Un procedimiento nuevo para adaptar cualquier tipo de suelo para la construcción y consolidación de estructuras de tierra: Sistema de Tierra Proyectada

The “projected earth system” is put forward as an alternative construction method. The soil from each site is adapted following a specific protocol to make it suitable for spraying. The type of construction and the receiving surface determine the machinery and spraying system used (dry or wet mix). The result will be similar in texture and colour to the original material (in the case of earth walls) or to the surrounding material.Un procedimiento nuevo para adaptar cualquier tipo de suelo para la construcción y consolidación de estructuras de tierra: Sistema de Tierra Proyectada. Se plantea la “tierra proyectada” como nuevo sistema constructivo. Se adecuará la tierra de cada intervención con un protocolo para poder ser proyectada. El tipo de intervención y el soporte sobre el que se proyectará determinarán la maquinaria y el sistema de proyección (vía seca o húmeda). El resultado tendrá similar textura y color que el soporte restaurado (en muros de tierra) o que el material del entorno (en taludes carreteros u obras de tierra de nueva construcción)

El tapial de las murallas de Granada

Español: En este trabajo se establecen las características del material empleado en las construcciones de los distintos recintos amurallados de la ciudad de Granada, que se conocen históricamente como "Alcazabas de Granada" y arrabales, distinguiendo entre material de interior de muro y revestimientos. Como objetivo final, este estudio nos ha permitido establecer conclusiones más precisas sobre la metodología constructiva utilizada en estos recintos amurallados, y la evolución de ésta a lo largo de las distintas épocas. Inglés: This paper deals with a general analysis of the materials used in the city walls, commonly known as Alcazabas, of Granada. The study concentrates in the material of the inner walls as well as the exterior. This has allowed for a deeper insight in the construction methods used for city walls during different ages

Diagnosis of stoneware pathology placed on bonded façade

Esta investigación analiza las causas del desprendimiento de un revestimiento de gres porcelánico colocado en fachada. En el momento de abordar este trabajo comprobamos que hay métodos normalizados para la determinación de las características de los adhesivos para las baldosas cerámicas y de las propias baldosas, pero en ambos casos, son métodos a aplicar durante el proceso de fabricación. No existen métodos normalizados para la determinación de las características de aplacados en servicio, cuestión que aborda este trabajo. Las técnicas de diagnosis empleadas han consistido en la comprobación de la capacidad de adherencia del adhesivo, la localización de juntas de movimiento, el análisis de las juntas de colocación y la detección de anclajes mecánicos ocultos. Finalmente, los resultados obtenidos tras la aplicación de dicha metodología para el análisis de la patología han permitido establecer las causas que han originado los daños, proponiéndose como método de diagnosis del desprendimiento de un aplacado cerámico en servicio.This research examines the causes of the detachment of stoneware placed on façade cladding. In dealing with this work we see that there are standard methods for the determination of the characteristics of adhesives for ceramic tiles and own tiles, but in both cases, the methods are to be applied during the manufacturing process. There are no standard methods for the determination of the characteristics of facings in service, which deals with this work. Employed diagnosis techniques have consisted of checking the capacity of adhesion of adhesive, the location of movement joints, joints of positioning analysis and detection of hidden mechanical anchors. Finally, the results obtained after the application of this methodology to the analysis of Pathology have allowed establishing the causes that have given rise to the damage; we propose a method of diagnosis of the evolution of a ceramic covering

The technique of underpinning with micropiles in conserving a compacted earth wall using "tapial-technic"

Durante el proceso de ejecución de un aparcamiento público subterráneo en la ciudad de Granada (España) se descubrió una obra de ingeniería hidráulica periurbana de 55 m de longitud con tres tajamares (declarado BIC en el 2007) ligado a la margen izquierda del río Genil. Se detectaron tres fases constructivas, muro monolítico (s. XI), tapia real (s. XII-XIII) y una reparación posterior (s. XIX) a base de cajones de mampostería con machones e hiladas de ladrillo. Para la conservación de este elemento en su posición original se ejecutaron: micropilotes verticales en su perímetro; otros horizontales en su base; viga riostra de encepado y bulones con barra Gewi pasantes a la viga de arriostramiento. Durante la excavación, se ejecutó un entramado de perfiles metálicos laminados «L» soldados entre sí y a los micropilotes. El elemento está totalmente integrado en la obra subterránea y en el entorno del Paseo del Violón.In this paper, the discovery of a peri-urban work of hydraulic engineering is presented. A wall-dike was found during the excavation for an underground public parking on the left bank of the Genil River in Granada city (Spain). Those consist in a compacted earth wall (using “Tapial-technic”) of 55 m length with three cutwaters. Three different construction methodologies were detected in the wall-dike: monolithic-wall (s. XI), royal wall (s. XII-XIII) and contemporary reparation (s. XIX). These elements were conserved in the original position with the help of the micropiles technique. The consolidation stages were as follows: vertical micropiles in its perimeter; horizontals micropiles in the base of the wall; brace beam and thought bolts with Gewi rod. After the digging, also, laminated metal sections with an “L” were welded together and to vertical micropiles. That element is fully integrated with both underground construction and its environment, “Paseo del Violón”.Queremos agradecer la colaboración de las empresas Ges-pad-Al-Andalus.S.L. y SITE S.A

Corrigendum to: Comparative study of obstetric antiphospholipid syndrome (OAPS) and non-criteria obstetric APS (NC-OAPS): report of 1640 cases from EUROAPS registry

Rheumatology 2020;59:1306–1314. doi:https://doi.org/10.1093/rheumatology/kez419 In the original article, the affiliation of co-author Cecilia Beatrice Chighizola should have read: “Experimental Laboratory of Immunological and Rheumatologic Researches, Istituto Auxologico Italiano, IRCCS, Cusano Milanino, Milan, Italy”. These details have been corrected only in this corrigendum to preserve the published version of record

Assessment of a primary and tertiary care integrated management model for chronic obstructive pulmonary disease

<p>Abstract</p> <p>Background</p> <p>The diagnosis and treatment of patients with chronic obstructive pulmonary disease (COPD) in Spain continues to present challenges, and problems are exacerbated when there is a lack of coordinated follow-up between levels of care. This paper sets out the protocol for assessing the impact of an integrated management model for the care of patients with COPD. The new model will be evaluated in terms of 1) improvement in the rational utilization of health-care services and 2) benefits reflected in improved health status and quality of life for patients.</p> <p>Methods/Design</p> <p>A quasi-experimental study of the effectiveness of a COPD management model called COPD PROCESS. The patients in the study cohorts will be residents of neighborhoods served by two referral hospitals in Barcelona, Spain. One area comprises the intervention group (n = 32,248 patients) and the other the control group (n = 32,114 patients). The study will include pre- and post-intervention assessment 18 months after the program goes into effect. Analyses will be on two datasets: clinical and administrative data available for all patients, and clinical assessment information for a cohort of 440 patients sampled randomly from the intervention and control areas. The main endpoints will be the hospitalization rates in the two health-care areas and quality-of-life measures in the two cohorts.</p> <p>Discussion</p> <p>The COPD PROCESS model foresees the integrated multidisciplinary management of interventions at different levels of the health-care system through coordinated routine clinical practice. It will put into practice diagnostic and treatment procedures that are based on current evidence, multidisciplinary consensus, and efficient use of available resources. Care pathways in this model are defined in terms of patient characteristics, level of disease severity and the presence or absence of exacerbation. The protocol covers the full range of care from primary prevention to treatment of complex cases.</p

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks