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This study develops a decision-making procedure to help policymakers compare alternative patterns for sustainable diets by reaching a compromise among three criteria: socio-economic perspective, health and environment (including carbon and water footprints). An Analytical Hierarchy Process (AHP) was performed in several stages. First, a total of 25 stakeholders (members of organizations on the Valencia Food Policy Council) evaluated criteria that are relevant to the sustainability of diets. Secondly, a workshop with 14 experts from different backgrounds evaluated by consensus four dietary alternatives: Mediterranean, flexitarian, pescatarian and vegan. In terms of environment, experts gave priority to the vegan diet. However, the Mediterranean diet pattern (MDP) appeared, according to the process, as the most suitable pattern from the holistic perspective that integrates all relevant criteria. The MDP was ranked first in terms of the health criterion and the socio-economic perspective. These include culture, affordability, social impact and local production as decision elements that food policy advisory bodies take into consideration to define sustainable diets.
The random encounter model, a method for estimating animal density using camera traps without the need for individual recognition, has been developed over the past decade. A key assumption of this model is that cameras are placed randomly in relation to animal movements, requiring that cameras are not set only at sites thought to have high animal traffic. The aim of this study was to define a correction factor that allows the random encounter model to be applied in photo-trapping surveys in which cameras are placed along tracks to maximize capture probability. Our hypothesis was that applying such a correction factor would compensate for the different rates at which lynxes use tracks and the surrounding area, and should thus improve the estimates obtained with the random encounter model. We tested this using data from a well-known Iberian lynx Lynx pardinus population. Firstly, we estimated Iberian lynx densities using a traditional camera-trapping design followed by spatially explicit capture–recapture analyses. We estimated the differential use rate for tracks vs the surrounding area using data from a lynx equipped with a GPS collar, and subsequently calculated the correction factor. As expected, the random encounter model overestimated densities by 378%. However, the application of the correction factor improved the estimate and reduced the error to 16%. Although there are limitations to the application of the correction factor, the corrected random encounter model shows potential for density estimation of species for which individual identification is not possible.
The tomato Mi-1 gene mediates plant resistance to whitefly Bemisia tabaci, nematodes, and aphids. Other genes are also required for this resistance, and a model of interaction between the proteins encoded by these genes was proposed. Microarray analyses were used previously to identify genes involved in plant resistance to pests or pathogens, but scarcely in resistance to insects. In the present work, the GeneChip™ Tomato Genome Array (Affymetrix®) was used to compare the transcriptional profiles of Motelle (bearing Mi-1) and Moneymaker (lacking Mi-1) cultivars, both before and after B. tabaci infestation. Ten transcripts were expressed at least twofold in uninfested Motelle than in Moneymaker, while other eight were expressed half or less. After whitefly infestation, differences between cultivars increased to 14 transcripts expressed more in Motelle than in Moneymaker and 14 transcripts less expressed. Half of these transcripts showed no differential expression before infestation. These results show the baseline differences in the tomato transcriptomic profile associated with the presence or absence of the Mi-1 gene and provide us with valuable information on candidate genes to intervene in either compatible or incompatible tomato–whitefly interactions.
Conventional tests with written information used for the evaluation of sign language (SL) comprehension introduce distortions due to the translation process. This fact affects the results and conclusions drawn and, for that reason, it is necessary to design and implement the same language interpreter-independent evaluation tools. Novel web technologies facilitate the design of web interfaces that support online, multiple-choice questionnaires, while exploiting the storage of tracking data as a source of information about user interaction. This paper proposes an online, multiple-choice sign language questionnaire based on an intuitive methodology. It helps users to complete tests and automatically generates accurate, statistical results using the information and data obtained in the process. The proposed system presents SL videos and enables user interaction, fulfilling the requirements that SL interpretation is not able to cover. The questionnaire feeds a remote database with the user answers and powers the automatic creation of data for analytics. Several metrics, including time elapsed, are used to assess the usability of the SL questionnaire, defining the goals of the predictive models. These predictions are based on machine learning models, with the demographic data of the user as features for estimating the usability of the system. This questionnaire reduces costs and time in terms of interpreter dedication, as well as widening the amount of data collected while employing user native language. The validity of this tool was demonstrated in two different use cases.
The demographic transition is a global event intensified during the last decades that represents population aging. Thus, the studies directed to the elderly 80 years of age or more with preserved cognitive functions (named SuperAgers) emerges as a possible path to full comprehension of the health of those aging with acceptable levels of functionality and independency.
To evaluate the cognitive performance of the elderly over 80 years old, associating the results to their educational level.
We evaluated 144 healthy elders with 80 years or more through the following cognitive tests Mini-Mental State Examination (MMSE), Cambridge Cognitive Examination (CAMCOG), Clock Drawing Test (CDT), and Verbal Fluency Test (VF) and compared the tests’ scores with their educational level segmented in years of formal education, being the groups ILLITR (<1 year of schooling), 1TO4 (from 1 to 4 years of schooling), and 5MORE (>5 years of schooling).
There was positive influence of educational level on the cognitive tests’ score, which indicates higher cognitive reserve of the elderly with higher educational levels.
The functionality and independence of the so-called SuperAgers is determined by the cognitive reserve acquired throughout life, mainly developed by the years of formal education.
This paper aims to critically appraise the incorporation of opium poppy into medical practice in Song-dynasty China. By analysing materia medica and formularies, along with non-medical sources from the Song period, this study sheds light on the role of Chinese Buddhist monasteries in the process of incorporation of foreign plants into Chinese medicine. It argues that Buddhist monasteries played a significant role in the evolution of the use of opium poppy in Song dynasty medicine. This is because the consumption practices in Buddhist monasteries inspired substantial changes in the medical application of the flower during the Southern Song dynasty. While, at the beginning of Song dynasty, court scholars incorporated opium poppy into official materia medica in order to treat disorders such as huangdan and xiaoke, as well as cinnabar poisoning, this study of the later Song medical treatises shows how opium poppy was repurposed to treat symptoms such as diarrhoea, coughing and spasms. Such a shift in the medical use of the poppy occurred after Chinese literati and doctors became acquainted with the role of the flower in the diet and medical practices of Buddhist monks across China. Therefore, the case study of the medical application of opium poppy during the Song dynasty provides us with insights into how the spread of certain practices in Buddhist monasteries might have contributed to the change in both professional medical practices and daily-life healthcare in local communities in that period.
Within out-of-hospital emergencies, primary health care (PHC) nurses must face life-threatening emergencies (LTEs), which are defined as “a situation associated with an imminent life risk that entails the start-up of resources and special means to resolve the situation.”
The objectives of this study were to know the training received for out-of-hospital LTEs by PHC nurses of Asturias, Spain and the perception they have about their theoretical knowledge and practical skills in a series of emergency procedures or techniques used in LTE emergencies; as well as to analyze the differences according to the geographical area of their work.
Cross-sectional, descriptive, and observational study was conducted in 2018 of a sample of PHC service nurses of Asturias, Spain.
A total of 236 nurses from PHC service centers of Asturias, Spain, from among the total of 730 nurses who make up the staff of nurses of the PHC service of Asturias, between April and May 2018, were surveyed. The survey was designed ad hoc using the Doctrinal Body of Emergency Nursing (DBEN) proposed by the Spanish Society of Emergency Medicine (SEMES; Madrid, Spain), which indicates the theoretical and practical procedures that must be acquired by the PHC nurses. It is composed of 37 procedures or techniques employed in LTEs using an 11-point Likert scale rating to detect their self-perception about theoretical knowledge and practical skills from zero (“Minimum”) to ten (“Maximum”).
There were significant differences in the mean of theoretical knowledge and practical skills in many procedures or techniques studied, depending on the different areas of work.
All PHC nurses must be perfectly trained to provide initial quality assistance to the LTE, with both theoretical and practical knowledge of the different techniques, so that it can continue to be attended by the corresponding Emergency Service.
OBJECTIVES/SPECIFIC AIMS: The Title V Cooperative Project between the University of Puerto Rico- Medical Sciences Campus (UPR-MSC) and Universidad Central del Caribe (UCC) has trained US, GS and F (participants) of HSPs to engage them in CTR. METHODS/STUDY POPULATION: First stage of the training sessions (TS) dealt with the theory of CTR. After TS and responding to their research interests, as answered in a questionnaire, the participants formed a CTMT, under the mentorship of a well-established CT researcher. This, as a prelude to their hands-on experiences in Intensive Development and Experiences in Advancement of Research and Increased Opportunities (IDEARIO), for which a research proposal is needed. RESULTS/ANTICIPATED RESULTS: Five (5) CTMTs were formed in different research areas – cardio, neuro, liver, renal, Zika–, as submitted in their research concept papers.Eight (8) CT researchers are currently mentoring 2 US, 7 GS and 6 F of HSPs through the CTMTs. They have submitted a research proposal, as a bridge between the theory in the TS and the practice in IDEARIO. Five (5) proposals were received and 2 of them approved, while the other 3 are in the evaluation process. We will present the composition, research topics, development of research and the feedback of participants in IDEARIO and CTMTs. DISCUSSION/SIGNIFICANCE OF IMPACT: The CTMTs and their respective proposals are effective strategies for the mentoring of US, GS and F in CTR.
OBJECTIVES/SPECIFIC AIMS: The Title V Cooperative Project of the UPR-MSC and UCC has demonstrated that educational interventions in CTR are very effective in fulfilling the objective of promoting awareness, stimulate interest and increase the knowledge, skills and opportunities, to US, GS and F (participants) in CTR. METHODS/STUDY POPULATION: The training sessions (TS) offered through the Title V initiative have become an engine for the involvement in CTR for participants from higher education institutions island-wide. TS consisted of cycles –level 1 and 2–: Research Education Towards Opportunities (RETO,I,II) and Mentorship Offering Training Opportunities for Research (MOTOR,I,II), ending in the formation of the Clinical and Translational Mentoring Teams (CTMT)s, in which participants, paired by their research interests, were mentored by a well-established CT researchers in their research project, to be developed in the Intensive Development and Experiences in Advancement of Research and Increased Opportunities (IDEARIO). RESULTS/ANTICIPATED RESULTS: Up to date, 4 TS-level 1 and 2 TS-level 2 were offered. Eighty (80) participants completed level 1, distributed: 42 (52.5%) US in RETO, 21 (26.25%) GS and 17 (21.25%) F in MOTOR and 17 participants completed level 2, distributed: 4 (23.52%) US in RETO, 6 (25.29%) GS and 7 (41.17%) F in MOTOR. From which, 15, with 8 CT researchers, formed 5 CTMTs in different research areas – cardio, neuro, liver, renal, Zika–. DISCUSSION/SIGNIFICANCE OF IMPACT: US, GS and F were integrated in the active process throughout educational levels for their development in CTR.
According to the UNEP, mercury pollution is one of the main contamination problems of the world. The UN showed that more than 1,870 tons of this metal are released into the environment annually. This material arrives to water bodies where fish consume it and then reaches humans, producing negative effects on their health. The hydroxyapatite is one of the main components of bones and has proven itself to be useful in the removal of mercury from polluted sources. The aim of this research project is to synthesize and characterize different formulations of this substance and to determine which is the best selective formulation to remove mercury in water. Currently, twenty-one formulations have been produced. The experimental variables examined are the pH, the temperature and the time of calcination. These variables are characterized with Infrared Spectrophotometry (IR), Scanning Electron Microscope (SEM) and X-ray diffraction (XRD). Before calcination the samples contained 70% of hydroxyapatite. This concentration increased in some of them after calcination. The analysis of the results allowed to test the efficiency of these formulations at removing mercury from water. These materials will also be combined, in future stages of the research, with other substances such as activated carbon and organic fibers to improve their performance. The material will be used to coat a filter so that it can become a piping accessory to remove mercury from polluted waters as it is being recirculated.
Conclusions and recommendations of health technology assessment (HTA) reports have an impact on all relevant actors involved in the health system (health authorities, administrators, health professionals, patients, citizens and industry). The involvement of all those relevant stakeholders in the HTA process facilitates making valid and informed decisions and an efficient allocation of resources. Improving communication, participation and transparency among all agents will lead to more efficient evaluation and decision-making processes.
To review key aspects of the relations between HTA agencies and health industries, two process were carried out: a narrative review of literature searched in Medline, PubMed, Embase, CINAHL and WOS (2007-2017) and a review of websites of international HTA agencies. References and webs with information on the framework, objectives, methodologies, impact or results of the relationships were included.
A total of 1961 references were located and forty-five were selected. From the synthesis of the selected references the following key aspects of the relationships between HTA and industry were identified: (i) the importance of early dialogues with industry to align HTA objectives with the generation of evidence; (ii) challenges of the bias in the evidence produced by industry; (iii) difficulties in industry engagement in HTA processes; and (iv) industry interest in HTA. The review of six agency websites provided information on industry involvement in strategic activities, early dialogues, provision of documentation, management of industry clarifications, review of the report/allegations and other forms of relationship.
Both the review of the literature and the contents of the web pages of international agencies with experience in relations with industry show that the interest is in the creation of collaborative frameworks between regulatory authorities that decide on authorization and price and reimbursement and HTA agencies, while both try to maintain an early, transparent and systematic interaction with the healthcare industry.
In December 2017, a patient involvement (PI) Interest Group was created in the Spanish Network of Agencies for Assessing National Health System Technologies and Performance (RedETS) Annual conference. It started as a voluntary group of health technology assessment (HTA) methodologists interested in PI. The objective of the Group is to promote and facilitate PI in HTA. With the support of the Spanish Ministry of Health and the RedETS Council the Interest Group grew to at least one member for each of the eight RedETS regional agencies and units. It currently has 22 members. The PI Interest Group works in periodic online meetings and an annual offline meeting to establish a space for experiences exchange and reach consensus on main issues regarding PI.
RedETS published a strategy to facilitate effective and efficient PI in HTA processes in 2017. The long-term objective is to mainstream PI in all RedETS products. This strategy was built on a literature review and a qualitative study with semi-structured interviews. The interviews detected capacity building needs for technicians and methodologist in the network to be able to actively engage patients in HTA reports.
Since the kick-off meeting the PI Interest Group has worked in a number of activities. The main lines of action since its creation were: (i) evaluation of PI process in RedETS HTA reports in 2017 and in current reports, (ii) discussion on main methodological and procedural aspects, and feasibility of different patient participation approaches, (iii) development of technical protocols and templates to facilitate PI, (iv) the creation/adaptation of educational materials for patients and (v) translation of the HTAi Glossary for patients to Spanish.
Peer-to-peer learning processes can foster technical capacity of HTA methodologist in the Spanish HTA Network and may favor the implementation of the PI strategy.
This meta-analytic review is the first to synthesise findings from prospective research on the long-term course of borderline personality disorder in adult clinical populations.
Systematic searches were conducted in Medline, PsycINFO, PsycArticles, PubMed and Scopus within the period 1990-2017. Inclusion criteria were: (1) adult BPD sample diagnosed by a validated, semi-structured interview; (2) at least two prospective assessments of outcomes; and (3) follow-up period ≥ 5 years. Quality of evidence was rated with the Systematic Assessment of Quality in Observational Research (SAQOR). Four outcomes were meta-analysed using mixed-effect methods: remission from BPD diagnosis, completed suicide, depressive symptoms, and functioning. Potential moderators regarding the natural course and the initial treatment received were studied.
Eleven studies met the inclusion criteria, with 837 participants from nine countries being followed. Between 50% and 70% of the BPD patients achieved remission in the long-term. Significant reductions in depression and functional impairment were also found. Mean suicide rate ranged from 2% to 5%. Younger age was associated with higher likelihood for remission. Being female was correlated with lower functional improvement. Despite some positive trends, there were no significant associations between treatment moderators and the long-term outcome.
Findings suggest that the course of BPD is characterised by symptomatic amelioration and a slight functional improvement in the long-term. Age and gender modulate the long-term prognosis and should be considered to adapt treatment resources. Further research is required to draw robust conclusions on the long-term effects of psychotherapeutic interventions.
On the surface, the two books under review seem to have little in common. The Bonnitcha/Poulsen/Waibel (BPW) book, written by two legal academics and a political scientist, provides a balanced, fact-grounded account of international investment agreements (IIAs) and investor-state dispute settlement (ISDS). This is the “international treaty regime” in that book's title which the authors argue needs to be distinguished from the broader “international regime complex” that their book explicitly does not address, namely the number of other international instruments that at least incidentally also protect foreign investments (including, for example, political risk insurance, tax treaties, certain World Trade Organization agreements, and certain human rights treaties like the European Convention on Human Rights (ECHR)) (p. 7 and Figure 1.2). As one of the encomiums on its back cover page suggests, the BPW book seeks to answer the fraught competing contentions of defenders and critics of the regime that all too frequently generate “more heat than light.” Their book dispassionately synthesizes the available legal, economic, and political literature relevant to understanding the investment treaty regime's oft-proclaimed “legitimacy crisis.” It seeks to supply lawyers needing political context and political scientists needing legal knowledge with the unfiltered facts required to assess whether such a “crisis” exists and, if so, what the ways forward might be.
This work proposes a strategy for position control and obstacle avoidance in a quadcopter based on constrained generalized predictive control and geometric attitude control. The approach allows real-time trajectory tracking using optimal control actions and avoids collisions with static obstacles whose position is known. An experimental validation of the proposed controller is presented.
OBJECTIVES/SPECIFIC AIMS: Responding to the need and interest of students and faculty of the UHSP in learning about CTR, the Title V Cooperative Project between UPR-MSC and UCC, developed and offered a training cycle (TC) in CTR. METHODS/STUDY POPULATION: Undergraduate students (US), undergraduate faculty (UF), and graduate students (GS) were invited to register in: Research Education Towards Opportunities (RETO) and Mentorship Offering Training Opportunities for Research (MOTOR), which consisted of 20 hours of training in CTR, with interdisciplinary sessions in: Introduction and preparation of a presentation in CTR; Identify, interview and share a presentation of a CT researcher; participation in conferences and a summer camp in CTR. At the end of the TC, surveys—satisfaction and needs assessment—for training in CTR were administered. RESULTS/ANTICIPATED RESULTS: Thirty-three (33) registered in the TC, distributed: 13 (39.39%) US in RETO, 12 (36.36%) GS and 8 (24.24%) UF in MOTOR. Of these, 25 (75.75%) answered and submitted the on-line surveys and received a completion certificate. All (100%) were satisfied with the TC, and for 96% of the respondents, their expectations were fulfilled, and will continue in the TC. They selected critical review, scientific communication, and cultural diversity as thematic areas of interest. In addition, 60% of them selected neuroscience, cancer and medical imaging as main research areas of interest. DISCUSSION/SIGNIFICANCE OF IMPACT: The TC demonstrated to be an effective strategy to provide new knowledge, experiences, and interest in CTR. It also established a pathway for future engagement in CTR.
OBJECTIVES/SPECIFIC AIMS: The University of Puerto Rico-Medical Sciences Campus and Universidad Central del Caribe, through the Title V Cooperative Project, devised a clinical and translational research (CTR) platform to pipeline students/faculty of undergraduate health sciences programs into CTR. Educational interventions in CTR—introductory intervention (II) and Annual Symposium (AS)—were designed to promote awareness, stimulate interest of students and faculty in CTR. METHODS/STUDY POPULATION: In the II the participants (n=159) were surveyed before and after a presentation and panel discussion about CTR. In addition, after the sessions—plenary, panel, and workshop—about CTR, the participants of AS (n=42) were surveyed for satisfaction and learning experience in CTR. RESULTS/ANTICIPATED RESULTS: Most participants of the II, 134 (84.3%) were students. In total, 58 (58, 36.5%) completed the post II survey. Of these, 53.4% satisfactorily defined the CTR concept Versus only 31.0% that could define CTR in the pre survey, 47 (81.7%) were unable to identify a CTR researcher and 45 (78.3 %) expressed interest in learning about CTR. In total, 28 (28, 66.7%) participants of the AS completed the satisfaction survey, out of which 17 (60.6%) were students. One hundred percent (100%) agreed that the AS served as a vehicle to increase their knowledge in CTR. DISCUSSION/SIGNIFICANCE OF IMPACT: The educational interventions demonstrated to be an effective strategy to promote awareness and stimulate interest of students and faculty in CTR. In addition, the results obtained, provided valuable baseline information for the planning—development of training cycles in CTR.