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La terapia dialéctica conductual (TDC) es un tratamiento con sustento empírico dirigido a personas con trastornos de salud mental complejos y considerados de difícil tratamiento; su meta final es que el paciente pueda construir una vida que valga la pena vivir. El objetivo del presente estudio fue evaluar la utilidad de la TDC para reducir la sintomatología del trastorno límite de personalidad, la depresión, la ansiedad y el estrés, y para aumentar la salud mental general y la atención plena en un grupo de estudiantes universitarios mexicanos. En una clínica universitaria de la Ciudad de México se identificaron a estudiantes que presentaron dificultades de regulación emocional y asistieron a una intervención basada en la TDC comprehensiva adaptada para una duración de seis meses. De los 19 pacientes enrolados en el programa, seis lo culminaron en su totalidad. Se encontraron mejoras en todas las variables. Los resultados sugieren que esta versión abreviada de la TDC podría ser efectiva para ayudar a estudiantes con dificultades de regulación emocional. Palabras clave: Terapia dialéctica conductual; regulación emocional; trastorno límite de personalidad; estrés.

Statins possess antithrombotic and profibrinolytic properties. The association between statin use and short-term outcomes in patients with acute pulmonary embolism (PE) remains unknown.We used the data from the Registro Informatizado de Pacientes con Enfermedad TromboEmbólica registry to compare the 30-day all-cause mortality in patients with acute PE according to the use of statins. Secondary outcome was fatal PE. We used cancer-related mortality as a falsification endpoint.From January 2009 to April 2021, 31 169 patients with PE were recruited. Of these, 5520 (18%) were using statins at baseline: low intensity: 829, moderate: 3636, high intensity: 1055. Statin users were older and had a higher frequency of diabetes, hypertension, or atherosclerotic disease than non-users (P0.001 for all comparisons). During the first 30 days, 1475 patients died (fatal PE, 255). On multivariable analysis, statin users had a lower risk of all-cause death (odds ratio [OR]: 0.65; 95% confidence interval [CI]: 0.56-0.76) and fatal PE (OR: 0.42; 95% CI: 0.28-0.62) than non-users. The risk for death was lower in patients using either low- (OR: 0.51; 95% CI: 0.34-0.77), moderate- (OR: 0.68; 95% CI: 0.57-0.81), or high-intensity statins (OR: 0.68; 95% CI: 0.51-0.92). Results did not change in mixed effects logistic regression models with hospitals as a random effect. Statins were not associated with a significant chance in cancer mortality (falsification endpoint).PE patients using statins at baseline had a significantly lower risk of dying within the first 30 days than non-users. Randomized trials are needed to confirm these data.

Background: The association between heart rate (HR) and pulmonary embolism (PE) outcomes has not been well studied. Furthermore, optimal cutoffs to identify low-risk and intermediate- to high-risk patients are not well known. Research Question: Does an association exist between baseline HR and PE outcome across the continuum of HR values? Study Design and Methods: The current study included 44,331 consecutive nonhypotensive patients with symptomatic PE from the Registro Informatizado de la Enfermedad TromboEmbólica registry between 2001 and 2021. Outcomes included 30-day all-cause and PE-specific mortality. We used hierarchical logistic regression to assess the association between admission HR and outcomes. Results: A positive relationship was found between admission HR and 30-day all-cause and PE-related mortality. Considering an HR of 80 to 99 beats/min as a reference, patients in the higher HR strata showed higher rates of all-cause death (adjusted OR, 1.5 for HR of 100-109 beats/min; adjusted OR, 1.7 for HR of 110-119 beats/min; adjusted OR, 1.9 for HR of 120-139 beats/min; and adjusted OR, 2.4 for HR of ≥ 140 beats/min). Patients in the lower strata of HR showed significantly lower rates of 30-day all-cause mortality compared with the same reference group (adjusted OR, 0.6 for HR of 60-79 beats/min; and adjusted OR, 0.5 for HR of < 60 beats/min). The findings for 30-day PE-related mortality were similar. For identification of low-risk patients, a cutoff value of 80 beats/min (vs 110 beats/min) increased the sensitivity of the simplified Pulmonary Embolism Severity Index (sPESI) from 93.4% to 98.8%. For identification of intermediate- to high-risk patients, a cutoff value of 140 beats/min (vs 110 beats/min) increased the specificity of the Bova score from 93.2% to 98.0%. Interpretation: In nonhypotensive patients with acute symptomatic PE, a high HR portends an increased risk of all-cause and PE-related mortality. Modifying the HR cutoff in the sPESI and the Bova score improves prognostication of patients with PE.

Ventilation/perfusion (V/Q) imaging and computed tomography pulmonary angiography (CTPA) are common tools for acute pulmonary embolism (PE) diagnosis. Limited contemporary data exist about the utilization of each modality, including the predictors of using V/Q versus CTPA. We used the data from patients diagnosed with PE using V/Q or CTPA from 2007 to 2019 in Registro Informatizado Enfermedad ThromboEmbolica, an international prospective registry of patients with venous thromboembolism. Outcomes was to determine the trends in utilization of V/Q vs. CTPA and, in a contemporary subgroup fitting with current practices, to evaluate predictors of V/Q use with multivariable logistic regression. Among 26,540 patients with PE, 89.2% were diagnosed with CTPA, 7.1% with V/Q and 3.7% with > 1 thoracic imaging modality. Over time, the proportional use of V/Q scanning declined (13.9 to 3.3%, P

Advances in interference filter technology permit currently using selected parts of the N2 and O2 pure rotational Raman spectra with very low temperature sensitivity, while rejecting sufficiently the elastic return. The Raman technique to retrieve the aerosol extinction coefficient can then be used with higher signal-to-noise ratios, because of a higher (about 8 times) effective differential backscatter cross-section as compared to the cross-section of the N2 vibro-rotational spectra. The design and results of pure rotational Raman channels at 354 nm and 530 nm allowing daytime aerosol extinction measurements implemented at the EARLINET/ACTRIS Barcelona lidar station are presented and discussed. © 2022 SPIE. The authors acknowledge the funding of this research by the Spanish Ministry for Science and Innovation for the project PID2019-103886RB-I00 and its support to ACTRIS ERIC. The authors also acknowledge the support of the European Commission through the Horizon 2020 Research and Innovation Framework Programme projects ACTRIS IMP (grant agreement No 871115) and ATMO-ACCESS (grant agreement No 101008004)

Introduction Some local protocols suggest using intermediate or therapeutic doses of anticoagulants for thromboprophylaxis in hospitalized patients with coronavirus disease 2019 (COVID‐19). However, the incidence of bleeding, predictors of major bleeding, or the association between bleeding and mortality remain largely unknown. Methods We performed a cohort study of patients hospitalized for COVID‐19 that received intermediate or therapeutic doses of anticoagulants from March 25 to July 22, 2020, to identify those at increased risk for major bleeding. We used bivariate and multivariable logistic regression to explore the risk factors associated with major bleeding. Results During the study period, 1965 patients were enrolled. Of them, 1347 (69%) received intermediate‐ and 618 (31%) therapeutic‐dose anticoagulation, with a median duration of 12 days in both groups. During the hospital stay, 112 patients (5.7%) developed major bleeding and 132 (6.7%) had non‐major bleeding. The 30‐day all‐cause mortality rate for major bleeding was 45% (95% confidence interval [CI]: 36%‐54%) and for non‐major bleeding 32% (95% CI: 24%‐40%). Multivariable analysis showed increased risk for in‐hospital major bleeding associated with D‐dimer levels >10 times the upper normal range (hazard ratio [HR], 2.23; 95% CI, 1.38–3.59), ferritin levels >500 ng/ml (HR, 2.01; 95% CI, 1.02–3.95), critical illness (HR, 1.91; 95% CI, 1.14–3.18), and therapeutic‐intensity anticoagulation (HR, 1.43; 95% CI, 1.01–1.97). Conclusions Among patients hospitalized with COVID‐19 receiving intermediate‐ or therapeutic‐intensity anticoagulation, a major bleeding event occurred in 5.7%. Use of therapeutic‐intensity anticoagulation, critical illness, and elevated D‐dimer or ferritin levels at admission were associated with increased risk for major bleeding.

Introduction An increased risk of ischemic stroke in patients with acute pulmonary embolism (PE) and patent foramen ovale (PFO) was reported but few data exist regarding prognostic outcomes of those patients. Material and methods Using data in the RIETE registry, we compared the characteristics, therapeutic approaches and outcomes of patients with PE according to the presence or absence of PFO. Results From August 2016 to January 2020, 4148 patients with acute PE were enrolled. Of these, 2775 (67%) had no transthoracic echocardiogram (TTE), 993 (24%) underwent TTE but had no reported results on PFO. Among the remaining 380 patients, 287 (74%) did not have PFO and 93 (26%) had PFO. Patients with PFO were more likely to have chronic heart failure, prior myocardial infarction or ischemic stroke than those without PFO. Patients with PFO had a higher rate of subsequent ischemic stroke than those without PFO (hazard ratio (HR): 9.28; 95% CI: 1.83–69.1), than those with TTE but no data on PFO (HR: 10.1; 95% CI: 2.56–42.4) or without TTE (HR: 9.78; 95% CI: 3.02–28.4). On multivariable analysis, patients with PFO were at increased risk for subsequent ischemic stroke than those without PFO (HR: 8.96; 95% CI: 1.68–47.7). Conclusions PFO was searched in a minority of patients with an acute PE in real life setting. Subject to possible selection and measurement biases, our results confirmed a higher risk of ischemic stroke in PE patients with PFO compared to those without PFO. This association warrants further investigation before determining the best therapeutic option in patients with acute PE and concomitant PFO.

Introduction In Parkinson's disease (PD), anxiety is common, associated with lower health-related quality of life, and undertreated. The primary objective of this study was to determine the tolerability of buspirone for the treatment of anxiety in PD. Methods Individuals with PD and clinically significant anxiety were randomized 4:1 to flexible dosage buspirone or placebo for 12 weeks. Treatment was initiated at 7.5 mg twice daily and titrated based on response and tolerability to an optimal dosage (maximum 30 mg twice daily). The primary outcome was the proportion of participants who failed to complete the study on study drug. Secondary outcomes included adverse events, dosage reductions, motor function, dyskinesias, and anxiety. Results A total of 21 participants enrolled, 4 were randomized to placebo and 17 to buspirone (mean (SD) age 65.5 (9.8), 76.5% male, 88% on concomitant antidepressant or anxiolytic). In the buspirone group, 7 (41%) failed to complete the study on drug, 5 due to intolerability. The median buspirone dosage was 7.5 mg twice daily. No serious adverse events occurred. A total of 9 (53%) buspirone participants experienced adverse events consistent with worsened motor function. In the buspirone group, mean (SD) improvement from baseline to week 12 in Hamilton Anxiety Rating Scale was −3.9 (3.8) and Parkinson Anxiety Scale −7.1 (6.4). Conclusion Tolerability concerns do not support moving immediately forward with a large-scale efficacy trial. However, concomitant anxiolytics may have affected tolerability and a signal of efficacy was seen suggesting that future studies of buspirone monotherapy be considered.

Little attention has been given to the development of remediation strategies for soils polluted with mixture of pollution (metal(loid)s and organic compounds). The present study evaluates the effectiveness of different types of commercial iron nanoparticles (nanoscale zero valent iron (nZVI), bimetallic nZVI-Pd, and nano-magnetite (nFe3O4)), for the remediation of an industrial soil co-contaminated with Cr and PCBs. Soil samples were mixed with nZVI, nZVI-Pd, or nFe3O4 at doses selected according to their reactivity with PCBs, homogenized, saturated with water and incubated at controlled conditions for 15, 45 and 70 days. For each sampling time, PCBs and chromium were analyzed in aqueous and soil fractions. Cr(VI) and Cr leachability (TCLP test) were determined in the soil samples. The treatment with the three types of iron nanoparticles showed significant reduction in Cr concentration in aqueous extracts at the three sampling times (> 98%), compared to the control samples. The leachability of Cr in treated soil samples also decreased and was stable throughout the experiment. Results suggested that nZVI and nZVI-Pd immobilized Cr through adsorption of Cr(VI) on the shell and reduction to Cr(III). The mechanism of interaction of nFe3O4 and Cr(VI) included adsorption and reduction although its reducing character was lower than those of ZVI nanoparticles. PCBs significantly decreased in soil samples (up to 68%), after 15 days of treatment with the three types of nanoparticles. However, nFe3O4 evidenced reversible adsorption of PCBs after 45 days. In general, nZVI-Pd reduced PCB concentration in soil faster than nZVI. Control soils showed a similar reduction in PCBs concentration as those obtained with nZVI and nZVI-Pd after a longer time (45 days). This is likely due to natural bioremediation, although it was not effective for Cr remediation. Results suggest that the addition of nZVI or nZVI-Pd and pseudo-anaerobic conditions could be used for the recovery of soil co-contaminated with Cr and PCBs.

El programa DBT STEPS-A es una adaptación para implementar en la escuela habilidades derivada de la terapia dialéctica conductual estándar. En este estudio se evaluó su impacto en universitarios de una institución privada de la ciudad de Puebla (México). Participaron 70 mujeres y 19 varones de entre 18 y 25 años de edad, distribuidos en cuatro grupos: TAU consistió en una materia de educación socioemocional no estandarizada que imparte la universidad; TAU + DBT STEPS-A, la suma de dicha materia más el programa DBT STEPS-A; DBT STEPS-A, exclusivamente el programa, y un grupo control. Como medidas se aplicaron en tres momentos las escalas DERS-E, DASS 21 y GHQ-12. El análisis de datos se realizó por medio de las pruebas estadísticas Kruskal-Wallis y Friedman. Se realizaron comparaciones intergrupales de los puntajes previos y posteriores a la aplicación de dichas escalas. Los resultados sugieren que los grupos se encontraban en igualdad de condiciones antes de la implementación de los tratamientos. En la comparación intragrupal utilizando la prueba de Friedman, los grupos TAU + DBT STEPS-A y DBT STEPS-A tuvieron diferencias estadísticamente significativas, mostrando disminución en las dimensiones ansiedad y depresión de la escala DASS 21, así como modificaciones en el puntaje total de la escala DERS-E; asimismo, en las subdimensiones de aceptación y metas y en los puntajes totales de la escala GHQ-12 en el grupo TAU + DBT STEPS-A. Por el contrario, no hubo diferencias en las comparaciones entre los demás grupos del estudio, ni tampoco por género.

Título, resumen y palabras clave también en inglés Resumen basado en el de la publicación Se evalúa el impacto de dos intervenciones en el patio de recreo, una mediada por adultos, y otra por los compañeros, en el juego social y simbólico de un grupo de 4 niños con autismo (de sexo masculino y de entre 7 y 11 años de edad) en un colegio público de enseñanza Infantil y Primaria. Para ello se utiliza un diseño experimental de reversión de caso único (ABACA), donde A es la línea base u observación en ausencia de intervención, B es la intervención mediada por compañeros del aula y C es la intervención mediada por monitoras. La dimensión simbólica del juego evalúa cuatro categorías ordenadas, que van desde la ausencia de juego hasta la realización de juegos simbólicos y de ficción. La dimensión social del juego hace referencia a las relaciones que establece el niño con los demás compañeros y se divide en cinco categorías que van desde la situación de aislamiento hasta la participación con los demás compartiendo las metas del juego. Los resultados sugieren que las intervenciones medidas por compañeros y adultos consiguieron incrementar el juego social, pero sólo la intervención mediada por adultos incrementó el juego simbólico. Se concluye que para mejorar el aislamiento de los niños con autismo en el recreo escolar se necesitan intervenciones mediadas por compañeros y por adultos. ESP

The association between elevated liver enzymes or FIB-4 (fibrosis index 4) and outcome in patients with venous thromboembolism (VTE) has not been evaluated. Data from patients in RIETE (Registro Informatizado Enfermedad TromboEmbólica) were used to assess the association between elevated liver enzymes or FIB-4 levels and the rates of major bleeding or death in apparent liver disease-free patients with acute VTE under anticoagulation therapy. A total of 6206 patients with acute VTE and without liver disease were included. Of them, 92 patients had major bleeding and 168 died under anticoagulation therapy. On multivariable analysis, patients with elevated liver enzymes were at increased mortality risk (HR: 1.58; 95% CI: 1.10-2.28), while those with FIB-4 levels > 2.67 points were at increased risk for major bleeding (HR: 1.69; 95% CI: 1.04-2.74). Evaluation of liver enzymes and FIB-4 index at baseline in liver disease-free patients with VTE may provide additional information on the risk for major bleeding or death during anticoagulation.

Resumen basado en el de la publicación Título, resumen, palabras clave en español e ingles Se evaluan situaciones vitales estresantes y sintomatología depresiva en 105 adolescentes de bachillerato de una comunidad rural del estado de Michoacán en México, de los cuales el 35,2% fueron hombres y 64,8% fueron mujeres, de entre 15 y 17 años (M = 15,52; DE = .557). El método fue cuantitativo y transversal. Se evaluaron situaciones estresantes, sintomatología depresiva e indicadores de riesgo en la trayectoria académica. Entre los principales resultados se encontraron que los sucesos de vida estresantes que correlacionaron con un mayor número de síntomas depresivos fueron las dificultades de tipo amoroso, las discusiones con la pareja y el divorcio de los padres. Las mujeres presentaron puntuaciones más altas que los hombres en la mayoría de los síntomas depresivos. Se concluye que la presencia de ciertos eventos estresantes en la vida de los adolescentes se relacionan con el desarrollo de síntomas depresivos. Se describen algunas temáticas que podrían retomarse en programas de orientación para adolescentes de contextos rurales, siendo el escenario educativo un espacio ideal para su aplicación. ESP

Cyanobacteria respond to light stimulation, activating localised assembly of type IV pili for motility. The resulting phototactic response is highly dependent on the nature of the incoming light stimulus, and the final motility parameters depend on the surface properties. Conventionally, phototaxis studies are carried out on hydrogel surfaces, such as agarose, with surface properties that vary in time due to experimental conditions. This study considers five substrates, widely utilized in microfluidic technology, to identify the most suitable alternative for performing reliable and repeatable phototaxis assays. The surfaces are characterised via a contact angle goniometer to determine the surface energy, white light interferometry for roughness, zeta-potentials and AFM force distance curves for charge patterns, and XPS for surface composition. Cell motility assays showed 1.25 times increment on surfaces with a water contact angle of 80° compared to a reference glass surface. To prove that motility can be enhanced, polydimethylsiloxane (PDMS) surfaces were plasma treated to alter their surface wettability. The motility on the plasma-treated PDMS showed similar performance as for glass surfaces. In contrast, untreated PDMS surfaces displayed close to zero motility. We also describe the force interactions of cells with the test surfaces using DLVO (Derjaguin-Landau-Verwey-Overbeek) and XDLVO (extended DLVO) theories. The computed DLVO/XDLVO force-distance curves are compared with those obtained using atomic force microscopy. Our findings show that twitching motility on tested surfaces can be described mainly from adhesive forces and hydrophobicity/hydrophilicity surface properties. STATEMENT OF SIGNIFICANCE: The current article focuses on unravelling the potential Micro-Electro-Mechanical System (MEMS) compatible surfaces for studying phototactic twitching motility of cyanobacteria. This is the first exhaustive surface characterization study coupled with phototaxis experiments, to understand the forces contributing to twitching motility. The methods shown in this paper can be further extended to study other surfaces and also to other bacteria exhibiting twitching motility.

Introduction: Hospitalized patients with COVID-19 are at increased risk for venous thromboembolism (VTE), but also for bleeding. We previously derived a prognostic score including four variables (elevated D-dimer, elevated ferritin, critical illness, and therapeutic-dose anticoagulation) that identified those at increased risk for major bleeding. Methods: We aimed to validate the score in a subsequent cohort of hospitalized patients with COVID-19 receiving standard-, intermediate- or therapeutic doses of VTE prophylaxis. We evaluated its capacity to predict major bleeding, non-major bleeding, and bleeding-related death. Results: The cohort included 972 patients from 29 hospitals, of whom 280 (29%) received standard, 412 (42%) intermediate-, 157 (16%) therapeutic doses of VTE prophylaxis and 123 (13%) other drugs. Median duration of prophylaxis was 14.7 ± 10.3 days. Major bleeding occurred in 65 patients (6.7%) and non-major bleeding in 67 (6.9%). Thirty patients with major bleeding (46%) died within the first 30 days after bleeding. The prognostic score identified 203 patients (21%) at very low risk, 285 (29%) at low risk, 263 (27%) intermediate-risk and 221 (23%) at high risk for bleeding. Major bleeding occurred in 1.0%, 2.1%, 8.7% and 15.4% of the patients, respectively. Non-major bleeding occurred in 0.5%, 3.5%, 9.5% and 14.2%, respectively. The c-statistics was: 0.74 (95% confidence intervals [CI]: 0.68–0.79) for major bleeding, 0.73 (95% CI: 0.67–0.78) for non-major bleeding and 0.82 (95% CI: 0.76–0.87) for bleeding-related death. Conclusions: In hospitalized patients with COVID-19, we validated that a prognostic score including 4 easily available items may identify those at increased risk for bleeding.

Ventilation/perfusion (V/Q) imaging and computed tomography pulmonary angiography (CTPA) are common tools for acute pulmonary embolism (PE) diagnosis. Limited contemporary data exist about the utilization of each modality, including the predictors of using V/Q versus CTPA. We used the data from patients diagnosed with PE using V/Q or CTPA from 2007 to 2019 in Registro Informatizado Enfermedad ThromboEmbolica, an international prospective registry of patients with venous thromboembolism. Outcomes was to determine the trends in utilization of V/Q vs. CTPA and, in a contemporary subgroup fitting with current practices, to evaluate predictors of V/Q use with multivariable logistic regression. Among 26,540 patients with PE, 89.2% were diagnosed with CTPA, 7.1% with V/Q and 3.7% with 1 thoracic imaging modality. Over time, the proportional use of V/Q scanning declined (13.9 to 3.3%, P 0.001). In multivariable analysis, heart failure history (odds ratio [OR]:1.5; 95% confidence interval [CI] 1.14-1.98), diabetes ([OR 1.71; 95% CI 1.39-2.10]), moderate and severe renal failure (respectively [OR 1.87; 95% CI 1.47-2.38] and [OR 9.36; 95% CI 6.98-12.55]) were the patient-level predictors of V/Q utilization. We also observed an influence of geographical and institutional factors, partly explained by time-limited V/Q availability (less use over weekends) and regional practices. Use of V/Q for the diagnosis of PE decreased over time, but it still has an important role in specific situations with an influence of patient-related, institution-related and logistical factors. Local and regional resources should be evaluated to improve V/Q accessibility than could benefit for this population.

It has been suggested that focal hand dystonia (FHD) should be viewed as a neuropsychiatric disorder rather than as a pure movement disorder. We aimed to compare the personality factors that are common to people with FHD and evaluate how personality factors could affect the functionality of the upper limbs and community participation. We conducted a cross-sectional case–control study in which 12 people with FHD were matched with 12 age and gender matched healthy control participants. The Big Five Questionnaire, the Quick Disabilities, Arm, Shoulder, and Hand questionnaire, and the Jebsen–Taylor Test of Hand Function were used as assessment measures. Control of emotions was the only variable for which a significant difference was found, with participants with FHD displaying lesser control. Correlations were not observed between different personality profiles, the functionality of the upper limb,s and the perceived participation of people with FHD in activities of daily living. People with FHD may present with low emotional stability, but this does not have a negative impact on the functionality of the upper limbs and activities of daily living. These findings have clinical implications to be considered for interventions, as they suggest that personality aspects, such as extraversion, may not predict for better functionality and perceived participation in activities of daily living.

Cerebral venous sinus thrombosis (CVST) after coronavirus (COVID-19) vaccination has been reported. There are no data about thrombosis risk in prior CVST patients. The objective of the study was to describe short-term serious adverse events to COVID-19 vaccines in patients with history of CVST.We present an observational prospective study of patients with known CVST who received COVID-19 vaccination. Serious event rates within 30 days after second dose vaccination (except one dose for Janssen) were evaluated, including recurrences, hospital admission and death.The 62 vaccinated patients received: BNT162b2 (Pfizer-BioNTech) in 43 patients (69.4%), mRNA-1273 (Moderna) in 7 patients (11.3%), AZD1222 (ChAdOx1) in 7 patients (11.3%) and Ad26.COV2.S (Janssen) in 5 patients (8.1%). There were no thrombotic recurrences within 30 days of vaccination (95% confidence interval, 0.0-5.8). There was one death (1.6%), not attributable to the vaccine.COVID-19 vaccines are safe for previous CVST patients.

Climate change is a big challenge that may affect water and sanitation services. The authors studied a strategy to adapt current infrastructure to adverse effects due to climate change, such as more frequent and heavier rainfall, through sustainable urban drainage systems (SUDS). A part of the sewer network of Santander, in Spain, is taken as a case study. After building the model under the SWMM-5 code, some scenarios were simulated, including short-duration storm analysis, under the current climate and with climate change estimation, for an extended period simulation. The same analysis was performed adding SUDS. Peak flow, energy consumption reductions and the total storm water volume disconnected were measured. Every action had a positive effect in adapting the existing infrastructure to climate change, but the authors observed that when SUDS worked together, the benefits were greater, as expected. Any future intervention might be focused on encouraging SUDS as a drainage solution, not as isolated pilot projects.

In the last decade, several laboratory-scale experiments have shown the use of nanoscale zero-valent iron (nZVI) to be effective in reducing metal(loid) availability in polluted soils. The present study evaluates the capacity of nZVI for reducing the availability of As and Hg in brownfield soils at a pilot scale, and monitors the stability of the immobilization of these contaminants over a 32 month period. To the best of our knowledge, this is the first study to apply nZVI to metal(loid)-polluted soils under field conditions. Two sub-areas (A and B) that differed in pollution load were selected, and a 5 m2 plot was treated with 2.5% nZVI (by weight) in each case (Nanofer 25S, NanoIron). In sub-area A, which had a greater degree of pollution, a second application was performed eight months after the first application. Overall, the treatment significantly reduced the availability of both As and Hg, after only 72 h, although the effectiveness of the treatment was highly dependent on the degree of initial contamination. Sub-area B (with a lower level of pollution) showed the best and most stable immobilization results, with As and Hg in toxicity characteristics leaching procedure (TCLP) extracts decreasing by 70% and 80%, respectively. In comparison, the concentrations of As and Hg in sub-area A decreased by 65% and 50%, respectively. Based on our findings, the use of nZVI at a dose of 2.5% appears to be an effective approach for the remediation of soils at this brownfield site, especially in sub-area B. For sub-area A, a higher dose of nZVI—or its use in combination with other remediation strategies—should be tested.

Despite major management efforts initiated in 1987 and 2007 and decreasing emissions in the Gironde watershed, cadmium (Cd) levels in oysters from the downstream Gironde estuary are still higher to the consumption limit (5 mg/kg, dw, EC). Dissolved Cd concentrations were measured in surface water collected in the Gironde estuary during nine cruises (2014 – 2015). The obtained theoretical (Cdd0) concentrations and the daily net Cdd fluxes, using the Boyle’s method, confirm a decadal stepping decrease of the Cd pollution corresponding to that observed in the oysters from the long term national monitoring for priority contaminants at the estuary mouth. As this observation invalidates the previous estimating methods for estimating annual net Cdd fluxes, we propose an original empirical model applicable for the four last decades. This model is based on four exponential functions with defined boundaries for low water discharges. Each of them is representative of one distinct situation of Cd pollution in the watershed relative to major remediation processes implemented in the last four decades. These results allow to develop a direct estimation of the annual net Cdd fluxes only based on the data of the annual mean discharge. Thus, this study demonstrates the strength of the field research in geochemistry to obtain a better quantification of the exportation of dissolved bioavailable pollutants from the continental watersheds to the coastal ocean., Malgré d’importants efforts d’aménagement initiés en 1987 et 2007 et la diminution consécutive des émissions issues du bassin versant de la Gironde, les teneurs en cadmium (Cd) présentent dans les huîtres de l’aval de la Gironde restent supérieures à la norme de consommation (5 mg/kg, p.s., CE). Des concentrations en cadmium dissous ont été mesurées dans les eaux de surface collectées dans l’estuaire de la Gironde au cours de neuf campagnes océanographiques (2014–2015). Les concentrations théoriques en cadmium dissous (Cdd0) et les flux nets journaliers de Cdd ont été obtenus, selon la méthode de Boyle. Ils confirment une diminution de la pollution en Cd par paliers décennaux, correspondant à celle observée dans les huîtres girondines grâce au réseau national de surveillance des contaminants prioritaires. Cette observation invalidant les précédentes méthodes d’estimation des flux nets annuels, nous proposons un modèle empirique original appliqué aux quatre dernières décennies et basé sur quatre fonctions exponentielles tronquées. Chaque fonction est représentative d’une situation distincte de la pollution du bassin versant relative aux principaux processus de remédiation entrepris au cours des quatre dernières décennies. Les résultats nous ont permis de proposer un abaque de quantification des flux nets annuels de Cdd utilisant uniquement les données de débit moyen annuel. Ainsi, cette étude démontre l’efficacité de la géochimie de terrain pour obtenir une meilleure quantification de l’exportation de polluants dissous et biodisponibles, des bassins continentaux vers l’océan côtier.

The effect of organic matter on the As bioavailability in soils and thus on phytoremediation processes is still controversial. The objective of the present study was to evaluate the combined effect of compost and microorganisms from rhizosphere on the tolerance of barley and wheat plants to soil polluted with different concentrations of As for the application on phytoremediation strategies. A greenhouse experiment was performed using soil artificially contaminated with As at two doses. A compost obtained from sewage sludge composted with pruning waste was used (40 t/ha) as amendment. Plants were grown until the end of their growing cycle. Arsenic uptake and plant physiological and biochemical parameters as well as As availability and physicochemical properties in soil samples were analyzed. The impact of compost addition on the structure and diversity of the microbial communities of the rhizosphere was also evaluated using PCR-DGGE. Compost application induced a different behavior in both species. Compared to wheat and irrespective of As doses, in compost amended soils, barley plants showed an enhanced As translocation to the aerial part. The different bacterial communities structure found for each species, according to the PCR-DGGE cluster analysis, suggested that specific rhizobacteria of barley may have increased As bioavailability, and would therefore enhance its translocation to aerial parts. Both species could be used for phytoremediation proposes of As-polluted soils, and specifically, barley would be an interesting option for phytoextraction due to its higher biomass and high As translocation when compost is applied to As-polluted soil.

Antimony (Sb) radionuclides (e.g., 125Sb half-life of 2.76 y), are fission products of nuclear reactions released to the environment during nuclear power plant (NPP) accidental events and current operating fuel reprocessing. In coastal systems, 125Sb shows high mobility and dispersion in the dissolved phase but its environmental biogeochemical behaviour in continent-ocean transition systems is still not fully understood [1]. Based on the widely accepted hypothesis of similar geochemical behaviour between radioactive and stable isotopes of the same element, this work quantified inherent concentrations of dissolved Sb (Sbd, -1 in the freshwater endmember (i.e., matching known upstream concentrations [2]) to max. 440 ng L-1 in mid-salinities during drought conditions, followed by decreasing values towards the marine endmember due to dilution (mixing) with seawater (i.e., ~200 ng L-1). The specific mechanisms behind Sb desorption from the particle phase are unknown, potentially related to the interplay between biogeochemical processes and intra-estuarine residence times of water and suspended particles in macrotidal, hyperturbid estuaries, independent from the salinity gradient [3]. Daily gross Sbd fluxes into the estuary (i.e., 10.4 kg d-1 and 3.4 kg d-1) and net estuarine coastal output (i.e., 27.0 kg d-1 and 11.4 kg d-1) for intermediate and drought conditions were calculated, respectively, following known methods [4]. Sorption experiments using isotopically labelled spikes of stable Sb exposed to water and particles from the Gironde Estuary simulating the salinity and turbidity gradients showed 125Sb from a NPP in the central Gironde Estuary may persist in the dissolved fraction. Dispersion scenarios of hypothetical 125Sb discharges are expected to reflect water residence times, resulting in long-term intra-estuarine 125Sb retention during draught (water residence times of 80 days) and highest concentrations of inherent Sb. In contrast, hypothetical 125Sb releases during intermediate conditions (i.e., water residence times of 1-2 months) would result in faster exportation of 125Sb to the coastal ocean, where enhanced dilution might probably limit the exposure levels of coastal organisms to 125Sb but imply a wider dispersion following oceanic currents along the Atlantic coast, possibly reaching the oyster farms north of the estuary mouth. Bio-uptake of Sb radionuclides, related radiotoxicity and potential sorption onto suspended particles (e.g., after longer contact times) or plankton and the resulting reactivity/mobility need further investigation. References:[1] Periáñez R., Miró C.J. Radiol Prot, 2009, 29(2), 219.[2] Gil-Díaz T., Schäfer J., et al. Environ Chem, 2018, 15(3), 121.[3] van der Sloot H.A., Hoede D., et al. Estuar Coast Shelf S, 1985, 21, 633.[4] Andreae M.O., Byrd J.T., et al. Envir Sci Tech, 1983, 17, 731.[5] Gil-Díaz T., Schäfer J., et al. Appl Geochem, 2019, 108, 104386.

Con el creciente uso de las tecnologías IoT y el avance de las redes 5G, se está tendiendo a una sociedad conectada. Conceptos como las Smart cities son cada día una realidad más clara. Con el objetivo de adaptar la tecnología que permita el desarrollo de estos conceptos, es necesario una amplia red de sensores y sistemas que permitan el manejo y envío de la información. Para la consecución de este objetivo, es necesario dotarlos de dispositivos que generen la energía que van que van a consumir aprovechando las fuentes de energía que hay en el entorno. Es aquí donde juega un papel crucial los sistemas de harvesting. Estos van a transformar dicha energía en potencia eléctrica que permita la autonomía de los dispositivos que integren la red. Dado la gran cantidad de señales que están presentes en el espectro radioeléctrico, estas pueden suponer una fuente de energía que permita la autonomía de los dispositivos que la logren captar. Los sistemas de harvesting de RF usan antenas que permiten captar esta señal y convertirla en una fuente de energía. El objetivo que persigue este trabajo es el diseño de un sistema harvesting de RF, establecer los requisitos necesarios de funcionamiento y de control y manejo del almacenamiento de la energía. Con este motivo, se implementará un demostrador, que permita almacenar la energía de RF del ambiente y que gestione la energía necesaria para el funcionamiento del sistema. El resultado esperado será un sistema inteligente, capaz de gestionar la energía y que optimice el consumo de esta. With the increasing use of IoT technologies and the advancement of 5G networks, there is a trend towards a connected society. Concepts such as Smart Cities are becoming a clearer reality every day. In order to adapt the technology that allows the development of these concepts, a wide network of sensors and systems that allow the handling and sending of information is necessary. To achieve this objective, it is necessary to equip them with devices that generate the energy that they are going to consume, taking advantage of the energy sources in the environment. This is where harvesting systems play a crucial role. These will transform this energy into electrical power that allow the autonomy of the devices that make up the network. Given the large number of signals that are present in the radioelectric spectrum, these can be a source of energy that allows the autonomy of the devices that manage to capture it. RF harvesting systems use antennas to capture this signal and convert it into an energy source. The objective pursued by this work is the design of an RF collection system, establish the necessary requirements for operation and control and management of energy storage. For this reason, a demonstrator will be implemented to store the RF energy in the environment and manage the energy necessary for the operation of the system. The expected result will be an intelligent system, capable of managing energy and optimizing its consumption. Amb el creixent ús de les tecnologies IoT i l'avanç de les xarxes 5G, s'està tendint a una societat connectada. Conceptes com les Smart cities són cada dia una realitat més clara. Amb l'objectiu d'adaptar la tecnologia que permeti el desenvolupament d'aquests conceptes, és necessari una àmplia xarxa de sensors i sistemes que permetin el maneig i enviament de la informació. Per a la consecució d'aquest objectiu, és necessari dotar-los de dispositius que generin l'energia que van que consumiran aprofitant les fonts d'energia que hi ha en l'entorn. És aquí on juga un paper crucial els sistemes de harvesting. Aquests transformaran aquesta energia en potència elèctrica que permeti l'autonomia dels dispositius que integrin la xarxa. Donat la gran quantitat de senyals que són presents en l'espectre radioelèctric, aquestes poden suposar una font d'energia que permeti l'autonomia dels dispositius que l'aconsegueixin captar. Els sistemes de harvesting de RF usen antenes que permeten captar aquest senyal i convertir-la en una font d'energia. L'objectiu que persegueix aquest treball és el disseny d'un sistema harvesting de RF, establir els requisits necessaris de funcionament i de control i maneig de l'emmagatzematge de l'energia. Amb aquest motiu, s'implementarà un demostrador, que permeti emmagatzemar l'energia de RF de l'ambient i que gestioni l'energia necessària per al funcionament del sistema. El resultat esperat serà un sistema intel·ligent, capaç de gestionar l'energia i que optimitzi el consum d'aquesta.

IntroductionParkinson's disease (PD) research is hampered by slow, inefficient recruitment and burdensome in-person assessments that may be challenging to conduct in a world affected by COVID-19. Fox Insight is an ongoing prospective clinical research study that enables individuals to participate in clinical research from their own homes by completing online questionnaires. To date, over 45,000 participants with and without PD have enrolled. We sought to validate self-reported PD diagnosis in the Fox Insight cohort, assess the validity of other self-reported health information, and evaluate the willingness of participants to participate in video-based research studies.MethodsIndividuals with and without self-reported PD enrolled in Fox Insight were invited to participate in this virtual research study. Participants completed online questionnaires and two virtual visits, during which we conducted standard cognitive and motor assessments. A movement disorder expert determined the most likely diagnosis, which was compared to self-reported diagnosis.ResultsA total of 203 participants from 40 U.S. states, 159 with remote clinician-determined PD and 44 without, completed the study (59% male, mean (SD) age 65.7 (9.8)). Level of agreement between self-reported PD diagnosis in Fox Insight and clinician-determined diagnosis was very good ((kappa=0.85, 95% CI 0.76-0.94). Overall, 97.9% of participants were satisfied with the study, 98.5% were willing to participate in a future observational study with virtual visits, and 76.1% were willing to participate in an interventional trial with virtual visits.ConclusionAmong the Fox Insight cohort, self-reported diagnosis is accurate and interest in virtual research studies is high.

Background: The choice of the imaging modality for diagnosis of pulmonary embolism (PE) could be influenced by provider, patient or hospital characteristics, or over time. However, little is known about the choice of the diagnostic modalities in practice. The aim of this study was to evaluate the variations in the use of imaging modalities for patients with acute PE. Methods: Using the data from Registro Informatizado Enfermedad TromboEmbolica (RIETE), a prospective international registry of patients with venous thromboembolism (March 2001–January 2019), we explored the imaging modalities used in patients with acute PE. The imaging modalities included computed tomography pulmonary angiography, ventilation/perfusion scanning, pulmonary angiography, a combination of these tests, or PE signs and symptoms plus imaging-confirmed proximal deep vein thrombosis but no chest imaging. Results: Among 38 025 patients with confirmed PE (53.1% female, age: 67.3±17 years), computed tomography pulmonary angiography was the dominant modality of diagnosis in all RIETE enrollees (78.2% [99% CI, 77.6–78.7]); including pregnant patients (58.9% [99% CI, 47.7%–69.4%]) and patients with severe renal insufficiency (62.5% [99% CI, 59.9–65.0]). A greater proportion of patients underwent ventilation/perfusion scanning in larger hospitals compared with smaller hospitals (13.1% versus 7.3%, P P Conclusions: In a large multinational PE registry, variations were observed in the use of imaging modalities according to patient or institutional factors and over time. However, computed tomography pulmonary angiography was the dominant modality of diagnosis, even in pregnancy and severe renal insufficiency. The safety, costs, and downstream effects of these tests on PE-related and non-PE-related outcomes warrant further investigation.

Registro Informatizado de Enfermedad Tromboembólica Investigators., [Objective] Overlap exists between the risk factors for coronary artery disease and venous thromboembolism (VTE). However, a paucity of data is available on the incidence of major acute cardiovascular events (MACE) and major adverse limb events (MALE) among patients presenting with VTE. Moreover, it is unknown whether the rate of cardiovascular outcomes differs among patients with unprovoked vs provoked VTE., [Methods] We analyzed the data from 2009 to 2017 in the Registro Informatizado de Enfermedad Tromboembólica registry, an ongoing, multicenter, international registry of consecutive patients with a diagnosis of objectively confirmed VTE. The query was restricted it to patients with data entry for the arterial outcomes. The baseline prevalence of coronary artery disease risk factors was compared between patients with provoked (ie, immobility, cancer, surgery, travel >6 hours, hormonal causes) and unprovoked VTE. After the initial VTE event, we followed up patients for the composite primary outcome of incident MACE (ie, stroke, myocardial infarction, unstable angina) and/or MALE (ie, major limb events). We used the χ2 test for baseline associations and a Cox proportional hazard for multivariate analysis. We used IBM SPSS, version 24 (IBM Corp, Armonk, NY) for statistical analysis. A P value of, [Results] We analyzed the data from 41,259 patients with VTE, of whom 22,633 (55.6%) had experienced a provoked VTE. During follow-up, the patients with provoked VTE were more likely to develop MACE or MALE than were patients with unprovoked VTE (hazard ratio [HR], 1.3; 95% confidence interval [CI], 1.1-1.5). The association of arterial events with recent immobility (HR, 1.4; 95% CI, 1.5-12.1) and cancer (HR, 1.7; 95% CI, 1.4-1.9) was strong. After adjusting for multiple conventional cardiovascular risk factors, provoked VTE, compared with unprovoked VTE, was significantly associated with an increased hazard for MACE (HR, 1.4; 95% CI, 1.1-1.7). Cancer remained a significant adjusted predictor for both MACE (HR, 1.7; 95% CI, 1.4-2.1) and MALE (HR, 2.1; 95% CI 1.01-4.6) in those with provoked VTE., [Conclusions] Among patients with VTE, provoked cases, specifically those with cancer-associated VTE, have an increased risk of major arterial events.

Soil pollution is one of the ten major soil threats identified in the 2015 Status of the World’s Soil Resources by the Food and Agriculture Organization of the United Nations and Intergovernmental Technical Panel on Soils. The presence of high concentration of metals and metalloids (metal(loid)s) is one of the main causes of soil pollution and action to reduce this contamination is urgently needed, especially in agricultural soils. Metal(loid)s cannot be chemically degraded, and consequently persist in soil for extended periods after their introduction. There is a wide variety of strategies for the remediation of soils polluted with metals and metalloids based on physicochemical or biological technologies. The physicochemical technologies can be in situ or ex situ and may have a great impact on the edaphic environment. Among the biological techniques, phytoremediation is referred to the use of plants for decontamination purposes. Since its introduction in the 1980s, a considerable number of research and review papers on phytoremediation processes has been published. The capacity of plants for absorption of metal(loid)s depends on their characteristics and availability, plant species, soil properties, and environmental factors. Cereals such as barley and wheat are widely present across different soil typologies and climatic conditions. This chapter collects the main researches on phytoremediation capacity of barley and wheat plants to metal(loid) pollution.

The Parkinson’s disease (PD)-specific Parkinson Anxiety Scale (PAS) is an anxiety rating scale that has been validated in cross-sectional studies. In a study of buspirone for anxiety in PD, it appears that the PAS may be sensitive to change in anxiety demonstrating moderate-to-high correlation with participant-reported and clinician-administered scales.

Resumen Objetivo Analizar la actividad de interconsulta (IC) realizada por los servicios de medicina interna (MI), sus aspectos formales, el perfil de la atencion clinica requerida y cuantificar la carga de trabajo que supone. Material y metodo Estudio multicentrico, observacional, prospectivo, sobre enfermos consecutivos hospitalizados atendidos por servicios de MI mediante IC entre el 15 de mayo y el 15 de junio del ano 2016. Se estimo la carga de trabajo relacionada con dicha actividad (1 UT = 10 min). Resultados Se registraron 1.141 IC procedentes de 43 hospitales, edad 69,4 (DE: 16,2) anos, 51,2% hombres. El indice de Charlson fue 2,3 (DE: 2,2). Los motivos de consulta mas frecuentes fueron: valoracion general (27,4%), fiebre (18,1%), disnea (13,6%), trastorno metabolico (9,6%), HTA (6,3%) y sindrome confusional (5,3%). Las UT estimadas fueron 4 (DE: 5,9) para la primera visita y 7,3 (DE: 21,5) para la suma de las sucesivas. Los pacientes quirurgicos fueron mayores (70,6 [DE: 15,9] vs 64,4 [DE: 16,3]; p = 0,0001) y precisaron mas dias de seguimiento (5 [DE: 7,3] vs 3,5 [DE: 4,2]; p = 0,009). Los siguientes aspectos fueron mas frecuentes en el formato de las IC realizadas por servicios medicos: numero de IC ordinarias (respuesta > 24 h), especificacion del motivo de IC, datos minimos referentes a la historia clinica y coincidencia de la adecuacion en el tiempo con el consultor. Conclusion Los pacientes atendidos mediante IC por los servicios de MI representan una carga de trabajo importante. La adecuacion al formato de solicitud de IC es mayor en las procedentes de servicios medicos.

Objective To analyze the activity of interconsultations conducted by internal medicine (IM) departments, their formal aspects and the profile of clinical care required and to quantify the workload they represent. Material and method A multicentre, observational prospective study was conducted with consecutive hospitalized patients treated by IM departments using interconsultations between May 15 and June 15, 2016. We estimated the workload related to this activity (1 time unit [TU] = 10 min). Results We recorded 1141 interconsultations from 43 hospitals. The mean age of the patients involved was 69.4 years (SD: 16.2), and 51.2% were men. The mean Charlson index was 2.3 (SD: 2.2). The most common reasons for the consultations were general assessments (27.4%), fever (18.1%), dyspnea (13.6%), metabolic disorder (9.6%), arterial hypertension (6.3%) and delirium (5.3%). The duration of the first visit was 4 TUs (SD: 5.9) and 7.3 (SD: 21.5) for the sum of all subsequent visits. The surgical patients were older (70.6 [SD, 15.9] vs. 64.4 [SD, 16.3] years; p = .0001) and required more follow-up time (5 [SD, 7.3] vs. 3.5 [SD, 4.2] days; p = .009). The following issues were more common in the interconsultation format performed by medical services: number of regular interconsultations (response >24 h), specification of the reason for the interconsultation, minimal data regarding the medical history and agreement on the appropriateness of the time spent with the consultant. Conclusion The patients treated through interconsultations by the IM departments represented a significant workload. The interconsultations from the medical departments were more in line with the request format.

Iron nanoparticles have been successfully used to remove metals from contaminated water. However, most research in this field has been performed with nanoparticles synthesized at the lab-scale. This study compares the capacity of three types of commercial iron nanoparticles, nanoscale zero-valent iron (nZVI), nano-magnetite (nFe3O4) and iron sulfide (nFeS) nanoparticles to remove Hg2+ from artificially contaminated water over a range of pH, dose, and time of contact. The three types of commercial nanoparticles removed Hg2+ from aqueous solutions being the immobilization processes stable for at least 48 h nZVI particles were faster and more efficient than nFe3O4 and nFeS in terms of Hg removal per unit of iron mass under the experimental conditions tested. The nZVI suspension (0.18 g Fe/L) immobilized 98% of Hg2+ after 15 min, removal ranging between 94 and 98% at the times tested, regardless of the pH (pH 3 to 9). X-ray photoelectron spectroscopy (XPS) analysis revealed that the mechanism by which nZVI immobilizes Hg2+ depends on the dose and includes reduction to Hg0 and adsorption and/or complexation of Hg2+ to the nZVI shell. In contrast, adsorption was the main mechanism for nFeS (1.6 g Fe/L) and nFe3O4 (3.9 g Fe/L), which removed almost 85 and 80% of Hg2+, respectively, after 3 h of contact. The effectiveness of nFe3O4 and nFeS increased slightly over time (until 48 h). The Hg2+removal capacity of nFe3O4 increased with the pH, while that of nFeS peaked at neutral and alkaline pH. Given these findings, the three types of iron nanoparticles emerge as potential candidates for the decontamination of Hg-polluted waters. The choice of nanoparticle depends on the efficacy required, the degree of pollution, the cost and length of the process.

Surface chemistry of mineral phases in aqueous environments generates the electrostatic forces involved in particle-particle interactions. However, few models directly take into account the influence of surface speciation and changes in solution speciation when the diffuse layer potential profiles of approaching particles overlap and affect each other. These electrostatic interactions can be quantified, ideally, through charge regulation, considering solution and surface speciation changes upon particle approach by coupling state-of-the-art surface complexation models for the two particle surfaces with a Poisson-Boltzmann type distribution of electrostatic potential and ions in the inter-particle space. These models greatly improve the accuracy of inter-particle force calculations at small inter-particle separations compared to constant charge and constant potential approaches. This work aims at advancing charge regulation calculations by including full chemical speciation and advanced surface complexation models (Basic Stern-, three-, or four plane models and charge distribution concepts), for cases of similar and dissimilar surfaces involving the numerical solution of the Poisson-Boltzmann equation for arbitrary electrolytes. The concept was implemented as a Python-based code and in COMSOL. The flexibility and precision of both, concept and implementations are demonstrated in several benchmark calculations testing the new codes against published results or simulations using established speciation codes, including aqueous speciation, surface complexation and various interaction force examples. Due to the flexibility in terms of aqueous chemistry and surface complexation models for various geometries, a large variety of potential applications can be tackled with the developed codes including industrial, biological, and environmental systems, from colloidal suspensions to gas bubbles, emulsions, slurries like cement paste, as well as new possibilities to assess the chemistry in nano-confined systems.

Background Venous thromboembolism (VTE) is a major cause of morbidity and mortality postoperatively. The use of pharmacologic prophylaxis is effective in reducing the incidence of VTE. However, the prophylaxis is often discontinued at hospital discharge, especially for those with benign disease. The implications of this practice are not known. We assessed the data from a large, ongoing registry regarding the time course of VTE and outcomes after noncancer surgery. Methods We analyzed the RIETE (Computerized Registry on Venous Thromboembolism) registry, which includes data from consecutive patients with symptomatic confirmed VTE. In the present study, we focused on general surgical patients who had developed symptomatic postoperative VTE in the first 8 weeks after noncancer surgery. The main objective was to assess the interval between surgery and the occurrence of VTE. Additional variables included the clinical presentation associated with the event, the use of thrombosis prophylaxis, and unfavorable outcomes. Results The data from 3296 patients were analyzed. The median time from surgery to the detection of VTE was 16 days (interquartile range, 8-30 days). Of the VTE events, 77% were detected after the first postoperative week and 27% after 4 weeks. Overall, 43.9% of the patients with VTE had received pharmacologic prophylaxis after surgery for a median of 8 days (interquartile range, 5-14 days), and three quarters of the VTE events were detected after pharmacologic prophylaxis had been discontinued. Overall, 54% of the patients with VTE had presented with pulmonary embolism. For 15% of the patients, the clinical outcome was unfavorable, including 4% who had died within 90 days. Conclusions The risk of VTE after noncancer general surgery remains high for ≤2 months. More than one half of the patients had presented with symptomatic PE as the VTE event, and 15% had had unfavorable outcomes. Only 44% of these patients had received pharmacologic prophylaxis for around 1 week.

Mujer de 89 años ingresada por fractura quirúrgica de cadera izquierda. Durante el posoperatorio presentó deterioro del estado general con desorientación temporoespacial, agitación, hipotensión arterial, taquicardia y taquipnea, objetivándose sangrado activo en el área de herida quirúrgica, con deterioro de la función renal, alteraciones hidroelectrolíticas, anemización y desarrollo de arritmia e insuficiencia cardíaca secundarias. Tras la reposición hidroelectrolítica y transfusión de hematíes, la paciente presentó mejoría con cese de los síntomas de delirium. La identificación de las causas precipitantes del delirium, así como la actuación precoz sobre los factores de riesgo del mismo, son esenciales para lograr el éxito terapéutico.

Nanoscale zero valent iron (nZVI) particles obtained by different methods differ in their structure, which lead to different reactivity, and therefore a likely difference in the remediation efficiency. The present study compares the effectiveness of three commercial ZVI nanoparticles to immobilize As and Hg in two soils (A and B) collected from a brownfield highly contaminated by mining and metallurgy activities. Scarce data are available on the effectiveness of nZVI for Hg immobilization in soil. Two commercial nZVI slurries from Toda (RNIP and RNIP-D) and one from Nano Iron (25S) were used at different doses (1, 5 and 10%). The metal(loid) availability and mobility was evaluated with the TCLP test and Tessier extraction procedure. The influence of nZVI application on As and Hg speciation was also evaluated as well as its impact on soil pH, electrical conductivity and soil phytotoxicity to vetch germination. The three commercial nZVI particles significantly reduced As and Hg availability in the two soils studied, which led to a decrease in soil phytotoxicity. At the dose of 5% of nZVI a decrease of exchangeable-As higher than 70% was observed for both soils, whereas in the case of Hg, a higher dose of nZVI (10%) was necessary to achieve reductions of exchangeable-Hg between 63 and 90% depending on the type of nZVI and soil. No impact on soil pH and electrical conductivity was observed. The effectiveness of metal(loid) immobilization depended on type of nZVI, soil properties and metal(loid) characteristics. Nanoparticles from Nano Iron showed better results for As immobilization whereas RNIP nanoparticles were more effective for Hg. Overall, 25S at the dose of 5% resulted more effective than RNIP nanoparticles for the reduction of exchangeable-As (in the range of 6-14%), whereas RNIP and RNIP-D were 10 and 13% more effective, respectively, for the reduction of exchangeable-Hg at the dose of 10% in soil B. Thus, nZVI can be used for the remediation of highly As and Hg polluted soils, although previous experiments at lab scale are necessary to determine the most viable type of nZVI and its dose.

The effectiveness of single- and multi-metal(loid) immobilization of As, Cd, Cr, Pb and Zn using different doses of nanoscale zero-valent iron (nZVI) was evaluated and compared in two different soils, a calcareous and an acidic one. The effectiveness of nZVI to immobilize metal(loid)s in soil strongly depended on the metal characteristics, soil properties, dose of nZVI and presence of other metal(loid)s. In the case of single contamination, this nanoremediation strategy was effective for all of the metal(loid)s studied except for Cd. When comparing the two soils, anionic metal(loid)s (As and Cr) were more easily retained in acidic soil, whereas cationic metal(loid)s (Cd, Pb and Zn), were immobilized more in calcareous soil. In multi-metal(loid) contaminated soils, the presence of several metal(loid)s affected their immobilization, which was probably due to the competitive phenomenon between metal(loid) ions, which can reduce their sorption or produce synergistic effects. At 10% of nZVI, As, Cr and Pb availability decreased more than 82%, for Zn it ranged between 31 and 75% and for Cd between 13 and 42%. Thus, the application of nZVI can be a useful strategy to immobilize As, Cr, Pb and Zn in calcareous or acidic soils in both single- or multi-metal(loid) contamination conditions.

This paper has studied the success of implantation for 16 commercial active dry yeasts (ADYs) during industrial fermentation (30) and the impact of these yeasts during spontaneous fermentations (19) in 10 wineries from the Denomination of Origin “Vinos de Madrid” over two consecutive years. Yeasts strains were identified by molecular techniques, pulsed field electrophoresis and microsatellite analysis. According to these techniques, all the ADYs were different with the exceptions of two strains, L2056 and Rh, which showed the same karyotype and loci size. The results showed that inoculating fermentations with ADYs did not ensure their dominance throughout the fermentation; the implantation level of ADYs was above 80% in only 9 of the 30 commercial fermentations studied; while in 16 fermentations, the dominance of the inoculated ADYs was below 50%. The type of vinification with the best implantation results overall were those associated with red wine fermentations. ADYs affected spontaneous fermentations, although their impact was observed to decrease in the second year of the study. Therefore, specific adaptation studies are necessary before using commercial yeasts during the fermentation process. At the same time, a study was carried out on the frequency of commercial strains in IMIDRA’s yeast collection, made up of strains isolated from spontaneous fermentations of the different areas and cellars since the beginning of the Denomination of Origin “Vinos de Madrid” in 1990. Six different ADYs were found with a frequency of less than 5%. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13205-019-1913-3) contains supplementary material, which is available to authorized users.

The skeletal complications of type 1 diabetes (T1D) include low bone density, poor bone quality and fractures. Greater calcium intake, vitamin D intake, and physical activity are commonly recommended to improve bone health in patients with T1D. However, it is not clear whether these factors are affected by T1D or improve clinical outcomes. The objective of this study was to systematically review the literature for evidence of associations between calcium intake, vitamin D intake, and physical activity and skeletal outcomes in T1D. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, twenty-two studies were included in this review. The prevalence of calcium deficiency was high and encompassed greater than 50% of participants in the majority of studies. Despite this finding, there was no clear association between calcium intake and bone density in any study. Calcitriol use was associated with gains in bone density in one study but was not associated with changes in bone turnover markers in a second report. No studies specifically investigated the impact of vitamin D2 or D3 supplementation on bone health. Two studies reported a beneficial effect of physical activity interventions on bone accrual in children. The findings from observational studies of physical activity were mixed. In conclusion, there are insufficient data to determine if deficient calcium intake, vitamin D intake, or physical activity contribute to the skeletal complications of T1D. Future studies specifically designed to assess the impact of these interventions on the skeleton in T1D participants are needed.