Drenaje Urbano Sostenible

Sustainable Urban Drainage Systems (SUDS) aim the stormwater management by getting the infiltration property of the sealed soils back, as well as its retention capacity and peak flow attenuation. They are essential in urban area over sandy subsoil whose absorption capacity has been voided and need to be regained. It is depicted the situation of coastal residential areas with low slopes and sandy soils, which require pumping to convey the water, and, thus, the energy consumption increases to unsustainable values. Measures favouring infiltration are needed wherever runoff is generated. Catching the stormwater by inlet grates1 results ineffective because they become obstructed and cause damage to the sewer pipes, thus surface drainage and filtration systems appears as a solution backed by its implementation in countries such as USA, Great Britain and Australia for decades. The participation of stakeholders, manager and citizen, must be considered when implementing this techniques. Cooperation with the stakeholders in the design process is essential to disseminate the knowledge and encourage its acceptance. The ongoing research aims to demonstrate the benefit of efficient and sustainable runoff management as well as the social and economic benefits involved, contextualizing measures in the South of SpainLos Sistemas de Drenaje Urbano Sostenible (SUDS) tienen como fin gestionar las aguas de lluvia devolviendo a los suelos impermeabilizados urbanos su capacidad de filtración, de retención y de laminación de las escorrentías que en ellos se generan. Se hacen indispensables en zonas urbanas donde el subsuelo está constituido por arenas, cuya capacidad de absorción ha sido anulada y se requiere recuperar. Se recoge la situación de las urbanizaciones costeras con bajas pendientes y suelos arenosos, que requieren bombeos que elevan el consumo de energía a valores insostenibles, aconsejándose el empleo de técnicas que favorezcan la filtración al terreno de las aguas de lluvia en lugar de dejarlas escurrir. En estas zonas el uso de imbornales resulta ineficaz por aterramiento y daño a la red de conducciones, por ello, las técnicas de drenaje superficial y filtración constituyen una solución, avalada por su empleo en países como EEUU, Gran Bretaña y Australia desde hace décadas. La implantación de estas nuevas técnicas incluye la participación de técnicos y gestores así como de la ciudadanía afectada o interesada. La inclusión de estos actores en el proceso de diseño resulta indispensable para difundir el conocimiento de las medidas y favorecer su aceptación. Con la investigación en curso se espera poder demostrar el beneficio de la gestión eficaz y sostenible de las escorrentías así como el social y económico, contextualizando las medidas en el Sur de España

Intelligent Dolls and robots for the treatment of elderly people with dementia

Doll and robot are effective and beneficial non-pharmacological therapies applied in different clinical settings. Doll therapy (DT), principally based in Bowlby's attachment theory, uses an empathy or lifelike baby doll to conduct caring behaviors of it. Robot therapies (RT) use care robots with a friendly attitude and appearance that create emotions and movements that lead to different verbal, motor and emotional reactions. Both DT and RT are person-centred therapies that aim to improve wellbeing of people that suffer from different neurological, psychological and mental health disorders, such as Alzheimer's Disease, autism spectrum disorder, stress or depression, by providing a realistic experience. In this paper, the characteristics of both therapies, their benefits and the possibilities of innovation in the therapeutic field are presented

RING1B contributes to Ewing sarcoma development by repressing the Na(V)1.6 sodium channel and the NF-kappa B pathway, independently of the fusion oncoprotein

Ewing sarcoma (ES) is an aggressive tumor defined by EWSR1 gene fusions that behave as an oncogene. Here we demonstrate that RING1B is highly expressed in primary ES tumors, and its expression is independent of the fusion oncogene. RING1B-depleted ES cells display an expression profile enriched in genes functionally involved in hematological development but RING1B depletion does not induce cellular differentiation. In ES cells, RING1B directly binds the SCN8A sodium channel promoter and its depletion results in enhanced Nav1.6 expression and function. The signaling pathway most significantly modulated by RING1B is NF-κB. RING1B depletion results in enhanced p105/p50 expression, which sensitizes ES cells to apoptosis by FGFR/SHP2/STAT3 blockade. Reduced NaV1.6 function protects ES cells from apoptotic cell death by maintaining low NF-κB levels. Our findings identify RING1B as a trait of the cell-of-origin and provide a potential targetable vulnerability.Ministerio de Economía y Competitividad SAF2012-31089 and SAF2015-69762-RMEC FEDER RD12/0036/0017, PT13/0010/0056, RTC-2014- 2102-1, ISCIII Sara Borrell CD06/00001, PI12/03102, PI14/01466European FP7 Projects EuroSARC FP7- HEALTH-2011-two-stage, Project 278742 EUROSARCEuroewing FP7-HEALTH.2013.2.4.1-1, Project 60285

Metabolomics-guided insights on bariatric surgery versus behavioral interventions for weight loss.

Despite evidence to support their utility, lifestyle-based strategies for weight loss and treatment of obesity (i.e., based on diet and physical activity) have met so far with little success in the long term in terms of permanent weight loss (1). Bariatric surgery is the only current treatment for obesity leading to sustained weight loss (2) and to improvements in glucose regulation, up to a complet

Vascular and cognitive effects of cocoa-rich chocolate in postmenopausal women: a study protocol for a randomised clinical trial

Introduction The intake of polyphenols has certain health benefits. This study will aim to assess the effect of adding a daily amount of chocolate high in cocoa content and polyphenols to the normal diet on blood pressure, vascular function, cognitive performance, quality of life and body composition in postmenopausal women. Methods and analysis Here we plan a randomised clinical trial with two parallel groups involving a total of 140 women between 50 and 64 years in the postmenopausal period, defined by amenorrhoea of at least 12 consecutive months. The main variable will be the change in blood pressure. Secondary variables will be changes in vascular function, quality of life, cognitive performance and body composition. The intervention group will be given chocolate containing 99% cocoa, with instructions to add 10 g daily to their normal diet for 6 months. The daily nutritional contribution of this amount of chocolate is 59 kcal and 65.4 mg of polyphenols. There will be no intervention in the control group. All variables will be measured at the baseline visit and 3 and 6 months after randomisation, except cognitive performance and quality of life, which will only be assessed at baseline and at 6 months. Recruitment is scheduled to begin on 1 June 2018, and the study will continue until 31 May 2019. Ethics and dissemination This study was approved by the Clinical Research Ethics Committee of the Health Area of Salamanca, Spain (‘CREC of Health Area of Salamanca’), in February 2018. A SPIRIT checklist is available for this protocol. The clinical trial has been registered at ClinicalTrials. gov provided by the US National Library of Medicine, number NCT03492983. The results will be disseminated through open access peer-reviewed journals, conference presentations, broadcast media and a presentation to stakeholders.Gerencia Regional de Castilla y León (GRS 1583/B/1

Beneficial Effect of Short-Term Supplementation of High Dose of Vitamin D3 in Hospitalized Patients With COVID-19: A Multicenter, Single-Blinded, Prospective Randomized Pilot Clinical Trial.

There is now sufficient evidence to support that vitamin D deficiency may predispose to SARS-CoV-2 infection and increase COVID-19 severity and mortality. It has been suggested that vitamin D3 supplementation may be used prophylactically as an affordable and safe strategy that could be added to the existing COVID-19 standard treatment. This multicenter, single-blinded, prospective randomized pilot clinical trial aimed to evaluate the safety, tolerability, and effectiveness of 10,000 IU/day in comparison with 2000 IU/day of cholecalciferol supplementation for 14 days to reduce the duration and severity of COVID-19 in 85 hospitalized individuals. The median age of the participants was 65 years (Interquartile range (IQR): 53-74), most of them (71%) were men and the mean baseline of 25-hydroxyvitamin D (25(OH)D) in serum was 15 ng/ml (standard deviation (SD):6). After 14 days of supplementation, serum 25(OH)D levels were significantly increased in the group who received 10,000IU/day (p < 0.0001) (n = 44) in comparison with the 2,000IU/day group (n = 41), especially in overweight and obese participants, and the higher dose was well tolerated. A fraction of the individuals in our cohort (10/85) developed acute respiratory distress syndrome (ARDS). The median length of hospital stay in these patients with ARDS was significantly different in the participants assigned to the 10,000IU/day group (n = 4; 7 days; IQR: 4-13) and the 2,000IU/day group (n = 6; 27 days; IQR: 12-45) (p = 0.04). Moreover, the inspired oxygen fraction was reduced 7.6-fold in the high dose group (p = 0.049). In terms of blood parameters, we did not identify overall significant improvements, although the platelet count showed a modest but significant difference in those patients who were supplemented with the higher dose (p = 0.0492). In conclusion, the administration of 10,000IU/day of vitamin D3 for 14 days in association with the standard clinical care during hospitalization for COVID-19 was safe, tolerable, and beneficial, thereby helping to improve the prognosis during the recovery process.This work was supported by Fundación Universidad Alfonso X el Sabio (FUAX, Madrid, Spain; ID Project: 1.012.010; ID Project EQA: 925.280); the Coordinated Research Activities at the National Center of Microbiology (Instituto de Salud Carlos III) (COV20_00679) to promote an integrated response against SARS-CoV-2 in Spain (Spanish Ministry of Science and Innovation) that is coordinated by Dr. Inmaculada Casas (WHO National Influenza Center of the CNM); a generous donation provided by Chiesi España, S.A.U. (Barcelona, Spain). The work of Montserrat Torres was financed by the Coordinated Research Activities at the CNM (Instituto de Salud Carlos III) (COV20_00679). The work of Lorena Vigón was supported by a pre-doctoral grant from Instituto de Salud Carlos III (FIS PI16CIII/00034-ISCIII-FEDER). The work of Sara Rodríguez-Mora was financed by NIH grant R01AI143567.S

Combined use of smartphone and smartband technology in the improvement of lifestyles in the adult population over 65 years: study protocol for a randomized clinical trial (EVIDENT-Age study)

Background The increasing use of smartphones by older adults also increases their potential for improving different aspects of health in this population. Some studies have shown promising results in the improvement of cognitive performance through lifestyle modification. All this may have a broad impact on the quality of life and carrying out daily living activities. The objective of this study is to evaluate the effectiveness of combining the use of smartphone and smartband technology for 3 months with brief counseling on life habits, as opposed to providing counseling only, in increasing physical activity and improving adherence to the Mediterranean diet. Secondary objectives are to assess the effect of the intervention on body composition, quality of life, independence in daily living activities and cognitive performance. Methods This study is a two-arm cluster-randomized trial that will be carried out in urban health centers in Spain. We will recruit 160 people aged between 65 and 80 without cardiovascular disease or cognitive impairment (score in the Mini-mental State Examination ≥24). On a visit to their center, intervention group participants will be instructed to use a smartphone application for a period of 3 months. This application integrates information on physical activity received from a fitness bracelet and self-reported information on the patient’s daily nutritional composition. The primary outcome will be the change in the number of steps measured by accelerometer. Secondary variables will be adherence to the Mediterranean diet, sitting time, body composition, quality of life, independence in daily living activities and cognitive performance. All variables will be measured at baseline and on the assessment visit after 3 months. A telephone follow-up will be carried out at 6 months to collect self-reported data regarding physical activity and adherence to the Mediterranean diet. Discussion Preventive healthy aging programs should include health education with training in nutrition and lifestyles, while stressing the importance of and enhancing physical activity; the inclusion of new technologies can facilitate these goals. The EVIDENT-AGE study will incorporate a simple, accessible intervention with potential implementation in the care of older adults.This study was supported in part by grants funded by the Instituto de Salud Carlos III, Institute of Biomedical Research of Salamanca (IBSAL)-IBY17/00003, and the Spanish Research Network for Preventive Activities and Health Promotion in Primary Care (REDIAPP)-RD16/0007

Sustained Cytotoxic Response of Peripheral Blood Mononuclear Cells from Unvaccinated Individuals Admitted to the ICU Due to Critical COVID-19 Is Essential to Avoid a Fatal Outcome

The main objective of this study was to determine the influence of the cytotoxic activity of peripheral blood mononuclear cells (PBMCs) on the outcome of unvaccinated individuals with critical COVID-19 admitted to the ICU. Blood samples from 23 individuals were collected upon admission and then every 2 weeks for 13 weeks until death (Exitus group) (n = 13) or discharge (Survival group) (n = 10). We did not find significant differences between groups in sociodemographic, clinical, or biochemical data that may influence the fatal outcome. However, direct cellular cytotoxicity of PBMCs from individuals of the Exitus group against pseudotyped SARS-CoV-2-infected Vero E6 cells was significantly reduced upon admission (−2.69-fold; p = 0.0234) and after 4 weeks at the ICU (−5.58-fold; p = 0.0290), in comparison with individuals who survived, and it did not improve during hospitalization. In vitro treatment with IL-15 of these cells did not restore an effective cytotoxicity at any time point until the fatal outcome, and an increased expression of immune exhaustion markers was observed in NKT, CD4+, and CD8+ T cells. However, IL-15 treatment of PBMCs from individuals of the Survival group significantly increased cytotoxicity at Week 4 (6.18-fold; p = 0.0303). Consequently, immunomodulatory treatments that may overcome immune exhaustion and induce sustained, efficient cytotoxic activity could be essential for survival during hospitalization due to critical COVID-19.This work was supported by the Coordinated Research Activities at the National Center of Microbiology (CNM, Instituto de Salud Carlos III) (COV20_00679) to promote an integrated response against SARS-CoV-2 in Spain (Spanish Ministry of Science and Innovation) that is coordinated by Dr Inmaculada Casas (WHO National Influenza Center of the CNM); a generous donation provided by Chiesi España, S.A.U. (Barcelona, Spain); the Spanish Ministry of Science and Innovation (PID2019-110275RB-I00). The work of Guiomar Casado is financed by CIBERINFEC, co-financed by the European Regional Development Fund (FEDER) “A way to make Europe”. The work of Montserrat Torres is supported by Instituto de Salud Carlos III (COV20_00679). The work of Fernando Ramos Martín is financed by the Spanish Ministry of Science and Innovation (PID2019-110275RB-I00). The work of Mario Manzanares is supported by a pre-doctoral grant from Instituto de Salud Carlos III (ISCIII-PFIS FI20CIII/00021). The work of Lorena Vigón is supported by a pre-doctoral grant from Instituto de Salud Carlos III (FIS PI16CIII/00034-ISCIII-FEDER). The work of Sara Rodríguez-Mora is financed by NIH grant R01AI143567.N

Uncles ex Machina: Familial Epiphany in Euripides' Electra

At the close of Euripides’ Electra, the Dioscuri suddenly appear ‘on high’ to their distraught niece and nephew, who have just killed their mother, the divine twins’ mortal sister. This is in fact the second longest extant deus ex machina (after the final scene in Hippolytus), and the only scene in which a tragedian attempts to resolve directly the aftermath of the matricide. In this article, I argue that Castor's and Polydeuces’ sudden apparition to Orestes and Electra constitutes a specialised point of intersection between the mortal and immortal realms in Greek tragedy: familial epiphany, an appearance by a god who has an especially intimate relationship with those on stage. Euripides’ focus on the familial divine as a category accentuates various contradictions inherent to both ancient Greek theology and dramaturgy. The Dioscuri are a living paradox, ambiguously traversing the space between dead heroes and gods, managing at the same time to occupy both. They oscillate uniquely between the mortal and immortal worlds, as different sources assign different fathers to each brother, and others speak of each one possessing divinity on alternate days. As I propose, the epiphany of these ambiguous brothers crystallises the problem of the gods’ physical presence in drama. Tragedy is the arena in which gods burst suddenly into the mortal realm, decisively and irrevocably altering human action. The physical divine thus tends to be both marginal and directorial, tasked with reining in the plot or directing its future course. The appearance of the familial divine, on the other hand, can in fact obscure the resolution and future direction of a play, undermining the authority of the tragic gods. In the specific case of Electra, I contend that the involvement of the Dioscuri, who are Electra's and Orestes’ maternal uncles, produces a sense of claustrophobia at the close of the play, which simultaneously denies the resolution that is expected from a deus ex machina while also revealing the pessimistic nature of what is typically considered a reassuringly ‘domestic’ and character driven drama

Rituximab in the treatment of interstitial lung disease associated with autoimmune diseases: experience from a single referral center and literature review

ABSTRACT: In the present study, we aimed to report our experience with rituximab (RTX) in the treatment of patients with ILD associated with AD (AD-ILD) at a single center. For this purpose, clinical characteristics, radiological findings, and pulmonary function tests (PFTs) of RTX-treated AD-ILD-patients seen from May 2016 until March 2020 at a referral center for individuals with ILD were retrospectively reviewed. Additionally, an updated literature review was conducted. A total of 26 patients (mean age 58.3 ± 11.1 years at ILD diagnosis) was included. The most common ADs related to ILD were systemic sclerosis, idiopathic inflammatory myositis (including anti-synthetase syndrome) and rheumatoid arthritis. Non-specific interstitial pneumonia (n = 12) and usual interstitial pneumonia (n = 11) were the predominant radiological patterns. The sustained improvement in PFTs was observed from the start of RTX, with a statistically significant increase in DLCO from basal to one year after RTX (mean + 4.2%, p = 0.024). Overall, there were no differences when comparing PFT outcome according to the radiological pattern or the specific type of AD. In conclusion, RTX constitutes a good therapeutic option to preserve lung function in patients with AD-ILD, regardless of the radiological pattern or the underlying AD.This research received no external funding. B.A.-M. is recipient of a and “López Albo” Post-Residency Programme funded by Servicio Cántabro de Salud. S.R.-M. is supported by funds of the RETICS Program (RD16/0012/0009) (Instituto de Salud Carlos III, co-funded by the European Regional Development Fund)