Linking land cover changes in the subalpine and montane belts to changes in a torrential river.

Channel cbanges are the consequence of cbanges in sediment yield from the slopes and in the connectivity between slopes and channels bccause of distinct land use and climate inJpacts. In Ibis study, we investigated the characteristics and evolution of a short reach in the headwater of the !juez River, central-soutbem Pyrenees. Assessment of a series of sedimentar)' and geomorphic structures confirtned major cbanges to the valley boUom, mainly related to changes in the intensity of human activity. 'The oldest sedimentar)' structure is a terrace leve! located 3 10 4 m above the current alluvial plain. General deforestation, overgrazing and recwring tires in the montane belt ( 1100-1600 m a.sJ.) have led 10 increased soil erosioo and connectivity, and to tbe triggering of debris llows thal have been deposited on the fluvial tmace. Woody fragments from within the debris llows were dated using acceleraror mass spectrOmetry '"e radiocaroon tcchniques (AMS), yielding ages between 1 00 and 115 cal years BP, whicb coincides with tbe period of maximum deforestalion and human density in the Pyrenees. Depopulation and fannland abaodonment since tbe beginning of tbe 2001 oenrury has resulled in generalliJcod natural and artificial reforestation, a shrinkage of the eroded arcas aod a decline in connectivi¡y bdween slopes and the channel. 1be rnost impor1an1 consequence has been cbannel incision and oarrowing, and the development of a sedimed annour !ayer. Active sedimenl b8llSpOI1 is continui.Qg, although there has been a decrease in sed.iment yield from the slopes. Copyright O 2014 John Wiley & Soos, Ltd

Zim17/Tim15 links mitochondrial iron–sulfur cluster biosynthesis to nuclear genome stability

Genomic instability is related to a wide-range of human diseases. Here, we show that mitochondrial iron–sulfur cluster biosynthesis is important for the maintenance of nuclear genome stability in Saccharomyces cerevisiae. Cells lacking the mitochondrial chaperone Zim17 (Tim15/Hep1), a component of the iron–sulfur biosynthesis machinery, have limited respiration activity, mimic the metabolic response to iron starvation and suffer a dramatic increase in nuclear genome recombination. Increased oxidative damage or deficient DNA repair do not account for the observed genomic hyperrecombination. Impaired cell-cycle progression and genetic interactions of ZIM17 with components of the RFC-like complex involved in mitotic checkpoints indicate that replicative stress causes hyperrecombination in zim17Δ mutants. Furthermore, nuclear accumulation of pre-ribosomal particles in zim17Δ mutants reinforces the importance of iron–sulfur clusters in normal ribosome biosynthesis. We propose that compromised ribosome biosynthesis and cell-cycle progression are interconnected, together contributing to replicative stress and nuclear genome instability in zim17Δ mutants

Combination of Tocilizumab and Steroids to Improve Mortality in Patients with Severe COVID-19 Infection : A Spanish, Multicenter, Cohort Study

We aimed to determine the impact of tocilizumab use on severe COVID-19 (coronavirus disease 19) pneumonia mortality. We performed a multicentre retrospective cohort study in 18 tertiary hospitals in Spain from March to April 2020. Consecutive patients admitted with severe COVID-19 treated with tocilizumab were compared to patients not treated with tocilizumab, adjusting by inverse probability of the treatment weights (IPTW). Tocilizumab's effect in patients receiving steroids during the 48 h following inclusion was analysed. During the study period, 506 patients with severe COVID-19 fulfilled the inclusion criteria. Among them, 268 were treated with tocilizumab and 238 patients were not. Median time to tocilizumab treatment from onset of symptoms was 11 days [interquartile range (IQR) 8-14]. Global mortality was 23.7%. Mortality was lower in patients treated with tocilizumab than in controls: 16.8% versus 31.5%, hazard ratio (HR) 0.514 [95% confidence interval (95% CI) 0.355-0.744], p < 0.001; weighted HR 0.741 (95% CI 0.619-0.887), p = 0.001. Tocilizumab treatment reduced mortality by 14.7% relative to no tocilizumab treatment [relative risk reduction (RRR) 46.7%]. We calculated a number necessary to treat of 7. Among patients treated with steroids, mortality was lower in those treated with tocilizumab than in those treated with steroids alone [10.9% versus 40.2%, HR 0.511 (95% CI 0.352-0.741), p = 0.036; weighted HR 0.6 (95% CI 0.449-0.804), p < 0.001] (interaction p = 0.094). These results show that survival of patients with severe COVID-19 is higher in those treated with tocilizumab than in those not treated and that tocilizumab's effect adds to that of steroids administered to non-intubated patients with COVID-19 during the first 48 h of presenting with respiratory failure despite oxygen therapy. Randomised controlled studies are needed to confirm these results. European Union electronic Register of Post-Authorization Studies (EU PAS Register) identifier, EUPAS34415 The online version of this article (10.1007/s40121-020-00373-8) contains supplementary material, which is available to authorized users

Red “Universidad, género, docencia e igualdad”

La Red de investigación en docencia universitaria “Universidad, docencia, genero e igualdad” persigue avanzar en la calidad e innovación de las enseñanzas universitarias a partir de la inclusión de la perspectiva de género. Se busca dar cumplimiento a las directrices generales de los nuevos planes de estudio respecto del principio de igualdad de oportunidades entre hombres y mujeres en la formación universitaria (Real Decreto 1393/2007. BOE nº 260, 30 de octubre de 2007). En la quinta edición de la Red, y dada su composición multidisciplinar, se ha trabajado en tres líneas de investigación: 1) mantenimiento del “Portal web con recursos docentes con perspectiva de género”, proyecto financiado por el Instituto de la Mujer (PACUI, 2012) e iniciado en el curso 2012-2013; 2) desarrollo de la primera versión de “iLengUA”, una herramienta informática para un discurso inclusivo e igualitario; y 3) diseño de una Guía de recomendaciones para la inclusión de la perspectiva de género en la docencia universitaria

Effectiveness of a strategy that uses educational games to implement clinical practice guidelines among Spanish residents of family and community medicine (e-EDUCAGUIA project):A clinical trial by clusters

This study was funded by the Fondo de Investigaciones Sanitarias FIS Grant Number PI11/0477 ISCIII.-REDISSEC Proyecto RD12/0001/0012 AND FEDER Funding.Background: Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for changes in routine clinical practice. Using educational games as a strategy for implementing recommendations among health professionals has been demonstrated to be effective in some studies; however, evidence is still scarce. The primary objective of this study is to assess the effectiveness of a teaching strategy for the implementation of CPGs using educational games (e-learning EDUCAGUIA) to improve knowledge and skills related to clinical decision-making by residents in family medicine. The primary objective will be evaluated at 1 and 6months after the intervention. The secondary objectives are to identify barriers and facilitators for the use of guidelines by residents of family medicine and to describe the educational strategies used by Spanish teaching units of family and community medicine to encourage implementation of CPGs. Methods/design: We propose a multicenter clinical trial with randomized allocation by clusters of family and community medicine teaching units in Spain. The sample size will be 394 residents (197 in each group), with the teaching units as the randomization unit and the residents comprising the analysis unit. For the intervention, both groups will receive an initial 1-h session on clinical practice guideline use and the usual dissemination strategy by e-mail. The intervention group (e-learning EDUCAGUIA) strategy will consist of educational games with hypothetical clinical scenarios in a virtual environment. The primary outcome will be the score obtained by the residents on evaluation questionnaires for each clinical practice guideline. Other included variables will be the sociodemographic and training variables of the residents and the teaching unit characteristics. The statistical analysis will consist of a descriptive analysis of variables and a baseline comparison of both groups. For the primary outcome analysis, an average score comparison of hypothetical scenario questionnaires between the EDUCAGUIA intervention group and the control group will be performed at 1 and 6months post-intervention, using 95% confidence intervals. A linear multilevel regression will be used to adjust the model. Discussion: The identification of effective teaching strategies will facilitate the incorporation of available knowledge into clinical practice that could eventually improve patient outcomes. The inclusion of information technologies as teaching tools permits greater learning autonomy and allows deeper instructor participation in the monitoring and supervision of residents. The long-term impact of this strategy is unknown; however, because it is aimed at professionals undergoing training and it addresses prevalent health problems, a small effect can be of great relevance. Trial registration: ClinicalTrials.gov: NCT02210442.Publisher PDFPeer reviewe

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Reflexiones desde la enseñanza y el aprendizaje de la arquitectura 2

La segunda entrega del libro Doceo “Reflexiones desde la enseñanza y el aprendizaje de la arquitectura”, es fruto de metodologías de enseñanza- aprendizaje diseñadas para cada caso, y que representan la impronta personal de cada autor. Es importante resaltar, que todos los argumentos presentados en esta obra corresponden a experiencias en el aula, conclusiones de docentes y/o estudiantes en el marco de una asignatura desarrollada en la Universidad de la Costa con sede en Barranquilla, Colombia. El Volumen dos de esta entrega se ha editado progresivamente, en una primera parte la compilación estuvo a cargo de la profesora Stephania Mouthon, quien centralizó todos los manuscritos, luego de esto, hemos construido de manera conjunta el diseño editorial, estructura del cuerpo y demás aspectos de perfeccionamiento del documento.Departamento de Arquitectura, Universidad de la Cost

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Caracterización de líneas transgénicas de tomate que sobreexpresan los genes RAMLESS de Solanum lycopersicon y S. pimpinellifolium

[ES] La raíz, vía de conexión de la planta con el suelo, es un órgano esencial para explorar y explotar los recursos más esenciales que necesita una planta para su crecimiento y desarrollo. El creciente interés por la biología radicular obedece a dos razones. A nivel básico, la arquitectura del sistema radicular es un excelente ejemplo de plasticidad del desarrollo, donde las estructuras de los órganos dependen de una interacción entre vías de desarrollo genéticamente programadas y señales ambientales que de forma colectiva activan y modelan grupos de células madre. A nivel práctico, este interés emana de alguno de los desafíos a los que tiene que enfrentarse la agricultura moderna, como, por ejemplo, el mantenimiento de la producción en suelos con menores recursos de agua y nutrientes. Al respecto, el desarrollo de nuevos cultivares con sistemas radiculares más eficientes para la absorción de nutrientes o para la adquisición de agua en condiciones de estrés hídrico podría tener un impacto significativo en la producción. Sin embargo, este objetivo sólo se puede lograr sobre la base del conocimiento de los determinantes genéticos que regulan el desarrollo radicular. El tomate es la hortícola de mayor relevancia económica a nivel mundial, pero se conoce aún poco sobre los factores que determinan el desarrollo radicular, debido sobre todo a la escasez de mutantes alterados en este carácter. Nuestro grupo está empleando la mutagénesis insercional en tomate y especies silvestres relacionadas para la identificación de genes que controlan caracteres del desarrollo, así como los responsables de la tolerancia a estrés abiótico. En el contexto de este programa de mutagénesis insercional, se ha identificado un gen implicado en el desarrollo del sistema radicular a partir del mutante insercional ramless de Solanum pimpinellifolium. El análisis genético del mutante indicó que su fenotipo co-segregaba con un inserto de T-DNA, lo que facilitó la clonación del gen responsable del fenotipo ramless en el laboratorio del Dr. Lozano. Además, se ha clonado su ortólogo de S. lycopersicon, y se han obtenido colecciones de plantas transgénicas de tomate que sobreexpresan cada uno de estos genes. El principal objetivo de este Trabajo Final de Máster ha sido la caracterización de dos colecciones de plantas transgénicas de tomate que sobreexpresan el gen RAMLESS de S. pimpinellifolium y su ortólogo de S. lycopersicon. El primer objetivo del trabajo ha sido la selección de progenies transgénicas de simple copia. En segundo lugar, se ha llevado a cabo una caracterización in vitro del desarrollo de la raíz embrionaria y el sistema radicular adventicio. Por último, se ha realizado una evaluación exhaustiva de caracteres relacionados con el desarrollo vegetativo y reproductivo en invernadero.[EN] The root, which connects the plant with the soil, is an essential organ to explore and exploit the most essential resources a plant needs for its growth and development. The growing interest in root biology is due to two reasons. At the basic level, the architecture of the root system is an excellent example of plasticity development, where the structures of the organs depend on an interaction between genetically programmed development pathways and environmental signals that are collectively active and model stem cell groups. On a practical level, this interest emanates from some of the challenges that modern agriculture has to face, such as maintaining production in soils with less water and nutrient resources. On that subject, the development of new crops with more efficient root systems for nutrient absorption or for the acquisition of water under conditions of water stress could have a significant impact on production. However, this objective can only be achieved on the basis of knowledge of the genetic determinants that regulate root development. Tomato is a vegetable of great economic relevance worldwide, but little is known about the factors that determine root development, mainly due to the shortage of mutants which altered it. Our group is using insertional mutagenesis in tomatos and related wild species to identify genes that control developmental characters, as well as those responsible for abiotic stress tolerance. In the context of this insertional mutagenesis program, a gene involved in the development of the root system has been identified from the ramless insertional mutant of Solanum pimpinellifolium. Genetic analysis of the mutant indicated that its phenotype co-segregated with a T-DNA insert, which facilitated the cloning of the gene responsible for the ramless phenotype in Dr. Lozano's laboratory. In addition, its ortholog of S. lycopersicon has been cloned, and collections of transgenic tomato plants that overexpress each of these genes have been obtained. The main objective of this Master's Dissertation has been the characterization of two collections of transgenic tomato plants that overexpress the RAMLESS gene of S. pimpinellifolium and its ortholog of S. lycopersicon. The first objective of the work has been the selection of transgenic progeny of simple copy. Secondly, an in vitro characterization of the development of the embryonic root and the adventitious root system has been carried out. Finally, an exhaustive evaluation of characters related to vegetative and reproductive development in the greenhouse has been carried out.Sanjuan Ruiz, MP. (2019). Caracterización de líneas transgénicas de tomate que sobreexpresan los genes RAMLESS de Solanum lycopersicon y S. pimpinellifolium. http://hdl.handle.net/10251/129861TFG