Environmental and Economic Viability of Using Concrete Block Wastes from a Concrete Production Plant as Recycled Coarse Aggregates.

The construction sector must incorporate the circular economy to improve sustainability and efficiency. The use of recycled aggregates (RAs) as a substitute for natural aggregates (NAs) is currently being investigated and is expected to yield considerable benefits in the future. The objective of this research is to evaluate the environmental and economic benefits of using recycled coarse aggregates (RCAs) in different 1 m3 samples of concrete, substituting the natural coarse aggregate (NCAs) with RCAs in different percentages. RCAs generally come from the treatment of construction and demolition wastes (CDWs). However, in this research, the RCAs are the concrete block wastes (CBWs) generated by a concrete production plant. Among the most notable results is that compared to concrete with no RCAs, using alternatives in which RCAs have replaced 50% of the NCAs leads to an average decrease in impact category statistics of -3.30%. In contrast to the existing literature on the subject, the process of producing RCAs generated efficiency improvements in categories such as abiotic depletion of fossil fuels (-58.72%) and global warming potential (-85.13%). This is because the transport process, a key factor in determining the viability of using RAs instead of NAs, was eliminated. In economic terms, there is a slight decrease in the financial cost of producing 1 m3 of concrete as the quantity of RCAs increases. The maximum decrease was 0.23€/m3 in the samples studied. Combining both the environmental and economic aspects resulted in a reduction factor of 0.420 g of CO2/€cent, which means fewer CO2 emissions per unit cost when using RCAs. In conclusion, these results are intended to further knowledge in the field of using RAs instead of NAs in order to help the sector achieve sustainability and find an alternative use for a particular type of business waste.

High Exposure to Livestock Pathogens in Southern Pudu (Pudu puda) from Chile.

A significant gap in exposure data for most livestock and zoonotic pathogens is common for several Latin America deer species. This study examined the seroprevalence against 13 pathogens in 164 wild and captive southern pudu from Chile between 2011 and 2023. Livestock and zoonotic pathogen antibodies were detected in 22 of 109 wild pudus (20.18%; 95% CI: 13.34-29.18) and 17 of 55 captive pudus (30.91%; 95% CI: 19.52-44.96), including five Leptospira interrogans serovars (15.38% and 10.71%), Toxoplasma gondii (8.57% and 37.50%), Chlamydia abortus (3.03% and 12.82%), Neospora caninum (0.00% and 9.52%), and Pestivirus (8.00% and 6.67%). Risk factors were detected for Leptospira spp., showing that fawn pudu have statistically significantly higher risk of positivity than adults. In the case of T. gondii, pudu living in "free-range" have a lower risk of being positive for this parasite. In under-human-care pudu, a Pestivirus outbreak is the most strongly suspected as the cause of abortions in a zoo in the past. This study presents the first evidence of Chlamydia abortus in wildlife in South America and exposure to T. gondii, L. interrogans, and N. caninum in wild ungulate species in Chile. High seroprevalence of livestock pathogens such as Pestivirus and Leptospira Hardjo in wild animals suggests a livestock transmission in Chilean template forest.

Tissue engineering in otorhinolaryngology: A knowledge-based analysis.

Objective: To analyze the impact, performance, degree of specialization, and collaboration patterns of the worldwide scientific production on tissue engineering in otorhinolaryngology at the level of countries and institutions. Methods: Two different techniques were used, performance and science mapping analyses, using as samples all the available documents regarding tissue engineering focused on otorhinolaryngology applications. The dataset was retrieved from the Core Collection of the Web of Science database from 1900 to 2020. Social structure was analyzed using science mapping analysis with VOSviewer software. Results: The United States was the main producer, followed by Germany, and Japan. Malaysia and Germany had the highest Relative Specialization Index, indicating their greater relative interest in this area compared to other countries. The social structure analysis showed that the United States and Germany had significant co-authorship relationships with other countries. The University of California System, Kyoto University, and Harvard University were the leading institutions producing literature in this field. These latter two institutions showed the largest number of collaborations, although most of them were with institutions within their own country. There was a lack of connections between different communities of research. Conclusion: The United States is the main country driving progress in this research area, housing the most notable institutions. However, significant collaborations between these research centers are currently lacking. Encouraging greater cooperation among these institutions and their researchers would promote the exchange of knowledge, ultimately facilitating and accelerating advancements in this field.

Molecular survey and phylogenetic analysis of Bartonella sp., Coxiella sp., and hemoplamas in pudu (Pudu puda) from Chile: first report of Bartonella henselae in a wild ungulate species.

Introduction: Recent evidence shows a high diversity of infectious agents in wildlife that represent a threat to human, domestic, and wild animal health. In Chile, wild populations of the most common cervid species, pudu (Pudu puda), have been reported as hosts for novel pathogens such as Mycoplasma ovis-like and a novel ecotype of Anaplasma phagocytophilum. A better understanding of the epidemiology of this group and other intracellular bacteria that might have cervids as hosts would enlighten their population relevance. This study aimed to determine the occurrence and genetic diversity of Bartonella spp., hemotropic mycoplasmas, and Coxiella burnetii in pudus from Chile. Methods: The DNA was extracted from the blood samples of 69 wild free-ranging and 30 captive pudus from Chile. A combination of real-time (nouG gene for Bartonella and IS1111 element for C. burnetii) and conventional PCR (16S rRNA for hemotropic Mycoplasma spp. and rpoB, gltA, and ITS for Bartonella spp.) was used for pathogen screening and molecular characterization. Results: DNA of Bartonella spp. was detected in 10.1% [95% CI (5.2-18.2%)] samples, hemotropic Mycoplasma spp. in 1.7% [95% CI (0.08-10.1%)], and C. burnetii in 1.0% [95% CI (0.05-6.3%)] samples. Two sequenced samples were identified as Mycoplasma ovis-like, and one free-ranging pudu was positive for C. burnetii. While one captive and two free-ranging pudus were positive for Bartonella henselae, one wild pudu was co-positive for B. henselae and Bartonella sp., similar to Bartonellae identified in ruminants. Discussion: To the best of our knowledge, this is the first report of B. henselae in wild ungulate species, and C. burnetii and Bartonella spp. in wild ungulate species in South America. Further research will be necessary to evaluate the potential role of pudu as reservoirs of infection and identify the sources for disease transmission among humans and wild and domestic animals.

Mechanical and Environmental Assessment of Lathe Waste as an Addiction to Concrete Compared to the Use of Commercial Fibres.

The use of fibres applied to concrete in order to improve its properties is widely known. Nowadays, research is not only focused on improving mechanical properties but also on the environmental implications. The aim of this research was a mechanical and environmental comparison between different types of fibres. For this purpose, commercial fibres of three materials were used: low carbon steel, modified polyolefins, and glass fibre. In order to improve the sustainability of the sector, we also analysed and compared the performance of using a waste product, such as fibres from machining operations on lathes. For the evaluation of the mechanical properties, compression and flexural tests were carried out. The results show that the use of low carbon steel fibres increases the flexural strength by 4.8%. At the environmental level, and in particular for impact categories such as the Global Warming Potential (GWP), lathe waste fibres prove to be the most suitable. For instance, compared to glass fibres, CO2 emissions are reduced by 14.39%. This is equivalent to a total of 38 kg CO2 emissions per m3 of reinforced concrete. In addition to avoiding the consumption of 482 MJ/m3 of fossil fuels, the results of the research indicate the feasibility of using waste fibres as a substitute for commercial fibres, contributing to an improved environmental balance without losing mechanical performance.

Assessing micro-macroparasite selective pressures and anthropogenic disturbance as drivers of immune gene diversity in a Neotropical wild cat.

Anthropogenic environmental change is reducing available habitat for wild species, providing novel selection pressures such as infectious diseases and causing species to interact in new ways. The potential for emerging infectious diseases and zoonoses at the interface between humans, domestic animals, and wild species is a key global concern. In vertebrates, diversity at the major histocompatibility complex MHC is critical to disease resilience, and its study in wild populations provides insights into eco-evolutionary dynamics that human activities alter. In natural populations, variation at MHC loci is partly maintained by balancing selection, driven by pathogenic selective pressures. We hypothesize that MHC genetic diversity differs between guigna populations inhabiting human-dominated landscapes (higher pathogen pressures) versus more natural habitats (lower pathogen pressures). We predict that MHC diversity in guignas would be highest in human-dominated landscapes compared with continuous forest habitats. We also expected to find higher MHC diversity in guignas infected with micro and macro parasites (higher parasite load) versus non infected guignas. We characterized for the first time the genetic diversity at three MHC class I and II exons in 128 wild guignas (Leopardus guigna) across their distribution range in Chile (32-46° S) and Argentina, representing landscapes with varying levels of human disturbance. We integrated MHC sequence diversity with multiple measures of anthropogenic disturbance and both micro and macro parasite infection data. We also assessed signatures of positive selection acting on MHC genes. We found significantly higher MHC class I diversity in guignas inhabiting landscapes where houses were present, and with lower percentage of vegetation cover, and also in animals with more severe cardiorespiratory helminth infection (richness and intensity) and micro-macroparasite co-infection. This comprehensive, landscape-level assessment further enhances our knowledge on the evolutionary dynamics and adaptive potential of vertebrates in the face of emerging infectious disease threats and increasing anthropogenic impacts.

Analysis of cognitive framework and biomedical translation of tissue engineering in otolaryngology.

Tissue engineering is a relatively recent research area aimed at developing artificial tissues that can restore, maintain, or even improve the anatomical and/or functional integrity of injured tissues. Otolaryngology, as a leading surgical specialty in head and neck surgery, is a candidate for the use of these advanced therapies and medicinal products developed. Nevertheless, a knowledge-based analysis of both areas together is still needed. The dataset was retrieved from the Web of Science database from 1900 to 2020. SciMAT software was used to perform the science mapping analysis and the data for the biomedical translation identification was obtained from the iCite platform. Regarding the analysis of the cognitive structure, we find consolidated research lines, such as the generation of cartilage for use as a graft in reconstructive surgery, reconstruction of microtia, or the closure of perforations of the tympanic membrane. This last research area occupies the most relevant clinical translation with the rest of the areas presenting a lower translational level. In conclusion, Tissue engineering is still in an early translational stage in otolaryngology, otology being the field where most advances have been achieved. Therefore, although otolaryngologists should play an active role in translational research in tissue engineering, greater multidisciplinary efforts are required to promote and encourage the translation of potential clinical applications of tissue engineering for routine clinical use.

Implantación de un equipo de asistencia al trauma grave. Análisis de la activación y tiempos de asistencia en pacientes ingresados en UCI / Implementation of a severe trauma assistance team: Analysis of activation and attendance times in patients admitted to the ICU

Objetivo Analizar los factores asociados a la activación del equipo de asistencia al trauma grave (EATG) en pacientes que ingresan en la Unidad de Cuidados Intensivos (UCI), medir su repercusión en los tiempos de asistencia, y analizar los grupos de pacientes según activación y nivel de afectación anatómica. Diseño Estudio de cohortes prospectivo del trauma grave que ingresan en UCI. Desde junio 2017 a mayo 2019. Factores de riesgo de la activación analizados con regresión logística y árbol de clasificación tipo CART. Ámbito UCI hospital de segundo nivel. Pacientes Pacientes ingresados de forma consecutiva. Intervenciones Ninguna. Variables de intereses principales Activación del EATG. Variables demográficas. Puntuación de la gravedad de la lesión (ISS), intencionalidad, mecanismo, tiempos de asistencia, complicaciones evolutivas y mortalidad. Resultados Ingresaron un total de 188 pacientes (46,8% de activación EATG), edad mediana de 52 (37-64) años (activados 47 (27-62) vs. no activados 55 (42-67) p = 0,023), varones 84,0%. No diferencias en la mortalidad según activación. El modelo logístico encuentra como factores: la atención (16,6 [2,1-13,2]) e intubación prehospitalaria (4,2 [1,8-9,8]) y, la lesión grave de extremidades inferiores (4,4 [1,6-12,3]). Padecer una caída accidental (0,2 [0,1-0,6]) hace menos probable la activación. El modelo CART selecciona el tipo de mecanismo del traumatismo y es capaz de separar los traumatismos de alta y baja energía. Conclusiones Los factores asociados con activación del ETAG fueron la atención prehospitalaria, requerir intubación previa, mecanismos de alta energía y lesiones graves de extremidades inferiores. Menores tiempos de asistencia si activación sin influir en la mortalidad. Debemos mejorar la activación en pacientes mayores con traumatismos de baja energía y sin atención prehospitalaria (AU)

Objective To analyse the factors associated with the activation of the severe trauma care team (STAT) in patients admitted to the ICU, to measure its impact on care times, and to analyse the groups of patients according to activation and level of anatomical involvement. Design Prospective cohort study of severe trauma admitted to the ICU. From June 2017 to May 2019. Risk factors for the activation of the STAT analysed with logistic regression and CART type classification tree. Setting Second level hospital ICU. Patients Patients admitted consecutively. Interventions No. Main variables of interest STAT activation, demographic variables, injury severity (ISS), intentionality, mechanism, assistance times, evolutionary complications, and mortality. Results A total of 188 patients were admitted (46.8% of STAT activation), median age of 52 (37–64) years (activated 47 (27–62) vs. not activated 55 (42–67), p = 0.023), males 84.0%. No difference in mortality according to activation. The logistic model finds as factors: care (16.6 (2.1–13.2)) and prehospital intubation (4.2 (1.8–9.8)) and severe lower extremity injury (4.4 (1.6–12.3)). Accidental fall (0.2 (0.1–0.6)) makes activation less likely. The CART model selects the type of trauma mechanism and can separate high and low energy trauma. Conclusions Factors associated with STAT activation were prehospital care, requiring prior intubation, high-energy mechanisms, and severe lower extremity injuries. Shorter care times if activated without influencing mortality. We must improve activation in older patients with low-energy trauma and without prehospital care (AU)

Time to sputum conversion in patients with pulmonary tuberculosis: A score to estimate the infectious period.

Introduction: Patients with pulmonary tuberculosis (PTB) disease and positive sputum cultures are the main source of infection. Culture conversion time is inconsistent and defining the length of respiratory isolation is challenging. The objective of this study is to develop a score to predict the length of isolation period. Methods: A retrospective study was carried out to evaluated risk factors associated with persistent positive sputum cultures after 4 weeks of treatment in 229 patients with PTB. A multivariable logistic regression model was used to determinate predictors for positive culture and a scoring system was created based on the coefficients of the final model. Results: Sputum culture was persistently positive in 40.6%. Fever at consultation (1.87, 95% CI:1.02-3.41), smoking (2.44, 95% CI:1.36-4.37), >2 affected lung lobes (1.95, 95% CI:1.08-3.54), and neutrophil-to-lymphocyte ratio > 3.5 (2.22, 95% CI:1.24-3.99), were significantly associated with delayed culture conversion. Therefore, we assembled a severity score that achieved an area under the curve of 0.71 (95% CI:0.64-0.78). Conclusions: In patients with smear positive PTB, a score with clinical, radiological and analytical parameters can be used as a supplemental tool to assist clinical decisions in isolation period.

HeadwaterstreamSNevada: Data on riparian vegetation and water parameters of headwater streams in Sierra Nevada, Spain.

Providing historical data on riparian plant biodiversity and physico-chemical parameters of stream water in Mediterranean mountains helps to assess the effects of climate change and other human stressors on these sensitive and critical ecosystems. This database collects data from the main natural headwater streams of the Sierra Nevada (southeastern Spain), a high mountain (up to 3479 m above sea level [m asl]) recognized as a biodiversity super hotspot in the Mediterranean basin. On this mountain, rivers and landscapes depend on snowmelt water, representing an excellent scenario for evaluating global change's impacts. This dataset covers first- to third-order headwater streams at 41 sites from 832 to 1997 m asl, collected from December 2006 to July 2007. Our goal is to supply information on the vegetation associated with streambanks, the essential physico-chemical parameters of stream water, and the physiographic features of the subwatersheds. Riparian vegetation data correspond to six plots sampled at each site, including total canopy, individual number, height and DBH (diameter at breast height) in woody species, and cover percentage for herbs. Physico-chemical parameters were measured in situ (electric conductivity, pH, dissolved O2 concentration, stream discharge) and determined in the laboratory (alkalinity, soluble reactive phosphate-phosphorus [SRP], total phosphorus [TP], nitrate-nitrogen [ NO 3 - -N], ammonium-nitrogen [ NH 4 + -N], total nitrogen [TN]). Watershed physiographic variables comprise drainage area, minimum altitude, maximum altitude, mean slope, orientation, stream order, stream length, and land cover surface percentage. We recorded 197 plant taxa (67 species, 28 subspecies, and 2 hybrids), representing 8.4% of the Sierra Nevada vascular flora. Due to the botanical nomenclature used, the database can be linked to FloraSNevada database, contributing to Sierra Nevada (Spain) as a laboratory of global processes. This data set can be freely used for non-commercial purposes. Users of these data should cite this data paper in any publications resulting from its use.

Molecular surveillance of potential SARS-CoV-2 reservoir hosts in wildlife rehabilitation centers.

BACKGROUND: The COVID-19 pandemic, caused by SARS-CoV-2 infection, has become the most devastating zoonotic event in recent times, with negative impacts on both human and animal welfare as well as on the global economy. Although SARS-CoV-2 is considered a human virus, it likely emerged from animals, and it can infect both domestic and wild animals. This constitutes a risk for human and animal health including wildlife with evidence of SARS-CoV-2 horizontal transmission back and forth between humans and wild animals. AIM: Molecular surveillance in different wildlife rehabilitation centers and wildlife associated institutions in Chile, which are critical points of animal-human interaction and wildlife conservation, especially since the aim of wildlife rehabilitation centers is to reintroduce animals to their original habitat. MATERIALS AND METHODS: The survey was conducted in six WRCs and three wildlife associated institutions. A total of 185 samples were obtained from 83 individuals belonging to 15 different species, including vulnerable and endangered species. Each specimen was sampled with two different swabs: one oropharyngeal or nasopharyngeal according to the nostril diameter, and/or a second rectal sample. RNA was extracted from the samples and two different molecular assays were performed: first, a conventional RT-PCR with pan-coronavirus primers and a second SARS-CoV-2 qPCR targeting the N and S genes. RESULTS: All 185 samples were negative for SARS-CoV-2. CLINICAL RELEVANCE: This study constitutes the first report on the surveillance of SARS-CoV-2 from wildlife treated in rehabilitation centers in Chile, and supports the biosafety procedures adopted in those centers.

Molecular survey of selected viruses in Pudus (Pudu puda) in Chile revealing first identification of caprine herpesvirus-2 (CpHV-2) in South American ungulates.

Viral diseases jeopardize the health of wildlife in Chile. However, this country lacks health surveillance programs that allow for defining preventive measures to tackle such diseases. The objective of this study was to determine the occurrence and the genetic diversity of pestivirus, herpesvirus and adenovirus in pudus from Chile. Blood samples from wild (n=34) and captive (n=32) pudus were collected between 2011 and 2019 and analyzed through consensus PCR. All the samples were negative to pestivirus and adenovirus. Herpesvirus was confirmed in four captive, and one wild pudu. All four zoo animals share the same sequence for both polymerase and glycoprotein genes. Both sequences share a 100% identity with caprine herpesvirus-2, classifying them in the same cluster as the Macavirus group. In turn, novel sequences of the polymerase and glycoprotein B genes were obtained from the wild pudu. Our study reports the first evidence of CpHV-2 infection in Chile and South American ungulate populations. Further research will be necessary to assess the pathogenicity of CpHV-2 in this species. It is also urgently recommended that molecular, serological and pathological screening should be conducted in Chilean wild and captive pudus to understand the impact of the herpesvirus on their populations.

Molecular and phylogenetic analysis of herpesviruses in endangered free-ranging cervids of Chile: ovine gammaherpesvirus-2-A novel threat to wild and domestic animal health in Chilean Patagonia.

Introduction: Herpesvirus infections have been highlighted as emerging diseases affecting wildlife health and the conservation of several taxa. Malignant catarrhal fever (MCF) and infectious keratoconjunctivitis (IKC) are two viruses that infect wild ruminants. Nevertheless, epidemiological data on herpesviruses in South American wild ruminants are limited. An outbreak of caprine gammaherpesvirus-2 (CpHV-2) that recently was suspected as the cause of MCF in southern pudus (Pudu puda) prompted the need to conduct molecular screenings in Chilean cervids to understand the epidemiology of herpesviruses. The aim of this study was to determine the occurrence and genetic diversity of herpesviruses in free-ranging cervids from Chile. Methods: Herpesvirus infection was assessed in antemortem blood samples (n = 86) from pudus (n = 81) and huemuls (Hippocamelus bisulcus) (n = 5), as well as postmortem samples of spleen (n = 24) and lung (n = 3) from pudus, using a nested pan-herpesvirus PCR assay. Results: Combining all suitable sample types, DNA of pudu gammaherpesvirus-1 was detected in five pudues and five huemuls, with an overall prevalence of 9.90% (n = 10/101; 95% CI = 5.11-17.87%). One pudu tested positive for ovine gammaherpesvirus-2 (n = 1/96; 1.04%; 95% CI = 0.05-6.49%), and one pudu tested positive for a Macavirus sequence with 98.63 similarity to ovine gammaherpesvirus-2 (n = 96; 1.04%; 95% CI = 0.05-6.49%). Discussion: To the best of our knowledge, this is the first report of a herpesvirus in huemul and of ovine gammaherpesvirus-2 in Chile. Our results also confirm the active circulation of herpesvirus in free-ranging cervids in Chilean Patagonia, and as such, MCF should be considered as a possible cause of disease in free-ranging Chilean pudus and livestock species. Further research is necessary to develop a plan of systematic monitoring (serological and pathological screening) of herpesviruses in Chilean wild and domestic ruminants to understand their diversity and impact on animal health and conservation.

The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?

Background: The present research aimed to evaluate the effect on outcomes of immunonutrition (IMN) enteral formulas during the intensive care unit (ICU) stay. Methods: A multicenter prospective observational study was performed. Patient characteristics, disease severity, nutritional status, type of nutritional therapy and outcomes, and laboratory parameters were collected in a database. Statistical differences were analyzed according to the administration of IMN or other types of enteral formulas. Results: In total, 406 patients were included in the analysis, of whom 15.02% (61) received IMN. Univariate analysis showed that patients treated with IMN formulas received higher mean caloric and protein intake, and better 28-day survival (85.2% vs. 73.3%; p = 0.014. Unadjusted Hazard Ratio (HR): 0.15; 95% CI (Confidence Interval): 0.06−0.36; p < 0.001). Once adjusted for confounding factors, multivariate analysis showed a lower need for vasopressor support (OR: 0.49; 95% CI: 0.26−0.91; p = 0.023) and continuous renal replacement therapies (OR: 0.13; 95% CI: 0.01−0.65; p = 0.049) in those patients who received IMN formulas, independently of the severity of the disease. IMN use was also associated with higher protein intake during the administration of nutritional therapy (OR: 6.23; 95% CI: 2.59−15.54; p < 0.001), regardless of the type of patient. No differences were found in the laboratory parameters, except for a trend toward lower triglyceride levels (HR: 0.97; 95% CI: 0.95−0.99; p = 0.045). Conclusion: The use of IMN formulas may be associated with better outcomes (i.e., lower need for vasopressors and continuous renal replacement), together with a trend toward higher protein enteral delivery during the ICU stay. These findings may ultimately be related to their modulating effect on the inflammatory response in the critically ill. NCT Registry: 03634943.

Methods for identifying biomedical translation: a systematic review.

Translational medicine is an important area of biomedicine, and has significantly facilitated the development of biomedical research. Despite its relevance, there is no consensus on how to evaluate its progress and impact. A systematic review was carried out to identify all the methods to evaluate translational research. Seven methods were found according to the established criteria to analyze their characteristics, advantages, and limitations. They allow us to perform this type of evaluation in different ways. No relevant advantages were found between them; each one presented its specific limitations that need to be considered. Nevertheless, the Triangle of Biomedicine could be considered the most relevant method, concerning the time since its publication and usefulness. In conclusion, there is still a lack of a gold-standard method for evaluating biomedical translational research.

The potential of groundwater-dependent ecosystems to enhance soil biological activity and soil fertility in drylands.

Water availability controls the functioning of dryland ecosystems, driving a patchy vegetation distribution, unequal nutrient availability, soil respiration in pulses, and limited productivity. Groundwater-dependent ecosystems (GDEs) are acknowledged to be decoupled from precipitation, since their vegetation relies on groundwater sources. Despite their relevance to enhance productivity in drylands, our understanding of how different components of GDEs interconnect (i.e., soil, vegetation, water) remains limited. We studied the GDE dominated by the deep-rooted phreatophyte Ziziphus lotus, a winter-deciduous shrub adapted to arid conditions along the Mediterranean basin. We aimed to disentangle whether the groundwater connection established by Z. lotus will foster soil biological activity and therefore soil fertility in drylands. We assessed (1) soil and vegetation dynamics over seasons (soil CO2 efflux and plant activity), (2) the effect of the patchy distribution on soil quality (properties and nutrient availability), and soil biological activity (microbial biomass and mineralization rates) as essential elements of biogeochemical cycles, and (3) the implications for preserving GDEs and their biogeochemical processes under climate change effects. We found that soil and vegetation dynamics respond to water availability. Whereas soil biological activity promptly responded to precipitation events, vegetation functioning relies on less superficial water and responded on different time scales. Soil quality was higher under the vegetation patches, as was soil biological activity. Our findings highlight the importance of groundwater connections and phreatophytic vegetation to increase litter inputs and organic matter into the soils, which in turn enhances soil quality and decomposition processes in drylands. However, biogeochemical processes are jeopardized in GDEs by climate change effects and land degradation due to the dependence of soil activity on: (1) precipitation for activation, and (2) phreatophytic vegetation for substrate accumulation. Therefore, desertification might modify biogeochemical cycles by disrupting key ecosystem processes such as soil microbial activity, organic matter mineralization, and plant productivity.

Apophysitis Among Male Youth Soccer Players at an Elite Soccer Academy Over 7 Seasons.

BACKGROUND: Apophyseal injuries are common in children and adolescent athletes. These injuries are believed to be caused by repetitive overloading, which can create inflammatory and degenerative conditions in growing bone prominences. However, their prevalence, diagnosis, and treatment in young soccer players have been understudied. PURPOSE: To evaluate characteristics of apophyseal injuries in adolescent athletes at an elite soccer academy. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: All apophyseal injuries between July 2008 and June 2015 were evaluated. For each injury, the authors recorded the type and location, age of the player, injury date, imaging modalities, and time absent from training/competition. RESULTS: Over the 7 seasons of this study, 210 apophyseal injuries were documented, including 172 simple apophyseal injuries and 38 apophyseal avulsion fractures. The rate of apophyseal injuries was 0.35 per 1000 hours of training exposure. A total of 196 (93.3%) cases were primary injuries, and the rest (6.7%) were reinjuries. Ultrasonography was the most commonly used imaging modality for diagnosis (172 cases; 81.9%). The most common location of apophyseal injuries was the anterior inferior iliac spine (AIIS). Return to sport was faster in athletes with apophyseal injury at the ischiopubic ramus, those with simple apophyseal injuries, and younger athletes. CONCLUSION: The most common location for apophyseal injury among soccer players was the AIIS. Return to training and competition differed according to injury location, type of apophyseal injury, and age.

Evaluation of Nutritional Practices in the Critical Care patient (The ENPIC study): Does nutrition really affect ICU mortality?

BACKGROUND & AIMS: The importance of artificial nutritional therapy is underrecognized, typically being considered an adjunctive rather than a primary therapy. We aimed to evaluate the influence of nutritional therapy on mortality in critically ill patients. METHODS: This multicenter prospective observational study included adult patients needing artificial nutritional therapy for >48 h if they stayed in one of 38 participating intensive care units for ≥72 h between April and July 2018. Demographic data, comorbidities, diagnoses, nutritional status and therapy (type and details for ≤14 days), and outcomes were registered in a database. Confounders such as disease severity, patient type (e.g., medical, surgical or trauma), and type and duration of nutritional therapy were also included in a multivariate analysis, and hazard ratios (HRs) and 95% confidence intervals (95%CIs) were reported. RESULTS: We included 639 patients among whom 448 (70.1%) and 191 (29.9%) received enteral and parenteral nutrition, respectively. Mortality was 25.6%, with non-survivors having the following characteristics: older age; more comorbidities; higher Sequential Organ Failure Assessment (SOFA) scores (6.6 ± 3.3 vs 8.4 ± 3.7; P < 0.001); greater nutritional risk (Nutrition Risk in the Critically Ill [NUTRIC] score: 3.8 ± 2.1 vs 5.2 ± 1.7; P < 0.001); more vasopressor requirements (70.4% vs 83.5%; P=0.001); and more renal replacement therapy (12.2% vs 23.2%; P=0.001). Multivariate analysis showed that older age (HR: 1.023; 95% CI: 1.008-1.038; P=0.003), higher SOFA score (HR: 1.096; 95% CI: 1.036-1.160; P=0.001), higher NUTRIC score (HR: 1.136; 95% CI: 1.025-1.259; P=0.015), requiring parenteral nutrition after starting enteral nutrition (HR: 2.368; 95% CI: 1.168-4.798; P=0.017), and a higher mean Kcal/Kg/day intake (HR: 1.057; 95% CI: 1.015-1.101; P=0.008) were associated with mortality. By contrast, a higher mean protein intake protected against mortality (HR: 0.507; 95% CI: 0.263-0.977; P=0.042). CONCLUSIONS: Old age, higher organ failure scores, and greater nutritional risk appear to be associated with higher mortality. Patients who need parenteral nutrition after starting enteral nutrition may represent a high-risk subgroup for mortality due to illness severity and problems receiving appropriate nutritional therapy. Mean calorie and protein delivery also appeared to influence outcomes. TRIAL REGISTRATION: ClinicaTrials.gov NCT: 03634943.