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A wide diversity was found in the materials for most traits. Most of the cultivated tomato materials of the CC and BS were also genotyped using the high-throughput ddRAD sequencing technique revealing a high genetic diversity in the collection and allowing the detection of candidate genes and associations for relevant traits under organic conditions. The screening of BS for several diseases (Phytophthora, Fusarium, TSWV, ToMV) has allowed the identification of new sources of tolerance and resistance. A Selected Set of materials has been screened both in Italy and in Spain under control, drought and low N fertilization conditions, and resilient materials under these conditions have been identified. Hybrids obtained between selected materials has allowed the identification of promising hybrids heterotic for yield and with high fruit quality. In addition, several backcross programmes have been undertaken in order to introduce resistance to several diseases, and advanced backcrosses with introgressed resistances have been obtained. New intraspecific and interspecific hybrids have been developed and tested as rootstocks. Some of them outperformed control rootstocks commonly used for grafting tomato. The new improved tomato materials specifically selected for organic conditions can have a dramatic impact in the production of organically grown tomato.

Background and objective: The availability of chest computed tomography (CT) imaging can help diagnose comorbidities associated with chronic obstructive pulmonary disease (COPD). Their systematic identification and relationship with allcause mortality have not been explored. Furthermore, whether their CT-detected prevalence differs from clinical diagnosis is unknown. Methods: The prevalence of 10 CT-assessed comorbidities was retrospectively determined at baseline in 379 patients (71% men) with mild to severe COPD attending pulmonary clinics. Anthropometrics, smoking history, dyspnoea, lung function, exercise capacity, BODE (BMI, Obstruction, Dyspnoea and Exercise capacity) index and exacerbations rate were recorded. The prevalence of CT-determined comorbidities was compared with that recorded clinically. Over a median of 78 months of observation, the independent association with all-cause mortality was analysed. A ‘CT-comorbidome’ graphically expressed the strength of their association with mortality risk. Results: Coronary artery calcification, emphysema and bronchiectasis were the most prevalent comorbidities (79.8%, 62.7% and 33.9%, respectively). All were underdiagnosed before CT. Coronary artery calcium (hazard ratio [HR] 2.09; 95% CI 1.03–4.26, p = 0.042), bronchiectasis (HR 2.12; 95% CI 1.05–4.26, p = 0.036) and low psoas muscle density (HR 2.61; 95% CI 1.23–5.57, p = 0.010) were independently associated with all-cause mortality and helped define the ‘CT-comorbidome’. Conclusion: This study of COPD patients shows that systematic detection of 10 CT-diagnosed comorbidities, most of which were not detected clinically, provides information of potential use to patients and clinicians caring for them.

This article details the GesEPOC 2021 recommendations on the diagnosis and treatment of COPD exacerbation syndrome (CES). The guidelines propose a definition-based syndromic approach, a new classification of severity, and the recognition of different treatable traits (TT), representing a new step toward personalized medicine. The evidence is evaluated using GRADE methodology, with the incorporation of 6 new PICO questions. The diagnostic process comprises four stages: 1) establish a diagnosis of CES, 2) assess the severity of the episode, 3) identify the trigger, and 4) address TTs. This diagnostic process differentiates an outpatient approach, that recommends the inclusion of a basic battery of tests, from a more comprehensive hospital approach, that includes the study of different biomarkers and imaging tests. Bronchodilator treatment for immediate relief of symptoms is considered essential for all patients, while the use of antibiotics, systemic corticosteroids, oxygen therapy, and assisted ventilation and the treatment of comorbidities will vary depending on severity and possible TTs. The use of antibiotics will be indicated particularly if sputum color changes, when ventilatory assistance is required, in cases involving pneumonia, and in patients with elevated C-reactive protein (>= 20 mg/L). Systemic corticosteroids are recommended in CES that requires admission and are suggested in moderate CES. These drugs are more effective in patients with blood eosinophil counts >= 300 cells/mm(3). Acute-phase non-invasive mechanical ventilation is specified primarily for patients with CES who develop respiratory acidosis despite initial treatment. (C) 2021 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.

The Spanish COPD Guidelines (GesEPOC) were first published in 2012, and since then have undergone a series of updates incorporating new evidence on the diagnosis and treatment of COPD. GesEPOC was drawn up in partnership with scientific societies involved in the treatment of COPD and the Spanish Patients' Forum. Their recommendations are based on an evaluation of the evidence using GRADE methodology, and a narrative description of the evidence in areas in which GRADE cannot be applied. In this article, we summarize the recommendations on the pharmacological treatment of stable COPD based on 9 PICO questions. COPD treatment is a 4-step process: 1) diagnosis, 2) determination of the risk level, 3) initial and subsequent inhaled therapy, and 4) identification and management of treatable traits. For the selection of inhaled therapy, high-risk patients are divided into 3 phenotypes: non-exacerbator, eosinophilic exacerbator, and non-eosinophilic exacerbator. Some treatable traits are general and should be investigated in all patients, such as smoking or inhalation technique, while others affect severe patients in particular, such as chronic hypoxemia and chronic bronchial infection. COPD treatment is based on long-acting bronchodilators with single agents or in combination, depending on the patient's risk level. Eosinophilic exacerbators must receive inhaled corticosteroids, while non-eosinophilic exacerbators require a more detailed evaluation to choose the best therapeutic option. The new GesEPOC also includes recommendations on the withdrawal of inhaled corticosteroids and on indications for alpha-1 antitrypsin treatment. GesEPOC offers a more individualized approach to COPD treatment tailored according to the clinical characteristics of patients and their level of complexity. (c) 2021 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.

Despite the fact that in the last decades, several mental health studies have shown that companion animals contribute to psychological and social well- being in humans (e.g., positive impacts have been observed in the elderly medicated for chronic diseases such as anxiety, dementia, and depression), bonds between humans and other animals continue to be under-estimated. The aim of this study is to assess the impact of an animal’s visits (twice a week, N = 30) in depression and anxiety levels of an institutionalized male population diagnosed with dementia. While some of these patients are being partially medicated with antidepressants and/or anxiolytics, others are not subject to any medication (control group). The GAI and GDS measuring instruments were used and there were differences in anxiety and depression levels between the first and last dog visit, statistically significant in depression levels of nonmedicated patients. Such findings allow us to conclude that the effects of the visits of an animal near nonmedicated patients are greater than near medicated ones. The complementary role of animals in mental health institutions where patients are being treated for psychiatric disorders (in the particular case of dementia) should be considered.

[Background] The value of the single-breath diffusing capacity of the lungs for carbon monoxide (Dlco) relates to outcomes for patients with COPD. However, little is known about the natural course of Dlco over time, intersubject variability, and factors that may influence Dlco progression., [Research Question] What is the natural course of Dlco in patients with COPD over time, and which other factors, including sex differences, could influence this progression?, [Study Design and Methods] We phenotyped 602 smokers (women, 33%), of whom 506 (84%) had COPD and 96 (16%) had no airflow limitation. Lung function, including Dlco, was monitored annually over 5 years. A random coefficients model was used to evaluate Dlco changes over time., [Results] The mean (± SE) yearly decline in Dlco % in patients with COPD was 1.34% ± 0.015%/y. This was steeper compared with non-COPD control subjects (0.04% ± 0.032%/y; P = .004). Sixteen percent of the patients with COPD, vs 4.3% of the control subjects, had a statistically significant Dlco % slope annual decline (4.14%/y). At baseline, women with COPD had lower Dlco values (11.37% ± 2.27%; P < .001) in spite of a higher FEV1 % than men. Compared with men, women with COPD had a steeper Dlco annual decline of 0.89% ± 0.42%/y (P = .039)., [Interpretation] Patients with COPD have an accelerated decline in Dlco compared with smokers without the disease. However, the decline is slow, and a testing interval of 3 to 4 years may be clinically informative. The lower and more rapid decline in Dlco values in women, compared with men, suggests a differential impact of sex in gas exchange function., [Trial Registry] ClinicalTrials.gov; No.: NCT01122758; URL: www.clinicaltrials.gov, This study was funded in part by an unrestricted grant from AstraZeneca, and also by the COPD Research Program of the Spanish Respiratory Society (PII de EPOC of SEPAR).

Planar cell polarity (PCP) is essential to optimize information processing and functional response in many tissues. While the fly eye is a classic example of PCP, it remains unknown whether PCP exists in the mammalian retina and whether it plays a part in vision. Here we used 3D reconstructions of the mouse retina to show that the basal body of cone photoreceptor cilia, but not rods, is systematically located on the side of the cell facing the centre of the retina. We further show that light is required during a critical window of development to establish cone PCP, and that both cone transducin and the G-protein signaling modulator protein 2 are required to mediate this effect. Importantly, we report that disruption of cone PCP impairs visual acuity. This work uncovers a non-canonical PCP pathway, mediated by light, and identifies cone PCP as a feature supporting mammalian vision.

This article presents the characterization ofr multiple composition traits of 44 accessions of the long-shelf flie "de penjar" tomato.

In our daily visual environment, the primary visual cortex (V1) processes distributions of oriented features as the basis of our visual computations. Changes of the global, median orientation of such inputs form the basis of our canonical knowledge about V1. However, another overlooked but defining characteristic of these sensory variables is their precision, which characterizes the level of variance in the input to V1. Such variability is an intrinsic part of natural images, yet it remains unclear if and how V1 accounts for the changes in orientation precision to achieve its robust orientation recognition performances. Here, we used naturalistic stimuli to characterize the response of V1 neurons to quantified variations of orientation precision. We found that about thirty percent of the recorded neurons showed a form of invariant responses to input precision. While feedforward mechanisms failed to account for the existence of these resilient neurons, neuronal competition within V1 explained the extent to which a neuron is invariant to precision. Using a decoding algorithm, we showed that the existence of such neurons in the population response of V1 can serve to encode both the orientation and its precision in the V1 population activity, which improves the robustness of the overall neural code. These precision-specific neurons operate with slow recurrent cortical dynamics, which supports the notion of predictive precisionweighted processes in V1.

Background: Two previous national epidemiological studies, IBERPOC in 1997 and EPISCAN in 2007, determined the COPD burden in Spain. Changes in demographics and exposure to risk factors demand the periodic update of COPD prevalence and its determinants. Methods: EPISCAN II aimed to estimate the prevalence of COPD in the general population aged 40 years or older in all 17 regions of Spain. A random population screening sample, requiring 600 participants per region performed a questionnaire plus post-bronchodilator (post-BD) spirometry. Results: A total of 12,825 subjects were initially contacted, and 9433 (73.6%) agreed to participate, of whom 9092 performed a valid spirometry. Baseline characteristics were: 52.6% women, mean +/- SD age 60 +/- 11 years, 19.8% current- and 34.2% former-smokers. The prevalence of COPD measured by post-BD fixed ratio FEV1/FVC < 0.7 was 11.8% (95% C.I. 11.2-12.5) with a high variability by region (2.4-fold). Prevalence was 14.6% (95% C.I. 13.5-15.7) in males and 9.4% (95% C.I. 8.6-10.2) in females; according to the lower limit of normal (LLN) was 6.0% (95% C.I. 5.5-6.5) overall, by sex being 7.1% (95% C.I. 6.4-8.0) in males and 4.9% (95% C.I. 4.3-5.6) in females. Underdiagnosis of COPD was 74.7%. Cases with COPD were a mean of seven years older, more frequently male, of lower attained education, and with more smokers than then on COPD population (p < 0.001). However, the number of cigarettes and pack-years in non-COPD participants was substantial, as it was the reported use of e-cigarettes (7.0% vs. 5.5%) (p = 0.045). There were also significant social and clinical differences including living alone, previous respiratory diagnoses, more comorbidities measured with the Charlson index, greater BODE and COTE scores, cognitive impairment, and depression (all p < 0.001). Conclusions: COPD remains prevalent in Spain and frequently underdiagnosed. (C) 2020 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.

OBJECTIVE: The objective of this work was to design and validate a questionnaire on Male Sexual Function (MSF) in the Spanish language, following the criteria contemplated in the Diagnostic and Statistical Manual of Mental Disorders, DSM-5, for the diagnosis of sexual dysfunctions. MATERIAL AND METHODS: A cross-sectional and multicentre study was conducted on 163 men (18-70 years) who self-completed a test (MSF questionnaire). They then answered questions on the Structured History of Male Sexual Function (AMSF). Four weeks later they completed a re-test, which was the same, but including a supplementary question about the possible influence of recent events. RESULTS: Internal consistency: Cronbach's alpha test 0.840, AMSF 0.835, retest 0.855. Test-retest reliability: mean test scores 33.13±6.566, retest 33.11±6.791; Student t 0.122, not significant (P=.903); correlation total test-retest scores (intraclass correlation coefficient) 0.979, significant correlation (P90% for all items / domains, sensitivity>80% except item 4 (76%). Content validity: using factor analysis, grouping of items into 4 components (explain 75% variance); high correlation between "sexual desire" and "confidence in erection". CONCLUSIONS: The MSF questionnaire is reliable, stable and valid, with high specificity and sensitivity. It evaluates the sexual response of the male, describing aspects of interest: anticipatory anxiety, initiative, confidence to communicate preferences, events that may influence. Can detect sexual dysfunction in the couple.

The phenotypic characteristics of chronic obstructive pulmonary disease (COPD) in individuals younger than 50 years of age (early COPD) are not well defined. This prospective, multi-centre, case-control study sought to describe these characteristics and compare them with those of smokers (>= 10 pack-years) of similar age with normal spirometry (controls). We studied 92 cases (post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC)