Pulmonary Thrombosis or Embolism in a Large Cohort of Hospitalized Patients With Covid-19.

Objective: We set out to analyze the incidence and predictive factors of pulmonary embolism (PE) in hospitalized patients with Covid-19. Methods: We prospectively collected data from all consecutive patients with laboratory-confirmed Covid-19 admitted to the Hospital de la Santa Creu i Sant Pau, a university hospital in Barcelona, between March 9 and April 15, 2020. Patients with suspected PE, according to standardized guidelines, underwent CT pulmonary angiography (CTPA). Results: A total of 1,275 patients with Covid-19 were admitted to hospital. CTPA was performed on 76 inpatients, and a diagnosis of PE was made in 32 (2.6% [95%CI 1.7-3.5%]). Patients with PE were older, and they exhibited lower PaO2:FiO2 ratios and higher levels of D-dimer and C-reactive protein (CRP). They more often required admission to ICU and mechanical ventilation, and they often had longer hospital stays, although in-hospital mortality was no greater than in patients without PE. High CRP and D-dimer levels at admission (≥150 mg/L and ≥1,000 ng/ml, respectively) and a peak D-dimer ≥6,000 ng/ml during hospital stay were independent factors associated with PE. Prophylactic low molecular weight heparin did not appear to prevent PE. Increased CRP levels correlated with increased D-dimer levels and both correlated with a lower PaO2:FiO2. Conclusions: The 2.6% incidence of PE in Covid-19 hospitalized patients is clearly high. Higher doses of thromboprophylaxis may be required to prevent PE, particularly in patients at increased risk, such as those with high levels of CRP and D-dimer at admission. These findings should be validated in future studies.

Scaling-Up of Bio-Oil Upgrading during Biomass Pyrolysis over ZrO2 /ZSM-5-Attapulgite.

Ex situ catalytic biomass pyrolysis was investigated at both laboratory and bench scale by using a zeolite ZSM-5-based catalyst for selectively upgrading the bio-oil vapors. The catalyst consisted of nanocrystalline ZSM-5, modified by incorporation of ZrO2 and agglomerated with attapulgite (ZrO2 /n-ZSM-5-ATP). Characterization of this material by means of different techniques, including CO2 and NH3 temperature-programmed desorption (TPD), NMR spectroscopy, UV/Vis microspectroscopy, and fluorescence microscopy, showed that it possessed the right combination of accessibility and acid-base properties for promoting the conversion of the bulky molecules formed by lignocellulose pyrolysis and their subsequent deoxygenation to upgraded liquid organic fractions (bio-oil). The results obtained at the laboratory scale by varying the catalyst-to-biomass ratio (C/B) indicated that the ZrO2 /n-ZSM-5-ATP catalyst was more efficient for bio-oil deoxygenation than the parent zeolite n-ZSM-5, producing upgraded bio-oils with better combinations of mass and energy yields with respect to the oxygen content. The excellent performance of the ZrO2 /n-ZSM-5-ATP system was confirmed by working with a continuous bench-scale plant. The scale-up of the process, even with different raw biomasses as the feedstock, reaction conditions, and operation modes, was in line with the laboratory-scale results, leading to deoxygenation degrees of approximately 60 % with energy yields of approximately 70 % with respect to those of the thermal bio-oil.

Conductas de ciberadicción y experiencias de cyberbullying entre adolescentes / Online addiction behaviors and cyberbullying among adolescents

La relación de los jóvenes con las tecnologías plantea diversos riesgos como la ciberadicción y el cyberbullying. Este estudio analiza el consumo que una muestra de adolescentes hace del móvil y del ordenador, de conductas de ciberadicción, y de bullying y cyberbullying, teniendo en cuenta su relación con el sexo y el nivel educativo. También se relaciona el consumo con la supervisión familiar durante la conexión a la red. Se aplicó un cuestionario autoinformado a 1353 adolescentes escolares de Educación Secundaria y Bachillerato, de un rango de edad de 12-21 años (M = 14.8; DT = 1.62; 52.8% varones). Los resultados indican que el consumo medio del móvil y del ordenador se encuentra entre 1-2 horas al día. Casi un 13% se encuentra en situación de ciberadicción y el 32% en situación de riesgo. Se aprecian diferencias por sexo y nivel educativo. Se constata un mayor nivel de incidencia del bullying (12%) frente al cyberbullying (7.7%), así como una considerable asociación entre estas conductas y el consumo de medios. La supervisión familiar actúa como factor de protección. Estos resultados plantean la necesidad de alentar a adolescentes y educadores sobre la importancia de educar en los riesgos del abuso de las tecnologías

The relationship between young people and technologies implies some risks like online addiction and cyberbullying. This study analyses the use of mobile phones and computers in a sample of adolescents, their online addiction behaviours, and bullying and cyberbullying experiences considering the influence of gender and school level. Parental control during Internet use is also considered. Using a self-report questionnaire, 1353 secondary and high school adolescents between 12-21 years-old participated (M = 14.8; SD = 1.62; 52.8% boys). Results show an average of 1-2 hours daily use of mobile phone and computers. Around 13% of students report online addictions behaviors and 32% are in risk of, with differences by gender and school level. Results indicate more involvement in traditional bullying (12%) than in cyberbullying (7.7%), and a significant association between both behaviors and technologies use. Besides, parental mediation acts as protective factor. In conclusion, this study underlines the need to teach young people and educators about risks regarding excessive use of technolog

Clinical validation of dysfunctional ventilatory weaning response: The Spanish experience.

PURPOSE: To validate dysfunctional ventilatory weaning response (DVWR). METHODS: Descriptive, longitudinal, and prospective study of 80 patients from three different university hospitals in Spain. FINDINGS: Twenty defining characteristics were associated with DVWR; eight factors from the NANDA model and four non-NANDA factors were associated with the diagnosis. Adventitious breath sounds, decreased air entry on auscultation, anxiety, and adverse environment resulted as predictive variables of dysfunctional response. CONCLUSIONS: The incidence of DVWR is high, although clinical nurses do not always recognize it. DVWR has different manifestations and associated factors along the course of the weaning stage, but anxiety is associated with DVWR across the time continuum. PRACTICE IMPLICATIONS: Validation of DVWR for use in nursing clinical practice is supported. Early detection of predictive variables could help to identify DVWR and facilitate the diagnosis in the clinical practice.