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Introduction The Spanish Haematology and Haemotherapy Society organizes peripheral blood smear review scheme, focused on the evaluation of diagnostic proficiency of participants by blood cell morphology analysis. The objective was to evaluate the efficacy of this scheme as an educational tool to improve the diagnostic proficiency of the participants. Methods During 2011-2019, 54 peripheral blood smears, alongside with patient details such as age, sex, blood cell counts and relevant clinical information, were sent to an average of 125 ± 13 laboratories per year. A number of 44 shipments were selected to analyse whether successive surveys of the same disease may lead to an improvement in the diagnostic success rate proposed by the laboratories. Participants were asked to select the most relevant morphological abnormalities, alongside the diagnostic orientation. Agreement of participant responses with RR was evaluated. Results Spanish laboratories showed a diagnostic proficiency greater than 80% in acute myeloid leukaemia, including acute promyelocytic leukaemia, mature B-cell neoplasms (hairy cell leukaemia and splenic marginal zone lymphoma), chronic myeloid leukaemia, sickle cell disease, Bernard-Soulier syndrome and infectious mononucleosis. It was important to note the significant improvement over the time in the successive shipments of the same disease, with a 31% and 13% increase in their diagnostic orientation success rate for acute myeloid leukaemia and acute promyelocytic leukaemia cases, respectively, 15% for mantle cell lymphoma and 6% for sickle cell disease. Conclusions The present study provides evidence that peripheral blood smear review scheme can be a valid educational tool to improve the clinical pathologist skills in blood morphology and haematological diagnosis.

The aim of this paper is to examine the influence of the right to information laws on sustainability transparency in European local governments. This goal is novel, in that previous studies have examined the effects of various factors on the dissemination of government information (demographic, socioeconomic, political and financial) but not the contribution of legal factors to online transparency on environmental, social and economic sustainability. Our research question is this: Do information laws contribute to transparency on sustainability? Using the Global Reporting Initiative guidelines and a statistical regression analysis, we studied the websites of 106 local governments in ten European countries. The results obtained show that when transparency laws clearly stipulate the rules applicable and the procedures established for appeals, exceptions, refusals and requests, this can favour transparency on environmental, social and economic sustainability. Our findings advance understanding of this field and reinforce the basis for legal reforms to enhance sustainability transparency.

Background and Purpose Non-alcoholic steatohepatitis (NASH) is the hepatic manifestation of metabolic syndrome and is characterized by steatosis, inflammation and fibrosis. Soluble guanylate cyclase (sGC) stimulation reduces inflammation and fibrosis in experimental models of lung, kidney and heart disease. Here, we tested whether sGC stimulation is also effective in experimental NASH. Experimental Approach NASH was induced in mice by feeding a choline-deficient, l-amino acid-defined, high-fat diet. These mice received either placebo or the sGC stimulator IW-1973 at two different doses (1 and 3 mg·kg−1·day−1) for 9 weeks. IW-1973 was also tested in high-fat diet (HFD)-induced obese mice. Steatosis, inflammation and fibrosis were assessed by Oil Red O, haematoxylin–eosin, Masson's trichrome, Sirius Red, F4/80 and α-smooth muscle actin staining. mRNA expression was assessed by quantitative PCR. Levels of IW-1973, cytokines and cGMP were determined by LC-MS/MS, Luminex and enzyme immunoassay respectively. Key Results Mice with NASH showed reduced cGMP levels and sGC expression, increased steatosis, inflammation, fibrosis, TNF-α and MCP-1 levels and up-regulated collagen types I α1 and α2, MMP2, TGF-β1 and tissue metallopeptidase inhibitor 1 expression. IW-1973 restored hepatic cGMP levels and sGC expression resulting in a dose-dependent reduction of hepatic inflammation and fibrosis. IW-1973 levels were ≈40-fold higher in liver tissue than in plasma. IW-1973 also reduced hepatic steatosis and adipocyte hypertrophy secondary to enhanced autophagy in HFD-induced obese mice. Conclusions and Implications Our data indicate that sGC stimulation prevents hepatic steatosis, inflammation and fibrosis in experimental NASH. These findings warrant further evaluation of IW-1973 in the clinical setting.

Background: Patients with acutely decompensated cirrhosis (AD) may or may not develop acute-on-chronic liver failure (ACLF). ACLF is characterized by high-grade systemic inflammation, organ failures (OF) and high short-term mortality. Although patients with AD cirrhosis exhibit distinct clinical phenotypes at baseline, they have low short-term mortality, unless ACLF develops during follow-up. Because little is known about the association of profile of systemic inflammation with clinical phenotypes of patients with AD cirrhosis, we aimed to investigate a battery of markers of systemic inflammation in these patients. Methods: Upon hospital admission baseline plasma levels of 15 markers (cytokines, chemokines, and oxidized albumin) were measured in 40 healthy controls, 39 compensated cirrhosis, 342 AD cirrhosis, and 161 ACLF. According to EASL-CLIF criteria, AD cirrhosis was divided into three distinct clinical phenotypes (AD-1: Creatinine, SCOPUS: ar.j, info:eu-repo/semantics/published

Acute-on-chronic liver failure (ACLF) in cirrhosis is an increasingly recognized syndrome characterized by acute decompensation, organ failure(s) and high short-term mortality. Recent findings suggest that an overexuberant systemic inflammation plays a primary role in ACLF progression. In this study, we examined whether genetic factors shape systemic immune responses in patients with decompensated cirrhosis. Six single-nucleotide polymorphisms (SNPs) in inflammation-related genes (interleukin [IL]-1 beta [IL-1β], rs1143623; IL-1 receptor antagonist [IL-1ra], rs4251961; IL-10, rs1800871; suppressor of cytokine signaling-3, rs4969170; nucleotide-binding oligomerization domain-containing protein 2, rs3135500; and chemerin chemokine-like receptor 1, rs1878022) were genotyped in 279 patients with cirrhosis with (n = 178) and without (n = 101) ACLF from the CANONIC study of the CLIF consortium. Among these SNPs, we identified two polymorphisms belonging to the IL-1 gene cluster (IL-1β and IL-1ra) in strong association with ACLF. Both SNPs were protective against ACLF; IL-1β (odds ratio [OR], 0.34, 95% confidence interval [CI], 0.13-0.89; P < 0.05) and IL-1ra (OR, 0.58; 95% CI, 0.35-0.95; P < 0.05) under the recessive and overdominant inheritance models, respectively. These protective SNPs translated into reduced circulating levels of IL-1β, IL-1α, IL-6, granulocyte-colony stimulating factor, granulocyte-macrophage colony-stimulating factor, and C-reactive protein at enrollment as well as after 7-14 days of admission. These findings were confirmed in vitro in leukocytes incubated with plasma from patients with decompensated cirrhosis carrying the protective SNP genotypes. Notably, a higher frequency of the protective genotypes was observed in patients without (80%) than in those with (20%) ACLF. Consistently, patients carrying the combined protective genotypes showed a lower 28-day mortality rate.CONCLUSION: These data identify two common functional polymorphisms in the IL-1 gene cluster, which are associated with the inflammatory process related to development of ACLF. (Hepatology 2017;65:202-216).

ObjectiveSystemic inflammation predisposes acutely decompensated (AD) cirrhosis to the development of acute-on-chronic liver failure (ACLF). Supportive treatment can improve AD patients, becoming recompensated. Little is known about the outcome of patients recompensated after AD. We hypothesise that different inflammasome activation is involved in ACLF development in compensated and recompensated patients.Design249 patients with cirrhosis, divided into compensated and recompensated (previous AD), were followed prospectively for fatal ACLF development. Two external cohorts (n=327) (recompensation, AD and ACLF) were included. Inflammasome-driving interleukins (ILs), IL-1α (caspase-4/11-dependent) and IL-1β (caspase-1-dependent), were measured. In rats, bile duct ligation-induced cirrhosis and lipopolysaccharide exposition were used to induce AD and subsequent recompensation. IL-1α and IL-1β levels and upstream/downstream gene expression were measured.ResultsPatients developing ACLF showed higher baseline levels of ILs. Recompensated patients and patients with detectable ILs had higher rates of ACLF development than compensated patients. Baseline CLIF-C (European Foundation for the study of chronic liver failure consortium) AD, albumin and IL-1α were independent predictors of ACLF development in compensated and CLIF-C AD and IL-1β in recompensated patients. Compensated rats showed higher IL-1α gene expression and recompensated rats higher IL-1β levels with higher hepatic gene expression. Higher IL-1β detection rates in recompensated patients developing ACLF and higher IL-1α and IL-1β detection rates in patients with ACLF were confirmed in the two external cohorts.ConclusionPrevious AD is an important risk factor for fatal ACLF development and possibly linked with inflammasome activation. Animal models confirmed the results showing a link between ACLF development and IL-1α in compensated cirrhosis and IL-1β in recompensated cirrhosis.

Developers and managers of websites are key players in conveying the transparency of governments. Although previous research has highlighted the need for further progress in transparency on sustainability, very few studies have considered how websites can better contribute to providing sustainability information. This paper identifies determinant factors that can help website developers and managers enhance the online transparency on sustainability provided by regional governments. In an empirical study of 17 Spanish regional governments, we identified technological factors (such as broadband availability and the online compilation of information) and transparency-stimulating factors (such as convergence with the information society, accessibility and usability) that can be useful to increase the volume of social, economic and environmental information published on their websites.

Although the transparency and sustainability of governments are currently of great interest to researchers, few studies have specifically addressed these issues. Nevertheless, previous research has found sustainability transparency as a key issue in government–citizen relations, especially for local governments (LGs). The aim of this article is to identify factors that promote online transparency regarding the sustainability of public policies, by means of an empirical study of 62 LGs in the United Kingdom, Ireland, and Southern Europe. Our results show that the prevailing administrative tradition may influence the degree of transparency of LGs, with population, socioeconomic, and financial factors being relevant.

Citizens increasingly demand an active role in public affairs and decision-making processes. From a critical standpoint, this chapter consolidates existing knowledge and, in turn, provides a better understanding on how social media tools promote the citizens' engagement and participation. The main aim is to assist researchers in the development of their future analyses, identifying trends of research and the methodology used. In so doing, a systematic literature review has been used to examine social media and e-participation research in journals listed in ISI in the field of public administration and information science and library science during the period 2000-2016. The findings reveal that although research on social media and e-participation has increased in the last year, it remains immature. Therefore, further research is needed in order to understand the true impacts of social media tools and their involvement in e-participation.

Obesity comorbidities are closely associated with chronic low-grade adipose tissue inflammation. A number of SNPs associated with inflammation has been identified, underscoring the impact of genetic determinants on this process. Here, we screened SNPs in genes with pro-inflammatory (IL-1β, IL-6, STAT3 and JAK2), anti-inflammatory (IL-10 and SOCS3) and pro-resolving (ERV1/ChemR23) properties in 101 obese and 99 non-obese individuals. Among the SNPs analyzed, we identified that individuals carrying a C allele in the rs1878022 polymorphism of the ERV1/ChemR23 gene, which encodes for the receptor of the pro-resolving mediator RvE1, had increased ERV1/ChemR23 protein expression and reduced levels of the inflammatory cytokine IL-6 in adipose tissue. Moreover, patients carrying the C allele in homozygosity had lower plasma levels of IL-6, IFN-α2, IL-15, IL-1ra, IL-10, GM-CSF, G-CSF and VEGF and enhanced leukocyte responsiveness to RvE1. C-carriers also exhibited decreased TAG to HDL ratio, a surrogate marker of insulin resistance and a predictor of incident fatty liver. Finally, we confirmed in vivo that the ERV1/ChemR23 receptor regulates systemic and tissue inflammation since mice lacking ERV1/ChemR23 expression showed increased IL-6 levels in adipose tissue and peritoneal macrophages. Together, our study identified an ERV1/ChemR23 variant that protects patients with obesity from excessive inflammatory burden.

In several European countries decentralization has promoted the creation of Regional Governments (RGs) with high levels of competence and responsibilities, such as promoting good governance and sustainability. Information and communication technologies (ICTs), and hence, the adoption of e-government has contributed to the adoption and dissemination of government transparency in a usable and accessible way. In this chapter, we study the transparency, accessibility and usability of websites of Spanish RGs.

Although international organizations and prior literature have recognized the importance of sustainability reporting for governments nowadays, some studies have revealed that this is an issue that has received little attention and thus needs further investigation. This article studies the publication of information on sustainability issues by local governments, analysing the relationship between diverse levels of sustainability information disclosure and some socioeconomic, financial and population variables. Based on the increased use of the Internet by governments, the methodology applied in this study is to analyse the websites of 55 major towns and cities in Spain, seeking 61 items that are recommended in the Global Reporting Initiative guidelines. By applying multiple linear regression analysis, we analysed the influence of 13 factors on the sustainability reporting provided by these municipal authorities. The results show that social information is the most widespread, and that the dependent population has a positive impact on the sustainability disclosures. The major opportunities to improve sustainability practices lie in improving the disclosure of economic and environmental information, through the publication of formal sustainability reports and the enhanced coordination of information published individually by different departments. Points for practitioners The results obtained highlight several issues of particular interest for managers. On the one hand, the public sector financial crisis has heightened the need to legitimize government actions. Moreover, the incidence of the variable ‘dependent population’ on the disclosure of sustainability information suggests that there is an important relation between the population structure and such disclosure, highlighting the need to consider the age of the population and its evolution over time as the basis for creating specific reports on sustainability. The public demand for information on sustainability does not depend on the level of taxes paid. Finally, local governments are not motivated by their level of financial autonomy with respect to information about their commitments on economic sustainability.

International organisations such as the EU, the OECD and the WBG have recommended that governments provide information to citizens about the sustainability of their public policies. Furthermore, previous studies have concluded that while stakeholders are demanding greater transparency from public entities about the sustainability of their actions, little research has been conducted into governmental information disclosure concerning sustainability. Accordingly, the aim of the present paper is to contribute to our understanding of sustainability practices and information transparency in this respect in governmental institutions, and thus enable improvements to be made in this field. In the view that e-government, based on information and communication technologies, is a key element in good governance aimed at achieving sustainable development, we identify factors that may promote the disclosure of information on the sustainability of public entities, by analysing the information content of regional governments' websites and its relationship with certain variables. Our main findings are that socio-economic factors such as education, population density and access to internet, and e-government factors such as the provision of public information online, the percentage of procedures completed after online start, the level of online services provided and broadband availability, are all relevant to the disclosure of sustainability information by regional governments.

Although the importance of sustainability reporting in the public sector is widely recognized, there are few studies about this issue. This paper analyzed the practices of diffusion of information on sustainability in local governments. So, we observed the Websites of the largest local governments in Spain using a list of items from the guidelines of GRI and comparing the results with the results of the Spanish regional governments. Our findings show that local governments reported some information (50% of the items), but less than regional governments (60%). Social information is the most widespread and environmental information is the least reported.

In the current socioeconomic context, the question of local government sustainability transparency is of great interest to policymakers, managers, citizens and other stakeholders, and yet one to which previous research has devoted little specific attention. At the same time, the Internet has become an instrument of good governance worldwide and government entities in Europe have strived to promote e-government to improve transparency towards citizens. The aim of this study was to identify factors that can help politicians and managers improve practices of sustainability information disclosed by European local governments. To do so, an empirical study was conducted of 91 municipalities in nine countries, comparing three main administrative cultures. Our analysis of the study results highlights various demographic, socioeconomic, financial and legal factors that may be useful to policymakers and managers in promoting the online provision of sustainability information in Anglo-Saxon, Nordic and Southern European countries.