Modelling the impacts of climate and land use changes on water quality in the Guadiana basin and the adjacent coastal area.

The increasing pressure on water resources and the management problems related to it, highlight the need of a multidisciplinary approach in the hydrological, social, economic and ecological field, applicable to every considered catchment. Changes in land use means changes in quantity and quality of water resources; this scenario could bemore severe with the intensification of some chemical and physical processes, as a consequence of climate change. Based on this concept, the present work has been developed to support the use of information systems tools in the decision making process, from integrated river management to the integrated coastal management. For this purpose, it is used a hydrological model, using the Guadiana catchment as case study. The model has been calibrated and validated for river flow and nitrate load with satisfactory results, and then it was used for water quality simulation. Furthermore, simulations were done under two future Climate Change (CC, Representative Concentration Pathway — RCP 4.5 and RCP 8.5) scenarios, three Land Use Change (LUC) scenarios and the combination of both of them, to evaluate their contribution to the nutrient concentration that reaches the estuary. In this study, an extension of land use change from forest to olive groves would produce a greater contribution of nutrients under the most abrasive climate change scenario (RCP 8.5). Such scenario could be beneficial for the productivity of estuarine ecosystem. The same change in land use, instead, is not recommended under a climate change scenario RCP 4.5, as itwould cause a net reduction in the supply of nutrients to the estuary. With this information as support, it can be sought solutions with policies and incentives that are considered convenient and that allow to control, prevent or correct the deterioration of water bodies and thereby accomplish with the quality levels required by European Directives

New antioxidant drugs for neonatal brain injury

The brain injury concept covers a lot of heterogeneity in terms of aetiology involving multiple factors, genetic, hemodynamic, metabolic, nutritional, endocrinological, toxic, and infectious mechanisms, acting in antenatal or postnatal period. Increased vulnerability of the immature brain to oxidative stress is documented because of the limited capacity of antioxidant enzymes and the high free radicals (FRs) generation in rapidly growing tissue. FRs impair transmembrane enzyme Na(+)/K(+)-ATPase activity resulting in persistent membrane depolarization and excessive release of FR and excitatory aminoacid glutamate. Besides being neurotoxic, glutamate is also toxic to oligodendroglia, via FR effects. Neuronal cells die of oxidative stress. Excess of free iron and deficient iron/binding metabolising capacity are additional features favouring oxidative stress in newborn. Each step in the oxidative injury cascade has become a potential target for neuroprotective intervention. The administration of antioxidants for suspected or proven brain injury is still not accepted for clinical use due to uncertain beneficial effects when treatments are started after resuscitation of an asphyxiated newborn. The challenge for the future is the early identification of high-risk babies to target a safe and not toxic antioxidant therapy in combination with standard therapies to prevent brain injury and long-term neurodevelopmental impairment

Isoprostanes as Biomarker for Patent Ductus Arteriosus in Preterm Infants

Context: It has been reported that isoprostanes (IPs) have a role in the pathophysiology of ductus arteriosus during the fetal and neonatal period. Our aim in this study was to assess if urinary IPs (uIPs) levels correlate with the risk of developing a hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. Materials and methods: Infants with 23 + 0 - 33 + 6 weeks of gestational age and respiratory distress syndrome (RDS) were consecutively enrolled. Urine samples were collected on the 2nd and 10th day of life (DOL) for uIPs measurement. Echocardiography for hsPDA diagnosis was performed between 24 and 48 h of life. Regression analysis was performed to assess the correlation between uIPs and hsPDA. Receiver operating characteristic (ROC) curve analysis was used to evaluate the accuracy of the uIPs in predicting the occurrence of hsPDA. Results: Sixty patients were studied: 33 (55%) developed a hsPDA, 27 (45%) had ibuprofen hsPDA closure, and six (10%) required surgical closure. uIPs levels decreased from the 2nd to the 10th DOL. Adjusted regression analysis demonstrated that uIPs on the 2nd DOL were associated (p = 0.02) with the risk of developing a hsPDA. A cut-off level of 1627 ng/mg of creatinine of uIPs predicted the development of a hsPDA with a sensitivity of 82% and a specificity of 73%. Conclusion: Early measurement of uIPs on the 2nd DOL is a reliable biomarker of hsPDA development and, alone or combined with other markers, might represent a non-invasive tool useful for planning the management of PDA in preterm infants

The fate of Guadalquivir River discharges in the coastal strip of the Gulf of Cadiz. A study based on the linking of watershed catchment and hydrodynamic models.

A catchmentmodel for river basins and a hydrodynamicmodelwere combined in order to simulate the spreading of the turbidity plume produced by sediment discharges from the Guadalquivir River basin within the Gulf of Cádiz under different meteorological conditions. The current fields provided by the hydrodynamic model and a transport-diffusion scheme based on tracking virtual particles tracking released at the river mouth have enabled us to simulate turbidity plumes that show great similarity with the plumes observed in satellite images. The most relevant results of the study show that in the absence of winds, the plume tends to spread very slowly, gradually progressing northwards; this is because of the symmetry between the filling and draining flows at the mouth of the Guadalquivir and low intensity of the tidal currents beyond the mouth. In addition, the transport of the plume towards the Strait of Gibraltar requires wind conditions with a northerly, north-westerly or westerly component. Westwards transport, however, requires winds with an easterly, southerly, or south-easterly component. The periods of heaviest rainfall in the Guadalquivir River basin coincide with winds mainly from the west; therefore, the times ofmaximum discharge at the mouth of the river occurwhen there are wind conditions that favour the transport of the matter suspended in the plume, southwards along the coast, towards the Strait of Gibraltar and the Alboran Sea. Linking the watershed catchment and hydrodynamic models has proved its suitability to predict the evolution and reaching of the sediment plumes fromthe Guadalquivir River discharges and the experience encourages the use of that methodology to be applied in a future prediction systemfor the creation and evolution of those sediment plumes.We would like to thank the Regional Government of Andalusia ( P11-RNM-7722 project), the Spanish Government (TRUCO project RTI2018-100865-B-C22 ), the SUDOE INTERREG AGUAMOD and OCASO projects for supporting this work financially. We are also grateful to NASA for distributing the MODIS data used in this study, and to the AERONET project for the MODIS AQUA RGB True Color Images, especially those from the Malaga-San Jose and Huelva stations

Improving the therapist’s metacognition and capacity to intersubjectively attune with a patient with psychosis through the exploration of the therapist’s developmental history: a case report

Clinical literature emphasizes how symptoms of psychosis can be efficiently targeted by psychological treatments. The most well-known approach to these symptoms is cognitive-behavioral therapy; but in the last few decades also other approaches are enriching the landscape, focusing on the dysfunctions in mentalization or metacognition, a spectrum of mental activities involving thinking about one’s own and others’ mental states. This huge amount of theoretical reflection and empirical research focused on the implementation of treatments does not seem to be associated with an attention to the inner world of the therapist who relates to the patient with psychosis; for example, to the impact of the therapist’s developmental history on the therapeutic relationship. In this paper the authors are inspired by an intersubjective perspective, according to which although the treatment is for the patient’s benefit, both the patient’s and the therapist’s developmental history and psychological organization are equally relevant for understanding the clinical exchange. On this basis, the authors make a “parallel” analysis of the clinical case of a young woman with symptoms of psychosis (i.e., persecutory delusions, auditory verbal hallucinations, social withdrawal) and its supervision process. They show how the therapeutic relationship can be significantly conditioned by the therapist’s developmental history; and how a process of supervision focused on the exploration of the traumatic elements of this history can effectively promote the therapist’s metacognitive capabilities, a functional patient-therapist intersubjective attunement, and a good clinical outcome

Isoprostanes as Biomarker for White Matter Injury in Extremely Preterm Infants

Background and Aim: Preterm white matter is vulnerable to lipid peroxidation-mediated injury. F2-isoprostanes (IPs), are a useful biomarker for lipid peroxidation. Aim was to assess the association between early peri-postnatal IPs, white matter injury (WMI) at term equivalent age (TEA), and neurodevelopmental outcome in preterm infants. Methods: Infants with a gestational age (GA) below 28 weeks who had an MRI at TEA were included. IPs were measured in cord blood (cb) at birth and on plasma (pl) between 24 and 48 h after birth. WMI was assessed using Woodward MRI scoring system. Multiple regression analyses were performed to assess the association between IPs with WMI and then with BSITD-III scores at 24 months corrected age (CA). Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of pl-IPs for the development of WMI. Results: Forty-four patients were included. cb-IPs were not correlated with WMI score at TEA, whereas higher pl-IPs and lower GA predicted higher WMI score (p = 0.037 and 0.006, respectively) after controlling for GA, FiO2 at sampling and severity of IVH. The area under the curve was 0.72 (CI 95% = 0.51-0.92). The pl-IPs levels plotted curve indicated that 31.8 pg/ml had the best predictive threshold with a sensitivity of 86% and a specificity of 60%, to discriminate newborns with any WMI from newborns without WMI. IPs were not associated with outcome at 24 months. Conclusion: Early measurement of pl-IPs may help discriminate patients showing abnormal WMI score at TEA, thus representing an early biomarker to identify newborns at risk for brain injury