Quantification of microplastics in wastewater systems of German industrial parks and their wastewater treatment plants.

Microplastics (MP) enter the aquatic environment via several pathways. Many research groups have focused on municipal discharge, while research on industrial sources is rare. This study provides one of the first insights into MP occurrence and distribution in the wastewater systems of industrial parks (IPs) and their wastewater treatment plants (IPWWTPs). The effluents from production plants as well as influent, effluent, and internal samples from the IPWWTPs were assessed. Sampling methods for parallel MP mass and number analyses were developed for varying conditions. The total item emissions of MP (≥10 µm) into the environment were analyzed using µ-Raman spectroscopy and ranged from 3 · 102 to 8 · 104 MP m-3, with a median of 6 · 103 MP m-3 per IPWWTP. Masses analyzed using differential scanning calorimetry showed an MP mass discharge into the environment of 0.2 to 11 mg m-3 with a median of 3.7 mg m-3 per IPWWTP. MP item concentrations within an IPWWTP varied by two to three log levels over several days. Fibers were rare in all samples. Polymer types varied depending on the types of industrial sites and the production plants discharging into the IPWWTP. Within an IP, MP could be allocated to its dischargers, which could be useful for future regulatory requirements. Further research is needed to include different types of IPs producing various polymers and additional processing plants to expand this data set.

Influenza and pneumococcal vaccine prescription for adults during COVID-19 first wave in three regions of Argentina.

Immunizations for influenza and pneumococcus are effective interventions in reducing morbidity and mortality. The objective of this study was to describe the vaccination rates in volunteers from three regions of Argentina during the COVID-19 pandemic. In 2020, 3853 adults were surveyed, 61.6 % were females, 45 % were aged between 40 and 60 and 18.6 % were > 60 years old. The commonest comorbidities were hypertension (12.9 %), dyslipidemia (8.5 %), and smokers or former smokers (9.2 %). The global influenza vaccination rate was 37.7 %, pneumococcal vaccination 24.7 %, and both 17.8 %. Multivariable regression showed that the vaccination rate increased with age and the presence of comorbidities. However, in the subgroup with indications for both vaccines, 71.7 % had the influenza vaccine, 59 % had the pneumococcal vaccine, and 28.3 % received neither. Our study suggests that influenza and pneumococcal vaccine percentages in high-risk patients in Argentina remain sub-optimal. Immunizations with proven reductions in morbimortality could have also been relegated during the COVID pandemic.

Valoración del strain auricular izquierdo en competidores de ultramaratón ¿Se extiende la fatiga cardíaca a todas las estructuras miocárdicas? / Evaluation of the left atrium strain in ultramarathon competitors. Does cardiac fatigue extend to all myocardial structures?

Resumen Introducción: La aurícula izquierda cumple varias funciones durante el ciclo cardíaco (reservorio, conducción y contracción), que podrían verse afectadas por la remodelación fisiológica al igual que por el estrés inducido por el ejercicio intenso (carreras de ultra-trail de montaña). Objetivo: Valorar si las adaptaciones fisiológicas de la aurícula izquierda al deporte (aumento del volumen auricular), así como el estrés inducido por las competiciones de ultramaratón, influyen en la función auricular izquierda estimada por strain auricular realizado mediante speckle tracking. Método: Fueron evaluados 28 participantes antes y después del ejercicio (en el transcurso de 1 hora posterior al esfuerzo de carreras de ultra-trail) utilizando ecocardiografía Doppler y nuevas técnicas ecocardiográficas (posprocesamiento). Se excluyeron cinco deportistas: dos por regular ventana ecocardiográfica que no permitía visualizar correctamente el borde endomiocárdico y tres por no finalizar la carrera. Se realizaron estadística descriptiva convencional, análisis comparativo para datos pareados mediante test t de Student y correlación de Pearson para valorar factores que influyeran en las alteraciones detectadas. Resultados La mediana de edad de los competidores fue de 38 ± 9 años, con predominancia del sexo masculino (n = 17, 65%). En el ecocardiograma basal se encontró una media de volumen auricular izquierdo de 33 ± 7 ml/m2 (min. 21 ml/m2, max. 47 ml/m2), con strain auricular izquierdo basal promedio del 31%. En la evaluación tras el esfuerzo se observó una disminución no significativa del volumen auricular izquierdo, que mantuvo el strain auricular e incluso aumentó su deformación, como en el caso de las mujeres evaluadas. Conclusiones: A diferencia de lo observado en otros parámetros de función ventricular tras un esfuerzo, el strain auricular no se ve afectado por la fatiga cardíaca.

Abstract Introduction: The left atrium fulfills several functions during the cardiac cycle (reservoir, conduction and contraction) that could be affected by physiological remodeling as well as by stress induced by intense exercise (ultra-mountain trail races). Objective: To assess whether the physiological adaptations of the left atrium to sport (increase in atrial volume) as well as the stress induced by ultramarathon competitions influence left atrial function estimated by atrial strain performed by speckle tracking. Method: 28 participants were evaluated pre and post exercise, using Doppler echocardiography and new echocardiographic techniques. Conventional descriptive statistics, comparative analysis were performed for paired data using the t test and Pearson correlation to assess factors that influence the detected alterations. Results: The median age of the competitors was 38 ± 9 years with a predominance of males (n = 17, 65%). In the basal echocardiogram, we found an average left atrial volume of 33 ± 7 ml/m2 (min. 21 ml/m2, max. 47 ml/m2), with an average baseline left atrial strain of 31%. In the post-effort evaluation, a non-significant decrease in left atrial volume was observed, maintaining atrial strain and even increasing its deformation, as in the case of the women evaluated. Conclusions: Unlike what was observed in other parameters of ventricular function after effort, atrial strain is not affected by cardiac fatigue.

Risk factors for nosocomial SARS-CoV-2 infections in patients: results from a retrospective matched case-control study in a tertiary care university center.

BACKGROUND: Factors contributing to the spread of SARS-CoV-2 outside the acute care hospital setting have been described in detail. However, data concerning risk factors for nosocomial SARS-CoV-2 infections in hospitalized patients remain scarce. To close this research gap and inform targeted measures for the prevention of nosocomial SARS-CoV-2 infections, we analyzed nosocomial SARS-CoV-2 cases in our hospital during a defined time period. METHODS: Data on nosocomial SARS-CoV-2 infections in hospitalized patients that occurred between May 2020 and January 2021 at Charité university hospital in Berlin, Germany, were retrospectively gathered. A SARS-CoV-2 infection was considered nosocomial if the patient was admitted with a negative SARS-CoV-2 reverse transcription polymerase chain reaction test and subsequently tested positive on day five or later. As the incubation period of SARS-CoV-2 can be longer than five days, we defined a subgroup of "definite" nosocomial SARS-CoV-2 cases, with a negative test on admission and a positive test after day 10, for which we conducted a matched case-control study with a one to one ratio of cases and controls. We employed a multivariable logistic regression model to identify factors significantly increasing the likelihood of nosocomial SARS-CoV-2 infections. RESULTS: A total of 170 patients with a nosocomial SARS-CoV-2 infection were identified. The majority of nosocomial SARS-CoV-2 patients (n = 157, 92%) had been treated at wards that reported an outbreak of nosocomial SARS-CoV-2 cases during their stay or up to 14 days later. For 76 patients with definite nosocomial SARS-CoV-2 infections, controls for the case-control study were matched. For this subgroup, the multivariable logistic regression analysis revealed documented contact to SARS-CoV-2 cases (odds ratio: 23.4 (95% confidence interval: 4.6-117.7)) and presence at a ward that experienced a SARS-CoV-2 outbreak (odds ratio: 15.9 (95% confidence interval: 2.5-100.8)) to be the principal risk factors for nosocomial SARS-CoV-2 infection. CONCLUSIONS: With known contact to SARS-CoV-2 cases and outbreak association revealed as the primary risk factors, our findings confirm known causes of SARS-CoV-2 infections and demonstrate that these also apply to the acute care hospital setting. This underscores the importance of rapidly identifying exposed patients and taking adequate preventive measures.

Diferencias de sexo entre deportistas de ultramaratón preesfuerzo y posesfuerzo / Sex differences between pre and post effort ultra marathon athletes

RESUMEN Introducción: La presencia de mujeres en las competencias de ultramaratón se observa cada vez con más frecuencia. Las adaptaciones fisiológicas y la respuesta al máximo esfuerzo se diferencian influenciados por el sexo. Objetivos: Evaluar las diferencias observadas en los deportistas de ultramaratón o ultratrail (carreras de montaña de más de 42 km) en reposo (adaptaciones fisiológicas) y en el posesfuerzo (fatiga cardíaca inducida por el ejercicio [FCIE]), estratificado por parámetros de entrenamiento. Material y métodos: Se reclutaron veinticinco deportistas (mujeres n 6) que participaron de la carrera cruce Mendoza (55 km en montaña); fueron evaluados antes y después de la finalización de la carrera mediante ecocardiografía Doppler y técnicas de deformación miocárdica (posprocesamiento). Mediante relojes deportivos se documentaron parámetros durante el entrenamiento y la carrera. Se realizó extracción de sangre posesfuerzo inmediato para documentar variables asociadas con fatiga cardíaca. Resultados: Completaron la carrera 24 deportistas, 19 hombres (42 ± 12 años) y 5 mujeres (38 ± 4 años). Las mujeres presentaban parámetros similares de entrenamiento y completaron la prueba sin diferencia en tiempos respecto a los hombres. Se observó disminución de los parámetros de función miocárdica izquierda (fatiga cardíaca inducida por el ejercicio) en el 50% de los hombres y el 5% de las mujeres. Conclusiones: A pesar de no encontrar diferencias en las características del entrenamiento, se observó en las mujeres menos adaptación fisiológica basal y menor incidencia de fatiga cardíaca inducida por el ejercicio.

ABSTRACT Introduction: the presence of women in ultramarathon competitions is observed with increasing frequency. Physiological adaptations and response to maximum effort are differentiated influenced by sex. Objectives: to evaluate the differences observed in ultramarathon or ultratrail athletes (mountain races over 42 km) at rest (physiological adaptations) and at post-effort (exercise-induced cardiac fatigue-FCIE), stratified by training parameters. Material and methods: twenty-five athletes (women n 6) who participated in the Mendoza crossing race (55 km in the mountains) were recruited, being evaluated before and after the end of the race using Doppler echocardiography and myocardial deformation techniques (post-processing). Through sports watches, parameters during training and running are documented. Immediate post-effort blood collection was performed to document variables associated with cardiac fatigue. Results: 24 athletes completed the race, 19 men (42 ± 12 years) and 5 women (38 ± 4 years). The women presented similar training loads and completed the test with no difference in time compared to the men. Decreased left myocardial function parameters (exercise-induced cardiac fatigue) were observed in 50% of men and 5% of women. Conclusions: Despite not finding differences in training characteristics, less baseline physiological adaptation and a lower incidence of exercise-induced cardiac fatigue were observed in women.

Electrocardiografía en chequeo médico precompetitivo: subanálisis de un registro unicéntrico prospectivo / Electrocardiography in pre-competitive medical fit: Subanalysis of a prospective single-center registry

Resumen Introducción: La interpretación del electrocardiograma del deportista muchas veces se ve complicada por los cambios producidos por el entrenamiento prolongado. Objetivos: Comparar la aplicación de los criterios de Seattle para valoración electrocardiográfica en deportistas en un grupo de cardiólogos del instituto de Cardiología y medicina del deporte, contra un profesional especializado en electrocardiografía del deportista, bajo los mismos criterios. Material y métodos: Sobre una base de datos prospectiva de pacientes que concurrieron al centro de medicina del deporte entre junio de 2017 y enero de 2018 para realización de apto físico, se incluyeron para el análisis 499 electrocardiogramas. Siete cardiólogos del Instituto de deportes (IW) valoraron los electrocardiogramas como "normales"; "alteraciones normales" o "alteraciones dudosas o anormales" (que requirieron más estudios en el seguimiento) conociendo los antecedentes del paciente al igual que los estudios realizados y la valoración cruzada de los electrocardiogramas dentro del instituto. Un cardiólogo del cuerpo médico de Boca Juniors especializado en electrocardiografía del deportista (FR) valoró los 499 electrocardiogramas de manera ciega (sin conocer los datos demográficos de los pacientes o los antecedentes patológicos) utilizando los mismos criterios. Resultados: De un total de 499 electrocardiogramas, 448 (89%) fueron interpretados como normales por el especialista en electrocardiografía del deporte vs. 459 (91%) por los cardiólogos del instituto de deporte. Respecto a alteraciones normales, 21 (4%) electrocardiogramas fueron considerados como alteraciones normales para el especialista en electrocardiografía vs. 23 (4%) por el instituto de deportes. 30 (6%) electrocardiogramas presentaron alteraciones dudosas o anormales para el especialista vs. 17 (3%) para el instituto de deporte. Conclusiones: La interpretación electrocardiográfica puede presentar variaciones de un centro a otro a pesar de utilizar criterios estandarizados. Es probable que la evaluación clínica influencie los resultados.

Abstract Introduction: The interpretation of the athlete's electrocardiogram is often complicated by the changes produced by prolonged training. Objective: To compare the application of Seattle criteria for electrocardiographic assessment in a group of cardiologists against a professional specialized in electrocardiography of the athlete under the same criteria. Material and methods: On a prospective database of recreational athletes who attended between June 2017 and January 2018 to perform physical fitness, 499 electrocardiograms were included for the analysis. Seven cardiologists from the Sports Institute (IW) rated the electrocardiograms as "normal"; "Normal alterations" or "dubious or abnormal alterations" knowing the patient's background as well as the studies performed. A cardiologist from the Boca Juniors medical team specialized in sportsman's electrocardiography (RF) assessed the 499 electrocardiograms blindly (without knowing the demographic data of the patients or the pathological background) using the same criteria. Results: Out of a total of 499 electrocardiograms, 448 (89%) were interpreted as normal by the sports electrocardiography specialist vs 459 (91%) by the cardiologists of the sports institute. Regarding normal alterations, 21 (4%) electrocardiograms were considered normal alterations for the electrocardiography specialist vs 23 (4%) by the sports institute. 30 (6%) electrocardiograms showed doubtful or abnormal alterations for the specialist vs 17 (3%) for the sports institute. Conclusions: The electrocardiographic interpretation can present variations from one center to another despite using standardized criteria. It is likely that the clinical evaluation.

Exercise-Induced Cardiac Fatigue in Recreational Ultramarathon Runners at Moderate Altitude: Insights From Myocardial Deformation Analysis.

BACKGROUND: Controversy exists on the actual occurrence of exercise-induced cardiac fatigue (EICF) with ultraendurance exercise, as well as on whether factors such as age or training status might predispose to this condition. The present study aimed to assess the occurrence of EICF among recreational ultramarathon runners, as well as to determine potential predictive factors. METHODS: Nineteen male recreational runners (42 ± 12yrs) participated in a 55-km trial race at moderate altitude (1,800-2,500 m). Participants were evaluated before and after the race using Doppler echocardiography and myocardial deformation analysis. EICF was determined as a reduction >5% of either left ventricular global longitudinal strain (LVGLS) or right ventricular free wall strain (RVFWS). Demographical (age, body mass index), training (training experience, volume and intensity), competition (finishing time, relative intensity) and biochemical variables (blood lactate, creatine kinase [CK] and CK-MB) were assessed as predictors of EICF. RESULTS: A significant reduction in LVGLS (20.1 ± 2.1% at baseline vs. 18.8 ± 2.4% at post-race, p = 0.026), but not in RVFWS (27.4 ± 7.0 vs. 24.6 ± 5.3%, p = 0.187), was observed after the race. EICF was present in 47 and 71% of the participants attending to the decrease in LVGLS and RVFWS, respectively. No associations were found between any of the analyzed variables and EICF except for age, which was associated with the magnitude of decrement of RVFWS (r = 0.58, p = 0.030). CONCLUSIONS: Ultramarathon running at moderate altitude seems to induce EICF in a considerable proportion of recreational athletes.

Investigation of microplastics contamination in drinking water of a German city.

The drinking water of a German city was investigated for microplastics. Random samples were taken from three house connections, one transfer station, and five consumption taps in an educational institution, an apartment, a single-family house, a residential building, and a commercial enterprise. The sample volumes ranged from 0.25-1.3 m3. A stainless-steel membrane served as a sampling filter. HCl was used for the acidic digestion of the inorganic precipitates. Raman micro spectroscopy was used for the analysis of microplastic particles. The detection limit was 10 µm. Particles and fibers ≥100 µm were measured on 100% of the filter area, while particles and fibers <100 µm were measured on 50% of the filter area. The analytical procedure was validated by determining recovery rates and analyses of blanks. In addition to microplastics, pigmented particles and fibers were also analyzed. Neither microplastic particles and fibers nor pigmented particles and fibers were detected at house connections and the transfer station. No microplastics were detected in any sample at consumption taps. At one tap, 113 ± 83 copper phthalocyanine particles m-3 were detected.

Impacto psicosocial de la pandemia por COVID-19 en adultos de Buenos Aires / Psychosocial Impact of the COVID-19 Pandemic on the Adult Population of Buenos Aires

RESUMEN Introducción: En marzo de 2020, la Organización Mundial de la Salud (OMS) declaró a la enfermedad SARS-CoV-2, coronavirus, una pandemia. Desde ese momento, se lleva a cabo un experimento psicológico notablemente grande en el mundo: el aislamiento social. Objetivos: Analizar la repercusión del aislamiento social sobre los hábitos saludables y algunos aspectos psicosociales y conductuales durante el confinamiento y las restricciones impuestas por la pandemia en el área metropolitana de Buenos Aires (AMBA). Material y métodos: Se confeccionó una encuesta y se convocó por redes sociales (WhatsApp, Instagram, Facebook, e-mail) a que la respondieran en forma anónima todos excepto el personal médico. Resultados: Tras 7 días de enviado el correspondiente enlace, habían contestado la encuesta 2912 personas; el 48,2% de ellas tenía entre 40 y 60 años y en su mayoría eran mujeres. El 43,53% percibieron modificaciones en sus hábitos de vida, como el aumento en las horas frente a dispositivos electrónicos, que se duplicó en la cuarentena. Esto se acompañó de mayor sedentarismo: el 83,5% hacía ejercicio antes de la pandemia, pero solo el 6,4% mantuvo la cantidad de horas semanales de ejercicio que hacía antes del aislamiento. El 43,52% presentó alteración en sus hábitos alimenticios y el 41% refirió síntomas compatibles con depresión, ansiedad, tristeza, falta de voluntad o desesperanza. Conclusiones: Nuestro estudio sugiere que el bienestar psicológico y los hábitos saludables son amenazados por el confinamiento establecido para contener la transmisión de COVID-19, por lo que es preciso implementar medidas para prevenir consecuencias en nuestra población.

ABSTRACT Background: In March 2020 the World Health Organization (WHO) declared the SARS-CoV-2 coronavirus a pandemic, and since then a remarkably large psychological experiment has been carried out in the world: social isolation. Objectives: The aim of this study was to analyze the impact of social isolation on healthy habits and psychosocial and behavioral aspects during the confinement and restrictions imposed by the pandemic in the metropolitan area of Buenos Aires (AMBA). Methods: An anonymous survey, excluding medical personnel, was carried out through social networks (WhatsApp, Instagram, Facebook and e-mail). Results: Within 7 days of sending the link 2,912 people answered the survey. Age was between 40 and 60 years in 48.2% of participants, with a predominance of women. In 43.53% of cases, respondents perceived changes in their lifestyle, such as a twofold increase of hours in front of electronic devices during quarantine. This was accompanied by a more sedentary lifestyle, since 83.5% exercised before the pandemic but only 6.4% maintained the prior hours of weekly physical activity. Altered eating habits was reported by 43.52% of participants and 41% referred symptoms compatible with depression, anxiety, sadness, unwillingness or hopelessness. Conclusions: Our study suggests that psychological wellbeing and healthy habits are threatened by confinement in the face of the COVID-19 pandemic, so it is necessary to implement measures to prevent consequences in our population.

Aspectos psicosociales de la pandemia COVID-19 en la población de la ciudad de Mendoza / Psychosocial aspects of the COVID-19 pandemic in the Mendoza population

RESUMEN Introducción: En marzo de 2020 la Organización Mundial de la Salud (OMS) declaró a la enfermedad SARS-CoV-2 coronavirus una pandemia; desde ese momento se lleva a cabo un experimento psicológico notablemente grande en el mundo: el aislamiento social. Objetivos: Analizar los aspectos psicosociales del confinamiento y las restricciones impuestas por la pandemia en la ciudad de Mendoza (Argentina). Material y métodos: Mediante la utilización de las redes sociales (WhatsApp, Instagram, Facebook, e-Mail) se realizó de manera anónima por medio de un formulario, una encuesta diseñada para valorar los aspectos psicosociales y conductuales del confinamiento obligatorio por la situación de pandemia, y cómo afectó a la población. Fue realizada en la ciudad de Mendoza capital y gran Mendoza utilizando la población que asiste al instituto de cardiología y medicina del deporte. Resultados: Contestaron la encuesta 915 personas en 10 días de enviado el link; el 49% de los participantes se encontraba entre los 20 y 40 años y la mayoría eran mujeres. El 80,7% de la población encuestada realizó ejercicio durante el tiempo de confinamiento, pero solo el 3,8% mantuvo la cantidad de horas previas de ejercicio semanal. El 44% de las personas aumentó el tiempo que pasaba frente a una pantalla y el 61% alteró sus hábitos alimentarios saludables. Al menos el 60% de la población encuestada refirió síntomas compatibles con depresión, ansiedad, tristeza, falta de voluntad o desesperanza. Conclusiones: El tiempo de confinamiento sin permitir actividades al aire libre, a pesar de la prohibición de contacto social, se asocia con cambios en el estilo de vida saludable.

ABSTRACT Background: In March 2020 the World Health Organization (WHO) declared SARS-CoV-2 coronavirus disease a pandemic, and since then the largest psychological experiment in the world is being carried out: social isolation. Objectives: The aim of this study was to analyze the psychosocial aspects of confinement and the restrictions imposed by the pandemic in the city of Mendoza, Argentina Methods: An anonymous survey using social networks (WhatsApp, Instagram, Facebook and e-mail) was designed to assess the psychosocial and behavioral aspects of mandatory confinement due to the pandemic and its impact in the population that attends the Institute of Cardiology and Sports in the city of Mendoza and Greater Mendoza. Results: The survey was answered by 915 persons within 10 days of sending the link; 49% of participants were between 20 and 40 years old with a majority of female gender. In 80.7% of cases they performed physical exercise during the confinement, but only 3.8% maintained the previous number of hours of weekly activity, 44% increased their time in front of a screen and 61% altered their healthy eating habits. At least 60% of the surveyed population reported symptoms compatible with depression: anxiety, sadness, unwillingness or hopelessness. Conclusions: Confinement without allowing outdoor activities, notwithstanding the proscription of social contact, is associated with changes in healthy lifestyle.

Fatiga cardíaca en corredores de ultra trail, observada por parámetros de nuevas técnicas ecocardiográficas / Cardiac Fatigue in Ultra-Marathon Runners Measured with Novel Techniques in Echocardiography

RESUMEN Introducción: El ejercicio físico intenso y prolongado puede producir adaptaciones fisiológicas y cambios agudos en el sistema cardiovascular, que han sido motivo de estudio en múltiples oportunidades. En este contexto, algunos autores sostienen que estas alteraciones agudas y transitorias serían adjudicables a la fatiga cardíaca. Objetivos: Examinar los cambios ecocardiográficos observados en los deportistas de ultratrail o ultramaratón (carreras de montaña con recorridos superiores a 42 km) en pre- y posesfuerzo mediante técnicas de deformación miocárdica por speckle tracking, teniendo en cuenta algunas características de la población (sexo, edad, carga de entrenamiento semanal). Material y métodos: Se reclutaron 28 participantes para ser evaluados antes y después del ejercicio (dentro de la primera hora posterior a aquel) utilizando ecocardiografía Doppler y nuevas técnicas ecocardiográficas (posprocesamiento). Se excluyeron 5 deportistas, 2 por presentar Regular ventana ecocardiográfica ecocardiográfica que no permitía visualizar correctamente el borde endomiocárdico y 3 por no haber finalizado la carrera. Se realizó una estadística descriptiva convencional y el análisis comparativo para datos apareados (pre- y posesfuerzo) mediante el test t de Student. Resultados: La mediana de edad de los deportistas fue de 38 ± 9 años, con predominancia de sexo masculino (n=17; 65%). En el ecocardiograma basal, encontramos función sistólica biventricular conservada, media de strain longitudinal global (SLG) de -19 ± 2% y media de strain de la pared libre del ventrículo derecho (SPLVd) de -25 ± 3%. En la evaluación posesfuerzo, se observaron alteraciones significativas al compararlas con los datos del ecocardiograma basal, como caída de la fracción de eyección, disminución del strain longitudinal global (SLG) y del SPLVd, y aumento del volumen del Vd. La torsión ventricular no se vio afectada. Conclusión: Después del ejercicio intenso se observa una disminución de los parámetros de deformación miocárdica medidos por speckle tracking, esto se interpreta como fatiga cardíaca inducida por el ejercicio.

ABSTRACT Introduction: Intense and prolonged physical exercise can produce physiological adaptations and acute changes in the cardiovascular system that have been the subject of study multiple times. In this context some authors speak that these acute and transient alterations would be attributable to cardiac fatigue. Objective: The objective of this work is to examine the echocardiographic changes observed in ultra trail athletes (mountain races over 42 kilometers) pre and post effort, according to population characteristics (sex, age, weekly training load), using techniques of myocardial deformation by speckle traking. Material and methods: Twenty-eight participants were evaluated pre and post exercise (within one hour after exertion) using Doppler echocardiography and new echocardiographic techniques (post processing). Conventional descriptive statistics and comparative analysis were performed for paired data using a T test. Results: The median age of the patients was 38 ± 9 years with male predominance (N17 / 65%). In the baseline echocardiogram, we found preserved bi-ventricular systolic function, mean global longitudinal strain (GLS) of -19% ± 2, mean right ventricular free wall strain (FWSVd) -25% ± 3. In the Post-stress evaluation significant alterations were observed when compared with the baseline echocardiogram data, such as drop in ejection fraction, decrease in GLS, FWSVd and increase in volume of you. Ventricular torsion was not affected. Conclusion: Post intense exercise is observed a decrease in myocardial deformation parameters measured by Speckle tracking, this is interpreted as cardiac fatigue induced by the exercise.

Determination of the microplastics emission in the effluent of a municipal waste water treatment plant using Raman microspectroscopy.

Samples from the secondary clarifier effluent of a waste water treatment plant (serving 98500 inhabitants) were analyzed to determine the microplastics (MP) emission. The samples were collected using a stainless steel centrifugal pump and filtered through a 10 µm stainless steel cartridge filter. Microplastics particles (MPPs) and microplastics fibers (MPFs) were recovered by chemical and physical sample purification. To remove natural organic matter, the samples were first subjected to oxidative treatment with H2O2 and NaClO. Inorganic materials were subsequently removed by density separation in ZnCl2 (ρ = 1.9 g/cm3) using a centrifuge. Special centrifuge tubes were developed for this purpose. Sample analysis was performed on a Si filter by Raman micro-spectroscopy. Particles with a diameter (dp) ≥ 10 µm were analyzed. The results were differentiated by dry and wet weather samples. On average, 5900 MPPs m-3 were identified in the effluent on wet weather days compared to 3000 MPPs m-3 on dry weather days. Most of the MPPs detected were in the 30 µm < dp < 100 µm size range. The MPFs ranged between 100 µm and 1000 µm in length. While most of the MPFs were of PET origin, the MPPs consisted mainly of PET, PP, PE and PS.

Genome-wide association analysis of diverticular disease points towards neuromuscular, connective tissue and epithelial pathomechanisms.

OBJECTIVE: Diverticular disease is a common complex disorder characterised by mucosal outpouchings of the colonic wall that manifests through complications such as diverticulitis, perforation and bleeding. We report the to date largest genome-wide association study (GWAS) to identify genetic risk factors for diverticular disease. DESIGN: Discovery GWAS analysis was performed on UK Biobank imputed genotypes using 31 964 cases and 419 135 controls of European descent. Associations were replicated in a European sample of 3893 cases and 2829 diverticula-free controls and evaluated for risk contribution to diverticulitis and uncomplicated diverticulosis. Transcripts at top 20 replicating loci were analysed by real-time quatitative PCR in preparations of the mucosal, submucosal and muscular layer of colon. The localisation of expressed protein at selected loci was investigated by immunohistochemistry. RESULTS: We discovered 48 risk loci, of which 12 are novel, with genome-wide significance and consistent OR in the replication sample. Nominal replication (p<0.05) was observed for 27 loci, and additional 8 in meta-analysis with a population-based cohort. The most significant novel risk variant rs9960286 is located near CTAGE1 with a p value of 2.3×10-10 and 0.002 (ORallelic=1.14 (95% CI 1.05 to 1.24)) in the replication analysis. Four loci showed stronger effects for diverticulitis, PHGR1 (OR 1.32, 95% CI 1.12 to 1.56), FAM155A-2 (OR 1.21, 95% CI 1.04 to 1.42), CALCB (OR 1.17, 95% CI 1.03 to 1.33) and S100A10 (OR 1.17, 95% CI 1.03 to 1.33). CONCLUSION: In silico analyses point to diverticulosis primarily as a disorder of intestinal neuromuscular function and of impaired connective fibre support, while an additional diverticulitis risk might be conferred by epithelial dysfunction.

Eficacia y seguridad de la guía ecocardiográfica para la toma de biopsias endomiocárdicas en el postrasplante cardíaco / Efficacy and Safety of Echocardiographic Guidance for Post-Transplant Endomyocardial Biopsy Sampling

RESUMEN Introducción: La biopsia endomiocárdica es un procedimiento de mucha utilidad para valorar el rechazo agudo en pacientes trasplantados, sin embargo, puede causar complicaciones. Objetivo: El propósito de este estudio es demostrar la eficacia y seguridad del ecocardiograma como guía para la biopsia endomiocárdica. Material y métodos: Se realizó un análisis retrospectivo de pacientes trasplantados sometidos a biopsia endomiocárdica entre noviembre de 2004 y noviembre de 2016. Se analizaron datos demográficos y complicaciones mediante estadística descriptiva. Resultados: Un total de 200 pacientes se sometieron a 2665 biopsias endomiocárdicas, con un promedio de 13 procedimientos por paciente. Se produjeron complicaciones en 5 pacientes: 2 neumotórax (0,1%), 3 alteraciones transitorias en el electrocardiograma (0,1%). No se logró acceso vascular en 25 pacientes (0,9%). Ningún paciente falleció durante el procedimiento o requirió cirugía de urgencia para tratar las complicaciones. Conclusión: La biopsia endomiocárdica guiada por ecocardiografía es un procedimiento seguro y con baja tasa de complicaciones.

ABSTRACT Background: Endomyocardial biopsy is a very useful procedure to assess acute rejection in transplant patientis, but it can cause several complications. Objective: The purpose of this study is to demonstrate the efficacy and safety of echocardiography as a guide for endomyo-cardial biopsy sampling. Methods: A retrospective analysis of transplant patientis undergoing endomyocardial biopsies was carried out between No-vember 2004 and November 2016. Demographic data and complications were analyzed with descriptive statistics. Resultis: A total of 200 patientis underwent 2,665 endomyocardial biopsies, with an average of 13 procedures per patient. Complications occurred in 5 patientis: 2 pneumothorax (0.1%) and 3 transient alterations in the electrocardiogram (0.1%), and vascular access could not be achieved in 25 patientis (0.9%). No patient died during the procedure or required emergency surgery to treat the complications. Conclusion: Endomyocardial biopsy guided by echocardiography is a safe procedure with a low rate of complications.

[Trauma, Resilience, and Emotion Regulation]. / Trauma, Resilienz und Emotionsregulation.

Background: History of childhood abuse and neglect is considered to be a relevant risk factor for adult psychopathology. A functional emotion regulation (ER) can account for resilience despite of traumatic experiences in childhood. Materials & Methods: This study compares the habitual use of specific ER strategies among mentally healthy individuals with (n=61) and without (n=52) experience of childhood abuse and neglect by using the self-rating instrument Heidelberg Form for Emotion Regulation Strategies (H-FERST). SCID-I, ADP-IV, SCL-27, and BDI-II were used for assessment of psychopathological distress. Results: We found no group difference in the habitual use of ER strategies. Healthy individuals with childhood abuse and neglect showed significantly more subjective distress symptoms. Discussion & Conclusion: Considering the significantly higher psychopathological distress reported by the trauma group, the functional habitual use of ER strategies could serve as a path to explain the resilient development of adult individuals after childhood abuse and neglect.

Planning of mandibular reconstructions based on statistical shape models.

PURPOSE: The reconstruction of large continuity defects of the mandible is a challenging task, especially when the shape of the missing part is not known prior to operation. Today, the surgical planning is based mainly on visual judgment and the individual skills and experience of the surgeons. The objective of the current study was to develop a computer-based method that is capable of proposing a reconstruction shape from a known residual mandible part. METHODS: The volumetric data derived from 60 CT scans of mandibles were used as the basis for the novel numerical procedure. To find a standardized representation of the mandible shapes, a mesh was elaborated that follows the course of anatomical structures with a specially developed topology of quadrilaterals. These standard meshes were transformed with defined mesh modifications toward each individual mandible surface to allow for further statistical evaluations. The data were used to capture the inter-individual shape variations that were considered as random field variations and mathematically evaluated with principal component analysis. With this information of the mandibular shape variations, an algorithm was developed that proposes shapes for reconstruction planning based on given residual mandible geometry parts. RESULTS: The accuracy of the novel method was evaluated on six different virtually defined continuity defects that were each created on three mandibles that were not part of the initial database. Virtual reconstructions showed sufficient accuracy of the algorithm for the planning of surgical reconstructions, with average deviations toward the actual geometry of [Formula: see text] mm for small missing parts and 5 mm for large hemi-lateral defects. CONCLUSIONS: The presented algorithm may be a valuable tool for the planning of mandibular reconstructions. The proposed shapes can be used as templates for computer-aided manufacturing, e.g., with 3D printing devices that use biocompatible materials.

Substance use to regulate intense posttraumatic shame in individuals with childhood abuse and neglect.

Childhood abuse and neglect (CAN) is considered as a risk factor for substance use disorder (SUD). Based on the drinking to cope model, this study investigated the association of two trauma-relevant emotions (shame and sadness) and substance use. Using ecological momentary assessment we compared real-time emotion regulation in situations with high and low intensity of shame and sadness in currently abstinent patients with CAN and lifetime SUD (traumaSUD group), healthy controls with CAN (traumaHC group), and without CAN (nontraumaHC group). Multilevel analysis showed a positive linear relationship between high intensity of both emotions and substance use for all groups. The traumaSUD group showed heightened substance use in low, as well as in high, intensity of shame and sadness. In addition, we found an interaction between type of emotion, intensity, and group: the traumaHC group exhibited a fourfold increased risk for substance use in high intense shame situations relative to the traumaSUD group. Our findings provide evidence for the drinking to cope model. The traumaSUD group showed a reduced distress tolerance for variable intensity of negative emotions. The differential effect of intense shame for the traumaHC group emphazises its potential role in the development of SUD following CAN. In addition, shame can be considered a relevant focus for therapeutic preinterventions and interventions for SUD after CAN.

Emotion dysregulation mediates the relationship between child maltreatment and psychopathology: A structural equation model.

The present study investigated the mediating effects of emotion dysregulation on the relationship between child maltreatment and psychopathology. An adult sample (N=701) from diverse backgrounds of psychopathology completed the Childhood Trauma Questionnaire (CTQ), the Difficulties in Emotion Regulation Scale (DERS), the Brief Symptom Inventory (BSI), and the negative affect subscale of the Positive and Negative Affect Schedule (PANAS) in a cross-sectional online survey. Correlational analyses showed that all types of child maltreatment were uniformly associated with emotion dysregulation, and dimensions of emotion dysregulation were strongly related to psychopathology. Limited access to strategies for emotion regulation emerged as the most powerful predictor. Structural equation modeling analyses revealed that emotion dysregulation partially mediated the relationship between child maltreatment and psychopathology, even after controlling for shared variance with negative affect. These findings emphasize the importance of emotion dysregulation as a possible mediating mechanism in the association between child maltreatment and later psychopathology. Additionally, interventions targeting specific emotion regulation strategies may be effective to reduce psychopathology in victims of child maltreatment.

Does Emotion Dysregulation Mediate the Relationship between Early Maltreatment and Later Substance Dependence? Findings of the CANSAS Study.

BACKGROUND/AIMS: Maltreatment in childhood and adolescence is a risk factor for substance use disorders (SUDs) in adulthood. This association has rarely been investigated in the light of emotion dysregulation. To fill this gap, this study examines emotion dysregulation and SUDs among adults with a history of early maltreatment. METHODS: Comparison of emotion dysregulation in adults with a history of early abuse and neglect who developed either an SUD (n = 105) or no mental disorder (n = 54). Further, a mediation model for the association between the severity of early maltreatment and SUDs was tested. Participants completed research diagnostic interviews for psychopathology, the Difficulties in Emotion Regulation Scale, and the Childhood Trauma Questionnaire. RESULTS: By using hierarchical regression techniques and mediational analyses controlling for age and gender, it was possible to provide evidence for the mediating role of emotion dysregulation between early emotional and physical maltreatment and later SUDs. CONCLUSIONS: Emotion dysregulation is a potential mechanism underlying the relationship between early emotional and physical maltreatment and the development of SUDs. In light of these findings, focusing on the early training of adaptive emotion regulation strategies after childhood maltreatment might be of considerable relevance to prevent the development of SUDs.

Structural heterogeneity in microcrystalline ubiquitin studied by solid-state NMR.

By applying [1-(13) C]- and [2-(13) C]-glucose labeling schemes to the folded globular protein ubiquitin, a strong reduction of spectral crowding and increase in resolution in solid-state NMR (ssNMR) spectra could be achieved. This allowed spectral resonance assignment in a straightforward manner and the collection of a wealth of long-range distance information. A high precision solid-state NMR structure of microcrystalline ubiquitin was calculated with a backbone rmsd of 1.57 to the X-ray structure and 1.32 Å to the solution NMR structure. Interestingly, we can resolve structural heterogeneity as the presence of three slightly different conformations. Structural heterogeneity is most significant for the loop region ß1-ß2 but also for ß-strands ß1, ß2, ß3, and ß5 as well as for the loop connecting α1 and ß3. This structural polymorphism observed in the solid-state NMR spectra coincides with regions that showed dynamics in solution NMR experiments on different timescales.