Preliminary Design for Wave Run-Up in Offshore Wind Farms: Comparison between Theoretical Models and Physical Model Tests

Estimation of wave run-up has been of increasing concern for offshore wind structures and a critical aspect for designers. The highly nonlinear phenomenon makes the study difficult. That is the reason for the very few design rules and experimental data available to estimate it. Actual wave run-up is greater than commonly predicted. The goal of this research is to benchmark the theoretical formulations with the results of the physical model tests performed by Deltares in the field of crest elevation, run-up, forces and pressures. The laboratory reproduced in a wave tank (75 m length; 8.7 m width; 1 m depth; and a 1:60 scale, with Froude similarity) an offshore power converter platform located at intermediate water depths (25–43.80 m) in the Southern North Sea, designed by the Norwegian company Aibel. The purpose of this research is to offer a preliminary design guide for wave run–up using theoretical expressions both for cylinders and gravity based structures (GBS), leaning on the cited laboratory tests to validate the results obtained by such theoretical models.This research was funded by La Caixa PhD Program Fellowship

Inventario y descripción de las soluciones de accesibilidad a la web existentes para personas con discapacidad fisica y sensorial

El elemento más representativo de la nueva sociedad de la información lo constituye sin duda la World Wide Web. La Red, como es conocida popularmente, une a millones de ordenadores en todo el mundo, aportando una riqueza de información inimaginable hace pocos años y un interfaz de uso tan gráfico e intuitivo que ha significado una expansión permanente de su uso a millones de usuarios nuevos cada año. La accesibilidad Web se puede definir como la posibilidad de que un producto o servicio Web sea usado por el mayor número posible de personas, independientemente de las limitaciones del individuo o de las del contexto de uso. De acuerdo con el Tratado de Amsterdam de la Unión Europea, en aplicación de la cláusula de no-discriminación, las políticas europeas y la de los Estados miembros deberían inspirarse en el principio de no-discriminación con vistas a hacer realidad la igualdad para las personas con discapacidad. Este informe tiene como objetivo realizar un inventario de las soluciones, existentes en el mercado, tanto de software como de hardware para poder garantizar esa no discriminación de todas las personas

The case of a southern European glacier disappearing under recent warming that survived Roman and Medieval warm periods

Mountain glaciers have generally experienced an accelerated retreat over the last three decades as a rapid response to current global warming. However, the response to previous warm periods in the Holocene is not well-described for glaciers of the of southern Europe mountain ranges, such as the Pyrenees. The situation during the Medieval Climate Anomaly (900-1300 CE) is particularly relevant since it is not certain whether the glaciers just experienced significant ice loss or whether they actually disappeared. We present here the first chronological study of a glacier located in the Central Pyrenees (N Spain), the Monte Perdido Glacier (MPG), carried out by different radiochronological techniques and their comparison with geochemical proxies with neighboring paleoclimate records. The result of the chronological model proves that the glacier endured during the Roman Period and the Medieval Climate Anomaly. The lack of ice from last 600 years indicates that the ice formed during the Little Ice Age has melted away. The analyses of the content of several metals of anthropogenic origin, such as Zn, Se, Cd, Hg, Pb, appear in low amounts in MPG ice, which further supports our age model in which the record from the industrial period is lost. This study confirms the exceptional warming of the last decades in the context of last two millennia. We demonstrate that we are facing an unprecedented retreat of the 55 Pyrenean glaciers which survival is compromised beyond a few decades

Análisis de Costes y de Coste/Eficacia de las Pautas Recomendadas por GESIDA/Plan Nacional sobre el Sida en 2018 Para el Tratamiento Antirretroviral Inicial en Adultos Infectados Por el VIH

[Background]: The GESIDA/National AIDS Plan expert panel recommended preferred regimens (PR), alternative regimens (AR) and other regimens (OR) for antiretroviral treatment (ART) as initial therapy in HIV-infected patients for 2018. The objective of this study was to evaluate the costs and the efficiency of initiating treatment with PR and AR. [Methods]: Economic assessment of costs and efficiency (cost-effectiveness) based on decision tree analyses. Effectiveness was defined as the probability of reporting a viral load <50 copies/mL at week 48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regimen was defined as the costs of ART and its consequences (adverse effects, changes of ART regimen, and drug-resistance studies) over the first 48 weeks. The payer perspective (National Health System) was applied considering only differential direct costs: ART (official prices), management of adverse effects, studies of resistance, and HLA B*5701 testing. The setting was Spain and the costs correspond to those of 2018. A deterministic sensitivity analysis was conducted, building three scenarios for each regimen: base case, most favourable and least favourable. [Results]: In the base-case scenario, the cost of initiating treatment ranges from 6788 euros for TAF/FTC/RPV (AR) to 10,649 euros for TAF/FTC + RAL (PR). The effectiveness varies from 0.82 for TAF/FTC + DRV/r (AR) to 0.91 for TAF/FTC + DTG (PR). The efficiency, in terms of cost-effectiveness, ranges from 7814 to 12,412 euros per responder at 48 weeks, for ABC/3TC/DTG (PR) and TAF/FTC + RAL (PR), respectively. [Conclusion]: Considering ART official prices, the most efficient regimen was ABC/3TC/DTG (PR), followed by TAF/FTC/RPV (AR) and TAF/FTC/EVG/COBI (AR).[Introducción]: El panel de expertos de GESIDA/Plan Nacional del Sida ha recomendado pautas preferentes (PP), pautas alternativas (PA) y otras pautas (OP) para el tratamiento antirretroviral (TAR) como terapia de inicio en pacientes infectados por VIH para 2018. El objetivo de este estudio es evaluar los costes y la eficiencia de iniciar tratamiento con PP y PA. [Métodos]: Evaluación económica de costes y eficiencia (coste/eficacia) mediante construcción de árboles de decisión. Se definió eficacia como la probabilidad de tener carga viral <50 copias/ml en la semana 48 en análisis por intención de tratar. Se definió coste de iniciar tratamiento con una pauta como los costes del TAR y de todas sus consecuencias (efectos adversos, cambios de pauta y estudio de resistencias) que se producen en las siguientes 48 semanas. Se utilizó la perspectiva del Sistema Nacional de Salud, considerando solo costes directos diferenciales: TAR (a precio oficial), manejo de efectos adversos, estudios de resistencias y determinación de HLA-B*5701. El ámbito es España, con costes de 2018. Se realizó un análisis de sensibilidad determinista construyendo 3 escenarios para cada pauta: basal, más favorable y más desfavorable. [Resultados]: En el escenario basal, los costes de iniciar tratamiento oscilaron entre 6.788 para TAF/FTC/RPV (PA) y 10.649 para TAF/FTC + RAL (PP). La eficacia osciló entre 0,82 para TAF/FTC + DRV/r (PA) y 0,91 para TAF/FTC + DTG (PP). La eficiencia, en términos de coste/eficacia, osciló entre 7.814 y 12.412 por respondedor a las 48 semanas, para ABC/3TC/DTG (PP) y TAF/FTC + RAL (PP), respectivamente. [Conclusión]: Considerando el precio oficial del TAR, la pauta más eficiente fue ABC/3TC/DTG (PP), seguida de TAF/FTC/RPV (PA) y TAF/FTC/EVG/COBI (PA)

High-resolution hepatitis C virus subtyping using NS5B deep sequencing and phylogeny, an alternative to current methods

HepatitisCvirus(HCV)is classified into seven major genotypesand67 subtypes. Recent studies haveshownthat inHCVgenotype 1-infected patients, response rates to regimens containingdirect-acting antivirals(DAAs)are subtype dependent. Currently available genotypingmethods have limited subtyping accuracy.Wehave evaluated theperformanceof adeep-sequencing-basedHCVsubtyping assay, developed for the 454/GS-Junior platform, in comparisonwith thoseof two commercial assays (VersantHCVgenotype 2.0andAbbott Real-timeHCVGenotype II)andusingdirectNS5Bsequencing as a gold standard (direct sequencing), in 114 clinical specimenspreviously tested by first-generation hybridization assay (82 genotype 1and32 with uninterpretable results). Phylogenetic analysis of deep-sequencing reads matched subtype 1 callingbypopulation Sanger sequencing(69%1b,31%1a) in 81 specimensandidentified amixed-subtype infection (1b/3a/1a) in one sample. Similarly,amongthe 32previously indeterminate specimens, identical genotypeandsubtype results were obtained by directanddeep sequencing in all but four samples with dual infection. In contrast, both VersantHCVGenotype 2.0andAbbott Real-timeHCVGenotype II failed subtype 1 calling in 13 (16%) samples eachandwere unable to identify theHCVgenotype and/or subtype inmore than half of the nongenotype 1 samples.Weconcluded that deep sequencing ismore efficient forHCVsubtyping than currently available methodsandallows qualitative identificationofmixed infectionsandmay bemorehelpfulwith respect to informing treatment strategies withnewDAA-containing regimens across allHCVsubtypesThis study has been supported by CDTI (Centro para el Desarrollo Tecnológico Industrial), Spanish Ministry of Economics and Competitiveness (MINECO), IDI-20110115; MINECO projects SAF 2009-10403; and also by the Spanish Ministry of Health, Instituto de Salud Carlos III (FIS) projects PI10/01505, PI12/01893, and PI13/00456. CIBERehd is funded by the Instituto de Salud Carlos III, Madrid, Spain. Work at CBMSO was supported by grant MINECO-BFU2011-23604, FIPSE, and Fundación Ramón Areces. X. Forns received unrestricted grant support from Roche and has acted as advisor for MSD, Gilead, and Abbvie. M. Alvarez-Tejado, J. Gregori, and J. M. Muñoz work in Roche Diagnostic

Comprehensive approach to people with type 2 diabetes. Diabetes Knowledge Area of the Spanish Society of Endocrinology and Nutrition

[ES] Objetivo: Proporcionar recomendaciones prácticas para el abordaje integral de las personas con diabetes tipo 2 según la medicina basada en la evidencia. Participantes: Miembros del Área de Conocimiento de Diabetes de la Sociedad Española de Endocrinología y Nutrición. Métodos: Las recomendaciones se formularon según los grados de evidencia de los Standards of Medical Care in Diabetes—2022. Tras la revisión de la evidencia disponible y la formulación de recomendaciones por los autores de cada apartado, se desarrollaron varias rondas de comentarios con incorporación de las aportaciones y votación de los puntos controvertidos. Por último, el documento final se remitió al resto de los miembros del área para revisión e incorporación de aportaciones, para, finalmente, realizar el mismo proceso con los miembros de la Junta Directiva de la Sociedad Española de Endocrinología y Nutrición. Conclusiones: El documento establece unas recomendaciones prácticas basadas en la última evidencia disponible para el manejo de las personas con diabetes tipo 2.[EN] Objective. To provide practical recommendations for the comprehensive approach of people with type 2 diabetes according to evidence-based medicine. Participants. Members of the Diabetes Knowledge Area of the Spanish Society of Endocrinology and Nutrition. Methods. The recommendations were formulated according to the degrees of evidence of the Standards of Medical Care in Diabetes—2022. After reviewing the available evidence and formulating recommendations by the authors of each section, several rounds of comments were developed incorporating the contributions and voting on controversial points. Finally, the final document was sent to the rest of the members of the area for review and incorporation of contributions, to finally carry out the same process with the members of the Spanish Society of Endocrinology and Nutrition Board of Directors. Conclusions. The document establishes practical recommendations based on the latest available evidence for the management of people with type 2 diabetes.Peer reviewe

Plasma ACE2 species are differentially altered in COVID-19 patients

Studies are needed to identify useful biomarkers to assess the severity and prognosis of COVID-19 disease, caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) virus. Here, we examine the levels of various plasma species of the SARS-CoV-2 host receptor, the angiotensin-converting enzyme 2 (ACE2), in patients at different phases of the infection. Human plasma ACE2 species were characterized by immunoprecipitation and western blotting employing antibodies against the ectodomain and the C-terminal domain, using a recombinant human ACE2 protein as control. In addition, changes in the cleaved and full-length ACE2 species were also examined in serum samples derived from humanized K18-hACE2 mice challenged with a lethal dose of SARS-CoV-2. ACE2 immunoreactivity was present in human plasma as several molecular mass species that probably comprise truncated (70 and 75 kDa) and full-length forms (95, 100, 130, and 170 kDa). COVID-19 patients in the acute phase of infection (n = 46) had significantly decreased levels of ACE2 full-length species, while a truncated 70-kDa form was marginally higher compared with non-disease controls (n = 26). Levels of ACE2 full-length species were in the normal range in patients after a recovery period with an interval of 58-70 days (n = 29), while the 70-kDa species decreased. Levels of the truncated ACE2 species served to discriminate between individuals infected by SARS-CoV-2 and those infected with influenza A virus (n = 17). In conclusion, specific plasma ACE2 species are altered in patients with COVID-19 and these changes normalize during the recovery phase. Alterations in ACE2 species following SARS-CoV-2 infection warrant further investigation regarding their potential usefulness as biomarkers for the disease process and to asses efficacy during vaccination.This study was funded in part by the Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL; grants 190258 and 2020-0308) and by the Instituto de Salud Carlos III (ISCIII, grants PI19-01359), co-financed by the Fondo Europeo de Desarrollo Regional (FEDER, “Investing in your future”) and through CIBERNED, ISCIII. We also acknowledge financial support from the Spanish Ministerio de Economía y Competitividad, through the “Severo Ochoa” Programme for Centres of Excellence in R&D (SEV-2017-0723). Work at CNB and CISA is funded by the Spanish Health Ministry, ISCIII, Fondo COVID-19 grant COV20/00151, and Fondo Supera COVID-19 (Crue Universidades-Banco Santander) (to JGA). MACG is supported by BEFPI fellowship from the Generalitat Valenciana. HZ is a Wallenberg Scholar supported by grants from the Swedish Research Council (#2018-02532), the European Research Council (#681712), and Swedish State Support for Clinical Research (#ALFGBG-720931).Peer reviewe

Al margen. Reflexiones en torno a la imagen

Colección de textos de investigación en torno a la imagen fija y la imagen en movimiento

Impacto de la pandemia de COVID en la salud mental de la población general y de los trabajadores sanitarios.

La pandemia de COVID-19 cumplirá próximamente 3 años de evolución con consecuencias catastróficas y bien conocidas en la salud física y la mortalidad de los habitantes del planeta. Sus consecuencias sobre la salud mental han sido igualmente enormes y su análisis se ha llevado a cabo en momentos distintos de la pandemia y con enfoques lógicamente parciales. Por otro lado, las condiciones para alterar la salud mental de los individuos y de los grupos que la pandemia ha supuesto han sido diferentes en distintos lugares. El patronato de la Fundación de Ciencias de la Salud se planteó, en su momento, una serie de preguntas sobre las consecuencias sobre la salud mental de la pandemia de COVID-19 tanto en la población general, con o sin buena salud mental previa, como sobre el colectivo de trabajadores sanitarios. Muy particularmente, preocupaban esas consecuencias en la población española. Por ello, se reunió a una serie de expertos en distintas materias relacionadas con el tema que han tratado de ir dando respuesta a dichas preguntas a la luz de la evidencia científica y de su propia opinión y experiencia. Tras la exposición del tema, en cada una de las preguntas y con la discusión de todo el grupo, se llegó a una conclusión de consenso que trataba de resumir el estado del arte sobre el tema. El documento que sigue a continuación es el resultado de ese proceso. Todos los autores han revisado el manuscrito final y han dado su aprobación al mismo. El documento está dividido en una primera parte que evalúa el impacto de la pandemia en la salud mental de la población general y una segunda sobre su impacto en los sanitarios