Search

Resumen: Antecedentes y objetivos: El objetivo de este estudio es analizar las indicaciones, complicaciones, supervivencia y el resultado clínico y funcional de las vainas metafisarias como opción terapéutica en las revisiones de prótesis total de rodilla. Material y método: Se realizó una revisión sistemática siguiendo las recomendaciones PRISMA sobre el uso de vainas metafisarias para cirugía de revisión de artroplastia de rodilla. Se incluyeron estudios prospectivos y retrospectivos publicados en los últimos 10 años que analizasen la supervivencia del implante, el resultado clínico y funcional con un seguimiento mínimo de 2 años. Resultados: Los estudios incluidos mostraron buenos resultados tanto funcionales como clínicos. El porcentaje de reintervención global fue del 16,2%, con una tasa de supervivencia global del 92,2% y una supervivencia aséptica de un 98,2%. Conclusiones: Las vainas metafisarias suponen una buena opción de tratamiento de esta cirugía, especialmente en defectos tipo AORI II o III consiguiendo buena estabilidad intraoperatoria y primaria del implante, con buena y rápida osteointegración. Abstract: Background and objectives: The purpose of this study is to analyze the indications, complications, survivorship and clinical/functional outcome of metaphyseal sleeves as a treatment option in revision total knee arthroplasty. Material and method: A systematic review was made following the PRISMA recommendations on the use of metaphyseal sleeves for revision total knee arthroplasty. We included prospective and retrospective studies published in the last 10 years looking at implant survivorship, clinical and functional outcome with a minimum follow-up of 2 years. Results: The included studies showed good both functional and clinical outcomes. The overall reoperation rate was 16.2%, with an overall survival rate of 92.2% and aseptic survivorship of 98.2%. Conclusions: Metaphyseal sleeves are a good treatment option for this surgery, especially in AORI II or III type bone defects, achieving good intraoperative and primary stability of the implant, with good and rapid osseointegration.

Background and objectives: The purpose of this study is to analyse the indications, complications, survivorship and clinical/functional outcome of metaphyseal sleeves as a treatment option in revision total knee arthroplasty. Material and method: A systematic review was made following the PRISMA recommendations on the use of metaphyseal sleeves for revision total knee arthroplasty. We included prospective and retrospective studies published in the last 10 years looking at implant survivorship, clinical and functional outcome with a minimum follow-up of 2 years. Results: The included studies showed good both functional and clinical outcomes. The overall reoperation rate was 16.2%, with an overall survival rate of 92.2% and aseptic survivorship of 98.2%. Conclusions: Metaphyseal sleeves are a good treatment option for this surgery, especially in AORI II or III type bone defects, achieving good intraoperative and primary stability of the implant, with good and rapid osseointegration. Resumen: Antecedentes y objetivos: El objetivo de este estudio es analizar las indicaciones, complicaciones, supervivencia y el resultado clínico y funcional de las vainas metafisarias como opción terapéutica en las revisiones de prótesis total de rodilla. Material y método: Se realizó una revisión sistemática siguiendo las recomendaciones PRISMA sobre el uso de vainas metafisarias para cirugía de revisión de artroplastia de rodilla. Se incluyeron estudios prospectivos y retrospectivos publicados en los últimos 10 años que analizasen la supervivencia del implante, el resultado clínico y funcional con un seguimiento mínimo de dos años. Resultados: Los estudios incluidos mostraron buenos resultados tanto funcionales como clínicos. El porcentaje de reintervención global fue de 16,2%, con una tasa de supervivencia global de 92,2% y una supervivencia aséptica de 98,2%. Conclusiones: Las vainas metafisarias suponen una buena opción de tratamiento de esta cirugía, especialmente en defectos tipo AORI II o III consiguiendo buena estabilidad intraoperatoria y primaria del implante, con buena y rápida osteointegración.

The comprehensive management of organic urban solid waste is a concern due to its direct and indirect impact on the environment. Anaerobic Digestion (AD) has been recognized as an alternative and environmentally friendly technology for waste disposal, converting them into organic fertilizers and renewable energy. This research presents an experiment involving four reactors fed with household organic waste, three inoculated with canine, goat, and rabbit manure, and one without inoculum. The experiment was observed for 30 consecutive days to analyze the pH and temperature parameters involved in the AD process in domestic reactors. Statistical methodology, including one-way analysis of variance for assessing the effect of the type of inoculum, Tukey's simultaneous confidence intervals for mean differences, and 90 % confidence intervals for μ in temperature and manure, was utilized. Additionally, main effects analysis of the factors of average temperature and pH were conducted. The results of the one-factor experiment show that the type of inoculum does not significantly influence the variation in pH, while temperature remains relatively stable throughout the AD process. However, the analysis of main effects indicates that goat manure tends to stabilize the temperature with minimal variation, whereas variation is more heterogeneous in the other experiments.

Introduction Given that child and adolescent mental health has been affected by several factors in recent years, such as the distance between home and specialized centers that provide psychological care to children, the lack of care resources, or the lockdown caused by the COVID-19 pandemic, online psychological treatments are becoming increasingly common among the child and adolescent population, although it is necessary to develop this type of treatment for children at psychosocial risk, since these have been developed mostly for the general population. To this aim, the Online Emotional Self-Regulation Improvement program (Mejora de la Auto-regulación para Menores, Online MAM@) was developed. Objectives To assess the acceptability of the Online Emotional Self-Regulation Improvement program, by the adolescent. Methods The intervention program was applied to a total of n = 32 children (n = 17 girls) between 11 and 15 years of age. The program consists of 7 target emotions to be worked on, and the acceptance, usability, usefulness, enjoyment of each module and barriers to use by the children were assessed with an adaptation of the Venkatesh and Davis scale. These measures were taken post-test, once the intervention module was completed. The program was applied online for five weeks by the children, and their regular therapists contacted them to provide them with weekly access codes and reminders in case they were not completing the modules. Results It was observed that the best rated module was the anger module, the most useful module was the sadness module, the module considered to have the highest usability was the fear module, and the most enjoyed module was the sadness module, although all the modules had very high scores above the average and no significant differences were found in the rating of the modules between sexes. As for the most common barriers to use among the children, problems were found with the completion of the intervention, since they often forgot to access the web, and these did not apply what they had learned outside the intervention program. Conclusions The Online Emotional Self-Regulation Improvement program is the first program developed in Spanish language for adolescents at psychosocial risk, and may represent a breakthrough to consolidate these programs in the national scene and bring the therapeutic possibilities for adolescents to the same level as in other parts of the world. Focusing on future versions of the program, it would be advisable to reduce its length and incorporate activities outside the treatment program to guarantee a generalization of what is learned in the intervention program in everyday life situations. Disclosure of Interest None Declared

Peroxisome proliferator-activated receptor-gamma coactivator-1α (PGC-1α) transcriptional coactivators are key regulators of energy metabolism-related genes and are expressed in energy-demanding tissues. There are several PGC-1α variants with different biological functions in different tissues. The brain is one of the tissues where the role of PGC-1α isoforms remains less explored. Here, we used a toxin-based mouse model of Parkinson's disease (PD) and observed that the expression levels of variants PGC-1α2 and PGC-1α3 in the nigrostriatal pathway increases at the onset of dopaminergic cell degeneration. This increase occurs concomitant with an increase in glial fibrillary acidic protein levels. Since PGC-1α coactivators regulate cellular adaptive responses, we hypothesized that they could be involved in the modulation of astrogliosis induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Therefore, we analysed the transcriptome of astrocytes transduced with expression vectors encoding PGC-1α1 to 1α4 by massively parallel sequencing (RNA-seq) and identified the main cellular pathways controlled by these isoforms. Interestingly, in reactive astrocytes the inflammatory and antioxidant responses, adhesion, migration, and viability were altered by PGC-1α2 and PGC-1α3, showing that sustained expression of these isoforms induces astrocyte dysfunction and degeneration. This work highlights PGC-1α isoforms as modulators of astrocyte reactivity and as potential therapeutic targets for the treatment of PD and other neurodegenerative disorders.

Abstract Background Clinical research on nutritional and metabolic interventions in critically ill patients is heterogenous regarding time points, outcomes and measurement instruments used, impeding intervention development and data syntheses, and ultimately worsening clinical outcomes. We aimed to identify and develop a set of core outcome domains and associated measurement instruments to include in all research in critically ill patients. Methods An updated systematic review informed a two-stage modified Delphi consensus process (domains followed by instruments). Measurement instruments for domains considered ‘essential’ were taken through the second stage of the Delphi and a subsequent consensus meeting. Results In total, 213 participants (41 patients/caregivers, 50 clinical researchers and 122 healthcare professionals) from 24 countries contributed. Consensus was reached on time points (30 and 90 days post-randomisation). Three domains were considered ‘essential’ at 30 days (survival, physical function and Infection) and five at 90 days (survival, physical function, activities of daily living, nutritional status and muscle/nerve function). Core ‘essential’ measurement instruments reached consensus for survival and activities of daily living, and ‘recommended’ measurement instruments for physical function, nutritional status and muscle/nerve function. No consensus was reached for a measurement instrument for Infection. Four further domains met criteria for ‘recommended,’ but not ‘essential,’ to measure at 30 days post-randomisation (organ dysfunction, muscle/nerve function, nutritional status and wound healing) and three at 90 days (frailty, body composition and organ dysfunction). Conclusion The CONCISE core outcome set is an internationally agreed minimum set of outcomes for use at 30 and 90 days post-randomisation, in nutritional and metabolic clinical research in critically ill adults.

Resumen: Introducción: La fractura de cuello del quinto metacarpiano se trata tradicionalmente mediante la reducción cerrada e inmovilización con férula en intrínseco plus. Una alternativa es el tratamiento funcional mediante sindactilia. Nuestro objetivo es comparar ambos tratamientos buscando diferencias de resultado funcional entre ambas opciones. Método: Realizamos un estudio de cohortes prospectivo, controlado, enmascarado y aleatorizado con pacientes mayores de 18 años con esta lesión y angulación

Resumen: Introducción: Las fracturas de la extremidad distal de radio (FEDR) representan una carga cada vez mayor para los recursos sanitarios debido a los cambios demográficos de la población y a las estrategias de gestión, por lo que la comprensión precisa de su epidemiología es esencial. Presentamos un estudio epidemiológico de FEDR y lo comparamos con otras áreas de la península y Europa. Método: Se recogieron todas las FEDR de nuestra área sanitaria registradas en 2017 y 2018 en pacientes mayores de 18 años de forma retrospectiva y observacional agrupándolos según la clasificación de AO-OTA. Se analizaron las variables de edad, sexo, época del año, mecanismo de fractura, presencia de lesiones asociadas y tratamiento realizado. Resultados: Registramos 1.121 FEDR en 1.108 pacientes, 903 mujeres (81,5%) y 205 varones (18,5%). En 612 casos se vio afectado el lado izquierdo (54,6%) y en 509 el lado derecho (45,4%). La edad media de la muestra fue de 65,9 años (IC95%: 65-66,9 años). La tasa de incidencia de FEDR fue de 158,5 fracturas por 100.000 habitantes/año. El 49,2% se clasificaron como tipo A de AO-OTA y se intervinieron quirúrgicamente un 19%. Conclusión: La incidencia de FEDR alcanza un máximo en la sexta década tanto en hombres como en mujeres. Las fracturas de tipo A de la clasificación AO-OTA son las más frecuentes. La mayoría se trataron de forma conservadora. El patrón de paciente tratado quirúrgicamente con más frecuencia es el de una mujer mayor de 50 años con FEDR articular compleja. Abstract: Introduction: Distal radius fractures (DRF) are being a bigger burden for health resources as changes continue to happen in our population demography and in management strategies, so a precise epidemiologic comprehension is mandatory. We present a DRF epidemiology study and we compared it with other sanitary areas of the Iberian Peninsula and Europe. Method: Every DRF in our sanitary area registered between 2017 and 2018 in patients older than 18 years old were observational and retrospectively recorded and classified using AO-OTA classification. Age, sex, season of the year, mechanism of injury, presence of associated injuries and type of treatment were analysed. Results: 1,121 DRF in 1,108 patients, 903 women (81.5%) and 205 men (18.5%), were registered. Left side was affected in 612 cases (54.6%) and right side in 509 cases (45.4%). The average age of our sample was 65.9 years old (CI95%: 65-67.9 years old). The incidence rate of DRF in our population was 158.5 fractures per 100,000 people-year; 49.2% were classified as type A of AO-OTA classification and 19% were treated surgically. Conclusion: Incidence of DRF had a maximum during males and women sixth decade of age. Type A fractures of AO-OTA classification were the most frequent. Most part of the fractures were treated non-surgically. The usual patient treated surgically was a woman, over 50 years old with a distal radius intraarticular complex fracture.

Resumen: Antecedentes y objetivos: Comparar la morbimortalidad, el tiempo de estancia hospitalaria y el gasto económico de la fractura por fragilidad de cadera en 2 años no consecutivos gracias a la atención ortogeriátrica integrada. Material y método: Estudio observacional retrospectivo de cohorte con 633 pacientes con fractura por fragilidad de cadera, con una media de edad de 85,5 años, tratados en un mismo servicio de cirugía ortopédica y traumatología en 2 años diferentes (2012 y 2017). Se midieron la estancia media, la demora quirúrgica, la mortalidad perioperatoria, al mes y al año, y las complicaciones perioperatorias como la retención aguda de orina, las úlceras por presión y la necesidad de transfusión. Resultados: La mortalidad durante el ingreso disminuyó del 10% en 2012 al 3,6% en 2017 (p = 0,004), a la vez que la mortalidad a los 30 días (10,5% frente a 7%) (p = 0,123) y al año (28,9% frente a 24,9%) (p = 0,277). También disminuyeron los tiempos de estancia hospitalaria, la demora quirúrgica y el tiempo de ingreso postoperatorio. El ahorro económico total anual estimado gracias a la atención ortogeriátrica integrada supuso 1.017.084,94 €. Conclusiones: La atención ortogeriátrica integrada del paciente con fractura por fragilidad de la cadera resulta en un modelo de atención más efectivo y eficiente. Se mejora tanto la calidad asistencial como la situación clínica de los pacientes en el periodo perioperatorio, se disminuyen significativamente tanto la estancia hospitalaria como la mortalidad durante el ingreso, y todo ello con un importante ahorro económico asociado. Abstract: Background and objectives: Compare the morbidity and mortality, the length of hospital stay and the economic cost of the fragility fracture of the hip, in two nonconsecutive years thanks to the integrated orthogeriatric care. Material and method: Retrospective observational cohort study with 633 patients with hip fragility fracture with a mean age of 85.5 years, treated in the same Trauma and Orthopaedic Surgery service in two different years (2012 and 2017). Mean stay, surgical delay, perioperative mortality, one month and one year, and perioperative complications such as acute urine retention, pressure ulcers, and need for transfusion were measured. Results: Mortality during admission decreased from 10% in 2012 to 3.6% in 2017 (P = .004 *), while mortality at thirty days (10.5% vs 7%) (P = .123) and one year (28.9% versus 24.9%) (P = .277). Hospital stay times, surgical delay, and postoperative admission time also decreased. The estimated total annual economic savings thanks to integrated orthogeriatric care amounted to € 1,017,084.94. Conclusions: Integrated orthogeriatric care of the patient with fragility fracture of the hip, results in a more effective and efficient care model. Both the care and the clinical situation of patients are improved in the perioperative period, both hospital stay and mortality during admission are significantly reduced, and all this with significant associated economic savings.

First of all, this article aimed to evidence the role of a modified printer developed for continuous carbon fibre reinforced PolyAmide (cCF/PA6-I) together with the use of a fully open slicing step on the printing quality and the longitudinal/transverse tensile and in-plane shear properties. A comprehensive assessment of the microstructure and properties with a similar material (cCF/PA6-I), but produced with a commercial printer (i.e., Markforged® MarkTwo) has been achieved. Our customised printer and the open slicer used have made possible to better control the print conditions (i.e., layer height and distance between filaments), to reduce the porosity from more than 10% to about 2% and improve the mechanical properties.Moreover, the understanding of the behaviour of these 3D printed composites with wide-ranging external temperatures is mandatory for future use in a severe environment and/or development of new thermally active 4D printed composites.The 3D printed cCF/PA6-I composites have been then thermomechanically characterised along different printing directions (0, 90 and ± 45°) from −55 to +100 °C. Unlike the longitudinal properties that hardly change with temperature, the transverse and in-plane shear stiffness and strength of these 3D printed composites were particularly sensitive to temperature variations, with decreases of 25–30% and 30–55%, respectively. This was due to the high sensitivity of the polymer matrix, the fibre/matrix and interfilament interfaces when the composites were loaded along those directions, because damages induced by internal thermal stresses. Fractography has also been carried out to reveal damage mechanisms.

Currently there is a huge amount of freely available hydrographic data, and it is increasingly important to have easy access to it and to be provided with as much information as possible. Argo is a global collection of around 4000 active autonomous hydrographic profilers. Argo data go through two quality processes, real time and delayed mode. This work shows a methodology to filter profiles within a given polygon using the odd–even algorithm; this allows analysis of a study area, regardless of size, shape or location. The aim is to offer two filtering methods and to discard only the real-time quality control data that present salinity drifts. This takes advantage of the largest possible amount of valid data within a given polygon. In the study area selected as an example, it was possible to recover around 80 % in the case of the first filter that uses cluster analysis and 30 % in the case of the second, which discards profilers with salinity drifts, of the total real-time quality control data that are usually discarded by the users due to problems such as salinity drifts. This allows users to use any of the filters or a combination of both to have a greater amount of data within the study area of their interest in a matter of minutes, rather than waiting for the delayed-mode quality control that takes up to 12 months to be completed. This methodology has been tested for its replicability in five selected areas around the world and has obtained good results.

Abstract Introduction Diagnosis and treatment of obstructive sleep apnea (OSA) in children is often delayed due to the high prevalence and limited physician and sleep testing resources. As a result, children may be referred to multiple specialties, such as pediatric sleep medicine and pediatric otolaryngology, resulting in long waitlists. Method We used data from our pediatric OSA clinic to identify predictors of tonsillectomy and/or adenoidectomy (AT). Before being seen in the clinic, parents completed the Pediatric Sleep Questionnaire (PSQ) and screening questionnaires for restless leg syndrome (RLS), nasal rhinitis, and gastroesophageal reflux disease (GERD). Tonsil size data were obtained from patient charts and graded using the Brodsky-five grade scale. Children completed an overnight oximetry study before being seen in the clinic, and a McGill oximetry score (MOS) was assigned based on the number and depth of oxygen desaturations. Logistic regression, controlling for otolaryngology physician, was used to identify significant predictors of AT. Three triage algorithms were subsequently generated based on the univariate and multivariate results to predict AT. Results From the OSA cohort, there were 469 eligible children (47% female, mean age = 8.19 years, SD = 3.59), with 89% of children reported snoring. Significant predictors of AT in univariate analysis included tonsil size and four PSQ questions, (1) struggles to breathe at night, (2) apneas, (3) daytime mouth breathing, and (4) AM dry mouth. The first triage algorithm, only using the four PSQ questions, had an odds ratio (OR) of 4.02 for predicting AT (sensitivity = 0.28, specificity = 0.91). Using only tonsil size, the second algorithm had an OR to predict AT of 9.11 (sensitivity = 0.72, specificity = 0.78). The third algorithm, where MOS was used to stratify risk for AT among those children with 2+ tonsils, had the same OR, sensitivity, and specificity as the tonsil-only algorithm. Conclusion Tonsil size was the strongest predictor of AT, while oximetry helped stratify individual risk for AT. We recommend that referral letters for snoring children include graded tonsil size to aid in the triage based on our findings. Children with 2+ tonsil sizes should be triaged to otolaryngology, while the remainder should be referred to a pediatric sleep specialist. Graphical abstract

Service-Learning (SL) is a powerful methodology to acquire competences and values in Higher Education. However, there is still no widespread use in Information and Computer Science (ICS) degrees where most of the subjects are focused on the development of theoretical and practical contents purely related to technical competences. In this paper, we show the structure of a SL methodology to develop Bachelor's Thesis: 1) definition of proposals considering all the competencies of the Bachelor's Thesis subject and the needs of entities; 2) development of applications using agile methodologies, and 3) assessment of the SL experience from students, entities and professors. We present an experience developed in the 2019/2020 academic year with two entities devoted to disfavoured people. The results show both the high technical and professional quality of the projects and the high satisfaction of entities and students. We hope that the development of applications with the collaboration of non-profit entities allows the acquisition of both specific and transversal competencies on ICS degrees at the same time enhancing the development of useful professional ones.

Background: Fruits and vegetables are potential vehicle of transmission of intestinal parasites. The main aim of this study was to determine prevalence of intestinal parasitic contamination in fruits and vegetables sampled from Caborca region, Northwest Mexico. Methods: A total of 400 fruit and vegetable samples were collected from unregulated open-air markets and closed (i.e., regulated) markets in Caborca region of Northwest Mexico; including melon, peach, asparagus, and grapes. Faust, Kinyoun, and Enzyme-Linked Immunosorbent Assay (ELISA) techniques were used to detect and identify the genus and species of all parasites found in the examined samples. Data were statistically analyzed using STATA/SE (version 12.0). Results: An overall prevalence (45%) of parasitic contamination was found in the 400 fruit and vegetable samples. Endolimax nana (27.5%) and Entamoeba coli (17.5%) were the most common nonpathogenic parasites, while the most prevalent parasitic pathogens were Cryptosporidium spp. (11.7%), Cyclospora spp., (11.0%), and Blastocystis hominis (9.2%). Asparagus (31%) and grapes (38.9%) had significantly (p

Introduction: The fifth metacarpal neck fracture is traditionally treated with closed reduction and intrinsic plus cast immobilisation. Another alternative and more functional treatment is the syndactylia. The aim of our study is to compare both treatments searching for any differences in their functional outcomes. Method: We did a prospective, controlled, masked, randomised cohort study with patients over 18 years old attended from May 2019 to May 2020 in Vigo's Sanitary Area with this injure and an angle below 40°. The collected data was: sex, age, fracture angle, range of motion of the metacarpophalangeal articulation (MCFA), grip strength, pain, fracture consolidation, Quick DASH and comfort 4 and 6 weeks after the injury. Results: 39 men and 1 woman were included in the sample. 36.1 years old as the age average. 90% of the injuries affected the right hand, being all the patients right-handed, finding statistically significant differences in MCFA flexion within 4 weeks and in grade of discomfort, both in favour of the syndactylia (p

Patients with Fontan circulation have increased cardiac and pulmonary risks. In spinal surgery these risks are increased given the nature of the surgery and patient positioning. In this case report, we describe the anesthetic technique used in an 8-year-old female with congenital heart disease and restrictive lung disease requiring spinal surgery for severe scoliosis. We will discuss our management of this complex patient including choice of general anesthetic, hemodynamic goals, ventilator settings, and inherent risks of this procedure.

Abstract Background There is an emerging field to put into practice new strategies for developing molecules with antimicrobial properties. In this line, several metals and metalloids are currently being used for these purposes, although their cellular effect(s) or target(s) in a particular organism are still unknown. Here we aimed to investigate and analyze Au3+ toxicity through a combination of biochemical and molecular approaches. Results We found that Au3+ triggers a major oxidative unbalance in Escherichia coli, characterized by decreased intracellular thiol levels, increased superoxide concentration, as well as by an augmented production of the antioxidant enzymes superoxide dismutase and catalase. Because ROS production is, in some cases, associated with metal reduction and the concomitant generation of gold-containing nanostructures (AuNS), this possibility was evaluated in vivo and in vitro. Conclusions Au3+ is toxic for E. coli because it triggers an unbalance of the bacterium’s oxidative status. This was demonstrated by using oxidative stress dyes and antioxidant chemicals as well as gene reporters, RSH concentrations and AuNS generation.

Sight distance is key to ensure safe road geometric design under all circumstances. Road design standards propose models simulating nighttime driving that contemplate the features of vehicle frontlighting systems to address the design of sag curves. These models are based on a deterministic approach, which is known to present a number of drawbacks. It neglects the stochastic nature of the variables involved and, therefore, no information is available about the safety margin of the design output. As opposed to design based on deterministic methods, probabilistic methods overcome these inconveniences providing a solid approach to broach the analysis of sag curves. This research study applied a probabilistic approach to evaluate the risk level (probability of noncompliance, Pnc) associated to sag curve designs, and assessed the effect of the variables involved in headlight sight distance (HSD) on the Pnc. The required stopping sight distance was considered not to be met when it exceeded the HSD. A total of 71,334 case studies were generated by combining the range of values of the variables involved in the HSD as per the Spanish geometric design standard. The risk level associated to each case was calculated by means of a Monte Carlo simulation. The results showed that variables modeling headlight features significantly affect the risk level. Moreover, the risk associated to design outputs that are considered equivalent by the standard varies significantly. Therefore, the use reliability theory in the development of standards and design guides is recommended.

A comparative study was conducted on the efficiency of mercury removal using bacterial nanocellulose (BNC) membranes obtained from the fermentation of the microorganism Komagataeibacter medellinensis, in contrast with its oxidized analog obtained by modifying the bacterial nanocellulose membranes via oxidation with 2,2,6,6-Tetramethylpiperidine-1-oxyl. Both types of membranes (modified and unmodified) were characterized to identify variations in the Physico-chemical parameters after modification. FTIR spectra confirmed the chemical modification of cellulose in all reaction conditions by the presence of a new characteristic band at ∼1730 cm−1, corresponding to the new carboxylic groups produced by the oxidative process, and the decline of the band at ∼1,650 cm−1, corresponding to the hydroxyl groups of the C6 carbon. While the XRD profiles indicated that the percentage of BNC crystallinity decreased and the SEM images showed that the nanoribbon network was interrupted as the amount of oxidizing agent increased. The kinetics of mercury removal from both types of membrane was evaluated by calculating the concentration of mercury at different times and establishing a mathematical model to describe the kinetics of this process. The modified membranes improved significantly the adsorption process of the metal ion and it was found that the modification that results in the greatest adsorption efficiency was BNC-m 7.5 with a value of 92.97%. The results obtained suggest that the modification of the bacterial nanocellulose membranes by oxidation transcendentally improves the mercury removal capacity, outlining the modified membranes as an excellent material for mercury removal in wastewater.

Introduction: Distal radius fractures (DRF) are being a bigger burden for health resources as changes continue to happen in our population demography and in management strategies, so a precise epidemiologic comprehension is mandatory. We present a DRF epidemiology study and we compared it with other sanitary areas of the Iberian Peninsula and Europe. Method: Every DRF in our sanitary area registered between 2017 and 2018 in patients older than 18 years old were observational and retrospectively recorded and classified using AO-OTA classification. Age, sex, season of the year, mechanism of injury, presence of associated injuries and type of treatment were analysed. Results: 1121 DRF in 1108 patients, 903 women (81.5%) and 205 men (18.5%), were registered. Left side was affected in 612 cases (54.6%) and right side in 509 cases (45.4%). The average age of our sample was 65.9 years old (CI95%: 65–67.9 years old). The incidence rate of DRF in our population was 158.5 fractures per 100,000 people-year; 49.2% were classified as type A of AO-OTA classification and 19% were treated surgically. Conclusion: Incidence of DRF had a maximum during males and women sixth decade of age. Type A fractures of AO-OTA classification were the most frequent. Most part of the fractures were treated non-surgically. The usual patient treated surgically was a woman, over 50 years old with a distal radius intraarticular complex fracture. Resumen: Introducción: Las fracturas de la extremidad distal de radio (FEDR) representan una carga cada vez mayor para los recursos sanitarios debido a los cambios demográficos de la población y a las estrategias de gestión, por lo que la comprensión precisa de su epidemiología es esencial. Presentamos un estudio epidemiológico de FEDR y lo comparamos con otras áreas de la peninsula y Europa. Método: Se recogieron todas las FEDR de nuestra área sanitaria registradas en 2017 y 2018 en pacientes mayores de 18 años de forma retrospectiva y observacional agrupándolos según la clasificación de AO-OTA. Se analizaron las variables de edad, sexo, época del año, mecanismo de fractura, presencia de lesiones asociadas y tratamiento realizado. Resultados: Registramos 1.121 FEDR en 1.108 pacientes, 903 mujeres (81,5%) y 205 varones (18,5%). En 612 casos se vio afectado el lado izquierdo (54,6%) y en 509 el lado derecho (45,4%). La edad media de la muestra fue de 65,9 años (IC95%: 65–66,9 años). La tasa de incidencia de FEDR fue de 1585 fracturas por 100.000 habitantes/año. El 49,2% se clasificaron como tipo A de AO-OTA y se intervinieron quirúrgicamente un 19%. Conclusión: La incidencia de FEDR alcanza un máximo en la sexta década tanto en hombres como en mujeres. Las fracturas de tipo A de la clasificación AO-OTA son las más frecuentes. La mayoría se trataron de forma conservadora. El patrón de paciente tratado quirúrgicamente con más frecuencia es el de una mujer mayor de 50 años con FEDR articular compleja.

Background and objectives: Compare the morbidity and mortality, the length of hospital stay and the economic cost of the fragility fracture of the hip, in two nonconsecutive years thanks to the integrated orthogeriatric care. Material and method: Retrospective observational cohort study with 633 patients with hip fragility fracture with a mean age of 85.5 years, treated in the same Trauma and Orthopaedic Surgery service in two different years (2012 and 2017). Mean stay, surgical delay, perioperative mortality, one month and one year, and perioperative complications such as acute urine retention, pressure ulcers, and need for transfusion were measured. Results: Mortality during admission decreased from 10% in 2012 to 3.6% in 2017 (p = .004*), while mortality at thirty days (10.5% vs 7%) (p = .123) and one year (28.9% versus 24.9%) (p = .277). Hospital stay times, surgical delay, and postoperative admission time also decreased. The estimated total annual economic savings thanks to integrated orthogeriatric care amounted to € 1,017,084.94. Conclusions: Integrated orthogeriatric care of the patient with fragility fracture of the hip, results in a more effective and efficient care model. Both the care and the clinical situation of patients are improved in the perioperative period, both hospital stay and mortality during admission are significantly reduced, and all this with significant associated economic savings. Resumen: Antecedentes y objetivos: Comparar la morbimortalidad, el tiempo de estancia hospitalaria y el gasto económico de la fractura por fragilidad de cadera en 2 años no consecutivos gracias a la atención ortogeriátrica integrada. Material y método: Estudio observacional retrospectivo de cohorte con 633 pacientes con fractura por fragilidad de cadera con una media de edad de 85,5 años, tratados en un mismo servicio de Cirugía Ortopédica y Traumatología en dos años diferentes (2012 y 2017). Se midieron la estancia media, la demora quirúrgica, la mortalidad perioperatoria, al mes y al año, y complicaciones perioperatorias como la retención aguda de orina, las úlceras por presión y la necesidad de transfusión. Resultados: La mortalidad durante el ingreso disminuyó del 10% en 2012 al 3,6% en 2017 (p = 0,004), a la vez que la mortalidad a los 30 días (10,5% frente a 7%) (p = 0,123) y al año (28,9% frente a 24,9%) (p = 0,277). También disminuyeron los tiempos de estancia hospitalaria, la demora quirúrgica y el tiempo de ingreso postoperatorio. El ahorro económico total anual estimado gracias a la atención ortogeriátrica integrada supuso 1.017.084,94€. Conclusiones: La atención ortogeriátrica integrada del paciente con fractura por fragilidad de la cadera, resulta en un modelo de atención más efectivo y eficiente. Se mejoran tanto la calidad asistencial como la situación clínica de los pacientes en el periodo perioperatorio, se disminuyen significativamente tanto la estancia hospitalaria como la mortalidad durante el ingreso, y todo ello con un importante ahorro económico asociado.

Characterizing the cyclic magnetic activity of stars that are close approximations of our Sun offers our best hope for understanding our Sun’s current and past magnetism, the space weather around solar-type stars, and more generally, the dynamos of other cool stars. The nearest current approximation to the Sun is the solar twin 18 Scorpii, a naked-eye Sun-like star of spectral type G2 Va. However, while 18 Scorpii’s physical parameters closely match those of the Sun, its activity cycle is about 7 yr, and shorter than the solar cycle. We report the measurement of a periodicity of 15 yr that corresponds to a longer activity cycle for 18 Scorpii based on observations extending to the last three decades. The global magnetic geometry of 18 Scorpii changes with this 15 yr cycle and appears to be equivalent to the solar 22 yr magnetic polarity cycle. These results suggest that 18 Scorpii is also a magnetic proxy for a younger Sun, adding an important new datum for testing dynamo theory and magnetic evolution of low-mass stars. The results perturb our understanding of the relationship between cycle and rotation, constrain the Sun’s magnetism and the Sun–Earth connection over the past billion years, and suggest that solar Schwabe and Hale cycle periods have increased over that time span.

4D printing focus on the integration of a targeted morphing function by controlling the properties and the architecture of the materials.The present work evaluates the potential of tailoring 4D printing to Hygromorph BioComposite (HBC), which paves the way for the construction of a new generation of sustainable shape-changing metamaterials with a sequential response. HBCs are made of continuous flax fibres that have been proven to be relevant for actuation and thus 4D printing due to their hygromorphism function.The morphing performance of HBCs can be boosted by selecting an appropriate matrix. The soft Poly Buthylene Succinate (PBS) matrix showed a 92% increase in responsiveness and 500% increase in reactivity compared to the Poly Lactic Acid (PLA)/Flax HBC.4D printing with Layer Height (LH) control within layers allows for complex actuation potential with a local control of the thickness and stiffness ratio. The Interfilament Distance of the 0° oriented passive layer (IDp) offers the opportunity to achieve non-uniform reactivity and responsiveness for autonomous smart surfaces.Finally, the programming of the spatial distribution of the flax yarn can be combined with heterogeneities. As an illustration, simple compliant mechanism via localized microstructure changes is proposed.

Lily (genus Lilium) is one of the most important flowers for bulb and cut flower production in the world. Lilium rubellum Baker is a native species of Japan that exhibits early flowering, is pink coloured, and possesses a pleasant fragrance, which makes it an important genetic resource for breeding lilies. In this work, the genetic diversity of L. rubellum was studied among three natural populations located in Fukushima Prefecture, Japan, which have been designated as the Mt. Azuma, Nango and Atsushio-kano populations. A total of 31 accessions collected in 1997 were analysed using Random Amplified Polymorphic DNA (RAPD) markers. Eighteen decamer primers produced 98% polymorphic RAPD bands; furthermore, 11 of the 18 primers produced 10 or more polymorphic bands with a mean per primer Polymorphic Information Content of 0.382. Among the three populations, the mean Shannon index, Nei´s gene diversity and percentage of polymorphic loci were 0.2749, 0.4099 and 76.7%, respectively. These data revealed that there is a high genetic diversity within all the populations. Analysis of the three genetic diversity indices within populations showed that the Nango population had the highest genetic diversity, whereas the Atsushio-kano population had the lowest. An unweighted pair group method with arithmetic mean dendrogram based on Jaccard´s similarity coefficient was constructed, and the three populations of L. rubellum collected in the Fukushima prefecture were clearly differentiated at 0.61 similarity index. The Nango and Mt. Azuma populations were genetically closer than the Atsushio-kano population. The analysis of molecular variance showed a 29.53% variance among the populations. This study revealed that there is high genetic diversity within populations and moderate genetic diversity among the three natural populations of L. rubellum Baker in the Fukushima Prefecture of Japan.

Doping effects of CuO on the sintering behavior and electrical properties of 0.94(Bi0.5Na0.5)TiO3–0.06(BaTiO3)–xCuO (BNT–BT6–xCu) lead-free piezoceramic obtained by the conventional solid-state reaction method were investigated. Regarding the undoped system, it is already known that it presents the best densification values when it is sintered at 1150∘C, however, the doped system was sintered at 1150∘C, 1100∘C, 1050∘C, 1025∘C, and 975∘C to determine the effect of Cu on the densification process. Therefore, it was obtained that the CuO-doped samples sintered at 1050∘C presented the highest density values and therefore were the ones chosen to perform the characterization tests together with the undoped system. The samples were characterized using X-ray diffraction (XRD), Raman microspectroscopy, and scanning electron microscopy (SEM) analysis, whereas the ferroelectric and dielectric properties were evaluated by means of ferroelectric hysteresis loops and impedance spectroscopy studies. As a result, the addition of CuO allowed an improvement in sinterability and densification, with the subsequent grain growth, and the improvement of the piezoelectric coefficient (d33).

The effect of sintering condition on structure, microstructure, and ferroelectric properties of (K0.44Na0.52Li0.04) (Nb0.86Ta0.10Sb0.04)- O3 (KNL–NTS) has been investigated. Ceramic powders have been synthesized by the solid-state reaction method and sintered at different temperatures (1115∘C, 1125∘C, and 1140∘C). Then, samples were characterized by thermogravimetric analysis, X-ray diffraction, scanning electron microscopy, and impedance spectroscopy. Through XRD results, the perovskite structure and small peaks corresponding to a secondary phase were detected. Ceramics processed at the highest temperatures showed higher densities and good piezoelectric properties (d33, Kp, and Kt), particularly specimens sintered at 1125∘C presented the highest piezoelectric performance.

Introduction The intravenous (IV) is one of the main parenteral routes for drug administration. Rapid onset of action, precise titration, patient-specific dosing and bypass of liver metabolism are a few of its advantages, while hypersensitivity reactions, adverse effects, infection risk and a higher overall cost some of its most debated downsides. Unlike other areas of Medicine, IV has been significantly under-utilized in Psychiatry. Objectives This systematic review analyzed the evidence for effectiveness and safety behind the use of IV medication used for the management of acute disturbance. Methods APA PsycINFO, MEDLINE, and EMBASE databases were searched for eligible studies. Studies were included if they used IV medication to treat acute disturbance, in English language, had participants aged >18. The quality of the included studies was assessed using the National Institutes of Health quality checklist. Results 17 studies were deemed eligible. Data analysis was limited to narrative synthesis since primary outcome measures varied significantly between each study. Findings showed strong evidence for efficacy and safety of dexmedetomidine, droperidol, midazolam, and olanzapine. These medications displayed a short time to sedation, reduction in agitation levels, or large percentage of patients adequately sedated with a low number of adverse events. Results did not provide enough evidence for the use of IV ketamine, haloperidol, diazepam, lorazepam, and promethazine. Conclusions This review supports dexmedetomidine, droperidol, midazolam, and olanzapine as safe and efficacious options for managing acute disturbance via the intravenous route, particularly in special clinical settings where trained staff, optimal monitoring, resuscitation equipment and ventilators are all at hand.

Purpose: The main purpose of this research was to show if there are differences between the Mediterranean diet and physical activity in students from Romania and Spain. Material: The study was carried out on a sample of 567 participants, 149 of which (24.69%) are from Romania (Transilvania University of Braşov) and 427 (75.31%) are students from Spain (University of Granada ). To evaluate adherence to the Mediterranean diet we used The Mediterranean Diet Quality Index (KIDMED), and for the assessment of the level of physical activity, we used the Physical Activity Questionnaire for Adolescents (PAQ-A). The reliability of the KIDMED was good (Cronbach’s α = 0.83) and for PAQ-A is 0.874. Statistical analyses were done through program IBM SPSS Statistics 22. The statistical indicators used in this study, were the following: standard deviation (SD), arithmetic average (X), chi-square test, Student’s T-test (t), percent%, Levene’s test, ANOVA One-Way. Results: The results of the variance analysis showed that there is no statistically significant relationship between the adherence to the Mediterranean diet and physical activity in Romanian students (F=0.517; p=0.598), or in Spanish students (F=0.255; p=0.775). Also, the results regarding adherence to the MD and PA was: poor adherence , n=31, (mean=29.06; standard deviation=3.723), average adherence , n=275, (mean=28.62; standard deviation=3.386), and high adherence, n=261 (mean=28.50; standard deviation=3.779). Conclusions: This study highlighted the fact that there are no significant differences regarding the adherence to the Mediterranean diet and the level of physical activity between the two countries (Romania and Spain). Unlike Spanish students, we found that Romanian students have a poor adherence to the MD.

Polyploidization has been traditionally considered a phenomenon that mediates ecological differentiation; however, the adaptive value of genome duplications has been seldom explored. Natural or synthetic polyploids offer unique opportunities to experimentally quantify the immediate consequences of genome duplications in plant traits that may be involved with ecological differentiation. Jasione maritima is a diploid-tetraploid complex with cytotypes distributed allopatrically in an environmental gradient ideal for exploring the role of genome duplications in the success of polyploid lineages. However, like in numerous other polyploid complexes, neotetraploids of J. maritima have not been found in nature. In this study we developed a methodology to obtain synthetic tetraploids from seeds collected in wild diploid plants of J. maritima. We tested the effect of different colchicine concentrations and seedling ages in survival and polyploidization success of J. maritima seedlings, using flow cytometry to assess ploidy level and considering the population of origin. A methodology to synchronize seed germination was also explored. Synchronization of seed germination was best achieved using a cold treatment of 2 weeks before the transference to a growth chamber. An overall survival rate of 11.5±0.7 % and further tetraploid conversion of 35.6±2.9 % was obtained using 3-day-old seedlings of J. maritima. Survival rates were variable depending on colchicine treatment (the highest the most lethal) and seedling origin (i.e. population), while conversion rate was similar across these factors and high rates of tetraploid conversion were obtained. Considering that the main constraint was survival to the colchicine treatment, we suggest the use of the lowest colchicine concentration tested, i.e. 0.1 % colchicine. The use of older seedlings increased survival rates but, in many cases, compromised a complete tetraploid conversion, generating many diploid-tetraploid mixoploid plants.

T cells can be activated by a small, two-digit, number of antigen peptide molecules even though the receptor for antigen (TCR) is of low affinity. Here the authors present evidence that all TCRs within a nanocluster can become activated when only a subset is bound to antigen.

Abstract Background Chondrotoxic effects of local anaesthetics are well reported in humans and some animal species but knowledge on their toxic effects on synoviocytes or equine chondrocytes or the effects on cellular production of inflammatory cytokines is limited. The purpose of this study was to evaluate the in vitro effects of local anaesthetics, morphine, magnesium sulphate (MgSO4) or their combinations on cell viability and pro-inflammatory cytokine gene expression of equine synoviocytes and chondrocytes. Equine synoviocytes and cartilage explants harvested from normal joints in a co-culture system were exposed to mepivacaine (4.4 mg/ml), bupivacaine (2.2 mg/ml), morphine (2.85 mg/ml) and MgSO4 (37 mg/ml) alone or each local anaesthetic plus morphine or MgSO4 or both together. Chondrocyte and synoviocyte cell viability was assessed by CellTiter-Glo Luminescent Cell Viability Assay. Synoviocyte gene expression of IL-1β, IL-6 or TNF-α was measured and compared using the ∆∆CT method. Results Morphine alone, MgSO4 alone or their combination did not alter cell viability or the expression of IL-1β, IL-6 or TNF-α. However, local anaesthetics alone or in combination with morphine and/or MgSO4 reduced cell viability and increased the gene expression of IL-1β, IL-6 or TNF-α. Single short exposure to local anaesthetics is toxic to both chondrocytes and synoviocytes and their combination with morphine and/or MgSO4 enhanced the cytotoxic effects. Conclusions This in vitro study gives further evidence of the absence of cytotoxic effects of morphine alone, MgSO4 alone or their combination on normal articular tissues. However, local anaesthetics alone or in combination with morphine and/or MgSO4 have cytotoxic effects on equine articular tissues.

Introducción: El consumo de tabaco es considerado factor de riesgo ante el desarrollo de múltiples patologías a nivel pulmonar y cardio-vascular, entre otras. En este sentido, la práctica de actividad física es considerada un factor de protección. Objetivo: Describir las variables socio-demográficas y de calidad de vida en cuanto al consumo de tabaco y la práctica de actividad física en una población Melillense. Material y Método: Trabajo de investigación con diseño cuantitativo, de carácter descriptivo y corte transversal de una muestra de residentes en Melilla, acerca del consumo de tabaco y la práctica de actividad física. Resultados: Más de tres cuartas partes de los participantes manifestaron no fumar tabaco y tres de cada diez sujetos no realizaba ningún tipo de actividad física. Conclusiones: Hay que seguir trabajando por afianzar conductas saludables en la población, en relación al consumo de sustancias nocivas y la práctica de actividad física.

Recently, interest has been increasing in natural fibres as composite reinforcing fillers for polymer-based filaments manufactured with the Fused Deposition Modeling (FDM) process, despite their moderate mechanical properties compared to pure polymer.An innovative way was proposed in the present work to optimize the mechanical properties of biocomposites. It was based on novel continuous flax fibre/PLA (cFF/PLA) composite filaments made with a customized co-extrusion process and printed with a simple and affordable printing machine. The microstructure of the printed cFF/PLA biocomposite evidenced a homogeneous distribution of yarn within the cross section, while the twisted flax yarn led to fibre-rich areas at mesoscale. The cFF/PLA showed tensile modulus and strength values that exceeded the only available published result on continuous natural fibre printed composites by >4.5 times. Tensile properties were in the same range as those for continuous glass fibre/PolyAmide (PA) printed composites, paving the way for the use of biocomposites in structural applications. Their weakest point was their transverse properties that remained poorer than similar flax/PLA thermocompressed composites. Keywords: 3D printing, Natural fibres, Mechanical properties

El sedentarismo se constituye como uno de los principales problemas para la salud de la población mundial del siglo XXI. Debido a las características socioculturales que presentan los estudiantes universitarios, resulta una población idónea para el estudio y fomento de actividad física (AF). El objetivo principal de la presente revisión sistemática es dar una visión general sobre la adherencia a la práctica de AF entre la población universitaria, así como de los programas de intervención dirigidos a fomentar dicha práctica, desde el año 2007 hasta nuestros días. La metodología utilizada ha estado dirigida por la declaración PRISMA. Como principales conclusiones, el 100% de los estudios de la primera selección sostienen la urgente necesidad de la creación e implementación de programas de intervención dirigidos a fomentar la práctica de AF entre estudiantes universitarios. Finalmente, la mayoría de los programas de intervención estudiados consiguen incrementar la adherencia a la práctica de AF.

La presente investigación tiene como objetivo analizar el clima motivacional de deportistas de diferentes modalidades deportivas en función del sexo, en una muestra compuesta por un total de 372 sujetos de edades comprendidas entre los 18 y 50 años, evaluados mediante el cuestionario de Clima Motivacional (PMCQS-2) y una hoja de auto registro que midió las variables sexo y modalidad deportiva practicada. Los resultados indican que los individuos analizados se orientan en su mayoría hacia a la tarea, encontrando una mayor orientación al ego en hombres que en mujeres. Los sujetos analizados que practican la modalidad de deporte individual con contacto son los que obtienen puntuaciones más elevadas en clima ego. El estudio revela la importancia de trabajar la motivación autodeterminada en los deportistas, como un medio para centrarse en el esfuerzo y la superación personal.

Resumen Aunque las luxaciones carpianas son lesiones relativamente frecuentes, la luxación aislada del piramidal es excepcional. Presentamos un caso aislado de luxación volar del hueso piramidal, revisando los casos similares publicados en la literatura y analizando los aspectos más importantes en relación con su diagnóstico y tratamiento. Varón de 38 años de edad, con caída sobre su mano derecha en hiperextensión. Inicialmente el diagnóstico pasó desapercibido. Al mes se realizó reducción abierta y estabilización con agujas de Kirchner. A los 4 años de la cirugía el paciente se encuentra asintomático y con la misma fuerza de agarre que la mano contralateral. Las radiografías postoperatorias muestran una buena reducción del carpo sin signos de inestabilidad. La falta de un diagnóstico inicial y en consecuencia un retraso en el tratamiento hacen más difícil el manejo de las lesiones, pero es una reducción inadecuada del carpo el factor pronóstico más negativo.