Deuda viva municipal en un contexto de crisis económica: análisis de los factores determinantes y de las formas de gestión

ResumenLa especial situación de crisis económica, junto con las restricciones al endeudamiento impuestas a los ayuntamientos y el control del déficit público, han reducido los recursos de las administraciones locales. En este contexto, los gestores encuentran en la creación de entes instrumentales una herramienta que permite al ayuntamiento no computar en su presupuesto determinados niveles de deuda. El objetivo del presente trabajo es determinar si la cooperación intermunicipal, la colaboración público-privada y la descentralización, junto con los aspectos políticos y financieros de la entidad, son factores que condicionan que el ayuntamiento presente un determinado nivel de deuda en período de crisis económica. Para ello, utilizando diferentes bases de datos, se estudia sobre una muestra de 1.238 municipios, para el período 2008-2011, cuáles de estos factores influyen sobre la deuda de los municipios españoles. Los resultados muestran, tras la aplicación de un modelo de regresión agrupada, que las variables financieras influyen sobre el nivel de deuda del municipio, así como la tasa de inmigración y la presencia o no de fragmentación política en el gobierno local. Igualmente, se ha obtenido evidencia de que tanto los ayuntamientos con mayor cooperación intermunicipal como aquellos con un mayor grado de descentralización presentan un mayor nivel de deuda.AbstractAs a result of the current economic crisis, with the consequent borrowing constraints imposed on municipalities and curbs on public deficit, the resources of local governments have been severely reduced. In this context, the creation of devolved organizations provides municipalities with a means of eliminating certain forms of debt from their budget items. The aim of this study is to determine whether inter-municipal cooperation, public-private collaboration and decentralization, together with the political and financial characteristics of the local authority in question, are factors constraining it to present a particular level of debt in times of economic crisis. To achieve these goals, various databases were used to study a sample of 1,238 local authorities for the period 2008-2011, to determine which of these factors influence municipal debt in Spain. Application of a pooled regression model showed that financial variables are factors that influence the level of municipal debt, as does the political orientation of the governing local party. We also found that local councils presenting higher levels of inter-municipal cooperation and those with a higher degree of decentralization have higher levels of debt

Induced and logarithmic distances with multi-region aggregation operators

Copyright © 2019 The Author(s). Published by VGTU Press. This paper introduces the induced ordered weighted logarithmic averaging IOWLAD and multiregion induced ordered weighted logarithmic averaging MR-IOWLAD operators. The distinctive characteristic of these operators lies in the notion of distance measures combined with the complex reordering mechanism of inducing variables and the properties of the logarithmic averaging operators. The main advantage of MR-IOWLAD operators is their design, which is specifically thought to aid in decision-making when a set of diverse regions with different properties must be considered. Moreover, the induced weighting vector and the distance measure mechanisms of the operator allow for the wider modeling of problems, including heterogeneous information and the complex attitudinal character of experts, when aiming for an ideal scenario. Along with analyzing the main properties of the IOWLAD operators, their families and specific cases, we also introduce some extensions, such as the induced generalized ordered weighted averaging IGOWLAD operator and Choquet integrals. We present the induced Choquet logarithmic distance averaging ICLD operator and the generalized induced Choquet logarithmic distance averaging IGCLD operator. Finally, an illustrative example is proposed, including real-world information retrieved from the United Nations World Statistics for global regions

Sinus elevation by in situ utilization of bone scrapers : technique and results

Objectives: The objective was to present a novel technique for antrostomy performed before sinus elevation in atrophic maxilla for subsequent implant placement. Material and methods: The study included 10 sinus elevations performed by the proposed technique in nine consecutive patients presenting with inadequate posterior maxillary height. The technique is described, calculating the antrostomy surface area, volume of bone tissue obtained and final height attained in each case. A total of 16 implants were placed. Results: All ten elevations were accomplished. Mean antrostomy surface area was 0.55 mm2 , mean bone volume obtained was 0.56 cm3 and mean height attained was 11.7 mm from a baseline mean height of 5.6 mm. Out of the 16 implants, 14 were inserted immediately after the elevation and 2 were inserted in a second step, after ossification; 93.7% of the implants were osseointegrated at 6 months after prosthesis placement. Conclusion: The use of bone scrapers to create antrostomy for sinus elevation is a simple and very safe procedure. It provides a variable amount of particulate bone graft that is easily handled and highly useful for packing the cavity that will elevate the sinus membrane

Is it necessary to show virtual limbs in action observation neurorehabilitation systems?

Action observation neurorehabilitation systems are usually based on the observation of a virtual limb performing different kinds of actions. In this way, the activity in the frontoparietal Mirror Neuron System is enhanced, which can be helpful to rehabilitate stroke patients. However, the presence of limbs in such systems might not be necessary to produce mirror activity, for example, frontoparietal mirror activity can be produced just by the observation of virtual tool movements. The objective of this work was to explore to what point the presence of a virtual limb impacts the Mirror Neuron System activity in neurorehabilitation systems.info:eu-repo/semantics/publishedVersio

Prognostic factors in left-sided endocarditis: results from the andalusian multicenter cohort

<p>Abstract</p> <p>Background</p> <p>Despite medical advances, mortality in infective endocarditis (IE) is still very high. Previous studies on prognosis in IE have observed conflicting results. The aim of this study was to identify predictors of in-hospital mortality in a large multicenter cohort of left-sided IE.</p> <p>Methods</p> <p>An observational multicenter study was conducted from January 1984 to December 2006 in seven hospitals in Andalusia, Spain. Seven hundred and five left-side IE patients were included. The main outcome measure was in-hospital mortality. Several prognostic factors were analysed by univariate tests and then by multilogistic regression model.</p> <p>Results</p> <p>The overall mortality was 29.5% (25.5% from 1984 to 1995 and 31.9% from 1996 to 2006; Odds Ratio 1.25; 95% Confidence Interval: 0.97-1.60; p = 0.07). In univariate analysis, age, comorbidity, especially chronic liver disease, prosthetic valve, virulent microorganism such as <it>Staphylococcus aureus</it>, <it>Streptococcus agalactiae </it>and fungi, and complications (septic shock, severe heart failure, renal insufficiency, neurologic manifestations and perivalvular extension) were related with higher mortality. Independent factors for mortality in multivariate analysis were: Charlson comorbidity score (OR: 1.2; 95% CI: 1.1-1.3), prosthetic endocarditis (OR: 1.9; CI: 1.2-3.1), <it>Staphylococcus aureus </it>aetiology (OR: 2.1; CI: 1.3-3.5), severe heart failure (OR: 5.4; CI: 3.3-8.8), neurologic manifestations (OR: 1.9; CI: 1.2-2.9), septic shock (OR: 4.2; CI: 2.3-7.7), perivalvular extension (OR: 2.4; CI: 1.3-4.5) and acute renal failure (OR: 1.69; CI: 1.0-2.6). Conversely, <it>Streptococcus viridans </it>group etiology (OR: 0.4; CI: 0.2-0.7) and surgical treatment (OR: 0.5; CI: 0.3-0.8) were protective factors.</p> <p>Conclusions</p> <p>Several characteristics of left-sided endocarditis enable selection of a patient group at higher risk of mortality. This group may benefit from more specialised attention in referral centers and should help to identify those patients who might benefit from more aggressive diagnostic and/or therapeutic procedures.</p

Generation and characterization of a defective HIV-1 Virus as an immunogen for a therapeutic vaccine

BACKGROUND: The generation of new immunogens able to elicit strong specific immune responses remains a major challenge in the attempts to obtain a prophylactic or therapeutic vaccine against HIV/AIDS. We designed and constructed a defective recombinant virus based on the HIV-1 genome generating infective but non-replicative virions able to elicit broad and strong cellular immune responses in HIV-1 seropositive individuals. RESULTS: Viral particles were generated through transient transfection in producer cells (293-T) of a full length HIV-1 DNA carrying a deletion of 892 base pairs (bp) in the pol gene encompassing the sequence that codes for the reverse transcriptase (NL4-3/ΔRT clone). The viral particles generated were able to enter target cells, but due to the absence of reverse transcriptase no replication was detected. The immunogenic capacity of these particles was assessed by ELISPOT to determine γ-interferon production in a cohort of 69 chronic asymptomatic HIV-1 seropositive individuals. Surprisingly, defective particles produced from NL4-3/ΔRT triggered stronger cellular responses than wild-type HIV-1 viruses inactivated with Aldrithiol-2 (AT-2) and in a larger proportion of individuals (55% versus 23% seropositive individuals tested). Electron microscopy showed that NL4-3/ΔRT virions display immature morphology. Interestingly, wild-type viruses treated with Amprenavir (APV) to induce defective core maturation also induced stronger responses than the same viral particles generated in the absence of protease inhibitors. CONCLUSIONS: We propose that immature HIV-1 virions generated from NL4-3/ΔRT viral clones may represent new prototypes of immunogens with a safer profile and stronger capacity to induce cellular immune responses than wild-type inactivated viral particles.This study was supported by grants FIS PI050265, FIS PI040503, FIS PI070291, FIS Intrasalud 080752, FIS PS09/01297, FIS PI10/02984, SAF2006-26667-E, FIT 09-010-205-9, FIPSE 36780/08, Fundación Mútua Madrileña, TRA-094, EC10-153, ISCIII-RETIC RD06/0006, HIVACAT–HIV Development Program in Catalonia, FIPSE 36630/07, UE Program Health 2009 CHAARM. Spanish Health Institute Carlos III (ISCIII) and the Health Department of the Catalan Government (Generalitat de Catalunya). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.S

Risk factors for infections caused by carbapenem-resistant Enterobacterales: an international matched case-control-control study (EURECA)

Cases were patients with complicated urinary tract infection (cUTI), complicated intraabdominal (cIAI), pneumonia or bacteraemia from other sources (BSI-OS) due to CRE; control groups were patients with infection caused by carbapenem-susceptible Enterobacterales (CSE), and by non-infected patients, respectively. Matching criteria included type of infection for CSE group, ward and duration of hospital admission. Conditional logistic regression was used to identify risk factors. Findings Overall, 235 CRE case patients, 235 CSE controls and 705 non-infected controls were included. The CRE infections were cUTI (133, 56.7%), pneumonia (44, 18.7%), cIAI and BSI-OS (29, 12.3% each). Carbapenemase genes were found in 228 isolates: OXA-48/like, 112 (47.6%), KPC, 84 (35.7%), and metallo-beta-lactamases, 44 (18.7%); 13 produced two. The risk factors for CRE infection in both type of controls were (adjusted OR for CSE controls; 95% CI; p value) previous colonisation/infection by CRE (6.94; 2.74-15.53; <0.001), urinary catheter (1.78; 1.03-3.07; 0.038) and exposure to broad spectrum antibiotics, as categorical (2.20; 1.25-3.88; 0.006) and time-dependent (1.04 per day; 1.00-1.07; 0.014); chronic renal failure (2.81; 1.40-5.64; 0.004) and admission from home (0.44; 0.23-0.85; 0.014) were significant only for CSE controls. Subgroup analyses provided similar results. Interpretation The main risk factors for CRE infections in hospitals with high incidence included previous coloni-zation, urinary catheter and exposure to broad spectrum antibiotics