Evidencia científica y recomendaciones sobre cribado de agudeza visual: revisión bibliográfica

Fundamentos: En los ámbitos científico e institucional existe controversia sobre cuándo recomendar la práctica del cribado visual en la población. El objetivo de este trabajo es valorar el nivel de evidencia científica que existe sobre el cribado visual para determinar si las recomendaciones existentes son o no adecuadas. Métodos: Revisión sistemática de artículos científicos consultando las bases de datos MedLine y The Cochranre Library Plus, sin restricción de fecha, en los idiomas español e inglés. Se incluyó literatura gris mediante búsqueda manual. No se hicieron restricciones respecto al tipo de estudio. Se revisaron los abstracts y en los casos necesarios los artículos completos, teniéndose en cuenta finalmente todos los artículos que incluían recomendaciones sobre cribado de agudeza visual y eliminando el resto. Resultados: Se seleccionaron 6 artículos. La mayoría de las recomendaciones realizadas por las sociedades fueron a través de guías de práctica clínica o artículos de opinión. Respecto a los diseños de los artículos científicos localizados hubo 2 ensayos aleatorios controlados, 3 ensayos no controlados y 1 estudio transversal. Conclusiones: Los estudios sobre adultos no permiten determinar que las recomendaciones realizadas por las sociedades científicas tengan una base científica sólida. En el caso de los niños, los estudios y las sociedades científicas no aclaran cuál es la edad más idónea para realizar cribado visual.

Does the scientific evidence support the advertising claims made for products containing Lactobacillus casei and Bifidobacterium lactis? A systematic review

Background To analyse the scientific evidence that exists for the advertising claims made for two products containing Lactobacillus casei and Bifidobacterium lactis and to conduct a comparison between the published literature and what is presented in the corporate website. Methods Systematic review, using Medline through Pubmed and Embase. We included human clinical trials that exclusively measured the effect of Lactobacillus casei or Bifidobacterium lactis on a healthy population, and where the objective was related to the health claims made for certain products in advertising. We assessed the levels of evidence and the strength of the recommendation according to the classification criteria established by the Oxford Centre for Evidence Based Medicine (CEBM). We also assessed the outcomes of the studies published on the website that did not appear in the search. Results Of the 440 articles identified, 16 met the inclusion criteria. Only four (25%) of these presented a level of evidence of 1b and a recommendation grade of A, all corresponding to studies on product containing Bifidobacterium lactis, and only 12 of the 16 studies were published on the corporate website (47). Conclusions There is insufficient scientific evidence to support the health claims made for these products, especially in the case of product containing Lactobacillus casei.

SMEs and Level 2 BIM, the Way Forward

The UK construction industry comprises a very high proportion of SMEs that is companies employing up to 250. A Department for Business, Innovation and Skills research paper, found that SMEs had a 71.2% share of work in the construction industry. Micro and small firms (i.e. those employing up to 50) had a share of 46.7% of work (Ive and Murray 2013). The Government has high ambitions for UK construction. Having been found by successive government commissioned studies to be inefficient and highly fragmented, ambitious targets have been set for the industry to achieve 33% reduction in costs and 50% faster delivery by 2025. As a significant construction client, the Government has mandated the use of Level 2 BIM from 2016 on publicly funded projects over £5 million. The adoption of BIM plays a key role in the 2025 vision but a lack of clarity persists in the industry over BIM and significant barriers are perceived to its implementation, particularly amongst SMEs. However, industry wide transformation will be challenging without serious consideration of the capabilities of this large majority. Many larger firms, having implemented Level 2 BIM are now working towards Level 3 BIM while many of the smaller firms in the industry have not even heard of BIM. It would seem that fears of a ‘two tier’ industry are perhaps being realised. This paper builds on an earlier one (Mellon & Kouider 2014) and investigates, through field work, the level of Level 2 BIM implementation amongst SMEs compared to a large organisation. Challenges and innovative solutions identified through collected data are fully discussed and compared. It is suggested that where the SME perceives barriers towards adoption of the technologies which underpin BIM, they may consider collaborative methods of working as an interim step in order to work towards realising the efficiencies and benefits that these methods can yield. While the barriers to adoption of BIM are significant, it is suggested that they are not insurmountable for the SME and some recommendations for possible solutions are made.

Paleoenvironmental changes during the late Miocene (Messinian)–Pliocene transition (Bajo Segura Basin, southeastern Spain): sedimentological and ichnological evidence

A detailed sedimentological and paleontological analysis of the uppermost Miocene (Messinian)–Pliocene boundary at the northern border of the Bajo Segura Basin, southeastern Spain, was carried out in order to describe the evolution of the regional paleocoastline during the Pliocene reflooding of the Mediterranean immediately after the sea-level fall related to the Messinian Salinity Crisis. Multiple trace fossils typical of firm- and hardgrounds were recognized, allowing identification of Glossifungites (two different types), Entobia, and Gnathichnus ichnofacies. Trace-fossil analysis showed that lithology and media consistency exerted considerable control on the development of the different ichnocoenoses and that there was a clear decrease in hydrodynamic energy from a coastal to a shallow-water shelf environment related to progressive sea-level rise. Ichnological and sedimentological data provide evidence that the definitive flooding of the Mediterranean was rapid and synchronous throughout the northern margin of the Bajo Segura Basin. The following model for the Pliocene transgression in the study area is therefore proposed: (1) the marine ingression penetrated along the incised paleovalleys carved as a consequence of the fall in sea level, where the first two Pliocene systems were deposited (P0–P1); (2) during the maximum flooding surface of the transgression, the sea overflowed the margins of the paleovalleys and extended throughout the entire northern margin of the basin; and (3) the third Pliocene system was deposited, forming the lower part of a highstand systems tract (P2).

The outburst decay of the low magnetic field magnetar SWIFT J1822.3−1606: phase-resolved analysis and evidence for a variable cyclotron feature

We study the timing and spectral properties of the low-magnetic field, transient magnetar SWIFT J1822.3−1606 as it approached quiescence. We coherently phase-connect the observations over a time-span of ∼500 d since the discovery of SWIFT J1822.3−1606 following the Swift-Burst Alert Telescope (BAT) trigger on 2011 July 14, and carried out a detailed pulse phase spectroscopy along the outburst decay. We follow the spectral evolution of different pulse phase intervals and find a phase and energy-variable spectral feature, which we interpret as proton cyclotron resonant scattering of soft photon from currents circulating in a strong (≳1014 G) small-scale component of the magnetic field near the neutron star surface, superimposed to the much weaker (∼3 × 1013 G) magnetic field. We discuss also the implications of the pulse-resolved spectral analysis for the emission regions on the surface of the cooling magnetar.