Protección del ambiente y supranacionalidad

El objetivo del trabajo consiste en comprobar la eficacia de las normas supranacionales del sistema jurídico denominado SUPRANACIONALIDAD en la protección del ambiente. Para ello, en primer lugar se establece el marco de trabajo dentro de la ciencia jurídica, encontrando en el Derecho Ambiental y el Derecho Internacional el punto exacto del campo de trabajo, determinando así la existencia del Derecho Ambiental Internacional. Este, con sus caracteres y principios, constituye el lugar preciso donde centralizar el análisis científico, tanto del instituto de la SUPRANACIONALIDAD como el de su acción para la protección del Ambiente, hallando una perfecta combinación entre ambos campos. En segundo lugar, analizaré el sistema jurídico supranacional, sus órganos y funciones y sus características. En especial, la norma supranacional, el efecto que ella produce, las propiedades de la norma supranacional y sus relaciones con la Integración; el efecto provocado por algunos principios del sistema supranacional como el efecto directo y la primacía para, luego, precisar si las acciones que provocan aquéllas normas, junto a los principios que la informan y los efectos que producen en el campo de la protección del Ambiente, contribuyen a comprobar la eficacia del sistema. Finalmente, a través de la observación de los cambios provocados por la acción de las normas y los principios que informan al sistema supranacional en el campo de la protección del Ambiente, se proyecta la existencia de un sistema jurisdiccional supranacional, es decir, la existencia de un órgano dotado de competencia ambiental con jurisdicción universal o regional, denominado Tribunal Internacional Ambiental,nominado Tribunal Internacional Ambiental, cuya existencia como herramienta jurídica para la protección del ambiente será dentro del sistema supranacional, no del intergubernamental. El trabajo consiste en analizar la norma supranacional ambiental y su respuesta ante los problemas ambientales, analizada desde el derecho sustantivo no desde el procedimental. Sin perjuicio, y para la aplicación de la norma supranacional, se proyecta la existencia de dos sistemas jurisdiccionales internacionales que tendrán como función la interpretación y aplicación del derecho supranacional ambiental.</jats:p

Data-Driven Modeling of High-Speed Centrifugal Compressors for Aircraft Environmental Control System

The Environmental Control System (ECS) is the main consumer of non-propulsive power onboard aircraft, accounting for up to 3-5% of the total fuel consumption. The use of an electrically-driven Vapor Compression Cycle (VCC) system, in place of the conventional Air Cycle Machine (ACM), can lead to both a substantial increase of the Coefficient Of Performance (COP) at cruise conditions, and to a reduction of maintenance costs. The performance of the VCC system is highly affected by the design of its main components, namely, the compact heat exchangers and the high-speed centrifugal compressor. Therefore, the optimal system design requires the use of an integrated design methodology. This work documents the development of a data-driven compressor model based on Artificial Neural Networks (ANNs). The objective is to reduce the VCC model complexity, and the computational cost of the associated optimization problem. The model has been trained on a synthetic dataset composed of 165k unique centrifugal compressor designs generated with an in-house tool, validated with experimental data. The data-driven model has been coupled to an in-house integrated design framework for aircraft ECS, and it has been used to perform the multi-objective optimization of a VCC system for a single-aisle, short-haul aircraft, flying at cruise conditions. The results show that the number of function evaluations used to identify the Pareto front reduces by a factor of three, when leveraging the capabilities of the data-driven model. Moreover, the optimal solutions identified with the novel method cover a wider design space, due to the improved robustness of the VCC system model.</jats:p

Epidemiology and Management of Patients With Acute Coronary Syndromes in Contemporary Real-World Practice: Evolving Trends From the EYESHOT Study to the START-ANTIPLATELET Registry

The epidemiology and management of patients with acute coronary syndromes (ACSs) have evolved. We aimed to describe recent demographics and therapeutic changes in the Italian ACS population. We analyzed data from 2 multicenter consecutive Italian registries (the EYESHOT [EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalised in iTalian cardiac care units] and START-ANTIPLATELET registries) enrolling patients with ACS between December 2013 and June 2016. An overall population of 3756 patients with ACS was enrolled: 2585 in the EYESHOT and 1171 in the START-ANTIPLATELET. Compared with the EYESHOT, patients in the START-ANTIPLATELET registry presented more frequently with ST-segment elevation myocardial infarction and were more often smokers and dyslipidemic (all P < .001) and had atrial fibrillation ( P = .018) but were less frequently aged ≥75 years and with a history of major bleeding (all P < .001). Analysis of treatment strategy showed a significant increase in the use of percutaneous coronary intervention, drug-eluting stents, dual antiplatelet therapy, and ticagrelor in the START-ANTIPLATELET (all P < .001), with a substantial decline in the proportion of patients conservatively managed and on clopidogrel at discharge ( P < .001). A lower rate of in-hospital events was recorded in the START-ANTIPLATELET compared with the EYESHOT. The START-ANTIPLATELET and EYESHOT registries provide consecutive snapshots in the contemporary management of patients with ACS in Italy, showing important changes in both demographic characteristics and treatment strategies

EU-Wi<i>d</i>e Cross-Section<i>a</i>l Obser<i>v</i>at<i>i</i>o<i>n</i>al Study of Lipid-Modifying Therapy Use in Se<i>c</i>ondary and Pr<i>i</i>mary Care: the DA VINCI study

Abstract Aims To provide contemporary data on the implementation of European guideline recommendations for lipid-lowering therapies (LLTs) across different settings and populations and how this impacts low-density lipoprotein cholesterol (LDL-C) goal achievement. Methods and results An 18 country, cross-sectional, observational study of patients prescribed LLT for primary or secondary prevention in primary or secondary care across Europe. Between June 2017 and November 2018, data were collected at a single visit, including LLT in the preceding 12 months and most recent LDL-C. Primary outcome was the achievement of risk-based 2016 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) LDL-C goal while receiving stabilized LLT; 2019 goal achievement was also assessed. Overall, 5888 patients (3000 primary and 2888 secondary prevention patients) were enrolled; 54% [95% confidence interval (CI) 52–56] achieved their risk-based 2016 goal and 33% (95% CI 32–35) achieved their risk-based 2019 goal. High-intensity statin monotherapy was used in 20% and 38% of very high-risk primary and secondary prevention patients, respectively. Corresponding 2016 goal attainment was 22% and 45% (17% and 22% for 2019 goals) for very high-risk primary and secondary prevention patients, respectively. Use of moderate–high-intensity statins in combination with ezetimibe (9%), or any LLT with PCSK9 inhibitors (1%), was low; corresponding 2016 and 2019 goal attainment was 53% and 20% (ezetimibe combination), and 67% and 58% (PCSK9i combination). Conclusion Gaps between clinical guidelines and clinical practice for lipid management across Europe persist, which will be exacerbated by the 2019 guidelines. Even with optimized statins, greater utilization of non-statin LLT is likely needed to reduce these gaps for patients at highest risk. </jats:sec