Simulated acoustic field in mudejar-gothic churches

In this work we have undertaken an acoustic simulation of the sound field in several churches in the city of Seville. The simulation has been carried out through the RAYNOISE program and has been based on the reverberation times measured in those spaces. We have focused on Sound Ressure Levels SPL, Clarity C80 and Definition D50 indices data in relation to their spectral variations and spatial distributions and their comparison with the experimental values

Size segregated ionic species collected in a harbour area

Water-soluble ions were analysed in size segregated aerosol samples collected in the port of Alicante (Southeastern Spain) during summer and winter using a multistage cascade impactor. Seasonal variations in the size distributions of the analysed components and the influence of bulk materials handling (loading/unloading and stockpiling) at the docks were investigated. The size distributions of SO42−, NH4+ and K+ were characterized by prominent peaks in the condensation and droplet modes, both in summer and winter, while those of Ca2+, Na+, Mg2+ and Cl− had a main peak centred at ∼4 μm. Although oxalate size distributions were similar during both seasons, the fraction of coarse-mode oxalate increased in summer most likely as a result of volatilization and repartition processes or reactions of oxalic acid with coarse alkaline particles. Nitrate size distributions were dominated by a coarse mode; however, during winter, modal peaks in the submicron size range were also observed due to favourable conditions for the formation of fine-mode NH4NO3. Harbour activities had a significant impact only on the concentrations of calcium, particularly in the coarse fraction, during both summer and winter.This work was supported by the Spanish Ministry of Science, Innovation and Universities (COSMOS Project, ref. RTI2018-098639-B-I00). The authors would also like to thank ACTRIS-Spain network (CGL2017-90884-REDT). A. Clemente thanks the Spanish Ministry of Education for a predoctoral grant (FPU18/00081)

Simulations and measurements of automotive turbocharger compressor whoosh noise

Turbocharger noise has become a major concern in downsized automotive engine development. In this paper, the analysis is focused on the whoosh noise produced by the compressor when it is working near surge. A centrifugal compressor has been acoustically characterized on a turbocharger test rig mounted on an anechoic chamber. Three in-duct pressure signals forming a linear array are registered in order to obtain pressure components. In this way, meaningful pressure spectra and sound intensity level (SIL) compressor maps are obtained, showing an increase of SIL in the frequency window corresponding to whoosh noise. Besides, detached eddy simulations (DES) of the centrifugal compressor flow in two operating conditions near surge are performed. Good agreement is found between the experimental measurements and the CFD solutions in terms of predicted pressure spectra. Flow analysis is used to identify patterns responsible for the different features of the pressure spectra. At the simulated conditions, rotating instabilities in the compressor diffuser and inducer cause pressure oscillations in the frequency range of whoosh noise.The equipment used in this work has been partially supported by the Spanish Ministerio de Economia y Competitividad through grant no. TRA2012-36954 and by FEDER project funds "Dotacion de infraestructuras cientifico tecnicas para el Centro Integral de Mejora Energetica y Medioambiental de Sistemas de Transporte (CiMeT), (FEDER-ICTS-2012-06)" framed in the operational program of unique scientific and technical infrastructure of the Spanish Ministerio de Economia y Competitividad.Broatch Jacobi, JA.; Galindo, J.; Navarro García, R.; García Tíscar, J.; Daglish, A.; Sharma, RK. (2015). Simulations and measurements of automotive turbocharger compressor whoosh noise. Engineering Applications of Computational Fluid Mechanics. 9(1):12-20. https://doi.org/10.1080/19942060.2015.1004788S12209

La valoración acústica en los proyectos de rehabilitación de teatros. El ejemplo andaluz

Se presentan algunos de los resultados obtenidos en el marco del Plan de Rehabilitación de Teatros de Andalucía, en el que, desde 1987, hemos trabajado como consultores acústicos de la Junta de Andalucía, sobre un total de 35 teatros. Las salas que estudiamos son el Teatro Villamarta de Jerez de la Frontera (Cádiz), el Gran Teatro de Córdoba, el Teatro Isabel la Católica de Granada y el Gran Teatro de Huelva. Ponencia presentada II Congreso Iberoamericano de Acústica. II Jornadas Iberoamericanas de Ultrasonidos. II Congreso Ibérico de Acústica. EAA Symposium on Architectural Acoustic. Madrid, 2000.This paper presents some of the results obtained in the mark of the Plan of Rehabilitation of Theaters of Andalucía, where we have worked as acoustic consultants of the Junta de Andalucía, from 1987, on a total of 35 theaters. The rooms we study are the Villamarta Theater in Jerez de la Frontera (Cádiz), the Great Theater of Córdoba, the Isabel the Catholic Theater in Granada and the Great Theater of Huelva

Acondicionamiento acústico del Teatro Villamarta de Jerez de la Frontera

The 1928 Villamarta Theatre in Jerez de la Frontera (Cádiz) was inaugurated in late 1996 after having restored with the help of our team. This paper shows the results of the acoustics measurements and the analysis of the values of several acoustic parameters before and after the renovation. These values are classified according to the different uses foreseen. Ponencia presentada en Encuentro Ibérico de Acústica. Oviedo, España. 199

Una experiencia de proyecto coordinado I+D+I en acústica de salas

Los firmantes de este trabajo, seis arquitectos y tres físicos, siete de ellos doctores, profesores de la Escuela Técnica Superior de Arquitectura de Sevilla, constituyen un grupo de investigación consolidado, multidisciplinar, que realiza su investigación principal en Acústica de Salas. Actualmente desarrollan un Proyecto Coordinado del Plan Nacional I+D+i, denominado “Establecimiento de parámetros acústicos determinantes de la calidad en salas de conciertos y auditorios para su aplicación a los proyectos de nueva planta o rehabilitación”, junto con grupos de investigación de otras tres universidades: Universidad Politécnica de Cataluña, Universidad Politécnica de Valencia y Universidad Pública de Navarra. El ámbito general del estudio se extiende a teatros y salas de concierto de las Comunidades Autónomas de Andalucía, Valencia, Cataluña, Navarra y País Vasco. El proyecto, siguiendo una metodología común para los cuatro grupos de investigación, acomete el establecimiento de los parámetros acústicos objetivos que permiten una valoración acústica de las salas, optimizando el número de esos parámetros a partir de las correlaciones con aquellos otros subjetivos relativos a la calidad percibida por los oyentes. El estudio, realizado en diferentes salas del territorio español, permitirá valorar las preferencias acústicas propias para la audición musical en nuestro entorno socio-cultural y, por tanto, disponer de una escala de los parámetros objetivos de medida, acorde con la tradición y el gusto musical de nuestro entorno cultural. Con ello se llena una laguna, ya que en la bibliografía y en las publicaciones especializadas existen referencias implementadas en el ámbito anglosajón (y japonés), fundamentalmente, pero no en el nuestro. Se pretende realizar, además, una propuesta de escala de exigencias básicas en función del uso de la sala, como herramienta de diseño para la definición de proyectos de edificación de nueva planta, o de restauración, rehabilitación o reforma, con especial atención al caso de los edificios históricos. Los objetivos planteados sólo se pueden alcanzar mediante un trabajo coordinado entre grupos de investigadores de diferentes Comunidades Autónomas que, además de aportar su bagaje científico, enriquecen el estudio al considerar las diferentes realidades sociales, con sus usos y costumbres, así como la extensión del estudio a las diferentes tipologías de auditorios existentes, en función de los usos alternativos que se desarrollan en ellos en cada una de las regiones. De esta forma, además, se proporciona al estudio el soporte suficiente que permita la vinculación y comparación del tema con los realizados en ámbitos internacionales. En este trabajo se pretende compartir la experiencia llevada a cabo en este proyecto coordinado, presentando los objetivos del mismo y mostrando la metodología utilizada

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research