Microplastic in industrial aquaculture: Occurrence in the aquatic environment, feed and organisms (Dicentrarchus labrax).

The increasing use of plastics and the growing concern about their impact on the environment and living beings makes it necessary to study how microplastics (MP) affect aquaculture systems. In order to gain an in-depth understanding of these systems, this study covers the water intake, the purification treatment at the inlet, the water in the culture tanks, as well as the feed used in the feeding and the organism itself. For this purpose, five samples were taken, both in the water line, feed and sea bass during the weeks of the experiment. It is shown that the available purification systems reduce the amount of MP entering from the receiving environment. However, new MP are observed in the sea bass tank, which may be due mainly to those added through the feed and found in the feed, as well as in the piping and other materials used in current aquaculture systems (PTFE, PA, among others). If focusing on the feed that can reach the consumer, in the case of this study, carried out with sea bass, some types of MP (PE, PTFE, PS and PA) were found in 4 head samples and 4 skin/muscle samples. Although inlet water purification systems manage to reduce a high percentage of MPs in the system, it is observed that there are other access routes that should be considered and reduced in aquaculture facilities to prevent them from reaching the human consumer.

Medico-legal evaluation of torture victims in the USA before the Istanbul Protocol.

Now that the updated version of the Istanbul Protocol has been published, there is an opportunity to reconstruct pieces of history on the long road to having forensic torture assessment tools. This article is an attempt to contribute to that journey through our firstperson personal memories of those experiences, especially in the early years, far before the drafting and approval of the Istanbul Protocol: Amnesty International (AI).

Solar photo-Fenton optimization at neutral pH for microcontaminant removal at pilot plant scale.

The increasing occurrence of micropollutants in natural water bodies has medium to long-term effects on both aquatic life and human health. The aim of this study is to optimize the degradation of two pharmaceutical pollutants of emerging concern: amoxicillin and acetaminophen in aqueous solution at laboratory and pilot scale, by solar photo-Fenton process carried out at neutral pH using ethylenediamine-N,N'-disuccinic acid (EDDS) as a complexing agent to maintain iron in solution. The initial concentration of each compound was set at 1 mg/L dissolved in a simulated effluent from a municipal wastewater treatment plant (MWTP). A factorial experimental design and its surface response analysis were used to optimize the operating parameters to achieve the highest initial degradation rate of each target. The evolution of the degradation process was measured by ultra-performance liquid chromatography (UPLC/UV), obtaining elimination rates above 90% for both contaminants. Statistical study showed the optimum concentrations of Fe(III) at 3 mg/L at an Fe-EDDS ratio of 1:2 and 2.75 mg/L H2O2 for the almost complete removal of the target compounds by solar photo-Fenton process. Validation of the experimental design was successfully carried out with actual MWTP effluent spiked with 100 µg/L of amoxicillin and acetaminophen, each at pilot plant scale.

Influence of tourism on microplastic contamination at wastewater treatment plants in the coastal municipality of Chiclana de la Frontera.

The tourism is one of the most important sources of the economy in the Bay of Cadiz. Specifically, the municipality of Chiclana de la Frontera, with a population lower than 90,000 citizens, located in the southeast of Spain. During the summer season the population duplicates leading to an increment in flow at wastewater treatment plants (WWTPs). These facilities have been reported as a source of microplastics (MPs) into marine ecosystems, therefore the aim of the present study is to investigate if the tourism affects the presence, discharge and in the receiving environment. Samples were taken at the influent and effluent of the municipal WWTPs (one located at the urban area and other located at resort area) during 2021 (including low and high season). MPs were collected and extracted from wastewater matrixes following the method recommended by the National Oceanic and Atmospheric Administration and UTS treatment to reduce organic matter and cellulose, respectively. The analysis of the samples was performed according to their abundance, shape, size, and type of polymer, along with the removal rates of MPs at WWTPs. The results showed heterogeneous MPs abundance ranging from 1246.4 to 345.7 MPs/L and 72.9 to 4.2, in the influent and effluent, respectively, increasing the presence of MPs at resort WWTP during high season. Fibers were the predominant shape within all the samples. A total of 17 polymers were identified, by ATR-FTIR, where Acrylates, PE and PA were the largest polymers found. Despite the high MPs retention performance of the WWTPs analyzed (84.1-99.3 %), a combined contribution of approximately 1.4 × 107-5.9 × 108 MPs/d to the aquatic environment was estimated. Finally, these results indicate that the increase of MPs in the wastewater at WWTP-B was related with the population increase as a consequence of summer tourism.

Características epidemiológicas y clínicas autorreportadas en pacientes con obesidad y COVID-19: un estudio de corte transversal / Epidemiological and clinical characteristics self-reported in patients with obesity and COVID-19 disease: a cross-sectional study

RESUMEN INTRODUCCIÓN En Argentina, la obesidad en adultos es una problemática con una prevalencia media de 25,4%. En la relación entre COVID-19 y obesidad, se observa mayor prevalencia de sobrepeso/obesidad y enfermedad severa entre los pacientes con COVID-19. Por ello, el objetivo del estudio fue conocer las características clínicas y epidemiológicas en pacientes con diagnóstico de obesidad sobrevivientes a la infección por SARS-CoV-2. MÉTODOS Se realizó un estudio observacional descriptivo y analítico de corte transversal. Se aplicó una encuesta autoadministrada. RESULTADOS La mediana de edad fue 41 años, y hubo un 69,9% de mujeres. Los síntomas de presentación más prevalentes fueron astenia (86,7%), anosmia (64,5%) y tos (64%). Con respecto a los síntomas persistentes luego de las 12 semanas del diagnóstico, los más prevalentes fueron astenia (52,9%), trastornos de sueño (32,4%) y falta de concentración/memoria (31,7%). Hubo mayor riesgo en mujeres (OR: 2,86; IC95%: 2,23-3,67) con obesidad (OR: 1,58; IC95%: 1,16-2,16). La enfermedad grave en obesos fue casi el triple comparado con no obesos (15,7% vs. 5,4%; p<0,001). DISCUSIÓN Los pacientes obesos mostraron síntomas de presentación que orientan a un estado inflamatorio sistémico, con disnea y tos más frecuentes, y tienen mayor prevalencia de enfermedad grave y neumonía, así como mayor riesgo de desarrollar síntomas persistentes, sobre todo si las personas son mujeres y sedentarias.

ABSTRACT INTRODUCTION In Argentina, obesity in adults is a problem with an average prevalence of 25.4%. The relationship between COVID-19 and obesity shows a higher prevalence of overweight/obesity and severe disease among patients with COVID-19. Therefore, the objective of the study was to know the clinical and epidemiological characteristics of patients diagnosed with obesity who survived SARSCoV- 2 infection. METHODS A descriptive and analytical cross-sectional observational study was carried out. A self-administered survey was applied. RESULTS The median age was 41 years and 69.9% were women. The most prevalent presenting symptoms were asthenia (86.7%), anosmia (64.5%) and cough (64%). Regarding persistent symptoms 12 weeks after diagnosis, the most prevalent ones were asthenia (52.9%), sleep disorders (32.4%) and lack of concentration/memory (31.7%). The risk was higher for women (OR: 2.865; CI95%: 2.23-3.67) with obesity (OR: 1.58; CI95%: 1.16-2.16). Severe disease in obese was almost threefold that in non-obese patients (15.7% vs. 5.4%; p<0.001). DISCUSSION Obese patients showed presenting symptoms that point to a systemic inflammatory state, with dyspnea and cough being more common, and have a higher prevalence of severe disease and pneumonia, as well as a higher risk of developing persistent symptoms, especially if they are women and sedentary.

The Prevalence and Treatment of ADHD in Spain: A Retrospective Cohort Analysis.

OBJECTIVE: Estimate the prevalence and incidence of Attention Deficit Hyperactivity Disorder (ADHD) and analyze variations in its treatment across Spain. METHOD: Analyses were performed using IQVIA's clinical practice RealWorld Database, the electronic medical records of some 1 million patients from 2013 to 2018. MPH treatment was assessed using the Defined Daily Dose (DDD), MPH sales were extracted from IQVIA's Sell-Out database and the number of active psychiatrists from IQVIA's OneKey Database. RESULTS: Significantly higher ADHD prevalence and incidence (1) in children than in adults and (2) in males compared to females. 91% of patients take MPH. Regional variations in MPH consumption range from 247 Daily Dose per Inhabitant (DDI) per 100,000 inhabitants to 414. CONCLUSION: ADHD continues to be underdiagnosed and undertreated, particularly in adults, and more so in females. The lack of diagnostic tools for adults and the variations in treatment across the country need to be addressed.

The military coup in Chile in 1973, the immediate reaction of international organisations, and the founding of the first rehabilitation program for torture victims in 1977.

This paper documents the historical steps of the immediate reactions of the United Nations, Amnesty International, the World Council of Churches (WCC), the Inter-American Com-mission on Human Rights, and lawyers' or-ganisations in support of the victims of torture and others suffering gross violations of their human rights, as perpetrated by the Chilean military from 1973 to 1990. This article is also the history of the founding of the first rehabili-tation programs for torture victims in Chile in 1977 and the other care programs for victims under local and international churches' pro-tection during the worst period of the military dictatorship. The actions of denunciation and defense of the victims were possible through national and international networks sustained in collaborative work from inside and outside Chile, which lasted for 17 years. The results and lessons learned projected the creation of new commissions, funds, and international networks that continue today in the inter-national arena. The rehabilitation programs under the dictatorship began as a solidarity response to the needs of victims The reha-bilitation programs, born during the dictator-ship, projected their practice and experience to create a comprehensive health program as part of the State's reparation measures. The testimonies of the victims made it possible to understand the consequences of human rights violations on individuals and society. State policies and civil society actions have sought to contribute to the reparation of victims through rehabilitation actions directly. This paper is part of the memory of that past by reconstructing the solidarity actions of denunciation and rehabilitation, and the details of which are often unknown.

Comparative Effect of UV, UV/H2O2 and UV/H2O2/Fe on Terbuthylazine Degradation in Natural and Ultrapure Water.

Different advanced oxidation processes (AOPs) (ultraviolet radiation, hydrogen peroxide photolysis and photo-Fenton) were applied to test the degradation of terbuthylazine in three types of water: (a) ultrapure water, (b) surface water from the Gaditana area (Los Hurones reservoir, Cádiz, Spain) and (c) groundwater from the Tempul spring in Jerez de la Frontera (Cádiz, Spain). The experiments were carried out on a laboratory scale, using two different types of reactors, batch and semi-continuous. In batch reactors, the most efficient process for the experiments carried out with both ultrapure water and underground groundwater was ultraviolet radiation, whereas for surface water from the Gaditana area, the process that obtained the best results was the photolysis of hydrogen peroxide with 2.5 mg L-1 of H2O2. In semi-continuous reactors, the most efficient process was the photolysis of hydrogen peroxide with 2.5 mg L-1 of H2O2 for all the matrices studied. In both types of reactors, terbuthylazine degradation percentages higher than 90% were achieved; the main difference was in the reaction time, which varied from minutes in the batch reactor to seconds in the semi-continuous reactor. In all the applied AOPs, N-terbutyl-6-hydroxy-N'ethyl-1,3,5-triazine-2,4-diamine (TBA-212) was generated as a reaction intermediate.

Clinical efficacy of a virtual reality tool for the treatment of obesity: study protocol of a randomised controlled trial.

INTRODUCTION: Previous research has shown that it is feasible to integrate motivational interviewing techniques with behavioural and psychological interventions for the treatment of obesity. Moreover, these combined interventions have the potential to improve health-related outcomes of people living with obesity (PLWO) and to afford maintenance of behavioural changes over time. In addition, the use of virtual reality (VR) embodiment techniques in the treatment of eating disorders and obesity has promising preliminary effectiveness. The objective of this study is to assess the clinical efficacy of a VR intervention that uses embodiment and body-swapping techniques and has been specifically developed to cover the needs of PLWO. METHODS AND ANALYSIS: A randomised control trial will be carried out with an estimated sample of 96 participants with body mass index (BMI)>30. The whole duration of the trial will be 12 months. Participants will be recruited from the external consultations of the Vall d'Hebron University Hospital and be randomly assigned to three groups. The experimental group 1 will engage in a virtual self-conversation using the ConVRself platform, the experimental group 2 will participate in a 'pre-established discourse' provided by the virtual counsellor, who will give psychoeducation advice, and the control group will continue with treatment as usual. Readiness to change, BMI, eating habits and physical activity, psychological well-being, body image satisfaction, quality of life in relation to body image, and weight bias internalisation will be assessed at baseline, post intervention, 1-week and 4-week follow-up. Finally, variables related to adherence and satisfaction with the VR tool will be evaluated for the experimental groups. ETHICS AND DISSEMINATION: This study was approved by the Research Projects Committee of the Vall d'Hebron University Hospital. Findings will be disseminated through peer-reviewed journals, reports to the funding body, conferences and other events for the scientific and clinical community, and the general public. TRIAL REGISTRATION NUMBER: NCT05094557.

An empirical evaluation of Lex/Yacc and ANTLR parser generation tools.

Parsers are used in different software development scenarios such as compiler construction, data format processing, machine-level translation, and natural language processing. Due to the widespread usage of parsers, there exist different tools aimed at automizing their generation. Two of the most common parser generation tools are the classic Lex/Yacc and ANTLR. Even though ANTLR provides more advanced features, Lex/Yacc is still the preferred choice in many university courses. There exist different qualitative comparisons of the features provided by both approaches, but no study evaluates empirical features such as language implementor productivity and tool simplicity, intuitiveness, and maintainability. In this article, we present such an empirical study by conducting an experiment with undergraduate students of a Software Engineering degree. Two random groups of students implement the same language using a different parser generator, and we statistically compare their performance with different measures. Under the context of the academic study conducted, ANTLR has shown significant differences for most of the empirical features measured.

Nurse admissions at a specialized mental health programme: A pre-Covid-19 retrospective review (2000-2019).

AIMS: Nursing is a stressful and emotionally demanding profession. To date, few mental health treatment interventions have been developed for them worldwide. This study aims to explore referral trends in nurses with mental disorders admitted to a pioneer specialized mental health programme in Europe from 2000 to 2019. DESIGN: A retrospective observational study of 1297 medical e-records of nurses with mental health disorders admitted to the Galatea Care Programme in Barcelona was conducted. METHODS: Three periods were analysed: 2000-2006, 2007-2012 and 2013-2019. Socio-demographic and clinical variables were compared. Diagnoses followed Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria. RESULTS: Gender and age at referral did not change over time. Self-referrals grew from 85.1% in the first period to 95.3% in the last period; inpatient admissions decreased from 24.1% to 18.2%, although this was not significant; nurses were less frequently on sick leave on admission over time (59.1% vs. 45.7%); they were more likely to have a temporary contract in the second period (9.5% vs. 4.8% and 4%) and prevalence of main diagnosis changed with a considerable decrease in affective and substance use disorders after 2006 and a progressive increase in adjustment disorders during the whole period. CONCLUSION: Free, voluntary, highly confidential programmes for nurses with mental disorders may enhance voluntary and earlier help seeking. These findings can be considered when implementing specialized interventions for them in other settings. WHAT PROBLEM DID THE STUDY ADDRESS?: Nursing is a stressful and emotionally demanding profession. To date, few specialized mental health services have been developed for them worldwide. This study aims to explore referral trends in nurses with mental disorders admitted to a pioneer programme in Europe, the Galatea Care Programme in Barcelona, from 2000 to 2019. WHAT WERE THE MAIN FINDINGS?: The number of referrals to the programme grew especially after the first 7-year period. Admissions were more likely to be voluntary during the last period. Prevalence of substance use disorders at admission dropped steadily while prevalence of adjustment disorders progressively increased over the two decades. Nurses were also less likely to be on sick leave at admission. WHERE AND ON WHOM WILL THE RESEARCH HAVE IMPACT?: Free, voluntary, highly confidential programmes for nurses with mental disorders may enhance voluntary and earlier help seeking. These findings can be considered when implementing specialized interventions for them in other settings.

Characteristics of resident physicians accessing a specialised mental health service: a retrospective study.

OBJECTIVES: Little is known about resident physicians being treated at physician health programmes around the world despite the fact that it is a highly demanding training period. This study aims to describe the profiles of resident physicians accessing a specialised mental health service in Spain over a 20-year period and to compare them to consultant-grade physicians. DESIGN: Retrospective observational study. SETTING: Medical records of the Galatea Care Programme for Sick Physicians. PARTICIPANTS: 1846 physicians registered at the Barcelona Medical Council-Association and admitted to the programme from January 1998 to December 2018. PRIMARY AND SECONDARY OUTCOME MEASURES: Number of admissions, sociodemographic and clinical variables, including medical specialty, main diagnosis and need of hospitalisation. RESULTS: Residents accounted for 18.1% (n=335) of the sample and admissions increased over the years. Most residents (n=311; 94.5%) and consultant-grade physicians (n=1391; 92.8%) were self-referred. The most common specialty among residents was family medicine (n=107; 31.9%), followed by internal medicine (n=18; 5.4%), paediatrics (n=14; 4.2%), psychiatry (n=13; 3.9%) and anaesthesiology (n=13; 3.9%). Residents, regardless of year of training, mainly asked for help because of adjustment (n=131; 39.1%), affective (n=77; 23%), anxiety disorders (n=40; 18.8%) and addictions (n=19; 5.7%). There were no significant differences between groups in the main diagnosis and in the variables related to need of hospitalisation. The percentage of residents accessing the programme was higher than in the reference population registered at the Barcelona Medical Council-Association (18.1% vs 7.6%; z=7.2, p<0.001) as was the percentage of family medicine residents (31.9% vs 19.6%; z=5.7, p<0.001). CONCLUSIONS: Residents are more likely than consultant-grade physicians to seek help when suffering from mental disorders. Local primary prevention actions since the beginning of their training period and having access to a well-known highly reliable programme may partly explain these findings.

Pharmaceutical Products and Pesticides Toxicity Associated with Microplastics (Polyvinyl Chloride) in Artemia salina.

Pharmaceutical products, as well as insecticides and antimicrobials, have been extensively studied, but knowledge of their effects-especially those caused by their mixtures with microplastics-on aquatic organisms remains limited. However, it should be borne in mind that the state of knowledge on acute and chronic effects in aquatic organisms for pharmaceuticals and pesticides is not similar. In response, this investigation analyzed the presence of microplastics (polyvinyl chloride) and their impacts on the toxicity of chlorpyrifos (an insecticide) and triclosan (an antibacterial) when they coincide in the environment, alongside the two most consumed drugs of their type (hypolipemic and anticonvulsant, respectively), namely simvastatin and carbamazepine, in Artemia salina. LC50 and cholinesterase enzyme activity were calculated to determine the possible neurotoxicity associated with emergent contaminants in the treatments. The LC50 values obtained were 0.006 mg/dm3 for chlorpyrifos, 0.012 mg/dm3 for chlorpyrifos associated with microplastics, 4.979 mg/dm3 for triclosan, 4.957 mg/dm3 for triclosan associated with microplastics, 9.35 mg/dm3 for simvastatin, 10.29 mg/dm3 for simvastatin associated with microplastics, 43.25 mg/dm3 for carbamazepine and 46.50 mg/dm3 for carbamazepine associated with microplastics in acute exposure. These results indicate that the presence of microplastics in the medium reduces toxicity, considering the LC50 values. However, exposure to chlorpyrifos and carbamazepine, both alone and associated with microplastics, showed a decline in cholinesterase activity, confirming their neurotoxic effect. Nevertheless, no significant differences were observed with the biomarker cholinesterase between the toxicant and the toxicant with microplastics.

Biodegradability and toxicity of dodecyl trimethyl ammonium chloride in sea water.

Studies were conducted to assess the biodegradability and toxicity of the cationic surfactant dodecyl trimethyl ammonium chloride (DTMAC) in sea water samples collected from the Gulf of Cadiz (Spain). Ultimate biodegradation was studied following the guideline proposed by the United States Environmental Protection Agency (USEPA). Growth inhibition tests on five marine microalgae species and mortality tests on a marine crustacean (Artemia franciscana) were carried out. Biodegradation process was modelled according to a logistic kinetic model. Lag time and half-life were 15.17 and 26.95 days, respectively. Depending on the microalgae, 96-h EC50 values ranged from 0.69 to 6.34 mg L-1 DTMAC, respectively. 48-h and 72-h LC50 to A. franciscana were 46.74 and 34.19 mg L-1 DTMAC, respectively. The results indicate that DTMAC can be mineralised in sea water. Marine crustacean was more resistant than the microalgae. Surfactant tolerance on microalgae followed this order: T. chuii > N. gaditana > C. gracilis ≈ I. galbana ≈ D. salina, being the Green microalgae T. chuii the most tolerant.

Insomnia Symptoms in Patients With Substance Use Disorders During Detoxification and Associated Clinical Features.

Background: Insomnia is highly prevalent in patients with substance use disorders (SUD), and it has been related to a worse course of addiction. Insomnia during detoxification in a hospital has not been adequately studied. This study aims to compare sociodemographic, clinical, and psychopathological characteristics of SUD patients undergoing a detoxification program, by comorbidity and insomnia symptoms. Methodology: We recruited 481 patients who received pharmacological and psychotherapeutic treatment for detoxification. They were evaluated through semi-structured interviews, standardized questionnaires, and a specific sleep log. A bivariate and multivariate analysis of the data was performed. Results: Insomnia was reported by 66.5% patients, with sleep-maintenance insomnia the most frequent issue, followed by early morning awakening and sleep-onset insomnia. Patients with alcohol use disorder and cannabis use disorder had higher prevalence of sleep-onset insomnia. Patients with cocaine and heroin use disorder had higher prevalence of sleep-maintenance insomnia. Independent factors that allowed the identification of insomnia symptoms included being female (OR: 3.43), polysubstance use (OR: 2.85), comorbid anxiety disorder (OR: 2.02), and prior admission for detoxification (OR: 1.22). Conclusions: Insomnia symptoms are very prevalent in patients admitted for detoxification. The diagnosis and therapeutic strategies for the insomnia symptoms should be improved, especially in women and in patients with greater addiction severity and with anxiety disorders.

Assessing the user experience and usability of the PRECIOUS system: a randomized controlled trial in obese patients.

Objective To assess users' usability, satisfaction, acceptance and effectiveness of the PRECIOUS system to promote behavior change toward healthier lifestyles. Design: Thirty-one adult patients with BMI>30 (M = 44.23, SD = 5.91) were recruited and randomized into three conditions for a longitudinal study (3 months length): 1) Control group (TAU + biofeedback + follow-ups); 2) PRECIOUS only (app + biofeedback + follow-ups); 3) PRECIOUS + MI (app + biofeedback + motivational interviewing follow-ups). Main Outcome Measures: Usability, satisfaction, acceptance and effectiveness of PRECIOUS, and stages of change (S-Weight questionnaire). Results: The system was described as easy to use, flexible, fairly satisfying and good as a preventive health system. Participants rated biofeedback and the Physical Activity module as the most satisfying features. However, participants were unsatisfied with the Diet module. All additional features received acceptable scores in terms of satisfaction. Despite this, the PRECIOUS only group reported that they would probably recommend the system to others because it meets its purposes quite well. Conclusion: PRECIOUS was found a usable and acceptable solution, although improving several features in the Diet module in successive versions of the app would promote sustained use and satisfaction among users, possibly increasing its effectiveness in promoting healthier lifestyles. Abbreviations: ADA American Diabetes Association; BG2: BodyGuard2; BMI: Body Mass Index; CBT: Cognitive-behavioral therapy; EMA: Ecological Momentary Assessment; eHealth: Electronic health; mHealth: Mobile health; MI: Motivational interviewing; NCD: Non-communicable diseases; PA: Physical activity; PRECIOUS: PREventive Care Infrastructure based On Ubiquitous Sensing.

Statement of the Independent Forensic Expert Group on Conversion Therapy.

Conversion therapy is a set of practices that aim to change or alter an individual's sexual orientation or gender identity. It is premised on a belief that an individual's sexual orientation or gender identity can be changed and that doing so is a desirable outcome for the individual, family, or community. Other terms used to describe this practice include sexual orientation change effort (SOCE), reparative therapy, reintegrative therapy, reorientation therapy, ex-gay therapy, and gay cure. Conversion therapy is practiced in every region of the world. We have identified sources confirming or indicating that conversion therapy is performed in over 60 countries. In those countries where it is performed, a wide and variable range of practices are believed to create change in an individual's sexual orientation or gender identity. Some examples of these include: talk therapy or psychotherapy (e.g., exploring life events to identify the cause); group therapy; medication (including anti-psychotics, anti- depressants, anti-anxiety, and psychoactive drugs, and hormone injections); Eye Movement Desensitization and Reprocessing (where an individual focuses on a traumatic memory while simultaneously experiencing bilateral stimulation); electroshock or electroconvulsive therapy (ECT) (where electrodes are attached to the head and electric current is passed between them to induce seizure); aversive treatments (including electric shock to the hands and/or genitals or nausea-inducing medication administered with presentation of homoerotic stimuli); exorcism or ritual cleansing (e.g., beating the individual with a broomstick while reading holy verses or burning the individual's head, back, and palms); force-feeding or food deprivation; forced nudity; behavioural conditioning (e.g., being forced to dress or walk in a particular way); isolation (sometimes for long periods of time, which may include solitary confinement or being kept from interacting with the outside world); verbal abuse; humiliation; hypnosis; hospital confinement; beatings; and "corrective" rape. Conversion therapy appears to be performed widely by health professionals, including medical doctors, psychiatrists, psychologists, sexologists, and therapists. It is also conducted by spiritual leaders, religious practitioners, traditional healers, and community or family members. Conversion therapy is undertaken both in contexts under state control, e.g., hospitals, schools, and juvenile detention facilities, as well as in private settings like homes, religious institutions, or youth camps and retreats. In some countries, conversion therapy is imposed by the order or instructions of public officials, judges, or the police. The practice is undertaken with both adults and minors who may be lesbian, gay, bisexual, trans, or gender diverse. Parents are also known to send their children back to their country of origin to receive it. The practice supports the belief that non-heterosexual orientations are deviations from the norm, reflecting a disease, disorder, or sin. The practitioner conveys the message that heterosexuality is the normal and healthy sexual orientation and gender identity. The purpose of this medico-legal statement is to provide legal experts, adjudicators, health care professionals, and policy makers, among others, with an understanding of: 1) the lack of medical and scientific validity of conversion therapy; 2) the likely physical and psychological consequences of undergoing conversion therapy; and 3) whether, based on these effects, conversion therapy constitutes cruel, inhuman, or degrading treatment or torture when individuals are subjected to it forcibly2 or without their consent. This medico-legal statement also addresses the responsibility of states in regulating this practice, the ethical implications of offering or performing it, and the role that health professionals and medical and mental health organisations should play with regards to this practice. Definitions of conversion therapy vary. Some include any attempt to change, suppress, or divert an individual's sexual orientation, gender identity, or gender expression. This medico-legal statement only addresses those practices that practitioners believe can effect a genuine change in an individual's sexual orientation or gender identity. Acts of physical and psychological violence or discrimination that aim solely to inflict pain and suffering or punish individuals due to their sexual orientation or gender identity, are not addressed, but are wholly condemned. This medico-legal statement follows along the lines of our previous publications on Anal Examinations in Cases of Alleged Homosexuality1 and on Forced Virginity Testing.2 In those statements, we opposed attempts to minimise the severity of physical and psychological pain and suffering caused by these examinations by qualifying them as medical in nature. There is no medical justification for inflicting on individuals torture or other cruel, inhuman, or degrading treatment or punishment. In addition, these statements reaffirmed that health professionals should take no role in attempting to control sexuality and knowingly or unknowingly supporting state-sponsored policing and punishing of individuals based on their sexual orientation or gender identity.

Removal of emerging contaminants from wastewater through pilot plants using intermittent sand/coke filters for its subsequent reuse.

Effluents from wastewater treatment plants (WWTPs) are widely recognized as the main source of emerging contaminants (stimulants and antibiotics). In this study, intermittent sand and/or coke filters were installed as a tertiary treatment at the outlet of a secondary settling tank at the WWTP in Medina Sidonia, Spain. Regular sampling followed by solid-phase extraction (SPE) and analysis by liquid chromatography-mass spectrometry (UPLC-MS) showed the complete removal of the concentrations of the emerging contaminants (caffeine, theobromine, theophylline, amoxicillin and penicillin G). Moreover, optimal filtration conditions for the reuse of treated water were presented.