Assessment of the Interelectrode Distance Effect over the Omnipole with High Multielectrode Arrays.

The development of high-density multielectrode catheters has significantly advanced cardiac electrophysiology mapping. High-density grid catheters have enabled the creation of a novel technique for reconstructing electrogram (EGM) signals known as "omnipole," which is believed to be more reliable than other methods, especially in terms of orientation independence. This study aims to evaluate how distance affects the omnipolar reconstruction of EGMs by comparing different configurations. Using an animal set up of perfused isolated rabbit hearts, recordings were taken using an ad hoc high-density epicardial multielectrode catheter. Inter-electrode distances ranging from 1 to 4 mm were analysed for their effect on the quality of resulting EGMs. Two biomarkers were computed to evaluate the robustness of the reconstructions: the areas contained within the bipolar loops and the amplitudes of the omnipoles. We hypothesised that both bipolar and omnipolar electrograms would be more robust at shorter inter-electrode distances. The results showed that an increase in distance triggers an increase in loop areas and amplitudes, which supports the hypothesis. This finding provides a more reliable estimate of wavefront propagation for the cross-omnipolar reconstruction method. These results emphasise the importance of distance in cardiac electrophysiology mapping and provide valuable insights into the use of high-density multielectrode catheters for EGM reconstruction.Clinical Relevance- The results of this study have direct clinical relevance in the application of the described techniques to recording systems in the cardiac electrophysiology laboratory, enabling clinicians to obtain more precise characterisation of signals in the myocardium.

Sensitivity analysis in a life cycle assessment of an aged red wine production from Catalonia, Spain.

Sustainability in agriculture and food processing is an issue with a clear growing interest; especially in products were consumers have particular awareness regarding its environmental profile. This is the case of wine industry depending on grape production, winemaking and bottling. Also viticulture and generally agricultural production is significantly affected by climate variations. The aim of this article is to determine the environmental load of an aged red wine from a winery in Catalonia, Spain, over its entire life cycle, including sensitivity analysis of the main parameters related to the cultivation, vinification and bottling. The life cycle assessment (LCA) methodology is used for the environmental analysis. In a first step, life cycle inventory (LCI) data were collected by questionnaires and interviews with the winemaker, all data are actual operating data and all the stages involved in the production have been taken into account (viticulture, vinification, bottling and the disposal subsystem). Data were then used to determine the environmental profile by a life cycle impact assessment using the ReCiPe method. Annual variability in environmental performance, stresses the importance of including timeline analysis in the wine sector. Because of that this study is accompanied with a sensitivity analysis carried out by a Monte Carlo simulation that takes into account the uncertainty and variability of the parameters used. In this manner, the results are presented with confidence intervals to provide a wider view of the environmental issues derived from the activities of the studied wine estate regardless of the eventualities of a specific harvesting year. Since the beverage packaging has an important influence in this case, a dataset for the production of green glass was adapted to reflect the actual recycling situation in Spain. Furthermore, a hypothetical variation of the glass-recycling rate in the glass production completes this article, as a key variable of sensitivity analysis, in order… in order to show the potential reduction of total greenhouse gas emissions. It was found that in almost all categories the production of the glass bottles has the highest environmental impact (10%-80% depending on the impact category) followed by the viticulture stage, i.e. the agricultural activities (17%-84% depending on the impact category). The vinification step, i.e. the winemaking itself, has an almost negligible effect on the overall load (1%-5%). The sensitivity analysis showed that the results do not differ by more than ±4% from the expected values except for the water depletion indicator. With the variation of the recycling rate, it could be shown that an increase in the rate from 60% to 85% allows for a reduction of 102gCO2eq. per bottle (-11.1%). The results show that glass production causes the highest environmental load. The key parameters that determine the impact are the recycling rate and the bottle weight. A glass container deposit legislation might be a promising way to enhance the glass recycling. Lightweight bottles and alternative packaging should also be considered.

Quantification of anaesthetic effects on atrial fibrillation rate by partial least-squares.

The mechanism underlying atrial fibrillation (AF) remains poorly understood. Multiple wandering propagation wavelets drifting through both atria under hierarchical models are not understood. Some pharmacological drugs, known as antiarrhythmics, modify the cardiac ionic currents supporting the fibrillation process within the atria and may modify the AF propagation dynamics terminating the fibrillation process. Other medications, theoretically non-antiarrhythmic, may slightly affect the fibrillation process in non-defined mechanisms. We evaluated whether the most commonly used anaesthetic agent, propofol, affects AF patterns. Partial least-squares (PLS) analysis was performed to reduce significant noise into the main latent variables to find the differences between groups. The final results showed an excellent discrimination between groups with slow atrial activity during the propofol infusion.

Characterization of typical and atypical atrial flutter loops from the vectorcardiogram.

Current techniques for atrial flutter (AFL) treatment involve radiofrequency ablation. This is a relatively simple and short procedure for typical AFL, whereas becomes more complex and unpredictable in the case of atypical AFL. Therefore, non-invasive characterization of AFL would be helpful for the management of ablation procedures. In this study the behavior of typical and atypical AFL groups is characterized from the vectorcardiographic AFL loops. The initial hypothesis is that typical AFL loops resemble each other, whereas atypical AFL loops differ from typical AFL ones. All patient loops were compared to a reference, by analyzing the global trajectory, pathway complexity and distance to the reference loop. The distance was the most significative parameter, being 0.445 ± 0.135 and 0.799 ± 0.144 for typical and atypical AFL (p = 8.00 e-5). In addition, an intrapatient analysis revealed a higher stability of typical AFL loops than in the case of atypical AFL.

Entropy measurements in paroxysmal and persistent atrial fibrillation.

Recent studies on atrial fibrillation (AF) have identified different activation patterns in paroxysmal and persistent AF. In this study, bipolar intra-atrial registers from 28 patients (14 paroxysmal AF and 14 persistent AF) were analyzed in order to find out regional differences in the organization in both types of arrhythmias. The organization of atrial electrical activity was assessed in terms of nonlinear parameters, such as entropy measurements. Results showed differences between the atrial chambers with a higher disorganization in the left atrium in paroxysmal AF patients and a more homogenous behavior along the atria in persistent AF patients.

Environmental performance of construction waste: Comparing three scenarios from a case study in Catalonia, Spain.

The main objective of this paper is to evaluate environmental impacts of construction wastes in terms of the LIFE 98 ENV/E/351 project. Construction wastes are classified in accordance with the Life Program Environment Directive of the European Commission. Three different scenarios to current waste management from a case study in Catalonia (Spain) have been compared: landfilling, recycling and incineration, and these scenarios were evaluated by means of Life Cycle Assessment. The recommendations of the Catalan Waste Catalogue and the European Waste Catalogue have been taken into account. Also, the influence of transport has been evaluated. Results show that in terms of the Global Warming Potential, the most environmentally friendly treatment was recycling, followed by incineration and lastly landfilling. According to the influence of treatment plants location on the GWP indicator, we observe that incineration and recycling of construction wastes are better than landfilling, even for long distances from the building site to the plants. This is true for most wastes except for the stony types, than should be recycled close to the building site. In summary, data from construction waste of a Catalan case study was evaluated using the well established method of LCA to determine the environmental impacts.

Ventricular rhythm in atrial fibrillation under anaesthetic infusion with propofol.

Changes in patients' autonomic tone and specific pharmacologic interventions may modify the ventricular response (actual heart rate) during atrial fibrillation (AF). Hypnotic agents such as propofol may modify autonomic balance as they promote a sedative state. It has been shown that propofol slightly slows atrial fibrillatory activity, but the net global effect on the ventricular response remains unknown. We aimed to evaluate in patients in AF the effect of a propofol bolus on the ventricular rate and regularity at ECG. We analysed the possible relation with local atrial fibrillatory activities, as ratios between atrial and ventricular rates (AVRs), analysing atrial activity from intracardiac electrograms at the free wall of the right and left atria and at the interatrial septum. We compared data at the baseline and after complete hypnosis. Propofol was associated with a more homogeneous ventricular response and lower AVR values at the interatrial septum.

Anesthesia with propofol slows atrial fibrillation dominant frequencies.

The mechanisms responsible for the maintenance of atrial fibrillation (AF) are not completely understood yet. It has been demonstrated that AF can be modulated by several cardiac diseases, the autonomic nervous system and even drugs with purportedly no antiarrhythmic properties. We evaluated the effects of a widely used anaesthetic agent (propofol) in the fibrillation patterns. Spectral analysis was performed over atrial electrograms at baseline and immediately after a propofol bolus. Only after performing principal component analysis (PCA), we were able to significantly detect that propofol slows AF.

Human intake fractions of pesticides via greenhouse tomato consumption: comparing model estimates with measurements for Captan.

Human intake due to pesticide residues in food commodities can be much higher than those related to water consumption and air inhalation, stressing the importance to correctly estimate pesticide uptake into plants and predict subsequent intake by humans. We calculated the human intake fraction of captan via tomato consumption taking into account the time between pesticide application and harvest, the time between harvest and consumption, the absorption of spray deposit on plant surfaces, transfer properties through the cuticle, degradation inside the plant and loss due to food processing. Human population intake fractions due to ingestion were calculated for complete, washed and peeled tomatoes. The calculated intake fractions were compared with measurements derived from an experimental setup in a Mediterranean greenhouse. The fraction of captan applied in the greenhouse as plant treatment that eventually is ingested by the human population is on average 10(-2)-10(-5), depending on the time between pesticide application and ingestion of tomatoes and the processing step considered. Model and experimentally derived intake fractions deviated less than a factor of 2 for complete and washed tomatoes and a factor of 3 for peeled tomatoes. Intake fractions due to air inhalation and consumption of drinking water are expected to be significantly lower (5-9 orders of magnitude) than those induced by the intake of tomatoes in this case study.

Spatiotemporal blind source separation approach to atrial activity estimation in atrial tachyarrhythmias.

The analysis and characterization of atrial tachyarrhythmias requires, in a previous step, the extraction of the atrial activity (AA) free from ventricular activity and other artefacts. This contribution adopts the blind source separation (BSS) approach to AA estimation from multilead electrocardiograms (ECGs). Previously proposed BSS methods for AA extraction--e.g., independent component analysis (ICA)--exploit only the spatial diversity introduced by the multiple spatially-separated electrodes. However, AA typically shows certain degree of temporal correlation, with a narrowband spectrum featuring a main frequency peak around 3.5-9 Hz. Taking advantage of this observation, we put forward a novel two-step BSS-based technique which exploits both spatial and temporal information contained in the recorded ECG signals. The spatiotemporal BSS algorithm is validated on simulated and real ECGs from a significant number of atrial fibrillation (AF) and atrial flutter (AFL) episodes, and proves consistently superior to a spatial-only ICA method. In simulated ECGs, a new methodology for the synthetic generation of realistic AF episodes is proposed, which includes a judicious comparison between the known AA content and the estimated AA sources. Using this methodology, the ICA technique obtains correlation indexes of 0.751, whereas the proposed approach obtains a correlation of 0.830 and an error in the estimated signal reduced by a factor of 40%. In real ECG recordings, we propose to measure performance by the spectral concentration (SC) around the main frequency peak. The spatiotemporal algorithm outperforms the ICA method, obtaining a SC of 58.8% and 44.7%, respectively.

Estimation of atrial fibrillatory wave from single-lead atrial fibrillation electrocardiograms using principal component analysis concepts.

A new method for the assessment of the atrial fibrillatory wave (AFW) from the ECG is presented. This methodology is suitable for signals registered from Holter systems, where the reduced number of leads is insufficient to exploit the spatial information of the ECG. The temporal dependence of the bio-electrical activity were exploited using principal component analysis. The main features of ventricular and atrial activity were extracted, and several basis signals for each subspace were determined. Hence, the estimated (AFW) are reconstructed exclusively from the basis signals that formed the atrial subspace. Its main advantage with respect to adaptive template subtraction techniques was its robustness to variations in the QRST morphology, which thus minimised QRST residua. The proposed approach was first validated using a database of simulated recordings with known atrial activity content. The estimated AFW was compared with the original AFW, obtaining correlation indices of 0.774 +/- 0.106. The suitability of this methodology for real recordings was also proven, though its application to a set of paroxysmal AF ECGs. In all cases, it was possible to detect the main frequency peak, which was between 4.6 Hz and 6.9 Hz for the patients under study.

Environmental engineering education in Spain.

There is a growing demand for engineers and technologists who show multidisciplinary expertise to deal with environmental issues. As a result of this demand, most countries are adapting their old university programs on environmental engineering education. In Spain an official environmental engineering degree does not yet exist, but the Council of Universities is working to present a proposal, based on Bologna agreement concepts. The paper summarizes not only the future perspectives of environmental engineering education in Spain, but also the evolution of the approach during the last decades, which includes the role of the private initiative, the environmental sciences degree, and the intensification in different traditional engineering degrees. Finally, the paper briefly details and compares the syllabus developed in the only four Spanish universities where environmental engineering is offered as a non-official post-graduate course lasting two years.

Comparison of toxicological impacts of integrated and chemical pest management in Mediterranean greenhouses.

The goal of this paper is to assess the relative impacts of pest-control methods in greenhouses, based on current LCA tools. As a case study, the relative impacts of two tomato production methods, chemical pest management (CPM) and integrated pest management (IPM), are assessed. The amount of the active ingredients applied, the fate of the ingredients in the various greenhouse and environmental compartments, the human exposure routes via the various compartments and the inherent toxicity of the ingredients were taken into account in the relative impact calculations. To assess the importance of model selection in the assessment, pesticide-specific fate and exposure factors for humans and aquatic and terrestrial ecosystems, used to aggregate pesticide emissions, were calculated with two different models: (1) the USES-LCA model, adapted in order to calculate the pesticide transfer from greenhouse air and soil to fruits, and (2) the empirical model critical surface time (CST). Impact scores have in general shown a higher level of potential contamination in greenhouses treated with CPM compared to IPM (a factor of 1.4 to 2.3). Relative impacts have been shown highly dependent on the selection of specific pesticides and crop stage development at the moment of pesticide application. This means that both CPM and IPM could be improved by a careful selection of pesticides. In order to improve the relative impact calculations, future research in pesticide transfer to food will be necessary.

Framework for the environmental damage assessment of an industrial process chain.

On the basis of the life cycle approach, a framework for the assessment of the environmental damages generated by an industrial process chain is established. In order to consider all the processes of the life cycle, a methodology is developed based on an eco-matrix formed by chemical process eco-vectors containing all their environmental loads. To perform the impact assessment, environmental damage indicators are estimated in the most accurate way possible for each process. For this, site-specific evaluation is carried out applying damage functions and, hence, for each damage indicator, a damage matrix is obtained. In order to make the methodology more practical, options like dominance analysis are presented. Because of the large number of environmental loads, the focus is on the priority pollutants and then the final estimations are done with one indicator per safeguard subject. The damage indicators selected in this paper are damage costs, ecological damage parameter (both site-specific) and global damage estimates. As for the verification of the methodology, a study has been carried out based on the life cycle of the electricity produced by a municipal waste incinerator.

Osteotomía distal en Chevron modificada para el tratamiento del hallux valgus

La modificación de la osteotomía distal en Chevron del primer metatarsiano, difundida y modificada por K. Johnson en 1991, sola o en combinación con la osteotomía de la falange proximal descrita por Akin, se indica para el tratamiento del hallux valgus sintomático moderado. Fueron evaluados 30 pies de 21 pacientes, todos de sexo femenino, de los cuales 18 fueron intervenidos con la doble osteotomía. Los resultados fueron medidos con la puntuación de la AOFAS (American Orthopedic Foot-Ankle Society) para las articulaciones metatarsofalángica e interfalángica del hallux, que evalúa dolor y función posoperatoria en porcentaje de normalidad, sobre un total de 100 puntos correspondiente a un pie sin patología. El seguimiento promedio fue de 23,11 meses. La edad promedio de los pacientes fue de 32,03 años. La puntuación promedio alcanzada fue de 86,3. Las pacientes sometidas a la doble osteotomía obtuvieron una puntuación promedio de 89,4 ; aquellas a las que se les realizó sólo la metatarsiana, 83 puntos. No hubo retardos en la consolidación, necrosis aséptica ni neuromas incisionales. Se detectaron en 8 pacientes molestias causadas por la osteosíntesis interna, que obligó al retiro del tornillo de tracción utilizado para la fijación