The COVID-19 pandemic and the measures adopted are having a profound impact on a major goal of public healthcare systems: universal access to health services. The objective is to synthesize the ...available knowledge on access to health care for non-COVID-19 conditions and to identify knowledge gaps. A scoping review was conducted searching different databases (Medline, Google Scholar, etc.) for original articles published between December 2019 and September 2021. A total of 53 articles were selected and analyzed using the Aday and Andersen framework as a guide. Of these, 37 analyzed changes in levels of use of health services, 15 focused on the influencing factors and barriers to access, and 1 studied both aspects. Most focused on specific diseases and the early stages of the pandemic, based on a review of records. Analyses of the impact on primary care services' use, unmet needs or inequalities in access were scarce. A generalized reduction in the use of health services was described. The most frequent access barrier described for non-COVID-19 conditions related to the services was a lack of resources, while barriers related to the population were predisposing (fear of contagion, stigma, or anticipating barriers) and enabling characteristics (worse socioeconomic status and an increase in technological barriers). In conclusion, our results show a general reduction in services' use in the early stages of the pandemic, as well as new barriers to access and the exacerbation of existing ones. In view of these results, more studies are required on the subsequent stages of the pandemic, to shed more light on the factors that have influenced access and the pandemic's impact on equity of access.
Studies on Multilingual Lexicography Domínguez Vázquez, María José; Mirazo Balsa, Mónica; Valcárcel Riveiro, Carlos
De Gruyter eBooks,
2019, 2019-12-16, Letnik:
157
eBook
Odprti dostop
The series features monographs and edited volumes on the topics of lexicography and meta-lexicography. Works from the broader domain of lexicology are also included if they strengthen the ...theoretical, methodological and empirical basis of lexicography and meta-lexicography. Thevolumes focus on aspects of lexicography such as micro- and macrostructure, typology, history of the discipline, and application-oriented lexicographical documentation.
Although electro‐organic synthesis is currently receiving renewed interest because of its potential to enable sustainability in chemical processes to value‐added products, challenges in process ...development persist: For reductive transformations performed in protic media, an inherent issue is the limited choice of metallic cathode materials that can effectively suppress the parasitic hydrogen evolution reaction (HER) while maintaining a high activity toward the targeted electro‐organic reaction. Current development trends are aimed at avoiding the previously used HER‐suppressing elements (Cd, Hg, and Pb) because of their toxicity. Here, this work reports the rational design of highly porous foam‐type binary and ternary electrocatalysts with reduced Pb content. Optimized cathodes are tested in electro‐organic reductions using an oxime to nitrile transformation as a model reaction relevant for the synthesis of fine chemicals. Their electrocatalytic performance is compared with that of the model CuSn7Pb15 bronze alloy that has recently been endorsed as the best cathode replacement for bare Pb electrodes. All developed metal foam catalysts outperform both bare Pb and the CuSn7Pb15 benchmark in terms of chemical yield and energetic efficiency. Moreover, post‐electrolysis analysis of the crude electrolyte mixture and the cathode's surfaces through inductively coupled plasma mass spectrometry (ICP‐MS) and scanning electron microscopy (SEM), respectively, reveal the foam catalysts’ elevated resistance to cathodic corrosion.
This work develops leaded foam‐type electrodes through the dynamic hydrogen bubble template (DHBT) method and tests them in electro‐organic reductions using an oxime to nitrile transformation for synthesis of fine chemicals. All developed catalysts outperformed both Pb and CuSn7Pb15 in terms of chemical yields and energy efficiency. The latter material is deemed the best replacement for Pb in reductive organo‐electrosynthesis.
Thermogenesis in brown adipose tissue (BAT) is fundamental to energy balance and is also relevant for humans. Bone morphogenetic proteins (BMPs) regulate adipogenesis, and, here, we describe a role ...for BMP8B in the direct regulation of thermogenesis. BMP8B is induced by nutritional and thermogenic factors in mature BAT, increasing the response to noradrenaline through enhanced p38MAPK/CREB signaling and increased lipase activity. Bmp8b−/− mice exhibit impaired thermogenesis and reduced metabolic rate, causing weight gain despite hypophagia. BMP8B is also expressed in the hypothalamus, and Bmp8b−/− mice display altered neuropeptide levels and reduced phosphorylation of AMP-activated protein kinase (AMPK), indicating an anorexigenic state. Central BMP8B treatment increased sympathetic activation of BAT, dependent on the status of AMPK in key hypothalamic nuclei. Our results indicate that BMP8B is a thermogenic protein that regulates energy balance in partnership with hypothalamic AMPK. BMP8B may offer a mechanism to specifically increase energy dissipation by BAT.
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► BMP8B is expressed in BAT and is regulated in response to thermogenic stimuli ► BMP8B increases the thermogenic response of BAT to adrenergic stimulation ► Loss of BMP8B substantially increases susceptibility to diet-induced obesity ► BMP8B acts in the CNS to increase SNS activation of thermogenesis
Cold exposure and a high-fat diet trigger BMP8 signaling in brown adipose tissue and in the brain to boost energy expenditure.
Current evidence suggests that ghrelin, a stomach derived peptide, exerts its orexigenic action through specific modulation of Sirtuin1 (SIRT1)/p53 and AMP-activated protein kinase (AMPK) pathways, ...which ultimately increase the expression of agouti-related protein (AgRP) and neuropeptide Y (NPY) in the arcuate nucleus of the hypothalamus (ARC). However, there is a paucity of data about the possible action of ghrelin on alternative metabolic pathways at this level. Here, we demonstrate that ghrelin elicits a marked upregulation of the hypothalamic mammalian target of rapamycin (mTOR) signaling pathway. Of note, central inhibition of mTOR signaling with rapamycin decreased ghrelin's orexigenic action and normalized the mRNA expression of AgRP and NPY, as well as their key downstream transcription factors, namely cAMP response-element binding protein (pCREB) and forkhead box O1 (FoxO1, total and phosphorylated). Taken together, these data indicate that, in addition to previous reported mechanisms, ghrelin also promotes feeding through modulation of hypothalamic mTOR pathway.
Thyroid hormones have widespread cellular effects; however it is unclear whether their effects on the central nervous system (CNS) contribute to global energy balance. Here we demonstrate that either ...whole-body hyperthyroidism or central administration of triiodothyronine (T3) decreases the activity of hypothalamic AMP-activated protein kinase (AMPK), increases sympathetic nervous system (SNS) activity and upregulates thermogenic markers in brown adipose tissue (BAT). Inhibition of the lipogenic pathway in the ventromedial nucleus of the hypothalamus (VMH) prevents CNS-mediated activation of BAT by thyroid hormone and reverses the weight loss associated with hyperthyroidism. Similarly, inhibition of thyroid hormone receptors in the VMH reverses the weight loss associated with hyperthyroidism. This regulatory mechanism depends on AMPK inactivation, as genetic inhibition of this enzyme in the VMH of euthyroid rats induces feeding-independent weight loss and increases expression of thermogenic markers in BAT. These effects are reversed by pharmacological blockade of the SNS. Thus, thyroid hormone-induced modulation of AMPK activity and lipid metabolism in the hypothalamus is a major regulator of whole-body energy homeostasis.
Self‐Standing Metal foam Catalysts
In article number 2307461, Pavel Moreno‐García, Peter Broekmann, Siegfried R. Waldvogel, and co‐workers established self‐standing metal foam catalysts for the ...cathodic electro‐organic synthesis. The strongly enhanced surface and specific phases enable a tremendously enhanced performance in preparative electro‐synthesis compared to planar electrodes.
La transparencia es uno de los principales retos que afrontan las confesiones religiosas, puesto que deben explicar su misión y el uso de los bienes materiales requeridos para llevarla a cabo, ...sujetas a una normativa que no contempla su singularidad. La amplia autonomía de organización que el ordenamiento jurídico les reconoce no puede esgrimirse como argumento para eludir el cumplimiento de las obligaciones legales establecidas en materia de transparencia, sin perjuicio de su invocación para adecuar o flexibilizar el cumplimiento de alguna obligación en concreto que les resulte de dudosa o difícil aplicación. El objeto de este estudio es analizar la sujeción de las confesiones religiosas a las obligaciones de transparencia y presentarlas como una herramienta positiva y favorable que otorga a las confesiones religiosas la oportunidad de explicar su misión; difundir su mensaje; publicitar el abanico de actividades que desarrollan; y demostrar que, en el ejercicio de su misión, la dimensión económica tiene un carácter meramente instrumental.
Like many cancers, an early diagnosis of melanoma is fundamental to ensure a good prognosis, although an important proportion of stage I–II patients may still develop metastasis during follow‐up. The ...aim of this work was to discover serum biomarkers in patients diagnosed with primary melanoma that identify those at a high risk of developing metastasis during the follow‐up period. Proteomic and mass spectrophotometry analysis was performed on serum obtained from patients who developed metastasis during the first years after surgery for primary tumors and compared with that from patients who remained disease‐free for more than 10 years after surgery. Five proteins were selected for validation as prognostic factors in 348 melanoma patients and 100 controls by ELISA: serum amyloid A and clusterin; immune system proteins; the cell adhesion molecules plakoglobin and vitronectin and the antimicrobial protein dermcidin. Compared to healthy controls, melanoma patients have high serum levels of these proteins at the moment of melanoma diagnosis, although the specific values were not related to the histopathological stage of the tumors. However, an analysis based on classification together with multivariate statistics showed that tumor stage, vitronectin and dermcidin levels were associated with the metastatic progression of patients with early‐stage melanoma. Although melanoma patients have increased serum dermcidin levels, the REPTree classifier showed that levels of dermcidin <2.98 μg/ml predict metastasis in AJCC stage II patients. These data suggest that vitronectin and dermcidin are potent biomarkers of prognosis, which may help to improve the personalized medical care of melanoma patients and their survival.
What's new?
The discovery of serum biomarkers capable of predicting metastatic risk during post‐operative follow‐up in early‐stage primary melanoma patients could significantly benefit patient prognosis and survival. The present study identifies two promising biomarker candidates: vitronectin and dermcidin. Analysis and comparison of serum proteins in melanoma patients who either remained disease‐free or developed metastases in the years after surgery to remove primary tumors revealed a strong association between metastatic progression of early‐stage melanomas (AJCC stage III) and vitronectin and dermcidin serum levels. Further study of these proteins could open up new opportunities in the effort to improve long‐term survival among melanoma patients.
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