85 research outputs found
Experimental data on SOA formation from mixtures of anthropogenic and biogenic organic compounds
AbstractSecondary organic aerosols (SOA) constitute a significant fraction of the atmospheric particulate matter. Theses particles are formed as a consequence of the oxidation reaction of certain organic gases that leads to the formation of low-volatility compounds. As for other pollutants, air quality models allow the simulation of particle levels and thus models constitute a powerful tool in air quality management. Nevertheless, the accepted use of models must be based on the validation of its capacity to reproduce observed concentrations. Air monitoring sites provide measured information of a large variety of ambient pollutants. Unfortunately, measurements on SOA are not normally available, as current monitoring networks do not include instrumentation to distinguish primary from secondary sources of organic carbonaceous aerosol. This paper presents a set of photooxidation experiments performed in the European Photorreactor (EUPHORE) smog chamber (CEAM, Spain) under different experimental conditions to investigate SOA formation. The use of chambers allows the isolation of atmospheric chemistry and aerosol formation processes. Thus, although these measurements were obtained at initial precursor concentrations higher than those in atmospheric conditions, they constitute a valuable set of information for SOA model evaluation purposes
Follow-up with Telemedicine in Early Discharge for COPD Exacerbations: Randomized Clinical Trial (TELEMEDCOPD-Trial)
The results reported by different studies on telemonitoring in patients with chronic obstructive pulmonary disease (COPD) have been contradictory, without showing clear benefits to date. The objective of this study was to ascertain whether an early discharge and home hospitalization telehealth program for patients with COPD exacerbation is as effective as and more efficient than a traditional early discharge and home hospitalization program. A prospective experimental non-inferiority study, randomized into two groups (telemedicine/control) was conducted. The telemedicine group underwent monitoring and was required to transmit data on vital constants and ECGs twice per day, with a subsequent telephone call and 2 home visits by healthcare staff (intermediate and at discharge). The control group received daily visits. The main variable was time until first exacerbation. The secondary variables were: number of exacerbations; use of healthcare resources; satisfaction; quality of life; anxiety-depression; and therapeutic adherence, measured at one and 6 months of hospital discharge. A total of 116 patients were randomized (58 to each group) without significant differences in baseline characteristics or time until first exacerbation, i.e. median 48 days (pp. 25-75:23-120) in the control group, and 47 days (pp. 25-75:19-102) in the intervention group; p = 0.52). A significant decrease in the number of visits was observed in the intervention versus the control group, 3.8 ± 1 vs 5.1 ± 2(p = 0.001), without significant differences in the number of exacerbations. In conclusion follow-up via a telemedicine program in early discharge after hospitalization is as effective as conventional home follow up, being the cost of either strategy not significantly different.This study was awarded a Health Research Fund (Fondo de Investigaciones Sanitarias/FIS) grant, dossier No. PI12/01161 of the Carlos III Institute of Health and the Ministry of Sciences, Innovation and Universities.S
Validation of the INCREMENT-SOT-CPE score in a large cohort of liver transplant recipients with carbapenem-resistant Enterobacterales infection
Background: Management of infections due to carbapenemase-resistant Enterobacterales (CRE) in solid organ transplant (SOT) recipients remains a difficult challenge. The INCREMENT-SOT-CPE score has been specifically developed from SOT recipients to stratify mortality risk, but an external validation is lacking.Methods: Multicenter retrospective cohort study of liver transplant (LT) recipients colonized with CRE infection who developed infection after transplant over 7-year period. Primary endpoint was all-cause 30-day mortality from infection onset. A comparison between INCREMENT-SOT-CPE and other selected scores was performed. A two-level mixed effects logistic regression model with random effects for the center was fitted. Performance characteristics at optimal cut-point were calculated. Multivariable Cox regression analysis of risk factors for all-cause 30-day mortality was carried out.Results: Overall, 250 CRE carriers developed infection after LT and were analyzed. The median age was 55 years (interquartile range [IQR]: 46-62) and 157 were males (62.8%). All-cause 30-day mortality was 35.6%. A sequential organ failure assessment (SOFA) score >= 11 showed a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 69.7%, 76.4%, 62.0%, 82.0%, and 74.0%, respectively. An INCREMENT-SOT-CPE >= 11 reported a sensitivity, specificity, PPV, NPV, and accuracy of 73.0%, 62.1%, 51.6%, 80.6% and 66.0%, respectively. At multivariable analysis acute renal failure, prolonged mechanical ventilation, INCREMENT-SOT-CPE score >= 11 and SOFA score >= 11 were independently associated with all-cause 30-day mortality, while a tigecycline-based targeted regimen was found to be protective.Conclusions: Both INCREMENT-SOT-CPE >= 11 and SOFA >= 11 were identified as strong predictors of all-cause 30-day mortality in a large cohort of CRE carriers developing infection after LT
Forced Solid-State Interactions for the Selective “Turn-On” Fluorescence Sensing of Aluminum Ions in Water Using a Sensory Polymer Substrate
Selective and sensitive solid sensory substrates for detecting Al(III) in pure
water are reported. The material is a flexible polymer film that can be handled and exhibits gel
behavior and membrane performance. The film features a chemically anchored salicylaldehyde
benzoylhydrazone derivative as an aluminum ion fluorescence sensor. A novel procedure for
measuring Al(III) at the ppb level using a single solution drop in 20 min was developed. In this
procedure, a drop was allowed to enter the hydrophilic material for 15 min before a 5 min
drying period. The process forced the Al(III) to interact with the sensory motifs within the
membrane before measuring the fluorescence of the system. The limit of detection of Al(III)
was 22 ppm. Furthermore, a water-soluble sensory polymer containing the same sensory
motifs was developed with a limit of detection of Al(III) of 1.5 ppb, which was significantly
lower than the Environmental Protection Agency recommendations for drinking water.Spanish Ministerio de Economía
y Competitividad-Feder
(MAT2011-22544) and by the Consejería
de Educación - Junta
de Castilla y León (BU232U13)
The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry
Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes
A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)
Meeting abstrac
Early Diagnosis of Vegetation Health From High-Resolution Hyperspectral and Thermal Imagery: Lessons Learned From Empirical Relationships and Radiative Transfer Modelling
[Purpose of Review] We provide a comprehensive review of the empirical and modelling approaches used to quantify the radiation–vegetation interactions related to vegetation temperature, leaf optical properties linked to pigment absorption and chlorophyll fluorescence emission, and of their capability to monitor vegetation health. Part 1 provides an overview of the main physiological indicators (PIs) applied in remote sensing to detect alterations in plant functioning linked to vegetation diseases and decline processes. Part 2 reviews the recent advances in the development of quantitative methods to assess PI through hyperspectral and thermal images.[Recent Findings] In recent years, the availability of high-resolution hyperspectral and thermal images has increased due to the extraordinary progress made in sensor technology, including the miniaturization of advanced cameras designed for unmanned aerial vehicle (UAV) systems and lightweight aircrafts. This technological revolution has contributed to the wider use of hyperspectral imaging sensors by the scientific community and industry; it has led to better modelling and understanding of the sensitivity of different ranges of the electromagnetic spectrum to detect biophysical alterations used as early warning indicators of vegetation health.[Summary] The review deals with the capability of PIs such as vegetation temperature, chlorophyll fluorescence, photosynthetic energy downregulation and photosynthetic pigments detected through remote sensing to monitor the early responses of plants to different stressors. Various methods for the detection of PI alterations have recently been proposed and validated to monitor vegetation health. The greatest challenges for the remote sensing community today are (i) the availability of high spatial, spectral and temporal resolution image data; (ii) the empirical validation of radiation–vegetation interactions; (iii) the upscaling of physiological alterations from the leaf to the canopy, mainly in complex heterogeneous vegetation landscapes; and (iv) the temporal dynamics of the PIs and the interaction between physiological changes.The authors received funding provided by the FluorFLIGHT (GGR801) Marie Curie Fellowship, the QUERCUSAT and ESPECTRAMED projects (Spanish Ministry of Economy and Competitiveness), the Academy of Finland (grants 266152, 317387) and the European Research Council Synergy grant ERC-2013-SyG-610028 IMBALANCE-P.Peer reviewe
Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.
BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362
RICORS2040 : The need for collaborative research in chronic kidney disease
Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true
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