The role of check dams in retaining organic carbon and nutrients. A study case in the Sierra de Ávila mountain range (Central Spain).

Soil organic carbon plays an important role in the global carbon cycle, accounting for 70% of the Earth's carbon. However, soil erosion can have a major impact on the stocks of soil carbon and other soil nutrients, such as nitrogen and phosphorous. Soil and water conservation techniques, such as the building of check dams, are usually employed to control sediment yields and the losses of other soil components. The aim of this research is thus to quantify the soil organic carbon (SOC), soil nitrogen (SN) and soil phosphorous (SP) retained by the check dams of a hydrologic and forest restoration project in the Sierra de Ávila mountain range (Ávila, Central Spain). Soil samples were taken from the sediment wedges of 30 check dams and from 30 native soils. Soil texture, electric conductivity, pH, C, N and P were measured in all the soil samples. The volume of sediment retained by the check dams was calculated by the Sections Method, which is very accurate in estimating the real volume of the sediment wedges. The total sediment yield in the area was thus estimated at 6.40 Mg·ha-1·yr-1 and the mean SOC, SN and SP densities were respectively 13.76, 0.48 and 0.05 kg·m-2. These findings thus are very reliable and allow us to conclude that check dams constitute an important instrument for controlling losses of SOC, SN and SP, and preventing these substances from passing into watercourses downstream of the area.

Estrategia multimodal para la mejora de la adherencia a la higiene de manos en un hospital universitario / A multimodal strategy to improve adherence to hand hygiene in a university hospital

Objetivo. Enmarcado en el Proyecto PaSQ, el Hospital Universitario Marqués de Valdecilla implementa una estrategia multimodal de mejora de la higiene de manos (HM) para fomentar su cumplimiento de forma mantenida en el tiempo y mejorar la seguridad de los pacientes. Material y métodos. Durante 2014 se desarrollaron diferentes actividades siguiendo los 5 puntos de la estrategia multimodal de la OMS. En 4 unidades seleccionadas (135 camas) se implementó la estrategia 3/3, una metodología de evaluación y retroalimentación que proporciona resultados inmediatos a los profesionales, contribuyendo a su formación, y que consiste en una evaluación directa de profesionales, no enmascarada y realizada durante 3 días a la semana cada 3 semanas. Se monitorizaron los indicadores de HM del Ministerio de Sanidad, Servicios Sociales e Igualdad. Resultados. El consumo de preparados de base alcohólica aumentó en 2014 con relación a 2013: 17,5 a 19,7ml/pacientes-día. En las unidades de intervención el consumo fue 24,8 pre-intervención, 42,5 durante la intervención y 30,4 2 meses-postintervención. Se realizaron 137 sesiones de observación: 737 profesionales observados y 1.870 oportunidades de HM. La adherencia a la HM fue 54,5%, variando a lo largo del periodo desde 44,8% en mayo a 69,9% y 69,4% al inicio y fin del proyecto. La incidencia de infecciones por S. aureus meticilín-resistente disminuyó en las unidades piloto durante 2014: de 13,2 a 5,7 infecciones por 10.000 pacientes-día. Conclusiones. La estrategia de mejora implementada, apoyada en la estrategia 3/3, aumentó el consumo de preparados de base alcohólica, al mismo tiempo que se observó una reducción de las infecciones por S. aureus meticilín-resistente (AU)

Objective. Within the framework of the PaSQ (Patient Safety and Quality care) Project, this hospital decided to implement a multifaceted hospital-wide Hand Hygiene (HH) intervention based on a multimodal WHO approach over one year, focusing on achieving a sustained change in HH cultural change in this hospital. Material and methods. Setting: University Hospital Marqués de Valdecilla, Santander (Spain), a tertiary hospital with 900 beds. Intervention period: 2014. An action plan was developed that included the implementation of activities in each component of the 5-step multimodal intervention. An observation/feedback methodology was used that included the provision of performance and results feedback to the staff. A 3/3 strategy (non-blinded direct observation audits performed during 3 randomised days every 3 weeks with pro-active corrective actions at the end of each observation period). HH compliance, alcohol-based hand-rub (ABHR) consumption, and rate of MRSA infection, were monitored during the intervention. Results. Hospital ABHR consumption increased during the study period: from 17.5 to 19.7mL/patient-days. In the intervention units, this consumption was 24.8mL pre-intervention, 42.5mL during the intervention, and 30.4mL two months post-intervention. There were 137 evaluation periods in 30 different days, in which a total of 737 health-care workers were observed and 1,870 HH opportunities. HH compliance was 54.5%, ranging between 44.8% and 69.9%. The incidence of MRSA infection decreased during the intervention in the selected units, from 13.2 infections per 10,000 patient-days pre-intervention to 5.7 three months post-intervention. Conclusions. Our HH strategy, supported by a 3/3 strategy increased alcohol-based hand-rub consumption and compliance. A reduction in MRSA infections was observed (AU)

[A multimodal strategy to improve adherence to hand hygiene in a university hospital]. / Estrategia multimodal para la mejora de la adherencia a la higiene de manos en un hospital universitario.

OBJECTIVE: Within the framework of the PaSQ (Patient Safety and Quality care) Project, this hospital decided to implement a multifaceted hospital-wide Hand Hygiene (HH) intervention based on a multimodal WHO approach over one year, focusing on achieving a sustained change in HH cultural change in this hospital. MATERIAL AND METHODS: Setting: University Hospital Marqués de Valdecilla, Santander (Spain), a tertiary hospital with 900 beds. Intervention period: 2014. An action plan was developed that included the implementation of activities in each component of the 5-step multimodal intervention. An observation/feedback methodology was used that included the provision of performance and results feedback to the staff. A 3/3 strategy (non-blinded direct observation audits performed during 3 randomised days every 3 weeks with pro-active corrective actions at the end of each observation period). HH compliance, alcohol-based hand-rub (ABHR) consumption, and rate of MRSA infection, were monitored during the intervention. RESULTS: Hospital ABHR consumption increased during the study period: from 17.5 to 19.7mL/patient-days. In the intervention units, this consumption was 24.8mL pre-intervention, 42.5mL during the intervention, and 30.4mL two months post-intervention. There were 137 evaluation periods in 30 different days, in which a total of 737 health-care workers were observed and 1,870 HH opportunities. HH compliance was 54.5%, ranging between 44.8% and 69.9%. The incidence of MRSA infection decreased during the intervention in the selected units, from 13.2 infections per 10,000 patient-days pre-intervention to 5.7 three months post-intervention. CONCLUSIONS: Our HH strategy, supported by a 3/3 strategy increased alcohol-based hand-rub consumption and compliance. A reduction in MRSA infections was observed.

In vivo murine model of acquired resistance in myeloma reveals differential mechanisms for lenalidomide and pomalidomide in combination with dexamethasone.

The development of resistance to therapy is unavoidable in the history of multiple myeloma patients. Therefore, the study of its characteristics and mechanisms is critical in the search for novel therapeutic approaches to overcome it. This effort is hampered by the absence of appropriate preclinical models, especially those mimicking acquired resistance. Here we present an in vivo model of acquired resistance based on the continuous treatment of mice bearing subcutaneous MM1S plasmacytomas. Xenografts acquired resistance to two generations of immunomodulatory drugs (IMiDs; lenalidomide and pomalidomide) in combination with dexamethasone, that was reversible after a wash-out period. Furthermore, lenalidomide-dexamethasone (LD) or pomalidomide-dexamethasone (PD) did not display cross-resistance, which could be due to the differential requirements of the key target Cereblon and its substrates Aiolos and Ikaros observed in cells resistant to each combination. Differential gene expression profiles of LD and PD could also explain the absence of cross-resistance. Onset of resistance to both combinations was accompanied by upregulation of the mitogen-activated protein kinase/extracellular signal-regulated kinase (ERK) kinase (MEK)/ERK pathway and addition of selumetinib, a small-molecule MEK inhibitor, could resensitize resistant cells. Our results provide insights into the mechanisms of acquired resistance to LD and PD combinations and offer possible therapeutic approaches to addressing IMiD resistance in the clinic.

Phenotypic identification of subclones in multiple myeloma with different chemoresistant, cytogenetic and clonogenic potential.

Knowledge about clonal diversity and selection is critical to understand multiple myeloma (MM) pathogenesis, chemoresistance and progression. If targeted therapy becomes reality, identification and monitoring of intraclonal plasma cell (PC) heterogeneity would become increasingly demanded. Here we investigated the kinetics of intraclonal heterogeneity among 116 MM patients using 23-marker multidimensional flow cytometry (MFC) and principal component analysis, at diagnosis and during minimal residual disease (MRD) monitoring. Distinct phenotypic subclones were observed in 35/116 (30%) newly diagnosed MM patients. In 10/35 patients, persistent MRD was detected after 9 induction cycles, and longitudinal comparison of patient-paired diagnostic vs MRD samples unraveled phenotypic clonal tiding after therapy in half (5/10) of the patients. After demonstrating selection of distinct phenotypic subsets by therapeutic pressure, we investigated whether distinct fluorescence-activated cell-sorted PC subclones had different clonogenic and cytogenetic profiles. In half (5/10) of the patients analyzed, distinct phenotypic subclones showed different clonogenic potential when co-cultured with stromal cells, and in 6/11 cases distinct phenotypic subclones displayed unique cytogenetic profiles by interphase fluorescence in situ hybridization, including selective del(17p13). Collectively, we unravel potential therapeutic selection of preexisting diagnostic phenotypic subclones during MRD monitoring; because phenotypically distinct PCs may show different clonogenic and cytogenetic profiles, identification and follow-up of unique phenotypic-genetic myeloma PC subclones may become relevant for tailored therapy.

Correlation between physicochemical and ecotoxicological approaches to estimate landfill leachates toxicity.

Leachates from municipal solid waste (MSW) landfills may contain a huge diversity of contaminants; these wastewaters should be considered as potentially hazardous complex mixtures, representing a potential environmental risk for surface and groundwater. Current MSW landfill wastes regulatory approaches deem exclusively on the physicochemical characterization and does not contemplate the ecotoxicological assessment of landfill leachates. However, the presence of highly toxic substances in consumer products requires reconsideration on the need of more specific ecotoxicological assessments. The main aim of this study was to evaluate the toxicity of different MSW landfill leachates using a battery of toxicity tests including acute toxicity tests with Daphnia magna and the anuran Xenopus laevis and the in vitro toxicity test with the fish cell line RTG-2. The additional objective was to study the possible correlation between physicochemical properties and the toxicity results obtained for untreated landfill leachates. The results showed that the proposed test battery was effective for the ecotoxicological characterization of MSW landfill leachates. A moderate to strong correlation between the measured physicochemical parameters and the calculated toxicity units was detected for all toxicity assays. Correlation factors of 0.85, 0.86 and 0.55 for Daphnia, Xenopus and RTG-2 tests, respectively, were found. The discriminant analysis showed that certain physicochemical parameters could be used for an initial categorization of the potential aquatic acute toxicity of leachates; this finding may facilitate leachates management as the physicochemical characterization is currently the most common or even only monitoring method employed in a large majority of landfills. Ammonia, alkalinity and chemical oxygen demand (COD), together with chloride, allowed a proper categorization of leachates toxicity for up to 75% of tested samples, with a small percentage of false negatives.