Cheese whey and dairy manure anaerobic co-digestion at psychrophilic conditions: Technical and environmental evaluation.

Cheese whey (CW) and dairy manure (DM) are the main residues from the dairy industry, both of which can led to significant negative environment impacts if not properly managed. However, their combined anaerobic digestion represents an opportunity to obtain bioenergy and a stabilised material as a soil improver on the farm. Biochemical potential of methane (BMP) assays were carried out at psychrophilic conditions (20 °C) to analyse the influence on biomethane production of different CW:DM mixtures (% w/w) at different of inoculum-to-substrate ratios (ISR). Based on the BMP results, a life cycle assessment (LCA) of the cheese manufacturing process was carried out considering two scenarios (i) considering the current process, where propane gas and electricity are used for cheese production (ii) the incorporation of the biogas generated in the cheese production process in the company. BMP results showed that the best mixture between CW and DM was 65:35 (weight basis) at an organic load of 0.6 gVS/L (ISR of X). The LCA showed that CW and DM anaerobic digestion allowed to reduce the cheese manufacturing carbon footprint from through the substitution of propane by the biogas produced, changing from 5.5 to 3.1 kg CO2-eq/kg cheese produced, which indicates that according to the monthly production (633.6 kg) it would stop emitting about 1519 kg CO2-eq, i.e. a saving in terms of emissions of approximately 43,6% of the total currently generated.

[Analysis of ageism during the pandemic, a global elder abuse]. / Análisis del edadismo durante la pandemia, un maltrato global hacia las personas mayores.

Ageism is a form of abuse which has negative influence on elderly people. Although COVID-19 affects people of all ages, it has increased ageism effects, reducing the access of the elderly to different resources, including health system. Ageism is associated to cost overruns, poorer health and early mortality. From «GdT atención al mayor de semFYC¼ we make a series of proposals to decrease it based on community activities that favour intergenerational relationships and ageing education allowing a correct integration of the elderly on society.

Mental well-being of the general population: direct and indirect effects of socioeconomic, relational and health factors.

PURPOSE: The aim of this study was to analyse the association between individual mental well-being and social, economic, lifestyle and health factors. METHODS: Cross-sectional study on a representative sample of 13,632 participants (> 15y/o) from the Catalan Health Interview Survey 2013-2016 editions. Mental well-being was assessed with the Warwick-Edinburg Mental Well-being Scale (WEMWBS). Linear regressions were fitted to associate well-being and sociodemographic, relational, lifestyle and health variables according to minimally sufficient adjustment sets identified using directed acyclic graphs. Predictors entered the model in blocks of variable types and analysed individually. Direct and total effects were estimated. RESULTS: Health factors significantly contributed to mental well-being variance. Presence of a mental disorder and self-reported health had the largest effect size (eta2 = 13.4% and 16.3%). The higher individual impact from a variable came from social support (ß = - 12.8, SE = 0.48, eta2 = 6.3%). A noticeable effect gradient (eta2 = 4.2%) from low to high mental well-being emerged according to economic difficulties (from ß = 1.59, SE = 0.33 for moderate difficulties to ß = 6.02 SE = 0.55 for no difficulties). Younger age (ß = 5.21, SE = 0.26, eta2 = 3.4%) and being men (ß = 1.32, SE = 0.15, eta2 = 0.6%) were associated with better mental well-being. Direct gender effects were negligible. CONCLUSIONS: This study highlights health and social support as the most associated factors with individual mental well-being over socioeconomic factors. Interventions and policies aimed to these factors for health promotion would improve population mental well-being.

A Close Look to the Oxaphosphetane Formation along the Wittig Reaction: A [2+2] Cycloaddition?

The Wittig reaction between triphenylphosphine methylide and benzaldehyde has been studied both from conceptual and computational approaches. The supernucleophilic character of ylide accounts for the feasibility of the initial nucleophilic attack. The nature of bonding driving the formation of the first oxaphosphetane (OPA) intermediate in such a domino reaction is examined within a topological-based bonding evolution theory perspective. The sequence of the electronic flow associated to the changes in electron density supports a rationalization via two main electronic stages characterizing the single kinetic step: first, the C-C bond formation, which takes place via donation of electron density of the ylide carbon to the carbonyl carbon of benzaldehyde at a C-C distance of 2.02 Å, is formally associated to the transition state region; then, the P-O bond formation via the donation of electron density of the nonbonding region of the carbonyl oxygen to phosphorus at a P-O distance of 2.06 Å is located at the end of the reaction path. The detailed picture of bonding patterns suggests that the OPA formation in the Wittig mechanism can be better understood in terms of a two-stage one-step mechanism beyond molecular orbital considerations behind the traditionally accepted [2+2] cycloaddition proposal.

Magnetic-Assisted Reduced-Port Sleeve Gastrectomy Versus Laparoscopic Sleeve Gastrectomy: a Comparative Study.

BACKGROUND: Sleeve gastrectomy is one of the most popular bariatric surgeries. With the advent of new technologies, a reduced-port approach assisted by magnets for sleeve gastrectomy (RPSG-MA) has been developed. The aim of our study is to compare the short-term results of RPSG-MA vs conventional laparoscopic SG (CLSG). METHODS: A comparative study was performed. We compared two groups who underwent RPSG-MA (n=150) and CLSG (n=135) between January 2020 and January 2022. RESULTS: Both groups were similar in body mass index, age, sex, and type of comorbidities. The operative time was similar in both groups (RPSG-MA, 52.5 min vs CLSG, 52.9 min; p = 0.829). Length of hospital (1.07 days) stay was significantly shorter in the RPSG-MA group (p = 0.00) than in the CLSG group (1.51 days). There were no conversions to open surgery in any patient or any fatal event. Complications encountered were similar in both groups postoperative. There were minor adverse events directly related to the magnetic device in 3 cases, these being mild hepatic lacerations, resolved with hemostatic measures. CONCLUSION: The magnet-assisted reduced-port gastric sleeve compared to the conventional technique has proven to be safe, technically feasible and with multiple benefits.

Dermatologic manifestations in patients with the Hermansky-Pudlak syndrome types 1 and 3.

BACKGROUND: The Hermansky-Pudlak syndrome (HPS) is a genetically heterogeneous group of diseases characterized by oculocutaneous albinism, bleeding diathesis, and systemic complications. It is the most common genetic disorder in Puerto Rico. These patients are at a significant risk of developing a variety of skin complications and little is known about the prevalence of dermatologic diagnoses in this population. OBJECTIVES: To report dermatologic manifestations in patients with Hermansky-Pudlak syndrome (HPS). Secondary aims include skin concerns, sun protection habits, barriers to dermatologic care, and skin cancer knowledge. METHODS: Cross-sectional study with twenty-nine Puerto Rican patients who carried a clinical diagnosis of HPS type 1 or type 3 through a telephonic questionnaire. RESULTS: Twenty-nine patients participated with a mean (SD) age of 37.3 (16.8) years and the majority were female (69%). The most common diagnoses were skin cancer (34.5%), acne (34.5%), bacterial skin infections (34.5%), warts (24%), urticaria (17.2%), and psoriasis (17.2%). The most common skin concerns were dry skin (62.1%), hair loss (58.9%), redness (34.5%), moles (31%), and rash (31%). The most common sun protection behavior was wearing a shirt that covers the shoulders (93.1%, often or always) and the least common was wearing a hat (24.1%, often or always). Higher income was significantly associated with being more likely to use sunscreen often or always (OR = 3.38, 95% CI 1.02-11.18, p = 0.04). Those in northern urban areas were significantly less likely to report barriers to dermatologic care (OR = 0.13, 95% CI 0.02-0.76, p = 0.02). CONCLUSIONS: This study provides an important overview of the most common self-reported skin manifestations in patients with HPS. Unfortunately, a high prevalence of cutaneous malignancy was reported. The results stress the need for adequate care and potential interventions to promote sun protection behaviors and skin cancer prevention.

Life cycle inventory data for ethyl levulinate production from Colombian rice straw.

This data article is associated with the research article "Sustainable production of ethyl levulinate by levulinic acid esterification obtained from Colombian rice straw". This paper shows the methodology to calculate the Life Cycle Inventory (LCI) of the foreground system to perform the Life Cycle Assessment (LCA) of the ethyl levulinate (EL) production from Colombian rice straw (RS). This process encompasses two main stages: (i) RS production (involving cultivation and harvesting) and (ii) EL production (involving acid hydrolysis, levulinic acid (LA) purification, and El production). On one hand, foreground data related to paddy rice cultivation was gathered from the literature review. Besides, emissions of the cultivation stage were calculated using the IPCC (Intergovernmental Panel on Climate Change) methodology. The SQCB (Sustainable Quick Check for Biofuels) methodology was used to calculate NH3, NOx, N2O and NO3 emissions, whereas the SALCA (Swiss Agricultural Life Cycle Assessment) model was used to calculate phosphorous emissions to water. The Turc method was employed to calculate the irrigation requirements based on the rainfall and agrological features of rice culture. On the other hand, foreground data related to RS conversion to EL within a biorefinery scheme was obtained from simulation using Aspen Plus v.12. Lastly, background data associated with raw materials, catalysts, and utilities were gathered from Ecoinvent database. All the inventories are meaningful to carry out future environmental assessments involving sustainable production processes using RS as raw material or biorefinery processes using dilute acid hydrolysis.

Hybrid revisional surgery: biliary limb distalization plus endoscopic transoral outlet reduction (eTOR).

Roux-en-Y gastric bypass (RYGB) is one of the best procedures for the treatment of obesity and associated comorbidities. However, the percent of revisional procedures after a gastric bypass by weight regain has been increased, therefore several surgical options are available for the treatment of weight regain. In this case report, we combined a biliary limb distalization with endoscopic transoral outlet reduction (eTOR). The purpose of this case report is to expose the viability to perform combined procedures such as the distalization of the biliopancreatic limb plus eTOR increasing malabsorptive and restrictive components that would represent a secure and efficient weight loss in our patient. We could demonstrate the technical feasibility of the combination of both procedures to increase the restrictive and malabsorptive components at the same time with a low-risk range.

An Unusual Case of Deep Localized Scleroderma in a Patient with Chronic Kidney Disease.

Localized scleroderma (LS) is a rare fibrosing disorder of skin and underlying tissues. Although it can affect all races, it has a higher prevalence in whites. Deep LS is the least common among seven LS variants, representing less than 5% of cases, and typically affects areas of pressure such as the hips and waist. We report a unique clinical case of bilateral lower extremity deep LS in a 51-year-old Puerto Rican woman with chronic kidney disease (CKD). In patients with CKD, it is important to distinguish LS from nephrogenic systemic fibrosis (NSF). Both can present with skin fibrosis and contractures over joints yet have significantly differing treatment approaches and prognosis. Our case report is unique due to the patient's Puerto Rican ethnicity, CKD history, and isolated anterior lower extremity involvement. In this report, we highlight key clinical and histopathological findings of LS, and how they differ from that of NSF.

A Randomized, Controlled Trial of Trifarotene Plus Doxycycline for Severe Acne Vulgaris.

Objective: We evaluated the efficacy and safety of trifarotene plus oral doxycycline in acne. Methods: This was a randomized (2:1 ratio) 12-week, double-blind study of once-daily trifarotene cream 50µg/g plus enteric-coated doxycycline 120mg (T+D) versus trifarotene vehicle and doxycycline placebo (V+P). Patients were aged 12 years or older with severe facial acne (≥20 inflammatory lesions, 30 to 120 non-inflammatory lesions, and ≤4 nodules). Efficacy outcomes included change from baseline in lesion counts and success (score of 0/1 with ≥2 grade improvement) on investigator global assessment (IGA). Safety was assessed by adverse events and local tolerability. Results: The study enrolled 133 subjects in the T+D group and 69 subjects in the V+P group. The population was balanced, with an approximately even ratio of adolescent (12-17 years) and adult (≥18 years) subjects. The absolute change in lesion counts from baseline were: -69.1 T+D versus -48.1 V+P for total lesions, -29.4 T+D versus -19.5 V+P for inflammatory lesions, and -39.5 T+D versus -28.2 for non-inflammatory lesions (P<0.0001 for all). Success was achieved by 31.7 percent of subjects in the T+D group versus 15.8 percent in the V+P group (P=0.0107). The safety and tolerability profiles were comparable between the T+D and V+P arms. Conclusion: T+D was demonstrated to be safe and efficacious as a treatment option for patients with severe acne.

[Health status among immigrant in Catalonia from a gender perspective: PELFI project]. / Estado de salud de personas inmigrantes en Cataluña desde una perspectiva de género: Proyecto PELFI.

OBJECTIVE: The objective of the study is to assess the health status of immigrant men and women from non-EU countries living in the Metropolitan Area of Barcelona (Catalonia, Spain) and to identify the social determinants of health from a gender perspective. METHOD: Cross-sectional analysis from a cohort of immigrant families recruited in Badalona and Santa Coloma de Gramenet, in Spain (PELFI cohort). In 2015-2016, 167 immigrants answered the baseline epidemiological questionnaire and the 5-level EuroQol instrument (EQ-5D) which measures health status. To identify health determinants, Tobit models were constructed to the EQ-5D index. RESULTS: Women rated poorer self-perceived health (p=0.005). To be diagnosed with and illness was only associated with poor self-perceived health among men (p<0.05). Length of residence, domestic work, and especially double workload deteriorated women's health. After adjusting models by demographics and social determinants, permanent administrative status (-0.136; p=0.015) and social support (0.182; p=0.02) were associated with health status in both sexes. To have a job was associated with better health only in men. CONCLUSIONS: Non-EU immigrants living in the Metropolitan Area of Barcelona are a socially vulnerable group of population and present inequalities in health by sex. Social support and occupation are key factors of their health status. Interventions to reduce immigrant vulnerabilities and inequalities in health should promote their social inclusion and cohesion from a gender perspective.

Magnetic device in reduced port and single port bariatric surgery: First 170 cases experience.

INTRODUCTION: Magnetic devices have been successfully used in bariatric surgery. To the date, the only reported use of the magnet was for liver retraction. Our purpose in this study is to demonstrate the safety and viability of using a magnetic system in different steps in single port and reduced port bariatric surgery. METHODS: Prospective and observational study was performed. Patients older than 18 years, undergoing primary laparoscopic sleeve gastrectomy (SG), one-anastomosis gastric bypass (OAGB), and Roux-en-Y gastric bypass (RYGB) or revisional surgery by single-port or reduced-port approach between July 2020 and June 2021 were included. RESULTS: A total of 170 patients (mean BMI, 41.47kg/m2; mean age 36.92 yrs) completed laparoscopic bariatric surgery (54 single-port sleeve gastrectomy [SPSG], 16 reduced-port SG, 83 RYGB, 4 OAGB and 14 revision surgeries), using the magnetic surgical system in different steps of the surgery. Mean surgical time for SPSG and reduced-port SG was 65.52min and 59.36min respectively; and for RYGB 74.19min, OAGB 70.98min, and revisional surgeries 88.38min. As for intraoperative complications, 2.94% mild liver laceration without significant bleeding was reported. There were no 30-day mortalities and no major complications. CONCLUSION: Magnetic assistance in single-port and reduced-port bariatric surgery is an innovative technique. With this prospective study we attempt to demonstrate the safety profile and potential uses that may improve the implementation of new surgical approaches in bariatric surgery.

Life cycle inventory data for power production from sugarcane press-mud.

This data article is associated with the research article "Technical and environmental analysis on the power production from residual biomass using hydrogen as energy vector". This paper shows the procedure to calculate the Life Cycle Inventory (LCI) of the foreground system to perform the Life Cycle Assessment (LCA) of the power production from sugarcane press-mud. Said process encompasses four main stages: i) bioethanol production; ii) bioethanol purification; iii) syngas production and purification; and iv) power production. Additionally, other processes such as biomethane production and manufacturing of catalyst were included. Foreground data related to bioethanol production was gathered from experimental procedures at lab-scale. While foreground data, concerning the other processes such as bioethanol purification, syngas production and purification, power production, and biomethane production, was built by using material and energy flows obtained from Aspen Plus®. Lastly, LCI of the catalyst manufacturing was built based on literature review and the approach stated by Ecoinvent. All the inventories are meaningful to carry out future environmental assessments involving sustainable energy systems based on bioethanol, biomethane, or hydrogen.

Magnetic device in reduced port and single port bariatric surgery: First 170 cases experience.

INTRODUCTION: Magnetic devices have been successfully used in bariatric surgery. To the date, the only reported use of the magnet was for liver retraction. Our purpose in this study is to demonstrate the safety and viability of using a magnetic system in different steps in single port and reduced port bariatric surgery. METHODS: Prospective and observational study was performed. Patients older than 18 years, undergoing primary laparoscopic sleeve gastrectomy (SG), one-anastomosis gastric bypass (OAGB), and Roux-en-Y gastric bypass (RYGB) or revisional surgery by single-port or reduced-port approach between July 2020 and June 2021 were included. RESULTS: A total of 170 patients (mean BMI, 41.47kg/m2; mean age 36.92 yrs) completed laparoscopic bariatric surgery (54 single-port sleeve gastrectomy [SPSG], 16 reduced-port SG, 83 RYGB, 4 OAGB and 14 revision surgeries), using the magnetic surgical system in different steps of the surgery. Mean surgical time for SPSG and reduced-port SG was 65.52min and 59.36min respectively; and for RYGB 74.19min, OAGB 70.98min, and revisional surgeries 88.38min. As for intraoperative complications, 2.94% mild liver laceration without significant bleeding was reported. There were no 30-day mortalities and no major complications. CONCLUSION: Magnetic assistance in single-port and reduced-port bariatric surgery is an innovative technique. With this prospective study we attempt to demonstrate the safety profile and potential uses that may improve the implementation of new surgical approaches in bariatric surgery.

Environmental and economic analysis of bioethanol production from sugarcane molasses and agave juice.

In this article, sugarcane molasses and agave juice were compared as potential feedstocks for producing bioethanol in Mexico in terms of their environmental impact and economic factors. Life cycle assessment (LCA) using SimaPro was carried out to calculate environmental impacts by using a cradle-to-gate approach. A preliminary economic analysis was performed to determine the economic feasibility of the studied options. Also, capital goods costs were obtained using the Aspen Plus economy package. Moreover, a sensitivity analysis was involved to compare the environmental and economic viability of producing bioethanol from sugarcane molasses and agave juice. LCA results revealed that cultivation and fermentation were the most harmful stages when producing bioethanol from sugarcane molasses and agave juice, respectively. Furthermore, when it was derived from agave juice rather than sugarcane molasses, it had more environmental benefits. This was ascribed to the lower consumption rate of fertilizers, pesticides, and emissions given off from the former. Regarding financial aspects, the preliminary analysis showed that producing bioethanol was not economically viable when grid energy alone was used. However, if power from the grid is partially replaced with renewable energy, producing bioethanol becomes economically feasible, and sugarcane molasses is the most suitable feedstock.

Correlation among PME activity, viscoelastic, and structural parameters for Carica papaya edible tissue along ripening.

Papaya fruit, widely consumed around the world, is mechanically and structurally affected by several enzymatic processes during ripening, where pectin methylesterase plays a key role. Hence, the aim of this work was to evaluate possible correlations among physicochemical changes, mechanical parameters, viscoelastic behavior, and enzyme activity of pectin methylesterase to provide information about the softening phenomenon by applying the Maxwell and Peleg models. Mechanical parameters were estimated by texture profile analysis, enzyme activity by Michaelis-Menten parameters, and viscoelastic behavior by relaxation test responses fitted to these models. The Maxwell model described properly mechanical changes during ripening, displaying a better adjustment (R2 > 0.97) than the Peleg model (0.80 < R2 < 0.84). Pearson correlation analysis (P ≤ 0.01) indicated an inversely proportional relation among firmness, total soluble solids, and the first elastic element of the Maxwell model. Besides, the PME Michaelis-Menten affinity constant showed a correlation between the first elastic element and the first viscoelastic element of the Maxwell model. Findings of this work pointed out that the first Maxwell elastic element could explain structural changes as papaya ripening advance, associated with pectin methylesterase activity, cell wall disruption, and cell assembling into the tissue. PRACTICAL APPLICATION: Mechanical and viscoelastic behavior of papaya fruit tissue were described by the Maxwell model associating both viscous and elastic elements to the softening process. The results provide background and practical knowledge to describe structural changes during the ripening process of papaya depending on its enzymatic activity. Outcomes could be further applied to understand changes in other fruits or food matrixes that soften during postharvest, storage, and food chain supply processes.

Gastric bypass with weight regain - Biliary limb distalization plus endoscopic transjejunal A.P.C. pouch therapy in one step: Case report.

INTRODUCTION: In recent years there has been a significant growth in the percentage of patients with weight regain after Roux-en-Y gastric bypass (RYGB). Approximately 20% RYGB patients may experience weight regain 24 months after the intervention. PRESENTATION OF CASE: A 53 yr male patient who underwent RYGB in 2011 with an initial weight of 140 kg and BMI of 44.19 kg/m who consults in 2019 for a weight regain of 45.9%. Transoperative endoscopy assessment revealed a gastric pouch and gastrojejunal anastomosis with a diameter of 7 cm and 2.5 cm respectively. During the procedure we found a common channel of 725 cm, it is decided to shorten it through the distalization of the biliopancreatic limb. Afterward using the same laparoscopic ports to introduce the endoscope through jejunal cane to realize the APC therapy. He was discharged on the 2nd-day, without any complaint. DISCUSSION: The purpose of this case report is to expose the viability to perform a combined surgical technique such as the distalization of the biliopancreatic limb with endoscopic techniques of argon plasma coagulation (APC) via transjejunal in the same operative course. Using this combined technique we can increase hypoabsortive and restrictive components that would represent a secure and efficient weight loss in our patient. CONCLUSIONS: This innovative technique can represent a viable alternative that is secure and reproducible in revisional surgery for weight regain context.

Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines.

BACKGROUND: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. METHODS: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, Supplementary data) concluded the following. RESULTS: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50-200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. CONCLUSIONS: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed.

Controlling sugarcane press-mud fermentation to increase bioethanol steam reforming for hydrogen production.

Hydrogen (H2) production from sugarcane press-mud, a waste obtained from the non-centrifugal sugarcane agroindustry, was assessed by coupling hydrolysis, fermentation, purification, and ethanol steam reforming (ESR). Two culture media were employed on three different sugarcane press-mud samples to produce bioethanol by fermentation using Saccharomyces cerevisiae at 30 °C. One culture medium was supplemented with nutrients and the other without supplementation. The supplementation did not have a significant effect over ethanol production (∼82.1 g L-1) after 70 h fermentation, but the concentration of the impurities was always lower under supplemented conditions. Among tested impurities, differences in 3-methyl-1-butanol showed the effect of the supplementation on the ESR over RhPt/CeO2-SiO2 catalyst at 700 °C, where the H2 yield decreased significantly in the presence of 3-methyl-1-butanol (p < 0.05). The spearman correlation coefficient showed that the H2 yield was correlated with the 3-methy-1-butanol content (RHO = -0.929) and carbon deposits (RHO = -0.964). Therefore, supplemented bioethanol could deliver 3.0 g H2 kg-1 sugarcane press-mud, which is almost twice that of the non-supplemented samples, likely due to the reduction of harmful impurities in the bioethanol. Additionally, supplemented conditions allowed for energy savings in the process and improved catalyst stability. This study provides insights into the effect of supplementing culture media to produce purer bioethanol samples, which further deliver higher H2 yields by ESR.

Asma: uso adecuado de dispositivos para inhalación.

Inhaled therapy is considered the cornerstone of asthma treatment. However, despite being the ideal form of drug delivery, it is recognized that only 70% of patients have an adequate attachment to their treatment and only 39-67% of physicians can explain the optimal inhaler technique. Inhaled therapy has very specific characteristics. Pulmonary deposit of an inhaled medication through the respiratory tract is more complex than when administered orally and depends on several factors inherent to both the medication and the administration. For successful inhaled therapy, the drug needs to be converted into particles of an appropriate size, which can enter beyond the oropharynx and larynx, and be deposited in the lungs. There are multiple devices for the administration of drugs in the lower respiratory tract, each one with a similar efficacy as long as it is used with the correct technique. The decision of which device should be used is made based on the age of the patient, the ability to coordinate between the inhalation and activation of the device, and the presence of acute symptoms. The choice of the device must be evaluated individually.

La terapia inhalada se considera la piedra angular del manejo del asma. Sin embargo, a pesar de ser la forma ideal de administración de estos medicamentos, solamente el 70% de los pacientes cumple el tratamiento adecuadamente y sólo del 39 al 67% de los médicos conocen y pueden explicar de forma adecuada las distintas técnicas de inhalación. La terapia inhalada tiene características muy particulares. El depósito pulmonar de un medicamento inhalado a través del tracto respiratorio es más complejo que cuando se administra por vía oral, y varía dependiendo de varios factores, tanto inherentes al medicamento como a la forma de administrarlo. Para que la terapia inhalada sea exitosa, se requiere que se generen partículas del medicamento de un tamaño apropiado que penetren más allá de la orofaringe y la laringe, y que puedan depositarse en los pulmones. Existen múltiples dispositivos para la administración de medicamentos en la vía respiratoria baja. Cada uno ha probado tener una eficacia similar, siempre y cuando se utilicen con la técnica correcta. La decisión para su uso se realiza con base en la edad del paciente, la capacidad de coordinar entre la inhalación y la activación del dispositivo y la presencia de síntomas agudos. La elección del dispositivo a utilizar siempre deberá hacerse de forma conjunta, evaluando pros y contras de cada uno de los dispositivos y siempre de forma individualizada.