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The melanocortin 1 receptor (MC1R) gene is considered to be a major determinant of the risk of melanoma. The role of MC1R polymorphisms as predisposing factors for the development of a second primary melanoma is not well established. The present study analyses the characteristics from subjects with certain MC1R variants without any other genetic predisposition, as well as the risk of second primary melanoma associated with these variants. We performed a prospective longitudinal single-center study based on follow-up information of 402 patients diagnosed with cutaneous melanoma. MC1R gene was sequenced in all subjects. High-risk variants were defined as those previously associated with melanoma (V60L, V92M, I155T, R160W, R163Q and D294H). 253 (63 %) patients had at least one predisposing variant. These individuals had higher proportion of red/blonde hair, multiple primary melanomas and first melanoma diagnosis under the age of 60. Second primary melanomas were detected in 28 (3.8 %) subjects. Having more than 25 melanocytic nevi was associated significantly to the development of second primary melanomas. A higher proportion of individuals carrying at least one predisposing MC1R variant develop a second melanoma, although statistical significance was not reached. Therefore, some MC1R polymorphisms might determine clinical and histological differences between patients with cutaneous melanoma and may represent a risk factor for second primary melanoma, although more studies are needed.

Supplementary Table S1. List of primary antibodies and primer sequences.

Supplementary Figure S2. TAM CD14+/CD163+ are the major source of CCL20 in human melanoma.

The chemokine axis CCR6/CCL20 is involved in cancer progression in a variety of tumors. Here, we show that CCR6 is expressed by melanoma cells. The CCR6 ligand, CCL20, induces migration and proliferation in vitro, and enhances tumor growth and metastasis in vivo. Confocal analysis of melanoma tissues showed that CCR6 is expressed by tumor cells, whereas CCL20 is preferentially expressed by nontumoral cells in the stroma of certain tumors. Stromal CCL20, but not tumoral CCR6, predicted poor survival in a cohort of 40 primary melanoma patients. Tumor-associated macrophages (TAM), independently of their M1/M2 polarization profile, were identified as the main source of CCL20 in primary melanomas that developed metastasis. In addition to CCL20, TAMs expressed TNF and VEGF-A protumoral cytokines, suggesting that melanoma progression is supported by macrophages with a differential activation state. Our data highlight the synergistic interaction between melanoma tumor cells and prometastatic macrophages through a CCR6/CCL20 paracrine loop. Stromal levels of CCL20 in primary melanomas may be a clinically useful marker for assessing patient risk, making treatment decisions, and planning or analyzing clinical trials. Cancer Immunol Res; 6(3); 267–75. ©2018 AACR.

Background The "rainbow pattern" was initially described as a highly specific dermoscopic feature of Kaposi's sarcoma. Since then, it has been reported in many benign and malignant cutaneous tumors, including few melanomas. Aim To determine the frequency and presentation of this dermoscopic pattern in primary cutaneous melanomas in comparison to other cutaneous tumors. Methods The presence of "rainbow pattern" was evaluated in a sample of 1100 dermoscopic images of different melanocytic and non-melanocytic cutaneous neoplasms. Results Rainbow pattern was observed in 23/245 (9.4%) melanomas and 44/855 (5.1%) non-melanoma neoplasms. Melanomas presenting this feature were thicker than 1 mm (82.6%) and 2 mm (43.0%). Compared to non-melanomas, rainbow pattern was more commonly focal (82.7% vs 36.4%, p=0.001) and associated with more than two dermoscopic structures associated to melanoma (100% vs 9%, p=0.001) CONCLUSION: The "rainbow pattern" is a dermoscopic sign that can occasionally be observed in invasive melanomas. In melanomas, this feature is usually associated to other dermoscopic criteria of melanoma and located in a focal and eccentric area, as opposed to a diffuse and isolated presentation in non-melanoma neoplasms.

Large defects in plantar surface secondary to acral melanoma excision can be difficult to repair with local flaps, and skin grafts in weight-bearing surfaces often suffer necrosis causing prolonged disability. Acellular dermal matrices represent an easy alternative to cover deep wounds or those with bone or tendon exposure. Despite their high cost and the requirement of two surgical procedures, this alternative may offer excellent functional and aesthetic results in acral defects.

We study distinguished objects in the category $\mathcal{BL}$ of Banach lattices and lattice homomorphisms. The free Banach lattice construction introduced by de Pagter and Wickstead generates push-outs, and combining this with an old result of Kellerer on marginal measures, the amalgamation property of Banach lattices is established. This will be the key tool to prove that $L_1([0,1]^{\mathfrak{c}})$ is separably $\mathcal{BL}$-injective, as well as to give more abstract examples of Banach lattices of universal disposition for separable sublattices. Finally, an analysis of the ideals on $C(\Delta,L_1)$, which is a separably universal Banach lattice as shown by Leung, Li, Oikhberg and Tursi, allows us to conclude that separably $\mathcal{BL}$-injective Banach lattices are necessarily non-separable., Comment: third version, the main change is a proof that $L_1([0,1]^\kappa)$ is 1-separably $\mathcal{BL}$-injective for arbitrary uncountable $\kappa$, not only for $\kappa\geq \mathfrak{c}$

We study the class of compact spaces that appear as structure spaces of separable Banach lattices. In other words, we analyze what C(K) spaces appear as principal ideals of separable Banach lattices. Among other things, it is shown that every such compactum K admits a strictly positive regular Borel measure of countable type that is analytic, and in the nonmetrizable case these compacta are saturated with copies of βN. Some natural questions about this class are left open., Research partially supported by Fundación Séneca-ACyT Región de Murcia grant 20797/PI/18 and Agencia Estatal de Investigación and EDRF/FEDER “A way of making Europe” (MCIN/AEI/10.13039/501100011033) through grants MTM2017-86182-P and PID2021-122126NB-C32 (Avilés, Martínez-Cervantes and Rueda Zoca), PGC2018-093794-B-I00 (Rueda Zoca), PID2020-116398GB-I00 and CEX2019-000904-S (Tradacete). The research of A. Rueda Zoca was also supported by Junta de Andalucía Grants A-FQM-484-UGR18 and FQM-0185.

We prove that a Banach space of continuous functions C ( K ) C(K) has a renorming that is uniformly rotund in every direction (URED) if and only if the compact space K K supports a strictly positive measure.

Light, or visible radiation, serves as a source of energy for photosynthesis of plants and most algae. In addition, light and ultraviolet radiation (UV-A and UV-B) act as a biological signal, triggering several cellular processes that are mediated by photoreceptors. The aim of this study was to evaluate the physiological and biochemical responses of Osmundea pinnatifida driven by different radiations through putative photoreceptors. For this, O. pinnatifida was grown under different radiation treatments composed by high intensity of light emitted by a low pressure sodium lamp (SOX), aiming to saturate photosynthesis, which was supplemented by low intensities of visible (red, green and blue) and ultraviolet radiation (UV-A and UV-B), in order to activate photoreceptors. Growth rates, photosynthesis, antioxidant activity, polyphenols, soluble proteins, phycobiliproteins, mycosporine-like amino acids (MAAs) and carotenoids were evaluated during the experiment. Complementary UV-A radiation positively influenced growth rates after 15 days of experiment, although the presence of a peak of blue light in this treatment can also have contributed. UV-B radiation increased the concentration of zeaxanthin and chlorophyll a. The blue light caused the accumulation of chlorophyll a, violaxanthin, phycoerythrin and polyphenols on different days of the experiment. Phycoerythrin also increased under green and red light conditions. Our results showed that some compounds can be modulated by different radiation, and the involvement of photoreceptors is suggested. In red algae, photoreceptors sensitive to red, green and blue light have been identified, however little is known about UV photoreceptors. The presence of photoreceptors sensitive to UV radiation in O. pinnatifida is discussed.

Short-term N-NH4+ and N-NO3- removal by U. pseudorotundata under different initial nutrient concentrations and biomass stocking densities, monitoring in parallel photosynthetic parameters obtained by Pulse-Amplitude-Modulation (PAM) Fluorometry of chlorophyll-a and evaluating biomass characteristics (CHN, proteins, carbohydrates) was investigated. The results showed that U. pseudorotundata cultivated under solar radiation in a land-based out-door pilot scale was efficient in removing N-NH4+ and N-NO3- even in concentrations as high as 500 µmol L⁻¹ ensuring complete water remediation in a period of 24 h and in all experimental conditions tested, although differences were observed depending on the stocking density and type of N-source. Treatments with N-NH4+ showed faster N removal than those with N-NO3-, however, treatments with N-NO3- demanded more photosynthetic energy. Part of the ammonium removed in the respective treatments may have been volatilized as a combined effect of the pH increase related to photosynthesis and aeration in the tanks. The results presented here establish the fundamental parameters for the use of U. pseudorotundata as a biofiltering organism for effluents with high concentrations of N-NH4+ and N-NO3-.

El artículo presenta un análisis de las principales conceptualizaciones y tendencias en torno a las estrategias de comunicación institucional y la diferencia conceptual con el término comunicación estratégica. Establece la definición y alcance de los planes, campañas y programas de comunicación, y sus interrelaciones. Muestra diferentes posturas respecto a la definición del término y las maneras de elaborar esta herramienta de comunicación, así como la importancia de la misma por su impacto en la gestión empresarial, la cultura organizacional y la identidad e imagen.

Con el propósito de evaluar el efecto de los usos de suelo; sistema de coberturas de suelo (SCS), agroforestal (SAF), tradicional (Tr) y bosque secundario (Bs) sobre la erosión hídrica y la restauración de las propiedades hidrofísicas; infiltración del agua en el suelo, contenidos de arcilla, materia orgánica, y porcentaje de humedad a capacidad de campo. Fue establecido un ensayo experimental de parcelas divididas en tres fincas localizadas la unidad hidrográfica Quebrada Arriba, Yalagüina-Madriz, Nicaragua. Los sistemas que presentan mayor cobertura superficial presentaron, menor tasa de erosión de 41.75 ton ha-1 en los SAF versus 123.08 ton ha-1 en los sistemas tradicionales. Y mayores contenidos de materia orgánica de 10% en el sistema ASA a 2.98 % en el tradicional. A nivel espacial los tratamientos que se ubicaron en la parte baja del relieve, presentaron mayores porcentajes de humedad retenida y materia orgánica (MOS) en comparación a los tratamientos ubicados en la parte alta. Finalmente, los altos contenidos de arcilla contribuyen al incremento de la capacidad de retener agua en el suelo de la microcuenca. Por tanto, es necesario promover tecnologías que brinden al suelo mayor cobertura para mejorar su calidad y reducir la tasa erosión hídrica.

Resumen Introduccion La esclerodermia engloba un conjunto de enfermedades que provocan fibrosis de la piel y en el tejido subcutaneo. Se distinguen dos subtipos: esclerodermia sistemica (ES), con afectacion visceral asociada, y esclerodermia localizada o morfea, limitada a la piel y a los tejidos subyacentes. Existen pocos estudios que evaluen las caracteristicas de estos pacientes. El objetivo de nuestro estudio fue analizar las caracteristicas clinicas y epidemiologicas de los pacientes con esclerodermia. Metodologia Se analizaron los datos de los pacientes con diagnostico de esclerodermia en seguimiento en la consulta monografica de colagenosis de un hospital de tercer nivel. Resultados Se analizaron un total de 100 pacientes con diagnostico de esclerodermia (80 con morfea y 20 con ES). La mediana de edad al diagnostico fue de 45 anos, con predominio femenino. Los pacientes fueron clasificados segun el subtipo de esclerodermia. Se analizo ademas la asociacion a otras enfermedades autoinmunes (presente en el 28%) y a liquen escleroatrofico (5%). Propusimos otra clasificacion para los pacientes con morfea segun la distribucion de las lesiones: morfea isomorfica (lesiones en zonas de roce) y no isomorfica (en otras localizaciones). Los pacientes con morfea isomorfica presentaron mayor tasa de sobrepeso, obesidad y sindrome metabolico. Los pacientes con morfea no isomorfica requirieron con mayor frecuencia tratamiento sistemico. Conclusiones Recomendamos subclasificar a los pacientes segun la distribucion de las lesiones, ya que los pacientes con morfea isomorfica y no isomorfica parecen presentar diferentes caracteristicas.

In this article we deal with the free Banach lattice F B L ⟨ L ⟩ FBL\langle \mathbb {L} \rangle generated by a lattice L \mathbb {L} . We prove that if F B L ⟨ L ⟩ FBL\langle \mathbb {L} \rangle is projective then L \mathbb {L} has a maximum and a minimum. On the other hand, we show that if L \mathbb {L} has maximum and minimum then F B L ⟨ L ⟩ FBL\langle \mathbb {L} \rangle is 2 2 -lattice isomorphic to a C ( K ) C(K) -space. As a consequence, F B L ⟨ L ⟩ FBL\langle \mathbb {L} \rangle is projective if and only if it is lattice isomorphic to a C ( K ) C(K) -space with K K being an absolute neighborhood retract. As an application, we characterize those linearly ordered sets and Boolean algebras for which the corresponding free Banach lattice is projective.

It follows from a theorem of Rosenthal that a compact space is ccc if and only if its every Eberlein continuous image is metrizable. Motivated by this result, for a class of compact spaces $${\mathcal {C}}$$ C we define its orthogonal $${\mathcal {C}}^\perp $$ C ⊥ as the class of all compact spaces for which every continuous image in $${\mathcal {C}}$$ C is metrizable. We study how this operation relates classes where centeredness is scarce with classes where it is abundant (like Eberlein and ccc compacta), and also classes where independence is scarce (most notably weakly Radon-Nikodým compacta) with classes where it is abundant. We study these problems for zero-dimensional compact spaces with the aid of Boolean algebras, and show the main difficulties that arise when we deal with general settings. Our main results are the constructions of several relevant examples.

Given two Banach spaces X and Y , we analyze when the projective tensor product X⊗πY has Corson’s property (C) or is weakly Lindelöf determined (WLD), subspace of a weakly compactly generated (WCG) space or subspace of a Hilbert generated space. For instance, we show that: (i) X⊗πY is WLD if and only if both X and Y are WLD and all operators from X to Y ∗ and from Y to X∗ have separable range; (ii) X ⊗πY is subspace of a WCG space if the same holds for both X and Y under the assumption that every operator from X to Y ∗ is compact; (iii) p(Γ)⊗πq(Γ) is subspace of a Hilbert generated space for any 1 < p,q < ∞ such that 1/p + 1/q < 1 and for any infinite set Γ. We also pay attention to the injective tensor product X⊗εY . In this case, the stability of property (C) and the property of being WLD turn out to be closely related to the condition that all regular Borel probability measures on the dual ball have countable Maharam type. Along this way, we generalize a result of Plebanek and Sobota that if K is a compact space such that C(K × K) has property (C), then all regular Borel probability measures on K have countable Maharam type. This generalization provides a consistent negative answer to a question of Ruess and Werner about the preservation of the w∗-angelicity of the dual unit ball under injective tensor products. The research is partially supported by grants MTM2017-86182-P (funded by MCIN/AEI/10.13039/501100011033 and “ERDF A way of making Europe”) and 20797/PI/18 (funded by Fundación Séneca - ACyT Región de Murcia). A. Rueda Zoca was also partially supported by: grant PGC2018-093794-B-I00 (funded by MCIN/AEI/10.13039/501100011033 and “ERDF A way of making Europe”), grant FJC2019-039973 (funded by MCIN/AEI/10.13039/501100011033) and grants A-FQM-484-UGR18 and FQM-0185 (funded by Junta de Andalucía).

In this article we deal with the free Banach lattice generated by a lattice and its behavior with respect to subspaces. In general, any lattice embedding i:L⟶M between two lattices L⊆M induces a Banach lattice homomorphism ı^:FBL⟨L⟩⟶FBL⟨M⟩ between the corresponding free Banach lattices. We show that this mapping ı^ might not be an isometric embedding neither an isomorphic embedding. In order to provide sufficient conditions for ı^ to be an isometric embedding we define the notion of locally complemented lattices and prove that, if L is locally complemented in M, then ı^ yields an isometric lattice embedding from FBL⟨L⟩ into FBL⟨M⟩. We provide a wide number of examples of locally complemented sublattices and, as an application, we obtain that every free Banach lattice generated by a lattice is lattice isomorphic to an AM-space or, equivalently, to a sublattice of a C(K)-space. Furthermore, we prove that ı^ is an isomorphic embedding if and only if it is injective, which in turn is equivalent to the fact that every lattice homomorphism x∗:L⟶[−1,1] extends to a lattice homomorphism x^∗:M⟶[−1,1]. Using this characterization we provide an example of lattices L⊆M for which ı^ is an isomorphic not isometric embedding. Research partially supported by Fundación Séneca [20797/PI/18] and by project MTM2017-86182-P (Government of Spain, AEI/FEDER, EU). The research of G. Martínez-Cervantes was co-financed by the European Social Fund and the Youth European Initiative under Fundación Séneca [21319/PDGI/19]. J. D. Rodríguez Abellán was also supported by project 20262/FPI/17, Fundación Séneca, Región de Murcia (Spain). The research of A. Rueda Zoca was also supported by Juan de la Cierva-Formación fellowship FJC2019-039973, by MICINN (Spain) Grant PGC2018-093794-B-I00 (MCIU, AEI, FEDER, UE), by Junta de Andalucía Grant A-FQM-484-UGR18 and by Junta de Andalucía Grant FQM-0185.

Background: Haemosiderotic and aneurysmal dermatofibromas are uncommon and frequently misdiagnosed lesions, which can be considered as different histopathological stages of the same tumour. A dermoscopic diagnosis testing accuracy has not been performed for these tumours to date. Objectives: To determine the diagnostic significance of dermoscopic structures and patterns associated with haemosiderotic/ aneurysmal dermatofibromas in a large series. Methods: Dermoscopic images of histopathologically proven cases of 110 haemosiderotic/ aneurysmal dermatofibromas and 501 other tumours were collected. The frequency, sensitivity, specificity, positive predictive value and negative predictive value of the dermoscopic structures and patterns associated with these lesions were calculated. Results: Haemosiderotic/ aneurysmal dermatofibromas are mostly symmetric lesions (86.5%), and a prominent homogeneous area was present in 100% of them. The presence of vascular structures was very common (86.4%), and dotted vessels were predominant (58.2%). Shiny white structures were seen in 85.5% of lesions, while a peripheral delicate pigment network was present in 69.1%. The most significant pattern was the one composed of a prominent homogeneous area and peripheral delicate pigment network, which showed a specificity of 100% with a relatively good sensitivity (69.1%). All the patterns containing a peripheral delicate pigment network showed very good specificities, positive predictive values and negative predictive values. Those patterns without a peripheral delicate pigment network showed the highest sensitivities, but they showed a significant overlap with other tumours, mainly with melanoma. Conclusions: Dermoscopy is helpful in improving the diagnostic accuracy of haemosiderotic/ aneurysmal dermatofibromas. However, there is a considerable dermoscopic overlap between these tumours and melanoma, specifically when the peripheral delicate pigment network is absent. © 2022 European Academy of Dermatology and Venereology.

Paraclinoid aneurysms take importance due to the technical difficulty due to anatomical relationships, which is why different approaches have been sought for their proper management. This is a female patient with a finding of a paraclinoid aneurysm and treatment using an endonasal approach with adequate angiographic support. Knowledge of the anatomy and surgical skill are required for the management of these lesions, assisted by angiographic controls for successful treatment. The endoscopic endonasal approach is adequate if the anatomy allows it and the basic hospital infrastructure is available to obtain high success rates.Los aneurismas paraclinoideos cobran importancia debido a la dificultad técnica por sus relaciones anatómicas, por lo que se han buscado diferentes abordajes para su adecuado manejo. Se presenta el caso de una paciente con un aneurisma paraclinoideo y tratamiento mediante abordaje endonasal con apoyo angiográfico adecuado. Se requieren conocimientos de la anatomía y habilidad quirúrgica para el manejo de estas lesiones, así como asistencia de controles angiográficos para el éxito del tratamiento. El abordaje endonasal endoscópico es adecuado en caso de que la anatomía lo permita y se tenga la infraestructura hospitalaria básica para obtener un alto índice de éxitos.

Digital melanoma is an uncommon form of acral melanoma that is anatomically restricted to the finger. The aim of this study is to provide specific epidemiological and clinical information about this subtype of melanoma, as well as to identify differences in recurrence and survival depending on the anatomical sublocation.We describe a group of 45 Caucasian patients with digital melanoma divided into three groups: nail unit melanoma (group A), finger skin melanoma (group B), and those melanomas that involve both nail and adjacent skin (group C).The mean tumor thickness was 4.66 mm, and the most common histological subtype is acral lentiginous melanoma. Group C was more frequent in older men and was thicker and more frequently ulcerated (P 0.05). In addition, patients in group C developed distant metastases more frequently and had a significantly lower median disease-free survival (26.60 months) compared with group A (69.47 months) and group B (89.81 months) (P 0.05).According to our results, digital melanoma limited to nail apparatus or finger skin was associated with a better prognosis, while those affecting both nail apparatus and skin showed lower melanoma-specific survival.

TAMs constitute a large fraction of infiltrating immune cells in melanoma tissues, but their significance for clinical outcomes remains unclear. We explored diverse TAM parameters in clinically relevant primary cutaneous melanoma samples, including density, location, size, and polarization marker expression, in addition, because cytokine production is a hallmark of macrophages function, we measured CCL20, TNF, and VEGFA intracellular cytokines by single-cell multiparametric confocal microscopy. The Kaplan–Meier method was used to analyze correlation with melanoma-specific disease-free survival and overall survival. No significant correlations with clinical parameters were observed for TAM density, morphology, or location. Significantly, higher contents of the intracellular cytokines CCL20, TNF, and VEGFA were quantified in TAMs infiltrating metastasizing compared to non-metastasizing skin primary melanomas (p &lt, 0.001). To mechanistically explore cytokine up-regulation, we performed in vitro studies with melanoma-conditioned macrophages, using RNA-seq to explore involved pathways and specific inhibitors. We show that p53 and NF-κB coregulate CCL20, TNF, and VEGFA in melanoma-conditioned macrophages. These results delineate a clinically relevant pro-oncogenic cytokine profile of TAMs with prognostic significance in primary melanomas and point to the combined therapeutic targeting of NF-kB/p53 pathways to control the deviation of TAMs in melanoma.

Introduccion Actualmente existe controversia respecto a los beneficios de realizar linfadenectomia en pacientes de melanoma con una biopsia selectiva de ganglio centinela (BSGC) positiva. La carga tumoral > 1 mm se ha propuesto como el parametro mas relevante asociado a una linfadenectomia positiva y un deterioro de la supervivencia libre de enfermedad. Material y metodos Se analizaron los datos de 119 pacientes de melanoma con BSGC positiva atendidos en el periodo entre Junio de 1997 y Junio de 2017. Los pacientes se clasificaron segun la carga tumoral en dos grupos: ≤ 1 mm and > 1 mm. Resultados La linfadenectomia resulto positiva en solo 6 (10%) pacientes con una carga tumoral ≤ 1 mm, y en 23 (37.7%) pacientes con carga tumoral > 1 mm (p Conclusion Aunque la realizacion de linfadenectomia debe individualizarse en cada caso, la carga tumoral > 1 mm puede ser un factor predictivo de la presencia de ganglios no centinelas positivos en piezas de linfadenectomia, y un factor pronostico independiente importante para la SEM. Background The benefits of complete lymph node dissection (CLND) in melanoma patients with a positive sentinel lymph node biopsy (SLNB) have been recently questioned. Sentinel node (SN) tumor burden > 1 mm has been proposed as the most reliable parameter associated with positive CLND and poorer disease-free survival. Material and methods Between June 1997 and June 2017, data from 119 melanoma patients with positive SLNB were analyzed. Patients were classified by SN burden in two groups: ≤ 1 mm and > 1 mm. Results CLND was positive in 6 (10%) patients with SN tumor burden ≤ 1 mm and in 23 (37.7%) patients with > 1 mm (p Conclusion Although CLND should still be considered individually in patients with positive SLNB, SN tumor burden >1 mm might be a good predictive factor of additional positive non-sentinel nodes and a strong independent prognostic factor in melanoma-specific survival.

Introduction Short-duration ambulatory surgery for the removal of skin tumors under local anesthesia is increasingly common in dermatology. Preoperative assessment has traditionally targeted the identification of any unknown diseases or other health conditions that might lead to changes in plans for anesthesia or surgery. Hospitals and specialists differ greatly in the tests they order in patients about to undergo outpatient dermatologic surgery given that hardly any finding would be likely to contraindicate or lead to changes in the procedure. This study aimed to provide guidance for those ordering tests before outpatient dermatologic surgery. Methods In 2017 our hospital developed a protocol to standardize preoperative testing for outpatient dermatologic surgery. We designed an observational, descriptive, retrospective analysis of tests ordered for patients scheduled for such surgery before and after the protocol was applied. Results Fewer tests were ordered after the protocol was introduced. We detected no statistically significant differences in relation to type of surgery planned or postoperative complications. Conclusions Patients about to undergo outpatient dermatologic surgery under local anesthesia who have no unusual health risks may not require preoperative testing.

A metric space M is length when every two points have an approximate midpoint, while M has property (Z) when for every x , y ∈ M there exists z such that d ( x , z ) + d ( z , y ) − d ( x , y ) is arbitrarily smaller than d ( x , z ) and d ( z , y ) . Answering a problem posed by Garcia-Lirola, Prochazka and Rueda Zoca, we prove that every complete metric space with property (Z) is length. As a consequence, we get that for the Lipschitz-free space of a metric space a number of geometric properties are all equivalent, like the Daugavet property, the diameter-2 property, the absence of strongly exposed points or the absence of preserved extreme points.

A Banach space X is said to have Efremov's property ( E ) if every element of the weak⁎-closure of a convex bounded set C ⊆ X ⁎ is the weak⁎-limit of a sequence in C. By assuming the Continuum Hypothesis, we prove that there exist maximal almost disjoint families of infinite subsets of N for which the corresponding Johnson–Lindenstrauss spaces enjoy (resp. fail) property ( E ). This is related to a gap in Plichko (2015) [12] and allows to answer (consistently) questions of Plichko and Yost.

La investigación se la realizó bajo la modalidad paradigmática cuantitativa, analiza como factores de la crisis económica afectaron la calidad de vida de la población Riobambeña; se enriquece con los aportes de una metodología descriptiva basada en la recolección de datos, explora los impactos en el ámbito económico de la población en Riobamba. Como primer punto, se revisa la situación a nivel material generada por la pandemia y relacionada a la cotidianidad de la población, a través de un análisis proveniente de la economía del cantón; se señalaron las principales problemáticas que dicha crisis genera en el campo de lo económico, así como también en el ámbito de la salud mental. Trasversalmente, se reconocen posibles escenarios en el tema de seguridad. El objetivo general de este proyecto de investigación descriptiva es determinar la influencia del covid-19 en la situación económica de las familias de Riobamba, al mismo tiempo.

First author was supported by Projects MTM2014-54182-P and MTM2017-86182-P (MINECO, AEI/FEDER, UE) and by 19275/PI/14 (Fundacion Seneca). Second author gratefully acknowledges support of Spanish Ministerio de Economia, Industria y Competitividad through Grants MTM2016-76808-P, MTM2016-75196-P, and the “Severo Ochoa Programme for Centres of Excellence in R&D” (SEV-2015-0554). Third author was supported by MINECO MTM2017-88385-P.

Tumor cells attract and dynamically interact with monocytes/macrophages to subvert their differentiation into tumor-associated macrophages (TAMs), which mainly promote immune suppression and neoplastic progression, but the pathways and microenvironmental cues governing their protumoral deviation are not completely understood. To identify the molecular pathways responsible for TAM differentiation, we screened the biomarkers secreted during melanoma‒macrophage interactions using Quantibody microarrays and RNA sequencing of macrophages. We found that activin A, a member of the transforming GF family, plays an instrumental role in the cross-talk between melanoma cells and monocytes/macrophages, which results in the upregulation of distinct tumor-sustaining genes and the achievement of proinvasive and immunosuppressive functions of TAMs. Blockade of activin reduces the upregulation of part of these genes and prevents the acquisition of protumoral functions, facilitating human melanoma rejection by transferred human lymphocytes in a xenograft mouse model. Remarkably, screening of two independent cutaneous primary melanoma collections showed that activin A is enriched in TAMs and melanoma cells from patients with worse outcomes and constitutes a new and independent prognostic marker. Thus, we identify activin A as a key intermediary in the protumoral and immunosuppressive functions of TAMs, with significant potential as a disease biomarker as well as an immunotherapeutic target.