Susceptibility to acidification of groundwater-dependent wetlands affected by water level declines, and potential risk to an early-breeding amphibian species

Eggs of the Western spadefoot toad (Pelobates cultripes) reached a 100% mortality in all 29 clutches deposited at a pH below 5.0 in a temporary pond of the Doñana National Park (SW Spain) throughout the wet season of 2006-2007. A similar trend was detected in a neighbouring pond. The proximity of these two ponds to a groundwater pumping area (<1.5km), prompted us to elucidate the possible links between the reduction in pond hydroperiod over past decades (1989-2008) and the decrease of groundwater pH-buffering capacity. The average hydroperiod had decreased by 4months since 1998-99 in the pond where the extensive egg mortality had occurred. The total alkalinity, and the Mg(2+)concentration had also significantly declined in the shallow water-table since 1998-99, from an average of 8.56 to 0.32meql(-1), and of 3.57 to 1.15meql(-1), respectively. This decline of the shallow groundwater buffering capacity could turn this pond more susceptible to the inorganic acidity associated with pyrite oxidation as the sediment S content was often above 0.03%. The initial ratio of S/Ca+Mg in the summer dry sediment was a good predictor of pore-water pH on re-wetting after desiccation (r(2)=0.802, p<0.01). Therefore, this ratio can give some anticipation to mitigate the impact of acidity on toad hatching before these temporary ponds are reflooded on the next wet season. Our results suggest that the long-term damage to pond water levels can trigger a potential risk of soil acidification in the presence of iron-sulphide minerals.

Mobile Universal Lexicon Evaluation System (MULES) test: A new measure of rapid picture naming for concussion

OBJECTIVE

This study introduces a rapid picture naming test, the Mobile Universal Lexicon Evaluation System (MULES), as a novel, vision-based performance measure for concussion screening. The MULES is a visual-verbal task that includes 54 original photographs of fruits, objects and animals. We piloted MULES in a cohort of volunteers to determine feasibility, ranges of picture naming responses, and the relation of MULES time scores to those of King-Devick (K-D), a rapid number naming test.

METHODS

A convenience sample (n=20, age 34±10) underwent MULES and K-D (spiral bound, iPad versions). Administration order was randomized; MULES tests were audio-recorded to provide objective data on temporal variability and ranges of picture naming responses.

RESULTS

Scores for the best of two trials for all tests were 40-50s; average times required to name each MULES picture (0.72±0.14s) was greater than those needed for each K-D number ((spiral: 0.33±0.05s, iPad: 0.36±0.06s, 120 numbers), p<0.0001, paired t-test). MULES scores showed the greatest degree of improvement between trials (9.4±4.8s, p<0.0001 for trials 1 vs. 2), compared to K-D (spiral 1.5±3.3s, iPad 1.8±3.4s). Shorter MULES times demonstrated moderate and significant correlations with shorter iPad but not spiral K-D times (r=0.49, p=0.03).

CONCLUSION

The MULES test is a rapid picture naming task that may engage more extensive neural systems than more commonly used rapid number naming tasks. Rapid picture naming may require additional processing devoted to color perception, object identification, and categorization. Both tests rely on initiation and sequencing of saccadic eye movements.

A New Quantitative Approach to Assessing Noncompliance With Medical Recommendations in Heart Transplant Recipients

BACKGROUND

Failure of compliance with medical regimen is one of the major risk factors associated with morbidity and mortality in heart transplant (HT) recipients. Nevertheless, to date, there is no specific, gold-standard, comprehensive set of tools for assessing compliance in these patients.

OBJECTIVE

The objective of the present study was to develop a specific instrument for the assessment of noncompliance with medical recommendations in HT recipients.

METHODS

This prospective observational study used a nonprobability sampling method, which was performed from January 2006 to December 2012. All of the patients met clinical criteria for being included on the waiting list for a HT. We designed a scale for measuring the compliance degree at 12 months after heart transplantation. This scale included the most important aspects of the medical regimen, using nine discrete quantitative variables. The total score was described as the patient's Noncompliance Factor (NCF). The results were analysed by mean, ranks, and percentages.

RESULTS

The sample was constituted of 61 participants who underwent surgical HT intervention and completed the 12-month follow-up assessment. The overall incidence of noncompliance was around 30% and only 43.1% of the recipients had an acceptable degree of compliance.

CONCLUSIONS

The overall incidence of noncompliance in HT recipients is high and this can generate worse clinical outcomes. Evaluation by specific screening instruments like the one proposed in the present study can be useful for a systematic detection of this phenomenon.

Sleep Disorders Associated With Mild Traumatic Brain Injury Using Sport Concussion Assessment Tool 3

BACKGROUND

Sleep problems affect 30% to 80% of patients with mild traumatic brain injury. We assessed the prevalence of sleep disorders after mild traumatic brain injury and its correlation with other symptoms.

METHODS AND MATERIALS

Individuals with mild traumatic brain injury were assessed at the New York University Concussion Center during 2013-2014 with the Sports Concussion Assessment Tool, third edition, data following mild traumatic brain injury. The relationship between sleep problems (drowsiness, difficulty falling asleep, fatigue or low energy), psychiatric symptoms (sadness, nervousness or anxiousness), headache, and dizziness were analyzed by Spearman correlation and logistic regression using moderate to severe versus none to mild categorization.

RESULTS

Ninety-three patients were retrospectively considered. The most common injury causes were falls (34.4%) and motor vehicle accidents (21.5%). There was a positive correlation between dizziness, headache, psychiatric problems (sadness, anxiety, irritability), and sleep problems (fatigue, drowsiness, and difficulty falling asleep) (P < 0.001). Logistic regression showed a significant association between moderate to severe psychiatric symptoms and moderate to severe sleep symptoms (P < 0.05). Sleep symptoms became more severe with increased time interval from mild traumatic brain injury to Sport Concussion Assessment Tool 3 administration (odds ratio = 1.005, 1.006, and 1.008, P < 0.05). There was significant correlation between motor vehicle accident and drowsiness and difficulty falling asleep (P < 0.05). Medications given in the emergency department had a positive correlation with drowsiness (P < 0.05).

CONCLUSIONS

Individuals who report moderate to severe headache, dizziness, and psychiatric symptoms have a higher likelihood of reporting moderate to severe sleep disorders following mild traumatic brain injury and should be counseled and initiated with early interventions.

Toward a comprehensive care of HIV patients: finding a strategy to detect depression in a Spanish HIV cohort

Depression is a common but frequently undiagnosed feature in individuals with HIV infection. To find a strategy to detect depression in a non-specialized clinical setting, the overall performance of the Hospital Anxiety and Depression Scale (HADS) and the depression identification questions proposed by the European AIDS Clinical Society (EACS) guidelines were assessed in a descriptive cross-sectional study of 113 patients with HIV infection. The clinician asked the two screening questions that were proposed under the EACS guidelines and requested patients to complete the HADS. A psychiatrist or psychologist administered semi-structured clinical interviews to yield psychiatric diagnoses of depression (gold standard). A receiver operating characteristic (ROC) analysis for the HADS-Depression (HADS-D) subscale indicated that the best sensitivity and specificity were obtained between the cut-off points of 5 and 8, and the ROC curve for the HADS-Total (HADS-T) indicated that the best cut-off points were between 12 and 14. There were no statistically significant differences in the correlations of the EACS (considering positive responses to one [A] or both questions [B]), the HADS-D ≥ 8 or the HADS-T ≥ 12 with the gold standard. The study concludes that both approaches (the two EACS questions and the HADS-D subscale) are appropriate depression-screening methods in HIV population. We believe that using the EACS-B and the HADS-D subscale in a two-step approach allows for rapid, assumable and accurate clinical diagnosis in non-psychiatric hospital settings.

New use cases for remote control and configuration of interoperable medical devices

The newest branch of the ISO/IEEE 11073 (X73) standard for Personal Health Devices (X73PHD), allow the development of interoperable personal health ecosystems. At the moment of this writing, more than 11 specializations have been successfully published by the Personal Health Device (PHD) Working Group (PHD WG). Nevertheless, some recent specializations at draft stage show the need for a procedure to control configuration parameters. As a solution, some ad-hoc methods have been elaborated to deal with it, but, the aim of the PHD WG is to standardize a general procedure, valid for longer term. Then it is needed to identify use cases requiring remote configuration services. This work identifies and studies new use cases that employ remote configuration services. The resulting use cases, discussed within the PHD WG to get the maximum consensus, are within the scope of the Basic Electrocardiograph (X73-10406), the Sleep Apnea Breathing Therapy Equipment (X73-10424), and the Medication Monitor (X73-10472) specializations. In addition, a classification of the findings is proposed for each use case. These findings could be the basis for the new remote configuration extension.

Decoy receptors block TRAIL sensitivity at a supracellular level: the role of stromal cells in controlling tumour TRAIL sensitivity

Tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) is a death ligand cytokine known for its cytotoxic activity against malignantly transformed cells. TRAIL induces cell death through binding to death receptors DR4 and DR5. The inhibitory decoy receptors (DcR1 and DcR2) co-expressed with death receptor 4 (DR4)/DR5 on the same cell can block the transmission of the apoptotic signal. Here, we show that DcRs also regulate TRAIL sensitivity at a supracellular level and thus represent a mechanism by which the microenvironment can diminish tumour TRAIL sensitivity. Mathematical modelling and layered or spheroid stroma-extracellular matrix-tumour cultures were used to model the tumour microenvironment. By engineering TRAIL to escape binding by DcRs, we found that DcRs do not only act in a cell-autonomous or cis-regulatory manner, but also exert trans-cellular regulation originating from stromal cells and affect tumour cells, highlighting the potent inhibitory effect of DcRs in the tumour tissue and the necessity of selective targeting of the two death-inducing TRAIL receptors to maximise efficacy.

Proposal of a novel remote command and control configuration extension for interoperable Personal Health Devices (PHD) based on ISO/IEEE11073 standard

New use cases to extend the interoperability standard ISO/IEEE11073 (X73) were found during the development of recent specializations. These use cases expose the need of remote command and control extensions to allow managers to configure agents through the standard. This paper presents a proposal for an extension of remote control and configuration service able to standardize a general procedure within the newest branch of this standard called X73 for Personal Health Devices (X73PHD). In order to develop a service for remote control, several approaches have been studied and discussed in the Personal Health Device Working Group (PHD-WG). The final solution is defined following the PHD-WG guidelines and integrated with the Optimized Exchange Protocol (X73-20601) and device specializations (X73-104xx). Previous works such as the classic command and control and the extended services packages from X73-10201 and X73-20301, respectively, have also been taken into account.

Influence of low levels of water salinity on toxicity of nitrite to anuran larvae

Reactive nitrogen compounds such as nitrite (NO2(-)) are highly toxic to aquatic animals and are partly responsible for the global decline of amphibians. On some fish and Caudata amphibian species low levels of sodium chloride significantly reduce the toxicity of nitrite. However, the nitrite-salinity interaction has not been properly studied in anuran amphibians. To verify if chloride (Cl(-)) attenuates NO2(-) toxicity, eggs and larvae of three anuran species were subjected to a series of NO2(-) solutions combined with three salt concentrations (0, 0.4 and 2 or 0, 0.052 and 0.2gL(-1)NaCl). One of the species tested originated from two different populations inhabiting highly contrasted nutrient richness environments: lowland Doñana Natural Park and Sierra de Gredos Mountain. In general, the presence of Cl(-) increased survival and growth of lowland Pelophylax perezi and activity of mountain P. perezi larvae exposed to NO2(-), thus attenuating the toxicity of NO2(-) to developing amphibians. Mountain amphibian populations appeared to be much more sensitive to the concentrations of NO2(-) and Cl(-) used in this experiment than coastal conspecifics, suggesting possible adaptation of populations to local conditions. Nitrogen pollution in coastal wetlands poses a serious threat to aquatic organisms, causing direct toxicity or indirect effects via ecosystem eutrophication. The presence of low to medium levels of salinity that would be common in coastal wetlands may attenuate the direct effects of increasing concentrations of nitrogenous compounds in water bodies. Furthermore, treating cultures of endangered anurans with small amounts of NaCl may provide an additional protective measure.

Autohydrolysis and organosolv process for recovery of hemicelluloses, phenolic compounds and lignin from grape stalks

A combination of two environment-friend processes for hemicelluloses and lignin recovery from red grape stalks were investigated: an autohydrolysis pretreatment at 180°C for 30 min followed by a non-catalysed ethanol organosolv step at 180°C for 90 min. Hemicelluloses were precipitated by ethanol addition to autohydrolysis liquor, while lignin was tentatively precipitated by acidification of liquors from both the processes. Results suggest that stalks hemicelluloses can be easily hydrolysed requiring a milder treatment to reduce sugar degradation, while the organosolv process did not give a consistent delignification. Autohydrolysis allowed a recovery of 2% (on stalks d.m.) of total phenols in the liquor. Organosolv liquor had a higher concentration of phenols (corresponding to 0.72% of stalks d.m.) which almost completely precipitated with lignin.