Objetivos: El objetivo de esta revisión es resumir la evidencia disponible sobre la asociación entre el consumo de azúcar, principalmente sacarosa, y el riesgo de cáncer de distinta localización. ...Métodos: Se ha realizado una revisión de los principales informes publicados, las revisiones sistemáticas, metanálisis, así como grandes estudios epidemiológicos prospectivos publicados con fecha posterior al 1 de enero de 2007 hasta 31 de diciembre de 2012 sobre la asociación entre el consumo de azúcar, principalmente sacarosa, y el riesgo de cáncer. Resultados: La evidencia de asociación entre la ingesta de mono y disacáridos con los distintos tipos de cáncer es insuficiente o existe evidencia de no asociación. Sólo existe evidencia posible de una relación positiva entre la ingesta de monosacáridos (fructosa y glucosa) y el riesgo de cáncer de páncreas. La evidencia sobre la asociación entre la ingesta de monosacáridos y el riesgo de obesidad es insuficiente, lo mismo que en relación con la ingesta de sacarosa o azúcar añadido y el riesgo de obesidad en adultos o en niños. Existe evidencia posible de una asociación positiva entre el índice glucémico (IG) y cáncer colorrectal y de que no hay asociación entre el IG y el riesgo de cáncer de endometrio, mama y páncreas. Conclusiones: Es necesario seguir investigando. Son especialmente necesarios estudios de cohortes y serían deseables estudios aleatorizados de intervención, aunque son difíciles en este ámbito.
The effects of trade liberalization on wages, inequality, and employment in middle-income countries remains an important empirical question. However, with few exceptions, most of the empirical ...literature has focused on aggregate impacts at a national or regional level and the effects on skilled versus unskilled workers. This paper focuses on the effects of trade liberalization on industry-specific wages, earnings, and employment in rural and urban areas of Peru, providing more nuanced evidence on the distributional effects of trade. We use an instrumental variable approach and different measures of trade liberalization for the 2001-2016 period. Our main results suggest that, first, trade openness is associated with an increase in urban workers' earnings and wages, with self-employed workers benefitting the most. Second, whereas wages of workers with low and high levels of education decrease as a consequence of trade openness, the earnings of self-employed workers are affected positively, benefiting unskilled workers the most. In addition, while earnings increase in almost all industries in both rural and urban areas, effects are heterogeneous for wages. Overall, both salaried and self-employed agricultural workers benefitted from trade openness, indicative that agriculture is a competitive sector with important export potential.
Veterinary medicine has focused recently on reptiles, due to the existence of captive collections in zoos and an increase in the acquisition of reptiles as pets. The protozoan parasite, Entamoeba can ...cause amoebiasis in various animal species and humans. Although amoebiasis disease is remarkably rare in most species of chelonians and crocodiles, these species may serve as Entamoeba species carriers that transmit parasites to susceptible reptile species, such as snakes and lizards, which can become sick and die. In this study, we identified the Entamoeba species in a population of healthy (disease-free) chelonians, and evaluated their diversity through the amplification and sequencing of a small subunit rDNA region. Using this procedure, three Entamoeba species were identified: Entamoeba invadens in 4.76 % of chelonians, Entamoeba moshkovskii in 3.96 % and Entamoeba terrapinae in 50 %. We did not detect mixed Entamoeba infections. Comparative analysis of the amplified region allowed us to determine the intra-species variations. The E. invadens and E. moshkovskii strains isolated in this study did not exhibit marked differences with respect to the sequences reported in GenBank. The analysis of the E. terrapinae isolates revealed three different subgroups (A, B and C). Although subgroups A and C were very similar, subgroup B showed a relatively marked difference with respect to subgroups A and C (Fst = 0.984 and Fst = 1.000, respectively; 10-14 % nucleotide variation, as determined by blast) and with respect to the sequences reported in GenBank. These results suggested that E. terrapinae subgroup B may be either in a process of speciation or belong to a different lineage. However, additional research is necessary to support this statement conclusively.
Resumen Introducción y objetivos: numerosos determinantes ambientales influyen en el crecimiento y en el desarrollo y condicionan la expresión potencial o su evolución en el tiempo. Se analiza la ...influencia de algunos condicionantes sociodemográficos en la sobrecarga ponderal, en el peso y en la talla en la población adulta española. Métodos: el análisis se ha realizado en una submuestra (25 a 64 años) del estudio ENPE, estudio observacional transversal sobre una muestra poblacional aleatoria de población. Se recogió información sobre edad, género, nivel de estudios, ocupación y lugar de residencia. La clase social se codificó en función de la ocupación. Se tomaron mediciones individuales de peso y talla. Resultados: la prevalencia de obesidad es mayor en hombres, aumenta con la edad y se observa una relación inversa con el nivel de estudios y la clase social. Es mayor en Asturias, Galicia y Andalucía. La talla baja es más frecuente en personas con estudios primarios incompletos y clase social baja, al contrario que la talla alta, más frecuente también en las regiones norte-este y centro. El bajo peso corporal es menos frecuente en personas sin estudios y de clase social baja. Conclusiones: en base a la desigual distribución del sobrepeso y de la obesidad, las estrategias preventivas en nutrición comunitaria deben contemplar la mejora del nivel de educación nutricional y del grado de entornos más desfavorecidos.
Carbon dioxide embolus has been reported as a rare but clinically important risk associated with transanal total mesorectal excision surgery. To date, there exists limited data describing the ...incidence, risk factors, and management of carbon dioxide embolus in transanal total mesorectal excision.
This study aimed to obtain data from the transanal total mesorectal excision registries to identify trends and potential risk factors for carbon dioxide embolus specific to this surgical technique.
Contributors to both the LOREC and OSTRiCh transanal total mesorectal excision registries were invited to report their incidence of carbon dioxide embolus. Case report forms were collected detailing the patient-specific and technical factors of each event.
The study was conducted at the collaborating centers from the international transanal total mesorectal excision registries.
Characteristics and outcomes of patients with carbon dioxide embolus associated with transanal mesorectal excision were measured.
Twenty-five cases were reported. The incidence of carbon dioxide embolus during transanal total mesorectal excision is estimated to be ≈0.4% (25/6375 cases). A fall in end tidal carbon dioxide was noted as the initial feature in 22 cases, with 13 (52%) developing signs of hemodynamic compromise. All of the events occurred in the transanal component of dissection, with mean (range) insufflation pressures of 15 mm Hg (12-20 mm Hg). Patients were predominantly (68%) in a Trendelenburg position, between 30° and 45°. Venous bleeding was reported in 20 cases at the time of carbon dioxide embolus, with periprostatic veins documented as the most common site (40%). After carbon dioxide embolus, 84% of cases were completed after hemodynamic stabilization. Two patients required cardiopulmonary resuscitation because of cardiovascular collapse. There were no deaths.
This is a retrospective study surveying reported outcomes by surgeons and anesthetists.
Surgeons undertaking transanal total mesorectal excision must be aware of the possibility of carbon dioxide embolus and its potential risk factors, including venous bleeding (wrong plane surgery), high insufflation pressures, and patient positioning. Prompt recognition and management can limit the clinical impact of such events. See Video Abstract at http://links.lww.com/DCR/A961.
This letter presents a novel system to perform range detections using an artificial neural network on the time-domain baseband signal of frequency-modulated continuous wave radar sensors. The network ...is trained and evaluated with synthetic signals, which are generated with a point target simulator. To evaluate the performance of the proposed approach, it is compared with an order statistics constant false alarm rate (CFAR) detector at different signal-to-noise ratios. The detection system is shown to work-in some cases even outperforming the baseline-in synthetic single-target, as well as in multiple-target scenarios. Therefore, it is capable of replacing the usual fast Fourier transform and CFAR detection procedures in radar signal processing. Furthermore, it is demonstrated that the detection system also works with real radar measurement data.
As new applications of artificial intelligence continue to emerge, there is an increasing interest to explore how this type of technology can improve automated service interactions between the firm ...and its customers. This paper aims to develop a conceptual framework that details how firms and customers can enhance the outcomes of firm-solicited and firm-unsolicited online customer engagement behaviors through the use of information processing systems enabled by artificial intelligence. By building on the metaphor of artificial intelligence systems as organisms and taking a Stimulus-Organism-Response theory perspective, this paper identifies different types of firm-solicited and firm-unsolicited online customer engagement behaviors that act as stimuli for artificial intelligence organisms to process customer-related information resulting in both artificial intelligence and human responses which, in turn, shape the contexts of future online customer engagement behaviors.
The aim of the study presented here was to determine the relationship between age and certain socioeconomic factors and the effect that physical activity may have on the prevalence of overweight and ...obesity among Spanish children and adolescents. The sample derived from the enKid study, a cross-sectional study of a representative sample of the Spanish population aged 2-24 years. Body mass index was calculated from measured weight and height. A physical activity questionnaire was administered. Age, socioeconomic level of the families, the mother's level of education, and the geographical area of residence were related to the prevalence of overweight and obesity among Spanish males.
The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is a specific outcome instrument developed to measure upper-extremity disability and symptoms. The aim of this work is to develop a ...Spanish version of the DASH questionnaire and to analyze its reliability, validity and responsiveness.
We performed cross-cultural adaptation of the DASH to Spanish, using a process that included double forward and backward translations, expert review and field-testing. The Spanish version's reliability, content, construct and criterion validity and responsiveness were then evaluated in 98 patients with upper-extremity conditions that completed the DASH and SF-36 generic health questionnaire before and after medical rehabilitation treatment.
We obtained a Spanish DASH version (DASHe) linguistically and conceptually equivalent to the original version. Internal consistency of the DASHe was high (Cronbach alpha = 0.96), test-retest reliability was excellent (r = 0.96) and the floor and ceiling effects were negligible. Construct and criteria validity was shown by a positive association of DASHe scores with worse condition, and a significant correlation with the SF-36 scores, stronger with the SF-36 pain dimension. Responsiveness was excellent (effect size and standardized response means higher than 0.80).
The DASHe is a reliable, valid and responsive instrument that can provide a standardized measure in Spanish patients with upper-extremity musculoskeletal conditions.
El presente artículo efectúa una aproximación a la recuperación simbólica como argumento fundamental utilizado en la edición revisada de Aprendiendo de Las Vegas (Venturi, Scott Brown & Izenour, ...1977), texto que asumió una importante repercusión en la teoría arquitectónica contramodernista. Esta recuperación, extremadamente crítica con la imposición vulgarizada del funcionalismo del estilo internacional, resulta coincidente con el rechazo de la neovanguardia norteamericana hacia el academicismo formalista del expresionismo abstracto, así como con la crisis del concepto de modernidad, propiciada por lo que —no sin cierta confusión— se conceptualizó como pensamiento posmoderno.
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