Highly Active W2C-Based Composites for the HER in Alkaline Solution: the Role of Surface Oxide Species.

The hydrogen evolution reaction (HER) is a crucial electrochemical process for the proposed hydrogen economy since it has the potential to provide pure hydrogen for fuel cells. Nowadays, hydrogen electroproduction is considerably expensive, so promoting the development of new non-noble catalysts for the cathode of alkaline electrolyzers appears as a suitable way to reduce the costs of this technology. In this sense, a series of tungsten-based carbide materials have been synthesized by the urea-glass route as candidates to improve the HER in alkaline media. Moreover, two different pyridinium-based ionic liquids were employed to modify the surface of the carbide grains and control the amount and nature of their surface species. The main results indicate that the catalyst surface composition is modified in the hybrid materials, which are then distinguished by the appearance of tungsten suboxide structures. This implies the action of ionic liquids as reducing agents. Consequently, differential electrochemical mass spectrometry (DEMS) is used to precisely determine the onset potentials and rate-determining steps (RDS) for the HER in alkaline media. Remarkably, the modified surfaces show high catalytic performance (overpotentials between 45 and 60 mV) and RDS changes from Heyrovsky-Volmer to Heyrovsky as the surface oxide structures get reduced. H2O molecule reduction is then faster at tungsten suboxide, which allows the formation of the adsorbed hydrogen at the surface, boosting the catalytic activity and the kinetics of the alkaline HER.

ILEOSTIM trial: a study protocol to evaluate the effectiveness of efferent loop stimulation before ileostomy reversal.

PURPOSE: A protective loop ileostomy is the most useful method to reduce sequelae in the event of an anastomotic leakage (AL) after rectal cancer surgery. However, it requires an additional stoma reversal surgery with its own potential complications. Postoperative ileus (POI) remains the most common complication after ileostomy reversal, which leads to an increase in morbidity, length of hospital stay (LOS) and overall healthcare costs. Several retrospective studies carried out in this field have concluded that there are insufficient evidence-based recommendations about the routine application of preoperative bowel stimulation in clinical practice. Here we discuss whether stimulation of the efferent limb before ileostomy reversal might reduce POI and improve postoperative outcomes. METHODS: This is a multicentre randomised controlled trial to determine whether mechanical stimulation of the efferent limb during the 2 weeks before the ileostomy reversal would help to reduce the development of POI after surgery. This study was registered on Clinicaltrials.gov (NCT05302557). Stimulation will consist of infusing a solution of 500 ml of saline chloride solution mixed with a thickening agent (Resource©, Nestlé Health Science; 6.4 g sachet) into the distal limb of the ileostomy loop. This will be performed within the 2 weeks before ileostomy reversal, in an outpatient clinic under the supervision of a trained stoma nurse. CONCLUSION: The results of this study could provide some insights into the preoperative management of these patients.

Effects of tetracycline, sulfonamide, fluoroquinolone, and lincosamide load in pig slurry on lettuce: Agricultural and human health implications.

The application of pig slurry as fertilizer in agriculture provides nutrients, but it can also contain veterinary medicines, including antibiotic residues (ABs), which can have an ecotoxicological impact on agroecosystems. Furthermore, uptake, translocation, and accumulation of ABs in crops can mobilize them throughout the food chain. This greenhouse study aims to assess AB uptake from soil fertilized with pig slurry and its phenotypical effects on Lactuca sativa L. The plants were cropped in loamy clay soil dosed at 140 kg total N/ha and containing antibiotics (lincomycin, sulfadiazine, oxytetracycline, and enrofloxacin) at different concentration levels (0, 0.05, 0.5, 5, 50, and 500 mg/kg fresh weight, fw). Whereas sulfadiazine (11.8 ng/g fw) was detected in lettuce leaves at the intermediate doses (0.5 mg/kg), lincomycin and its transformation products (hydroxy/sulfate) were only detected at the 50 mg/kg fw dose. In addition, increased AB doses in the pig slurry resulted in decreased lettuce fresh weight and lipid and carbohydrate content and became lethal to lettuce at the highest AB concentrations (500 mg/kg fw). Nevertheless, even at higher doses, the AB content in lettuce following pig-slurry fertilization did not pose any direct significant human health risk (total hazard quotient<0.01). However, the promotion of antimicrobial resistance in humans due to the intake of these vegetables cannot be ruled out.

Data supporting the in situ synthesis by organometallic method of Vulcan supported PdNi nanostructures for hydrogen evolution reaction in alkaline solution.

This document presents the supporting information for the evaluation of the role of Ni amount during the in situ synthesis of vulcan supported PdNi nanostructures using an organometallic approach for hydrogen evolution reaction in alkaline medium [1]. The data here presented included analysis of deconvolution during structural characterization, chemical composition and transmission electron microscopy. The information also contains complement data of cyclic voltammograms during activation in alkaline media. Supplement data of electrochemical impedance spectroscopy measurements at two different overpotentials (-100 and -300 mV) and temperatures on the onset potential for hydrogen evolution reaction (HER) are also showed in this paper. The files can be used as a reference to determinate the effect of adding different in situ amount of Ni to Pd/C catalysts in presence of 2 equivalents of hexadecylamine (HDA) in order to improve the electrochemical performance on HER using an adjusted organometallic method. The data provided in this article have not been previously published and are available to enable critical or extended analyses.

Effect of continuous positive airway pressure in very elderly with moderate-to-severe obstructive sleep apnea pooled results from two multicenter randomized controlled trials.

STUDY OBJECTIVE: There is very limited information about the effect of continuous positive airway pressure (CPAP) in the very elderly. Here we aimed to analysed the effect of CPAP on a clinical cohort of patients with obstructive sleep apnea (OSA) ≥80 years old. METHODS: Post-hoc pooled analysis of two open-label, multicenter clinical trials aimed to determine the effect of CPAP in a consecutive clinical cohort of elderly (≥70 years old) with moderate-to-severe OSA (apnea-hipopnea index ≥15 events/hour) randomized to receive CPAP or no CPAP for three months. Those consecutive patients ≥80 years old were included in the study. The primary endpoint was the change in Epworth Sleepiness scale (ESS). Secondary outcomes included sleep-related symptoms, quality of life, neurocognitive and mood status as well as office blood pressure measurements. RESULTS: From the initial 369 randomized individuals with ≥70 years, 97 (26.3%) with ≥80 years old were included (47 in the CPAP group and 50 in the no-CPAP group). The mean (SD) age was 81.5 (2.4) years. Average use of CPAP was 4.3 (2.6) hours/night (53% with good adherence) Patients in the CPAP group significantly improved snoring and witnessed apneas as well as AHI (from 41.9 to 4.9 events/hour). However no clinical improvements were seen in ESS (-1.2 points, 95%CI, 0.2 to -2.6), any domain of QSQ, any neurocognitive test, OSA-related symptoms, depression/anxiety or blood pressure levels. CONCLUSIONS: The present study does not support the use of CPAP in very elderly patients with moderate-to-severe OSA.

Ultrafast Loss of Lattice Coherence in the Light-Induced Structural Phase Transition of V_{2}O_{3}.

In solids, the response of the lattice to photoexcitation is often described by the inertial evolution on an impulsively modified potential energy surface which leads to coherent motion. However, it remains unknown if vibrational coherence is sustained through a phase transition, during which coupling between modes can be strong and may lead to rapid loss of coherence. Here we use coherent phonon spectroscopy to track lattice coherence in the structural phase transition of V_{2}O_{3}. In both the low and high symmetry phases unique coherent phonon modes are generated at low fluence. However, coherence is lost when driving between the low and high symmetry phases. Our results suggest strongly damped noninertial dynamics dominate during the phase transition due to disorder and multimode coupling.

Enfermedad de Stargardt: a propósito de dos hermanas con distintas evoluciones clínicas / Stargardt Disease: a clinical case report of two sisters with different clinical development

Se describen las manifestaciones clínicas y pruebas diagnósticas complementarias de dos hermanas de 26 y 31 años, con diagnóstico de enfermedad de Stargardt y su diferente evolución. Una de ellas presentó una agudeza visual (AV) inicial de 0,7, con disminución progresiva de la visión central por atrofia de las capas externas de la retina a nivel subfoveal, y fue reclutada para participar en un ensayo clínico con Avancincaptad Pegol (Zimura®), un inhibidor del factor de complemento C5. La otra hermana permaneció asintomática, con AV de 1 en ambos ojos. En los dos casos se apreciaron lesiones pisciformes blanco-amarillentas distribuidas en el polo posterior. No existe un tratamiento curativo para esta enfermedad, aunque en la actualidad hay numerosas líneas de investigación. La clínica y las pruebas diagnósticas permiten confirmar la enfermedad y dar a los pacientes un pronóstico adecuado (AU)

The purpose of this article is to describe the clinical manifestations and complementary diagnostic tests of two sisters aged 26 and 31 with a diagnosis of Stargardt's disease. One of them presented with an initial visual acuity of 0.7 and showed a progressive central visual loss due to the atrophy of the external layers of the retina in the subfoveal region. She was recruited to participate in a clinical trial of Avancincaptad Pegol (Zimura®), an inhibitor of C5 of the complement's system. The other sister remained asymptomatic with a visual acuity of 1 in both eyes. In both cases white-yellow pisciform lesions were observed on the posterior pole. Although there is no curative treatment for this disease, there are many lines of investigation on this topic. The clinical and diagnostic tests can confirm the disease, and provide patients with an accurate prognosis (AU)

Stargardt disease: A clinical case report of two sisters with different clinical development.

The purpose of this article is to describe the clinical manifestations and complementary diagnostic tests of two sisters aged 26 and 31 with a diagnosis of Stargardt's disease. One of them presented with an initial visual acuity of 0.7 and showed a progressive central visual loss due to the atrophy of the external layers of the retina in the subfoveal region. She was recruited to participate in a clinical trial of Avancincaptad Pegol (Zimura®), an inhibitor of C5 of the complement's system. The other sister remained asymptomatic with a visual acuity of 1 in both eyes. In both cases white-yellow pisciform lesions were observed on the posterior pole. Although there is no curative treatment for this disease, there are many lines of investigation on this topic. The clinical and diagnostic tests can confirm the disease, and provide patients with an accurate prognosis.

Stargardt Disease: a clinical case report of two sisters with different clinical development. / Enfermedad de Stargardt: a propósito de dos hermanas con distintas evoluciones clínicas.

The purpose of this article is to describe the clinical manifestations and complementary diagnostic tests of two sisters aged 26 and 31 with a diagnosis of Stargardt's disease. One of them presented with an initial visual acuity of 0.7 and showed a progressive central visual loss due to the atrophy of the external layers of the retina in the subfoveal region. She was recruited to participate in a clinical trial of Avancincaptad Pegol (Zimura®), an inhibitor of C5 of the complement's system. The other sister remained asymptomatic with a visual acuity of 1 in both eyes. In both cases white-yellow pisciform lesions were observed on the posterior pole. Although there is no curative treatment for this disease, there are many lines of investigation on this topic. The clinical and diagnostic tests can confirm the disease, and provide patients with an accurate prognosis.

A class of fast-slow models for adaptive resistance evolution.

Resistance to insecticide is considered nowadays one of the major threats to insect control, as its occurrence reduces drastically the efficiency of chemical control campaigns, and may also perturb the application of other control methods, like biological and genetic control. In order to account for the emergence and spread of such phenomenon as an effect of exposition to larvicide and/or adulticide, we develop in this paper a general time-continuous population model with two life phases, subsequently simplified through slow manifold theory. The derived models present density-dependent recruitment and mortality rates in a non-conventional way. We show that in absence of selection, they evolve in compliance with Hardy-Weinberg law; while in presence of selection and in the dominant or codominant cases, convergence to the fittest genotype occurs. The proposed mathematical models should allow for the study of several issues of importance related to the use of insecticides and other adaptive phenomena.

Neoadjuvant chemotherapy in locally advanced colon cancer: a systematic review.

BACKGROUND: Preoperative or neoadjuvant chemotherapy (NAC) has emerged as a novel alternative to treat locally advanced colon cancer (LACC), as in other gastrointestinal malignancies. However, evidence of its efficacy and safety has not yet been gathered in the literature. The aim of the present study was to perform an extensive review of the scientific evidence for NAC in patients with LACC. METHODS: PubMed, EMBASE, MEDLINE and Cochrane Library were searched for a systematic review of the literature from 2010 to 2019. Six eligible studies were included, with a total of 27,937 patients, 1232 of them (4.4%) treated with NAC. There were only one randomized controlled trial, three phase II non-randomized single arm studies and two retrospective studies. RESULTS: The baseline computed tomography scan showed that most of patients had a T3 tumor. The completion rate of the planned neoadjuvant treatment ranged from 52.5 to 93.8%. Between 97.2 and 100% of patients had the scheduled surgery. The median tumor volume reduction after NAC ranged from 62.5 to 63.7%. The anastomotic leak rate in the NAC group ranged from 0 to 7%, with no cases of postoperative mortality. There was major pathological tumor regression in 4-34.7% of cases. Between 84 and 100% of NAC patients had R0-surgery. Survival after NAC seems to be encouraging although significant improvement has only been proven in T4b tumours. CONCLUSIONS: According to our systematic review, the NAC may be a safe and effective emerging therapeutic alternative for treating LACC. This approach, which is still being tested, increases the reliance on accurate radiological staging.

Evaluación del espesor de la capa retiniana de fibras del nervio óptico en fumadores / Evaluation of the retinal nerve fiber layer thickness in smokers

No disponible

Individualized lung recruitment maneuver guided by pulse-oximetry in anesthetized patients undergoing laparoscopy: a feasibility study.

BACKGROUND: We conducted this study to test whether pulse-oximetry hemoglobin saturation (SpO2 ) can personalize the implementation of an open-lung approach during laparoscopy. Thirty patients with SpO2  ≥ 97% on room-air before anesthesia were studied. After anesthesia and capnoperitoneum the FIO2 was reduced to 0.21. Those patients whose SpO2 decreased below 97% - an indication of shunt related to atelectasis - completed the following phases: (1) First recruitment maneuver (RM), until reaching lung's opening pressure, defined as the inspiratory pressure level yielding a SpO2 ≥ 97%; (2) decremental positive end-expiratory (PEEP) titration trial until reaching lung's closing pressure defined as the PEEP level yielding a SpO2  < 97%; (3) second RM and, (4) ongoing ventilation with PEEP adjusted above the detected closing pressure. RESULTS: When breathing air, in 24 of 30 patients SpO2 was < 97%, PaO2 /FIO2  Ë‚ 53.3 kPa and negative end-expiratory transpulmonary pressure (PTP-EE ). The mean (SD) opening pressures were found at 40 (5) and 33 (4) cmH2 O during the first and second RM, respectively (P < 0.001; 95% CI: 3.2-7.7). The closing pressure was found at 11 (5) cmH2 O. This SpO2 -guided approach increased PTP-EE (from -6.4 to 1.2 cmH2 O, P < 0.001) and PaO2 /FIO2 (from 30.3 to 58.1 kPa, P < 0.001) while decreased driving pressure (from 18 to 10 cmH2 O, P < 0.001). SpO2 discriminated the lung's opening and closing pressures with accuracy taking the reference parameter PTP-EE (area under the receiver-operating-curve of 0.89, 95% CI: 0.80-0.99). CONCLUSION: The non-invasive SpO2 monitoring can help to individualize an open-lung approach, including all involved steps, from the identification of those patients who can benefit from recruitment, the identification of opening and closing pressures to the subsequent monitoring of an open-lung condition.

Neumonía familiar grave con aislamiento de Streptococcus pneumoniae / No disponible

Introducción: Presentamos una agregación intrafamiliar de neumonía grave, con aislamiento de Streptococcus pneumoniae en la esposa. Caso 1: Hombre de 54 años, ingresa el 27 de julio por dolor torácico y fiebre. Radiografía de tórax consolidación LID. Microbiología: antígenos urinarios negativos. Hemocultivos y cultivo de esputo negativos. A las pocas horas es trasladado a Cuidados Intensivos por shock séptico. Se instauró levofloxacino y ceftriaxona. Fiebre persistente, que mejoró tras la administración de vancomicina. Evolución favorable. Caso 2: Mujer de 50 años, esposa del caso 1, consulta el 31 de julio por fiebre y tos. Rx tórax condensación alveolar basal bilateral, pequeño derrame pleural derecho. Microbiología: antígeno neumococo en orina positivo, Streptococcus pneumoniae serotipo 1 en los hemocultivos. Toracocentesis exudado pleural con pH 7,46, cultivo negativo. Presentó hipotensión, oliguria, sepsis grave, e ingreso en UCI el mismo día del ingreso. Inicialmente se trata con ceftriaxona y azitromicina. Por persistencia de la fiebre, posteriormente con levofloxacino y vancomicina, con recuperación. Conclusiones: Presentamos un brote familiar de neumonía grave con aislamiento de neumococo serotipo 1

Introduction: We present a case of family aggregation of severe pneumonia with Streptococcus pneumoniae isolation in wife. Case 1: A 54 year old man was admited on July 27 for chest pain and fever. The chest radiograph LID consolidation. Microbiology: Streptococcus pneumoniae urinary antigens and Legionella pneumophila serogroup 1: negative. Negative blood cultures and sputum culture. A few hours later he was transferred to intensive care from septic shock. It was established antibiotic therapy with levofloxacin and ceftriaxone. He had persistent fever despite antibiotic, which improved after administration of vancomycin. Favorable clinical evolution. Case 2: 50 year old woman, wife of case 1, consulting on July 31 with fever and cough. The Rx chest bilateral basal alveolar condensation, small right pleural effusion. Microbiology: positive urine pneumococcus antigen, was isolated Streptococcus pneumoniae serotype 1 in blood cultures. Thoracentesis pleural exudate with pH 7.46, negative culture. He presented hypotension, oliguria, severe sepsis, and ICU admission the day of admission. Initially it treated with ceftriaxone and azithromycin. By persistent fever, later with levofloxacin and vancomycin, with recovery. Conclusions: We present a family outbreak of severe pneumonia with pneumococcal serotype 1 isolation

El inmunodeprimido, el escondite idóneo para microorganismos oportunistas / No disponible

Las inmunodeficiencias primarias constituyen el 50% de las inmunodeficiencias, cuyo defecto principal se encuentra a nivel de la inmunidad humoral. La más frecuente es la inmunodeficiencia variable común (IDVC). Describimos el caso de una paciente de 25 años con IDVC y déficit de todos los isotipos de anticuerpos, que presenta clínica de infección respiratoria de un mes de evolución, asociada a derrame pleural derecho e infiltrado basal izquierdo, y sin mejoría clínica a pesar del tratamiento antibiótico pautado. Tras la negatividad de los análisis microbiológicos realizados sobre distintas muestras, el estudio molecular por PCR para micobacterias en esputo es positivo, con resolución del cuadro clínico tras el inicio del tratamiento antituberculoso. Aunque la IDCV afecta principalmente a la inmunidad humoral, también produce alteraciones en la celular, pudiendo desarrollarse infecciones por agentes oportunistas como las micobacterias. El estudio molecular mediante PCR para micobacterias permite un rápido diagnóstico y un tratamiento precoz

Primary immunodeficiency constitutes 50% of all immunodeficiency disease, which primarily affect humoral immunity. The most frequent one is the Common Variable Immunodeficiency (CVID). We present the case of a 25 year-old female previously diagnosed of IDVC with a deficit of all antibodies isotypes who had a respiratory tract infection history for a month. It radiologically associated a basal left opacity and a right pleural effusion that showed no improvement after completing several antibiotic cycles. The microbiological analyses on different samples were negative but the molecular PCR for mycobacteria in sputum turned out to be positive. The patient was treated with antituberculosis drugs and soon after starting the treatment there was a complete resolution of the clinical picture. Although CVID mainly affects the humoral immunity, it can also produce alterations in the cellular immunity which may lead to develop opportunistic infections such as mycobacteria. The molecular PCR analysis for mycobacteria allows a fast diagnosis for an early treatment

MACVIA-LR (Fighting Chronic Diseases for Active and Healthy Ageing in Languedoc-Roussillon): A Success Story of the European Innovation Partnership on Active and Healthy Ageing.

The Région Languedoc Roussillon is the umbrella organisation for an interconnected and integrated project on active and healthy ageing (AHA). It covers the 3 pillars of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA): (A) Prevention and health promotion, (B) Care and cure, (C) and (D) Active and independent living of elderly people. All sub-activities (poly-pharmacy, falls prevention initiative, prevention of frailty, chronic respiratory diseases, chronic diseases with multimorbidities, chronic infectious diseases, active and independent living and disability) have been included in MACVIA-LR which has a strong political commitment and involves all stakeholders (public, private, patients, policy makers) including CARSAT-LR and the Eurobiomed cluster. It is a Reference Site of the EIP on AHA. The framework of MACVIA-LR has the vision that the prevention and management of chronic diseases is essential for the promotion of AHA and for the reduction of handicap. The main objectives of MACVIA-LR are: (i) to develop innovative solutions for a network of Living labs in order to reduce avoidable hospitalisations and loss of autonomy while improving quality of life, (ii) to disseminate the innovation. The three years of MACVIA-LR activities are reported in this paper.

Mujer de 71 años con edema cervical doloroso y derrame pleural bilateral / No disponible

El derrame pleural de tipo exudado tiene múltiples etiologías, siendo las más frecuentes los derrames paraneumónicos (50-70%), las neoplasias (15-35%) y la tuberculosis. Presentamos el caso de una mujer de 71 años con edema doloroso en la región laterocervical izquierda y radiografía de tórax con aumento de partes blandas en dicha región y pinzamiento de senos costofrénicos, que tras los estudios complementarios fue diagnosticada de quilotórax espontáneo con extravasación de quilo a regiones cervical y mediastínica, en probable relación con sobreesfuerzo o traumatismo mínimo. Presentó una mejoría clínica y radiológica tras dieta exenta de grasas y administración de suplementos de triglicéridos de cadena media. Las causas más frecuentes de quilotórax son las intervenciones quirúrgicas, los traumatismos y las neoplasias. Además, se describen también casos de quilotórax espontáneo sin causa objetivable. Por último, en pacientes con derrame pleural y edema cervical hemos de tener en cuenta la posibilidad de una patología aguda del conducto torácico

Exudative pleural effusion has several etiologies, being the most frequent parapneumonic effusion, neoplasias and tuberculosis. We report a case of a 71-year-old woman with painful edema on the left side of the lateral cervical region, accompanied by increased soft tissues in that region in chest radiography and bilateral pleural effusion. After additional studies were conducted, she was diagnosed with spontaneous chylothorax with extravasation of chyleinto the cervical and mediastinal regions, possibly due to overexertion or minimal trauma. She underwent clinical and radiological improvement after a fat-free diet and the administration of medium chain triglycerides supplements. The most common causes of chylothorax are surgical procedures, trauma and cancer. In addition, cases of spontaneous chylothorax are also described without apparent cause. Finally, in patients with pleural effusion and cervical edema we must consider the possibility of an acute disorder of the thoracic duct