La depuradora de Begues : reactor biològic o aiguamolls construïts?. Estudi comparatiu dels vectors : superfície, consum energètic, integració en el medi

L'objectiu del present estudi és comparar els vectors de superfície, consum energètic i integració en el medi entre 2 tipus d'instal·lacions EDAR al municipi de Begues; una ja existent amb tractament secundari i terciari mitjançant un reactor biològic i una potencial amb tractament secundari i terciari mitjançant aiguamolls construïts. La finalitat del projecte és determinar, gràcies a l'estudi dels principals vectors ambientals de la infraestructura i a altres estudiats per en Jordi Gómez Castillo, quina de les 2 tipologies d'instal·lació s'ajusta més al territori i a les necessitats de tractament de les aigües del mateix. Els resultats de la investigació indiquen que els aiguamolls construïts fan un ús més productiu del sòl però ocupen l'espai de reserva disponible amb el sistema de reactor biològic. A més, consumeixen 50kWh/dia menys que l'altra instal·lació, fet que implica un 7% menys d'emissions de CO2 anuals. Finalment, tenen una millor integració en el medi i proporcionen uns beneficis auxiliars afegits. Amb el projecte d'en Jordi Gómez Castillo, les conclusions que es poden establir en referència a la decisió d'instal·lar una depuradora o una altra indiquen que l'EDAR sense aiguamolls té més probabilitat de ser escollida com la més adient per les necessitats del territori d'estudi.El objetivo del presente estudio es comparar los vectores de superficie, consumo energético e integración en el medio entre 2 tipos de instalaciones EDAR en el municipio de Begues; una ya existente con tratamiento secundario y terciario mediante un reactor biológico y una potencial con tratamiento secundario y terciario mediante humedales construidos. La finalidad del proyecto es determinar, gracias al estudio de los principales vectores ambientales de la infraestructura y a otros estudiados por Jordi Gómez Castillo, cuál de las 2 tipologías de instalación se ajusta más al territorio y a las necesidades de tratamiento de las aguas del mismo. Los resultados de la investigación indican que los humedales construidos hacen un uso más productivo del suelo pero ocupan el espacio de reserva disponible con el sistema de reactor biológico. Además, consumen 50kWh/día menos que la otra instalación, hecho que implica un 7% menos de emisiones de CO2 anuales. Finalmente, tienen una mejor integración en el medio y proporcionan unos beneficios auxiliares añadidos. Con el proyecto de Jordi Gómez Castillo, las conclusiones que se pueden establecer en referencia a la decisión de instalar una depuradora u otra indican que la EDAR sin humedales tiene más probabilidad de ser escogida como la más adecuada por las necesidades del territorio de estudio.The aim of this study is to compare the vectors of surface, energy and integration in the environment between two types of wastewater treatment plants in Begues town; one is existing now with a secondary and tertiary treatment by a biological reactor and the other one is a potential plant with a secondary and tertiary treatment with constructed wetlands, reed beds. The finality is to determine, by studying the main environmental vectors of the infrastructure and others' studied by Jordi Gómez Castillo, which of the two types of plant conforms better to the territory and to the needs of water treatment. The research results show that constructed wetlands are more productive in the use of land but they occupy reserve space available with the bioreactor system. In addition, they consume 50kWh/day less than the other installation, which implies a 7% less of CO2 emissions per year. Finally, they have a better integration into the environment and provide added ancillary benefits. With the project done by Jordi Gómez Castillo, the conclusions that can be set about the decision to install a sewage treatment plant or another indicate that the WWTP without wetlands is more likely to be chosen because of the needs of the area of study

Mutations in TP53 and JAK2 are independent prognostic biomarkers in B-cell precursor acute lymphoblastic leukaemia

[EN]Background: In B-cell precursor acute lymphoblastic leukaemia (B-ALL), the identification of additional genetic alterations associated with poor prognosis is still of importance. We determined the frequency and prognostic impact of somatic mutations in children and adult cases with B-ALL treated with Spanish PETHEMA and SEHOP protocols. Methods: Mutational status of hotspot regions of TP53, JAK2, PAX5, LEF1, CRLF2 and IL7R genes was determined by next-generation deep sequencing in 340 B-ALL patients (211 children and 129 adults). The associations between mutation status and clinicopathological features at the time of diagnosis, treatment outcome and survival were assessed. Univariate and multivariate survival analyses were performed to identify independent prognostic factors associated with overall survival (OS), event-free survival (EFS) and relapse rate (RR). Results: A mutation rate of 12.4% was identified. The frequency of adult mutations was higher (20.2% vs 7.6%, P=0.001). TP53 was the most frequently mutated gene (4.1%), followed by JAK2 (3.8%), CRLF2 (2.9%), PAX5 (2.4%), LEF1 (0.6%) and IL7R (0.3%). All mutations were observed in B-ALL without ETV6-RUNX1 (P=0.047) or BCR-ABL1 fusions (P<0.0001). In children, TP53mut was associated with lower OS (5-year OS: 50% vs 86%, P=0.002) and EFS rates (5-year EFS: 50% vs 78.3%, P=0.009) and higher RR (5-year RR: 33.3% vs 18.6% P=0.037), and was independently associated with higher RR (hazard ratio (HR)=4.5; P=0.04). In adults, TP53mut was associated with a lower OS (5-year OS: 0% vs 43.3%, P=0.019) and a higher RR (5-year RR: 100% vs 61.4%, P=0.029), whereas JAK2mut was associated with a lower EFS (5-year EFS: 0% vs 30.6%, P=0.035) and a higher RR (5-year RR: 100% vs 60.4%, P=0.002). TP53mut was an independent risk factor for shorter OS (HR=2.3; P=0.035) and, together with JAK2mut, also were independent markers of poor prognosis for RR (TP53mut: HR=5.9; P=0.027 and JAK2mut: HR=5.6; P=0.036). Conclusions: TP53mut and JAK2mut are potential biomarkers associated with poor prognosis in B-ALL patients.European Commision (EC). Funding FP7/SP1/HEALTH. Project Code: 30624

Genome-wide DNA copy number analysis of acute lymphoblastic leukemia identifies new genetic markers associated with clinical outcome

Altres ajuts: FUCALHH 2013; HUS272U13; GRS 994/A/14, BIO/SA10/14, BIO/SA31/13; Fundación Española de Hematología y Hemoterapia (FEHH), Universidad Pedagógica y Tecnológica de Colombia 223-2011Identifying additional genetic alterations associated with poor prognosis in acute lymphoblastic leukemia (ALL) is still a challenge. Aims: To characterize the presence of additional DNA copy number alterations (CNAs) in children and adults with ALL by whole-genome oligonucleotide array (aCGH) analysis, and to identify their associations with clinical features and outcome. Array-CGH was carried out in 265 newly diagnosed ALLs (142 children and 123 adults). The NimbleGen CGH 12x135K array (Roche) was used to analyze genetic gains and losses. CNAs were analyzed with GISTIC and aCGHweb software. Clinical and biological variables were analyzed. Three of the patients showed chromothripsis (cth6, cth14q and cth15q). CNAs were associated with age, phenotype, genetic subtype and overall survival (OS). In the whole cohort of children, the losses on 14q32.33 (p = 0.019) and 15q13.2 (p = 0.04) were related to shorter OS. In the group of children without good- or poor-risk cytogenetics, the gain on 1p36.11 was a prognostic marker independently associated with shorter OS. In adults, the gains on 19q13.2 (p = 0.001) and Xp21.1 (p = 0.029), and the loss of 17p (p = 0.014) were independent markers of poor prognosis with respect to OS. In summary, CNAs are frequent in ALL and are associated with clinical parameters and survival. Genome-wide DNA copy number analysis allows the identification of genetic markers that predict clinical outcome, suggesting that detection of these genetic lesions will be useful in the management of patients newly diagnosed with ALL

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

La depuradora de Begues: reactor biològic o aiguamolls construïts?. Estudi comparatiu dels vectors: superfície, consum energètic, integració en el medi

L’objectiu del present estudi és comparar els vectors de superfície, consum energètic i integració en el medi entre 2 tipus d’instal·lacions EDAR al municipi de Begues; una ja existent amb tractament secundari i terciari mitjançant un reactor biològic i una potencial amb tractament secundari i terciari mitjançant aiguamolls construïts. La finalitat del projecte és determinar, gràcies a l’estudi dels principals vectors ambientals de la infraestructura i a altres estudiats per en Jordi Gómez Castillo, quina de les 2 tipologies d’instal·lació s’ajusta més al territori i a les necessitats de tractament de les aigües del mateix. Els resultats de la investigació indiquen que els aiguamolls construïts fan un ús més productiu del sòl però ocupen l’espai de reserva disponible amb el sistema de reactor biològic. A més, consumeixen 50kWh/dia menys que l’altra instal·lació, fet que implica un 7% menys d’emissions de CO2 anuals. Finalment, tenen una millor integració en el medi i proporcionen uns beneficis auxiliars afegits. Amb el projecte d’en Jordi Gómez Castillo, les conclusions que es poden establir en referència a la decisió d’instal·lar una depuradora o una altra indiquen que l’EDAR sense aiguamolls té més probabilitat de ser escollida com la més adient per les necessitats del territori d’estudi.El objetivo del presente estudio es comparar los vectores de superficie, consumo energético e integración en el medio entre 2 tipos de instalaciones EDAR en el municipio de Begues; una ya existente con tratamiento secundario y terciario mediante un reactor biológico y una potencial con tratamiento secundario y terciario mediante humedales construidos. La finalidad del proyecto es determinar, gracias al estudio de los principales vectores ambientales de la infraestructura y a otros estudiados por Jordi Gómez Castillo, cuál de las 2 tipologías de instalación se ajusta más al territorio y a las necesidades de tratamiento de las aguas del mismo. Los resultados de la investigación indican que los humedales construidos hacen un uso más productivo del suelo pero ocupan el espacio de reserva disponible con el sistema de reactor biológico. Además, consumen 50kWh/día menos que la otra instalación, hecho que implica un 7% menos de emisiones de CO2 anuales. Finalmente, tienen una mejor integración en el medio y proporcionan unos beneficios auxiliares añadidos. Con el proyecto de Jordi Gómez Castillo, las conclusiones que se pueden establecer en referencia a la decisión de instalar una depuradora u otra indican que la EDAR sin humedales tiene más probabilidad de ser escogida como la más adecuada por las necesidades del territorio de estudio.The aim of this study is to compare the vectors of surface, energy and integration in the environment between two types of wastewater treatment plants in Begues town; one is existing now with a secondary and tertiary treatment by a biological reactor and the other one is a potential plant with a secondary and tertiary treatment with constructed wetlands, reed beds. The finality is to determine, by studying the main environmental vectors of the infrastructure and others’ studied by Jordi Gómez Castillo, which of the two types of plant conforms better to the territory and to the needs of water treatment. The research results show that constructed wetlands are more productive in the use of land but they occupy reserve space available with the bioreactor system. In addition, they consume 50kWh/day less than the other installation, which implies a 7% less of CO2 emissions per year. Finally, they have a better integration into the environment and provide added ancillary benefits. With the project done by Jordi Gómez Castillo, the conclusions that can be set about the decision to install a sewage treatment plant or another indicate that the WWTP without wetlands is more likely to be chosen because of the needs of the area of study

La depuradora de Begues : reactor biològic o aiguamolls construïts?. Estudi comparatiu dels vectors : superfície, consum energètic, integració en el medi

L'objectiu del present estudi és comparar els vectors de superfície, consum energètic i integració en el medi entre 2 tipus d'instal·lacions EDAR al municipi de Begues; una ja existent amb tractament secundari i terciari mitjançant un reactor biològic i una potencial amb tractament secundari i terciari mitjançant aiguamolls construïts. La finalitat del projecte és determinar, gràcies a l'estudi dels principals vectors ambientals de la infraestructura i a altres estudiats per en Jordi Gómez Castillo, quina de les 2 tipologies d'instal·lació s'ajusta més al territori i a les necessitats de tractament de les aigües del mateix. Els resultats de la investigació indiquen que els aiguamolls construïts fan un ús més productiu del sòl però ocupen l'espai de reserva disponible amb el sistema de reactor biològic. A més, consumeixen 50kWh/dia menys que l'altra instal·lació, fet que implica un 7% menys d'emissions de CO2 anuals. Finalment, tenen una millor integració en el medi i proporcionen uns beneficis auxiliars afegits. Amb el projecte d'en Jordi Gómez Castillo, les conclusions que es poden establir en referència a la decisió d'instal·lar una depuradora o una altra indiquen que l'EDAR sense aiguamolls té més probabilitat de ser escollida com la més adient per les necessitats del territori d'estudi.El objetivo del presente estudio es comparar los vectores de superficie, consumo energético e integración en el medio entre 2 tipos de instalaciones EDAR en el municipio de Begues; una ya existente con tratamiento secundario y terciario mediante un reactor biológico y una potencial con tratamiento secundario y terciario mediante humedales construidos. La finalidad del proyecto es determinar, gracias al estudio de los principales vectores ambientales de la infraestructura y a otros estudiados por Jordi Gómez Castillo, cuál de las 2 tipologías de instalación se ajusta más al territorio y a las necesidades de tratamiento de las aguas del mismo. Los resultados de la investigación indican que los humedales construidos hacen un uso más productivo del suelo pero ocupan el espacio de reserva disponible con el sistema de reactor biológico. Además, consumen 50kWh/día menos que la otra instalación, hecho que implica un 7% menos de emisiones de CO2 anuales. Finalmente, tienen una mejor integración en el medio y proporcionan unos beneficios auxiliares añadidos. Con el proyecto de Jordi Gómez Castillo, las conclusiones que se pueden establecer en referencia a la decisión de instalar una depuradora u otra indican que la EDAR sin humedales tiene más probabilidad de ser escogida como la más adecuada por las necesidades del territorio de estudio.The aim of this study is to compare the vectors of surface, energy and integration in the environment between two types of wastewater treatment plants in Begues town; one is existing now with a secondary and tertiary treatment by a biological reactor and the other one is a potential plant with a secondary and tertiary treatment with constructed wetlands, reed beds. The finality is to determine, by studying the main environmental vectors of the infrastructure and others' studied by Jordi Gómez Castillo, which of the two types of plant conforms better to the territory and to the needs of water treatment. The research results show that constructed wetlands are more productive in the use of land but they occupy reserve space available with the bioreactor system. In addition, they consume 50kWh/day less than the other installation, which implies a 7% less of CO2 emissions per year. Finally, they have a better integration into the environment and provide added ancillary benefits. With the project done by Jordi Gómez Castillo, the conclusions that can be set about the decision to install a sewage treatment plant or another indicate that the WWTP without wetlands is more likely to be chosen because of the needs of the area of study

HVOF-sprayed HAp/S53P4 BG composite coatings on an AZ31 alloy for potential applications in temporary implants

Bioactive thermal spray coatings produced via high-velocity oxygen fuel spray (HVOF) from hydroxyapatite (HAp) and bioactive glasses (BG) have the potential to be employed on temporary implants due to the ability of both HAp and BG to dissolve and promote osseointegration, considering that both phases have different reaction and dissolution rates under in-vitro conditions. In the present work, 75% wt. HAp - 25% wt. S53P4 bioactive glass powders were HVOF-sprayed to obtain HAp/S53P4 BG composite coatings on a bioresorbable AZ31 alloy. The study is focused on exploring the effect of the stand-off distance and fuel/oxygen ratio variation as HVOF parameters to obtain stable structural coatings and to establish their effect on the phases and microstructure produced in those coatings. Different characterization techniques, such as scanning electron microscopy, X-ray diffraction, and Fourier transform infrared spectroscopy, were employed to characterize relevant structural and microstructural properties of the composite coatings. The results showed that thermal gradients during coating deposition must be managed to avoid delamination due to the high temperature achieved (max 550 °C) and the differences in coefficients of thermal expansion. It was also found that both spraying distance and oxygen/fuel ratio allowed to keep the hydroxyapatite as the main phase in the coatings. In addition, in-vitro electrochemical studies were performed on the obtained HAp/S53P4 BG composite coatings and compared against the uncoated AZ31 alloy. The results showed a significant decrease in hydrogen evolution (at least 98%) when the bioactive coating was applied on the Mg alloy during evaluation in simulated body fluid (SBF)

Hopelessness in Patients with Early-Stage Relapsing-Remitting Multiple Sclerosis

Background: Hopelessness is a risk factor for depression and suicide. There is little information on this phenomenon among patients with relapsing-remitting multiple sclerosis (RRMS), one of the most common causes of disability and loss of autonomy in young adults. The aim of this study was to assess state hopelessness and its associated factors in early-stage RRMS. Methods: A multicenter, non-interventional study was conducted. Adult patients with a diagnosis of RRMS, a disease duration ≤ 3 years, and an Expanded Disability Status Scale (EDSS) score of 0– 5.5 were included. The State-Trait Hopelessness Scale (STHS) was used to measure patients´ hopelessness. A battery of patient-reported and clinician-rated measurements was used to assess clinical status. A multivariate logistic regression analysis was conducted to determine the association between patients’ characteristics and state hopelessness. Results: A total of 189 patients were included. Mean age (standard deviation-SD) was 36.1 (9.4) years and 71.4% were female. Median disease duration (interquartile range-IQR) was 1.4 (0.7, 2.1) years. Symptom severity and disability were low with a median EDSS (IQR) score of 1.0 (0, 2.0). A proportion of 65.6% (n=124) of patients reported moderate-to-severe hopelessness. Hopelessness was associated with older age (p=0.035), depressive symptoms (p=< 0.001), a threatening illness perception (p=0.001), and psychological and cognitive barriers to workplace performance (p=0.029) in the multivariate analysis after adjustment for confounders. Conclusion: Hopelessness was a common phenomenon in early-stage RRMS, even in a population with low physical disability. Identifying factors associated with hopelessness may be critical for implementing preventive strategies helping patients to adapt to the new situation and cope with the disease in the long term

Long-term prognosis communication preferences in early-stage relapsing-remitting multiple sclerosis.

Multiple sclerosis is one of the most common causes of neurological disability in young adults with major consequences for their future lives. Improving communication strategies on prognosis may help patients deal with the disease and adjust their long-term life goals. However, there is limited information on patients' preferences of long-term prognosis (LTP) communication and associated factors. The aim of this study was to describe patients' preferences and assess the factors associated with LTP communication preferences in early-stage relapsing-remitting multiple sclerosis (RRMS) patients. A multicenter, non-interventional study was conducted. Adult patients with a diagnosis of RRMS, a disease duration from first attack ≤ 3 years, and an Expanded Disability Status Scale (EDSS) score of 0-5.5 were included. The Prognosis in MS questionnaire was used to assess how much patients want to know about their LTP. Different patient-reported measures were administered to gather information on symptom severity, pain, fatigue, mood/anxiety, quality of life, stigma, illness perception, feeling of hopelessness, self-efficacy, information avoidance and coping strategies. Cognition was assessed using the Symbol Digit Modalities Test (SDMT). A multivariate logistic regression analysis was performed to assess the association between LTP information preference and demographic and clinical characteristics, as well as patients' perspectives. A total of 189 patients were included (mean age: 36.1  ±  9.4 years, 71.4% female, mean disease duration: 1.2  ±  0.8 years). Median EDSS score was 1.0 (IQR = 0.0-2.0). A proportion of 68.5% (n  =  126) of patients had never discussed LTP with their neurologists, whereas 69.2% (n = 126) reported interest in knowing it (73.5% at diagnosis). Bivariate analyses suggested that patients were significantly more likely to have higher LTP information preferences if they were male and had a lower SDMT score. Male gender and a lower SDMT score were predictors of LTP information preferences. Patients with early-stage RRMS want to discuss their LTP shortly after diagnosis. Understanding the factors involved may be useful to design individualized communication strategies

Detecting disability using self-reported and clinical assessments in early-stage relapsing-remitting multiple sclerosis: Looking for a complementary approach

Disability accrual is mainly driven by progression independent of relapse activity, which is present even in early stages of relapsing-remitting multiple sclerosis (RRMS) and sometimes overlooked. This multicenter, non-interventional study evaluated whether patient-reported outcomes measures (PROMs) could capture disability in 189 early-stage RRMS patients (mean age: 36.1 ± 9.4 years, 71.4% female, mean disease duration: 1.4 ± 0.8 years, median EDSS: 1.0). The 9-Hole Peg Test (9-HPT), NeuroQoL Upper Extremity (NeuroQoL-UE), Timed 25-Foot Walk (T25-FW), Multiple Sclerosis Walking Scale (MSWS-12), Symbol Digit Modalities Test (SDMT), and Perceived Deficits Questionnaire (PDQ-5) were used to assess hand function, gait, and cognition, respectively. These functions were at least mildly affected in this early-stage population, finding significant correlations between PROMs and clinical assessments. PROMs could enable early-stage RRMS patients to communicate their perceived disability in different domains, assisting clinicians in disease monitoring and decision making