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Introducción: La ciudad de Xalapa, Veracruz, enfrenta un problema de abastecimiento de agua potable que incrementa cada año debido, entre otros factores, a la deforestación y al incremento poblacional.Objetivo: Determinar la disposición a pagar (DAP) de los usuarios de agua de uso doméstico para la conservación de bosques, considerando las zonas de recarga de la subcuenca Pixquiac.Materiales y métodos: Se diseñó y aplicó aleatoriamente una encuesta estructurada a una muestra representativa de 113 hogares en Xalapa. La información se analizó a través de un modelo econométrico que identificó los principales aspectos sociales, económicos y ambientales, relacionados con la DAP por el servicio hidrológico de uso doméstico.Resultados y discusión: El potencial de la DAP anual asciende a 17 243 032.08 MXN por parte de usuarios del servicio de agua potable a nivel doméstico en Xalapa, Veracruz; 92.04 % de la población tiene una DAP mensual promedio de 10.23 MXN para la conservación de las áreas forestales. Este valor se considera alto en relación con otros estudios cuyo promedio de aportación por persona oscila en 5.00 MXN y puede deberse al alto nivel de concientización que existe en la región sobre la importancia de los bosques. El ingreso, la fuente de ingresos, el nivel educativo y la edad son variables significativas que se relacionan positivamente con la DAP.Conclusión: Existe la DAP por parte de los usuarios que puede aprovecharse para incentivar la conservación forestal en las zonas de recarga de agua en el área de estudio

Background In recent years, evidence shows that long non-coding RNAs (lncRNAs) are key regulators of gene transcription and play important roles in the pathogenesis of inflammatory bowel diseases. LncRNA are involved in regulation of intestinal epithelial cell apoptosis, cell-cell interactions, enhancing inflammation, among others. Biological therapies, which are considered the most potent for disease control, only benefit one-third of patients. For this reason, a deeper understanding regarding the mechanisms by which biological drugs elicit their effect on intestinal mucosal is needed. Hence, we aimed to unravel the ex vivo modulator effect of infliximab on the lncRNAs expression in intestinal biopsies from patients with Crohn′s Disease (CD). Methods We performed an unbiased transcriptomic analysis of intestinal biopsies from the ileum and colon from 30 patients [active CD = 10, quiescent CD = 10, healthy controls (HC) = 10] to identify lncRNA differentially expressed in the setting of infliximab modulation (Figure 1). Endoscopic biopsies were cultured with or without infliximab, and the transcriptome was determined by stranded total-RNAseq (reagents from Illumina Inc.). We used different databases (Ensembl Biomart, RNAcentral and ToppGene) to search for non-annotated lncRNA information and data on the location (cellular component), biological process and molecular function of differentially expressed lncRNAs. Results Transcriptomic results revealed a widespread dysregulation of lncRNAs in ileum biopsies from patients with active CD, quiescent CD and HC compared to the colon at baseline and after infliximab culture (Figure 2). These differentially expressed lncRNAs were enriched in such pathways as proliferation, apoptosis, migration, inflammatory response of fibroblasts, response to wounding, posttranscriptional regulation of inflammatory genes and activation of the mitogen-activated protein kinase signaling pathways. Regarding the effect of infliximab according to intestinal location, presence of disease and activity, no significant lncRNAs were identified in the different study comparatives. Conclusion We have characterized the basal transcriptomic landscape of lncRNAs in patients with CD (active and quiescent) and HC both in ileum and left colon. However, we have not found differential lncRNA expression due to the effect of infliximab, suggesting that the location (ileum or colon) is more relevant when analyzing differences in lncRNA expression in the intestinal tissue.

Context: Cardiovascular disease (CVD) is one of the leading causes of morbidity and premature mortality across Spain. According to the World Health Organization (WHO), 80% of these premature deaths are preventable by controlling cardiovascular risk factors. Community pharmacists (CPs) are well situated to provide professional educational advice and implement interventions for the reduction of CVD. Aims: To analyze the impact of community pharmacists’ interventions on cardiovascular risk factors and CVD prevention in Spain. Methods: Two independent reviewers searched PubMed/MEDLINE; SCOPUS; Cochrane Central Register of Controlled Trials (CENTRAL); EMBASE; National Regional Database (LILACS BIREME); CINAHL; Pharm-line; ClinicalTrials.gov; ISRCTN; DOAJ (Directory of Open Access Journals), International Pharmaceutical Abstracts (IPA), the Spanish National Research Council (CSIC), WHO ICTRP, SCIELO and opengrey.eu and Google Scholar and considered research published between January 2000 and August 2020. The Cochrane risk of bias (RoB2) and ROBINS-I tools were used to evaluate the randomised/quasi-randomised controlled trials and the nonrandomised studies of interventions (NRSI), respectively. Results: The database search resulted in 457 items from which fourteen met our inclusion criteria. A total of 4,250 participants, aged 18 to 85, were included in the pharmacists’ interventions offered in the form of medication reconciliation and patient education. Studies showed a beneficial effect of CPs intervention on medication reconciliation and the control of hypertension, dyslipidaemias, obesity, and diabetes. However, evidence on smoking cessation and alcohol advice services is meager. Conclusions: This study suggests that community pharmacist counselling and personalized intervention could contribute to improving cardiovascular outcomes in Spain.

Anxiety disorders are the most frequent type of mental disorder. Threat-conditioning memory plays a central role in anxiety disorders, impacting complex cognitive systems by modifying behavioral responses to fearful stimuli and inducing an overestimation of potential threats. Here, we analyzed the reminder-dependent amnesia on physiological responses, unconditioned stimulus (US) expectancy ratings, and measures of cognitive bias towards the threat of a threat-conditioning memory. Subjects received differential threat-conditioning. Twenty-four hours later, after reactivation of the memory of threat-conditioning, one group performed a high demand working memory task (HWM) and a second group a low demand working memory task (LWM). A third group only performed the HWM task. Retention of conditioned threat memory was tested on Day 3 in an extinction session followed by a reinstatement test. Tasks targeting stimulus representation, valuation, and attentional bias towards threat were performed. We show that the reminder-dependent intervention with an HWM weakened memory retention as expressed in skin conductance response (SCR) and faded the representation and valuation towards the threat, but it did not affect US expectancy or attentional bias. Our findings provide evidence for the experimental psychopathology approach opening the possibility to weaken both Threat conditioning memory and the systems associated with the maintenance of anxiety features.

Aim Describe the use of botulinum toxin A (BT) and preoperative progressive pneumoperitoneum (PPP) in a loss of domain inguinoscrotal hernia following our hospital's protocol. Material and methods Single case report of a 60-year-old male, with loss of domain bilateral inguinoscrotal hernia. We performed prehabilitation with respiratory physiotherapy (RP), BT and PPP. We applied BT 30 days before surgery, injecting a total of 500U in 12 sites of abdominal wall: 4 in the lateral abdominal muscle and 2 of them in each rectus abdominis. We calculated, using the Tanaka index, the ratio between the abdominal cavity volume (ACV) and the hernia volume (HV), which was 32%, as well as the amount of pneumoperitoneum to insufflate, which according to our protocol is HV x3 + 100cc. The PPP catheter was placed 10 days before repair, insufflating a total of 6.900cc within seven consecutive days of catheter placement. Results With the application of prehabilitation (BT, RP, PPP) we achieve a lengthening of 18.5 cm and a decrease of 27 mm of the thickness as well as an increase in the volume of the abdominal cavity of×4.200cc. Afterwards, a hernioplasty with Stoppa and bilateral Litchenstein technique was performed. as well as a scrotoplasty and circumcision for the patient's phimosis in collaboration with Plastic and Urology services. The surgical procedure was performed without complications. After 7 months there is no hernia recurrence. Conclusions BT and PPP help to repair the inguinoscrotal hernia, avoiding the mayor surgical techniques like component separation diminishing morbidity.

Translation initiation defines the identity and quantity of a synthesized protein. The process is dysregulated in many human diseases1,2. A key commitment step is when the ribosomal subunits join at a translation start site on a messenger RNA to form a functional ribosome. Here, we combined single-molecule spectroscopy and structural methods using an in vitro reconstituted system to examine how the human ribosomal subunits join. Single-molecule fluorescence revealed when theuniversally conserved eukaryotic initiation factors eIF1A and eIF5B associate with and depart from initiation complexes. Guided by single-molecule dynamics, we visualized initiation complexes that contained both eIF1A and eIF5B using single-particle cryo-electron microscopy. The resulting structure revealed how eukaryote-specific contacts between the two proteins remodel the initiation complex to orient the initiator aminoacyl-tRNA in a conformation compatible with ribosomal subunit joining. Collectively, our findings provide a quantitative and architectural framework for the molecular choreography orchestrated by eIF1A and eIF5B during translation initiation in humans.

Development of obesity and its comorbidities is not only the result of excess energy intake, but also of dietary composition. Understanding how hypothalamic metabolic circuits interpret nutritional signals is fundamental to advance towards effective dietary interventions.We aimed to determine the metabolic response to diets enriched in specific fatty acids.Male mice received a diet enriched in unsaturated fatty acids (UOLF) or saturated fatty acids (SOLF) for 8 weeks.UOLF and SOLF mice gained more weight and adiposity, but with no difference between these two groups. Circulating leptin levels increased on both fatty acid-enriched diet, but were higher in UOLF mice, as were leptin mRNA levels in visceral adipose tissue. In contrast, serum non-esterified fatty acid levels only rose in SOLF mice. Hypothalamic mRNA levels of NPY decreased and of POMC increased in both UOLF and SOLF mice, but only SOLF mice showed signs of hypothalamic astrogliosis and affectation of central fatty acid metabolism. Exogenous leptin activated STAT3 in the hypothalamus of all groups, but the activation of AKT and mTOR and the decrease in AMPK activation in observed in controls and UOLF mice was not found in SOLF mice.Diets rich in fatty acids increase body weight and adiposity even if energy intake is not increased, while increased intake of saturated and unsaturated fatty acids differentially modify metabolic parameters that could underlie more long-term comorbidities. Thus, more understanding of how specific nutrients affect metabolism, weight gain, and obesity associated complications is necessary.

Resumen Antecedentes y objetivo El melanoma uveal es el tumor primario maligno intraocular mas frecuente en la poblacion adulta, con una tasa de supervivencia del 50% a pesar de los avances en el tratamiento y conocimiento de esta enfermedad. La presencia de extension extraocular (EE) empeora el pronostico de estos pacientes, por lo que su correcta identificacion puede asegurar su manejo e intervencion temprana. La ecografia oftalmologica es la tecnica de eleccion para el diagnostico y seguimiento de estos pacientes, tanto de la EE anterior mediante biomicroscopia ultrasonica (UBM), como de la EE posterior mediante ecografia A y B. El objetivo de este estudio es describir las caracteristicas ecograficas de la UBM y de la ecografia A y B. Material y metodos Se realiza un estudio descriptivo y retrospectivo de los pacientes diagnosticados de melanoma uveal (UM) y EE desde 2003 hasta 2019. Las caracteristicas ecograficas de la enfermedad local y el seguimiento luego del tratamiento se registraron de manera completa y en cada visita. En caso de EE anteriores se realizaron fotografias de segmento anterior y BMU, por el contrario las que involucran el segmento posterior se exploraron bajo ecografia modo A y B. Todos los ojos enucleados se enviaron para su estudio anatomopatologico. Resultados Se incluyeron 10 pacientes con una edad media de 72,3 anos. La mayor proporcion de ellos eran tumores de tamano medio, seguidos de los grandes y pequenos. La morfologia mas frecuente del tumor primario fue la cupuliforme. Todos los EE presentaban una reflectividad interna inferior a la del tumor primario. No se encontraron puentes de conexion transescleral entre el tumor primario y el EE en los estudios ecograficos. El 50% de los pacientes fueron sometidos a enucleacion primaria en el momento del diagnostico del MU intraocular debido a la presencia de la EE, y el 50% restante presento la EE tras el tratamiento inicial del tumor primario con braquiterapia I125. El 60% de los pacientes presentaron EE posterior, por lo que fueron diagnosticados con ecografia A y B. El patron histopatologico mas frecuente con el 87,5% de los pacientes fue el patron epitelioide. Discusion La ecografia en pacientes con MU es obligatoria para el diagnostico y seguimiento de la EE. La BMU y la ecografia A y B son las pruebas de eleccion para las EE anteriores y posteriores, respectivamente. Las EE tienen caracteristicas ecograficas particulares como la baja reflectividad interna, la regularidad de su contorno y su localizacion generalmente adyacente a la base del tumor intraocular primario.

Uveal melanoma is the most common primary malignant intraocular tumour in the adult population, with a survival rate of 50% despite advances in treatment and knowledge of this disease. The presence of extraocular extension (EE) worsens the prognosis of these patients, so its proper identification can ensure its management and early intervention. Ophthalmological ultrasound is the technique of choice for the diagnosis and follow-up of these patients, both of the anterior EE using ultrasonic biomicroscopy (UBM), and the posterior EE using A and B ultrasound. The aim of this study is to describe the ultrasound characteristics of the BMU and the A and B ultrasound.A descriptive and retrospective study is carried out on patients diagnosed with uveal melanoma (UM) and EE from 2003 to 2019. The ultrasound characteristics of the local disease and the follow-up after treatment were recorded completely and at each visit. In the case of anterior EE, photographs of the anterior segment and UBM were taken, while those involving the posterior segment were explored under A and B mode ultrasound. All enucleated eyes were sent for anatomopathological study.Ten patients with an average age of 72.3 years were included. The largest proportion of them were medium-sized tumours, followed by large and small ones. The most frequent morphology of the primary tumour was cupuliform. All the EE presented lower internal reflectivity compared to the primary tumour. No trans-scleral connection bridges were found between the primary tumour and the EE in the ultrasound studies. 50% of patients underwent primary enucleation at the time of diagnosis of intraocular MU due to the presence of the EE, and the remaining 50% presented the EE after initial treatment of the primary tumour with I125 brachytherapy. Sixty percent of the patients presented with posterior EE, and were therefore diagnosed with ultrasound A and B. The most frequent histopathological pattern with 87.5% of patients was the epithelioid pattern.Ultrasound scanning in patients with MU is mandatory for diagnosis and follow-up of EE. BMU and A and B ultrasound are the test of choice for anterior and posterior EE, respectively. EE have particular ultrasound characteristics such as low internal reflectivity, regularity of their contour and their location usually adjacent to the base of the primary intraocular tumor.

Resumen: Antecedentes: Revisión retrospectiva de pacientes con diagnóstico de síndrome del túnel del tarso (STT) tratados quirúrgicamente. Método: Serie retrospectiva de pacientes con diagnóstico de STT operados entre los años 2005 y 2020 en un mismo centro. Se analizan variables como edad, género, lado, nervio o rama afectada, clasificación, tipo de estudio imagenológico, resultado biopsia, tasa de infección, tasa recurrencia, secuelas, entre otras. Resultados: Se incluyen ocho hombres y dos mujeres con edad promedio de 47 años (rango 34-67) y seguimiento promedio de 62,2 meses (rango 2-149). Todos los casos se relacionan con una compresión intrínseca. La causa más frecuente fue la presencia de quiste (40%), seguida de adherencias perineurales (20%). El nervio tibial posterior fue el más afectado (50%) y 30% la rama plantar medial. La ecografía (70%) y resonancia magnética (50%) fueron los estudios más solicitados. No hubo casos de infección postoperatoria. Hubo tres pacientes que presentaron recurrencia de la lesión requiriendo una nueva cirugía. Conclusiones: El STT es una neuropatía que compromete al nervio tibial posterior o a algunas de sus ramas. En general su causa es la compresión del nervio por distintas estructuras como músculos accesorios, gangliones, entre otras. El diagnóstico es eminentemente clínico apoyándose en estudio por imágenes. El tratamiento quirúrgico presenta mejores resultados cuando la causa es una compresión intrínseca, aunque se describen tasas variables de recurrencia. Abstract: Background: Retrospective review of patients with a diagnosis of Tarsal Tunnel Syndrome (TTS) treated surgically. Methods: Retrospective series of patients with diagnosis of TTS operated between 2005 and 2020 in the same center. Variables such as age, sex, side, affected nerve or branch, classification, type of imaging study, biopsy result, infection rate, recurrence rate, sequelae, among others, were analyzed. Results: We included 8 men and 2 women with an average age of 47 years (range 34-67) and an average follow-up of 62.2 months (range 2-149). All cases were related to intrinsic compression. The most frequent cause was the presence of cyst (40%) followed by perineural adhesions (20%). The Posterior Tibial Nerve was the most affected (50%) and 30% the Medial Plantar Branch. Ultrasound (70%) and MRI (50%) were the most requested studies. There were no cases of postoperative infection. There were 3 patients who presented recurrence of the lesion requiring a new surgery. Conclusions: TTS is a neuropathy involving the posterior tibial nerve or some of its branches. In general, it is caused by compression of the nerve by different structures such as accessory muscles and ganglions, among others. The diagnosis is eminently clinical, supported by imaging studies. Surgical treatment presents better results when the cause is an intrinsic compression, although variable recurrence rates are described.

Sulfidic mine wastes have the potential to generate acid mine drainage (AMD) and release acid leachates containing high levels of iron, sulfate and potentially toxic elements (PTEs). Soils receiving AMD discharges are generally devoid of vegetation. Only a few metal-tolerant plant species can survive under such adverse soil conditions. This work investigates two plant species, Nicotiana glauca and Euphorbia segetalis, that have successfully colonized an AMD-impacted wetland area in south-western Spain. The uptake of PTEs from the soil by roots and their transfer and accumulation in the above-ground biomass were quantified. Results showed that these pioneer plants grew in patches of neutral soil within the wasteland despite the high concentrations of PTEs in the rhizosphere soil (up to: 613 mg kg-1 As, 18.7 mg kg-1 Cd, 6370 mg kg-1 Cu, 2210 mg kg-1 Pb and 5250 mg kg-1 Zn). The target organs of As, Cu and Pb accumulation were: root > leaf > stem in N. glauca, and root > stem > leaf in E. segetalis. Zinc and Cd showed a significant decrease in roots relative to aerial parts of N. glauca, and Co was preferentially partitioned in stems of N. glauca and leaves of E. segetalis. The soil-plant transfer coefficient values of PTEs in all parts of both plants were well below unity with the only exception of Cd in leaves of N. glauca (1.254), suggesting that roots acted as a barrier limiting the uptake of PTEs by plants. Interestingly, under the same soil conditions, N. glauca absorbed Cd in considerable proportions from soil and accumulated it in its leaves, while E. segetalis was not effective in transferring PTEs from roots shoots except for Co. In conclusion, soil pH and plant-related factors greatly influence the stabilization of PTE in the rhizospheric soil and produce inconsistencies in PTE phytoavailability. The findings of this study provide criteria to assist in natural remediation in other legacy contaminated sites worldwide., Funding for open access publishing: Universidad de Sevilla/CBUA. This research was partially supported by the Regional Government of Andalusia (Spain) and the European Regional Development Fund Andalusia 2014–2020 through the Project P-18-TP-3503.

The analysis of the topography of brain neuromodulation following transcranial alternating current (AC) stimulation is relevant for defining strategies directed to specific nuclei stimulation in patients. Among the different procedures of AC stimulation, temporal interference (tTIS) is a novel method for non-invasive neuromodulation of specific deep brain targets. However, little information is currently available about its tissue effects and its activation topography in in vivo animal models. After a single session (30 min, 0.12 mA) of transcranial alternate current (2,000 Hz; ES/AC group) or tTIS (2,000/2,010 Hz; Es/tTIS group) stimulation, rat brains were explored by whole-brain mapping analysis of c-Fos immunostained serial sections. For this analysis, we used two mapping methods, namely density-to-color processed channels (independent component analysis (ICA) and graphical representation (MATLAB) of morphometrical and densitometrical values obtained by density threshold segmentation. In addition, to assess tissue effects, alternate serial sections were stained for glial fibrillary acidic protein (GFAP), ionized calcium-binding adapter molecule 1 (Iba1), and Nissl. AC stimulation induced a mild superficial increase in c-Fos immunoreactivity. However, tTIS stimulation globally decreased the number of c-Fos-positive neurons and increased blood brain barrier cell immunoreactivity. tTIS also had a stronger effect around the electrode placement area and preserved neuronal activation better in restricted areas of the deep brain (directional stimulation). The enhanced activation of intramural blood vessels’ cells and perivascular astrocytes suggests that low-frequency interference (10 Hz) may also have a trophic effect.

This material can be considered to be an interesting eco-friendly choice to be used in the photovoltaic field. In this work, we present the fabrication of Cu3N thin films by reactive radio-frequency (RF) magnetron sputtering at room temperature, using nitrogen as the process gas. Different RF power values ranged from 25 to 200 W and gas pressures of 3.5 and 5 Pa were tested to determine their impact on the film properties. The morphology and structure were exhaustively examined by Atomic Force Microscopy (AFM), Fourier Transform Infrared (FTIR) and Raman Spectroscopies and X-ray Diffraction (XRD), respectively. The AFM micrographs revealed different morphologies depending on the total pressure used, and rougher surfaces when the films were deposited at the lowest pressure; whereas FTIR and Raman spectra exhibited the characteristics bands related to the Cu-N bonds of Cu3N. Such bands became narrower as the RF power increased. XRD patterns showed the (100) plane as the preferred orientation, that changed to (111) with the RF power, revealing a worsening in structural quality. Finally, the band gap energy was estimated from transmission spectra carried out with a Perkin Elmer 1050 spectrophotometer to evaluate the suitability of Cu3N as a light absorber. The values obtained demonstrated the capability of Cu3N for solar energy conversion applications, indicating a better film performance under the sputtering conditions 5.0 Pa and RF power values ranged from 50 to 100 W.

It has been proposed that oxidative stress is a pathogenic mechanism to induce cytotoxicity and to cause cardiovascular and neuronal diseases. At present, natural compounds such as plant extracts have been used to reduce the cytotoxic effects produced by agents that induce oxidative stress. Our study aimed to evaluate the antioxidant and cytoprotective capacity of Desmodium tortuosum (D. tortuosum) extract in the co- and pre-treatment in EA.hy926 and SH-SY5Y cell lines subjected to oxidative stress induced by tert-butylhydroperoxide (t-BOOH). Cell viability, reactive oxygen species (ROS), nitric oxide (NO), caspase 3/7 activity, reduced glutathione (GSH), glutathione peroxidase (GPx), glutathione reductase (GR), and molecular expression of oxidative stress biomarkers (SOD2, NRF2 and NFκB1) and cell death (APAF1, BAX, Caspase3) were all evaluated. It was observed that the D. tortuosum extract, in a dose-dependent manner, was able to reduce the oxidative and cytotoxicity effects induced by t-BOOH, even normalized to a dose of 200 µg/mL, which would be due to the high content of phenolic compounds mainly phenolic acids, flavonoids, carotenoids and other antioxidant compounds. Finally, these results are indicators that the extract of D. tortuosum could be a natural alternative against the cytotoxic exposure to stressful and cytotoxic chemical agents.

The present study analyses the effect of a beverage composed of citrus and maqui (Aristotelia chilensis) with different sweeteners on male and female consumers. Beverages were designed and tested (140 volunteers) as a source of polyphenols, in a previous work. Plasma samples were taken before and after two months of daily intake. Samples were measured for bioactive-compound levels with metabolomics techniques, and the resulting data were analysed with advanced versions of ANOVA and clustering analysis, to describe the effects of sex and sweetener factors on bioactive compounds. To improve the results, machine learning techniques were applied to perform feature selection and data imputation. The results reflect a series of compounds which are more regulated for men, such as caffeic acid or 3,4-dihydroxyphenylacetic acid, and for women, trans ferulic acid (TFA) or naringenin glucuronide. Regulations are also observed with sweeteners, such as TFA with stevia in women, or vanillic acid with sucrose in men. These results show that there is a differential regulation of these two families of polyphenols by sex, and that this is influenced by sweeteners.

Introduction The age adjusted Charlson Comorbidity Index (aCCI) is the most widely used prognostic tool in patients with comorbidity. Our aim is to evaluate its relationship with postoperative morbidity and mortality. Methods Retrospective observational analysis of 145 patients >80 years with CRC operated upon between 2018–2020 in a tertiary center with 2-year follow-up. Pre- and postoperative variables such as aCCI, tumor stage and location, Clavien-Dindo and 2-year survival were selected. Survival analysis was performed according to Kaplan-Meier and ROC curves to predict postoperative mortality/complications. To determine association, a Cox univariate regression model was used. Results The mean age was 86 years, the right colon was the most frequent tumor location and laparoscopy was the predominant approach. Only 12.4% presented major complications (Clavien-Dindo >=3). There was no statistically significant association between aCCI and surgical complications HR 1.118 (p 0.095), and there was a relationship with the development of medical complications OR 1.28 (p 0.020) with a sensitivity of 71% and a cut-off point of aCCI 7.5 AUC 0. 637. Overall survival at 2 years was 79% (26 deaths). We did not find a statistically significant association between aCCI and mortality (p 0.286), a weak predictor AUC 0.582. Conclusions Elevated aCCI is not related to a higher risk of postoperative morbidity and mortality and has little predictive capacity for surgical complications; however, aCCI >7 is associated with a higher probability of medical complications. Prospective studies are needed to include multivariable analyses associated with aCCI.

The present work analyzes the effect of different Zr contents on the microstructure and thermal behavior of non-irradiated UO2. A set of Zr-doped UO2 (0, 20, 40, 80, and 100 wt%) pellets was prepared via solid-state synthesis by mimicking the chemical bonding between ZrO2 and UO2. After sintering, the Zr-doped UO2 monoliths were characterized by scanning electron microscopy, Raman spectroscopy, and X-ray diffraction. Oxidation of the Zr-doped UO2 samples has been monitored by thermogravimetric analysis. Results of thermal behavior under air and low oxygen partial pressure show a profound effect of delayed oxidation with the addition of Zr to UO2 and then an increased oxidation resistance of UO2 to U3O8 when compared to pure UO2 pellet. Graphical abstract

Objective The “Open Lung Approach” (OLA), that includes high levels of positive end-expiratory pressure coupled with limited tidal volumes, is considered optimal for adult patients with ARDS. However, many previous meta-analyses have shown only marginal benefits of OLA on mortality but with statistical heterogeneity. It is crucial to identify the most likely moderators of this effect. To determine the effect of OLA strategy on mortality of ventilated ARDS patients. We hypothesized that the degree of recruitment achieved in the control group (PaO2/FiO2 ratio on day 3 of ventilation), and the difference in Mechanical Power (MP) or Driving Pressure (DP) between experimental and control groups will be the most likely sources of heterogeneity. Design A Systematic Review and Meta-analysis was performed according to PRISMA statement and registered in PROSPERO database. We searched only for randomized controlled trials (RCTs). GRADE guidelines were used for rating the quality of evidence. Publication bias was assessed. For the Meta-analysis, we used a Random Effects Model. Sources of heterogeneity were explored with Meta-Regression, using a priori proposed set of possible moderators. For model comparison, Akaike's Information Criterion with the finite sample correction (AICc) was used. Setting Not applicable. Patients Fourteen RCTs were included in the study. Interventions Not applicable. Main variables of interest Not applicable. Results Evidence of publication bias was detected, and quality of evidence was downgraded. Pooled analysis did not show a significant difference in the 28-day mortality between OLA strategy and control groups. Overall risk of bias was low. The analysis detected statistical heterogeneity. The two “best” explicative meta-regression models were those that used control PaO2/FiO2 on day 3 and difference in MP between experimental and control groups. The DP and MP models were highly correlated. Conclusions There is no clear benefit of OLA strategy on mortality of ARDS patients, with significant heterogeneity among RCTs. Mortality effect of OLA is mediated by lung recruitment and mechanical power.

Resumen Objetivos El cuestionario Migraine Disability Assessment (MIDAS) es el instrumento mas empleado para valorar el grado de discapacidad en los estudios de migrana. El objetivo del estudio es determinar el nivel de cumplimentacion del cuestionario, valorar su facilidad de uso y conocer la percepcion subjetiva del paciente sobre la capacidad del cuestionario para medir realmente su discapacidad. Material y metodos Estudio prospectivo sobre una poblacion de 78 pacientes con migrana cronica. Se determina el nivel educativo y la situacion laboral. En la visita basal se adiestra a los pacientes sobre la correcta cumplimentacion del cuestionario. A los 3 meses se determina la puntuacion total y el nivel de cumplimentacion. Ademas los pacientes contestan una encuesta que mide: facilidad de uso y percepcion del paciente sobre si la escala refleja su propia discapacidad. Resultados Solo el 46% rellena completamente el cuestionario. El 69% de los pacientes indica que el cuestionario no les resulta facil de cumplimentar (resultado no influido por el nivel educativo, pero si por la situacion laboral de los pacientes). El 62% de los encuestados opina que el cuestionario no refleja completamente su propia percepcion de discapacidad. Conclusiones Aunque esta mas que demostrada la validez y consistencia del cuestionario MIDAS, un porcentaje elevado de nuestra poblacion reconoce que el cuestionario no es facil de rellenar y ademas es percibido por muchos de nuestros pacientes como un cuestionario que no refleja adecuadamente su discapacidad. Conocer la opinion de los pacientes sobre la idoneidad de los cuestionarios administrados en las consultas es crucial para mejorar su cumplimentacion.

Arterial stiffness is a major vascular complication of chronic kidney disease (CKD). The development of renal damage, hypertension, and increased pulse wave velocity (PWV) in CKD might be associated with an imbalance in bone morphogenetic proteins (BMP)-2 and BMP-7. Plasma BMP-2 and BMP-7 were determined by ELISA in CKD patients (stages I–III; n = 95) and Munich Wistar Frömter (MWF) rats. Age-matched Wistar rats were used as a control. The expression of BMP-2, BMP-7, and profibrotic and calcification factors was determined in kidney and perivascular adipose tissues (PVAT). BMP-2 was higher in stage III CKD patients compared to control subjects. BMP-7 was lower at any CKD stage compared to controls, with a significant further reduction in stage III patients. A similar imbalance was observed in MWF rats together with the increase in systolic (SBP) and diastolic blood pressure (DBP), or pulse wave velocity (PWV). MWF exhibited elevated urinary albumin excretion (UAE) and renal expression of BMP-2 or kidney damage markers, Kim-1 and Ngal, whereas renal BMP-7 was significantly lower than in Wistar rats. SBP, DBP, PWV, UAE, and plasma creatinine positively correlated with the plasma BMP-2/BMP-7 ratio. Periaortic and mesenteric PVAT from MWF rats showed an increased expression of BMP-2 and profibrotic and calcification markers compared to Wistar rats, together with a reduced BMP-7 expression. BMP-2 and BMP-7 imbalance in plasma, kidney, and PVATs is associated with vascular damage, suggesting a profibrotic/pro-calcifying propensity associated with progressive CKD. Thus, their combined analysis stratified by CKD stages might be of clinical interest to provide information about the degree of renal and vascular damage in CKD.

La fertilidad del suelo es la capacidad más importante en la nutrición de las plantas y su variabilidad espacial puede determinarse mediante técnicas geoestadísticas que permiten mapear y delimitar áreas de manejo. Una de las ventajas importantes de los sistemas de información geográf ica (SIG) es el análisis espacial, en particular el uso de las interpolaciones de diferentes variables físicas químicas del suelo. El objetivo del trabajo fue analizar la fertilidad del suelo en la comunidad de Santo Domingo, Huasca de Ocampo, Hidalgo; utilizando mapas temáticos creados por el método de interpolación Kriging ordinario y validados con las técnicas de validación en campo y cruzada para las variables de fertilidad del suelo: contenido de nutrientes N, P, K, Ca, Mg y Na, y las propiedades pH, CE, MO y CIC. La información estadística para las variables demostró ser uniforme y fácilmente predecible; a excepción del pH y MO donde se observa poca representatividad de la media asociadas a una variabilidad intrazonal. El modelo seleccionado para el ajuste del semivariograma experimental, que mejor ajustó al de las variables estudiadas, fue el modelo Gaussiano; a excepción de la variable CE la cual se ajustó al modelo esférico. Los resultados muestran suelos con pH

Food safety is a widespread challenge. Every year it is estimated that almost 1 in 10 people in the world fall ill after eating contaminated food resulting in over 400,000 deaths. The risk of outbreaks is higher when consuming ready-to-eat (RTE) products because they are eaten without a further cooking process that could inactivate pathogenic microorganisms. Hence, food processing is essential to increase the safety of RTE products. Microbiological risk assessment (MRA) integrates food science, microbiology and data science to provide a comprehensive understanding of the safety of the food system. MRA provides qualitative and/or quantitative information to decision makers, which might promote the adoption of better food practices. In this contest, this project aims to study and implement tools for quantitative microbial risk assessment (QMRA) of food products along the food chain. A common RTE product (cured ham) from Spain was used as a case study. Following, the exposure assessment model was implemented using mathematical models and statistical software to describe the microbial behaviour along the food chain. The study presents the possibility to identify the risk exposure in different scenarios (e.g. growth during different storage conditions, inactivation induced by traditional or innovative decontamination techniques), showing the flexibility of the predictive tools developed.

Background Crohn’s disease (CD) is characterized by severe transmural inflammation with subsequent destruction of the intestinal barrier. Bacterial infiltration across this leaky gut facilitates access to the mesenteric fat and the development of a subsequent inflammatory reaction in the surrounding adipose tissue named creeping fat (CF). Dysbiosis in CD patients has been associated with an increase in succinate-producing bacteria and a decrease in succinate-consuming bacteria. In fact, elevated succinate levels have been found in the intestine and feces of CD patients. Furthermore, succinate is an inductor of beige adipogenesis in white adipose tissue progenitors. Methods Visceral and subcutaneous adipose tissue biopsies (VAT and SAT), serum, and plasma were obtained from a cohort of active CD (n=20), inactive CD (n=12), and control group (n=15). From adipose tissue biopsies, adipose-derived stem cells (ASCs) and adipose tissue macrophages (ATMs) were isolated. Different experiments were performed such as protein uncoupling protein 1 (UCP1)-immunohistochemistry and immunofluorescence, gene expression studies, adipose tissue explants, proteomic analysis of ASCs, succinate determinations, bio-impedancemetry, and infrared photographs. Results Succinate treatment increased markers of beige adipose tissue in ASCs from controls and inactive CD patients (Fig. A). Surprisingly, the markers of beige adipose tissue were already high in ASCs isolated from active CD, due to being exposed to an environment with high levels of succinate in vivo. Proteomic analysis of isolated CD-ASCs revealed that these cells secrete beige adipose tissue-related proteins compared to Control-ASCs (Fig. B). Furthermore, bacterial translocation increases the conversion of pre-adipocytes from white to beige adipose tissue in CD individuals (Fig. C). Immunohistochemical study of UCP-1, confirms increased staining in adipose samples from CD patients from both depots (SAT and VAT) (Fig. D). Altogether, adipose tissue depots from CD patients had a conversion from white to beige adipose tissue with a high protein UCP1-gene expression. Thermic images show an increase of temperature in the intestinal area of active CD patients that is not observed in inactive CD patients or the control group. Conclusion Understanding the role of beige adipose tissue in CD could help develop new therapeutic or diagnostic strategies in these patients.

The aim of our study is to demonstrate that the Pfannenstiel incision is a reliable option in terms of postoperative complications compared to other types of incisions usually performed for kidney extraction after laparoscopic nephrectomy.Retrospective and comparative study of 256 patients who underwent laparoscopic nephrectomy or nephroureterectomy. Patients were divided into two groups: specimen extraction by Pfannenstiel incision (group 1) and specimen extraction by way of other incisions (group 2). Incisional hernia, surgical site infection, pain score, seroma, haematoma/bleeding, wound dehiscence and muscle paralysis were analyzed in each patient.Patients in Pfannenstiel group presented a rate of wound complications of 11.72% vs. 27.34% with other incisions, p=0.002, it was significantly inferior the rate of wound dehiscence (5.5% vs. 12.5%, p=0.047) and seroma (3.1% vs. 7.8%, p=0.022). Using multivariate logistic regression, Pfannenstiel incision was a significant protective predictor factor for wound complications (OR=0.34, p=0.005).The Pfannenstiel incision allowed the extraction of bigger kidney masses with less incidence of dehiscence, seroma and in general wound complications. The hospital stay was lower in Pfannenstiel extraction group. These results present this incision as a reliable and safe option in the decision of which incision to select.

The tempo and mode of colonization of the Iberian Peninsula (IP) by Cannabis sativa, its further internal spreading and the potential cultural and environmental factors involved remain unknown. The available continental-wide European meta-analyses using pollen and archaeological evidence account for only a few IP sites, insufficient for a sound assessment. This paper presents a nearly comprehensive database of almost 60 IP sites with palynological evidence of Cannabis and analyzes the corresponding spatiotemporal patterns. The first scattered records of this pollen type, likely corresponding to wild Cannabis, date from the Middle and Upper Paleolithic (150 to 12 ky BP) and would have entered the IP by maritime Mediterranean or terrestrial continental pathways, or both. A first burst of introductions, probably in a cultivated form, would have occurred during the Neolithic (7-5 ky BP) using similar paths. Human participation in this Neolithic acceleration remains unclear but cannot be dismissed. A period of reduced Cannabis arrivals (mostly via MP) occurred between the Chalcolithic and the Roman Epoch (4.5-2 ky BP), when the innermost parts of the IP were colonized (Late Bronze). A second, likely anthropogenic, introduction acceleration took place in the Middle Ages (1.5 ky BP onward) using the MP and CP. Maximum cultivation and hemp retting activity was recorded during the Modern Ages (16th-19th centuries), coinciding with the increased demand of hemp fiber to supply the Spanish royal navy for imperial expansion and commerce. A potential link between Cannabis colonization/introduction bursts and climatic warmings has been observed that should be tested with future studies. Regional moisture variations seem to be less influential. Further efforts to enhance and improve the database used in this study are encouraged. The results of this paper should be compared with archaeological and historical evidence to clarify the role of human migrations and cultural changes in the historical biogeography of Cannabis in the IP.

Funder: Gianna Angelopoulos Programme for Science, Technology and Innovation, Funder: Engineering and Physical Sciences Research Council, Funder: Stanford University, Funder: Rowland Institute at Harvard, Metal-halide perovskite nanocrystals have demonstrated excellent optoelectronic properties for light-emitting applications. Isovalent doping with various metals (M2+) can be used to tailor and enhance their light emission. Although crucial to maximize performance, an understanding of the universal working mechanism for such doping is still missing. Here, we directly compare the optical properties of nanocrystals containing the most commonly employed dopants, fabricated under identical synthesis conditions. We show for the first time unambiguously, and supported by first-principles calculations and molecular orbital theory, that element-unspecific symmetry-breaking rather than element-specific electronic effects dominate these properties under device-relevant conditions. The impact of most dopants on the perovskite electronic structure is predominantly based on local lattice periodicity breaking and resulting charge carrier localization, leading to enhanced radiative recombination, while dopant-specific hybridization effects play a secondary role. Our results suggest specific guidelines for selecting a dopant to maximize the performance of perovskite emitters in the desired optoelectronic devices.

Pt-based bimetallic electrocatalysts are promising candidates to convert surplus glycerol from the biodiesel industry to value-added chemicals and coproduce hydrogen. It is expected that the nature and content of the elements in the bimetallic catalyst can not only affect the reaction kinetics but also influence the product selectivity, providing a way to increase the yield of the desired products. Hence, in this work, we investigate the electrochemical oxidation of glycerol on a series of PtNi nanoparticles with increasing Ni content using a combination of physicochemical structural analysis, electrochemical measurements, operando spectroscopic techniques, and advanced product characterizations. With a moderate Ni content and a homogenously alloyed bimetallic Pt-Ni structure, the PtNi2 catalyst displayed the highest reaction activity among all materials studied in this work. In situ FTIR data show that PtNi2 can activate the glycerol molecule at a more negative potential (0.4

Children and adolescents in residential care often present with emotional and/or behavioral problems associated to previous adverse experiences such as abuse and neglect. Consequently, child welfare systems have developed therapeutic residential care (TRC) programs to address the most complex needs of this population. The aim of this study is to explore the characteristics of youths in TRC comparing them with those of youth in general residential care (GRC), and to detect the factors predicting referral to TRC programs. The sample consisted of 900 adolescents aged 12–17 years old (M = 15.57; SD = 1.33; 66.2% boys), from General Residential Care (n = 554) and Therapeutic Residential Care (n = 346). Profile information was collected through official files and an ad hoc questionnaire. Mental health problems were evaluated using the youth self-report (YSR). Significant sociodemographic differences were found between groups. Also, a higher frequency of emotional abuse and neglect, worse mental health, more breakdowns in child welfare measures and risk behaviors were found among adolescents in TRC. Sociodemographic and familial characteristics, features of the protective process and risk behaviors were associated to referral to TRC programs. Youths in GRC and TRC present with mental and behavioral problems that make it necessary to implement prevention programs and early detection procedures. Screening and evaluation of youth’s mental health and establishment of concrete criteria are suggested to ensure appropriate referral to the most suitable resource according to the individual needs of adolescents.

Obesity is considered a risk factor in severe cases of COVID-19, which has been analysed using body mass index (BMI), an estimator that does not correlate adequately with body fat (BF) percentage. The aim of this study was to analyse the population attributable fraction to BF in severe forms of COVID-19 based on BMI and CUN-BAE.Multicentre observational prevalence study. Sociodemographic information, personal history, BMI and CUN-BAE were collected in SARS-CoV-2 positive cases from the provinces of León and La Rioja. Logistic regression models were used to calculate odds ratios with their respective 95% confidence intervals adjusting for age and personal history, as well as the population attributable fraction to BF.Seven hundred eighty-five patients participated, 123 (15.7%) were severe. Age, obesity (both by BMI and CUN-BAE) and personal history were detected as risk factors. 51.6% of severe cases could be attributed to excess BMI and 61.4% to excess BF estimated according to CUN-BAE, with a higher underestimation of risk in women.Excess BF is a risk factor for severe forms of COVID-19 together with advanced age and the presence of cardiovascular, chronic respiratory or oncohematological diseases. BMI underestimates the risk especially in women, being CUN-BAE the predictor selected for its better estimation of the percentage of BF.

Vanishing bile duct syndrome is a rare paraneoplastic syndrome occasionally seen in pediatric Hodgkin lymphoma. It is usually regarded as a fatal disorder. Here, we present a case of vanishing bile duct syndrome cholestasis related to Hodgkin lymphoma that resolved after chemotherapy and radiation.

The evolution of Thalattosuchia documents the unique shift among Crocodylomorpha from aquatic continental/coastal habitats to a fully pelagic lifestyle. This transition was coupled with deep modification of their skeletons, such as hydrofoil forelimbs, hypocercal tail, and loss of osteoderms. The natural snout casts of the rhacheosaurin Cricosaurus araucanensis showed that it also included changes in the internal anatomy of the snout like the enlargement of nasal glands (probably for salt excretion) and the rearrangement of the paranasal sinus system, including the internalization of the antorbital sinus. Here we described the snout natural cast of the geosaurin Dakosaurus andiniensis from the Late Jurassic of Patagonia. The information provided by it indicates that, despite having different external morphologies and ecology, D. andiniensis and C. araucanensis share the same facial anatomy. The new cast preserves a suborbital diverticulum of the antorbital sinus protruding into the orbit through the postnasal fenestra. Its location indicates that it was interleaved with jaw adductor muscles suggesting an active airflow in the paranasal sinus. We provide a putative functional interpretation of this peculiar arrangement where bellow pumps actions of musculature may help drain salt glands. The rearrangement of the paranasal sinuses predates the transition to a completely pelagic-lifestyle. We proposed a stepwise evolutionary scenario of Thalattosuchia, implying changes in the preorbital region (and orbit orientation) where the internalized antorbital sinus via its subsidiary diverticulum was co-opted for helping nasal glands drainage. Further scrutiny of facial anatomy of a larger sample of thalattosuchians will help to test this hypothesis. Fil: Fernández, Marta S.. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Paleontología Vertebrados; Argentina Fil: Herrera, Laura Yanina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Paleontología Vertebrados; Argentina

espanolObjetivos. Argentina ha informado de altos niveles de farmacorresistencia transmitida (TDR), en mujeres embarazadas infectadas por el VIH por secuenciacion poblacional. Nuestro objetivo fue describir, en pacientes con TDR, el porcentaje de cuasiespecies que albergan mutaciones de resistencia (RAM) y la carga mutacional (ML). Pacientes y metodos. Estudio retrospectivo en una cohorte de 40 mujeres embarazadas VIH positivas naive, cuyas muestras pretratamiento habian sido genotipificadas por TRUGENE (periodo 2008-2014). Las muestras se genotipificaron por secuenciacion ultraprofunda y se calculo la ML considerando la carga viral multiplicada por la frecuencia de las cuasiespecies que albergan RAMs. Resultados. La TDR para ITINN, ITIAN e IP fue del 17,5% (n=7 pacientes), 10% (n=4), 12,5% (n=5) respectivamente. Las RAMs ITINN predominantes fueron K103N (n=4; 10%) y G190A/E/ S (n=3; 7,5%). Para los ITINN, el 78% de los RAM estaban presentes en >93,5% de la poblacion viral y la ML fue >1000 copias/ml (c/mL) para el 89%, con una mediana (IQR) de 8330 c/ml (7738-29796). Se describieron los siguientes RAM de ITIAN (% de cuasiespecies, ML): T215I (99,7%, 11014 c/ml); D67G (1,28%, 502 c/ml); M41L (79,8%, 88578 c/mL) y M184I (1,02%, 173 c/mL). Las IP-RAMs mas frecuentes fueron I85V, M46I, I50V y L90M (n=2, 5% cada una). Para los IP, las cuasiespecies con RAMs fueron Conclusion. Los ITINN-RAMs son predominantes dentro de la poblacion viral, por lo general superan el umbral de 1000 c/mL, que indicaria un riesgo potencial mas alto de transmision perinatal. Por el contrario, las mutaciones de IP aparecen principalmente como variantes minoritarias, con un riesgo menor de transmision. Para ITIAN, las cuasiespecies que albergan RAM y los valores de ML fueron variables. EnglishObjective. Argentina has reported high levels of transmitted drug resistance (TDR), in HIV-infected pregnant women by population sequencing. We aimed to describe, in patients with TDR, the percentage of quasispecies harboring resistance mutations (RAMs) and mutational load (ML). Patients and Methods. Retrospective study in a cohort of 40 naive HIV-infected pregnant women, whose pretreatment samples had been genotyped by TRUGENE (period 2008-2014). Samples were re-sequenced with Ultra-deep Sequencing and ML was calculated considering baseline HIV-1 RNA load multiplied by the frequency of quasispecies harboring RAMs. Results. TDR for NNRTIs, NRTIs and PIs was 17.5% (n=7 patients), 10% (n=4), 12.5% (n=5) respectively. Predominant NNRTI RAMs were K103N (n=4; 10%) and G190A/E/S (n=3; 7.5%). For NNRTIs, 78% of RAMs were present in >93.5% of viral population and ML was >1000 copies/mL (c/mL) for 89%, with a median (IQR) of 8330 c/ml (7738-29796). The following NRTI RAMs were described (per patient: % of quasispecies, ML): T215I (99.7%, 11014 c/ml); D67G (1.28%, 502 c/mL); M41L (79.8%, 88578 c/mL) and M184I (1.02%, 173 c/mL). Most frequent PI-RAMs were I85V, M46I, I50V and L90M (n=2, 5% each). For PIs, quasispecies with RAMs were Conclusion. NNRTI-RAMs are predominant within the viral population, usually exceeding the threshold of 1000 c/mL, indicating potential higher risk of perinatal transmission. Conversely, PI mutations appear mostly as minority variants, with potential lower risk of transmission. Among NRTI, quasispecies harboring RAMs and ML values were variable.