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Acute soft tissue defects, such as persistent drainage, wound dehiscence, or necrosis, following total knee arthroplasty (TKA) can lead to the devastating complication of deep infection. Typically, when a medium-sized defect is present, a gastrocnemius flap is widely employed for soft tissue reconstruction due to its low morbidity and favourable functional outcomes. When facing this situation, we should consider associating the coverage treatment with a debridement, antibiotics, and implant retention (DAIR) surgery procedure, in order to treat a possible acute infection, even when the diagnosis of infection is not clear. We performed a retrospective study to compare TKA outcomes in patients with DAIR and flap procedures in the same surgical act against those who had received an isolated flap procedure for soft tissue reconstruction after an acute surgical wound defect. Patients had been identified from a prospectively collated TKA database. Between 2005 and 2021, 18 patients met our inclusion criteria, with a mean follow-up of approximately 8 years. A medial gastrocnemius flap procedure was performed for 15 patients (83 %). We compared the rates of infection clearance between the two groups. No differences in comorbidities or risk factors were observed between both groups. In the combination treatment group, 66.6 % of patients healed after treatment compared to 33.3 % in the isolated flap group. Although no significant statistical differences were found, the association of DAIR with the muscle flap procedure is highly recommended in the treatment of acute soft tissue defects after TKA. Further studies with larger sample sizes are necessary to extrapolate these findings to the general population.

Resumen: Introducción y objetivos: En cirugía protésica de rodilla y cadera está claro que aún no se ha desarrollado una técnica de cierre estandarizada óptima. A nivel local no existen datos que describan la práctica quirúrgica habitual en cierre de herida. El objetivo de este trabajo es analizar el cierre de herida en cirugía protésica a través de una encuesta sobre una muestra representativa a nivel nacional y así obtener información sobre el contexto del cierre en España. Material y método: Se conforma un grupo ad hoc de especialistas en cirugía protésica. El grupo de expertos, posterior al análisis de la literatura, elabora un cuestionario de 32 preguntas cerradas de opción múltiple, divididas en los siguientes bloques: hemostasia, cierre quirúrgico de la herida y apósitos. Resultados: Un total de 471 cirujanos respondieron la encuesta de forma completa y con información suficiente para efectuar el análisis descriptivo; 79% cree que el ácido tranexámico (ATX) puede influir en la disminución de tasa de infección de sitio quirúrgico; 96% cree que el tipo de cierre profundo a nivel de la artrotomía podría influir en los resultados y complicaciones tras prótesis de cadera y/o rodilla; 85% cree que el tipo de cierre superficial a nivel subcutáneo puede influir en los resultados y complicaciones tras prótesis de cadera y/o rodilla; 64% de los cirujanos utiliza la terapia de presión negativa incisional de simple uso para el tratamiento de las complicaciones de la herida quirúrgica (seromas, drenaje prolongado, dehiscencias). Conclusiones: Existe en nuestro entorno una alta variabilidad en el cierre de la herida y una baja inversión en formación sobre este tema. Los autores recomiendan a las diferentes sociedades científicas la inversión de recursos para mejorar la formación en dicho campo y reducir el porcentaje de cirujanos que se consideran inadecuadamente formados, así como adaptar las técnicas de cierre a aquellas consideradas patrón oro según la evidencia. Abstract: Background and objective: In orthopedic surgery, it is clear that an optimal standardized closure technique has not yet been developed. Locally, there are no objective data describing the standard surgical practice in wound closure. The aim of this study is to analyze the clinical practice of surgical wound closure in orthopedic surgery by means of a survey of a representative local sample and thus obtain information on the context of closure in Spain. Method: an ad hoc group of specialists in orthopedic surgery and traumatology was formed. The group of experts, after analyzing the literature, developed a questionnaire of 32 closed multiple-choice questions divided into the following blocks: hemostasis, surgical wound closure (deep, superficial, and cutaneous), and dressings. Results: A total of 471 surgeons responded to the survey completely and with sufficient information to perform the descriptive analysis. 79% believe that ATX can influence the decrease in surgical site infection rate. 96% believe that the type of deep closure at the level of the arthrotomy could influence outcomes and complications after hip and/or knee replacements. 85% believe that the type of shallow closure at the subcutaneous level may influence outcomes and complications after hip and/or knee replacement. 64% of surgeons use single-use incisional negative pressure therapy for the treatment of surgical wound complications (seroma, prolonged drainage, dehiscence). Conclusions: There is a high level of variability in wound closure in our setting and a low level of training on the subject. The authors recommend that the different scientific societies invest resources to improve training in this field and reduce the percentage of surgeons who are considered inadequately trained, as well as adapting closure techniques to those considered gold standard according to the evidence.

Abstract The frequency response of the photocurrent (Iph) generated in perovskite photodetectors is a crucial issue in imaging or telecommunication applications, although it is briefly discussed in the literature. The present work obtains for the first time the complete expression of the Iph generated on MAPbI3 (MA:methylamoniumI) perovskite polycrystalline thin films. A conditioning circuit is used to extract Iph at 1 V of bias voltage under a square‐modulated laser excitation with a sensitivity smaller than 1 nW and a linear dynamic range LDR > 200 dB; It allows an accurate determination of the module of Iph together with the phase, which is not usually reported in photodetector systems. The frequency domain analysis reveals that Iph can be modeled by two fractional poles located at low (10 kHz) and high (39–250 kHz) cut‐off frequencies. Optimum geometrical parameters and excitation fluence are found for the wider response, resulting for the best device on a cut off frequency up to 250 kHz, and the reproduction of square‐modulated optical waves up to 100 kHz. These results represent an important strategy toward the electrical analysis of MAPbI3 (or other perovskite materials) for the design of posterior electronic stages, optimization of devices and determination of their figures of merit.

En este trabajo se recaban opiniones de profesionales de la salud y otros agentes sobre el tratamiento periodístico dado a las autolesiones no suicidas en menores y jóvenes. Se recurre al método Delphi en dos rondas, en las que se pregunta a expertos de cuatro especialidades diferentes (psicólogos, psiquiatras, pediatras y trabajadores sociales) sobre el concepto, perfil y motivos de las autolesiones en menores y su opinión sobre el tratamiento informativo. Posteriormente se contrastan sus afirmaciones con los resultados de un análisis previo de noticias publicadas en la prensa española (2012-2022). Se recaban también opiniones de profesionales de salud sobre el tratamiento dado en redes y series de ficción. Las principales conclusiones destacan la necesidad de trabajar de forma más estrecha entre los medios y los profesionales de la salud. Además, se señala la necesidad de informar desde la prevención y buscar ayuda con un mensaje esperanzador evitando el sensacionalismo.

Summary: Iron serves as a cofactor for enzymes involved in several steps of protein translation, but the control of translation during iron limitation is not understood at the molecular level. Here, we report a genome-wide analysis of protein translation in response to iron deficiency in yeast using ribosome profiling. We show that iron depletion affects global protein synthesis and leads to translational repression of multiple genes involved in iron-related processes. Furthermore, we demonstrate that the RNA-binding proteins Cth1 and Cth2 play a central role in this translational regulation by repressing the activity of the iron-dependent Rli1 ribosome recycling factor and inhibiting mitochondrial translation and heme biosynthesis. Additionally, we found that iron deficiency represses MRS3 mRNA translation through increased expression of antisense long non-coding RNA. Together, our results reveal complex gene expression and protein synthesis remodeling in response to low iron, demonstrating how this important metal affects protein translation at multiple levels.

Introduction: The assessment of white blood cell (WBC) count and polymorphonuclear cell (PMN) percentage in synovial fluid can help in the diagnosis of acute postoperative peri-prosthetic joint infection (PJI). Their cutoff values, which would differ from those for chronic PJI, have not yet been determined in acute postoperative PJI. The aim of this study was (1) to analyse studies reporting the optimal cutoff values for WBC count and the PMN percentage in synovial fluid and (2) to determine which is the best diagnostic tool for acute postoperative PJI. Methods: We performed a systematic review (SR) of primary studies analysing WBC count and the PMN percentage for diagnosis of acute postoperative PJI. A search was performed in MEDLINE and EMBASE. We studied the risk of bias and quality assessment. We extracted data on cutoff values, sensitivity, specificity, positive and negative predictive value, area under the curve, and accuracy. We calculated the diagnosis odds ratio (DOR), performed the meta-analysis and summarized receiver operating curves (sROCs) for WBC count and the PMN percentage. Results: We included six studies. WBC count showed a DOR of 123.61 (95 % CI: 55.38–275.88), an sROC with an area under the curve (AUC) of 0.96 (SE: 0.009) and a Q index of 0.917. The PMN percentage showed a summary DOR of 18.71 (95 % CI: 11.64–30.07), an sROC with an AUC 0.88 (SE: 0.018) and a Q index of 0.812. Conclusion: We concluded that WBC count and the PMN percentage are useful tests for the diagnosis of acute PJI; WBC is the more powerful of the two. Studies centred on other synovial fluid biomarkers not yet studied could help in this diagnosis.

Background and objective: In orthopaedic surgery, it is clear that an optimal standardised closure technique has not yet been developed. Locally, there are no objective data describing the standard surgical practice in wound closure. The aim of this study is to analyse the clinical practice of surgical wound closure in orthopaedic surgery by means of a survey of a representative local sample and thus obtain information on the context of closure in Spain. Material and Method: An ad hoc group of specialists in orthopaedic surgery and traumatology was formed. The group of experts, after analyzing the literature, developed a questionnaire of 32 closed multiple-choice questions divided into the following blocks: hemostasis, surgical wound closure (deep, superficial, and cutaneous), and dressings. Results: A total of 471 surgeons responded to the survey completely and with sufficient information to perform the descriptive analysis. 79% believe that ATX can influence the decrease in surgical site infection rate. 96% believe that the type of deep closure at the level of the arthrotomy could influence outcomes and complications after hip and/or knee replacements. 85% believe that the type of shallow closure at the subcutaneous level may influence outcomes and complications after hip and/or knee replacement. 64% of surgeons use single-use incisional negative pressure therapy for the treatment of surgical wound complications (seroma, prolonged drainage, dehiscence). Conclusions: There is a high level of variability in wound closure in our setting and a low level of training on the subject. The authors recommend that the different scientific societies invest resources to improve training in this field and reduce the percentage of surgeons who are considered inadequately trained, as well as adapting closure techniques to those considered gold standard according to the evidence. Resumen: Introducción y objetivos: En cirugía protésica de rodilla (PTR) y cadera (PTC) está claro que aún no se ha desarrollado una técnica de cierre estandarizada óptima. A nivel local no existen datos que describan la práctica quirúrgica habitual en cierre de herida. El objetivo de este trabajo es analizar el cierre de herida en cirugía protésica a través de una encuesta sobre una muestra representativa a nivel nacional y así obtener información sobre el contexto del cierre en España. Material y método: El estudio se conforma de un grupo ad hoc de especialistas en cirugía protésica. El grupo de expertos, posterior al análisis de la literatura, elabora un cuestionario de 32 preguntas cerradas de opción múltiple, divididas en los siguientes bloques: hemostasia, cierre quirúrgico de la herida y apósitos. Resultados: Un total de 471 cirujanos respondieron la encuesta de forma completa y con información suficiente para efectuar el análisis descriptivo; de estos, 79% cree que el ácido tranexámico (ATX) puede influir en la disminución de tasa de infección de sitio quirúrgico; por otro lado, 96% piensa que el tipo de cierre profundo a nivel de la artrotomía podría influir en los resultados y complicaciones tras prótesis de cadera y/o rodilla; mientras, 85% considera que el tipo de cierre superficial a nivel subcutáneo es el que puede influir en los resultados y las complicaciones después de prótesis de cadera y/o rodilla; de los cirujanos, 64% utiliza la terapia de presión negativa incisional de simple uso para el tratamiento de las complicaciones de la herida quirúrgica (seromas, drenaje prolongado, dehiscencias). Conclusiones: Existe en nuestro entorno una alta variabilidad en el cierre de la herida y una baja inversión en formación sobre este tema. Los autores recomiendan a las diferentes sociedades científicas la inversión de recursos para mejorar la formación en dicho campo y reducir el porcentaje de cirujanos que se consideran inadecuadamente formados, así como adaptar las técnicas de cierre a aquellas estimadas patrón oro según la evidencia.

This article reviews the advertising content on the YouTube channels featuring kid influencers with the highest number of subscribers in Spain. The goal is to observe the evolution of the elements that define this type of content as advertising content, even though the vast majority of the advertising content is not labelled as such. An analysis was conducted of all the videos posted during the 2022 Christmas period on the 15 YouTube channels with the largest audiences, which produced a sample of 61 videos that possessed the pertinent characteristics. Content analysis was applied and the degree to which the content complied with food and toy advertising regulations was examined.

El artículo analiza si la flexibilidad laboral y la última Gran Recesión abrieron una brecha entre los trabajadores estables y precarios con respecto a su confianza en los sindicatos en España. Para ello se utilizan cuatro encuestas del Centro de Investigaciones Sociológicas llevadas a cabo en los años de bonanza y de la última Gran Recesión. Se comparan medias y se aplican varios análisis de regresión lineal. En una escala de 0 a 10, la confianza en los sindicatos en España cayó del 4,5 en 2005 al 2,5 en 2014. Sin embargo, los datos indican que ni la flexibilidad laboral ni la Gran Recesión fracturaron a los trabajadores estables y precarios en relación a su confianza en los sindicatos.

Este artículo expone una breve perspectiva de las leyes que han guiado el sistema educativo español desde mediados del siglo XIX hasta principios del XXI, y propone una serie de posibles medidas que pueden aplicarse para la corrección del sistema educativo español, en la etapa de la enseñanza secundaria obligatoria. Tal propuesta se basa en el análisis del sistema educativo en España y de lo que a nuestro juicio supone un desacierto de las políticas educativas en los últimos años. Del conjunto de medidas para la mejora del sistema propuestas eliminamos las que supongan una fuerte inversión económica desde las arcas públicas. Son, por lo tanto, medidas que no afectan a los medios invertidos, sino medidas de tipo curricular y organizativo.

Este artículo tiene como propósito analizar el tratamiento de las autolesiones en menores en los diarios El País, El Mundo y ABC del 2012 al 2022. El universo muestral fueron 718 noticias de las cuales, 58 noticias se referían a autolesiones y menores. Se realizó un análisis de contenido para conocer la frecuencia en torno a este tema y enfoque, identificar las emociones que se asocian con las autolesiones e identificar si hay sesgos de género. Los resultados arrojaron que el tratamiento de las autolesiones es muy escaso, solo hay una relativa presencia durante el año 2022 y, en la mayoría de los casos, se vincula con el suicidio. La mayor parte de las noticias aluden a ambos sexos, pero, los testimonios autobiográficos suelen ser del género femenino frente al masculino. También llama la atención que las emociones que priman son las secundarias vinculadas con el factor social.

The TGF-β and Hippo pathways are critical for liver size control, regeneration, and cancer progression. The transcriptional cofactor TAZ, also named WWTR1, is a downstream effector of Hippo pathway and plays a key role in the maintenance of liver physiological functions. However, the up-regulation of TAZ expression has been associated with liver cancer progression. Recent evidence shows crosstalk of TGF-β and Hippo pathways, since TGF-β modulates TAZ expression through different mechanisms in a cellular context-dependent manner but supposedly independent of SMADs. Here, we evaluate the molecular interplay between TGF-β pathway and TAZ expression and observe that TGF-β induces TAZ expression through SMAD canonical pathway in liver cancer HepG2 cells. Therefore, TAZ cofactor is a primary target of TGF-β/SMAD-signaling, one of the pathways altered in liver cancer.