Risk factors and outcome of acute kidney injury in critically ill patients with SARS-CoV-2 pneumonia: a multicenter study.

OBJECTIVE: To assess incidence, risk factors and impact of acute kidney injury(AKI) within 48 h of intensive care unit(ICU) admission on ICU mortality in patients with SARS-CoV-2 pneumonia. To assess ICU mortality and risk factors for continuous renal replacement therapy (CRRT) in AKI I and II patients. DESIGN: Retrospective observational study. SETTING: Sixty-seven ICU from Spain, Andorra, Ireland. PATIENTS: 5399 patients March 2020 to April 2022. MAIN VARIABLES OF INTEREST: Demographic variables, comorbidities, laboratory data (worst values) during the first two days of ICU admission to generate a logistic regression model describing independent risk factors for AKI and ICU mortality. AKI was defined according to current international guidelines (kidney disease improving global outcomes, KDIGO). RESULTS: Of 5399 patients included 1879 (34.8%) developed AKI. These patients had higher ICU mortality and AKI was independently associated with a higher ICU mortality (HR 1.32 CI 1.17-1.48; p < 0.001). Male gender, hypertension, diabetes, obesity, chronic heart failure, myocardial dysfunction, higher severity scores, and procalcitonine were independently associated with the development of AKI. In AKI I and II patients the need for CRRT was 12.6% (217/1710). In these patients, APACHE II, need for mechanical ventilation in the first 24 h after ICU admission and myocardial dysfunction were associated with risk of needing CRRT. AKI I and II patients had a high ICU mortality (38.5%), especially if CRRT were required (64.1% vs. 34,8%; p < 0.001). CONCLUSIONS: Critically ill patients with SARS-CoV-2 pneumonia and AKI have a high ICU mortality. Even AKI I and II stages are associated with high risk of needing CRRT and ICU mortality.

Exploring the Nutritional and Bioactive Potential of Olive Leaf Residues: A Focus on Minerals and Polyphenols in the Context of Spain's Olive Oil Production.

Lyophilized plant-origin extracts are rich in highly potent antioxidant polyphenols. In order to incorporate them into food products, it is necessary to protect these phytochemicals from atmospheric factors such as heat, light, moisture, or pH, and to enhance their bioavailability due to their low solubility. To address these challenges, recent studies have focused on the development of encapsulation techniques for antioxidant compounds within polymeric structures. In this study, lyophilized olive leaf extracts were microencapsulated with the aim of overcoming the aforementioned challenges. The method used for the preparation of the studied microparticles involves external ionic gelation carried out within a water-oil (W/O) emulsion at room temperature. HPLC analysis demonstrates a high content of polyphenols, with 90% of the bioactive compounds encapsulated. Meanwhile, quantification by inductively coupled plasma optical emission spectroscopy (ICP-OES) reveals that the dried leaves, lyophilized extract, and microencapsulated form contain satisfactory levels of macro- and micro-minerals (calcium, potassium, sodium). The microencapsulation technique could be a novel strategy to harness the polyphenols and minerals of olive leaves, thus enriching food products and leveraging the antioxidant properties of the polyphenolic compounds found in the lyophilized extract.

Decomposition of Luminescent Hydroxyapatite Scaffolds in Simulated Body Fluid.

We present a luminescence study investigating the dissolution of rare-earth-doped hydroxyapatite scaffolds in simulated body fluid (SBF), aiming to assess the luminescence stability of Tb-, Ce-, and Eu-doped scaffolds over time. Our findings reveal a consistent decrease in luminescence emission intensity across all samples over a four-week period in which the scaffolds were immersed in the SBF. In addition, energy-dispersive spectroscopy confirms a decrease in rare-earth ion concentration in the scaffolds with respect to time, whereas fluorescence spectroscopy shows the presence of rare-earth ions in the SBF, indicating the partial dissolution of the scaffolds over time. The use of rare-earth ions as luminescence markers provides insights into the mechanisms of apatite formation in hydroxyapatites. Thus, these scaffolds may find wider use in regenerative medicine, particularly in targeted drug delivery systems, where their luminescent properties have the potential to noninvasively track drug release.

Postsurgical Outcomes of Mesial Temporal Lobe Epilepsy due to Hippocampal Sclerosis Associated with Calcified Neurocysticercosis.

The aim of this study was to analyze postsurgical outcomes for individuals with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) who underwent anterior temporal lobectomy, based on the presence of calcified neurocysticercosis (cNCC). A retrospective cross-sectional study was conducted on 89 patients with MTLE-HS who underwent anterior temporal lobectomy between January 2012 and December 2020 at a basic epilepsy surgery center located in Lima, Peru. We collected sociodemographic, clinical, and diagnostic information. The postsurgical results were analyzed using bivariate analysis according to the Engel classification. We included 89 individuals with a median age of 28 years (interquartile range [IQR]: 24-37), and more than half (55.1%) were male. Seventeen (19.1%) were diagnosed with cNCC. A greater number of patients with cNCC had lived in rural areas of Peru during their early life compared with those without cNCC (12 [70.6%] versus 26 [36.1%]; P = 0.010). Patients with cNCC exhibited a greater median frequency of focal to bilateral tonic-clonic seizures per month (1 [IQR: 0-2] versus 0 [0-0.5]; P = 0.009). Conversely, a lower proportion of patients with cNCC reported a history of an initial precipitating injury in comparison to the group without cNCC (4 [23.5%] versus 42 [58.3%]; P = 0.014). At the 1-year follow-up, most patients (82.4%) with cNCC were categorized as Engel IA. Similarly, at the 2-year follow-up, nine (75.0%) were classified as Engel IA. Our findings suggest that most patients diagnosed with cNCC exhibit favorable postsurgical outcomes, comparable to those without cNCC. Additionally, it can be postulated that cNCC may play a role as an initial precipitating injury.

Shall we always use hydraulic models? A graph neural network metamodel for water system calibration and uncertainty assessment.

Representing reality in a numerical model is complex. Conventionally, hydraulic models of water distribution networks are a tool for replicating water supply system behaviour through simulation by means of approximation of physical equations. A calibration process is mandatory to achieve plausible simulation results. However, calibration is affected by a set of intrinsic uncertainty sources, mainly related to the lack of system knowledge. This paper proposes a breakthrough approach for calibrating hydraulic models through a graph machine learning approach. The main idea is to create a graph neural network metamodel to estimate the network behaviour based on a limited number of monitoring sensors. Once the flows and pressures of the entire network have been estimated, a calibration is carried out to obtain the set of hydraulic parameters that best approximates the metamodel. Through this process, it is possible to estimate the uncertainty that is transferred from the few available measurements to the final hydraulic model. The paper sparks a discussion to assess under what circumstances a graph-based metamodel might be a solution for water network analysis.

White emission in 3D-printed phosphor microstructures.

Microscale functional materials permit advanced applications in optics and photonics. This work presents the additive manufacturing of three-dimensional structured phosphors emitting red, green, blue, and white. The development is a step forward to realizing additive colour synthesis within complex architectures of relevance in integrated optics or light-emitting sources.

Depression and suicide after temporal lobe epilepsy surgery: A systematic review.

Psychiatric comorbidities, including depression and suicide, contribute substantially to the illness burden of patients with refractory temporal lobe epilepsy (TLE). The aim of this systematic review was to synthesize the existing literature assessing the effect of TLE surgery on (1) depression prevalence and (2) severity, and estimating the incidence of (3) de novo depression and (4) attempted and completed suicide following TLE surgery. A literature search was performed using Ovid Medline, Embase, Clarivate Web of Science, Cochrane Library, and ProQuest Dissertations and Theses. Studies of patients with TLE who underwent TLE surgery and reported estimates of at least one of the following outcomes were included: pre- and postoperative depression prevalence or severity, the incidence of postoperative de novo depression, or attempted or completed suicide. The search yielded 2,127 citations related to TLE surgery and postoperative depression or suicide. After a full-text review of 98 articles, 18 met the final eligibility criteria. Most studies reported a reduced or similar prevalence (n = 12) and severity of depression (n = 5) postoperatively, compared with the preoperative period. Eleven studies reported the incidence of postoperative de novo depression, which ranged from 0 % to 38 % over follow-up periods of three months to nine years. Four studies assessed the incidence of postoperative attempted or completed suicide, with completed suicide incidence ranging from 0 % to 3 % over follow-up periods of one to four years. Overall, the effect of TLE surgery on depression and suicide remains unclear, as many studies did not assess the statistical significance of depression prevalence or severity changes following TLE surgery. Therefore, timely psychosocial follow-up for patients after TLE surgery should be considered. Future longitudinal studies with consistent measures are needed to elucidate the effect of TLE surgery on the prevalence and severity of depression and estimate the incidence of de novo depression and suicide following surgery.

Tratamiento quirúrgico ambulatorio en la solución de las afecciones de la glándula tiroides / Outpatient surgical treatment in the solution of the thyroid gland conditions

RESUMEN Introducción: La cirugía tiroidea es uno de los procedimientos más comúnmente realizados en la cirugía de cabeza y cuello. Era tradicional que los pacientes tuvieran estancias hospitalarias que, en ocasiones, superaban los 3 días. Objetivo: Describir los resultados de la cirugía mayor ambulatoria, en la solución de las afecciones quirúrgicas de la glándula tiroides. Métodos: Se realizó un estudio descriptivo en 307 pacientes con afecciones de la glándula tiroides que recibieron tratamiento quirúrgico ambulatorio. Se confeccionó modelo de recogida de datos para las variables: edad, sexo, afección tiroidea, tipo de intervención quirúrgica, método anestésico y complicaciones. Se calcularon frecuencias absolutas y relativas. Resultados: El grupo de edades más frecuente fue entre los 30-39 años (32,57 %), predominó el sexo femenino (91,53 %). Las afecciones tiroideas más frecuentes fueron el bocio adenomatoso (23,13 %) y el carcinoma (20,85 %), la intervención quirúrgica más frecuente fue la tiroidectomía total (39,08 %); se aplicó analgesia quirúrgica acupuntural en 39 pacientes (12,71 %), 8 pacientes presentaron complicaciones posoperatorias (2,6 %). La estancia hospitalaria fue inferior a 24 horas en el 99,02 % de los pacientes. Conclusiones: La cirugía mayor ambulatoria se emplea en la solución de las afecciones quirúrgicas de la glándula tiroides, más frecuente en las afecciones benignas, en pacientes mayores de 19 años de edad, con predominio del sexo femenino, la intervención quirúrgica realizada con mayor frecuencia es la tiroidectomía total. Con mayor frecuencia se aplica anestesia general orotraqueal; se reserva la analgesia quirúrgica acupuntural para casos seleccionados.

ABSTRACT Introduction: Thyroid surgery is one of the most commonly performed procedures in otorhinolaryngology, and head and neck surgery. Traditionally, it presented hospital stays that were sometimes longer than 3 days. Objective: To describe the results of major outpatient surgery in the solution of surgical conditions of the thyroid gland. Methods: A descriptive study was carried out in 307 patients with thyroid gland disorders who received outpatient surgical treatment. A data collection model was created for the variables: age, sex, thyroid disease, type of surgical intervention, anesthetic method and complications, absolute and relative frequencies were calculated. Results: The most frequent age group was between 30-39 years (32.57 %), females predominated (91.53 %). The most frequent thyroid conditions were adenomatous goiter (23.13 %) and carcinoma (20.85 %), the most frequent surgical intervention was total thyroidectomy (39.08 %), surgical acupuncture analgesia was applied in 39 patients (12.71 %), 8 patients presented postoperative complications (2.6 %). The hospital stay was less than 24 hours in 99.02 % of the patients. Conclusions: Major outpatient surgery is used in the solution of surgical conditions of the thyroid gland, more frequent in benign conditions, in patients over 19 years of age, with a predominance of females, the surgical intervention performed with greater frequency is total thyroidectomy. The most frequent was general orotracheal anesthesia, reserving acupuncture surgical analgesia for selected cases.

Spectroscopic Ellipsometry Study on Tuning the Electrical and Optical Properties of Zr-Doped ZnO Thin Films Grown by Atomic Layer Deposition.

This work reports the ellipsometry analysis of atomic layer deposition (ALD) films of ZnO doped with Zr to determine parameters like free carrier concentration and mobility. Thin films of zinc oxide (ZnO) and Zr-doped ZnO of thickness ∼100 nm were prepared by atomic layer deposition on sapphire, SiO2/Si(100), and Si(100) substrates. Variable-angle spectroscopic ellipsometry was used to study their optical properties in the 0.5-3.5 eV spectral range. The optical constants were accurately obtained using a model that combines Drude and Tauc-Lorentz oscillators with Bruggeman effective medium approximations, allowing the inclusion of a roughness layer in the optical model. The effect of Zr doping (ca. 1.9-4.4 atom %) was then investigated in both as-prepared samples and samples annealed in the temperature range of 100-300 °C. All of the films exhibited good optical transparency (ca. 70-90% in the visible region). For doping levels below 2.7 atom %, the real part of the dielectric permittivity reveals a semiconductor-to-metal transition in the near-infrared (NIR) region, as the permittivity goes from positive to negative. Besides, the plasma energy increases with increasing Zr concentration, and both resistivity and carrier concentration exhibit slightly parabolic behaviors, with a minimum of ∼1.5 × 10-3 Ω cm and a maximum of 2.4 × 1020 cm-3, respectively, at the same critical Zr concentration (2.7 atom %). In contrast, the carrier mobility decreases rapidly from 76.0 to 19.2 cm2/(V s) with increasing Zr content, while conductivities and carrier mobilities worsen when the annealing temperature increases, probably due to the segregation of ZnO crystals. Finally, the optical band gap is very stable, revealing its interesting independence of substrate composition and annealing temperature, as it collapses to a single master curve when band gap energy is plotted versus free carrier concentration, following the Burstein-Moss effect. Overall, the Zr-doped ZnO films studied here would be a highly desirable system for developing thermally stable transparent conductive oxides (TCOs).

Auditory verbal hallucinations as ictal phenomena in a patient with drug-resistant epilepsy.

PURPOSE: The presence of verbal auditory hallucinations is often associated with psychotic disorders and rarely is considered as an ictal phenomena. The aim of this paper is to describe the anatomical structures involved in the genesis of this ictal symptom during epileptic seizures and direct cortical stimulation using stereo encephalography (SEEG). METHOD: The case is of a 31-year-old right-handed female, bilateral speech representation, schizophrenia and with drug-resistant epilepsy and focal aware sensory seizures characterized by ictal verbal auditory hallucinations. She was implanted with depth electrodes, and she was monitored using SEEG recordings. RESULTS: She had focal aware sensory seizures characterized by verbal auditory hallucinations, with the following features: hearing numerous voices (both male and/or female), talking at the same time (not able to distinguish how many). The voices were inside her head, consisted of negative content, and lasted up to two minutes. Some of her focal aware sensory seizures evolved to focal motor seizures and rarely progressed to bilateral tonic clonic seizures. Her neurological examination, her brain MRI and her interictal SPECT were unremarkable. Her PET scan identified mild hypo metabolism over the right temporal and right frontal lobes. Her neuropsychological evaluation showed language laterality undetermined but her functional MRI showed bilateral language representation. On her video-EEG, three seizures were captured with a right posterior temporal onset. A subsequent SEEG showed thirteen typical seizures originating from the posterior temporal neocortical region. The cortical stimulation of the right posterior temporo-parietal neocortical region and right amygdala triggered her typical phenomena, which was multiple voices, inside her head, speaking in the second person, negative content, unable to identify gender, in English, and no side lateralization. CONCLUSION: Verbal auditory hallucinations should be analyzed carefully because they can be part of the seizure presentation. Our case supports the localization of these hallucinations in the right posterior neocortical temporal regions.

[SARS-CoV-2 seroprevalence among workers in a hospital in Madrid.] / Seroprevalencia frente a SARS-CoV-2 en los trabajadores de un hospital de Madrid.

OBJECTIVE: The impact of the first wave of the pandemic due to SARS-CoV-2 has been enormous in Spanish hospitals, being Madrid one of the most affected communities. The aim of this study was to analyze the impact of the pandemic on the workers of a hospital located in one of the most affected areas of Madrid (Alcalá de Henares) using a chemiluminescence immunoassay (CLIA). METHODS: We conducted a seroprevalence survey between June 25th and July 31st, 2020, over hospital workers from our institution. This study population was previously analyzed using a diagnostic approach which consisted of PCR and a serologic rapid test. For the present survey, prevalence of IgG antibodies against SARS-CoV-2 was studied using chemiluminescence. We analyzed the prevalence in healthcare workers (HCW) and non-healthcare workers (nHCW). Information about professional category, use of personal protective equipment (PPEs) and previous COVID-19 contacts was collected to determine the risk factors associated with SARS-CoV-2 seropositivity. Comparisons were made using the Mann-Whitney U test (continuous variables) and the two-tailed Fisher's exact test (categorical variables). Risk factors for seropositivity were analyzed using multivariate logistic regression. RESULTS: A total of 2,219 workers were included and 847 of them (38.2%) presented IgG antibodies against SARS-CoV-2, being seroprevalence significantly higher for HCW (39.3%) than for nHCW (30.7%, p=0.006). We found no differences regarding positivity rates compared with the first diagnostic approach for symptomatic and asymptomatic workers, or infected workers per professional category. In the multivariate logistic regression analysis, the use of PPE (protective, OR=0.65; 95%CI: 0.48-0.89; p<0.001) and previous contact with COVID-19 patients (risk factor, OR=1.93; 95%CI: 1.37-2.72; p<0.001) were independent factors that were associated with SARS-CoV-2 seropositivity. CONCLUSIONS: More than 38% of our workers presented IgG antibodies against SARS-CoV-2. We found no differences in the positivity rates between diagnostic approaches. The use of PPE (protective) and previous contact with COVID-19 patients (risk factor) were associated with infection.

OBJETIVO: El impacto de la primera oleada de la pandemia debida a SARS-CoV-2 ha sido enorme en los hospitales españoles, siendo Madrid una de las comunidades más afectadas. El objeto de este estudio fue analizar el impacto de la pandemia en los trabajadores de un hospital situado en una de las zonas más afectadas de Madrid (Alcalá de Henares) mediante un inmunoensayo de quimioluminiscencia. METODOS: Realizamos un estudio de seroprevalencia entre el 25 de junio y el 31 de julio de 2020 entre los trabajadores de nuestro centro, que se estudió previamente utilizando otra aproximación diagnóstica (PCR y test rápido serológico). Para este estudio, analizamos la prevalencia de anticuerpos tipo IgG contra SARS-CoV-2 mediante quimioluminiscencia. Analizamos la prevalencia en personal sanitario (PS) y no sanitario (PNS). Se recopiló información sobre la categoría profesional, uso de equipos de protección individual (EPI) y contactos COVID-19 para determinar los factores de riesgo asociados con la seropositividad. Las comparaciones se hicieron con el test de la U de Mann-Whitney (variables continuas) y la prueba exacta de Fisher de dos colas (variables categóricas). Los factores de riesgo para la seropositividad se analizaron mediante regresión logística multivariable. RESULTADOS: Incluimos a 2.219 trabajadores, de los cuales 847 (38,2%) presentaron anticuerpos IgG, siendo la seroprevalencia significativamente mayor en PS (39,3%) que en PNS (30,7%, p=0,006). No encontramos diferencias respecto a la primera aproximación diagnóstica en los porcentajes de positividad para personal sintomático, asintomático, o estratificando por categoría profesional. Mediante regresión logística multivariable, el uso de EPI (protector, OR=0,65; IC95%:0,48-0,89; p<0,001) y el contacto previo con pacientes COVID-19 (factor de riesgo, OR=1,93; IC95%:1,37-2,72; p<0,001) fueron factores asociados de forma independiente con la seropositividad. CONCLUSIONES: Más del 38% de nuestros trabajadores presentaron anticuerpos IgG contra SARS-CoV-2. No encontramos diferencias en los porcentajes de positividad entre ésta y la anterior aproximación diagnóstica. El uso de EPI (protector) y el contacto con pacientes con COVID-19 (factor de riesgo) se asociaron de forma independiente con la infección.

Case of refractory delirious mania responsive to lithium.

Delirious mania is an uncommon condition that is challenging to diagnose and treat. More often seen in patients with a history of bipolar disorder, it frequently presents with prominent catatonic features and overlaps with other diseases in the catatonic spectrum, such as neuroleptic malignant syndrome, serotonin syndrome and malignant catatonia. We present a case of delirious mania refractory to high doses of lorazepam, several antipsychotics and valproic acid, which responded dramatically to therapy with lithium after 26 days of minimal improvement with the other medications. The pathophysiology of delirious mania is reviewed, and the unique actions of lithium are discussed, highlighting possible reasons as to why lithium might offer advantages in the treatment of this disease.

Protein Profile and Simulated Digestive Behavior of Breast Milk from Overweight and Normal Weight Mothers.

Human milk proteins have shown to vary in concentration and distribution through lactation. However, while some regulatory components, such as hormones, have shown associations with regard to the mothers' body mass index, there is limited information on the possible influence of this condition on the whole protein distribution. The objective of this study was to evaluate the protein profile of human milk from normal weight and overweight or obese mothers to identify differences in protein expression in colostrum, transitional and mature milk. The mass spectrometry analysis showed the ability to class with a high degree of confidence the lactation state and the milk profile according to the mother's condition. Individual milk samples were subjected to a digestion in vitro model that takes into account the specificities of the gastrointestinal conditions of full-term newborn infants. The digestion products were compared with available data from the digestive contents in newborns. The behavior of the most abundant proteins and the overall peptide generation and survival, showed good correspondence with in vivo data.

Study of the phenolic compound profile and antioxidant activity of human milk from Spanish women at different stages of lactation: A comparison with infant formulas.

Human milk (HM) has been proven to have important and essential antioxidant properties to counteract infant susceptibility to oxidative stress. Phenolic compounds are secondary metabolites which come from plants and are potent natural antioxidants. The ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method used in the present study allowed the quantification of 26 phenolic compounds (ten hydroxybenzoic acids, seven hydroxycinnamic acids, four flavonoids, three hydroxybenzaldehydes and two other polyphenols) in HM samples at different stages of lactation (colostrum, transitional milk and mature milk) and infant formulas (IF). Many of the phenolic compounds identified have been reported to be present in HM for the first time. The total phenolic compound content (TPC) was quantified using the Folin assay and the antioxidant activity (AC) was evaluated with the DPPH, ABTS and FRAP assays. Significant differences were evidenced between HM and IF. HM from mothers with an adherence to a Mediterranean diet contained twice as many individual phenolic compounds as infant formulas, with a higher proportion of hydroxybenzoic acids. Conversely, IF showed a higher proportion of hydroxycinnamic acids. Overall, the antioxidant activity of HM showed small variations during lactation.

Web of lies: a tool for determining the limits of verification in preventing the spread of false information on networks.

The spread of false information on social networks has garnered substantial scientific and popular attention. To counteract this spread, verification of the truthfulness of information has been proposed as a key intervention. Using a novel behavioral experiment with over 2000 participants, we analyze participants' willingness to spread false information in a network. All participants in the network have aligned incentives making lying attractive and countering the explicit norm of truth-telling that we impose. We investigate how verifying the truth, endogenously or exogenously, impacts the choice to lie or to adhere to the norm of truth-telling and how this compares to the spread of information in a setting in which such verification is not possible. The three key take-aways are (1) verification is only moderately effective in reducing the spread of lies, and (2) its effectivity is contingent on the agency of people in seeking the truth, and (3) on the exposure of liars, not only on the exposure of the lies being told. These results suggest that verification is not a blanket solution. To enhance its effectivity, verification should be combined with efforts to foster a culture of truth-seeking and with information on who is spreading lies.

Does historical data still count? Exploring the applicability of smart building applications in the post-pandemic period.

The emergence of COVID-19 pandemic is causing tremendous impact on our daily lives, including the way people interact with buildings. Leveraging the advances in machine learning and other supporting digital technologies, recent attempts have been sought to establish exciting smart building applications that facilitates better facility management and higher energy efficiency. However, relying on the historical data collected prior to the pandemic, the resulting smart building applications are not necessarily effective under the current ever-changing situation due to the drifts of data distribution. This paper investigates the bidirectional interaction between human and buildings that leads to dramatic change of building performance data distributions post-pandemic, and evaluates the applicability of typical facility management and energy management applications against these changes. According to the evaluation, this paper recommends three mitigation measures to rescue the applications and embedded machine learning algorithms from the data inconsistency issue in the post-pandemic era. Among these measures, incorporating occupancy and behavioural parameters as independent variables in machine learning algorithms is highlighted. Taking a Bayesian perspective, the value of data is exploited, historical or recent, pre- and post-pandemic, under a people-focused view.