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Estimating the consumption of prescription opioids through wastewater analysis: The patterns of use in Italy
No full textPrescription opioids have recently experienced a diversion of use in several countries causing a huge number of overdoses due to their high potency. The aim of this study was to develop a wastewater-based epidemiology (WBE) approach to assess the use of prescription opioids and evaluate the compliance to prescriptions to highlight the potential misuse of these substances in Italy. The most prescribed opioids have been selected and validated as WBE biomarkers and a nation-wide study has been conducted over a three-year period (2020–2022). Wastewater (WW) samples were collected as 24-hour composite samples in eight Italian cities and parent substances or metabolites were quantified using validated analytical methods based on liquid chromatography – tandem mass spectrometry (LC-MS/MS). Daily loads have been normalized to therapeutic doses to obtain a real figure of use that showed higher use of tapentadol and morphine compared to oxycodone and fentanyl. Back-calculation of consumption estimates was done by using the most reliable WBE biomarkers and were compared with prescription data. Spatial and temporal differences were found and highlighted a lower use in the south compared to the north and the center of Italy. Data comparison with prescriptions gave results in the same range indicating that the use of these substances in Italy seems to be predominantly from prescription for therapeutic purposes. This study highlighted the suitability of WBE to investigate the potential non-medical use of prescription pharmaceuticals in a population, providing relevant information for supporting public health emergencies and policies
Experiencias adversas en la infancia y su relación con el bienestar en jóvenes adultos: salud física y mental
No full textCompendi d'articlesLa presente tesis examina el impacto de las Experiencias Adversas en la Infancia (ACEs) sobre la salud física y mental durante la adultez emergente, considerando variables culturales y contextuales específicas de España y Latinoamérica. El Estudio 1 se centró en una muestra de jóvenes españoles, abordando el impacto de las ACEs sobre la salud física, un aspecto poco explorado en esta etapa vital. El Estudio 2 analizó la relación entre las ACEs, las estrategias de afrontamiento y la manifestación de rasgos psicopáticos y altruistas. Este estudio incorpora un enfoque innovador al considerar combinaciones específicas de ACEs en lugar de analizarlas de forma aislada. El Estudio 3 se desarrolló con una muestra de jóvenes latinoamericanos, ampliando el análisis hacia ACEs expandidas, que incluyen factores económicos y sociales relevantes en ese contexto. La tesis propone estrategias de intervención culturalmente sensibles, orientadas a la prevención y tratamiento del impacto adverso de las mismas.This thesis examines the impact of Adverse Childhood Experiences (ACEs) on physical and mental health during emerging adulthood, taking into account cultural and contextual variables specific to Spain and Latin America. Study 1 focused on a sample of Spanish young adults, addressing the impact of ACEs on physical health—an area that has received little attention during this life stage. Study 2 analysed the relationship between ACEs, coping strategies, and the manifestation of psychopathic and altruistic traits. This study adopts an innovative approach by considering specific combinations of ACEs rather than analysing them in isolation. Study 3 was conducted with a sample of Latin American young adults, expanding the analysis to include expanded ACEs, which take into account economic and social factors relevant to that context. The thesis proposes culturally sensitive intervention strategies aimed at preventing and addressing the adverse impact of such experiences.Programa de Doctorat en Estudis Internacionals de Pau, Conflictes i Desenvolupamen
La calidad de vida de los pacientes con enfermedad reumatológica inflamatoria en tratamiento biológico
No full textIntroducción: La siguiente Tesis de Doctorado versa sobre las enfermedades reumatológicas inflamatorias o enfermedades reumáticas autoinmunes sistémicas (ERAS). El cometido de su composición pretende contribuir a la comprensión de la importancia de la calidad de vida (CdV) que permiten conseguir las personas con dichas patologías con la utilización de los nuevos tratamientos biológicos (TB) derivados de la investigación de las nuevas dianas terapéuticas a nivel molecular. Y para llegar a ese punto se pregunta si los pacientes en tratamiento con biológicos están mejor controlados que los que utilizan fármacos antirreumáticos. El objetivo principal es el de conocer el grado de control de los pacientes con enfermedades crónicas reumatológicas (AR, APs y EA) y su repercusión en la calidad de vida relacionada con la salud (CVRS), en la población asignada al Departament de Castelló. Material y métodos: Tras una búsqueda bibliográfica sobre el estado de la cuestión se plantea la realización de un estudio observacional con medicamentos (EOm). Para la consecución del objetivo principal y de los secundarios se formaliza la realización de dos estudios: un primer estudio observacional retrospectivo para conocer la realidad de la población con las patologías de interés, para posteriormente realizar un estudio prospectivo de cohortes con la inclusión de pacientes que inician tratamiento con fármacos modificadores de enfermedad (FAMEs) o bien TB. Resultados: En el estudio se objetivan prevalencias similares a los valores actuales a nivel mundial, siendo de 0,2% para la AR, y 0,1% tanto para la APs como para la EA. El grado de control de las diferentes entidades es adecuado, ya sea de forma analítica o bien mediante los cuestionarios de capacidad funcional específicos, siendo mayor de forma generalizada en el TB. A nivel de costes, la media del gasto de los tratamientos ajustados a la anualidad es de 7529€ utilizando FAMEs, siendo de 9122€ en el caso del TB. Por lo que respecta a los cuestionarios de CVRS, se observan diferencias a de forma puntual en el momento inicial, al mes, a los tres meses, a los seis meses y al año (en aquellos que se ha podido realizar el estudio completo). Conclusiones: Los resultados sugieren que la diferencia entre la utilización de FAME o TB bien sea en su grado de control y la CVRS, no puede generalizarse aunque se hayan objetivado tendencias, puesto que no son los tratamientos iguales, aunque en los cuestionarios de CVRS sí que había diferencias significativas.Introduction: The following PhD thesis is about inflammatory rheumatic diseases or systemic autoimmune rheumatic diseases (SARD). The purpose of its composition is to contribute to the understanding of the importance of the quality of life (QoL) that people with these pathologies can achieve with the use of new biological treatments (BT) derived from the research of new therapeutic targets at a molecular level. And to reach this point, it is asked whether patients under treatment with biologicals are better controlled than those who use antirheumatic drugs. The main objective is to know the degree of control of patients with chronic rheumatic diseases (RA, PsA and AS) and its impact on health-related quality of life (HRQoL), in the population assigned to the Department of Castelló. Material and methods: After a bibliographic search on the state of the art, the realization of an observational study with medications (EOm) is proposed. In order to achieve the main objective and the secondary ones, two studies were carried out: a first retrospective observational study to find out the reality of the population with the pathologies of interest, and then a prospective cohort study with the inclusion of patients who start treatment with with disease-modifying drugs (DMARDs) or biological treatment (BT). Results: The study found prevalences similar to current values worldwide, being 0.2% for RA, and 0.1% for both PsA and AS. The degree of control of the different entities is adequate, whether analytically or through specific functional capacity questionnaires, being generally higher in TB. In terms of costs, the average cost of treatments adjusted to the year is 7529€ using DMARDs, being 9122€ in the case of BT. Regarding the HRQoL questionnaires, differences were observed at baseline, at one month, at three months, at six months and at one year (in those for which the full study could be carried out). Conclusions: The results suggest that the difference between the use of DMARDs or TB, whether in their degree of control or HRQoL, cannot be generalised, although trends have been observed, since they are not the same treatments, although there were significant differences in the HRQoL questionnaires.Programa de Doctorat en Ciències Biomèdiques i Salu
The differential transpiration response of plants to stress
No full textAn increase in the frequency and intensity of heat waves, floods, droughts and other environmental stresses, resulting from climate change, is threatening agricultural food production worldwide. Heat waves are especially problematic to grain yields, as the reproductive processes of almost all our main grain crops are highly sensitive to heat. At times, heat waves can occur together with drought, high ozone levels, pathogen infection and/or waterlogging stress that suppress the overall process of plant cooling by transpiration. We recently reported that under conditions of heat and water-deficit stress combination, the stomata on sepals and pods of soybean (Glycine max) remain open, while the stomata on leaves close. This process, termed ‘differential transpiration’, enabled the cooling of reproductive organs, while leaf temperature increased owing to suppressed transpiration. In this review article, we focus on the impacts on crops of heat waves occurring in isolation and of heat waves combined with drought or waterlogging stress, address the main processes impacted in plants by these stresses and discuss ways to mitigate the negative effects of isolated heat waves and of heat waves that occur together with other stresses (i.e. stress combination), on crops, with a focus on the process of differential transpiration
Modelización avanzada y efectos de interacción vehículo—vía—estructura para el análisis del comportamiento dinámico de puentes de FFCC en vía convencional y de alta velocidad
No full textCompendi d'articlesEn los próximos 25 años se prevé un crecimiento considerable de la Red Transeuropea de Transporte, pudiendo verse comprometida la seguridad del tráfico. Para asegurar la integridad estructural de las infraestructuras existentes, la Agencia Ferroviaria Europea ha advertido que resulta necesario mejorar los métodos de predicción actuales. Con el foco puesto en los puentes de vigas isostáticos de luces medias—cortas, estructuras propensas a sufrir elevados niveles de aceleración vertical en sus tableros, la presente Tesis Doctoral se centra en el análisis de éstos empleando modelos detallados y tratando de identificar situaciones donde los modelos planos de viga pueden no resultar conservadores a la hora de predecir la máxima respuesta. Además, se evalúa el grado de ajuste alcanzado al considerar el fenómeno de interacción vehículo—vía balasto—estructura en presencia de irregularidades del carril, para mejorar la predicción dinámica en el tablero en condiciones de resonancia y no resonancia.The Trans—European Transport Network is expected to experience significant growth over the next 25 years, which could compromise traffic safety. To ensure the structural integrity of existing infrastructures, the European Union Agency for Railways has highlighted the need to enhance current prediction methods. Focusing on simply supported railway girder bridges of short—to—medium span lengths, which are prone to suffer high vertical acceleration levels, this Doctoral Thesis centres on the analysis of the aforementioned structures using detailed models, trying to identify situations where simplified planar beam assumptions may not be conservative for predicting the maximum response. Furthermore, the degree of adjustment achieved considering the train—track—bridge interaction phenomenon accounting for the vertical irregularities of the rails is evaluated, in order to improve the dynamic predictions under resonant and non—resonant conditions.Programa de Doctorat en Tecnologies Industrials i Material
Ultra-high performance concrete-filled dual steel tubular slender columns subjected to eccentric loads
No full textThis paper experimentally investigates slender ultra-high performance concrete-filled dual steel tubular (UHPCFDST) columns under eccentric axial loading. Four typologies were tested: double-skin (DS), double-tube (DT), and single-tube columns as reference (OT, IT). All tested columns exhibited ductile behaviour, with global flexural buckling as the dominant failure mode. The UHPC-DT column achieved the highest absolute axial load, but the UHPC-DS configuration showed superior relative efficiency due to its lower slenderness. Compared to normal-strength concrete, UHPC specimens achieved up to 85 % higher absolute axial strength. However, their relative structural efficiency and ductility were lower. This is attributed to the fact that UHPC markedly increases the plastic axial resistance without a proportional increase in the critical buckling load, resulting in higher relative slenderness. Furthermore, the simplified design approach provided by EN 1994-1-1 was assessed through comparison with experimental data, confirming its suitability as a conservative and reliable basis for the design of UHPC-filled slender composite columns.Funding for open access charge: CRUE-Universitat Jaum
Wild Beasts, Domestic Beasts & Stuffed Beasts: An Analysis of the Concepts «Universe» & «World», «Meaning» & «Sense», in the Thought of Juan David García Bacca
No full textEl presente artículo aborda la dicotomía que, en García Bacca, se da entre los conceptos «universo» y «mundo», así como en los de «significado» y «sentido», desde una perspectiva tanto ontológica como estética. El «universo» se presenta como una totalidad objetiva, regida por leyes naturales, mientras que el «mundo» emerge como una construcción subjetiva, moldeada por la percepción humana. Por otro lado, el «significado» se entiende como la decodificación cognitiva de símbolos, en contraste con el «sentido», que se revela en la experiencia concreta y vivencial de esa misma realidad. García Bacca postula que este último tiene una incidencia ontológica profunda al no ser meramente una experiencia subjetiva sino la base de la realidad.This paper addresses García Bacca's dichotomy between the concepts of «universe» and «world», as well as those of «meaning» and «sense», from both an ontological and an aesthetic perspective. The «universe» is presented as an objective totality, governed by natural laws, while the «world» emerges as a subjective construction, shaped by human perception. On the other hand, «meaning» is understood as the cognitive decoding of symbols, in contrast to «sense», which is revealed in the concrete and experiential experience of that same reality. García Bacca postulates that the latter has a profound ontological impact as it is not merely a subjective experience but the basis of reality
Epidemiología y factores de riesgo de COVID-19 en centros residenciales: impacto de la pandemia, importancia de la vacunación y transmisión aérea
No full textCompendi d'articlesEsta tesis doctoral analiza la epidemiología y los factores de riesgo asociados a la COVID-19 en poblaciones vulnerables, destacando la importancia de la prevención, el control y la transmisión aérea del virus. A través de seis artículos, se abordan distintos aspectos del impacto de la pandemia. Se estudia la variante Delta en residencias con personas vacunadas, evidenciando la eficacia de la inmunidad previa e híbrida. También se examina la incidencia y mortalidad en residencias de mayores durante la primera ola, y en centros para personas con discapacidad intelectual, subrayando la necesidad de estrategias específicas. Otro estudio demuestra la presencia de SARS-CoV-2 en aerosoles, resaltando la ventilación como medida clave. El último artículo analiza cómo las medidas no farmacológicas afectaron otras enfermedades infecciosas. En conjunto, la tesis destaca el valor de la vigilancia epidemiológica y la investigación en brotes, proponiendo estrategias preventivas que orienten futuras políticas de salud pública ante pandemias.This thesis analyzes the epidemiology and risk factors of COVID-19 in vulnerable populations, with a focus on prevention measures, control strategies, and airborne transmission. It consists of six articles addressing various aspects of the pandemic. The first explores Delta variant infections in vaccinated individuals, showing reduced viral load and severity. The second examines hybrid immunity in vaccinated elderly people, highlighting its protective effect. The third investigates COVID-19 incidence and mortality in 27 nursing homes during the first wave, emphasizing the need for isolation and vaccination. The fourth evaluates hospitalizations and deaths in residential centers for people with intellectual disabilities, recommending tailored preventive strategies. The fifth analyzes the presence of SARS-CoV-2 in aerosols indoors, stressing the importance of ventilation. The sixth, a time-series study, assesses the impact of non-pharmaceutical interventions on other infectious diseases. The thesis underscores the role of epidemiological surveillance in shaping effective strategies for future pandemics.Programa de Doctorat en Ciències Biomèdiques i Salu
Measuring User Experience in Voice and Multimodal User Interfaces: Development, Validation, and Standardization of a Usability Scale for VUIs and a Context-Aware Usability Scale for Multimodal Interfaces
No full textCompendi d'articlesThis doctoral thesis enhances the usability and user experience (UX) of Voice and Multimodal User Interfaces (VUIs) through four core objectives. First, a systematic literature review maps the state of the art in VUI usability and UX, identifying six research themes and future directions. Second, the System Usability Scale (SUS) is evaluated for VUIs through empirical comparisons of Amazon Alexa and Google Nest devices and a cross-modality study versus graphical interfaces, confirming both its usefulness and limitations. Third, a dedicated and validated VUI usability questionnaire is developed to address conversational and auditory interaction needs. Fourth, the Context-Aware Usability Scale (CAUS) is introduced for multimodal in-vehicle systems, integrating contextual factors such as traffic, cognitive load, and environment. Additionally, an AI-augmented evaluation framework for healthcare interfaces demonstrates the value of sentiment analysis, eye-tracking, and confusion prediction. Overall, this work provides validated, context-aware tools for advancing VUI and multimodal usability research.Programa de Doctorat en Informàtic
La intención emprendedora comercial y social: un modelo de antecedentes y desencadenantes del comportamiento emprendedor
No full textEsta tesis analiza el proceso emprendedor desde una perspectiva integral, explorando los factores que influyen en la formación de la intención emprendedora y su conversión en comportamiento efectivo, tanto en su vertiente comercial como social. El modelo propuesto incorpora valores personales (individualistas y colectivistas), capital social cognitivo (bonding y bridging) y eventos desencadenantes (realización personal, insatisfacción laboral, orientación a la innovación y herencia). Los resultados evidencian que los valores individualistas, especialmente los vinculados a la automejora, influyen significativamente en la intención emprendedora, incluso en proyectos de carácter social. Asimismo, se confirma que el capital social bonding facilita la intención comercial, y que la orientación a la innovación actúa como desencadenante del comportamiento. Finalmente, se valida empíricamente que una alta intención predice la acción emprendedora, sin diferencias sustanciales entre los tipos de emprendimiento. Estos hallazgos ofrecen implicaciones teóricas y prácticas para fortalecer políticas de apoyo y programas formativos en emprendimiento.This dissertation delves into the analysis of the entrepreneurial process that connects the formation of entrepreneurial intention with its manifestation as effective entrepreneurial behavior, considering both commercial and social forms of entrepreneurship. The study proposes a research model that identifies the factors explaining this transition by integrating personal, cognitive, social, and contextual variables. It highlights the role of personal values, cognitive social capital, and triggering events as key elements in the conversion of intention into action. Through a quantitative approach and structural equation modeling analysis (PLS-SEM) applied to entrepreneurs in the Valencian Region, the results show that individualistic values, particularly those oriented toward achievement and power, are significant determinants of entrepreneurial intention. Moreover, the study underscores the importance of specific triggering events, such as innovation orientation and family succession.Programa de Doctorat en Desenvolupament Local i Cooperació Internaciona