Eduardo Torroja's Zarzuela Racecourse grandstand: Design, construction, evolution and critical assessment from the Structural Art perspective

The grandstands of La Zarzuela Racecourse in Madrid designed by the engineer E. Torroja and the architects C. Arniches and M. Dominguez are one of the world s most outstanding concrete constructions of the first half of the 20th century. This paper describes the design competition and the conceptual design process that led to their construction and carries out a critical assessment of the grandstands from the perspective of Structural Art. By doing so, the paper helps to develop the discipline of structural criticism, and points out lessons learned from their design and construction process which should not be forgotten at the present time, such as: (a) the importance of design competitions; (b) the fact that the pursuit of economy and efficiency can actually improve the quality and aesthetics of the design; (c) the importance of combining logical reasoning based on technical criteria with imagination to achieve excellence in structural design; and (d) the importance of estimating structural behavior by simple formulas and of learning from both existing structures and experimental models.The authors are very grateful to the engineers G. Ayuso and L. Fernandez Troyano from Carlos Fernandez Casado S.L. and C. Polo from the company Hipodromo de La Zarzuela S.A. for all the information and support provided. The authors also want to thank the Archivo Torroja and its former librarian, I. Garcia, for providing full access to the funds of the archive to develop this research. Funding for this research was provided by the Spanish Ministry for Science and Innovation (Research Project BIA 2011-27104).Moragues, JJ.; Paya-Zaforteza, I.; Medina, O.; Adam Martínez, JM. (2015). Eduardo Torroja's Zarzuela Racecourse grandstand: Design, construction, evolution and critical assessment from the Structural Art perspective. Engineering Structures. 105:186-196. https://doi.org/10.1016/j.engstruct.2015.10.008S18619610

Risk Factors and Outcomes for Late Presentation for HIV-Positive Persons in Europe: Results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE)

Background: Few studies have monitored late presentation (LP) of HIV infection over the European continent, including Eastern Europe. Study objectives were to explore the impact of LP on AIDS and mortality. Methods and Findings: LP was defined in Collaboration of Observational HIV Epidemiological Research Europe (COHERE) as HIV diagnosis with a CD4 count <350/mm3 or an AIDS diagnosis within 6 months of HIV diagnosis among persons presenting for care between 1 January 2000 and 30 June 2011. Logistic regression was used to identify factors associated with LP and Poisson regression to explore the impact on AIDS/death. 84,524 individuals from 23 cohorts in 35 countries contributed data; 45,488 were LP (53.8%). LP was highest in heterosexual males (66.1%), Southern European countries (57.0%), and persons originating from Africa (65.1%). LP decreased from 57.3% in 2000 to 51.7% in 2010/2011 (adjusted odds ratio [aOR] 0.96; 95% CI 0.95-0.97). LP decreased over time in both Central and Northern Europe among homosexual men, and male and female heterosexuals, but increased over time for female heterosexuals and male intravenous drug users (IDUs) from Southern Europe and in male and female IDUs from Eastern Europe. 8,187 AIDS/deaths occurred during 327,003 person-years of follow-up. In the first year after HIV diagnosis, LP was associated with over a 13-fold increased incidence of AIDS/death in Southern Europe (adjusted incidence rate ratio [aIRR] 13.02; 95% CI 8.19-20.70) and over a 6-fold increased rate in Eastern Europe (aIRR 6.64; 95% CI 3.55-12.43). Conclusions: LP has decreased over time across Europe, but remains a significant issue in the region in all HIV exposure groups. LP increased in male IDUs and female heterosexuals from Southern Europe and IDUs in Eastern Europe. LP was associated with an increased rate of AIDS/deaths, particularly in the first year after HIV diagnosis, with significant variation across Europe. Earlier and more widespread testing, timely referrals after testing positive, and improved retention in care strategies are required to further reduce the incidence of LP

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Utopía del tratamiento médico de la sordera: un agente cerumenolítico en el período colonial

6 páginasThe initial development of knowledge about a decrease in hearing acuity goes back to ancient Greece. Since then, various treatments have been used to cure this disability, focusing on its etiology. During the colonial period, almond oil was used as an effective agent to treat deafness. The use of almond oil in New Granada´s recipes for the treatment of deafness caused by impacted earwax is effective, safe, and is even currently used as a cerumenolytic. However, a lack of knowledge in the clinical evolution of the patients treated at that time makes it difficult to reach conclusive results.Los indicios acerca del desarrollo del conocimiento sobre la disminución de la agudeza auditiva se remontan hasta la antigua Grecia. Desde entonces, diversos tratamientos se han empleado para tratar dicha discapacidad, centrados en su etiología. Durante el período colonial se empleó el aceite de almendras como un agente eficaz para tratar la sordera. El uso del aceite de almendras en las recetas neogranadinas para el tratamiento de la sordera causada por cerumen impactado es efectivo, seguro e incluso es empleado como cerumenolítico en la actualidad. Sin embargo, un desconocimiento en la evolución clínica de los pacientes tratados en esa época dificulta llegar a resultados concluyente

Utopía del tratamiento médico de la sordera: un agente cerumenolítico en el período colonial

Los indicios acerca del desarrollo del conocimiento sobre la disminuci&oacute;n de la agudeza auditiva se remontan hasta la antigua Grecia. Desde entonces, diversos tratamientos se han empleado para tratar dicha discapacidad, centrados en su etiolog&iacute;a. Durante el per&iacute;odo colonial se emple&oacute; el aceite de almendras como un agente eficaz para tratar la sordera