Accounting for the annual variability when assessing non-point source pollution potential in Mediterranean regulated watersheds.

The characterization of non-point source pollution at the watershed scale difficult owing to its distributed nature combined with the lack of suitable measurements for validation. This study proposes the classification of land within a Mediterranean watershed according to its potential source of non-point pollution, considering interannual precipitation variability and dam regulation effects. For this purpose, the potential non-point pollution index (PNPI) developed by the Italian Environmental Protection Agency was modified to include annual local precipitation behavior, named local annual PNPI (APNPI). PNPI and APNPI were computed for the Guadalquivir River (Spain), which has a drainage surface of 57,500 km2 and is highly regulated by >60 reservoirs. The results reflect the vulnerability along the Guadalquivir River in terms of the spatially variable non-point pollutant nature of its contributing watersheds. The annual average nitrate concentration values on the southern side exceeded the average value on the northern side by almost five times and showed a statistically significant power fit with the PNPI, with an R2 of 0.65. Long-term available nitrate data (1981/82-2006/07) on a monthly scale at the outlets of some watersheds allowed us to rank priority pollutant source areas within the watershed. The power fits between the annual average nitrate loads and the APNPI (R2 = 0.51-0.99) were statistically significant, which validated the utility of adding the variability of precipitation at an annual scale as a dynamic factor in the index. The APNPI can constitute a simple dynamic classification index for assessing the relative risk of non-point source pollution across a large area, especially in data-scarce situations.

In vitro assessment of the combined effect of letermovir and sirolimus on cytomegalovirus replication.

OBJECTIVE: Letermovir (LMV) is used for prophylaxis of cytomegalovirus (CMV) reactivation and end-organ disease in adult CMV-seropositive allogeneic hematopoietic stem cell transplant recipients (allo-HSCT). In turn, sirolimus (SLM) which displays in vitro anti-CMV activity, is frequently employed for prophylaxis of Graft vs. Host disease in allo-HSCT. Here, we aimed at assessing whether LMV and SLM used in combination may act synergistically in vitro on inhibiting CMV replication. METHODS: The antiviral activity of LMV and SLM alone or in combination was evaluated by a checkerboard assay, using ARPE-19 cells infected with CMV strain BADrUL131-Y. LMV and SLM were used at concentrations ranging from 24 nM to 0.38 nM and 16 nM to 0.06 nM, respectively. RESULTS: The mean EC50 for LMV and SLM was 2.44 nM (95% CI, 1.66-3.60) and 1.40 nM (95% CI, 0.41-4.74), respective. LMV and SLM interaction yielded mainly additive effects over the range of concentrations tested. CONCLUSIONS: The additive nature of the combination of LMV and SLM against CMV may have relevant clinical implications in management of CMV infection in allo-HSCT recipients undergoing prophylaxis with LMV.

Inference for a discretized stochastic logistic differential equation and its application to biological growth.

In this paper, we present a method to adjust a stochastic logistic differential equation (SLDE) to a set of highly sparse real data. We assume that the SLDE have two unknown parameters to be estimated. We calculate the Maximum Likelihood Estimator (MLE) to estimate the intrinsic growth rate. We prove that the MLE is strongly consistent and asymptotically normal. For estimating the diffusion parameter, the quadratic variation of the data is used. We validate our method with several types of simulated data. For more realistic cases in which we observe discretizations of the solution, we use diffusion bridges and the stochastic expectation-maximization algorithm to estimate the parameters. Furthermore, when we observe only one point for each path for a given number of trajectories we were still able to estimate the parameters of the SLDE. As far as we know, this is the first attempt to fit stochastic differential equations (SDEs) to these types of data. Finally, we apply our method to real data coming from fishery. The proposed adjustment method can be applied to other examples of SDEs and is highly applicable in several areas of science, especially in situations of sparse data.

Simultaneous determination of 210Pb and 90Sr and 210Po isolation in sludge samples using a plastic scintillation resin.

This study describes a new and fast method for separating 210Po from 210Pb and 90Sr, before simultaneously measuring the individual activities of the latter two radionuclides using a plastic scintillation resin (PSresin) in sludge samples taken from a drinking water treatment plant. This method speeds up the analysis process significantly by simultaneously measuring 210Pb and 90Sr in a single step. The method is reproducible and has a relative standard deviation of less than 25% for 210Pb, 210Po and 90Sr. The method was satisfactorily validated with an intercomparison sample and applied to sludge samples from a drinking water treatment plant. The minimum detectable activities for 0.9 g of sludge are 5.5 Bq/kg and 8 Bq/kg for 210Pb and 90Sr respectively when measured for 180 min, and 0.5 Bq/kg for 210Po when measured for 5000 min.

The Lights and the Shadows of Controlled Sting Challenge With Hymenoptera.

Hymenoptera venom immunotherapy (VIT) is effective for protecting individuals with systemic allergic reactions caused by Hymenoptera stings. The need for a tool that shows the degree of protection afforded by VIT and the lack of useful biomarkers have made the sting challenge test (SCT) the gold standard for this disorder, although its use has both lights and shadows. SCT with Hymenoptera involves causing a real sting in a patient diagnosed with allergy to the venom of the stinging insect and who is undergoing treatment with specific immunotherapy. In Spain, SCT is included in the list of services offered by some hospitals and forms part of their daily clinical practice. This review aims to analyze the strengths and weaknesses of this test and to describe the standardized procedure and necessary resources, based on the experience of a group of Spanish experts and a review of the literature.

Response to azacitidine in patients with chronic myelomonocytic leukemia according to overlap myelodysplastic/myeloproliferative neoplasms criteria.

BACKGROUND: Azacitidine (AZA) is approved for the treatment of high-risk chronic myelomonocytic leukemia (CMML) of myelodysplastic (MD) subtype. Data of response rates using the specific response criteria for this disease are scarce. The aim of this study was to evaluate the response to AZA in patients diagnosed with CMML from the Spanish Registry of Myelodysplastic Syndromes (MDS) applying the overlap myelodysplastic/myeloproliferative neoplasms (MDS/MPN) response criteria. METHODS: We retrospectively studied 91 patients with CMML treated with at least one cycle of AZA from the Spanish Registry of MDS. As it was a real-world study, the response rate was evaluated between cycle 4 and 6, applying the MDS/MPN response criteria FINDINGS: The overall response rate at cycle 4-6 was 58%. Almost half of the patients achieved transfusion independence and one quarter showed clinical benefit, regardless of the CMML French-American-British (FAB) and World Health Organization (WHO) subtypes and CMML Specific Prognosis Scoring (CPSS) risk groups. Toxicity was higher in the MD-CMML subtype. INTERPRETATION: In our series, most CMML patients achieved an overall response rate with AZA according to the overlap-MDS/MPN response criteria regardless of the CMML FAB and WHO subtypes and CPSS risk groups. Thus, AZA may also be a treatment option for patients with the myeloproliferative CMML subtype and those with a lower-risk CPSS, but symptomatic.

Helios-Negative Regulatory T Cells as a Key Factor of Immune Tolerance in Nonallergic Beekeepers.

BACKGROUND AND OBJECTIVES: Although exposure to stings has been identified as the leading risk factor for anaphylaxis due to Hymenoptera venom allergy, professional beekeepers receive hundreds of stings yearly without developing systemic reactions. This study aims to analyze the mechanisms underlying bee venom tolerance in beekeepers. METHODS: A cross-sectional study was conducted. Participants were recruited and classified into 3 groups: allergic patients (APs), who experienced systemic reactions after bee stings, with a positive intradermal test and specific IgE (sIgE) to Apis mellifera venom (AmV); tolerant beekeepers (TBKs), who received ≥50 stings/year; and healthy nonexposed controls (HCs). We measured serum levels of sIgE and specific IgG4 (sIgG4) to AmV, rApi m 1, rApi m 2, rApi m 3, Api m 4, rApi m 5, and rApi m10, as well as AmV-induced basophil degranulation, percentage of T-cell subsets, regulatory T cells (Treg), and IL-10 production. RESULTS: Compared with TBKs, APs had high levels of sIgE to AmV and all its allergic components (P<.001), together with a high basophil activation rate (P<.001). Conversely, compared with APs, TBKs had higher levels of sIgG4 (P<.001) and IL-10 (P<.0001), as well as an enhanced CTLA-4+ Treg population (P=.001), expanded Helios- Treg (P<.003), and reduced type 1 helper T cells (TH1) (P=.008), TH2 (P=.004), and TH17 (P=.007) subsets. CONCLUSIONS: The profile of TBKs, which was strongly marked by Treg activity, differed from that of TBKs. This natural tolerance would be led by the expansion of inducible Helios- Treg cells at the peripheral level. The Helios- Treg population could be a novel candidate biomarker for monitoring tolerance.

The Lights and the Shadows of Controlled Sting Challenge With Hymenoptera

Hymenoptera venom immunotherapy (VIT) is effective for protecting individuals with systemic allergic reactions caused by Hymenopterastings. The need for a tool that shows the degree of protection afforded by VIT and the lack of useful biomarkers have made the stingchallenge test (SCT) the gold standard for this disorder, although its use has both lights and shadows. SCT with Hymenoptera involvescausing a real sting in a patient diagnosed with allergy to the venom of the stinging insect and who is undergoing treatment with specificimmunotherapy. In Spain, SCT is included in the list of services offered by some hospitals and forms part of their daily clinical practice. Thisreview aims to analyze the strengths and weaknesses of this test and to describe the standardized procedure and necessary resources,based on the experience of a group of Spanish experts and a review of the literature. (AU)

La inmunoterapia con veneno de himenóptero (ITV) es un tratamiento que se ha mostrado eficaz en la protección de sujetos con reaccionesalérgicas sistémicas por picaduras de himenópteros. La necesidad de una herramienta que demuestre el grado de protección proporcionadapor la ITV, y la ausencia de biomarcadores útiles, convierte a la Prueba de Provocación con Repicadura (PPR) en el gold standard en estapatología, con sus luces y sus sombras. La PPR con himenópteros es una prueba que consiste en provocar una picadura real, a un pacienteque ha sido diagnosticado de alergia al veneno del insecto picador y habitualmente está en tratamiento con inmunoterapia específica.En España, la PPR se incluye en la cartera de servicios de algunos hospitales, formando parte de su práctica clínica habitual. Esta revisióntrata de analizar las fortalezas y debilidades de esta prueba, integrando el procedimiento estandarizado y recursos necesarios, basándoseen la experiencia de un grupo de expertos españoles y en la revisión de la literatura. (AU)

Helios-Negative Regulatory T Cells as a Key Factor of Immune Tolerance in Nonallergic Beekeepers

Background: Although exposure to stings has been identified as the leading risk factor for anaphylaxis due to Hymenoptera venom allergy, professional beekeepers receive hundreds of stings yearly without developing systemic reactions. Objective: This study aims to analyze the mechanisms underlying bee venom tolerance in beekeepers. Methods: A cross-sectional study was conducted. Participants were recruited and classified into 3 groups: allergic patients (APs), who experienced systemic reactions after bee stings, with a positive intradermal test and specific IgE (sIgE) to Apis mellifera venom (AmV); tolerant beekeepers (TBKs), who received ≥50 stings/year; and healthy nonexposed controls (HCs). We measured serum levels of sIgE and specific IgG4 (sIgG4) to AmV, rApi m 1, rApi m 2, rApi m 3, Api m 4, rApi m 5, and rApi m10, as well as AmV-induced basophil degranulation, percentage of T-cell subsets, regulatory T cells (Treg), and IL-10 production. Results: Compared with TBKs, APs had high levels of sIgE to AmV and all its allergic components (P<.001), together with a high basophil activation rate (P<.001). Conversely, compared with APs, TBKs had higher levels of sIgG4 (P<.001) and IL-10 (P<.0001), as well as an enhanced CTLA-4+ Treg population (P=.001), expanded Helios– Treg (P<.003), and reduced type 1 helper T cells (TH1) (P=.008), TH2 (P=.004), and TH17 (P=.007) subsets. Conclusions: The profile of TBKs, which was strongly marked by Treg activity, differed from that of TBKs. This natural tolerance would be led by the expansion of inducible Helios– Treg cells at the peripheral level. The Helios– Treg population could be a novel candidate biomarker for monitoring tolerance (AU)

Impacto en el patrón de atención en cirugía de cabeza y cuello y las medidas sanitarias adoptadas durante los primeros 150 días de la era COVID-19 / Impact on the pattern of care in Head and Neck Surgery and the regional and institutional policy changes adopted during the first 150 days of the COVID-19 era

Resumen Introducción: La pandemia COVID-19 generó una reestructuración en la atención quirúrgica mundialmente debido a su alta transmisibilidad y la inherente limitación de los recursos humanos y materiales disponibles. Objetivo: Describir el impacto de la pandemia COVID-19 en el Equipo de Cirugía Cabeza y Cuello del Complejo Asistencial Barros Luco Trudeau (CABL) en su ejecución clínico-quirúrgica y la secuenciación organizada de las medidas sanitarias aplicadas a lo largo del tiempo durante los primeros 150 días de iniciada la pandemia en Chile. Materiales y Método: Realizamos una revisión retrospectiva de los pacientes sometidos a cirugía y/o evaluados ambulatoriamente durante el período COVID-19 comprendido entre el 3 de marzo y el 31 de julio de 2020, comparado con el mismo intervalo de tiempo de 2019. Características clínicas y medidas sanitarias empleadas durante este período fueron sintetizadas. Resultados: Detectamos un descenso del 64% en atención ambulatoria y un descenso del 58% en la carga quirúrgica, comparado con el año 2019. Durante el período COVID-19 de 2020, un total de 61 pacientes fueron sometidos a intervención quirúrgica. La principal indicación de cirugía fue cáncer en un 75,4% (46). No se reportaron pacientes contagiados por COVID-19 en los 14 días siguientes a la hospitalización. Se discuten las consideraciones perioperatorias empleadas y restricciones nacionales/institucionales sanitarias. Conclusión: La crisis sanitaria mundial secundaria al COVID-19 generó una reducción en las atenciones ambulatorias y cirugías realizadas por Equipo de Cabeza y Cuello CABL. A pesar de las restricciones sanitarias, organizamos estratificadamente la atención para preservar la resolución de casos críticos no diferibles en cabeza y cuello.

Introduction: The COVID-19 pandemic generated a restructuring of surgical care worldwide due to the disease's high transmissibility and the inherent limitation of available human and material resources. Aim: The study's aim was to describe the impact of the COVID-19 pandemic on the head and neck surgery team at Complejo Asistencial Barros Luco Trudeau (CABL) in clinical-surgical execution and organization of sanitary sequencing measures implemented over time during the first 150 days after the pandemic started in Chile. Materials and Method: We performed a retrospective review of patients undergoing surgery or outpatient evaluation during the COVID-19 period from 03-03-2020 to 07-31-2020, compared to the same time interval in 2019. Clinical characteristics and sanitary measures used during this period were synthesized. Results: We detected a 64% decrease in outpatient care and a 58% decrease in surgical load from 2019. During the COVID-19 period of 2020, a total of 61 patients underwent surgical intervention. The main indication for surgery was cancer, in 75.4% of patients (46). COVID-19 was not reported in any patients in the 14 days following hospitalization. We discussed the perioperative considerations used and the national/institutional sanitary restrictions. Conclusions: The global health crisis to COVID-19 generated a reduction in outpatient care and surgeries performed by the CABL head and neck team. Despite health restrictions, we organized care stratified to preserve critical head and neck non-deferrable cases.

Photoacoustic characterization of wheat bread mixed with Moringa oleifera.

Photoacoustic spectroscopy is applied to evaluate the impact of Moringa at different concentrations (0, 1.25, 2.5, 5 and 10%) on the elaboration, sanity, texture, and color of wheat bread. It was found that: i) Photoacoustic signal amplitude values of bread significantly increase from 37 to 90% when moringa powder concentration raises from 1.25% to 10%, at 300 nm wavelength. ii) Comparing the photoacoustic signal values at 300, 330, and 370 nm wavelengths, produced by the different bread types, there were statistically significant differences. iii) The sanitary quality of bread mixed with a 2.5% of moringa is relatively higher than the ones obtained for other concentrations, such that the number of fungal colonies were reduced by 99% in comparison with the control bread without moringa, after six days of storage. Moringa at 2.5% of concentration could thus improve the sanitary quality of wheat bread. iv) The addition of moringa for making bread slows down its textural changes (hardness, elasticity, cohesiveness, resilience, and chewiness) during storage. v) Finally, the highest correlation between the photoacoustic amplitude and the moringa concentration occurs at the wavelengths of 300 and 330 nm, which could be related to significant changes in the content of flavonoids and phenolic acids.

[Hip fracture in the elderly: epidemiology and costs of care]. / Fractura de cadera en el adulto mayor: epidemiología y costos de la atención.

INTRODUCTION: The aim of this study was to describe the epidemiology and to estimate the direct medical costs of hip fracture among elderly patients in Mexico. MATERIAL AND METHODS: An observational, cross sectional and retrospective study was undertaken. Hospital discharge and surgical procedures for the period 2013-2018 were the databases used for the analysis, and obtained from General Directorate of Health Information. Variables included were sex, federal entity, age, year of discharge, and fracture type according to the CIE-10; and also, the supplies needed for the surgical procedures. RESULTS: A total of 16,829 patients with hip fracture were discharge, 69% were women, and the mean for age was 79 years old and for the hospital stay length was nine days. The most frequent fracture type was the femur neck with 77% and the average medical costs was USD$45,122,228.00. CONCLUSION: Falling risks increase with age, especially in patients among 80-89 years of age, hence, is expected that this type of pathology increases in the following years. The medical costs for treatment of hip fracture represents an economic impact on health services. For that reason, the implementation of prevention strategies, risk of falling for example, is the one of most efficient approach.

INTRODUCCIÓN: El objetivo general de la investigación fue describir la epidemiología y estimar los costos médicos directos de la fractura de cadera en el adulto mayor en México. MATERIAL Y MÉTODOS: Se realizó un estudio observacional y transversal retrospectivo. Se utilizaron dos bases de datos obtenidas de la Dirección General de Información en Salud del período 2013-2018: egresos hospitalarios y procedimientos quirúrgicos. Las variables incluidas fueron: sexo, entidad federativa, edad, año de registro y tipo de fractura de acorde a la CIE-10; de igual forma, todos los insumos necesarios para la realización del procedimiento quirúrgico. RESULTADOS: Se registraron 16,829 ingresos de pacientes con fractura de cadera. Las mujeres representaron 69% del total de pacientes, la edad en promedio fue de 79 años y la estancia hospitalaria fue de nueve días, 77% de las fracturas fueron de cuello de fémur y el promedio de los costos médicos directos de los procedimientos ascendieron a USD $45,122,228.00 para el período estudiado. CONCLUSIÓN: El riesgo de caídas aumenta con la edad, especialmente en el grupo etario de 80-89 años, por lo que se espera que este tipo de patologías se incremente en los próximos años. De igual forma, los costos para la atención de estas fracturas representan un impacto económico para los sistemas de salud. De manera que la implementación de estrategias de prevención, por ejemplo, en caídas es el método más eficiente para contribuir al envejecimiento saludable.

Influence of high power ultrasound on natural microflora, pathogen and lactic acid bacteria in a raw meat emulsion.

Raw meat emulsions may have natural, spoilage and pathogenic microorganisms due to the origin and characteristics of this food matrix. All of these microorganisms must be minimized during industrial processing to make food consumption safe and meet quality regulations. Therefore, in this research, the effect of probe ultrasound on the inactivation of three kinds of microorganisms in a raw meat emulsion is evaluated. The microorganisms are: natural microflora NAM, Listeria monocytogenes LIS, and Lactobacillus delbrueckii LAC. A high-intensity probe ultrasound system was used, during 1.0, 2.5, 5.0, 7.5 and 10 min, with pulsed waves of 0.0, 10, 20 and 30 seg, and 200, 250, 300, 350 and 400 W of power. The interrelation between time, wave pulse cycle, and power factors was assessed. The results showed a positive linear independence effect in the treatments without wave pulse for each microorganism, and a quadratic interaction with the time and the ultrasound power for the inactivation of the three kinds of microorganisms. Besides, the desirability function for the inactivation reached up to 60% of the microbial population with the probe ultrasound treatment, with 10 min, a 7.56 s wave pulse and 400 W of power. Thus, these results could be useful to decide the incorporation of mild and emerging technologies in a meat industry line process.

Seroepidemiological evidence for Taenia solium taeniasis/cysticercosis in three Venezuelan rural communities.

Taenia solium is the most common parasite infection of the brain, causing neurocysticercosis and typically found in rural communities with free-ranging pigs. Identification of transmission in rural areas is essential for its control. Risk factors and transmission of the parasite were evaluated in three rural Venezuelan communities (Valle del Rio and Potrero Largo, Cojedes state; and Palmarito, Portuguesa state) by a questionnaire (112 households) and coprological (492 samples) and serological (433 human and 230 porcine sera) analysis, respectively. Typical risk factors were found in all three communities: free-foraging pig husbandry, deficient sanitary conditions, high open defecation and ignorance of the parasite life cycle. Coprological examinations revealed a high level of soil-transmitted parasites. Importantly, two T. solium adult worm carriers were identified in each of the three communities. Anti-metacestode antibodies and the HP10 secreted metacestode glycoprotein were detected at significant levels in human and porcine sera in Valle del Rio, Potrero Largo and Palmarito. In conclusion, these communities may be considered to be endemic for taeniasis/cysticercosis, and the instigation of an appropriate control programme is recommended.

Determination of the Dependence of Thermal Diffusivity with Moringa Concentration by Thermal Lens as a Sensitive Experimental Technique.

The use of photothermal techniques has become of special importance due to their versatile application in the thermal characterization of materials. Therefore, the thermal lens technique in the mismatched dual-beam mode is an alternative, sensitive and non-evasive tool that was used in this research to determine the thermal diffusivity of Moringa oleifera. The dual arrangement of the thermal lens technique is based on the use of an Ar+Xe excitation laser (422 nm) and a He-Ne laser (632 nm) test laser. Moringa solutions were prepared by green synthesis with different concentrations ranging from 1.56 mg·mL-1, 3.12 mg·mL-1, 6.25 mg·mL-1 to 12.50 mg·mL-1. Different optical techniques (UV-vis, FTIR, XPS and EDS) were used to characterize the Moringa leaf powders. Results showed that the increase of thermal diffusivity could be related to the presence of functional groups and metallic elements in Moringa elemental composition. In this work, it was found that the thermal diffusivity of Moringa increases with increasing concentration. This study will be useful for application in heat transport and drug release.

Enzymatic Biotransformation of Pomegranate Ellagitannins: Initial Approach to Reaction Conditions.

BACKGROUND: Ellagitannase (Ellagitannin acyl hydrolase) is an inducible enzyme with great potential use in food industry since allows the ellagic acid release from ellagitannins. OBJECTIVE: In this work, ellagitannase was produced by the fungus Aspergillus niger GH1 in solid state fermentation using polyurethane foam as solid support and pomegranate husk ellagitannins as sole carbon source and ellagitannase inducer and an initial approach to the enzymatic reaction conditions was reached. MATERIALS AND METHODS: Ellagitannase was produced by Aspergillus niger GH1 in solid state fermentation and the ideal reaction conditions for ellagitannase activity based on ellagic acid quantification as ellagitannins biotransformation product by high performance liquid chromatographic are reported. RESULTS: The enzyme ideal reaction conditions were substrate concentration of 1 mg.mL-1, 60 °C and pH 5.0, during 10 min of reaction. The kinetic enzyme constants (V max = 30.34 mM.mL-1.min-1 and K m = 1.48 x 103 mM) using punicalagin assubstrate were determined. CONCLUSION: The assay was completed in a short time and may find application in future studies of ellagic acid production.