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Inherited cardiovascular diseases are rare diseases that are difficult to diagnose by non-expert professionals. Genetic analyses play a key role in the diagnosis of these diseases, in which the identification of a pathogenic genetic variant is often a diagnostic criterion. Therefore, genetic variant classification and routine reinterpretation as data become available represent one of the main challenges associated with genetic analyses. Using the genetic variants identified in an inherited cardiovascular diseases unit during a 10-year period, the objectives of this study were: 1) to evaluate the impact of genetic variant reinterpretation, 2) to compare the reclassification rates between different cohorts of cardiac channelopathies and cardiomyopathies, and 3) to establish the most appropriate periodicity for genetic variant reinterpretation. All the evaluated cohorts (full cohort of inherited cardiovascular diseases, cardiomyopathies, cardiac channelopathies, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic cardiomyopathy, Brugada syndrome, long QT syndrome and catecholaminergic polymorphic ventricular tachycardia) showed reclassification rates above 25%, showing even higher reclassification rates when there is definitive evidence of the association between the gene and the disease in the cardiac channelopathies. Evaluation of genetic variant reclassification rates based on the year of the initial classification showed that the most appropriate frequency for the reinterpretation would be 2 years, with the possibility of a more frequent reinterpretation if deemed convenient. To keep genetic variant classifications up to date, genetic counsellors play a critical role in the reinterpretation process, providing clinical evidence that genetic diagnostic laboratories often do not have at their disposal and communicating changes in classification and the potential implications of these reclassifications to patients and relatives.

Valvulopathies are among the most common cardiovascular diseases, significantly increasing morbidity and mortality. While many valvular heart diseases are acquired later in life, an important genetic component has been described, particularly in mitral valve prolapse and bicuspid aortic valve. These conditions can arise secondary to genetic syndromes such as Marfan disease (associated with mitral valve prolapse) or Turner syndrome (linked to the bicuspid aortic valve) or may manifest in a non-syndromic form. When cardiac valve disease is the primary cause, it can appear in a familial clustering or sporadically, with a clear genetic component. The identification of new genes, regulatory elements, post-transcriptional modifications, and molecular pathways is crucial to identify at-risk familial carriers and for developing novel therapeutic strategies. In the present review we will discuss the numerous genetic contributors of heart valve diseases.

Background: Laminopathies are caused by rare alterations in LMNA, leading to a wide clinical spectrum. Though muscular dystrophy begins at early ages, disease progression is different in each patient. We investigated variability in laminopathy phenotypes by performing a targeted genetic analysis of patients diagnosed with LMNA-related muscular dystrophy to identify rare variants in alternative genes, thereby explaining phenotypic differences.Methods: We analyzed 105 genes associated with muscular diseases by targeted sequencing in 26 pediatric patients of different countries, diagnosed with any LMNA-related muscular dystrophy. Family members were also clinically assessed and genetically analyzed.Results: All patients carried a pathogenic rare variant in LMNA. Clinical diagnoses included Emery-Dreifuss muscular dystrophy (EDMD, 13 patients), LMNA-related congenital muscular dystrophy (L-CMD, 11 patients), and limb-girdle muscular dystrophy 1B (LGMD1B, 2 patients). In 9 patients, 10 additional rare genetic variants were identified in 8 genes other than LMNA. Genotype-phenotype correlation showed additional deleterious rare variants in five of the nine patients (3 L-CMD and 2 EDMD) with severe phenotypes.Conclusion: Analysis f known genes related to muscular diseases in close correlation with personalized clinical assessments may help identify additional rare variants of LMNA potentially associated with early onset or most severe disease progression.

Music is an art form and cultural activity whose language, the sounds and silences, is organized in time with logic and sensitivity. Music as a whole is the result of an ancestral nonverbal and international mode of human expression and communication. The primitive and former mother-child bonding might be highly influenced and modulated by the music and singing with their babies. Musicality and music imply two different sides of the same coin, where the former is based on the human capacity to produce the latter. Some theories about evolution suggest music might have an adaptive advantage for humans in society. Historical examples of different styles in music point out that if any allusion or reminder about gender in music might happen most probably occurs in folk non always written pagan or secular music with lyrics or voice. This genre of music usually tells about traditional gender differences in jobs, habits, lifestyles, etc., and has a clear preference for male musicians, while on the contrary, classical music usually does not have a clear gender difference in meaning, and instruments are played by both. In this text, I explore and empirically describe, neuroanatomically or functionally, some examples of different genres of music and brain differences, related to music and dance. Three different genres of music (Classical music, Fado and Flamenco) are explored in an attempt to elucidate some reasons for possible gender differences.

Estudiamos aquí el primer tramo del proceso productivo, común a toda producción humana, y que permite comprenderla mejor. Dicho proceso se inicia al ejecutar las facultades locomotrices el proyecto elegido; reviste la forma del método «ensayo- error-nuevo ensayo…», y alcanzará su primer objetivo al conseguir un producto suficientemente satisfactorio para la idea a plasmar. Sin embargo, este primer objetivo no cumple por completo el propósito inicial del proceso, que sólo se alcanza cuando el producto es usado para lo pretendido. Justificada la noción de uso, la consideración del primero de ellos sirve para establecer la noción básica de utilidad.

This work analyzes the evolutionary consequences of different aggregation levels of species distribution with an Evolutionary Cellular Automaton (ECA). We have found that in habitats with the same carrying capacity, aggregated distributions preserve smaller populations than do uniform distributions, i.e., they are less efficient. Nonetheless, we have also found that aggregated distributions, among other factors, can help the evolutionary stability of some biological interactions, such as predator–prey interactions, despite their granting less individual fitness. Besides, the competitive exclusion principle does not usually stand in populations with aggregated distribution. We have applied ECA to study the effects of aggregated distribution in two notorious cases: in the so-called paradox of the plankton and in gregarious animals. In doing so, we intend to ratify long-established ecological knowledge explaining these phenomena from a new perspective. In the first case, due to aggregate distribution, large aggregations of digital organisms mimicking very abundant planktonic species, leave large patches or oceanic areas free for other less competitive organisms, which mimic rare species, to prosper. In this case, we can see how effects, such as ecological drift and the small portion, act simultaneously. In the second case of aggregation, the aggregate distribution of gregarious animals could be explained under specialized predator–prey interactions and interdemic competition. Thus, digital organisms that imitate predators reduce the competitive capacity of their prey, destabilizing their competitiveness against other species. The specialized predator also goes extinct if the prey goes extinct by natural selection. Predators that have an aggregate distribution compensate the prey and thus avoid exclusion. This way there are more predator-free patches in which the prey can prosper. However, by granting greater colonization capacity to its prey, the predator loses competitiveness. Therefore, it is a multilevel selection event in which group adaptation grows to the detriment of the predator as an individual.

Manuel de Falla was a Spanish musician of the XIXth and XXth centuries who had international recognition likely due to his musical fusion talent. His knowledge about Spanish musical traditions gave to his early compositions a new and fresh intellectual interpretation for the typical Spanish folk music. However, in the middle of his musical career, he suffered a strange disease of his eyes named recurrent acute iridocyclitis. This eye flushing is caused by an inflammation of 2 structures of the anterior pole of the ocular globe, the iris, and the ciliary body. It is usually a symptom of another disease and it causes many psychological impairments and disabilities (severe eye pain in bright light, blurry vision, headache, stress for organization (orderliness), and depression in some cases). This soreness of his eyes had an effect over Falla’s compositions and marked an inflection point in his line of musical creations. Eyes in music have been so relevant in another composers and musicians throughout history.

ABSTRACT Background: The use of a successful Enhanced Recovery After Surgery (ERAS) in colorectal surgery favored its application in other organs, and hepatic resections were not excluded from this tendency. Some authors suggest that the laparoscopic approach is a central element to obtain better results. Aim: To compare the laparoscopic vs. open hepatic resections within an ERAS to evaluate if there are any differences between them. Methods: In a descriptive study 80 hepatic resections that were divided into two groups, regarding to whether they were submitted to laparoscopy or open surgery. Demographic data, those referring to the hepatectomy and the ERAS was analyzed. Results: Forty-seven resections were carried out in open surgery and the rest laparoscopically; in the first group there was only one conversion to open surgery. Of the total, 17 resections were major hepatectomies and in 18 simultaneous resections. There were no differences between procedures regarding hospital stay and number of complications. There was a greater adherence to the ERAS (p=0.046) and a faster ambulation (p=0.001) in the open surgery. Conclusion: The procedure, whether open or laparoscopically done in hepatic resections, does not seem to show differences in an ERAS evaluation.

This paper presents an Evolutionary Cellular Automaton (ECA) that simulates the evolutionary dynamics of biological interactions by manipulating strategies of dispersion and associations between digital organisms. The parameterization of the different types of interaction and distribution strategies using configuration files generates easily interpretable results. In that respect, ECA is an effective instrument for measuring the effects of relative adaptive advantages and a good resource for studying natural selection. Although ECA works effectively in obtaining the expected results from most well-known biological interactions, some unexpected effects were observed. For example, organisms uniformly distributed in fragmented habitats do not favor eusociality, and mutualism evolved from parasitism simply by varying phenotypic flexibility. Finally, we have verified that natural selection represents a cost for the emergence of sex by destabilizing the stable evolutionary strategy of the 1:1 sex ratio after generating randomly different distributions in each generation.

Aim: To perform a comprehensive phenotype-genotype correlation of all rare variants in Triadin leading to malignant arrhythmias in pediatrics.Methods: Triadin knockout syndrome is a rare entity reported in pediatric population. This syndrome is caused by rare variants in the TRDN gene. Malignant ventricular arrhythmias and sudden cardiac death can be a primary manifestation of disease. Although pharmacological measures are effective, some patients require an implantable defibrillator due to high risk of arrhythmogenic episodes.Main Results: Fourteen rare genetic alterations in TRDN have been reported to date. All of these potentially pathogenic alterations are located in a specific area of TRDN, highlighting this hot spot as an arrhythmogenic gene region.Conclusions: Early recognition and comprehensive interpretation of alterations in Triadin are crucial to adopt preventive measures and avoid malignant arrhythmogenic episodes in pediatric population.

Objetivo: Apresentar um panorama brasileiro acerca de marcos regulatórios que influenciam diretamente a prática da Ciência Aberta considerando a esfera governamental, institucional e das agências de fomento. Método: Estudo descritivo e exploratório com abordagem qualitativa. Resultado: As análises estão divididas em dois blocos: o primeiro com marcos regulatórios jurídicos brasileiros provenientes de instituições governamentais, que totalizam seis (6) normativas com tópicos referentes à transparência e abertura de dados, atos e do fazer científico; o segundo bloco traz marcos regulatórios provenientes das instituições científicas totalizando vinte e seis (26) políticas, uma (1) de agência de fomento e quatro(4) normativas de instituições provedoras de produtos e serviços em informação. Conclusões: Conclui-se que o Brasil tem trilhado seu caminho de maneira singular e de destaque uma vez que a abertura do fazer científico está em uma fase considerada transitória, consolidando o movimento de Acesso Aberto e inaugurando a Ciência Aberta, tendo o governo como agente essencial para esta implementação.

ABSTRACT: Background: Accurate interpretation of rare genetic variants is a challenge for clinical translation. Updates in recommendations for rare variant classification require the reanalysis and reclassification. We aim to perform an exhaustive re-analysis of rare variants associated with inherited arrhythmogenic syndromes, which were classified ten years ago, to determine whether their classification aligns with current standards and research findings. Methods: In 2010, the rare variants identified through genetic analysis were classified following recommendations available at that time. Nowadays, the same variants have been reclassified following current American College of Medical Genetics and Genomics recommendations. Findings: Our cohort included 104 cases diagnosed with inherited arrhythmogenic syndromes and 17 post-mortem cases in which inherited arrhythmogenic syndromes was cause of death. 71.87% of variants change their classification. While 65.62% of variants were classified as likely pathogenic in 2010, after reanalysis, only 17.96% remain as likely pathogenic. In 2010, 18.75% of variants were classified as uncertain role but nowadays 60.15% of variants are classified of unknown significance. Interpretation: Reclassification occurred in more than 70% of rare variants associated with inherited arrhythmogenic syndromes. Our results support the periodical reclassification and personalized clinical translation of rare variants to improve diagnosis and adjust treatment. Funding: Obra Social ''La Caixa Foundation'' (ID 100010434, LCF/PR/GN16/50290001 and LCF/PR/GN19/50320002), Fondo Investigacion Sanitaria (FIS PI16/01203 and FIS, PI17/01690), Sociedad Española de Cardiología, and “Fundacio Privada Daniel Bravo Andreu”. Keywords: Sudden cardiac death, Arrhythmias, Pathogenicity, Genetics

Abstract Background Technical advances in mobile devices such as smartphones and tablets have produced an extraordinary increase in their use around the world and have become part of our daily lives. The possibility of carrying these devices in a pocket, particularly mobile phones, has enabled ubiquitous access to Internet resources. Furthermore, in the life sciences world there has been a vast proliferation of data types and services that finish as Web Services. This suggests the need for research into mobile clients to deal with life sciences applications for effective usage and exploitation. Results Analysing the current features in existing bioinformatics applications managing Web Services, we have devised, implemented, and deployed an easy-to-use web-based lightweight mobile client. This client is able to browse, select, compose parameters, invoke, and monitor the execution of Web Services stored in catalogues or central repositories. The client is also able to deal with huge amounts of data between external storage mounts. In addition, we also present a validation use case, which illustrates the usage of the application while executing, monitoring, and exploring the results of a registered workflow. The software its available in the Apple Store and Android Market and the source code is publicly available in Github. Conclusions Mobile devices are becoming increasingly important in the scientific world due to their strong potential impact on scientific applications. Bioinformatics should not fall behind this trend. We present an original software client that deals with the intrinsic limitations of such devices and propose different guidelines to provide location-independent access to computational resources in bioinformatics and biomedicine. Its modular design makes it easily expandable with the inclusion of new repositories, tools, types of visualization, etc.

Dengue is the most significant arbovirus worldwide and a public health threat to non-endemic areas in which Aedes vectors are present. Autochthonous dengue transmission has been reported in several European countries in the last decade. Infected travelers from endemic regions arriving to areas colonized by Aedes albopictus in Europe need to be monitored in surveillance and control programs. We aimed to perform molecular characterization of RT-PCR-positive dengue cases detected in Catalonia, northeastern Spain, from 2013 to 2018. The basic demographic information and the geographical regions of importation were also analyzed. One-hundred four dengue cases were studied (103 imported infections and the first autochthonous case in our region). The dengue virus strains detected were serotyped and genotyped using molecular methods, and phylogenetic analyses were conducted. All four dengue serotypes were detected in travelers, including up to 10 different genotypes, reflecting the global circulation of dengue in endemic areas. The primary travel-related case of the 2018 autochthonous transmission was not identified, but the molecular analysis revealed dengue serotype 1, genotype I of Asian origin. Our results highlight the diversity of imported dengue virus strains and the role of molecular epidemiology in supporting arbovirus surveillance programs.

Cardiomyopathies are a heterogeneous group of inherited cardiac diseases characterized by progressive myocardium abnormalities associated with mechanical and/or electrical dysfunction. Massive genetic sequencing technologies allow a comprehensive genetic analysis to unravel the cause of disease. However, most identified genetic variants remain of unknown clinical significance due to incomplete penetrance and variable expressivity. Therefore, genetic interpretation of variants and translation into clinical practice remain a current challenge. We performed retrospective comprehensive clinical assessment and genetic analysis in six families, four diagnosed with arrhythmogenic cardiomyopathy, and two diagnosed with hypertrophic cardiomyopathy (HCM). Genetic testing identified three rare variants (two non-sense and one small indel inducing a frameshift), each present in two families. Although each variant is currently classified as pathogenic and the cause of the diagnosed cardiomyopathy, the onset and/or clinical course differed in each patient. New genetic technology allows comprehensive yet cost-effective genetic analysis, although genetic interpretation, and clinical translation of identified variants should be carefully done in each family in a personalized manner.

This retrospective, multicenter observational study aimed to describe the outcomes of surgical and medical treatment of C. acnes-related prosthetic joint infection (PJI) and the potential benefit of rifampin-based therapies. Patients with C. acnes-related PJI who were diagnosed and treated between January 2003 and December 2016 were included. We analyzed 44 patients with C. acnes-related PJI (median age, 67.5 years (IQR, 57.3–75.8)); 75% were men. The majority (61.4%) had late chronic infection according to the Tsukayama classification. All patients received surgical treatment, and most antibiotic regimens (43.2%) included β-lactam. Thirty-four patients (87.17%) were cured; five showed relapse. The final outcome (cure vs. relapse) showed a nonsignificant trend toward higher failure frequency among patients with previous prosthesis (OR: 6.89; 95% CI: 0.80–58.90) or prior surgery and infection (OR: 10.67; 95% IC: 1.08–105.28) in the same joint. Patients treated with clindamycin alone had a higher recurrence rate (40.0% vs. 8.8%). Rifampin treatment did not decrease recurrence in patients treated with β-lactams. Prior prosthesis, surgery, or infection in the same joint might be related to recurrence, and rifampin-based combinations do not seem to improve prognosis. Debridement and implant retention appear a safe option for surgical treatment of early PJI.

Objectives: To compare the characteristics and outcomes of cases with acute prosthetic joint infection (PJI; early post-surgical or hematogenous) by Staphylococcus aureus managed with implant removal (IRm) or debridement and retention (DAIR). To analyze the outcomes of all cases managed with IRm (initially or after DAIR failure). Methods: Retrospective, multicenter, cohort study of PJI by S. aureus (2003–2010). Overall failure included mortality within 60 days since surgery and local failure due to staphylococcal persistence/relapse. Results: 499 cases, 338 initially managed with DAIR, 161 with IRm. Mortality was higher in acute PJI managed initially with IRm compared to DAIR, but not associated with the surgical procedure, after propensity score matching. Underlying conditions, hemiarthroplasty, and methicillin-resistant S. aureus were risk factors for mortality. Finally, 249 cases underwent IRm (88 after DAIR failure); overall failure was 15.6%. Local failure (9.3%) was slightly higher in cases with several comorbidities, but independent of previous DAIR, type of IRm, and rifampin treatment. Conclusions: In a large multicenter study of S. aureus PJI managed with IRm, failure was low, but mortality significant, especially in cases with acute PJI and underlying conditions, but not associated with the IRm itself. Rifampin efficacy was limited in this setting.

Objetivo: Estimar la prevalencia de burnout y percepción de trabajo en equipo en los equipos de Atención Primaria (EAP) de Barcelona ciudad. Diseño: Transversal multicéntrico. Emplazamiento: EAP del Institut Català de la Salut (ICS) en Barcelona. Participantes: Trabajadores fijos e interinos, de todas las categorías profesionales de 51 EAP (N = 2398). Respondieron 879 (36,7%). Mediciones: Se envió por correo electrónico el cuestionario «Maslach Burnout Inventory», con las dimensiones agotamiento emocional, despersonalización y realización personal. Se consideró burnout la afectación en grado alto de 2 o más dimensiones. La percepción del trabajo en equipo y la valoración de jefaturas se midió con un cuestionario diseñado ad hoc. Resultados: La prevalencia de burnout fue del 17,2%. El 46,2% presentaron una o más subescalas alteradas. Presentan alto grado de agotamiento emocional 38,2%, 23,8% despersonalización y 7,7% baja realización personal. Un 49,2% consideran que se fomenta bastante o mucho el trabajo en equipo. Globalmente, trabajadores sociales presentan mayor media de dimensiones afectadas en grado alto, seguidas de administrativos, odontólogos, médicos y enfermeras (p

[This corrects the article DOI: 10.1371/journal.pone.0167358.].

Introducción. La hidatidosis hepática es endémica en dife - rentes regiones del mundo. Se han propuesto diversos trata - mientos para abordarla. La mejor alternativa terapéutica sigue siendo la cirugía. Los procedimientos quirúrgicos están divididos en radicales y no radicales. El objetivo de nuestro trabajo es evaluar la morbi-mortalidad y el porcentaje de re - cidivas de las resecciones hepáticas como tratamiento radical de la hidatidosis hepática y contrastarlos con las series publi - cadas en la literatura. Material y métodos. Este estudio re - trospectivo fue efectuado en una serie española y argentina y se analizan los siguientes datos: sexo, edad, tipo de resección, gestos quirúrgicos asociados, presencia de hepatopatía, tiem - po operatorio, transfusión de hemoderivados, morbilidad, mortalidad, estancia hospitalaria, re-internación, recidiva y tiempo de seguimiento. Tuvimos en cuenta la clasificación de Dindo - Clavien para las complicaciones y la clasificación de la International Hepato-Pancreato-Biliary Association (IHPBA) de Brisbane para resecciones hepáticas. Se conside - ró mortalidad la ocurrida en los primeros 90 días post-ciru - gía. Para evaluar la recurrencia, solo se incluyeron pacientes seguidos durante más de 6 meses. Resultados. Las indicacio - nes de las resecciones hepáticas se realizaron en pacientes con quistes mayores de 5 cm, quistes múltiples, quistes de gran tamaño, comunicados con la vía biliar o con sospecha de dicha comunicación. Cinco pacientes requirieron transfusio - nes de hemoderivados (10%) con una mediana para esos 5 pacientes de 740 ml cada uno y para el total de la serie de 74 ml. El tiempo operatorio tuvo una mediana de 186 minutos (rango 45 a 1.050 minutos). La estancia hospitalaria tuvo una mediana de 7,7 días. El seguimiento superior a 6 me - ses se realizó en 38 pacientes. Conclusiones. Creemos que la hidatidosis hepática es una patología polifacética y requiere de más de una posibilidad terapéutica. Las hepatectomías, más allá de cumplir con la resección del parásito de manera completa, ofrecen la posibilidad de hacerlo de una manera controlada y segura en manos experimentadas, asegurando buenos resultados en el tratamiento de esta patología.

Sudden unexplained death may be the first manifestation of an unknown inherited cardiac disease. Current genetic technologies may enable the unraveling of an etiology and the identification of relatives at risk. The aim of our study was to define the etiology of natural deaths, younger than 50 years of age, and to investigate whether genetic defects associated with cardiac diseases could provide a potential etiology for the unexplained cases.Our cohort included a total of 789 consecutive cases (77.19% males)

Sudden cardiac death is defined as an unexpected decease of cardiac origin. In individuals under 35 years old, most of these deaths are due to familial arrhythmogenic syndromes of genetic origin, also known as channelopathies. These familial cardiac syndromes commonly follow an autosomal dominant pattern of inheritance. Diagnosis, however, can be difficult, mainly due to incomplete penetrance and variable expressivity, which are hallmarks in these syndromes. The clinical manifestation of these diseases can range from asymptomatic to syncope but sudden death can sometimes be the first symptom of disease. Early identification of at-risk individuals is crucial to prevent a lethal episode. In this review, we will focus on the genetic basis of channelopathies and the effect of genetic and non-genetic modifiers on their phenotypes.

El interés y la abundacia de la información de prensa han puesto de relieve los problemas que existen para localizar y recuperar este tipo de contenidos en internet. Actualmente, la consulta de noticias retrospectivas se realiza a través de productos especializados que son poco conocidos no sólo por el gran público sino a veces también por los profesionales del sector. A partir de esta preocupación, hemos realizado diversos estudios que han tenido como objetivo general categorizar y evaluar los sistemas de documentación de prensa. En primer lugar, hemos categorizado los sistemas de documentación de prensa (hemerotecas históricas, hemerotecas del propio medio y bases de datos de prensa) y analizado sus características principales. En segundo lugar, hemos establecido un sistema de indicadores que sirven para la evaluación de estos sistemas documentales y, además, los hemos aplicado a casos concretos como son las hemerotecas digitales españolas (de los diarios de mayor difusión), las catalanas, etc. y en períodos de tiempo distintos, lo que ha permitido disponer de un análisis evolutivo. En este texto se presentan los resultados de ambas líneas de investigación.

La Virología se ha desarrollado durante la última parte del siglo XX en paralelo con las nuevas técnicas de análisis y manipulación genética y con el auxilio de técnicas físicas e informáticas. En España se han formado núcleos activos tanto en genética viral como en virus patógenos de animales y plantas. Contrariamente a predicciones de hace tan solo tres décadas, las enfermedades víricas siguen siendo un importante problema en medicina, veterinaria y agricultura. Un gran número de enfermedades víricas emergentes constituyen un importante desafío para el siglo XXI.

Sin resumen

Abstract Background High-throughput automated sequencing has enabled an exponential growth rate of sequencing data. This requires increasing sequence quality and reliability in order to avoid database contamination with artefactual sequences. The arrival of pyrosequencing enhances this problem and necessitates customisable pre-processing algorithms. Results SeqTrim has been implemented both as a Web and as a standalone command line application. Already-published and newly-designed algorithms have been included to identify sequence inserts, to remove low quality, vector, adaptor, low complexity and contaminant sequences, and to detect chimeric reads. The availability of several input and output formats allows its inclusion in sequence processing workflows. Due to its specific algorithms, SeqTrim outperforms other pre-processors implemented as Web services or standalone applications. It performs equally well with sequences from EST libraries, SSH libraries, genomic DNA libraries and pyrosequencing reads and does not lead to over-trimming. Conclusions SeqTrim is an efficient pipeline designed for pre-processing of any type of sequence read, including next-generation sequencing. It is easily configurable and provides a friendly interface that allows users to know what happened with sequences at every pre-processing stage, and to verify pre-processing of an individual sequence if desired. The recommended pipeline reveals more information about each sequence than previously described pre-processors and can discard more sequencing or experimental artefacts.

Objective: To compare the rates of R0 resection in pancreatoduodenectomy (PD) for pancreatic and periampullary malignant tumors by means of standard (ST-PD) versus artery-first approach (AFA-PD). Background: Standardized histological examination of PD specimens has shown that most pancreatic resections thought to be R0 resections are R1. "Artery-first approach" is a surgical technique characterized by meticulous dissection of arterial planes and clearing of retropancreatic tissue in an attempt to achieve a higher rate of R0. To date, studies comparing AFAPD versus ST-PD are retrospective cohort or case-control studies. Methods: A multicenter, randomized, controlled trial was conducted in 10 University Hospitals (NCT02803814, ClinicalTrials.gov). Eligible patients were those who presented with pancreatic head adenocarcinoma and periampullary tumors (ampulloma, distal cholangiocarcinoma, duodenal adenocarcinoma). Assignment to each group (ST-PD or AFA-PD) was randomized by blocks and stratified by centers. The primary end-point was the rate of tumor-free resection margins (R0); secondary end-points were postoperative complications and mortality. Results: One hundred seventy-nine patients were assessed for eligibility and 176 randomized. After exclusions, the final analysis included 75 ST-PD and 78 AFA-PD. R0 resection rates were 77.3% (95% CI: 68.4-87.4) with ST-PD and 67.9% (95% CI: 58.3-79.1) with AFA-PD, P=0.194. There were no significant differences in postoperative complication rates, overall 73.3% versus 67.9%, and perioperative mortality 4% versus 6.4%. Conclusions: Despite theoretical oncological advantages associated with AFA-PD and evidence coming from low-level studies, this multicenter, randomized, controlled trial has found no difference neither in R0 resection rates nor in postoperative complications in patients undergoing ST-PD versus AFA-PD for pancreatic head adenocarcinoma and other periampullary tumors. [ABSTRACT FROM AUTHOR]