Drought variability and change across the Iberian Peninsula

Drought variability and change is assessed in this study across the Iberian Peninsula along the 20th century and the first decade of the 21st century using state of the art drought indices: the Sc-PDSI, the SPI and the SPEI. The analysis conducted in this study confirms that drought conditions are worsening for most of the Iberian Peninsula across time except in the western and in the north-western area, where a wetting trend is identified. Furthermore, the severity and duration of droughts show a remarkable increase in the south-western area, while drought magnitude is increasing significantly in the Mediterranean region strongly induced by global warming especially during the last decades. Severity, duration and magnitude of wet events do not experience significantly variations. Our results are in agreement with other studies which project this evolution to the whole 21st century. For this reason, and as a link of our study to societal needs, the application of effective water management strategies will be crucial to minimize the impact of the hydrological droughts over the Iberian Peninsula into the near future.La següent tesi doctoral proporciona un anàlisi exhaustiu sobre la variabilitat i les tendències observades en l’evolució de les sequeres a la Península Ibèrica al llarg del s.XX i la primera dècada del s.XXI. El Sc-PDSI, el SPI i el SPEI són els índexs de sequera calculats a escala mensual usant una xarxa de sèries climàtiques d’alta qualitat per avaluar l’evolució espacio-temporal de les sequeres hidrològiques i els events humits a escala anual i estacional, tenint en compte la severitat, la magnitud i la durada d’aquests events extrems. A partir dels resultats, una clara tendència a la sequera ha estat detectada a gran part de la Península Ibèrica al llarg del s.XX a excepció de la regió oest i nord-oest, on ha estat identificada una tendència a l’increment de les condicions humides. Llavors, la disponibilitat d’aigua podria estar empitjorant en aquesta àrea provocant impactes ambientals i socio-econòmics realment difícils de solucionar. L’aplicació d’estratègies efectives de gestió de l’aigua, seran crucials per minimitzar l’impacte de les sequeres a la Península Ibèrica en un futur pròxim

Espectrometría de impedancia eléctrica en tejido pulmonar

Las biopsias de pulmón son necesarias para el estudio de diversas enfermedades pulmonares. Este es un procedimiento agresivo y tiene la dificultad añadida de conocer la ubicación exacta de la toma de muestras. El método de detección de tejido mediante bioimpedancia eléctrica podría suponer un sistema guía más fiable dado que es capaz de identificar regiones con diferentes propiedades histológicas. Se evalúa la efectividad de este sistema obteniendo datos de impedancia en distintas localizaciones de pulmones en pacientes, mediante el procedimiento de broncoscopia. Por medio de un posterior procesado de señales se obtienen diferencias significativas entre distintos grupos de tejidos.Postprint (published version

Use of information and communication technologies (ICTs) in cancer multidisciplinary team meetings: an explorative study based on EU healthcare professionals

Objectives: Multidisciplinary teams in cancer care are increasingly using information and communication technology (ICT), hospital health information system (HIS) functionalities and ICT-driven care components. We aimed to explore the use of these tools in multidisciplinary team meetings (MTMs) and to identify the critical challenges posed by their adoption based on the perspective of professionals representatives from European scientific societies. Design: This qualitative study used discussion of cases and focus group technique to generate data. Thematic analysis was applied. Setting: Healthcare professionals working in a multidisciplinary cancer care environment. Participants: Selection of informants was carried out by European scientific societies in accordance with professionals' degree of experience in adopting the implementation of ICT and from different health systems. Results: Professionals representatives of 9 European scientific societies were involved. Up to 10 ICTs, HIS functionalities and care components are embedded in the informational and decision-making processes along three stages of MTMs. ICTs play a key role in opening MTMs to other institutions (eg, by means of molecular tumour boards) and information types (eg, patient-reported outcome measures), and in contributing to the internal efficiency of teams. While ICTs and care components have their own challenges, the information technology context is characterised by the massive generation of unstructured data, the lack of interoperability between systems from different hospitals and HIS that are conceived to store and classify information rather than to work with it. Conclusions: The emergence of an MTM model that is better integrated in the wider health system context and incorporates inputs from patients and support systems make traditional meetings more dynamic and interconnected. Although these changes signal a second transition in the development process of multidisciplinary teams, they occur in a context marked by clear gaps between the information and management needs of MTMs and the adequacy of current HIS

Evaluation of the impact of the Covid-19 pandemic on people and organisations in long-term care facilities of Catalonia and proposals for improving the care model: the resicovid-19 project

Background: During the first wave of the COVID-19 pandemic, it is estimated that around 25% of infected residents in Nursing Homes in Catalonia died, which accounted for more than 50% of total COVID-19 deaths in the region. This devastating impact not only highlights the structural deficits of the long-term care facilities system, but it also provides a unique opportunity to gather evidence to support a redesign of the health and social care models–a redesign that focuses on individuals and their singularities, and is equipped with the staff and infrastructure required to meet their needs. Methods: The ResiCOVID-19 project will include five work packages to assess the impact of the COVID-19 pandemic (from March 2020 to June 2022) on the individuals living in long-term care facilities in Catalonia, their family members, health care workers, and the organisations themselves. In this project, we will develop proposals for improvement and indicators for the long-term care model in Catalonia to better adapt to the current and future needs of people-centred care through conducting a rapid review, analysis of international experiences, retrospective analysis, and a cross-sectional study. The analysis will be conducted both from a quantitative and a qualitative perspective, measuring the impact at a system level as well as at a setting and individual level, including residents, families, professionals, and managers of longterm care facilities. Conclusions: The ResiCOVID-19 project is expected to have a significant impact at different dimensions, including the care model, social and organisational aspects (on professionals and facilities), systemic efforts (both for the healthcare and the social systems), and scientific contributions (providing evidence in a field of limited research in Catalonia)

A common cognitive, psychiatric, and dysmorphic phenotype in carriers of NRXN1 deletion

Altres ajuts: Fundació Parc Taulí - Institut Universitari UAB CIR2009/33 i CIR2010/034Deletions in the 2p16.3 region that includes the neurexin (NRXN1) gene are associated with intellectual disability and various psychiatric disorders, in particular, autism and schizophrenia. We present three unrelated patients, two adults and one child, in whom we identified an intragenic 2p16.3 deletion within the NRXN1 gene using an oligonucleotide comparative genomic hybridization array. The three patients presented dual diagnosis that consisted of mild intellectual disability and autism and bipolar disorder. Also, they all shared a dysmorphic phenotype characterized by a long face, deep set eyes, and prominent premaxilla. Genetic analysis of family members showed two inherited deletions. A comprehensive neuropsychological examination of the 2p16.3 deletion carriers revealed the same phenotype, characterized by anxiety disorder, borderline intelligence, and dysexecutive syndrome. The cognitive pattern of dysexecutive syndrome with poor working memory and reduced attention switching, mental flexibility, and verbal fluency was the same than those of the adult probands. We suggest that in addition to intellectual disability and psychiatric disease, NRXN1 deletion is a risk factor for a characteristic cognitive and dysmorphic profile. The new cognitive phenotype found in the 2p16.3 deletion carriers suggests that 2p16.3 deletions might have a wide variable expressivity instead of incomplete penetrance

The effect of external stimulation on functional networks in the aging healthy human brain

Understanding the brain changes occurring during aging can provide new insights for developing treatments that alleviate or reverse cognitive decline. Neurostimulation techniques have emerged as potential treatments for brain disorders and to improve cognitive functions. Nevertheless, given the ethical restrictions of neurostimulation approaches, in silico perturbation protocols based on causal whole-brain models are fundamental to gaining a mechanistic understanding of brain dynamics. Furthermore, this strategy could serve to identify neurophysiological biomarkers differentiating between age groups through an exhaustive exploration of the global effect of all possible local perturbations. Here, we used a resting-state fMRI dataset divided into middle-aged (N =310, <65 years) and older adults (N =310, ≥65) to characterize brain states in each group as a probabilistic metastable substate (PMS) space. We showed that the older group exhibited a reduced capability to access a metastable substate that overlaps with the rich club. Then, we fitted the PMS to a whole-brain model and applied in silico stimulations in each node to force transitions from the brain states of the older- to the middle-aged group. We found that the precuneus was the best stimulation target. Overall, these findings could have important implications for designing neurostimulation interventions for reversing the effects of aging on whole-brain dynamics

The biliary epithelium gives rise to liver progenitor cells: RODRIGO-TORRES ET AL.

Severe liver diseases are characterized by expansion of liver progenitor cells (LPC), which correlates with disease severity. However, the origin and role of LPC in liver physiology and in hepatic injury remains a contentious topic. We found that ductular reaction cells in human cirrhotic livers express hepatocyte nuclear factor 1 homeobox B (HNF1β). However, HNF1β expression was not present in newly generated epithelial cell adhesion molecule (EpCAM)-positive hepatocytes. In order to investigate the role of HNF1β- expressing cells we used a tamoxifen-inducible Hnf1βCreER/R26RYfp/LacZ mouse to lineage-trace Hnf1β+ biliary duct cells and to assess their contribution to LPC expansion and hepatocyte generation. Lineage tracing demonstrated no contribution of HNF1β+ cells to hepatocytes during liver homeostasis in healthy mice or after loss of liver mass. After acute acetaminophen or carbon tetrachloride injury no contribution of HNF1β+ cells to hepatocyte was detected. We next assessed the contribution of Hnf1β+ -derived cells following two liver injury models with LPC expansion, a diethoxycarbonyl-1,4-dihydrocollidin (DDC)-diet and a choline-deficient ethionine-supplemented (CDE)-diet. The contribution of Hnf1β+ cells to liver regeneration was dependent on the liver injury model. While no contribution was observed after DDC-diet treatment, mice fed with a CDE-diet showed a small population of hepatocytes derived from Hnf1β+ cells that were expanded to 1.86% of total hepatocytes after injury recovery. Genome-wide expression profile of Hnf1β+ -derived cells from the DDC and CDE models indicated that no contribution of LPC to hepatocytes was associated with LPC expression of genes related to telomere maintenance, inflammation, and chemokine signaling pathways

Microbiota alterations in proline metabolism impact depression

The microbiota-gut-brain axis has emerged as a novel target in depression, a disorder with low treatment efficacy. However, the field is dominated by underpowered studies focusing on major depression not ad- dressing microbiome functionality, compositional nature, or confounding factors. We applied a multi-omics approach combining pre-clinical models with three human cohorts including patients with mild depression. Microbial functions and metabolites converging onto glutamate/GABA metabolism, particularly proline, were linked to depression. High proline consumption was the dietary factor with the strongest impact on depression. Whole-brain dynamics revealed rich club network disruptions associated with depression and circulating proline. Proline supplementation in mice exacerbated depression along with microbial translocation. Human microbiota transplantation induced an emotionally impaired phenotype in mice and alterations in GABA-, proline-, and extracellular matrix-related prefrontal cortex genes. RNAi-mediated knockdown of pro-line and GABA transporters in Drosophila and mono-association with L. plantarum, a high GABA producer, conferred protection against depression-like states. Targeting the microbiome and dietary proline may open new windows for efficient depression treatment