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Resumen Introduccion El sindrome de piernas inquietas (SPI) es un trastorno caracterizado por la necesidad imperiosa de mover las piernas, estando a menudo acompanado de sensaciones desagradables. Su frecuencia es superior en pacientes con esclerosis multiple (EM) que en la poblacion general. Objetivos Evaluar la prevalencia del SPI, segun el cumplimiento de los 4 requisitos esenciales incluidos en los criterios diagnosticos propuestos por la International Restless leg syndrome study group (IRLSSG, 2003), en una cohorte de pacientes con EM e identificar posibles factores de riesgo y repercusion clinica. Resultados Se incluyeron 120 pacientes con EM, con una edad media de inicio de 40 anos y un tiempo medio de evolucion de 46 meses. La prevalencia de SPI, segun el cumplimiento de criterios diagnosticos de la IRLSSG, fue del 23,3%. El tiempo de evolucion de EM, desde la aparicion de los primeros sintomas, fue significativamente menor en pacientes con SPI (p=0,001). La presencia de un brote reciente, asi como de sintomas de ansiedad, depresion y dolor neuropatico se asociaron de forma significativa con el riesgo de SPI (p=0,001, p Conclusiones El SPI debe ser considerado en la evaluacion neurologica de pacientes con EM, cuyo diagnostico y tratamiento precoz mejoraria la calidad de vida de estos sujetos.

CD19-directed chimeric antigen receptor (CAR) T cells have yielded impressive response rates in refractory/relapse B cell acute lymphoblastic leukemia (B-ALL); however, most patients ultimately relapse due to poor CAR T cell persistence or resistance of either CD19(+) or CD19(-) B-ALL clones. CD22 is a pan-B marker whose expression is maintained in both CD19(+) and CD19(-) relapses. CD22-CAR T cells have been clinically used in B-ALL patients, although relapse also occurs. T cells engineered with a tandem CAR (Tan-CAR) containing in a single construct both CD19 and CD22 scFvs may be advantageous in achieving higher remission rates and/or preventing antigen loss. We have generated and functionally validated using cutting-edge assays a 4-1BB-based CD22/CD19 Tan-CAR using in-house-developed novel CD19 and CD22 scFvs. Tan-CAR-expressing T cells showed similar in vitro expansion to CD19-CAR T cells with no increase in tonic signaling. CRISPR-Cas9-edited B-ALL cells confirmed the bispecificity of the Tan-CAR. Tan-CAR was as efficient as CD19-CAR in vitro and in vivo using B-ALL cell lines, patient samples, and patient-derived xenografts (PDXs). Strikingly, the robust antileukemic activity of the Tan-CAR was slightly more effective in controlling the disease in long-term follow-up PDX models. This Tan-CAR construct warrants a clinical appraisal to test whether simultaneous targeting of CD19 and CD22 enhances leukemia eradication and reduces/delays relapse rates and antigen loss.

The dynamic response of modern slender footbridges is usually sensitive to both the pedestrian actions and the uncertainties associated with their inherent structural behavior. Thus, tuned mass dampers have been widely integrated in the design of these structures to guarantee the fulfillment of the vibration serviceability limit state during their overall life cycle. Three different techniques of tuned mass dampers (active, semi-active and passive) are usually considered for this purpose. Although there are algorithms for the robust design of each particular technique, however, this specificity makes difficult the implementation of all these techniques in practical engineering applications. Herein, the motion-based design method under uncertainty conditions is proposed and further implemented to create a common framework for the robust design of all these techniques when they are employed to mitigate pedestrian-induced vibrations in slender footbridges. According to this method, the design problem may be transformed into the combination of two sequential sub-problems: (i) a reliability multi-objective optimization sub-problem; and (ii) a decision-making sub-problem. Subsequently, the performance of this proposal has been validated through a numerical case study in which the dynamic response of a steel footbridge has been controlled by three different tuned mass damper techniques designed according to the proposed common framework.

Resumen Presentamos el caso de una mujer hondurena de 27 anos sin antecedentes medicos de interes que presento multiples areas de desprendimientos de retina (DR) exudativos y una mejor agudeza visual corregida de 1,3 logMAR en ambos ojos. Fue diagnosticada de sindrome de Vogt-Koyanagi-Harada incompleto y tratada con prednisolona intravenosa (1 g/24 h) durante 3 dias, tal y como recomienda la evidencia publicada, junto con micofenolato de mofetilo (2 g/24 h). Durante el descenso paulatino de corticoesteroides, los DR recidivaron, por lo que se reintrodujeron las megadosis de 1 g/24 h de corticoesteroides intravenosos durante 6 dias hasta la resolucion completa de los DR y se anadieron ciclosporina (100 mg/24 h), triamcinolona subtenoniana (40 mg/mL) e inyecciones intravitreas mensuales de ranibizumab en ambos ojos, con un adecuado control de la inflamacion coroidea que se tradujo en la remision de los sintomas y signos.

Load models that account for Human-Structure Interaction (HSI) may be preferable to accurately predict the dynamic response of lightweight footbridges subjected to pedestrian actions. Representing each person within a crowd may not be practical in engineering design calculations as time-variant models with a large number of degrees of freedom have to be managed. In addition, high computational time may be required to achieve the steady-state response. In this sense, this paper proposes a novel approach to calculate the vertical steady-state response of footbridges from a time-invariant coupled crowd-structure system. Considering the model of the structure and a feedback model of the crowd, a total closed-loop Transfer Function (TF) of the coupled system is derived. Based on this frequency-domain interacting methodology, a step-by-step procedure is set to asses the vibration serviceability of lightweight footbridges due to harmonic excitations through simple algebraic operations. The proposal is used to study a Fibre Reinforced Polymer footbridge subjected to two streams of walking pedestrians. For this structure, a good compromise between experimental and numerical results is obtained in terms of vertical vibrations and TFs. To further validate the proposed approach, a pre-stressed concrete laboratory facility is also analysed, obtaining a satisfactory agreement between the experimental and numerical TFs. Thus, the proposed approach allows to evaluate lightweight footbridges under crowd-induced loads considering HSI in a simple and accurate manner, which is clearly geared to practice.

Syndrome of the trephined (SoT) is the neurological deterioration that occurs after the performance of decompressive craniectomy in which bone is not replaced. The incidence of SoT varies, but this entity seems to be underdiagnosed. It is characterized by symptom reversal after bone replacement, which is the only definitive treatment. We report the case of a patient assessed by the Rehabilitation Service in the Critical Care Unit after a stroke, who had altered level of consciousness and abrupt motor impairment. The patient was diagnosed with SoT. Rehabilitation, with early postural changes, helped to ameliorate the symptoms until the provision of definitive treatment.

Slender footbridges with long spans and light materials may lead to serviceability problems in lateral vibrations due to walking pedestrians. The phenomenon, known as the “lock-in effect” occurs when the number of pedestrians on the footbridge reaches the “critical number”. Considering the mode of vibration in which the instability is more likely to develop, the footbridge response depends on the structural natural frequency and modal damping ratio. These parameters may not have a fixed value during the footbridge overall life cycle due to environmental and operational changes. Therefore, lateral vibration serviceability procedures should include the uncertainty in the footbridge modal parameters in the most simple and applicable way, as the dynamic response of slender footbridges is very sensitive to these uncertainties. Hence, this paper proposes a simple approach, useful for practical engineering applications, to assess the lateral vibration serviceability of slender footbridges, considering the uncertainties in natural frequency and modal damping ratio. The uncertainty is considered by two approaches: probability theory and possibility theory (fuzzy sets). As a result, the study allows checking the vibration serviceability criteria over a range of levels of uncertainty, suggesting that the external factors that affect the modal parameters are more significant when the crowd density exceeds the critical number. The study also shows the simplicity and effectiveness of the possibility theory to deal with the uncertainty in modal parameters, although for similar level of uncertainty, the dynamic response is slightly higher than using the probability theory. Finally, the proposal is applied in two real footbridges, showing a good agreement with the experimental data.

The relationship between psychotic symptoms and global measures of functioning has been widely studied. No previous study has assessed so far the interplay between specific clinical symptoms and particular areas of functioning in first-episode psychosis (FEP) using network analysis methods. A total of 191 patients with FEP (age 24.45 ± 6.28 years, 64.9% male) participating in an observational and longitudinal study (AGES-CM) comprised the study sample. Functioning problems were assessed with the WHO Disability Assessment Schedule (WHODAS), whereas the Positive and Negative Syndrome Scale (PANSS) was used to assess symptom severity. Network analysis were conducted with the aim of analysing the patterns of relationships between the different dimensions of functioning and PANSS symptoms and factors at baseline. According to our results, the most important nodes were “conceptual disorganization”, “emotional withdrawal”, “lack of spontaneity and flow of conversation”, “delusions”, “unusual thought content”, “dealing with strangers” and “poor rapport”. Our findings suggest that these symptoms and functioning dimensions should be prioritized in the clinical assessment and management of patients with FEP. These areas may also become targets of future early intervention strategies, so as to improve quality of life in this population, This work was supported by the Madrid Regional Government (R&D activities in Biomedicine (grant number S2017/BMD-3740 - AGES-CM 2-CM)) and Structural Funds of the European Union. Ana Izquierdo’s work is supported by the PFIS predoctoral program (FI17/00138) from the Instituto de Salud Carlos III (Spain) and co-funded by the European Union (ERDF/ESF, "A way to make Europe”/ “Investing in your future”) and The Biomedical Research Foundation of La Princesa University Hospital. Angela Ib´a˜nez thanks the support of CIBERSAM and of the Spanish Ministry of Science, Innovation and Universities. Instituto de Salud Carlos III (PI16/00834 and PI19/01295) co-financed by ERDF Funds from the European Commission. Covadonga M. Díaz-Caneja holds a Juan Rod´es Grant from Instituto de Salud Carlos III (JR19/00024). Celso Arango was supported by the Spanish Ministry of Science and Innovation. Instituto de Salud Carlos III (SAM16PE07CP1, PI16/02012, PI19/ 024), co-financed by ERDF Funds from the European Commission, “A way of making Europe”, CIBERSAM. Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), European Union Structural Funds. European Union Seventh Framework Program under grant agreements FP7-4-HEALTH-2009-2.2.1-2-241909 (Project EU-GEI), FP7- HEALTH- 2013-2.2.1-2-603196 (Project PSYSCAN) and FP7- HEALTH-2013- 2.2.1-2-602478 (Project METSY); and European Union H2020 Program under the Innovative Medicines Initiative 2 Joint Undertaking (grant agreement No 115916, Project PRISM, and grant agreement No 777394, Project AIMS-2-TRIALS), Fundaci´on Familia Alonso, Fundaci´on Alicia Koplowitz and Fundaci´on Mutua Madrile˜na

We present a case of a woman with idiopathic macular telangiectasia type 1, characterized by the presence of a capillary macroanaeurysm associated with macular edema with a macular star pattern. Several differential diagnoses were proposed, in which the study with a multimodal image was key to clarify the diagnosis. In addition, the various treatments used and their effectiveness are discussed.

Resumen Se presenta un caso de una mujer con telangiectasia macular idiopatica de tipo 1, caracterizado por la presencia de un macroaneurisma capilar asociado a un edema macular con patron en estrella macular. Se plantearon varios diagnosticos diferenciales, en los que el estudio con imagen multimodal fue clave para aclarar el diagnostico. Ademas, se discuten los diversos tratamientos empleados y su efectividad.

Dual-Process Models of Attitudes (DPMA) have provided new concepts and methods for attitude-behavior research in the field of transportation. Notwithstanding, there is a lack of critical reviews on this topic; leaving researchers with an unclear picture of the key issues to consider in developing new research. This paper reviews previous studies on DPMA in traffic and transportation research. A systematic review of English and non-English language articles using Transport Research International Documentation (TRID) as main database was conducted. Additional studies were identified by searching in ScienceDirect and Google Scholar. A total of 1674 references were revised. Twenty-eight articles met the inclusion criteria. Four central issues were examined: (a) the role of implicit and explicit attitudes in transport behavior, (b) the degree of relationship between implicit and explicit attitudes, (c) the types of measures used to assess implicit attitudes, and (d) the malleability of implicit attitudes. The review has identified that: (a) implicit attitudes were associated with a wide variety of transport-related behavior, (b) implicit and explicit attitudes were weakly correlated (mean correlation, weighted by sample size was r = 0.11), and little knowledge exists on factors moderating the implicit-explicit relationship, (c) the evidence on the indirect measures’ better resistance to social desirability bias as compared with traditional techniques is scant and inconclusive, (d) some studies exhibit problems in the application of indirect measures, and (e) few studies (n = 2) aimed to evaluate interventions for attitude change. The analysis showed the sustained growth of the applications, the potential of DPMA, and the need for more rigorous research. Most studies of area do not consider the theoretical and methodological shortcomings of the DPMA, and tend to be based on a controversial notion of implicit and explicit attitudes.

Introduction: Attitudes toward risky driving behaviors are commonly evaluated through direct self-report measures. Nevertheless, these instruments have limitations, such as socially-desirable responding. This study examines the validity of the Implicit Association Test (IAT) as an indirect measure of attitudes towards risky driving. An IAT with “risky” vs. “safe” driving behaviors categories was evaluated. Method: A sample of 100 participants (ranging from 18 to 70 years of age) completed the IAT and measures of attitudes, driving styles, personality traits, risk-taking (IOWA Gambling Task), and social desirability (Driver Social Desirability Scale). Results: A high level of internal consistency was found for IAT scores. The IAT was correlated with driving styles (risky, dissociative, and careful dimensions), risk-related personality traits (impulsive/sensation seeking and aggression/hostility) and risk-taking measures. IAT scores were also associated with self-reported risky driving behaviors (r = 0.33). As expected, a higher level of negative implicit attitudes was found among young drivers. The driver social desirability scale was correlated with most self-report measures, but not with the IAT. Conclusion: The present study provides reliability and validity evidence for the IAT as an indirect measure of attitudes towards risky driving. The IAT can serve as an important complement to conventional self-report measures of driving attitudes. Practical Applications: Potential use of global measure of implicit attitudes toward risky driving behaviors in the evaluation, education, and training of drivers are discussed.

Fluidized beds are particularly suitable for integration into Concentrated Solar Power (CSP) plants with beam-down reflectors. Due to the high mixing rates and heat diffusion typical of fluidized beds, they enable the highly concentrated solar flux from the beam-down reflector to impinge directly on the particles. Depending on size, density, surface roughness, optical and mechanical properties, some granular materials are more appropriate than others to store thermal energy at high-temperatures in a fluidized bed. In this line, this work compares the experimental performance of three different granular materials: sand, carbo Accucast ID50 and SiC, considering different airflow rates, and two fluidization technologies: bubbling and spouted bed. Experimental tests were carried out in a facility specifically tailored for these type of tests that permitted different flow arrangements to apply different fluidization techniques using air as the working fluid, including a beam-down reflector with a 4 kW e lamp to simulate the concentrated solar radiation (peak radiation flux of 115 kW/m2). The temperature evolution and storage/recovery efficiencies for the different materials were compared using the two fluidization technologies, and varying the radiation level and airflow rate. Because of these tests, the influence of the airflow rate and radiation levels on the thermal efficiency of the beds was evaluated. The experimental results showed that SiC was the best candidate, as it exhibited the best thermal performance, reaching a peak storage efficiency of η C = 0.95 , obtained with an airflow rate of 2.5 U mf . Maximum temperatures of 250 ° C were reached in a cylindrical bed with an aspect ratio of L/D ≈ 1.

Negative symptoms are associated with poor clinical and psychosocial outcome in schizophrenia. Their prevalence and identification in first-episode patients remains controversial. In a large cohort of patients in the early stage of schizophrenia, schizophreniform or schizoaffective disorder, we investigated, over the different phases of the OPTiMiSE trial (baseline, 4, 10 and 22 weeks of treatment), the prevalence of negative symptoms of moderate severity, unconfounded by depression and extrapyramidal symptoms at baseline. Moreover, we assessed symptomatic remission, attrition rate and psychosocial functioning in subjects with short-term (4 weeks) persistent unconfounded negative symptoms (PNS) and in those with negative symptoms that did not persist at follow-up and/or were confounded at baseline (N-PNS). Negative symptoms of moderate severity were observed in 59% of subjects at baseline. They were associated with worse psychosocial functioning and longer duration of psychosis at intake in the study. Eleven percent of subjects had PNS unconfounded at baseline and 7.9% had PNS unconfounded at both baseline and end of 4-week treatment. Psychosocial functioning was comparable in PNS and N-PNS subjects at baseline but it was significantly worse in the former group after 4-weeks. PNS subjects showed lower remission and higher attrition rates at the end of all treatment phases. Fifty-six percent of subjects completing phase 3 (clozapine treatment) had PNS, and 60% of them were non-remitters at the end of this phase. The presence of short-term PNS during the first phases of psychosis was associated with poor clinical outcome and resistance to antipsychotic treatment, including clozapine.

Methanol poisoning is often described in the literature, but not transdermal or inhalational poisoning. It usually involves variable multi-organ damage, among which visual, neurological, and gastrointestinal involvement, as well as the metabolic and electrolyte changes that can lead to death. Contact with toluene by occupational or intentional inhalation may also cause neurological abnormalities. This article describes the case of a female patient who was seen in the Emergency Department due to bilateral visual loss secondary to accidental poisoning (inhalation-transdermal) with a solvent containing methanol and toluene. She had a favorable outcome during admission after treatment with ethanol in perfusion and corticosteroids.

Resumen La manometria y la pH-metria esofagicas son tecnicas diagnosticas esenciales en la seccion de pruebas funcionales de los servicios de aparato digestivo. Permiten documentar alteraciones de naturaleza funcional en el tracto digestivo superior, bien en la motilidad esofagica y de la union esofagogastrica o bien en la exposicion al acido de la mucosa del esofago. La impedanciometria combinada con la ph-metria es necesaria para el estudio de pacientes con sintomas de enfermedad por reflujo refractarios al tratamiento. Una correcta ejecucion e interpretacion de estos procedimientos es imprescindible para tratar adecuadamente varias enfermedades funcionales esofagicas y esofagogastricas, siempre con apoyo de otras tecnicas diagnosticas como las endoscopicas y radiologicas.

This paper presents two simple numerical models to analyze the behavior of two different fluidization technologies with concentrated solar energy on the top of the bed. A bubbling fluidized bed, which operates with low particle size (Geldart A-B particles with d p = 0.1 - 0.5 mm) and a spouted bed, which uses particles with larger sizes (Geldart D with d p ≳ 1 mm). Two cases were studied with the same mass of particles (150 kg), considering the same incident solar radiation concentrated on the top of the bed (50 kW). The results obtained indicate that the airflow rate in the bubbling fluidized bed has a notable effect on the maximum temperature reached in the bed. Increasing the airflow rate (from 1.5 to 2.5 times the minimum fluidization velocity), the maximum temperature reached in the bed is reduced from 950 to 750 K. In the spouted bed, higher temperatures are reached (over 1000 K), although it takes almost 4 times longer for the temperature to be reached than in the bubbling bed. Consequently, the charging efficiency, defined as the energy stored in the particles divided by the solar energy concentrated on the bed, are similar for both cases.

Objective Impaired multisensory integration in autism spectrum disorder (ASD) may arise from functional dysconnectivity among brain systems. Our study examines the functional connectivity integration between primary modal sensory regions and heteromodal processing cortex in ASD, and whether abnormalities in network integration relate to clinical severity. Method We studied a sample of 55 high-functioning ASD and 64 healthy control (HC) male children and adolescents (total n = 119, age range 7−18 years). Stepwise functional connectivity analysis (SFC) was applied to resting state functional magnetic resonance images (rsfMRI) to characterize the connectivity paths that link primary sensory cortices to higher-order brain cognitive functional circuits and to relate alterations in functional connectivity integration with three clinical scales: Social Communication Questionnaire, Social Responsiveness Scale, and Vineland Adaptive Behavior Scales. Results HC displayed typical functional connectivity transitions from primary sensory systems to association areas, but the ASD group showed altered patterns of multimodal sensory integration to heteromodal systems. Specifically, compared to the HC group, the ASD group showed the following: (1) hyperconnectivity in the visual cortex at initial link step distances; (2) hyperconnectivity between sensory unimodal regions and regions of the default mode network; and (3) hypoconnectivity between sensory unimodal regions and areas of the fronto-parietal and attentional networks. These patterns of hyper- and hypoconnectivity were associated with increased clinical severity in ASD. Conclusion Networkwise reorganization in high-functioning ASD individuals affects strategic regions of unimodal-to-heteromodal cortical integration predicting clinical severity. In addition, SFC analysis appears to be a promising approach for studying the neural pathophysiology of multisensory integration deficits in ASD.

Chronic kidney disease (CKD) is associated with a wide number of abnormalities in mineral metabolism. Often, these alterations are the leading players in the development of comorbidities associated with CKD, which are risk factors of mortality. In this context, mineral and bone disorder associated with CKD (CKD-MBD) are highlighted, connecting bone, renal, and cardiovascular disorders. Many studies have been led to propose strategies to avoid, reduce, or slow down CKD-MBD progression using different compositions of metallic elements-based P binders such as aluminum, magnesium, or calcium. Magnesium, the aim of this review, has been used by nephrologists to treat CKD-MBD with a variable acceptation due mainly to different results on bone homeostasis. Nowadays, we have new evidence about the efficacy of magnesium supplementation on vascular calcification, renal function, and bone disorders, suggesting potential beneficial effects of Magnesium in the management of CKD-MBD.

The Asian freshwater snail Melanoides tuberculata has been established since the 1960s in the Americas, where it transmits cercariae of a small number of digenetic trematode species from its native range. In 2021-2022, 24 M. tuberculata were discovered shedding transversotrematid cercariae in Puerto Rico, where parasites of this snail have not been previously studied. Adult transversotrematids (in some cases, gravid) were found on field-caught fish and on fish exposed to shedding snails, including on fish species native to Puerto Rico. Adults and cercariae were identified as Transversotrema patialense (Soparkar, 1924), a species native to the Indomalayan region. Morphological identification was supported with 28S rDNA sequences closely matching that from unidentified transversotrematid cercariae in Thailand. The absence of T. patialense in snails collected prior to 2021, increasing prevalence of infection in snails collected thereafter, and lack of variation in parasite DNA sequences (28S, internal transcribed spacer 2, cytochrome c oxidase I) from three isolates are consistent with a recently introduced and possibly expanding parasite population. Transversotrema patialense has been recorded outside its native range before, but most studies (including a prior record in the Americas) reported the parasite from captive hosts from commercial sources such as pet shops. The present results thus provide the first demonstration of natural transmission of T. patialense in the Americas. Phylogenetic analysis of 28S but not of ITS2 show the transversotrematid genus Transversotrema Witenberg, 1944 is paraphyletic, with Crusziella Cribb, Bray and Barker 1992 nested within it.

This study is part of a coordinated-multicentre Project, funded by the Ministerio deEconomia y Competitividad (PI08/0208; PI11/00325; PI14/00612), Instituto de Salud Car-los III–Fondo Europeo de Desarrollo Regional, Union Europea, Una manera de hacer Eu-ropa, Centro de Investigacion Biomedica en Red de salud Mental, CIBERSAM, by theCERCA Programme/Generalitat de Catalunya and Secretaria d’Universitats i Recerca delDepartament d’Economia I Coneixement (2017SGR1355), Departament de Salut de laGeneralitat de Catalunya, en la convocatoria corresponent a l’any 2017 de concessio desubvencions del Pla Estrategic de Recerca i Innovacio en Salut (PERIS) 2016-2020,modalitat Projectes de recerca orientats a l’atencio primaria, amb el codi d’expedientSLT006/17/00345

Resumen Se presenta el caso clinico de una mujer de 67 anos, que desarrollo un cordon subcutaneo en la axila hasta la cara interna del brazo, acompanado de dolor axilar de caracteristicas neuropaticas, sin antecedente quirurgico ni infeccioso. Se le instruyo en ejercicios domiciliarios, y la evolucion fue favorable con mejoria progresiva y espontanea. A los 4 meses persistia un pequeno cordon visible con la abduccion y leve disestesia axilar, de menor intensidad que al inicio. Se diagnostico de sindrome axillary web (SAW) idiopatico, por exclusion. Es ampliamente conocido este sindrome tras cirugia ganglionar axilar en el tratamiento del cancer mama, siendo aun desconocida la etiopatogenia. Son excepcionales los casos publicados sobre el SAW sin antecedente quirurgico, y los pocos documentados tienen como antecedente un proceso infeccioso o esfuerzo fisico intenso. No se ha encontrado descrito en la literatura ningun caso de SAW de etiologia idiopatica, pudiendo ser este el primer caso. La localizacion anatomica, presentacion y evolucion clinica del SAW no quirurgico es extrapolable al posquirurgico.

Introduction Although vaccination has proven to be one of the most effective public health interventions for disease prevention, a small section of the population presents the so-called ‘vaccine hesitancy’ or vaccination doubts. It would be interesting to know the possible factors related to rejection of vaccination. Material and methods Study of cases and controls in which data have been collected from children registered in the REVA programme in the province of Valladolid with explicit rejection of parents (cases), paired with children of the same age, sex and basic health area that do have been vaccinated (controls). Telephone interview was conducted to obtain sociodemographic factors and opinion on vaccination. Results and discussion A total of 82 children were selected, of whom 30 parents agreed to take to the survey. 55% of them mention the doctor as the main source of vaccination information, which contrasts with the distrust of the detected system. Statistically significant differences in the perception of vaccination side effects between cases and controls and in the different items were observed. Statistically significant association was observed between the use of homeopathy the risk of being a case (OR = 5.75, 95% CI = 1.9 to 17.34). Conclusions Although the number of children not vaccinated by explicit rejection by their parents in Valladolid is very low, it is important to know the reasons for this decision and to make an approach guided by the approach of postures rather than the judgment of values towards these families.

Resumen Introduccion A pesar de que la vacunacion ha demostrado ser una de las intervenciones en salud publica mas eficaz para la prevencion de enfermedades, un pequeno sector de la poblacion presenta el llamado «vaccine hesitancy» o dudas sobre vacunacion. Resultaria interesante conocer los posibles factores relacionados con el rechazo a la vacunacion. Material y metodos Estudio de casos y controles en los que se han recogido datos de ninos y ninas registrados en el programa REVA en la provincia de Valladolid con rechazo explicito de los padres (casos), emparejados con ninos de su misma edad, sexo y zona basica de salud que si han sido vacunados (controles). Se realizo entrevista telefonica para obtener factores sociodemograficos y opinion sobre vacunacion. Resultados y discusion Se seleccionaron un total de 82 ninos y ninas, de los cuales 30 padres aceptaron contestar a la encuesta. El 55% de ellos mencionan como principal fuente de informacion en vacunacion al medico, lo que contrasta con la desconfianza hacia el sistema detectada. Se observaron diferencias estadisticamente significativas en la percepcion de los efectos secundarios de la vacunacion entre casos y controles y en los diferentes items. Se observo asociacion estadisticamente significativa entre el uso de homeopatia y el riesgo de ser caso (OR = 5,75, IC 95% = 1,9 a 17,34). Conclusiones A pesar de que es muy bajo el numero de ninos no vacunados por rechazo explicito de sus progenitores en Valladolid, es importante conocer los motivos de esta decision y hacer un abordaje guiado por el acercamiento de posturas en lugar del juicio de valores hacia estas familias.

Acetic acid (HOAc) and diethylenetriaminepentaacetic acid (DTPA) single extraction agents were evaluated as screening methods to estimate the mobility of some trace elements in coastal sediments from Algeciras Bay. Sediments’ total metal concentrations of most heavy metals were found to be high around the areas impacted by anthropogenic activities such a sewage, atmospheric deposition and industrial activities, with notable values for As, Ni, Cr, Pb and Cd. The order of significant extraction efficiencies obtained with DTPA, were as follows: Pb (25.65%), Cu (19.78%), Cd (14.80%) and Zn (11.25%), while those obtained with HOAc were: Mn (33.00%), Tl (24.88%), Pb (18.99%), Cd (13.59%) and Co (11.78%). The comparison between the risk assessment codes (RAC) and the percent metal extractable fractions provided results of serious concern. Very high risk values of Cu, Zn, Cd and Pb extracts in DTPA were observed near the metallurgical industry, with Mn and Tl in HOAc extracts showing high risk values near the same industrial area and harbour activities. Sediments’ total metal concentrations were compared with the Low Alert-Level (LAL) sediment quality guidelines, where Co, Pb, Zn and Ni in both extractants and Cd and Cu in DTPA as well as Tl extracted in HOAc exceeded the LAL values respectively. The Spearman Rank test showed positive correlations between Co, Cu, Ni and Zn in DTPA extracts and their corresponding total metal concentrations, with Co, Cr, Fe, Ni, Tl and Zn in HOAc and total concentrations showing positive correlations. Furthermore, higher positive correlations were found between both extraction methods for Co (ρ = 0.797), Cu (ρ = 0.777), Ni (ρ = 0.789) and Zn (ρ = 0.942), indicating comparable potential extraction efficiencies between these extractants for these metals in the sediment studied. Keywords: Acetic acid, DTPA, Coastal sediment, Single extraction, Trace-element mobility

This review summarizes different solar thermal energy storage techniques from a particle technology perspective, including sensible, latent and thermochemical techniques for low- and high-temperature applications that use particles as the storage medium in the thermal energy storage system. The focus is on applications, experimental results, modeling and future trends. This review describes two different particle technologies used to store thermal energy: packed and fluidized beds. The advantages and disadvantages of both technologies are reviewed throughout different studies found in the literature for various thermal energy storage systems. Packed beds have the main advantage of thermal stratification, which increases the efficiency of solar collectors in low-temperature sensible energy storage systems and augments the exergy content in the bed. Moreover, they have been proven to be suitable as dual-media thermocline storage systems for CSP plants. In contrast, the high mixing rates of fluidized beds makes them suitable for the rapid distribution of concentrated solar energy in particle receiver CSP systems. In addition, their high heat and mass transfer rates, compared with those of packed beds, make them the preferred particle technology for thermochemical energy storage applications. This review also notes that it is important to find new materials with an appropriate size and density that can be properly used in a fluidized bed. Additionally, more specific research efforts are necessary to improve the understanding of the behavior of these materials during the fluidization process and over a high number of charging/discharging cycles.