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Heating magnetic nanoparticles (MNPs) with AC (Alternating Current) magnetic fields has received significant attention in recent years, particularly for biomedical uses. However, most studies focus on characterizing the heat release, overlooking the fact that the MNPs in the viscous cell environment constitute a dynamic magnetic colloid whose configuration may evolve over time, particularly if a driving force as the AC field is applied. Aiming to shed light on this matter, in this workthe dynamics of the colloid structure during hyperthermia experiments are studied. By combining various experimental and theoretical tools, it is concluded that the AC field may drive the formation of aligned structures, and the impact that such structures may have on the associated heating is assessed. Remarkably, the results show that those field‐driven structures are highly unstable for small particle sizes, rapidly disassembling upon field removal. Moreover, an analogous behavior in vitro is found, with the AC magnetic field also promoting a reversible alignment of vesicles containing the MNPs within the cells. The results suggest that the observed alignment, both of MNPs and intracellular vesicles, may be a common phenomenon in usual hyperthermia experiments, but unnoticed because of the intrinsic unstable nature of the aligned structures. [ABSTRACT FROM AUTHOR]

This study presents a new methodology, based on Monte-Carlo techniques to evaluate the reliability of a carbon-free electricity generation system based on renewable sources; it uses as inputs the variation of the electricity demand and the fluctuations in the renewable supply and provides the renewable system to be installed to guarantee a specific supply reliability level. Additionally, looking for a reduction of this renewable system, the methodology determines the improvements by the incorporation of nuclear power and electricity storage. The methodology is of general application, its implementation being possible under different contexts, such as different time horizons and different future energy scenarios, both for developing, emerging, and developed countries. The only requirement is to have a sufficient database from which to make predictions for future scenarios of electrical generation–demand balances. As an example of practical implementation, the electrical system reliability for the particular case of Spain in 2040 has been forecasted. When considering the fluctuations in solar and wind power contributions, very high values of the installed power from these renewable sources are needed to reach a high reliability of the system. These values decrease substantially if contributions from nuclear and storage technologies are included. [ABSTRACT FROM AUTHOR]

One of the hallmarks of tissue repair is the production of reactive oxygen species (ROS), which modulate processes such as cell proliferation. Although several attempts have been made to manipulate ROS levels to increase tissue repair, the lack of techniques able to remotely manipulate the redox homeostasis with spatio–temporal fashion has hindered its progress. Herein, a new approach for tuning the ROS levels using magnetic nanoparticles (MNPs) that act as nanoheaters when exposed to an alternating magnetic field is presented. Two manganese–iron oxide (MnxFe3−xO4) MNPs (with a low and a high Mn2+ content) are designed and probed for the possibility of modulating the ROS balance by magneto–thermal stimulation in the invertebrate model organism Hydra vulgaris, able to fully regenerate. By evaluating the expression of selected genes involved in the maintenance of ROS homeostasis and proliferation pathways, a biphasic modulation of the ROS levels played by the MNPs is found. While MNPs with a lower Mn2+ content are able to positively modulate the regeneration potential under magnetostimulation, MNPs with a higher Mn2+ content cause a different redox imbalance, negatively affecting the regeneration dynamic. This innovative approach reveals a novel way of manipulating redox homeostasis that can advance in the field of tissue engineering. [ABSTRACT FROM AUTHOR]

Background: Dynein is a cytoskeletal molecular motor protein that transports cellular cargoes along microtubules. Biomimetic synthetic peptides designed to bind dynein have been shown to acquire dynamic properties such as cell accumulation and active intra- and inter-cellular motion through cell-to-cell contacts and projections to distant cells. On the basis of these properties dynein-binding peptides could be used to functionalize nanoparticles for drug delivery applications. Results: Here, we show that gold nanoparticles modified with dynein-binding delivery sequences become mobile, powered by molecular motor proteins. Modified nanoparticles showed dynamic properties, such as travelling the cytosol, crossing intracellular barriers and shuttling the nuclear membrane. Furthermore, nanoparticles were transported from one cell to another through cell-to-cell contacts and quickly spread to distant cells through cell projections. Conclusions: The capacity of these motor-bound nanoparticles to spread to many cells and increasing cellular retention, thus avoiding losses and allowing lower dosage, could make them candidate carriers for drug delivery. [ABSTRACT FROM AUTHOR]

We describe the case of a second trimester placenta accreta presenting as postabortal haemorrhage complicated by disseminated intravascular coagulation, requiring hysterectomy. [ABSTRACT FROM AUTHOR]

Tuning the fundamental properties of iron oxide magnetic nanoparticles (MNPs) according to the required biomedical application is an unsolved challenge, as the MNPs' properties are affected by their composition, their size, the synthesis process, and so on. In this work, we studied the effect of zinc and manganese doping on the magnetic and structural properties of MNPs synthesized by the microwave-assisted polyol process, using diethylene glycol (DEG) and tetraethylene glycol (TEG) as polyols. The detailed morpho-structural and magnetic characterization showed a correspondence between the higher amounts of Mn and smaller crystal sizes of the MNPs. Such size reduction was compensated by an increase in the global magnetic moment so that it resulted in an increase of the saturation magnetization. Saturation magnetization M S values up to 91.5 emu/g and NMR transverse relaxivities r 2 of 294 s − 1 mM − 1 were obtained for Zn and Mn- doped ferrites having diameters around 10 nm, whereas Zn ferrites with diameters around 15 nm reached values of M S ∼ 97.2 emu/g and of r 2 ∼ 467 s − 1 mM − 1 , respectively. Both kinds of nanoparticles were synthesized by a simple, reproducible, and more sustainable method that makes them very interesting for diagnostic applications as MRI contrast agents. [ABSTRACT FROM AUTHOR]

West Nile fever is an emergent disease in Europe. The objective of this study was to conduct a predictive risk mapping of West Nile Virus (WNV) circulation in Spain based on historical data of WNV circulation. Areas of Spain with evidence of WNV circulation were mapped based on data from notifications to the surveillance systems and a literature review. A logistic regression-based spatial model was used to assess the probability of WNV circulation. Data were analyzed at municipality level. Mean temperatures of the period from June to October, presence of wetlands and presence of Special Protection Areas for birds were considered as potential predictors. Two predictors of WNV circulation were identified: higher temperature [adjusted odds ratio (AOR) 2.07, 95% CI 1.82–2.35, p < 0.01] and presence of wetlands (3.37, 95% CI 1.89–5.99, p < 0.01). Model validations indicated good predictions: area under the ROC curve was 0.895 (95% CI 0.870–0.919) for internal validation and 0.895 (95% CI 0.840–0.951) for external validation. This model could support improvements of WNV risk- based surveillance in Spain. The importance of a comprehensive surveillance for WNF, including human, animal and potential vectors is highlighted, which could additionally result in model refinements. [ABSTRACT FROM AUTHOR]

• An outbreak of 5 autochthonous dengue cases (2 generations) was confirmed in Spain. • Dengue transmission is effective in areas with presence of Ae. albopictus. • There was significant delay in the identification of the first generation of cases. • This prevented the implementation of effective and timely control measures. • Challenges to control dengue transmission in a non-endemic contexts are discussed. On October 3rd 2018, dengue virus (DENV) infection was confirmed in three family members (symptoms onset between August 18th and 27th) without travel history outside of Spain. They had been together in the Autonomous Communities (AC) of Murcia and Andalusia. By the end of October, a second cluster of two dengue cases (symptoms onset on September 27th and 30th) was confirmed in the AC of Murcia. DENV type 1 sequence was identical to the first cluster, and the epidemiological link was a visit from a case of the first cluster to a fruit-farm neighboring the small village of residence of the second cluster. The entomological investigation found Aedes albopictus activity in this area although all mosquitoes were PCR-negative for DENV. This is the first autochthonous dengue outbreak identified in Spain. This outbreak highlights challenges to timely detect and respond to DENV transmission and opens questions on dengue dynamics in a non-endemic context. Image, graphical abstract [ABSTRACT FROM AUTHOR]

The accumulation of senescent cells, a hallmark of aging and age-related diseases, is also considered as a side effect of anticancer therapies, promoting drug resistance and leading to treatment failure. The use of senolytics, selective inducers of cell death in senescent cells, is a promising pharmacological antiaging and anticancer approach. However, more studies are needed to overcome the limitations of first-generation senolytics by the design of targeted senolytics and nanosenolytics and the validation of their usefulness in biological systems. In the present study, we have designed a nanoplatform composed of iron oxide nanoparticles functionalized with an antibody against a cell surface marker of senescent cells (CD26), and loaded with the senolytic drug HSP90 inhibitor 17-DMAG (MNP@CD26@17D). We have documented its action against oxidative stress-induced senescent human fibroblasts, WI-38 and BJ cells, and anticancer drug-induced senescent cutaneous squamous cell carcinoma A431 cells, demonstrating for the first time that CD26 is a valid marker of senescence in cancer cells. A dual response to MNP@CD26@17D stimulation in senescent cells was revealed, namely, apoptosis-based early response (2 h treatment) and ferroptosis-based late response (24 h treatment). MNP@CD26@17D-mediated ferroptosis might be executed by ferritinophagy as judged by elevated levels of the ferritinophagy marker NCOA4 and a decreased pool of ferritin. As 24 h treatment with MNP@CD26@17D did not induce hemolysis in human erythrocytes in vitro , this newly designed nanoplatform could be considered as an optimal multifunctional tool to target and eliminate senescent cells of skin origin, overcoming their apoptosis resistance.

In this work, we report the disruptive use of membrane-localized magnetic hyperthermia to promote the internalization of cell-impermeant probes. Under an alternating magnetic field, magnetic nanoparticles (MNPs) immobilized on the cell membrane via bioorthogonal click chemistry act as nanoheaters and lead to the thermal disruption of the plasma membrane, which can be used for internalization of different types of molecules, such as small fluorescent probes and nucleic acids. Noteworthily, no cell death, oxidative stress and alterations of the cell cycle are detected after the thermal stimulus, although cells are able to sense and respond to the thermal stimulus through the expression of different types of heat shock proteins (HSPs). Finally, we demonstrate the utility of this approach for the transfection of cells with a small interference RNA (siRNA), revealing a similar efficacy to a standard transfection method based on the use of cationic lipid-based reagents (such as Lipofectamine), but with lower cell toxicity. These results open the possibility of developing new procedures for "opening and closing" cellular membranes with minimal disturbance of cellular integrity. This on-demand modification of cell membrane permeability could allow the direct intracellular delivery of biologically relevant (bio)molecules, drugs and nanomaterials, thus overcoming traditional endocytosis pathways and avoiding endosomal entrapment.

BackgroundBy mid-September 2023, several event notifications related to cryptosporidiosis had been identified from different regions in Spain. Therefore, a request for urgent notification of cryptosporidiosis cases to the National Surveillance Network was launched.AimWe aimed at assessing the extent of the increase in cases, the epidemiological characteristics and the transmission modes and compared to previous years.MethodsWe analysed data on case notifications, outbreak reports and genotypes focusing on June-October 2023 and compared the results to 2016-2022.ResultsIn 2023, 4,061 cryptosporidiosis cases were notified in Spain, which is an increase compared to 2016-2022. The cumulative incidence was 8.3 cases per 100,000 inhabitants in 2023, sixfold higher than the median of 1.4 cases per 100,000 inhabitants 2016-2022. Almost 80% of the cases were notified between June and October. The largest outbreaks were related to contaminated drinking water or swimming pools. Cryptosporidium hominis was the most common species in the characterised samples (115/122), and the C. hominis IfA12G1R5 subtype, previously unusual in Spain, was detected from 76 (62.3%) of the 122 characterised samples.ConclusionsA substantial increase in cryptosporidiosis cases was observed in 2023. Strengthening surveillance of Cryptosporidium is essential for prevention of cases, to better understand trends and subtypes circulating and the impact of adverse meteorological events.

Background: This study compares the severity of SARS-CoV-2 infections caused by Alpha, Delta or Omicron variants in periods of co-circulation in Spain, and estimates the variant-specific association of vaccination with severe disease., Methods: SARS-CoV-2 infections notified to the national epidemiological surveillance network with information on genetic variant and vaccination status were considered cases if they required hospitalisation or controls otherwise. Alpha and Delta were compared during June-July 2021; and Delta and Omicron during December 2021-January 2022. Adjusted odds ratios (aOR) were estimated using logistic regression, comparing variant and vaccination status between cases and controls., Results: We included 5,345 Alpha and 11,974 Delta infections in June-July and 5,272 Delta and 10,578 Omicron in December-January. Unvaccinated cases of Alpha (aOR: 0.57; 95% CI: 0.46-0.69) or Omicron (0.28; 0.21-0.36) had lower probability of hospitalisation vs. Delta. Complete vaccination reduced hospitalisation, similarly for Alpha (0.16; 0.13-0.21) and Delta (June-July: 0.16; 0.14-0.19; December-January: 0.36; 0.30-0.44) but lower from Omicron (0.63; 0.53-0.75) and individuals aged 65+ years., Conclusion: Results indicate higher intrinsic severity of the Delta variant, compared with Alpha or Omicron, with smaller differences among vaccinated individuals. Nevertheless, vaccination was associated to reduced hospitalisation in all groups., (Copyright © 2022 The Author(s). Published by Elsevier España, S.L.U. All rights reserved.)

Oriented and covalent immobilization of proteins on magnetic nanoparticles (MNPs) is particularly challenging as it requires both the functionality of the protein and the colloidal stability of the MNPs to be preserved. Here, we describe a simple, straightforward, and efficient strategy for MNP functionalization with proteins using metal affinity binding. Our method involves a single-step process where MNPs are functionalized using a preformed, ready-to-use nitrilotriacetic acid-divalent metal cation (NTA-M 2+ ) complex and polyethylene glycol (PEG) molecules. As a proof-of-concept, we demonstrate the oriented immobilization of a recombinant cadherin fragment engineered with a hexahistidine tag (6His-tag) onto the MNPs. Our developed methodology is simple and direct, enabling the oriented bioconjugation of His-tagged cadherins to MNPs while preserving protein functionality and the colloidal stability of the MNPs, and could be extended to other proteins expressing a polyhistidine tag. When compared to the traditional method where NTA is first conjugated to the MNPs and afterward free metal ions are added to form the complex, this novel strategy results in a higher functionalization efficiency while avoiding MNP aggregation. Additionally, our method allows for covalent bonding of the cadherin fragments to the MNP surface while preserving functionality, making it highly versatile. Finally, our strategy not only ensures the correct orientation of the protein fragments on the MNPs but also allows for the precise control of their density. This feature enables the selective targeting of E-cadherin-expressing cells only when MNPs are decorated with a high density of cadherin fragments.

In autumn 2022, the Spanish Influenza National Reference Laboratory (NRL) confirmed the detection of influenza A(H5N1) in samples from two asymptomatic workers linked to an outbreak in a poultry farm in Spain. Nasopharyngeal swabs were taken according to a national screening protocol for exposed workers. Absence of symptoms, low viral load and negative serology in both workers suggested environmental contamination. These findings motivated an update of the early detection strategy specifying timing and sampling conditions in asymptomatic exposed persons.

Introduction: The state of alarm was declared in Spain due to the COVID-19 epidemic on March 14, 2020, and established population confinement measures. The objective is to describe the process of lifting these mitigation measures., Methods: The Plan for the Transition to a New Normality, approved on April 28, contained four sequential phases with progressive increase in socio-economic activities and population mobility. In parallel, a new strategy for early diagnosis, surveillance and control was implemented. A bilateral decision mechanism was established between the Spanish Government and the autonomous communities (AC), guided by a set of qualitative and quantitative indicators capturing the epidemiological situation and core capacities. The territorial units were established ad-hoc and could be from Basic Health Zones to entire AC., Results: The process run from May 4 to June 21, 2020. AC implemented plans for reinforcement of core capacities. Incidence decreased from a median (50% of territories) of 7.4 per 100,000 in 7 days at the beginning to 2.5 at the end. Median PCR testing increased from 53% to 89% of suspected cases and PCR total capacity from 4.5 to 9.8 per 1000 inhabitants weekly; positivity rate decreased from 3.5% to 1.8%. Median proportion of cases with traced contacts increased from 82% to 100%., Conclusion: Systematic data collection, analysis, and interterritorial dialogue allowed adequate process control. The epidemiological situation improved but, mostly, the process entailed a great reinforcement of core response capacities nation-wide, under common criteria. Maintaining and further reinforcing capacities remained crucial for responding to future waves., (Copyright © 2021 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. All rights reserved.)

Over 79,000 confirmed cases of mpox were notified worldwide between May and November 2022, most of them in men who have sex with men. Cases in women, for whom mpox might pose different risks, are rare, and Spain has reported more than one third of those in Europe. Using surveillance data, our study found similar time trends, but differences in delay of diagnosis, sexual transmission and signs and symptoms between men and women.

During the last decades, healthcare has undergone important changes. Increased life expectancy has given rise to an aging population that, according to the United Nations, is about to become one of the most important social transformations of the 21st century. Globally, there were 727 million people aged 65 or over in 2020 (9.3% of the total population) and this is estimated to increase to 16% by 2050 . In the European Union (EU), the percentage of the population aged 65 or over has increased from 9.6% in 1960 to 20.3% in 2019 and is projected to increase to 31.3% by 2100. We are also witnessing a process of aging of the elderly population, with a proportion of very old people (those aged 80 and over) in the total population of the European Union of 5.8% in 2019 . Spain is one of the countries with the highest proportion of older people, with a percentage of citizens aged 65 or over in 2020 of 19.6% of the total population, and with a projection of 26.5% for 2035. Almost a third of this population (6%) are 80 years or older.

During June 2022, Spain was one of the countries most affected worldwide by a multicountry monkeypox outbreak with chains of transmission without identified links to disease-endemic countries. We provide epidemiologic features of cases reported in Spain and the coordinated measures taken to respond to this outbreak.

The simultaneous detection and quantification of several iron-containing species in biological matrices is a challenging issue. Especially in the frame of studies using magnetic nanoparticles for biomedical applications, no gold-standard technique has been described yet and combinations of different techniques are generally used. In this work, AC magnetic susceptibility measurements are used to analyze different organs from an animal model that received a single intratumor administration of magnetic nanoparticles. The protocol used for the quantification of iron associated with the magnetic nanoparticles is carefully described, including the description of the preparation of several calibration standard samples of nanoparticle suspensions with different degrees of dipolar interactions. The details for the quantitative analysis of other endogenous iron-containing species such as ferritin or hemoglobin are also described. Among the advantages of this technique are that tissue sample preparation is minimal and that large amounts of tissue can be characterized each time (up to hundreds of milligrams). In addition, the very high specificity of the magnetic measurements allows for tracking of the nanoparticle transformations. Furthermore, the high sensitivity of the instrumentation results in very low limits of detection for some of the iron-containing species. Therefore, the presented technique is an extremely valuable tool to track iron oxide magnetic nanoparticles in samples of biological origin.

Objective: The nursing homes represented high-risk settings for SARS-CoV-2 infection, both for residents and for the employees. The COVID-19 impact on long-term care facilities (LTCFs) is evaluated, measured through the employees sick leave (SL). The pandemic evolution in the general population aged between 16 and 65 years was analyzed together with the sick leave to assess the latter as a complementary indicator of the SARS-CoV-2 surveillance., Methods: A descriptive study of all sick leave processes due to COVID-19 recorded between February 15 th 2020 and May 1st 2021 in nursing homes was carried out. The close contact sick leave/infection sick leave ratios, the 100,000 affiliated/occupied sick leave rates were computed and compared with the COVID-19 cases cumulative incidence notified to the National Network of epidemiological Surveillance (RENAVE)., Results: 261.892 SL processes were recorded. The close contact sick leave/infection sick leave median ratio in nursing homes was 1.8 (Interquartile range, ICR: 1.1-3.3), with values lower than 1 at certain periods. The infection sick leaves were higher in number and ratio and prior to the cases recorded in RENAVE. The sick leave ratio ranged between 81.679/100.000 occupied in nursing homes with medical care and 4.895/100.000 in other residential facilities., Conclusions: The results confirmed the dramatic impact of COVID-19 in nursing homes and the inequalities characterizing this impact. They also confirmed the potential use of sick leave as an alternative source for epidemiological and public health surveillance, especially now, when the transition of the COVID-19 surveillance to a system not including universal individual surveillance is being discussed., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

During the last decade, the possibility to remotely control intracellular pathways using physical tools has opened the way to novel and exciting applications, both in basic research and clinical applications. Indeed, the use of physical and non-invasive stimuli such as light, electricity or magnetic fields offers the possibility of manipulating biological processes with spatial and temporal resolution in a remote fashion. The use of magnetic fields is especially appealing for in vivo applications because they can penetrate deep into tissues, as opposed to light. In combination with magnetic actuators they are emerging as a new instrument to precisely manipulate biological functions. This approach, coined as magnetogenetics, provides an exclusive tool to study how cells transform mechanical stimuli into biochemical signalling and offers the possibility of activating intracellular pathways connected to temperature-sensitive proteins. In this review we provide a critical overview of the recent developments in the field of magnetogenetics. We discuss general topics regarding the three main components for magnetic field-based actuation: the magnetic fields, the magnetic actuators and the cellular targets. We first introduce the main approaches in which the magnetic field can be used to manipulate the magnetic actuators, together with the most commonly used magnetic field configurations and the physicochemical parameters that can critically influence the magnetic properties of the actuators. Thereafter, we discuss relevant examples of magneto-mechanical and magneto-thermal stimulation, used to control stem cell fate, to activate neuronal functions, or to stimulate apoptotic pathways, among others. Finally, although magnetogenetics has raised high expectations from the research community, to date there are still many obstacles to be overcome in order for it to become a real alternative to optogenetics for instance. We discuss some controversial aspects related to the insufficient elucidation of the mechanisms of action of some magnetogenetics constructs and approaches, providing our opinion on important challenges in the field and possible directions for the upcoming years.

In this article we provide the most important epidemiological aspects in the first phases of the pandemic and some preliminary reflections from the Coordinating Centre for Health Alerts and Emergencies, the unit that has coordinated surveillance at the national level. COVID-19 has brought to light the weaknesses in the surveillance system and how difficult it is to manage a health crisis in the absence of a robust public health structure. The commitment of public health professionals during this epidemic has made up for the lack of resources in many occasions, and has evidenced the need to incorporate new professional profiles to surveillance teams. The need to rapidly adapt has achieved an improvement in existing systems and the development of new tools and new systems. These need to turn into structural changes that improve the quality of surveillance, decreasing territorial gaps and ensuring a better and coordinated response to future health crises. It is urgent to incorporate tools for process automation and to grant timely availability of data. To that end, public health and epidemiological surveillance must participate in the process of digital development within the National Health System. Profound changes are needed in public health surveillance, which has to be integrated in all healthcare levels. It is also important to strengthen the capacity for analysis by promoting alliances and joint actions. During this alert, the importance of coordination in public health in a decentralized country has been evident. At international level, it is necessary to review the tools to share data to coordinate an alert from the early stages., (Copyright © 2022 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: The state of alarm was declared in Spain due to the COVID-19 epidemic on March 14, 2020, and established population confinement measures. The objective is to describe the process of lifting these mitigation measures., Methods: The Plan for the Transition to a New Normality, approved on April 28, contained four sequential phases with progressive increase in socio-economic activities and population mobility. In parallel, a new strategy for early diagnosis, surveillance and control was implemented. A bilateral decision mechanism was established between the Spanish Government and the autonomous communities (AC), guided by a set of qualitative and quantitative indicators capturing the epidemiological situation and core capacities. The territorial units were established ad-hoc and could be from Basic Health Zones to entire AC., Results: The process run from May 4 to June 21, 2020. AC implemented plans for reinforcement of core capacities. Incidence decreased from a median (50% of territories) of 7.4 per 100,000 in 7 days at the beginning to 2.5 at the end. Median PCR testing increased from 53% to 89% of suspected cases and PCR total capacity from 4.5 to 9.8 per 1000 inhabitants weekly; positivity rate decreased from 3.5% to 1.8%. Median proportion of cases with traced contacts increased from 82% to 100%., Conclusion: Systematic data collection, analysis, and interterritorial dialogue allowed adequate process control. The epidemiological situation improved but, mostly, the process entailed a great reinforcement of core response capacities nation-wide, under common criteria. Maintaining and further reinforcing capacities remained crucial for responding to future waves., (Copyright © 2021 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Publicado por Elsevier España, S.L.U. All rights reserved.)

Cases of West Nile neuroinvasive disease (WNND) in Spain increased in summer 2020. Here we report on this increase and the local, regional and national public health measures taken in response. We analysed data from regional surveillance networks and the National Epidemiological Surveillance Network, both for human and animal West Nile virus (WNV) infection. During the 2020 season, a total of 77 human cases of WNV infection (median age 65 years; 60% males) were detected in the south-west of Spain; 72 (94%) of these cases developed WNND, presenting as meningoencephalitis, seven of which were fatal. In the previous two decades, only six human cases of WNND were detected in Spain. Reduced activities for vector control this season, together with other factors, might have contributed to the massive increase. Public health measures including vector control, campaigns to raise awareness among physicians and the general population, and interventions to ensure the safety of donations of blood products, organs, cells and tissues were effective to reduce transmission. Going forward, maintenance of vector control activities and an update of the vector-borne diseases response plan in Spain is needed.

By mid-2015, an increase in the number of cases of microcephaly among newborns and neurologic disorders was detected in the Northwest of Brazil, which was possibly associated with Zika virus infection. Later on, this phenomenon was also observed in several Latin-American countries. In February 2016, the World Health Organization (WHO) on this basis, declared a Public Health Emergency of International Concern. From that moment on, several measures were adopted to achieve the epidemic control at both international and national levels. The WHO launched a strategic response plan based on case detection, infection control and treatment, as well as, the research and development of new vector control tools, diagnostic tests and vaccines. In Europe both surveillance and vector control systems were reinforced. The countries reporting most cases were France, Spain and the United Kingdom. In Spain, due to the high probability of case importation based on the close relationships with Latin-America, numerous measures were adopted to achieve a rapid response and an optimal control. Those included: the implementation of an active surveillance in collaboration with several experts, institutions and scientific societies; entomologic surveillance enhancement; the development of communication activities and recommendations for both healthcare workers and general population.

Introduction: We analysed the efficacy and safety of double-balloon catheter for cervical ripening in women with a previous cesarean section and which were the most important variables associated with an increased risk of repeated cesarean delivery., Materials and Methods: We designed an observational retrospective study of 418 women with unfavourable cervices (Bishop Score <5), a prior cesarean delivery, and induction of labour with a double-balloon catheter. Baseline maternal data and perinatal outcomes were recorded for a descriptive, bivariate, and multivariate analysis. A p value <0.05 was considered statistically significant., Results: Most women improved their initial Bishop Score (89.5%) although only a 20.8% of them went into spontaneous active labour. Finally, 51.4% of the women achieved a vaginal delivery. Five cases of intrapartum uterine rupture (1.2%) occurred. After multivariate analysis, main risk factors for repeated cesarean section were dystocia in the previous pregnancy (OR 1.744; CI 95% 1.066-2.846), the absence of previous vaginal delivery (OR 2.590; CI 95% 1.066-6.290), suspected fetal macrosomia (OR 2.410; CI 95% 0.959-6.054), and duration of oxytocin induction period (OR 1.005; CI 95% 1.004-1.006). The area under the curve was 0.789 (p < 0.001)., Conclusions: Double-balloon catheter seems to be safe and effective for cervical ripening in women with a previous cesarean delivery and unfavourable cervix. In our study, most women could have a vaginal delivery in spite of their risk factors for cesarean delivery. A multivariate model based on some clinical variables has moderate predictive value for intrapartum cesarean section.

At present, epidemiological surveillance in Spain remains focused on the communicable diseases included in the list of notifiable diseases. However, there has been a change in epidemiological pattern that predominated until the last few decades of the twentieth century. Infectious diseases, which used to be the leading causes of morbidity and mortality, have given way to a predominance of chronic diseases. In this regard, progress has been made in the drafting and adoption of specific legal regulations on public health monitoring. However, Spain has yet to develop this legislation which, among other elements, includes the mandate to organize the surveillance of non-communicable diseases in Spain. This article aims to describe some points that should be considered in the development of a national surveillance system linked to existing strategies for the prevention and control of chronic diseases., (Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.)

Dengue has become a major public health problem worldwide. Ae. albopictus, vector responsible for transmission, was first detected in Catalonia in 2004. Since then, it has established along Mediterranean coast. The aim of this paper is to describe the risk of importation and possible autochthonous transmission of dengue virus in Spain, qualitatively reviewing factors that could influence the emergence of dengue in our country, and the implications for public health. No autochthonous transmission has occurred in our country to date, but infected travelers coming from endemic countries are arriving to Spain constantly. The transmission of this disease could occur on the Mediterranean coast. Transmission would be more likely in the warmer months due to cultural habits and higher vector densities. While most of the population would be susceptible, given the characteristics of the disease, the impact on health's population would be low. The main public health strategy to reduce the risk of importation and possible dengue transmission should focus on primary prevention, to prevent interaction of the virus, vector and human. These three components must be addressed in a comprehensive and multisectoral plan of action, intensifying some activities in the areas of greatest risk. Coordination of public health from all sectors involved is essential for the proper functioning of this integrated response plan for vector-borne diseases.

Background: To decrease maternal and fetal morbidity oftem is indicated the elective termination of pregnancy; when the cervix is unfavourable, it is possible to try to artificially reproduce these changes with exogenous prostaglandins., Objectives: Comparative evaluation of maternal and fetal results between patients in which cervical ripening is practiced with indication of premature rupture of membranes and those with prolonged pregnancy., Material and Method: Historic cohorts study about pregnancies requiring cervical ripening, either for premature rupture of membranes or for gestational age > or = 41 weeks, in the "Miguel Servet" Hospital (Zaragoza, Spain), from 15/11/2005 to 15/05/2008. In all the cases dinoprostone (slow release vaginal system) was employed and the initial Bishop score was < 7. The main analysed outcomes were: intrapartum fetal heart monitoring characteristics, type of delivery, umbilical artery pH, Apgar score, hospitalization in neonatal unit requirement and time from cervical ripening start to delivery., Results: Neonatal hospitalization was significantly more frequent in the ruptured membranes cohort (11.70% vs 2.33%); p = 0.001. This difference could be justified by gestational age (OR: 2,623. IC: 0.515-13.353. P = 0.246). It was observed more time cervical ripening - delivery in prolonged pregnancies cohort (25.96h vs 20.11h); p < 0.001. Umbilical cord medium pH was significantly superior in ruptured membranes group (7.25 vs 7.23); p = 0.017. No significant differences were observed in the rest of analyzed outcomes., Conclusions: Pregnancies electively ended for premature rupture of membranes are associated with a shorter time to delivery and a slightly superior umbilical cord pH than induced prolonged pregnancies. Neonatal hospitalization requirement is determined by gestational age but not by the rupture of the membranes. Cervical ripening in those patients has been demonstrated to be secure and effective.

Multiple antibody immobilization methodologies have been developed for several applications including affinity chromatography, immunosensing, and drug delivery. Most of them have been carried out without considering the orientation of the antigen binding site of the antibody, or after the chemical modification of the antibody. An efficient immobilization to improve the biological activity of the antibody is one of the key fundamental issues to pursue. A simple and effective methodology for well-oriented covalently immobilization of antibodies on nanoparticles is reported in this chapter.

In Spain, leishmaniasis is an endemic zoonosis present in most of the Iberian Peninsula and the Balearic Islands. The parasite detected is Leishmania infantum and the main reservoir is the dog. Competent vectors to transmit the parasite are sandflies, of which there are two species distributed throughout the Iberian Peninsula and the Balearic Islands. This article reviews the current situation and the behaviour of leishmaniasis in Spain. It analyzes and compares information about the disease from hospital discharges and from the National Epidemiological Surveillance Network. It also analyses the risk factors that facilitate transmission identified in previous studies. Since 2009 an outbreak is occurring in the southwest part of the Community of Madrid, with a significant number of cases, about 400 and the detection of a new reservoir, the hare. The conditions that can increase the incidence of leishmaniasis are linked to the increase number of infected vectors, increase sandfly density, increase hosts or the appearance of new reservoirs in a geographic area. This infection has got a complex transmission dynamic. To timely respond to outbreaks a comprehensive and multisectoral action plan should be developed joined by all the institutions involved in the preparation and response. Before an outbreak occurs, it is important to study all the factors affecting the transmission in that place and to adapt the action plan to the specific characteristics.

Several strategies for linking antibodies (Abs) through their Fc region in an oriented manner have been proposed at the present time. By using these strategies, the Fab region of the Ab is available for antigen molecular recognition, leading to a more efficient interaction. Most of these strategies are complex processes optimized mainly for the functionalization of surfaces or microbeads. These methodologies imply though the Ab modification through several steps of purification or the use of expensive immobilized proteins. Besides, the functionalization of magnetic nanoparticles (MNPs) turned out to be much more complex than expected due to the lack of stability of most MNPs at high ionic strength and non-neutral pH values. Therefore, there is still missing an efficient, easy and universal methodology for the immobilization of nonmodified Abs onto MNPs without involving their Fab regions during the immobilization process. Herein, we propose the functionalization of MNPs via a two-steps strategy that takes advantage of the ionic reversible interactions between the Ab and the MNP. These interactions make possible the orientation of the Ab on the MNP surface before being attached in an irreversible way via covalent bonds. Three Abs (Immunoglobulin G class) with very different isoelectric points (against peroxidase, carcinoembryonic antigen, and human chorionic gonadotropin hormone) were used to prove the general applicability of the strategy here proposed and its utility for the development of more bioactive NPs.

Nonpharmacological public health measures are used to reduce exposure of susceptible persons to an infectious agent. Its use is recommended at the start of a pandemic, when the transmission begins, and the characteristics of the new virus are unknown. The National Plan for Preparedness and Response to Pandemic Influenza included the application of these measures, recommending the establishment of an Advisory Committee for implementation, with a multidisciplinary composition. The mandate at this Committee is to analyze the epidemiological and social context in confronting the pandemic and to propose public health measures according to their evolution. This article describes isolation, quarantine and closure of schools measures, aiming to reduce the spread of the virus in the population. It also reviews the epidemiological parameters that help to understand the impact of its implementation. The public health measures reviewed in this paper reduce transmission of the virus, and they have to be considered in response to an influenza pandemic. The impact on health will depend on how quickly they are taken and how people accept and follow them. Response plans should recommend its use, depending on the severity and characteristics of the new pandemic virus. The data analysis should be considered as part of the response, because the information collection and analysis will be key to advising health authorities on what measures should be adopted.