Las grisallas de la ermita del calvario de Bordón y su contexto artístico

La comarca del Maestrazgo se encuentra salpicada de ermitas, santuarios y lugares de devoción que todavía son prácticamente desconocidos. Este es el caso de los espacios con conjuntos de pintura mural: los recientemente descubiertos en el convento de Agustinas de Mirambel o la cripta bajo el altar de la ermita del calvario de Bordón. En este artículo queremos poner el acento en las pinturas de Bordón con un interesante programa iconográfico en torno a la muerte de Cristo. Maestrazgo shire is dotted with hermitages, sanctuaries and cult places that are practically unknown nowadays. That is the case of spaces with mural paintings such as the recently discovered in the Agustinas convent in Mirambel or the crypt under the altar in the calvary hermitage in Bordón. In this article we would like to emphasize the paintings in Bordón which have a very interesting iconographic program around Christ’s death

Electroluminescence Imaging and Light-Beam Induced Current as characterization techniques of Multi-Crystalline Si Solar Cells

There is an increasing demand for characterizing multicrystalline solar cells at different stages of its service life. Luminescence techniques, e.g. electroluminescence (EL) and photoluminescence (PL), have acquired a paramount interest in the last years. These techniques are used in imaging mode, allowing to take a luminescence picture at a full wafer/cell scale. This imaging approach is fast and sensitive, but has a low spatial resolution, which avoids a detailed analysis of the defect distribution, which can led to misinterpretations about critical parameters as the minority carrier diffusion length, or the internal and external quantum efficiencies. If one complements these techniques with high spatial resolution techniques, such as light beam induced current (LBIC), one can study the electrical activity of the defects at a micrometric scale, providing additional understanding about the role played by the defects in full wafer/cell luminescence images. The combination of the macroscopic and microscopic resolution scales is necessary for the analysis of the full luminescence images in mc-Si solar cells.Proyecto de Investigación ENE2014-56069-C4- 4-R (MCIN)Proyecto de Investigación ENE2017-89561-C4-3-R (MCIN)Proyecto de Investigación VA081U16 (Junta de Castilla y León

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Technological change and global suply chains: an approximation from a global multisectoral model

Esta tesis está escrita en un contexto de un largo periodo de crisis económica, particularmente fuerte para España y otros países Europeos mediterráneos. Este contexto de creciente incertidumbre inspira el leivmotiv de esta tesis; el reflejo de los factores que conducen el crecimiento económico, el papel de las relaciones internacionales e intersectoriales en la generación y evaluación de la renta, así como su evolución en las últimas décadas. Más específicamente, dos son los temas principales en los que esta tesis se va a centrar; cambio tecnológico y globalización, siendo las cadenas de producción su mayor representación. Una herramienta útil para captar las interrelaciones entre sectores y países son las tablas input-output y los modelos asociados: los modelos multisectoriales y multiregionales. Elegimos estos modelos por su capacidad para mostrar los links entre países y sectores, lo favorece el estudio mundial y captar las consecuencias de la globalización con mayor precisión que con otro tipo de técnicas. Primero analizamos como el papel de la tecnología ha cambiado a través de creciente proceso de globalización. Particularmente queremos estudiar el efecto de la globalización y la tecnología sobre la productividad. Nos aproximamos a la globalización a través del análisis en el tamaño, composición y evolución de las cadenas globales de valor dentro de un marco multiregional. Como es bastante común en la literatura, utilizamos el gasto en I+D por país y sector como una aproximación al esfuerzo innovador. Además, centramos nuestro estudio no sólo en la inversión realizada por cada país sino también por su capacidad para absorber tecnología. Como hemos visto anteriormente, la literatura defiende que los flujos de I+D entre países están adquiriendo especial relevancia debido a las relaciones comerciales globales. Capítulos 1 y 2 tratan con estos temas. Una vez que la importancia de estas relaciones comerciales en los procesos tecnológicos se muestra a través de la evolución de las cadenas globales de producción; el siguiente objetivo es analizar la anatomía de estas cadenas de producción en un contexto globalizado, así como su evolución a lo largo del tiempo. En este contexto seguiremos dos líneas. La primera línea de aborda en el caopítulo 3.En él desarrollamos y analizamos diferentes índices de concentración dentro de un marco MRIO. El diseño de los índices nos ayudará a conocer diferentes características para la cadena de producción de cada país, al mismo tiempo que subrayamos la potencialidad de los modelos MRIO para caracterizar las cadenas globales de producción. La segunda línea relacionada con las cadenas de producción está basada en su link con el cambio tecnológico. De esta forma, nuestro siguiente objetivo es el estudio del efecto de la composición de las cadenas de producción sobre el crecimiento económico. En otras palabras, como los diferentes elementos que componen las cadenas de producción (productividad, especialización…) están captando los procesos de cambio tecnológico y estructural. Nuestra propuesta para captar estas cuestiones está basada en la normalización de cada uno de los elementos de la matriz tecnológica para hacer las estructuras completamente comparables entre ellas, y para aislar, los efectos del tamaño, dispersión y estructura. Esta aproximación nos ayudará a comparar el tamaño y la dispersión de cada cadena captando información importante paras las diferentes economías; y, además, a analizar los cambios tecnológicos y estructurales de una manera más profunda. El capítulo 4 se centra en el análisis de estas cuestiones. <br /

Subcutaneous anti-COVID-19 hyperimmune immunoglobulin for prevention of disease in asymptomatic individuals with SARS-CoV-2 infection: a double-blind, placebo-controlled, randomised clinical trialResearch in context

Summary: Background: Anti-COVID-19 hyperimmune immunoglobulin (hIG) can provide standardized and controlled antibody content. Data from controlled clinical trials using hIG for the prevention or treatment of COVID-19 outpatients have not been reported. We assessed the safety and efficacy of subcutaneous anti-COVID-19 hyperimmune immunoglobulin 20% (C19-IG20%) compared to placebo in preventing development of symptomatic COVID-19 in asymptomatic individuals with SARS-CoV-2 infection. Methods: We did a multicentre, randomized, double-blind, placebo-controlled trial, in asymptomatic unvaccinated adults (≥18 years of age) with confirmed SARS-CoV-2 infection within 5 days between April 28 and December 27, 2021. Participants were randomly assigned (1:1:1) to receive a blinded subcutaneous infusion of 10 mL with 1 g or 2 g of C19-IG20%, or an equivalent volume of saline as placebo. The primary endpoint was the proportion of participants who remained asymptomatic through day 14 after infusion. Secondary endpoints included the proportion of individuals who required oxygen supplementation, any medically attended visit, hospitalisation, or ICU, and viral load reduction and viral clearance in nasopharyngeal swabs. Safety was assessed as the proportion of patients with adverse events. The trial was terminated early due to a lack of potential benefit in the target population in a planned interim analysis conducted in December 2021. ClinicalTrials.gov registry: NCT04847141. Findings: 461 individuals (mean age 39.6 years [SD 12.8]) were randomized and received the intervention within a mean of 3.1 (SD 1.27) days from a positive SARS-CoV-2 test. In the prespecified modified intention-to-treat analysis that included only participants who received a subcutaneous infusion, the primary outcome occurred in 59.9% (91/152) of participants receiving 1 g C19-IG20%, 64.7% (99/153) receiving 2 g, and 63.5% (99/156) receiving placebo (difference in proportions 1 g C19-IG20% vs. placebo, −3.6%; 95% CI -14.6% to 7.3%, p = 0.53; 2 g C19-IG20% vs placebo, 1.1%; −9.6% to 11.9%, p = 0.85). None of the secondary clinical efficacy endpoints or virological endpoints were significantly different between study groups. Adverse event rate was similar between groups, and no severe or life-threatening adverse events related to investigational product infusion were reported. Interpretation: Our findings suggested that administration of subcutaneous human hyperimmune immunoglobulin C19-IG20% to asymptomatic individuals with SARS-CoV-2 infection was safe but did not prevent development of symptomatic COVID-19. Funding: Grifols