SARS-CoV-2 Infection During the First and Second Pandemic Waves in Spain: the ENE-COVID Study.

Objectives. To describe participant characteristics associated with severe acute respiratory syndrome coronavirus 2 infection in Spain's first 2 COVID-19 waves per the Spanish National Seroepidemiological Survey of SARS-CoV-2 Infection (ENE-COVID). Methods. A representative cohort of the noninstitutionalized Spanish population, selected through stratified 2-stage sampling, answered a questionnaire and received point-of-care testing April to June 2020 (first wave: n = 68 287); previously seronegative participants repeated the questionnaire and test November 2020 (second wave: n = 44 451). We estimated seropositivity by wave and participant characteristics, accounting for sampling weights, nonresponse, and design effects. Results. We found that 6.0% (95% confidence interval [CI] = 5.7%, 6.4%) of Spain's population was infected by June and 3.8% (95% CI = 3.5%, 4.1%) more by November 2020. Both genders were equally affected. Seroprevalence decreased with age in adults 20 years and older in the second wave; socioeconomic differences increased. Health care workers were affected at 11.1% (95% CI = 9.0%, 13.6%) and 6.1% (95% CI = 4.4%, 8.5%) in the first and second waves, respectively. Living with an infected person increased infection risk to 22.1% (95% CI = 18.9%, 25.6%) in the first and 35.0% (95% CI = 30.8%, 39.4%) in the second wave. Conclusions. ENE-COVID characterized the first 2 pandemic waves, when information from surveillance systems was incomplete. (Am J Public Health. 2023;113(5):533-544. https://doi.org/10.2105/AJPH.2023.307233).

Design and Implementation of a Nationwide Population-Based Longitudinal Survey of SARS-CoV-2 Infection in Spain: The ENE-COVID Study.

Data System. The Spanish National Seroepidemiological Survey of SARS-CoV-2 (or ENE-COVID; SARS-CoV-2 [severe acute respiratory syndrome coronavirus 2] is the causative agent of COVID-19) was funded by the Spanish Ministry of Health, the Instituto de Salud Carlos III, and the Spanish National Health System. Data Collection/Processing. A stratified 2-stage probability sampling was used to select a representative cohort of the noninstitutionalized population of Spain. ENE-COVID collected longitudinal data from epidemiological questionnaires and 2 SARS-CoV-2 IgG antibody tests. From April 27 to June 22, 2020, 68 287 participants (77.0% of contacted persons) received a point-of-care test and 61 095 (68.9%) also underwent a laboratory immunoassay. A second follow-up phase was conducted between November 16 and 30, 2020. Data Analysis/Dissemination. Analyses use weights to adjust for oversampling and nonresponse and account for design effects of stratification and clustering. ENE-COVID data for research purposes will be available upon request from the official study Web page. Public Health Implications. ENE-COVID, a nationwide population-based study, allowed monitoring seroprevalence of antibodies against SARS-CoV-2 at the national and regional levels, providing accurate figures by gender, age (from babies to nonagenarians), and selected risk factors; characterizing symptomatic and asymptomatic infections; and estimating the infection fatality risk during the first pandemic wave. (Am J Public Health. 2023;113(5):525-532. https://doi.org/10.2105/AJPH.2022.307167).

Tracking end-of-life stage of chemicals: A scalable data-centric and chemical-centric approach.

Chemical flow analysis (CFA) can be used for collecting life-cycle inventory (LCI), estimating environmental releases, and identifying potential exposure scenarios for chemicals of concern at the end-of-life (EoL) stage. Nonetheless, the demand for comprehensive data and the epistemic uncertainties about the pathway taken by the chemical flows make CFA, LCI, and exposure assessment time-consuming and challenging tasks. Due to the continuous growth of computer power and the appearance of more robust algorithms, data-driven modelling represents an attractive tool for streamlining these tasks. However, a data ingestion pipeline is required for the deployment of serving data-driven models in the real world. Hence, this work moves forward by contributing a chemical-centric and data-centric approach to extract, transform, and load comprehensive data for CFA at the EoL, integrating cross-year and country data and its provenance as part of the data lifecycle. The framework is scalable and adaptable to production-level machine learning operations. The framework can supply data at an annual rate, making it possible to deal with changes in the statistical distributions of model predictors like transferred amount and target variables (e.g., EoL activity identification) to avoid potential data-driven model performance decay over time. For instance, it can detect that recycling transfers of 643 chemicals over the reporting years (1988 to 2020) are 29.87%, 17.79%, and 20.56% for Canada, Australia, and the U.S. Finally, the developed approach enables research advancements on data-driven modelling to easily connect with other data sources for economic information on industry sectors, the economic value of chemicals, and the environmental regulatory implications that may affect the occurrence of an EoL transfer class or activity like recycling of a chemical over years and countries. Finally, stakeholders gain more context about environmental regulation stringency and economic affairs that could affect environmental decision-making and EoL chemical exposure predictions.

The PDZ protein SCRIB regulates sodium/iodide symporter (NIS) expression at the basolateral plasma membrane.

The sodium/iodide symporter (NIS) expresses at the basolateral plasma membrane of the thyroid follicular cell and mediates iodide accumulation required for normal thyroid hormonogenesis. Loss-of-function NIS variants cause congenital hypothyroidism due to impaired iodide accumulation in thyroid follicular cells underscoring the significance of NIS for thyroid physiology. Here we report novel findings derived from the thorough characterization of the nonsense NIS mutant p.R636* NIS-leading to a truncated protein missing the last eight amino acids-identified in twins with congenital hypothyroidism. R636* NIS is severely mislocalized into intracellular vesicular compartments due to the lack of a conserved carboxy-terminal type 1 PDZ-binding motif. As a result, R636* NIS is barely targeted to the plasma membrane and therefore iodide transport is reduced. Deletion of the PDZ-binding motif causes NIS accumulation into late endosomes and lysosomes. Using PDZ domain arrays, we revealed that the PDZ-domain containing protein SCRIB binds to the carboxy-terminus of NIS by a PDZ-PDZ interaction. Furthermore, in CRISPR/Cas9-based SCRIB deficient cells, NIS expression at the basolateral plasma membrane is compromised, leading to NIS localization into intracellular vesicular compartments. We conclude that the PDZ-binding motif is a plasma membrane retention signal that participates in the polarized expression of NIS by selectively interacting with the PDZ-domain containing protein SCRIB, thus retaining the transporter at the basolateral plasma membrane. Our data provide insights into the molecular mechanisms that regulate NIS expression at the plasma membrane, a topic of great interest in the thyroid cancer field considering the relevance of NIS-mediated radioactive iodide therapy for differentiated thyroid carcinoma.

ADAM: A web platform for graph-based modeling and optimization of supply chains.

Modeling and optimization are essential tasks that arise in the analysis and design of supply chains (SCs). SC models are essential for understanding emergent behavior such as transactions between participants, inherent value of products exchanged, as well as impact of externalities (e.g., policy and climate) and of constraints. Unfortunately, most users of SC models have limited expertise in mathematical optimization, and this hinders the adoption of advanced decision-making tools. In this work, we present ADAM, a web platform that enables the modeling and optimization of SCs. ADAM facilitates modeling by leveraging intuitive and compact graph-based abstractions that allow the user to express dependencies between locations, products, and participants. ADAM model objects serve as repositories of experimental, technology, and socio-economic data; moreover, the graph abstractions facilitate the organization and exchange of models and provides a natural framework for education and outreach. Here, we discuss the graph abstractions and software design principles behind ADAM, its key functional features and workflows, and application examples.

Targeted Next-Generation Sequencing of Congenital Hypothyroidism-Causative Genes Reveals Unexpected Thyroglobulin Gene Variants in Patients with Iodide Transport Defect.

Congenital iodide transport defect is an uncommon autosomal recessive disorder caused by loss-of-function variants in the sodium iodide symporter (NIS)-coding SLC5A5 gene and leading to dyshormonogenic congenital hypothyroidism. Here, we conducted a targeted next-generation sequencing assessment of congenital hypothyroidism-causative genes in a cohort of nine unrelated pediatric patients suspected of having a congenital iodide transport defect based on the absence of 99mTc-pertechnetate accumulation in a eutopic thyroid gland. Although, unexpectedly, we could not detect pathogenic SLC5A5 gene variants, we identified two novel compound heterozygous TG gene variants (p.Q29* and c.177-2A>C), three novel heterozygous TG gene variants (p.F1542Vfs*20, p.Y2563C, and p.S523P), and a novel heterozygous DUOX2 gene variant (p.E1496Dfs*51). Splicing minigene reporter-based in vitro assays revealed that the variant c.177-2A>C affected normal TG pre-mRNA splicing, leading to the frameshift variant p.T59Sfs*17. The frameshift TG variants p.T59Sfs*17 and p.F1542Vfs*20, but not the DUOX2 variant p.E1496Dfs*51, were predicted to undergo nonsense-mediated decay. Moreover, functional in vitro expression assays revealed that the variant p.Y2563C reduced the secretion of the TG protein. Our investigation revealed unexpected findings regarding the genetics of congenital iodide transport defects, supporting the existence of yet to be discovered mechanisms involved in thyroid hormonogenesis.

A data engineering approach for sustainable chemical end-of-life management.

The presence of chemicals causing significant adverse human health and environmental effects during end-of-life (EoL) stages is a challenge for implementing sustainable management efforts and transitioning towards a safer circular life cycle. Conducting chemical risk evaluation and exposure assessment of potential EoL scenarios can help understand the chemical EoL management chain for its safer utilization in a circular life-cycle environment. However, the first step is to track the chemical flows, estimate releases, and potential exposure pathways. Hence, this work proposes an EoL data engineering approach to perform chemical flow analysis and screening to support risk evaluation and exposure assessment for designing a safer circular life cycle of chemicals. This work uses publicly-available data to identify potential post-recycling scenarios (e.g., industrial processing/use operations), estimate inter-industry chemical transfers, and exposure pathways to chemicals of interest. A case study demonstration shows how the data engineering framework identifies, estimates, and tracks chemical flow transfers from EoL stage facilities (e.g., recycling and recovery) to upstream chemical life cycle stage facilities (e. g., manufacturing). Also, the proposed framework considers current regulatory constraints on closing the recycling loop operations and provides a range of values for the flow allocated to post-recycling uses associated with occupational exposure and fugitive air releases from EoL operations.

Analysis of incentive policies for phosphorus recovery at livestock facilities in the Great Lakes area.

Livestock operations have been highly intensified over the last decades, resulting in the advent of large concentrated animal feeding operations (CAFOs). Intensification decreases production costs but also leads to substantial environmental impacts. Specifically, nutrient runoff from livestock waste results in eutrophication, harmful algal blooms, and hypoxia. The implementation of nutrient recovery systems in CAFOs can abate nutrient releases and negative ecosystem responses, although they might negatively affect the economic performance of CAFOs. We design and analyze potential incentive policies for the deployment of phosphorus recovery technologies at CAFOs considering the geospatial vulnerability to nutrient pollution. The case study demonstration consists of 2217 CAFOs in the U.S. Great Lakes area. The results reveal that phosphorus recovery is more economically viable in the largest CAFOs due to economies of scale, although they also represent the largest eutrophication threats. For small and medium-scale CAFOs, phosphorus credits progressively improve the profitability of nutrient management systems. The integration of biogas production does not improve the economic performance of phosphorus recovery systems at most of CAFOs, as they lack enough size to be cost-effective. Phosphorus recovery proves to be economically beneficial by comparing the net costs of nutrient management systems with the negative economic impact derived from phosphorus releases. The incentives necessary for avoiding up to 20.7×103 ton/year phosphorus releases and achieve economic neutrality in the Great Lakes area are estimated at $223 million/year. Additionally, the fair distribution of limited incentives is studied using a Nash allocation scheme, determining the break-even point for allocating monetary resources.

Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study.

BACKGROUND: Spain is one of the European countries most affected by the COVID-19 pandemic. Serological surveys are a valuable tool to assess the extent of the epidemic, given the existence of asymptomatic cases and little access to diagnostic tests. This nationwide population-based study aims to estimate the seroprevalence of SARS-CoV-2 infection in Spain at national and regional level. METHODS: 35 883 households were selected from municipal rolls using two-stage random sampling stratified by province and municipality size, with all residents invited to participate. From April 27 to May 11, 2020, 61 075 participants (75·1% of all contacted individuals within selected households) answered a questionnaire on history of symptoms compatible with COVID-19 and risk factors, received a point-of-care antibody test, and, if agreed, donated a blood sample for additional testing with a chemiluminescent microparticle immunoassay. Prevalences of IgG antibodies were adjusted using sampling weights and post-stratification to allow for differences in non-response rates based on age group, sex, and census-tract income. Using results for both tests, we calculated a seroprevalence range maximising either specificity (positive for both tests) or sensitivity (positive for either test). FINDINGS: Seroprevalence was 5·0% (95% CI 4·7-5·4) by the point-of-care test and 4·6% (4·3-5·0) by immunoassay, with a specificity-sensitivity range of 3·7% (3·3-4·0; both tests positive) to 6·2% (5·8-6·6; either test positive), with no differences by sex and lower seroprevalence in children younger than 10 years (<3·1% by the point-of-care test). There was substantial geographical variability, with higher prevalence around Madrid (>10%) and lower in coastal areas (<3%). Seroprevalence among 195 participants with positive PCR more than 14 days before the study visit ranged from 87·6% (81·1-92·1; both tests positive) to 91·8% (86·3-95·3; either test positive). In 7273 individuals with anosmia or at least three symptoms, seroprevalence ranged from 15·3% (13·8-16·8) to 19·3% (17·7-21·0). Around a third of seropositive participants were asymptomatic, ranging from 21·9% (19·1-24·9) to 35·8% (33·1-38·5). Only 19·5% (16·3-23·2) of symptomatic participants who were seropositive by both the point-of-care test and immunoassay reported a previous PCR test. INTERPRETATION: The majority of the Spanish population is seronegative to SARS-CoV-2 infection, even in hotspot areas. Most PCR-confirmed cases have detectable antibodies, but a substantial proportion of people with symptoms compatible with COVID-19 did not have a PCR test and at least a third of infections determined by serology were asymptomatic. These results emphasise the need for maintaining public health measures to avoid a new epidemic wave. FUNDING: Spanish Ministry of Health, Institute of Health Carlos III, and Spanish National Health System.

No antibody response in cutaneous manifestations associated with COVID-19: An observational study of 64 cases with microbiological and clinical characterization.

BACKGROUND: The microbiological diagnosis of skin lesions related to COVID-19 is not well known. OBJECTIVE: Perform a microbiological diagnosis in COVID19-related cutaneous manifestations. METHODS: A cross-sectional study was performed with 64 patients with cutaneous manifestations associated with COVID-19 who underwent serological and nasopharyngeal reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2. RESULTS: Out of the 64 patients, 6 patients had positive RT-PCR, with all of them developing SARS-CoV-2 IgG and 4 of them had positive IgM + IgA. Of the 58 patients with negative RT-PCR, 8 cases had positive IgM + IgA and only one of them had IgG seroconversion. Therefore, the infection was demonstrated in 7 cases (10.9%) and was doubtful in 7 other cases (10.9%) who presented negative RT-PCR and presence of IgA + IgM without subsequent seroconversion of IgG. Fifty patients (78.1%) had negative serological tests. The most frequent cutaneous pattern was pseudo-chilblain (48.4%) followed by maculo-papular pattern (26.6%), urticarial lesions (10.9%), vesicular eruptions (6.3%) and livedoid pattern (4.7%). The maculo-papular pattern showed the highest positivity in RT-PCR (3 cases; 17.6%) and serologies (4 cases; 23.5%). Skin lesions developed after the systemic symptoms in most patients (19 cases; 61.3%). CONCLUSIONS: Microbiological confirmation tests may not be an effective diagnostic technique for COVID-related cutaneous manifestations or that attributed lesions are not related to COVID-19. Confounding factors such as adverse drug reaction, serological cross-reactions with other viruses, the low production of antibodies in asymptomatic or mild forms of COVID-19 or its rapid disappearance, increase diagnostic uncertainty.

Plaque-like cutaneous mucinosis of childhood.

A healthy 10-year-old boy presented with plaque-like cutaneous mucinosis (PCM) on his back. Cutaneous biopsy was followed by progressive resolution of the skin lesion. Pediatric PCM could differ clinically from the adult form. However, more cases are necessary to draw conclusions.

A geospatial environmental and techno-economic framework for sustainable phosphorus management at livestock facilities.

Nutrient pollution of waterbodies is a major worldwide water quality problem. Excessive use and discharge of nutrients can lead to eutrophication and algal blooms in fresh and marine waters, resulting in environmental problems associated with hypoxia, public health issues related to the release of toxins and freshwater scarcity. A promising option to address this problem is the recovery of nutrient releases prior to being discharged into the environment. Driven by the sustainable materials management concept, the COW2NUTRIENT (Cattle Organic Waste to NUTRIent and ENergy Technologies) framework is developed for the techno-economic evaluation and selection of nutrient recovery systems at livestock facilities. Environmental vulnerability to nutrient pollution determined through a geographic information system (GIS)-based model and techno-economic information of different state-of-the-art nutrient management technologies are combined in a multi-criteria decision analysis (MCDA) model, resulting in the selection and economic analysis of the most suitable process for each studied livestock facility. This framework has been employed for studying the implementation of sustainable phosphorus management systems at 2,217 livestock facilities in the Great Lakes area, resulting in capital expenses of 2.5 billion USD if only phosphorus recovery technologies are installed, and up to 5.2 billion USD if nutrient management is combined with biogas and power production. However, considering potential economic incentives for the recovery of phosphorus, net revenues up to 230 million USD per year can be achieved. Therefore, the framework presented reveals the potential of implementing nutrient management systems at regional scale for the abatement of phosphorus releases from livestock facilities.

A data engineering framework for on-site end-of-life industrial operations.

Sustainable initiatives for converting end-of-life (EoL) material flows into feedstocks would make a crucial contribution towards protecting our environment and mitigating the negative impacts of anthropogenic activities. Chemical flow analysis enables decision-makers to identify potential environmental releases and exposure pathways at the EoL stage and, therefore, improves the estimation of chemical exposure. Certain industrial facilities apply on-site pollution abatement operations, thereby constituting nodes of the chemical EoL management chain that can be evaluated and improved to enable greater circularity of materials. This work enhances and extends a recently published EoL data engineering framework by using publicly-available databases, data- driven models, and analytic hierarchy approaches to track chemicals, estimate releases, and potential exposure pathways at on-site industrial pollution management operations. The extended framework develops pollution abatement unit (PAU) technologies and estimates their efficiencies, chemical releases, exposure media, operating expenses, and capital expenditures. Relevant case studies based on the food and pharmaceutical industry sectors illustrate the application of the framework for chemical flow allocation and analysis of a chemical of concern and the benefits of integrating and extending the framework with data-driven and multi-criteria decision-making models. The results show how the enhanced framework designs and evaluates PAU technology systems for managing EoL chemical flows and provides release inventories and pathways for conducting chemical risk evaluation and exposure assessment of potential on-site EoL scenarios.

Saturday night purpura: An uncommon presentation of exercise-induced vasculitis.

Exercise-induced vasculitis (EIV) is a benign cutaneous vasculitis that affects healthy individuals. We report a case of EIV in a 15-year-old male patient with a striking clinical appearance triggered by a combination of prolonged standing and disco dancing in a warm environment. Pediatric dermatologists should be aware of this activity as a possible trigger of EIV, especially in teenagers.

Model-driven spatial evaluation of nutrient recovery from livestock leachate for struvite production.

Nutrient pollution is one of the major worldwide water quality problems, resulting in environmental and public health issues. Agricultural activities are the main source of nutrient release emissions, and the livestock industry has been proven to be directly related to the presence of high concentrations of phosphorus in the soil, which potentially can reach waterbodies by runoff. To mitigate the phosphorus pollution of aquatic systems, the implementation of nutrient recovery processes allows the capture of phosphorus, preventing its release into the environment. Particularly, the use of struvite precipitation produces a phosphorus-based mineral that is easy to transport, enabling redistribution of phosphorus to deficient locations. However, livestock leachate presents some characteristics that hinder struvite precipitation, preventing extrapolation of the results obtained from wastewater studies to cattle waste. Consideration of these elements is essential to determine the optimal operating conditions for struvite formation, and for predicting the amount of struvite recovered. In this work, a detailed thermodynamic model for precipitates formation from cattle waste is used to develop surrogate models to predict the formation of struvite and calcium precipitates from cattle waste. The variability in the organic waste composition, and how it affects the production of struvite, is captured through a probability framework based on the Monte Carlo method embedded in the model. Consistent with the developed surrogate models, the potential of struvite production to reduce the phosphorus releases from the cattle industry to watersheds in the United States has been assessed. Also, the more vulnerable locations to nutrient pollution were determined using the techno-ecological synergy sustainability metric (TES) by evaluating the spatial distribution and balance of phosphorus from agricultural activities. Although only struvite formation from cattle operations is considered, reductions between 22% and 36% of the total phosphorus releases from the agricultural sector, including manure releases and fertilizer application, can be achieved.

Exogenous acral pigmentation induced by coleoptera: an underdiagnosed mimic of severe disease.

Acral purpura is generally a hallmark for severe internal disease. However, exogenous pigmentation related to contact with invertebrates, can induce acral purpura-like lesions. Data regarding the beetle's ability to cause skin hyperpigmentation or purpura-like lesions are scarce. We report a case of exogenous pigmentation caused by accidental contact with a darkling beetle, clinically simulating acral purpuric lesions. The history of recent drug inhalation and abnormal autoimmunity tests made this diagnosis difficult.

[Painful nodules on the soles in a pediatric patient: A diagnostic challenge]. / Nodulos plantares dolorosos tras ejercicio intenso en paciente pediátrica: Un reto diagnóstico.

INTRODUCTION: Idiopathic Palmoplantar Eccrine Hidradenitis (IPPH) is a rare neutrophilic derma tosis, with painful erythematous nodules of sudden onset in the plantar or palmoplantar region, in children without other underlying diseases. OBJECTIVE: To present a case that shows the main clinical and histological characteristics of this entity. CLINICAL CASE: 11-year-old girl with a 48-hours history of painful erythematous-violaceous nodules on the right foot plant associated with fever of up to 38.2 °C, with no history of interest except hyperhidrosis and intense exercising on previous days. Given the clinical suspicion of IPPH, a skin biopsy was performed, which showed inflammatory neutrophil infiltration around eccrine sweat glands and neutrophilic abscesses, confirming the diagnosis. Oral NSAIDs and rest were prescribed, with resolution of the lesions in 7 days. CONCLUSIONS: This case demonstrates the most important aspects of this entity, in many cases underdiagnosed, since it can be confused with other pathologies that occur with painful acral nodules, but have different pathogenic and therapeutic implications. To properly identify the IPPH allows preventing an unnecessary alarm, both patients and their parents, as in dermatologists and pediatricians themselves.

A multi-objective optimization approach for the selection of working fluids of geothermal facilities: Economic, environmental and social aspects.

The selection of the working fluid for Organic Rankine Cycles has traditionally been addressed from systematic heuristic methods, which perform a characterization and prior selection considering mainly one objective, thus avoiding a selection considering simultaneously the objectives related to sustainability and safety. The objective of this work is to propose a methodology for the optimal selection of the working fluid for Organic Rankine Cycles. The model is presented as a multi-objective approach, which simultaneously considers the economic, environmental and safety aspects. The economic objective function considers the profit obtained by selling the energy produced. Safety was evaluated in terms of individual risk for each of the components of the Organic Rankine Cycles and it was formulated as a function of the operating conditions and hazardous properties of each working fluid. The environmental function is based on carbon dioxide emissions, considering carbon dioxide mitigation, emission due to the use of cooling water as well emissions due material release. The methodology was applied to the case of geothermal facilities to select the optimal working fluid although it can be extended to waste heat recovery. The results show that the hydrocarbons represent better solutions, thus among a list of 24 working fluids, toluene is selected as the best fluid.