Myopic PPPs: Risk allocation and hidden liabilities for taxpayers and users

Drawing on evidence from three case studies, we show how the State's Financial Liability has worked in assigning risk in large PPP contracts in Spain. Project failure and the concessionaires' bankruptcy have resulted in the government having to assume heavy financial obligations, which have ultimately been absorbed by taxpayers and users. In contrast, Spain's leading construction companies, which were also major investors in the concessionaires, have been able to minimize their risk. Myopic PPPs have been entered into based on the transference of liabilities to taxpayers and users, and the, consequent, minimization of risks for the main private investors

Evaluación cualitativa del programa comunitario Irunsasoi para la promoción de la actividad física: la perspectiva de los médicos

Objectives: The sedentarism is an important conditioner of morbidity and mortality. The communitarian programs of promotion of physical activity that include a pursuit protocol can help and complement to the medical advice in the consultation. The objectives that we marked ourselves with this study have been to know the opinion the doctors on the prescription of physical activity and the implantation of the Irunsasoi program, collaboration between the doctors of Primary Attention and the technicians of physical activity of the council of Irún City to help the sedentary people. Methodology Design: Technique of focal groups. The discussions were recorded and later transcribed, previous authorization, for their analysis. Location: Primary attention. Irún Centro health Center. Subjects: The study population was the 15 doctors of AP. Two groups of 5 doctors, homogenous were made in age and sex, the recruitment was made, the invitation at random to participate was verbal by the investigator without no refusal took place. Measures: The discussion lines were grouped in: attitude before the advice and participation in the program, difficulties of collaboration and proposals of improvement. Results: Positive evaluation of the program to have enabled personnel, sufficient time and guarantees of pursuit. The collaboration difficulties are based on the forgetfulness not to have it built-in to our mechanics of work and to wort in other activities by lack of time. Conclusions: He is positive to work jointly with the technicians of physical activity. Aspects to improve: the formation in prescription of physical activity, the implication of nurses, the circuit of communication and the support in computerized historyObjetivos: El sedentarismo es un importante condicionante de morbilidad y mortalidad. Los programas comunitarios de promoción de actividad física que incluyan un protocolo de seguimiento pueden ayudar y complementar al consejo médico en la consulta. Los objetivos que nos marcamos con este estudio han sido conocer la opinión de los médicos sobre la prescripción de actividad física y sobre la implantación del programa Irunsasoi, de colaboración entre los médicos de Atención Primaria y los técnicos de actividad física del Ayuntamiento de Irún para ayudar a las personas sedentarias. Metodología: Diseño: Técnica de grupos focales. Las discusiones fueron grabadas y posteriormente transcritas, previa autorización, para su análisis. Emplazamiento: Atención primaria. Centro de salud Irún Centro. Sujetos: La población de estudio fueron los 15 médicos de AP. Se realizaron dos grupos de 5 médicos, homogéneos en edad y sexo, el reclutamiento se realizó al azar, la invitación a participar fue verbal por el investigador sin que se produjera ninguna negativa. Medidas: Los ejes de discusión se agruparon en: actitud ante el consejo y participación en el programa, dificultades de colaboración y propuestas de mejora. Resultados: Valoración positiva del programa por disponer de personal capacitado, tiempo suficiente y garantías de seguimiento. Las dificultades de colaboración se basan en el olvido por no tenerlo incorporado a nuestra mecánica de trabajo y priorización de otras actividades por falta de tiempo. Conclusiones: Es positivo trabajar conjuntamente con los técnicos de actividad física. Aspectos a mejorar: la formación en prescripción de actividad física, la implicación de enfermería, el circuito de comunicación y el soporte en la historia informatizad

Metastatic non-small-cell lung cancer: consensus on pathology and molecular tests, first-line, second-line, and third-line therapy: 1st ESMO Consensus Conference in Lung Cancer; Lugano 2010

The 1st ESMO Consensus Conference on lung cancer was held in Lugano, Switzerland on 21 and 22 May 2010 with the participation of a multidisciplinary panel of leading professionals in pathology and molecular diagnostics, medical oncology, surgical oncology and radiation oncology. Before the conference, the expert panel prepared clinically relevant questions concerning five areas: early and locally advanced non-small-cell lung cancer (NSCLC), first-line metastatic NSCLC, second-/third-line NSCLC, NSCLC pathology and molecular testing, and small-cell lung cancer to be addressed through discussion at the Consensus Conference. All relevant scientific literature for each question was reviewed in advance. During the Consensus Conference, the panel developed recommendations for each specific question. The consensus agreement on three of these areas: NSCLC pathology and molecular testing, the treatment of first-line, and second-line/third-line therapy in metastatic NSCLC are reported in this article. The recommendations detailed here are based on an expert consensus after careful review of published data. All participants have approved this final updat

Candil de calle... y de la casa

Estudio sobre los Premios Nacionales otorgados por el estado mexicano durante el periodo 1945-1984. Se analiza la lista de premiados según la entidad federativa de nacimiento, lo que revela las desigualdades de la sociedad mexicana. Se presentan bioviñetas de los 16 jaliscienses premiados durante ese periodo: José Clemente Orozco, Mariano Azuela, Gerardo Murillo "Dr. Atl", Blas Galindo, Roberto Montenegro, Jorge González Camarena, Juan Rulfo, Antonio González Ochoa, Agustín Yáñez, Luis Barragán, Antonio Gómez Robledo, Juan José Arreola, José Luis Martínez, Carlos Orozco Romero, Elías Nandino y Manuel Enríquez.ITESO, A.C

Reduction of motion artifacts using a two-frequency impedance plethysmograph and adaptative filtering

We measured transthoracic impedance in nine presumed healthy adult subjects with a two-frequency plethysmograph at 57 kHz and 185 kHz. The measurement protocol included periods of normal breathing without motion and periods of motion without breathing. We analyzed the cross-correlation and the ratio between the signals at both frequencies for all the different maneuvers. The correlation coefficient was between 0.97 and 1 for breathing, the minimal cross-correlation (0.81) was for simulated obstructive apnea. We found that the amplitude ratio between the two-frequency signals was different for normal breathing and for motion. Based on these results, we designed and tested an adaptive filter to increase the signal-to-artifact ratio (SAR). The increase in SAR(mean ± standard deviation) compared with the signal at 57 Miz was: 183% ± 117% for arm movement, 133% ± 93% for leg movement, and 34% ± 62% for simulated obstructive apnea.Peer Reviewe

The Smc5/6 complex is required for dissolution of DNA-mediated sister chromatid linkages

Mitotic chromosome segregation requires the removal of physical connections between sister chromatids. In addition to cohesin and topological entrapments, sister chromatid separation can be prevented by the presence of chromosome junctions or ongoing DNA replication. We will collectively refer to them as DNA-mediated linkages. Although this type of structures has been documented in different DNA replication and repair mutants, there is no known essential mechanism ensuring their timely removal before mitosis. Here, we show that the dissolution of these connections is an active process that requires the Smc5/6 complex, together with Mms21, its associated SUMO-ligase. Failure to remove DNA-mediated linkages causes gross chromosome missegregation in anaphase. Moreover, we show that Smc5/6 is capable to dissolve them in metaphase-arrested cells, thus restoring chromosome resolution and segregation. We propose that Smc5/6 has an essential role in the removal of DNA-mediated linkages to prevent chromosome missegregation and aneuploidy

Evaluation of ethyl tert-butyl ether biodegradation in a contaminated aquifer by compound specific isotope analysis and in situ microcosms

Ethyl tert-butyl ether (ETBE) is an upcoming groundwater pollutant in Europe whose environmental fate has been less investigated thus far. In the present study, we investigated the in situ biodegradation of ETBE in a fuel-contaminated aquifer using compound-specific stable isotope analysis (CSIA) and in situ microcosms in combination with total lipid fatty acid (TLFA)-stable isotope probing (SIP). In a first field investigation, CSIA revealed no significant carbon isotope fractionation but low hydrogen isotope fractionation of up to +14 ¿ along the prevailing anoxic ETBE plume suggesting biodegradation of ETBE. Ten months later, oxygen injection was conducted to enhance the biodegradation of petroleum hydrocarbons (PH) at the field site. Within the framework of this remediation measure, in situ microcosms loaded with [13C6]-ETBE (BACTRAP®s) were exposed for 119 days in selected groundwater wells to assess the biodegradation of ETBE by TLFA-SIP under the following conditions: (i) ETBE as main contaminant; (ii) ETBE as main contaminant subjected to oxygen injection; (iii) ETBE plus other PH; (iv) ETBE plus other PH subjected to oxygen injection. Under all conditions investigated, significant 13C-incorporation into microbial total lipid fatty acids extracted from the in situ microcosms was found, providing clear evidence of ETBE biodegradation