Understanding the effect of economic recession on healthcare services: a systematic review

Background: We aimed to examine the available evidence about the impact of the crisis on the use of healthcare services in Europe. Methods: We developed a systematic review of scientific literature for the period 2008-2017. The researchers searched three databases Medline/PubMed, Scopus and Web of Knowledge. For manual searching, several spe-cialized journals of related scope as well as the finalized articles'' reference list were searched. Descriptive and thematic analyses were carried out. PRISMA quality criteria and the recommendations of the Centre for Reviews and Dissemination were followed. Results: Of 3, 685 studies, 35 met inclusion criteria. Regarding “Effects of the social structure” healthcare accessibility inequalities increased by socioeconomic levels, especially in unemployed, people with low educational levels and migrants. Regarding “Healthcare effect”, the impact of the recession was observed in unmet needs, pharmaceutical spending containment, reduction of hospital beds, and privatization of services. Conclusion: Austerity policies have contributed to increasing inequalities in the use of health services during the economic downturn. In the current economic climate, new management and health planning strategies such as hospitalisation at home, new models of integrated care and pharmaceutical management are needed to help achieve greater equity and equality in health

Un modelo de potencialidad climática para la trufa negra (Tuber melanosporum) en Teruel (España)

Black truffle (Tuber melanosporum) is an edible ectomycorrhizal mushroom whose cultivation is an economically-viable alternative in rural areas affected by depopulation. In the province of Teruel (Spain), truffle plantations occupy nowadays more than 4,500 ha, but no land use planning guidelines have been available. Species distribution models are tools that allow managers, farmers and foresters to plan ahead and make decisions with a scientific basis. The territory climatically suitable for T. melanosporum in Teruel has been predicted using a method based on the ecology field theory, previously tested in the development of distribution models for forest species. A dataset of 924 locations where black truffle has been collected in the Catalano-Aragonesa ecoregion and eight climatic parameters deeply influencing the presence and fructification of the black truffle have been considered and their corresponding habitats have been built. The distribution model, corrected under lithological criteria, has identified more than 8,000 km² as suitable for black truffle fructification in Teruel, almost 55% of the province, belonging 3,000 of them to the optimal class. This land is mainly distributed over the regions of Gúdar-Javalambre, Comunidad de Teruel and Maestrazgo. A further correction based on land-use criteria has identified more than 4,000 km² as suitable for truffle plantations, being 1,150 of them optimal. The model here presented will help to a proper planning for truffle cultivation in the province of Teruel.La trufa negra (Tuber melanosporum) es un hongo ectomicorrícico comestible cuyo cultivo supone en la actualidad una alternativa económica viable para zonas rurales afectadas gravemente por la despoblación. En la provincia de Teruel (España) hay más de 4.500 ha de plantaciones truferas, instaladas sin ningún proceso de planificación orientado a alcanzar un territorio rural ordenado. Los modelos territoriales de potencialidad o aptitud para las especies son herramientas que permiten a los gestores, agricultores y selvicultores desarrollar dicha planificación y tomar decisiones fundamentadas en un conocimiento científico lo más riguroso posible. Utilizando un método basado en la teoría de campos aplicada a la ecología, habitual para elaborar las áreas potenciales de especies forestales vegetales, se ha determinado el territorio climáticamente apto para T. melanosporum en la provincia Teruel. Para construir este modelo se han utilizado 924 localizaciones de la ecorregión Catalano-Aragonesa. Elaborando ocho parámetros climáticos trascendentes para la fructificación de la trufa negra, se han construido sus correspondientes hábitats. El modelo de potencialidad climática elaborado, completado con una corrección litológica, ha permitido identificar algo más de 8.000 km2 como aptos para la recolección de la trufa negra en Teruel, casi el 55% de la provincia, de los cuales 3.000 corresponden a la clase óptima y están distribuidos por las comarcas de Gúdar-Javalambre, Comunidad de Teruel y Maestrazgo. La adaptación del modelo ha permitido identificar más de 4.000 km2 como aptos para la instalación de plantaciones truferas, 1.150 de los cuales tienen potencialidad óptima. El modelo generado en el presente trabajo permitirá la adecuada planificación territorial de la truficultura en la provincia de Teruel

Integrating state-of-the-art CNNs for multi-sensor 3D vehicle detection in real autonomous driving environments

2019 IEEE Intelligent Transportation Systems Conference (ITSC), Auckland, New Zealand, 27-30 Oct. 2019This paper presents two new approaches to detect surrounding vehicles in 3D urban driving scenes and their corresponding Bird’s Eye View (BEV). The proposals integrate two state-of-the-art Convolutional Neural Networks (CNNs), such as YOLOv3 and Mask-RCNN, in a framework presented by the authors in [1] for 3D vehicles detection fusing semantic image segmentation and LIDAR point cloud. Our proposals take advantage of multimodal fusion, geometrical constrains, and pre-trained modules inside our framework. The methods have been tested using the KITTI object detection benchmark and comparison is presented. Experiments show new approaches improve results with respect to the baseline and are on par with other competitive state-of-the-art proposals, being the only ones that do not apply an end-to-end learning process. In this way, they remove the need to train on a specific dataset and show a good capability of generalization to any domain, a key point for self-driving systems. Finally, we have tested our best proposal in KITTI in our driving environment, without any adaptation, obtaining results suitable for our autonomous driving application.Ministerio de Economía y CompetitividadComunidad de Madri

Real-time semantic segmentation for fisheye urban driving images based on ERFNet

The interest in fisheye cameras has recently risen in the autonomous vehicles field, as they are able to reduce the complexity of perception systems while improving the management of dangerous driving situations. However, the strong distortion inherent to these cameras makes the usage of conventional computer vision algorithms difficult and has prevented the development of these devices. This paper presents a methodology that provides real-time semantic segmentation on fisheye cameras leveraging only synthetic images. Furthermore, we propose some Convolutional Neural Networks (CNN) architectures based on Efficient Residual Factorized Network (ERFNet) that demonstrate notable skills handling distortion and a new training strategy that improves the segmentation on the image borders. Our proposals are compared to similar state-of-the-art works showing an outstanding performance and tested in an unknown real world scenario using a fisheye camera integrated in an open-source autonomous electric car, showing a high domain adaptation capability.Ministerio de Economía y CompetitividadComunidad de MadridDirección General de Tráfic

Resultados del tratamiento de la hepatitis crónica por VHC genotipo 4: Un análisis comparativo con el genotipo 1 Results of the treatment of chronic hepatitis C genotype 4: A comparative analysis with genotype 1

Antecedentes y objetivos: casi todos los datos sobre la eficacia del tratamiento antiviral combinado en la infección por el virus de la hepatitis C (VHC) genotipo 4, que es poco frecuente en España, se han obtenido en países del Oriente Próximo. Aportamos nuestra experiencia en pacientes tratados en España con criterios homogéneos. Pacientes y métodos: en el periodo 2001-2007 hemos tratado a 30 enfermos con hepatitis crónica por VHC genotipo 4 (20 varones) con interferón pegilado α-2b (26 casos) o α-2a (4 casos) y ribavirina en dosis ajustada al peso. En todos los casos se conoce el resultado del tratamiento y se dispone de bioquímica y datos virológicos basales, y en 24 de biopsia hepática. Hemos comparado estos resultados con los obtenidos en 355 pacientes infectados por VHC genotipo 1. Resultados: diez pacientes (33,3%) obtuvieron respuesta viral sostenida (RVS: ARN del VHC negativo en sangre a los 6 meses de finalizado el tratamiento), 12 no respondieron (fracaso viral primario), 4 recidivaron y 4 abandonaron por intolerancia. Estos resultados son muy similares a los obtenidos en el grupo de genotipo 1 (RVS: 35,1%). Conclusión: el genotipo 4 del VHC debe considerarse como tan "difícil de tratar" como el genotipo 1. La mayor eficacia del tratamiento en otras zonas geográficas (Oriente Próximo) pueden deberse a la diferente distribución de los subtipos virales existentes.Introduction: nearly all the data on the efficacy of combined antiviral therapy on chronic hepatitis C genotype 4 have been obtained in countries of Middle East. Genotype 4 is quite unusual in Spain. We report our experience in a group of Spanish patients treated with homogeneous criteria. Patients and methods: between 2001 and 2007 we have treated 30 patients with chronic hepatitis C genotype 4 (20 males) with pegylated Interferon a-2b (26 cases) or a-2a (4 cases) combined with ribavirin at a weight-adjusted dose. Results of therapy are known in all patients and liver biopsy is available in 24 cases. Results: ten patients (33.3%) obtained sustained viral response (SVR: HCV-RNA undetectable in blood 6 months after the end of therapy), 12 were primary non-responders, 4 relapsed after reaching undetectable HCV-RNA at the end of therapy and 4 interrupted the treatment due to severe adverse events. These results are very close to those obtained in 355 patients infected with HCV genotype 1. Conclusion: HCV genotype 4 should be considered as "difficult to treat". The better results of therapy in other geographical areas (Middle East) may be due to a different distribution of the subtypes of HCV genotype 4

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Stoichiometric network analysis in reaction networks yielding spontaneous mirror symmetry breaking in a prebiotic atmosphere

The generation of amino acid homochirality in prebiotic atmosphere conditions, is a relevant issue in the study of the origin of life. This research is based on the production of amino acids via Strecker synthesis and how it is adjusted to the Kondepudi - Nelson autocatalytic model. The spontaneous mirror symmetry breaking (SMSB) of the new Kondepudi-Nelson-Strecker model, subject to two modifications of (with Limited Enantioselective and Cross Inhibition) and also their combination were studied using stoichiometric network analysis (SNA). In the calculations, the values obtained from the literature for Alanine were considered. A total production of Alanine of 7.56 × 109 mol y-1 was determined under prebiotic atmosphere conditions and starting from that value, the reaction rates for the models studied were estimated. Only the Model with cross inhibition or achiral dimer formation is driven by stochastic fluctuations during SMSB. The stochastic fluctuation was estimated for a value of 2.619 × 10-15 mol L-1. This perturbation was sufficient to trigger SMSB. Finally, the results of SMSB were used to calculate the entropy production for the cross inhibition model.R. B. acknowledges Minciencias - Universidad Nacional de Colombia for financial support through the 617 fellowship: Formación de alto nivel para la Ciencia, la Tecnología y la Innovación - Doctorados Nacionales (Colombia). P. B. is funded by the Beatriz Galindo contract BEAGAL 18/00207 (Spain). J.A. thanks the financial support provided by Minciencias under the project 110171250639, contract 463 - 2016, and the Universidad Nacional de Colombia HERMES 35497. D.H. and J.M.R. acknowledge the coordinated research grants CTQ2017-87864-C2-1(2)-P and PID2020-116846GB-C21/C22 (MINECO), Spain

Mystica ciudad de Dios : milagro de su omnipotencia, y abismo de la gracia : historia divina y vida de la Virgen, Madre de Dios...

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