State of research, feasibility, safety, acceptability, and outcomes examined on remotely delivered exercises using technology for older adult with cancer: a scoping review.

INTRODUCTION: Technology-based exercise is gaining attention as a promising strategy for increasing physical activity (PA) in older adults with cancer (OACA). However, a comprehensive understanding of the interventions, their feasibility, outcomes, and safety is limited. This scoping review (1) assessed the prevalence and type of technology-based remotely delivered exercise interventions for OACA and (2) explored the feasibility, safety, acceptability, and outcomes in these interventions. METHODS: Studies with participant mean/median age ≥ 65 reporting at least one outcome measure were included. Databases searched included the following: PubMed, CINAHL, Embase, Cochrane Library Online, SPORTDiscus, and PsycINFO. Multiple independent reviewers completed screening and data abstractions of articles in English, French, and Spanish. RESULTS: The search yielded 2339 citations after removing duplicates. Following title and abstract screening, 96 full texts were review, and 15 were included. Study designs were heterogeneous, and sample sizes were diverse (range 14-478). The most common technologies used were website/web portal (n = 6), videos (n = 5), exergaming (n = 2), accelerometer/pedometer with video and/or website (n = 4), and live-videoconferencing (n = 2). Over half (9/15) of the studies examined feasibility using various definitions; feasibility outcomes were reached in all. Common outcomes examined include lower body function and quality of life. Adverse events were uncommon and minor were reported. Qualitative studies identified cost- and time-savings, healthcare professional support, and technology features that encourage engagement as facilitators. CONCLUSION: Remote exercise interventions using technology appear to be feasible and acceptable in OACA. IMPLICATIONS FOR CANCER SURVIVORS: Some remote exercise interventions may be a viable way to increase PA for OACA.

Pleural effusion in a child with a correctly placed ventricle-peritoneal shunt.

Pleural effusions in children (PE) due to ventricle-peritoneal shunt (VPS) is very rare, with few cases reported. We present a new case of an infant with VPS who had a massive hydrothorax not associated with misplacement or migration of the distal catheter or with ascites. After the evacuation of the PE we managed the patient by adjusting the pressure of the adjustable valve (AV). Sequential thoracic ultrasounds showed a satisfactory outcome. We review the literature thoroughly and describe the possible pathophysiological mechanisms.

The effect of nut growth limitation on triose phosphate utilization and downregulation of photosynthesis in almond.

There is a controversy regarding when it is appropriate to apply the irrigation restriction in almond trees (Prunus dulcis Mill.) to save water without penalizing yield. We hypothesized that knowing when plants demand fewer photoassimilates would be a good indicator of less sensitivity of the crop to water deficit. One parameter that defines the photosynthetic capacity is the triose phosphate utilization (TPU). Due to its connection to the export of sugars from the leaves to other sink organs, it is a good candidate for being such an indicator. The objective was to analyze the seasonal evolution of the photosynthetic capacity of three almond cultivars (cvs Guara, Marta and Lauranne) subjected to water stress during vegetative, kernel-filling and postharvest stages. Two sustained deficit irrigation (SDI) treatments (SDI75 and SDI65 with water reductions of 25 and 35%, respectively) and a control treatment (FI) consisting of fully irrigated trees were applied. The response of curves AN-Ci was analyzed to assess the maximum carboxylation rate (Vcmax), maximum rate of electron transport (Jmax), TPU and mesophyll conductance to CO2. In addition, leaf water potential and yield were measured. Our experimental findings showed any significant differences in the variables analyzed among cultivars and irrigation treatments. However, consistent differences arose when the results were compared among the phenological stages. During the kernel-filling and the postharvest stages, a progressive limitation by TPU was measured, suggesting that the demand for photoassimilates by the plant was reduced. This result was supported by the correlation found between TPU and fruit growth rate. As a consequence, a downregulation in Jmax and Vcmax was also measured. This study confirms that the kernel-filling stage might be a good time to apply a reduction in the irrigation and suggests a method to detect the best moments to apply a regulated deficit irrigation in almond trees.

Enhancing Nut Quality Parameters and Sensory Profiles in Three Almond Cultivars by Different Irrigation Regimes.

The climate change is already affecting many agricultural systems and human environments, and the implementation of adaptation strategies, especially those related to irrigated agriculture in semiarid regions, is urgent. In this regard, deep knowledge about the effects that irrigation has on the food quality parameters will allow us to estimate the potential benefits of deficit irrigation (DI) strategies. This work presents the effects on the quality parameters of three almond cultivars (Marta, Guara, and Lauranne) subjected to three irrigation doses: (i) full-irrigated treatment (FI) at 100% crop evapotranspiration (ETC), (ii) an overirrigated treatment at 150% ETC (150% ETC), and (iii) regulated deficit irrigation (RDI65) treatment, in which irrigation was done as in FI, expect during the kernel-filling period when this treatment received 65% ETC. According to experimental findings, the cultivar most sensitive to water stress was Marta, having the most significant improvements for RDI65. In general, the effects of the irrigation dose on the morphological and physicochemical parameters were not huge but some improvements were observed in key parameters such as the color and contents of specific sugars, organic acids, and unsaturated fatty acids. Thus, it can be concluded that the irrigation dose did not drastically affect the fruit almond quality, although it is possible to improve several key parameters when a moderate RDI strategy is applied.

Mass transfer enhancement and improved nitrification in MABR through specific membrane configuration.

One of the main energy consumptions in wastewater treatment plants (WWTPs) is due to the oxygenation of aerobic biological processes. In order to approach to an energy self-sufficient scenario in WWTPs, Membrane Aerated Biofilm Reactors (MABRs) provide a good opportunity to reduce the impact of aeration on the global energy balance. However, mass transfer limitations derived from poor flow distribution must be tackled to take advantage of this technology. In this work, in order to improve mass transfer between biofilm and bulk water, a specific configuration was developed and studied at laboratory scale, aimed at compactness, energy efficiency and high nitrification rates. Nitrification rates were higher in the innovative configuration than in the conventional one, achieving a Volumetric Nitrification Rate (VNR) as high as 575.84 g NH4-N m-3 d-1, which is comparable with confirmed technologies. Regarding energy consumption due to aeration, a reduction of 83.7% was reached in comparison with aeration through diffusers with the same Oxygen Transfer Efficiency (OTE). These results highlight the importance of hydrodynamic conditions and the membranes configuration on treatment performance.

[The effect of age on the prognosis of patients with traumatic brain injury who undergo a craniotomy: analysis of a surgical series]. / Efecto de la edad en el pronostico de pacientes con traumatismo craneoencefalico sometidos a craneotomia: analisis de una serie quirurgica.

INTRODUCTION: In our setting, the ageing of the population has led to management of traumatic brain injury (TBI) in the later stages of life becoming an increasingly frequent problem. AIM: To evaluate the association between age and the functional and survival prognosis of patients who have undergone surgery due to TBI. PATIENTS AND METHODS: We performed a retrospective analysis of a series of 404 patients submitted to surgery between the years 2000 and 2015: 144 youngsters (12-44 years), 77 adults (45-64 years), 148 geriatric patients (65-79 years) and 26 'super geriatric' patients (> 80 years). We reviewed the demographic and nosological characteristics of the population, the survival and functional prognosis (Glasgow Outcome Scale, GOS) on discharge and at six months. RESULTS: Age presents a positive linear association with both intra-hospital mortality and the proportion of patients with an unfavourable prognosis (GOS 1-3) on hospital discharge and at six months (p < 0.001). Taking the population of youngsters as a reference, the relative risk for an unfavourable prognosis at six months was 1.5 (95% CI: 1.04-2.19) for adults; 2.37 (95% CI: 1.77-3.17) for the geriatric patients; and 3.5 (95% CI: 2.63-4.7) for the 'super geriatric' patients. These latter present a mortality rate while in hospital of 77.78% and a percentage of poor functional prognosis at six months of 94.44%. CONCLUSION: Increased age is a major negative determining factor in the prognosis of patients who undergo a craniotomy due to TBI. More precise knowledge of these outcomes and an adequate pre-operative discussion with the family will be an invaluable aid in the decision-making process.

TITLE: Efecto de la edad en el pronostico de pacientes con traumatismo craneoencefalico sometidos a craneotomia: analisis de una serie quirurgica.Introduccion. En nuestro entorno, el envejecimiento poblacional ha convertido el manejo del traumatismo craneoencefalico (TCE) en etapas avanzadas de la vida en un problema de frecuencia creciente. Objetivo. Valorar la asociacion entre la edad y el pronostico vital y funcional de pacientes intervenidos por TCE. Pacientes y metodos. Analizamos retrospectivamente una serie de 404 pacientes intervenidos en nuestro centro entre los años 2000 y 2015: 144 jovenes (12-44 años), 77 adultos (45-64 años), 148 pacientes geriatricos (65-79 años) y 26 supergeriatricos (> 80 años). Revisamos las caracteristicas demograficas y nosologicas de la poblacion, y el pronostico vital y funcional (escala pronostica de Glasgow, GOS) en el momento del alta y a los seis meses. Resultados. La edad presenta asociacion lineal positiva tanto con la mortalidad intrahospitalaria como con la proporcion de pacientes con pronostico desfavorable (GOS 1-3) en el alta y a los seis meses (p < 0,001). Tomando como referencia la poblacion de jovenes, el riesgo relativo para pronostico desfavorable a los seis meses fue de 1,5 (IC 95%: 1,04-2,19) para los adultos, 2,37 (IC 95%: 1,77-3,17) para los geriatricos y 3,5 (IC 95%: 2,63-4,70) para los supergeriatricos. Estos ultimos presentan una mortalidad durante el ingreso del 77,78% y un porcentaje de mal pronostico funcional a los seis meses del 94,44%. Conclusion. El aumento de la edad es un factor determinante negativo mayor en el pronostico de pacientes sometidos a craneotomia por TCE. Un conocimiento preciso de estos resultados y una adecuada discusion preoperatoria con la familia resultaran de gran ayuda en el proceso de toma de decisiones.

Luis Sánchez Granjel (1920-2014) y su contribución a la Historia de la urología española / Luis Sánchez Granjel (1920-2014) and his contribution to the History of Spanish urology

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Comparison between a fixed bed hybrid membrane bioreactor and a conventional membrane bioreactor for municipal wastewater treatment: a pilot-scale study.

A hybrid membrane bioreactor (HMBR) was developed, by adding biofilm support media into a conventional membrane bioreactor (CMBR), and operated in parallel with a CMBR. Results showed that effluent quality was significantly better with the HMBR. The removal efficiencies of COD, BOD5, NH4(+)-N and TN with the HMBR were 84%, 98%, 97% and 75%, respectively, as compared to 80%, 96%, 93% and 38% with the CMBR. There were no differences in phosphorus removal. The membrane fouling rate in the HMBR was on average only 57% of that in the CMBR. The lower concentration of colloidal biopolymer clusters in the HMBR sludge, probably due to their retention by the biofilm, could be partially responsible for this difference. Filterability and settleability of the sludge were also better in the HMBR. Consequently, it is concluded that the addition of fixed support media for biofilm growth can improve the performance of CMBRs.

Evaluation of a hybrid vertical membrane bioreactor (HVMBR) for wastewater treatment.

A new hybrid membrane bioreactor (HMBR) has been developed to obtain a compact module, with a small footprint and low requirement for aeration. The aim of this research was to assess its performance. The system consists of a single vertical reactor with a filtration membrane unit and, above this, a sponge fixed bed as support medium. The aeration system is located under the membrane unit, allowing for membrane cleaning, oxygenation, biofilm thickness control and bulk liquid mixing. Operated under continuous aeration, a bench-scale reactor (70 L) was fed with pre-treated, raw (unsettled) municipal wastewater. BOD(5) and suspended solids removal efficiencies (96 and 99% respectively) were comparable to those obtained with other membrane bioreactors (MBRs). Total nitrogen removal efficiencies of 80% were achieved, which is better than those obtained in other HMBRs and similar to the values reached using more complex MBRs with extra anoxic tanks, intermittent aeration or internal deflectors.

Distribution of the concentration of heavy metals associated with the sediment particles accumulated on road surfaces.

The heavy metal pollution caused by road run-off water constitutes a problem in urban areas. The metallic load associated with road sediment must be determined in order to study its impact in drainage systems and receiving waters, and to perfect the design of prevention systems. This paper presents data regarding the sediment collected on road surfaces in the city of Torrelavega (northern Spain) during a period of 65 days (132 samples). Two sample types were collected: vacuum-dried samples and those swept up following vacuuming. The sediment loading (g m(-2)), particle size distribution (63-2800 microm) and heavy metal concentrations were determined. The data showed that the concentration of heavy metals tends to increase with the reduction in the particle diameter (exponential tendency). The concentrations ofPb, Zn, Cu, Cr, Ni, Cd, Fe, Mn and Co in the size fraction <63 microm were 350, 630, 124, 57, 56, 38, 3231, 374 and 51 mg kg(-1), respectively (average traffic density: 3800 vehicles day(-1)). By increasing the residence time of the sediment, the concentration increases, whereas the ratio of the concentration between the different size fractions decreases. The concentration across the road diminishes when the distance between the roadway and the sampling siteincreases; when the distance increases, the ratio between size fractions for heavy metal concentrations increases. Finally, the main sources of heavy metals are the particles detached by braking (brake pads) and tyre wear (rubber), and are associated with particle sizes <125 microm.

Particle size distribution of accumulated sediments on an urban road in rainy weather.

The study of the behavior of deposited sediments on an urban surface serves to determine its characteristics of build-up, in dry periods, and of wash-off, during a rain event. Thus, these can be used later to indicate the presence of pollutants in an area. This paper presents data regarding the sediment collected on a road surface in the city of Torrelavega in northern Spain during a period of 65 days during which 132 samples were collected. The rainfall during the sampling period corresponded to 29% of the total rainfall registered in the same year. Two types of sediment collection samples were obtained: vacuumed dry samples (free load) and those swept up following vacuuming (fixed load). For each type of collected sample, the sediment loading, particle size distribution in seven fractions and moisture were determined. The data showed that the sediment loading (g m(-2)) and vacuumed availability of the load that was more strongly adhered to the surface, "fixed load", increases with the number of dry days. The particle size distribution of the collected sediment tended to be finer with the increase in number of dry days. Particle sizes less than 125 microm presented the greater rate of accumulation in dry weather and those less than 500 microm, the greater susceptibility to being washed off during a storm event.

Characterisation of solid and liquid fractions of dairy manure with regard to their component distribution and methane production.

Dairy manure with a total solids content of 77.2g TS/l was separated by means of screening and coagulation-flocculation treatments, using CaO as coagulant and a cationic polyacrylamide as flocculant, obtaining liquid and solid fractions. The solid fraction separated contained 33.4% of the initial total mass of dairy manure plus chemical solutions, containing also 75.2% of the TS, 80.4% of the VS, 58.5% of the total Kjeldahl nitrogen (TKN) and 87.4% of the total phosphorus (P(T)) present in the initial dairy manure. 83.7% of the liquid fraction chemical oxygen demand (COD) was anaerobically biodegradable (COD(BD)). Methane production for the separated liquid fraction was 0.604l CH4 NCTP/g VS added, being 0.307 and 0.371l CH4 NCTP/g VS added for dairy manure and screened dairy manure, respectively. The characteristics of this liquid fraction would allow its treatment in high loading anaerobic reactors having shorter hydraulic retention times, smaller reactor size and a higher methane volumetric production rate than conventional anaerobic reactors treating either manure or screened manure.

Environmental engineering education in Spain.

There is a growing demand for engineers and technologists who show multidisciplinary expertise to deal with environmental issues. As a result of this demand, most countries are adapting their old university programs on environmental engineering education. In Spain an official environmental engineering degree does not yet exist, but the Council of Universities is working to present a proposal, based on Bologna agreement concepts. The paper summarizes not only the future perspectives of environmental engineering education in Spain, but also the evolution of the approach during the last decades, which includes the role of the private initiative, the environmental sciences degree, and the intensification in different traditional engineering degrees. Finally, the paper briefly details and compares the syllabus developed in the only four Spanish universities where environmental engineering is offered as a non-official post-graduate course lasting two years.

Detention storage volume for combined sewer overflow into a river.

This article discusses the storage volume needed in a combined sewer system tank in order to preserve the water quality. There are a lot of design criteria which do not take into account the conditions of the receiving water, and as a result are inappropriate. A model was used to simulate the performance of a theoretical combined sewer system where a tank was located downstream. Results were obtained from the overflows produced by the rain recorded in Santander (Spain) for 11 years, with several combinations of storage volume and treatment capacity in the wastewater treatment plant. Quality criteria were also proposed for faecal coliforms, BOD, and total nitrogen to evaluate the effects from the overflows in the river water quality. Equations have been obtained which relate the number of overflows, the storage volume and the treatment plant capacity. The bacteriological pollution, quantified by means of faecal coliforms, was the analytical parameter which produced the most adverse effects in the river, so that more storage volume is needed (45 to 180 m3 ha(-1) net) than with other simulated pollutants (5 to 50 m3 ha(-1) net for BOD, and less than 4 m3 ha(-1) net for the total nitrogen). The increase in the treatment plant's capacity, from two to three times the flow in dry weather, reduces the impact on the river water in a more effective way, allowing a reduction of up to 65% in the number of overflows rather than increasing the storage volume.

[Detubularized ureterosigmoidostomy Mainz II: a diversion with a future?]. / Ureterosigmoidostomía destubulizada Mainz II: una derivación con futuro?

OBJECTIVE: To review the results achieved with the Mainz II detubularized ureterosigmoidostomy for urinary diversion in patients undergoing bladder resection. METHODS: This study was conducted on 12 prospective patients undergoing radical cystectomy for urothelial carcinoma after 1996. All patients met the following selection criteria: no changes in upper urinary tract functions, normal rectosigmoid, no previous radiation to the area and good anal continence. RESULTS: All patients had a diagnosis of infiltrating urothelial carcinoma of the bladder. Four of these patients died from tumor progression. Renal function is preserved at 31.7 months' mean follow-up, although 3 patients developed moderate metabolic acidosis despite the prophylactic alkalization therapy instituted after surgery. One patient presented recurrent pyelonephritis and stricture of the ureterointestinal anastomosis that required surgical correction. Colonoscopy was unremarkable in all but one patient who showed adenomatous polyp of the colon, which was removed endoscopically, and no other local changes. Continence was complete from the time the urinary catheters were removed. Voiding occurred every 2.9 hours during the day and 2.2 times during the night. CONCLUSIONS: The Mainz II modified ureterosigmoidostomy clearly reduces the upper urinary tract complications because accommodation of the reservoir is better and the pressure inside the pouch is reduced. This technique of urinary diversion is well-accepted by the patients because voiding can be achieved comfortably, a stoma is not required and body image is preserved. The degree of patient satisfaction was high in all cases.

[Penile fracture: diagnostic assessment and therapeutic approach. Review of the literature]. / Fractura de pene: evaluación diagnóstica y actitudes terapéuticas. Revisión de la literatura.

OBJECTIVE: Rupture of the corpus cavernosum is an uncommon condition that requires immediate treatment in the emergency services. The diagnostic methods and therapeutic approaches are discussed and the literature reviewed. METHODS: Two cases of rupture of the corpus cavernosum diagnosed 8 years and 3 months earlier are presented. One was treated conservatively and the other was submitted to early surgical management. Images showing the technique utilized for cavernosal repair in one of the patients and the satisfactory clinical course of both patients are presented. RESULTS/CONCLUSIONS: Rupture of the corpus cavernosum is an uncommon urological emergency in our setting. Patient history and examination are diagnostic in most of the cases. Early surgical management is advocated.

[The historical setting of cystine lithiasis]. / Entorno histórico de la litiasis cistínica.

W. H. Wollaston, who first described cystine stones, as well as the most outstanding contemporary figures and their contribution to the understanding of this uncommon type of lithiasis are described.

[Infrequent association: massive inguinoscrotal bladder hernia, multiple scrotal lithiasis, and bilateral obstructive uropathy]. / Una asociación poco frecuente: hernia vesical inguinoescrotal masiva, litiasis escrotal múltiple y uropatía obstructiva bilateral.

Vesical hernias occur in a significant number of patients with inguinal hernia, though massive inguinoscrotal vesical hernias are uncommon. This paper presents a case report of a male patient where massive inguinoscrotal vesical hernia, and scrotum-located multiple vesical lithiasis was associated to a large amount of lithiasic mass and bilateral ureterohydronephrosis. We consider this association of urinary conditions extremely rare, since to our knowledge bilateral ureterohydronephrosis has only been formerly documented in one case.