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Introduction: The general objective of this research is to improve the quality of colorectal cancer screening (CRC) by assessing, as an indicator of effectiveness, the ability of colonoscopy to detect more advanced adenomas in the exposed group than in the control group. Material and Methods: The present work is designed as an open-label randomized study on cancer screening, using two groups based on their exposure to the protocol: an exposed to intervention group (EIG, 167), and a control group (CG, 167), without the intervention of the protocol and by 1:1 matching. Results: In 167 patients in the GEI, 449 polyps are visualized and 274 are adenomas (80.58%), of which 100 (36.49%) are advanced adenomas. In the CG (n = 174), there are 321 polyps and 152 adenomas (82.60%). The variables significantly associated by logistic regression to the detection of adenomas are the male sex with an OR of 2.52. The variable time to withdrawal, ≥9 min, is significant at 99% confidence (p = 0.002/OR 34.67) and the fractional dose is significant at 99% (p = 0.009, OR 7.81). Conclusion: Based on the observations made, our study suggests that the intervention in collaboration between primary care and hospital care is effective from a preventive point of view and achieves the objective of effectiveness and quality of the PCCR. [ABSTRACT FROM AUTHOR]

Inadequate sleep has been linked to a variety of impairments in bodily functions, including endocrine, metabolic, higher cortical function, and neurological disorders. For this reason, the aim of this study was to analyze the link between occupational pesticide exposure and sleep health among farmers in Almeria. A cross-sectional study was conducted among a population living on the coast of Almeria (southeastern Spain), where about 33,321 hectares of land are used for intensive agriculture in plastic greenhouses. A total of 380 individuals participated in the study: 189 greenhouse workers and 191 control subjects. The participants were contacted during their annual scheduled occupational health survey. Data on sleep disturbances were collected using the Spanish version of the Oviedo Sleep Questionnaire. Agricultural workers were found to be at a significantly higher risk of insomnia, especially among those who did not wear protective gloves (OR = 3.12; 95% C.I. = 1.93-3.85; p = 0.04) or masks (OR = 2.43; 95% C.I. = 1.19-4.96; p = 0.01). The highest risk of insomnia related to pesticide applicators was observed in those who did not wear a mask (OR = 4.19; 95% C.I. = 1.30-13.50; p = 0.01) or goggles (OR = 4.61; 95% C.I. = 1.38-10.40; p = 0.01). This study supports previous findings indicating an increased risk of sleep disorder in agricultural workers exposed to pesticides at work.

Background: This research aimed to develop a questionnaire to analyze perceived aspects of using digital technology among nursing students as a collaborative tool. We further sought to evaluate the psychometric reliability of the instrument., Methods: A cross-sectional observational study was performed using a questionnaire developed from scratch. Psychometric studies and univariate and bivariate analyses were performed., Results: 132 nursing students participated. The exploratory and confirmatory analyses of the questionnaire excluded 4 of the initial 18 items and established four domains, and internal consistency was found. The mean global score of the answers to the questionnaire was 4.67 on a scale of 1-5 points, and all the domains obtained high scores. Men scored higher on the usefulness and the global score, while no differences were found regarding age., Conclusions: Nursing students positively assess the use of digital technology as a collaborative tool, regardless of age. Digital technology as a collaborative tool is perceived as beneficial, improves their involvement, and allows nursing students to obtain a better knowledge of their partners. These findings can help develop group projects and tools based on technology to train future nursing professionals. The questionnaire developed is a valid tool to assess this.

Those infected by COVID-19 develop various kinds of complications with varying degrees of severity. For this reason, it is necessary to evaluate its analytical values to predict and reduce the risks and complications derived from this pathology. A cross-sectional study was carried out a population in Almeria (south-eastern Spain) who had a positive Polymerase Chain Reaction test result from 1 March 2020 to 30 November 2020. The study involved 4575 patients, with 1346 who were asymptomatic, 1653 mildly symptomatic (no hospitalisation needed) and 1576 severely symptomatic (symptomatic patients hospitalised). Laboratory values for D-dimer, glucose, serum ferritin, and C-reactive protein were analysed. The mean age of the participants in the study was 53.60 (16.89) years old. A total of 70.6% of the patients were symptomatic, of which 36.1% had mild symptoms. For all of the laboratory predictors analysed (D-dimer, glucose, serum ferritin, and C-reactive protein), it was found that severe alterations in the parameters were more frequent in severely symptomatic patients with statistically significant differences (p < 0.001), although these alterations also occurred in asymptomatic patients. Age correlated with analytical values (D-dimer, glucose, serum ferritin, and C-reactive protein) with statistically significant differences. Patients with severe symptoms presented alterations in the analytical values of D-dimer, glucose, serum ferritin, and C-reactive protein. Asymptomatic patients presented alterations in the analysed parameters, though with less frequency and severity than patients with severe symptoms.

Two eco-friendly healing bioproducts generated from microbial mixed cultures (MMC) for the production of polyhydroxyalkanoates (PHA) were used as surface treatments, with two residual materials used as the substrates, namely crude glycerol and pinewood bio-oil. Their ability to improve the durability of concrete samples containing recycled aggregates was assessed. To determine this protective capacity, 180 samples were analyzed using different tests, such as water penetration under pressure, capillary absorption, freeze-thaw and water droplet absorption test. Three types of conditions were used: outdoor-indoor exposure, re-application of biopolymers and application in vertical exposure conditions. The results showed reductions of up to 50% in the water penetration test and a delay in the water droplet absorption test of up to 150 times relative to the reference. The surface application of these bioproducts significantly reduced the degree of water penetration in recycled concrete, increasing its useful lifespan and proving to be a promising treatment for protecting concrete surfaces.

The coronavirus 2019 (COVID-19) pandemic has had a significant impact on the economy and health, especially for the most vulnerable social groups. The social determinants of health are one of the most relevant risks for becoming infected with COVID-19, due to the health consequences for those who are exposed to it. The objective of this study was to analyze the influence of social determinants in health on COVID-19 infection in vulnerable social groups. A transversal epidemiological study was carried out on 746 individuals in vulnerable situations living in conditions of extreme poverty in disadvantaged areas in the province of Almeria (southeast of Spain). Social determinants of health such access to drinking water ( p < 0.001) and economic income ( p = 0.04) influenced the infection of COVID-19. A binary logistic regression model showed that the significant predictors of COVID-19 infection were the lack of economic income and inaccessible drinking water. The government and social health services must be aware of this problem in order to play an active role in searching for solutions and implementing public health prevention measures to eliminate social inequalities in health.

The rear wall of the header box serves as a tubesheet in heat exchangers of double plate header box. Tube-to-tubesheet welding must be performed using orbital Gas Tungsten Arc Welding (GTAW) with a head extension, which is passed through the corresponding hole in the front wall (plugsheet) of the header box, where the welding machine is supported. In this project, the effect of parallelism deviations between the plugsheet and the tubesheet of carbon steel header box is analyzed to evaluate its influence on the quality of the tube-to-tubesheet welding. Welded tube (SA-210 Gr. A1) to tubesheet (SA-516 Gr. 70) coupons are manufactured simulating the parallelism deviations previously analyzed in two double plate header boxes of air-cooled heat exchangers using two different preheating temperatures. Macrographic analysis is performed in order to evaluate the weld penetration (minimum leak path) and length of the weld leg in tube-to-tubesheet joints. The results obtained show important variations in those parameters when the parallelism deviations are equal to or greater than -1 mm over the theoretical distance as well as when the distance approaches +1 mm or more. Finally, the incorporation of dimensional controls prior to the welding process is discussed and the implementation of improvements in orbital GTAW equipment is recommended as an optimal solution for this kind of heat exchangers.

Approximately 200 million women and girls have undergone female genital mutilation (FGM) worldwide. Migration has spread the practice of FGM around the world, thus making it a global public health issue. The objective of this descriptive qualitative study was to explore the perceptions of Sub-Saharan immigrant women in Spain in relation to the causes of the persistence of FGM. In-depth interviews were carried out with 13 female FGM survivors of African origin, followed by inductive data analysis using ATLAS.ti software. Two main themes emerged from the analysis: (1) A family ritual symbolic of purification and (2) a system of false beliefs and deception in favour of FGM. The FGM survivors living in Europe are aware that FGM is a practice that violates human rights yet persists due to a system of false beliefs rooted in family traditions and deception that hides the reality of FGM from young girls or forces them to undergo the practice. The ritualistic nature of FGM and the threat of social exclusion faced by women who have not had it performed on them contributes to its persistence nowadays.

The root is the below-ground organ of a plant, and it has evolved multiple signaling pathways that allow adaptation of architecture, growth rate, and direction to an ever-changing environment. Roots grow along the gravitropic vector towards beneficial areas in the soil to provide the plant with proper nutrients to ensure its survival and productivity. In addition, roots have developed escape mechanisms to avoid adverse environments, which include direct illumination. Standard laboratory growth conditions for basic research of plant development and stress adaptation include growing seedlings in Petri dishes on medium with roots exposed to light. Several studies have shown that direct illumination of roots alters their morphology, cellular and biochemical responses, which results in reduced nutrient uptake and adaptability upon additive stress stimuli. In this review, we summarize recent methods that allow the study of shaded roots under controlled laboratory conditions and discuss the observed changes in the results depending on the root illumination status.

The linear economy paradigm in place to date has to be seriously challenged to give way to a new school of thought known as the circular economy. In this research work, precast kerbs and paving blocks made with recycled concrete (RACC-mixture) bearing 50 wt% mixed recycled aggregate (masonry content of 33%) and an eco-efficient cementitious material as 25 wt% conventional binder replacement were evaluated to assess their intrinsic potential to replace traditional raw materials, in keeping with circular economy criteria. Therefore, precast products were subjected to mechanical strength, durability and microstructure tests and were compared to conventional concrete units (CC-mixture and commercially available precast elements). Although a class demotion was observed for water absorption and some decreases in flexural strength (26%), splitting tensile strength (12.8%) and electrical resistivity (45%) and a lower class water absorption were registered, and the recycled mixture also exhibited a greater performance in terms of compressive strength (6%), a better abrasion resistance classification and a comparable porosity and microstructure, which ensures a good concrete durability. In any case, the results showed that precast pieces were European standard-compliant, thus supporting the viability of the mixed recycled aggregates and eco-efficient cementitious replacement in footways.

One approach to tackle the problems created by the vast amounts of construction and demolition waste (CDW) generated worldwide while at the same time lengthening concrete durability and service life is to foster the use of recycled aggregate (RA) rather than natural aggregate (NA). This article discusses the use of polyhydroxyalkanoates (PHAs)-producing mixed microbial cultures (MMCs) to treat the surface of recycled concrete with a view to increase its resistance to water-mediated deterioration. The microorganisms were cultured in a minimal medium using waste pinewood bio-oil as a carbon source. Post-application variations in substrate permeability were determined with the water drop absorption and penetration by water under pressure tests. The significant reduction in water absorption recorded reveals that this bioproduct is a promising surface treatment for recycled concrete.

The large increase in the world population has resulted in a very large amount of construction waste, as well as a large amount of waste glycerol from transesterification reactions of acyl glycerides from oils and fats, in particular from the production of biodiesel. Only a limited percentage of these two residues are recycled, which generates a large management problem worldwide. For that reason, in this study, we used crude glycerol as a carbon source to cultivate polyhydroxyalkanoates (PHA)-producing mixed microbial cultures (MMC). Two bioproducts derived from these cultures were applied on the surface of concrete with recycled aggregate to create a protective layer. To evaluate the effect of the treatments, tests of water absorption by capillarity and under low pressure with Karsten tubes were performed. Furthermore, SEM-EDS analysis showed the physical barrier caused by biotreatments that produced a reduction on capillarity water absorption of up to 20% and improved the impermeability of recycled concrete against the penetration of water under pressure up to 2.7 times relative to the reference. Therefore, this bioproduct shown to be a promising treatment to protect against penetration of water to concrete surfaces increasing its durability and useful life.

Synthetic cannabinoids can cause acute adverse psychological effects, but the potential impact when exposure happens before birth is unknown. Use of synthetic cannabinoids during pregnancy may affect fetal brain development, and such effects could be moderated by the genetic makeup of an individual. Disrupted in schizophrenia 1 ( DISC1 ) is a gene with important roles in neurodevelopment that has been associated with psychiatric disorders in pedigree analyses. Using zebrafish as a model, we investigated (1) the behavioral impact of developmental exposure to 3 μM 1-pentyl-3-(1-naphthoyl)-indole (JWH-018; a common psychoactive synthetic cannabinoid) and (2) whether disc1 moderates the effects of JWH-018. As altered anxiety responses are seen in several psychiatric disorders, we focused on zebrafish anxiety-like behavior. Zebrafish embryos were exposed to JWH-018 from one to six days post-fertilization. Anxiety-like behavior was assessed using forced light/dark and acoustic startle assays in larvae and novel tank diving in adults. Compared to controls, both acutely and developmentally exposed zebrafish larvae had impaired locomotion during the forced light/dark test, but anxiety levels and response to startle stimuli were unaltered. Adult zebrafish developmentally exposed to JWH-018 spent less time on the bottom of the tank, suggesting decreased anxiety. Loss-of-function in disc1 increased anxiety-like behavior in the tank diving assay but did not alter sensitivity to JWH-018. Results suggest developmental exposure to JWH-018 has a long-term behavioral impact in zebrafish, which is not moderated by disc1 .

Training in basic life support (BLS) using clinical simulation improves compression rates and the development of cardiopulmonary resuscitation (CPR) skills. This study analyzed the learning outcomes of undergraduate nursing students taking a BLS clinical simulation course. A total of 479 nursing students participated. A pre-test and post-test were carried out to evaluate theoretical knowledge of BLS through questions about anatomical physiology, cardiac arrest, the chain of survival, and CPR. A checklist was used in the simulation to evaluate practical skills of basic CPR. The learning outcomes showed statistically significant differences in the total score of the pre-test and after completing the BLS clinical simulation course (pre-test: 12.61 (2.30), post-test: 15.60 (2.06), p < 0.001). A significant increase in the mean scores was observed after completing the course in each of the four parts of the assessment protocol ( p < 0.001). The increase in scores in the cardiac arrest and CPR sections were relevant (Rosenthal's r: -0.72). The students who had prior knowledge of BLS scored higher on both the pre-test and the post-test. The BLS simulation course was an effective method of teaching and learning BLS skills.

Basketball is a sport in which, beyond the physical and technical skills, the psychological aspects are a decisive factor and could negatively affect the well-being of the player. The present study analyzes how 11 items belonging to two stakeholders (coach and player) could negatively affect the well-being of the athlete. A sample of elite young basketball players ( n = 121) consisting of 55 males and 66 females, ranging in age from 16 to 23 ( M = 20.12 ± 1.71), completed the Negative Factors Affecting Players' Well-being (NFAPW) Questionnaire. This questionnaire was designed ad hoc and demonstrated good psychometric properties that confirmed that it is a valid and reliable instrument to measure how those factors negatively affect their well-being. The results showed that females have a greater perception of the factors that negatively affect their well-being, especially those related to the actions of the coach. However, no differences were found regarding the experience. Although this research provides an initial tool for measuring the well-being of the player during competition, future studies are encouraged to provide guidance to the coaches and players in dealing with the psychological variables in a better way.

MET alterations may provide a potential biomarker to evaluate patients who will benefit from treatment with MET inhibitors. Therefore, the purpose of the present study is to investigate the utility of a liquid biopsy-based strategy to assess MET alterations in cancer patients. We analyzed MET amplification in circulating free DNA (cfDNA) from 174 patients with cancer and 49 healthy controls and demonstrated the accuracy of the analysis to detect its alteration in patients. Importantly, a significant correlation between cfDNA concentration and MET copy number (CN) in cancer patients ( r = 0.57, p <10 -10 ) was determined. Furthermore, we evaluated two approaches to detect the presence of MET on circulating tumor cells (CTCs), using the CellSearch ® and Parsortix systems and monitored patients under anti-EGFR treatment ( n = 30) combining both cfDNA and CTCs analyses. This follow-up provides evidence for the potential of MET CN assessment when patients develop resistance to anti-EGFR therapy and a significant association between the presence of CTCs MET + and the Overall Survival (OS) in head and neck cancer patients (P = 0.05; HR = 6.66). In conclusion, we develop specific and noninvasive assays to monitor MET status in cfDNA/CTCs and demonstrate the utility of plasma MET CN determination as a biomarker for monitoring the appearance of resistance to anti-EGFR therapy.

This manuscript reports a study of the capacity of polymer composites to increase flexural strength in concrete. The polymer composites reinforced with carbon fiber and bonded with epoxy adhesive were used in prismatic test specimens of mass concrete corresponding to two different morphologies. The aim was to simulate the restoration of deteriorating concrete agricultural structures in order to explore the viability of this alternative against replacing them. An increase was found in the strength of the elements tested, with a higher strength being observed in those test specimens presenting a modified geometry.

This research aimed to prove the feasibility of producing two types of precast elements widely used in construction, such as curbstones and paving blocks, using recycled concrete made with a 50% substitution of the natural gravel by recycled mixed aggregates with a significant ceramic content (>30%). In order to prove the quality of such mass concrete recycled precast elements, two different mixes were used: the first one was a conventional concrete mix provided by Prefabricados de Hormigón Pavimentos Páramo S.L., one of the collaborating companies in this study, and the other was a mixture in which wt 50% of the natural coarse aggregates were substituted for recycled mixed aggregates ceramic (RMAc). This recycled aggregate is a heterogeneous mixture of unbound aggregates, concrete, ceramic, etc., used as a secondary recycled aggregate and commonly produced in a lot of recycling plants in many European countries. This material was supplied by Tecnología y Reciclado S.L., the other collaborating company. Both mixtures were representative in order to establish the comparative behavior between them, taking into account that smaller percentages of replacement of the natural with recycled aggregates will also produce good results. This percentage of substitution represents a high saving of natural resources (gravel) and maintains a balanced behavior of the recycled concrete, so this new material can be considered to be a viable and reliable option for precast mass concrete paving elements. The characterization of the recycled precast elements, covering mechanical, microstructural, and durability properties, showed mostly similar behavior when compared to the analogous industrially-produced pieces made with conventional concrete.

The replacement of natural aggregates by recycled aggregates in the concrete manufacturing has been spreading worldwide as a recycling method to counteract the large amount of construction and demolition waste. Although legislation in this field is still not well developed, many investigations demonstrate the possibilities of success of this trend given that concrete with satisfactory mechanical and durability properties could be achieved. However, recycled aggregates present a low quality compared to natural aggregates, the water absorption being their main drawback. When used untreated in concrete mix, the recycled aggregate absorb part of the water initially calculated for the cement hydration, which will adversely affect some characteristics of the recycled concrete. This article seeks to demonstrate that the technique of pre-saturation is able to solve the aforementioned problem. In order to do so, the water absorption of the aggregates was tested to determine the necessary period of soaking to bring the recycled aggregates into a state of suitable humidity for their incorporation into the mixture. Moreover, several concrete mixes were made with different replacement percentages of natural aggregate and various periods of pre-saturation. The consistency and compressive strength of the concrete mixes were tested to verify the feasibility of the proposed technique.

Construction and demolition waste (CDW) constitutes an increasingly significant problem in society due to the volume generated, rendering sustainable management and disposal problematic. The aim of this study is to identify a possible reuse option in the concrete manufacturing for recycled aggregates with a significant ceramic content: mixed recycled aggregates (MixRA) and ceramic recycled aggregates (CerRA). In order to do so, several tests are conducted in accordance with the Spanish Code on Structural Concrete (EHE-08) to determine the composition in weight and physic-mechanical characteristics (particle size distributions, fine content, sand equivalent, density, water absorption, flakiness index, and resistance to fragmentation) of the samples for the partial inclusion of the recycled aggregates in concrete mixes. The results of these tests clearly support the hypothesis that this type of material may be suitable for such partial replacements if simple pretreatment is carried out. Furthermore, this measure of reuse is in line with European, national, and regional policies on sustainable development, and presents a solution to the environmental problem caused by the generation of CDW.