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Tobacco smoking is the leading cause of disability and preventable deaths worldwide, but it should be differentiated from tobacco use disorder, which is, according to the Diagnostic and Statistical Manual of Mental Disorders, a bona fide mental disorder. The rapid delivery of nicotine to the brain activates acetylcholine receptors and stimulates the release of dopamine, both systems implicated in other mental disorders. Rates of tobacco use disorder are much higher among people suffering from other mental disorders and these patients find it more difficult to quit. Dual disorders, from a transdiagnostic perspective, identify patients with substance use disorder, in this case tobacco use disorder, and other mental disorders. A dual disorder is a complex clinical condition that is often underdiagnosed, undertreated, and difficult to manage. Appropriate and integrated tobacco use disorder treatment programs for people also suffering from other mental disorders could improve outcomes. Bio-psycho-social approaches to tobacco use disorder include specific biological treatments (e.g., bupropion, varenicline, cytisine, nicotine replacement therapy or deep trans-magnetic stimulation). However, these treatments don’t have the same outcomes in patients with dual disorders. Therefore, as in other dual disorders, harm reduction measures, such as vaping nicotine through electronic cigarettes or tobacco replacement therapies should be considered as alternative tools for dual tobacco use disorder management. These clinical considerations emerge from a narrative literature review and expert consensus and will specifically address considerations for changes in clinical practice to improve the treatment of tobacco use disorder and other mental disorders.

Urban areas are experiencing rapid growth, accompanied by significant disorder in Lima Metropolitan area and many other cities in South America. Due to decades of uncontrolled construction practices, it is imperative to identify and better understand the types of informalities prevalent in these recent urban areas. Addressing this lack of information is crucial for implementing appropriate countermeasures and developing new policies that benefit the communities residing in such areas. It is worth noting that understanding disaster risk aligns with the first priority of the Sendai Framework for Disaster Risk Reduction. In this study, we propose the use of radar satellite imagery recorded by the Sentinel-1 constellation since 2017 to identify clusters of urban growth in Lima Metropolitan area. Then, the informal urban clusters can be depicted by visual inspection of the last recorded high-resolution optical image. With good spatial and temporal resolution, we identified 25 clusters informal areas. Among our findings, we observed that several of these clusters are situated in landfills comprised of construction and other waste, increasing their vulnerability to debris flow, landslides, and earthquakes. Additionally, we noted that some new urban areas mainly consist of temporarily empty houses, highlighting the feasibility of implementing countermeasures, such as relocations, in the early stages of informal occupation. These results underscore the significant contribution of satellite radar imagery in identifying recent informal urban areas.

La ciudad desde la antropología. Miradas Etnográficas es un libro, editado por Gerardo Castillo y Laura Soria, que reúne un conjunto de artículos académicos que brindan una reflexión diversa, a nivel temático y metodológico, sobre los debates antropológicos alrededor de la ciudad. Vinculando el análisis de la espacialidad de los lugares abordados con las dinámicas que constituyen los grupos sociales que la habitan, esta publicación supone un aporte clave en el campo de la investigación de la antropología urbana.

Este artículo presenta parte del trabajo realizado en el marco del programa Modural “Las prácticas de movilidad sostenible en las metrópolis de América Latina: estudio comparativo de Bogotá y Lima”, iniciado en enero de 2020. Modural es un programa internacional y plu­ridisciplinario financiado por la anr(Agencia Nacional de la Investigación de Francia). Está enfocado en estudiar las prácticas de movilidad sostenible en la situación específica de las periferias populares. El artículo tiene dos objetivos. Primero, evidenciar los patrones socio-espaciales de desigualdad de movilidad y las dificultades en las periferias en Lima y Bogotá. Segundo, presentar la metodología de selección de las zonas con mayor desventaja social y mayores dificultades de movilidad cotidiana.

Abstract Aim To evaluate the efficacy and impact of long-acting injectable (LAI) aripiprazole in patients with schizophrenia with a coexisting substance use disorder (SUD). Patients and methods A multicenter, observational, descriptive and retrospective study was conducted in patients with a DSM-5 diagnosis of schizophrenia who had a coexisting SUD and were treated with LAI-aripiprazole. Disease severity was evaluated with the Clinical Global Impression (CGI) severity scale for schizophrenia, daily functioning and disability were evaluated with the World Health Organisation Disability Assessment Scale (WHODAS-2.0), and the severity of the addiction was evaluated with the Severity of Dependence Scale (SDS). Results The sample included 40 patients. Overall, after 6 months of treatment with LAI-aripiprazole at a dose of 400 mg/4 weeks in 77.5% of the patients, we observed significant improvement in the psychopathological symptoms, with a reduction of over 30% in the scores of the five CGI-severity scales. The WHODAS-2.0 mean (standard deviation) score was also significantly reduced from 57.6 (8.2) to 42.3 (4.3) points (p

Objectives: We aimed to evaluate a hepatitis C (HCV) micro-elimination program in 2 addiction centers among subjects with substance use disorders (SUD). Methods: The program was based on simplifying the diagnosis of HCV infections by avoiding referral to primary care for the diagnosis and performing the necessary tests at the point of care (ie, the addition center) and simplifying the patient pathway by directly referring patients to the specialized care for treatment. Descriptive and multivariate analyses are presented. Results: Of the 1497 subjects included in the program, 327 reported that they were anti-HCV-positive. Among the 1170 patients who were offered the HCV rapid antibody test, 180 (15.4%) did not perform the test. Performing the HCV rapid antibody test only contributed ten patients (3%) to the 337 who were anti-HCV-positive. A high proportion (147 out of 327 [45%]) of subjects who reported being anti-HCV-positive also reported that they had not been treated for HCV. Among the 67 subjects who were HCV-RNA-positive and were referred for treatment, 53 (79%) ultimately received and completed antiviral treatment. Unfortunately, we did not find any factors associated with not performing dry blood testing, and the factors associated with not performing the HCV rapid antibody test were difficult to interpret, and the model showed low goodness of fit. Conclusions: Our results suggest that a micro-elimination program focused on patients with SUD attending an addiction center is not effective for screening the presence of hepatitis C but is successful for linking patients with hepatitis C to antiviral treatment.

Background: A recently registered device containing 80 mg of adalimumab (ADA) allows an alternative dose escalation regimen with ADA 80 mg every other week (EOW) given as a single subcutaneous injection instead of 40 mg every week. The ADASCAL study evaluated the preferences and satisfaction of inflammatory bowel disease (IBD) patients after switching their ADA regimen from 40 mg weekly to 80 mg EOW given with a single-dose pen. Methods: In this multicentre cross-sectional study, patients in whom the ADA regimen was changed from 40 mg weekly to 80 mg EOW completed the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4), a four-item questionnaire [a Likert-type 5-point scale for preferences, two closed questions for convenience and a 100-point visual analogue scale (VAS) to assess which escalated ADA regimen patients would prefer to continue] and two Health-Related Quality of Life (HRQoL) questionnaires: the generic European Quality of Life–5 Dimensions (EQ-5D) and disease-specific Spanish version of the Inflammatory Bowel Disease Questionnaire (SIBDQ-9). Results: In total, 77 patients (64 Crohn’s disease and 13 ulcerative colitis) were included. The TSQM score showed a notably high global satisfaction [83.4, standard deviation (SD) = 14.1] of patients with ADA 80 mg EOW given with a single-dose pen, with high TSQM scores for individual components: effectiveness (77.6, SD = 16.9), convenience (83.7, SD = 14.5) and side effects (86.1, SD = 23.4). Most of the patients (74%) preferred the ADA EOW regimen (59.7% had strong preference, 14.3% slight preference). ADA EOW interferes less with daily activity (59.7%) and with travel plans (81.8%). Most patients (77%) would prefer to continue with ADA EOW (mean VAS score of 84.7, SD = 24.1, where 100 indicates a preference for ADA EOW). Patients reported high HRQoL scores on both the EQ-5D (72.3, SD = 20.1) and SIBDQ-9 (75.1, SD = 14.7). Conclusion: IBD patients in whom the ADA regimen was changed from 40 mg weekly to 80 mg EOW reported a higher preference for the EOW regimen and therefore most decided to continue with a single self-injection EOW.

La junta directiva es el principal órgano de gobierno de libre designación en las federaciones deportivas españolas. En el presente trabajo se analiza la diversidad de género de los miembros que las componen en las 61 federaciones deportivas españolas, comparando los valores con los observados en los consejos de administración de las empresas de otros sectores económicos. Se estudia la evolución de la presencia de mujeres en las juntas directivas en el período 2008-2013 y, mediante el uso de un análisis discriminante, se analiza si de manera estadísticamente significativa su diversidad de género tiene relación con el rendimiento operacional y económico de las federaciones. La desigualdad de género existe en las juntas directivas y, aunque está disminuyendo, la situación no afecta significativamente a los resultados económicos y operacionales de las federaciones deportivas españolas.

Several behaviors, including compulsive gambling, have been considered non-substance-related addictive disorders. Categorical mental disorders (e.g., DSM-5) are usually accompanied by very different symptomatic expressions (affective, behavioral, cognitive, substance abuse, personality traits). When these mental disorders occur with addictive disorders, either concomitantly or sequentially over the life span, this clinical condition is called a dual disorder. Gambling disorder (GD) has been associated with other categorical psychiatric diagnoses: attention deficit hyperactivity disorder, depression, bipolar disorder, social anxiety, schizophrenia, substance use disorder, antisocial personality disorder; and dimensional symptoms including higher impulsivity, poorer emotional wellbeing, cognitive distortion, psychosis, deficient self-regulation, suicide, poorer family environment, and greater mental distress. We are calling this clinical condition Gambling Dual Disorder. From a clinical perspective, it is clear that Gambling Dual Disorder is not the exception but rather the expectation, and this holds true not just for GD, but also for other mental disorders including other addictions. Mental disorders are viewed as biological disorders that involve brain circuits that implicate specific domains of cognition, emotion, and behavior. This narrative review presents the state of the art with respect to GD in order to address current matters from a dual disorder, precision psychiatry, and clinical neuroscience perspective, rather than the more subjective approach of symptomatology and clinical presentation. This review also presents Gambling Dual Disorder as a brain and neurodevelopmental disorder, including from the perspectives of evolutionary psychiatry, genetics, impulsivity as an endophenotype, the self-medication hypothesis, and sexual biological differences. The wide vision of the disease advances a paradigm shift, highlighting how GD and dual disorders should be conceptualized, diagnosed, and treated. Rethinking GD as part of a dual disorder is crucial for its appropriate conceptualization from the perspective of clinical neuroscience and precision psychiatry.

En países como Perú, la actividad económica a escala global ocurre en territorios diversos de población dispersa. No se han podido evaluar de manera eficiente sus efectos debido a que hemos estudiado poco las redes urbanas cuando hay aglomeraciones pequeñas y dispersas en el territorio. Por ello, el interés se centró en realizar un estudio sobre cómo se distribuyen y relacionan las diferentes localidades que ocupan territorios de geografía diversa y accidentada. La investigación propone la elaboración de tipologías de redes en unidades territoriales como estrategia de análisis para identificar el rol de intermediación de las ciudades pequeñas. Para el análisis tipológico se tomaron como indicadores la densidad de ocupación, la distribución de servicios públicos, los usos del suelo y la contracción espaciotemporal. Como estudio de caso se eligieron tres unidades territoriales en la región de La Libertad, en el norte del Perú. Los resultados permitieron identificar tipologías de redes de ciudades pequeñas que muestran marcadas diferencias en la ocupación del territorio.

The main challenges in drug delivery systems are to protect, transport and release biologically active compounds at the right time in a safe and reproducible manner, usually at a specific target site. In the past, drug nano-carriers have contributed to the development of precision medicine and to a lesser extent have focused on its inroads in agriculture. The concept of engineered nano-carriers may be a promising route to address confounding challenges in agriculture that could perhaps lead to an increase in crop production while reducing the environmental impact associated with crop protection and food production. The main objective of this review is to contrast the advantages and disadvantages of different types of nanoparticles and nano-carriers currently used in the biomedical field along with their fabrication methods to discuss the potential use of these technologies at a larger scale in agriculture. Here we explain what is the problem that nano-delivery systems intent to solve as a technological platform and describe the benefits this technology has brought to medicine. Also here we highlight the potential drawbacks that this technology may face during its translation to agricultural applications, based on the lessons learned so far from its use for biomedical purposes. We discuss not only the characteristics of an ideal nano-delivery system, but also the potential constraints regarding the fabrication including technical, environmental, and legal aspects. A key motivation is to evaluate the potential use of these systems in agriculture, especially in the area of plant breeding, growth promotion, disease control, and post-harvest quality control. Further, we highlight the importance of a rational design of nano-carriers and identify current research gaps to enable scale-up relevant to applications in the treatment of plant diseases, controlled release of fertilizers, and plant breeding.

Abstract Background Symptom based referral criteria for colorectal cancer (CRC) detection are the cornerstone of the strategy to improve prognosis in CRC. In 2017, the National Institute for Health and Care Excellence (NICE) updated their referral criteria (2017 NG12). Recently, several studies have evaluated the faecal haemoglobin (f-Hb) concentration in this setting. The aim of this study is to evaluate the diagnostic accuracy of the 2017 NG12 referral criteria and to compare them with the CG27 referral criteria, the f-Hb concentration and two f-Hb based prediction model: COLONPREDICT and FAST Score. Methods This is a post-hoc diagnostic test study performed within the COLONPREDICT study database (1572 patients, CRC prevalence 13.6%). We assessed symptoms, the 2017 NG12 and CG27 referral criteria and determined the f-Hb before performing a colonoscopy. We compared the discriminatory ability using the area under the curve (AUC) and the sensitivity and specificity at pre-stablished thresholds with the McNemar’s test. Results The 2017 NG12 referral criteria discriminatory ability (AUC 0.53; 95% confidence interval- CI 0.49–0.57) was inferior to the CG27 version (AUC 0.59; 95% CI 0.55–0.63; p = 0.01), the f-Hb concentration (AUC 0.86; 95% CI 0.84–0-89; p

Leaching outdoor tests (LOT) are commonly used to assess the leaching of substances from construction materials. In this context, the amount of stormwater in contact with the surface material is of special interest for analyzing the runoff loads of substances from building façades. A numerical model was developed in MATLAB on the basis of previous analytical models to calculate the collected stormwater runoff volumes from the vertical test panels (VTP) during LOT. In the model, wind-driven rain (WDR) is considered to be the main mechanism for determining the amount of water impinging on the VTP, so it is a crucial factor in the modeling for the façade runoff. The new model makes it possible to simulate the runoff volumes from VTP that are covered with a wide variety of plaster and mortar. Using the new model, it was possible to relate the VTP runoff volumes obtained during an 18-month sampling period for LOTs performed at the Fraunhofer Institute for Building Physics in Valley, Germany. When comparing the simulation results with the field test accumulated runoffs, the model exhibited a difference of no more than 3.5% for each of the analyzed materials. The simulation results are satisfying, and the paper demonstrates the feasibility of the modelling approach for the runoff assessment of VTP covered with a variety of plaster and mortar.

During the last decades, archaeological site looting throughout Iraq has increased significantly up to a point where some of the most famous and relevant ancient Mesopotamian cities are currently threatened in their integrity. Several important archaeological monuments and artifacts have been destroyed, due to ISIL attacks and associated looting. Since 2016, the policies of the European Union have been increasingly harsh to condemn these atrocious acts of destruction. In such a scenario, the European Union Satellite Centre can be an invaluable instrument for the identification and assessment of the damage in areas occupied by ISIL. A detailed view of the damage suffered by the Nineveh and Nebi Yunus ancient sites, in Iraq, was assessed via visual inspection. The analysis was conducted considering the main events that occurred in the city of Mosul, between November 2013 and March 2018. More than 25 satellite images, new acquisitions and archived, supported by collateral data, allowed the detection and classification of the damage occurred over time. A description of the methodology and the classification of category and type of damage is presented. The results of the analysis confirm the dramatic levels of destruction that these two ancient sites have been suffering since 2013. The analysis reported in this paper is part of a wider study that the SatCen conducted in cooperation with the EU Counter-Terrorism Office and PRISM Office. The whole activity aimed at confirming to EU institutions the massive looting and trafficking operated in the area. The results have been provided to archaeologists in the field as well in support of local authorities who are trying to evaluate the current situation in the area.

A randomized, 1-year follow-up study comparing LAI aripiprazole with LAI paliperidone in patients with psychosis, mostly schizophrenia, and SUD reported a large effect of the change from baseline in the CGI severity score, from 5.9 to 2.4 for LAI aripiprazole and from 5.7 to 2.6 for LAI risperidone [29].

Patients with alcohol-use disorders (AUDs) have a high prevalence of anxiety disorders (AnxDs). “Co-occurring disorders” refers to the coexistence of an AUD and/or drug related disorders with another non-addictive psychiatric disorder. The aim of this study was to assess the effectiveness of psychopharmacological treatments and psychotherapy in patients with AUD and AnxD and to propose recommendations for the treatment of patients with comorbid AnxDs and AUDs. Randomized clinical trials, meta-analyses, and clinical guidelines were retrieved from PubMed, Embase, and Cochrane databases. Paroxetine was found to be effective in social anxiety patients with alcohol dependence. Selective serotonin reuptake inhibitors (SSRIs), especially sertraline, showed effective results in posttraumatic stress disorder and in comorbid AnxD–AUD. However, SSRIs should be used with caution when patients are actively drinking because they may increase alcohol consumption. Buspirone, gabapentin, and pregabalin were found to be effective in comorbid AnxD–AUD. The treatment of dual AnxDs should start as early as possible. Since AUDs and AnxDs can reinforce each other, treatments targeting both pathologies can be effective. Women suffer from higher levels of stress and AnxDs than men, and they are also more vulnerable to maintaining alcohol consumption levels. Further research is needed in this comorbid patient population, including the study of different types of patients and gender perspectives.

El proceso de transformación que experimenta Lima en la actual era de la globalización ha supuesto la agudización de prácticas de segregación y/o exclusión en la forma de usar los espacios públicos de la ciudad aunque, paradójicamente, éste no parece ser un problema que preocupe a los limeños. El objetivo de este artículo es sustentar que la vida cotidiana en los espacios públicos expresa las grandes desigualdades sociales que existen en Lima, las cuales ofrecen múltiples facetas en conflicto, como la del conductor de vehículo motorizado con el habitante-transeúnte o la del habitante-residente con el habitante-transeúnte, las que se suelen superponer a desigualdades más visibles como el nivel de ingreso o el lugar de residencia.

Background: the Galician Health Service established indications and priority levels (I = fast track, II = preferential, III = normal) for colonoscopy, according to the risk of colorectal cancer and significant colonic lesions detection with access from primary health care. Our aim is to show the results of the implementation. Methods: we included colonoscopies requested in symptomatic patients from June to October 2012 in a prospective observational cross sectional study. We collected health care level (primary, secondary), priority, appropriateness to the established criteria, wait times (from colonoscopy application and initial consultation) and diagnostic yield for colorectal cancer and/or significant colonic lesion. We compared health care levels in priorities I and II. Results: 425 colonoscopies were included (I = 221, II = 141, III = 63). The appropriateness rate to the protocol was 67.5 %. Priority levels were significantly associated to wait times (days) from application (I = 8.7 ± 8.9, II = 50 ± 20.3, III = 80.2 ± 32.2; p < 0.001) and initial consultation (I = 32.2 ± 38, II = 74.5 ± 44.2, III = 128.5 ± 47.4; p < 0.001), and with colorectal cancer (I = 20.1 %, II = 19.1 %, III = 4.8 %, p < 0.001) and significant colonic lesion (I = 35.3 %, II = 34 %, III = 19 %, p = 0.002) detection rates. In priority I and II, 21.8 % of colonoscopies were requested from primary health care. Referral form primary health care reduced wait times from initial consultation to colonoscopy (primary = 29.3 ± 26, secondary = 55.2 ± 48.6, p < 0.001). Instead, colorectal cancer (OR 2.41, 95 % CI 1.31-4.42) and significant colonic lesion (OR 1.88, 95 % CI 1.13-3.15) detection rate was increased. Conclusions: Galician Health Service priority levels are significantly associated with colorectal cancer and significant colonic lesion detection. Referrals to colonoscopy from primary health care reduce waiting times and increase diagnostic yield.

El artículo que a continuación se presenta, es el resultado de un trabajo de investigación relacionado con el significado que le otorgan los estudiantes y docentes de primaria a las actividades circenses en la clase de Educación Física. Esta investigación se enmarca en el paradigma interpretativo fenomenológico y la metodología cualitativa no experimental, toda vez que lo central es comprender las nociones de significancia en el marco de las actividades circenses y circo. En el estudio emerge con nitidez que el currículo escolar del subsector carece de espacios para el desarrollo y despliegue de éste núcleo temático. Por otro lado, permite visualizar la pertinencia dentro del modelo curricular de la disciplina, entendiendo que este enfoque paradigmático sobrepasa la perspectiva mecanicista, dualista e instrumental asignada a la Educación Física, para centrar su mirada en la resignificación que emerge de las concepciones y vivencias de los sujetos participantes de estas actividades.

El artículo no presenta resumen.

No presenta resumen