From Pre‐Roman Bailo To Roman Baelo: Long‐Term Landscape Dynamics In The Straits Of Gibraltar

The Straits of Gibraltar have been historically an important maritime axis of connection between the Mediterranean and Atlantic areas of the Iberian Peninsula. For this reason, most of the archaeological research has focused on the coastal settlements, but its broader archaeological landscape remains mostly unknown. In this paper, we present recent intensive surveys in which a wide range of sites was detected, dating from the eighth century BC to the fourteenth AD. The ancient landscape is thus reconstructed over a long‐term perspective. Prior to the Roman expansion, the earlier Bailo‐La Silla del Papa was an urban central place that supported a dense network of subordinate settlements. Later on, the central settlement was transported from inland to the coastal town of Baelo Claudia, but the territorial structure remained based on a similar pattern.This study has been carried out as part of the Franco-German (Agence Nationale de la Recherche Scientifique and Deutsche Forschungsgemeinschaft) project – ARCHEOSTRAITS. Espaces protohistoriques du détroit de Gibraltar: les territoires de la Silla del Papa et de Los Castillejos de Alcorrín (IXe – Ier siècle av. J.-C.) – led by D.Marzoli and P.Moret. In this article we have presented the analysis of the Atlantic sector, drawing on a study included in a Junta de Andalucía General Research Project led by P. Moret – La Silla del Papa (Tarifa, Cádiz): oppidum, necropolis and territory (2014-2019)

Measurement of double beta decay of 100Mo to excited states in the NEMO 3 experiment

The double beta decay of 100Mo to the 0^+_1 and 2^+_1 excited states of 100Ru is studied using the NEMO 3 data. After the analysis of 8024 h of data the half-life for the two-neutrino double beta decay of 100Mo to the excited 0^+_1 state is measured to be T^(2nu)_1/2 = [5.7^{+1.3}_{-0.9}(stat)+/-0.8(syst)]x 10^20 y. The signal-to-background ratio is equal to 3. Information about energy and angular distributions of emitted electrons is also obtained. No evidence for neutrinoless double beta decay to the excited 0^+_1 state has been found. The corresponding half-life limit is T^(0nu)_1/2(0^+ --> 0^+_1) > 8.9 x 10^22 y (at 90% C.L.). The search for the double beta decay to the 2^+_1 excited state has allowed the determination of limits on the half-life for the two neutrino mode T^(2nu)_1/2(0^+ --> 2^+_1) > 1.1 x 10^21 y (at 90% C.L.) and for the neutrinoless mode T^(0nu)_1/2(0^+ --> 2^+_1) > 1.6 x 10^23 y (at 90% C.L.).Comment: 23 pages, 7 figures, 4 tables, submitted to Nucl. Phy

Reaction Front in an A+B -> C Reaction-Subdiffusion Process

We study the reaction front for the process A+B -> C in which the reagents move subdiffusively. Our theoretical description is based on a fractional reaction-subdiffusion equation in which both the motion and the reaction terms are affected by the subdiffusive character of the process. We design numerical simulations to check our theoretical results, describing the simulations in some detail because the rules necessarily differ in important respects from those used in diffusive processes. Comparisons between theory and simulations are on the whole favorable, with the most difficult quantities to capture being those that involve very small numbers of particles. In particular, we analyze the total number of product particles, the width of the depletion zone, the production profile of product and its width, as well as the reactant concentrations at the center of the reaction zone, all as a function of time. We also analyze the shape of the product profile as a function of time, in particular its unusual behavior at the center of the reaction zone

Surgical treatment for colorectal cancer: Analysis of the influence of an enhanced recovery programme on long-term oncological outcomes-a study protocol for a prospective, multicentre, observational cohort study

Introduction The evidence currently available from enhanced recovery after surgery (ERAS) programmes concerns their benefits in the immediate postoperative period, but there is still very little evidence as to whether their correct implementation benefits patients in the long term. The working hypothesis here is that, due to the lower response to surgical aggression and lower rates of postoperative complications, ERAS protocols can reduce colorectal cancer-related mortality. The main objective of this study is to analyse the impact of an ERAS programme for colorectal cancer on 5-year survival. As secondary objectives, we propose to analyse the weight of each of the predefined items in the oncological results as well as the quality of life. Methods and analysis A multicentre prospective cohort study was conducted in patients older than 18 years of age who are scheduled to undergo surgery for colorectal cancer. The study involved 12 hospitals with an implemented enhanced recovery protocol according to the guidelines published by the Spanish National Health Service. The intervention group includes patients with a minimum implementation level of 70%, and the control group includes those who fail to reach this level. Compliance will be studied using 18 key performance indicators, and the results will be analysed using cancer survival indicators, including overall survival, cancer-specific survival and relapse-free survival. The time to recurrence, perioperative morbidity and mortality, hospital stay and quality of life will also be studied, the latter using the validated EuroQol Five questionnaire. The propensity index method will be used to create comparable treatment and control groups, and a multivariate regression will be used to study each variable. The Kaplan-Meier estimator will be used to estimate survival and the log-rank test to make comparisons. A p value of less than 0.05 (two-tailed) will be considered to be significant. Ethics and dissemination Ethical approval for this study was obtained from the Aragon Ethical Committee (C.P.-C.I. PI20/086) on 4 March 2020. The findings of this study will be submitted to peer-reviewed journals (BMJ Open, JAMA Surgery, Annals of Surgery, British Journal of Surgery). Abstracts will be submitted to relevant national and international meetings. Trial registration number NCT04305314

Estudio de las rocas paleozoicas y los macizos graníticos que afloran en el Parc Natural de l'Alt Pirineu y zonas colindantes mediante datos geológicos, geofísicos y petrofísicos

The Parc Natural de l’Alt Pirineu is located between the La Maladeta and Andorra- Mount Louis granites. The characterization of the Parc’s geology at depth can help to know the emplacement mechanism of these granites, their relationships with the plutonic and volcanic rocks outcropping to the North and South of the Parc, respectively, and if all these rocks belong to the same magmatic system. To achieve these objectives, in the frame of the present research project, we have compiled and homogenezed previous gravimetric and magnetic data, and acquired new geophysical data, in particular, gravity data. We have also constructed new geological cross-sections oriented NE-SW from previous and new acquired geological data and characterized the petrophysical properties of the geological units in order to obtain the density and magnetic susceptibility of all different rocks outcropping in the study area. The geological cross-sections together with the petrophysical data will be used in the 2,5 and 3D gravimetric modelling to improve our understanding of the subsurface geology of this part of the Central Pyrenees and of the Parc Natural de l’Alt Pirineu.El Parc Natural de l’Alt Pirineu se encuentra en la zona situada entre el granito de La Maladeta y el granito de Andorra-Mount Louis. Conocer y entender la geología del subsuelo del Parc nos ayudará a saber cómo se produjo el emplazamiento de ambos macizos graníticos, su relación con las rocas plutónicas y volcánicas que afloran en la parte norte y sur del Parc, respectivamente, y si forman parte de un mismo sistema magmático. Para alcanzar estos objetivos, se está realizando una recopilación y homogeneización de datos gravimétricos y magnéticos ya existentes, así como la adquisición de nuevos datos geofísicos, en particular de gravimetría. Además, partiendo de estudios geológicos previos y datos propios, se está llevando a cabo la realización de cortes geológicos de dirección NE-SO y el estudio petrofísico de las unidades geológicas para obtener los valores de densidad y susceptibilidad magnética de todos los tipos de rocas que afloran en el área de estudio. Los cortes geológicos junto con los datos de petrofísica se utilizarán en la modelización gravimétrica 2,5D y 3D para mejorar la interpretación de la geología del subsuelo en este sector de II Jornades de Recerca del Parc Natural de l‘Alt Pirineu 87 los Pirineos Centrales y del Parc Natural de l’Alt Pirineu.Este trabajo se está llevando a cabo en el marco de los subproyectos CGL2017-84901-C2-1 y CGL2017-84901-C2-2-P del Ministerio de Ciencia, Innovación y Universidades. Los desarrollos metodológicos en exploración con técnicas geofísicas se encuentran alineados con el proyecto europeo 3DGeoEU- GeoERA (ERANET Cofund action 731166 [H2020], Project code GeoE.171.005). Los autores agradecen al Parc Natural de l’Alt Pirineu las facilidades prestadas y la organización de las jornadas de investigación para mostrar los trabajos realizados

Effectiveness and Safety of the Sequential Use of a Second and Third Anti-TNF Agent in Patients with Inflammatory Bowel Disease: Results from the Eneida Registry

Background: The effectiveness of the switch to another anti-tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients. Methods: We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent. Results: A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8-3; P < 0.0001) and ulcerative colitis vs Crohn''s disease (HR, 1.6; 95% CI, 1.1-2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug. Conclusions: Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response

Trends and outcome of neoadjuvant treatment for rectal cancer: A retrospective analysis and critical assessment of a 10-year prospective national registry on behalf of the Spanish Rectal Cancer Project

Introduction: Preoperative treatment and adequate surgery increase local control in rectal cancer. However, modalities and indications for neoadjuvant treatment may be controversial. Aim of this study was to assess the trends of preoperative treatment and outcomes in patients with rectal cancer included in the Rectal Cancer Registry of the Spanish Associations of Surgeons. Method: This is a STROBE-compliant retrospective analysis of a prospective database. All patients operated on with curative intention included in the Rectal Cancer Registry were included. Analyses were performed to compare the use of neoadjuvant/adjuvant treatment in three timeframes: I)2006–2009; II)2010–2013; III)2014–2017. Survival analyses were run for 3-year survival in timeframes I-II. Results: Out of 14, 391 patients, 8871 (61.6%) received neoadjuvant treatment. Long-course chemo/radiotherapy was the most used approach (79.9%), followed by short-course radiotherapy ± chemotherapy (7.6%). The use of neoadjuvant treatment for cancer of the upper third (15-11 cm) increased over time (31.5%vs 34.5%vs 38.6%, p = 0.0018). The complete regression rate slightly increased over time (15.6% vs 16% vs 18.5%; p = 0.0093); the proportion of patients with involved circumferential resection margins (CRM) went down from 8.2% to 7.3%and 5.5% (p = 0.0004). Neoadjuvant treatment significantly decreased positive CRM in lower third tumors (OR 0.71, 0.59–0.87, Cochrane-Mantel-Haenszel P = 0.0008). Most ypN0 patients also received adjuvant therapy. In MR-defined stage III patients, preoperative treatment was associated with significantly longer local-recurrence-free survival (p < 0.0001), and cancer-specific survival (p < 0.0001). The survival benefit was smaller in upper third cancers. Conclusion: There was an increasing trend and a potential overuse of neoadjuvant treatment in cancer of the upper rectum. Most ypN0 patients received postoperative treatment. Involvement of CRM in lower third tumors was reduced after neoadjuvant treatment. Stage III and MRcN + benefited the most

Evolution of the use of corticosteroids for the treatment of hospitalised COVID-19 patients in Spain between March and November 2020: SEMI-COVID national registry

Objectives: Since the results of the RECOVERY trial, WHO recommendations about the use of corticosteroids (CTs) in COVID-19 have changed. The aim of the study is to analyse the evolutive use of CTs in Spain during the pandemic to assess the potential influence of new recommendations. Material and methods: A retrospective, descriptive, and observational study was conducted on adults hospitalised due to COVID-19 in Spain who were included in the SEMI-COVID- 19 Registry from March to November 2020. Results: CTs were used in 6053 (36.21%) of the included patients. The patients were older (mean (SD)) (69.6 (14.6) vs. 66.0 (16.8) years; p < 0.001), with hypertension (57.0% vs. 47.7%; p < 0.001), obesity (26.4% vs. 19.3%; p < 0.0001), and multimorbidity prevalence (20.6% vs. 16.1%; p < 0.001). These patients had higher values (mean (95% CI)) of C-reactive protein (CRP) (86 (32.7-160) vs. 49.3 (16-109) mg/dL; p < 0.001), ferritin (791 (393-1534) vs. 470 (236- 996) µg/dL; p < 0.001), D dimer (750 (430-1400) vs. 617 (345-1180) µg/dL; p < 0.001), and lower Sp02/Fi02 (266 (91.1) vs. 301 (101); p < 0.001). Since June 2020, there was an increment in the use of CTs (March vs. September; p < 0.001). Overall, 20% did not receive steroids, and 40% received less than 200 mg accumulated prednisone equivalent dose (APED). Severe patients are treated with higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%. Conclusions: Patients with greater comorbidity, severity, and inflammatory markers were those treated with CTs. In severe patients, there is a trend towards the use of higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%