Effect of FeCl3 concentration in chemically enhanced primary treatment on the performance of a conventional wastewater treatment plant. A case study.

The effect of coagulant dosage in a chemically enhanced primary treatment (CEPT) on the performance of a conventional wastewater treatment plant (WWTP) has been investigated. Lab-scale experiments simulations were carried out in order to evaluate the effect of coagulant addition on the primary settling performance. In these experiments, FeCl3 was used as coagulant. Later, the WWTP was theoretically simulated using a commercial software (WEST®) to evaluate the effect of coagulation/flocculation on the global system, based on the results obtained at lab-scale. According to these results, the CEPT modifies the organic matter balance in the WWTP, decreasing the contribution of readily (SS) and slowly (XS) biodegradable fractions of COD to the aerobic biological process up to 27.3% and 80.8%, respectively, for a dosage of FeCl3 of 24 mg L-1. Consequently, total suspended solids in the aerobic reactor and the secondary purged sludge decreased up to 33% and 13%, respectively. However, the influence on effluent quality was negligible. On the contrary, suspended solids concentration in the sludge to be treated by anaerobic digestion increased, mainly regarding the Ss and Xs fractions, which caused an 8.1% increase in biogas production potential, with approximately 60% of CH4 concentration.

Mortality and cardiovascular risk in vasculitis ANCA. Importance of hypertension and renal function. Experience from southern Spain.

BACKGROUND: Cardiovascular disease (CVD) is one of the principal causes of death in antineutrophil cytoplasmic antibody-(ANCA)-associated vasculitis (AAV). OBJECTIVES: To evaluate the mortality and it's causes and CVD and its vascular risk factors (VRFs) in AAV patients in Andalusia. METHODS: A multicenter cohort of 220 AAV patients followed-up from 1979 until June 2020 was studied in Andalussia, south of Spain. The information, including socio-demographic and clinical data was recorded retrospectively through chart review. Data was analysed using Chi2, ANOVA and Cox proportional hazards regresion as uni and multivariate test with a 95% confidence interval (CI). RESULTS: During a mean ± standard deviation follow-up of 96.79 ± 75.83 months, 51 patients died and 30 presented at least one CVE. Independent prognostic factors of mortality were age (HR 1.083, p=0.001) and baseline creatinine (HR 4.41, p=0.01). Independent prognostic factors of CVE were age [hazard ratio (HR) 1.042, p=0.005] and the presence of hypertension (HTN) six months after diagnosis (HR 4.641, p=0.01). HTN, diabetes and renal failure, all of these important VRFs, are more prevalent in AAV patients than it is described in matched general population. CONCLUSIONS: Age and baseline renal function, but not CVEs, are predictors of mortality and age and early HTN are independent predictors for having a CVE. CVD screening in AAV patients is demanded.

A solar evaporator fabricated from corncob waste for the desalination of seawater and removal of oil/herbicides from contaminated water.

Corncob (CC) based solar evaporators were employed to desalinize seawater brought from the Vallarta coast in Mexico. The pure CC produced an evaporation-rate and evaporation-efficiency of 0.63 kg m-2 h-1 and 38.4%, respectively, under natural solar light. Later, the CC was coated with carbonized CC (CCCE evaporator) or was coated with graphene (CCGE evaporator). Those evaporators were used for the desalination of seawater and obtained higher evaporation rates of 1.59-1.67 kg m-2 h-1, and higher evaporation efficiencies of 92-94% (under natural solar light). The desalination experiments were repeated under artificial solar light and the evaporation-rates/evaporation-efficiencies slightly decreased to 1.43-1.52 kg m-2 h-1/88-92%. The surface analysis of the evaporators by FTIR, XPS and Raman revealed that the CCGE evaporator had on its surface a lower content of defects and a higher amount of OH groups than the CCCE evaporator. Therefore, the CCGE evaporator had higher evaporation-rates/evaporation-efficiencies in comparison with the CCCE evaporator. Furthermore, we purified water contaminated with three different herbicides (fomesafen, 2-6 dichlorobenzamide and 4-chlorophenol at 30 ppm) by evaporation and using natural solar light. Interestingly, the CCCE and CCGE evaporators also removed the herbicides by physical adsorption with efficiencies of 12-22.5%. Moreover, the CCGE evaporator removed vegetable oil from contaminated water by adsorption and its maximum adsorption capacity was 1.72 g/g. Overall, our results demonstrated that the corncob-based evaporators studied here are a low-cost alternative to obtain clean water under natural solar light and this one was more effective for the desalination of seawater than the artificial sunlight (Xe lamp).

Corpus callosum-fastigium and tectal lengths in late-onset small fetuses.

OBJECTIVE: To investigate measurements on neurosonography of midbrain morphology, including corpus callosum-fastigium length and tectal length, in late-onset small fetuses subclassified as small-for-gestational-age (SGA) or growth-restricted (FGR). METHODS: This was a case-control study of consecutive singleton pregnancies delivered at term at a single center between January 2019 and July 2021, including those with late-onset smallness (estimated fetal weight (EFW) < 10th centile) and appropriate-for-gestational-age controls matched by age at neurosonography. Small fetuses were further subdivided into SGA (EFW between 3rd and 9th centile and normal fetoplacental Doppler) and FGR (EFW < 3rd centile or EFW < 10th centile with abnormal cerebroplacental ratio and/or uterine artery Doppler). Transvaginal neurosonography was performed at a mean ± SD gestational age of 33 ± 1 weeks in all fetuses to evaluate corpus callosum-fastigium length and tectal length in the midsagittal plane. Intra- and interobserver agreement was evaluated using the intraclass correlation coefficient and Bland-Altman plots. RESULTS: A total of 70 fetuses with late-onset smallness (29 with SGA and 41 with FGR) and 70 controls were included. Compared with controls, small fetuses showed significantly shorter corpus callosum-fastigium length (median (interquartile range), 44.7 (43.3-46.8) mm vs 43.7 (42.4-45.5) mm, P < 0.001) and tectal length (mean ± SD, 10.5 ± 0.9 vs 9.6 ± 1.0 mm, P < 0.001). These changes were more prominent in FGR fetuses, with a linear trend across groups according to severity of smallness. Corpus callosum-fastigium length and tectal length measurements showed excellent intra- and interobserver reliability. CONCLUSIONS: Small fetuses exhibited shorter corpus callosum-fastigium length and tectal length compared with controls, and these differences were more pronounced in fetuses with more severe smallness. These findings illustrate the potential value of midbrain measurements assessed on neurosonography as biomarkers for brain development in a high-risk population. However, further studies correlating these parameters with postnatal functional tests and follow-up are needed. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

Plasma rich in growth factors as treatment for a full-thickness macular hole due to macular telangiectasia type 2.

Full-thickness macular hole is a rare complication of macular telangiectasia type 2, and its treatment is still controversial. A patient with a full-thickness macular hole secondary to macular telangiectasia type 2 underwent vitreoretinal surgery with a plasma rich in growth factors membrane in the macular hole. At the sixth month of follow-up, anatomical and functional improvements were achieved, with no adverse effects. Plasma rich in growth factors is a new option, with advantages due to its biological properties that achieves good results in terms of safety and effectiveness in the surgical treatment of macular hole.

Production of gas diffusion layers with cotton fibers for their use in fuel cells.

The gas diffusion layer (GDL) is one of the most important parts of a proton exchange membrane fuel cell, that plays a key role transporting the current to the collector plates, distributing the reactant gases to the catalyst surface, and evacuating heat and water that is generated during the redox reactions inside the fuel cell. Speaking in terms of production cost, the GDL represents up to 45% of the total cost of the membrane electrode assembling (MEA). However, and despite its crucial role in a fuel cell, until recent years, the GDLs have not been studied with the same intensity as other MEA components, such as the catalyst or the proton exchange membrane. In this work, we present the production process, at laboratory scale, of a low cost GDL, using a non-woven paper-making process. A relevant aspect of this GDL is that up to 40% of their composition is natural cotton, despite which they present good electrical and thermal conductivity, high porosity, good pore morphology, high hydrophobicity as well as gas permeability. Furthermore, when the GDL with its optimum cotton content was tested in a single open cathode fuel cell, a good performance was obtained, which makes this GDL a promising candidate for its use in fuel cells.

Occurrence of antibiotics and antibiotic-resistant bacteria (ARB) in the Nervión river.

The main hydrometeorological, microbiological and physico-chemical characteristics of the Nervión river were monitored during a year, including 10 antibiotics and the presence of bacteria resistant to these antibiotics among faecal coliforms (FC) and total aerobic bacteria at 22 °C (TAB22). The characteristics of the river water were variable without a clear seasonal component, strongly influenced by rainfall, with a good quality for drinking water production throughout the year according to the physico-chemical parameters. The antibiotic resistant bacteria isolated from the water of the Nervión river were especially resistant to ß-lactams and macrolide antibiotics, highlighting the absence of resistance to derivatives of tetracyclines among strains of TAB22. A third of the isolated strains were multi-resistant to antibiotics with a seasonal component in its presence, with multi-resistant FC more abundant during summer and multi-resistant TAB22 more abundant during winter. The presence of antibiotics in the waters of the Nervión river was not very significant, with total absence of ß-lactams, minocycline and ciprofloxacin. Erythromycin and clarithromycin can be considered ubiquitous with mean concentrations of 2.5 ± 2.3 ngL-1 and 5.7 ± 4.6 ngL-1 respectively, and the presence of sulfamethoxazole and trimethoprim was also noticeable with maximum concentrations of 78.3 ngL-1 for sulfamethoxazole. Dilution due to the increase of rainfall was observed for several analysed antibiotics, but without significant seasonal differences.

[Use of 48-hour ABPM in specialist care. Experience in our centre]. / Empleo de la MAPA de 48 horas en atención especializada. Experiencia en nuestro centro.

Ambulatory blood pressure monitoring (ABPM) is a basic tool in the diagnosis and treatment of hypertension (HT). Validity is based on the number of readings taken and their duration. Our aim was to study in our 48-hour ABPM series whether extending the duration of ABPM to 48 hours is justified. MATERIAL AND METHODS: Retrospective analysis of a case series comprising 81 patients with 48-hour ABPM over a 5-year period (2013 to 2018). We analysed the differences between the first and second day. RESULTS: Eighty-one patients, 44 men, mean age of 52 years (± 18). The mean blood pressure (BP) was higher on the first day (132/77 mmHg vs. 130/76 mmHg, p ≤ .01) and there was also a greater proportion of patients with HT on the first day (59 vs. 50%; p ≤ .05). The patients with chronic kidney disease (CKD) (n = 33) had higher systolic BP (SBP) on the second night (p ≤ .05), a circadian rhythm of higher risk on the second day (dipper 13.6 vs. 86.4%, non-dipper 60.7 vs. 41.7%, and riser 30.3 vs. 18.8%; p ≤ .05), more diabetes (39%, p ≤ .01) and more left ventricular hypertrophy (LVH) (74%, p ≤ .05). CONCLUSIONS: 48-hour ABPM could determine BP readings and circadian rhythm better than 24-hour ABPM, especially in patients with CKD and diabetes, both diseases carrying high cardiovascular risk.

A new protocol reduces median door-to-needle time to the benchmark of 30 minutes in acute stroke treatment.

INTRODUCTION: Recent analyses emphasise that The Benchmark Stroke Door-to-Needle Time (DNT) should be 30min. This study aimed to determine if a new in-hospital IVT protocol is effective in reducing door-to-needle time and correcting previously identified factors associated with delays. MATERIAL AND METHODS: In 2014, we gradually introduced a series of measures aimed to reduce door-to-needle time for patients receiving IVT, and compared it before (2009-2012) and after (2014-2017) the new protocol was introduced. RESULTS: The sample included 239 patients before and 222 after the introduction of the protocol. Median overall door-to-needle time was 27min after the protocol was fully implemented (a 48% reduction on previous door-to-needle time [52min], P<.001)]. Median door-to-needle time was lower when pre-hospital code stroke was activated (22min). We observed a 26-min reduction in the median time from onset to treatment (P<.001). After the protocol was implemented, the "3-hour-effect" did not affect door-to-needle time (P=.98). Computed tomography angiography studies performed before IVT were associated with increased door-to-needle time (P<.001); however, the test was performed after IVT was started in most cases. CONCLUSIONS: Hospital reorganisation and multidisciplinary collaboration brought median door-to-needle time below 30min and corrected previously identified delay factors. Furthermore, overall time from onset to treatment was also reduced and more stroke patients were treated within 90min of symptom onset.

Drops of Lactiplantibacillus plantarum CRL 759 culture supernatant attenuates eyes inflammation induced by lipopolysaccharide.

Anti-inflammatory effect of soluble secreted compounds of probiotic bacteria was widely demonstrated as therapy for different inflammatory diseases, but was not investigated in inflammatory eye disorders. The aim of this study was to determine whether Lactiplantibacillus plantarum CRL759 cell-free supernatant reduced inflammatory parameters and clinical signs in ocular inflammations. First, we evaluated the effect of L. plantarum CRL759 supernatant in vitro on human retinal cell line, ARPE-19 cells, stimulated with lipopolysaccharide (LPS). Then, we investigated in vivo its capacity to decrease inflammation by local administration on the eyes of mice with endotoxin induced inflammation. In vitro assays demonstrated that L. plantarum CRL759 supernatant reduced the production of interleukin (IL)-6, IL-8, nitric oxide and thiobarbituric acid reactive substances in LPS-stimulated ARPE-19 cells. Our in vivo data proved that L. plantarum supernatant significantly reduced the clinical score of endotoxin treated mice and diminished levels of tumour necrosis factor alpha, interferon gamma and protein concentration in aqueous humour. Histological examination showed reduction of infiltrating inflammatory cells in the posterior segment of the eyes. As far as we know, this is the first report showing that Lactobacillus spp. supernatant administered as drops reduces some parameters of ocular inflammation. This promising strategy is safe and could alleviate symptoms and signs of ocular inflammation in people that are refractories to the conventional therapies.

Plasma rich in growth factors as treatment for a full-thickness macular hole due to macular telangiectasia type 2. / Plasma rico en factores de crecimiento como tratamiento para agujero macular de espesor total secundario a telangiectasia macular tipo 2.

Full-thickness macular hole is a rare complication of macular telangiectasia type 2, and its treatment is still controversial. A patient with a full-thickness macular hole secondary to macular telangiectasia type 2 underwent vitreoretinal surgery with a plasma rich in growth factors membrane in the macular hole. At the sixth month of follow-up, anatomical and functional improvements were achieved, with no adverse effects. Plasma rich in growth factors is a new option, with advantages due to its biological properties that achieves good results in terms of safety and effectiveness in the surgical treatment of macular hole.

Analysis of styles of play according to season and end of season rank in the National Rugby League.

OBJECTIVES: This study aimed to identify styles of play in the National Rugby League (NRL) relative to season and end of season rank (position on the NRL ladder) across the 2015-2019 seasons. DESIGN: Retrospective, longitudinal analysis of performance indicators. METHODS: Forty-eight performance indicators (e.g. runs, tackles) from all NRL teams and matches during the 2015-2019 seasons (n=2010) were quantified. Principal component analysis (PCA) was then used to identify styles of play based on dimensions (Factors) of performance indicators. Multivariate analysis of covariance (MANCOVA) was then used to explain these emergent styles of play relative to 'season' and 'end of season rank'. RESULTS: The PCA revealed nine Factors (six attacking, two defensive and one contested style) accounting for ∼51% of seasonal team performance variance. These nine Factors differed across 'seasons', with four showing an effect against 'end of season rank'. From these four, two Factors (ball possession and player efforts) impacted upon the combined effects of 'season' and 'end of season rank'. CONCLUSIONS: The PCA identified nine Factors reflecting a spread of attacking, defensive and contested styles of play within the NRL. These styles differed relative to season and a team's end of season ranking. These results may assist practitioners with the recognition of more contemporary styles of play in the NRL, enabling the development of strategies to exploit competition trends.

Open angle glaucoma secondary to endogenous cortisone due to pituitary microadenoma in a young patient, a case report. / Glaucoma de ángulo abierto secundario a cortisona endógena por microadenoma hipofisario en un paciente joven, a propósito de un caso.

CASE REPORT: A 31-year-old male was referred for evaluation after being diagnosed with Cushing syndrome secondary to a pituitary microadenoma. He presented with a reduced visual acuity and high intraocular pressure (IOP) of 48mmHg in both eyes. The examination with biomicroscopy showed normal anterior segment, increased cup to disc ratio, and open angle. There was a moderate-advanced involvement in the visual field. The patient was diagnosed with glaucoma secondary to endogenous corticosteroids, and medical treatment was initiated pending the removal of the adenoma. The IOP did not return to normal after the incomplete removal of the adenoma, so a trabeculectomy was performed to control the IOP. As conclusions: In the case of an ocular hypertension with pituitary tumour, secondary glaucoma to endogenous cortisone should be suspected. Early treatment of the tumour is necessary to bring the cortisone and IOP levels back to normal. Late diagnosis or incomplete treatment of these tumours may lead to not obtaining adequate IOP control.

Examining the evolution and classification of player position using performance indicators in the National Rugby League during the 2015-2019 seasons.

OBJECTIVES: This study aimed to: 1) examine recent seasonal changes in performance indicators for different National Rugby League (NRL) playing positions; and 2) determine the accuracy of performance indicators to classify and discriminate positional groups in the NRL. DESIGN: Retrospective, longitudinal analysis of individual performance metrics. METHODS: 48 performance indicators (e.g. passes, tackles) from all NRL games during the 2015-2019 seasons were collated for each player´s match-related performance. The following analyses were conducted with all data: (i) one-way ANOVA to identify seasonal changes in performance indicators; (ii) principal component analysis (PCA) to group performance indicators into factors; (iii) two-step cluster analysis to classify playing positions using the identified factors; and (iv) discriminant analysis to discriminate the identified playing positions. RESULTS: ANOVA showed significant differences in performance indicators across seasons (F=2.3-687.7; p=0-0.05; partial η2=0.00-0.075). PCA pooled all performance indicators and identified 14 factors that were included in the two-step cluster analysis (average silhouette=0.5) that identified six positional groups: forwards, 26.7%, adjustables, 17.2%, interchange, 23.2%, backs, 20.9%, interchange forwards, 5.5% and utility backs, 6.5%. Lastly, discriminant analysis revealed five discriminant functions that differentiated playing positions. CONCLUSIONS: Results indicated that player's performance demands across different playing positions did significantly change over recent seasons (2015-2019). Cluster analysis yielded a high-level of accuracy relative to playing position, identifying six clusters that best discriminated positional groups. Unsupervised analytical approaches may provide sports scientists and coaches with meaningful tools to evaluate player performance and future positional suitability in RL.

[Characteristics of motor behaviour in premature infants during the first months of postnatal life. A literature review]. / Rasgos característicos del comportamiento motor del niño con prematurez durante los primeros meses de vida posnatal: una revisión de la literatura.

OBJECTIVE: To describe the characteristics of motor behaviour in premature infants during the first months of postnatal life, according to the available evidence. MATERIALS AND METHODS: A systematic literature review was carried out; this method forms part of secondary studies under investigation and describes a phenomenon in detail based on primary sources of information. RESULTS: The literature search in the databases consulted yielded 7,228 articles; of these, 15 more were identified through "snowball" search strategies. At the start of the screening process, 63 eligible records were chosen based on their title and summary, and 14 were excluded because they were duplicates. A total of 49 articles were selected for a full text revision and, of these, 37 were excluded because they did not meet all the inclusion criteria. Finally, 12 articles were selected to prepare the qualitative synthesis of the present research work. CONCLUSIONS: In comparison with neonates born at term, premature infants demonstrate a particular motor repertoire, due to the immaturity of their systems; their motor behaviour follows a line of development mainly characterised by deficits in muscle tone, postural control, muscle balance, and antigravity muscle activation.

Predictive modelling of the physical demands during training and competition in professional soccer players.

OBJECTIVES: The present study aimed to predict the cut-off point-values that best differentiate the physical demands of training and competition tasks including friendly matches (FM), small sided games (SSG), large sided games (LSG), mini-goal games (MG) and ball circuit-training (CT) in professional soccer players. DESIGN: Experimental randomized controlled trial. METHODS: Fourteen professional players participated in all tasks with the CT, SSG and MG consisting of 8 repetitions of 4-min game play, interspersed by 2-min of active recovery. The training data were compared to the first 32-min of the LSG and two competitive FM per player. All movement patterns from walking to sprint running were recorded using 10Hz GPS devices while player perception of exertion was recorded via a visual analogue scale, post-task. Decision tree induction was applied to the dataset to assess the cut-off point-values from four training drills (SSG, LSG, MG, and CT) and FM for every parameter combination. RESULTS: Distance covered during jogging (2.3-3.3m/s; >436m), number of decelerations (≤730.5) and accelerations (≤663), and maximum velocity reached (>5.48m/s) characterized the physical demands during competition (FM) with great variability amongst training drills. CONCLUSION: The use of these novel, cut-off points may aid coaches in the design and use of training drills to accurately prepare athletes for soccer competition.

[Glucose-6-phosphate-dehydrogenase deficiency management in western countries. A literature review]. / Déficit de glucosa-6-fosfato-deshidrogenasa (G6PD) en países occidentales. Revisión bibliográfica.

Glucose-6-phosphate-dehydrogenase (G6PD) deficiency is the most prevalent abnormal enzyme condition in the general population, but most patients are asymptomatic (crises are triggered by certain drugs or foods). The clinical consequences are greater in patients coming from endemic areas of malaria (antimalarial medication can trigger a crisis). The increase in migratory flows has led to an increase in the number of people affected by the deficiency in our practice, which makes it interesting to carry out a literature review of this condition. Some authors have communicated that patients with G6PD deficiency have an increase in prevalence of cardiovascular diseases, which requires the strict control of cardiovascular risk factors. However, these patients show a decrease in colorectal cancer prevalence. In addition, donations of bone marrow and haematopoietic derivatives could be performed safely.