•Critical care nurses have had to perform tasks for which they have not received proper training.•Nurses have had to manage the fear of becoming infected and spreading it to their families.•Moral ...suffering and emotional exhaustion are major consequences of front-line care.•Heavy workloads, high patient-nurse ratios, and lack of rest are causing exhaustion among nurses.
The COVID-19 pandemic is a public health challenge that puts health systems in a highly vulnerable situation. Nurses in critical care units (CCUs) and hospital emergency services (HESs) have provided care to patients with COVID-19 under pressure and uncertainty.
To identify needs related to safety, organisation, decision-making, communication and psycho-socio-emotional needs perceived by critical care and emergency nurses in the region of Madrid, Spain, during the acute phase of the epidemic crisis.
This is a cross-sectional study (the first phase of a mixed methods study) with critical care and emergency nurses from 26 public hospitals in Madrid using an online questionnaire.
The response rate was 557, with 37.5% reporting working with the fear of becoming infected and its consequences, 28.2% reported elevated workloads, high patient-nurse ratios and shifts that did not allow them to disconnect or rest, while taking on more responsibilities when managing patients with COVID-19 (23.9%). They also reported deficiencies in communication with middle management (21.2%), inability to provide psycho-social care to patients and families and being emotionally exhausted (53.5%), with difficulty in venting emotions (44.9%).
Critical care and emegency nurses may be categorised as a vulnerable population. It is thus necessary to delve deeper into further aspects of their experiences of the pandemic.
Clean technologies are rapidly increasing in the last decade. In the transport sector, market share of global electric car sales has changed from 0.0 % in 2010 to 3.2 % (2.1million) in 2020, and ...predictions show that sales could reach near 30 % in 2030. This drastic change is mainly encouraged by environmental goals set to reduce greenhouse gas emissions (GHG) expressed in CO2-eq, not emitted by electric vehicles (EVs) during the use phase. However, clean technologies might cause other impacts during manufacture and, while clearly reduce the dependency on oil, can increase the dependency on other materials. In this context, the objectives of our work are quantifying the critical raw materials needed by permanents magnets and batteries of EVs (neodymium, lithium, and cobalt); their supply risk, performing a material flow analysis; and studying their environmental impacts using the methodology “Environmentally-Extended Multi-Regional Input-Output Analysis”. This methodology is used to quantify the produced impacts and the country where the impacts are being produced, in contrast to conventional methodologies that only calculate global impacts. Therefore, environmental impacts are estimated considering different scenarios, based on environmental objectives of the European Union and China. In most scenarios China shows a key role in mining and processing of metals, being the country where major impacts are produced. Obtained results are useful to assess which environmental proposals are more effective to reduce the environmental impact of EVs and set the ground to understand the geostrategic importance of key metals used for EVs manufacture.
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•Methodology EEMRIO allows studying where emissions are produced.•China manufactures 61 % of magnets and 79 % of batteries for EV produced globally.•Europe has 35 % of EVs global stock but only 1.2 % of global CO2-eq emissions produced.•Europe could reduce emissions 1.5 times by manufacturing batteries instead importing.
We describe a second primase in human cells, PrimPol, which has the ability to start DNA chains with deoxynucleotides unlike regular primases, which use exclusively ribonucleotides. Moreover, PrimPol ...is also a DNA polymerase tailored to bypass the most common oxidative lesions in DNA, such as abasic sites and 8-oxoguanine. Subcellular fractionation and immunodetection studies indicated that PrimPol is present in both nuclear and mitochondrial DNA compartments. PrimPol activity is detectable in mitochondrial lysates from human and mouse cells but is absent from mitochondria derived from PRIMPOL knockout mice. PRIMPOL gene silencing or ablation in human and mouse cells impaired mitochondrial DNA replication. On the basis of the synergy observed with replicative DNA polymerases Polγ and Polε, PrimPol is proposed to facilitate replication fork progression by acting as a translesion DNA polymerase or as a specific DNA primase reinitiating downstream of lesions that block synthesis during both mitochondrial and nuclear DNA replication.
Electric and hybrid vehicles are being promoted in European countries to significantly improve air quality in urban areas and reduce Greenhouse Gases emissions. This study evaluates and compares the ...potential environmental effects of electric, hybrid, petrol, and diesel cars in Spain using a cradle-to-grave Life Cycle Assessment approach. It aims to accomplish a precise analysis of a wide range of environmental impact categories. To this end, we provide a transparent inventory of components and vehicle manufacture, their distribution, use phase, and end-of-life, together with a detailed description of the Spanish 2014–2018 electricity generation mix. Furthermore, based on European projections, the work evaluates future energy scenarios, 2030 and 2050, to assess the impact of increasing renewable electricity in electric cars. In the current Spanish scenario and assuming a lifetime of 150,000 km, BEV life cycle CO2-eq emissions are 48% lower than petrol ICEV. Future scenarios of the Spanish electricity grid confirm that a massive introduction of renewable energies would lead to a 19.26% and 27.41% decrease of CO2-eq emissions in 2030 and 2050, respectively. Nevertheless, current and future energy scenario predictions show that electric vehicles will produce an increase in fine particulate matter formation (26%), human carcinogenic (20%) and non-carcinogenic toxicity (61%), terrestrial ecotoxicity (31%), freshwater ecotoxicity (39%), and marine ecotoxicity (41%) relative to petrol vehicles. Transfer of environmental burdens from the use phase to the raw materials extraction and manufacturing phases entails a delocalisation of the impacts, which constitutes a new challenge at environmental, social, and legal levels. This study is the first comparative analysis of the environmental impacts of passenger vehicles in Spain from a cradle-to-grave perspective, considering different impact categories and time scopes.
•Future scenarios for Spain enhance electric vehicle carbon footprint reduction.•Electric vehicles show the highest toxicity on ecosystems and human health.•Electric and hybrid vehicles transfer most of their impacts to the manufacture.•Future scenarios rise the geographical delocalisation of environmental impacts.•Data inventories are proposed for the current and future Spanish electricity mixes.
Obesity hypoventilation syndrome is commonly treated with continuous positive airway pressure or non-invasive ventilation during sleep. Non-invasive ventilation is more complex and costly than ...continuous positive airway pressure but might be advantageous because it provides ventilatory support. To date there have been no long-term trials comparing these treatment modalities. We therefore aimed to determine the long-term comparative effectiveness of both treatment modalities.
We did a multicentre, open-label, randomised controlled trial at 16 clinical sites in Spain. We included patients aged 15–80 years with untreated obesity hypoventilation syndrome and an apnoea-hypopnoea index of 30 or more events per h. We randomly assigned patients, using simple randomisation through an electronic database, to receive treatment with either non-invasive ventilation or continuous positive airway pressure. Both investigators and patients were aware of the treatment allocation. The research team was not involved in deciding hospital treatment, duration of treatment in the hospital, and adjustment of medications, as well as adjudicating cardiovascular events or cause of mortality. Treating clinicians from the routine care team were not aware of the treatment allocation. The primary outcome was the number of hospitalisation days per year. The analysis was done according to the intention-to-treat principle. This study is registered with ClinicalTrials.gov, number NCT01405976.
From May 4, 2009, to March 25, 2013, 100 patients were randomly assigned to the non-invasive ventilation group and 115 to the continuous positive airway pressure group, of which 97 patients in the non-invasive ventilation group and 107 in the continuous positive airway pressure group were included in the analysis. The median follow-up was 5·44 years (IQR 4·45–6·37) for all patients, 5·37 years (4·36–6·32) in the continuous positive airway pressure group, and 5·55 years (4·53–6·50) in the non-invasive ventilation group. The mean hospitalisation days per patient-year were 1·63 (SD 3·74) in the continuous positive airway pressure group and 1·44 (3·07) in the non-invasive ventilation group (adjusted rate ratio 0·78, 95% CI 0·34–1·77; p=0·561). Adverse events were similar between both groups.
In stable patients with obesity hypoventilation syndrome and severe obstructive sleep apnoea, non-invasive ventilation and continuous positive airway pressure have similar long-term effectiveness. Given that continuous positive airway pressure has lower complexity and cost, continuous positive airway pressure might be the preferred first-line positive airway pressure treatment modality until more studies become available.
Instituto de Salud Carlos III, Spanish Respiratory Foundation, and Air Liquide Spain.
An Amerindian genetic background could play an important role in susceptibility to metabolic diseases, which have alarmingly increased in recent decades. Mexico has one of the highest prevalences of ...metabolic disease worldwide. The purpose of this study was to determine the prevalence of metabolic syndrome and its components in a population with high Amerindian ancestry.
We performed a descriptive, quantitative, and analytical cross-sectional study of 2596 adult indigenous volunteers from 60 different ethnic groups. Metabolic syndrome and its components were evaluated using the American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement criteria.
The overall prevalence of metabolic syndrome in the indigenous Mexican population was 50.3%. Although females had a higher prevalence than males (55.6% vs. 38.2%), the males presented with combinations of metabolic syndrome components that confer a higher risk of cardiovascular disease. The most frequent metabolic syndrome component in both genders was low HDL-cholesterol levels (75.8%). Central obesity was the second most frequent component in females (61%), though it had a low prevalence in males (16.5%). The overall prevalence of elevated blood pressure was 42.7% and was higher in males than females (48.8 vs. 40%). We found no gender differences in the overall prevalence of elevated triglycerides (56.7%) or fasting glucose (27.9%).
We documented that individuals with Amerindian ancestry have a high prevalence of metabolic syndrome. Health policies are needed to control the development of metabolic disorders in a population with high genetic risk.
A simple strategy for the induction of extracellular hydroxyl radical (OH) production by white-rot fungi is presented. It involves the incubation of mycelium with quinones and Fe³⁺-EDTA. Succinctly, ...it is based on the establishment of a quinone redox cycle catalyzed by cell-bound dehydrogenase activities and the ligninolytic enzymes (laccase and peroxidases). The semiquinone intermediate produced by the ligninolytic enzymes drives OH production by a Fenton reaction (H₂O₂ + Fe²⁺ rightward arrow OH + OH⁻ + Fe³⁺). H₂O₂ production, Fe³⁺ reduction, and OH generation were initially demonstrated with two Pleurotus eryngii mycelia (one producing laccase and versatile peroxidase and the other producing just laccase) and four quinones, 1,4-benzoquinone (BQ), 2-methoxy-1,4-benzoquinone (MBQ), 2,6-dimethoxy-1,4-benzoquinone (DBQ), and 2-methyl-1,4-naphthoquinone (menadione MD). In all cases, OH radicals were linearly produced, with the highest rate obtained with MD, followed by DBQ, MBQ, and BQ. These rates correlated with both H₂O₂ levels and Fe³⁺ reduction rates observed with the four quinones. Between the two P. eryngii mycelia used, the best results were obtained with the one producing only laccase, showing higher OH production rates with added purified enzyme. The strategy was then validated in Bjerkandera adusta, Phanerochaete chrysosporium, Phlebia radiata, Pycnoporus cinnabarinus, and Trametes versicolor, also showing good correlation between OH production rates and the kinds and levels of the ligninolytic enzymes expressed by these fungi. We propose this strategy as a useful tool to study the effects of OH radicals on lignin and organopollutant degradation, as well as to improve the bioremediation potential of white-rot fungi.
The deposition and manipulation of human remains in natural caves are well known for the Neolithic of Southern Iberia. The cultural meaning of these practices is however still largely unclear. Cueva ...de los Marmoles (CM, Priego-Córdoba) is one of the most important cave contexts from Southern Spain, which returned a large number of commingled skeletal remains suggesting its funerary use from the Neolithic to the Late Bronze Age. Here we discuss CM from a chronological and cultural perspective based on new radiocarbon, anthropological, and taphonomic analyses. These include the estimation of the minimum number of individuals, the exploration of fragmentation patterns characterizing different skeletal regions, and the macroscopic and microscopic analysis of modifications to the remains of possible anthropic origin. Radiocarbon data point to a funerary use of CM between the 5
th
-2
nd
millennium cal. BCE. MNI estimates reveal the presence of at least 12 individuals (seven adults and five nonadults). The low representation of elements from hands and feet suggests that individuals were placed in the cave while partially decomposed. Anthropic traces on the remains (e.g. fresh fractures, marrow canal modifications, and scraping marks) hint at their intentional fragmentation, cleaning from residual soft tissues, and in some cases reutilization. These practices are well-exemplified by the recovery of one "skull cup" and of two long bones used as tools. These data align with those from other cave contexts from the same geographic region, suggesting the presence, especially during the Neolithic period, of shared ideologies centered on the human body.
The need to find sustainable alternatives to fossil fuels in aviation without requiring drastic structural changes in turbines and tanks has prompted a search for new components to blend with the ...standard Jet A1. Turpentine obtained by vacuum distillation of resin extracted from the common pine Pinus pinaster or as a byproduct of the paper industry is compared with hydrogenated turpentine at different levels of conversion as a component of jet blends. Properties such as density, kinematic viscosity, heating values, lubricity, flash point, pour point, crystallization onset temperature, and smoke point are reported. Turpentine shows high soot formation tendency. Hydrogenation was carried out as a method to saturate the double bonds of pinenes and to overcome this problem. The performance of four hydrogenated turpentines at different levels of turpentine–hydroturpentine conversion proves improvements in some key properties and especially reductions in the sooting tendency, concluding that partially hydrogenated turpentine can be blended up to 50% v/v with Jet A1, fulfilling the limit required by the standard specification for aviation turbine fuels containing synthesized hydrocarbons.
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