Degradable Alternating Copolymers by Radical Copolymerization of 2-Methylen-1,3-dioxepane and Crotonate Esters.

Producing backbone degradable copolymers via free-radical copolymerization is a promising, yet challenging method to develop more sustainable materials for many applications. In this work, we present the copolymerization of 2-methylen-1,3-dioxepane (MDO) with crotonic acid derivative esters. MDO can copolymerize by radical ring-opening polymerization incorporating degradable ester moieties in the polymer backbone, although this can often be difficult due to the very unfavorable reactivity ratios. Crotonic acid derivatives, on the other hand, can be easily produced completely from biomass but are typically very difficult to (co)polymerize due to low propagation rates and very unfavorable reactivity ratios. Herein, we present the surprisingly easy copolymerization between MDO and butyl crotonate (BCr), which shows the ability to form alternating copolymers. The alternating nature of the copolymer was characterized by MALDI-TOF and supported by the reactivity ratios calculated experimentally (rMDO = 0.105 and rBCr = 0.017). The alternating nature of the copolymers favored the degradability that could be achieved under basic conditions (in 2 h, all chains have molar masses smaller than 2 kg/mol). Last, the work was expanded to other crotonate monomers to expand the portfolio and show the potential of this copolymer family.

Wavelength exponent based calibration for turbidity spectroscopy: Monitoring the particle size during emulsion polymerization reactions.

Particle size and particle size distribution (PSD) are important properties of polymer latexes because they strongly affect the film formation and the rheological properties of the latexes. Thus, monitoring the particle size is of paramount importance during the production of waterborne polymeric dispersions, for which online/inline measurements of the particle size are required. Herein, turbidity spectroscopy (TUS) is used to measure the particle size of nanoparticles in dispersed media. Calibration curves based on a modified wavelength exponent method are introduced and assessed to monitor the evolution of a broad range of particle sizes in seeded semibatch emulsion polymerizations of methyl methacrylate, butyl acrylate, methacrylic acid (MMA/BA/MAA 51/47/2) terpolymers. It is shown that the wavelength exponent based calibration curves can be successfully used to retrieve the particle size during the polymerization process.

Standardizing nursing degree curriculum structure in Spain: A mixed-methods study.

BACKGROUND: Legislation regulating Spanish and European academic curricula prescribes a certain level of knowledge and skills any student must master. Spanish universities freely decide the number of credits assigned to each subject and in which year the subject will be taught. We hypothesize that this flexibility may give way to excessively heterogeneous training across universities in nursing degrees. Such curricula heterogeneity hinders inter-university transfers and weakens educational excellence. OBJECTIVES: 1) To review the existing differences in nursing degrees in Spanish universities; 2) to compare our results against current legislation; 3) to propose changes in the legislation, if necessary. DESIGN: Mixed-methods approach. SETTING: Spain. METHODS: We reviewed nursing degree curricula of all 60 Spanish universities. Inter-university differences were analyzed and checked against current legislation. A focus group proposed legislative changes accordingly. RESULTS: Several differences between public and private universities were statistically significant. During the first cycle, public universities´ course loads include more theoretical teachings, more credits in core subjects during the first year, and more compulsory subjects in second year. Private universities are more likely to offer external internships during the first cycle whereas the public ones are more likely to offer them during the second cycle. Public universities offer more credits under the following curricular blocks than private ones: "Nutrition/Dietetics," "Psychiatry," "Public and Community Health," and "Geriatrics." In turn, private universities offer more credits in the areas of "Theory/Methodology," "Ethics/Legislation," "English," and "Theology." Academic curricula meet most of the criteria established by the Spanish and European legislation. The proposed legislative changes aim at standardizing curricula by associating specific credits and their timeline to the teaching blocks. CONCLUSIONS: Nursing degree curricula among Spanish universities are highly heterogeneous. Legislative changes to homogenize teaching blocks would facilitate credit validations and student mobility across universities, in addition to increasing nursing degrees´ standardization and excellence.

Taking Advantage of Phosphate Functionalized Waterborne Acrylic Binders to Get Rid of Inhibitors in Direct-to-Metal Paints.

In this paper, two phosphate functionalized acrylic binders are formulated to yield direct-to-metal paints without using corrosion inhibitors. The difference between both binders is the addition of polystearylacrylate crystalline nanodomains in one of them, and an amorphous methyl methacylate-co-butyl acrylate copolymer in the other. The water sensitivity, mechanical stability, adhesion, and the performance of the paints against corrosion (high humidity resistance, accelerated weathering, and salt-spray tests) are assessed and compared with a DTM paint formulated from a commercial binder. The performance of both phosphate functionalized paints formulated without corrosion inhibitors in high humidity and weathering tests is superior to the commercial DTM paint formulated without corrosion inhibitors and similar to the DTM paint formulated with them. Furthermore, the paint based on the amorphous copolymer binder provides significantly good performance in the salt spray test (even superior to that of the DTM paint formulated with corrosion inhibitors).

Asymmetric-Flow Field-Flow Fractionation of complex waterborne polymer dispersions: Effect of the concentration of water in the measurement of molar mass distributions.

Asymmetric-Flow Field-Flow Fractionation is a very powerful technique for measuring the molar mass distribution of polymers with complex microstructures. The analysis of some samples such as self-crosslinkable latexes requires to directly dissolve the polymer dispersion in the eluent (THF) without drying it, and this work studies the effect of the presence of this water in those analysis. Taking a polystyrene latex as model system, it was observed that the measured molar mass and radius of gyration increased as the concentration of water in the sample increased. This was an effect of a decrease in the compatibility between the solvent mixture (THF and water) and the polymer, which formed aggregates, and could be predicted calculating the polymer-solvent interaction parameter. When the study was extended to poly(methyl methacrylate), poly(n-butyl acrylate) and poly(vinyl acetate) the same general trend was observed, however, the impact of the water was less significant as the hydrophilicity of the polymer increased. Most importantly, if the samples with the highest water content were first dissolved in THF and afterwards dried using MgSO4 the measured molar mass and radius of gyration values were the same as for the reference sample (dried in the oven), providing a method to analyze samples that cannot be dried into a film and remove the negative effect of the water at the same time.

Assessing the Effect of CeO2 Nanoparticles as Corrosion Inhibitor in Hybrid Biobased Waterborne Acrylic Direct to Metal Coating Binders.

CeO2 nanoparticles were incorporated in waterborne binders containing high biobased content (up to 70%) in order to analyze the anticorrosion performance for direct to metal coatings. Biobased binders were synthesized by batch miniemulsion polymerization of 2-octyl acrylate and isobornyl methacrylate monomers using a phosphate polymerizable surfactant (Sipomer PAM200) that lead to the formation of phosphate functionalized latexes. Upon the direct application of such binders on steel, the functionalized polymer particles were able to interact with steel, creating a thin phosphatization layer between the metal and the polymer and avoiding flash rust. The in situ incorporation of the CeO2 nanoparticles during the polymerization process led to their homogeneous distribution in the final polymer film, which produced outstanding anticorrosion performance according to the Electrochemical Impedance Spectroscopy measurements. In fact, steel substrates coated with the hybrid polymer film (30-40 µm thick) showed high barrier corrosion resistance after 41 days (~1000 h) of immersion in NaCl water solution and active inhibition capabilities thanks to the presence of the CeO2 nanoparticles. This work opens the door to the fabrication of sustainable hybrid anticorrosion waterborne coatings.

Green Electrospinning of Polymer Latexes: A Systematic Study of the Effect of Latex Properties on Fiber Morphology.

Green electrospinning is a relatively new promising technology in which a polymer (latex) can be spun from an aqueous dispersion with the help of a template polymer. This method is a green, clean and safe technology that is able to spin hydrophobic polymers using water as an electrospinning medium. In this article, a systematic study that investigates the influence of the template polymer molar mass, the total solids content of the initial dispersion and the particle/template ratio is presented. Furthermore, the influence of the surfactant used to stabilize the polymer particles, the surface functionality of the polymer particles and the use of a bimodal particle size distribution on the final fiber morphology is studied for the first time. In green electrospinning, the viscosity of the initial complex blend depends on the amount and molar mass of the template polymer but also on the total solids content of the dispersion to be spun. Thus, both parameters must be carefully taken into account in order to fine-tune the final fiber morphology. Additionally, the particle packing and the surface chemistry of the polymer particles also play an important role in the obtained nanofibers quality.

Lactide-Valerolactone Copolymers for Packaging Applications.

Lactide-valerolactone copolymers have potential application in the packaging sector. Different copolymers were synthesized, and the kinetics of the copolymerization reactions and the microstructure of the copolymers were analysed. Lactide showed higher reactivity than valerolactone which leads to composition drift through the reaction. Thermal, mechanical and barrier properties of the selected copolymers were studied. Overall, the incorporation of valerolactone results in copolymers with higher ductility than poly(lactide) with intermediate water and oxygen permeability which makes these materials appropriate candidates for use in the packaging sector.

[Impact of COVID-19 on mortality in the autonomous community of Castilla y León (Spain)]. / Impacto de la COVID-19 en la mortalidad de la comunidad autónoma de Castilla y León.

OBJECTIVE: To estimate the increase in mortality associated with the SARS-CoV-2 coronavirus pandemic in the autonomous community of Castilla y León (Spain). METHOD: Ecological study based on population and death data for the months of March 2016 to 2020 in Castilla y León. The general and provincial standardized rates, the relative risks of the year 2020 with respect to previous years and the risks adjusted by sex, periods and province, using Poisson regression, were calculated. Trend analysis was performed using joinpoint linear regression. RESULTS: An increase in mortality was observed in March 2020 with respect to previous years, with an increase of 39% for men (relative risk [RR]: 1.39; 95% confidence interval [95%CI]: 1.32-1.47) and 28% for women (RR: 1.28; 95%CI: 1.21-1.35). The model predicts excess mortality of 775 deaths. In the trend analysis there is a significant turning point in 2019 in men, globally and for almost all provinces. The increase in mortality is general, although heterogeneous by sex, age group and province. CONCLUSIONS: Although the observed increase in mortality cannot be totally attributed to the disease, it is the best estimate we have of the real impact on deaths directly or indirectly related to it. The number of declared deaths only reaches two thirds of the increase in mortality observed.

Removable Biobased Waterborne Pressure-Sensitive Adhesives Containing Mixtures of Isosorbide Methacrylate Monomers.

Growing environmental concerns are enforcing sustainable recycling processes for glass substrates, especially bottles, where a fast cleaning and minimization of the use of solvents is desired. In this process, labels and adhesives are mostly removed by the addition of harsh reagents, alkaline solutions, or high temperature, increasing economic costs and harming the environment. Herein, high performance and biobased waterborne pressure-sensitive adhesives with fast removability in water have been developed using small percentages of isosorbide (derived from glucose)-based methacrylate monomers. Formulations containing 2-octyl acrylate and isobornyl methacrylate and small amounts (1 wt %) of these monomers not only yield stronger adhesive fibrils, but also promote a removability in water 6× faster than that of nonisosorbide-based counterparts. This waterborne isosorbide containing PSAs represents an alternative to current PSA formulations toward more sustainable glass recycling and reusing processes.

Objective ADHD Diagnosis Using Convolutional Neural Networks Over Daily-Life Activity Records.

Attention Deficit/Hyperactivity Disorder (ADHD) is the most common neurobehavioral disorder in children and adolescents. However, its etiology is still unknown, and this hinders the existence of reliable, fast and inexpensive standard diagnostic methods. OBJECTIVE: This paper proposes an end-to-end methodology for automatic diagnosis of the combined type of ADHD. METHODS: Diagnosis is based on the analysis of 24 hour-long activity records using Convolutional Neural Networks to classify spectrograms of activity windows. RESULTS: We achieve up to [Formula: see text] average sensitivity, [Formula: see text] specificity and AUC values over [Formula: see text]. Overall, our figures overcome those obtained by actigraphy-based methods reported in the literature as well as others based on more expensive (and not so convenient) acquisition methods. CONCLUSION: These results reinforce the idea that combining deep learning techniques together with actimetry can lead to a robust and efficient system for objective ADHD diagnosis. SIGNIFICANCE: Reliance on simple activity measurements leads to an inexpensive and non-invasive objective diagn-ostic method, which can be easily implemented with daily devices.

Impacto de la COVID-19 en la mortalidad de la comunidad autónoma de Castilla y León / Impact of COVID-19 on mortality in the autonomous community of Castilla y León (Spain)

OBJETIVO: Estimar el aumento de la mortalidad asociado a la pandemia por SARS-CoV-2 en la comunidad autónoma de Castilla y León. MÉTODO: Estudio ecológico basado en los datos de población y los fallecimientos correspondientes a los meses de marzo de los años 2016 a 2020 en Castilla y León. Se calcularon las tasas estandarizadas globales y por provincias, los riesgos relativos del año 2020 respecto a los años previos y los riesgos ajustados por sexo, periodo y provincia mediante regresión de Poisson. Se hizo un análisis de tendencias mediante regresión lineal joinpoint. RESULTADOS: En marzo de 2020 se observó un aumento de la mortalidad respecto a los años previos, con un incremento del 39% para los hombres (riesgo relativo [RR]: 1,39; intervalo de confianza del 95% [IC95]: 1,32-1,47) y del 28% para las mujeres (RR: 1,28; IC95: 1,21-1,35). El modelo predice un exceso de mortalidad en 2020 de 775 fallecimientos. En el análisis de tendencias hay un punto de inflexión significativo en 2019 para los varones, globalmente y para casi todas las provincias. El aumento de la mortalidad es global, aunque heterogéneo por sexos, grupos de edad y provincias. CONCLUSIONES: Aunque el aumento de la mortalidad observado no puede ser totalmente atribuido a la enfermedad, es la mejor estimación que tenemos del impacto real en muertes directamente o indirectamente relacionadas con ella. El número de muertes declaradas solo alcanza dos terceras partes del aumento de la mortalidad observado

OBJECTIVE: To estimate the increase in mortality associated with the SARS-CoV-2 coronavirus pandemic in the autonomous community of Castilla y León (Spain). METHOD: Ecological study based on population and death data for the months of March 2016 to 2020 in Castilla y León. The general and provincial standardized rates, the relative risks of the year 2020 with respect to previous years and the risks adjusted by sex, periods and province, using Poisson regression, were calculated. Trend analysis was performed using joinpoint linear regression. RESULTS: An increase in mortality was observed in March 2020 with respect to previous years, with an increase of 39% for men (relative risk [RR]: 1.39; 95% confidence interval [95%CI]: 1.32-1.47) and 28% for women (RR: 1.28; 95%CI: 1.21-1.35). The model predicts excess mortality of 775 deaths. In the trend analysis there is a significant turning point in 2019 in men, globally and for almost all provinces. The increase in mortality is general, although heterogeneous by sex, age group and province. CONCLUSIONS: Although the observed increase in mortality cannot be totally attributed to the disease, it is the best estimate we have of the real impact on deaths directly or indirectly related to it. The number of declared deaths only reaches two thirds of the increase in mortality observed

Dynamic Optimization and Non-linear Model Predictive Control to Achieve Targeted Particle Morphologies.

An event-driven approach based on dynamic optimization and nonlinear model predictive control (NMPC) is investigated together with inline Raman spectroscopy for process monitoring and control. The benefits and challenges in polymerization and morphology monitoring are presented, and an overview of the used mechanistic models and the details of the dynamic optimization and NMPC approach to achieve the relevant process objectives are provided. Finally, the implementation of the approach is discussed, and results from experiments in lab and pilot-plant reactors are presented.

Relación entre las tasas de gripe estacional y las tasas de hospitalización y mortalidad hospitalaria por enfermedades cardiovasculares agudas en una región española / Relationship between seasonal influenza rates and hospitalization and mortality rates due to acute cardiovascular diseases in a Spanish region

Introducción y objetivo: La infección por virus de la gripe puede contribuir a la morbimortalidad cardiovascular. El objetivo de este estudio es analizar si el incremento en las tasas de gripe estacional se asocia a un crecimiento en las tasas de hospitalización y mortalidad hospitalaria por enfermedades cardiovasculares agudas (ECVA). Métodos: Estudio de cohortes retrospectivo sobre altas hospitalarias por ECVA (infarto de miocardio, angina inestable, insuficiencia cardiaca, accidente cerebrovascular isquémico) del sistema hospitalario de Castilla y León durante el periodo 2001-2015. Se analizaron tasas de hospitalización y mortalidad hospitalaria, y tasas de gripe en Castilla y León. Para calcular las tasas de hospitalización y mortalidad se empleó el Conjunto Mínimo Básico de Datos (CMBD); para las tasas de gripe, los informes semanales del Sistema Centinela de Vigilancia de la Gripe en España (Instituto de Salud Carlos III). Se realizó análisis estadístico de regresión lineal y multivariante de regresión logística. Resultados: Se estudiaron 239.586 ECVA (infarto, 55.004; angina inestable, 15.406; insuficiencia cardiaca, 11.1647; accidente cerebrovascular, 57.529). Tasas de gripe ascendentes se ajustaron a mortalidad creciente por todas las enfermedades, salvo angina inestable. Se observó una correlación lineal entre tasas de gripe y de hospitalización (r2=0,03; p=0,02) y mortalidad (r2=0,14; p<0,001) por ECVA. Las tasas de gripe se asociaron, como variables independientes, a un aumento de la mortalidad por ECVA, siendo mayor en tasas >139 casos/100.000 habitantes (OR: 1,25; p<0,001). Conclusiones: Las tasas de hospitalización y mortalidad hospitalaria por ECVA en el periodo estudiado aumentaron en relación con las tasas de infección por el virus de la gripe

Introduction and objective: Influenza virus infection can contribute to cardiovascular morbidity and mortality. The purpose of this study is to confirm if the increase in seasonal influenza rates is associated with a growth in hospitalisation and mortality rates for acute cardiovascular diseases (ACVD). Methods: Retrospective cohort study of hospital discharges due to ACVD (myocardial infarction, unstable angina, heart failure and ischemic stroke) in the Castilla y León (Spain) hospital system between 2001 and 2015. Hospitalisation and hospital mortality rates due to ACVD, and influenza rates in Castilla y León between 2001 and 2015 were studied. To calculate hospitalisation and mortality rates, the hospital discharges database was used; for influenza rates, the weekly reports of the Sentinel System for the surveillance of influenza in Spain (Carlos III Health Institute) were used. A statistical analysis of linear and multivariate logistic regressions was performed. Results: 239,586 ACVD (myocardial infarction: 55,004; unstable angina: 15,406; heart failure: 11,1647; ischemic stroke: 57,529) were studied. Increasing rates of influenza were associated with increased mortality due to ACVD and all the diseases studied, except unstable angina. A linear correlation was observed between influenza rates and hospitalisation (r2=0.03; p=0.02) and mortality (r2=0.14; p<0.001) rates by ACVD. Virtually all influenza rates were associated, as independent variables, to an increase in mortality due to ACVD, being higher in rates>139/100,000 inhabitants (OR: 1.25; p<0.001). Conclusions: The rates of hospitalisation and in-hospital mortality due to ACVD in the period 2001-2015 increased in relation to infection rates due to the influenza virus

Relationship between seasonal influenza rates and hospitalization and mortality rates due to acute cardiovascular diseases in a Spanish region. / Relación entre las tasas de gripe estacional y las tasas de hospitalización y mortalidad hospitalaria por enfermedades cardiovasculares agudas en una región española.

INTRODUCTION AND OBJECTIVE: Influenza virus infection can contribute to cardiovascular morbidity and mortality. The purpose of this study is to confirm if the increase in seasonal influenza rates is associated with a growth in hospitalisation and mortality rates for acute cardiovascular diseases (ACVD). METHODS: Retrospective cohort study of hospital discharges due to ACVD (myocardial infarction, unstable angina, heart failure and ischemic stroke) in the Castilla y León (Spain) hospital system between 2001 and 2015. Hospitalisation and hospital mortality rates due to ACVD, and influenza rates in Castilla y León between 2001 and 2015 were studied. To calculate hospitalisation and mortality rates, the hospital discharges database was used; for influenza rates, the weekly reports of the Sentinel System for the surveillance of influenza in Spain (Carlos III Health Institute) were used. A statistical analysis of linear and multivariate logistic regressions was performed. RESULTS: 239,586 ACVD (myocardial infarction: 55,004; unstable angina: 15,406; heart failure: 11,1647; ischemic stroke: 57,529) were studied. Increasing rates of influenza were associated with increased mortality due to ACVD and all the diseases studied, except unstable angina. A linear correlation was observed between influenza rates and hospitalisation (r2=0.03; p=0.02) and mortality (r2=0.14; p<0.001) rates by ACVD. Virtually all influenza rates were associated, as independent variables, to an increase in mortality due to ACVD, being higher in rates>139/100,000 inhabitants (OR: 1.25; p<0.001). CONCLUSIONS: The rates of hospitalisation and in-hospital mortality due to ACVD in the period 2001-2015 increased in relation to infection rates due to the influenza virus.

Co-encapsulation of CdSe/ZnS and CeO2 nanoparticles in waterborne polymer dispersions: enhancement of fluorescence emission under sunlight.

Hybrid core/shell polymer particles with co-encapsulated quantum dots (QDs) (CdSe/ZnS) and CeO2 nanoparticles have been synthesized in a two stage semi-batch emulsion polymerization process. In the first stage, both inorganic nanoparticles are incorporated into cross-linked polystyrene (PS) particles by miniemulsion polymerization. This hybrid dispersion is then used as the seed to produce the core/shell particles by starved feeding of methyl methacrylate and divinylbenzene (MMA/DVB) monomers. The core/shell hybrid dispersions maintained in the dark exhibit stable fluorescence emission over time, and notably their fluorescence intensity increases under sunlight, likely due to the effect of the co-encapsulated CeO2 nanoparticles that change the optical properties of the environment of the quantum dot particles. The fluorescence increase depends on the QD : CeO2 ratio, with the 1 : 2 ratio resulting in the highest increase (280%). Furthermore, a film forming hybrid latex has been synthesized using the former core/shell PS/QD/CeO2/PMMA particles as seeds and feeding under semi-batch conditions methyl methacrylate, butyl acrylate and acrylic acid. Films cast from this core/shell/shell hybrid dispersion also exhibit fluorescence, and as for the core/shell latex the fluorescence increases under sunlight exposure. Interestingly, the increase in the film is at least two times higher than that in the latex, which is attributed to the additional effect of the neighboring coalesced particles containing CeO2 affecting the environment of the QDs.

Variabilidad circadiana de la efectividad de la técnica de reperfusión y del pronóstico del infarto de miocardio con elevación del ST tratado mediante angioplastia primaria / Circadian variation in the effectiveness of reperfusion therapy in ST-segment elevation myocardial infarction treated with primary angioplasty and circadian associations with prognosis

Objetivo: Estudiar la presencia de un patrón de variabilidad circadiana en la efectividad del tratamiento con angioplastia coronaria transluminal percutánea (ACTPp) del infarto agudo de miocardio con elevación del segmento ST (IAMCEST), así como su relación con la extensión del infarto y la presencia de complicaciones intrahospitalarias. Método: Estudio observacional de cohortes retrospectivo que incluyó a pacientes con IAMCEST tratados con ACTPp en un hospital terciario universitario entre marzo 2003 y agosto 2009. La variable de estudio fue la hora de inicio de los síntomas del IAMCEST, agrupando en periodos de riesgo cronobiológico de 6 horas. La variable de resultado principal fue la efectividad de ACTPp. Las variables de resultado secundarias fueron la extensión del infarto y la presencia de complicaciones intrahospitalarias. Resultados: Se incluyeron 522 pacientes con una edad media de 62,3 (DE 13,6) años, de los cuales 404 (77,4%) fueron hombres. La franja horaria entre las 6-12 h fue la que presentó una mayor frecuencia de IAMCEST tratado con ACTPp (201 casos, 38,5%) (p < 0,001). Del total, 122 casos (23,4%) mostraron una ACTPp no efectiva. La franja horaria de 6-12 h fue un factor independiente de ACTPp no efectiva (OR 1,79; IC95% 1,09-2,94; p = 0,012). Además, se asoció con la extensión del infarto, aunque no con la presencia de complicaciones durante el ingreso hospitalario. Conclusiones: La hora de inicio de infarto de miocardio, en la franja de 6-12 h, es un predictor independiente de ACTPp no efectiva y de una mayor extensión del infarto, pero no de complicaciones intrahospitalarias (AU)

Objectives: To explore circadian variation in the effectiveness of percutaneous transluminal coronary angioplasty (PTCA) to treat ST-elevation myocardial infarction (STEMI) To explore the effects of circardian variation on infarct extension and in-hospital complications. Methods: Observational retrospective cohort study including patients with PTCA-treated STEMI in a tertiary care university hospital between March 2003 and August 2009. The independent variable of interest was the time of onset of STEMI symptoms, grouped in 6-hour time frames. The main outcome variable was PTCA effectiveness. Secondary outcome variables were infarct extension and the presence of in-hospital complications. Results: A total of 522 patients records were studied. The mean (SD) age was 62.3 (13.6) years and 404 (77.4%) were men. The largest proportion of PTCA-treated STEMI cases first experienced symptoms between 6 AM and 12 PM (201 cases, 38.5%) (P<.001). PTCA was ineffective in 122 (23.4%). The 6 AM to 12 PM time frame was an independent predictor of PTCA ineffectiveness (odds ratio, 1.79; 95% CI, 1.09–2.94; P=.012). Onset in this interval was also associated with infarct extension but not with in-hospital complications. Conclusions: A time of onset of STEMI between 6 AM and 12 PM predicts the ineffectiveness of PTCA and greater infarct extension but not in-hospital complications (AU)

[Circadian variation in the effectiveness of reperfusion therapy in ST-segment elevation myocardial infarction treated with primary angioplasty and circadian associations with prognosis]. / Variabilidad circadiana de la efectividad de la técnica de reperfusión y del pronóstico del infarto de miocardio con elevación del ST tratado mediante angioplastia primaria.

OBJECTIVES: To explore circadian variation in the effectiveness of percutaneous transluminal coronary angioplasty (PTCA) to treat ST-elevation myocardial infarction (STEMI) To explore the effects of circardian variation on infarct extension and in-hospital complications. MATERIAL AND METHODS: Observational retrospective cohort study including patients with PTCA-treated STEMI in a tertiary care university hospital between March 2003 and August 2009. The independent variable of interest was the time of onset of STEMI symptoms, grouped in 6-hour time frames. The main outcome variable was PTCA effectiveness. Secondary outcome variables were infarct extension and the presence of in-hospital complications. RESULTS: A total of 522 patients records were studied. The mean (SD) age was 62.3 (13.6) years and 404 (77.4%) were men. The largest proportion of PTCA-treated STEMI cases first experienced symptoms between 6 AM and 12 PM (201 cases, 38.5%) (P<.001). PTCA was ineffective in 122 (23.4%). The 6 AM to 12 PM time frame was an independent predictor of PTCA ineffectiveness (odds ratio, 1.79; 95% CI, 1.09-2.94; P=.012). Onset in this interval was also associated with infarct extension but not with in-hospital complications. CONCLUSION: A time of onset of STEMI between 6 AM and 12 PM predicts the ineffectiveness of PTCA and greater infarct extension but not in-hospital complications.

OBJETIVO: Estudiar la presencia de un patrón de variabilidad circadiana en la efectividad del tratamiento con angioplastia coronaria transluminal percutánea (ACTPp) del infarto agudo de miocardio con elevación del segmento ST (IAMCEST), así como su relación con la extensión del infarto y la presencia de complicaciones intrahospitalarias. METODO: Estudio observacional de cohortes retrospectivo que incluyó a pacientes con IAMCEST tratados con ACTPp en un hospital terciario universitario entre marzo 2003 y agosto 2009. La variable de estudio fue la hora de inicio de los síntomas del IAMCEST, agrupando en periodos de riesgo cronobiológico de 6 horas. La variable de resultado principal fue la efectividad de ACTPp. Las variables de resultado secundarias fueron la extensión del infarto y la presencia de complicaciones intrahospitalarias. RESULTADOS: Se incluyeron 522 pacientes con una edad media de 62,3 (DE 13,6) años, de los cuales 404 (77,4%) fueron hombres. La franja horaria entre las 6-12 h fue la que presentó una mayor frecuencia de IAMCEST tratado con ACTPp (201 casos, 38,5%) (p < 0,001). Del total, 122 casos (23,4%) mostraron una ACTPp no efectiva. La franja horaria de 6-12 h fue un factor independiente de ACTPp no efectiva (OR 1,79; IC95% 1,09-2,94; p = 0,012). Además, se asoció con la extensión del infarto, aunque no con la presencia de complicaciones durante el ingreso hospitalario. CONCLUSIONES: La hora de inicio de infarto de miocardio, en la franja de 6-12 h, es un predictor independiente de ACTPp no efectiva y de una mayor extensión del infarto, pero no de complicaciones intrahospitalarias.

New evidence for hybrid acrylic/TiO2 films inducing bacterial inactivation under low intensity simulated sunlight.

This study addresses the preparation and characterization of hybrid films prepared from Titanium dioxide (TiO2) Pickering stabilized acrylic polymeric dispersion as well as their bacterial inactivation efficiency under sunlight irradiation. Complete bacterial inactivation under low intensity simulated solar light irradiation (55 mW/cm(2)) was observed within 240 min for the films containing 10 weight based on monomers (wbm) % of TiO2, whereas 360 min were needed for the films containing 20 wbm% of TiO2. The hybrid films showed repetitive Escherichia coli (E. coli) inactivation under light irradiation. TiO2 released from the films surfaces was measured by inductively coupled plasma mass spectrometry (IPC-MS), obtaining values of ∼ 0.5 and 1 ppb/cm(2) for the films containing 10 wbm% and 20 wbm% of TiO2, respectively, far below the allowed cytotoxicity level for TiO2 (200 ppb). Transmission electron microscopy (TEM) of the hybrid films showed that TiO2 nanoparticles (NPs) were located at the polymer particle's surface forming a continuous inorganic network inside the film matrix. Atomic force microscopy (AFM) images showed differences in the TiO2 dispersion between the air-film and film-substrate interfaces. Films containing 10 wbm% of TiO2 had higher roughness (Rg) at both interfaces than the one containing 20 wbm% of TiO2 inducing an increase in the bacterial adhesion as well as the bacterial inactivation kinetics. The highly oxidative OH-radicals participating in the bacterial inactivation were determined by fluorescence.

Relación entre infarto de miocardio y ritmo circadiano en pacientes atendidos por un servicio de emergencias prehospitalario / Relation between myocardial infarction and cyrcadian rhythm in patients attended in a prehospital emergency service

Fundamento y objetivo. El objetivo de este estudio es analizar la presencia de ritmo circadiano en la hora de inicio del infarto agudo de miocardio atendido por un sistema de emergencias prehospitalario, y la influencia en dicho ritmo de algunos factores de riesgo cardiovascular modificables y no modificables como posibles moduladores de ese patrón circadiano. Pacientes y método. Análisis retrospectivo de 709 pacientes con diagnóstico clínico confirmado in situ de infarto agudo de miocardio. Se analizan las variables: hora de inicio de los síntomas, edad, sexo, cardiopatía isquémica previa, hipertensión arterial, diabetes mellitus, dislipidemia y tabaquismo. El análisis de ritmo se ha efectuado utilizando un test simple de igualdad de series basado en el análisis cosinor de múltiples sinusoides, eligiendo 3 armónicos (24,12 y 8h) para su ajuste. Resultados. La hora de inicio del infarto muestra ritmo circadiano (p<0,001), con un pico máximo a las 10.39 y un valle a las 4.28, mostrando una curva sinusoidal ajustada de aspecto bimodal, con un pico matinal predominante y otro vespertino de menor amplitud. Todos los subgrupos categorizados por la presencia de las variables analizadas presentaron ritmo circadiano, con una curva sinusoidal similar a la de la población global. Los pacientes fumadores muestran un pico vespertino predominante. Conclusiones. El infarto de miocardio presenta ritmo circadiano. El tabaquismo y la diabetes modifican el patrón de ritmo circadiano habitual del infarto(AU)

Background and objectives. The aim of this study is to analyze the presence of circadian rhythm in the time of onset of symptoms of acute myocardial infarction treated by a prehospital emergency system and the influence of modifiable cardiovascular risk factors and non-modifiable as modulators of that circadian rhythm. Patients and methods. Retrospective analysis of 709 patients clinically diagnosed with acute myocardial infarction on-site in the prehospital setting. The variables were time to onset of symptoms, age, sex, previous ischemic heart disease, hypertension, diabetes mellitus, hyperlipidemia and smoking. We analyzed the rhythm with cosinor multiple sinusoid method, with 3 harmonics (24, 12 and 8h) for the adjustment. Results. The time of onset of pain showed circadian rhythm (P <,001), peaking at 10.39 and a valley at 4.28, showing a sinusoidal curve fitting bimodal aspect with a predominant morning peak and another evening one of lower amplitude. All subgroups categorized by the study variables showed circadian rhythm, with a cosine curve similar to the global infarction. Smokers had a predominantly evening peak. Conclusions. Acute myocardial infarction shows a circadian rhythm. Smoking and diabetes mellitus can modify the standard incidence rate of occurrence of myocardial infarction(AU)