Calculation and design of an energy efficient and self-sustaining building in Cantabria

Máster en Ingeniería Industria

Cardiac Hepatopathy

Liver disease resulting from heart disease has generally been referred as “cardiac hepatopathy.” The two main forms of cardiac hepatopathy are acute cardiogenic liver injury (ACLI) and congestive hepatopathy (CH). ACLI most commonly occurs in the setting of acute cardiocirculatory failure, whereas CH results from passive venous congestion in the setting of chronic right-sided heart failure (HF). Both conditions often coexist and potentiate the deleterious effects of each other on the liver. In CH, the chronic passive congestion leads to sinusoidal hypertension, centrilobular fibrosis, and ultimately, cirrhosis (“cardiac cirrhosis”) and hepatocellular carcinoma. The differentiation between congestion and fibrosis currently represents an unmet need and a growing research area. Although cardiac cirrhosis may only arise after several decades of ongoing injury, the long-term survival of cardiac patients due to advances in medical and surgical treatments is responsible for the increased number of liver complications in this setting. Eventually, the liver disease could become as clinically relevant as the cardiac disease and further complicate its management

Experiencias de análisis territorial y zonificación para la integración del desarrollo, el patrimonio y el paisaje en la ordenación del territorio

We present a series of experiences of territorial analysis for zoning in the context of regional planning. They are based on a methodology that allows the integration of all territorial values and provides an adequate basis for the development of proposals for action in environmental, cultural, economic, social and landscape matters. Appropriate to meet the new legislative and social requirements of regional planning, this methodology is based on the decomposition of space into small territorial units that, taken as a whole, help to understand the behaviour of society with respect to its physical space or living environment and, individually, facilitate the analysis of the characteristics and values of the different parts of the territory.This reflection on regional planning aims to contribute to the renewal of a discipline that, nowadays, should be able to expand its scope overcoming the single-centered approaches (spatial planning, regional development planning, land administration and sectorial policies) and developing new integrative methodologies that facilitate decision making to protect, regulate and manage the heritage values of the territory and landscape, thereby contributing to sustainable development and definition of territorial governance models.Se presenta una serie de experiencias de análisis territorial para la zonificación en el marco de la ordenación del territorio. Están basadas en una metodología que permite la integración del conjunto de los valores del territorio y proporciona una base adecuada para el desarrollo de propuestas de actuación en materia ambiental, cultural, económica, social y paisajística. Apropiada para dar respuesta a las nuevas exigencias legislativas y sociales de la ordenación del territorio, esta metodología se basa en la descomposición del espacio en pequeñas unidades territoriales que, agrupadas, permiten explicar los modelos de comportamiento de la sociedad respecto a su espacio físico o entorno de vida, y que, individualmente, facilitan el análisis de las características y valores de las diversas partes del territorio.Esta reflexión sobre la ordenación del territorio pretende contribuir a la renovación de una disciplina que debe ser capaz de ampliar su campo de acción superando las perspectivas centradas en un único planteamiento (planificación espacial, planificación del desarrollo regional, administración del territorio y políticas sectoriales) y construir nuevas metodologías integradoras que faciliten la toma de decisiones destinadas a proteger, ordenar y gestionar los valores patrimoniales del territorio y el paisaje contribuyendo con ello al desarrollo sostenible y a la definición de modelos de gobernanza territorial

Experiences of territorial analysis and zoning in order to integrate the development, heritage and landscape policies in land planning

RESUMEN: Se presenta una serie de experiencias de análisis territorial para la zonificación en el marco de la ordenación del territorio. Están basadas en una metodología que permite la integración del conjunto de los valores del territorio y proporciona una base adecuada para el desarrollo de propuestas de actuación en materia ambiental, cultural, económica, social y paisajística. Apropiada para dar respuesta a las nuevas exigencias legislativas y sociales de la ordenación del territorio, esta metodología se basa en la descomposición del espacio en pequeñas unidades territoriales que, agrupadas, permiten explicar los modelos de comportamiento de la sociedad respecto a su espacio físico o entorno de vida, y que, individualmente, facilitan el análisis de las características y valores de las diversas partes del territorio. Esta reflexión sobre la ordenación del territorio pretende contribuir a la renovación de una disciplina que debe ser capaz de ampliar su campo de acción superando las perspectivas centradas en un único planteamiento (planificación espacial, planificación del desarrollo regional, administración del territorio y políticas sectoriales) y construir nuevas metodologías integradoras que faciliten la toma de decisiones destinadas a proteger, ordenar y gestionar los valores patrimoniales del territorio y el paisaje contribuyendo con ello al desarrollo sostenible y a la definición de modelos de gobernanza territorial.ABSTRACT: We present a series of experiences of territorial analysis tor zoning in the context of regional planning. They are based on a methodology that allows the integration of all territorial values and provides an adequate basis for the development of proposals for action in environmental, cultural, economic, social and landscape matters. Appropriate to meet the new legislative and social requirements of regional planning, this methodology is based on the decomposition of space into small territorial units that, taken as a whole, help to understand the behaviour of society with respect to its physical space or living environment and, individually, facilitate the analysis of the characteristics and values of the different parts of the territory. This reflection on regional planning aims to contribute to the renewal of a discipline that, nowadays, should be able to expand its scope overcoming the single-centered approaches (spatial planning, regional development planning, land administration and sectorial policies) and developing new integrative methodologies that facilitate decision making to protect, regulate and manage the heritage values of the territory and landscape, thereby contributing to sustainable development and definition of territorial governance models

Fibromyalgia: Evidence for Deficits in Positive Psychology Resources. A Case-Control Study from the Al-Ándalus Project

Positive psychology is the study of positive subjective experience and individual traits. Identifying deficits in positive psychology regarding fibromyalgia may inform targets for management. Therefore, the aim of the present case–control study was to compare the levels of positive affect, negative affect, satisfaction with life, optimism and emotional repair in a large sample of women with fibromyalgia (cases) and age-matched peers without fibromyalgia (controls). This case–control study included 437 women with fibromyalgia (51.6 ± 7.1 years old) and 206 age-matched women without fibromyalgia (50.6 ± 7.2 years old). Participants self-reported their levels of (i) subjective well-being on the Positive and Negative Affect Schedule and the Satisfaction with Life Scale, (ii) dispositional optimism on the Life Orientation Test-Revised and (iii) emotional repair on the Trait Meta-Mood Scale. Women with fibromyalgia showed lower levels of positive affect, satisfaction with life, optimism and emotional repair and higher levels of negative affect. Large effect sizes were found for positive affect, negative affect and satisfaction with life (all, Cohen’s d ≥ 0.80) and small-to-moderate for emotional repair and optimism (both, Cohen’s d ≥ 0.50). Women with fibromyalgia experience deficits of positive psychology resources. Thus, developing tailored therapies for fibromyalgia focusing on reducing deficits in positive psychology resources may be of clinical interest, though this remains to be corroborated in future researchThis work was supported by the Spanish Ministry of Economy and Competitiveness (I+D+i DEP2010-15639, I+D+I DEP2013-40908); the Spanish Ministry of Education (FPU15/00002), Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES). F.E.-L. has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement no. 707404. The funders of this study did not have any role in the study design, data collection and analyses, decision to publish or preparation of the manuscript We would like to thank the researchers of the cts-1018 research group, particularly Manuel Delgado-Fernández, and acknowledge the “Fibromyalgia, Chronic Fatigue Syndrome and Chemistry Sensibility Federation” (“ALBA ANDALUCIA”, association of fibromyalgia, Andalucía, southern Spai

Targeted gene sequencing, bone health, and body composition in Cornelia de Lange Syndrome

The aim of this study was to evaluate bone health and body composition by dual-energy X-ray absorptiometry (DXA) in individuals with Cornelia de Lange Syndrome (CdLS). Overall, nine individuals with CdLS (five females, all Caucasian, aged 5-38 years) were assessed. Total body less head (TBLH) and lumbar spine (LS) scans were performed, and bone serum biomarkers were determined. Molecular analyses were carried out and clinical scores and skeletal features were assessed. Based on deep sequencing of a custom target gene panel, it was discovered that eight of the nine CdLS patients had potentially causative genetic variants in NIPBL. Fat and lean mass indices (FMI and LMI) were 3.4-11.1 and 8.4-17.0 kgm2, respectively. For TBLH areal bone mineral density (aBMD), after adjusting for height for age Z-score of children and adolescents, two individuals (an adolescent and an adult) had low BMD (aBMD Z-scores less than -2.0 SD). Calcium, phosphorus, 25-OH-vitamin D, parathyroid hormone, and alkaline phosphatase levels were 2.08-2.49 nmolL, 2.10-3.75 nmolL, 39.94-78.37 nmolL, 23.4-80.3 pgmL, and 43-203 IUL, respectively. Individuals with CdLS might have normal adiposity and low levels of lean mass measured with DXA. Bone health in this population seems to be less of a concern during childhood and adolescence. However, they might be at risk for impaired bone health due to low aBMD in adulthood

Impacto emocional y resiliencia enadolescentes de España y Ecuador durante la COVID-19: estudio transcultural

La pandemia de la COVID-19 está impactando en la salud emocional de los adolescentes. Factores como la resiliencia pueden amortiguar este importante impacto sobre su bienestar. Nuestro objetivo fue estudiar la asociación entre la sintomatología ansioso-depresiva y la resiliencia en adolescentes de España y Ecuador, y comparar las diferencias existentes entre ambas muestras. Participaron 476 adolescentes (70,10 % mujeres) entre 9 y 18 años (M = 15,62; DT = 1,22), distribuidos por igual entre ambos países. Se evaluaron mediante la Escala de Depresión, Ansiedad y Estrés y la Escala de Resiliencia. Realizamos análisis descriptivos, pruebas t para muestras independientes, cálculo del tamaño del efecto y correlaciones de Pearson. Los resultados evidenciaron que el perfil de ajuste adaptativo ante la pandemia fue: ser chico, no haber presentado un evento vital estresante, no tener problemas de salud física ni psicológica previos y residir en España. Mientras que el perfil de riesgo ante la pandemia fue: ser chica, presentar un evento vital estresante, tener algún tipo de problema de salud física y psicológica previo y residir en Ecuador. Nuestros datos señalan la importancia de detectar las necesidades específicas de los adolescentes en función de su contexto socioeconómico y cultural, para poder poner en marcha intervenciones destinadas a proteger su salud mental durante la pandemi

Is Routine Prophylaxis Against Pneumocystis jirovecii Needed in Liver Transplantation? A Retrospective Single-Centre Experience and Current Prophylaxis Strategies in Spain

In liver transplant (LT) recipients, Pneumocystis jirovecii pneumonia (PJP) is most frequently reported before 1992 when immunosuppressive regimens were more intense. It is uncertain whether universal PJP prophylaxis is still applicable in the contemporary LT setting. We aimed to examine the incidence of PJP in LT recipients followed at our institution where routine prophylaxis has never been practiced and to define the prophylaxis strategies currently employed among LT units in Spain. All LT performed from 1990 to October 2019 were retrospectively reviewed and Spanish LT units were queried via email to specify their current prophylaxis strategy. During the study period, 662 LT procedures were carried out on 610 patients. Five cases of PJP were identified, with only one occurring within the first 6 months. The cumulative incidence and incidence rate were 0.82% and 0.99 cases per 1000 person transplant years. All LT units responded, the majority of which provide prophylaxis (80%). Duration of prophylaxis, however, varied significantly. The low incidence of PJP in our unprophylaxed cohort, with most cases occurring beyond the usual recommended period of prophylaxis, questions a one-size-fits-all approach to PJP prophylaxis. A significant heterogeneity in prophylaxis strategies exists among Spanish LT centres.Funding: This study was supported by the Health Research Institute Marqués de Valdecilla. IDIVAL. Santander. NEXT VAL17/07 grant to José Ignacio Fortea Ormaechea

Impacto emocional y resiliencia en adolescentes de España y Ecuador durante la COVID-19: estudio transcultural

La pandemia de la COVID-19 está impactando en la salud emocional de los adolescentes. Factores como la resiliencia pueden amortiguar este importante impacto sobre su bienestar. Nuestro objetivo fue estudiar la asociación entre la sintomatología ansioso-depresiva y la resiliencia en adolescentes de España y Ecuador, y comparar las diferencias existentes entre ambas muestras. Participaron 476 adolescentes (70,10 % mujeres) entre 9 y 18 años (M = 15,62; DT = 1,22), distribuidos por igual entre ambos países. Se evaluaron mediante la Escala de Depresión, Ansiedad y Estrés y la Escala de Resiliencia. Realizamos análisis descriptivos, pruebas t para muestras independientes, cálculo del tamaño del efecto y correlaciones de Pearson. Los resultados evidenciaron que el perfil de ajuste adaptativo ante la pandemia fue: ser chico, no haber presentado un evento vital estresante, no tener problemas de salud física ni psicológica previos y residir en España. Mientras que el perfil de riesgo ante la pandemia fue: ser chica, presentar un evento vital estresante, tener algún tipo de problema de salud física y psicológica previo y residir en Ecuador. Nuestros datos señalan la importancia de detectar las necesidades específicas de los adolescentes en función de su contexto socioeconómico y cultural, para poder poner en marcha intervenciones destinadas a proteger su salud mental durante la pandemia. Emotional impact and resilience in adolescents in Spain and Ecuador during COVID-19: A cross-cultural study. The COVID-19 pandemic is impacting the emotional health of adolescents. Factors such as resilience can buffer this important impact on their well-being. Our aim was to study the association between anxious-depressive symptomatology and resilience in adolescents from Spain and Mexico, and to compare the differences between the two samples. A total of 476 adolescents (70.10 % female) aged 9-18 years (M = 15.62; SD = 1.22), equally distributed between the two countries, participated in the study. They were assessed using the Depression, Anxiety and Stress Scale and the Resilience Scale. We conducted descriptive analyses, independent samples t-tests, effect size calculation and Pearson correlations. The results showed that the profile of adaptive adjustment to the pandemic was: being a male, not having experienced a stressful life event, not having previous physical or psychological health problems and residing in Spain. While the risk profile for the pandemic was: being a female, having a stressful life event, having some type of previous physical and psychological health problem, and residing in Ecuador. Our data point to the importance of detecting the specific needs of adolescents according to their socio-economic and cultural context in order to implement interventions to protect their mental health during the pandemic

Applied diagnostics in liver cancer. Efficient combinations of sorafenib with targeted inhibitors blocking AKT/mTOR

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths worldwide. There is increasing interest in developing specific markers to serve as predictors of response to sorafenib and to guide targeted therapy. Using a sequencing platform designed to study somatic mutations in a selection of 112 genes (HepatoExome), we aimed to characterize lesions from HCC patients and cell lines, and to use the data to study the biological and mechanistic effects of case-specific targeted therapies used alone or in combination with sorafenib. We characterized 331 HCC cases in silico and 32 paired samples obtained prospectively from primary tumors of HCC patients. Each case was analyzed in a time compatible with the requirements of the clinic (within 15 days). In 53% of the discovery cohort cases, we detected unique mutational signatures, with up to 34% of them carrying mutated genes with the potential to guide therapy. In a panel of HCC cell lines, each characterized by a specific mutational signature, sorafenib elicited heterogeneous mechanistic and biological responses, whereas targeted therapy provoked the robust inhibition of cell proliferation and DNA synthesis along with the blockage of AKT/mTOR signaling. The combination of sorafenib with targeted therapies exhibited synergistic anti-HCC biological activity concomitantly with highly effective inhibition of MAPK and AKT/mTOR signaling. Thus, somatic mutations may lead to identify case-specific mechanisms of disease in HCC lesions arising from multiple etiologies. Moreover, targeted therapies guided by molecular characterization, used alone or in combination with sorafenib, can effectively block important HCC disease mechanisms.FUNDING: Grants from ISCIII, co-financed by the European Union (FEDER) (PI16/00156), Ramón and Cajal research program from MINECO (RYC-2013-14097) and FUNDACIÓN LUCHAMOS POR LA VIDA to JPV. Grants from ISCIII (RD06/0020/0107-RD012/0036/0060) to MAP. Grant from ISCIII (Ref. PIE15/00079) to JC & JPV. NGD is a recipient of a UC-IDIVAL pre-doctoral fellow. I.V. was also supported by the Ramón and Cajal research program