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BackgroundChagas cardiomyopathy (CHCM) is the most important clinical manifestation of Chagas disease. The analysis of cardiac miRNAs may contribute to predicting the progression to CHCM in Chagas indeterminate phase and/or to the differential diagnosis for cardiomyopathy.MethodsWe carried out a case-control study to identify circulating miRNAs associated with CHCM. We assigned 104 participants to four groups: healthy controls (HC), Chagas non-cardiomyopathy controls, CHCM cases, and ischemic cardiomyopathy controls. We performed a clinical, echocardiographic, and laboratory evaluation and profiled circulating miRNA in the serum samples.ResultsDifferences between groups were observed in clinical variables and in the analysis of miRNAs. Compared to HC, CHCM participants had 4 over-expressed and 6 under-expressed miRNAs; miR-95-3p and miR-130b-3p were upregulated in CHCM compared with controls, Chagas non-cardiomyopathy and ischemic cardiomyopathy participants, suggesting that might be a hallmark of CHCM. Analysis of gene targets associated with cardiac injury yielded results of genes involved in arrhythmia generation, cardiomegaly, and hypertrophy.ConclusionsOur data suggest that the expression of circulating miRNAs identified by deep sequencing in CHCM could be associated with different cardiac phenotypes in CHCM subjects, compared with Chagas non-CHCM, ischemic cardiomyopathy controls, and healthy controls.

Objective: To analyze the excipients and impurities contained in the various docetaxel products available on the market and find out whether they may be responsible for any of the different adverse events associated with the use of docetaxel in patients with breast cancer receiving adjuvant or neoadjuvant treatment. Method: This is a prospective, multicenter, longitudinal observational, study carried in 26 hospitals in Madrid, Catalonia, Andalusia, and the Valencia Region. The different docetaxel formulations were characterized in terms of their pH, amount of The active ingredient and impurities. The cumulative incidence of adverse events of any grade was evaluated. Adverse events were stratified by drug type and differences were analyzed by means of a chi-square test. Results: Statistically significant differences were found between the different docetaxel formulations in the cumulative per-cycle incidence of: dosage change, anemia, hypersensitivity reactions and anaphylaxis, neuropathy, palmoplantar and dermal toxicity, ungual toxicity and facial edema. The formulation with the lowest content of impurities showed better results in terms of change of dosage, visits to the emergency room and incidence of anemia and facial edema. However, it was associated with poorer results regarding hospitalization, febrile neutropenia, motor neuropathy and palmoplantar toxicity. Conclusions: The results of the study showed differences In the incidence of adverse events of the different docetaxel products available in Spain. Such differences were statistically significant for some of the variables analyzed. The study was not able to determine which of the products offered the best toxicity profile. Nor was it possible to establish a correlation with respect to the composition of excipients or the content of impurities.

Abstract Background Malnutrition and sarcopenia are highly prevalent in patients with head neck cancer (HNC). An accurate early diagnosis is necessary for starting nutritional support, as both are clearly associated with clinical outcomes and mortality. We aimed to evaluate the applicability and accuracy of body composition analysis using electrical bioimpedance vectorial analysis (BIVA) for diagnosing malnutrition and sarcopenia in patients with HNC cancer undergoing systemic treatment with chemotherapy or radiotherapy. Methods Cross‐sectional, observational study that included 509 HNC patients. A comprehensive nutritional evaluation that included BIVA was performed. Results The prevalence of malnutrition was higher in patients that received treatment with chemotherapy (59.2% vs. 40.8%, P

Background: Clinically important perioperative atrial fibrillation (POAF) is a common cardiac complication after noncardiac surgery. Little is known about how patients with POAF are managed acutely and whether practices have changed over time. Methods: We conducted an observational substudy of patients who had POAF, were at elevated cardiovascular risk, and were enrolled in the PeriOperative Ischemic Evaluation (POISE)-1, 2 and 3 trials between 2002 and 2021. POAF was defined as new, clinically important atrial fibrillation occurring within 30 days after surgery. We assessed the use of rhythm-control and anticoagulation treatment in response to POAF, at hospital discharge and at 30 days after surgery. We assessed for temporal trends using multivariable logistic regression. Results: Of the 27,896 patients included, 545 (1.9%) developed clinically important POAF. Patients received rhythm-control treatment in 48.6% of cases. The level of use of rhythm-control treatment increased over the course of the trials (POISE-1 vs POISE-2 vs POISE-3; 40.9% vs 49.5% vs 59.1%). A later randomization date was associated independently with use of rhythm-control treatment (odds ratio, 1.05 per year; 95% confidence interval, 1.01-1.09). Anticoagulation treatment was prescribed in 21% of POAF cases. The level of anticoagulation treatement use was higher in POISE-3, compared to that in the 2 previous trials (POISE-1 vs POISE-2 vs POISE-3—16.4% vs 16.5% vs 33.6%). A later randomization date was associated independently with use of anticoagulation treatment (odds ratio, 1.06 per year; 95% confidence interval, 1.02-1.11). Conclusions: Despite the absence of randomized controlled trials, the level of use of rhythm-control and anticoagulation treatment for POAF is rising. High-quality trials are needed urgently to determine whether these interventions are safe and effective in this population. Résumé: Contexte: En chirurgie non cardiaque, la fibrillation auriculaire postopératoire (FAPO) d’importance clinique est une complication cardiaque fréquente. La prise en charge ponctuelle des patients présentant une FAPO est mal connue et on ne sait pas précisément si les pratiques ont évolué au fil du temps. Méthodologie: Nous avons mené une sous-étude d’observation auprès de patients ayant présenté une FAPO et dont le risque cardiovasculaire était élevé, et qui avaient participé aux études 1, 2 ou 3 du programme d’essais cliniques POISE (PeriOperative Ischemic Evaluation) entre 2002 et 2021. La FAPO était définie comme un nouvel épisode de fibrillation auriculaire (FA) d’importance clinique au cours des 30 jours suivant une intervention chirurgicale. Nous avons évalué l’utilisation d’un traitement visant à régulariser le rythme cardiaque et de l’anticoagulothérapie dans la prise en charge d’une FAPO, au moment du congé de l’hôpital, puis 30 jours après l’intervention chirurgicale. Nous avons procédé à l’évaluation des tendances temporelles par régression logistique multivariée. Résultats: Sur les 27 896 patients inclus dans l’analyse, 545 (1,9 %) ont présenté une FAPO d’importance clinique. Dans 48,6 % des cas, les patients ont reçu un traitement visant à régulariser le rythme cardiaque. Le taux d’utilisation d’un traitement visant à régulariser le rythme cardiaque a augmenté d’une étude à l’autre (étude POISE-1 vs étude POISE-2 vs étude POISE-3; 40,9 % vs 49,5 % vs 59,1 %, respectivement). Une date plus tardive de la répartition aléatoire était un facteur indépendant de l’utilisation d’un traitement visant à régulariser le rythme cardiaque (rapport de cotes = 1,05 par an; intervalle de confiance [IC] à 95 % : 1,01-1,09). Une anticoagulothérapie a été prescrite à 21 % des patients ayant présenté une FAPO. Le taux d’utilisation d’une anticoagulothérapie était plus élevé dans l’étude POISE-3, comparativement aux deux essais précédents (étude POISE-1 vs étude POISE-2 vs étude POISE-3; – 16,4 % vs 16,5 % vs 33,6 %, respectivement). Une date plus tardive de la répartition aléatoire était un facteur indépendant d’utilisation d’une anticoagulothérapie (rapport de cotes = 1,06 par an; IC à 95 % : 1,02-1,11). Conclusions: Malgré l’absence d’essais comparatifs avec répartition aléatoire, le taux d’utilisation d’un traitement visant à régulariser le rythme cardiaque ou d’une anticoagulothérapie chez les patients présentant une FAPO est en augmentation. Il existe un besoin urgent de réaliser des études cliniques de grande qualité afin de déterminer si ces interventions sont sûres et efficaces dans cette population de patients.

IntroductionBefore implementing a new health care strategy, it is important to assess effectiveness but also to perform an economic evaluation. The goal of the present study was to perform a comparative economic evaluation of a new strategy aimed at using proposed implementation of the Plateletworks guidance (measurement of platelet function) with usual practice (delayed time to surgery) in patients on chronic antiplatelet treatment and scheduled for surgery with neuraxial anaesthesia due to proximal femur fracture.MethodsThis is an economic evaluation carried out alongside a randomised controlled clinical trial at four centres in Spain. Patients were randomised to undergo either early platelet function-guided surgery (experimental group) or delayed surgery (control group). As AFFEcT trial results demonstrated significative difference between groups in the primary efficacy endpoint, the median time to surgery, a cost-effectiveness analysis was performed. Direct costs associated with hospitalisation until one-month post-discharge were considered and measured from a hospital perspective. All costs were reported in euros. Analyses were performed on a per protocol basis. Effectiveness outcome measures were the incremental cost and incremental cost per reduction in days to surgery. A deterministic sensitivity analysis was implemented to quantify uncertainty.ResultsA total of 156 patients were randomized to the two groups (n = 78 per group). A total of 143 patients were included in the per protocol population (75 and 68 patients in the experimental and control groups, respectively). The median time to surgery was 2.30 days (IQR: 1.53–3.73) in the experimental group and 4.87 days (4.36–5.60) in the control group (a reduction of 2.40 days). Total costs during the 1-month study perioperative period were higher in the delayed surgery group (€18,495.19) than for the early surgery group (€16,497.59). The incremental cost was negative (€1,997.60), a statistically significant difference (P

La poesía confesional traza una línea delgada entre voz poética y autor. Como género, puede utilizarse como vehículo de introspección, para el auto reconocimiento, y como un ejercicio catártico-terapéutico. La obra intensamente autobiográfica de Sylvia Plath se encuentra en este espacio liminal donde sus versos concisos permiten vislumbrar la experiencia de la autora misma. “Lady Lazarus” y “Daddy” presentan instancias específicas de violencia donde el yo poético pretende dar sentido al trauma personal mediante metáforas bíblicas y del Holocausto. En ambos poemas, el cuerpo es un elemento desmembrado, catalogado en partes y escindido dolorosamente para recalcar disconformidad durante la búsqueda de identidad. El trato brutalizado del cuerpo evoca procesos de disociación, según la teoría del “cuerpo fragmentado” de Jacques Lacan, semejante a cómo Primo Levi lidia con el trauma de la deshumanización en relatos memorísticos de los campos de concentración. Por lo tanto, el uso de una tragedia histórica ajena en estos poemas actúa como recurso de generalización para la expresión personal de Plath. El yo poético lleva a cabo una “cosificación” propia mediante el préstamo de la experiencia grupal histórica más próxima, como el Holocausto, para capturar las preocupaciones íntimas de la autora (como la ansiedad hacia la guerra nuclear y su difícil relación con la masculinidad represiva). En “Lady Lazarus” y “Daddy”, el entramado del dolor psíquico con el corporal es un hilo conductor que brinda coherencia a la sensibilidad dislocada de Plath, tanto como potenciador del trauma o como medio contemplativo y liberador. Con esta aproximación, este artículo analiza, en ambos poemas, el uso de imágenes con asociaciones históricas ajenas a la autora y, por lo tanto, “problemáticas” para la expresión del cuerpo; así mismo, este texto busca poner a prueba los posibles límites del recurso semiautobiográfico en la obra confesional de Sylvia Plath.

ObjectiveIdiopathic central precocious puberty (CPP) precipitates epiphyseal fusion of growth plates in long bones, leading to reduced adult stature. Gonadotropin-releasing hormone analogues (GnRHa) are the treatment of choice for idiopathic CPP, but their benefit on height gain is unclear. We aimed to elucidate the effects of GnRHa treatment on adult height in girls with idiopathic CPP.DesignThis prospective observational descriptive study analyzed data of girls with idiopathic CPP diagnosed at 55 centers in Spain between January 1, 1998 and December 31, 2012 included in the Spanish Society for Pediatric Endocrinology’s national registry.MethodsWe included girls with idiopathic CPP (thelarche < 8 years, positive LHRH stimulation test, bone age > 1 year older than chronological age, and normal brain imaging) treated with triptorelin (3.75 mg monthly, adjusted according to LHRH test results and clinical findings). We assessed weight, height, BMI, and secondary sexual characteristics every 6 months and bone age every 12 months until adult height (AH) was attained. The primary outcome was the difference between AH and target height (TH).ResultsA total of 465 girls (18.90% adopted) were included; we analyzed data recorded at treatment end in 358 girls and at AH in 216. Mean difference between AH and TH was -1.5 (95%CI: -2.56− -0.45) cm and between AH and PAH 2,57 (95%CI:-3.56− -1.58) cm.ConclusionsGnRHa treatment helps preserve genetic growth potential in girls with idiopathic CPP.

Background Lung ultrasound (LUS) has emerged as a useful tool in the acute phase of patients admitted for ST‐segment–elevation myocardial infarction. However, its long‐term significance remains uncertain, and risk scores do not include LUS findings as a predictor. This study aims to assess the 1‐year prognostic value of LUS and its ability to enhance existing risk scores. Methods and Results This is a multicenter prospective cohort study involving 373 patients with ST‐segment–elevation myocardial infarction. LUS was performed during the first 24 hours after angiography. LUS results were assessed both as a categorical (wet/dry lung) and continuous variable (LUS score). The primary end point comprised the following major adverse cardiovascular events: all‐cause mortality or hospitalization for heart failure, acute coronary syndrome, or stroke within 1 year. We also evaluated whether LUS could enhance the predictive value of the GRACE (Global Registry of Acute Coronary Events) score. Major adverse cardiovascular events occurred in 51 (13.7%) patients over a median follow‐up of 368 days. After multivariate analysis, the LUS score was an independent predictor (hazard ratio [HR], 1.06 [95% CI, 1.01–1.10]; P=0.009] for each additional B‐line), whereas the categorical classification was an independent predictor in patients with ST‐segment–elevation myocardial infarction Killip I (HR, 3.12 [95% CI, 1.34–7.31]; P=0.009). Incorporating LUS into GRACE resulted in a net reclassification index of 31.6% and a significant increase in the area under the curve; GRACE alone scored 0.705 compared with GRACE+LUS 0.791 (P=0.002). Conclusions Detecting B‐lines on LUS at the acute phase predicts major adverse cardiovascular events at 1 year in patients with ST‐segment–elevation myocardial infarction and enhances the predictive value of the GRACE score. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04526535.

Macrophomina phaseolina (Tassi) Goid. (Mp) is the causal agent of charcoal rot in soybean, an economically serious and potentially destructive disease. Chemical control sometimes has limited effects on disease severity and may pose a threat to the environment, so the use of Trichoderma as a biological product could be a feasible alternative for charcoal rot management. The objective of this research was to isolate and characterize native Trichoderma spp. from northwestern Argentina and study their antagonistic effect against Mp in soybean. Isolations were performed from soil samples followed by cultural and microbiological characterization of the Trichoderma spp. isolates collected. Then, the antagonist effect against Mp was studied in vitro, under greenhouse conditions, and finally under field conditions with pathogen artificial inoculations during two soybean crop seasons (2020 and 2021). The results demonstrated that isolate Tr009 had a biocontrol effect against Mp in soybean. This control was evidenced in vitro and under controlled and field conditions with high emergency of plants compared to the Mp inoculated control. Under field conditions, treatments that included Trichoderma presented lower disease severity, colony-forming unit index and disease severity index values than the pathogen inoculated control. Moreover, Tr009 improved weight and length of soybean plants under greenhouse conditions. Isolate Tr009 was identified as Trichoderma koningiopsis by molecular methods. These results indicate that this biological tool can be used against Mp and thus favor a sustainable management of soybean charcoal rot.

Spatial assessment of the risks faced by marine habitats provides essential information for adaptation to the impacts of multiple anthropogenic stressors. Climate change is one of the main stressors affecting the persistence and resilience of healthy marine ecosystems. However, protection against other stressors such as marine habitat loss and direct exploitation of natural marine resources is needed to ensure that conservation efforts are not threatened by cumulative combined effects. We used habitat risk assessment to explore the cumulative impacts of multiple stressors, including aquaculture activities, fishing vessel pressure, and climate change, on marine habitats of giant kelp forests. The assessment was applied in Chilean Patagonia, focusing on three protected areas: Magdalena Island National Park, Guaitecas National Reserve, and Kawésqar National Reserve. Our findings reveal that sea surface temperature increases, salmon farming, and the aquaculture-associated ship fleet are the stressors contributing most significantly to risk. High-risk areas are concentrated in northern Patagonia, specifically in the fjords of Guaitecas National Reserve and Magdalena Island National Park, with some risk hotspots found in the fjords of Kawésqar National Reserve. The highest risk levels are observed in scenarios that include both climate change and industrial salmon farming. Identifying the areas most at-risk is crucial for marine spatial planning because it allows for the design of targeted conservation actions to mitigate stressors and prevent risks from reaching levels that could compromise the integrity of marine habitats. The spatial approach used is key for informing future planning processes in Chilean Patagonia, where conflicts between intensive salmon farming, small-scale fishing, traditional Indigenous sea uses, and nature conservation are escalating. Despite some limitations in the data, our study provides valuable insights that can guide future conservation planning and policy-making, helping to balance economic activities with the need to protect and maintain the health of marine habitats in Chilean Patagonia.

Plants are a valuable source of specialized metabolites that provide a plethora of therapeutic applications. They are natural defenses that plants use to adapt and respond to their changing environment. Decoding their biosynthetic pathways and understanding how specialized plant metabolites (SPMs) respond to biotic or abiotic stress will provide vital knowledge for plant biology research and its application for the future sustainable production of many SPMs of interest. Here, we focus on the proteomic approaches and strategies that help with the study of plant-specialized metabolism, including the: (i) discovery of key enzymes and the clarification of their biosynthetic pathways; (ii) study of the interconnection of both primary (providers of carbon and energy for SPM production) and specialized (secondary) metabolism; (iii) study of plant responses to biotic and abiotic stress; (iv) study of the regulatory mechanisms that direct their biosynthetic pathways. Proteomics, as exemplified in this review by the many studies performed to date, is a powerful tool that forms part of omics-driven research. The proteomes analysis provides an additional unique level of information, which is absent from any other omics studies. Thus, an integrative analysis, considered versus a single omics analysis, moves us more closely toward a closer interpretation of real cellular processes. Finally, this work highlights advanced proteomic technologies with immediate applications in the field.

This article aims to explore the conceptions of forgiveness and resilience, and the relationship that may exist between them, from the perspective of victims of the Colombian armed conflict in the municipality of San Juan Nepomuceno in Montes de María. We followed an exploratory qualitative methodology with a descriptive and interpretative focus. The data was analyzed based on grounded theory, and a non-probabilistic snowball sampling approach was employed. Six semi-structured interviews were conducted including questions about forgiveness and resilience, whether victims believed forgiveness was possible, how they perceived resilience in their community, and their opinions on expressions of remorse by former members of armed groups. Within the framework of these two study categories, victims’ perspectives provided definitions of forgiveness and resilience. Forgiveness was described as a personal decision influenced by individual thinking, serving as a means to heal wounds and free oneself from negative emotions while not erasing the memory of past events. Resilience, on the other hand, was perceived as the individuals’ ability to navigate through challenges and traumatic situations, to explore alternative possibilities regardless of their available resources, and to empower themselves in order to enhance their own quality of life. Individual and collective coping strategies also came to light, encompassing practices such as art, dialogue, and communal memory processes.

En este artículo se vinculan dos temáticas relevantes para la calidad educativa, a saber, la participación familiar y la convivencia escolar. En concreto, los objetivos planteados parten del conocimiento del clima de convivencia en unos centros de educación primaria, exploran el sentimiento de pertenencia y la implicación en el hogar de las familias, y tratan de establecer relaciones entre el clima de convivencia y la participación de las familias en la educación escolar. Estamos ante un estudio cuantitativo, no experimental, exploratorio y evaluativo. Los participantes han sido 1326 familias y 844 estudiantes, que pertenecen a un contexto agrícola, en un municipio de la Región de Murcia, España, en el que la población migrante está sobre el 30 %. La recogida de información se llevó a cabo con dos instrumentos: un cuestionario ad hoc dirigido a las familias y el cuestionario CRAE-P de Bueno et al. (2017) a los estudiantes. Los resultados nos indican que las familias manifiestan un adecuado sentimiento de pertenencia hacia los centros y la implicación que muestran en la educación de sus hijos e hijas en el hogar es alta. Por la parte de los estudiantes, en su mayoría manifiestan un estado de bienestar positivo.

Bladder duplication (BD) is a rare malformation that is often associated to other anomalies. We report a newborn diagnosed with BD in the sagittal plane, associated to persistent urogenital sinus (UGS), given the opening of the vagina immediately below the bladder neck. It is the fourth time this association is reported. Surgical repair was made: both bladders were joined, the common channel was left as urethra and the vagina was descended with a vaginoplasty with an intestinal segment. She also presented an anterior anus, that required posterior mobilization. The patient is currently 3 years old with good sphincter control.

Anti-dsDNA, anti-Sm, and anti-ribosomal-P autoantibodies are hallmarks of systemic lupus erythematosus (SLE), being anti-dsDNA and anti-Sm included in 2019-ACR/EULAR SLE-Classification Criteria. Enzyme-linked (ELISA) and chemiluminescence assays (CIA) are widely established in immunology laboratories, but new technologies, such as particle-based multi-analyte technology (PMAT), are nowadays available. The present study aimed to compare the presence of anti-dsDNA and anti-Sm autoantibodies measured by CIA and PMAT and analyze diagnostic and clinical SLE activity performance. Anti-ribosomal-P autoantibodies by PMAT were also included. Consequently, anti-dsDNA and anti-Sm detected by CIA showed substantial agreement with PMAT (Cohen's kappa = 0.662 and 0.671, respectively). Anti-dsDNA autoantibodies measured by PMAT showed a positive correlation with clinical SLEDAI-2K (p

Abstract This study aimed to establish factors associated with delayed surgery in patients with proximal femoral fracture and to assess patients’ health-related quality of life (HRQoL) after surgery including all-cause 6-months mortality. This was a single-center, observational, prospective cohort study that included patients with a proximal femur fracture. We described patients’ HRQoL measured by EuroQoL (EQ-5D-5L and EQ-VAS) questionnaire and perioperative complications (including mortality) 6 months after surgery. We included 163 patients with a mean age of 80.5 years, the majority were women and 76.1% reported falling from their own height. The mean time between hospital admission and surgery was 8.3 days (SD 4.9 days) and the mean hospital stay was 13.5 days (SD 10.4 days). After adjustment, the principal factor associated with delayed surgery was adjournment in surgery authorization (3.7 days). EQ-5D-5L index values and the VAS score at 1 month after surgery were 0.489 and 61.1, at 3 months were 0.613 and 65.8, and at 6 months 0.662 and 66.7 respectively. Mortality at 6 months of follow-up was 11% (18 patients). In conclusion, administrative authorization was the strongest associated factor with delayed time from hospital admission to surgery. HRQoL of patients with a proximal femoral fracture improved 6 months after surgery. Trial registration: NCT04217642.

IntroductionBioelectrical impedance analysis (BIA) serves as a method to estimate body composition. Parameters such as phase angle (PA), standardized phase angle (SPA), body mass cell (BCM), BCM index (BCMI), and fat-free mass (FFM) might significantly impact the prognosis of head and neck cancer (HNC) patients. The present study aimed to investigate whether bioelectrical parameters can be used to predict survival in the HNC population and establish the optimal cutoff points for predictive accuracy.MethodsA multicenter observational study was performed across 12 tertiary hospitals in Andalusia (a region from the south of Spain). A total of 494 patients diagnosed with HNC between 2020 and 2022 at different stages were included in this study, with a minimum follow-up period of 12 months. The BIA assessment was carried out during the first 2 weeks of radical radiotherapy treatment with chemotherapy or other systemic treatments. A multivariate logistic regression analysis of overall survival, complications, hospital admission, and palliative care and its relationship with BIA nutritional assessment was performed.ResultsSignificant prognostic factors identified in the multivariable analysis encompassed phase angle (PA), standardized phase angle (SPA), body cell mass (BCM), and BCM index (BCMI). Lower PA and BCM values were significantly associated with adverse clinical outcomes. A BCM threshold above 17 kg/m2 was the most significant predictor for predicting survival within the overall HNC population. The PA values of

RESUMEN introducción: El uso exclusivo de clavo suprapatelar para la osteosíntesis de las fracturas de tercio proximal de tibia se ha perdido con el tiempo, ampliándose su indicación para las fracturas de tibia en todos sus niveles. El objetivo de este trabajo es mostrar nuestra experiencia en instrumentación de la tibia por esta vía para todas las fracturas de tibia que cumplan con indicación de clavo endomedular, en un periodo de 3 años del equipo de cirujano especialista en pierna y pie. Material y Método: se operaron 40 pacientes de los cuales luego de aplicar criterios de inclusión y exclusión se eliminaron 14, siendo el total evaluado 26 pacientes, bajo normas abaladas por el comité de ética de la institucion. Se utilizó los scores Olerud & Molander (0-100); Lower Extremity Functional Scale (LEFS): 80/80 100% Se analizó dolor de rodilla, haciendo una subdivisión en 6 cuadrantes, para valorar situación anatómica del dolor. Resultados: Olerud & Molander promedio fue de 76,92. LEFS promedio fue de 72,33. 5 pacientes presentaron dolor en región de la rodilla cuadrante 3, reproduciéndose este a la flexión máxima de la rodilla y 1 en el cuadrante 5, sitio del bloqueo proximal, que resolvió con retiro del mismo. Ninguno presentó dolor en sitio ingreso del clavo ni dolor femoropatelar. Conclusión: La instrumentación suprapatelar de las fracturas de tibia se ha vuelto el gold standard en el tratamiento de estas fracturas en el equipo CEPP debido a sus ventajas técnicas y evolución favorable posoperatoria Estudio retrospectivo. nivel de evidencia IV Autores declaran no tener conflictos de interés.

Introduction Climate change is one of the greatest threats to public health today, placing considerable pressure on the healthcare sector. During patient care processes, hospital facilities contribute to greenhouse gas emissions through the use of greater resources and higher energy consumption. Consequently, there is growing interest among researchers, universities, organisations and governments to study the impact of the healthcare sector on the environment and to develop strategies to mitigate its effects. The aim of this scoping review is to determine the extent and nature of current literature on global warming from hospitals and clinical services, and ways in which they contribute to its effect. Planning and execution of future research are possible once those areas with existing gaps are identified.Methods and analysis A broad literature search will be carried out to illustrate the ways in which hospitals and clinical services, processes and activities contribute to climate change. Our protocol was drafted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. The final protocol was registered prospectively with the Open Science Framework. All identified studies indexed in Medline, Scopus and Embase will be examined.Ethics and dissemination This project is literature-based research; therefore, it does not require ethical approval. The results will be presented to researchers as well as policymakers in this particular area, via conferences, webinars, podcasts and online events. A peer-reviewed publication will be submitted to specific journals of interest.

This paper evaluates an experimental wetland as part of a pilot soil reclamation project in a mining area. The wetland was constructed using materials of mining origin from the area; most reactive materials of acid pH were stabilised using limestone filler. The study selected macrophytes that are tolerant to potentially toxic elements (PTEs) and resistant to salinity, namely Phragmites australis, Juncus effusus, and Iris pseudacorus. These macrophytes were then placed in pots containing substrates composed of different mixtures of topsoil, peat, and mining waste (black or yellow sand). A thorough analysis of the physicochemical and mineralogical characteristics of the materials included studies of PTE mobilisation. This study emphasises the significance of the rhizosphere in directing the transfer of PTEs to the plant and the correlation between the substrate and the development of plant defence mechanisms, such as the formation of Fe-plates. Scanning electron microscopy was used to highlight these aspects and validate the results of the analytical determinations. These wetlands can be proposed as a phytoremediation strategy for areas affected by mining and maritime influence. They are easy to construct and remain stable, providing important ecosystem services such as the natural attenuation of acid mine drainage, support for vegetation development and fauna, and a clean ecosystem.

Prenylated flavonoids (PFs) are natural flavonoids with a prenylated side chain attached to the flavonoid skeleton. They have great potential for biological activities such as anti-diabetic, anti-cancer, antimicrobial, antioxidant, anti-inflammatory, enzyme inhibition, and anti-Alzheimer’s effects. Medicinal chemists have recently paid increasing attention to PFs, which have become vital for developing new therapeutic agents. PFs have quickly developed through isolation and semi- or full synthesis, proving their high value in medicinal chemistry research. This review comprehensively summarizes the research progress of PFs, including natural PFs from the Moraceae family and their pharmacological activities. This information provides a basis for the selective design and optimization of multifunctional PF derivatives to treat multifactorial diseases.

This Guide for Living Donor Kidney Transplantation (LDKT) has been prepared with the sponsorship of the Spanish Society of Nephrology (SEN), the Spanish Transplant Society (SET), and the Spanish National Transplant Organization (ONT). It updates evidence to offer the best chronic renal failure treatment when a potential living donor is available. The core aim of this Guide is to supply clinicians who evaluate living donors and transplant recipients with the best decision-making tools, to optimise their outcomes.Moreover, the role of living donors in the current KT context should recover the level of importance it had until recently. To this end the new forms of incompatible HLA and/or ABO donation, as well as the paired donation which is possible in several hospitals with experience in LDKT, offer additional ways to treat renal patients with an incompatible donor.Good results in terms of patient and graft survival have expanded the range of circumstances under which living renal donors are accepted. Older donors are now accepted, as are others with factors that affect the decision, such as a borderline clinical history or alterations, which when evaluated may lead to an additional number of transplantations.This Guide does not forget that LDKT may lead to risk for the donor. Pre-donation evaluation has to centre on the problems which may arise over the short or long-term, and these have to be described to the potential donor so that they are able take them into account. Experience over recent years has led to progress in risk analysis, to protect donors’ health. This aspect always has to be taken into account by LDKT programmes when evaluating potential donors.Finally, this Guide has been designed to aid decision-making, with recommendations and suggestions when uncertainties arise in pre-donation studies. Its overarching aim is to ensure that informed consent is based on high quality studies and information supplied to donors and recipients, offering the strongest possible guarantees. Resumen: Esta guía de recomendaciones para el TR de donante vivo (TRDV) es un documento elaborado con el patrocinio de la Sociedad Española de Nefrología, la Sociedad Española de Trasplantes y la Organización Nacional de Trasplantes que actualiza la calidad de la evidencia disponible para ofrecer el mejor tratamiento de la insuficiencia renal crónica cuando se disponga de un donante vivo potencial. El objetivo principal de esta guía es proporcionar a los profesionales con responsabilidad en los estudios previos del donante vivo y del receptor trasplantado, las mejores herramientas para tomar decisiones en beneficio del donante vivo y del receptor del trasplante.Además, en el contexto actual del TR, el donante vivo debe recuperar el protagonismo que alcanzó en un pasado reciente. Para ello, las nuevas modalidades de donación HLA y/o ABO incompatible, así como la donación cruzada disponibles en diversos centros con experiencia en TRDV, son oportunidades adicionales para el tratamiento de enfermos renales que tienen un donante incompatible.Los buenos resultados en supervivencia del paciente y del injerto están ampliando las circunstancias de aceptación de donantes vivos de riñón, incluyendo donantes de mayor edad y otros con algunos condicionantes que incluyen antecedentes o alteraciones límite que, cuando son evaluados con criterios objetivos, pueden aportar un numero adicional de trasplantes.No se ha obviado en esta guía que el TRDV puede representar algún riesgo para el que dona. Estos problemas que pueden aparecer a corto o largo plazo tienen que ser objeto principal de valoración previa a la donación y presentados al potencial donante para que en ejercicio de su autonomía los asuma o rechace. La experiencia acumulada en los últimos años ha permitido avanzar en el análisis de riesgos para preservar la salud de los donantes, aspecto que debe estar siempre presente en los responsables de programas de TRDV cuando se procede al estudio de idoneidad de un potencial donante.Finalmente, esta guía ha sido estructurada para facilitar la toma de decisiones con recomendaciones y sugerencias ante incertidumbres derivadas de los resultados en los exhaustivos estudios predonación. Y todo ello, con el objetivo de que el consentimiento informado que debe certificar la calidad de los estudios y la información proporcionada a donante y receptor, alcancen las mayores garantías posibles.

This article is part of an International Cooperation Project funded by the Andalusian Agency for Development Cooperation of the Junta de Andalucía, Spain in collaboration with the Mayan Technological Institute (ITMES) in San Juan de Chamelco-Cobán at the University of San Carlos de Guatemala: 2018UC006 “Maestras y maestros para niñas y niños mayas en zonas rurales diseminadas: formando los formadores.” (Teachers for Mayan girls and boys in remote rural areas: training the trainers). This cooperation project arose from the need of the university unit attached to the University of San Carlos to develop a university degree program in teacher training in bilingual infant and primary education that would consider the characteristics of the communities these new professionals would impact rural Mayan communities. In this sense, ITMES is particularly interesting for three reasons: (1) the unit is attached to the University of San Carlos, the only public university in Guatemala, as a response to the Guatemalan Constitution that indicates the need for a Mayan University; (2) the unit’s distinctive development for the formation and empowerment of Mayan culture; and (3) because its organizational structure combines receiving face-to-face instruction on weekends in the urban campus of San Juan de Chamelco-Cobán, while during the week, students carry out their personal, professional and educational activities in rural areas. Thus, a double dimension has been addressed through this international cooperation project, which has the complex task of training professionals who will work with children in rural areas but who will be trained in San Juan de Chamelco-Cobán, an urban area, the commercial and economic hub of the region, On the one hand, as will be developed further in this article, the selection and initial psycho-pedagogical-curricular training, attention to cultural, gender, and sociological diversity, of university teachers who, in the future, will be entrusted with the implementation and development of a university curriculum in teacher training aimed at and from the inclusion of children from Mayan rural communities. On the other hand, while considering the center’s organizational structure, establishing the fundamental psycho-pedagogical and organizational principles with an inclusive curricular plan will allow the training of teachers whose actions will be carried out in rural Mayan environments. As a starting hypothesis, we consider that in order to provide quality, responsible and inclusive education to children from rural Mayan environments, and beyond the traditionally technical contents that support the training curriculum legislated by the Guatemalan government, it is necessary to approach this reality by linking vitally constructed knowledge and technical contents, so that they can be formulated and reformulated in a relevant way and thus generate powerful knowledge. Thus, there arises a necessity to equip a team of professionals, prospective university teachers, who are sensitive to Mayan needs and attention to diversity, with a deep and relevant knowledge of psycho-pedagogical and curricular aspects, and with a sociological contextual knowledge of the needs of the post-modern, neoliberal and digital world. To this end, our methodology encompasses three levels: (a) the selection of a group of professionals to be trained; (b) contextual analysis of the training needs of the selected group of professionals, thereby facilitating the adaption of the training program to their individual needs and circumstances; and (c) semi-structured and in-depth interviews with seven female and nine male leaders of Mayan communities. These leaders were selected using a non-probabilistic intentional sampling method, which was collaboratively determined with the ITMES team. During these interactions, we extensively explored their perspectives on Mayan identity, as well as their perceptions of the educational system and its impact on the formation of their identity as a person and as Mayans. Through the integration of these three components, we have obtained invaluable insights into (a) the evolving training needs of the instructional team and (b) the socio-educational pressures experienced by Mayan women, and the significance of “Mayan being” as an aspect of identity. This emergent data has informed the development of a comprehensive psycho-pedagogical, curricular and sociological training plan that underpins the content of this article. Thus, for the selection of the training team, the following aspects were considered: knowledge of Mayan culture and experience in rural Mayan contexts and relationship with the educational-school world. The selection resulted in a total of 29 candidates, 18 women and 11 men, with whom the training was carried out. Regarding the initial training plan for university teachers, and after the contextual analysis, we consider it necessary to correlate three dimensions: (1) the psycho-pedagogical nature of the technical dimension. In this sense, the plan has addressed aspects related to the conceptualization of teaching, and of learning and the development of the fundamental aspects of the curriculum; (2) the idiosyncratic dimension of rural Mayan communities, beyond being a transversal axis, has also been incorporated into the plan. We incorporated analyses related to gender, in general, and gender in schools, making a triangulation with the emerging knowledge from the interviews and the conceptualization of inclusion and Mayan identity as the backbone of a quality education; and (3) the post-modern sociological dimension of today’s societies. Finally, a flexible and emerging training plan of the Mayan idiosyncrasy has been designed that allows its applicability in other similar sociological contexts, adapting the plan to the individual training needs of each context.

Eating disorders are psychiatric and behavioral health pathologies of high complexity and different etiology, which can affect age groups, sexes, and ethnicities indistinctly. This study aimed to evaluate the risk of eating disorders and the possible relation with the sports profile of Colombian adolescent athletes. This was an exploratory cross-sectional quantitative study that used an online form designed with a sociodemographic questionnaire and the EAT-26 scale to determine the eating disorder risk of the object population. A total of 354 adolescent athletes participated. There were 182 men and 172 women and the mean age was 15.59 (range: 10–19 years, SD = 1.938). The participants presented a significantly low risk of eating disorders (21.2%) with no differences in prevalence between both sexes. The risk of eating disorder was related to the result of the last competition (p = 0.01), the type of sport (p = 0.032), the years of sports practice (p = 0.004), and the number of training hours a day (p = 0.011). It is relevant to recognize that adolescents and athletes are vulnerable populations regarding eating disorders. In conclusion, adolescent athletes should be the object of special attention to prevent eating disorders and their consequences on health and sports performance.

In the present paper, we efficiently solve the two-body problem for extreme cases such as those with high eccentricities. The use of numerical methods, with the usual variables, cannot maintain the perihelion passage accurately. In previous articles, we have verified that this problem is treated more adequately through temporal reparametrizations related to the mean anomaly through the partition function. The biparametric family of anomalies, with an appropriate partition function, allows a systematic study of these transformations. In the present work, we consider the elliptical orbit as a meridian section of the ellipsoid of revolution, and the partition function depends on two variables raised to specific parameters. One of the variables is the mean radius of the ellipsoid at the secondary, and the other is the distance to the primary. One parameter regulates the concentration of points in the apoapsis region, and the other produces a symmetrical displacement between the polar and equatorial regions. The three most used geodesy latitude variables are also studied, resulting in one not belonging to the biparametric family. However, it is in the one introduced now, which implies an extension of the biparametric method. The results obtained using the method presented here now allow a causal interpretation of the operation of numerous reparametrizations used in the study of orbital motion.

Entre el nutrido conjunto de bienes artísticos que Arthur Byne y Mildred Stapley adquirieron y exportaron desde España con destino a Estados Unidos, durante los años veinte y treinta del siglo XX, se encontraba el patio de la casa del conde de Ayamans (Palma de Mallorca). Nuevos datos permiten ilustrar esta operación que tenía como principal objetivo satisfacer las demandas de su principal cliente: el magnate de la comunicación W. R. Hearst. El negocio fue desarrollado gracias a José Costa Ferrer, conocido en su faceta de dibujante como «Picarol», quien dotó a Mallorca del primer negocio estable dedicado al comercio internacional de arte y antigüedades; fue quien puso en manos de Byne el valioso conjunto. El estudio de la correspondencia entre José Costa y Arthur Byne ofrece pistas sobre el carácter de esta transacción que terminó con el traslado a EE.UU. del bello patio; pero también sobre la estrecha relación que en esos años se tejió entre el estudio de arte, el mercado de antigüedades y la promoción turística y cultural. Prueba de ello, los homenajes que los Byne recibieron por tal labor.

Abstract Primary ventricular fibrillation (PVF) is a life-threatening complication of ST-segment elevation myocardial infarction (STEMI). It is unclear what roles viral infection and/or systemic inflammation may play as underlying triggers of PVF, as a second hit in the context of acute ischaemia. Here we aimed to evaluate whether the circulating virome and inflammatory proteome were associated with PVF development in patients with STEMI. Blood samples were obtained from non-PVF and PVF STEMI patients at the time of primary PCI, and from non-STEMI healthy controls. The virome profile was analysed using VirCapSeq-VERT (Virome Capture Sequencing Platform for Vertebrate Viruses), a sequencing platform targeting viral taxa of 342,438 representative sequences, spanning all virus sequence records. The inflammatory proteome was explored with the Olink inflammation panel, using the Proximity Extension Assay technology. After analysing all viral taxa known to infect vertebrates, including humans, we found that non-PVF and PVF patients only significantly differed in the frequencies of viruses in the Gamma-herpesvirinae and Anelloviridae families. In particular, most showed a significantly higher relative frequency in non-PVF STEMI controls. Analysis of systemic inflammation revealed no significant differences between the inflammatory profiles of non-PVF and PVF STEMI patients. Inflammatory proteins associated with cell adhesion, chemotaxis, cellular response to cytokine stimulus, and cell activation proteins involved in immune response (IL6, IL8 CXCL-11, CCL-11, MCP3, MCP4, and ENRAGE) were significantly higher in STEMI patients than non-STEMI controls. CDCP1 and IL18-R1 were significantly higher in PVF patients compared to healthy subjects, but not compared to non-PVF patients. The circulating virome and systemic inflammation were not associated with increased risk of PVF development in acute STEMI. Accordingly, novel strategies are needed to elucidate putative triggers of PVF in the setting of acute ischaemia, in order to reduce STEMI-driven sudden death burden.

This study aims to better understand students who attend Basic Vocational Training Cycles (Basic Professional Training, BTP) by implementing measures that ensure diversity. This quantitative research project approximated students’ perception of their passage through previous studies and their satisfaction and goals after finishing the school year. The sample consisted of 352 students from Cordoba (Spain). A questionnaire was used that follows the CIPP model. After exploratory factor analysis was completed with different groups of items and their descriptive analyses, various tests were carried out to consider the hypotheses (Pearson’s correlation (r), one-factor analysis of variance, and repeated ANOVA measures). The results indicate that the educational interest of the students is academic and professional. Likewise, there is no relationship detected between socio-professional goals and average academic levels and attributions with respect to repetitions of previous courses, although these goals vary depending on students’ satisfaction with the vocational cycles. We conclude that the course of the FPB influences decisions regarding academic–professional projects.

Sport has never been a more appreciated tool than at present, particularly when dealing with development at various levels of society, be it communities, gender issues, or factors affecting youth. The objective of this systematic review was to determine the level of empirical evidence on the impact of sport based interventions on human development. A Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach was utilized to conduct a systematic literature search of selected databases with a search range of 2010 to 2021. Findings indicate an increase in the number of studies on the subject, continent, research design, and journal publication. Content analysis revealed the sample characteristics; objectives and content used in the programs; methodology and intervention strategies; and program limitations. Future research should extend the search to other databases, languages, and subjects related sustainability of community interventions.

Abstract To analyze whether there is improvement in adherence to inhaled treatment in patients with COPD and asthma after an educational intervention based on the teach-to-goal method. This is a prospective, non-randomized, single-group study, with intervention and before-after evaluation. The study population included 120 patients (67 females and 53 males) diagnosed with asthma (70.8%) and COPD (29.1%). The level of adherence (low and optimal) and the noncompliance behavior pattern (erratic, deliberate and unwitting) were determined by the Test of the adherence to Inhalers (TAI). This questionnaire allows you to determine the level of adherence and the types of noncompliance. Low Adherence (LowAd) was defined as a score less than 49 points. All patients received individualized educational inhaler technique intervention (IEITI). Before the IEITI, 67.5% of the patients had LowAd. Following IEITI, on week 24, LowAd was 55% (p = 0.024). Each patient can present one or more types of noncompliance. The most frequent type was forgetting to use the inhaler (erratic), 65.8%. The other types were deliberate: 43.3%, and unwitting: 57.5%. All of them had decreased on the final visit: 51.7% (p = 0.009), 25.8% (p = 0.002), 39.2% (p = 0.002). There were no significant differences in adherence between asthma and COPD patients at the start of the study. The only predicting factor of LowAd was the female gender. An individualized educational intervention, in ambulatory patients with COPD and asthma, in real-world clinical practice conditions, improves adherence to the inhaled treatment.

ObjectivesTo assess performance of interstitial pneumonia (IP) with autoimmune features (IPAF) criteria in clinical practice and describe the utility of additional workup in identifying patients with underlying connective tissue diseases (CTD).MethodsWe set a retrospective study of our patients with autoimmune IP, who were allocated to CTD-IP, IPAF or undifferentiated autoimmune IP (uAIP) subgroups according to the updated classification criteria. Presence of the process-related variables comprising IPAF defining domains was scrutinized in all patients, and, when available, the results of nailfold videocapillaroscopy (NVC) were recorded.ResultsThirty nine out of 118 patients, accounting for 71% of former undifferentiated cases, fulfilled IPAF criteria. Arthritis and Raynaud’s phenomenon were prevalent in this subgroup. While systemic sclerosis-specific autoantibodies were restricted to CTD-IP patients, anti-tRNA synthetase antibodies were also present in IPAF. In contrast, rheumatoid factor, anti-Ro antibodies and ANA nucleolar patterns could be found in all subgroups. Usual interstitial pneumonia (UIP) / possible UIP were the most frequently observed radiographic patterns Therefore, the presence of thoracic multicompartimental findings as also performance of open lung biopsies were useful in characterizing as IPAF those UIP cases lacking a clinical domain. Interestingly, we could observe NVC abnormalities in 54% of IPAF and 36% of uAIP tested patients, even though many of them did not report Raynaud’s phenomenon.ConclusionBesides application of IPAF criteria, distribution of IPAF defining variables along with NVC exams help identify more homogeneous phenotypic subgroups of autoimmune IP of potential relevance beyond clinical diagnosis.

El objetivo de la investigación fue diseñar una escala permita examinar los valores en el deporte del alumnado de ESO y Bachillerato españoles sobre los valores generados en el ámbito deportivo. La muestra del estudio estuvo formada por 1316 alumnos pertenecientes a quince centros educativos de Enseñanza Secundaria Obligatoria (ESO) y Bachillerato españoles. Se realizó un Análisis Factorial exploratorio (AFE) para comprobar la validez interna del cuestionario y un análisis factorial confirmatorio. Finalmente, el “cuestionario de valores deportivos y olímpicos” es un instrumento con el que se pueden conocer la percepción de los valores asociados al deporte por la población de entre 12 y 18 años. Palabras clave: Educación, Olimpismo, deporte, adolescentes, lengua española Abstract. The aim of the present research was to design a scale that would allow us to examine the sporting values of Spanish middle and high school students associated to the values generated in the sports sphere. The sample was composed of 1316 students from fifteen high school education centers in Spain. An exploratory factor analysis (EFA) was performed to verify the internal validity of the questionnaire, as well as a confirmatory factory analysis (CFA). Finally, the "questionnaire of sports and Olympic values" is an instrument with which the perception of the values ​​associated with sport by the population between 12 and 18 years of age can be known. Keywords: Education; Olympism; Sport, teenagers, Spanish language.

IntroductionThere is currently no validated score capable of classifying cancer-associated pulmonary embolism (PE) in its full spectrum of severity. This study has validated the EPIPHANY Index, a new tool to predict serious complications in cancer patients with suspected or unsuspected PE.MethodThe PERSEO Study prospectively recruited individuals with PE and active cancer or receiving antineoplastic therapy from 22 Spanish hospitals. The estimation of the relative frequency θ of complications based on the EPIPHANY Index categories was made using the Bayesian alternative for the binomial test.ResultsA total of 900 patients, who were diagnosed with PE between October 2017 and January 2020, were enrolled. The rate of serious complications at 15 days was 11.8%, 95% highest density interval [HDI], 9.8-14.1%. Of the EPIPHANY low-risk patients, 2.4% (95% HDI, 0.8-4.6%) had serious complications, as did 5.5% (95% HDI, 2.9-8.7%) of the moderate-risk participants and 21.0% (95% HDI, 17.0-24.0%) of those with high-risk episodes. The EPIPHANY Index was associated with overall survival (OS) in patients with different risk levels: median OS was 16.5, 14.4, and 4.4 months for those at low, intermediate, and high risk, respectively. Both the EPIPHANY Index and the Hestia criteria exhibited greater negative predictive value and a lower negative likelihood ratio than the remaining models. The incidence of bleeding at 6 months was 6.2% (95% HDI, 2.9-9.5%) in low/moderate-risk vs 12.7% (95% HDI, 10.1-15.4%) in high-risk (p-value = 0.037) episodes. Of the outpatients, serious complications at 15 days were recorded in 2.1% (95% HDI, 0.7-4.0%) of the cases with EPIPHANY low/intermediate-risk vs 5.3% (95% HDI, 1.7-11.8%) in high-risk cases.ConclusionWe have validated the EPIPHANY Index in patients with incidental or symptomatic cancer-related PE. This model can contribute to standardize decision-making in a scenario lacking quality evidence.

The biocompatible polymer polyetheretherketone (PEEK) is a suitable candidate to be part of potential all-polymer total joint replacements, provided its use is associated with better osseointegration, mechanical performance, and wear resistance. Seeking to meet the aforementioned requirements, respectively, we have manufactured a PEEK composite with different fillers: carbon fibers (CF), hydroxyapatite particles (HA) and graphene platelets (GNP). The mechanical outcomes of the composites with combinations of 0, 1.5, 3.0 wt% GNP, 5 and 15 wt% HA and 30% of wt% CF concentrations pointed out that one of the best filler combinations to achieve the previous objectives was 30 wt% CF, 8 wt% HA and 2 wt% of GNP. The study compares the bioactivity of human osteoblasts on this composite prepared by injection molding with that on the material manufactured by the Fused Filament Fabrication 3D additive technique. The results indicate that the surface adhesion and proliferation of human osteoblasts over time are better with the composite obtained by injection molding than that obtained by 3D printing. This result is more closely correlated with morphological parameters of the composite surface than its wettability behavior.

Here we present a study of the characterization and optimization of the production of trans-Resveratrol (t-R) in grape (Vitis vinifera cv. Gamay) cell cultures elicited with methyl jasmonate (MeJA) and dimethyl-β-cyclodextrin (DIMEB). The aim of this study was to determine the influence of a number of factors of the grapevine cell culture on t-R production level in 250 mL shaken flasks that would enable the better control of this bioproduction system when it is upscaled to a 2 L stirred bioreactor. The factors included the optimal growth phase for elicitation, the concentration of elicitors and of biomass, the order of addition of elicitors, and the illumination regime and ageing of cells. We found out that the optimal biomass density for the production of t-R was 19% (w/v) with an optimal ratio of 0.5 g DIMEB/g biomass. The most productive concentrations of the elicitors tested were 50 mM DIMEB and 100 µM MeJA, reaching maximum values of 4.18 mg·mL−1 and 16.3 mg·g biomass−1 of t-R concentration and specific production, respectively. We found that the order of elicitor addition matters since, as compared with the simultaneous addition of both elicitors, the addition of MeJA 48 h before DIMEB results in ca. 40% less t-R production, whilst there is no significant difference when MeJA is added 48 h after DIMEB. Upon upscaling, the better conditions tested for t-R production were aeration at 1.7 vol/vol/min without agitation, 24 °C, and 30 g·L−1 sucrose, achieving production rates similar to those obtained in shaken flasks.