Changing trends in transgender demographics and morbidity: baseline data from a Spanish cohort.

The number of transgender people who request hormone treatment is increasing worldwide. We obtained base clinical and demographic information from transgender people treated at a specialised clinic in Spain (n =484) and studied changes over time. Transgender women treated in 2009-14 were older than those treated in 2015-20 (29years vs 17years), had a lower academic level and had higher anxiolytics consumption. Transgender men treated in 2009-14 were older than those treated later (27years vs 17years) and had a lower academic level. These trends reflect favourable changes in how the transgender population is treated by society and health services.

Risk reductions during pyrene biotransformation and mobilization in a model plant-bacteria-biochar system.

The productive application of motile microorganisms for degrading hydrophobic contaminants in soil is one of the most promising processes in modern remediation due to its sustainability and low cost. However, the incomplete biodegradation of the contaminants and the formation of the intermediary metabolites in the process may increase the toxicity in soil during bioremediation, and motile inoculants may mobilize the pollutants through biosorption. Therefore, controlling these factors should be a fundamental part of soil remediation approaches. The aim of this study was to evaluate the sources of risk associated with the cometabolism-based transformation of 14C-labeled pyrene by inoculated Pseudomonas putida G7 and identify ways to minimize risk. Our model scenario examined the increase in bioaccessibility to a distant source of contamination facilitated by sunflower (Helianthus annuus L.) roots. A biochar trap for mobilized pollutant metabolites and bacteria has also been employed. The experimental design consisted of pots filled with a layer of sand with 14C-labeled pyrene (88 mg kg-1) as a contamination focus located several centimeters from the inoculation point. Half of the pots included a biochar layer at the bottom. The pots were incubated in a greenhouse with sunflower plants and P. putida G7 bacteria. Pots with sunflower plants showed a higher biodegradation of pyrene, its mobilization as metabolites through the percolate and the roots, and bacterial mobilization toward the source of contamination, also resulting in increased pyrene transformation. In addition, the biochar layer efficiently reduced the concentrations of pyrene metabolites collected in the leachates. Therefore, the combination of plants, motile bacteria and biochar safely reduced the risk caused by the biological transformation of pyrene.

Nature-based approaches to reducing the environmental risk of organic contaminants resulting from military activities.

As is the case with many other industrial activities, the organic contaminants at military-impacted sites may pose significant hazards to the environment and human health. Given the expected increase in defense investments globally, there is a need to make society aware of the risks of emissions of organic contaminants generated by military activities and to advance risk minimization approaches. The most recent advances in environmental analytical chemistry, persistence, bioavailability and risk assessment of organic contaminants indicate that efficient risk reductions through biological means are possible. This review debates the organic contaminants of interest associated with military activities, the methodology used to extract and analyze these contaminants, and the nature-based remediation technologies available to recover these sites. In addition, we revise the military environmental regulatory frameworks designed to sustain such actions. Military activities that potentially release organic contaminants on land could be classified as infrastructure and base operations, training exercises and armed conflicts; additionally, chemicals may include potentially toxic compounds, energetic compounds, chemical warfare agents and military chemical compounds. Fuel components, PFASs, TNT, RDX and dyphenylcyanoarsine are examples of organic contaminants of environmental concern. Particularly in the case of potentially toxic and energetic compounds, bioremediation and phytoremediation are considered eco-friendly and low-cost technologies that can be used to remediate these contaminated sites. In addition, this article identifies implementing the bioavailability of organic contaminants as a justifiable approach to facilitate the application of these nature-based approaches and to reduce remediation costs. More realistic risk assessment in combination with new and economically feasible remediation methods that reduce risk by reducing bioavailability (instead of lowering the total contaminant concentration) will serve as an incentive for the military and regulators to accept nature-based approaches.

Behavior of the Uptake of Ibuprofen in Five Varieties of Horticultural Crops Irrigated with Regenerated Water.

The current use of regenerated water in agriculture has led to the emergence of new forms of pollutants, such as pharmaceutical compounds (PCs) which are not fully eliminated in wastewater treatment plants (WWTPs). Therefore, if the effluents of such WWTPs are to be used for agricultural irrigation, the presence of PCs must be analysed and their concentrations determined. The main objective of this study was to evaluate the uptake of ibuprofen (IBP) in horticultural crops irrigated with WWTP effluents and its subsequent effect on human health due to their incorporation into the food chain. The study involved five varieties of crops (lettuce, parsley, cabbage, zucchini and broccoli) grown in a greenhouse and irrigated with WWTP effluent water, in which IBP was analysed. Of the varieties of regenerated water-irrigated horticultural crops, only the leaves of mini-romaine lettuce presented detectable levels of IBP, but without meaning any risk to human health.

SeDREno study - prevalence of hospital malnutrition according to GLIM criteria, ten years after the PREDyCES study.

INTRODUCTION: Background & aims: the last large multicenter study on disease-related malnutrition (DRM) in Spain (the PREDyCES study) showed a 23.7 % prevalence of malnutrition, according to the Nutritional Risk Screening (NRS-2002) tool. The main objective of the SeDREno study was to assess the prevalence of hospital malnutrition upon admission, according to GLIM criteria, ten years later. Methods: a cross-sectional, observational, multicenter study in standard clinical practice, conducted in 17 hospitals during a period of five to seven days. Patients were initially screened using the Malnutrition Universal Screening Tool (MUST), and then assessed using the GLIM criteria for diagnosis and severity grading. Results: a total of 2,185 patients, 54.8 % males, mean age 67.1 (17.0) years (50.2 % aged ≥ 70 years), were evaluated. Malnutrition was observed in 29.7 % of patients according to GLIM criteria (12.5 % severe, 17.2 % moderate). In patients ≥ 70 years malnutrition was observed in 34.8 %. The clinical conditions significantly associated with a higher prevalence of malnutrition were dysphagia (47.6 %), cognitive impairment (43.4 %), cancer (39.1 %), gastrointestinal disease (37.7 %), diabetes (34.8 %), and cardiovascular disease (33.4 %). The multivariate analysis revealed that gender, BMI, diabetes, cancer, gastrointestinal disorders, and polypharmacy were the main independent factors associated with DRM. Malnutrition was associated with an increase in length of hospital stay and death (p < 0.001). Conclusions: DRM in admitted patients has increased in Spain in the last 10 years paralleling ageing of the population. In the SeDREno study almost one in three patients are malnourished. A systematic assessment of nutritional status allows early detection and implementation of nutritional interventions to achieve a better clinical outcome.

INTRODUCCIÓN: Antecedentes y objetivos: el último gran estudio multicéntrico sobre desnutrición relacionada con la enfermedad (DRE) en España (el estudio PREDyCES) mostró una prevalencia de desnutrición del 23,7 % según la herramienta Nutritional Risk Screening (NRS-2002). El principal objetivo del estudio SeDREno fue evaluar la prevalencia de la desnutrición hospitalaria al ingreso según los criterios GLIM diez años después. Métodos: estudio transversal, observacional, multicéntrico, según la práctica clínica estándar, realizado en 17 hospitales durante un período de cinco a siete días. Los pacientes fueron evaluados inicialmente con la herramienta de detección universal de desnutrición (MUST) y luego con los criterios GLIM para el diagnóstico de DRE y la clasificación de la gravedad. Resultados: se evaluaron 2185 pacientes, con un 54,8 % de varones una edad media de 67,1 (17,0) años (50,2 % ≥ 70 años). Se observó desnutrición en el 29,7 % de los pacientes según los criterios GLIM (12,5 % grave, 17,2 % moderada). Entre los pacientes ≥ 70 años se observó desnutrición en el 34,8 %. Las condiciones clínicas asociadas significativamente con una mayor prevalencia de desnutrición fueron la disfagia (47,6 %), el deterioro cognitivo (43,4 %), el cáncer (39,1 %), las enfermedades gastrointestinales (37,7 %), la diabetes (34,8 %) y la patología cardiovascular (33,4 %). El análisis multivariante reveló que el sexo, el IMC, la diabetes, el cáncer, los trastornos gastrointestinales y la polimedicación eran los principales factores independientes asociados a la DRE. La desnutrición se asoció a un aumento de la duración de la estancia hospitalaria y la muerte (p < 0,001). Conclusiones: la DRE en pacientes ingresados ha aumentado en España en los últimos 10 años en paralelo con el aumento del envejecimiento de la población. En el estudio SeDREno, casi uno de cada tres pacientes está desnutrido. La evaluación sistemática del estado nutricional permite la detección e implementación precoces de intervenciones nutricionales para lograr un mejor resultado clínico.

Root-mediated bacterial accessibility and cometabolism of pyrene in soil.

Partial transformation of pollutants and mobilization of the produced metabolites may contribute significantly to the risks resulting from biological treatment of soils polluted by hydrophobic chemicals such as polycyclic aromatic hydrocarbons (PAHs). Pyrene, a four-ringed PAH, was selected here as a model pollutant to study the effects of sunflower plants on the bacterial accessibility and cometabolism of this pollutant when located at a spatially distant source within soil. We compared the transformation of passively dosed 14C-labeled pyrene in soil slurries and planted pots that were inoculated with the bacterium Pseudomonas putida G7. This bacterium combines flagellar cell motility with the ability to cometabolically transform pyrene. Cometabolism of this PAH occurred immediately in the inoculated and shaken soil slurries, where the bacteria had full access to the passive dosing devices (silicone O-rings). Root exudates did not enhance the survival of P. putida G7 cells in soil slurries, but doubled their transport in column tests. In greenhouse-incubated soil pots with the same pyrene sources instead located centimeters from the soil surface, the inoculated bacteria transformed 14C-labeled pyrene only when the pots were planted with sunflowers. Bacterial inoculation caused mobilization of 14C-labeled pyrene metabolites into the leachates of the planted pots at concentrations of approximately 1 mg L-1, ten times greater than the water solubility of the parent compound. This mobilization resulted in a doubled specific root uptake rate of 14C-labeled pyrene equivalents and a significantly decreased root-to-fruit transfer rate. Our results show that the plants facilitated bacterial access to the distant pollutant source, possibly by increasing bacterial dispersal in the soil; this increased bacterial access was associated with cometabolism, which contributed to the risks of biodegradation.

Predicting the uptake of emerging organic contaminants in vegetables irrigated with treated wastewater - Implications for food safety assessment.

Emerging organic contaminants (EOCs) undergoing incomplete removal during wastewater treatment may be found in treated wastewater (TWW) used for irrigation of agricultural products. Following uptake into edible plant parts, EOCs may eventually enter in the food chain, with associated human exposure. In the present study, we used a newly developed steady-state plant uptake model with added phloem transport to predict the uptake of four EOCs (carbamazepine, ibuprofen, ketoprofen and naproxen) into three varieties of lettuce. Input data were derived from an experimental study with vegetables grown in greenhouse and irrigated with TWW spiked with CBZ at 0, 30, 60, 120 and 210 µg/L in each variety of lettuce. Predicted carbamazepine concentrations in leaves were on average 82% higher than in roots, with good agreement between measured and calculated data. We subsequently predicted the uptake of anti-inflammatory compounds ibuprofen, ketoprofen and naproxen, for which the chemical analysis could not provide concentrations above detection limit. These three substances are weak acids and predicted concentrations in roots were higher than in the edible leaves, mainly due to phloem transport downwards. The daily dietary intake of all four EOCs was estimated for consumption of leafy vegetables, being far below usual therapeutic doses.

Pharmaceutical grey water footprint: Accounting, influence of wastewater treatment plants and implications of the reuse.

Emerging pollutants, including pharmaceutical compounds, are producing water pollution problems around the world. Some pharmaceutical pollutants, which mainly reach ecosystems within wastewater discharges, are persistent in the water cycle and can also reach the food chain. This work addresses this issue, accounting the grey component of the water footprint (GWFP) for four of the most common pharmaceutical compounds (carbamazepine (CBZ), diclofenac (DCF), ketoprofen (KTP) and naproxen (NPX)). In addition, the GWFC for the main conventional pollutants is also accounted (nitrate, phosphates and organic matter). The case study is the Murcia Region of southeastern Spain, where wastewater treatment plants (WWTPs) purify 99.1% of the wastewater discharges and there is an important direct reuse of the treated wastewater in irrigation. Thus, the influence of WWTPs and reuse on the GWF is analysed. The results reveal that GWFP, only taking into account pharmaceutical pollutants, has a value of 301 m3 inhabitant-1 year-1; considering only conventional pollutants (GWFC), this value increases to 4718 m3 inhabitant-1 year-1. So, the difference between these values is such that in other areas with consumption habits similar to those of the Murcia Region, and without wastewater purification, conventional pollutants may well establish the value of the GWF. On average, the WWTPs reduce the GWFC by 90% and the GWFP by 26%. These different reductions of the pollutant concentrations in the treated effluents show that the GWF is not only due to conventional pollutants, and other contaminants can became critical, such as the pharmaceutical pollutants. The reuse further reduces the value of the GWF for the Murcia Region, by around 43.6%. However, the reuse of treated wastewater is controversial, considering the pharmaceutical contaminants and their possible consequences in the food chain. In these cases, the GWF of pharmaceutical pollutants can be used to provide a first approximation of the dilution that should be applied to the treated wastewater discharges when they are reused for another economic activity that imposes quality restrictions. For the case of agriculture in the Murcia Region, the dilution required is 2 (fresh water) to 1 (treated wastewater), taking into account the pollution thresholds established in this work.