A Comprehensive Strategy for Stepwise Design of a Lab PROTOTYPE for the Removal of Emerging Contaminants in Water Using Cyclodextrin Polymers as Adsorbent Material.

The significant environmental issue of water pollution caused by emerging contaminants underscores the imperative for developing novel cleanup methods that are efficient, economically viable, and that are intended to operate at high capacity and under continuous flows at the industrial scale. This study shows the results of the operational design to build a prototype for the retention at lab scale of pollutant residues in water by using as adsorbent material, insoluble polymers prepared by ß-cyclodextrin and epichlorohydrin as a cross-linking agent. Laboratory in-batch tests were run to find out the adsorbent performances against furosemide and hydrochlorothiazide as pollutant models. The initial evaluation concerning the dosage of adsorbent, pH levels, agitation, and concentration of pharmaceutical pollutants enabled us to identify the optimal conditions for conducting the subsequent experiments. The adsorption kinetic and the mechanisms involved were evaluated revealing that the experimental data perfectly fit the pseudo second-order model, with the adsorption process being mainly governed by chemisorption. With KF constant values of 0.044 (L/g) and 0.029 (L/g) for furosemide and hydrochlorothiazide, respectively, and the determination coefficient (R2) being higher than 0.9 for both compounds, Freundlich yielded the most favorable outcomes, suggesting that the adsorption process occurs on heterogeneous surfaces involving both chemisorption and physisorption processes. The maximum monolayer adsorption capacity (qmax) obtained by the Langmuir isotherm revealed a saturation of the ß-CDs-EPI polymer surface 1.45 times higher for furosemide (qmax = 1.282 mg/g) than hydrochlorothiazide (qmax = 0.844 mg/g). Based on these results, the sizing design and building of a lab-scale model were carried out, which in turn will be used later to evaluate its performance working in continuous flow in a real scenario.

Usefulness of extended inflammatory parameters related to neutrophil activation reported by Sysmex XN-1000 hematology analyzer for predicting complicated acute appendicitis. Comparison with canonical inflammatory laboratory tests.

AIM: Accurate diagnosis of complicated appendicitis is of importance to ensure that patients receive early and effective treatment, minimizing the risk of postoperative complications to promote successful recovery. Biochemical markers are a promising tool to identify complicated appendicitis. We aimed to evaluate the potential role of novel parameters related with neutrophil activation, known as "Extended Inflammation Parameters" (EIP), included in blood cell count reported by Sysmex XN-Series analyzers, compared to other canonical biomarkers in identifying complicated appendicitis. METHOD: Prospective observational study including patients with confirmed diagnosis of acute appendicitis. C-reactive protein (CRP), procalcitonin, cell blood count, including white blood cell (WBC), absolute neutrophil (ANC) and immature granulocyte (IG) count and EIP (neutrophil reactivity [NEUT-RI] and granularity intensity [NEUT-GI]) were analyzed before surgery. Their accuracy to diagnose complicated appendicitis was tested in an ROC curve analysis. RESULTS: Our population study included 119 patients, and appendicitis was complicated in 58 (48.7%). NLR, CRP and procalcitonin levels, ANC and IG count and NEUT-RI and NEUT-GI were higher in patients with complicated appendicitis. Regarding accuracy for complicated appendicitis, CRP was the biomarker with the highest performance (ROC AUC: 0.829), with an optimal cutoff of 73.1 mg/L (sensitivity: 63.8%, specificity: 88.5%). NEUT-RI and NEUT-GI achieved both significant but poor accuracy, with ROC AUC of 0.606 and 0.637, respectively. CONCLUSIONS: Novel laboratory tests reported by Sysmex XN-Series analyzers have poor accuracy for identifying complicated appendicitis. In this study, CRP was the biomarker with the highest performance and may be useful as predictor of the severity of acute appendicitis.

Reliability of a point of care testing blood gas analyzer for measurement of lactate levels in cerebrospinal fluid.

Analysis of cerebrospinal fluid (CSF), including lactate, is key for diagnosis of acute meningitis. Since blood gas analyzers (BGA) enable rapid and safe blood-lactate measurements, we evaluated the reliability of RAPIDPoint 500 BGA to provide a fast and accurate measure of CSF lactate. In this study, CSF lactate levels were measured by a reference assay and on RAPIDPoint 500 BGA. Comparability was evaluated through difference analysis, using Bland Altman test, and linear regression analysis, using the Passing Bablok test. Agreement rate according to CSF lactate (≥3.5 and <3.5 mmol/L) was calculated using kappa (κ) statistic. Population study included 98 CSF samples. Concerning difference analysis, according to Bland-Altman test, bias was 0.13 mmol/L (CI 95%: -0.26 to 0.52 mmol/L. In regression analysis, according to Passing-Bablok equation a systematic difference between both assays was found. In concordance analysis, the interrate realibility was very high (κ: 0.964). According to our resuls, although a systematic difference was detected when lactate levels were measured on RAPIDPoint 500 BGA, the results from Bland-Altman test and the high agreement rate support that this POCT analyzer could be useful for a early and safe detection of patients with high probability of increased CSF lactate level.

Evaluation of the impact of "speak out" and "human libraries" educational methodologies on nursing students' attitudes toward immigration.

Introduction: Measuring and understanding attitudes toward migrants is crucial in Health Sciences professionals. Nursing students, as future professionals in the healthcare system, must be comprehensively trained and prepared from the undergraduate level to effectively face the challenges of caring for health and disease processes in an increasingly globalized world. Our study aims to determine the level of attitudinal change in nursing students for immigrants, based on a training intervention with sessions of coexistence with immigrants in Spain. Methods: Quasi-experimental controlled and non-randomized study, carried out in 2019 in Nursing School La Fe, Valencia (Spain), with 201 participants (74 intervention group, 127 control group). Instrument: Attitudes toward Immigration Instrument (IAHI) questionnaire. Educational techniques of the training intervention: Speak outs and Human Libraries. Descriptive statistical analysis and comparison of results between groups was performed. Results: The participants in the intervention group showed significant changes in attitude modification, both in the total score of the questionnaire and in 4 of the 5 dimensions (pre-post intervention medition). When comparing the differences between the intervention group and the control group, we observed significant differences in 3 of the 5 dimensions: equality principles and policies, positive favorability, and negative favorability. Conclussion: Sessions involving coexistence, discussion, and reflection with immigrants, as educational intervention methods for nursing students (Speak outs and Human Libraries), are useful and effective tools to promote positive attitudinal changes toward immigrants within the healthcar context in nursing students.

A Systematic Review of the Effectiveness of Non-Pharmacological Therapies Used by Nurses in Children Undergoing Surgery.

OBJECTIVE: The aim of this study was to identify non-pharmacological pain relief therapies in children undergoing surgery. DESIGN AND DATA SOURCES: Using keywords extracted from Medical Subject Headings and "Descriptores en Ciencias de la Salud" we searched for articles in the Web of Science, Scopus, Cuiden, PubMed, and CINHAL databases from the last five years, and performed a reverse search. We assessed the documentary quality of the articles using various standardized instruments. RESULTS: The final review included eleven studies. In terms of cognitive-behavioral techniques, there is evidence that both music and video therapy are effective in reducing postoperative pain in children in seven studies, and therapeutic play in five studies. Other methods used less frequently but found to be effective included laughter therapy in one study and deep breathing in another. Regarding physical methods of pain relief, massage was found to be an effective non-pharmacological therapy for reducing pediatric postoperative pain in two studies and ineffective in another. CONCLUSIONS: In this study, we highlight the importance of non-pharmacological therapies in pediatric postoperative pain management. Cognitive-behavioral techniques, especially music therapy, video therapy, and therapeutic play, reduce pediatric postoperative pain. They are therefore effective therapies that nurses can use in this area. Further research into the effectiveness of storytelling is necessary, as the evidence is not entirely conclusive. More evidence is also needed on physical methods of pain relief, particularly massage.

External Validation of SAFE Score to Predict Atrial Fibrillation Diagnosis after Ischemic Stroke: A Retrospective Multicenter Study.

Introduction: The screening for atrial fibrillation (AF) scale (SAFE score) was recently developed to provide a prediction of the diagnosis of AF after an ischemic stroke. It includes 7 items: age ≥ 65 years, bronchopathy, thyroid disease, cortical location of stroke, intracranial large vessel occlusion, NT-ProBNP ≥250 pg/mL, and left atrial enlargement. In the internal validation, a good performance was obtained, with an AUC = 0.88 (95% CI 0.84-0.91) and sensitivity and specificity of 83% and 80%, respectively, for scores ≥ 5. The aim of this study is the external validation of the SAFE score in a multicenter cohort. Methods: A retrospective multicenter study, including consecutive patients with ischemic stroke or transient ischemic attack between 2020 and 2022 with at least 24 hours of cardiac monitoring. Patients with previous AF or AF diagnosed on admission ECG were excluded. Results: Overall, 395 patients were recruited for analysis. The SAFE score obtained an AUC = 0.822 (95% CI 0.778-0.866) with a sensitivity of 87.2%, a specificity of 65.4%, a positive predictive value of 44.1%, and a negative predictive value of 94.3% for a SAFE score ≥ 5, with no significant gender differences. Calibration analysis in the external cohort showed an absence of significant differences between the observed values and those predicted by the model (Hosmer-Lemeshow's test 0.089). Conclusions: The SAFE score showed adequate discriminative ability and calibration, so its external validation is justified. Further validations in other external cohorts or specific subpopulations of stroke patients might be required.

Recovery course of persistent posterior subretinal fluid after successful repair of rhegmatogenous retinal detachment.

PURPOSE: To investigate best corrected visual acuity (BCVA), subretinal fluid (SRF) absorption time or ellipsoid zone (EZ) restoration time and various variables in patients with persistent SRF after successful primary repair of rhegmatogenous retinal detachment (RRD). METHODS: This retrospective multicenter study allowed independent analysis of the healing pattern by two observers based on composite of serial cross-sectional macular optical coherence tomography (OCT) scans. Univariate and multivariate analyses were implemented. RESULTS: One hundred and three cases had persistent SRF after pars plana vitrectomy, scleral buckling, or pneumatic retinopexy. By univariate analysis, SRF resolution time correlated positively with the number of retinal breaks (p < 0.001) and with increased myopia (p = 0.011). Using multivariate analysis, final BCVA (log MAR) correlated positively with age, duration of RRD, initial BCVA (OR = 3.28; [95%CI = 1.44-7.47]; p = 0.015), and SRF resolution time (OR = 0.46 [95%CI 0.21-1.05]; p = 0.049). EZ restoration time was longer with increasing number of retinal tears (OR = 0.67; [95%CI 0.29-1.52]; p = 0.030), worse final BCVA, and presence of macula-off RRD (OR = 0.26; [95%CI 0.08-0.88]; p = 0.056). SRF resolution time correlated marginally with prone position. CONCLUSIONS: Residual posterior SRF is more common in eyes with multiple breaks or in myopic eyes. Final BCVA is better in younger subjects and in eyes with shorter duration of RRD. Persistent SRF is a self-limited disorder with a mean resolution of 11.2 months with good visual prognosis improving from a mean baseline logMAR of 1.08 to 0.25 at one year.

Resultados y experiencia en salud en gestión de casos de enfermería en pacientes con patologías crónicas: una revisión de revisiones / Results and experience in Health in Nursing Case Management in Patients with Chronic Pathologies: a review of reviews

Objetivo: Sintetizar la evidencia reciente sobre la atención por gestión de casos de enfermería dirigida a pacientes adultos con patologías crónicas, en relación a resultados en salud, calidad de vida y satisfacción para el paciente. Material y métodos: Revisión de revisiones realizada en el año 2022, incluyendo estudios publicados entre 2011 y 2021, ambos incluidos, a través de las bases de datos Pubmed, Web of Science (WoS), Cochrane y el Índice bibliográfico español de ciencias de la Salud (IBECS). Resultados: Se incluyeron un total de 9 revisiones. Todas ellas analizaron la gestión de casos enfermera en relación a la efectividad en general. De ello, cinco estudios, además, se centraron también en calidad de vida del paciente, cuatro estudios en satisfacción del paciente, uno de ellos se centró en resultados en salud y otro hizo alusión a aspectos emocionales. La mayor parte de los artículos se centran en analizar la gestión de casos en varias enfermedades crónicas. El resto de artículos analizaron otras situaciones concretas: presión arterial y colesterol, insuficiencia cardiaca, depresión en enfermedades crónicas y atención domiciliaria. Discusión y conclusiones: Los estudios demuestran que existe una mejoría en los resultados de salud tras la gestión de casos, disminuyendo los ingresos hospitalarios y la atención en los servicios de urgencias. También se observa un aumento en la satisfacción del paciente. Con respecto a la calidad de vida, aunque existente escaso respaldo, los estudios reflejan resultados positivos en dicha variable. Los diferentes autores subrayan la necesidad de realizar más estudios con mayor calidad metodológica. (AU)

Objective: Synthesize recent evidence on nursing case management care aimed at adult patients with chronic pathologies, in relation to health outcomes, quality of life and patient satisfaction. Material and methods: Review of reviews carried out in the year 2022, including studies published between 2011 and 2021, both included, through the Pubmed, Web of Science (WoS), Cochrane databases and the Spanish Bibliographic Index of Health Sciences (IBECS). Results: A total of 9 reviews were included. All of them analyzed nursing case management in relation to overall effectiveness. Of this, five studies also focused on patient quality of life, four studies on patient satisfaction, one of them focused on health outcomes and another alluded to emotional aspects. Most of the articles focus on analyzing case management in various chronic diseases. The rest of the articles analyzed other specific situations: blood pressure and cholesterol, heart failure, depression in chronic diseases and home care. Discussion and Conclusions: Studies show that there is an improvement in health outcomes after case management, decreasing hospital admissions and care in emergency services. The existence of very little published bibliography on the repercussion on the quality of life of patients with chronic pathologies has been evidenced. Regarding patient satisfaction, it can be concluded that said satisfaction has increased compared to patients who have received care without SG. The best valued aspect was accessibility to health care. The different authors underline the need to carry out more studies with higher methodological quality. (AU)

Physiotherapists' ethical behavior in professional practice: a qualitative study.

Background: In health professions, ethics is considered a fundamental competence. The increase in clinical autonomy in the field of physiotherapy is associated with an increase in ethical situations in their clinical practice. Objective: To explore the ethics of the clinical relationship between physiotherapists and patients, the ethics training received by physiotherapists, and if in the clinical context, physiotherapists identify the necessary attitudes and apply the ethical recommendations of the profession for the ethical situations they experience. Methods: A qualitative exploratory and descriptive study was performed with physiotherapists. Data were collected through semi-structured interviews. The data were analyzed using content analysis, as proposed by Krippendorf. The study protocol was approved by the University of Valencia Ethics Committee of Human Research. Results: This study included 15 physiotherapists (66.66% women, average age = 42.2 years), which was sufficient to reach data saturation. We identified four categories: (i) Ethics of the clinical relationship (ethical values, principles, and norms; type of clinical relationship), (ii) Ethics training received (during the physiotherapy studies; current training of students; low importance of ethics in the curriculum), (iii) Necessary attitudes for professional ethical practice (main attitudes were identified: personal attitudes and professional attitudes); (iv) Experiences from professional practice (general; public sector vs. private sector). Conclusion: The ethics of the clinical relationship between physiotherapists and patients is determined by the attitudes of the practitioner, which are the result of his or her values and previous experiences; and are very centered on ethics of indication (founded mainly on the principles of Beneficence and Non-Maleficence). It is necessary to improve the ethical training received by physiotherapists, which is poorly focused on professional attitudes.

Plasma sodium concentration in older patients as an indicator of severity in emergencies: Results from the Emergency Department and Elder Needs-16 study. / Estudio EDEN-16: sodio plasmático determinado a la llegada a urgencias como indicador de gravedad en pacientes ancianos.

OBJECTIVES: To study baseline factors associated with hypo- and hypernatremia in older patients attended in emergency departments (EDs) and explore the association between these dysnatremias and indicators of severity in an emergency. MATERIAL AND METHODS: We included patients attended in 52 Spanish hospital EDs aged 65 years or older during a designated week. All included patients had to have a plasma sodium concentration on record. Patients were distributed in 3 groups according to sodium levels: normal, 135-145 mmol/L; hyponatremia, 135 mmol/L; or hypernatremia > 145 mmol/L. We analyzed associations between sodium concentration and 24 variables (sociodemographic information, measures of comorbidity and baseline functional status, and ongoing treatment for hypo- or hypernatremia). Indicators of the severity in emergencies were need for hospitalization, in-hospital mortality, prolonged ED stay (> 12 hours) in discharged patients, and prolonged hospital stay (> 7 days) in admitted patients. We used restricted cubic spline curves to analyze the associations between sodium concentration and severity indicators, using 140 mmol/L as the reference. RESULTS: A total of 13 368 patients were included. Hyponatremia was diagnosed in 13.5% and hypernatremia in 2.9%. Hyponatremia was associated with age ($ 80 years), hypertension, diabetes mellitus, an active neoplasm, chronic liver disease, dementia, chemotherapy, and needing help to walk. Hypernatremia was associated with needing help to walk and dementia. The percentages of cases with severity indicators were as follows: hospital admission, 40.8%; in-hospital mortality, 4.3%; prolonged ED stay, 15.9%; and prolonged hospital stay, 49.8%. Odds ratios revealed associations between lower sodium concentration cut points in patients with hyponatremia and increasing need for hospitalization (130 mmol/L, 2.24 [IC 95%, 2.00-2.52]; 120 mmol/L, 4.13 [3.08-5.56]; and 110 mmol/L, 7.61 [4.53-12.8]); risk for in-hospital death (130 mmol/L, 3.07 [2.40-3.92]; 120 mmol/L, 6.34 [4.22- 9.53]; and 110 mmol/L, 13.1 [6.53-26.3]); and risk for prolonged ED stay (130 mmol/L, 1.59 [1.30-1.95]; 120 mmol/L, 2.77 [1.69-4.56]; and 110 mmol/L, 4.83 [2.03-11.5]). Higher sodium levels in patients with hypernatremia were associated with increasing need for hospitalization (150 mmol/L, 1.94 [1.61-2.34]; 160 mmol/L, 4.45 [2.88-6.87]; 170 mmol/L, 10.2 [5.1-20.3]; and 180 mmol/L, 23.3 [9.03-60.3]); risk for in-hospital death (150 mmol/L, 2.77 [2.16-3.55]; 160 mmol/L, 6.33 [4.11-9.75]; 170 mmol/L, 14.5 [7.45-28.1]; and 180 mmol/L, 33.1 [13.3-82.3]); and risk for prolonged ED stay (150 mmol/L, 2.03 [1.48-2.79]; 160 mmol/L, 4.23 [2.03-8.84]; 170 mmol/L, 8.83 [2.74-28.4]; and 180 mmol/L, 18.4 [3.69-91.7]). We found no association between either type of dysnatremia and prolonged hospital stay. CONCLUSION: Measurement of sodium plasma concentration in older patients in the ED can identify hypo- and hypernatremia, which are associated with higher risk for hospitalization, death, and prolonged ED stays regardless of the condition that gave rise to the dysnatremia.

OBJETIVO: Estudiar los factores basales asociados a hiponatremia e hipernatremia en pacientes mayores atendidos en urgencias y la relación de estas disnatremias con eventos indicadores de gravedad. METODO: Se incluyeron durante una semana a todos los pacientes atendidos en 52 servicios de urgencias hospitalarios españoles de edad $ 65 años con determinación de sodio plasmático. Se formaron tres grupos: sodio normal (135-145 mmol/L), hiponatremia ( 135 mmol/L) e hipernatremia (> 145 mmol/L). Se investigó la relación de 24 factores sociodemográficos, de comorbilidad, estado funcional basal y tratamiento crónico con hipo e hipernatremia. Como eventos de gravedad se recogieron necesidad de hospitalización, mortalidad intrahospitalaria, estancia prolongada en urgencias (> 12 horas) en dados de alta y hospitalización prolongada (> 7 días) en hospitalizados, y se analizó su relación con la concentración de sodio mediante curvas spline cúbicas restringidas ajustadas, tomando el valor 140 mmol/L como referencia. RESULTADOS: Se incluyeron 13.368 pacientes (13,5% hiponatremia, 2,9% hipernatremia). La hiponatremia se asoció a edad $ 80 años, hipertensión arterial, diabetes mellitus, neoplasia activa, hepatopatía crónica, demencia, tratamiento con quimioterápicos y ayuda para la deambulación, y la hipernatremia a dependencia, necesidad de ayuda para deambular y demencia. La hospitalización fue del 40,8%, la mortalidad intrahospitalaria del 4,3%, la estancia prolongada en urgencias del 15,9% y la hospitalización prolongada del 49,8%. A mayor hiponatremia, mayor necesidad de hospitalización (sodio 130 mmol/L: OR:2,24; IC 95%: 2,00-2,52; 120 mmol/L: 4,13, 3,08-5,56; 110 mmol/L: 7,61, 4,53-12,8), mortalidad intrahospitalaria (130 mmol/L: 3,07, 2,40-3,92; 120 mmol/L: 6,34, 4,22-9,53; 110 mmol/L: 13,1, 6,53-26,3) y estancia prolongada en urgencias (130 mmol/L: 1,59, 1,30-1,95; 120 mmol/L: 2,77, 1,69-4,56; 110 mmol/L: 4,83, 2,03-11,5), y a mayor hipernatremia mayor necesidad de hospitalización (150 mmol/L: 1,94, 1,61-2,34; 160 mmol/L: 4,45, 2,88-6,87; 170 mmol/L: 10,2, 5,1-20,3; 180 mmol/L: 23,3, 9,03-60,3), mortalidad intrahospitalaria (150 mmol/L: 2,77, 2,16-3,55; 160 mmol/L: 6,33, 4,11-9,75; 170 mmol/L: 14,5, 7,45-28,1; 180 mmol/L: 33,1, 13,3-82,3) y estancia prolongada en urgencias (150 mmol/L: 2,03, 1,48-2,79; 160 mmol/L: 4,23, 2,03-8,84; 170 mmol/L: 8,83, 2,74-28,4; 180 mmol/L: 18,4, 3,69-91,7). No hubo asociación entre estas disnatremias y hospitalización prolongada. CONCLUSIONES: El sodio plasmático determinado en urgencias en pacientes mayores permite identificar hiponatremias e hipernatremias, las cuales se asocian a un riesgo incrementado de hospitalización, mortalidad y estancia prolongada en urgencias independientemente de la causa que haya generado la disnatremia.

Evaluation of the In Vitro Antimicrobial Efficacy against Staphylococcus aureus and epidermidis of a Novel 3D-Printed Degradable Drug Delivery System Based on Polycaprolactone/Chitosan/Vancomycin-Preclinical Study.

Acute and chronic bone infections, especially those caused by methicillin-resistant Staphylococcus aureus (MRSA), remains a major complication and therapeutic challenge. It is documented that local administration of vancomycin offers better results than the usual routes of administration (e.g., intravenous) when ischemic areas are present. In this work, we evaluate the antimicrobial efficacy against S. aureus and S. epidermidis of a novel hybrid 3D-printed scaffold based on polycaprolactone (PCL) and a chitosan (CS) hydrogel loaded with different vancomycin (Van) concentrations (1, 5, 10, 20%). Two cold plasma treatments were used to improve the adhesion of CS hydrogels to the PCL scaffolds by decreasing PCL hydrophobicity. Vancomycin release was measured by means of HPLC, and the biological response of ah-BM-MSCs growing in the presence of the scaffolds was evaluated in terms of cytotoxicity, proliferation, and osteogenic differentiation. The PCL/CS/Van scaffolds tested were found to be biocompatible, bioactive, and bactericide, as demonstrated by no cytotoxicity (LDH activity) or functional alteration (ALP activity, alizarin red staining) of the cultured cells and by bacterial inhibition. Our results suggest that the scaffolds developed would be excellent candidates for use in a wide range of biomedical fields such as drug delivery systems or tissue engineering applications.

Polarimetric imaging for the detection of synthetic models of SARS-CoV-2: A proof of concept.

Objective: To conduct a proof-of-concept study of the detection of two synthetic models of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using polarimetric imaging. Approach: Two SARS-CoV-2 models were prepared as engineered lentiviruses pseudotyped with the G protein of the vesicular stomatitis virus, and with the characteristic Spike protein of SARS-CoV-2. Samples were prepared in two biofluids (saline solution and artificial saliva), in four concentrations, and deposited as 5-µL droplets on a supporting plate. The angles of maximal degree of linear polarization (DLP) of light diffusely scattered from dry residues were determined using Mueller polarimetry from87 samples at 405 nm and 514 nm. A polarimetric camera was used for imaging several samples under 380-420 nm illumination at angles similar to those of maximal DLP. Per-pixel image analysis included quantification and combination of polarization feature descriptors in 475 samples. Main results: The angles (from sample surface) of maximal DLP were 3° for 405 nm and 6° for 514 nm. Similar viral particles that differed only in the characteristic spike protein of the SARS-CoV-2, their corresponding negative controls, fluids, and the sample holder were discerned at 10-degree and 15-degree configurations. Significance: Polarimetric imaging in the visible spectrum may help improve fast, non-contact detection and identification of viral particles, and/or other microbes such as tuberculosis, in multiple dry fluid samples simultaneously, particularly when combined with other imaging modalities. Further analysis including realistic concentrations of real SARS-CoV-2 viral particles in relevant human fluids is required. Polarimetric imaging under visible light may contribute to a fast, cost-effective screening of SARS-CoV-2 and other pathogens when combined with other imaging modalities.

The Parental Stress Scale: Psychometric Properties in Pediatric Hospital Emergency Setting.

Parental psychological distress has been identified as a predisposing factor in attendance at and the inappropriate use of hospital pediatric emergency departments (PEDs). The aim of the study was to validate the Parental Stress Scale (PSS), a 12-item Spanish scale, in parents seeking care at PEDs. The study involved 270 participants with a mean age of 37.9 (SD = 6.76) years, of which 77.4% were women. The properties of the PSS were analyzed. The scale showed adequate internal consistency for the different factors (0.80 for the "Stressors" factor and 0.78 for the "Baby's Rewards" factor) and optimal model fit (chi-square = 107.686; df = 53; CFI = 0.99; TLI = 0.98; RMSEA = 0.028; 90% CI = 0.00-0.05). The 12-item Spanish version of the PSS is a valid and reliable instrument for assessing the stress levels of parents seeking care in PEDs.

Leisure Programmes in Hospitalised People: A Systematic Review.

Nurses carry out holistic assessments of patients during hospital admission. This assessment includes the need for leisure and recreation. Different intervention programmes have been developed to meet this need. The aim of this study was to investigate hospital leisure intervention programmes described in the literature in order to determine their effects on patient health and highlight the strengths and weaknesses of the programmes as reported by health professionals. A systematic review of articles in English or Spanish published between 2016 and 2022 was carried out. A search was performed in the following databases: CINAHL COMPLETE, PubMed, Cochrane Library and Dialnet and the Virtual Health Library and Web of Science resources. A total of 327 articles were obtained, of which 18 were included in the review. The methodological quality of the articles was assessed using the PRISMA, CASPe and STROBE scales. A total of six hospital-based leisure programmes were identified, including a total of 14 leisure interventions. The activities developed in most of the interventions effectively reduced the levels of anxiety, stress, fear and pain in patients. They also improved factors such as mood, humour, communication, wellbeing, satisfaction and hospital adaptation. Among the main barriers to implementing hospital leisure activities is the need for more training, time and adequate spaces for them develop. Health professionals consider it beneficial for the patient to develop leisure interventions in the hospital.

Novel technique for late scleromalacia in a ciliary body melanoma due to brachytherapy.

INTRODUCTION: We describe a technique using an sclerocorneal endograft sewed through the cornea to solve late scleromalacia following exoresection and brachytherapy of a ciliary body melanoma. METHODS: Vitrectomy ports were placed. A perforating 400-micron trepan keratoplasty of the cornea was performed allowing the prepared donor graft to be inserted and sutured in place. Intravitreal Perfluorocarbon liquid (PFCL) was used to stabilize the pressure throughout and maintain the graft in place. Once sutured in place, the PFCL was removed and 5000cs of silicone oil introduced. An amniotic membrane was placed surrounding the scleromalacia. The cornea was closed with running sutures. RESULTS: At one month, the anterior segment optical coherence tomography showed successful endograft placement with no aqueous humor leakage nor hypotony. Currently, the conjunctiva is becoming slightly thicker due to light inflammation, and the eye has recovered the whiteness at the scleromalacia. CONCLUSIONS: This internal graft technique provides advantages when dealing with poorly healing radiated tissue and reduces the risk of post-operative aqueous humor leakage. Surgeons may consider this approach in cases with a high risk of poor healing or complications resulting from lack of tissue.

Carvacrol and HP-ß-Cyclodextrin Complexes: Extensive Characterization and Potential Cytotoxic Effect in Human Colorectal Carcinoma Cells.

The aim of this study was to obtain solid carvacrol-cyclodextrin (CD) complexes for use in the pharmaceutical industry. To this end, the complexation of carvacrol at different pH values was studied in detail, to determine the type of CD and the reaction environment that supported the highest amount of encapsulated carvacrol. Evidence of the capability of hydroxypropyl-ß-cyclodextrins (HP-ß-CD) to form inclusion complexes with carvacrol (KC = 5042 ± 176 L mol-1) and more high complexation efficiency (2.824) was demonstrated for HP-ß-CDs using two different energy sources, ultrasound (US) (KC = 8129 ± 194 L mol-1 24 h) and microwave irradiation (MWI) (KC = 6909 ± 161 L mol-1), followed by spraying the resulting solution in a spray dryer. To confirm complex formation, the complexes were characterized using various instrumental methods to corroborate the carvacrol incorporation into the hydrophobic cavity of HP-ß-CD. The obtained carvacrol solid complexes were analyzed by 1H nuclear magnetic resonance (1H-NMR) and 2D nuclear magnetic resonance (ROSEY), differential scanning calorimetry (DSC), thermogravimetric analysis (TG) and Fourier transform infrared spectroscopy (FTIR) characterization. The structures of the resulting complexes were also characterized by molecular modeling. Furthermore, 1 mM HP-ß-CD-carvacrol complex has been shown to reduce cell proliferation in HCT-116 colorectal cancer cells by 43%, much more than in a healthy lung fibroblast MRC-5 cell line (11%).

Hypovitaminosis D in patients with type 2 diabetes: risk factors and association with glycemic control and established microvascular complications

Introduction: Several studies reported than vitamin D deficiency increases the risk of macrovascular and microvascular disease in patients with type 2 diabetes (T2DM). We investigated the plasma levels of 25OHD in adult patients T2DM, risk factors for 25OHD deficiency and the relationship between 25OHD, glycemic control and chronic complications of T2DM. Methods: A cross-sectional study was carried out, in which 25OHD levels were evaluated in adult patients (over 18 years) with T2DM. Correlation analyses were performed to evaluate the interdependence of the 25OHD with other continuous variables. A receiver operating characteristic analysis was also performed to identify cutoff values for diagnosing vitamin D deficiency. Logistic regression was performed to identify the independent association between vitamin D deficiency and the variables associated with lower 25OHD. Results: 208 patients were analyzed. The mean age of the patients was 62 years.  The 25OHD level was 19 ng/ml (IQR 13.28-24.43), 59.78% had vitamin D deficiency, and 10.33% had severe deficiency. Glycemia, HbA1c, and BMI were negatively correlated with 25OHD. Cutoff point for vitamin D deficiency was 33.39 kg/m2 for body mass index (BMI), 123 mg/dl for glycemia, and 6.65% for HbA1c. In multivariate logistic regression, BMI>33.39 kg/m2, glycemia >123.5 mg/dl, and albuminuria presented higher odds of vitamin D deficiency. Conclusion: Vitamin D deficiency was highly prevalent among patients with T2DM. Low levels were related to higher fasting plasma glucose, higher BMI, and diabetic nephropathy.

Introducción: Varios estudios reportaron que la deficiencia de vitamina D aumenta el riesgo de enfermedad macrovascular y microvascular en pacientes con diabetes tipo 2 (DM2). Investigamos los niveles de 25OHD en adultos con DM2, factores de riesgo de deficiencia de 25OHD y relación entre 25OHD, control glucémico y complicaciones crónicas de la DM2. Métodos: Se realizó un estudio transversal en el que se evaluaron los niveles de 25OHD en adultos (mayores de 18 años) con DM2. Se realizaron análisis de correlación para evaluar la interdependencia de la 25OHD con otras variables continuas. Se realizó un análisis de las características operativas del receptor para identificar valores de corte para diagnóstico de deficiencia de vitamina D. Se realizó una regresión logística para identificar asociación independiente entre deficiencia de 25OHD y variables asociadas con una menor 25OHD. Resultados: Se analizaron 208 pacientes. La edad media fue 62 años. El nivel de 25OHD fue 19 ng/ml (IQR 13.28-24.43), 59.78% tenía deficiencia de vitamina D y 10.33% tenía deficiencia severa. Glucemia, HbA1c y IMC correlacionaron negativamente con 25OHD. El punto de corte para deficiencia de vitamina D fue 33,39 kg/m2 para índice de masa corporal (IMC), 123 mg/dl para glucemia y 6,65% para HbA1c. En la regresión logística multivariada, IMC >33,39 kg/m2, glucemia >123,5 mg/dl y albuminuria presentaron mayores probabilidades de deficiencia de vitamina D. Conclusión principal: La deficiencia de vitamina D fue altamente prevalente en los pacientes con DM2. Niveles bajos de 25OHD se relacionaron con mayor glucemia, mayor IMC y nefropatía diabética.

Removal of an Azo Dye from Wastewater through the Use of Two Technologies: Magnetic Cyclodextrin Polymers and Pulsed Light.

Water pollution by dyes is a huge environmental problem; there is a necessity to produce new decolorization methods that are effective, cost-attractive, and acceptable in industrial use. Magnetic cyclodextrin polymers offer the advantage of easy separation from the dye solution. In this work, the ß-CD-EPI-magnetic (ß-cyclodextrin-epichlorohydrin) polymer was synthesized, characterized, and tested for removal of the azo dye Direct Red 83:1 from water, and the fraction of non-adsorbed dye was degraded by an advanced oxidation process. The polymer was characterized in terms of the particle size distribution and surface morphology (FE-SEM), elemental analysis (EA), differential scanning calorimetry (DSC), thermal gravimetric analysis (TGA), infrared spectrophotometry (IR), and X-ray powder diffraction (XRD). The reported results hint that 0.5 g and pH 5.0 were the best conditions to carry out both kinetic and isotherm models. A 30 min contact time was needed to reach equilibrium with a qmax of 32.0 mg/g. The results indicated that the pseudo-second-order and intraparticle diffusion models were involved in the assembly of Direct Red 83:1 onto the magnetic adsorbent. Regarding the isotherms discussed, the Freundlich model correctly reproduced the experimental data so that adsorption was confirmed to take place onto heterogeneous surfaces. The calculation of the thermodynamic parameters further demonstrates the spontaneous character of the adsorption phenomena (ΔG° = −27,556.9 J/mol) and endothermic phenomena (ΔH° = 8757.1 J/mol) at 25 °C. Furthermore, a good reusability of the polymer was evidenced after six cycles of regeneration, with a negligible decline in the adsorption extent (10%) regarding its initial capacity. Finally, the residual dye in solution after treatment with magnetic adsorbents was degraded by using an advanced oxidation process (AOP) with pulsed light and hydrogen peroxide (343 mg/L); >90% of the dye was degraded after receiving a fluence of 118 J/cm2; the discoloration followed a pseudo first-order kinetics where the degradation rate was 0.0196 cm2/J. The newly synthesized ß-CD-EPI-magnetic polymer exhibited good adsorption properties and separability from water which, when complemented with a pulsed light-AOP, may offer a good alternative to remove dyes such as Direct Red 83:1 from water. It allows for the reuse of both the polymer and the dye in the dyeing process.

La necesaria formación en competencia cultural / The necessary training in cultural competence

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