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Abstract Background Biological systems respond to changes in both the Earth's magnetic and gravitational fields, but as experiments in space are expensive and infrequent, Earth-based simulation techniques are required. A high gradient magnetic field can be used to levitate biological material, thereby simulating microgravity and can also create environments with a reduced or an enhanced level of gravity (g), although special attention should be paid to the possible effects of the magnetic field (B) itself. Results Using diamagnetic levitation, we exposed Arabidopsis thaliana in vitro callus cultures to five environments with different levels of effective gravity and magnetic field strengths. The environments included levitation, i.e. simulated μg* (close to 0 g* at B = 10.1 T), intermediate g* (0.1 g* at B = 14.7 T) and enhanced gravity levels (1.9 g* at B = 14.7 T and 2 g* at B = 10.1 T) plus an internal 1 g* control (B = 16.5 T). The asterisk denotes the presence of the background magnetic field, as opposed to the effective gravity environments in the absence of an applied magnetic field, created using a Random Position Machine (simulated μg) and a Large Diameter Centrifuge (2 g). Microarray analysis indicates that changes in the overall gene expression of cultured cells exposed to these unusual environments barely reach significance using an FDR algorithm. However, it was found that gravitational and magnetic fields produce synergistic variations in the steady state of the transcriptional profile of plants. Transcriptomic results confirm that high gradient magnetic fields (i.e. to create μg* and 2 g* conditions) have a significant effect, mainly on structural, abiotic stress genes and secondary metabolism genes, but these subtle gravitational effects are only observable using clustering methodologies. Conclusions A detailed microarray dataset analysis, based on clustering of similarly expressed genes (GEDI software), can detect underlying global-scale responses, which cannot be detected by means of individual gene expression techniques using raw or corrected p values (FDR). A subtle, but consistent, genome-scale response to hypogravity environments was found, which was opposite to the response in a hypergravity environment.

Backward: The COVID-19 pandemic has severely tested global health systems. Non-invasive respiratory support, especially combining high-flow nasal cannula (HFNC) and continuous positive airway pressure, has effectively treated COVID-19 induced Acute Hypoxemic Respiratory Failure and reduced mortality. However, HFNC alone is more comfortable, better tolerated, and less costly than non-invasive ventilation. Understanding which patients benefit from HFNC monotherapy versus combined therapies is essential., Methods: This observational study included patients admitted to the intermediate respiratory care unit of a COVID-19 hospital between December 2020 and September 2021. All patients treated with HFNC were included (n = 1301). HFNC failure was defined as the need for escalated therapy (non-invasive ventilation, intubation) or death. Epidemiological, clinical, non-invasive respiratory support parameters, and laboratory data were collected, and a multivariable analysis identified key determinants., Results: HFNC was successful in 39.9 % of patients. (n = 511) Risk factors for HFNC failure included increased age, male gender, obesity, obstructive sleep apnea, higher respiratory rate, initial SpO2/FiO2 ≤ 148, and initial PaO2/FiO2 ≤ 100. An increase in the ROX Index at 24 h and slower disease progression were associated with successful treatment. These findings led to the developmet of an index to identify patients who benefit most from HFNC monotherapy., Conclusions: HFNC monotherapy can be effective for a specific profile of patients with Acute Hypoxemic Respiratory Failure due to COVID-19. This tool may help manage these patients more appropriately. Further studies are needed to determine if these findings can be applied to Acute Hypoxemic Respiratory Failure caused by other pathologies., Implications for Clinical Practice: This study underscores the importance of early identification and management of patients at risk of HFNC failure in intermediate respiratory care units. By recognizing factors such as age, comorbidities, and respiratory indices, healthcare providers can implement targeted strategies to enhance HFNC success. These strategies may include more stringent monitoring, tailored respiratory support, and timely escalation to more intensive therapies if needed. Our findings highlight the need for a comprehensive approach to managing severe respiratory failure in critical care settings, ultimately improving patient outcomes and reducing the burden on healthcare systems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

COVID-19 pandemic, caused by the novel SARS-CoV-2 virus, has raised significant interest in understanding potential cross-immunity mechanisms. Recent evidence suggests that T-cells associated with common cold coronaviruses (229E, NL63, OC43, HKU1) may provide some level of cross-immunity against SARS-CoV-2. It is also known that the prevalence of smokers among patients admitted to hospital for COVID-19 is lower than expected according to the corresponding country's smoking prevalence, which is known as smoker's paradox in COVID-19. No clear consensus to explain it has yet been reached. This phenomenon suggests a complex interaction between smoking and immune response. Nonetheless, very few works have studied the prevalence of smokers in those infected by common cold coronaviruses, and its relation to COVID-19 has not been investigated. We performed a systematic review and meta-analysis to study the prevalence of smokers among patients infected by common cold coronaviruses, and to compare them to the corresponding country's smoking prevalence. L'Abbé plots were used to visually assess the consistency of the observed effects across the different studies included in the meta-analysis. Additionally, significant differences were found in smoking prevalence among the various types of ccCoV, indicating the need for further research into the biological mechanisms driving these disparities. The results show that smoking prevalence is higher among those patients infected by these coronaviruses than in the general population (OR = 1.37, 95% CI: 0.81-2.33). A study was separately done for the four coronavirus types, and the prevalence of smokers was higher in three of the four than that corresponding to country, gender and study year: OC43 (OR = 1.93, 95% CI: 0.64-5.82); HKU1 (OR = 3.62, 95% CI: 1.21-10.85); NL63 (OR = 1.93, 95% CI: 0.64-5.82); 229E (OR = 0.97, 95% CI: 0.50-1.90). The heterogeneity of the studies was assessed using the Cochrane Chi-squared test, I-squared (I2), and Tau-squared (τ2). This detailed statistical analysis enhances the robustness of our findings and highlights the variations in smoking prevalence among different ccCoVs. Our data suggest that COVID-19 might be less prevalent among smokers due to greater cross-immunity from a larger number or more recent infections by common cold coronaviruses than the non-smoking population, which would explain smoker's paradox in COVID-19. IMPLICATIONS. The low prevalence of current smokers among SARS-CoV-2 patients is a finding recurrently repeated, even leading to postulate the "smoker's paradox" in COVID-19. This fact compelled us to study the prevalence of smokers among patients infected by common cold coronaviruses, and to compare them to the corresponding country's smoking prevalence. Our data could explain smoker's paradox in COVID-19 by a greater cross immunity due to a larger number, or more recent infections by common cold coronaviruses than the non-smoking population. This manuscript allow understand potential unrevealed mechanism for low prevalence of current smokers among SARS-CoV-2 patients., (© 2024. The Author(s).)

Introduction: Antimicrobial resistance is a major public health challenge recognised by the WHO as an urgent global healthcare concern. Patients in Intensive Care Units (ICUs) are particularly prone to colonisation and/or infection by multidrug-resistant organisms (MDROs)., Objectives: Delineate the epidemiological characteristics and risk factors for MDROs colonisation in mixed ICUs and Resuscitation Units by focusing on initial and nosocomial colonisation., Material and Methods: A descriptive observational study with analytical elements. It uses the Zero-Resistance register from the Preventive Medicine Service of the Albacete General University Hospital (Spain) from April 2016 to December 2021. It identifies the risk factors for MDROs colonisation., Results: Of 7,541 cases, 61.0 % with initial colonisation had risk factors for MDROs versus 34.0 % not colonised upon hospitalisation (p < 0.001). Significant risk factors for initial colonisation included hospitalisation for ≥ 5 days within the last 3 months, prior MDROs colonisation/infection and institutionalization. No significant risk factor differences were found for nosocomial colonisation. An association between longer ICU stays and nosocomial colonisation (p < 0.001) was noted., Conclusions: Significant risk factors for initial MDROs colonisation were hospitalisation for ≥ 5 days in the last 3 months, prior MDROs colonisation/infection and institutionalisation. Longer ICU stays increased the nosocomial colonisation risk., Implications for Clinical Practice: This study underscores the importance to early identify and manage patients at risk for MDROs colonisation in ICUs. By recognising factors (i.e. previous hospitalisations, existing colonisation or infection, impact of prolonged ICU stay), healthcare providers can implement targeted strategies to mitigate the spread of MDROs; e.g. enhanced surveillance, stringent infection control measures and judicious antibiotics use. Our findings highlight the need for a comprehensive approach to manage antimicrobial resistance in critical care settings to ultimately improve patient outcomes and reduce MDROs burden in hospitals., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: The functional-cognitive impact of first-episode psychosis (FEP) is extremely relevant and implies dysfunction from early life stages like adolescence and youth. Like other illnesses, FEP incidence is also influenced by environmental factors. It is necessary to attend to this age group with early interventions and to act on the environmental factors that the literature correlates with increased FEP incidence: socio-economic aspects, social adversity, bullying at school or cannabis use. In this context, identifying the areas of cities where FEP patients concentrate is important to perform early interventions. The spatial analysis of patient distribution in a whole city is one way to identify the most vulnerable areas and to propose psycho-social interventions for the possible prevention and/or early detection of FEP by improving urban mental health., Methods: An epidemiological study of point patterns to determine the areas of a city with a higher incidence of patients with FEP. To do so, the addresses of FEP cases were georeferenced from 1 January 2016 to 31 October 2022, and 109 FEP patients were analysed. Data from a random sample of 383 controls, comprising their addresses, age, and sex, were randomly obtained from the official city council database. By GIS, the areas with higher FEP incidence were analysed to see if they coincided with the zones where inhabitants with lower incomes lived., Results: The risk ratio of the FEP patients was compatible with the constant risk ratio in Albacete (p = 0.22). When performing the process separately with cases and controls only in men and women, the results were not significant for both distributions (p value: 0.12 and 0.57, respectively). Nonetheless, areas within the city had a significantly higher risk. These groups of cases coincided with those who had lower income and more inequality for women, but this pattern was not clear for men., Conclusions: Classifying city areas per income can help to determine the zones at higher risk of FEP, which would allow early healthcare and preventive measures for these zones., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Background: Chronic hepatitis B (HB) remains a significant global health concern, despite the widespread availability of the HB vaccine. While the standard vaccine demonstrates an impressive serological response rate exceeding 90%, a subset of individuals exhibit suboptimal immunity. This study aims to elucidate the efficacy of the AS04C-adjuvanted HB vaccine in addressing non-responsiveness., Methods: Conducted at the Preventive Medicine Service of the University Albacete Hospital in Spain from 2017 to 2021, this single-center observational study enrolled 195 patients. Among them, 126 (65%) were classified as non-responders following one or two complete standard vaccination courses., Results: After the administration of a complete four-dose regimen of the AS04C-adjuvanted vaccine, 73.81% of non-responder patients exhibited antibody titers indicative of robust immunity (anti-HBs >10)., Conclusions: These findings underscore the pivotal role of the AS04C-adjuvanted HB vaccine in addressing non-responsiveness, emphasizing its potential as a crucial tool in augmenting immunization strategies for various populations. This includes non-responders to standard vaccination, individuals with chronic kidney disease, those requiring seroprotection due to factors like immunosuppression or occupational hazards, as well as patients for whom conventional revaccination strategies have proven futile. Additional research is needed to expand on the promising results obtained through our protocol., (© The Author(s) 2023. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Introduction: The Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which caused the coronavirus disease 2019 (COVID-19) pandemic, enters the human body via the epithelial cells of the airway tract. To trap and eject pathogens, the airway epithelium is composed of ciliated and secretory cells that produce mucus which is expelled through a process called mucociliary clearance. Methods: This study examines the early stages of contact between SARS-CoV-2 particles and the respiratory epithelium, utilizing 3D airway tri-culture models exposed to ultraviolet light-irradiated virus particles. These cultures are composed of human endothelial cells and human tracheal mesenchymal cells in a fibrin hydrogel matrix covered by mucociliated human tracheal epithelial cells. Results: We found that SARS-CoV-2 particles trigger a significant increase in ciliation on the epithelial surface instructed through a differentiation of club cells and basal stem cells. The contact with SARS-CoV-2 particles also provoked a loss of cell-cell tight junctions and impaired the barrier integrity. Further immunofluorescence analyses revealed an increase in FOXJ1 expression and PAK1/2 phosphorylation associated with particle-induced ciliation. Discussion: An understanding of epithelial responses to virus particles may be instrumental to prevent or treat respiratory infectious diseases such as COVID-19., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Gonzalez-Rubio, Le-Trilling, Baumann, Cheremkhina, Kubiza, Luengen, Reuter, Taube, Ruetten, Duarte Campos, Cornelissen, Trilling and Thiebes.)

Introduction: Non invasive respiratory support (NIRS) is useful for treating acute respiratory distress syndrome (ARDS) secondary to COVID-19, mainly in mild-moderate stages. Although continuous positive airway pressure (CPAP) seems superior to other NIRS, prolonged periods of use and poor adaptation may contribute to its failure. The combination of CPAP sessions and high-flow nasal cannula (HFNC) breaks could improve comfort and keep respiratory mechanics stable without reducing the benefits of positive airway pressure (PAP). Our study aimed to determine if HFNC+CPAP initiates early lower mortality and endotracheal intubation (ETI) rates., Methods: Subjects were admitted to the intermediate respiratory care unit (IRCU) of a COVID-19 monographic hospital between January and September 2021. They were divided according to Early HFNC+CPAP (first 24h, EHC group) and Delayed HFNC+CPAP (after 24h, DHC group). Laboratory data, NIRS parameters, and the ETI and 30-day mortality rates were collected. A multivariate analysis was performed to identify the risk factors associated with these variables., Results: The median age of the 760 included patients was 57 (IQR 47-66), who were mostly male (66.1%). The median Charlson Comorbidity Index was 2 (IQR 1-3) and 46.8% were obese. The median PaO 2 /FiO 2 upon IRCU admission was 95 (IQR 76-126). The ETI rate in the EHC group was 34.5%, with 41.8% for the DHC group (p=0.045), while 30-day mortality was 8.2% and 15.5%, respectively (p=0.002)., Conclusions: Particularly in the first 24h after IRCU admission, the HFNC+CPAP combination was associated with a reduction in the 30-day mortality and ETI rates in patients with ARDS secondary to COVID-19., (Copyright © 2023. Published by Elsevier España, S.L.U.)

Patients suffering from irresectable tracheal stenosis often face limited treatment options associated with low quality of life. To date, an optimal tracheal replacement strategy does not exist. A tissue-engineered tracheal substitute promises to overcome limitations such as implant vascularization, functional mucociliary clearance and mechanical stability. In order to advance a tracheal mucosa model recently developed by our group, we examined different supporting cell types in fibrin-based tri-culture with primary human umbilical vein endothelial cells (HUVEC) and primary human respiratory epithelial cells (HRE). Bone marrow-derived mesenchymal stromal cells (BM-MSC), adipose-derived mesenchymal stromal cells (ASC) and human nasal fibroblasts (HNF) were compared regarding their ability to promote mucociliary differentiation and vascularization in vitro . Three-dimensional co-cultures of the supporting cell types with either HRE or HUVEC were used as controls. Mucociliary differentiation and formation of vascular-like structures were analyzed by scanning electron microscopy (SEM), periodic acid Schiff's reaction (PAS reaction), two-photon laser scanning microscopy (TPLSM) and immunohistochemistry. Cytokine levels of vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), interleukin-6 (IL6), interleukin-8 (IL8), angiopoietin 1, angiopoietin 2, fibroblast growth factor basic (FGF-b) and placenta growth factor (PIGF) in media supernatant were investigated using LEGENDplex™ bead-based immunoassay. Epithelial morphology of tri-cultures with BM-MSC most closely resembled native respiratory epithelium with respect to ciliation, mucus production as well as expression and localization of epithelial cell markers pan-cytokeratin, claudin-1, α-tubulin and mucin5AC. This was followed by tri-cultures with HNF, while ASC-supported tri-cultures lacked mucociliary differentiation. For all supporting cell types, a reduced ciliation was observed in tri-cultures compared to the corresponding co-cultures. Although formation of vascular-like structures was confirmed in all cultures, vascular networks in BM-MSC-tri-cultures were found to be more branched and extended. Concentrations of pro-angiogenic and inflammatory cytokines, in particular VEGF and angiopoietin 2, revealed to be reduced in tri-cultures compared to co-cultures. With these results, our study provides an important step towards a vascularized and ciliated tissue-engineered tracheal replacement. Additionally, our tri-culture model may in the future contribute to an improved understanding of cell-cell interactions in diseases associated with impaired mucosal function., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Luengen, Cheremkhina, Gonzalez-Rubio, Weckauf, Kniebs, Uebner, Buhl, Taube, Cornelissen, Schmitz-Rode, Jockenhoevel and Thiebes.)

Background: The main objective of the present study was to analyze both clinical characteristics and evolution during hospitalization of a cohort of patients admitted for COVID-19 pneumonia who were not vaccinated, or with a complete or incomplete vaccination schedule., Methods: This COVID-19 specialized single-center cohort study of 1888 COVID-19 patients hospitalized at the "Enfermera Isabel Zendal" Emergencies Hospital (HEEIZ), Madrid (Spain) was performed between July 1 and September 30, 2021. It compared the results of 1327 hospitalized unvaccinated patients to 209 hospitalized fully vaccinated and 352 hospitalized partially vaccinated patients. The four different COVID-19 vaccines authorized in Spain during the time-period studied were: BNT162b2 (Pfizer); ChAdOx1 nCoV-19 (AstraZeneca), mRNA-1273 (Moderna); Ad26.COV2.S (Janssen)., Findings: Hospitalized patients' median age was 41 years (IQR 33-50) for the unvaccinated and 61 years (IQR 53-67) for the fully vaccinated ones. The main comorbidities were obesity, hypertension and diabetes mellitus. 20% of unvaccinated patients (266) required noninvasive respiratory care, as did 14% (51) of partially and 14% (30) of fully vaccinated; 6% (78) of the unvaccinated patients also needed invasive respiratory care, as did 5% (16) of partially and 11 (5%) fully vaccinated., Interpretation: Fully vaccinated patients were 84% (95% CI: 82-86%) less likely to be admitted to hospital, and protection rose for those aged <50 years. Once hospitalized, vaccinated patients displayed more protection against requiring respiratory care than unvaccinated ones, despite being older and having more comorbidities. No differences appeared for the four studied COVID-19 vaccines and complying with vaccination recommendations proved relevant., Funding: The research was funded by the "Plan Propio de Investigación" Program of the Castilla-La Mancha University /European Regional Development Fund (2021-GRIN-31,039)., Competing Interests: Jose Rafael Teran-Tinedo declares a Madrid Society of Pneumology Young Researchers Grant 2020; funds from Air Liquide Healthcare for registration in the National Congress of the Spanish Society of Pneumology and Thoracic Surgery 2021; funds from Bial for registration in the European Respiratory Congress 2021. Miguel Lorente-González is a Secondary researcher in NEPTUNO clinical trial to evaluate utility of plitidepsin in COVID-19 patients. PharmaMar payments were made to all the researchers. He also declares payment from Gilead Sciences for a session at his hospital about the use of remdesivir in COVID-19. Pedro Landete declares support for educational activities from Linde Healthcare, Bial, Boehringer Ingelheim, Air Liquide, GSK, FAES Farma and Novartis; payment from PharmaMar for expert investigation support; payment from Boehringer Ingelheim for registration for congress, travel and hotel; is on the PharmaMar Advisory board; funding from Phillips/Cardiva formedical writing at his institution. All other authors have nothing to declare., (© 2022 The Authors.)

We live in a global pandemic caused by the COVID-19 disease where severe social distancing measures are necessary. Some of these measures have been taken into account by the administrative boundaries within cities (neighborhoods, postal districts, etc.). However, considering only administrative boundaries in decision making can prove imprecise, and could have consequences when it comes to taking effective measures. To solve the described problems, we present an epidemiological study that proposes using spatial point patterns to delimit spatial units of analysis based on the highest local incidence of hospitalisations instead of administrative limits during the first COVID-19 wave. For this purpose, the 579 addresses of the cases hospitalised between March 3 and April 6, 2020, in Albacete (Spain), and the addresses of the random sample of 383 controls from the Inhabitants Register of the city of Albacete, were georeferenced. The risk ratio in those hospitalised for COVID-19 was compatible with the constant risk ratio in Albacete (p = 0.49), but areas with a significantly higher risk were found and coincided with those with greater economic inequality (Gini Index). Moreover, two districts had areas with a significantly high incidence that were masked by others with a significantly low incidence. In conclusion, taking measures conditioned exclusively by administrative limits in a pandemic can cause problems caused by managing entire districts with lax measures despite having interior areas with high significant incidences. In a pandemic context, georeferencing disease cases in real time and spatially comparing them to updated random population controls to automatically and accurately detect areas with significant incidences are suggested. This would facilitate decision making, which must be fast and accurate in these situations., Competing Interests: Declaration of competing interest We have no conflicts of interest to disclose., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Regenerative therapies based on tissue engineering are becoming the most promising alternative for the treatment of osteoarthritis and rheumatoid arthritis. However, regeneration of full-thickness articular osteochondral defects that reproduces the complexity of native cartilage and osteochondral interface still remains challenging. Hence, in this work, we present the fabrication, physic-chemical characterization, and in vitro and in vivo evaluation of biomimetic hierarchical scaffolds that mimic both the spatial organization and composition of cartilage and the osteochondral interface. The scaffold is composed of a composite porous support obtained by cryopolymerization of poly(ethylene glycol) dimethacrylate (PEGDMA) in the presence of biodegradable poly(D,L-lactide- co -glycolide) (PLGA), bioactive tricalcium phosphate β-TCP and the bone promoting strontium folate (SrFO), with a gradient biomimetic photo-polymerized methacrylated hyaluronic acid (HAMA) based hydrogel containing the bioactive zinc folic acid derivative (ZnFO). Microscopical analysis of hierarchical scaffolds showed an open interconnected porous open microstructure and the in vitro behaviour results indicated high swelling capacity with a sustained degradation rate. In vitro release studies during 3 weeks indicated the sustained leaching of bioactive compounds, i.e., Sr 2+ , Zn 2+ and folic acid, within a biologically active range without negative effects on human osteoblast cells (hOBs) and human articular cartilage cells (hACs) cultures. In vitro co-cultures of hOBs and hACs revealed guided cell colonization and proliferation according to the matrix microstructure and composition. In vivo rabbit-condyle experiments in a critical-sized defect model showed the ability of the biomimetic scaffold to promote the regeneration of cartilage-like tissue over the scaffold and neoformation of osteochondral tissue.

In recent years, personal exposure to Radiofrequency Electromagnetic Fields (RF-EMF) has substantially increased, and most studies about RF-EMF with volunteers have been developed in Europe. To the best of our knowledge, this is the first study carried out in Mexico with personal exposimeters. The main objective was to measure personal exposure to RF-EMF from Wireless Fidelity or wireless Internet connection (Wi-Fi) frequency bands in Tamazunchale, San Luis Potosi, Mexico, to compare results with maximum levels permitted by international recommendations and to find if there are differences in the microenvironments subject to measurements. The study was conducted with 63 volunteers in different microenvironments: home, workplace, outside, schools, travel, and shopping. The mean minimum values registered were 146.5 μW/m 2 in travel from the Wi-Fi 2G band and 116.8 μW/m 2 at home from the Wi-Fi 5G band, and the maximum values registered were 499.7 μW/m 2 and 264.9 μW/m 2 at the workplace for the Wi-Fi 2G band and the Wi-Fi 5G band, respectively. In addition, by time period and type of day, minimum values were registered at nighttime, these values being 129.4 μW/m 2 and 93.9 μW/m 2 , and maximum values were registered in the daytime, these values being 303.1 μW/m 2 and 168.3 μW/m 2 for the Wi-Fi 2G and Wi-Fi 5G bands, respectively. In no case, values exceeded limits established by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). Of the study participants ( n = 63), a subgroup ( n = 35) answered a survey on risk perception. According to these results, the Tamazunchale (Mexico) population is worried about this situation in comparison with several European cities; however, the risk perception changes when they are informed about the results for the study.

SARS-CoV-2 is a new coronavirus that has caused a worldwide pandemic. It causes severe acute respiratory syndrome (COVID-19), which is fatal in many cases, and is characterized by a cytokine release syndrome (CRS). Great efforts are currently being made to block the signal transduction pathway of pro-inflammatory cytokines in order to control this "cytokine storm" and rescue severely affected patients. Consequently, possible treatments for cytokine-mediated hyperinflammation, preferably within approved safe therapies, are urgently being researched to reduce rising mortality. One approach to inhibit proinflammatory cytokine release is to activate the cholinergic anti-inflammatory pathway through nicotinic acetylcholine receptors (α7nAchR). Nicotine, an exogenous α7nAchR agonist, is clinically used in ulcerative colitis to counteract inflammation. We have found epidemiological evidence, based on recent clinical SARS-CoV-2 studies in China, that suggest that smokers are statistically less likely to be hospitalized. In conclusion, our hypothesis proposes that nicotine could constitute a novel potential CRS therapy in severe SARS-CoV-2 patients., (Copyright © 2020 Gonzalez-Rubio, Navarro-Lopez, Lopez-Najera, Lopez-Najera, Jimenez-Diaz, Navarro-Lopez and Najera.)

In the last two decades, due to the development of the information society, the massive increase in the use of information technologies, including the connection and communication of multiple electronic devices, highlighting Wi-Fi networks, as well as the emerging technological advances of 4G and 5G (new-generation mobile phones that will use 5G), have caused a significant increase in the personal exposure to Radiofrequency Electromagnetic Fields (RF-EMF), and as a consequence, increasing discussions about the possible adverse health effects. The main objective of this study was to measure the personal exposure to radiofrequency electromagnetic fields from the Wi-Fi in the university area of German Jordanian University (GJU) and prepare georeferenced maps of the registered intensity levels and to compare them with the basic international restrictions. Spot measurements were made outside the university area at German Jordanian University. Measurements were made in the whole university area and around two buildings. Two Satimo EME SPY 140 (Brest, France) personal exposimeters were used, and the measurements were performed in the morning and afternoon, and on weekends and weekdays. The total average personal exposure to RF-EMF from the Wi-Fi band registered in the three study areas and in the four days measured was 28.82 μW/m 2 . The average total exposure from the Wi-Fi band registered in the ten measured points of the university area of GJU was 22.97 μW/m 2 , the one registered in the eight measured points of building H was 34.48 μW/m 2 , and the one registered in the eight points of building C was 29.00 μW/m 2 . The maximum average values registered in the campus of GJU are below the guidelines allowed by International Commission on Non-ionizing Radiation Protection (ICNIRP). The measurement protocol used in this work has been applied in measurements already carried out in Spain and Mexico, and it is applicable in university areas of other countries.

Several studies have characterized personal exposure to RF-EMF, which allows possible effects on health to be studied. All equipment has a detection limit, below which we obtain nondetects or censored data. This problem is a challenge for researchers as it makes the analysis of such data complex. We suggest reconsidering the statistical protocols of the nondetects analysis by comparing four different methods. Three of them substitute censored data using different approaches: regression on order of statistics (ROS) to simulate data below the detection limit (Method 1), substituting nondetect values by the detection limit divided by 2 (Method 2), a naïve calculation (Method 3) using the detection limit as a valid measurement. The fourth method consists of considering censored data to be missing values (Method 4). This article examines how these methods affect the quantification of personal exposure. We considered data from 14 frequency bands from FM to WiMax measured in Albacete (Spain) for 76 days every 10 s by a personal exposimeter (PEM) Satimo EME Spy 140.Methods 3 and 2 gave similar mean and median values to Method 1, but both underestimated the mean values when high nondetects records occurred, which conditioned the physical description of the real situation. The mean values calculated by Method 4 differed from those obtained by Method 1 but were similar when the percentage of nondetects was below 20%.Our comparison suggests that nondetects can be neglected when the percentage of censored data is low to provide a more realistic physical situation.

Background: In recent years, radiofrequency electromagnetic fields (RF-EMF) exposure has increased owing to new communication technologies. Simultaneously, increased exposure to RF-EMF has led to society's growing concern about the possible effects they may have on human health. Many studies have described personal RF-EMF exposure by using personal exposimeters to know a population's daily exposure to mobile phone base stations and to other sources whose installations tend to be permanent. Nonetheless during special events like concerts or fairs, where many people gather, permanent installations might not suffice to cover demand. So telephone companies install temporary stations for these events, and modify the exposure pattern of these areas or populations., Objective: To study if installing temporary antennae for large events, and high concentrations of mobile phones, modify the exposure pattern compared to usual situations., Methods: Personal RF-EMF exposure from mobile phones (uplink) and mobile phone base stations (downlink) installed at the 2017 Albacete Fair (Spain) was recorded. Between 7 and 17 September, more than 2,500,000 people visited this Fair. Measurements were taken by two Satimo EME SPY 140 personal exposimeters, placed one each side of a research team member's waist. These exposimeters were programmed to take measurements every 4 s at different time of day; morning, afternoon and night; and in several places, around the Fair Enclosure (zones Ejidos and Paseo) and inside the enclosure (Interior). These measurements were repeated on a weekday, at the weekend and the day after the Fair ended after temporary base stations had been removed. They were also taken for 1 h in all three zones, for each time of day; that is, 9 h were recorded for each study day., Results: The mean RF-EMF recorded exposure from base stations (downlink-DL) on the days the Fair opened (morning, afternoon and night) for the three studied zones was 791.8 μW/m 2 , while the exposure produced by mobile phones (uplink-UL) was 59.0 μW/m 2 . These values were 391.2 μW/m 2 (DL) and 10.3 μW/m 2 (UL) a few days after the event ended. In study zones Ejidos and Paseo, both outside, the highest mean exposure was recorded at the weekend as 1494.1 and 848.1 μW/m 2 respectively. For the Interior zone, the mean value recorded during the Fair was 354.8 μW/m 2 . These values contrast with those recorded in the three zones after the event ended: 556.37 (Ejidos), 144.1 (Paseo); 473.21 μW/m 2 (Interior). The fact that the mean exposure recorded at Interior was slightly higher after the Fair could be due to signal shielding by so many people. The reduction in exposure in Paseo after the Fair was outstanding, probably due to the antennae being placed on low towers. Major differences were also found in the RF-EMF exposure from UL. In this case, the weekend values taken during the Fair were between 28.2 μW/m 2 at Interior (weekday) and 98.1 μW/m 2 at Ejidos (weekend), which dropped to 5.5 at Paseo after the Fair, to 11.7 μW/m 2 at Interior and to 13.6 μW/m 2 at Ejidos., Conclusions: Installing mobile phone base stations, and a dense public using mobile phones, imply a significant increase in personal RF-EMF exposure compared to that recorded during normal periods in the same area. However, the recorded measurements were below legally established limits., (Copyright © 2019 Elsevier Inc. All rights reserved.)

In the last decades, exposure to radiofrequency electromagnetic fields (RF-EMF) has substantially increased as new wireless technologies have been introduced. Society has become more concerned about the possible effects of RF-EMF on human health in parallel to the increase in their exposure. The appearance of personal exposimeters opens up wide-ranging research possibilities. Despite studies having characterised personal exposure to RF-EMF, part of the population is still worried, to the extent that psychogenic diseases ("nocebo" effect) appear, and patients suffer. It could be interesting to share personal exposure results with the population to better understand and promote public health. The main objective was to characterise personal exposure to environmental RF-EMF in Albacete (166,000 inhabitants, SE Spain), and assess the effect of sharing the results of the study on participants' risk perception. Measurements were taken by a personal Satimo EME SPY 140 exposimeter, which was programmed every 10 s for 24 h. To measure personal exposure to RF-EMF, we worked with 75 volunteers. Their personal exposure, 14 microenvironments in the city, e.g., home, outdoors, work, etc., and possible time differences were analysed. After participating in the study, 35 participants completed a questionnaire about their RF-EMF risk perception, which was also answered by a control sample to compare the results (N = 36). The total average exposure of 14 bands was 37.7 μW/m 2 , and individual ranges fell between 0.2 μW/m 2 , recorded in TV4&5, and a maximum of 264.7 μW/m 2 in DECT. For Friday, we recorded a mean of 53.9 μW/m 2 as opposed to 23.4 μW/m 2 obtained on Saturday. The recorded night-time value was 27.5 μW/m 2 versus 43.8 μW/m 2 recorded in the daytime. The mean personal exposure value also showed differences between weekdays and weekend days, with 39.7 μW/m 2 and 26.9 μW/m 2 , respectively. The main source that contributed to the mean total personal exposure was enhanced cordless telecommunications (DECT) with 50.2%, followed by mobile phones with 18.4% and mobile stations with 11.0% (GSM, DCS and UMTS), while WiFi signals gave 12.5%. In the analysed microenvironments, the mean exposure of homes and workplaces was 34.3 μW/m 2 and 55.2 μW/m 2 , respectively. Outdoors, the mean value was 34.2 μW/m 2 and the main sources were DECT, WiFi and mobile phone stations, depending on the place. The risk perception analysis found that 54% of the participants perceived that RF-EMF were less dangerous than before participating in the study, while 43% reported no change in their perceptions. Only 9% of the volunteers who received information about their measurements after the study assessed the possible RF-EMF risk with a value over or equal to 4 (on a scale from 1 to 5) versus 39% of the non-participant controls. We conclude that personal exposure to RF-EMF fell well below the limits recommended by ICNIRP and showed wide temporal and spatial variability. The main exposure sources were DECT, followed by mobile phones and WiFi. Sharing exposure results with participants lowered their risk perception., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objectives: Based on the criteria of a group of experts, this study aims to select a set of functional performance tests which can be applied to evaluate the functional status of a football player in the recovery process and make a decision in relation to their return to practice., Materials and Methods: A total of 16 experts were selected by the coordinator group to judge an initial list of functional performance tests and, thus, reach a consensus about the tests which are best suited to the needs of the injured player. Each of the experts had to evaluate each one of the tests in a scale from 1 to 5 in relation to their suitability. Delphi method was used to reach consensus in the expert group., Results: From the initial list of 25, the tests which obtained the best evaluation were: Counter movement jump (4.3±0.9), Single hop test (4.1±0.8), Triple hop test (4.1±0.9), Crossover hop test (4.1±0.7), Yo-Yo intermittent recovery (4.2±0.6), Barrow test (4.1±0.6), Shuttle run 8¥5 m (4.1±0.8). Star excursion balance test (4±0.7) and Y balance test (4.1±0.7)., Conclusion: In the opinion of the experts selected here, these tests are the ones which best respond to the needs involved in a complex decision such as RTP., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Simultaneously with the increase of Radiofrequency Electromagnetic Fields (RF-EMF) in recent decades, there has been increasing concern about their potential relation with the etiology of several tumors. At this time, the techniques of spatial data analysis jointly with the study of the personal exposure to these fields offer a new approach to the problem. This paper presents the results of a preliminary epidemiological study, combining Epidemiology, Statistics and Geographical Information Systems (GIS), in which we analyzed the correlation between exposure to RF-EMF in the city of Albacete (166,000 inhabitants, southeast Spain) and the incidence of several cancers with unspecific causes (lymphomas, and brain tumors). We used statistical tools to analyze the spatial point patterns and aggregate data with the aim to study the spatial randomness and to determine the zones with the highest incidence from 95 tumors studied (65 lymphomas, 12 gliomas and 18 meningiomas). We also perform a correlation (Spearman) study between the personal exposure to RF-EMF in 14 frequency bands, recorded by an EME Spy 140 (Satimo) exposimeter in the city's administrative regions, and the incidence of the tumors registered from January 2012 to May 2015. The studied cancer cases have a random spatial distribution inside the city. On the other hand, and by means of an ecological study, we verified that the exposure to RF-EMF registered in the city of Albacete shows little correlation with the incidence of the studied tumors (gliomas (ρ=0.15), meningiomas (ρ=0.19) and lymphomas (ρ=-0.03)). The proposed methodology inaugurates an unexplored analysis path in this field., (Copyright © 2017 Elsevier B.V. All rights reserved.)

In recent years, numerous epidemiological studies, which deal with the potential effects of mobile phone antennas on health, have almost exclusively focused on their distance to mobile phone base stations. Although it is known that this is not the best approach to the problem, this situation occurs due to the numerous difficulties when determining the personal exposure to the radiofrequency electromagnetic fields (RF-EMF). However, due to the rise of personal exposimeters, the evolution of spatial statistics, the development of geographical information systems and the use of powerful software, new alternatives are available to deal with these epidemiological studies and thus overcome the aforementioned difficulties. Using these tools, this paper presents a lattice map of personal RF-EMF exposure from exterior mobile phone base stations, covering the entire 110 administrative regions in the city of Albacete (Spain). For this purpose, we used a personal exposimeter, Satimo EME Spy 140 model, performing measurements every 4s The exposimeter was located inside the plastic basket of a bicycle, whose versatility permitted the access to all the zones of the city. Once the exposure map was prepared, its relation with the known antenna locations was studied. The 64 mobile telephone antennas of the city were also georeferenced; the randomness of both variables (exposure and antennas) were studied by means of the Moran's I test. Results showed that the distribution of the antennas follows a grouped pattern (p<0.001), while the distribution of the average exposure values have a random distribution (p=0.618). In addition, we showed two Spearman correlation studies: the first between the average exposure values and the number of mobile telephone antennas per administrative region, and the second, also considering the antennas of the neighbouring regions. No substantial correlation was detected in either of the two cases. This study also reveals the weaknesses of the epidemiological studies, which only take into account the distance to the antennas, which would provide a new approach to the problem. By precisely knowing the resident population of each administrative region of the city, this proves to be highly useful to rely on a prepared aggregate data map based on the mean exposure values to RF-EMF in these sections. The displayed map would permit the execution of more accurate epidemiological studies, since it would be possible to compare the exposure measurements with the incidence data of a disease., (Copyright © 2016 Elsevier Inc. All rights reserved.)