Impact of medium-scale traveling ionospheric disturbances on network real-time kinematic services: CATNET study case

Medium-scale traveling ionospheric disturbances (MSTIDs) are fluctuations in the plasma density that propagate through the upper layer of the atmosphere at velocities of approximately 100 m/s and periods reaching some tens of minutes. Due to their wavelengths, MSTIDs can degrade the performance of differential positioning techniques, such as real-time kinematics (RTK) or network-RTK (NRTK). This paper defines a novel methodology as a tool for relating the errors in NRTK positioning based on an MSTIDs indicator using the second difference in time of the slant total electron content (STEC). The pro-posed methodology performs integer ambiguity resolution (IAR) on the undifferenced measurements instead of using double-differenced carrier-phase measurements, as it is usual in RTK and NRTK. Statistical tests are applied to evaluate the degradation in the position errors caused by the impacts of MSTIDs on RTK and NRTK positioning over a data set spanning one year gathered from the CATNET network; a dual-frequency network of fixed permanent GNSS receivers located at the mid-latitudes of northeastern Spain. With the development of the proposed methodology for measuring the position degradation, another results of the present research are the establishment of thresholds for the proposed MSTIDs index, which can be used to monitor the positioning solution and to warn users when the measurements are affected by MSTIDs events, relating the position error to MSTIDs that affect not only the user receivers but also of the reference receivers within the network.Peer ReviewedPostprint (published version

Apparent selective advantage of leucism in a coastal population of Southern caracaras (Falconidae)

ABSTRACT Background: Southern caracaras are medium-sized raptors with a large range stretching to the southern tip of South America. An aberrant, leucistic plumage is found commonly along the coast of Chubut Province (Patagonia, Argentina). Leucistic birds do not produce dark melanin in their feathers. However, they are not albinos because their eyes are not red. No genetic studies of caracara plumages are known. Hypothesis: The high frequency of leucistic birds in Chubut Province arises because of natural selection. Methods: Map the distribution of leucistic individuals relative to normal individuals. Combine a variety of anecdotal natural history observations, collected over 20 years, into a logical inference. Observations: Leucistic caracaras were found only along a 250-km stretch of rocky oceanic islands and continental outcrops with large seabird colonies in Chubut Province. In the rest of their range, Southern caracaras have dark plumage. Where they do occur, leucistic birds are frequent and co-occur with dark-plumaged birds. Intermediate individuals, presumabl

Daptomycin plus Fosfomycin versus Daptomycin Alone for Methicillin-Resistant Staphylococcus 2 aureus Bacteremia and Endocarditis. A Randomized Clinical Trial

Background We aimed to determine whether daptomycin plus fosfomycin provides higher treatment success than daptomycin alone for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and endocarditis. Methods A randomized (1:1) phase 3 superiority, open-label, and parallel group clinical trial of adult inpatients with MRSA bacteremia was conducted at 18 Spanish hospitals. Patients were randomly assigned to receive either 10 mg/kg of daptomycin intravenously daily plus 2 g of fosfomycin intravenously every 6 hours, or 10 mg/kg of daptomycin intravenously daily. Primary endpoint was treatment success 6 weeks after the end of therapy. Results Of 167 patients randomized, 155 completed the trial and were assessed for the primary endpoint. Treatment success at 6 weeks after the end of therapy was achieved in 40 of 74 patients who received daptomycin plus fosfomycin and in 34 of 81 patients who were given daptomycin alone (54.1% vs 42.0%; relative risk, 1.29 [95% confidence interval, .93-1.8]; P = .135). At 6 weeks, daptomycin plus fosfomycin was associated with lower microbiologic failure (0 vs 9 patients; P = .003) and lower complicated bacteremia (16.2% vs 32.1%; P = .022). Adverse events leading to treatment discontinuation occurred in 13 of 74 patients (17.6%) receiving daptomycin plus fosfomycin, and in 4 of 81 patients (4.9%) receiving daptomycin alone (P = .018). Conclusions Daptomycin plus fosfomycin provided 12% higher rate of treatment success than daptomycin alone, but this difference did not reach statistical significance. This antibiotic combination prevented microbiological failure and complicated bacteremia, but it was more often associated with adverse events

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Urinary metals and metal mixtures and oxidative stress biomarkers in an adult population from Spain: The Hortega Study

INTRODUCTION: Few studies have investigated the role of exposure to metals and metal mixtures on oxidative stress in the general population. OBJECTIVES: We evaluated the cross-sectional association of urinary metal and metal mixtures with urinary oxidative stress biomarkers, including oxidized to reduced glutathione ratio (GSSG/GSH), malondialdehyde (MDA), and 8‑oxo‑7,8‑dihydroguanine (8-oxo-dG), in a representative sample of a general population from Spain (Hortega Study). METHODS: Urine antimony (Sb), barium (Ba), cadmium (Cd), chromium (Cr), cobalt (Co), copper (Cu), molybdenum (Mo), vanadium (V) and zinc (Zn) were measured by ICPMS in 1440 Hortega Study participants. RESULTS: The geometric mean ratios (GMRs) of GSSG/GSH comparing the 80th to the 20th percentiles of metal distributions were 1.15 (95% confidence intervals [95% CI]: 1.03-1.27) for Mo, 1.17 (1.05-1.31) for Ba, 1.23 (1.04-1.46) for Cr and 1.18 (1.00-1.40) for V. For MDA, the corresponding GMRs (95% CI) were 1.13 (1.03-1.24) for Zn and 1.12 (1.02-1.23) for Cd. In 8-oxo-dG models, the corresponding GMR (95% CI) were 1.12 (1.01-1.23) for Zn and 1.09 (0.99-1.20) for Cd. Cr for GSSG/GSH and Zn for MDA and 8-oxo-dG drove most of the observed associations. Principal component (PC) 1 (largely reflecting non-essential metals) was positively associated with GSSG/GSH. The association of PC2 (largely reflecting essential metals) was positive for GSSG/GSH but inverse for MDA. CONCLUSIONS: Urine Ba, Cd, Cr, Mo, V and Zn were positively associated with oxidative stress measures at metal exposure levels relevant for the general population. The potential health consequences of environmental, including nutritional, exposure to these metals warrants further investigation

O31 Integrative analysis reveals a molecular stratification of systemic autoimmune diseases

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CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3

ObjectivesCARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain.MethodsIn total, 71 hospitals, representing all 50 Spanish provinces, collected the first 10 isolates per hospital (February to May 2019); CPE isolates were first identified according to EUCAST (meropenem MIC > 0.12 mg/L with immunochromatography, colorimetric tests, carbapenem inactivation, or carbapenem hydrolysis with MALDI-TOF). Prevalence and incidence were calculated according to population denominators. Antibiotic susceptibility testing was performed using the microdilution method (EUCAST). All 403 isolates collected were sequenced for high-resolution single-nucleotide polymorphism (SNP) typing, core genome multilocus sequence typing (cgMLST), and resistome analysis.ResultsIn total, 377 (93.5%) CP-Kpn and 26 (6.5%) CP-Eco isolates were collected from 62 (87.3%) hospitals in 46 (92%) provinces. CP-Kpn was more prevalent in the blood (5.8%, 50/853) than in the urine (1.4%, 201/14,464). The cumulative incidence for both CP-Kpn and CP-Eco was 0.05 per 100 admitted patients. The main carbapenemase genes identified in CP-Kpn were blaOXA–48 (263/377), blaKPC–3 (62/377), blaVIM–1 (28/377), and blaNDM–1 (12/377). All isolates were susceptible to at least two antibiotics. Interregional dissemination of eight high-risk CP-Kpn clones was detected, mainly ST307/OXA-48 (16.4%), ST11/OXA-48 (16.4%), and ST512-ST258/KPC (13.8%). ST512/KPC and ST15/OXA-48 were the most frequent bacteremia-causative clones. The average number of acquired resistance genes was higher in CP-Kpn (7.9) than in CP-Eco (5.5).ConclusionThis study serves as a first step toward WGS integration in the surveillance of carbapenemase-producing Enterobacterales in Spain. We detected important epidemiological changes, including increased CP-Kpn and CP-Eco prevalence and incidence compared to previous studies, wide interregional dissemination, and increased dissemination of high-risk clones, such as ST307/OXA-48 and ST512/KPC-3

The NAVSCIN Project: Towards High-Accuracy Navigation under Scintillation

The main goal of the Marie Sklodowska-Curie Action (MSCA) titled “High Accuracy Navigation under Scintillation Conditions (NAVSCIN)” is to develop an improved strategy to mitigate scintillation –a particular type of space weather perturbation–tailored for satellite-based navigation techniques, in close collaboration with users and manufacturers of these technologies. Indeed, once the scintillation effect is correctly detected and mitigated, the availability and accuracy of the Global Navigation Satellite Systems (GNSSs) receivers will dramatically improve.Scintillation is one of the most challenging problems in GNSS. This phenomenon appears when the signal pass through ionospheric irregularities, producing rapid changes on refraction index and, depending on the size of such irregularities, also diffractive effects affecting the signalamplitude and the tracking of the carrier-phase measurements. In this work, we present the results being achieved within NAVSCIN to deal with scintillation effects on GNSS signal, exploiting the evidence that low and high latitudes present different characteristics.At low-latitude, we observe an increase of the carrier phase noise and a fade on the signal intensity that can produce frequent cycle-slips in the GNSS signal and, in extreme conditions, it can lead to the loss of GNSS signals. The detection of these cycle-slips associated with scintillation condition is a challenging problem for precise navigation. In the current state of the art, these uncorrected discontinuities can produce meters of position error. In contrast, we show that high accuracy isstill possible for dual-frequency users, if the cycle-slips are detected in a reliable way. In high latitude, the size of the ionospheric irregularities is typically larger than the Fresnel scale. Therefore, the main effects are related with the fast change on the refractive index associated to the fast movement of the irregularities (which can reach up to several km/s). Consequently, the main effect on the GNSS signal is a fast fluctuation of the carrier phase, but with a moderate fading in the intensity. Thus, on one hand, this rapid fluctuation of carrier phases is mostly proportional to the inverse squared frequency of the signals, being the effect quite limited (practically null) on the ionosphere-free combination. On the other hand, these fluctuations do not usually produce cycle-slips. These two characteristics make feasible the use of the dual-frequency ionospheric free combination for high accuracy navigation in high latitudes, also during high ionospheric activity.Postprint (published version

Urinary metals and metal mixtures and oxidative stress biomarkers in an adult population from Spain: The Hortega Study.

Few studies have investigated the role of exposure to metals and metal mixtures on oxidative stress in the general population. We evaluated the cross-sectional association of urinary metal and metal mixtures with urinary oxidative stress biomarkers, including oxidized to reduced glutathione ratio (GSSG/GSH), malondialdehyde (MDA), and 8‑oxo‑7,8‑dihydroguanine (8-oxo-dG), in a representative sample of a general population from Spain (Hortega Study). Urine antimony (Sb), barium (Ba), cadmium (Cd), chromium (Cr), cobalt (Co), copper (Cu), molybdenum (Mo), vanadium (V) and zinc (Zn) were measured by ICPMS in 1440 Hortega Study participants. The geometric mean ratios (GMRs) of GSSG/GSH comparing the 80th to the 20th percentiles of metal distributions were 1.15 (95% confidence intervals [95% CI]: 1.03-1.27) for Mo, 1.17 (1.05-1.31) for Ba, 1.23 (1.04-1.46) for Cr and 1.18 (1.00-1.40) for V. For MDA, the corresponding GMRs (95% CI) were 1.13 (1.03-1.24) for Zn and 1.12 (1.02-1.23) for Cd. In 8-oxo-dG models, the corresponding GMR (95% CI) were 1.12 (1.01-1.23) for Zn and 1.09 (0.99-1.20) for Cd. Cr for GSSG/GSH and Zn for MDA and 8-oxo-dG drove most of the observed associations. Principal component (PC) 1 (largely reflecting non-essential metals) was positively associated with GSSG/GSH. The association of PC2 (largely reflecting essential metals) was positive for GSSG/GSH but inverse for MDA. Urine Ba, Cd, Cr, Mo, V and Zn were positively associated with oxidative stress measures at metal exposure levels relevant for the general population. The potential health consequences of environmental, including nutritional, exposure to these metals warrants further investigation.This work was supported by the Strategic Action for Research in Health Sciences [CP12/03080, PI10/0082, PI13/01848, PI07/0497 and PI11/00726]; GRUPOS 03/101, PROMETEO/2009/029 and 2005/027, AMP07/075 and ACOMP/2013/039 from the Valencia Government; GRS/279/A/08 from Castilla-Leon Government; European Network of Excellence Ingenious Hypercare (EPSS-037093) from the European Commission; Retics (PREDIMED RD06/0045/0006); CIBER Fisiopatología Obesidad y Nutrición (CIBERobn) [CIBER-02-08-2009, CB06/03 and CB12/03/30016] and CIBER de Diabetes y Enfermedades Metabólicas Relacionadas (CIBERDEM CB07/0/018). The Strategic Action for Research in Health sciences, Retics, CIBEROBN and CIBERDEM are initiatives from Carlos III Health Institute Madrid and the Spanish Ministry of Economy and Competitiveness and co-funded with European Funds for Regional Development (FEDER). The authors declare they have no actual or potential competing financial interests.S

Second week methyl-prednisolone pulses improve prognosis in patients with severe coronavirus disease 2019 pneumonia: An observational comparative study using routine care data.

ObjectiveTo analyze the effects of a short course of methyl-prednisolone pulses (MP) during the second week of disease (week-2) in patients with severe coronavirus disease 2019 (COVID-19) pneumonia.MethodsComparative observational study using data collected from routine care at Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain in patients with COVID-19 pneumonia. We compared patients who received week-2-MP (125-250 mg/d x3) with those who did not, with the end-points time to death and time to death or endotracheal intubation.ResultsWe included 242 patients with COVID-19 pneumonia and elevated inflammatory markers at admission. Sixty-one patients (25%) received week-2-MP. Twenty-two patients (9%) died and 31 (12.8%) suffered death or intubation. The adjusted HRs for death and death or intubation for patients in the week-2-MP group were 0.35 (95%CI 0.11 to 1.06, p = 0.064) and 0.33 (95%CI 0.13 to 0.84, p = 0.020), respectively. These differences were specifically seen in the subcohort of patients with a SpO2/FiO2 at day 7 lower than 353 (adjusted HR 0.31, 95% CI 0.08 to 1.12, p = 0.073 and HR 0.34, 95%CI 0.12 to 0.94, p = 0.038, respectively) but not in patients with higher SpO2/FiO2. Patients receiving out-of-week-2-MP, non-pulse glucocorticoids or no glucocorticoids had an increased adjusted risk for both outcomes compared with week-2-MP group: HR 5.04 (95% CI 0.91-27.86), HR 10.09 (95% CI 2.14-47.50), HR 4.14 (95% CI 0.81-21.23), respectively, for death; HR 7.38 (95% CI 1.86-29.29), HR 13.71 (95% CI 3.76-50.07), HR 3.58 (95% CI 0.89-14.32), respectively, for death or intubation. These differences were significant only in the subgroup with low SpO2/FiO2.ConclusionsWeek-2-MP are effective in improving the prognosis of patients with COVID-19 pneumonia with features of inflammatory activity and respiratory deterioration entering the second week of disease. The recognition of this high-risk population should prompt early use of MP at this point