Late Neonatal Sepsis in Very-low-birth-weight Premature Newborns Is Associated With Alterations in Neurodevelopment at Twenty-five Months of Age

Aim: To evaluate the impact of late-onset sepsis (LOS) on the neurodevelopment of very-low–birth-weight (VLBW) premature infants. Methods: This is a retrospective cohort study of VLBW premature infants.The Mental Development Index (MDI) was determined for a population of 546 VLBW infants, at 14 and 25 months of age, and evaluated using the Bayley test. A history of meningitis or early neonatal sepsis was considered an exclusion criterion. The study parameters analyzed included perinatal variables, the development of neonatal comorbidities and a history of LOS. Multivariate linear regression and multinomial logistic regression analyses were performed. Results: LOS was observed in 115 newborns, among whom microbiological testing showed that 65.0% presented Gram-positive bacteria, with Staphylococcus epidermidis being responsible for 55.4%. There was a significant association between the 25-month MDI and a history of LOS. This represents a decrease of 7.9 points in the MDI evaluation of newborns with a history of LOS. The latter history is also associated with the following neurodevelopmental alternations: mild motor disorders [odds ratio (OR): 2.75; 95% confidence intervals (CI): 1.07–7.05], moderate cognitive delay (OR: 3.07; 95% CI: 1.17–8.00) and cerebral palsy (OR: 2.41; 95% CI: 1.09–5.35). Conclusions: In our study cohort, LOS was associated with alterations in neurodevelopment, including reduced MDI, together with motor and cognitive disorders and cerebral palsy. To improve neurodevelopmental outcomes in this group of newborns, neonatal intensive care unit personnel should focus attention on preventing hospital-acquired infections

Effect of the forest-mine boundary form on woody colonization and forest expansion in degraded ecosystems

[ENG]We evaluated the ecological significance of the boundary form between two patches with contrasting vegetation (mine grassland and adjacent forest) on woody colonization and forest expansion in open-cast coal mines in Northern Spain. Woody colonization and browsing traces were measured on three mine sites, along 24 transects that were laid out perpendicular to the forest-mine boundary and classified according to their shape (concave, convex, straight). Mine sites were colonized from the close forest by woody species, whose colonization intensity depends on the boundary form. The overall colonization intensity decreased with increasing distance to the forest and differed depending on the boundary form. The more intense colonization was found in concave boundaries and the strongest decrease in convex boundaries close to the forest, whereas straight boundaries showed an intermediate colonization pattern. Concave boundaries reached higher woody cover in the basal strata of the mines than convex (up to 2 m) or straight boundaries (up to 1 m) from 11 m to the forest edge, mainly by the presence of dense patches of Cytisus scoparius (L.) Link, with a scattered overstory of Genista florida L. These shrubs might reduce the browsing intensity and act as nurse plants facilitating the establishment of Quercus petraea (Matt.) Liebl. in mine areas at greater distances from the forest edge. The forest-mine boundary form does not affect the forest vertical structure that is homogenous and does not help explain the woody colonization pattern in the mines. We conclude that edge characteristics have a strong potential to be used in the restoration of native forests based on natural processes. The implications of our results for sessile oak (Quercus petraea (Matt.) Liebl.) forest expansion along edges in fragmented Mediterranean forest landscapes were discussed

Application of multiple proxies in Mexican tropical coasts to prove evidence of tsunami deposits

"The study of tsunami deposits has significantly advanced since the Chilean 2010 and Tohoku 2011 tsunamis providing opportunities to analyze tsunami deposits and their characteristics (Rubin et al., 2017)." (fragm.

Datación de sedimentos recientes utilizando radionucleidos de vida corta

Se presentan las características principales del método de datación de sedimentos recientes mediante el radioisótopo natural 210Pb y su validación utilizando radionucleidos artificiales tales como 137Cs y 239,240Pu. Se hace una revisión de los principios generales de esta metodología, se aportan recomendaciones prácticas para la recogida de testigos sedimentarios en el campo y su posterior procesamiento en el laboratorio, se describen diferentes técnicas analíticas utilizadas en la determinación de sus concentraciones y se explican brevemente varios modelos para la interpretación de los perfiles obtenidos. Por último, se incluyen ejemplos prácticos de su aplicación en secuencias sedimentarias procedentes de distintos ambientes marinos (estuario, bahía y plataforma continental) en el norte de la Península Ibérica.Trabajo financiado por los proyectos RTI2018-095678-B-C21, MCIU/AEI/FEDER, UE (MINECO) e IT976-16 (EJ/GV)

Polyphenols in Urine and Cardiovascular Risk Factors: A Cross-Sectional Analysis Reveals Gender Differences in Spanish Adolescents from the SI! Program

Abstract: (1) Background: Epidemiological studies have shown an inverse association between polyphenol intake and cardiovascular risk factors (CVRFs) in adults, but few have provided information about adolescents. The aim of this study was to evaluate the relationship between urinary total polyphenol excretion (TPE) and CVRFs in adolescents. (2) Methods: A cross-sectional study was performed in 1194 Spanish adolescents from the SI! (Salud Integral) program. TPE in urine samples was determined by the Folin-Ciocalteu method, after solid-phase extraction, and categorized into quartiles. The association between TPE and CVRFs was estimated using mixed-effect linear regression and a structural equation model (SEM). (3) Results: Linear regression showed negative associations among the highest quartile of TPE and body fat percentage (B = −1.75, p-value = <0.001), triglycerides (TG) (B = −17.68, p-value = <0.001), total cholesterol (TC) (B = −8.66, p-value = 0.002), and low-density lipoprotein (LDL)-cholesterol (LDL-C) (B = −4.09, p-value = 0.008) in boys, after adjusting for all confounder variables. Negative associations between TPE quartiles and systolic blood pressure (SBP), diastolic blood pressure (DBP), and TC were also found in girls. Moreover, a structural equation model revealed that TPE was directly associated with body composition and blood glucose and indirectly associated with blood pressure, TG, LDL-C, and high-density lipoprotein-cholesterol (HDL-C) in boys. Conclusions: Higher concentrations of TPE were associated with a better profile of cardiovascular health, especially in boys, while in girls, the association was not as strong. Keywords: antioxidants; pediatric; body composition; cardiovascular; lipid profile; Folin-Ciocalte

Breakthrough invasive fungal infection among patients with haematologic malignancies: A national, prospective, and multicentre study

Objectives: We describe the current epidemiology, causes, and outcomes of breakthrough invasive fungal infections (BtIFI) in patients with haematologic malignancies.Methods: BtIFI in patients with & GE; 7 days of prior antifungals were prospectively diagnosed (36 months across 13 Spanish hospitals) according to revised EORTC/MSG definitions.Results: 121 episodes of BtIFI were documented, of which 41 (33.9%) were proven; 53 (43.8%), probable; and 27 (22.3%), possible. The most frequent prior antifungals included posaconazole (32.2%), echinocandins (28.9%) and fluconazole (24.8%)-mainly for primary prophylaxis (81%). The most common haematologic malignancy was acute leukaemia (64.5%), and 59 (48.8%) patients had undergone a hematopoietic stem-cell transplantation. Invasive aspergillosis, principally caused by non-fumigatus Aspergillus, was the most fre-quent BtIFI with 55 (45.5%) episodes recorded, followed by candidemia (23, 19%), mucormycosis (7, 5.8%), other moulds (6, 5%) and other yeasts (5, 4.1%). Azole resistance/non-susceptibility was commonly found. Prior antifungal therapy widely determined BtIFI epidemiology. The most common cause of BtIFI in proven and probable cases was the lack of activity of the prior antifungal (63, 67.0%). At diagnosis, antifungal therapy was mostly changed (90.9%), mainly to liposomal amphotericin-B (48.8%). Overall, 10 0-day mor-tality was 47.1%; BtIFI was either the cause or an essential contributing factor to death in 61.4% of cases.Conclusions: BtIFI are mainly caused by non-fumigatus Aspergillus, non-albicans Candida, Mucorales and other rare species of mould and yeast. Prior antifungals determine the epidemiology of BtIFI. The exceed-ingly high mortality due to BtIFI warrants an aggressive diagnostic approach and early initiation of broad-spectrum antifungals different than those previously used.& COPY; 2023 The Author(s). Published by Elsevier Ltd on behalf of The British Infection Association. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Combination of Tocilizumab and Steroids to Improve Mortality in Patients with Severe COVID-19 Infection : A Spanish, Multicenter, Cohort Study

We aimed to determine the impact of tocilizumab use on severe COVID-19 (coronavirus disease 19) pneumonia mortality. We performed a multicentre retrospective cohort study in 18 tertiary hospitals in Spain from March to April 2020. Consecutive patients admitted with severe COVID-19 treated with tocilizumab were compared to patients not treated with tocilizumab, adjusting by inverse probability of the treatment weights (IPTW). Tocilizumab's effect in patients receiving steroids during the 48 h following inclusion was analysed. During the study period, 506 patients with severe COVID-19 fulfilled the inclusion criteria. Among them, 268 were treated with tocilizumab and 238 patients were not. Median time to tocilizumab treatment from onset of symptoms was 11 days [interquartile range (IQR) 8-14]. Global mortality was 23.7%. Mortality was lower in patients treated with tocilizumab than in controls: 16.8% versus 31.5%, hazard ratio (HR) 0.514 [95% confidence interval (95% CI) 0.355-0.744], p < 0.001; weighted HR 0.741 (95% CI 0.619-0.887), p = 0.001. Tocilizumab treatment reduced mortality by 14.7% relative to no tocilizumab treatment [relative risk reduction (RRR) 46.7%]. We calculated a number necessary to treat of 7. Among patients treated with steroids, mortality was lower in those treated with tocilizumab than in those treated with steroids alone [10.9% versus 40.2%, HR 0.511 (95% CI 0.352-0.741), p = 0.036; weighted HR 0.6 (95% CI 0.449-0.804), p < 0.001] (interaction p = 0.094). These results show that survival of patients with severe COVID-19 is higher in those treated with tocilizumab than in those not treated and that tocilizumab's effect adds to that of steroids administered to non-intubated patients with COVID-19 during the first 48 h of presenting with respiratory failure despite oxygen therapy. Randomised controlled studies are needed to confirm these results. European Union electronic Register of Post-Authorization Studies (EU PAS Register) identifier, EUPAS34415 The online version of this article (10.1007/s40121-020-00373-8) contains supplementary material, which is available to authorized users

Invasive Fusariosis in Nonneutropenic Patients, Spain, 2000-2015

Invasive fusariosis (IF) is associated with severe neutropenia in patients with concurrent hematologic conditions. We conducted a retrospective observational study to characterize the epidemiology of IF in 18 Spanish hospitals during 2000-2015. In that time, the frequency of IF in nonneutropenic patients increased from 0.08 cases per 100,000 admissions in 2000-2009 to 0.22 cases per 100,000 admissions in 2010-2015. Nonneutropenic IF patients often had nonhematologic conditions, such as chronic cardiac or lung disease, rheumatoid arthritis, history of solid organ transplantation, or localized fusariosis. The 90-day death rate among nonneutropenic patients (28.6%) and patients with resolved neutropenia (38.1%) was similar. However, the death rate among patients with persistent neutropenia (91.3%) was significantly higher. We used a multivariate Cox regression analysis to characterize risk factors for death: persistent neutropenia was the only risk factor for death, regardless of antifungal therapy

Disentangling the geologic, human and climate drivers influencing sediment deposition in volcanic lakes on the Azores Archipelago

IAL-IPA joint meeting "Lakes as Memories of the Landscape", Patagonia, Argentina, 27 November-01 December 2022The Azores Archipelago Western (AAWG) and Central (AACG) groups present a high diversity of tectono-volcanic settings, and, therefore, a wide range of lake-watershed system morphometries. This archipelago has suffered from anthropic impacts, mainly abrupt land-use changes, since medieval times (between 700 and 850 CE), and increasingly after the Portuguese arrival in the 15th century. In this complex geologic and human context, we used a multiproxy approach in sediment records from Lakes Caldeirão (Corvo Island), Funda (Flores Island), and Caveiro (Pico Island) to demonstrate a complex interlinking among several environmental drivers over the last millennia. Paleoenvironmental changes have been defined by a multivariate analysis of sedimentary facies, biogeochemical and mineralogical data. This analysis highlights that the most prominent sedimentary process in the AAWG lakes (Caldeirao and Funda) is hydrological grain size sorting, driven by runoff. Additionally, smooth catchment slopes of the low-gradient lake, Caldeirão, modulated this process by favouring rock grain size diminution through weathering, whereas the steep topographic-bathymetric profile of the high-gradient lake, Funda, do through water-level fluctuations. The frequent volcanic activity of the AACG and the small size of Caveiro lake catchment favoured the deposit of pyroclastic tephra through direct fallout in the lake, over the catchment-sourced inputs, reworked by climate and tectonic activity. The biogeochemical and mineral composition of the sedimentary records present extreme change rates at 1288+28-22-1388+41-32 CE, corresponding with the age of the most intense landscape transformation. Therefore, to obtain robust climate reconstructions from these Azorean lacustrine records, we present a detailed statistical approach to isolate the climate signal from volcano-tectonic, morphometric, and anthropic driversThis research was funded by the Spanish Ministry of Economy and Competitiveness research projects PaleoNAO (CGL2010-15767), RapidNAO (CGL2013-40608-R), PaleoModes (CGL2016-75281-C2), and NEOCLIM (PID2020-113798GB-C33), and through Portuguese Science Foundation (FCT) (DL57/2016/ICETA/EEC2018/25) and the DISCOVERAZORES (PTDC/CTA-AMB/28511/2017)N