Complications of pneumococcal bacteremia after 13-valent conjugate vaccine withdrawal

In the Region of Madrid, universal immunization with the 13-serotypes pneumococcal conjugate vaccine (PCV13) started in May 2010. In July 2012, public funding ceased. Vaccination coverage decreased from >95% to 82% in 2013 and to 67% in 2014. Our aim was to investigate the impact of PCV13 withdrawal from Madrid Region's universal immunization program on the incidence of complicated pneumococcal bacteremia. We performed a multi-center retrospective cohort study, from 2009 to 2014. Participants were children aged <14 years with Streptococcus pneumoniae bacteremia. Complications were defined as any condition requiring intensive care or surgery. Sequelae were conditions lasting ≥90 days. A total of 168 patients were recruited. One-fourth of both immunized and non-immunized patients had complications. Global complications increased after PCV13 withdrawal. A total of 28% of PCV13 serotypes presented complications. Complications due to PCV13 serotypes did not increase after July 2012. No-PCV13 serotypes increased progressively from 2009 on, and 23% presented complications. A significant risk of complications was found for patients with meningitis, empyema, C-reactive protein >100 mg/L, and serotype 1. A multivariate analysis indicated that complications were associated with meningitis and hospital admission after July 2012. Sequelae were significantly associated with children <2 years of age, meningitis and no-PCV13 serotypes. The incidence of complications due to PCV13 serotypes did not increase two years after PCV13 withdrawal. Nevertheless, all-serotypes complications increased. The likely cause was that no-PCV13 serotypes (associated with meningitis) are on the rise.

An internet-based control engineering laboratory

This paper presents LABNET, an internet-based remote laboratory for control engineering education developed at UEM-University. At present, the remote laboratory integrates three basic physical systems (level control, temperature control and ship stabilizing system). In this paper, the LABNET architecture is presented and discussed in detail. Issues concerned with concurrent user access, local or remote feedback, automatic report generating and reusing of experiment’s templates have been addressed. Furthermore, the experiences gained developing, testing and using the system will be also presented and their consequences for future design.

Singularity and multifractal characterization of signals with wavelets. Application to clay soil images

In the field of multiscale analysis of signals, including images, the wavelet transform is one of the most attractive and powerful tool due to its ability to focus on signals structures at different scales. Wavelet Transform at different scales is successfully applied to image characterization (which can be applied to a watermarking scheme) and multiscale singularity detection and processing. In this work we show further research of computation of multifractals properties such as the multifractal spectrum (D(alpha)) applied to dye stained images of natural terrain. This can be useful for statically describing preferential flow path geometry.

Excessive blood pressure increase with exercise and risk of all-cause mortality and cardiac events

The association of an excessive blood pressure increase with exercise (EBPIE) on cardiovascular outcomes remains controversial. We sought to assess its impact on the risk of all-cause mortality and major cardiac events in patients with known or suspected coronary artery disease (CAD) referred for stress testing. Exercise echocardiography was performed in 10,047 patients with known or suspected CAD. An EBPIE was defined as an increase in systolic blood pressure with exercise ≥80 mmHg. The endpoints were all-cause mortality and major cardiac events (MACE), including cardiac death or nonfatal myocardial infarction (MI). Overall, 573 patients exhibited an EBPIE during the tests. Over a mean follow-up of 4.8 years, there were 1,950 deaths (including 725 cardiac deaths), 1,477 MI, and 1,900 MACE. The cumulative 10-year rates of all-cause mortality, cardiac death, nonfatal MI and MACE were 32.9%, 13.1%, 26,9% and 33% in patients who did not develop an EBPIE vs. 18.9%, 4.7%, 17.5% and 20.7% in those experiencing an EBPIE, respectively (p <0.001 for all comparisons). In Cox regression analyses, an EBPIE remained predictive of all-cause mortality (hazard ratio [HR] 0.73, 95% confidence interval [CI] 0.59-0.91, p = 0.004), cardiac death (HR 0.67, 95% CI 0.46-0.98, p = 0.04), MI (HR 0.67, 95% CI 0.52-0.86, p = 0.002), and MACE (HR 0.69, 95% CI 0.56-0.86, p = 0.001). An EBPIE was associated with a significantly lower risk of mortality and MACE in patients with known or suspected CAD referred for stress testing.

Pregnancy in Spanish elite sportswomen: A qualitative study

Pregnancy and motherhood have been historically considered as reasons why elite sportswomen may end their sport careers. During pregnancy, the safety of both mother and baby has been identified as a key reason for ceasing sport participation. Recent “official” statistics on how many elite athletes are mothers suggest that pregnancy, motherhood, and sport could be no longer mutually exclusive. The aim of this qualitative phenomenological study was to describe the lived pregnancy of Spanish elite sportswomen. Spanish elite sportswomen (n = 20) aged between 18 and 65 years that had been pregnant during their sporting professional career and after the end of their pregnancy had taken up again their professional sporting career for at least one year were included. Data were collected from May 2010 to April 2012 using in-depth personal interviews, investigator’s field notes, and extracts from the participants’ personal letters. Identified themes included: choosing the right moment; fears and doubts; and justifying physical exercise. By giving voice to these elite Spanish sportswomen, their pregnancy experiences are made visible, which might help to gain a better understanding into their expectations and develop policies and practices focused on elite sportswomen during and after pregnancy.

La ética hacker: marco para la disrupción educativa de la "universidad zombi"

La crisis actual de la educación es, ante todo, una crisis de las instituciones y su filosofía,señala Bauman(2007: 148),por eso en este trabajo vamos a centrarnos en la ética que afecta a una institución educativa: la universidad. No vamos a hablar, por tanto, del futuro, sino del presente, caracterizadoprecisamente por el «desmantelamiento de marcos y liquidación de pautas» (Bauman, 2007: 145) que producen la sensación de «fin de ciclo». Efectivamente, la idea de que vivimos momentos de cambios profundos es recurrente en el pensamiento contemporáneo occidental. No hay más que repasar someramente las etiquetas acuñadas para testimoniar el cambio de paradigmas: sociedad líquida (Bauman), sociedad red, de la información y del conocimiento (Castells), posmodernidad (Bell), sobremodernidad (Augé), modernidad tardía (Giddens), era tecnotrónica (Brzezinski), tercera ola (Toffler), sociedad de la incultura (Mayos), era del acceso (Watts)o civilización empática (Rifkin)son sólo algunos de los términos que, si bien fijan la atención en diversos componentes y los explican desde diferentes disciplinas y épocas, coinciden, sin embargo, en señalar aspectos comunes de dichos cambios. ¿Cómo afectan estas trasformaciones a la universidad y a la educación en general?

B2C Digital business presence in the automobile industry

The purpose of this work is to investigate the digital online- and website- presence of the international automobile industry. The focus is on the business-to-consumer area to find out how digital communication is designed and if there are differences in the design dependent on the type of company or its cultural origin. The research is based on different quantitative as well as qualitative studies. After the selection and validation of the test sample, a qualitative content analysis for each corporate website in the test sample is conducted. Then, an extensive quantitative content analysis is applied. In a third step interviews with nine different experts from different sectors of the automobile company are carried out to validate the previous findings and obtain deeper insights. All of the findings are statistically analyzed and comprehensively evaluated.

The era of smartphones: Back to our biological makeup?

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Physical exercise minimizes the toxic triad for cancer: Physical inactivity, low fitness, and obesity

The so-called toxic triad of factors linked to cancer, namely obesity, poor cardiorespiratory fitness and physical inactivity, increase the risk of cancer and, when cancer is present, worsen its prognosis. Thus, obesity and a sedentary lifestyle have been linked to an elevated cancer risk whereas regular physical exercise and good cardiorespiratory function (CRF) diminish this risk. Despite genetic risk factors, there is evidence to show that some lifestyle modifications are capable of reducing the incidence of cancer and its associated morbidity and mortality. Regular physical exercise targeted at maintaining body weight within healthy limits and improving CRF will reduce a person's cancer risk and, once diagnosed, will also improve its prognosis, reducing mortality and the risk of disease recurrence through similar effects. In this review, we describe how physical activity can be used as a pleiotropic, coadjuvant tool to minimize the toxic triad for cancer and update the mechanisms proposed to date for the effects observed.