Attenuation by clouds of UV radiation for low stratospheric ozone conditions

Stratospheric poor ozone air masses related to the polar ozone hole overpass subpolar regions in the Southern Hemisphere during spring and summer seasons, resulting in increases of surface Ultraviolet Index (UVI). The impact of these abnormal increases in the ultraviolet radiation could be overestimated if clouds are not taking into account. The aim of this work is to determine the percentage of cases in which cloudiness attenuates the high UV radiation that would reach the surface in low total ozone column situations and in clear sky hypothetical condition for Río Gallegos, Argentina. For this purpose, we analysed UVI data obtained from a multiband filter radiometer GUV-541 (Biospherical Inc.) installed in the Observatorio Atmosférico de la Patagonia Austral (OAPA-UNIDEF (MINDEF - CONICET)) (51 °33´ S, 69 °19´ W), Río Gallegos, since 2005. The database used covers the period 2005-2012 for spring seasons. Measured UVI values are compared with UVI calculated using a parametric UV model proposed by Madronich (2007), which is an approximation for the UVI for clear sky, unpolluted atmosphere and low surface albedo condition, using the total ozone column amount, obtained from the OMI database for our case, and the solar zenith angle. It is observed that ∼76% of the total low ozone amount cases, which would result in high and very high UVI categories for a hypothetical (modeled) clear sky condition, are attenuated by clouds, while 91% of hypothetical extremely high UVI category are also attenuated.Fil: Orte, Facundo. Consejo Nacional de Investigaciones Científicas y Técnicas. Unidad de Investigación y Desarrollo Estratégico para la Defensa. Ministerio de Defensa. Unidad de Investigación y Desarrollo Estratégico para la Defensa; ArgentinaFil: Wolfram, Elian Augusto. Consejo Nacional de Investigaciones Científicas y Técnicas. Unidad de Investigación y Desarrollo Estratégico para la Defensa. Ministerio de Defensa. Unidad de Investigación y Desarrollo Estratégico para la Defensa; ArgentinaFil: Salvador, Jacobo Omar. Consejo Nacional de Investigaciones Científicas y Técnicas. Unidad de Investigación y Desarrollo Estratégico para la Defensa. Ministerio de Defensa. Unidad de Investigación y Desarrollo Estratégico para la Defensa; ArgentinaFil: D'elia, Raul Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Unidad de Investigación y Desarrollo Estratégico para la Defensa. Ministerio de Defensa. Unidad de Investigación y Desarrollo Estratégico para la Defensa; ArgentinaFil: Quiroga, Jonathan Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Unidad de Investigación y Desarrollo Estratégico para la Defensa. Ministerio de Defensa. Unidad de Investigación y Desarrollo Estratégico para la Defensa; ArgentinaFil: Quel, Eduardo Jaime. Consejo Nacional de Investigaciones Científicas y Técnicas. Unidad de Investigación y Desarrollo Estratégico para la Defensa. Ministerio de Defensa. Unidad de Investigación y Desarrollo Estratégico para la Defensa; ArgentinaFil: Mizuno, Akira. Nagoya University; Japó

Experts react: Catalan elections

Catalonia held elections on 27 September, with the poll being framed by several parties as a de facto vote on Catalan independence. The final result produced a majority of seats in the Catalan Parliament for pro-independence parties, with these parties securing 47.8 per cent of the votes cast. We asked some of EUROPP’s contributors for their reaction to the result and what it means for Catalonia and Spain going forward. Jonathan Hopkin: “The elections have produced a very complex outcome” Luis Moreno: “The Spanish elections in December will be crucial in determining what happens next” Alejandro Quiroga: “Artur Mas might have more pressing issues than the declaration of independence in the short term” Jose Javier Olivas: “Unilateral solutions, even when they seek to impose the ‘will of the majority’, are unlikely to deliver satisfactory results in the long run” Karlo Basta: “All sides have at least some leverage, and the true commitments of none are fully known, confounding any reliable predictions” Joan Costa Font: “The independence cause has attained an exceptional result, now it is time to either negotiate a referendum or, failing this, prepare for an orderly break up“ Mireia Borrell Porta: “A referendum has now become unavoidable

Clinical value of next generation sequencing of plasma cell-free DNA in gastrointestinal stromal tumors

[Background] Gastrointestinal stromal tumor (GIST) initiation and evolution is commonly framed by KIT/PDGFRA oncogenic activation, and in later stages by the polyclonal expansion of resistant subpopulations harboring KIT secondary mutations after the onset of imatinib resistance. Thus, circulating tumor (ct)DNA determination is expected to be an informative non-invasive dynamic biomarker in GIST patients.[Methods] We performed amplicon-based next-generation sequencing (NGS) across 60 clinically relevant genes in 37 plasma samples from 18 GIST patients collected prospectively. ctDNA alterations were compared with NGS of matched tumor tissue samples (obtained either simultaneously or at the time of diagnosis) and cross-validated with droplet digital PCR (ddPCR).[Results] We were able to identify cfDNA mutations in five out of 18 patients had detectable in at least one timepoint. Overall, NGS sensitivity for detection of cell-free (cf)DNA mutations in plasma was 28.6%, showing high concordance with ddPCR confirmation. We found that GIST had relatively low ctDNA shedding, and mutations were at low allele frequencies. ctDNA was detected only in GIST patients with advanced disease after imatinib failure, predicting tumor dynamics in serial monitoring. KIT secondary mutations were the only mechanism of resistance found across 10 imatinib-resistant GIST patients progressing to sunitinib or regorafenib.[Conclusions] ctDNA evaluation with amplicon-based NGS detects KIT primary and secondary mutations in metastatic GIST patients, particularly after imatinib progression. GIST exhibits low ctDNA shedding, but ctDNA monitoring, when positive, reflects tumor dynamics.This research is supported by a Fero Fellowship Award (C.S.), Asociación Española Contra el Cáncer (J.P. Barcelona) (C.S.), and ISCIII PI16/01371 (C.S.). C.S. and A.V. acknowledge to the Cellex Foundation for providing facilities and equipment

La normativa IEC para sistemas eólicos e híbridos aislados, y la utilización de tecnologías de medición remota: aplicación en contexto patagónico

Se presentan los aspectos más relevantes de la normativa IEC (Comisión Electrotécnica Internacional) en lo relativo a sistemas eólicos en general incluyendo la reciente incorporación de Sensores Remotos (RSDs), los de baja potencia en particular y la normativa que rige los sistemas híbridos aislados basados en energía renovable para electrificación rural. Uno de los aspectos de la IEC 61400-2 (ensayo de duración) en los sistemas eólicos baja potencia se puede llevar adelante utilizando como base la normativa para medición de curva de potencia IEC 61400-12-1 en su Anexo H para Pequeñas Turbinas Eólicas (PTEs). Si dicho sistema combina además alimentación por fuentes fotovoltaicas, se lo encuadra como caso híbrido práctico para electrificación de comunidades aisladas bajo la norma IEC 62257, identificando la tipología particular que sin embargo es aplicable a un número importante de sistemas similares en la zona patagónica austral.This work presents relevant aspects of the IEC standards relating to wind turbine systems in their design and testing, with emphasis in low power systems (IEC 61400-2) and also the possibility of using (in latest IEC61400-12-1, ed 2017) LIDAR or other RSD (Remote Sensing Devices) to simplify wind measurements in case of power curve or AEP estimation. Also assessed are the rural electrification standards collectively known as the IEC 62257 standards, with emphasis in renewable energy deployment for isolated systems.Asociación Argentina de Energías Renovables y Medio Ambiente (ASADES

Mi barrio es el paraíso, el infierno son los otros. Interacción y fragmentación socio-espacial en Victoria, San Fernando, R.M.B.A. 2014

Se ha elegido la zona de Victoria, San Fernando, Provincia de Buenos Aires, como un ejemplo de fragmentación urbana y segregación social. En un recorrido muy corto, de Oeste a Este, encontramos todas las clases sociales sucesivamente, coincidiendo la distancia geográfica y la social, desde la marginación en el Oeste (Reconquista) hasta la clase alta en la costa del Luján en el Este. En algún lugar de este recorrido observamos, muros y paredones sin comercios ni edificios comunes, solo depósitos, cementerios y barrios cerrados. Aunque las causas son variadas y algunas tienen su origen en la política urbana de los años noventa, en este artículo damos cuenta del problema urbanístico y social y estudiamos las diversas formas que ha tomado y toma la estrategia tanto de pobladores como de gestiones de gobierno para resistirse al cambio, que estaría representado por la interacción entre clases sociales, base de la vida ciudadana, casi ausente o muy débil en este caso. Parte del problema es geográfico, las barreras urbanas (Tren Mitre, Avenida Libertador, Tren de la Costa, Tren a Capilla del Señor, Autopista Acceso Norte) proliferaron desde el siglo XIX en adelante. Sin embargo en una comparación con el corredor Norte, solo San Fernando ha privatizado su costa. San Fernando (y Victoria) está fragmentado en tres grandes zonas a causa de estas barreras geográficas. Los conflictos se darán sólo en las fronteras (muro entre partidos) y en los bordes sociales, pero siempre tratando de evitar los grandes cambios. El corte temporal del estudio corresponde al período 2004-2014. A través de este estudio se verifica la importancia del aislamiento espacial producido por las barreras urbanas, que en su fragmentación van consolidando la segregación, la segmentación social y la exclusión como resultado último.The area of Victoria, San Fernando, Buenos Aires Province has been selected as an example of urban fragmentation and social segregation. On a very short tour we found all the social classes successively, matching the geographical and social distance, from the marginalization in the West (Renconquista) to the upper class on the shore of the Lujan river in the East. Somewhere along this tour, we observed thick walls without shops or ordinary buildings but only with stores, cemeteries and gated communities. Even though the causes are varied and some of them have their origin from urban politics in the 90’s. In this article we explain the urban and social problem and study the various forms of the strategy of both citizens and government management has taken and still takes to resist change, which would be represented by interaction of social classes, basis of the citizen life, which is almost absent or very weak in this case. Part of the problem is geographical, the urban barriers (Mitre train, Libertador, Tren de la Costa, train to Capilla del Señor, Acceso Norte) proliferated from the nineteenth century onwards. However, in a comparison with the Northern corridor, only San Fernando has privatized its shore. San Fernando (and Victoria) is fragmented into three big areas because of these geographical barriers. Conflicts will occur only in the borderlines (a wall between towns) and in social borders, but always trying to avoid big changes. The temporary cut of the study covers the period between 2004-2014.Fil: Guevara, Celia. Universidad de Buenos Aires. Facultad de Arquitectura y Urbanismo. Instituto de Arte Americano e Investigación Estéticas "Mario Buschiazzo"; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Areco, Alberto. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Barneche, Javier. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Brandone, Sofía I.. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Camardon, Lucía. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Castañeda, María Lucía. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Castro, Leticia. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Croce, Federico. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Cuberos, Alfonso Javier. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Donadío, Laura E.. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Fuentes, Ariel Rodolfo. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Gómez Salmerón, Fabián A.. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Pierro, Sabrina M.. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Plate, Lisandro. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Porta, Yanina. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Quiroga, Ayelén Rocio. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Raap, Johanna. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Solver, Juan Manuel. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Souza, Kelly. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Szencis Ferriolo, Jonathan Lucas. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Torrez, Jeannette. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; Argentin

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake