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ABSTRACT The daily values of UVB irradiation (290-315 nm), IUVB, and the broadband total irradiation (300-2800 nm), IT, measured on a horizontal plane have been correlated for the period 2000-2008 at 16 measurement sites in Spain. The results have been compared with the daily experimental values registered at the same sites during the period 2009-2011. The coefficients of determination R2 obtained by applying a linear regression are higher than 0.88 for all sites and increase to 0.94 when using a quadratic regression. When all data are considered together, the values of R2 are 0.91 and 0.97 for the linear and quadratic regressions, respectively. Three different clearness indices, which are dimensionless parameters, have been also used in order to reduce the uncertainties of the estimations and to reduce the local nature of the coefficients: (1) the UVB clearness index, kTUVB = IUVB/ I0UVB; (2) the modified UVB clearness index, k′TUVB and (3) the estimated UVB clearness index, k*TUVB. The results show a strong dependence on the solar zenith angle. The bi-dimensional regression of kTUVB as a function of the solar zenith angle and the clearness index, kT, substantially improves the correlation, with R2 values higher than 0.81 for all sites. Finally, a formula relating kTUVB and kT, valid for latitudes between 36°N and 44°N, has been obtained: kTUVB = 0.064 kT - 0.0011 θz - 1.24 E-05 ϕ + 7.6 E-05 λ + 0.063, where θz represents the solar zenith angle (in degrees), ϕ is the latitude (in degrees) of the site and λ is the distance to the sea (in km). We have compared the experimental values for the period 2009-2011 with those estimated using this expression. For this, the coefficient of determination (R2) is 0.87, with a MBD of -3.4%, a RMSE of 21% and a NRMSE of 8.7%. [ABSTRACT FROM AUTHOR]

The most intense wildfire experienced in Eastern Spain since 2004 happened in Valencia during summer 2012. Although the fire was mostly active during days 29-30 June, a longer temporal period (from 24 June to 4 July) was selected for this analysis. Column-integrated, vertical resolved and surface aerosol observations were performed continuously at the Burjassot station throughout the studied period. The aerosol optical depth at 500nm shows values larger than 2 for the most intense part of the wildfire and an extremely high maximum of 8 was detected on 29 June. The simultaneous increase of the Ångström exponent was also observed, indicating the important contribution of small particles in the smoke plume. An extraordinary increase in the particle concentration near the ground was observed and hence the measured scattering coefficient was drastically enhanced. The scattering coefficient and the PM2.5 level maxima reached the unusually high values of 2100Mm-1 and 160 µgm-3, respectively. These records represent an enhancement factor of 26 and 7 with respect to the climatological averages found in this station during June and July. The surface maxima were observed with 1-day lag from the maximum AOD, and this fact is linked with the mixing layer amplitude and the sedimentation of smoke particles. The aerosol microphysical parameters and optical properties were determined for the whole period by combination of an inversion procedure and the Mie Theory. The smoke particles enhanced drastically the volume concentration of the fine mode with a maximum of 0.4 µm³ µm-2, which is 10 times higher than the climatological summer background in this site. The simultaneous presence of dust and smoke particles at different altitudes was observed and hence the coarse mode was also significant during the most intense period of the wildfire episode. Therefore the aerosol single scattering albedo and the asymmetry parameter obtained during the smoke cases display high variability which is partially modulated by the volume of coarse particles. The smoke episode highly contributed to increase the load of particles remaining in the atmosphere after the event, especially in the fine mode, although similar aerosol microphysical and optical properties were observed before and after the event. In addition, the particle concentration observed at surface level due to the wildfire episode largely contributes to exceed the EU annual limits for the particulate matter in the studied region. [ABSTRACT FROM AUTHOR]

The solar background illumination has a strong effect on CALIOP (Cloud-Aerosol Lidar with Orthogonal Polarization) measurements, leading to a decrease in the signal-to-noise ratio of the lidar signal. Because of this, CALIOP level 2 data algorithms might be limited in the retrieval of the properties of the aerosols in the atmosphere. In this work, we present a methodology that combines CALIOP level 1 data with AERONET (Aerosol RObotic NETwork) measurements to retrieve aerosol extinction profiles and li-dar ratios in daytime conditions. In this way, we fulfill a two-fold objective: first, we obtain more accurate daytime aerosol information; second, we supplement column integrated measurements from AERONET sun photometers with information about the vertical distribution of aerosols. The methodology has been applied to Burjassot (39.30° N, 0.25° W) and Barcelona (41.39° N, 2.11° E) AERONET stations in the Mediterranean coast of Spain in the period from June 2006 to September 2011. We have found good agreement for the extinction profiles in several study cases of ground lidar measurements in Barcelona, coincident with CALIOP overpasses. Finally, the methodology has proved to be useful for the study of special episodes such as Saharan dust outbreaks [ABSTRACT FROM AUTHOR]

The article presents a study to test the operational procedure of Microtops II ozone monitor measurements and its reliability of total ozone determination in extended time intervals. The testing take into account the data quality by the signal postprocessing to acquire practical indications useful for the community of Microptops II. Results of the study show that the measurements does not depend on latitude and season.

Rationale: The use of psychotropic drugs in the paediatric population has not been the subject of many studies, due to the fact that this population is generally not included in clinical trials and these drugs are not authorized for use on minors., Objectives: This study aims to provide an accurate description of psychotropic drug use in children and adolescents in the North of Europe and Catalonia., Methods: Data from 2008 to 2017 on psychotropic drug consumption in children and adolescents were retrieved from the databases of Catalonia, Denmark, Norway and Sweden. Psychotropic drugs were divided into antipsychotics, anxiolytics (also hypnotics and sedatives), antidepressants and psychostimulants. Data were stratified by group of age (0-4, 5-9, 10-14 and 15-19/15-17 for Denmark and Catalonia) and sex., Results: Overall, the group of anxiolytics shows the highest consumption and the group of antipsychotics the lowest. In 2017, Sweden was the country with the highest consumption of psychotropic drugs (6.67‰) and has the highest increase in consumption (152.8%), and Denmark has the lowest consumption for all groups (3.13‰). Catalonia shows a decrease in psychotropic drugs (-15.9%). Girls consume more than twice as many antidepressants as boys while the opposite is true for psychostimulants. Risperidone and quetiapine are among the most consumed antipsychotics in the Nordic countries, whereas in Catalonia they are risperidone and aripiprazole. Among antidepressants, sertraline is the most consumed. No differences are found among the psychostimulants., Conclusions: Psychotropic consumption in younger populations is increasing, although there are differences between the countries as far as which drugs are used. Nordic countries show a higher prevalence of use than Catalonia. Psychotropic drug consumption increases with age, except for psychostimulants, which have the highest utilization rate among 10-14-year-olds.

Purpose: The purpose of this study was to characterize the profile of patients with non-valvular atrial fibrillation who start an anticoagulant treatment after diagnosis with dabigatran and compare it with those who start with vitamin K antagonists (VKAs)., Methods: We analysed primary health care-based electronic health records data from 15,075 people with new diagnosis of atrial fibrillation who initiated treatment with dabigatran or VKA spanning 2011-2013. Logistic regression analysis for determination of factors associated with initiation of dabigatran was performed., Results: We identified 14,266 (94.6%) people who initiated VKA and 809 (5.4%) who initiated dabigatran. Mean age of people treated with dabigatran was lower than in VKA patients (73.7 vs 75.5 years, p < 0.001). People (90.5%) in VKA group and 83.6% in the dabigatran group had a high risk of stroke, according to CHA 2 DS 2 VASc score. There was higher proportion of people with hypertension, diabetes mellitus, dyslipidaemia, and chronic kidney disease among people treated with VKA. The proportion of people with a history of cerebral haemorrhage and stroke was higher among dabigatran patients compared with VKA patients (1.4 vs 0.6%, p = 0.015 and 14.0% vs 10.8%, p = 0.006, respectively). Multivariable logistic model showed that treatment with dabigatran was associated with male sex, history of stroke and Mortalidad en áreas pequeñas Españolas y Desigualdades Socioeconómicas index., Conclusions: Most patients recently diagnosed with non-valvular atrial fibrillation initiated treatment with VKA. Primary healthcare patients with non-valvular atrial fibrillation initiating dabigatran are younger, had a lower risk of stroke or bleeding, fewer comorbidity and more history of stroke and intracranial haemorrhage compared to those who were initiated on VKA.

Objective: Many people with diabetes often reuse disposable needles for subcutaneous insulin injection. We aimed to identify, critically appraise and summarize the available evidence about the safety of this practice., Design: Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement., Data Sources: MEDLINE (via PubMed), CINALH (via EBSCO), SCOPUS, Web of Science, Cochrane Central Register of Controlled Trials and Open Grey were searched from their inception to December 2015, with no language restrictions., Review Methods: Epidemiologic and experimental studies assessing adverse effects of reusing needles in people of any age or sex, with or without diabetes, were included. Two reviewers independently assessed the methodological quality of included studies using a multi-design tool., Results: In total, 25 studies were included. All studies had a high risk of bias and data from only nine studies could be pooled. Five studies showed no association between infection at site of injection and reuse of needles (risk difference=-0.00; 95% confidence interval=-0.12-0.11; P=0.99); heterogeneity between these studies was substantial (I(2)=66%; P=0.02). Five cross-sectional studies showed an association between lipohypertrophy and needle reuse (risk difference=0.16, 95% confidence interval=0.05-0.28, P=0.006); there was strong evidence of heterogeneity between these studies (I(2)=87%; P<0.001). Pooled data of two studies with no evidence of heterogeneity between them showed more perceived pain among reusers (risk difference=0.24; 95% confidence interval=0.06-0.43; P=0.006). Reusing a pen needle or disposable syringe-needle was not associated with worse glycaemic control., Conclusions: There is currently no clear scientific evidence to suggest for or against the reuse of needles for subcutaneous insulin injection. This practice is very common among people with diabetes; consequently, further research is necessary to establish its safety., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: Paracetamol's solubility is achieved by adding to the excipient sodium salts, either as bicarbonate, carbonate or citrate. As the relationship between salt and hypertension is well known, due to the sodium content it has raised a hypothesis that may interfere with the control of that risk factor. Therefore, the objective of this study is to evaluate the effect on blood pressure of effervescent paracetamol compared to non-effervescent, in hypertensive patients., Methods/design: This is the protocol of a phase IV multicenter clinical trial, randomized, controlled, crossover, open, which will compare the effect of two different formulations of paracetamol (effervescent or non-effervescent) in the blood pressure of hypertensive patients, with a seven weeks follow up. 49 controlled hypertensive patients will be included (clinical BP lower than 150 and 95 mmHg, and lower than 135 mmHg and 85 mmHg in patients with diabetes or a history of cardiovascular event, and daytime ambulatory measurements lower than 140 and 90 mmHg) and mild to moderate pain (Visual Analog Scale between 1 and 4). The study was approved by the ethics committee of the Fundació Jordi Gol i Gurina and following standards of good clinical practice. The primary endpoint will be the variations in systolic BP in 24 h Ambulatory Blood Pressure Monitoring, considering significant differences 2 or more mmHg among those treated with non-effervescent and effervescent formulations. Intention-to-treat and per-protocol analysis will be held., Discussion: Despite the broad recommendation not to use effervescent drugs in patients with hypertension, there are relatively little studies that show exactly this pressor effect due to sodium in salt that gives the effervescence of the product. This is the first clinical trial designed to study the effect of effervescence compared to the non-effervescent, in well-controlled hypertensive patients with mild to moderate pain, performed in routine clinical practice., Trial Registration: NCT 02514538.

Measurements of broadband UVB irradiance (290-315 nm) at 14 locations in Spain for the period 2000-2009 have been used to generate instantaneous, hourly and daily values of irradiance (W m(-2)) and radiant exposure (kJ m(-2)). These measurements, and its statistical indices, have been analyzed. For the UVB irradiance, the values corresponding to July (maximum) and December (minimum) have been analyzed as representative of the year during the whole period for all locations. For the UVB radiant exposure, the temporal evolution of daily values has been evaluated for all locations to estimate an average yearly behavior. The accumulated radiant exposure for an average year has also been studied for each location. Finally, to determine possible trends in the evolution of the UVB levels, the linear regressions for the mean daily values for all locations have been determined., (© 2012 Wiley Periodicals, Inc. Photochemistry and Photobiology © 2012 The American Society of Photobiology.)

Chlorophyll a fluorescence can be used as an early stress indicator. Fluorescence is also connected to photosynthesis so it can be proposed for global monitoring of vegetation status from a satellite platform. Nevertheless, the correct interpretation of fluorescence requires accurate physical models. The spectral shape of the leaf fluorescence free of any re-absorption effect plays a key role in the models and is difficult to measure. We present a vegetation fluorescence emission spectrum free of re-absorption based on a combination of measurements and modelling. The suggested spectrum takes into account the photosystem I and II spectra and their relative contribution to fluorescence. This emission spectrum is applicable to describe vegetation fluorescence in biospectroscopy and remote sensing.

Objective: The aim of this study was to evaluate the efficacy of treatment of asthmatic children by inhalation., Patients and Methods: Two hundred twenty-seven young patients have taken part in a practical inquiry regarding the handling of their inhalation device and showing how they attained the appropriate dosage of medicine by using either the direct pressurized aerosol, the dry powder device or pressurized aerosol in an expansion chamber. Five different steps have been observed in the handling of the above mentioned devices. After assembling the data, a profile has been compiled (through absolute and relative frequencies and a 95% confidence interval) and a logistic regression multivariant analysis., Results: Correct handling was observed in 37.2% of the children who used the dry powder device, 51.2% in the children who used the direct pressurized aerosol and 58.6% of those who used the expansion chamber aerosol. The influence of the duration of the treatment plus the age of the patient was also taken into consideration., Conclusions: From this study it follows that the direct pressurized aerosol treatment and the dry powder device are incorrectly handled by a high percentage of children and this problem gets worse as the age of the patient increases. In contrast, the proportion of children who use correctly the expansion chamber aerosol is highest and remains similar for all age groups. Misusage increases when the explanation of the treatment is provided by the parents and also when the treatment occurs for a period greater than 22 months without reminding the patient of the correct usage of the apparatus.