Oxidative dissolution mechanism of both undoped and Gd2O3-doped UO2(s) at alkaline to hyperalkaline pH.

The dissolution rates of unirradiated UO2 and unirradiated UO2 doped with Gd2O3 were determined as a function of pH using flow-through experiments in the presence of O2(g) and bicarbonate. The dissolution rate of non-doped UO2 was very low under hyperalkaline conditions (pH 12-13) whereas it increased drastically as the pH decreased to 9. The dissolution of non-doped UO2 in the pH range of 9-13 was consistent with the oxidative dissolution mechanism already described for UO2 dissolution in the presence of bicarbonate and oxygen. XPS analysis performed on the solid after dissolution experiments at pH 10 and 13 supported the bicarbonate effect to complex UO22+ and accelerate dissolution. Moreover, UO2 doped with Gd2O3 (5 wt% and 10 wt%) showed dissolution rates as low as non-doped UO2 under hyperalkaline conditions, which were maintained throughout the pH range studied (9-13). No substantial differences in the dissolution rates between these two doping levels were found. XPS analysis evidenced a similar surface composition both at pH 10 and 13, with U(V) being the dominant oxidation state. The low dissolution rates were assumed to be a consequence of the gadolinium capacity to retard the oxidation of U(V) to U(VI). The slight increase in dissolution rates observed in the hyperalkaline region was attributed to a shift in the oxidative dissolution mechanism, in which the presence of OH- promotes the formation of soluble uranyl hydroxo complexes.

Athletes with Eating Disorders: Analysis of Their Clinical Characteristics, Psychopathology and Response to Treatment.

Eating disorders (ED) have frequently been described among athletes. However, their specific features and therapy responses are lacking in the literature. The aims of this article were to compare clinical, psychopathological and personality traits between ED patients who were professional athletes (ED-A) with those who were not (ED-NA) and to explore differences in response to treatment. The sample comprised n = 104 patients with ED (n = 52 ED-A and n = 52 matched ED-NA) diagnosed according to DSM-5 criteria. Evaluation consisted of a semi-structured face-to-face clinical interview conducted by expert clinicians and a psychometric battery. Treatment outcome was evaluated when the treatment program ended. ED-A patients showed less body dissatisfaction and psychological distress. No differences were found in treatment outcome among the groups. Within the ED-A group, those participants who performed individual sport activities and aesthetic sports presented higher eating psychopathology, more general psychopathology, differential personality traits and poor therapy outcome. Individual and aesthetic sports presented more severity and worse prognosis. Although usual treatment for ED might be similarly effective in ED-A and ED-NA, it might be important to develop preventive and early detection programs involving sports physicians and psychologists, coaches and family throughout the entire athletic career and afterwards.

Catatonia and Cognitive Impairments: A Systematic Review.

Background: Catatonia is an underdiagnosed and undertreated neuropsychiatric syndrome characterized by catalepsy, negativism, mutism, muscular rigidity, and mannerism, often accompanied by autonomic instability and fever. Although there is growing interest in studying cognitive impairments before and after catatonia, little is known about the cognitive features of the syndrome. Methods: This systematic review was registered at PROSPERO (CRD42022299091). Using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, we searched PubMed, ScienceDirect, and PsycArticles using a combination of the terms "Catatonia" and "Cognitive impairment" and "Executive function" and "Frontal lobe" and "Parietal lobe." Studies included original research articles enrolling patients with catatonic syndrome according to specified criteria. Fourteen studies were deemed relevant for inclusion. The abstraction form included age, assessment during acute episode, associated diagnosis, assessment procedure, and cognitive domains. Outcome measures were extracted. Results: Executive functions and visuospatial abilities proved to be the most investigated domains. A great heterogeneity has been observed in the assessment tools used among the 14 evaluated studies. Findings showed that catatonic patients had worse performance than healthy and non-catatonic psychiatric patients in frontal and parietal cortical functions. Conclusion: Because of the small number of studies in such heterogeneous areas and significant methodological limitations, the results should be regarded with caution. Future research assessing cognitive impairments on catatonic patients is needed. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=299091], identifier [CRD42022299091].

Effect of intermittent induced aeration on nitrogen removal and denitrifying-bacterial community structure in Cork and gravel vertical flow pilot-scale treatment wetlands.

In this work, we have evaluated the impact of intermittent induced aeration in total nitrogen (TN), ammonia (NH4-N) and nitrate-nitrogen (NO3-N) removal in four pilot-scale vertical flow constructed wetlands (VFCW) (two aerated two non-aerated) using cork by-product or gravel as the filter material and planted with Phragmites australis. Both aerated and non-aerated systems achieved high COD and BOD5 elimination rates (≥ 90%) at the end of the 5-month test period. However, the aerated systems presented maximal COD and BOD5 removal from the third month of operation onwards since air supply favored the oxidative bioprocesses occurring within the wetlands. Cork and gravel aerated VFCW also proved to be more efficient (p < 0.05) in NO3-N removal than the non-aerated systems and this upgraded performance was correlated with a significant higher relative abundance of the nirS gene. The aerated systems also showed a slightly improved NH4-N removal. Noticeably, cork VFCW showed higher TN removal mean values (∼35%) than gravel wetlands (27-28%) regardless aeration. Moreover, cork VFCW showed higher relative abundance of the nosZ gene. Our results demonstrated a better nitrogen elimination for the aerated cork pilot-scale VFCW, and this behavior was correlated with a higher abundance of both nirS and nosZ, two of the key functional genes involved in nitrogen metabolism.

Mental disorders, psychopharmacological treatments, and mortality in 2150 COVID-19 Spanish inpatients.

OBJECTIVE: To determine how mental disorders and psychopharmacological treatments before and during COVID-19 hospital admissions are related to mortality. METHODS: Subjects included in the study were all adult patients with a diagnosis of COVID-19, confirmed clinically and by PCR, who were admitted to a tertiary university hospital in Badalona (Spain) between March 1 and November 17, 2020. Data were extracted anonymously from computerized clinical records. RESULTS: 2,150 subjects were included, 57% males, mean age 61 years. History of mental disorders was registered in 957 (45%). Throughout admission, de novo diagnosis of mood or anxiety, stress, or adjustment disorder was made in 12% of patients without previous history. Delirium was diagnosed in 10% of cases. 1011 patients (47%) received a psychotropic prescription during admission (36% benzodiazepines, 22% antidepressants, and 21% antipsychotics). Mortality rate was 17%. Delirium during admission and history of mood disorder were independently associated with higher mortality risk (hazard ratios, 1.39 and 1.52 respectively), while previous year's treatments with anxiolytics/hypnotics and antidepressants were independently associated with lower mortality risk (hazard ratios, 0.47 and 0.43, respectively). CONCLUSION: Mental symptoms are very common in patients hospitalized for COVID-19 infection. Detecting, diagnosing, and treating them is key to determining the prognosis of the disease and functional recovery.

Genetics and genetic counseling in psychiatry: Results from an opinion survey of professionals and users.

BACKGROUND: The heritability of several psychiatric disorders is high, and specific at-risk variants have been identified. Therefore, genetic counseling and genetic testing can be prescribed to some psychiatric patients, but these services are not standardized for most of the population. The aims of the study were to gather opinions from mental health professionals and users regarding (a) the genetics of psychiatric disorders and (b) the usefulness of a genetic counseling unit in psychiatry. METHODS: The survey was conducted in the province of Tarragona (Spain), and we analyzed 152 valid questionnaires from professionals and 959 from users. RESULTS: Sixty-one percent of professionals strongly believed that psychiatric disorders have a genetic basis, and 59% rated a genetic counseling unit in psychiatry as very or extremely useful. However, only a few professionals reported that patients asked them about the genetics of their diseases (12%) or the possibility of transmitting the disease to offspring (19%). Forty-seven percent of users strongly believed that psychiatric disorders have a genetic basis, 30% responded that they talked with their families about the genetics of their diseases, and 43% were worried about transmitting the disease to offspring; however, only 14% reported that their psychiatrist had talked to them about this topic. Remarkably, 80% of users would consider a genetic counseling unit very or extremely useful. CONCLUSIONS: The present study showed that mental health professionals were more aware of the genetic basis of psychiatric disorders than users, and both considered the implementation of a genetic counseling service very useful.

Retention of cesium and strontium by uranophane, Ca(UO2)2(SiO3OH)2·5H2O.

This work determines the capacity of uranophane, one of the long-term uranyl secondary solid phases formed on the spent nuclear fuel (SNF), to retain radionuclides (cesium and strontium) released during the dissolution of the SNF. Sorption was fast in both cases, and uranophane had a high sorption capacity for both radionuclides (maximum sorption capacities of 1.53·10-5 mol m-2 for cesium and 3.45·10-3 mol m-2 for strontium). The high sorption capacity of uranophane highlights the importance of the formation of uranyl silicates as secondary phases during the SNF dissolution, especially in retaining the release of radionuclides not retarded by other mechanisms such as precipitation.

Ag Nanoparticles Drop-Casting Modification of Screen-Printed Electrodes for the Simultaneous Voltammetric Determination of Cu(II) and Pb(II).

A new silver nanoparticle modified screen-printed electrode was developed and applied to the simultaneous determination of Pb(II) and Cu(II). Two different types of silver nanoparticles with different shapes and sizes, Ag nanoseeds and Ag nanoprisms, were microscopically characterized and three different carbon substrates, graphite, graphene and carbon nanofibers, were tested. The best analytical performance was achieved for the combination of Ag nanoseeds with a carbon nanofiber modified screen-printed electrode. The resulting sensor allowed the simultaneous determination of Pb(II) and Cu(II) at trace levels and its applicability to natural samples was successfully tested with a groundwater certified reference material, presenting high reproducibility and trueness.

Noninterventional, Naturalistic, Retrospective Study to Describe Prescription Patterns of Long-Acting Injectable Antipsychotics and the Impact of Introducing a New Atypical Antipsychotic in the Spanish Province of Tarragona Catchment Area.

Background: We studied the patterns and predictors of long-acting injectable (LAI) antipsychotic (AP) use in the treatment of schizophrenia and the effect of introducing a new LAI (paliperidone palmitate [paliperidone-LAI]) in the Spanish province of Tarragona. Methods: This noninterventional, naturalistic, retrospective study included electronic medical record data from a large population-based database of 1,646 patients who were diagnosed with schizophrenia according to ICD-10 criteria and treated between January 2011 and December 2013. Results: During the study period, 42.0% of patients were treated with an LAI AP. The most frequently prescribed initial LAI was risperidone (52.0% of patients). A total of 23% of patients initially treated with an oral AP were switched to an LAI AP, a change that was associated with younger age (P = .001), undifferentiated schizophrenia (P = .015), substance abuse (P < .001), and neuropsychiatric comedication with the following agents: anticonvulsants (P = .004), anticholinergics (P < .001), and hypnotics/sedatives (P = .03). The change from an oral AP to paliperidone-LAI was predicted by younger age (P < .001). Overall, 27.5% of patients switched to another LAI AP, and paliperidone-LAI was the preferred option in 64.7% of cases. The most frequent change involved patients taking risperidone-LAI, many of whom transitioned to paliperidone-LAI (85.0% of cases), particularly patients with a disease duration > 5 years (P = .019). Conclusions: There was a progressive increase in the use of LAI formulations in our catchment area. These agents were preferentially prescribed to patients with chronic disease and a history of substance abuse, as well as patients receiving neuropsychiatric comedication. One-month LAI formulations were commonly used in young patients.

Subsyndromal delirium compared with delirium, dementia, and subjects without delirium or dementia in elderly general hospital admissions and nursing home residents.

INTRODUCTION: Subsyndromal delirium (SSD) complicates diagnosis of delirium and dementia, although there is little research comparing their symptom profiles. METHODS: Cross-sectional study of 400 elderly patients' admission to a general hospital or nursing home diagnosed with delirium, SSD, dementia, or no-delirium/no-dementia (NDND). Symptom profiles were assessed using the Delirium Rating Scale-Revised-98 (DRS-R98). RESULTS: Twenty percent patients had delirium, 19.3% had SSD, 29.8% had dementia-only, and 31% had NDND. Eighty-one percent of subsyndromal and 76% of delirium groups had comorbid dementia. DRS-R98 scores showed ascending severity from NDND < dementia-only < SSD < delirium. DRS-R98 scores for items evaluating the three core symptom domains (cognitive, higher-order thinking, and circadian) distinguished SSD from delirium and both from nondelirium groups. DRS-R98 profiles were essentially the same in delirium and SSD subgroups with or without dementia, although total scale scores were generally higher when in comorbid subgroups. DISCUSSION: SSD shared characteristic core domain symptoms with delirium, which distinguished each from nondelirium groups, although severity was intermediate in the subsyndromal group. Delirium core symptoms overshadowed the dementia phenotype when comorbid. Milder disturbances of delirium core domain symptoms are highly suggestive of SSD.

Delirium diagnosis defined by cluster analysis of symptoms versus diagnosis by DSM and ICD criteria: diagnostic accuracy study.

BACKGROUND: Information on validity and reliability of delirium criteria is necessary for clinicians, researchers, and further developments of DSM or ICD. We compare four DSM and ICD delirium diagnostic criteria versions, which were developed by consensus of experts, with a phenomenology-based natural diagnosis delineated using cluster analysis of delirium features in a sample with a high prevalence of dementia. We also measured inter-rater reliability of each system when applied by two evaluators from distinct disciplines. METHODS: Cross-sectional analysis of 200 consecutive patients admitted to a skilled nursing facility, independently assessed within 24-48 h after admission with the Delirium Rating Scale-Revised-98 (DRS-R98) and for DSM-III-R, DSM-IV, DSM-5, and ICD-10 criteria for delirium. Cluster analysis (CA) delineated natural delirium and nondelirium reference groups using DRS-R98 items and then diagnostic systems' performance were evaluated against the CA-defined groups using logistic regression and crosstabs for discriminant analysis (sensitivity, specificity, percentage of subjects correctly classified by each diagnostic system and their individual criteria, and performance for each system when excluding each individual criterion are reported). Kappa Index (K) was used to report inter-rater reliability for delirium diagnostic systems and their individual criteria. RESULTS: 117 (58.5 %) patients had preexisting dementia according to the Informant Questionnaire on Cognitive Decline in the Elderly. CA delineated 49 delirium subjects and 151 nondelirium. Against these CA groups, delirium diagnosis accuracy was highest using DSM-III-R (87.5 %) followed closely by DSM-IV (86.0 %), ICD-10 (85.5 %) and DSM-5 (84.5 %). ICD-10 had the highest specificity (96.0 %) but lowest sensitivity (53.1 %). DSM-III-R had the best sensitivity (81.6 %) and the best sensitivity-specificity balance. DSM-5 had the highest inter-rater reliability (K =0.73) while DSM-III-R criteria were the least reliable. CONCLUSIONS: Using our CA-defined, phenomenologically-based delirium designations as the reference standard, we found performance discordance among four diagnostic systems when tested in subjects where comorbid dementia was prevalent. The most complex diagnostic systems have higher accuracy and the newer DSM-5 have higher reliability. Our novel phenomenological approach to designing a delirium reference standard may be preferred to guide revisions of diagnostic systems in the future.

A Non-Interventional Naturalistic Study of the Prescription Patterns of Antipsychotics in Patients with Schizophrenia from the Spanish Province of Tarragona.

BACKGROUND: The analysis of prescribing patterns in entire catchment areas contributes to global mapping of the use of antipsychotics and may improve treatment outcomes. OBJECTIVE: To determine the pattern of long-term antipsychotic prescription in outpatients with schizophrenia in the province of Tarragona (Catalonia-Spain). METHODS: A naturalistic, observational, retrospective, non-interventional study based on the analysis of registries of computerized medical records from an anonymized database of 1,765 patients with schizophrenia treated between 2011 and 2013. RESULTS: The most used antipsychotic was risperidone, identified in 463 (26.3%) patients, followed by olanzapine in 249 (14.1%), paliperidone in 225 (12.7%), zuclopenthixol in 201 (11.4%), quetiapine in 141 (8%), aripiprazole in 100 (5.7%), and clozapine in 100 (5.7%). Almost 8 out of 10 patients (79.3%) were treated with atypical or second-generation antipsychotics. Long-acting injectable (LAI) formulations were used in 44.8% of patients. Antipsychotics were generally prescribed in their recommended doses, with clozapine, ziprasidone, LAI paliperidone, and LAI risperidone being prescribed at the higher end of their therapeutic ranges. Almost 7 out of 10 patients (69.6%) were on antipsychotic polypharmacy, and 81.4% were on psychiatric medications aside from antipsychotics. Being prescribed quetiapine (OR 14.24, 95% CI 4.94-40.97), LAI (OR 9.99, 95% CI 6.45-15.45), psychiatric co-medications (OR 4.25, 95% CI 2.72-6.64), and paliperidone (OR 3.13, 95% CI 1.23-7.92) were all associated with an increased likelihood of polypharmacy. Being prescribed risperidone (OR 0.54, 95% CI 0.35-0.83) and older age (OR 0.98, 95% CI 0.97-0.99) were related to a low polypharmacy probability. CONCLUSIONS: Polypharmacy is the most common pattern of antipsychotic use in this region of Spain. Use of atypical antipsychotics is extensive. Most patients receive psychiatric co-medications such as anxiolytics or antidepressants. Polypharmacy is associated with the use of quetiapine or paliperidone, use of a LAI, younger age, and psychiatric co-medication.

The Barcelona Sleepiness Index: A New Instrument to Assess Excessive Daytime Sleepiness in Sleep Disordered Breathing.

STUDY OBJECTIVES: To develop the Barcelona Sleepiness Index (BSI), an interviewer-administered instrument for assessing excessive daytime sleepiness (EDS) in sleep-disordered breathing (SDB) that correlates well with objective measures of EDS and which is sensitive to change with treatment. METHODS: (1) Generation of a preliminary item list: Fifty-three consecutive SDB patients complaining of EDS and their bed partners were interviewed using a focus group methodology to generate a list of situations prone to cause sleepiness. Sixty different consecutive SDB patients were then evaluated using cognitive interviews to refine this list. (2) Construct validity: The maintenance of wakefulness test (MWT), the multiple sleep latency test (MSLT) and the sustained attention to response task (SART) test were used in an additional 98 consecutive SDB patients with and without EDS. The item combination that best correlated with the objective tests constituted the BSI. Cutoff values were determined to differentiate between patients with and without EDS. (3) Sensitivity to change: Thirty patients requiring continuous positive airway pressure (CPAP) were evaluated after satisfactory treatment. RESULTS: A combination of two items, "in the morning, when relaxing" and "in the afternoon, standing inactive, in a public place," presented the highest correlations with the MWT (r: -0.50, p < 0.001), the MSLT (r: -0.21, p = 0.07), and the SART (r: 0.27, p < 0.02) and constituted the BSI. The BSI significantly correlated with oxyhemoglobin saturation measures (nadir SpO2: r: -0.28, p = 0.01; CT 85: r: 0.23, p = 0.04) and showed a high sensitivity to change with CPAP treatment (t: 3.4, p = 0.002). A score of 2 or more identified patients with objective EDS (sensitivity = 64.9%, specificity = 72.1%). CONCLUSION: The Barcelona Sleepiness Index is a simple, brief instrument for measuring subjective EDS in SDB.

Performance of a field-scale permeable reactive barrier based on organic substrate and zero-valent iron for in situ remediation of acid mine drainage.

A permeable reactive barrier (PRB) was installed in Aznalcóllar (Spain) in order to rehabilitate the Agrio aquifer groundwater severely contaminated with acid mine drainage after a serious mining accident. The filling material of the PRB consisted of a mixture of calcite, vegetal compost and, locally, Fe(0) and sewage sludge. Among the successes of the PRB are the continuous neutralisation of pH and the removal of metals from groundwater within the PRB (removals of >95%). Among the shortcomings are the improper PRB design due to the complexity of the internal structure of the Agrio alluvial deposits (which resulted in an inefficient capture of the contaminated plume), the poor degradability of the compost used and the short residence time within the PRB (which hindered a complete sulphate reduction), the clogging of a section of the PRB and the heterogeneities of the filling material (which resulted in preferential flows within the PRB). Undoubtedly, it is only through accumulated experience at field-scale systems that the potentials and limits of the PRB technology can be determined.

Three core domains of delirium validated using exploratory and confirmatory factor analyses.

OBJECTIVE: To confirm the existence of the proposed three-core symptom domains in delirium by analyzing a dataset of nondemented adults using selected core symptoms as measured by the Delirium Rating Scale-Revised-98 (DRS-R98) scale. METHODS: Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) of proposed delirium core symptoms were conducted in a pooled international dataset of 592 delirious and nondelirious patients using DSM-IV criteria from 14 studies with comparable methodologies. Using DRS-R98 categorization, 445 had either subsyndromal or full delirium and comprised the delirium group. The dataset was divided into three independent random subsamples to perform a stepwise analysis. First we performed EFA in 100 cases to delineate latent factor loadings of DRS-R98 items selected to represent the three-core domains (circadian, higher level thinking, and cognitive). These items were then assessed using CFA-modeling (n = 246) followed by a CFA-validation (n = 246). Reliability and goodness of fit of these two CFA were assessed statistically. RESULTS: DRS-R98 items representing the proposed delirium core symptoms loaded onto one factor in the EFA, supporting their core nature. The two CFA confirmed the nature of this core factor as comprising three core domains where DRS-R98 items each loaded with high values (>0.7) onto their corresponding core domain (circadian, higher level thinking, and cognitive) with good fit and reliability. Attention was DRS-R98 item with the highest loading in CFA, followed by thought process, and then by sleep-wake cycle and motor behavior. CONCLUSIONS: Our EFA and CFA confirm and validate the proposed three-core domains of delirium, where symptoms were highly related to the domain that they were hypothesized to represent. These domains are consistent with delirium being a state of impaired consciousness, and should be considered necessary to assess whether in clinical or research settings.

Chromium recovery from exhausted baths generated in plating processes and its reuse in the tanning industry.

Chromium plating used for functional purposes provides an extremely hard, wear and corrosion resistant layer by means of electrolytic deposition. Typical layer thicknesses range between 2.5 and 500 µm. Chromium electroplating baths contain high concentrations of Cr(VI) with chromium trioxide (CrO(3)) as the chromium source. When because of technical or economic reasons a bath gets exhausted, a waste containing mainly chromium as dichromate as well as other heavy metals is generated. Chromium may then be purified for use in other industrial processes with different requirements. In this work, a sustainable system for using galvanic wastes as reagents in the leather tanning industry, thus reducing quantity of wastes to be treated, is presented. Metal cations present in the chromium exhausted bath were precipitated with NaOH. Then, the solution containing mainly soluble Cr(VI) was separated. By means of sodium sulphite in acidic conditions, Cr(VI) was reduced to Cr(III) as chromium (III) sulphate. From chromium (III) sulphate a basic Cr(III) sulphate may be obtained, which is one of most used compounds in the tanning industry. Cr(III) concentration in the final solution allows its reuse without concentration, but with a slight dilution.

Removal of cadmium, copper, nickel, cobalt and mercury from water by Apatite II™: column experiments.

Apatite II™, a biogenic hydroxyapatite, was evaluated as a reactive material for heavy metal (Cd, Cu, Co, Ni and Hg) removal in passive treatments. Apatite II™ reacts with acid water by releasing phosphates that increase the pH up to 6.5-7.5, complexing and inducing metals to precipitate as metal phosphates. The evolution of the solution concentration of calcium, phosphate and metals together with SEM-EDS and XRD examinations were used to identify the retention mechanisms. SEM observation shows low-crystalline precipitate layers composed of P, O and M. Only in the case of Hg and Co were small amounts of crystalline phases detected. Solubility data values were used to predict the measured column experiment values and to support the removal process based on the dissolution of hydroxyapatite, the formation of metal-phosphate species in solution and the precipitation of metal phosphate. Cd(5)(PO(4))(3)OH(s), Cu(2)(PO(4))OH(s), Ni(3)(PO(4))(2)(s), Co(3)(PO(4))(2)8H(2)O(s) and Hg(3)(PO(4))(2)(s) are proposed as the possible mineral phases responsible for the removal processes. The results of the column experiments show that Apatite II™ is a suitable filling for permeable reactive barriers.