Delaying carbon dioxide removal in the European Union puts climate targets at risk.

Carbon dioxide removal (CDR) will be essential to meet the climate targets, so enabling its deployment at the right time will be decisive. Here, we investigate the still poorly understood implications of delaying CDR actions, focusing on integrating direct air capture and bioenergy with carbon capture and storage (DACCS and BECCS) into the European Union power mix. Under an indicative target of -50 Gt of net CO2 by 2100, delayed CDR would cost an extra of 0.12-0.19 trillion EUR per year of inaction. Moreover, postponing CDR beyond mid-century would substantially reduce the removal potential to almost half (-35.60 Gt CO2) due to the underused biomass and land resources and the maximum technology diffusion speed. The effective design of BECCS and DACCS systems calls for long-term planning starting from now and aligned with the evolving power systems. Our quantitative analysis of the consequences of inaction on CDR-with climate targets at risk and fair CDR contributions at stake-should help to break the current impasse and incentivize early actions worldwide.

Fondaparinux versus enoxaparin in the contemporary management of non-ST-elevation acute coronary syndromes. Insights from a multicenter registry.

BACKGROUND: Fondaparinux is thought to have the most favorable risk-benefit profile among all anticoagulants in non-ST-elevation acute coronary syndrome (NSTE-ACS). However, conflicting findings exist whether this holds true in current clinical practice. We aimed to assess the net clinical benefit of fondaparinux versus enoxaparin in the contemporary management of NSTE-ACS. METHODS: Analysis of prospective multicenter registry data of NSTE-ACS patients who received fondaparinux or enoxaparin from February 2015, through December 2017. Survival models within a competing risks framework including site-specific random effects, were used to assess the composite of clinically relevant bleedings and major adverse cardiovascular events at 30 days. RESULTS: Of 2094 patients, 1724 (82%) received enoxaparin and 370 (18%) fondaparinux. Both groups were comparable except for a lower prevalence of diabetes and renal impairment, and greater use of transradial approach in the fondaparinux group. Multivariate analysis revealed a net clinical benefit in favour of fondaparinux versus enoxaparin (Subhazard Ratio [SHR] 0.59; 95%CI 0.37-0.92), mainly driven by a reduction in bleeding (SHR 0.57; 95%CI 0.37-0.89). Exploratory analysis suggested greater reductions in bleeding with fondaparinux among patients undergoing transradial approach, revealing a significant interaction between treatment and vascular access on the multiplicative scale (Pinteraction = 0.0056), but not on an additive scale (P = 0.457). Propensity-score-matching analysis yielded similar results. CONCLUSIONS: In contemporary management of NSTE-ACS, fondaparinux seems to provide a favorable net clinical benefit compared with enoxaparin, primarily driven by a bleeding reduction. Effect modification on the safety profile of fondaparinux by the vascular access approach warrants further investigation.

A generalized disjunctive programming framework for the optimal synthesis and analysis of processes for ethanol production from corn stover.

The aim of this study is to analyze the techno-economic performance of process configurations for ethanol production involving solid-liquid separators and reactors in the saccharification and fermentation stage, a family of process configurations where few alternatives have been proposed. Since including these process alternatives creates a large number of possible process configurations, a framework for process synthesis and optimization is proposed. This approach is supported on kinetic models fed with experimental data and a plant-wide techno-economic model. Among 150 process configurations, 40 show an improved MESP compared to a well-documented base case (BC), almost all include solid separators and some show energy retrieved in products 32% higher compared to the BC. Moreover, 16 of them also show a lower capital investment per unit of ethanol produced per year. Several of the process configurations found in this work have not been reported in the literature.

Adecuación a la dieta mediterránea y actividad física en adolescentes de Canarias / Adequacy to mediterranean diet and physical activity in canarian teenagers

El objetivo de este estudio es describir el nivel de adecuación a la dieta mediterránea y su asociación con los niveles de práctica de actividad física en la población adolescente de la Comunidad de Canarias. Se seleccionó una muestra representativa de los estudiantes de ESO (Educación Secundaria Obligatoria) de las escuelas públicas de la Comunidad de Canarias (413 chicos y 387 chicas). La adecuación a la dieta mediterránea se midió con el cuestionario KIDMED y los niveles de práctica de actividad física se obtuvieron mediante el empleo del cuestionario “PACE Adolescent Physical Activity Measure”, recodificando la variable práctica de actividad física en dos grupos, los que cumplían y no cumplían las recomendaciones de práctica de actividad física tanto de intensidad moderada como vigorosa. Un 22,3% de los sujetos estudiados presentaron una dieta de muy baja calidad, un 52,9% un patrón que puede mejorar y un 24,9% una dieta mediterránea óptima. Así como la existencia de una asociación positiva con los niveles de práctica de actividad física. En conclusión, los sujetos estudiados presentaron unos datos nutricionales peores que los de hace diez años para población adolescente nacional y de las comunidades del centro y norte del territorio español. Con un elevado porcentaje de adolescentes (18,8%) que no desayunan. Los adolescentes que realizaban mayores niveles de práctica de actividad física tanto de intensidad moderada como vigorosa, mostraron una mayor adherencia al patrón alimentario que se asocia a la recomendación de dieta mediterránea óptima (AU)

The aim of the study was to describe the adequacy to Mediterranean diet and his association with the levels of practice of physical activity of the adolescent population of Canary Island Community. A representative sample of Canary Island Community secondary public school students (ESO), (413 boys and 387 girls) participated in the study. The adequacy to Mediterranean diet was measured with the KIDMED questionnaire and the levels of practice of physical activity was measured with the “PACE Adolescent Physical Activity Measure”, re-codifying the practical variable of physical activity in two groups, which were fulfilling and fulfilling the recommendations of practice of physical activity so much of intensity moderated like vigorous. A 22.3% of the subjects presented a very low quality diet, a 52.9% a diet that should improve and a 24.9% presented an optimal Mediterranean diet. As well as the existence of a positive association with the levels of practice of physical activity. In conclusion, the studied subjects presented a few nutritional information make a speech that those of ten years ago for teen national population and of the communities of the center and north of the Spanish territory. With a high percentage of teenagers (18,8%) they have not breakfast. And that the teenagers who realized major levels of practice of physical activity so much of intensity moderated like vigorous, showed a major adherence to the food boss who associates to the recommendation of Mediterranean ideal Diet (AU)

Primary frontal hyperhidrosis successfully treated with low doses of botulinum toxin A as a useful alternative to surgical treatment.

Frontal hyperhidrosis appears to be a special and rare form of focal hyperhidrosis. These patients may suffer greatly from the condition so an efficient treatment is highly demanded. Surgical treatment may solve this problem permanently, but the possibility of serious complications and low satisfactory results makes it less advisable than in other types of hyperhidrosis where surgery has shown great benefits. We report a case of primary frontal hyperhidrosis in a young man who refused surgery and was treated with low doses of botulinum toxin type A injected into the forehead. The patient noted a high level of satisfaction, with the abolishment of sweating and a long effect that was maintained for up to 10 months without any complications. In conclusion, we consider that low doses of botulinum toxin A is a well tolerated, safe and very effective treatment for primary frontal hyperhidrosis and it should be offered as an alternative to patients who suffer from this disorder.

Severe compensatory hyperhidrosis following thoracic sympathectomy successfully treated with low doses of botulinum toxin A.

Compensatory hyperhidrosis is an adverse effect of thoracic sympathectomy that can be debilitating, which is why an efficient treatment is demanded. Botulinum toxin is an emerging treatment, not well known yet. We report two cases of compensatory hyperhidrosis following thoracic sympathectomy which were both treated with low doses of botulinum toxin A. The patients, a male and a female, noted a high level of satisfaction with the abolishment of sweating that was maintained up to 10 months. We consider that low doses of botulinum toxin A is a well tolerated, safe and effective treatment for compensatory hyperhidrosis and should be offered as an alternative treatment.

Modificaciones técnicas del modelo de trasplante pulmonar ortotópico en ratas con donantes en muerte cerebral / Technical Modifications of the Orthotopic Lung Transplantation Model in Rats with Brain-Dead Donors

Introducción: El trasplante microquirúrgico de pulmón en ratas ha permitido adquirir nuevos conocimientos sobre el trasplante de pulmón. Sin embargo, algunos aspectos de la técnica de trasplante en humanos aún no han sido incluidos en este modelo, lo que podría interferir en la interpretación clínica y en la extrapolación de los resultados. Método: Se han realizado 20 trasplantes pulmonares izquierdos con la técnica de manguitos (cuff) incorporando algunas modificaciones técnicas como la inducción de la muerte cerebral, el control del tiempo de isquemia, la perfusión retrógrada en el donante y la reperfusión secuencial controlada del pulmón implantado en el receptor. Resultados: La supervivencia ha sido del 80%. Los pulmones trasplantados mostraron una adecuada perfusión y ventilación con buena permeabilidad de las anastomosis. Se han observado signos de isquemia-reperfusión en todos los animales, y de rechazo agudo leve en la mitad de ellos. Conclusiones: El modelo que presentamos es válido y similar al procedimiento que se realiza en humanos, lo que reduciría el número de posibles variables derivadas de la técnica quirúrgica a la hora de extrapolar los resultados a la clínica(AU)

Background: Microsurgical lung transplantation in rats has allowed us to obtain new knowledge about lung transplantation. However, some aspects in human transplantation technique still have not been included in this model, which could interfere with the clinical interpretation and extrapolation of results .Methods: Twenty left lung transplantations were performed with a cuff technique and technical modifications, such as brain death induction, the control of ischemia time and retrograde perfusion in the donor and the controlled sequential reperfusion of the implanted lung in the recipient. Results: Survival rate was 80%. The transplanted lungs showed proper perfusion and ventilation with good permeability of the anastomoses. Signs of ischemia-reperfusion injury were observed in all animals while mild acute rejection was seen in half of them. Conclusions: The model shown proves valid and is very similar to the procedure carried out in humans, which would reduce the number of possible variables derived from the surgical technique when extrapolating the study results to clinical use(AU)

Technical modifications of the orthotopic lung transplantation model in rats with brain-dead donors.

BACKGROUND: Microsurgical lung transplantation in rats has allowed us to obtain new knowledge about lung transplantation. However, some aspects in human transplantation technique still have not been included in this model, which could interfere with the clinical interpretation and extrapolation of results. METHODS: Twenty left lung transplantations were performed with a cuff technique and technical modifications, such as brain death induction, the control of ischemia time and retrograde perfusion in the donor and the controlled sequential reperfusion of the implanted lung in the recipient. RESULTS: Survival rate was 80%. The transplanted lungs showed proper perfusion and ventilation with good permeability of the anastomoses. Signs of ischemia-reperfusion injury were observed in all animals while mild acute rejection was seen in half of them. CONCLUSIONS: The model shown proves valid and is very similar to the procedure carried out in humans, which would reduce the number of possible variables derived from the surgical technique when extrapolating the study results to clinical use.

[Assessment of ischemia-reperfusion injury and early acute rejection in experimental lung transplantation after prolonged ischemia]. / Valoración de la lesión de isquemia-reperfusión y del rechazo agudo precoz en el trasplante pulmonar experimental con tiempo de isquemia prolongado.

OBJECTIVE: To assess ischemia-reperfusion injury and early acute rejection of the lung subjected to ischemia for 10 hours. MATERIAL AND METHODS: Fifteen of 30 Sprague-Dawley rats underwent transplantation of a left lung that had been subjected to ischemic times of 4 (n=5), 6 (n=5), or 10 hours (n=5). The cardiopulmonary block was removed from the donor, the left lung was dissected, and the transplant was carried out using the cuff technique. The cardiopulmonary block was extracted after 48 hours. We assessed postoperative progress, ischemia-reperfusion injury and acute rejection of the transplanted and contralateral lungs. Statistical probabilities were analyzed using the chi2 and Fisher exact tests. RESULTS: Clinical course was not worse after an ischemic time of 10 hours (P=.711). No significant differences were observed in histological markers of ischemia-reperfusion injury and acute rejection or in clinical course in relation to the different ischemic times; nor was clinical course related to the presence or severity of lesions or rejection. Similarly, acute rejection was unrelated to ischemia-reperfusion injury (P>.05). CONCLUSIONS: In this study, a prolonged ischemic time of 10 hours was not associated with ischemia-reperfusion injuries, with more severe acute rejection, or with a worse clinical course. Acute rejection was also unrelated to the presence or severity of ischemia-reperfusion injury.

Valoración de la lesión de isquemia-reperfusión y del rechazo agudo precoz en el trasplante pulmonar experimental con tiempo de isquemia prolongado / Assessment of ischemia reperfusion injury and early acute rejection in experimental lung transplantation after prolonged ischemia

Objetivo: Valorar la lesión de isquemia-reperfusión y el rechazo agudo precoz del pulmón sometido a un tiempo de isquemia de 10 h. Material y métodos: Se han utilizado 30 ratas Sprague-Dawley, en 15 de las cuales se realizó un trasplante pulmonar izquierdo con tiempos de isquemia de 4 h (n = 5), 6 h (n = 5) y 10 h (n = 5). Del donante se extrajo el bloque cardiopulmonar, se disecó el pulmón izquierdo y se efectuó el implante con la técnica de manguitos (cuffs). A las 48 h se extrajo el bloque cardiopulmonar. Se valoraron la evolución postoperatoria, la lesión de isquemia-reperfusión y el rechazo agudo del X2 pulmón trasplantado y del contralateral. El análisis estadístico se realizó con el test de la X2 y el test exacto de Fisher para el cálculo de probabilidades. Resultados: Los animales trasplantados con un tiempo de isquemia de 10 h no tuvieron peor evolución clínica (p = 0,711). No se observaron diferencias significativas entre los parámetros histológicos de lesión de isquemia-reperfusión y de rechazo agudo con los distintos tiempos de isquemia, ni en la evolución clínica por la presencia y gravedad de éstos. Tampoco se observó que el rechazo agudo se relacionara con la lesión de isquemia-reperfusión (p > 0,05). Conclusiones: En nuestro estudio, el tiempo de isquemia pulmonar prolongado de 10 h no se asocia ni a lesiones de isquemia-reperfusión y rechazo agudo más graves ni a una peor evolución clínica. El rechazo agudo no se relaciona con la presencia ni con la gravedad de la lesión de isquemia-reperfusión

Objective: To assess ischemia­reperfusion injury and early acute rejection of the lung subjected to ischemia for 10 hours. Material and methods: Fifteen of 30 Sprague­Dawley rats underwent transplantation of a left lung that had been subjected to ischemic times of 4 (n=5), 6 (n=5), or 10 hours (n=5). The cardiopulmonary block was removed from the donor, the left lung was dissected, and the transplant was carried out using the cuff technique. The cardiopulmonary block was extracted after 48 hours. We assessed postoperative progress, ischemia­reperfusion injury and acute rejection of the transplanted and contralateral lungs. Statistical probabilities were analyzed using the X2 and Fisher exact tests. Results: Clinical course was not worse after an ischemic time of 10 hours (P=.711). No significant differences were observed in histological markers of ischemia­reperfusion injury and acute rejection or in clinical course in relation to the different ischemic times; nor was clinical course related to the presence or severity of lesions or rejection. Similarly, acute rejection was unrelated to ischemia­reperfusion injury (P>.05). Conclusions: In this study, a prolonged ischemic time of 10 hours was not associated with ischemia­reperfusion injuries, with more severe acute rejection, or with a worse clinical course. Acute rejection was also unrelated to the presence or severity of ischemia­reperfusion injury

Depresión y memoria: ¿Es la información congruente con el estado de ánimo más accesible? / Depression and memory: Is mood-congruent information more accesible?

La teoría de red semántica de la emoción y la memoria de Bower (1981) postula que el estado de ánimo depresivo incrementa la activación y accesibilidad de las cogniciones negativas previamente asociadas al estado de ánimo. Sin embargo, recientemente Teasdale y colaboradores (e.g., Teasdale y Barnard, 1993) han sugerido que los "sesgos" cognitivos asociados a los estados de ánimo depresivos serían productos de cambios a nivel de los modelos mentales utilizados por estos individuos para procedimientos mediante la utilización del paradigma clásico de congruencia. Los resultados obtenidos confirman las predicciones basadas en el modelo de la red asociativa de Bower (1981) (AU)

Bower’s (1981) associative network theory of mood and memory suggests that depressed mood selectively increases the activation or accessibility of all negative cognitions previously associated with depressed mood. However, in their Interacting Cognitive Subsystems theory, Teasdale and colleagues (e.g., Teasdale y Barnard, 1993) suggest that negative depressive thinking reflects changes, with depression, in the schematic mental models through which information is processed, rather than from changes in the accessibility of cognitive constructs. The aim of the present experiment was to explore the predictions derived from both accounts. The results obtained in this study confirm the predictions based on Bower’s(1981) associative network theory. The theoretical implications of these results are discussed (AU)