Web Application for Atmospheric Aerosol Data Management: Software and Case Study in the Spanish Network on Environmental Differential Mobility Analysers

[Abstract] SCALA© (Sampling Campaigns for Aerosols in the Low Atmosphere) is a web-based software system that was developed in a multidisciplinary manner to integrally support the documentation and the management and analysis of atmospheric aerosol data from sampling campaigns. The software development process applied considered the prototyping and the evolutionary approaches. The software product (SCALA©) allows for the comprehensive management of the sampling campaigns’ life cycle (management of the profiles and processes involved in the start-up, development and closure of a campaign) and provides support for both intra- and inter-campaigns data analysis. The pilot deployment of SCALA© considers the Spanish Network on Environmental Differential Mobility Analysers (DMAs) (REDMAAS) and the PROACLIM project. This research project involves, among other objectives, the study of temporal and spatial variations of the atmospheric aerosol through a set of microphysical properties (size distribution, optical properties, hygroscopicity, etc.) measured in several locations in Spain. The main conclusions regarding size distribution are presented in this work. These have been have been extracted through SCALA© from the data collected in the REDMAAS 2015 and 2019 intercomparison campaigns and two years (2015 and 2016) of measurements with two Scanning Mobility Particle Sizers (SMPS) at CIEMAT (Madrid, central Spain) and UDC (A Coruña, NW of Spain) sites.Ministerio de Economía y Competitividad; CGL2014-52877-RMinisterio de Economía y Competitividad; CGL2017-85344-RXunta de Galicia; GRC2013-047Xunta de Galicia; ED431C 2017/28Gobierno Regional de Madrid; Y2018/EMT-517

Sistema de Seguridad del Paciente y Gestión de Riesgos Sanitarios Del modelo corporativo de gestión integrada de la calidad del Servicio Gallego de Salud

La Subdirección General de Atención al Ciudadano y Calidad, del Servicio Gallego de Salud, en consonancia con la Estrategia Sergas 2014 se propuso como objetivo la creación de un Sistema de Seguridad del paciente y que sirviera como hoja de ruta para la mejora de la seguridad asistencial en todos los centros sanitarios públicos gallegos. El equipo de trabajo de la mencionada Subdirección, desarrolló una labor de recopilación y revisión de documentación partiendo de la bibliografía relevante. A continuación se elaboró un primer borrador de trabajo, en el que se propusieron las líneas estratégicas, los objetivos y criterios de evaluación sobre las áreas que se consideraron esenciales y prioritaria

The REDMAAS 2014 intercomparison campaign: CPC, SMPS, UFPM and neutralizers

Ponencia presentada en:2nd Iberian Meeting on Aerosol Science and Technology (RICTA 2014) celebrado en Tarragona del 7 al 9 de julio de 2014.The Spanish network on environmental DMAs (Red Española de DMAs Ambientales, REDMAAS), working since 2010, is currently formed by six groups involved in the measurement of atmospheric aerosol size distributions by means of Differential Mobility Analyzers (DMAs). One of its activities is an annual intercomparison of mobility size spectrometers (SMPS and UFPM). In this work we show the results obtained in the 2014 campaign: the verification of DMA calibrations with latex, the results of the CPC and SMPS + UFPM intercomparisons, and a comparison of the new TSI 3087 X-ray and the former TSI 3077 85Kr neutralizers. The concentrations measured by different types of CPC were within the range of 10% of the average value. CPCs working at higher flow rates measured slightly higher concentrations, probably related to the smaller losses in the lines. All the SMPS worked at the same sampling and sheath flow rates (1:10 lpm). Four of the SMPS gave very good results for particles larger than 20 nm. The UFPM measured particle number concentrations in the average +/-10% band measured by the SMPS. Instruments working with the X-ray neutralizer measured higher concentrations than with the 85Kr neutralizers. This could mean that particle losses are smaller inside this neutralizer.This work has been financed by the Ministry of Science and Innovation (CGL2011-15008-E, CGL2010-1777, CGL2011-27020 & CGL2011-26259)

Atmospheric particle size distributions in the Spanish Network of Environmental DMAs (REDMAAS)

The present work is a first approach to the study of the spatio-temporal variability of the submicrometer atmospheric aerosol in Spain. The aerosol measurements have been obtained simultaneously at seven monitoring stations that compose the REDMAAS network during two measurement campaigns corresponding to summer and winter seasons. In both summer and winter periods those measurement stations with a direct influence of anthropogenic emissions recorded the highest concentrations of particle number. In the summer campaign, the average daily pattern of the aerosol size distribution in the traffic and background urban stations was conditioned by the traffic emissions and secondary aerosol formation through photochemical reactions (new particle formation events, NPF). However, the secondary aerosol had a higher contribution to the aerosol total number concentration in the rural background and high-altitude stations. In the winter campaign, in all sampling sites with the exception of Izaña station, the traffic and domestic activity emissions had a greater contribution than secondary aerosol formation on particle number total concentration. New particle formation events were identified at all sites during the summer period, and at sites without direct influence of anthropogenic emissions during the winter campaign. Some aerosol shrinkage processes were also observed at the Madrid and El Arenosillo stations.This work has been financed by the Ministry of Science and Innovation (CGL2011-15008-E, CGL2010-1777, CGL2011-27020, CGL2014-52877-R & CGL2014-55230-R), Xunta de Galicia (GRC2013-047 potentially cofounded by ERDF) and the European Union Seventh Framework Programme (FP7/2007–2013) ACTRIS under grant agreement no. 262254

The C Allele of ATM rs11212617 Associates With Higher Pathological Complete Remission Rate in Breast Cancer Patients Treated With Neoadjuvant Metformin

Background: The minor allele (C) of the single-nucleotide polymorphism (SNP) rs11212617, located near the ataxia telangiectasia mutated (ATM) gene, has been associated with an increased likelihood of treatment success with metformin in type 2 diabetes. We herein investigated whether the same SNP would predict clinical response to neoadjuvant metformin in women with early breast cancer (BC). Methods: DNA was collected from 79 patients included in the intention-to-treat population of the METTEN study, a phase 2 clinical trial of HER2-positive BC patients randomized to receive either metformin combined with anthracycline/taxane-based chemotherapy and trastuzumab or equivalent regimen without metformin, before surgery. SNP rs11212617 genotyping was assessed using allelic discrimination by quantitative polymerase chain reaction. Results: Logistic regression analyses revealed a significant relationship between the rs11212617 genotype and the ability of treatment arms to achieve a pathological complete response (pCR) in patients (odds ratio [OR](genotypexarm) = 10.33, 95% confidence interval [CI]: 1.29-82.89, p = 0.028). In the metformin-containing arm, patients bearing the rs11212617 C allele had a significantly higher probability of pCR (ORA/C,C/C = 7.94, 95% CI: 1.60-39.42, p = 0.011). Conversely, no association was found between rs11212617 and clinical response in the reference arm (ORA/C,C/C = 0.77, 95% CI: 0.20-2.92, p = 0.700). After controlling for tumor size and hormone receptor status, the rs11212617 C allele remained a significant predictor of pCR solely in the metformin-containing arm. Conclusions: If reproducible, the rs11212617 C allele might warrant consideration as a predictive clinical biomarker to inform the personalized use of metformin in BC patients

Chronic Obstructive Pulmonary Disease in Elderly Patients with Acute and Advanced Heart Failure: Palliative Care Needs—Analysis of the EPICTER Study

Introduction: There are studies that evaluate the association between chronic obstructive pulmonary disease (COPD) and heart failure (HF) but there is little evidence regarding the prognosis of this comorbidity in older patients admitted for acute HF. In addition, little attention has been given to the extracardiac and extrapulmonary symptoms presented by patients with HF and COPD in more advanced stages. The aim of this study was to evaluate the prognostic impact of COPD on mortality in elderly patients with acute and advanced HF and the clinical manifestations and management from a palliative point of view. Methods: The EPICTER study (Epidemiological survey of advanced heart failure) is a cross-sectional, multicenter project that consecutively collected patients admitted for HF in 74 Spanish hospitals. Demographic, clinical, treatment, organ-dependent terminal criteria (NYHA III-IV, LVEF <20%, intractable angina, HF despite optimal treatment), and general terminal criteria (estimated survival <6 months, patient/family acceptance of palliative approach, and one of the following: evidence of HF progression, multiple Emergency Room visits or admissions in the last six months, 10% weight loss in the last six months, and functional impairment) were collected. Terminal HF was considered if the patient met at least one organ-dependent criterion and all the general criteria. Both groups (HF with COPD and without COPD) were compared. A Kaplan-Meier survival analysis was performed to evaluate the presence of COPD on the vital prognosis of patients with HF. Results: A total of 3100 patients were included of which 812 had COPD. In the COPD group, dyspnea and anxiety were more frequently observed (86.2% vs. 75.3%, p = 0.001 and 35.4% vs. 31.2%, p = 0.043, respectively). In patients with a history of COPD, presentation of HF was in the form of acute pulmonary edema (21% vs. 14.4% in patients without COPD, p = 0.0001). Patients with COPD more frequently suffered from advanced HF (28.9% vs. 19.4%; p < 0.001). Consultation with the hospital palliative care service during admission was more frequent when patients with HF presented with associated COPD (94% vs. 6.8%; p = 0.036). In-hospital and six-month follow-up mortality was 36.5% in patients with COPD vs. 30.7% in patients without COPD, p = 0.005. The mean number of hospital admissions during follow-up was higher in patients with HF and COPD than in those with isolated HF (0.63 +/- 0.98 vs. 0.51 +/- 0.84; p < 0.002). Survival analysis showed that patients with a history of COPD had fewer survival days during follow-up than those without COPD (log Rank chi-squared 4.895 and p = 0.027). Conclusions: patients with HF and COPD had more severe symptoms (dyspnea and anxiety) and also a worse prognosis than patients without COPD. However, the prognosis of patients admitted to our setting is poor and many patients with HF and COPD may not receive the assessment and palliative care support they need. Palliative care is necessary in chronic non-oncologic diseases, especially in multipathologic and symptom-intensive patients. This is a clinical care aspect to be improved and evaluated in future research studies

Do specific antimicrobial stewardship interventions have an impact on carbapenem resistance in Gram-negative bacilli? A multicentre quasi-experimental ecological study: time-trend analysis and characterization of carbapenemases

CarbaPIRASOA team.[Background] Carbapenem-resistant Gram-negative bacilli (CR-GNB) are among the most threatening microorganisms worldwide and carbapenem use facilitates their spread. Antimicrobial stewardship programmes (ASPs) can help to optimize the use of antibiotics. This study evaluates the impact of a multifaceted educational ASP on carbapenem use and on the epidemiology of CR-GNB.[Methods] We conducted a quasi-experimental, time-series study in seven hospitals, from January 2014 to September 2018. The key intervention was composed of educational interviews promoting the appropriate use of carbapenems. The primary endpoints were carbapenem consumption and incidence density (ID) of CR-GNB. All non-duplicated CR-GNB clinical isolates were tested using phenotypic assays and PCR for the presence of carbapenemases. Joinpoint regression and interrupted time-series analyses were used to determine trends.[Results] A decrease in carbapenem consumption throughout the study period [average quarterly percentage change (AQPC) −1.5%, P < 0.001] and a −8.170 (−16.064 to −0.277) level change following the intervention were observed. The ID of CR-Acinetobacter baumannii decreased (AQPC −3.5%, P = 0.02) and the overall ID of CR-GNB remained stable (AQPC −0.4%, P = 0.52). CR-GNB, CR-Pseudomonas aeruginosa and CR-A. baumannii IDs per hospital correlated with the local consumption of carbapenems. The most prevalent carbapenem resistance mechanisms were OXA-23 for CR-A. baumannii (76.1%), OXA-48 for CR-Klebsiella pneumoniae (66%) and no carbapenemases for CR-P. aeruginosa (91.7%). The epidemiology of carbapenemases was heterogeneous throughout the study, especially for carbapenemase-producing Enterobacteriaceae.[Conclusions] In conclusion, a multifaceted, educational interview-based ASP targeting carbapenem prescribing reduced carbapenem use and the ID of CR-A. baumannii.This work was funded by the Spanish Infectious Diseases and Clinical Microbiology Society (SEIMC).Peer reviewe