Design of a simpler ampere-hourmeter

In any application in which working with batteries is a must, the knowledge of the batteries’ state-of-charge (SOC) is a fundamental parameter for anyone, so it determines the remaining capacity in the battery. There exist several methods for the estimation of this SOC in Lead-acid batteries; however, when the requisites of the measuring method must offer, besides precision and reliability, the possibility to integrate the results into an automatized system, the Coulomb’s counter is the method that prevails. This paper presents, then, the design of a simpler Ampere-hourmeter based lead-acid battery SOC estimating system. Supported by previous studies in the field of SOC estimation in Hybrid Electric Vehicles and by experimental tests carried out by the researchers, the modelling of the simpler measuring system has been parameterized by following Peukert’s Equation, and afterwards it has been integrated into a data acquisition and processing system designed through a CSNX25 current sensor and a low-cost and low-consume 16F877 microcontroller. The fundamental conclusion of this paper is that obtaining an accurate result while estimating the SOC of a lead-acid battery with an simpler Ampere-hourmeter developed through a microcontroller based system is achievable but only if the used microcontroller holds enough memory to include the whole data treatment algorithms.Peer ReviewedPostprint (published version

Navigating in Time. Notes on Enric Miralles’ Approach to Work

[EN] After winning his first contest, Cemetery Nuevo de Igualada, Enric Miralles travels to Stockholm to visit the Woodland Cemetery, where he comes in contact with the work of Asplund.  He then develops an extraordinary interest for the architect’s personal approach, the local landscape and Nordic architecture at large. He feels attracted to the way Asplund’s work relates to the more subtle and psychological aspects of architecture as well as his apparent awareness of time and natural rhythms as key players in it - always from a place of radical subjectivity and an essential human feeling which strives to confer sense upon constructed space. Another fundamental and inseparable basic value to add to the aforementioned would be the importance of approaching the project with absolute honesty and a pure spirit -ingenious, generous, receptive to each situation and alert to the voice of intuition. By this means, a unique and original response is generated by each circumstance - and the arena of preconceived automatisms altogether avoided. Reading the words of Miralles, Asplund, Aalto, Peter Smithson as well as their analogies with other disciplines gives one a better understanding of such projecting methodology.[ES] Tras ganar su primer concurso, el Cementerio Nuevo de Igualada, Enric Miralles viaja a Estocolmo para visitar el Cementerio del Bosque, entrando así en contacto con la obra de Asplund. Miralles se interesa extraordinariamente por su enfoque arquitectónico, por el propio personaje y por la arquitectura nórdica en general. De Asplund le atrae el cuidado con que su trabajo se relaciona con los aspectos psicológicos más sutiles de la arquitectura, y su consciencia del papel clave del tiempo y de  los ritmos de la naturaleza como lo único capaz -siempre desde la radical subjetividad de la mirada y sentimiento humano- de generar y dar sentido al espacio construido. A estos valores básicos se suma otro fundamental e indisociable de ellos: abordar el proyecto desde la más absoluta honestidad, con espíritu limpio -ingenuo, generoso-, receptivo a cada situación y atento a las respuestas de la propia intuición. Se genera así una respuesta única y original  en cada circunstancia, evitando todo automatismo o artificio preconcebido. Las palabras de Miralles, Asplund, Aalto, Peter Smithson y las analogías con otras disciplinas permitirán un mejor entendimiento de esta forma de proyectar.Bigas Vidal, M.; Bravo Farré, L. (2020). Navegar en el tiempo. Apuntes sobre enfoques de trabajo en Enric Miralles. EN BLANCO. Revista de Arquitectura. 12(29):120-132. https://doi.org/10.4995/eb.2020.14271OJS1201321229Alto, Alvar. "The Stockholm Exhibition I ." En Göran Schildt, Sketches, 15-17. Cambridge: MIT Press, 1978.Alto, Alvar. "E.G. Asplund in memorian." En Göran Schildt, Sketches, 66-67. Cambridge: MIT Press, 1978.Bravo, Luís y Gustavo Contepomi. "Conversación con Enric Miralles." En "El País Fértil. Notas para una Pedagogía del Proyecto." Tesis doctoral, Universidad Politécnica de Cataluña, 2009.Deren, Maya. An Anagram of Ideas on Art, Form, and Film. New York: The Alicat Book Press, 1946. Citado por Josep Quetglas, en Breviario de Ronchamp. Madrid: Ediciones asimétricas, 2017.Miralles, Enric. "Una conversación con Enric Miralles." Entrevistado por Alejandro Zaera. El Croquis no. 72, Madrid 1995.Miralles, Enric. "Apuntes de una conversación informal con Enric Miralles." Entrevistado por Tuñon, E. y Moreno Mansilla, L. El Croquis no. 100-101, (2002): 8-21.Miralles, Enric. "Miralles Tagliabue. Arquitecturas del tiempo." Entrevistado por Anatxu Zabalbeascoa. Time Architecture 4, Barcelona, 1999.Miralles, Enric. Obras y proyectos. Milan: Skyra, 2002.Miralles, Enric. "Es aixó de Jujol?." Quaderns no. 179-180, COAC (1988): 52-55.Ruskin, John. Praeterita. Oxford: University Press, 1978.Sánchez Ferlosio, Rafael. Las semanas del jardín. Barcelona: Ediciones Destino, 2003.Smithson, Peter. "Peter Smithson." Entrevistado por Anatxu Zabalbeascoa. El País, Arquitectura, 8 abril, 2000

Severity of post-cardiac surgery acute kidney injury and long-term mortality: is chronic kidney disease the missing link?

While the retrospective cohort study by Lopez-Delgado and colleagues suggests a strong association of the RIFLE classification and long-term mortality of acute kidney injury (AKI) after post-cardiac surgery, it has a number of limitations. The numbers of patients with pre-existing chronic kidney disease (CKD) or with non-recovery of renal function, de novo CKD or progression of CKD to stage V are not given. The authors used an obsolete definition of CKD and a modified RIFLE classification system for definition and grading of AKI. Taken together, numerous studies underscore the strong association between AKI and de novo CKD. Severity, duration and frequency of AKI as well as age, comorbidities and pre-existing CKD are known risk factors for the development and/or progression of CKD. Careful analyses of the cumulative mortality curves reported by Lopez-Delgado and colleagues or by our group revealed a triphasic pattern. In the early phase, survival rates drop steeply due to critical illness, followed by a phase of smaller decline (caused by patient characteristics and development of CKD) and later on by a flatter survival curve attributable to the high cardiovascular mortality of progressive CKD. Physicians need to consider the long-term sequels of severe AKI. Lopez Delgado and colleagues's study provides further arguments for an early follow-up of survivors of AKI by nephrologists

Reliability of two measurement indices for gingival enlargement

Background and objective: The objective of this study was to analyze the concordance of the vertical gingival overgrowth index (GOi) and the horizontal Miranda & Brunet index (MBi) and to compare their reliability and reproducibility for an early diagnosis of gingival enlargement. A wide range of methods has been employed to determine the severity of drug-induced gingival enlargement (DIGE) that has resulted in uncertainty with regard to the prevalence of this side effect. In recent studies, different indices have been used to grade DIGE. The large variability observed between studies and the differences between vertical and horizontal gingival-enlargement measurements could be the result of the use of nonreliable indices during the measurement process. Some indices involve invasive procedures that require many measurements, or even a data-processing system, while others are less convenient and technically expensive and complex. In previous studies we used two complementary indices - the vertical GOi and the horizontal MBi. The results of these studies found some differences between both indices, with the MBi rendering higher estimates of DIGE prevalence that was attributed to its greater sensitivity for the detection of minimal changes in gingival thickness. To our knowledge, there are no studies comparing different measurement indices for gingival enlargement that are supported by statistical concordance analysis. Material and methods:   Twelve plaster casts from patients who had worn orthodontic brackets, and who had different degrees of chronic inflammatory gingival enlargement, were analyzed. Three previously trained examiners registered twice the degree of buccal overgrowth, using the GOi and MBi, in all cast models with a minimum interval of 7 d between the first and the second evaluation. In total, from each cast, measurements from 16 gingival sites were taken using the GOi, and from nine gingival units (mesial and distal sites measurements) using the MBi. Concordance analysis of the registered measurements (intra-examiner and among examiners) for each index and between indices was assessed using the nonweighted Kappa index with a confidence interval of 95%. Results: We obtained 648 values for the GOi and the MBi. The overall score 0 (indicating absence of enlargement) was 32.7% and 19.8% for GOi and MBi, respectively, score 1 (light/moderate) was 39.7% and 48.1%, and score 2 (severe) was 27.6% and 32.1%. Concordance analysis for each index showed intra-examiner Kappa values of 0.820 for the GOi and 0.830 for the MBi. Interexaminer Kappa values were 0.720 for the GOi and 0.770 for the MBi. Concordance between indices showed Kappa values for the same examiner of 0.600, whereas concordance among different examiners was 0.550. Discrepancies between indices indicated a systematic skew, with 79-82.1% of discrepancy associated with a higher value for the MBi compared with the GOi. Conclusion: Both gingival enlargement indices analyzed are reliable, complementary and applicable for measuring gingival overgrowth. However, the MBi shows, with fewer measurements, a greater sensitivity than the GOi for the detection of the early stages of gingival enlargement, being adequate for the screening of large populations at risk

Barrier-protective effects of activated protein C in human alveolar epithelial cells

Acute lung injury (ALI) is a clinical manifestation of respiratory failure, caused by lung inflammation and the disruption of the alveolar-capillary barrier. Preservation of the physical integrity of the alveolar epithelial monolayer is of critical importance to prevent alveolar edema. Barrier integrity depends largely on the balance between physical forces on cell-cell and cell-matrix contacts, and this balance might be affected by alterations in the coagulation cascade in patients with ALI. We aimed to study the effects of activated protein C (APC) on mechanical tension and barrier integrity in human alveolar epithelial cells (A549) exposed to thrombin. Cells were pretreated for 3 h with APC (50 mg/ml) or vehicle (control). Subsequently, thrombin (50 nM) or medium was added to the cell culture. APC significantly reduced thrombin-induced cell monolayer permeability, cell stiffening, and cell contraction, measured by electrical impedance, optical magnetic twisting cytometry, and traction microscopy, respectively, suggesting a barrier-protective response. The dynamics of the barrier integrity was also assessed by western blotting and immunofluorescence analysis of the tight junction ZO-1. Thrombin resulted in more elongated ZO-1 aggregates at cell-cell interface areas and induced an increase in ZO-1 membrane protein content. APC attenuated the length of these ZO-1 aggregates and reduced the ZO-1 membrane protein levels induced by thrombin. In conclusion, pretreatment with APC reduced the disruption of barrier integrity induced by thrombin, thus contributing to alveolar epithelial barrier protection

Impact of non-neurological complications in severe traumatic brain injury outcome

Introduction: Non-neurological complications in patients with severe traumatic brain injury (TBI) are frequent, worsening the prognosis, but the pathophysiology of systemic complications after TBI is unclear. The purpose of this study was to analyze non-neurological complications in patients with severe TBI admitted to the ICU, the impact of these complications on mortality, and their possible correlation with TBI severity. Methods: An observational retrospective cohort study was conducted in one multidisciplinary ICU of a university hospital (35 beds); 224 consecutive adult patients with severe TBI (initial Glasgow Coma Scale (GCS) < 9) admitted to the ICU were included. Neurological and non-neurological variables were recorded. Results: Sepsis occurred in 75% of patients, respiratory infections in 68%, hypotension in 44%, severe respiratory failure (arterial oxygen pressure/oxygen inspired fraction ratio (PaO2/FiO(2)) < 200) in 41% and acute kidney injury (AKI) in 8%. The multivariate analysis showed that Glasgow Outcome Score (GOS) at one year was independently associated with age, initial GCS 3 to 5, worst Traumatic Coma Data Bank (TCDB) first computed tomography (CT) scan and the presence of intracranial hypertension but not AKI. Hospital mortality was independently associated with initial GSC 3 to 5, worst TCDB first CT scan, the presence of intracranial hypertension and AKI. The presence of AKI regardless of GCS multiplied risk of death 6.17 times (95% confidence interval (CI): 1.37 to 27.78) (P < 0.02), while ICU hypotension increased the risk of death in patients with initial scores of 3 to 5 on the GCS 4.28 times (95% CI: 1.22 to15.07) (P < 0.05). Conclusions: Low initial GCS, worst first CT scan, intracranial hypertension and AKI determined hospital mortality in severe TBI patients. Besides the direct effect of low GCS on mortality, this neurological condition also is associated with ICU hypotension which increases hospital mortality among patients with severe TBI. These findings add to previous studies that showed that non-neurological complications increase the length of stay and morbidity in the ICU but do not increase mortality, with the exception of AKI and hypotension in low GCS (3 to 5)

Combined intermittent hypobaric hypoxia and muscle electro-stimulation: a method to increase circulating progenitor cell concentration?

Our goal was to test whether short-term intermittent hypobaric hypoxia (IHH) at a level well tolerated by healthy humans could, in combination with muscle electro-stimulation (ME), mobilize circulating progenitor cells (CPC) and increase their concentration in peripheral circulation. Nine healthy male subjects were subjected, as the active group (HME), to a protocol involving IHH plus ME. IHH exposure consisted of four, three-hour sessions at a barometric pressure of 540 hPa (equivalent to an altitude of 5000 m). These sessions took place on four consecutive days. ME was applied in two separate 20-minute periods during each IHH session. Blood samples were obtained from an antecubital vein on three consecutive days immediately before the experiment, and then 24 h, 48 h, 4 days, 7 days and 14 days after the last day of hypoxic exposure. Four months later a control study was carried out involving seven of the original subjects (CG), who underwent the same protocol of blood samples but without receiving any special stimulus. In comparison with the CG the HME group showed only a non-significant increase in the number of CPC CD34+ cells on the fourth day after the combined IHH and ME treatment. CPC levels oscillated across the study period and provide no firm evidence to support an increased CPC count after IHH plus ME, although it is not possible to know if this slight increase observed is physiologically relevant. Further studies are required to understand CPC dynamics and the physiology and physiopathology of the hypoxic stimulus

Incidencia y gravedad de la enfermedad por citomegalovirus en pacientes trasplantados renales que han recibido tratamiento anticipado o profilaxis con valganciclovir oral

Antecedentes: La infección por CMV es la más frecuente que sufren los receptores de trasplante de órgano sólido (TOS) en los primeros meses del trasplante. Son abundantes las estrategias de prevención y tratamiento de la enfermedad por CMV que se han desarrollado. Métodos: El objetivo fue evaluar la incidencia y severidad de la enfermedad por CMV en 387 receptores de trasplante renal que recibieron tratamiento profiláctico (grupo de alto riesgo, n = 251) o realizaron seguimiento de PCR de CMV por ser grupo de bajo riesgo (n = 136) y recibieron tratamiento anticipado (n = 17) con valganciclovir oral (900 mg/día) cuando presentaron & 1000 copias/ml. Resultados: Presentaron enfermedad por CMV, 2 (11,76%) pacientes del grupo de riesgo estándar, descrita como enfermedad leve y 20 (7,96%) pacientes del grupo de alto riesgo, descrita como enfermedad leve en 15 casos y como enfermedad grave en 5 casos. Aquellos pacientes que desarrollaron la enfermedad, respondieron al tratamiento con ganciclovir endovenoso durante 14 días seguido de valganciclovir oral hasta completar tres meses. Conclusión: El tratamiento profiláctico con valganciclovir oral para la prevención de enfermedad o infección por CMV solamente es necesario en los receptores de TOS de alto riesgo.Antecedents: La infecció per CMV es la més freqüent que pateixen els receptors de trasplantament d'òrgan sòlid (TOS) als primers mesos del trasplantament. Són abundants les estratègies de prevenció i tractament de la malaltia per CMV que s'han desenvolupat. Mètodes: L'objectiu fou avaluar la incidència i severitat de la malaltia per CMV en 387 receptors de trasplantament renal que van rebre tractament profilàctic (grup d'alt risc n = 251) o van realitzar seguiment de PCR de CMV per ser grup de baix risc (n= 136) i van rebre tractament anticipat ( n = 17) amb valganciclovir oral (900 mg/dia) quan van presentar & 1000 còpies/ml. Resultats: Van presentar malaltia per CMV, 2 (11,76%) pacients del grup de risc estàndard, descrita com malaltia lleu i 20 (7,96%) pacients del grup d'alt risc, descrita com malaltia lleu en 15 casos i com malaltia greu en 5 casos. Aquells pacients que van desenvolupar la malaltia, varen respondre al tractament amb ganciclovir endovenós durant 14 dies seguit de valganciclovir oral fins a completar tres mesos. Conclusió: El tractament profilàctic amb valganciclovir oral per a la prevenció de malaltia o infecció per CMV només és requerit pels receptors de TOS d'alt risc

Aortic remodelling induced by obstructive apneas is normalized with mesenchymal stem cells infusion

Obstructive sleep apnea syndrome (OSA) promotes aortic dilatation, increased stiffness and accelerated atherosclerosis, but the mechanisms of vascular remodelling are not known. We aimed to assess vascular remodelling, its mechanisms, and the effect of mesenchymal stem cells (MSC) infusions in a clinically relevant rat model of chronic OSA involving recurrent airway obstructions leading thoracic pressure swings and intermittent hypoxia/hypercapnia (OSA-rats). Another group of rats were placed in the same setup without air obstructions (Sham-rats) and were considered controls. Our study demonstrates that chronic, non-invasive repetitive airway obstructions mimicking OSA promote remarkable structural changes of the descending thoracic aorta such as eccentric aortic hypertrophy due to an increased wall thickness and lumen diameter, an increase in the number of elastin fibers which, in contrast, get ruptured, but no changes in tunica media fibrosis. As putative molecular mechanisms of the OSA-induced vascular changes we identified an increase in reactive oxygen species and renin-angiotensin system markers and an imbalance in oxide nitric synthesis. Our results also indicate that MSC infusion blunts the OSA-related vascular changes, most probably due to their anti-inflammatory properties

Circulating progenitor cells during exercise, muscle electro-stimulation and intermittent hypobaric hypoxia in patients with traumatic brain injury. A pilot study

BACKGROUND: Circulating progenitor cells (CPC) treatments may have great potential for the recovery of neurons and brain function. OBJECTIVE: To increase and maintain CPC with a program of exercise, muscle electro-stimulation (ME) and/or intermittent-hypobaric-hypoxia (IHH), and also to study the possible improvement in physical or psychological functioning of participants with Traumatic Brain Injury (TBI). METHODS: Twenty-one participants. Four groups: exercise and ME group (EEG), cycling group (CyG), IHH and ME group (HEG) and control group (CG). Psychological and physical stress tests were carried out. CPC were measured in blood several times during the protocol. RESULTS: Psychological tests did not change. In the physical stress tests the VO2 uptake increased in the EEG and the CyG, and the maximal tolerated workload increased in the HEG. CPC levels increased in the last three weeks in EEG, but not in CyG, CG and HEG. CONCLUSIONS: CPC levels increased in the last three weeks of the EEG program, but not in the other groups and we did not detect performed psychological test changes in any group. The detected aerobic capacity or workload improvement must be beneficial for the patients who have suffered TBI, but exercise type and the mechanisms involved are not clear