8 research outputs found
Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)
Get PDFObjectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters.
Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs).
Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001).
Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio
Dating the Earliest Pleistocene alluvial terrace of the Alcanadre River (Ebro Basin, NE Spain): Insights into the landscape evolution and involved processes
Get PDFThis work presents the results of a multi-approach study of the extensive highest terrace (Qt1) of the Alcanadre River system (Ebro Basin, Spain). The timing of the earliest morphosedimentary fluvial archives in the Ebro Basin (NE Spain) under exorheic conditions is provided from ESR dating techniques applied to optically bleached quartz grains and complemented by palaeomagnetic data and morphopedosedimentary features. A mean ESR age estimate of 1276 ± 104 ka based on the Ti-centre provides the oldest numerical age obtained for a Quaternary terrace in the Iberian Peninsula. The polarity determined by palaeomagnetic analysis is normal, although it must be contained within the Matuyama reversed period. Therefore, Cobb Mt is the more suitable chron, although Jaramillo cannot be fully ruled out. This age is consistent with the last stretch of the Matuyama reversed Chron deduced from palaeomagnetism. Relevant consequences concerning the palaeogeographical setting, palaeoclimatic context and fluvial incision rates are discussed to elucidate the landscape evolution of NE Iberia.MD is currently the recipient of an International Outgoing Fellowship from the People Program (Marie Curie Actions) of the European Union's Seventh Framework Program (FP7/2007e2013) under REA grant agreement PIOF-GA-2013-626474.Peer Reviewe
Evaluación de la peligrosidad de las crecidas extraordinarias del río Duero en Zamora: hidrología histórica, hidráulica y patrimonio histórico
No full textTrabajo presentado en la XV Reunión Nacional de Geomorfología: Geomorfología del “Antropoceno”: Efectos del cambio global sobre los procesos geomorfológicos, celebrada en Palma, Mallorca (España) del 11 al 14 de septiembre de 2018The
present
study
aims
at
the
appraisal
and
latter
development
of
a
comprehensive
methodology
that
enables
a
better
assessment
of
extraordinary
river
Duero
floods
impact
on
infrastructures
in
general
and
on
historical
heritage
areas
in
particular.
Due
to
the
long-‐lasting
historical
and
sedimentary
records
of
the
area,
estimations
and
evaluations
integrate
different
data
sources
and
time
scales.
Flood
data
for
the
Douro
River
at
Zamora
have
been
compiled
(760
years).
During
this
period
a
total
of
11
catastrophic
floods
were
identified
(e.g.
1739
and
1860),
as
well
as
over
30
extreme
floods
(e.g.
1636).
Documentary
data
provided
information
on:
1)
flood
levels;
2)
classification
of
events
according
to
flood
water
level
and
damage.
Temporal
changes
in
the
magnitude
and
frequency
of
floods
have
a
strong
correlation
with
climatic
variations.
Flood
frequency
analysis
using
gauged
and
historical
floods
shows
differences
in
the
discharge
figures
calculated
by
the
Water
Authority
in
Zamora.Este
trabajo
ha
sido
financiado
por
la
Fundación
Biodiversidad
(MITEC)
proyecto
"Información
regional
sobre
cambio
climático
y
las
inundaciones
para
la
adaptación
del
diseño
y
análisis
de
seguridad
de
infraestructuras
sensibles”.Peer reviewe
Geospatial artificial intelligence (GeoAI) in the integrated hydrological and fluvial systems modeling:review of current applications and trends
No full textAbstract
This paper reviews the current GeoAI and machine learning applications in hydrological and hydraulic modeling, hydrological optimization problems, water quality modeling, and fluvial geomorphic and morphodynamic mapping. GeoAI effectively harnesses the vast amount of spatial and non-spatial data collected with the new automatic technologies. The fast development of GeoAI provides multiple methods and techniques, although it also makes comparisons between different methods challenging. Overall, selecting a particular GeoAI method depends on the application’s objective, data availability, and user expertise. GeoAI has shown advantages in non-linear modeling, computational efficiency, integration of multiple data sources, high accurate prediction capability, and the unraveling of new hydrological patterns and processes. A major drawback in most GeoAI models is the adequate model setting and low physical interpretability, explainability, and model generalization. The most recent research on hydrological GeoAI has focused on integrating the physical-based models’ principles with the GeoAI methods and on the progress towards autonomous prediction and forecasting systems
Aproximación multidisciplinar al estudio del impacto del cambio climático en las inundaciones para la adaptación del diseño y análisis de seguridad de presas
No full textTrabajo presentado en la XV Reunión Nacional de Geomorfología: Geomorfología del “Antropoceno”: Efectos del cambio global sobre los procesos geomorfológicos, celebrada en Palma, Mallorca (España) del 11 al 14 de septiembre de 2018This
paper
discusses
the
advances
in
the
development
of
new
data
and
methods
that
allow
the
reconstruction
of
long
series
of
extreme
flood
data,
and
the
application
of
flood
analysis
tools
in
conditions
of
climatic
variability
(past
records
and
future
projections).
The
work
focuses
on
one
case
studies
located
in
the
Rambla
de
la
Viuda
(Maria
Cristina
Dam),
with
Mediterranean
climate.The
aim
is
to
compare
the
effects
of
climate
change
on
future
extreme
floods,
with
changes
in
flood
frequency
laws
determined
from
paleo-‐grazed
and
historical
data.
This
methodology
aims
to
improve
the
impact
of
climate
change
on
hydrological
extremes
and
their
application
to
the
design
of
sensitive
infrastructures,
with
emphasis
on
dams.
Hydro-‐
climatic
indicators
will
be
estimated
using
historical,
instrumental
and
climate
series
data
projected
with
CMIP5
models.Este
trabajo
ha
sido
financiado
por
Fundación
Biodiversidad
(MAPAMA)
a
través
del
proyecto
Adaptapresa,
y
por
la
CICYT
Proyectos
FLOOD-‐
MED
(CGL2008-‐06474-‐C02-‐01),
TETIS-‐MED
(CGL2008-‐06474-‐C02-‐02)
y
EPHIMED
(CGL2017-‐
86839-‐C3-‐1-‐R).Peer reviewe
Paleofloods and historical floods during warming trends on climate in Spain
No full textResumen del trabajo presentado al Floods WG Workshop: 'Floods in a warmer world: insights from paleohydrology' organizado por PAGES' Floods Working Group, celebrado en Geneva (Suiza) el 11 de noviembre de 2019
