Desalination and water security in Southeastern Spain

The Segura Hydrographic Demarcation (DHS), in Southeastern Spain, is an area of hydric deficit caused by low and irregular rainfall and a dense population. In this region water scarcity is a burning issue that polarizes society for or against different models of ensuring water supply. Given the current demand for water throughout Spain, desalination has been used to increase water supply, and as insurance against drought. Ten seawater desalination plants and hundreds of brackish aquifer desalination plants treat water in the Southeast of the Iberian Peninsula, both for human consumption and for irrigation, contributing to economic, energetic, processual and economic aspects of territorial organization in the Southeast of Spain. This article reviews debates over desalination, water transfers, and the best way to meet water demands in that region. While desalination allows an increase in water supply, dependence on that source increases energy costs and may lead to mistaken assumptions among users about water scarcity and availabilityLa Demarcación Hidrográfica del Segura (DHS) comprende un área hídricamente deficitaria motivada por una reducida e irregular pluviometría y una intensa ocupación del territorio, en la que el recurso agua ha sido y es un bien limitado y muy preciado desde la antigüedad, y es un candente asunto de la actualidad que polariza a la sociedad a favor o en contra de un modelo u otro de abastecimiento. Ante las actuales demandas de este recurso, se hace necesario recurrir a la desalación para un incremento de la oferta hídrica que actúa como un seguro ante situaciones de sequía en España. Un total de diez plantas desaladoras y cientos de desalobradoras suministran agua desalada procedente del mar o de acuíferos salobres en el Sureste de la Península Ibérica, tanto para consumo humano como para la irrigación de los fértiles campos, aportando su idiosincrasia económica, energética, procesual y de ordenación territoria

Expression of sterol regulatory element-binding proteins in epicardial adipose tissue in patients with coronary artery disease and diabetes mellitus: preliminary study

[Abstract] Objectives: Sterol regulatory element-binding proteins (SREBP) genes are crucial in lipid biosynthesis and cardiovascular homeostasis. Their expression in epicardial adipose tissue (EAT) and their influence in the development of coronary artery disease (CAD) and type-2 diabetes mellitus remain to be determined. The aim of our study was to evaluate the expression of SREBP genes in EAT in patients with CAD according to diabetes status and its association with clinical and biochemical data. Methods: SREBP-1 and SREBP-2 mRNA expression levels were measured in EAT from 49 patients with CAD (26 with diabetes) and 23 controls without CAD or diabetes. Results: Both SREBPs mRNA expression were significantly higher in patients with CAD and diabetes (p<0.001) and were identified as independent cardiovascular risk factor for coronary artery disease in patients with type-2 diabetes (SREBP-1: OR 1.7, 95%CI 1.1-2.5, p=0.02; SREBP-2: OR 1.6, 95%CI 1.2-3, p=0.02) and were independently associated with the presence of multivessel CAD, left main and anterior descending artery stenosis, and higher total and LDL cholesterol levels, and lower HDL cholesterol levels, in patients with CAD and diabetes. Conclusions: SREBP genes are expressed in EAT and were higher in CAD patients with diabetes than those patients without CAD or diabetes. SREBP expression was associated as cardiovascular risk factor for the severity of CAD and the poor lipid control. In this preliminary study we suggest the importance of EAT in the lipid metabolism and cardiovascular homeostasis for coronary atherosclerosis of patients with diabetes and highlight a future novel therapeutic target.Instituto de Salud Carlos III; PI13/02542Instituto de Salud Carlos III; PI11/01661Red de Investigación Cardiovascular; RD12/0042/003

Clinical utility of urinary gluten immunogenic peptides in the follow-up of patients with coeliac disease

[Background] Gluten-free diet (GFD) is the only treatment for patients with coeliac disease (CD) and its compliance should be monitored to avoid cumulative damage.[Aims] To analyse gluten exposures of coeliac patients on GFD for at least 24 months using different monitoring tools and its impact on duodenal histology at 12-month follow-up and evaluate the interval of determination of urinary gluten immunogenic peptides (u-GIP) for the monitoring of GFD adherence.[Methods] Ninety-four patients with CD on a GFD for at least 24 months were prospectively included. Symptoms, serology, CDAT questionnaire, and u-GIP (three samples/visit) were analysed at inclusion, 3, 6, and 12 months. Duodenal biopsy was performed at inclusion and 12 months.[Results] At inclusion, 25.8% presented duodenal mucosal damage; at 12 months, this percentage reduced by half. This histological improvement was indicated by a reduction in u-GIP but did not correlate with the remaining tools. The determination of u-GIP detected a higher number of transgressions than serology, regardless of histological evolution type. The presence of >4 u-GIP-positive samples out of 12 collected during 12 months predicted histological lesion with a specificity of 93%. Most patients (94%) with negative u-GIP in ≥2 follow-up visits showed the absence of histological lesions (p < 0.05).[Conclusion] This study suggests that the frequency of recurrent gluten exposures, according to serial determination of u-GIP, could be related to the persistence of villous atrophy and that a more regular follow-up every 6 months, instead of annually, provides more useful data about the adequate adherence to GFD and mucosal healing.This study was funded in part by Fundación Progreso y Salud, Consejería de Salud, Junta de Andalucía (PI-0427-2017 and PI-0053-2018).Peer reviewe

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

LAS FRUTAS DE HUESO EN LA REGIÓN DE MURCIA (RASGOS DE LA CAMPANA FRUTERA)

This is a study of the sector of fruit of bones in Spain during the period 1974-1988. Special attention is paid to the special characteristics of the production and distributions campaigns of such fruit as apricot, peach, nectarine, plum, cheny and mazzard cherry in the region of Murcia. It is precisely in this Spanish Autonomous Region where a greater development of this fruit sector takes place (more than a fourth of the national activity of this sector) due to the fact that almost 30.000 Has of its temtory are devoted to the growing of fruit of bone (mean anual production of 200.000 Tm. In addition, more than 100 fírms are devoted to the manipulation and transformation of such fruits, and whose export trade alone amounted to 50.000 million ptas. in 1988Se estudia el subsector de frutas de hueso en España, durante el período 1974-1988, dedicando una mayor atención a las carasterísticas que presentan, en la Región de Murcia, las campañas de producción y distribución de frutas como albaricoque, melocotón, nectarina, ciruela, cereza y guinda. Ya que es la Comunidad Autónoma Española en la que se desarrolla una mayor actividad en este subsector frutero (más de su cuarta parte), al reunir en su territorio casi 30.000 hectáreas dedicadas al cultivo de prunáceas, con una producción media anual superior a las 200.000 Tm, y más de 100 empresas que se encargan de manipular y transformar estas frutas, en la que sólo el valor de sus envíos al exterior ascendió a más de 50.000 millones de pesetas en 1988

Towards a sustainable agriculture: strategies involving phytoprotectants against salt stress

Salinity is one of the main constraints for agriculture productivity worldwide. This important abiotic stress has worsened in the last 20 years due to the increase in water demands in arid and semi-arid areas. In this context, increasing tolerance of crop plants to salt stress is needed to guarantee future food supply to a growing population. This review compiles knowledge on the use of phytoprotectants of microbial origin (arbuscular mycorrhizal fungi and plant growth-promoting rhizobacteria), osmoprotectants, melatonin, phytohormones and antioxidant metabolism-related compounds as alleviators of salt stress in numerous plant species. Phytoprotectants are discussed in detail, including their nature, applicability, and role in the plant in terms of physiological and phenotype effects. As a result, increased crop yield and crop quality can be achieved, which in turn positively impact food security. Herein, efforts from academic and industrial sectors should focus on defining the treatment conditions and plant-phytoprotectant associations providing higher benefits.This work was supported by “Fundación Séneca” of the Agency of Science and Technology of the Region of Murcia (grant numbers 20405/SF/17 and 19903/GERM/1), RTI2018-093997-B-100 (MCIU/AEI/FEDER, UE project).Peer reviewe

MOLINOS HIDRÁULICOS EN LA CUENCA DE FORTUNA-ABANILLA (MURCIA) LOS APROVECHAMIENTOS DE LA RED DEL RIO CHÍCAMO Y EL MANANTIAL DE LOS BAÑOS

This work proposes the study and analysis of the grinding activity in the basin of Abanilla and Fortuna, located in the Region of Murcia. This espace is characterized by the scarcity and irregularity of the precipitations due to the subtropical arid enviroment, like it is the Mediterranean of coat in the peninsular South-East, the one which conditions the use of a tipology determined of hydraulic mill: mill of horizontal wheel 'rodezno' and niillpond. Investigation from documents and our researches in these zones have allowed us to find and describe six hidraulic mills in Abanilla (Chícanio. Partidor, Arco, Puente, Cal, Prao), and three in Fortuna (Molinico Viejo, Las Parecicas and the one in La Cana). In those whose rates of flows are scarce and variable ponds are included, in order to acumulate the enough water to the niill; Puente and Cal Mills, in the left bank of the river Chícamo next to Abanilla. and Prao Mill, in the right bank of the Zurca in the inmediacies of Barinas. are provided of this Technique.Este trabajo se propone el estudio y análisis de la actividad molinar en la Cuenca de Abanilla y Fortuna, términos municipales situados en el sector centro-oriental de la Región de Murcia. Este espacio se caracteriza por la escasez e irregularidad de las precipitaciones propias del medio subtropical hido, que es característico del clima Mediterráneo de abrigo del Sureste Peninsular. Este hecho condiciona el uso de una tipología determinada de molino hidráulico: molino de rueda horizontal "rodezno" y cubo. La investigación documental y el trabajo de campo nos han permitido localizar y describir seis molinos hidráulicos en Abanilla (Chícamo, Partidor, Arco. Puente, Cal, Prao) y tres en Fortuna (Molinico Viejo. Las Parecicas y de La Cana). En aquellos complejos donde los caudales son escasos y variables se incluye una balsa o estanque, con el fin de acumular el agua suficiente para la molienda; disponen de este sistema los conjuntos del Puente y la Cal en la margen izquierda del Chícamo, próximos a Abanilla, y el molino del Prao, en la margen derecha del Zurca, en las inmediaciones de Barinas