Research activities at european level performed at the Institute for Públic Safety of Catalonia

To start off, this document describes the Catalan model for emergencies response and its reference frame in terms of geography, location population…In addition, describes the main actors involved in emergencies response such as: police, the Fire and Rescue Emergency Service, the Emergency Medical System, Civil Protection, Reception and Management of Emergency Calls, Rural Agents, ADF’s and UME. Civil Protection, Firefighters and Police are includes in the training model developed by the Institute for Public Safety of Catalonia which at the same time does research in both security and safety matters. Research activities are performed by the Area for Research, Knowledge and International Cooperation at the ISPC and an example of these activities are European Research Projects such as COIM-Best (Coordination Improvement by Best Practices) and BESECU (cross-cultural differences of human behaviour in fire disasters and other crisis situations) among others.

A Multiagent System for Coordinating Ambulances for Emergency Medical Services

To coordinate ambulances for emergency medical services, a multiagent system uses an auction mechanism based on trust. Results of tests using real data show that this system can efficiently assign ambulances to patients, thereby reducing transportation time. Emergency transportation on specialized vehicles is needed when a person's health is in risk of irreparable damage. A patient can't benefit from sophisticated medical treatments and technologies if she or he isn't placed in a proper healthcare center with the appropriate medical team. For example, strokes are neurological emergencies involving a limited amount of time in which treatment measures are effective

Preventive medicine for epidemic outbreaks and risky behavior through mobile devices and ubiquitous computing

In this work, we have developed the first free software for mobile devices with the Android operating system that can preventively mitigate the number of contagions of sexually transmitted infections (STI), associated with risk behavior. This software runs in two modes. The normal mode allows the user to see the alerts and nearby health centers. The second mode enables the service to work in the background. This software reports the health risks, as well as the location of different test centers.

The use of the SeDeM diagram expert system for the formulation of Captopril SR matrix tablets by direct compression

The SeDeM Diagram Expert System has been used to study excipients, Captopril and designed formulations for their galenic characterization and to ascertain the critical points of the formula affecting product quality to obtain suitable formulations of Captopril Direct Compression SR Matrix Tablets. The application of the Sedem Diagram Expert System enables selecting excipients with in order to optimize the formula in the preformulation and formulation studies. The methodology is based on the implementation of ICH Q8, establishing the design space of the formula with the use of experiment design, using the parameters of the SeDeM Diagram Expert System as system responses.

Systems medicine and integrated care to combat chronic noncommunicable diseases

We propose an innovative, integrated, cost-effective health system to combat major non-communicable diseases (NCDs), including cardiovascular, chronic respiratory, metabolic, rheumatologic and neurologic disorders and cancers, which together are the predominant health problem of the 21st century. This proposed holistic strategy involves comprehensive patient-centered integrated care and multi-scale, multi-modal and multi-level systems approaches to tackle NCDs as a common group of diseases. Rather than studying each disease individually, it will take into account their intertwined gene-environment, socio-economic interactions and co-morbidities that lead to individual-specific complex phenotypes. It will implement a road map for predictive, preventive, personalized and participatory (P4) medicine based on a robust and extensive knowledge management infrastructure that contains individual patient information. It will be supported by strategic partnerships involving all stakeholders, including general practitioners associated with patient-centered care. This systems medicine strategy, which will take a holistic approach to disease, is designed to allow the results to be used globally, taking into account the needs and specificities of local economies and health systems.

The planarian flatworm: an in vivo model for stem cell biology and nervous system regeneration

Planarian flatworms are an exception among bilaterians in that they possess a large pool of adult stem cells that enables them to promptly regenerate any part of their body, including the brain. Although known for two centuries for their remarkable regenerative capabilities, planarians have only recently emerged as an attractive model for studying regeneration and stem cell biology. This revival is due in part to the availability of a sequenced genome and the development of new technologies, such as RNA interference and next-generation sequencing, which facilitate studies of planarian regeneration at the molecular level. Here, we highlight why planarians are an exciting tool in the study of regeneration and its underlying stem cell biology in vivo, and discuss the potential promises and current limitations of this model organism for stem cell research and regenerative medicine.

Metal dealing at the origin of the Chordata phylum: The metallothionein system and metal overload response in Amphioxus.

Non-vertebrate chordates, specifically amphioxus, are considered of the utmost interest for gaining insight into the evolutionary trends, i.e. differentiation and specialization, of gene/protein systems. In this work, MTs (metallothioneins), the most important metal binding proteins, are characterized for the first time in the cephalochordate subphylum at both gene and protein level, together with the main features defining the amphioxus response to cadmium and copper overload. Two MT genes (BfMT1 and BfMT2) have been identified in a contiguous region of the genome, as well as several ARE (antioxidant response element) and MRE (metal response element) located upstream the transcribed region. Their corresponding cDNAs exhibit identical sequence in the two lancelet species (B. floridae and B. lanceolatum), BfMT2 cDNA resulting from an alternative splicing event. BfMT1 is a polyvalent metal binding peptide that coordinates any of the studied metal ions (Zn, Cd or Cu) rendering complexes stable enough to last in physiological environments, which is fully concordant with the constitutive expression of its gene, and therefore, with a metal homeostasis housekeeping role. On the contrary, BfMT2 exhibits a clear ability to coordinate Cd(II) ions, while it is absolutely unable to fold into stable Cu (I) complexes, even as mixed species. This identifies it as an essential detoxification agent, which is consequently only induced in emergency situations. The cephalochordate MTs are not directly related to vertebrate MTs, neither by gene structure, protein similarity nor metal-binding behavior of the encoded peptides. The closest relative is the echinoderm MT, which confirm proposed phylogenetic relationships between these two groups. The current findings support the existence in most organisms of two types of MTs as for their metal binding preferences, devoted to different biological functions: multivalent MTs for housekeeping roles, and specialized MTs that evolve either as Cd-thioneins or Cu-thioneins, according to the ecophysiological needs of each kind of organisms.

Systems Medicine and Integrated Care to Combat Chronic Noncommunicable Diseases.

We propose an innovative, integrated, cost-effective health system to combat major non-communicable diseases (NCDs), including cardiovascular, chronic respiratory, metabolic, rheumatologic and neurologic disorders and cancers, which together are the predominant health problem of the 21st century. This proposed holistic strategy involves comprehensive patient-centered integrated care and multi-scale, multi-modal and multi-level systems approaches to tackle NCDs as a common group of diseases. Rather than studying each disease individually, it will take into account their intertwined gene-environment, socio-economic interactions and co-morbidities that lead to individual-specific complex phenotypes. It will implement a road map for predictive, preventive, personalized and participatory (P4) medicine based on a robust and extensive knowledge management infrastructure that contains individual patient information. It will be supported by strategic partnerships involving all stakeholders, including general practitioners associated with patient-centered care. This systems medicine strategy, which will take a holistic approach to disease, is designed to allow the results to be used globally, taking into account the needs and specificities of local economies and health systems.

A new multidisciplinary home care telemedicine system to monitor stable chronic human immunodeficiency virus-infected patients: a randomized study.

Background: Antiretroviral therapy has changed the natural history of human immunodeficiency virus (HIV) infection in developed countries, where it has become a chronic disease. This clinical scenario requires a new approach to simplify follow-up appointments and facilitate access to healthcare professionals. Methodology: We developed a new internet-based home care model covering the entire management of chronic HIV-infected patients. This was called Virtual Hospital. We report the results of a prospective randomised study performed over two years, comparing standard care received by HIV-infected patients with Virtual Hospital care. HIV-infected patients with access to a computer and broadband were randomised to be monitored either through Virtual Hospital (Arm I) or through standard care at the day hospital (Arm II). After one year of follow up, patients switched their care to the other arm. Virtual Hospital offered four main services: Virtual Consultations, Telepharmacy, Virtual Library and Virtual Community. A technical and clinical evaluation of Virtual Hospital was carried out. Findings: Of the 83 randomised patients, 42 were monitored during the first year through Virtual Hospital (Arm I) and 41 through standard care (Arm II). Baseline characteristics of patients were similar in the two arms. The level of technical satisfaction with the virtual system was high: 85% of patients considered that Virtual Hospital improved their access to clinical data and they felt comfortable with the videoconference system. Neither clinical parameters [level of CD4 + T lymphocytes, proportion of patients with an undetectable level of viral load (p = 0.21) and compliance levels 90% (p = 0.58)] nor the evaluation of quality of life or psychological questionnaires changed significantly between the two types of care. Conclusions: Virtual Hospital is a feasible and safe tool for the multidisciplinary home care of chronic HIV patients. Telemedicine should be considered as an appropriate support service for the management of chronic HIV infection.

Organización de la reanimación cardiopulmonar intrahospitalaria. Situación actual en España.

La parada cardiorrespiratoria (PCR) dentro del hospital es considerada una emergencia vital y está demostrado que existe una relación directa entre la respuesta asistencial y la mortalidad asociada a este evento. Los resultados del tratamiento de la PCR son un indicador de calidad de los centros sanitarios. En el caso en concreto de España, la mayoría de hospitales no disponen de un sistema organizado e integral de atención a la PCR. A pesar de los avances en medicina y tecnológicos, la tasa de supervivencia no ha variado significativamente en los últimos 30 años por lo que se ha de considerar como un problema social, económico y sanitario de gran magnitud que cabe abordar con todas las herramientas disponibles. Objetivos: Conocer cómo se organiza la reanimación cardiopulmonar (RCP) dentro del hospital y conocer los planes integrales de RCP publicados por los hospitales españoles. Metodología: Se realiza una revisión de la literatura a través de las bibliotecas indexadas Pubmed y Web of Science mediante criterios de inclusión/exclusión, uso de operadores booleanos y búsqueda bibliográfica manual. Además se realiza una entrevista a un médico referente nacional en la investigación sobre RCP. Resultados: Se han encontrado 7 planes integrales para la atención a la PCR y solo 2 de ellos están avalados por el Plan Nacional de RCP (PNRCP), miembro del Consejo Español de RCP (CERCP). Conclusiones: Existe una falta de publicaciones por parte de los hospitales españoles sobre planes integrales para la organización de la RCP que cumplan los criterios de calidad necesarios. Si bien todos los hospitales disponen de protocolos propios dirigidos a sus profesionales para la actuación en caso de PCR, estos son de uso interno y solo tienen en común entre ellos el hecho de seguir las recomendaciones de las guías del European Resuscitation Council (ERC). III Es necesario que los centros sanitarios fomenten y compartan su actividad investigadora sobre el tema. Palabras clave: parada cardíaca hospitalaria, resucitación cardiopulmonar, Plan hospitalario de resucitación.

Construction and validation of a scoring system for the selection of high-quality data in a Spanish population primary care database (SIDIAP)

Background Computerised databases of primary care clinical records are widely used for epidemiological research. In Catalonia, the InformationSystem for the Development of Research in Primary Care (SIDIAP) aims to promote the development of research based on high-quality validated data from primary care electronic medical records. Objective The purpose of this study is to create and validate a scoring system (Registry Quality Score, RQS) that will enable all primary care practices (PCPs) to be selected as providers of researchusable data based on the completeness of their registers. Methods Diseases that were likely to be representative of common diagnoses seen in primary care were selected for RQS calculations. The observed/ expected cases ratio was calculated for each disease. Once we had obtained an estimated value for this ratio for each of the selected conditions we added up the ratios calculated for each condition to obtain a final RQS. Rate comparisons between observed and published prevalences of diseases not included in the RQS calculations (atrial fibrillation, diabetes, obesity, schizophrenia, stroke, urinary incontinenceand Crohn’s disease) were used to set the RQS cutoff which will enable researchers to select PCPs with research-usable data. Results Apart from Crohn’s disease, all prevalences were the same as those published from the RQS fourth quintile (60th percentile) onwards. This RQS cut-off provided a total population of 1 936 443 (39.6% of the total SIDIAP population). Conclusions SIDIAP is highly representative of the population of Catalonia in terms of geographical, age and sex distributions. We report the usefulness of rate comparison as a valid method to establish research-usable data within primary care electronic medical records