Real-Time Measurements of Indoor-Outdoor Exchange of Gaseous and Particulate Atmospheric Pollutants in an Urban Area.

Air pollution is one of the greatest environmental risks to health, causing millions of deaths and deleterious health effects worldwide, especially in urban areas where citizens are exposed to high ambient levels of pollutants, also influencing indoor air quality (IAQ). Many sources of indoor air are fairly obvious and well known, but the contribution of outside sources to indoor air still leads to significant uncertainties, in particular the influence that environmental variables have on outdoor/indoor pollutant exchange mechanisms. This is a critical aspect to consider in IAQ studies. In this respect, an experimental study was performed at a public site such as a university classroom during a non-academic period in Madrid city. This includes two field campaigns, in summer (2021) and winter (2020), where instruments for measuring gases and particle air pollutants simultaneously measured outdoor and indoor real-time concentrations. This study aimed to investigate the dynamic variations in the indoor/outdoor (I/O) ratios in terms of ambient outdoor conditions (meteorology, turbulence and air quality) and indoor features (human presence or natural ventilation). The results show that the I/O ratio is pollutant-dependent. In this sense, the infiltration capacity is higher for gaseous compounds, and in the case of particles, it depends on the particle size, with a higher infiltration capacity for smaller particles (

[Proposal for a new information model about the surgical waiting list.] / Propuesta de un nuevo modelo de información sobre la lista de espera quirúrgica.

In these moments in which the pandemic seems to have granted a truce, hospitals are beginning to normalize their care activity and data on waiting lists have begun to regain their prominence as they are the object of attention by all interest groups: citizens, the media, politicians and health professionals themselves. An improvement is proposed in the treatment of the information on the surgical waiting list that is usually published based on the analysis of some relevant indicators of it. This proposal can contribute to a better understanding and interpretation of waiting list data at such an important time as the present.

En estos momentos en los que la pandemia parece haber concedido una tregua, los hospitales están comenzando a normalizar su actividad asistencial y los datos sobre listas de espera han empezado a recuperar su protagonismo al ser objeto de atención por parte de todos los grupos de interés: ciudadanos, medios de comunicación, políticos y los propios profesionales de la salud. Se propone una mejora en el tratamiento de la información sobre la lista de espera quirúrgica que suele publicarse fundamentado en el análisis de algunos indicadores relevantes de la misma. Dicha propuesta puede contribuir a entender e interpretar mejor los datos de lista de espera en un momento tan importante como el actual.

EView: An electric field visualization web platform for electroporation-based therapies.

BACKGROUND AND OBJECTIVES: Electroporation is the phenomenon by which cell membrane permeability to ions and macromolecules is increased when the cell is briefly exposed to high electric fields. In electroporation-based treatments, such exposure is typically performed by delivering high voltage pulses across needle electrodes in tissue. For a given tissue and pulsing protocol, an electric field magnitude threshold exists that must be overreached for treatment efficacy. However, it is hard to preoperatively infer the treatment volume because the electric field distribution intricately depends on the electrodes' positioning and length, the applied voltage, and the electric conductivity of the treated tissues. For illustrating such dependencies, we have created EView (https://eview.upf.edu), a web platform that estimates the electric field distribution for arbitrary needle electrode locations and orientations and overlays it on 3D medical images. METHODS: A client-server approach has been implemented to let the user set the electrode configuration easily on the web browser, whereas the simulation is computed on a dedicated server. By means of the finite element method, the electric field is solved in a 3D volume. For the sake of simplicity, only a homogeneous tissue is modeled, assuming the same properties for healthy and pathologic tissues. The non-linear dependence of tissue conductivity on the electric field due to the electroporation effect is modeled. The implemented model has been validated against a state of the art finite element solver, and the server has undergone a heavy load test to ensure reliability and to report execution times. RESULTS: The electric field is rapidly computed for any electrode and tissue configuration, and alternative setups can be easily compared. The platform provides the same results as the state of the art finite element solver (Dice = 98.3 ± 0.4%). During the high load test, the server remained responsive. Simulations are computed in less than 2 min for simple cases consisting of two electrodes and take up to 40 min for complex scenarios consisting of 6 electrodes. CONCLUSIONS: With this free platform we provide expert and non-expert electroporation users a way to rapidly model the electric field distribution for arbitrary electrode configurations.

Impact of weather changes on air quality and related mortality in Spain over a 25 year period [1993-2017].

Climate change is a major public health concern. In addition to its direct impacts on temperature patterns and extreme weather events, climate change affects public health indirectly through its influence on air quality. Pollution trends are not only affected by emissions changes but also by weather changes. In this paper we analyze air quality trends in Spain of important air pollutants (C6H6, CO, NO2, NOx, O3, PM10, PM2.5, and SO2) recorded during the last 25 years, from 1993 to 2017. We found substantial reductions in ambient concentration levels for all the pollutants studied except for O3. To assess the influence of recent weather changes on air quality trends we applied generalized additive models (GAMs) using nonparametric smoothing; with and without adjusting for weather parameters including temperature, wind speed, humidity and precipitation frequency. The difference of annual slopes estimated by the models without and with adjusting for these meteorological variables represents the impact of weather changes on pollutant trends, i.e. the 'weather penalty'. The analyses were seasonally and geographically stratified to account for temporal and regional differences across Spain. The results were meta-analyzed to estimate weather penalties on ambient concentration trends at a national level as well as the impact on mortality for the most relevant pollutants. We found significant penalties for most pollutants, implying that air quality would have improved even more during our study period if weather conditions had remained constant. The largest weather influences were found for PM10, with seasonal penalties up to 22 µg⋅m-3 accumulated over the 25-year period in some regions. The national meta-analysis shows penalties of 0.060 µg⋅m-3 per year (95% Confidence Interval, CI: 0.004, 0.116) in cold months and 0.127 µg⋅m-3 per year (95% CI: 0.089, 0.164) in warm months. Penalties of this magnitude would correspond to 129 annual deaths (95% CI: 25, 233), i.e. approximately 3200 deaths over the 25-year period in Spain. According to our results, the health benefits of recent emission abatements for this pollutant in Spain would have been up to 10% greater if weather conditions had remained constant during the last 25 years.

In silico Optimization of Left Atrial Appendage Occluder Implantation Using Interactive and Modeling Tools.

According to clinical studies, around one third of patients with atrial fibrillation (AF) will suffer a stroke during their lifetime. Between 70 and 90% of these strokes are caused by thrombus formed in the left atrial appendage. In patients with contraindications to oral anticoagulants, a left atrial appendage occluder (LAAO) is often implanted to prevent blood flow entering in the LAA. A limited range of LAAO devices is available, with different designs and sizes. Together with the heterogeneity of LAA morphology, these factors make LAAO success dependent on clinician's experience. A sub-optimal LAAO implantation can generate thrombi outside the device, eventually leading to stroke if not treated. The aim of this study was to develop clinician-friendly tools based on biophysical models to optimize LAAO device therapies. A web-based 3D interactive virtual implantation platform, so-called VIDAA, was created to select the most appropriate LAAO configurations (type of device, size, landing zone) for a given patient-specific LAA morphology. An initial LAAO configuration is proposed in VIDAA, automatically computed from LAA shape features (centreline, diameters). The most promising LAAO settings and LAA geometries were exported from VIDAA to build volumetric meshes and run Computational Fluid Dynamics (CFD) simulations to assess blood flow patterns after implantation. Risk of thrombus formation was estimated from the simulated hemodynamics with an index combining information from blood flow velocity and complexity. The combination of the VIDAA platform with in silico indices allowed to identify the LAAO configurations associated to a lower risk of thrombus formation; device positioning was key to the creation of regions with turbulent flows after implantation. Our results demonstrate the potential for optimizing LAAO therapy settings during pre-implant planning based on modeling tools and contribute to reduce the risk of thrombus formation after treatment.

Application of a short term air quality action plan in Madrid (Spain) under a high-pollution episode - Part I: Diagnostic and analysis from observations.

Exceedances of NO2 hourly limit value (200 µg·m-3) imply the need to implement short term action plans to avoid adverse effects on human health in urban areas. The Madrid City Council applied the stage 3 of the NO2 protocol during a high-pollution episode under stable meteorological conditions on December 2016 for the first time. This included road traffic access restrictions to the city centre (50% of conventional private vehicles based on plate numbers). In this contribution we analyse different meteorological and air quality observations, including non-standard parameters (such as number of ultrafine particles and remote sensing techniques MAXDOAS) for a better understanding of the effectivity of short-term emission abatement measures under real conditions and to identify options to improve the NO2 protocol in the future. According to our results, the inversion base height computed from vertical temperature soundings is a meaningful index to anticipate very unfavourable conditions and trigger the actions included in the protocol. The analysis of the concentration levels of the main pollutants from the Madrid air quality monitoring network indicate that only stage 3 of the protocol had a significant effect on NO2 maximum concentrations. The restrictions applied may have prevented NO2 concentrations to further increase in the city centre (up to 15%) although pollution levels in the city outskirts, outside the area directly affected by the traffic restrictions, remained unchanged or may have been slightly increased. Nonetheless, further studies are needed to estimate more precisely the effect of the measures taken and to assess potential trade-offs. Our results suggest that emissions play an important role also under very strong stability conditions although drastic measures are needed to achieve a significant impact. This highlights the importance of an appropriate timing for short-term actions and the need of permanent abatement measures related to air quality plans and policies.