How Will U.S.-Cuban Normalization Affect Economic Policy in Cuba?

The effects of the U.S.-Cuban rapprochement announced on December 17, 2014 on the Cuban economy and economic policy will be profound. The main direct economic effect will be a significant boost to Cuban earnings from US visitors, together with a transformation of expectations. For the longer term, the change in US policy has initiated a new phase in Cuba's international economic opening that will gather pace and transform the Cuban economy

Culture-specific programs for children and adults from minority groups who have asthma (Review)

Background People with asthma who come from minority groups have poorer asthma outcomes and more asthma related visits to Emergency Departments (ED). Various programmes are used to educate and empower people with asthma and these have previously been shown to improve certain asthma outcomes. Models of care for chronic diseases in minority groups usually include a focus of the cultural context of the individual and not just the symptoms of the disease. Therefore, questions about whether culturally specific asthma education programmes for people from minority groups are effective at improving asthma outcomes, are feasible and are cost-effective need to be answered. Objectives To determine whether culture-specific asthma programmes, in comparison to generic asthma education programmes or usual care, improve asthma related outcomes in children and adults with asthma who belong to minority groups. Search strategy We searched the Cochrane Register of Controlled Trials (CENTRAL), the Cochrane Airways Group Specialised Register, MEDLINE, EMBASE, review articles and reference lists of relevant articles. The latest search was performed in May 2008. Selection criteria All randomised controlled trials (RCTs) comparing the use of culture-specific asthma education programmes with generic asthma education programmes, or usual care, in adults or children from minority groups who suffer from asthma. Data collection and analysis Two review authors independently selected, extracted and assessed the data for inclusion. We contacted authors for further information if required. Main results Four studies were eligible for inclusion in the review. A total of 617 patients, aged from 5 to 59 years were included in the meta-analysis of data. Use of a culture-specific programme was superior to generic programmes or usual care, in improving asthma quality of life scores in adults, pooled WMD 0.25 (95% CI 0.09 to 0.41), asthma knowledge scores in children, WMD 3.30 (95% CI 1.07 to 5.53), and in a single study, reducing asthma exacerbation in children (risk ratio for hospitalisations 0.32, 95% CI 0.15, 0.70). Authors' conclusions Current limited data show that culture-specific programmes for adults and children from minority groups with asthma, are more effective than generic programmes in improving most (quality of life, asthma knowledge, asthma exacerbations, asthma control) but not all asthma outcomes. This evidence is limited by the small number of included studies and the lack of reported outcomes. Further trials are required to answer this question conclusively

Movilidad sostenible: alternativa viable para las ciudades cubanas

Las reformas económicas hacia la ‘normalización’ de las relaciones con los Estados Unidos ha suscitado la esperanza de un aumento de los propietarios de autos en Cuba. Sin embargo, la experiencia internacional ofrece vasta evidencia del gran costo de esta dependencia en las ciudades. Siguiendo las enseñanzas de las tendencias globales, La Habana puede evitar errores y crecer a partir de sus únicas fortalezas. Una visión política clara basada en el ‘acceso y habitabilidad’ podría convertir a La Habana en líder mundial en términos de sostenibilidad y movilidad urbana socialmente equitativa. ABSTRACT (ENGLISH): Economic reforms and moves towards ‘normalization’ of relations with the US have raised hopes for increasing car ownership in Cuba. But international experience provides plenty of evidence of the huge costs of private car dependency in cities. By learning from global trends in urban mobility, Havana can avoid mistakes and build on its unique strengths. A clear policy vision based on ‘access and liveability’ could enable Havana to become a leader in the world in terms of sustainable and socially equitable urban mobility

Differences in the signaling pathways of α1A- and α1B-adrenoceptors are related to different endosomal targeting

Aims: To compare the constitutive and agonist-dependent endosomal trafficking of α1A- and α1B-adrenoceptors (ARs) and to establish if the internalization pattern determines the signaling pathways of each subtype. Methods: Using CypHer5 technology and VSV-G epitope tagged α1A- and α1B-ARs stably and transiently expressed in HEK 293 cells, we analyzed by confocal microscopy the constitutive and agonist-induced internalization of each subtype, and the temporal relationship between agonist induced internalization and the increase in intracellular calcium (determined by FLUO-3 flouorescence), or the phosphorylation of ERK1/2 and p38 MAP kinases (determined by Western blot). Results and Conclusions: Constitutive as well as agonist-induced trafficking of α1A and α1B ARs maintain two different endosomal pools of receptors: one located close to the plasma membrane and the other deeper into the cytosol. Each subtype exhibited specific characteristics of internalization and distribution between these pools that determines their signaling pathways: α1A-ARs, when located in the plasma membrane, signal through calcium and ERK1/2 pathways but, when translocated to deeper endosomes, through a mechanism sensitive to β-arrestin and concanavalin A, continue signaling through ERK1/2 and also activate the p38 pathway. α1B-ARs signal through calcium and ERK1/2 only when located in the membrane and the signals disappear after endocytosis and by disruption of the membrane lipid rafts by methyl-β-cyclodextrin

The Contribution of Desert-Dwelling Bats to Pest Control in Hyper-Arid Date Agriculture

This is the final version. Available on open access from MDPI via the DOI in this recordData Availability Statement: Data is part of bigger unpublished data sets which will be available once published.Over 40% of the Earth’s surface has been converted to agricultural use and agroecosystems have become important habitats for wildlife. In arid regions, intensive agriculture creates artificial oasis-like habitats due to their high irrigation inputs. Date production is one of the primary agricultural practices in the deserts of the Middle East and North Africa. Insectivorous bats are known to use agricultural areas, but the role of date plantations as their foraging habits and the importance of insectivorous bats as date bio-pest control agents are still unknown. We assessed the role of date plantations as foraging habitats for local desert bat species by acoustically recording bat activity in conventional and organic date plantations in the southern Arava Valley, Israel. In addition, we captured bats in the plantations and collected feces for DNA metabarcoding analysis to investigate the presence of pest species in their diets. We found that 12 out of the 16 known species of bats in this region frequently used both conventional and organic date plantations as foraging habitats. Species richness was highest in the organic plantation with complex ground vegetation cover. Foraging activity was not affected by plantation type or management. However, bat species richness and activity increased in all plantations during summer date harvesting. Molecular analysis confirmed that bats feed on a variety of important date pests, but the particular pests consumed and the extent of consumption varied among bat species. Our results highlight a win–win situation, whereby date plantations are an important foraging habitat for desert bats, while bats provide bio-pest control services that benefit the date plantations. Therefore, date farmers interested in bio-pest control should manage their plantations to support local desert bat populations.CA in IsraelKKL-JNFIsrael Ministry of Agriculture and Rural Developmen

Post-colonoscopy colorectal cancer (PCCRC) rates vary considerably depending on the method used to calculate them: a retrospective observational population-based study of PCCRC in the English National Health Service

OBJECTIVE: Post-colonoscopy colorectal cancer (PCCRC) is a key quality indicator of colonoscopy. This study compares methods for defining PCCRC rates, proposes a new method of calculating them and quantifies them across the English National Health Service (NHS). DESIGN: This retrospective observational population-based study involved all individuals with a first primary diagnosis of colorectal cancer made between 2001 and 2010 and treated in the English NHS. Previously published methods for deriving PCCRC rates were applied to the linked routine health data for this population to investigate the effect on the rate. A new method, based on the year of the colonoscopy rather than colorectal cancer diagnosis, was then used to calculate PCCRC rates. RESULTS: Of 297 956 individuals diagnosed with colorectal cancer, a total of 94 648 underwent a colonoscopy in the 3 years prior to their diagnosis. The application of the published methods and exclusion criteria to the dataset produced significantly different PCCRC rates from 2.5% to 7.7%. The new method demonstrates that PCCRC rates within 3 years of colonoscopy (without exclusions) decreased in the English NHS over 8 years, falling from 10.6% to 7.3% for colonoscopies performed in 2001 and 2007 respectively. CONCLUSIONS: The method used to determine PCCRC rates significantly affects findings with potential to substantially underestimate rates. To enable international benchmarking there needs to be a standardised method for defining PCCRC. This study proposes a new methodology using colonoscopy as a denominator and between 2001 and 2007 this method indicated an 8.6% PCCRC rate across the English NHS. It also demonstrated PCCRC rates have fallen over time

Rising adiposity curbing decline in the incidence of myocardial infarction: 20-year follow-up of British men and women in the Whitehall II cohort

Aims To estimate the contribution of risk factor trends to 20-year declines in myocardial infarction (MI) incidence in British men and women. Methods and results From 1985 to 2004, 6379 men and 3074 women in the Whitehall II cohort were followed for incident MI and risk factor trends. Over 20 years, the age-sex-adjusted hazard of MI fell by 74% (95% confidence interval 48-87%), corresponding to an average annual decline of 6.5% (3.2-9.7%). Thirty-four per cent (20-76%) of the decline in MI hazard could be statistically explained by declining non-HDL cholesterol levels, followed by increased HDL cholesterol (17%, 10-32%), reduced systolic blood pressure (13%, 7-24%), and reduced cigarette smoking prevalence (6%, 2-14%). Increased fruit and vegetable consumption made a non-significant contribution of 7% (-1-20%). In combination, these five risk factors explained 56% (34-112%). Rising body mass index (BMI) was counterproductive, reducing the scale of the decline by 11% (5-23%) in isolation. The MI decline and the impact of the risk factors appeared similar for men and women. Conclusion In men and women, over half of the decline in MI risk could be accounted for by favourable risk factor time trends. The adverse role of BMI emphasizes the importance of addressing the rising population BMI

Temporal trends in mode, site and stage of presentation with the introduction of colorectal cancer screening: a decade of experience from the West of Scotland

background:  Population colorectal cancer screening programmes have been introduced to reduce cancer-specific mortality through the detection of early-stage disease. The present study aimed to examine the impact of screening introduction in the West of Scotland. methods:  Data on all patients with a diagnosis of colorectal cancer between January 2003 and December 2012 were extracted from a prospectively maintained regional audit database. Changes in mode, site and stage of presentation before, during and after screening introduction were examined. results:  In a population of 2.4 million, over a 10-year period, 14 487 incident cases of colorectal cancer were noted. Of these, 7827 (54%) were males and 7727 (53%) were socioeconomically deprived. In the postscreening era, 18% were diagnosed via the screening programme. There was a reduction in both emergency presentation (20% prescreening vs 13% postscreening, P0.001) and the proportion of rectal cancers (34% prescreening vs 31% pos-screening, P0.001) over the timeframe. Within non-metastatic disease, an increase in the proportion of stage I tumours at diagnosis was noted (17% prescreening vs 28% postscreening, P0.001). conclusions:  Within non-metastatic disease, a shift towards earlier stage at diagnosis has accompanied the introduction of a national screening programme. Such a change should lead to improved outcomes in patients with colorectal cancer

Relationship between Tibial conformation, cage size and advancement achieved in TTA procedure

Previous studies have suggested that there is a theoretical discrepancy between the cage size and the resultant tibial tuberosity advancement, with the cage size consistently providing less tibial tuberosity advancement than predicted. The purpose of this study was to test and quantify this in clinical cases. The hypothesis was that the advancement of the tibial tuberosity as measured by the widening of the proximal tibia at the tibial tuberosity level after a standard TTA, will be less than the cage sized used, with no particular cage size providing a relative smaller or higher under-advancement, and that the conformation of the proximal tibia will have an influence on the amount of advancement achieved