Solar/lamp-irradiated tubular photoreactor for air treatment with transparent supported photocatalysts

A novel versatile tubular reactor that may use both types of radiation, solar and/or artificial, and different types of suspended or immobilized photocatalysts is proposed. The photocatalytic reactor was evaluated for air treatment at laboratory scale and semi-pilot-plant scale. UV-A transparent immobilized photocatalysts were employed, which allowed an efficient use of radiation. Two different types of photocatalytic modules were tested: (a) TiO2-coated PET monoliths and (b) TiO2-coated glass slides, arranged in monolith-like units with the help of especially designed star-shaped polygonal structures. Both types of units were easy to handle and assured the adequate distribution of the photocatalyst inside the tubular reactor. The efficiency of the photocatalytic system with both solar and artificial radiation to oxidize the H2S contained in an air stream was demonstrated at the laboratory roof and in the treatment of real air of a wastewater treatment plant located in Madrid (Spain). As a consequence of the chemical nature of the pollutant, the photocatalytic activity decayed over time due to the accumulation of sulfate on the surface, but easy regeneration of the exhausted photocatalyst was achieved by washing with water.The authors would like to acknowledge Comunidad de Madrid (DETOX-H2S S-0505/AMB/0406), Ministerio de Ciencia e Innovación (CTM2008-06876-C02-01) and AECID for financial support and Gloria Simón Naranjo and Francisco Sánchez Moreno for the help with the reactor set-up.Peer reviewe

Photocatalysis for Continuous Air Purification in Wastewater Treatment Plants: From Lab to Reality

The photocatalytic efficiency of TiO2–SiMgOx plates to oxidize H2S was first evaluated in a flat laboratory reactor with 50 mL min–1 synthetic air containing 100 ppm H2S in the presence of humidity. The use of the photocatalyst-adsorbent hybrid material enhanced the photocatalytic activity in terms of pollutant conversion, selectivity, and catalyst lifetime compared to previous H2S tests with pure TiO2 because total H2S elimination was maintained for more than 30 operating hours with SO2 appearing in the outlet as reaction product only after 18 h. Subsequently, the hybrid material was successfully tested in a photoreactor prototype to treat real polluted air in a wastewater treatment plant. For this purpose, a new tubular photocatalytic reactor that may use solar radiation in combination with artificial radiation was designed; the lamp was turned on when solar UV-A irradiance was below 20 W m–2, which was observed to be the minimum value to ensure 100% conversion. The efficient distribution of the opaque photocatalyst inside the tubular reactor was achieved by using especially designed star-shaped structures. These structures were employed for the arrangement of groups of eight TiO2–SiMgOx plates in easy-to-handle channelled units obtaining an adequate flow regime without shading. The prototype continuously removed during one month and under real conditions the H2S contained in a 1 L min–1 air current with a variable inlet concentration in the range of tens of ppmv without release of SO2.The authors would like to acknowledge Comunidad de Madrid (DETOX-H2S S-0505/AMB/0406), Spanish Ministry of Science and Innovation (CTM2008-06876-C02-01/02 and postdoctoral contracts of R.P., S.S. and M.D.H.A), and AECID for financial support and M.L. Rojas-Cervantes for the TG-MS instrument.Peer reviewe

EoE CONNECT, the European Registry of Clinical, Environmental, and Genetic Determinants in Eosinophilic Esophagitis: rationale, design, and study protocol of a large-scale epidemiological study in Europe

Background: The growing prevalence of eosinophilic esophagitis (EoE) represents a considerable burden to patients and health care systems. Optimizing cost-effective management and identifying mechanisms for disease onset and progression are required. However, the paucity of large patient cohorts and heterogeneity of practice hinder the defining of optimal management of EoE. Methods: EoE CONNECT is an ongoing, prospective registry study initiated in 2016 and currently managed by EUREOS, the European Consortium for Eosinophilic Diseases of the Gastrointestinal Tract. Patients are managed and treated by their responsible specialists independently. Data recorded using a web-based system include demographic and clinical variables; patient allergies; environmental, intrapartum, and early life exposures; and family background. Symptoms are structurally assessed at every visit; endoscopic features and histological findings are recorded for each examination. Prospective treatment data are registered sequentially, with new sequences created each time a different treatment (active principle, formulation, or dose) is administered to a patient. EoE CONNECT database is actively monitored to ensure the highest data accuracy and the highest scientific and ethical standards. Results: EoE CONNECT is currently being conducted at 39 centers in Europe and enrolls patients of all ages with EoE. In its aim to increase knowledge, to date EoE CONNECT has provided evidence on the effectiveness of first- and second-line therapies for EoE in clinical practice, the ability of proton pump inhibitors to induce disease remission, and factors associated with improved response. Drug effects to reverse fibrous remodeling and endoscopic features of fibrosis in EoE have also been assessed. Conclusion: This prospective registry study will provide important information on the epidemiological and clinical aspects of EoE and evidence as to the real-world and long-term effectiveness and safety of therapy. These data will potentially be a vital benchmark for planning future EoE health care services in Europe

HTLV-1 infection in solid organ transplant donors and recipients in Spain

HTLV-1 infection is a neglected disease, despite infecting 10-15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely considered in the transplantation setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ transplants in a survey conducted in Spain. All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients attended since the year 2008. A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312 (42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards represented nearly 80%. Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients. Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in dialysis but otherwise asymptomatic. The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along with the rapid development of subacute myelopathy

Consensus classification of posterior cortical atrophy

INTRODUCTION: A classification framework for posterior cortical atrophy (PCA) is proposed to improve the uniformity of definition of the syndrome in a variety of research settings. METHODS: Consensus statements about PCA were developed through a detailed literature review, the formation of an international multidisciplinary working party which convened on four occasions, and a Web-based quantitative survey regarding symptom frequency and the conceptualization of PCA. RESULTS: A three-level classification framework for PCA is described comprising both syndrome- and disease-level descriptions. Classification level 1 (PCA) defines the core clinical, cognitive, and neuroimaging features and exclusion criteria of the clinico-radiological syndrome. Classification level 2 (PCA-pure, PCA-plus) establishes whether, in addition to the core PCA syndrome, the core features of any other neurodegenerative syndromes are present. Classification level 3 (PCA attributable to AD [PCA-AD], Lewy body disease [PCA-LBD], corticobasal degeneration [PCA-CBD], prion disease [PCA-prion]) provides a more formal determination of the underlying cause of the PCA syndrome, based on available pathophysiological biomarker evidence. The issue of additional syndrome-level descriptors is discussed in relation to the challenges of defining stages of syndrome severity and characterizing phenotypic heterogeneity within the PCA spectrum. DISCUSSION: There was strong agreement regarding the definition of the core clinico-radiological syndrome, meaning that the current consensus statement should be regarded as a refinement, development, and extension of previous single-center PCA criteria rather than any wholesale alteration or redescription of the syndrome. The framework and terminology may facilitate the interpretation of research data across studies, be applicable across a broad range of research scenarios (e.g., behavioral interventions, pharmacological trials), and provide a foundation for future collaborative work

The Caldera. No. 25 Special Edition 2022. 70 years

Especial: Instituto Caldas, 70 años de historia En las siguientes páginas, los estudiantes rinden homenaje a nuestra querida Institución, a través, especialmente, de la Palabra. Mi eterna gratitud a cada uno de ellos, jóvenes lectores, escritores, dibujantes pero, sobre todo, Caldistas de CORAZÓN: Laura Camila Herrera, Victoria Chacón Gil, María Paula Méndez, Steven Gómez Guerrero, Constanza Narváez Solano, Yatana Zea Arenas, Carolina Valencia Neira, Valery Samara Meza, Steffy Picón Carrillo y Gabriela Portilla Castellanos.Especial 70 años. Instituto Caldas 6 Reloj Solar 2021 43 IX Concurso de Lectura en Voz Alta 46 La Cuna de Excélsior 48 Equipo de Maestros 51 Perfiles Caldistas 54 Expresiones Caldistas 58 Día Caldista 98 Galería de Imágenes 103Special: Instituto Caldas, 70 years of history In the following pages, the students pay homage to our beloved Institution, especially through the Word. My eternal gratitude to each of them, young readers, writers, cartoonists but, above all, Caldistas of HEART: Laura Camila Herrera, Victoria Chacón Gil, María Paula Méndez, Steven Gómez Guerrero, Constanza Narváez Solano, Yatana Zea Arenas, Carolina Valencia Neira, Valery Samara Meza, Steffy Picón Carrillo and Gabriela Portilla Castellanos

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