Early estimates of nirsevimab immunoprophylaxis effectiveness against hospital admission for respiratory syncytial virus lower respiratory tract infections in infants, Spain, October 2023 to January 2024.

The monoclonal antibody nirsevimab was at least 70% effective in preventing hospitalisations in infants with lower respiratory tract infections (LRTI) positive for respiratory syncytial virus (RSV) in Spain (Oct 2023-Jan 2024), where a universal immunisation programme began late September (coverage range: 79-99%). High protection was confirmed by two methodological designs (screening and test-negative) in a multicentre active surveillance in nine hospitals in three regions. No protection against RSV-negative LRTI-hospitalisations was shown. These interim results could guide public-health decision-making.

Investigating the Potential Barrier Function of Nanostructured Materials Formed in Engineered Barrier Systems (EBS) Designed for Nuclear Waste Isolation.

Clay and cement are known nano-colloids originating from natural processes or traditional materials technology. Currently, they are used together as part of the engineered barrier system (EBS) to isolate high-level nuclear waste (HLW) metallic containers in deep geological repositories (DGR). The EBS should prevent radionuclide (RN) migration into the biosphere until the canisters fail, which is not expected for approximately 103  years. The interactions of cementitious materials with bentonite swelling clay have been the scope of our research team at the Autonomous University of Madrid (UAM) with participation in several European Union (EU) projects from 1998 up to now. Here, we describe the mineral and chemical nature and microstructure of the alteration rim generated by the contact between concrete and bentonite. Its ability to buffer the surrounding chemical environment may have potential for further protection against RN migration.

Validation and comparison of instruments to identify frail patientes in primary care settings: Study protocol.

BACKGROUND: In the last few years several indices and tools, aimed at identifying frail subjects in various care settings have been developed. However, to date none of them has been incorporated into usual practice in the primary care setting. The purposes of this study are: 1) to evaluate the predictive capacity of the Tilburg Frailty Indicator (TFI), the Gérontopôle Frailty Screening Tool (GFST) and the KoS model together with two biomarker levels (SOX2 and p16INK4a) for adverse events related to frailty; 2) to determine differences in the use of healthcare services according to frailty. METHODS/DESIGN: Prospective multicentre cohort study with a 2-year follow-up. The study will be performed in primary care centres of Gipuzkoa and Costa del Sol, both located in Spain. Autonomous, non-institutionalized individuals aged 70 and over that agree to participate in this study will constitute the study population. A total of 900 individuals will be randomly selected from the healthcare administrative data bases of the participating health services. Data will be collected at baseline and at 1 and 2 years. The main independent variables assessed at baseline will be TFI outcomes, GFST and the KoS model, together with the expression of SOX2 and p16INK4a levels. During follow-up, loss of autonomy, the occurrence of death and consumption of healthcare resources will be assessed. DISCUSSION: The main focus of this work is the identification and evaluation of several instruments constructed under different rationales to identify frail subjects in primary care settings. The resulting outcomes have potential for direct application to the primary care practice. Early identification of the onset of functional impairment of elderly is an essential, still unresolved aspect in the prevention of dependence in the scope of primary care.

Comparative Impact of Hydroxychloride and Organic Sources of Manganese, Zinc, and Copper in Rearing Diets on Pullet Growth, Tibia Traits, Egg Production, and Eggshell Quality in Lohmann Brown Birds up to 50 Weeks of Age.

(1) Background: This study assessed the efficacy of hydroxychloride sources of zinc (Zn), manganese (Mn), and copper (Cu) compared with organic sources in the rearing diets of Lohmann brown pullets, focusing on pullet performance, tibia quality, egg production, and eggshell quality. (2) Methods: A total of 120 birds (six replications and 10 birds each) received diets with Mn, Zn, and Cu from organic or hydroxychloride sources during the rearing phase. After the onset of lay, birds were fed diets containing oxide/sulfate sources up to 50 weeks of age. (3) Results: no significant differences were observed in growth performance and tibia quality during the rearing phase (p > 0.05). From 18 to 24 weeks of age, no carryover effect on egg production performance was observed. However, from 25-50 weeks, pullets fed hydroxychloride sources showed lower feed intake and egg mass compared to the organic group (p < 0.05), whereas egg production and eggshell quality remained similar between groups (p > 0.05). (4) Conclusions: These findings suggest the potential of hydroxychloride sources in rearing diets without compromising overall growth in the pullet phase and feed efficiency in the laying cycle.

Application of bioelectrical impedance analysis to assess body composition of male and female broiler chickens from 2 different strains throughout the growth period.

Bioelectrical impedance analysis (BIA) was performed in males and females of 2 different broiler strains from 0 to 42 d of age to develop and validate equations to predict body composition (BC). A total of 528 birds, 132 birds per sex and strain (Ross 308 and Cobb 500) were used in the experiment. Birds were fed ad libitum following CVB recommendations with a common starter (0-14 d), grower (15-29 d), and finisher diet (30-42 d). Bioelectrical impedance analysis was measured weekly from 0 to 42 d. Birds were euthanized, frozen and ground for sample collection. Each sample was analyzed through proximate analysis for dry matter (DM), protein, fat, ash, and energy content. Water (%), protein and ash (% DM) decreased with age (77.5-67.5, 69.1-52.2, and 8.12-7.29, respectively; P < 0.0001); whereas fat (% DM) and energy (cal/g DM) increased with the age (20.7-36.4 and 5,421-6151, respectively; P < 0.0001). Males had significantly higher water (%) and protein (% DM) contents, and lower lipid (% DM) deposits than females (70.5, 55.5, and 32.6 vs. 69.6, 54.6, and 33.7, respectively; P < 0.0001). Cobb 500 had a higher fat and lower protein (% DM) and water (%) content than Ross (34.6, 54.0, and 69.7 vs. 31.7, 56.1, and 70.4, respectively; P < 0.0001). A multiple linear regression analysis was carried out to select the equation model to predict BC using the relative mean prediction error (RMPE, %) to evaluate the accuracy. The coefficients of determination (R2) to estimate water (%), protein, fat, ash (% DM) and energy content (cal/g DM) were 0.909, 0.825, 0.795, 0.493, and 0.838, respectively, and the RMPE were 1.26, 3.46, 7.73, 8.85, and 1.86%, respectively. A t test analysis was run, observing no differences in any of the parameters under study between the analyzed and estimated values. Based on these results, we can conclude that BIA can be used as a valid non-invasive technique to estimate in vivo BC in broilers.

Evaluation of fibrous feed ingredients alternatives to oat hulls as a source of feed structure in broiler diets.

This study aimed to evaluate several fibrous feed ingredients as potential substitutes for oat hulls (OH), assessing their efficacy in providing structural integrity to broiler feeds. A total of 4,160 day-old male Ross-308 broilers were allocated to eight dietary treatments, including a control group (CON) without additional fiber supplementation and 7 diets where 3% of the wheat content was replaced by either OH, soy hulls (SH), beet pulp (BP), carob bean (CB), wheat straw (WS), rice hulls (RH), or wheat bran (WB). The experimental design followed a complete randomized block design with 10 pens per treatment and 52 birds each. Growth performance and gut development indices were monitored, and the coefficients of total tract apparent retention (CTTAR) of nutrients were measured at 28 d. The OH improved feed conversion ratio (FCR) during the entire growth period (1-36 d) compared to the CON, SH, CB, WS, RH, and WB (P < 0.05). Conversely, BP diets reduced the final BW and ADFI compared to OH (P < 0.05) but were not different from the CON (P > 0.05). However, the FCR in birds fed with BP was similar to OH but lower than the CON group. In addition, BP-fed birds had higher CTTAR of ether extract and non-starch polysaccharides and relative weight of empty proventriculus and gizzard to BW at 14 and 28 d compared to CON. The WS, RH, and WB yielded similar final BW to OH and CON but higher FCR (P < 0.05). The CB, on the other hand, resulted in the highest FCR when contrasted with the other substitutes and CON (P < 0.05). Finding an alternative to OH with comparable benefits remains a challenge, with WS, RH, and WB showing similar final BW but inferior FCR to OH, and BP showing similar FCR but lower BW and ADFI.

Enterovirus reverse transcriptase polymerase chain reaction assay in cerebrospinal fluid: an essential tool in meningitis management in childhood.

BACKGROUND: Enteroviruses (EV) are the main aetiological agents of aseptic meningitis in children and a common cause of febrile illnesses in young infants in summer. A rapid diagnosis is essential to rule out other conditions. Real-time reverse transcriptase polymerase chain reaction (RT-PCR) assay performed in cerebrospinal fluid (CSF) has proved to be a very fast and useful tool. METHODS: We collected demographic, clinical and laboratory data of children (aged 11-years or younger) with EV RT-PCR (Cepheid(®) Xpert EV) positive in CSF from December 2007 to July 2010, to describe EV meningitis in children and to determine the role of this assay. RESULTS: We included 92 children (mean age 2.5 years), 32% of whom were neonates. There was no pleocytosis in the CSF of 18.5% (36% in newborn) of the patients, and 23 (25%) were discharged to home from the Emergency Room after the positive results. Length of hospital stay was 2 days (>2 years) versus 4.5 days in newborns (P<0.0001). Antibiotic treatment was prescribed in 38% (75% <3 months), but in 40% of these, it was stopped after the positive results. Mean EV RT-PCR information time was 7h (4-18h). All children had a good clinical outcome. CONCLUSIONS: EV RT-PCR assay in CSF has played an essential role in the management of children with EV meningitis, allowing earlier discharges and decreasing avoidable inappropriate antibiotic treatments. This test should be considered as part of the initial study of children with aseptic meningitis, especially during epidemic seasons.

Evaluation of Fillers for Magnesium Potassium Phosphate Cement (MKPC) for the Encapsulation of Low and Intermediate Level Metallic Radioactive Wastes.

This study investigates the effect of coal fly ash (FA), wollastonite (WO), pumice (PM), and metakaolin (MK) as filler materials in the rheological, mechanical, chemical, and mineralogical properties of a magnesium potassium phosphate cement (MKPC), designed for the encapsulation of low and intermediate level radioactive wastes containing reactive metals. Workability, compression strength, dimensional stability, pH, chemical composition, and mineralogical properties were studied in different pastes and mortars of MKPC with a fixed molar ratio of MgO/KH2PO4 = 1. No new mineral phases were found with the addition of the fillers, denoting their low chemical impact on the MKPC system. Moreover, all formulations with a water/cement mass ratio of <0.65 presented compressive strengths higher than 30 MPa after 90 days, and pH values lower than 8.5, corresponding to the passivation zone of aluminum corrosion.

The impact of digestible lysine and sulfur amino acids on eggshell quality and egg weight control in old ISA brown hens during 62 to 74 wk.

Modifying dietary amino acids has been proposed as a strategy to improve eggshell quality by slowing down increases in egg weight (EW). This study aimed to investigate the effects of different levels of digestible lysine (dLYS) and ratios of digestible sulfur amino acids (dTSAA) to dLYS on performance and eggshell quality in ISA brown hens. A total of 288 hens were individually housed and assigned to 8 treatments, which combined 2 levels of dLYS (5.9 and 5.5 g/kg) with 4 ratios of dTSAA:dLYS (90, 85, 80, and 75) in a factorial arrangement. The study lasted 12 wk, starting at 62 wk of age. The number of eggs was not affected by the interaction between dLYS and dTSAA:dLYS or their main effect. However, the interaction between dLYS and dTSAA:dLYS showed that reducing the dTSAA:dLYS ratio from 85 to 75 when hens were fed 5.5 g/kg of dLYS resulted in a lower EW. Conversely, when hens were fed 5.9 g/kg of dLYS, no significant difference was found in EW among the different ratios of dTSAA:dLYS. Although there was no interaction between the levels of dLYS and dTSAA:dLYS on eggshell quality, reducing the dLYS level from 5.9 to 5.5 slowed down the deterioration in eggshell-breaking strength and eggshell thickness, regardless of the dTSAA:dLYS ratio. These findings suggest that adjusting dietary dLYS while maintaining the dTSAA:dLYS ratio of no less than 85 may be an effective strategy for decelerating the deterioration of eggshell quality in laying hen operations without impacting the egg production rate.

Application of Bioelectrical Impedance Analysis (BIA) to Assess Carcass Composition and Nutrient Retention in Rabbits from 25 to 77 Days of Age.

The aim of this study was to assess and validate, using independent data, the prediction equations obtained to estimate in vivo carcass composition using bioelectrical impedance analysis (BIA) to determine the nutrient retention and overall energy and nitrogen retention efficiencies of growing rabbits. Seventy-five rabbits grouped into five different ages (25, 35, 49, 63 and 77 days) were used in the study. A four-terminal body-composition analyzer was applied to obtain resistance (Rs, Ω) and reactance (Xc, Ω) values. All the animals were stunned and bled at each selected age, and the chilled carcasses were analyzed to determine water, fat, crude protein (CP), ash and gross energy (GE). Multiple linear regression analysis was conducted to determine the equations, using body weight, length and impedance data as independent variables. The coefficients of determination (R2) to estimate the content of water, protein, fat and ash in grams, and energy in Mega Jules(MJ), were: 0.99, 0.99, 0.95, 0.96 and 0.98, respectively, and the relative mean prediction errors (RMPE) were: 4.20, 5.48, 21.9, 9.10 and 6.77%, respectively. Carcass yield (%) estimation had values of 0.50 and 10.0 for R2 and RMPE, respectively. When water content was expressed as a percentage, the R2 and RMPE were 0.79 and 1.62%, respectively. When the protein, fat and ash were expressed as a percentage of dry matter (%DM) and the energy content as kJ/100 g DM, the R2 values were 0.68, 0.76, 0.66 and 0.82, respectively, and the RMPEs were 3.22, 10.5, 5.82 and 2.54%, respectively. Energy Retention Efficiency was 20.4 ± 7.29%, 21.0 ± 4.18% and 20.8 ± 2.79% from 35 to 49, from 49 to 63 and from 35 to 63 d, respectively. Nitrogen Retention Efficiency was 46.9 ± 11.7%, 34.5 ± 7.32% and 39.1 ± 3.23% for the same periods. Energy was retained in body tissues for growth with an efficiency of approximately 52.5%, and the energy efficiency for protein and fat retention was 33.3 and 69.9%, respectively. This work shows that BIA is a non-invasive and good method to estimate in vivo carcass composition and to determine the nutrient retention of growing rabbits from 25 to 77 days of age.

Hydroxychloride trace minerals have a positive effect on growth performance, carcass quality and impact ileal and cecal microbiota in broiler chickens.

BACKGROUND: The objective was to study the effect of hydroxychloride trace minerals (HTM) on growth performance, carcass quality and gut microbiota of broiler chickens in comparison to sulphate trace minerals (STM). In total 1440 male Ross 308 day-old chicks were divided into 12 replicate pens with 30 birds each per treatment. Four different treatments were tested according to a 2 × 2 factorial study design, where the animals received a three phase diet containing either inorganic Zn from sulphates or Zn from HTM in high (80 mg/kg Zn) or low Zn dosage (20 mg/kg Zn). In all treatments 15 mg/kg Cu was added from the same mineral source as the Zn. Body weight and feed intake were measured on day 0, 10, 27 and 34, while carcass and breast meat yields were measured at the end of the study (day 34). In addition, high-throughput sequencing analysis was performed in digesta samples from ileum and cecum to study the gut microbiome (day 34). RESULTS: The results showed an improved (P < 0.05) body weight of broiler chickens fed HTM, regardless of Zn level, on day 27, while on day 34 this effect remained as a tendency (P = 0.0542). In the overall study period, birds fed HTM had a higher (P < 0.05) average daily gain and average daily feed intake when compared to birds fed STM. The mineral source did not affect the carcass characteristics, however, feeding 80 mg/kg Zn resulted in a significantly higher (P = 0.0171) breast meat yield, regardless of source. High-throughput sequencing analysis of the microbiota revealed a higher microbial diversity in the ileum and cecum of HTM fed birds compared to STM fed birds. Taxonomical differences were mainly found in the cecum, specifically between the group fed high and low Zn levels from HTM. This correlated with the mineral contents observed in the cecal digesta. Comparing both groups fed 80 mg/kg Zn, the HTM group had more Streptococcaceae, Streptococcus, Clostridia, Weissella and Leuconostocaceae compared to the STM group. CONCLUSIONS: HTM improved growth performance of broiler chickens; and the source and level of Zn modulated the gut microbiota communities in broilers differentially.

Mortality in Perinatally HIV-infected Adolescents After Transition to Adult Care in Spain.

INTRODUCTION: After the introduction of combination antiretroviral treatment, (ART) mortality in HIV-infected patients has dramatically decreased. However, it is still high in patients at risk, as adolescents transitioning to adult care (AC) without virologic control. The aim of this study was to characterize mortality and comorbidities of perinatally infected HIV (PHIV) patients after transition to AC. METHODS: A multicenter retrospective study from patients included in the CoRISpe-FARO Spanish cohort was conducted. PHIV patients who died after transition to AC between 2009 and 2019 were included. Clinical, immunovirologic characteristics, treatments received, comorbidities and causes of death were described. RESULTS: Among 401 PHIV patients, 14 died (3.5%). All were Spanish, 11/14 (78.6%) women. The median age at diagnosis was 1.5 years (interquartile range [IQR] 0.5-3.9), at transfer to AC was 18 years [16.1-19.9] and at death was 25.8 years [23.6-27.1]. In pediatric units [pediatric care (PC)], CD4+ nadir was 85 cells/µL [IQR 9.7-248.5] and 6/14 patients were classified as C-clinical stage. During AC, all patients were on C-clinical stage and CD4+ nadir dropped to 11.5 cells/µL [4.5-43.3]. cART adherence was extremely poor: in PC, 8/14 patients registered voluntary treatment interruptions; only one had undetectable VL at transition. In AC, 12/14 patients stopped treatment 2 or more periods of time. All deaths were related to advanced HIV disease. Mental health disorders were observed in 7/14 (50%). Main complications described: recurrent bacterial infections (57.1%), wasting syndrome (42.9%), esophageal candidiasis (28.6%) and Pneumocystis jirovecii pneumonia (28.6%). Four women had 11 pregnancies; 5 children were born (none infected). CONCLUSIONS: Young adults PHIV infected who transition to AC without virologic suppression or proven ability to adhere to ART are at high risk of mortality. Mortality was noted as a consequence of advanced HIV disease, frequent mental health problems and poor adherence to ART.

Relationship between Bone Quality, Egg Production and Eggshell Quality in Laying Hens at the End of an Extended Production Cycle (105 Weeks).

(1) Background: Nowadays the industry aims to improve lay persistency for extended cycles (100 weeks or longer) to make egg production more sustainable. However, intensive egg production challenges hen health, inducing severe osteoporosis and the incidence of bone fractures. In this study, the relationship between bone quality and egg production, and/or eggshell quality, was evaluated at the end of an extended laying cycle of 100 weeks, comparing groups of hens with different production and eggshell quality parameters; (2) Methods: Quality parameters of egg (as weight, egg white height), eggshell (as thickness, weight, breaking strength, elasticity and microstructure) and tibiae bone (weight, diameter, cortical thickness, ash weight, breaking strength, medullary bone) were determined; (3) Results: Hens from groups with a high egg production and good eggshell quality have poorer bone quality (lower ash weight and lesser amount of medullary bone). However, Pearson's correlation analysis shows no clear relationship between bone and egg/eggshell parameters. (4) Conclusions: Bone and egg production/eggshell quality are independent and can be improved separately. Medullary bone has an important contribution to bone mechanical properties, being important to accumulate enough bone medullary bone early in life to maintain skeletal integrity and eggshell quality in old hens.

Gelatin-clay bio-nanocomposites: structural and functional properties as advanced materials.

Clay minerals such as the layered silicates montmorillonite and vermiculite, as well as the fibrous clay sepiolite, and a layered double hydroxide ([Zn2Al(OH)6]Cl.nH2O) have been used to prepare gelatin-clay micro- and nano-composites. This biopolymer can be assembled to those inorganic solids through interactions at the nanometric range, but only in the case of montmorillonite intercalation of gelatin takes place. One of the most salient features of the resulting bio-nanocomposites is the possibility to be processed as homogeneous thin films provided of good mechanical properties and transparency. The Young's modulus of gelatin-sepiolite bio-nanocomposites may increase by a factor of 2.5 with respect to neat gelatin. The incorporation of pH indicator dyes to the montmorillonite bio-nanocomposite films allows their application for optical pH sensing.

Prevalence of frailty among community-dwelling elderly persons in Spain and factors associated with it.

Background: For effective prevention and intervention, and reduction of dependency, it is essential to determine the presence of frailty in the community.Objectives: To describe the prevalence of frailty among elderly persons living independently, in two primary healthcare areas in Spain; to identify factors correlated with its presence.Methods: This descriptive cross-sectional study was conducted between May 2015 and July 2016 among non-institutionalized individuals aged ≥70 years living in the primary healthcare areas of Gipuzkoa and Costa del Sol (Spain). The main outcome variable was the prevalence of frailty (determined by modified Fried criteria). The independent study variables were sociodemographic characteristics, anthropometric data and health-related life habits.Results: The study population consisted of 855 individuals (53% women). The overall prevalence of frailty was 26.2% (Gipuzkoa 14.2%, Costa del Sol 38.0%). Using multiple logistic regression, the following factors were associated with frailty: female sex (OR: 1.98; 95%CI: 1.37-2.86); cumulative illness rating scale (OR: 1.05; 95%CI: 1.00-1.10); self-perceived health status (OR: 0.96; 95%CI: 0.95-0.97); self-perceived unhealthy lifestyle (OR: 3.37; 95%CI: 2.05-8.87); dissatisfaction with the domestic environment (OR: 2.11; 95%CI: 1.18-3.76); and cognitive impairment (OR: 4.10; 95%CI: 2.05-8.19). In the multivariable model, 'geographical area' differences persisted, with an OR of 3.51 (95%CI: 2.29-5.36) for the Costa del Sol area, using Gipuzkoa as reference.Conclusion: In this population of community-dwelling persons aged 70 years and over, the prevalence of frailty was 26%. Factors correlated with frailty were female sex, comorbidity, poorer self-perceived lifestyle and health status, and dissatisfaction with the domestic environment.

Stevensite-based geofilter for the retention of tetracycline from water.

The antibiotic tetracycline, is considered a contaminant of emerging concern due to its presence in wastewater effluents, surface waters and groundwaters. Adsorption of tetracycline on soils and clays has been extensively studied to remove the contaminant from the water. A decreasing adsorption as the pH increases is normally reported in the pH range 3-9. However, adsorption isotherms performed on a commercial stevensite presented increasing adsorption with the increasing pH, in the pH range 2-8. This is very interesting since the pH in natural and wasterwaters are normally in the range 6-8. A laboratory design of a geofilter using a mixture of sand and stevensite was tested against an inflow solution of tetracycline 1 g/L, NaNO3 0.1 M and pH = 7 in an advective transport cell experiment. The number of tetracycline molecules exceed by >3 times the number exchangeable positions in the stevensite geofilter. Under these conditions, the TC adsorption on the geofilter reaches 590 mg/g, surpassing the retention capacity of most adsorbents found in literature. Besides, the tetracycline is completely desorbed by the inflow of a saline solution (Mg(NO3)2 0.5 M, at pH = 2) with capacity to replace the exchangeable positions, thus, recovering the geofilter and the tetracycline.

[Tinea capitis in adults caused by Trichophyton violaceum. One case report]. / Tinea capitis en el adulto por Trichophyton violaceum. Presentación de un caso.

Nowadays, tinea capitis is not the most frequent clinical presentation of dermatophytoses. Classically, Sabouraud defined this condition as common in childhood and rare in adults. Nevertheless, it is occasionally observed in adults, most frequently in women over 50 years-old. Trichophyton violaceum is one of the species isolated. We report this case for its rarity and to advise the clinician that one should consider a possible fungal infection in adults showing desquamating plaques in the scalp.