Artificial intelligence application in adsorption of uremic toxins: Towards the eco-friendly design of highly efficient with potential applications as hemodialysis membranes.

Six Functionalized Activated Carbon Cloths (FACCs) were designed to obtain fundamental information for training a Bayesian Regularized Artificial Neural Network (BRANN) capable of predicting adsorption capacity of the FACCs to synthesize tailor-made materials with potential application as dialysis membranes. Characterization studies showed that FACCs have a high surface area (1354-2073 m2 g-1) associated with increased microporosity (W0, average: 0.57 cm3 g-1). Materials are carbonaceous, with a carbon content between 69 and 92%. Chemical treatments modify the pHpzc of materials between 4.1 and 7.8 due to incorporating functional groups on the surface (C=O, -COOH, -OH, -NH, -NH2). Uremic toxins tests showed a high elimination rate of p-cresol (73 mg g-1) and creatinine (90 mg g-1) which is not affected by the matrix (aqueous solution and simulated serum). However, in the case of uric acid, adsorption capacity decreased from 143 mg g-1 to 71 mg g-1, respectively. When comparing the kinetic constants of the adsorption studies in simulated serum versus the studies in aqueous solution, it can be seen that this does not undergo significant changes (0.02 min-1), evidencing the versatility of the material to work in different matrices. The previous studies, in combination with characterization of the materials, allowed to establish the adsorption mechanism. Thus, it permitted to train the BRANN to obtain mathematical models capable to predict the kinetic adsorption of the toxins studied. It is concluded that the predominant adsorption mechanism is due to π-π interactions between the adsorbate unsaturations with the material's pseudo-graphitic planes. Results show that FACCs are promising materials for hemodialysis membranes. Finally, taking into consideration the adsorption capacities and rates, as well as the semiquantitative analysis of the environmental impact associated with the preparation of the adsorbents, the best adsorbent (CC, Eco-Scale = 91.5) was selected. The studies presented show that the material is eco-friendly and highly efficient in the elimination of uremic toxins.

Corrigendum: Simulation of COVID-19 propagation scenarios in the Madrid metropolitan area.

[This corrects the article DOI: 10.3389/fpubh.2021.636023.].

Review of industry reports on EU priority tobacco additives part A: Main outcomes and conclusions.

The European Union Tobacco Products Directive (EU TPD) mandates enhanced reporting obligations for tobacco manufacturers regarding 15 priority additives. Within the Joint Action on Tobacco Control (JATC), a review panel of independent experts was appointed for the scientific evaluation of the additive reports submitted by a consortium of 12 tobacco manufacturers. As required by the TPD, the reports were evaluated based on their comprehensiveness, methodology and conclusions. In addition, we evaluated the chemical, toxicological, addictive, inhalation facilitating and flavoring properties of the priority additives based on the submitted reports, supplemented by the panel's expert knowledge and some independent literature. The industry concluded that none of the additives is associated with concern. Due to significant methodological limitations, we question the scientific validity of these conclusions and conclude that they are not warranted. Our review demonstrates that many issues regarding toxicity, addictiveness and attractiveness of the additives have not been sufficiently addressed, and therefore concerns remain. For example, menthol facilitates inhalation by activation of the cooling receptor TRPM8. The addition of sorbitol and guar gum leads to a significant increase of aldehydes that may contribute to toxicity and addictiveness. Titanium dioxide particles (aerodynamic diameter <10 µm) are legally classified as carcinogenic when inhaled. For diacetyl no report was provided. Overall, the industry reports were not comprehensive, and the information presented provides an insufficient basis for the regulation of most additives. We, therefore, advise MS to consider alternative approaches such as the precautionary principle.

Review of industry reports on EU priority tobacco additives part B: Methodological limitations.

The Tobacco Products Directive (TPD) defines enhanced reporting obligations applying to 15 priority additives added to cigarettes and roll-your-own tobacco. A consortium of 12 international tobacco companies submitted 14 reports that were reviewed by an independent scientific body within the Joint Action on Tobacco Control (JATC). The reports were evaluated in accordance with the TPD with regard to their comprehensiveness, methodology and conclusions. Here we present their significant identified methodological limitations. The toxicological and chemical evaluation in the industry reports was mainly based on comparative testing, which lacks discriminative power for products with high toxicity and variability, like cigarettes. The literature reviews were biased, the comparative chemical studies did not assess previously identified pyrolysis products, the toxicological evaluation did not include the assessment of inhalation toxicity, and pyrolysis products were not assessed in terms of toxicity, including their genotoxic and carcinogenic potential. For both chemistry and toxicity testing, the statistical approach applied to test the difference between test and additive-free control cigarettes resulted in a high chance of false negatives. The clinical study for inhalation facilitation and nicotine uptake had limitations concerning study design and statistical analysis, while addictiveness was not assessed. Finally, the methodology used to assess characterizing flavors was flawed. In conclusion, there are significant limitations in the methodology applied by the industry. Therefore, the provided reports are of insufficient quality and are clearly not suitable to decide whether a priority additive should be banned in tobacco products according to the TPD.

[Impact of vaccination against COVID-19 in children aged 5-11 years: a mathematical model.] / Estimación del impacto de la vacunación frente a la COVID-19 en la población infantil de 5-11 años.

On November 25, 2021, the European Medicines Agency (EMA) authorized the presentation of Comirnaty vaccine (Pfizer-Biontech) for children between 5 and 11 years of age. In our country, this vaccination began on December 15, after it was approved by the Public Health Commission. A mathematical model has been developed to evaluate the possible impact of this vaccination and contribute to assessing the risk-benefit balance. The model parameters were adjusted including all those characteristics that may influence the impact of childhood vaccination. The results indicate this vaccination involves a significant reduction in the number of infections, and to a lesser extent in the number of hospitalizations and deaths. This reduction will be more important in a future epidemic wave, when this population has been fully vaccinated. Mathematical models can be very powerful tools to predict the impact of vaccination in different epidemiological situations, and help to adjust vaccination programs to be more efficient.

El 25 de noviembre de 2021 la Agencia Europea del Medicamento (EMA) autorizó la vacuna Comirnaty (Pfizer-Biontech) en su presentación infantil para la población entre 5 y 11 años de edad. En nuestro país esta campaña se inició el 15 de diciembre, tras su aprobación por la Comisión de Salud Pública. Se ha desarrollado un modelo matemático para evaluar el posible impacto de la vacunación en esta población y contribuir a evaluar el balance riesgo-beneficio. Se ajustaron los parámetros del modelo original incluyendo todas aquellas características que pueden influir en el impacto de la vacunación infantil. Los resultados indican que vacunar a esta población supone una reducción destacable en el número de infecciones, y en menor medida, en el número de hospitalizaciones y fallecimientos. Esta reducción será más importante en una onda epidémica futura, cuando la población infantil ya esté vacunada con la pauta completa. Los modelos matemáticos pueden ser herramientas muy potentes para predecir el impacto de la vacunación en diferentes situaciones epidemiológicas, y ayudar a ajustar los programas de vacunación para que sean más eficientes.

Estimación del impacto de la vacunación frente a la COVID-19 en la población infantil de 5-11 años / Impact of vaccination against COVID-19 in children aged 5-11 years: a mathematical model

El 25 de noviembre de 2021 la Agencia Europea del Medicamento (EMA) autorizó la vacuna Comirnaty (Pfizer-Biontech) en su presentación infantil para la población entre 5 y 11 años de edad. En nuestro país esta campaña se inició el 15 de diciembre, tras su aprobación por la Comisión de Salud Pública. Se ha desarrollado un modelo matemático para evaluar el posible impacto de la vacunación en esta población y contribuir a evaluar el balance riesgo-beneficio. Se ajustaron los parámetros del modelo original incluyendo todas aquellas características que pueden influir en el impacto de la vacunación infantil. Los resultados indican que vacunar a esta población supone una reducción destacable en el número de infecciones, y en menor medida, en el número de hospitalizaciones y fallecimientos. Esta reducción será más importante en una onda epidémica futura, cuando la población infantil ya esté vacunada con la pauta completa. Los modelos matemáticos pueden ser herramientas muy potentes para predecir el impacto de la vacunación en diferentes situaciones epidemiológicas, y ayudar a ajustar los programas de vacunación para que sean más eficientes.(AU)

On November 25, 2021, the European Medicines Agency (EMA) authorized the presentation of Comirnaty vaccine (PfizerBiontech) for children between 5 and 11 years of age. In our country, this vaccination began on December 15, after it was approved by the Public Health Commission. A mathematical model has been developed to evaluate the possible impact of this vaccination and contribute to assessing the risk-benefit balance. The model parameters were adjusted including all those characteristics that may influence the impact of childhood vaccination. The results indicate this vaccination involves a significant reduction in the number of infections, and to a lesser extent in the number of hospitalizations and deaths. This reduction will be more important in a future epidemic wave, when this population has been fully vaccinated. Mathematical models can be very powerful tools to predict the impact of vaccination in different epidemiological situations, and help to adjust vaccination programs to be more efficient.(AU)

Evaluation of vaccination strategies for the metropolitan area of Madrid via agent-based simulation.

OBJECTIVE: We analyse the impact of different vaccination strategies on the propagation of COVID-19 within the Madrid metropolitan area, starting on 27 December 2020 and ending in Summer of 2021. MATERIALS AND METHODS: The predictions are based on simulation using EpiGraph, an agent-based COVID-19 simulator. We first summarise the different models implemented in the simulator, then provide a comprehensive description of the vaccination model and define different vaccination strategies. The simulator-including the vaccination model-is validated by comparing its results with real data from the metropolitan area of Madrid during the third COVID-19 wave. This work considers different COVID-19 propagation scenarios for a simulated population of about 5 million. RESULTS: The main result shows that the best strategy is to vaccinate first the elderly with the two doses spaced 56 days apart; this approach reduces the final infection rate by an additional 6% and the number of deaths by an additional 3% with respect to vaccinating first the elderly at the interval recommended by the vaccine producer. The reason is the increase in the number of vaccinated individuals at any time during the simulation. CONCLUSION: The existing level of detail and maturity of EpiGraph allowed us to evaluate complex scenarios and thus use it successfully to help guide the strategy for the COVID-19 vaccination campaign of the Spanish health authorities.

Assessing population-sampling strategies for reducing the COVID-19 incidence.

As long as critical levels of vaccination have not been reached to ensure heard immunity, and new SARS-CoV-2 strains are developing, the only realistic way to reduce the infection speed in a population is to track the infected individuals before they pass on the virus. Testing the population via sampling has shown good results in slowing the epidemic spread. Sampling can be implemented at different times during the epidemic and may be done either per individual or for combined groups of people at a time. The work we present here makes two main contributions. We first extend and refine our scalable agent-based COVID-19 simulator to incorporate an improved socio-demographic model which considers professions, as well as a more realistic population mixing model based on contact matrices per country. These extensions are necessary to develop and test various sampling strategies in a scenario including the 62 largest cities in Spain; this is our second contribution. As part of the evaluation, we also analyze the impact of different parameters, such as testing frequency, quarantine time, percentage of quarantine breakers, or group testing, on sampling efficacy. Our results show that the most effective strategies are pooling, rapid antigen test campaigns, and requiring negative testing for access to public areas. The effectiveness of all these strategies can be greatly increased by reducing the number of contacts for infected individual.

Úlceras por presión: riesgo, factores predisponentes y pronóstico hospitalario en pacientes mayores de 65 años

RESUMEN Introducción: las úlceras por presión (UPP) influyen drásticamente en la estancia hospitalaria produciendo malestar y dolor a los pacientes. Objetivo: determinar el riesgo de desarrollar UPP y evaluar conjuntamente nutrición / alimentación y grado de independencia en pacientes mayores de 65 años. Método: diseño descriptivo y transversal. Se evaluó a 444 pacientes con y sin UPP mediante la Escala de Braden, el Mini Nutritional Assessment Short y Prisma 7, internados en el Hospital Adventista Silvestre, Rio de Janeiro, Brasil, entre 2018 y 2019. Resultados: respecto de la Escala de Braden el grupo con mayor representación es el Riesgo Moderado de sufrir UPP (37,6%). La estratificación en grupo del Prima 7 muestra 2 grupos principales, el mayor (51,8%) que corresponde a Prisma positivo (>3), seguido por el grupo de Prisma negativo (35,1%). Según la escala Mini Nutritional Assessment Short 41,9% de los pacientes internados tiene riesgo de desnutrición y 34% se halla con desnutrición. Conclusión: el estudio relaciona las UPP con una serie factores como la malnutrición, la inmovilidad y pérdida de la independencia. La escala de Braden demostró ser un buen predictor de UPP. Se evidenció que las UPP son un problema con gran prevalencia en el hospital, que el acompañamiento multidisciplinar para el cuidado y tratamiento de estas lesiones es fundamental.

ABSTRACT Introduction: Pressure ulcers (PUs) drastically influence the hospital stay, causing discomfort and pain to patients. Objective: To determine the risk of developing PUs and jointly evaluate nutrition / diet and degree of independence in patients over 65 years of age. Method: Descriptive and cross-sectional design. Four hundred and forty-four patients with and without PUs, admitted to the Silvestre Adventist Hospital, Rio de Janeiro, Brazil between 2018 and 2019, were evaluated using the Braden Scale, the Mini Nutritional Assessment Short Form and the Prisma 7. Results: Regarding the Braden Scale, the group with the highest representation was the Moderate Risk of suffering Pus (37.6%). The group stratification of Prima 7 showed two main groups, the largest (51.8%) corresponding to positive Prism (> 3), followed by the negative Prism group (35.1%). According to the Mini Nutritional Assessment Short scale, 41.9% of hospitalized patients were at risk of malnutrition and 34% were malnourished. Conclusion: The study related PUs to a series of factors such as malnutrition, immobility and loss of independence. The Braden scale proved to be a good predictor of UPP. It was evidenced that PUs are a highly prevalent problem in the hospital, and that multidisciplinary support for the care and treatment of these injuries is essential.

Simulation of COVID-19 Propagation Scenarios in the Madrid Metropolitan Area.

This work presents simulation results for different mitigation and confinement scenarios for the propagation of COVID-19 in the metropolitan area of Madrid. These scenarios were implemented and tested using EpiGraph, an epidemic simulator which has been extended to simulate COVID-19 propagation. EpiGraph implements a social interaction model, which realistically captures a large number of characteristics of individuals and groups, as well as their individual interconnections, which are extracted from connection patterns in social networks. Besides the epidemiological and social interaction components, it also models people's short and long-distance movements as part of a transportation model. These features, together with the capacity to simulate scenarios with millions of individuals and apply different contention and mitigation measures, gives EpiGraph the potential to reproduce the COVID-19 evolution and study medium-term effects of the virus when applying mitigation methods. EpiGraph, obtains closely aligned infected and death curves related to the first wave in the Madrid metropolitan area, achieving similar seroprevalence values. We also show that selective lockdown for people over 60 would reduce the number of deaths. In addition, evaluate the effect of the use of face masks after the first wave, which shows that the percentage of people that comply with mask use is a crucial factor for mitigating the infection's spread.

Deletion of the adenosine A2A receptor increases the survival rate in a mice model of polymicrobial sepsis.

We aim to investigate the role of A2A receptor in peritonitis-related sepsis by injection of a fecal solution (FS) as a model of polymicrobial infection. C57/black J6 wild-type (WT) and A2A-deficient mice (A2AKO) were exposed to sepsis induced by intraperitoneal injection of a FS (FS-induced peritonitis) or instead was injected with saline buffer (Sham). Survival rate and sepsis score were measured up to 48 h. The presence of bacteria in tissue homogenates was analyzed. Telemetry and speckle laser Doppler were used for systemic blood pressure and peripheral blood perfusion analysis, respectively. Histological analysis and identification of active caspase 3 were performed in selected organs, including the liver. The survival rate of A2AKO mice exposed to FS-induced peritonitis was significantly higher, and the sepsis score was lower than their respective WT counterpart. Injection of FS increases (50 to 150 folds) the number of colonies forming units in the liver, kidney, blood, and lung in WT mice, while these effects were significantly attenuated in A2AKO mice exposed to FS-induced peritonitis. A significant reduction in both systolic and diastolic blood pressure, as well as in the peripheral perfusion was observed in WT and A2AKO mice exposed to FS-induced peritonitis. Although, these last effects were significantly attenuated in A2AKO mice. Histological analysis showed a large perivascular infiltration of polymorphonuclear in the liver of WT and A2AKO mice exposed to FS-induced peritonitis, but again, this effect was attenuated in A2AKO mice. Finally, high expression of active caspase 3 was found only in the liver of WT mice exposed to FS-induced peritonitis. The absence of the A2A receptor increases the survival rate in mice exposed to polymicrobial sepsis. This outcome was associated with both hemodynamic compensation and enhanced anti-bacterial response.

Rol de los receptores de adenosina en la interacción adipocito-macrófago durante la obesidad / Role of adenosine receptors in the adipocyte-macrophage interaction during obesity

La inflamación generada en el tejido adiposo o lipoinflamación, puede contribuir al desarrollo de la resistencia a la insulina. Los mecanismos asociados a la lipoinflamación están relacionados con la función de los adipocitos y los macrófagos presentes en el tejido adiposo. En este contexto, el nivel del nucleósido adenosina está aumentado en individuos con obesidad. Las causas o consecuencias de este aumento no se conocen. Aunque, adenosina al activar a sus receptores (A1, A2A, A2B y A3) es capaz de modular diferencialmente la función de adipocitos y macrófagos, con el fin de evitar la reducción de la sensibilidad a la insulina y generar un estado antiinflamatorio en el individuo con obesidad. En esta revisión proponemos que adenosina podría ser un elemento clave en el desarrollo de nuevas estrategias para el control de la lipoinflamación y homeostasis metabólica a través de la regulación del diálogo adipocito-macrófago (AU)

Lipoinflamation is the inflammation generated in the adipose tissue. It can contribute to the development of insulin resistance. The lipoinflammation-associated mechanisms are related to the function of adipocytes and macrophages present in the adipose tissue. In this regard, the level of nucleoside adenosine is increased in individuals with obesity. Causes or consequences of this increase are unknown. Although, adenosine activating its receptors (A1, A2A, A2B and A3) is able to differentially modulate the function of adipocytes and macrophages, in order to avoid the reduction of insulin sensitivity and generate an anti-inflammatory state in subject with obesity. In this review we propose that adenosine could be a key element in the development of new strategies for limit lipoinflammation and regulate metabolic homeostasis through modulation of adipocyte-macrophage dialogue (AU)

Role of adenosine receptors in the adipocyte-macrophage interaction during obesity. / Rol de los receptores de adenosina en la interacción adipocito-macrófago durante la obesidad.

Lipoinflamation is the inflammation generated in the adipose tissue. It can contribute to the development of insulin resistance. The lipoinflammation-associated mechanisms are related to the function of adipocytes and macrophages present in the adipose tissue. In this regard, the level of nucleoside adenosine is increased in individuals with obesity. Causes or consequences of this increase are unknown. Although, adenosine activating its receptors (A1, A2A, A2B and A3) is able to differentially modulate the function of adipocytes and macrophages, in order to avoid the reduction of insulin sensitivity and generate an anti-inflammatory state in subject with obesity. In this review we propose that adenosine could be a key element in the development of new strategies for limit lipoinflammation and regulate metabolic homeostasis through modulation of adipocyte-macrophage dialogue.

Cáncer de recto: qué pacientes se benefician de la radioterapia / Rectal cancer: Which patients benefit from radiotherapy

El pronóstico de los pacientes con cáncer de recto ha mejorado en los últimos años, sobre todo en relación con la menor probabilidad de recidiva local. Estos resultados se consiguen con una correcta estadificación preoperatoria, una adecuada escisión quirúrgica de la lesión y un abordaje terapéutico multidisciplinar. Basándonos en la evidencia científica disponible, nuestro propósito es tratar de clarificar el marco en el cual se toman las decisiones terapéuticas, especialmente en relación con la estadificación preoperatoria y sus limitaciones y con el tratamiento con radioterapia y sus indicaciones, así como resaltar la necesidad de un enfoque individualizado en cada caso (AU)

The prognosis of patients with rectal cancer has improved in recent years, particularly as regards the lower probability of local recurrence. These positive results are obtained through correct preoperative staging and an adequate surgical resection of the affected lesion, as well as a multidisciplinary therapeutic approach. Based on the available scientific evidence, our aim is to clarify the framework in which options for the right therapy can be taken, especially in relation to the preoperative staging and its limitations, with regards to radiotherapy and its indications. We also emphasize the need of a tailor-made approach for each case (AU)

[Rectal cancer: which patients benefit from radiotherapy?]. / Cáncer de recto: qué pacientes se benefician de la radioterapia.

The prognosis of patients with rectal cancer has improved in recent years, particularly as regards the lower probability of local recurrence. These positive results are obtained through correct preoperative staging and an adequate surgical resection of the affected lesion, as well as a multidisciplinary therapeutic approach. Based on the available scientific evidence, our aim is to clarify the framework in which options for the right therapy can be taken, especially in relation to the preoperative staging and its limitations, with regards to radiotherapy and its indications. We also emphasize the need of a tailor-made approach for each case.

Temperature dependence of herbicide adsorption from aqueous solutions on activated carbon fiber and cloth.

Diuron and amitrole adsorption from aqueous solution on an activated carbon fiber and an activated carbon cloth were studied as a function of temperature. Diuron adsorption was greater than that of amitrole and increased with rising temperature, whereas amitrole adsorption decreased when the temperature increased. Endothermicity of diuron adsorption was due to an increase in the planarity and diffusion of diuron molecules with higher temperatures. However, the exothermicity found for amitrole was due to the increase in amitrole solubility and in vibrational energy of adsorbed molecules with higher temperature. External mass transfer resistance was also found to play an important role in diuron adsorption on activated carbon cloth.

A study of the static and dynamic adsorption of Zn(II) ions on carbon materials from aqueous solutions.

The effect of surface oxidation, solution pH, and ionic strength on the adsorption of Zn(II) ions from aqueous solution under static conditions was studied using commercial activated carbons in the form of grains and cloth. In addition, the effects of surface oxidation and the presence of dissolved natural organic matter (tannic acid) were studied under dynamic conditions using activated carbon cloth column beds. Under static conditions, surface oxidation largely increased Zn2+ uptake and two H+ ions were displaced from the oxidized carbon surface per Zn(II) ion adsorbed. It is proposed that adsorption of Zn(II) on the as-received basic carbons was due to C(pi)-cation interactions. An increase in solution pH in the range 3-6 increased Zn(II) uptake, whereas an increase in ionic strength decreased Zn(II) uptake because of the screening effect of the added salt. In the experiments carried out with carbon column beds, the oxidized activated carbon cloth was also more effective than the as-received carbon to remove Zn(II) ions. In this case, the presence of tannic acid decreased the efficiency of the oxidized activated carbon cloth bed to remove Zn(II) ions. An increase in the tannic acid initial concentration had a greater effect on the removal of tannic acid than on the removal of Zn(II) by the column bed. This may be a consequence of the greater size of tannic acid molecules and their low affinity for oxidized carbon surfaces.

Valores de referencia en la citometría hemática del personal que acude a consulta al Hospital Central Militar / Out-patient average values of blood cell counts in the Military Central Hospital of Mexico. A reference pattern

Con el objeto de comprobar si los valores de referencia en la citometría hemática que utiliza el Hospital Central Militar, eran aplicables a la población, se realizó un estudio transversal, observacional y analítico. El estudio abarcó población militar, derechohabiente y civil (pediátricos y adultos) a los cuales se les determinó hemoglobina, hematócrito, número de eritrocitos, índices eritrocitarios, número de leucosito, plaquetas y volumen plaquetario; el aparato que se utilizó para realizar estas determinaciones fue el analizador de hamatología Coulter Mod. STKS. Mediante el análisis estadístico se llegó a la conclusión de que sí existía diferencia estadísticamente significativa de los parámetros estudiados con los reportados en las referencias nacionales e internacionales encontradas. Estas diferencias muy probablemente se hayan debido a la diferencia de altitudes y metodologías utilizadas para cada uno de los estudios en cuestión