Waste-treating-waste: Effective heavy metals removal from electroplating wastewater by ladle slag.

Ladle slag, a by-product of steelmaking, presents a valuable strategy for waste reduction and valorization in wastewater treatment. This work demonstrates the successful simultaneous removal of Al(III), B(III), Ba(II), Cr(III), Mg(II), Sr(II), Pb(II), and Zn(II), from electroplating wastewater by ladle slag. First, Cr(III) and Pb(II) removals were evaluated in single synthetic systems by analyzing the influence of pH, temperature, and ladle slag dosage. Competitive removal was observed in binary batch experiments of Cr(III) - Pb(II), achieving 88% and 96% removal, respectively, with fast kinetics following a pseudo-second-order model. The findings of XRD, SEM, EDX, and FTIR of the slag after removal helped to elucidate the synergic removal mechanism involving ladle slag dissolution, precipitation, ion exchange, and adsorption in a tight relationship with the solution pH. Lastly, ladle slag was tested in real electroplating wastewater with the aforementioned ions at concentrations ranging from <1 to 1700 mg/L. The removal was performed in two steps, the first attained the following efficiencies: 73% for Al(III), 88% for B(III), 98% for Ba(II), 80% for Cr(III), 82% for Mg(II), 99% for Pb(II), 88% for Sr(II), and 88% for Zn(II). Visual MINTEQ simulation was utilized to identify the different species of ions present during the removal process. Furthermore, the leaching tests indicated a minimal environmental risk of secondary pollution in its application. The results promote an effective and sustainable approach to wastewater treatment within the circular economy.

Presión arterial en recién nacidos sanos de término y pretérmino tardío en la Ciudad de México / Blood pressure in healthy term and late preterm newborns in Mexico City

Resumen Objetivo: Describir medidas de presión arterial sistólica (PAS), diastólica (PAD) y media (PAM) en recién nacidos sanos de término y pretérmino tardío para establecer parámetros de normalidad. Método: Estudio transversal realizado en el cunero fisiológico del Hospital Español, Ciudad de México. Se incluyeron 551 pacientes recién nacidos sanos. Las tomas de PA fueron realizadas dentro de las primeras 48 horas de vida con método oscilométrico. Posterior a la evaluación de normalidad, se realizó un análisis descriptivo de la población y cálculo de percentiles (25, 50 y 75) específicos para cada semana de gestación. Todos los análisis fueron realizados en STATA v14.2. Resultados: Los recién nacidos de sexo masculino tuvieron un valor medio de PAS de 64.6 mmHg en la semana 35 de gestación, este valor aumentó a 69.8 mmHg en la semana 40. El valor de la PAD fue de 42.6 mmHg en la semana 35 de gestación, disminuyendo a 40.8 mmHg para la semana 40. Los valores medios de PAS en los recién nacidos de sexo femenino fueron de 65.5 mmHg en la semana 35, teniendo un incremento a 73.5 mmHg en la semana 40. El valor de la PAD en la semana 35 de gestación fue 38 mmHg, incrementando a 41.3 mmHg en la semana 40. Conclusiones: Los valores de PA en recién nacidos sanos se modifican con la edad gestacional y el sexo. Estos resultados pueden servir como referencia para otros médicos ubicados en países o ciudades con alturas similares a la Ciudad de México.

Abstract Objective: Describe the measurements of systolic, diastolic and mean blood pressure in healthy term and late preterm newborns to establish normal values. Methods: Cross-sectional study carried out in the nursery of the Hospital Español, located in Mexico City. A sample of 551 healthy newborns were included in the study. Blood pressure (BP) measurements were taken within the first 48 hours of life with the oscillometric method. After the evaluation of normality, a descriptive analysis of the population and calculation of percentiles (25, 50 and 75) specific for each week of gestation was performed. All analyzes were performed in STATA v14.2. Results: Male newborns had a mean SBP value of 64.6 mmHg at week 35 of gestation, this value increased to 69.8 mmHg at week 40; the systolic blood pressure (SBP) value was 42.6 mmHg at week 35 of gestation, which decreased to 40.8 mmHg at week 40. The mean SBP values in female newborns were 65.5 mmHg at week 35, increasing to 73.5 mmHg at week 40; the diastolic blood pressure (DBP) value at week 35 of gestation was 38 mmHg, increasing to 41.3 mmHg at week 40. Conclusions: The BP values in healthy newborns are modified by the gestational age and sex of the patients. These results can serve as a reference for other physicians located in countries or cities with a similar altitude than the one in Mexico City.

Blood pressure in healthy term and late preterm newborns in Mexico City.

OBJECTIVE: Describe the measurements of systolic, diastolic and mean blood pressure in healthy term and late preterm newborns to establish normal values. METHODS: Cross-sectional study carried out in the nursery of the Hospital Español, located in Mexico City. A sample of 551 healthy newborns were included in the study. Blood pressure (BP) measurements were taken within the first 48 hours of life with the oscillometric method. After the evaluation of normality, a descriptive analysis of the population and calculation of percentiles (25, 50 and 75) specific for each week of gestation was performed. All analyzes were performed in STATA v14.2. RESULTS: Male newborns had a mean SBP value of 64.6 mmHg at week 35 of gestation, this value increased to 69.8 mmHg at week 40; the systolic blood pressure (SBP) value was 42.6 mmHg at week 35 of gestation, which decreased to 40.8 mmHg at week 40. The mean SBP values in female newborns were 65.5 mmHg at week 35, increasing to 73.5 mmHg at week 40; the diastolic blood pressure (DBP) value at week 35 of gestation was 38 mmHg, increasing to 41.3 mmHg at week 40. CONCLUSIONS: The BP values in healthy newborns are modified by the gestational age and sex of the patients. These results can serve as a reference for other physicians located in countries or cities with a similar altitude than the one in Mexico City.

OBJETIVO: Describir medidas de presión arterial sistólica (PAS), diastólica (PAD) y media (PAM) en recién nacidos sanos de término y pretérmino tardío para establecer parámetros de normalidad. MÉTODO: Estudio transversal realizado en el cunero fisiológico del Hospital Español, Ciudad de México. Se incluyeron 551 pacientes recién nacidos sanos. Las tomas de PA fueron realizadas dentro de las primeras 48 horas de vida con método oscilométrico. Posterior a la evaluación de normalidad, se realizó un análisis descriptivo de la población y cálculo de percentiles (25, 50 y 75) específicos para cada semana de gestación. Todos los análisis fueron realizados en STATA v14.2. RESULTADOS: Los recién nacidos de sexo masculino tuvieron un valor medio de PAS de 64.6 mmHg en la semana 35 de gestación, este valor aumentó a 69.8 mmHg en la semana 40. El valor de la PAD fue de 42.6 mmHg en la semana 35 de gestación, disminuyendo a 40.8 mmHg para la semana 40. Los valores medios de PAS en los recién nacidos de sexo femenino fueron de 65.5 mmHg en la semana 35, teniendo un incremento a 73.5 mmHg en la semana 40. El valor de la PAD en la semana 35 de gestación fue 38 mmHg, incrementando a 41.3 mmHg en la semana 40. CONCLUSIONES: Los valores de PA en recién nacidos sanos se modifican con la edad gestacional y el sexo. Estos resultados pueden servir como referencia para otros médicos ubicados en países o ciudades con alturas similares a la Ciudad de México.

Mediterranean Diet and Lung Function in Adults Current Smokers: A Cross-Sectional Analysis in the MEDISTAR Project.

BACKGROUND: Previous studies have shown that adherence to the Mediterranean Diet (MeDi) has a positive impact on lung function in subjects with lung disease. In subjects free of respiratory diseases, but at risk, this association is not yet well established. METHODS: Based on the reference data from the MEDISTAR clinical trial (Mediterranean Diet and Smoking in Tarragona and Reus; ISRCTN 03.362.372), an observational study was conducted with 403 middle-aged smokers without lung disease, treated at 20 centres of primary care in Tarragona (Catalonia, Spain). The degree of MeDi adherence was evaluated according to a 14-item questionnaire, and adherence was defined in three groups (low, medium, and high). Lung function were assessed by forced spirometry. Logistic regression and linear regression models were used to analyse the association between adherence to the MeDi and the presence of ventilatory defects. RESULTS: Globally, the pulmonary alteration prevalence (impaired FEV1 and/or FVC) was 28.8%, although it was lower in participants with medium and high adherence to the MeDi, compared to those with a low score (24.2% and 27.4% vs. 38.5%, p = 0.004). Logistic regression models showed a significant and independent association between medium and high adherence to the MeDi and the presence of altered lung patterns (OR 0.467 [95%CI 0.266, 0.820] and 0.552 [95%CI 0.313, 0.973], respectively). CONCLUSIONS: MeDi adherence is inversely associated with the risk impaired lung function. These results indicate that healthy diet behaviours can be modifiable risk factors to protect lung function and reinforce the possibility of a nutritional intervention to increase adherence to MeDi, in addition to promoting smoking cessation.

Thiabendazole degradation by photo-NaOCl/Fe and photo-Fenton like processes, using copper slag as an iron catalyst, in spiked synthetic and real secondary wastewater treatment plant effluents.

Thiabendazole degradation (TBZD) in diferent types of water matrices was assessed by applying two Advanced Oxidation Processes, both using simulated solar light (SSL), copper slag (CS) as an iron based catalyst, and separately H2O2 or NaOCl as oxidants. First, optimum conditions for TBZD were evaluated in distilled water, TBZD = 90% at 60 min for CS-H2O2-SSL, and 92% of TBZD in a twelfth of the time by the system CS-NaOCl-SSL; minimum TBZ depletion variations were observed between the first and the fifth reuse test: 88 ± 2% for CS-H2O2-SSL (60 min) and 90 ± 1% for CS-NaOCl-SSL (5 min). Those conditions were tested using a synthetic (SE) and a real secondary effluent (RE) from a wastewater treatment plant. The CS-H2O2-SSL system achieved TBZD of 88 and 77% after 90 min for SE and RE, with kinetic constants of 0.024 and 0.016 min-1, respectively, whereas photo-NaOCl/Fe showed values of 0.365 and 0.385 min-1 for SE and RE, achieving a 94% TBZD removal in both types of water at 10 min. That might be related to the formation of Cl· and HO• during the photo-NaOCl/Fe process, highlighting that the CS-NaOCl-SSL is an attractive option that has great possibilities for scaling up by a better knowledge in real aqueous matrices.

Frecuencia y factores asociados a las enfermedades crónicas no transmisibles en adultos mayores en el Perú, año 2005

Introducción: Las enfermedades crónicas no transmisibles son un problema de salud pública. Objetivo: Determinar la prevalencia de enfermedades crónicas no transmisibles en población adulta mayor y su asociación con factores demográficos. Métodos: Estudio transversal de fuente secundaria (ENIN 2005), en el que se incluyeron los adultos con edad ≥ 60 años. Se estimó la prevalencia de hipertensión arterial, diabetes mellitus, obesidad, síndrome metabólico y dislipidemia. Asimismo, se determinó la asociación a variables demográficas (sexo, grupo etario, altitud de residencia y ámbito) mediante la razón de prevalencia (RP) obtenida por modelos lineales generalizados. Resultados: La muestra fue de 620 adultos mayores, tres de cuatro presentaron al menos una enfermedad no transmisible. Se encontró una prevalencia de hipertensión arterial (36,3%), síndrome metabólico (31,0%), obesidad (8,4%), diabetes mellitus (6,0%), colesterol HDL bajo (47,3%), hipertrigliceridemia (35,8%), hipercolesterolemia (28,4%), colesterol LDL alto (7,4%). Los varones presentaron menor frecuencia de obesidad, síndrome metabólico y dislipidemia (RPa 0,37; 0,27 y 0,56 respectivamente) respecto a las mujeres. Asimismo, los residentes a más de 3000 msnm tuvieron menor prevalencia de hipertensión, diabetes, síndrome metabólico y dislipidemia (RPa 0,56; 0,09; 0,23 y 0,71, respectivamente) comparado con los que residen a menos de 1000 msnm. Conclusión: Entre adultos mayores las enfermedades no transmisibles más prevalentes la hipertensión arterial, el síndrome metabólico, colesterol HDL bajo e hipertrigliceridemia. El sexo femenino y personas que vivieron en ciudades debajo de 1000 msnm fueron los más afectados.

Introduction: Chronic non-communicable diseases are a public health problem. Objective: To determine the prevalence of chronic non-communicable diseases (NCD) in the elderly population and its association with demographic factors. Methods: Cross-sectional study from a secondary source (ENIN 2005), which included adults aged ≥60 years. The prevalence of arterial hypertension, diabetes mellitus, obesity, metabolic syndrome and dyslipidemia was estimated. Likewise, the association to demographic variables was determined (sex, age group, altitude of residence and area) through the prevalence ratio (PR) obtained by generalized linear models. Results: The sample was 620 AM, where three out of four presents at least one chronic non communicable diseases. A prevalence of hypertension (36.3%), metabolic syndrome (31.0%), obesity (8.4%), diabetes mellitus (6.0%), low HDL-C (47.3%), hypertriglyceridemia (35.8%), hypercholesterolemia (28.4%) and high LDL-C (7.4%). Men presented lower frequency of obesity, metabolic syndrome and dyslipidemia (RPa 0.37, 0.27 and 0.56, respectively) compared to women. Likewise, residents at more than 3000 masl had lower prevalence of hypertension, diabetes mellitus, metabolic syndrome and dyslipidemia (RPa 0.56, 0.09, 0.23 and 0.71, respectively) compared to those who reside at less than 1000 masl. Conclusion: There is a significant presence of chronic non-communicable diseases in elderly population, the most prevalent being hypertension, metabolic syndrome, low HDL-C and hypertriglyceridemia. The female sex and people who lived in cities below 1000 masl were the most affected.

Estilos de vida relacionados con la salud en estudiantes de Enfermería / Lifestyles health related in Nursing students

Introducción: los cambios de conductas saludables a las no saludables ponen en riesgo la salud, los universitarios son una población muy vulnerable para adoptar estilos de vida que puedan favorecer su calidad de vida. El consumo de alcohol y tabaco como conducta es un tema importante en esta etapa de formación profesional. Objetivo: determinar las conductas de estilo de vida relacionados con la salud como el consumo de cigarrillos, alcohol y drogas, hábitos alimentarios, forma física, control del estrés y seguridad que realizan los estudiantes de la Licenciatura en Enfermería de la Universidad Juárez Autónoma de Tabasco, México. Metodología: estudio de tipo cuantitativo, descriptivo, transversal en una muestra de 666 estudiantes de la Licenciatura en Enfermería seleccionados por muestreo no probabilístico. Resultados: predominó el género femenino con 83%, el 62.8% presenta un buen estilo de vida, seguido del 30.3% que tiene un excelente estilo de vida; el 79.1% corresponde a los estudiantes que no fuman y el 37.8% de los estudiantes tiene una buena alimentación. Los estudiantes calificaron su forma física como regular en el 41% de los casos, seguida de mala con el 34.5%. En cuanto a la práctica de control del estrés calificaron como buena con un 50.8% y excelente con 26.1%. Conclusión: los estudiantes de Enfermería tienen un nivel de estilo de vida bueno relacionado con la salud, los más practicados corresponden a las dimensiones de consumo de alcohol, hábitos alimentarios, control de estrés y seguridad. Es importante considerar la dimensión relacionada con la forma física (práctica de ejercicio físico), ya que se practica ocasionalmente, lo que demuestra que los estudiantes llevan un estilo de vida sedentario.

Introduction: Changes from healthy to unhealthy behaviors put health at risk, so university students are a very vulnerable population to adopt lifestyles that can favor their quality of life. The consumption of alcohol and tobacco as conduct is an important issue at this stage of professional training. Objective: To determine the lifestyle behaviors related to health such as the consumption of cigarettes, alcohol and drugs, eating habits, physical fitness, stress control and safety carried out by the students of the Bachelor of Nursing at the Universidad Juárez Autónoma de Tabasco, in Mexico. Methodology: Quantitative, descriptive, cross-sectional study in a sample of 666 Nursing undergraduate students selected by non-probabilistic sampling. Results: The female gender predominated with 83%, 62.8% have a good lifestyle, followed by 30.3% who have an excellent lifestyle; 79.1% corresponds to students who do not smoke and 37.8% of students have a good diet. The students rated their physical fitness as fair in 41% of the cases, followed by poor with 34.5%. Regarding the practice of stress control, they qualified as good with 50.8% and excellent with 26.1%. Conclusion: Nursing students have a good level of lifestyle related to health, the most practiced correspond to the dimensions of alcohol consumption, eating habits, stress control and safety. It is important to consider the dimension related to physical fitness (practice of physical exercise), since it is only practiced occasionally, which shows that students lead a sedentary lifestyle.

Loop-mediated isothermal amplification-based electrochemical sensor for detecting SARS-CoV-2 in wastewater samples.

The current pandemic COVID-19 caused by the coronavirus SARS-CoV-2, has generated different economic, social and public health problems. Moreover, wastewater-based epidemiology could be a predictor of the virus rate of spread to alert on new outbreaks. To assist in epidemiological surveillance, this work introduces a simple, low-cost and affordable electrochemical sensor to specifically detect N and ORF1ab genes of the SARS-CoV-2 genome. The proposed sensor works based on screen-printed electrodes acting as a disposable test strip, where the reverse transcription loop-mediated isothermal amplification (RT-LAMP) reaction takes place. Electrochemical detection relies upon methylene blue as a redox intercalator probe, to provide a diffusion-controlled current encoding the presence and concentration of RT-LAMP products, namely amplicons or double-stranded DNA. We test the performance of the sensor by testing real wastewater samples using end-point and time course measurements. Results show the ability of the electrochemical test strip to specifically detect and quantify RT-LAMP amplicons below to ~ 2.5 × 10-6 ng/µL exhibiting high reproducibility. In this sense, our RT-LAMP electrochemical sensor is an attractive, efficient and powerful tool for rapid and reliable wastewater-based epidemiology studies.

Effectiveness of a Motivational Nutritional Intervention through Social Networks 2.0 to Increase Adherence to the Mediterranean Diet and Improve Lung Function in Active Smokers: The DIET Study, a Randomized, Controlled and Parallel Clinical Trial in Primary Care.

BACKGROUND: Diet can help preserve lung function in smokers, as well as aid individuals who avoid smoking. This study aimed to evaluate the effectiveness of a nutritional intervention, using the Social Networks 2.0 tool, to increase adherence to the Mediterranean diet (MD) and improve lung function in smokers without prior respiratory disease. METHODS: A randomized controlled parallel design was used. The participants were assigned to either the intervention or control group. Data from representative smokers without respiratory disease (n = 77) aged 18-70 years were analyzed. The participants completed a validated semi-quantitative food-frequency questionnaire, and their adherence to the diet was evaluated by using the questionnaire called the Mediterranean Diet Adherence Score (MEDAS, with 14 items), which considers ≥9 points to indicate high adherence. The lung function was assessed by spirometry. Associations among variables were determined by logistic regression. RESULTS: A comparison of the variables at the end of the study between the control and intervention groups showed that the intervention significantly increased adherence to the MD based on the MEDAS questionnaire (0.69 (2.1) vs. 2.05 (2.03); p = 0.009). Specifically, the consumption of fruits was increased after two years in both groups; however, a more significant increase was detected in the intervention group (121 (178) vs. 12.7 (167) in the control group; p-value = 0.008). In the unadjusted analysis, the intervention only showed a statistical significant increase in the score of adherence to the MD (ß: 1.36; 95% CI 0.35; 2.3; p = 0.009), and this increase was maintained after adjusting for age and sex (ß: 1.15; 95% CI 0.05; 2.2; p = 0.040) and after adjusting for various sociodemographic, lifestyle and anthropometric variables (ß: 1.17; 95% CI 0.02; 2.31; p = 0.046). The pulmonary function parameters improved more in the intervention group; however, no significant differences were observed between the two groups. CONCLUSIONS: A nutritional intervention based on a dietetic-nutritional education program resulted in a significant increase in adherence to the MD. However, some evidence suggests that an MD dietary intervention can improve lung function, but in our study, we were not able to demonstrate this. Further research is needed to obtain more robust data and confirm a possible benefit of the program before it can be extended to general practice.

Nationwide prevalence and clinical characteristics of inpatient diabetic foot complications: A Peruvian multicenter study.

OBJECTIVE: To evaluate the burden of diabetic foot complications amongst inpatients in Peru. MATERIALS AND METHODS: Cross-sectional multicenter study, performed in public hospitals, in one-day enrollment between October and December 2018. RESULTS: We included 8346 patients from 39 national hospitals. Diabetic foot (DF) inpatient point prevalence was 2.8% (CI 95% 2.4-3.1), and DF point prevalence among Diabetes Mellitus (DM) inpatients was 18.9% (CI 95% 16.7-21.1). DF prevalence was higher in jungle and coastal hospitals than highlands ones, and there was no difference according to its care complexity level. Of the 234 patients with DF, 73% were males, age average was 62 ± 12 years, with DM mean time duration of 15 ± 9.9 years. Regarding to DF etiology, 91% and 68% had some degree of peripheral neuropathy and peripheral artery disease, respectively. According to the Infectious Diseases Society of America criteria, 61% presented moderate to severe infections, and 40% had bone involvement. Debridement within 48 h was performed in 36% of sepsis cases. CONCLUSION: Peru has a substantial burden of DF disease, with a greater share of that burden falling on less equipped hospitals in the country's jungle and coastal regions. Interdisciplinary teams and pathways may improve the time of surgical debridement in the highest risk patients.

Enhanced activated persulfate oxidation of ciprofloxacin using a low-grade titanium ore under sunlight: influence of the irradiation source on its transformation products.

In this work, the activated persulfate oxidation of ciprofloxacin (CIP) using a low-grade titanium ore under sunlight or simulated sunlight were conducted to analyze the CIP degradation efficiency and to identify the transformation products (TPs) generated during oxidation under both types of irradiation sources by using liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-QTOF-MS). All advance oxidation process experiments were performed in a 2700-mL raceway reactor at a pH value of ~ 6.5 and an initial CIP concentration of 1 mg/L, during 90 min of reaction time. The control experiments carried out under simulated sunlight achieved a 97.7 ± 0.6% degradation efficiency, using 385 W/m2 of irradiation with an average temperature increase of 11.7 ± 0.6 °C. While, the experiments under sunlight reached a 91.2 ± 1.3% degradation efficiency, under an average irradiation value of 19.2 ± 0.3 W/m2 in October-November 2019 at hours between 11:00 am and 3:00 pm with an average temperature increase of 1.4 ± 0.8 °C. Mass spectrometry results indicated that 14 of the 108 possible TPs reported in the literature were detected. The calculated exact mass, measured accurate mass, and its characteristic diagnostic fragment ions were listed, and two new TPs were tentative identified. The TP generation analysis showed that some specific compounds were detected in different time intervals with kinetic variations depending on the irradiation used. Consequently, two CIP degradation pathways were proposed, since the type of irradiation determines the CIP degradation mechanism. Graphical abstract.

Actitudes del personal de enfermería ante la muerte de sus pacientes / Atitudes dos profissionais de enfermagem frente à morte dos pacientes / Nursing Staff Attitudes Towards Patients' Death

Introducción: El proceso de morir se ha desplazado a lo largo de la historia desde la familia y el hogar hasta los profesionales de salud y los hospitales. Cuidar demanda actitudes, conocimientos y destrezas que se deben adquirir y perfeccionarse durante la formación disciplinar. Objetivo: Explorar las actitudes que muestra el personal de enfermería que labora en áreas hospitalarias críticas ante el proceso de la muerte de pacientes. Materiales y métodos: Estudio descriptivo de corte transversal, bajo un muestreo no probabilístico por conveniencia se obtuvo una muestra final de 71 enfermeras profesionales que laboran en áreas críticas de dos hospitales de alta especialidad en Tabasco, México. El instrumento utilizado fue "Actitudes ante la muerte" (CAM-2), traducido del original de Martin y Salovely. Resultados: Los profesionales de enfermería que participaron en el estudio tienen una edad promedio de 32.5 años (DE=7), donde el 71.8% de los participantes pertenecen al sexo femenino. El 67.6% del personal de enfermería muestra una actitud de indiferencia ante la muerte, solo un 9.9% muestra una actitud positiva. Con relación a la perspectiva de actitud de temor el 46.5% manifiesta que pensar en la muerte les genera ansiedad, mientras que el 39.4% ve la muerte de los pacientes como algo natural. Conclusiones: El personal de enfermería posee sentimientos de indiferencia ante el cuidado del paciente ante la muerte, sin embargo, consideran que aceptar su propia muerte los lleva a cuidar con más libertad.

Introduction: The dying process has historically shifted from family and home settings to healthcare professionals and hospital settings. Caring involves attitudes, knowledge and skills that should be acquired and honed through nursing training. Objective: To explore nursing staff attitudes who work in critical hospital departments when faced with the process of dying patients. Materials and Methods: A descriptive cross-sectional study was conducted using a non-probability convenience sampling, from which a final sample of 71 professional nurses who work in critical departments of higher-level specialty hospitals in Tabasco, Mexico was obtained. The CAM-2 Attitudes Towards Death instrument originally developed by Martin & Salovely was translated and applied. Results: The average age of nursing professionals participating in this study were 32.5 years (SD=7), of which 71.8% were women. 67.6% of nurses had an attitude of indifference to death and only 9.9% had a positive attitude. From an attitude of fear perspective, 46.5% of the nurses expressed that thinking about death causes them anxiety, while 39.4% considered the death of patients as something natural. Conclusions: Nursing staff feel indifferent to patient care when facing death. However, nurses believe that accepting their own death leads them to care more freely.

Introdução: O processo de morte passou ao longo da história da família e do lar para profissionais de saúde e hospitais. O cuidado exige atitudes, conhecimentos e habilidades que devem ser adquiridos e aperfeiçoados através do treinamento de enfermagem. Objetivo: Explorar as atitudes dos profissionais de enfermagem que trabalham em áreas hospitalares críticas frente ao processo de morte de pacientes. Materiais e Métodos: Estudo descritivo transversal com base em uma amostragem não-probabilística por conveniência, foi obtida uma amostra final de 71 enfermeiros profissionais que trabalham em áreas críticas de hospitais especializados em alta complexidade em Tabasco, México. O instrumento CAM-2 Atitudes frente à morte originalmente desenvolvido pela Martin & Salovely foi traduzido e aplicado. Resultados: A idade média dos profissionais de enfermagem que participaram deste estudo foi de 32,5 anos (SD=7), onde 71,8% dos participantes eram do sexo feminino. 67,6% dos enfermeiros mostraram uma atitude de indiferença em relação à morte e apenas 9,9% mostraram uma atitude positiva. Em relação à perspectiva de uma atitude de medo, 46,5% dos enfermeiros expressaram que pensar na morte gera ansiedade, enquanto 39,4% consideraram a morte dos pacientes como algo natural. Conclusões: Os profissionais de enfermagem se sentem indiferentes em relação aos cuidados do paciente frente à morte. No entanto, eles sentem que aceitar sua própria morte os leva a cuidar mais livremente.

TSH y factores de riesgo cardiovascular: análisis en una población escolar eutiroidea con sobrepeso y obesidad / TSH and cardiovascular risk factors: analysis in an overweight and obese euthyroid school population

RESUMEN Objetivos. Describir el nivel de hormona tiroestimulante (TSH) y tiroxina plasmática libre (T4L) en escolares con sobrepeso y obesidad; además, determinar asociación entre TSH y factores de riesgo cardiovascular. Métodos. Participaron del estudio 96 escolares mujeres, entre 7 a 17 años, eutiroideas. Se definió sobrepeso IMC de 85 a < 95p y obesidad ≥ de 95p. Se determinó glucosa, triglicéridos, colesterol total, colesterol de alta y baja densidad, TSH y T4L. Para definir los subgrupos se optó valor del 75p de TSH. Resultados. Las variables antropométricas y la TSH fue significativamente mayor entre escolares obesas; sin embargo, las variables bioquímicas no difirieron entre grupos. Las que tuvieron sobrepeso y una TSH>75p presentaron medidas de circunferencia de cintura (CC) significativamente mayores, respecto al grupo TSH<75p, sin diferencia en las demás variables. Se encontró asociación lineal positiva y significativa (p<0,001) entre el nivel de TSH y el puntaje z-IMC (r=0,37) y la CC (r=0,51); no hubo asociación entre TSH con otros factores de riesgo cardiovascular. En la regresión lineal se encontró que por cada unidad de TSH incrementada, el puntaje z-IMC aumentó en 0,25 y la CC en 2,25 cm ajustado por edad, siendo este hallazgo significativo. Conclusión. Los valores de TSH fueron significativamente mayores en escolares obesas en comparación a las con sobrepeso. El puntaje z-IMC y la circunferencia de cintura se incrementaron conforme lo hace la TSH, independientemente de la edad. No se encontró relación entre los niveles de TSH con los niveles de colesterol, triglicéridos y glucosa.

ABSTRACT Objective. To describe the level of thyroid stimulating hormone (TSH) and free plasma thyroxine (FT4) in school students with overweight and obesity; also determine the association between TSH and cardiovascular risk factors. Methods. 96 women schoolchildren, between 7 to 17 years old, euthyroid, were studied. Overweight BMI was defined as 85 to <95p and obesity ≥ 95p. Glucose, triglycerides, total cholesterol, high and low density cholesterol, TSH and FT4 were determined. To define the subgroups, a value of 75p of TSH was chosen. Results. Anthropometric variables and TSH was significantly higher among obese women, however, biochemical variables did not differ between groups. Those who were overweight and had a TSH> 75p had significantly higher waist circumference (WC) measurements, compared to the TSH <75p group, with no difference in the other variables. A positive and significant linear association (p <0,001) was found between the TSH level and the z-BMI score (r = 0,37) and the WC (r = 0,51); there was no association between TSH and other cardiovascular risk factors. In the linear regression it was found that for each TSH unit increased, the z-BMI score increased by 0,25 and the WC by 2,25 cm adjusted for age, this finding being significant. Conclusion. TSH values were significantly higher in obese girls compared to overweight girls. Z-BMI score and waist circumference increase as TSH increases, regardless of age. No relationship was found between TSH levels and cholesterol, triglycerides and glucose levels.

Degradation of ciprofloxacin using a low-grade titanium ore, persulfate, and artificial sunlight.

In this study, the magnetic fraction (MF) of a low-grade titanium ore (TO) was successfully used as an alternative Fe2+ source in five reuse cycles, in combination with persulfate (PS) and simulated sunlight (SSL) for the degradation of ciprofloxacin (CIP). The best response of the CIP initial concentration, irradiation time, and doses of MF and PS to degrade completely this pollutant were determined based on an experimental design. However, the individual application of MF, PS, or SSL fails to achieve this goal at the optimal experimental condition. Furthermore, the MF-PS-SSL system showed a higher production of sulfate radicals and a concentration of dissolved Fe2+ ions compared with data obtained for the MF-PS system. The best performance attained by the former system is due to the synergy produced between the photo-generated electrons, and the reaction of PS with the Fe2+ ions leached gradually from the MF, which increased sulfate radical production. After five reuse cycles of the MF, the oxidation system showed a CIP degradation of 100% in 100 min, no residual content of PS, a CIP mineralization of 6%, a marginal increase in the biodegradability (BOD5/COD ratio), a MF loss of 7.5%, and a twofold increase in toxicity; however, this parameter was lower than the effective concentration at 50% inhibition (EC50). The substitution of MF with an iron salt decreased the degradation efficiency of the antibiotic by 14%, probably owing to the immediate excess of Fe2+ in the solution, which can be oxidized to Fe3+ ions, and as a consequence of this, the production rate of the sulfate radical was also reduced.

Asociación entre obesidad abdominal y factores demográficos, según niveles de altitud en el Perú / Association between abdominal obesity and demographic factors according to altitude levels in Peru

RESUMEN Objetivo. Determinar en la población adulta del Perú, las características de la obesidad abdominal y su relación con los diferentes niveles de altitud geográfica, de acuerdo a género, grupos de edad, estado nutricional y área de residencia. Métodos. Se realizó un estudio descriptivo en base a las fuentes secundarias: Encuesta Nacional de Hogares (ENAHO 2012-2013) del Instituto Nacional de Estadística e Informática (INEI) y Ministerio de Salud Lima, Perú. La obesidad abdominal se identificó mediante la circunferencia de la cintura y el índice cintura/talla. La altitud se estratificó en 3 niveles: < 1000 m.s.n.m., de 1000 a 2999 m.s.n.m. y ≥ 3000 m.s.n.m. Resultados. Las mayores prevalencias de obesidad abdominal se encontraron en el género femenino (48,2% - 87,4%), en el grupo de edad de 40 a 59 años (38,4 % - 89,5%), en los obesos (85,9% - 99,9%), y en las áreas urbanas (36,8% - 86,3%), respectivamente. Estas prevalencias disminuyeron a partir de los 1000 m.s.n.m., a excepción de las que correspondieron al estado nutricional. La razón de prevalencia ajustada por género, grupo étareo y área de residencia, mostró una disminución en relación a la altitud. Conclusión. La población que vive en ciudades de gran altitud mostró bajas prevalencias de obesidad abdominal en relación a los que viven en ciudades de menor altitud.

ABSTRACT Objective. To determine in the adult population of Peru, the characteristics of abdominal obesity and its relationship with different levels of geographic altitude, according to gender, age groups, nutritional status, and area of residence. Methods. A descriptive study was carried out based on secondary sources: National Household Survey (ENAHO 2012-2013) of the National Institute of Statistics and Informatics (INEI) and Ministry of Health Lima, Peru. Abdominal obesity was identified by waist circumference and waist / height ratio. The altitude was stratified into 3 levels: <1000 meters above sea level, from 1000 to 2999 meters above sea level, and ≥ 3000 m.a.s.l. Results. The highest prevalence of abdominal obesity was found in the female gender (48,2% - 87,4%), in the age group from 40 to 59 years (38,4% - 89,5%), in the obese (85,9% - 99,9%), and in urban areas (36,8% - 86,3%), respectively. These prevalences decreased from 1000 meters above sea level, with the exception of those corresponding to nutritional status. The prevalence ratio adjusted for gender, age group and area of residence, showed a decrease in relation to altitude. Conclusion. The population living in high-altitude cities showed low prevalence of abdominal obesity in relation to those living in lower-altitude cities.

Altitude and its inverse association with abdominal obesity in an Andean country: a cross-sectional study.

Background: Abdominal obesity represents an accurate predictor of overall morbidity and mortality, which is worrisome because it is also continuously increasing across Andean countries. However, its relationship with altitude remains unclear. The objective of this study was to assess the association between altitude and abdominal obesity in Peru, and how sociodemographic variables impact this association. Methods: We estimated the prevalence of abdominal obesity in Peru and analyzed its association with altitude using the data from the 2012-2013 National Household Survey (ENAHO). During this survey, a representative sample of Peruvians was screened for abdominal obesity, using waist circumference as a proxy, and the Adult Treatment Panel III guidelines cutoffs. Results: Data were analyzed from a sample of 20,489 Peruvians (51% male). The prevalence of abdominal obesity was estimated at 33.6% (95% CI: 32.5 to 34.6%). In Peru, altitude was significantly and inversely associated with abdominal obesity, decreasing with higher altitudes: 1500-2999 meters above mean sea level (MAMSL) vs <1500 MAMSL, adjusted prevalence rate [aPR]= 0.86 (95% CI: 0.75 to 0.97); ≥3000 MAMSL vs <1500 MAMSL, aPR= 0.98 (95% CI: 0.87 to 1.11), when adjusting by age, gender and residence area (rural/urban). However, this association was significantly modified by age and gender ( p< 0.001). Conclusion: Abdominal obesity is highly prevalent in Peru and decreases significantly with altitude, but age and gender modify this association. Thus, abdominal obesity appears to affect older women from low altitudes more than younger men from high altitudes.

A clinical trial to evaluate the effect of the Mediterranean diet on smokers lung function.

Data on the association between lung function and some dietary patterns have been published. However, it is not yet well known if whether the Mediterranean Diet (MD) pattern can preserve or improve lung function. Our purpose is to evaluate the effect of increased MD adherence on lung function in smokers. A multicenter, parallel, cluster-randomized, controlled clinical trial is proposed. A total of 566 active smokers (>10 packs-year), aged 25-75 years will be included, without previous respiratory disease and who sign an informed consent to participate. Twenty Primary Care Centres in Tarragona (Spain) will be randomly assigned to a control or an intervention group (1:1). All participants will receive advice to quit smoking, and the intervention group, a nutritional intervention (2 years) designed to increase MD adherence by: (1) annual visit to deliver personalized nutritional education, (2) annual telephone contact to reinforce the intervention, and (3) access to an online dietary blog. We will evaluate (annually for 2 years): pulmonary function by forced spirometry and MD adherence by a 14-item questionnaire and medical tests (oxidation, inflammation and consumption biomarkers). In a statistical analysis by intention-to-treat basis, with the individual smoker as unit of analysis, pulmonary function and MD adherence in both groups will be compared; logistic regression models will be applied to analyze their associations. We hope to observe an increased MD adherence that may prevent the deterioration of lung function in smokers without previous respiratory disease. This population may benefit from a dietary intervention, together with the recommendation of smoking cessation.

Obesidad severa en adolescentes peruanos: análisis de la Encuesta Nacional de Hogares (ENAHO), 2009-2010 / Severe obesity in peruvian adolescents: analysis of the National Household Survey (ENAHO), 2009 - 2010

Introducción. La obesidad infantil es un problema de salud pública en nuestro país; sin embargo, la situación de la población entre 10 a 19 años ha sido poco estudiada. Objetivo. Determinar la prevalencia de obesidad y obesidad severa en adolescentes peruanos. Métodos. Estudio de datos secundarios provenientes de la Encuesta Nacional de Hogares 2009-2010. Se utilizó el índice de masa corporal (IMC) definiendo obesidad con un valor de IMC ≥ percentil 95 (p95). Obesidad severa (OS) mediante dos criterios: IMC ≥ percentil 99 (p99) y el 120% del valor correspondiente al percentil 95 del IMC. Resultados. El 7,6% presentó obesidad, el 2,4 y 1,4% presentaron OS según los criterios citados. Las mayores prevalencias de OS se evidenciaron en varones (3% vs 1,8%), en el grupo de 10 a 14 años (3,4% vs 2%), en Lima Metropolitana (4,2% vs 2,4%), área urbana (3,2% vs 1,9%), no pobres (3,1% vs 1,9%) y en ciudades de menos de 1000 msnm (3,5% vs 2.1%). Se encontró mayor razón de prevalencia (RP) de OS en los varones y no pobres. Tener de 15 a 19 años, residir en sierra o selva, área rural y ser pobre se asoció independientemente a menor RP. Conclusión. La prevalencia de OS fue baja a predominio de varones, en el grupo de 10 a 14 años, en la costa y Lima Metropolitana, en áreas urbanas, en los considerados no pobres y en los que viven por debajo de los 1000 msnm.

Introduction. Childhood obesity is a Public Health problem in our country; instead of that, the situation of population aged between 10-19 years-old has been poorly studied. Objective. To determine the prevalence of obesity and severe obesity in Peruvian adolescents. Methods. A secondary study of data from the National Household Survey 2009-2010. The Body Mass Index (BMI) was used to define obesity as a BMI value ≥ 95 percentile. Severe obesity (SO) was defined using two criteria, BMI ≥ 99 p and 120% of the value corresponding to 95p of BMI. Results. 7,6% presented obesity, and 2,4 and 1,4% were diagnosed with SO according to the mentioned criteria. The highest prevalence of SO was evidenced in men (3% vs. 1,8%), age group of 10 to 14 years-old (3,4% vs. 2%), people who are living in Lima Metropolitana (4,2% vs. 2,4%), or in a urban area (3,2% vs. 1,9%), non-poor (3,1% vs. 1,9%) and in cities less than 1000 meters above sea level (3,5% vs. 2,1%). A higher prevalence ratio (PR) of SO was found in men and non-poor. Having an age between 15 to 19 years old, residing in the mountains or jungle, rural area and being poor, were independently associated with a lower PR. Conclusion. The prevalence of SO was low, with a predominance of men, in the 10 to 14 year old group, on the coast and Metropolitan Lima, in urban areas, in those considered non-poor and in those living below 1000 meters above sea level.

Obesidad no morbida y morbida del adulto en el Perú, 1975 - 2013 / Adult non-morbid and morbid obesity in Peru, 1975 - 2013

Introducción: La obesidad es una enfermedad considerada como problema de salud pública que afecta a un gran número de personas y que requiere políticas de gobierno que enfrenten esta situación. Objetivo: Determinar las variaciones en las frecuencias de obesidad no mórbida (ONM) y obesidad mórbida (OM) de acuerdo a diferentes encuestas nacionales en función de variables socio-demográficas. Métodos: Estudio descriptivo secundario de datos de cinco encuestas nacionales: Evaluación Nutricional del Poblador Peruano (ENPPE 1975), Encuesta Nacional de Indicadores Nutricionales, Bioquímicos, Socio-económicos y Culturales (CENAN 2005), Encuesta Nacional de Hogares (ENAHO 2009-2010) y Encuesta Nacional de Hogares (ENAHO 2012-2013). La ONM se identificó por un IMC de 30 a 39,99 kg/m² y para la OM con un IMC igual o mayor de 40 kg/m². Resultados: La frecuencia de la ONM se incrementó de 8,5% en 1975 a 18,5% en el 2013, mientras la OM de 0,5 a 0,9% en el mismo periodo. La presencia de OM fue mayor en el género femenino (1,3%) frente al masculino (0,4%), con un incremento promedio en mujeres de 0,6% (0,7% en 1975 y 1,3% en 2013) y en varones de 0,2%. La presencia de obesidad fue mayor en el grupo de 50 a 59 años, en quienes viven en regiones costeras, áreas urbanas y ciudades ubicadas por debajo de 1000 msnm. Conclusiones: La ONM y la OM, presentes desde hace muchos años en nuestro país, tuvieron tendencia al incremento progresivo en los años de estudio, a predominio del género femenino.

Introduction: Obesity is a chronic disease, which is considered as a public health problem. It affects a large number of people and requires governmental policies that encourage this situation. Objective: To determine the variations in the frequencies of non-morbid obesity (NMO) and morbid obesity (MO) according with different national surveys, and in function of socio-demographic variables. Methods: A descriptive study with data of five national surveys: Nutritional Evaluation of the Peruvian Population (ENPPE 1975), National Survey of Nutritional, Biochemical, Socio-economic and Cultural Indicators (CENAN 2005), National Household Survey (ENAHO 2009-2010) and National Household Survey (ENAHO 2012-2013). NMO was identified by a BMI of 30 to 39.99 kg/m² and MO was defined by a BMI equal to or greater than 40 kg/m². Results: The frequency of NMO has increased from 8,5% in 1975 to 18,5% in 2013, and the MO increased from 0,5 to 0,9% in the same period. OM is most presented in females (1,3%) with an average increasing of 0,6% (0,7% in 1975 and 1,3% in 2013) while in men it was 0,2%. Similarly, the frequency of MO was higher in the age group of 50 to 59 years, in those who live in coastal regions, urban areas and cities located below 1000 meters above sea level. Conclusions: ONM and OM, present for many years in our country, had a tendency to the progressive increase in the years of study, with a predominance of the female gender.

Optimization of the integral valorization process for orange peel waste using a design of experiments approach: Production of high-quality pectin and activated carbon.

The aim of this study was to optimize the integral valorization of orange peel waste by obtaining activated carbon after a process of pectin recovery in recycling of orange peel by transformation to value-added products of pectin extraction and activated carbon preparation. The study was supported by statistical analysis, and the significant factors and optimal conditions were obtained from the statistical analysis. Using a representative sample of orange peel waste, a yield of 29.37% pectin was recovered at the optimal operating conditions (phosphoric acid as the extraction agent, 95 °C as the impregnation temperature and a 2-hour extraction time). Activated carbon (AC) was prepared from the remaining solid residue. The conditions that improve the resulting material quality were H3PO4 [0.6 M] used as the activating agent, an impregnation temperature of 95 °C, a carbonization temperature of 400 °C and 1 h of carbonization time. The obtained AC showed a sorption capacity of 2342.91 mg g-1, a value higher than that reported for commercial activated carbon. Using a model dye chemical, the sorption kinetics and thermodynamics of AC were found to follow a pseudo-second-order rate and the Freundlich models, respectively. Using the process conditions obtained in this study, it was possible to optimize the yield and also obtain good-quality products from valorization of orange peel.