Understanding the local and remote source contributions to ambient O3 during a pollution episode using a combination of experimental approaches in the Guadalquivir valley, southern Spain.

The Guadalquivir Valley is one of three major O3 hotspots in Spain. An airborne and surface measurement campaign was carried out from July 9th to 11th, 2019 to quantify the local/regional O3 contributions using experimental approaches. Air quality and meteorology data from surface measurements, a microlight aircraft, a helium balloon, and remote sensing data (TROPOMI-NO2-ESA) were used to obtain the 3D distribution of O3 and various tracer pollutants. O3 accumulation over 2.5 days started with inputs from oceanic air masses transported inland by sea breezes, which drew O3 and its precursors from a local/regional origin to the northeastern end of the basin. The orographic-meteorological setting of the valley caused vertical recirculation of the air masses inside the valley that caused the accumulation by increasing regional background O3 concentration by 25-30 ppb. Furthermore, possible Mediterranean O3 contributions and additional vertical recirculation through the entrainment zone of the convective boundary layer also contributed. Using particulate matter finer than 2.5 µm (PM2.5), ultrafine particles (UFP), and black carbon (BC) as tracers of local sources, we calculated that local contributions increased regional O3 levels by 20 ppb inside specific pollution plumes transported by the breeze into the valley, and by 10 ppb during midday when flying over an area with abundant agricultural burning during the morning. Air masses that crossed the southern boundaries of the Betic system at mid-altitude (400-1850 m a.s.l.) on July 10th and 11th may have provided additional O3. Meanwhile, a decreasing trend at high altitudes (3000-5000 m a.s.l.) was observed, signifying that the impact of stratospheric O3 intrusion decreased during the campaign.

GIRADS: método de clasificación de masas anexiales, revisión sistemática y metanálisis. 10 años de experiencia / GIRADS: adnexal masses classification method, systematic review and metanalysis. 10 years of experience

OBJETIVO: evaluar la experiencia en la utilización del método GIRADS para clasificar masas anexiales a diez años de su primera publicación. MÉTODO: Se realizó búsqueda de estudios que utilizan el sistema GIRADS: Medline (Pubmed), Google Scholar y Web of Science, desde enero de 2009 hasta diciembre de 2019. Se calculó la sensibilidad y especificidad agrupada, Likelihood ratio (LR) (+) y LR (-) y Odds ratio de diagnóstico (DOR). La calidad de los estudios se evaluó con QUADAS-2. RESULTADOS: Se identificaron 15 estudios y se incluyeron 13 de ellos con 4473 masas, 878 de ellas malignas. La prevalencia media de malignidad ovárica fue del 23 % y la agrupada de 19.6%. El riesgo de sesgo fue alto en cuatro estudios para el dominio "selección de pacientes" y fue bajo en todos en todos los estudios para los dominios "prueba índice" y "prueba de referencia". La sensibilidad, especificidad, LR (+) y LR (-) agrupadas y el DOR del sistema GIRADS para clasificar las masas anexiales fueron: 96.8% (intervalo de confianza [IC] 95% = 94% - 98%), 91.2 % (IC 95 % = 85% - 94%), 11.0 (IC 95% = 6.9 -13.4) y 0.035 (IC 95% = 0.02- 0.09), y 209 (IC 95% = 99-444), respectivamente. La heterogeneidad fue alta para la sensibilidad y especificidad. De acuerdo a la metaregresión, la heterogeneidad entre los estudios se explica por la prevalencia de malignidad, múltiples observadores y la ausencia de diagnóstico histopatológico para todos los casos incluidos en un determinado estudio. CONCLUSIÓN: el sistema GIRADS tiene un buen rendimiento diagnóstico para clasificar masas anexiales.

OBJECTIVE: to evaluate the experience of using GIRADS method to classify adnexal masses ten years after its publication. METHOD: A search was carried out for studies reporting on the use of the GIRADS system in the Medline (Pubmed), Google Scholar and Web of Science databases, from January 2009 to December 2019. Pooled sensitivity and specificity, Likelihood ratio (LR) (+) and LR (-) and Diagnostic Odds ratio (DOR) were calculated. The quality of the studies was assessed by QUADAS-2. RESULTS: 15 studies were identified, and 13 of them were included with 4473 masses, of which 878 were malignant. The mean prevalence of ovarian malignancy was 23% and the prevalence pooled. of 19.6%. The risk of bias was high in four studies for the domain 'patient selection' and low for all studies for the domains 'index test' and 'reference test'. The sensitivity, specificity, pooled LR (+) and LR (-) and the DOR of the GIRADS system to classify adnexal masses were 96.8% (95% confidence interval [CI] = 94% -98%), 91.2 % (95% CI = 85% -94%), 11.0 (95% CI = 6.9-13.4) and 0.035 (95% CI = 0.02-0.09), and 209 (95% CI = 99-444), respectively. Heterogeneity was high for both sensitivity and specificity. According to meta-regression, this heterogeneity was explained by the prevalence of malignancy, the use of multiple observers, and the absence of histopathological diagnosis for all cases included in a given study. CONCLUSION: the GIRADS system has a good diagnostic performance to classify adnexal masses.

Post graduate training in oral surgery in Spain.

The objective of this investigative study is to provide information on the type of public postgraduate training in oral surgery currently being taught in Spain. A descriptive study is made relating to the theoretical and practical syllabuses of the different Masters, through questionnaires answered by students who had previously completed the postgraduate course. Later, a possible relationship between age, sex and previous training in dentistry or stomatology was explored. The results show a poorer preparation in subjects related to the planning and carrying out of treatment of salivary gland pathologies, transposition of the inferior alveolar nerve, treatment of oral tumors, and the treatment planning for osteitis and osteomyelitis. There is a difference between the sexes in a number of answers, where females give higher scores. The stomatologist scores higher in treatment planning for complicated extractions and in the carrying out of dental transplants. It seems that the older the student, the less prepared they are to carry out a treatment plan which includes a biopsy, and the better prepared they are to treat dental emergencies, dentoalveolar trauma, osteitis and osteomyelitis. We can conclude principally that the students give a generally positive evaluation of the oral surgical training, both theoretical and practical, except in the more complex topic areas which appear to relate to the maxillofacial surgeons.

Update on immediate implant loading: a review of the literature.

The treatment of totally or partially edentulous patients with osseointegrated implants is an increasing part of daily dental practice. The greater aesthetic and functional demands made by these patients have created a constant pressure to reduce the waiting time before implants are loaded. In some cases, however, a shortening of the waiting period may compromise the osseointegration of the fixtures. The present review aims to inform the clinician about the continuing controversy on this issue. Data from the reviewed studies allow comparisons to be made between the different success rates obtained after immediate implant loading, offering a more objective basis for our advice to patients on this type of treatment. According to our review, the type and quality of the bone and the surface of the implant are the factors that determine the selection of patients who can undergo the premature loading of implants.