A time series analysis of the relationship between apparent temperature, air pollutants and ischemic stroke in Madrid, Spain

The understanding of the role of environment on the pathogenesis of stroke is gaining importance in the context of climate change. This study analyzes the temporal pattern of ischemic stroke (IS) in Madrid, Spain, during a 13-year period (2001-2013), and the relationship between ischemic stroke (admissions and deaths) incidence and environmental factors on a daily scale by using a quasi-Poisson regression model. To assess potential delayed and non-linear effects of air pollutants and Apparent Temperature (AT), a biometeorological index which represents human thermal comfort on IS, a lag non-linear model was fitted in a generalized additive model. The mortality rate followed a downward trend over the studied period, however admission rates progressively increased. Our results show that both increases and decreases in AT had a marked relationship with IS deaths, while hospital admissions were only associated with low AT. When analyzing the cumulative effects (for lag 0-14 days), with an AT of 1.7?°C (percentile 5%) a RR of 1.20 (95% CI, 1.05-1.37) for IS mortality and a RR of 1.09 (95% CI, 0.91-1.29) for morbidity is estimated. Concerning gender differences, men show higher risks of mortality in low temperatures and women in high temperatures. No significant relationship was found between air pollutant concentrations and IS morbi-mortality, but this result must be interpreted with caution, since there are strong spatial fluctuations of the former between nearby geographical areas that make it difficult to perform correlation analyses

Teriflunomide-induced Raynaud's phenomenon: a serious adverse event, previously unreported

Teriflunomide, sold under the brand name Aubagio®, is an immunomodulatory drug inhibiting pyrimidine de novo synthesis by blocking the enzyme dihydroorotate dehydrogenase. It has been approved by the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for the treatment of patients with remitting relapsing multiple sclerosis (rrMS) (1). This drug exhibits a favourable safety profile and is well tolerated by most patients (2). Most common adverse events include hair thinning, mild lymphocytopenia and headache (2). We report the first case of teriflunomide-associated Raynau's phenomeno

Forensic implications of the presence of chimerism after hematopoietic stem cell transplantation

Biological vestiges are used in forensic science to resolve a large number of cases by typing the genetic profile and identifying the individual to whom it belongs. However, chimeric persons that possess cells with two or more different DNA make these types of analyses difficult. This situation can occur naturally, by errors in the fertilization or early embryogenesis, or in an artificial way, for example after hematopoietic stem cell transplantation (HSCT), when host and donor cells coexist in the patient. In this paper, we will specially focus on the latter. The vestiges from transplant patients represent a challenge from a forensic perspective since the interpretation of the genetic fingerprint can be misleading because of the presence of chimerism. Due to the high number of transplant patients (and their increase over the years) and the existence of natural chimeras (probably many of them hidden), it is necessary to consider whether we are facing a possible chimeric person or someone who has been a donor of hematopoietic stem cells in a forensic context. In this review, the presence of donor bone marrow derived cells in some tissues of forensic interest will be discussed. Finally, to emphasize the importance of chimerism after HSCT in forensic genetics, some real-life cases will be examined

Epigenetic related changes on air quality

The exposure to airborne particulate matter (PM) increases the risk of developing human diseases. Epigenetic mechanisms have been related to environmental exposures and human diseases. The present review is focused on current available studies, which show the relationship between epigenetic marks, exposure to air pollution and human's health. Air contaminants involved in epigenetic changes have been related to different specific mechanisms (DNA methylation, post-translational histone modifications and non-coding RNA transcripts), which are described in separate sections. Several studies describe how these epigenetic mechanisms are influenced by environmental factors including air pollution. This interaction between PM and epigenetic factors results in an altered profile of these marks, in both, globally and locus specific. Following this connection, specific epigenetic marks can be used as biomarkers, as well as, to find new therapeutic targets. For this purpose, some significant characteristics have been highlighted, such as, the spatiotemporal specificity of these marks, the relevance of the collected tissue and the specific changes stability. Air pollution has been related to a higher mortality rate due to non-accidental deaths. This exposure to particulate matter induces changes to the epigenome, which are increasing the susceptibility of human diseases. In conclusion, as several epigenetic change mechanisms remain unclear yet, further analyses derived from PM exposure must be performed to find new targets and disease biomarkers

Scrutinizing the profile and risk factors of suicide: a perspective from a case–control study focused on a northern region of Spain

Suicide is a major public health problem the prevention of which has become a priority, and, to this end, knowledge of its risk factors is essential. This study aims to evaluate the impact of some social, medico-legal, and clinical issues on suicide deaths. A total of 135 cases were identified as suicides that occurred in a region of northern Spain between 2018 and 2020. Controls (three for each case) were matched by age, sex, and urban-rural areas. The information was collected retrospectively through electronic health record systems. A binary logistic regression analysis was performed to study the association between individual risk factors and suicide. Being male (78.5%), between 40 and 60 years of age, unmarried (70.9%), and unemployed (85%) were associated with suicide deaths. Although the existence of a previous self-harm attempt is presented as the most robust risk factor (OR 22.121 [8.997-54.389]), the presence of a psychiatric diagnosis (OR 12.583 [7.686-20.601]) and cancer (OR 3.729 [1.845-7.536]) also showed a significant relationship with suicide (p < 0.05). Defining and knowing the risk factors for suicide helps to better understand the profiles of those individuals who are vulnerable, and enables prevention actions to be taken in both social and medical spheres.Funding: This work was partially supported by the Government of Cantabria (CONTRATO PROGRAMA GOB. CANTABRIA-UC)

Work accidents, climate change and COVID-19

The effects brought by climate change and the pandemic uponworker health and wellbeing are varied and necessitate the identification and implementation of improved strategic interventions. This review aims, firstly, to assess how climate change affects occupational accidents, focusing on the impacts of extreme air temperatures and natural disasters; and, secondly, to analyze the role of the pandemic in this context. Our results show that the manifestations of climate change affect workers physically while on the job, psychologically, and by modifying the work environment and conditions; all these factors can cause stress, in turn increasing the risk of suffering a work accident. There is no consensus on the impact of the COVID-19 pandemic on work accidents; however, an increase in adverse mental effects on workers in contact with the public (specifically in healthcare) has been described. It has also been shown that this strain affects the risk of suffering an accident. During the pandemic, many people began to work remotely, and what initially appeared to be a provisional situation has been made permanent or semi-permanent in some positions and companies. However, we found no studies evaluating the working conditions of those who telework. In relation to the combined impact of climate change and the pandemic on occupational health, only publications focusing on the synergistic effect of heat due to the obligation to wear COVID-19-specific PPE, either outdoors or in poorly acclimatized indoor environments, were found. It is essential that preventive services establish newmeasures, trainworkers, and determine newpriorities for adapting working conditions to these altered circumstances.This work is sponsored by the Fulbright Program and the Spanish Ministry of Education under the José Castillejo International Mobility Program [Grant Number CAS21/00179

Business internationalisation in the basque country, does public financing influence in the results?

Currently, almost all the territories consider the internationalisation of their enterprises as a key enabler to realize their competitiveness, welfare and regional development. However, so far, very few studies have been conducted that analyze the relationship between the internationalisation aids and the degree of internationalisation achieved by a territory. Thus, the objective of this research paper is to analyze the relationships between the internationalisation indicators and the budget expenditure devoted to internationalisation by Basque government. This requires definition of the indicators for assessing the internationalisation, which have been obtained from the Plan for Business Competitiveness 2010-2013 and the Plan for Business Internationalisation 2014-2016 elaborated by Basque Government. Moreover, in order to carry out the research study, the necessary data has been obtained from different Basque and Spanish institutions. After obtaining the data, the estimation method used has been a bivariate correlation analysis that has helped to achieve the target set in the investigation. Results shows that there is a positive relationship between the expenditure on business internationalisation and the main indicators studied, but the same is not true, however, for the degree of openness of the economy and the investment relations with foreign countries. The article provides new information on how the government of a small region, such as the Basque Country, perform in relation to the internationalisation policies

Implementation of a Linked Open Data Solution for the Statistics Agency of Cantabria's Metadata and Data Bank

Statistics is a fundamental piece inside the Open Government philosophy, being a basic tool for citizens to know and make informed decisions about the society in which they participate. Due to the great number of organizations and agencies that collect, process and publish statistical data all over the world, several standards and methodologies for information exchange have been created in recent years in order to improve interoperability between data producers and consumers, of which SDMX is one of the most renowned examples. Despite having been developed independently of this, the global Semantic Web effort (backed mainly by the W3C-driven Linked Open Data initiatives) presents itself as an extremely useful tool for publishing both completely contextualized metadata and data, therefore making them easily understandable and processable by third parties. This report details the changes made to the IT systems of the Statistical Agency of Cantabria (Instituto Cántabro de Estadística, ICANE) with the purpose of implementing a Linked Open Data solution for its website and statistical data bank, making all data and metadata published by this Agency available not only to humans, but to automatized consumers, too. Multiple standards, recommendations and vocabularies were used for this task, ranging from Dublin Core metadata RDFa tagging, through the creation of several SKOS concept schemes, to providing statistical data using the RDF Data Cube vocabulary

Noise disturbance and well-being in the north of Spain

Environmental noise is considered one of the main risks for physical and mental health and well-being, with a significant associated burden of disease in Europe. This work aims to explore the main sources of noise exposure at home and its effect on well-being in northern Spain. A transversal opinion study has been performed through a closed questionnaire. The questionnaire included three different parts: sociodemographic data, noise disturbance, and the 5-item World Health Organization Well-Being Index (WHO-5). A Binary Logistics Regression model was performed to analyze the relationship between noise exposure and well-being. Overall, 16.6% of the participants consider that the noise isolation of their homes is bad or very bad. The noise generated by the neighbors (air and impact noise) is considered the most disturbing indoor noise source, while street works are the most disturbing outdoor noise source in urban areas and road traffic is the most disturbing in rural areas. People who indicate that noise interferes with their life at home have a worse score on the WHO-5 (decreased perception of well-being). The exposure to outdoor noise (specifically the noise coming from the street and trains), internal impact noise produced by neighbors, and in general, the noise that wakes you up, is related to receiving a worse score in the WHO-5 (p &lt; 0.05). Administrative bodies must ensure that laws regulating at-home noise levels, which are continually being updated with stricter restrictions, are enforced.Funding: This work was partially supported by the Government of Cantabria (CONTRATO PROGRAMA GOB. CANTABRIA-UC)

Do patients diagnosed with a neurological disease present increased risk of suicide?

RESUMEN: Introducción: Las enfermedades neurológicas representan la principal causa de discapacidady la segunda causa de muerte a nivel mundial. El dolor físico y psicológico, la desesperanzay la desconexión con el medio están presentes tras el diagnóstico de numerosos procesosneurológicos y especialmente de las enfermedades neurodegenerativas.Desarrollo: Existe un mayor riesgo de suicidio en pacientes con enfermedades neurológicascomunes como la epilepsia, la migra?na y la esclerosis múltiple, así como en quienes padecentrastornos degenerativos como la enfermedad de Alzheimer, la enfermedad de Huntington, laesclerosis lateral amiotrófica o la enfermedad de Parkinson. En la mayoría de los casos, la idea-ción suicida aparece en la etapa próxima al diagnóstico, ante sintomatología invalidante, y/oen pacientes que presentan comorbilidad psiquiátrica (a menudo asociada con dichas dolenciasneurológicas).Conclusiones: Para una prevención efectiva del suicidio en este grupo de la población debeevaluarse el riesgo principalmente en pacientes recién diagnosticados, ante la expresión demarcada desesperanza, ante sintomatología invalidante y en pacientes que presentan comorbi-lidad psiquiátrica (especialmente síntomas depresivos). La formación de los especialistas paradetectar signos de alerta es fundamental tanto para que puedan hacer un correcto abordajecomo para que sean capaces de determinar cuándo es necesaria la valoración de un especialistaen psiquiatría.ABSTRACT: Introduction: Neurological diseases are the leading cause of disability and the second leading cause of death worldwide. Physical and psychological pain, despair, and disconnection with the environment are observed after the diagnosis of numerous neurological processes, particularly neurodegenerative diseases. Development: A higher risk of suicide is observed in patients with such common neurological diseases as epilepsy, migraine, and multiple sclerosis, as well as in those with such degenerative disorders as Alzheimer disease, Huntington disease, amyotrophic lateral sclerosis, and Parkinson's disease. In most cases, suicidal ideation appears in the early stages after diagnosis, in the presence of disabling symptoms, and/or in patients with psychiatric comorbidities (often associated with these neurological diseases). Conclusions: Effective suicide prevention in this population group requires assessment of the risk of suicide mainly in newly diagnosed patients, in patients showing unmistakable despair or disabling symptoms, and in patients presenting psychiatric comorbidities (especially depressive symptoms). It is essential to train specialists to detect warning signs in order that they may adopt a suitable approach and determine when psychiatric assessment is required