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Rationale: Clozapine has proven to be superior to other antipsychotic drugs in the treatment of schizophrenia but is under-prescribed due to its potentially severe side effects. Clozapine-induced sialorrhea (CIS) is a frequent and extremely uncomfortable side effect, which remains understudied. Objectives: To examine the prevalence of diurnal and nocturnal CIS in a sample of patients treated with clozapine, and to evaluate its impact on quality of life. Methods: We conducted a cross-sectional, observational study of 130 patients with schizophrenia spectrum disorders treated with clozapine. The prevalence of CIS was evaluated via specific sialorrhea scales. None of the patients included in the study was receiving a specific treatment for hypersalivation during the study period. Possible associations between sialorrhea and clinical and quality of life variables were analyzed. Results: Of 130 subjects, 120 (92.3%) suffered from CIS. Eighty-one (62.31%) suffered from diurnal CIS, 115 (88.56%) from nocturnal CIS, and 85 (65.38%) suffered from both. Significant positive associations between quality of life and diurnal CIS (B = 0.417; p = 2.1e - 6, R2 = 0.156) and nocturnal CIS (B = 0.411; p = 7.7e - 6, R2 = 0.139) were detected. Thirty per cent of the subjects reported a moderate to severe negative impact of sialorrhea on their quality of life. Conclusions: The present study suggests that CIS is highly prevalent in patients with schizophrenia and has an important impact on quality of life in one-third of our sample. Therefore, the inclusion of a systematic evaluation and treatment of CIS in standard clinical practice is highly recommended. Trial registration: Clinical Trials ( https://clinicaltrials.gov ) under reference NCT04197037.

Today, patient management generally requires a multidisciplinary approach. However, due to the growing knowledge base and increasing complexity of Medicine, clinical practice has become even more specialised. Radiation oncology is not immune to this trend towards subspecialisation, which is particularly evident in ablative radiotherapy techniques that require high dose fractions, such as stereotactic radiosurgery (SRS), and stereotactic body radiotherapy (SBRT). The aim of the present report is to establish the position of the Spanish Society of Radiation Oncology (SEOR), in collaboration with the Spanish Society of Medical Physics (SEFM), with regard to the roles and responsibilities of healthcare professionals involved in performing SRS and SBRT. The need for this white paper is motivated due to the recent changes in Spanish Legislation (Royal Decree [RD] 601/2019, October 18, 2019) governing the use and optimization of radiotherapy and radiological protection for medical exposure to ionizing radiation (article 11, points 4 and 5) [1 ], which states: “In radiotherapy treatment units, the specialist in Radiation Oncology will be responsible for determining the correct treatment indication, selecting target volumes, determining the clinical radiation parameters for each volume, directing and supervising treatment, preparing the final clinical report, reporting treatment outcomes, and monitoring the patient’s clinical course.” Consequently, the SEOR and SEFM have jointly prepared the present document to establish the roles and responsibilities for the specialists—radiation oncologists (RO), medical physicists (MP), and related staff —involved in treatments with ionizing radiation. We believe that it is important to clearly establish the responsibilities of each professional group and to clearly establish the professional competencies at each stage of the radiotherapy process.

Pro-social behavior is crucial to the sustainable governance of common-pool resources such as fisheries. Here, we investigate how key socioeconomic characteristics influence fishers’ pro-social and bargaining behavior in three types of experimental economic games (public goods, trust, and trade) conducted in fishing associations in Chile. Our games revealed high levels of cooperation in the public goods game, a high degree of trust, and that sellers rather than buyers had more bargaining power, yet these results were strongly influenced by participants’ socioeconomic characteristics. Specifically, gender, having a secondary income source, age, and being the main income provider for the household all had a relationship to multiple game outcomes. Our results highlight that engagement in pro-social behaviors such as trust and cooperation can be influenced by people’s socioeconomic context.

Background Patients with resected oral cavity squamous cell carcinoma (OCSCC) are often treated with adjuvant radiation (RT) ± concomitant chemotherapy based on pathological findings. Standard RT volumes include all surgically dissected areas, including the tumour bed and dissected neck. RT has significant acute and long-term toxicities including odynophagia, dysphagia, dermatitis and fibrosis. The goal of this study is to assess the rate of regional failure with omission of radiation to the surgically dissected pathologically node negative (pN0) hemi-neck(s) compared to historical control, and to compare oncologic outcomes, toxicity, and quality of life (QoL) profiles between standard RT volumes and omission of RT to the pN0 neck. Methods This is a multicentre phase II study randomizing 90 patients with T1–4 N0–2 OCSCC with at least one pN0 hemi-neck in a 1:2 ratio between standard RT volumes and omission of RT to the pN0 hemi-neck(s). Patients will be stratified based on overall nodal status (nodal involvement vs. no nodal involvement) and use of concurrent chemotherapy. The primary endpoint is regional failure in the pN0 hemi-neck(s); we hypothesize that a 2-year regional recurrence of 20% or less will be achieved. Secondary endpoints include overall and progression-free survival, local recurrence, rate of salvage therapy, toxicity and QoL. Discussion This study will provide an assessment of omission of RT to the dissected pN0 hemi-neck(s) on oncologic outcomes, QoL and toxicity. Results will inform the design of future definitive phase III trials. Trial registration Clinicaltrials.gov identifier: NCT03997643. Date of registration: June 25, 2019, Current version: 2.0 on July 11 2020.

Global advances in pain relief have improved the quality of life of cancer populations. Yet, variation in cancer pain outcomes has been found in populations with social disparities compared to mainstream groups. Populations with social disparities bear an inequitable distribution of resources such as ethnic minorities, low income individuals, and women in vulnerable circumstances. A systematic review and meta-analysis of the effect of non-pharmacological cancer pain interventions in cancer populations with social disparities of income, ethnicity, or gender. Randomized controlled trials, controlled trials, and before and after studies were targeted through comprehensive multidatabase searches. Two reviewers independently screened titles/abstracts for potentially relevant studies and reviewed the full text of relevant articles for inclusion. Data were extracted from included studies by one reviewer and verified by another reviewer. Four reviewers independently completed quality assessment. Studies were grouped by intervention. Effects were evaluated for heterogeneity and pooled. The search found 5219 potential records. Full text of 26 reports was evaluated. Three randomized controlled trials (RCTs) met inclusion criteria, targeting ethnic minorities and underserved populations and/or women. Interventions included education, coaching, and online support groups. Studies found no significant differences in pain reduction between intervention and control groups or between ethnic minorities and their counterparts. A high risk of bias was found in all studies. Meta-analysis found no statistically significant difference on pain intensity among underserved groups, ethnic minorities, or between ethnic minorities and white counterparts. Results show the need to examine supportive care interventions particularly in populations with social disparities.

Agro-industrial activities generate millions of tons of residues all over the world. Although many of them contain bioactive compounds, they are underexplored. Ethanolic extracts of beetroot stems (EEB) and guava pomace (peels, seeds) (EEG) were analyzed to assess their chemical composition (phenolic compounds and chemical profile by GC-MS) and antioxidant activity (EC50 and ABTS). Posteriorly, EEB and EEG were added to processed chicken meat, which was cooked and stored in vacuum and aerobic packages at 4 ± 1 °C for 14 days, to assess their oxidative stability and color. EEB presented higher content of phenolic compounds and antioxidant activity compared to EEG. Using GC-MS, we identified 11 phenolic compounds in EEB and EEG. When added to chicken meat, EEG and EEB retarded lipid oxidation compared to the control after 14 days of storage in aerobic packages. In general, in both packages the natural extracts proved to be as effective as BHT to maintain oxidative stability of chicken meat.

The aim of the present study was to develop a new restructured product, cooked and frozen ready-to-eat product that was prepared with boneless chicken meat (breast and drumstick) and mechanically separated chicken meat (MSCM). Non-meat ingredients, such as transglutaminase (TG) and egg albumin powder, were tested to obtain a better strength of adhesion between the meat particles. Five formulations for restructured chicken were developed as follows: T1 (1 % transglutaminase), T2 (1 % transglutaminase and 15 % MSCM), T3 (1 % egg albumin powder), T4 (1 % egg albumin powder and 15 % MSCM) and T5 (1 % transglutaminase, 1 % egg albumin powder and 15 % MSCM). The results of the experiment showed a greater luminosity (L*) in the treatments with TG (T1) and albumin (T3). The treatments without MSCM (T1 and T3) presented significantly lower mean values for redness (a*) when compared to treatments with MSCM (T2, T4 and T5) (p ≤ 0.05). No significant differences were noted between the treatments (p ≥ 0.05) when analyzing the percentage of total saturated fatty acids (SFA), polyunsaturated fatty acids (PUFA) and cholesterol content. Consumer testing showed a high acceptance of the restructured products in all evaluated attributes. Similarly, with regard to the purchase intention, consumers mostly expressed that they would probably or certainly buy the products, for treatments T1, T2, T3 and T5. Moreover, the meat cuts with no commercial value, can transform into new ready-to-eat products that have a high probability of success in the market.

Sensory analysis, instrumental color, pH, and thiobarbituric acid reactive substances (TBARS) were determined on cooked chicken meat with and without grape seed extract during refrigerated storage. The effectiveness of extracts of winery grape residue from the grape varieties ‘Isabel’ and ‘Niagara’ were tested to evaluate their effectiveness at delaying lipid oxidation in cooked chicken meat and stored under refrigeration (4±1°C). The samples were aerobically and vacuum packaged and stored for 14 days. ‘Isabel’ grape extract (IGE) and ‘Niagara’ grape extract (NGE) proved effective at promoting oxidative stability when applied at concentrations of 40 or 60 mg of gallic acid equivalents (GAE)/kg, with results similar to the synthetic antioxidant butylated hydroxytoluene (BHT). The antioxidant efficiency of the extracts was highly dependent on the concentration used. The addition of grape-residue extracts combined with vacuum packaging proved to be a good method for increasing lipid stability in cooked chicken meat stored under refrigeration.

The immunologic signals participating in immune responses early in life have not been completely elucidated. Regarding the characterization of neonatal cells, little is known concerning the activity of transcription factor nuclear factor kappa B (NF-kappaB), which regulates inflammatory genes and cytokine production. The aim of this study was to characterize NF-kappaB activation in cord blood mononuclear cells (CBMC). We analyzed the potential association of NF-kappaB activity with lymphocyte proliferation and influences on cytokine secretion in the early immune system. To determine the contribution of a disease whereby inheritance may impact neonatal immunity, we assessed the influence of maternal allergic disease on NF-kappaB regulation and cytokine secretion. CBMC from healthy newborns were isolated and stimulated with mitogen (n = 28). Nuclear extracts were analyzed by electrophoretic mobility shift assay, cytokine secretion by ELISA. FISH analysis excluded relevant maternal contamination of CBMC. All samples showed a positive lymphoproliferative response, and NF-kappaB activity was both increased and decreased after mitogen stimulation. Increased NF-kappaB activation was significantly associated with decreased TNF-alpha secretion (median 6.1 versus 50.3 pg/mL) in unstimulated CBMC. Mitogen stimulation resulted in increased NF-kappaB activity with a trend to increased IL-13 production. Maternal allergic disease was associated with higher TNF-alpha (median 982 versus 173 pg/mL) and IL-13 secretion (median 1328 versus 1120 pg/mL) after mitogen stimulation. Together, NF-kappaB activity is differentially activated in cord blood and associated with a distinct cytokine pattern. Whether differential NF-kappaB activity in cord blood is related to the subsequent development of immune diseases requires further investigation.

The vasculitides are a group of protean diseases, some of which are caused by conditions including infections, other autoimmune diseases, or neoplasias. They are a challenge to the clinician, in terms of both diagnosis and therapy. No diagnostic criteria exist, although a multinational effort to develop them is in progress. However, many classification criteria have been proposed, and these have served as diagnostic surrogates and have made it possible to discriminate between many, although not all, of the vasculitides, mainly for epidemiological and therapeutic trial design purposes. In this review we recognise the difficulties of defining such criteria, but at the same time attempt to provide a critical overview of efforts to do so. The increasing knowledge regarding many of these diseases makes us confident that the time will come when their aetiology, or at least their main pathogenic features, is known, rendering proposed classification criteria obsolete.

The chemical composition, digestibility and toxin contents of two wild legumes: Styphnolobium burseroides and Acacia bilimekii, collected in a semi-arid zone of Mexico, were determined. Both legumes had a high fiber content. The seeds of Styphnolobium burseroides had a low protein content (14%), and the pod a high content of reducing sugars. However the seeds of Acacia bilimekii had a high protein concentration (35%). The seed proteins were low in sulphur amino acids and tryptophan in both legumes but were rich in lysine. Trypsin inhibitors and lectins were present in low concentrations; alkaloids and cyanogenic glucosides were not detected. The in vitro digestibility for monogastric animals was low but the same test with ruminal juice showed a high digestibility for both legumes. Based on their chemical composition and digestibility, these legumes could be a good alternative source in the feeding of ruminants.

The electric space charge behaviour of chlorinated PVC has been studied via thermal step (TS) and thermally stimulated discharge current (TSDC). Chlorination has been found to change strongly the ratio between polarization and injection charges in comparison with unmodified PVC. The results allow one to take the fundamentals of the space charge behaviour of PVC an important step further.

Between 1987 and 1992 the phytogeographic region of southern Mexico was explored during three collecting trips made in search of cultivated and wild germplasm of the sweetpotato (Ipomoea batatas). The first trip was made in 1987, when we collected wild species in Ipomoea section Batatas found in the southeastern and southwestern regions of Mexico. A second trip was made in 1990, when we collected accessions of the cultivated species as well as wild species in the southeast, southwest and northeast. The third and final trip was oriented at identification, characterization and collecting seeds in the ecological niches ofI.tabascana andI.umbraticola. As a result of the three trips we collected 165 accessions of cultivated and wild germplasm with populations dispersed in 147 localities in 15 states of the Mexican region: Veracruz, Tabasco, Campeche, Chiapas, Oaxaca, Yucatan, Guerrero, Michoacan, San Luis Potosi, Hidalgo, Queretaro, Tamaulipas, Guanajuato, Puebla and Mexico. Of the total accessions some 64 (38.3%) were of the cultivated species including nine accessions of feral material, and 103 accessions (61.7%) were of wild species made up of 59 accessions of seven species in the section Batatas, 37 of other species in the family Convolvulaceae, and seven yet to be determined. We have identified the largest genetic biodiversity in six localities of five states: Tabasco, Oaxaca, Michoacan, San Luis Potosi, and Puebla. Biodiversity maintenance in this region is associated with the day-of-the-dead festivities.

Poly(methyl methacrylate) [PMMA], Bisphenol A polycarbonate [BAPC] and its blends of different weight compositions irradiated under static vacuum conditions, were investigated by UV spectroscopy and gel permeation chromatography. Analysis indicated that photolysis of PMMA is retarded by blending with BAPC. This effect is attributed to photo products formed in the BAPC, most probably due to Fries rearrangement, that reduces the photodegradation of PMMA.

A total of 284 patients with stress urinary incontinence underwent Pereyra's modified procedure between March 1980 and December 1987. The main surgical indication was the coexistence of stress urinary incontinence and genital prolapse in patients who had not previously undergone a retropubic surgical approach. Besides the clinical study, endoscopic, radiologic and cystometric evaluations were performed. Postoperative evaluations were also obtained. Suprapubic bladder drainage was used in all patients. Follow-up ranged from 2 to 5 years; 20% completed 5 years, 24% completed 4 years, 40% completed 3 years and 100% completed 2 years. The average follow-up rate was 34 months. A surgical success rate of 87% was observed. Of the failures 66% occurred during the first 6 months and 82% during the first year. Few complications were encountered, mostly postoperative bladder dysfunction, at a rate of 14%.