Five years of sleep apnea treatment with a mandibular advancement device. Side effects and technical complications

Objective: To determine the variation in prevalence of temporomandibular disorders (TMD), other side effects, and technical complications during 5 years of sleep apnea treatment with a mandibular advancement device. Materials and Methods: Forty patients diagnosed with obstructive sleep apnea received an adjustable appliance at 70% of the maximum protrusion. The protrusion was then progressively increased. TMD (diagnosed according to the Research Diagnostic Criteria for TMD), overjet, overbite, occlusal contacts, subjective side effects, and technical complications were recorded before and a mean of 14, 21, and 58 months after treatment and analyzed by the Wilcoxon test (P Less-than .05). Results: Fifteen patients still used the oral appliance at the 5-year follow-up, and no significant variation in TMD prevalence was observed. Subjective side effects were common, and a significant reduction was found in overjet, overbite, and in the number of occlusal contacts. Furthermore, the patients made a mean of 2.5 unscheduled dental visits per year and a mean of 0.8 appliance repairs/relines per year by a dental technician. The most frequent unscheduled visits were needed during the first year and were a result of acrylic breakage on the lateral telescopic attachment, poor retention, and other adjustments to improve comfort. Conclusions: Five-year oral appliance treatment does not affect TMD prevalence but is associated with permanent occlusal changes in most sleep apnea patients during the first 2 years. Patients seek several unscheduled visits, mainly because of technical complications.

Membrane interaction of polymyxin B and synthetic analogues studied in biomimetic systems: implications for antibacterial action

Membrane-active antimicrobial peptides, such as polymyxin B (PxB), are currently in the spotlight as potential candidates toovercome bacterial resistance. We have designed synthetic analogs ofPxB in order to determine the structural requirements for membraneaction. Since the mechanism of action of PxB involves interaction withboth the outer membrane and the cytoplasmic membrane of Gramnegative bacteria, we have used an approach based on mimicking theouter layers of these membranes using monolayers, Langmuir-Blodgettfilms and unilamelar vesicles, and applying a battery of biophysicalmethods in order to dissect the different events of membraneinteraction. Collectively, results indicate that the PxB analogues act inthe bacterial membrane by the same mechanism than PxB, and that cationic amphipathicity determines peptide activity.

Community pharmacist intervention in depressed primary care patients (PRODEFAR study): randomized controlled trial protocol.

Background: Treatment of depression, the most prevalent and costly mental disorder, needs to be improved. Non-concordance with clinical guidelines and non-adherence can limit the efficacy of pharmacological treatment of depression. Through pharmaceutical care, pharmacists can improve patients' compliance and wellbeing. The aim of this study is to evaluate the effectiveness and costeffectiveness of a community pharmacist intervention developed to improve adherence and outcomes of primary care patients with depression. Methods/design: A randomized controlled trial, with 6-month follow-up, comparing patients receiving a pharmaceutical care support programme in primary care with patients receiving usual care. The total sample comprises 194 patients (aged between 18 and 75) diagnosed with depressive disorder in a primary care health centre in the province of Barcelona (Spain). Subjects will be asked for written informed consent in order to participate in the study. Diagnosis will be confirmed using the SCID-I. The intervention consists of an educational programme focused on improving knowledge about medication, making patients aware of the importance of compliance, reducing stigma, reassuring patients about side-effects and stressing the importance of carrying out general practitioners' advice. Measurements will take place at baseline, and after 3 and 6 months. Main outcome measure is compliance with antidepressants. Secondary outcomes include; clinical severity of depression (PHQ-9), anxiety (STAI-S), health-related quality of life (EuroQol-5D), satisfaction with the treatment received, side-effects, chronic physical conditions and sociodemographics. The use of healthcare and social care services will be assessed with an adapted version of the Client Service Receipt Inventory (CSRI). Discussion: This trial will provide valuable information for health professionals and policy makers on the effectiveness and cost-effectiveness of a pharmaceutical intervention programme in the context of primary care. Trial registration: NCT00794196

Rapid Biodiversity Assessment and Monitoring Method for Highly Diverse Benthic Communities: A Case Study of Mediterranean Coralligenous Outcrops

Increasing anthropogenic pressures urge enhanced knowledge and understanding of the current state of marine biodiversity. This baseline information is pivotal to explore present trends, detect future modifications and propose adequate management actions for marine ecosystems. Coralligenous outcrops are a highly diverse and structurally complex deep-water habitat faced with major threats in the Mediterranean Sea. Despite its ecological, aesthetic and economic value, coralligenous biodiversity patterns are still poorly understood. There is currently no single sampling method that has been demonstrated to be sufficiently representative to ensure adequate community assessment and monitoring in this habitat. Therefore, we propose a rapid non-destructive protocol for biodiversity assessment and monitoring of coralligenous outcrops providing good estimates of its structure and species composition, based on photographic sampling and the determination of presence/absence of macrobenthic species. We used an extensive photographic survey, covering several spatial scales (100s of m to 100s of km) within the NW Mediterranean and including 2 different coralligenous assemblages: Paramuricea clavata (PCA) and Corallium rubrum assemblage (CRA). This approach allowed us to determine the minimal sampling area for each assemblage (5000 cm² for PCA and 2500 cm²for CRA). In addition, we conclude that 3 replicates provide an optimal sampling effort in order to maximize the species number and to assess the main biodiversity patterns of studied assemblages in variability studies requiring replicates. We contend that the proposed sampling approach provides a valuable tool for management and conservation planning, monitoring and research programs focused on coralligenous outcrops, potentially also applicable in other benthic ecosystems

Difusión del consumo de leche en España (1865- 1981)

La aproximación habitual en el estudio de la difusión del consumo de un alimento, además de descomponer su aportación nutricional, consiste en estudiar la evolución de sus consumos medios. Pero en todo proceso de difusión de un nuevo producto, establecer el consumo promedio es tan importante como conocer el número de consumidores. Este artículo propone un análisis de la recepción del consumo de leche entre la población española atendiendo a ambas dimensiones entre finales del siglo XIX y 1981. Esto es, se combinará el conocimiento de la evolución del número de consumidores con el de sus niveles medios de consumo. Adoptar este planteamiento supone enfrentarse con el problema de la ausencia de datos sobre la magnitud de consumidores en las fuentes estadísticas disponibles. Este artículo propone una estrategia metodológica diseñada para reconstruir la evolución de esa población tanto en una escala temporal como espacial.

Las cooperativas de consumo en España, 1865- 1939: Un mecanismo alternativo de acceso a los alimentos

Desde su nacimiento a mediados del siglo XIX en Rochdale (Gran Bretaña), el movimiento cooperativo de consumo se expandió rápidamente por toda Europa. Conocer cómo funcionaron estas entidades puede proporcionar nuevos elementos de análisis sobre el consumo de alimentos, especialmente en aquellas regiones o ciudades donde tuvieron una mayor difusión. Las cooperativas de consumo distribuían alimentos básicos entre sus asociados, por lo que pudieron constituir un importante mecanismo de acceso a los alimentos en las primeras fases de la transición nutricional. En esta investigación se propone una primera aproximación a la evolución del cooperativismo de consumo en España entre mediados del siglo XIX y la Guerra Civil, prestando especial atención a su desarrollo cronológico y geográfico; estructura ideológica; organización y gestión interna; y a su impacto en la dieta. Las primeras conclusiones indican que el cooperativismo de consumo en España se desarrolló más tarde que en otros países de Europa, y que se localizó en las regiones más industrializadas y urbanizadas del país. Este cooperativismo estuvo inicialmente muy vinculado a las organizaciones obreras, y más tarde también bajo la influencia de la Iglesia Católica. Principalmente distribuían alimentos básicos a precios de mercado entre los asociados y sus familiares, a los que además se les ofrecían servicios de tipo asistencial, cultural y educativo. Es decir, eran cooperativas que respondían al modelo rochdaliano y que no ayudaron en gran medida a la difusión de nuevos alimentos en el marco de la transición nutricional, pero sí a mantener los niveles de vida en segmentos de población urbana con bajos ingresos que debían acceder a los productos básicos por vía monetaria.

GDP and life expectancy in Italy and Spain over the long-run (1861-2008): insights from a timeseries approach

The article presents and discusses long-run series of per capita GDP and life expectancy for Italy and Spain (1861-2008). After refining the available estimates in order to make them comparable and with the avail of the most up-to-date researches, the main changes in the international economy and in technological and sociobiological regimes are used as analytical frameworks to re-assess the performances of the two countries; then structural breaks are searched for and Granger causality between the two variables is investigated. The long-run convergence notwithstanding, significant cyclical differences between the two countries can be detected: Spain began to modernize later in GDP, with higher volatility in life expectancy until recent decades; by contrast, Italy showed a more stable pattern of life expectancy, following early breaks in per capita GDP, but also a negative GDP break in the last decades. Our series confirm that, whereas at the early stages of development differences in GDP tend to mirror those in life expectancy, this is no longer true at later stages of development, when, if any, there seems to be a negative correlation between GDP and life expectancy: this finding is in line with the thesis of a non-monotonic relation between life expectancy and GDP and is supported by tests of Granger causality.

Low environmental impact bleaching sequences for attaining high brightness level with eucalyptus SPP pulp

The alternatives used for minimizing the usage of chlorine dioxide in bleaching sequences included a hot acid hydrolysis (Ahot) stage, the use of hot chlorine dioxide (Dhot) and ozone stages at medium consistency and high consistency (Zmc and Zhc), in addition to stages with atmospheric hydrogen peroxide (P) and pressurized hydrogen peroxide (PO). The results were interpreted based on the cost of the chemical products, bleaching process yields and on minimizing the environmental impact of the bleaching process. In spite of some process restrictions, high ISO brightness levels were kept around 90 % brightness. Additionally, the inclusion of stages like acid hydrolysis, pressurized peroxide and ozone in the bleaching sequences provided an increase in operating flexibility, aimed at reducing environmental impact (ECF Light). The Dhot(EOP)D(PO) sequence presented lower operating cost for ISO brightness above 92 %. However, this kind of sequence was not allowed for closing the wastewater circuit, even partially. For ISO brightness level around 91%, the AhotZhcDP sequence presented a lower operating cost than the others

Contribution of S6K1/MAPK signaling pathways in the response to oxidative stress: activation of RSK and MSK by hydrogen peroxide

Cells respond to different kind of stress through the coordinated activation of signaling pathways such as MAPK or p53. To find which molecular mechanisms are involved, we need to understand their cell adaptation. The ribosomal protein, S6 kinase 1 (S6K1), is a common downstream target of signaling by hormonal or nutritional stress. Here, we investigated the initial contribution of S6K1/MAPK signaling pathways in the cell response to oxidative stress produced by hydrogen peroxide (H2O2). To analyze S6K1 activation, we used the commercial anti-phospho-Thr389-S6K1 antibody most frequently mentioned in the bibliography. We found that this antibody detected an 80-90 kDa protein that was rapidly phosphorylated in response to H2O2 in several human cells. Unexpectedly, this phosphorylation was insensitive to both mTOR and PI3K inhibitors, and knock-down experiments showed that this protein was not S6K1. RSK and MSK proteins were candidate targets of this phosphorylation. We demonstrated that H2O2 stimulated phosphorylation of RSK and MSK kinases at residues that are homologous to Thr389 in S6K1. This phosphorylation required the activity of either p38 or ERK MAP kinases. Kinase assays showed activation of RSK and MSK by H2O2. Experiments with mouse embryonic fibroblasts from p38 animals" knockout confirmed these observations. Altogether, these findings show that the S6K1 signaling pathway is not activated under these conditions, clarify previous observations probably misinterpreted by non-specific detection of proteins RSK and MSK by the anti-phospho-Thr389-S6K1 antibody, and demonstrate the specific activation of MAPK signaling pathways through ERK/p38/RSK/MSK by H2O2.

Membrane interaction of polymyxin B and synthetic analogues studied in biomimetic systems: implications for antibacterial action

Membrane-active antimicrobial peptides, such as polymyxin B (PxB), are currently in the spotlight as potential candidates toovercome bacterial resistance. We have designed synthetic analogs ofPxB in order to determine the structural requirements for membraneaction. Since the mechanism of action of PxB involves interaction withboth the outer membrane and the cytoplasmic membrane of Gramnegative bacteria, we have used an approach based on mimicking theouter layers of these membranes using monolayers, Langmuir-Blodgettfilms and unilamelar vesicles, and applying a battery of biophysicalmethods in order to dissect the different events of membraneinteraction. Collectively, results indicate that the PxB analogues act inthe bacterial membrane by the same mechanism than PxB, and that cationic amphipathicity determines peptide activity.

El sobreendeudamiento público, ¿solución o problema?

El present Treball Final de Carrera pretén donar una aproximació al problema del sobre endeutament públic de l’economia mundial en general i espanyola en particular per comprendre els fets que ens han dut a la situació actual i així intentar donar resposta si l’endeutament públic excessiu és un problema pel creixement de l’economia espanyola o bé un baix creixement acaba derivant en sobre endeutament. De l’anàlisi es desprèn que el finançament extern és bàsic pel desenvolupament i progrés econòmic, sent la situació actual una causa directa de la mala gestió del finançament obtingut.

Disseny d'espais ideals a una llar d'infants

És el moment de donar a conèixer tot el que s’ha après durant el Grau en Mestre d’Educació Infantil. Es tracta d’una part molt important del nostre camí com a aprenents ja que demostra els interessos que tenim i els objectius que volem aconseguir. A continuació es podrà observar un treball pensat en dissenyar espais ideals que haurien de tenir les llars d’infants. Sempre es pot millorar, però aquest projecte en fa una idea general i detallada de com seria, des del meu punt de vista, una llar d’infants ideal.

Entrevistes i Estudi de Cas. desembre 2013 i gener 2014

Aquest document consta de les nou entrevistes realitzades durant els mesos de desembre 2013 igener 2014, per tal d'elaborar la comunicació La enseñanza y el aprendizaje de la música tradicional y popular en Cataluña: el caso del AMTP, CAT y los grupos de castellers y gigantes, que es presenta al III Congrés CEIMUS Congreso de Educación y Investigación Musical, Enseñar y aprender música: modelo tradicional, online y semipresencial, que es celebra a Barcelona el 28 de febrer i 1 i 2 de març de 2014.

Disseny d’una turbina de riu per a la generació d’electricitat a l’Amazònia equatoriana

Aquest projecte pretén donar un impuls a una tecnologia de generació elèctrica per a comunitats aïllades de l’Amazònia equatoriana i regions semblants. Aquestes són zones rurals on la densitat de població és molt baixa i dispersa, que solen tindre petits consums d’energia. Així la provisió d’aquesta des de centres de generació llunyans requereix d’un transport desmesurat. Com a conseqüència d’aquesta situació desfavorable molta gent no pot disposar d’electricitat.La font d’il•luminació més utilitzada són les espelmes, els encenedors de querosè i els llums de gas. Aquests tenen deficient intensitat lluminosa, el seu ús habitual provoca danys a la vista i pulmons, i és causa d’incendis. En algunes ocasions es fa ús de generadors diesel que a part del soroll, així com les altres solucions esmentades, depèn de la provisió de les ciutats allunyades. En els últims anys s’han introduït sistemes fotovoltaics domiciliaris que han demostrat ser una alternativa eficaç. En qualsevol cas el cost de l’energia resulta molt elevat per tals regions.La solució adoptada ha sigut una turbina Darrieus de D=1,5 i L=1,5, amb 6 àleps NACA 0018 inclinats 8 graus cap a fora, amb una corda de 0,22 m, a un regim de 2,67 rad/s, que correspon a un rati de velocitats de TSR=2 quan el riu baixa a 1m/s. Aquesta pot treballar en un rang de velocitats de 0,8 a 1,2 m/s com són les velocitats habituals registrades al riu Napo, emplaçament indicat per a la construcció d’una turbina pilot

Progress in front propagation research

We review the progress in the field of front propagation in recent years. We survey many physical, biophysical and cross-disciplinary applications, including reduced-variable models of combustion flames, Reid's paradox of rapid forest range expansions, the European colonization of North America during the 19th century, the Neolithic transition in Europe from 13 000 to 5000 years ago, the description of subsistence boundaries, the formation of cultural boundaries, the spread of genetic mutations, theory and experiments on virus infections, models of cancer tumors, etc. Recent theoretical advances are unified in a single framework, encompassing very diverse systems such as those with biased random walks, distributed delays, sequential reaction and dispersion, cohabitation models, age structure and systems with several interacting species. Directions for future progress are outlined