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Aims: To explore the efficacy of extracorporeal shockwave therapy (ESWT) in the treatment of osteochondral defect (OCD), and its effects on the levels of transforming growth factor (TGF)-β, bone morphogenetic protein (BMP)-2, -3, -4, -5, and -7 in terms of cartilage and bone regeneration. Methods: The OCD lesion was created on the trochlear groove of left articular cartilage of femur per rat (40 rats in total). The experimental groups were Sham, OCD, and ESWT (0.25 mJ/mm2, 800 impulses, 4 Hz). The animals were euthanized at 2, 4, 8, and 12 weeks post-treatment, and histopathological analysis, micro-CT scanning, and immunohistochemical staining were performed for the specimens. Results: In the histopathological analysis, the macro-morphological grading scale showed a significant increase, while the histological score and cartilage repair scale of ESWT exhibited a significant decrease compared to OCD at the 8- and 12-week timepoints. At the 12-week follow-up, ESWT exhibited a significant improvement in the volume of damaged bone compared to OCD. Furthermore, immunohistochemistry analysis revealed a significant decrease in type I collagen and a significant increase in type II collagen within the newly formed hyaline cartilage following ESWT, compared to OCD. Finally, SRY-box transcription factor 9 (SOX9), aggrecan, and TGF-β, BMP-2, -3, -4, -5, and -7 were significantly higher in ESWT than in OCD at 12 weeks. Conclusion: ESWT promoted the effect of TGF-β/BMPs, thereby modulating the production of extracellular matrix proteins and transcription factor involved in the regeneration of articular cartilage and subchondral bone in an OCD rat model. Cite this article: Bone Joint Res 2024;13(7):342–352.

El advenimiento de la litotricia renal en la década de los 80 tuvo un efecto disruptivo en el tratamiento de los cálculos renales. El descubrimiento de los efectos biológicos de las ondas de choque expandió rápidamente el uso de este método terapéutico al campo de la Ortopedia y Traumatología. Si bien, en los últimos años, ha tenido un amplio desarrollo, persisten muchas confusiones y dudas en el ambiente de nuestra especialidad, sobre todo entre los profesionales que no están directamente involucrados en el tema. El objetivo de esta presentación es hacer un análisis de los puntos de controversia y las dudas más frecuentes, basado en la bibliografía científica.

La neuropatía del nervio supraescapular es una causa poco común de dolor y debilidad en el hombro y, por lo tanto, a menudo, es mal diagnosticada. Como consecuencia, el diagnóstico erróneo puede llevar a indicar un tratamiento conservador inapropiado o un procedimiento quirúrgico fallido. Se presenta el caso de un hombre de 55 años con síndrome de atrapamiento del nervio supraescapular. El paciente fue sometido a una artroscopia de hombro y se le diagnosticó una compresión del nervio supraescapular por el ligamento transverso escapular superior. La liberación artroscópica del nervio supraescapular alivió el dolor, la debilidad y la atrofia de los músculos supraespinoso e infraespinoso.

The modification of fire regimes and their impact on vegetation recovery, soil properties, and fuel structure are current key research areas that attempt to identify the thresholds of vegetation’s susceptibility to wildfires. This study aimed to evaluate the vulnerability of Mediterranean pine forests (Pinus halepensis Mill. and Pinus pinaster Aiton) to wildfires, analyzing two major forest fires that occurred in Yeste (Spain) in 1994 and 2017, affecting over 14,000 and 3200 hectares, respectively. Four recovery regions were identified based on fire severity—calculated using the delta Normalized Burn Ratio (dNBR) index—and recurrence: areas with high severity in 2017 but not in 1994 (UB94-HS17), areas with high severity in 1994 but not in 2017 (HS94-UB17), areas with high severity in both fires (HS94-HS17), and areas unaffected by either fire (UB94-UB17). The analysis focused on examining the recovery patterns of three spectral indices—the Normalized Difference Vegetation Index (NDVI), Normalized Moisture Index (NDMI), and Normalized Burn Ratio (NBR)—using the Google Earth Engine platform from 1990 to 2023. Additionally, the Relative Recovery Indicator (RRI), the Ratio of Eighty Percent (R80P), and the Year-on-Year average (YrYr) metrics were computed to assess the spectral recovery rates by region. These three spectral indices showed similar dynamic responses to fire. However, the Mann–Kendall and unit root statistical tests revealed that the NDVI and NDMI exhibited distinct trends, particularly in areas with recurrence (HS94-HS17). The NDVI outperformed the NBR and NDMI in distinguishing variations among regions. These results suggest accelerated vegetation spectral regrowth in the short term. The Vegetation Recovery Capacity After Fire (VRAF) index showed values from low to moderate, while the Vulnerability to Fire (V2FIRE) index exhibited values from medium to high across all recovery regions. These findings enhance our understanding of how vegetation recovers from fire and how vulnerable it is to fire.

El 28 de abril de 2021 se inició la ola de protestas más importante de la historia reciente de Colombia: el Paro Nacional. La reforma tributaria fue el principal punto de conflicto, que luego se trasladó a las políticas neoliberales del gobierno de Iván Duque, la violencia policial y la desigualdad, entre otros asuntos. Las protestas se cobraron la vida de más de 60 personas y movilizaron a miles de ciudadanos en todo el país, lo que acaparó la atención de la prensa nacional e internacional. Este artículo analiza el tratamiento informativo que los diarios de tirada nacional en España El País, El Mundo, La Vanguardia y abc concedieron a las protestas, para valorar qué importancia le otorgaron y apuntar de qué manera contribuyeron al conocimiento informativo de los españoles. La investigación se apoya en un análisis de contenido cuantitativo, en el que además de analizar la cobertura periodística se establece una comparación entre los cuatro periódicos seleccionados durante el primer mes desde el estallido. Las primeras conclusiones muestran que, si bien la cobertura fue casi diaria, no se abordó el tema en profundidad.

Wildfires are a natural part of the dynamics of Mediterranean forest ecosystems. The fire patterns in the Mediterranean basin have been altered mainly due to changes in land use and climate change. In 2017, a wildfire in Yeste (Spain) burned 3200 hectares of two Mediterranean pine forests. We investigated the effects of burn severity and postfire salvage logging practices on vegetation and soil properties in four experimental areas distributed within the wildfire perimeter. These areas included unburned, low, high, and high burn severity with salvage logging, all located under Pinus halepensis Mill and Pinus pinaster Aiton stands. Salvage logging was applied 18 months after the fire. We established 72 circular plots (nine per treatment and pine species). We collected soil samples to analyze physicochemical and biological soil properties, including pH, electrical conductivity (EC), soil organic matter (SOM) content, carbon from microbial biomass (CBM), basal soil respiration (BSR), metabolic quotient (qCO2), and two enzymatic activities: β-glucosidase (GLU) and phosphatase (PHP). To understand how vegetation changed after fire, we implemented three linear transects per plot to calculate α-diversity indices (richness, Shannon, and Simpson), vegetation coverage (COBV), fraction of bare soil (BSOIL), the number of postfire seedlings (NSeed) and their average height (Hm), and we grouped vegetation into different postfire adaptive strategies: facultative seeder (R+S+), obligate resprouter (R+S−), obligate seeder (R−S+), and non-fire-adapted (R−S−). We ran ANOVA and Tukey’s HSD post hoc tests to evaluate the differences between burn severity and salvage logging practices on the variables examined for each pine stand. We used PCA and correlation analysis to identify plant-soil interactions. Our results suggest that Pinus halepensis stands were more affected by the wildfire than Pinus pinaster stands due to the distinct characteristics of each species (morphology of the leaves, bark thickness, cone structure, etc.) and the significant differences observed in terms of pH, SOM, CBM, qCO2, GLU, PHP, and Nseed. The proportion of obligate resprouter species was higher in Pinus halepensis stands, and the obligate seeder species were higher in Pinus pinaster stands. The study highlighted the importance of monitoring burn severity and postfire management practices to promote forest recovery and reduce wildfire risk. Limiting the negative impact of postfire salvage logging practices can enhance the resilience of vulnerable ecosystems.

Un nivel de satisfacción laboral adecuado de los miembros del equipo de salud es esencial para garantizar una buena prestación de servicios, generar compromiso personal, estimular el deseo de actualización y fomentar la retención dentro del sistema. No hemos encontrado ninguna publicación que aborde específicamente este tema en el ámbito de la Ortopedia y Traumatología en nuestro medio. El objetivo de este estudio es conocer cómo perciben los especialistas que pertenecen a la Asociación Argentina de Cirugía de Hombro y Codo sus condiciones de trabajo, cuál es su remuneración y su grado de satisfacción y compararlos con equivalentes de otros países iberoamericanos. Los resultados de la encuesta mostraron niveles promedio de satisfacción bajos en los profesionales argentinos encuestados. Existen diferencias estadísticamente significativas con profesionales de otros países de Iberoamérica tanto en lo relativo a la remuneración como en los índices de bienestar. Si no se producen profundos cambios en el sistema de atención, la remuneración y las condiciones de trabajo, tarde o temprano aparecerán consecuencias que afectarán no solo a los profesionales, sino también a los pacientes y al sistema en general.

Introducción: Pocos cuestionarios para cuantificar y categorizar las limitaciones funcionales subjetivas y objetivas en la patología de hombro han sido traducidos al español de la Argentina. Objetivo: Realizar la estandarización, traducción y adaptación transcultural del Constant-Murley Score al español de la Argentina. Materiales y Métodos: La adaptación cultural se realizó siguiendo las etapas propuestas en la guía de la International Society of Pharmacoeconomic and Outcomes Research que establece las directrices para la traducción y adaptación cultural de medidas reportadas por los pacientes. Resultados: La versión traducida al español fue evaluada mediante entrevistas cognitivas en dos etapas. Posteriormente se reformularon preguntas para el mejor entendimiento de los elementos y sus opciones de respuesta y, dentro de cada apartado, se realizaron modificaciones específicas. Conclusión: Se logró realizar la traducción y adaptación transcultural del Constant-Murley Score, con lo que se obtuvo una herramienta para aplicar en la población argentina con patologías de hombro.

Metabolic reprogramming upon SIRT6 loss induces tumour formation in the intestine but the mechanism is unclear. Here, the authors show that loss of SIRT6 leads to the expansion of epithelial cells with high pyruvate dehydrogenase kinase activity resulting in enhanced stem cell activity and tumour-initiating potential

El acceso a la tecnología de planificación e impresión 3D está destinado a tener un impacto disruptivo en la práctica quirúrgica de la Ortopedia y Traumatología. Sus ventajas incluyen una mejor comprensión de las lesiones por tratar, mayor precisión técnica, acortamiento de los tiempos quirúrgicos, disminución de la pérdida sanguínea y menor exposición a los rayos. El objetivo de esta publicación es ofrecer una guía práctica paso a paso tomando como ejemplo el tratamiento de una fractura desplazada del tercio medio de la clavícula.

Aims Our objective is to compare the functional results in patients that underwent surgery for recurrent anterior shoulder instability (RAGHI) during the COVID-19 pandemic with remotely-based rehabilitation, to those who had surgery before the pandemic and had in-person rehabilitation therapy. Methods A retrospective case series of 68 patients were included and divided into two groups: In person-group and Home-based group. Western Ontario Shoulder Instability Index (WOSI) and Subjective Shoulder Value (SSV) scores were used to evaluate objective and subjective clinical parameters. Time and level of return to sports was studied by the Subjective Patient Outcome for Return to Sports (SPORTS) score. Results The mean SSV score was 82% (40–100) on the In-Person group compared with 87% (65–100) for the Home-Based group. Results for WOSI score were similar, with an average of 210.42 (90%) for In-Person and 261.45 (88%) for the Home-Based group ( p 0.12). Return to sports was carried out in an average of 6.6 (4–16) months for In-Person group, compared to 6.5 (5–8) months for Home-Based. Conclusion Follow-up and rehabilitation methods for patients who underwent surgery for RAGHI, during COVID-19 lockdown, were not significantly ( p 0.12) affected on functional and athletic return in comparison to traditional methods according to WOSI scale. Level of evidence IV Retrospective series of cases

Las lesiones de hombro atribuibles a la vacunación son aquellos efectos adversos secundarios a una inoculación. Su causa más frecuente ha sido la vacunación contra la gripe, pero la actual campaña masiva por la pandemia de SARS-CoV-2 determina que los especialistas conozcan este cuadro para un mejor diagnóstico y tratamiento. Estas lesiones tienen una evolución tórpida y prolongada. Deben notificarse a las agencias de control sanitario. Su tratamiento se basa en la administración temprana de corticoides y la rehabilitación.

Summary: This protocol presents the use of SARS-CoV-2 isolates to infect human kidney organoids, enabling exploration of the impact of SARS-CoV-2 infection in a human multicellular in vitro system. We detail steps to generate kidney organoids from human pluripotent stem cells (hPSCs) and emulate a diabetic milieu via organoids exposure to diabetogenic-like cell culture conditions. We further describe preparation and titration steps of SARS-CoV-2 virus stocks, their subsequent use to infect the kidney organoids, and assessment of the infection via immunofluorescence.For complete details on the use and execution of this protocol, please refer to Garreta et al. (2022).1 : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

The differentiation of human pluripotent stem cells (hPSCs) towards organoids is one of the biggest scientific advances in regenerative medicine. Kidney organoids have not only laid the groundwork for various organ-like tissue systems but also provided insights into kidney embryonic development. Thus, several protocols for the differentiation of renal progenitors or mature cell types have been established. Insights into the interplay of developmental pathways in nephrogenesis and determination of different cell fates have enabled the in vitro recapitulation of nephrogenesis. Here we first provide an overview of kidney morphogenesis and patterning in the mouse model in order to dissect signalling pathways that are key to define culture conditions sustaining renal differentiation from hPSCs. Secondly, we also highlight how genome editing approaches have provided insights on the specific role of different genes and molecular pathways during renal differentiation from hPSCs. Based on this knowledge we further review how CRISPR/Cas9 technology has enabled the recapitulation and correction of cellular phenotypes associated with human renal disease. Last, we also revise how the field has positively benefited from emerging technologies as single cell RNA sequencing and discuss current limitations on kidney organoid technology that will take advantage from bioengineering solutions to help standardizing the use of this model systems to study kidney development and disease.

Worsening climate change and increasing temperatures generate more sever and extended wildfires, raising concerns about ecosystem services. Prescribed burns (PB) are used to reduce forest fuel loads. Improving knowledge regarding the vegetation response after PB is essential for generating common points for monitoring ecological burning effects and generating a protocol or practice guide. We compared the PB seasonality of low-intensity (spring, summer, and autumn) and unburned areas in a total of 12 plots in Pinus nigra Arnold ssp. salzmannii Mediterranean forest. Our vegetation analysis was short term (one year after each PB). We analyzed vegetation coverage, α-diversity (Pielou, Simpson, and Shannon’s index), life forms, and fire-adapted traits using the Canfield transect method, followed by statistical analyses such as non-metric multidimensional scaling (NMDS) and two-way ANOVA. α-diversity was significantly decreased (>55% of dissimilarity) in the burned plots during each season, with the lowest values after summer PB (69% of dissimilarity) when comparing the burned and unburned plots. There was a significant increase in hemicryptophytes (15−20%) and geophyte coverage (from 6% to 14%, or from 4% to 8% in certain cases) in the burned plots after PB seasonality; however, the phanerophytes were reduced (from 13% to 5%). Resprouters were more dominant after PB (an increase of 15–20%), which indicates that resprouters have a faster recovery and generate a fuel load quickly for highly flammable species such as Bromus after low-intensity burning. This suggests that low-intensity prescribed burning may not be the best methodology for these resprouting species. This study helps to understand how burning in the early season can affect inflammable vegetation and the change in fuel that is available in semi-arid landscapes. This is key to achieving the basis for the development of a standardized system that allows for the efficient management of forest services in order to reduce wildfire risks. One objective of this line of research is to observe the effects of recurrent burning in different seasons on vegetation, as well as plant−soil interaction using the microbial and enzyme soil activity.

BackgroundCell therapies and derived products have a high potential in aiding tissue and organ repairing and have therefore been considered as potential therapies for treating renal diseases. However, few studies have evaluated the impact of these therapies according to the stage of chronic kidney disease. The aim of this study was to evaluate the renoprotective effect of murine bone marrow mesenchymal stromal cells (BM-MSCs), their extracellular vesicles (EVs) and EVs-depleted conditioned medium (dCM) in an aggressive mouse model of chronic cyclosporine (CsA) nephrotoxicity in a preventive and curative manner.MethodsAfter 4 weeks of CsA-treatment (75 mg/kg daily) mice developed severe nephrotoxicity associated with a poor survival rate of 25%, and characterized by tubular vacuolization, casts, and cysts in renal histology. BM-MSC, EVs and dCM groups were administered as prophylaxis or as treatment of CsA nephrotoxicity. The effect of the cell therapies was analyzed by assessing renal function, histological damage, apoptotic cell death, and gene expression of fibrotic mediators.ResultsCombined administration of CsA and BM-MSCs ameliorated the mice survival rates (6–15%), but significantly renal function, and histological parameters, translating into a reduction of apoptosis and fibrotic markers. On the other hand, EVs and dCM administration were only associated with a partial recovery of renal function or histological damage. Better results were obtained when used as treatment rather than as prophylactic regimen i.e., cell therapy was more effective once the damage was established.ConclusionIn this study, we showed that BM-MSCs induce an improvement in renal outcomes in an animal model of CsA nephrotoxicity, particularly if the inflammatory microenvironment is already established. EVs and dCM treatment induce a partial recovery, indicating that further experiments are required to adjust timing and dose for better long-term outcomes.

In the last decades of the 19th century, the business press opened a new stage in the history of journalism. It was not only a change in management, but also a conceptual change in the way of conceiving journalism and perceiving information. This New Journalism required a strong investment, the involvement of businessmen and politicians. This fact created a network of external dependencies that compromised its independence, the germ of what we call now media structure. In the Andalusian case it was not different, a socio-economic, political and media elite was formed. This article outlines the situation of the property of the main Andalusian newspapers of the time from an unusual theoretical perspective.

Objetivo El ligamento de Caldani o córacoclavicular medial (LCCM) ha sido estudiado anatómicamente pero no hemos hallado mención alguna sobre su identificación imagenológica. El objetivo del presente trabajo es presentar una técnica original de resonancia magnética que hemos desarrollado para identificarlo, y describir las imágenes correspondientes. Materiales y Métodos Se incluyeron en el protocolo de investigación a 7 voluntarios sin patología de hombro conocida. Se utilizó un Resonador Magnético PHILLIPS INGENIA de una intensidad de campo magnético de 1.5 Tesla Versión 4.1, diámetro de Gantry (túnel del resonador) de 70 cm, bobina Sense específica para Hombro de 8 canales con imágenes de alta resolución. Se realizaron las secuencias de búsqueda del ligamento en tres planos. Resultados El LCCM fue identificado en todos los casos, extendiéndose oblicuamente desde la apófisis coracoides a la clavícula coincidiendo con las descripciones de la bibliografía anatómica consultada. Presentó una señal hipointensa en todas las secuencias, indicando el poco espacio entre fibras y correspondiendo a tejido colágeno compacto. Su longitud promedio fue de 41,15mm (entre 34mm y 47mm, desvío standard de 4,40). El espesor promedio fue de 2,11mm (entre 1,3mm y 3,2mm, desvío standard de 0,66). Conclusión El LCCM puede ser observado en imágenes de resonancia magnética mediante la técnica original que describimos. La posibilidad de localizar y observar el LCCM mediante resonancia magnética abre las puertas al estudio del mismo en futuras investigaciones, no sólo de compresiones neurovasculares sino también en lesiones traumáticas acromioclaviculares, especialmente en las tipo V de la clasificación de Rockwood.

BackgroundMesenchymal stromal cells (MSCs) from different sources possess great therapeutic potential due to their immunomodulatory properties associated with allograft tolerance. However, a crucial role in this activity resides in extracellular vesicles (EVs) and signaling molecules secreted by cells. This study aimed to evaluate the immunomodulatory properties of donor and recipient MSCs isolated from adipose tissue (AD) or bone marrow (BM) and their EVs on kidney outcome in a rat kidney transplant model.MethodsThe heterotopic-kidney-transplant Fisher-to-Lewis rat model (F-L) was performed to study mixed cellular and humoral rejection. After kidney transplantation, Lewis recipients were assigned to 10 groups; two control groups; four groups received autologous MSCs (either AD- or BM- MSC) or EVs (derived from both cell types); and four groups received donor-derived MSCs or EVs. AD and BM-EVs were purified by ultracentrifugation. Autologous cell therapies were administered three times intravenously; immediately after kidney transplantation, 4 and 8 weeks, whereas donor-derived cell therapies were administered once intravenously immediately after transplantation. Survival and renal function were monitored. Twelve weeks after kidney transplantation grafts were harvested, infiltrating lymphocytes were analyzed by flow cytometry and histological lesions were characterized.ResultsAutologous AD- and BM-MSCs, but not their EVs, prolonged graft and recipient survival in a rat model of kidney rejection. Autologous AD- and BM-MSCs significantly improved renal function during the first 4 weeks after transplantation. The amelioration of graft function could be associated with an improvement in tubular damage, as well as in T, and NK cell infiltration. On the other side, the application of donor-derived AD-MSC was harmful, and all rats died before the end of the protocol. AD-EVs did not accelerate the rejection. Contrary to autologous MSCs results, the single dose of donor-derived BM-MSCs is not enough to ameliorate kidney graft damage.ConclusionEVs treatments did not exert any benefit in our experimental settings. In the autologous setting, BM-MSCs prompted as a potentially promising therapy to improve kidney graft outcomes in rats with chronic mixed rejection. In the donor-derived setting, AD-MSC accelerated progression to end-stage kidney disease. Further experiments are required to adjust timing and dose for better long-term outcomes.

Introducción El objetivo del presente trabajo es evaluar, en forma prospectiva, los resultados del tratamiento mediante la aplicación de ondas de choque focales, en un grupo de pacientes con calcificaciones sintomáticas del manguito rotador. Material y métodos Se incluyeron 44 casos consecutivos de calcificaciones localizadas en alguno de los tendones del manguito rotador, en 43 pacientes con cirugías fallidas o tratamiento previo, al menos, por 6 meses, con síntomas persistentes. Resultados En la evaluación al año, la calcificación había desaparecido completamente en 20 pacientes (45,5%). En 13 casos (29,5%), hubo un cambio significativo en el tamaño o la densidad. En 11 casos (25%), no hubo modificaciones. El dolor, según la escala analógica visual descendió de un promedio de 5,5 a 1,4 (p

Species diversity and genetic diversity, the most basic elements of biodiversity, have long been treated as separate topics, although populations evolve within a community context. Recent studies on community genetics and ecology have suggested that genetic diversity is not completely independent of species diversity. The Mexican Picea chihuahuana Martínez is an endemic species listed as "Endangered" on the Red List. Forty populations of Chihuahua spruce have been identified. This species is often associated with tree species of eight genera in gallery forests. This rare Picea chihuahuana tree community covers an area no more than 300 ha and has been subject of several studies involving different topics such as ecology, genetic structure and climate change. The overall aim of these studies was to obtain a dataset for developing management tools to help decision makers implement preservation and conservation strategies. However, this unique forest tree community may also represent an excellent subject for helping us to understand the interplay between ecological and evolutionary processes in determining community structure and dynamics. The AFLP technique and species composition data were used together to test the hypothesis that species diversity is related to the adaptive genetic structure of some dominant tree species (Picea chihuahuana, Pinus strobiformis, Pseudotsuga menziesii and Populus tremuloides) of the Picea chihuahuana tree community at fourteen locations. The Hill numbers were used as a diversity measure. The results revealed a significant correlation between tree species diversity and genetic structure in Populus tremuloides. Because the relationship between the two levels of diversity was found to be positive for the putative adaptive AFLP detected, genetic and species structures of the tree community were possibly simultaneously adapted to a combination of ecological or environmental factors. The present findings indicate that interactions between genetic variants and species diversity may be crucial in shaping tree communities.