A solar evaporator fabricated from corncob waste for the desalination of seawater and removal of oil/herbicides from contaminated water.

Corncob (CC) based solar evaporators were employed to desalinize seawater brought from the Vallarta coast in Mexico. The pure CC produced an evaporation-rate and evaporation-efficiency of 0.63 kg m-2 h-1 and 38.4%, respectively, under natural solar light. Later, the CC was coated with carbonized CC (CCCE evaporator) or was coated with graphene (CCGE evaporator). Those evaporators were used for the desalination of seawater and obtained higher evaporation rates of 1.59-1.67 kg m-2 h-1, and higher evaporation efficiencies of 92-94% (under natural solar light). The desalination experiments were repeated under artificial solar light and the evaporation-rates/evaporation-efficiencies slightly decreased to 1.43-1.52 kg m-2 h-1/88-92%. The surface analysis of the evaporators by FTIR, XPS and Raman revealed that the CCGE evaporator had on its surface a lower content of defects and a higher amount of OH groups than the CCCE evaporator. Therefore, the CCGE evaporator had higher evaporation-rates/evaporation-efficiencies in comparison with the CCCE evaporator. Furthermore, we purified water contaminated with three different herbicides (fomesafen, 2-6 dichlorobenzamide and 4-chlorophenol at 30 ppm) by evaporation and using natural solar light. Interestingly, the CCCE and CCGE evaporators also removed the herbicides by physical adsorption with efficiencies of 12-22.5%. Moreover, the CCGE evaporator removed vegetable oil from contaminated water by adsorption and its maximum adsorption capacity was 1.72 g/g. Overall, our results demonstrated that the corncob-based evaporators studied here are a low-cost alternative to obtain clean water under natural solar light and this one was more effective for the desalination of seawater than the artificial sunlight (Xe lamp).

Using NIR irradiation and magnetic bismuth ferrite microparticles to accelerate the removal of polystyrene microparticles from the drinking water.

Magnetic bismuth ferrite (BiFO) microparticles were employed for the first time for the removal of polystyrene (PS) nano/microplastics from the drinking water. BiFO is formed by porous agglomerates with sizes of 5-11 µm, while the PS nano/microparticles have sizes in the range of 70-11000 nm. X-ray diffraction studies demonstrated that the BiFO microparticles are composed of BiFeO3/Bi25FeO40 (the content of Bi25FeO40 is ≈ 8.6%). Drinking water was contaminated with PS nano/microparticles (1 g L-1) and BiFO microparticles were also added to the contaminated water. Later, the mixture of PS-particles + BiFO was irradiated with NIR light (980 nm). Consequently, PS nano/microparticles melted on the BiFO microparticles due to the excessive heating on their surface. At the same time, the NIR (near infrared) light generated oxidizing agents (∙OH and h+), which degraded the by-products formed during the photocatalytic degradation of PS nano/microparticles. Subsequently, the NIR irradiation was stopped, and a Neodymium magnet was utilized to separate the BiFO microparticles from the water. This last procedure also permitted the removal of PS nano/microparticles by physical adsorption. Zeta potential measurements demonstrated that the BiFO surface was positively charged, allowing the removal of the negatively charged PS nano/microparticles by electrostatic attraction. The combination of the photocatalytic process and the physical adsorption permitted a complete removal of PS nano/microparticles after only 90 min as well as a high mineralization of by-products (≈95.5% as confirmed by the total organic carbon measurements). We estimate that ≈23.6% of the PS nano/microparticles were eliminated by photocatalysis and the rest of PS particles (≈76.4%) by physical adsorption. An outstanding adsorption capacity of 195.5 mg g-1 was obtained after the magnetic separation of the BiFO microparticles from the water. Hence, the results of this research demonstrated that using photocatalysis + physical-adsorption is a feasible strategy to quickly remove microplastic contaminants from the water.

Novel polypropylene-TiO2:Bi spherical floater for the efficient photocatalytic degradation of the recalcitrant 2,4,6-TCP herbicide.

In this work, spherical photocatalytic floaters were fabricated by depositing TiO2:Bi (TBi) particles on polypropylene (PP) spheres (recycled from beer cans). These particles were deposited on the sphere (TBi-sphere) by the spray coating technique and evaluated their performance for the photocatalytic degradation of 2,4,6-trichlorophenol (2,4,6-TCP) herbicide. SEM images demonstrated that the BTi powders consisted in conglomerated grains with sizes of 20-80 nm and the analysis by X-ray diffraction confirmed the presence of rutile and anatase phases in the BTi. The photocatalytic experiments showed that the TBi and TBi-sphere produced maximum degradation of 90 and 97% for 2,4,6-TCP, respectively, after 4 h under UV-Vis light. The photocatalytic powders/composites were reused 3 times and the loss of degradation efficiency was 3 and 16% for the TBi powder and TBi-sphere, respectively. This means that the TBi-sphere is more stable for the continuous degradation of the 2,4,6-TCP contaminant. The TiO2:Bi powder was compared with the commercial TiO2 (P25) and found that the TiO2:Bi powder had higher light absorption (≈42%) and higher surface area (≈105%) than the P25. Therefore, the degradation percentage for the 2,4,6-TCP was 52% higher in the sample doped with Bi. Also, scavenger experiments were carried out and found that the main oxidizing agents produced for the degradation of 2,4,6-TCP were •OH- radicals and •O2- anions. Other species such as h+ were also produced at lower amount. Hence, our results demonstrated that spherical/floatable photocatalytic composites are a viable option to remove herbicide residuals from the water, which is of interest in water-treatment-plants.

An eco-friendly and sustainable support of agave-fibers functionalized with graphene/TiO2:SnO2 for the photocatalytic degradation of the 2,4-D herbicide from the drinking water.

In this research, we evaluated the photocatalytic performance of biodegradable composites for the removal of the 2,4-Dichlorophenoxyacetic acid (2,4-D) herbicide. The composite was composed by agave fibers (AgF), graphene-microplates (GM) and titanium dioxide TiO2/SnO2 (TSn) nanoparticles (NPs) and was named TSn + AgF/GM. Both, the TSn NPs and the GM were deposited on the AgF using the Dip-coating method. According to the analysis by X-Ray Diffraction (XRD), the crystalline phase for the TiO2 and SnO2 was anatase and tetragonal-rutile, respectively. The Scanning Electron Microscopy (SEM) images demonstrated that the AgF were completely saturated by the GM (which had average dimensions of 15 µm × 22 µm) and by conglomerations of TSn NPs with average size of 642 nm. The TSn NPs and the TSn + AgF/GM composite were evaluated for the photocatalytic degradation of the 2,4-D herbicide under ultraviolet-visible (UV-Vis) light and found a maximum degradation of 98.4 and 93.7% (after 4 h) for the TSn NPs and the TSn + AgF/GM composite, respectively. Reuse cycles were also performed and the degradation percentage decreased by 13.1% and by 7.8% (after 3 cycles of reuse) when the TSn NPs and the TSn + AgF/GM composite are employed, respectively. Scavenger experiments were also carried out and found that the oxidizing agents are mainly produced in the order of: •OH>•O2- > h+; then, the main oxidizing agents generated during the photocatalytic reaction were the hydroxyl radicals. Thus, the photocatalytic system studied in this work for the degradation of 2,4-D could pave the way for the development of new eco-friendly/floatable photocatalysts, which can be applied in wastewater-treatment plants.

A sustainable and green chlorophyll/TiO2:W composite supported on recycled plastic bottle caps for the complete removal of Rhodamine B contaminant from drinking water.

This investigation reports the photocatalytic performance of the tungsten doped titania (TiO2:W or TW) with and without coating of chlorophyll (Chl) for the removal of the RhB dye from the drinking water. These particles were also supported on recycled plastic bottle caps (Bcap) to form other photocatalytic composites (TW/Bcap and TW + Chl/Bcap). The SEM images demonstrated that the TW particles without Chl had irregular shapes and sizes of 0.8-12 µm. The TW particles coated by the Chl presented shapes of quasi-rounded grains and smaller particle sizes of 0.8-1.8 µm. The photocatalytyic experiments showed that the photocatalyst powders containing Chl removed completely the RhB dye from the water after 2h under UV-VIS light, while the photocatalyst without Chl removed a maximum of 95% of the RhB. Interestingly, the TW/Bcap and TW + Chl/Bcap composites removed 94-100% of the RhB after 2h. Those ones removed such dye by photocatalysis and by physical adsorption at the same time (as confirmed by the absorbance and FTIR measurements), therefore, the removal of RhB was still very high. Scavenger experiments were also achieved and found that the •OH radicals are the main oxidizing species generated by the photocatalysts with and without Chl. The •O2- radicals and holes (h+) were the secondary oxidizing species. The presence of the chlorophyll on the photocatalyst increased in general the light absorption and the photocurrent. Overall, our work demonstrated that making composites with recycled plastic bottle caps is a feasible alternative to remove dyes from contaminated drinking water with high efficiency and low cost.

Vitamin D supplementation and COVID-19 risk: a population-based, cohort study.

PURPOSE: To analyze the associations between cholecalciferol or calcifediol supplementation, serum 25-hydroxyvitamin D (25OHD) levels and COVID-19 outcomes in a large population. METHODS: All individuals ≥ 18 years old living in Barcelona-Central Catalonia (n = 4.6 million) supplemented with cholecalciferol or calcifediol from April 2019 to February 2020 were compared with propensity score-matched untreated controls. Outcome variables were SARS-CoV2 infection, severe COVID-19 and COVID-19 mortality occuring during the first wave of the pandemic. Demographical data, comorbidities, serum 25OHD levels and concomitant pharmacological treatments were collected as covariates. Associations between cholecalciferol or calcifediol use and outcome variables were analyzed using multivariate Cox proportional regression. RESULTS: Cholecalciferol supplementation (n = 108,343) was associated with slight protection from SARS-CoV2 infection (n = 4352 [4.0%] vs 9142/216,686 [4.2%] in controls; HR 0.95 [CI 95% 0.91-0.98], p = 0.004). Patients on cholecalciferol treatment achieving 25OHD levels ≥ 30 ng/ml had lower risk of SARS-CoV2 infection, lower risk of severe COVID-19 and lower COVID-19 mortality than unsupplemented 25OHD-deficient patients (56/9474 [0.6%] vs 96/7616 [1.3%]; HR 0.66 [CI 95% 0.46-0.93], p = 0.018). Calcifediol use (n = 134,703) was not associated with reduced risk of SARS-CoV2 infection or mortality in the whole cohort. However, patients on calcifediol treatment achieving serum 25OHD levels ≥ 30 ng/ml also had lower risk of SARS-CoV2 infection, lower risk of severe COVID-19, and lower COVID-19 mortality compared to 25OHD-deficient patients not receiving vitamin D supplements (88/16276 [0.5%] vs 96/7616 [1.3%]; HR 0.56 [CI 95% 0.42-0.76], p < 0.001). CONCLUSIONS: In this large, population-based study, we observed that patients supplemented with cholecalciferol or calcifediol achieving serum 25OHD levels ≥ 30 ng/ml were associated with better COVID-19 outcomes.

Photocatalytic materials immobilized on recycled supports and their role in the degradation of water contaminants: A timely review.

Global concern about environmental pollution has increased in recent times due to the cumulative harmful impact on the human health occasioned by the diverse toxic substances released into the environment. Water reduced availability for human consumption and its pollution have been paid so much attention due to their relevance in agricultural and industrial activities. In this context, the advanced oxidation processes for removing contaminants from water, more specifically photocatalytic processes, have displayed their usefulness due to features such as easy application, low-cost, harmless effects and sustainable decontamination efficiency. This timely review is centered on worldwide studies, where efforts aimed at employing recycled materials as supports for purification applications such as the removal of different contaminants (dyes, pharmaceutical contaminants, and heavy metals) dissolved in aqueous environments have been reported. Materials like polyethylene terephthalic (PET), polystyrene (PS), disposal textile fabrics, newspapers, aluminum soda cans, rubber, waste electronic and electric components and used batteries have been employed either as supports for immobilizing catalysts or as photocatalysts. The present work offers a discussion of the ways through which photocatalytic composites have been immobilized or produced, employed characterization techniques, removal efficiencies achieved during photocatalytic degradation and possible degradation mechanism of pollutants; not only the highlights of all these studies are discussed, but also paths for future research works that could help improve the reported results are suggested. These new practical tools stand as novel sustainable strategies for the removal of emerging contaminants reusing waste flexible materials.

Extensive morphological and behavioural diversity among fourteen new and seven described species in Phytophthora Clade 10 and its evolutionary implications.

During extensive surveys of global Phytophthora diversity 14 new species detected in natural ecosystems in Chile, Indonesia, USA (Louisiana), Sweden, Ukraine and Vietnam were assigned to Phytophthora major Clade 10 based on a multigene phylogeny of nine nuclear and three mitochondrial gene regions. Clade 10 now comprises three subclades. Subclades 10a and 10b contain species with nonpapillate sporangia, a range of breeding systems and a mainly soil- and waterborne lifestyle. These include the previously described P. afrocarpa, P. gallica and P. intercalaris and eight of the new species: P. ludoviciana, P. procera, P. pseudogallica, P. scandinavica, P. subarctica, P. tenuimura, P. tonkinensis and P. ukrainensis. In contrast, all species in Subclade 10c have papillate sporangia and are self-fertile (or homothallic) with an aerial lifestyle including the known P. boehmeriae, P. gondwanensis, P. kernoviae and P. morindae and the new species P. celebensis, P. chilensis, P. javanensis, P. multiglobulosa, P. pseudochilensis and P. pseudokernoviae. All new Phytophthora species differed from each other and from related species by their unique combinations of morphological characters, breeding systems, cardinal temperatures and growth rates. The biogeography and evolutionary history of Clade 10 are discussed. We propose that the three subclades originated via the early divergence of pre-Gondwanan ancestors > 175 Mya into water- and soilborne and aerially dispersed lineages and subsequently underwent multiple allopatric and sympatric radiations during their global spread. Citation: Jung T, Milenkovic I, Corcobado T, et al. 2022. Extensive morphological and behavioural diversity among fourteen new and seven described species in Phytophthora Clade 10 and its evolutionary implications. Persoonia 49: 1-57. https://doi.org/10.3767/persoonia.2022.49.01.

Clinical risk factors for early mortality in patients with community-acquired septic shock. The importance of adequate source control.

OBJECTIVE: To evaluate the incidence and risk factors for early mortality (EM) in the ICU in patients with community-acquired septic shock (CASS). DESIGN: A retrospective cohort study of patients with CASS admitted to the ICU (2003-2016). SETTING: ICU at a University Hospital in Spain. PATIENTS: All consecutive patients admitted to the ICU with CASS. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: CASS was defined according to the Sepsis-3 definitions. EM were defined as occurring within of 72h following ICU admission. A multinomial logistic regression analysis was performed to identify the risk factors associated with early deaths. RESULTS: During the study period, 625 patients met the Sepsis-3 criteria and admitted with CASS. 14.4% of all patients died within the first 72h. Of 161 patients who died in the ICU, 90 (55.9%) died within the first 72h. The percentage of early and late mortality did not vary significantly during the study period. The need and adequacy of source control were significantly lower in patients with EM. In the multivariate analysis, ARDS, non-respiratory infections, bacteremia and severity at admission were variables independently associated with EM. The only factor that decreased EM was adequate source control in patients with infections amenable to source control. CONCLUSIONS: The incidence of EM has remained stable over time, which means that more than half of the patients who die from CASS do so within the first 72h. Infections where adequate source control can be performed have lower EM.

Efficient solar removal of acetaminophen contaminant from water using flexible graphene composites functionalized with Ni@TiO2:W nanoparticles.

This work presents the morphological, structural and photocatalytic properties of flexible graphene composites decorated with Ni@TiO2:W nanoparticles (TiNiW NPs) with an average size of 27 ± 2 nm. The TiNiW NPs were immobilized on the surface of a flexible graphene composite using a PVA-based slurry-paste (FG/TiNiW composite). The SEM study showed that the TiNiW NPs remained exposed on the surface of the FG/TiNiW composite, which benefited its photocatalytic activity. The photocatalytic performance for the degradation of acetaminophen (ACT) was evaluated using both the TiNiW powders and the FG/TiNiW composite, obtaining maximum degradation efficiencies of 100 and 86%, respectively, after 3 h under natural solar irradiation. The degradation of ACT was caused mainly by the reactive oxygen species such as OH radicals and h+, which was confirmed by scavenger experiments. Photoluminescence, XPS and absorbance experiments revealed that oxygen vacancy defects were created by i) doping the TiNiW NPs with W and by ii) introducing graphene into the composites. These defects enhanced the absorbance of light in the range of 400-800 nm, which in turn, promoted the photocatalytic degradation of ACT. Moreover, the reuse experiments confirmed that both the TiNiW NPs and FG/TiNiW composite were very stable for the degradation of ACT, since degradation efficiencies >82% were obtained after 4 reuse cycles for both photocatalysts. The experimental findings of this work demonstrate that the flexible TiO2/graphene composites are a feasible option for the removal of pharmaceutical contaminants from water using natural solar irradiation.

Corticosteroids and tocilizumab reduce in-hospital mortality in severe COVID-19 pneumonia: a retrospective study in a Spanish hospital.

BACKGROUND: There is an urgent need to reduce mortality of COVID-19. We examined if corticosteroids and tocilizumab reduce risk for death in patients with severe pneumonia caused by SARS-CoV-2. METHODS: A retrospective cohort study was performed in a single university hospital. All adult patients admitted with confirmed severe COVID-19 pneumonia from 9 March to 9 April 2020 were included. Severe pneumonia was defined as multi-lobar or bilateral pneumonia and a ratio of oxygen saturation by pulse oximetry to the fraction of inspired oxygen (SpFi)<315. All patients received antiviral and antibiotic treatment. From March 26, patients also received immunomodulatory treatment with corticosteroids (methylprednisolone 250 mg/day for 3 days), or tocilizumab or both. In-hospital mortality in the entire cohort and in a 1:1 matched cohort sub-analysis was evaluated. RESULTS: 255 patients were included, 118 received only antiviral and antibiotic treatment while 137, admitted after March 26, also received immunomodulators. In-hospital mortality of patients on immunomodulatory treatment was significantly lower than in those without [47/137(34.3%) vs. 69/118(58.5%), (p < .001)]. The risk of death was 0.44 (CI, 0.26-0.76) in patients receiving corticosteroids alone and 0.292 (CI, 0.18-0.47) in those treated with corticosteroids and tocilizumab. In the sub-analysis with 202 matched patients, the risk of death was 0.356 (CI 0.179-0.707) in patients receiving corticosteroids alone and 0.233 (0.124-0.436) in those treated with the combination. CONCLUSIONS: Combined treatment with corticosteroids and tocilizumab reduced mortality with about 25% in patients with severe COVID-19 pneumonia. Corticosteroids alone also resulted in lower in-hospital mortality rate compared to patients receiving only antiviral and antibiotic treatment. Corticosteroids alone or combined with tocilizumab may be considered in patients with severe COVID-19 pneumonia.

Glucagon stimulation test to assess growth hormone status in Prader-Willi syndrome.

PURPOSE: Growth hormone deficiency (GHD) must be confirmed before starting treatment in adults with Prader-Willi syndrome (PWS). Most studies use the growth-hormone-releasing hormone plus arginine (GHRH-arginine) test. No data are available on the glucagon stimulation test (GST) in PWS. We compared the utility of fixed-dose (1 mg) GST versus GHRH-arginine test in diagnosing GHD. METHODS: Adults and late adolescents with PWS underwent both tests on separate days. In the GHRH-arginine test, GHD was defined according to body mass index. In the GST, two cutoffs were analyzed: peak GH concentration < 3 ng/mL and < 1 ng/mL. For analyses, patients were divided into two groups according to body weight (≤ 90 kg and > 90 kg). RESULTS: We analyzed 34 patients: 22 weighing ≤ 90 kg and 12 weighing > 90 kg. In patients weighing ≤ 90 kg, the two tests were concordant in 16 (72.72%) patients (k = 0.476, p = 0.009 with GST cutoff < 3 ng/mL, and k = 0.450, p = 0.035 with GST cutoff < 1 ng/mL). In patients weighing > 90 kg, the two tests were not concordant with GST cutoff < 3 ng/mL, but were concordant in 11 (91.6%) patients (k = 0.833, p = 0.003) with GST cutoff < 1 ng/mL. GH peaks on the two tests correlated (r = 0.725, p = 0.008). CONCLUSION: Fixed-dose (1 mg) GST using a peak GH cutoff of < 3 ng/mL or < 1 ng/mL promises to be useful for screening for GHD in adults and late adolescents with PWS. However, in those weighing > 90 kg, the < 1 ng/mL cutoff seems better. Larger studies are necessary to establish definitive glucagon doses and cutoffs, especially in extremely obese patients.

Clinical risk factors for early mortality in patients with community-acquired septic shock. The importance of adequate source control.

OBJECTIVE: To evaluate the incidence and risk factors for early mortality (EM) in the ICU in patients with community-acquired septic shock (CASS). DESIGN: A retrospective cohort study of patients with CASS admitted to the ICU (2003-2016). SETTING: ICU at a University Hospital in Spain. PATIENTS: All consecutive patients admitted to the ICU with CASS. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: CASS was defined according to the Sepsis-3 definitions. EM were defined as occurring within of 72h following ICU admission. A multinomial logistic regression analysis was performed to identify the risk factors associated with early deaths. RESULTS: During the study period, 625 patients met the Sepsis-3 criteria and admitted with CASS. 14.4% of all patients died within the first 72h. Of 161 patients who died in the ICU, 90 (55.9%) died within the first 72h. The percentage of early and late mortality did not vary significantly during the study period. The need and adequacy of source control were significantly lower in patients with EM. In the multivariate analysis, ARDS, non-respiratory infections, bacteremia and severity at admission were variables independently associated with EM. The only factor that decreased EM was adequate source control in patients with infections amenable to source control. CONCLUSIONS: The incidence of EM has remained stable over time, which means that more than half of the patients who die from CASS do so within the first 72h. Infections where adequate source control can be performed have lower EM.

Non-donor specific anti-human leukocyte antigen (HLA) antibodies are not associated with poor outcome in hematopoietic stem cell transplant recipients.

Testing for anti-human leukocyte antigen (HLA) antibodies has now become standard practice in allogeneic hematopoietic stem cell transplantation (HSCT), and anti-HLA antibodies (both donor specific and non-donor specific) are being identified and have many potential consequences. Most studies suggest that donor-specific HLA antibodies lead to adverse outcomes, though little is reported on non-donor specific anti-HLA antibodies. We present the results of a retrospective cohort analysis of 157 patients who received HSCT at the University of Rochester over a period of four years. We identified 45 patients (28.7%) who had detectable anti-HLA antibodies, while only one patient (0.6%) had donor-specific anti-HLA antibodies. Patients with prior pregnancies and multiple transfusions were at increased risk to develop antibodies. In our cohort, the presence of non-donor specific anti-HLA antibodies did not significantly impact overall survival, progression free survival, graft failure, or transplant-related mortality.

Removal residues of pesticides in apricot, peach and orange processed and dietary exposure assessment.

The effects of the industrial processing are evaluated of the removal of 16 pesticide residues in canned apricots and peaches and in orange juice. A method of multi-residual extraction that uses QuEChERS and liquid chromatography in tandem with triple quadrupole mass spectrometry was used. The method shows good linearity for the 16 pesticides studied (R2 > 0.999); it is accurate and precise (recoveries of 87-115%, relative standard deviation <8.0%). The processing factors are <0.6, indicating that all the processes significantly reduce the residue levels (spinosad, thiacloprid, pyridaben, bupirimate, flusilazole, triflumizole, flonicamid, imidacloprid, lambda-cyhalothrin, cyproconazole, fludioxinil and cyprodinil, abamectin, chlorpyrifos-methyl, hexythiazox and metalaxyl) initially present in the raw fruits and very significantly during washing/cutting, squeezing and hot pack canning (>55% loss). The risk quotient (EDI/ADI ratio) for canned foods is below 100, indicating that the potential consumer risk for the pesticides studied is practically negligent for human health.

Comparison of the defined daily dose and days of treatment methods for evaluating the consumption of antibiotics and antifungals in the intensive care unit.

OBJECTIVE: To compare the measurement of antimicrobial consumption by defined daily dose (DDD) versus by days of therapy (DOT). DESIGN: Retrospective analysis of clinical and administrative data from patients admitted to a polyvalent ICU. SETTING: ICU at a University Hospital in Spain. PATIENTS: All patients admitted to the ICU. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: For the DDD method, the World Health Organization (WHO)-assigned DDD was determined for the all the prescribed antimicrobials. For the DOT method, one DOT represented the administration of a single agent on a given day regardless of the number of doses administered. To express aggregate use, total DDDs and total DOTs were normalized to 100 patient-days. RESULTS: During the study period, 2393 adult patients were admitted to the ICU. Total median antimicrobial drugs measured by DDDs was 535.3 (IQR 319.8-845.5) vs. 344.0 (IQR 117.2-544.5) when measured by DOTs, p<0.001. When antimicrobial consumption was normalized to 100 patient-days, median antimicrobial consumption was also higher when measured by DDDs [2.98/100 patient-days (IQR 1.76-5.25) vs. 1.89/100 patient-days (IQR 0.64-3.0) when measured by DOTs, p<0.001]. CONCLUSIONS: For most antibacterial and antifungal drugs used in critically ill patients, estimates of aggregate antibiotic use by DDDs per 100 patient-days and DOTs per 100 patient-days are discordant because the administered dose is dissimilar from the WHO-assigned DDD. DOT methods should be recommended to avoid the overestimation that occurs with DDDs in adult critically ill patients.

Murine Model for the Study of Influenza D Virus.

A novel genus within the Orthomyxoviridae family was identified in the United States and named influenza D virus (IDV). Bovines have been proposed to be the primary host, and three main viral lineages (D/OK-like, D/660-like, and D/Japan-like) have been described. Experimental infections had previously been performed in swine, ferrets, calves, and guinea pigs in order to study IDV pathogenesis. We developed a murine experimental model to facilitate the study of IDV pathogenesis and the immune response. DBA/2 mice were inoculated with 105 50% tissue culture infective dose (TCID50) of D/bovine/France/5920/2014 (D/OK-like). No clinical signs or weight loss were observed. Viral replication was observed mainly in the upper respiratory tract (nasal turbinates) but also in the lower respiratory tract of infected mice, with a peak at 4 days postinfection. Moreover, the virus was also detected in the intestines. All infected mice seroconverted by 14 days postinfection. Transcriptomic analyses demonstrated that IDV induced the activation of proinflammatory genes, such as gamma interferon (IFN-γ) and CCL2. Inoculation of NF-κB-luciferase and Ifnar1-/- mice demonstrated that IDV induced mild inflammation and that a type I interferon response was not necessary in IDV clearance. Adaptation of IDV by serial passages in mice was not sufficient to induce disease or increased pathogenesis. Taken together, present data and comparisons with the calf model show that our mouse model allows for the study of IDV replication and fitness (before selected viruses may be inoculated on calves) and also of the immune response.IMPORTANCE Influenza D virus (IDV), a new genus of Orthomyxoviridae family, presents a large host range and a worldwide circulation. The pathogenicity of this virus has been studied in the calf model. The mouse model is frequently used to enable a first assessment of a pathogen's fitness, replication, and pathogenesis for influenza A and B viruses. We showed that DBA/2 mice are a relevant in vivo model for the study of IDV replication. This model will allow for rapid IDV fitness and replication evaluation and will enable phenotypic comparisons between isolated viruses. It will also allow for a better understanding of the immune response induced after IDV infection.

Anticoagulantes orales directos en la fibrilación auricular no valvular: cómo mejorar su uso en España / Novel oral anticoagulants in non-valvular atrial fibrillation: How to improve its management in Spain

INTRODUCCIÓN Y OBJETIVOS: Recientes estudios con datos en vida real sobre el uso de anticoagulantes de acción directa (ACOD) en pacientes con fibrilación auricular no valvular, aportan datos del empleo de los diferentes ACOD según las características de los pacientes. El objetivo de este trabajo fue elaborar un documento sobre las sugerencias de uso de los ACOD en función de la evidencia existente en la literatura y de la experiencia clínica. MATERIALES Y MÉTODOS: Un panel multidisciplinar de 8 expertos consensuó y desarrolló el contenido. El documento elaborado fue completado en 10 reuniones regionales con expertos de distintas especialidades. El panel valoró las aportaciones de los expertos regionales y elaboró las sugerencias definitivas. RESULTADOS: El documento final recoge las aportaciones generadas a lo largo de todo el proceso en 3 apartados. Se detallan las conclusiones/sugerencias generales sobre el empleo de los ACOD. Se proponen sugerencias concretas de empleo de cada ACOD en función de características clínicas específicas de los pacientes. Por último, se definen las limitaciones al empleo de los ACOD y se proponen acciones para mejorar el manejo de la anticoagulación. CONCLUSIONES: Es necesario superar las barreras clínicas y administrativas que dificultan el óptimo empleo de los ACOD con el fin de mejorar el tratamiento de los pacientes con fibrilación auricular no valvular que precisan anticoagulación

INTRODUCTION AND OBJECTIVES: Recent real-world data studies on the use of direct oral anticoagulants (DOAC) in patients with non-valvular atrial fibrillation, provide data on the use of different DOAC according to patient characteristics. The objective of this work was to elaborate on the suggestions on the use of DOAC based on evidence and clinical experience. MATERIALS AND METHODS: A multidisciplinary panel of 8 experts developed the agreed content. The document was completed in 10 regional meetings with experts from different specialties. According to these contributions, the panel prepared the final suggestions. RESULTS: The final document includes the contributions generated throughout the entire process in 3 sections. The general conclusions / suggestions on the use of DOAC are detailed. Specific tips on the use of each DOAC are proposed, based on the specific clinical profiles of the patients. Finally, the limitations on the use of DOAC are defined, and a group of actions are proposed to improve the management of anticoagulation. CONCLUSIONS: It is necessary to overcome the clinical and administrative barriers that hinder the optimal use of DOAC, in order to improve the treatment of patients with non-valvular atrial fibrillation who require anticoagulation

Porous aerogel and core/shell nanoparticles for controlled drug delivery: A review.

This review presents the methods and general strategies for the synthesis of porous aerogels and core/shell nanoparticles with efficient and controlled drug delivery. Different mechanisms of drug delivery are also discussed, which are influenced by the porosity, surface area, pH and surface functionalization of the aerogel and core/shell nanoparticles. Various porous inorganic, organic, and hybrid systems were compared. In addition, the main physical and chemical characteristics of these porous nanoparticles which enhance the drug loading on the porous nanoparticles were discussed.

[Novel oral anticoagulants in non-valvular atrial fibrillation: How to improve its management in Spain]. / Anticoagulantes orales directos en la fibrilación auricular no valvular: cómo mejorar su uso en España.

INTRODUCTION AND OBJECTIVES: Recent real-world data studies on the use of direct oral anticoagulants (DOAC) in patients with non-valvular atrial fibrillation, provide data on the use of different DOAC according to patient characteristics. The objective of this work was to elaborate on the suggestions on the use of DOAC based on evidence and clinical experience. MATERIALS AND METHODS: A multidisciplinary panel of 8 experts developed the agreed content. The document was completed in 10 regional meetings with experts from different specialties. According to these contributions, the panel prepared the final suggestions. RESULTS: The final document includes the contributions generated throughout the entire process in 3 sections. The general conclusions / suggestions on the use of DOAC are detailed. Specific tips on the use of each DOAC are proposed, based on the specific clinical profiles of the patients. Finally, the limitations on the use of DOAC are defined, and a group of actions are proposed to improve the management of anticoagulation. CONCLUSIONS: It is necessary to overcome the clinical and administrative barriers that hinder the optimal use of DOAC, in order to improve the treatment of patients with non-valvular atrial fibrillation who require anticoagulation.