Modulating redox properties of solid-state ion-conducting materials using microwave irradiation

The industrial adoption of low-carbon technologies and renewable electricity requires novel tools for electrifying unitary steps and efficient energy storage, such as the catalytic synthesis of valuable chemical carriers. The recently-discovered use of microwaves as an effective reducing agent of solid materials provides a novel framework to improve this chemical-conversion route, thanks to promoting oxygen-vacancy formation and O-surface exchange at low temperatures. However, many efforts are still required to boost the redox properties and process efficiency. Here, we scrutinise the dynamics and the physicochemical dependencies governing microwave-induced redox transformations on solid-state ion-conducting materials. The reduction is triggered upon a material-dependent induction temperature, leading to a characteristically abrupt rise in electric conductivity. This work reveals that the released O yield strongly depends on the material's composition and can be tuned by controlling the gas-environment composition and the intensity of the microwave power. The reduction effect prevails at the grain surface level and, thus, amplifies for fine-grained materials, and this is ascribed to limitations in oxygen-vacancy diffusion across the grain compared to a microwave-enhanced surface evacuation. The precise cyclability and stability of the redox process will enable multiple applications like gas depuration, energy storage, or hydrogen generation in several industrial applications.This study forms part of the MFA programme and was supported by MCIN with funding from European Union NextGenerationEU (PRTR-C17.I1) and by Generalitat Valenciana. Financial support by the Spanish Ministry of Science and Innovation (PID2022-139663OB-100 and CEX2021-001230-S grants funded by MCIN/AEI/10.13039/501100011033, and “Ramon y Cajal” Fellowship RYC2021-033889-I), and the Universitat Politècnica de València (UPV) are gratefully acknowledged. Also, we acknowledge the support of the Servicio de Microscopía Electrónica of the UPV

Enteritis secundaria a nivolumab, una causa creciente de diarrea

La inmunoterapia es una herramienta cada vez más utilizada en el campo de la oncología. Conviene conocerla debido a sus crecientes usos, entre los que se incluye el tratamiento de tumores del aparato digestivo (hepatocarcinoma1, adenocarcinoma colorrectal con alta inestabilidad en microsatelites2) así como por las reacciones adversas que con elevada frecuencia afectan al tubo digestivo. Presentamos el caso de un varón de 74 años, con antecedentes personales de enfermedad pulmonar obstructiva crónica (EPOC) y melanoma con metástasis pulmonares. Debido a estas patologías tomaba de manera habitual inhaladores de salbutamol y había estado en tratamiento con nivolumab, suspendido hacía cuatro meses tras conseguir una respuesta radiológica completa de las metástasis pulmonares. El paciente refería cuadro diarreico de un mes de evolución, consistente en tres a cuadro deposiciones (Bristol 5-6) sin productos patológicos, que afectaban el descanso nocturno, asociaban molestias centroabdominales intermitentes y pérdida de peso de unos 3-4 kg. No había ingerido alimentos crudos, antibióticos o nuevas medicaciones. Tampoco había convivientes con la misma sintomatología ni había realizado viajes al extranjero. Negaba cualquier otra sintomatología y antecedentes familiares de interés. La exploración física era anodina a excepción de unas ligeras molestias a la palpación profunda en mesogastrio..

Aproximación al manejo de la disección del tronco celíaco

El dolor abdominal constituye uno de los motivos de consulta más frecuentes en los servicios de Urgencias y de Aparato Digestivo. Además, el diagnóstico diferencial supone un importante reto, dado el amplio abanico de entidades clínicas que pueden provocarlo, algunas de ellas con un pronóstico desfavorable. En este sentido, en algunas cohortes no se ha llegado a un diagnóstico específico en más de un 30% de los casos1, 2. Se presenta el caso de un varón de 40 años, fumador activo desde hace más de 20 años, sin otros antecedentes personales ni familiares de interés, excepto traumatismo cerrado abdominal hace cuatro años, que no seguía tratamiento farmacológico habitual. Presentaba dolor abdominal epigástrico continuo e irradiado hacia ambos hipocondrios, de ocho horas de evolución. No asociaba ictericia mucocutánea ni coluria o acolia, tampoco náuseas ni vómitos ni alteraciones en el ritmo y características de las deposiciones. No presentaba fiebre, síndrome constitucional ni otra sintomatología asociada. A la exploración física destacaba dolor a la palpación de epigastrio, sin signos de irritación peritoneal, con peristaltismo y pulsos distales conservados. Asimismo, no presentaba signos de colagenopatía. Para una primera aproximación diagnóstica se realizó analítica de sangre, destacando como únicos hallazgos ligera alteración del perfil hepático (AST 66 U/L, ALT 58 U/L, GGT 106 U/L, FA 76 U/L) con amilasemia, ..

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42\ub74% vs 44\ub72%; absolute difference \u20131\ub769 [\u20139\ub758 to 6\ub711] p=0\ub767; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5\u20138] vs 6 [5\u20138] cm H2O; p=0\ub70011). ICU mortality was higher in MICs than in HICs (30\ub75% vs 19\ub79%; p=0\ub70004; adjusted effect 16\ub741% [95% CI 9\ub752\u201323\ub752]; p<0\ub70001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0\ub780 [95% CI 0\ub775\u20130\ub786]; p<0\ub70001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status. Funding: No funding

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Naturaleza y cultura en Ámerica Latina

La concreción del XVIII Foro de Estudiantes Latinoamericanos de Antrología y Arqueología: Cultura y naturaleza en América Latina: escenarios para un modelo de desarrollo no civilizatorio, efectuado en Quito desde el 17 al 23 de julio del 2011, se constituyó en un acontecimiento sumamente significativo para la antropología latinoamericana debido a dos motivos. Primero porque coincidió con la emergencia del movimiento universitario estudiantil latinoamericano que expresaba sus tendencias, propuestas y exigencias de cambios tanto de las prácticas académicas como de los patrones civilizatorios que rigen las relaciones actuales. Segundo, porque se inscribía en un contexto de consolidación de las nuevas democracias de los países andinos, de carácter antineoliberal y basadas en los sujetos de derecho entre los cuales se incluye la naturaleza. Estos contextos determinaron que el Foro no ponga en escena certidumbres teóricas o metodológicas, ni se preste al exhibicionismo estéril de los avances disciplinares. Más bien, la convocatoria de la antropología y la arqueología fue apenas un pretexto para hablar, con su lenguaje, de nosotros mismos, de lo que somos, de lo que pensamos, de lo que aspiramos y sentimos sobre nuestra Latinoamérica. Lo que hemos visto, oído y compartido, en realidad, no han sido solamente ideas o conceptos sino opciones y toma de posiciones respecto a múltiples encrucijadas. Posición ante situaciones que amenazan la vida, la justicia y los derechos de todos, un desafío epistemológico todavía en ciernes y que no termina de cuajar aún en nuestras prácticas académicas

Climate changes in mangrove forests and salt marshes

Abstract This synthesis is framed within the scope of the Brazilian Benthic Coastal Habitat Monitoring Network (ReBentos WG 4: Mangroves and Salt Marshes), focusing on papers that examine biodiversity-climate interactions as well as human-induced factors including those that decrease systemic resilience. The goal is to assess difficulties related to the detection of climate and early warning signals from monitoring data. We also explored ways to circumvent some of the obstacles identified. Exposure and sensitivity of mangrove and salt marsh species and ecosystems make them extremely vulnerable to environmental impacts and potential indicators of sea level and climate-driven environmental change. However, the interpretation of shifts in mangroves and salt marsh species and systemic attributes must be scrutinized considering local and setting-level energy signature changes; including disturbance regime and local stressors, since these vary widely on a regional scale. The potential for adaptation and survival in response to climate change depends, in addition to the inherent properties of species, on contextual processes at the local, landscape, and regional levels that support resilience. Regardless of stressor type, because of the convergence of social and ecological processes, coastal zones should be targeted for anticipatory action to reduce risks and to integrate these ecosystems into adaptation strategies. Management must be grounded on proactive mitigation and collaborative action based on long-term ecosystem-based studies and well-designed monitoring programs that can 1) provide real-time early warning and 2) close the gap between simple correlations that provide weak inferences and process-based approaches that can yield increasingly reliable attribution and improved levels of anticipation