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We investigated the changes in faunal activities as measures of the ecological functions of soils impacted by potentially toxic metals (PTMs) under urban, industrial, agricultural, and natural uses. Concentrations and distributions of Zn, Cd, Pb, Cu, Mn, and Fe were estimated by sequential chemical extractions, while relicts and present faunal activities were studied by micromorphological analyses. Urban and natural lands were contaminated with Pb, Cd, and Zn. Microarthropods and fungi are observed to be active in the litter decomposition in natural, agricultural and urban lands which indicates that total concentration of PTMs in soils is not a good indicator to evaluate the limitations of PTMs to fauna activity. Metals immobilization on carbonates and Fe/Mn oxides, and fertilizations reduced the negative effects of metals on faunal activity. Micromorphological analyses showed the impacts of metal on soil ecological functions in industrial site, where the surface soils are devoid of any evidence of faunal activity; likely due to high proportion of Pb and Zn in organic components. Therefore, the impacts of metals in soil fauna activities, hence ecological functions of soils, are best evaluated by the knowledge of metal partitioning on solid phases in combination with observations of fauna activities using micromorphological techniques. [ABSTRACT FROM AUTHOR]

The reactive nitrogen released to the environment caused by food consumption can be quantified through the Nitrogen Footprint (NF). Spain has been traditionally regarded to follow the worldwide recognized healthy Mediterranean diet. However, dietary changes among the population have started to shift from the traditional Spanish food consumption. Based on the established method for quantifying the NF from the consumer perspective, this study aimed to estimate the NF from food consumption in Spain, distinguishing between different age groups and gender. The results show that the food NF in Spain was 12.78 kg of N/cap/year and 601 Gg N/year in total. The main food contributors to the overall food NF in Spain were cereals, beef, and pork, while the food products oilseeds and oil, fruits, and legumes presented a lower contribution to the Spanish food NF. Additionally, differences in the food NF among the Spanish population were also observed. Younger age groups (<10 years) and the elderly (>65 years) presented lower food NF per capita than the rest of the population. In relation to gender, it was observed that women have a food NF slightly lower than men. It was seen that food production NF contributes 91 % to the overall food NF in Spain compared to the total food consumption NF. Key strategies based on improving the N use efficiency of crops and livestock, recycling and avoiding food waste, and implementing more sustainable eating patterns can be applied to reduce the food NF in Spain., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

A quantitative assessment of the embodied environmental impacts of infrastructures can provide initial guidance to industry practitioners and engineers at the outset of the construction projects. This study presents the applicability of the Environmentally Extended Input-Output Analysis as a pre-construction evaluation tool for quantifying the embodied environmental impacts of a small diversion dam in Spain. Seven impact categories are assessed from a production-based and consumption-based perspective identifying the main sectors and regions contributing to the environmental impacts. From the consumption-based perspective, Spain is the only contributor to the environmental impacts, and from the production-based perspective, Spain is the main polluting country in all the impact categories contributing on average 68.9%. The use of high quantities of construction material leads to the sectors of steel and cement to significantly increase the environmental impacts. From the production-based perspective, steel and cement contribute on average 29.5% and 17.2%, respectively. From the consumption-based perspective, both sectors account for 74% of the overall environmental impacts. As observed in this case study, the application of the EEIOA model enables engineers and designers to focus during the early design stages on decisions that achieve high embodied impact reductions, such as prioritizing recycled materials for the construction of this infrastructure and, when possible, use materials from a less polluting origin., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Reactive nitrogen (N) emissions can lead to severe environmental and human damages. To quantify these reactive N emissions the Nitrogen Footprint (NF) can serve as a valuable indicator. This work is the first attempt to quantify an institutional NF in Spain and the first institutional NF of a research center. The NF of the Spanish research center of INIA was quantified for the year 2019 taking into account all N emission sources. The total NF of the research center INIA for 2019 was 9289 kg N and its NF per capita is 16.1 kg N per full-time equivalent population. The largest N emission sources were food (57%) and utilities (33%), while the least N loss was fertilization for groundskeeping (0.01%), and research plots (0.15%). Taking the NF of INIA as baseline the following strategies of N mitigation were analyzed: (1) beef replacement in the menu, (2) reduction of meat by non-meat sources, (3) reduction of beef, fish, and seafood by other protein sources, (4) improving the wastewater treatment efficiency, and (5) recycling food waste. This institutional NF approach serves INIA's institution as an indicator to quantify its N pollution and allows the identification of useful mitigation strategies to reduce the overall NF., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Coronavirus disease-2019 (COVID-19) is caused by severe acute respiratory-syndrome coronavirus-2 that interfaces with the renin-angiotensin-aldosterone system (RAAS) through angiotensin-converting enzyme 2. This interaction has been proposed as a potential risk factor in patients treated with RAAS inhibitors., Objectives: This study analyzed whether RAAS inhibitors modify the risk for COVID-19., Methods: The RASTAVI (Renin-Angiotensin System Blockade Benefits in Clinical Evolution and Ventricular Remodeling After Transcatheter Aortic Valve Implantation) trial is an ongoing randomized clinical trial randomly allocating subjects to ramipril or control groups after successful transcatheter aortic valve replacement at 14 centers in Spain. A non-pre-specified interim analysis was performed to evaluate ramipril's impact on COVID-19 risk in this vulnerable population., Results: As of April 1, 2020, 102 patients (50 in the ramipril group and 52 in the control group) were included in the trial. Mean age was 82.3 ± 6.1 years, 56.9% of the participants were male. Median time of ramipril treatment was 6 months (interquartile range: 2.9 to 11.4 months). Eleven patients (10.8%) have been diagnosed with COVID-19 (6 in control group and 5 receiving ramipril; hazard ratio: 1.150; 95% confidence interval: 0.351 to 3.768). The risk of COVID-19 was increased in older patients (p = 0.019) and those with atrial fibrillation (p = 0.066), lower hematocrit (p = 0.084), and more comorbidities according to Society of Thoracic Surgeons score (p = 0.065). Admission and oxygen supply was required in 4.9% of patients (2 in the ramipril group and 3 in the control group), and 4 of them died (2 in each randomized group). A higher body mass index was the only factor increasing the mortality rate (p = 0.039)., Conclusions: In a high-risk population of older patients with cardiovascular disease, randomization to ramipril had no impact on the incidence or severity of COVID-19. This analysis supports the maintenance of RAAS inhibitor treatment during the COVID-19 crisis. (Renin-Angiotensin System Blockade Benefits in Clinical Evolution and Ventricular Remodeling After Transcatheter Aortic Valve Implantation [RASTAVI]; NCT03201185)., (Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Household consumption has been identified to have an essential role in influencing ultimately the environmental pressures generated by human activities. This study assesses the indirect environmental footprint of the Spanish households applying a combination of consumer expenditure surveys with environmentally extended multi-regional input-output analysis. A total of fourteen environmental impact categories are studied from 2006 to 2015. All the impact categories present a similar trend, particularly affected by the economic crisis. The impacts decreased from 2008 to 2013 and finally slightly started rising again from 2014 to 2015. Results show that the dominant categories influencing the indirect environmental footprint in 2015 are (1) food and beverages, (2) housing, and (3) furnishings. From the intensity perspective, housing, transport, and food and beverages appear to be the most intensive consumption clusters in the Spanish household indirect environmental footprint. In relation to the indirect water impacts embodied in the Spanish households' imports, the largest amount is from European countries and the highest virtual water (59%) corresponds to food and agriculture, in particular from wheat, fruit, vegetables, and dairy products. The findings obtained in relation to the sources generating indirect impacts from household consumption could aid the implementation of future mitigation policies.

Background: Different studies have evaluated changes in adipo/cytokine levels after bariatric surgery and have given conflicting results. The adipo/cytokines, leptin and chemerin, and the orexigenic hormone, ghrelin, have been shown to play a role in the regulation of metabolism and appetite. The aims of our study were to test the levels of these molecules after bariatric surgery and to compare the results between Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy., Methods: We analysed circulating levels of chemerin, ghrelin and leptin in 30 morbidly obese women (body mass index of >40 kg/m2). Subjects were studied at three time points: baseline (before the surgery started), and after 6 and 12 months., Results: After surgery, chemerin (baseline, 95.03 ± 23.79; after 12 months, 76.80 ± 21.51; p = 0.034) and leptin levels (baseline, 248.17 ± 89.16; after 12 months, 63.85 ± 33.48; p < 0.001) were significantly lower than their baseline levels, whereas ghrelin was higher (baseline, 0.87 ± 0.38; after 12 months, 1.08 ± 0.31; p = 0.010). Fasting glucose, insulin and homeostasis model assessment of insulin resistance levels were markedly lower postoperatively. High-density lipoprotein levels moderately increased and triglyceride levels sharply decreased. There were no differences between the types of bariatric surgery in terms of weight reduction, general metabolic state or adipo/cytokine levels after surgery., Conclusions: Our study demonstrates a marked decrease in fasting leptin and chemerin levels, and an increase in ghrelin levels, after bariatric surgery-induced weight loss, independently of the type of surgery performed. Further studies are needed on the interrelation between the changes in the circulating levels of these molecules and the efficacy of the bariatric surgery procedures to induce the beneficial metabolic changes and to sustain body weight loss.

Introduction: Domiciliary mechanical ventilation (DMV) use is increasing in children. Few studies have analysed the characteristics of patients using this technique., Materials and Methods: An observational, descriptive, transversal, multicentre study was conducted on patients between 1 month and 16 years of age dependent on domiciliary mechanical ventilation., Results: A total of 163 patients with a median age of 7.6 years from 17 Spanish hospitals were studied. The main reasons for DMV were neuromuscular disorders. The median age at beginning of DMV was 4.6 years. Almost three-quarters (71.3%) received non-invasive ventilation. Patients depending on invasive ventilation were younger, started DMV at an earlier age, and had more hours of mechanical ventilation per day. The large majority (80.9%) used DMV during sleep time only, and 11.7% during the whole day. Only 3.4% of patients had external health assistance. Just under half (48.2%) were being followed up in specific DMV or multidisciplinary clinics. Almost three-quarters (72.1%) of patients attended school (42.3% with adapted schooling). Only 47.8% of school patients had specific caregivers in their schools., Conclusions: DMV in children is used in a very heterogeneous group of patients, and in an important number of patients it is started before the third year of life. Despite there being a significant proportion of patients with a high dependency on DMV, few families receive specific support at home or at school, and health care surveillance is variable and poorly coordinated., (Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.)

The aim of the study was to find morphological changes in the feto-placental unit due to prenatal exposure to drugs of abuse. A blind histomorphometric study was performed using 225 placentas. Based on meconium testing, the fetuses were classified as exposed or unexposed to opiates, cocaine, cannabis or alcohol. To establish prenatal tobacco exposure, cotinine in cord blood was analyzed. At the microscopic level a non statistically significant reduction of placental vascularization was observed in cocaine, opiates and alcohol using mothers. In addition, alcohol-consuming mothers did not present with larger placental vessel diameter than controls. Prenatal use of cocaine and tobacco was associated with a decrease in newborn weight and length. Furthermore, tobacco use was associated with a higher rate of previous abortions. In conclusion, placentas from mothers using tobacco, cocaine, opiates or alcohol during pregnancy present vasculature changes that may explain the adverse perinatal outcomes in their newborns., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Aims:   This study aims to estimate the prevalence of drug use by pregnant women living in Ibiza, using structured interviews and biomarkers in maternal hair. In addition, the potentially detrimental effects of maternal drug abuse on their newborns were investigated. Ibiza has a large international night-life resort associated with clubs, music and use of recreational drugs., Design, Setting and Participants:   Hair samples were collected prospectively from January to March 2010 from a cohort of consecutive mothers after giving birth in the Hospital Can Misses in Ibiza., Measurements:   Opiates, cocaine, cannabis, methadone, amphetamines, 3,4-methylenedioxymethamphetamine (MDMA) and their metabolites were detected in a 3-cm-long proximal segment of maternal hair corresponding to the last trimester of pregnancy by gas chromatography coupled to mass spectrometry (n = 107). Data on socio-demographic characteristics and on tobacco, alcohol, drugs of prescription and drugs of abuse consumption during pregnancy were collected using a structured questionnaire., Findings:   Hair analysis showed an overall 16% positivity for drugs of abuse in the third trimester of pregnancy, with a specific prevalence of cannabis, cocaine, MDMA and opiates use of 10.3, 6.4, 0.9 and 0%, respectively. In the questionnaires, only 1.9% of mothers declared using drugs of abuse during pregnancy. Gestational drug of abuse consumption was associated with active tobacco smoking, a higher number of smoked cigarettes and the mother being Spanish., Conclusions:   Illicit drug use is substantially under-reported among pregnant women living in Ibiza, particularly among Spanish nationals. Voluntary, routine objective biological toxicology screening should be considered as part of routine examinations in antenatal clinics on this Mediterranean island., (© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.)

Background and Aims: Adipocytokines may have a key role in the development of atherosclerosis and type 2 diabetes. The purpose of this study was to examine the independent and joint associations of physical activity (PA), cardiorespiratory fitness (CRF) and muscular fitness (MF) with adiponectin and leptin in adolescents., Methods and Results: A sample of 198 adolescents (96 girls), aged 13-17-year, was selected. Participants completed anthropometric measurements (height, weight, and waist circumference) and percentage of body fat (%BF) was estimated by bioelectrical impedance. PA was measured by accelerometer for 7-day. The 20-m shuttle-run test was used to assess CRF and two MF tests (handgrip strength and standing broad jump) were used to create an MF score. A cluster score of health status (0-3 risks) was created. Serum adiponectin and plasma leptin were also determined. Regression analyses controlling for age, sex, pubertal status and waist circumference showed that PA was not significantly associated with adiponectin and vigorous PA showed a significant inverse association with leptin. Both CRF and MF were significantly and inversely associated with adiponectin and leptin. Further analyses revealed that the 'healthy' group (0 risks) had significantly lower adiponectin and leptin than 'medium-healthy' (1 risk) and 'unhealthy' (2-3 risks) status groups., Conclusions: PA, CRF and MF are inversely and jointly associated with adiponectin and leptin concentrations in adolescents., (Copyright © 2010 Elsevier B.V. All rights reserved.)

Objective: To examine the associations between lifestyle factors and active commuting to school in Spanish adolescents., Design: Cross-sectional study. Lifestyle factors (overall/extracurricular physical activity, television viewing, reading as a hobby, sleep duration, breakfast/fruit intake, smoking and alcohol intake) as well as mode and duration of commuting to school were self-reported. Active commuters were defined as those adolescents who walked or cycled to school., Setting: Secondary schools in Madrid, Spain., Subjects: Adolescents (n 2029) aged 13 to 17 years., Results: Similar percentages of adolescent boys (57·6 %) and girls (56·1 %) were classified as active commuters to school (P = 0·491). The analysis showed that only adequate sleep duration (OR = 1·35, 95 % CI 1·11, 1·66; P = 0·003) and breakfast consumption (OR = 0·66, 95 % CI 0·49, 0·87; P = 0·004) were independently associated with active commuting to school., Conclusions: Only those behaviours that occur immediately before commuting to school (sleep and breakfast) are associated with active commuting in Spanish adolescents.

Identifying factors related to physical activity levels in young people is important for a more efficient health promotion. The aims of this study were to assess physical activity levels in a national sample of urban Spanish adolescents, and to examine the association between significant others' physical activity (father, mother, brother, sister, and close friends) and that of the adolescents. The present study comprised 2260 adolescents (1157 boys, 1103 girls) aged 13.0-18.5 years participating in the AVENA Study. Both the adolescents' physical activity and that of their relatives and close friends was assessed by questionnaire. The odds of being active were higher in boys than girls (odds ratio = 2.79, 95% confidence interval = 2.34-3.33) and tended to decrease across age groups in both boys and girls. Father's and older brother's physical activity was associated with boys' physical activity, while that of any significant other was associated with girls' physical activity. When both parents reported being active, boys had nearly two times higher odds of being active and girls had nearly three times higher odds of being active. The physical activity levels of Spanish adolescents are in line with those previously reported. Physical activity levels in girls are strongly related to the physical activity of any significant other, whereas physical activity levels in boys are only related to their male relatives' physical activity.

Objective: To examine the independent associations of objectively measured physical activity (PA), cardiorespiratory fitness (CRF) and fatness with low-grade inflammatory markers in adolescents., Design: Cross-sectional study in Spain., Subjects: A sample of 192 adolescents aged 13-17 years., Measurements: PA was assessed with an accelerometer for 7 days. A 20-m shuttle-run test was used to assess CRF. Skinfold thicknesses at six sites and WCs were measured. BMI was calculated from measured height and weight. C-reactive protein (CRP), interleukin-6 (IL-6) and complement factors C3 and C4 were assayed. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated from glucose and insulin. Regression analysis adjusted for potential confounders and HOMA-IR was used to determine the associations between PA, CRF and fatness with low-grade inflammatory markers., Results: Total PA, vigorous PA and MVPA were positively associated with CRF (r=0.25-0.48), whereas vigorous PA was negatively associated with skinfolds (r=-0.27). CRF was inversely associated with fatness, (r=-0.30 to -0.48). CRF and fatness were inversely and positively associated with HOMA-IR (r=-0.16 and 0.21, respectively). PA variables were not independently associated with inflammatory markers. CRF and fatness were inversely and positively associated with CRP, C3 and C4, respectively. Only body fat explained a relevant amount of the variance of the model in CRP (4%) and C4 (19%), whereas CRP and body fat jointly explained the variance in C3 (25%). All these observations were independent of HOMA-IR., Conclusions: These findings support the key role of CRF and fatness on low-grade inflammation, as well as the possible indirect role of habitual PA through CRF and body fat in adolescents.

Background: The prevalence of overweight and obesity (OW/OB) among adolescents worldwide has increased since the 60 s. Spain has reached one of the highest OW/OB prevalence rates among adolescents from European countries. The aim of this methodological paper is to describe the design and evaluation in the EVASYON study (Development, implementation and evaluation of the efficacy of a therapeutic programme for adolescents with OW/OB: integral education on nutrition and physical activity)., Methods/design: The EVASYON was planned by a multidisciplinary team to treat OW/OB in Spanish adolescents. The EVASYON is a multi-centre study conducted in 5 hospitals in 5 Spanish cities (Granada, Madrid, Pamplona, Santander and Zaragoza) and two hundred and four OW/OB Spanish adolescents were recruited for this intervention. The treatment was implemented for approximately one-year follow-up. The adolescents were treated in groups of a maximum of 10 subjects; each group had 20 visits during the treatment period in two phases: intensive during the first 2 months (1st to 9th visits), and extensive during the last 11 months (10th to 20th visits). In order to assess the efficacy of the treatment, 8 dimensions were measured: diet; physical activity and fitness; eating behaviour; body composition; haematological profile; metabolic profile; minerals and vitamins; immuno-inflammatory markers. Moreover, genetic polymorphisms were also determined., Discussion: The treatment programme developed in the EVASYON study was designed as a national pilot study to be implemented as an effective treatment for adolescents with OW/OB into the Spanish Health Care Service.

Objective: To identify which social and health variables are associated with receiving social services in patients included in home care programmes with the implementation of the Dependence Law., Design: Cross-sectional study., Setting: 72 primary health care teams in Catalonia., Patients: Patients over 64 years old with chronic diseases in home care programmes in Catalonia., Measurements: Health status variables: Charlson, Barthel, Pfeiffer, Braden and Gijon, data from their carer (Zarit), self perception of health (SF-12), health professional visits, as well as: emergency visits, temporary admissions, and final results such as death or definitive admission in a nursing home or a hospital., Results: A total of 1068 patients were included, 46.8% of the patients received some kind of social service, public or private. We observed that the variables related to receive some kind of social services are: high dependence (Barthel test), pressure sores and home care rehabilitation. Barthel test is highly associated with having social problems (Gijon test), living without an informal carer, more than 2 GP visits and having additional private health care., Conclusions: To be more fair, the evaluation of the provisions of the Dependence Law should also consider the health status of the patient. With the implementation of this law we can observe difficulties in access to social services for middle class patients. These patients do not have access to public social assistance and cannot pay for a private one. Social services are still an alternative to family care.