La política de las coaliciones en Cataluña

En este trabajo se analizan las diferentes características de los gobiernos autonómicos de Cataluña, todos ellos de coalición. La atención se centra, especialmente, en analizar los efectos que tienen los gobiernos de coalición sobre tres grandes ámbitos: el rendimiento electoral, la distribución intracoalicional del poder y el rendimiento intergubernamental

Biomecánica y mecanismo de producción del traumatismo cráneo-encefálico en el peatón atropellado. Evaluación de la normativa actual en la automoción

Introducción Los atropellos son una de las principales causas de muerte entre los accidentes de tráfico. Recientemente, ha aumentado el estudio de los atropellos, principalmente debido a la aplicación de la normativa europea y japonesa en protección de peatones. Esta investigación presenta un análisis del traumatismo cráneo-encefálico del peatón atropellado, asociándolo con la estructura del vehículo responsable de la lesión, su mecanismo de daño y comparando el resultado con la normativa existente. Métodos La metodología empleada ha consistido en un estudio epidemiológico descriptivo y transversal, mediante el estudio de datos de peatones atropellados recogidos en la base de datos americana (PCDS) que analiza a un total de 552 peatones atropellados y un total de 4.500 lesiones documentadas. Resultados De acuerdo con este estudio, el capó es el causante del 15,1% de las lesiones de la cabeza del peatón, mientras que el parabrisas es responsable de 41,8% de todas las lesiones. En el caso de los vehículos tipo utilitario la ubicación del impacto de la cabeza se produce por encima de lo que se espera en la regulación actual y, por lo tanto, no se aplican las contramedidas necesarias. De todas las lesiones en la cabeza sufridas por los peatones solo el 20% tiene la aceleración lineal como mecanismo de lesión, el 40% de las lesiones se deben a la aceleración rotacional. Conclusiones En esta investigación se pone de manifiesto la importancia de la aceleración rotacional como mecanismo de daño en la cabeza del peatón atropellado. En la normativa actual solo la aceleración lineal está contemplada en la formulación del principal criterio biomecánico utilizado para predecir el traumatismo cráneo-encefálico.Peer ReviewedPostprint (author's final draft

Injury pattern in lethal motorbikes-pedestrian collisions, in the area of Barcelona, Spain

Introduction: There are several studies about M1 type vehicle-pedestrian collision injury pattern, and based on them, there has been several changes in automobiles for pedestrian protection. However, the lack of sufficient studies about injury pattern in motorbikes-pedestrian collisions leads to a lack of optimization design of these vehicles. The objective of this research is to study the injury pattern of pedestrians involved in collisions with motorized two-wheeled vehicles. Methods: A retrospective descriptive study of pedestrian’s deaths after collisions with motorcycles in an urban area, like Barcelona was performed. The cases were collected from the Forensic Pathology Service database of the Institute of Legal Medicine of Catalonia. The selected cases were categorized as pedestrian-motorcycle collision, between January 1st 2006 and December 31th 2014. Data were collected from the autopsy, medical, and police report. The collected information was then analyzed using Microsoft Excel statistical functions. Results: Traumatic Brain Injury is the main cause of death in pedestrian hit by motorized two-wheeled vehicles (62.85%). The most frequent injury was the subarachnoid hemorrhage, in 71.4% of cases, followed by cerebral contusions and skull base fractures (65.7%). By contrast, pelvic fractures and tibia fractures only appeared in 28.6%. Conclusions: The study characterizes the injury pattern of pedestrians involved in a collision with motorized two-wheeled vehicles in an urban area, like Barcelona, which has been found to be different from other vehicle-pedestrian collisions, with a higher incidence of brain injuries and minor frequency of lower extremities fractures in pelvis, tibia and fibula.Peer ReviewedPostprint (published version

Innovative passive and active countermeasures for near side crash safety

This research presents six simultaneous innovative occupant near side lateral impact protection concepts including a dynamic door, high-volume side airbag, a large external airbag that covers doors, sill and B-pillar of the struck vehicle and other concepts for increasing the distance between the occupant and the door panel (active armrest, inflatable door beam and moving seat). All systems are based on pre crash detection of the impact and are activated as soon as 80ms before the impact. This paper details the task of integrating these systems into a vehicle using FE models, sled tests, and full scale crash tests. Sled test dummy responses were compared with and without the countermeasures.Postprint (published version

Clinical trials for elderly patients with multiple diseases (CHROMED) pilot study

The problem COPD (Chronic Obstructive Pulmonary Disease) is a significant socioeconomic burden which, particularly when associated with comorbidities such as Chronic Heart Failure (CHF), markedly affects patient outcomes. Care models based on telemedicine systems that enable early diagnosis and treatment of exacerbations are advocated to reduce the impact of chronic diseases on patient outcomes and health service costs. CHROMED (www.chromed.eu) is an international EU-funded project aimed at developing a multi-centre clinical trial to evaluate the impact of a new integrated home care approach to reduce care costs and improve quality of life in COPD. The approach We collaborated in a pilot study prior to the main trial which will include 300 patients from seven European countries (Italy, Spain, UK, Estonia, Slovenia, Sweden and Norway) with nine partners. The home monitoring system includes a novel forced oscillation technique (FOT) device for self-measurement of lung mechanics (RESMONPRO DIARY, Restech srl, Italy), a touch screen for collecting patients' symptoms and, where COPD is associated with CHF, by a device for measuring heart rate (HR), blood pressure (BP), pulse oximetry (SpO2) and body temperature (WRIST CLINIC, Medic4all, Israel). Findings The pilot included 16 patients (n=11 COPD, 5 COPD+CHF). The average monitoring period was 48.3±23.4 days resulting in a total of 504 patient days. The percentage of data correctly received within the period was: lung impedance and breathing pattern 90.0%; HR 91.7%, BP 91.7%; SpO2 74.0% and body temperature 71.4%. During the pilot, one patient was treated pharmacologically for an exacerbation of COPD. Offline processing demonstrated that the system identified warning of an exacerbation five days prior to admission. We also analysed qualitative data from patients and professionals about the acceptability of the telemedicine system and the interaction between patients, professionals and the monitoring system. Consequences The data suggest good acceptability and short-term compliance among patients with COPD. Lung function, HR and BP provided the most reliable data. The full RCT is currently under way and will be completed in August 2015

Influence of anthopometric variables on the mechanical properties of human rib cortical bone

Objective. The mechanical properties of ribs from a large number of post-mortem human subjects (PMHS) were analyzed to search for variation according to age, sex or BMI in the sample. A large sample of specimens from different donors (N = 64) with a very wide range of ages and anthropometric characteristics was tested. Methods. Uniaxial tensile tests were used for a sample of coupons machined from cortical bone tissue in order to isolate the purely mechanical properties from the geometrically influenced properties of the rib. Each coupon is about 25 mm long and has a thickness of about 0.5 mm. The mechanical properties measured for each specimen/coupon include YM, yield stress, ultimate stress (maximum failure stress), ultimate strain, and resilience (energy to fracture of SED). The study provides new methodological improvements in DIC techniques. Results. This study is notable for using an atypically large sample of number of PMHS. The size of the sample allowed the authors to determine that age has a significant effect on failure stress (p < 0.0001), yield stress (p = 0.0047), ultimate strain (p < 0.0001) and resilience (p < 0.0001) [numbers in parentheses represent the corresponding p - values]. Finally, there is a combined effect, so that for a given age, an increase of BMI leads to a decrease of the maximum strain (i.e. cortical bone is less stiff when both age and BMI are higher).Peer ReviewedPostprint (author's final draft

Decrease in sleep depth is associated with higher cerebrospinal fluid neurofilament light levels in patients with Alzheimer's disease

STUDY OBJECTIVES: The majority of studies investigating the association between sleep and Alzheimer's disease (AD) biomarkers have been performed in healthy participants. Our objective was to investigate the association between sleep and several biomarkers that reflect distinct aspects of AD physiopathology. METHODS: The cohort included 104 individuals with mild-moderate AD. The participants were submitted to one-night polysomnography, and cerebrospinal fluid was collected in the following morning to measure the selected biomarkers associated with amyloid deposition, tau pathology, neurodegeneration, axonal damage, synaptic integrity, neuroinflammation, and oxidative damage. RESULTS: There was a positive correlation between neurofilament light (NF-L) and the time spent in stage 1 of non-rapid eyes movement (NREM) (N1) sleep and a negative correlation between this marker and the time spent in stage 3 of NREM (N3) sleep. Accordingly, we observed that deep sleep was associated with lower levels of NF-L, whereas light sleep increased the probability of having higher levels of this marker. Furthermore, chitinase-3-like-1 (YKL-40) was negatively correlated with sleep efficiency, the time spent in stage 2 of NREM (N2) sleep, and the time spent in N3 sleep. Conversely, there was a positive correlation between N3 sleep and the oxidative protein damage markers N-ε-(carboxyethyl)lysine and N-ε-(malondialdehyde)lysine. CONCLUSIONS: There were significant correlations between sleep parameters and AD biomarkers related to axonal damage and neuroinflammation, such as NF-L and YKL-40. A lack of deep sleep was associated with higher levels of NF-L. This highlights a potential role for NF-L as a biomarker of sleep disruption in patients with mild-moderate AD in addition to its role in predicting neurodegeneration and cognitive decline

Early functional and morphological muscle adaptations during short-term inertial-squat training

Purpose: To assess early changes in muscle function and hypertrophy, measured as increases in muscle cross-sectional areas (CSAs) and total volume, over a 4 weeks inertial resistance training (RT) program. Methods: Ten young RT-naive volunteers (age 23.4 4.1 years) underwent 10 training sessions (2-3 per week) consisting of five sets of 10 flywheel squats (moment of inertia 900 kg cm2). Magnetic resonance imaging (MRI) scans of both thighs were performed before (PRE), and after 2 (IN) and 4 (POST) weeks of training to compute individual muscle volumes and regional CSAs. Scans were performed after 96 h of recovery after training sessions, to avoid any influence of acute muscle swelling. PRE and POST regional muscle activation was assessed using muscle functional MRI (mfMRI) scans. Concentric (CON) and eccentric (ECC) squat force and power, as well as maximal voluntary isometric contraction force (MVIC) of knee extensors and flexors, were measured in every training session. Results: Significant quadriceps hypertrophy was detected during (IN: 5.5% 1.9%) and after (POST: 8.6% 3.6%) the training program. Increases in squat force (CON: 32% 15%, ECC: 31 15%) and power (CON: 51% 30%, ECC: 48% 27%) were observed over the training program. Knee extensor MVIC significantly increased 28% 17% after training, but no changes were seen in knee flexor MVIC. No correlation was found between regional muscular activation in the first session and the % of increase in regional CSAs (r = -0.043, P = 0.164). Conclusion: This study reports the earliest onset of whole-muscle hypertrophy documented to date. The process initiates early and continues in response to RT, contributing to initial increases in force. The results call into question the reliability of mfMRI as a tool for predicting the potential hypertrophic effects of a given strengthening exercise