Experimental and Theoretical Estimations of Atrazine's Adsorption in Mangosteen-Peel-Derived Nanoporous Carbons.

Nanoporous carbons were prepared via chemical and physical activation from mangosteen-peel-derived chars. The removal of atrazine was studied due to the bifunctionality of the N groups. Pseudo-first-order, pseudo-second-order, and intraparticle pore diffusion kinetic models were analyzed. Adsorption isotherms were also analyzed according to the Langmuir and Freundlich models. The obtained results were compared against two commercially activated carbons with comparable surface chemistry and porosimetry. The highest uptake was found for carbons with higher content of basic surface groups. The role of the oxygen-containing groups in the removal of atrazine was estimated experimentally using the surface density. The results were compared with the adsorption energy of atrazine theoretically estimated on pristine and functionalized graphene with different oxygen groups using periodic DFT methods. The energy of adsorption followed the same trend observed experimentally, namely the more basic the pH, the more favored the adsorption of atrazine. Micropores played an important role in the uptake of atrazine at low concentrations, but the presence of mesoporous was also required to inhibit the pore mass diffusion limitations. The present work contributes to the understanding of the interactions between triazine-based pollutants and the surface functional groups on nanoporous carbons in the liquid-solid interface.

Stress Intensity Factor (SIF) Solutions and Fatigue Crack Paths in Eccentric Circumferentially Cracked Round Bar (CCRB) in Tension.

In this paper, a numerical modeling was developed to study (on the basis of the Paris law) the fatigue propagation paths of eccentric external (outer) cracks in circumferentially cracked round bars (CCRB) subjected to a cyclic type of loading in the form of either remote tensile loading or imposed axial displacement. Results show how the eccentricity (in relation to the wire axis) of the circular resistant ligament increases with the growth of outer circumferential cracks by subcritical fatigue mechanisms. This phenomenon is more pronounced when the solicitation consists of a remote tensile loading than when it is an axial displacement, when the initial eccentricity of the ligament increases (for a given initial diameter), and when the Paris exponent characteristic of the material rises. The paper also analyzes in depth the different situations regarding contact between crack faces during subcritical cyclic fatigue propagation, covering a wide range of cases including no contact, partial contact, and full contact depending on the ligament diameter (during the process of fatigue crack advance) and the relative eccentricity of the annular crack that loses its axial symmetry in relation to the round bar (cylinder) axis. In addition to the fatigue crack path study, closed-form stress intensity factor (SIF) solutions for the considered geometry (a cylinder with an outer annular crack) are provided in the form of third-degree polynomial expressions as a function of the ligament diameter and the crack eccentricity (both in dimensionless terms).

Notch Effects on the Stress Intensity Factor and on the Fatigue Crack Path for Eccentric Circular Internal Cracks in Elliptically Notched Round Bars under Tensile Loading.

In this paper, stress intensity factor (SIF) solutions are numerically obtained for notched bars subjected to tensile loading containing an eccentric circular inner crack located in the cross-section corresponding to the notch root. The finite element method and the J-integral have been used to obtain the SIF and to analyze the effect on it of three elliptical notch geometries (of equal radial depth). The results show how the SIF is greater in the notched bars than in the smooth bar and within the former when the axial semi-axis of the notch rises, its effect being greater as the diameter and eccentricity of the inner crack increase. In addition, the fatigue growth of an eccentric crack induces an increase in such eccentricity, greater as the notch axial semi-axis increases. The cause of these phenomena can be attributed to the constraint loss caused by the notch, which also facilitates bending of the specimen due to the asymmetry generated by the crack eccentricity.

Central Stellated Scar Sign: Classic Imaging Finding of Renal Oncocytoma with Radiopathological Correlation.

Oncocytomas are benign tumors, with the classic stellate scar found in up to a third of cases, mainly in large ones. We present the case of a 69-year-old man with a palpable, mobile, and painless mass on the right flank, where abdominal ultrasound and abdominal computed tomography detected the presence of a solid right kidney lesion with a central stellate area in the sinus. Postoperative histological analysis confirmed the presence of oncocytoma with a central stellate scar. Biopsy may not be useful to distinguish this entity from renal carcinoma, surgery being necessary for definitive confirmation of the diagnosis of oncocytoma.

Performance of a C-containing Cu-based photocatalyst for the degradation of tartrazine: Comparison of performance in a slurry and CPC photoreactor under artificial and natural solar light.

A carbon-containing Cu-based material (Cu@C) was used as photocatalyst for the degradation of a commonly food-industry azo-dye (tartrazine, also called Y5), under solar light at laboratory and pilot scale photoreactors. Important performance parameters such as dark adsorption capacity, catalyst́s loading and initial concentration of the dye were first optimized in a slurry photoreactor at laboratory scale under artificial solar light following the kinetics of degradation of the dye. Afterwards, the photocatalytic activity was investigated at pilot scale in a compound parabolic collector (CPC) photoreactor operating for 10 h of irradiation. The degradation of tartrazine is among the highest values reported for alternative metal oxide semiconductors, in both photoreactor configurations. Catalytic data revealed a 3 times faster degradation kinetics of tartrazine in the CPC photoreactor under natural solar light than in the slurry reactor under artificial solar light. This behavior indicates that a moderate photon flux in the CPC is more adequate to operate with the prepared photocatalyst, as it minimizes the recombination of charge carriers in the catalyst. This is important, since most of the photocatalytic tests designed to evaluate the activity of novel materials are frequently carried out under simulated solar light and disregard the impact of photon flux in outdoor conditions.

Effective Phase Space Representation of the Quantum Dynamics of Vibrational Predissociation of the ArBr2(B,ν =16···25) Complex.

We perform trajectory-based simulations of the vibrational predissociation of the ArBr2(B,ν=16···25) van der Waals triatomic complex, constrained to the T-shape geometry. To this aim, we employ a 2-fold mapping of the quantum dynamics into classical-like dynamics in an extended phase space. The effective phase space comprises two distinct sets of degrees of freedom, namely a collection of coupled harmonic oscillators and an ensemble of quantum trajectories. The time evolution of these variables represent bound and unbound motions of the quantum system, respectively. Quantum trajectories are propagated within the interacting trajectory representation. The comparison between the lifetimes of the predissociating complexes computed using the trajectory-based approach and the experimental results available for the target systems indicates that the present method is competitive with wavepacket propagation techniques. The competition between several simultaneous vibrational relaxation pathways was found to have a direct impact on the time scales of vibrational predissociation. Likewise, the analysis of the time evolution of the trajectories reveals the existence of regions in the effective phase space where transitions to vibrational states of higher energy are more likely to occur. The size and location of these regions influence the transient vibrational distributions and therefore the computed lifetimes. Furthermore, the mechanisms of energy redistribution along the dissociation coordinate are analyzed.

Modos ventilatorios usados en pacientes críticos con covid-19 en la región de Lombardía, Italia / Ventilation modes used in critical patient with COVID-19 in the region of Lombardy, Italy

RESUMEN Introducción: la covid-19 es una enfermedad donde la ventilación mecánica artificial cobra vital importancia. Se estima que el 50 % de los casos graves o críticos que requieren manejo en unidades de cuidados intensivos fallecen. Objetivos: se evaluó el impacto de los modos ventilatorios usados en pacientes con covid-19 en Lombardía, Italia, en la oxigenación, la hemodinámica y la mortalidad. Materiales y métodos: se realizó un estudio analítico longitudinal retrospectivo en 86 pacientes críticos con covid-19, en el Hospital Mayor de Crema, en Lombardía, Italia, desde el 1 de abril al 20 de mayo de 2020. Se realizaron análisis no paramétrico y de la varianza. Resultados: Hubo una supervivencia del 76,7 %. El modo utilizado tuvo igual comportamiento en occisos (BiPAP-3, PCV-4, VCRP-4, APRV-5, VCV-4) y en vivos (BiPAP-10, PCV-17, VCRP-14, APRV-15, VCV-10); test de x2 = 0,59; test de análisis de la varianza media índice PO2/FIO2 (PCV = 132), (BiPAP = 132) (VCV = 115) p = 0,924. La presión de final de espiración positiva (BiPAP-12, PCV-13, VCRP-13, APRV-13, VCV-14) con p = 0,205. PCO2 (BiPAP-55, PCV-52, VCRP-57, APRV-59, VCV-57) con p = 0,512. La tensión arterial media (BiPAP-84, PCV-83, VCRP-84, APRV-82, VCV-83) con p = 0,988. Modelos de cálculo de la presión de final de espiración positiva, según modo ventilatorio: BiPAP: PEEP = -0,0331 (índice PO2/FiO2) +18,215; PCV: PEEP = -0,0047 (índice PO2/FiO2) +13,717; VCRP: PEEP = -0,0204 (índice PO2/FiO2) +15,678; APRV: PEEP = -0,0092 (índice PO2/FiO2) +14,889. Conclusiones: la evolución del paciente crítico con covid-19 está determinada en gran medida por la ventilación mecánica invasiva; sin embargo, no existió suficiente evidencia para recomendar una u otra modalidad ventilatoria. El éxito está en conocer con exactitud las características del respirador, su modalidad y el paciente en cuestión. (AU)

ABSTRACT Introduction: COVID-19 is a disease in which mechanical ventilation acquires vital importance. It is estimated that 50 % of the serious and critical patients requiring management in intensive care units die. Objectives: to assess the impact of the ventilation modes used in patients with COVID-19 in Lombardy, Italy, on oxygenation, hemodynamics and mortality. Materials and methods: a retrospective, longitudinal, analytic study was carried out in 86 critical patients with COVID-19 who entered the Main Hospital of Crema, in Lombardy, Italy, from April 1st to May 20, 2020. Results: the survival was 76.7 %. The used mode showed the same behavior in deceased patients (BiPAP-3, PCV-4, VCRP-4, APRV-5, VCV-4) and in alive patients (BiPAP-10, PCV-17, VCRP-14, APRV-15, VCV-10). X2 = 0.59. ANOVA test index PO2/FIO2 (PCV = 132), (BiPAP = 132) (VCV=115) p = 0.924. PEEP (BiPAP-12, PCV-13, VCRP-13, APRV-13, VCV-14) p = 0.205. PCO2 (BiPAP-55, PCV-52, VCRP-57, APRV-59, VCV-57) p = 0.512. Average blood pressure (BiPAP-84, PCV-83, VCRP-84, APRV-82, VCV-83) p = 0.988. PEEP models according to ventilation mode: BiPAP: PEEP = -0.0331 (PO2/FiO2 index) +18.215. PCV: PEEP = -0.0047 (PO2/FiO2 index) + 13.717; VCRP: PEEP = -0.0204 (PO2/FiO2 index) + 15.678; APRV: PEEP = -0.0092 (PO2/FiO2 index) +14.889. Conclusion: the evolution of the critical patient with COVID-19 is determined mostly by the invasive mechanical ventilation; but we did not find evidence enough to recommend one or the other ventilation mode. The success stands in knowing accurately the characteristics of the ventilator, the ventilation modes and the patient (AU).

Effect of the Crack Tip Bifurcation on the Plasticity-Induced Fatigue Propagation in Metallic Materials.

This article deals with the influence of the crack path branching (at the micro level) on the plasticity-induced fatigue crack growth. With regard to this, a modeling by means of the finite element method was performed considering a cracked panel subjected to tension with different symmetric and asymmetric configurations of the bifurcated crack tip. The results show the appearance of a retardation effect in the growth rate of the bifurcated crack in relation to the growth rate of the fully straight crack in different cases studied, namely: (i) if the two branches of the bifurcation have different initial projected length, the propagation rate is greater at the crack tip corresponding to the long-branch than that of the short-branch, and the long-branch growth rate increases with the decrease of the initial branch angle and of the initial projected short-branch length and with the increase of the intensity of fatigue; (ii) if the two branches of the bifurcation have identical initial projected length, the retardation effect depends on the initial distance between the two bifurcated crack tips, the growth rate going up with the decrease of such a distance and with the increase of the fatigue intensity.

Stress Intensity Factors for Embedded, Surface, and Corner Cracks in Finite-Thickness Plates Subjected to Tensile Loading.

The aim of this study is to obtain the stress intensity factor (SIF) along the crack front of elliptical cracks located in finite-thickness plates subjected to imposed displacement or applied tensile load, for different crack geometries (relative depths and aspect ratios) and crack configurations (embedded, surface, and corner). The SIF was calculated from the J-integral, obtained by the finite element method. The results show how the SIF grows with the increase in the relative crack depth and with the decrease in the aspect ratio, with the corner crack being the most dangerous configuration and the embedded crack the most favorable configuration. By increasing the plate length, the SIF rises when the plate is under imposed displacement and decreases when the plate is subjected to applied tensile load, both cases tending towards the same SIF curve.

Upgrading of pine tannin biochars as electrochemical capacitor electrodes.

Biochar derived from the pyrolysis of pine tannin is a green and available by-product of oil manufacturing that presents interesting features after having been activated by KOH at 650 °C. Different weight ratios of KOH to biochar were used and the resulting activated carbons (ACs) presented highly developed specific surface areas of up to 2190 m2 g-1, well-connected porosity and high oxygen content, leading to enhanced electrochemical performance when used as electrochemical capacitor electrodes in a 1 M H2SO4 aqueous electrolyte. Galvanostatic charge/discharge experiments evidenced that the best material achieved a maximum electrode capacitance of up to 232 F g-1 (at 0.5 A g-1) with a capacitance retention of 70% at 10 A g-1 using commercial mass loadings (i.e., approx. 10 mg cm-2). In addition, long cycling stability with a residual capacitance of 92 to 94% after 10,000 cycles at 5 A g-1 was achieved. These results prove that ACs derived from pine tannin biochars have great potential for their commercial use as electrochemical energy storage devices.

The Cramer's rule for the parametrization of phenol and its hydroxylated byproducts: UV spectroscopy vs. high performance liquid chromatography.

A linear algebra theorem like Cramer's rule was used for the analysis of a system of equations obtained from UV spectroscopy, and results were compared against those obtained from HPLC analysis. This parametrization allowed to quantify the concentration of the main intermediate products detected along the photodegradation of phenol under UV-Vis irradiation of TiO2. UV spectroscopy data for phenol, hydroquinone, and benzoquinone were analyzed using the Cramer's rule. The overlapping interference of the intermediate products in the UV spectra was corrected. It can be concluded that the Cramer's rule can be used for the parametrization of the UV absorbance data of phenol and its main intermediate products. This methodology permitted to obtain the concentration of phenol and their intermediate products by UV-visible with a high precision in comparison of HPLC. The parametrization showed a correlation coefficient of ca. 0.9775 between the phenol concentration obtained by UV spectroscopy and values obtained from HPLC analysis. In this sense, results can be considered with good precision, and accordingly, it can be concluded that the methodology is reliable, and UV-visible spectroscopy can be selected instead of HPLC in much of the experiments concerning with aqueous-phase reactions.

Sustainable production of nanoporous carbons: Kinetics and equilibrium studies in the removal of atrazine.

Nanoporous carbons have been prepared from mangosteen peels-derived chars by physical activation under CO2 flow as a function of temperature. As an example of circular bioeconomy, these sustainable adsorbents were used to remove atrazine, a common pesticide from the agroindustry. Several adsorption models such as Langmuir (two parameter), Sips and Redlich-Peterson (three parameters) were applied to verify the influence of carbon's properties on the uptake of atrazine. Additional kinetic models (pseudo-first order, pseudo-second order and Avrami's) allowed to establish that a mixture of physisorption and chemisorption describes the interaction between the nanoporous carbons and atrazine. As a general fact, an important diffusion of atrazine from the bulk of solution to the surface of carbons was observed. All samples were able to remove atrazine, but the highest uptake was found in the carbon with the highest contribution of micropores to the total pore of volume and with the lowest content of basic surface groups. Several correlations between the kinetic and equilibrium parameters for the atrazine adsorption were found as a function of the textural properties and surface chemistry. Based on the kinetics and equilibrium parameters, the present work proposes a mechanism for the atrazine adsorption on nanoporous carbons contributing to the understanding of the interactions between pollutant molecules and the surface functional groups on nanoporous carbons in the liquid-solid interface.

TiO2/S-Doped Carbons Hybrids: Analysis of Their Interfacial and Surface Features.

Hybrids containing approximately equal amounts of P25 TiO2 and S-doped porous carbons were prepared using a water-based slurry mixing method. The materials were extensively characterized by adsorption of nitrogen, potentiometric titration, thermal analysis in air and in helium, XRD, XPS and SEM. The collected results showed the significant blockage of carbon micropores by TiO2 particles deposited on their outer surface. The formation of a new interface, especially for the S-rich samples, might also contribute to the porosity alteration. Analysis of surface chemistry suggested the presence of Ti-S bonds with an involvement of sulfur from thiophenic species in the carbon phase. The latter, especially when polymer-derived, was mainly deposited on the TiO2 nanoparticles. Formation of Ti-S stabilized sulfur and increased the ignition temperature of the hybrids, especially those with a high content of sulfur, in comparison with the ignition temperature of carbons. The surfaces of hybrid with S-containing carbons was also thermally very stable and of basic chemical nature. The formation of interfacial structures Ti-C was detected by XPS analysis suggesting a partial reduction of the Ti.

C-doped anatase TiO2: Adsorption kinetics and photocatalytic degradation of methylene blue and phenol, and correlations with DFT estimations.

This work shows an easy and eco-friendly methodology to obtain almost pristine anatase phase of TiO2 by using furfural, a biomass-derived molecule, as a bio-template. The photocatalytic activity was studied following the degradation of methylene blue and phenol under artificial solar irradiation. Results were compared against those obtained on a commercial pristine anatase TiO2. The pseudo first-order, the second-order and the intraparticle diffusion kinetic models were verified. The textural and surface chemistry properties of the materials were correlated with the surface density of molecules adsorbed in equilibrium. The reaction-rate showed an almost perfect quadratic regression as a function of the surface density. Theoretical estimations of the density of states by DFT + U were performed showing that the total electron charge in the oxygen bonded to anatase TiO2 increased due to carbon doping in agreement with the prediction of appearance of atomic orbitals 2p from carbon atom in the hybrid material. C-doping is responsible of the red-shift from 3.14 to 2.94 eV observed for a Ti15O32C super-cell than pristine anatase Ti16O32. The increase in the activity of the C-doped TiO2 photocatalyst was due to the decrease in the energy band-gap promoting a higher absorption of photons from the visible light.

Hybrid Material Based on an Amorphous-Carbon Matrix and ZnO/Zn for the Solar Photocatalytic Degradation of Basic Blue 41.

Innovative composites based on an amorphous-carbon matrix containing a second phase ZnO oxide and/or highly dispersed Zn metallic were synthesized via a modified Pechini route, in which a partial pyrolysis method was reached. Studies of adsorption in the dark and the photocatalytic activity for the cationic azo-dye, basic blue 41, and degradation were carried out. X-ray diffraction patterns for the carbon matrix and its composite with Zn show characteristics of the amorphous carbon. The infrared in the mid region of the composite prepared with ZnO and Zn exhibit vibrational bands related to bonds zinc oxide. The surface pH of the material is the main factor responsible for the adsorption of the azo-dye, but the contribution of mesopores favored the diffusion of molecules from the bulk of solution to the pore framework. Esters-like functional groups on the surface of carbons hinder the adsorption of the azo-dye. When Zn is embedded within amorphous carbon the photocatalytic activity of the composites showed up to 2.4 higher than neat ZnO. The enhancement in the photocatalytic activity and stability of C/ZnO/Zn and C/Zn composites is discussed in terms of a protector effect by the carbon layers inserted in composites. Carbon layers are responsible to inhibit the lixiviation of ZnO particles along irradiation.

Spatial Assessment of the Association between Long-Term Exposure to Environmental Factors and the Occurrence of Amyotrophic Lateral Sclerosis in Catalonia, Spain: A Population-Based Nested Case-Control Study.

BACKGROUND: It is believed that an interaction between genetic and non-genetic factors may be involved in the development of amyotrophic lateral sclerosis (ALS). With the exception of exposure to agricultural chemicals like pesticides, evidence of an association between environmental risk factors and ALS is inconsistent. Our objective here was to investigate the association between long-term exposure to environmental factors and the occurrence of ALS in Catalonia, Spain, and to provide evidence that spatial clusters of ALS related to these environmental factors exist. METHODS: We carried out a nested case-control study constructed from a retrospective population-based cohort, covering the entire region. Environmental variables were the explanatory variables of interest. We controlled for both observed and unobserved confounders. RESULTS: We have found some spatial clusters of ALS. The results from the multivariate model suggest that these clusters could be related to some of the environmental variables, in particular agricultural chemicals. In addition, in high-risk clusters, besides corresponding to agricultural areas, key road infrastructures with a high density of traffic are also located. CONCLUSION: Our results indicate that some environmental factors, in particular those associated with exposure to pesticides and air pollutants as a result of urban traffic, could be associated with the occurrence of ALS.

Design of Ag/ and Pt/TiO2-SiO2 nanomaterials for the photocatalytic degradation of phenol under solar irradiation.

The design of hybrid mesoporous TiO2-SiO2 (TS1) materials decorated with Ag and Pt nanoparticles was performed. The photocatalytic degradation of phenol under artificial solar irradiation was studied and the activity and selectivity of the intermediate products were verified. TiO2-SiO2 was prepared by sol-gel method while Ag- and Pt-based photocatalysts (TS1-Ag and TS1-Pt) were prepared by photodeposition of the noble metals on TS1. Two series of photocatalysts were prepared varying Ag and Pt contents (0.5 and 1.0 wt%). An increase in the photocatalytic activity up to two and five times higher than TS1 was found on TS1-Ag-1.0 and TS1-Pt-1.0, respectively. Changes in the intermediate products were detected on Ag- and Pt-based photocatalysts with an increase in the catechol formation up to 3.3 and 6.6 times higher than that observed on TS1, respectively. A two-parallel reaction mechanism for the hydroquinone and catechol formation is proposed. A linear correlation between the photocatalytic activity and the surface concentration of noble metals was found indicating that the electron affinity of noble metals is the driven force for both the increase in the photoactivity and for the remarkable changes in the selectivity of products.

Corrosion-Fatigue Crack Growth in Plates: A Model Based on the Paris Law.

In this paper, a Paris law-based model is presented whereby crack propagation occurs under cyclic loading in air (fatigue) and in an aggressive environment (corrosion-fatigue) for the case of corner cracks (with a wide range of aspect ratios in the matter of the initial cracks) in finite-thickness plates of 316L austenitic stainless steel subjected to tension, bending, or combined (tension + bending) loading. Results show that the cracks tend during their growth towards a preferential propagation path, exhibiting aspect ratios slightly lower than unity only for the case of very shallow cracks, and diminishing as the crack grows (increasing the relative crack depth)-more intensely in the case of bending than in the case of tension (the mixed loading tension/bending representing an intermediate case). In addition, the crack aspect ratios during fatigue propagation evolution are lower in fatigue (in air) than in corrosion-fatigue (in aggressive environment).

Photochemical reactivity of apical oxygen in KSr(2)Nb(5)O(15) materials for environmental remediation under UV irradiation.

The photocatalytic activity of a series of novel KSr2Nb5O15 materials was studied using the photooxidation of methylene blue as model reaction. The influence of the calcination time upon the crystalline structure and photoactivity was verified. Characterization was performed by XRD, SEM, FTIR, UV-Vis/DR, Helium picnometry, and N2 and CO2 adsorption-desorption isotherms. The diffraction line profile and the refinement of the structural parameters of KSr2Nb5O15 were obtained from the XRD patterns by the Rietveld method. Data showed that samples were photoactive under UV irradiation, regardless the synthesis conditions. However, the calcination time had a clear influence upon the photocatalytic activity of the samples, being more efficient towards the degradation of the dye those obtained at a lower calcination time. Indeed, the sample calcined for 4h showed up to 4 times higher photocatalytic activity than commercial TiO2. Additionally, a correlation between the photocatalytic activity and the displacement of the Nb ion from the central position in the [NbO6] octahedron was found. It is suggested that this fact causes an important polarization of the niobate structure. The apical oxygen in these samples is very reactive and can lead to the formation of superoxoradical anions (O2-) showing that KSr2Nb5O15 can be potentially used in photocatalytic reactions under UV irradiation.

Prognosis of patients with syncope seen in the emergency room department: an evaluation of four different risk scores recommended by the European Society of Cardiology guidelines.

AIM: To apply, analyze, and evaluate the four syncope risk scores recommended by the 2009 European guidelines and the different parameters that they use to predict death, syncope recurrence, and hospital readmission in the population seen in the emergency room department (ERD) for syncope. METHODS AND RESULTS: A total of 323 patients aged older than 14 years [mean age 59 (32-75) years] and seen in ERD for syncope over a 2-month period were included in the study; 50.7% were women. Patients were evaluated using the four risk scores and were followed up for at least 2 years. In all, 275 patients (85.2%) were discharged directly from ERD after evaluation. During 28±5 months of follow-up, 8% died, 18.3% presented a further syncopal episode, and 18.6% were readmitted to hospital. Only two of the four risk scores were useful in risk discrimination, but no statistically significant differences were detected between predicted risk and observed risk. Multivariate analysis indicated relationships between age and death, a history of cardiovascular disease and syncope recurrence, and between presyncopal palpitations and hospital readmission. CONCLUSION: Although a large number of events occur after syncope, the risk scores recommended by guidelines overestimate risk, but there were no statistically significant differences between observed and predicted risk.