Traumatic renewal of values and value criteria in crisis management

This work tries to be an empirical sample in the study of learning in public policies, that is, how learning is linked to policy change. Particularly, we have studied political-administrative elites’ learning process on crisis provoked by oil spill off the coast of Spain. After expounded our premises about policy learning and the working hypothesis that have guided our work, we explain the methodology we have employed: the Nominal Group Technique, its advantages in this kind of research and how we used it. Finally, we display the reflection generated from the empirical work to better understand policy learning process. In this sense, political factors have been revealed as absolutely essential in order to explain what political-administrative elites learn and whatever they decide to implement. Aspects that make crises different from each other (these being technical aspects) show up as less important than political ones. Political aspects make crisis similar, because of political reasons behind the decision, communication, and attention strategies. Two concepts have appeared as the connection of crisis and elites’ learning: sensitization and political profitability. The former means the process of becoming fully aware of the problem, being concerned about it, and predisposed towards a faster and more coherent action. At the same time, it is difficult to imagine a government undertaking polices that involve political costs, or anything proved to be unprofitable. This is especially true of learning and implementation of whatever has been learnt from crisis that happened in distant points of time

Prospective evaluation of indirect costs due to acute rotavirus gastroenteritis in Spain: the ROTACOST study.

BACKGROUND: The effect of rotavirus in developed countries is mainly economic. This study aimed to assess the indirect costs induced by rotavirus acute gastroenteritis (RVAGE) in Spain. METHODS: A prospective observational study was conducted from October 2008 to June 2009. It included 682 children up to 5 years of age with acute gastroenteritis (AGE) who attended primary care (n = 18) and emergency room/hospital settings (n = 10), covering the regions of Galicia and Asturias (North-west Spain). All non-medical expenses incurred throughout the episode were recorded in detail using personal interviews and telephone contact. RESULTS: Among the 682 enrolled children, 207 (30.4%) were rotavirus positive and 170 (25%) had received at least one dose of rotavirus vaccine. The mean (standard deviation) indirect cost caused by an episode of AGE was estimated at 135.17 (182.70) Euros. Costs were 1.74-fold higher when AGE was caused by rotavirus compared with other etiologies: 192.7 (219.8) Euros vs. 111.6 (163.5) Euros (p < .001). The costs for absenteeism were the most substantial with a mean of 91.41 (134.76) Euros per family, resulting in a loss of 2.45 (3.17) days of work. In RVAGE patients, the absenteeism cost was 120.4 (154) Euros compared with 75.8 (123) for the other etiologies (p = .002), because of loss of 3.5 (3.6) vs 1.9 (2.9) days of work (p < .001). Meals costs were 2-fold-higher (48.5 (55) vs 24.3 (46) Euros, p < .001) and travel costs were 2.6-fold-higher (32 (92) vs 12.5 (21.1) Euros, p = .005) in RVAGE patients compared with those with other etiologies. There were no differences between RVAGE and other etiologies groups regarding costs of hiring of caregivers or purchase of material. Patients with RVAGE were admitted to hospital more frequently than those with other etiologies (47.8% vs 14%, p < .001). CONCLUSIONS: Rotavirus generates a significant indirect economic burden. Our data should be considered in the decision-making process of the eventual inclusion of rotavirus vaccine in the national immunization schedule of well developed countries

Rotavirus infection beyond the gut

The landscape of rotavirus (RV) infection has changed substantially in recent years. Autoimmune triggering has been added to clinical spectrum of this pathology, which is now known to be much broader than diarrhea. The impact of RV vaccines in these other conditions is becoming a growing field of research. The importance of host genetic background in RV susceptibility has been revealed, therefore increasing our understanding of vaccine effectiveness and giving some clues about the limited efficacy of RV vaccines in low-income settings. Also, interaction of RV with intestinal microbiota seems to play a key role in the process of infection vaccine effect. This article reviews current findings on the extraintestinal impact of RV infection and their widening clinical picture, and the recently described mechanisms of host susceptibility to infection and vaccine effectiveness. RV infection is a systemic disease with clinical and pathophysiological implications beyond the gut. We propose an “iceberg” model for this pathology with almost hidden clinical implications away from the gastrointestinal tract and eventually triggering the development of autoimmune diseases. Impact of current vaccines is being influenced by host genetics and gut microbiota interactions and these factors must be taken into account in the development of public health programs.This work was supported by grants from the Instituto de Salud Carlos III (Proyecto de Investigación en Salud, Acción Estratégica en Salud): project GePEM ISCIII/PI16/01478/Cofinanciado FEDER (AS) and project ReSVinext ISCIII/PI16/01569/Cofinanciado FEDER (FMT); Consellería de Sanidade, Xunta de Galicia (RHI07/2-intensificación actividad investigadora, PS09749 and 10PXIB918184PR), Instituto de Salud Carlos III (Intensificación de la actividad investigadora 2007-2012, PI16/01569), Fondo de Investigación Sanitaria (FIS; PI070069/PI1000540) del plan nacional de I + D + I (FMT), and 2016-PG071 Consolidación e Estructuración REDES 2016GI-1344 G3VIP (Grupo Gallego de Genética Vacunas Infecciones y Pediatría, ED341D R2016/021) (AS and FMT)S

Further considerations on rotavirus vaccination and seizure-related hospitalization rates

Response to letter to the editor: Sánchez A, López-Lacort M, Muñoz-Quiles C, Martinez-Beneito MA, Díez-Domingo J. Letter to the editor regarding “Rotavirus infection beyond the gut”. Infect Drug Resist. 2019;12:707-708 https://doi.org/10.2147/IDR.S202716S

Rotavirus infection beyond the gut

The landscape of rotavirus (RV) infection has changed substantially in recent years. Autoimmune triggering has been added to clinical spectrum of this pathology, which is now known to be much broader than diarrhea. The impact of RV vaccines in these other conditions is becoming a growing field of research. The importance of host genetic background in RV susceptibility has been revealed, therefore increasing our understanding of vaccine effectiveness and giving some clues about the limited efficacy of RV vaccines in low-income settings. Also, interaction of RV with intestinal microbiota seems to play a key role in the process of infection vaccine effect. This article reviews current findings on the extraintestinal impact of RV infection and their widening clinical picture, and the recently described mechanisms of host susceptibility to infection and vaccine effectiveness. RV infection is a systemic disease with clinical and pathophysiological implications beyond the gut. We propose an "iceberg" model for this pathology with almost hidden clinical implications away from the gastrointestinal tract and eventually triggering the development of autoimmune diseases. Impact of current vaccines is being influenced by host genetics and gut microbiota interactions and these factors must be taken into account in the development of public health programs

Evaluating the accuracy of AIM panels at quantifying genome ancestry

Background There is a growing interest among geneticists in developing panels of Ancestry Informative Markers (AIMs) aimed at measuring the biogeographical ancestry of individual genomes. The efficiency of these panels is commonly tested empirically by contrasting self-reported ancestry with the ancestry estimated from these panels. Results Using SNP data from HapMap we carried out a simulation-based study aimed at measuring the effect of SNP coverage on the estimation of genome ancestry. For three of the main continental groups (Africans, East Asians, Europeans) ancestry was first estimated using the whole HapMap SNP database as a proxy for global genome ancestry; these estimates were subsequently compared to those obtained from pre-designed AIM panels. Panels that consider >400 AIMs capture genome ancestry reasonably well, while those containing a few dozen AIMs show a large variability in ancestry estimates. Curiously, 500-1,000 SNPs selected at random from the genome provide an unbiased estimate of genome ancestry and perform as well as any AIM panel of similar size. In simulated scenarios of population admixture, panels containing few AIMs also show important deficiencies to measure genome ancestry. Conclusions The results indicate that the ability to estimate genome ancestry is strongly dependent on the number of AIMs used, and not primarily on their individual informativeness. Caution should be taken when making individual (medical, forensic, or anthropological) inferences based on AIMs.The research leading to these results has received funding from the “Ministerio de Ciencia e Innovación” (SAF2008-02971) and from the Plan Galego IDT, Xunta de Galicia (EM 2012/045) (A.S.) and Consellería de Sanidade/Xunta de Galicia (RHI07/2-intensificación actividad investigadora and 10PXIB918184PR), Instituto Carlos III (Intensificación de la actividad investigadora) and Fondo de Investigación Sanitaria (FIS; PI070069 and PI1000540) del Plan Nacional de I + D + I and ‘fondos FEDER’ (F.M.T.), and the grant from the Sistema Universitario Gallego- Modalidad REDES (2012-PG226) of the Consellería de Cultura, Educación e Ordenación Universitaria of the Xunta de Galicia (A.S., F.M.T.)S

Bacteremia in Children Hospitalized with Respiratory Syncytial Virus Infection

Background The risk of bacteremia is considered low in children with acute bronchiolitis. However the rate of occult bacteremia in infants with RSV infection is not well established. The aim was to determine the actual rate and predictive factors of bacteremia in children admitted to hospital due to confirmed RSV acute respiratory illness (ARI), using both conventional culture and molecular techniques. Methods A prospective multicenter study (GENDRES-network) was conducted between 2011–2013 in children under the age of two admitted to hospital because of an ARI. Among those RSV-positive, bacterial presence in blood was assessed using PCR for Meningococcus, Streptococcus pneumoniae, Haemophilus influenzae, Streptococcus pyogenes, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus, in addition to conventional cultures. Results 66 children with positive RSV respiratory illness were included. In 10.6% patients, bacterial presence was detected: H. influenzae (n = 4) and S. pneumoniae (n = 2). In those patients with bacteremia, there was a previous suspicion of bacterial superinfection and had received empirical antibiotic treatment 6 out of 7 (85.7%) patients. There were significant differences in terms of severity between children with positive bacterial PCR and those with negative results: PICU admission (100% vs. 50%, P-value = 0.015); respiratory support necessity (100% vs. 18.6%, P-value < 0.001); Wood-Downes score (mean = 8.7 vs. 4.8 points, P-value < 0.001); GENVIP scale (mean = 17 vs. 10.1, P-value < 0.001); and length of hospitalization (mean = 12.1 vs. 7.5 days, P-value = 0.007). Conclusion Bacteremia is not frequent in infants hospitalized with RSV respiratory infection, however, it should be considered in the most severe casesThis work was supported by the Spanish Government (Research Program Health Research Fund (FIS; PI10/00540 y PI13/02382) National Plan I + D + I and FEDER funds) and Regional Galician funds (Promotion of Research Project 10 PXIB 918 184 PR) (FMT), and Ministerio de Ciencia e Innovación (SAF2011-26983) and the Plan Galego IDT, Xunta de Galicia (EM 2012/045) (AS). MC’s research activities had been supported by grants from Instituto de Investigación Sanitaria de Santiago de Compostela. FMT’s research activities have been supported by grants from Instituto Carlos III (Intensificación de la actividad investigadora). Investigators received funding from the European Union’s Seventh Framework Program under ECGA no. 279185 (EUCLIDS) during the production of this paperS

A 2-transcript host cell signature distinguishes viral from bacterial diarrhea and it is influenced by the severity of symptoms

Recently, a biomarker signature consisting of 2-transcript host RNAs was proposed for discriminating bacterial from viral infections in febrile children. We evaluated the performance of this signature in a different disease scenario, namely a cohort of Mexican children (n = 174) suffering from acute diarrhea of different infectious etiologies. We first examined the admixed background of the patients, indicating that most of them have a predominantly Native American genetic ancestry with a variable amount of European background (ranging from 0% to 57%). The results confirm that the RNA test can discriminate between viral and bacterial causes of infection (t-test; P-value = 6.94×10−11; AUC = 80%; sensitivity: 68% [95% CI: 55%–79%]; specificity: 84% [95% CI: 78%–90%]), but the strength of the signal differs substantially depending on the causal pathogen, with the stronger signal being that of Shigella (P-value = 3.14 × 10−12; AUC = 89; sensitivity: 70% [95% CI: 57%–83%]; specificity: 100% [95% CI: 100%–100%]). The accuracy of this test improves significantly when excluding mild cases (P-value = 2.13 × 10−6; AUC = 85%; sensitivity: 79% [95% CI: 58%–95%]; specificity: 78% [95% CI: 65%–88%]). The results broaden the scope of previous studies by incorporating different pathogens, variable levels of disease severity, and different ancestral background of patients, and add confirmatory support to the clinical utility of these 2-transcript biomarkers.S

Homo antecessor y su relación con los neandertales y las poblaciones humanas modernas

Este trabajo examina las evidencias morfológicas del conjunto de fósiles humanos recuperados del nivel TD6-2 del yacimiento de la cueva de la Gran Dolina (sierra de Atapuerca, Burgos). Estos fósiles, incluidos en la especie Homo antecessor y con una cronología compatible con el MIS 21, presentan rasgos plesiomorfos del clado Homo, rasgos derivados compartidos con H. sapiens, rasgos derivados compartidos con H. neanderthalensis, rasgos derivados compartidos con estas dos últimas especies y rasgos derivados compartidos con poblaciones del Pleistoceno Medio de Eurasia. Este complejo mosaico, con un sello netamente europeo, podría ser explicado en el marco de un proceso de cladogénesis, ocurrido durante el Pleistoceno Inferior, posiblemente en el suroeste de Asia. La población polimórfica resultante de este proceso pudo originar diferentes pulsos migratorios al menos hacia Europa cuando las condiciones climáticas fueron favorables. Este proceso pudo ser muy complejo desde el punto de vista de las relaciones de la “población madre” con otros grupos humanos y tendría que contemplar al menos una migración hacia el continente africano a través del Corredor Levantino. Solo así se podría justificar el origen y evolución de H. sapiens en África durante el Pleistoceno Medio.This report examines the morphological evidences of the human fossils recovered from the TD6-2 level of the Gran Dolina cave site (Sierra de Atapuerca, Burgos, northern Spain). These fossils, which were included in the species Homo antecessor and might have been deposited during the MIS 21, exhibit plesiomorphic features for the Homo clade, apomorphic features shared with H. sapiens, apomorphic features shared with H. neanderthalensis, apomorphic features shared with the two latter species, and apomorphic features shared with the Eurasian Middle Pleistocene populations. This complex mosaic, which has a distinctly European hallmark, could be explained in the framework of a cladogenetic process occurred during the early Pleistocene, probably in Southwest Asia. The polymorphic population originated in this process might have been source of different migratory waves, at least towards Europe, during favourable climatic conditions. This process could have been very complex concerning the interactions of the “mother population” with other human groups and must consider at least one migration to the African continent through the Levantine Corridor. Only this way we could justify the origin and evolution of H. sapiens in Africa during the Middle Pleistocene.Este trabajo ha sido realizado en el marco del proyecto CGL2012-38434-C03-02, del Ministerio de Economía y Competitividad, el proyecto de excavaciones anual subvencionado por las Consejerías de Cultura y Turismo y Familia e Igualdad de Oportunidades de la Junta de Castilla y León, la Fundación Atapuerca y la Fundación Leakey, a través de donaciones realizadas por Gordon Getty y Dub Crook

A Genome-Wide Study of Modern-Day Tuscans: Revisiting Herodotus's Theory on the Origin of the Etruscans

Background: The origin of the Etruscan civilization (Etruria, Central Italy) is a long-standing subject of debate among scholars from different disciplines. The bulk of the information has been reconstructed from ancient texts and archaeological findings and, in the last few years, through the analysis of uniparental genetic markers. Methods: By meta-analyzing genome-wide data from The 1000 Genomes Project and the literature, we were able to compare the genomic patterns (.540,000 SNPs) of present day Tuscans (N = 98) with other population groups from the main hypothetical source populations, namely, Europe and the Middle East. Results: Admixture analysis indicates the presence of 25–34% of Middle Eastern component in modern Tuscans. Different analyses have been carried out using identity-by-state (IBS) values and genetic distances point to Eastern Anatolia/Southern Caucasus as the most likely geographic origin of the main Middle Eastern genetic component observed in the genome of modern Tuscans. Conclusions: The data indicate that the admixture event between local Tuscans and Middle Easterners could have occurred in Central Italy about 2,600–3,100 years ago (y.a.). On the whole, the results validate the theory of the ancient historian Herodotus on the origin of Etruscans.The research leading to these results has received funding from the ‘‘Ministerio de Ciencia e Innovacio´n’’ (SAF2011-26983) and from the Plan Galego IDT, Xunta de Galicia (EM 2012/045) (A.S.) and Consellerı´a de Sanidade/Xunta de Galicia (RHI07/2-intensificacio´n de la actividad investigadora and 10PXIB918184PR), Instituto Carlos III (Intensificacio´n de la actividad investigadora) and Fondo de Investigacio´n Sanitaria (FIS; PI07/0069, PI10/00540 and PI13/ 02382) of the Plan Nacional de I+D+I and ‘fondos FEDER’ (F.M.T.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.S