Us vehicles sales. Evidence of persistence after COVID-19.

In this paper, the sales of vehicles in the US are examined to understand if the shock caused by the current COVID-19 pandemic has had permanent or transitory effects on its subsequent evolution. Using monthly data from January 1976 until April 2021 and fractional integration methods, our results indicate that the series reverts and the shocks tend to disappear in the long run, even when they appear to be long lived. The results also indicate that the COVID-19 pandemic has not increased the degree of persistence of the series but, unexpectedly, has slightly reduced its dependence. Thus, shocks are transitory, long lived but, as time goes by, the recovery seems to be faster, which is possibly a sign of the strength of the industry.

Exploring the relationship between midwives' work environment, women's safety culture, and intent to stay.

BACKGROUND: The shortage of midwives is a concern for healthcare systems as it compromises the quality maternity care. Various studies argue that a favorable work environment increases nurses' job satisfaction and intention to continue working at their current workplace. AIM: To analyze the work environment and its relationship with women's clinical safety culture and midwives' intention to stay in their current job and the midwifery profession. METHODS: A cross-sectional, correlational study was performed on N = 218 midwives working in Spain. Standardized instruments were used, including The Practice Environment Scale of the Nursing Work Index (PES-NWI) and the Hospital Survey on Patient Safety Culture (HSOPSC). Descriptive and bivariable statistics were used. The study followed the STROBE guidelines. RESULTS: The work environment in the labor wards was mixed, according to the PES-NWI classification. The mean total score of the PES-NWI significantly and positively correlated with the mean total score of the HSOPSC (rs = 0.498, p < 0.001), indicating that as the quality of midwives' work environment increased, women's clinical safety increased. Significant correlations were observed between the midwives' intent to stay in the hospital where they work and features of women's safety culture. CONCLUSION: The results of this study showed significant relationships between the work environment, women's safety culture, and midwives' intentions to leave their job/profession. Creating a favorable working environment could be a potentially effective strategy that encourages improvement in the women's safety culture in healthcare organizations and greater intention of midwives to stay at their current job.

Immunity After Vaccination Against SARS-CoV-2 in Lung Transplant?

BACKGROUND: SARS-CoV2 infection causes high morbidity and mortality in lung transplant (LT) recipients. Vaccination with messenger RNA vaccines has been shown to play a key role in controlling the severity of infection in the general population. The aim of our study is to analyze whether vaccination with 2 doses of SARS-Cov2 provides immunity in LT recipients. METHODS: Retrospective descriptive and analytical study of LT recipients vaccinated with 2 doses of SARS-CoV2. We analyzed the vaccine received, if they had COVID-19, antibody levels (antispike and antinucleoprotein), anticalcineurin levels, infections in the last year, and presence of neoplasias. RESULTS: The most commonly administered vaccine was from Moderna, with 27% of patients showing immunity with a median antibody levels of 4.81 binding antibody units/mL, far from the values considered protective (> 34 binding antibody units/mL). Thirteen patients were infected with SARS-CoV2, 7 post vaccination (5 of them were antispike-positive). No relationship was demonstrated between generation of immunity and age and level of immunosuppression. CONCLUSIONS: Vaccination against SARS-CoV2 in LT recipients generates limited and ineffective immunity with only 2 doses.

[Parenteral nutrition-associated complications in patients with SARS-CoV-2 infection]. / Complicaciones asociadas a la nutrición parenteral en los enfermos con infección por SARS-CoV-2.

Introduction: Background: it is unknown whether patients with acute respiratory distress syndrome (ARDS) secondary to COVID-19 are at greater risk of developing complications associated with parenteral nutrition (PN). Aim: to describe the incidence, risk factors, and clinical impact of complications in patients with ARDS-COVID-19 receiving PN. Methods: a prospective cohort study of 87 patients with ARDS-COVID-19 infection. The incidence of complications and odds ratios of risk factors were analysed. Results: age ≥ 65 years (OR, 2.52, 95 % CI: 1.16 to 5.46), obesity (OR, 3.34, 95 % CI: 2.35 to 4.33) and treatment with propofol (OR, 2.45, 95 % CI: 1.55 to 3.35) or lopinavir/ritonavir (OR, 4.98, 95 % CI: 3.60 to 6.29) were risk factors for hipertriglyceridemia. Obesity (OR, 3.11, 95 % CI: 1.10 to 8.75), dyslipidemia (OR, 3.22, 95 % CI: 1.23 to 8.40) or treatment with propofol (OR, 5.47, 95 % CI: 1.97 to 15.1) were risk factors for intravascular catheter-related infection. No risk factors were described for hiperglycemia. Mortality was higher in patients with intravascular catheter-related infection (46.7 % vs 10.8 %, p = 0.014). Mortality risk was higher in older patients (OR, 2.74, 95 % CI: 1.08 to 6.95) or patients with intravascular catheter-related infection (OR, 3.22, 95 % CI: 1.23 to 8.40). Conclusions: the incidence of complications associated with PN in patients with COVID-19-related ARDS is frequent. The mortality risk is higher in older patients or those with catheter-related infection.

Introducción: Introducción: se desconoce si los pacientes diagnosticados de infección respiratoria aguda por SARS-CoV-2 (COVID-19) presentan más riesgo de complicaciones asociadas a la nutrición parenteral (NP). Objetivo: conocer la incidencia, los factores de riesgo y la mortalidad de las complicaciones asociadas a la NP en esta población. Métodos: estudio de cohortes prospectivo de 87 pacientes diagnosticados de infección por SARS-CoV-2. Se analizan la tasa de incidencia de las complicaciones y las odds ratio (OR) de diferentes factores. Resultados: la edad ≥ 65 años (OR: 2,52, IC 95 %: 1,16 a 5,46), los antecedentes de obesidad (OR: 3,34, IC 95 %: 2,35 a 4,33) y el tratamiento con propofol (OR: 2,45, IC 95 %: 1,55 a 3,35) o lopinavir/ritonavir (OR: 4,98, IC 95 %: 3,60 a 6,29) se asociaron al desarrollo de hipertrigliceridemia. Los pacientes con obesidad (OR: 3,11, IC 95 %: 1,10 a 8,75) o dislipemia (OR: 3,22, IC 95 %: 1,23 a 8,40) y los tratados con propofol (OR: 5,47, IC 95 %: 1,97 a 15,1) presentaron mayor riesgo de infección asociada al catéter (IAC). No se observó ningún factor de riesgo relacionado con el desarrollo de hiperglucemia. La mortalidad fue mayor en los pacientes con IAC (46,7 % vs. 10,8 %, p = 0,014). El riesgo de mortalidad fue superior en los enfermos de ≥ 65 años (OR: 2,74, IC 95 %: 1,08 a 6,95) o con IAC (OR: 3,22, IC 95 %: 1,23 a 8,40). Conclusiones: la incidencia de complicaciones asociadas a la NP en pacientes diagnosticados de infección por SARS-CoV-2 es elevada. El riesgo de mortalidad es superior en los enfermos mayores de 65 años o con IAC.

Acute Hypertriglyceridemia in Patients with COVID-19 Receiving Parenteral Nutrition.

Hypertriglyceridemia is a metabolic complication associated with parenteral nutrition (PN). It is unknown if patients with acute respiratory distress syndrome (ARDS) secondary to COVID-19 are more at risk. Our aim was to describe the incidence, risk factors and clinical impact of hypertriglyceridemia in critically ill patients with ARDS-COVID-19 receiving PN. We designed a cohort study of patients with ARDS-COVID-19 infection that required admission to critical care units and nutritional support with PN. Individual PN prescriptions for macronutrients and insulin were provided. Lipid emulsion contained fish oil (SMOFlipid® or Lipoplus®). Hypertriglyceridemia was defined as plasma levels above 400 mg/dL. Eighty-seven patients, 66.6% men, 60.1 ± 10.8 years old, BMI 29.1 ± 5.6 kg/m2, 71% of whom received lopinavir/ritonavir, 56% received Propofol and 55% received Tocilizumab were included. The incidence of hypertriglyceridemia was 37 × 100 patient-days with PN. This complication was more frequent in obese patients (OR 3.34; 95% CI, 2.35-4.33) and in those treated with lopinavir/ritonavir (OR 4.98; 95% CI, 3.60-6.29) or Propofol (OR 2.45; 95% CI, 1.55-3.35). Total mortality was 33.3%, similar between the type of lipid emulsion (p = 0.478). On average, patients with hypertriglyceridemia had a longer requirement of PN compared to the group without elevated triglycerides (TG), probably because of their longer survival (p = 0.001). TG higher than 400 mg/dL was not a protective factor for mortality (OR 0.31; 95% CI, 0.01-1.30). In conclusion, the incidence of hypertriglyceridemia was 37 × 100 patient-days with PN. The risk of this complication is associated with obesity and the use of lopinavir/ritonavir or Propofol.

Enzymatic synthesis of phlorizin fructosides.

Phlorizin is a low soluble dihydrochalcone with relevant pharmacological properties. In this study, enzymatic fructosylation was approached to enhance the water solubility of phlorizin, and consequently its bioavailability. Three enzymes were assayed for phlorizin fructosylation in aqueous reactions using sucrose as fructosyl donor. Levansucrase (EC 2.4.1.10) from Gluconacetobacter diazotrophicus (Gd_LsdA) was 6.5-fold more efficient than invertase (EC 3.2.1.26) from Rhodotorula mucilaginosa (Rh_Inv), while sucrose:sucrose 1-fructosyltransferase (EC 2.4.1.99) from Schedonorus arundinaceus (Sa_1-SST) failed to modify the non-sugar acceptor. Gd_LsdA synthesized series of phlorizin mono- di- and tri-fructosides with maximal conversion efficiency of 73 %. The three most abundant products were identified by ESI-MS and NMR analysis as ß-D-fructofuranosyl-(2→6)-phlorizin (P1a), phlorizin-4'-O-ß-D-fructofuranosyl-(2→6)-D-fructofuranoside (P2c) and phlorizin-4-O-monofructofuranoside (P1b), respectively. Purified P1a was 16 times (30.57 g L-1 at 25 °C) more soluble in water than natural phlorizin (1.93 g L-1 at 25 °C) and exhibited 44.56 % free radical scavenging activity. Gd_LsdA is an attractive candidate enzyme for the scaled synthesis of phlorizin fructosides in the absence of co-solvent.

One-pot bi-enzymatic cascade synthesis of puerarin polyfructosides.

Enzymatic glycosylation is an efficient way to increase the water solubility and the bioavailability of flavonoids. Levansucrases from Bacillus subtilis (Bs_SacB), Gluconacetobacter diazotrophicus (Gd_LsdA), Leuconostoc mesenteroides (Lm_LevS) and Zymomonas mobilis (Zm_LevU) were screened for puerarin (daidzein-8-C-glucoside) fructosylation. Gd_LsdA transferred the fructosyl unit of sucrose onto the glucosyl unit of the acceptor forming ß-d-fructofuranosyl-(2→6)-puerarin (P1a), while Bs_SacB, Lm_LevS and Zm_LevU synthesized puerarin-4'-O-ß-D-fructofuranoside (P1b) and traces of P1a. The Gd_LsdA product P1a was purified and assayed as precursor for the synthesis of puerarin polyfructosides (PPFs). Bs_SacB elongated P1a more competently forming a linear series of water-soluble PPFs reaching at least 21 fructosyl units, as characterized by HPLC-UV-MS, HPSEC and MALDI-TOF-MS. Simultaneous or sequential Gd_LsdA/Bs_SacB reactions yielded PPFs directly from puerarin with the acceptor conversion ranging 82-92 %. The bi-enzymatic cascade synthesis of PPFs in the same reactor avoided the isolation of the intermediate product P1a and it is appropriate for use at industrial scale.

Spatial Trends in Salmonella Infection in Pigs in Spain.

Salmonella is one of the most important foodborne pathogens worldwide. Its main reservoirs are poultry and pigs, in which infection is endemic in many countries. Spain has one of the largest pig populations in the world. Even though Salmonella infection is commonly detected in pig farms, its spatial distribution at the national level is poorly understood. Here we aimed to report the spatial distribution of Salmonella-positive pig farms in Spain and investigate the presence of potential spatial trends over a 17-year period. For this, data on samples from pigs tested for Salmonella in 2002-2013, 2015, 2017, and 2019 as part of the Spanish Veterinary Antimicrobial Resistance Surveillance program, representing 3,730 farms were analyzed. The spatial distribution and clustering of Salmonella-positive pig farms at the province level were explored using spatial empirical Bayesian smoothing and global Moran's I, local Moran's I, and the Poisson model of the spatial scan statistics. Bayesian spatial regression using a reparameterized Besag-York-Mollié Poisson model (BYM2 model) was then performed to quantify the presence of spatially structured and unstructured effects while accounting for the effect of potential risk factors for Salmonella infection at the province level. The overall proportion of Salmonella-positive farms was 37.8% (95% confidence interval: 36.2-39.4). Clusters of positive farms were detected in the East and Northeast of Spain. The Bayesian spatial regression revealed a West-to-East increase in the risk of Salmonella infection at the province level, with 65.2% (50% highest density interval: 70-100.0%) of this spatial pattern being explained by the spatially structured component. Our results demonstrate the existence of a spatial variation in the risk of Salmonella infection in pig farms at the province level in Spain. This information can help to optimize risk-based Salmonella surveillance programs in Spain, although further research to identify farm-level factors explaining this pattern are needed.

Identifying emerging trends in antimicrobial resistance using Salmonella surveillance data in poultry in Spain.

Despite of controls and preventive measures implemented along the food chain, infection with non-typhoidal Salmonella (NTS) remains one of the major causes of foodborne disease worldwide. Poultry is considered one of the major sources of NTS. This has led to the implementation of monitoring and control programmes in many countries (including Spain) to ensure that in poultry flocks infection is kept to a minimum and to allow the identification and monitoring of circulating NTS strains and their antimicrobial resistance (AMR) phenotypes. Here, we investigated the information from the monitoring programme for AMR in Salmonella from poultry in Spain in 2011-2017 to assess the diversity in phenotypic resistance and to evaluate the programme's ability to detect multi-resistance patterns and emerging strains in the animal reservoir. Data on serotype and AMR to nine antimicrobials obtained from 3,047 NTS isolates from laying hens (n = 1,060), broiler (n = 765) and turkey (n = 1,222) recovered during controls performed by the official veterinary services and food business operators were analysed using univariate and multivariate methods in order to describe host and serotype-specific profiles. Diversity and prevalence of phenotypic resistance to all but one of the antimicrobials (colistin) were higher in NTS from broiler and turkey compared with laying hen isolates. Certain combinations of serotype and AMR pattern (resistotype) were particularly linked with certain hosts (e.g. susceptible Enteritidis with laying hens, multi-drug resistant (MDR) Derby in turkey, MDR Kentucky in turkey and broiler). The widespread presence of certain serotype-resistotype combinations in certain hosts/years suggested the possible expansion of MDR strains in the animal reservoir. This study demonstrates the usefulness of the analysis of data from monitoring programmes at the isolate level to detect emerging threats and suggests aspects that should be subjected to further research to identify the forces driving the expansion/dominance of certain strains in the food chain.

Fructosylation of phenolic compounds by levansucrase from Gluconacetobacter diazotrophicus.

Fructosylation can significantly improve the solubility, stability and bioactivity of phenolic compounds, increasing their health benefits. Levansucrase from Gluconacetobacter diazotrophicus (LsdA, EC 2.4.1.10) was found to transfer the fructosyl unit of sucrose to different classes of phenolic compounds. Among the various acceptors tested, the isoflavone puerarin and the phenol coniferyl alcohol were the most efficiently fructosylated compounds, with conversion rates of 93% and 25.1%, respectively. In both cases, mono-, di-, and trifructosides were synthesized at a ratio of 37:14:1 and 32:8:1, respectively. Structural characterization of the puerarin mono-fructoside revealed that the enzyme transferred the fructosyl moiety of sucrose to the O6-position of the glucosyl unit of puerarin. The water solubility of fructosyl-ß-(2→6)-puerarin was increased 23-fold, up to 16.2 g L-1, while its antioxidant capacity was only decreased 1.25-fold compared with that of puerarin.

Functionalization of natural compounds by enzymatic fructosylation.

Enzymatic fructosylation of organic acceptors other than sugar opens access to the production of new molecules that do not exist in nature. These new glycoconjugates may have improved physical-chemical and bioactive properties like solubility, stability, bioavailability, and bioactivity. This review focuses on different classes of acceptors including alkyl alcohols, aromatic alcohols, alkaloids, flavonoids, and xanthonoids, which were tested for the production of fructoderivatives using enzymes from the glycoside hydrolase (GH) families 32 and 68 that use sucrose as donor substrate. The enzymatic strategies and the reaction conditions required for the achievement of these complex reactions are discussed, in particular with regard to the type of acceptors. The solubility and pharmacokinetic and antioxidant activity of some of these new ß-D-fructofuranosides in comparison is reviewed and compared with their glucoside analogs to highlight the differences between these molecules for technological applications.

Sistemas de autoligado. Caso clínico

En la actualidad, la ortodoncia desempeña un papel muy importante en la vida de los pacientes. Han salido muchos sistemas ortodónticos al mercado tratando de que el tratamiento de ortodoncia sea más rápido, cómodo y eficaz. Sin duda alguna, el sistema de autoligado viene a revolucionar la ortodoncia, debido a que es un sistema pensado en la comodidad del paciente, así como reducir el tiempo disminuyendo la fricción. El lapso de tratamiento es un factor clave, ya que se puede dar estabilidad postretención, aun cuando este haya sido corto. Se presenta una paciente de 21 años, con clase II esquelético, hiperdivergente, clase I molar bilateral, clase I canina bilateral, mordida abierta anterior, mordida cruzada del segundo premolar superior derecho, caninos fuera de arco, apiñamiento moderado superior y leve inferior, líneas medias dentales desviadas superior de 1 mm a la derecha, e inferior de 0,5 mm a la izquierda hipoplasia generalizada del esmalte. Terceros molares ausentes. Se le realizó el tratamiento de alineación, nivelación, suavizado interproximal, detallado y retención.

Today, orthodontics plays a very important role in the lives of patients. There is many orthodontic systems market trying to orthodontic treatment faster, convenient and effective. The self-ligating system will revolutionize orthodontics because it is a thought system patient comfort and reduce time reducing friction. The treatment time is a key factor, because it can provide stability post retention, even when there has been short. A 21 years old female patient is presented with a skeletal class II, hyperdivergent, molar and canine bilateral class I, anterior open bite, second right premolar in crossbite, canines outside arc, moderated upper crowding and light lower crowding. Deviated lower midline 0.5 mm to left, widespread enamel hipoplasia. Third molars absent. She underwent in alighment, leveling, stripping, detailing and retention treatment. Keywords: Class II, cross bite, moderated crowding. Trainer.

Surface passivation and optical characterization of Al2O3/a-SiCx stacks on c-Si substrates.

The aim of this work is to study the surface passivation of aluminum oxide/amorphous silicon carbide (Al2O3/a-SiCx) stacks on both p-type and n-type crystalline silicon (c-Si) substrates as well as the optical characterization of these stacks. Al2O3 films of different thicknesses were deposited by thermal atomic layer deposition (ALD) at 200 °C and were complemented with a layer of a-SiCx deposited by plasma-enhanced chemical vapor deposition (PECVD) to form anti-reflection coating (ARC) stacks with a total thickness of 75 nm. A comparative study has been carried out on polished and randomly textured wafers. We have experimentally determined the optimum thickness of the stack for photovoltaic applications by minimizing the reflection losses over a wide wavelength range (300-1200 nm) without compromising the outstanding passivation properties of the Al2O3 films. The upper limit of the surface recombination velocity (S eff,max) was evaluated at a carrier injection level corresponding to 1-sun illumination, which led to values below 10 cm/s. Reflectance values below 2% were measured on textured samples over the wavelength range of 450-1000 nm.

Converging hazard assessment of gold nanoparticles to aquatic organisms.

The gold nanoparticles (Au-NPs) are being increasingly used because of their huge diversity of applications, and consequently, elevated levels in the environment are expected. However, due to their physico-chemical properties and functionalization a high variety of Au-NPs can be found, and complete toxicological information for each type of Au-NPs still lacks, and even, the toxicological information for the same species is sometimes contradictory. Therefore, hazard assessment should be done case by case. Hence, the objective of this study was to obtain ecotoxicological information of the same Au-NPs in aquatic organisms and to find a rationale for Au-NPs toxicity. For such a purpose, bare and hyaluronic acid capped Au-NPs (12.5 nm) along with Au-NPs bulk material were tested on freshwater algae, Daphnia and zebrafish. Results showed that while gold nanoparticles were found to be harmless to the tested organisms, the soluble gold showed to be toxic to algae and Daphnia, with an LC50 between 1 and 2 mg L(-1). Comparing our results with those gathered in the literature, it appears that a common hazard assessment of Au-NPs on the studied organisms can be elucidated.

First characterization of fluoroquinolone resistance in Streptococcus suis.

We have identified and sequenced the genes encoding the quinolone-resistance determining region (QRDR) of ParC and GyrA in fluoroquinolone-susceptible and -resistant Streptococcus suis clinical isolates. Resistance is the consequence of single point mutations in the QRDRs of ParC and GyrA and is not due to clonal spread of resistant strains or horizontal gene transfer with other bacteria.