708 research outputs found
Liver safety of two nucleoside analogs plus efavirenz, nevirapine or a ritonavir-boosted protease inhibitor in HIV/HCV-coinfected drug-naĂŻve patients
Alpine bogs of southern Spain show human-induced environmental change superimposed on long-term natural variations
Recent studies have proved that high elevation environments, especially remote wetlands, are exceptional ecological sensors of global change. For example, European glaciers have retreated during the 20th century while the Sierra Nevada National Park in southern Spain witnessed the first complete disappearance of modern glaciers in Europe. Given that the effects of climatic fluctuations on local ecosystems are complex in these sensitive alpine areas, it is crucial to identify their long-term natural trends, ecological thresholds, and responses to human impact. In this study, the geochemical records from two adjacent alpine bogs in the protected Sierra Nevada National Park reveal different sensitivities and long-term environmental responses, despite similar natural forcings, such as solar radiation and the North Atlantic Oscillation, during the late Holocene. After the Industrial Revolution both bogs registered an independent, abrupt and enhanced response to the anthropogenic forcing, at the same time that the last glaciers disappeared. The different response recorded at each site suggests that the National Park and land managers of similar regions need to consider landscape and environmental evolution in addition to changing climate to fully understand implications of climate and human influence.This study was supported by the project P11-RNM 7332 of the âJunta de AndalucĂaâ, the projects CGL2013-47038-R and CGL2015-67130-C2-1-R of the âMinisterio de EconomĂa y Competitividad of Spain and Fondo Europeo de Desarrollo Regional FEDERâ and the research group RNM0190 and RNM309 (Junta de AndalucĂa). A.G.-A. was also supported by a Marie Curie Intra-European Fellowship of the 7th Framework Programme for Research, Technological Development and Demonstration of the European Commission (NAOSIPUK. Grant Number: PIEF-GA-2012-623027) and by a RamĂłn y Cajal Fellowship RYC-2015-18966 of the Spanish Government (Ministerio de EconomĂa y Competividad). J.L.T. was also supported by a Small Research Grant by the Carnegie Trust for the Universities of Scotland and hosted the NAOSIPUK project (PIEF-GA-2012-623027). M. J. R-R acknowledges the PhD funding provided by ConsejerĂa de EconomĂa, InnovaciĂłn, Ciencia y Empleo de la Junta de AndalucĂa (P11-RNM 7332)
Holocene geochemical footprint from Semiarid alpine wetlands in southern Spain
Here we provide the geochemical dataset that our research group has collected after 10 years of investigation in the Sierra Nevada National Park in southern Spain. These data come from Holocene sedimentary records from four alpine sites (ranging from âŒ2500 to âŒ3000âmasl): two peatlands and two shallow lakes. Different kinds of organic and inorganic analyses have been conducted. The organic matter in the bulk sediment was characterised using elemental measurements and isotope-ratio mass spectrometry (EA-IRMS). Leaf waxes in the sediment were investigated by means of chromatography with flame-ionization detection and mass spectrometry (GC-FID, GC-MS). Major, minor and trace elements of the sediments were analysed with atomic absorption (AAS), inductively coupled plasma mass spectrometry (ICP-MS), as well as X-ray scanning fluorescence. These data can be reused by environmental researchers and soil and land managers of the Sierra Nevada National Park and similar regions to identify the effect of natural climate change, overprinted by human impact, as well as to project new management policies in similar protected areas.Universidad de Granada. Departamento de EstratigrafĂa y PaleontologĂaJunta de AndalucĂa: Grupos de investigaciĂłn RNM190 y RNM309Junta de AndalucĂa: Proyecto P11-RNM-7332España, Ministerio de EconomĂa y Competitividad: Proyecto CGL2013-47038-RRamĂłn y Cajal Fellowship: RYC-2015-18966Small Research Grant by the Carnegie Trust for the Universities of ScotlandMarie Curie Intra-European Fellowship of the 7th Framework Programme for Research,
Technological Development and Demonstration of the European Commission: NAOSIPUK. Grant Number: PIEF-GA-2012-62302
An approach for a negotiation model inspired on social networks
Supporting group decision-making in ubiquitous contexts is a complex
task that needs to deal with a large amount of factors to be successful. Here
we propose an approach for a negotiation model to support the group decisionmaking
process specially designed for ubiquitous contexts. We propose a new
look into this problematic, considering and defining strategies to deal with important
points such as the type of attributes in the multi-criteria problem and
agents' reasoning. Our model uses a social networking logic due to the type of
communication employed by the agents as well as to the type of relationships
they build as the interactions occur. Our approach intends to support the ubiquitous
group decision-making process in a similar way to the real process, which
simultaneously preserves the amount and quality of intelligence generated in
face-to-face meetings and is adapted to be used in a ubiquitous context.This work is part-funded by ERDF - European Regional Development Fund through
the COMPETE Programme (operational programme for competitiveness) and by
National Funds through the FCT - Fundação para a CiĂȘncia e a Tecnologia (Portuguese
Foundation for Science and Technology) within project FCOMP-01-0124-
FEDER-028980 (PTDC/EEISII/1386/2012) and SFRH/BD/89697/2012.info:eu-repo/semantics/publishedVersio
State of emergency medicine in Spain
Spain has universal public health care coverage. Emergency care provisions are offered to patients in different modalities and levels according to the characteristics of the medical complaint: at primary care centers (PCC), in an extrahospital setting by emergency medical services (EMS) and at hospital emergency departments (ED). We have more than 3,000 PCCs, which are run by family doctors (general practitioners) and pediatricians. On average, there is 1 PCC for every 15,000 to 20,000 inhabitants, and every family doctor is in charge of 1,500 to 2,000 citizens, although less populated zones tend to have lower ratios. Doctors spend part of their duty time in providing emergency care to their own patients. While not fully devoted to emergency medicine (EM) practice, they do manage minor emergencies. However, Spanish EMSs contribute hugely to guarantee population coverage in all situations. These EMS are run by EM technicians (EMT), nurses and doctors, who usually work exclusively in the emergency arena. EDs dealt with more than 25 million consultations in 2008, which implies, on average, that one out of two Spaniards visited an ED during this time. They are usually equipped with a wide range of diagnostic tools, most including ultrasonography and computerized tomography scans. The academic and training background of doctors working in the ED varies: nearly half lack any structured specialty residence training, but many have done specific master or postgraduate studies within the EM field. The demand for emergency care has grown at an annual rate of over 4% during the last decade. This percentage, which was greater than the 2% population increase during the same period, has outpaced the growth in ED capacity. Therefore, Spanish EDs become overcrowded when the system exerts minimal stress. Despite the high EM caseload and the potential severity of the conditions, training in EM is still unregulated in Spain. However, in April 2009 the Spanish Minister of Health announced the imminent approval of an EM specialty, allowing the first EM resident to officially start in 2011. Spanish emergency physicians look forward to the final approval, which will complete the modernization of emergency health care provision in Spain
Novel insights into host-fungal pathogen interactions derived from live-cell imaging
Acknowledgments The authors acknowledge funding from the Wellcome Trust (080088, 086827, 075470 and 099215) including a Wellcome Trust Strategic Award for Medical Mycology and Fungal Immunology 097377 and FP7-2007â2013 grant agreement HEALTH-F2-2010-260338âALLFUN to NARG.Peer reviewedPublisher PD
Intelligent negotiation model for ubiquitous group decision scenarios
Supporting group decision-making in ubiquitous contexts is a complex task that must deal with a large amount of
factors to succeed. Here we propose an approach for an intelligent negotiation model to support the group decision-making process
specially designed for ubiquitous contexts. Our approach can be used by researchers that intend to include arguments, complex
algorithms and agents' modelling in a negotiation model. It uses a social networking logic due to the type of communication
employed by the agents and it intends to support the ubiquitous group decision-making process in a similar way to the real process,
which simultaneously preserves the amount and quality of intelligence generated in face-to-face meetings. We propose a new look
into this problematic by considering and defining strategies to deal with important points such as the type of attributes in the multicriteria
problems, agents' reasoning and intelligent dialogues.This work has been
supported by COMPETE Programme (operational
programme for competitiveness) within project
POCI-01-0145-FEDER-007043, by National Funds
through the FCT â Fundação para a CiĂȘncia e a
Tecnologia (Portuguese Foundation for Science and
Technology) within the Projects
UID/CEC/00319/2013, UID/EEA/00760/2013, and
the JoĂŁo Carneiro PhD grant with the reference
SFRH/BD/89697/2012 and by Project MANTIS -
Cyber Physical System Based Proactive Collaborative
Maintenance (ECSEL JU Grant nr. 662189).info:eu-repo/semantics/publishedVersio
Geographical variations in the benefit of applying a prioritization system for cataract surgery in different regions of Spain
<p>Abstract</p> <p>Background</p> <p>In Spain, there are substantial variations in the utilization of health resources among regions. Because the need for surgery differs in patients with appropriate surgical indication, introducing a prioritization system might be beneficial. Our objective was to assess geographical variations in the impact of applying a prioritization system in patients on the waiting list for cataract surgery in different regions of Spain by using a discrete-event simulation model.</p> <p>Methods</p> <p>A discrete-event simulation model to evaluate demand and waiting time for cataract surgery was constructed. The model was reproduced and validated in five regions of Spain and was fed administrative data (population census, surgery rates, waiting list information) and data from research studies (incidence of cataract). The benefit of introducing a prioritization system was contrasted with the usual first-in, first-out (FIFO) discipline. The prioritization system included clinical, functional and social criteria. Priority scores ranged between 0 and 100, with greater values indicating higher priority. The measure of results was the waiting time weighted by the priority score of each patient who had passed through the waiting list. Benefit was calculated as the difference in time weighted by priority score between operating according to waiting time or to priority.</p> <p>Results</p> <p>The mean waiting time for patients undergoing surgery according to the FIFO discipline varied from 1.97 months (95% CI 1.85; 2.09) in the Basque Country to 10.02 months (95% CI 9.91; 10.12) in the Canary Islands. When the prioritization system was applied, the mean waiting time was reduced to a minimum of 0.73 months weighted by priority score (95% CI 0.68; 0.78) in the Basque Country and a maximum of 5.63 months (95% CI 5.57; 5.69) in the Canary Islands. The waiting time weighted by priority score saved by the prioritization system varied from 1.12 months (95% CI 1.07; 1.16) in Andalusia to 2.73 months (95% CI 2.67; 2.80) in Aragon.</p> <p>Conclusion</p> <p>The prioritization system reduced the impact of the variations found among the regions studied, thus improving equity. Prioritization allocates the available resources within each region more efficiently and reduces the waiting time of patients with greater need. Prioritization was more beneficial than allocating surgery by waiting time alone.</p
Efficacy of Anakinra in Refractory Adult-Onset Still's Disease: Multicenter Study of 41 Patients and Literature Review
Adult-onset Still's disease (AOSD) is often refractory to standard therapy. Anakinra (ANK), an interleukin-1 receptor antagonist, has demonstrated efficacy in single cases and small series of AOSD. We assessed the efficacy of ANK in a series of AOSD patients. Multicenter retrospective open-label study. ANK was used due to lack of efficacy to standard synthetic immunosuppressive drugs and in some cases also to at least 1 biologic agent. Forty-one patients (26 women/15 men) were recruited. They had a mean age of 34.4 ± 14 years and a median [interquartile range (IQR)] AOSD duration of 3.5 [2-6] years before ANK onset. At that time the most common clinical features were joint manifestations 87.8%, fever 78%, and cutaneous rash 58.5%. ANK yielded rapid and maintained clinical and laboratory improvement. After 1 year of therapy, the frequency of joint and cutaneous manifestations had decreased to 41.5% and to 7.3% respectively, fever from 78% to 14.6%, anemia from 56.1% to 9.8%, and lymphadenopathy from 26.8% to 4.9%. A dramatic improvement of laboratory parameters was also achieved. The median [IQR] prednisone dose was also reduced from 20 [11.3-47.5] mg/day at ANK onset to 5 [0-10] at 12 months. After a median [IQR] follow-up of 16 [5-50] months, the most important side effects were cutaneous manifestations (n = 8), mild leukopenia (n = 3), myopathy (n = 1), and infections (n = 5). ANK is associated with rapid and maintained clinical and laboratory improvement, even in nonresponders to other biologic agents. However, joint manifestations are more refractory than the systemic manifestations
Observation of associated near-side and away-side long-range correlations in âsNN=5.02ââTeV proton-lead collisions with the ATLAS detector
Two-particle correlations in relative azimuthal angle (ÎÏ) and pseudorapidity (Îη) are measured in âsNN=5.02ââTeV p+Pb collisions using the ATLAS detector at the LHC. The measurements are performed using approximately 1ââÎŒb-1 of data as a function of transverse momentum (pT) and the transverse energy (ÎŁETPb) summed over 3.1<η<4.9 in the direction of the Pb beam. The correlation function, constructed from charged particles, exhibits a long-range (2<|Îη|<5) ânear-sideâ (ÎÏâŒ0) correlation that grows rapidly with increasing ÎŁETPb. A long-range âaway-sideâ (ÎÏâŒÏ) correlation, obtained by subtracting the expected contributions from recoiling dijets and other sources estimated using events with small ÎŁETPb, is found to match the near-side correlation in magnitude, shape (in Îη and ÎÏ) and ÎŁETPb dependence. The resultant ÎÏ correlation is approximately symmetric about Ï/2, and is consistent with a dominant cosâĄ2ÎÏ modulation for all ÎŁETPb ranges and particle pT
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