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Resumen Introduccion y objetivos Evaluar y comparar la utilidad diagnostica (UD) para el cribado de deterioro cognitivo (DC) de los test cognitivos breves (TCB) recomendados por la Guia de practica clinica sobre la atencion integral a las personas con enfermedad de Alzheimer y otras demencias. Material y metodos Estudio de fase iii de evaluacion de pruebas diagnosticas en el que se ha incluido en Atencion Primaria a sujetos con sospecha de DC. A todos se les ha aplicado Mini-Mental State Examination (Mini-Mental), Mini Examen Cognoscitivo (MEC), Short Portable Mental Status Questionnaire (SPMSQ), Memory Impairment Screen (MIS), test del reloj (TdR), Eurotest, Fototest y test de alteracion de memoria (T@M). El diagnostico de DC se ha realizado de forma independiente y cegada con respecto a los resultados de los TCB. La UD se ha evaluado mediante el area bajo la curva ROC (aROC). Resultados Se ha incluido a 141 sujetos (86 con DC). El Eurotest y el T@M (0,91 ± 0,02 [aROC ± EE] y 0,90 ± 0,02, respectivamente), los instrumentos que requieren mas tiempo (7,1 ± 1,8 [media ± DE] y 6,8 ± 2,2 min, respectivamente) tienen una UD significativamente superior a la del Mini-Mental, MEC, SPMSQ y TdR, pero no a la del MIS y Fototest (0,87 ± 0,03 ambas), requiriendo este ultimo menos de la mitad del tiempo (2,8 ± 0,8 min). T@M y MIS solo evaluan memoria y el ultimo no es aplicable a analfabetos. Conclusiones Los instrumentos mas recomendables para el cribado de DC en Atencion Primaria son Eurotest, T@M y Fototest, siendo el ultimo mas eficiente por requerir la mitad de tiempo.

Resumen Introduccion y objetivos El desfibrilador automatico implantable (DAI) es una alternativa coste-efectiva para la prevencion secundaria de la muerte subita cardiaca, pero sigue habiendo dudas sobre su eficiencia en prevencion primaria, sobre todo en pacientes con cardiopatia no isquemica. Metodos Analisis de coste-utilidad del DAI mas tratamiento medico convencional frente a tratamiento medico convencional para la prevencion primaria de arritmias cardiacas desde la perspectiva del Sistema Nacional de Salud. Se simulo el curso de la enfermedad mediante modelos de Markov en pacientes con y sin cardiopatia isquemica. Los parametros del modelo se basaron en los resultados obtenidos mediante metanalisis de los ensayos clinicos publicados entre 1996 y 2018 en los que se comparaba el DAI con el tratamiento medico convencional, los resultados de seguridad del ensayo DANISH y el analisis de la practica clinica habitual en un hospital terciario. Resultados Se estimo un beneficio del DAI sobre la muerte por cualquier causa con HR = 0,70 (IC95%, 0,58-0,85) en cardiopatia isquemica y HR = 0,79 (IC95%, 0,66-0,96) en no isquemica. La razon de coste-efectividad incremental estimada mediante analisis probabilistico fue de 19.171 euros/ano de vida ajustado por calidad (AVAC) en pacientes con cardiopatia isquemica, 31.084 euros/AVAC en pacientes con miocardiopatia dilatada no isquemica y 23.230 euros/AVAC en los menores de 68 anos. Conclusiones La eficiencia del DAI monocameral ha mejorado en la ultima decada y este resulta coste-efectivo para los pacientes con disfuncion ventricular izquierda de origen isquemico o no isquemico menores de 68 anos considerando una disposicion a pagar 25.000 euros/AVAC. En pacientes no isquemicos mayores, la razon de coste-efectividad incremental estimada se situa alrededor de los 30.000 euros/AVAC.

Introduction and objectives Implantable cardioverter-defibrillators (ICD) are a cost-effective alternative for secondary prevention of sudden cardiac death, but their efficiency in primary prevention, especially among patients with nonischemic heart disease, is still uncertain. Methods We performed a cost-effectiveness analysis of ICD plus conventional medical treatment (CMT) vs CMT for primary prevention of cardiac arrhythmias from the perspective of the national health service. We simulated the course of the disease by using Markov models in patients with ischemic and nonischemic heart disease. The parameters of the model were based on the results obtained from a meta-analysis of clinical trials published between 1996 and 2018 comparing ICD plus CMT vs CMT, the safety results of the DANISH trial, and analysis of real-world clinical practice in a tertiary hospital. Results We estimated that ICD reduced the likelihood of all-cause death in patients with ischemic heart disease (HR, 0.70; 95%CI, 0.58-0.85) and in those with nonischemic heart disease (HR, 0.79; 95%CI, 0.66–0.96). The incremental cost-effectiveness ratio (ICER) estimated with probabilistic analysis was €19 171/quality adjusted life year (QALY) in patients with ischemic heart disease and €31 084/QALY in those with nonischemic dilated myocardiopathy overall and €23 230/QALY in patients younger than 68 years. Conclusions The efficiency of single-lead ICD systems has improved in the last decade, and these devices are cost-effective in patients with ischemic and nonischemic left ventricular dysfunction younger than 68 years, assuming willingness to pay as €25 000/QALY. For older nonischemic patients, the ICER was around €30 000/QALY.

Resumen Introduccion Los resultados de la reparacion de la hernia paraestomal (HP) basados en datos provenientes de registros son escasos. El objetivo del presente trabajo es analizar los datos recogidos sobre la HP en el Registro Nacional de Hernia Incisional (EVEREG) y asi evaluar las practicas actuales y resultados en la reparacion de una HP. Metodos Se analizan los datos de la cohorte de HP registradas en el periodo desde julio de 2012 hasta junio de 2018. Se analizan las complicaciones, recidivas y factores asociados a ellas de la cohorte completa de HP, independientemente del tipo de estoma al que se asocian. Posteriormente, se realiza el mismo analisis del grupo de HP con relacion a una colostomia (grupo mas numeroso). Resultados Se estudiaron 353 HP. De estas, 259 (73%) fueron HP en el contexto de una colostomia terminal, 74 (21%) en el de una ileostomia terminal y 20 (6%) en el de una ureteroileostomia (Bricker). La edad media global fue de 68,7 ± 11,1 anos y 135 (38%) pacientes fueron del sexo femenino. El abordaje abierto y la cirugia electiva fueron predominantes (78% y 92%, respectivamente). El 99% se reparo con una malla sintetica no absorbible. Las complicaciones postoperatorias globales fueron altas (30,6%), asi como la recurrencia global (27,5%) tras un seguimiento medio de 9,4 meses. Conclusiones La reparacion de la HP es poco frecuente comparada con el conjunto de reparaciones de la hernia incisional. La cirugia de la HP parece relacionarse con un porcentaje elevado de complicaciones postoperatorias y recidiva.

Palatable food and drugs of abuse activate common neurobiological pathways and numerous studies suggest that fat consumption increases vulnerability to drug abuse. In addition, preclinical reports show that palatable food may relieve craving for drugs, showing that an ad libitum access to a high-fat diet (HFD) can reduce cocaine-induced reinstatement. The main aim of the present study was to evaluate the effect of a limited and intermittent exposure to HFD administered during the extinction and reinstatement processes of a cocaine-induced conditioned place preference (CPP). Male and female mice underwent the 10 mg/kg cocaine CPP. From post-conditioning onwards, animals were divided into four groups: SD (standard diet); HFD-MWF with 2-h access to the HFD on Mondays, Wednesdays, and Fridays; HFD-24h, with 1-h access every day; and HFD-Ext with 1-h access to the HFD before each extinction session. Our results showed that all HFD administrations blocked reinstatement in males, while only the HFD-MWF was able to inhibit reinstatement in females. In addition, HFD-Ext males needed fewer sessions to extinguish the preference, which suggests that administration of fat before being exposed to the environmental cues is effective to extinguish drug-related memories. HFD did not affect Oprμ gene expression but increased CB1r gene expression in the striatum in HFD-Ext males. These results support that palatable food could act as an alternative reward to cocaine, accelerating extinction and blocking reinstatement, these effects being sex specific.

espanolEl objetivo de este estudio fue determinar las caracteristicas morfologicas de 9 arbitros centrales y 13 arbitros asistentes de futbol de la segunda division de la liga MX en Mexico. Se les tomaron mediciones antropometricas y evaluaciones con la Absorciometria dual de rayos X (DEXA) para obtener la masa grasa y la masa libre de grasa. En la proporcionalidad se utilizo en metodo del somatotipo para poder obtener el biotipo. Los arbitros centrales obtuvieron menor porcentaje graso (antropometria y DEXA) que los arbitros asistentes, presentandose en estos ultimos un somatotipo con mayor robustez musculo esqueletica. A pesar de que los arbitros centrales obtuvieron un estado corporal con menos grasa que los asistentes, por el simple hecho de que las exigencias fisicas en un partido de futbol son doblemente mayores, no se encontraron diferencias acordes a las caracteristicas que muestran los arbitros de elite. EnglishThe objective of this study was to determine the morphological characteristics of 9 central and 13 assistant soccer referees of the second division of the MX league in Mexico. Anthropometric measurements and evaluations were taken with dual X-ray absorptiometry (DEXA) to obtain the fat mass and fat-free mass. In proportionality, the body type method was used to obtain the biotype. The central referees obtained lower fat percentage (anthropometry and DEXA) than the assistant referees, these second ones presenting a body type with greater skeletal muscle robustness. Although the central referees obtained a body composition with less fat than the assistants, by the simple fact that the physical demands in a football match are higher, no differences were found according to the characteristics shown by the elite referees.

Background Clustering of cardiovascular risk factors (CVRFs) is extraordinarily common and is associated with an increased risk of cardiovascular disease (CVD). However, the particular impact of the sum of CVRFs on cardiovascular morbidity and mortality has not been sufficiently explored in Europe. Objective The aim of this study was to analyze the differences in survival-free probability of CVD in relation to the number of CVRFs in a Spanish population. Methods A prospective cohort study was conducted from 1992 to 2016 in a Spanish population that included 1144 subjects with no history of CVD (mean age, 46.7 years) drawn from the general population. We calculated the number of CVRFs for each subject (male sex, smoking, diabetes, hypertension, dyslipidemia, obesity, and left ventricular hypertrophy). Cardiovascular morbidity and mortality records were collected, and survival analysis was applied (competing risk models). Results There were 196 cardiovascular events (17.1%). The differences in total survival-free probability of cardiovascular morbidity and mortality of the different values of the sum of CVRFs were significant, increasing the risk of CVD (hazard ratio, 1.30; 95% confidence interval, 1.13-1.50) per each additional risk factor. Conclusion Differences in survival-free probability of CVD in relation to the number of CVRFs present were statistically significant. Further studies are needed to corroborate our results.

Introduction Factor XI (FXI) deficiency is a mild bleeding disorder, common among Ashkenazis, that may be underestimated in Caucasians. Management of FXI deficiency in women is a challenge, due to its unpredictable bleeding tendency and the little evidence available on this issue. Objective To describe gynaecological/obstetrical bleeding complications and to analyze the effectiveness and safety of the antihaemorrhagic treatment among women with FXI deficiency. Material and methods A retrospective, observational study of 214 Caucasian subjects with FXI deficiency collected during 20 years (1994–2014) without clinical selection. Results We identified 95 women with FXI deficiency. Any haemorrhagic event was communicated by 26/95 (27.4%), being abnormal uterine bleeding the most frequently found (12/95, 12.6%). Nine postpartum haemorrhages were recorded from 136 deliveries (6.6%) in 57 women. Four postsurgical bleeding complications were registered among 25 gynaecological surgeries (16%) in 20 women. Abnormal uterine bleeding, postpartum and postsurgical haemorrhages were related to both a positive bleeding history and FXI:C values ≤43.5%. Prophylaxis with fresh frozen plasma, used in 12/25 (48%) gynaecological surgeries, did not prevent from postoperative bleeding in three cases, but two developed severe adverse reactions. Conclusion Women with FXI deficiency, especially those with a positive history of bleeding or FXI:C ≤43.5%, are at risk of developing gynaecological/obstetrical haemorrhages, most of them mild/moderate. Systematic prophylaxis has questionable effectiveness, but might cause severe side effects.

Background: Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods: We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients' preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings: Between June 16, 2014, and April 29, 2015, data from 22 803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21 694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj −4·4%, 95% CI −5·5 to −3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj −2·6%, 95% CI −3·9 to −1·4) and the administration of reversal agents (1·23, 1·07–1·41; −1·9%, −3·2 to −0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj −0·3%, 95% CI −2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; −0·4%, −3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation: We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications. Funding: European Society of Anaesthesiology.

The development and implementation of artificial intelligence (AI) applications in health care contexts is a concurrent research and management question. Especially for hospitals, the expectations regarding improved efficiency and effectiveness by the introduction of novel AI applications are huge. However, experiences with real-life AI use cases are still scarce. As a first step towards structuring and comparing such experiences, this paper is presenting a comparative approach from nine European hospitals and eleven different use cases with possible application areas and benefits of hospital AI technologies. This is structured as a current review and opinion article from a diverse range of researchers and health care professionals. This contributes to important improvement options also for pandemic crises challenges, e.g., the current COVID-19 situation. The expected advantages as well as challenges regarding data protection, privacy, or human acceptance are reported. Altogether, the diversity of application cases is a core characteristic of AI applications in hospitals, and this requires a specific approach for successful implementation in the health care sector. This can include specialized solutions for hospitals regarding human–computer interaction, data management, and communication in AI implementation projects.

Desert truffles are edible hypogeous (forming fruit bodies below ground) fungi that grow in semi-arid and arid areas. They are highly valued for both their culinary and medicinal properties in the Mediterranean basin, the Middle East and the Gulf areas. Desert truffles form mycorrhizae mostly with plants belonging to the Cistaceae family, mainly with Helianthemum species. These truffles are still, usually, collected from the wild, but loss of habitats due to urbanization, desertification, intensive agriculture and global warming, along with an urgent need to develop new crops adapted to arid conditions, are currently hastening efforts towards their domestication. Here, we sum up the successful research leading to cultivation of this crop, based on plots that were established in sandy to silt soils with high pH values and low mineral contents. We report suitable methods for production of mycorrhized seedlings and preferred planting methods. We found that under natural conditions yields are affected by water availability, so irrigation regimes to ensure good yields were sought. Although good yields were indeed obtained in some years, fluctuations in yields over the years were significant; the reasons for this are not entirely clear and are currently under study. This crop is particularly well suited to relatively marginal conditions but prospects for establishment of desert truffles as a niche crop for arid and semi-arid areas depend on further improvements in yields.

Root cells take up K+ from the soil solution, and a fraction of the absorbed K+ is translocated to the shoot after being loaded into xylem vessels. K+ uptake and translocation are spatially separated processes. K+ uptake occurs in the cortex and epidermis whereas K+ translocation starts at the stele. Both uptake and translocation processes are expected to be linked, but the connection between them is not well characterized. Here, we studied K+ uptake and translocation using Rb+ as a tracer in wild-type Arabidopsis thaliana and in T-DNA insertion mutants in the K+ uptake or translocation systems. The relative amount of translocated Rb+ to the shoot was positively correlated with net Rb+ uptake rates, and the akt1 athak5 T-DNA mutant plants were more efficient in their allocation of Rb+ to shoots. Moreover, a mutation of SKOR and a reduced plant transpiration prevented the full upregulation of AtHAK5 gene expression and Rb+ uptake in K+ -starved plants. Lastly, Rb+ was found to be retrieved from root xylem vessels, with AKT1 playing a significant role in K+ -sufficient plants. Overall, our results suggest that K+ uptake and translocation are tightly coordinated via signals that regulate the expression of K+ transport systems.

The Scientific Societies of Primary Care, being the area in which there is a considerable prevalence of Arterial Hypertension (AHT), need to periodically evaluate the international guidelines for its management. This is particularly relevant when disparate guidelines make it difficult to make decisions in daily clinical practice. The present document has as its aim to analyse the changes and new developments proposed in the guidelines of the American College of Cardiology and the American Heart Association (ACC/AHA 2017), as well as in the guidelines of the European Society of Cardiology and European Society of Hypertension (ESC/ESH 2018). An analysis will be made of any differences, limitations, and their applicability to Primary Care in Spain. Finally, the most relevant available and appropriate information is extracted and integrated in order to homogenise the care of the hypertensive patient, from a critical, but also a reasoned, perspective. The discrepancies between the recommendations in such essential aspects as the management of the disease, require the compiling and critical analysis of the information that enables us as scientific society, interested in providing all PC physicians with the most relevant, and at the same time, sensible, recommendations of all the guidelines.

Reactive Oxygen Species (ROS) and Reactive Nitrogen Species (RNS) are central regulators of plant performance and adaptation to a changing environment. In this sense, increasing evidence points to a prominent role of ROS and RNS in coping with changes in nutrient availability (either deficiency or excess). However, decoding of ROS and RNS signatures into specific nutrient responses still remains a mystery. Thus far, it is known that nutrient deficiencies result in high levels of ROS and exert profound effects on the antioxidant cell machinery. ROS signal propagation relies, in part, on the activation of an array of transmembrane transport systems at the plasma membrane. The intracellular ROS signal leads to the upregulation of adaptation mechanisms (involving activation or de novo synthesis of proteins). Unlike ROS, RNS production under nutrient stress is a much less understood process. Nevertheless, RNS, and NO in particular, intensify the antioxidant responses through the stimulation of their respective scavengers which is helpful for minimizing oxidative damage that can occur during nutrient stress. In the present review, we summarize the current state in the field of ROS and RNS signaling in plant nutrition and identify the main gaps in our knowledge, which should be filled in the forthcoming years. Further understanding of the ROS and RNS signaling cascades is pivotal for improving crop function within a context of limited nutrient resources and harsher climatological conditions.

Resumen Existe una gran variedad de marcadores utiles tanto en el diagnostico como en el seguimiento de la enfermedad inflamatoria intestinal. Clasicamente se han utilizado los serologicos, ampliamente distribuidos y accesibles, pero en los ultimos anos han cobrado importancia los fecales, en especial la calprotectina fecal, por haber demostrado mayor precision a la hora tanto de establecer la sospecha de la enfermedad como de predecir la curacion mucosa o la persistencia de actividad inflamatoria. La calprotectina fecal muestra buena capacidad para predecir estudios endoscopicos patologicos, pero tiene una especificidad limitada ya que puede alterarse en otros cuadros digestivos con sintomas similares. La calprotectina fecal presenta mayor precision cuando se asocia a otros parametros, en especial a la proteina C reactiva, y a escalas clinicas de actividad inflamatoria. Finalmente, hay multiples marcadores de nueva generacion, serologicos y fecales, de los que hay escasa evidencia, aunque algunos han mostrado resultados prometedores en diferentes estudios.

Recent research into how the pulsation type affects goat milking concluded that alternate pulsation (AP) and simultaneous pulsation (SP) similarly affect the milking efficiency (milking duration and milking fractioning) and teat end condition after milking when both pulsations are employed in short-term experiments. However, the use of SP in high pipeline milking machines led to higher vacuum fluctuations, which, in the long term, may entail a potential risk factor for the mammary gland health status. The aim of this work was to study how AP and SP affect the milk yield, mammary gland health status, and milk composition of goats in the long term, during a complete lactation period, in a high pipeline milking machine. With this objective, 100 Murciano-Granadina goats with similar parturition dates (4 ± 1 postpartum weeks) were divided into 2 similar groups (50 goats per group) according their parity, milk yield, mammary gland health status, and milking duration (after a 15-d pre-experimental period). Throughout the experimental period (7 mo), one group was milked using SP and the other group using AP. Every month, samplings were carried out of the variables related to sanitary status of the mammary gland, milk fractioning, milking duration, average and maximum milk flows, milk composition, teat end status, vacuum fluctuations at the short milk tube during milking, and pulsation tests. Results showed that the use of SP in a high pipeline milking machine showed higher vacuum fluctuations without involving any difference in the other variables studied. We concluded that the use of AP in the milking of Murciano-Granadina goats offers little improvement of the milking performance and increases the investment required for installation and maintenance of the milking machines.

Resumen Objetivos Evaluar el conocimiento y habilidades de enfermeras y medicos en ventilacion mecanica no invasiva en diferentes contextos: equipamiento e influencias contextuales. Metodo Estudio descriptivo transversal en 4 unidades de cuidados intensivos (una quirurgica, 3 polivalentes), una reanimacion posquirurgica, 2 areas de urgencias y 3 salas de hospitalizacion, de 4 hospitales (3 universitarios y uno general) con 407 profesionales. Se administro una encuesta con 13 items, evaluando la validez del contenido (indice de Kappa 0,97 [95% IC: 0,965-0,975]). Resultados Respondieron el 63,7% de las enfermeras y el 39% de los medicos. El porcentaje de respuestas correctas fue del 50%. Con una puntuacion del 1 al 5, en la que a menor puntuacion mas conocimiento, las enfermeras puntuaron 3,27 ±0,5 vs. 2,62 ±0,5 los medicos (diferencia de la media 0,65 [IC 95%: 0,48-0,82; p Conclusiones No hubo diferencias en el conocimiento por unidades entre enfermeras y medicos. La falta de conocimiento relacionada con la terapia de la ventilacion mecanica no invasiva es dependiente de la formacion recibida y del material disponible en la unidad. Para reducir la confusion entre fugas intencionadas y no intencionadas se recomienda usar un solo tipo de ventilador y mantener un entrenamiento regular de las enfermeras.

Background Although studies exist comparing low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (HDL-C) in the development of cardiovascular disease (CVD), most have limitations in the mathematical models used to evaluate their prognostic power adjusted for the other risk factors (cardiovascular risk). Objective The aim of this study was to compare LDL-C and non-HDL-C in patients with CVD to determine whether both parameters predict CVD similarly. Methods A cohort of 1322 subjects drawn from the general population of a Spanish region was followed between 1992 and 2006. The outcome was time to CVD. Secondary variables were gender, age, hypertension, diabetes, personal history of CVD, current smoker, body mass index, LDL-C, and non-HDL-C. Two CVD prediction models were constructed with the secondary variables, with only the lipid parameter varying (non-HDL-C or LDL-C). In the construction of the models, the following were considered: multiple imputation, events per variable of 10 or more, and continuous predictors as powers. The validation was conducted by bootstrapping obtaining the distribution of the C statistic (discrimination) and the probabilities observed by smooth curves. These results were compared in both models using graphical and analytical testing. Results There were a total of 137 CVD events. The models showed no differences in the distributions of the C statistic (discrimination, P = .536) or in the calibration plot. Conclusions In our population, LDL-C and non-HDL-C were equivalent at predicting CVD. More studies using this methodology are needed to confirm these results.

Resumen Cuando la probabilidad de tromboembolia pulmonar (TEP) es baja, hacer una angiografia pulmonar por tomografia computarizada (APTC) depende del valor del dimero D. Sobreutilizar esta determinacion puede dar lugar a estudios de imagen innecesarios, tratar de manera inadecuada al paciente o incrementar indebidamente la probabilidad estimada para enfermedad tromboembolica venosa a partir de ese momento. El objetivo principal de este trabajo es valorar cuando puede evitarse la APTC en pacientes con baja probabilidad clinica de TEP a partir de una busqueda bibliografica eficiente de los estudios publicados al respecto.

Spray-dried animal plasma (SDAP) is widely used in diets of domestic animals to improve health status and increase growth and feed efficiency. Individual steps in the SDAP manufacturing process, including spray-drying, have been validated to inactivate potential pathogens. Manufacturing standards have established a minimum exit temperature of 80°C and a minimum post-drying storage period of 14 days at 20°C for production of SDAP. Also, UV-C irradiation has been evaluated as another inactivation step that could be included in the manufacturing process. The aim of this study was to assess the inactivation effectiveness of spray-drying on Classical swine fever virus (CSFV) and African swine fever virus (ASFV) and the effect of UV-C inactivation on ASFV as redundant biosafety steps of the manufacturing process for producing spray-dried porcine plasma (SDPP). This study demonstrated that UV-C treatment of liquid porcine plasma can inactivate more than 4 Log10 TCID50/mL of ASFV at 3000 J/L. Spray-drying effectively inactivated at least 4 Log10 TCID50/mL of both CSFV and ASFV. Incorporating UV-C technology within the SDAP manufacturing process can add another biosafety step to further enhance product safety.

The high-affinity K+ transporter HAK5 from Arabidopsis (Arabidopsis thaliana) is essential for K+ acquisition and plant growth at low micromolar K+ concentrations. Despite its functional relevance in plant nutrition, information about functional domains of HAK5 is scarce. Its activity is enhanced by phosphorylation via the AtCIPK23/AtCBL1-9 complex. Based on the recently published three-dimensionalstructure of the bacterial ortholog KimA from Bacillus subtilis, we have modeled AtHAK5 and, by a mutational approach, identified residues G67, Y70, G71, D72, D201, and E312 as essential for transporter function. According to the structural model, residues D72, D201, and E312 may bind K+, whereas residues G67, Y70, and G71 may shape the selective filter for K+, which resembles that of K+shaker-like channels. In addition, we show that phosphorylation of residue S35 by AtCIPK23 is required for reaching maximal transport activity. Serial deletions of the AtHAK5 C-terminus disclosed the presence of an autoinhibitory domain located between residues 571 and 633 together with an AtCIPK23-dependent activation domain downstream of position 633. Presumably, autoinhibition of AtHAK5 is counteracted by phosphorylation of S35 by AtCIPK23. Our results provide a molecular model for K+ transport and describe CIPK-CBL-mediated regulation of plant HAK transporters.

International audience; Desert truffles are edible hypogeous fungi forming ectendomycorrhizal symbiosis with plants of Cistaceae family. Knowledge about the reproductive modes of these fungi and the molecular mechanisms driving the ectendomycorrhizal interaction is lacking. Genomes of the highly appreciated edible desert truffles Terfezia claveryi Chatin and Tirmania nivea Trappe have been sequenced and compared with other Pezizomycetes. Transcriptomes of T. claveryi × Helianthemum almeriense mycorrhiza from well-watered and drought-stressed plants, when intracellular colonizations is promoted, were investigated. We have identified the fungal genes related to sexual reproduction in desert truffles and desert-truffles-specific genomic and secretomic features with respect to other Pezizomycetes, such as the expansion of a large set of gene families with unknown Pfam domains and a number of species or desert-truffle-specific small secreted proteins differentially regulated in symbiosis. A core set of plant genes, including carbohydrate, lipid-metabolism, and defence-related genes, differentially expressed in mycorrhiza under both conditions was found. Our results highlight the singularities of desert truffles with respect to other mycorrhizal fungi while providing a first glimpse on plant and fungal determinants involved in ecto to endo symbiotic switch that occurs in desert truffle under dry conditions.

Q waves may be observed in the absence of non-viable tissue. However, their scintigraphic translation in patients with ischemic cardiomyopathy (ICM) has not been properly assessed. This study sought to establish the determinants of Q waves in the absence of non-viable tissue and the diagnostic accuracy in this population. A retrospective study enrolling 487 consecutive patients (67.0 [57.4 – 75.4] years), with ICM, LVEF

Novel species of fungi described in this study include those from various countries as follows: Algeria, Phaeoacremonium adelophialidum from Vitis vinifera. Antarctica, Comoclathris antarctica from soil. Australia, Coniochaeta salicifolia as endophyte from healthy leaves of Geijera salicifolia, Eremothecium peggii in fruit of Citrus australis, Microdochium ratticaudae from stem of Sporobolus natalensis, Neocelosporium corymbiae on stems of Corymbia variegata, Phytophthora kelmanii from rhizosphere soil of Ptilotus pyramidatus, Pseudosydowia backhousiae on living leaves of Backhousia citriodora, Pseudosydowia indoor oopillyensis, Pseudosydowia louisecottisiae and Pseudosydowia queenslandica on living leaves of Eucalyptus sp. Brazil, Absidia montepascoalis from soil. Chile, Ilyonectria zarorii from soil under Maytenus boaria. Costa Rica, Colletotrichum filicis from an unidentified fern. Croatia, Mollisia endogranulata on deteriorated hardwood. Czech Republic, Arcopilus navicularis from tea bag with fruit tea, Neosetophoma buxi as endophyte from Buxus sempervirens, Xerochrysium bohemicum on surface of biscuits with chocolate glaze and filled with jam. France, Entoloma cyaneobasale on basic to calcareous soil, Fusarium aconidiale from Triticum aestivum, Fusarium juglandicola from buds of Juglans regia. Germany, Tetraploa endophytica as endophyte from Microthlaspi perfoliatum roots. India, Castanediella ambae on leaves of Mangifera indica, Lactifluus kanadii on soil under Castanopsis sp., Penicillium uttarakhandense from soil. Italy, Penicillium ferraniaense from compost. Namibia, Bezerromyces gobabebensis on leaves of unidentified succulent, Cladosporium stipagrostidicola on leaves of Stipagrostis sp., Cymostachys euphorbiae on leaves of Euphorbia sp., Deniquelata hypolithi from hypolith under a rock, Hysterobrevium walvisbayicola on leaves of unidentified tree, Knufia hypolithi and Knufia walvisbayicola from hypolith under a rock, Lapidomyces stipagrostidicola on leaves of Stipagrostis sp., Nothophaeotheca mirabibensis (incl. Nothophaeotheca gen. nov.) on persistent inflorescence remains of Blepharis obmitrata, Paramyrothecium salvadorae on twigs of Salvadora persica, Preussia procaviicola on dung of Procavia sp., Sordaria equicola on zebra dung, Volutella salvadorae on stems of Salvadora persica. Netherlands, Entoloma ammophilum on sandy soil, Entoloma pseudocruentatum on nutrient poor(acid)soil, Entoloma pudens on plant debris, amongst grasses. [...], Leslie W.S. de Freitas and colleagues express their gratitude to Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) for scholarships provided to Leslie Freitas and for the research grant provided to André Luiz Santiago; their contribution was financed by the projects ‘Diversity of Mucoromycotina in the different ecosystems of the Atlantic Rainforest of Pernambuco’ (FACEPE–First Projects Program PPP/ FACEPE/CNPq–APQ–0842-2.12/14) and ‘Biology of conservation of fungi s.l. in areas of Atlantic Forest of Northeast Brazil’ (CNPq/ICMBio 421241/ 2017-9) H.B. Lee was supported by the Graduate Program for the Undiscovered Taxa of Korea (NIBR202130202). The study of O.V. Morozova, E.F. Malysheva, V.F. Malysheva, I.V. Zmitrovich, and L.B. Kalinina was carried out within the framework of a research project of the Komarov Botanical Institute RAS (АААА-А19-119020890079-6) using equipment of its Core Facility Centre ‘Cell and Molecular Technologies in Plant Science’. The work of O. V. Morozova, L.B. Kalinina, T. Yu. Svetasheva, and E.A. Zvyagina was financially supported by Russian Foundation for Basic Research project no. 20-04-00349. E.A. Zvyagina and T.Yu. Svetasheva are grateful to A.V. Alexandrova, A.E. Kovalenko, A.S. Baykalova for the loan of specimens, T.Y. James, E.F. Malysheva and V.F. Malysheva for sequencing. J.D. Reyes acknowledges B. Dima for comparing the holotype sequence of Cortinarius bonachei with the sequences in his database. A. Mateos and J.D. Reyes acknowledge L. Quijada for reviewing the phylogeny and S. de la Peña- Lastra and P. Alvarado for their support and help. Vladimir I. Kapitonov and colleagues are grateful to Brigitta Kiss for help with their molecular studies. This study was conducted under research projects of the Tobolsk Complex Scientific Station of the Ural Branch of the Russian Academy of Sciences (N АААА-А19-119011190112-5). E. Larsson acknowledges the Swedish Taxonomy Initiative, SLU Artdatabanken, Uppsala (dha.2019.4.3-13). The study of D.B. Raudabaugh and colleagues was supported by the Schmidt Science Fellows, in partnership with the Rhodes Trust. Gregorio Delgado is grateful to Michael Manning and Kamash Pillai (Eurofins EMLab P&K) for provision of laboratory facilities. Jose G. Maciá-Vicente acknowledges support from the German Research Foundation under grant MA7171/1-1, and from the Landes-Offensive zur Entwicklung Wissenschaftlich-ökonomischer Exzellenz (LOEWE) of the state of Hesse within the framework of the Cluster for Integrative Fungal Research (IPF). Thanks are also due to the authorities of the Cabañeros National Park and Los Alcornocales Natural Park for granting the collection permit and for support during field work. The study of Alina V. Alexandrova was carried out as part of the Scientific Project of the State Order of the Government of Russian Federation to Lomonosov Moscow State University No. 121032300081-7. Michał Gorczak was financially supported by the Ministry of Science and Higher Education through the Faculty of Biology, University of Warsaw intramural grant DSM 0117600- 13. M. Gorczak acknowledges M. Klemens for sharing a photo of the Białowieża Forest logging site and M. Senderowicz for help with preparing the illustration. Ivona Kautmanová and D. Szabóová were funded by the Operational Program of Research and Development and co-financed with the European Fund for Regional Development (EFRD). ITMS 26230120004: ‘Building of research and development infrastructure for investigation of genetic biodiversity of organisms and joining IBOL initiative’. Ishika Bera, Aniket Ghosh, Jorinde Nuytinck and Annemieke Verbeken are grateful to the Director, Botanical Survey of India (Kolkata), Head of the Department of Botany & Microbiology & USIC Dept. HNB Garhwal University, Srinagar, Garhwal for providing research facilities. Ishika Bera and Aniket Ghosh acknowledge the staff of the forest department of Arunachal Pradesh for facilitating the macrofungal surveys to the restricted areas. Sergey Volobuev was supported by the Russian Science Foundation (RSF project N 19-77- 00085). Aleksey V. Kachalkin and colleagues were supported by the Russian Science Foundation (grant No. 19-74-10002). The study of Anna M. Glushakova was carried out as part of the Scientific Project of the State Order of the Government of Russian Federation to Lomonosov Moscow State University No. 121040800174-6. Tracey V. Steinrucken and colleagues were supported by AgriFutures Australia (Rural Industries Research and Development Corporation), through funding from the Australian Government Department of Agriculture, Water and the Environment, as part of its Rural Research and Development for Profit program (PRJ-010527). Neven Matočec and colleagues thank the Croatian Science Foundation for their financial support under the project grant HRZZ-IP-2018-01-1736 (ForFungiDNA). Ana Pošta thanks the Croatian Science Foundation for their support under the grant HRZZ-2018-09-7081. The research of Milan Spetik and co-authors was supported by Internal Grant of Mendel University in Brno No. IGAZF/ 2021-SI1003. K.C. Rajeshkumar thanks SERB, the Department of Science and Technology, Government of India for providing financial support under the project CRG/2020/000668 and the Director, Agharkar Research Institute for providing research facilities. Nikhil Ashtekar thanks CSIR-HRDG, INDIA, for financial support under the SRF fellowship (09/670(0090)/2020-EMRI), and acknowledges the support of the DIC Microscopy Facility, established by Dr Karthick Balasubramanian, B&P (Plants) Group, ARI, Pune. The research of Alla Eddine Mahamedi and co-authors was supported by project No. CZ.02.1.01/0.0/0.0/16_017/0002334, Czech Republic. Tereza Tejklová is thanked for providing useful literature. A. Polhorský and colleagues were supported by the Operational Program of Research and Development and co-financed with the European fund for Regional Development (EFRD), ITMS 26230120004: Building of research and development infrastructure for investigation of genetic biodiversity of organisms and joining IBOL initiative. Yu Pei Tan and colleagues thank R. Chen for her technical support. Ernest Lacey thanks the Cooperative Research Centres Projects scheme (CRCPFIVE000119) for its support. Suchada Mongkolsamrit and colleagues were financially supported by the Platform Technology Management Section, National Center for Genetic Engineering and Biotechnology (BIOTEC), Project Grant No. P19-50231. Dilnora Gouliamova and colleagues were supported by a grant from the Bulgarian Science Fund (KP-06-H31/19). The research of Timofey A. Pankratov was supported by the Russian Foundation for Basic Research (grant No. 19-04-00297a). Gabriel Moreno and colleagues wish to express their gratitude to L. Monje and A. Pueblas of the Department of Drawing and Scientific Photography at the University of Alcalá for their help in the digital preparation of the photographs, and to J. Rejos, curator of the AH herbarium, for his assistance with the specimens examined in the present study. Vit Hubka was supported by the Charles University Research Centre program No. 204069. Alena Kubátová was supported by The National Programme on Conservation and Utilization of Microbial Genetic Resources Important for Agriculture (Ministry of Agriculture of the Czech Republic). The Kits van Waveren Foundation (Rijksherbariumfonds Dr E. Kits van Waveren, Leiden, Netherlands) contributed substantially to the costs of sequencing and travelling expenses for M. Noordeloos. The work of B. Dima was supported by the ÚNKP-20-4 New National Excellence Program of the Ministry for Innovation and Technology from the source of the National Research, Development and Innovation Fund, and by the ELTE Thematic Excellence Programme 2020 supported by the National Research, Development and Innovation Office of Hungary (TKP2020-IKA-05). The Norwegian Entoloma studies received funding from the Norwegian Biodiversity Information Centre (NBIC), and the material was partly sequenced through NorBOL. Gunnhild Marthinsen and Katriina Bendiksen (Natural History Museum, University of Oslo, Norway) are acknowledged for performing the main parts of the Entoloma barcoding work. Asunción Morte is grateful to AEI/FEDER, UE (CGL2016-78946-R) and Fundación Séneca - Agencia de Ciencia y Tecnología de la Región de Murcia (20866/PI/18) for financial support. Vladimír Ostrý was supported by the Ministry of Health, Czech Republic - conceptual development of research organization (National Institute of Public Health – NIPH, IN 75010330). Konstanze Bensch (Westerdijk Fungal Biodiversity Institute, Utrecht) is thanked for correcting the spelling of various Latin epithets.

[EN] Although catheter ablation (CA) is still the first-line treatment for persistent atrial fibrillation (AF) patients, its limited long-term success rate has motivated clinical interest in preoperative prediction on the procedure¿s outcome to provide optimized patient selection, limit repeated procedures, hospitalization rates, and treatment costs. To this respect, dominant frequency (DF) and amplitude of fibrillatory waves (f-waves) reflected on the ECG have provided promising results. Hence this work explores the ability of a novel set of frequency and amplitud f-waves features, such as spectral entropy (SE), spectral flatness measure (SFM), and amplitud spectrum area (AMSA), along with DF and normalized f-wave amplitude (NFWA), to improve CA outcome prediction. Despite all single indices reported statistically significant differences between patients who relapsed to AF and those who maintained sinus rhythm after a follow-up of 9 months for 204 6 s-length ECG intervals extracted from 51 persistent AF patients, they obtained a limited discriminant ability ranging between 55 and 62%, which was overcome by 15¿23% when NFWA, SE and AMSA were combined. Consequently, this combination of frequency and amplitude features of the fwaves seems to provide new insights about the atrial substrate remodeling, which could be helpful in improving preoperative CA outcome prediction., This research has been supported by grants DPI201783952-C3 from MINECO/AEI/FEDER EU, SBPLY/17/180501/000411 from Junta de Comunidades de Castilla-la Mancha and AICO/2019/036 from Generalitat Valenciana. Moreover, Pilar Escribano holds a graduate research scholarship from University of Castilla-La Mancha

Mycobacterium caprae, a member of the Mycobacterium tuberculosis complex, causes tuberculosis in humans and animals, but the incidence in humans is very low worldwide. Direct contact with animals and with unpasteurized dairy products is the most frequent source of contagion. Cutaneous tuberculosis supposes a diagnostic challenge due to its variety of clinical manifestations and the difficulty in demonstrating resistant acid-alcohol bacilli in histological samples. In cases of high suspicion, the initiation of antituberculosis treatment should be considered empirically. Combined therapeutic regimens are necessary to prevent long-term resistance and complications, although the duration of treatment has not been fully established.

Ajuts: Secretaria de Universitats i Recerca del Departament d'Economia i Coneixement de la Generalitat de Catalunya 014 DI 066 Spray dried plasma (SDP) is a functional protein source obtained from blood of healthy animals, approved by the veterinary authorities from animals declared to be fit for slaughter for human consumption. Blood of these animals is collected at the slaughterhouse, treated with an anticoagulant, chilled and transported to industrial facilities in which blood is centrifuged to separate the red blood cells from the plasma fraction. Plasma is then concentrated, and spray dried at high temperatures (80 °C throughout its substance) to convert it in a powder. Such method preserves the biological activity of its proteins, mainly albumins and globulins. SDP is mainly used in pig feed diets to significantly improve daily gain, feed intake, production efficiency, and to reduce post-weaning lag caused by the appearance of post-weaning diarrhea. Although SDP is considered a safe product and its manufacturing process consists of several biosafety steps, the security of the SDP is often questioned due to its nature as raw blood by-product, especially when emergent or re-emergent pathogens appear. This review provides an evaluation and validation of the different safety steps present in the manufacturing process of SDP, with special focus on a new redundant pathogen inactivation step, the UV-C irradiation, that may be implemented in the manufacturing process of the SDP. Overall results showed that the manufacturing process of SDP is safe and the UV-C radiation was effective in inactivating a wide range of bacteria and viruses spiked and naturally present in commercially collected liquid animal plasma and it can be implemented as a redundant biosafety step in the manufacturing process of the SDP.

[EN] Genetic selection for feed efficiency has increased the growth rate and requirements of growing rabbits, while the protein content of commercial feeds has been adjusted to avoid digestive disorders. The aim of this work was to evaluate how a diet with moderate levels of protein content [146 g crude protein (CP)/kg] could be affecting protein and amino acids acquisition depending on the growth rate of the animals. From 189 weaned rabbits (28 days old), only 41 animals were selected at 42 days, in order to ensure the greatest variability for growth rate during fattening. To achieve this goal, animals came from three genetic lines: H and LP (maternal lines selected by litter size) and R (paternal line selected for growth rate), characterised by normal, moderate and high growth rate during the fattening period, respectively. Apparent faecal digestibility of dry matter (DM), CP and gross energy (GE) of the diet from 49-53 days of age, as well as the ileal apparent digestibility of DM, CP and amino acids at 63 days of age, was determined in all the selected animals. Protein, energy and amino acids retained in the empty body during the fattening period were also determined by slaughtering 15 weaning rabbits at 28 days, and the 41 selected animals at 63 days of age. Animals from the R line showed higher feed intake than those from maternal lines, as well as lower feed conversion ratio, even below that expected from their growth rate. Apparent faecal digestibility of GE and apparent ileal digestibility of DM, CP and cystine of the diet were higher in LP than in H rabbits (P < 0.05), showing intermediate values in R rabbits. However, apparent ileal digestibility of glutamic acid and glycine was significantly higher in R than in H rabbits (P < 0.05), showing intermediate values in LP rabbits. As expected, both daily protein and energy retained in the empty body increased as growth increased. However, R growing rabbits seem to have lower protein retained and higher energy retained in the empty body than that expected from their growth. In fact, protein to energy retained ratio was clearly lower for R growing rabbits. These results seem to show the possible existence of some limiting amino acid when current moderate protein diets are used in growing rabbits with high growth rates, recommending a review of the amino acid requirements for the growing rabbits from paternal lines., This study was supported by the Interministerial Commission for Science and Technology (CICYT) from the Spanish Government (AGL2017-85162-C2-1-R). The grant for Pablo Marin from the Ministry of Education, Culture and Sports (FPU-2014-01203) is also gratefully acknowledged.

Keywords: allergic contact dermatitis;carbamates;case report;elastic bands;FFP2 mask;thiuram EN allergic contact dermatitis carbamates case report elastic bands FFP2 mask thiuram 168 169 2 07/27/20 20200801 NES 200801 CASE REPORT A 43-year-old nonatopic woman, working as a hospital cleaner, was referred to our contact eczema department with face and neck dermatitis developing since 20 days ago Skin barrier dysfunction and potential skin microbiota dysbalance on the face might make patients more vulnerable to side effects from the masks 2 Acne and rosacea patients are the most vulnerable to developing skin reactions to protective equipment [Extracted from the article] Copyright of Contact Dermatitis (01051873) is the property of Wiley-Blackwell 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 )

In Spain, with full confinement measures and coinciding with the pandemic, pediatricians and dermatologists have received, through teledermatology/teleconsultation and social networks, a barrage of diverse images, which have subsequently allowed us to approach some of them by direct physical examination of early and late skin manifestations associated with SARS-Cov-2 infection. We designed a retrospective, cross-sectional study to evaluate the dermatological care of all those patients under the age of 16 who consulted, in person or telematically, for acral lesions (chilblain-like or erythema multiforme-like) in the context of the Coronavirus disease (COVID-19) pandemic, since 15 March 2020 to 24 April 2020, both included in the health area of the Hospital Universitario San Cecilio de Granada. Of all the patients collected, 18 (66%) were male and the overall mean age was 14.44 years. All lacked a personal history of interest and denied previous episodes of chilblains or Raynaud's phenomenon/disease. The clinic was limited to purpuric lesions located on acral regions distributed on hands and feet. Dermatologists and pediatricians should be aware of the lesions associated with COVID-19 infection and their possible complications. It remains to be identified if there are different dermatological patterns in the pediatric and adult population.

A total of 27 experimental diets were formulated starting from the same basal mixture, with a moderate content of crude protein and digestible energy (155 g and 9.86 MJ/kg of digestible matter (DM), respectively, both estimated). The contents of lysine, sulphur amino acids and threonine were variable. The first one, close to the current recommendations (Medium, M, 8.1, 5.8 and 6.9 g/kg DM for lysine, sulphur amino acids and threonine, respectively), and two other levels were on average 15% higher (High, H, 9.4, 6.6 and 7.8 g/kg DM for lysine, sulphur amino acids and threonine, respectively) or lower (Low, L, 6.7, 4.9 and 5.7 g/kg DM for lysine, sulphur amino acids and threonine, respectively). Diets were named with three letters, indicating lysine, sulphur amino acids and threonine levels, respectively. In total, 918 weaned rabbits (28 days old) were used (34 per diet). At weaning, animals were fed ad libitum with a commercial diet until day 46, day 47 each collective cage was randomly switched to one experimental diet. At day 48, blood samples were collected at 08:00h then the animals were subjected to 10 h of fasting and a second blood sample was extracted at 21.00h. At 08:00h, Pasmatic urea nitrogen (PUN) was higher with the L level of lysine (p &lt, 0.001), unaffected by the level of sulphur amino acids and increased with the level of threonine (p &lt, 0.001). At 21:00h, minimum PUN was observed with the MHL diet (14.72 &plusmn, 0.661 mg/dL). Taken into account the usual recommendations (established for a diet containing 11.3 MJ DE/kg DM, and then being 0.72, 0.51 and 0.61 g/MJ DE for lysine, sulphur amino acids and threonine, respectively), these results suggest that a diet containing more lysine and sulphur amino acids per energy unit (around 0.82 and 0.67 g/MJ DE) could better fit the growing rabbit requirements, although studies on the effects of such a diet on performance and protein retention are necessary.

Background Severe aortic stenosis (AoS) is considered a primary cause of syncope. However, other mechanisms may be present in these patients and accurate diagnosis can have important clinical implications. The aim of this study is to assess the different etiologies of syncope in patients with severe AoS and the impact on prognosis of attaining a certain or highly probable diagnosis for the syncope. Methods Out of a cohort of 331 patients with AoS and syncope, 61 had severe AoS and were included in the study. Main cause of syncope and adverse cardiac events were assessed. Results In 40 patients (65.6%), we reached a certain or highly probable diagnosis of the main cause of the syncope. AoS was considered the primary cause of the syncope in only 7 patients (17.5% of the patients with known etiology). Atrioventricular block (14 patients, 35.0%) and vasovagal syncope (6 patients, 15.0%) were the most frequently diagnosed causes. The presence of a known cause for syncope during the admission was not associated with a lower incidence of recurrence during follow-up (hazard ratio [HR] 0.69, 95% confidence interval [CI] 0.20-2.40). Syncope of unknown etiology was independently associated with greater mortality during 1-year follow-up (HR 5.4, 95% CI 1.3-21.6) and 3-year follow-up (HR 3.5, 95% CI 1.2-10.3). Conclusions In a high proportion of patients with severe AoS admitted for syncope, the valvulopathy was not the main cause of the syncope. Syncope in two-thirds of this population was caused by either bradyarrhythmia or reflex causes. Syncope of unknown cause was associated with increased short- and medium-term mortality, independently from treatment of the valve disease. An exhaustive work-up should be conducted to determine the main cause for syncope.

The right parietal cortex has been widely associated with a spatial orienting network. Its damage frequently produces the Neglect syndrome consisting in deficits in spatial attention to the left hemifield. Neglect has also been related to temporal deficits (such as the estimation of the duration of a stimulus or the discrimination of two stimuli that occur at the same spatial location but at different time intervals). Such attentional deficits have been much less studied in the temporal as compared to the spatial domain. The current research focused on the study of temporal attention processes in patients with Neglect syndrome, specifically, on temporal preparation. We recruited 10 patients with Neglect syndrome, 10 patients without Neglect syndrome, as well as 11 healthy individuals. Each participant completed an experimental task which measures three main temporal preparation effects described in the literature: Temporal orienting and Foreperiod effects (both related to control mechanisms and prefrontal areas) and Sequential effects (automatic in nature and related to parietal and subcortical structures). The results showed a deficit in the sequential effects only in those patients who suffered from Neglect syndrome. The results suggest a causal relation between Neglect syndrome and the automatic mechanisms of temporal preparation. Since our sample of Neglect patients had suffered lesions mainly in the parietal cortex, the results are discussed taking into account the role of the parietal lobe in the processing of time and the models explaining sequential effects., This work was supported by the Junta de Andalucía (Research Project Reference: SEJ-3054.

[EN] The main objective of this study was to evaluate the influence of pig's age on the effectiveness of a new microbial 3-phytase, produced by Komagataella phaffii, under commercial conditions in barley-wheat based diets. Two experiments were conducted in weaned, growing and finishing pigs; firstly, to determine phytase efficacy on dry matter, organic matter, energy, protein and mineral (phosphorus, P and calcium, Ca) digestibility (n = 48; Experiment 1), and secondly, to evaluate the effect of phytase on growth performance and bone mineralization (n = 312; Experiment 2). In each experiment, three barley-wheat based diets were formulated following the recommendations for each animal age, of which two versions were manufactured, including 0 and 1000 phytase units (FTU)/kg of feed of the new 3-phytase to be tested. Results showed the new phytase had the potential to increase the digestibility of Ca and P (on av. + 0.05 and +0.06, respectively; P < 0.01), especially P digestibility in growing pigs (+0.10; P < 0.001), consequently decreasing P and Ca excretion. Digestible energy (DE) of the diet increased with the addition of phytase in weaned pigs (+0.69 MJ/kg of dry matter (DM); P < 0.001). Dietary inclusion of new 3-phytase enhanced average daily gain from 46 to 94 days of age (+0.07 kg/d; P < 0.05) and decreased feed conversion ratio from 46 to 154 days of age (on av. -0.13; P < 0.05), although no significant effect was observed from 154 to 185 days of age. Addition of the new 3-phytase also promoted bone mineralization, increasing the weight of the bones (+3.99 and +3.64 g of tibia at 95 days and metacarpus at 100 days of age, respectively; P < 0.05) and the ash, Ca and P content in these bones (e.g. + 0.46 and +0.33 g of P in tibia at 95 days and metacarpus at 100 days of age, respectively; P < 0.001). In conclusion, pig age affected the efficacy of a new 3-phytase on P and Ca digestibility both in weaned and growing diets and DE content of the weaned diets, which also resulted in improvements in growth, feed conversion and bone development until 154 days of age. These effects seem to be reduced during the finishing period, although the advantages of the new 3-phytase on bone mineralization were maintained until 185 days of age., We thank the technical staff at the experimental farms of the Research and Technology Animal Centre (CITA-IVIA), the Institute of Animal Science and Technology (Universitat Politècnica de Valencia) and Javier Gómez (Crianzas Campovivo) for expert technical assistance and experimental support.

The objective of this study was to determine if commercially collected liquid porcine plasma contaminated with African swine fever virus (ASFV) and fed for 14 consecutive days would infect pigs. Commercially collected liquid porcine plasma was mixed with the serum from an ASFV experimentally infected pig. To simulate the potential of pigs slaughtered being ASFV viremic but asymptomatic and passing antemortem inspection, the ratio of liquid plasma from healthy animals to serum from an ASFV infected pig used in this study represented 0.4% or 2.0% of the pigs slaughtered being viremic (Studies 1 or 2, respectively). The contaminated liquid plasma was mixed on commercial feed and pigs were fed for 14 consecutive days providing to each pig 104.3 or 105.0 TCID50 ASFV daily (Studies 1 or 2, respectively). Pigs were observed for an additional 5 or 9 days (Studies 1 or 2, respectively). In both experiments, the pigs did not become infected with ASFV during the 14d feeding period or during the subsequent observation period. In these experiments, unprocessed liquid plasma contaminated with ASFV mixed on commercial feed and fed for 14 consecutive days did not infect pigs. From our results we can conclude that the infectious dose of ASFV on feed is much higher than that previously reported, at least with ASFV-spiked raw plasma. info:eu-repo/semantics/publishedVersion

Novel species of fungi described in this study include those from various countries as follows: Australia, Austroboletus asper on soil, Cylindromonium alloxyli on leaves of Alloxylon pinnatum, Davidhawksworthia quintiniae on leaves of Quintinia sieberi, Exophiala prostantherae on leaves of Prostanthera sp., Lactifluus lactiglaucus on soil, Linteromyces quintiniae (incl. Linteromyces gen. nov.) on leaves of Quintinia sieberi, Lophotrichus medusoides from stem tissue of Citrus garrawayi, Mycena pulchra on soil, Neocalonectria tristaniopsidis (incl. Neocalonectria gen. nov.)and Xyladictyochaeta tristaniopsidis on leaves of Tristaniopsis collina, Parasarocladium tasmanniae on leaves of Tasmannia insipida, Phytophthora aquae-cooljarloo from pond water, Serendipita whamiae as endophyte from roots of Eriochilus cucullatus, Veloboletus limbatus (incl. Veloboletus gen. nov.)onsoil. Austria, Cortinarius glaucoelotus onsoil. Bulgaria, Suhomyces rilaensis from the gut of Bolitophagus interruptus found on a Polyporus sp. Canada, Cantharellus betularum among leaf litter of Betula, Penicillium saanichii from house dust. Chile, Circinella lampensis on soil, Exophiala embothrii from rhizosphere of Embothrium coccineum. China, Colletotrichum cycadis on leaves of Cycas revoluta. Croatia, Phialocephala melitaea on fallen branch of Pinus halepensis. Czech Republic, Geoglossum jirinae on soil, Pyrenochaetopsis rajhradensis from dead wood of Buxus sempervirens. Dominican Republic, Amanita domingensis on litter of deciduous wood, Melanoleuca dominicana on forest litter. France, Crinipellis nigrolamellata (Martinique) on leaves of Pisonia fragrans, Talaromyces pulveris from bore dust of Xestobium rufovillosum infesting floorboards. French Guiana, Hypoxylon hepaticolor on dead corticated branch. Great Britain, Inocybe ionolepis on soil. India, Cortinarius indopurpurascens among leaf litter of Quercus leucotrichophora. Iran, Pseudopyricularia javanii on infected leaves of Cyperus sp., Xenomonodictys iranica (incl. Xenomonodictys gen. nov.) on wood of Fagus orientalis. Italy, Penicillium vallebormidaense from compost. Namibia, Alternaria mirabibensis on plant litter, Curvularia moringae and Moringomyces phantasmae (incl. Moringomyces gen. nov.) on leaves and flowers of Moringa ovalifolia, Gobabebomyces vachelliae (incl. Gobabebomyces gen. nov.) on leaves of Vachellia erioloba, Preussia procaviae on dung of Procavia capensis. Pakistan, Russula shawarensis from soil on forest floor. Russia, Cyberlindnera dauci from Daucus carota. South Africa, Acremonium behniae on leaves of Behnia reticulata, Dothiora aloidendri and Hantamomyces aloidendri (incl. Hantamomyces gen. nov.) on leaves of Aloidendron dichotomum, Endoconidioma euphorbiae on leaves of Euphorbia mauritanica , Eucasphaeria proteae on leaves of Protea neriifolia , Exophiala mali from inner fruit tissue of Malus sp., Graminopassalora geissorhizae on leaves of Geissorhiza splendidissima, Neocamarosporium leipoldtiae on leaves of Leipoldtia schultzii, Neocladosporium osteospermi on leaf spots of Osteospermum moniliferum, Neometulocladosporiella seifertii on leaves of Combretum caffrum, Paramyrothecium pituitipietianum on stems of Grielum humifusum, Phytopythium paucipapillatum from roots of Vitis sp., Stemphylium carpobroti and Verrucocladosporium carpobroti on leaves of Carpobrotus quadrifolius, Suttonomyces cephalophylli on leaves of Cephalophyllum pilansii. Sweden, Coprinopsis rubra on cow dung, Elaphomyces nemoreus fromdeciduouswoodlands. Spain, Polyscytalum pini-canariensis on needles of Pinus canariensis, Pseudosubramaniomyces septatus from stream sediment, Tuber lusitanicum on soil under Quercus suber. Thailand, Tolypocladium flavonigrum on Elaphomyces sp. USA, Chaetothyrina spondiadis on fruits of Spondias mombin, Gymnascella minnisii from bat guano, Juncomyces patwiniorum on culms of Juncus effusus, Moelleriella puertoricoensis on scale insect, Neodothiora populina (incl. Neodothiora gen. nov.) on stem cankers of Populus tremuloides, Pseudogymnoascus palmeri fromcavesediment. Vietnam, Cyphellophora vietnamensis on leaf litter, Tylopilus subotsuensis on soil in montane evergreen broadleaf forest. Morphological and culture characteristics are supported by DNA barcodes.

[EN] Surgical ablation (SA) is the most effective procedure to terminate atrial fibrillation (AF) in patients requiring concomitant open-heart surgery. However, considering the great stress provoked in the patient¿s heart, along with the benefits of anticipating antiarrhythmic therapeutical decisions, preoperative prediction of long-term failure of the procedure is an interesting clinical challenge. Hence, the present work introduces a novel algorithm to anticipate SA outcome after one year of follow-up by just analyzing the surface ECG. The method firstly extracts fibrillatory waves reflected on standard lead V1 using an adaptive QRST cancellation approach. The resulting signal is then segmented into 1 s-length intervals and wavelet energy is computed for all of them. Finally, the coefficient of variation of the time series obtained for the 7th scale is computed. Analyzing 20 second-length preoperative ECG excerpts from 53 persistent AF patients undergoing concomitant openheart surgery, only the proposed method reported statistically significant differences between the patients who relapsed to AF and those who maintained sinus rhythm during the follow-up. The algorithm also provided values of sensitivity, specificity, and accuracy between 10 and 20% better than the well-established dominant atrial frequency and fibrillatory waves amplitude, thus suggesting to be a promising predictor of AF recurrence after SA., This research has been supported by grants DPI2017-83952-C3 from MINECO/AEI/FEDER EU, SBPLY/17/180501/000411 from Junta de Comunidades de Castilla-la Mancha and AICO/2019/036 from Generalitat Valenciana. Moreover, Pilar Escribano holds a graduate research scholarship from University of Castilla-La Mancha.

Potassium (K+ ) is a macronutrient known for its high mobility and positive charge, which allows efficient and fast control of the electrical balance and osmotic potential in plant cells. Such features allow K+ to remarkably contribute to plant stress adaptation. Some agricultural lands are deficient in K+ , imposing a stress that reduces crop yield and makes fertilization a common practice. However, individual stress conditions in the field are rare, and crops usually face a combination of different stresses. As plant response to a stress combination cannot always be deduced from individual stress action, it is necessary to gain insights into the specific mechanisms that connect K+ homeostasis with other stress effects to improve plant performance in the context of climate change. Surprisingly, plant responses to environmental stresses under a K+ -limiting scenario are poorly understood. In the present review, we summarize current knowledge and find substantial gaps regarding specific outcomes of K+ deficiency in addition to other environmental stresses. In this regard, combined nutrient deficiencies of K+ and other macronutrients are covered in the first part of the review and interactions arising from K+ deficiency with salinity, drought and biotic factors in the second part. Information available so far suggests a prominent role of potassium and nitrate transport systems and their regulatory proteins in the response of plants to several stress combinations. Thus, such molecular pathways, which are located at the crossroad between K+ homeostasis and environmental stresses, could be considered biotechnological targets in future studies.

Resumen Introduccion La seguridad y los resultados oncologicos de los pacientes tratados con stents colicos como puente a la cirugia (PAC) son controvertidos. El objetivo de este estudio es evaluar los efectos sobre los resultados quirurgicos y oncologicos de los stents como PAC de las neoplasias colorrectales oclusivas potencialmente resecables. Metodos Analisis retrospectivo de los pacientes intervenidos por neoplasia colorrectal oclusiva potencialmente resecable con o sin enfermedad a distancia entre septiembre de 2002 y octubre de 2015, comparando los pacientes tratados con stent como PAC (grupo Stent) con los intervenidos de forma urgente (grupo Cirugia). Resultados Veinte pacientes fueron intervenidos directamente, mientras que se intento la colocacion de un stent en 57 pacientes. En el grupo Stent hubo mas intervenciones laparoscopicas (64,9 vs. 5%, p Conclusiones La utilizacion de stents colicos como PAC de las neoplasias colorrectales oclusivas potencialmente resecables parece proporcionar mejores resultados quirurgicos y resultados oncologicos equiparables a los de los pacientes intervenidos directamente.

Phenotypic screening has produced most of the new chemical entities currently in clinical development for malaria, plus many lead compounds active against Plasmodium falciparum asexual stages. However, lack of knowledge about the mode of action of these compounds delays and may even hamper their future development. Identifying the mode of action of the inhibitors greatly helps to prioritise compounds for further development as novel antimalarials. Here we describe a whole-cell method to detect inhibitors of the mitochondrial electron transport chain, using oxygen consumption as high throughput readout in 384-well plate format. The usefulness of the method has been confirmed with the Tres Cantos Antimalarial Compound Set (TCAMS). The assay identified 124 respiratory inhibitors in TCAMS, seven of which were novel anti-plasmodial chemical structures never before described as mitochondrial inhibitors., Graphical abstract Image 1, Highlights • High throughput method to detect mitochondrial electron transport chain inhibitors. • 149 selective respiratory inhibitors identified among the 13,103-compound set TCAMS. • Seven new chemical entities described as anti-plasmodial cytochrome b inhibitors.

The SOS Children’s Village at Sant Feliu de Codines in Barcelona (1970), the Hifrensa village (completed), and the Prat I and II urban development plans (not completed) were the final major urban complexes designed by Antonio Bonet (not counting his projects for the tourist sector). At SOS, Bonet designed a residential ensemble for orphaned children comprising communal educational and sporting facilities, by recreating, on a human scale, the atmosphere of the villages depicted in the photographs published in issue 18 (1935) of the GATEPAC magazine AC Documentos de Actividad Contemporánea, which was dedicated to popular architecture. Whitewashed pavilions, vaults, porches, patios, walls and stone platforms arranged like agricultural terraces were the features by which he constructed the landscape of a modern village but with old-fashioned forms. In this paper we analyse this unprecedented work, which, although it was never constructed, expresses the architect’s singular interpretation of the countryside and habitability conditions for orphans. Moreover, this work concentrates the architect’s experience as an experienced urbanist who in the 1970s challenged his fundamental theoretical creed, the Athens Charter, from a historical perspective.

Resumen Introduccion El colesterol no transportado por las lipoproteinas de alta densidad (c-no-HDL) esta adquiriendo relevancia en su participacion en la valoracion del riesgo cardiovascular y como diana terapeutica. El objetivo del presente estudio ha sido valorar la capacidad predictiva independiente, tanto del c-no-HDL como del colesterol de las lipoproteinas de baja densidad (cLDL), principal prioridad en las dislipidemias para reducir el riesgo cardiovascular (RCV), en la morbilidad de causa cardiovascular, en una muestra de origen poblacional. Metodos El diseno del estudio corresponde a una cohorte prospectiva en la que han participado 1.186 individuos en el grupo c-no-HDL y 1.177 en el grupo cLDL, seguidos durante 10,7 anos (DE = 2,2), los cuales no habian padecido ningun episodio cardiovascular (CV) previo. Las variables predictoras incluidas en el ajuste han sido: genero, edad, hipertension arterial, diabetes mellitus, estado de fumador y c-no-HDL en un grupo. En el otro grupo, formado por pacientes que presentaban niveles de trigliceridos ≤ 400 mg/dl, se sustituyo el c-no-HDL por el cLDL. Se calcularon curvas de supervivencia (Kaplan-Meier) y se aplicaron dos modelos de regresion de Cox, uno por cada grupo. Resultados El grupo c-no-HDL presento un 6,2% de episodios CV no mortales durante el seguimiento, y el grupo cLDL, un 6,0%. Despues del ajuste, por cada aumento de 30 mg/dl de c-no-HDL, la incidencia de nuevos episodios CV no mortales aumento un 31% (HR = 1,31; IC 95%: 1,06-1,61; p = 0,018) y en el grupo del cLDL un 27% (HR = 1,27; IC 95%: 0,97-1,61; p = 0,068). Conclusiones Tras un seguimiento de 10,7 anos, el c-no-HDL se ha mostrado en nuestra poblacion como un factor pronostico de enfermedad CV no mortal, pero no el cLDL, aunque su HR se encuentra proxima a la significacion estadistica.

Introduction Non-HDL cholesterol (non-HDL-C) is becoming relevant both in its participation in cardiovascular risk assessment and as a therapeutic target. The objective of the present study was to assess the independent predictive capacity of both non-HDL-C and LDL-C (the main priority in dyslipidemias to reduce cardiovascular risk), in cardiovascular morbidity in a population-based sample. Methods A prospective cohort study involving 1186 individuals in the non-HDL-C group and 1177 in the LDL-C group, followed for 10.7 years (SD = 2.2), who had not had any previous cardiovascular event. The predictor variables included in the adjustment were: gender, age, arterial hypertension, diabetes mellitus, smoker status and non-HDL-C in one group. In the other group, consisting of patients presenting TG levels of 400 mg/dl, non-HDL-C was replaced by LDL-C. Survival curves (Kaplan–Meier) were calculated and two Cox regression models were applied, one for each group. Results Non-HDL-C group presented 6.2% of non-fatal cardiovascular episodes during follow-up and the LDL-C group 6.0%. After adjustment, for each 30 mg/dl increase in non-HDL-C, the incidence of new non-fatal cardiovascular events increased by 31% (HR = 1.31, 95% CI: 1.06–1.61; p = 0.018) and in the LDL-C group by 27% (HR = 1.27, 95% CI: 0.97–1.61, p = 0.068). Conclusions After a follow-up of 10.7 years, non-HDL-C has been shown in our population as a prognostic factor of non-fatal cardiovascular disease, but not LDL-C, although its HR is close to statistical significance.

Potassium (K+ ) and cesium (Cs+ ) are chemically similar but while K+ is an essential nutrient, Cs+ can be toxic for living organisms, plants included. Two different situations could lead to problems derived from the presence of Cs+ in agricultural systems: (1) presence of Cs+ at high concentrations that could produce toxic effects on plants, (2) presence of micromolar concentrations of radiocesium, which can be accumulated in the plant and affect animal and human health through the food chain. While K+ uptake has been well described in tomato plants, information on molecular mechanisms involved in Cs+ accumulation in this species is absent. Here, we show that in tomato plants, high concentrations of Cs+ produce deficiency of K+ but do not induce high-affinity K+ uptake or the gene encoding the high-affinity K+ transporter SlHAK5. At these concentrations, Cs+ uptake takes place through a Ca2+ -sensitive pathway, probably a non-selective cation channel. At micromolar concentrations, Cs+ is accumulated by a high-affinity uptake system upregulated in K+ -starved plants. This high-affinity Cs+ uptake shares features with high-affinity K+ uptake. It is sensitive to NH4+ and insensitive to Ba2+ and Ca2+ and its presence parallels the pattern of SlHAK5 expression. Moreover, blockers of reactive oxygen species and ethylene action repress SlHAK5 and negatively regulate both high-affinity K+ and Cs+ uptake. Thus, we propose that SlHAK5 contributes to Cs+ uptake from micromolar concentrations in tomato plants and can constitute a pathway for radiocesium transfer from contaminated areas to the food chain.

Producción Científica, Dermo-epidermal equivalents based on plasma-derived fibrin hydrogels have been ex tensively studied for skin engineering. However, they showed rapid degradation and contraction over time and low mechanical properties which limit their reproducibility and lifespan. In order to achieve better mechanical properties, elasticity and biological properties, we incorporated a elastin-like recombinamer (ELR) network, based on two types of ELR, one modified with azide (SKS-N3 ) and other with cyclooctyne (SKS-Cyclo) chemical groups at molar ratio 1:1 at three different SKS (serine-lysine-serine sequence) concentrations (1, 3, and 5 wt.%), into plasma-derived fibrin hydrogels. Our results showed a decrease in gelation time and contraction, both in the absence and presence of the encapsulated human primary fibroblasts (hFBs), higher mechanical properties and increase in elasticity when SKSs content is equal or higher than 3%. However, hFBs proliferation showed an improvement when the lowest SKS content (1 wt.%) was used but started decreasing when increasing SKS concentration at day 14 with respect to the plasma control. Proliferation of human primary keratinocytes (hKCs) seeded on top of the hybrid-plasma hydrogels containing 1 and 3% of SKS showed no differences to plasma control and an increase in hKCs proliferation was observed for hybrid-plasma hydrogels containing 5 wt.% of SKS. These promising results showed the need to achieve a balance between the reduced contraction, the better mechanical properties and biological properties and indicate the potential of using this type of hydrogel as a testing platform for pharmaceutical products and cosmetics, and future work will elucidate their potential., Gobierno Español, (Grant/Award Numbers: FPU15-00448, PID2019-110709RB-100, RED2018-102417-T), Junta de Castilla y León (VA317P18, Infrared2018-UVA06), Interreg. V España-Portugal POCTEP (0624_2IQBIONEURO_6_E), Programa de Actividades de I + D entre Grupos de Investigación de la Comunidad de Madrid (S2018/BAA-4480), Programa Estatal de I + D + i Orientada a los Retos de la So-ciedad (RTI2018-101627-B-I00)

The classic ketogenic diet is a diet high in fat, low in carbohydrates, and well-adjusted proteins. The reduction in glucose levels induces changes in the body’s metabolism, since the main energy source happens to be ketone bodies. Recent studies have suggested that nutritional interventions may modulate drug addiction. The present work aimed to study the potential effects of a classic ketogenic diet in modulating alcohol consumption and its rewarding effects. Two groups of adult male mice were employed in this study, one exposed to a standard diet (SD, n = 15) and the other to a ketogenic diet (KD, n = 16). When a ketotic state was stable for 7 days, animals were exposed to the oral self-administration paradigm to evaluate the reinforcing and motivating effects of ethanol. Rt-PCR analyses were performed evaluating dopamine, adenosine, CB1, and Oprm gene expression. Our results showed that animals in a ketotic state displayed an overall decrease in ethanol consumption without changes in their motivation to drink. Gene expression analyses point to several alterations in the dopamine, adenosine, and cannabinoid systems. Our results suggest that nutritional interventions may be a useful complementary tool in treating alcohol-use disorders.

Background and objectives A broad range of skin flaps can be used to repair facial surgical defects after the excision of a tumor. The aim of our study was to develop a practical guideline covering the most useful skin grafts for each of the distinct facial cosmetic units. Material and methods This was a multicenter study in which 10 dermatologists with extensive experience in reconstructive surgery chose their preferred technique for each cosmetic unit. The choice of flaps was based on personal experience, taking into account factors such as suitability of the reconstruction technique for the specific defect, the final cosmetic result, surgical difficulty, and risk of complications. Each dermatologist proposed 2 flaps in order of preference for each cosmetic subunit. A score of 10 was given to the first flap and a score of 5 to the second. Results The total score obtained for each of the options proposed by the participating dermatologists was used to draw up a list of the 3 best grafts for each site. There was notable unanimity of criteria among most of the dermatologists for reconstructive techniques such as the glabellar flap for defects of the medial canthus of the eye, the bilateral advancement flag flap or H flap for the forehead, the rotary door flap for the auricle of the ear, the Mustarde flap for the infraorbital cheek, the O-Z rotation flap for the scalp, the Tenzel flap for the lower eyelid, and the island flap for the upper lip. Conclusions The results of this study will be useful as a practical guide to choosing the best reconstruction technique for each of the facial cosmetic units.

Resumen Introduccion y objetivos Existe una enorme variedad de colgajos cutaneos empleados para la reparacion de defectos quirurgicos faciales tras la extirpacion de tumores. El objetivo del estudio fue consensuar una guia practica de los colgajos mas utiles para cada una de las distintas unidades esteticas faciales. Material y metodos Estudio multicentrico donde 10 dermatologos de larga experiencia quirurgica reconstructiva eligieron sus tecnicas preferidas para cada unidad estetica. La eleccion de estos colgajos se fundamento en la experiencia personal de cada dermatologo basandose en factores como la idoneidad de la tecnica reconstructiva para ese defecto, el resultado estetico final, la facilidad de ejecucion y la baja probabilidad de complicaciones, entre otros. Eligieron 2 colgajos por orden de preferencia para cada subunidad estetica y se le asignaron 10 puntos al primer colgajo y 5 al segundo. Resultados Con la suma obtenida de todas las opciones aportadas por los dermatologos encuestados se obtuvo una relacion de los 3 mejores colgajos para cada localizacion. Destacar la unanimidad de criterio por parte de la mayoria de los dermatologos para tecnicas reconstructivas como el colgajo glabelar para defectos de canto interno del ojo, el colgajo de avance bilateral en bandera o H para frente, el colgajo en puerta giratoria para concha auricular, el colgajo pangeniano para mejilla infraorbitaria, el colgajo de rotacion O-Z para cuero cabelludo, el colgajo de Tenzel para parpado inferior y el colgajo en isla para labio superior. Conclusiones Los resultados de este estudio son de utilidad para ofrecer una guia practica para la eleccion de las mejores tecnicas reconstructivas en cada una de las distintas subunidades esteticas faciales.

Regulation of essential macronutrients acquisition by plants in response to their availability is a key process for plant adaptation to changing environments. Here we show in tomato and Arabidopsis plants that when they are subjected to NO3- , PO43- and SO42- deprivation, low-affinity K+ uptake and K+ translocation to the shoot are reduced. In parallel, these nutritional deficiencies produce reductions in the messenger levels of the genes encoding the main systems for low-affinity K+ uptake and K+ translocation, i.e. AKT1 and SKOR in Arabidopsis and LKT1 and the tomato homolog of SKOR, SlSKOR in tomato, respectively. The results suggest that the shortage of one nutrient produces a general downregulation of the acquisition of other nutrients. In the case of K+ nutrient, one of the mechanisms for such a response resides in the transcriptional repression of the genes encoding the systems for K+ uptake and translocation.