Hospital Epidemics Tracker (HEpiTracker): Description and pilot study of a mobile app to track COVID-19 in hospital workers.

BACKGROUND: Hospital workers have been the most frequently and severely affected professional group during the COVID-19 pandemic, and have a big impact on transmission. In this context, innovative tools are required to measure the symptoms compatible with COVID-19, the spread of infection, and testing capabilities within hospitals in real time. OBJECTIVE: We aimed to develop and test an effective and user-friendly tool to identify and track symptoms compatible with COVID-19 in hospital workers. METHODS: We developed and pilot tested Hospital Epidemics Tracker (HEpiTracker), a newly designed app to track the spread of COVID-19 among hospital workers. Hospital staff in 9 hospital centers across 5 Spanish regions (Andalusia, Balearics, Catalonia, Galicia, and Madrid) were invited to download the app on their phones and to register their daily body temperature, COVID-19-compatible symptoms, and general health score, as well as any polymerase chain reaction and serological test results. RESULTS: A total of 477 hospital staff participated in the study between April 8 and June 2, 2020. Of note, both health-related (n=329) and non-health-related (n=148) professionals participated in the study; over two-thirds of participants (68.8%) were health workers (43.4% physicians and 25.4% nurses), while the proportion of non-health-related workers by center ranged from 40% to 85%. Most participants were female (n=323, 67.5%), with a mean age of 45.4 years (SD 10.6). Regarding smoking habits, 13.0% and 34.2% of participants were current or former smokers, respectively. The daily reporting of symptoms was highly variable across participating hospitals; although we observed a decline in adherence after an initial participation peak in some hospitals, other sites were characterized by low participation rates throughout the study period. CONCLUSIONS: HEpiTracker is an already available tool to monitor COVID-19 and other infectious diseases in hospital workers. This tool has already been tested in real conditions. HEpiTracker is available in Spanish, Portuguese, and English. It has the potential to become a customized asset to be used in future COVID-19 pandemic waves and other environments. TRIAL REGISTRATION: ClinicalTrials.gov NCT04326400; https://clinicaltrials.gov/ct2/show/NCT04326400.

Temporal transitions in COPD severity stages within the GOLD 2017 classification system.

BACKGROUND: The stability of the new GOLD 2017 COPD staging is unknown, as well as the frequency of individual transitions in COPD stages beyond one year. METHODS: All COPD participants in the CHAIN cohort were re-analysed according to GOLD 2017 up to five years of follow-up. Their individual changes within COPD stages were aggregated into cohort-wide Markov chains; group stability was evaluated using joinpoint regression. RESULTS: At baseline, 959 COPD patients were distributed according to GOLD 2017 stages as 37.7% in A, 38.3% B, 8.2% C, and 15.7% D. The group proportion of patients in each stage was maintained from years one to five. However, we found significant changes between stages at the individual patient level, especially in the more severe stages. The probability of a patient remaining in the same GOLD 2017 COPD stage for two consecutive years ranged during the five years of follow-up for stage C from 16% to 31% per year, while for D from 23% to 43% per year, indicating substantial variation either increasing or decreasing severity for the vast majority of patients. CONCLUSIONS: We conclude that group stability observed in COPD staging according to GOLD 2017 recommendations is paired with a large variability at the individual patient level.

Medicina planetaria respiratoria / Respiratory Planetary Medicine

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Description of extreme longevity in the Balearic Islands: Exploring a potential Blue Zone in Menorca, Spain.

AIM: We aimed to determine whether there was a Blue Zone, an area characterized by extreme longevity, in Menorca, Spain. METHODS: We explored official statistics of the Balearic Islands, Spain, and calculated life expectancy from 1991 to 2009, by sex and island, among other demographic estimators. RESULTS: The life expectancy at birth in Menorca reached a peak in 2007 with 82.3 years, but since 2001 in females and 2007 in males, it plateaued and then descended. The percentage of centenarians in Es Migjorn Gran was 0.17% in 2001, only because of the 0.33% male contribution, and it returned to within the average Balearic rates. There is no record of any other surviving centenarian after 2006 in Es Migjorn Gran. Results obtained with other demographic indices are confirmatory. CONCLUSIONS: It appears there was no extreme longevity or Blue Zone in Es Migjorn Gran and the surrounding villages in Menorca.

Valorization of pellets from municipal WWTP sludge in lightweight clay ceramics.

A direct result of the growing number of municipal wastewater-treatment plants (WWTPs) has been an increase in the generation of large amounts of sewage sludge that requires environmentally acceptable final destination. To decrease the volume of sludge, a common technique is drying the sludge at a low temperature in rotary kilns. The result of this process is a granulated material consisting of dehydrated sludge pellets. After this treatment, this pelletized material becomes easier to manipulate, but it also becomes a more toxic waste, containing dangerous substances, mostly of the lipid type. At its final stage, this material is usually incinerated, used as a comburent material, used as an agricultural fertilizer, or used in the cement industry. Each application has its own problems and requires remediation measures from the safety and environmental viewpoints. In this study, we looked beyond these possible applications and analyzed the transformation of sewage sludge through a ceramization process into a material similar to expanded clays; we subsequently explored its uses in the building industry or in the agriculture industry, among others. Both the properties of the product material and the production method were characterized, and an environmental analysis was conducted. The new, lightweight material had a microstructure with open porosity and low thermal conductivity. Environmental characterization such as the leaching test revealed that undetectable amounts of hazardous metals from the sludge were present in the leachate after the sludge went through a thermal treatment, despite their initial presence (with the exception of vanadium, which could pose some restrictions on some of the proposed uses for the final product). Toxicity tests also showed negative results. The study of gaseous emissions during production revealed emissions factors similar to those during the production of conventional clay ceramics, although with higher organic emissions. As for conventional clay ceramics, industrial production would require the implementation of some type of air-depuration system. The results showed that the ceramization of sludge pellets is a promising valorization technique worth considering from both the economic and technological perspectives.

Urban photochemical pollution in the Iberian Peninsula: Lisbon and Barcelona airsheds.

Numerical simulations with photochemical transport models were independently performed for two domains situated in the Iberian Peninsula covering the Lisbon and Barcelona airsheds. Although the days chosen for simulation of the two cities are not the same, the synoptic situations in both cases, known as typical summertime situations, were similar, which allowed the development of typical mesoscale circulations, such as sea breezes and mountain and valley winds dominated by the Azores anticyclone. Emission inventories for the two areas were developed. The O3 concentrations recorded in both cities have a similar level. Nevertheless, O(x) values in Barcelona are higher than in Lisbon, which may, at a first glance, indicate an apparently more oxidant atmosphere in Barcelona. Photochemical modeling for the two cities has shown that the behavior of the circulatory patterns in both urban areas is rather different, which mainly has to do with the different strengths of the sea breeze and the topography, inducing an important offshore vertical layered dimension of pollutant transport in Barcelona versus an important inland horizontal transport in Lisbon.