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Abstract: The aim of this research has been to determine the causes of the damages located in Santiago church (Jerez de la Frontera, Spain), such as the collapse of the pillars, the wall and vault fissures and others, which have occurred over its five hundred year existence. The most significant aspects of the investigation works performed are related to the use of combined non-destructive techniques, such as the use of georadar with ultrasounds to detect voids inside pillars and main walls, videoscope, thermograph systems, accelerator and other seismic techniques, reducing up to 20% the excavations and unnecessary bore holes in order to know the composition and heterogeneities of the elements. In addition, by using these techniques, the deformation module E – dynamic and static – at different heights in pillars, as well as the bearing capacity could be obtained, not only among the pillars, but also at the bottom, central and upper parts of each pillar. An important goal of the investigation was to determine the extent of the reinforcement works developed in 1961, checking geometric features and conservation status of concrete elements. From all the data collected, the origin of the existing damages and pathologies can be set out, and hence, a building restoration can be adequately carried out. [Copyright &y& Elsevier]

Abstract: A great number of damages and injuries affecting buildings are originated either in the foundations or at the supporting ground. This involves a rehabilitation using different techniques of reinforcing and underpinning so as to give the stability back to the architectural collection of buildings. This activity has a great social impact and relevance when dealing with monumental or emblematic constructions where the adopted solution needs to be efficient and safe, and therefore it implies the development of studies before and after the process of rehabilitation to ensure the durability of the intervention. This article shows the research works been done to check the suitability of the adopted solution to consolidate the ground in the restoration of the emblematic building of “La Normal” in Granada. Reinforced jet grouting has been used with the incorporation of fuse elements inserted in the sleeve pipe. It has been defined as a “fuse” since it is a helicoidal tube made of a synthetic material, which can be deformed longitudinally but not transversely and incorporates a spiral steel collar acting as a bellow. With this system, the excessive ground rigidity is avoided as a consequence of the injections which could affect the building if settlements are produced. Seismic techniques have been used, such as the Cross-hole and Down-hole and pressuremetric tests have been carried out to determine the consolidation degree achieved on the supporting soil using reinforced injections. The works carried out serve as a basis to establish actuating and control criteria in soil consolidation treatments using cement–bentonite reinforced jet grouting. [Copyright &y& Elsevier]

Purpose: To describe the clinical and epidemiological characteristics of patients with Vogt-Koyanagi-Harada (VKH) disease in Spain., Methods: This was a retrospective multicenter analysis of data from VKH patients followed for at least 6 months. The data collected were related to demographics, clinical manifestations, treatments, and complications., Results: Participants were 112 patients (224 eyes), from 13 tertiary referral centers, of mean age 37.5 ± 14.7 years; 83.9% were women. Ethnicities were 61.6% Caucasian and 30.4% Hispanic. The disease was classified as complete in 16.1%, incomplete in 55.4%, and probable in 28.6%. When seen for the first time, the clinical course was acute in 69.6%, recurrent chronic in 15.2%, and chronic in 14.3%. The most frequent treatment was corticosteroids (acute stage 42.2%, maintenance stage 55.6%). The most common complications were cataract (41.1%) and ocular hypertension (16.1%). In most eyes, visual acuity was improved (96.7%) or remained stable at the end of follow up., Conclusion: VKH in Spain mostly affects women and presents as incomplete acute stage disease. Visual prognosis is good. Cataract and glaucoma are the two most frequent complications.

Aim: To evaluate the incidence and outcome of secondary immune thrombocytopenia (ITP) in a large cohort of paediatric Spanish patients., Methods: A retrospective observational study was conducted in two paediatric University hospitals in Spain between 2009 and 2019, which included children from 4 months to 18 years old diagnosed with ITP. Data were recorded from clinical charts: gender, age at diagnosis, coexisting condition and associated characteristics, outcome and treatment., Results: Secondary ITP was diagnosed in 87 out of 442 patients (19.6%). Post-immunisation ITP was seen in younger children. The onset of secondary ITP to autoimmune diseases (AD) and immunodeficiencies (ID) was at an older age and had more tendency to be insidious, and platelet level was higher than primary ITP. Mean time from ITP onset to AD diseases or ID diagnosis was 1.2 and 2.6 years, respectively. Whereas the cumulative incidence of remission was significantly higher in post-immunisation and post-viral infection (compared with primary ITP patients), it was worse in AD and ID patients., Conclusions: Identification of secondary ITP is important as it predicts outcome. Most of them are diagnosed at ITP onset, but AD diseases and ID should be ruled out periodically as they are usually identified later., (©2021 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Aim: To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW)., Methods: Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality., Results: As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001)., Conclusions: Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality., Competing Interests: The authors have declared that no competing interests exist.

This work provides information on nitrification with nitrite accumulation in low strength ammonia (below 50 mg L -1 NH 4 -N) and low organic matter (below 150 mg L -1 COD) reclaimed wastewater. In the South Tenerife reclaimed wastewater pipeline (62 km long), injection of O 2 has been applied to promote a nitrification process in order to improve water quality and to avoid anaerobic conditions. Nitrification occurs, in most cases, with nitrite accumulation. The amount of oxidized nitrogen compounds produced increases with the oxygen dose applied. The nitrification process is usually favoured instead of the organic matter transformation, due to the low organic matter/ammonia nitrogen ratio of water. The influence of organic matter content on nitrification has been analysed, and a good suitability for COD has been found as an indicator for nitrification limitation (for the range of COD and NH 4 -N concentrations of the system). Nitrification limitation has been observed above 85 mg L -1 COD, and nitrification inhibition above a concentration of 105 mg L -1 . In addition, the limitation of nitrite oxidation bacteria activity (nitrite accumulation) by free ammonia and temperature has been assessed, finding that, for the range of free ammonia (0.6-2.1 mg L -1 NH 3 ) and temperature (20.4-27.0°C) in the study, temperature plays a much more relevant role than free ammonia on nitrite accumulation. The lower limiting temperature for nitrite build-up in the system has been 21.0°C. Below this temperature, nitrite accumulation did not exist or was very low.

Theoretical and experimental studies have shown that activity concentrations of fallout radionuclides (such as 137 Cs and excess 210 Pb) decrease with particles size in aqueous suspensions. This paper is aimed at reviewing the theoretical fundamentals for granulometric speciation of radionuclides, and at exploring its practical use in the analytical context of gamma spectrometry for the radiometric dating of recent sediments, with view to: i) improving the detection of 137 Cs (since its use as independent chronostratigraphic mark is challenging in the southern hemisphere because its low fallout rate), ii) supporting refined CIC models and normalization techniques in 210 Pb-based radiogeochronologies. The work uses surface sediments sampled from the Tinto Estuary (SW Spain), affected by mining and phosphate-fertilizer industries, and from the Ankobra Estuary (Ghana), affected by intensive artisanal gold-mining. Granulometric classes have been separated by a sieving column with decreasing mesh sizes and the obtained cumulative percentage of mass mathematically described by a Rosin-Rammler particle-size distribution. The target radionuclides for gamma spectrometry were 210 Pb, 226 Ra and 137 Cs, complemented with 40 K, 234 Th and 228 Ra. Results revealed that, far from ideal experiments, under actual environmental conditions the increase in activity concentrations with decreasing particle sizes is too moderate, and in general they are affected by larger counting uncertainties due to the small available amount of mass. Indeed, there was no correlation between grain-size and 137 Cs concentrations (p = 0.25), and similarly for excess 210 Pb (p = 0.53). No effect of the organic matter content was observed in 137 Cs (p = 0.58) and excess 210 Pb (p = 0.85) concentrations. Present results pose some concerns to the general use of granulometric speciation in the context of gamma spectrometry for supporting the radiometric dating of recent sediments. A detailed discussion on the use of normalization methods is also presented., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Fanconi anemia (FA) is a DNA repair syndrome generated by mutations in any of the 22 FA genes discovered to date 1,2 . Mutations in FANCA account for more than 60% of FA cases worldwide 3,4 . Clinically, FA is associated with congenital abnormalities and cancer predisposition. However, bone marrow failure is the primary pathological feature of FA that becomes evident in 70-80% of patients with FA during the first decade of life 5,6 . In this clinical study (ClinicalTrials.gov, NCT03157804 ; European Clinical Trials Database, 2011-006100-12), we demonstrate that lentiviral-mediated hematopoietic gene therapy reproducibly confers engraftment and proliferation advantages of gene-corrected hematopoietic stem cells (HSCs) in non-conditioned patients with FA subtype A. Insertion-site analyses revealed the multipotent nature of corrected HSCs and showed that the repopulation advantage of these cells was not due to genotoxic integrations of the therapeutic provirus. Phenotypic correction of blood and bone marrow cells was shown by the acquired resistance of hematopoietic progenitors and T lymphocytes to DNA cross-linking agents. Additionally, an arrest of bone marrow failure progression was observed in patients with the highest levels of gene marking. The progressive engraftment of corrected HSCs in non-conditioned patients with FA supports that gene therapy should constitute an innovative low-toxicity therapeutic option for this life-threatening disorder.

Objective: To estimate the annual cost of temporary work disability (TWD) caused by musculoskeletal diseases (MSDs) in Spain and its variations between regions (autonomous communities: ACs) and paying institutions., Method: Descriptive study of the costs of MSD-related TWD in ACs in 2007. The Spanish National Institute of Social Security (NISS) provided aggregate data. Extrapolations to the rest of the TWD payers (mutual societies and employers) were used., Results: MSDs were the leading cause of TWD in Spain in 2007, causing 908,781 episodes of TWD (18% of the total), 39,342,857 lost working days (23%), and a cost of 1,702 million euros (23%). The annual incidence of TWD episodes per 1,000 employed was 45. The cost per TWD process was 1,873 €, ranging from 1,391 € (La Rioja) to 2,429 € (Basque Country)., Conclusion: MSDs produce annually in Spain over 39 million days lost by TWD with a cost of over 1,700 million euros. Regions observed wide variations of the TWD cost., (Copyright © 2013 Elsevier España, S.L. All rights reserved.)

Objective: To explore knowledge on musculoskeletal-diseases (MSDs) by the Spanish population., Methods: This was a cross-sectional study of the general population (> 18 years) using a telephone survey of 1,009 subjects stratified by habitat size, age, sex, and geographic area. A structured questionnaire was used to collect information on the subjects, their general knowledge of MSDs (GK), their specific knowledge of particular MSDs (SK), and their knowledge of their social impact (KSI). Synthetic indicators of the level of knowledge were used to analyze, using univariate and multivariate models, variables associated to the level of knowledge., Results: The KSI level ranges from medium-high (mean: 0.62 ± 0.16 out of 1), suggesting that most subjects recognize MSDs as disabling conditions which affect the ability to work and have a high personal and social cost. The GK level is intermediate (mean: 0.50 ± 0.17); 60% of subjects know something about MSDs, but 54% state that their information is poor/very poor. The SK level is low (mean: 0.18 ± 0.10), and there are some MSDs that are little known (lupus, spondylitis). Being male or retired or having a MSD is associated to a greater knowledge of MSDs., Conclusion: The Spanish population has a medium level of knowledge of the frequency and extent to which MSDs affect performance of activities by those who suffer them. They identify them adequately and have a GK of their symptoms, but have little information about them. The level of knowledge varies depending on social and demographic factors and on whether or not the subject has direct or indirect experience of what a MSD means., (Copyright © 2012 Elsevier España, S.L. All rights reserved.)

Seventy-seven olive accessions corresponding to 25 cultivars from the Extremadura region of Spain were studied using four microsatellite or SSR markers in order to fingerprint them, and evaluate genetic similarity and relationships between local and introduced olive cultivars. The number of alleles per locus ranged from 4 to 8, with a mean of 6.25 alleles per primer pair (a total of 25 alleles). The observed heterozygosity ranged from 0.58 to 0.95, while the expected heterozygosity varied between 0.68 and 0.83. The polymorphism information content values ranged from 0.63 to 0.79. The mean polymorphism information content value of 0.70 for the SSR loci provided sufficient discriminating ability to evaluate the genetic diversity among the cultivars. The SSR data allowed unequivocal identification of all the cultivars; a combination of three SSR markers was sufficient to discriminate all 25 olive cultivars. A dendrogram was prepared, using the unweighted pair-group method with arithmetic mean clustering algorithm; it depicted the pattern of relationships between the cultivars. Most of the local cultivars grouped according to their geographic origin. No clear clustering trends were observed when the morphological traits of fruit endocarps or fruit use of cultivars were employed as analysis criteria. We conclude that there is a high level of variability among local olive cultivars from the Extremadura region at both the morphological and molecular levels; these data should be useful for identifying and distinguishing local germplasm.

Fanconi anemia is characterized by congenital abnormalities, bone marrow failure, and cancer predisposition. To investigate the origin, functional role, and clinical impact of FANCA mutations, we determined a FANCA mutational spectrum with 130 pathogenic alleles. Some of these mutations were further characterized for their distribution in populations, mode of emergence, or functional consequences at cellular and clinical level. The world most frequent FANCA mutation is not the result of a mutational "hot-spot" but results from worldwide dissemination of an ancestral Indo-European mutation. We provide molecular evidence that total absence of FANCA in humans does not reduce embryonic viability, as the observed frequency of mutation carriers in the Gypsy population equals the expected by Hardy-Weinberg equilibrium. We also prove that long distance Alu-Alu recombination can cause Fanconi anemia by originating large interstitial deletions involving FANCA and 2 adjacent genes. Finally, we show that all missense mutations studied lead to an altered FANCA protein that is unable to relocate to the nucleus and activate the FA/BRCA pathway. This may explain the observed lack of correlation between type of FANCA mutation and cellular phenotype or clinical severity in terms of age of onset of hematologic disease or number of malformations.

This paper presents a set of technologies developed to exploit Grid infrastructures for breast cancer CAD, that include (1) federated repositories of mammography images and clinical data over Grid storage, (2) a workstation for mammography image analysis and diagnosis and (3) a framework for data analysis and training machine learning classifiers over Grid computing power specially tuned for medical image based data. An experimental mammography digital repository of approximately 300 mammograms from the MIAS database was created and classifiers were built achieving a 0.85 average area under the ROC curve in a dataset of 100 selected mammograms with representative pathological lesions and normal cases. Similar results were achieved with classifiers built for the UCI Breast Cancer Wisconsin dataset (699 features vectors). Now these technologies are being validated in a real medical environment at the Faculty of Medicine in Porto University after a process of integrating the tools within the clinicians workflows and IT systems.

There is scanty information about invasive aspergillosis (IA) in the pediatric population. A review of IA at Hospital Infantil Universitario Niño Jesús between 1996 and 2006 was undertaken to analyze incidence, risk factors, and treatment response. Twenty patients were diagnosed with probable or proven IA during the study period, with a cumulative incidence of 1.96%. Incidence was higher in hematopoietic stem cell transplantation (HSCT) recipients: 2.26% (3.5% in allogeneic HSCT and 1.2% in autologous HSCT). A significative increase in IA incidence was observed along the study period (P=0.013), although this increase did not reach signification if only proven cases were compared (P=0.058). Most patients presented multiple risk factors for IA (87% more than 1, and 47% more than 3). The most frequently described risk factor was chemotherapy (90%), after by long-term neutropenia (90%), and corticotherapy (75%). Main locations of the infection were pulmonary (8 patients), cutaneous (3 patients) and intestinal (3 patients). Six patients presented disseminated IA. Initial response to treatment was 55%, although 3 of these cases had a subsequent episode. Global antifungal response, at the end of the follow-up, was 45%. IA-related mortality was 55%. Global mortality was 90%. Only 2 patients (isolated cutaneous IA cases) survived. Seven patients died due to their underlying malignant disease without active fungal disease. Incidence of IA in oncology children is increasing, and in adults. In our experience, IA is a marker of poor outcome even for patients who initially respond to antifungal treatment.

Background and Objectives: Although several studies have reported on the use of children as donors for peripheral blood progenitor cells (PBPC), no specific characteristics have been identified as predictors of PBPC collection in this population. In this study we analyzed predictive factors for PBPC collection in pediatric donors., Design and Methods: We retrospectively analyzed factors predicting the yield for a target CD34+ cell dose of > or =4x10(6)/Kg donor or recipient body weight, in 105 aphereses from 76 healthy pediatric donors (36 boys and 40 girls) included in the Spanish National Donor Registry. Mobilization consisted of granulocyte colony-stimulating factor (G-CSF) in single doses of 10 microg/kg per day subcutaneously for 4 or 5 days. Apheresis started after the fourth dose of G-CSF., Results: Median age and body weight were 10 years (range 1-18) and 42 kg (range 9-89), respectively. The median number of CD34+ cells/kg recipient body weight was 4.22 (range 0.1-32). On multivariate analysis variables that had a significant negative impact on the CD34+ cell yield, considering the recipient's body weight were the total blood volume processed (regression coefficient (RC): 0.41, 95% CI: 0.21-0.81; p=0.01) and day of apheresis other than first (RC: 0.16, 95% CI: 0.07-0.34; p<0.0001). When considering donor's body weight the variables that positively influenced collection were younger age (RC: 6.79, 95% CI: 1.57-29.25; p<0.01) and large volume leukapheresis (RC: 3.33, 95% CI: 1.13-9.77; p<0.02)., Interpretation and Conclusions: Our data suggest that pediatric donors mobilized by G-CSF may donate sufficient numbers of CD34+ cells for allogeneic transplantation. The variables that influenced the yield were the donor's age, blood volume processed and the first day of the apheresis.

The composition of 185 Spanish compounds containing chloramphenicol, along with the information supplied in ther package inserts, were studied. Only 11 of these compounds contained chloramphenicol alone, this antibiotic being associated with other chemotherapeutic agents and/or other drugs in the remainder. Indications listed in the leaflet largely went beyond the limits of the medically established uses of chloramphenicol, and information concerning side effects, contraindications, or precautions was scanty and in some instances even confusing. A change in the availability of drug combinations containing chloramphenicol and an improvement of the information accompanying them is urged.