La libertad que existe. Bioética internacional durante el estado de emergencia por covid–19

A través de la revisión de 40 de las 51 guías bioéticas de 28 países publicadas por la Organización Mundial de la Salud en sus contenidos sobre covid–19 en el primer semestre de 2020, se hace una reflexión crítica del accionar ético de tres gobiernos durante el estado de emergencia sanitario: el alemán, el inglés y el jalisciense, para después realizar una valoración de los aportes normativos de estas guías y plantear líneas de reflexión para la deliberación médica, política, jurídica y bioética, útiles en posibles estados de emergencia futuros.ITESO, A.C

Fuzzy PD+I Embedded Control System for a Multi-Phase DC-DC Bidirectional Converter

[EN] In this work is presented the design of a Fuzzy PD+I control system applied to the voltage control of a multi-phase DC-DC power electronic converter. The fuzzy controller has two inputs. The first input, named Error, is the difference between the desired voltage value in the output of the converter and the measured voltage at this particular point; the second input is defined by the changes in the measured voltage of the converter. The control system is embedded in the NI myRIO-1900 development kit, using LabVIEW as programming software employing the embedded system for experimental tests with a prototype of the converter. This control system allows the stabilization of the converter in the buck and boost operation modes, showing an appropriate behavior at the startup and under resistive load changes, presenting acceptable times for DC microgrids future applications while connecting the DC bus with supercapacitors or a battery bank.[ES] En este trabajo se presenta el diseño de un sistema de control difuso PD+I embebido aplicado en el control de voltaje de un convertidor electrónico de potencia bidireccional multi-fase CD-CD. El controlador difuso cuenta con dos entradas, la primera se le denomina Error y es la diferencia entre el valor de voltaje deseado en la salida del convertidor y el voltaje medido en la salida del mismo; la segunda entrada es definida por las variaciones en el voltaje medido. La salida del controlador difuso define las variaciones en el ciclo de trabajo de los interruptores de potencia que controlan el convertidor. El sistema de control difuso se embebió en la tarjeta de desarrollo NI myRIO-1900 utilizando como software de programación LabVIEW, empleando el sistema embebido para realizar pruebas experimentales con el prototipo del convertidor. Con este sistema de control de voltaje se logra estabilizar el convertidor en los modos de operación reductor y elevador, demostrando un adecuado comportamiento del convertidor en el arranque y ante cambios de carga resistiva, manteniendo tiempos aceptables para aplicaciones futuras en micro-redes de CD conectando el bus de CD con un banco de super-capacitores o un banco de baterías.Martínez Nolasco, JJ.; Rodríguez, E.; Rodríguez, H.; Morfin, J.; Padilla, A. (2018). Fuzzy PD+I Embedded Control System for a Multi-Phase DC-DC Bidirectional Converter. Revista Iberoamericana de Automática e Informática industrial. 15(4):457-466. https://doi.org/10.4995/riai.2018.8721OJS457466154Baek J. B., Choi, W. I., Cho, B. H., 2013. Digital adaptive frequency modulation for bidirectional DC-DC converter. IEEE Transactions on Industrial Electronics, 60(11), 5167-5176. DOI: 10.1109/TIE.2012.2224075Bolognani S., Morandin M., Calligaro S., Petrella R., Pevere A., 2014. Bidirectional PMSM drive employing a three level ANPC inverter and a multi-phase interleaved DC/DC converter for hybrid electric vehicles. Twenty-Ninth Annual IEEE in Applied Power Electronics Conference and Exposition (APEC), IEEE, 818-825. DOI: 10.1109/APEC.2014.6803402Brox M., Sánchez S., del Toro E., Brox P., Moreno F. J., 2013. CAD tools for hardware implementation of embedded fuzzy systems on FPGAs. IEEE Transactions on Industrial Informatics, 9(3), 1635-1644. DOI: 10.1109/TII.2012.2228871Burrett R., Clini C., Dixon R., Eckhart M., El-Ashry M., Gupta D., Houssin D., 2009. Renewable Energy Policy Network for the 21st Century.Dusmez S., Hasanzadeh A., Khaligh A., 2015. Comparative analysis of bidirectional three-level DC-DC converter for automotive applications. IEEE Transactions on Industrial Electronics, 62(5), 3305-3315. DOI: 10.1109/TIE.2014.2336605Hart D., 2011. Power Electronics, 1ra ed., McGraw-Hill, New York. 198-220.Hegazy O., Van Mierlo J., Lataire P., 2011. Design and control of bidirectional DC/AC and DC/DC converters for plug-in hybrid electric vehicles. International Conference in Power Engineering, Energy and Electrical Drives (POWERENG), IEEE, 1-7. DOI: 10.1109/PowerEng.2011.6036530Hossain M. I., Khan S. A., Shafiullah M., Hossain M. J. 2011. Design and implementation of MPPT controlled grid connected photovoltaic system. Symposium in Computers & Informatics (ISCI), IEEE, 284-289. DOI: 10.1109/ISCI.2011.5958928Khan S. A., Hossain M. I., 2010. Design and implementation of microcontroller based fuzzy logic control for maximum power point tracking of a photovoltaic system. International Conference in Electrical and Computer Engineering (ICECE), IEEE, 322-325. DOI: 10.1109/ICELCE.2010.5700693Kumar A., Gaur P., 2014. Bidirectional DC/DC converter for hybrid electric vehicle. International Conference in Advances in Computing, Communications and Informatics (ICACCI), IEEE, 839-843. DOI: 10.1109/ICACCI.2014.6968295Lee S. Y., Pfaelzer A. G., van Wyk, J. D., 2004. Thermal analysis for improved packaging of 4-channel 42 V/14 V DC/DC converter. 39th IAS Annual Meeting in Industry Applications Conference Vol. 4, IEEE, 2330-2336. DOI: 10.1109/IAS.2004.1348800Lee S. Y., Pfaelzer A. G., van Wyk J. D., 2007. Comparison of different designs of a 42-V/14-V dc/dc converter regarding losses and thermal aspects. IEEE Transactions on Industry Applications, 43(2), 520-530. DOI: 10.1109/TIA.2006.889808Liu D., Hu A., Wang G., Hu W., 2010. Current sharing schemes for multiphase interleaved DC/DC converter with FPGA implementation. International Conference in Electrical and Control Engineering (ICECE), IEEE, 3512-3515. DOI: 10.1109/iCECE.2010.854Markvart T., 2006. Microgrids: Power systems for the 21st century. Refocus, 7(4), 44-48.Martínez, J. J., Padilla-Medina, J. A., Cano-Andrade, S., Sancen, A., Prado, J., & Barranco, A. I. (2018). Development and Application of a Fuzzy Control System for a Lead-Acid Battery Bank Connected to a DC Microgrid. International Journal of Photoenergy, 2018.Omara A. M., Sleptsov M. A., 2016. Comparative study of different electric propulsion system configurations based on IPMSM drive for battery electric vehicles. International Conference in Electrical Machines and Systems (ICEMS), IEEE, 1-6.Sánchez S., Cabrera A., Baturone M. I., Moreno F. J., Brox M., 2007. FPGA implementation of embedded fuzzy controllers for robotic applications. IEEE Transactions on Industrial Electronics, 54(4), 1937-1945. DOI: http://dx.doi.org/10.1109/TIE.2007.898292Santos M., 2011. Un enfoque aplicado del control inteligente. Revista Iberoamericana de Automática e Informática Industrial RIAI, 8(4), 283-296. DOI: 10.1016/j.riai.2011.09.016Sikkabut S., Mungporn P., Ekkaravarodome C., Bizon N., Tricoli P., Nahid-Mobarakeh B., Thounthong P., 2016. Control of High-Energy High-Power Densities Storage Devices by Li-ion Battery and Supercapacitor for Fuel Cell/Photovoltaic Hybrid Power Plant for Autonomous System Applications. IEEE Transactions on Industry Applications, 52(5), 4395-4407. DOI: 10.1109/TIA.2016.2581138Thao N. G. M., Dat M. T., Binh T. C., Phuc N. H., 2010. PID-fuzzy logic hybrid controller for grid-connected photovoltaic inverters. International Forum in Strategic Technology (IFOST), IEEE, 140-144. DOI: 10.1109/IFOST.2010.5668024Vanti V. M., Leite L. C., Batista E. A., 2015. Monitoring and control of the processes involved in the capture and filtering of biogas using FPGA embedded fuzzy logic. IEEE Latin America Transactions, 13(7), 2232-2238. DOI: 10.1109/TLA.2015.7273782Yang Y., Li T., Liu J., Li H., 2012. A comprehensive analysis of coupled inductors in 4 phases interleaving bidirectional DC/DC converter. International Symposium in Power Electronics for Distributed Generation Systems (PEDG), IEEE, 603-607. DOI: 10.1109/PEDG.2012.6254064Yang Y., Ma J., Ma Y., Zou Y., 2014. The universal design criterion of coupled inductor in multiphase interleaving and magnetically integrated bidirectional DC/DC converter. Conference and Exposition International in Power Electronics and Application, IEEE, 1008-1013. DOI: 10.1109/PEAC.2014.7037998Yang Y., Dai S., 2015. Design criterion for asymmetric coupled inductors in interleaving & magnetically integrated bidirectional DC/DC converter. 2nd Conference International in Future Energy Electronics, IEEE, 1-11. DOI: 10.1109/IFEEC.2015.7361443Yu, B. (2016). Design and experimental results of battery charging system for microgrid system. International Journal of Photoenergy, 2016

Prediction of onset of acute kidney injury after cardiovascular surgery at the intensive care unit of Hospital San Ignacio

Objetivo: identificar pacientes de alto riesgo de presentar injuria renal aguda en el posoperatorio de cirugía cardiovascular en la unidad de cuidados intensivos del Hospital Universitario San Ignacio. Contexto y tipo de estudio: la población de referencia estuvo conformada por aquellos pacientes atendidos en el Hospital San Ignacio de la ciudad de Bogotá, institución de IV nivel de complejidad, con una población estudio conformada por aquellos pacientes que ingresaron a la unidad de cuidados intensivos en posoperatorio inmediato de cirugía cardiovascular. Material y métodos: estudio observacional descriptivo, retrospectivo, tipo serie de casos. La información fue recolectada por los investigadores a partir de la revisión de las historias clínicas, es decir, a partir de una fuente secundaria. Dicha recolección se realizó teniendo en cuenta un formulario diseñado para ese fin, el cual incluye datos generales y datos de las variables de la escala de predicción, registrando los datos generales de cada uno de los pacientes, incluyendo antecedentes personales y las variables de la escala de predicción. Durante la recolección de información se fue conformando la base de datos, la cual fue debidamente revisada y depurada, y posteriormente analizada utilizando el programa Epi Info 2000. Resultados: se analizaron 213 pacientes que ingresaron a la unidad de cuidado intensivo del Hospital Universitario San Ignacio en el posoperatorio inmediato de CVC. Entre los pacientes analizados la incidencia de IRA fue 3.3% (n=7) los cuales fueron sometidos a TRR. Estos pacientes tuvieron una creatinina posterior al procedimiento significativamente más alta (p=0.000). Entre los pacientes que requirieron TRR se encontró una proporción significativamente mayor de casos con una FEVI menor a 40% (71.4% vs 14.1%). Otra diferencia significativa fue el porcentaje de pacientes en quienes se utilizó el balón intraaórtico, el cual fue mucho mayor entre los pacientes que recibieron TRR (p=0.000). En cuanto a la relación entre la IRA y los procedimientos realizados a los pacientes se evidenció una mayor proporción de casos manejados con CEC dentro del grupo de pacientes que requirieron TRR; así mismo, la proporción de pacientes a quienes se les colocó balón intraaórtico fue significativamente mayor (p=0.000). Al aplicar la escala de riesgo en los pacientes analizados se evidenció que existían cuatro pacientes con alto riesgo de IRA cuyo puntaje fue mayor a cuatro. De estos pacientes solamente dos (50%) terminaron en TRR. Conclusiones: la aparición de lesión renal aguda en pacientes que son llevados a cirugía cardiovascular se ha demostrado como factor independiente de mortalidad en los pacientes en las unidades de cuidado intensivo. Los modelos predictivos para determinar la aparición de IRA en el posoperatorio de CVC han facilitado la toma de decisiones y la evaluación y estratificación del riesgo, abriendo la posibilidad de realizar intervenciones más tempranas y efectivas en pro de la recuperación, disminución de complicaciones y descenso de la morbimortalidad en estos pacientesArtículo original166-174Objective: to identify patients at high risk for acute kidney injury in postoperative cardiovascular Objective: To identify patients at high risk for acute kidney injury in postoperative cardiovascular surgery in the Intensive Care Unit of Hospital Universitario San Ignacio. Context and type of study: the reference population consisted of patients treated at the Hospital San Ignacio de Bogotá, institution of IV level of complexity, with a study population comprised patients admitted to the intensive care unit in the immediate postoperative period of cardiac surgery. Materials and Methods: descriptive observational study, retrospective case series. The information was gathered by researchers from the review of medical records, that is from a secondary source. This collection is made based on a form designed for that purpose, which includes general information and data variables in the prediction, recording the general data of each patient, including personal background variables and scale prediction. During the collection of information was forming the database, which was duly revised and refined, and then analyzed using Epi Info 2000. Results: we analyzed 213 patients admitted to the Intensive Care Unit, Hospital Universitario San Ignacio in the immediate postoperative period CVC. Among the patients analyzed the incidence of ARF was 3.3% (n = 7) which were subjected to TRR. These patients had post-procedure creatinine was significantly higher (p = 0.000). Among patients requiring RRT found a significantly higher proportion of patients with an LVEF less than 40% (71.4% vs 14.1%). Another significant difference was the percentage of patients in whom intra-aortic balloon was used, which was much higher among patients who received RRT (p = 0.000). As for the relationship between the IRA and the procedures performed on patients showed a higher proportion of cases managed with CPB in the group of patients requiring RRT, likewise, the proportion of patients who were placed intra-aortic balloon was significantly higher (p = 0.000). In applying the risk score in patients analyzed showed that there were 4 patients with high risk of IRA whose score was greater than 4. Of these patients only 2 (50%) ended in TRR. Conclusions: the occurrence of acute kidney injury in patients who are taking cardiovascular surgery has been shown as independent risk factor for mortality in patients in intensive care units. Predictive models to determine the occurrence of ARF in pediatric CVC has facilitated decision making and evaluation and risk stratification, opening the possibility of early and effective interventions towards recovery, decreased complications and decreased morbidity and mortality in these patient

The PAU survey: classifying low-z SEDs using Machine Learning clustering

This is a pre-copyedited, author-produced PDF of an article accepted for publication in Monthly Notices of the Royal Astronomical Society following peer review. The version of record Monthly Notices of the Royal Astronomical Society 524.3 (2023): 3569-3581 is available online at: https://academic.oup.com/mnras/article-abstract/524/3/3569/7225529?redirectedFrom=fulltextWe present an application of unsupervised Machine Learning clustering to the PAU survey of galaxy spectral energy distribution (SED) within the COSMOS field. The clustering algorithm is implemented and optimized to get the relevant groups in the data SEDs. We find 12 groups from a total number of 5234 targets in the survey at 0.01 < z < 0.28. Among the groups, 3545 galaxies (68 per cent) show emission lines in the SEDs. These groups also include 1689 old galaxies with no active star formation. We have fitted the SED to every single galaxy in each group with CIGALE. The mass, age, and specific star formation rates (sSFR) of the galaxies range from 0.15 < age/Gyr <11; 6 < log (M/M⊙) <11.26, and -14.67 < log (sSFR/yr-1) <-8. The groups are well-defined in their properties with galaxies having clear emission lines also having lower mass, are younger and have higher sSFR than those with elliptical like patterns. The characteristic values of galaxies showing clear emission lines are in agreement with the literature for starburst galaxies in COSMOS and GOODS-N fields at low redshift. The star-forming main sequence, sSFR versus stellar mass and UVJ diagram show clearly that different groups fall into different regions with some overlap among groups. Our main result is that the joint of low- resolution (R ∼50) photometric spectra provided by the PAU survey together with the unsupervised classification provides an excellent way to classify galaxies. Moreover, it helps to find and extend the analysis of extreme ELGs to lower masses and lower SFRs in the local UniverseThis work has been supported by the Ministry of Science and Innovation of Spain, project PID2019-107408GB-C43 (ESTALLIDOS), and the Government of the Canary Islands through EU FEDER funding, projects PID2020010050 and PID2021010077. This article is based on observations made in the Observatorios de Canarias of the Instituto de Astrofísica de Canarias (IAC) with the WHT operated on the island of La Palma by the Isaac Newton Group of Telescopes (ING) in the Observatorio del Roque de los Muchachos. The PAU Survey is partially supported by MINECO under grants CSD2007-00060, AYA2015-71825, ESP2017-89838, PGC2018-094773, PGC2018-102021, PID2019-111317GB, SEV-2016-0588, SEV-2016-0597, MDM-2015-0509 and Juan de la Cierva fellowship and LACEGAL and EWC Marie Sklodowska-Curie grant No 734374 and no.776247 with ERDF funds from the EU Horizon 2020 Programme, some of which include ERDF funds from the European Union. IEEC and IFAE are partially funded by the CERCA and Beatriu de Pinos program of the Generalitat de Catalunya. Funding for PAUS has also been provided by Durham Univer sity (via the ERC StG DEGAS-259586), ETH Zurich, Leiden University (via ERC StG ADULT-279396 and Netherlands Organisation for Scientific Research (NWO) Vici grant 639.043.512), University College London and from the European Union’s Horizon 2020 research and innovation programme under the grant agreement No 776247 EWC. The PAU data center is hosted by the Port d’Información Científica (PIC), maintained through a collaboration of CIEMAT and IFAE, with additional support from Universitat Autónoma de Barcelona and ERDF. We acknowledge the PIC services department team for their support and fruitful discussion

In vivo cholinergic basal forebrain degeneration and cognition in Parkinson's disease: Imaging results from the COPPADIS study

COPPADIS Study Group.[Introduction] We aimed to assess associations between multimodal neuroimaging measures of cholinergic basal forebrain (CBF) integrity and cognition in Parkinson's disease (PD) without dementia.[Methods] The study included a total of 180 non-demented PD patients and 45 healthy controls, who underwent structural MRI acquisitions and standardized neurocognitive assessment through the PD-Cognitive Rating Scale (PD-CRS) within the multicentric COPPADIS-2015 study. A subset of 73 patients also had Diffusion Tensor Imaging (DTI) acquisitions. Volumetric and microstructural (mean diffusivity, MD) indices of CBF degeneration were automatically extracted using a stereotactic CBF atlas. For comparison, we also assessed multimodal indices of hippocampal degeneration. Associations between imaging measures and cognitive performance were assessed using linear models.[Results] Compared to controls, CBF volume was not significantly reduced in PD patients as a group. However, across PD patients lower CBF volume was significantly associated with lower global cognition (PD-CRStotal: r = 0.37, p < 0.001), and this association remained significant after controlling for several potential confounding variables (p = 0.004). Analysis of individual item scores showed that this association spanned executive and memory domains. No analogue cognition associations were observed for CBF MD. In covariate-controlled models, hippocampal volume was not associated with cognition in PD, but there was a significant association for hippocampal MD (p = 0.02).[Conclusions] Early cognitive deficits in PD without dementia are more closely related to structural MRI measures of CBF degeneration than hippocampal degeneration. In our multicentric imaging acquisitions, DTI-based diffusion measures in the CBF were inferior to standard volumetric assessments for capturing cognition-relevant changes in non-demented PD.This work was supported by the Alzheimer Forschung Initiative e.V. (AFI International Training Grant to MJG), the Instituto de Salud Carlos III-Fondo Europeo de Desarrollo Regional (ISCIII-FEDER) [PI14/01823, PI16/01575, PI18/01898, PI19/01576, PI20/00613], the Consejería de Economía, Innovación, Ciencia y Empleo de la Junta de Andalucía [CVI-02526, CTS-7685], the Consejería de Salud y Bienestar Social de la Junta de Andalucía [PI-0471-2013, PE-0210-2018, PI-0459-2018, PE-0186-2019], the Fundación Alicia Koplowitz and the Fundación “Curemos el Parkinson” (https://www.curemoselparkinson.org). MJG is supported by the “Miguel Servet” program [CP19/00031], MALE by the University of Seville [USE-20046-J], JFM by the “Sara Borrell” program [CD13/00229] and VI-PPIT-US from the University of Seville [USE-18817-A], SJ by the “Acción B-Clínicos-Investigadores” program [B-0007-2019], and DMG by the “Río Hortega” program [CM18/00142].Peer reviewe

In vivo cholinergic basal forebrain degeneration and cognition in Parkinson's disease: Imaging results from the COPPADIS study

Introduction: We aimed to assess associations between multimodal neuroimaging measures of cholinergic basal forebrain (CBF) integrity and cognition in Parkinson’s disease (PD) without dementia. Methods: The study included a total of 180 non-demented PD patients and 45 healthy controls, who underwent structural MRI acquisitions and standardized neurocognitive assessment through the PD-Cognitive Rating Scale (PD-CRS) within the multicentric COPPADIS-2015 study. A subset of 73 patients also had Diffusion Tensor Imaging (DTI) acquisitions. Volumetric and microstructural (mean diffusivity, MD) indices of CBF degeneration were automatically extracted using a stereotactic CBF atlas. For comparison, we also assessed multimodal indices of hippocampal degeneration. Associations between imaging measures and cognitive performance were assessed using linear models. Results: Compared to controls, CBF volume was not significantly reduced in PD patients as a group. However, across PD patients lower CBF volume was significantly associated with lower global cognition (PD-CRStotal: r =0.37, p <0.001), and this association remained significant after controlling for several potential confounding variables (p =0.004). Analysis of individual item scores showed that this association spanned executive and memory domains. No analogue cognition associations were observed for CBF MD. In covariate-controlled models, hippocampal volume was not associated with cognition in PD, but there was a significant association for hippocampal MD (p =0.02). Conclusions: Early cognitive deficits in PD without dementia are more closely related to structural MRI measures of CBF degeneration than hippocampal degeneration. In our multicentric imaging acquisitions, DTI-based diffusion measures in the CBF were inferior to standard volumetric assessments for capturing cognition- relevant changes in non-demented PD

Shortened Version of the Token Test: Normative data for Spanish-speaking pediatric population

OBJECTIVE: To generate normative data for the Shortened Version of the Token Test in Spanish-speaking pediatric populations. METHOD: The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the Shortened Version of the Token Test as part of a larger neuropsychological battery. Shortened Version of the Token Test total scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. RESULTS: The final multiple linear regression models showed main effects for age in all countries, such that score increased linearly as a function of age. In addition, age2 had a significant effect in all countries, except Guatemala and Puerto Rico. Models showed that children whose parent(s) had a MLPE >12 years obtained higher score compared to children whose parents had a MLPE ≤12 years in Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, Puerto Rico, and Spain. The child’s sex did not have an effect in the Shortened Version of the Token Test total score for any of the countries. CONCLUSIONS: This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate interpretation of the Shortened Version of the Token Test when used in pediatric populations

Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019

Altres ajuts: Spanish AIDS Research Network; European Funding for Regional Development (FEDER).Objectives: We assessed the prevalence of anti-hepatitis C virus (HCV) antibodies and active HCV infection (HCV-RNA-positive) in people living with HIV (PLWH) in Spain in 2019 and compared the results with those of four similar studies performed during 2015-2018. Methods: The study was performed in 41 centres. Sample size was estimated for an accuracy of 1%. Patients were selected by random sampling with proportional allocation. Results: The reference population comprised 41 973 PLWH, and the sample size was 1325. HCV serostatus was known in 1316 PLWH (99.3%), of whom 376 (28.6%) were HCV antibody (Ab)-positive (78.7% were prior injection drug users); 29 were HCV-RNA-positive (2.2%). Of the 29 HCV-RNA-positive PLWH, infection was chronic in 24, it was acute/recent in one, and it was of unknown duration in four. Cirrhosis was present in 71 (5.4%) PLWH overall, three (10.3%) HCV-RNA-positive patients and 68 (23.4%) of those who cleared HCV after anti-HCV therapy (p = 0.04). The prevalence of anti-HCV antibodies decreased steadily from 37.7% in 2015 to 28.6% in 2019 (p < 0.001); the prevalence of active HCV infection decreased from 22.1% in 2015 to 2.2% in 2019 (p < 0.001). Uptake of anti-HCV treatment increased from 53.9% in 2015 to 95.0% in 2019 (p < 0.001). Conclusions: In Spain, the prevalence of active HCV infection among PLWH at the end of 2019 was 2.2%, i.e. 90.0% lower than in 2015. Increased exposure to DAAs was probably the main reason for this sharp reduction. Despite the high coverage of treatment with direct-acting antiviral agents, HCV-related cirrhosis remains significant in this population

Assessing Outcomes of Patients Subject to Intensive Care to Facilitate Organ Donation: A Spanish Multicenter Prospective Study

Intensive Care to facilitate Organ Donation (ICOD) consists of the initiation or continuation of intensive care measures in patients with a devastating brain injury (DBI) in whom curative treatment is deemed futile and death by neurological criteria (DNC) is foreseen, to incorporate organ donation into their end-of-life plans. In this study we evaluate the outcomes of patients subject to ICOD and identify radiological and clinical factors associated with progression to DNC. In this first prospective multicenter study we tested by multivariate regression the association of clinical and radiological severity features with progression to DNC. Of the 194 patients, 144 (74.2%) patients fulfilled DNC after a median of 25 h (95% IQR: 17–44) from ICOD onset. Two patients (1%) shifted from ICOD to curative treatment, both were alive at discharge. Factors associated with progression to DNC included: age below 70 years, clinical score consistent with severe brain injury, instability, intracranial hemorrhage, midline shift ≥5 mm and certain types of brain herniation. Overall 151 (77.8%) patients progressed to organ donation. Based on these results, we conclude that ICOD is a beneficial and efficient practice that can contribute to the pool of deceased donors

The European Solar Telescope

The European Solar Telescope (EST) is a project aimed at studying the magnetic connectivity of the solar atmosphere, from the deep photosphere to the upper chromosphere. Its design combines the knowledge and expertise gathered by the European solar physics community during the construction and operation of state-of-the-art solar telescopes operating in visible and near-infrared wavelengths: the Swedish 1m Solar Telescope, the German Vacuum Tower Telescope and GREGOR, the French Télescope Héliographique pour l'Étude du Magnétisme et des Instabilités Solaires, and the Dutch Open Telescope. With its 4.2 m primary mirror and an open configuration, EST will become the most powerful European ground-based facility to study the Sun in the coming decades in the visible and near-infrared bands. EST uses the most innovative technological advances: the first adaptive secondary mirror ever used in a solar telescope, a complex multi-conjugate adaptive optics with deformable mirrors that form part of the optical design in a natural way, a polarimetrically compensated telescope design that eliminates the complex temporal variation and wavelength dependence of the telescope Mueller matrix, and an instrument suite containing several (etalon-based) tunable imaging spectropolarimeters and several integral field unit spectropolarimeters. This publication summarises some fundamental science questions that can be addressed with the telescope, together with a complete description of its major subsystems