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Written entirely in Spanish by instructors with years of experience, this textbook is a comprehensive guide to essay writing in Spanish. It provides advanced students of Spanish with the necessary tools to write fluently and effectively, both developing their reading, writing and critical thinking skills, and teaching them to practically analyse the rules of spelling, punctuation and grammar. It is organised into six chapters, progressing in level and complexity, which take students step-by-step through the writing process. Each chapter contains a number of features such as lists of new vocabulary, assessment checklists, questionnaires, and activities based on writing samples. It also includes an accompanying web resource, which features additional exercises for students, and a lesson plan and downloadable PowerPoint presentations for teachers. By drawing on the principles of grammar, this essential resource will help students become proficient writers, across a range of textual genres.
Cuba is a paradigmatic case where the term and concept of the peasantry remains of lived importance. Cuban peasants had a significant role in the past as they did return to the political agenda after the Revolution with particular emphasis under Raul Castro’s administration. However, the Cuban case has not been significantly explored from a long-term perspective that connects the old debates and dimensions of land reforms under developmentalist states to the new agrarian questions in the global era. Based on secondary sources, semi-structured interviews and updated data on land structures, this article explores the long-term process of land reform in Cuba.
Negative interactions between people and crocodilians have increased worldwide, but in Mexico there have been few systematic reports and no rigorous evaluation of this problem. We compiled information on negative interactions between people and the spectacled caiman Caiman crocodilus and American crocodile Crocodylus acutus from the Worldwide Crocodilian Attack Database for 1993–2018, and we investigated interactions in greater depth, through interviews with people in La Encrucijada Biosphere Reserve. We examined the relationship between the occurrence of negative interactions between people and C. acutus and the species' nesting season and abundance, and presence records. In Mexico, the frequency of negative interactions increases when anthropogenic activities occur close to nesting sites (< 30 km) and during the nesting season (February–September). In La Encrucijada, following negative interactions with crocodiles, the local inhabitants killed 30 crocodiles measuring > 2.5 m long in 2011–2012. The frequency of negative human–crocodilian interactions was not correlated with the abundance of crocodilians but was correlated with the number of presence records of crocodiles. Strategies to minimize these interactions include warnings at nesting sites, increased monitoring of anthropogenic activities during the nesting season, and management of nests to prevent them being destroyed by people.
The Late Intermediate period in the south-central Andes is known for the widespread use of open sepulchres called chullpas by descent-based ayllus to claim rights to resources and express idealized notions of how society should be organized. Chullpas, however, were rarer on the coast, with the dead often buried individually in closed tombs. This article documents conditions under which these closed tombs were used at the site of Quilcapampa on the coastal plain of southern Peru, allowing an exploration into the ways that funerary traditions were employed to both reflect and generate community affiliation, ideals about sociopolitical organization, and land rights. After a long hiatus, the site was reoccupied and quickly expanded through local population aggregation and highland migrations. An ayllu organization that made ancestral claims to specific resources was poorly suited to these conditions, and the site's inhabitants instead seem to have organized themselves around the ruins of Quilcapampa's earlier occupation. In describing what happened in Quilcapampa, we highlight the need for a better understanding of the myriad ways that Andean peoples used mortuary customs to structure the lives of the living during a period of population movements and climate change.
A cumulative environmental exposure score for schizophrenia (exposome score for schizophrenia [ES-SCZ]) may provide potential utility for risk stratification and outcome prediction. Here, we investigated whether ES-SCZ was associated with functioning in patients with schizophrenia spectrum disorder, unaffected siblings, and healthy controls.
This cross-sectional sample consisted of 1,261 patients, 1,282 unaffected siblings, and 1,525 healthy controls. The Global Assessment of Functioning (GAF) scale was used to assess functioning. ES-SCZ was calculated based on our previously validated method. The association between ES-SCZ and the GAF dimensions (symptom and disability) was analyzed by applying regression models in each group (patients, siblings, and controls). Additional models included polygenic risk score for schizophrenia (PRS-SCZ) as a covariate.
ES-SCZ was associated with the GAF dimensions in patients (symptom: B = −1.53, p-value = 0.001; disability: B = −1.44, p-value = 0.001), siblings (symptom: B = −3.07, p-value < 0.001; disability: B = −2.52, p-value < 0.001), and healthy controls (symptom: B = −1.50, p-value < 0.001; disability: B = −1.31, p-value < 0.001). The results remained the same after adjusting for PRS-SCZ. The degree of associations of ES-SCZ with both symptom and disability dimensions were higher in unaffected siblings than in patients and controls. By analyzing an independent dataset (the Genetic Risk and Outcome of Psychosis study), we replicated the results observed in the patient group.
Our findings suggest that ES-SCZ shows promise for enhancing risk prediction and stratification in research practice. From a clinical perspective, ES-SCZ may aid in efforts of clinical characterization, operationalizing transdiagnostic clinical staging models, and personalizing clinical management.
In this paper, we introduce a family of processes with values on the nonnegative integers that describes the dynamics of populations where individuals are allowed to have different types of interactions. The types of interactions that we consider include pairwise interactions, such as competition, annihilation, and cooperation; and interactions among several individuals that can be viewed as catastrophes. We call such families of processes branching processes with interactions. Our aim is to study their long-term behaviour under a specific regime of the pairwise interaction parameters that we introduce as the subcritical cooperative regime. Under such a regime, we prove that a process in this class comes down from infinity and has a moment dual which turns out to be a jump-diffusion that can be thought as the evolution of the frequency of a trait or phenotype, and whose parameters have a classical interpretation in terms of population genetics. The moment dual is an important tool for characterizing the stationary distribution of branching processes with interactions whenever such a distribution exists; it is also an interesting object in its own right.
A crossover trial was conducted to compare hand rub and hand scrub-brush methods for reducing bacterial loads when using propan-1-ol-60% according to European regulations. Both methods significantly reduced the bacterial load immediately after antisepsis, but only the hand rub method achieved significant bacterial load reduction 3 hours after the procedure.
The Monitoring Studies (MS) program, the approach developed by RedETS to generate postlaunch real-world evidence (RWE), is intended to complement and enhance the conventional health technology assessment process to support health policy decision making in Spain, besides informing other interested stakeholders, including clinicians and patients. The MS program is focused on specific uncertainties about the real effect, safety, costs, and routine use of new and insufficiently assessed relevant medical devices carefully selected to ensure the value of the additional research needed, by means of structured, controlled, participative, and transparent procedures. However, despite a clear political commitment and economic support from national and regional health authorities, several difficulties were identified along the development and implementation of the first wave of MS, delaying its execution and final reporting. Resolution of these difficulties at the regional and national levels and a greater collaborative impulse in the European Union, given the availability of an appropriate methodological framework already provided by EUnetHTA, might provide a faster and more efficient comparative RWE of improved quality and reliability at the national and international levels.
Interactions between smooth muscle cells (SMCs) and biomaterials must not result in phenotype changes as this may generate uncontrolled multiplication processes and occlusions in vascular grafts. The aim of this study was to relate the hydrolytic stability and biocompatibility of polyurethanes (PUs) on SMCs. A higher polycaprolactone (PCL) concentration was found to improve the hydrolytic stability of the material and the adhesion of SMCs. A material with 5% polyethylene glycol, 90% PCL, and 5% pentaerythritol presented high cell viability and adhesion, suggesting a contractile phenotype in SMCs depending on the morphology. Nevertheless, all PUs retained their elastic modulus over 120 days, similar to the collagen of native arteries (~10 MPa). Furthermore, aortic SMCs did not present toxicity (viability over 80%) and demonstrated adherence without any abnormal cell multiplication processes, which is ideal for the function to be fulfiled in situ in the vascular grafts.
There is evidence that environmental and genetic risk factors for schizophrenia spectrum disorders are transdiagnostic and mediated in part through a generic pathway of affective dysregulation.
We analysed to what degree the impact of schizophrenia polygenic risk (PRS-SZ) and childhood adversity (CA) on psychosis outcomes was contingent on co-presence of affective dysregulation, defined as significant depressive symptoms, in (i) NEMESIS-2 (n = 6646), a representative general population sample, interviewed four times over nine years and (ii) EUGEI (n = 4068) a sample of patients with schizophrenia spectrum disorder, the siblings of these patients and controls.
The impact of PRS-SZ on psychosis showed significant dependence on co-presence of affective dysregulation in NEMESIS-2 [relative excess risk due to interaction (RERI): 1.01, p = 0.037] and in EUGEI (RERI = 3.39, p = 0.048). This was particularly evident for delusional ideation (NEMESIS-2: RERI = 1.74, p = 0.003; EUGEI: RERI = 4.16, p = 0.019) and not for hallucinatory experiences (NEMESIS-2: RERI = 0.65, p = 0.284; EUGEI: −0.37, p = 0.547). A similar and stronger pattern of results was evident for CA (RERI delusions and hallucinations: NEMESIS-2: 3.02, p < 0.001; EUGEI: 6.44, p < 0.001; RERI delusional ideation: NEMESIS-2: 3.79, p < 0.001; EUGEI: 5.43, p = 0.001; RERI hallucinatory experiences: NEMESIS-2: 2.46, p < 0.001; EUGEI: 0.54, p = 0.465).
The results, and internal replication, suggest that the effects of known genetic and non-genetic risk factors for psychosis are mediated in part through an affective pathway, from which early states of delusional meaning may arise.
Unwanted loneliness is a public health issue due to its high prevalence among elderly people (20-40%) and its relation with morbidity and mortality. There is no clear strategy for addressing this problem given the diversity of needs and resources people with feelings of loneliness have.
Identify the needs and resources of elderly people with chronic conditions and feelings of loneliness by comparing the patient’s outlook with that of their primary healthcare professional.
Observational, cross-sectional, descriptive pilot study using theoretical convenience sampling at 5 health facilities in Barcelona (Spain), performed between October and May 2020. Of 159 people selected, 42 were identified to have feelings of loneliness (UCLA < 30) who agreed to participate in the study and their care needs were analysed using the Camberwell Assessment of Need for the Elderly (CANE) questionnaire. A descriptive and comparative analysis (Kappa coefficient and discrepancy percentage) of needs was performed using the outlook of the patients and their healthcare professionals. Data was analysed using SAS assuming a 5% significance level. A qualitative analysis was also performed to understand the relation between the feeling of loneliness and needs across 24 care areas (environmental, social, psychological, and physical). The study was approved by the IDIAP Jordi Gol Healthcare Ethics Committee (19/138-P).
The needs perceived focused on physical health, distress, companionship, and relationships (30% to 41.7%). Professionals showed a severe lack of knowledge regarding housing, home care, relationships, and social services (22% to 48%). The qualitative analysis revealed the relation between the feeling of loneliness and the irreversible losses of those close to the patient, along with insufficient support and understanding during the aging process, and feelings of abandonment and guilt. Meanwhile, other notable aspects include the need of independence and resistance towards starting activities requiring commitment and travel. Caring for others and mobility and sensory restrictions act as extra barriers.
This study enables the needs of people with feelings of loneliness to be identified. Discrepancies between them and their healthcare professionals were recorded, in turn providing direction regarding which areas need to be improved when designing patient-focused primary healthcare approaches.
This work presents a multimode flight framework control scheme for a quadrotor based on the super twisting algorithm. The controller design stages for six flight control modes are presented. The stability proof for each flight mode is carried out by means of Lyapunov functions, while the stability analysis for the complete control scheme, when a transition from one flight mode to another occurs, is demonstrated using the switching nonlinear systems theory. The performance of the proposed framework is shown in a 3D simulation environment considering a forest fire detection task, which takes into account external disturbances.
Fewer than 200 radiocarbon (14C) dates with secure contextual information are available for Cuba, making it challenging to reconstruct Caribbean indigenous population dynamics, their identities and interactions. In this paper, we discussed 21 accelerator mass spectrometry (AMS) 14C dates from two mounds (M1 and M2) at the Playa del Mango site (Granma province, Cuba), traditionally associated with the Banwaroid stone tool tradition. The ΔR calculated for the site was –132.0 ± 176 and –164.0 ± 68. The chronology of burials from the peripheral area of M2 suggested that the cemetery was continuously used from at least cal BC 116–AD 241 (2 σ). The domestic area of M2 was used at minimum between cal BC 55–AD 435 (2 σ), which encompasses the use of the funerary areas. An isolated human tooth from M1 [cal AD 125–435 (2 σ)] suggested that this funerary area is later than the one at the periphery of M2, and possibly contemporaneous with the later formation of the M2 shell midden. The archaeological assemblage of the “Banwaroid tradition” is widely distributed in Cuba, and mixed with other archaeological traditions, supporting that a complex web of human interactions took place in the Caribbean in precolonial times.
The presence of at least five dimensions in mania has recently been established. This study extends previous findings by comparing the dimensions of pure vs. mixed mania.
Materials and method
One hundred and three inpatients with bipolar I disorder, manic or mixed (DSM IV), were assessed with SCID-I, YMRS and HDRS-21. The five-factor solution found after applying factorial analysis with Varimax rotation was compared between manic and mixed patients.
There were differences between pure mania and mixed states on factor 1 (depression) and factor 3 (hedonism). There was a tendency to present higher values on factor 5 (activation) in the pure manic group. No differences were found in factor 2 (dysphoria) and factor 4 (psychosis).
Hedonism and activation dimensions are present to a lesser degree in mixed states. Although the principal difference between mixed and pure bipolar disorder is the existence of depressive symptoms, the depressive dimension is strongly present in patients with pure mania.
There is need to search for core depressive symptoms in all patients suffering from mania and to evaluate their outcome in clinical trials.
Recent studies have led to suggest that the multifunctional protein clusterin could be envisaged as a potential diagnostic biomarker of addictive behaviours. However, this hypothesis has not been yet tested in nicotine addicts.
We have studied possible associations between clusterin levels in saliva from smokers under cessation treatment and variables related to tobacco consumption, dependence and addiction.
Eighty-one patients were included in an ambulatory smoking cessation programme that involved the use of pharmacological and behavioural therapy. The participants underwent psychological assessment of addiction and dependence (DAST-20, ASSIST, Fagerström tests) and provided saliva samples at the onset of the intervention and 6 months after smoking discontinuation to study the evolution of clusterin levels by enzyme-linked immunosorbent assays.
Clusterin concentration did not correlate with nicotine addiction/dependence scores but was significantly elevated in smokers with prolonged tobacco use and high intensity of tobacco consumption. Moreover, the levels of the protein significantly decreased 6 months after smoking cessation.
The results obtained provide strong evidence of a close association between tobacco use and salivary clusterin, a protein that emerges as a biomarker of tobacco toxicity with potential interest to monitor the beneficial effects of smoking cessation.
Genetic data on threatened plant populations can facilitate the development of adequate conservation strategies to reduce extinction risk. Such data are particularly important for species affected by habitat fragmentation such as Magnolia cubensis subsp. acunae, a Critically Endangered magnolia subspecies endemic to Cuba. Using genetic data from 67 individuals, we aimed to evaluate the effect of habitat fragmentation on two subpopulations in the Guamuhaya mountain range, in Topes de Collantes Protected Natural Landscape and Lomas de Banao Ecological Reserve. We characterize the structure and genetic diversity of these subpopulations, with the objective of managing their conservation more effectively. We used Landsat satellite images to determine land-cover types at the two locations and calculated indices of habitat fragmentation. For genetic analyses, we extracted DNA from the leaf tissue of individuals from the two subpopulations and used 11 microsatellite markers to genotype them. We calculated heterozygosity, allelic richness and the F-statistics, to evaluate genetic variability. The montane rainforest in Topes de Collantes was most affected by habitat fragmentation, with smaller patches of more irregular shapes, compared to submontane forest at this location and both montane and submontane forests in Lomas de Banao. Genetic diversity was higher in Topes de Collantes, but we found no genetic differentiation between subpopulations. Our findings suggest the two subpopulations can be considered a single evolutionary unit and conservation entity. We propose to use individuals from both subpopulations for reinforcement to increase the overall genetic diversity of the subspecies.
As a consequence of axenic growth and the elimination of accompanying bacterial flora, Entamoeba histolytica virulence decreases rapidly, and pathogenicity is lost. This paper evaluated the impact of vitamin supplementation on the pathogenicity of E. histolytica. Growth of E. histolytica trophozoites, cultured axenically in PEHPS (a Spanish acronym for the main ingredients – casein peptone, liver, pancreas extract and bovine serum) medium, with or without vitamins, exhibited a similar growth rate. However, the vitamin-enriched PEHPS preparations expressed 2.65 times more haemolytic activity (at 60 min: 98 vs 48%, P < 0.05), 2.5 times more phospholipase A2 activity at 150 min of incubation and generated more hepatic abscesses (88 vs 60%, P = 0.05) than the preparations without vitamins. The haemolytic and phospholipase A2 activity for the PEHPS − V preparations were restored following vitamin supplementation with A and D. These data highlight, for the first time, that vitamins and specifically vitamin A and D were essential for the recovery of amoebic virulence, lost through axenic growth.
This paper examines the cost of living and evolution of welfare ratios among urban workers in Rio Grande's vila, the main commercial enclave of the southern Portuguese dominions in America. From diverse sources (military and hospital expenditure accounts, merchant credit bills from probate inventories), we build different consumption baskets to calculate their cost in seven benchmark years: 1772, 1792, 1802, 1809, 1816, 1819 and 1823. The evolution of cost of living shows a consistent upward trend during the period, which, however, does not substantially affect welfare ratios. In order to build regional comparisons, we follow Allen's methodology (2001) to estimate welfare ratios of skilled and unskilled workers in Rio Grande, Buenos Aires and Montevideo. The results of using this approach could be useful to adjust the methodology for further international comparisons.
The knowledge about the association of physical activity (PA) and sedentary behaviours (SB) with the most considered healthy dairy products consumption, as milk and yogurt, in childhood is scared.
To assess the longitudinal relationship between specific lifestyle behaviours (PA and SB) and combined dairy consumption (milk + yogurt) in a sample of European children.
Two measurements, with 2 years’ interval (T0 and T1), were conducted in 1 688 (50.8% boys) childrenfrom the IDEFICS study. Dietary information was parental-registered by a 24-hour dietary recall. At both time points, sedentary behaviour and objective estimation of PA was obtained by accelerometers. Different groups were defined according to the international children's PA and SB behaviours recommendations over time. The cut-offs for the SB and PA recommendations were established on 2hour/day of SB and 2 hour/day of moderate to vigorous PA. Multilevel ordinal logistic regression models were used to assess the group's association with the combined dairy consumption (milk + yogurt), adjusted for potential confounders (sex, body mass index zscore, intervention versus control region, parental education level, dietary quality index, energy intake and the consumption by each dairy group at T0).
Nine groups of meeting or not both recommendations (SB and PA) were obtained. Those children who meeting both lifestyle recommendations at both measurement points, had higher probability to consume more milk and yogurt (p < 0.05), in comparison to the rest of combinations.Those children who did not meet any recommendations at both time points were less likely to consume milk + yogurt (OR: 0.47, 95%CI:0.26–0.83) than those who met both recommendations at both time points. Those children which improved one behaviours (PA or SB) between both measurement point were associated with low consumption of milk + yogurt (OR:0.41, 95%CI 0.22;0.74; OR:0.40, 95%CI 0.22,0.72), compared with those who meet both lifestyle recommendations at both periods (T0 and T1). Also, those which improved both behaviours (PA and SB) were less likely to consume milk + yogurt (OR:0.34, 95%CI 0.15–0.80) than those who were physically active and low sedentary at both time points.
These results suggest that European children with a healthy lifestyle regarding PA and SB over time, had the highest milk and yogurt consumption in comparison with other children.