Background: Objectives. The objective of this study was to compare the efficacy of direct current stimulation (DCS) applied at the transcranial, suboccipital and spinal level on experimental sensory modalities and pain outcome measures in healthy subjects. The hypothesis of this study was that systematic analysis of the efficacy of DCS on modulating evoked thermal and mechanical pain modalities and mechanisms such as endogenous pain modulation in healthy individuals would reveal sensitive outcome measures help develop this technique for the control of chronic pain. Materials and Methods. Database searches were conducted up to December 2019 for randomized controlled trials that performed sham-controlled DCS of experimental sensory modalities and pain outcomes following transcranial, suboccipital and spinal locations in healthy participants. Standardized mean differences with 95% confidence intervals were calculated for sensory modalities, including random-effect metanalysis. Results: Thirty-one studies were included for analysis (647 participants). A significant decrease in pain intensity for active vs sham transcranial stimulation was identified for pain intensity (n=158; SMD=0.79; 95% CI=0.56 to 1.02), a significant increase in heat pain threshold (n=222; SMD=1.16; 95% CI=0.95 to 1.37), and a significant increase in cold pain threshold (n = 155; SMD = 0.77, 95% CI 0.53 to 1.01). No significant modulation of pressure pain threshold was identified with DCS and only a limited number of studies focused on experimental pain modulation following neuromodulation at the suboccipital or spinal level. Conclusions: These results show significant transcranial DCS neuromodulation of pain intensity and on thermal pain modalities. Future studies should focus on endogenous pain and sensory modality modulation with sham-controlled DCS applied at transcranial, suboccipital and spinal locations.

We analyzed the characteristics of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infected children during lock-down period in Catalonia (Spain), and their transmission role within the households. Among 295 traced household contacts of 89 pediatric patients, children were classified as final index cases in only 3.4% of the traced homes.

Cultures in Mediterranean climate zones (MCZs) around the world have long been reliant on groundwater and springs as freshwater sources. While their ecology and cultural sustainability are recognized as critically important, inter-relationships between springs and culture in MCZs has received little attention. Here we augmented a global literature review with case studies in MCZ cultural landscapes to examine the intensity of cultural and socio-economic impacts on springs ecohydrogeology. MCZs are often oriented on the west and southern coasts in tectonically active landscapes, which control aquifer structure, the prevalence of westerly winds, and aridity, and generally expose associated habitats to harsh, afternoon sunlight. Cultural appreciation and appropriation of springs ranges widely, from their use as subsitence supplies to profound traditions, such as Greco-Roman nymphs, and Asian and Abrahamic spiritual cleansing and baptism. Commoditization of water resources for agriculture, industry (e.g., mining, water bottling, geothermal resorts), and urban needs is placing ever-increasing, non-sustainable demands on aquifers and springs. When economic values approach or exceed cultural values, these irreplaceable aquatic resources are degraded and lost. Sustainable stewardship of springs and the aquifers that support them are a little-recognized, but central conservation challenge for modern society facing global climate changes.