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This study aims to contribute to the improvement of the chickpea agri-food industry and adapt it to future challenges. For this, the effect of a Rhizobacteria-based biostimulant mixture was analyzed in Amelia variety of chickpea (Cicer arietinum L.) in two different experiments: one in flowerpots in a greenhouse and the other one in the field grown under rainfed conditions. Germination success, vegetative development and phenological stages of the plants were studied after applying liquid biostimulant mixture on the seeds 24 h before sowing or spraying it on the soil after sowing. The results indicated that the way of application of the biostimulant was relevant concerning germination success, vegetative development, and phenological state of chickpea plants and it should be adapted to intensive agriculture with the use of seed drill that requires dry seeds. Regarding germination success, vegetative development and phenological stages in the flower pot assay, the volume of biostimulant mixture applied to the seeds was remarkable as higher volumes affected negatively while lower volumes were positive. Biostimulant had a negative effect on the development of chickpea plants in the field assay, probably because it also promoted the growth of weeds, which lessened the growth of the chickpea plants.

Resumen Introduccion La mielopatia cervical degenerativa representa una entidad patologica producida por la estenosis del canal medular cervical, resultando en una compresion cronica de la medula espinal, variable y progresiva. El abordaje quirurgico de la columna cervical puede realizarse por via anterior y/o via posterior. Respecto al abordaje posterior, existen 2 tecnicas fundamentales: laminoplastia y laminectomia con fijacion posterior (LFP). En la literatura actual existe controversia acerca de cual de las 2 tecnicas permite obtener mejores resultados postoperatorios. El objetivo es el estudio de las diferencias entre laminoplastia y LFP desde el punto de vista clinico y radiologico. Materiales y metodos Se realiza un estudio de una cohorte historica de 39 pacientes (12 LFP y 27 laminoplastia) intervenidos en un periodo de 10 anos en el Hospital Universitario La Paz con un seguimiento de 12 meses tras la cirugia. Se analizan y comparan los resultados clinicos mediante la escala de Nurick y la Escala Japanese Orthopaedic Association modificada (mJOA) y los resultados radiologicos mediante el angulo de Cobb, eje sagital vertical, T1 Slope y el alineamiento (medido mediante Cobb-T1 Sloppe). Resultados Se observan diferencias significativas en la mejoria postoperatoria de la escala Nurick (p = 0,008) y mJOA (p = 0,018) en el grupo de laminoplastia. En LFP se objetiva una tendencia a una mejoria mayor, pero no se alcanza la significacion estadistica debido al bajo tamano muestral de este grupo. No se objetivan diferencias estadisticamente significativas en cuanto a la variables radiologicas. Respecto al total de complicaciones, se observo un numero mayor en el grupo de laminoplastia (7 casos) frente a LFP (un caso), pero no se vieron diferencias estadisticamente significativas. Conclusiones La laminoplastia y la LFP son ambos procedimientos seguros y efectivos en el tratamiento de la mielopatia cervical degenerativa. Los hallazgos de nuestro estudio demuestran una mejoria clinica estadisticamente significativa en base a las escalas de Nurick y mJOA en el grupo de laminoplastia. No se observan diferencias significativas en cuanto a complicaciones ni variables radiologicas entre ambas tecnicas.

The objective of this study was to compare the efficiency of two methodologies, seed germination (SG) and seed physical extraction SPE), to assess the weed community from two locations with different soil and climatic conditions: M, with dry and low soil fertility, and S with high soil humidity and fertility. Over three years of study, the analysis of both methodologies confirmed differences in seed bank composition. In M, fewer seeds were recorded by SG than SPE (13.5% and 86.5% respectively), while in S, the difference between percentages was less (31.58% by SG and 68.41% by SPE). Our findings confirmed that Portulaca oleracea L., Amaranthus blitoides S. Watson and Chenopodium album L. were abundantly found in M. Anacyclus clavatus (Def.) Res. seeds were also found, mainly detected by SG. In S, Stellaria media (L.) Vill. was widely found. All species found in S were similarly detected by SG and SPE. The results confirmed that climatic and soil conditions influenced the efficiency of the methodology used to assess the seed bank. M conditions led to an increased seed reservoir, and both methodologies were necessary to obtain the seed bank composition. In S conditions, the seed bank was continuously renewed, and either one of methodologies defined the seed bank composition equally well.

12 Pág. Departamento de Medio Ambiente y Agronomía​ (INIA), Extreme climate events (ECEs) of drought are becoming common in Mediterranean areas and farmers need adapt agricultural practices to achieve sustainability. This field study took place in to gain insight into the effects of seasonal rainfall, tillage and crop systems on wheat yield and weed parameters. Conventional (CT), minimum (MT) and no-tillage (NT) systems in wheat monoculture and rotation cropping systems were tested during 3 years of study (2014-2015, 2015-2016 and 2016-2017). Growing Season Rainfall (GSR) was the most influential factor on yield parameters and weed population. In 2016-2017, categorized as an extreme climate event by drought, the GSR accounted for 43.4% of the historical average. This year, the wheat yield (373 kg ha-1) and harvest index (0.18) were the lowest. In 2015-2016, scarcer autumn rainfall (44 mm) affected the weed germination period, reducing the density (17 plants m-2) and diversity of weed species (3 species m-2) while yield was favoured by high winter and spring rainfall (247 mm). Our study revealed that tillage effects was not significant on wheat yield, but NT systems consistently showed higher weed density and diversity than CT and MT despite the irregular GSR during this study. The rotation system presented higher values of wheat grain yield (781 kg/ha) and dry straw biomass (1803 kg/ha) but also weed biomass (48.54 g m-2) compared to monoculture (27.50 g m-2). NT and rotation combined increased the weed community although did not reduce the wheat yield compare to conventional systems even with an ECE of drought., This work has been funded by Project RTA 2017-00006-C03-01 (Spanish Ministry of Science and Innovation). All authors have contributed significantly, and all authors are in agreement with the content of the manuscript. We confirm that this work is original and has not been published elsewhere, nor is it currently under consideration for publication elsewhere. We have no conflicts of interest to disclose. The datasets analysed during the current study are available from the corresponding author on reasonable request.

Introduction: Chronic pain inflicts damage in multiple spheres of patient's life and remains a challenge for health care providers. Real-world evidence derived from outcome registries represents a key aspect of the ongoing systematic assessment and future development of neurostimulation devices. Research question: The objective of the present study was to assess the long-term effectiveness of neurostimulation as a treatment for spinal chronic pain. Material and methods: The patients analyzed in the present study represent a singlecenter cohort of 52 individuals. Primary outcome measures included numeric pain rating scale, Beck depression index II and Oswestry disability index variation from baseline to 36-month visits. Secondary outcomes included its evaluation at 6-month, 12-month and 24-month visits. Results: A significant improvement in targeted pain, depression and disability values were observed at 36-month follow-up (P ​

Resumen El traumatismo craneoencefalico (TCE) representa una cantidad significativa de muertes y discapacidad a nivel mundial, afectando la mayor parte de esta carga a los paises con ingresos medios y bajos. El estudio GNOS es un estudio internacional multicentrico de cohorte prospectiva. Es el primer estudio neuroquirurgico global que tiene como objetivo proporcionar una imagen completa del manejo y los resultados de los pacientes que han sido tratados mediante cirugia urgente por TCE a nivel mundial.

SARS-CoV2 infection can lead to a prothrombotic state. Large vessel occlusion, as well as malignant cerebral stroke have been described in COVID-19 patients. In the following months, given the increase in COVID-19 cases, an increase in malignant cerebral SARS-CoV2 associated strokes are expected. The baseline situation of the patients as well as the risk of evolution to a serious disease due to the virus, depict a unique scenario. Decompressive craniectomy is a life-saving procedure indicated in patients who suffer a malignant cerebral stroke; however, it is unclear whether the same eligibility criteria should be used for patients with COVID-19. To our knowledge seven cases of decompressive craniectomy and malignant cerebral stroke have been described to date. We report on a 39-year-old female with no major risk factors for cerebrovascular disease, apart from oral contraception, and mild COVID-19 symptoms who suffered from left hemispheric syndrome. The patient underwent endovascular treatment with stenting and afterward decompressive craniectomy due to a worsening neurological status with unilateral unreactive mydriasis. We present the case and provide a comprehensive review of the available literature related to the surgical treatment for COVID-19 associated malignant strokes, to establish whether the same eligibility criteria for non-COVID-19 associated strokes should be used. Eight patients, including our case, were surgically managed due to malignant cerebral stroke. Seven of these patients received decompressive craniectomy, and six of them met the eligibility criteria of the current stroke guidelines. The mortality rate was 33%, similar to that described in non-COVID-19 cases. Two patients had a left middle cerebral artery (MCA) and both survived after decompressive craniectomy. Our results support that decompressive craniectomy, using the current stroke guidelines, should be considered an effective life-saving treatment for COVID-19-related malignant cerebral strokes.

INTRODUCTION Cervical degenerative myelopathy is a variable and progressive degenerative disease caused by chronic compression of the spinal cord. Surgical approaches for the cervical spine can be performed anteriorly and/or posteriorly. Regarding the posterior approach, there are 2 fundamental techniques: laminoplasty and laminectomy with posterior fixation (LPF). There is still controversy concerning the technique in terms of outcome and complications. The aim of the present work is to analyze from the clinical and radiological point of view these 2 techniques: laminoplasty and LPF. MATERIALS AND METHODS A historical cohort of 39 patients was reviewed (12 LFP and 27 laminoplasty) including patients operated in a 10 years period at the Hospital Universitario La Paz with a follow-up of 12 months after surgery was carried out. The clinical results were analyzed and compared using the Nurick scale and the modified Japanese Orthopaedic Association Scale (mJOA) and the radiological results using the Cobb angle, Sagittal Vertical Axis, T1 Slope and alignment (measured by Cobb-T1 Sloppe). RESULTS Significant differences were observed in the postoperative improvement of the Nurick scale (p = 0.008) and mJOA (p = 0.018) in the laminoplasty group. In LFP there is a tendency to a greater improvement, but statistical significance is not reached due to the low sample size of this group. No statistically significant differences were observed in the radiological variables. Regarding the total number of complications, a higher number was observed in the laminoplasty group (7 cases) versus LFP (one case), but no statistically significant differences were observed. CONCLUSIONS Laminoplasty and LFP are both safe and effective procedures in the treatment of cervical degenerative myelopathy. The findings of our study demonstrate statistically significant clinical improvement based on the Nurick and mJOA scales with laminoplasty. No significant differences in terms of complications or radiological variables were observed between the 2 techniques.

© 2020 Palpan Flores, Vivancos Sanchez, Roda, Cerdán, Barrios, Utrilla, Royo and Gandía González., [Objective]: We evaluate the performance of three MRI methods to determine non-invasively tumor size, as overall survival (OS) and Progression Free Survival (PFS) predictors, in a cohort of wild type, IDH negative, glioblastoma patients. Investigated protocols included bidimensional (2D) diameter measurements, and three-dimensional (3D) estimations by the ellipsoid or semi-automatic segmentation methods. [Methods]: We investigated OS in a cohort of 44 patients diagnosed with wild type IDH glioblastoma (58.2 ± 11.4 years, 1.9/1 male/female) treated with neurosurgical resection followed by adjuvant chemo and radiotherapy. Pre-operative MRI images were evaluated to determine tumor mass area and volume, gadolinium enhancement volume, necrosis volume, and FLAIR-T2 hyper-intensity area and volume. We implemented then multivariate Cox statistical analysis to select optimal predictors for OS and PFS. [Results]: Median OS was 16 months (1–42 months), ranging from 9 ± 2.4 months in patients over 65 years, to 18 ± 1.6 months in younger ones. Patients with tumors carrying O6-methylguanin-DNA-methyltransferase (MGMT) methylation survived 30 ± 5.2 vs. 13 ± 2.5 months in non-methylated. Our study evidenced high and positive correlations among the results of the three methods to determine tumor size. FLAIR-T2 hyper-intensity areas (2D) and volumes (3D) were also similar as determined by the three methods. Cox proportional hazards analysis with the 2D and 3D methods indicated that OS was associated to age ≥ 65 years (HR 2.70, 2.94, and 3.16), MGMT methylation (HR 2.98, 3.07, and 2.90), and FLAIR-T2 ≥ 2,000 mm2 or ≥60 cm3 (HR 4.16, 3.93, and 3.72), respectively. Other variables including necrosis, tumor mass, necrosis/tumor ratio, and FLAIR/tumor ratio were not significantly correlated with OS. [Conclusion]: Our results reveal a high correlation among measurements of tumor size performed with the three methods. Pre-operative FLAIR-T2 hyperintensity area and volumes provided, independently of the measurement method, the optimal neuroimaging features predicting OS in primary glioblastoma patients, followed by age ≥ 65 years and MGMT methylation., This work was supported in part by grants PI 2017/00361 from Instituto de Salud Carlos III to JR, MG, and AP and by grant B2017/BMD3688 from the Community of Madrid to JR, MG, and SC.

11 Pág., (1) Background: In agro-ecosystems, the success of the crops has a strong connection to biodiversity in the landscape. In the face of climate change, it is important to understand the response to environmental variation of weed species by means of their distribution. In the last century, biodiversity has been impacted due to a variety of stresses related to climate change. Although the composition of vegetation tends to change at a slower rate than climate change, we hypothesize species present in weed communities are distributed in diverse patterns as a response to the climate. Therefore, the general aim of this paper is to investigate the effect of temperature, using latitude as an indicator, on the composition and distribution of weed communities in agro-ecosystems. (2) Methods: Weeds were monitored in georeferenced cereal fields which spanned south and central Spanish regions. The graphic representation according to latitude allowed us to identify groups of weeds and associate them to a temperature range. We classified weeds as generalist, regional, or local according to the range of distribution. (3) Results: The monitoring of species led to the classification of weeds as generalist, regional or local species according to latitude and associated temperature ranges. Three weed species that were present in all latitude/temperature regions, were classified as generalist (Linaria micrantha (Cav) Hoffmanns & Link, Sonchus oleraceous L., and Sysimbrium irium L.). The species were classified as regional or local when their presence was limited to restricted latitude/temperature ranges. One weed, Stellaria media (L.) Vill., was considered a local species and its distribution dynamics can be considered an indicator of temperature. (4) Conclusions: The novel methodology used in this study to assign weed distribution as an indicator of climatic conditions could be applied to evaluate climate gradients around the world., This work has been funded by projects AT2017-003 and RTA2017-00006-C03-01 (Spanish Ministry of Science and Innovation) and by Biodiversity Foundation of Spain (Ministry for the Ecological Transition) and INIA by means of the project PRCV00590 (“The role of resilience in the composition of weed communities of cereal agro-ecosystems. Adaptive responses of flora to climate change”).

Resumen Objetivo La espondilitis anquilosante es una enfermedad reumatica inflamatoria que afecta principalmente al esqueleto axial. La columna vertebral rigida puede secundariamente desarrollar osteoporosis, lo que aumenta aun mas el riesgo de fractura vertebral. En este estudio, hemos revisado las fracturas en pacientes con espondilitis anquilosante que habian sido diagnosticados clinicamente para definir mejor el mecanismo de la lesion, deficit neurologico asociado y las estrategias de tratamiento. Metodos Entre enero del 2004 y diciembre del 2014, 6 pacientes fueron revisados con espondilitis anquilosante y con complicaciones neurologicas despues de caidas. El estudio de neuroimagen se obtuvo en todos los pacientes mediante el uso de la radiografia simple, TC y RM. La discapacidad se valoro segun la escala de ASIA, se utilizo con el fin de evaluar el estado neurologico de los pacientes. La decision quirurgica se baso en relacion con la afectacion neurologica y la inestabilidad espinal. Resultados Se identificaron un total de 6 lesiones cervicales en pacientes con espondilitis anquilosante: 2 presentaron fracturas por mecanismos de extension y 4 por mecanismos de flexion. Todos los casos fueron intervenidos quirurgicamente. Los 6 pacientes presentaron deficit neurologico postraumatico y en 4 de ellos se observo mejoria neurologica tras la cirugia. Dos casos no mejoraron tras la cirugia. Uno de ellos presento un grado de ASIA A y el otro paciente, que mejoro inicialmente con la cirugia, fallecio por neumonia en el postoperatorio dos meses despues. Conclusiones Los pacientes con espondilitis anquilosante son altamente susceptibles a la fractura vertebral y lesiones de la medula espinal, incluso despues de traumatismos leves. Se recomienda la TC inicial o la RM de toda la columna vertebral, incluso si los sintomas del paciente son leves. El paciente tambien debe tener la estabilizacion quirurgica temprana para corregir la deformidad espinal y evitar el empeoramiento del estado neurologico del paciente.

Objective Ankylosing spondylitis is an inflammatory rheumatic disease mainly affecting the axial skeleton. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. In this study, we reviewed fractures in patients with ankylosing spondylitis that had been clinically diagnosed to better define the mechanism of injury, associated neurological deficit, predisposing factors, and management strategies. Methods Between January 2004 and December 2014, 6 patients with ankylosing spondylitis and neurological complications after injuries were treated. Neuroimaging evaluation was obtained in all patients by using plain radiography, CT scan, and MR imaging. The ASIA Impairment Scale was used in order to evaluate the neurologic status of the patients. Surgical decision was based on relationship of neurological involvement and spinal instability. Results A total of 6 cervical injuries were identified in a review of patients in whom ankylosing spondylitis had been diagnosed. Of these, 2 patients were associated with a hyperextension mechanism and 4 cases by flexion mechanism. Posttraumatic neurological deficits were demonstrated in all 6 cases and neurological improvement after surgery was observed in 4 of these cases. The two cases were not improved by the surgery was on a case by presenting a degree of Asia A and another patient who initially improved with surgery but died of pneumonia in the postoperative. Conclusions Patients with ankylosing spondylitis are highly susceptible to spinal fracture and spinal cord injury even after only mild trauma. Initial CT or MR imaging of the whole spine is recommended even if the patient's symptoms are mild. The patient should also have early surgical stabilisation to correct spinal deformity and avoid worsening of the patient's neurological status.

Traumatic brain injury (TBI) accounts for a significant amount of death and disability worldwide and the majority of this burden affects individuals in low-and-middle income countries. The GNOS is a multi-centre international, prospective cohort study. This study is the first global neurosurgical study that aims to provide a comprehensive picture of the management and outcomes of patients undergoing emergency surgery for TBI worldwide.

We read with interest the article "Cervical Foraminal and Discal Height after Dynamic Rotational Plating in the Cervical Discectomy and Fusion" [1] showing that apart from clinical improvement after anterior cervical discectomy and fusion, with the use of rotational dynamic plates, the achieved height increases after surgery for both the disc space and the foramina were noticeably lost and they were down to preoperative measures at follow-up. This was, however, without any apparent clinical consequence. Interestingly, this finding seems to be similar to another study, where translational dynamic plates were used [2]. Regarding translational dynamic plates, there is the fear of their use leading to lordosis loss, but at least with ABC, even though there is a partial loss of gained lordosis (around 50%) after surgery, there is still a global lordotic gain, which may explain why changes in cervical angles did not affect the outcome. Biomechanical evidence from in vitro studies showed similar load sharing for the two dynamic mechanisms (rotational or translational) [3,4]; however, from in vivo clinical experiences [5,6], the translational dynamic plates led to fewer pseudoarthroses and with faster fusion and better results than the rotational plates [7,8,9]. One possible explanation could be, at least theoretically, that rotational plates may cause screw-bone interface weakening if the fusion has not been accomplished yet.

Authors should be congratulated for their effort in reviewing the usefulness of dynamic plate use in their paper ‘‘Dynamic cervical plate versus static cervical plate in the anterior cervical discectomy and fusion: a systematic review’’ [1], and the contribution in the conclusion of ‘‘similar clinical results with fewer hardware complications for one-level and better similar results for multiple level ACDF’’ is quite clarifying; nevertheless, we would like to point out some issues. The main limitation of the study is the global approach of considering all types of dynamic plates as working identically; no distinction is made among several types of dynamic plates mentioned in the papers (CTEK in Nunleýs [2], Atlantis in DuBois’ [3], and ABC in Pitzens [4]); they are different not only from static plates but also among them, depending on the dynamism based on either rotational (Atlantis) or translational = axial (uni -DOCor bidirectional -ABC-, the latter also has some degree of combined dynamism). This is important because, of the three RCT studies for two-level ACDF, while one study shows no difference in clinical outcome or fusion speed with rotational type (Atlantis, unidirectional) [3], contrarily others favor dynamic for both C-TEK (better clinical outcomes for multilevel ACCF even with higher nonunion rate which—as stated in the paper—may be the consequence of the increased motion and toggling at the graft–bone interface) [2], or ABC (faster fusion, including not only two but also at one level, with fewer hardware complications, which is the reason for progression in the plate design) [4]; on the other hand, even dynamic plates obtain same or superior fusion results with fibular allograft compared to using autologous crest plus static [5]. So the affirmation that ‘‘whether the dynamic plate is advantageous over the static plate in multilevel ACDF is still debated’’ has no longer enough strength, and dynamic (translational) plates should be considered superior not only biomechanically but also in the clinical arena even for one-level ACDF, as the hardware failure rate was higher in ACDF with static plates.

We read, ‘‘Systematic review of the effect of dynamic fixation systems compared with rigid fixation in the anterior cervical spine’’ by Campos RR, Botelho RV [1], who should be congratulated for their literature review; nevertheless, we would like to point out several issues. The worse fear about using dynamic plates would be the clinical impact of lordosis loss; as shown by Ghahreman and colleagues who analyzed ABC use [2], even though there is a partial loss (around 50 %) of gained lordosis after surgery, there is still a global lordotic gain, which may explain why changes in cervical angles do not affect clinical outcome in the study. The second fear is about adjacent segment irritation and subsequent early degeneration (which may just happen because of the surgery itself) as with axial dynamic plates there may be plate invasion of the disc space (not any longer with modern designs), which seems to be caused mainly because of surgical technique, and as such can be prevented when using the DOC plate by turning it [3], and when using the ABC the screws should be placed as far as possible from the adjacent level. Once addressed these two issues, the main criticism about the review is the global approach of considering all types of dynamic plates as working identically: no distinction is made among several types of dynamic plates, as they are different not only from static plates but also among them, depending on the dynamism based on rotational or axial (uni-DOCor bilateral-ABC)—the latter also has a combined dynamism. This is important because of the three RCT studies for two level ACDF, while one study shows no difference in clinical outcome or fusion speed of static (CSLP) against rotational (Atlantis) or unidirectional axialangular dynamic plate (Premier), others favor dynamic both with C-TEK [4] (better clinical outcomes) and ABC [2] (faster fusion, including not only two but also at onelevel); further more, even dynamic plates obtain same or superior fusion results with fibular allograft compared to with autologous crest plus static [4]. Finally, the best way of assessing usefulness may be to examine complications—particularly those requiring reoperation—decrease, which should be looked at more carefully as this could be one of the mainstones for advising the use of dynamic plates; translational plates seem to decrease the rate of pseudoarthroses [3, 4].