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Background: The 2016 cumulative incidence of Clostridioides difficile infection (CDI) in Spain was reported by the European Center for Disease Control to be above the mean of other European countries. The aim of this multicenter prospective observational cohort study was to examine the risk factors that determine 90-day CDI recurrence in Catalonia, Spain. Methods: The study included 558 consecutive adults admitted to hospital who had a symptomatic, first positive CDI diagnosis. Sociodemographic, clinical and epidemiological variables were recorded. The primary outcome was 90-day CDI recurrence. Results: In this Catalan population, having received more than one course of antibiotics in the 30 days prior to CDI diagnosis (odds ratio: 2.459; 95% CI: 1.195–5.060; p = 0.015) and active chemotherapy (odds ratio: 4.859; 95% CI: 1.495–15.792; p = 0.009) are significant predictors of 90-day CDI recurrence. Conclusion: The identification of independent risk factors of 90-day CDI recurrence will enable the optimization of preventive measures in at-risk populations.

The Copernicus Sentinel-6 mission was planned to keep studying the sea-surface height and ocean state measurements and since April 2022 its first satellite, the Sentinel-6 Michael Freilich (S6MF), has become the current reference altimetry mission.One of the key design aspects of the S6MF altimeter is the “interleaved” chronogram pattern, which increases the number of received pulses, reducing the ambiguities in the along-track dimension, and increasing the energy obtained from the surface. Thanks to the continuous surface illumination, the echoes from the same target can be coherently integrated making a significant improvement in the along-track resolution leading to more detailed understanding of the ocean, the polar zones and inland and coastal waters dynamics. Measurement parameters such as swell state, lead and iceberg detection or inland water level changes can take advantage of these advances.Nowadays, unfocused azimuth steering methods, such as Delay Doppler, provide along-track resolutions around 300 meters. However Fully-Focused SAR (FF-SAR) algorithms can improve it to the order of sub-meter. In 2017, Alejandro Egido and Walter H.F. Smith published the FF-SAR method description, based on the backprojection approach. Compared to the unfocused steering, it requires more computational time, making it difficult to be implemented operationally, keeping the data generation rate in the same order of magnitude as the unfocused chain products. In 2018, Pietro Guccione et. al. published the FF-SAR 2D Frequency Domain algorithm, based on the Omega-K (WK) algorithm from SAR radar. In this paper, it is shown that the two dimensional frequency domain can be used to decrease the number of operations needed to focus the data, under some circumstances that depend on the type of orbit and the emitted signal. FF-SAR WK algorithm achieves similar results in terms of along-track resolution for the CryoSat-2 mission, but notably improving the computational efficiency. Although Omega-K algorithm intrinsic assumptions can impact negatively in the accuracy estimation of parameters such as the sea surface height, there are applications like sea ice related activities that could benefit of faster execution times. In this presentation, an adapted and redesigned Omega-K algorithm for Sentinel-6 is presented. FF-SAR Omega-K and Backprojection have been used to process Sentinel-6 data over the Crete transponder, evidencing that both FF-SAR methods are capable to achieve the expected theoretical along-track resolution. Moreover, open ocean data from Sentinel-6 has been processed for both algorithms and results have been compared.

BACKGROUND Invasive pneumococcal disease (IPD) is the most important bacterial infection in young children, and the introduction of pneumococcal conjugate vaccines has changed its presentation. This study compared the incidence, characteristics and serotype distribution of IPD before and after the introduction of the pneumococcal conjugate vaccine (PCV13). METHODS Prospective enrolment of patients with IPD aged less than 60 months and admitted to either of 2 tertiary care hospitals between January 2007 and December 2009 (pre-PCV13 period) and January 2012 and June-2016 (PCV13 period). RESULTS We identified 493 cases, 319 in the pre-PCV13 period and 174 in the PCV13 period. The incidence of IPD decreased from 89.7 to 34.4 casos per 100 000 habitantes ( -62%; P

Background. Antimicrobial resistance killed 1.27 million people in 2019, so urgent actions are desperately needed. Antimicrobial stewardship programmes (ASPs) are essential to optimize antimicrobial use. The objective was to acknowledge the current role of clinical pharmacists engaged in ASP activities in Catalonia. Methods. This was a cross-sectional survey shared through the Catalan Infection Control Programme (VINCat). The survey consisted of four sections and was sent by e-mail. Results. A total of 69.0% of the centres answered. Pharmacists dedicated a median of 5.0 h per week (2.1 h/week/100 acute care beds), representing 0.15 full time equivalents. The ASP lacked information technology (IT) support, as only 16.3% of centres automatically calculated defined daily doses and days of therapy. Those with less than 15% of their time available for ASPs conducted fewer clinical activities, especially prospective audits and feedback. Those without official infectious diseases training also performed fewer clinical activities, but training was less determinant than IT support or time. Pharmacists performed interventions mostly through annotation in the medical records. Conclusions. Clinical pharmacists from Catalonia dedicated to ASPs present an important lack of time and IT support to perform clinical activities. Pharmacists should also improve their clinical skills and try to conduct clinical advice to prescribers, either by phone or face-to-face.

Background Cancer has been associated with an increased risk of in-hospital mortality in CDI patients. However, data on delayed mortality in cancer patients with CDI are scarce. Aim/Objective The aim of the present study was to compare outcomes between oncological patients and the general population with Clostridioides difficile infection (CDI) after 90 days of follow-up. Methods A multicenter prospective cohort study was conducted in 28 hospitals participating in the VINCat program. Cases were all consecutive adult patients who met the case definition of CDI. Sociodemographic, clinical, and epidemiological variables and evolution at discharge and after 90 days were recorded for each case. Findings/results The mortality rate was higher in oncological patients (OR = 1.70, 95% CI: 1.08–2.67). In addition, oncological patients receiving chemotherapy (CT) presented higher recurrence rates (18.5% vs 9.8%, p = 0.049). Among oncological patients treated with metronidazole, those with active CT showed a higher rate of recurrence (35.3% vs 8.0% p = 0.04). Discussion Oncological patients presented a higher risk of poor outcomes after CDI. Their early and late mortality rates were higher than in the general population, and in parallel, those undergoing chemotherapy (especially those receiving metronidazole) had higher rates of recurrence

Objective After the introduction of 13-valent pneumococcal conjugate vaccine (PCV13), a decrease of serotype-3 invasive pneumococcal disease (IPD) has not been homogenously observed around Europe. The aim of the study is to analyze the incidence of serotype-3 IPD in our area (Catalonia, Spain) and describe what microbiological and clinical characteristics distinguish serotype-3 IPD from nonserotype-3 IPD. Methods This study is a prospective observational study performed in three hospitals of Barcelona (Spain), from January 2012 to June 2016. Patients younger than 18 years with a diagnosis of IPD were included. Epidemiological, clinical, and microbiological data were collected. Results A total of 253 cases of IPD were included; of these, 53 were caused by serotype 3. The incidence rate of serotype-3 IPD remained stable over the study years (risk ratio [RR] = 0.64; 95% confidence interval [CI]: 0.3–1.38). In 92.5% (49/53) of the cases of serotype-3 IPD, the diagnosis was pneumonia and 89.8% (44/49) of them reported a complicated pneumonia. Also, 98.1% (52/53) were detected by positive real-time polymerase chain reaction (PCR) in blood or pleural effusion. Seventeen patients were properly vaccinated with PCV13 before the infection. Conclusion After the introduction of PCV13 a global decline of invasive pneumococcal disease has been reported, specially, due to a decrease of serotypes 1 and 19A cases. Serotype-3 Streptococcus pneumoniae IPD remained stable throughout the years of study, being currently the main serotype causing IPD in our area. Serotype 3 causes mostly pneumonia and physicians must be aware of possible complications. Real-time PCR have a significantly higher diagnostic yield for serotype 3 compared with culture. Some vaccination failures were observed.

Lead-free PEA2SnI4-based perovskite LEDs are successfully inkjet-printed on rigid and flexible substrates. Red-emitting devices (λmax = 633 nm) exhibit, under ambient conditions, a maximum external quantum efficiency (EQEmax) of 1% with a related brightness of 30 cd/m2 at 10 mA/cm2. This work was made possible by the Horizon 2020 research and innovation program through the DROP-IT project (Grant Agreement No. 862656) and MSCA Innovative Training Network (Grant Agreement No. 764787), the Ministry of Science and Innovation of Spain under Project STABLE PID2019-107314RB-I00 and the European Research Council (ERC) via Consolidator Grant (724424-No-LIMIT). The authors wish to acknowledge the financial support from MINECO (Spain) for Grant PID2019-105658RB-I00 (PRITES Project).

Background: The impact of antimicrobials generic entry (GE) is controversial. Their introduction could provide an economic benefit yet may also increase their consumption, leading to a higher risk of resistance. Our aim was to analyze the impact of GE on trends of antimicrobial consumption in an acute-care hospital. Methods: A retrospective quasi-experimental interrupted time series analysis was conducted at a 400-bed tertiary hospital in Barcelona, Spain. All antimicrobials for systemic use for which a generic product entered the hospital from January 2000 to December 2019 were included. Antimicrobial consumption was expressed as DDD/100 bed days. Results: After GE, the consumption of cefotaxime (0.09, p &lt, 0.001), meropenem (0.54, p &lt, 0.001), and piperacillin-tazobactam (0.13, p &lt, 0.001) increased, whereas the use of clindamycin (−0.03, p &lt, 0.001) and itraconazole (−0.02, p = 0.01) was reduced. An alarming rise in cefepime (0.004), daptomycin (1.02), and cloxacillin (0.05) prescriptions was observed, despite not achieving statistical significance. On the contrary, the use of amoxicillin (−0.07), ampicillin (−0.02), cefixime (−0.06), fluconazole (−0.13), imipenem–cilastatin (−0.50) and levofloxacin (−0.35) decreased. These effects were noticed beyond the first year post GE. Conclusions: GE led to an increase in the consumption of broad-spectrum molecules. The potential economic benefit of generic antibiotics could be diluted by an increase in resistance. Antimicrobial stewardship should continue to monitor these molecules despite GE.

International audience; (Tb, Eu)–co-doped ZnO films with about 3 at.% total doping rate were grown by magnetron sputtering on Si substrate. Post annealing treatments were performed at 973–1373 K in continuous nitrogen flow to investigate the transformation of microstructural and optical characteristics by means of X-ray diffraction, transmission electron microscopy, photoluminescence and electroluminescence. For annealing temperatures lower than 1073 K, segregation of Eu and Tb was observed mainly at the film/substrate junction. For temperatures higher than 1173 K, additional phases appeared, namely, Zn2SiO4 and rare earth silicates. For the highest temperature investigated (1373 K), only silica and rare earth silicates remained in the film due to Zn evaporation. PL measurements indicated a very intense Eu emission associated with the presence of rare earth silicate inclusions. Energy transfer from Tb towards Eu was evidenced in this secondary phase. At last, based on these preliminary works, a (Tb, Eu)–co-doped ZnO/Si electroluminescent structure was produced and showed very promising results paving the way for very thin ZnO based light emitting diodes.

In this work we present the results obtained on the simulation and nanofabrication of photonic crystals based on silicon nanopillars. The simulations show the formation of photonic band gaps within 1.31 and 1.89μm, with a gap-to-midgap ratio approaching 40%. The introduction of waveguides and cavities prove the adaptability of these structures to tune the wavelengths allowed to be transmitted through the system within the photonic band gaps. On the other hand, thanks to the use of advanced nanofabrication techniques, the modelled structures have been successfully fabricated.

Background: Invasive meningococcal disease (IMD) is an urgent notifiable disease and its early notification is essential to prevent cases. The objective of the study was to assess the sensitivity of two independent surveillance systems, the statutory disease reporting system (SDR) and the microbiological reporting system (MRS), and to estimate the incidence of IMD.Methods: The study was performed in Catalonia, Spain, between 2011 and 2015. The variables collected were age, sex, year of report, size of municipality (< 10,000 and ≥ 10,000), clinical form, death, serogroup, country of birth and type of reporting centre (private and public). The capture-recapture analysis and 95% confidence intervals were calculated using the Chapman formula. Multinomial logistic regression was performed for adjusted estimation.Results: The sensitivity of the two combined surveillance systems was 88.5% (85.0-92.0). SDR had greater sensitivity than the MRS (67.9%; 62.7-73.1 vs. 64.7%; 59.4-70.0). In 2014-2015, the sensitivity of both systems was higher (80.6%; 73.2–87.9 vs. 73.4%; 65.2–81.6) than in 2011-2013 (59.3%; 52.6–66.0 vs. 58.3%; 51.6–65.1). In private centres, the sensitivity was higher for SDR than for MRS (100%; 100–100 vs. 4.8%; -4.4–13.9). The adjusted estimate of cases was lower than that obtained using the Chapman formula (279; 266–296 vs. 313; 295–330). The estimated adjusted incidence of IMD was 0.7/100,000 persons-year.Conclusions: The sensitivity of enhanced surveillance through the combination of two complementary sources was higher than for the sources individually. Factors associated with under-reporting in different systems should be analysed to improve IMD surveillance.

AIM The aim was to analyze the epidemiological, microbiological and clinical characteristics of patients with complicated pneumococcal pneumonia with pleural effusion (PE) or empyema. METHOD Prospective study in three Catalan hospitals in persons aged

BACKGROUND We studied the impact of 13-valent pneumococcal conjugate vaccine (PCV13) on the incidence of invasive pneumococcal disease (IPD) and serotype distribution in a region with intermediate levels of vaccination (around 64% in children aged

Rhenium disulfide (ReS2), known in nature as the mineral rheniite, is a very interesting compound owing to its remarkable fundamental properties and great potential to develop novel device applications. Here we perform density functional theory (DFT) calculations to investigate the structural properties and compression behavior of this compound and also of the (Re,Mo)S-2 solid solution as a function of Re/Mo content. Our theoretical analysis is complemented with high-pressure X-ray diffraction (XRD) measurements, which have allowed us to reevaluate the phase transition pressure and equation of state of 1T-ReS2. We have observed the 1T-to-1T' phase transition at pressures as low as similar to 2 GPa, and we have obtained an experimental bulk modulus, B-0, equal to 46(2) GPa. This value is in good agreement with PBE+D3 calculations, thus confirming the ability of this functional to model the compression behavior of layered transition metal dichalcogenides, provided that van der Waals corrections are taken into account. Our experimental data and analysis confirm the important role played by van der Waals effects in the high-pressure properties of 1T-ReS2., J.I. and C.P. acknowledge the Spanish Ministry of Science, Innovation and Universities via Grant FIS2017-2017-83295-P. T.W. acknowledges financial support from Polish Ministry of Science and Higher Education via Diamond Grant no. D\2015 002645.

Introducción: La enfermedad neumocócica invasiva (ENI) es la infección bacteriana más relevante en niños pequeños y la introducción de las vacunas antineumocócicas conjugadas (VNC) ha cambiado su presentación clínica. En este estudio se analizaron los cambios en la incidencia, características clínicas y distribución de serotipos en los casos de ENI antes y después de la disponibilidad de la VNC13. Métodos: Se incluyeron prospectivamente pacientes con ENI menores de 60 meses ingresados en 2 hospitales pediátricos terciarios desde enero de 2007 a diciembre de 2009 (período pre-VNC13) y de enero de 2012 a junio de 2016 (período VNC13). Resultados: Se identificaron 493 casos, 319 en el período pre-VNC13 y 174 en el período VNC13. La incidencia de ENI disminuyó de 89,7 a 34,4 casos por 100.000 habitantes (−62%, p < 0,001). Esta disminución de la incidencia se dio por igual en todas las presentaciones clínicas de la enfermedad excepto en la neumonía necrotizante (aumentó de 0,8 a 3,7 casos por 100.000 habitantes). Todos los serotipos incluidos en la VNC13 pero no incluidos en la VNC7 disminuyeron significativamente. No se encontraron diferencias significativas en la estancia hospitalaria, muerte y/o secuelas entre ambos períodos, aunque durante el período VNC13, los pacientes requirieron más días en la unidad de cuidados intensivos pediátricos y de ventilación mecánica (p = 0,00). La incidencia del serotipo 3 disminuyó de 10,4 a 6,9 casos por 100.000 habitantes, aunque fue el serotipo más frecuente en los pacientes con un cuadro clínico grave. Conclusiones: Luego de la introducción de la VNC13 se ha producido una disminución significativa de los casos de ENI. El serotipo 3 sigue siendo una causa importante de casos graves de ENI. Background: Invasive pneumococcal disease (IPD) is the most important bacterial infection in young children, and the introduction of pneumococcal conjugate vaccines has changed its presentation. This study compared the incidence, characteristics and serotype distribution of IPD before and after the introduction of the pneumococcal conjugate vaccine (PCV13). Methods: Prospective enrolment of patients with IPD aged less than 60 months and admitted to either of 2 tertiary care hospitals between January 2007 and December 2009 (pre-PCV13 period) and January 2012 and June-2016 (PCV13 period). Results: We identified 493 cases, 319 in the pre-PCV13 period and 174 in the PCV13 period. The incidence of IPD decreased from 89.7 to 34.4 cases per 100,000 population (−62%; P < .001). This decrease was observed in all forms of disease except necrotising pneumonia (increase from 0.8 to 3.7 cases/100,000 population). There was a significant reduction in all serotypes included in the PCV13 and not included in the PCV7. We did not find significant differences in length of stay, mortality or the frequency of sequelae between both periods, but in the PCV13 period, the length of stay in the paediatric intensive care unit and the duration of mechanical ventilation were longer (P = .00). The incidence of serotype 3 decreased from 10.4 to 6.9 cases per 100,000 population, although it was the serotype involved most frequently in patients with severe disease. Conclusions: After the introduction of the PCV13, there has been a significant decrease in IPD cases. Serotype 3 continues to be an important cause of severe IPD. info:eu-repo/semantics/publishedVersion

Volume 57, no. 8, e00363-19, 2019, [https://doi.org/10.1128/JCM.00363-19][1]. This article was published on 26 July 2019 with the title “Invasive Pneumococcal Disease and Influenza Activity in a Pediatric Population: Impact of PCV13 Vaccination in Pandemic and Nonpandemic Influenza Periods.” The

By using ZnO thin films doped with Ce, Tb or Eu, deposited via radiofrequency magnetron sputtering, we have developed monochromatic (blue, green and red, respectively) light emitting devices (LEDs). The rare earth ions introduced with doping rates lower than 2% exhibit narrow and intense emission peaks due to electronic transitions in relaxation processes induced after electrical excitation. This study proves zinc oxide to be a good host for these elements, its high conductivity and optical transparency in the visible range being as well exploited as top transparent electrode. After structural characterization of the different doped layers, a device structure with intense electroluminescence is presented, modeled, and electrically and optically characterized. The different emission spectra obtained are compared in a chromatic diagram, providing a reference for future works with similar devices. The results hereby presented demonstrate three operating monochromatic LEDs, as well as a combination of the three species into another one, with a simply-designed structure compatible with current Si technology and demonstrating an integrated red-green-blue emission.

Resumen La infeccion causada por el nuevo coronavirus SARS-CoV-2 (COVID-19) representa actualmente una de las mayores emergencias sanitarias a nivel mundial. La aparicion de una nueva infeccion potencialmente grave y la situacion de pandemia actual ha implicado importantes ajustes en la practica clinica en medicina materno-fetal. Aunque no parece existir una mayor afectacion o susceptibilidad al virus de las mujeres embarazadas respecto la poblacion general, existen aspectos especificos ligados a la gestacion que deben tenerse en cuenta de cara al diagnostico y manejo de la COVID-19 en pacientes embarazadas. En el siguiente documento se exponen las recomendaciones y el protocolo de actuacion ante la infeccion por COVID-19 durante el embarazo desarrollado en nuestro centro, basado en la evidencia cientifica disponible hasta la fecha y las principales recomendaciones internacionales.

Vaccination with the 13-valent conjugated pneumococcal disease (PCV13) has reduced invasive pneumococcal disease (IPD), but there have been reports of vaccine failures. We performed a prospective study in children aged 2-59 months who received diagnoses of IPD during January 2012-June 2016 in 3 pediatric hospitals in Catalonia, Spain, a region with a PCV13 vaccination coverage of 63%. We analyzed patients who had been age-appropriately vaccinated but who developed IPD caused by PCV13 serotypes. We detected 24 vaccine failure cases. The serotypes involved were 3 (16 cases); 19A (5 cases); and 1, 6B, and 14 (1 case each). Cases were associated with children without underlying conditions, with complicated pneumonia (OR 6.65, 95% CI 1.91-23.21), and with diagnosis by PCR (OR 5.18, 95% CI 1.84-14.59). Vaccination coverage should be increased to reduce the circulation of vaccine serotypes. Continuous surveillance of cases of IPD using both culture and PCR to characterize vaccine failures is necessary.

Some studies have observed an increased incidence of necrotizing pneumonia (NP) in recent years. This might be related to the emergence of non-vaccine S. pneumoniae serotypes after PCV7 introduction although it is suggested that evolutionary factors may have modified the virulence and the interactions of pneumococci. The aim of this study was to clinically and microbiologically define NP in the population served by the three major paediatric hospitals in Barcelona (Catalonia, Spain).A prospective observational study was conducted in patients18 years hospitalized due to invasive pneumococcal disease (January 2012-June 2016). Data of confirmed cases of pneumococcal NP (diagnosed by culture or DNA detection and serotyped) were collected. PCV13 was not systematically administered in Catalonia during the study period, but was available in the private market so the vaccination coverage in children increased from 48.2% to 74.5%.35 cases of NP were identified. 77.1% of cases were associated with empyema. In the first 4 years, a trend to a decrease in NP incidence was observed (p=0.021), especially in children5 years (p=0.006). Serotype 3 was responsible for 48.6% of NP cases. Five patients with NP due to serotype 3 were fully vaccinated for their age with PCV13.Serotype 3 has a preeminent role in pneumococcal NP and was associated with all PCV13 vaccination failures. Although in our series the incidence does not seem to be increasing, evolution of pneumococcal NP rates should be monitored after inclusion of PCV13 in the systematic calendar.