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Mediterranean high-mountain lakes are being increasingly affected by strong Saharan dust deposition events. However, the ecological impacts of these severe atmospheric episodes remain largely unknown. We examined the effects of a strong Saharan dust intrusion to the Iberian Peninsula in 2022 on the physicochemical parameters and prokaryotic communities in sediments of nine high-mountain lakes of Sierra Nevada (Spain) located above 2800 m.a.s.l and in different orientations (north vs. south). A previous year (2021), with lower Saharan dust deposition with respect to 2022, was used for interannual comparisons. The strong dust deposition to the high-mountain lakes resulted in a significant increase in sediment nutrient availability which was linked to changes in the composition of prokaryotic communities. Decreases in alpha diversity and changes in beta diversity of prokaryotic communities were mainly observed in lakes located in the south compared to the north orientation likely because the former was more affected by the atmospheric dust deposition episode. Dust intrusion to the high-mountain lakes resulted in significant changes in the relative abundance of specific genera involved in important nutrient cycling processes such as phosphate solubilization, nitrogen fixation, nitrification, and denitrification. Saharan dust deposition also increased predicted microbial functionality in all lakes. Our findings show that severe atmospheric dust inputs to remote high-mountain lakes of Sierra Nevada can have significant biogeochemical and biodiversity consequences through changes in nutrient availability and prokaryotic communities in sediments of these freshwater ecosystems. This information contributes to understanding how Mediterranean high-mountain lakes of Sierra Nevada face strong intrusions of Saharan dust and their ecological consequences.

The Caribbean faces many environmental issues, and the mitigation and adaptation strategies to address the challenges of global warming are not sufficient in this geographical region. Considering that agriculture is a relevant activity in most countries around this region, our study proposes to enhance Caribbean waste management by transitioning to a sustainable and resilient process in the framework of a green, circular economy. The research has been focused on the thermochemical transformation of the typical residues of Caribbean farm products (plantain rachis, and cassava peel). Biochar samples were synthesized from these biomasses by the slow pyrolysis method at different temperatures (300 °C, 400 °C, and 500 °C). Biochar samples with a smooth surface were synthesized from plantain rachis biomass, while biochar samples with a porous surface were obtained from cassava peel biomass. At the same pyrolysis temperature, all biochar samples derived from plantain rachis exhibited higher production biochar yields than those biochar samples derived from cassava peel. The yield percentages were determined to be 65.7% and 62.0% at a pyrolysis temperature of 300 °C; 45.6% and 37.5% at 400 °C; and 33.7% and 25.4% at 500 °C, respectively. XRD measurements revealed that both biomass-derived biochar samples were found to be enriched with several compounds, such as kalicinite, arcanite, sylvite, CaO3Si, and MgO3Si, which vary according to the pyrolysis temperature. FTIR analysis revealed the presence of carbonyl and carboxyl functional groups on the surface of all biochar samples. However, only the aliphatic functional groups were observed on the surface of the biochar samples derived from cassava peel. These characteristics are of particular relevance due to their potential application in soil amendment or water remediation.

Background Cesarean sections are the most common abdominal surgical interventions worldwide, with increasing rates in both developed and developing countries. Postpartum (hemorrhage PPH) during cesarean sections can lead to maternal morbidity, prolonged hospital stays, and increased mortality rates. Although various non-surgical measures have been recommended for PPH prevention, surgical techniques such as uterine artery ligation and embolization have been used to manage PPH effectively. Objective This study aimed to evaluate the effectiveness of a surgical technique based on the temporary bilateral clamping of uterine arteries to reduce blood loss during cesarean sections. Methods A longitudinal prospective, randomized, controlled study was conducted with a preliminary population group of 180 patients at the University Hospital Regional de Málaga from November 2023 to January 2024. The study protocol was approved by the Ethics Committee of the Regional University Hospital of Malaga (protocol 1729-N-23 and registred with ISRCTN15307819|| http://www.isrctn.org/ , Date submitted 12 June 2023 ISRCTN 15307819). The patients were divided into two groups based on whether the clamping technique was applied during their cesarean sections. The study assessed hemoglobin levels before and after surgery, hospitalization durations, and the prevalence of anemia at discharge as the primary outcomes. Results The patients who underwent the clamping technique demonstrated significant reductions in hemoglobin differences (0.80 g/dL) compared to the control group (1.42 g/dL). The technique also resulted in shorter hospital stays (3.02 days vs. 3.90 days) and a lower prevalence of anemia at discharge (76.2% vs. 60%). Conclusion Temporary clamping of uterine arteries during cesarean sections appears to be an effective measure for preventing postpartum hemorrhaging, reducing hospital stays, and decreasing the prevalence of anemia at discharge. Further research with larger sample sizes and standardized indications is warranted to confirm the benefits and potential broader applications of this technique. Trial registration ISRCTN 15,307,819.

Dengue and leptospirosis are prevalent diseases in tropical and subtropical regions, posing significant public health challenges. These illnesses exhibit overlapping symptoms, including fever, muscle pain, and headaches, which complicates diagnosis and delays appropriate treatment. This study explores the use of attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR) combined with multivariate analysis to distinguish between the two infections by analyzing blood plasma in both liquid and dry states. A total of 114 patient samples at varying infection stages ( n  = 43 for leptospirosis and n  = 71 for dengue) were examined using linear discriminant analysis (LDA), quadratic discriminant analysis (QDA), and support vector machine (SVM) in conjunction with genetic algorithms (GA), successive projection algorithms (SPA), and principal component analysis (PCA) for feature selection and extraction. The SPA-QDA model applied to dried plasma delivered exceptional results, achieving 100% sensitivity, specificity, and accuracy in distinguishing the two diseases using only 30 spectral variables. ANOVA calculations, conducted with a 95% confidence level, identified four key wavenumbers (1601 cm −1 , 1735 cm −1 , 1747 cm −1 , and 1870 cm −1 ) as critical for class differentiation.

Patients with severe mental disorder have health and social needs that require care. The aim of the study was to determine the main areas of perceived needs among inpatients with severe mental disorders and to identify risk factors of the group of patients with the greatest unmet needs. A total of 150 patients with severe mental illness were assessed during admission prior to discharge from the hospital. Camberwell Assessment of Needs was used as evaluation measure, in addition to clinical status (The Brief Psychiatric Rating Scale), social functioning (Personal and Social Performance) and sociodemographic variables. A descriptive and a multivariate logistic regression analysis were used to analyse variables related to the group of patients with the highest number of unmet needs (≥3). Mean number of needs was 7.93, being 4.61 the mean number of needs met and 3.32 the needs unmet. The highest proportion of unmet needs were intimate relationships (44.0%), company (40.7%) and daytime activities (38.7%). A relationship was also found between the presence of three or more unmet needs and the following variables: Brief Psychiatric Rating Scale score (p=0.004), Personal and Social Performance score (p = 0.013), marital status (p=0.018), employment status (p=0.009) and voluntary admission (p=0.032). The multivariate model explained 29.5% of the variance (Nagelkerke's R : 0.295). Treatments aimed at improving social relationships and daytime activities could be a good option for inpatients with many unmet needs.

Background: While criteria for the diagnosis of nosocomial pneumonias exist, objective definitions are a challenge and there is no gold standard for diagnosis. We analyzed the impact of the implementation of a logical, consensus-based diagnostic and treatment protocol for managing nosocomial pneumonias in the cardiovascular surgery intensive care unit (CVS-ICU). Methods: We conducted a quasi-experimental, interrupted time series analysis to evaluate the impact of a diagnostic and treatment protocol for nosocomial pneumonias in the CVS-ICU. Impacts were measured relative to patient outcomes, diagnostic processes, and antimicrobial stewardship improvement. Descriptive statistics were used to analyze results. Results: Overall, 35 pre-protocol and 39 post-protocol patients were included. Primary clinical variables suggesting pneumonia in pre- and post-protocol patients were new lung consolidation (50% vs. 71%), new leukocytosis (59% vs. 64%), and positive culture (32% vs. 55%). Appropriate diagnostic testing improved (23% vs. 54%, p = 0.008) after protocol implementation. The proportion of patients meeting the criteria for nosocomial pneumonia (77% vs. 87%) was not statistically significant, though more patients in the post-protocol group met probable diagnostic criteria (51% vs. 77%). Duration of therapy was not significantly different (6 days [IQR = 5.0, 10.0] vs. 7 days [IQR = 6.0, 9.0]). Conclusions: The implementation of a diagnostic and treatment protocol for management of nosocomial pneumonias in the CVS-ICU resulted in improved diagnostic accuracy, advanced antimicrobial and diagnostic stewardship efforts, and laboratory cost savings without an adverse impact on patient-centered outcomes.

Vaccination of pregnant women (PW) is an essential public health measure with benefits for both mothers and newborns. Vaccination against seasonal influenza and pertussis have been recommended in Spain for almost a decade; however, the adherence to this recommendation is variable. The objective of this study was to assess pertussis vaccination coverage (PVC) and influenza vaccination coverage (IVC) among PW in the region of Madrid, Spain, and to explore the factors associated with vaccination. We conducted a retrospective cohort study using administrative registries. For PVC 197,984 PW who gave birth between 2019 and 2022 were included in the study. For IVC, 182,014 PW target of the 2018–19 to 2022–23 seasonal influenza campaigns were included. Generalized estimating equations were used to estimate factors associated with vaccination. The global VC in PW was 87.0 % for pertussis and 53.2 % for influenza. A peak was observed coinciding with the start of COVID-19 vaccination. Factors associated with lower probability of being vaccinated were mother born in a foreign country (Pertussis: aOR:0.73 (95 %CI:0.71–0.76); Influenza: aOR:0.71 (95 %CI:0.69–0.73)), enrolment in public healthcare insurance in last stages or after delivery (Pertussis: aOR:0.04 (95 %CI:0.04–0.05); Influenza: aOR:0.09 (95 %CI:0.08–0.11)) and home births (Pertussis: aOR:0.11 (95 %CI:0.08–0.16); Influenza: aOR:0.22 (95 %CI:0.15–0.31)). PW aged between 30 and 39 years old, with full term pregnancies, who live in areas with middle net incomes and have at least one chronic condition with indication for vaccination were more likely to be vaccinated. Significant challenges remain to improve vaccination uptake in PW, particularly concerning influenza. These findings may prove useful to tailor strategies to reach specific subgroups within the PW population. •Vaccination in pregnancy reduces disease burden in women and their infants.•In Madrid, Spain, vaccine coverage is lower for influenza than for whooping cough.•Vaccination uptake has decreased since COVID-19 pandemic.•Foreign, lower-income and adolescent women are less likely to get vaccinated.•Potential inequalities in maternal immunization coverage should be addressed.

  La motivación como un elemento propio de cada deportista es generadora de respuestas positivas en la práctica deportiva, por tanto, la evaluación de esta en los deportistas adaptados contribuye a generar propuestas que consideren las expectativas de los mismos. Objetivo: Identificar los motivos de la práctica deportiva en jugadores de tenis en silla de ruedas y goalball. Método: Quince deportistas: 5 de tenis en silla de ruedas y 10 de goalball, pertenecientes a diferentes clubes regionales, respondieron el Cuestionario “Participation Motivation Inventory”. Resultados: El 100% de los jugadores en tenis en silla de ruedas valoraron muy importante los ítems: “Me gusta ganar”, “Quiero estar en forma”, “Me gusta hacer ejercicio”, “Me gusta la acción”, “Me gusta la competición”, “Me gusta practicar deporte”, “Quiero estar físicamente bien”, y “Quiero alcanzar un status – elite”; mientras que en goalball fueron los ítems: “Quiero mejorar mis habilidades”, “Quiero aprender nuevas habilidades”, “Me gusta la competición”, “Me gusta practicar deporte”, “Quiero mejorar mi nivel”, “Quiero estar físicamente bien” y “Me gusta divertirme”. En ambas poblaciones los ítems: “Es por satisfacer a mis padres o amigos” y “Por influencia de los entrenadores o instructores” fueron valorados como nada importante por el 40% de los deportistas. Conclusiones: Los motivos más valorados por los jugadores de tenis en silla de ruedas y los jugadores de goalball están relacionados con el factor de superación y el factor personal respectivamente, mientras que el factor socio-deportivo es el menos importante en su motivación para la práctica deportiva.  Abstract. Motivation as an element of each athlete generates positive responses in practice, therefore, its evaluation in adapted athletes contributes to generating proposals that consider their sporting expectations. Aims: To identify the motives for sports practice in wheelchair tennis and goalball players. Method: Fifteen athletes: 5 for wheelchair tennis and 10 for goalball, belonging to different clubs in the region, answered the Questionnaire “Participation Motivation Inventory”. Results: 100% of wheelchair tennis players rated the items as very important: \"I like to win\", \"I want to be fit\", \"I like to exercise\", \"I like action\", \"I like the competition \",\" I like to practice sports \",\" I want to be physically well \", and\" I want to achieve elite status \"; while in goalball there were the items: \"I want to improve my skills\", \"I want to learn new skills\", \"I like competition\", \"I like to practice sports\", \"I want to improve my level\", \"I want to be physically well\" and \"I like to have fun\". In both populations the items: \"It is to satisfy my parents or friends\" and \"Due to the influence of the coaches or instructors\" were valued as not important by 40% of the athletes. Conclusions: The motives most valued by wheelchair tennis players and goalball players are related to the overcoming factor and the personal factor respectively, while the socio-sports factor is the least important in their motivation for sports practice.

Colombia is a fish exporter and consumer country because of its geographical location. Since 2012, imported fish have become a more economical option than domestic species due to free trade agreements. Concentrations of Pb, Cd, and Zn were evaluated in three imported and highly commercialized fish species in a city on the Caribbean coast of Colombia: Prochilodus lineatus , Prochilodus reticulatus , and Pangasianodon hypophthalmus , plus one brand of canned tuna and one brand of sardines. The canned species showed the highest values for Pb, Cd, and Zn; canned tuna (oil-packed) contained 0.189 ± 0.047 mg/kg Pb and 238.93 ± 76.43 mg/kg Zn, while canned sardines contained 0.111 ± 0.099 mg/kg Cd, suggesting a relationship between the canning process and the metal concentrations. The estimated daily intake (EDI) and hazard quotient (HQ) suggested that there is no risk for consumer health in the short term, but the presence of these heavy metals certainly should be a concern in the long term because of the bioaccumulation phenomenon due to the high intake of these fish species in this coastal and tourist community. It is recommended that continuous monitoring of heavy metal concentrations take place to protect communities in a local and global context.

Improper de facto unions represent a complex legal concept that arises when one or both members of a de facto couple maintain a previous, undissolved marital bond, preventing legal recognition of their current relationship. This article analyzes the various scenarios in which this institution manifests itself, from the perspective of impediment to a bond, examining the solutions adopted in different legal systems and the challenges posed by the protection of the rights of the individuals involved, especially those acting in good faith. This study adopts a qualitative approach to legal research, using the comparative method to analyze the different normative and jurisprudential approaches to the problem of improper de facto unions. Documentary analysis of primary sources (legislation, jurisprudence) and secondary sources (specialized doctrine) from several Latin American countries is employed. The research is structured around the analysis of paradigmatic cases identified in Mexican, Brazilian, and Peruvian jurisprudence, contrasting them with the Ecuadorian regime, where these unions lack legal protection. The hermeneutic method is used to interpret normative texts, and critical analysis is used to evaluate the solutions proposed in each legal system. Three main scenarios are identified: the persistence of marriages with community of life (parallel families), the persistence of marriages without community of life, and cases where a previously recognized de facto union exists. The study reveals the need to develop more flexible regulatory frameworks that recognize contemporary social reality and protect the fundamental rights of people in vulnerable situations, considering criteria of good faith and equity.