Vulnerability Research Articles

Frailty syndrome in rheumatoid arthritis and symptomatic osteoarthritis: an emerging concept in rheumatology.

Musculoskeletal conditions such as rheumatoid arthritis (RA) and symptomatic osteoarthritis (OA) were the leading cause of disability in developed countries and disproportionately affects older adults. Frailty is an emerging concept in rheumatology, which represents an important construct to aid in the identification of individuals who are vulnerable to adverse events and less favourable outcomes. The prevalence of frailty among the community-dwelling population increases with age: it ranges from 7% to 10% in those aged over 65 years and to 20–40% among octogenarians. Among patients with RA, the prevalence of frailty is comparable to, or even greater, that of older geriatric cohorts and pre-frailty, a condition including a major health vulnerability between robust and frail, is much more prevalent in RA than in geriatric cohorts. Clinical OA is also associated with frailty and pre-frailty in older adults in European countries. The overall prevalence of clinical OA at any site was 30.4%; frailty was present in 10.2% and pre-frailty in 51.0 %. The diagnosis of frailty is usually clinical and based on specific criteria, which are sometimes inconsistent. Therefore, there is an increasing need to identify and validate robust biomarkers for this condition. In the literature, different criteria have been validated to identify frail older subjects, which mainly refer to two conceptual models: the Physical Frailty (PF) phenotype proposed by Fried and the cumulative deficit approach proposed by Rockwood. The purpose of this review was to quantitatively synthesize published literature on the prevalence of frailty in RA and OA and summarize current evidence on the validity and practicality of the most commonly used screening tools for frailty. (www.actabiomedica.it)

Pastoralno-liturgična navodila slovenskih škofov v času razglasitve epidemije nalezljive bolezni SARS-CoV-2 in neposredno po njem

Sunday, on which the paschal mystery is celebrated, must be by apostolic tradition observed in the universal Church as the primordial holy day of obligation On Sundays and other holy days of obligation, the faithful are obliged to participate in the Mass (can 1246 §1, 1247 CCL) The duty to keep Sunday holy, especially by sharing in the Eucharist and by relaxing in a spirit of Christian joy and fraternity, is easily understood if we consider the many different aspects of this day upon which the present discussion will focus our attention (DD No 7) In the discussion, we would like to emphasize the empathic and protective attitude of the Slovenian Bishops' Conference, as they strengthened the resilience of believers in order to successfully overcome their own vulnerability, maintain resilience, persistence, flexibility, optimism and human solidarity The instructions of the Slovenian bishops deal with a number of security measures in connection with the public confession of faith and the celebration of Sunday and holiday masses © 2020 Slatinek

Preventive strategies and renal replacement therapies for patients with COVID-19

The current pandemic of coronavirus disease 2019 (COVID-19) spotlighted the vulnerability of patients with chronic kidney disease stage 5 on maintenance hemodialysis (HD) to the viral infection, A baseline hyperinflammatory state driven by factors such as the retention of uremic toxins afflicts these patients. Emphasis is placed on preparedness and prevention strategies for infection with this new COVID-19 Virus. Extracorporeal techniques can be helpful in the modulation of an immune dysregulated response, both in the severely ill and in the chronic HD patient. The use of high-flux (HF) dialyzers for HD is the standard of care. However, with HF membranes the effect is augmented when applied in a Hemodiafiltration mode, thanks for its dragging effect, on the other hand the use of superflux or Medium cut off dialyzers MCO are advantageous in removing the larger middle molecules with special respect to the cytokines release as a main cause of deterioration in those patients the use of more prolonged Hemodialysis, namely Continuous Renal Replacement Therapy (CRRT) as well the Prolonged Intermittent Renal Replacement Therapy (PIRRT) are considered best options as per its more prolongated time so compensate for the balance between production and elimination. Important issues are to improve the overall patients conditions on Maintenance Hemodialysis (MHD) in the term of maximizing the HD Dose, Nutritional support, treatment of any comorbidity as well inflammation as first step in preparedness of patients beside the strict and extensively adherent to preventive strategies that may improve the overall outcomes if they get infected with COVID-19.

The Unpleasant Sight: Vulnerability and Bodily Fragmentation

The Unpleasant Sight: Vulnerability and Bodily Fragmentation

The Unpleasant Sight: Vulnerability and Bodily Fragmentation

The Unpleasant Sight: Vulnerability and Bodily Fragmentation

Physical Vulnerability Index before the Landsliding Hazard in Houses Located in the Locality of Rafael Uribe Uribe, Bogotá D.C.

N. El presente trabajo realizo un estudio del indice de vulnerabilidad fisica para la amenaza de deslizamiento de suelos para la localidad Rafael Uribe Uribe en Bogota D.C., utilizando la metodologia Leone con datos historicos de remocion en masa entre los anos 2008 al 2015, con un registro de 454 eventos, de los cuales se consideraron 426, dado que el resto corresponde a caidas de rocas, que aunque tambien pueden generar vulnerabilidad fisica, no aplica la metodologia utilizada. Se considero conceptos tecnicos generados por la entidades competentes en los sectores que han presentado fenomeno de remocion en masa en la localidad de Rafael Uribe Uribe y las Fichas tecnicas existentes para cada uno de ellos, asi como la delimitacion de cada poligono, se realizo un mapa local con 31 poligonos que historicamente han presentado fenomeno de remocion en masa. Se establecio el indice de vulnerabilidad fisica de los elementos expuestos considerando la magnitud de los eventos (solicitacion) que corresponde a deformaciones o desplazamientos laterales, que se pueden catalogar como moderados, sin embargo en los periodos de lluvias, las solicitaciones pueden presentar deformaciones muy rapidas.

Redes de apoyo en los hogares con personas adultas mayores en México

En México, el incremento de la población adulta mayor y la situación económica y de salud que esta presenta son elementos que transforman la dinámica de las familias en las que residen. En las familias latinoamericanas, particularmente las mexicanas, la corresidencia suele ser un factor de protección para los familiares envejecidos. No obstante, esta tendencia ha ido modificándose en el tiempo; cada vez se observan más personas mayores viviendo solas. Si bien es cierto que esta población podría recibir algún tipo de transferencias económicas y atenciones de sus familiares que viven fuera del hogar o de personas no familiares, también puede ocurrir que no todas las personas mayores que viven solas reciban apoyo, y que su condición socioeconómica, junto con los deterioros en la salud, las coloque en una situación de vulnerabilidad. Este estudio tiene como objetivo analizar las redes de apoyo con las que cuentan las personas mayores en distintos tipos de hogares. La hipótesis planteada es que la cohabitación con familiares permitirá que las personas mayores cuenten con una red más amplia de apoyo en comparación con quienes residen solos/as.

Survival Benefit of Heart Transplant Varies by Center

The allocation of donor hearts has long been controversial because of organ scarcity and the vulnerability of the U.S. allocation system to gaming, due

Hereditary vulnerabilities to postoperative cognitive dysfunction

In recent years, studies concerning the pathogenesis and risk factors of postoperative cognitive dysfunction (POCD) has shifted from surgical and anesthetic factors to hereditary vulnerability. Many candidate genes have been investigated for their association with POCD and epigenetic dysregulation might be a critical mechanism underlying POCD. In this paper, we summarized the current researches on gene polymorphism and epigenetics, and discussed future research plans. Strengthening POCD gene research can be helpful for screening high-risk groups and taking appropriate interventions. Key words: Postoperative cognitive dysfunction; Gene polymorphism; Epigenetics

“Azote imperialista”, petróleo y cambio climático en el Caribe

De acuerdo con la literatura especializada, el Caribe es una de las regiones más sensibles a los efectos del cambio climático y del calentamiento global. Esta posición le convierte en un espacio de referencia cuyo entendimiento se torna central para evaluar los impactos por venir, las alternativas posibles y las dificultades y peligros a enfrentar por la humanidad. De ahí que, tras un breve análisis de los procesos que han contribuido y contribuyen a incrementar la vulnerabilidad de la región (específicamente, su función como vertedero de desechos y receptora de daños, así como su rol subordinado dentro de la diplomacia climática), el texto presenta el modo en que el cambio climático impactará la economía, la política y la geografía del Caribe.

Mujeres de refugiados, mujeres refugiadas en la Francia del siglo XIX (años 1830-1870)

El artículo se interroga sobre el lugar ocupado por unas mujeres extranjeras consideradas como “étrangers réfugiés” por la administración francesa desde la Monarquía de Julio hasta el final del Segundo Imperio. Después de las Tres Gloriosas, una serie de emigraciones políticas europeas contribuyó a ampliar los rangos de los extranjeros tratados en Francia como unos “refugiados”: liberales italianos, españoles y portugueses, polacos de la “Gran Emigración”, pero también carlistas españoles que atravesaron la frontera durante la primera guerra carlista.Nuestro estudio analiza la manera con la que la administración francesa privilegió el reconocimiento del título de “refugiado” a los padres de familia, descartando a las mujeres que eran sin embargo numerosas, tanto extranjeras como francesas. Las mujeres aisladas, solteras o viudas en exilio representaban un grupo aparte que recibía peculiar atención. ¿Cómo, en ausencia de hombres adultos en su entorno, consiguieron ser designadas y reconocidas como unas refugiadas? ¿En qué medida la administración francesa desarrolló la idea de vulnerabilidad para ellas? Mostraremos el papel que aquellas mujeres pudieron desempeñar en las relaciones con la administración francesa y con la sociedad local.

GIS analysis for vulnerability assessment of drought in Khuzestan province in Iran using standardized precipitation index (SPI)

The Standardized Precipitation Index (SPI) is a widely used drought index to provide good estimations of the intensity, magnitude and spatial extent of droughts. The objective of this study was to analyze the spatial pattern of drought by SPI index. In this paper, patterns of drought hazard in Khuzestan are evaluated according to the data of 17 weather stations during data recording. The influenced zone of each station was specified by the Thiessen method. Then, it was attempted to make a new model of drought hazard using GIS. Three criteria for drought were studied and considered to define areas of vulnerability. Drought hazard criteria used in the present model included: maximum severity of drought in the period, trend of drought, and the maximum number of sequential arid years. Each of the vulnerability indicators was mapped. These maps along with a final hazard map were classified into 5 hazard classes of drought included none, slight, moderate, severe and very severe classes. The final drought vulnerability map was prepared by overlaying three criteria maps in GIS, and the final hazard classes were defined on the basis of hazard scores, which were determined according to the means of the main indicators. The final vulnerability map showed that severe hazard areas (29% of the province) which were observed in the northern and central parts of study area are much more widespread than areas under the slight hazard class. Nevertheless, approximately more than half (64%) of the province area was determined to be moderate hazard class for drought.

Scape of Vulnerability and Resilience in Viramma, life of an untouchable

Scape of Vulnerability and Resilience in Viramma, life of an untouchable

La Formación inicial del profesorado para la inclusión. Un urgente desafío que es necesario atender

La Agenda Educativa 2030, vigente desde el año 2016 y adoptada por los países miembros de la UNESCO en 2015 tiene como centro el Objetivo de Desarrollo Sostenible 4º: “Asegurar una educación inclusiva y equitativa de calidad y promover oportunidades de aprendizaje a lo largo de la vida para todos y todas”. En consecuencia, los programas de formación de profesores deben incluir la inclusión y la equidad como componentes básicos. Está reconocido que los profesores son pieza clave para la consolidación de la inclusión en cada centro educativo. Por ello, podrán ser promotores de la participación y el aprendizaje de todos los estudiantes; particularmente, de aquellos que pudieran estar en condición de vulnerabilidad. Al reconocer la complejidad del tema, el artículo presenta una trayectoria explicativa sobre algunos de los desafíos, al tiempo que ofrece algunos elementos que permiten perfilar los rasgos de un profesor inclusivo.

A Method for Fast Evaluation of Potential Consequences of Dam Breach

Dam breach has catastrophic consequences for human lives and economy. In previous studies, empirical models are often, to a limited extent, due to the inadequacy of historical dam breach events. Physical models, which focus on simulating human behavior during floods, are not suitable for fast analysis of a large number of dams due to the complexities of many key parameters. Therefore, this paper proposes a method for fast evaluation of potential consequences of dam breach. Eight main indices, i.e., capacity of reservoir (CR), dam height (HD), population at risk (PR), economy at risk (ER), understanding of dam breach (UB), industry type (TI), warning time (TW), and building vulnerability (VB), are selected to establish an evaluation index system. A catastrophe evaluation method is introduced to establish an evaluation model for potential consequences of dam breach based on the indices which are divided into five grades according to the relevant standards and guidelines. Validation of the method by twelve historical dam breach events shows a good accuracy. The method is applied to evaluate potential consequences of dam breach of Jiangang Reservoir in Henan Province, China. It is estimated that loss of life in the worst scenario is between that of Hengjiang Reservoir and that of Shimantan Reservoir dam breach, of which fatalities are 941 and 2717, respectively, showing that risk management measures should be taken to reduce the risk of potential loss of life.

Violência doméstica e os desafios na implementação da Lei Maria da Penha: uma análise jurisprudencial dos Tribunais de Justiça de Minas Gerais e São Paulo

Nesse artigo propusemo-nos analisar os desafios enfrentados na interpretação jurídica e na aplicação prática da Lei Maria da Penha. Para isso, três perguntas moveram a nossa pesquisa: como os juízes e tribunais brasileiros interpretam e, consequentemente, aplicam essa Lei? A quem eles têm concedido à aplicação? E quem tem solicitado a sua aplicação? A partir de uma pesquisa empírica quantitativa nos Tribunais de Justiça de Minas Gerais e de São Paulo, concluímos que, embora criada para proteger exclusivamente a ofendida do gênero feminino, a Lei foi aplicada em determinadas situações ao/a ofendido/a, quando reconhecida a sua vulnerabilidade, e não o foi às ofendidas do gênero feminino quando os Tribunais não constataram: a hipossuficiência ou vulnerabilidade delas, a existência de violência de gênero ou do estereótipo “mulher adulta cujo agressor é o homem”.

The role of chemokine CCL5/RANTES and metalloproteinase-9 as inflammatory modulators in symptomatic internal carotid artery stenosis.

Up to 80% of all ischemic strokes (IS) attributed to internal carotid athero-occlusive artery stenosis (ICAS) are related to a thromboembolic mechanism. One athero-occlusive ischemic event increases the risk for ischemia in another vascular territory, resulting from inflammation within the atherosclerotic plaque induced by cytokines. Thus, ultrasonographic characteristics of vulnerable plaques in ICAS, including plaque echolucency and ulceration might correspond to cytokine activity. The present study aimed to investigate the associations between serum cytokines and atherosclerotic plaque characteristics and the 3-year risk of a major adverse coronary and carotid ischemic event (MACCE) in symptomatic patients treated for ICAS. Plaque characteristics on ultrasonography, serum levels of C-C motif chemokine ligand 5 (CCL5)/regulated on activation, normal T-cell expressed and secreted (RANTES), metalloproteinase-9 (MMP-9), interleukin-6 (IL-6), transforming growth factor beta (TGF-β), C-X-C motif chemokine ligand 16 (CXCL16), FAS ligand (FASL) and high sensivity C-reactive protein (hs-CRP) were analyzed in 103 symptomatic patients with ICAS prior to carotid revascularization. The incidence of MACCE: cardiovascular death (CVD), myocardial infarction (MI) and recurrent ischemic stroke (IS) were recorded prospectively for up to 5 years (median 37; IQR 21 - 40 months). Echolucent plaques, in comparison to echogenic plaques, displayed lower median levels of RANTES (P = 0.042) but higher median levels of IL-6 (P = 0.039). There was no relationship between plaque characteristics and median levels of MMP-9, TGF β, CXCL16, FASL, or hs-CRP (P = NS). During follow-up, MACCE occurred in 15 (14.6%) patients. Univariate Cox proportional hazard analysis indicated median RANTES levels < 45.5ng/mL (hazard ratio (HR) = 3.95; 95%CI = 1.10 - 14.2; P = 0.035), MMP-9 > 0.6 μg/mL (HR 4.5; 95%CI = 1.4 - 13.9; P = 0.009), renal impairment (HR 3.48; 95%CI = 1.29 - 9.34; P = 0.013) as potential MACCE risk factors. On multivariate Cox proportional hazard analysis, MMP-9 > 0.6 μg/mL and RANTES < 45.5 ng/ml were associated with a 4.72-fold (95%CI = 1.3 - 17.0; P = 0.017) and a 3.8-fold risk increase (95%CI = 1.07 - 13.89; P = 0.038) of MACCE. Kaplan-Meier analysis showed significant differences in MACCE-free survival rates depending on RANTES and MMP-9 median levels. We conclude that serum RANTES, IL-6, and MMP-9 were associated with plaque vulnerability and predicted adverse MACCE in patients treated for ICAS.

Progress in diagnosis and treatment of restless legs syndrome

Restless legs syndrome (RLS) is defined as a sleep-wake disorder, with the key feature being an urge to move, which can be classified as two types as primary RLS and secondary RLS. Iron deficiency is a key role of RLS, low levels of serum ferritin is noted in RLS lab tests. Pathophysiology of RLS is complex, genetic variants, anatomical network vulnerability, neurotransmission abnormalities and abnormal dopaminergic neurotransmission may all contribute to its pathogenesis. The mild RLS can choose non-drug therapy, but most of the patients need drug therapy especially the severe cases. The aboved aspects are discussed in this review based on recent literatures. Key words: Restless legs syndrome; Sleeping disorder; Dopa; Iron

Risk-based Vulnerability Analysis of Chemical Facilities Affected by Flooding

Flooding may affect chemical facilities leading to major accidents (fires, explosions, contamination), following damages to structures and equipment. This type of accident is indicated as natural-technological (Natech) event and occurred in the past, often leading to severe accidental scenarios. Recent studies allowed developing a specific methodology aimed at including Natech scenarios triggered by flooding into Quantitative Risk Assessment (QRA) analyses for chemical facilities. The methodology relies on the use of specific fragility models for the evaluation of failure probability of process units affected by flooding. Despite these models consider different types of equipment geometries and flooding conditions, they do not account for the presence of safety barriers (e.g., fire-protection systems, bunds, blanketing system). In the present work, the previously developed QRA methodology is improved in order to provide a risk-based vulnerability analysis of Natech scenarios induced by severe flooding taking into account the presence of safety barriers. The methodology is improved by including the availability assessment of safety barriers based on the possibility the systems have been impacted by the flood. A tailored Failure Mode and Effect and Criticality Analysis (FMECA) is presented for assessing the damages to safety barriers resulting from flooding events. As an example, the analysis of an important safety barrier through the FMECA approach is presented. The study shows an example of both risk informed decision-making concerning protection systems and development of new criteria for the assessment of safety barrier failure in case of natural hazards.

Vulnerabilidad ante el uso del Internet de niños y jóvenes de comunidades mayahablantes del sureste de México

La Internet aporta muchos beneficios educativos a niños y jóvenes. Sin embargo, también expone a los estudiantes jóvenes a ciertos riesgos: a) tener acceso a contenido inapropiado, b) interacción con otros niños o adultos, c) exposición a prácticas agresivas de marketing y d) abuso infantil, sexual y emocional. Este artículo describe los resultados de una encuesta sobre la vulnerabilidad que enfrentan los niños y jóvenes de ocho comunidades de habla maya en el estado de Yucatán al sumergirse en la Web, particularmente en el cuidado de la privacidad de sus datos personales, su reputación digital y el ciberacoso. El estudio fue cuantitativo de tipo descriptivo y transversal. Los participantes fueron 410 jóvenes, 51 % hombres y 49 % mujeres. Los resultados de la encuesta se compararon con las políticas sobre el uso de Internet descritas en documentos oficiales, como el Plan Nacional de Desarrollo de México (2013-2018), Derechos del Niño en la Era Digital del Fondo de las Naciones Unidas para la Infancia [Unicef] (2017) y la Ley para la Protección de los Derechos de Niños, Niñas y Adolescentes del Estado de Yucatán (2015). Los resultados proporcionan evidencia de que los niños y los jóvenes de las comunidades de lengua maya tienen información y preparación muy limitadas con respecto a la seguridad cibernética y sobre los riesgos que podrían enfrentar al usar las redes digitales. Otros hallazgos indican que cuanto mayor sea el nivel de educación de los padres, mejores serán las habilidades tecnológicas de los jóvenes y mayor el uso responsable del Internet.