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INTRODUCTION: We analyze the diagnostic utility of urgent EEG (electroencephalogram) performed in children under 16 years of age in our center. MATERIAL AND METHODS: Descriptive, retrospective, observational study of consecutive patients from 0 to 16 years of age, who underwent an urgent EEG for any reason, from January to December 2022. RESULTS: Of the 388 patients, 70 were children: 37 (52.85%) women, and 33 (47.14%) men. Average age: 6.27⯱â¯4.809. Of the 70 patients, 6 (8.57%) had previous epilepsy. Reasons for consultation: 17 febrile seizures, 10 first focal seizures, 10 first TCG seizures, 6 paroxysmal episodes, 6 absences, 3 myoclonus of extremities, 3 syncope, 2 SE, 2 visual alterations, 2 low level of consciousness, 2 cyanosis, 2 suspected meningitis or encephalitis, 1 choking, 1 atypical headache, 1 chorea, 1 presyncope, 1 language delay. Of the 70 patients, 47 had a normal EEG (67.14%). Of the 47 patients with a normal EEG, 10 were diagnosed with epilepsy, and 3 of them began receiving antiepileptic treatment upon discharge. None of the patients with suspected syncope or paroxysmal disorder (17 patients, 24.28%) had EEG abnormalities. Of the 17 patients with atypical febrile seizures, 3 had EEG abnormalities. CONCLUSIONS: A third of the EEG records performed in the Emergency Department showed alterations, probably due to the time taken. Almost half of the patients with suspected epilepsy or EE showed EEG abnormalities, which confirmed the diagnosis in these cases and encouraged the clinician to start drug treatment. No case with a high suspicion of epilepsy was dismissed due to the normality of the EEG recording in our series. No patient diagnosed with syncope or paroxysmal disorder had EEG abnormalities. Nearly a quarter of patients with atypical febrile seizures showed EEG abnormalities. We barely register cases of status epilepticus, probably due to the degree of complexity of our center.
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The present numerical study reports the performance of a cooling system for solar photovoltaic panels (PV) using different nanofluids (Al2O3, CuO, and ZnO). A novel parallel flow channel with strategically placed baffles was analyzed to improve the heat transfer between the back of PV and the nanofluid. The nanoparticles' Brownian motion and the nanofluid temperature effect were considered. Computational fluid dynamics was used to simulate the interaction between the fluid in motion and panel materials. Various nanoparticle concentrations, Reynolds numbers (18-1800), and solar radiation values (200-1000 W/m2) were examined. The results showed that the nanofluid composed of CuO was the most effective, improving thermal efficiency by 5.67 % compared to pure water in the lowest Re range. A 10 % vol. concentration of Al2O3 reduced temperature by up to 15 % and increased electrical efficiency by 4 % when the Re varied from 18 to 42. However, increasing the Re number and having low solar radiation values decreased the contribution of the nanofluid. Additionally, using baffles in the flow channel improved electrical efficiency by 2 %.
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OBJECTIVE: The Autonomous Community of Galicia has adopted DECREE 216/2011 on health standards for poultry production, in addition to the Spanish national programs. However, no program has yet been implemented to eradicate campylobacteriosis, which shares the same reservoir. The aim of this study was to compare the evolution of Salmonella spp. isolates with respect to those of Campylobacter spp. in faecal samples received by the Microbiology Department. METHODS: A retrospective descriptive comparative study was conducted through the Laboratory Information System (SIL) of Salmonella spp. isolated against Campylobacter spp. in faeces between 2011 and 2022 at the Lucus Augusti University Hospital (HULA), Lugo, Spain. RESULTS: A total of 35,704 stool samples were analysed, of which 3,045 were positive. 751 Salmonella spp. were isolated. Statistical differences were observed in the annual distribution (p<0.01), with a clear turning point in 2018. Five hundred and five patients required hospital care, especially in 2014 with 72 patients (69%). On the other hand, 1,587 Campylobacter spp. were isolated. Required hospital care 1,002 patients during the study, with a peak in 2019 with 111 cases (62%). CONCLUSIONS: The reduction of salmonellosis cases and the maintenance of campylobacteriosis cases are directly related to the implementation of DECREE 216/2011. This, in turn, has reduced the pressure on hospitals in the HULA health area. Therefore, we believe that the ONE Health concept is being strengthened in the area studied.
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PURPOSE: The present umbrella review aimed to synthesize and critically assess the methodological and reporting quality of previous systematic reviews about the potential relationship between obesity or overweight and caries dental experience in pediatric patients. METHOD: Electronic database and manual searches were conducted in PubMed, Embase, and Cochrane Library up to July 2023. The risk of bias assessment of eligible systematic reviews was performed using the Risk Of Bias In Systematic reviews (ROBIS) tool. A systematization of the results was carried out in order to understand the possible relationship between the two conditions. RESULTS: Electronic and manual searches identified 136 titles and abstracts. After the removal of duplicates, 15 full-text articles were assessed for eligibility. Six studies were excluded, resulting in 8 systematic reviews and 1 scoping review that met the inclusion criteria. Five were systematic reviews without meta-analysis and the rest were conducted with quantitative analysis. CONCLUSION: Conflicting findings to date from this umbrella review suggest that the relationship between obesity and dental caries in children is still inconclusive and likely to be complex.
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In addition to its central role in cellular metabolism, adenosine 5'-triphosphate (ATP) is an important extracellular signalling molecule involved in various physiological processes. In reproduction, extracellular ATP participates in both autocrine and paracrine paths regulating gametogenesis, gamete maturation and fertilisation. This review focusses on how extracellular ATP modulates sperm physiology with emphasis on the mammalian acrosome reaction. The presence of extracellular ATP in the reproductive tract is primarily determined by the ion channels and transporters that influence its movement within the cells comprising the tract. The main targets of extracellular ATP in spermatozoa are its own transporters, particularly species-specific sperm purinergic receptors. We also discuss notable phenotypes from knock-out mouse models and human Mendelian inheritance related to ATP release mechanisms, along with immunological, proteomic, and functional observations regarding sperm purinergic receptors and their involvement in sperm signalling.
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Adenosina Trifosfato , Espermatozoides , Animales , Masculino , Espermatozoides/metabolismo , Espermatozoides/fisiología , Adenosina Trifosfato/metabolismo , Humanos , Reacción Acrosómica/fisiología , Receptores Purinérgicos/metabolismo , Transducción de Señal , Mamíferos/fisiología , RatonesRESUMEN
Deforestation is one of the most relevant transformations characterizing global environmental change in the tropics at present. There is wide consensus in pointing the context-dependent nature of tropical deforestation. In this sense, a better characterization of the phenomenon considering the social context could provide a more accurate picture of tropical deforestation. With this aim, a Q-methodology discourse analysis was conducted to characterise the different discourses that coexist in the particular region of the Paraguayan Chaco concerning the development of cattle ranching and derived deforestation. Four different discourses were identified as making sense the wide range of interests and values coexisting and clashing in the Paraguayan Chaco, namely: the Environmentalist discourse, the Business discourse, the Resigned discourse, and the Possibilist discourse. The results point that the fundamental differences between the discourses are largely explained by the different positions on three specific domains: (i) the socio-economic benefits the expansion of cattle ranching brings about; (ii) the environmental impacts the expansion of cattle ranching and the derived deforestation brings on; and, finally (iii) the degree to which an active intervention from the side of policy making to regulate the expansion of cattle ranching and to minimize possible detrimental effects is seen as necessary. The position of the different discourses in relation to these domains could help policy makers to make measures and regulations more widely accepted and followed.
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Conservación de los Recursos Naturales , Ganado , Animales , Conservación de los Recursos Naturales/métodos , Paraguay , BovinosRESUMEN
A chain formation strategy based on mobile frames for a set of n differential drive mobile robots is presented. Considering two consecutive robots in the formation, robots Ri and Ri+1. It is intended that robot Ri+1 follows the delayed trajectory, τ units of time, of the leader robot Ri. In this way, the follower robot Ri+1 becomes the leader robot for robot Ri+ 2 in the formation and so on. With this formation policy, the trailing distance between two consecutive robots varies accordingly to the velocity of the Ri leader robot. Mobile frames are located on the body of the vehicles, in such a way that the position of robot Ri is determined with respect to the frame located on Ri+1 robot. The strategy relies on the fact that the general leader robot R1 describes any trajectory generated by bounded linear v1(t) and angular ω1(t) velocities. For the remaining vehicles in the string, the strategy considers a desired trajectory for the follower robot Ri+1 obtained by an estimation of the delayed trajectory of the leader robot Ri. This desired estimated trajectory is obtained under the knowledge of the actual and past input velocities of the Ri robot. To formally prove the convergence of the formation strategy, the equations describing the time variation of the relative posture between any pair of consecutive vehicles in the formation are obtained, and a feedback law based on local measurements is proposed to get the convergence of robot Ri+1 to the delayed trajectory, τ units of time, of the trajectory previously described by robot Ri. Lyapunov techniques are considered for this fact. The effectiveness of the chain formation solution is evaluated by means of numerical simulations and real time experiments showing an adequate convergence.
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Robótica , Conocimiento , Políticas , Postura , Sistemas de LecturaRESUMEN
Production of agricultural biofuels is expected to rise due to increasing climate change mitigation ambitions. Policy interventions promoting targeted bioenergy solutions can be motivated by the large environmental externalities present in agricultural systems and the local context of biomass production co-benefits. Introducing energy crops in crop rotations in arable land with depleted Soil Organic Carbon (SOC) levels offers the potential to increase SOC stocks and future crop yields as a step towards more sustainable agricultural systems. However, the environmental performance of a policy incentive for energy crops with SOC co-benefits is less evident when considering its land-use effects within and outside of the target agricultural system. We study the potential impacts of a change in agricultural policy on regional agricultural structure and production, and the environment with an Agent-Based Life Cycle Assessment approach. We simulate a policy payment that would achieve adoption of grass leys in crop rotations corresponding to 25 % of the highly productive land in an intensive farming region of southern Sweden. Although enhancing soil health in SOC-depleted farming regions is a desirable environmental objective, its significance is limited within the life-cycle performance of the payment. Instead, crop-displacement impacts and the grass potential as biofuel feedstock are the main drivers. The active utilisation of grasses for biofuel purposes is key in reaching a positive environmental evaluation of the policy instrument. Our environmental evaluation is likely generalisable to other regions with similar technological levels and farming intensity, while our analysis on structural shifts is specific to the policy instrument and agricultural production system under study. Overall, our work provides a method to contrast regional effects and global environmental impacts of policy instruments supporting agricultural biomass for biofuels prior to implementation. This contributes to the environmental assessment of land-based biofuels at a time when their sustainability is highly debated.
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Biocombustibles , Suelo , Animales , Suelo/química , Biomasa , Carbono/análisis , Agricultura/métodos , Estadios del Ciclo de VidaRESUMEN
As the human population grows, an increase in food trade is needed. This elevates the risk of epidemiological outbreaks. One of the prevalent pathogens associated with food production in Mexico has been Salmonella Oranienburg. Effective surveillance systems require microbial genetic knowledge. The objective of this work is to describe the genetic composition of Mexican S. Oranienburg genomes. For that, 53 strains from different environmental sources were isolated and sequenced. Additionally, 109 S. Oranienburg genomes were downloaded. Bioinformatic analyses were used to explore the clonal complex and genomic relatedness. A major clonal group formed by ST23 was identified comprising four STs. 202 SNPs were found the maximum difference among isolates. Virulence genes for host invasion and colonization as rpoS, fimbria type 1, and, T3SS were found common for all isolates. This study suggests that Mexican S. Oranienburg strains are potential pathogens circulating continuously in the region between host and non-host environments.
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Genómica , Humanos , MéxicoRESUMEN
Winter legume cover crops or double-cropping in high N-fertilizer maize-based sprinkler-irrigated systems enhance agroecosystem diversity and potentially increase yields. However, the effects on direct N2O emissions and global warming potential (GWP) have not been fully established. For two years, in the Ebro Valley (Spain), four maize-based systems consisted of: long-season maize (Zea mays) with winter fallow period (F-LSM) the reference system; or after a leguminous cover crop (common vetch, Vicia sativa) (CC-LSM); and short-season maize after a cereal crop (barley, Hordeum vulgare) (B-SSM) or after a leguminous crop (pea, Pisum sativum) (P-SSM). They were assessed in terms of productivity, direct greenhouse gasses emissions (GHG: N2O, CH4, CO2), and global warming potential (GWP). Direct GHG emissions were measured using the static chamber technique, while soil parameters were monitored. Crop yields and nitrogen uptake were also quantified. GHG emissions linked to management and inputs were calculated to obtain GWP and greenhouse gas intensity (GHGI). The most productive system (B-SSM) obtained the highest direct (79 %, 35 %, and 30 % higher than the F-LSM, P-SSM, and CC-SSM, respectively) and scaled N2O emissions. The P-SSM system had similar N-uptake-scaled emissions to the monocropping (MC) systems. Irrigation, fertilizer, and farm operations accounted for the 26 %, 31 %, and 27 % of the total indirect emissions, respectively. Fertilizer production-related emissions in B-SSM and F-LSM systems were 172 % and 45 % higher than the average emissions in the systems with legumes (461 kg CO2eq. ha-1). Diversified systems lead to slightly higher GHGI values than the reference system (F-LSM). However, no differences were found between the F-LSM and P-SSM systems in GWP (4521 and 5512 kg CO2-eq. ha-1, respectively) or GHGI (144 and 158 kg CO2-eq. ha-1, respectively). The P-SSM system may be a potential alternative for increasing the diversification of maize-based irrigated agrosystems without increasing GHG emissions.
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Fabaceae , Gases de Efecto Invernadero , Zea mays , Dióxido de Carbono/análisis , Fertilizantes/análisis , Óxido Nitroso/análisis , Suelo , Verduras , Agricultura/métodos , Metano/análisisRESUMEN
OBJECTIVE: Urine culture as a gold standard for the diagnosis of urinary tract infection (UTI) involves a considerable workload in Clinical Microbiology Departments, due to the high number of samples received that will ultimately be negative. Therefore, it is necessary to use screening systems that also reduce the turnaround time for UTI diagnosis. The new flow cytometer UF-5000 (Sysmex Corporation) is able to differentiate between Gram-negative and Gram-positive bacteria using the BACT-info parameter according to manufacturer. The aim of our study was to evaluate the gram discrimination ability of the UF-5000 cytometer. METHODS: A prospective study with 449 urine samples collected consecutively was conducted, in the period 7/3/2022-27/5/2022, in which the BACT-info flag was compared with urine culture as the reference method. RESULTS: The sensitivity obtained for both Gram-negative and Gram-positive bacteria was above 95%. However, for Gram-positive bacteria, the moderate Kappa index (0.49) and the low positive predictive value (37.1%) indicated that the correlation between BACT-info flag and urine culture was not acceptable and should not be reported to the requesting clinician. CONCLUSIONS: Implementation of the third generation UF-5000 cytometer represents a significant advance in the aetiological orientation of UTIs caused by Gram-negative bacteria. Reporting the Gram morphology in the urine samples reduces the response time in the microbiological diagnosis of UTI, which would have an impact on the reduction and optimisation of empirical treatment, and thus on the generation of antimicrobial resistance.
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Infecciones Urinarias , Humanos , Estudios Prospectivos , Infecciones Urinarias/microbiología , Urinálisis/métodos , Bacterias Grampositivas , Bacterias Gramnegativas , Sensibilidad y Especificidad , Orina/microbiologíaRESUMEN
La hipotensión postoperatoria es un problema de salud frecuentemente subestimado, asociado a una elevada morbimortalidad y a un mayor uso de recursos sanitarios. También plantea importantes retos clínicos, tecnológicos y humanos para la asistencia sanitaria. Al tratarse de un factor de riesgo modificable y evitable, este documento pretende aumentar su visibilidad, definiendo su impacto clínico y los retos tecnológicos que conlleva la optimización de su manejo, teniendo en cuenta aspectos clínico-tecnológicos, humanísticos y económicos.(AU)
Postoperative hypotension is a frequently underestimated health problem associated with high morbidity and mortality and increased use of health care resources. It also poses significant clinical, technological, and human challenges for healthcare. As it is a modifiable and avoidable risk factor, this document aims to increase its visibility, defining its clinical impact and the technological challenges involved in optimizing its management, taking clinical-technological, humanistic, and economic aspects into account.(AU)
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Humanos , Masculino , Femenino , Indicadores de Morbimortalidad , Monitorización Hemodinámica , Complicaciones Posoperatorias , Hipotensión/prevención & controlRESUMEN
This systematic review assessed whether studies on the outcomes of perpetrator programs comply with the model recommendations for outcome evaluation. Three databases (PsycINFO, Medline, and Scopus) were used to identify perpetrator program outcome studies from 1988 to 2021. The inclusion criteria were as follows: empirical studies with no time restriction; published in English or Spanish; evaluated interventions aimed at male perpetrators of any type of abuse toward women; evaluated the effectiveness of the intervention in a follow-up post-intervention; and provided an indicator of recidivism. The search and selection process resulted in 46 original studies. The results showed that studies did not include a thorough description of the study sample. Many approaches to psychological intervention are used, with cognitive behavioral therapy being the most widely used. Most studies did not describe the program content. Dropout rates varied greatly from one study to another (from 0% to 64%) and only eight studies provided dropout rates specified by each type of perpetrator. The follow-up period ranged from 3 months to 9 years. The recidivism rates (ranging from 5% to 72.5%), and their assessments were also very different. Only 12 of the 46 studies (26.1%) used more than one source to obtain recidivism rates. In terms of outcomes, few studies considered (ex-) partner accounts. Some studies had other measures of outcome, whereas a few included a pretest-posttest. In summary, these studies do not follow the recommendations of the model.
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France and Spain have been fighting against bovine tuberculosis (bTB) for years, even though new outbreaks continue to appear on both sides of the border, generating misconceptions about the disease and social distrust in the eradication programme and competent authorities. The perceived disease risk and the commitment of all interested parties are key factors for the successful implementation of control programmes, as they might influence the acceptability of recommended measures. Effective communication can contribute to increasing knowledge, trust and stakeholders' engagement, thus ensuring the acceptability of the eradication programme. This study was conducted in Catalonia (Spain) and Pyrenees-Atlantiques (France) in the frame of the INNOTUB project (https://innotub.eu/) to characterise the communication on bTB in the trans-Pyrenees region and provide recommendations to improve it. The communication on bTB was characterised by analysing 153 (Spain) and 66 (France) online freely available texts, published between 2018 and 2020, through Content Analysis and Critical Metaphor Analysis. Moreover, six farmers and four veterinarians were in-depth interviewed in each area to gather information about the communication on bTB. Interviews were made in original languages and analysed using a qualitative thematic approach. A pilot participatory intervention inspired by the Systematic Tool for Behavioural Assumption Validation and Exploration (STAVE) method was used to develop a list of proposals to improve communication and to promote the creation of territorial networks/committees on bTB prevention and control. It included three focus groups with farmers and veterinarians, a meeting with representatives of the regional veterinary services, and a final deliberative workshop. Results highlight the existence of a controversial debate on bTB and a heterogeneous understanding between stakeholders. Institutional and scientific communication mainly focus on bTB detection and control while other aspects are left in the background. On the contrary, farmers extend their communication to a greater variety of topics. The metaphorical framing strongly differed among actors, while veterinary services and researchers "fight" against bTB and "progress" toward the eradication, farmers place themselves in a framework of "sacrifice" and, particularly in Spain, they play a passive role. The proposals developed by the participants to improve the current communication on bTB included: (i) create participatory meeting spaces to share opinions and information; (ii) improve data accessibility (on epidemiological situations); (iii) develop clearer and written protocols and informative visual material; (iv) redesign the training courses (v) increase the stakeholders' participation in the design of protocols.
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Enfermedades de los Bovinos , Tuberculosis Bovina , Veterinarios , Animales , Bovinos , Humanos , Tuberculosis Bovina/prevención & control , Tuberculosis Bovina/epidemiología , Agricultores , Comunicación , Actitud , Enfermedades de los Bovinos/prevención & controlRESUMEN
Water-use efficiency (WUE) is an under-researched but very important drought tolerance trait in forage breeding. This research estimated quantitative genetic parameters of morpho-physiological traits linked to agronomic water-use efficiency (WUEA) and its proxy measures based on δ13C (WUEi) or gas exchange (evapotranspiration, WUEAET, or stomatal conductance WUEASC) of genotypes from half-sib families of Lolium perenne L. (PRG) in a simulated summer drought cycle. Principal component analysis (PCA) of trait data distinguished a group of PRG genotypes where high WUEA and dry matter yield was associated with deep rooting, leaf hydration at more negative leaf osmotic and water potential, and reduced soil moisture depletion. Plants with this trait association sustained net assimilation and postdefoliation regrowth in drought. However, WUEi, WUEASC, and WUEAET were poorly correlated with most traits of interest at p < .05. Another PCA revealed a weak association between WUEA and its proxy measures under conditions tested. Quantitative genetic parameters including high estimates of narrow-sense heritability (hn2>0.7;p<.05) of WUEA and related traits emphasized the genetic potential of the key trait combination for selecting PRG for improved drought tolerance. Research findings highlight the relative importance of WUEA and its proxy measures in the broad definition of PRG drought tolerance for breeding purposes.
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En un esfuerzo por estandarizar el manejo perioperatorio y mejorar los resultados posoperatorios de los pacientes adultos sometidos a cirugía, el Ministerio de Sanidad, a través del Grupo Español de Rehabilitación Multimodal (GERM) y el Instituto Aragonés de Ciencias de la Salud, en colaboración con diversas sociedades científicas españolas, y sobre la base de la evidencia disponible, publicó en 2021 la guía Recuperación intensificada en cirugía del adulto (RICA). Dicho documento incluye 12 medidas perioperatorias relacionadas con la fluidoterapia y la monitorización hemodinámica. La administración de fluidos y la monitorización hemodinámica no son sencillas, pero están directamente relacionadas con los resultados de los pacientes. El Subcomité de Fluidoterapia y monitorización hemodinámica de la Sección de Hemostasia, Medicina transfusional y Fluidoterapia (SHTF) de la Sociedad Española de Anestesiología y Reanimación (SEDAR) ha analizado dichas recomendaciones, concluyendo que deberían ser revisadas, ya que no siguen la metodología adecuada. (AU)
In an effort to standardize perioperative management and improve postoperative outcomes of adult patients undergoing surgery, the Ministry of Health, through the Spanish Multimodal Rehabilitation Group (GERM), and the Aragonese Institute of Health Sciences, in collaboration with multiple Spanish scientific societies and based on the available evidence, published in 2021 the Spanish Intensified Adult Recovery (RICA) guideline. This document includes 12 perioperative measures related to fluid therapy and hemodynamic monitoring. Fluid administration and hemodynamic monitoring are not straightforward but are directly related to postoperative patient outcomes. The Fluid Therapy and Hemodynamic Monitoring Subcommittee of the Hemostasis, Transfusion Medicine and Fluid Therapy Section (SHTF) of the Spanish Society of Anesthesiology and Critical Care (SEDAR) has reviewed these recommendations and concluded that they should be revised as they do not follow an adequate methodology. (AU)