Impact of mediterranean diet promotion on environmental sustainability: a longitudinal analysis.

OBJECTIVE: This article aims to estimate the differences in environmental impact (greenhouse gas [GHG] emissions, land use, energy used, acidification and potential eutrophication) after one year of promoting a Mediterranean diet (MD). METHODS: Baseline and 1-year follow-up data from 5800 participants in the PREDIMED-Plus study were used. Each participant's food intake was estimated using validated semi-quantitative food frequency questionnaires, and the adherence to MD using the Dietary Score. The influence of diet on environmental impact was assessed through the EAT-Lancet Commission tables. The influence of diet on environmental impact was assessed through the EAT-Lancet Commission tables. The association between MD adherence and its environmental impact was calculated using adjusted multivariate linear regression models. RESULTS: After one year of intervention, the kcal/day consumed was significantly reduced (-125,1 kcal/day), adherence to a MD pattern was improved (+0,9) and the environmental impact due to the diet was significantly reduced (GHG: -361 g/CO2-eq; Acidification:-11,5 g SO2-eq; Eutrophication:-4,7 g PO4-eq; Energy use:-842,7 kJ; and Land use:-2,2 m2). Higher adherence to MD (high vs. low) was significantly associated with lower environmental impact both at baseline and one year follow-up. Meat products had the greatest environmental impact in all the factors analysed, both at baseline and at one-year follow-up, in spite of the reduction observed in their consumption. CONCLUSIONS: A program promoting a MD, after one year of intervention, significantly reduced the environmental impact in all the factors analysed. Meat products had the greatest environmental impact in all the dimensions analysed.

Synthesis and Raman Detection of 5-Amino-2-mercaptobenzimidazole Self-Assembled Monolayers in Nanoparticle-on-a-Mirror Plasmonic Cavity Driven by Dielectric Waveguides.

Functionalization of metallic surfaces by molecular monolayers is a key process in fields such as nanophotonics or biotechnology. To strongly enhance light-matter interaction in such monolayers, nanoparticle-on-a-mirror (NPoM) cavities can be formed by placing metal nanoparticles on such chemically functionalized metallic monolayers. In this work, we present a novel functionalization process of gold surfaces using 5-amino-2-mercaptobenzimidazole (5-A-2MBI) molecules, which can be used for upconversion from THz to visible frequencies. The synthesized surfaces and NPoM cavities are characterized by Raman spectroscopy, atomic force microscopy (AFM), and advancing-receding contact angle measurements. Moreover, we show that NPoM cavities can be efficiently integrated on a silicon-based photonic chip performing pump injection and Raman-signal extraction via silicon nitride waveguides. Our results open the way for the use of 5-A-2MBI monolayers in different applications, showing that NPoM cavities can be effectively integrated with photonic waveguides, enabling on-chip enhanced Raman spectroscopy or detection of infrared and THz radiation.

Bovine Herpes Virus Type 1 (BoHV-1) seroprevalence, risk factor and Bovine Viral Diarrhoea (BVD) co-infection analysis from Ireland.

Surveillance of endemic pathogens is essential for disease control, providing an evidence base for policy and advice. Bovine Herpes Virus Type 1 (BoHV-1), the causative agent of Infectious Bovine Rhinotracheitis (IBR), has been found to have high seroprevalence within the Irish cattle population. The aim of the present study was to establish seroprevalence levels for culled cattle in Ireland aged < 30 months and to establish whether BVD exposure and other factors was associated with BoHV-1 exposure. We employed random effects logit models coupled with repeated bootstrap sampling to provide robust estimates. The final dataset contained results for 5273 animals tested over two study years, 2018 and 2020. The animal-level seroprevalence of BoHV-1 was 21.43% (1130/5273; 95%CI: 20.32-22.53%). Univariable analysis suggested that BoHV-1 seropositivity risk was associated with BVDV serodiagnosis status, age, sex, year sampled, herd type, herd-size, and metrics of movement into the herd. Final random-effects multivariable models suggested increased risk associated with increasing herd size of the last herd, movements made by animals during the previous year, and the year the animal was sampled. Despite BVDV status and sex being retained in the final model, repeated bootstrap sampling of the regression model to estimate biased-corrected 95%CI suggested that these associations were not robust. The overall apparent prevalence of BoHV-1 exposure for culled cattle in Ireland declined in 2020 relative to 2018 (from 23.32 to 17.61%). Herd-size and the movement of animals were found to be important factors associated with animal-level risk, but there was less statistical support for sex-based or BVDV status associations.

Mediastinitis secondary to invasive infection by group A Streptococcus in Spain.

This study describes 5 mediastinitis cases secondary to invasive group A Streptococcus (iGAS) disease in a recent outbreak in Spain. Among 398 iGAS cases between January 2019-March 2023, 5 (1.3%) were mediastinitis, 4 occurring in December 2022, all secondary to pneumonia or deep neck infection. We outline the clinical outcome with a review of the scarce pediatric literature.  Conclusion: mediastinistis is a rare but severe complication of iGAS and a high level of suspicion is required to diagnose it. What is Known: • Group A Streptococcus can cause invasive and severe infections in children. • Mediastinitis is a severe complication from some bacterial infections, mainly secondary due to deep-neck abscesses. What is New: • Mediastinitis is an unrecognized complication due to an invasive group A Streptococcus (iGAS) infection. • In cases of a deep-neck abscess or complicated pneumonia a high clinical suspicion of iGAS mediastinitis is required, especially when the clinical course is not favorable.

Incandescent temporal metamaterials.

Regarded as a promising alternative to spatially shaping matter, time-varying media can be seized to control and manipulate wave phenomena, including thermal radiation. Here, based upon the framework of macroscopic quantum electrodynamics, we elaborate a comprehensive quantum theoretical formulation that lies the basis for investigating thermal emission effects in time-modulated media. Our theory unveils unique physical features brought about by time-varying media: nontrivial correlations between fluctuating electromagnetic currents at different frequencies and positions, thermal radiation overcoming the black-body spectrum, and quantum vacuum amplification effects at finite temperature. We illustrate how these features lead to striking phenomena and innovative thermal emitters, specifically, showing that the time-modulation releases strong field fluctuations confined within epsilon-near-zero (ENZ) bodies, and that, in turn, it enables a narrowband (partially coherent) emission spanning the whole range of wavevectors, from near to far-field regimes.

Antibiotic resistance in bloodstream isolates from high-complexity paediatric units in Madrid, Spain: 2013-2021.

BACKGROUND: Antimicrobial resistance (AMR) has become a significant challenge in high-complexity healthcare settings. AIM: To evaluate the prevalence of AMR in bloodstream isolates from high-complexity paediatric units in Spain over a nine-year period. METHODS: A retrospective observational multicentre study was conducted in three tertiary hospitals, analysing bloodstream isolates from patients aged <18 years admitted to the paediatric intensive care, neonatology, and oncology-haematology units between 2013 and 2021. Demographics, antimicrobial susceptibility, and resistance mechanisms were analysed in two periods (2013-2017 and 2017-2021). FINDINGS: In all, 1255 isolates were included. AMR was more prevalent in older patients and those admitted to the oncology-haematology unit. Multidrug resistance was observed in 9.9% of Gram-negative bacteria (GNB); 20.0% of P. aeruginosa vs 8.6% of Entero-bacterales (P < 0.001), with an increase in Enterobacterales from 6.2% to 11.0% between the first and the second period (P = 0.021). Difficult-to-treat resistance was observed in 2.7% of GNB; 7.4% of P. aeruginosa vs 1.6% of Enterobacterales (P < 0.001), with an increasing trend in Enterobacterales from 0.8% to 2.5% (P = 0.076). Carbapenem resistance among Enterobacterales increased from 3.5% to 7.2% (P = 0.029), with 3.3% producing carbapenemases (67.9% VIM). Meticillin resistance was observed in 11.0% of S. aureus and vancomycin resistance in 1.4% of Enterococcus spp., with both rates remaining stable throughout the study period. CONCLUSION: This study reveals a high prevalence of AMR in high-complexity paediatric units. Enterobacterales showed a concerning increasing trend in resistant strains, with higher rates among older patients and those admitted to oncology-haematology units.

Are GES carbapenemases underdiagnosed? An allelic discrimination assay for their accurate detection and differentiation.

GES (Guiana Extended Spectrum) carbapenemases belong to "minor class A carbapenemases" and its prevalence could be underestimated due to the lack of specific tests. The aim of this study was to develop an easy PCR method to differentiate between GES ß-lactamases with or without carbapenemase activity, based on an allelic discrimination system of SNPs that encode E104K and G170S mutations, without need of sequencing. Two pair of primers and Affinity Plus probes, labeled with different fluorophores; FAM/IBFQ and YAK/IBFQ, were designed for each one of the SNPs. This allelic discrimination assay allows to detect in real time the presence of all type of GES- ß-lactamases, being able to differentiate between carbapenemases and extended-spectrum ß-lactamase (ESBL), through a quick PCR test that avoid costly sequencing approaches and could help to decrease the current underdiagnosis of minor carbapenemases that scape of phenotypic screenings.

Revisiting methods for the assessment of naturally-occurring radioactivity in drinking water.

A comprehensive radioactivity characterisation of Castilla y León (Spain) groundwater intakes intended for human consumption is addressed between 2017 and 2021. This study responds to the radiological requirements stated in the European Council Directive 51/2013/EURATOM concerning drinking water for public health. Given that the gross α- and gross ß-activity determination is used as a screening strategy for water radioactivity monitoring, the reliability of the thin-source deposit method (ISO 10704, 2019) has been improved to achieve representative values of the total activity coming from α- and ß-particle emitters in the samples. More than 400 groundwater samples have been considered for this purpose, analysing their 238,235,234U, 228,226Ra, 210Pb, and 210Po activity concentrations, which are needed for the indicative dose assessment. These results, considered reference activity values, are compared with the gross α- and gross ß-activities determined by the different procedure approaches. Ultimately, the results of the liquid scintillation counting method (ISO 11704, 2018) are also used to validate the optimised method.

Neutrophil-Lymphocyte ratio is associated with poor clinical outcome after mechanical thrombectomy in stroke in patients with COVID-19.

BACKGROUND: The neutrophil-lymphocyte ratio (NLR) is emerging as an important biomarker of acute physiologic stress in a myriad of medical conditions, and is a confirmed poor prognostic indicator in COVID-19. OBJECTIVE: We sought to describe the role of NLR in predicting poor outcome in COVID-19 patients undergoing mechanical thrombectomy for acute ischemic stroke. METHODS: We analyzed NLR in COVID-19 patients with large vessel occlusion (LVO) strokes enrolled into an international 12-center retrospective study of laboratory-confirmed COVID-19, consecutively admitted between March 1, 2020 and May 1, 2020. Increased NLR was defined as ≥7.2. Logistic regression models were generated. RESULTS: Incidence of LVO stroke was 38/6698 (.57%). Mean age of patients was 62 years (range 27-87), and mortality rate was 30%. Age, sex, and ethnicity were not predictive of mortality. Elevated NLR and poor vessel recanalization (Thrombolysis in Cerebral Infarction (TICI) score of 1 or 2a) synergistically predicted poor outcome (likelihood ratio 11.65, p = .003). Patients with NLR > 7.2 were 6.8 times more likely to die (OR 6.8, CI95% 1.2-38.6, p = .03) and almost 8 times more likely to require prolonged invasive mechanical ventilation (OR 7.8, CI95% 1.2-52.4, p = .03). In a multivariate analysis, NLR > 7.2 predicted poor outcome even when controlling for the effect of low TICI score on poor outcome (NLR p = .043, TICI p = .070). CONCLUSIONS: We show elevated NLR in LVO patients with COVID-19 portends significantly worse outcomes and increased mortality regardless of recanalization status. Severe neuro-inflammatory stress response related to COVID-19 may negate the potential benefits of successful thrombectomy.

Complex vesical diverticulum, an unusual cause of obstructive uropathy.

We report a case of complex bladder diverticulum causing lower urinary tract symptoms and obstructive uropathy with acute kidney injury. The diagnosis is usually based on clinical and imaging findings. Laparoscopic diverticulectomy and transurethral prostate resection were performed with good functional outcomes. We report a case of a large complex bladder diverticulum presenting as obstructive uropathy with voiding symptoms.

Automatically Annotated Dataset of a Ground Mobile Robot in Natural Environments via Gazebo Simulations.

This paper presents a new synthetic dataset obtained from Gazebo simulations of an Unmanned Ground Vehicle (UGV) moving on different natural environments. To this end, a Husky mobile robot equipped with a tridimensional (3D) Light Detection and Ranging (LiDAR) sensor, a stereo camera, a Global Navigation Satellite System (GNSS) receiver, an Inertial Measurement Unit (IMU) and wheel tachometers has followed several paths using the Robot Operating System (ROS). Both points from LiDAR scans and pixels from camera images, have been automatically labeled into their corresponding object class. For this purpose, unique reflectivity values and flat colors have been assigned to each object present in the modeled environments. As a result, a public dataset, which also includes 3D pose ground-truth, is provided as ROS bag files and as human-readable data. Potential applications include supervised learning and benchmarking for UGV navigation on natural environments. Moreover, to allow researchers to easily modify the dataset or to directly use the simulations, the required code has also been released.

Enhanced excitation and readout of plasmonic cavity modes in NPoM via SiN waveguides for on-chip SERS.

Metallic nanoparticle-on-a-mirror (NPoM) cavities enable extreme field confinement in sub-nm gaps, leading to unrivaled performance for nonlinear processes such as surface-enhanced Raman scattering (SERS). So far, prevailing experimental approaches based on NPoMs have been performed by means of free-space light excitation and collection under oblique incidence, since the fundamental radiatively-coupled NPoM mode does not scatter in the normal direction. Retaining this working principle, here we numerically show that plasmonic cavity modes in NPoM configurations can be efficiently excited in an integrated SERS approach through TM guided modes of silicon nitride (SiN) waveguides. Intensity enhancements beyond 105 can be achieved for gap spacings around 1 nm. So as to reduce unwanted SiN Raman background, the output Stokes signals are transferred to transversely placed waveguides, reaching coupling efficiencies of up to 10%. Geometrical parameters such as the gap thickness as well as the radius and position of the nanoparticle provide full control over the main spectral features, thereby enabling us to engineer and drive the optical response of NPoMs for high-performance SERS in Si-based photonic integrated platforms.

Contextualist Perspectives in the Treatment of Antisocial Behaviors and Offending: A Comparative Review of FAP, ACT, DBT, and MDT.

This article presents a comparative review of the application of four contextualist therapies in the treatment of antisocial behavior and offending. The therapies reviewed are functional analytic psychotherapy (FAP), acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), and mode deactivation therapy (MDT). A descriptive and comparative review was conducted through a search carried out in both general and specific databases related to each therapy. We included a total of 44 studies treating any type of antisocial behavior or offending. Results show that these interventions have been used to treat challenging behavioral patterns, inmates' institutional behaviors, exhibitionism, at-risk adolescents' aggressive conducts, and offending behaviors performed by juveniles who committed robbery and/or serious sexual offenses. The main conclusions are that the four therapies show very positive outcomes: Although FAP and ACT have been used more sparsely, DBT and MDT have been employed in a larger number of interventions and using more controlled comparative designs. The therapeutic components that seem to be relevant to understanding in a transversal way how changes in behavior are achieved are acceptance/validation of clients' histories of neglect and abuse and clients' commitment to behaving toward their valued directions in life.

Association between neuroimaging findings and neurological sequelae in patients with congenital cytomegalovirus infection.

BACKGROUND: Congenital cytomegalovirus (CMV) infection is an important cause of disability. There is little evidence on the prognostic value of lesions identified in neuroimaging studies. AIM: The study aimed to assess the severity of lesions detected with brain MRI and transfontanellar ultrasound and their relationship with long-term neurological deficits. PATIENTS AND METHODS: We performed a retrospective, analytical, observational study of 36 patients with congenital CMV infection. Neuroimaging studies were reviewed and classified according to the modified Noyola' scale. Imaging findings were compared with neurological alterations in the patients' most recent follow-up evaluation at the paediatric neurology department. RESULTS: Thirty-six patients were studied (transfontanellar ultrasound: 30; brain MRI: 29). Twenty of 30 patients showed ultrasound abnormalities; of these, 11 showed alterations on brain MR images (P = .04) and 10 had neurological impairment (P = .008). Transfontanellar ultrasound had a sensitivity of 83.3%, 90% CI: 58-100 and a specificity of 44.4%, 90% CI: 18.7-70.2 for predicting neurological sequelae. Brain MRI displayed abnormalities in 20 of 29 patients, of whom 16 had neurological impairment (P < .001). MRI had a sensitivity of 94%, 95% CI: 80-100 and a specificity of 66.6%, 95% CI: 36-97.5 for predicting neurological sequelae. Modified Noyola' scale values > 2 were correlated with psychomotor retardation (P < .001). CONCLUSIONS: Our findings validate previous studies reporting a statistical significant correlation between the extension of neuroimaging lesions and severity of neurological deficits.