Ofrendas en el humedal: el santuario ibero de Haza del Rayo (Sabiote, Jaén)

We present a new Iberian sanctuary situated on the hill known as La Loma de Úbeda (Jaén), located at a key connecting point between the Guadalquivir and Guadalimar valleys. It is an open-air site with a 3rd century BCE votive deposit. A large part of the interest in this case study lies in the application of a strongly interdisciplinary protocol which combines archaeological excavations, systematic magnetic micro-surveying and combined analyses (soil micromorphology, pollen and phytolith analyses, OSL datings, 3D groundpenetrating radar studies and metallographic analysis). This protocol has made it possible to document the ritual dynamics involving this small area of paleo-wetland. The site is placed at a key point on the ritual itinerary between the town of Baecula (Santo Tomé, Jaén) and the sanctuary of La Cueva de la Lobera in Castellar (Jaén). The present study reveals the complexity of the religious landscapes in a territory similar to that of Cástulo (Linares, Jaén) in the 4th and 3rd centuries BCE, in which the natural landmarks with strong specific cultural significances played an important role.Damos a conocer el hallazgo de un santuario ibero, situado en la Loma de Úbeda (Jaén), en un punto clave de conexión entre los valles del Guadalquivir y del Guadalimar, definido como un espacio al aire libre, al que se asocia un depósito votivo del siglo III a. n. e. El interés de este estudio de caso radica en la aplicación de un protocolo fuertemente interdisciplinar, que parte de excavaciones arqueológicas, microprospecciones magnéticas sistemáticas y análisis combinados (micromorfología de suelos, análisis de polen y fitolitos, dataciones, estudios geo-radar 3D y análisis metalográficos). Este protocolo ha permitido documentar la dinámica ritual que involucra a una pequeña área de paleo-humedal, así como su caracterización general. Este espacio, definido como un punto clave en el itinerario ritual que parte de la ciudad de Baecula (Santo Tomé, Jaén) y se dirige al santuario de la Cueva de la Lobera en Castellar (Jaén), nos sitúa ante la complejidad de los paisajes religiosos en un territorio como el de Cástulo (Linares, Jaén) para los siglos IV-III a. n. e., en los que cobra importancia la incorporación de hitos naturales con significados culturales muy específicos

Programa de desarrollo de sistemas integrales de infraestructura y movilidad colectiva. Nuevas formas de movilidad para la vida

Las poblaciones urbanas padecen diversos problemas ambientales, de salud, segregación y pérdida de espacios públicos, derroche energético, ruido, así como altas inversiones de tiempo y dinero. Estas situaciones poseen un denominador común: una tecnología inadecuada llamada automóvil unipersonal. Buscamos intervenir tecnológicamente el contexto de las ciudades mediante un sistema de movilidad público, eficiente, no invasivo, silencioso, de bajo costo, saludable y ecológico. En este trabajo presentamos diferentes soluciones, con la intención de ir llevando esta tecnología hacia su transferencia tecnológica.ITESO, A.C.CoecytjalIngenieros Sin Frontera

Early Stepdown From Echinocandin to Fluconazole Treatment in Candidemia: A Post Hoc Analysis of Three Cohort Studies

[Background] There are no clear criteria for antifungal de-escalation after initial empirical treatments. We hypothesized that early de-escalation (ED) (within 5 days) to fluconazole is safe in fluconazole-susceptible candidemia with controlled source of infection.[Methods] This is a multicenter post hoc study that included consecutive patients from 3 prospective candidemia cohorts (2007–2016). The impact of ED and factors associated with mortality were assessed.[Results] Of 1023 candidemia episodes, 235 met inclusion criteria. Of these, 54 (23%) were classified as the ED group and 181 (77%) were classified as the non-ED group. ED was more common in catheter-related candidemia (51.9% vs 31.5%; P = .006) and episodes caused by Candida parapsilosis, yet it was less frequent in patients in the intensive care unit (24.1% vs 39.2%; P = .043), infections caused by Nakaseomyces glabrata (0% vs 9.9%; P = .016), and candidemia from an unknown source (24.1% vs 47%; P = .003). In the ED and non-ED groups, 30-day mortality was 11.1% and 29.8% (P = .006), respectively. Chronic obstructive pulmonary disease (odds ratio [OR], 3.97; 95% confidence interval [CI], 1.48–10.61), Pitt score > 2 (OR, 4.39; 95% CI, 1.94–9.20), unknown source of candidemia (OR, 2.59; 95% CI, 1.14–5.86), candidemia caused by Candida albicans (OR, 3.92; 95% CI, 1.48–10.61), and prior surgery (OR, 0.29; 95% CI, 0.08–0.97) were independent predictors of mortality. Similar results were found when a propensity score for receiving ED was incorporated into the model. ED had no significant impact on mortality (OR, 0.50; 95% CI, 0.16–1.53).[Conclusions] Early de-escalation is a safe strategy in patients with candidemia caused by fluconazole-susceptible strains with controlled source of bloodstream infection and hemodynamic stability. These results are important to apply antifungal stewardship strategies.This research forms part of an activity that has received funding from EIT Health. EIT Health is supported by the European Institute of Innovation and Technology (EIT), a body of the European Union that receives support from the European Union´s Horizon 2020 Research and Innovation Program. This study has been cofunded by the European Regional Development Fund. E. M.-G. (PI18/01061), P. P.-A. (“Rio Hortega” contract CM18/00132), M. F.-R. (“Miguel Servet” contract CP18/00073), and C. G.-V. (FIS PI18/01061) have received research grants from the Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III.Peer reviewe

Endothelial dysfunction is an early indicator of sepsis and neutrophil degranulation of septic shock in surgical patients

Producción CientíficaBackground: Stratification of the severity of infection is currently based on the Sequential Organ Failure Assessment (SOFA) score, which is difficult to calculate outside the ICU. Biomarkers could help to stratify the severity of infection in surgical patients. Methods: Levels of ten biomarkers indicating endothelial dysfunction, 22 indicating emergency granulopoiesis, and six denoting neutrophil degranulation were compared in three groups of patients in the first 12 h after diagnosis at three Spanish hospitals. Results: There were 100 patients with infection, 95 with sepsis and 57 with septic shock. Seven biomarkers indicating endothelial dysfunction (mid-regional proadrenomedullin (MR-ProADM), syndecan 1, thrombomodulin, angiopoietin 2, endothelial cell-specific molecule 1, vascular cell adhesion molecule 1 and E-selectin) had stronger associations with sepsis than infection alone. MR-ProADM had the highest odds ratio (OR) in multivariable analysis (OR 11·53, 95 per cent c.i. 4·15 to 32·08; P = 0·006) and the best area under the curve (AUC) for detecting sepsis (0·86, 95 per cent c.i. 0·80 to 0·91; P < 0·001). In a comparison of sepsis with septic shock, two biomarkers of neutrophil degranulation, proteinase 3 (OR 8·09, 1·34 to 48·91; P = 0·028) and lipocalin 2 (OR 6·62, 2·47 to 17·77; P = 0·002), had the strongest association with septic shock, but lipocalin 2 exhibited the highest AUC (0·81, 0·73 to 0·90; P < 0·001). Conclusion: MR-ProADM and lipocalin 2 could be alternatives to the SOFA score in the detection of sepsis and septic shock respectively in surgical patients with infection.Instituto de Salud Carlos III (grants PI15/01959, PI15/01451 and PI16/01156

The polygenic basis of relapse after a first episode of schizophrenia

Little is known about genetic predisposition to relapse. Previous studies have linked cognitive and psychopathological (mainly schizophrenia and bipolar disorder) polygenic risk scores (PRS) with clinical manifestations of the disease. This study aims to explore the potential role of PRS from major mental disorders and cognition on schizophrenia relapse. 114 patients recruited in the 2EPs Project were included (56 patients who had not experienced relapse after 3 years of enrollment and 58 patients who relapsed during the 3-year follow-up). PRS for schizophrenia (PRS-SZ), bipolar disorder (PRS-BD), education attainment (PRS-EA) and cognitive performance (PRS-CP) were used to assess the genetic risk of schizophrenia relapse.Patients with higher PRS-EA, showed both a lower risk (OR=0.29, 95% CI [0.11–0.73]) and a later onset of relapse (30.96± 1.74 vs. 23.12± 1.14 months, p=0.007. Our study provides evidence that the genetic burden of neurocognitive function is a potentially predictors of relapse that could be incorporated into future risk prediction models. Moreover, appropriate treatments for cognitive symptoms appear to be important for improving the long-term clinical outcome of relapse

Protocolo transdiagnóstico PsicAP de entrenamiento cognitivo-conductual en grupo para trastornos emocionales

Anxiety disorders and depression are highly prevalent today. The PsicAP clinical trial showed that adding 7 sessions of group cognitive-behavioural training with a transdiagnostic approach to the usual treatment of emotional disorders in adult primary care patients increased efficacy and cost-effectiveness in reducing symptom levels, reduced disability and improved quality of life. In this work, these 7 sessions of the PsicAP protocol of transdiagnostic treatment are described, aimed at intervening on the factors common to the different disorders: cognitive distortions and emotional regulation strategies. It is an intervention based on learning through psychoeducation, cognitive restructuring, relaxation, behavioural techniques and relapse prevention. It concludes by arguing about the usefulness of this protocol to reduce the gap between research and clinical practice, something necessary in today's societyLos trastornos de ansiedad y la depresión son altamente prevalentes en la sociedad actual. El ensayo clínico PsicAP demostró que añadir 7 sesiones de entrenamiento cognitivo-conductual en grupo con enfoque transdiagnóstico al tratamiento habitual de trastornos emocionales en pacientes adultos de atención primaria aumentó la eficacia y coste-efectividad para reducir los niveles de síntomas, redujo la discapacidad y mejoró la calidad de vida. En este trabajo se describen esas 7 sesiones del protocolo PsicAP de tratamiento transdiagnóstico, dirigido a la intervención sobre los factores comunes a los distintos trastornos: las distorsiones cognitivas y las estrategias de regulación emocional. Se trata de una intervención basada en el aprendizaje mediante psicoeducación, reestructuración cognitiva, relajación, técnicas conductuales y prevención de recaídas. Se concluye argumentando sobre la utilidad de este protocolo para reducir la brecha entre investigación y práctica clínica, algo necesario en la sociedad actua

Subhaloes gone Notts: subhaloes as tracers of the dark matter halo shape

We study the shapes of subhalo distributions from four dark-matter-only simulations of Milky Way-type haloes. Comparing the shapes derived from the subhalo distributions at high resolution to those of the underlying dark matter fields, we find the former to be more triaxial if the analysis is restricted to massive subhaloes. For three of the four analysed haloes, the increased triaxiality of the distributions of massive subhaloes can be explained by a systematic effect caused by the low number of objects. Subhaloes of the fourth halo show indications for anisotropic accretion via their strong triaxial distribution and orbit alignment with respect to the dark matter field. These results are independent of the employed subhalo finder. Comparing the shape of the observed Milky Way satellite distribution to those of high-resolution subhalo samples from simulations, we find agreement for samples of bright satellites, but significant deviations if faint satellites are included in the analysis. These deviations might result from observational incompleteness

F-Spondin/spon1b Expression Patterns in Developing and Adult Zebrafish

F-spondin, an extracellular matrix protein, is an important player in embryonic morphogenesis and CNS development, but its presence and role later in life remains largely unknown. We generated a transgenic zebrafish in which GFP is expressed under the control of the F-spondin (spon1b) promoter, and used it in combination with complementary techniques to undertake a detailed characterization of the expression patterns of F-spondin in developing and adult brain and periphery. We found that F-spondin is often associated with structures forming long neuronal tracts, including retinal ganglion cells, the olfactory bulb, the habenula, and the nucleus of the medial longitudinal fasciculus (nMLF). F-spondin expression coincides with zones of adult neurogenesis and is abundant in CSF-contacting secretory neurons, especially those in the hypothalamus. Use of this new transgenic model also revealed F-spondin expression patterns in the peripheral CNS, notably in enteric neurons, and in peripheral tissues involved in active patterning or proliferation in adults, including the endoskeleton of zebrafish fins and the continuously regenerating pharyngeal teeth. Moreover, patterning of the regenerating caudal fin following fin amputation in adult zebrafish was associated with F-spondin expression in the blastema, a proliferative region critical for tissue reconstitution. Together, these findings suggest major roles for F-spondin in the CNS and periphery of the developing and adult vertebrate