Diabetes relacionada a la fibrosis quística (DRFQ)

Importancia: el paciente con fibrosis quística después de las complicaciones gastrointestinales y pulmonares debe enfrentar otras comorbilidades como la diabetes relacionada a su condición . Dado el aumento en la esperanza de vida y el hecho de que virtualmente todas los pacientes con esta enfermedad pueden desarrollar alteración en el metabolismo de los carbohidratos, se requiere una sensibilización frente al tema que posibilite una detección temprana de esta entidad y un tratamiento óptimo que evite las complicaciones microvasculares e impacte entre otros el crecimiento pondo-estatural en pacientes en desarrollo y la función pulmonar. Objetivo : realizar una revisión actualizada de la literatura sobre la diabetes relacionada a la fibrosis quística, destacando las indicaciones de tamización y tratamiento. Conclusión : la FQ dentro de su abordaje requiere la detección temprana de la alteración del metabolismo de los carbohidratos con una prueba de tolerancia a la glucosa , el daño del islote pancreático , la disfunción inmune, la resistencia a la insulina, el estrés oxidativo entre otros elementos fisiopatológicos conllevan a un estado de depleción de insulina que producirán un efecto negativo microvascular así como a una reducción marcada de la función pulmonar, mayores tasa de infección e incremento de la mortalidad. La piedra angular del tratamiento en pacientes con o sin hiperglicemia es la insulina que mejora tanto el estado nutricional como la función pulmonar ; nuevos antidiabéticos orales con efecto incretinas y fármacos modificadores de la enfermedad se vislumbran como alternativas al corto plazo

Does uncertainty cause inertia in decision making? An experimental study of the role of regret aversion and indecisiveness

Previous research has shown that often there is clear inertia in individual decision making---that is, a tendency for decision makers to choose a status quo option. I conduct a laboratory experiment to investigate two potential determinants of inertia in uncertain environments: (i) regret aversion and (ii) ambiguity-driven indecisiveness. I use a between-subjects design with varying conditions to identify the effects of these two mechanisms on choice behavior. In each condition, participants choose between two simple real gambles, one of which is the status quo option. I find that inertia is quite large and that both mechanisms are equally important.

Risk, ambiguity, and diversification

Attitudes toward risk influence the decision to diversify among uncertain options. Yet, because in most situations the options are ambiguous, attitudes toward ambiguity may also play an important role. I conduct a laboratory experiment to investigate the effect of ambiguity on the decision to diversify. I find that diversification is more prevalent and more persistent under ambiguity than under risk. Moreover, excess diversification under ambiguity is driven by participants who stick with a status quo gamble when diversification among gambles is not feasible. This behavioral pattern cannot be accommodated by major theories of choice under ambiguity.

L'obra filològica d'Antoni de Bastero i Lledó. Edició de la Història de la llengua catalana

S'estudia l'obra filològica d' Antoni de Bastero i Lledó (1675-1737), des d'una perspectiva de conjunt, per tal de concretar I'activitat d'aquest estudiós en els camps de la lingüística, la filologia o la crítica literària, i fer-ne una valoració adequada als coneixements actuals sobre I'exercici d'aquestes disciplines durant la primera meitat del segle XVIII. La tesi inclou un estudi biogràfic, absolutament necessari per establir moltes de les circumstancies vitals del canonge Bastero, que ens resultaven obscures i que són decisives per explicar el propi interès per la filologia, les relacions amb determinats cercles acadèmics, la datació aproximada dels diversos projectes iniciats, la interpretació correcta de la seva activitat. S'inclou, així mateix, un catàleg exhaustiu de tots els manuscrits conservats d'Antoni de Bastero i que tenen alguna relació amb el seu treball filològic. En total es tenen en compte 69 volums manuscrits, actualment escampats per diversos arxius i biblioteques de Barcelona i Girona, alguns dels quals eren fins ara desconeguts. D'aquests 69 volums, 48 contenen pròpiament obres de Bastero o altres materials publicables, i la resta són materials de treball. En conseqüència, l' obra filològica del canonge es pot concretar en: la producció d'una gramàtica italiana i d'una gramàtica francesa, en català, que va deixar inacabades; la realització de La Crusca provenzale, un magne diccionari etimològic i d'autoritats que recull una gran quantitat d'hipotètics provençalismes italians -només es va publicar el primer volum d'aquesta obra a Roma, l'any 1724, però n'he localitzat pràcticament tot el contingut; l'elaboració d'una extensa antologia de poesies trobadoresques, copiades amb gran rigor d'alguns còdexs de la Biblioteca Vaticana; el plantejament d'una Història de llengua catalana, que havia de ser una gran compilació dels mèrits i les excel·lències d'aquesta llengua -que l'autor identifica amb la provençal- i la seva literatura, i que es va poder desenvolupar nomes de forma parcial. Precisament, la part central de la tesi l'ocupa l'estudi particular i l'edició crítica de les parts redactades d'aquesta obra, que suposa la concreció de la particular percepció lingüística i literària que Bastero havia anat perfilant al llarg dels seus anys d'estudi. Es tracta d'una edició molt complexa, perquè l'obra ens ha arribat només en un esborrany, que presenta múltiples correccions i esmenes i evidencia diferents estadis redaccionals; els manuscrits inclouen, així mateix, nombrosos papers amb anotacions o fragments que, o no pertanyen al cos de l'obra, o bé s'han hagut de resituar en el lloc que els correspon. EI resultat és, tanmateix, un text prou coherent que comprèn quasi la totalitat del Llibre primer -sobre l'origen, el naixement i els diversos noms de la llengua, i sobre el nom de Catalunya- i un capítol del Llibre tercer -sobre la primitiva extensió del català per tot Espanya. EI més rellevant d'aquesta obra és el fet que s'hi basteix una original teoria sobre la formació de les diverses llengües romàniques que té el català com a eix central -proposa la identificació del català provençal amb la lingua romana dels documents alt medievals, en una operació que s'avança quasi cent anys a François Raynouard, que propugnava això mateix, referint-se nomes al provençal, amb un àmplia aprovació de la comunitat científica del seu temps. Destaquen també un excepcional rigor històric i documental, i una notable sensibilitat vers l'oralitat lingüística, que és objecte d'algunes anotacions ben interessants. Tanquen la tesi un seguit d'annexos documentals on es transcriuen diversos documents relacionats amb els aspectes tractats anteriorment.

Origin and structure of Devensian depressions at Letton, Herefordshire

Groups of circular to oval enclosed depressions in soft sediments of Pleistocene age are relatively common in north-west Europe. These features are normally interpreted as being either glacial or periglacial in origin. Where these features are developed in glacial sediments, a glacial (and specifically ‘kettle hole’) genesis is considered most likely. Some groups of features, however, have been re-interpreted as being periglacial in origin and are thought to be the remains of cryogenic mounds (former pingos or palsas/lithalsas). The problem at many sites, of course, is correct identification and previously this was often resolved through extensive trenching of the sediments. The use of geophysics in the form of electrical resistivity tomography and ground probing radar, however, can aid investigation and interpretation and is less invasive. A group of enclosed depressions in the Letton area of Herefordshire within the Last Glacial Maximum ice limit (Late Devensian) have been investigated in this way. The morphology and internal structure of the features and their existence in glaciolacustrine sediments of Late Devensian age strongly suggests that these depressions are kettle holes resulting from ice block discharge into a shallow lakes or lakes, and hence a glacial origin is supported. The lack of any ramparts surrounding the depressions (at the surface or any evidence of these at depth) and the fact that they do not overlap (‘mutually interfere’) indicates that they are not the remains of cryogenic mounds.

Dirty tariffication revisited: The EU and sugar

It is widely believed that a number of countries, including the EU, engaged in dirty tariffication during the Uruguay Round of trade talks. This article examines the EU’s record on sugar and finds little evidence to substantiate the claim. However, world prices increased between the base period (1986-88) and the date of implementation (1995), and so tariffication resulted in an increase in the tax that would have been charged on sugar imports into the EU. As well, the Special Safeguard provisions meant that a substantial additional levy could be charged.

Green tea (Camellia sinensis) catechins and vascular function

The health benefits of green tea (Camellia sinensis) catechins are becoming increasingly recognised. Amongst the proposed benefits are the maintenance of endothelial function and vascular homeostasis and an associated reduction in atherogenesis and CVD risk. The mounting evidence for the influential effect of green tea catechins on vascular function from epidemiological, human intervention and animal studies is subject to review together with exploration of the potential mechanistic pathways involved. Epigallocatechin-3-gallate, one of the most abundant and widely studied catechin found in green tea, will be prominent in the present review. Since there is a substantial inconsistency in the published data with regards to the impact of green tea catechins on vascular function, evaluation and interpretation of the inter- and intra-study variability is included. In conclusion, a positive effect of green tea catechins on vascular function is becoming apparent. Further studies in animal and cell models using physiological concentrations of catechins and their metabolites are warranted in order to gain some insight into the physiology and molecular basis of the observed beneficial effects.

Shakespeare and Islam

This special issue conceives of “Shakespeare and Islam” in its broadest sense, conceptually, and opens up the conjunction to consideration of both the early modern and more recent periods. It is not directly concerned with addressing doctrinal questions: “Islam” is a flag of convenience for our purposes, an umbrella term that takes in not only the Ottoman Empire but also the Persian (a subject that, perhaps unsurprisingly, tends to be overshadowed by its stronger neighbour), and extends to a discussion of twentieth- and twenty-first-century issues of Shakespearean interpretation. In line with this journal's principal remit, the essays concentrate on questions of staging and interpretation, adaptation and appropriation, thus drawing on and contributing to one of the dominant fields of Shakespeare studies today. While the early modern period remains the collection's central interest, two concluding essays remind us (if we need reminding) that the seemingly endless recycling and reinterpretation of Shakespeare have implications for how we understand the conjunction with Islam today.

‘Pre-plan mapping’, networks, capital resources and community strategies in England

In this working paper we discuss current attempts to engage communities in planning policy formulation in the UK. In particular we focus on the preparation of Community Strategies (CS) in England to inform local public policy and the wider proposals recently published by the UK government to move towards enhanced community engagement in planning (DTLR, 2001). We discuss how such strategies could be operationalised with a conceptual framework developed following ideas derived from ANT (cf. Murdoch, 1997, 1998; Selman, 2000; Parker & Wragg, 1999; Callon, 1986, 1998) and the ‘capitals’ literature (Lin, 2002; Fine, 2001; Selman, 2000; Putnam, 1993). We see this as an expression of neo-pragmatic planning theory, (Hoch, 1996; Stein & Harper, 2000) to develop a form of ‘pre-plan mapping’.

Design and management of sustainable built environments

The United Nation Intergovernmental Panel on Climate Change (IPCC) makes it clear that climate change is due to human activities and it recognises buildings as a distinct sector among the seven analysed in its 2007 Fourth Assessment Report. Global concerns have escalated regarding carbon emissions and sustainability in the built environment. The built environment is a human-made setting to accommodate human activities, including building and transport, which covers an interdisciplinary field addressing design, construction, operation and management. Specifically, Sustainable Buildings are expected to achieve high performance throughout the life-cycle of siting, design, construction, operation, maintenance and demolition, in the following areas: • energy and resource efficiency; • cost effectiveness; • minimisation of emissions that negatively impact global warming, indoor air quality and acid rain; • minimisation of waste discharges; and • maximisation of fulfilling the requirements of occupants’ health and wellbeing. Professionals in the built environment sector, for example, urban planners, architects, building scientists, engineers, facilities managers, performance assessors and policy makers, will play a significant role in delivering a sustainable built environment. Delivering a sustainable built environment needs an integrated approach and so it is essential for built environment professionals to have interdisciplinary knowledge in building design and management . Building and urban designers need to have a good understanding of the planning, design and management of the buildings in terms of low carbon and energy efficiency. There are a limited number of traditional engineers who know how to design environmental systems (services engineer) in great detail. Yet there is a very large market for technologists with multi-disciplinary skills who are able to identify the need for, envision and manage the deployment of a wide range of sustainable technologies, both passive (architectural) and active (engineering system),, and select the appropriate approach. Employers seek applicants with skills in analysis, decision-making/assessment, computer simulation and project implementation. An integrated approach is expected in practice, which encourages built environment professionals to think ‘out of the box’ and learn to analyse real problems using the most relevant approach, irrespective of discipline. The Design and Management of Sustainable Built Environment book aims to produce readers able to apply fundamental scientific research to solve real-world problems in the general area of sustainability in the built environment. The book contains twenty chapters covering climate change and sustainability, urban design and assessment (planning, travel systems, urban environment), urban management (drainage and waste), buildings (indoor environment, architectural design and renewable energy), simulation techniques (energy and airflow), management (end-user behaviour, facilities and information), assessment (materials and tools), procurement, and cases studies ( BRE Science Park). Chapters one and two present general global issues of climate change and sustainability in the built environment. Chapter one illustrates that applying the concepts of sustainability to the urban environment (buildings, infrastructure, transport) raises some key issues for tackling climate change, resource depletion and energy supply. Buildings, and the way we operate them, play a vital role in tackling global greenhouse gas emissions. Holistic thinking and an integrated approach in delivering a sustainable built environment is highlighted. Chapter two demonstrates the important role that buildings (their services and appliances) and building energy policies play in this area. Substantial investment is required to implement such policies, much of which will earn a good return. Chapters three and four discuss urban planning and transport. Chapter three stresses the importance of using modelling techniques at the early stage for strategic master-planning of a new development and a retrofit programme. A general framework for sustainable urban-scale master planning is introduced. This chapter also addressed the needs for the development of a more holistic and pragmatic view of how the built environment performs, , in order to produce tools to help design for a higher level of sustainability and, in particular, how people plan, design and use it. Chapter four discusses microcirculation, which is an emerging and challenging area which relates to changing travel behaviour in the quest for urban sustainability. The chapter outlines the main drivers for travel behaviour and choices, the workings of the transport system and its interaction with urban land use. It also covers the new approach to managing urban traffic to maximise economic, social and environmental benefits. Chapters five and six present topics related to urban microclimates including thermal and acoustic issues. Chapter five discusses urban microclimates and urban heat island, as well as the interrelationship of urban design (urban forms and textures) with energy consumption and urban thermal comfort. It introduces models that can be used to analyse microclimates for a careful and considered approach for planning sustainable cities. Chapter six discusses urban acoustics, focusing on urban noise evaluation and mitigation. Various prediction and simulation methods for sound propagation in micro-scale urban areas, as well as techniques for large scale urban noise-mapping, are presented. Chapters seven and eight discuss urban drainage and waste management. The growing demand for housing and commercial developments in the 21st century, as well as the environmental pressure caused by climate change, has increased the focus on sustainable urban drainage systems (SUDS). Chapter seven discusses the SUDS concept which is an integrated approach to surface water management. It takes into consideration quality, quantity and amenity aspects to provide a more pleasant habitat for people as well as increasing the biodiversity value of the local environment. Chapter eight discusses the main issues in urban waste management. It points out that population increases, land use pressures, technical and socio-economic influences have become inextricably interwoven and how ensuring a safe means of dealing with humanity’s waste becomes more challenging. Sustainable building design needs to consider healthy indoor environments, minimising energy for heating, cooling and lighting, and maximising the utilisation of renewable energy. Chapter nine considers how people respond to the physical environment and how that is used in the design of indoor environments. It considers environmental components such as thermal, acoustic, visual, air quality and vibration and their interaction and integration. Chapter ten introduces the concept of passive building design and its relevant strategies, including passive solar heating, shading, natural ventilation, daylighting and thermal mass, in order to minimise heating and cooling load as well as energy consumption for artificial lighting. Chapter eleven discusses the growing importance of integrating Renewable Energy Technologies (RETs) into buildings, the range of technologies currently available and what to consider during technology selection processes in order to minimise carbon emissions from burning fossil fuels. The chapter draws to a close by highlighting the issues concerning system design and the need for careful integration and management of RETs once installed; and for home owners and operators to understand the characteristics of the technology in their building. Computer simulation tools play a significant role in sustainable building design because, as the modern built environment design (building and systems) becomes more complex, it requires tools to assist in the design process. Chapter twelve gives an overview of the primary benefits and users of simulation programs, the role of simulation in the construction process and examines the validity and interpretation of simulation results. Chapter thirteen particularly focuses on the Computational Fluid Dynamics (CFD) simulation method used for optimisation and performance assessment of technologies and solutions for sustainable building design and its application through a series of cases studies. People and building performance are intimately linked. A better understanding of occupants’ interaction with the indoor environment is essential to building energy and facilities management. Chapter fourteen focuses on the issue of occupant behaviour; principally, its impact, and the influence of building performance on them. Chapter fifteen explores the discipline of facilities management and the contribution that this emerging profession makes to securing sustainable building performance. The chapter highlights a much greater diversity of opportunities in sustainable building design that extends well into the operational life. Chapter sixteen reviews the concepts of modelling information flows and the use of Building Information Modelling (BIM), describing these techniques and how these aspects of information management can help drive sustainability. An explanation is offered concerning why information management is the key to ‘life-cycle’ thinking in sustainable building and construction. Measurement of building performance and sustainability is a key issue in delivering a sustainable built environment. Chapter seventeen identifies the means by which construction materials can be evaluated with respect to their sustainability. It identifies the key issues that impact the sustainability of construction materials and the methodologies commonly used to assess them. Chapter eighteen focuses on the topics of green building assessment, green building materials, sustainable construction and operation. Commonly-used assessment tools such as BRE Environmental Assessment Method (BREEAM), Leadership in Energy and Environmental Design ( LEED) and others are introduced. Chapter nineteen discusses sustainable procurement which is one of the areas to have naturally emerged from the overall sustainable development agenda. It aims to ensure that current use of resources does not compromise the ability of future generations to meet their own needs. Chapter twenty is a best-practice exemplar - the BRE Innovation Park which features a number of demonstration buildings that have been built to the UK Government’s Code for Sustainable Homes. It showcases the very latest innovative methods of construction, and cutting edge technology for sustainable buildings. In summary, Design and Management of Sustainable Built Environment book is the result of co-operation and dedication of individual chapter authors. We hope readers benefit from gaining a broad interdisciplinary knowledge of design and management in the built environment in the context of sustainability. We believe that the knowledge and insights of our academics and professional colleagues from different institutions and disciplines illuminate a way of delivering sustainable built environment through holistic integrated design and management approaches. Last, but not least, I would like to take this opportunity to thank all the chapter authors for their contribution. I would like to thank David Lim for his assistance in the editorial work and proofreading.