Factorial Analysis and Thermal Kinetics of Chemical Recycling of Poly(ethylene terephthalate) Aided by Neoteric Imidazolium-Based Ionic Liquids.

Poly(ethylene terephthalate) (PET) waste accumulation poses significant environmental challenges due to its persistent nature and current management limitations. This study explores the effectiveness of imidazolium-based neoteric solvents [Emim][OAc] and [Bmim][OAc] as catalytic co-solvents in the glycolysis of PET with ethylene glycol (EG). Reaction thermal kinetics showed that both ionic liquids (ILs) significantly enhanced the depolymerization rate of PET compared to traditional methods. The use of [Emim][OAc] offered a lower activation energy of 88.69 kJ·mol-1, thus making the process more energy-efficient. The contribution of key process parameters, including temperature (T), plastic-to-ionic liquid (P/IL) mass ratio, and plastic-to-solvent (P/S) mass ratio, were evaluated by means of a factorial analysis and optimized to achieve the maximum PET conversion for both neoteric solvents. The relevance sequence for both ionic liquids involved the linear factors T and P/S, followed by the interaction factors T×P/S and T×P/IL, with P/IL being the less significant parameter. The optimal conditions, with a predicted conversion of 100%, involved a temperature of 190 °C, with a P/IL of 1:1 and a P/S of 1:2.5, regardless of the IL used as the catalytic co-solvent.

Integrative assessment of immunity, health-state, growth and survival of Magellanic penguin chicks in a colony exposed to ecotourism.

Accumulating reports of negative impacts of tourist activities on wildlife emphasize the importance of closely monitoring focal populations. Although some effects are readily noticed, more subtle ones such as changes in physiological functions of individuals might go overlooked. Based on evidence of altered physiology associated with ecotourism on Magellanic penguins Spheniscus magellanicus, here we performed an integrated assessment using a diverse physiological toolkit together with more traditional fitness-related measures to better understand mechanisms and potential consequences. Chicks exposed to tourism showed altered immune parameters and elevated flea prevalence, reinforcing previous findings. Tourism-exposed female, but not male, chicks also showed relatively lower hematocrit and plasma protein levels, providing evidence consistent with a sex-specific response to tourist visitation. Physiological alterations detected in tourism-exposed young chicks (week 1-2) were maintained and the effect on flea infestation increased during the study period (week 4-5 of post-hatch). Despite the effects on physiology, these did not seem to translate into immediate fitness costs. No detectable tourism effects were found on brood sex ratios, chick growth and body condition, and survival until week 5-6 post-hatch. We detected no effects on reproductive output and only a marginal effect on nest survival during incubation despite previous reports of tourism-associated alterations in stress indices of adults. This disconnection could result if the physiological changes are not strong enough to impact fitness, if effects balance each other out, or if changes are part of a copying strategy. Alternatively, the physiological alterations might only show impacts later in the brooding cycle or even after chick emancipation from their parents. Our results suggest that integrative monitoring of potential anthropogenic impacts on wildlife should include evaluation of physiological mechanisms and individual-level responses in populations exposed to human activities.

Los síndromes pericárdicos agudos en la unidad de cuidados intensivos / Acute pericardial syndromes in the intensive care unit

No disponible

[Economics and equity in urgency and emergency care]. / Economía y equidad en urgencias y emergencias.

The financial sustainability of public health systems (PHS) is currently threatened by population growth, increased prevalence of chronic conditions and disabilities, inequality in access and use of resources, zero cost delivery and global economic crisis. The emergency department (ED) is one for which demand is highest--without relation to the health model--because disease becomes established in disadvantaged socio-demographic areas and inequalities, hyperconsumption and decision making more closely linked to the user are maintained. The medical device of ED is a multiple one and its diverse product lines make it difficult to measure. This review discusses the need to deploy measurement tools in ED, where there are high direct costs--primarily structural--and other variables related to the activity, where the marginal cost is higher than the average and there is no economy of scale in such interventions. The possible mechanisms of private copayment in financing the supply of EDs are also studied, showing their advantages and disadvantages, with the conclusion that they are not recommendable--due to their scarce fund raising and deterrent capacity, which is why fundamental strategic changes in the management of these resources are needed.

Diagnostic stability and evolution of bipolar disorder in clinical practice: a prospective cohort study.

OBJECTIVE: To evaluate the long-term stability of International Classification of Diseases-10th revision bipolar affective disorder (BD) in multiple settings. METHOD: A total of 34 368 patients received psychiatric care in the catchment area of a Spanish hospital (1992-2004). The analyzed sample included patients aged > or =18 years who were assessed on > or =10 occasions and received a diagnosis of BD at least once (n = 1153; 71,543 assessments). Prospective and retrospective consistencies and the proportion of subjects who received a BD diagnosis in > or =75% of assessments were calculated. Factors related to diagnostic shift were analyzed with traditional statistical methods and Markov's models. RESULTS: Thirty per cent of patients received a BD diagnosis in the first assessment and 38% in the last assessment. Prospective and retrospective consistencies were 49% and 38%. Twenty-three per cent of patients received a BD diagnosis during > or =75% of the assessments. CONCLUSION: There was a high prevalence of misdiagnosis and diagnostic shift from other psychiatric disorders to BD. Temporal consistency was lower than in other studies.

Economía y equidad en urgencias y emergencias / Economics and equity in urgency and emergency care

públicos (SSP) está amenazada por el crecimientopoblacional, la mayor prevalencia de procesos crónicosy discapacidades, la inequidad residual en el acceso yutilización de los recursos, el coste nulo en la prestacióny la crisis económica mundial.Los servicios de Urgencias y Emergencias (SUE)son uno de los más demandados –sin relación con elmodelo de salud– porque la enfermedad asienta enáreas sociodemográficas menos favorecidas, se mantieneninequidad, hiperconsumo y capacidad de decisiónmás ligada al usuario. El producto sanitario de los SUEes múltiple y con líneas de producción diversas quedificultan su medición. En esta revisión se analiza lanecesidad de implantar herramientas de medida en losSUE, donde existen altos costes directos –fundamentalmenteestructurales– y otros variables relacionadoscon la actividad, donde el coste marginal es superior almedio y sin economía de escala en estas intervenciones.Se estudian, asimismo, los posibles mecanismos decoparticipación privada en la financiación de la ofertade los SUE, se muestran sus ventajas e inconvenientesy se concluye que no son recomendables –por su escasacapacidad recaudadora y disuasoria– por lo queson necesarios cambios estratégicos fundamentales enla gestión de estos recursos(AU)

The financial sustainability of public health systems(PHS) is currently threatened by populationgrowth, increased prevalence of chronic conditions anddisabilities, inequality in access and use of resources,zero cost delivery and global economic crisis.The emergency department (ED) is one for whichdemand is highest – without relation to the health model– because disease becomes established in disadvantagedsocio-demographic areas and inequalities, hyperconsumptionand decision making more closely linkedto the user are maintained. The medical device of EDis a multiple one and its diverse product lines make itdifficult to measure.This review discusses the need to deploy measurementtools in ED, where there are high direct costs– primarily structural – and other variables related tothe activity, where the marginal cost is higher than theaverage and there is no economy of scale in such interventions.The possible mechanisms of private copaymentin financing the supply of EDs are also studied,showing their advantages and disadvantages, with theconclusion that they are not recommendable – due totheir scarce fund raising and deterrent capacity, whichis why fundamental strategic changes in the managementof these resources are needed(AU)

Coma y acidosis metabólica: intoxicación por metanol / Coma and metabolic acidosis: methanol poisoning

La intoxicación por metanol es un proceso poco frecuente en la actualidad, a pesar de su uso habitual en la industria, laboratorios y hogar. La vía de intoxicación suele ser la oral y, dada su elevada mortalidad, debe considerarse siempre una intoxicación grave. Se presenta el caso clínico de un paciente joven extranjero sin antecedentes, en coma y con acidosis metabólica grave, que evoluciona a muerte encefálica a pesar de establecer medidas de soporte y tratamiento específico (corrección de acidosis, etanol, diálisis) instaurado empíricamente a las 12 horas del ingreso, confirmándose posteriormente la intoxicación por metanol. En conclusión, debe destacarse la importancia del diagnostico precoz, dado el amplio periodo de latencia, la escasa sintomatología inicial y la alta mortalidad, sospechándose ante un paciente con acidosis metabólica con anión gap aumentado y alteraciones neurológicas, pues el diagnóstico de certeza es su presencia en plasma, técnica no disponible en la mayoría de los hospitales (AU)

Today, the methanol poisoning is an uncommon disease, although it is the regular use in the industry, the laboratories and home products. The more frequent route of intoxication is oral and always it has to considerate that is a severe poisoning. The case report is about a foreign young male without personal history. On first examination he presents coma and severe metabolic acidosis developing encephalic death, despite supportive measures and specific treatment (correction of acidosis, ethanol and dialysis) administered 12 hours after the admission time. Later, the methanol poisoning was confirmed. In conclusion, we want to emphasize the importance of early diagnostic, because this intoxication has a wide latent period, poor initial symptoms and high mortality, and it should be suspected when a patient shows metabolic acidosis with increased gap anion and neurological disorders, since certainly diagnostic is the presence of methanol in blood and this technique is not available in most hospitals (AU)