Blueing green water from forests as strategy to cope with climate change in water scarce regions: The case of the Catalan river basin District.

Water scarcity in Mediterranean basins is a critical concern exacerbated by climate change and afforestation of abandoned lands. This study addresses the impact of forest management on water availability, specifically blue water, at a regional scale. Utilizing the SWAT + model, we assess water yield increases resulting from various forest thinning scenarios (light, moderate, heavy) and compare benefits to costs. Our approach incorporates site-specific marginal values of water yield, accounting for urban water supply abstractions. The findings reveal the efficacy of hydrological-oriented forest management in alleviating water scarcity. Thinning intensity positively correlates with water yield, with coniferous forests exhibiting the greatest response and deciduous forests the least. Emphasizing blue water enhancement as a significant co-benefit in forest management planning, our study underscores the economic advantages. Particularly valuable in certain areas, this approach can offset a substantial portion of associated costs. Spatially explicit results enable optimal resource allocation, facilitating efficient planning and prioritization of intervention areas for successful hydrological-oriented strategies. In conclusion, our study not only highlights the economic benefits of forest management in enhancing water availability but also offers actionable insights for sustainable and effective hydrological-oriented planning amid escalating water scarcity.

The SHAPES Smart Mirror Approach for Independent Living, Healthy and Active Ageing.

The benefits that technology can provide in terms of health and support for independent living are in many cases not enough to break the barriers that prevent older adults from accepting and embracing technology. This work proposes a hardware and software platform based on a smart mirror, which is equipped with a set of digital solutions whose main focus is to overcome older adults' reluctance to use technology at home and wearable devices on the move. The system has been developed in the context of two use cases: the support of independent living for older individuals with neurodegenerative diseases and the promotion of physical rehabilitation activities at home. Aspects such as reliability, usability, consumption of computational resources, performance and accuracy of the proposed platform and digital solutions have been evaluated in the initial stages of the pilots within the SHAPES project, an EU-funded innovation action. It can be concluded that the SHAPES smart mirror has the potential to contribute as a technological breakthrough to overcome the barriers that prevent older adults from engaging in the use of assistive technologies.

Relationship Between Depression and the Use of Mobile Technologies and Social Media Among Adolescents: Umbrella Review.

BACKGROUND: Despite the relevance of mobile technologies and social media (MTSM) for adolescents, their association with depressive disorders in this population remains unclear. While there are previous reviews that have identified the use of MTSM as a risk factor for developing depression, other reviews have indicated their possible preventive effect. OBJECTIVE: The aim of this review was to synthesize the current evidence on the association between MTSM use and the development or prevention of depressive disorders in adolescents. METHODS: An umbrella review was conducted using information published up to June 2019 from PubMed/MEDLINE, PsycINFO, Web of Science, and The Cochrane Library. Systematic reviews focusing on the adolescent population (up to 20 years old) and depression and its potential relationship with MTSM use were included. Screening of titles, abstracts, and full texts was performed. After selecting the reviews and given the heterogeneity of the outcome variables and exposures, a narrative synthesis of the results was carried out. RESULTS: The search retrieved 338 documents, from which 7 systematic reviews (3 meta-analyses) were selected for data extraction. There were 11-70 studies and 5582-46,015 participants included in the 7 reviews. All reviews included quantitative research, and 2 reviews also included qualitative studies. A statistically significant association between social media and developing depressive symptoms was reported in 2 reviews, while 5 reviews reported mixed results. CONCLUSIONS: Excessive social comparison and personal involvement when using MTSM could be associated with the development of depressive symptomatology. Nevertheless, MTSM might promote social support and even become a point of assistance for people with depression. Due to the mixed results, prospective research could be valuable for providing stronger evidence.

ALTAI Tool for Assessing AI-Based Technologies: Lessons Learned and Recommendations from SHAPES Pilots.

Across European countries, the SHAPES Project is piloting AI-based technologies that could improve healthcare delivery for older people over 60 years old. This article aims to present a study developed inside the SHAPES Project to find a theoretical framework focused on AI-assisted technology in healthcare for older people living in the home, to assess the SHAPES AI-based technologies using the ALTAI tool, and to derive ethical recommendations regarding AI-based technologies for ageing and healthcare. The study has highlighted concerns and reservations about AI-based technologies, namely dealing with living at home, mobility, accessibility, data exchange procedures in cross-board cases, interoperability, and security. A list of recommendations is built not only for the healthcare sector, but also for other pilot studies.

Modeling dissolved and particulate organic carbon dynamics at basin and sub-basin scales.

Dissolved organic carbon (DOC) and particulate organic carbon (POC) play a fundamental role in biogeochemical cycles of freshwater ecosystems. However, the lack of readily available distributed models for carbon export has limited the effective management of organic carbon fluxes from soils, through river networks and to receiving marine waters. We develop a spatially semi-distributed mass balance modeling approach to estimate organic carbon flux at a sub-basin and basin scales, using commonly available data, to allow stakeholders to explore the impacts of alternative river basin management scenarios and climate change on riverine DOC and POC dynamics. Data requirements, related to hydrological, land-use, soil and precipitation characteristics are easily retrievable from international and national databases, making it appropriate for data-scarce basins. The model is built as an open-source plugin for QGIS and can be easily integrated with other basin scale decision support models on nutrient and sediment export. We tested the model in Piave river basin, in northeast Italy. Results show that the model reproduces spatial and temporal changes in DOC and POC fluxes in relation to changes in precipitation, basin morphology and land use across different sub-basins. For example, the highest DOC export were associated with both urban and forest land use classes and during months of elevated precipitation. We used the model to evaluate alternative land use scenarios and the impact of climate on basin level carbon export to Mediterranean.

Evaluating the Energy Requirements of Assistive Technologies for Older Adults.

The successful adoption of assistive technologies for older adults requires considering and evaluating many different factors and dimensions such as effectiveness, usability, cost and equity of access, to name some of the most relevant. In line with this, the energy requirements to power such assistive technologies remains a hidden factor that might to some extent influence the success in their adoption and the user experience in a wider sense. Very often energy availability is taken for granted and its associated costs and operational requirements are mostly neglected. In this paper, the energy-related requirements of assistive technologies are analysed from a general perspective. This analysis is subsequently particularised for a use case within the SHAPES project, in the context of active and healthy ageing. This use case includes a wide variety of assistive technologies, namely: wearable devices, home sensors and a smart mirror, which provides connectivity and a set of software services. The energy requirements of all these technologies are evaluated and analysed to investigate their impact and relevance on the overall cost and user experience, following the proposed protocol.

Validation of an Electronic Visual Analog Scale App for Pain Evaluation in Children and Adolescents With Symptomatic Hypermobility: Cross-sectional Study.

BACKGROUND: Rapid advances in mobile apps for clinical data collection for pain evaluation have resulted in more efficient data handling and analysis than traditional paper-based approaches. As paper-based visual analogue scale (p-VAS) scores are commonly used to assess pain levels, new emerging apps need to be validated prior to clinical application with symptomatic children and adolescents. OBJECTIVE: This study aimed to assess the validity and reliability of an electronic visual analogue scale (e-VAS) method via a mobile health (mHealth) App in children and adolescents diagnosed with hypermobility spectrum disorder/hypermobile Ehlers-Danlos syndrome (HSD/HEDS) in comparison with the traditional p-VAS. METHODS: Children diagnosed with HSD/HEDS aged 5-18 years were recruited from a sports medicine center in Sydney (New South Wales, Australia). Consenting participants assigned in random order to the e-VAS and p-VAS platforms were asked to indicate their current lower limb pain level and completed pain assessment e-VAS or p-VAS at one time point. Instrument agreement between the 2 methods was determined from the intraclass correlation coefficient (ICC) and through Bland-Altman analysis. RESULTS: In total, 43 children with HSD/HEDS aged 11 (SD 3.8) years were recruited and completed this study. The difference between the 2 VAS platforms of median values was 0.20. Bland-Altman analysis revealed a difference of 0.19 (SD 0.95) with limits of agreement ranging -1.67 to 2.04. An ICC of 0.87 (95% CI 0.78-0.93) indicated good reliability. CONCLUSIONS: These findings suggest that the e-VAS mHealth App is a validated tool and a feasible method of collecting pain recording scores when compared with the traditional paper format in children and adolescents with HSD/HEDS. The e-VAS App can be reliably used for pediatric pain evaluation, and it could potentially be introduced into daily clinical practice to improve real-time symptom monitoring. Further research is warranted to investigate the usage of the app for remote support in real clinical settings.

Phyx.io: Expert-Based Decision Making for the Selection of At-Home Rehabilitation Solutions for Active and Healthy Aging.

While the importance of physical activity in older adults is beyond doubt, there are significant barriers limiting the access of older adults to physical exercise. Existing technologies to support physical activity in older adults show that, despite their positive impacts on health and well-being, there is in general a lack of engagement due to the existing reluctance to the use of technology. Usefulness and usability are two major factors for user acceptance along with others, such as cost, privacy, equipment and maintenance requirements, support, etc. Nevertheless, the extent to which each factor impacts user acceptance remains unclear. Furthermore, other stakeholders, besides the end users, should be considered in the decision-making process to develop such technologies, including caregivers, therapists and technology providers. In this paper, and in the context of physical rehabilitation and exercise at home, four different alternatives with incremental characteristics have been defined and considered: a software-based platform for physical rehabilitation and exercise (Alternative 1), the same software platform with a conventional RGB camera and no exercise supervision (Alternative 2), the same software platform with a convention RGB camera and exercise supervision (Alternative 3) and finally, the same software platform with a depth camera and exercise supervision (Alternative 4). A multiple attribute decision-making methodology, based on the ordinal priority approach (OPA) method, is then applied using a group of experts, including end users, therapists and developers to rank the best alternative. The attributes considered in this method have been usefulness, cost, ease of use, ease of technical development, ease of maintenance and privacy, concluding that Alternative 3 has been ranked as the most appropriate.

Bedtime Monitoring for Fall Detection and Prevention in Older Adults.

Life expectancy has increased, so the number of people in need of intensive care and attention is also growing. Falls are a major problem for older adult health, mainly because of the consequences they entail. Falls are indeed the second leading cause of unintentional death in the world. The impact on privacy, the cost, low performance, or the need to wear uncomfortable devices are the main causes for the lack of widespread solutions for fall detection and prevention. This work present a solution focused on bedtime that addresses all these causes. Bed exit is one of the most critical moments, especially when the person suffers from a cognitive impairment or has mobility problems. For this reason, this work proposes a system that monitors the position in bed in order to identify risk situations as soon as possible. This system is also combined with an automatic fall detection system. Both systems work together, in real time, offering a comprehensive solution to automatic fall detection and prevention, which is low cost and guarantees user privacy. The proposed system was experimentally validated with young adults. Results show that falls can be detected, in real time, with an accuracy of 93.51%, sensitivity of 92.04% and specificity of 95.45%. Furthermore, risk situations, such as transiting from lying on the bed to sitting on the bed side, are recognized with a 96.60% accuracy, and those where the user exits the bed are recognized with a 100% accuracy.

Waves affect predator-prey interactions between fish and benthic invertebrates.

Little is known about the effects of waves on predator-prey interactions in the littoral zones of freshwaters. We conducted a set of mesocosm experiments to study the differential effects of ship- and wind-induced waves on the foraging success of littoral fish on benthic invertebrates. Experiments were conducted in a wave tank with amphipods (Gammarus roeseli) as prey, and age-0 bream (Abramis brama, B0), age-0 and age-1 dace (Leuciscus leuciscus, D0 and D1) as predators. The number of gammarids suspended in the water column was higher in the wave treatments compared to a no-wave control treatment, especially during pulse waves mimicking ship-induced waves in comparison to continuous waves mimicking wind-induced waves. The resulting higher prey accessibility in the water column was differently exploited by the three types of predatory fish. D0 and D1 showed significantly higher foraging success in the pulse wave treatment than in the continuous and control treatments. The foraging success of D0 appears to be achieved more easily, since significantly higher swimming activity and more foraging attempts were recorded only for D1 under the wave treatments. In contrast, B0 consumed significantly fewer gammarids in both wave treatments than in the control. Hence, waves influenced predator-prey interactions differently depending on wave type and fish type. It is expected that regular exposure to ship-induced waves can alter littoral invertebrate and fish assemblages by increasing the predation risk for benthic invertebrates that are suspended in the water column, and by shifting fish community compositions towards species that benefit from waves.

Analgesic and antiallodynic effects of antidepressants after infiltration into the rat.

Tricyclic antidepressants (TCA) have potent local anesthetic properties and may produce a long-lasting pain blockade that could be of interest in relieving chronic pain states such as neuropathic pain, but there are only few data comparing their dose-response curves of analgesic activity under the same experimental conditions. This study examines the time course of pain-relieving properties of 7 TCA in heat-induced paw withdrawal after subcutaneous administration. Mixed inhibitors of norepinephrine and serotonin uptake (amitriptyline, nortriptyline, imipramine, desipramine, doxepin) and selective inhibitors of serotonin uptake (fluoxetine and fluvoxamine) were assayed. The TCA with the longest analgesic activity were selected to test its antiallodynic effect in the neuropathic pain model of chronic sciatic nerve constriction injury. Bupivacaine was used as a reference drug in both experiments. A dose versus time of maximal analgesic effect curve was constructed for each drug. The longest analgesic effect was obtained for doxepin and imipramine. Although low doses of amitriptyline showed the same activity than doxepin, higher doses failed to reach the same effect. Selective inhibitors of serotonin showed no action at all doses tested. In the chronic sciatic nerve constriction injury model, doxepin and, to a smaller degree, amitriptyline and imipramine protected from allodynia; bupivacaine was ineffective. The antiallodynic effect always lasted less long than the analgesic effect. These observations provide support for the potential use of TCA as durable analgesics. Doxepin overall showed the most outstanding results in pain relief.

A Cost-Minimization Analysis of a Medical Record-based, Store and Forward and Provider-to-provider Telemedicine Compared to Usual Care in Catalonia: More Agile and Efficient, Especially for Users.

BACKGROUND: Telemedicine (interconsultation between primary and hospital care teams) has been operating in the counties of Central Catalonia Bages, Moianès and Berguedà since 2011, specializing in teledermatology, teleulcers, teleophthalmology and teleaudiometries. For the period until the end of 2019, a total of 52,198 visits were recorded. OBJECTIVE: To analyze the differential costs between telemedicine and usual care in a semi-urban environment. METHODOLOGY: A cost-minimization evaluation, including direct and indirect costs from a societal perspective, distinguishing healthcare and user's costs, was carried out over a three-month period. RESULTS: Telemedicine saved € 780,397 over the period analyzed. A differential cost favorable to telemedicine of about € 15 per visit was observed, with the patient being the largest beneficiary of this saving (by 85%) in terms of shorter waiting times and travel costs. From the healthcare system perspective, moving the time spent in a hospital care consultation to primary care is efficient in terms of the total time devoted per patient. In social terms and in this context, telemedicine is more efficient than usual care. CONCLUSION: Allowing users to save time in terms of consultation and travel is the main driver of interconsultation between primary and hospital care savings in a semi-urban context. The telemedicine service is also economically favorable for the healthcare system, enabling it to provide a more agile service, which also benefits healthcare professionals.

The association between breast cancer and consumption of dairy products: a systematic review.

INTRODUCTION: Introduction: breast cancer is the most common cancer in women and its relationship with dietary factors particularly dairy products, has been investigated trough several studies but up to now there are still not enough results to confirm the association between breast cancer and dairy products. Objective: the purpose of this systematic review was to expand the number of systematic reviews that to date exist on the relationship between dairy products consumption and risk of breast cancer. A comprehensive search of the PubMed, Scopus and Embase was performed from September 2005 to September 2018 in which one case control and cohorts' studies were included. Results: Eighteen studies were finally selected for the review (10 case-control and 8 cohorts' studies). These studies reported several statistically significant associations (OR, HR, RR) between dairy product consumption and the risk of breast cancer. Seven case-control and four cohorts' studies showed that dairy product consumption was inversely associated with the risk of breast cancer, on the other hand, a positive association was found in two case-control and non- significant association was found between dairy product consumption and the risk of breast cancer in the remaining studies (one case-control and four cohorts' studies) Conclusion: Although an inverse association was observed in most studies, it's difficult to draw conclusions when the methodology methods to collect the dairy product intake and the servings or portions measurements were different in each study. On the other hand, not all studies used the same confounding variable to estimate risk.

INTRODUCCIÓN: Introducción: el cáncer de mama es de los más comunes en mujeres, y su relación con los factores dietéticos y, en particular, con los productos lácteos, ha sido investigada a través de varios estudios, pero hasta ahora no hay resultados suficientes que confirmen la asociación entre cáncer de mama y productos lácteos. Objetivo: ampliar y actualizar el número de revisiones sistemáticas que hasta día de hoy existen sobre la relación entre el consumo de productos lácteos y el cáncer de mama. Metodología: se realizó una búsqueda exhaustiva en las bases de datos PubMed, Scopus y Embase entre septiembre de 2005 y septiembre de 2018 en la que se incluyeron estudios de casos y controles y estudios de cohortes. Resultados: se seleccionaron 18 estudios (10 estudios de casos-controles y 8 estudios de cohorte). Siete casos-controles y cuatro estudios de cohorte mostraron que el consumo de productos lácteos tenía una asociación inversa con el riesgo de cáncer de mama y, por otro lado, en dos estudios de casos-controles se observó una asociación positiva. No se encontró una asociación significativa entre el consumo de productos lácteos y el cáncer de mama en los restantes estudios (1 caso-control y 4 cohortes). Conclusión: aunque se observó una asociación inversa en la mayoría de los estudios, es difícil sacar conclusiones cuando los métodos metodológicos para recolectar la ingesta de lácteos y las porciones o las mediciones de las porciones fueron diferentes en cada estudio. Por otro lado, no todos los estudios tienen en cuenta las mismas variables de confusión.

Evaluation of Malolactic Bacteria Associated with Wines from Albariño Variety as Potential Starters: Screening for Quality and Safety.

The biodiversity of lactic acid bacteria in musts and wines of Albariño variety has been studied. The identification of species was addressed through a combination of biochemical and genetic methods (API® 50 CHL test, 16S rDNA and recA gene sequences, Amplified Ribosomal DNA Restriction Analysis -ARDRA- and 16S-26S intergenic region analysis). The results grouped the isolates into six species predominating those of the genus Lactobacillus and showing a typical biogeographical distribution. Among sixteen strains evaluated, eight of them showed malolactic activity. The study of the presence of genes hdc, odc, and tdc, along with the LC/MS-MS analysis of biogenic amines in wine, showed five strains lacking aminogenic ability. The absence of the pad gene in the above-mentioned strains discards its ability to produce volatile phenols that may adversely affect the aroma. Finally, all malolactic strains showed ß-glucosidase activity so that they could contribute to enhance and differentiate the aromatic profile of Albariño wines.

Numerical study of the effects of particle shape and polydispersity on permeability.

We study through numerical simulations the dependence of the hydraulic permeability of granular materials on the particle shape and the grain size distribution. Several models of sand are constructed by simulating the settling under gravity of the grains; the friction coefficient is varied to construct packs of different porosity. The size distribution and shapes of the grains mimic real sands. Fluid flow is simulated in the resulting packs using a finite element method and the permeability of the packs is successfully compared with available experimental data. Packs of nonspherical particles are less permeable than sphere packs of the same porosity. Our results indicate that the details of grain shape and size distribution have only a small effect on the permeabilty of the systems studied.

Analysis of neurotransmitters in Daphnia magna affected by neuroactive pharmaceuticals using liquid chromatography-high resolution mass spectrometry.

Neurotransmission plays an essential role during the central nervous system (CNS) development. During the last years, several studies based on the changes produced in neurotransmitters of aquatic organisms caused by pharmaceuticals have been reported. Daphnia magna, the aquatic ecotoxicological model organism, shares several of the neurotransmitters targeted by antidepressant and other neuro-active drugs with vertebrates. Therefore, a method based on liquid chromatography coupled to high-resolution mass spectrometry (LC-HRMS) has been applied for the first time to study the levels of 41 neurotransmitters in Daphnia magna under the effect of four different neuro-active pharmaceuticals (sertraline, venlafaxine, duloxetine and fluoxetine). In addition, the performance of LC-HRMS was studied in terms of linearity, sensitivity, intra- and inter-day precision, and overall robustness. The developed analytical method using LC-HRMS is a new tool for neurotoxicology research using the Daphnia magna model. As a result, general differences on the concentrations of those neurotransmitters exposed to the mentioned pharmaceuticals were observed.

Deciphering the mode of action of pollutants impairing the fish larvae escape response with the vibrational startle response assay.

The escape response evoked by vibrational stimuli and its habituation, essential behaviors for fish larvae survival, can be altered by neurotoxic environmental pollutants commonly found in our aquatic ecosystems. In this study we have analyzed the suitability of the Vibrational Startle Response Assay (VSRA) to obtain mechanistic information about the mode of action (MoA) of the chemicals impairing the escape response and its habituation. As a proof of concept, the pathophysiological mechanisms behind the action of two common neurotoxic pesticides, chlorpyrifos-oxon (CPO) and imidacloprid, over their effects on arousal and habituation of the escape response were studied by using pharmacological antagonists of the nicotinic and muscarinic acetylcholine receptors, mecamylamine (MCA) and scopolamine, respectively. Furthermore, potential changes in the neurotransmitter profile were analyzed. Results revealed that whereas the effect of CPO on arousal was mainly mediated by the activation of nAChRs, its effect on habituation was mainly mediated by mAChRs. On the other hand, imidacloprid only affected larvae arousal which was found to be mediated by a cholinergic independent mechanism. No association between behavioral effects on arousal or habituation in affected larvae was found with their corresponding neurotransmitter profile. These results confirm the suitability of VSRA to provide mechanistic information about the potential MoA of neuroactive compounds.

Safety and Effectiveness of Shoulder Arthroplasties in Spain: A Systematic Review.

The effectiveness and safety of shoulder arthroplasties in the general context of a Spanish patient population remains unclear. The aim of this study was to ascertain both the effectiveness and safety of primary shoulder arthroplasties and the prosthesis types used in Spain. A systematic review of all the available literature evaluating the effectiveness and safety of primary shoulder arthroplasties in Spain was performed. A narrative synthesis was performed, and evidence tables were created in four dimensions: study design, arthroplasty characteristics, safety, and effectiveness. Orthopaedic Data Evaluation Panel (ODEP) scores were used to evaluate prosthesis types. Twenty-one studies were selected that included a total of 1293 arthroplasties. The most common indication was fractures, while the prosthesis most frequently used was the Delta Xtend (ODEP 10A). The most common complication was scapular notching. Prosthesis revision rate was approximately 6% for follow-ups between 12 and 79 months. In addition, significant improvements were observed in the Constant-Murley test score after the intervention. Currently in Spain, shoulder arthroplasty can be considered a safe and effective procedure with functional recovery and pain reduction for eligible patients with humeral fracture, rotator cuff arthropathy, fracture sequelae and malunion of the proximal humerus, and degenerative disease. Future longitudinal research and population-based studies could serve to confirm these results and identify points of improvement.

Cost and Mortality Analysis of an Intermediate Respiratory Care Unit. Is It Really Efficient and Safe? / Análisis de costes y mortalidad de una unidad de cuidados intermedios respiratorios. ¿Es realmente eficiente y segura?

INTRODUCTION: Historically, it has been assumed that Intermediate Respiratory Care Units (IRCU) were efficient, because they saved costs by reducing the number of admissions to intensive care units (ICU), and effective, because they specialized in respiratory diseases. METHODS: The number of IRCU admissions and mortality rate, historically and in 2016, were evaluated. For 2016, the grouped Related Diagnostic Groups (DRGs) were also described, and the savings achieved under all budgetary headings by avoiding UCI stays were calculated. A multivariate analysis was performed to associate costs with mean weights and complexity, and multiple logistic regression was performed on all patients admitted from 2004 to 2017 to describe the variables associated with mortality in our unit. RESULTS: An IRCU generates savings of €500,000/year by reducing length of ICU stay. Analysis of the 2016 cohort shows that costs correlate with mean weight and mortality, and consequently complexity. The multivariate logistic regression analysis of the 2004-2017 cohort found respiratory frequency, leukopenia, anemia, hyperkalemia, and acidosis to be the variables best associated with mortality. The area under the curve for the logistic model was 0.75. CONCLUSION: The IRCU analyzed in our study was efficient in terms of 'avoided costs' and savings associated with complexity. Our results suggest that IRCUs have a lower mortality rate than other similar units, and are therefore a safe environment for patients.