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Resumen La Colangiopancreatografía Retrógrada Endoscópica (CPRE) constituye la técnica de elección para el drenaje de la vía biliar, ya sea en casos de obstrucción biliar benigna o maligna. Sin embargo, una vez esta técnica no resulta eficaz o factible, tenemos a nuestra disposición varias alternativas, siendo la más utilizada hasta ahora la colangiografía transhepática percutánea (CTPH). Sin embargo, a día de hoy el drenaje biliar guiado por ecoendoscopia (USE-BD) constituye una alternativa cada vez más factible a la radiología intervencionista o la cirugía. En esta revisión se abordarán los resultados de este tipo de drenaje en comparación con los demás, así como los diferentes tipos de técnicas disponibles y sus resultados en la práctica clínica.

A wide range of chemicals was measured in different types of drinking water and urine samples through target and non-target screening (NTS) to estimate human exposure. Tap water samples collected from 42 locations in Barcelona (August–October/2020, May/2021), tap water filtered with domestic activated carbon filters (AC, N = 6) and reverse osmosis (RO, N = 5), commercial bottled water (N = 10), and urine (N = 39) samples were included. 35 per- and polyfluoroalkyl substances (PFAS), bisphenol A, and nonylphenol were analyzed using LC–MS/MS and GC–MS/MS, and NTS using LC–HRMS. 9 PFAS were detected in unfiltered tap water of first sampling (79% samples, median = 30 ng/L), 6 in the second (69%, median = 9.8 ng/L), and 5 in 13% urine samples. NTS tentatively identified pharmaceuticals and other industrial chemicals in drinking water. PFAS were removed by RO and not by AC filters. Findings provide valuable information for exposure science and water quality monitoring of emerging drinking water contaminants., This project has been funded by Project “PI20/00829”, funded by Instituto de Salud Carlos III and co-funded by European Union (ERDF) “A way to make Europe”, and by Ajuntament de Barcelona (Institut de Cultura, Pla Barcelona Ciencia 2019. #19S01446-006). We acknowledge support from the Spanish Ministry of Science and Innovation through the “Centro de Excelencia Severo Ochoa 2019–2023” Program (CEX2018-000806-S and CEX2018-000794-S financed by MCIN/AEI/ 10.13039/501100011033, for ISGlobal and IDAEA-CSIC, respectively), and support from the Generalitat de Catalunya through the CERCA Program. M.J.F. acknowledges her Ramón y Cajal fellowship (RyC-2015-17108), from the AEI-MICIU. We thank Natalia Lopo, Lourdes Arjona, and Antonia Valentín (ISGlobal) for their technical assistance during the sampling, analytical measurements, and data analysis. We thank Patricia González, Anna Gómez, Sònia Navarro, and Laia Font-Ribera (Public Health Agency of Barcelona) for providing valuable information on Barcelona’s drinking water supplies. The PFAS analyses in urine were carried out in the framework of the final master’s thesis (Universitat de Barcelona) by Paula Villasante. We finally would like to acknowledge all the volunteers that participated in the project.

Microplastic particles are ubiquitous in the environment, from the air we breathe to the food we eat. The key question with respect to these particles is to what extent they cause risks for the environment and human health. There is no risk assessment framework that takes into account the multidimensionality of microplastic particles against the background of numerous natural particles, which together encompass an infinite combination of sizes, shapes, densities and chemical signatures. We review the current tenets in defining microplastic characteristics and effects, emphasizing advances in the analysis of the diversity of microplastic particles. We summarize the unique characteristics of microplastic compared with those of other environmental particles, the main mechanisms of microplastic particle effects and the relevant dose metrics for these effects. To characterize risks consistently, we propose how exposure and effect thresholds can be aligned and quantified using probability density functions describing microplastic particle diversity.

The Laurentian Great Lakes represent important and iconic ecosystems. Microplastic pollution has become a major problem among other anthropogenic stressors in these lakes. There is a need for policy development, however, assessing the risks of microplastics is complicated due to the uncertainty and poor quality of the data and incompatibility of exposure and effect data for microplastics with different properties. Here we provide a prospective probabilistic risk assessment for Great Lakes sediments and surface waters that corrects for the misalignment between exposure and effect data, accounts for variability due to sample volume when using trawl samples, for the random spatiotemporal variability of exposure data, for uncertainty in data quality (QA/QC), in the slope of the power law used to rescale the data, and in the HC5 threshold effect concentration obtained from Species Sensitivity Distributions (SSDs). We rank the lakes in order of the increasing likelihood of risks from microplastics, for pelagic and benthic exposures. A lake-wide risk, i.e. where each location exceeds the risk limit, is not found for any of the lakes. However, the probability of a risk from food dilution occurring in parts of the lakes is 13–15% of the benthic exposures in Lakes Erie and Huron, and 8.3–10.3% of the pelagic exposures in Lake Michigan, Lake Huron, Lake Superior, and Lake Erie, and 24% of the pelagic exposures in Lake Ontario. To reduce the identified uncertainties, we recommend that future research focuses on characterizing and quantifying environmentally relevant microplastic (ERMP) over a wider size range (ideally 1–5000 μm) so that probability density functions (PDFs) can be better calibrated for different habitats. Toxicity effect testing should use a similarly wide range of sizes and other ERMP characteristics so that complex data alignments can be minimized and assumptions regarding ecologically relevant dose metrics (ERMs) can be validated.

Determining the risks of microplastics is difficult because data is of variable quality and cannot be compared. Although sediments are important sinks for microplastics, no holistic risk assessment framework is available for this compartment. Here we assess the risks of microplastics in freshwater sediments worldwide, using strict quality criteria and alignment methods. Published exposure data were screened for quality using new criteria for microplastics in sediment and were rescaled to the standard 1–5000 µm microplastic size range. Threshold effect data were also screened for quality and were aligned to account for the polydispersity of environmental microplastics and for their bioaccessible fraction. Risks were characterized for effects triggered by food dilution or translocation, using ingested particle volume and surface area as ecologically relevant metrics, respectively. Based on species sensitivity distributions, we determined Hazardous Concentrations for 5% of the species (HC5, with 95% CI) of 4.9 × 109 (6.6 × 107 – 1.9 × 1011) and 1.1 × 1010 (3.2 × 108 – 4.0 × 1011) particles / kg sediment dry weight, for food dilution and translocation, respectively. For all locations considered, exposure concentrations were either below or in the margin of uncertainty of the HC5 values. We conclude that risks from microplastics to benthic communities cannot be excluded at current concentrations in sediments worldwide. Also see: https://micro2022.sciencesconf.org/427047/document, In MICRO 2022, Online Atlas Edition: Plastic Pollution from MACRO to nano

Community-acquired pneumonia (CAP) continues to be an important cause of morbidity and mortality in adults. The aim of this study is to update the practical prevention guide for CAP through vaccination in Spain developed in 2016 and updated in 2018, based on available vaccines and evidence through bibliographic review and expert opinion. The arrival of COVID-19 as a new cause of CAP and the recent availability of safe and effective vaccines constitutes the most significant change. Vaccines against pneumococcus, influenza, pertussis and COVID-19 can help to reduce the burden of disease from CAP and its associated complications. The available evidence supports the priority indications established in this guide, and it would be advisable to try to achieve a widespread dissemination and implementation of these recommendations in routine clinical practice.

Resumen Introducción y objetivos: Los pacientes con HDA intrahospitalaria presentan una mayor tasa de mortalidad, sin embargo, las razones de este incremento no se han estudiado en profundidad. Nuestro objetivo es comparar pacientes con HDA que acuden de forma ambulatoria, con aquellos que presentan un episodio de HDA estando hospitalizados por otra causa; así como identificar predictores de mortalidad hospitalaria en este subgrupo de pacientes. Material y métodos: Estudio prospectivo de pacientes con HDA (varicosa y no varicosa) tratados en el Hospital Universitario "Virgen de las Nieves" de 2013-2017. Se recolectaron datos clínicos, bioquímicos, procedimientos, datos de evolución intrahospitalaria (resangrado, mortalidad) y mortalidad diferida a los 6 meses. Resultados: Se incluyeron 540 pacientes con HDA, 59 hospitalizados y 481 ambulatorios. Los primeros diferían de los segundos, en la tasa de mortalidad intrahospitalaria (42,1% vs 7,8%; P Conclusiones: Los pacientes hospitalizados con un episodio de HDA tienen una mayor morbimortalidad siendo la clasificación ASA un claro predictor de mortalidad, tanto en pacientes con HDA varicosa como no varicosa.

To determine the presence of a group of mutations, and establish the prognostic value for recurrence and progression. Prospective observational study. Intermediate-to-high-risk non-muscle invasive bladder cancer (NMIBC) was evaluated. Data from genetic analyses were included in a database along with clinicopathological variables of interest. Seventy-four patients. Twenty-five (33.8%) recurred and 3 (4.1%) progressed. Median time to recurrence: 8 months (5.7–12.7). Median time to progression: 14 months (P75: 12). Mutation distribution: KRAS codon 12: one patient (1.4%), BAT25: five patients (6.8%), BAT-26: four patients (5.4%), and D2S123: 6 patients (8.1%). Arg72Pro polymorphism: 50 patients (67.6%) exhibited homozygous mutations, 23 (31.1%) were heterozygous, and 1 patient (1.4%) did not present the mutation. We found an association between presence of MSI at BAT26 and female sex (p

Resumen El objetivo de este estudio es evaluar las caracteristicas generales y los resultados oncologicos en una cohorte de 408 casos de prostatectomia radical asistida por robot da Vinci Standard de 4 brazos, realizadas entre octubre del 2006 y febrero del 2015. El analisis estadistico se realizo con el programa SPSS 20.0. Las variables cualitativas se presentan con su distribucion de frecuencias y las cuantitativas con su media y desviacion estandar o mediana y rango intercuartil. La asociacion entre variables cualitativas se analizo con el test de la χ2. La variable de resultado de la supervivencia libre de enfermedad se evaluo con un analisis de curvas de Kaplan-Meier y se contrastaron las diferencias con el test de Breslow. Se ajusto un modelo de regresion de Cox. Entre los resultados destacamos un seguimiento 47 meses (32-68,75 meses), supervivencia libre de recurrencia 90 meses (IC del 95%, 86-94), mediana de tiempo a recurrencia de 23 meses (10,5-37 meses), recurrencia del 16,6% (68/408), recidiva bioquimica (62/498, 15,2%) y un 22% de complicaciones, la mayoria Clavien I-II. Los resultados se resumen en las tablas 1 a 7 y en la figura 1. Conclusiones: 1) la prostatectomia radical robotica es una tecnica segura con un porcentaje asumible de complicaciones, en su mayoria menores (grados i y ii de Clavien); 2) encontramos mayor probabilidad de permanecer libre de recidiva en los grados mas bajos de la clasificacion de ISUP y mayor probabilidad de recidiva en casos de alto riesgo, y 3) en el modelo multivariante comprobamos que el grado ISUP se relaciono de forma significativa con la supervivencia y fueron variables pronosticas independientes los grados de la clasificacion ISUP y los margenes quirurgicos positivos.

The objective of this study is to evaluate the general characteristics and oncological results in a cohort of 408 cases submitted to da Vinci Standard 4-armed robot-assisted radical prostatectomy (RARP), performed between October 2006 and February 2015 at Clinico San Carlos hospital. Statistical analysis was performed with the SPSS 20.0 program. Qualitative variables are presented with their frequency distribution and quantitative variables with their mean and standard deviation or median and interquartile range. The χ2 test was used to analyze the association of qualitative variables. The disease-free survival outcome variable was evaluated with a Kaplan-Meier curve analysis, and the differences were contrasted with the Breslow test. A Cox regression model was adjusted. Among the results, we highlight the follow-up of 47 months (32-68.75m), recurrence-free survival of 90 months (95% CI, 86-94), median time to recurrence of 23 months (10.5-37 m), recurrence 16'6% (68/408), biochemical recurrence (62/498, 15'2%) and 22% of complications, mostly Clavien I-II. The results are summarized in Tables 1 to 7 and Figure 1. CONCLUSIONS: 1) RARP is a safe technique with an acceptable percentage of complications, mostly minor (Clavien grades iandii), 2) We found a higher probability of remaining recurrence-free in the lower grades of the ISUP classification and a higher probability of recurrence in high-risk cases, and 3) The multivariate model showed that the ISUP grade was significantly related to survival and the ISUP and PSM classification grades were independent prognostic variables.

Resumen El cáncer colorrectal (CCR) constituye el tumor más frecuente en el mundo occidental y la segunda causa de muerte por cáncer. Sin embargo, el CCR es una enfermedad que se puede prevenir. Los programas de prevención y diagnóstico precoz del CCR basados en el cribado mediante test de sangre oculta en heces han demostrado la reducción de la mortalidad y la incidencia por CCR en las poblaciones en la que se ha aplicado. La colonoscopia realizada en el contexto del cribado de CCR se efectúa sobre individuos sanos y asintomáticos, y su realización debe garantizar a estos individuos que quedan libres de contraer un CCR durante un periodo de tiempo que llega hasta los 10 años. Las unidades donde se realicen colonoscopias de cribado deben cumplir unos requisitos de calidad mínimos necesarios. Pero el programa de cribado no termina con la realización de la colonoscopia, ya que tras la realización de ésta hay que garantizar el correcto seguimiento de la población con lesiones de riesgo, además de todas aquellas personas con síndromes hereditarios que serán identificadas durante todo este proceso. Con este documento, la Sociedad Andaluza de Patología Digestiva pretende establecer, en base a la evidencia disponible, las condiciones mínimas imprescindibles para la implantación del Programa Poblacional de Cribado de CCR y servir de guía para aquellas unidades y servicios que tienen puesto en marcha el programa o lo van a implementar.

In recent years, the fight against climate change and the mitigation of the impact of fluorinated gases (F-gases) on the atmosphere is a global concern. Development of technologies that help to efficiently separate and recycle hydrofluorocarbons (HFCs) at the end of the refrigeration and air conditioning equipment life is a priority. The technological development is important to stimulate the F-gas capture, specifically difluoromethane (R-32) and 1,1,1,2-tetrafluoroethane (R-134a), due to their high global warming potential. In this work, the COSMO-RS method is used to analyze the solute-solvent interactions and to determine Henry's constants of R-32 and R-134a in more than 600 ionic liquids. The three most performant ionic liquids were selected on the basis of COSMO-RS calculations, and F-gas absorption equilibrium isotherms were measured using gravimetric and volumetric methods. Experimental results are in good agreement with COSMO-RS predictions, with the ionic liquid tributyl(ethyl)phosphonium diethyl phosphate, [P2444][C2C2PO4], being the salt presenting the highest absorption capacities in molar and mass units compared to salts previously tested. The other two ionic liquids selected, trihexyltetradecylphosphonium glycinate, [P66614][C2NO2], and trihexyl(tetradecyl)phosphonium 2-cyano-pyrrole, [P66614][CNPyr], may be competitive as far as their absorption capacities are concerned. Future works will be guided on evaluating the performance of these ionic liquids at an industrial scale by means of process simulations, in order to elucidate the role in process efficiency of other relevant absorbent properties such as viscosity, molar weight, or specific heat, This work was also supported by Associate Laboratory for Green Chemistry–LAQV, financed by national funds from FCT/MCTES (UID/QUI/50006/2020), the contracts of Individual Call to Scientific Employment Stimulus 2020.00835.CEECIND (J.M.M.A.)/2021.01432.CEECIND (A.B.P.) and by FCT/MCTES (Portugal) through the project PTDC/EQU-EQU/29737/2017. The authors thank Solvay for providing the ionic liquid tri(butyl) ethylphosphonium diethylphosphate. M.C.G. and J.A. thank IDEX-LYON for financial support (Programme Investissement d’Avenir ANR-16-IDEX-0005)

Microplastics (MPLs) are emerging persistent pollutants affecting drinking water systems, and different studies have reported their presence in tap water. However, most of the work has a focus on particles in the 100-5 µm range. Here, a workflow to identify and quantify polymers of micro and nanoplastics (MNPLs), with sizes from 0.7 to 20 µm in tap water, is presented. The analytical method consisted of water fractionated filtration followed by toluene ultrasonic-assisted extraction and size-exclusion chromatography, using an advanced polymer chromatography column coupled to high-resolution mass spectrometry with atmospheric pressure photoionization source with negative and positive ionization conditions (HPLC(APC)-APPI(±)-HRMS) and normal phase chromatography HILIC LUNA® column and electrospray ionisation source in positive and negative mode (HPLC(HILIC)-ESI(±)-HRMS). The acquisition was performed in full scan mode, and the subsequent tentative identification of MNPLs polymers has been based on increasing the confirmation level, including the characterisation of monomers by using Kendrick Mass Defect (KMD) analysis, and confirmation and quantification using standards. This approach was applied to assess MNPLs in tap water samples of the Barcelona Metropolitan Area (BMA), that were collected from August to October 2020 from home taps of volunteers distributed in the 42 postal codes of the BMA. Polyethylene (PE), polypropylene (PP), polyisoprene (PI), polybutadiene (PBD), polystyrene (PS), polyamide (PA), and polydimethylsiloxanes (PDMS) were identified. PE, PP, and PA were the most highly detected polymers, and PI and PBD were found at the highest concentrations (9,143 and 1,897 ng/L, respectively). A principal component analysis (PCA) was conducted to assess differences in MNPLs occurrence in drinking water, that was provided from the two drinking water treatment plants (DWTPs) suppliers. Results showed that no significant differences (at 95% confidence level) were established between the drinking water supplies to the different areas of the BMA., This work was supported by IMAGE project (PID2020-116789RB) from the Spanish Ministry of Science and Innovation, and by the Ajuntament de Barcelona (Institut de Cultura, Pla Barcelona Ciencia 2019. #19S01446–006). Albert Vega-Herrera thanks his grant PRE2018–083989 from the Spanish Ministry of Science and Innovation. The authors also thank R. Chaler and A. García for their technical support during the analyses that were performed with the Acquity HPLC and Q-Exactive instruments. IDAEA-CSIC and ISGlobal are Severo Ochoa Centre of Research Excellence (Spanish Ministry of Science and Innovation; Project CEX2018–000794-S, and CEX2018–000806-S, respectively).

Microplastics (MPs) are one of the most widespread contaminants worldwide, yet their risks for freshwater ecosystems have seldom been investigated. In this study, we performed a large monitoring campaign to assess the presence and risks of MPs in Amazonian freshwater ecosystems. We investigated MP pollution in 40 samples collected along 1500 km in the Brazilian Amazon, including the Amazon River, three major tributaries, and several streams next to the most important urban areas. MPs in the 55–5000 µm size range were characterized (size, shape, color) by microscopy and identified (polymer composition) by infrared spectroscopy. Ecotoxicological risks were assessed using chronic Species Sensitivity Distributions for effects triggered by food dilution and tissue translocation using data alignment methods that correct for polydispersity of environmental MPs and bioaccessibility. This study shows that MPs are ubiquitous contaminants in Amazonian freshwater ecosystems, with measured concentrations (55–5000 µm) ranging between 5 and 152 MPs/m3 in the Amazon River and its main tributaries, and between 23 and 74,550 MPs/m3 in urban streams. The calculated Hazardous Concentration for the 5% of species (HC5) derived from the SSDs for the entire MP range (1–5000 µm) were 1.6 × 107 MPs/m3 (95% CI: 1.2 × 106 – 4.0 × 108) for food dilution, and 1.8 × 107 MPs/m3 (95% CI: 1.5 × 106 – 4.3 × 108) for translocation. Rescaled exposure concentrations (1–5000 µm) in the Amazon River and tributaries ranged between 6.0 × 103 and 1.8 × 105 MPs/m3, and were significantly lower than the calculated HC5 values. Rescaled concentrations in urban streams ranged between 1.7 × 105 and 5.7 × 108 MPs/m3, and exceeded both calculated HC5 values in 20% of the locations. This study shows that ecological impacts by MP contamination are not likely to happen in the Amazon River and its major tributaries. However, risks for freshwater organisms may be expected in near densely populated areas, such as the cities of Manaus or Belem, which have limited wastewater treatment facilities. Large-scale monitoring and risk assessment of microplastics in the Amazon River

The generation of disinfection by-products during water chlorination is a major concern in water treatment, given the potential health risks that these substances may pose. In particular, nitrogen-containing DBPs are believed to have greater toxicological significance than carbon-based DBPs. Hence, high performance liquid chromatography coupled to high-resolution mass spectrometry (HPLC-HRMS) in positive mode was employed to identify new non-volatile nitrogen containing disinfection by-products (DBPs) and to assess their presence in potable water. Nine water samples were taken in the Llobregat river, in the context of a water reuse trial, near the catchment of a drinking water treatment plant (DWTP) in 2019. River samples were disinfected with chlorine under controlled formation potential tests conditions and analysed with a non-target approach. The peak lists of raw and chlorinated samples were compared exhaustively, resulting in an extensive list of 495 DBPs that include bromine and/or chlorine atoms. 172 of these species were found frequently, in three or more chlorinated samples. The empirical formulae of these DBPs were unambiguously annotated on the basis of accurate m/z measurements, isotopic patterns and common heuristic rules. Most of the annotated species (310) contained bromide, which is consistent with the relatively high bromide content of the Llobregat basin (>0.3 mg/l). Drinking water samples were taken at the outlet of the DWTP during the same sampling period. According to their analysis, a large portion of the DBPs detected after the formation potential tests do not reach real-life drinking water, which suggests that the treatment train successfully removes a significant fraction of DBP precursors. However, 131 DBPs could still be detected in the final product water. A larger sampling was carried in the Barcelona water distribution network, during six consecutive weeks, and it revealed the presence of 78 halogenated DBPs in end-consumer water, most of which were nitrogen-containing. MS/MS fragmentation and retention times were employed to tentatively suggest molecular structure for these recalcitrant DBPs Catalunya through Consolidated Research Group ENV 2017 SGR 1124 and Tech 2017 SGR 1318. ICRA, Spain researchers thank funding from CERCA program. MJF acknowledges her Ramon y Cajal fellowship (RyC-2015-17108), from the AEI-MICI. CMV and PRH acknowledge the support from the Spanish Ministry of Science and Innovation through the “Centro de Excelencia Severo Ochoa 2019–2023” Program (CEX 2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program Open Access funding provided thanks to the CRUE-CSIC agreement with Elsevier

Knowledge about human exposure and health effects associated with non-routinely monitored disinfection by-products (DBPs) in drinking water is sparse., This project has been funded by Ajuntament de Barcelona (Institut de Cultura, Pla Barcelona Ciencia 2019. #19S01446-006), and partly funded by Instituto de Salud Carlos III and co-funded by European Union (ERDF) “A way to make Europe” (PI20/00829). We acknowledge support from the Spanish Ministry of Science and Innovation and State Research Agency through the “Centro de Excelencia Severo Ochoa 2019-2023” Program (CEX2018-000806-S and CEX2018-000794-S, for ISGlobal and IDAEA-CSIC, respectively), and support from the Generalitat de Catalunya through the CERCA Program. MJF acknowledges her Ramón y Cajal fellowship (RyC-2015-17108), from the AEI-MICIU. We thank Alexandra Paraian, Eva Maria Herrera (IDAEA-CSIC), Natalia Lopo, Lourdes Arjona and Antonia Valentín (ISGlobal) for their technical assistance during the sampling, analytical measurements and data analysis. The HAAs analyses in urine were carried out in the framework of the final master’s thesis (Universitat de Barcelona) by Paula Villasante. We also thank Patricia González, Anna Gómez, Sònia Navarro, and Laia Font-Ribera (Public Health Agency of Barcelona) for providing valuable information on Barcelona’s drinking water supplies. We finally would like to acknowledge all the volunteers that participated in the project.

Background Inflammatory bowel disease is a chronic disease characterized by digestive symptoms with an increasing incidence and prevalence. It is well established its impact on the quality of life of patients and their main caregivers but no study has yet considered the consequences of IBD on cohabitants with no direct involvement in patient`s care. Our aims were to analyze quality of life in cohabitants of people with IBD and identify potential related factors. Methods We conducted a cross-sectional study that included patients with IBD and their house-hold members. Participants were recruited from a period of two months from patients attending the IBD unit of our hospital. Inclusion criteria were a definite diagnosis of IBD and household members living in the same house for a period of 1 year or more. Exclusion criteria were an age Demographic data was obtained for patients and household members. IBD activity was assessed by using the Partial Mayo Score and the Harvey-Bradshaw score. Other relevant information regarding the prior and current state of the disease was collected. Quality of life was assessed in the case of the patients with the Inflammatory Bowel Disease Questionnaire (IBDQ-32) and for the household members we used the Household Members Quality of Life-Inflammatory Bowel Disease (HHMQoL-IBD) questionnaire. Results We included 22 patients with UC, 32 patients with CD and 2 patients with indeterminate colitis and 82 household members. Both groups had similar sociodemographic characteristics. The univariate analysis of the quality of life of cohabitants showed a significant association of HHMQoL-IBD and IBDQ-32 score in their relatives (p Cohabitants of patients with CD had significantly lower HHMQoL-IBD than UC ones (53 ± 18 vs. 62 ± 23; p=0.049). Among cohabitants of patients with UC and CD, patient’s CRP in the last control was related to HHMQoL-IBD score (p=0.043 and p=0.04 respectively). In a linear multiple regression analysis, IBDQ-32 score (p Conclusion Quality of life in household members of patients with IBD is related to patient’s quality of life and extraintestinal conditions related to the disease. Our study shows how important is to analyze and act in the patient’s whole environment, taking into consideration not only clinical variables but also the relational conditions and impact of the disease.

The lack of standard approaches in microplastic research limits progress in the abatement of plastic pollution. Here, we propose and test rescaling methods that are able to improve the alignment of methods used in microplastic research. We describe a method to correct for the differences in size ranges as used by studies reporting microplastic concentrations and demonstrate how this reduces the variation in aqueous-phase concentrations caused by method differences. We provide a method to interchange between number, volume, and mass concentrations using probability density functions that represent environmental microplastic. Finally, we use this method to correct for the incompatibility of data as used in current species sensitivity distributions (SSDs), caused by differences in the microplastic types used in effect studies and those in nature. We derived threshold effect concentrations from such a corrected SSD for freshwater species. Comparison of the rescaled exposure concentrations and threshold effect concentrations reveals that the latter would be exceeded for 1.5% of the known surface water exposure concentrations worldwide. Altogether, this toolset allows us to correct for the diversity of microplastic, to address it in a common language, and to assess its risks as one environmental material.

Significance Immunotherapy has revolutionized cancer treatment, yielding unprecedented long-term responses and survival. However, a significant proportion of patients remain refractory, which correlates with the absence of immune-infiltrated (“hot”) tumors. Here, we observed that FDA-approved unadjuvanted seasonal influenza vaccines administered via intratumoral injection not only provide protection against active influenza virus lung infection, but also reduce tumor growth by increasing antitumor CD8+ T cells and decreasing regulatory B cells within the tumor. Ultimately, intratumoral unadjuvanted seasonal influenza vaccine converts immunologically inactive “cold” tumors to “hot,” generates systemic responses, and sensitizes resistant tumors to checkpoint blockade. Repurposing the “flu shot” may increase response rates to immunotherapy, and based on its current FDA approval and safety profile, may be quickly translated for clinical care., Reprogramming the tumor microenvironment to increase immune-mediated responses is currently of intense interest. Patients with immune-infiltrated “hot” tumors demonstrate higher treatment response rates and improved survival. However, only the minority of tumors are hot, and a limited proportion of patients benefit from immunotherapies. Innovative approaches that make tumors hot can have immediate impact particularly if they repurpose drugs with additional cancer-unrelated benefits. The seasonal influenza vaccine is recommended for all persons over 6 mo without prohibitive contraindications, including most cancer patients. Here, we report that unadjuvanted seasonal influenza vaccination via intratumoral, but not intramuscular, injection converts “cold” tumors to hot, generates systemic CD8+ T cell-mediated antitumor immunity, and sensitizes resistant tumors to checkpoint blockade. Importantly, intratumoral vaccination also provides protection against subsequent active influenza virus lung infection. Surprisingly, a squalene-based adjuvanted vaccine maintains intratumoral regulatory B cells and fails to improve antitumor responses, even while protecting against active influenza virus lung infection. Adjuvant removal, B cell depletion, or IL-10 blockade recovers its antitumor effectiveness. Our findings propose that antipathogen vaccines may be utilized for both infection prevention and repurposing as a cancer immunotherapy.

Resumen Es conocida la relacion bidireccional entre enfermedades infecciosas y diabetes. Las personas con diabetes tienen mayor riesgo de presentar enfermedades infecciosas, pudiendo ser estas de mayor severidad; y por otro lado, las enfermedades infecciosas desestabilizan el control metabolico de las personas con diabetes. El envejecimiento importante de la poblacion es debido en parte al aumento de la supervivencia de pacientes con enfermedades cronicas, entre ellas la diabetes. Mejorar la prevencion de enfermedades infecciosas en este grupo de poblacion podria disminuir las complicaciones de estas enfermedades, asi como las consecuencias de la desestabilizacion de la enfermedad de base (morbilidad, discapacidad, ingresos hospitalarios, costes sanitarios, tasas de mortalidad), mejorando ademas la calidad de vida de las personas con diabetes. La presente revision expone el tratamiento de las enfermedades infecciosas en personas con diabetes y el abordaje de las enfermedades inmunoprevenibles con las vacunas recomendadas en la actualidad.

Background Inflammatory bowel disease (IBD) patients undergoing treatments that act on the inmune system and present an increased risk of infections. For this reason, we could consider that these patients may have an increased risk of severe SARS-CoV-2 infection, however, it remains unclear. We aimed to analyze the cumulative incidence, the severity of the infection and its influence on the natural history of IBD in patients under biological treatment and also evaluating the possible differences with another group without these therapy. Methods Retrospective observational study about our IBD patients followed from March 2020 to January 2021 divided into two groups: patients on treatment with biological drugs (anti-TNF, vedolizumab, ustekinumab and tofacitinib) and patients without biological drugs (thiopurines or 5-ASA). We evaluated: the cumulative incidence in 10 months for COVID-19 in the 2 cohorts; clinical variables considered risk factors for the infection, the infection severity and influence on the course of IBD employing Harvey-Bradshaw index in Crohn′s disease and Mayo partial index in ulcerative colitis before and after infection. Results It collected 755 IBD patients. 89 were infected by SARS-COV-2, 43 in the biological group and 46 in non biological group. The cumulative incidence in 10 months was 10.85% in the first group (figure 1) and 12.81% in the second group with no significant differences. We verified comparability of the groups discarded the existence of statistical differences in all of the risk factors (sex, age, hypertension, diabetes, dyslipidemia, cardiovascular disease and BMI). In most cases, the infection was mild (94.4%) and the required treatment was symptomatic in 86.4% of the total (Figure 2), without significant differences between groups. Pneumonia was diagnosed in 5 patients, whose required hospital admission (3 belonged to the biological group and 2 to the other). The maximum respiratory support required was FIO2 36%, no patient required admission to ICU and there were no deaths. Additionally, the course of IBD was not affected because of COVID-19, considering no significant differences were observed in clinical scores in each group before and after infection, even taking into account 14 patients discontinued biological therapy temporarily during infection. Conclusion Our study suggests that IBD patients under biological therapy do not have an increased incidence of SARS-COV-2 infection and also do not have a higher risk of severe disease than IBD patients without this therapy. Furthermore, COVID-19 does not affect the natural history of IBD. These data go in the same direction as those published to date, however, we need multicentre registries with a larger sample size in the future

Community-acquired pneumonia (CAP) continues to be an important cause of morbidity and mortality in adults. The aim of this study is to update the practical prevention guide for CAP through vaccination in Spain developed in 2016 and updated in 2018, based on available vaccines and evidence through bibliographic review and expert opinion. The arrival of COVID-19 as a new cause of CAP and the recent availability of safe and effective vaccines constitutes the most significant change. Vaccines against pneumococcus, influenza, pertussis and COVID-19 can help to reduce the burden of disease from CAP and its associated complications. The available evidence supports the priority indications established in this guide, and it would be advisable to try to achieve a widespread dissemination and implementation of these recommendations in routine clinical practice.

This deliverableD4.3 presents the knowledge transfer activities to targeted stakeholders that INCREDIBLE partners performed over the duration of the project. It lists articles in sectorial and practitioners’ magazines and journals, as well as articles targeted at broader audiences (e.g,. blogs or web stories), published at both national and international levels. The dissemination items are subdivided per thematic iNets (Aromatic and medicinal plants; Cork; Mushrooms and truffles; Resins; Wild nuts and berries), and inter-iNets activities. This deliverable details how key project outcomes, processes, and lessons learned from the iterative multi-actor processes have been disseminated to target audiences outside the project, as to increase the project impact and outreach.

Microplastic particles can be deposited to sediments and subsequently ingested by benthic organisms. It is unknown to what extent ingestion of microplastic is taxon-specific or whether taxa can be selective toward certain types of microplastics. Here, we used state-of-the-art automated micro-Fourier-transform infrared (μFTIR) imaging and attenuated total reflectance FTIR spectroscopy to determine small-size (20–500 μm) and large-size (500–5000 μm) microplastic particles in sediments and a range of benthic invertebrate species sampled simultaneously from the Dommel River in the Netherlands. Microplastic number concentrations differed across taxa at the same locations, demonstrating taxon-specific uptake, whereas size distributions were the same across sediments and taxa. At the site with the highest concentration, microplastic occupied up to 4.0% of the gut volume of Asellidae. Particle shape distributions were often not statistically different between sediments and taxa, except for Astacidea at one of the locations where the proportion of particles with a length to width ratio >3 (i.e., fibers) was twice as high in sediments than in Astacidea. Acrylates/polyurethane/varnish was predominately found in sediments, while soft and rubbery polymers ethylene propylene diene monomer and polyethylene-chlorinated were the dominant polymers found in invertebrates. Microplastic polymer composition and thus polymer density differed significantly between invertebrates and their host sediment. Trophic transfer at the base of the food web appears to have a filter function with respect to microplastic particle types and shapes. Together with the very high ingestion rates, this has clear implications for ecological and human health risks, where uptake concerns edible species (e.g., Astacidea)., Automated μFTIR imaging demonstrates taxon-specific and selective uptake of microplastic by freshwater invertebrates, with relevance for microplastic risk assessment.

Because of the difficulty of measuring nanoplastics (NP), the use of NPs doped with trace metals has been proposed as a promising approach to detect NP in environmental media and biota. In the present study, the freshwater amphipod Gammarus pulex were exposed to palladium (Pd)-doped NP via natural sediment at six spiking concentrations (0, 0.3, 1, 3, 10 and 30 g plastic per kg of sediment dry weight) with the aim of assessing their uptake and chronic effects using 28 days standardized single species toxicity tests. NP concentrations were quantified based on Pd concentrations measured by ICP-MS on digests of the exposed organisms and faecal pellets excreted during a post-exposure 24 hour depuration period. Additionally, NP concentrations were measured in sediments and water to demonstrate accuracy of NP dosing and to quantify the resuspension of NP from the sediment caused by the organisms. A significant positive linear relationship between the uptake of NP by G. pulex and the concentration of NP in the sediments was observed, yet no statistically significant effects were found on the survival or growth of G. pulex. A biodynamic model fitted well to the data and suggested bioaccumulation would occur in two kinetic compartments, the major one being reversible with rapid depuration to clean medium. Model fitting yielded a mass based trophic transfer factor (TTF), conceptually similar to the traditional biota sediment accumulation factor, for NP in the gut of 0.031. This value is close to a TTF value of 0.025 that was obtained for much larger microplastic particles in a similar experiment performed previously. Mechanistically, this suggests that ingestion of plastic is limited by the total volume of ingested particles. We demonstrated that using metal-doped plastics provides opportunities for precise quantification of NP accumulation and exposure in fate and effect studies, which can be a clear benefit for NP risk assessment., The combination of nanoplastic metal doping and biodynamic modeling allows for accurate assessment of bioaccumulation and effects on Gammarus pulex, even in a complex environmental matrix such as sediment.

RESUMEN Las personas mayores son uno de los colectivos que más sufren los efectos de la gripe estacional. Aunque la vacuna antigripal es efectiva a la hora de prevenir la infección por el virus de la gripe y sus complicaciones, no resulta tan efectiva en personas de edad avanzada debido al fenómeno de inmunosenescencia asociado a la edad. Desde 2009 existe en EE. UU. una vacuna antigripal trivalente de alta dosis aprobada para la inmunización de personas ≥ 65 años con una concentración de antígeno cuatro veces mayor que la vacuna estándar. Múltiples ensayos clínicos llevados a cabo a lo largo de distintas temporadas, y mediante diferentes metodologías, han demostrado que la vacuna antigripal trivalente de alta dosis no solo es más efectiva, sino que además presenta un perfil de seguridad similar y es más inmunogénica que la vacuna de dosis estándar en la prevención de la gripe y sus complicaciones en personas de avanzada edad. En este documento se hace una revisión de la evidencia científica actual sobre la seguridad e inmunogenicidad de la vacuna antigripal de alta dosis en personas ≥ 65 años, y se incluye información de ensayos clínicos aleatorizados, estudios observacionales con datos de práctica clínica real y revisiones sistemáticas y metaanálisis.

PTDC/EQU-EQU/29737/2017; FCT/MCTES (UIDB/50006/2020). The environmental impact resulting from the release of fluorinated gases (F-gases), commonly used in refrigeration, is prompting the development of technologies to recover and recycle them. Fluorinated ionic liquids (FILs) have been investigated as promising candidates for the absorption and selective separation of F-gases. In this work, we prepared deep eutectic solvents (DESs) composed of FILs and perfluorinated acids to explore the excellent gas solubilization properties of FILs with high melting points in a wider liquid range. A screening of DESs prepared from five different FILs was performed for the solubilization of 1,1,1,2-tetrafluoroethane (R-134a) at 303.15 K, using a stainless steel volumetric system. [N4444][C4F9SO3]/C4F9CO2H and [C2C1Im][C8F17SO3]/C4F9CO2H were selected as the systems with the best absorption capacities and were studied in three different molar ratios of FIL/perfluorinated acid. Then, the absorption of difluoromethane (R-32), pentafluoroethane (R-125), and R-134a were determined at 303.15, 313.15, and 323.15 K. All studied DESs have high selectivity for the separation of R-134a from their mixtures with the other two F-gases. The results presented here provide knowledge of the behavior of these new alternative solvents for the separation of F-gases from commercial refrigerants, at three different temperatures, and in a wide range of operating pressures. authorsversion published

To determine the presence of a group of mutations, and establish the prognostic value for recurrence and progression.Prospective observational study. Intermediate-to-high-risk non-muscle invasive bladder cancer (NMIBC) was evaluated. Data from genetic analyses were included in a database along with clinicopathological variables of interest.Seventy-four patients. Twenty-five (33.8%) recurred and 3 (4.1%) progressed. Median time to recurrence: 8 months (5.7-12.7). Median time to progression: 14 months (P75: 12). Mutation distribution: KRAS codon 12: one patient (1.4%), BAT25: five patients (6.8%), BAT-26: four patients (5.4%), and D2S123: 6 patients (8.1%). Arg72Pro polymorphism: 50 patients (67.6%) exhibited homozygous mutations, 23 (31.1%) were heterozygous, and 1 patient (1.4%) did not present the mutation. We found an association between presence of MSI at BAT26 and female sex (p 0.05) and tumor stage and the TP53 Arg72Pro polymorphism. Recurrence-free survival (RFS) was significantly associated with presence of MSI at D2S123, with a HR of 5.44 for patients presenting the mutation (95% CI 1.83-16.16). On multivariate analysis, we found a statistically significant increase in risk of recurrence among patients with MSI at D2S123 (HR 5.15; p 0.05) and more than 2 previous transurethral bladder resections (TURBs) (HR 5.07; p 0.05) adjusted for tumor stage and grade. Harrell's concordance index revealed an accuracy of 0.74 (p 0.05).An association was found between presence BAT26 MSI and female sex, Arg72Pro polymorphism with tumor stage and D2S123 and more than 2 TUR procedures were associated with RFS adjusted to tumor stage and grade.

Community-acquired pneumonia (CAP) continues to be an important cause of morbidity and mortality in adults. The aim of this study is to update the 2016 practical prevention guidelines for CAP through vaccination in Spain, based on the available vaccines, as well as the evidence using a literature review and expert opinion. Vaccines against pneumococcus and influenza continue to be the main prevention tools available against CAP, and can contribute to reduce the burden of disease due to CAP and its associated complications. The available evidence supports the priority indications established in these guidelines, and it would be advisable to try to achieve a widespread dissemination and implementation of these recommendations in routine clinical practice.