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This note explores the influence of environmental effects, as those induced by cyclic changes in relative humidity, on the degradation of the shear strength parameters in Lilla claystone, a low-porosity clayey rock from northern Spain. The results of a comprehensive experimental programme, combining long-term relative humidity cycling tests with saturated direct shear tests, are described. A continuous monitoring of the evolution of volumetric strain during the previous relative humidity cycling is used to evaluate the swelling behaviour of the rock. Both undisturbed and degraded specimens are subjected to shearing at saturated conditions to determine the peak and post-rupture shear strength envelopes. The effects on rock brittleness and dilation angle are also analysed. Shear strength shows a strong dependence on the history of relative humidity cycling. In particular, the evolution of the peak shear strength parameters (′ and ′) seem to be related to the accumulated irreversible strains developed during each cycle. A damage law, recently proposed by the authors, is used to represent the progressive degradation of the shear strength parameters as a function of the accumulated irreversible strains. [ABSTRACT FROM AUTHOR]

The increasing costs associated with water supply and the disposal of wastewater has stimulated industries to seek more efficient water management systems. Mathematical modelling and simulation can be a very valuable tool for the study of the multiple alternatives available whilst assessing optimum solutions for water management in industry. This study introduces a new steady state model library able to reproduce industrial water circuits. It has been implemented in a novel software framework for the representation, simulation and optimization of industrial water networks. A water circuit representing a paper mill has been modelled and simulated showing the capability to reproduce real case studies. Alternative scenarios for the water network have also been tested to assess the capability of the models to optimize water circuits minimizing total cost. [ABSTRACT FROM AUTHOR]

This paper presents the characterisation procedure of different types of sludge generated in a wastewater treatment plant to be reproduced in a mathematical model of the sludge digestion process. The automatic calibration method used is based on an optimisation problem and uses a set of mathematical equations related to the a priori knowledge of the sludge composition, the experimental measurements applied to the real sludge, and the definition of the model components. In this work, the potential of the characterisation methodology is shown by means of a real example, taking into account that sludge is a very complex matter to characterise and that the models for digestion also have a considerable number of model components. The results obtained suit both the previously reported characteristics of the primary, secondary and mixed sludge, and the experimental measurements specially done for this work. These three types of sludge have been successfully characterised to be used in complex mathematical models. [ABSTRACT FROM AUTHOR]

The "whirl sign" is an uncommon finding on emergency CT. However, it is easy to overlook if not kept in mind. Its recognition is of capital importance, being most of its causes potentially lethal. Surgical treatment is also mandatory when signs of complication are found. The whirl sign is usually found associated to midgut, cecal and sigmoid volvulus, small-bowel volvulus and closed-loop obstructions, and post-surgical mesenteric windows (including retroanastomotic hernias). CT is an optimal imaging technique to depict the so-called sign and associated CT features suggesting complication (circumferential wall thickening, pneumatosis intestinalis, pneumoperitoneum, mesenteric fat stranding, free intraperitoneal fluid, mesenteric haziness). Radiologists must be able to recognize the whirl sign and seek associated findings that strongly support the diagnosis of a spectrum of entities, some of them lethal if no treatment is established. [ABSTRACT FROM AUTHOR]

The objective of this study was to illustrate the wide spectrum of subcutaneous emphysema in the emergency room; to show the key findings on computed tomography, plain radiographs, and echography; and to discuss the differential diagnoses. Subcutaneous emphysema is a common finding in emergency department imaging studies. It has a great importance due to its broad casualty, some of them totally benign, but others potentially lethal. We retrospectively reviewed our database of emergency pathology, analyzing its origins and associated features. SE was associated to traumatic, iatrogenic, or infectious causes (necrotizing fasciitis, Fournier gangrene). It also was found associated with thoracic (causing pneumothorax and pneumomediastinum) and abdominal pathology related to intraperitoneal and retroperitoneal gas. Diagnostic difficulties and differential diagnoses are emphasized. Radiologists must be aware of abnormal gas in soft tissue because it may be the main or unique sign leading to an underlying pathology, which can be lethal. [ABSTRACT FROM AUTHOR]

Based on on/off aeration strategies, this paper describes all the steps involved in the development and implementation of three identification algorithms aimed at monitoring the oxygen uptake rate (OUR), the oxygen mass-transfer coefficient (KLa), and oxygen transfer efficiency (OTE) in aerated biological reactors. Firstly, a detailed explanation of the theoretical background behind every algorithm is given. In addition, practical issues have also been taken into account in order to guarantee the quality of estimations. Finally, the three algorithms have been implemented and validated in a full-scale industrial wastewater treatment plant with satisfactory results. Although short-term noise has been observed in the estimated data (especially at high OURs), the medium and long-term data trajectories have been correctly reproduced. [ABSTRACT FROM AUTHOR]

This paper proposes an algebraic solution of the mass and charge balanced ADM1 model to predict the steady state performance of an anaerobic digester for sewage sludge treatment. The algebraic solution consists of three sequential stages: a kinetic stage that considers only the slowest transformations of the model, a stoichiometric stage based on the complete mass fluxes of the biological process and a physicochemical stage from which some digester outputs are calculated. The predictive capacity and the applicability of this model solution are corroborated by its comparison to the differential equation's model solution and the experimental data of a real case study. The algebraic solution is used to explore the digester response under different operational conditions. An example of application is used to verify the potential of the algebraic solution to be used, together with optimisation algorithms, for optimising the design of the digester and the operational conditions for specified performance criteria, such as effluent quality. [ABSTRACT FROM AUTHOR]

This paper proposes a new methodology for the automatic characterization of the influent wastewater in WWTP. With this methodology, model components are automatically estimated by means of optimization algorithms combining a-priori knowledge of the expected wastewater composition with experimental information from the available measurement data. The characterization is carried out based on an extended model components list in which components are described by means their elemental mass fractions. This allows an easy establishment of relationships between model components with experimental data and also, to obtain a general methodology applicable to any model used for wastewater biological treatments. The characterization of the wastewater influent of Galindo-Bilbao according this methodology has demonstrated its validity and the easy application to the ASM1 model influent characterization. [ABSTRACT FROM AUTHOR]

This paper presents a systematic methodology to characterise the influent sludge in terms of the ADM1 components from the experimental measurements traditionally used in wastewater engineering. For this purpose, a complete characterisation of the model components in their elemental mass fractions and charge has been used, making a rigorous mass balance for all the process transformations and enabling the future connection with other unit-process models. It also makes possible the application of mathematical algorithms for the optimal characterisation of several components poorly defined in the ADM1 report. Additionally, decay and disintegration have been necessarily uncoupled so that the decay proceeds directly to hydrolysis instead of producing intermediate composites. The proposed methodology has been applied to the particular experimental work of a pilot-scale CSTR treating real sewage sludge, a mixture of primary and secondary sludge. The results obtained have shown a good characterisation of the influent reflected in good model predictions. However, its limitations for an appropriate prediction of alkalinity and carbon percentages in biogas suggest the convenience of including the elemental characterisation of the process in terms of carbon in the analytical program. [ABSTRACT FROM AUTHOR]

This paper proposes a systematic methodology for the analysis of the mass and charge balances in dynamic models expressed using the Petersen matrix notation. This methodology is based on the definition of the model components via elemental mass fractions and in the estimation of the COD as a function of the redox equations associated with these elements. This approach makes the automatic calculation of all the stoichiometric coefficients under different measuring units and the study of COD, charge or mass fluxes easier. As an example of its application this methodology was applied to the ADM1 in order to illustrate its usefulness for the analysis of organic matter characterisation, nitrogen release or biogas composition in anaerobic digestion. The application of the methodology for a rigorous integration of different WA models is proposed for further study. [ABSTRACT FROM AUTHOR]

The injection of green hydrogen into the natural gas grid is a way to decarbonize the gas sector and build an economic transport route for the large-scale delivery of hydrogen. The suitability of the natural gas infrastructure for this purpose depends on the impact that hydrogen may have on the correct operation of its components and understanding the new flow conditions in the system is essential for this aim. Computational studies can anticipate the expected environment in the pipe system, assessing the readiness of the system. However, the experience on this topic is not extensive enough and deeper understanding is necessary. Here we show a CFD study to simulate the transport of H 2 /NG blends in a gas setup with the main characteristics of injection sites and gas pipelines representatives of the transmission gas network. This setup considers a blending station, the pumping and injection procedure, and different pipelines geometries to predict the behavior of various mixtures of H 2 /NG. It can be seen how (1) a good mixing is achieved in the blending station after a pipe length equivalent to 20–30 diameters is reached; (2) pumping gas by a piston type compressor shows pulsations in the flow regardless the composition of the blend that can be damped implementing mitigation measurements; and (3) asymmetries in the flow are found when the direction of the fluid changes after section reduction, but 20 diameters downstream of the reduction the flow is fully developed. [Display omitted] • Modelling the injection of hydrogen in the natural gas transmission grid. • CFD studies to anticipate the behavior of the new fluid. • Mixing quality and possible segregation in blending stations considered. • Flow pattern when DN 80 pipes expands to a DN 150 or a DN 250 pipes. • Simulation of pumping of H 2 and CH 4 by a piston type compressor. [ABSTRACT FROM AUTHOR]

Patients attending the emergency department (ED) with cervical inflammatory/infectious symptoms or presenting masses that may involve the aerodigestive tract or vascular structures require a contrast-enhanced computed tomography (CT) scan of the neck. Its radiological interpretation is hampered by the anatomical complexity and pathophysiological interrelationship between the different component systems in a relatively small area. Recent studies propose a systematic evaluation of the cervical structures, using a 7-item checklist, to correctly identify the pathology and detect incidental findings that may interfere with patient management. As a conclusion, the aim of this paper is to review CT findings in non-traumatic pathology of the neck in the ED, highlighting the importance of a systematic approach in its interpretation and synthesis of a structured, complete, and concise radiological report., (Copyright © 2023 SERAM. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Critical care survivors often experience symptoms of anxiety, depression, or post-traumatic stress disorder (PTSD)., Aims: To determine the prevalence and severity of psychological symptoms during the first 6 months after discharge from the intensive care unit (ICU) and to evaluate its association with patients who are difficult to sedate during admission., Design: Descriptive, prospective analysis of psychological symptoms in survivors from medicosurgical ICU over a 2-year period., Methods: All ICU survivors who required mechanical ventilation (MV) for more than 24 hours were followed for 6 months after their ICU discharge. ICU outcome and complications as well as the presence of psychological symptoms, 1 to 3 to 6 months after discharge were prospectively evaluated through phone interviews comparing the incidence and intensity of patients who were difficult to sedate during their ICU stay with those who were not. Descriptive analysis and multivariate logistic regression were performed., Results: Data were obtained for 195 patients, of whom 30% experienced difficult sedation (DS). Difficult-to-sedate patients were younger (P = .001), less critically ill (APACHE II score P = .002), and more likely to engage in harmful use of alcohol (P = .001) and psychoactive/psychotropic drug abuse. They also spent longer times on MV and in the ICU (P = .001). Anxiety incidence at 1 to 3 to 6 months post-discharge was significantly higher in DS patients than in those who were not (87.7% vs 45.4%, 75.5% vs 29.0%, and 70.8% vs 23.7%; P < .01), respectively. Depression incidence was also significantly higher in the DS group (82.4% vs 43.1%, 66% vs 33.9%, and 60.4% vs 27.2%; [P = .001]) at 1 to 3 to 6 months, respectively. A higher percentage of patients in the DS group reported symptoms of PTSD at 1 month (28.1% vs 11.5%) (P = .007) when compared with non-DS group., Conclusions: Critical care survivors who are difficult to sedate during their ICU stay are more likely to present psychological sequelae. Early identification of at-risk patients is necessary to implement appropriate preventive strategies., Relevance to Clinical Practice: Patients who are difficult to sedate in the ICU may develop psychological disorders upon discharge, which may negatively affect their recovery. The prevention of DS and the early detection of psychological disorders are essential to minimize its subsequent impact., (© 2021 British Association of Critical Care Nurses.)

Cervical spine trauma encompasses a wide of injuries, ranging from stable, minor lesions to unstable, complex lesions that can lead to neurologic sequelae or vascular involvement. The Canadian C-Spine Rule and the NEXUS criteria aim to identify individuals with a low risk of cervical spine trauma who can safely forgo imaging tests. In high-risk patients, an imaging test is indicated. In adult patients the imaging test of choice is multidetector computed tomography. Complementary imaging tests such as CT angiography of the supra-aortic vessels and/or magnetic resonance imaging are occasionally necessary. It can be challenging for radiologists to diagnose and classify these lesions, because some of them can be subtle and difficult to detect. This paper aims to describe the most important imaging findings and the most widely used classification systems., (Copyright © 2022 SERAM. Published by Elsevier España, S.L.U. All rights reserved.)

Background: In the past months, several lung ultrasonography (LUS) protocols have been proposed, mainly on previously validated schemes independent of coronavirus disease 2019 (COVID-19)., Objectives: The main purpose of this study was to determine the impact and accuracy of different LUS protocols proposed in COVID-19., Methods: Patients were evaluated with a standard sequence of LUS scans in 72 intercostal spaces along 14 anatomic lines in the chest. A scoring system of LUS findings was reported and then analyzed separately according to each proposed LUS protocol zones. This score was then correlated to a validated Pulmonary Inflammation Index (PII) on chest Computed Tomography (CT)., Results: Thirty-two patients were enrolled. The most frequent pattern was ground-glass opacities in the chest X-ray (53.1%), chest CT (59.1%) and subpleural or lobar consolidations (40.8%) in the posteroinferior areas (p < 0.001) on LUS. The Interclass Correlation Coefficient (ICC) was significantly correlated with almost every protocol analyzed except the 8-zone (p = 0.119) and the 10-zone protocol that only included one posterior point (p = 0.052). The highest ICC was obtained with a 12-zone protocol (ICC 0.500; p = 0.027) and decreased as more points were included., Conclusions: In conclusion, our study results suggest that performing an ultrasound protocol with 12-zone scanning, including the superior and inferior areas of the anterior, lateral and posterior regions of the chest was consistent with higher ICC and higher degree of concordance with CT. We emphasize the need of a more standardization technique to further implement and develop this imaging modality in COVID-19., (© 2021. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Competing Interests: The authors declare that they have no conflict of interest.

There is growing evidence regarding chest X-ray and computed tomography (CT) findings for coronavirus disease 2019 (COVID-19). At present, the role of lung ultrasonography (LUS) has yet to be explored. The main purpose of this study was to evaluate the correlation between LUS findings and chest CT in patients confirmed to have (positive reverse transcription polymerase chain reaction [RT-PCR]) or clinically highly suspected of having (dyspnea, fever, myasthenia, gastrointestinal symptoms, dry cough, ageusia or anosmia) COVID-19. This prospective study was carried out in the emergency department, where patients confirmed of having or clinically highly suspected of having COVID-19 were recruited and underwent chest CT and concurrent LUS exam. An experienced emergency department physician performed the LUS exam blind to the clinical history and results of the CT scan, which were reviewed by two radiologists in consensus for signs compatible with COVID-19 (bilateral ground-glass opacities in peripheral distribution). A compatible LUS exam was considered a bilateral pattern of B-lines, irregular pleural line and subpleural consolidations. Between March and April 2020, 51 patients were consecutively enrolled. The indication for CT was a negative or indeterminate RT-PCR test (49.0%) followed by suspicion of pulmonary embolism (41.2%). Radiologic signs compatible with COVID-19 were present in 37 patients (72.5%) on CT scan and 40 patients (78.4%) on LUS exam. The presence of LUS findings was correlated with a positive CT scan suggestive of COVID-19 (odds ratio: 13.3, 95% confidence interval: 4.5-39.6, p < 0.001) with a sensitivity of 100.0%, specificity of 78.6%, positive predictive value of 92.5% and negative predictive value of 100.0%. There was no missed diagnosis of COVID-19 with LUS compared with CT in our cohort. The correlation between LUS score and CT total severity score was good (intraclass correlation coefficient: 0.803, 95% confidence interval: 0.60-0.90, p < 0.001). LUS exhibited similar accuracy compared with chest CT in the detection of lung abnormalities in COVID-19 patients., Competing Interests: Conflict of interest disclosure The authors have declared no conflicts of interest., (Copyright © 2020 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Significant increasing prevalences have been observed in gambling disorder (GD) in the last decades. This study analyzed the underlying mechanisms of the gambling severity with path analysis (implemented through Structural Equation Modeling, SEM), and assessed the potential moderator effect of the patients' sex. A sample of n = 512 treatment-seeking patients was assessed for sociodemographics and clinical state previously to the treatment. Results obtained in two separate SEM (for men and women) revealed differences in the direct effects and the mediational links. Among the male subsample, higher GD severity was directly related to the higher cognitive bias and the younger age of onset of the problematic gambling, while impulsivity levels and age of onset achieved an indirect effect on the disordered gambling mediated by the cognitive bias. Among females, GD severity was directly increased by younger age of onset, higher cognitive bias and lower self-directedness, while lower socioeconomic positions, and higher levels in harm avoidance achieved an indirect effect on the gambling severity mediated also by the distortions related to the gambling activity. These results provide new empirical evidence for a better understanding of the GD etiology, suggesting that the underlying complex links mediating the GD severity are strongly related to the patients' sex. The results can also contribute to design more effectiveness and precise therapy programs of patient-centered care.

Background: There are no studies based on a person-centered approach addressing sex-related differences in the characteristics of treatment-seeking patients with gambling disorder (GD). The main objective of the current study is to identify empirical clusters of GD based on several measures of the severity of gambling behavior, and considering the potential role of patient sex as a moderator., Methods: An agglomerative hierarchical clustering method was applied to an adult sample of 512 treatment-seeking patients (473 men and 39 women) by using a combination of the Schwarz Bayesian Information Criterion and log-likelihood function., Results: Three clusters were identified in the subsample of men: cluster M1 (low-mild gambling severity level, 9.1%), cluster M2 (moderate level, 60.9%), and cluster M3 (severe level, 30.0%). In the women subsample, two clusters emerged: cluster W1 (mild-moderate level, 64.1%), and cluster W2 (severe level, 35.9%). The most severe GD profiles were related to being single, multiple gambling preference for nonstrategic plus strategic games, early onset of the gambling activity, higher impulsivity levels, higher dysfunctional scores in the personality traits of harm avoidance, and self-directedness, and higher number of lifespan stressful life events (SLE). Differences between the empirical men and women clusters were found in different sociodemographic and clinical measurements., Conclusions: Men and women have distinct profiles regarding gambling severity that can be identified by a clustering approach. The sociodemographic and clinical characterization of each cluster by sex may help to establish specific preventive and treatment interventions.

Background: Since the confirmation of the first patient infected with SARS-CoV-2 in Spain in January 2020, the epidemic has grown rapidly, with the greatest impact on the region of Madrid. This article describes the first 2226 adult patients with COVID-19, consecutively admitted to La Paz University Hospital in Madrid., Methods: Our cohort included all patients consecutively hospitalized who had a final outcome (death or discharge) in a 1286-bed hospital of Madrid (Spain) from 25 February (first case admitted) to 19 April 2020. The data were manually entered into an electronic case report form, which was monitored prior to the analysis., Results: We consecutively included 2226 adult patients admitted to the hospital who either died (460) or were discharged (1766). The patients' median age was 61 years, and 51.8% were women. The most common comorbidity was arterial hypertension (41.3%), and the most common symptom on admission was fever (71.2%). The median time from disease onset to hospital admission was 6 days. The overall mortality was 20.7% and was higher in men (26.6% vs. 15.1%). Seventy-five patients with a final outcome were transferred to the intensive care unit (ICU) (3.4%). Most patients admitted to the ICU were men, and the median age was 64 years. Baseline laboratory values on admission were consistent with an impaired immune-inflammatory profile., Conclusions: We provide a description of the first large cohort of hospitalized patients with COVID-19 in Europe. Advanced age, male sex, the presence of comorbidities and abnormal laboratory values were more common among the patients with fatal outcomes.

Introduction: Impairments in emotion regulation are understood to be a transdiagnostic risk factor of suffering from compulsive and addictive behaviors. The aim of this study was to investigate the role of emotion regulation deficits in gambling disorder and to analyze these differences taking gender, age, and gambling activity preferences into account., Methods: The sample included n = 484 patients seeking treatment for gambling disorder at a specialized outpatient service. Main outcomes were sociodemographic variables, emotion regulation, and gambling severity., Results: Differences between sexes were found in non-acceptance of emotions. Older patients obtained higher levels in non-acceptance of emotions, lack of emotion regulation strategies, emotional clarity, and global emotion regulation scores. No differences were found in emotion scores considering gambling preferences (non-strategic versus strategic). Path analysis showed that emotion regulation scores and age had a direct effect on gambling disorder severity, while emotion regulation and gambling preference were not mediational variables in the relationships of gender and age with gambling severity., Conclusions: Emotion regulation impairments differ in patients seeking treatment for gambling problems. Early prevention and intervention programs should incorporate the different dimensions of this process, taking into account clinical phenotypes., (Copyright © 2019 Sancho, de Gracia, Granero, González-Simarro, Sánchez, Fernández-Aranda, Trujols, Mallorquí-Bagué, Mestre-Bach, del Pino-Gutiérrez, Mena-Moreno, Vintró-Alcaraz, Steward, Aymamí, Gómez-Peña, Menchón and Jiménez-Murcia.)

The Venturia genus comprises fungal species that are pathogens on Rosaceae host plants, including V. inaequalis and V. asperata on apple, V. aucupariae on sorbus and V. pirina on pear. Although the genetic structure of V. inaequalis populations has been investigated in detail, genomic features underlying these subdivisions remain poorly understood. Here, we report whole genome sequencing of 87 Venturia strains that represent each species and each population within V. inaequalis We present a PacBio genome assembly for the V. inaequalis EU-B04 reference isolate. The size of selected genomes was determined by flow cytometry, and varied from 45 to 93 Mb. Genome assemblies of V. inaequalis and V. aucupariae contain a high content of transposable elements (TEs), most of which belong to the Gypsy or Copia LTR superfamilies and have been inactivated by Repeat-Induced Point mutations. The reference assembly of V. inaequalis presents a mosaic structure of GC-equilibrated regions that mainly contain predicted genes and AT-rich regions, mainly composed of TEs. Six pairs of strains were identified as clones. Single-Nucleotide Polymorphism (SNP) analysis between these clones revealed a high number of SNPs that are mostly located in AT-rich regions due to misalignments and allowed determining a false discovery rate. The availability of these genome sequences is expected to stimulate genetics and population genomics research of Venturia pathogens. Especially, it will help understanding the evolutionary history of Venturia species that are pathogenic on different hosts, a history that has probably been substantially influenced by TEs., (Copyright © 2019 Le Cam et al.)

Background: Emotion (dys)regulation as well as the interventions for improving these difficulties are receiving a growing attention in the literature. The aim of the present paper was to conduct a systematic review about the efficacy of mindfulness-based interventions (MBIs) in both substance and behavioral addictions (BAs)., Method: A literature search was conducted using Cochrane, PubMed, and Web of Science. Fifty-four randomized controlled trials published in English since 2009 to April 2017 were included into a narrative synthesis., Results: Mindfulness-based interventions were applied in a wide range of addictions, including substance use disorders (from smoking to alcohol, among others) and BAs (namely, gambling disorder). These treatments were successful for reducing dependence, craving, and other addiction-related symptoms by also improving mood state and emotion dysregulation. The most commonly used MBI approaches were as follows: Mindfulness-Based Relapse Prevention, Mindfulness Training for Smokers, or Mindfulness-Oriented Recovery Enhancement, and the most frequent control group in the included studies was Treatment as Usual (TAU). The most effective approach was the combination of MBIs with TAU or other active treatments. However, there is a lack of studies showing the maintenance of the effect over time. Therefore, studies with longer follow-ups are needed., Conclusion: The revised literature shows support for the effectiveness of the MBIs. Future research should focus on longer follow-up assessments as well as on adolescence and young population, as they are a vulnerable population for developing problems associated with alcohol, drugs, or other addictions.