Integrated tsunami vulnerability and risk assessment: application to the coastal area of El Salvador

ABSTRACT. Advances in the understanding and prediction of tsunami impacts allow for the development of risk reduction strategies for tsunami-prone areas. This paper presents a tsunami vulnerability and risk assessment for the case study of El Salvador, the applied methodology dealing with the complexity and variability of coastal zones by means of (i) an integral approach to cover the entire risk-related process from the hazard, vulnerability and risk assessments to the final risk management; (ii) an integrated approach to combine and aggregate the information stemming from the different dimensions of coupled human and natural systems; and (iii) a dynamic and scale-dependent approach to integrate the spatiotemporal variability considerations. This work also aims at establishing a clear connection to translate the vulnerability and risk assessment results into adequate target-oriented risk reduction measures, trying to bridge the gap between science and management for the tsunami hazard. The approach is applicable to other types of hazards, having been successfully applied to climate-change-related flooding hazard

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Adelante / Endavant

Séptimo desafío por la erradicación de la violencia contra las mujeres del Institut Universitari d’Estudis Feministes i de Gènere "Purificación Escribano" de la Universitat Jaume

Antimicrobial resistance in pasteurellaceae isolates from pyrenean chamois (Rupicapra pyrenaica) and domestic sheep in an alpine ecosystem

Antimicrobial resistance (AMR) has spread worldwide due to the inappropriate use of antimicrobial drugs in human and veterinary medicine, becoming a public health problem. However, little is known about its occurrence and maintenance in wild animals, and very few studies have been carried out in ecosystems subjected to low human pressure. In our study, nasal and lung swabs were collected from hunted Pyrenean chamois (Rupicapra pyrenaica), and nasal swabs from sympatric domestic sheep were also collected. The swabs were cultured in agar plates to obtain bacterial isolates from the Pasteurellaceae family. The presence of AMR was assessed in a total of 28 Pasteurellaceae isolates from 45 Pyrenean chamois, and 9 isolates from sympatric domestic sheep found in the National Hunting Reserve of Freser-Setcases (Northeastern Pyrenees, Spain). The isolates belonged to one of the following three species: Pasteurella multocida, Mannheimia haemolytica and Bibersteinia trehalosi. Some P. multocida and M. haemolytica isolates tested positive for AMR. The statistical analysis revealed no differences between the AMR levels from chamois and domestic sheep isolates. However, one P. multocida of chamois origin presented resistance to cephalosporins and fluoroquinolones, which are antibiotics of critical importance for human health. Further studies are required to elucidate potential routes of dissemination of AMR genes in natural environments and assess any significant persistence in wildlife to design risk mitigation actions

Analysis from the school stting :use of social networks vs. practice of phisical activity

El objetivo de esta investigación es describir la adicción a las redes sociales y el nivel de práctica de AF de los adolescentes considerando el papel del género, la edad y el IMC. Se trata de un estudio descriptivo transversal en el que participaron 103 estudiantes de Educación Secundaria Obligatoria (ESO) de entre 14 y 17 años. Se utilizó un cuestionario sociodemográfico (que sirvió para dividir la muestra por sexo -hombres y mujeres- y por edad -14, 15, 16 y 17 años), la Escala para medir la adicción de los estudiantes a las redes sociales, adaptada por Cabero-Almenara et al. (2020) a partir del instrumento original de Sahin (2018) y para el Cuestionario Global de Actividad Física (GPAQ) diseñado por la Organización Mundial de la Salud (2014), siguiendo las recomendaciones los escolares fueron clasificados en activos y sedentarios. El IMC de los escolares se obtuvo de forma autodeclarada (Baile & González-Calderón, 2014) y posteriormente se clasificaron los escolares según los indicadores de referencia recogidos en las tablas de la fundación Orbegozo (Sobradillo et al., 2004). Los resultados de este estudio muestran que las niñas tienen una mayor necesidad de estar conectadas que los niños. Aunque en un grado moderado, los escolares obesos son los que más problemas tienen por su adicción a las redes sociales. El problema de la adicción a las redes sociales es más significativo entre los escolares de mayor edad, y los más jóvenes muestran menos satisfacción por estar conectados. El nivel de actividad física determina que los chicos dedican más tiempo a la actividad física que las chicas, siendo los de 14 años los más activos físicamente. En relación con el índice de masa corporal IMC los escolares más activos físicamente son los que tienen un peso normal. Se puede concluir que el nivel de satisfacción con el uso de las redes sociales aumenta con la edad. El nivel de práctica de AF moderada es mayor en los chicos, siendo los escolares de peso normal más activos que los de sobrepeso.The aim of this research is to describe the addiction to social networks and the level of PA practice of adolescents considering the role of sex, age and BMI. The study carried out was a cross-sectional descriptive study, with the participation of 103 students of compulsory secondary education (ESO) between 14 and 17 years of age. A sociodemographic questionnaire (which was used to divide the sample by sex - male and female - and by age - 14, 15, 16 and 17 years old-9), the Scale to measure students' addiction to social networks, adapted by Cabero-Almenara et al. (2020) from the original instrument by Sahin (2018) and for the Global Physical Activity Questionnaire (GPAQ) designed by the World Health Organization (2014), following the recommendations the schoolchildren were classified into active and sedentary. The BMI of the schoolchildren was obtained in a self-reported manner (Baile & González-Calderón, 2014) and subsequently the schoolchildren were classified according to the reference indicators collected in the tables of the Orbegozo foundation (Sobradillo et al., 2004). The results of this study show that girls have a greater need to be connected than boys. Although to a moderate extent, obese schoolchildren have the greatest problems with social networking. The problem of social networking is more significant among older schoolchildren, with younger schoolchildren showing less satisfaction with being online. The level of physical activity determines that boys spend more time than girls, and it is schoolchildren aged 14 who engage in more intense physical activity. In relation to body mass index, the schoolchildren who do more physical activity are those who are normal weight. It can be concluded that the level of satisfaction with the use of social networks increases with age. The level of moderate PA practice is higher in boys, with normal-weight schoolchildren being more active than those with excess weigh

3D skin microfluidic phantom for in vitro wearable testing

A standardized and cost-effective perspiration phantom for in vitro testing is needed to replace the variable and resource consuming human tests at research level. Here, an alternative to the existing devices, which mainly are made of laser-perforated thin membranes, is presented using polydimethylsiloxane (PDMS) and soft lithography. The proposed method overcomes the fabrication challenges of replicating the eccrine sweat gland structure. Sweat glands conduits are faithfully defined in-plane and the skin interface is created by bonding multiple PDMS layers. Parameters such as sweat duct diameter, sweat gland density and wettability properties were successfully replicatedPostprint (published version

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society