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Background: Carbapenem non-susceptible Enterobacterales (CNSE) can be broadly divided into those that produce carbapenemases (carbapenemase-producing Enterobacterales (CPE)), and those that harbour other mechanisms of resistance (non-carbapenemase-producing CNSE (NCP-CNSE)).Aim: To determine the predictors of CNSE nosocomial incidence rates according to their mechanism of resistance.Methods: A time-series analysis was conducted (July 2013 to December 2018) to evaluate the relationship in time between hospital antibiotic use and the percentage of adherence to hand hygiene with the CNSE rates.Findings: In all, 20,641 non-duplicated Enterobacterales isolates were identified; 2.2% were CNSE. Of these, 48.1% and 51.9% were CPE and NCP-CNSE, respectively. Of the CPE, 78.3% possessed a blaOXA-232 gene. A transfer function model was identified for CNSE, CPE, and OXA-232 CPE that explained 20.8%, 19.3%, and 24.2% of their variation, respectively. According to the CNSE and CPE models, an increase in piperacillin-tazobactam (TZP) use of 1 defined daily dose (DDD) per 100 hospital patient-days (HPD) would lead to an increase of 0.69 and 0.49 CNSE and CPE cases per 10,000 HPD, respectively. The OXA-232 CPE model estimates that an increase of 1 DDD per 100 HPD of TZP use would lead to an increase of 0.43 OXA-232 CPE cases per 10,000 HPD. A transfer function model was not identified for NCP-CNSE, nor was there an association between the adherence to handhygiene and the CNSE rates.Conclusion: The use of TZP is related in time with the CPE nosocomial rates, mostly explained by its effect on OXA-232 CPE. [ABSTRACT FROM AUTHOR]

A one-year black carbon (BC) experimental study was performed at three different locations (urban traffic, urban background, rural) in Spain with different equivalent BC (eBC) source characteristics by means of multi-wavelength Aethalometers. The Aethalometer model was used for the source apportionment study, based on the difference in absorption spectral dependence of emissions from biomass burning (bb) and fossil fuel (ff) combustion. Most studies use a single bb and ff absorption Ångström exponent (AAE) pair (AAE bb and AAE ff ), however in this work we use a range of AAE values associated with fossil fuel and biomass burning based on the available measurements, which represents more properly all conditions. A sensitivity analysis of the source specific AAE was carried out to determine the most appropriate AAE values, being site dependent and seasonally variable. Here we present a methodology for the determination of the ranges of AAE bb and AAE ff by evaluating the correlations between the source apportionment of eBC using the Aethalometer model with four biomass burning tracers measured at the rural site. The best combination was AAE bb = [1.63–1.74] and AAE ff = [0.97–1.12]. Mean eBC values (±SD) obtained during the period of study were 3.70 ± 3.73 μg m −3 at the traffic urban site, 2.33 ± 2.96 μg m −3 at the urban background location, and 2.61 ± 5.04 μg m −3 in the rural area. High contributions of eBC to the PM 10 mass were found (values up to 21% in winter), but with high eBC/PM 10 variability. The hourly mean eBC ff and eBC bb concentrations varied from 0 to 51 μg m −3 and from 0 to 50 μg m −3 at the three sites, respectively, exhibiting distinct seasonal and daily patterns. The fossil fuel combustion was the dominant eBC source at the urban sites, while biomass burning dominated during the cold season (88% of eBC bb ) in the rural area. Daily PM 2.5 and PM 10 samples were collected using high-volume air samplers and analyzed for OC and EC. Analysis of biomass burning tracers and organic (OC) and elemental (EC) carbon in the rural area indicate that biomass combustion is the main source, while OC and EC indicate a lower influence of this source at the urban site. [ABSTRACT FROM AUTHOR]

The field of reverse vaccinology developed as an outcome of the genome sequence revolution. Following the introduction of live vaccinations in the western world by Edward Jenner in 1798 and the coining of the phrase ‘vaccine’, in 1881 Pasteur developed a rational design for vaccines. Pasteur proposed that in order to make a vaccine that one should ‘isolate, inactivate and inject the microorganism’ and these basic rules of vaccinology were largely followed for the next 100 years leading to the elimination of several highly infectious diseases. However, new technologies were needed to conquer many pathogens which could not be eliminated using these traditional technologies. Thus increasingly, computers were used to mine genome sequences to rationally design recombinant vaccines. Several vaccines for bacterial and viral diseases ( i.e. meningococcus and HIV) have been developed, however the on-going challenge for parasite vaccines has been due to their comparatively larger genomes. Understanding the immune response is important in reverse vaccinology studies as this knowledge will influence how the genome mining is to be conducted. Vaccine candidates for anaplasmosis, cowdriosis, theileriosis, leishmaniasis, malaria, schistosomiasis, and the cattle tick have been identified using reverse vaccinology approaches. Some challenges for parasite vaccine development include the ability to address antigenic variability as well the understanding of the complex interplay between antibody, mucosal and/or T cell immune responses. To understand the complex parasite interactions with the livestock host, there is the limitation where algorithms for epitope mining using the human genome cannot directly be adapted for bovine, for example the prediction of peptide binding to major histocompatibility complex motifs. As the number of genomes for both hosts and parasites increase, the development of new algorithms for pan-genomic mining will continue to impact the future of parasite and ricketsial (and other tick borne pathogens) disease vaccine development. [ABSTRACT FROM AUTHOR]

By 2050, 34.5 % of Spaniards will be over the age of 65, making Spain's population the third oldest in the world. Ageing populations present numerous challenges and opportunities and these are particularly apparent in the area of healthcare and health communication. Longer life expectancy pushes greater demand for information regarding health and healthcare institutions are exploring ways of meeting these demands in an effective and efficient manner. This study listens to the voices of older people themselves, exploring seniors’ use of digital communication to find information related to health and healthy living. Part of a wider project examining the use of digital health communication for active aging by Spanish health institutions, this research used focus groups to explore the extent to which older people trust and feel empowered by digital media in finding out about health issues. It found that online healthcare information is giving older people the chance to take more responsibility for their own health and, when well founded and well used, it can act as part of a safety net that complements the work of healthcare professionals. Being able to compare and contrast the information received from one's physician is in itself an empowering development. [ABSTRACT FROM AUTHOR]

Venous ulcer of the lower extremity is a common vascular condition and is associated with decreased quality of life, reduced mobility, and social isolation. Treatment of chronic venous ulcer (CVU) includes compression therapy, debridement of the ulcer when necessary, and wound care. Collagen and antimicrobial dressings can improve the proportion of ulcers healed compared with compression alone. Acellular skin equivalents are not superior to compression, but cellular human skin equivalents can promote more rapid healing, particularly in patients with longstanding ulcers. Current vascular surgical practice is to eliminate documented reflux or obstruction in patients with CVU that have failed a 3-month period of compression dressing, debridement, and local wound care. We found that surgical treatment of the superficial venous system can decrease the time to healing of CVUs compared with compression therapy alone, but does not increase the proportion of ulcers healed. [ABSTRACT FROM AUTHOR]

Riboflavin (vitamin B2) plays an important role in cellular metabolism participating in numerous oxidation-reduction reactions and energy usage. In this work, lactic acid bacteria that can produce vitamin B2 in soymilk were identified from 179 strains tested that were previously isolated from a wide range of food products. Only 42 strains were able to grow in a commercial riboflavin-free medium after which the concentration of this vitamin was determined by HPLC. Five of these strains were pre-selected for their capacity to produce elevated concentrations of riboflavin. These were then inoculated in soymilk to evaluate their capacity to grow in this food matrix and increase its low riboflavin concentrations. Only the strain Lactobacillus plantarum CRL 725 was able to significantly increase the initial concentration of riboflavin in soy milk from 309±9ng/mL to 700±20ng/mL after 12h of incubation at 37°C. Roseoflavin resistant variants of this strain were obtained and evaluated in soymilk. One of the variant strains increased 6 times (1860±20ng/mL) the initial riboflavin levels of soy milk. Roseoflavin-resistant strains capable of synthesizing riboflavin in soymilk constitute an interesting and economically feasible biotechnology strategy that could be easily adapted by the food industry to develop novel vitamin-bioenriched functional foods with enhanced consumer appeal. [ABSTRACT FROM AUTHOR]

The incidence of infectious complications due to several contributory causes is particularly elevated and life-threatening in patients undergoing peritonectomy and HIPEC procedure for peritoneal carcinomatosis. Following a previous experience, we started a prospective protocol study of preoperative screening, perioperative prophylaxis and postoperative surveillance and treatment. A total of 111 patients with peritoneal carcinomatosis of various origin underwent CRS with HIPEC between April 2004 and December 2012. The group was divided into a pilot group of 30 patients (04/04 to 05/08) and a main group of 81 patients (06/08 to 12/12). Overall postoperative morbidity rate was 44%, with 35.8% of symptomatic infections. No post-operative mortality was observed. Microorganisms were isolated in 24 patients (80.0%) in the first group and 54 (66.7%) in the second. They were symptomatic in 18 cases (75.0%) and 25 (46.3%) cases respectively. In addition, 7 invasive candidosis were recorded (25.9%). Colon resection (P = 0.01) and duration of surgery (P = 0.0008) were associated with infection at logistic regression model. Concerning symptomatic infections, only Infection Risk Index (P = 0.009) showed significance at multivariate analysis. Despite a significant incidence of infectious complications, establishment of a prevention, surveillance and treatment protocol lead to a zero mortality rate in the observed patients of our experience. Owing to the obtained results, we suggest the use of a standardized protocol for the prevention, monitoring and treatment in all patients enrolled for cytoreductive surgery and HIPEC. [ABSTRACT FROM AUTHOR]

Abstract: The objective of this work was to perform the quantitative analysis of 4 amino acids: phenylalanine (Phe), tyrosine (Tyr), ornithine (Ort) and glutamic acid (Glu) in mixtures with the use of potentiometric sensor array (electronic tongue) and Sequential Injection Analysis (SIA) measurement system. The flow-through sensor array was composed of 6 miniaturized classical ion-selective electrodes based on polymeric membranes (plasticized PVC) containing phenylboronic acid ionophore and/or an ion exchanger. The PLS analysis of the sensor array responses, measured in amino acids mixtures prepared by the SIA system (in two buffer solutions), permitted a correct quantitative analysis of only Glu and Ort. Further chemometric treatment, involving the extraction of dynamic components of the transient response employing the Fourier transform plus training of an Artificial Neural Network (ANN) with its coefficients led to the simultaneous determination of 3 amino acids, with a separate semiquantitative estimation of Tyr. [Copyright &y& Elsevier]

Abstract: Aim: The present study was specifically designed to assess the major clinical and pathological variables of patients with colorectal peritoneal carcinomatosis in order to investigate whether currently used criteria appropriately select candidates for peritonectomy procedures (cytoreductive surgery) combined with hyperthermic intraperitoneal chemotherapy (HIPEC). Patients and methods: Preoperative, operative and follow-up data on 146 consecutive patients presenting with peritoneal carcinomatosis of colorectal origin and treated by surgical cytoreduction combined with HIPEC in 5 Italian Hospital and University Centers were prospectively entered in a common database. Univariate and multivariate analyses were used to assess the prognostic value of clinical and pathologic factors. Results: Over a minimum 24-month follow-up, the overall morbidity rate was 27.4% (mortality rate: 2.7%) and was directly related to the extent of surgery. Peritoneal cancer index (PCI), unfavorable peritoneal sites, synchronous or previously resected liver metastasis and the completeness of cytoreduction, all emerged as independent prognostic factors correlated with survival. Conclusions: Until research provides more effective criteria for selecting patients based upon the biomolecular features of carcinomatosis, patients should be selected according to the existing independent prognostic variables. [Copyright &y& Elsevier]

This paper presents a review on the implications of climate change on the monitoring, modelling and regulation of persistent organic pollutants (POPs). Current research gaps are also identified and discussed. Long-term data sets are essential to identify relationships between climate fluctuations and changes in chemical species distribution. Reconstructing the influence of climatic changes on POPs environmental behaviour is very challenging in some local studies, and some insights can be obtained by the few available dated sediment cores or by studying POPs response to inter-annual climate fluctuations. Knowledge gaps and future projections can be studied by developing and applying various modelling tools, identifying compounds susceptibility to climate change, local and global effects, orienting international policies. Long-term monitoring strategies and modelling exercises taking into account climate change should be considered when devising new regulatory plans in chemicals management. [Copyright &y& Elsevier]

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Climate change has the potential of affecting the behaviour and distribution of organic pollutants, including POPs. Direct effects of climate change, like temperature increase, modification of wind and precipitation patterns, sea level rise, snow and ice cover, may be very effective in altering the partitioning of POPs among the environmental compartments. Other consequences of future climate scenarios may imply the alteration of degradation rates, soil properties (and hence land use), air-particle partitioning of chemicals and so forth. A case study is here presented to illustrate the major implications of climate change on the long term at the local scale. A dynamic multimedia model was applied to selected PCB and PCDD/F congeners to simulate the effects of climate change on their distribution and fluxes over the next 50y in the Venice Lagoon (Italy). Different climate change scenarios were tested, finding noticeable variations in POPs concentration even for minor environmental changes. PCBs and PCDFs environmental concentrations may differ by a factor two in a moderate climate change scenario, compared to a situation with stable climate over the next 50y. However, model results also suggest that if global warming may have the potential of reducing the environmental levels of these chemicals, it would probably enhance their mobility and hence their potential for long range atmospheric transport. [Copyright &y& Elsevier]

Objective: To evaluate the effect of osteoporosis (OP) in cartilage damage developed in an experimental model of osteoarthritis (OA) in mature female rabbits in order to investigate the relationship between OP and OA.Methods: OA was experimentally induced by anterior cruciate section and partial medial meniscectomy in the left knee of 12 rabbits. OP was experimentally induced prior to OA in six rabbits by bilateral ovariectomy (OVX) and systemic corticosteroid administration during 4 weeks. Knees were evaluated with high resolution magnetic resonance imaging (MRI) before knee surgery to rule out any detrimental effect of corticosteroids on cartilage. Gross and microscopic cartilage changes were assessed 16 weeks after surgery in bilateral knees. Left knees were considered osteoarthritic or osteoarthritic plus osteoporotic. Right knees were used as osteoporotic and healthy controls, respectively. Bone mineral density (BMD) was measured with dual energy X-ray absorptiometry (DXA) at the lumbar spine, global knee and subchondral knee bone, and its variations correlated with cartilage abnormalities.Results: MRI before knee surgery disclosed no cartilage or bone abnormalities in any of the studied groups. OP increased the severity of cartilage abnormalities in experimental knee OA significantly (P<0.05). Cartilage damage was inversely correlated with BMD variations measured at the lumbar spine (r=-0.74; P=0.015). BMD changes in global and subchondral knee bone also showed a trend to correlate inversely with cartilage damage.Conclusions: Prior induction of OP increases the severity of cartilage damage in experimental OA. Increase in cartilage damage correlates with bone loss. These findings suggest a direct relationship between OP and OA. [ABSTRACT FROM AUTHOR]