The Use of Industrial Waste for the Bioremediation of Water Used in Industrial Processes

Recently the interest in the remediation of liquid effluents from industries such as paint manufacturing, leather tanning, etc. has increased, because the quality of the water used in these processes is highly compromised and is generally discarded without any process of purification, causing an inadequate use of water and contributing to the hydric stress of the planet. Therefore, it is necessary to find alternatives for the remediation of water used in industrial processes; one of the methods that has been widely accepted given its high efficiency, low cost, and versatility compared to others is the bioadsorption using materials derived from various processes used for the elimination of metals such as Cr, Co, Cu, Ni, etc. from liquid effluents. Among the materials used for this purpose are rice husk, orange, and wheat as well as apatite (hydroxyapatite and brushite), derived from animal bones, which have shown good capacity (>90%) to adsorb metals from aqueous solutions. Through the characterization by DRX, FTIR, and SEM, of the brushite and studies in equilibrium and kinetics of adsorption, it has been demonstrated that this material has a good capacity to remove metals present in water

The job incorporation of new graduated nurses at the University of La Laguna in times of pandemic. A descriptive phenomenological study

El presente documento es continuación de una investigación realizada con enfermeras egresadas de la Universidad de La Laguna entre los años 2020 y 2021 teniendo en cuenta el contexto de pandemia y crisis sanitaria por la COVID-19. Al tener en cuenta los resultados de dicho anterior trabajo, se plantea un estudio fenomenológico para comprender las vivencias de las enfermeras al pasar de estudiante a profesional y ejercer en una institución sanitaria de la provincia de Santa Cruz de Tenerife (España). De entre los resultados obtenidos, se destaca que el paso de estudiante a profesional es un hecho significativo a nivel emocional con una gran consciencia de responsabilidad y de que las enfermeras se sienten arropadas por parte del resto de profesionales más veteranas. Sin embargo, no existe período de tuto- rización y orientación por parte de la institución sanitaria.This document is a continuation of an investigation carried out with nurses graduated from the University of La Laguna between 2020 and 2021, taking into account the context of the pandemic and health crisis caused by COVID-19. Taking into account the results of that previous work, a phenomenological study is proposed to understand the experiences of nurses when they finish their degree and begin in the professional world in a health institution in the province of Santa Cruz de Tenerife (Spain). Among the results obtained, it stands out that the transition from student to professional is a significant fact at an emotional level with a great awareness of responsibility and that nurses feel supported by the rest of the more veteran professionals. However, there is no period of tutoring and orientation by health institutions

Desnutrición Infantil en Niños y Niñas Menores de Cinco Años en los Municipios del Departamento del Amazonas

Tabla 1. Descripción de Responsabilidades y Actividades - Tabla 2 Estrategias Objetivos y Actividades.En Colombia uno de los departamentos más golpeados por la pobreza, la falta de acceso a la salud y de recursos se encuentra ubicado en el departamento de la amazonia, este departamento es rico en fauna, flora; en estas tierras habitan nuestros indígenas los cuales debido a sus diferentes creencias y culturas muchas de las leyes que se crean para el país no son tomadas en cuenta en esta parte de Colombia ya que las culturas indígenas se rigen por sus propias leyes por sus creencias; Debido a esta creencias se presentan muchas problemáticas en donde se ve afectada su población en especial los niños menores de cinco años. El objetivo de esta investigación es plantear una propuesta para intervenir la problemática de desnutrición en niños y niñas menores de cinco años en los municipios que componen el departamento de la Amazonia, esta problemática lleva en estudio catorce años en donde se evidencia que los parásitos y las enfermedades infecciosas no son tratadas correctamente causando la muerte. Por lo cual frente a esta problemática como administradoras en salud queremos que esta población se beneficie y conozca los diferentes programas de promoción y prevención para así lograr que los niños y niñas gocen de una mejor salud, con el acompañamiento de diferentes instituciones como el ICBF, apoyo de la alcaldía municipal, grupo de médicos y enfermeros y el apoyo del grupo éxito quienes cuentan con la experiencia para hacer posible una jornada de salud productiva la cual nos permitirá bajar el índice de mortalidad en esta parte del país. Teniendo en cuenta lo anterior se deben realizar diferentes actividades para lograr el resultado que se quiere, por lo cual cada integrante de esta investigación contara con un rol y actividad para lograr el cumplimiento de los diferentes objetivos propuestos.In Colombia, one of the departments hardest hit by poverty, the lack of access to health and resources is located in the department of the Amazon, this department is rich in fauna, flora; our indigenous peoples live in these lands, due to their different beliefs and cultures, many of the laws that are created for the country are not taken into account in this part of Colombia since indigenous cultures are governed by their own laws for their beliefs; Because these beliefs present many problems where its population is affected, especially children under five years of age. The objective of this research is to propose a proposal to intervene in the problem of malnutrition in children under five years of age in the municipalities that make up the department of Amazonia, this problem has been under study for fourteen years where it is evidenced that parasites and Infectious diseases are not treated properly causing death. Therefore, in the face of this problem, as health administrators we want this population to benefit and learn about the different promotion and prevention programs in order to ensure that children enjoy better health, with the support of different institutions such as the ICBF, Group of doctors and nurses and the support of the successful group who have the experience to make possible a productive health day which will allow us to lower the mortality rate in this part of the country. Taking into account the above, different activities must be carried out to achieve the desired result, for which each member of this research will have a role and activity to achieve the fulfillment of the different proposed objectives

Using Interpretable Machine Learning to Identify Baseline Predictive Factors of Remission and Drug Durability in Crohn’s Disease Patients on Ustekinumab

Ustekinumab has shown efficacy in Crohn's Disease (CD) patients. To identify patient profiles of those who benefit the most from this treatment would help to position this drug in the therapeutic paradigm of CD and generate hypotheses for future trials. The objective of this analysis was to determine whether baseline patient characteristics are predictive of remission and the drug durability of ustekinumab, and whether its positioning with respect to prior use of biologics has a significant effect after correcting for disease severity and phenotype at baseline using interpretable machine learning. Patients' data from SUSTAIN, a retrospective multicenter single-arm cohort study, were used. Disease phenotype, baseline laboratory data, and prior treatment characteristics were documented. Clinical remission was defined as the Harvey Bradshaw Index <= 4 and was tracked longitudinally. Drug durability was defined as the time until a patient discontinued treatment. A total of 439 participants from 60 centers were included and a total of 20 baseline covariates considered. Less exposure to previous biologics had a positive effect on remission, even after controlling for baseline disease severity using a non-linear, additive, multivariable model. Additionally, age, body mass index, and fecal calprotectin at baseline were found to be statistically significant as independent negative risk factors for both remission and drug survival, with further risk factors identified for remission

Long-Term Real-World Effectiveness and Safety of Ustekinumab in Crohn’s Disease Patients: The SUSTAIN Study

Background Large real-world-evidence studies are required to confirm the durability of response, effectiveness, and safety of ustekinumab in Crohn’s disease (CD) patients in real-world clinical practice. Methods A retrospective, multicentre study was conducted in Spain in patients with active CD who had received ≥1 intravenous dose of ustekinumab for ≥6 months. Primary outcome was ustekinumab retention rate; secondary outcomes were to identify predictive factors for drug retention, short-term remission (week 16), loss of response and predictive factors for short-term efficacy and loss of response, and ustekinumab safety. Results A total of 463 patients were included. Mean baseline Harvey-Bradshaw Index was 8.4. A total of 447 (96.5%) patients had received prior biologic therapy, 141 (30.5%) of whom had received ≥3 agents. In addition, 35.2% received concomitant immunosuppressants, and 47.1% had ≥1 abdominal surgery. At week 16, 56% had remission, 70% had response, and 26.1% required dose escalation or intensification; of these, 24.8% did not subsequently reduce dose. After a median follow-up of 15 months, 356 (77%) patients continued treatment. The incidence rate of ustekinumab discontinuation was 18% per patient-year of follow-up. Previous intestinal surgery and concomitant steroid treatment were associated with higher risk of ustekinumab discontinuation, while a maintenance schedule every 12 weeks had a lower risk; neither concomitant immunosuppressants nor the number of previous biologics were associated with ustekinumab discontinuation risk. Fifty adverse events were reported in 39 (8.4%) patients; 4 of them were severe (2 infections, 1 malignancy, and 1 fever). Conclusions Ustekinumab is effective and safe as short- and long-term treatment in a refractory cohort of CD patients in real-world clinical practice

GACETA SANITARIA in 2016. A new stage; the strengthening of e-Gaceta and its internationalisation

En el año 2016 empezamos una nueva etapa en Gaceta Sanitaria con la conformación de un nuevo equipo editorial, después de 6 años de servicio del equipo liderado por Carme Borrell y Felicitas Domínguez Berjón. El comité editorial se ha constituido tras convocatoria pública, usando las figuras que están representadas en el reglamento de SESPAS, e incluye miembros de fuera de España. El nuevo equipo firmó un acuerdo explicitando el trabajo a desarrollar en cuanto a volumen, puntualidad y calidad del servicio prestado, salvaguardando los aspectos éticos de la publicación científica y representando todas las sensibilidades profesionales que conforman SESPAS

A randomized, double-blind study on the efficacy of oral domperidone versus placebo for reducing SARS-CoV-2 viral load in mild-to-moderate COVID-19 patients in primary health care

15 p.-3 fig.-3 tab.Introduction:The clinical effect of domperidone against COVID-19 has been investigated in a double-blind phase III clinical trial (EudraCT number 2021-001228-17). Domperidone has shown in vitro antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and potential immudolatory properties through the stimulation of prolactin secretion.Patients and methods:The efficacy of oral domperidone plus standard of care (SOC; n = 87) versus placebo plus SOC (n = 86) was evaluated in a 28-day randomized double-blind multicentre study in primary health care centres. A total of 173 outpatients with mild-to-moderate COVID-19 were included. Three daily doses of 10 mg (30 mg/day) of domperidone or placebo were administered for 7 days. Reduction of viral load on day 4 was the primary efficay endpoint. It was estimated in saliva samples by reverse transcription-quantitative polymerase chain reaction (RT-qPCR), as the cycle thresholds detected ORF1ab, N Protein and S Protein genes.Results:A significant reduction in the viral load was observed (p < 0.001) from baseline to days 4, 7 and 14 of the three genes studied with non-significant differences between domperidone and placebo groups. Twenty-three patients (13.3%) experienced adverse events, 14 patients in the domperidone group (16.1%) and 9 patients in the placebo group (10.5%). No patients needed to be hospitalized.Conclusion: Results do not prove the use of domperidone as antiviral in patients with COVID-19.This research was funded by CSIC (grant no. PIE 201980E024) and by the European Commission: NextGeneration EU (Regulation EU 2020/2094) through CSIC’s Global Health Platform (PTI Salud Global). The study sponsor was Agencia Estatal Consejo Superior de Investigaciones Científicas, M.P. (CSIC), Madrid, Spain. The sponsor was involved in the design, data interpretation, manuscript review and the decision to submit the article for publication.Peer reviewe

Memoria del III Coloquio Internacional sobre Diversidad Cultural y Estudios Regionales

Del 05 al 07 de noviembre de 2014 se llevó a cabo en la Sede de Occidente de la Universidad de Costa Rica, el III Coloquio Internacional sobre Diversidad Cultural y Estudios Regionales, dicado a Julieta Dobles Izaguirre, Premio Nacional de Cultura Magón, 2013. Este III Coloquio Internacional fue organizado por el Centro de Investigaciones sobre Diversidad Cultural y Estudios Regionales (CIDICER), primer Centro de Investigaciones de una Sede Regional de la Universidad de Costa Rica. Se contó con personas investigacdoras nacionales e internacionales quienes presentaron sobre temas relacionados con la diversidad cultural y los estudios regionales.Universidad de Costa Rica/[836-B4-702]/UCR/Costa RicaUCR::Sedes Regionales::Sede de Occidente::Recinto San Ramón::Centro de Investigaciones sobre Diversidad Cultural y Estudios Regionales (CIDICER

Innovación en las enseñanzas universitarias: experiencias presentadas en las III Jornadas de Innovación Educativa de la ULL

En este libro se recoge un conjunto de experiencias de innovación educativa desarrolladas en la ULL en el curso 2011-12. Se abordan distintos ámbitos y ramas del conocimiento, y ocupan temáticas variadas que han sido desarrolladas con rigor, y con un claro potencial para su extrapolación a efectos de la mejora educativa en el ámbito universitario. Esta publicación constituye una primera edición de una serie que irá recogiendo las experiencias de innovación educativa de la ULL. Este es un paso relevante para su impulso en nuestra institución, como lo es el de su vinculación con la investigación educativa, para potenciar su publicación en las revistas científicas en este ámbito cada vez más pujante y relevante para las universidades. Sobre todo representan el deseo y el compromiso del profesorado de la ULL para la mejora del proceso educativo mediante la investigación, la evaluación y la reflexión compartida de nuestras prácticas y planteamientos docentes

CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3

ObjectivesCARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain.MethodsIn total, 71 hospitals, representing all 50 Spanish provinces, collected the first 10 isolates per hospital (February to May 2019); CPE isolates were first identified according to EUCAST (meropenem MIC &gt; 0.12 mg/L with immunochromatography, colorimetric tests, carbapenem inactivation, or carbapenem hydrolysis with MALDI-TOF). Prevalence and incidence were calculated according to population denominators. Antibiotic susceptibility testing was performed using the microdilution method (EUCAST). All 403 isolates collected were sequenced for high-resolution single-nucleotide polymorphism (SNP) typing, core genome multilocus sequence typing (cgMLST), and resistome analysis.ResultsIn total, 377 (93.5%) CP-Kpn and 26 (6.5%) CP-Eco isolates were collected from 62 (87.3%) hospitals in 46 (92%) provinces. CP-Kpn was more prevalent in the blood (5.8%, 50/853) than in the urine (1.4%, 201/14,464). The cumulative incidence for both CP-Kpn and CP-Eco was 0.05 per 100 admitted patients. The main carbapenemase genes identified in CP-Kpn were blaOXA–48 (263/377), blaKPC–3 (62/377), blaVIM–1 (28/377), and blaNDM–1 (12/377). All isolates were susceptible to at least two antibiotics. Interregional dissemination of eight high-risk CP-Kpn clones was detected, mainly ST307/OXA-48 (16.4%), ST11/OXA-48 (16.4%), and ST512-ST258/KPC (13.8%). ST512/KPC and ST15/OXA-48 were the most frequent bacteremia-causative clones. The average number of acquired resistance genes was higher in CP-Kpn (7.9) than in CP-Eco (5.5).ConclusionThis study serves as a first step toward WGS integration in the surveillance of carbapenemase-producing Enterobacterales in Spain. We detected important epidemiological changes, including increased CP-Kpn and CP-Eco prevalence and incidence compared to previous studies, wide interregional dissemination, and increased dissemination of high-risk clones, such as ST307/OXA-48 and ST512/KPC-3