Comunidad de Madrid

The real and the virtual worlds are growing speedily and closely to form the Internet of Things (IoT). In fact, IoT has stimulated the factories and the governments to launch an evolutionary journey toward the fourth industrial revolution called Industry 4.0. Industrial production of the new era will be highly flexible in production volume and customization, extensive integration between customers, companies, and suppliers, and above all sustainable. Reviewing and analyzing the current initiatives and related studies of the smart factories/Industry 4.0, this paper presents a reference architecture for IoT-based smart factories, defines the main characteristics of such factories with a focus on the sustainability perspectives. And then it proposes an approach for energy management in smart factories based on the IoT paradigm: a guideline and expected benefits are discussed and presented.

Abstract A l’invitation gracieuse que m’ont faite les honorables membres de cette société savante de venir dans cette séance rendre compte de mes travaux sur la structure des centres nerveux, mon premier dessein, je ne le cacherai pas, a été de renoncer à un honneur que je jugeais par trop disproportionné avec mes mérites; mais je songeai ensuite que votre bienveillance à m’écouter ne saurait être moindre que la générosité de votre invitation, et je me suis résigné au rôle, peu flatteur du reste, d’interrompre un moment l’harmonieux concert de vos beaux travaux. J’ai d’autant plus besoin de toute vobre indulgence que je vais vous entretenir d’un sujet qui vous est parfaitement connu. Tout ce que je vais vous dire, des maîtres aussi éminents que His, Kölliker, Waldeyer, von Lenhossék, van Gehuchten, l’ont déjà publié et résumé d’une manière presque irréprochable.

a) Describir la metodología seguida en la construcción de un índice de privación por sección censal en ciudades, que permite identificar las secciones con situaciones socioeconómicas más desfavorables, y b) analizar la relación de este índice con la mortalidad general. Se elaboraron diversos indicadores socioeconómicos (Censo 2001) correspondientes a las secciones censales de las ciudades de Barcelona, Bilbao, Madrid, Sevilla y Valencia. Se estudiaron sus correlaciones con la razón estandarizada de mortalidad (1996-2003), así como sus dimensiones conceptuales. Finalmente, mediante el análisis de componentes principales, se agregaron en un índice los indicadores seleccionados, usando como valores de peso las saturaciones correspondientes al primer eje. Los indicadores que presentaron mayores correlaciones con la mortalidad general fueron los referidos a trabajo, educación, vivienda-entorno y hogares monoparentales. En el análisis dimensional de los indicadores aparece una primera dimensión que contiene los indicadores relativos a trabajo (desempleo, trabajadores manuales y eventuales) y educación (instrucción insuficiente total y en jóvenes). El índice elaborado con estos 5 indicadores recoge, en todas las ciudades estudiadas, más del 75% de la variabilidad de los indicadores que lo componen. Las correlaciones de este índice con la mortalidad muestran, en general, mayores valores que las obtenidas individualmente con cada indicador. El índice de privación que se propone puede ser un instrumento útil para la planificación sanitaria al detectar áreas pequeñas de grandes ciudades con una situación socioeconómica desfavorable, que se relaciona con la mortalidad, y puede contribuir al estudio de las desigualdades sociales en salud en España. a) To describe the methodology used to construct a deprivation index by census tract in cities, to identify the tracts with the least favorable socioeconomic conditions, and b) to analyze the association between this index and overall mortality. Several socioeconomic indicators (Census 2001) were defined by the census tracts of the following cities: Barcelona, Bilbao, Madrid, Seville and Valencia. The correlations with the standardized mortality ratio (1996-2003), and the dimensionality of the socioeconomic indicators were studied. Finally, the selected indicators were aggregated in an index, in which the results of the factor loadings from extraction of a factor by principal components were used as weighting values. The indicators with the strongest correlations with overall mortality were those related to work, education, housing conditions and single parent homes. In the analysis of dimensionality, a first dimension appeared that contained indicators related to work (unemployment, manual and eventual workers) and education (insufficient education overall and in young people). In all the cities studied, the index created with these 5 indicators explained more than 75% of their variability. The correlations between this index and mortality generally showed higher values than those obtained with each indicator separately. The deprivation index proposed could be a useful instrument for health planning as it detects small areas of large cities with unfavorable socioeconomic characteristics and is associated with mortality. This index could contribute to the study of social inequalities in health in Spain.

BACKGROUND: This article summarizes the ERA-EDTA Registry's 2016 Annual Report, by describing the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 2016 within 36 countries. METHODS: In 2017 and 2018, the ERA-EDTA Registry received data on patients undergoing RRT for ESRD in 2016 from 52 national or regional renal registries. In all, 32 registries provided individual patient data and 20 provided aggregated data. The incidence and prevalence of RRT and the survival probabilities of these patients were determined. RESULTS: In 2016, the incidence of RRT for ESRD was 121 per million population (pmp), ranging from 29 pmp in Ukraine to 251 pmp in Greece. Almost two-thirds of patients were men, over half were aged ≥65 years and almost a quarter had diabetes mellitus as their primary renal diagnosis. Treatment modality at the start of RRT was haemodialysis for 84% of patients. On 31 December 2016, the prevalence of RRT was 823 pmp, ranging from 188 pmp in Ukraine to 1906 pmp in Portugal. In 2016, the transplant rate was 32 pmp, varying from 3 pmp in Ukraine to 94 pmp in the Spanish region of Catalonia. For patients commencing RRT during 2007-11, the 5-year unadjusted patient survival probability on all RRT modalities combined was 50.5%. For 2016, the incidence and prevalence of RRT were higher among men (187 and 1381 pmp) than women (101 and 827 pmp), and men had a higher rate of kidney transplantation (59 pmp) compared with women (33 pmp). For patients starting dialysis and for patients receiving a kidney transplant during 2007-11, the adjusted patient survival probabilities appeared to be higher for women than for men.

BACKGROUND: Studies exploring the role of diet during pregnancy are still scarce, in part due to the complexity of measuring diet and to the lack of valid instruments. The aim of this study was to examine the reproducibility and validity (against biochemical biomarkers) of a semi-quantitative food frequency questionnaire (FFQ) in pregnant women. METHODS: Participants were 740 pregnant women from a population-based birth cohort study in Valencia (INMA Study). We compared nutrient and food intakes from FFQs estimated for two periods of pregnancy (reproducibility), and compared energy-adjusted intake of several carotenoids, folate, vitamin B12, vitamin C and α-tocopherol of the FFQ in the first trimester with their concentration in blood specimens (validity). RESULTS: Significant correlations for reproducibility were found for major food groups and nutrients but not for lycopene (r=0.06); the average correlation coefficients for daily intake were 0.51 for food groups and 0.61 for nutrients. For validity, statistically significant correlations were observed for vitamin C (0.18), α-carotene (0.32), β-carotene (0.22), lutein-zeaxantin (0.29) and β-cryptoxantin(0.26); non-significant correlations were observed for retinol, lycopene, α-tocopherol, vitamin B12 and folate (r≤0.12). When dietary supplement use was considered, correlations were substantially improved for folate (0.53) and to a lesser extent for vitamin B12 (0.12) and vitamin C (0.20). CONCLUSION: This study supports that the FFQ has a good reproducibility for nutrient and food intake, and can provide a valid estimate of several important nutrients during pregnancy.

BACKGROUND: Prophylaxis against Pneumocystis carinii pneumonia is indicated in patients with human immunodeficiency virus (HIV) infection who have less than 200 CD4 cells per cubic millimeter and in those with a history of P. carinii pneumonia. However, it is not clear whether prophylaxis can be safely discontinued after CD4 cell counts increase in response to highly active antiretroviral therapy. METHODS: We conducted a randomized trial of the discontinuation of primary or secondary prophylaxis against P. carinii pneumonia in HIV-infected patients with a sustained response to antiviral therapy, defined by a CD4 cell count of 200 or more per cubic millimeter and plasma HIV type 1 (HIV-1) RNA level of less than 5000 copies per milliliter for at least three months. Prophylactic treatment was restarted if the CD4 cell count declined to less than 200 per cubic millimeter. RESULTS: The 474 patients receiving primary prophylaxis had a median CD4 cell count at entry of 342 per cubic millimeter, and 38 percent had detectable HIV-1 RNA. After a median follow-up period of 20 months (758 person-years), there had been no episodes of P. carinii pneumonia in the 240 patients who discontinued prophylaxis (95 percent confidence interval, 0 to 0.85 episode per 100 person-years). For the 113 patients receiving secondary prophylaxis, the median CD4 cell count at entry was 355 per cubic millimeter, and 24 percent had detectable HIV-1 RNA. After a median follow-up period of 12 months (123 person-years), there had been no episodes of P. carinii pneumonia in the 60 patients who discontinued prophylaxis (95 percent confidence interval, 0 to 4.5 episodes per 100 person-years). CONCLUSIONS: In HIV-infected patients receiving highly active antiretroviral therapy, primary and secondary prophylaxis against P. carinii pneumonia can be safely discontinued after the CD4 cell count has increased to 200 or more per cubic millimeter for more than three months.

This review focuses on papers on Hate Speech, particularly in legal and communication studies indexed in Web of Science. It analyzes output published in English and in Spanish as well as surveys the predominant disciplines in which these studies are written, their trend over time, by country, and type of document. This research is extended to determine the debates, lines of work of greatest interest, and the theories elaborated. The legal literature is intended to define hate speech and hate crime for the purposes of applying criminal sanctions. From the communication standpoint, the analysis of hate speech in the media is key to understanding the type of message used, its emitter, the way in which the message rallies supporters, and how they interpret the message. Spanish studies mostly fall within the legal area, in which they focus on cases of insult directed at the Catholic religion. We discuss the importance of interdisciplinarity and transversality and propose a mapping of hate speech that lends itself to comparisons between countries to assess measures to counteract their effects.

BACKGROUND: Timely influenza surveillance is important to monitor influenza epidemics. OBJECTIVES: (i) To calculate the epidemic threshold for influenza-like illness (ILI) and acute respiratory infections (ARI) in 19 countries, as well as the thresholds for different levels of intensity. (ii) To evaluate the performance of these thresholds. METHODS: The moving epidemic method (MEM) has been developed to determine the baseline influenza activity and an epidemic threshold. False alerts, detection lags and timeliness of the detection of epidemics were calculated. The performance was evaluated using a cross-validation procedure. RESULTS: The overall sensitivity of the MEM threshold was 71·8% and the specificity was 95·5%. The median of the timeliness was 1 week (range: 0-4·5). CONCLUSIONS: The method produced a robust and specific signal to detect influenza epidemics. The good balance between the sensitivity and specificity of the epidemic threshold to detect seasonal epidemics and avoid false alerts has advantages for public health purposes. This method may serve as standard to define the start of the annual influenza epidemic in countries in Europe.

Abstract Critical illness in COVID-19 is an extreme and clinically homogeneous disease phenotype that we have previously shown 1 to be highly efficient for discovery of genetic associations 2 . Despite the advanced stage of illness at presentation, we have shown that host genetics in patients who are critically ill with COVID-19 can identify immunomodulatory therapies with strong beneficial effects in this group 3 . Here we analyse 24,202 cases of COVID-19 with critical illness comprising a combination of microarray genotype and whole-genome sequencing data from cases of critical illness in the international GenOMICC (11,440 cases) study, combined with other studies recruiting hospitalized patients with a strong focus on severe and critical disease: ISARIC4C (676 cases) and the SCOURGE consortium (5,934 cases). To put these results in the context of existing work, we conduct a meta-analysis of the new GenOMICC genome-wide association study (GWAS) results with previously published data. We find 49 genome-wide significant associations, of which 16 have not been reported previously. To investigate the therapeutic implications of these findings, we infer the structural consequences of protein-coding variants, and combine our GWAS results with gene expression data using a monocyte transcriptome-wide association study (TWAS) model, as well as gene and protein expression using Mendelian randomization. We identify potentially druggable targets in multiple systems, including inflammatory signalling ( JAK1 ), monocyte–macrophage activation and endothelial permeability ( PDE4A ), immunometabolism ( SLC2A5 and AK5 ), and host factors required for viral entry and replication ( TMPRSS2 and RAB2A ).

In addition to being a well-liked form of recreation, escape rooms have drawn the attention of educators due to their ability to foster teamwork, leadership, creative thinking, and communication in a way that is engaging for students. As a consequence, educational escape rooms are emerging as a new type of learning activity under the promise of enhancing students’ learning through highly engaging experiences. These activities consist of escape rooms that incorporate course materials within their puzzles in such a way that students are required to master these materials in order to succeed. Although several studies have reported on the use of escape rooms in a wide range of disciplines, prior research falls short of addressing the use of educational escape rooms for teaching programming, one of the most valuable skills of the twenty-first century that students often have difficulties grasping. This paper reports on the use of an educational escape room in a programming course at a higher education institution and provide, for the first time, insights on the instructional effectiveness of using educational escape rooms for teaching programming. The results of this paper show that appropriate use of educational escape rooms can have significant positive impacts on student engagement and learning in programming courses. These results also suggest that students prefer these activities over traditional computer laboratory sessions. Finally, another novel contribution of this paper is a set of recommendations and proposals for educators in order to help them create effective educational escape rooms for teaching programming.

Healthcare workers are vulnerable to adverse mental health impacts of the COVID-19 pandemic. We assessed prevalence of mental disorders and associated factors during the first wave of the pandemic among healthcare professionals in Spain. All workers in 18 healthcare institutions (6 AACC) in Spain were invited to web-based surveys assessing individual characteristics, COVID-19 infection status and exposure, and mental health status (May 5 – September 7, 2020). We report: probable current mental disorders (Major Depressive Disorder-MDD- [PHQ-8≥10], Generalized Anxiety Disorder-GAD- [GAD-7≥10], Panic attacks, Posttraumatic Stress Disorder –PTSD- [PCL-5≥7]; and Substance Use Disorder –SUD-[CAGE-AID≥2]. Severe disability assessed by the Sheehan Disability Scale was used to identify probable “disabling” current mental disorders. 9,138 healthcare workers participated. Prevalence of screen-positive disorder: 28.1% MDD; 22.5% GAD, 24.0% Panic; 22.2% PTSD; and 6.2% SUD. Overall 45.7% presented any current and 14.5% any disabling current mental disorder. Workers with pre-pandemic lifetime mental disorders had almost twice the prevalence than those without. Adjusting for all other variables, odds of any disabling mental disorder were: prior lifetime disorders (TUS: OR=5.74; 95%CI 2.53-13.03; Mood: OR=3.23; 95%CI:2.27-4.60; Anxiety: OR=3.03; 95%CI:2.53-3.62); age category 18-29 years (OR=1.36; 95%CI:1.02-1.82), caring “all of the time” for COVID-19 patients (OR=5.19; 95%CI: 3.61-7.46), female gender (OR=1.58; 95%CI: 1.27-1.96) and having being in quarantine or isolated (OR= 1.60; 95CI:1.31-1.95). One in seven Spanish healthcare workers screened positive for a disabling mental disorder during the first wave of the COVID-19 pandemic. Workers reporting pre-pandemic lifetime mental disorders, those frequently exposed to COVID-19 patients, infected or quarantined/isolated, female workers, and auxiliary nurses should be considered groups in need of mental health monitoring and support. Los profesionales sanitarios son vulnerables al impacto negativo en salud mental de la pandemia COVID-19. Evaluamos la prevalencia de trastornos mentales y factores asociados durante la primera oleada de la pandemia en sanitarios españoles. Se invitó a todos los trabajadores de 18 instituciones sanitarias españolas (6 CCAA) a encuestas en línea evaluando características individuales, estado de infección y exposición a COVID-19 y salud mental (5 Mayo – 7 Septiembre, 2020). Reportamos: probables trastornos mentales actuales (Trastorno depresivo mayor TDD [PHQ-8≥10], Trastorno de ansiedad generalizada TAG [GAD-7≥10], Ataques de pánico, Trastorno de estrés postraumático TEP [PCL-5≥7]; y Trastorno por uso de sustancias TUS [CAGE-AID≥2]. La interferencia funcional grave (Escala de Discapacidad de Sheehan) identificó los probables trastornos “discapacitantes”. Participaron 9.138 sanitarios. Prevalencia de cribado positivo: 28,1% TDD; 22,5% TAG, 24,0% Pánico; 22,2% PTE; y 6,2% TUS. En general, el 45,7% presentó algún trastorno mental actual y el 14,5% algún trastorno discapacitante. Los sanitarios con trastornos mentales previos tuvieron el doble de prevalencia que aquellos sin patología mental previa. Ajustando por todas las variables, el trastorno mental incapacitante se asoció positivamente con: trastornos previos (TUS: OR=5.74; 95%CI 2.53-13.03; Ánimo: OR=3.23; 95%CI:2.27-4.60; Ansiedad: OR=3,03; IC 95%: 2,53-3,62); edad 18-29 años (OR=1,36; IC 95%: 1,02-1,82); atender “siempre” a pacientes COVID-19 (OR=5,19; IC 95%: 3,61-7,46), género femenino (OR=1,58; IC 95%: 1,27-1,96) y haber estado en cuarentena o aislado (OR=1,60; IC 95%: 1,31-1,95). Uno de cada 7 sanitarios españoles presentaron un probable trastorno mental discapacitante durante la primera oleada de COVID-19. Aquéllos con trastornos mentales alguna vez antes de la pandemia, los que están expuestos con frecuencia a pacientes con COVID-19, los infectados o en cuarentena / aislados, las mujeres y las enfermeras auxiliares deben considerarse grupos que necesitan seguimiento y apoyo de su salud mental.

Animal tolerance to human approaches may be used to establish buffers for wildlife that can minimize the probability that animals will be disturbed by human activity. Alert distance (the distance between an animal and an approaching human at which point the animal begins to exhibit alert behaviours to the human) has been proposed as an indicator of tolerance mainly for waterbirds; however, little is known about its utility for other bird species. The factors that influenced alert distances of four bird species to pedestrian approaches in five large wooded fragments in the city of Madrid (Spain) were analysed. Location of human activity affected only Passer domesticus alert distances, which increased in the proximity of pathways. Habitat structure modified alert distances of all the species ( Passer domesticus , Turdus merula , Columba palumbus , and Pica pica ), increasing bird tolerance with greater availability of escape cover (shrub and coniferous cover, and shrub height). Alert distances varied among species, with large species being less tolerant of human disturbance than small ones. Alert distance appears to be a more conservative indicator of tolerance than flight distances, because it includes a buffer zone (the difference between alert and flight distance) in which birds may adapt their reaction to the behaviour of visitors. Alert distance may be used in the determination of minimum approaching areas, allowing people to enjoy their visit to parks, and birds to use patches for foraging and breeding without being displaced.

Young transgender and non-binary individuals (TNBI) are exposed to situations of discrimination and have a greater risk of violence. The purpose of this study is to analyze which protective, violence and health and well-being factors have more influence on TNBI compared to cisgender people. The sample comprised 856 youth between 14 and 25 years old. A survey including questions about sociodemographic information and protective, violence and health and well-being factors was designed ad hoc for this study. The results show the non-binary group received the least support from family and friends, higher risk of suffering cyberbullying, and many feel isolated and unhappy. TNBI have suffered more verbal attacks both inside and outside their school and physical attacks at school than cisgender young. These results are important because they may contribute to the promotion of public policies and clinical interventions that favor the integration of TNBI in our society.

Liver disease secondary to hepatitis C virus (HCV) infection is a rising cause of morbidity and mortality among individuals who have been infected parenterally with human immunodeficiency virus (HIV) such as injection drug users, hemophiliacs, and transfused patients. We analyzed both the efficacy of interferon (IFN) alpha therapy in these patients and the predictors of response to this agent. A total of 119 patients with chronic hepatitis C (90 of whom were infected with HIV and 29 of whom were not) were included in a multicenter, prospective, open, nonrandomized observational study. IFN-alpha was given subcutaneously in a dosage of 5 million units three times a week during a 3-month period; those patients who responded received a dose of 3 million units given subcutaneously three times a week for an additional 9 months. One hundred seven patients completed the study; the level of aminotransferases returned to normal and sera became negative (complete response) for HCV RNA in 26 (32.5%) of 80 HIV-infected patients and 10 (37.0%) of 27 non-HIV-infected patients (P = .666) after completion of the treatment. Two variables were independently associated with a response in HIV-infected patients: a CD4+ T lymphocyte count of > 500 x 10(6)/L and a baseline HCV viremia level of < 10(7) copies/mL. In the 12 months following treatment, relapses occurred in 30.8% of the HIV-infected patients and 12.5% of non-HIV-infected patients (P = .403).

OBJECTIVE: To estimate the risk and probability of heterosexual transmission of HIV-1 from infected people taking combined antiretroviral treatment. DESIGN: Cross sectional and prospective cohort studies. SETTING: HIV clinic in Madrid, Spain. PARTICIPANTS: Stable heterosexual couples with one partner with HIV-1 infection (index partner) and the other reporting this sexual relationship as the only risk exposure. MAIN OUTCOME MEASURES: HIV seroprevalence in non-index partners at enrolment and seroconversions in follow-up according to antiretroviral treatment taken by the index partner. RESULTS: In 476 couples in which the index partner was not taking antiretroviral treatment, HIV seroprevalence at enrolment in non-index partners was 9.2% (n=44), whereas in 149 couples in which the index partner was taking combined antiretroviral therapy no partner was infected (P<0.001). During follow-up, the 341 serodiscordant couples in which the index partner was not taking antiretroviral treatment had about 11 000 acts of intercourse without condoms, 50 natural pregnancies, and five HIV seroconversions (0.0004 per unprotected intercourse; 95% confidence interval 0.0001 to 0.0010); 294 of these couples always used condoms, accounting for about 42 000 acts of intercourse, 136 risk exposures from condom failure, and one HIV seroconversion. The relative risk associated with condom use was 0.07 (0.01 to 0.58). In 144 couples the index partner was taking combined antiretroviral treatment; they accounted for over 7000 unprotected acts of intercourse and 47 natural pregnancies but no HIV seroconversion (0 to 0.0005 per unprotected intercourse). CONCLUSIONS: The heterosexual infectivity of HIV-1 in individuals taking effective antiretroviral treatment is low. Avoidance of unprotected intercourse and receipt of antiretroviral treatment by the infected partner in accordance with protocols are complementary measures to prevent HIV transmission.

OBJECTIVE: To assess the risk for development of tuberculosis among anergic patients infected with the human immunodeficiency virus (HIV). DESIGN: Retrospective cohort study. SETTING: Tertiary referral center. PATIENTS: All HIV-infected patients who had a baseline positive protein purified derivative test (PPD) and delayed-type hypersensitivity skin tests. MEASUREMENTS: Development of active tuberculosis. RESULTS: Of 374 patients, 108 (29%) had positive results of PPD tests, 154 (41%) had negative results of PPD tests but no skin anergy, and 112 (30%) were anergic. Conversion of the PPD to positive was observed in 10 of 67 (15%) patients with previously negative results of PPD tests and no anergy and in 3 of 36 (8%) anergic patients who were retested during the follow-up period (mean, 26 months). The risk for active tuberculosis to develop in patients not receiving isoniazid chemoprophylaxis was similar in patients with a positive PPD test result (10.4 cases per 100 person-years) and in anergic patients (12.4 cases per 100 person-years) and higher in both groups than in nonanergic patients with a negative PPD test result (5.4 cases per 100 person-years). Tuberculosis was more frequent among intravenous drug abusers with no previous isoniazid treatment (63 of 290, 22%) than among homosexual men (0 of 29) or patients in other HIV transmission categories (0 of 31). Preventive therapy with isoniazid reduced tuberculosis development (4% as compared with 31%; P = 0.008). Among 15 anergic patients who had CD4 counts measured within 3 months of tuberculosis development, only 1 (7%) had more than 500 CD4 cells/mm3. CONCLUSIONS: Anergic HIV-infected patients are at high risk for development of tuberculosis. Anergic HIV-infected patients, in addition to HIV-infected patients with positive results of PPD tests, should be offered preventive therapy if they live in areas with a high prevalence of tuberculosis, at least when the CD4 count decreases to less than 500 CD4 cells/mm3.

Background: A novel pedagogical approach that is becoming increasingly popular in educational contexts is called Gamification. To our knowledge, empirical research on its effectiveness in education is scarse, and almost absent in physical education.Purpose: The goal was to explore how Gamification can be used in physical education, and what experiential effects may have on students and teachers.Participants and settings: Two hundred and ninety students (age range 6–14 years) enrolled in four schools located in four regions of Spain agreed to participate. The study involved five different grades (from year two of primary school to year two of secondary school), and 12 different classes. Four physical education teachers, one from each school, also agreed to participate. All participating classes experienced the same intervention programme: MarvEF [MarvPE], based on the Marvel universe of super heroes. The project lasted 15 weeks, the whole fall semester, for a total of 30 physical education sessions (2 per week/50 min each). Gamification was the basic methodological approach used to design the three consecutive learning units experienced by all the participating students.Research design: The study followed a pre-experimental, one group pre-test-post-test design, where the same dependent variable (intrinsic motivation) is measured in only one group of participants prior and after the intervention.Data collection: A mixed methods approach was followed. It included quantitative information obtained from a questionnaire for the older students (n = 161), and qualitative information extracted from the younger students’ drawings (n = 126), discussion groups with the participating teachers (n = 5), and teachers’ diary (n = 2).Data analysis: Quantitative data was analysed using the statistical package SPSS (version 22.0). Qualitative data was assessed through content analysis and constant comparison.Findings: Quantitative results showed a significant increase in the students’ intrinsic motivation after experiencing Gamification. Students’ responses reflected one major theme: enjoyment, and two minor themes: friends and learning. On the other hand, teachers’ responses showed three themes: workload, portfolio and narrative.Conclusions: Gamification, implemented on a long-term basis, has been found an instructional framework capable of increasing students’ motivation towards physical education, beyond the initial ‘novelty effect’. Students enjoyed the different approach, and some, despite their young age (seven-eight years), believed that they have learned (which upgrades the education value of the subject). Four of the five elements identified as central to promote meaningful experiences in physical education and sport appeared in this study (Beni, Fletcher, and Ní Chróinín [2017]. ‘Meaningful Experiences in Physical Education and Youth Sport: A Review of the Literature.’ Quest (grand Rapids, Mich ) 69 (3): 291–312.): social interaction, fun, challenge and learning. Therefore, Gamification has the ingredients to foster significant physical education experiences in different educational levels (primary and secondary education), in students with different social (low, medium and high socio-economic status) and educational backgrounds (urban, rural) and teachers with different expertise on Gamification (novel and experienced). Finally, as expected, teachers showed concern for the workload of the new pedagogical approach.

We aimed to describe changes in the prevalence of chronic obstructive pulmonary disease (COPD) in Spain by means of a repeated cross-sectional design comparing two population-based studies conducted 10 yrs apart. We compared participants from IBERPOC (Estudio epidemiológico de EPOC en España) (n = 4,030), conducted in 1997, with those of EPI-SCAN (Epidemiologic Study of COPD in Spain) (n = 3,802), conducted in 2007. Poorly reversible airflow obstruction compatible with COPD was defined according to the old European Respiratory Society definitions. COPD prevalence in the population between 40 to 69 yrs of age dropped from 9.1% (95% CI 8.1-10.2%) in 1997 to 4.5% (95% CI 2.4-6.6%), a 50.4% decline. The distribution of COPD prevalence by severity also changed from 38.3% mild, 39.7% moderate and 22.0% severe in 1997, to 85.6% mild, 13.0% moderate and 1.4% severe in 2007, and in the 40-69 yr EPI-SCAN sub-sample to 84.3% mild, 15.0% moderate and 0.7% severe. Overall, underdiagnosis was reduced from 78% to 73% (not a significant difference) and undertreatment from 81% to 54% (p<0.05) within this 10-yr frame. The finding of a substantial reduction in the prevalence of COPD in Spain is unexpected, as were the observed changes in the severity distribution, and highlights the difficulties in comparisons between repeated cross-sectional surveys of spirometry in the population.

Vehicle and pedestrian collisions often result in fatality to the vulnerable road users, indicating a strong need of technologies to protect such vulnerable road users. Wireless communications have potential to support road safety by enabling road users to exchange information. In contrast to vehicle to vehicle (V2V) and vehicle to infrastructure (V2I) communications for avoidance of inter-vehicle collisions, very limited efforts are made on communication mechanisms for pedestrian safety. This paper addresses the issue in a concrete way. We first formulate the requirement of the minimum information exchange distance for providing road users to have the necessary amount of time to perceive the situation and react. We then report our field tests and measurement based analysis to investigate if a Wi-Fi system can satisfy the application requirement. We also introduce a pedestrian protection application, V2ProVu, which provides the functionalities of the Wi-Fi communications, risk calculation, and hazard alarming. Our study discloses several useful insights including 1) information exchange for a velocity of 80 km/h has to be made before vehicle to pedestrian (V2P) distance is below 72 meters and 2) while this requirement is not too hard for radio communications technologies, the V2P communication range is greatly reduced if the signal is blocked by a human body.

Securing the exchange of intellectual property and providing protection to multimedia contents in distribution systems have enabled the advent of digital rights management (DRM) systems. User authentication, a key component of any DRM system, ensures that only those with specific rights are able to access the digital information. It is here that biometrics play an essential role. It reinforces security at all stages where customer authentication is needed. Biometric recognition, as a means of personal authentication, is an emerging signal processing area focused on increasing security and convenience of use in applications where users need to be securely identified. In this article, we outline the state-of-the-art of several popular biometric modalities and technologies and provide specific applications where biometric recognition may be beneficially incorporated. In addition, the article also discussed integration strategies of biometric authentication technologies into DRM systems that satisfy the needs and requirements of consumers, content providers, and payment brokers, securing delivery channels and contents.