Immigrants' membership in civic associations: why are some immigrants more active than others

This study focuses on the level of membership in associations of the migrant population in Spain. Three types of civic engagement are considered: participation in all types of civic associations, in associations for immigrants and in non-immigrant associations. The article investigates whether immigrants coming from countries with higher levels of civic participation are more likely to participate in civic associations and if immigrants who have lived longer in and stayed in closer contact with a home country with a higher level of civic participation are more likely to join civic associations. Data used come from the Spanish National Immigrant Survey (2007) and the World Values Survey (2000, 2005). The results of multilevel logistic regressions show that immigrants who have spent more time in a more participatory context at origin and who are in closer contact with these societies are more likely to get involved in civic associations at destination. (author's abstract

Suiza: un paraíso verde al pie de los Alpes

En este trabajo se trata de caracterizar y explicar el turismo de naturaleza en Suiza, pero también de plantear propuestas y acciones para un mejor desarrollo turístico o, por qué no, para el desarrollo de un turismo sostenible. Suiza es un país que goza de recursos naturales y recibe muchísimos turistas a lo largo del año. También tiene fama de tener instituciones competentes al cargo del desarrollo turístico. En el primer capítulo se realizan una introducción y una justificación que tienen como propósito dejar claro el formato del trabajo y todo lo que va a contener. En el segundo capítulo se aplica la metodología a seguir mediante los objetivos, las preguntas y las técnicas de investigación. Esto ayuda a diseñar las propuestas de desarrollo turístico. En el tercer capítulo se define el concepto de turismo natural y sus tipologías además de su demanda, oferta y los agentes implicados. También se presenta una breve descripción del país. El análisis de caso se desarrolla en el cuarto capítulo y se realiza a nivel internacional, nacional y regional. También se realiza en este capítulo un análisis de los recursos naturales significativos de Suiza. Se añade a este análisis de recursos los espacios naturales protegidos. Para finalizar el capítulo se examina la imagen de destino y su promoción y se realiza un análisis DAFO. En el último capítulo se explica la propuesta de desarrollo. Para esto se realiza un folleto turístico que ilustra una de las mejores maneras para disfrutar del turismo de naturaleza, el viaje en tren. Se explica todo el formato del folleto y las herramientas utilizadas para su realización. Por último, se sacan las conclusiones generales de todo el trabajo y se citan las referencias bibliográficas.Grado en Turism

Recovering the past for resilient communities: territorial identity, cultural landscape and symbolic places in Năsăud town, Romania

By exploring inhabitants’ perceptions of territorial identity in the Land of Năsăud (partly overlapping the former Military Frontier District of Năsăud), Romania, and the present practices building symbolic places, cultural landscapes, community spirit and togetherness in Năsăud town, its polarising centre, we discuss the relevance of recovering the past for building a resilient community. For collecting research data on locals’ perceptions, we administered a questionnaire survey and employed a qualitative analysis of the information, while on place symbols, and events organised related to the Military Frontier District history and heritage, we collected data from the local mass media and through field trips investigating the cultural landscape. Our findings include facts and locals’ perceptions about their history, features of their community (discourse and symbolic places), the most recent local initiatives and events recreating a landscape of feeling. Despite running the risk of romanticising a place and a period, one cannot ignore the impact of shaping a certain cultural landscape and discourse on community’s self-defining process and future prospects. The roles of culture and community spirit are very strong in empowering and building the confidence of the communities in the present Land of Năsăud, as proved by the perceptions, initiatives, and events in the town of Năsăud.Bei der Untersuchung der Wahrnehmungen der Bewohner zur territorialen Identität im Land Năsăud (Rumänien) (teilweise überlappend mit dem ehemaligen Militärgrenzbezirk Năsăud), und der gegenwärtigen Praxis des Aufbaus symbolischer Orte, von Kulturlandschaften, Gemeinschaftsgeist und Zusammengehörigkeit in der Stadt Năsăud, seinem polarisierenden Zentrum, sprechen wir über die Bedeutung des Wiedergewinnens der Vergangenheit zum Aufbau einer anpassungsfähigen, belastbaren Gemeinschaft. Zur Erhebung von Forschungsdaten über die Wahrnehmungen der Einheimischen haben wir eine Umfrage durchgeführt und eine qualitative Analyse der Informationen vorgenommen, während wir bei Ortssymbolen und Veranstaltungen, die sich auf die Geschichte und die Vergangenheit des militärischen Grenzbezirks beziehen, Daten aus den lokalen Massenmedien erhoben und bei Exkursionen die Kulturlandschaft untersucht haben. Unsere Befunde umfassen Fakten und Wahrnehmungen der Einheimischen über ihre Geschichte, Merkmale ihrer Gemeinschaft (Diskurs und symbolische Orte), die jüngsten lokalen Initiativen und Veranstaltungen zur Wiederherstellung einer Gefühlslandschaft. Obwohl die Gefahr besteht, Orte und alte Zeiten zu romantisieren, kann man die Auswirkungen der Gestaltung einer bestimmten Kulturlandschaft und der Diskussion auf den Selbstbestimmungsprozess und die Zukunftsperspektiven der Gemeinschaft nicht ignorieren. Die Rolle, die die Kultur und der Gemeinschaftsgeist für die Stärkung der Identität und den Aufbau von Vertrauen der Gemeinschaften im heutigen Land Năsăud spielen, ist sehr bedeutend. Dies zeigen die Eindrücke, Initiativen und Veranstaltungen in der Stadt Năsăud

Development of some Models for Assessment the Dynamic Migration Processes of Phosphates in Soil Columns

Due to complexity of phosphate (P) migration in soil columns, the problem of theoretical approach of modeling the process is specially difficult. So, numerous semiempirical models based on admission of simplifying assumptions were developed, some of them being apart from the real phenomenon. In this paper are presented the breakthrough curves, the phosphate (P) usage degree in soil, based on a dynamic study, realised in order to determine phosphate sorption rate on the granules of two soil types (cambic chernozem and psamosoil) from Romania. Due to random character of the process, which is influenced by many naturally variable factors, this can be addressed from stochastic point of view. Experimental data regarding phosphate migration in soil column evolution process are represented like curves with sigmoid profile. Based on this observation, Rosin- Rammler and Schuhman sigmoid profile curves, known models and logistic type equations were used as simulation models representing phosphate transport and sorption kinetics for laboratory experiments in columns. Testing the models with the experimental data resulted with the conclusion that the most appropriate models describing the process of phosphate migration in soil columns are Rosin-Rammler and logistic type equation, C = 1-exp(-btn) and C = [1+exp(α+βt)]-1, (C – relative concentration; t – time; b, n, α, β - constant coefficients determined from experimental data by non-linear regression) for which the correlation coefficient is R2 ≥ 0.983 for both types of soil

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

The COVID-19 pandemic and refugees. A scoping review

Refugees increasingly become part of the European societies. Afghans, Syrians, Ukrainians fled their countries due to war, conflicts, persecution, and settled, temporary or not, in more stable countries. During pandemics, with openness towards foreigners shrinking, and borders closing, the situation of refugees might become uncertain. Our scoping review explores what academics considered relevant about refugees to Europe in relation to the COVID-19 pandemic. The findings reveal increasing resentment against immigrants, a need for redesigning European migration policies, preparing welfare systems, asylum protection mechanisms, and societies as a whole, in order to prevent disruptions in the eventuality of large-scale crises. Such implications are to also be considered for the consequences of the current Russian aggression on Ukraine

Short Tandem Repeats as a High-Resolution Marker for Capturing Recent Orangutan Population Evolution

The genus Pongo is ideal to study population genetics adaptation, given its remarkable phenotypic divergence and the highly contrasting environmental conditions it’s been exposed to. Studying its genetic variation bears the promise to reveal a motion picture of these great apes’ evolutionary and adaptive history, and also helps us expand our knowledge of the patterns of adaptation and evolution. In this work, we advance the understanding of the genetic variation among wild orangutans through a genome-wide study of short tandem repeats (STRs). Their elevated mutation rate makes STRs ideal markers for the study of recent evolution within a given population. Current technological and algorithmic advances have rendered their sequencing and discovery more accurate, therefore their potential can be finally leveraged in population genetics studies. To study patterns of population variation within the wild orangutan population, we genotyped the short tandem repeats in a population of 21 individuals spanning four Sumatran and Bornean (sub-) species and eight Southeast Asian regions. We studied the impact of sequencing depth on our ability to genotype STRs and found that the STR copy number changes function as a powerful marker, correctly capturing the demographic history of these populations, even the divergences as recent as 10 Kya. Moreover, gene ontology enrichments for genes close to STR variants are aligned with local adaptations in the two islands. Coupled with more advanced STR-compatible population models, and selection tests, genomic studies based on STRs will be able to reduce the gap caused by the missing heritability for species with recent adaptations