Fertigation to recover nitrate-polluted aquifer and improve a long time eutrophicated lake, Spain.

Use of nitrogen and phosphorus in agriculture increases agricultural production but also generates important environmental problems around the world, such as high nitrate levels in aquifers and an increase in eutrophication of waters. A set of tools and models are used, ENVIRO-GRO and PATRICAL models, to analyse the effect of large irrigation system modernization, 13,700 ha, from traditional flood irrigation to modernized drip irrigation, in the aquifer nitrate levels and in the phosphorus inputs to a 50-years eutrophicated RAMSAR lake, Albufera lake. Based on data collected from end users, modernized irrigation system reduces the amount of nitrogen applied from 25 % to 45 % and phosphorus applied around 90-95 %, so phosphorus content on soil, phosphorus legacy, is reducing by time. Obtained results indicate that nitrogen leaching as nitrate is reduced by 70 % to 83 % and surface runoff during irrigation events disappear, hence phosphorus contributions to surface waters are eliminated. Nitrate polluted aquifer will be recovered in 5-6 years after complete implement of measures and phosphorus inputs to the lake are reduced around 20 % contributing to improve the status of the eutrophicated Albufera lake. Results show great agreement with the European Strategy to reduce the use of fertilizers and how the fertilizers technical management in fertigation can contribute to greater efficiency in it use and improvement of the environment.

Drug-delivering devices in the urinary tract: A systematic review.

OBJECTIVE: : To systematically review the use of drug-eluting stents (DES) and drug-coated balloons (DCB) in urology. MATERIALS AND METHODS: The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, Scopus, Web of science and Cochrane Library online databases were searched in February 2019. Experimental and clinical studies, which included the placement of a DES or dilatation with DCB for investigating their potential use in the urinary tract for the management of ureteric or urethral pathologies, were included. The primary endpoint was to evaluate the current use of DES and DCB in urology. RESULTS: A total of 29 articles were included in the systematic review. A total of 10 studies tested DES or DCB containing anti-proliferative agents (paclitaxel, zotarolimus, sirolimus, halofugione). Antibiotic agent-containing DES were tested in nine studies (triclosan, quinolones, teicoplanin, nitrofurantoin, silver sulfadiazine). A total of eight studies investigated the release of anti-inflammatory agents by DES (ketorolac, indomethacin, EW-7197). Another group studied heparin-eluting stents. CONCLUSION: Despite the inconclusive outcomes of the three randomised controlled trials, drug-coated/eluting devices constitute a promising field in urology for the prevention of complications associated with conventional stents including pain and encrustation. Pre-clinical in vitro and in vivo studies have shown their ability to mitigate inflammation, inhibit re-stenosis and improve pain as indicated by declined use of anti-inflammatory drugs.Abbreviations: DES: drug-eluting stents; DCB: drug-coated balloons; DCS: drug-coated stents; HF: halofungione; MCP-1: monocyte chemoattractant protein 1; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PTCA: percutaneous transluminal coronary angioplasty; RANTES: regulated on activation, normal T-cell expressed and secreted; RCT: randomised controlled trial; USSQ, Ureteric Stent Symptoms Questionaire.

Tumor Budding: Prognostic Value in Muscle-invasive Bladder Cancer.

OBJETIVES: To assess if "tumor budding" (TB) behaves as a poor prognostic factor in muscle-invasive bladder carcinoma (MIBC). TB is the presence of tumor cells isolated or in small groups of fewer than 5 cells located at the tumor invasion front. MATERIAL AND METHODS: Retrospective study of 106 patients with MIBC who underwent radical cystectomy. A cytokeratin AE1/AE3 immunostaining was applied to identify and quantify TB by the "hot-spot" method. The variables evaluated were: age, gender, Tumour, Node, Metastasis Classification (TNM) stage, associated Carcinoma in situ, differentiation degree, tumor size, tumor location, lymphatic, venous or perineural invasion, p53, Ki67, molecular subtype (basal/luminal) and chemotherapy. Main variables were overall and cancer-specific survival. RESULTS: The mean follow-up time was 47 ± 46.45 months. The mean TB count was 32.3 ± 25.9 "buds." The ROC curve established 14 "buds" as the cut-off point: the median survival rate for the "low-grade TB" group (≤14 "buds") was 69.5 months, and for the "high-grade TB" group (>14 "buds") was 18.5 months (P= .003). In the multivariate analysis, independent predictive variables regarding mortality were: age, TB, and TNM stage. Patients with more than 14 "buds" had 2.27 times more risk of mortality, 95%CI:1.19-4.34, P = .013. In addition, the risk of mortality rises progressively as the number of "buds" increases, at a rate of 2% per "bud." CONCLUSION: According to our results, TB becomes an independent predictor factor for cancer-specific mortality in MIBC, with a cut-off point of 14 "buds."

Exceso de proteínas en la pobreza: la paradoja del exceso de peso en niños colombianos / Excess protein in poverty settings: the paradox of overweight in colombian children

The objective was to describe the total caloric value (TCV) derived from macronutrients in children under 18 years in relation to overweight in four Colombian cities between 2009-2011. Two 24 hour dietary recalls were measured in 505 children between 0 and 17 years, 51% living in urban areas. Nutritional status was calculated based on anthropometry. We used linear regression to test the association between TCV and excess weight. Overweight in children without stunting was 6.2%. Overweight (BMI>=25) was 16.3% overall, with 18.2% overweight in urban areas and 14.2%, in rural (p= 0.253). Children who were overweight usually consumed 0.25 g/kg/day more protein (95% CI 0.11 to 0.40), 0.18 g/kg /day less fat (95%; -0.25 to -0.11) and 1.80 g/kg/day less carbohydrates (95% CI -2.50 to -1.10) compared to those without overweight, for all differences p< 0.0001. Overweight subjects consumed 0.8% more protein derived TCV than those without excess weight, p= 0.006. Being overweight was associated with TCV in Colombian children, particularly energy derived from protein consumption and also it was associated with the quantities/day of milk intake.

El objetivo fue describir el valor calórico total (VCT) derivado de macronutrientes en menores de 18 años con relación al exceso de peso, en cuatro ciudades de Colombia, 2009-2011. Se realizaron dos recordatorios del consumo dietario en las últimas 24 horas aplicados a 505 niños entre 0 y 17 años, el 51% residentes en áreas urbanas. Además, se estableció su estado de nutrición con base en antropometría. Mediante regresión lineal se estableció la asociación del VCT y el exceso de peso. El sobrepeso en niños sin retraso en talla fue de 6,2%. El exceso de peso (IMC>= 25) fue de 16,3%, El exceso en la zona urbana fue de 18,2% y en la rural de 14,2%, p= 0,253. Los niños con exceso de peso consumieron usualmente 0,25 g/kg/día más de proteínas (IC 95%; 0,11 a 0,40), -0,18 g/kg/día menos de grasa (IC 95%; -0,25 a -0,11) y -1,80 g/kg/día menos de carbohidratos (IC 95%; -2,50 a -1,10), que aquellos sin exceso de peso, para todas las diferencias p< 0,0001. Los sujetos con exceso de peso consumieron 0,8% más VCT derivado de proteínas que aquellos sin exceso, p= 0,006. El exceso de peso en niños colombianos se asoció al VCT, en particular con la energía derivada del consumo de proteínas y también se asoció a las cantidades/día de la ingesta de leche.

Dietary transition and excess weight in adults according to the Encuesta de la Situación Nutricional en Colombia, 2010.

INTRODUCTION: Dietary transition is codetermined by demographic and nutritional transitions.  OBJECTIVES: To establish the prevalence of overweight individuals among Colombians aged 18 to 64, identify their dietary patterns and establish the relationship between this and their excess weight.  MATERIALS AND METHODS: We analyzed the Encuesta de la Situación Nutricional en Colombia, 2010 (National Survey of the Nutritional Situation in Colombia, 2010). Dietary patterns were established with factor analysis in 5,217 subjects, who answered a questionnaire on food consumption frequency. The relationship between excess weight and adherence to quartiles in the patterns was established with binomial regression.  RESULTS: The prevalence of excess weight was 47.4% in men (95% CI: 44.7; 50.0) and 57.1% in women (95% CI: 54.9; 59.3, p<0.0001). Three patterns were established: protein/fiber, sandwich/snack and traditional/starch. When the models were adjusted for age, sex and level of food security in the home, the protein/fiber and traditional/starch patterns were found to be associated with excess weight (test of linear trend for quartiles of adherence, p=0.007 and p=0.001, respectively). Neither the frequency of consumption of carbonated and sugary drinks, with an adjusted relative risk of 100 (95% CI: 93 - 109; p=0.913), nor that of fast food with 102 (95% CI: 89; 117; p=0.759) were associated with excess weight.  CONCLUSIONS: Excess weight increases constantly with age, particularly in women, and is associated positively with indicators of socioeconomic status and subjects changing from the traditional/starch pattern to the protein/fiber one.

La transición alimentaria y el exceso de peso en adultos evaluados con base en la Encuesta de la Situación Nutricional en Colombia, 2010 / Dietary transition and excess weight in adults according to the Encuesta de la Situación Nutricional en Colombia, 2010

Introducción. La transición alimentaria está determinada por las transiciones demográfica y nutricional. Objetivos. Establecer la prevalencia del exceso de peso en colombianos de 18 a 64 años de edad, determinar su patrón alimentario y su relación con el exceso de peso. Materiales y métodos. Se analizó la Encuesta Nacional de la Situación Nutricional en Colombia, 2010. Los patrones alimentarios se establecieron mediante un análisis de factores en 5.217 sujetos que contestaron un cuestionario de frecuencia de consumo. La relación entre el exceso de peso y la inclusión en los cuartiles de los patrones se estableció con regresión binomial. Resultados. La prevalencia del exceso de peso en hombres fue de 47,4 % (IC 95% 44,7-50,0) y en mujeres de 57,1 % (IC 95% 54,9 59,3; p<0,0001). Se establecieron tres patrones alimentarios: proteína-fibra, bocadillo- snack y tradicional-almidón. Los modelos ajustados por edad, sexo y nivel de seguridad alimentaria del hogar, evidenciaron que los patrones de proteína-fibra y tradicional-almidón estaban asociados al exceso de peso (test de tendencia lineal para la inclusión en los cuartiles: p=0,007 y p=0,001, respectivamente). Ni la frecuencia del consumo de gaseosas y refrescos azucarados, con un sesgo relativo ajustado de 100 (IC 95% 93-109; p=0,913), ni de comidas rápidas, con un sesgo de 102 (IC 95% 89-117; p=0,759), se asociaron al exceso de peso. Conclusiones. El exceso de peso aumentó de manera constante con la edad y más en las mujeres, y se asoció con los indicadores de estatus socioeconómico y con el cambio del patrón tradicional-almidón al de proteína-fibra.

Introduction: Dietary transition is codetermined by demographic and nutritional transitions. Objectives: To establish the prevalence of overweight individuals among Colombians aged 18 to 64, identify their dietary patterns and establish the relationship between this and their excess weight. Materials and methods: We analyzed the Encuesta de la Situación Nutricional en Colombia, 2010 ( National Survey of the Nutritional Situation in Colombia, 2010). Dietary patterns were established with factor analysis in 5,217 subjects, who answered a questionnaire on food consumption frequency. The relationship between excess weight and adherence to quartiles in the patterns was established with binomial regression. Results: The prevalence of excess weight was 47.4% in men (95% CI: 44.7; 50.0) and 57.1% in women (95% CI: 54.9; 59.3, p<0.0001). Three patterns were established: protein/fiber, sandwich/snack and traditional/starch. When the models were adjusted for age, sex and level of food security in the home, the protein/fiber and traditional/starch patterns were found to be associated with excess weight (test of linear trend for quartiles of adherence, p=0.007 and p=0.001, respectively). Neither the frequency of consumption of carbonated and sugary drinks, with an adjusted relative risk of 100 (95% CI: 93 - 109; p=0.913), nor that of fast food with 102 (95% CI: 89; 117; p=0.759) were associated with excess weight. Conclusions: Excess weight increases constantly with age, particularly in women, and is associated positively with indicators of socioeconomic status and subjects changing from the traditional/starch pattern to the protein/fiber one.

Digital pyramid wavefront sensor with tunable modulation.

The pyramid wavefront sensor is known for its high sensitivity and dynamic range that can be tuned by mechanically altering its modulation amplitude. Here, a novel modulating digital scheme employing a reflecting phase only spatial light modulator is demonstrated. The use of the modulator allows an easy reconfigurable pyramid with digital control of the apex angle and modulation geometry without the need of any mechanically moving parts. Aberrations introduced by a 140-actuator deformable mirror were simultaneously sensed with the help of a commercial Hartmann-Shack wavefront sensor. The wavefronts reconstructed using the digital pyramid wavefront sensor matched very closely with those sensed by the Hartmann-Shack. It is noted that a tunable modulation is necessary to operate the wavefront sensor in the linear regime and to accurately sense aberrations. Through simulations, it is shown that the wavefront sensor can be extended to astronomical applications as well. This novel digital pyramid wavefront sensor has the potential to become an attractive option in both open and closed loop adaptive optics systems.

Exploring the Stiles-Crawford effect of the first kind with coherent light and dual Maxwellian sources.

The visual impact of light obliquely incident on the retina is diminished due to the Stiles-Crawford effect of the first kind. It is normally analyzed by scanning a small Maxwellian source across the eye pupil while making subjective visibility comparisons to a static reference field that enters the eye near the pupil center. Here, we propose an alternative characterization method with two coherent Maxwellian point sources located at opposing sides of the pupil. This produces interference fringes at the retina with an underlying phase gradient. Altering the power ratio of the two point sources makes tuning of the wavefront inclination at the retina feasible. Thus, the Stiles-Crawford effect of the first kind can be examined without scanning the incident light across the pupil. In this paper, a spatial light modulator with holographic phase maps has been used to generate two Maxwellian point sources at the pupil that project a given phase variation onto the retina. We found that the effective obliqueness of light at the retina is determined by the weighted center-of-mass of the field amplitude at the pupil. Alternative techniques to generate the two secondary point sources may improve the accuracy of the method.

Inseguridad alimentaria: variables asociadas y elementos para la política social / Food insecurity: associated variables and issues for public policy

Introducción. La vigencia de las explicaciones cambia con las transiciones demográfica, epidemiológica y nutricional. Objetivo. Establecer la magnitud de inseguridad alimentaria y sus variables asociadas. Materiales y métodos . Se clasificaron 432 hogares mediante cinco métodos; se utilizaron las escalas de percepción de seguridad alimentaria (EPSA), la latinoamericana y caribeña (ELCSA), y otros tres: a) según el consumo usual de energía del jefe del hogar, b) según el consumo usual de energía de todos los miembros, y c) según un algoritmo basado en el consumo y la condición de los menores. Mediante regresión binomial, se establecieron las variables asociadas a la inseguridad alimentaria. Resultados. La inseguridad varió entre 35,9 y 87 %. Según la ELCSA y b), los hogares con menores tienen menor riesgo de inseguridad 0,51 (IC95% 0,25-0,90) y 0,72 (IC95% 0,48-0,96). Según la EPSA y la ELCSA, no pagar los servicios públicos 1,75 (IC95% 1,23-2,28) y que el jefe del hogar declare que no accede a los alimentos 1,48 (IC95% 1,20-1,68), aumentan la inseguridad. Obtener ingresos esporádicamente se asoció con el método a), 1,34 (IC95% 1,04-1,53) y el método b), 1,32 (IC95% 1,03-1,52). Pagar arriendo 1,12 (IC95% 1,01-1,16), el tiempo de permanencia en el municipio 0,59 (IC95% 0,23-0,93) y no contar con alcantarillado 1,13 (IC95% 1,01-1,16), se asociaron a la inseguridad por el método c). Conclusiones. No es pertinente o útil recomendar estos métodos con fines de elaborar la política social.

Introduction. The validity of the explanations change over time according to the state of demographic, epidemiological and nutritional transitions. Objective. Five methods were compared to establish t he magnitude of food insecurity and related variables. Material and methods. Four hundred and thirty-two households in Colombia were classified using five methods, including (1) the scale of perceptions of food safety (EPSA),(2) the Latin American and Caribbean scale (ELCSA), (3) the usual intake of energy from the head of household, (4) the usual consumption of energy of all members of the home, and (5) an algorithm based on consumption and status of children. Binomial regression established variables associated with food insecurity. Results . Insecurity varied between 35.9% and 87.0%. According ELCSA and method 3, households with children have a lower risk of insecurity, 0.51 (95% CI 0.25 to 0.90) and 0.72 (95% CI 0.48 to 0.96). Under the EPSA and ELCSA, increased insecurity is associated with nonpayment of utilities, 1.75 (95% CI: 1.23 to 2.28) and the head of household declared limited access to food, 1.48 (95% CI: 1, 20 to 1.68). Sporadic income was associated with the method 3, 1.34 (95% CI 1.04 to 1.53) and method 4, 1.32 (95% CI 1.03 to 1.52). Paying rent, 1.12 (95% CI: 1.01 to 1.16), time spent in the municipality, 0.59 (95% CI 0.23 to 0.93) and not having sewer, 1.13 (95% CI 1.01 to 1.16) were associated with the food insecurity using method 5. Conclusions . Since the country has reliable information that is obtained routinely it is not relevant or useful to use these methods with the purpose of developing social policies.

Metabolic, mental health, behavioural and socioeconomic characteristics of migrants with Chagas disease in a non-endemic country.

OBJECTIVES: Chronic Chagas disease causes cardiopathy in 20-40% of the 8-10 million people affected. The prevalence of atherogenic factors increases rapidly in Latin America. Somatic, mental, behavioural and social characteristics of the 80,000 Latino migrants with Chagas disease in Europe are not known. We postulate that they may accumulate these factors for poor health--notably cardiovascular-outcomes. METHODS: This study took place at the Geneva University Hospitals in 2011. Latin American migrants with Chagas disease diagnosed in Geneva since 2008 were contacted. Interviews and blood tests assessed behavioural, socioeconomic, metabolic and cardiovascular factors. RESULTS: One hundred and thirty-seven patients (women: 84.7%; median age: 43 years) with chronic Chagas disease were included in the study. The majority were Bolivians (94.2%), undocumented (83.3%), uninsured (72.3%) and living below the Swiss poverty line (89.1%). Prevalence of obesity was 25.5%, of hypertension 17.5%, of hypercholesterolemia 16.1%, of impaired fasting glucose 23.4%, of diabetes 2.9%, of metabolic syndrome 16.8%, of anxiety 58.4%, of depression 28.5%, of current smoking 15.4% and of sedentary lifestyle 62.8%. High (>10%) 10-year cardiovascular risk affected 12.4%. CONCLUSIONS: Latin American migrants with Chagas disease accumulate pathogenic chronic conditions of infectious, non-transmissible, socioeconomic and behavioural origin, putting them at high risk of poor health, notably cardiovascular, outcomes. This highlights the importance of screening for these factors and providing interventions to tackle reversible disorders; facilitating access to care for this hard-to-reach population to prevent delays in medical interventions and poorer health outcomes; and launching prospective studies to evaluate the long-term impact of these combined factors on the natural course of Chagas disease.

[Food insecurity: associated variables and issues for public policy]. / Inseguridad alimentaria: variables asociadas y elementos para la política social.

INTRODUCTION: The validity of the explanations change over time according to the state of demographic, epidemiological and nutritional transitions. OBJECTIVE: Five methods were compared to establish t he magnitude of food insecurity and related variables. MATERIAL AND METHODS: Four hundred and thirty-two households in Colombia were classified using five methods, including (1) the scale of perceptions of food safety (EPSA),(2) the Latin American and Caribbean scale (ELCSA), (3) the usual intake of energy from the head of household, (4) the usual consumption of energy of all members of the home, and (5) an algorithm based on consumption and status of children. Binomial regression established variables associated with food insecurity. RESULTS: Insecurity varied between 35.9% and 87.0%. According ELCSA and method 3, households with children have a lower risk of insecurity, 0.51 (95% CI 0.25 to 0.90) and 0.72 (95% CI 0.48 to 0.96). Under the EPSA and ELCSA, increased insecurity is associated with nonpayment of utilities, 1.75 (95% CI: 1.23 to 2.28) and the head of household declared limited access to food, 1.48 (95% CI: 1, 20 to 1.68). Sporadic income was associated with the method 3, 1.34 (95% CI 1.04 to 1.53) and method 4, 1.32 (95% CI 1.03 to 1.52). Paying rent, 1.12 (95% CI: 1.01 to 1.16), time spent in the municipality, 0.59 (95% CI 0.23 to 0.93) and not having sewer, 1.13 (95% CI 1.01 to 1.16) were associated with the food insecurity using method 5. CONCLUSIONS: Since the country has reliable information that is obtained routinely it is not relevant or useful to use these methods with the purpose of developing social policies.

Wavefront sensing with an axicon.

The use of a large apex-angle axicon for common-path interferometric wavefront sensing is proposed. The approach is a variant of point-diffraction interferometry bearing similarities to pyramidal wavefront sensing. A theoretical basis for wavefront sensing with an axicon is developed, and the outcomes of numerical simulations are compared to experimental results obtained with spherical and cylindrical ophthalmic trial lenses. It is confirmed that the axicon can be used for wavefront sensing, although its refraction may ultimately complicate and limit its operational range.