Nuevo índice para evaluar anomalías de elementos traza en suelos: el caso del SE español

In this work, an index is established to detect anomalies in trace elements in the soil. This index, which relates the total concentration of each element with the regional geochemical background value of the element considered, was defined by studying the levels of trace elements from different soils located in SE Spain. In the area, a previous screening of trace elements detected seven zones with anomalies and revealed two conflictive areas: Sierra Gador and Cabo de Gata. In each zone, a second sampling was undertaken at two different depths (0-20 cm and 20-40 cm). The results indicate that the main anomalies were due to arsenic (As), lead (Pb), and zinc (Zn). In Sierra Gador Pb was the element that registered the highest rate of enrichment with respect to the regional geochemical background, reaching values up to 270-fold higher in some samples. In this zone, more than 50% of the samples were anomalous in any of the trace elements studied (higher than regional geochemical background). In Cabo de Gata, As concentration was higher than the geochemical background in more than 40% of the samples; meanwhile Pb concentration was higher in 50% of the samples.En este trabajo establecemos un índice para detectar anomalías en el contenido de elementos traza en suelos. Este índice relaciona el contenido total de cada elemento traza con el fondo geoquímico regional, definido mediante el estudio de los niveles de elementos traza en diferentes suelos localizados en el sureste español. En un primer estudio sobre niveles de elementos traza en suelos del área de estudio detectaron siete zonas con anomalías, de las cuales dos fueron consideradas conflictivas: Sierra de Gádor y Cabo de Gata. En cada una de estas dos zonas se realizó un segundo estudio más exhaustivo a dos niveles de profundidad (0-20 y 20-40 cm). Los resultados indican que las principales anomalías correspondes a los niveles de As, Pb y Zn. En Sierra de Gádor el Pb es el elemento que presenta una mayor tasa de enriquecimiento con respecto al fondo geoquímico regional, con valores puntuales que lo superan hasta 270 veces. También en esta zona más del 50% de las muestras presentan anomalías en alguno de los elementos analizados. En Cabo de Gata el As supera el fondo geoquímico regional en más del 40% de las muestras; mientras que el Pb lo supera en el 50% de las muestras.This study has been made possible by the research Project no. 1550 of the Regional Environmental Department of the Andalusian Government

A strategic reflection for the management and implementation of CAR-T therapy in Spain: an expert consensus paper

CAR-T cell therapy represents a therapeutic revolution in the prognosis and treatment of patients with certain types of hematological cancer. However, they also pose new challenges in the healthcare, regulatory and financial fields. The aim of the RET-A project was to undertake a strategic reflection on the management of CAR-T therapies within the Spanish National Health System, to agree on recommendations that will help to better deal with the new context introduced by these cell therapies in the present and in the future. This think tank involved 40 key agents and opinion leaders. The experts identified three great challenges for implementing advanced therapies in Spain: therapeutic individualisation, with a multidisciplinary approach; acceleration of access times, by minimizing bureaucracy; and increase in the number of centers qualified to manage the CAR-T therapies in the NHS. The experts agreed on the ideal criteria for designating those qualified centers. They also agreed on a comprehensive CAR-T care pathway with the timings and roles which would ideally be involved in each part of the process.This study was funded by Gilead Sciences, Inc.Peer reviewe

Climate change impacts on the water resources of Andean countries

RESUMEN: Latinoamérica presenta una alta disponibilidad y un elevado volumen de recurso hídrico. Este hecho, combinado con una abrupta topografía, permite generar importantes aprovechamientos hidroeléctricos con estructuras relativamente reducidas, lo que ha hecho proliferar este tipo de explotaciones. De manera reciente, sin embargo, ha comenzado a manifestarse inquietud respecto a los efectos que el cambio climático pueda tener sobre las centrales hidroeléctricas, y cómo esto pueda afectar a la disponibilidad y distribución de energía eléctrica en los distintos países. En el presente trabajo presentamos la metodología y principales resultados obtenidos en el estudio Vulnerabilidad al cambio climático y medidas de adaptación de sistemas hidroeléctricos en países andinos que ha cubierto los sistemas hidroeléctricos de Bolivia, Colombia, Ecuador y Perú. Focalizaremos nuestros esfuerzos en el análisis del recurso hídrico, paso previo al análisis de la evolución del recurso hidroeléctrico, a nivel regional, donde se han generado unas bases de datos homogéneas para toda el área de estudio mediante reconstrucción temporal y espacial, haciendo uso de técnicas de krigeado. También se ha procedido a homogeneizar la información sobre tipos de suelo y usos del suelo. La hidrología se ha resuelto con el modelo hidrológico semidistribuido VIC. Se ha analizado el periodo histórico 1980-2010, y se han generado proyecciones de cambio climático para el corto plazo (2011-2040), el medio plazo (2041-2070) y el largo plazo (2071-2100) para los escenarios RCP4.5 y RCP8.5 utilizados en el 5° informe del IPCC (Panel Intergubernamental para el Cambio Climático). Se ha tenido en cuenta además la posible evolución socioeconómica y su impacto sobre los usos del suelo.ABSTRACT: Latin America is characterized by a highly available, large amount of water resources. This fact, combined with an abrupt topography allows the creation of important hydropower stations with relatively small structures, what has fostered this kind of infrastructures. Recently, however, some worries have started to appear related to the effects that climate change may have on hydropower stations, and how these effects may change the spatial distribution of energy generation in the region. In this work, we present a methodology and the main results obtained in the study Climate change vulnerability and adaptation measures of hydropower stations in Andean countries that has studied the hydropower systems of Bolivia, Colombia, Ecuador and Peru. The main focus of this work is on the regional analysis of the water resources, a previous step to the analysis of the evolution of hydropower resources, where homogeneous databases of hydroclimatic variables have been generated for the whole study area, making use of spatio-temporal reconstruction through Kriging. Land use and soil type information has also been homogenized for the whole study area. Hydrology has been resolved with the semi distributed hydrologic model VIC. We have analyzed the historic period 1980-2010 and have e ISSN: 1886-4996 ISSN: 1134-2196220 del Jesus et al. | Efectos del cambio climático en el recurso hídrico de los países andinos Ingeniería del Agua | 24.4 | 2020 generated climate change projections for the short term (2011-2040), the medium term (2041-2070) and the long term (2071-2100) for scenarios RCP4.5 and RCP8.5 of the 5th Assessment Report of the IPCC. We have also considered the socio-economic evolution and its impact on land use.Los autores agradecen al Banco Interamericano de Desarrollo (BID) y a la Organización Latinoamericana de la Energía (OLADE) la financiación aportada para la realización del estudio. Manuel del Jesus, Salvador Navas y Javier Díez-Sierra agradecen, además, a la Agencia Estatal de Investigación (AEI) y al Fondo Europeo de Desarrollo Regional (FEDER) la financiación aportada a través del proyecto BIA2016-78397-P (AEI/FEDER, UE)

Groups without cultured representatives dominate eukaryotic picophytoplankton in the oligotrophic South East Pacific Ocean

Background: Photosynthetic picoeukaryotes (PPE) with a cell size less than 3 µm play a critical role in oceanic primary production. In recent years, the composition of marine picoeukaryote communities has been intensively investigated by molecular approaches, but their photosynthetic fraction remains poorly characterized. This is largely because the classical approach that relies on constructing 18S rRNA gene clone libraries from filtered seawater samples using universal eukaryotic primers is heavily biased toward heterotrophs, especially alveolates and stramenopiles, despite the fact that autotrophic cells in general outnumber heterotrophic ones in the euphotic zone. Methodology/Principal Findings: In order to better assess the composition of the eukaryotic picophytoplankton in the South East Pacific Ocean, encompassing the most oligotrophic oceanic regions on earth, we used a novel approach based on flow cytometry sorting followed by construction of 18S rRNA gene clone libraries. This strategy dramatically increased the recovery of sequences from putative autotrophic groups. The composition of the PPE community appeared highly variable both vertically down the water column and horizontally across the South East Pacific Ocean. In the central gyre, uncultivated lineages dominated: a recently discovered clade of Prasinophyceae (IX), clades of marine Chrysophyceae and Haptophyta, the latter division containing a potentially new class besides Prymnesiophyceae and Pavlophyceae. In contrast, on the edge of the gyre and in the coastal Chilean upwelling, groups with cultivated representatives (Prasinophyceae clade VII and Mamiellales) dominated. Conclusions/Significance: Our data demonstrate that a very large fraction of the eukaryotic picophytoplankton still escapes cultivation. The use of flow cytometry sorting should prove very useful to better characterize specific plankton populations by molecular approaches such as gene cloning or metagenomics, and also to obtain into culture strains representative of these novel groups

Cohort Profile: The epidemiology of chronic diseases and multimorbidity. The EpiChron cohort study

Why was the cohort set up? Greater life expectancy in Europe over the past few decades has been translated into an increasing burden of chronic diseases that accumulate as the population ages, whereas acute infectious diseases have been progressively pushed into the background. The incidence of conditions such as hypertension, obesity and asthma has increased dramatically worldwide, and cancer, diabetes and respiratory and cardiovascular diseases are responsible for almost 70% of global deaths. Concurrently, the prevalence of multimorbidity (as of people affected by more than one chronic disorder) is also increasing and appears as the most common chronic condition at present. Multimorbidity affects almost 3 in 4 individuals aged 65 years and older, although it represents a problem not only for the elderly but also for adult and even young populations, at whom prevention strategies should aim. People affected by multimorbidity often experience fragmentation of care, greater and inadequate use of health services and polypharmacy, which in turn may increase the risk of low adherence and adverse drug reactions. All of this leads to individuals’ quality of life deterioration and higher risk of mortality. Besides, handling patients with multimorbidity represents a daily challenge for physicians and health systems..

Baseline chronic comorbidity and mortality in laboratory-confirmed COVID-19 cases: Results from the PRECOVID study in Spain

We aimed to analyze baseline socio-demographic and clinical factors associated with an increased likelihood of mortality in men and women with coronavirus disease (COVID-19). We conducted a retrospective cohort study (PRECOVID Study) on all 4412 individuals with laboratory-confirmed COVID-19 in Aragon, Spain, and followed them for at least 30 days from cohort entry. We described the socio-demographic and clinical characteristics of all patients of the cohort. Age-adjusted logistic regressions models were performed to analyze the likelihood of mortality based on demographic and clinical variables. All analyses were stratified by sex. Old age, specific diseases such as diabetes, acute myocardial infarction, or congestive heart failure, and dispensation of drugs like vasodilators, antipsychotics, and potassium-sparing agents were associated with an increased likelihood of mortality. Our findings suggest that specific comorbidities, mainly of cardiovascular nature, and medications at the time of infection could explain around one quarter of the mortality in COVID-19 disease, and that women and men probably share similar but not identical risk factors. Nonetheless, the great part of mortality seems to be explained by other patient-and/or health-system-related factors. More research is needed in this field to provide the necessary evidence for the development of early identification strategies for patients at higher risk of adverse outcomes

One-year longitudinal association between changes in dietary choline or betaine intake and cardiometabolic variables in the PREvención con DIeta MEDiterránea-Plus (PREDIMED-Plus) trial

Choline and betaine intakes have been related to cardiovascular health. We aimed to explore the relation between 1-y changes in dietary intake of choline or betaine and 1-y changes in cardiometabolic and renal function traits within the frame of the PREDIMED (PREvención con DIeta MEDiterránea)-Plus trial. We used baseline and 1-y follow-up data from 5613 participants (48.2% female and 51.8% male; mean ± SD age: 65.01 ± 4.91 y) to assess cardiometabolic traits, and 3367 participants to assess renal function, of the Spanish PREDIMED-Plus trial. Participants met ≥3 criteria of metabolic syndrome and had overweight or obesity [BMI (in kg/m 2) ≥27 and ≤40]. These criteria were similar to those of the PREDIMED parent study. Dietary intakes of choline and betaine were estimated from the FFQ. The greatest 1-y increase in dietary choline or betaine intake (quartile 4) was associated with improved serum glucose concentrations (−3.39 and −2.72 mg/dL for choline and betaine, respectively) and HbA1c levels (−0.10% for quartile 4 of either choline or betaine intake increase). Other significant changes associated with the greatest increase in choline or betaine intake were reduced body weight (−2.93 and −2.78 kg, respectively), BMI (−1.05 and −0.99, respectively), waist circumference (−3.37 and −3.26 cm, respectively), total cholesterol (−4.74 and −4.52 mg/dL, respectively), and LDL cholesterol (−4.30 and −4.16 mg/dL, respectively). Urine creatinine was reduced in quartile 4 of 1-y increase in choline or betaine intake (−5.42 and −5.74 mg/dL, respectively). Increases in dietary choline or betaine intakes were longitudinally related to improvements in cardiometabolic parameters. Markers of renal function were also slightly improved, and they require further investigation. This trial was registered at as ISRCTN89898870

Effect of an Intensive Weight-Loss Lifestyle Intervention on Kidney Function: A Randomized Controlled Trial

Introduction: Large randomized trials testing the effect of a multifactorial weight-loss lifestyle intervention including Mediterranean diet (MedDiet) on renal function are lacking. Here, we evaluated the 1-year efficacy of an intensive weight-loss intervention with an energy-reduced MedDiet (erMedDiet) plus increased physical activity (PA) on renal function. Methods: Randomized controlled "PREvención con DIeta MEDiterránea-Plus"(PREDIMED-Plus) trial is conducted in 23 Spanish centers comprising 208 primary care clinics. Overweight/obese (n = 6,719) adults aged 55-75 years with metabolic syndrome were randomly assigned (1:1) to an intensive weight-loss lifestyle intervention with an erMedDiet, PA promotion, and behavioral support (intervention) or usual-care advice to adhere to an energy-unrestricted MedDiet (control) between September 2013 and December 2016. The primary outcome was 1-year change in estimated glomerular filtration rate (EGFR). Secondary outcomes were changes in urine albumin-to-creatinine ratio (UACR), incidence of moderately/severely impaired EGFR (<60 mL/min/1.73 m2) and micro-to macroalbuminuria (UACR ≥30 mg/g), and reversion of moderately (45 to <60 mL/min/1.73 m2) to mildly impaired GFR (60 to <90 mL/min/1.73 m2) or micro-to macroalbuminuria. Results: After 1 year, EGFR declined by 0.66 and 1.25 mL/min/1.73 m2 in the intervention and control groups, respectively (mean difference, 0.58 mL/min/1.73 m2; 95% CI: 0.15-1.02). There were no between-group differences in mean UACR or micro-to macroalbuminuria changes. Moderately/severely impaired EGFR incidence and reversion of moderately to mildly impaired GFR were 40% lower (HR 0.60; 0.44-0.82) and 92% higher (HR 1.92; 1.35-2.73), respectively, in the intervention group. Conclusions: The PREDIMED-Plus lifestyle intervention approach may preserve renal function and delay CKD progression in overweight/obese adults.This work was supported by the official Spanish Institutions for funding scientific biomedical research, CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN) and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigación para la Salud (FIS), which is cofunded by the European Regional Development Fund (5 coordinated FIS projects leaded by J.S.-S and J.V., including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926; PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, and PI19/01332); the Especial Action Project entitled Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to J.S.-S.; the European Research Council (Advanced Research Grant 2014–2019; agreement #340918) granted to M.Á.M.-G.; the Recercaixa (No. 2013ACUP00194) grant to J.S.-S.; grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, and PI0137/2018); the PROMETEO/2017/017 grant from the Generalitat Valenciana; the SEMERGEN grant; funds from the European Regional Development Fund (CB06/03); International Nut & Dried Fruit Council – FESNAD (Long-term effects of an energyrestricted Mediterranean diet on mortality and cardiovascular disease 2014–2015, No. 201302) (PI: M.Á.M.-G.); the AstraZeneca Young Investigators Award in Category of Obesity and T2D 2017 (PI: D.R.); grant of support to research groups No. 35/2011 (Balearic Islands Gov.; FEDER funds) (J.A.T. and C.B.); the JR17/00022 (ISCIII) grant to O.C.; the Boosting young talent call grant program for the development of IISPV research projects 2019–2021 (Ref.: 2019/IISPV/03 grant to A.D.-L.); the Societat Catalana d’Endocrinologia i Nutrició (SCEN) Clinical-Research Grant 2019 (IPs: J.S.-S. and A.D.-L.). Collaborative Nutrition and/or Obesity Project for Young Researchers 2019 supported by CIBEROBN entitled Lifestyle Interventions and Chronic Kidney Disease: Inflammation, Oxidative Stress and Metabolomic Profile (LIKIDI study) grant to A.D.-L