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Abstract In citrus, the synthetic auxin 3,5,6-trichloro-2-pyridyloxyacetic acid (3,5,6-TPA), applied as a foliar spray at a concentration of 15 mg l− 1 during physiological fruitlet abscission, caused additional fruitlet drop and reduced the number of fruits reaching maturity. The effect was much more pronounced at full physiological abscission than after. In this study, this thinning effect was successfully exploited for the first time in sour orange trees grown in an urban environment, reducing harvesting costs by up to almost 40%. This effect is mediated by the leaves, which alter their photosynthetic activity. Our results show a reduction of carbon fixation and sucrose synthesis in the leaf, by 3,5,6-TPA repression of the RbcS, SUS1 and SUSA genes, its transport to the fruit, as shown by the reduced expression of the sucrose transporter genes SUT3 and SUT4, and its hydrolysis in the fruit, mainly by repression of the SUS1 gene expression. Genes involved in auxin homeostasis in the fruit, TRN2 and PIN1, were also repressed. The coordinated repression of all these genes is consistent with the decrease in the fruit cell division rate, as shown by the repression of CYCA1-1 gene, leading to the production of ethylene, which ultimately induces fruitlet abscission.

Abstract Cancer therapy-related cardiac dysfunction (CTRCD), which commonly includes left ventricular dysfunction and heart failure, is the main adverse effect of anticancer therapy. In recent years several candidate genes studies and genome-wide association studies have identified common genetic variants associated with CTRCD, but evidence remains limited and few genetic variants are robust. A genome-wide meta-analysis of CTRCD was performed with 852 oncology patients receiving cancer therapy. DNA samples were genotyped and imputed to perform a GWAS meta-analysis for case–control (N = 852 (380 cases and 472 controls) and extreme phenotypes (N = 618 (78 cases and 472 controls) looking for genetic variants that predispose to CTRCD. The results were validated in a replicate cohort of 1,191 oncology patients (245 cases and 946 controls). Functional mapping of the replicated loci was then performed. The meta-analysis showed 9 and 17 loci suggestively associated (P-value

Intertidal macroalgae play a vital role in marine ecosystems, necessitating effective monitoring of their coverage and diversity. Traditional monitoring methods are labour-intensive and costly, prompting exploration of the use of unmanned aerial vehicles (UAVs) to characterize intertidal ecosystems. We propose an alternative process integrating UAV red-green-blue (RGB) imagery and topographic indexes to classify complex intertidal macroalgae assemblages automatically. We studied two intertidal areas capturing eight flights between May and September 2023. Orthoimages and Digital Elevation Models (DEMs) were generated. Manual segmentations for 24 classes were cropped into images of individual labels. Additional channels with five topographic indices were added to the RGB images. The resulting dataset of 6412 images was then used to train a Convolutional Neural Network (CNN). We tested the benefit of the additional topographic indices by training the CNN with and without the topographic channels. The best results were given by the inclusion of the Analytical hillshade to the RGB images, showing a relative 11.3% increase in classification accuracy. This indicates that 3D data can enhance the performance of macroalgae classification models. However, there was no significant improvement when using more than one topographic index to train the CNN. Our workflow offers a cost-effective and robust solution for intertidal macroalgae monitoring, contributing to ecological conservation efforts.

Abstract Mesoscale eddies influence the distribution of diazotrophic (nitrogen-fixing) cyanobacteria, impacting marine productivity and carbon export. Non-cyanobacterial diazotrophs (NCDs) are emerging as potential contributors to marine nitrogen fixation, relying on organic matter particles for resources, impacting nitrogen and carbon cycling. However, their diversity and biogeochemical importance remain poorly understood. In the subtropical North Atlantic along a single transect, this study explored the horizontal and vertical spatial variability of NCDs associated with suspended, slow-sinking, and fast-sinking particles collected with a marine snow catcher. The investigation combined amplicon sequencing with hydrographic and biogeochemical data. Cyanobacterial diazotrophs and NCDs were equally abundant, and their diversity was explained by the structure of the eddy. The unicellular symbiotic cyanobacterium UCYN-A was widespread across the eddy, whereas Trichodesmium and Crocosphaera accumulated at outer fronts. The diversity of particle-associated NCDs varied more horizontally than vertically. NCDs constituted most reads in the fast-sinking fractions, mainly comprising Alphaproteobacteria, whose abundance significantly differed from the suspended and slow-sinking fractions. Horizontally, Gammaproteobacteria and Betaproteobacteria exhibited inverse distributions, influenced by physicochemical characteristics of water intrusions at the eddy periphery. Niche differentiations across the anticyclonic eddy underscored NCD-particle associations and mesoscale dynamics, deepening our understanding of their ecological role and impact on ocean biogeochemistry.

Chemical signaling through pheromones is an ancient and widespread mode of communication. Turtles and tortoises (chelonians) secrete pheromones via mental (chin) glands and have superior olfactory capacities rendering them a promising group to study the evolution and function of chemical communication in vertebrates. Here, we use state-of-the art proteomics and lipidomics techniques to identify and explore the possible functions of proteins and lipids secreted by mental glands in turtles. We examined four turtle species all from the family Geoemydidae, to understand among-species as well as sexual variation in the composition of mental gland secretions. Differential expression of a relatively small number (ca. 65) of proteins explained a large portion of the proteome variation across species, highlighting the existence of specific signals evolving even in closely related species. Lipidomic analysis revealed high inter-individual variation, but species differences could be attributed to five different lipid classes. The lipids found in mental glands could have a dietary origin or be related to individual condition, but may nonetheless be used in communication. We also examined sex-specific differences in the proteome of a single species (Mauremys leprosa) and found that males expressed a much larger array of proteins than females. Our findings establish a group of candidate proteins potentially involved in chemical signaling in freshwater geoemydid turtles. Alternatively, differently expressed proteins in mental glands could have an indirect link to chemical communication, being involved in pheromone transport and/or antioxidant protection.

Abstract A model-independent expression for the Dalitz plot of the semileptonic decays of a neutral kaon K μ 3 0 $$ {K}_{\mu 3}^0 $$ , including radiative corrections to order O $$ \mathcal{O} $$ [(α/π)(q/M 1)], where q is the four-momentum transfer and M 1 is the mass of the decaying kaon, is presented. In this paper the emitted muon is considered to be polarized so the analysis is centered on numerically evaluating the radiative corrections to the longitudinal, transverse, and normal polarization muon components. The model dependence of radiative corrections is kept in general form within this approximation, which is useful for model-independent experimental analyses. The final expressions, with the triple integration of the bremsstrahlung photon variables are ready to be evaluated numerically, they are free of the infrared divergence or ultraviolet cutoff. The radiative corrections to the components of the muon polarization are found to be very small compared to their respective uncorrected values.

Abstract Seawater transported into the South Atlantic from the Indian Ocean via “Agulhas leakage” modulates global ocean circulation and has been linked to glacial‐interglacial climate cycles. However, constraining past Agulhas leakage has been a challenge. We sampled a transect of the Cape Basin in winter 2017 that intersected a mature Agulhas eddy and found that the 15N/14N ratio (δ15N) of mixed‐layer nitrate, zooplankton, and foraminifera (tissue and shells) was 2‰–3‰ lower in the eddy than in the background Atlantic even though the δ15N of the underlying thermocline nitrate was indistinguishable between the two settings. We suggest that the δ15N of foraminifera and other zooplankton in the eddy reflects the original Agulhas Current thermocline nitrate, which is ∼2‰ lower than that of the South Atlantic due to N2 fixation that occurs in the Indian Ocean. Foraminifera δ15N may have been lowered further during eddy migration by in situ N2 fixation and/or recycling of low‐δ15N ammonium. The absence of low‐δ15N Agulhas nitrate in the eddy thermocline can be explained by partial assimilation of the nitrate as it was mixed into the euphotic zone during and after eddy formation, raising its δ15N. The low δ15N of eddy foraminifera, apparent even after several months of eddy migration across the Cape Basin, suggests that fossil foraminifer‐bound δ15N from the region could record variations in past Agulhas leakage.

Abstract This work presents the synthesis and evaluation of Pd-Ni aerogels toward the urea oxidation reaction (UOR). The incorporation of Ni led to a 0.13 V reduction in the energy required for the oxidation and reduction of PdO compared to monometallic Pd, both in alkaline medium with and without urea. Varying the Ni ratios in Pd (Pd-Ni 4:1, Pd-Ni 1:1, and Pd-Ni 1:4) led to significant changes in the electrochemical behaviour. In alkaline medium without urea, PdNi 4:1 showed the formation of NiOOH at 1.35 V, which promoted oxygen diffusion on the electrode surface and increased the current density, confirming the increase in the active sites of NiOOH and NiPdOOH and enabling urea-based electrolysis at these sites. While palladium aerogels alone are ineffective for UOR, the presence of nickel plays a key role in enhancing the UOR efficiency. On the other hand, physicochemical characterisation revealed that PdNi 4:1 has a crystal size of 4.37 nm and a larger shift in the 2θ positions of the (111) and (200) planes, which favours electronic changes that were investigated by XPS. These changes affected the electrocatalytic activity, which is primarily related to electronic effects. The results of SEM and TEM studies and nitrogen adsorption-desorption isotherm confirmed that the aerogels are highly porous and have an effective surface area and abundant active sites for reactions that allow efficient mass transfer and low diffusion resistance. TEM observations revealed interconnected nanochains indicating optimal electrocatalytic activity for both ORR and UOR due to high mass transfer. These interconnected networks are crucial for improving electrocatalytic activity in the urea oxidation reaction.

Abstract Background Mammals are subject to circadian rhythms for the control of various physiological events. One of the parameters known to be subject to variations throughout the day is body temperature, which is also subject to influences such as environmental temperature. However, there are not many studies on these rhythms in breeding sows. The aim of this study was to determine the circadian parameters for body temperature in post-weaning sows during oestrus period, throughout the seasons in a warm climate. Results Differences were observed in inter-daily stability, intra-daily fragmentation and cycle length comparing the summer sows with the other seasons. Differences were also observed in the period that the sows were in oestrus compared to the non-oestrus period for intra-daily fragmentation, with these differences being more important in the warm seasons compared to the cold seasons. The parameters normalised by COSINOR also showed significant differences when comparing seasons, especially in the acrophase of the temperature maximum. Another significant finding was an increase in vaginal temperature during oestrus in sows monitored in summer compared to the other seasons. Correlations between body, vaginal and environmental temperature were observed. Conclusion There is a seasonal influence on the circadian rhythm of temperature and summer is clearly the season with the greatest differences in circadian parameters when compared to the other seasons. The extreme summer conditions seem to definitely influence this rhythm and make the body and vaginal temperature of the sows different from the rest of the year. The increase in period robustness in both body and vaginal temperature during the days when sows are in oestrus could be related to the hormonal events of oestrus and ovulation and seems to be independent of weather since it occurs in all controlled seasons. However, this robustness is significantly higher in summer than in the other seasons both in the oestrus period and on days when sows are not in oestrus.

Background: The COVID-19 pandemic may have adversely affected the early diagnosis of skin cancer. Objective: To compare epidemiological, clinical and histopathological characteristics in patients undergoing cutaneous squamous cell carcinoma (SCC) surgery before and after the beginning of the pandemic. Material & methods: We conducted a cross-sectional study including two case series: (1) patients operated on for SCC in the year after the first state of alarm in Spain (15 March 2020), and (2) patients with SCC operated on in the previous year. Epidemiological, clinical and histopathological variables, tumour stage and risk grade were collected. Results: 248 patients were included (127 undergoing surgery before the pandemic and 121 after the pandemic). After the beginning of the pandemic, the percentage of high-risk SCC significantly increased from 35.3% to 46.2% (p = 0.011). However, no significant differences were found in thickness, perineural invasion or metastases. Conclusions: Although there has not been a significant reduction in the number of SCC operated on after the pandemic, there has been a significant increase in high-risk SCC. All this could lead to an increase in skin cancer mortality in the future. Resumen: Antecedentes: La pandemia de COVID-19 ha podido afectar negativamente el diagnóstico precoz del cáncer de piel. Objetivo: Comparar las características epidemiológicas, clínicas e histopatológicas en los pacientes intervenidos de carcinoma de células escamosas (CCE) cutáneo antes de la pandemia y después del inicio de la pandemia. Material y métodos: Se diseñó un estudio transversal que incluía 2 series de pacientes: 1) pacientes intervenidos de CCE el año posterior a la declaración del confinamiento general en España (15 de marzo de 2020), y 2) pacientes intervenidos de CCE el año previo. Se recogieron variables epidemiológicas, clínicas e histopatológicas, así como el estadio tumoral y el grado de riesgo. Resultados: Se incluyeron 248 pacientes (127 intervenidos antes de la pandemia y 121 intervenidos después de la pandemia). Tras el inicio de la pandemia, el porcentaje de CCE de alto riesgo aumentó significativamente de 32,3 a 45,5% (p = 0,011). No obstante, no se encontraron diferencias significativas en el grosor tumoral, la invasión perineural o la presencia de metástasis. Conclusiones: Aunque no se produjo una reducción significativa en el número de CCE intervenidos después de la pandemia, ha habido un incremento significativo en los CCE de alto riesgo. Todo ello puede conllevar un incremento en la mortalidad por cáncer de piel en el futuro.

Summary: Background: Paediatric acute bronchiolitis normally occurs from October to April in the temperate northern hemisphere, peaking in January. Nonpharmacological measures to control the spread of COVID-19 resulted in a decrease in the number of cases of bronchiolitis during the 2020–21 season. The discontinuation of these measures created an uncertain scenario. Aim: To describe the epidemiological evolution of acute bronchiolitis seasons and the changes in the demographics of the affected population before, during, and after the implementation of nonpharmacological interventions for COVID-19 in Spain. Methods: This was a multicentre and descriptive study. A total of 6,334 infants aged up to 12 months who were diagnosed with acute bronchiolitis were recruited from sixteen Spanish hospitals. We collected data from participants from September 1st, 2021, through August 31st, 2023, as part of the ECEALHBA research project. The study periods were before (P1), during (P2), and after (P3) the COVID-19 pandemic. Findings: In P2 and after the discontinuation of nonpharmacological interventions, an unexpected increase in the number of acute bronchiolitis cases was observed from June–August 2021, resulting in an out-of-season peak. A subsequent peak was observed in November 2021, earlier than expected for the 2021-22 season. In the 2022-23 season, admissions followed a historical trend, with a greater number of cases than in the two previous seasons. Statistically significant differences in the length of stay (p

Millennial-scale climate variations during the last glacial period, such as Dansgaard–Oeschger (DO) cycles and Heinrich events, have been extensively studied using ice core and marine proxy records. However, there is a limited understanding of the magnitude of these temperature fluctuations in continental regions, and questions remain about the seasonal signal of these climate events. This study presents a 60 000-year-long temperature reconstruction based on branched glycerol dialkyl glycerol tetraethers (brGDGTs) extracted from lake sediments from the Eifel Volcanic Field, Germany. brGDGTs are bacterial membrane-spanning lipids that are known to have a strong relationship with temperature, making them suitable for temperature reconstructions. We test several temperature calibration models on modern samples taken from soils and multiple maar lakes. We find a negative bias in brGDGT-based temperature estimates associated with water depth and anoxic conditions that can be corrected for by accounting for a brGDGT isomer that is only produced in anoxic conditions. The corrected temperature reconstruction correlates with proxy and climate model estimates of temperature spanning the same time period, validating the calibration approach we selected. However, millennial-scale variability is significantly dampened in the brGDGT record, and in contrast to other Northern Hemisphere climate records, during several Heinrich stadials, temperatures actually increase. We demonstrate that these apparent discrepancies can be explained by the unique seasonal response of the brGDGT paleothermometer to temperatures of months above freezing (TMAF). Our data support the view that warm-season temperatures in Europe varied minimally during the last glacial period and that abrupt millennial-scale events were defined by colder, longer winters. Our continuous high-resolution temperature reconstruction provides important information about the magnitude of seasonal climate variability during the last glacial period that can be used to test climate models and inform studies of paleoecological change.

Resumen: Antecedentes y objetivo: La calidad de vida profesional se define como el bienestar derivado del equilibrio entre las exigencias del ámbito laboral y los recursos para afrontarlas, el deterioro de la calidad de vida profesional puede contribuir en el síndrome de burnout o del profesional quemado. El objetivo de este estudio consiste en evaluar mediante cuestionario validado la calidad de vida profesional de los dermatólogos españoles. Material y métodos: Se diseñó un estudio transversal que incluyó dermatólogos españoles que respondieran a un formulario autoadministrado enviado a través de aplicaciones de mensajería online. El formulario incluyó datos sociodemográficos, 3 preguntas de respuestas abiertas y el Cuestionario de Calidad de Vida Profesional (CVP-35). Resultados: Se incluyó a 106 participantes en este estudio, siendo un 58% (62/106) mujeres. La edad media fue de 41 años (intervalo de confianza [IC] del 95%: 43,3-38,8). Las puntuaciones para el dominio «carga de trabajo» de CVP-35 fueron superiores en las mujeres (p = 0,02) y en los jefes de servicio (p = 0,005). La presión asistencial fue el tema tratado con más frecuencia como factor limitante de la calidad de vida laboral, y el principal cambio identificado tras la pandemia de COVID-19. Conclusiones: En nuestro estudio las mujeres refirieron una mayor carga de trabajo. El incremento de carga asistencial y de trabajo a distancia fueron los principales cambios por la pandemia de COVID-19. La presión asistencial es una gran limitante de la calidad de vida profesional de nuestros compañeros, reducirla mejoraría la satisfacción diaria y la calidad asistencial. Abstract: Background and objective: Quality of professional life (QPL) is defined as a sense of well-being derived from a balance between the challenges of work and the resources available to deal with them. Impaired QPL can contribute to burnout. The aim of this study was to evaluate QPL in Spanish dermatologists using a validated questionnaire. Material and methods: We designed a cross-sectional study in which Spanish dermatologists were invited to complete an online questionnaire sent out by messaging applications. The dermatologists were asked to provide sociodemographic information, answer 3 open questions, and complete the 35-item Spanish QPL questionnaire (Spanish abbreviation, CVP-35). Results: We analyzed the information submitted by 106 dermatologists (62 women, 58%) with a mean age of 41 years (95% CI, 43.3-38.8 years). Women and department heads scored significantly higher in the workload domain of the questionnaire (P = .02 and P = .005, respectively). A heavy caseload was mentioned as the main factor contributing to impaired QPL and the main change in the wake of the COVID-19 pandemic. Conclusions: Female dermatologists reported heavier workloads. Heavy caseloads and more remote work were the main changes identified after the COVID-19 pandemic. Heavy caseloads have a significant impact on the QPL of dermatologists in Spain. Reducing caseloads would improve general job satisfaction and quality of care provision.

Background: Dupilumab is a new targeted therapy for severe atopic dermatitis (AD) with limited real-world evidence. Objective: Explore our experience with dupilumab for AD in clinical practice at a tertiary care center. Material and method: Unicentric observational retrospective study including adult and pediatric patients with severe AD receiving dupilumab between December 2017 and December 2021. The Eczema Area and Severity Index (EASI) score, Pruritus Numerical Rating Scale (P-NRS) and Sleep disturbance Numerical Rating Scale (S-NRS) were recovered to assess severity and response. Results: Fifty-nine patients received dupilumab: 52, 48, 26 and 13 patients reached 6, 12, 24 and 36 months of treatment, respectively. The EASI-75 response rates were 94.2%, 95.8%, 92.3% and 100% at months 6, 12, 24 and 36. The EASI-90 response rates were 63.5%, 72.9%, 84.6% and 92.3% at months 6, 12, 24 and 36. The EASI

Introduction: The growth hormone (GH) has been reported as a crucial neuronal survival factor in the hippocampus against insults of diverse nature. Status epilepticus (SE) is a prolonged seizure that produces extensive neuronal cell death. The goal of this study was to evaluate the effect of intracerebroventricular administration of GH on seizure severity and SE-induced hippocampal neurodegeneration. Methodology: Adult male rats were implanted with a guide cannula in the left ventricle and different amounts of GH (70, 120 or 220 ng/3 μl) were microinjected for 5 days; artificial cerebrospinal fluid was used as the vehicle. Seizures were induced by the lithium–pilocarpine model (3 mEq/kg LiCl and 30 mg/kg pilocarpine hydrochloride) one day after the last GH administration. Neuronal injury was assessed by Fluoro-Jade B (F-JB) staining. Results: Rats injected with 120 ng of GH did not had SE after 30 mg/kg pilocarpine, they required a higher number of pilocarpine injections to develop SE than the rats pretreated with the vehicle, 70 ng or 220 ng GH. Prefrontal and parietal cortex EEG recordings confirmed that latency to generalized seizures and SE was also significantly higher in the 120 ng group when compared with all the experimental groups. FJ-B positive cells were detected in the hippocampus after SE in all rats, and no significant differences in the number of F-JB cells in the CA1 area and the hilus was observed between experimental groups. Conclusion: Our results indicate that, although GH has an anticonvulsive effect in the lithium–pilocarpine model of SE, it does not exert hippocampal neuroprotection after SE. Resumen: Introducción: La hormona de crecimiento (HC) es un factor que favorece la supervivencia neuronal en el hipocampo ante agresiones de diversa naturaleza. El status epilepticus (SE) es un tipo de crisis epiléptica de larga duración que produce muerte neuronal. El objetivo de este estudio fue evaluar el efecto de la administración intracerebroventricular de HC en la severidad de las convulsiones y la neurodegeneración hipocampal debida al SE. Metodología: A ratas macho adultas se les implantó una cánula guía en el ventrículo lateral izquierdo y se les microinyectaron diferentes cantidades de HC (70, 120 o 220 ng/3 μl) durante 5 días; como vehículo se inyectó líquido cefalorraquídeo artificial. Las convulsiones se generaron con el modelo de litio-pilocarpina (3 mEq/kg LiCl y 30 mg/kg clorhidrato pilocarpina) un día después de la última inyección de HC. La neurodegeneración se identificó con la tinción de Fluoro-Jade B (F-JB). Resultados: Las ratas a las que se les inyectaron 120 ng de HC requirieron 2 o 3 inyecciones de pilocarpina para desarrollar SE, en comparación con el resto de los grupos experimentales que requirieron solo una aplicación del convulsivante. Los registros EEG de la corteza prefrontal y parietal confirmaron que la latencia a las crisis generalizadas y al SE fue mayor en dicho grupo experimental. Todas las ratas con SE presentaron células positivas al FJ-B en el área CA1 e hilus del hipocampo, y no se identificaron diferencias entre los tratamientos. Conclusión: Nuestros resultados muestran que, aunque la HC tiene un efecto anticonvulsivante, una vez que se ha desarrollado el SE no promueve neuroprotección en el hipocampo.

El Teatro de Cartagena es un importante exponente de la arquitectura monumental de la Hispania romana. Para su construcción fueron utilizados diversos pétreos locales, entre ellos una arenisca conocida como Tabaire. Este artículo tiene como objetivo la caracterización física del Tabaire, así como la identificación de sus formas de deterioro y el estudio de su consolidación mediante nanopartículas de cal y de dióxido de silicio (silicato de etilo). Los análisis iniciales mediante técnicas de imagen como la Microscopía Óptica (OM), Microscopía Electrónica de Barrido (SEM) y Tomografía de Rayos X (CT) muestran que es una roca de elevada porosidad y escasa dureza. La eficacia de los tratamientos consolidantes se comprobó mediante métodos no destructivos, basados en la identificación de la dispersión y penetrabilidad en el sustrato (OM y SEM) y en la detección de la variación del color (CIEL*a*b*), o mínimamente destructivos, como el peeling test y la dureza Shore-D, para conocer su incidencia en las características del material.

This work introduces a novel scheme for driving light-emitting diodes (LEDs) with thermal compensation. The primary objective of the system is to address the issue of emitted light intensity drift caused by temperature variations, with a particular focus on the automotive industry. The developed technique proposes an alternative approach to the traditional thermal approach, which primarily focuses on heat dissipation. In contrast, the presented strategy utilizes a temperature-dependent element, such as a thermistor, to generate a reference current that increases with temperature. The generated current is then amplified by a commercial integrated driver and employed to bias the LEDs. Consequently, the reduction in the emitted light intensity resulting from an increase in the internal temperature of the LED is counterbalanced by an elevation in the bias current. The luminous flux model developed for the proposed system predicts the attainment of stable light intensity across a wide temperature range. The proposed strategy has been applied to three commercial LEDs commonly employed in automotive signal lighting to produce red, yellow, and white light. Experimental results confirm a significant reduction in the thermal dependence of the luminous flux, with reduction factor of temperature dependence ranging between 3.7 and 14.2 for the least and most temperature-sensitive LED models analyzed, respectively.

Resumen: Antecedentes: La pandemia de COVID-19 ha podido afectar negativamente el diagnóstico precoz del cáncer de piel. Objetivo: Comparar las características epidemiológicas, clínicas e histopatológicas en los pacientes intervenidos de carcinoma de células escamosas (CCE) cutáneo antes de la pandemia y después del inicio de la pandemia. Material y métodos: Se diseñó un estudio transversal que incluía 2 series de pacientes: 1) pacientes intervenidos de CCE el año posterior a la declaración del confinamiento general en España (15 de marzo de 2020), y 2) pacientes intervenidos de CCE el año previo. Se recogieron variables epidemiológicas, clínicas e histopatológicas, así como el estadio tumoral y el grado de riesgo. Resultados: Se incluyeron 248 pacientes (127 intervenidos antes de la pandemia y 121 intervenidos después de la pandemia). Tras el inicio de la pandemia, el porcentaje de CCE de alto riesgo aumentó significativamente de 32,3 a 45,5% (p = 0,011). No obstante, no se encontraron diferencias significativas en el grosor tumoral, la invasión perineural o la presencia de metástasis. Conclusiones: Aunque no se produjo una reducción significativa en el número de CCE intervenidos después de la pandemia, ha habido un incremento significativo en los CCE de alto riesgo. Todo ello puede conllevar un incremento en la mortalidad por cáncer de piel en el futuro. Abstract: Background: The COVID-19 pandemic may have adversely affected the early diagnosis of skin cancer. Objective: To compare epidemiological, clinical and histopathological characteristics in patients undergoing cutaneous squamous cell carcinoma (SCC) surgery before and after the beginning of the pandemic. Material & methods: We conducted a cross-sectional study including two case series: (1) patients operated on for SCC in the year after the first state of alarm in Spain (15 March 2020), and (2) patients with SCC operated on in the previous year. Epidemiological, clinical and histopathological variables, tumour stage and risk grade were collected. Results: 248 patients were included (127 undergoing surgery before the pandemic and 121 after the pandemic). After the beginning of the pandemic, the percentage of high-risk SCC significantly increased from 35.3% to 46.2% (p = 0.011). However, no significant differences were found in thickness, perineural invasion or metastases. Conclusions: Although there has not been a significant reduction in the number of SCC operated on after the pandemic, there has been a significant increase in high-risk SCC. All this could lead to an increase in skin cancer mortality in the future.

Introduction The treatment of patients with severe psychotic disorders presents significant clinical challenges, and the choice of appropriate therapy is essential to ensure long-term stability1. In this context, long-acting injectable antipsychotics (LAIs) have emerged as a promising therapeutic option. LAIs were developed to counteract poor treatment adherence in patients with psychotic disorders2. Paliperidone palmitate 3-monthly injectable (PP3M) is a novel formulation of intramuscular injectable paliperidone palmitate with a significantly longer half-life than the once-monthly formulation. PP3M has shown a longer time to relapse and good safety and tolerability in many studies3. Objectives The aim of this work was to describe the profile of patients initiating PP3M in an acute inpatient psychiatric unit. Methods A descriptive study was conducted on patients admitted to the acute psychiatric unit from January 2021 to December 2022. The sample included 23 inpatients who initiated PP3M during the admission. Data were collected regarding age, gender, diagnosis, substance abuse, previous antipsychotic treatment, antipsychotic treatment adherence and adverse effects during the admission. Results 23 patients sample, with an average age of 44.04 years-old, 16 male and 7 female, diagnosed with psychotic disorder (22) and schizoaffective disorder (1). Out of the 23 patients, 7 had active substance abuse upon admission. Out of the total simple, 9 of them were prescribed LAIs, with 6 on PP1M (Paliperidone palmitate 1-monthly injectable), 2 on PP3M, and 1 on aripiprazole long-acting injection. Twelve were prescribed oral antipsychotics, including 4 on paliperidone, 4 on risperidone, 1 on aripiprazole, 1 on olanzapine, and 2 on other oral antipsychotics. Two patients did not have a previous antipsychotic prescription. Among the 23 patients, 17 of them did not have previous antipsychotic treatment adherence. 5 out of the 23 patients experienced adverse effects, with 3 of them having extrapyramidal symptoms and 2 hyperprolactinemia.Upon discharge, 11 out of the 23 patients were prescribed antipsychotic monotherapy with PP3M. Conclusions In this sample, we observed that inpatients who initiated PP3M in an acute psychiatric unit were males, with psychotic disorders, lacked adherence to previous antipsychotic treatment. Most of them did not experience adverse effects with PP3M during admission. More research should be done to assess the use of PP3M in an acute inpatient psychiatric unit. REFERENCES 1. Morris MT, Tarpada SP. Psychopharmacol Bull. 2017 May 15;47(2):42-52. 2. Brasso, C., Bellino, S., Bozzatello, P., Montemagni, C., & Rocca, P. (2017). Neuropsychiatric Disease and Treatment, 3. Edinoff AN, Doppalapudi PK, Orellana C, Ochoa C, Patti S, Ghaffar Y, Cornett EM, Kaye AJ, Viswanath O, Urits I, Kaye AM, Kaye AD. Front Psychiatry. 2021. Disclosure of Interest None Declared

Introduction A clinical case is presented of an 18-year-old woman diagnosed with Dandy-Walker malformation, who is admitted to an Acute Inpatient Psychiatry Unit due to atypical psychotic symptoms, pseudology and aggressive behaviour. After several medication trials, there is a partial response observed with low doses of clozapine, consolidating the improvement afterwards, being referred to an open-door community mental health center because of poor family and social network. Objectives Review clinical information about Dandy-Walker malformation and the development of psychiatric disorders, specifically psychotic symptoms, pointing out the peculiarities regarding clinical presentation and treatment management. Methods Search in the medical database PUBMED, MEDSCAPE and UPTODATE. Keywords: “Dandy-Walker Syndrome”,” Psychotic Disorders”. Results The Dandy-Walker syndrome consists on a cystic dilatation of the fourth ventricle, an abnormally high tentorium and the agenesis of the cerebellar vermis. Cerebellar structures are involved in cognitive, emotional and behavioural processes. This syndrome is related to the development of psychotic and affective disorders, as well as obsessive-compulsive disorder. The clinical presentation is usually atypical, being characterised by an early onset, a family history of psychosis and a high prevalence of cognitive deficit and borderline intelligence. There are no specific drugs recommended for the treatment of these patients, which present a high rate of refractoriness to antipsychotic treatments, together with a greater sensitivity to its side effects. Depending on the clinical presentation it is advisable to focus on the most relevant symptoms to be treated and potential side effects in order to reduce polypharmacy. Image: Conclusions - The Dandy-Walker syndrome is related to a higher risk of psychiatric disorders - Clinical presentation is usually atypical and in early stages - There is a high rate of refractoriness and greater sensitivity to treatments - A specific pharmacological treatment is not recommended and it is recommended to avoid polypharmacy Disclosure of Interest None Declared

Introduction Hiccups are involuntary, spasmodic contractions of the diaphragm and intercostal muscles that cause inspiration and are interrupted by closure of the glottis. Most sources define the term “persistent hiccups” as lasting more than 2 days and “intractable” as lasting more than 1 month. Both are most likely associated with a pathologic process. “Intractable hiccups” should lead to investigation of organic pathology. If it does not improve, it can interfere with the patient’s ability to eat, socialize and sleep, leading to a significant worsening of quality of life. “Intractable hiccups” are more frequent in men (91%), over 50 years of age. Women suffer from psychogenic hiccups more frequently than men. Anxiety or stress can trigger hiccups. Multiple neurotransmitters are involved. Objectives We present a theoretical review on the topic. Methods A bibliographic review on the topic. Results In recent years, new trials and case series have been published, and regulatory agencies have issued new recommendations on the use of pharmacologic agents for this indication. The literature has described the efficacy of several pharmacologic agents in the empiric treatment of persistent and intractable hiccups. Most of these target dopaminergic and GABAergic receptors. Based on limited efficacy and safety data, Baclofen and Gabapentin can be considered as first-line treatment for intractable and persistent hiccups, as they suggest efficacy and are less likely to cause long-term side effects than standard neuroleptic agents. Dopamine blocking agents such as Metoclopramide, Chlorpromazine, and Haloperidol, could be used as second line. In one study, withdrawal of Benzodiazepines or addition of Pregabalin was found to help reduce hiccups. The patient we consulted came for persistent hiccups or singultus of 2 years of evolution. Organic pathology was ruled out. She related the onset of the symptoms to different stressors that had caused her anxiety. We administered Escitalopram and Gabapentin and indicated withdrawal of Bromazepam, which she started taking months ago. In follow-up appointments she reported a decrease in the intensity and frequency of the symptoms, with a notable improvement in her quality of life. Conclusions Considering all available evidence, a treatment algorithm with Baclofen is recommended as first-line therapy for persistent and intractable hiccups. Gabapentin may also be safe and effective in the long-term treatment of this condition, especially for patients with CNS disease. Metoclopramide is no longer recommended for long-term treatment of hiccups. Clinical experience also supports the use of Chlorpromazine and other neuroleptics for acute, but not long-term, treatment. Going forward, large multicenter studies will be needed to create an adequate evidence base for the treatment of persistent and intractable hiccups. Until then, guidelines will continue to be based on unreliable data and clinical experience. Disclosure of Interest None Declared

Introduction There is a broad consensus that risk taking is largely determined by risk perception. However, previous literature has shown numerous examples of situations associated with potential health risks where our decisions are not made in accordance with the level of perceived risk. Objectives The aim of the present research was to investigate the role of impulsivity in the explanation of the discordance observed between risk perception and risk-taking in health-related domains. Methods The sample consisted of 612 participants (Mage = 23.54, 73,2% women). All participants were assessed for levels impulsivity and levels of risk perception and risk-taking propensity in contexts related to health. Results Results revealed that higher levels of impulsivity were significantly related to a lower tendency to perceive and take risks in the health domain. Most important for our objectives, we observed that the relationship with impulsivity was significantly stronger for risk taking than for risk perception. Moreover, impulsivity significantly predicted risk taking propensity when controlling for risk perception. Conclusions These findings suggest that, in the health-related domains, impulsivity can differentially affect risk perception and risk taking, thus, offering a possible explanation for the inconsistencies observed in the previous literature. Disclosure of Interest None Declared

Introduction Given that child and adolescent mental health has been affected by several factors in recent years, such as the distance between home and specialized centers that provide psychological care to children, the lack of care resources, or the lockdown caused by the COVID-19 pandemic, online psychological treatments are becoming increasingly common among the child and adolescent population, although it is necessary to develop this type of treatment for children at psychosocial risk, since these have been developed mostly for the general population. To this aim, the Online Emotional Self-Regulation Improvement program (Mejora de la Auto-regulación para Menores, Online MAM@) was developed. Objectives To assess the acceptability of the Online Emotional Self-Regulation Improvement program, by the adolescent. Methods The intervention program was applied to a total of n = 32 children (n = 17 girls) between 11 and 15 years of age. The program consists of 7 target emotions to be worked on, and the acceptance, usability, usefulness, enjoyment of each module and barriers to use by the children were assessed with an adaptation of the Venkatesh and Davis scale. These measures were taken post-test, once the intervention module was completed. The program was applied online for five weeks by the children, and their regular therapists contacted them to provide them with weekly access codes and reminders in case they were not completing the modules. Results It was observed that the best rated module was the anger module, the most useful module was the sadness module, the module considered to have the highest usability was the fear module, and the most enjoyed module was the sadness module, although all the modules had very high scores above the average and no significant differences were found in the rating of the modules between sexes. As for the most common barriers to use among the children, problems were found with the completion of the intervention, since they often forgot to access the web, and these did not apply what they had learned outside the intervention program. Conclusions The Online Emotional Self-Regulation Improvement program is the first program developed in Spanish language for adolescents at psychosocial risk, and may represent a breakthrough to consolidate these programs in the national scene and bring the therapeutic possibilities for adolescents to the same level as in other parts of the world. Focusing on future versions of the program, it would be advisable to reduce its length and incorporate activities outside the treatment program to guarantee a generalization of what is learned in the intervention program in everyday life situations. Disclosure of Interest None Declared

Background and objective: Quality of professional life (QPL) is defined as a sense of well-being derived from a balance between the challenges of work and the resources available to deal with them. Impaired QPL can contribute to burnout. The aim of this study was to evaluate QPL in Spanish dermatologists using a validated questionnaire. Material and methods: We designed a cross-sectional study in which Spanish dermatologists were invited to complete an online questionnaire sent out by messaging applications. The dermatologists were asked to provide sociodemographic information, answer 3 open questions, and complete the 35-item Spanish QPL questionnaire (Spanish abbreviation, CVP-35). Results: We analyzed the information submitted by 106 dermatologists (62 women, 58%) with a mean age of 41 years (95% CI, 43.3-38.8 years). Women and department heads scored significantly higher in the workload domain of the questionnaire (P = .02 and P = .005, respectively). A heavy caseload was mentioned as the main factor contributing to impaired QPL and the main change in the wake of the COVID-19 pandemic. Conclusions: Female dermatologists reported heavier workloads. Heavy caseloads and more remote work were the main changes identified after the COVID-19 pandemic. Heavy caseloads have a significant impact on the QPL of dermatologists in Spain. Reducing caseloads would improve general job satisfaction and quality of care provision. Resumen: Antecedentes y objetivo: La calidad de vida profesional se define como el bienestar derivado del equilibrio entre las exigencias del ámbito laboral y los recursos para afrontarlas, el deterioro de la calidad de vida profesional puede contribuir en el síndrome de burnout o del profesional quemado. El objetivo de este estudio consiste en evaluar mediante cuestionario validado la calidad de vida profesional de los dermatólogos españoles. Material y métodos: Se diseñó un estudio transversal que incluyó dermatólogos españoles que respondieran a un formulario autoadministrado enviado a través de aplicaciones de mensajería online. El formulario incluyó datos sociodemográficos, 3 preguntas de respuestas abiertas y el Cuestionario de Calidad de Vida Profesional (CVP-35). Resultados: Se incluyó a 106 participantes en este estudio, siendo un 58% (62/106) mujeres. La edad media fue de 41 años (intervalo de confianza [IC] del 95%: 43,3-38,8). Las puntuaciones para el dominio «carga de trabajo» de CVP-35 fueron superiores en las mujeres (p = 0,02) y en los jefes de servicio (p = 0,005). La presión asistencial fue el tema tratado con más frecuencia como factor limitante de la calidad de vida laboral, y el principal cambio identificado tras la pandemia de COVID-19. Conclusiones: En nuestro estudio las mujeres refirieron una mayor carga de trabajo. El incremento de carga asistencial y de trabajo a distancia fueron los principales cambios por la pandemia de COVID-19. La presión asistencial es una gran limitante de la calidad de vida profesional de nuestros compañeros, reducirla mejoraría la satisfacción diaria y la calidad asistencial.

Introduction and aim: In recent years, probiotics have been used in functional gastrointestinal disorders, including chronic constipation (CC). The effect of Bifidobacterium infantis strain 35624 on the gut microbiota of CC patients has not been previously studied.Our aim was to analyze the fecal microbiota of constipated patients, before and after consuming a single-strain probiotic (B. infantis strain 35624). Materials and methods: We used 16S rRNA gene high-throughput sequencing to analyze the fecal microbiota of female patients (n = 13) with CC. Patients were instructed to ingest one capsule of Alflorex® (containing 1 × 109 CFUs/g B. infantis strain 35624) daily for eight weeks. Fecal samples were obtained at the baseline and end (final) of probiotic administration. Results: Alpha diversity metrics did not differ between the baseline and final periods. The butyrate producer, Oscillospira, was the taxon most strongly correlated with amplicon sequence variants (R2 = 0.55, p

Resumen: Introducción y objetivo: En los últimos años, los probióticos se han utilizado en trastornos gastrointestinales funcionales, incluido el estreñimiento crónico (EC). El efecto de la cepa 35624 de Bifidobacterium infantis sobre la microbiota intestinal de pacientes con EC no se ha estudiado previamente.Nuestro objetivo fue analizar la microbiota fecal de pacientes estreñidos antes y después de consumir un probiótico de una sola cepa (B. infantis cepa 35624). Material y métodos: Usamos secuenciación de alto rendimiento del gen 16S ARNr para analizar la microbiota fecal de pacientes mujeres (n = 13) con EC. Se indicó a los pacientes que consumieran una cápsula de Alflorex® (con 1 × 109 UFC/g de B. infantis 35624) al día durante 8 semanas. Se obtuvieron muestras fecales al inicio del estudio y al final de la administración de probióticos. Resultados: Las métricas de diversidad alfa no fueron diferentes entre la línea de base y la final. El productor de butirato Oscillospira fue el taxón más fuertemente correlacionado con las variantes de secuencia de amplicones (R2 = 0.55, p

Acute pancreatitis (AP) and recurrent acute pancreatitis (RAP) are conditions, whose incidence is apparently on the rise. Despite the ever-increasing evidence regarding the management of AP in children and adults, therapeutic actions that could potentially affect having a poor prognosis in those patients, especially in the pediatric population, continue to be carried out. Therefore, the Asociación Mexicana de Gastroenterología convened a group of 24 expert pediatric gastroenterologists from different institutions and areas of Mexico, as well as 2 pediatric nutritionists and 2 specialists in pediatric surgery, to discuss different aspects of the epidemiology, diagnosis, and treatment of AP and RAP in the pediatric population. The aim of this document is to present the consensus results. Different AP topics were addressed by 6 working groups, each of which reviewed the information and formulated statements considered pertinent for each module, on themes involving recommendations and points of debate, concerning diagnostic or therapeutic approaches. All the statements were presented and discussed. They were then evaluated through a Delphi process, with electronic and anonymous voting, to determine the level of agreement on the statements. A total of 29 statements were formulated, all of which reached above 75% agreement in the first round of voting. Resumen: La pancreatitis aguda (PA) y la pancreatitis aguda recurrente (PAR) son enfermedades cuya incidencia aparentemente va en incremento. A pesar de la creciente evidencia sobre el manejo de la PA en adultos y niños, aún se siguen teniendo conductas que potencialmente podrían impactar en un pronóstico no tan adecuado de estos pacientes, sobre todo en población pediátrica. Es por esto que la Asociación Mexicana de Gastroenterología convocó a un grupo de 24 gastroenterólogos pediatras expertos, de diferentes instituciones y de diferentes zonas geográficas de México, 2 nutriólogas pediatras, así como 2 especialistas en cirugía pediátrica para discutir sobre diferentes aspectos de la epidemiología, diagnóstico y tratamiento de la PA y PAR en población pediátrica. El objetivo de este documento es presentar los resultados obtenidos de este consenso. Se organizaron 6 mesas de trabajo con diferentes tópicos sobre la PA. Cada mesa de trabajo revisó la información y generó los enunciados/declaraciones que consideraron pertinentes para cada módulo, en tópicos que representaran recomendaciones o puntos de debate sobre cuestiones de abordaje diagnóstico o terapéutico. Se presentaron y discutieron todas las declaraciones. Posteriormente, se sometieron a evaluación mediante un proceso Delphi, de voto anónimo, vía electrónica, para conocer el nivel de acuerdo en los enunciados/declaraciones. Se elaboraron un total de 29 enunciados/declaraciones. Todas las declaraciones tuvieron un porcentaje de consenso mayor del 75% en la primera ronda de votación.

Resumen: La pancreatitis aguda (PA) y la pancreatitis aguda recurrente (PAR) son enfermedades cuya incidencia aparentemente va en incremento. A pesar de la creciente evidencia sobre el manejo de la PA en adultos y niños, aún se siguen teniendo conductas que potencialmente podrían impactar en un pronóstico no tan adecuado de estos pacientes, sobre todo en población pediátrica. Es por esto que la Asociación Mexicana de Gastroenterología convocó a un grupo de 24 gastroenterólogos pediatras expertos, de diferentes instituciones y de diferentes zonas geográficas de México, 2 nutriólogas pediatras, así como 2 especialistas en cirugía pediátrica para discutir sobre diferentes aspectos de la epidemiología, diagnóstico y tratamiento de la PA y PAR en población pediátrica. El objetivo de este documento es presentar los resultados obtenidos de este consenso. Se organizaron 6 mesas de trabajo con diferentes tópicos sobre la PA. Cada mesa de trabajo revisó la información y generó los enunciados/declaraciones que consideraron pertinentes para cada módulo, en tópicos que representaran recomendaciones o puntos de debate sobre cuestiones de abordaje diagnóstico o terapéutico. Se presentaron y discutieron todas las declaraciones. Posteriormente, se sometieron a evaluación mediante un proceso Delphi, de voto anónimo, vía electrónica, para conocer el nivel de acuerdo en los enunciados/declaraciones. Se elaboraron un total de 29 enunciados/declaraciones. Todas las declaraciones tuvieron un porcentaje de consenso mayor del 75% en la primera ronda de votación. Abstract: Acute pancreatitis (AP) and recurrent acute pancreatitis (RAP) are conditions, whose incidence is apparently on the rise. Despite the ever-increasing evidence regarding the management of AP in children and adults, therapeutic actions that could potentially affect having a poor prognosis in those patients, especially in the pediatric population, continue to be carried out. Therefore, the Asociación Mexicana de Gastroenterología convened a group of 24 expert pediatric gastroenterologists from different institutions and areas of Mexico, as well as 2 pediatric nutritionists and 2 specialists in pediatric surgery, to discuss different aspects of the epidemiology, diagnosis, and treatment of AP and RAP in the pediatric population. The aim of this document is to present the consensus results. Different AP topics were addressed by 6 working groups, each of which reviewed the information and formulated statements considered pertinent for each module, on themes involving recommendations and points of debate, concerning diagnostic or therapeutic approaches. All the statements were presented and discussed. They were then evaluated through a Delphi process, with electronic and anonymous voting, to determine the level of agreement on the statements. A total of 29 statements were formulated, all of which reached above 75% agreement in the first round of voting.

Resumen: Antecedentes: Dupilumab es una nueva terapia dirigida para la dermatitis atópica (DA) grave con una evidencia en la vida real aún limitada. Objetivo: Explorar nuestra experiencia con dupilumab para la DA en práctica clínica en un centro terciario. Material y método: Estudio observacional retrospectivo y unicéntrico que incluye pacientes adultos y pediátricos con DA grave en tratamiento con dupilumab entre diciembre de 2017 y diciembre de 2021. La gravedad y la respuesta se evaluaron con las escalas Eczema Area and Severity Index (EASI), Pruritus Numerical Rating Scale y Sleep Disturbance Numerical Rating Scale. Resultados: Cincuenta y nueve pacientes recibieron dupilumab: 52, 48, 26 y 13 pacientes alcanzaron los 6, 12, 24 y 36 meses de tratamiento, respectivamente. La tasa de EASI-75 fue del 94,2; 95,8; 92,3 y 100% a los 6, 12, 24 y 36 meses, respectivamente. La tasa de EASI-90 fue del 63,5; 72,9; 84,6 y 92,3% a los 6, 12, 24 y 36 meses, respectivamente. La tasa de EASI

Introduction: Advances in the treatment of myasthenia gravis (MG) have improved quality of life and prognosis for the majority of patients. However, 10%–20% of patients present refractory MG, with frequent relapses and significant functional limitations. Patients and methods: Patients with refractory MG were selected from a cohort of patients diagnosed with MG between January 2008 and June 2019. Refractory MG was defined as lack of response to treatment with prednisone and at least 2 immunosuppressants, inability to withdraw treatment without relapse in the last 12 months, or intolerance to treatment with severe adverse reactions. Results: We identified 84 patients with MG, 11 of whom (13%) met criteria for refractory MG. Mean (standard deviation) age was 47 (18) years; 64% of patients with refractory MG had early-onset generalised myasthenia (as compared to 22% in the group of patients with MG; P

Abstract Background To date, only twenty-one cases diagnosed postnatally with mosaic trisomy 12 have been reported. The most frequent phenotypic manifestations are developmental delay, dysmorphic facial features, congenital heart defects, digital alterations, and pigmentary disorders. In the present report, detailed clinical and genetic profiles of three unrelated new patients with mosaic trisomy 12 are described and compared with previously reported cases. Case presentation In the present report, we include the clinical, cytogenetic, and molecular description of three Mexican patients diagnosed postnatally with mosaic trisomy 12. At phenotypic level, the three patients present with developmental delay, dysmorphic facial features, congenital heart defects and skin pigmentary anomalies. Particularly, patient 1 showed unique eye alterations as bilateral distichiasis, triple rows of upper lashes, and digital abnormalities. In patient 2 redundant skin, severe hearing loss, and hypotonia were observed, and patient 3 presented with hypertelorism and telecanthus. Hyperpigmentation with disseminated pigmentary anomalies is a common trait in all of them. The cytogenetic study was carried out under the strict criteria of analysis, screening 50–100 metaphases from three different tissues, showing trisomy 12 mosaicism in at least one of the three different tissues analyzed. With SNParray, the presence of low-level mosaic copy number variants not previously detected by cytogenetics, and uniparental disomy of chromosome 12, was excluded. STR markers allowed to confirm the absence of uniparental disomy as well as to know the parental origin of supernumerary chromosome 12. Conclusions The detailed clinical, cytogenetic, and molecular description of these three new patients, contributes with relevant information to delineate more accurately a group of patients that show a heterogeneous phenotype, although sharing the same chromosomal alteration. The possibility of detecting mosaic trisomy 12 is directly associated with the sensitivity of the methodology applied to reveal the low-level chromosomal mosaicism, as well as with the possibility to perform the analysis in a suitable tissue.

Abstract There is no definition for the metabolic syndrome; visceral obesity, elevated lipids and glucose, and hypertension coexist. The aim of the study is to determine which anthropometric indicators best determine it. Cross-sectional study in 418,343 Spanish workers. Metabolic syndrome was determined using the NCEP-ATPIII, IDF and JIS criteria. The anthropometric variables studied were: body mass index, waist circumference, waist-to-height ratio, CUNBAE, Deuremberg formula, body fat index, body surface index, normalized weight adjusted index, body roundness index, body shape index, visceral adiposity index (VAI), dysfunctional adiposity index, conicity index, metabolic score for visceral fat (METS-VF), waist triglyceride index. In men, the anthropometric indices with the largest areas under the ROC curve are VAI with ATPIII criteria and JIS. If we use the IDF criteria: waist circumference and METS-VF, with the same result. In women, the largest areas under the curve were observed with the Deuremberg formula in both ATPIII and JIS while with the IDF criteria it is METS-VF. The most useful anthropometric indices for identifying metabolic syndrome are CUN-BAE and Deuremberg, followed by the VAI. A single definition of metabolic syndrome should be agreed to determine the best anthropometric index with predictive capacity for its diagnosis.

Abstract In this work we investigate the possibility of the formation of states from the dynamics involved in the $$D^*D^*D^*$$ D ∗ D ∗ D ∗ system by considering that two $$D^*$$ D ∗ ’s generate a $$J^P=1^+$$ J P = 1 + bound state, with isospin 0, which has been predicted in an earlier theoretical work. We solve the Faddeev equations for this system within the fixed center approximation and find the existence of $$J^P=0^-$$ J P = 0 - , $$1^-$$ 1 - and $$2^-$$ 2 - states with charm 3, isospin 1/2, masses $$\sim 6000$$ ∼ 6000 MeV, which are manifestly exotic hadrons, i.e., with a multiquark inner structure.

Environments or learning spaces in school classrooms contribute to the improvement of educational processes. Specifically, in the Early Childhood Education, teachers can design learning spaces, which fosters an environment of safety and autonomy for the students of the Early Childhood Education. This study explores the teachers' narratives concerning the meanings they assign to the school space, the criteria by which they design and transform it, and its connection to model of educational. We have collected 34 stories of pre-primary education teachers through a semi-structured interview in which they had to reflect on this pedagogical design. As most relevant result we identify a model sustained under constructivist or cognitive criteria, rather than a dialogical one. We conclude that this epistemological perspective of the construction of the school environment should be oriented towards a more participatory and co-constructed model of the educational space.

In this study we show the results of the eagle owls’ (Bubo bubo) helminthfauna found in Andalusia. A total number of 50 specimens have been analysed in a period of 10 years (from 2011 to 2020). Prevalence (P%), mean intensity (IM) and mean abundance (AM) of parasitation have been obtained. The percentage of parasitation in the total sample was 80% (40 out of 50 eagle owls): 78% nematodes, 8% trematodes, 6% cestodes and 4% acantocephalans. 7 species of helminths were identified: 6 nematodes, and 1 trematode. In the case of cestodes and acantocephalans it was not possible to determine species and only the genus was identified.The intestinal nematode Capillaria tenuissima (P% = 58% (44–71.2); IM = 11,52 (5.83–28.9)) was the core species whereas Synhimantus laticeps (P% = 16 (7.5–28.8); IM = 4 (1.75–7.25)) and Hartertia hispanica (P% = 16 (7.5–28.8); IM = 1,5 (1–2)) were the secondary species. The remainder species were considered satellite species, with low prevalence and average abundance. Likewise, descriptive parameters of the helminth community were determined: species richness, 1.56 (1.29–1.94), total abundance, 12 (7.24–26.40), Brillouin's diversity index, 0.18 (0.10–0.29) and Berger-Parker dominance index, 0.88 (0.81–0.93).The data from this study show a non-diverse helminthic community, without species dominance with C. tenuissima as the central species, followed by S. laticeps and H. hispanica as secondary species. Worth mentioning is the presence of H. hispanica, which is considered an endemic species in Spain and specifically in Andalusia.To the authors’ knowledge, this is the largest population sample taken in parasitological studies about helminths of this raptor in Europe and the first one carried out in the south of Spain (Andalusia).

Resumen: Introducción y objetivo: La rosácea es una dermatosis acneiforme crónica donde la disrupción de la barrera cutánea puede provocar una facilidad para la sensibilización a distintos alérgenos. Nuestro objetivo es analizar la sensibilización alérgica de contacto en los pacientes con rosácea de nuestro medio. Material y métodos: Se realizó estudio de cohortes retrospectivo analizando todos los pacientes parchados en la consulta de Alergia Cutánea de nuestro servicio entre mayo de 1991 hasta mayo de 2019. Resultados: Durante el tiempo de estudio han sido remitidos a nuestra consulta un total de 200 pacientes con rosácea, el 2,1% del total de pacientes parchados en este tiempo. El 81% de los pacientes eran mujeres, con una edad media de 44,7 años. El 46,5% presentaron al menos un parche positivo, considerándose de relevancia presente (RP) en el 15%. Los parches positivos más frecuentes fueron níquel (26%), seguido de cloruro de cobalto (6,5%), isotiazolinonas (6%), PPDA (5,5%), mezcla II de perfumes (5%) y thiomersal (3,5%). Los parches positivos de RP más frecuentes fueron isotiazolinonas en 10/200 pacientes (5%), PPDA, mezcla II de fragancias, toluensulfonamida formaldehído resina en 4/200 pacientes cada uno (2%), tixocortol y mezcla I de fragancias en 2/200 cada uno (1%). El grupo de sustancias más frecuentemente detectadas fueron los metales, con una RP en el 12,6%, seguido de los fármacos con una RP en el 25,8%. Los conservantes y las fragancias fueron los siguientes grupos de sustancias más frecuentemente positivas, con una RP en el 70,8% y el 43,7%, respectivamente. La fuente de sensibilización más frecuente fueron los cosméticos, seguidos de los fármacos tópicos, destacando los corticoides y los antifúngicos tópicos. Conclusiones: Destacamos una elevada prevalencia de dermatitis alérgica de contacto en pacientes con rosácea, lo que sustenta la realización de pruebas epicutáneas, especialmente en aquellos con empeoramiento de sus lesiones en relación con la aplicación de productos cosméticos o fármacos tópicos. Abstract: Background and objective: Rosacea is a chronic acneiform skin disorder in which impaired skin barrier function can lead to sensitization to allergens. We aimed to analyze contact allergies in our patients with rosacea. Material and methods: Retrospective cohort study of all patients who underwent patch testing in our skin allergy clinic between May 1991 and May 2019. Results: A total of 200 patients with rosacea were referred to our clinic for patch testing during the study period; they represented 2.1% of all patch tested patients in the period. Eighty-one percent were women (mean age, 44.7 years). At least 1 positive patch test was recorded for 46.5%; 15% were of current relevance. The most frequent positive reaction was to nickel (26%), followed by cobalt chloride (6.5%), isothiazolinones (6%), p-phenylenediamine (5.5%), fragrance mix II (5%), and thimerosal (3.5%). The most common currently relevant patch test reactions were to isothiazolinones in 10 of the 200 patients (5%); to phenylenediamine, fragrance mix II, and toluensulfonamide formaldehyde resin in 4 patients (2%) each; and to tixocortol and fragrance mix I in 2 patients (1%) each. The allergen groups most often implicated were metals (of current relevance in 12.6%) and drugs (of current relevance in 25.8%). Preservatives and fragrances were the next most common allergen groups, and 70.8% and 43.7% of the positive reactions in these groups, respectively, were of current relevance. Cosmetics were the most frequent source of sensitization, followed by topical medications — notably corticosteroids and antifungal agents. Conclusions: We emphasize the high prevalence of allergic contact dermatitis in patients with rosacea, a finding which supports patch testing, especially if eruptions worsen when these patients use cosmetics and topical medications.

Introduction and aims: Esophageal perforation is an uncommon event that is a medical/surgical emergency, with a 15-30% mortality rate. The aim of the present study was to communicate our experience in the management of esophageal perforation, evaluating the different strategies utilized, in an effort to establish measures to guide decision-making in selecting treatment. Materials and methods: A retrospective descriptive study was conducted on patients diagnosed with esophageal perforation at our hospital center, within the time frame of 2000 and 2019. Results: Over the past 19 years, 15 patients were diagnosed with esophageal perforation. Surgical treatment was carried out in 80% of the cases. Primary closure, reinforced with plasty, was performed in 67% of the patients, of whom 62.5% had early diagnosis and a 100% survival rate. Diagnosis was late in 37.5% of the cases, with a 33.3% survival rate. Esophagectomy and gastric pull-up were performed on 25% of the patients, 66.6% of whom had early diagnosis and a 100% survival rate. In the 33.3% that had late diagnosis, the mortality rate was 100%. Esophagectomy, with cervical esophagostomy and feeding jejunostomy, was performed on one of the patients (8.3%) that had early diagnosis and a 100% survival rate. Conclusions: The main survival predictor in esophageal perforation is the interval of time between the injury and its diagnosis, and in turn, the resulting treatment. Each patient with esophageal perforation should have individualized treatment to adequately manage the condition. Resumen: Introducción y objetivo: La perforación de esófago es una patología poco frecuente, siendo una urgencia médico-quirúrgica con una mortalidad del 15-30%. El objetivo del estudio es comunicar nuestra experiencia en el manejo de la perforación esofágica, evaluando las distintas estrategias usadas, y tratar de establecer unas pautas para orientar en la toma de decisiones en el tratamiento a seguir. Material y métodos: Estudio descriptivo retrospectivo de pacientes diagnosticados con perforación de esófago en nuestro centro desde el año 2000 hasta el 2019. Resultados: En los últimos 19 años, 15 pacientes fueron diagnosticados con perforación de esófago. Se realizó tratamiento quirúrgico en el 80% de los casos. Se realizó sutura primaria reforzada con plastia en el 67% de los pacientes, y de ellos fueron diagnosticados de manera precoz el 62.5% con una supervivencia del 100%. El 37.5% fueron diagnosticados tardíamente con una supervivencia del 33.3%. Se realizó esofaguectomía y ascenso gástricos en el 25% de los pacientes, de ellos se diagnosticaron de manera precoz el 66.6% con una supervivencia del 100%. El 33.3% fueron diagnosticados tardíamente con una mortalidad del 100%. En uno de los pacientes (8.3%) se realizó esofaguectomía con esofagostoma cervical y yeyunostomía de alimentación, siendo diagnosticado de manera precoz con una supervivencia del 100%. Conclusiones: El principal predictor de supervivencia en la perforación de esófago es el intervalo de tiempo entre la lesión y el diagnóstico, y por tanto del tratamiento. El tratamiento de la perforación esofágica debe individualizarse en cada paciente, para poder realizar un adecuado manejo de esta patología.

Resumen: Introducción y objetivo: La perforación de esófago es una patología poco frecuente, siendo una urgencia médico-quirúrgica con una mortalidad del 15-30%. El objetivo del estudio es comunicar nuestra experiencia en el manejo de la perforación esofágica, evaluando las distintas estrategias usadas, y tratar de establecer unas pautas para orientar en la toma de decisiones en el tratamiento a seguir. Material y métodos: Estudio descriptivo retrospectivo de pacientes diagnosticados con perforación de esófago en nuestro centro desde el año 2000 hasta el 2019. Resultados: En los últimos 19 años, 15 pacientes fueron diagnosticados con perforación de esófago. Se realizó tratamiento quirúrgico en el 80% de los casos. Se realizó sutura primaria reforzada con plastia en el 67% de los pacientes, y de ellos fueron diagnosticados de manera precoz el 62.5% con una supervivencia del 100%. El 37.5% fueron diagnosticados tardíamente con una supervivencia del 33.3%. Se realizó esofaguectomía y ascenso gástricos en el 25% de los pacientes, de ellos se diagnosticaron de manera precoz el 66.6% con una supervivencia del 100%. El 33.3% fueron diagnosticados tardíamente con una mortalidad del 100%. En uno de los pacientes (8.3%) se realizó esofaguectomía con esofagostoma cervical y yeyunostomía de alimentación, siendo diagnosticado de manera precoz con una supervivencia del 100%. Conclusiones: El principal predictor de supervivencia en la perforación de esófago es el intervalo de tiempo entre la lesión y el diagnóstico, y por tanto del tratamiento. El tratamiento de la perforación esofágica debe individualizarse en cada paciente, para poder realizar un adecuado manejo de esta patología. Abstract: Introduction and aim: Esophageal perforation is an uncommon event that is a medical/surgical emergency, with a 15-30% mortality rate. The aim of the present study was to communicate our experience in the management of esophageal perforation, evaluating the different strategies utilized, in an effort to establish measures to guide decision-making in selecting treatment. Materials and methods: A retrospective descriptive study was conducted on patients diagnosed with esophageal perforation at our hospital center, within the time frame of 2000 and 2019. Results: Over the past 19 years, 15 patients were diagnosed with esophageal perforation. Surgical treatment was carried out in 80% of the cases. Primary closure, reinforced with plasty, was performed in 67% of the patients, of whom 62.5% had early diagnosis and a 100% survival rate. Diagnosis was late in 37.5% of the cases, with a 33.3% survival rate. Esophagectomy and gastric pull-up were performed on 25% of the patients, 66.6% of whom had early diagnosis and a 100% survival rate. In the 33.3% that had late diagnosis, the mortality rate was 100%. Esophagectomy, with cervical esophagostomy and feeding jejunostomy, was performed on one of the patients (8.3%) that had early diagnosis and a 100% survival rate. Conclusions: The main survival predictor in esophageal perforation is the interval of time between the injury and its diagnosis, and in turn, the resulting treatment. Each patient with esophageal perforation should have individualized treatment to adequately manage the condition.

Wetlands play a key role in hydrological and biogeochemical cycles and provide multiple ecosystem services to society. However, reliable data on the extent of global inundated areas and the magnitude of their contribution to local hydrological dynamics remain surprisingly uncertain. Global hydrological models and land surface models (LSMs) include only the most major inundation sources and mechanisms; therefore, quantifying the uncertainties in available data sources remains a challenge. We address these problems by taking a leading global data product on inundation extents (Global Inundation Extent from Multi-Satellites, GIEMS) and matching against predictions from a global hydrodynamic model (Catchment-based Macro-scale Floodplain – CaMa-Flood) driven by runoff data generated by a land surface model (Joint UK Land and Environment Simulator, JULES). The ability of the model to reproduce patterns and dynamics shown by the observational product is assessed in a number of case studies across the tropics, which show that it performs well in large wetland regions, with a good match between corresponding seasonal cycles. At a finer spatial scale, we found that water inputs (e.g. groundwater inflow to wetland) became underestimated in comparison to water outputs (e.g. infiltration and evaporation from wetland) in some wetlands (e.g. Sudd, Tonlé Sap), and the opposite occurred in others (e.g. Okavango) in our model predictions. We also found evidence for an underestimation of low levels of inundation in our satellite-based inundation data (approx. 10 % of total inundation may not be recorded). Additionally, some wetlands display a clear spatial displacement between observed and simulated inundation as a result of overestimation or underestimation of overbank flooding upstream. This study provides timely information on inherent biases in inundation prediction and observation that can contribute to our current ability to make critical predictions of inundation events at both regional and global levels.