La reconfiguración de la acción concertada reservada a la iniciativa no lucrativa basada en la regulación de los servicios de interés general de solidaridad

Tradicionalmente, las entidades de la economía social han sido un agente protagonista en la prestación de servicios sociales a la ciudadanía. La configuración del Estado de bienestar como manifestación del Estado social supuso la incorporación de numerosos servicios asistenciales de titularidad pública prestados en colaboración con entidades del tercer sector de acción social a través de varios instrumentos de colaboración público-privada.  No obstante, las entidades del tercer sector, por sus propias características intrínsecas, no pueden competir en condiciones de igualdad con entidades con fines lucrativos en la adjudicación de contratos para la prestación de servicios sociales. En este contexto, surgió la acción concertada como vía de gestión indirecta de naturaleza no contractual para la prestación de servicios a las personas; modelo basado en el respeto a los principios del Derecho comunitario y que, en muchas ocasiones, se reservó a entidades sin fines lucrativos. Precisamente, dicha reserva a entidades sin ánimo de lucro ha venido poniendo en riesgo el modelo de acción concertada. En concreto, su principal amenaza deriva de la impugnación ante el Tribunal Superior de Justicia de la Comunidad Valenciana, por parte de la Asociación Estatal de Entidades de Servicios de Atención a Domicilio (ASADE), de la normativa autonómica reguladora de la acción concertada, por considerar que resulta contraria a Derecho al excluir a las entidades con ánimo de lucro.  Ante el riesgo de que los tribunales puedan concluir que la acción concertada reservada a entidades sin ánimo de lucro puede resultar contraria a los principios de igualdad de trato y no discriminación, como ya ha ocurrido con la reserva de contratos públicos a centros especiales de empleo de iniciativa social, será necesario que las entidades de la economía social trabajen en un nuevo planteamiento de la acción concertada que asegure el modelo actual basado en la ausencia de beneficio económico en la prestación de servicios a las personas y la priorización de la calidad asistencial.  Para ello, en este trabajo se plantean las áreas sobre las que debería pivotar una reconfiguración del régimen de la acción concertada reservada a entidades sin ánimo de lucro que tuviera en consideración la diferenciación de los servicios sociales de interés económico general de aquellos servicios de interés no económico, como servicios que atienden a las necesidades de los ciudadanos más vulnerables basados en la doctrina fijada por el Tribunal de Justicia de la Unión Europea en relación con los principios de igualdad, universalidad, solidaridad, eficiencia y adecuación, como servicios no sometidos al derecho de la competencia, de forma que se produzca una distinción y un desarrollo específico para los servicios de interés general de solidaridad. Recibido: 20 julio 2022  Aceptado: 27 abril 202

Computational evaluation of cochlear implant surgery outcomes accounting for uncertainty and parameter variability

Cochlear implantation (CI) is a complex surgical procedure that restores hearing in patients with severe deafness. The successful outcome of the implanted device relies on a group of factors, some of them unpredictable or difficult to control. Uncertainties on the electrode array position and the electrical properties of the bone make it difficult to accurately compute the current propagation delivered by the implant and the resulting neural activation. In this context, we use uncertainty quantification methods to explore how these uncertainties propagate through all the stages of CI computational simulations. To this end, we employ an automatic framework, encompassing from the finite element generation of CI models to the assessment of the neural response induced by the implant stimulation. To estimate the confidence intervals of the simulated neural response, we propose two approaches. First, we encode the variability of the cochlear morphology among the population through a statistical shape model. This allows us to generate a population of virtual patients using Monte Carlo sampling and to assign to each of them a set of parameter values according to a statistical distribution. The framework is implemented and parallelized in a High Throughput Computing environment that enables to maximize the available computing resources. Secondly, we perform a patient-specific study to evaluate the computed neural response to seek the optimal post-implantation stimulus levels. Considering a single cochlear morphology, the uncertainty in tissue electrical resistivity and surgical insertion parameters is propagated using the Probabilistic Collocation method, which reduces the number of samples to evaluate. Results show that bone resistivity has the highest influence on CI outcomes. In conjunction with the variability of the cochlear length, worst outcomes are obtained for small cochleae with high resistivity values. However, the effect of the surgical insertion length on the CI outcomes could not be clearly observed, since its impact may be concealed by the other considered parameters. Whereas the Monte Carlo approach implies a high computational cost, Probabilistic Collocation presents a suitable trade-off between precision and computational time. Results suggest that the proposed framework has a great potential to help in both surgical planning decisions and in the audiological setting process

Disminución de la reserva de flujo coronario en pacientes con insuficiencia cardíaca no isquémica

Introduction and objectives. Coronary flow reserve (CFR) is impaired not only in ischemic heart disease, but also in cardiac diseases that may or may not course with heart failure. The aim of the present study was to determine if the severity of heart failure can influence CFR impairment. Methods. Forty patients with non-ischemic heart disease and heart failure were studied 41 times. Four groups were established: 1. 10 patients in functional class III-IV; 2. 10 patients in functional class II not taking beta-blockers; 3. 11 patients in class II treated with carvedilol, and 4. 10 patients in class I. These patients had a history of heart failure and systolic dysfunction. Myocardial blood flow (MBF) was measured with positron emission tomography (PET) and N-13 ammonia at rest (r) and during adenosine triphosphate (ATP) infusion. Results. MBF and CFR were significantly higher in group 4 (1.95 ± 0.58 and 2.40 ± 0.95 ml/min/g) than in group 1 (1.02 ± 0.52 and 1.46 ± 0.48 ml/min/g). CFR tended to be higher in groups 2 (1.73 ± 0.72), and 3 (1.89 ± 0.75) vs group 1. No significant correlation was found between CFR and the following variables: age, systolic blood pressure, ventricular mass index, ventricular volume indexes, and ejection fraction. Conclusions. Coronary microvascular function is impaired in non-ischemic heart failure, and the impairment is related to functional class, regardless of the underlying responsible heart disease

Biochemical Trade-Offs: Evidence for Ecologically Linked Secondary Metabolism of the Sponge Oscarella balibaloi

Secondary metabolite production is assumed to be costly and therefore the resource allocation to their production should be optimized with respect to primary biological functions such as growth or reproduction. Sponges are known to produce a great diversity of secondary metabolites with powerful biological activities that may explain their domination in some hard substrate communities both in terms of diversity and biomass. Oscarella balibaloi (Homoscleromorpha) is a recently described, highly dynamic species, which often overgrows other sessile marine invertebrates. Bioactivity measurements (standardized Microtox assay) and metabolic fingerprints were used as indicators of the baseline variations of the O. balibaloi secondary metabolism, and related to the sponge reproductive effort over two years. The bioactivity showed a significant seasonal variation with the lowest values at the end of spring and in early summer followed by the highest bioactivity in the late summer and autumn. An effect of the seawater temperature was detected, with a significantly higher bioactivity in warm conditions. There was also a tendency of a higher bioactivity when O. balibaloi was found overgrowing other sponge species. Metabolic fingerprints revealed the existence of three principal metabolic phenotypes: phenotype 1 exhibited by a majority of low bioactive, female individuals, whereas phenotypes 2 and 3 correspond to a majority of highly bioactive, non-reproductive individuals. The bioactivity was negatively correlated to the reproductive effort, minimal bioactivities coinciding with the period of embryogenesis and larval development. Our results fit the Optimal Defense Theory with an investment in the reproduction mainly shaping the secondary metabolism variability, and a less pronounced influence of other biotic (species interaction) and abiotic (temperature) factors

Urban commons: From collective management to the right to the city

© EURE. There is a growing interest and emerging academic literature regarding the commons and their application in urban studies. On the one hand, those contributions related to urban areas, Elinor Ostrom studies on forms of self-management of the natural common pool resources, are pointed. On the other hand, the critical literature on neoliberalism, new forms of accumulation by dispossession and the resistances to them in the form of social movements have also addressed the commons in the city from different Marxist perspectives. In this paper the contributions of both approaches are addressed and analyzed, as well as their critical points and possible complementarities to move towards a better conceptualization and a future research agenda on the urban commons.Postprint (published version

Urban commons: From collective management to the right to the city

© EURE. There is a growing interest and emerging academic literature regarding the commons and their application in urban studies. On the one hand, those contributions related to urban areas, Elinor Ostrom studies on forms of self-management of the natural common pool resources, are pointed. On the other hand, the critical literature on neoliberalism, new forms of accumulation by dispossession and the resistances to them in the form of social movements have also addressed the commons in the city from different Marxist perspectives. In this paper the contributions of both approaches are addressed and analyzed, as well as their critical points and possible complementarities to move towards a better conceptualization and a future research agenda on the urban commons

Exploration of the Activity of Heparin-loaded PDMAEMA Nanocarriers against Plasmodium falciparum Blood Stages

Nanophele

Study of the aerodynamic forces on a simplified shape X-43 aircraft under supersonic conditions, design optimization

The paper focuses on the shape optimization, based on the resultant aerodynamic forces, of a simplified X-43 aircraft. The equations of oblique shock waves and Prandtl-Meyer expansion waves, along with the improvement of the aircraft geometry using a genetic algorithm optimisation, will allow to shape and optimize the external dimensions of the bi-dimensional simplified aircraft design. The main purpose of the optimisation is the reduction of the drag force while maintaining a sufficient lift to hold the weight of the aircraft. The optimization is undertaken at four different altitudes, obtaining for each altitude the most favourable aircraft shape to maximize the aircraft efficiency. The study can be extended to various possible aircraft weight configurations

Industrial Application of Genetic Algorithms to Cost Reduction of a Wind Turbine Equipped with a Tuned Mass Damper

Design optimization has already become an important tool in industry. The benefits are clear, but several drawbacks are still present, being the main one the computational cost. The numerical simulation involved in the solution of each evaluation is usually costly, but time and computational resources are limited. Time is key in industry. The present communication focuses on the methodology applied to optimize the installation and design of a Tuned Mass Damper. It is a structural device installed within the tower of a wind turbine aimed to stabilize the oscillations and reduce the tensions and the fatigue loads. The paper describes the decision process to define the optimization problem, as well as the issues and solutions applied to deal with a huge computational cost