Assessing Value-based Health Care Delivery for Hemodialysis

Rationale, aims and objectives Disparities in haemodialysis outcomes among centres have been well-documented. Besides, attempts to assess haemodialysis results have been based on non-comprehensive methodologies. This study aimed to develop a comprehensive methodology for assessing haemodialysis centres, based on the value of health care. The value of health care is defined as the patient benefit from a specific medical intervention per monetary unit invested (Value = Patient Benefit/Cost). This study assessed the value of health care and ranked different haemodialysis centres. Method A nephrology quality management group identified the criteria for the assess- ment. An expert group composed of stakeholders (patients, clinicians and managers) agreed on the weighting of each variable, considering values and preferences. Multi-criteria methodology was used to analyse the data. Four criteria and their weights were identified: evidence-based clinical performance measures = 43 points; yearly mortality = 27 points; patient satisfaction = 13 points; and health-related quality of life = 17 points (100-point scale). Evidence-based clinical performance measures included five sub-criteria, with respective weights, including: dialysis adequacy; haemoglobin concentration; mineral and bone disorders; type of vascular access; and hospitalization rate. The patient benefit was determined from co-morbidity–adjusted results and corresponding weights. The cost of each centre was calculated as the average amount expended per patient per year. Results The study was conducted in five centres (1–5). After adjusting for co-morbidity, value of health care was calculated, and the centres were ranked. A multi-way sensitivity analysis that considered different weights (10–60% changes) and costs (changes of 10% in direct and 30% in allocated costs) showed that the methodology was robust. The rankings: 4-5-3-2-1 and 4-3-5-2-1 were observed in 62.21% and 21.55%, respectively, of simula- tions, when weights were varied by 60%. Conclusions Value assessments may integrate divergent stakeholder perceptions, create a context for improvement and aid in policy-making decisions

Shopping for Ecological Indices? On the Use of Incidence-Based Species Compositional Similarity Measures

β-diversity has been under continuous debate, with a current need to better understand the way in which a new wave of measures work. We assessed the results of 12 incidence-based β-diversity indices. Our results of gradual species composition overlap between paired assemblages considering progressive differences in species richness show the following: (i) four indices (β-2, β-3, β-3.s, and βr) should be used cautiously given that results with no shared species retrieve results that could be misinterpreted; (ii) all measures conceived specifically as partitioned components of species compositional dissimilarities ought to be used as such and not as independent measures per se; (iii) the non-linear response of some indices to gradual species composition overlap should be interpreted carefully, and further analysis using their results as dependent variables should be performed cautiously; and (iv) two metrics (βsim and βsor) behave predictably and linearly to gradual species composition overlap. We encourage ecologists using measures of β-diversity to fully understand their mathematical nature and type of results under the scenario to be used in order to avoid inappropriate and misleading inferences

Shopping for Ecological Indices? On the Use of Incidence-Based Species Compositional Similarity Measures

β-diversity has been under continuous debate, with a current need to better understand the way in which a new wave of measures work. We assessed the results of 12 incidence-based β-diversity indices. Our results of gradual species composition overlap between paired assemblages considering progressive differences in species richness show the following: (i) four indices (β-2, β-3, β-3.s, and βr) should be used cautiously given that results with no shared species retrieve results that could be misinterpreted; (ii) all measures conceived specifically as partitioned components of species compositional dissimilarities ought to be used as such and not as independent measures per se; (iii) the non-linear response of some indices to gradual species composition overlap should be interpreted carefully, and further analysis using their results as dependent variables should be performed cautiously; and (iv) two metrics (βsim and βsor) behave predictably and linearly to gradual species composition overlap. We encourage ecologists using measures of β-diversity to fully understand their mathematical nature and type of results under the scenario to be used in order to avoid inappropriate and misleading inferences

Herramienta para la enseñanza en la carrera de Ingeniería Automática: Nodo Virtual de Procesos

Tradicionalmente en la carrera de ingeniería Automática, los contenidos teóricos de las diferentes asignaturas son impartidos en clase pero esto no garantiza que los estudiantes adquieran las habilidades para hacer frente a los problemas reales. Este proyecto consiste en un Nodo Virtual en el cual se implementan los modelos de distintos procesos, agrupados por tipos que dan la posibilidad de realizar simulaciones con los mismos o probar aplicaciones en tiempo real.Red de Universidades con Carreras en Informática (RedUNCI

Herramienta para la enseñanza en la carrera de Ingeniería Automática: Nodo Virtual de Procesos

Tradicionalmente en la carrera de ingeniería Automática, los contenidos teóricos de las diferentes asignaturas son impartidos en clase pero esto no garantiza que los estudiantes adquieran las habilidades para hacer frente a los problemas reales. Este proyecto consiste en un Nodo Virtual en el cual se implementan los modelos de distintos procesos, agrupados por tipos que dan la posibilidad de realizar simulaciones con los mismos o probar aplicaciones en tiempo real.Red de Universidades con Carreras en Informática (RedUNCI

Negative Impacts of Human Land Use on Dung Beetle Functional Diversity

The loss of biodiversity caused by human activity is assumed to alter ecosystem functioning. However our understanding of the magnitude of the effect of these changes on functional diversity and their impact on the dynamics of ecological processes is still limited. We analyzed the functional diversity of copro-necrophagous beetles under different conditions of land use in three Mexican biosphere reserves. In Montes Azules pastures, forest fragments and continuous rainforest were analyzed, in Los Tuxtlas rainforest fragments of different sizes were analyzed and in Barranca de Metztitlán two types of xerophile scrub with different degrees of disturbance from grazing were analyzed. We assigned dung beetle species to functional groups based on food relocation, beetle size, daily activity period and food preferences, and as measures of functional diversity we used estimates based on multivariate methods. In Montes Azules functional richness was lower in the pastures than in continuous rainforest and rainforest fragments, but fragments and continuous forest include functionally redundant species. In small rainforest fragments (<5 ha) in Los Tuxtlas, dung beetle functional richness was lower than in large rainforest fragments (>20 ha). Functional evenness and functional dispersion did not vary among habitat types or fragment size in these reserves. In contrast, in Metztitlán, functional richness and functional dispersion were different among the vegetation types, but differences were not related to the degree of disturbance by grazing. More redundant species were found in submontane than in crassicaule scrub. For the first time, a decrease in the functional diversity in communities of copro-necrophagous beetles resulting from changes in land use is documented, the potential implications for ecosystem functioning are discussed and a series of variables that could improve the evaluation of functional diversity for this biological group is proposed

Increased Expression of Musashi-1 Evidences Mesenchymal Repair in Maxillary Sinus Floor Elevation

This study aimed to analyze the expression of Musashi-1 (MSI1) in maxillary native bone and grafted bone after maxillary sinus floor elevation. To do so, fifty-seven bone biopsies from 45 participants were studied. Eighteen samples were collected from native bone while 39 were obtained 6 months after maxillary sinus grafting procedures. Musashi-1 was analyzed by immunohistochemistry and RT-PCR. MSI1 was detected in osteoblasts and osteocytes in 97.4% (38/39) of grafted areas. In native bone, MSI1 was detected in only 66.6% (12/18) of the biopsies, mainly in osteocytes. Detection of MSI1 was significantly higher in osteoprogenitor mesenchymal cells of grafted biopsies (p < 0.001) but minor in smooth muscle and endothelial cells; no expression was detected in adipocytes. The mesenchymal cells of the non-mineralized tissue of native bone showed very low nuclear expression of MSI1, in comparison to fusiform cells in grafted areas (0.28(0.13) vs. 2.10(0.14), respectively; p < 0.001). Additionally, the detection of MSI1 mRNA was significantly higher in biopsies from grafted areas than those from native bone (1.00(0.51) vs. 60.34(35.2), respectively; p = 0.029). Thus, our results regardig the significantly higher detection of Musashi-1 in grafted sites than in native bone reflects its importance in the remodeling/repair events that occur after maxillary sinus floor elevation in humans.This investigation was partially supported by Research Groups #CTS-138 and #CTS-1028 (Junta de Andalucía, Spain). MPM was supported by the Andalucía Talent Hub Program from the Andalusian Knowledge Agency (co-funded by the European Union’s Seventh Framework Program, Marie Skłodowska-Curie actions (COFUND – Grant Agreement n° 291780) and the Ministry of Economy, Innovation, Science and Employment of the Junta de Andalucía)

In vitro propagation from nodal segments of Lippia origanoides (chemotype A)

This research described an efficient micropropagation protocol for Lippia origanoides (Verbenaceae). Sterile seeds were used to obtain germinated seedlings in Murashige and Skoog medium (MS) supplemented with sucrose and agar. The nodal segments obtained from seedlings were grown on MS medium supplemented with different concentrations of gibberellic acid (GA), benzylaminopurine (BAP) and 1-naphthalenacetic acid (NAA) with BAP. The callus induction, shoots length, shoots number and root length, were analyzed. The treatments showed high percentage of callus formation at 0.5 to 1.5 mg L-1 of BAP alone or in combination with NAA (0.1 mg L-1). The highest value of shoot number per nodal segments was obtained at 1.5 mg L-1 of BAP (4.3 ± 0.8). The obtained plantlets were better rooted in vitro in the absence of plant growth regulators (PGRs) and they showed acclimatization rate of 90%. We reported a protocol for in vitro propagation and acclimatization of L. origanoides for A chemotypes from Colombia

The Mauritian Archaeology and Cultural Heritage Project: exploring the impact of colonialism and colonisation in the Indian Ocean

The main aim of this project is to understand how European colonial activity influenced environmental and cultural transformations in this region of the Indian Ocean (Seetah 2010) by targeting specific locations (Figure 2), incorporating slave, indentured and imperial sites, as well as sites with high eco-archaeological potential. Establishing base-line soil conditions formed the focus of the first season and centred on a site in the north of the island at Mon Choisy (overall size 800m!). It forms part of a former plantation and offers a valuable opportunity to record the transition from virgin soil to agriculture. Core data showed clear indications of enrichment, with 14C dating providing a timeframe for the agricultural intensification of sugar agriculture that coincided with the arrival of the British. Subsequent research has centred on broadening the geographical and thematic scope of the project to delve deeper into the human and ecological implications of satisfying Europe's appetite for sugar

Cognition, culture and utility:Plant classification by Paraguayan immigrant farmers in Misiones, Argentina

Background: This study was conducted in three rural communities of small farmers of Paraguayan origin living in the province of Misiones, Argentina. These Criollos (Mestizos) hail chiefly from departments located in the east of Paraguay, where the climate and flora have similar characteristics as those in Misiones. These ecological features contribute to the continuation and maintenance of knowledge and practices related to the use of plants. Methods: Fieldwork was conducted between September 2014 and August 2015. Forty five informants from three rural localities situated along the Parana River participated in an ethno-classification task. For the classification event, photographs of 30 medicinal and edible plants were chosen, specifically those yielding the highest frequency of mention among the members of that community (based on data obtained in the first stage of research in 2014). Variation in local plant classifications was examined and compared using principal component analysis and cluster analysis. Results: We found that people classify plants according to application or use (primarily medicinal, to a lesser extent as edible). Morphology is rarely taken into account, even for very similar and closely-related species such as varieties of palms. In light of our findings, we highlight a dominant functionality model at work in the process of plant cognition and classification among farmers of Paraguayan origin. Salient cultural beliefs and practices associated with rural Paraguayan plant-based medicine are described. Additionally, the manner by which residents’ concepts of plants articulate with local folk epistemology is discussed. Conclusions: Culturally constructed use patterns ultimately override morphological variables in rural Paraguayans’ ethnobotanical classification.Antecedentes: Este trabajo se realizó con pequeños agricultores de origen paraguayo, que habitan en la provincia de Misiones, Argentina. Los criollos (mestizos) en su mayoría provienen de departamentos ubicados al oriente del Paraguay, donde el clima y la flora presentan características similares a la provincia de Misiones. Estas características ecológicas contribuyen a la continuación y el mantenimiento de los conocimientos y las prácticas relacionados al uso de las plantas. Métodos El trabajo de campo se realizó entre septiembre de 2014 y agosto de 2015. En la etnoclasificación participaron 45 informantes, provenientes de tres localidades rurales, situadas a lo largo del río Paraná, frontera entre los dos países. Para la clasificación se utilizaron imágenes fotográficas de 30 especies -comestibles y medicinales- preseleccionadas como las de mayor frecuencia de mención entre los habitantes de la región (a partir de los datos obtenidos en una primera etapa de investigación en el año 2014). Por medio del análisis de componentes principales y el análisis de agrupamiento (cluster) se contrastaron y compararon las variaciones en las etnoclasificaciones locales de plantas. Resultados Se encontró que los pobladores clasifican sus plantas según su aplicación y uso (mayormente asociadas a la categoría medicinal y en menor medida a la comestible). Mientras, la morfología rara vez se tiene en cuenta, incluso en aquellas especies muy similares y estrechamente relacionadas como las palmeras. A la luz de los hallazgos, se destaca un modelo de funcionalidad dominante en el proceso de cognición y de clasificación de las plantas entre los agricultores de origen paraguayo. Se describen las principales creencias y prácticas culturales asociadas a la medicina rural paraguaya. Adicionalmente, se discuten algunos de los conceptos de las plantas que mantienen los paraguayos y su articulación con la epistemología local. Conclusiones En la clasificación etnobotánica de los pobladores de origen paraguayo los patrones de uso construidos culturalmente tienen mayor peso que las variables morfológicas.Fil: Kujawska, Monika. University Of Lodz; ArgentinaFil: Jiménez Escobar, Néstor David. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Antropología de Córdoba. Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Instituto de Antropología de Córdoba; ArgentinaFil: Nolan, Justin M.. University Of Arkansas; Estados UnidosFil: Arias Mutis, Daniel. University of Groningen; Países Bajo