Antithrombotic Medication for Cardioembolic Stroke Prevention

Embolism of cardiac origin accounts for about 20% of ischemic strokes. Nonvalvular atrial fibrillation is the most frequent cause of cardioembolic stroke. Approximately 1% of population is affected by atrial fibrillation, and its prevalence is growing with ageing in the modern world. Strokes due to cardioembolism are in general severe and prone to early recurrence and have a higher long-term risk of recurrence and mortality. Despite its enormous preventive potential, continuous oral anticoagulation is prescribed for less than half of patients with atrial fibrillation who have risk factors for cardioembolism and no contraindications for anticoagulation. Available evidence does not support routine immediate anticoagulation of acute cardioembolic stroke. Anticoagulation therapy's associated risk of hemorrhage and monitoring requirements have encouraged the investigation of alternative therapies for individuals with atrial fibrillation. New anticoagulants being tested for prevention of stroke are low-molecular-weight heparins (LMWH), unfractionated heparin, factor Xa inhibitors, or direct thrombin inhibitors like dabigatran etexilate and rivaroxaban. The later exhibit stable pharmacokinetics obviating the need for coagulation monitoring or dose titration, and they lack clinically significant food or drug interaction. Moreover, they offer another potential that includes fixed dosing, oral administration, and rapid onset of action. There are several concerns regarding potential harm, including an increased risk for hepatotoxicity, clinically significant bleeding, and acute coronary events. Therefore, additional trials and postmarketing surveillance will be needed

Strategies to reengage patients lost to follow up in HIV care in high income countries, a scoping review

Background: Despite remarkable achievements in antiretroviral therapy (ART), losses to follow-up (LTFU) might prevent the long-term success of HIV treatment and might delay the achievement of the 90-90-90 objectives. This scoping review is aimed at the description and analysis of the strategies used in high-income countries to reengage LTFU in HIV care, their implementation and impact. Methods: A scoping review was done following Arksey & O'Malley's methodological framework and recommendations from Joanna Briggs Institute. Peer reviewed articles were searched for in Pubmed, Scopus and Web of Science; and grey literature was searched for in Google and other sources of information. Documents were charted according to the information presented on LTFU, the reengagement procedures used in HIV units in high-income countries, published during the last 15 years. In addition, bibliographies of chosen articles were reviewed for additional articles. Results: Twenty-eight documents were finally included, over 80% of them published in the United States later than 2015. Database searches, phone calls and/or mail contacts were the most common strategies used to locate and track LTFU, while motivational interviews and strengths-based techniques were used most often during reengagement visits. Outcomes like tracing activities efficacy, rates of reengagement and viral load reduction were reported as outcome measures. Conclusions: This review shows a recent and growing trend in developing and implementing patient reengagement strategies in HIV care. However, most of these strategies have been implemented in the United States and little information is available for other high-income countries. The procedures used to trace and contact LTFU are similar across reviewed studies, but their impact and sustainability are widely different depending on the country studied

Anisotropic low-temperature magnetoresistivity in the normal state of L2−xCexCuO4 single crystals

We report in-plane ρab(T, H) and c-axis ρc(T, H) electrical magnetoresistivity measurements on several L2−x CexCuO4 (L=Pr, Sm, Nd) superconducting single crystals. It is found that in the normal state both resistivities ρab(T) and ρc(T) display a minimum at certain temperatures Tminab and Tminc which separates regions of metallic behavior at T>Tmin from semiconducting-like behavior at T<Tmin. In the low-temperature region (T<Tmin), ρab(T) has a logarithmic temperature dependence ρab≈-ln T and negative magnetoresistivity which are argued to be due to 2D localization effects. In contrast, at low temperatures, ρc(T) can be described in terms of a hopping conductivity

Proposta d'integració de les competències informàtiques i informacionals (CI2) als estudis de grau i postgrau de la UB

Document elaborat per el grup de treball de Formació d'usuaris del CRAI amb la col·laboració del departament de Biblioteconomia i Documentació, el Servei d'Atenció a l'Estudiant de la UB i la Unitat de Serveis als Usuaris de l'Àrea de Tecnologies.El canvi de paradigma en la docència universitària impulsat per els Acords de Bolonya porta implícita, entre d'altres, la formació en competències informàtiques i informacionals als alumnes de Grau, Postgrau i Doctorat de les universitats. El personal bibliotecari del CRAI de la UB és expert en aquest tipus de formació ja que per una banda es tracta d'habilitats bàsiques en el desenvolupament de la seva professió i per l'altra compta amb molts anys d'experiència acumulada oferint i realitzant sessions de formació per als usuaris de la UB. És a partir del reconeixement d'aquestes condicions del personal de les biblioteques del CRAI que, d'acord amb el vicerectorat de Docència i Convergència Europea de la UB, es va crear un grup de treball, en el qual hi ha participat també el departament de Biblioteconomia i Documentació, el Servei d'Atenció a l'Estudiant (SAE) i la Unitat de Serveis als Usuaris de l'Àrea de Tecnologies, amb l'encàrrec d'elaborar una proposta per implementar la formació en competències informàtiques i informacionals als graus, postgraus i doctorats de la UB. La finalitat: dotar als usuaris de les habilitats necessàries per a la cerca, obtenció, avaluació, processament i comunicació de la informació en qualsevol suport i aconseguir un millor coneixement i per tant una millor utilització dels recursos d¿informació que s'ofereixen des de les biblioteques del CRAI de la UB

Effect of magnesium sulphate and L-tryptophan and genotype on the feed intake, behaviour and meat quality of pigs

Sixty-nine entire male pigs with different halothane genotype (homozygous halothanepositive – nn-, n=36; and homozygous halothane negative – NN-, n=33) were fed with a supplementation of magnesium sulphate (Mg) and/or L-tryptophan (Trp) in the diet for 5days before slaughter. Animals were housed individually and were submitted to stressful ante mortem conditions (mixed in the lorry according to treatments and transported 1h on rough roads). Individual feed intake was recorded during the 5-day treatment. At the abattoir, pig behaviour was assessed in the raceway to the stunning system and during the stunning period by exposure to CO2. Muscle pH, colour, water holding capacity, texture and cathepsin activities were determined to assess meat quality. The number of pigs with an individual feed intake lower than 2kg/day was significantly different among diets (P 2kg/day, all of them from thestress-sensitive pigs (nn). In general, no differences were observed in the behaviour ofpigs along the corridor leading to the stunning system and inside the CO2 stunningsystem. During the stunning procedure, Trp diet showed shorter periods of muscularexcitation than control and Mg&Trp diets. The combination of a stressful ante mortemtreatment and Mg&Trp supplementation led to carcasses with high incidence of severeskin lesions. Different meat quality results were found when considering all pigs orconsidering only those with adequate supplement intake. In this later case, Trp increased pH45 (6.15) vs Control diet (5.96) in the Longissimus thoracis (LT) muscle (P<0.05) and pH at 24h (Trp: 5.59 vs C: 5.47) led to a higher incidence of dark, firm and dry (DFD) traits in SM muscle (P<0.05). Genotype affected negatively all the meat quality traits. Seventy-five percent of LT and 60.0% of the SM muscles from nn pigs wereclassified as pale, soft and exudative (PSE), while none of the NN pigs showed these traits (P<0.0001). No significant differences were found between genotypes on the incidence of DFD meat. Due to the negative effects observed in the Mg&Trp group in feed intake and carcass quality, the utilization of a mixture of magnesium sulphate and tryptophan is not recommende

Proposta d'integració de les competències informàtiques i informacionals (CI2) als estudis de grau i postgrau de la UB

Document elaborat per el grup de treball de Formació d'usuaris del CRAI amb la col·laboració del departament de Biblioteconomia i Documentació, el Servei d'Atenció a l'Estudiant de la UB i la Unitat de Serveis als Usuaris de l'Àrea de Tecnologies.El canvi de paradigma en la docència universitària impulsat per els Acords de Bolonya porta implícita, entre d'altres, la formació en competències informàtiques i informacionals als alumnes de Grau, Postgrau i Doctorat de les universitats. El personal bibliotecari del CRAI de la UB és expert en aquest tipus de formació ja que per una banda es tracta d'habilitats bàsiques en el desenvolupament de la seva professió i per l'altra compta amb molts anys d'experiència acumulada oferint i realitzant sessions de formació per als usuaris de la UB. És a partir del reconeixement d'aquestes condicions del personal de les biblioteques del CRAI que, d'acord amb el vicerectorat de Docència i Convergència Europea de la UB, es va crear un grup de treball, en el qual hi ha participat també el departament de Biblioteconomia i Documentació, el Servei d'Atenció a l'Estudiant (SAE) i la Unitat de Serveis als Usuaris de l'Àrea de Tecnologies, amb l'encàrrec d'elaborar una proposta per implementar la formació en competències informàtiques i informacionals als graus, postgraus i doctorats de la UB. La finalitat: dotar als usuaris de les habilitats necessàries per a la cerca, obtenció, avaluació, processament i comunicació de la informació en qualsevol suport i aconseguir un millor coneixement i per tant una millor utilització dels recursos d¿informació que s'ofereixen des de les biblioteques del CRAI de la UB

Guia per a l’abordatge de la patologia infecciosa del tracte respiratori baix a l’atenció primària

Patologia infecciosa; Tracte respiratori baix; Bronquitis; Penumònia; BronquiolitisPatología infecciosa; Tracto respiratorio inferior; Bronquitis; Neumonía; BronquiolitisInfectious pathology; Lower respiratory tract; Bronchitis; Penumonia; BronchiolitisAquest document aporta una revisió acurada del coneixement científic actualment disponible sobre la patologia infecciosa del tracte respiratori baix, i el tradueix en recomanacions per a la pràctica diària. Pel seu contingut docent, la Guia constitueix també un valuós document per facilitar l’adquisició de competències clíniques que ha de caracteritzar el desenvolupament dels professionals de l’Institut Català de la Salut

Carns vermelles i salut

The purpose of this paper is to present a scientific consideration of the consumption of red meats as it relates to health and to the sustainability of our planet, and to help professionals and consumers to reflect on this matter and make suitable decisions in this respect. An interdependence clearly exists between climate change, our dietary models and our health, and all of this involves various factors. It should be kept in mind that not all types of foods, diets or alimentary patterns have the same environmental impact. The most highly &ldquo;questioned&rdquo; foods include intensively produced red meats and processed foods. These types of foods are consumed in larger quantities and with greater frequency in the developed societies, and above all in the most highly urbanised areas. It is known that 22% of the deaths in our world may be attributed to diet (overeating, poor diets or malnutrition) and this obliges us to consider the importance of carefully choosing the foods that we eat, together with the quantities of these foods and the frequency with which we eat them. It should also be recalled that 14% of the greenhouse gases (GHGs) come from livestock and 30% are related to the food system, which explains the great influence of livestock on food sustainability. A balanced diet based on varied foods, above all including those of vegetable origin, is a possible solution for reducing greenhouse gas emissions (per gramme of protein and per calorie ingested). Such a diet is also healthier, helping to reduce the risk of non-communicable chronic illnesses. Progress should be made towards the achievement of environmentally more sustainable livestock management and a careful monitoring of impacts should be carried out, while increasing the production of vegetable foods and their consumption in different fields.L&rsquo;objectiu d&rsquo;aquest article &eacute;s presentar una visi&oacute; cient&iacute;fica sobre el consum de les carns vermelles en relaci&oacute; amb la salut i la sostenibilitat del planeta, i ajudar els professionals i els consumidors a reflexionar-hi i prendre les seves decisions. Hi ha una clara interdepend&egrave;ncia del canvi clim&agrave;tic amb els models alimentaris i la nostra salut, tot relacionat amb diferents factors. Cal tenir present que no totes les formes d&rsquo;alimentaci&oacute;, dietes o patrons alimentaris generen els mateixos impactes ambientals. Entre els aliments m&eacute;s &laquo;q&uuml;estionats&raquo; hi ha les carns vermelles de producci&oacute; intensiva i els aliments processats. Aquest tipus d&rsquo;aliments s&oacute;n consumits en majors quantitats i freq&uuml;&egrave;ncia en les societats desenvolupades i sobretot en les zones m&eacute;s urbanitzades. Sabem que el 22 % de les morts que es produeixen al m&oacute;n es poden atribuir a l&rsquo;alimentaci&oacute; (sobrealimentaci&oacute;, mala alimentaci&oacute; o desnutrici&oacute;) i aquesta dada ens fa reflexionar sobre la import&agrave;ncia d&rsquo;escollir b&eacute; els aliments que prenem, les quantitats i la freq&uuml;&egrave;ncia. Tamb&eacute;, cal ser conscients que el 14 % dels gasos amb efecte d&rsquo;hivernacle (GEH) provenen del bestiar, i un 30 % t&eacute; a veure amb el sistema alimentari, la qual cosa aclareix la dimensi&oacute; important de la influ&egrave;ncia del bestiar en la sostenibilitat aliment&agrave;ria. Una dieta equilibrada, basada en aliments variats, sobretot d&rsquo;origen vegetal, &eacute;s una alternativa possible per a la disminuci&oacute; de l&rsquo;emissi&oacute; de gasos (per gram de prote&iuml;na i caloria ingerida), i tamb&eacute; &eacute;s m&eacute;s saludable per reduir el risc de l&rsquo;aparici&oacute; de malalties cr&ograve;niques no transmissibles. Caldr&agrave; avan&ccedil;ar en una gesti&oacute; ramadera ambiental m&eacute;s sostenible, fer un seguiment acurat d&rsquo;impactes i eixamplar la producci&oacute; vegetal (i el seu consum) en diversos sentits

Història gràfica de Cervera

Direcció de l'obra: Max Turull RubinatLa Història gràfica de Cervera és un volum excepcional, per mirar i per llegir; una obra coral on són presents des de la vida privada de les persones i les famílies fins als grans actes públics multitudinaris, des del naixement fins a la mort, des del rerefons paisatgístic i monumental fins als esclats de vida més quotidians, des del petit gest fins a la grandiloqüència, de la guerra a la pau, del progrés al conservadorisme, dels empresaris als empleats, de la pagesia secular a la indústria, dels grans homes a les persones anònimes; totes les edats de l’individu hi són presents: nadons, infants, joves, adults i gent gran; homes i dones... Hi trobareu imatges i textos sobre paisatges i vistes generals, patrimoni, el món del treball, la vida privada, la vida social, política i religiosa, el lleure i la cultura, i les festes i celebracions

Discovering HIV related information by means of association rules and machine learning

Acquired immunodeficiency syndrome (AIDS) is still one of the main health problems worldwide. It is therefore essential to keep making progress in improving the prognosis and quality of life of affected patients. One way to advance along this pathway is to uncover connections between other disorders associated with HIV/AIDS-so that they can be anticipated and possibly mitigated. We propose to achieve this by using Association Rules (ARs). They allow us to represent the dependencies between a number of diseases and other specific diseases. However, classical techniques systematically generate every AR meeting some minimal conditions on data frequency, hence generating a vast amount of uninteresting ARs, which need to be filtered out. The lack of manually annotated ARs has favored unsupervised filtering, even though they produce limited results. In this paper, we propose a semi-supervised system, able to identify relevant ARs among HIV-related diseases with a minimal amount of annotated training data. Our system has been able to extract a good number of relationships between HIV-related diseases that have been previously detected in the literature but are scattered and are often little known. Furthermore, a number of plausible new relationships have shown up which deserve further investigation by qualified medical experts