Sudden singularities in semiclassical gravity

It has been claimed in a recent paper \cite{bbfhd12} that sudden singularities will survive in semiclassical gravity. This issue is here carefully reviewed, pointing out that such conclusion, even if valid under some specific conditions, does not stand in other cases. An explicit example is studied in detail to support our statement, stemming from these other situations, that quantum effects may in fact drastically modify the behavior of sudden singularities.Comment: Accepted for publication in PR

Lessons Learned From 10 Years of Preschool Intervention for Health Promotion: JACC State-of-the-Art Review.

Implementing a health promotion program for children is a complex endeavor. In this review, we outline the key lessons learned over 10 years of experience in implementing the SI! Program (Salud Integral-Comprehensive Health) for cardiovascular health promotion in preschool settings in 3 countries: Colombia (Bogotá), Spain (Madrid), and the United States (Harlem, New York). By matching rigorous efficacy studies with implementation science, we can help bridge the divide between science and educational practice. Achieving sustained lifestyle changes in preschool children through health promotion programs is likely to require the integration of several factors: 1) multidisciplinary teams; 2) multidimensional educational programs; 3) multilevel interventions; 4) local program coordination and community engagement; and 5) scientific evaluation through randomized controlled trials. Implementation of effective health promotion interventions early in life may induce long-lasting healthy behaviors that could help to curb the cardiovascular disease epidemic.This work is supported by the SHE Foundation and “la Caixa” Foundation (LCF/CE16/10700001). The project in Colombia was funded by Santo Domingo Foundation; the study in the United States (FAMILIA) was funded by the American Heart Association (grant no. 14SFRN20490315); and the study in Spain (SI! Program) was funded by the SHE Foundation, the research grant FIS-PI11/ 01885 (Fondo de Investigación Sanitaria del Instituto de Salud Carlos III), and Fundació la Marató de TV3 (369/C/2016). Dr SantosBeneit is the recipient of grant LCF/PR/MS19/12220001 funded by “la Caixa” Foundation (ID 100010434). Dr Fernández-Jiménez is the recipient of grant PI19/01704 funded by the Fondo de Investigación Sanitaria–Instituto de Salud Carlos III and co-funded by the European Regional Development Fund/European Social Fund “A way to make Europe”/“Investing in your future.” The Centro Nacional de Investigaciones Cardiovasculares is supported by the Instituto de Salud Carlos III, the Ministerio de Ciencia e Innovación, and the Pro CNIC Foundation, and is a Severo Ochoa Center of Excellence (CEX2020-001041-S). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.S

Mutations in TOP3A Cause a Bloom Syndrome-like Disorder

Bloom syndrome, caused by biallelic mutations in BLM, is characterized by prenatal-onset growth deficiency, short stature, an erythematous photosensitive malar rash, and increased cancer predisposition. Diagnostically, a hallmark feature is the presence of increased sister chromatid exchanges (SCEs) on cytogenetic testing. Here, we describe biallelic mutations in TOP3A in ten individuals with prenatal-onset growth restriction and microcephaly. TOP3A encodes topoisomerase III alpha (TopIIIα), which binds to BLM as part of the BTRR complex, and promotes dissolution of double Holliday junctions arising during homologous recombination. We also identify a homozygous truncating variant in RMI1, which encodes another component of the BTRR complex, in two individuals with microcephalic dwarfism. The TOP3A mutations substantially reduce cellular levels of TopIIIα, and consequently subjects’ cells demonstrate elevated rates of SCE. Unresolved DNA recombination and/or replication intermediates persist into mitosis, leading to chromosome segregation defects and genome instability that most likely explain the growth restriction seen in these subjects and in Bloom syndrome. Clinical features of mitochondrial dysfunction are evident in several individuals with biallelic TOP3A mutations, consistent with the recently reported additional function of TopIIIα in mitochondrial DNA decatenation. In summary, our findings establish TOP3A mutations as an additional cause of prenatal-onset short stature with increased cytogenetic SCEs and implicate the decatenation activity of the BTRR complex in their pathogenesis

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Habitar los objetos

La presente tesina parte del entendimiento de un espacio arquitectónico flexible, producto de la incertidumbre contemporánea, así como de un contexto en el que la arquitectura deja de ofrecer soluciones espaciales que permitan una jerarquización programática, o una posibilidad de acotar acciones a recintos determinados. En este contexto, la presencia del objeto ofrece en su autonomía e hiperflexibilidad, una nueva manera de establecer órdenes espaciales, así como estrategias arquitectónicas. En este sentido la primera parte de este trabajo parte de la comprensión del objeto como objeto en sí mismo. Así, se reflexionará sobre aquellos objetos que, entendidos como dispositivos o gadgets funcionales, suponen una objetualización de las componentes espaciales de la arquitectura, así como una reducción de sus variables programáticas a una suerte de mecanismos empaquetados. Por otro lado, este trabajo propone un análisis de los objetos en su capacidad de asociación y disposición. Partiendo de una escala de objetos menores, y del entendimiento de los mismos como píxeles dentro de un conjunto espacial complejo, la segunda parte de este documento tratará de explorar las posibilidades arquitectónicas que, surgiendo del entendimiento del espacio como una suma de elementos puntuales, se pueden llegar a producir

Espacios domésticos topológicos : las Casas Electrodoméstico de Alison y Peter Smithson = Domestic Spaces for the Consumption : the Alison and Peter Smithson's Appliance Houses

En el año 1952 los arquitectos Alison y Peter Smithson comenzaron, a través de las reuniones celebradas en el seno del Independent Group, a producir una serie de reflexiones en torno al concepto de objeto dentro de la nueva sociedad de consumo. Como resultado, y entre los años 1956 y 1959, dibujaron una colección de cuatro casas a las que llamaron Appliance Houses (Casas Electrodoméstico), que partían de establecer una nueva relación entre los objetos –muebles y electrodomésticos– y la propia arquitectura. Esta nueva asociación, que se producía al separar conceptual y físicamente estas dos variables (lo mueble y lo inmueble), permitió al final de la década de los cincuenta y con el proyecto con el que finalizaba la serie (Retirement House en Kent, 1959) generar una nueva estrategia arquitectónica que sustituía, por primera vez, la estancia por el objeto. ----------ABSTRACT---------- In 1952 the architects Alison and Peter Smithson started, through the meetings held within the Independent Group, a series of analysis and thoughts about the concept of good within the consumption society. As a result, the Smithson drew between 1956 and 1959 a collection of houses that, with the name of Appliance Houses, provoked a new way of understanding the relation between architecture and objects. This new association, materialized through a different manner of comprehending the appliances and the furniture, allowed at the latest 50's with the project that ended the series, generated at in the Retirement House in Kent (1959) a new kind of domestic space that broke definitely with the pre-war idea of house

Espacios domésticos topológicos : las Casas Electrodoméstico de Alison y Peter Smithson = Domestic Spaces for the Consumption : the Alison and Peter Smithson's Appliance Houses

En el año 1952 los arquitectos Alison y Peter Smithson comenzaron, a través de las reuniones celebradas en el seno del Independent Group, a producir una serie de reflexiones en torno al concepto de objeto dentro de la nueva sociedad de consumo. Como resultado, y entre los años 1956 y 1959, dibujaron una colección de cuatro casas a las que llamaron Appliance Houses (Casas Electrodoméstico), que partían de establecer una nueva relación entre los objetos –muebles y electrodomésticos– y la propia arquitectura. Esta nueva asociación, que se producía al separar conceptual y físicamente estas dos variables (lo mueble y lo inmueble), permitió al final de la década de los cincuenta y con el proyecto con el que finalizaba la serie (Retirement House en Kent, 1959) generar una nueva estrategia arquitectónica que sustituía, por primera vez, la estancia por el objeto. ----------ABSTRACT---------- In 1952 the architects Alison and Peter Smithson started, through the meetings held within the Independent Group, a series of analysis and thoughts about the concept of good within the consumption society. As a result, the Smithson drew between 1956 and 1959 a collection of houses that, with the name of Appliance Houses, provoked a new way of understanding the relation between architecture and objects. This new association, materialized through a different manner of comprehending the appliances and the furniture, allowed at the latest 50's with the project that ended the series, generated at in the Retirement House in Kent (1959) a new kind of domestic space that broke definitely with the pre-war idea of house

Una fiesta contracultural: El espacio doméstico en Andy Warhol y Superstudio

The present text is a way of looking to two spaces: The old New Yorker workshop where Andy Warhol invented the pop between 1963 and 1969, The Factory, and the series of collages drawn by the radical Italian architects Superstudio in 1971 under the title Supersurface, presented afterwards as part of the 1972 MoMa Exhibition: The New Domestic Landscape´s catalogue. The given look is focused on the observation of the objects within both spaces. Pieces of furniture or simply belongings, the objects are understood along the article as the generative aspects of these two spaces, representative both of them of the American and European counter-cultural way of thinking from the sixties to the early seventies.El texto que se presenta es una mirada a dos espacios, uno físico, otro solo soñado: El viejo taller de producción en el que Andy Warhol inventó el pop en Nueva York entre los años 1963 a 1969, The Factory, y los collages dibujados por los arquitectos radicales italianos Superstudio en 1971 bajo el título de Supersuperficie, presentados más tarde como parte del catálogo de la exposición The New Domestic Landscape en 1972 en el MoMA de Nueva York. Dicha mirada se centrará a su vez en la observación de los objetos contenidos en ambos espacios. Muebles o simples enseres, los objetos son entendidos a lo largo del artículo como herramientas sustantivas y conformadoras de estos dos espacios que representan el pensamiento contracultural europeo y americano de la década de los sesenta y primeros años de los setenta