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Purpose: Hyperthyroidism guidelines have not been updated over the past five years, despite numerous data on the subject, and recent studies providing a wide variation in treatment success rates. We aim to compare the effectiveness and safety of treatment modalities in patients with Graves' disease or toxic nodular disease., Methods: Single center retrospective cohort study of Graves' disease and toxic nodular disease patients treated between 1983 and 2023., Results: A total of 411 patients were treated for hyperthyroidism, 245 due to Graves' disease and 166 due to or toxic nodular disease, followed for a median of 7 years. In Graves' disease, 90.2% were treated with antithyroid drugs over 250 cycles, achieving 41.7% cumulative remission. Half of all relapses (50.9%) occurred in the first year, 76.3% in the first three years, and 98.3% within nine years. Treatment periods of 12-24 months showed higher remission and lower relapse rates than longer periods. I-131 was used in 103 cycles with 82.5% remission and 7.1% relapse. A total of 29 thyroidectomies resulted in 100% remission, with no relapse. In toxic nodular disease, surgery was the most frequently used treatment (54.5%), followed by I-131 (37.1%)., Conclusion: Our findings support antithyroid drugs as the preferential first-line treatment for Graves' disease, allowing for euthyroidism with minimal adverse effects. Given the propensity for relapse, we suggest a rigorous monitoring, particularly within the first three years. In toxic nodular disease, surgery should be the preferred option, with I-131 being reserved for single adenomas and small goiters., Competing Interests: Compliance with ethical standards. Conflict of interest: The authors declare no competing interests. Ethics approval: This study was approved by our center’s ethics committee and complies with the Declaration of Helsinki. Informed consent: Confidentiality was kept throughout the study., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Developing highly sensitive and selective measurement techniques to detect trace compounds in diverse matrices is a significant challenge in analytical chemistry. These techniques must adhere to green chemistry principles by minimizing organic solvent use, simplifying sample preparation, and streamlining process steps. Additionally, there is a growing need for sustainable analytical methods due to increased environmental awareness. The problem addressed in this work is the need for an eco-friendly and efficient method for the extraction and detection of trace organochlorine pesticides in water samples., Results: We employed SPME using a novel clay thin film sorbent, deposited on a nickel-titanium alloy wire via magnetron sputtering. Montmorillonite clay was chosen for its excellent adsorption properties and eco-friendly nature, aligning with green chemistry principles. The approach involved coating the SPME fiber with hydrophobic modified montmorillonite clay, followed by silylation. The method was tested for extracting 12 model organochlorine pesticides, including BHC, lindane, and DDT, demonstrating high isolation efficiency. The coated thin film and its silylation modification were characterized using standard spectroscopic techniques, confirming the successful creation of a new adsorbent phase. The direct immersion SPME approach achieved relative recoveries ranging from 65 % to 99 %, with reproducibility (RSD) below 6 %. This method provided low detection limits (10-15 ng L -1 ) and quantitation limits (32-50 ng L -1 )., Significance: Our approach offers an eco-friendly, highly efficient solution for the extraction and detection of trace organochlorine pesticides. The significant improvement in recovery rates and reproducibility, combined with low detection and quantitation limits, underscores the potential of this method to enhance analytical practices in environmental monitoring and public health. Furthermore, the use of sustainable materials and processes aligns with global efforts to reduce environmental impact in analytical chemistry., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

A considerable number of vehicular accidents occur in low-millage zones like school streets, neighborhoods, and parking lots, among others. Therefore, the proposed work aims to provide a novel ADAS system to warn about dangerous scenarios by analyzing the driver's attention and the corresponding distances between the vehicle and the detected object on the road. This approach is made possible by concurrent Head Pose Estimation (HPE) and Object/Pedestrian Detection. Both approaches have shown independently their viable application in the automotive industry to decrease the number of vehicle collisions. The proposed system takes advantage of stereo vision characteristics for HPE by enabling the computation of the Euler Angles with a low average error for classifying the driver's attention on the road using neural networks. For Object Detection, stereo vision is used to detect the distance between the vehicle and the approaching object; this is made with a state-of-the-art algorithm known as YOLO-R and a fast template matching technique known as SoRA that provides lower processing times. The result is an ADAS system designed to ensure adequate braking time, considering the driver's attention on the road and the distances to objects., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Acute aortic syndrome was fully described in 2001, it refers to a heterogeneous group of patients with a set of signs and symptoms where the main one is aortic pain. This syndrome encompasses a group of four acute aortic conditions: aortic dissection (AD), intramural hematoma, penetrating aortic ulcer, and incomplete dissection. Aortic dissection usually follows the sudden onset of acute chest pain, which is worse at the point of manifestation., Case Report: 50-year-old male patient admitted to the emergency department for abdominal pain; he reported a history of systemic arterial hypertension for 22 years of diagnosis, treatment with Irbesartan (225 mg/day), chronic kidney disease without replacement therapy, with previous appendectomy 30 years ago., Conclusion: The diagnostic difficulty of acute aortic syndrome in the emergency department has been a challenge due to the diffuse clinical picture in which it presents, but it is extremely important to have a high level of suspicion, to keep in mind that AD is an underdiagnosed etiology and to relate it to risk factors. The importance of establishing a timely diagnosis is a priority, since mortality increases from 1 to 2% per hour of elapsed time., (Licencia CC 4.0 (BY-NC-ND) © 2024 Revista Médica del Instituto Mexicano del Seguro Social.)

In this article we can observe the scanning by the literature for the pretreatment of steam explosion applied to lignocellulose biomass. A comparison of the chemical and physical characterization of potato peel as a lignocellulose biomass. Besides, the innovative design of a continuous reactor for the potato peel steam explosion process is shown, with specific temperature and pressure conditions on a pilot scale, detailing its parts. Finally, a finite element analysis was performed where stress results were obtained from the reactor material, severity factor, structural analysis and thermal analysis, providing a panorama of the reactor's behavior with the conditions specific., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Carlos Guerrero reports financial support was provided by Colombia Ministry of Science Technology and Innovation. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Didactic videos have proven to be particularly beneficial for Science, Technology, Engineering and Mathematics (STEM) education challenges. This is due to their contribution to the reduction of the intrinsic cognitive load, as well as fostering connections among subjects to promote generative processing. This fact, together with the wide presence of STEM dissemination videos on YouTube, creates an opportunity both for teachers to focus on dissemination channels to acquire quality materials, and for content creators to develop specific videos aiming to serve as pedagogical aid. Aligned with such reasoning, this paper intends to evaluate the use and performance of a STEM YouTube channel that already publishes didactic videos categorized by intentionality into dissemination or educational. Using owners' data, the channel has been analyzed, considering a six-year extension period, from 2017 to 2022, and distinguishing between the two categories of contents. This dual intention of the channel allows to evaluate the educational use of dissemination channels, compared to their use for curiosity satisfaction. Through Mann-Whitney U and correlation analyses, the main channels' metrics have been analyzed in terms of awareness (i.e., impressions, views, or subscribers), use (view duration) and interaction (comments, shares, likes or dislikes). Significant differences have been found in the performance of educational and dissemination contents, such as in views (p < 0.001), average view duration (p = 0.044) and likes (p < 0.001). Additionally, video length optimization has been found as a determining parameter influencing video performance, being educational videos more sensitive to this metric than dissemination videos. This study has shown that a STEM YouTube channel of these characteristics can benefit from publishing videos aiming to a pedagogical purpose, increasing its use compared with other STEM dissemination channels only aiming to an entertainment purpose. Additionally, this study supports previous findings that video length optimization is a determinant characteristic for audience retention rate., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The corresponding author is the creator of Sígueme la Corriente YouTube channel analyzed in the research, and this is what could enable the possibility of counting with owner's data as described in the article. Other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

This review essay examines five Spanish-language books published in Latin America on the emergence of engineering in the region. Focusing on a period from roughly 1850 to 1970, these works share themes of foreigners and foreign education, nation-state construction, and social conceptions of prestige. This research suggests that throughout Latin America foreign educators and models were prominent in early engineering programs and enterprises. However, many historians associate the growth of engineering, especially civil engineering, with increasing state consolidation and economic intervention. As social perceptions of the value of professional engineering changed, domestic engineers increasingly became important planners and mediators. Some engineers became state leaders. By contextualizing these works with other scholarship on the history of engineering, this review essay highlights new insights while suggesting the need for greater attention to gender, race, and labor; comparisons between developments in Latin America, Africa, and Asia; and more research on private-sector engineers.

We report the first case of partial albinism in the Critically Endangered angelshark, Squatina squatina. The encounter with this specimen took place while SCUBA diving on the beach of Tufia, located on the east coast of the island of Gran Canaria on 2 April 2021. This is also the first confirmed finding of an albino elasmobranch specimen in the Canary Island archipelago., (© 2023 The Authors. Journal of Fish Biology published by John Wiley & Sons Ltd on behalf of Fisheries Society of the British Isles.)

Background: The management of antidiabetic therapy in people with type 2 diabetes (T2D) has evolved beyond glycemic control. In this context, Brazil and Portugal defined a joint panel of four leading diabetes societies to update the guideline published in 2020., Methods: The panelists searched MEDLINE (via PubMed) for the best evidence from clinical studies on treating T2D and its cardiorenal complications. The panel searched for evidence on antidiabetic therapy in people with T2D without cardiorenal disease and in patients with T2D and atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), or diabetic kidney disease (DKD). The degree of recommendation and the level of evidence were determined using predefined criteria., Results and Conclusions: All people with T2D need to have their cardiovascular (CV) risk status stratified and HbA1c, BMI, and eGFR assessed before defining therapy. An HbA1c target of less than 7% is adequate for most adults, and a more flexible target (up to 8%) should be considered in frail older people. Non-pharmacological approaches are recommended during all phases of treatment. In treatment naïve T2D individuals without cardiorenal complications, metformin is the agent of choice when HbA1c is 7.5% or below. When HbA1c is above 7.5% to 9%, starting with dual therapy is recommended, and triple therapy may be considered. When HbA1c is above 9%, starting with dual therapyt is recommended, and triple therapy should be considered. Antidiabetic drugs with proven CV benefit (AD1) are recommended to reduce CV events if the patient is at high or very high CV risk, and antidiabetic agents with proven efficacy in weight reduction should be considered when obesity is present. If HbA1c remains above target, intensification is recommended with triple, quadruple therapy, or even insulin-based therapy. In people with T2D and established ASCVD, AD1 agents (SGLT2 inhibitors or GLP-1 RA with proven CV benefit) are initially recommended to reduce CV outcomes, and metformin or a second AD1 may be necessary to improve glycemic control if HbA1c is above the target. In T2D with HF, SGLT2 inhibitors are recommended to reduce HF hospitalizations and mortality and to improve HbA1c. In patients with DKD, SGLT2 inhibitors in combination with metformin are recommended when eGFR is above 30 mL/min/1.73 m 2 . SGLT2 inhibitors can be continued until end-stage kidney disease., (© 2023. The Author(s).)

Introduction: Insulin-like growth factor receptor 2 (IGF2R) regulates placental nutrient transport, and its soluble form is related to obesity in adults. If the placental expression of IGF2R is altered in women with obesity is unknown. Whether maternal supplementation with docosahexaenoic acid (DHA), a polyunsaturated fatty acid with anti-inflammatory properties, has a modulatory role in IGF2R's function has not been elucidated. We hypothesized that maternal obesity (Ob) would be associated with alterations in placental IGF2R expression, which may be prevented with DHA supplementation during pregnancy., Methods: At delivery, we obtained placentas from women with Ob (BMI ≥ 30 kg/m 2 , n  = 17), Ob supplemented with 800 mg/day of DHA during pregnancy (Ob + DHA, n  = 13), and normal-weight women (Nw, BMI ≥ 18.5 ≤ 24.9 kg/m 2 , n  = 14). The IGF2R mRNA and protein were determined by RT-PCR and western blotting, respectively. Moreover, we quantified the gene expression of molecules that modulate the IGF2R function in the extracellular domain, such as TACE/ADAM17, PLAU, and IGF2. Mann-Whitney and Kruskal-Wallis nonparametric tests were used to compare results between two or three groups accordingly., Results: The IGF2R levels in the Ob placentas of the male offspring were higher than in the Nw group. The DHA supplementation prevented this effect, suggesting an unknown relationship between IGF2R-Ob-DHA in placental tissues., Conclusion: We report, for the first time, that DHA supplementation during pregnancy in women with obesity normalizes the increased IGF2R levels in male placentas, reducing the risk of adverse outcomes related to the IGF2/IGF2R system in male newborns., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Juan José Castro et al.)

The presence of spiny butterfly rays, Gymnura altavela , in waters less than 20 m deep off the Canary Islands shows marked seasonality, with relatively high abundances in the summer and autumn. Large aggregations of sometimes hundreds of individuals, primarily females, appear in specific shallow areas of the archipelago and seem to be associated with the seasonal variation in water temperature. This seasonal pattern of presence or absence in shallow areas suggests that spiny butterfly rays migrate into deeper waters or other unknown areas during the rest of the year. G. altavela shows sexual dimorphism; in our study, females were larger and more abundant than males, with a sex ratio of 1:18.9. The species' estimated asymptotic length, L ∞ , was 183.75 cm and thus close to the common length reported for the species (200 cm). The von Bertalanffy growth constant ( k ) oscillated between 0.210 and 0.310 year -1 , as similarly described for the species in the Western North Atlantic off the U.S. coast. From June to November, the seawater temperature oscillated between 19 and 24 °C, and massive aggregations of females occurred at 22-24 °C and in a few specific sandy beaches on the islands. Spiny butterfly rays, mostly females, show a preference for aggregating in shallow waters during summertime, probably conditionate to mating or breeding behaviour.

Percnon gibbesi is a native crab species characteristic of intertidal and subtidal zones of the Atlantic coast of the European Macaronesian archipelagos (Azores, Madeira, and Canary Islands), and probably also in the neighbouring rocky coasts of northwest Africa. P. gibbesi is considered an invasive alien species in almost all of the Mediterranean, with expanding populations from Spain to Turkey, including Libya; However, its biology and ecology are highly unknown, despite all its range of distribution. In the intertidal zones of Gran Canaria Island, this crab, in the intertidal zones of Gran Canaria Island, shows a carapace length range between 4.1 and 22.7 mm (4.1-22.7 in males and 5.7-22.3 in females), where females showed higher weights and lengths than males on average; However, males predominated in all samples, with a sex ratio of 1:0.57. The L ∞ for this crab was estimated to be 27 ± 3 mm (23 ± 4 mm for females and 25 ± 4 mm for males). The growth coefficient (K) was 0.24 year -1 , the total mortality (Z) was Z = 1.71 year -1 , and the natural mortality (M) was 0.47 year -1 . Although females grow faster than males, males are more abundant in the larger length classes. Although the presence of ovigerous females indicated that reproduction takes place twice a year, from March to April and from August to September, the number of cohorts detected by the modal progression analysis showed that reproduction takes place all year.

A new sorbent material based on modified clay with ionic liquid immobilized into an agarose film was developed as part of this study. It was applied to determine organochlorine pollutants, like disinfection byproducts, through headspace solid-phase microextraction-gas chromatography-electron capture detection (HS-SPME-GC-ECD). The disinfection byproducts determined in this study were used as model molecules because they were volatile compounds, with proven severe effects on human health. Their presence in aquatic environments is in trace concentrations (from pg L -1 to mg L -1 ). They are classified as emergent pollutants and their determination is a challenge for analytical chemists. The parameters which affected the extraction efficiency, i.e., number and distance between SPME discs, salt concentration, the temperature of extraction, extraction time, and desorption time, were optimized. A wide linear dynamic range of 10-1000 ng mL -1 and coefficients of determination better than 0.997 were achieved. The limits of detection and the limits of quantitation were found in the ranges of (1.7-3.7) ng mL -1 and (5.6-9.9) ng mL -1 , respectively. The precision, expressed as relative standard deviation (RSD), was better than 8%. The developed sorbent exhibits good adsorption affinity. The applicability of the proposed methodology for the analysis of trihalomethanes in environmental and water samples showed recoveries in the range of 86-95%. Finally, the newly created method fully complied with the principles of green chemistry. Due to the fact that the sorbent holder was made of agarose, which is a wholly biodegradable material, sorbent clay is a widespread material in nature. Moreover, the reagents intercalated into the montmorillonite are new green solvents, and during the whole procedure, low amounts of organic solvents were used.

Background: Health self-perception (HSP) is the individual and subjective concept that a person has of their state of health. Despite its simplicity, HSP is considered a valid and relevant indicator employed in epidemiological research and in professional practice as an overall measure of health., Objectives: (1) To describe and analyze the associations between HSP and demographic variables, lifestyle and diseases prevalent in a population and (2) to investigate the relationship between HSP and mortality., Materials and Methods: In a primary care setting, we conducted a longitudinal study of a random populational sample of a Galician municipality, stratified by decade of life. A total of 1,516 adults older than 18 years, recruited by the 2013-2015 AEGIS study, were followed-up for more than 5 years. During the clinical interview, data were collected on lifestyle and prevalent diseases. The HSP was grouped into 2 categories (good/poor). The statistical analysis consisted of a logistic regression, Kaplan-Meier curves and Cox regression., Results: A total of 540 (35.6%) participants reported poor HSP. At the end of the follow-up, 78 participants had died (5.1%). The participants with increased age and body mass index and chronic diseases (anxiety, depression, ischemic heart disease, diabetes, and cancer) presented a poorer subjective health. A high level of physical activity and moderate alcohol consumption were associated with better HSP. A poorer HSP was associated with increased mortality, an association that disappeared after adjusting for the rest of the covariates (HR, 0.82; 95% CI 0.50-1.33)., Conclusion: (1) Health self-perception is associated with age, lifestyle, and certain prevalent diseases. (2) A poorer HSP is associated with increased mortality, but this predictive capacity disappeared after adjusting for potential confounders such as age, lifestyle, and prevalent diseases., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Rañó-Santamaría, Fernandez-Merino, Castaño-Carou, Lado-Baleato, Fernández-Domínguez, Sanchez-Castro and Gude.)

This article aims to analyse the excited delirium syndrome, especially, when Law Enforcement Officers have to make use of force and deaths in custody occur. Through a bibliographic review, inferences have been obtained to identify, in first place, what a death in custody is and the differences between positional asphyxia and excited delirium syndrome. Subsequently, we have summarized the major findings that the medical examiner should look for in order to diagnose the excited delirium syndrome from the scene examination, the autopsy and the complementary analysis. Finally, we propose some directives that may help to avoid the death of these subjects and to study them in case they occur., (Copyright © 2022. Published by Elsevier Ltd.)

Objective: Registers of diagnoses and treatments exist in different forms in the European countries and are potential sources to answer important research questions. Prevalence and incidence of thyroid diseases are highly dependent on iodine intake and, thus, iodine deficiency disease prevention programs. We aimed to collect European register data on thyroid outcomes to compare the rates between countries/regions with different iodine status and prevention programs., Design: Register-based cross-sectional study., Methods: National register data on thyroid diagnoses and treatments were requested from 23 European countries/regions. The provided data were critically assessed for suitability for comparison between countries/regions. Sex- and age-standardized rates were calculated., Results: Register data on ≥1 thyroid diagnoses or treatments were available from 22 countries/regions. After critical assessment, data on medication, surgery, and cancer were found suitable for comparison between 9, 10, and 13 countries/regions, respectively. Higher rates of antithyroid medication and thyroid surgery for benign disease and lower rates of thyroid hormone therapy were found for countries with iodine insufficiency before approx. 2001, and no relationship was observed with recent iodine intake or prevention programs., Conclusions: The collation of register data on thyroid outcomes from European countries is impeded by a high degree of heterogeneity in the availability and quality of data between countries. Nevertheless, a relationship between historic iodine intake and rates of treatments for hyper- and hypothyroid disorders is indicated. This study illustrates both the challenges and the potential for the application of register data of thyroid outcomes across Europe.

Batoids, distributed from shallow to abyssal depths, are considerably vulnerable to anthropogenic threats. Data deficiencies on the distribution patterns of batoids, however, challenge their effective management and conservation. In this study, we took advantage of the particular geological and geomorphological configuration of the Canary Islands, across an east-to-west gradient in the eastern Atlantic Ocean, to assess whether patterns in the occurrence and abundance of batoids varied between groups of islands (western, central, and eastern). Data were collected from shallow (<40 m, via underwater visual counts and by a local community science program) and deep waters (60-700 m, via ROV deployments). Eleven species of batoids, assessed by the IUCN Red List of Threatened Species, were registered, including three "Critically Endangered" ( Aetomylaeus bovinus , Dipturus batis , and Myliobatis aquila ), three "Endangered" ( Gymnura altavela , Mobula mobular , and Rostroraja alba ), two "Vulnerable" ( Dasyatis pastinaca and Raja maderenseis ), and two "Data Deficient" ( Taeniurops grabata and Torpedo marmorata ). Also, a "Least Concern" species ( Bathytoshia lata ) was observed. Overall, batoids were ~1 to 2 orders of magnitude more abundant in the central and eastern islands, relative to the western islands. This pattern was consistent among the three sources of data and for both shallow and deep waters. This study, therefore, shows differences in the abundance of batoids across an oceanic archipelago, likely related to varying insular shelf area, availability of habitats, and proximity to the nearby continental (African) mass. Large variation in population abundances among islands suggests that "whole" archipelago management strategies are unlikely to provide adequate conservation. Instead, management plans should be adjusted individually per island and complemented with focused research to fill data gaps on the spatial use and movements of these iconic species., Competing Interests: None declared., (© 2021 The Authors. Ecology and Evolution published by John Wiley & Sons Ltd.)

Covid-19 pandemic has affected worldwide in many different ways. Fisheries around the world are not an exception due to the long-term isolation and the non-activities period suffered. To do an evaluation of its impact on the fishing sectors in the Canary Islands, 87 online and phone questionnaires were carried out between July and September 2020, conducting the interviews to artisanal fishermen, fishmongers, recreational charter boats fishermen and tackle shops along the archipelago. Both, the artisanal and recreational fishing sectors have been affected by this pandemic, but in an unequal manner. The drop of the demand of fresh fishing products in the islands markets due to the closure of hotels, restaurants and other services, and the highly significant decreasing in the number of tourists, provoked an estimated income loss for the artisanal fishermen about the 40% on average, but the majority of vessels continued their activities during the pandemic, with very limited effects on direct employment. However, the fishmonger's activity apparently was not affected and increased their monthly income in relation to the previous year. Likewise, the infeasibility of fishing charter companies due to the great reduction in the number of tourists contrasted with the significant increase in the number of recreational fishing licenses immediately after the confinement ended. Even though that fishing tackle shops increased sales by over 60% in relation to the similar period of the year before, only 4.4% of these shops declared not to have had economic losses., Competing Interests: None., (© 2021 The Authors.)

Understanding the regulation of cellular AA uptake as protein supply changes is critical for predicting milk component yields because intracellular supplies partly regulate protein synthesis. Our objective was to evaluate cellular uptake and kinetic behavior of individual AA when cells are presented with varying extracellular AA supplies. Bovine primary mammary epithelial cells were grown to confluency and transferred to medium with an AA profile and concentration similar to that of plasma from dairy cows for 24 h. Treatments were 4 AA concentrations, 0.36, 2.30, 4.28, and 6.24 mM, which represented 16, 100, 186, and 271% of typical plasma AA concentrations, respectively, in lactating dairy cows. Twenty-four plates of cells (89.4 × 19.2 mm) were assigned to each treatment. Cells were first subjected to treatment medium enriched with 15 N-labeled AA for 24 h and then incubated with treatment medium enriched with 13 C-labeled AA for 0, 15, 60, 300, 900, 1,800, and 3,600 s. Intracellular free AA, intracellular protein-bound AA, and extracellular medium free AA were analyzed for concentrations and isotopic enrichment using gas chromatography-mass spectrometry. A dynamic, 12-pool model was fitted to the data for 14 AA to derive unidirectional uptake and efflux, protein turnover, transamination, oxidation, and synthesis. The derived concentration for half the maximal uptake (k m ) indicated no saturation of AA uptake at typical in vivo concentrations for 11 of the 14 AA. Arginine, Pro, and Val appeared to exhibit saturation kinetics. Net uptake of all essential AA except Phe was positive across treatments. Most nonessential AA exhibited negative net uptake values. Efflux of AA was quite high, with several AA exhibiting greater than 100% efflux of the respective influx. Intracellular pool turnover was rapid for most AA (e.g., 2 min for Arg), demonstrating plasticity in matching needs for protein translation to supplies. Intracellular AA concentrations increased linearly in response to treatment for most AA, whereas 9 AA exhibited quadratic responses. Amino acid uptake is responsive to varying extracellular supplies to maintain homeostasis. No saturation of uptake was evident for most AA, indicating that transporter capacity is likely not a limitation for most AA except possibly Arg, Val, and Pro in mammary epithelial cells., (Copyright © 2021 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

Rhinosporidiosis is a chronic mucosal infection caused by Rhinosporidium seeberi, an aquatic protistan parasite. It presents as nasal or ocular polypoidal or vascularized masses. It is endemic in tropical and subtropical areas, especially in South Asia; R. seeberi´s endemicity in the Americas is often overlooked. The objective of this study was to describe the demographic and clinical characteristics of patients with rhinosporidiosis in the Americas, its management, and patient outcomes. This study is a systematic review of cases of human rhinosporidiosis in the Americas reported in the literature from 1896 to February 28, 2019. This review screened 1,994 reports, of which 115 were eligible for further analysis. The selected reports described 286 cases of human rhinosporidiosis between 1896 and 2019. Cases were diagnosed in Brazil (32.2%), Colombia (24.4%), Paraguay (12.6%), and the United States (11.9%). The majority of the cases (91%) occurred in geographic areas with altitudes < 1,000 m above sea level and in areas with median temperatures ≥ 25°C (67.3%). Most of the patients presented nasal (65%) and ocular involvement (35%). Surgical treatment was provided for 99.6% of patients, but 19.8% of them recurred. This review describes the under-recognized geographic distribution and clinical presentation of rhinosporidiosis in the Americas and highlights clinical differences to cases in Asia, specifically in reference to a higher prevalence of ocular disease and higher relapse rates.

Ticagrelor is anantiplatelet agent which acts through reversible binding to the P2Y12 adenosine-diphosphate receptors. In acute coronary syndromes it has been shown to reduce the risk of major cardiovascular events such as myocardial infarction, stroke and death. Although some hemorrhagic, kidney, liver and respiratory complications have been described in detail with the use of ticagrelor, other less frequent adverse effects are not so well clarified. We report the case of a patient with a systemic inflammatory response syndrome secondary to the use of ticagrelor.

Understanding uptake of AA by mammary tissue as supply varies is critical for predicting milk component production. Our objective was to develop an in vitro method to quantify cellular uptake, efflux, and intracellular metabolism of individual AA that could be implemented for evaluating these factors when AA supply and profile are varied. Bovine primary mammary epithelial cells were grown to confluency and exposed to medium with an AA profile and concentration similar to lactating dairy cow plasma for 24 h. Cells were then preloaded in medium enriched with 15 N-labeled AA for 24 h followed by removal of the 15 N-labeled medium and incubation with medium enriched with 13 C-labeled AA for 0, 15, 60, 300, 900, 1,800, and 3,600 s. Extracellular free AA and intracellular free and protein-bound AA were analyzed for concentrations and isotopic enrichment by gas chromatography-mass spectrometry. A dynamic, 12-pool model was constructed representing extracellular and intracellular free and protein-bound pools of an AA, and their respective 15 N and 13 C isotopes. Markov chain Monte Carlo simulation (n = 5,000) was conducted to evaluate prediction errors by deriving standard errors and posterior distributions for rate constants, fluxes, and pools. Cellular Ala influx and efflux were higher than Leu, reflecting Ala role in driving system L transport and the high capacity of sodium-dependent transport. The Ala and Leu turnover rates were 181 and 95, 580 and 857, and 74 and 157% per hour for extracellular, intracellular, and fast protein-bound pools, respectively. The intracellular and extracellular Ala to Leu ratios were quite different, meaning the blood AA profile is not the AA profile provided for protein translation. The high level of exchange and rapid turnover of pools provide a mechanism for matching the AA supplies to the precision necessary for translation. This also understates the importance of using experimental medium similar to what is observed in vivo given that some AA depend on other AA for influx (exchange driven). The average root mean squared prediction error across the isotope enrichments, pools, and concentrations was 9.7 and 14.1% for Ala and Leu, respectively, and collinearity among parameters was low, indicating adequate fit and identifiability. The described model provides insight on individual AA transport kinetics and a method for future evaluation of AA transport and intracellular metabolism when subjected to varying AA supplies., (Copyright © 2020 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

Notoscopelus resplendens is an abundant myctophid in the region of the Central-Eastern Atlantic. As with a majority of other myctophid species, this species performs vertical migration, playing a key role in the oceanic food web and in carbon sequestration. We examined the reproductive biology of N. resplendens based on 579 specimens caught between 1997 and 2002 off the Canary Islands. We found that the maximum standard length (SL) was lower than the size reported by other authors. The sex ratio was not different from 1:1. The average size at first maturity (L 50 ) was higher in females (60.34 mm SL) than in males (56.61 mm SL). The gonadosomatic index (GSI) at 50% sexual maturity in females was higher than that in males. The reproductive activity was observed from January to April, while from May onwards, the majority of fish caught were in the process of maturation. The macroscopic scale of maturation was validated through the histological analysis of the ovarian development. The batch fecundity was related to the standard length, with an average of 1068.69 ± 369.84 eggs/spawn. These first data obtained for N. resplendens indicated that it is a batch spawner with asynchronous ovarian development.

Background: Knowledge about the population's iodine status is important, because it allows adjustment of iodine supply and prevention of iodine deficiency. The validity and comparability of iodine-related population studies can be improved by standardization, which was one of the goals of the EUthyroid project. The aim of this study was to establish the first standardized map of iodine status in Europe by using standardized urinary iodine concentration (UIC) data. Materials and Methods: We established a gold-standard laboratory in Helsinki measuring UIC by inductively coupled plasma mass spectrometry. A total of 40 studies from 23 European countries provided 75 urine samples covering the whole range of concentrations. Conversion formulas for UIC derived from the gold-standard values were established by linear regression models and were used to postharmonize the studies by standardizing the UIC data of the individual studies. Results: In comparison with the EUthyroid gold-standard, mean UIC measurements were higher in 11 laboratories and lower in 10 laboratories. The mean differences ranged from -36.6% to 49.5%. Of the 40 postharmonized studies providing data for the standardization, 16 were conducted in schoolchildren, 13 in adults, and 11 in pregnant women. Median standardized UIC was <100 μg/L in 1 out of 16 (6.3%) studies in schoolchildren, while in adults 7 out of 13 (53.8%) studies had a median standardized UIC <100 μg/L. Seven out of 11 (63.6%) studies in pregnant women revealed a median UIC <150 μg/L. Conclusions: We demonstrate that iodine deficiency is still present in Europe, using standardized data from a large number of studies. Adults and pregnant women, particularly, are at risk for iodine deficiency, which calls for action. For instance, a more uniform European legislation on iodine fortification is warranted to ensure that noniodized salt is replaced by iodized salt more often. In addition, further efforts should be put on harmonizing iodine-related studies and iodine measurements to improve the validity and comparability of results.

Traditionally, the medial temporal lobe has been considered a key brain region for spatial memory. Nevertheless, executive functions, such as working memory, also play an important role in complex behaviors, such as spatial navigation. Thus, the main goal of this study is to clarify the relationship between working memory capacity and spatial memory performance. Spatial memory was assessed using a virtual reality-based procedure, the Boxes Room task, and the visual working memory with the computer-based Change Localization Task. One hundred and twenty-three ( n = 123) participants took part in this study. Analysis of Covariance (ANCOVA) revealed a statistically significant relationship between working memory capacity and spatial abilities. Thereafter, two subgroups n = 60, were formed according to their performance in the working memory task (1st and 4th quartiles, n = 30 each). Results demonstrate that participants with high working memory capacity committed fewer mistakes in the spatial task compared to the low working memory capacity group. Both groups improved their performance through repeated trials of the spatial task, thus showing that they could learn spatial layouts independent of their working memory capacity. In conclusion, these findings support that spatial memory performance is directly related to working memory skills. This could be relevant for spatial memory assessment in brain lesioned patients.

Extracellular amino acid profiles affect intracellular AA concentrations and profile as well as signaling proteins that regulate protein translation rates. The objective of this study was to assess whether various extracellular AA profiles and varied ratios of Lys to Met would increase the phosphorylation of signaling proteins related to protein metabolism. Six AA profiles, reflecting Dulbecco's modified Eagle's medium (DMEM), blood meal (BM), corn gluten meal (CGM), casein (CAS), plasma of lactating cows (PLA), and a negative control (NEG) represented the first factor (F1), and the ratio of Lys to Met (unaltered or set to 3:1) was the second factor (F2). Treatments were arranged in a 6 × 2 factorial manner, resulting in 12 treatments that were replicated 4 times. The total AA masses for all treatments were set to 659 mg/L (63% of DMEM) except NEG (0 mg/L). Confluent mammary epithelial cells were exposed to treatment media for 80 min (SD = 7.4). Intracellular concentrations of 17 AA were changed according to F1. The Met and Leu percent of total intracellular AA mass, as an example, varied from 0.58 (PLA) to 6.94 (NEG, +F2) for Met and 0.05 (NEG, -F2) to 4.63 (CGM, +F2) for Leu. Overall, balancing for Lys and Met at a 3:1 ratio increased intracellular concentrations of Lys and Met by 54 and 71%, respectively. Within the mechanistic target of rapamycin (mTOR) pathway, phosphorylation of mTOR (Ser2448), ribosomal protein S6 (Ser235/236), and eukaryotic initiation factor 4E binding protein 1 (Thr37/46) (4EBP1) were increased by all 5 AA profiles compared with the NEG control. We found no differences in phosphorylation state among the 5 AA profiles, indicating lack of sensitivity to various AA profiles. This lack of sensitivity between AA profiles might also be due to assay imprecision or other experimental limitations. Only phosphorylation of 4EBP1 was increased for F2. Phosphorylation of eukaryotic initiation factor 2 α subunit (Ser51) was unaffected by either F1 or F2 factors. Regression analyses indicated that intracellular concentrations of Met, Thr, Ile, and Leu predicted phosphorylation of mTOR-related proteins with adequate precision and accuracy, suggesting that multiple EAA dictate regulation, regardless of AA ratios. Changes in extracellular AA profiles translated to modified intracellular AA profiles, and no single profile uniquely stimulated phosphorylation of the mTOR pathway-related proteins., (Copyright © 2019 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

In this study, we used a historical collection of photographs taken by recreational fishers from 1940 to 2014, at the island of Gran Canaria, to show both a significant decrease in the mean total length of Epinephelus marginatus and a concurrent change in the composition of captures. Before 1980, the mean total length of fish caught and photographed was c. 100 cm, while after 2009 this was typically < 40 cm. Before 1980, the predominant captured species was E. marginatus (an apex predator), but currently the majority of catches are of omnivorous species, in particular the parrotfish, Sparisoma cretense and seabreams Diplodus spp. Overall, integration of these results indicates a qualitative and quantitative variation in captures of recreational fishers, probably as a sign of change in ecological balances and the overfished status of many target species., (© 2019 The Fisheries Society of the British Isles.)

In this paper we consider what may happen to the marine ecosystem of Gran Canaria Island within the 2030 horizon, if fishing strategies different from those currently in place were implemented and we evaluate the effect of, for example, reduction of recreational-artisanal fishing, limitation of catches (e.g. total allowable catches, TAC), or spatial distribution of fishing sectors. From all scenarios tested, only those that significantly reduce the high effort of the recreational fishing would allow the recovery of the most exploited stocks in the marine ecosystem in the short and medium-term. Moreover, the best management strategy, in contribution to abundance, was obtained with a scenario that has a spatial partition of exploitation rights between artisanal and recreational fishermen and includes no-fishing zones (NTZ). This work is a first attempt to use spatial and temporal models to assess the effectiveness of alternative fishery policies in the Canary Islands., (© 2019 The Fisheries Society of the British Isles.)

Introduction: Fetal growth restriction may be the consequence of maternal, fetal, or placental factors. The insulin-like growth factors (IGFs) are major determinants of fetal growth, and are expressed in the mother, fetus and placenta in most species. Previously we reported higher placental protein content of IGF-I, IGF-IR, and AKT in small (SGA) compared with those from appropriate for gestational age (AGA) placentas. The protein Klotho, has been reported in placenta and may regulate IGF-I activity. In this study we determined Klotho gene expression and protein immunostaining in term (T-SGA y T-AGA) and preterm (PT-SGA y PT-AGA) human placentas. In addition, we assessed the effect of Klotho on the IGF-IR and AKT activation induced by IGF-I. Methods: Placentas ( n = 1 17) from 32 T-SGA (birth weight (BW) = -1.74 ± 0.08 SDS), 37 T-AGA (BW = 0.12 ± 0.12 SDS), 20 PT-SGA (BW = -2.08 ± 0.14 SDS), and 28 PT-AGA (BW = -0.43 ± 0.13 SDS) newborns were collected. mRNA expression by RT-PCR in the chorionic (CP) and basal (BP) plates of the placentas, and the presence of Klotho was evaluated by immunohistochemistry (integral optical density, IOD). In addition, we developed placental explants that were incubated with IGF-I in the presence or absence of Klotho. Results: We found a lower mRNA expression and protein immunoreactivity of Klotho in the CP of SGA (term and preterm) compared with AGA placentas. We also observed a significant reduction in IGF-IR tyrosine activation induced by IGF-I 10 nM when preincubated with 2.0 nM of Klotho (2.4 ± 0.5 arbitrary units vs. 1.3 ± 0.3 AU), and similar results we observed on AKT and ERK 42/44 activation. Conclusion: We describe for the first time that Klotho mRNA and protein varies according to fetal growth and gestational age. In addition, Klotho appears to down-regulate the activation induced by IGF-I on IGF-IR and AKT, suggesting that Klotho may be regulating IGF-I activity in human placentas according to intrauterine fetal growth.

Introduction: Chronic pain (CP) is highly prevalent and generally undertreated health condition. Noninvasive brain stimulation may contribute to decrease pain intensity and influence other aspects related to CP., Objective: To provide consensus-based recommendations for the use of noninvasive brain stimulation in clinical practice., Methods: Systematic review of the literature searching for randomized clinical trials followed by consensus panel. Recommendations also involved a cost-estimation study., Results: The systematic review wielded 24 transcranial direct current stimulation (tDCS) and 22 repetitive transcranial magnetic stimulation (rTMS) studies. The following recommendations were provided: (1) Level A for anodal tDCS over the primary motor cortex (M1) in fibromyalgia, and level B for peripheral neuropathic pain, abdominal pain, and migraine; bifrontal (F3/F4) tDCS and M1 high-definition (HD)-tDCS for fibromyalgia; Oz/Cz tDCS for migraine and for secondary benefits such as improvement in quality of life, decrease in anxiety, and increase in pressure pain threshold; (2) level A recommendation for high-frequency (HF) rTMS over M1 for fibromyalgia and neuropathic pain, and level B for myofascial or musculoskeletal pain, complex regional pain syndrome, and migraine; (3) level A recommendation against the use of anodal M1 tDCS for low back pain; and (4) level B recommendation against the use of HF rTMS over the left dorsolateral prefrontal cortex in the control of pain., Conclusion: Transcranial DCS and rTMS are recommended techniques to be used in the control of CP conditions, with low to moderate analgesic effects, and no severe adverse events. These recommendations are based on a systematic review of the literature and a consensus made by experts in the field. Readers should use it as part of the resources available to decision-making., Competing Interests: Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

This paper investigates the effect that texting with WhatsApp, one of the most common applications for instant messaging, exerts on driving performance. Because distracted driving also affects older drivers, who can have seriously compromised vision, we also analysed the associations between visual-function parameters and driving performance. A total of 75 drivers, experienced in sending WhatsApp messages (≥10WhatsApp messages/week), participated in this study and were divided into four age categories. Visual-function tests included contrast sensitivity with and without glare, retinal straylight and objective assessment of optical quality. Simulated driving performance was assessed under a baseline driving condition (without distraction) as well as a texting condition (WhatsApp messages) while driving. The participants used their own mobile phone. Lastly, objective results of driving performance were compared with subjective self-report data from the Driver Behaviour Questionnaire (DBQ). The analysis indicated that functional changes occurring with age, such as a lower contrast sensitivity and greater retinal straylight, were correlated with a higher number of collisions, longer distances driven outside the lane, and greater standard deviation of lateral position (SDLP). The results showed a significant main effect of age for the driving-performance parameters. Also, compared to the baseline, texting WhatsApp messages while driving worsens driving performance for all age groups, most notably among older participants. Thus, the older drivers' SDLP was ∼14% higher than that for the baseline average of all the other drivers and rose to 29% under distraction, reflecting the impact of secondary tasks. The negative effect of the use of the smartphone during driving was also reflected in the number of collisions, with a greater risk of accidents in all the groups of drivers (by 8.3% for young adults, 25.0% for adults, 80.5% for middle-aged adults, and 134.5% for older drivers). Lastly, participants' subjective responses indicated that younger drivers (18-24 years) had a higher risk of deliberately violating safe driving practices (p < 0.05). The present study demonstrates that texting WhatsApp messages while driving significantly impairs the ability to drive safely, with older drivers being the group most adversely affected. It would be recommendable to include other nonstandard vision tests, which have shown associations with driving performance, in the examination for driver licensing. This would help raise the awareness of older drivers concerning their visual limitations, permitting them to adopt compensatory measures to improve their driving safety. Nevertheless, it is also necessary to raise awareness among the younger drivers of the risks involved in behaviour behind the wheel., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Purpose: To analyze stereoscopic vision under a broad range of experimental conditions simulating small-aperture corneal inlay and monovision conditions., Methods: A total of 10 patients participated in the study. The anisocoria generated by corneal inlays was simulated by using a small-aperture contact lens fitted on the non-dominant eye. Visual acuity, contrast sensitivity function, visual discrimination capacity (halo perception), and stereoacuity tests were performed under natural conditions or when the non-dominant eye wore the small-aperture contact lens under two conditions: induced anisocoria and induced anisocoria combined with monovision (using two add-powers: +0.75 and +1.25 diopters [D]). Stereoscopic vision and binocular summation were analyzed under those experimental conditions and for far, intermediate, and near vision., Results: The results showed a deterioration in stereoacuity with respect to natural conditions, being significant mainly for near and intermediate distances. Results with other visual functions showed a deterioration of the binocular summation and therefore of visual performance, although not in a generalized way for all distances. Binocular visual acuity under the conditions that used the small-aperture contact lens was comparable to that of the natural eye., Conclusions: The deterioration of stereopsis and other binocular functions found in this study may be acceptable for patients who had this surgical technique because it is similar to the deterioration found in other surgical procedures of emmetropization. [J Refract Surg. 2018;34(7):482-488.]., (Copyright 2018, SLACK Incorporated.)

Background: Eosinophilic esophagitis (EoE) is the most common cause of dysphagia and esophageal food impaction (EFI) in the USA, Western Europe, and Australia. In Mexico, the uncomplicated form of this disease is infrequent, and prevalence in patients with EFI is unknown., Aims: To determine the prevalence and causes of EFI, endoscopic and therapeutic aspects, and establish the prevalence of biopsy-proven EoE in patients with EFI., Methods: Diagnostic upper gastrointestinal endoscopy reports from January 2011 to December 2016 were retrospectively reviewed. Patients with therapeutic procedures, gastrointestinal hemorrhage, or non-food foreign body impaction were excluded. The number of patients with EFI was determined. Additionally, patients with esophageal biopsy were retained for EoE prevalence calculation. The diagnosis of EoE was defined with the presence of eosinophil infiltration count ≥ 15/high-power field with or without typical endoscopic abnormalities., Results: A total of 4700 reports of the same number of patients were selected; 2209 were males (47%) with a mean age of 57.6 ± 12.3 years (range 14-93). We identified 36 patients with EFI (0.76, 95% CI 0.51-1.01), 16 males (44.4%) with a mean age of 54.9 ± 19.7 (range 22-92). Esophageal biopsies were obtained in 17/36 (47.2%) cases. The diagnosis of EoE was confirmed in 2 patients (11.7%). Peptic stenosis was the most frequent cause of EFI., Conclusions: EoE is an infrequent cause of EFI in the Mexican population (11.7%). EoE had the lowest prevalence compared to that reported in Caucasian populations. The prevalence of EFI was also low.

Astatine-211 is considered to be one of the most promising alpha-emitters in targeted alpha therapy (TAT). However, its development has been hindered by its not so well understood chemistry. Hence, any attempt to understanding it better is imperative. Here, we show through DFT calculations that the neutral endohedral Al13 cluster follows a reactivity pattern very similar to At, more than any other halogen. The halogen and alkali bonding with Al13 and At presented a strong similarity in their charge transfer processes. Moreover, upon the interchange of At with Al13, we found a stable configuration of the compound corresponding to the astatination of aryliodonium salts, which have been considered as possible precursors for the synthesis of 211At-labeled tracers. Our results provide promising proof of concept that the Al13 cluster mimics the behaviour of At and might help in better understanding its chemistry and in streamlining the chemical processes of radiolabeling biomolecules.

Pain is highly prevalent among the adult Latin American population. However, many patients with moderate to severe pain do not have access to effective pain management with opioids due to limited access to healthcare, overuse of nonopioid analgesics, regulatory barriers and lack of appropriate information about opioids. There is scarce training on use of opioids among physicians and other healthcare providers, which leads to misconceptions, mainly related to a fear of prescribing opioids. Although opioids are safe and effective drugs for the treatment of moderate to severe chronic pain, the use of opioids in Latin American nations is clearly below standards compared with developed countries.

Objective: Chronic pain conditions profoundly affect the daily living of a significant number of people and are a major economic and social burden, particularly in developing countries. The Change Pain Latin America (CPLA) advisory panel aimed to identify the most appropriate guidelines for the treatment of neuropathic pain (NP) and chronic low back pain (CLBP) for use across Latin America., Methods: Published systematic reviews or practice guidelines were identified by a systematic search of PubMed, the Guidelines Clearinghouse, and Google. Articles were screened by an independent reviewer, and potential candidate guidelines were selected for more in-depth review. A shortlist of suitable guidelines was selected and critically evaluated by the CPLA advisory panel., Results: Searches identified 674 and 604 guideline articles for NP and CLBP, respectively. Of these, 14 guidelines were shortlisted for consensus consideration, with the following final selections made: "Recommendations for the pharmacological management of neuropathic pain from the Neuropathic Pain Special Interest Group in 2015-pharmacotherapy for neuropathic pain in adults: A systematic review and meta-analysis.""Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society" (2007)., Conclusions: The selected guidelines were endorsed by all members of the CPLA advisory board as the best fit for use across Latin America. In addition, regional considerations were discussed and recorded. We have included this expert local insight and advice to enhance the implementation of each guideline across all Latin American countries.

Objective: Change Pain Latin America (CPLA) was created to enhance chronic pain understanding and develop pain management improving strategies in this region. During its seventh meeting (August 2016), the main objective was to discuss tramadol's role in treating pain in Latin America. Furthermore, potential pain management consequences were considered, if tramadol was to become more stringently controlled., Methods: Key topics discussed were: main indications for prescribing tramadol, its pharmacological characteristics, safety and tolerability, effects of restrictions on its availability and use, and consequent impact on pain care quality., Results: The experts agreed that tramadol is used to treat a wide spectrum of non-oncological pain conditions (e.g. post-surgical, musculoskeletal, post-traumatic, neuropathic, fibromyalgia), as well as cancer pain. Its relevance when treating special patient groups (e.g. the elderly) is recognized. The main reasons for tramadol's high significance as a treatment option are: its broad efficacy, an inconspicuous safety profile and its availability, considering that access to strong analgesics - mainly controlled drugs (classical opioids) - is highly restricted in some countries. The CPLA also agreed that tramadol is well tolerated, without the safety issues associated with long-term nonsteroidal anti-inflammatory drug (NSAID) use, with fewer opioid-like side effects than classical opioids and lower abuse risk., Conclusions: In Latin America, tramadol is a valuable and frequently used medication for treating moderate to severe pain. More stringent regulations would have significant impact on its availability, especially for outpatients. This could cause regression to older and frequently inadequate pain management methods, resulting in unnecessary suffering for many Latin American patients.

Aim: Latin-American experts in the use of opioids in patients with chronic nononcologic pain (CNOP) have updated existing recommendations to current Latin-American reality., Methods: Several key opinion leaders from Latin America participated in a face-to-face meeting in Guatemala (April 2015) to discuss the use of opioids in CNOP. Subgroups of experts worked on specific topics, reviewed the literature and shaped the final manuscript., Results: The expert panel developed guidelines taking into consideration the utility of both opioid and nonopioid analgesics and factors pertaining to their efficacy, safety, adherence, administration and risks for abuse/addiction., Conclusion: Latin-American guidelines for the use of opioids in CNOP should improve pain relief and patients' quality of life by increasing access to these effective agents.

Background: The latest terrorist attacks in Europe and in the rest of the world, and the military experience in the most recent conflicts leave us with several lessons learned. The most important is that the fate of the wounded rests in the hands of the one who applies the first dressing, because the victims usually die within the first 10 minutes, before professional care providers or police personnel arrive at the scene. A second lesson is that the primary cause of preventable death in these types of incidents involving explosives and firearms is massive hemorraghe., Objective: There is a need to develop a training oriented to citizens so they can identify and use available resources to avoid preventable deaths that occur in this kind of incidents, especially massive hemorrhage., Methods: A 7-hour training intervention program was developed and conducted between January and May 2017. Data were collected from participants' answers on a multiple-choice test before and after undertaking the training. Improved mean score for at least 75% of a group's members on the posttraining test was considered reflective of adequate knowledge., Results: A total of 173 participants (n = 74 men [42.8%]; n = 99 women [57.2%]) attended the training. They were classified into three groups: a group of citizens/ first responders with no prior health training, a group of health professionals, and a group of nursing students. Significant differences (ρ < .05) between mean pre- and post-training test scores occurred in each of the three groups., Conclusion: There was a clear improvement in the knowledge of the students after the training when pre- and post-training test scores were compared within the three groups. The greatest improvement was seen in the citizens/first responders group., (2017.)

The objective of this work was to assess the effects of age and gastrointestinal location (rumen vs. colon) on bacterial community diversity and composition, as well as short-chain fatty acid profiles of preruminant male Holstein calves on an intensive milk replacer feeding program. Thirty-two calves were fed at 2% of their body weight (dry matter basis) from d 10 until harvest. Sixteen calves were euthanized at 2wk and another 16 at 4wk of age to collect digesta samples from the rumen and colon. The rumen and colon bacterial communities of preruminant calves showed a similar degree of diversity (i.e., Shannon index) whereas composition differed considerably. The colonic bacterial population was characterized by dominance of lactic acid bacteria such as Lactobacillus, Streptococcus, Enterococcus, and Bifidobacterium. In addition, colonic short-chain fatty acid and lactic acid concentrations were between 50 and 850% higher than in the rumen, indicating greater fermentative activity in the colon. On the other hand, in the rumen, no genus over-dominated and more variation was present among calves. Because of an active reticular groove and low starter grain intake during the first 1 to 3wk of life, ruminal fermentation may not contribute to significant metabolizable energy supply until after 4wk of life in intensively fed calves. Until then, calf hindgut fermentation, characterized by high abundance of lactic acid bacteria along with increased lactate and butyrate concentrations, could be beneficial for intestinal health and survival of the calf during the first weeks of life., (Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

Digestive disorders are common during the first few weeks of life of newborn calves. Prebiotics are nondigestible but fermentable oligosaccharides that modulate growth and activity of beneficial microbial populations, which can result in enhanced gut health and function. Galactooligosaccharides (GOS) have demonstrated such prebiotic potential. In this study, the effect of GOS supplementation on intestinal bacterial community composition and fermentation profiles; intestinal health, development, and function; and growth was evaluated in dairy calves fed for high rates of growth. Eighty male Holstein calves were assigned either to a control treatment consisting of commercial milk replacer or to a GOS-rich (i.e., 3.4% of dry matter) milk replacer treatment. After 2 and 4wk, 8 calves per treatment were slaughtered at each age. Samples of intestinal digesta and tissue were collected for assessment of bacterial communities, short-chain fatty acid concentrations, in vitro measurement of nutrient transport and permeability, histomorphology, and gastrointestinal organ size. The remaining 48 calves continued to wk 8 to measure body growth, nutrient intake, and fecal and respiratory scores. Calves fed GOS displayed greater Lactobacillus and Bifidobacterium relative abundance and more developed intestinal epithelial structures, but also had greater fecal scores presumably related to greater colonic water secretion. Control calves showed slightly better growth and milk dry matter intake. Size of intestinal organs, intestinal nutrient transport, and epithelium paracellular resistance were not affected by treatment. Excessive GOS supplementation had both prebiotic and laxative effects, which led to slightly lower growth performance while promoting commensal bacteria population and greater intestinal epithelium growth., (Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

Purpose: The objective of this study was to evaluate, by halometry and under low illumination conditions, the effects of short-wavelength light absorbance filters on visual discrimination capacity in retinitis pigmentosa patients., Methods: This was an observational, prospective, analytic, and transversal study on 109 eyes of 57 retinitis pigmentosa patients with visual acuity better than 1.25 logMAR. Visual disturbance index (VDI) was determined using the software Halo 1.0, with and without the interposition of filters which absorb (totally or partially) short-wavelength light between 380 and 500 nm., Results: A statistically significant reduction in the VDI values determined using filters which absorb short-wavelength light was observed (p < 0.0001). The established VDIs in patients with VA logMAR <0.4 were 0.30 ± 0.05 (95% CI, 0.26-0.36) for the lens alone, 0.20 ± 0.04 (95% CI, 0.16-0.24) with the filter that completely absorbs wavelengths shorter than 450 nm, and 0.24 ± 0.04 (95% CI, 0.20-0.28) with the filter that partially absorbs wavelengths shorter than 450 nm, which implies a 20 to 33% visual discrimination capacity increase. In addition, a decrease of VDI in at least one eye was observed in more than 90% of patients when using a filter., Conclusions: Short-wavelength light absorbance filters increase visual discrimination capacity under low illumination conditions in retinitis pigmentosa patients. Use of such filters constitutes a suitable method to improve visual quality related to intraocular light visual disturbances under low illumination conditions in this group of patients.