This research has allowed to provide new information about the geochemical groundwater composition in the Central Pacific of Costa Rica, a place with an important commercial, touristic, and real ...estate development with a continues water resource demand. Previous reports of iron and manganese elevated concentrations, and flow water rate decrease in production wells, turn the area into an object of hydrogeological studies as the resource demand increases. The main objective of this research was to provide information about the quality and composition of the groundwater, and to understand the relationship with the geological and structural context. A total of 25 groundwater samples were collected, subsequently hierarchical clustering method were applied to analyze chemical concentrations and characterized the groundwater. Results showed some samples with atypical trace elements concentrations such as Al, Mn, and Fe, which are above the water quality limits. After applied the hierarchical clustering, results evidence the presence of two main clusters, which one cluster have samples with high temperatures and mineralized waters in common. The groups are distributed between three major neotectonics faults Barranca, Jesús María, and Tárcoles that creates a complex structural context that provides pathways movement for the contribution of thermal waters which can strongly dissolve the rocks, and provide a certain water chemical composition related with the presence of volcanic rocks with high concentrations of K, Mg, Mo, P, Rb, Si, Fe, Mn, F and U, and sedimentary rocks with high concentrations of B, Ba, Ca, Cu, Fe, Ge, Li, Na, S, SO4 and Zn.
•Hierarchical clustering evidenced the presence of two clusters which groundwater composition are correlated with the lithological units.•High temperature values in groundwater evidenced the presence of a structural graben.•High concentrations of Al, Fe and Mn in groundwater are related to the dissolution of hydrothermalized volcanic rocks.•High groundwater temperatures may indicate the presence of blind faults.
Accurate solar radiation forecasting is essential to operate power systems safely under high shares of photovoltaic generation. This paper compares the performance of several machine learning ...algorithms for solar radiation forecasting using endogenous and exogenous inputs and proposes an ensemble feature selection method to choose not only the most related input parameters but also their past observations values. The machine learning algorithms used are: Support Vector Regression (SVR), Extreme Gradient Boosting (XGBT), Categorical Boosting (CatBoost) and Voting-Average (VOA), which integrates SVR, XGBT and CatBoost. The proposed ensemble feature selection is based on Pearson coefficient, random forest, mutual information and relief. Prediction accuracy is evaluated based on several metrics using a real database from Salvador, Brazil. Different prediction time-horizons are considered: 1 h, 2 h and 3 h ahead. Numerical results demonstrate that the proposed ensemble feature selection approach improves forecasting accuracy and that VOA performs better than the other algorithms in all prediction time horizons.
Background
Smoking at the time of surgery is associated with postoperative complications. Quitting smoking before surgery is linked to fewer complications during the hospital stay. This work analysed ...whether a smoking cessation intervention before surgery is economically worthwhile when funded by the National Health System (NHS) in Spain.
Methods
The economic analysis considered costs and benefits of the intervention to the NHS for the year 2016. The population who would benefit comprised adult smokers who were ready to quit and for whom surgery requiring admission to hospital was planned. The intervention, a combination of medical counselling and use of a smoking cessation drug which should occur 12 weeks before surgery, considered one attempt only to quit smoking. Benefits were costs avoided by averting postoperative complications if cessation was successful. The analysis compared the net economic outcome (benefit minus cost of intervention) and the return on investment, for intervention funded by the NHS versus the current situation without funding.
Results
Smoking cessation increased by 21·7 per cent with funding; the rate was 32·5 per cent when funded versus 10·7 per cent without funding, producing 9611 extra quitters. The cost per averted smoker was €1753 with a benefit of €503, achieving a net economic benefit of €4·8 million per year. Given the annual cost of the intervention (€17·4 million, of which €5·6 million (32·5 per cent) represents drugs), the return on investment was 28·7 per cent annually, equivalent to €1·29 per €1 of investment.
Conclusion
From the perspective of the Spanish NHS, the benefit of funding smoking cessation before surgery, in terms of healthcare cost savings, appears to greatly outweigh the costs.
Antecedentes
Ser fumador activo hasta el momento de la cirugía se asocia con complicaciones postoperatorias. Se ha descrito una disminución de las complicaciones durante la hospitalización al abandonar el hábito de fumar antes de la cirugía. Este trabajo analizó si una intervención preoperatoria para dejar de fumar es económicamente beneficiosa cuando se financia por el Sistema Nacional de Salud (SNS) en España.
Métodos
En el análisis económico se consideraron tantos los costes como los beneficios de la intervención para el SNS, en euros, correspondientes al año 2016. La población que se beneficiaría eran fumadores adultos dispuestos a dejar de fumar, en los que se programase una intervención quirúrgica con hospitalización. La intervención, una combinación de asesoramiento médico y tratamiento farmacológico para dejar de fumar, se llevó a cabo a las 12 semanas antes de la cirugía, considerando únicamente un intento para dejar de fumar. Los beneficios fueron los costes evitados por una reducción en la tasa de complicaciones postoperatorias en los casos en los que se hubiese conseguido la eliminación del hábito. El análisis comparó el resultado económico neto (beneficio menos coste de la intervención) y el retorno de la inversión (return on investment, ROI), cuando la intervención era financiada por el SNS en comparación con la situación actual sin financiamiento público.
Resultados
La tasa de abandono del hábito tabáquico aumentó en un 21,8%; 32,5% cuando se financiaba frente al 10,7% sin financiación, consiguiendo un extra de 9.611 personas que dejaron de fumar. El coste por fumador rescatado fue de €1753 con un beneficio de €503, por lo que el beneficio económico neto conseguido fue de €4,8 millones por año. Dado que el coste anual de la intervención (€17,4 millones, de los cuales €5,6 millones corresponden a fármacos (32%)), el ROI anual fue del 28,7% con un beneficio de €1,29 por cada €1 de inversión.
Conclusión
Desde la perspectiva del SNS español, los beneficios de financiar el abandono del hábito de fumar en el preoperatorio de los pacientes, en términos de ahorro de costes parecen ser muy superiores a los costes de la intervención.
Smoking at the time of surgery is associated with postoperative complications. Quitting smoking before surgery is linked to fewer complications during the hospital stay. This work analysed whether a smoking cessation intervention before surgery is worthwhile economically when funded by the National Health System in Spain. The benefit of funding smoking cessation before surgery, in terms of healthcare cost savings, greatly outweighed the costs, with a substantial return on investment.
Benefits from funding smoking cessation
Vascular endothelial growth factor (VEGF) inhibits differentiation and maturation of dendritic cells (DC), suggesting a potential immunosuppressive role for this proangiogenic factor. Bevacizumab, ...sorafenib and sunitinib target VEGF-mediated angiogenesis and are active against several types of cancer, but their effects on the immune system are poorly understood. In this study, VEGF and supernatants of renal carcinoma cell lines cultured under hypoxia were found to alter the differentiation of human monocytes to DC. Resulting DC showed impaired activity, as assessed by the alloreactive mixed T-lymphocyte reaction. Bevacizumab and sorafenib, but not sunitinib, reversed the inhibitory effects of VEGF, but not of those mediated by tumour supernatants. Dendritic cells matured under the influence of VEGF expressed less human leukocyte antigen-DR (HLA-DR) and CD86, and this effect was restored by bevacizumab and sorafenib. Finally, tumour-cell supernatants decreased interleukin-12 (IL-12) production by mature DC, and such inhibition was not restored by any of the tested drugs, delivered either as single agents or in combination. The deleterious effects of tumour-cell supernatants were mainly mediated by thermostable molecules distinct from VEGF. These results indicate that inhibition of the differentiation of monocytes to DC is a multifactorial effect, and that they support the development of combinations of angiogenesis inhibitors with immunological modulators.
Gastrointestinal symptoms are common in Coronavirus Disease 2019 (COVID-19), related to infection of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) of intestinal cells through the ...angiotensin converting enzyme 2 (ACE2) receptor in the brush border. Also, patients are treated with multiple antibiotics. Therefore, an increase in gut dysbiosis and in the prevalence of Clostridium difficile infection (CDI) is expected in patients with COVID-19.
A PubMed search was conducted using the terms "gut microbiota," "gut mycobiota," "dysbiosis" AND "COVID-19"; "Clostridium difficile," "Clostridioides difficile" AND "COVID-19"; "probiotics," "bacteriotherapy AND COVID-19." Only case series, observational and experimental studies were included.
A total of 384 papers were retrieved and 21 fulfilled selection criteria. Later, a new paper was identified, thus 22 papers were reviewed. Main findings: (1) gut bacterial dysbiosis has been found in fecal samples of COVID-19 patients, with enrichment of opportunistic organisms and decrease of beneficial commensals such as Faecalibacterium prausnitizii. Dysbiosis is related to inflammatory markers and illness severity. (2) There is evidence for abnormal gut barrier and bacterial translocation with a negative impact in the lungs. (3) Fungal dysbiosis correlating with pulmonary mycobiota, has also been found. (4) There is controversy in the CDI rates among COVID-19 patients versus controls and pandemic versus prepandemic era. (5) There is no available evidence yet to support bacteriotherapy in COVID-19. (6) Fecal microbiota transplantation (FMT) has been proposed for COVID-19, although there is no evidence to support it. Also, FMT can be safely used during the pandemic for CDI if strict screening protocols for donors and fecal product are implemented.
In COVID-19 there is bacterial and fungal dysbiosis that correlates with systemic and pulmonary inflammation, and illness severity. Further investigations are warranted to determine the efficacy of bacteriotherapy and FMT for modulating gut dysbiosis in COVID-19.
Purpose
The prevalence of childhood obesity continues to increase worldwide. The aims of this study were to (1) assess the psychological well-being and rates of teasing of Spanish children with ...obesity (OG) and compare them with their non-overweight peers (NG), and (2) analyze the mediating role of weight-related teasing on the relation between children’s BMI
z
score and psychological well-being.
Methods
The cross-sectional study included 50 preadolescents with obesity, matched with non-overweight children according to age, sex, and socioeconomic status, who were assessed via self-report instruments measuring anxiety, depression, self-esteem, and teasing.
Results
The OG reported higher anxiety, depression, and teasing, and lower self-esteem. SEM revealed that children who scored worse on instruments assessing psychological well-being had higher BMI
z
scores. Weight-related teasing predicted poor psychological well-being scores and weight-related teasing mediated the relation between BMI and psychological well-being.
Conclusions
The high rates of anxiety, depression, and weight-related teasing, as well as the low self-esteem, which was observed amongst the children with obesity, raise concerns about the quality of life of this population. Furthermore, the finding that weight-related teasing mediated the relationship between BMI and psychological well-being adds to a growing body of research, highlighting the harmful effects of weight-related stigma. Overall, these results highlight the importance of early intervention to assess for, and address, the presence of weight-related teasing and psychological well-being difficulties in preadolescents with obesity.
Level of evidence
Level III, case-control study.
Fuzzy-logic-based inference techniques provide efficient solutions for control problems in classical and emerging applications. However, the lack of specific design tools and systematic approaches ...for hardware implementation of complex fuzzy controllers limits the applicability of these techniques in modern microelectronics products. This paper discusses a design strategy that eases the implementation of embedded fuzzy controllers as systems on programmable chips. The development of the controllers is carried out by means of a reconfigurable platform based on field-programmable gate arrays. This platform combines specific hardware to implement fuzzy inference modules with a general-purpose processor, thus allowing the realization of hybrid hardware/software solutions. As happens to the components of the processing system, the specific fuzzy elements are conceived as configurable intellectual property modules in order to accelerate the controller design cycle. The design methodology and tool chain presented in this paper have been applied to the realization of a control system for solving the navigation tasks of an autonomous vehicle.
This work sought to estimate the economic and environmental potential of palm kernel shell for hydrogen production as energy vector in Norte de Santander, Colombia. A field research determined that ...the department generates monthly 14082 t of palm biomass of which 12501 of palm kernel shell remain available for their use. The proximate and ultimate analyses of the palm kernel shell report high heating value (19.53 MJ/kg) compared with other agro-industrial biomasses, high content of volatile material (69.82% w/w) and fixed carbon (21.68% w/w), promoters of chemical reactions in pyrolysis and gasification processes, respectively. In the Aspen Plus® simulation process of the palm kernel shell gasification at 900 °C and steam/biomass ratio of 1.5, a yield is obtained of hydrogen production of 40.7%, equivalent to a monthly production in Norte de Santander of 51.6 t. Using H2 in the generation of electric power permits producing 470.9 MWh/month that represent theoretical utilities of US$27734.5. In another scenario, 55848.8 gal/month of gasoline are substituted, equivalent to US$11708.6 through the sale of carbon credits. Regarding diesel, 45905.1 gal are replaced per month, which add US$9725.4 through the commercial transaction in the carbon market. It is concluded that using palm kernel shell as primary source to obtain H2, has, in principle, a favorable economic and environmental impact for sustainable development of the department of Norte de Santander, besides contributing to the knowledge base on the penetration of this vector in Colombia's energy matrix; however, more detailed technical and economic studies are needed to conclude regarding the economic viability of this energy conversion process.
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