In rural destinations different programmes coexist to promote tourism which involves many organizations and relationships. The complexity of stakeholder networks in some cases implies that the result ...of the application of the programmes is not efficient enough. This paper aims to explore some of these challenges regarding destinations located in rural areas taking the case study of Castilla-La Mancha (Spain). While much of the literature focuses on pinpointing the factors that have a bearing on destination governance, this research attempts to sort the importance of each factor. Structured qualitative questionnaires have been held with rural tourism suppliers (n = 52). The findings highlight that public-private partnerships, coordination on both horizontal and vertical levels, marketing management skills and integration of local activities are shown as priorities according to supply-based stakeholders’ opinions. A consolidation of a neoliberal approach of tourism governance is necessary, in which local governments assume a secondary role, and management is decentralised through community-based public-private partnerships.
The new European training model has led to innovations in Higher Education as the incorporation of Information and Communication Technology (ICT) to learning processes. Each student learns in a ...different way and therefore the ways of studying are very relevant in the academic development. This fact has revealed the need for the use of ICT in the university environment. It has been a quantitative research using the questionnaire REATIC using a sample (N = 2117) of students from the five areas of knowledge at the University of Salamanca, to know the use and opinion they have about ICT in their learning. The results presented students management above all basic and personal interrelation programs, search engines in the network, online video portals and virtual libraries. They value the help and importance of ICT in their learning process and consider positively them as relevant tools. The results showed significant differences in the use and consideration of ICT in the five areas of knowledge. Health Sciences students present the highest preference level in use of ICT. Four well-differentiated clusters were identified by applying the factor analysis to obtain a multivariate characterization of the students: One was formed by students with a medium-low level of ICT consideration and use, another by the graduates with a high level of ICT consideration and use, to a third consisting of students with a medium-high level of ICT consideration and use and to final covering students with low level of ICT consideration and medium-low level of ICT use.
•Students of the University of Salamanca use different ICT.•University students value positively the ICT in their learning process.•Depending on the areas of knowledge there are differences in the use of ICT.•Health Sciences students present the highest preference level in use of ICT.•There are four well-differentiated clusters according to ICT's consideration.
Key points
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Glucocorticoids are stress hormones used in the treatment of many chronic inflammatory diseases including asthma. They exert most of their physiological/pharmacological actions by ...regulating the activity of genes involved in the inflammatory response. However, they also have rapid/non‐genomic effects whose functions are poorly understood.
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In this study we used two widely prescribed glucocorticoids, beclomethasone dipropionate and prednisolone acetate, to investigate whether these hormones have rapid/non‐genomic effects in mammalian skeletal muscles.
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Both glucocorticoids increased maximum force in slow‐twitch muscle fibres/cells without significantly affecting that of fast‐twitch muscle fibres.
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The increase in force occurred within 10 min and was blocked by an inhibitor of the glucocorticoid receptor and a protein (antibody) that binds the receptor.
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These findings suggest that these hormones/drugs have rapid/non‐genomic effects in mammalian skeletal muscles; these effects are mediated by a membrane glucocorticoid receptor and are physiologically/pharmacologically beneficial, especially in slow muscles.
Glucocorticoids (GCs) are steroid hormones released from the adrenal gland in response to stress. They are also some of the most potent anti‐inflammatory and immunosuppressive drugs currently in clinical use. They exert most of their physiological and pharmacological actions through the classical/genomic pathway. However, they also have rapid/non‐genomic actions whose physiological and pharmacological functions are still poorly understood. Therefore, the primary aim of this study was to investigate the rapid/non‐genomic effects of two widely prescribed glucocorticoids, beclomethasone dipropionate (BDP) and prednisolone acetate (PDNA), on force production in isolated, intact, mouse skeletal muscle fibre bundles. The results show that the effects of both GCs on maximum isometric force (Po) were fibre‐type dependent. Thus, they increased Po in the slow‐twitch fibre bundles without significantly affecting that of the fast‐twitch fibre bundles. The increase in Po occurred within 10 min and was insensitive to the transcriptional inhibitor actinomycin D. Also, it was maximal at ∼250 nm and was blocked by the glucocorticoid receptor (GCR) inhibitor RU486 and a monoclonal anti‐GCR, suggesting that it was mediated by a membrane (m) GCR. Both muscle fibre types expressed a cytosolic GCR. However, a mGCR was present only in the slow‐twitch fibres. The receptor was more abundant in oxidative than in glycolytic fibres and was confined mainly to the periphery of the fibres where it co‐localised with laminin. From these findings we conclude that the rapid/non‐genomic actions of GCs are mediated by a mGCR and that they are physiologically/therapeutically beneficial, especially in slow‐twitch muscle fibres.
Humans have many cognitive skills not possessed by their nearest primate relatives. The cultural intelligence hypothesis argues that this is mainly due to a species-specific set of social-cognitive ...skills, emerging early in ontogeny, for participating and exchanging knowledge in cultural groups. We tested this hypothesis by giving a comprehensive battery of cognitive tests to large numbers of two of humans' closest primate relatives, chimpanzees and orangutans, as well as to 2.5-year-old human children before literacy and schooling. Supporting the cultural intelligence hypothesis and contradicting the hypothesis that humans simply have more "general intelligence," we found that the children and chimpanzees had very similar cognitive skills for dealing with the physical world but that the children had more sophisticated cognitive skills than either of the ape species for dealing with the social world.
In this work, we studied 217 Mexican subjects divided into six groups with different stages of glucose intolerance: 76 Controls (CO), 54 prediabetes (PRE), 14 T2D no medication (T2D-No-M), 14 T2D ...with Metformin (T2D-M), 22 T2D with polypharmacy (T2D-P), and 37 T2D with polypharmacy and insulin (T2D-P+I). We aimed to determine differences in the gut microbiota diversity for each condition. At the phylum level, we found that Firmicutes and Bacteroidetes outline major changes in the gut microbiota. The gut bacterial richness and diversity of individuals in the T2D-No-M group were lesser than other groups. Interestingly, we found a significant difference in the beta diversity of the gut microbiota among all groups. Higher abundance was found for
in PRE, and
spp. in T2D-No-M. In addition, we found associations of specific microbial taxa with clinical parameters. Finally, we report predicted metabolic pathways of gut microbiota linked to T2D-M and PRE conditions. Collectively, these results indicate that each group has specific predicted metabolic characteristics and gut bacteria populations for each phenotype. The results of this study could be used to define strategies to modulate gut microbiota through noninvasive treatments, such as dietary intervention, probiotics or prebiotics, and to improve glucose tolerance of individuals with prediabetes or T2D.
Electrons feed into the mitochondrial electron transport chain (mETC) from NAD- or FAD-dependent enzymes. A shift from glucose to fatty acids increases electron flux through FAD, which can saturate ...the oxidation capacity of the dedicated coenzyme Q (CoQ) pool and result in the generation of reactive oxygen species. To prevent this, the mETC superstructure can be reconfigured through the degradation of respiratory complex I, liberating associated complex III to increase electron flux via FAD at the expense of NAD. Here, we demonstrate that this adaptation is driven by the ratio of reduced to oxidized CoQ. Saturation of CoQ oxidation capacity induces reverse electron transport from reduced CoQ to complex I, and the resulting local generation of superoxide oxidizes specific complex I proteins, triggering their degradation and the disintegration of the complex. Thus, CoQ redox status acts as a metabolic sensor that fine-tunes mETC configuration in order to match the prevailing substrate profile.
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•High CoQH2/CoQ ratio induces reverse electron transport under physiological conditions•RET-generated ROS induces partial complex I degradation•Increase in the CIII fraction detached of CI optimizes mETC to consume fatty acids•The CoQH2/CoQ ratio serves as a sensor of respiratory chain efficiency
Guarás et al. show how the mitochondrial electron transport chain (mtETC) is optimized to better oxidize different nutrients or fuels using the reducing status of ubiquinone as a metabolic sensor and ROS generated by complex I by reverse electron transport as an executor.
Objectives
Performing lung ultrasound during the clinical assessment of patients with suspicion of noncritical COVID‐19 may increase the diagnostic rate of pulmonary involvement over other diagnostic ...techniques used in routine clinical practice. This study aims to compare complications (readmissions, emergency department ED visits, and length of outpatient follow‐up) in the first 30 days after ED discharge in patients with confirmed COVID‐19 who were managed with versus without lung ultrasound.
Materials and Methods
Prospective, observational, analytical study in noncritical patients with confirmed respiratory disease due to SARS‐CoV‐2, assessed in the ED of a tertiary Spanish hospital in March and April 2020. We compared 2 cohorts, differentiated by the use of lung ultrasound as a diagnostic tool. Complications were assessed (hospital admissions, ED revisits and days of outpatient follow‐up) at 30 days postdischarge.
Results
Of the 88 included patients, 31% (n = 27) underwent an initial lung ultrasound, while 61 (68%) did not. In 82.5% of the patients evaluated with ultrasound, the most predominant areas affected were the posterobasal regions, in the form of focalized and confluent B‐lines; 70.4% showed pleural irregularity in these same areas. Use of the lung ultrasound was associated with a greater probability of hospital admission (odds ratio 5.63, 95% confidence interval 3.31 to 9.57; p < 0.001). However, it was not significantly associated with mortality or short‐term complications.
Conclusions
Lung ultrasound could identify noncritical patients with lung impairment due to SARS‐CoV‐2, in whom other tests used routinely show no abnormalities. However, it has not shown a prognostic value in these patients and could generate a higher percentage of hospital admissions. More studies are still needed to demonstrate the clear benefit of this use.
Detection of epidermal growth factor receptor (EGFR) mutations in exons 18-21 is recommended in all patients with advanced Non-small-cell lung carcinoma due to the demonstrated efficiency of the ...standard therapy with tyrosine kinase inhibitors in EGFR-mutated patients. Therefore, choosing a suitable technique to test EGFR mutational status is crucial to warrant a valid result in a short turnaround time using the lowest possible amount of tissue material. The Idylla™ EGFR Mutation Test is a simple, fast and reliable method designed for the detection of EGFR mutations from formalin-fixed paraffin-embedded samples. The aim of this study was the Clinical Performace Evaluation of the Idylla™ EGFR Mutation Test on the Idylla™ System.
EGFR mutational status was determined on 132 archived formalin-fixed paraffin-embedded tissue sections with Idylla™ technology. Results were compared with the results previously obtained by routine method in the reference lab (Therascreen® EGFR RGQ PCR v2, Qiagen in Molecular Pathology lab, Hospital Universitario Virgen del Rocío de Sevilla).
The overall agreement between results obtained with the Idylla™ EGFR Mutation Test and the Comparator test method was 95.38% (with 1-sided 95% lower limit of 91.7%) showing Positive Diagnostic Agreement of 93.22% and Negative Diagnostic Agreement of 97.18%, with a Limit Of Detection ≤5%.
The Idylla™ EGFR Mutation Test passed its clinical validity performance characteristics for accuracy.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Early childhood development (ECD) is a critical stage in the intergenerational process of human development. Targeted interventions depend on accurate and up-to-date ECD measurements. This paper ...presents estimates for the nutritional and neurodevelopmental status of socially marginalized children in Mexico. We performed a cross-sectional study based on data collected in 2019-2020 during home visits to 1,176 children aged 0-38 months across 24 highly marginalized locations in Oaxaca. We assessed nutritional status according to the World Health Organization 2006 child-growth standards and ECD status using the Child Development Evaluation Test, 2.sup.nd Edition. We stratified results by sex. Prevalence of stunting was 5.3 percentage points (p.p.) higher (p = 0.023) in males (25.3%; 95% CI: 20.2%, 31.1%) compared to females (20.0%; 95% CI: 15.0%, 26.1%). Overall prevalence rates stood at 5.7% (95% CI: 4.0%, 8.1%) for underweight, 1.5% (95% CI: 0.9%, 2.7%) for wasting and 3.6% (95% CI: 2.3%, 5.7%) for overweight/obesity, with no significant differences by sex. Prevalence of normal development was 8.3 p.p. lower (p = 0.001) in males (39.3%; 95% CI: 34.5%, 44.4%) compared to females (47.6%; 95% CI: 41.6%, 53.6%). By development area, the highest prevalence of suboptimal outcomes among children with developmental lag or at risk of delay was observed in their gross motor and language skills: 24.1% (95% CI: 20.0%, 28.8%) and 38.6% (95% CI: 34.0%, 43.3%), respectively. The largest difference between the sexes was found in the language area. Our results show that childhood development strategies have been insufficient thus far in the studied population. Programs specifically designed to prevent ECD lags and bridge inequality gaps are urgently needed.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Although recent work has described the microbiome in solid tumors, microbial content in hematological malignancies is not well-characterized. Here we analyze existing deep DNA sequence data from the ...blood and bone marrow of 1870 patients with myeloid malignancies, along with healthy controls, for bacterial, fungal, and viral content. After strict quality filtering, we find evidence for dysbiosis in disease cases, and distinct microbial signatures among disease subtypes. We also find that microbial content is associated with host gene mutations and with myeloblast cell percentages. In patients with low-risk myelodysplastic syndrome, we provide evidence that Epstein-Barr virus status refines risk stratification into more precise categories than the current standard. Motivated by these observations, we construct machine-learning classifiers that can discriminate among disease subtypes based solely on bacterial content. Our study highlights the association between the circulating microbiome and patient outcome, and its relationship with disease subtype.
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