Water infrastructure and social housing in Bogotá: an intersection between modern water management and social housing production

En la actualidad Bogotá afronta la presión de construir viviendas sociales en ecosistemas frágiles, áreas rurales o zonas propensas a las inundaciones, y al mismo tiempo proteger estas áreas para asegurar la capacidad de resiliencia del medio ambiente. Ante esta contradicción, la pregunta de investigación es: ¿Cómo se pueden modificar las tendencias de urbanización para crear una interacción que favorezca el manejo sustentable del agua? Con el fin de responder esta pregunta ésta comunicación presenta un análisis histórico de planes de alcantarillado y control hidráulico desarrollados desde 1990, junto con una revisión de proyectos de vivienda social representativos, e investiga la interacción entre estos dos campos. El análisis permite definir diferentes etapas en la transformación física del sistema hídrico que se basan en los cambios universales de paradigma en la gestión del agua e ilustra diferentes construcciones socio-culturales en torno a la naturaleza, además analiza la producción de vivienda en relación a la transformación del sistema hídrico.Currently, Bogotá faces the pressure to continue to urbanize fragile ecosystems, rural lands and flood prone areas with low-cost housing projects and simultaneously protect these areas to ensure environmental resilience. Given this contradiction, the question is how urbanization trends could be reversed into a constructive interplay with a revised water management? In order to that, this paper provides an historical analysis of representative water infrastructure projects, urban plans and housing projects in Bogotá developed after 1900 and investigates the interplays between this two realms. The analysis allows to define different stages in the physical transformation of the water system that are based on universal paradigm shifts in water management and illustrates different socio-cultural constructions around nature. It also analysis the production of social housing in relation to the water system transformation

Dwelling in an ecological substrate: landscape based strategies for flood adaptation in the Sabana de Bogotá

La Sabana de Bogotá afronta el conflicto creciente entre el desarrollo urbano y un sistema de manejo de agua ineficiente. Ante esta contradicción, la investigación estudia cómo se pueden modificar las relaciones conflictivas entre la vivienda dirigida a sectores de bajos ingresos y el medio ambiente para crear una interacción constructiva. La necesidad incuestionable de construir vivienda social puede ser vista como un riesgo para el manejo sostenible de agua, pero también como una oportunidad única para proponer intervenciones espaciales estratégicas. El artículo presenta la investigación y diseño de dos secciones que atraviesan el Río Bogotá y están expuestas a la presión de desarrollo urbano. En cada sección, el diseño interviene el sistema hídrico para que resuelva problemas cuantitativos y cualitativos del agua y al mismo tiempo genere la estructura para nuevos tejidos de vivienda. La tesis tiene tres objetivos. Primero, presentar una aproximación crítica a las tendencias actuales de urbanización. Segundo, cuestionar los modelos de planeamiento actual basados en la distinción entre las áreas rurales y urbanas y el abandono de la conservación ambiental en el ámbito urbano. Finalmente, desarrollar nuevas tipologías urbanas que integren el manejo sostenible de agua. La hipótesis de la investigación es que, a través del diseño del sistema hídrico, las inversiones privadas y públicas se pueden dirigir para crear una estructura urbana pública, sostenible y resiliente a largo plazo.The Sabana de Bogotá is facing a continuously increasing conflict between urban development and a saturated water management system. The research investigates how current contested relations between lowincome housing and environmental stress can be converted into a constructive interplay. The unquestionable necessity of building new social housing can be seen as a major threat for sustainable water management but also as a unique opportunity to propose strategic spatial interventions. This paper present design investigations in two sections that cut across the Bogotá River and are undergoing development pressure. In each site the design proposes a water structure that solve qualitative and quantitative water issues while delivers a framework for new housing fabrics. The thesis has three objectives. First, to develop a critical approach to current development trends and to envision alternative development schemes for the region. Second, to challenge the current planning models based on the distinction of “urban” and “rural” areas and the abandonment of environmental conservation in the urban sphere. Finally, to develop new urban typologies that integrate sustainable water management. By designing the water system, public and private investment can be oriented towards a sustainable and resilience public structure in the long term

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

Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores

Funder: Funder: Fundación bancaria ‘La Caixa’ Number: LCF/PR/PR16/51110003 Funder: Grifols SA Number: LCF/PR/PR16/51110003 Funder: European Union/EFPIA Innovative Medicines Initiative Joint Number: 115975 Funder: JPco-fuND FP-829-029 Number: 733051061Genetic discoveries of Alzheimer's disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer's disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer's disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer's disease

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

Common variants in Alzheimer's disease and risk stratification by polygenic risk scores.

Funder: Funder: Fundación bancaria ‘La Caixa’ Number: LCF/PR/PR16/51110003 Funder: Grifols SA Number: LCF/PR/PR16/51110003 Funder: European Union/EFPIA Innovative Medicines Initiative Joint Number: 115975 Funder: JPco-fuND FP-829-029 Number: 733051061Genetic discoveries of Alzheimer's disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer's disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer's disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer's disease

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Settling with waters. Design investigations for flood adaptation in the Sabana de Bogotá

The Sabana de Bogotá is facing a continuously increasing conflict between urban development and a saturated water management system. The research investigates how current contested relations between low-income housing and environmental stress can be converted into a constructive interplay. The unquestionable necessity of building new social housing can be seen as a major threat for sustainable water management but also as a unique opportunity to propose strategic spatial interventions. This paper presents the results of a doctoral thesis that investigates how can the current contested relations between water, settlement and productive landscapes become a constructive interplay? The paper is divided in two parts. The first part describes the main challenges to address these issues. The second part presents the design investigations in two case studies that cut across the Bogotá River and are undergoing development pressure. In each site the design proposes a water structure that solve qualitative and quantitative water issues while delivers a framework for new housing fabrics. The design investigations develop new low income housing morphologies, settlements with waters that are differentiated from land-based morphologies.status: submitte

Section across the horizontal field: a case study of the asymmetrical condition of Bogotás periphery

The Sabana de Bogotá is facing an increased contradiction between development (urban, agriculture, flower production or any or kind) and a saturated water management system. Heavy pollution, subsidence, flooding, drinkable water demand, and a loss of biodiversity are some of the most pressing issues. In order to develop an alternative vision for the ongoing unsustainable urbanization of the territory, in which the river, rather than being denied or just seen as an obstacle, is read as the backbone of the territory. This paper presents an interpretative mapping exercise that proposes the section as a â system of mediationâ to analyse contemporary conditions of peripheral urban formation along the Bogotá River, and the rationalities of its correlative water system. The section also reveals the often contradictory conditions that shape the landscape of the Sabana (urban/rural, local/global, and formal/informal), especially between fragile ecosystems and the complex infrastructural network in which water is harvested, redistributed, recycled and transformed. It also incorporates the potential to develop a constructive interplay between water management and settlement development.no issnstatus: publishe