Efectividad de la implementación de la unidad "OPTITS exprés“ en la satisfacción de la población de Lleida

Introducción: Según la Organización Mundial de la Salud (OMS), cada día en el mundo, más de un millón de personas contraen una Infección de Transmisión Sexual (ITS). Si no se detectan precozmente, las consecuencias que estas infecciones pueden provocar son alarmantes, convirtiéndose en un problema de salud pública global, por su elevada incidencia y morbilidad. El método más eficaz para prevenir las ITS, es la prevención combinada de estrategias conductuales, biomédicas y estructurales con métodos primarios de prevención. Además, se ha demostrado que las pruebas rápidas de cribado contribuyen a la reducción de su prevalencia. Objetivo: Evaluar el impacto de la implementación de un circuito rápido para el abordaje de las ITS en el nivel de satisfacción de los usuarios atendidos en la Unidad “OPTITS exprés” en comparación con el nivel de satisfacción de los usuarios del servicio convencional mediante el cuestionario SERVPERF (Service Performance). Metodología: Estudio observacional en el que se comparan dos grupos: un grupo basal (servicio convencional) y un grupo intervención (servicio centralizado Unidad “OPTITS exprés), midiéndose en ambos el nivel de satisfacción del usuario. Se implementará la unidad en las consultas externas del HUAV, para centralizar la atención a la salud sexual y reproductiva de la población de Lleida. Esta unidad dispondrá de un equipo multidisciplinar y de los recursos necesarios para asegurar un acceso rápido y de calidad para el cribaje de las ITS. Conclusiones: Según los proyectos existentes, la implementación de un circuito rápido para el cribaje de las ITS permitirá agilizar la atención al usuario asegurando un diagnóstico rápido y tratamiento precoz, no solo de las personas afectadas, sino también de sus contactos, minimizando así la cadena de transmisión, previniendo nuevos casos y favoreciendo a la vez su pronóstico, pudiendo contribuir en la disminución de la incidencia de las ITS.Introducció: Segons la Organització Mundial de la Salut (OMS), cada dia en el món, més d’un milió de persones contreuen una Infecció de Transmissió Sexual (ITS). Si no es detecten precoçment, les conseqüències que aquestes infeccions poden provocar són alarmants, convertint-se en un problema de salut pública global, degut a la seva elevada incidència i morbiditat. El mètode més eficaç per prevenir les ITS, és la prevenció combinada d’estratègies conductuals, biomèdiques i estructurals amb mètodes primaris de prevenció. A més, s’ha demostrat que les proves ràpides de cribratge contribueixen a la reducció de la seva prevalença. Objectiu: Avaluar l’impacte de la implementació d’un circuit ràpid per l’abordatge de les ITS en el nivell de satisfacció dels usuaris atesos en la Unitat “OPTITS exprés” en comparació amb el nivell de satisfacció del servei convencional mitjançant el qüestionari SERVPERF (Service Performance). Metodologia: Estudi observacional en el que es compara dos grups: un grup basal (servei convencional) i un grup intervenció (servei centralitzat Unitat “OPTITS exprés”), mesurant-se en els dos el nivell de satisfacció de l’usuari. S’implementarà la unitat en les consultes externes de l’HUAV, per centralitzar l’atenció a la salut sexual i reproductiva de la població de Lleida. Aquesta unitat comptarà amb un equip multidisciplinari i amb els recursos necessaris per assegurar un accés ràpid i de qualitat per al cribratge de les ITS. Conclusions: Segons els projectes existents, la implementació d’un circuit ràpid per al cribratge de les ITS permetrà agilitzar l’atenció de l’usuari assegurant un diagnòstic ràpid i tractament precoç, no sols de les persones afectades, sinó també dels seus contactes, minimitzant així la cadena de transmissió, prevenint nous casos i afavorint també el seu pronòstic, contribuint en la disminució de la incidència de les ITS.Introduction: According to the World Health Organization (WHO), every day in the world, more than a million people contract a Sexually Transmitted Infection (STI). If they are not detected early, the consequences that these infections can cause are alarming, becoming a global public health problem, due to their high incidence and morbidity. The most effective method of preventing ITS, is the combined prevention of behavioural, biomedical, and structural strategies with primary prevention methods. Furthermore, rapid screening tests have been shown to help reduce its prevalence. Objective: Evaluate the impact of the implementation of a rapid circuit for addressing STIs on the satisfaction level of the users served in the “OPTITS Exprés Unit” compared to the level of satisfaction of the conventional services. Methods: Observational study in which two groups are compared: a basal group (conventional service) and an intervention group (centralized service “OPTITS Exprés Unit”) measuring in both the level of user satisfaction. The unit will be implemented in outpatient HUAV consultations, to centralize sexual and reproductive health care for the Lleida population. This unit will have a multidisciplinary team and the necessary resources to ensure a rapid and quality access for STIs screening. Conlusion: According to the existing projects, the implementation of a rapid circuit for the screening of STIs will speed up user care, ensuring rapid diagnosis and early treatment, not only of those affected, but also of their contacts. In this way, the chain of transmission will be minimised, preventing new cases and at the same time favouring their prognosis and being able to reduce the incidence of STIs

Investigating Demographic and Evolutionary Factors Important for Fish Reintroduction

Reintroduction programs are used to re-establish species back into their historical habitat. Most reintroduction programs have failed and few papers have evaluated factors that may be important to Pacific salmon. The 158 meter tall Cougar Dam has blocked Chinook salmon (Oncorhynchus tshawytscha) from accessing 40 kilometers of historical spawning and rearing habitat for over 50 years. Here, I evaluated a Chinook salmon trap and transport reintroduction program above Cougar Dam on the South Fork McKenzie River, Oregon from 2007 to 2015. First, I evaluated if release location and date correlated with two measures of fitness based on adult assignments to age-0 juveniles collected above the dam and adult offspring returning to the South Fork McKenzie River, respectively. I found that release location and date had little to no effect on either measure of fitness. I also evaluated if there were fitness differences between hatchery and natural origin (HOR and NOR, respectively) adults. I found consistent fitness differences between males (RRS=0.48, p<0.001), but not females (RRS=0.72, p=0.81). In addition, I found that origin (p=0.352) no longer explained variation in fitness after accounting for variation in fork-length, which suggests that HOR fish may be less fit, in part, because they are 2-4 cm (95% CI) smaller, or perhaps younger. I also evaluated a measure of population productivity known as cohort replacement rate (CRR) - defined as the number of future spawners produced by a spawner. Based on genetic parentage assignments to NOR adults returning to the trap and transport facility, hereafter Cougar Trap, I found that adults reintroduced in 2007 and 2008 did not meet demographic replacement (CRR: 0.40 and 0.31, respectively). I also found a seasonal decline in the proportion of NOR adults produced above the dam that returned to the Cougar Trap. I also developed grandparentage assignment methods to determine how many precocial males and adfluvial Chinook salmon, two non-anadromous life history tactics, contributed to population productivity. I found 31 unsampled precocial males, as well as 48 age-4 and -5 probable adfluvial male and female adults contributed to the reintroduced population. My discovery of adfluvial Chinook salmon contributing to population productivity is significant because little is known about this life history tactic, and they provide resiliency to a reintroduced population. I show that adfluvial adults can be produced by anadromous mate pairs. Adfluvial adults increased CRR estimates; however, neither the 2007 or 2008 cohorts met replacement after incorporating this non-anadromous life history tactic (CRR: 0.46 and 0.35, respectively). Finally, I assessed if genetic variation in founding cohorts was maintained in their returning adult offspring returning to the South Fork McKenzie River, hereafter F₁ offspring. On average, 6 alleles were lost per locus between founding cohorts and their F₁ offspring. N[subscript e] estimates were high using either demographic or genetic methods (range: 344 to 893). My dissertation research provides valuable information on factors that may be important to population productivity, as well as the maintenance of genetic variation in nascent populations established through reintroduction

Biomechanical role and motion contribution of ligaments and bony constraints in the elbow stability: A preliminary study

In flexion-extension motion, the interaction of several ligaments and bones characterizes the elbow joint stability. The aim of this preliminary study was to quantify the relative motion of ulna respect to humerus in two human elbow specimens and to investigate the constraints role for maintaining the joint stability in different dissections condition. Two clusters of 4 markers were fixed respectively to ulna and humerus, and their trajectory was recorded by a motion capture system during orthopedic maneuver. Considering the medial ulnar collateral posterior bundle (pMUCL) and the coronoid, two dissection sequences were executed. The orthopedic maneuver of compression, pronation and varus force was repeated at 30°, 60°, 90° flexion for the functional investigation of constraints. Ulna deflection was compared to a baseline flexion condition. Respect to intact elbow, the coronoid osteotomy influences the elbow stability at 90° (deflection=11.49±17.39 mm), while small differences occur at 30° and 60°, due to ligaments constraint. The contemporary pMUCL dissection and coronoid osteotomy causes elbow instability, with large deflection at 30° (deflection=34.40±9.10 mm), 60° (deflection=45.41±18.47 mm) and 90° (deflection=52.16±21.92 mm). Surgeons may consider the pMUCL reconstruction in case of unfixable coronoid fracture

Penrose type inequalities for asymptotically hyperbolic graphs

In this paper we study asymptotically hyperbolic manifolds given as graphs of asymptotically constant functions over hyperbolic space \bH^n. The graphs are considered as subsets of \bH^{n+1} and carry the induced metric. For such manifolds the scalar curvature appears in the divergence of a 1-form involving the integrand for the asymptotically hyperbolic mass. Integrating this divergence we estimate the mass by an integral over an inner boundary. In case the inner boundary satisfies a convexity condition this can in turn be estimated in terms of the area of the inner boundary. The resulting estimates are similar to the conjectured Penrose inequality for asymptotically hyperbolic manifolds. The work presented here is inspired by Lam's article concerning the asymptotically Euclidean case.Comment: 29 pages, no figure, includes a proof of the equality cas

Factors influencing spawner success in a spring Chinook salmon (Oncorhynchus tshawytscha) reintroduction program

Dams have contributed to the decline of migratory fishes by blocking access to historical habitat. The active transport (trap and haul) of migratory fish species above existing dams can sometimes support population recovery when the use of fish ladders or dam removal is infeasible. However, little is known about the efficacy of trap and haul conservation strategies. Here we used genetic parentage assignments to evaluate the efficacy of reintroducing adult Chinook salmon above Cougar Dam on the South Fork McKenzie River, Oregon, USA from 2008-2011. We found that mean reproductive success (RS) declined as adults were released later in the spawning season in 2009 and 2010; however release location did not affect RS. In 2010 and 2011, we tested for RS differences between hatchery and natural origin (HOR and NOR) adults. HOR males were consistently less fit than NOR males, but little evidence for fitness differences was apparent between HOR and NOR females. Interestingly, the effect of origin on RS was not significant after accounting for variation explained by body length. Our results indicate that release date and location have inconsistent or no effect on the reproductive success of reintroduced adults when active transport strategies are employed for migratory fishes.This is an author's peer-reviewed final manuscript, as accepted by the publisher. The published article is copyrighted by Canadian Science Publishing, NRC Research Press and can be found at: http://www.nrcresearchpress.com/doi/10.1139/cjfas-2015-0007#.VuHGB3rci0jKeywords: hatchery and natural origin, reproductive success, genetic parentage, reintroduction, active transportKeywords: hatchery and natural origin, reproductive success, genetic parentage, reintroduction, active transpor

REMOVABLE SETS FOR LIPSCHITZ HARMONIC FUNCTIONS ON CARNOT GROUPS

Abstract. Let G be a Carnot group with homogeneous dimension Q ≥ 3 and let L be a sub-Laplacian on G. We prove that the critical dimension for removable sets of Lipschitz L-harmonic functions is (Q − 1). Moreover we construct self-similar sets with positive and finite H Q−1 measure which are removable. 1

Role of the first WHO mutation catalogue in the diagnosis of antibiotic resistance in Mycobacterium tuberculosis in the Valencia Region, Spain: a retrospective genomic analysis

9 páginas, 2 figuras, 1 tablaBackground: In June, 2021, WHO published the most complete catalogue to date of resistance-conferring mutations in Mycobacterium tuberculosis. Here, we aimed to assess the performance of genome-based antimicrobial resistance prediction using the catalogue and its potential for improving diagnostics in a real low-burden setting. Methods: In this retrospective population-based genomic study M tuberculosis isolates were collected from 25 clinical laboratories in the low-burden setting of the Valencia Region, Spain. Culture-positive tuberculosis cases reported by regional public health authorities between Jan 1, 2014, and Dec 31, 2016, were included. The drug resistance profiles of these isolates were predicted by the genomic identification, via whole-genome sequencing (WGS), of the high-confidence resistance-causing variants included in the catalogue and compared with the phenotype. We determined the minimum inhibitory concentration (MIC) of the isolates with discordant resistance profiles using the resazurin microtitre assay. Findings: WGS was performed on 785 M tuberculosis complex culture-positive isolates, and the WGS resistance prediction sensitivities were: 85·4% (95% CI 70·8–94·4) for isoniazid, 73·3% (44·9–92·2) for rifampicin, 50·0% (21·1–78·9) for ethambutol, and 57·1% (34·0–78·2) for pyrazinamide; all specificities were more than 99·6%. Sensitivity values were lower than previously reported, but the overall pan-susceptibility accuracy was 96·4%. Genotypic analysis revealed that four phenotypically susceptible isolates carried mutations (rpoB Leu430Pro and rpoB Ile491Phe for rifampicin and fabG1 Leu203Leu for isoniazid) known to give borderline resistance in standard phenotypic tests. Additionally, we identified three putative resistance-associated mutations (inhA Ser94Ala, katG Leu48Pro, and katG Gly273Arg for isoniazid) in samples with substantially higher MICs than those of susceptible isolates. Combining both genomic and phenotypic data, in accordance with the WHO diagnostic guidelines, we could detect two new multidrug-resistant cases. Additionally, we detected 11 (1·6%) of 706 isolates to be monoresistant to fluoroquinolone, which had been previously undetected. Interpretation: We showed that the WHO catalogue enables the detection of resistant cases missed in phenotypic testing in a low-burden region, thus allowing for better patient-tailored treatment. We also identified mutations not included in the catalogue, relevant at the local level. Evidence from this study, together with future updates of the catalogue, will probably lead in the future to the partial replacement of culture testing with WGS-based drug susceptibility testing in our setting. Funding: European Research Council and the Spanish Ministerio de Ciencia.This project received funding from the European Research Council under the European Union’s Horizon 2020 Research and Innovation Program Grant 101001038 (TB-RECONNECT; awarded to IC), from Ministerio de Ciencia (Spanish Government) Project PID2019-104477RB-I00 (awarded to IC), and from Generalitat Valenciana Project AICO/2018/113 (awarded to IC). AMG-M is funded by a Formación deProfesorado Universitario grant programme (FPU19/04562) from Ministerio de Universidades (Spanish Government). IC is also supported by the European Commission–NextGenerationEU, through Centro Superior de Investigaciones Científicas Global Health Platform (PTI Salud Global). We thank all the members of the Valencia RegionTuberculosis Working Group

The Mars Environmental Dynamics Analyzer, MEDA. A Suite of Environmental Sensors for the Mars 2020 Mission

86 pags., 49 figs., 24 tabs.NASA’s Mars 2020 (M2020) rover mission includes a suite of sensors to monitor current environmental conditions near the surface of Mars and to constrain bulk aerosol properties from changes in atmospheric radiation at the surface. The Mars Environmental Dynamics Analyzer (MEDA) consists of a set of meteorological sensors including wind sensor, a barometer, a relative humidity sensor, a set of 5 thermocouples to measure atmospheric temperature at ∼1.5 m and ∼0.5 m above the surface, a set of thermopiles to characterize the thermal IR brightness temperatures of the surface and the lower atmosphere. MEDA adds a radiation and dust sensor to monitor the optical atmospheric properties that can be used to infer bulk aerosol physical properties such as particle size distribution, non-sphericity, and concentration. The MEDA package and its scientific purpose are described in this document as well as how it responded to the calibration tests and how it helps prepare for the human exploration of Mars. A comparison is also presented to previous environmental monitoring payloads landed on Mars on the Viking, Pathfinder, Phoenix, MSL, and InSight spacecraft.This work has been funded by the Spanish Ministry of Economy and Competitiveness, through the projects No. ESP2014-54256-C4-1-R (also -2-R, -3-R and -4-R) and AYA2015-65041-P; Ministry of Science, Innovation and Universities, projects No. ESP2016-79612-C3-1-R (also -2-R and -3-R), ESP2016-80320-C2-1-R, RTI2018-098728-B-C31 (also -C32 and -C33) and RTI2018-099825-B-C31; Instituto Nacional de Técnica Aeroespacial; Ministry of Science and Innovation’s Centre for the Development of Industrial Technology; Grupos Gobierno Vasco IT1366-19; and European Research Council Consolidator Grant no 818602. The US co-authors performed their work under sponsorship from NASA’s Mars 2020 project, from the Game Changing Development program within the Space Technology Mission Directorate and from the Human Exploration and Operations Directorate