Evaluating the performance of WHO and CDC case definitions for influenza-like illness in diagnosing influenza during the 2022-2023 flu season in Mexico.

OBJECTIVE: This study aimed to evaluate the performance of the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) case definitions for influenza-like illness (ILI) in diagnosing influenza during the 2022-2023 flu season in Mexico. STUDY DESIGN: We conducted a cross-sectional analysis of national epidemiological surveillance data in Mexico, focusing on respiratory viral pathogens. METHODS: We analyzed data from 6027 non-hospitalized patients between 5 and 65 years old who underwent molecular testing for respiratory viral pathogens. The performance of both case definitions was evaluated in terms of sensitivity, specificity, and the area under the receiver operating characteristic (AUROC) curve. RESULTS: Overall, the diagnostic accuracy of the evaluated ILI definitions in identifying influenza patients was low, particularly among older patients. When compared to the CDC, the WHO definition had a lower sensitivity but a higher specificity, resulting in a higher AUROC (P = 0.031) for the WHO criteria. CONCLUSIONS: Our findings suggest that the WHO and CDC ILI case definitions have limited accuracy for diagnosing influenza in non-hospitalized patients and highlight the need for more specific diagnostic tools to improve the detection of influenza cases during the flu season.

Survival in adult pneumonia inpatients fulfilling suspected COVID-19 criteria and baseline negative RT-qPCR.

OBJECTIVES: The objective of this study was to evaluate the survival experience of suspicion COVID-19 hospitalized patients with pneumonia and negative baseline reverse-transcription quantitative polymerase chain reaction (RT-qPCR) test results. STUDY DESIGN: We conducted a nationwide retrospective cohort study in Mexico. METHODS: Adult pneumonia inpatients fulfilling suspected COVID-19 criteria, and hospital entry from March to August 2020, were enrolled. The Kaplan-Meier method was to use to compare survival estimates among patients with negative RT-qPCR nasopharyngeal or oropharyngeal swabs and those with a baseline positive test. RESULTS: Data from 64,624 individuals fulfilling suspected COVID-19 criteria were analyzed and 1.6% of them had negative RT-qPCR tests. The overall mortality rate was higher among laboratory-positive patients (48.5% vs. 34.2%, P < 0.001) and, at any given threshold, the survival estimates were higher among RT-qPCR-negative pneumonia inpatients. CONCLUSIONS: The pathogenic mechanism of COVID-19 remains poorly understood and suspected cases with pneumonia and negative laboratory results represent a major challenge for healthcare systems. Our findings suggest that RT-qPCR-negative inpatients may have an improved disease prognosis, but the in-hospital mortality was still high among them. However, further research is needed to clarify the clinical and epidemiological implications of our results.

Middle-Term Evolution of Efficiency in Permeable Pavements: A Real Case Study in a Mediterranean climate.

Sustainable Drainage Systems (SuDS) are solutions used to reduce the effects of soil sealing and to contribute to sustainable storm water management. In recent years, many projects have been implemented in Europe, the United States, and Australia, but most of them have either not been monitored at all or have only been monitored in the short-term, so there is little information on the evolution of efficiency and clogging. Experiences in the Mediterranean are even rarer, so the main purpose of this research is to provide information about the long-term behavior of one kind of SuDS, the permeable pavements, in the middle-term under Mediterranean climatic conditions. This work shows the results of a real project developed in southern Spain, which has been monitored for five years. The evolution of efficiency in permeable pavements and their relationship with saturation are analyzed and discussed in this research. These results will help to manage and maintain permeable pavements in areas with a Mediterranean climatology.

Construction and demolition waste applications and maximum daily output in Spanish recycling plants.

The pursuit of construction sustainability has driven the use of partially or wholly waste-based eco-materials. New applications are being sought for recycled aggregate (RA) to further the use of this material and ensure the survival of the construction and demolition waste (C&DW) industry. RA, currently used in the construction of pavements, fills and embankments and only incipiently to manufacture structural or non-structural concrete, is a mere 8.99% of the total aggregate extracted in EU countries where RA is produced. Against this backdrop, the utility of this study lies in the overview afforded of RA typology, the application of the product in bound or unbound materials, the pursuit of new applications, structural or otherwise, and the assessment of daily maximum output by C&DW recycling facilities in Spain. The findings show that irrespective of its origin, RA most commonly adopts the form of wet mix macadam, gravel or sand used primarily in unbound applications with only dubious quality standards. Plant managers contend that RA from clean waste can feasibly be used in bound applications that require higher-performance materials. Maximum daily output varies widely, with capacity under 200 t d-1 in 30% of the plants. One of the conclusions drawn is that the current business model is in need of revision, with an emphasis on aggregate quality control (certification) and the adoption of technology for separating out impurities, pollutants and undesirable materials to improve the quality of RA.

A study of the application of permeable pavements as a sustainable technique for the mitigation of soil sealing in cities: A case study in the south of Spain.

The use of 'Sustainable Urban Drainage Systems' (SuDS) has become a more sustainable alternative for managing stormwater, greatly reducing the effects of soil sealing. However, the lack of monitored projects is a barrier to their implementation, as the companies which manage sewer systems cannot quantify the impact and cost-efficiency of SuDS. This paper presents a project developed in the south of Spain, in which the hydrological performance of 3 types of permeable pavements has been analyzed. The efficiencies obtained (over 70%), are higher than or similar to the efficiencies of vegetated SuDS, demonstrating the capacity of these pavements for delaying catchment area response and slow flow velocities, reducing the operating costs of sewer systems and the flood risk, while also ensuring service conditions for cities and safety for pedestrian and vehicular circulation. This pilot site has generated results which are sufficiently consistent so as to be representative, and serve as a reference for other cities with a similar climate.

The origin of high electrocatalytic activity of hydrogen peroxide reduction reaction by a g-C3N4/HOPG sensor.

Graphitic carbon nitride (g-C3N4) was synthesized from a low-cost precursor by means of a thermal process. The product was characterized by several spectroscopic techniques and the crystallinity was analyzed by X-ray diffraction. In the manufacture of the sensor, g-C3N4 was chemically exfoliated and a film was placed on the surface of a Highly Oriented Pyrolytic Graphite (HOPG). We compared the electrocatalytic activities of g-C3N4/HOPG and pristine HOPG surfaces as sensors for H2O2 quantification in buffer solution at pH 7. The results indicate that the surface of g-C3N4/HOPG exhibits striking analytical stability as well as reproducibility, enabling a reliable and sensitive determination within the 0.12-120 µM interval with a detection limit of 0.12 µM. These results suggest that this g-C3N4 film is a really particularly good nano-structured material to be applied as a biosensor. Chemical and physical factors are responsible for the outstanding electrocatalytic activity observed. The N in the g-C3N4 allows huge uptake of H2O2 through the hydrogen-bonding interaction and the change in the electronic structure since the HOPG/g-C3N4 heterojunction favors the charge transfer process through the interface.

Economic and environmental review of Waste-to-Energy systems for municipal solid waste management in medium and small municipalities.

The application of Directive 2008/98/CE on Municipal Solid Waste (MSW) implies the need to introduce technologies to generate energy from waste. Incineration, the most widely used method, is difficult to implement in low populated areas because it requires a large amount of waste to be viable (100,000 tons per year). This paper analyses the economic and environmental costs of different MSW-to-Energy technologies (WtE) in an area comprising of 13 municipalities in southern Spain. We analyse anaerobic digestion (Biomethanization), the production of solid recovered fuel (SRF) and gasification, and compare these approaches to the present Biological Mechanical Treatment (BMT) with elimination of the reject in landfill, and incineration with energy recovery. From an economic standpoint the implementation of WtE systems reduces the cost of running present BMT systems and incineration; gasification presents the lowest value. From the environmental standpoint, Life Cycle Assessment shows that any WtE alternatives, including incineration, present important advantages for the environment when compared to BMT. Finally, in order to select the best alternative, a multi-criteria method is applied, showing that anaerobic digestion is the optimal solution for the area studied.

Is hydrogen storage possible in metal-doped graphite 2D systems in conditions found on Earth?

Density functional theory (DFT) calculations are performed for the adsorption energy of hydrogen and oxygen on graphene decorated with a wide set of metals (Li, Na, K, Al, Ti, V, Ni, Cu, Pd, Pt). It is found that oxygen interferes with hydrogen adsorption by either blocking the adsorption site or by the irreversible oxidation of the metal decoration. The most promising decorations are Ni, Pd, and Pt due to a reasonable relationship of adsorption energies which minimize the oxygen interference. The DFT results are used to parametrize a statistical mechanical model which allows evaluation of the effect of partial pressures in the gas phase during storage. According to this model, even in the most promising case, it is necessary to reduce the oxygen partial pressure close to ultrahigh vacuum conditions to allow hydrogen storage.

Quantitative and qualitative normal regulatory T cells are not capable of inducing suppression in SLE patients due to T-cell resistance.

Previous reports have suggested that regulatory T cells (Treg) are abnormal in patients with systemic lupus erythematosus (SLE). In the present work, we quantified CD4+FOXP3+ Treg cells in patients with SLE and found no quantitative alterations. However, we found a clear defect in suppression assays. Surprisingly, SLE-derived Treg cells exhibited a normal phenotype and functional capacity. Conversely, SLE-derived CD4+CD25(-) effector T cells resisted suppression by autologous and allogeneic regulatory cells. Our findings strongly suggest that the defect in T-cell suppression observed in SLE is because of effector cell resistance and not because of an abnormal regulatory function.

Detección precoz de hipotiroidismo congénito: encuesta preliminar / Early detection of congenital hypothyroidism: preliminary survey

En muchos países se ha demostrado ampliamente la importancia de implementar programas de detección precoz del hipotiroidismo congénito, a través de los cuales se ha podido establecer la existencia de un caso de hipotiroidismo por cada 3,000 a 4,000 recién nacidos, prevalencia mayor que cuando recién se iniciaron estos estudios (1:6,000). Se presentan los resultados del primer estudio preliminar de este tipo realizado en el Perú. La muestra consistió en 1254 recién nacidos en los hospitales Maternidad de Lima y Dos de Mayo, durante los meses de julio a agosto de 1983. Se determinó la TSH neonatal en muestras de sangre de talón impregnadas en papel de filtro Whatman 3MM, mediante el uso de kits. El índice de sospecha encontrado fue de 5.1%, 64 neonatos con niveles de TSH mayores de 20uUl/ml que debió retornar para una determinación de TSH y T4 en una muestra obtenida por venipunción; pero únicamente retornaron 24 (1.91%), entre quienes se identificó un neonato con hipotiroidismo congénito primario. Este se encontraba asintomático y se le indicó terapia de reemplazo con un compuesto de levotiroxina y triyodotironina. Otros aspectos de la encuesta, como la procedencia materna y antecedentes de patología tiroidea no influenciaron los resultados. Se discute la aparentemente alta incidencia encontrada (1:1254) sugiriéndose la necesidad de continuar estudios similares y ampliándose a zonas de bocio endémico donde se supone el problema debe ser mayor

Estudio viral y parasitario en personal de un consultorio periferico. / Viral and parasitological study among personnel of a peripheric policlinic

Los autores-motivados por varios casos de embarazos patologicos afectaron a algunas funcionarias de uno de los Consultorios Perifericos investigaron las causas eventuales de estas anomalias a traves del analisis de las tasas de anticuerpos contra rubeola, citomegalovirus, virus herpes simple, toxoplasmosis y chagas, de todos los funcionarios (82 personas). Las tasas registradas en los distintos rubros antes senalados permiten concluir, que los resultados se encuadran dentro del promedio normal de la poblacion chilena y que en los cuatro casos de anomalias obstetricas les causas probables fueron rubeola (2), toxoplasmosis (1) y cuerpo extrano (1)

[Thrombocytopenic purpura of the young infant caused by perinatal infection by cytomegaloviruses]. / Púrpura trombocitopénica del lactante menor causada por la infección perinatal por citomegalovirus.

Two cases of idiopathic trombocytopenic purpura, in infants 37 and 42 days old, and one case of atypical congenital cytomegaloviral disease are presented, the latter proved at necropsy. Cytomegalic inclusion cells are found in urine in both cases of purpura with hepatosplenomegaly and mononucleosis syndrome. In one of the cases, cytomegalovirus cultures are positive in urine and blood. The hemorrhagic syndrome is mild and recuperation is achieved in less than thirty days, without relapse. The use of corticosteroids is not recommended. With these two new cases, thirteen similar clinical observation of thrombocytopenic purpura in infants, six of them in 1977, are completed. Thus, a new entity is added to the growing list of clinical manifestations caused by human CMV infection.