Worsening of alcohol abuse disorder in a Spanish population during the first twelve months of the COVID-19 pandemic and associated factors: retrospective, ecological and community study.

PURPOSE: To analyse: (1) Changes in clinical parameters and in the use of social healthcare resources by patients with alcohol abuse disorder between the six months prior to the start of the pandemic and the first year of the pandemic. (2) The factors related to a worsening of clinical parameters among patients with alcohol abuse disorder. METHODS: A retrospective and observational study of a population who have been diagnosed with alcohol abuse disorders according to their primary health care (PHC) electronic medical records was performed. The total sample was made up of 11,384 patients. The variables (sociodemographic variables, chronic comorbidities, analytical parameters related to alcohol abuse disorder, COVID-19 infection, and use of healthcare resources) were collected in three different time periods: (i) six months before the onset of the strict lockdown, (ii) six months following the end of lockdown and (iii) from six to twelve months after the end of lockdown. Paired Student's T-test and a multivariate logistic regression were performed. RESULTS: Along the first year after the onset of the pandemic, between 44% and 54% of the patients suffered a decline in every clinical parameter. The number of PHC nursing, GP visits and social worker visits reduced significantly. As regards the associated factors related to deterioration of alcohol abuse disorder, being younger than 40 years old, having an income of over 18,000 euros/year and not having visited the social worker were associated with a worsening of the disorder. CONCLUSIONS: These results suggest that the impact of COVID-19 on this group has been high, and the social care offered to these patients plays a significant role in minimising the repercussions of the pandemic.

Use of health services and medication use, new comorbidities, and mortality in patients with chronic diseases who did not contract COVID-19 during the first year of the pandemic: a retrospective study and comparison by sex.

BACKGROUND: The restrictions introduced to stop the spread of the COVID-19 virus have also had a direct impact on people with chronic diseases and especially on diseases to which lifestyles are relevant in their control and management, such as diabetes, hypertension, chronic obstructive pulmonary disease (COPD), etc. The purpose of this paper is to conduct a longitudinal analysis of new comorbidities, mortality, medication use, and the use of health resources in patients with chronic diseases who did not contract COVID-19, comparing the six months before the strict lockdown to the 12 months following the end of the strict lockdown. METHOD: An observational real world data pre-post study of 668,974 people was undertaken. The patients studied were over 16 years of age, had been receiving care from the Aragon Health Service (Northeastern Spain), were diagnosed with one or more chronic diseases, and had not contracted COVID-19. Sociodemographic, comorbidity, pharmacological and health resource use variables were collected during the six months before the onset of the lockdown and during the six and 12 months following the end of the lockdown. The comparisons by sex were carried out using a Student T-test or chi-squared test to analyse differences. RESULTS: Dyslipidaemia (42.1%) followed by hypertension (35.1%) and anxiety and depression (34.6%) were the most prevalent chronic diseases among the study population. 78.% of patients had between one and four chronic illnesses. There was a decrease in new diagnoses of other chronic comorbidities in this population and a decrease in medications prescribed and the use of health services.  Although women received more diagnoses of chronic diseases, the number of medications dispensed was lower, but the use of health services was higher. These figures were maintained throughout the pandemic. CONCLUSION: Our results suggest an underdiagnosis of new chronic comorbidities and a decrease in mortality rates from causes unrelated to COVID-19 due to the closure of health centres in Aragón (Spain) during the lockdown. This trend was exacerbated in women. The underdiagnosis of new chronic comorbidities during confinement can cause the disease to worsen, with the consequent increase in symptoms and the worsening of chronic pathologies in patients with a severe evolution.

Application of probability theory to neonatal cardiac evaluation.

Based on probability theory, a methodology that allows diagnosing neonatal cardiac dynamics was previously developed; however, diagnostic applications of this method are required to validate it to the neonatal cardiac dynamics was conducted, allowing to differentiate normal from pathological dynamics. The hourly maximum and minimum heart rate values from 39 continuous and ambulatory electrocardiographic records with a minimum length of 21 hours were taken, from newborns between 0 and 10 days of life, 9 clinically within normality limits and 30 with cardiac pathologies. The probability of occurrence of heart rates in ranges of 5 beats/minute was calculated. The distributions of probability were analysed, and finally the diagnosis was determined by the physical-mathematical methodology. Then, a statistical validation of sensitivity, specificity, and diagnostic agreement was performed. Normal registries showed probability distributions with absent or minimal presence of heart rates of the ranges between 125 and 135 beats/minute, while the abnormal ones had values within these ranges, as well as absence or minimal presence of heart rates from 75 beats/minute to 85 beats/minute. The sensitivity and specificity were 100%, and the Kappa coefficient had a value of 1. Hereby, it is concluded that through an application of a physical-mathematical methodology of neonatal cardiac diagnosis, it is possible to differentiate normality from disease.

Factors associated with non-nutritive sucking habits at 2 years of age among very preterm children: EPIPAGE-2 cohort study.

BACKGROUND: The association between prolonged non-nutritive sucking habits (NNSHs, ie, sucking pacifiers or fingers) and maxillofacial growth anomalies in the general population has been widely described. Because maturation of sucking abilities is not fully achieved in very preterm infants (<32 weeks' gestation), neonatal services worldwide rely on the use of pacifiers to promote the development of adequate sucking reflexes, possibly prolonging NNSHs during infancy. OBJECTIVE: We aimed to describe the frequency and to identify factors associated with NNSHs at age 2 years in very preterm children. METHODS: The study was based on data from EPIPAGE-2, a French national prospective cohort study of preterm births during 2011 that included 2593 children born between 24 and 31 weeks' gestation. The primary outcome was NNSHs at 2 years. Multivariable log-linear regression models with generalized estimation equations were used to study the association between the characteristics studied and NNSHs. Multiple imputations were used to take into account missing data. RESULTS: The frequency of NNSHs was 69% in the overall sample but higher among girls (adjusted risk ratio [RR] 1.12, 95% confidence interval [CI] 1.05, 1.17), children born from multiple pregnancies (eg, twins/triplets) (RR 1.07, 95% CI 1.00, 1.11), children who were fed by nasogastric tube (RR 1.07, 95% CI 1.01, 1.13), or those who benefitted from developmental care programmes (RR 1.10, 95% CI 1.02, 1.19). The NNSHs frequency was lower if mothers were not born in France (RR 0.70, 95% CI 0.64, 0.77), children had 2 or more older siblings (RR 0.88, 95% CI 0.82, 0.96), or children were breast-fed at discharge (RR 0.90, 95% CI 0.85, 0.95). CONCLUSIONS: NNSHs at 2 years seemed associated with cultural background, development care programmes, and breast feeding. Whether NNSHs at 2 years among very preterm children are associated with future maxillofacial growth anomalies deserves further attention.

Long-Term Effect of Lactation on Maternal Cardiovascular Function and Adiposity in a Murine Model.

OBJECTIVE: Epidemiological studies suggest that lactation is associated with long-term maternal health benefits. To avoid confounders in human studies, we used a previously characterized murine model to investigate the long-term effect of lactation on both cardiovascular function and adiposity. STUDY DESIGN: After the delivery of the pups, CD-1 female mice were randomly divided into two groups: lactated and nonlactated (NL). Before pregnancy and at 9 months postdelivery, blood pressure was measured using a tail cuff, visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were assessed by computed tomography (CT), echocardiography was performed using microultrasound, and cholesterol panels and fasting blood glucose were measured. The data were analyzed using Student's t-test (significance at p < 0.05). RESULTS: There were no differences in baseline parameters between the two groups. At 9 months postdelivery, the NL group weighed significantly more (p = 0.03) and demonstrated a significantly lower cardiac output (p = 0.05) and ejection fraction (p = 0.03). The mice in the NL group also had higher VAT (p < 0.01) and SAT percentiles (p = 0.03). Fasting glucose (p = 0.01) and low-density lipoprotein (p = 0.01) were significantly higher in the NL group at 9 months. CONCLUSION: Our results show the benefit of lactation is not just limited to the immediate postpartum period but it also extends into midlife in a murine model.

Stroke Volume Recruitability during the Third Trimester of Pregnancy.

OBJECTIVE: It is unknown whether the heart operates in the ascending or flat portion of the Starling curve during normal pregnancy. Pregnant women do not respond to the passive leg-raising maneuver secondary to mechanical obstruction of the inferior vena cava by the gravid uterus. Our objective was to evaluate if administration of a fluid bolus increases baseline stroke volume (SV) among healthy pregnant patients during the third trimester. STUDY DESIGN: Healthy pregnant women who underwent elective term cesarean sections were included. A noninvasive cardiac output monitor was used to measure hemodynamic variables at baseline and after administration of a 500-mL crystalloid bolus. RESULTS: Forty-five women were included in the study. Fluid administration was associated with a statistically significant increase in SV from a baseline value of 71 ± 11 to 90 ± 19 mL (95% confidence interval [CI]: 13.67-21.49; p < 0.01) and a significant decrease in maternal heart rate from a baseline of 87 ± 9 beats per minute to 83 ± 8 after the fluid bolus (95% CI: -6.81 to -2.78; p = 0.03). No changes in peripheral vascular resistances or any other measured hemodynamic parameters were noted with volume expansion. CONCLUSION: In healthy term pregnancy, the heart operates in the ascending portion of the Starling's curve, rendering it fluid responsive.

Motivational Interviewing as a Tool to Increase Motivation and Adherence to a Long COVID Telerehabilitation Intervention: Secondary Data Analysis from a Randomized Clinical Trial.

Background: Although motivational interviewing was originally developed to address abuse disorders, scientific evidence confirms that it is an increasingly used and effective approach in a wide range of therapeutic interventions. To date, however, no studies have analyzed the use of this tool in patients with persistent symptoms following coronavirus disease 2019, a condition known as Long COVID. Purpose: To analyze the effectiveness of motivational interviewing with regard to the adherence to telerehabilitation for Long COVID using a mobile application. As a secondary objective, factors related to greater motivation before and after the motivational interviewing techniques were analyzed. Patients and Methods: This longitudinal design substudy used a sample of 52 adult patients with Long COVID participating in the intervention group of a randomized clinical trial. This trial examined the effectiveness of a telerehabilitation program for this population using a mobile application. This program included three motivational interviews to achieve maximum treatment adherence. In this study, the main variables were motivation and adherence to application use. Sociodemographic and clinical data, personal constructs, and affective state were also collected. Subsequently, a descriptive, correlational, and regression statistical analysis was performed using the SPSS Statistics program. Results: The median motivation prior to the first motivational interview was 8 (IQR 2), the median at the end of the last motivational interview was 8.5 (IQR 2.75), and the change in motivation levels after the three motivational interviews was 0.5 (IQR 1). Affective state and final motivation scores were predictors of greater adherence to telerehabilitation treatment. Conclusion: A high level of motivation after participating in motivational interviewing appears to be related to higher levels of adherence to telerehabilitation in patients with Long COVID. This suggests that motivational interviewing may be an effective tool in the treatment of this disease.

Loss of socioemotional and occupational roles in individuals with Long COVID according to sociodemographic and clinical factors: Secondary data from a randomized clinical trial.

BACKGROUND: Long COVID syndrome can have a major impact on life organization. Its persistent symptoms may cause a potentially disabling condition that affects the quality of life of those suffering from it. The resulting loss of functional independence hinders the ability to return to normal life. Many research studies carried out on this novel syndrome have focused on describing its extensive symptomatology. Studies on later repercussions, however, such as disability or loss of significant roles, remain scarce. This study examines the loss of socioemotional and occupational roles experienced by individuals suffering from Long COVID, as a result of the disease. A secondary objective is to analyze the sociodemographic and clinical factors associated with this loss of roles. PATIENTS AND METHODS: A cross-sectional study was conducted with the participation of 100 patients diagnosed with Long COVID, over the age of 18, and attended by Primary Health Care in the Autonomous Community of Aragon. The main study variable was the loss of significant socioemotional and occupational roles by the participants. Sociodemographic and clinical data were also collected through a structured interview. Subsequently, a descriptive, correlational, and regression-based statistical analysis was performed using the SPSS Statistics program. RESULTS: Based on the 100 study participants, the median number of roles lost was 3 (IQR 2) and the median number of valuable roles lost was 2 (IQR 2). More cognitive impairment and not having an active work role were predictors of a greater loss of valuables roles. CONCLUSION: Long COVID symptoms hinder the development of socioemotional and occupational roles. Healthcare professionals should consider this when intervening to ensure that their patients may recover their life as it was before the disease.

[Development of autoimmunity in patients with primary immunodeficiencies]. / Desarrollo de autoinmunidad en pacientes con inmunodeficiencias primarias.

The autoimmune diseases include many in which the immune system is directed against the host, leading to life-threatening destruction of organs. The origin of autoimmune disorders can be multifactorial and, there are no specific therapy for these diseases. Primary immunodeficiencies are a group of immune disorders that affect different components of the innate and adaptive responses. Interestingly, patients with primary immunodeficiencies have an increased susceptibility to infectious diseases and non-infectious complications including allergies, malignancies, and autoimmune diseases. The molecular mechanism for development of autoimmunity in immunodeficiencies is unclear. The study of the complex immune regulatory and signaling mechanisms is revealing the relationships between primary immunodeficiency syndromes and autoimmune diseases. Newly, it has been demonstrated that a deficient maturation of immune cells; the deficiency of proteins important for T and B lymphocyte function and impaired signally pathways that include key molecules in regulation and activation of immune cells are associated with the development of autoimmunity in patients with primary immunodeficiencies. The aim of the present work is to review the evidence available to date regarding the cellular and molecular mechanisms involved in the development of autoimmunity in patients with primary immunodeficiencies.

Las enfermedades autoinmunes constituyen un grupo de trastornos del sistema inmunológico en dónde este ataca a las células propias del organismo. Las causas pueden ser multifactoriales y no hay tratamientos específicos contra estas enfermedades. Por su parte, las inmunodeficiencias primarias (IDP) son un grupo de alteraciones originadas por defectos genéticos que tienen como consecuencia la deficiencia en la función del sistema inmunológico. Actualmente, se han descrito algunos mecanismos celulares y moleculares por los cuales se desarrollan trastornos autoinmunes en pacientes con inmunodeficiencias, sin embargo, dichos mecanismos no se han descrito con exactitud. Lo anterior, representa uno de los principales retos de las personas que lo padecen. De manera interesante, diversos reportes indican que la autoinmunidad secundaria a la inmunodeficiencia sigue algunos mecanismos celulares y moleculares como: una deficiente maduración de células inmunológicas; deficiencia de proteínas importantes para la función de los linfocitos T y B y; fallas en la función de moléculas de señalización intracelular importantes para la regulación inmunológica. En conjunto, estos mecanismos se relacionan con el desarrollo de autoinmunidad en pacientes con IDP. El objetivo del presente trabajo fue realizar una revisión de la evidencia disponible hasta la fecha respecto a los mecanismos celulares y moleculares implicados en el desarrollo de autoinmunidad en pacientes con IDP.

Use of community resources as health assets for rehabilitation of people with Long COVID in northeastern Spain two years after the outbreak of the COVID-19 pandemic: qualitative study.

INTRODUCTION: The epidemiology of Post COVID Condition is not yet known. There are different treatment options, but they are not recommended or suitable for all those affected. For this reason and due to the lack of health treatment, many of these patients have tried to carry out their own rehabilitation through the use of community resources. OBJECTIVE: The objective of this study is to deepen into the understanding about the use of community resources as assets for health and rehabilitation by people with Long COVID and their utility. METHODOLOGY: A qualitative design was carried out with the participation of 35 Long COVID patients, of which 17 subjects were interviewed individually and 18 of them were part of two focus groups. The participating patients were recruited in November and December 2021 from the Primary Health Care centers and through the Association of Long COVID patients of Aragon. The research topics were the use of community resources, before and after their infection by COVID-19, rehabilitation through their use, as well as barriers and strengths for their employment. All analyses were performed iteratively using NVivo software. RESULTS: Long COVID patients who have used community resources for rehabilitation have seen an improvement in their physical and mental health. Most of them, specifically those affected, have used green spaces, public facilities, physical or cultural activities and associations. The main barriers identified have been the symptoms themselves and the fear of reinfection, with the main advantage of these activities being the perceived health benefits. CONCLUSION: The use of community resources seems to be beneficial in the recovery process of Long COVID patients, so it is necessary to continue delving into this topic and promote the formal use of the Recommendation of Health Assets from Primary healthcare.

Clinical characterization and factors associated with quality of life in Long COVID patients: Secondary data analysis from a randomized clinical trial.

BACKGROUND: Long COVID patients suffer a negative impact on their quality of life, as well as their functioning, productivity or socialization. There is a need to better understand the individual experience and circumstances surrounding these patients. OBJECTIVE: To characterize clinical picture of Long COVID patients and to identify factors associated with quality of life. METHODS: A secondary data analysis from a randomized clinical trial (RCT) was carried out with 100 Long COVID patients treated by Primary Health Care and residents in the territory of Aragon (northeast of Spain). The main variable of the study was quality of life, evaluated using the SF-36 Questionnaire, in relation to socio-demographic and clinical variables. In addition, ten validated scales were used that contemplated their cognitive, affective, functional and social status, as well as personal constructs. Correlation statistics and linear regression model were calculated. RESULTS: Long COVID patients suffer a decrease in their levels of physical and mental health. On the one hand, the higher number of persistent symptoms (b = -0.900, p = 0.008), worse physical functioning (b = 1.587, p = 0.002) and sleep quality (b = -0.538, p = 0.035) are predictors of worse quality of life, physical subscale. On the other hand, higher educational level (b = 13.167, p = 0.017), lower number of persistent symptoms (b = -0.621, p = 0.057) and higher affective affectation (b = -1.402, p<0.001) are predictors of worse quality of life, mental subscale. CONCLUSION: It is necessary to design rehabilitation programs that consider both the physical and mental health of these patients, thus obtaining an improvement in their quality of life.

Online multimodal rehabilitation programme to improve symptoms and quality of life for adults diagnosed with long COVID-19: a Randomised Clinical Trial protocol.

Background: Long COVID is a multisystemic condition which affects quality of life and implies a multidisciplinary treatment approach. There is still limited evidence on management techniques for this syndrome. "Telerehabilitation" could be an important tool when addressing the symptoms of this patients with the aim of increasing their quality of life. The purpose of this trial is to analyse the effectiveness of an online multimodal rehabilitation programme to improve the symptomatology of people with long COVID and their quality of life. Methods: A pragmatic randomised controlled trial will be performed with two parallel groups: (1) usual treatment by the primary care practitioner (Treatment as usual, TAU; control group) and (2) TAU plus the use of an online multimodal rehabilitation programme, including videoconferences and content published on a Moodle platform (intervention group). The data will be collected before and after the intervention. A follow-up will take place 3 months later. Discussion: There is still a lack of knowledge regarding the management of the symptoms of long COVID. This creates the need to add scientific evidence about the care of this disease, considering that multidisciplinary social and health teams can offer the necessary care so that these patients can recover their previous quality of life.Clinical trial registration: The protocol for this study was registered with the ISRCTN Registry [registration number: ISRCTN15414370] on 28 December 2022.

Risk Factors for High-Arched Palate and Posterior Crossbite at the Age of 5 in Children Born Very Preterm: EPIPAGE-2 Cohort Study.

Introduction: Children born very preterm have an immature sucking reflex at birth and are exposed to neonatal care that can impede proper palate growth. Objectives: We aimed to describe the frequency of high-arched palate and posterior crossbite at the age of 5 in children born very preterm and to identify their respective risk factors. Methods: Our study was based on the data from EPIPAGE-2, a French national prospective cohort study, and included 2,594 children born between 24- and 31-week gestation. Outcomes were high-arched palate and posterior crossbite. Multivariable models estimated by generalized estimation equations with multiple imputation were used to study the association between the potential risk factors studied and each outcome. Results: Overall, 8% of children born very preterm had a high-arched palate and 15% posterior crossbite. The odds of high-arched palate were increased for children with low gestational age (24-29 vs. 30-31 weeks of gestation) [adjusted odds ratio (aOR) 1.76, 95% confidence interval (CI) 1.17, 2.66], thumb-sucking habits at the age of 2 (aOR 1.53, 95% CI 1.03, 2.28), and cerebral palsy (aOR 2.18, 95% CI 1.28, 3.69). The odds of posterior crossbite were increased for children with pacifier-sucking habits at the age of 2 (aOR 1.75, 95% CI 1.30, 2.36). Conclusions: Among very preterm children, low gestational age and cerebral palsy are the specific risk factors for a high-arched palate. High-arched palate and posterior crossbite share non-nutritive sucking habits as a common risk factor. The oro-facial growth of these children should be monitored.

Development and validation of a sampling and analysis method to determine biogenic sulfur in a desulfurization bioreactor by gas chromatography coupled with a pulsed flame photometric detector (GC-PFPD).

Suspended biomass bioreactors can be operated to remove H2S from biogas under anoxic conditions and produce elemental sulfur, the commercial value of which has been demonstrated. In the present paper, a novel methodology comprising the optimization of a determination method performed in a gas chromatograph equipped with a pulsed flame photometric detector (GC-PFPD), combined with a simple preparation based on filtration and extraction with toluene, is proposed. The injector temperature and carrier gas flow rate (QHe) values were optimized using a response surface methodology based on a face-centred composite central design. This optimization revealed that the optimum conditions were an injector temperature and carrier gas flow rate of 222 °C and 7 mL min-1, respectively. The chromatographic method shows an analysis time of 48 min, a detection limit of more than 5.9 mg L-1, a relative standard deviation of less than 3.71%, and a sulfur recovery percentage of more than 98%. These values provide excellent linearity and a reasonable concentration range (10-200 mg L-1). Finally, a measurement error of 4.45% was obtained when using the present method in a selectivity test.

Effect of acute physical exercise on inhibitory control in young adults: High-intensity indoor cycling session.

There is growing evidence that physical exercise (PE) may boost cognitive performance. However, criteria regarding PE intensity, duration, and frequency are still being studied. We hypothesize that high PE intensities have effects on inhibitory control. For this reason, our aim was to study the effect of acute PE on IC in healthy young students of a bachelor's degree in physical education and exercise via a 20-minute indoor cycling session at 80-90% HRmax intensity. We devised an experimental group design (n = 9) relative to a control group (n = 10) with pre-and-post-test IC measures. A Stroop task (two conditions) was administered to undergraduate students (Mage = 23.3, SD = 1.6) of a bachelor's degree program in Physical Education and Sports Sciences from a public university in Colombia. The computed MANOVA did not show an interaction effect between the experimental task of Stroop A-B x measure x group. However, a main effect of reduced response time was obtained after PE in the experimental group. Other main effects were observed in the number of correct and incorrect trials in the Stroop-B condition. The experimental group showed fewer correct answers after PE, and the control group showed fewer errors. It is concluded that high-intensity PE confers favorable effects on inhibitory control.

Development and Validation of a Mobile Application as an Adjuvant Treatment for People Diagnosed with Long COVID-19: Protocol for a Co-Creation Study of a Health Asset and an Analysis of Its Effectiveness and Cost-Effectiveness.

OBJECTIVE: To analyse the overall effectiveness and cost-efficiency of a mobile application (APP) as a community health asset (HA) with recommendations and recovery exercises created bearing in mind the main symptoms presented by patients in order to improve their quality of life, as well as other secondary variables, such as the number and severity of ongoing symptoms, physical and cognitive functions, affective state, and sleep quality. METHODS: The first step was to design and develop the technologic community resource, the APP, following the steps involved in the process of recommending health assets (RHA). After this, a protocol of a randomised clinical trial for analysing its effectiveness and cost-efficiency as a HA was developed. The participants will be assigned to: (1st) usual treatment by the primary care practitioner (TAU), as a control group; and (2nd) TAU + use of the APP as a HA and adjuvant treatment in their recovery + three motivational interviews (MI), as an interventional group. An evaluation will be carried out at baseline with further assessments three and six months following the end of the intervention. DISCUSSION: Although research and care for these patients are still in their initial stages, it is necessary to equip patients and health care practitioners with tools to assist in their recovery. Furthermore, enhanced motivation can be achieved through telerehabilitation (TR).

Anoxic biogas biodesulfurization promoting elemental sulfur production in a Continuous Stirred Tank Bioreactor.

Biological desulfurization of biogas has been extensively studied using biotrickling filters (BTFs). However, the accumulation of elemental sulfur (S°) on the packing material limits the use of this technology. To overcome this issue, the use of a continuous stirred tank bioreactor (CSTBR) under anoxic conditions for biogas desulfurization and S° production is proposed in the present study. The effect of the main parameters (stirring speed, N/S molar ratio, hydraulic residence time (HRT) and gas residence time (GRT)) on the bioreactor performance was studied. Under an inlet load (IL) of 100 g S-H2S m-3 h-1 and a GRT of 119 s, the CSTBR optimal operating conditions were 60 rpm, N/S molar ratio of 1.1 and a HRT of 42 h, in which a removal efficiency (RE) and S° production of 98.6 ± 0.4 % and 88 % were obtained, respectively. Under a GRT of 41 s and an IL of 232 g S-H2S m-3 h-1 the maximum elimination capacity (EC) of 166.0 ± 7.2 g S-H2S m-3 h-1 (RE = 71.7 ± 3.1 %) was obtained. A proportional-integral feedback control strategy was successfully applied to the bioreactor operated under a stepped variable IL.

Mathematical law of cardiac dynamic systems: reduction of its evaluation time to 18 hours / [Ley matemática de los sistemas dinámicos cardiacos: reducción de su tiempo de evaluación a 18 horas]

Introduction: Previously, a physical-mathematical law was developed for the evaluation of continuous electrocardiographic and Holter registers, with which all cardiac attractors were deduced and normality, pathological states and evolution between states were differentiated.There were taken 200 cardiac dynamics, 150 with different types of cardiac pathologies and 50 normal ones, to which the exponential law was applied in 18 and 21 hours. For this, a sequence of heart rates was simulated, with which the chaotic attractor was constructed. Next, the mathematical diagnosis was determined with the law based on the spatial occupation of the attractor, and the fractal dimension was calculated. Finally, statistical validation of the mathematical method in 18 hours was performed against the Gold Standard. Results: Subjects with normal chaotic cardiac dynamics presented values in the Kp grid between 205 and 384, whereas subjects with pathological dynamics presented values between 61 and 191 in 18 hours. The evaluation of the concordance between the mathematical diagnosis in 18 hours and the conventional evaluation, taken as Gold Standard resulted in sensitivity and specificity values of 100% and a Kappa coefficient of 1. Conclusion: It was confirmed the clinical capacity of the law to diagnose objectively and with reproducibility in 18 hours.

Fractal geometry applied to the analysis of cervix biopsy.

BACKGROUND: the measurement of the spaces of occupation of irregular objects in the context of fractal geometry has had some applications at a cellular morphometric level, where characterizations of normality and disease have been established. The objective of the present study is to apply a fractal methodology to characterize images from cervical colposcopy. MATERIALS AND METHODS: a mathematical and geometrical characterization of 67 cell samples was performed by measuring cellular fractal characteristics through the Box-Counting method, being nine normal, eight low-intraepithelial lesions, 16 high-intraepithelial lesions, eight carcinomas in situ, 20 squamous cell carcinomas and six endocervical carcinomas. RESULTS: the values of fractal dimension of the nuclear and cytoplasmic borders with respect to the totality varied between 0.719 to 1128 and 0.81 to 1024 while the occupation spaces in the 2 pixels grid were between 293 to 1606 and 64 to 693 respectively and in the 4 pixels grid oscillated between 153 to 894 and 36 to 361, respectively. Exocervical cells values had sensitivities between 78.3% to 100% in order to differentiate them from different types of cervical lesions. CONCLUSIONS: according to the results obtained, the mathematical values found are suggestive of being able to differentiate between normality and some colposcopy-guided cervical biopsy lesions.

A Lineage of Begomoviruses Encode Rep and AC4 Proteins of Enigmatic Ancestry: Hints on the Evolution of Geminiviruses in the New World.

The begomoviruses (BGVs) are plant pathogens that evolved in the Old World during the Cretaceous and arrived to the New World (NW) in the Cenozoic era. A subgroup of NW BGVs, the "Squash leaf curl virus (SLCV) lineage" (S-Lin), includes viruses with unique characteristics. To get clues on the evolutionary origin of this lineage, a search for divergent members was undertaken. Four novel BGVs were characterized, including one that is basal to the group. Comparative analyses led to discover a ~670 bp genome module that is nearly exclusive of this lineage, encompassing the replication origin, the AC4 gene, and 480 bp of the Rep gene. A similar DNA module was found in two curtoviruses, hence suggesting that the S-Lin ancestor acquired its distinctive genomic segment by recombination with a curtovirus. This hypothesis was definitely disproved by an in-depth sequence analysis. The search for homologs of S-Lin Rep uncover the common origin of Rep proteins encoded by diverse Geminiviridae genera and viral "fossils" integrated at plant genomes. In contrast, no homolog of S-Lin Rep was found in public databases. Consequently, it was concluded that the SLCV clade ancestor evolved by a recombination event between a primitive NW BGV and a virus from a hitherto unknown lineage.