Evolución de las poblaciones y aspectos de conservación del endemismo valenciano en peligro de extinción Limonium perplexum

Limonium perplexum Sáez & Rosselló (Plumbaginaceae) es un endemismo exclusivo de la Comunidad Valenciana (Sáez & Rosselló, 1999), únicamente presente en los acantilados de la Sierra de Irta (Peñíscola, Castellón) (Gómez-Serrano et al., 2005), donde se localiza la única población nativa conocida hasta la fecha, dentro de la microrreserva de flora denominada "Torre de la Badum"

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Open Issues in Requirements Modeling for Reuse

[ES]Debido a la diversidad de formas de los requisitos de software tienen, su modeladoy las relaciones con otros elementos reutilizables en un repositorio puede significar el éxito o el fracaso de un programa de reutilización de conjunto. Se analiza la necesidad de estandarizar los requisitos de manera que sean efectivamente reutilizables. Esto puede ser logrado mediante el uso de patrones. Además, las alternativas para obtener conjuntos coherentes de requisitos relacionados con elementos reutilizables en otros niveles de abstracción son explorado, produciendo de este modo una interfaz externa reutilización de elementos más complejos. Finalmente, se proponen guías para la búsqueda de patrones comunes a diferentes elementos y para la obtención de requisitos genéricos que se puede adaptar a múltiples situaciones mediante la parametrización.[EN]Due to the many forms that software requirements take, their modeling and relationships with other reusable elements in a repository can signify the success or failure of a whole reuse programme. This article looks at the need to standardize the requirements to make them effectively reusable, and this can initially be achieved by using patterns. In addition, alternatives to obtain consistent sets of requirements related to reusable elements on other levels of abstraction are explored, thus producing an external reuse interface of more complex elements. Finally, guides are proposed for finding patterns common to different elements and for obtaining generic requirements which can be adapted to multiple situations by using parameterization

Plant micro-reserves in Valencia (E. Spain): A model to preserve threatened flora in China?

The Valencian Community (eastern Spain) was the pioneer territory establishing plant micro-reserves (PMRs). Its model to protect small sites for endemic and endangered plants has been exported to several countries around the globe. This paper highlights 1) the role of PMRs to complement the protection provided by large protected areas, 2) how the establishment of PMRs fosters the increase of floristic knowledge, and 3) the fact that continuous monitoring of PMRs also yields new records of endangered species found within the same PMRs. The flexibility of the PMR approach -it can be adapted to other national and regional legislations- allows its transfer to other rich-biodiversity regions and countries such as China. Keywords: Plant micro-reserves, in situ conservation, Threatened species, Endemic plants, Protected area

El análisis de flujos del trabajo

Proyecto realizado en la E.T.S.I Informática de la Universidad de Valladolid por los profesores que imparten docencia de Ingeniería de Software en las titulaciones Técnicas de Informática. Objetivo: Introducir una herramienta gráfica (también desarrollada en el proyecto) para la captura y análisis de los requisitos de los nuevos sistemas de información. El proyecto ha consistido en el desarrollo en sí de la herramienta y su puesta e marcha en los laboratorios de las asignaturas. El resultado que se busca con el proyecto es favorecer el aprendizaje, potenciando las prácticas con el uso de herramientas case. Materiales elaborados: CD con la herramienta 'Docflow', manual de usuario, páginas web con descripción y enlaces sobre tecnología de workflow, se incluye también la posibilidad de descargar la herramienta de la red e incluso experimentar 'en línea' con una versión limitada de la misma.Junta de Castilla y León. Dirección General de Universidades e Investigación. Monasterio Ntra. Sra. del Prado. Autovia Puente Colgante s/n.- 47071 Valladolid. Teléfono: 983-41.18.87Castilla y LeónES

DocFlow : workflow based requirements elicitation

[ES] Los casos de uso son convenientes para definir los requisitos funcionales de un sistema de software, pero su uso implica que la funcionalidad deseada del nuevo sistema se conozca bien. El objetivo de este trabajo es presentar una técnica alternativa - y herramienta de soporte- para definir con precisión esta funcionalidad, expresada como casos de uso, a partir de los flujos de trabajo que describe el trabajo del usuario final. El uso de hipergrafos en el algoritmo propuesto de transformación refuerza el proceso de generación. Además, la técnica es independiente del paradigma del desarrollo y la variación en el algoritmo permite la obtención de diagramas de flujo de datos[EN] Use cases are favoured for defining the functional requirements of a software system, but their use implies that the desired functionality of the new system is well known. The aim of this work is to present an alternative technique-and supporting tool- to accurately define this functionality, expressed as use cases, starting from the workflows that describes the end user work. The use of hypergraphs in the proposed algorithm of transformation reinforces the generation process. In addition the technique is independent of the development paradigm and variation in the algorithm allows obtaining data flo

Líneas de productos, componentes,frameworks y mecanos

La reutilización del software es una de las disciplinas que más beneficios promete a la hora dedesarrollar nuevos productos software con un enfoque de Ingeniería del Software. Sin embargo,a lo largo de su historia estos beneficios parece que no acaban de llegar. Una de las principalescausas ha sido la granularidad los elementos software a reutilizar, demasiado pequeña para serrealmente efectiva, por ejemplo el módulo o la clase. Para solucionar el problema de lagranularidad en la reutilización surgen diferentes alternativas de reutilización basadas enelementos reutilizables de grano grueso.En este trabajo se van a repasar los principales elementos reutilizables de grano grueso,relacionándolos con los métodos de ingeniería de dominio y con las líneas de productos. En estesentido interesa remarcar la idoneidad que presenta el Modelo de Mecano para dar soporte a laslíneas de productos.Software reuse is one of the most promising disciplines related to Software Engineering due toits potential benefits. However, through its history these benefits seem they are not real. One ofthe main reasons could be the granularity of the reusable elements that it was too finer to bereally effective, examples of this kind of reusable units was the module in seventies or the classin the eighties. To solve the granularity in reusable elements problem, several reuse alternativesbased on coarse-grained reusable elements arise.In this work the main coarse-grained reusable elements proposals are reviewed, relatingthen to the domain engineering methods and the product lines. In this way, the eligibility of theMecano Model to support the product line concept is underlined

Demografía del endemismo valenciano Limonium perplexum L. Sáez & Rosselló (Plumbaginaceae)

Limonium perplexum (Plumbaginaceae) es un endemismo exclusivo de una sola localidad de la Sierra de Irta (N provincia de Castellón, E de España), en peligro crítico por su reducido tamaño poblacional. En los últimos diez años se ha censado la población, que osciló entre los 75 y 383 ejemplares (media 213). La cifra más baja se obtuvo en el pasado año 2004, quizá por las malas condiciones meteorológicas. Se comentan algunos riesgos que afectan a la estabilidad poblacional de L. perplexum.Limonium perplexum (Plumbaginaceae) is a Valencian endemic, only known from a single population in Sierra de Irta (north of Castellón province, East of Spain). This species is critically endangered due to its small population size. During the last ten years we have studied the size of the population, which wavered between 75 and 383 (mean 213). Regarding the population size, the lowest number of individuals was recorded in 2004, probably due to the adverse climatic conditions. Comments on risks affecting the stability of the population of L. perplexum are included