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Introduction Mental health in the deaf community is a complex issue. Challenges in diagnosis and treatment arise from a lack of experienced interpreters and difficulties in translating Sign Language to spoken language. Deaf individuals, due to auditory limitations, are more vulnerable to abuse, increasing their risk of mental health disorders, including bipolar affective disorder (BPAD). BPAD is a prevalent, debilitating condition with varied prevalence estimates. Managing it is tough due to its lifelong, unpredictable nature. A new approach called Psychiatric Home Hospitalization Unit aims to provide acute mental health care at home as an alternative to hospitalization. Objectives To show the management of severe bipolar disorder with comorbidity from a Psychiatric Home Hospitalization Unit Methods A clinical case of bipolar disorder with deafness attended at the Psychiatric Home Hospitalization Unit of our hospital is presented. Results A 24-year-old deaf woman borned in Pakistan and later moving to Catalonia, she faced educational challenges but ultimately completed her studies with sign language support. Afterward, she struggled to find suitable employment, and her family had a history of bipolar disorder. She exhibited a sudden change in behavior, characterized by irritability, paranoia, and distrust. Communication was challenging due to her speech difficulties, but assessments using sign language and observation were conducted. Her physical examination was normal, but her speech was disorganized and pressured, suggesting possible auditory hallucinations and thought disturbances. She was hospitalized and diagnosed with bipolar disorder with psychotic features. During her initial hospitalization, she received lithium, olanzapine, clotiapine and benzodiacepines. After discharge, she continued treatment through a home hospitalization service during almost 4 month. During follow-up she presented a course with high affective instability, rapid cycling alternating brief periods of stability with other presenting manic and mixed features with high disorganization. Due to the rapid cycling pattern Valproic acid was considered. Valproic acid was introduced up to 700 mg/d (97.1 mcg/mL). Treatment with lithium carbonate 800 mg/d (0.91 mEq/L) was maintained. Previous antipsychotic regimen was changed to quetiapine 400mg/d, olanzapine 5mg/d. Her condition improved significantly with the adjusted treatment regimen. She was discharged to an outpatient service. Conclusions Diagnosing and treating bipolar affective disorder (BPAD) in a deaf and mute patient posed unique challenges. The rapid mood cycling pattern and complexity of her case made treatment challenging. Family information and interpreter support were vital. Cultural factors were considered, and home hospitalization was crucial in managing symptoms that lasted over four months. Disclosure of Interest None Declared

Resumen: Introducción: El tratamiento de las fracturas vertebrales metastásicas sin compresión neural se realiza con técnicas percutáneas de cementación. El aumento de presión intratumoral por estas técnicas puede enviar células tumorales al torrente sanguíneo. Para evitar esa diseminación y mejorar el tratamiento del dolor se han introducido las técnicas de ablación que permitirían crear una cavidad en el tumor previo a la cementación o directamente necrosar la metástasis cuando el tamaño es pequeño. Material: Presentamos la experiencia con la ablación de dos hospitales y dos técnicas de ablación distintas. El primer grupo usó la ablación por radiofrecuencia (ARF) en 14 pacientes (26 vértebras) de los cuales en cuatro se asoció una artrodesis vertebral. El segundo grupo usó la ablación por microondas (AMO); 93 pacientes (129 lesiones) sin asociar instrumentación vertebral. Resultados: En el grupo de ARF la mejoría del dolor en la escala visual analógica (EVA) fue de 7,7 a 2,6 a las seis semanas. No hubo complicaciones derivadas de la ablación. En la mayoría de los casos se asoció la cementación. En el grupo de AMO la mejoría del dolor en EVA pasó de 6,8 a 1,7 a las seis semanas. En todos los casos se asoció la cementación. No hubo complicaciones derivadas de la ablación. Conclusiones: La asociación de las técnicas de ablación a la cementación vertebral es una técnica segura, que permite mejorar notablemente el dolor del paciente y puede ayudar al control de la enfermedad. Abstract: Introduction: Treatment of metastatic vertebral fractures without neural compression is performed with percutaneous cementation techniques. The increase in intratumoral pressure by these techniques can send tumor cells into the bloodstream. To prevent this dissemination and improve pain treatment, ablation techniques have been introduced that would allow the creation of a cavity in the tumor prior to cementation or directly necrosing the metastasis when its size is small. Material: We present the experience with ablation of two hospitals and two different ablation techniques. The first group used radiofrequency ablation (A) in 14 patients (26 vertebrae), 4 of whom underwent vertebral arthrodesis. The second group used microwave ablation (B) in 93 patients (129 lesions) without associated vertebral instrumentation. Results: In group A pain improvement in VAS was 7.7–2.6 at 6 weeks. There were no complications derived from the ablation. In most cases cementation was associated. In the group B pain improvement in VAS went from 6.8–1.7 at 6 weeks. Cementation was associated in all cases. There were no complications derived from the ablation. Conclusion: The association of ablation techniques with vertebral cementation is a safe technique that significantly improves the patient's pain and can help control the disease.

Introduction: Treatment of metastatic vertebral fractures without neural compression is performed with percutaneous cementation techniques. The increase in intratumoral pressure by these techniques can send tumor cells into the bloodstream. To prevent this dissemination and improve pain treatment, ablation techniques have been introduced that would allow the creation of a cavity in the tumor prior to cementation or directly necrosing the metastasis when its size is small. Material: We present the experience with ablation of two hospitals and two different ablation techniques. The first group used radiofrequency ablation (A) in 14 patients (26 vertebrae), 4 of whom underwent vertebral arthrodesis. The second group used microwave ablation (B) in 93 patients (129 lesions) without associated vertebral instrumentation. Results: In group A pain improvement in VAS was 7.7–2.6 at 6 weeks. There were no complications derived from the ablation. In most cases cementation was associated. In the group B pain improvement in VAS went from 6.8 to 1.7 at 6 weeks. Cementation was associated in all cases. There were no complications derived from the ablation. Conclusion: The association of ablation techniques with vertebral cementation is a safe technique that significantly improves the patient's pain and can help control the disease. Resumen: Introducción: El tratamiento de las fracturas vertebrales metastásicas sin compresión neural se realiza con técnicas percutáneas de cementación. El aumento de presión intratumoral por estas técnicas puede enviar células tumorales al torrente sanguíneo. Para evitar esa diseminación y mejorar el tratamiento del dolor se han introducido las técnicas de ablación que permitirían crear una cavidad en el tumor previo a la cementación o directamente necrosar la metástasis cuando el tamaño es pequeño. Material: Presentamos la experiencia con la ablación de dos hospitales y dos técnicas de ablación distintas. El primer grupo usó la ablación por radiofrecuencia (ARF) en 14 pacientes (26 vértebras) de los cuales en cuatro se asoció una artrodesis vertebral. El segundo grupo usó la ablación por microondas (AMO); 93 pacientes (129 lesiones) sin asociar instrumentación vertebral. Resultados: En el grupo de ARF la mejoría del dolor en la escala visual analógica (EVA) fue de 7,7 a 2,6 a las seis semanas. No hubo complicaciones derivadas de la ablación. En la mayoría de los casos se asoció la cementación. En el grupo de AMO la mejoría del dolor en EVA pasó de 6,8 a 1,7 a las seis semanas. En todos los casos se asoció la cementación. No hubo complicaciones derivadas de la ablación. Conclusiones: La asociación de las técnicas de ablación a la cementación vertebral es una técnica segura, que permite mejorar notablemente el dolor del paciente y puede ayudar al control de la enfermedad.

Introduction Wernicke’s encephalopathy (WE) is a potentially reversible neuropsychiatric emergency caused by thiamine deficiency, whose classical triad consists of acute onset of confusion, gait ataxia, and oculomotor dysfunction. The diagnosis is missed in 75-80% of cases and approximately 80% of untreated patients develop Korsakoff Syndrome, which is characterized by memory impairment associated with confabulation. Early recognition of nutritional deficiency or any portion of the triad is critical and should prompt treatment, since WE is readily reversible if treated with adequate doses of parenteral thiamine. Objectives Starting from a case report of suspected WE, we pretend to discuss the differential diagnosis of seizures in dual pathology. Methods Non-systematic review of the literature was performed in PubMed database using the keywords “Wernicke’s Encephalopathy”, “Seizures”, “Alcohol” and “Benzodiazepines”. The articles were selected according to their relevance. A patient´s clinical record was reviewed and presented. Results We present a case of a 44-year-old Ukrainian man with suspected background of chronic alcohol abuse and psychiatric history of schizoaffective disorder, who presented with acute onset of confusion, psychomotor agitation, gait ataxia and nystagmus. Anamnesis was hampered by the language barrier and absence of past medical history and patient’s alcoholic habits remained unclear. After suspicion of WE it was introduced thiamine and diazepam, with significant improvement. After discontinuation of diazepam, the patient presented with several episodes of tonic-clonic seizures. He was medicated for seizures with clinical stabilization. At time of discharge the diagnostic discussion prevailed. Seizures are a common presentation of various conditions associated with alcohol use, whose differential diagnosis is difficult, especially in patients with dubious alcohol consumption. Alcohol abuse is a major precipitant of status epilepticus as seizure threshold is raised by alcohol drinking. Seizures may also occur during alcohol withdrawal, for which treatment with benzodiazepines is recommended, however carefully, since both abrupt cessation and high-dose use are critical for the appearance of seizures. Although very rare, WE may also present with seizures, whereby overdiagnosis and overtreatment are preferred to prevent persistent neurocognitive impairments. Conclusions This case illustrates the complexity of neuropsychiatric diagnoses in dual pathology. It requires a longitudinal assessment for a better understanding of clinical conditions and establishment of the best therapeutic approach. Disclosure of Interest None Declared

One of our grand challenges towards fusion energy is the achievement of a high-performance plasma core coupled to a boundary solution. The high confinement mode (H-mode) provides such a high-performance fusion core due to the build-up of an edge transport barrier leading to a pedestal. However, it usually features type-I edge localized modes (ELMs) which pose a threat for long-duration plasma operation in future fusion devices as they induce large energy fluences onto the plasma facing components and typically are projected to damage the first wall. For future fusion devices, the integration of a stationary no-ELM regime with a power exhaust solution is indispensable. Several no-ELM and small-ELM regimes have extended their operational space in the past years, with the ultimate goal of providing an alternative core–edge solution to ITER and EU-DEMO. Prominent no-ELM or small-ELM alternatives include the I-mode, QH-mode, EDA H-mode, quasi-continuous exhaust (QCE) and ‘grassy’ ELM regimes, X-point radiator scenarios and negative triangularity L-mode. The state-of-the-art, including access conditions and main signatures, of these alternative regimes is reviewed. Many of these regimes partly match the operational space of ITER and EU-DEMO, however, knowledge gaps remain. Besides compatibility with divertor detachment and a radiative mantle, these include extrapolations to high Q operations, low core collisionality, high Greenwald fractions, impurity transport, amongst others. The knowledge gaps and possible strategies to close these gaps to show their applicability to ITER and EU-DEMO are discussed.

Fabric-reinforced cementitious matrix (FRCM) composites are materials that are usually applied to strengthen existing structures. In this study, a hemp mesh coated with epoxy was manufactured and combined with a cementitious matrix to strengthen a concrete beam. This beam was subjected to bending cyclic loading tests and a nondestructive modal analysis test. The modal analysis was performed to determine the dynamic elastic properties of the beam under pre-cracking, post-cracking, and strengthened conditions. The beam stiffness increased following strengthening with hemp-FRCM. The results of the experimental cyclic loading test showed that the hemp-FRCM system improved the load-bearing capacity of the beam at the service limit state by 42%. Analytical and numerical models were adjusted and validated using the experimental results, and both proved to be effective calculation tools. The models accurately reproduced the behaviour of the FRCM-strengthened concrete beam if the strengthening connection could prevent sliding and mortar debonding failures.

Interaction between microbially induced calcium carbonate precipitation (MICP) and compaction procedures to stabilise raw soil materials has been studied with the aim of producing earthen engineering structures. Initial tests to optimise MICP in aqueous medium and in selected soils were performed. MICP and compaction were finally applied to assess medium-size elements. The main result was that sandy soils should be compacted before irrigation treatment to close the existing voids and prevent bacterial sweeping, whereas clayey soils should be compacted after irrigation treatment to avoid the plugging effect. MICP improved small sand soil compressive strength by up to 32% over the value reached by compaction alone. However, MICP had no positive effect on coarse soils and soils with an optimum particle size distribution: MICP treatment was not able to fill large connected voids in the first case and it caused little void generation due to bacteria sporulation in the second.

Introduction: Dialysis fluid (DF), an essential element in hemodialysis (HD), is manufactured in situ by mixing three components: treated water, bicarbonate concentrate and acid concentrate. To avoid the precipitation of calcium and magnesium carbonate that is produced in DF by the addition of bicarbonate, it is necessary to add an acid. There are 2 acid concentrates that contain acetate (ADF) or citrate (CDF) as a stabilizer. Objective: To compare the acute effect of HD with CDF vs. ADF on the metabolism of calcium, phosphorus and magnesium, acid base balance, coagulation, inflammation and hemodynamic stability. Methods: Prospective, multicenter, randomized and crossed study, of 32 weeks duration, in patients in three-week HD, AK-200-Ultra-S or Artis monitor, 16 weeks with ADF SoftPac®, prepared with 3 mmol/L of acetate, and 16 weeks with CDF SelectBag Citrate®, with 1 mmol/L of citrate. Patients older than 18 years were included in HD for a minimum of 3 months by arteriovenous fistula. Epidemiological, dialysis, pre and postdialysis biochemistry, episodes of arterial hypotension, and coagulation scores were collected monthly during the 8 months of the study. Pre and post-dialysis analysis were extracted: venous blood gas, calcium (Ca), ionic calcium (Cai), phosphorus (P), magnesium (Mg) and parathyroid hormone (PTH) among others.ClinicalTrials.gov NCT03319680. Results: We included 56 patients, 47 (84%) men and 9 (16%) women, mean age: 65.3 (16.4) years, technique HD/HDF: 20 (35.7%)/36 (64.3%).We found differences (p

Resumen: Introducción: El líquido de diálisis (LD), elemento esencial en la hemodiálisis (HD), se fabrica in situ mezclando 3 componentes: agua tratada, concentrado de bicarbonato y concentrado ácido. Para evitar la precipitación de carbonato cálcico y magnésico que se produce en el LD por la adición de bicarbonato, es necesario añadir un ácido. Existen 2 concentrados ácidos según contengan acetato (LDA) o citrato (LDC) como estabilizante. Objetivo: Comparar el efecto agudo de la HD con LDC vs. LDA sobre el metabolismo del calcio, fosforo y magnesio, el equilibrio ácido base, la coagulación, inflamación y la estabilidad hemodinámica. Métodos: Estudio prospectivo, multicéntrico, aleatorizado y cruzado, de 32 semanas de duración, en pacientes en HD trisemanal, monitor AK-200-Ultra-S o Artis, 16 semanas con LDA SoftPac®, elaborado con 3 mmol/l de acetato, y 16 semanas con LDC SelectBag Citrate®, con 1 mmol/l de citrato. Se incluyeron pacientes mayores de 18 años en HD durante un mínimo de 3 meses mediante fístula arteriovenosa. Se recogieron datos epidemiológicos, de diálisis, bioquímica pre- y posdiálisis, episodios de hipotensión arterial, y scores de coagulación mensualmente durante los 8 meses de estudio. Se extrajeron pre- y posdiálisis: gasometría venosa, calcio (Ca), calcio iónico (Cai), fósforo (P), magnesio (Mg) y hormona paratiroidea (PTH), entre otros.ClinicalTrials.gov NCT03319680. Resultados: Se incluyeron 56 pacientes, 47 (84%) hombres y 9 (16%) mujeres de edad media: 65,3 (16,4) años, técnica HD / HDF: 20 (35,7%) / 36 (64,3%).Encontramos diferencias (p

Recent I-mode investigations from the ASDEX Upgrade tokamak are reported. It is shown that neutral-beam-injection heated I-modes can be stationary, which is important in terms of extrapolability towards future fusion devices. Furthermore, detailed studies on the weakly coherent mode are reported. In particular, experimental observations point towards its existence in L-mode, before I-mode starts. Moreover, its impact on density and temperature fluctuations is evaluated. Studies of stationary divertor heat fluxes show that in I-mode, the upstream power fall-off length is between those observed in L-mode and H-mode, and it is connected to the scrape-off layer temperature fall-off length. Moreover, analysis of transient divertor heat loads shows that intermittent turbulent events, observed in the confinement region and linked to the weakly coherent mode, are responsible for a significant part of divertor heat loads.

Diabetes mellitus (DM) and also anemia are common in the elderly and have a negative impact on the clinical outcomes of patients. The coexistence of anemia and DM seems to be insufficiently recognized; therefore, the aim of our study is to analyze the incidence and clinical consequences of this coexistence, including mortality, in the population of people aged ≥60. A retrospective study was conducted on 981 primary care clinic patients aged ≥60 during 2013-2014. The prevalence of coexistence of DM and anemia (defined in accordance with WHO) and data on the incidence of comorbidities, hospitalization, medical procedures, and all-cause mortality were analyzed. In the study population, 25% had DM, while 5.4% had both DM and anemia. Peripheral artery disease (PAD) was found in 48 patients (4.89%) of the entire study population, more often in men (p

The thermal helium beam diagnostic at ASDEX Upgrade can access the whole plasma edge region simultaneously with a high spatiotemporal resolution. Manifold dynamics of plasma edge transport is observed for different plasma confinement regimes, comprising L- and H-mode scenarios with type-I and small ELMs as well as ELM free EDA regimes. The measurements show that the plasma dynamics in the confined region close to the separatrix is often dominated by regular high frequency modes (10–100 kHz), whereas filaments with an intermittent occurrence rate of 0.1–2 kHz dominate in particular the far scrape-off layer (SOL). The comparison among different regimes shows a similar filamentary activity between L-mode and inter-ELM H-mode phases. An increased filamentary activity in H-mode, however, is found for rising densities n∕nGW. This is the case for the regime of quasi continuous exhaust (QCE) with three times higher filament velocities compared to a clean inter-ELM H-mode.

This article utilizes perturbation method (PM) to find an analytical approximate solution for the Quasi-Steady-State Michaelis-Menten problem. From the comparison of Figures and absolute error values, between approximate and numerical solutions, it is shown that the obtained solutions are accurate, and therefore, they explain the general behaviour of the Michaelis-Menten mechanism.

A global heat flux model based on a fractional derivative of plasma pressure is proposed for the heat transport in fusion plasmas. The degree of the fractional derivative of the heat flux, α, is defined through the power balance analysis of the steady state. The model was used to obtain the experimental values of α for a large database of the Joint European Torus (JET) carbon-wall as well as ITER like-wall plasmas. The fractional degrees of the electron heat flux are found to be α

Microbial biodeposition of calcite induction for improving the performance of rammed earth is a research area that must be analysed in a representative environment. This analysis must consider the compaction force, particle size distribution and curing process as production variables. This paper investigates the effects of adding specific bacteria, Sporosarcina Pasteurii, into compressed earth cubes and the effect of production variables. Uniaxial compressive tests and direct shear tests have been conducted for 80 specimens. The results indicate that calcite precipitation interacts with the drying process of clay/silt resulting in reducing the compressive strength, the apparent cohesion and the friction angle. Finally, bacterial activity, which is more likely in samples cured in a high humidity environment, tends to reduce the dilatancy effect.

Resumen El propósito de esta revisión era presentar las bases bilógicas y fisiopatológicas de la formación de neuromas como causa de los síndromes dolorosos regional (SDRC) tipo II y el uso de la monitorización neurofisiológica intraoperatoria en el tratamiento de los SDRC tipo II secundarios a neuromas en continuidad y en nervios adheridos en cicatrices tras cirugías previas.

Quercus pyrenaica Willd. es un roble mediterráneo-occidental, ampliamente distribuido en la península ibérica que presenta una extraordinaria capacidad de rebrote, especialmente de raíz. Tradicionalmente ha sido aprovechado para leñas en monte bajo y, menos frecuentemente, adehesado para el uso ganadero. El abandono de la gestión tradicional mayoritaria ha puesto de manifiesto el estado de degradación de sus masas (falta decrecimiento, puntisecado, ausencia de fructificación), que de forma teórica se había atribuido al agotamiento de las cepas y a la falta de diversidadgenética. Sin embargo, el análisis reciente mediante marcadores moleculares microsatélites de numerosos rebollares, incluidos los que aquí se presentan, permite descartar la supuesta falta de variabilidad genética. No obstante, la falta de concordancia entre la estructuras forestales de montes bajos y adehesados y el origen asexual o sexual de sus pies, junto a la heterogeneidad en el tamaño y composición de las cepas dificulta la interpretación de la estructura clonal actual en cada monte. Este trabajo, en el que se evalúa el estado de conservación de los recursos genéticos de Q.pyrenaica en uno de los territorios más intensamente aprovechados por el hombre a lo largo de la historia, ilustra la importante resiliencia que presenta la especie frente al manejo tradicional en monte bajo. Mediante el estudio de tres rodales localizados en el mismo robledal en el Parque Nacional de Sierra Nevada, se analiza el efecto de la gestión pasada (en monte bajo y adehesado) y presente (en un rodal de monte bajo resalveado) sobre la diversidad genética y la estructura clonal de la especie. Además, se evalúa la evolución futura de la diversidad genética a través del análisis del regenerado en los tres rodales en función del manejo selvícola que han experimentado. A pesar de que los montes bajos presentan mayores niveles de diversidad genética para la cohorte adulta, el origen asexual de la cohorte juvenil podría limitar la evolución de la diversidad genética en el futuro. Por el contrario, en el monte adehesado, la regeneración mayoritaria mediante semilla de los pies juveniles asegura la sucesión generacional y el incremento de los niveles de diversidad genética en el futuro.

Los rebollares de Quercus pyrenaica son formaciones casi exclusivas de la península ibérica cuya regeneración sexual se encuentra fuertemente comprometida como consecuencia de su estructura dominada por rebrotes de cepa y raíz (monte bajo). El abandono del aprovechamiento histórico de estos rebrotes (leña, carbón, etc.) ha provocado que, actualmente, muchos rebollares se hayan convertido en ecosistemas degradados con exceso de espesura, puntisecado y estancamiento del crecimiento. Este trabajo trata de resumir el estado del conocimiento de las principales interacciones planta-animal en la regeneración sexual de los bosques dominados por el rebollo, con el fin de proporcionar bases científicas para una mejor gestión y conservación de estos ecosistemas. Algunas especies animales (arrendajo, ratón de campo, trepador azul) juegan un papel importante en la dispersión efectiva de las bellotas, lo que contribuye a un mejor flujo génico y a la colonización de nuevos lugares. Sin embargo, la creciente densidad de ungulados silvestres (ciervo, jabalí, etc.) es uno de los factores de mayor amenaza para estos bosques al reducir drásticamente el número de bellotas disponibles para la germinación y limitar el crecimiento y la supervivencia de las nuevas plántulas. Además, existen interacciones multi-tróficas (p. ej. bellota-predador-dispersor) y fenómenos de facilitación (plántula-matorral) que revelan la importancia de las relaciones múltiples en la regeneración de los rebollares. Finalmente, se exponen posibles medidas de gestión encaminadas a facilitar la regeneración sexual de estos sistemas de manera que pueda revertirse la actual situación de estancamiento y decaimiento de muchos rebollares.

Aim of study: Eucalyptus globulus Labill. is the most planted tree species in the Ethiopian highlands due to its potential to satisfy the increasing wood demand of the population. The objectives of this study are to assess the variation in growth traits and survival among E. globulus landraces and clones and to evaluate correlations between growth traits on saplings established in the field.Area of study: The study was performed in the central highlands of Ethiopia.Material and Methods: A landrace trial with Ethiopian seedlings and Spanish cuttings (Sancho and Tinto clones) of E. globulus was carried out. Root collar diameter, height and survival were evaluated on saplings one year after outplanted in the field.Main results: The Spanish landrace showed an improved field performance with 35% higher root collar diameter, 35% taller saplings and 27% higher survival rates as compared to the Ethiopian plants. Sancho clone attained 10% higher root collar diameter than Tinto clone. Strong positive correlation between root collar diameter and height for all saplings was observed (r=0.8785).Research highlights: The present study can be considered as a starting point to implement a breeding program for E. globulus, which is nowadays of great importance in Ethiopia. The introduction of a new Spanish landrace may contribute to broadening the genetic base of this species in Ethiopia. Further tree breeding efforts with E. globulus should be undertaken to raise such genetic base and to increase the productivity of eucalypt plantations in the Ethiopian highlands.Keywords: clone; rural development; tree breeding.

Materiales tipo Fibre Reinforced Polymer (FRP) y Textile Reinforced Mortar (TRM) han sido estudiados, comparados y aplicados para reforzar muros de fábrica de ladrillo. La comparación de su comportamiento frente a efectos de flexión de segundo orden se abordada en este artículo por primera vez. Datos experimentales y analíticos de investigaciones previas y nuevos datos analíticos para los casos de TRM son resumidos, ordenados y sistemáticamente comparados para analizar la respuesta estructural de los muros de fábrica de ladrillo reforzados. Los resultados muestran un comportamiento similar de los dos sistemas respecto su capacidad de carga y su respuesta en el plano. Los casos reforzados con TRM mostraron desplazamientos laterales superiores a los reforzados con FRP.

Se analiza el comportamiento mecánico de un distractor dinámico para el tratamiento de las fracturas conminutas de las articulaciones interfalángicas proximales (IFP) de los dedos. El objetivo es establecer cuáles son los patrones de la tendencia a luxarse, y por lo tanto saber dónde y cómo colocar las agujas de Kirschner correctamente. Metodológicamente se aplica un sistema de modelización matemática del comportamiento mecánico del dedo índice de la mano, con vistas a evaluar la mejor forma de movilizar, total o parcialmente, la articulación IFP, y conseguir la restauración de la superficie articular. Los resultados tienen importantes aplicaciones clínicas: en las lesiones con inestabilidad volar, cuanto más cerca de la articulación IFP se coloque la aguja, menor será la tendencia a la inestabilidad; en las lesiones con inestabilidad dorsal, se deberá colocar la aguja lo más distalmente posible.

An unusual presentation of Devic’s neuromyelitis optica (NMO) disease associated with bilateral internuclear ophthalmoplegia (INO) is described. A 32-year-old pregnant patient was diagnosed with NMO. First symptoms were headache and sudden visual loss in her right eye (RE). Eighteen months ago, she reported other neurologic symptoms such as paresthesia. Based on her visual field, fundoscopy and Ishihara test, she was diagnosed with retrobulbar neuritis of the RE. After delivery, new neurologic symptoms resembling transverse myelitis appeared. She was treated with methylprednisolone and plasmapheresis, which improved her visual acuity; however, a sudden bilateral INO appeared, with adduction defect and nystagmus with abduction in both eyes. No improvement was obtained after treatment with azathioprine and rituximab. Paresis of the legs and the right arm persisted, but double vision and OIN gradually disappeared. At the end, the patient had a residual exophoria in the RE and nystagmus with abduction in the left eye. Prevalence of NMO is lower than one case per one million inhabitants, and it is not likely to affect the encephalic trunk; furthermore, bilateral INO in NMO is rare. Two major criteria and at least two of the three minor ones are required to confirm a NMO diagnosis, and our patient fulfilled these diagnosis criteria.

La aleación de aluminio 7075-T6 es una aleación estructural ampliamente utilizada para aplicaciones aeronáuticas, debido a su alta relación entre resistencia mecánica y peso. Dependiendo de las condiciones ambientales, algunos mecanismos de corrosion tales como intergranular, exfoliacion, picadura y crevice se ha encontrado que ocurren en estructuras de aviones de aleaciones de aluminio. Un avance siginificativo para mejorar el comportamiento de esta aleación es la aplicación de recubrimientos autocatalíticos de Ni-P, los cuales confieren una excelente resistencia a la corrosión acoplado con una reducción del desgaste erosivo y un aumento de la dureza. El propósito de este trabajo fue investigar el efecto de la aplicación de un recubrimiento de Ni-P sobre la resistencia a la corrosión de una aleación de aluminio 7075-T6. Los resultados obtenidos indican que la aplicación del recubrimiento de Ni-P disminuye la susceptibilidad a la picadura y hace a la aleación de aluminio 7075 T6, prácticamente inmune al ataque por corrosion expoliación.

La encefalopatía hepática es un estado reversible de alteración en la función cognitiva, que puede ocurrir en pacientes con enfermedad hepática aguda o crónica o shunts porto-sistémicos, en el que puede aparecer cualquiera de los signos neurológicos o psiquiátricos conocidos. Las sustancias nitrogenadas procedentes de la digestión intestinal alcanzan el cerebro sin la depuración que supone su paso por el hígado, debido a las derivaciones porto-sistémicas, y dan lugar a los signos característicos de la encefalopatía hepática. A continuación presentamos dos casos clínicos de pacientes con shunt porto-sistémicos, diagnosticados de encefalopatía hepática crónica recurrente refractaria al tratamiento médico convencional, tratados satisfactoriamente con embolización de dicho shunt mediante técnicas de radiología intervencionista.Hepatic encephalopathy is a reversible state of altered cognition that may occur in patients with acute or chronic liver disease or porto-systemic shunt, and in which known neurological or psychiatric signs may develop. Nitrogenated substances from intestinal digestion reach the brain without being cleared by their passage through the liver due to the presence of porto-systemic shunt. We report two cases of patients with porto-systemic shunt diagnosed with recurrent chronic hepatic encephalopathy refractory to conventional medical treatment. They were satisfactorily treated with shunt embolization using interventionist radiology techniques.

Objetivo: establecer si es necesario realizar una ecografía de control a todos los pacientes sometidos a una biopsia hepática o una punción aspiración con aguja fina, para detectar posibles complicaciones con o sin repercusión clínica. Material y métodos: tras la realización de una biopsia hepática o una punción aspiración con aguja fina según el protocolo habitual, se mantiene al paciente en observación durante 24 horas, realizándose en ese momento una ecografía a todos los pacientes aunque no presenten datos clínicos de complicación. Resultados: se llevaron a cabo 298 biopsias hepáticas y 98 punciones mediante aguja fina. Presentaron complicaciones un total de 37 pacientes (9,34%), de las cuales 36 (9,09%) fueron complicaciones menores en forma de dolor, síncope vasovagal o hemorragia leve y 1 (0,25%) complicación mayor en forma de hemorragia grave. De las 396 exploraciones tan sólo uno de los casos presentó una complicación detectada en la ecografía (hematoma intraparenquimatoso) encontrándose asintomático. Conclusiones: la baja incidencia de complicaciones, que cursan de forma asintomática, y la buena evolución de las mismas hacen poco rentable la realización de ecografía de control tras la realización de dichas técnicas diagnósticas, siendo necesaria tan sólo en el caso de sospecha clínica de complicación.Objective: to determine the need to perform ultrasound scans to all patients after liver biopsy or fine-needle aspiration (FNA) in order to detect complications with or without symptoms. Material and methods: after liver biopsy or FNA using a regular protocol the patient is observed for 24 hours at the hospital, and all patients undergo an abdominal sonography at that time even in the absence of evident complications. Results: 298 liver biopsies and 98 FNAs were performed. There were complications in 37 patients (9.34%): 36 (9.09%) were minor complications such as pain, vasovagal episodes, or small bleeding, and 1 (0.25%) was a major complication with severe hemorrhage. Only 1 out of all 396 procedures had a complication detected by ultrasounds (intrahepatic hematoma) while the patient was asymptomatic. Conclusions: the low incidence of complications occurring without symptoms, and their favorable course suggest that routine ultrasonography is not necessary after these techniques, and that it should be only performed when a complication is suspected.

Una asignatura pendiente de las estrategias de conservación de la biodiversidad radica en las especies arbóreas de amplia distribución. Frente al mantenimiento de la diversidad interespecífica que se aplica a los taxones herbáceos/arbustivos, las especies arbóreas fundamentan su capacidad de cambio en la diversidad intraespecífica. El alcornoque es un ejemplo de especie longeva, de amplia distribución cuya conservación como tal no está en principio amenazada. No obstante, las diferentes estaciones en las que habita, la historia de sus poblaciones y el desconocimiento de su ecología, hacen que estas amenazas sean más crípticas y hayan permitido su extinción local o regional. Las estrategias de conservación de la especie deben priorizar el mantenimiento de su diversidad intraespecífica y de los procesos que la generan, como la introgresión con otras especies de Quercus.

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Efficient methylammonium lead iodide perovskite-based solar cells have been prepared in which the perovskite layer is sandwiched in between two organic charge transporting layers that block holes and electrons, respectively. This configuration leads to stable and reproducible devices that do not suffer from strong hysteresis effects and when optimized lead to efficiencies close to 15%. The perovskite layer is formed by using a dual-source thermal evaporation method, whereas the organic layers are processed from solution. The dual-source thermal evaporation method leads to smooth films and allows for high precision thickness variations. Devices were prepared with perovskite layer thicknesses ranging from 160 to 900 nm. The short-circuit current observed for these devices increased with increasing perovskite layer thickness. The main parameter that decreases with increasing perovskite layer thickness is the fill factor and as a result optimum device performance is obtained for perovskite layer thickness around 300 nm. However, here we demonstrate that with a slightly oxidized electron blocking layer the fill factor for the solar cells with a perovskite layer thickness of 900 nm increases to the same values as for the devices with thin perovskite layers. As a result the power conversion efficiencies for the cells with 300 and 900 nm are very similar, 12.7% and 12%, respectively.

El pino canario (Pinus canariensis), una especie singular. El pino canario (Pinus canariensis Chr. Sm. Ex DC in Buch), además de ser la principal especie forestal del Archipiélago y uno de sus endemismos botánicos más notables, es un interesante modelo de adaptación. Considerado un fósil viviente, representa un tipo ancestral de pino que se diversificó en las actuales especies mediterráneas. Este artículo revisa e interpreta un conjunto de resultados obtenidos a lo largo de trece años de estudio sobre la especie por parte del equipo investigador de la ETSI de Montes (UPM) y CIFOR-INIA, con el objetivo de contribuir al conocimiento de la estrategia vital de la especie y sus capacidades adaptativas con vistas al uso y conservación de sus recursos genéticos.

Peatland restoration and rehabilitation action has become more widely acknowledged as a necessary response to mitigating climate change risks and improving global carbon storage. Peatland ecosystems require restoration time spans of the order of decades and, thus, cannot be dependent upon the shorter-term monitoring often carried out in research projects. Hydrological assessments using geospatial tools provide the basis for planning restoration works as well as analysing associated environmental influences. “Restoration” encompasses applications to pre-restoration and post-restoration scenarios for both bogs and fens, across a range of environmental impact fields. The aim of this scoping review is to identify, describe, and categorize current process-based modelling uses in peatlands in order to investigate the applicability and appropriateness of ecohydrological and/or hydrological models for northern peatland restoration. Two literature searches were conducted using the entire Web of Science database in September 2022 and August 2023. Of the final 211 papers included in the review, models and their applications were categorized according to this review's research interests in seven distinct categories aggregating the papers' research themes and model outputs. Restoration site context was added by identifying 229 unique study site locations from the full database, which were catalogued and analysed against raster data for the Köppen–Geiger climate classification scheme. A majority of northern peatland sites were in temperate oceanic zones or humid continental zones that experienced snow. Over one in five models from the full database of papers were unnamed and likely intended for single use. Key themes emerging from topics covered by papers in the database included the following: modelling restoration development from a bog growth perspective, the prioritization of modelling greenhouse gas (GHG) emissions dynamics as a part of policymaking, the importance of spatial connectivity within or alongside process-based models to represent heterogeneous systems, and the increased prevalence of remote sensing and machine learning techniques to predict restoration progress with little physical site intervention. Models are presented according to their application to peatlands or broader ecosystem and organized from most to least complex. This review provides valuable context for the application of ecohydrological models in determining strategies for peatland restoration and evaluating post-intervention development over time.