Fault slip rate is one of the most crucial parameters to characterize earthquake occurrence in fault‐based seismic hazard assessments (SHA). Accordingly, paleoseismic studies have increasingly ...focused on constraining this parameter in active faults worldwide. We present a comprehensive paleoseismic study in the Alhama de Murcia Fault (AMF), one of the most active faults in SE Spain and source of destructing earthquakes such as the 2011 Mw 5.2 Lorca event. Contrasting with previous studies, we integrate paleoseismic data from four fault strands in the AMF and, based on trench slip analysis and numerical dates, we derive slip rate estimates of each strand over the whole transect and assess their time variability. The AMF has a minimum net slip rate between 1.35+0.16/−0.10 and 1.64+0.16/−0.11 mm/yr for the past 18 ± 1 to 15.2 ± 1.1 ka. These results prove the importance of accounting for the complete sections of a geological structure as they are almost twice the previous estimates for a single fault branch. Slip rate variability is identified in the AMF, with cyclic acceleration‐quiescence patterns that could be related to stress field changes driven by fault interaction or synchronicity with neighboring faults (e.g., Carrascoy). We hope that the data presented here motivates their inclusion into forthcoming fault‐based SHAs. In this regard, limitations related to the lack of paleoseismic data for one fault strand, along with poor characterization of the strike component of slip and insufficient age control of the units for another strand are highlighted and need to be accounted for by modelers.
Key Points
Multi‐site paleoseismic surveys allow to improve the estimations of the geological slip rates in the Alhama de Murcia Fault (AMF)
The AMF shows a geological slip rate between 1.35 and 1.64 mm/yr for the past 18–15 ka
Late Quaternary slip rate fluctuations suggest strain rate variations and highlight possible synchronicities with neighboring faults
We propose a novel technique for beat-to-beat heart rate detection based on the ballistocardiographic (BCG) force signal from a subject standing on a common electronic weighing scale. The detection ...relies on sensing force variations related to the blood acceleration in the aorta, works even if wearing footwear and does not require any sensors attached to the body because it uses the load cells in the scale. We have devised an approach to estimate the sensitivity and frequency response of three commercial weighing scales to assess their capability to detect the BCG force signal. Static sensitivities ranged from 490 nV V(-1) N(-1) to 1670 nV V(-1) N(-1). The frequency response depended on the subject's mass but it was broad enough for heart rate estimation. We have designed an electronic pulse detection system based on off-the-shelf integrated circuits to sense heart-beat-related force variations of about 0.24 N. The signal-to-noise ratio of the main peaks of the force signal detected was higher than 30 dB. A Bland-Altman plot was used to compare the RR time intervals estimated from the ECG and BCG force signals for 17 volunteers. The error was +/-21 ms, which makes the proposed technique suitable for short-term monitoring of the heart rate.
Most of the licit and illicit drugs consumed by the breastfeeding woman pass into the milk and can modify the production, volume and composition of the milk, as well as hypothetically have short- and ...long-term harmful effects on the infant. There is much confusion in the scientific community regarding this issue: should a woman breastfeed her baby while continuing to use prescription drugs and/or drugs of abuse? There are many case reports of clinically significant toxicity in breast-fed infants from some substances used by mothers (such as irritability, vomiting, sedation, respiratory depression, shock), but there are too few data on studies conducted in breastfeeding women and their infants to make a realistic risk assessment. The objective measurement of a drug and/or metabolites in maternal milk is the first step when investigating the amount of drug exctreted in milk and subsequently calculating the daily dose administered to the breast-fed infant. The present review reports the analytical methods developed to detect different drugs in the breast milk, listing the principal characteristics and validation parameters, advantages and disadvantges. Furthermore, the mechanisms of drug transfer into breast milk are discussed, the correlation between the concentration of the drug in breast milk and potential adverse outcomes on the infant are described for each drug, and suggested harm minimization strategies and approved breastfeeding recommendations are indicated. graphic removed
Objective: To describe policies towards family visiting in Neonatal Intensive Care Units (NICU) and compare findings with those of a survey carried out 10 years earlier.
Methods: A questionnaire on ...early developmental care practices was mailed to 362 units in eight European countries (Sweden, Denmark, the UK, the Netherlands, Belgium, France, Spain and Italy). Of them 78% responded, and among those responded, 175 reported caring for at least 50 very low birth weight infants every year and their responses were analysed further.
Results: A majority of all units allowed access at any time for both parents. This was almost universal in northern Europe and the UK, whereas it was the policy of less than one‐third of NICU in Spain and Italy, with France in an intermediate position. Restrictions on visiting of grandparents, siblings and friends, as well as restricting parents’ presence during medical rounds and procedures followed the same pattern. A composite visiting score was computed using all the variables related to family visiting. Lower median values and larger variability were obtained for the southern countries, indicating more restrictive attitudes and lack of national policy.
Conclusions: The presence of parents and other family members in European NICUs has improved over a 10‐year period. Several barriers, however, are still in place, particularly in the South European countries.
Donor milk is the best alternative for the feeding of preterm newborns when mother's own milk is unavailable. For safety reasons, it is usually pasteurized by the Holder method (62.5°C for 30 min). ...Holder pasteurization results in a microbiological safe product but impairs the activity of many biologically active compounds such as immunoglobulins, enzymes, cytokines, growth factors, hormones or oxidative stress markers. High-temperature short-time (HTST) pasteurization has been proposed as an alternative for a better preservation of some of the biological components of human milk although, at present, there is no equipment available to perform this treatment under the current conditions of a human milk bank. In this work, the specific needs of a human milk bank setting were considered to design an HTST equipment for the continuous and adaptable (time-temperature combination) processing of donor milk. Microbiological quality, activity of indicator enzymes and indices for thermal damage of milk were evaluated before and after HTST treatment of 14 batches of donor milk using different temperature and time combinations and compared to the results obtained after Holder pasteurization. The HTST system has accurate and simple operation, allows the pasteurization of variable amounts of donor milk and reduces processing time and labor force. HTST processing at 72°C for, at least, 10 s efficiently destroyed all vegetative forms of microorganisms present initially in raw donor milk although sporulated
sp. survived this treatment. Alkaline phosphatase was completely destroyed after HTST processing at 72 and 75°C, but γ-glutamil transpeptidase showed higher thermoresistance. Furosine concentrations in HTST-treated donor milk were lower than after Holder pasteurization and lactulose content for HTST-treated donor milk was below the detection limit of analytical method (10 mg/L). In conclusion, processing of donor milk at 72°C for at least 10 s in this HTST system allows to achieve the microbiological safety objectives established in the milk bank while having a lower impact regarding the heat damage of the milk.
Preterm infants are particularly vulnerable to developing iodine deficiency. Donor human milk (DHM) is the preferred feeding option if the mother’s own milk (MOM) is not available, but information on ...DHM iodine concentration (DHMIC) is lacking. Hence, we aimed to assess DHMIC to further evaluate the adequacy of iodine provision in preterm infants. Finally, associations that might influence DHMIC were studied. In 113 donors, we measured iodine intake by evaluating dietary records for five consecutive days with the DIAL® Software. From the second day of dietary record, donors provided human milk samples (at least one per day) for four consecutive days. Daily human milk samples were analyzed for DHMIC. A DHMIC ≥ 200 µg/L was considered an adequate iodine content for preterm infants. DHMIC and urine iodine concentration (UIC) were determined using ICP-MS. In our study, 83.2% of donors had a full-term infant. Breastfeeding time range was 1.5−49.4 months. During the dietary record, 55.8% took iodine-containing supplements, providing 40−200 µg/day of iodine. The medians (p25, p75) UIC and DHMIC were 112.4 (75.8, 160.1) and 148.5 (97.6, 206.1) µg/L, respectively. In this iodine-sufficient population, 70% had a DHMIC of <200 µg/L. Donors’ intake of iodine-containing supplements was associated with higher DHMIC.
Women of childbearing age in Western societies are increasingly adopting vegetarian diets. These women are sometimes rejected as milk donors, but little about the composition of their milk is known. ...The present study aimed to compare the intake, nutritional status, and nutritional composition of human milk from omnivore human milk donors (Donors) and vegetarian/vegan lactating mothers (Veg). Milk, blood, and urine samples from 92 Donors and 20 Veg were used to determine their fatty acid profiles, as well as vitamins and minerals. In a representative sample of both groups, we also determined the lipid class profile as a distribution of neutral and polar lipids, the molecular species of triacylglycerols, and the relative composition of phospholipids in their milk. A dietary assessment was conducted with a five-day dietary record (while considering the intake of supplements). We highlight the following results, expressed as the mean (SE), for the Veg vs. Donors: (1) Their docosahexaenoic acid (DHA) intake was 0.11 (0.03) vs. 0.38 (0.03) g/day; the plasma DHA was 0.37 (0.07) vs. 0.83 (0.06)%; and the milk DHA was 0.15 (0.04) vs. 0.33 (0.02)%. (2) Their milk B12 levels were 545.69 (20.49) vs. 482.89 (4.11) pM; 85% of the Veg reported taking B12 supplements (mean dose: 312.1 mcg/day); and the Veg group showed no differences with Donors in terms of total daily intake or plasma B12. (3) Their milk phosphatidylcholine levels were 26.88 (0.67) vs. 30.55 (1.10)%. (4) Their milk iodine levels were 126.42 (13.37) vs. 159.22 (5.13) mcg/L. In conclusion, the Vegs' milk was shown to be different from the Donors' milk, mainly due to its low DHA content, which is concerning. However, raising awareness and ensuring proper supplementation could bridge this gap, as has already been achieved for cobalamin.
The influence of the diet and nutritional status of milk donors on the nutritional composition of donor human milk (DHM) is unknown. The present study aimed to determine the nutritional profile of ...DHM and the associations between donors' dietary intake and nutritional status and the micronutrient and lipid composition in DHM. For this purpose, 113 donors completed a food frequency questionnaire, provided a five-day weighed dietary record, and collected milk for five consecutive days. Nutrient determinations in donors' erythrocytes, plasma, urine, and milk were performed. Multiple linear regressions were conducted for the evaluation of the associations. We highlight the following results: DHM docosahexaenoic acid (DHA) was positively associated with donors' plasma DHA content and donors' DHA intake (R
0.45,
< 0.001). For every 1 g/day DHA intake, an increase of 0.38% in DHA content and 0.78% in total omega-3 content was observed in DHM (R
0.29,
< 0.001). DHM saturated fatty acids were positively associated with erythrocyte dimethyl acetals, plasma stearic acid,
fatty acids intake, and breastfeeding duration and negatively associated with erythrocyte margaroleic acid (R
0.34,
< 0.01). DHM cholecalciferol was associated with plasma cholecalciferol levels and dairy intake (R
0.57,
< 0.01). Other weaker associations were found for free thiamin, free riboflavin, pyridoxal, dehydroascorbic acid, and the lipid profile in DHM. In conclusion, the diet and nutritional status of donors influence the fatty acid profile and micronutrient content of DHM.
To compare the frequency of electronic prescription errors when the prescription was validated by the clinical pharmacist vs. when it was not.
This prospective randomised controlled study was ...conducted in three phases. A randomised phase, in which patients were divided into control and intervention groups, and a pre- and post-intervention phase were consecutively performed to analyse the impact of pharmaceutical validation of prescriptions in a neonatal intensive care unit (NICU). This study was performed at a highly complex NICU at a tertiary hospital. All patients born during the study period who were admitted to the NICU, with a stay lasting ≥24 h, and received active pharmacological treatment were included in the study. Pharmaceutical validation was performed according to the paediatric pharmaceutical care model. A high level of validation was selected for this study. In the intervention group, discrepancies found during the review process were communicated to the medical team responsible for the patients and resolved on the same day.
In total, 240 patients were included in this study. Sixty-two patients were allocated to the pre-intervention (
= 38) or post-intervention (
= 24) groups, and 178 patients were randomly sorted into two groups, control (
= 82 newborns) and intervention (
= 96 newborns). During the randomisation phase, the number of prescription errors detected was significantly lower in the intervention group than that in the control group (129 vs. 270;
< 0.001). Similarly, prescription errors reaching the patient were significantly reduced from 40% (
= 108) in the control group to 1.6% (
= 2) in the intervention group. In the pre- and post-intervention periods, the prescription lines containing prescription errors decreased from 3.4% to 1.5% (
= 0.005).
This study showed that the pharmaceutical validation process decreased both the number of errors in the electronic prescribing tools and the number of prescription errors reaching the patient.
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