Epidemiology of Non-Tuberculous Mycobacteria isolated from clinical specimens in Madrid, Spain, from 2013 to 2017.

The epidemiology of non-tuberculous mycobacteria (NTM) in Spain is largely unknown because systematic reporting is not compulsory. The aim of our study was to describe the frequency and diversity of NTM species in our region and their distribution according to the source sample, gender, and age of the patients. We performed a multicenter study of all NTM isolated in 24 public hospitals in Madrid from 2013 to 2017. A total of 6.923 mycobacteria were isolated: 4535 (65.5%) NTM, and 2.388 (34.5%) Mycobacterium tuberculosis complex (MTB). Overall, 61 different NTM species were identified. The most frequently isolated species were Mycobacterium avium complex (47.7%), M. lentiflavum (12.2%), M. gordonae (9.2%), M. fortuitum (8.9%), and M. abscessus (3.9%). Whereas MTB cases were stable during the study period, the number of NTM isolates increased considerably from 930 isolates in 2013 to 1012 in 2017; a sharp increase occurred in the last year. The rise in NTM isolates was mostly due to M. lentiflavum, M. kansasii, and M. abscessus mainly isolated from respiratory specimens in patients older than 60. The increase in isolation rate of NTM in our region is consistent with the increasing rates reported worldwide in the last decades. The rise in NTM isolates was mainly attributed to M. lentiflavum but it also should be noted the increasing of species with high pathogenic potential such as M. kansasii and M. abscessus.

Validation in colorectal procedures of a useful novel approach for the use of C-reactive protein in postoperative infectious complications.

AIM: Our aim was to validate a novel use of C-reactive protein (CRP) measurement to identify postoperative infectious complications in patients undergoing colorectal surgery, and to compare the predictive value in this setting against white blood cell (WBC) count and neutrophil-to-lymphocyte ratio (NLR). METHOD: This was a retrospective study of CRP, NLR and WBC measurements in patients undergoing colorectal surgery. CRP, NLR and WBC were recorded on the second postoperative day and on the day of infectious complication (patients who developed infectious complications) or within 3 days prior to discharge (subjects with no complications). The test for detecting infectious complications consisted of comparing the value of the inflammatory marker on the day on which a complication was suspected against the value recorded on the second postoperative day. The test was considered positive if a given value was higher than the registered peak at postoperative day 2. Factors influencing the postoperative peak CRP were also studied. RESULTS: A total of 254 patients were retrospectively studied. Patients whose CRP value was higher than on the second postoperative day had a diagnostic accuracy for infectious complications of up to 94.4% and sensitivity, specificity, positive predictive value and negative predictive value of up to 97.4%, 93.4%, 85.7% and 99.1%, respectively. Poorer results were observed when WBC count and NLR were used rather than CRP measurement. Multiple linear regression analysis showed that surgical procedure and approach, as well as additional resections, were independent factors for 48 h peak CRP. CONCLUSION: C-reactive protein is a better parameter than WBC count and NLR for detecting infectious complications. Our proposed methodology presents good diagnostic accuracy and performance and could potentially be used for any surgical procedure.

What triggers colour change? Effects of background colour and temperature on the development of an alpine grasshopper.

BACKGROUND: Colour polymorphisms are a fascinating facet of many natural populations of plants and animals, and the selective processes that maintain such variation are as relevant as the processes which promote their development. Orthoptera, the insect group that encompasses grasshoppers and bush crickets, includes a particularly large number of species that are colour polymorphic with a marked green-brown polymorphism being particularly widespread. Colour polymorphism has been associated with the need for crypsis and background matching and background-dependent homochromy has been described in a few species. However, when and how different environmental conditions influence variation in colour remains poorly understood. Here we test for effects of background colour and ambient temperature on the occurrence of colour morph switches (green to brown or brown to green) and developmental darkening in the alpine dwelling club-legged grasshopper Gomphocerus sibiricus. RESULTS: We monitored individually housed nymphae across three of their four developmental stages and into the first week after final ecdysis. Our data show an absence of colour morph switches in G. sibiricus, without a single switch observed in our sample. Furthermore, we test for an effect of temperature on colouration by manipulating radiant heat, a limiting factor in alpine habitats. Radiant heat had a significant effect on developmental darkening: individuals under low radiant heat tended to darken, while individuals under high radiant heat tended to lighten within nymphal stages. Young imagoes darkened under either condition. CONCLUSIONS: Our results indicate a plastic response to a variable temperature and indicate that melanin, a multipurpose pigment responsible for dark colouration and presumed to be costly, seems to be strategically allocated according to the current environmental conditions. Unlike other orthopterans, the species is apparently unable to switch colour morphs (green/brown) during development, suggesting that colour morphs are determined genetically (or very early during development) and that other processes have to contribute to crypsis and homochromy in this species.

Relevant influence of limestone crystallinity on CO2 capture in the Ca-looping technology at realistic calcination conditions.

We analyze the role of limestone crystallinity on its CO2 capture performance when subjected to carbonation/calcination cycles at conditions mimicking the Ca-looping (CaL) technology for postcombustion CO2 capture. The behavior of raw and pretreated limestones (milled and thermally annealed) is investigated by means of thermogravimetric analysis (TGA) tests under realistic sorbent regeneration conditions, which necessarily involve high CO2 partial pressure in the calciner and quick heating rates. The pretreatments applied lead to contrasting effects on the solid crystal structure and, therefore, on its resistance to solid-state diffusion. Our results show that decarbonation at high CO2 partial pressure is notably promoted by decreasing solid crystallinity. CaO regeneration is fully achieved under high CO2 partial pressure at 900 °C in short residence times for the milled limestone whereas complete regeneration for raw limestone requires a minimum calcination temperature of about 950 °C. Such a reduction of the calcination temperature and the consequent mitigation of multicyclic capture capacity decay would serve to enhance the efficiency of the CaL technology. On the other hand, the results of our study suggest that the use of highly crystalline limestones would be detrimental since excessively high calcination temperatures should be required to attain full decarbonation at realistic conditions.

Synthesis and characterization of graphene: influence of synthesis variables.

The optimization of graphene growth on copper foils using an atmospheric pressure chemical vapor deposition setup is reported. CH4 and H2 were used as precursor gases and Raman spectroscopy as the main graphene characterization technique. Different growth parameters, including temperature and reaction time, the molar ratio of CH4/H2 in the feed and total flow of gases during the reaction step, were studied in detail. It was shown that graphene growth was not homogeneous in the entire sample, multilayer graphene was present in most of the sample, however as the synthesis parameters were optimized, graphene gained better quality, obtaining bilayer graphene over most of the sheet in the final optimized sample. Homemade software was used to analyze the quality of the synthesised graphene, obtaining a more quality graphene according to the synthesis parameters optimized. An optimal bilayer graphene sample was prepared at the lowest growth time (10 min) and the highest synthesis temperature (1050 °C), using a CH4/H2 flow ratio and a total flow rate ratio of precursors of 7% and 60 Nml (CH4 + H4) per min respectively.

National survey on perioperative cognitive dysfunction.

BACKGROUND: Perioperative cognitive dysfunction (PCD) is a very prevalent clinical syndrome due to the progressive aging of the surgical population.The aim of our study is to evaluate the clinical practice of Spanish anesthesiologists surveyed regarding this entity. MATERIAL AND METHODS: Prospective online survey conducted by the Neurosciences Section and distributed by SEDAR. RESULTS: 544 responses were obtained, with a participation rate of 17%. 54.4% of respondents never make a preoperative assessment of cognitive impairment, only 7.5% always do it. 79.6% lack an intraoperative management protocol for the patient at risk of PCD. In the anesthetic planning, only 23.3% of the patients was kept in mind. Eighty-nine percent considered regional anesthesia with or without sedation preferable to general anesthesia for the prevention of PCD. 88.8% considered benzodiazepines to present a high risk of PCD. 71.7% considered that anesthetic depth monitoring could prevent postoperative cognitive deficit. Routine evaluation of postoperative delirium is low, only 14%. More than 80% recognize that PCD is underdiagnosed. CONCLUSIONS: Among Spanish anesthesiologists surveyed, PCD is still a little known and underappreciated entity. It is necessary to raise awareness of the need to detect risk factors for PCD, as well as postoperative assessment and diagnosis. Therefore, the development of guidelines and protocols and the implementation of continuing education programs in which anesthesiologists should be key members of multidisciplinary teams in charge of perioperative care are suggested.

Epidemiological factors conditioning sarcoptic mange spreading in wild boar (Sus scrofa).

Sarcoptic mange is a widely distributed disease, with numerous potential hosts among domestic and wild animals. Nowadays it is considered a neglected re-emergent infection in humans. As a difference with domestic pigs, and even with several clinical cases reported in some European countries, it seems that Eurasian wild boars (Sus scrofa) have a low susceptibility to clinical mange. However, because of a case of confirmed transmission from Spanish ibex (Capra pyrenaica) to wild boar in the province of Tarragona, we planned a large-scale ELISA survey in the neighboring Valencian Community (SE Spain). We compared 419 wild boar sera from different management systems (fenced vs. open game estates), different ages (piglets, juveniles, and adults), with different behaviour (gregarious females of all ages and male piglets vs. solitary juveniles and adult males), from areas with different wild boar densities, different wild ruminant densities and different sarcoptic mange epidemiologic situations. The whole prevalence of antibodies against sarcoptic mange in the tested wild boars was 10.5%. No significant differences were found when comparing fenced and free ranging wild boars, males and females, gregarious vs. solitary individuals or among different ages. However, wild boar density was a relevant factor. In areas with a hunting bag of <1 wild boar/km2, considered as a low density of suids, the seroprevalence was 2.94%, but rose to 11.52% in high density districts, constituting a significant difference (p = 0.037). Low wild boar populations would act as a protective factor (OR 0.233; p = 0.049) against coming into contact with the mite. The wild ruminant densities or their sarcoptic mange status did not show any effect on wild boars seroprevalence against this disease. These results reinforce the suggested host-taxon Sarcoptes scabiei specificity and the independence of host-species foci.

Acoustic streaming enhances the Multicyclic CO2 capture of natural limestone at Ca-looping conditions.

The Ca-Looping (CaL) process, based on the multicyclic carbonation/calcination of CaO at high temperatures, is a viable technology to achieve high CO2 capture efficiencies in both precombustion and postcombustion applications. In this paper we show an experimental study on the multicyclic CO2 capture of a natural limestone in a fixed bed at CaL conditions as affected by the application of a high-intensity acoustic field. Our results indicate that sound promotes the efficiency of CO2 sorption in the fast carbonation phase by enhancing the gas-solids mass transfer. The fundamentals of the physical mechanism responsible for this effect (acoustic streaming) as well as the technical feasibility of the proposed technique allows envisaging that sonoprocessing will be beneficial to enhance multicyclic CO2 capture in large-scale applications.

A Langmuir-Hinshelwood approach to the kinetic modelling of catalytic ammonia decomposition in an integral reactor.

The increasing interest in ammonia decomposition is due to the fact that this compound can be used advantageously as a hydrogen carrier, allowing the development of single-step hydrogen generation systems. With the aim of developing efficient reactors for ammonia decomposition, e.g. for fuel cell applications, it is imperative to investigate the kinetics and reaction mechanism in depth. The main goal of this work is to develop reliable kinetic models that are able to predict the performance obtained using integral reactors, e.g. monoliths. In this case, an almost complete NH3 conversion is obtained, with a high H2 concentration at the exit of the reactor. The operating conditions, mainly the gas composition, are very different along the reactor. In addition, the temperatures needed to attain such large conversions are usually high. The kinetic models developed in this contribution are based on the Langmuir isotherm, considering that all the adsorbed species can be kinetically relevant, that the slow step or steps can be partially reversible, and that the surface can be considered as energetically uniform, i.e. ideal. Among other conclusions, the results obtained indicate that the variable kinetic orders and apparent activation energies frequently reported in the literature can be direct consequences of the data analysis and can therefore also be explained without considering any change in the controlling step with the reaction temperature or in the hydrogen or ammonia concentration.

Efficacy of Nanosilica Coatings in Calcium Looping Reactors.

Nanosilica coatings are considered a simple physical treatment to alleviate the effect of cohesion on powder flowability. In limestone powders, these coatings buffer the rise in cohesion at high temperatures. Here, we investigate the role of particle size in the efficiency (and resilience) of these layers. To this end, this work examines a series of four limestone powders with very sharp particle size distributions: average particle size ranged from 15 to 60 µm. All the samples were treated with nanosilica at different concentrations from 0 to 0.82 wt %. Powders were subjected to short- and long-term storage conditions in calcium looping based systems: temperatures that vary from 25 to 500 °C and moderate consolidations (up to 2 kPa). Experiments monitored powder cohesion and its ability to flow by tracking the tensile strength of different samples while fluidized freely. Fluidization profiles were also used to infer variation in packings and the internal friction of the powder bed. Interestingly, for particle sizes below 50 µm, the nanosilica treatment mitigated cohesion significantly-the more nanosilica content, the better the flowability performance. However, at high temperatures, the efficiency of nanosilica coatings declined in 60 µm samples. Scanning electron microscopy images confirmed that only 60 µm samples presented surfaces barely coated after the experiments. In conclusion, nanosilica coatings on limestone are not stable beyond the 50 µm threshold. This is a critical finding for thermochemical systems based on the calcium looping process, since larger particles can still exhibit a significant degree of cohesion at high temperatures.

TLR7/8/9 polymorphisms and their associations in systemic lupus erythematosus patients from southern Brazil.

Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease and can affect several organs and systems. It is characterized by high production of autoantibodies against nuclear compounds. TLR7/8/9 are responsible for nucleic acid recognition and they trigger proinflammatory responses through activation of NK-kappaB and Type I IFN production, making a bridge between the innate and the adaptative immune systems. We analyzed the frequency of TLR7 rs179008, TLR8 rs3764880, TLR9 rs5743836 and rs352140 in 370 patients with SLE and 415 healthy controls from southern Brazil. All analyses were conducted with regard to gender and ethnicity. Genotypic and allelic frequencies were different for TLR7 rs179008 (0.253 vs. 0.163, p = 0.020 and p = 0.003, OR for T allele: 1.74 CI 95% 1.12-2.70) and TLR9 rs5743836 (0.174 vs. 0.112, p = 0.045 and p = 0.017, OR for C allele: 1.59, CI 95% 0.99-2.57) between European-derived female groups. A higher frequency was observed for the presence of Anti-SSa/Ro for TRL9 rs5743836 C allele carriers (0.228 vs 0.126, Bonferroni corrected p = 0.06). No statistical differences were found for TLR9 haplotypic analyses. We suggest that TLR7 rs179008 and TLR9 rs5743836 can be considered SLE susceptibility factors for women of European descent in our population.

Enhancement of fast CO2 capture by a nano-SiO2/CaO composite at Ca-looping conditions.

In this paper we show the performance of a new CO(2) sorbent consisting of a dry physical mixture of a Ca-based sorbent and a SiO(2) nanostructured powder. Thermo-gravimetric analysis (TGA) performed at conditions close to the Ca-looping process demonstrate that the rate of CO(2) capture by the mixture is enhanced during the fast carbonation stage of practical interest in applications. Moreover, the residual capture capacity of the mixture is increased. SEM/EDX, physisorption, and XRD analyses indicate that there is a relevant interaction between the nanostructured SiO(2) skeleton and CaO at high temperatures, which serves to improve the efficiency of the transfer of CO(2) to small reactive pores as well as the stability of the sorbent pore structure.

Improving the gas-solids contact efficiency in a fluidized bed of CO2 adsorbent fine particles.

A modified CO(2) adsorbent is obtained by dry mixing of a Ca(OH)(2) fine powder as received with a commercial silica nanopowder. Silica nanoparticles form light agglomerates of size of the order of tens of microns, which are uniformly fluidizable. These agglomerates act as dispersants of the Ca(OH)(2) fine particles, which coat the nanoparticle agglomerates likely due to contact charging. Ca(OH)(2) particles (CO(2) adsorbent) are thus provided with a vehicle for uniform fluidization. In this way, the contact efficiency between the CO(2) adsorbent and CO(2) in the fluidized bed is greatly enhanced. Experimental results show that the improvement of Ca(OH)(2) fluidizability serves to enhance the carbonation reaction in the fluidized bed.

Prevalence and epidemiology of intestinal parasitism, as revealed by three distinct techniques in an endemic area in the Brazilian Amazon.

This survey aims to estimate the prevalence of intestinal parasitic infections in Santa Isabel do Rio Negro, Amazonian Brazil, through three distinct techniques, correlating the prevalence rates with family income and age groups as well as assessing the household clustering of infections. Prevalence rates were assessed through Graham (n=113), Baermann-Moraes (n=232) and Ritchie (n=463) methods. The Graham method was adopted only for children under 5 years old, 15% of whom were positive for Enterobius vermicularis. By the Baermann-Moraes technique, 5·6% of the samples were positive for Strongyloides stercoralis larvae. The Ritchie technique disclosed the following results: Ascaris lumbricoides (26%), Trichuris trichiura (22·5%), hookworms (9·5%), Entamoeba histolytica/Entamoeba dispar (25·3%), Giardia lamblia (12·5%) and E. vermicularis (0·6%). Children aged 5-14 years presented the highest prevalence for pathogenic parasites. Giardiasis and hookworm infection rates were inversely related to family income. The presence of positive contacts in the same household substantially increased the risk of infection by enteric parasites: odds ratio (OR)=2·70, 95% confidence interval (CI)=1·69-4·29 for ascariasis; OR=2·17, 95% CI=1·34-3·51 for trichuriasis; OR=2·13, 95% CI=1·08-4·17 for hookworm disease; OR=3·42, 95% CI=1·86-6·30 for giardiasis; and OR=2·16, 95% CI=1·35-3·47 for amoebiasis, supporting infection clustering in the home. Intestinal parasitoses are extremely frequent in the studied area, and routine methods for diagnosis may underestimate the prevalence of enterobiasis and strongyloidiasis.

Coastal armouring affects intertidal biodiversity across the Alboran Sea (Western Mediterranean Sea).

Intertidal ecosystems are key habitats that are being replaced by artificial hard substrates due to the increment of human activities in coastal areas. These new substrates host generally less biodiversity mainly due to differences in complexity and composition. This is a global phenomenon and has led to the development of strategies in the framework of eco-engineering. However, mitigating measures, such as new eco-designs, must cope with the high spatial variability of the region where they are applied. Therefore, in order to assess if differences in biodiversity detected at local scales in previous studies could be scaled up to predict patterns at a wider scale, we studied taxa richness and taxonomic structure of intertidal communities across the Alboran Sea (western Mediterranean Sea). We compared four different types of artificial substrates (cubes, rip-raps, seawalls and tetrapods) to assess which produces less impact. Overall, artificial substrates host low benthic biodiversity, specially on seawalls, whereas boulder-like artificial structures such as rip-raps were more similar to natural ones. Nevertheless, the effect of a particular type of artificial structure at a regional scale seems unpredictable, highlighting the challenge that eco-engineering measures face in order to establish global protocols for biodiversity enhancement and the importance of local scale in management programmes.

Consensus document for multimodal intraoperatory neurophisiological monitoring in neurosurgical procedures. Basic fundamentals. / Documento de consenso para la monitorización neurofisiológica intraoperatoria multimodal en procedimientos neuroquirúrgicos. Fundamentos básicos.

The present work aims to establish a guide to action, agreed by anaesthesiologists and neurophysiologists alike, to perform effective intraoperative neurophysiological monitoring for procedures presenting a risk of functional neurological injury, and neurosurgical procedures. The first section discusses the main techniques currently used for intraoperative neurophysiological monitoring. The second exposes the anaesthetic and non-anaesthetic factors that are likely to affect the electrical records of the nervous system structures. This section is followed by an analysis detailing the adverse effects associated with the most common techniques and their use. Finally, the last section describes a series of guidelines to be followed upon the various intraoperative clinical events.

Magnetic field induced inversion in the effect of particle size on powder cohesiveness.

Experimental measurements are reported on the tensile yield stress of magnetofluidized beds of fine magnetic powders operated in the cross-flow configuration. In the absence of externally applied magnetic field the yield stress of the powder depends on particle size as expected, i.e., it increases as bead size is decreased. This trend is however inverted when an external magnetic field is applied. It is suggested that the average orientation of interparticle contacts relative to the direction of the field as affected by particle size plays a relevant role on the magnetic yield stress of these systems.

Two-dimensional XXZ -Ising model on a square-hexagon lattice.

We study a two-dimensional XXZ -Ising model on a square-hexagon (denoted for simplicity by 4-6) lattice with spin 1/2. The phase diagram at zero temperature is discussed, where five states are found, two types of ferrimagnetic states, two types of antiferromagnetic states, and one ferromagnetic state. To solve this model, we have mapped onto the eight-vertex model with union Jack interaction term, and it was verified that the model cannot be completely mapped onto eight-vertex model. However, by imposing an exact solution condition, we have found the region where the XXZ -Ising model on 4-6 lattice is exactly soluble with one free parameter, particularly for the case of symmetric eight-vertex model condition. In this manner we have explored the properties of the system and have analyzed the interacting competition parameters which preserve the region where there is an exact solution. Unfortunately the present model does not satisfy the free fermion condition of the eight-vertex model, unless for a trivial solution. Even so, we are able to discuss the critical point region, beyond the region of exact resolvability.

Magnetofluidization of fine magnetite powder.

The behavior of a fluidized bed of fine magnetite particles as affected by a cross-flow magnetic field is investigated. A distinct feature of this naturally cohesive powder, as compared to noncohesive magnetic grains usually employed in magnetofluidized beds, is that the fluidized bed displays a range of stable fluidization even in the absence of an external magnetic field. Upon application of the magnetic field, the interval of stable fluidization is extended to higher gas velocities and bed expansion is enhanced. We have measured the tensile strength as affected by application of the external magnetic field according to two different operation modes. In the H off-on operation mode, the bed is driven to bubbling in the absence of external magnetic field. Once the gas velocity is decreased below the bubbling onset and the bed has returned to stable fluidization due to natural cohesive forces, the field is applied. In the H on-on mode, the field is maintained during the whole process of bubbling and return to stable fluidization. It is found that the tensile strength of the naturally stabilized bed is not essentially changed by application of the field ( H off-on) since the magnetic field cannot alter the bed structure once the particles are jammed in the stable fluidization state. Magnetic forces within the bulk of the jammed bed are partially canceled as a result of the anisotropic nature of the dipole-dipole interaction between the particles, which gives rise to just a small increment of the tensile strength. On the other hand, when the field is held on during bubbling and transition to stable fluidization ( H on-on mode), the tensile strength is appreciably increased. This suggests the formation of particle chains when the particles are not constrained due to the dipole-dipole attractive interaction which affects the mechanical strength of the stably fluidized bed. Experimental data are analyzed in the light of theoretical models on magnetic surface stresses.

Electromechanics of fluidized beds of nanoparticles.

The electromechanical behavior of a gas-fluidized bed of insulating silica nanoparticles is investigated. When fluidized by gas, these nanoparticles form highly porous agglomerates of size of the order of hundreds of microns, which gives rise to a nonbubbling fluidization regime. Bed expansion is enhanced by an imposed alternating electric field for oscillation frequencies in the range between tens and hundreds of hertzs and field strengths of about 1 kV/cm . Nanoparticle agglomerates are naturally charged and experience forced oscillations that cause an increase of the gas flow shear on their surface. As a consequence, the agglomerate size is expected to decrease, which can explain the observed behavior. A model based on the balance between attractive and flow shear forces is presented that accounts for agglomerate size reduction as the strength of the field is increased.