Search

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of the study was to determine whether the duration of preoperative pain affects outcomes of temporomandibular joint replacement (TMJR). Twenty-seven patients who underwent primary TMJR between 1 July 2020 and 31 October 2022 were retrospectively assessed for duration of preoperative pain, level of preoperative and postoperative pain on a visual analogue scale (VAS; 0, none; 10, severe), preoperative and postoperative range of motion (ROM), and net change in quality of life (much better, better, same, worse, much worse), reporting the longest available follow up for each patient. Surgical success was defined as postoperative pain of ≤4 and postoperative ROM of ≥30 mm, or net change (Δ) in ROM of ≥10 mm. Regression analyses evaluated associations between independent variables and postoperative pain and ROM. At a mean follow-up of 17.8 (SD: 6.8, range 3-32) months , pain (5.1, SD: 2.2, p < 0.001) and ROM (9.3 mm, SD: 8.0, p<0.001) significantly improved. Quality of life was much better in 16 patients, better in eight, the same in one, and worse in two. Longer duration of preoperative pain tended to be negatively associated with postoperative ROM (β = −0.27; 95% CI −0.6 to 0.0; p = 0.078) but was not associated with severity of postoperative pain. Surgical success was achieved in 23/27 patients. The successful group tended to have lower pain on VAS preoperatively (5.9, SD: 1.9) vs 7.5, SD: 1.3) and postoperatively (0.4, SD: 0.8 vs 4.8, SD: 2.6), and greater improvement in quality of life (much better: 14/23 vs 2/4). In conclusion, longer duration of preoperative pain tended to be associated with worse postoperative ROM following TMJR. Higher preoperative pain may be a predictor for unsuccessful surgery. [ABSTRACT FROM AUTHOR]

Prenatal folate exposure may alter epigenetic marks in the offspring. We aimed to evaluate associations between prenatal exposure to folic acid (FA) in preconception and in utero with cord blood DNA methylation in long interspersed nuclear element 1 (LINE-1) and Alu short interspersed nuclear elements (SINEs) as markers of global DNA methylation levels. Data come from 325 mother–child pairs participating in the Nutrition in Early Life and Asthma (NELA) birth cohort (2015–2018). Pregnant women were asked about supplement use, including brand name and dose, one month before pregnancy (preconception) and through the trimesters of pregnancy. Maternal dietary folate intake was assessed using a validated food frequency questionnaire with additional questions for FA supplement use. Folate serum levels were measured in mothers at 24 weeks of gestation and in cord blood of newborns. DNA methylation was quantitatively assessed by bisulfite pyrosequencing on 5 LINE-1 and 3 Alu different elements. Associations were estimated using multivariable linear regression models. A reduction in methylation levels of LINE-1 in newborns was associated with the use of FA supplements below the recommended doses (<400 ug/day) during preconception (−0.50; 95% CI: −0.91, −0.09; P = 0.016), and from preconception up to 12 weeks of gestation (−0.48; 95% CI: −0.88, −0.08; P = 0.018). Maternal use of FA supplements above the tolerable upper intake level of 1000 ug/day from preconception until 12 weeks of gestation was also related to lower methylation in LINE-1 at birth (−0.77; 95% CI: −1.52, −0.02; P = 0.044). Neither FA supplement use after 12 weeks of gestation nor maternal total folate intake (diet plus supplements) were associated with global DNA methylation levels at birth. Maternal non-compliance with the use of FA supplement recommendations from preconception up to 12 weeks of gestation reduces offspring global DNA methylation levels at birth. [ABSTRACT FROM AUTHOR]

Patients with systemic lupus erythematosus (SLE) bear a significant burden of pain. We aimed to identify factors that distinguish patients with SLE referred to comprehensive pain clinics and those who are not. Characterizing this patient population will identify unmet needs in SLE management and inform efforts to improve pain care in rheumatology. Among patients with SLE with ≥2 rheumatology clinic visits in a large hospital system from 1998 to 2023 (n = 1319), we examined factors that distinguished those who had at least one visit to multidisciplinary pain clinics (n = 77, 5.8%) from those who did not have any visits (n = 1242, 94.2%) with a focus on biopsychosocial and socioeconomic characteristics. We extracted demographic data and ICD-9/ICD-10 codes from the EHR. Patients with SLE attending the pain clinics exhibited characteristics including average older age (mean age ± SD: 54.1 ± 17.9 vs. 48.4 ± 19.9), a higher likelihood of relying on public health insurance (50.7% vs. 34.2%), and a greater representation of Black patients (9.1% vs. 4.4%) compared to SLE patients not seen in pain clinics. Nearly all patients seen at the pain clinics presented with at least one chronic overlapping pain condition (96.1% vs. 58.6%), demonstrated a higher likelihood of having a mental health diagnosis (76.7% vs. 42.4%), and exhibited a greater number of comorbidities (mean ± SD: 6.0 ± 3.0 vs. 2.9 ± 2.6) compared to those not attending the pain clinic. We found notable sociodemographic and clinical differences between these patient populations. Patients presenting with multiple comorbidities might benefit from further pain screening and referral to pain clinics to provide comprehensive care, and earlier referral could mitigate the development and progression of multimorbidities. [ABSTRACT FROM AUTHOR]

• More than 50% of young pediatric cancer survivors present muscle strength deficits. • Such deficits are associated with lower areal bone mineral density (aBMD) Z -scores at total body (less head), total hip, femoral neck, and lumbar spine. • Each 1-decile lower in muscle strength was associated with 30%–95% higher odds of having low aBMD at most sites. • Early detection of muscle strength deficits after pediatric cancer treatment could help survivors, who lack cancer-related treatment exposures to trigger surveillance, to be screened for low aBMD. Pediatric cancer survivors are at increased risk of muscle weakness and low areal bone mineral density (aBMD). However, the prevalence of muscle strength deficits is not well documented, and the associations of muscle strength with aBMD are unknown in this population. Therefore, this study aimed to investigate the prevalence of upper- and lower-body muscle strength deficits and to examine the associations of upper- and lower-body muscle strength with age-, sex, and race-specific aBMD Z -scores at the total body, total hip, femoral neck, and lumbar spine. This cross-sectional study included 116 pediatric cancer survivors (12.1 ± 3.3 years old, mean ± SD; 42.2% female). Upper- and lower-body muscle strength were assessed by handgrip and standing long jump test, respectively. Dual‑energy X‑ray absorptiometry was used to measure aBMD (g/cm2). Associations between muscle strength and aBMD were evaluated in multivariable linear regression models. Logistic regression was used to evaluate the contribution of muscle strength (1-decile lower) to the odds of having low aBMD (Z -score ≤ 1.0). All analyses were adjusted for time from treatment completion, radiotherapy exposure, and body mass index. More than one-half of survivors were within the 2 lowest deciles for upper- (56.9%) and lower- body muscle strength (60.0%) in comparison to age- and sex-specific reference values. Muscle strength deficits were associated with lower aBMD Z -scores at all sites (B = 0.133–0.258, p = 0.001–0.032). Each 1-decile lower in upper-body muscle strength was associated with 30%–95% higher odds of having low aBMD Z -scores at all sites. Each 1-decile lower in lower-body muscle strength was associated with 35%–70% higher odds of having low aBMD Z -scores at total body, total hip, and femoral neck. Muscle strength deficits are prevalent in young pediatric cancer survivors, and such deficits are associated with lower aBMD Z -scores at all sites. These results suggest that interventions designed to improve muscle strength in this vulnerable population may have the added benefit of improving aBMD. [Display omitted] [ABSTRACT FROM AUTHOR]

A number of minimally invasive osteotomies have been described for the repair of hallux abducto valgus (HAV) deformities. However, there are no known published studies that evaluate the effects of minimally invasive surgery techniques on the reduction of frontal plane rotation in patients with HAV. The purpose of this study was to assess correction in the transverse and frontal planes in patients undergoing surgical repair of HAV deformity utilizing a modified percutaneous technique. One hundred and five feet in 105 patients with HAV deformity were treated with a third generation minimally invasive technique using a first metatarsal osteotomy that allowed for frontal plane correction in conjunction with an Akin osteotomy. The minimum follow-up time was 12 months. Preoperative and postoperative anteroposterior weightbearing x-ray images were assessed and four measurements were evaluated: hallux abductus angle (HAA), intermetatarsal angle (IMA), tibial sesamoid position and frontal plane rotation of the first metatarsal. There were statistically significant differences for each of the assessments between the preoperative and postoperative radiographs (p <.001). There was a mean reduction in the HAA of 23.5° ± 9.6°, in the IMA, 7.0° ± 3.5°, in the tibial sesamoid position, 2.6 ± 1.3, and an improvement in the assessment of first metatarsal pronation (1.4 ± 0.9). The overall complication rate was 18.1%, with 5.7% of the feet requiring reoperation. The minimally invasive procedure employed by the authors demonstrated suitable outcomes in reducing deformity in both the transverse and frontal planes. [ABSTRACT FROM AUTHOR]

Intravascular lithotripsy (IVL) has demonstrated effectiveness in the treatment of calcified lesions in selected patients with stable coronary disease. The authors sought to assess the performance of coronary IVL in calcified coronary lesions in a real-life, all comers, setting. The REPLICA-EPIC18 study prospectively enrolled consecutive patients treated with IVL in 26 centers in Spain. An independent core laboratory performed the angiographic analysis and event adjudication. The primary effectiveness endpoint assessed procedural success (successful IVL delivery, final diameter stenosis <20%, and absence of in-hospital major adverse cardiovascular events [MACE]). The primary safety endpoint measured freedom from MACE at 30 days. A predefined substudy compared outcomes between acute coronary syndrome (ACS) and chronic coronary syndrome (CCS) patients. A total of 426 patients (456 lesions) were included, 63% of the patients presenting with ACS. IVL delivery was successful in 99% of cases. Before IVL, 49% of lesions were considered undilatable. The primary effectiveness endpoint was achieved in 66% of patients, with similar rates among CCS patients (68%) and ACS patients (65%). Likewise, there were no significant differences in angiographic success after IVL between CCS and ACS patients. The rate of MACE at 30 days (primary safety endpoint) was 3% (1% in CCS and 5% in ACS patients [ P = 0.073]). Coronary IVL proved to be a feasible and safe procedure in a "real-life" setting, effectively facilitating stent implantation in severely calcified lesions. Patients with ACS on admission showed similar angiographic success rates but showed a trend toward higher 30-day MACE compared with patients with CCS. (REPLICA-EPIC18 study [Registry of Coronary Lithotripsy in Spain]; NCT04298307) [Display omitted] [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• Neuron activation therapies improve relevant abilities in older adults. • Better results are obtained if the therapy includes functional activities. • The beneficial effects of adding MNAT to a PE program are controversial. : To identify the effects of mirror neuron activation (MNAT) combined or not with physical exercise (PE) in healthy older adults, on functionality, balance, gait velocity and risk of falls. : A systematic electronic search was performed in PubMed/MEDLINE, Cochrane, and Embase databases. : Thirteen randomized controlled trials were included in the qualitative analysis, and eleven in the quantitative analysis. All studies showed fair to high quality and the most frequent high-risk bias was "Blinding of participants and personnel". Compared to the control condition, higher improvement was shown in older people who received MNAT, on functionality (1.57 [0.57, 2.62], balance (1.95 [1.32, 2.572]), and gait velocity (1.20 [0.30, 2.11]). Compared to PE, MNAT combined with PE does not improve functionality. More studies are needed to assess MNAT effectiveness in the rest of the outcomes. : Neuron system activation through MNAT improves relevant abilities in older adults, with better results when including functional activities. However, the beneficial effects on these variables of adding MNAT to a PE program are controversial. [ABSTRACT FROM AUTHOR]

• Treatment of patients with decompensated HFrEF and RD is challenging. • Effect of RD on initiation of sacubitril/valsartan was studied. • Most HF patients with RD tolerated sacubitril/valsartan initiation. • Sacubitril/valsartan treatment led to early and significant improvements in eGFR. • Initiation and up-titration of ARNI early after ADHF are feasible and beneficial. Treatment of patients with heart failure with reduced ejection fraction (HFrEF) and renal dysfunction (RD) is challenging owing to the risk of further deterioration in renal function, especially after acute decompensated HF (ADHF). We assessed the effect of RD (estimated glomerular filtration rate of ≥30 to <60 mL/min/1.73 m2) on initiation, up-titration, and tolerability of sacubitril/valsartan in hemodynamically stabilized patients with HFrEF admitted for ADHF (RD, n = 476; non-RD, n = 483). At week 10, the target dose of sacubitril/valsartan (97/103 mg twice daily) was achieved by 42% patients in RD subgroup vs 54% in non-RD patients (P <.001). Sacubitril/valsartan was associated with greater estimated glomerular filtration rate improvements in RD subgroup than non-RD (change from baseline least squares mean 4.1 mL/min/1.73 m2, 95% confidence interval 2.2–6.1, P <.001). Cardiac biomarkers improved significantly in both subgroups; however, compared with the RD subgroup, the improvement was greater in those without RD (N-terminal pro-brain natriuretic peptide, −28.6% vs −44.8%, high-sensitivity troponin T −20.3% vs −33.9%) (P <.001). Patients in the RD subgroup compared with those without RD experienced higher rates of hyperkalemia (16.3% vs 6.5%, P <.001), investigator-reported cardiac failure (9.7% vs 5.6%, P =.029), and renal impairment (6.4% vs 2.1%, P =.002). Most patients with HFrEF and concomitant RD hospitalized for ADHF tolerated early initiation of sacubitril/valsartan and showed significant improvements in estimated glomerular filtration rate and cardiac biomarkers. NCT02661217. RD was defined as an eGFR (MDRD formula) of ≥30 to <60 mL/min/1.73 m2 determined at randomization bid, twice daily. CI, confidence interval; eGFR, estimated glomerular filtration rate; HF, heart failure; HFrEF, heart failure with reduced ejection fraction; hsTnT, high sensitivity troponin T; LSM, least squares mean; NT-proBNP, N-terminal prohormone of brain natriuretic peptide; RD, renal dysfunction. [Display omitted] [ABSTRACT FROM AUTHOR]

Several orthotopic transcatheter strategies have been developed to treat severe tricuspid regurgitation (TR); however, many patients are deemed unsuitable. Caval valve implantation with the TricValve system addresses this unmet need. This study sought to determine the impact of TricValve on systemic congestion and quality of life (QOL) at 1 year. The TRICUS (Safety and Efficacy of the TricValve® Transcatheter Bicaval Valves System in the Superior and Inferior Vena Cava in Patients With Severe Tricuspid Regurgitation) and TRICUS EURO studies were prospective, nonblinded, nonrandomized, single-arm trials representing the early-in-man experience of the TricValve system in NYHA functional class III or IV severe TR patients, optimally medicated and ineligible for open heart surgery, with significant caval backflow. The primary endpoint was QOL metrics and functional status. The 1-year results of the combined cohort are described here. Forty-four patients were included. Mean age was 76.2 ± 7.5 years, 81.0% were women, and the TRISCORE (risk score model for isolated tricuspid valve surgery) was 5.3 ± 1.3. Clinical improvement at 1 year was achieved in 42 (95.5%) patients, measured by (at least 1 of) an increase in ≥15 points from baseline in 12-item Kansas City Cardiomyopathy Questionnaire score, improvement to NYHA functional class to I or II, or an increase ≥40 m in the 6-minute walk test. There were 3 (6.8%) deaths at 1-year follow-up (1 cardiovascular), and the heart failure rehospitalization rate was 29.5%. Stent fracture, conduction system disturbances, or clinically significant leaflet thrombosis were not detected. Abolished hepatic vein backflow was achieved and persisted in 63.8% of the patients, contributing towards a reduction in congestive symptoms, N-terminal pro–B-type natriuretic peptide levels (P = 0.032), and diuretic treatment. Caval valve implantation with the TricValve system associated with meaningful 1-year clinical improvements in terms of QOL along with relatively low mortality rates. (TRICUS Study – Safety and Efficacy of the TricValve® Device; NCT03723239) [Display omitted] [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The global spread of Klebsiella pneumoniae ST15, causing multi-continental outbreaks, contributes to the movement of resistance genes between clones increasing the antimicrobial resistance crisis. The genomic traits providing it with the ability to outcompete other bacteria and cause epidemics remain unclear. To identify the specific genomic traits of K. pneumoniae ST15 to develop a diagnostic test. An outbreak caused by K. pneumoniae occurred in Hospital A Coruña, Spain. Antimicrobial susceptibility analysis and molecular typing (PGFE and MLST) were performed. One isolate of each sequence type was selected for whole-genome sequencing analysis. Comparative analysis of genomes was performed using RAST. BLASTn was used to evaluate the presence of the fhaC and kpiD genes. Two hundred and ninety-four K. pneumoniae from a Spanish nationwide collection were analysed by PCR. Genotyping showed that 87.5% of the isolates tested belonged to a clone with a unique PFGE pattern which corresponded to ST15. Comparative genomic analysis of the different STs enabled us to determine the specific genomic traits of K. pneumoniae ST15. Two adherence-related systems (Kpi and KpFhaB/FhaC) were specific markers of this clone. Multiplex-PCR analysis with kpiD and fhaC oligonucleotides revealed that K. pneumoniae ST15 is specifically detected with a sensitivity of 100% and a specificity of 97.76%. The PCR results showed 100% concordance with the MLST and whole-genome sequencing data. K. pneumoniae ST15 possesses specific genomic traits that could favour its dissemination. They could be used as targets to detect K. pneumoniae ST15 with high sensitivity and specificity. [ABSTRACT FROM AUTHOR]

The Trifecta aortic valve is a prosthesis with externally mounted leaflets and a stent which may be deformed during implant. Our aim was to know if the use of the holder as a protection device during the knotting has an impact on the incidence of structural valve deterioration (SVD) or endocarditis. Prospective cohort study where all patients who underwent aortic valve replacement with a Trifecta aortic valve between 2013 and 2018 were included. The use of the holder as a protection device was collected in a database. Propensity-score matched methods were used and analyses were based on competing events. Death without SVD or prosthesis replacement not due to SVD was considered competing events. 782 patients were included, 352 pairs after the matching. Rates of SVD at 5 and 8 years were 5.8% (95% CI 3.5–8.7) and 13.6% (95% CI 9.2–18.9) in the group without holder and 2.3% (95% CI 1–4.5) and 7% (95% CI 4.2–10.8) in the group with holder; sHR = 0.49 (95% CI 0.27–0.86; P = 0.015). The risk of endocarditis at 8 years was 4.8% (95% CI 2.8–7.4) in the group without holder and 2.3% (95% CI 1.1–4.3) in the group with holder, sHR = 0.49 (95% CI 0.21–1.15, P = 0.1). The use of holder as a protection device during the knotting of the Trifecta aortic valve is associated with less risk of SVD. [Display omitted] [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) is an important comorbidity in heart failure. The MIMO trial showed that patients with acute cardiogenic pulmonary edema (ACPE) treated with midazolam had fewer serious adverse events than those treated with morphine. In this post hoc analysis, we examined whether the presence/ absence of COPD modifies the reduced risk of midazolam over morphine. Patients >18 years old clinically diagnosed with ACPE and with dyspnea and anxiety were randomized (1:1) at emergency department arrival to receive either intravenous midazolam or morphine. In this post hoc analysis, we calculated the relative risk (RR) of serious adverse events in patients with and without COPD. Calculating the CochranMantel-Haenszel interaction test, we evaluated if COPD modified the reduced risk of serious adverse events in the midazolam arm compared to morphine. Overall, 25 (22.5%) of the 111 patients randomized had a history of COPD. Patients with COPD were more commonly men with a history of previous episodes of heart failure, than participants without COPD. In the COPD group, the RR for the incidence of serious adverse events in the midazolam versus morphine arm was 0.36 (95%CI, 0.1–1.46). In the group without COPD, the RR was 0.44 (95%CI, 0.22–0.91). The presence of COPD did not modify the reduced risk of serious adverse events in the midazolam arm compared to morphine (p for interaction =0.79). The reduced risk of serious adverse events in the midazolam group compared with morphine is similar in patients with and without COPD. [ABSTRACT FROM AUTHOR]

The clinical utility of the Apple Inc.® smartwatch in scenarios beyond detecting atrial fibrillation has been debated. Although the device has the capability to record electrocardiograms (ECG) and detect arrhythmias, voltage limitations hinder its accuracy in measuring real voltage when recording precordial leads. This limitation poses challenges for its clinical use in diagnosing ischemia and screening cardiomyopathies. This review aims to analyze the ECG recording capacity of the Apple Watch, investigate the reasons for voltage limitations, and explore alternative approaches for its use in these clinical scenarios. A comprehensive literature review was conducted to examine the ECG recording capacity of the Apple Watch and the limitations encountered when recording precordial leads. Data in CSV format files were analyzed to gain insights into the underlying causes of voltage limitations. The Apple Watch demonstrates effectiveness in detecting cardiac arrhythmias such as atrial fibrillation using photoplethysmography and ECG recording. However, voltage limitations during precordial lead recordings impede accurate voltage measurement, thereby limiting its clinical utility. Analysis of the data stored in the CSV files revealed that these voltage limitations are primarily attributed to the presentation format. Exploring alternative approaches for data processing could potentially overcome this challenge. This review highlights the potential for addressing voltage limitations through alternative data processing approaches. Further research is necessary to identify suitable alternatives that enable the Apple Watch to be effectively utilized in these clinical scenarios. • The Apple Watch has demonstrated the capability to record ECGs from a single lead and detect atrial fibrillation using photoplethysmography. • Strategically placing the smartwatch on body parts allows recording up to 9 leads, mimicking a standard ECG's morphology. • The device's format limits voltage in precordial leads, leading to inaccuracies and reducing its clinical utility. • This review analyzes Apple Watch's ECG recording capacity and CSV file utilization to explore and mitigate this limitations. [ABSTRACT FROM AUTHOR]

DISCOVER is a global programme of observational research that includes patients with type 2 diabetes initiating second-line glucose-lowering therapy from 38 countries worldwide, including many with little or no previous epidemiological data available. More than 15,000 patients were followed-up for 3 years, and comprehensive data were collected using a standardized electronic case report form at enrolment, and 6, 12, 24 and 36 months. The study has formed the basis for a long-term registry that is intended to expand the geographic and clinical scope of the study and allow data collection beyond 3 years. In this review, critical aspects of study planning and implementation are summarized, along with challenges that were faced, to provide a resource for researchers planning similar studies. In particular, it is essential to set realistic expectations regarding the degree of study representativeness that can be achieved, allow for sufficient time to obtain ethics committee approval, develop tools to help recruit patients effectively, ensure that data collection systems are robust, user-friendly and adaptable, plan adequate remote and on-site monitoring, maximize patient retention through continuous engagement with study sites and ensure that everyone involved in the study forms a friendly and effective team. Observational studies such as DISCOVER are crucial for understanding disease epidemiology and management in real-world settings. They are also increasingly used by governmental, regulatory and payor agencies for post-marketing surveillance and when considering new drug submissions. The development of future studies of similar scope and ambition to DISCOVER is encouraged. • Observational studies provide insight into disease management in the real world. • Lessons can be learned from DISCOVER, a study of patients with type 2 diabetes. • Studies should consider geographic coverage and regulatory and ethics approval. • Site selection and communications can impact patient recruitment and retention. • Operational aspects and challenges described here may help guide future study plans. [ABSTRACT FROM AUTHOR]

To assess short- and long-term outcomes from non-surgical management of diverticulitis with abscess formation and to develop a nomogram to predict emergency surgery. This nationwide retrospective cohort study was performed in 29 Spanish referral centers, including patients with a first episode of a diverticular abscess (modified Hinchey Ib–II) from 2015 to 2019. Emergency surgery, complications, and recurrent episodes were analyzed. Regression analysis was used to assess risk factors, and a nomogram for emergency surgery was designed. Overall, 1,395 patients were included (1,078 Hinchey Ib and 317 Hinchey II). Most (1,184, 84.9%) patients were treated with antibiotics without percutaneous drainage, and 194 (13.90%) patients required emergency surgery during admission. Percutaneous drainage (208 patients) was associated with a lower risk of emergency surgery in patients with abscesses of ≥5 cm (19.9% vs 29.3%, P =.035; odds ratio 0.59 [0.37–0.96]). The multivariate analysis showed that immunosuppression treatment, C-reactive protein (odds ratio: 1.003; 1.001–1.005), free pneumoperitoneum (odds ratio: 3.01; 2.04–4.44), Hinchey II (odds ratio: 2.15; 1.42–3.26), abscess size 3 to 4.9 cm (odds ratio: 1.87; 1.06–3.29), abscess size ≥5 cm (odds ratio: 3.62; 2.08–6.32), and use of morphine (odds ratio: 3.68; 2.29–5.92) were associated with emergency surgery. A nomogram was developed with an area under the receiver operating characteristic curve of 0.81 (95% confidence interval: 0.77–0.85). Percutaneous drainage must be considered in abscesses ≥5 cm to reduce emergency surgery rates; however, there are insufficient data to recommend it in smaller abscesses. The use of the nomogram could help the surgeon develop a targeted approach. [ABSTRACT FROM AUTHOR]

We present the case of a 77-year-old man with ischemic heart disease and baseline right bundle branch block having a well-tolerated and regular wide complex tachycardia with right bundle branch block morphology. A wide complex tachycardia (WCT) could be of supraventricular or ventricular origin. In this setting, we discuss the differential diagnosis of WCT, the usefulness and limitations of the diagnostic criteria for ventricular tachycardia. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Patient-reported outcome measures (PROMs) have gained considerable interest in health care moving beyond traditional outcome measures of morbidity and mortality. In breast cancer surgery, women's' perceptions of appearance, function and quality of life have become increasingly important. The BREAST-Q questionnaire is a validated PROM for use in cosmetic and reconstructive breast surgery in clinical practice. The objective of this study was to validate the Spanish electronic version of the BREAST-Q questionnaire, to verify the measurement equivalence of digital and paper versions and to identify the possible disadvantages and advantages of implementing this new tool. The study population included 113 patients undergoing breast cancer survey at a single hospital in Barcelona (Spain) who were able to complete both the electronic and paper versions of the preoperative module of the BREAST-Q questionnaire. The intraclass correlation coefficient (ICC) in the four domains of the questionnaire between the two versions of the questionnaire was >0.9, with a weighted kappa of >0.74 at item level. The reliability of the internal consistency was also excellent, with Cronbach's alpha coefficient of >0.70 in all domains. Age was a limiting factor for the delivery of the electronic version of BREAST-Q, with 69 years of age as the cut-off point to obtain reliable results. The interchangeability of the electronic and paper versions of the BREAST-Q questionnaire facilitates implementation of this instrument in routine surgical oncological practice. [ABSTRACT FROM AUTHOR]

There is a disparity in access, quality, and sustainability of cleft care in low and middle income countries, where burden of disease is greatest. CLEFT-Bridging the Gap (registered charity number: 1194581) is a UK-based charity that aims is to solve this through teaching, empowerment and development of sustainable cleft services. A Student Section, composed of medical, dental and speech and language therapy students, was established to support these endeavours through fundraising. 1) examine effectiveness of the Student Section, 2) explore students' perception of cleft care, 3) provide a framework for similar groups. Cross-sectional survey study design. Likert-Scale responses to questions regarding organisation and experience of the section were collected. Data was analysed using Chi statistical test, ordinal data assessed using Wilcoxon-Signed Rank test. 40/64 ambassadors responded to the survey. 90% had a positive perception on the organisation of the section, this correlated with group size (p = 0.012) and number of fundraising events organised (p = 0.032). 85% had an overall positive experience, scores for consideration of a career in cleft significantly improved from 2.25 (95%CI: 1.95–2.55) to 3.30 (95%CI: 3.03–3.57) (p < 0.001). This study presents the first example of a nationwide student group involved with a charitable cleft organisation. [ABSTRACT FROM AUTHOR]

We describe the clinical and pathological features of a brain collision tumour consisting of a fibrous meningioma and an anaplastic oligoastrocytoma in a 14-year-old male neutered French Bulldog. Computed tomography of the brain revealed a poorly defined, intra-axial lesion affecting the left frontal lobe. Following euthanasia, histological examination showed an anaplastic oligoastrocytoma invading the brain parenchyma and an adjacent fibrous meningioma. As synchronous intracranial tumours are rare in animals, the aims of this report are to describe the clinical, imaging and histopathological features of an intracranial collision tumour in a dog and highlight the importance of a complete histopathological study despite the imaging findings. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To assess whether feedback-guided exercises performed on a tablet touchscreen improve clinical recovery and reduce health care usage more than the conventional home exercise program prescribed on paper in patients with bone and soft tissue injuries of the wrist, hand, and/or fingers treated by public health services. A multicenter assessor-blinded, parallel, 2-group controlled trial. Trauma and rehabilitation services of 4 hospitals. Six hundred sixty-three patients with limited functional ability due to bone and soft tissue injuries of the wrist, hand, and/or fingers (N=663). The experimental group received a home exercise program using a tablet-based application with feedback, monitoring, and progression; the control group received an evidence-based home exercise program on paper. The primary outcome was functional ability through Patient Rated Wrist Evaluation for wrist conditions and the short version of Disabilities of the Arm, Shoulder and Hand for all other hand pathologies. Secondary outcomes included dexterity, pain intensity, grip strength, and health care usage (number of patients referred to rehabilitation service and number of clinical appointments). The experimental group showed a significant improvement on the Patient Rated Wrist Evaluation (P =.001) and the short version of Disabilities of the Arm, Shoulder and Hand (P =.001) with medium effect sizes (η2=0.066-0.067) when compared with the control group. Regarding health care usage, the experimental group presented a reduction of 41% in the rate of referrals to face-to-face rehabilitation service consultations, a reduction of rehabilitation consultations (mean difference=−1.64; 95% confidence interval, −2.64 to −0.65) and physiotherapy sessions (mean difference=−8.52, 95% confidence interval, −16.92 to −0.65) compared to the control group. In patients with bone and soft tissue injuries of the wrist, hand, and/or fingers, prescribing feedback-guided exercises performed on a tablet touchscreen was more effective for improving patients' functional ability and reduced the number of patients referred to rehabilitation consultation and number of clinical appointments. [ABSTRACT FROM AUTHOR]

Factor VII deficiency is one of the most common Rare Bleeding Disorders (RBDs). Its phenotype is highly variable, ranging from asymptomatic to spontaneous bleeding. Cardiac surgery is likely one of the most complex scenarios for this type of patients, where, according to limited literature, maintaining factor VIIa >20% is recommended. In this context, it is important to optimize the patient in the perioperative period, as well as establish an individualized anesthetic plan in order to minimize the risk of bleeding and guide our transfusion decisions according to targets. We present the case of a 40-year-old male patient with a history of hepatitis infection, diagnosed with subacute endocarditis and awaiting surgery. Preoperative tests during preanesthetic assessment revealed an incidental coagulation abnormality, with an INR of 2.5 uncorrected by vitamin K and plasma. Factor VIIa levels were requested, confirming a severe factor VIIa deficiency (15%). We decided, in collaboration with Cardiac Surgery and Hematology, to closely monitoring coagulation using viscoelastic tests (ROTEM®) and to reserve recombinant factor VII for uncontrollable bleeding situations, due to its high thrombotic risk. Thirty minutes before surgery, a CTextem of 92s was detected, and we transfused 2 units of fresh frozen plasma. In the operating room, we placed two large-caliber peripheral lines and a high-flow central line. Intraoperative advanced monitoring during cardiac surgery was performed, including: invasive blood pressure, conventional pulse oximetry, electrocardiography, BIS®, INVOS® (cerebral oximetry) and transesophageal ultrasound. Initially, we administered 1 gram of tranexamic acid intravenous bolus followed by continuous infusion (1mg/kg/h) according to the local protocol. Heparin was also administered to achieve an acting clotting time of 480s. The valvular defect was repaired without incidents. Before coming off cardiopulmonary bypass, we repeat ROTEM® detecting a CTextem of 94s and CTintem of 2058s. (Image1). Then, we transfused 1 unit of fresh frozen plasma, 500 IU of prothrombin complex, and 300mg of protamine. Although CTintem was corrected, CTextem remained prolonged. Finally, we transfused 3 doses of recombinant factor VII (3mg) as a result of evident uncontrollable bleeding despite surgical efforts, then viscoelastic test was repeated. Eventually, the bleeding was controlled, and the CTextem corrected (52s). (Image2). The patient was transferred to the intensive care unit (ICU) intubated for postoperative control. Extubation occurred 6 hours later without incidents. During his stay in the ICU, both bleeding and the potential thrombotic event were closely monitored. After 3 days without significant events, the patient was discharged to the Cardiac Surgery ward. The case presented illustrates how cardiac surgery can be safely performed in a patient with Factor VII deficiency under thromboelastography-guidance. Factors such as baseline factor activity, bleeding history, and the type of surgery are crucial in deciding the best management approach. A team effort involving cardiologists, anesthesiologists, and hematologists is key to plan the procedure. The monitoring of coagulation with viscoelastic tests can be used as a guide for safely performing the transfusion of blood products. Due to the rarity of Rare Bleeding Disorders, collecting case reports is essential to improve our understanding of RBD management. [ABSTRACT FROM AUTHOR]

Hip abductor deficiency resulting from gluteus medius and minimus pathology is increasingly recognized as a generator of lateral-sided hip pain. In the setting of a failed gluteus medius repair or in patients with irreparable tears, transfer of the anterior portion of the gluteus maximus muscle can be performed to treat gluteal abductor deficiency. The classic description of the gluteus maximus transfer technique relies solely on bone tunnel fixation. This article describes a reproducible technique that incorporates the addition of a distal row to the tendon transfer, which may improve fixation by both compressing the tendon transfer to the greater trochanter and providing improved biomechanical strength to the transfer. [Display omitted] [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A pharmacist-led, individualised, educational intervention (SUGAR) was formulated to prevent hypoglycaemia among elderly patients with type 2 diabetes mellitus (T2DM) in Jordan. To evaluate the effectiveness of the SUGAR intervention added to usual care compared with usual care only in preventing hypoglycaemic attacks in elderly patients with T2DM in Jordan. A single-centre, pragmatic, open-label, randomised controlled trial with embedded process evaluation was conducted at the outpatient clinics of a hospital in Jordan. Elderly patients (≥65 years) with T2DM and on sulfonylurea, insulin, or at least three anti-diabetic medications were recruited and parallelly randomised to the SUGAR intervention with usual care or the control (usual care) groups. The primary outcome was the rate of total hypoglycaemic attacks per patient after 3 months from randomisation. Secondary outcomes included rate of hypoglycaemia subtypes, the incidence of any and subtypes of hypoglycaemia, hypoglycaemia-free survival probability, and incidence of fasting hyperglycaemia necessitating therapy modification. Outcomes were measured through glucose meters and diaries, assessed at 3 months, and analysed by intention to treat. A total of 212 participants (mean age 68.98 years, 58.96% men) were randomly allocated (106 in each group), with 190 (89.62%) participants completing the study. The mean of total hypoglycaemic attacks was less in the intervention group compared with the control group (3.91 [SD 7.65] vs. 6.87 [SD 11.99]; p < 0.0001) at three months. The intervention significantly reduced the rate of hypoglycaemia subtypes; the odds to experience any, severe, and symptomatic hypoglycaemia; and increased hypoglycaemia-free survival probability compared with the control group at three months. Incidence of fasting hyperglycaemia necessitating therapy modification was similar between groups. The SUGAR intervention can prevent hypoglycaemia without increasing the risk of fasting hyperglycaemia warranting therapy adjustment in elderly Jordanians with T2DM. • The SUGAR intervention is an individualised, pharmacist-led, educational intervention. • The SUGAR intervention can reduce rate and incidence of hypoglycaemia in the elderly. • The SUGAR intervention can increase hypoglycaemia-free survival probability. • The SUGAR intervention does not increase the risk of fasting hyperglycaemia. [ABSTRACT FROM AUTHOR]

Opioids are the most effective painkillers, but their benefit-risk balance often hinder their therapeutic use. WLB-73502 is a dual, bispecific compound that binds sigma-1 (S1R) and mu-opioid (MOR) receptors. WLB-73502 is an antagonist at the S1R. It behaved as a partial MOR agonist at the G-protein pathway and produced no/unsignificant β -arrestin-2 recruitment, thus demonstrating low intrinsic efficacy on MOR at both signalling pathways. Despite its partial MOR agonism, WLB-73502 exerted full antinociceptive efficacy, with potency superior to morphine and similar to oxycodone against nociceptive, inflammatory and osteoarthritis pain, and superior to both morphine and oxycodone against neuropathic pain. WLB-73502 crosses the blood–brain barrier and binds brain S1R and MOR to an extent consistent with its antinociceptive effect. Contrary to morphine and oxycodone, tolerance to its antinociceptive effect did not develop after repeated 4-week administration. Also, contrary to opioid comparators, WLB-73502 did not inhibit gastrointestinal transit or respiratory function in rats at doses inducing full efficacy, and it was devoid of proemetic effect (retching and vomiting) in ferrets at potentially effective doses. WLB-73502 benefits from its bivalent S1R antagonist and partial MOR agonist nature to provide an improved antinociceptive and safety profile respect to strong opioid therapy. WLB-73502 is a bispecific sigma-1 antagonist and partial mu-opioid agonist (low intrinsic efficacy at G i/o -protein activation and undetectable β -arrestin-2 recruitment) with improved antinociceptive and safety profile respect to strong opioids. [Display omitted] [ABSTRACT FROM AUTHOR]

Preprocedural right ventricular–to–pulmonary artery (RV-PA) coupling is a major predictor of outcome in patients with secondary mitral regurgitation (SMR) undergoing transcatheter edge-to-edge mitral valve repair (M-TEER). However, clinical significance of changes in RV-PA coupling after M-TEER is unknown. The aim of this study was to evaluate changes in RV-PA coupling after M-TEER, their prognostic value, and predictors of improvement. This was a retrospective observational study, including patients undergoing successful M-TEER (residual mitral regurgitation ≤2+ at discharge) for SMR at 13 European centers and with complete echocardiographic data at baseline and short-term follow-up (30-180 days). RV-PA coupling was assessed with the use of echocardiography as the ratio of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP). All-cause death was assessed at the longest available follow-up starting from the time of the echocardiographic reassessment. Among 501 patients included, 331 (66%) improved their TAPSE/PASP after M-TEER (responders) at short-term follow-up (median: 89 days; IQR: 43-159 days), whereas 170 (34%) did not (nonresponders). Lack of previous cardiac surgery, low postprocedural mitral mean gradient, low baseline TAPSE, high baseline PASP, and baseline tricuspid regurgitation were independently associated with TAPSE/PASP improvement after M-TEER. Compared with nonresponders, responders had lower New York Heart Association functional class and less heart failure hospitalizations at short-term follow-up. Improvement in TAPSE/PASP was independently associated with reduced risk of mortality at long-term follow-up (584 days; IQR: 191-1,243 days) (HR: 0.65 [95% CI: 0.42-0.92]; P = 0.017). In patients with SMR, improvement in TAPSE/PASP after successful M-TEER is predicted by baseline clinical and echocardiographic variables and postprocedural mitral gradient, and is associated with a better outcome. [Display omitted] [ABSTRACT FROM AUTHOR]

In recent years, fluorescence imaging—relying both on parathyroid gland autofluorescence under near-infrared light and angiography using the fluorescent dye indocyanine green—has been used to reduce risk of iatrogenic parathyroid injury during thyroid and parathyroid resections, but no published guidelines exist regarding its use. In this study, orchestrated by the International Society for Fluorescence Guided Surgery, areas of consensus and nonconsensus were examined among international experts to facilitate future drafting of such guidelines. A 2-round, online Delphi survey was conducted of 10 international experts in fluorescence imaging use during endocrine surgery, asking them to vote on 75 statements divided into 5 modules: 1 = patient preparation and contraindications to fluorescence imaging (n = 11 statements); 2 = technical logistics (n = 16); 3 = indications (n = 21); 4 = potential advantages and disadvantages of fluorescence imaging (n = 20); and 5 = training and research (n = 7). Several methodological steps were taken to minimize voter bias. Overall, parathyroid autofluorescence was considered better than indocyanine green angiography for localizing parathyroid glands, whereas indocyanine green angiography was deemed superior assessing parathyroid perfusion. Additional surgical scenarios where indocyanine green angiography was thought to facilitate surgery are (1) when >1 parathyroid gland requires resection; (2) during redo surgeries, (3) facilitating parathyroid autoimplantation; and (4) for the predissection visualization of abnormal glands. Both parathyroid autofluorescence and indocyanine green angiography can be used during the same procedure and employing the same imaging equipment. However, further research is needed to optimize the dose and timing of indocyanine green administration. Though further research remains necessary, using fluorescence imaging appears to have uses during thyroid and parathyroid surgery. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We present a comprehensive, customizable workflow for inferring prokaryotic phenotypic traits from marker gene sequences and modelling the relationships between these traits and environmental factors, thus overcoming the limited ecological interpretability of marker gene sequencing data. We created the trait sequence database ampliconTraits , constructed by cross-mapping species from a phenotypic trait database to the SILVA sequence database and formatted to enable seamless classification of environmental sequences using the SINAPS algorithm. The R package MicEnvMod enables modelling of trait – environment relationships, combining the strengths of different model types and integrating an approach to evaluate the models' predictive performance in a single framework. Traits could be accurately predicted even for sequences with low sequence identity (80 %) with the reference sequences, indicating that our approach is suitable to classify a wide range of environmental sequences. Validating our approach in a large trans-continental soil dataset, we showed that trait distributions were robust to classification settings such as the bootstrap cutoff for classification and the number of discrete intervals for continuous traits. Using functions from MicEnvMod, we revealed precipitation seasonality and land cover as the most important predictors of genome size. We found Pearson correlation coefficients between observed and predicted values up to 0.70 using repeated split sampling cross validation, corroborating the predictive ability of our models beyond the training data. Predicting genome size across the Iberian Peninsula, we found the largest genomes in the northern part. Potential limitations of our trait inference approach include dependence on the phylogenetic conservation of traits and limited database coverage of environmental prokaryotes. Overall, our approach enables robust inference of ecologically interpretable traits combined with environmental modelling allowing to harness traits as bioindicators of soil ecosystem functioning. [Display omitted] • The trait sequence data base ampliconTraits combines phenotypical traits with SILVA sequences. • Environmental prokaryotic marker gene sequences can be classified with high accuracy using SINAPS. • Community weighted trait means were robust to classification settings in a large soil dataset. • Modelling of community traits with environmental predictors and cross validation with MicEnvMod. • Land cover and precipitation seasonality were key drivers of prokaryotic genome size. [ABSTRACT FROM AUTHOR]

• The principle of one-drug-one-target has failed in Alzheimer's disease and other neurodegenerative diseases during the last three decades. • The uncontrolled entry of calcium ions (Ca2+) through plasmalemmal calcium channels is a well-known cell death trigger, the conjecture is here raised that mitigating such an excess of Ca2+ entry should rescue from death the vulnerable neurons in neurodegenerative diseases. • A therapy to prevent neuronal death should be more efficient by targeting with various drugs. Here we propose to mitigate Ca2+ entry by the simultaneous partial blockade of three quite different subtypes of plasmalemmal calcium channels that is, the Cav1 subtype of VOCCs, the Orai1 store-operated calcium channel (SOCC), and the purinergic P2X7 calcium channel. As the uncontrolled entry of calcium ions (Ca2+) through plasmalemmal calcium channels is a cell death trigger, the conjecture is here raised that mitigating such an excess of Ca2+ entry should rescue from death the vulnerable neurons in neurodegenerative diseases (NDDs). However, this supposition has failed in some clinical trials (CTs). Thus, a recent CT tested whether isradipine, a blocker of the Cav1 subtype of voltage-operated calcium channels (VOCCs), exerted a benefit in patients with Parkinson's disease (PD); however, outcomes were negative. This is one more of the hundreds of CTs done under the principle of one-drug-one-target, that have failed in Alzheimer's disease (AD) and other NDDs during the last three decades. As there are myriad calcium channels to let Ca2+ ions gain the cell cytosol, it seems reasonable to predict that blockade of Ca2+ entry through a single channel may not be capable of preventing the Ca2+ flood of cells by the uncontrolled Ca2+ entry. Furthermore, as Ca2+ signaling is involved in the regulation of myriad functions in different cell types, it seems also reasonable to guess that a therapy should be more efficient by targeting different cells with various drugs. Here, we propose to mitigate Ca2+ entry by the simultaneous partial blockade of three quite different subtypes of plasmalemmal calcium channels that is, the Cav1 subtype of VOCCs, the Orai1 store-operated calcium channel (SOCC), and the purinergic P2X7 calcium channel. All three channels are expressed in both microglia and neurons. Thus, by targeting the three channels with a combination of three drug blockers we expect favorable changes in some of the pathogenic features of NDDs, namely (i) to mitigate Ca2+ entry into microglia; (ii) to decrease the Ca2+-dependent microglia activation; (iii) to decrease the sustained neuroinflammation; (iv) to decrease the uncontrolled Ca2+ entry into neurons; (v) to rescue vulnerable neurons from death; and (vi) to delay disease progression. In this review we discuss the arguments underlying our triad hypothesis in the sense that the combination of three repositioned medicines targeting Cav1, Orai1, and P2X7 calcium channels could boost neuroprotection and delay the progression of AD and other NDDs. [Display omitted] [ABSTRACT FROM AUTHOR]

This systematic literature review examines Occupant Behaviour (OB) modelling in residential buildings, focusing on its role in narrowing the energy performance gap and enhancing occupant comfort. It provides an overview of methodologies from simple statistical models to advanced machine learning algorithms. We conducted a chronological literature review on OB modelling in residential buildings, identifying the algorithms and the main remarks and limitations of each study. We also present sample populations for each study, offering a comprehensive view of OB modelling's evolution. Our study shows a trend towards incorporating intelligent technologies like IoT and Artificial Intelligence, highlighting an evolution towards more advanced and precise techniques. The review evaluates studies utilizing monitoring, diary, or survey data to improve behavioural model accuracy, covering aspects such as occupant presence, window manipulation, lighting and shading regulation, thermostat adjustment, and usage patterns of domestic hot water and appliances. The review underscores the importance of standardized data collection and integrating OB into building standards. It advocates for adaptive OB models leveraging IoT data with privacy considerations and calls for comparative analysis of modelling techniques. Future research should develop adaptable occupancy profile repositories and integrated modelling frameworks to address OB complexities. • Explores comprehensive occupant behaviour modelling methods in residential settings. • Urges integration of realistic occupant behaviour models into building standards. • Highlights IoT's crucial role in enhancing occupant behaviour model accuracy. • Proposes extensive future research directions in occupant behaviour modelling. [ABSTRACT FROM AUTHOR]

This paper aims to develop an assessment of the COVID-19 impact on key maritime sectors (small-scale and large fisheries) in Spain, one of the most important maritime regions in the world. We synthesize multiple data sources from across the seafood supply chain to show the relative seafood sector responses and variables of recovery during the pre-COVID-19 period (2015–2019) and during the pandemic (2020). Our results show that the reported landings made in 2020 by the different Spanish fleets (786,900 t) represented an 11 % reduction compared to the annual average landed between 2015 and 2019. On average, the fishing effort of the small-scale fishing fleets suffered a higher decline (16 %) related to the large-scale fleet (5 %), but the large-scale fleet experienced a higher reduction (25 %) in landing value between the pre-COVID-19 and pandemic. Although the decrease in catches affected almost all the Spanish-studied regions, the reductions were especially relevant in the Basque Country (-14 %) and Galicia (-11 %), since they are the main fishing regions responsible for 76 % of Spanish landings. The volume and value of imports and exports of fresh, frozen, and canned products in 2020 did not change (±5 %) compared to the previous period (2015-2019) but seafood trade was affected by country of origin and destination and by Autonomous Community. Overall, our study highlights that the fisheries sector in Spain was also able to implement a range of adaptive strategies, such as diversification of species portfolios or distribution of seafood door-to-door which appeared swiftly to compensate for the vanishing restaurant markets. [ABSTRACT FROM AUTHOR]

Andean Lupin (Lupinus mutabilis S.) or tarwi, a legume cultivated in the Andean region of South America, is considered a protein source. In this work, flours were prepared from different Andean Lupin genotypes, namely Cholo Fuerte (CHF), Común (CM), or Altagracia (ALT), grown at 2700 (1) or 3300 (2) meters above sea level. The effect of genotype and growth altitude on the chemical composition, color, phytochemical (alkaloids, free phenolics, fatty acids, and sterols) content, antioxidant activity, and microbiological quality of the flours was evaluated. CM-1 flour had higher protein, polyunsaturated fatty acid (PUFA), and Δ5-avenasterol content. CHF-1 flour had higher crude fiber, Δ7-campesterol, clerosterol, and saturated fatty acid (SFA) content and higher antioxidant activity. ALT-2 flour had the highest total sterol content, particularly stigmasterol and β-sitosterol. None of the flours contained alkaloids or microorganisms, confirming that the preparation process was efficient. Andean Lupin cultivated at high and low altitude provides flour with high phytosterol and PUFA content, respectively. CM-1 flour has potential use in the food and nutraceutical industry due to its higher protein, essential fatty acid or PUFA, and total sterol content as well as low SFA content. • Three genotypes of tarwi grown at two altitudes were used to obtain flour. • The tarwi Común genotype grown at low altitude yielded flour with high nutritional quality. • The tarwi Altagracia genotype grown at high altitude yielded flour with high sterol content. • The tarwi flours had low antioxidant activity and phenolic compounds content. • The chemical composition of tarwi flour were affected by the genotype and growth altitude. [ABSTRACT FROM AUTHOR]