Contrasting magma chemistry in the Candelaria IOCG district caused by changing tectonic regimes.

Iron oxide-copper-gold (IOCG) deposits are a vital source of copper and critical elements for emerging clean technologies. Andean-type IOCG deposits form in continental arcs undergoing extension, and they have a temporal relationship with magmatism although they do not exhibit a close spatial relation with the causative intrusions. The processes required to form IOCG deposits and their potential connections to iron oxide-apatite (IOA)-type mineralization remain poorly constrained, as well as the characteristics of magmatism linked to both deposit types. Here we combine zircon U-Pb geochronology with zircon trace element geochemistry of intrusive rocks associated with the Candelaria deposit, one of the world's largest IOCG deposits, to unravel distinctive signatures diagnostic of magmatic fertility. Our results reveal a marked transition in the geochemistry of intrusions in the Candelaria district, characterized by changes in the redox state, water content and temperature of magmas over time. The oldest magmatic stage (~ 128-125 Ma), prior to the formation of the Candelaria deposit, was characterized by zircon Eu/Eu* ratios of 0.20-0.42, and redox conditions of ΔFMQ - 0.4 to + 1.0. The earliest magmatic stage related to the formation of Fe-rich mineralization at Candelaria (118-115 Ma) exhibits low zircon Eu/Eu* ratios (0.09-0.18), low oxygen fugacity values (ΔFMQ ~- 1.8 to + 0.2) and relatively high crystallization temperatures. In contrast, the youngest stage at ~ 111-108 Ma shows higher zircon Eu/Eu* (~ 0.37-0.69), higher oxygen fugacity values (ΔFMQ ~ + 0.4 to + 1.3) and a decrease in crystallization temperatures, conditions that are favorable for the transport and precipitation of sulfur and chalcophile elements. We conclude that Candelaria was formed through two distinct ore-forming stages: the first associated with a reduced, high temperature, water-poor magma developed under a low tectonic stress, followed by a more oxidized, water-rich, and low temperature magmatic event related to a compressional regime. The first event led to Fe-rich and S-poor IOA-type mineralization, while the second event with geochemical signatures similar to those of porphyry copper systems, generated the Cu- and S-rich mineralization. This late stage overprinted preexisting IOA mineralization resulting in the formation of the giant Candelaria IOCG deposit.

Effectiveness of a specific follow up program for the management of the mental components of post-intensive care syndrome and chronic pain after COVID-19: results from the PAIN-COVID randomized clinical trial.

BACKGROUND: Critical COVID-19 survivors are at risk of developing Post-intensive Care Syndrome (PICS) and Chronic ICU-Related Pain (CIRP). We determined whether a specific care program improves the quality of life (QoL) of patients at risk of developing PICS and CIRP after COVID-19. METHODS: The PAIN-COVID trial was a parallel-group, single-centre, single-blinded, randomized controlled trial. The intervention consisted of a follow up program, patient education on PICS and pain, and a psychological intervention based on Rehm's self-control model in patients with abnormal depression scores (≥8) in the Hospital Anxiety and Depression Scale (HADS) at the baseline visit. QoL was evaluated with the 5-level EQ 5D (EQ 5D 5 L), mood disorders with the HADS, post-traumatic stress disorder (PTSD) with the PCL-5 checklist, and pain with the Brief Pain Inventory short form, the Douleur Neuropathique 4 questionnaire, and the Pain Catastrophizing Scale. The primary outcome was to determine if the program was superior to standard-of-care on the EQ visual analogue scale (VAS) at 6 months after the baseline visit. The secondary outcomes were EQ VAS at 3 months, and EQ index, CIRP incidence and characteristics, and anxiety, depression, and PTSD at 3 and 6 months after baseline visits. CONCLUSIONS: This program was not superior to standard care in improving QoL in critical COVID-19 survivors as measured by the EQ VAS. However, our data can help establish better strategies for the study and management of PICS and CIRP in this population. TRIAL REGISTRATION: # NCT04394169, registered on 5/19/2020.

Safety and effectiveness of direct-acting antiviral drugs in the treatment of hepatitis C in patients with inflammatory bowel disease.

BACKGROUND AND AIMS: Hepatitis C virus (HCV) management in Inflammatory Bowel Disease (IBD) is uncertain. The ECCO guidelines 2021 recommended HCV treatment but warn about the risk of IBD reactivation. We aimed to evaluate 1) the effectiveness and safety of direct-acting antivirals (DAAs) in IBD; 2) the interaction of DAAs with IBD drugs. METHODS: Multicentre study of IBD patients and HCV treated with DAAs. Variables related to liver diseases and IBD, as well as adverse events (AEs) and drug interactions, were recorded. McNemar's test was used to assess differences in the proportion of active IBD during the study period. RESULTS: We included 79 patients with IBD and HCV treated with DAAs from 25,998 IBD patients of the ENEIDA registry. Thirty-one (39.2 %) received immunomodulators/biologics. There were no significant differences in the percentage of active IBD at the beginning (n = 11, 13.9 %) or at the 12-week follow-up after DAAs (n = 15, 19 %) (p = 0.424). Sustained viral response occurred in 96.2 % (n = 76). A total of 8 (10.1 %) AEs occurred and these were unrelated to activity, type of IBD, liver fibrosis, immunosuppressants/biologics, and DAAs. CONCLUSIONS: We demonstrate a high efficacy and safety of DAAs in patients with IBD and HCV irrespective of activity and treatment of IBD.

External urology consultation quality at a third-level public hospital in Mexico.

INTRODUCTION: Patient satisfaction is the degree of conformity with the healthcare they receive. It is real evidence and one of the most important factors in determining the effectiveness and quality of healthcare systems. OBJECTIVE: To identify the quality of care in the Urology outpatient department of a third-level hospital. MATERIALS AND METHODS: The NHS (National Health Service) 2018 quality of care questionnaire with 11 sections, 133 items, and duration of approximately 25min was randomly administered to 250 patients attending Urology outpatients at a third-level public hospital in Mexico. RESULTS: According to responses, 92% (n=230) knew the reason for the consultation. 64.8% (n=162) had a consultation with the same physician by whom they were initially seen. The longest reported hospital wait time before being seen was more than 2h in 29.6% (n=74). As for consultation time, 212 patients responded and the duration was 11-20min in 52.8% (n=112). Finally, 33.2% (n=83) considered the quality of service to be good. CONCLUSIONS: The use of the NHS 2018 survey in the Urology service at a third-level public hospital in Mexico is feasible, since we managed to obtain a significant and continuous improvement in all its indicators which is satisfactory for all.

Assessment of chitosan-based adsorbents for glyphosate removal.

Exposure to glyphosate produces various toxic effects, due to this, different methods have been evaluated for its elimination. The objective of this work was to formulate chitosan-based adsorbents and evaluate their efficiency in the removal of glyphosate in vitro. Four films were made by varying the weight ratio of silica/chitosan particles, and four sponges were made by varying the chitosan/chitosan ratio in a reticulated manner. Both adsorbents were characterized based on their porosity, water absorption, glyphosate removal, and reusability. It was found that increasing the porosity in both films and sponges resulted in an increase in the adsorption efficiency of glyphosate. The adsorption process exhibited a better fit in both adsorbents to the pseudo-second-order model. The adsorption of glyphosate to the films fit better with the Langmuir model, demonstrating that the process occurs in the form of a monolayer. In the case of sponges, the adsorption of glyphosate fit better with the Freundlich model, indicating that the process takes place in a multilayer form. Finally, when the reusability was evaluated, the adsorbents showed a loss of effectiveness. However, they still proved to be an efficient alternative for the removal of glyphosate in water, providing a cost-effective and environmentally friendly solution.

Prospective study of the modified Atkins diet in adult drug-resistant epilepsy: effectiveness, tolerability, and adherence.

INTRODUCTION: Drug-resistant epilepsy presents high worldwide prevalence and is difficult to control despite the wide variety of available antiepileptic drugs (AED). The modified Atkins diet (MAD) is an additional treatment alternative. Several studies have addressed the use of the ketogenic diet and MAD in children with drug-resistant epilepsy, but insufficient research has been conducted into adults with the same condition. OBJECTIVE: To evaluate the effectiveness and tolerability of, and adherence to, the MAD in adults with drug-resistant epilepsy. MATERIAL AND METHODS: We conducted a 6-month pre-post prospective study at a reference hospital. Patients were prescribed the MAD with limited carbohydrate intake and unlimited fat intake. We conducted clinical and electroencephalographic follow-up according to the relevant guidelines, and assessed adverse effects changes in laboratory findings, and adherence. RESULTS: Thirty-two patients with drug-resistant epilepsy were included in the study. Patients' mean age was 30 years, mean disease progression time was 22 years, and all patients had focal or multifocal epilepsy. Thirty-four percent of patients presented > 50% decreases in overall seizure frequency (P =  .001); seizure control was greater in the first month and subsequently declined. These patients presented weight loss (RR: 7.2; 95% CI, 1.3-39.5; P = .02), good to fair adherence only in the first and third months (RR: 9.4; 95% CI, 0.9-93.6; P = .04 and RR: 0.4; 95% CI, 0.30-0.69; P = .02, respectively). Tolerability data showed that the MAD is safe: adverse effects were minor and short-lived in most cases, with the exception of mild to moderate hyperlipidaemia in one-third of patients. The adherence rate was 50% at the end of the study. CONCLUSIONS: In adults with drug-resistant focal epilepsy, the MAD showed adequate tolerability and moderate but decreasing effectiveness and adherence, probably due to a preference for a carbohydrate-based diet.

[Holistic semi-presential evaluation of oropharygeal dysphagia with the framework of International Classification of Functioning, Disability and Health: Optimizing evaluation to improve rehabilitation treatment]. / Evaluación holística semipresencial de la disfagia orofaríngea en el marco de la Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud: optimizar la valoración para mejorar el tratamiento rehabilitador.

INTRODUCTION: Oropharyngeal dysphagia can lead to medical complications and decreased quality of life. Although there is a wide diversity of instrumental and clinical procedures to assess it, consensus for its holistic evaluation is scarce and poorly defined. The objective of this article is to present the design of a model for the holistic examination of oropharyngeal dysphagia that takes into account the components of the International Classification of Functioning, Disability and Health (ICF) and that can be carried out both face to face and semi-presentially using Information and Communication Technology (ICT) tools. MATERIAL AND METHODS: A non-systematic review of the literature is carried out in order to select validated oropharyngeal dysphagia assessment tools with the highest degree of recommendation. These tools are analyzed by a group of experts in oropharyngeal dysphagia from the Hospital de la Santa Creu i Sant Pau in Barcelona to design a holistic exploration model. RESULTS: This evaluation model includes an assessment at the beginning and at the end of the treatment, as well as continuous monitoring during the rehabilitation process. It is implemented in a semi-presential and multidisciplinary way, and its purpose is to understand oropharyngeal dysphagia holistically to design and monitor an individualized therapeutic plan. CONCLUSIONS: The evaluation of oropharyngeal dysphagia should be within the biopsychosocial framework proposed by the ICF. The application of ICT in blended interventions facilitates this.

The state of the art in beyond 5G distributed massive multiple-input multiple-output communication system solutions.

Beyond fifth generation (5G) communication systems aim towards data rates in the tera bits per second range, with improved and flexible coverage options, introducing many new technological challenges in the fields of network architecture, signal pro- cessing, and radio frequency front-ends. One option is to move towards cell-free, or distributed massive Multiple-Input Multiple-Output (MIMO) network architectures and highly integrated front-end solutions. This paper presents an outlook on be- yond 5G distributed massive MIMO communication systems, the signal processing, characterisation and simulation challenges, and an overview of the state of the art in millimetre wave antennas and electronics.

Evaluation of the quality of life related to vision after penetrating keratoplasty. / Evaluación de la calidad de vida relacionada con la visión posterior a queratoplastia penetrante.

INTRODUCTION: Organ and tissue donation and transplantation represent the most important therapeutic advance of current times. The cornea is, by far, one of the most transplanted tissues worldwide due to the immune privilege of this tissue, as well as the advances in microsurgery, existence of cornea banks, preservation of corneas, and use of anti-rejection therapy. However, many patients with successful corneal transplants (with clear corneas) experience poor vision in the post-operative period due to irregular astigmatism, or other complications. OBJECTIVE: To evaluate the quality of life related to vision in patients undergoing penetrating keratoplasty. MATERIAL AND METHODS: A cross-analytical study including patients with a history of penetrating keratoplasty, over 18years of age, and at least 6months after surgery. The patients answered the Visual Function Questionnaire25 (VFQ-25) of visual function, a tool validated for use in Spanish, in which the higher the score, the better the quality of life. RESULTS: Thirty patients (20men and 10women), with a mean age of 61.2±18.7years, were included. The time of evolution after the transplant was 17.7±4months. The total quality of life score was 74.9±21.9, with significance in visual acuity (P<.001), and the presence of systemic comorbidities (P=.018). There was no significance between the transplant reason (P=.098) or ocular comorbidities (P=.119). CONCLUSION: The results suggest that visual acuity, as well as the presence of systemic comorbidities, has a significant impact on quality of life.

Disseminated intravascular coagulation as a form of presentation of coronavirus-19 disease. Clinical case. / Coagulación intravascular diseminada como forma de presentación de la enfermedad por coronavirus-19. Caso clínico.

The covid-19 disease (coronavirus disease 2019) is a novel disease causing a world pandemic. Its presentation varies from an asymptomatic infection to a pneumonia with acute respiratory distress syndrome. We present a case presenting initially as a covid-19 pneumonia together with a disseminated intravascular coagulopathy consisting of arterial and venous thrombosis in different locations and a shock requiring admission in the intensive care unit. The abnormal coagulation test in covid-19 patients have been described since the first cases observed in Wuhan, China, as well as an increased incidence of venous thrombosis. On the contrary, a higher incidence of arterial thrombosis has not been described in these patients. The unusual case we present could be a manifestation of this altered tests.