Translating Colloquial Registers in Catalan. A Case Study: The Translation of Fear and Loathing in Las Vegas

This thesis aims to find a model for translating colloquial registers into Catalan. Colloquial registers play an important part in literature today inasmuch as literature projects real life situations in which informal registers unfold. Many Catalan readers do not have a high regard for Catalan translations because established models for colloquial language do not reflect the way Catalan is spoken today, since there is a divorce between the linguistic norm and oral Catalan as a result of Castilian interference in informal registers. As a consequence, translations tend to be standardised and far from the spontaneous oral Catalan. In order to devise a flexible model for colloquial Catalan in translation, a text which contains a great deal of informal registers has been selected: Hunter S. Thompson’s novel Fear and Loathing in Las Vegas. The analysis of the sociolinguistic situation of the Catalan language and the position of translated literature in the Catalan system allows us to explain why the system is reluctant to change. Norms in the target culture and the principle of equivalence are explored as they prevent translators from shifting towards a model which accommodates Castilian words and expressions. With the aim of explaining why Catalan presents a particular problem in the translation of colloquial language, an analysis of both written and oral texts in English where colloquial registers have been translated into Catalan is carried out. In order to avoid a rigid model which follows the Catalan dictionary and grammar only, features of media oral registers have been applied to the translation of selected fragments of Fear and Loathing in Las Vegas. This allows us to obtain a text which does not include Castilian terms and, at the same time, reproduces a neutral but more realistic colloquial Catalan.Institut Ramon Llul

Diurnal radiative cooling of spaces in Mediterranean climate

The absence of solar radiation at night gives good opportunities for passive cooling of buildings in hot climates with frequently clear sky. However the possibility of also taking advantage of a clear sky cooling potential during the day is seldom considered. Thermal radiation to sky can be used to cool. A body surface emits thermal radiation (far IR) and if direct solar radiation (visible and near IR) and thermal radiation coming from other surfaces do not reach it, there would be a net heat flux out. A previous prototype was done with a simple element. That experiment confirmed that was possible to reduce around two degrees the interior temperature of the test unit exposed to sun light in July. In this work a new design based on the first one is developed to adapt it to architectonical needs in order to reduce interior spaces temperature in hot climates. The aim of this design is focused to so an architectonical adaptation is needed. Modular and replicable units could be a solution that permits to fulfill large flat surfaces as roofs or other architectonic elements. In this occasion, measurements were taken from a modular model with a geometrical design that avoided de direct solar incidence. These measurements were taken by a pyrgeometer during two weeks of August and results were similar to the previous experiment.Peer ReviewedPostprint (published version

Unidad de Hospitalización a Domicilio del paciente quirúrgico durante la pandemia de la COVID-19

Introduction: current COVID-19 pandemic is testing healthcare systems at a global level. From General Surgery Department we decided to provide a practical strategy for surgical patients’ hospitalization that allowed to treat them as if they were admitted in hospital.Home Hospitalization is an effective healthcare modality in medical and surgical pathology in which, for a limited time, health practitioners provide active treatment at patient’s home.The aim of this study is to describe our experience of home care hospitalization in surgical patients during the covid-19 pandemic.Method: Observational, descriptive, prospective, single-center study. 44 patients admitted to surgical home hospitalization unit from March 11 to May 10 2020. Patients with emergency or elective surgery and surgical patients who required conservative medical treatment or interventionism were included. Epidemiological variables, diagnosis, treatment, mean stay, readmissions rate, complications and mortality were evaluated.Results: Mean age 64 years ± 16,7 (23-89). 52% men and 49% women. 23 patients underwent emergency or elective surgery, 12 patients conservative medical treatment, 2 thoracic drainage, 5 percutaneous drainage due to intra-abdominal abscesses and 2 patients with negative pressure therapy for surgical wound healing. Mean hospital stay 8,6 days ± 3,6 (1-19).Five complications were registered: subocclusion, colo-rectal bleeding, subcutaneous emphysema, lung abscess and a COVID-19 infection. Readmissions rate: 4,5%.Conclusions: Home hospitalization is an effective model to decrease or avoid hospital stay in selected patients. It also appears to be as safe as inpatient hospitalization. Combination of short-stay admission and home admission could be a good therapeutic option in surgical patients.Introducción: la pandemia de la COVID-19 ha puesto a prueba sistemas sanitarios a nivel mundial. Desde el servicio de Cirugía General y ante la disminución de camas de hospitalización surgió la necesidad de planificar y organizar una estrategia para la hospitalización y cuidado de pacientes quirúrgicos.La hospitalización a domicilio (HAD) es una modalidad asistencial eficaz en patología médica y quirúrgica donde, por un tiempo limitado, personal sanitario realiza tratamiento y seguimiento de pacientes en su domicilio.Objetivo: describir nuestra experiencia de HAD en el paciente quirúrgico durante la pandemia de la COVID-19.Método: estudio observacional, descriptivo, prospectivo, unicéntrico. 44 pacientes en HAD del 11 de Marzo al 10 de Mayo de 2020. Se incluyeron pacientes sometidos a cirugía urgente, programada y pacientes quirúrgicos con tratamiento conservador o intervencionismo. Se evaluaron variables epidemiológicas, motivo de ingreso, tratamiento, estancia media, tasa de reingresos, complicaciones y mortalidad.Resultados: edad media 64 años ± 16,7 (23-89). 52% hombres y 49% mujeres. 23 pacientes con cirugía urgente o programada, 12 tratamiento conservador, 2 drenaje torácico, 5 drenaje percutáneo y 2 terapia de presión negativa para cura de herida quirúrgica. Estancia media 8,6 días ± 3,6 (1-19). Registradas 5 complicaciones: suboclusión, rectorragia, enfisema subcutáneo, absceso pulmonar e infección por COVID-19. 2 pacientes reingresaron.Conclusiones: La HAD es un modelo seguro y eficaz para disminuir la estancia hospitalaria en pacientes quirúrgicos seleccionados. La combinación de ingreso de corta estancia e ingreso en régimen de HAD podría ser una buena opción en el postoperatorio y recuperación de pacientes quirúrgicos

Efficacy of bosentan in patients with refractory thromboangiitis obliterans (Buerger disease): A case series and review of the literature

The cornerstone of therapy in thromboangiitis obliterans (TAO) is complete abstinence from tobacco. In addition to discontinuation of cigarette smoking, very few pharmacological and surgical options of controversial efficacy are available to date. New therapeutic options with greater efficacy are clearly needed to properly manage these patients. In this preliminary study, we assessed the effectiveness and safety of bosentan in a case series of 8 adults with TAO and severe ischemic ulceronecrotic lesions who were treated with bosentan after inadequate response to platelet inhibitors, vasodilators, and intravenous alprostadil. Additionally, we reviewed 18 well-documented patients with refractory TAO treated with bosentan, which was previously reported (PubMed 1965-2015). These 26 patients formed the basis of our present analysis. All were current smokers. The median duration of bosentan treatment (SD) was 4.5 +/- 4 months (range 3-16). Eleven patients (42%) were unable to completely abstain from smoking during their follow-up. With bosentan treatment, no new ischemic lesions were observed in the target extremities. A complete therapeutic response was achieved in 80% of patients, whereas a partial response was observed in 12%. Two patients (8%) ultimately required amputation despite treatment. After discontinuation of bosentan, patients were followed for a median of 20 +/- 14 months (range 3-60). Two patients whose trophic lesions had healed relapsed. When comparing patients who gave up smoking with those who were unable to completely abstain from smoking during follow-up, no significant differences were found in efficacy outcomes. Four patients (15%) developed adverse events, requiring bosentan discontinuation in 1 case. These preliminary data suggest that bosentan may be considered a therapeutic option for treatment of cases of severe TAO refractory to conventional treatment, and merit further evaluation in larger controlled, randomized clinical studies

Shrinking lung syndrome in systemic lupus erythematosus: A case series and review of the literature

Shrinking lung syndrome (SLS) is a rare and less known complication mainly associated with systemic lupus erythematosus (SLE). In this study, we analyze the clinical features, investigation findings, approaches to management, and outcome in a case series of 9 adult patients with SLE and SLS diagnosed during a 35-year period in 3 referral tertiary care hospitals in Spain. Additionally, we reviewed 80 additional cases previously reported (PubMed 1965-2015). These 80 cases, together with our 9 patients, form the basis of the present analysis. The overall SLS prevalence in our SLE population was 1.1% (9/829). SLS may complicate SLE at any time over its course, and it usually occurs in patients without previous or concomitant major organ involvement. More than half of the patients had inactive lupus according to SELENA-systemic lupus erythematosus disease activity index (SLEDAI) scores. Typically, it presents with progressive exertional dyspnea of variable severity, accompanied by pleuritic chest pain in 76% of the cases. An important diagnostic delay is common. The diagnostic tools that showed better yield for SLS detection are the imaging techniques (chest x-ray and high-resolution computed tomography) along with pulmonary and diaphragmatic function tests. Evaluation of diaphragm dome motion by M-mode ultrasonography and phrenic nerve conduction studies are less useful. There are no standardized guidelines for the treatment of SLS in SLE. The majority of patients were treated with medium or high doses of glucocorticoids. Several immunosuppressive agents have been used in conjunction with steroids either if the patient fails to improve or since the beginning of the treatment. Theophylline and beta-agonists, alone or in combination with glucocorticoids, have been suggested with the intent to increase diaphragmatic strength. The overall long-term prognosis was good. The great majority of patients had significant clinical improvement and stabilization, or mild to moderate improvement on pulmonary function tests. The mortality rate was very low

Evaluation of the COVID-19 response in Spain: principles and requirements

A resurgence of COVID-19 infections is occurring in Spain, with some of the worst figures in Europe. In August, 2020, we urged the Spanish Central Government and regional governments to independently evaluate their COVID-19 response to identify areas where public health and the health and social care system need to be improved

High incidence of clinical fragility fractures in postmenopausal women with rheumatoid arthritis. A case-control study.

Objectives: To estimate the incidence of clinical fragility fractures in postmenopausal women with rheumatoid arthritis (RA) and analyze risk factors for fracture. Methods: Incidence of clinical fragility fractures in 330 postmenopausal women with RA was compared to that of a control population of 660 age-matched postmenopausal Spanish women. Clinical fractures during the previous five years were recorded. We analyzed associations with risk factors for fracture in both populations and with disease-related variables in RA patients. Results: Median age of RA patients was 64 years; median RA duration was eight years. Sixty-nine percent were in remission or on low activity. Eighty-five percent had received glucocorticoids (GCs); 85 %, methotrexate; and 40 %, ≥1 biologic DMARD. Fifty-four patients and 47 controls had ≥1 major osteoporotic fracture (MOF). Incidence of MOFs was 3.55 per 100 patient-year in patients and 0.72 in controls (HR: 2.6). Risk factors for MOFs in RA patients were age, previous fracture, parental hip fracture, years since menopause, BMD, erosions, disease activity and disability, and cumulative dose of GCs. Previous fracture in RA patients was a strong risk for MOFs (HR: 10.37). Conclusion: Of every 100 postmenopausal Spanish women with RA, 3-4 have a MOF per year. This is more than double that of the general population. A previous fracture poses a high risk for a new fracture. Other classic risk factors for fracture, RA disease activity and disability, and the cumulative dose of GCs are associated with fracture development

Insight on how to assess and improve the response to the COVID-19 pandemic

La pandemia de COVID-19 ha afectado de manera particularmente intensa a España, pese a su nivel de desarrollo y la elogiada solidez de su Sistema Nacional de Salud. Para comprender qué ha pasado e identificar cómo mejorar la respuesta creemos imprescindible una evaluación independiente multidisciplinaria de la esfera sanitaria, política y socioeconómica. En este trabajo proponemos objetivos, principios, metodología y dimensiones a evaluar, además de esbozar el tipo de resultados y conclusiones esperadas. Nos inspiramos en los requerimientos formulados por el panel independiente de la Organización Mundial de la Salud y en las experiencias evaluativas en otros países, y detallamos la propuesta de aspectos multidimensionales que deben valorarse. La idea es comprender aspectos clave en los ámbitos estudiados y su margen de mejora en lo relativo a preparación, gobernanza, marco normativo, estructuras del Sistema Nacional de Salud (atención primaria, hospitalaria y de salud pública), sector de educación, esquemas de protección social, minimización del impacto económico, y marco y reformas en el ámbito laboral para una sociedad más resiliente. En definitiva, buscamos que este ejercicio sirva no solo para el presente, sino también para que en el futuro estemos mejor preparados y con más ágil capacidad de recuperación ante las amenazas pandémicas que puedan surgir.The COVID-19 pandemic has hit Spain particularly hard, despite being a country with a developed economy and being praised for the robustness of its national health system. In order to understand what happened and to identify how to improve the response, we believe that an independent multi-disciplinary evaluation of the health, political and socio-economic spheres is essential. In this piece we propose objectives, principles, methodology and dimensions to be evaluated, as well as outlining the type of results and conclusions expected. Inspired by the requirements formulated by the WHO Independent Panel for Pandemic Preparedness and Response and by experiences in other countries, we detail the multidimensional aspects to be evaluated. The goal is to understand key aspects in the studied areas and their scope for improvement in terms of preparedness, governance, regulatory framework, national health system structures (primary care, hospital, and public health), education sector, social protection schemes, minimization of economic impact, and labour framework and reforms for a more resilient society. We seek to ensure that this exercise serves not only at present, but also that in the future we are better prepared and more agile in terms of our ability to recover from any pandemic threats that may arise.Ayuda referencia: PI 18/01937 del Fondo de Investigación Sanitaria- Instituto de Salud Carlos III, España, con cofinanciación de Fondos FEDER

Primary respiratory disease in patients with systemic lupus erythematosus: data from the Spanish rheumatology society lupus registry (RELESSER) cohort

Background The purpose of this study was to assess the prevalence, associated factors, and impact on mortality of primary respiratory disease in a large systemic lupus erythematosus (SLE) retrospective cohort. Methods All adult patients in the RELESSER-TRANS (Registry of Systemic Lupus Erythematosus Patients of the Spanish Society of Rheumatology [SER], cross-sectional phase) registry were retrospectively investigated for the presence of primary pleuropulmonary manifestations. Results In total 3215 patients were included. At least one pleuropulmonary manifestation was present in 31% of patients. The most common manifestation was pleural disease (21%), followed by lupus pneumonitis (3.6%), pulmonary thromboembolism (2.9%), primary pulmonary hypertension (2.4%), diffuse interstitial lung disease (2%), alveolar hemorrhage (0.8%), and shrinking lung syndrome (0.8%). In the multivariable analysis, the variables associated with the development of pleuropulmonary manifestation were older age at disease onset (odds ratio (OR) 1.03, 95% confidence interval (CI) 1.02-1.04), higher SLEDAI (Systemic Lupus Erythematosus Disease Activity Index) scores (OR 1.03, 95% CI 1.00-1.07), the presence of Raynaud's phenomenon (OR 1.41, 95% CI 1.09-1.84), secondary antiphospholipid syndrome (OR 2.20, 95% CI 1.63-2.97), and the previous or concomitant occurrence of severe lupus nephritis, (OR 1.48, 95% CI 1.12-1.95) neuropsychiatric manifestations (OR 1.49, 95% CI 1.11-2.02), non-ischemic cardiac disease (OR 2.91, 95% CI 1.90-4.15), vasculitis (OR 1.81, 95% CI 1.25-2.62), hematological manifestations (OR 1.31, 95% CI 1.00-1.71), and gastrointestinal manifestations, excluding hepatitis (OR 2.05, 95% CI 1.14-3.66). Anti-RNP positivity had a clear tendency to significance (OR 1.32, 95% CI 1.00-1.75; P = 0.054). The development of pleuropulmonary manifestations independently contributes to a diminished survival (hazard ratio of 3.13). However, not all complications will influence the prognosis in the same way. Whereas the occurrence of pleural disease or pulmonary thromboembolism has a minimal impact on the survival of these patients, the remaining manifestations have a major impact on mortality. Conclusion Except for pleural disease, the remaining respiratory manifestations are very uncommon in SLE (<4%). Pleuropulmonary manifestations independently contributed to a decreased survival in these patients

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication