Mass tourism urban destinations and climate change in small islands: resilience to extreme rainfall in the Canary Islands.

The Canary Islands are one of the main destinations for mass tourism in the European context, characterized by the absence of seasonality in tourist activity. Moreover, the level of activity increases during the winters, coinciding with a greater probability of extreme rainfall events, whose danger seems to be increasing as a result of climate change. Owing to its pronounced orography, the southern coast of the island of Gran Canaria houses several tourist settlements built along ravines and steeply sloping terrain. This scenario presents considerable risk because of spatial probability of landslide occurrence. The case of San Agustín, especially, serves to test the model of tourist urbanization along the hillside, demonstrating its high fragility in the face of extreme rainfall events. Especially owing to its importance in providing assistance in emergency situations, its vulnerability has been analyzed with regard to accessibility, which is entirely dependent on road mobility. The growth model of San Agustín serves as an example of mass tourism in small islands, allowing urban planners and designers to assess corrective measures based on managing its existing road infrastructure and open spaces right from the planning stage.

Automatic Correction of Real-Word Errors in Spanish Clinical Texts.

Real-word errors are characterized by being actual terms in the dictionary. By providing context, real-word errors are detected. Traditional methods to detect and correct such errors are mostly based on counting the frequency of short word sequences in a corpus. Then, the probability of a word being a real-word error is computed. On the other hand, state-of-the-art approaches make use of deep learning models to learn context by extracting semantic features from text. In this work, a deep learning model were implemented for correcting real-word errors in clinical text. Specifically, a Seq2seq Neural Machine Translation Model mapped erroneous sentences to correct them. For that, different types of error were generated in correct sentences by using rules. Different Seq2seq models were trained and evaluated on two corpora: the Wikicorpus and a collection of three clinical datasets. The medicine corpus was much smaller than the Wikicorpus due to privacy issues when dealing with patient information. Moreover, GloVe and Word2Vec pretrained word embeddings were used to study their performance. Despite the medicine corpus being much smaller than the Wikicorpus, Seq2seq models trained on the medicine corpus performed better than those models trained on the Wikicorpus. Nevertheless, a larger amount of clinical text is required to improve the results.

A new combined sensory-instrumental tool for pomegranate seed hardness determination.

BACKGROUND: Scanning electron microscopy was assayed and linked with previous data with respect to obtaining a new combined sensory-instrumental tool for pomegranate seed hardness determination. The present study aimed to develop an effective tool for the prediction of sensory properties via instrumental determinations. RESULTS: Simple regression analysis determined a high correlation within descriptive seed hardness and thickness of the wall, as well as descriptive wood perception and thickness of the wall, with values of 0.71 in both cases. Multiple regression analysis improved correlations when (i) descriptive seed hardness correlated with instrumental seed hardness and wood index (0.94); (ii) descriptive wood perception correlated with instrumental seed hardness and wood index (0.79); (iii) descriptive seed hardness correlated with instrumental seed hardness and thickness of the seed wall (0.96); and (iv) descriptive wood perception correlated with instrumental seed hardness and thickness of the seed wall (0.82). The same trend was found when (i) seed hardness satisfaction degree correlated with instrumental seed hardness and wood index (0.92); (ii) wood perception satisfaction degree correlated with instrumental seed hardness and wood index (0.82); (iii) seed hardness satisfaction degree correlated with instrumental seed hardness and thickness of the wall (0.99); and (iv) wood perception satisfaction degree correlated with instrumental seed hardness and thickness of the wall (0.99). CONCLUSION: Regarding mechanical properties, the results of the present study confirm that texture analysis and scanning electron microscopy are an effective tool for obtaining reliable information. This research led to establish an objective tool allowing prediction of the consumer acceptance of pomegranate cultivars worldwide. © 2020 Society of Chemical Industry.

Anxiety, perceived stress and coping strategies in nursing students: a cross-sectional, correlational, descriptive study.

BACKGROUND: For many nursing students, clinical training represents a stressful experience. The levels of stress and anxiety may vary during students' educational training, depending on their ability to adopt behavioral strategies for coping with stress, and other factors. This study aimed to investigate the relationship between anxiety, perceived stress, and the coping strategies used by nursing students during their clinical training. METHODS: A cross-sectional correlational descriptive study. The sample consisted of 190 nursing students enrolled in the Nursing Faculty of Ciudad Real University in Spain. Participants provided data on background characteristics and completed the following instruments: the Perceived Stress Scale; the State-Trait Anxiety Inventory and the Coping Behavior Inventory. Relationships between scores were examined using Spearman's rho. RESULTS: The mean age of participants was 20.71 ± 3.89 years (range 18-46 years). Approximately half of the students (47.92%) indicated a moderate level of stress with a mean Perceived Stress Scale score of 22.78 (±8.54). Senior nursing students perceived higher levels of stress than novice students. The results showed a significant correlation for perceived stress and state anxiety (r = 0.463, p < .000) and also for trait anxiety (r = 0.718, p < .000). There was also a significant relationship between the total amount of perceived stress and the following domains of the coping behavior inventory: problem solving (r = -.452, p < .01), self-criticism (r = .408 p < .01), wishful thinking (r = .459, p < .01), social support(r = -.220, p < .01), cognitive restructuring (r = -.375, p < .01), and social withdrawal (r = .388, p < .01). In the current study, the coping strategy most frequently used by students was problem-solving, followed by social support and cognitive restructuring. CONCLUSIONS: Nursing students in our study presented a moderate level of stress, in addition there was a significant correlation with anxiety. Nursing teachers and clinical preceptors/mentors should be encouraged to develop programs to help prepare nursing students to cope with the challenges they are about to face during their clinical placements.

Selenium impedes cadmium and arsenic toxicity in potato by modulating carbohydrate and nitrogen metabolism.

Past studies have already determined that selenium (Se) is very effective in alleviating cell oxidative damage caused by various abiotic stresses in plants. Past studies have also indicated other physiological pathways by which Se may benefit plants. In order to better understand the full array of potential applications for Se in agriculture, this study investigated the influence of Se on carbohydrate and nitrogen (N) metabolism in potato plants (Solanum tuberosum L. cv. Sante) grown under cadmium (Cd) and/or arsenic (As) toxicity. Potato plants were grown in a growth chamber and fertigated with Hoagland nutrient solution with or without Se (9 µM). After 48-d of growth under Cd (40 µM) and/or As (40 µM) stress, carbohydrate and N metabolism in leaves, roots and stolons were measured. For carbohydrate metabolism, various sugars-i.e., sucrose, starch, glucose, fructose, and total soluble sugar contents (TSSC)-and the activities of enzymes associated with sucrose metabolism and glycolysis-i.e., acid invertase (AI), neutral invertase (NI), sucrose-synthetase (SS), sucrose phosphatesynthetase (SPS), fructokinase (FK), hexokinase (HK), phosphofructokinase (PFK), and pyruvatekinase (PK)-were measured. For N metabolism, NO3-, NO2- and NH4+ contents along with the enzymatic activities of nitrate reductase (NRA), nitrite reductase (NiRA), glutamine-synthetase (GS), and glutamate-synthetase (GOGAT) were measured. Overall, Cd and/or As treatments had reduced plant growth relative to those plants grown without heavy metal toxicity, due to hindered photosynthesis and alterations in N metabolism and glycolysis. Regarding N metabolism, heavy metal toxicity caused a reduction in NO3- and NO2- content and NRA and NiRA enzymatic activity and enhanced NH4+ content and GDH activity in leaves, roots and stolons. Regarding glycolysis, the activity of enzymes of glycolysis-i.e., FK, HK, PFK, and PK-were also reduced. In the C metabolism study, plants combatted Cd and As toxicity naturally by an adaptation mechanism which caused an increase in soluble sugars (fructose, glucose, sucrose) by increasing NI, SS and SSP enzymatic activity. Supplementation with Se in the Cd and/or As treatments in the carbohydrate and N metabolism studies improved plant growth. Selenium supplementation in the Cd and As treatments decreased Cd and/or As content in the plant tissue and alleviating the Cd- and/or As-induced toxicity by enhancing the C-metabolism adaptation mechanism. Applying Se to Cd and As treatments also decreased nitrogen losses by hindering Cd- and As-induced changes in the N-metabolism. Se also limited Cd and As accumulation in the plant tissue by the antagonistic effect between Cd/Se and As/Se in the roots. The results of this study indicate that in the presence of Cd and/or As. soil toxicity, Se may be a powerful tool for promoting plant growth.

Arbuscular mycorrhizal symbiosis improves tolerance of Carrizo citrange to excess boron supply by reducing leaf B concentration and toxicity in the leaves and roots.

This study explores the possibility of using mycorrhization as a novel technique for diminishing the negative effects of boron (B) in the nutrient solution on seedlings of Carrizo citrange rootstock plants. For this, an experiment was planned for studying the physiological (gas exchange and chlorophyll fluorescence parameters), morphological (vegetative growth parameters), nutritional (organic solutes, carbohydrates) and oxidative stress responses of seedlings that were either mycorrhized (+AM, Rhizophagus irregularis; previously known as Glomus intraradices) or not mycorrhized (-AM), and irrigated with water containing different concentrations of B (0.5, 5 and 10 mg L-1). It was observed that an excess of B in the nutrient solution decreased the vegetative growth in both +AM and -AM plants, but this decrease was greater in -AM plants. Mycorrhized plants (+AM) under high B concentration accumulated less B in the leaves, and had a smaller reduction of net assimilation rate of CO2 and lower MDA concentration than non-mycorrhized plants. Thus, it can be concluded that mycorrhization increased the tolerance to high boron concentration in the irrigation water of citrange Carrizo seedlings by reducing both the B concentration in the plant tissue and the B toxicity in the physiological processes. The study of organic solutes and carbohydrates also pointed to a different response model between +AM and -AM plants that could be related to the different tolerance observed between these plants.

Conceptualisations on home care for pressure ulcers in Spain: perspectives of patients and their caregivers.

BACKGROUND: Pressure ulcers represent an important worldwide public health problem, which substantially decrease the quality of life of those affected. Yet, few studies to date have analysed the perceptions regarding home care for pressure ulcers. AIMS: To explore the conceptualisations regarding home care of pressure ulcers from the perspective of affected patients and their caregivers. METHODS: A qualitative study design based on Grounded Theory. In-depth interviews were conducted on a theoretical sample of 10 people currently suffering from a pressure ulcer, or who had experienced one in the past, and 15 caregivers of patients who had suffered from this pathology, all of whom came from the four health districts of Puertollano (Ciudad Real, Spain). FINDINGS: Two categories emerged to explain the conceptualisations regarding pressure ulcers: (a) Cause of the pressure ulcer with three subcategories (unavoidable injuries, caregiver's lack of knowledge and painful wounds) and (b) Preferences regarding caring for pressure ulcers with two subcategories (home care as the best approach to treatment and noninstitutionalisation). CONCLUSIONS: This research provides a novel perspective on the specific problems surrounding home care for pressure ulcers, including the perceptions of both patients and their caregivers. It is important to give a voice to patients and their caregivers as this will help understand their needs and improve the care provided. Further studies are required to improve current treatment protocols and clinical practice guidelines for the prevention and treatment of this pathology.

Cost-benefit analysis of tomato in soilless culture systems with saline water under greenhouse conditions.

BACKGROUND: The current need to produce food for a growing population, from diminishing natural resources, such as water and energy, and with minimum environmental degradation, demands the optimization of production. We compare the economic feasibility of tomato production in an open system with a perlite substrate, a closed system with the nutrient film technique (NFT), and a hydroponic crop (deep flow technique, DFT) using three levels of salinity that are found within the normal range for irrigation water quality in southeastern Spain. RESULTS: Production with DFT resulted in an increase in the cost of phytosanitary treatments and the cost of maintenance. Production with perlite resulted in an increase in the cost of irrigation water and fertilization, and the use of NFT resulted in an increase in energy costs. The point of price equilibrium was exceeded in the three soilless systems when using low salinity water, and in perlite, with intermediate salinity water. CONCLUSION: Profitability was reduced in the following order: perlite > NFT > DFT. There were positive results when using irrigation water with low salinity, and in the case of perlite, with intermediate salinity. In every case, salinity reduced the profitability of the operation, and this was greater when NFT was employed. The analysis of these soilless systems should be continued to determine the possibility of reducing cultivation costs. © 2019 Society of Chemical Industry.

Response of three citrus genotypes used as rootstocks grown under boron excess conditions.

In citrus, the effects of an excess of boron (B) are conditioned by the type of rootstock. In the present work, the morphological, physiological and biochemical responses of seedlings from three citrus genotypes, commonly used as rootstocks in citriculture. In particular, Citrange Carrizo (CC), Citrus macrophylla (CM) and sour orange (SO) seedlings were treated with an excess of B (10 mg L-1) in the nutrient solution in order to determine the relative tolerance and to understand the possible mechanisms that make a rootstock more tolerant than the others. To assess these responses, different parameters were measured in plants, such as vegetative growth, B concentration in leaves, stems and roots, gas exchange and chlorophyll fluorescence, the concentration of osmolytes and the activity of enzymes related to the antioxidant system. The results showed, according to the growth parameters, that the SO rootstock was the most tolerant to an excess of B; while CC was the most sensitive. This result was due to the fact that SO plants accumulated less B in leaves, as its roots have a great capacity of restricting the uptake and transport of B towards the aerial part. Moreover, SO is suggested to diminish B toxicity risk through its antioxidant system, since it presented high activity of ascorbate peroxidase (APX) and superoxide dismutase (SOD), as well as high accumulation of quaternary ammonium compounds (QACs).

Tolerance to Stress Combination in Tomato Plants: New Insights in the Protective Role of Melatonin.

Abiotic stresses such as drought, heat or salinity are major causes of yield loss worldwide. Recent studies have revealed that the acclimation of plants to a combination of different environmental stresses is unique and therefore cannot be directly deduced from studying the response of plants to each of the different stresses applied individually. The efficient detoxification of reactive oxygen species (ROS) is thought to play a key role in enhancing the tolerance of plants to abiotic stresses. Here, we report on the role of melatonin in the protection of the photosynthetic apparatus through the increase in ROS detoxification in tomato plants grown under the combination of salinity and heat, two of the most common abiotic stresses known to act jointly. Plants treated with exogenous melatonin showed a different modulation in the expression on some antioxidant-related genes and their related enzymes. More specifically, ascorbate peroxidase, glutathione reductase, glutathione peroxidase and phospholipid hydroperoxide glutathione peroxidase (APX, GR, GPX and Ph-GPX, resepctively) showed an antagonistic regulation as compared to plants that did not receive melatonin. This translated into a better antioxidant capacity and to a lesser ROS accumulation under stress combination. The performance of the photosynthesis parameters and the photosystems was also increased in plants treated with exogenous melatonin under the combination of salinity and heat. In accordance with these findings, tomato plants treated with melatonin were found to grow better under stress combination that the non-treated ones. Our study highlights the important role that exogenous melatonin plays in the acclimation of plants to a combination of two different abiotic stresses, and how this compound can specifically regulate oxidative stress-related genes and enzymes to increase plant tolerance.

The combined effect of salinity and heat reveals a specific physiological, biochemical and molecular response in tomato plants.

Many studies have described the response mechanisms of plants to salinity and heat applied individually; however, under field conditions some abiotic stresses often occur simultaneously. Recent studies revealed that the response of plants to a combination of two different stresses is specific and cannot be deduced from the stresses applied individually. Here, we report on the response of tomato plants to a combination of heat and salt stress. Interestingly, and in contrast to the expected negative effect of the stress combination on plant growth, our results show that the combination of heat and salinity provides a significant level of protection to tomato plants from the effects of salinity. We observed a specific response of plants to the stress combination that included accumulation of glycine betaine and trehalose. The accumulation of these compounds under the stress combination was linked to the maintenance of a high K(+) concentration and thus a lower Na(+) /K(+) ratio, with a better performance of the cell water status and photosynthesis as compared with salinity alone. Our findings unravel new and unexpected aspects of the response of plants to stress combination and provide a proposed list of enzymatic targets for improving crop tolerance to the abiotic field environment.

Using data crawlers and semantic Web to build financial XBRL data generators: the SONAR extension approach.

Precise, reliable and real-time financial information is critical for added-value financial services after the economic turmoil from which markets are still struggling to recover. Since the Web has become the most significant data source, intelligent crawlers based on Semantic Technologies have become trailblazers in the search of knowledge combining natural language processing and ontology engineering techniques. In this paper, we present the SONAR extension approach, which will leverage the potential of knowledge representation by extracting, managing, and turning scarce and disperse financial information into well-classified, structured, and widely used XBRL format-oriented knowledge, strongly supported by a proof-of-concept implementation and a thorough evaluation of the benefits of the approach.

Evaluation of postoperative results after a presurgical optimisation programme.

BACKGROUND: Presurgical optimisation programmes decrease the risk of postoperative complications, reduce hospital stays and speed up patient recovery. They usually involve a multidisciplinary team addressing physical, nutritional and psychosocial issues. The objective of this study was to assess the results of implementing a presurgical optimisation programme led by a liaison nurse in patients undergoing major surgery in a primary general hospital. METHODS: An observational, retrospective, descriptive, cross-sectional, comparative study based on the revision of patients' health records undergoing major surgery between January 2019 and December 2022. Patients entering the presurgical optimisation programme (intervention group) were compared with patients receiving usual medical care (control group). The presurgical optimisation programme consisted of oral nutritional supplementation, physical exercise, strengthening of lung capacity and psychological and emotional support. Frequency (%) of surgery complications and use of healthcare resources (duration of hospitalisation, time spent in the intensive care unit (ICU), and readmission) at day 30 were recorded. Descriptive statistics were applied. RESULTS: Two hundred eleven patients (58.5% men, mean age: 65.76 years (SD 11.5), 75.2%. non-smokers; mean body mass index (BMI): 28.32 (SD 5.38); mean Nutritional Risk Score (NRS) 3.71 (SD 1.35; oncology diagnosis: 88.6%) were included: 135 in the intervention group, and 76 in the control group. The average duration of the presurgical optimisation programme was 20 days (SD 5). Frequency of postoperative complications was 25% (n = 33) in the intervention group and 52.6% (n = 40) in the control group (p < 0.001) [odds ratio (OR) = 3.4; 95% confidence interval (CI) (1.8; 6.2)]. 14.5% (n = 19) of patients in the intervention group and 34.2% (n = 26) in the control group had remote postoperative complications [OR = 3.1; 95% CI (1.6; 6.2)]. Patients in the intervention group spent fewer days in the hospital [mean 8.34 (SD 6.70) vs 11.63 (SD 10.63)], and there were fewer readmissions at 30 days (7.6% vs 19.7%) compared with the control group. CONCLUSIONS: A presurgical optimisation programme led by a liaison nurse decreases the rate of immediate and late surgical complications and reduces hospital stays and readmissions in patients undergoing major surgery.

Potential of Seed Halopriming in the Mitigation of Salinity Stress during Germination and Seedling Establishment in Durum Wheat (Triticum durum Desf.).

The salinity of soils and irrigation water is among the main factors that limit plant productivity worldwide. Several alternatives have been proposed to get around this problem. However, these alternatives have faced difficulties in their implementation. As an alternative, the adverse effects of salinity on crop yield can be minimized by selecting species and varieties better adapted to salinity and/or by finding priming agents that give plants a certain tolerance during the vegetative and reproductive stages. The latter are strictly dependent on germination and seedling establishment. For this purpose, a laboratory experiment was conducted on three Tunisian wheat cultivars (Karim, Razeg, and Maali) subjected to moderate salinity stress (MSS, 5 g L-1 NaCl), severe salinity stress (SSS, 10 g L-1 NaCl), or control (0 NaCl) after soaking the seeds in a solution of KNO3 or ZnSO4 (0.5 g L-1). Salinity stress significantly decreased germination capacity (GC) and induced osmotic stress under MSS, which declined under SSS in favor of toxic stress. Pretreatment of seeds with KNO3 or ZnSO4 alleviated the toxic effect, and seedlings recovered initial vigor and GC even under SSS. The Karim cultivar showed better tolerance to salinity and a higher ability to react to priming agents. The calculated sensitivity tolerance index (STI) based on germination capacity, seedling growth, and initial vigor decreased in all cultivars under salt stress; however, this parameter clearly discriminated the studied cultivars. Karim was the most tolerant as compared to Razeg and Maali. We conclude that halopriming provides a benefit by alleviating the harmful effects of salt toxicity and that cultivars differ in their response to priming and extent of salt stress. KNO3 and ZnSO4 effectively alleviated the inhibitory effect of salt stress on seed germination and seedling establishment while significantly improving initial vigor.

Evaluation of transformer models for financial targeted sentiment analysis in Spanish.

Nowadays, financial data from social media plays an important role to predict the stock market. However, the exponential growth of financial information and the different polarities of sentiment that other sectors or stakeholders may have on the same information has led to the need for new technologies that automatically collect and classify large volumes of information quickly and easily for each stakeholder. In this scenario, we conduct a targeted sentiment analysis that can automatically extract the main economic target from financial texts and obtain the polarity of a text towards such main economic target, other companies and society in general. To this end, we have compiled a novel corpus of financial tweets and news headlines in Spanish, constituting a valuable resource for the Spanish-focused research community. In addition, we have carried out a performance comparison of different Spanish-specific large language models, with MarIA and BETO achieving the best results. Our best result has an overall performance of 76.04%, 74.16%, and 68.07% in macro F1-score for the sentiment classification towards the main economic target, society, and other companies, respectively, and an accuracy of 69.74% for target detection. We have also evaluated the performance of multi-label classification models in this context and obtained a performance of 71.13%.

Metabolomic Approach to Study the 'Purple Queen' Pomegranate Cultivar Response to Alternative Culture Media and Phenological Stages.

The increasingly evident threat of depletion of world peat bogs is encouraging the search for and study of alternative agricultural substrates that can fully or partially replace peat, guaranteeing food supply (quality and quantity). On the other hand, the identification of the potential for the reuse of waste from relevant economic activities has increased in recent years, mainly motivated by the change to a sustainable circular economy, as is the case of port sediments. Taking into account that significant volumes of dredged port sediments are generated annually so that ports can maintain their economic activity, it is necessary to find objective, sustainable and safe reuse alternatives. In this sense, the objective of this study was to study the response of the "Purple Queen" pomegranate when grown with dredged port sediment. For this, the fruit production (kg), number of fruits (fruits tree-1), fruit weight (g), and seed yield (%) aiming to verify the correct tree development were evaluated. In addition, a 1H-NMR foliar metabolomic study for the three most relevant phenological phases was performed (flowering, fruit development, and post-harvest) to identify metabolic changes in trees. In total, 29 metabolites were identified; among them, 11 were amino acids, 6 organic acids, 5 sugars, and 7 secondary metabolites. The good agronomical development of the trees and fruits indicated the potential for using the dredged sediment as an agricultural substrate. On the other hand, the results revealed that the greatest variability in the metabolomic study occurred between the phenological phases and a lower variability is explained by the substrates used.

HPLC enantioseparation of alkaloid malacitanine using fluorimetric/polarimetric detection.

This work reports two methods developed for the separation and determination of the enantiomers of the new alkaloid malacitanine (MLC) and the determination of the enantiomeric purity in mixtures. First, the isomers were separated using a Chirex 3020 (250 mm × 4.6 mm, 5 µm) chiral column with a mobile phase of cyclohexane-1,2-dichloroethane-ethanol-trifluoroacetic acid (64:30:6:0.6, v/v/v/v) at a flow rate of 1 mL/min and fluorimetric detection. Obtained retention times were 12.4 and 15.9 min (+ and -) with a resolution Rs of 1.13. Relative standard deviations (RSDs) were 2.5 and 2.4% at the 0.5-µg level (four determinations). Second, a nonenantioselective procedure for the determination of enantiomeric purity of MLC using a Lichrospher ® Si-60 (250 mm × 5 mm, 5 µm) normal phase with a mobile phase of 100% ethanol at a flow rate of 0.9 mL/min coupled to two detectors in series, fluorimetric and polarimetric. RSD of 3.3% was obtained. Calculated enantiomeric purity by chiral chromatography gave 48.6% (-)-MLC in the near racemic product. Using polarimetric signal of the nonseparated enantiomers and comparing the slopes of the calibration curves (enantiomers) from the racemic product gave 47.8% (-)-MLC content. A study of accuracy of (-)-MLC gave recoveries from 98.3 to 100.7%.

Expectations and Experiences of Spanish Primiparous Women Who Decide to Breastfeed Their Infants and Strategies for Change in 2020-A Qualitative Study.

To describe the experiences and expectations of Spanish women regarding breastfeeding and the support they receive from healthcare professionals, family, and friends during the breastfeeding journey, A qualitative study using an empirical-phenomenological approach was conducted. Primiparous women that had already given birth were interviewed using a purposive and snowball sampling. In-depth interviews were conducted between 1 January and 30 April 2020. The interviews were transcribed verbatim and analysed using Haase's adaptation of Colaizzi's phenomenological method. We recruited 14 women who had recently become mothers. Three major themes describing experiences of infant feeding by maternal lactation were identified-institutional influences, establishing breastfeeding, and cessation of breastfeeding-as well as the following 10 categories: hospital routines, lactation concerns (amount and infant nutrition), antenatal breastfeeding decision, embarrassment to breastfeed, and normalisation of breastfeeding. Prior education and support were identified as key elements in possible breastfeeding support strategies.

Does admission acetylsalicylic acid uptake in hospitalized COVID-19 patients have a protective role? Data from the Spanish SEMI-COVID-19 Registry.

Acetylsalicylic acid (ASA) is widely used in the treatment and prevention of cardiovascular disorders. Our objective is to evaluate its possible protective role, not only in mortality but also in other aspects such as inflammation, symptomatic thrombosis, and intensive care unit (ICU) admission in hospitalized COVID-19 patients. We realized an observational retrospective cohort study of 20,641 patients with COVID-19 pneumonia collected and followed-up from Mar 1st, 2020 to May 1st, 2021, from the nationwide Spanish SEMI-COVID-19 Registry. Propensity score matching (PSM) was performed to determine whether treatment with ASA affected outcomes in COVID-19 patients. On hospital admission, 3291 (15.9%) patients were receiving ASA. After PSM, 3291 patients exposed to ASA and 2885 not-exposed patients were analyzed. In-hospital mortality was higher in the ASA group (30.4 vs. 16.9%, p < 0.001) in the global sample. After PSM, no differences were found between groups (30.4 vs. 30.3%, p = 0.938). There were no differences in inflammation, symptomatic thrombosis, or ICU admission. In conclusion, ASA intake is not associated with in-hospital mortality or any other health outcome evaluated after applying PSM analysis in a real-world large sample of hospitalized COVID-19 patients.

Fertility preservation in heterotopic cervical pregnancy: what is the best procedure?

We describe a patient who underwent assisted reproduction techniques and was diagnosed with heterotopic cervical pregnancy, and then discuss the management of this entity, which is rare and has no standard protocols. Treatment consisted of intra-arterial methotrexate (50 mg/m(2) body surface area) and simultaneous selective embolization of uterine arteries. The literature is also reviewed to identify other approaches and outcomes.