Potential relevance of differential settlements in earthquake-induced liquefaction damage assessment

The assessment of vulnerability of buildings subjected to earthquake-induced liquefaction requires the definition of an integrated damage scale accounting both for ground motion damage and ground permanent movements, which cause rigid-body settlement and tilt of the building but also flexural demand on members due to differential settlement of pad footings. Nevertheless, most of the existing procedures for the estimation of differential settlements rely only in soil characteristics, thus neglecting the influence of building stiffness on the soil-structure interaction. In the present work, based on simplified modelling of soil-structure variability and on preliminary assumption of force distributions, representative values of members' demand due to differential settlement are proposed. A simple approach relying on the structure-to-soil stiffness ratio and the equivalent soil degradation extent under pad footings is adopted. The methodology is calibrated by means of a parametric linear analysis for a set of planar frames. Relative flexural demand due to differential settlements normalised to the seismic flexural demand are obtained. Results show that their relevance may not be very severe, thus damage assessment of differential settlements could be likely accounted separately from flexural and rigid-body demand

Avaluació qualitativa del procés d’identificació i atenció als pacients amb necessitats complexes i malaltia avançada a l’atenció primària: període 2011-2014

Pacients crònics complexos; Malaltia crònica avançada; Equips d'atenció primària;Pacientes crónicos complejos; Enfermedad crónica avanzada; Equipos de atención primariaComplex chronic patients; Advanced chronic disease; Primary care teamsDocument resultat d'una recerca qualitativa que descriu el desenvolupament del procés d’identificació dels pacients crònics complexos i amb malaltia crònica avançada als equips d’atenció primària dels diferents territoris

Resultats de l’avaluació del Programa de prevenció i atenció a la cronicitat: tres anys de funcionament (2011-2014)

Programa de prevenció i atenció a la cronicitat; AvaluacióChronicity prevention and care program; EvaluationPrograma de prevención y atención a la cronicidad; EvaluaciónAquest document conté l'avaluació de les accions fetes dins del Programa de prevenció i atenció a la cronicitat creat el 2011 pel Departament de Salut amb la finalitat d’impulsar, planificar, coordinar i avaluar les actuacions a dur a terme per millorar el procés d’atenció a la cronicitat

Procediment per a la identificació i l’atenció de persones amb malalties cròniques avançades i necessitats d’atenció pal·liativa a l’atenció primaria i serveis de salut

Pacients crònics complexos; Atenció sanitària; ProcedimentsPacientes crónicos complejos; Atención sanitaria; ProcedimientosComplex chronic patients; Health care; ProceduresDocument que conté els procediments destinats als professionals sanitaris amb l'objectiu d'identificar i registrar la població que necessitarà atenció pal·liativa

Microbiological study of patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) and the usefulness of analytical and clinical parameters in its identification (VIRAE study)

Ramon Boixeda,1,5 Nuria Rabella,2 Goretti Sauca,3 Maria Delgado,1 Xavier Martinez-Costa1, Montserrat Mauri,1 Vanessa Vicente,1 Elisabet Palomera,4 Mateu Serra-Prat,4 Josep Antón Capdevila11Department of Internal Medicine, Hospital of Mataró, Barcelona, Spain; 2Department of Microbiology, Hospital of Santa Creu and Sant Pau, Barcelona, Spain; 3Department of Microbiology, Hospital of Mataró, Barcelona, Spain; 4Department of Research, Hospital of Mataró, Barcelona, Spain; 5Department of Medicine, Autonomous University of Barcelona, Barcelona, SpainPurpose: Respiratory infection is the most common cause for acute exacerbation of chronic obstructive pulmonary disease (AE-COPD). The aim of this work was to study the etiology of the respiratory infection in order to assess the usefulness of the clinical and analytical parameters used for COPD identification.Patients and methods: We included 132 patients over a period of 2 years. The etiology of the respiratory infection was studied by conventional sputum, paired serology tests for atypical bacteria, and viral diagnostic techniques (immunochromatography, immunofluorescence, cell culture, and molecular biology techniques). We grouped the patients into four groups based on the pathogens isolated (bacterial versus. viral, known etiology versus unknown etiology) and compared the groups.Results: A pathogen was identified in 48 patients. The pathogen was identified through sputum culture in 34 patients, seroconversion in three patients, and a positive result from viral techniques in 14 patients. No significant differences in identifying etiology were observed in the clinical and analytical parameters within the different groups. The most cost-effective tests were the sputum test and the polymerase chain reaction.Conclusion: Based on our experience, clinical and analytical parameters are not useful for the etiological identification of COPD exacerbations. Diagnosing COPD exacerbation is difficult, with the conventional sputum test for bacterial etiology and molecular biology techniques for viral etiology providing the most profitability. Further studies are necessary to identify respiratory syndromes or analytical parameters that can be used to identify the etiology of new AE-COPD cases without the laborious diagnostic techniques.Keywords: respiratory viruses, chronic obstructive pulmonary disease, exacerbation, diagnostic tests, hospitalizatio

Recomanacions pràctiques per a la identificació i la millora de l’atenció de persones amb malalties cròniques avançades (MACA) amb necessitat d’atenció pal·liativa en territoris i serveis de salut i socials

Modelo de atención de la enfermedad crónica avanzada; Profesionales sanitariosModel d’atenció de la malaltia crònica avançada; Professionals sanitarisAdvanced chronic disease care model; Health professionalsAquest document resumeix i proposa les mesures pràctiques per a la implementació d’un model d’atenció de la malaltia crònica avançada (MACA) en els territoris i en els seus serveis sanitaris i socials, en el context del Programa per a l’atenció de la cronicitat (PPAC) del Pla de salut de Catalunya

L’estudi de casos aplicat a l'educació física i esportiva. Tercera part

Aquest document és el resultat del treball docent mitjançant l’estudi de casos que el grup d’innovació docent GIDASRES estem desenvolupant des de fa alguns cursos. Recull nou casos que són el resultat de la tasca desenvolupada per una part de l’alumnat en el marc del Màster oficial de la Universitat de Barcelona “Activitat Motriu i Educació” en l’assignatura optativa “Socialització i cultura esportiva” el curs 2013-14. L’objectiu d’aquesta tercera i darrera part, atesa la finalització d’aquest màster específic, és la d’abordar altres temàtiques que pretenen anar engruixint el ventall de propostes per a facilitar el treball als professionals de l’educació física i esportiva mitjançant aquesta eina col•laborativa tan útil com és l’estudi de casos. Els temes plantejats ens obren noves perspectives en la pràctica professional per a resoldre situacions o per a plantejar-se’n d’hipotètiques, innovadores o possibles. De fet, l’actualitat de la salut i la qualitat de vida, la innovació docent, així com el reconeixement de la desigualtat i la discriminació en l’àmbit de l’educació física i esportiva són temes del present que es presenten com a casos per a ser debatuts en els equips de professionals que dia a dia treballen en aquests temes amb infants i joves. Es publiquen en la llengua original en que han estat escrits, atès que és un Màster oficial de la UB al que hi acudeix alumnat d’arreu

Phylogenetic analysis of an epidemic outbreak of acute hepatitis C in HIV-infected patients by ultra-deep pyrosequencing

Background: The incidence of acute hepatitis C (AHC) among HIV-infected men who have sex with men (MSM) has increased significantly in the last 10 years. Several studies point to a social and sexual network of HIV-positive MSM that extends internationally. Objectives: The aim of our study was to investigate the dynamics of HCV transmission in an outbreak of AHC in HIV-infected MSM in Barcelona by ultra-deep pyrosequencing. Study design: Between 2008 and 2013, 113 cases of AHC in HIV-infected MSM were diagnosed in the Infectious Diseases Unit, Hospital Clínic, Barcelona. Massive sequencing was performed using the Roche 454 GS Junior platform. To define possible transmission networks, maximum likelihood phylogenetic trees were constructed, and levels of genetic diversity within and among patients were compared. Results: Among the 70 cases analyzed, we have identified 16 potential clusters of transmission: 8 for genotype 1a (23 cases involved), 1 for genotype 1b (3 cases) and 7 for genotype 4d (27 cases). Although the initial phylogenetic reconstruction suggested a local transmission cluster of HCV gt4d, our approach based on low genetic differentiation did not corroborate it. Indeed, gt4d strains formed 4 independent groups related to patients from other countries. Conclusions: Frequent clustering of HIV-positive MSM shows that HCV infection has spread through a local network in Barcelona. This outbreak is related to a large international HCV transmission network among MSM. Public health efforts are needed to reduce HCV transmission among this high-risk group

Teriflunomide and Epstein–Barr virus in a Spanish multiple sclerosis cohort: in vivo antiviral activity and clinical response

BackgroundEpstein–Barr virus (EBV) and human herpesvirus 6 (HHV-6) have been associated with multiple sclerosis (MS). Teriflunomide is an oral disease-modifying therapy approved for treatment of relapsing forms of MS. In the preclinical Theiler’s murine encephalitis virus model of MS, the drug demonstrated an increased rate of viral clearance versus the vehicle placebo. Furthermore, teriflunomide inhibits lytic EBV infection in vitro.Objective1. To evaluate the humoral response against EBV and HHV-6 prior to teriflunomide treatment and 6 months later. 2. To correlate the variation in the humoral response against EBV and HHV-6 with the clinical and radiological response after 24 months of treatment with teriflunomide. 3. To analyze the utility of different demographic, clinical, radiological, and environmental data to identify early biomarkers of response to teriflunomide.MethodsA total of 101 MS patients (62 women; mean age: 43.4 years) with one serum prior to teriflunomide onset and another serum sample 6 months later were recruited. A total of 80 had been treated for at least 24 months, 13 had stopped teriflunomide before 24 months, and 8 were currently under teriflunomide therapy but with less than 24 months of follow-up. We analyzed the levels of the viral antibodies titers abovementioned in serum samples with ELISA commercial kits, and the levels of serum neurofilament light chain (Nf-L).ResultsAntiviral antibody titers decreased for EBNA-1 IgG (74.3%), VCA IgG (69%), HHV-6 IgG (60.4%), and HHV-6 IgM (73.3%) after 6 months of teriflunomide. VCA IgG titers at baseline correlated with Nf-L levels measured at the same time (r = 0.221; p = 0.028) and 6 months later (r = 0.240; p = 0.017). We found that higher EBNA-1 titers (p = 0.001) and a higher age (p = 0.04) at baseline were associated with NEDA-3 conditions. Thus, 77.8% of patients with EBNA-1 >23.0 AU and >42.8 years (P50 values) were NEDA-3.ConclusionTreatment with teriflunomide was associated with a reduction of the levels of IgG antibody titers against EBV and HHV-6. Furthermore, higher EBNA-1 IgG titers prior to teriflunomide initiation were associated with a better clinical response