Assessment of Rainwater Harvesting Potential from Roof Catchments through Clustering Analysis

Rainwater harvesting from rooftop catchments represents a climate change adaptation measure that is especially significant in areas affected by water scarcity. This article develops a Geographic Information Systems-based methodology to evaluate the spatial distribution of rainwater catchment potential to identify the most favorable urban areas for the installation of these infrastructures. Since performance and water saving potential of rainwater harvesting systems greatly depends on population density and roof size, this assessment was performed for each residential plot on a per capita basis, based on cadastral data and a method of demographic disaggregation. Furthermore, to evaluate spatial variation of runoff coefficient per building, a supervised classification was carried out to consider the influence of roof types on the rainwater catchment potential. After calculating rainwater catchment potential per capita for each residential plot, the spatial clustering of high (hot spots) and low values (cold spots) was assessed through the Getis-Ord General G statistic. Results indicate a spatial pattern of high rainwater catchment potential values in low-density urban areas, where rainwater catchment systems are expected to offer a better performance and a shorter amortization period. These results may be useful for the enactment of local legislation that regulates the obligation to install these infrastructures or offers subsidies for their implementation.This research was funded by the Spanish Ministry of Economy and Competitiveness under Grant Number CSO2015-65182-CS-2-P. This work is also a result of a predoctoral fellowship (FPU15/01144) and postdoctoral fellowship (IJCI-2016/29016), granted by the Spanish Ministry of Education, Culture and Sport

Síndrome de Guillain-Barré

En este artículo se lleva a cabo una revisión de conocimientos en materia de diagnóstico y tratamiento médico del síndrome de Guillain Barré o polirradiculoneuropatía inflamatoria desmielinizante aguda

Comprehensive cross-platform comparison of methods for non-invasive EGFR mutation testing : results of the RING observational trial.

Abstract Several platforms for noninvasive EGFR testing are currently used in the clinical setting with sensitivities ranging from 30% to 100%. Prospective studies evaluating agreement and sources for discordant results remain lacking. Herein, seven methodologies including two next-generation sequencing (NGS)-based methods, three high-sensitivity PCR-based platforms, and two FDA-approved methods were compared using 72 plasma samples, from EGFR-mutant non-small-cell lung cancer (NSCLC) patients progressing on a first-line tyrosine kinase inhibitor (TKI). NGS platforms as well as high-sensitivity PCR-based methodologies showed excellent agreement for EGFR-sensitizing mutations (K = 0.80-0.89) and substantial agreement for T790M testing (K = 0.77 and 0.68, respectively). Mutant allele frequencies (MAFs) obtained by different quantitative methods showed an excellent reproducibility (intraclass correlation coefficients 0.86-0.98). Among other technical factors, discordant calls mostly occurred at mutant allele frequencies (MAFs) ≤ 0.5%. Agreement significantly improved when discarding samples with MAF ≤ 0.5%. EGFR mutations were detected at significantly lower MAFs in patients with brain metastases, suggesting that these patients risk for a false-positive result. Our results support the use of liquid biopsies for noninvasive EGFR testing and highlight the need to systematically report MAFs. Keywords: NGS; circulating free DNA; epidermal growth factor receptor; non-small-cell lung cancer; osimertinib; tyrosine kinase inhibitor

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Utilidad de una técnica antigénica rápida en el diagnóstico de faringoamigdalitis por streptococcus pyogenes

El Streptococcus pyogenes (EGA) es la causa bacteriana más importante de faringoamigdalitis aguda (FA). Las pruebas microbiológicas (test antigénico rápido (TAR) y cultivo) aumentan la fiabilidad diagnóstica. Conocer la sensibilidad de los TAR es fundamental para determinar su perfil en el diagnóstico de la faringoamigdalitis estreptocócica (FAE). La Asociación Española de Pediatría recomienda validar el TAR que se utilice. Se analizó la validez diagnóstica de un TAR, el perfil clínico que genera su mejor rendimiento, la necesidad de confirmar sus resultados con cultivo faríngeo, comparado el uso de antibióticos cuando se usa el test o se hace diagnóstico clínico, determinado la sensibilidad del EGA a penicilina, eritromicina y clindamicina y elaborado un algoritmo diagnóstico para la FA Pacientes y métodos Estudio descriptivo transversal a pacientes de 2-13 años con FA atendidos en 5 consultas, desde Enero de 2008 a Septiembre de 2013. Tras el diagnóstico clínico se realizó frotis faringoamigdalar con 2 hisopos: con el primero se realizó un TAR y con el segundo un cultivo y sensibilidad antibiótica, siendo su análisis ciego al resultado del TAR. Se ha previsto una muestra de 546 personas y muestreo consecutivo. Resultados Se incluyó a 298 pacientes. La prevalencia de FAE fue del 42,3%. La impresión diagnóstica de FA bacteriana y el exantema escarlatiniforme fueron más probables con cultivo positivo. El mejor rendimiento del TAR se obtuvo si la impresión diagnóstica inicial era de FA bacteriana con sensibilidad del 96% y cociente de probablilidad negativo del 0,04. El uso del TAR permitió disminuir un 81% el empleo de antibióticos en las FA no estreptocócicas y tratar un 91,3% de las FAE. El 100% de los cultivos fueron sensibles a la penicilina, 91,9% a eritromicina y 98,4% a clindamicina. Conclusiones El TAR permite un uso más adecuado de antibióticos. Es recomendable su empleo en pediatría de atención primaria, sin confirmación con cultivo cuando el pediatra sospeche una FAE