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Abstract Background The incidence of frailty and non-healing wounds increases with patients’ age. Knowledge of the relationship between frailty and wound healing progress is greatly lacking. Methods The aim of this study is to characterize the degree of frailty in elderly patients attending a multidisciplinary wound care centres (MWCC). Additionally, we seek to assess the impact of frailty on the wound healing rate and wound healing time. An open cohort study was conducted on 51 consecutive patients aged > 70 years treated for wounds at an MWCC of an intermediate care hospital. The frailty score was determined according to the Frail-VIG index. Data were collected through patient questionnaires at the beginning of the study, and at 6 months or upon wound healing. Wounds were followed up every 2 weeks. To analyse the relationship between two variables was used the Chi-square test and Student’s or the ANOVA model. The t-test for paired data was used to analyse the evolution of the frailty index during follow-up. Results A total of 51 consecutive patients were included (aged 81.1 ± 6.1 years). Frailty prevalence was 74.5% according to the Frail-VIG index (47.1% mildly frail, 19.6% moderately frail, and 7.8% severely frail). Wounds healed in 69.6% of cases at 6 months. The frailty index (FI) was higher in patients with non-healing wounds in comparison with patients with healing wounds (IF 0.31 ± 0.15 vs IF 0.24 ± 0.11, p = 0.043). A strong correlation between FI and wound healing results was observed in patients with non-venous ulcers (FI 0.37 ± 0.13 vs FI 0.27 ± 0.10, p = 0.015). However, no correlation was observed in patients with venous ulcers (FI 0.17 ± 0.09 vs FI 0.19 ± 0.09, p = 0.637). Wound healing rate is statically significantly higher in non-frail patients (8.9% wound reduction/day, P25-P75 3.34–18.3%/day;AQ6 p = 0.044) in comparison with frail patients (3.26% wound reduction/day, P25-P75 0.8–8.8%/day). Conclusion Frailty is prevalent in elderly patients treated at an MWCC. Frailty degree is correlated with wound healing results and wound healing time.

The cooling water of nuclear power plants and discarded crayfish shells (CS), both containing Sr(II), are waste resources that cause environmental pollution and endanger human health. In this study, magnetic biochar produced by crayfish shells (mag@CSBC) was used as an adsorbent to remove radionuclide Sr(II) in an aqueous solution and under irradiation conditions. Scanning electron microscopy, X-ray diffraction analysis, Fourier-transform infrared spectroscopy and vibration sample magnetometer analysis were used to characterize mag@CSBC. In addition, an isothermal adsorption experiment conducted under irradiation conditions determined that the maximum adsorption capacity of mag@CSBC was 21.902 mg/g, which was 1.896 mg/g higher than that from experiments conducted under conditions without irradiation and more suitable for the Freundlich isotherm model. The kinetic experiment proved that irradiation could improve the adsorption cap acity of mag@CSBC and reduce the adsorption equilibrium time. At the same time, the experiment further proved that, under irradiated conditions, the adsorption rate of mag@CSBC can reach more than 90%, and the adsorption capacity is the highest when the pH is 8 and the reaction process is exothermic. Competitive adsorption with Na(I) has a high selectivity and strong recyclability. Finally, the mechanism of Sr(II) adsorption by mag@CSBC under irradiation was studied. In conclusion, mag@CSBC, as a low-cost, easy-to-synthesize, environmentally friendly and easy-to-recycle adsorbent, can be applied in batches for the removal of Sr(II) in aqueous solutions. In particular, the concept of using irradiation technology to optimize adsorption behavior serves as an inspiration for future research.

Environmental and economic costs demand a rapid transition to more sustainable farming systems, which are still heavily dependent on chemicals for crop protection. Despite their widespread application, powdery mildew (PM) and downy mildew (DM) continue to generate serious economic penalties for grape and wine production. To reduce these losses and minimize environmental impacts, it is important to predict infections with high confidence and accuracy, allowing timely and efficient intervention. This review provides an appraisal of the predictive tools for PM and DM in a vineyard, a specialized farming system characterized by high crop protection cost and increasing adoption of precision agriculture techniques. Different methodological approaches, from traditional mechanistic or statistic models to machine and deep learning, are outlined with their main features, potential, and constraints. Our analysis indicated that strategies are being continuously developed to achieve the required goals of ease of monitoring and timely prediction of diseases. We also discuss that scientific and technological advances (e.g., in weather data, omics, digital solutions, sensing devices, data science) still need to be fully harnessed, not only for modelling plant–pathogen interaction but also to develop novel, integrated, and robust predictive systems and related applied technologies. We conclude by identifying key challenges and perspectives for predictive modelling of phytopathogenic disease in vineyards.

Deep learning architectures for the classification of images have shown outstanding results in a variety of disciplines, including dermatology. The expectations generated by deep learning for, e.g., image-based diagnosis have created the need for non-experts to become familiar with the working principles of these algorithms. In our opinion, getting hands-on experience with these tools through a simplified but accurate model can facilitate their understanding in an intuitive way. The visualization of the results of the operations performed by deep learning algorithms on dermatological images can help students to grasp concepts like convolution, even without an advanced mathematical background. In addition, the possibility to tune hyperparameters and even to tweak computer code further empower the reach of an intuitive comprehension of these processes, without requiring advanced computational and theoretical skills. This is nowadays possible thanks to recent advances that have helped to lower technical and technological barriers associated with the use of these tools, making them accessible to a broader community. Therefore, we propose a hands-on pedagogical activity that dissects the procedures to train a convolutional neural network on a dataset containing images of skin lesions associated with different skin cancer categories. The activity is available open-source and its execution does not require the installation of software. We further provide a step-by-step description of the algorithm and of its functions, following the development of the building blocks of the computer code, guiding the reader through the execution of a realistic example, including the visualization and the evaluation of the results.

RESUMEN Introducción: A partir de las necesidades de enfermería es posible realizar el trabajo comunitario con pautas a seguir de manera organizada, teniendo en cuenta que estén vinculadas con la promoción de salud. Objetivo: Diseñar una guía de prácticas para Enfermería en la atención al cuidador de pacientes con demencia. Métodos: Investigación de desarrollo tecnológico, se trabajó con un universo de 80 cuidadores principales y cinco enfermeras del departamento de Salud Mental del municipio de Marianao, La Habana, en el período del 2016-2017, se utilizaron como técnicas la revisión documental, encuestas, la escala de Zarit y consulta a expertos. Resultados: Los cuidadores fueron mayoritariamente los hijos, del sexo femenino, amas de casas, con nivel de escolaridad universitario y todos habían experimentado ansiedad y depresión. Las tres primeras necesidades humanas de enfermería afectadas fueron: la comunicación, el autocuidado, el sueño y el descanso, más de la mitad presentaron sobrecarga intensa. Se identificó que el personal de enfermería requiere conocimientos para la atención al cuidador, lo que justificó la elaboración de la guía. Conclusiones: Se reconoció una sobrecarga intensa y necesidades de enfermería afectadas descritas por Virginia Henderson en los cuidadores principales, lo que permite realizar acciones de promoción de salud y prevención de enfermedades a través de la guía de prácticas para enfermería, que se sometió a validación por expertos.

Esta contribución analiza el juego de la ignorancia de la ley y del error de hecho y de derecho en materia de acciones colectivas en el ámbito del Derecho del consumo. Esencialmente, el Derecho de consumo está diseñado para proteger los derechos e intereses de la parte débil, o lo que es lo mismo, para la protección de los consumidores y usuarios. Sin embargo, cuando tal protección se canaliza a través de la interposición de las correspondientes acciones colectivas a iniciativa de asociaciones de consumidores y usuarios (art. 11 de la Ley de Enjuiciamiento Civil), el fragmentado marco jurídico español, tanto a nivel procesal como sustantivo, puede conducir a supuestos en los que incluso los derechos fundamentales de los consumidores —a la tutela judicial efectiva— a título individual, puedan ser vulnerados por la aplicación de los efectos de la cosa juzgada o de la excepción de litispendencia

In this work, carbon dots (CD) were synthesized and coupled to titanium dioxide (TiO2) to improve the photodegradation of antibiotics in aquaculture effluents under solar irradiation. Oxolinic acid (OXA) and sulfadiazine (SDZ), which are widely used in aquaculture, were used as target antibiotics. To prepare nanocomposites of CD containing TiO2, two modes were used: in-situ (CD@TiO2) and ex-situ (CD/TiO2). For CD synthesis, citric acid and glycerol were used, while for TiO2 synthesis, titanium butoxide was the precursor. In ultrapure water (UW), CD@TiO2 and CD/TiO2 showed the largest photocatalytic effect for SDZ and OXA, respectively. Compared with their absence, the presence of CD@TiO2 increased the photodegradation of SDZ from 23 to 97% (after 4 h irradiation), whereas CD/TiO2 increased the OXA photodegradation from 22 to 59% (after 1 h irradiation). Meanwhile, in synthetic sea salts (SSS, 30‰, simulating marine aquaculture effluents), CD@TiO2 allowed for the reduction of SDZ’s half-life time (t1/2) from 14.5 ± 0.7 h (in absence of photocatalyst) to 0.38 ± 0.04 h. Concerning OXA in SSS, the t1/2 remained the same either in the absence of a photocatalyst or in the presence of CD/TiO2 (3.5 ± 0.3 h and 3.9 ± 0.4 h, respectively). Overall, this study provided novel perspectives on the use of eco-friendly CD-TiO2 nanocomposites for the removal of antibiotics from aquaculture effluents using solar radiation.

The potential of using anaerobic digestion for the treatment of poultry blood has been evaluated in batch assays at the laboratory scale and in a mesophilic semi-continuous reactor. The biodegradability test performed on residual poultry blood was carried out in spite of high inhibitory levels of acid intermediaries. The use of activated carbon as a way to prevent inhibitory conditions demonstrated the feasibility of attaining anaerobic digestion under extreme ammonium and acid conditions. Batch assays with higher carbon content presented higher methane production rates, although the difference in the final cumulative biogas production was not as sharp. The digestion of residual blood was also studied under semi-continuous operation using granular and powdered activated carbon. The average specific methane production was 216 ± 12 mL CH4/g VS. This result was obtained in spite of a strong volatile fatty acid (VFA) accumulation, reaching values around 6 g/L, along with high ammonium concentrations (in the range of 6–8 g/L). The use of powdered activated carbon resulted in a better assimilation of C3-C5 acid forms, indicating that an enhancement in syntrophic metabolism may have taken place. Thermal analysis and scanning electron microscopy (SEM) were applied as analytical tools for measuring the presence of organic material in the final digestate and evidencing modifications on the carbon surface. The addition of activated carbon for the digestion of residual blood highly improved the digestion process. The adsorption capacity of ammonium, the protection this carrier may offer by limiting mass transfer of toxic compounds, and its capacity to act as a conductive material may explain the successful digestion of residual blood as the sole substrate.

Presentamos la primera experiencia en Uruguay de una biopsia endobiliar con pinza por acceso percutáneo que realizáramos en una paciente con estenosis biliar hiliar de probable causa neoplásica. Hasta nuestro conocimiento, no existen reportes de esta técnica en Uruguay. La difusión de la disponibilidad de esta técnica en nuestro medio es de gran importancia, ya que permite al equipo médico tratante disponer de una nueva herramienta para el manejo diagnóstico de las estenosis biliares.

Aquacultures are a sector facing a huge development: farmers usually applying antibiotics to treat and/or prevent diseases. Consequently, effluents from aquaculture represent a source of antibiotics for receiving waters, where they pose a potential threat due to antimicrobial resistance (AMR) induction. This has recently become a major concern and it is expectable that regulations on antibiotics’ discharge will be established in the near future. Therefore, it is urgent to develop treatments for their removal from wastewater. Among the different possibilities, photodegradation under solar radiation may be a sustainable option. Thus, this review aims at providing a survey on photolysis and photocatalysis in view of their application for the degradation of antibiotics from aquaculture wastewater. Experimental facts, factors affecting antibiotics’ removal and employed photocatalysts were hereby addressed. Moreover, gaps in this research area, as well as future challenges, were identified.

In view of a simple after-use separation, the potentiality of producing magnetic activated carbon (MAC) by intercalation of ferromagnetic metal oxide nanoparticles in the framework of a powder activated carbon (PAC) produced from primary paper sludge was explored in this work. The synthesis conditions to produce cost effective and efficient MACs for the adsorptive removal of pharmaceuticals (amoxicillin, carbamazepine, and diclofenac) from aqueous media were evaluated. For this purpose, a fractional factorial design (FFD) was applied to assess the effect of the most significant variables (Fe3+ to Fe2+ salts ratio, PAC to iron salts ratio, temperature, and pH), on the following responses concerning the resulting MACs: Specific surface area (SBET), saturation magnetization (Ms), and adsorption percentage of amoxicillin, carbamazepine, and diclofenac. The statistical analysis revealed that the PAC to iron salts mass ratio was the main factor affecting the considered responses. A quadratic linear regression model A = f(SBET, Ms) was adjusted to the FFD data, allowing to differentiate four of the eighteen MACs produced. These MACs were distinguished by being easily recovered from aqueous phase using a permanent magnet (Ms of 22–27 emu g−1), and their high SBET (741–795 m2 g−1) were responsible for individual adsorption percentages ranging between 61% and 84% using small MAC doses (35 mg L−1).

In this work, thermogravimetric analysis (TGA), differential thermogravimetry (DTG), and differential scanning calorimetric (DSC) were used to assess the combustion of microalgae biomass, a bituminous coal, and their blend. Furthermore, different correlations were tested for estimating the high heating value of microalgae biomass and coal, with both materials possessing similar values. TGA evidenced differences between the combustion of the studied fuels, but no relevant interaction occurred during their co-combustion, as shown by the DTG and DSC curves. These curves also indicated that the combustion of the blend mostly resembled that of coal in terms of weight loss and heat release. Moreover, non-isothermal kinetic analysis revealed that the apparent activation energies corresponding to the combustion of the blend and coal were quite close. Overall, the obtained results indicated that co-combustion with coal might be a feasible waste to energy management option for the valorization of microalgae biomass resulting from wastewater treatment.

Being mercury one of the most toxic heavy metals present in the environment, it is of major concern to develop cleanup technologies to remove it from wastewater and recover mercury polluted ecosystems. In this context, we study the potential of some microporous titanosilicates and zirconosilicates for taking up Hg2+ from aqueous solutions. These materials have unique chemical and physical properties, and here we are able to confirm that they readily remove Hg2+ from aqueous solutions. Moreover, the presence of the competitive Mg2+ and Na+, which are some of the dominant cations in natural waters, does not reduce the uptake capacity of some of these materials. Thus, several inorganic materials reported here may have important environmental applications, efficiently removing Hg2+ from aqueous solutions.

El linfoma tiroideo es una patología infrecuente, cuya presentación clínica recuerda a la de los carcinomas indiferenciados de dicha glándula. Son particularmente respondedores a la poliquimioterapia, quedando reservada la cirugía a la biopsia y decompresión de urgencia de la vía aérea. Se presentan cinco casos asistidos en el Hospital Maciel, en el período comprendido entre 1996 y 2001.

The first two Uruguayan cases of botryomycosis were diagnosed in white adult male patients with cutaneous lesions. Staphylococcus aureus was the etiologic agent in both cases. In one of them, however, Pseudomonas aeruginosa was also identified during relapse. General comments on diagnosis and pathogenesis of the disease are made.Apresentamos os dois primeiros doentes de Botriomicose tegumentar no Uruguai. Ambos doentes eram adultos do sexo masculino. Um tinha lesão isolada abscedida. No outro as lesões eram múltiplas e algumas fistulizadas. Em ambos doentes o agente etiológico isolado foi Staphylococcus aureus. No primeiro doente, além disso, foi isolado Pseudomonas aeruginosa na recidiva. Comentários gerais são feitos sobre o diagnóstico e patogenia da doença.

Los autores analizan el caso clínico de una paciente afecta de una enfermedad de Van Recklinghausen, con una obstrucción neoplásica asintomática de la vía biliar principal (VBP). Esta se presentó como un tumor del hepatocolédoco encontrado en el curso de una colecistectomía de urgencia.

Introducción y Objetivos. La radioterapia conlleva la aparición de complicaciones cutáneas que afectan a la calidad de vida del paciente y en algunos casos condicionan la reconstrucción. El plasma rico en plaquetas (PRP) es una terapia emergente; se trata de una sustancia autóloga, biocompatible, segura y económica. Está descrito su uso en disminución de la inflamación local, de los tiempos de curación de las heridas, en el tratamiento de lesiones por radioterapia y últimamente en el campo de la Medicina Estética mejorando la calidad de la piel. Nuestro estudio analiza el uso del PRP en la profilaxis de las lesiones cutáneas inducidas por radioterapia evaluando un modelo experimental. Material y Método. Realizamos un ensayo clínico controlado, doble ciego, en animales: 12 ratas Wistar, 2 para la obtención del PRP y 10 para el análisis clínico e histológico. Resultados. Del análisis clínico destacamos que de los sectores sin PRP previo a la radioterapia: 8 ratas presentaron alopecia y 7 hipopigmentación. La alopecia fue total en un 60%, parcial en 20% y un 20% no presentó alopecia. En los sectores con PRP: 4 presentaron alopecia y 3 hipopigmentación. La alopecia fue parcial en un 40%, un 60% no presentó alopecia y no hubo casos de alopecia total. Los resultados del análisis histológico demostraron un 100% de atrofia leve-moderada para los sectores con PRP. Por contrapartida, los sectores sin PRP presentaron 80% de atrofia moderada-severa y un 20% de atrofia leve-moderada. Conclusiones. Existe un beneficio en el uso del PRP como profilaxis de la alopecia (p < 0.05) e hipopigmentación (p < 0.1) inducido por radioterapia en un modelo experimental.