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Molecular imaging techniques based on hyperpolarisation-enhanced magnetic resonance (HP-MR) are revolutionising disease diagnoses. By measuring the chemical kinetics and pool sizes of specific biochemical compounds in vivo, these have the potential to detect small, yet significant differences between healthy and pathological cell metabolism in the imaging subject. In this chapter, fast-imaging strategies for spectral and spatially resolved HP-MR are reviewed. Presently there exist pulse sequences that can probe up to five spatiotemporal or frequency dimensions in vivo and can be tailored to the HP substrate and products to be measured, their SNR and resolution needed. We organize this review by discussing the current state of in vivo MR, including in vivo MR of hyperpolarised proton and carbon-13, as well as deuterium and nitrogen-15. Then, we discuss acquisition strategies for HP-MR in vivo and their limitations, including hardware and software capabilities of NMR spectroscopy/MRI detection systems, and other additional challenges of data sampling in living biological systems.

Las fibras de carbono y de vidrio que se encuentran en los residuos que se generan en los sectores industriales que fabrican o utilizan materiales compuestos reforzados con fibra pueden recuperarse a través del tratamiento térmico. Este tratamiento consiste en el calentamiento del material en atmósfera inerte (pirólisis) hasta la temperatura suficiente para que se descomponga la resina polimérica y la posterior oxidación de los productos carbonosos generados en esta descomposición en presencia de aire. El resultado de este tratamiento es la eliminación completa de la resina y la recuperación de las fibras, que mantienen buenas propiedades físico-químicas. En este trabajo se ha utilizado el diseño estadístico de experimentos para determinar la influencia que tienen las tres variables de operación principales involucradas en la recuperación de fibras por tratamiento térmico (temperatura de pirólisis, temperatura de oxidación y tiempo de oxidación) sobre el rendimiento de eliminación de resina polimérica. La estrategia experimental utilizada ha sido el diseño factorial completo 2k, donde k=3, las variables de operación estudiadas. El método se ha aplicado a residuos procedentes del sector eólico y del sector aeronáutico, tanto de piezas curadas como pre-pregs caducados, y reforzadas con fibra de carbono y fibra de vidrio. Con los resultados obtenidos en la experimentación con termobalanza se ha determinado la importancia relativa de las variables estudiadas para cada una de las muestras y se han definido las ecuaciones matemáticas que permiten predecir el rendimiento de eliminación de resina en función del valor que tomen estas variables.

Funding Acknowledgements Type of funding sources: None. Background Post-cardiac arrest myocardial dysfunction contributes to morbidity in survivors of cardiac arrest (CA) and, in case of refractory shock, some patients will benefit from aggressive mechanical support. In this scenario, a non-invasive, reliable and real-time estimation of potential neurological recovery is required to establish personalized treatment escalation plans. Methods We prospectively collected data of bispectral index (BIS) and suppression ratio (SR) monitoring of adult comatose survivors of CA consecutively admitted to an acute cardiac care unit and managed with targeted temperature management (TTM). Neurological status was assessed according to the Cerebral Performance Category (CPC) scale. Results We included 340 patients, 72.1% had an initial shockable rhythm, 72 (21.2%) were females and their mean age was 61.7 ± 14.3 years. Throughout 3-month follow-up, 210 patients (61.8%) achieved a CPC of 1-2 and 130 (38.2%) a CPC of 3-5. Mean BIS values were significantly higher and median SR lower in patients with CPC 1-2 (Figure 1). An average BIS value >26 during first 12 hours of TTM predicted good outcome with 89.3% sensitivity and 75.2% specificity (AUC of 0.86), while average SR values >24 during first 12 hours of TTM predicted poor outcome (CPC 3-5) with 83.6% of sensitivity and 91.8% of specificity (AUC of 0.92). Hourly BIS and SR values exhibited a good predictive performance (AUC > 0.85), starting as soon as hour 2 for SR and 4 for BIS. Conclusions BIS and SR real-time monitoring correlates with patient´s potential of neurological recovery after CA. This finding could help establish personalized treatment escalation plans that reduce consequences of inappropriate interventions, economic costs and uncertainty burden of the patient´s family.

Exploiting the labour of other people has historically been one of the main strategies to tackle the biophysical tension that always exists between the satisfaction of human needs and the labour required to fulfil them. Based on the insights of ecological, feminist, and Marxist economics, we disentangle the exploitation of the labour of women and labouring poor through a novel methodology that integrates energy, material, time, and cash balances. We apply it to the sociometabolic flows between household units endowed with different land and livestock resources in a traditional rural community in Catalonia (Spain) in the mid‐19th century. The results show that land and livestock hoarding led to a process of accumulation through dispossession that increased the exploitative relationships through the labour market, which in turn relied on the patriarchal division of labour between men and women at home. Our estimates of energy labour surplus reveal that male wages represented 88% of the equivalent consumption basket that would have been obtained by carrying out the same amount of labour on land of one's own. However, in the case of female wages, the percentage was 54%. This shows that wage labour incorporated a significant amount of unpaid domestic family labour.

Background Besides targeted temperature management (TTM), no other therapeutic strategy has shown to improve neurological outcome in cardiac arrest patients. Recently, it has been suggested that higher levels of mean arterial blood pressure (>90 mmHg) may have a protective neurological effect in this population, yet data is scarce. Objective To describe the association between neurological outcomes and MAP during TTM. Methods Retrospective study of a prospective database including survivors of a cardiac arrest undergoing TTM and admitted to the acute cardiac care of a tertiary university hospital from September 2007 to July 2020. MAP was recorded from arrival and hourly during TTM. Neurological outcome was graded 3 months after initial event using the Pittsburgh Cerebral Performance Category (CPC) scale and patients were divided classified as follows: Group A patients with CPC of 1 to 2 (good neurological outcome), and group B, with CPC 3 to 5 (poor neurological outcome or death). As CPC 5 comprises patients who have died but whose cause of death may not be related to their neurological condition, we sort to control this potential source of bias, by including a variable of “severe neurological injury”, which includes patients with CPC 3–4 and those CPC 5 who died due to WLST due to poor neurological prognosis/brain death. Results A total pf 431 patients were analysed. Baseline and cardiac arrest characteristics are depicted in Table 1. Patients in group B had a higher proportion of non-witnessed cardiac arrest, out-of-hospital cardiac arrest, non-shockable rhythm, and longer time before ROSC. The relation between MAP and neurological outcome is shown in Table 2. The were no differences of MAP in day 1 and 3 between groups. MAP was statistically higher in Group A during day 2 or rewarming phase. Mean MAP during day 1 and 2; and during day 1, 2 and 3 was also significantly higher in group A. However, when same analysis was performed under the variable “severe neurological injury” no statistically significant differences were observed. Conclusion There is no association between MAP and neurological outcomes, when true “severe neurological injury” is analysed. Therefore, and until further data is obtained, following actual practical guidelines or avoiding hypotension seems to be the goal in this population, as higher MAP may also have deleterious effects. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): University Hospital La Paz

onospheric scintillation consists on rapid fluctuations in the amplitude and phase of electromagnetic signals, which includes those of the Global Navigation Satellite System (GNSS), that can lead to cycle slips and even to a loss of lock on the receiver tracking. Hence, scintillation has become one of the major concerns in navigation and the detection and/or mitigation of its effects is one of the current challenges in achieving precise GNSS navigation. This study is focused in characterizing the ionospheric scintillation phenomenon mainly at high latitudes, although one mid-latitude and one low-latitude station have been included in order to compare the results obtained and to be able to correlate the Total Electron Content (TEC) fluctuations with phase scintillation at all latitudes. This characterization has been done based on the parameters σϕ, ROT IL1 and ROT ILGF , using a database of two years of data, 2014 and 2015, and dividing each of them into three different periods (January to April, May to August, and September to December) in order to better assess the levels of scintillation at each station of the year. Moreover, the results obtained using the signals from two different GNSS satellite constellations (GPS and GLONASS) have been studied and compared. The thresholds for moderate and intense scintillation have been computed from the Cumulative Distribution Functions (CDF) of each scintillation for each station, year, period of the year and GNSS satellite constellation using each parameter at 99% and 99.9% percentiles for moderate and intense levels of scintillation, respectively. Thus, using these thresholds and also using the 1-CDF plots, the seasonal evolution of parameters σϕ and ROT IL1 has been analyzed for different stations per constellation. Furthermore, the correlation between both ROT I parameters and σϕ has been assessed for each station, constellation, year and period of the year. It has been observed that these correlation indexes highly depend on the model of the receiver, location of the receiver and the type of constellation used, fact that will help to differentiate between the level of scintillation measured for different receivers per constellation. The scintillation phenomenon has been observed to depend on: the location of the receiver, period of the year, model of the receiver, GNSS satellite constellation, and obviously the ionosphere behaviour. Finally, the parameter ROT IL1 has been observed to perform better than ROT ILGF at high-latitude stations.

Background Cardiopulmonary resuscitation (CPR) Guidelines are updated every five years in the light of new evidence. Recent major changes emphasized the importance of quality chest compressions during CPR and simplified recommendations for lay providers, but it is unknown whether these changes improved neurological outcomes. Purpose To analyse whether changes in CPR guidelines had an impact on the prognosis of comatose survivors after cardiac arrest (CA). Methods Prospective database of consecutive patients (pts) admitted to the acute cardiac care unit of a tertiary hospital after in-hospital and out-of-hospital CA (IHCA and OHCA) treated with targeted temperature management (32–34°) from August 2006 to January 2020. Patients were divided into three groups, each one representing the 5-year time frame of publication/implementation of CPR Guidelines: G1 (2006–2010); G2 (2011–2015); G3 (2016–2020). Results A total of 510 pts were included: G1 94 (18.4%), G2 243 (47.6%), G3 173 (33.9%). Mean age was 62.6±14.5 and 413 (81.0%) were men. Demographic characteristics and cardiovascular risk factors did not differ significantly among groups. Changes in CA features among the three analysed periods are shown in Table 1. On regards of prehospital care, CPR provided by lay bystanders (G1 51.6%; G2 63.3%, G3 69.8%) and the use of automated external defibrillators (AED) (G1 11.0%; G2 14.9%; G3 18.9%) progressively increased (p=0.01 and p=0.04, respectively) (Figure 1, A and B). After 2010, there was a higher proportion of CPR-related injuries: G1 12.7%, G2 23.5%, G3 22.7% (p=0.02). Global survival at discharge was 51.6% (263/510). Cerebral Performance Category (CPC) of 1–2 within a 3-month follow-up period significantly increased over time when comparing G1, G2, G3 groups (p=0.04) (Figure 1, D). Among all pts, those with CPR related injuries had a higher proportion of CPC 1–2 (71/109, 65.1% vs 168/389, 43.2%, p Conclusions We found a progressive increase of lay bystander CPR and use of AED over the three time periods. Moreover, a higher proportion of CPR-related injuries was observed after publication of 2010 CPR Guidelines which recommended greater depth and higher rate of chest compressions. Survival and neurological outcomes improved significantly over time. Figure 1 Funding Acknowledgement Type of funding source: None

Background Previous parameters such as peak VO2, VE/VCO2 slope and OUES have been described to be prognostic in heart failure (HF). The aim of this study was to identify further prognostic factors of cardiopulmonary exercise testing (CPET) in HF patients. Methods A retrospective analysis of HF patients who underwent CPET from January to November 2019 in a single centre was performed. PETCO2 gradient was defined by the difference between final PETCO2 and baseline PETCO2. HF events were defined as decompensated HF requiring hospital admission or IV diuretics, or decompensated HF resulting in death. Results A total of 64 HF patients were assessed by CPET, HF events occurred in 8 (12.5%) patients. Baseline characteristics are shown in table 1. Patients having HF events had a negative PETCO2 gradient while patients not having events showed a positive PETCO2 gradient (−1.5 [IQR −4.8, 2.3] vs 3 [IQR 1, 5] mmHg; p=0.004). A multivariate Cox proportional-hazards regression analysis revealed that PETCO2 gradient was an independent predictor of HF events (HR 0.74, 95% CI [0.61–0.89]; p=0.002). Kaplan-Meier curves showed a significantly higher incidence of HF events in patients having negative gradients, p=0.002 (figure 1). Conclusion PETCO2 gradient was demonstrated to be a prognostic parameter of CPET in HF patients in our study. Patients having negative gradients had worse outcomes by having more HF events. Time to first event, decompensated heart Funding Acknowledgement Type of funding source: None

Background Cardiopulmonary resuscitation (CPR) manoeuvres involve vigorous compressions with the proper depth and rate in order to keep sufficient perfusion to organs, especially the brain. Accordingly, high incidences of CPR-related injuries (CPR-RI) have been observed in survivors after cardiac arrest (CA). Purpose To analyse whether CPR-related injuries have an impact on the survival and neurological outcomes of comatose survivors after CA. Methods Observational prospective database of consecutive patients (pts) admitted to the acute cardiac care unit of a tertiary university hospital after in-hospital and out-of-hospital CA (IHCA and OHCA) treated with targeted temperature management (TTM 32–34°) from August 2006 to December 2019. CPR-RI were diagnosed by reviewing medical records and analysing image studies during hospitalization. Results A total of 498 pts were included; mean age was 62.7±14.5 years and 393 (78.9%) were men. We found a total of 145 CPR-RI in 109 (21.9%) pts: 79 rib fractures, 20 sternal fractures, 5 hepatic, 5 gastrointestinal, 3 spleen, 1 kidney, 26 lung and 6 heart injuries. Demographic characteristics and cardiovascular risk factors did not differ between the non-CPR-RI group and CPR-RI group. Also, we did not find differences in CA features (Table 1). Survival at discharge was higher in the CPR-RI group [74 (67.8%) vs 188 (48.3%); p Conclusions In our cohort, the presence of CPR-RI was associated with higher survival at discharge and better neurological outcomes during follow-up. Figure 1 Funding Acknowledgement Type of funding source: None