New approaches and error assessment to snow cover thickness and density using air temperature data at different heights.

Snow poles are inexpensive systems composed of a wooden mast with temperature sensors affixed at varying heights with the purpose of estimating the snow depth. They are frequently utilised in cold, remote regions where the maintenance of complex monitoring instruments becomes impractical. In this study, snow cover thickness is determined using different methods, based on the thermal behaviour of air temperature measured by a snow pole on Deception Island, Antarctica. The methods are compared to high-resolution measurements of snow depth obtained using an ultrasonic sensor at the same site. A new modified method is proposed and shown to give the best results. Errors and sensitivity to chosen thresholds of the various methods have been compared. Sensitivity tests have been also conducted to evaluate the impact of missing data from some of the sensors. Finally, the insulating effect on the thermal signal produced by the snow is used to obtain information on the snowpack density. Promising results have been found from this effort, opening new possibilities for the usage of snow poles and may lead to future studies.

Acute Acetabular Protrusion: the Hardinge Approach for Implant Removal and One-stage Hip Reconstruction.

Acute penetration of a total hip arthroplasty into the pelvic cavity is a grave and potentially catastrophic scenario. Fortunately, this complication is uncommon and rarely encountered during a surgical career. Currently, a two-stage procedure is favoured by most surgeons, but the evidence for this is unconvincing and may expose the patient to unnecessary risks. Furthermore, a two-stage approach may be more suitable for the more common chronic migration of a loose acetabular shell, which fundamentally differs from acute pelvic penetration. We present the case of a 76-year-old man referred to our institution for reconstructive surgery following acute pelvic penetration of the acetabular shell during total hip arthroplasty. We used a single-stage Hardinge approach to retrieve the shell and successfully reconstruct the acetabulum. Specific indications for using this method are proposed. In carefully selected cases of intrapelvic implants, a single-stage method can improve patient outcomes while minimising unnecessary risks associated with the conventional two-stage approach.

Seguridad alimentaria, subalimentación y canasta alimentaría en el contexto de las políticas públicas en Venezuela. Período2017-2022 / Food security, undernourishment and food basket in thecontext of public policies in Venezuela. Period 2017-2022

El presente estudio tiene como objetivo analizarla relación entre los indicadores de seguridad alimentaria,subalimentación y costo de la canasta alimentaria en el contextode las políticas públicas en materia alimentaria en Venezuela,durante el periodo comprendido entre 2017 y 2022. Para ello, sellevó a cabo un análisis exhaustivo de los datos disponibles sobrela seguridad alimentaria en Venezuela, incluyendo informaciónsobre la subalimentación, y el costo de la canasta alimentaria.Asimismo, se analizaron las políticas públicas implementadas enel país en materia alimentaria durante el periodo de estudio, conel fin de entender su impacto en los indicadores de seguridadalimentaria. Ninguna de las asociaciones estudiadas resultó sersignificativa a nivel estadístico (p>0,05), por lo que, aunqueteóricamente existe una relación entre estos indicadores en elperíodo estudiado, el carácter multidimensional prevalece y hacecompleja la posibilidad de comparaciones. Se identificaron laspolíticas públicas que requieren mejoras o ajustes para proteger laseguridad alimentaria del venezolano. Estos resultados obtenidospodrán ser de utilidad para los responsables de la toma dedecisiones en el país, así como para los investigadores yprofesionales interesados en el tema de la seguridad alimentariay la nutrición

EL objective of this study is to analyzethe relationship between the indicators of food security,undernourishment and the cost of the food basket in thecontext of public policies on food in Venezuela, during theperiod between 2017 and 2022. For this, an exhaustive analysisof the available data on food security in Venezuela wascarried out, including information on undernourishment, andthe cost of the food basket. Likewise, the public policiesimplemented in the country regarding food during the studyperiod were analyzed, in order to understand their impacton food security indicators. None of the associations studiedturned out to be statistically significant (p>0.05), therefore,although theoretically there is a relationship between theseindicators in the period studied, the multidimensional natureprevails and makes comparability complex. Public policies that require improvements or adjustments to protect Venezuelanfood security were identified. These results obtained may beuseful for those responsible for decision-making in the country,as well as for researchers and professionals interested in thesubject of food security and nutrition.

Preoperative echocardiography for patients with hip fractures undergoing surgery in a low-resource setting: Asset or obstacle?

The aim of this study was to determine the rate of preoperative transthoracic echocardiography in hip fracture patients and to evaluate its effects on time to surgery and length of stay. We conducted a retrospective review of all patients with hip fractures treated at a tertiary referral hospital. Data examined included age, sex, comorbidities, time to surgery, length of stay, fracture type and transthoracic echocardiography findings. Forty-eight patients with hip fractures underwent surgery (men 41.7%; mean age 77.2 (49-95)). Nine patients (18.7%) had a preoperative transthoracic echocardiography. Preoperative transthoracic echocardiography was associated with a significantly longer time to surgery an abbreviation for days e.g dys should be added after the values to indicate what time frame is being measured (14.7 versus 6.8, p = 0.0051) and length of stay (23.6 versus 10.4, p = 0.0002). This study demonstrates a high rate of preoperative transthoracic echocardiography in hip fracture patients. The role of transthoracic echocardiography should be reassessed in view of its association with significant surgical delays.

Determinants of early antibody responses to COVID-19 mRNA vaccines in exposed and naive healthcare workers

BackgroundTwo doses of mRNA vaccination have shown >94% efficacy at preventing COVID-19 mostly in naive adults, but it is not clear if the second dose is needed to maximize effectiveness in those previously exposed to SARS-CoV-2 and what other factors affect responsiveness. MethodsWe measured IgA, IgG and IgM levels against SARS-CoV-2 spike (S) and nucleocapsid (N) antigens from the wild-type and S from the Alpha, Beta and Gamma variants of concern, after BNT162b2 (Pfizer/BioNTech) or mRNA-1273 (Moderna) vaccination in a cohort of health care workers (N=578). Neutralizing capacity and antibody avidity were evaluated. Data were analyzed in relation to COVID-19 history, comorbidities, vaccine doses, brand and adverse events. FindingsVaccination induced robust IgA and IgG levels against all S antigens. Neutralization capacity and S IgA and IgG levels were higher in mRNA-1273 vaccinees, previously SARS-CoV-2 exposed, particularly if symptomatic, and in those experiencing systemic adverse effects. A second dose in pre-exposed did not increase antibody levels. Smoking and comorbidities were associated with lower neutralization and antibody levels. Among fully vaccinated, 6.3% breakthroughs were detected up to 189 days post-vaccination. Among pre-exposed non-vaccinated, 90% were IgG seropositive more than 300 days post-infection. InterpretationOur data support administering a single-dose in pre-exposed healthy individuals. However, heterogeneity of responses suggests that personalized recommendations may be necessary depending on COVID-19 history and life-style. Higher mRNA-1273 immunogenicity would be beneficial for those expected to respond worse to vaccination. Persistence of antibody levels in pre-exposed unvaccinated indicates maintenance of immunity up to one year. FundingThis work was supported by Institut de Salut Global de Barcelona (ISGlobal) internal funds, in-kind contributions from Hospital Clinic de Barcelona, the Fundacio Privada Daniel Bravo Andreu, and European Institute of Innovation and Technology (EIT) Health (grant number 20877), supported by the European Institute of Innovation and Technology, a body of the European Union receiving support from the H2020 Research and Innovation Programme. We acknowledge support from the Spanish Ministry of Science and Innovation and State Research Agency through the "Centro de Excelencia Severo Ochoa 2019-2023" Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program. L. I. work was supported by PID2019-110810RB-I00 grant from the Spanish Ministry of Science & Innovation. Development of SARS-CoV-2 reagents was partially supported by the National Institute of Allergy and Infectious Diseases Centers of Excellence for Influenza Research and Surveillance (contract number HHSN272201400008C). The funders had no role in study design, data collection and analysis, the decision to publish, or the preparation of the manuscript.

Association Between the Placement of a Double-J Catheter and the Risk of Urinary Tract Infection in Renal Transplantation Recipients: A Retrospective Cohort Study of 1038 Patients.

BACKGROUND: The incidence of urinary complications in transplantation is 2% to 20%, which can be decreased with the use of a double-J catheter. The objective of this study was to determine the association between the use of the catheter and the probability of urinary tract infection (UTI). METHODS: We studied a retrospective cohort of 1038 patients divided into 2 groups: those treated with vs without a double-J catheter. Perioperative factors related to catheter use were analyzed. Second, whether the use of the catheter was associated with fewer other urinary complications was analyzed. RESULTS: Of the whole sample, 72 patients were eliminated from the study, and 358 (37%) received a double-J catheter. UTIs occurred in 190 patients (19.6%), of whom a greater proportion received a catheter: 88 of 358 (24.6%) vs 102 of 608 (16.8%) (odds ratio, 1.61; 95% confidence interval, 1.17-2.22; P = .003). CONCLUSIONS: The placement of a double-J catheter during transplant is associated with a higher proportion of UTIs, increasing their severity and the cost of care, without having a clear effect on other types of urinary complications.

Highly sensitive scent-detection of COVID-19 patients in vivo by trained dogs

Timely and accurate diagnostics are essential to fight the COVID-19 pandemic, but no test satisfies both conditions. Dogs can scent-identify the unique odors of the volatile organic compounds generated during infection by interrogating specimens or, ideally, the body of a patient. After training 6 dogs to detect SARS-CoV-2 in human respiratory secretions (in vitro scent-detection), we retrained 5 of them to diagnose the infection by scenting the patient directly (in vivo scent-detection). Then, efficacy trials were designed to compare the diagnostic performance of the dogs against that of the rRT-PCR in 848 human subjects: 269 hospitalized patients (COVID-19 prevalence 30.1%), 259 hospital staff (prevalence 2.7%), and 320 government employees (prevalence 1.25%). The limit of detection in vitro was lower than 10-12 copies ssRNA/mL. In vivo, all dogs detected 92 COVID-19 patients present among the 848 study subjects. Detection was immediate, and independent of prevalence, time post-exposure, or presence of symptoms, with 95.2% accuracy and high sensitivity (95.9%; 95% C.I. 93.6-97.4), specificity (95.1%; 94.4-95.8), positive predictive value (69.7%; 65.9-73.2), and negative predictive value (99.5%; 99.2-99.7). To determine real-life performance, we waited 75 days to carry out an effectiveness assay among the riders of the Metro System of Medellin, deploying the human-canine teams without previous training or announcement. Three dogs (one of each breed) scent-interrogated 550 citizens who volunteered for simultaneous canine and rRT-PCR testing. Negative predictive value remained at 99.0% (95% C.I. 98.3-99.4), but positive predictive value dropped to 28.2% (95% C.I. 21.1-36.7). Canine scent-detection in vivo is a highly accurate screening test for COVID-19, and it detects more than 99% of infected individuals independently of the key variables. However, real-life conditions increased substantially the number of false positives, indicating the necessity of training a threshold for the limit of detection to discriminate environmental odoriferous contamination from infection.

Seven-month kinetics of SARS-CoV-2 antibodies and protective role of pre-existing antibodies to seasonal human coronaviruses on COVID-19

Unraveling the long-term kinetics of antibodies to SARS-CoV-2 and its determinants, including the impact of pre-existing antibodies to human coronaviruses causing common cold (HCoVs), is essential to understand protective immunity to COVID-19 and devise effective surveillance strategies. IgM, IgA and IgG levels against six SARS-CoV-2 and four HCoV antigens were quantified by Luminex, and antibody neutralization capacity was assessed by flow cytometry, in a cohort of health care workers followed-up for 6 months. Seroprevalence increased over time from 13.5% (month 0) and 15.6% (month 1) to 16.4% (month 6). Levels of antibodies, including those with neutralizing capacity, were stable over time, except IgG to nucleocapsid antigen and IgM levels that waned. After the peak response, anti-spike antibody levels increased from [~]150 days post-symptom onset in all individuals (73% for IgG), in the absence of any evidence of re-exposure. Pre-existing antibodies to alpha-HCoV were lower in individuals who subsequently seroconverted for SARS-CoV-2. IgG and IgA to HCoV were significantly higher in asymptomatic than symptomatic seropositive individuals. Thus, pre-existing cross-reactive HCoVs antibodies could have a protective effect against SARS-CoV-2 infection and COVID-19 disease.

Determinants of health-system efficiency: evidence from OECD countries.

This paper analyzes the most important determinants of healthcare efficiency across OECD countries. As previously documented in the literature, we first provide evidence of significant differences in the cross-country level of efficiency in healthcare provision. We then investigate how improvements in efficiency can be achieved by considering alternative efficiency indices (parametric and non-parametric) and a novel dataset with information on the characteristics of healthcare systems across OECD countries. Our empirical findings suggest a positive correlation between policies such as increasing the regulation of prices billed by providers and reducing the degree of gate keeping and the efficiency of national healthcare systems.

Onychomadesis outbreak in Valencia, Spain associated with hand, foot, and mouth disease caused by enteroviruses.

This report evaluates the June 2008 onychomadesis outbreak in Valencia, Spain. The study sample consisted of 221 onychomadesis cases and 77 nonaffected individuals who lived close to those affected. We collected data on dietary variables, hygiene products, and individual pathological histories. Feces and blood specimens were collected from 44 cases and 24 controls to evaluate exposure to infectious agents. Pathological background data revealed a high frequency (61%) of hand, foot, and mouth disease among the onychomadesis cases. Coxsackievirus A10 was the most commonly detected enterovirus in both case and control groups (49%). Other enteroviruses such as coxsackieviruses A5, A6, A16, B1, and B3; echoviruses 3, 4, and 9; and enterovirus 71 were present in low frequencies in the case and control groups (3-9%). The 2008 onychomadesis outbreak in the metropolitan area of Valencia was associated with an outbreak of hand, foot, and mouth disease primarily caused by coxsackievirus A10.

Electronic substituent effects in the electron impact mass spectrometry of 2-(arylazo)-4-phenylphenols.

A mass spectrometric study of a set of six novel 2-(arylazo)-4-phenylphenols 1-6 was performed. The electron impact spectra were acquired and analyzed for five of the compounds in order to establish a fragmentation pattern. The suggested pathways were investigated and confirmed by means of tandem mass spectrometry (MS/MS) experiments together with high-resolution accurate mass data. However, the sixth molecule, a sodium sulfonate salt, was studied using fast atom bombardment (FAB) ionization in positive and negative modes. In addition, some electronic substituent effects were investigated by analyzing Hammett-McLafferty linear free energy correlations for some peaks derived from the corresponding molecular ions. Also, the role of the O-H...N hydrogen bond present in the target compounds was analyzed. The roles of these H-bonds were consistent with the corresponding acidity constant values obtained experimentally as well as by theoretical quantum chemistry calculations using HF/6-31 + G(d,p) and B3LYP/6-31G(d,p). Some spectrometric data were correlated with topological properties derived from the atoms-in-molecules (AIM) theory.

Response to treatment during medium-term follow-up in a series of patients with neurocardiogenic syncope.

BACKGROUND: Syncope is a common symptom that has different recurrence ratios. We hypothesized that an individualized treatment regimen including pharmacologic and nonpharmacologic measures considering kind of neurocardiogenic syncope (NCS) and basal characteristics of each patient could allow optimized therapy to avoid recurrences. METHODS: We conducted a prospective study to evaluate performance of diverse accepted treatments for NCS. Each patient received specific treatment including general measures such as an increase in salt and water intake, tilt training, specific pharmacologic treatment according to head-up tilt table test (HUTT) result, and patient basal blood pressure and heart rate measurements. RESULTS: We followed a group of 127 patients during a main period of 20.8 +/- 9 months (range, 6-38 months). Mean age was 47.8 +/- 19.2 years and 66.9% were females. We had six (4.7%) patients with recurrence of symptoms 4 +/- 0.9 months after diagnostic HUTT. Medications used were atenolol in 20 patients, pindolol in 17, dysopiramide in 50, and fluoxetine in 25. Two patients received fludrocortisone. Tilt training was not indicated initially for patients with recurrences but was indicated later; to date, these patients have not experienced further episodes. CONCLUSIONS: Increase in water and salt intake, as well as tilt training, showed great value in prevention of syncope recurrences in this specific set of patients. Pharmacologic treatment has an important role, but there is no single medication associated with significant improvement in symptom control.