El proyecto romano construido en Lusitania

Se inicia con una breve evolución histórica de la Hispania romana y su organización provincial, planteando a continuación un recorrido a través de la Arquitectura y el Urbanismo romanos en general, incluyendo los materiales y técnicas constructivas que más se utilizaron en su ejecución. Centrándome en la provincia romana en Lusitania, he seleccionado una serie de proyectos que por sus características tipológicas resultan más interesantes y representativos, a la vez que presentan suficiente cantidad de restos para su estudio. Únicamente, en lo que a teatros y anfiteatros se refiere, he incorporado ejemplos construidos en otras provincias romanas de Occidente, ya que por su riqueza y complejidad arquitectónicas considero conveniente hacer un estudio comparativo entre ellos, en el apartado de conclusiones finales, en cuanto a organización de la forma y el espacio, su relación con el entorno, circulaciones, aproximaciones y accesos, etc. En las conclusiones finales, se analiza la influencia que pudieron tener esas arquitecturas en su entorno a través de su enclave en la trama urbana, de su forma y volumen, dimensiones y proporciones, materiales, colores y texturas, luces y sombras proyectadas, etc

Fuzzy Logic in Genetic Regulatory Network Models

Interactions between genes and the proteins they synthesize shape genetic regulatory networks (GRN). Several models have been proposed to describe these interactions, been the most commonly used those based on ordinary differential equations (ODEs). Some approximations using piecewise linear differential equations (PLDEs), have been proposed to simplify the model non linearities. However they not allways give good results. In this context, it has been developed a model capable of representing small GRN, combining characteristics from the ODE’s models and fuzzy inference systems (FIS). The FIS is trained through an artificial neural network, which forms an Adaptive Nertwork-based Fuzzy Inference System (ANFIS). This network allows to adapt the membership and output functions from the FIS according to the training data, thus, reducing the previous knowledge needed to model the specific phenomenon. In addition, Fuzzy Logic allows to express their rules through linguistic labels, which also allows to incorporate expert knowledge in a friendly way. The proposed model has been used to describe the Lac Operon in E. Coli and it has been compared with the models already mentioned. The outcome errors due to the training process of the ANFIS network are comparable with those of the models based on ODEs. Additionally, the fuzzy logic approach provides modeling flexibility and knowledge acquisition advantages

Impacto económico de la crisis COVID-19 sobre la MIPYME en Ecuador

Este estudio, presentado ahora con el énfasis ecuatoriano, es parte de una investigación más amplia que, sobre la interacción promovida desde FAEDPYME —Red Iberoamericana de Investigación en MIPYME—, contribuye a la construcción de un escenario comparativo que permite ver cómo la pandemia, por su naturaleza, ha afectado la permanencia de las MIPYME. De manera especial en aquellas que, antes de la pandemia, no generaron las reservas de resiliencia que pudieron haberles ayudado a afrontar duros desafíos como los impuestos por un evento sanitario de cobertura global que no ha estado presente, desde hace varias décadas, en el radar de ningún país del mundo.La pandemia ha generado sendos coletazos al interior del tejido productivo de los países que, pensando en el futuro, se convierten en los focos directrices para las acciones que permitirán levantar a las pequeñas y medianas empresas (MIPYME) que integran este tejido. De ahí, la importancia de estudios como el presente Impacto económico de la crisis COVID-19 sobre la MIPYME en Ecuador que, gracias a la alianza de varias universidades ecuatorianas, permite conocer la realidad productiva de las MIPYME. Con ello, mediante la participación de multiactores, se pretende proponer un plan de acción integrado que, sobre la base del perfil de una crisis tridimensional - sanitaria, social y económica-, permita activar y/o reactivar la inversión, la producción y el empleo esperado por una sociedad que, desde antes de la pandemia, estaba ansiosa por encontrar soluciones laborales que le permitan generar un ingreso para mejorar su bienestar socioeconómico, personal y familiar

Prediction of unplanned hospitalizations in older patients treated with chemotherapy

Purpose: To determine the incidence of unplanned hospitalization (UH) and to identify risk factors for UH in elderly patients with cancer who start chemotherapy. Methods: In all, 493 patients over 70 years starting new chemotherapy regimens were prospectively included. A pre-chemotherapy geriatric assessment was performed, and tumor and treatment variables were collected. The association between these factors and UH was examined by using multivariable logistic regression. Score points were assigned to each risk factor. Results: During the first 6 months of treatment, 37% of patients had at least one episode of UH. Risk factors were the use of combination chemotherapy at standard doses, a MAX2 index ≥1, a Charlson comorbidity score ≥2, albumin level <3.5 g/dL, falls in the past 6 months ≥1, and weight loss >5%. Three risk groups for UH were established according to the score in all patients: 0–1: 17.5%; 2: 34%; and 3–7: 57% (p < 0.001). The area under receiver operation characteristic (ROC) curve was 0.72 (95% CI: 0.67–0.77). Conclusion: This simple tool can help to reduce the incidence of UH in elderly patients with cancer who are scheduled to initiate chemotherapy treatmen

Prediction of Chemotoxicity, Unplanned Hospitalizations and Early Death in Older Patients with Colorectal Cancer Treated with Chemotherapy

Simple Summary Chemotoxicity, unplanned hospitalizations (Uhs) and early death (ED) are common among older patients with cancer who receive chemotherapy. Our objective was to determine factors predicting these complications. A predictive score for these three complications based on geriatric, tumor and laboratory variables was developed in a series of 215 older patients with colorectal carcinoma receiving chemotherapy. The use of this score may reliably identify patients at risk to have excessive toxicity with chemotherapy, UH or ED, thus helping to plan treatment, implement adaptive measures, and intensify follow-up. Purpose: To identify risk factors for toxicity, unplanned hospitalization (UH) and early death (ED) in older patients with colorectal carcinoma (CRC) initiating chemotherapy. Methods: 215 patients over 70 years were prospectively included. Geriatric assessment was performed before treatment, and tumor and treatment variables were collected. The association between these factors and grade 3-5 toxicity, UH and ED (<6 months) was examined by using multivariable logistic regression. Score points were assigned to each risk factor. Results: During the first 6 months of treatment, 33% of patients developed grade 3-5 toxicity, 31% had UH and 23% died. Risk factors were, for toxicity, instrumental activities of daily living, creatinine clearance, weight loss and MAX2 index; for UH, Charlson Comorbidity Score, creatinine clearance, weight loss, serum albumin, and metastatic disease; and for ED, basic activities in daily living, weight loss, metastatic disease, and hemoglobin levels. Predictive scores were built with these variables. The areas under receiver operation characteristic (ROC) curves for toxicity, UH and ED were 0.70 (95% CI: 0.64-0.766), 0.726 (95% IC: 0.661-0.799) and 0.74 (95% IC: 0.678-0.809), respectively. Conclusion: Simple scores based on geriatric, tumor and laboratory characteristics predict severe toxicity, UH and ED, and may help in treatment planning

Dyslipidaemia in HIV-infected women on antiretroviral therapy. Analysis of 922 patients from the Spanish VACH cohort

Background: Information concerning lipid disturbances in HIV-infected women on antiretroviral therapy (ART) is scarce. The objective of the study is to describe the lipid profile in a large cohort of HIV-infected women on contemporary ART and analyse differences between regimes and patient's characteristics. Methods: Observational, multicentre, cross-sectional study from the Spanish VACH Cohort. 922 women on stable ART without lipid-lowering treatment were included. Results: Median age was 42 years, median CD4 lymphocyte count was 544 cells/mm3, and 85.6% presented undetectable HIV-1 viral load. Median total cholesterol (TC) was 189 mg/dL (interquartile range, IQR, 165-221), HDL cholesterol 53 mg/dL (IQR, 44-64), LDL cholesterol 108 mg/dL (IQR, 86-134), and triglycerides 116 mg/dL (IQR, 85-163). Mean accumulated time on ART was 116 months; 47.4% were on NNRTI-based regimes, 44.7% on PI, and 6.7% on only-NRTI therapy. 43.8% were also hepatitis C (HCV) coinfected. Patients on PI treatment presented higher TC/HDL ratio than those on NNRTI (p < 0.001). Significantly higher HDL values were observed in NNRTI-treated patients. HCV-coinfected patients presented lower TC/HDL ratio than the non HCV-coinfected. In multivariate analysis, factors independently associated with TC/HDL ratio were age, triglyceride levels and HCV co-infection. PI treatment presented a non-significant association with higher TC/HDL ratio. Conclusions: In HIV-infected women, the NNRTI-based ART is associated with a better lipid profile than the PI-based. Factors unrelated to ART selection may also exert an independent, significant influence on lipids; in particular, age, and triglyceride levels are associated with an increased TC/HDL ratio while HCV co-infection is associated with a reduced TC/HDL ratio

Development and Validation of an Early Mortality Risk Score for Older Patients Treated with Chemotherapy for Cancer

Background: Estimation of life expectancy in older patients is relevant to select the best treatment strategy. We aimed to develop and validate a score to predict early mortality in older patients with cancer. Patients and Methods: A total of 749 patients over 70 years starting new chemotherapy regimens were prospectively included. A prechemotherapy assessment that included sociodemographic variables, tumor/treatment variables, and geriatric assessment variables was performed. Association between these factors and early death was examined using multivariable logistic regression. Score points were assigned to each risk factor. External validation was performed on an independent cohort. Results: In the training cohort, the independent predictors of 6-month mortality were metastatic stage (OR 4.8, 95% CI [2.4-9.6]), ECOG-PS 2 (OR 2.3, 95% CI [1.1-5.2]), ADL ≤ 5 (OR 1.7, 95% CI [1.1-3.5]), serum albumin levels ≤ 3.5 g/dL (OR 3.4, 95% CI [1.7-6.6]), BMI < 23 kg/m2 (OR 2.5, 95% CI [1.3-4.9]), and hemoglobin levels < 11 g/dL (OR 2.4, 95% CI (1.2-4.7)). With these results, we built a prognostic score. The area under the ROC curve was 0.78 (95% CI, 0.73 to 0.84), and in the validation set, it was 0.73 (95% CI: 0.67-0.79). Conclusions: This simple and highly accurate tool can help physicians making decisions in elderly patients with cancer who are planned to initiate chemotherapy treatment

Smoking among hospitalized patients: a multi-hospital cross sectional study of a widely neglected problem

Introduction: A comprehensive smoking ban was recently enacted for acute-care hospital campuses in Spain. The aim of this study was to assess the prevalence and patterns of smoking among inpatients before and during hospitalization. Methods: Multi-center cross-sectional study was conducted in 13 hospitals in the province of Barcelona, Spain from May 2014 to May 2015. Participants were adults who provided informed consent. The sample size was calculated to be representative of each hospital (prevalence 29.4%, precision ± 5%, error 5%). We approached 1228 subjects, 888 accepted to participate and 170 were replaced (were not available or declined to participate). Final sample comprised 1047 subjects. We used a computer-assisted personal interview system to collect data, including sociodemographic variables and use of tobacco before and during hospitalization. Smoking status was validated with exhaled carbon monoxide. We calculated overall tobacco prevalence and investigated associations with participant and center characteristics. We performed multiple polytomous and multilevel logistic regression analyses to estimate odds ratios (ORs) and 95% confidence intervals (CIs), with adjustments for potential confounders. Results: In all, 20.5% (95% CI: 18.1-23.0) of hospitalized patients were smokers. Smoking was most common among men (aOR=7.47; 95% CI: 4.88-11.43), young age groups (18-64 years), and individuals with primary or less than primary education (aOR=2.76; 95% CI: 1.44-5.28). Of the smokers, 97.2% were daily consumers of whom 44.9% had medium nicotine dependence. Of all smokers, three-quarters expressed a wish to quit, and one-quarter admitted to consuming tobacco during hospitalization. Conclusions: Our findings indicate the need to offer smoking cessation interventions among hospitalized patients in all units and service areas, to avoid infringements and increase patient safety, hospital efficiency, and improve clinical outcomes. Hospitalization represents a promising window for initiating smoking interventions addressed to all patients admitted to smoke-free hospitals, specially after applying a smoke-free campus ban

Promoción de la salud y entornos saludables

A forestar forestalAplicaci&oacute;n de un programa educativo participativo en salud&nbsp; bucal a una comunidad de adultos mayoresBiblioteca m&oacute;vil y su implementaci&oacute;n en el hospital Padre HurtadoConsumo de riesgo de alcohol en Chile: una propuesta innovadora de intervenci&oacute;nDise&ntilde;o de un programa interactivo de promoci&oacute;n de la salud vocal para NB1Encuentro formativo en promoci&oacute;n de salud y gesti&oacute;n de entornos saludables para TenoExperiencia docente: programa intersectorial de promoci&oacute;n/prevenci&oacute;n en preescolares de comunas vulnerables, Regi&oacute;n MetropolitanaFiltrado glomerular, m&eacute;todo preventivo aparici&oacute;n de fibrosis sist&eacute;mica nefrog&eacute;nica por gadolinio en examen de RMImplementaci&oacute;n de consejer&iacute;as en vida sana en APS, Regi&oacute;n de los R&iacute;osMedicina preventiva en feria libre de la poblaci&oacute;n San Gregorio: Cecof San Gregorio, Contagiando SaludMetodolog&iacute;a innovadora en la ense&ntilde;anza de una ectoparasitosisPrevenci&oacute;n de accidentes por mon&oacute;xido de carbono en edificios, Providencia 2002-2009Programa de promoci&oacute;n y prevenci&oacute;n en salud bucal para preescolaresPromoviendo h&aacute;bitos saludables en los vecinos de Re&ntilde;aca Alto, Vi&ntilde;a del Mar, 2009Rol de la capacitaci&oacute;n en la implementaci&oacute;n de acciones para la prevenci&oacute;n de la obesidadSatisfacci&oacute;n usuaria en el Cesfam Natales a un a&ntilde;o de su funcionamientoTres estrategias publicitarias y de comunicaci&oacute;n aplicadas al consumo de alcohol de bajo riesgoTropa de la salud: uso de los medios como forma de promover la salu