La desafecció politica a Catalunya : problema o signe de normalitat?

No és la primera vegada que parlem de desafecció. En el número d'eines per a l'esquerra nacional hivern 2008, la professora de la UPF Mariona Ferrer identifica diferents elements vinculats amb la desafecció com les principals causes de la baixa participació a les eleccions al Parlament de Catalunya de 2006. Però no n'hi ha prou en conèixer el perfil dels desafectes. Cal anar més enllà i analitzar la desafecció des d'un punt de vista qualitatiu que ens acosti a les solucions més adequades a un problema que pot posar en qüestió l'estabilitat del sistema democràtic

Centraleta de codi obert per a un motor tèrmic

Al mercat actual existeixen poques opcions per a poder realitzar un canvi de centraleta a un vehicle amb motor de benzina d’encesa per guspira. En aquest context hi ha poques opcions de centraletes que siguin adaptables a qualsevol vehicle i encara menys que estiguin basades en un software i un hardware lliures. És per això que es va decidir dedicar aquest treball de final de grau a la construcció i desenvolupament d’una centraleta d’aquest tipus, per a poder-ne experimentar el potencial, avantatges i desavantatges. D’aquesta manera esperem poder aportar a qui ho necessiti o hi estigui interessat, un procés d’implementació d’una centraleta des d’inici fins al final, en forma de dues memòries de treball de final de grau, aquesta primera dedicada al muntatge i implementació de la centraleta, i una segona, sota el nom “Centraleta de codi obert per a un motor tèrmic Programació i mapejat motor”. Tot i no haver aconseguit la totalitat dels objectius que es plantejaven pensem que es tracta d’un desenvolupament ben documentat, que si bé no considerem que sigui una guia, pot servir de suport en realitzar un projecte de la mateixa naturalesa o servir com a motivació d’un projecte de modificació de la centraleta base per a un ús més concret.Nowadays there are few ECU’s on the market to upgrade petrol engine vehicles capabilities. In this context, there are not many generic ECU that are adaptable to any vehicle and even less options when looking for free software and hardware based ECU’s. Because of this lack of offer we decided to dedicate this final degree project to the construction and development of such an ECU, in order to be able to study its potential, advantages and disadvantages. With this memory we hope to provide some information and guidelines for those who are looking for a complete implementation ECU process. This project has been developed in coordination with the final degree project titled “Centraleta de codi obert per a un motor tèrmic-Programació i mapejat motor”. Specifically, this project focuses the assembly and implementation of the ECU and the other project targets the sensor calibration and the ECU implementation into the vehicle. Although we have not achieved all the objectives settled at the beginning of the project, we think that this is a well-documented development, which although we do not consider it to be a guide, can serve as support for people carrying out a project of the same nature or as motivation. of an ECU modification project for a more specific use

Disseny, càlcul i simulació de ginys: recursos pedagògics per a fomentar vocacions tecnològiques

La creixent demanda de personal als camps relacionats amb l’enginyeria i la tecnologia lligada a la davallada del nombre d’estudiants d’aquests camps obliga a generar noves estratègies per a atreure l’atenció d’infants i joves cap a l’enginyeria a les aules. Si bé en d’altres països fa anys que es treballa amb un model educatiu que fomenta les vocacions STEM, a Catalunya no ha estat fins ara que s’ha realitzat una reforma educativa amb aquesta òptica. En el marc d’aquesta reforma educativa de la Generalitat de Catalunya, que en general aposta pels perfils STEM, sorgeix la idea de desenvolupar aquest projecte, que pretén emprar ginys desenvolupats a partir de solucions existents, com ara la impressió 3D, per a fomentar noves vocacions tecnològiques. Si bé no s’ha pogut assolir el grau de realització que es pretenia en un inici, arribant a poder realitzar una prova amb estudiants de l’etapa educativa corresponent, serveix com a idea del que es podria replicar i implementar en centres educatius com a una eina més de treball per a l’alumnat.The increase of the required workforce in technology and engineering-related jobs linked to the decline of students in these fields requires applying new strategies to attract children and young people. Although other countries have been using educational models promoting STEM profiles for years, in Catalonia it has not been until now that an educational reform has been carried out with this perspective. In a context in which these changes are being applyed in schools, this project aims to develop gadgets with existing industrial solutions, such as 3D printing, to promote new technological vocations. Although the initial goal of performing tests with students of the corresponding grade has not been achieved, the project establishes an idea of what could be done from now on in educational centers as a tool for teaching engineering and technology to students

Head-to-head comparison of contemporary heart failure risk scores

Abstract Aims Several heart failure (HF) web-based risk scores are currently used in clinical practice. Currently, we lack head-to-head comparison of the accuracy of risk scores. This study aimed to assess correlation and mortality prediction performance of Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC-HF) risk score, which includes clinical variables + medications; Seattle Heart Failure Model (SHFM), which includes clinical variables + treatments + analytes; PARADIGM Risk of Events and Death in the Contemporary Treatment of Heart Failure (PREDICT-HF) and Barcelona Bio-Heart Failure (BCN-Bio-HF) risk calculator, which also include biomarkers, like N-terminal pro B-type natriuretic peptide (NT-proBNP). Methods and results A total of 1166 consecutive patients with HF from different aetiologies that had NT-proBNP measurement at first visit were included. Discrimination for all-cause mortality was compared by Harrell's C-statistic from 1 to 5?years, when possible. Calibration was assessed by calibration plots and Hosmer?Lemeshow test and global performance by Nagelkerke's R2. Correlation between scores was assessed by Spearman rank test. Correlation between the scores was relatively poor (rho value from 0.66 to 0.79). Discrimination analyses showed better results for 1-year mortality than for longer follow-up (SHFM 0.817, MAGGIC-HF 0.801, PREDICT-HF 0.799, BCN-Bio-HF 0.830). MAGGIC-HF showed the best calibration, BCN-Bio-HF overestimated risk while SHFM and PREDICT-HF underestimated it. BCN-Bio-HF provided the best discrimination and overall performance at every time-point. Conclusions None of the contemporary risk scores examined showed a clear superiority over the rest. BCN-Bio-HF calculator provided the best discrimination and overall performance with overestimation of risk. MAGGIC-HF showed the best calibration, and SHFM and PREDICT-HF tended to underestimate risk. Regular updating and recalibration of online web calculators seems necessary to improve their accuracy as HF management evolves at unprecedented paceFunding The NT-proBNP assays were partially provided by Roche Diagnostics. Roche Diagnostics had no role in the design of the study or the collection, management, analysis, or interpretation of the data.Peer Reviewed"Article signat per 24 autors/es: Pau Codina,Josep Lupón,Andrea Borrellas,Giosafat Spitaleri,Germán Cediel,Mar Domingo,Joanne Simpson,Wayne C. Levy,Evelyn Santiago-Vacas,Elisabet Zamora,David Buchaca,Isaac Subirana,Javier Santesmases,Crisanto Diez-Quevedo,Maria I. Troya,Maria Boldo,Salvador Altmir,Nuria Alonso,Beatriz González,Carmen Rivas,Julio Nuñez,John McMurray,Antoni Bayes-Genis"Postprint (published version

Gender-Related Differences in Heart Failure Biomarkers

Important differences in comorbidities and clinical characteristics exist between women and men with heart failure (HF). In particular, differences in the kinetics of biological circulating biomarkers-a critical component of cardiovascular care-are highly relevant. Most circulating HF biomarkers are assessed daily by clinicians without taking sex into account, despite the multiple gender-related differences observed in plasma concentrations. Even in health, compared to men, women tend to exhibit higher levels of natriuretic peptides and galectin-3 and lower levels of cardiac troponins and the cardiac stress marker, soluble ST2. Many biological factors can provide a reliable explanation for these differences, like body composition, fat distribution, or menopausal status. Notwithstanding, these sex-specific differences in biomarker levels do not reflect different pathobiological mechanisms in HF between women and men, and they do not necessarily imply a need to use different diagnostic cut-off levels in clinical practice. To date, the sex-specific prognostic value of HF biomarkers for risk stratification is an unresolved issue that future research must elucidate. This review outlines current evidence regarding gender-related differences in circulating biomarkers widely used in HF, the pathophysiological mechanisms underlying these differences, and their clinical relevance

Cardiovascular disease and COVID-19 : les liaisons dangereuses

Patients with cardiovascular risk factors or established cardiovascular disease have an increased risk of developing coronavirus disease 19 and have a worse outcome when infected, but translating this notion into effective action is challenging. At present it is unclear whether cardiovascular therapies may reduce the likelihood of infection, or improve the survival of infected patients. Given the crucial importance of this issue for clinical cardiologists and all specialists dealing with coronavirus disease 19, we tried to recapitulate the current evidence and provide some practical recommendations

Biomarkers in Heart Failure with Preserved Ejection Fraction

Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous disorder developing from multiple aetiologies with overlapping pathophysiological mechanisms. HFpEF diagnosis may be challenging, as neither cardiac imaging nor physical examination are sensitive in this situation. Here, we review biomarkers of HFpEF, of which the best supported are related to myocardial stretch and injury, including natriuretic peptides and cardiac troponins. An overview of biomarkers of inflammation, extracellular matrix derangements and fibrosis, senescence, vascular dysfunction, anaemia/iron deficiency and obesity is also provided. Finally, novel biomarkers from -omics technologies, including plasma metabolites and circulating microRNAs, are outlined briefly. A cardiac-centred approach to HFpEF diagnosis using natriuretic peptides seems reasonable at present in clinical practice. A holistic approach including biomarkers that provide information on the non-cardiac components of the HFpEF syndrome may enrich our understanding of the disease and may be useful in classifying HFpEF phenotypes or endotypes that may guide patient selection in HFpEF trials

Advanced remote care for heart failure in times of COVID-19 using an implantable pulmonary artery pressure sensor : the new normal

Heart failure (HF) is a major public health problem and a leading cause of hospitalization in western countries. Over the past decades, the goal has been to find the best method for monitoring congestive symptoms to prevent hospitalizations. Addressing this task through regular physician visits, blood tests, and imaging has proven insufficient for optimal control and has not decreased enough HF-related hospitalization rates. In recent years, new devices have been developed for this reason and CardioMEMS is one of the therapeutic monitoring options. CardioMEMS has shown to be effective in preventing and reducing HF hospitalizations in patients both with HF with reduced ejection fraction and HF with preserved ejection fraction. CardioMEMS' versatility has made it a great option for pulmonary artery pressure monitoring, both during the coronavirus disease-19 (COVID-19) pandemic and when the clinic visits have (partially) resumed. CardioMEMS is the remote haemodynamic monitoring system with the most evidence-driven efficacy, and COVID-19 has put it in the spot as a centre-stage technology for HF monitoring. In a few months of the COVID-19 epidemic, CardioMEMS has grown to maturity, making it the new normal for high-quality, high-value remote HF care

Quality of life in patients with heart failure and improved ejection fraction : one-year changes and prognosis

The criteria for patients with heart failure (HF) and improved ejection fraction (HFimpEF) are a baseline left ventricular ejection fraction (LVEF) ≤40%, a ≥10-point increase from baseline LVEF, and a second LVEF measurement >40%. We aimed to (i) assess patients with HF and reduced LVEF (HFrEF) at baseline and compare quality of life (QoL) changes between those that fulfilled and those that did not fulfil the HFimpEF criteria 1 year later and (ii) assess the prognostic role of QoL in patients with HFimpEF. We reviewed data from a prospective registry of real-world outpatients with HF that were assessed for LVEF and QoL at a first visit to the HF clinic and 1 year later. QoL was evaluated with the Minnesota Living with Heart Failure Questionnaire (MLWHFQ). The primary prognostic endpoint was the composite of all-cause death or HF hospitalization. Baseline and 1-year LVEF and MLWFQ scores were available for 1040 patients with an initial LVEF ≤40% (mean age, 65.2 ± 11.7 years; 75.9% men). The main aetiology was ischaemic heart disease (52.9%), and patients were mostly in New York heart Association Classes II (71.1%) and III (21.6%). At baseline, the mean LVEF was 28.5% ± 7.3, and the mean MLWHFQ score was 30.2 ± 19.5. After 1 year, the mean LVEF increased to 38.0% ± 12.2, and the MLWHFQ scores improved to 17.4 ± 16.0. In 361 patients that fulfilled the HFimpEF criteria (34.7%), significant improvements were observed in both LVEF (from 28.7% ± 6.6 to 50.9% ± 7.6, P < 0.001) and QoL (from 32.9 ± 20.6 to 16.9 ± 16.0, P < 0.001). Patients that did not fulfil the HFimpEF criteria also showed significant improvements in LVEF (from 28.4% ± 7.6 to 31.1% ± 7.9, P < 0.001) and QoL (from 28.7 ± 18.8 to 17.6 ± 15.9, P < 0.001). However, the QoL improvement was significantly higher in the HFimpEF group (−16.0 ± 23.8 vs. −11.1 ± 20.3, P = 0.001), despite the worse mean baseline MLWHFQ score, compared with the non-HFimpEF group (P = 0.001). The 1-year QoL was similar between groups (P = 0.50). The 1-year MLWHFQ score was independently associated with outcomes; the hazard ratio for the composite endpoint was 1.02 (95% CI: 1.01-1.03, P = 0.006). In contrast, the QoL improvement (with a cut-off ≥5 points) was not independently associated with the composite outcome. Patients with HFrEF showed improved QoL after 1 year, regardless of whether they met the HFimpEF criteria. The similar 1-year QoL perception between groups suggested that factors other than LVEF influenced QoL perception. The 1-year QoL was superior to the QoL change from baseline for predicting prognosis in patients with HFimpEF