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Innovación y financiarización en la indústria farmacéutica
No full textEl desarrollo de medicamentos innovadores es un proceso arriesgado que muestra un nivel de productividad limitado. Las estrategias destinadas a “desarriesgar” han coincidido con una creciente financiarización del medicamento. Su consideración como un activo financiero, más allá de un simple producto, provoca tensiones entre dedicar más recursos a la innovación y desarrollo (I+D) o satisfacer las exigencias del mercado de capitales. Al mismo tiempo, lo que se acaba observando en la práctica son unos precios crecientes que nos conducen a cuestionar el nivel de extracción de valor. El artículo muestra con ejemplos la evolución reciente, y ofrece algunas pistas para afrontar la situación actual.The development of innovative medicines is a risky process that exhibits a limited level of research and development (R&D) productivity. “De-risking” strategies have coincided with a growing financialization of medicines. Considering drugs as financial assets, beyond considering them as products, causes tensions between dedicating more resources to R&D and meeting the demands of the capital market. At the same time, what we end up observing are rising prices that lead us to question the size of value extraction. The article shows with examples the recent trends, and provides some clues to face the current situation
Sex differences in cardiovascular outcomes and cholesterol-lowering efficacy of PCSK9 inhibitors: systematic review and meta-analysis
No full textBackground: Guideline-recommended low-density lipoprotein cholesterol (LDL-C) thresholds are often not achieved in women. The proprotein convertase subtilisin/kexin type-9 inhibitor (PCSK9i) monoclonal antibodies can help further reduce LDL-C and major adverse cardiovascular events (MACE) although differences in efficacy by sex and type are less understood. Objectives: The authors sought to determine if there are differences in the efficacy of LDL-C lowering and reduction in the risk of MACE by sex and type of PCSK9i. Methods: A comprehensive literature search was done through October 17, 2022, for published trials comparing PCSK9i vs control. Outcomes assessed were LDL-C reduction and incidence of MACE following the use of PCSK9i vs placebo, stratified by sex and type of PCSK9i used. Results: We identified 16 trials with 54,996 adults, and 15,143 (27.5%) of them were female. PCSK9i significantly reduced MACE compared to placebo in both women (HR: 0.86, 95% CI: 0.74-0.97, P < 0.001) and men (HR: 0.85, 95% CI: 0.79-0.91, P < 0.001) with no significant sex difference (MD 0.01, 95% CI: 0.14 to 0.13, P = 0.930). PCSK9i also significantly reduced LDL-C levels in both sexes at 12 weeks (females: MD 62.57, 95% CI: 70.24 to 54.91, P < 0.001; males: MD 66.19, 95% CI: 72.03 to 60.34, P < 0.001) and 24 weeks (females: MD 47.52, 95% CI: 52.94 to 42.09, P < 0.001; males: MD 54.07, 95% CI: 59.46 to 48.68, P < 0.001). Significant sex difference was seen in the LDL reduction of PCSK9i for both 12 weeks (males vs females: MD 4.55, 95% CI: 7.34 to 1.75, P < 0.01) and 24 weeks (males vs females: MD 7.11, 95% CI: 9.99 to 4.23, P < 0.001). Conclusions: The use of PCSK9i results in significant LDL-C and MACE reduction in both males and females. While there is no significant sex difference in MACE reduction, LDL-C reduction is greater in males than in females. Our data support the equal use of PCSK9i in all eligible patients, regardless of sex
Procedural Generation Applied to Metroidvania Level Design
No full textTreball de fi de Grau en Enginyeria InformàticaDirectors: Alan Tapscott i Joaquim ColàsThe Metroidvania genre is a growing trend in the video game industry, with a wide range of acclaimed titles. It is characterized by the importance of good level design to correctly guide players in their progression. The task of designing a cohesive and engaging map structure, along with enough content to populate it, leads to infamously lengthy development cycles in both indie and major studios. This work aims to lay the groundwork for introducing procedural generation tools to the workflow of a level designer working in the development of a Metroidvania title, reducing the development time. To that end, a procedural generation algorithm for Metroidvania map structure and content is proposed and partially implemented into the Godot game engine following a set of requirements derived from a preliminary study into level design for Metroidvania video games.El género Metroidvania es una tendencia en auge en la industria del videojuego, con un amplio rango de títulos exitosos. Se caracteriza por la importancia de un buen diseño de nivel para guiar correctamente a los jugadores en la progresión del juego. La tarea de diseñar una estructura de mapa coherente y entretenida, así como suficiente contenido para llenarla, suele comportar largos ciclos de desarrollo tanto en estudios indie como en grandes producciones. Este trabajo pretende establecer la fundación para la futura introducción de herramientas de generación procedural en el flujo de trabajo de un diseñador de niveles trabajando en el desarrollo de un título Metroidvania. Con tal fin, este trabajo propone un algoritmo de generación procedural para estructura y contenido de niveles Metroidvania así como su implementación parcial en el motor de videojuegos Godot a partir de un estudio preliminar sobre el diseño de niveles en videojuegos Metroidvania.El gènere Metroidvania és una tendència en alça en la indústria del videojoc, amb un ampli rang de títols reeixits. Es caracteritza per la importància d'un bon disseny de nivell per a guiar correctament als jugadors en la progressió del joc. La tasca de dissenyar una estructura de mapa coherent i entretinguda, així com suficient contingut per a omplir-la, sol comportar llargs cicles de desenvolupament tant en estudis indie com en grans produccions. Aquest treball pretén establir la fundació per a la futura introducció d'eines de generació procedural en el flux de treball d'un dissenyador de nivells treballant en el desenvolupament d'un títol Metroidvania. Amb tal fi, aquest treball proposa un algorisme de generació procedural per a estructura i contingut de nivells Metroidvania així com la seva implementació parcial en el motor de videojocs Godot a partir d'un estudi preliminar sobre el disseny de nivells en videojocs Metroidvania
Disruption of students' linguistic attitudes in the Catalan immersive schools in France
No full textBeyond Boundaries: Leveraging Visual Data for Advancements in Social Science Research
No full textThis thesis focuses on visual data collected in the frame of online surveys, examining the main challenges and implications of collecting and analyzing these new data types. Given the relatively unexplored implementation of visual data submission in the field of survey methodology, it was necessary to explore the overall process, from the design of surveys asking for visual data, to data collection and subsequent analysis. This thesis first presents the feasibility of collecting photos and videos from the respondents’ perspective, including their skills, availability of visual data, and willingness to share them through a survey. Second, the collection of visual data is presented from a researcher’s perspective, outlining the challenges and decisions necessary for successful data collection and analysis. Third, an experiment was conducted, asking respondents for information about the books in their homes through conventional questions and photos, which facilitated the assessment and comparison of participation. Finally, the experiment also enabled the evaluation of the quality of the information provided through photos versus conventional methods, allowing for a comparison between the two formats. Thus, this thesis is a novel and valuable contribution for survey methodology, and for researchers interested in collecting visual or other new types of data.Aquesta tesi se centra en dades visuals recollides en el marc d'enquestes en línia, examinant els principals reptes i implicacions de la recollida i anàlisi d'aquests nous tipus de dades. Donada la implementació relativament inexplorada de la presentació de dades visuals en la metodologia d’enquestes, era necessari explorar el procés general, des del disseny d'enquestes que sol·liciten dades visuals, fins a la recopilació de dades i l'anàlisi posterior. Aquesta tesi presenta en primer lloc la viabilitat de recollir fotos i vídeos des de la perspectiva dels enquestats, incloent-hi les seves habilitats, disponibilitat de dades visuals i disposició a compartir-los a través d'una enquesta. En segon lloc, la recollida de dades visuals es presenta des de la perspectiva d'un investigador, esbossant els reptes i les decisions necessàries per a la recollida i l'anàlisi de dades amb èxit. En tercer lloc, es va realitzar un experiment demanant informació sobre els llibres a casa seva mitjançant preguntes convencionals i fotografies. Això va permetre valorar i comparar la participació. Finalment, l'experiment també va permetre l'avaluació de la qualitat de la informació continguda en les fotos i proporcionada a través de mètodes convencionals, permetent així la comparació de la qualitat entre formats. Així doncs, aquesta tesi és una contribució nova i valuosa per a la metodologia
de l'enquesta, i per als investigadors interessats en la recopilació de dades visuals o
d'altres nous tipus.Programa de Doctorat en Ciències Polítiques i Social
Factors influencing the attrition rate of a 10-week multimodal rehabilitation program in patients after lung transplant: a neural network analysis
No full textBackground/Objectives: Despite the effectiveness of exercise and nutritional interventions to improve aerobic capacity and quality of life in lung transplant (LT) recipients, their compliance is low. Strategies to reduce the high attrition rate (participants lost over time) is a major challenge. Artificial neural networks (ANN) may assist in the early identification of patients with high risk of attrition. The main objective of this study is to evaluate the usefulness of ANNs to identify prognostic factors for high attrition rate of a 10-week rehabilitation program after a LT. Methods: This prospective observational study included first-time LT recipients over 18 years of age. The main outcome for each patient was the attrition rate, which was estimated by the amount of missing data accumulated during the study. Clinical variables including malnutrition, sarcopenia, and their individual components were assessed at baseline. An ANN and regression analysis were used to identify the factors determining a high attrition rate. Results: Of the 41 participants, 17 (41.4%) had a high rate of attrition in the rehabilitation program. Only 23 baseline variables had no missing data and were included in the analysis, from which a low age-dependent body mass index (BMI) was the most important conditioning factor for a high attrition rate (p = 7.08 × 10), followed by end-stage respiratory disease requiring PT (p = 0.000111), low health-related quality-of-life (HRQoL) (p = 0.0009078), and low handgrip strength (p = 0.023). Conclusions: The prevalence of high attrition rate in LT recipients is high. The profile of patients with a high probability of attrition includes those with chronic obstructive pulmonary disease, low BMI and handgrip strength, and reduced HRQoL
Análisis y evolución del concurso de persona natural
No full textTreball de Fi de Grau en Dret. Curs 2024-2025Tutora: Miriam Magdalena CámaraEl procedimiento judicial de exoneración ofrece un mecanismo para que “cualquier persona natural o jurídica” pueda reestructurar o cancelar sus deudas, brindando una "segunda oportunidad" económica que le permite verse liberado de las deudas para su reinserción en la sociedad. Uno de los cambios más importantes y drásticos de la nueva normativa lo encontramos en el artículo 487.2 que, en lugar del sistema anterior que condicionaba la exoneración a la satisfacción de determinadas deudas (créditos contra la masa y privilegiados), ahora cualquier deudor de buena fe puede exonerar sus deudas, salvo aquellas que, de forma excepcional y por su especial naturaleza, se consideran legalmente no exonerables. En conclusión, permite que una persona, a pesar del fracaso económico sufrido, tenga la capacidad de reiniciarse y optar por nuevas iniciativas, sin la obligación de sostener indefinidamente el lastre de unas deudas imposibles de asumir
Which device is most suitable for measuring heart rate variability in the field? A comparative evaluation of two leading options
No full textObjective: The aim of the study was to compare the Polar H10 and Bittium Faros™ heart rate variability monitors for use in occupational and environmental health research, considering data collection, storage, transfer, resource needs, and limitations. Methods: A literature review, device testing, and expert interviews were conducted to assess device performance and usability. Results: Polar H10 is affordable, records RR intervals for up to 20 hours offline, and requires a smartwatch and app for extended storage. Bittium Faros™ is a certified electrocardiogram monitor that records full waveforms, supports long measurements, and enables automatic data transfer. Both devices can be worn with a chest strap, but placement issues may affect data quality. Patch electrodes improve stability but may cause skin irritation. Conclusions: This assessment highlights key device differences to guide HRV monitor selection for occupational and environmental epidemiological studies.M.K., E.M., M.C.T., and I.G.C. acknowledge funding from the European Union’s Horizon Europe Research and Innovation Programme under Grant Agreement No 101137149 (INTERCAMBIO; https://intercambio-project.eu/) and funding from the Swiss State Secretariat for Education, Research and Innovation under Grant Agreement N° 23.00491. M.C.T. is funded by a Ramón y Cajal fellowship (RYC-2017-01892) from the Spanish Ministry of Science, Innovation and Universities and co-funded by the European Social Fund. ISGlobal acknowledges support from the grant CEX2023-0001290-S funded by MCIN/AEI/10.13039/501100011033, and support from the Generalitat de Catalunya through the CERCA Program
Cincuenta años de economía de la salud
No full textEl propósito de los comentarios que siguen es ofrecer al lector una reflexión de corte eminentemente subjetivo acerca de la evolución de la Economía de la Salud como disciplina académica, así como de la investigación publicada en su intersección con la política sanitaria, y cuáles son los referentes fundamentales para comprender las grandes encrucijadas que hoy afrontan los sistemas sanitarios.The purpose of the following comments is to offer a subjective reflection on the evolution of Health Economics as an academic subject, as well as on the research published at its intersection with health policy, and on the key references necessary to understand the major crossroads currently faced by healthcare systems
Sub-Gaussian estimators of the mean of a random vector
No full textWe study the problem of estimating the mean of a random vector X given a sample of N independent, identically distributed points. We introduce a new estimator that achieves a purely sub-Gaussian performance under the only condition that the second moment of X exists. The estimator is based on a novel concept of a multivariate median.Supported by the Spanish Ministry of Economy and Competitiveness Grant MTM2015-67304-P and FEDER, EU