Backyard aerosol pollution monitors: foliar surfaces, dust enrichment, and factors influencing foliar retention.

Air pollution is one of the leading causes of death from noncommunicable diseases globally, and in Arizona, both mining activities and abandoned agriculture can generate erodible dust. This dust is transported via wind and can carry high amounts of toxic pollutants. Industry-adjacent communities, or "fenceline communities," are generally closer to the pollution sources and are disproportionally impacted by pollution, or in this case, dust. The dust transported from the mine settles into nearby rivers, gardens, and homes, and increases the concentrations of elements beyond their naturally occurring amounts (i.e., enriched). This study was built upon previous community science work in which plant leaves were observed to collect similar concentrations to an accepted dust collection method and illustrated promise for their use as low-cost air quality monitors in these communities. This work investigated the concentration of Na, Mg, Al, K, Ca, Mn, Co, Cu, Zn, Mo, and Ba in dust from the leaves of community-collected backyard and garden plants (foliar dust), as well as if certain variables affected collection efficacy. This assessment evaluated (1) foliar concentration versus surface area for 11 elements, (2) enrichment factor (EF) values and ratios, (3) comparisons of foliar, garden, and yard samples to US Geological Survey data, and (4) what variable significantly affected dust collection efficacy. The EF results indicate that many of the samples were enriched (anthropogenically contaminated) and that the foliar samples were generally more contaminated than the yard and garden soil samples. Leaf surface area was the most influential factor for leaf collection efficiency (p < 0.05) compared to plant family or sampling location. Further studies are needed that standardize the plant species and age and include multiple replicates of the same plant species across partnering communities. This study has demonstrated that foliar dust is enriched in the participating partnering communities and that plant leaf samples can serve as backyard aerosol pollution monitors. Therefore, foliar dust is a viable indicator of outdoor settled dust and aerosol contamination and this is an adoptable monitoring technique for "fenceline communities."

Nuclear shell-model simulation in digital quantum computers.

The nuclear shell model is one of the prime many-body methods to study the structure of atomic nuclei, but it is hampered by an exponential scaling on the basis size as the number of particles increases. We present a shell-model quantum circuit design strategy to find nuclear ground states by exploiting an adaptive variational quantum eigensolver algorithm. Our circuit implementation is in excellent agreement with classical shell-model simulations for a dozen of light and medium-mass nuclei, including neon and calcium isotopes. We quantify the circuit depth, width and number of gates to encode realistic shell-model wavefunctions. Our strategy also addresses explicitly energy measurements and the required number of circuits to perform them. Our simulated circuits approach the benchmark results exponentially with a polynomial scaling in quantum resources for each nucleus. This work paves the way for quantum computing shell-model studies across the nuclear chart and our quantum resource quantification may be used in configuration-interaction calculations of other fermionic systems.

Adaptación lingüística y cultural del Oxford Cognitive Screen (OCS) en población española / Cultural and linguistic adaptation of the Oxford Cognitive Screen to the Spanish population

Introducción: En España el ictus es la sexta causa de discapacidad. Sus secuelas producen alteraciones motoras, sensoriales y cognitivas, que pueden minimizarse con una actuación terapéutica temprana. Por ello se necesitan instrumentos de evaluación rápida que detecten déficits en estas áreas. El Oxford Cognitive Screen Test (OCS) es un test breve diseñado para la valoración de funciones cognitivas en pacientes con ictus. Nuestro objetivo fue generar una versión española (OCS-E) realizando una adaptación lingüística y cultural.Material y métodosDiseño de validación lingüística con doble traducción y 10 reuniones de consenso del equipo investigador multidisciplinar. Tres estudios piloto administrando el test respectivamente a 5 usuarios potenciales, 23 personas sanas y 23 diagnosticadas de ictus isquémico (61%) o hemorrágico, con edades entre 31-88 años.ResultadosEl OCS-E mantiene las 10 tareas originales, la codificación de respuestas y el sistema de puntuación. Se modificaron y ampliaron las instrucciones de administración, lo que asegura la fiabilidad del contenido y de su aplicación. En 5 tareas se han modificado imágenes, números y frases. La tarea praxia se amplió para evaluar ambos miembros superiores. Los estudios piloto confirmaron que las personas de la población diana comprendían de forma adecuada las tareas, con independencia de la existencia de problemas cognitivos.ConclusionesLa adaptación cultural ha generado una versión lingüística y conceptualmente equivalente, permitiendo su estudio psicométrico y posterior aplicación en población española. El OCS-E puede ser un instrumento de cribado útil para evaluación rápida de funciones cognitivas postictus. (AU)

Introduction: Stroke is the sixth leading cause of disability in Spain. Patients may present motor, sensory, or cognitive sequelae, which can be minimised with early treatment. To this end, there is a need for quick-to-administer assessment tools to evaluate deficits in these areas. The Oxford Cognitive Screen (OCS) is a brief test specifically designed to assess cognitive function in patients with stroke. Our aim in this study is to report the linguistic and cultural adaptation of a Spanish-language version of the test (OCS-S).Material and methodsThe linguistic validation was conducted with a process of double translation and 10 consensus meetings of the multidisciplinary research team. We also performed 3 pilot studies, with 5 potential users, 23 healthy individuals, and 23 patients with stroke (ischaemic in 61% of cases and haemorrhagic in 39%), respectively; participants were aged between 31 and 88 years.ResultsThe OCS-S includes the 10 subtests, the coding of responses, and the scoring system from the original version. We modified and extended the instructions for administration in order to ensure the reliability of the content and its application. Five tasks were modified (images, numbers, and sentences) and the praxis subtest was modified to evaluate both hands. The pilot studies confirmed comprehension in the target population, independently of any cognitive problems.ConclusionsThe OCS-S is conceptually and linguistically equivalent to the original test, enabling psychometric assessment and application of the test in the Spanish population. The OCS-S may be a useful screening tool for quickly assessing cognitive function after stroke. (AU)

[Impact of the COVID-19 pandemic on patient safety incident and medication error reporting systems]. / Impacto de la pandemia COVID-19 en los sistemas de notificación de incidentes de seguridad del paciente y errores de medicación.

BACKGROUND AND AIM: To determine the impact of the COVID-19 pandemic on the epidemiology of safety incidents (SI) and medication errors (ME) reported to the CISEMadrid notification system in the hospital and primary care settings of the Madrid Health Service (SERMAS). MATERIALS AND METHODS: Observational and descriptive study with a retrospective analysis of data including all CISEMadrid notifications from 01-Jan-2018 to 31-Dec-2020, from 33 hospitals and 262 health care centres of the SERMAS. The two periods in 2020 with the greatest increase in COVID-19 cases were identified to compare incidents reported in the pre-pandemic and pandemic periods. RESULTS: 36,494 incidents were reported. Comparing both periods, an overall decrease in pandemic notifications of 60.7% was observed, being higher in primary care, falling to 33% of previous levels. The reduction in notifications was similar in the peaks and valleys of the waves. The three most frequent SIs in both periods and care settings were: diagnostic tests, medical devices/equipment/clinical furniture and organisational management/citations. In ME, dose failure and inappropriate selection were the most frequent in both settings and periods. There were no relevant differences in patient consequences in both periods. CONCLUSIONS: During the pandemic, patient safety notifications decreased although the most frequent types remained the same, as did their impact on the patient, both in hospitals and in primary care. The safety culture of organisations is a critical aspect for the maintenance of reporting systems.

Criterios de justificación de discrepancias en el Servicio de Conciliación de la medicación al alta hospitalaria: Guía para farmacéuticos comunitarios / Criteria for Justifying Discrepancies in the Hospital Discharge Medication Reconciliation Service: Guidance for Community Pharmacists

JUSTIFICACIÓN: más del 90 % de los pacientes conciliados al alta hospitalaria presentan algún tipo de discrepancia en su medicación, aunque solo entre 5-15% son errores de conciliación. Para la prestación del Servicio de Conciliación, es necesario conocer la justificación clínica de la mayoría de las discrepancias.OBJETIVOS: seleccionar criterios que faciliten al farmacéutico comunitario la justificación de las discrepancias identificadas al alta hospitalaria, elaborar una guía y evaluar la satisfacción de los farmacéuticos con su uso en el estudio Concilia Medicamentos.MATERIAL Y MÉTODOS: un grupo constituido por un farmacéutico comunitario, un farmacéutico hospitalario, un profesor de farmacología y dos de atención farmacéutica seleccionaron los grupos terapéuticos que presentan discrepancias más habitualmente. Los criterios se seleccionaron de acuerdo con la evidencia científica disponible en las guías clínicas y fichas técnicas. Utilizaron la guía 188 farmacéuticos comunitarios de 8 provincias españolas para la justificación de las discrepancias detectadas en el estudio Concilia Medicamentos 2. La satisfacción de los farmacéuticos se analizó mediante un cuestionario online al finalizar el estudio.RESULTADOS/DISCUSIÓN: la guía de evaluación de discrepancias desarrollada recoge 20 grupos terapéuticos de tratamientos crónicos habituales, estructurados en 13 tablas: Inhibidores de la bomba de protones, antidiabéticos, antiagregantes plaquetarios, anticoagulantes orales, diuréticos, betabloqueantes, calcioantagonistas, IECA, ARA-II, estatinas, AINE, opioides, benzodiazepinas y análogos. (AU)

Minimization of measuring points for the electric field exposure map generation in indoor environments by means of Kriging interpolation and selective sampling.

In a world with increasing systems accessing to radio spectrum, the concern for exposure to electromagnetic fields is growing and therefore it is necessary to check limits in those areas where electromagnetic sources are working. Therefore, radio and exposure maps are continuously being generated, mainly in outdoor areas, by using many interpolation techniques. In this work, Surfer software and Kriging interpolation have been used for the first time to generate an indoor exposure map. A regular measuring mesh has been generated. Elimination of Less Significant Points (ELSP) and Geometrical Elimination of Neighbors (GEN) strategies to reduce the measuring points have been presented and evaluated. Both strategies have been compared to the map generated with all the measurements by calculating the root mean square and mean absolute errors. Results indicate that ELSP method can reduce up to 70% of the mesh measuring points while producing similar exposure maps to the one generated with all the measuring points. GEN, however, produces distorted maps and much higher error indicators even for 50% of eliminated measuring points. As a conclusion, a procedure for reducing the measuring points to generate radio and exposure maps is proposed based on the ELSP method and the Kriging interpolation.

Cultural and linguistic adaptation of the Oxford Cognitive Screen to the Spanish population.

INTRODUCTION: Stroke is the sixth leading cause of disability in Spain. Patients may present motor, sensory, or cognitive sequelae, which can be minimised with early treatment. To this end, there is a need for quick-to-administer assessment tools to evaluate deficits in these areas. The Oxford Cognitive Screen (OCS) is a brief test specifically designed to assess cognitive function in patients with stroke. Our aim in this study is to report the linguistic and cultural adaptation of a Spanish-language version of the test (OCS-S). METHODS: The linguistic validation was conducted with a process of double translation and 10 consensus meetings of the multidisciplinary research team. We also performed 3 pilot studies, with 5 potential users, 23 healthy individuals, and 23 patients with stroke (ischaemic in 61% of cases and haemorrhagic in 39%), respectively; participants were aged between 31 and 88 years. RESULTS: The OCS-S includes the 10 subtests, the coding of responses, and the scoring system from the original version. We modified and extended the instructions for administration in order to ensure the reliability of the content and its application. Five tasks were modified (images, numbers, and sentences) and the praxis subtest was modified to evaluate both hands. The pilot studies confirmed comprehension in the target population, independently of any cognitive problems. CONCLUSION: The OCS-S is conceptually and linguistically equivalent to the original test, enabling psychometric assessment and application of the test in the Spanish population. The OCS-S may be a useful screening tool for quickly assessing cognitive function after stroke.

Precision management of pollination services to blueberry crops.

While the cultivated area of pollinator-dependent crops is increasing, pollinator availability is decreasing, leading to problems in many agroecosystems. For this reason, pollinator-dependent crop growers often rent beehives to support their pollination requirements to sustain fruit productivity. However, the efficiency of those pollination systems has not been extensively studied. Here, we compared the effect of "precision" pollination (i.e., application of pesticides coordinated with growers, audit of hives, dietary supplementation and individual distribution of hives) with conventional practices (i.e., pesticides applications without coordination with growers and no audit of hives, low maintenance of hives and hives distributed in large groups) on the mean level of pollination and fruit production and quality in blueberry crops. In nine blueberry fields, we measured bee visitation rate to flowers, fruit set, fruit firmness and fruit weight. On average, precision-pollinated plots had 70% more bee visits to flowers and produced 13% more fruits that were 12% heavier and 12% firmer than those obtained through conventional practices. These results showed that pollination efficiency could be improved if key management related to bee strength, distribution and health care are taken into account. Due to these results, we encourage growers and beekeepers to include precision pollination practices to both increase the productivity of blueberry fields and the wellbeing of honey bees within agroecosystems.

Assessing Children's Lead Exposure in an Active Mining Community Using the Integrated Exposure Uptake Biokinetic Model.

Lead exposure has been shown to be harmful to humans in various settings and there are no safe levels of blood lead in children. At an Alternative Superfund site in Hayden-Winkelman, Arizona, with an active copper smelter and concentrator, lead exceedances in air and soil have been measured in the past 20 years. In this work, the U.S. Environmental Protection Agency's Integrated Exposure Uptake Biokinetic (IEUBK) model was used to estimate Hayden-Winkelman children's (age 6 months-7 years) blood lead levels (BLLs) using site-specific lead concentrations measured in indoor and outdoor air, soil, indoor dust, and drinking water. Values used by a state agency's airborne lead risk forecast program were also evaluated to determine whether their forecasting program is useful in protecting children's public health. Using site-specific values in the model, the results demonstrated that lead ingested via indoor dust was the major contributor to children's BLLs. In addition, the output of the IEUBK model overestimated actual BLLs of children sampled in the community. The IEUBK model was particularly sensitive to high indoor dust levels, and these site-specific measures increased modeled BLL values. This finding is of significance as the IEUBK model is used worldwide in communities with industrial contamination. This study confirmed that the chief contributor to lead exposure in children is household dust. Thus, for lead exposure risk reduction, agencies working at Superfund sites should focus efforts on decontaminating outdoor soil and dust and indoor lead decontamination.

Foliar surfaces as dust and aerosol pollution monitors: An assessment by a mining site.

Recent studies in the southwestern United States have shown that smelting processes and mine tailings emit heavy metal(loid)s that are distributed via wind dispersion to nearby communities. With increased attention regarding the effect of air pollution on environmental health, communities have begun to use citizen/community-based monitoring techniques to measure the concentration of metal(loid)s and evaluate their air quality. This study was conducted in a mining community to assess the efficacy of foliar surfaces as compared to an inverted disc (frisbee) to sample aerosol pollutants in ambient air. The assessment was conducted by evaluating As, Pb, Cd, Cu, Al, Ni, and Zn concentrations versus distance from a former smelter, statistical and regression analyses, and enrichment factor calculations compared to similar sites worldwide. Both the foliar and frisbee collection methods had a decrease in metal(loid)s concentration as a function of distance from the retired smelter. Statistical calculations show that the collection methods had similar mean concentrations for all of the metal(loid)s of interest; however, the tests also indicate that the frisbee collection method generally collected more dust than the foliar method. The enrichment factors from both collection methods were comparable to similar studies by other mining areas referenced, except for aluminum. Since there is evidence of enrichment, correlation between methods, and citizen/community science potential, these efforts show promise for the field. Further studies should consider alternating the types of plant used for foliar collection as well as collecting samples on a more frequent basis in order to sufficiently categorize results based on meteorological conditions.

[Alzemon: a prospective follow-up study of eslicarbazepine acetate monotherapy in patients with newly diagnosed epilepsy]. / Alzemon: estudio de seguimiento prospectivo del acetato de eslicarbacepina en monoterapia en pacientes con epilepsia de diagnóstico reciente.

INTRODUCTION: Eslicarbazepine acetate is a novel sodium channel blocker for use in the treatment of focal onset seizures. Prospective studies on its effectiveness in monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice are scarce. AIM: To evaluate the effectiveness of eslicarbazepine as initial monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice. PATIENTS AND METHODS: A prospective, multicentre, post-authorisation study. Patients with newly diagnosed partial epilepsy aged 18 years or older without previous treatment were included. The efficacy variables were: percentage of seizure-free patients, responders and reduction in monthly frequency of seizures. The safety variables analyse the 12-month retention rate and the occurrence of adverse effects. RESULTS: Fifty-three patients were included. The retention rate was 77.4%. At the end of the observation period, 83% of patients were seizure-free and 92.5% had reduced their baseline frequency by 50% or more. In addition, 68% of the patients reported some adverse effect and 7.5% of them dropped out of the study for this reason. The effectiveness analysis of the subgroup of patients aged 65 years or more showed no differences with respect to the overall population. CONCLUSION: Eslicarbazepine monotherapy in patients with newly diagnosed partial epilepsy, both in the general population and in the population over 65 years old, is effective and safe in routine clinical practice.

TITLE: Alzemon: estudio de seguimiento prospectivo del acetato de eslicarbacepina en monoterapia en pacientes con epilepsia de diagnóstico reciente.Introducción. El acetato de eslicarbacepina es un nuevo bloqueante de los canales de sodio en el tratamiento de las crisis de inicio focal. Los estudios prospectivos sobre su efectividad en monoterapia en pacientes con epilepsia parcial de reciente diagnóstico en la práctica clínica habitual son escasos. Objetivo. Evaluar la efectividad de la eslicarbacepina en monoterapia de inicio en pacientes con epilepsia parcial de reciente diagnóstico en la práctica clínica habitual. Pacientes y métodos. Estudio postautorización prospectivo y multicéntrico. Se incluyó a pacientes con epilepsia parcial de reciente diagnóstico de 18 años o más sin tratamiento previo. Las variables de eficacia fueron: porcentaje de pacientes libres de crisis, respondedores y reducción en la frecuencia mensual de crisis. Las variables de seguridad analizan la tasa de retención a los 12 meses y la aparición de efectos adversos. Resultados. Se incluyó a 53 pacientes. La tasa de retención fue del 77,4%. Al final del período de observación, el 83% de los pacientes se encontraba libre de crisis y el 92,5% había reducido en un 50% o más su frecuencia basal. El 68% de los pacientes notificó algún efecto adverso y el 7,5% de ellos abandonó el estudio por este motivo. El análisis de efectividad del subgrupo de 65 años o más no mostró diferencias respecto a la población global. Conclusión. La eslicarbacepina en monoterapia en pacientes con epilepsia parcial de reciente diagnóstico, tanto en la población general como en la población de más de 65 años, es eficaz y segura en la práctica clínica habitual.

Alzemon: estudio de seguimiento prospectivo del acetato de eslicarbacepina en monoterapia en pacientes con epilepsia de diagnóstico reciente / Alzemon: a prospective follow-up study of eslicarbazepine acetate monotherapy in patients with newly diagnosed epilepsy

Introducción: El acetato de eslicarbacepina es un nuevo bloqueante de los canales de sodio en el tratamiento de las crisis de inicio focal. Los estudios prospectivos sobre su efectividad en monoterapia en pacientes con epilepsia parcia l de reciente diagnóstico en la práctica clínica habitual son escasos.Objetivo: Evaluar la efectividad de la eslicarbacepina en monoterapia de inicio en pacientes con epilepsia parcial de reciente diagnóstico en la práctica clínica habitual.Pacientes y métodos: Estudio postautorización prospectivo y multicéntrico. Se incluyó a pacientes con epilepsia parcial de reciente diagnóstico de 18 años o más sin tratamiento previo. Las variables de eficacia fueron: porcentaje de pacientes libres de crisis, respondedores y reducción en la frecuencia mensual de crisis. Las variables de seguridad analizan la tasa de retención a los 12 meses y la aparición de efectos adversos.Resultados: Se incluyó a 53 pacientes. La tasa de retención fue del 77,4%. Al final del período de observación, el 83% de los pacientes se encontraba libre de crisis y el 92,5% había reducido en un 50% o más su frecuencia basal. El 68% de los pacientes notificó algún efecto adverso y el 7,5% de ellos abandonó el estudio por este motivo. El análisis de efectividad del subgrupo de 65 años o más no mostró diferencias respecto a la población global.Conclusión: La eslicarbacepina en monoterapia en pacientes con epilepsia parcial de reciente diagnóstico, tanto en la población general como en la población de más de 65 años, es eficaz y segura en la práctica clínica habitual.(AU)

Introduction: Eslicarbazepine acetate is a novel sodium channel blocker for use in the treatment of focal onset seizures. Prospective studies on its effectiveness in monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice are scarce. Aim: To evaluate the effectiveness of eslicarbazepine as initial monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice. Patients and methods: A prospective, multicentre, post-authorisation study. Patients with newly diagnosed partial epilepsy aged 18 years or older without previous treatment were included. The efficacy variables were: percentage of seizure-free patients, responders and reduction in monthly frequency of seizures. The safety variables analyse the 12-month retention rate and the occurrence of adverse effects. Results: Fifty-three patients were included. The retention rate was 77.4%. At the end of the observation period, 83% of patients were seizure-free and 92.5% had reduced their baseline frequency by 50% or more. In addition, 68% of the patients reported some adverse effect and 7.5% of them dropped out of the study for this reason. The effectiveness analysis of the subgroup of patients aged 65 years or more showed no differences with respect to the overall population. Conclusion: Eslicarbazepine monotherapy in patients with newly diagnosed partial epilepsy, both in the general population and in the population over 65 years old, is effective and safe in routine clinical practice.(AU)

Epidemiología y curso clínico de la hepatitis A en Cantabria antes y después del brote epidémico de junio 2016 / Epidemiology and clinical course of hepatitis A in Cantabria before and after the epidemic outbreak of June 2016

ANTECEDENTES Y OBJETIVOS: Desde junio de 2016 se han producido brotes de hepatitis A en diversos países europeos, afectando principalmente a hombres que tienen sexo con hombres (HSH). El objetivo del presente trabajo fue valorar su impacto clínico y epidemiológico en Cantabria. MATERIAL Y MÉTODOS: Se recogieron retrospectivamente todos los casos de hepatitis A diagnosticados en Cantabria entre enero de 2013 y septiembre de 2018. Se compararon dos periodos (enero 2013-mayo 2016 y junio 2016-septiembre 2018). RESULTADOS: Se diagnosticaron un total de 156 casos, objetivándose un aumento de la incidencia a partir de octubre de 2016. Con respecto al periodo 2013-2016, se observó una mayor proporción de varones (50,0 vs. 84,5%; p = 0,012) con una predominancia de la orientación sexual homosexual (80,6%) y una mayor frecuencia de transmisión sexual (0 vs. 48,3%; p = 0,061) en los pacientes del periodo 2016-2018. Desde el punto de vista clínico destacó que todos los casos de hepatitis grave ocurrieron en este último periodo. CONCLUSIONES: Nuestros resultados reafirman el elevado impacto clínico y epidemiológico del brote epidémico en Cantabria y ponen de relieve la necesaria optimización de las actuales medidas de prevención contra la hepatitis A

BACKGROUND AND OBJECTIVES: Since June 2016, there have been outbreaks of hepatitis A in various European countries, mainly affecting men who have sex with men (MSM). The aim of this study was to assess their clinical and epidemiological impact in Cantabria, Spain. MATERIAL AND METHODS: We retrospectively collected all cases of hepatitis A diagnosed in Cantabria between January 2013 and September 2018. We compared 2 periods: January 2013-May 2016 and June 2016-September 2018. RESULTS: A total of 156 cases were diagnosed, observing an increase in the incidence starting in October 2016. With regard to 2013-2016, we observed a higher proportion of men (50.0% vs. 84.5%; p=.012) with a predominance of the homosexual orientation (80.6%) and a higher rate of sexual transmission (0% vs. 48.3%; p=.061) for the patients in the 2016-2018 period. From the clinical standpoint, all cases of severe hepatitis occurred during this latter period. CONCLUSIONS: Our results reaffirm the high clinical and epidemiological impact of the epidemic outbreak in Cantabria and emphasizes the need for optimising the current prevention measures against hepatitis A

Ecology of the collapse of Rapa Nui society.

Collapses of food producer societies are recurrent events in prehistory and have triggered a growing concern for identifying the underlying causes of convergences/divergences across cultures around the world. One of the most studied and used as a paradigmatic case is the population collapse of the Rapa Nui society. Here, we test different hypotheses about it by developing explicit population dynamic models that integrate feedbacks between climatic, demographic and ecological factors that underpinned the socio-cultural trajectory of these people. We evaluate our model outputs against a reconstruction of past population size based on archaeological radiocarbon dates from the island. The resulting estimated demographic declines of the Rapa Nui people are linked to the long-term effects of climate change on the island's carrying capacity and, in turn, on the 'per-capita food supply'.

Cumplimentación del certificado médico de defunción en Madrid: un estudio descriptivo trasversal / Completion of the medical certificate of cause of death in Madrid: a descriptive cross-sectional study

INTRODUCCIÓN: El certificado médico de defunción es un documento con una doble función: registro oficial del fallecimiento de una persona y análisis estadístico de las causas de muerte de la población. La cumplimentación de este documento en la práctica clínica genera grandes conflictos. OBJETIVOS: Analizar la cumplimentación y detectar los principales errores que existen al rellenar estos documentos. Se procedió a la comparación de las variables más importantes entre los diferentes tipos de documentos analizados. MATERIAL Y MÉTODOS: Estudio transversal descriptivo. Se analizaron 513 certificados del municipio de Madrid. El análisis incluía documentos oficiales, nuevos y antiguos, y de los hospitales. RESULTADOS: Como principal hallazgo destacó que 316 documentos empleaban el término «parada cardiorrespiratoria» como causa inmediata de muerte. En otros 98 casos se emplearon otras causas inmediatas mal definidas. También se pudo concluir que los documentos de los hospitales no siempre tienen los apartados requeridos para que el certificado haga su función legal. En los certificados de la Organización Médica Colegial existe una peor cumplimentación en el documento actual porque el propio documento dificulta que se rellene adecuadamente y precisa una mejor formación del médico para rellenarlo. CONCLUSIONES: Se proponen posibles mejoras en el propio documento oficial para que se consideren las exigencias legales, se facilite su cumplimentación y cumpla su función. También se proponen recomendaciones para los hospitales que tengan su propio documento y sugerencias de mejora de la cumplimentación

BACKGROUND: The medical certificate of cause of death is a dual-purpose document: an official registration of an individual's death and a statistical analysis of the populational causes of death. However, the completion of this document in clinical practice creates significant conflicts. OBJECTIVES: To analyse the completion and detect the main errors that occur when filling in these documents. We then compared the most important variables between the various types of documents analysed. MATERIAL AND METHODS: We conducted a descriptive cross-sectional study that analysed 513 certificates in the municipality of Madrid, Spain. The analysis included official documents (new and old versions) and hospital documents. RESULTS: The study's main finding was that 316 documents employed the term "cardiopulmonary arrest" as the immediate cause of death. In 98 other cases, other poorly defined immediate causes were listed. We were able to conclude that the hospital documents do not always have the required sections for the certificate to be legally functional. In the Professional Medical Association certificates, there is poorer completion of the current document because the document itself hinders its appropriate completion and requires better physician training to complete. CONCLUSIONS: We propose possible improvements to the official document so that it meets the legal requirements, facilitates its completion and fulfils its function. We also offer recommendations for hospitals that have their own document and suggestions for improving its completion

Inflammatory bowel disease in Mexico: Epidemiology, burden of disease, and treatment trends. / Epidemiología, carga de la enfermedad y tendencias de tratamiento de la enfermedad inflamatoria intestinal en México.

INTRODUCTION AND AIMS: There is no systematized information for determining/monitoring the burden of inflammatory bowel disease in Mexico. The aim of the present study was to estimate the annual burden of inflammatory bowel disease on the Mexican National Healthcare System, by number of patients seen, hospitalizations, and specific deaths, stratified into age groups. MATERIALS AND METHODS: Utilizing specific databases of the Mexican National Healthcare System registries coded as ICD-10: K50 and K51, we retrieved and analyzed the data corresponding to the patients seen and hospitalized in 2015, stratified by age group, as well as the specific deaths. Treatment trends among physicians were also examined. RESULTS: In 2015, 5,009 women (8.1) and 4,944 men (8.4) with Crohn's disease received medical attention (prevalence of cases seen) and 35.1% of those patients were ≥50years of age. In that same period, 17,177 women (27.7) and 15,883 men (26.9) with ulcerative colitis were seen and 31.6% of those patients were ≥50years of age. The hospitalized cases (prevalence of hospitalized cases) were 1,097 patients (0.91) with Crohn's disease and 43.7% of those patients were ≥50years of age; and 5,345 patients (4.42) with ulcerative colitis and 47.6% of those patients were ≥50years of age. Deaths (specific mortality rate) were: 32 women (0.52) and 36 men (0.50) due to Crohn's disease, and 267 women (4.31) and 186 men (3.15) due to ulcerative colitis. CONCLUSIONS: Inflammatory bowel disease is a burden on the health of Mexican adults and the Mexican National Healthcare System, and it is expected to increase over the next 15years.

Environmental monitoring and exposure science dataset to calculate ingestion and inhalation of metal(loid)s through preschool gardening.

Metal(loid) contamination may pose an increased risk of exposure to children residing near legacy and active resource extraction sites. Children may be exposed to arsenic, cadmium, and/or lead by ingestion and/or inhalation while engaging in school or home outdoor activities via environmental media including water, soil, dust, and locally grown produce. It is thus critical to collect site-specific data to best assess these risks. This data article provides gastric and lung in-vitro bioaccessibility assay (IVBA) data, as well as environmental monitoring data for water, soil, dust, and garden produce collected from preschools (N = 4) in mining communities throughout Nevada County, California in 2018. Arsenic, cadmium, and lead concentrations in the aforementioned media and synthetic gastric and lung fluids were measured by inductively coupled plasma-mass spectrometry (ICP-MS). This dataset provides useful metal(loid) concentrations for future risk assessments for similar settings.

Cultural and linguistic adaptation of the Oxford Cognitive Screen to the Spanish population. / Adaptación lingüística y cultural del Oxford Cognitive Screen (OCS) en población española.

INTRODUCTION: Stroke is the sixth leading cause of disability in Spain. Patients may present motor, sensory, or cognitive sequelae, which can be minimised with early treatment. To this end, there is a need for quick-to-administer assessment tools to evaluate deficits in these areas. The Oxford Cognitive Screen (OCS) is a brief test specifically designed to assess cognitive function in patients with stroke. Our aim in this study is to report the linguistic and cultural adaptation of a Spanish-language version of the test (OCS-S). MATERIAL AND METHODS: The linguistic validation was conducted with a process of double translation and 10 consensus meetings of the multidisciplinary research team. We also performed 3 pilot studies, with 5 potential users, 23 healthy individuals, and 23 patients with stroke (ischaemic in 61% of cases and haemorrhagic in 39%), respectively; participants were aged between 31 and 88 years. RESULTS: The OCS-S includes the 10 subtests, the coding of responses, and the scoring system from the original version. We modified and extended the instructions for administration in order to ensure the reliability of the content and its application. Five tasks were modified (images, numbers, and sentences) and the praxis subtest was modified to evaluate both hands. The pilot studies confirmed comprehension in the target population, independently of any cognitive problems. CONCLUSIONS: The OCS-S is conceptually and linguistically equivalent to the original test, enabling psychometric assessment and application of the test in the Spanish population. The OCS-S may be a useful screening tool for quickly assessing cognitive function after stroke.

Completion of the medical certificate of cause of death in Madrid: A descriptive cross-sectional study. / Cumplimentación del certificado médico de defunción en Madrid: un estudio descriptivo trasversal.

BACKGROUND: The medical certificate of cause of death is a dual-purpose document: an official registration of an individual's death and a statistical analysis of the populational causes of death. However, the completion of this document in clinical practice creates significant conflicts. OBJECTIVES: To analyse the completion and detect the main errors that occur when filling in these documents. We then compared the most important variables between the various types of documents analysed. MATERIAL AND METHODS: We conducted a descriptive cross-sectional study that analysed 513 certificates in the municipality of Madrid, Spain. The analysis included official documents (new and old versions) and hospital documents. RESULTS: The study's main finding was that 316 documents employed the term "cardiopulmonary arrest" as the immediate cause of death. In 98 other cases, other poorly defined immediate causes were listed. We were able to conclude that the hospital documents do not always have the required sections for the certificate to be legally functional. In the Professional Medical Association certificates, there is poorer completion of the current document because the document itself hinders its appropriate completion and requires better physician training to complete. CONCLUSIONS: We propose possible improvements to the official document so that it meets the legal requirements, facilitates its completion and fulfils its function. We also offer recommendations for hospitals that have their own document and suggestions for improving its completion.

Ingestion and inhalation of metal(loid)s through preschool gardening: An exposure and risk assessment in legacy mining communities.

Children residing in mining towns are potentially disproportionately exposed to metal(loid)s via ingestion and dust inhalation, thus, increasing their exposure when engaging in school or home gardening or playing outside. This citizen science study assessed preschool children's potential arsenic (As), cadmium (Cd), and lead (Pb) exposure via locally grown produce, water, incidental soil ingestion, and dust inhalation at four sites. Participants were trained to properly collect water, soil, and vegetable samples from their preschools in Nevada County, California. As, Cd, and Pb concentrations in irrigation sources did not exceed the U.S. EPA's maximum contaminant and action levels. In general, garden and playground As and Pb soil concentrations exceeded the U.S. EPA Regional Screening Level, CalEPA Human Health Screening Level, and California Department of Toxic Substances Control Screening Level. In contrast, all Cd concentrations were below these recommended screening levels. Dust samples (<10 µm diameter) were generated from surface garden and playground soil collected at the preschools by a technique that simulated windblown dust. Soil and dust samples were then analyzed by in-vitro bioaccessibility assays using synthetic lung and gastric fluids to estimate the bioaccessible fraction of As, Cd, and Pb in the body. Metal(loid) exposure via grown produce revealed that lettuce, carrot, and cabbage grown in the preschool gardens accumulated a higher concentration of metal(loid) than those store-bought nation-wide. None of the vegetables exceeded the respective recommendation maximum levels for Cd and Pb set by the World Health Organization Codex Alimentarius Commission. The results of this study indicate that consumption of preschool-grown produce and incidental soil ingestion were major contributors to preschool-aged children's exposure to As, Cd, and Pb. Traditionally, this level of site- and age-specific assessment and analyses does not occur at contaminated sites. The results of this holistic risk assessment can inform future risk assessment and public health interventions related to childhood metal(loid) exposures.