Evaluación del daño en estructuras de pórticos con mampostería y obtención de un índice de daño estructural

Dentro de ámbito de las construcciones, es común el uso de mampostería para cerrar las estructuras de pórticos, sin embargo existe una escasez trabajos que analicen el comportamiento de este tipo de elementos estructurales. En este trabajo se presenta el estudio, mediante análisis numéricos, de la influencia que ejerce la mampostería en la respuesta de estas estructuras cuando son sometidas a esfuerzos laterales, tales como los de un sismo. En el presente documento se obtienen y discuten las curvas de capacidad, el daño local y global y los mecanismos de rotura de estructuras de pórticos con diferentes configuraciones de mampostería en su interior. El análisis numérico se ha llevado a cabo mediante el programa de elementos finitos PLCd, desarrollado por el CIMNE y por el departamento de Resistencia de Materiales y Estructuras. Finalmente, se extraerán una serie conclusiones de los resultados obtenidos del análisis de las estructuras y se propondrán futuras líneas de investigación

Relación entre el periodo fundamental de vibración y el índice de daño de un edificio de hormigón armado

Para evaluar numéricamente el comportamiento sísmico de un edificio debido a la acción de un terremoto existen diferentes herramientas que tienen su base en el cálculo estático incremental, también conocido como push-over, y en el cálculo dinámico no lineal. Para poder estudiar el periodo fundamental de vibración (periodo asociado al primer modo de vibración) de un edificio dañado, el método basado en el push-over ofrece serias limitaciones ya que no calcula los desplazamientos en el techo del edificio debidos a una acción dinámica, por lo que será necesario recurrir al análisis dinámico. Así, el índice de daño es calculado haciendo uso de un análisis dinámico incremental, donde la acción sísmica es escalada para varios valores de un determinado rango de aceleraciones máximas,. Diferentes acciones sísmicas han sido consideras: el terremoto de Lorca (2011), una muestra de terremotos europeos que se ajusten a un determinado espectro del Eurocódigo 8, y una muestra de señales generadas aleatoriamente. El periodo fundamental del edificio es calculado con dos metodologías distintas: a partir del deterioro de la matriz de rigidez de la estructura y a partir del espectro de desplazamientos en el techo. El edificio considerado es representativo para los edificios de viviendas en España. Se relacionaran los periodos calculados con los índices de daño estableciendo dos relaciones distintas con los mismos parámetros. Finalmente se compararan los resultados obtenidos con ambas metodologías. El principal objetivo de este trabajo es ofrecer diferentes metodologías para poder establecer una relación entre el periodo de un edificio y su estado de daño. Los resultados obtenidos muestran cómo ambas metodologías son parecidas hasta un cierto valor de daño y cómo la incertidumbre aumenta cuanto más fuerte es la acción sísmica

Gender differences in the plasma concentration of the GAS6-TAM system in COVID-19 patients

Resumen del trabajo presentado en el 4th European Congress on Thrombosis and Haemostasis, celebrado en Gante (Bélgica), los días 14 y 15 de octubre de 2021Background: SARS-CoV-2 induces an immune response with potentially harmful effects for the patient due to an uncontrolled release of inflammatory factors, specially at the capillary wall. The vitamin K-dependent plasma protein GAS6 and the TAM (TYRO3, AXL, and MERTK) receptors play a relevant role among restorative mechanisms that counterbalance pro-inflammatory responses at the endothelial interface. Aims: To study the influence of gender on the effects of SARS-CoV-2 infection in the GAS6/TAM system, as reflected by plasma concentration at patient admittance at the emergency ward. Methods: The plasma content of GAS6, AXL, and MERTK was analyzed in a first group of 132 patients, 68 females and 64 males consecutively admitted to the emergency ward during the first peak of COVID-19. A confirmatory group was studied from the second wave of contagions. An analysis of gender differences in relation to the GAS6/TAM concentrations in plasma was performed on this population. Results: In accordance with recently published GAS6 levels, significantly higher in the SARS-CoV-2 positive than in negative patients, increased progressively with the severity of the disease in SARS-CoV-2 positive individual irrespective of the gender of the patient. In contrast, while soluble AXL exhibited higher plasma concentration in deceased patients and no significant differences were observed in MERTK concentration, differential gender analysis suggest differences in soluble TAM receptors. While a COVID-19 related increase in sAXL was observed in men, this was not the case in women. Oppositely, MERTK differences due to COVID-19 infection were only significant in women. Summary/Conclusion: GAS6-TAM system of ligands and receptors is implicated in the immune response to SARS-CoV-2 in patients from both genders. Plasma GAS6 levels paralleled COVID-19 severity being an early marker of disease prognosis in both sexes. In contrast, soluble TAM receptors presented a gender-specific behavior. Sex-related differences in sAXL and sMERTK expression in COVID-19 patients could affect therapy efficacy deserving further investigation

Next-generation Sequencing in Bone Marrow Failure Syndromes and Isolated Cytopenias : Experience of the Spanish Network on Bone Marrow Failure Syndromes

Inherited bone marrow failure syndromes (IBMFSs) are a group of congenital rare diseases characterized by bone marrow failure, congenital anomalies, high genetic heterogeneity, and predisposition to cancer. Appropriate treatment and cancer surveillance ideally depend on the identification of the mutated gene. A next-generation sequencing (NGS) panel of genes could be 1 initial genetic screening test to be carried out in a comprehensive study of IBMFSs, allowing molecular detection in affected patients. We designed 2 NGS panels of IBMFS genes: version 1 included 129 genes and version 2 involved 145 genes. The cohort included a total of 204 patients with suspected IBMFSs without molecular diagnosis. Capture-based targeted sequencing covered > 99% of the target regions of 145 genes, with more than 20 independent reads. No differences were seen between the 2 versions of the panel. The NGS tool allowed a total of 91 patients to be diagnosed, with an overall molecular diagnostic rate of 44%. Among the 167 patients with classified IBMFSs, 81 patients (48%) were diagnosed. Unclassified IBMFSs involved a total of 37 patients, of whom 9 patients (24%) were diagnosed. The preexisting diagnosis of 6 clinically classified patients (6%) was amended, implying a change of therapy for some of them. Our NGS IBMFS gene panel assay is a useful tool in the molecular diagnosis of IBMFSs and a reasonable option as the first tier genetic test in these disorders

Factors associated with the clinical outcome of patients with relapsed/refractory CD19+acute lymphoblastic leukemia treated with ARI-0001 CART19-cell therapy

The prognosis of patients with relapsed/refractory (R/R) acute lymphoblastic leukemia (ALL) remains poor, particularly for those relapsing after allogeneic hema-topoietic cell transplantation (alloHCT). Novel agents such as inotuzumab ozogamicin or blinatumomab achieve increased response rates, but these are generally transient unless followed by alloHCT. Chimeric antigen receptors (CAR) targeting CD19 have shown promising results in R/R ALL, and one of these products (tisagenlecleucel) has been approved for the treatment of patients with R/R ALL up to 25 years of age

International Consensus Document on Obstructive Sleep Apnea

El objetivo principal de este documento internacional de consenso sobre apnea obstructiva del sueno es proporcionar unas directrices que permitan a los profesionales sanitarios tomar las mejores decisiones en la asistencia de los pacientes adultos con esta enfermedad según un resumen crítico de la literatura más actualizada. El grupo de trabajo de expertos se ha constituido principalmente por 17 sociedades científicas y 56 especialistas con amplia representación geográfica (con la participación de 4 sociedades internacionales), además de un metodólogo experto y un documentalista del Centro Cochrane Iberoamer icano. El documento consta de un manuscrito principal, con las novedades más relevantes del DIC, y una serie de manuscritos online que recogen las búsquedas bibliográficas sistemáticas de cada uno de los apartados del DIC. Este documento no cubre la edad pediátrica ni el manejo del paciente en ventilación mecánica crónica no invasiva (que se publicarán en sendos documentos de consenso aparte)

Safety and preliminary efficacy on cognitive performance and adaptive functionality of epigallocatechin gallate (EGCG) in children with Down syndrome. A randomized phase Ib clinical trial (PERSEUS study)

Purpose: Although some caregivers are using epigallocatechin gallate (EGCG) off label in hopes of improving cognition in young adults with Down syndrome (DS), nothing is known about its safety, tolerability, and efficacy in the DS pediatric population. We aimed to evaluate safety and tolerability of a dietary supplement containing EGCG and if EGCG improves cognitive and functional performance. Methods: A total of 73 children with DS (aged 6-12 years) were randomized. Participants received 0.5% EGCG (10 mg/kg daily dose) or placebo for 6 months with 3 months follow up after treatment discontinuation. Results: In total, 72 children were treated and 66 completed the study. A total of 38 participants were included in the EGCG group and 35 in the placebo group. Of 72 treated participants, 62 (86%) had 229 treatment-emergent adverse events (AEs). Of 37 participants in the EGCG group, 13 (35%) had 18 drug-related treatment-emergent AEs and 12 of 35 (34%) from the placebo group had 22 events. In the EGCG group, neither severe AEs nor increase in the incidence of AEs related to safety biomarkers were observed. Cognition and functionality were not improved compared with placebo. Secondary efficacy outcomes in girls point to a need for future work. Conclusion: The use of EGCG is safe and well-tolerated in children with DS, but efficacy results do not support its use in this population. (C) 2022 The Authors. Published by Elsevier Inc. on behalf of American College of Medical Genetics and Genomics

Anti-tumour necrosis factor discontinuation in inflammatory bowel disease patients in remission: study protocol of a prospective, multicentre, randomized clinical trial

Background: Patients with inflammatory bowel disease who achieve remission with anti-tumour necrosis factor (anti-TNF) drugs may have treatment withdrawn due to safety concerns and cost considerations, but there is a lack of prospective, controlled data investigating this strategy. The primary study aim is to compare the rates of clinical remission at 1?year in patients who discontinue anti-TNF treatment versus those who continue treatment. Methods: This is an ongoing, prospective, double-blind, multicentre, randomized, placebo-controlled study in patients with Crohn?s disease or ulcerative colitis who have achieved clinical remission for ?6?months with an anti-TNF treatment and an immunosuppressant. Patients are being randomized 1:1 to discontinue anti-TNF therapy or continue therapy. Randomization stratifies patients by the type of inflammatory bowel disease and drug (infliximab versus adalimumab) at study inclusion. The primary endpoint of the study is sustained clinical remission at 1?year. Other endpoints include endoscopic and radiological activity, patient-reported outcomes (quality of life, work productivity), safety and predictive factors for relapse. The required sample size is 194 patients. In addition to the main analysis (discontinuation versus continuation), subanalyses will include stratification by type of inflammatory bowel disease, phenotype and previous treatment. Biological samples will be obtained to identify factors predictive of relapse after treatment withdrawal. Results: Enrolment began in 2016, and the study is expected to end in 2020. Conclusions: This study will contribute prospective, controlled data on outcomes and predictors of relapse in patients with inflammatory bowel disease after withdrawal of anti-TNF agents following achievement of clinical remission. Clinical trial reference number: EudraCT 2015-001410-1

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research