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Introduction: Obesity is a complex systemic condition, involving numerous anatomical and metabolic changes. Therefore, a comprehensive preoperative assessment is essential for each patient contemplating bariatric surgery., Objetive: This study presents the findings of a proposed protocol designed to streamline the pre-anesthesia consultation process. Our aim was to compare the efficiency and costs of consultations guided by the protocol with those conducted without a specific strategy. The secondary outcomes assessed included postoperative (PO) length of hospital stay and surgical duration., Matherial and Methods: We conducted a retrospective cross-sectional analysis involving 206 clinical cases. Statistical analyses, including the chi-squared test, Student's t-test, and Mann-Whitney U test, were utilized based on the type of variables., Results: The results showed a significant reduction in the costs, pre-anesthesia consultation duration, time spent in the recovery unit, and the need for referrals. However, no statistically significant differences were observed in the delay before surgery and length of hospital stays, measured in days., Conclusion: This algorithm offers a promising approach for optimizing perioperative management in bariatric surgery, demonstrating its effectiveness in cutting costs and reducing the need for referrals., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Freire-Moreira, Sanchez-Conde, Sousa, Garrido-Gallego, Rodríguez-López, Juárez-Vela, Bragado, Carretero-Hernández, Vargas-Chiarella, Calderón-Moreno, Lorenzo-Gómez and Vaquero-Roncero.)

Real-world evidence on the impact of monoclonal antibodies as first-line treatment in Spain is limited. This observational, retrospective and prospective, multicenter, descriptive study included 117 transplant-ineligible newly diagnosed multiple myeloma (TIE-NDMM) patients divided into Group A, who received no daratumumab standard regimens, and the DVMP group (daratumumab, bortezomib, melphalan, and prednisone treatment). More than 90% of the patients in Group A received bortezomib, lenalidomide, or a combination of them. The median follow-up time for Group A was 38.2 months in comparison to 25.8 months for the DVMP group ( p < 0.0001). The rate of DVMP patients that experienced disease progression or death from any cause was 36.8%, compared to 67.3% of Group A patients at 36 months of follow-up. The DVMP group had a higher 36-month progression-free survival (PFS) rate (52.9% vs. 31.7%). During the retrospective period, 73.0% of patients reported adverse drug reactions, while in the prospective period, 40.5% experienced adverse events, with no clinical differences between groups. The study supports the use of daratumumab regimens in frontline therapy based on real-world data. The findings provide valuable insights into the clinical outcomes of daratumumab therapy, which can help physicians make informed decisions regarding the optimal treatment approach for this patient population.

Carotenoids constitute compounds of significant biological interest due to their multiple biological activities, such as antimicrobial, anticancer, antiadipogenic, antidiabetic, and antioxidant properties. Metabolic syndrome (MetS) comprehends a series of metabolic abnormalities (e.g., hypertension, obesity, and atherogenic dyslipidemia) that can affect children, adolescents, and the elderly. The treatment of MetS involves numerous medications, which, despite their efficacy, pose challenges due to prolonged use, high costs, and various side effects. Carotenoids and their derivatives have been proposed as alternative treatments to MetS because they reduce serum triglyceride concentrations, promote insulin response, inhibit adipogenesis, and downregulate angiotensin-converting enzyme activity. However, carotenoids are notably sensitive to pH, light exposure, and temperature. This review addresses the activity of carotenoids such as lycopene, lutein, fucoxanthin, astaxanthin, crocin, and β -carotene towards MetS. It includes a discussion of sources, extraction methods, and characterization techniques for analyzing carotenoids. Encapsulation approaches are critically reviewed as alternatives to prevent degradation and improve the biological performance of carotenoids. A brief overview of the physiopathology and epidemiology of the diseases, including MetS, is also provided.

Violence is a public health problem, and when it affects childhood, it can cause illness throughout the individual's life. Apart from being able to cause damage in the physical, mental and social spheres, it represents a violation of the rights of the affected children, and a high consumption of resources, both economic and social. A multitude of investigations have improved attention to this violence. However, these advances are not consistent with the practical management of victims, both in Primary and Hospital Care. There is a significant area of improvement for paediatric care. Through this article, different professionals from all established paediatric health care facilities develop general lines of knowledge and action regarding violence against children. An overview is taken of the legislation related to childhood, the different types of abuse that exist, their effects, management and prevention. It concludes with an epilogue, through which we aim to move sensibilities. In summary, this work aims to promote the training and awareness of all professionals specialized in children's health, so that they pursue the goal of achieving their patients' greatest potential in life, and in this way, to help create a healthier society, with less disease, and more justice., (Copyright © 2024. Published by Elsevier España, S.L.U.)

In this paper, a novel strategy to perform high-dimensional feature selection using an evolutionary algorithm for the automatic classification of coronary stenosis is introduced. The method involves a feature extraction stage to form a bank of 473 features considering different types such as intensity, texture and shape. The feature selection task is carried out on a high-dimensional feature bank, where the search space is denoted by O(2n) and n=473. The proposed evolutionary search strategy was compared in terms of the Jaccard coefficient and accuracy classification with different state-of-the-art methods. The highest feature selection rate, along with the best classification performance, was obtained with a subset of four features, representing a 99% discrimination rate. In the last stage, the feature subset was used as input to train a support vector machine using an independent testing set. The classification of coronary stenosis cases involves a binary classification type by considering positive and negative classes. The highest classification performance was obtained with the four-feature subset in terms of accuracy (0.86) and Jaccard coefficient (0.75) metrics. In addition, a second dataset containing 2788 instances was formed from a public image database, obtaining an accuracy of 0.89 and a Jaccard Coefficient of 0.80. Finally, based on the performance achieved with the four-feature subset, they can be suitable for use in a clinical decision support system.

Background: Surgical fatigue syndrome (SFS) is a frequent, but underestimated, entity that occurs during laparoscopic surgeries. It could impair surgical outcomes, patient safety, and surgeon health. Furthermore, current surgical education lacks effective interventions to avoid it. Discomfort represents the most common manifestation and includes musculoskeletal fatigue, numbness, or frank pain. The most common affected sites are the back neck, dominant hand shoulder, and high or low back. We propose an integral intervention (surgeon posture, instruments/devices design & use and discomfort improvement) that prevents or mitigates SFS., Methods: An experimental study was conducted on 57 general surgery residents and general surgeons. Participants in the experimental and control group executed standardized laparoscopic knots in a simulator and knowledge, body discomfort, and posture/ergonomic risk was evaluated before and after intervention application., Results: A statistically significant decrease in discomfort intensity was found in the experimental group. Also, discomfort presentation by the anatomic site diminishes and surgical performance improves., Conclusions: Intervention prevents or mitigates discomfort associated with muscle-skeletal component of SFS., Acgme Competency: Practice Based-Learning and Improvement., Competing Interests: The authors states don't have conflict of interest., (© 2023 The Authors.)

One of the main causes of food spoilage is the lipid oxidation of its components, which generates the loss of nutrients and color, together with the invasion of pathogenic microorganisms. In order to minimize these effects, active packaging has played an important role in preservation in recent years. Therefore, in the present study, an active packaging film was developed using polylactic acid (PLA) and silicon dioxide (SiO 2 ) nanoparticles (NPs) (0.1% w / w ) chemically modified with cinnamon essential oil (CEO). For the modification of the NPs, two methods (M1 and M2) were tested, and their effects on the chemical, mechanical, and physical properties of the polymer matrix were evaluated. The results showed that CEO conferred to SiO 2 NPs had a high percentage of 2,2-diphenyl-l-picrylhydrazyl (DPPH) free radical inhibition (>70%), cell viability (>80%), and strong inhibition to E. coli, at 45 and 11 µg/mL for M1 and M2, respectively, and thermal stability. Films were prepared with these NPs, and characterizations and evaluations on apple storage were performed for 21 days. The results show that the films with pristine SiO 2 improved tensile strength (28.06 MPa), as well as Young's modulus (0.368 MPa) since PLA films only presented values of 27.06 MPa and 0.324 MPa, respectively; however, films with modified NPs decreased tensile strength values (26.22 and 25.13 MPa), but increased elongation at break (from 5.05% to 10.32-8.32%). The water solubility decreased from 15% to 6-8% for the films with NPs, as well as the contact angle, from 90.21° to 73° for the M2 film. The water vapor permeability increased for the M2 film, presenting a value of 9.50 × 10 -8 g Pa -1 h -1 m -2 . FTIR analysis indicated that the addition of NPs with and without CEO did not modify the molecular structure of pure PLA; however, DSC analysis indicated that the crystallinity of the films was improved. The packaging prepared with M1 (without Tween 80) showed good results at the end of storage: lower values in color difference (5.59), organic acid degradation (0.042), weight loss (24.24%), and pH (4.02), making CEO-SiO 2 a good component to produce active packaging.

Background: The main objective was to evaluate differences in the clinical, motor, or functional variables in patients with Early Osteoarthritis (EOA) and individuals at risk of developing osteoarthritis (OA). Methods: A cross-sectional study was performed. All the participants were divided into two groups: EOA patients and healthy subjects (HS) at risk of developing OA. The main outcomes were clinical tests, such as those of knee morphology, instability, or proprioception; motor and functional variables, such as knee strength, range of motion, walking speed, and the sit-to-stand test; pain and disability, assessed through the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and Knee injury and Osteoarthritis Outcome Score (KOOS) scales; and knee alignment and leg length inequality, assessed via X-ray images. Results: A total of 97 participants were included (54 EOA and 43 HS). Patients with EOA showed a greater presence of knee pain (p < 0.01). In addition, more EOA patients showed instability both in the left (p < 0.01) and right legs (p < 0.05). Regarding the knee alignment variable, significant differences were found (p < 0.04), with more patients with EOA diagnosed as possessing a varus alignment. In addition, EOA patients showed lower knee strength, since statistically significant differences were found regarding flexion and extension strength in the left leg (Mean Difference (MD): 12.92; p = 0.03; d = −0.46 and MD:7.81; p = 0.04; d = −0.39). Differences were found for the sit-to-stand test scores, showing lower results for the EOA group (MD: −1.91; p < 0.01; d = 0.54). Conclusions: The results of this research show statistically significant differences between patients with EOA and HS at risk of developing OA with respect to pain, disability, instability, knee strength, and the sit-to-stand test. Our results suggest that the evaluation of clinical, motor, and functional features could contribute to an early management of knee OA.

Although microbial fuel cells (MFCs) are an attractive alternative to environmental remediation and power generation, there are still significant limitations related to power density and coulombic efficiency. Previous works have shown that the addition of humic acids (HA, a type of organic matter contained in soils and composting-by-products), improves the fuel to electricity conversion at the porous bioanodes (ba)|anolyte junction. In this work, MFCs having HA-modified bioanodes (MFC/baHA) were prepared and electrochemically analyzed utilizing discharge curves (cell potential vs current density plots) and electrochemical impedance spectroscopy (EIS). This investigation was motivated by looking for a deeper understanding of the functional effects of HA molecules on the operation of baHA-containing Microbial Fuel Cells (MFC/baHA). Our results revealed that the modification of bioanodes with HA molecules decreases the activation energy of the acetate ion oxidation, increasing by a factor of three the consumption rate of this fuel at the baHA|anolyte interface, and enhancing the diffusive transport of these ions through the pores of the baHA permeated by the anolyte., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Currently, there is no formally accepted pharmacological treatment for COVID-19., Materials and Methods: We included COVID-19 outpatients of a Peruvian primary care center from Lima, Peru, who were treated between April 30 - September 30, 2020, with hydroxychloroquine and azithromycin. Logistic regression was applied to determine factors associated with case-fatality rate., Results: A total of 1265 COVID-19 patients with an average age of 44.5 years were studied. Women represented 50.1% of patients, with an overall 5.9 symptom days, SpO2 97%, temperature of 37.3 °C, 41% with at least one comorbidity and 96.1% one symptom or sign. No patient treated within the first 72 h of illness died. The factors associated with higher case fatality rate were age (OR = 1.06; 95% CI 1.01-1.11, p = 0.021), SpO2 (OR = 0.87; 95% CI 0.79-0.96, p = 0.005) and treatment onset (OR = 1.16; 95% CI 1.06-1.27, p = 0.002), being the latter the only associated in the multivariate analysis (OR = 1.18; 95% CI 1.05-1.32, p = 0.005). 0.6% of our patients died., Conclusions: The case fatality rate in COVID-19 outpatients treated with hydroxychloroquine/azithromycin was associated with the number of days of illness on which treatment was started., (Copyright © 2021. Published by Elsevier Ltd.)

Introduction: Brain metastases (BM) in soft-tissue sarcomas (STS) is associated with poor prognosis. This large population analysis presents (1) demographic and clinical variables of these patients, (2) potential risk factors, (3) impact of BM on overall survival, and (4) treatment strategies., Methods: Patients with STS and BM were identified from the Surveillance, Epidemiology, and End Results database. Demographic and clinical variables, as well as treatment modalities, were analyzed. Overall 5-year survival was calculated using the Kaplan-Meier method, and the survival difference was assessed using the log-rank test. A multivariate analysis was performed using the Cox proportional hazard regression to determine the risk factors., Results: Twenty-two patients (22/8,433) with STS presented BM at diagnosis. A multivariate analysis showed that women and American Indians/Alaska Natives had a greater risk of presenting BM. The most common histological subtype to metastasize to the brain was alveolar soft part sarcoma (4/22). In 54.5% of patients with BM, the tumor had also metastasized to the lung, although having synchronous bone, liver, and lung metastases showed the greatest increase in risk for presenting BM (odd ratio [OR] = 1,857.7, confidence interval [CI] 95%, 88.4 to 3,9046.6, P < 0.0001). Individually, bone metastasis increased the risk of presenting BM the most (OR = 205.0, CI 95%, 30.5 to 1,379.6, P < 0.0001). The mean survival of patients with BM was 10.22 months. The standard treatment approach included surgery, radiation therapy, and chemotherapy., Conclusion: BM in patients with STS represents an infrequent but lethal event. Women and American Indians/Alaska Natives are at a higher risk of presenting BM, as well as patients with synchronous metastases. Patients are mainly managed with systemic therapy., (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.)

This work presents the study of the voltage and oxygen effect on bacterial inactivation in water using a pulsed dielectric barrier discharge (DBD) under atmospheric pressure, where Escherichia coli (E. coli) and Salmonella typhi (S. typhi) bacteria were used as model microorganisms. A cylindrical DBD reactor was developed and tested in applications to assay the efficiency of bacterial inactivation in water on a volume of 500 mL flowing continuously throughout the system assisted with a peristaltic pump at 4.4 ± 0.1 mL/s. The efficiency of the treatment reached a 6-log 10 reduction for both E. coli and S. typhi bacteria at 10 6 CFU/mL of concentration at the end of the first cycle of treatment at a minimum voltage of 12 kV with oxygen bubbling gas, concluding that there was a minimum voltage to produce inactivation of E. coli and S. typhi samples. Bacterial inactivation without the oxygen condition contrasted with the high rate of inactivation with oxygen at relatively low voltage discharges., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Introduction: Diabetes is one of the main pandemics in recent years. Its association with depression increases the risk of mortality and morbidity. The coexistence of both diseases leads to poor management of diabetes, which leads to a worse quality of life., Objective: To determine the frequency of depression in patients with diabetes mellitus and the effect of both pathologies on the quality of life in patients who attend outpatient appointments at public health facilities in Lima and Callao., Methodology: Secondary analysis of the Epidemiological Study of Mental Health of depression in diabetic adults. The instrument used to determine the depressive episode was the MINI (Mini-International Neuropsychiatric Interview) while quality of life was measured using the Mezzich Quality of Life Index. Diagnosis information of type 1 or 2 diabetes was obtained from the daily medical record (HIS) of care., Results: The frequency of depression in the 471 patients with diabetes was 5.8% in the last two weeks. While the annual frequency was 8.6% and 31.8% at some point in life. Being a woman was associated with a greater frequency of depression. Quality of life was lower in patients with diabetes and depression (p < 0.005)., Conclusions: The frequency of depression in patients with diabetes who are treated on an outpatient basis in public health centres is higher than the general population and their quality of life is significantly reduced, which raises the need for considering depression as an additional factor to the burden of morbidity of this condition., (Copyright © 2020 Asociación Colombiana de Psiquiatría. Published by Elsevier España, S.L.U. All rights reserved.)

Aims: The objective of this study is to analyze how the impact of Diabetes Mellitus [DM] in patients with COVID-19 varies according to altitudinal gradient., Methods: We obtained 1,280,806 records from adult patients with COVID-19 and DM to analyze the probability of COVID-19, development of COVID-19 pneumonia, hospitalization, intubation, admission to the Intensive Care Unit [ICU] and case-fatality rates [CFR]. Variables were controlled by age, sex and altitude of residence to calculate adjusted prevalence and prevalence ratios., Results: Patients with DM had a 21.8% higher prevalence of COVID-19 and an additional 120.2% higher prevalence of COVID-19 pneumonia. The adjusted prevalence was also higher for these outcomes as well as for hospitalization, intubation and ICU admission. COVID-19 and pneumonia patients with DM had a 97.0% and 19.4% higher CFR, respectively. With increasing altitudes, the probability of being a confirmed COVID-19 case and the development of pneumonia decreased along CFR for patients with and without DM. However, COVID-19 patients with DM were more likely to require intubation when residing at high altitude., Conclusions: The study suggests that patients with DM have a higher probability of being a confirmed COVID-19 case and developing pneumonia. Higher altitude had a protective relationship against SARS-CoV-2 infection; however, it may be associated with more severe cases in patients with and without DM. High altitude decreases CFR for all COVID-19 patients. Our work also shows that women are less affected than men regardless of altitude., Competing Interests: The authors declare that no competing interests exist.

Background: During COVID-19 pandemic, elective invasive cardiac procedures (ICP) have been frequently cancelled or postponed. Consequences may be more evident in patients with diabetes., Objectives: The objective was to identify the peculiarities of patients with DM among those in whom ICP were cancelled or postponed due to the COVID-19 pandemic, as well as to identify subgroups in which the influence of DM has higher impact on the clinical outcome., Methods: We included 2,158 patients in whom an elective ICP was cancelled or postponed during COVID-19 pandemic in 37 hospitals in Spain. Among them, 700 (32.4%) were diabetics. Patients with and without diabetes were compared., Results: Patients with diabetes were older and had a higher prevalence of other cardiovascular risk factors, previous cardiovascular history and co-morbidities. Diabetics had a higher mortality (3.0% vs. 1.0%; p = 0.001) and cardiovascular mortality (1.9% vs. 0.4%; p = 0.001). Differences were especially important in patients with valvular heart disease (mortality 6.9% vs 1.7% [p < 0.001] and cardiovascular mortality 4.9% vs 0.9% [p = 0.002] in patients with and without diabetes, respectively). In the multivariable analysis, diabetes remained as an independent risk factor both for overall and cardiovascular mortality. No significant interaction was found with other clinical variables., Conclusion: Among patients in whom an elective invasive cardiac procedure is cancelled or postponed during COVID-19 pandemic, mortality and cardiovascular mortality is higher in patients with diabetes, irrespectively on other clinical conditions. These procedures should not be cancelled in patients with diabetes.

From samples of the Paleozoic Tamatán Group (Huizachal-Peregrina Anticlinorium, Tamaulipas, Mexico), petrographic (qualitative and modal) and geochemical analyses (major, trace, and rare earth elements) were conducted. The first U-Pb geochronological data on detrital zircons of the Tamatán Group were generated using four samples. The data presented here contains a broad overview of photomicrography, recalculated modal point-count data, raw geochemical data, and simple statistics of selected geochemical parameters. The data presented in this article are interpreted and discussed in the research article titled "Provenance and tectonic setting of the Tamatán Paleozoic sequence, NE Mexico: Implications for the closure of the Rheic Ocean at the northwestern part of Gondwana" [1]., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships which have or could be perceived to have influenced the work reported in this article., (© 2021 The Authors.)

Background: The spectrum of pre-existing renal disease is known as a risk factor for severe COVID-19 outcomes. However, little is known about the impact of COVID-19 on patients with diabetic nephropathy in comparison to patients with chronic kidney disease., Methods: We used the Mexican Open Registry of COVID-19 patients 11 to analyze anonymized records of those who had symptoms related to COVID-19 to analyze the rates of SARS-CoV-2 infection, development of COVID-19 pneumonia, admission, intubation, Intensive Care Unit admission and mortality. Robust Poisson regression was used to relate sex and age to each of the six outcomes and find adjusted prevalences and adjusted prevalence ratios. Also, binomial regression models were performed for those outcomes that had significant results to generate probability plots to perform a fine analysis of the results obtained along age as a continuous variable., Results: The adjusted prevalence analysis revealed that that there was a a 87.9% excess probability of developing COVID-19 pneumonia in patients with diabetic nephropathy, a 5% excess probability of being admitted, a 101.7% excess probability of intubation and a 20.8% excess probability of a fatal outcome due to COVID-19 pneumonia in comparison to CKD patients (p<0.01).  Conclusions: Patients with diabetic nephropathy had nearly a twofold rate of COVID-19 pneumonia, a higher probability of admission, a twofold probability of intubation and a higher chance of death once admitted compared to patients with chronic kidney disease alone. Also, both diseases had higher COVID-19 pneumonia rates, intubation rates and case-fatality rates compared to the overall population.

Introduction: Diabetes is one of the main pandemics in recent years. Its association with depression increases the risk of mortality and morbidity. The coexistence of both diseases leads to poor management of diabetes, which leads to a worse quality of life., Objective: To determine the frequency of depression in patients with diabetes mellitus and the effect of both pathologies on the quality of life in patients who attend outpatient appointments at public health facilities in Lima and Callao., Methodology: Secondary analysis of the Epidemiological Study of Mental Health of depression in diabetic adults. The instrument used to determine the depressive episode was the MINI (Mini-International Neuropsychiatric Interview) while quality of life was measured using the Mezzich Quality of Life Index. Diagnosis information of type 1 or 2 diabetes was obtained from the daily medical record (HIS) of care., Results: The frequency of depression in the 471 patients with diabetes was 5.8% in the last two weeks. While the annual frequency was 8.6% and 31.8% at some point in life. Being a woman was associated with a greater frequency of depression. Quality of life was lower in patients with diabetes and depression (p <0.005)., Conclusions: The frequency of depression in patients with diabetes who are treated on an outpatient basis in public health centres is higher than the general population and their quality of life is significantly reduced, which raises the need for considering depression as an additional factor to the burden of morbidity of this condition., (Copyright © 2020 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: A Demographic and Family Health Survey (ENDES, for Encuesta Demográfica y de Salud Familiar in Spanish) is carried out annually in Peru. Based on it, the anemia prevalence was 43.6% in 2016 and 43.8% in 2017 using the WHO cutoff value of 11 g/dL and the altitude-correction equation., Objective: To assess factors contributing to anemia and to determine its prevalence in Peruvian children 6 to 35 months old., Methods: We used the MEASURE DHS-based ENDES survey to obtain representative data for11364 children from 6 to 35 months old on hemoglobin and health determinants. To evaluate normal hemoglobin levels, we used the original WHO criterion of the 5th percentile in children without chronic malnutrition and then applied it to the overall population. Relationships between hemoglobin and altitude levels, usage of cleaning methods to sanitize water safe to drink, usage of solid fuels and poverty status were tested using methodology for complex survey data. Percentile curves were made for altitude intervals by plotting hemoglobin compared to age. The new anemia rates are presented in graphs by Peruvian political regions according to the degree of public health significance., Results: Hemoglobin increased as age and altitude of residence increased. Using the 5th percentile, anemia prevalence was 7.3% in 2016 and 2017. Children from low altitudes had higher anemia prevalence (8.5%) than those from high altitudes (1.2%, p<0.0001). In the rainforest area of Peru, anemia prevalence was highest (13.5%), while in the highlands it was lowest (3.3%, p<0.0001). With access to safe drinking water and without chronic malnutrition, anemia rates could be reduced in the rainforest by 45% and 33%, respectively., Conclusion: Anemia prevalence in Peruvian children from 6 to 35 months old was 7.3% in 2016 and 2017., Competing Interests: The authors have declared that no competing interests exist.

In mammograms, a calcification is represented as small but brilliant white region of the digital image. Earlier detection of malignant calcifications in patients provides high expectation of surviving to this disease. Nevertheless, white regions are difficult to see by visual inspection because a mammogram is a gray-scale image of the breast. To help radiologists in detecting abnormal calcification, computer-inspection methods of mammograms have been proposed; however, it remains an open important issue. In this context, we propose a strategy for detecting calcifications in mammograms based on the analysis of the cluster prominence ( cp ) feature histogram. The highest frequencies of the cp histogram describe the calcifications on the mammography. Therefore, we obtain a function that models the behaviour of the cp histogram using the Vandermonde interpolation twice. The first interpolation yields a global representation, and the second models the highest frequencies of the histogram. A weak classifier is used for obtaining a final classification of the mammography, that is, with or without calcifications. Experimental results are compared with real DICOM images and their corresponding diagnosis provided by expert radiologists, showing that the cp feature is highly discriminative.

Silver birch (Betula pendula) is a pioneer boreal tree that can be induced to flower within 1 year. Its rapid life cycle, small (440-Mb) genome, and advanced germplasm resources make birch an attractive model for forest biotechnology. We assembled and chromosomally anchored the nuclear genome of an inbred B. pendula individual. Gene duplicates from the paleohexaploid event were enriched for transcriptional regulation, whereas tandem duplicates were overrepresented by environmental responses. Population resequencing of 80 individuals showed effective population size crashes at major points of climatic upheaval. Selective sweeps were enriched among polyploid duplicates encoding key developmental and physiological triggering functions, suggesting that local adaptation has tuned the timing of and cross-talk between fundamental plant processes. Variation around the tightly-linked light response genes PHYC and FRS10 correlated with latitude and longitude and temperature, and with precipitation for PHYC. Similar associations characterized the growth-promoting cytokinin response regulator ARR1, and the wood development genes KAK and MED5A.

Antimalarials have demonstrated beneficial effects in Systemic Lupus Erithematosus and Rheumatoid Arthritis. However, the mechanisms and the molecular players targeted by these drugs remain obscure. Although hydroxychloroquine (HCQ) is a known ion channel inhibitor, this property has not been linked to its anti-inflammatory effects. We aimed to study whether HCQ inhibits pro-inflammatory ion channels. Electrophysiology experiments demonstrated that HCQ inhibited Ca ++ -activated K + conductance in THP-1 macrophages in a dose-dependent manner. In macrophages, ATP-induced K + efflux plays a key role in activating the NLRP3 inflammasome. ATP-induced IL-1beta secretion was controlled by the KCa1.1 inhibitor iberiotoxin. NS1619 and NS309 (KCa1.1 and KCa3.1 activators respectively) induced the secretion of IL-1beta. This effect was inhibited by HCQ and also by iberiotoxin and clotrimazol (KCa3.1 inhibitor), arguing against off-target effect. In vitro, HCQ inhibited IL-1beta and caspase 1 activation induced by ATP in a dose-dependent manner. HCQ impaired K + efflux induced by ATP. In vivo, HCQ inhibited caspase 1-dependent ATP-induced neutrophil recruitment. Our results show that HCQ inhibits Ca ++ -activated K + channels. This effect may lead to impaired inflammasome activation. These results are the basis for i) a novel anti-inflammatory mechanism for HCQ and ii) a new strategy to target pro-rheumatic Ca ++ -activated K + channels.

Necrotizing fasciitis is a rapidly progressive destructive soft tissue infection with high mortality. Streptococcus pneumoniae as etiologic agent of necrotizing fasciitis is extremely unusual. The increased susceptibility to Streptococcus pneumoniae infection in patients with systemic lupus erythematosus is probably a multifactorial phenomenon. We report a case of a patient, a 36-year-old Caucasian female with 8-year history of systemic lupus erythematosus who presented a fatal Streptococcus pneumoniae necrotizing fasciitis. The role of computed tomography and the high performance of blood cultures for isolation of the causative microorganism are emphasized. Once diagnosis is suspected, empiric antibiotic treatment must be prescribed and prompt surgical exploration is mandatory., (© The Author(s) 2015.)

Introduction: The use of hydroxychloroquine (HCQ) in patients with systemic lupus erythematosus (SLE) offers a wide range of benefits. However, there are evidence in favour of cardiotoxicity, including heart conduction disturbances and congestive heart failure., Objective: To determine the effects of HCQ in the resting heart rate (RHR) of SLE patients., Patients and Methods: Included were patients with non active SLE, with a sedentary lifestyle and treated with HCQ. Excluded were patients on beta blocker treatment, trained patients, pacemaker's users and patients with clinical or analytical evidence of anemia, renal disease, obstructive pulmonary disease, obesity, uncontrolled thyroid disease, fever or current infection. Standard 12-lead electrocardiogram was performed in the resting condition (supine decubitus and orthostatic position). Comparison between groups was performed using Mann-Whitney U test. A multiple linear regression was performed. A p value <0.05 was considered statistically significant., Results: 42 patients were included. Patients were divided in two groups based on the cumulative dose of HCQ (CD-HCQ), considering 365 g as cut-off. There were 24 patients with low-HCQ (<365 g) and 18 patients with high-HCQ (>365 g). Non significant differences were found in age, sex, prednisone dose or SLEDAI. The mean RHR was 73 ± 6 beats/min in the low-HCQ and 65 ± 7 beats/min in the high-HCQ, with a significant decrease of 11% (p = 0.003). In multiple linear regressions, there were non significant association between the decrease of RHR and prednisone dose, age, SLEDAI or TSH, but there was significant association between RHR and CD-HCQ (p = 0.024) and RHR and time of exposure to HCQ (p = 0.029)., Conclusion: CD-HCQ higher than 365 g was associated with a significant decrease (11%) in RHR in non-active SLE patients, although a larger prospective study is required to allow more definitive conclusions., (© The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)

The implementation of signal filters in a real-time form requires a tradeoff between computation resources and the system performance. Therefore, taking advantage of low lag response and the reduced consumption of resources, in this article, the Recursive Least Square (RLS) algorithm is used to filter a signal acquired from a fiber-optics-based sensor. In particular, a Long-Period Fiber Grating (LPFG) sensor is used to measure the bending movement of a finger. After that, the Gaussian Mixture Model (GMM) technique allows us to classify the corresponding finger position along the motion range. For these measures to help in the development of an autonomous robotic hand, the proposed technique can be straightforwardly implemented on real time platforms such as Field Programmable Gate Array (FPGA) or Digital Signal Processors (DSP). Different angle measurements of the finger's motion are carried out by the prototype and a detailed analysis of the system performance is presented.

Unlabelled: The influence of antimalarials on lipids in systemic lupus erythematosus (SLE) has been identified in several studies but not in many prospective cohorts. The aim of this study was to longitudinally determine the effect of antimalarials on the lipoprotein profile in SLE., Patients and Methods: Fasting total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL) and low-density lipoprotein cholesterol (LDL) plasma levels were determined at entry and after 3 months of hydroxychloroquine (HCQ) treatment in a longitudinal evaluation of 24 patients with SLE., Results: a significant decrease in TC (198 ± 33.7 vs. 183 ± 30.3 mg/dl, p = 0.023) and LDL levels (117 ± 31.3 vs. 101 ± 26.2 mg/dl, p = 0.023) were detected after the 3 months of HCQ therapy. The reduction of 7.6% in TC (p = 0.055) and 13.7% in LDL levels (p = 0.036) determined a significant decrease in the frequency of dyslipidemia (26% vs. 12.5%, p = 0.013) after HCQ therapy., Conclusion: This longitudinal study demonstrated the beneficial effect of antimalarials on lipids in SLE since this therapy induced a reduction of atherogenic lipoproteins.

Paediatricians are in an excellent position to identify children with environmental risk, to advise their parents about the best way of reducing or preventing such risks, and to recommend actions to the responsible politicians involved. Paediatric environmental health speciality units (PEHSU) can help to qualify and support paediatricians in this task. PEHSU is defined as a unit within a paediatric hospital or clinic that is able to recognize, assess, and prevent environment-related health risks, to help other paediatric specialists in the management of such diseases in children, as well as to provide education, training, and research, putting emphasis on thorough and adequate establishment of paediatric environmental histories (PEHis) and to the application of the precautionary principle. Although activities and services provided by each PEHSU would differ depending on the centre or community where it is located, all should include training, research, medical care and community and school health.