in the 2020s. This will increase its instantaneous luminosity (rate of collisions) by a factor of five beyond the original design value and the integrated luminosity (total number of collisions) by a factor ten. The LHC is already a highly complex and exquisitely optimised machine so this upgrade must be carefully conceived and will require new infrastructures (underground and on surface) and over a decade to implement. The new configuration, known as High Luminosity LHC (HL-LHC), relies on a number of key innovations that push accelerator technology beyond its present limits. Among these are cutting-edge 11–12 Tesla superconducting magnets, compact superconducting cavities for beam rotation with ultra-precise phase control, new technology and physical processes for beam collimation and 100 metre-long high-power superconducting links with negligible energy dissipation, all of which required several years of dedicated R&D effort on a global international level. The present document describes the technologies and components that will be used to realise the project and is intended to serve as the basis for the detailed engineering design of the HL-LHC

International Wildlife Law : Understanding and Enhancing Its Role in Conservation

We gratefully acknowledge valuable input by Kees Bastmeijer, Sanja Bogojevic, Jennifer Dubrulle, and Han Somsen.Peer reviewedPublisher PD

.

Benign Prostatic Hyperplasia (BPH) is the result of excessive cellullar proliferation in the prostatic transition zone, that compresses the urethra, causing the symptoms of the disease. Evidence supports that atherogenic environment could contribute to the development and progression of BPH, increasing its incidence and aggressiveness. The BPH hyperproliferative state requires coordinated communication between the different components that maintain a permissive microenvironment. Thus, extracellular vesicles (EVs) have become relevant as intercellular communication regulators in multiple processes. It has been described that oxidized-LDL molecule (OxLDL) would be involved in numerous signaling pathways; including signaling by EVs promoting cellullar proliferation. EVs, may contain diverse biomolecules that confer them functions in cellular communication. In addition, it has been reported that EVs derived from different cell types are capable to mediate proliferative and inflammatory effects. In this context, we proposed as objectives: 1) to evaluate the effect of OxLDL, simulating an atherogenic state, on cell proliferation in primary cultures of human prostate stromal cells (HPSC) from patient samples (n=8) from the Sanatorio Allende of Córdoba; 2) to isolate EVs from primary cultures by differential ultracentrifugation and analyze their production and release into the medium in treatments with OxLDL vs. vehicle; 3) to morphologically characterize EVs by transmission electron microscopy (TEM) and confirm the identity and presence of exosomes, through CD63 immuno-staining using colloidal gold. It was observed that OxLDL (20μM) produced a significant increase in cell proliferation rate compared to vehicle. EVs were obtained by differential ultracentrifugations (2k, 10k, 150k pellets) and visualized by TEM using negative staining. HPSC from patients with BPH showed a very low frequency of EVs released, with OxLDL inducing a 10-fold increase, especially in the 15-20nm fraction (p&lt;0.001). Ultrastructurally, these EVs exhibited a spherical and concave appearance, compatible with exosomes. Therefore, they were positively verified by CD63 immunostaining. Finally, we conclude that OxLDL would favor cell proliferation, increase and release of EVs, which would participate in cell communication and maintenance of the permissive environment, propitious to progression and increased aggressiveness of BPH.La Hiperplasia Prostática Benigna (HPB) surge a consecuencia de la proliferación celular excesiva de la zona de transición prostática que comprime la uretra, provocando la sintomatología propia de la enfermedad. Evidencias sostienen que el entorno aterogénico podrían contribuir al desarrollo y progresión de la HPB, aumentando su incidencia y agresividad. El estado hiperproliferativo de la HPB requiere una coordinada comunicación entre los diferentes componentes que mantienen un microambiente permisivo. Así, las vesículas extracelulares (EVs) han tomado relevancia como reguladores de comunicación intercelular en múltiples procesos. Se ha descrito que la molécula de LDL-oxidada (OxLDL) estaría involucrada en diversas vías de señalización; incluida la señalización por EVs promoviendo la proliferación celular. Las EVs pueden contener diversas biomoléculas que les confieren funciones en comunicación intercelular y, además, se reportaron efectos proliferativos e inflamatorios mediados por EVs derivadas de distintos tipos celulares. Es este contexto, propusimos como objetivos: 1) evaluar el efecto de OxLDL, simulando un estado aterogénico, sobre la proliferación celular en cultivos primarios de células estromales prostáticas humanas (HPSC) de muestras de pacientes (n=8) del Sanatorio Allende de Córdoba; 2) aislar EVs de cultivos primarios mediante ultracentrifugaciones diferenciales y analizar su producción y liberación al medio en tratamientos con OxLDL vs. vehículo; 3) caracterizar morfológicamente EVs mediante microscopía electrónica de transmisión (TEM) y confirmar la identidad y presencia de exosomas, a través de inmuno-marcación de CD63 utilizando oro coloidal. Se observó que OxLDL (20μM) produjo un aumento significativo en la tasa de proliferación celular respecto al vehículo. EVs fueron obtenidas mediante utracentrifugaciones diferenciales (pellets 2k, 10k, 150k) y visualizadas por TEM utilizando tinción negativa. Las HPSC de pacientes con HPB mostraron una frecuencia muy baja de EVs liberadas, con OxLDL induciendo un aumento de 10 veces, especialmente en la fracción 15-20nm (p&lt;0,001). Ultraestructuralmente, estas EVs exhibieron una apariencia esférica y cóncava, compatible con exosomas; luego fueron verificados positivamente por inmuno-marcación de CD63. Finalmente, podemos concluir que OxLDL favorecería la proliferación celular, incremento y liberación de EVs, las cuales participarían en comunicación celular y mantención del ambiente permisivo propicio para la progresión y aumento de agresividad de la HPB.

How inclusive, user-centered design research can improve psychological therapies for psychosis: Development of SlowMo

Real-world implementation of psychological interventions for psychosis is poor. Barriers include therapy being insufficiently usable and useful for a diverse range of people. User-centered, inclusive design approaches could improve the usability of therapy, which may increase uptake, adherence, and effectiveness. This study aimed to optimize the usability of an existing psychological intervention, Thinking Well, which targets reasoning processes in paranoia using a basic digital interface. We conducted inclusive, user-centered design research characterized by purposive sampling of extreme users from the margins of groups, ethnographic investigation of the problem context, and iterative prototyping of solutions. The UK Design Council's double diamond method was used. This consisted of 4 phases: discover, including a case series of Thinking Well, stakeholder interviews, desk research, user profiling, system mapping, and a mood board; define, consisting of workshops to synthesize findings and generate the design brief; develop, involving concept workshops and prototype testing; and deliver, in which the final minimal viable product was storyboarded and iteratively coded. Consistent with our previous work, the Thinking Well case series showed medium to large effects on paranoia and well-being and small effects on reasoning. These were maintained at follow-up despite some participants reporting difficulties with the therapy interface. Insights from the discover phase confirmed that usability was challenged by information complexity and poor accessibility. Participants were generally positive about the potential of technology to be enjoyable, help manage paranoia, and provide tailored interpersonal support from therapists and peers, although they reported privacy and security concerns. The define phase highlighted that the therapy redesign should support monitoring, simplify information processing, enhance enjoyment and trust, promote personalization and normalization, and offer flexible interpersonal support. During the develop phase over 60 concepts were created, with 2 key concepts of thoughts visualized as bubbles and therapy as a journey selected for storyboarding. The output of the deliver phase was a minimal viable product of an innovative digital therapy, SlowMo. SlowMo works by helping people to notice their worries and fast thinking habits, and encourages them to slow down for a moment to find ways of feeling safer. A Web app supports the delivery of 8 face-to-face sessions, which are synchronized to a native mobile app. SlowMo makes use of personalization, ambient information, and visual metaphors to tailor the appeal, engagement, and memorability of therapy to a diversity of needs. Feasibility testing has been promising, and the efficacy of SlowMo therapy is now being tested in a multicentered randomized controlled trial. The study demonstrates that developments in psychological theory and techniques can be enhanced by improving the usability of the therapy interface to optimize its impact in daily life. [Abstract copyright: ©Amy Hardy, Anna Wojdecka, Jonathan West, Ed Matthews, Christopher Golby, Thomas Ward, Natalie D Lopez, Daniel Freeman, Helen Waller, Elizabeth Kuipers, Paul Bebbington, David Fowler, Richard Emsley, Graham Dunn, Philippa Garety. Originally published in JMIR Mental Health (http://mental.jmir.org), 05.12.2018.

Nanoinformatics: developing new computing applications for nanomedicine

Nanoinformatics has recently emerged to address the need of computing applications at the nano level. In this regard, the authors have participated in various initiatives to identify its concepts, foundations and challenges. While nanomaterials open up the possibility for developing new devices in many industrial and scientific areas, they also offer breakthrough perspectives for the prevention, diagnosis and treatment of diseases. In this paper, we analyze the different aspects of nanoinformatics and suggest five research topics to help catalyze new research and development in the area, particularly focused on nanomedicine. We also encompass the use of informatics to further the biological and clinical applications of basic research in nanoscience and nanotechnology, and the related concept of an extended ?nanotype? to coalesce information related to nanoparticles. We suggest how nanoinformatics could accelerate developments in nanomedicine, similarly to what happened with the Human Genome and other -omics projects, on issues like exchanging modeling and simulation methods and tools, linking toxicity information to clinical and personal databases or developing new approaches for scientific ontologies, among many others