The quality of primary care in a country with universal health care coverage.

BACKGROUND: Standard indicators of quality of care have been developed in the United States. Limited information exists about quality of care in countries with universal health care coverage.OBJECTIVE: To assess the quality of preventive care and care for cardiovascular risk factors in a country with universal health care coverage.DESIGN AND PARTICIPANTS: Retrospective cohort of a random sample of 1,002 patients aged 50-80 years followed for 2 years from all Swiss university primary care settings.MAIN MEASURES: We used indicators derived from RAND's Quality Assessment Tools. Each indicator was scored by dividing the number of episodes when recommended care was delivered by the number of times patients were eligible for indicators. Aggregate scores were calculated by taking into account the number of eligible patients for each indicator.KEY RESULTS: Overall, patients (44% women) received 69% of recommended preventive care, but rates differed by indicators. Indicators assessing annual blood pressure and weight measurements (both 95%) were more likely to be met than indicators assessing smoking cessation counseling (72%), breast (40%) and colon cancer screening (35%; all p < 0.001 for comparisons with blood pressure and weight measurements). Eighty-three percent of patients received the recommended care for cardiovascular risk factors, including > 75% for hypertension, dyslipidemia and diabetes. However, foot examination was performed only in 50% of patients with diabetes. Prevention indicators were more likely to be met in men (72.2% vs 65.3% in women, p < 0.001) and patients < 65 years (70.1% vs 68.0% in those a parts per thousand yen65 years, p = 0.047).CONCLUSIONS: Using standardized tools, these adults received 69% of recommended preventive care and 83% of care for cardiovascular risk factors in Switzerland, a country with universal coverage. Prevention indicator rates were lower for women and the elderly, and for cancer screening. Our study helps pave the way for targeted quality improvement initiatives and broader assessment of health care in Continental Europe.

Aplicacions de reconeixement de la parla: sistemes de respeaking III

En aquest projecte es fa una introducció als reconeixedors de la parla, el seu funcionament i la seva base matemàtica. Un cop tots els conceptes han quedat clars, es mostra el mètode de creació que hem seguit per obtenir el nostre propi reconeixedor de la parla, utilitzant les eines HTK, en català. S’avaluen les seves virtuts i els seus defectes a través de diferents proves realitzades als seus components. A més a més, el projecte arrodoneix la feina implementant un sistema de dictat automàtic que explota el reconeixedor de la parla utilitzant Julius.

Determinació de la regió del genoma o gens implicats en la síntesi del polièster extracel•lular present en la variant llisa de Mycobacterium vaccae mitjançant transformació

Estudi realitzat a partir d’una estada a la Universidad de Zaragoza, Espanya, entre novembre del 2007 i abril del 2008. Mycobacterium vaccae és un micobacteri ambiental de creixement ràpid molt estudiat pel seu interès com a possible ús immunoterapéutic en el tractament de la tuberculosis i altres malalties. M.vaccae a l’igual que altres micobacteris presenta dues morfologies colonials: llisa i rugosa. M.vaccae ATCC15483T té originàriament una morfologia llisa. Quant aquest es cultiva en medi sòlid a 30ºC apareixen espontàniament variants rugoses estables que no reverteixen a llises. El motiu pel qual aquest procés té lloc no es coneix, encara que s’ha descrit en Mycobacterium smegmatis i en Mycobacterium avium que els lípids de la paret cel•lular es troben involucrats en aquest canvi de morfologia colonial. L’anàlisi dels contingut en lípids i glicolípids de la paret cel•lular de les dos variants morfològiques de M.vaccae, ens ha indicat que les soques llises presenten un compost extracel•lular que no es troba en les rugoses i que mitjançant l’anàlisi estructural d’aquest compost ha sigut identificat com un polièster extracel•lular de cadena llarga. El present estudi s’ha centrat en determinar els gens implicats en la síntesis d’aquest compost. Per a realitzar aquest anàlisi genètic s’ha construit una llibreria de mutants per transposició de la soca llisa de M. vaccae mitjançant un plàsmid ts/sac i un transposó. S’han obtingut colònies de morfologia rugosa on el plàsmid s’ha insertat en la zona del genoma que codifica per aquest compost extracel•lular. Aquests nous mutants s’han analitzat mitjançant tècniques moleculars (PCR, Southern y seqüenciació). A mès, s’ha construit una llibreria genòmica amb DNA de la soca llisa en plàsmids replicatius de micobacteris derivats de pAL5000 i s’ha transformat la soca rugosa seleccionant per a un fenotip llis estudiant els gens que complementen.

Nineteen additional unpredicted transcripts from human chromosome 21.

The identification of all human chromosome 21 (HC21) genes is a necessary step in understanding the molecular pathogenesis of trisomy 21 (Down syndrome). The first analysis of the sequence of 21q included 127 previously characterized genes and predicted an additional 98 novel anonymous genes. Recently we evaluated the quality of this annotation by characterizing a set of HC21 open reading frames (C21orfs) identified by mapping spliced expressed sequence tags (ESTs) and predicted genes (PREDs), identified only in silico. This study underscored the limitations of in silico-only gene prediction, as many PREDs were incorrectly predicted. To refine the HC21 annotation, we have developed a reliable algorithm to extract and stringently map sequences that contain bona fide 3' transcript ends to the genome. We then created a specific 21q graphical display allowing an integrated view of the data that incorporates new ESTs as well as features such as CpG islands, repeats, and gene predictions. Using these tools we identified 27 new putative genes. To validate these, we sequenced previously cloned cDNAs and carried out RT-PCR, 5'- and 3'-RACE procedures, and comparative mapping. These approaches substantiated 19 new transcripts, thus increasing the HC21 gene count by 9.5%. These transcripts were likely not previously identified because they are small and encode small proteins. We also identified four transcriptional units that are spliced but contain no obvious open reading frame. The HC21 data presented here further emphasize that current gene prediction algorithms miss a substantial number of transcripts that nevertheless can be identified using a combination of experimental approaches and multiple refined algorithms.

Construcció i explotaciód'un magatzem de dades per a l'anàlisid'informació immobiliària

Per encàrrec d'una empresa immobiliària s'ha construït un magatzem de dades a partir d'un fitxer en format text amb els registres de 92.555 immobles amb la finalitat de, mitjançant consultes sobre aquestes dades utilitzant eines OLAP, obtenir informació sobre el mercatimmobiliari.

Desenvolupament d'un videojoc 3D basat en OpenGL

En aquest treball es presenta una aplicació gràfica per a desenvolupar un videojoc de tema lliure, amb premisses senzilles però fermes i amb la utilització d'unes eines el funcionament de les qual s'ha assolit durant la carrera i s?ha aprofundit durant el temps que ha durat la confecció d'aquest projecte.

Application of compositional data analysis to geochemical data of marine sediments

In an earlier investigation (Burger et al., 2000) five sediment cores near the RodriguesTriple Junction in the Indian Ocean were studied applying classical statistical methods(fuzzy c-means clustering, linear mixing model, principal component analysis) for theextraction of endmembers and evaluating the spatial and temporal variation ofgeochemical signals. Three main factors of sedimentation were expected by the marinegeologists: a volcano-genetic, a hydro-hydrothermal and an ultra-basic factor. Thedisplay of fuzzy membership values and/or factor scores versus depth providedconsistent results for two factors only; the ultra-basic component could not beidentified. The reason for this may be that only traditional statistical methods wereapplied, i.e. the untransformed components were used and the cosine-theta coefficient assimilarity measure.During the last decade considerable progress in compositional data analysis was madeand many case studies were published using new tools for exploratory analysis of thesedata. Therefore it makes sense to check if the application of suitable data transformations,reduction of the D-part simplex to two or three factors and visualinterpretation of the factor scores would lead to a revision of earlier results and toanswers to open questions . In this paper we follow the lines of a paper of R. Tolosana-Delgado et al. (2005) starting with a problem-oriented interpretation of the biplotscattergram, extracting compositional factors, ilr-transformation of the components andvisualization of the factor scores in a spatial context: The compositional factors will beplotted versus depth (time) of the core samples in order to facilitate the identification ofthe expected sources of the sedimentary process.Kew words: compositional data analysis, biplot, deep sea sediments

Identification of biologic markers of the premature rupture of fetal membranes: proteomic approach.

In obstetrics, premature rupture of the membranes (PROM) is a frequent observation which is responsible for many premature deliveries. PROM is also associated with an increased risk of fetal and maternal infections. Early diagnosis is mandatory in order to decrease such complications. Despite that current biological tests allowing the diagnosis of PROM are both sensitive and specific, contamination of the samples by maternal blood can induce false positive results. Therefore, in order to identify new potential markers of PROM (present only in amniotic blood, and absent in maternal blood), proteomic studies were undertaken on samples collected from six women at terms (pairs of maternal plasma and amniotic fluid) as well as on four samples of amniotic fluid collected from other women at the 17(th) week of gestation. All samples (N = 16) were analyzed by two-dimensional (2-D) high-resolution electrophoresis, followed by sensitive silver staining. The gel images were studied using bioinformatic tools. Analyses were focused on regions corresponding to pI between 4.5 and 7 and to molecular masses between 20 and 50 kDa. In this area, 646 +/- 113 spots were detected, and 27 spots appeared to be present on the gels of amniotic fluid, but were absent on those of maternal plasma. Nine out of these 27 spots were also observed on the gels of the four samples of amniotic fluids collected at the 17(th) week of pregnancy. Five of these 9 spots were unambiguously detected on preparative 2-D gels stained by Coomassie blue, and were identified by mass spectrometry analyses. Three spots corresponded to fragments of plasma proteins, and 2 appeared to be fragments of proteins not known to be present in plasma. These 2 proteins were agrin (SWISS-PROT: O00468) and perlecan (SWISS-PROT: P98160). Our results show that proteomics is a valuable approach to identify new potential biological markers for future PROM diagnosis.

Altered expression of beta-galactosidase-1-like protein 3 (Glb1l3) in the retinal pigment epithelium (RPE)-specific 65-kDa protein knockout mouse model of Leber's congenital amaurosis

Purpose: In this study, we investigated the expression of the gene encoding beta-galactosidase (Glb)-1-like protein 3 (Glb1l3), a member of the glycosyl hydrolase 35 family, during retinal degeneration in the retinal pigment epithelium (RPE)-specific 65-kDa protein knockout (Rpe65(-/-)) mouse model of Leber congenital amaurosis (LCA). Additionally, we assessed the expression of the other members of this protein family, including beta-galactosidase-1 (Glb1), beta-galactosidase-1-like (Glb1l), and beta-galactosidase-1-like protein 2 (Glb1l2).Methods: The structural features of Glb1l3 were assessed using bioinformatic tools. mRNA expression of Glb-related genes was investigated by oligonucleotide microarray, real-time PCR, and reverse transcription (RT) -PCR. The localized expression of Glb1l3 was assessed by combined in situ hybridization and immunohistochemistry.Results: Glb1l3 was the only Glb-related member strongly downregulated in Rpe65(-/-) retinas before the onset and during progression of the disease. Glb1l3 mRNA was only expressed in the retinal layers and the RPE/choroid. The other Glb-related genes were ubiquitously expressed in different ocular tissues, including the cornea and lens. In the healthy retina, expression of Glb1l3 was strongly induced during postnatal retinal development; age-related increased expression persisted during adulthood and aging.Conclusions: These data highlight early-onset downregulation of Glb1l3 in Rpe65-related disease. They further indicate that impaired expression of Glb1l3 is mostly due to the absence of the chromophore 11-cis retinal, suggesting that Rpe65 deficiency may have many metabolic consequences in the underlying neuroretina.

Methods for the ex vivo characterization of human CD8+ T subsets based on gene expression and replicative history analysis.

The generation of an antigen-specific T-lymphocyte response is a complex multi-step process. Upon T-cell receptor-mediated recognition of antigen presented by activated dendritic cells, naive T-lymphocytes enter a program of proliferation and differentiation, during the course of which they acquire effector functions and may ultimately become memory T-cells. A major goal of modern immunology is to precisely identify and characterize effector and memory T-cell subpopulations that may be most efficient in disease protection. Sensitive methods are required to address these questions in exceedingly low numbers of antigen-specific lymphocytes recovered from clinical samples, and not manipulated in vitro. We have developed new techniques to dissect immune responses against viral or tumor antigens. These allow the isolation of various subsets of antigen-specific T-cells (with major histocompatibility complex [MHC]-peptide multimers and five-color FACS sorting) and the monitoring of gene expression in individual cells (by five-cell reverse transcription-polymerase chain reaction [RT-PCR]). We can also follow their proliferative life history by flow-fluorescence in situ hybridization (FISH) analysis of average telomere length. Recently, using these tools, we have identified subpopulations of CD8+ T-lymphocytes with distinct proliferative history and partial effector-like properties. Our data suggest that these subsets descend from recently activated T-cells and are committed to become differentiated effector T-lymphocytes.

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Using analytical tools from game theory, we investigate the relevance of a series of hypotheses concerning natal dispersal, focusing in particular on the interaction between inbreeding and kin competition, as well as on the components of mating and social systems that are likely to interfere with these phenomena. A null model of pure kin competition avoidance predicts a balanced equilibrium in wich both sexes disperse equally. Inbreeding costs have the potential to destabilize the equilibrium, resulting in strongly sex-biased dispersal. This effect is mostly evident when the peculiarities of the mating system induce asymmetries in dispersal and/or inbreeding costs, or when kin cooperation counteracts kin competition. Inbreeding depression, however, is not the only possible cause for sex biases. The relevance of our results to empirical findings is dicussed and suggestions are made for further empirical or modelling work.

La percepció per part de l’alumnat del caràcter motivador d’un entorn virtual en l’aprenentatge d’una llengua estrangera

Aquest treball presenta una proposta d’investigació mitjançant la qual es pretendràanalitzar com percep l’aprenent la incidència de l’ús de les eines comunicatives de l’entornvirtual en la motivació envers l’aprenentatge d’una llengua estrangera. L’objectiu delprojecte d’investigació serà indagar com l’alumnat es relaciona amb l’ús d’eines decomunicació de l’entorn virtual com a recurs en l’aprenentatge de l’anglès i com percep elgrau en que aquestes estimulen el seu interès en adquirir la llengua.Aquesta indagació es durà a terme mitjançant una investigació bàsicament qualitativa. Elsresultats seran extrets a partir de dos grups de subjectes, que expressaran la seva pròpiapercepció del caràcter motivador de les eines de comunicació de l’entorn virtual. A partirde l’anàlisi i comparació dels resultats, s’inferirà quins estímuls resulten incitadors per al’estudiant, i si aquests estan relacionats amb les eines comunicatives de l’entorn virtual; o,al contrari, si en són independents.

Study of protein complexes

Summary : A lot of information can be obtained on proteins when proteomics methods are used. In our study, we aimed to characterize complexes containing pro-apoptotic proteins by different proteomics methods and finally focused on PIDD (p53-induced protein with a death domain), for which the most interesting results were obtained. PIDD has been shown to function as a molecular switch between genotoxic stress-induced apoptotis and genotoxic stress-induced cell survival through NF-κB activation. To exert these two functions, PIDD forms alternate complexes respectively with caspase2 and CRADD on one hand and RIP 1 and NEMO on the other hand. The first part of our study focuses on the processing of PIDD. PIDD full length (FL) is constitutively cleaved into three fragments, an N-terminal one (PIDD-N) and two fragments containing the C-terminus (PIDD-C and PIDD-CC). Localization of the two PIDD cleavage sites by mass spectrometry (MS) allowed to understand that PIDD is probably not cleaved by proteases but is subject to protein (self-)splicing and also to map the PIDD-N, PIDD-C and PIDD-CC fragments exactly. Further characterization of these three fragments by Tinel et al. (Tinel et al., 2007) showed that PIDD-C is involved in activation of an apoptotic pathway while PIDD-CC is involved in NF-κB activation. We also found that PIDD is subject to proline-directed phosphorylation at two serine residues in PIDD-N, the regulatory fragment of PIDD. The second part of the study aimed at identifying by proteomics techniques proteins that co-purify with PIDD and therefore are putative cellular interaction partners. In this respect we analyzed samples obtained in different conditions or with different PIDD constructs corresponding to processed fragments. This allowed us to identify a large number of potential interactors for PIDD. For example, by comparing data obtained from PIDD-C and PIDD-FL affinity purifications, we found that the Hsp90 chaperone system interacts strongly with PIDD-N. In the third part of this study, we developed methods to selectively and rapidly quantify by MS proteins of interest in PIDD affinity purifications or negative controls. Using these tools we detected significant changes in PIDD-FL-copurifying proteins treated by heat shock. Overall, our studies provide informative data on the processing of PIDD and its possible involvement in several molecular pathways.

Distributional patterns of the Neotropical genus Thecomyia Perty (Diptera, Sciomyzidae) and phylogenetic support

Distributional patterns of the Neotropical genus Thecomyia Perty (Diptera, Sciomyzidae) and phylogenetic support. The distributional pattern of the genus Thecomyia Perty, 1833 was defined using panbiogeographic tools, and analyzed based on the phylogeny of the group. This study sought to establish biogeographical homologies in the Neotropical region between different species of the genus, based on their distribution pattern and later corroboration through its phylogeny. Eight individual tracks and 16 generalized tracks were identified, established along nearly the entire swath of the Neotropics. Individual tracks are the basic units of a panbiogeographic study, and correspond to the hypothesis of minimum distribution of the organisms involved. The generalized tracks, obtained from the spatial congruence between two or more individual tracks, are important in the identification of smaller areas of endemism. Thus, we found evidence from the generalized tracks in support of previous classification for the Neotropical region. The Amazon domain is indicated as an area of outstanding importance in the diversification of the group, by the confluence of generalized tracks and biogeographic nodes in the region. Most of the generalized tracks and biogeographical nodes were congruent with the phylogenetic hypothesis of the genus, indicating support of the primary biogeographical homologies originally defined by the track analysis.

Genomics and the origin of species.

Speciation is a fundamental evolutionary process, the knowledge of which is crucial for understanding the origins of biodiversity. Genomic approaches are an increasingly important aspect of this research field. We review current understanding of genome-wide effects of accumulating reproductive isolation and of genomic properties that influence the process of speciation. Building on this work, we identify emergent trends and gaps in our understanding, propose new approaches to more fully integrate genomics into speciation research, translate speciation theory into hypotheses that are testable using genomic tools and provide an integrative definition of the field of speciation genomics.