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Exomoons are expected to orbit gas giant exoplanets just as moons orbit solar system planets. Tidal heating is present in solar system satellites and it can heat up their interior depending on their orbital and interior properties. We aim to identify a Tidally Heated Exomoon's (THEM) orbital parameter space that would make it observable in infrared wavelengths with MIRI/JWST around $\epsilon$ Eridani b. We study the possible constraints on orbital eccentricity and interior properties that a successful THEM detection in infrared wavelengths can bring. We also investigate what exomoon properties need to be independently known in order to place these constraints. We use a coupled thermal-tidal model to find stable equilibrium points between the tidally produced heat and heat transported within a moon. For the latter, we consider a spherical and radially symmetric satellite with heat being transported via magma advection in a sub-layer of melt (asthenosphere) and convection in the lower mantle. We incorporate uncertainties in the interior and tidal model parameters to assess the fraction of simulated moons that would be observable with MIRI. We find that a $2 R_{Io}$ THEM orbiting $\epsilon$ Eridani b with an eccentricity of 0.02, would need to have a semi-major axis of 4 planetary Roche-radii for 100% of the simulations to produce an observable moon. These values are comparable with the orbital properties of gas giant solar system satellites. We place similar constraints for eccentricities up to 0.1. We conclude that if the semi-major axis and radius of the moon are known (eg. with exomoon transits), tidal dissipation can constrain the orbital eccentricity and interior properties of the satellite, such as the presence of melt and the thickness of the melt containing sub-layer.

Objective To analyze the safety and efficacy of the LIRA (Laparoscopic Intracorporeal Rectus Aponeuroplasty) technique by evaluating postoperative pain, complications (seroma, infection, etc.), bulging, and recurrence rate. Methods Prospective analysis of patients who underwent elective laparoscopic repair of midline ventral and incisional hernias with defects 4 to 8 cm wide (W2, EHS classification). Endpoints: Recurrence rate (primary endpoint). Secondary objectives: acute pain, postoperative seroma, infection, chronic pain, bulging and patient satisfaction. Results From 2020 to 2021, LIRA repair was performed in 12 patients (mean age 51-y, mean BMI: 33.5 kg/m2). Mean defect width: 5.9 cm. Rectus diastasis>5cm. was present in 6 patients. No intraoperative complications were observed. Tension-free closure was achieved in all patients. Mean operative time: 79 minutes. Postop clinical seroma: 4/12 patients (No intervention needed). Postoperative pain (VAS): 4 at 24h, 0.6 at one month, and 0 in those patients who have completed one year of follow-up. No clinical or radiological recurrences, nor trocar hernias have been observed. The degree of patient satisfaction is 9/10. No one complained of bulging. Conclusions Despite being a technically demanding procedure, the LIRA technique allowed a tension-free midline reconstruction of patients suffering from hernia defects smaller than 8 cm without relevant complications. Although the follow-up time is short, no recurrences or trocar hernias have been observed to date. Therefore, LIRA should be considered a safe and efficient therapeutic alternative in patients with ventral and incisional hernias type W2.

Resumen La hidrosadenitis supurativa crónica es una afección dermatológica muy frecuente y se inicia a edad muy temprana, en la juventud , por lo que al ser enfermedad crónica presenta una evolución muy larga. Su complicación más grave es el carcinoma escamoso y la localización perineal puede conllevar a cirugías muy agresivas. La presentación de carcinoma escamoso a nivel perineal secundario a hidrosadenitis supurativa crónica es raro , peroconlleva alta recurrencia, progresión rápida y alta mortalidad por lo que precisa su conocimiento y actuación precoz.

Hazelnut (Corylus avellana L.) is one of the most important tree nut crops in Europe. Germplasm accessions are conserved in ex situ repositories, located in countries where hazelnut production occurs. In this work, we used ten simple sequence repeat (SSR) markers as the basis to establish a core collection representative of the hazelnut genetic diversity conserved in different European collections. A total of 480 accessions were used: 430 from ex situ collections and 50 landraces maintained on-farm. SSR analysis identified 181 genotypes, that represented our whole hazelnut germplasm collection (WHGC). Four approaches (utilizing MSTRAT, Power Core, and Core Hunter’s single- and multi-strategy) based on the maximization (M) strategy were used to determine the best sampling method. Core Hunter’s multi-strategy, optimizing both allele coverage (Cv) and Cavalli-Sforza and Edwards (Dce) distance with equal weight, outperformed the others and was selected as the best approach. The final core collection (Cv-Dce30) comprised 30 entries (16.6% of genotypes). It recovered all SSR alleles and preserved parameter variations when compared to WHGC. Entries represented all six gene pools obtained from the population structure analysis of WHGC, further confirming the representativeness of Cv-Dce30. Our findings contribute towards improving the conservation and management of European hazelnut genetic resources and could be used to optimize future research by identifying a minimum number of accessions on which to focus. info:eu-repo/semantics/acceptedVersion

Preliminary data suggest that allogeneic stem cell transplantation (allo-SCT) may be effective in T-prolymphocytic leukemia (T-PLL). The purpose of the present observational study was to assess the outcome of allo-SCT in patients aged 65 years or younger with a centrally confirmed diagnosis of T-PLL. Patients were consecutively registered with the EBMT at the time of transplantation and followed by routine EBMT monitoring but with an extended dataset. Between 2007 and 2012, 37 evaluable patients (median age 56 years) were accrued. Pre-treatment contained alemtuzumab in 95% of patients. Sixty-two percent were in complete remission (CR) at the time of allo-SCT. Conditioning contained total body irradiation with 6 Gy or more (TBI6) in 30% of patients. With a median follow-up of 50 months, the 4-year non-relapse mortality, relapse incidence, progression-free (PFS) and overall survival were 32, 38, 30 and 42%, respectively. By univariate analysis, TBI6 in the conditioning was the only significant predictor for a low relapse risk, and an interval between diagnosis and allo-SCT of more than 12 months was associated with a lower NRM. This study confirms for the first time prospectively that allo-SCT can provide long-term disease control in a sizable albeit limited proportion of patients with T-PLL.

Spherical resorcinol formaldehyde (SRF) resin is planned for use in removing cesium (137Cs) from Hanford tank waste supernates in preparation for waste vitrification at the Waste Treatment ...

Pacific Northwest National Laboratory has been tasked with demonstrating the unit operations for the Low Activity Waste Pretreatment System with actual Hanford tank waste. Crystalline silic...

The present experimental work was performed to investigate media performance in both cross-flow and dead-end filtration of 9 L of Hanford tank AP-107 supernate. Media grades 0.1 and 5 were tested f...

Background POEMS syndrome is a rare paraneoplastic disease caused by an underlying plasma cell disorder. The aim of this study is to describe clinical and biological features as well as outcomes in a series of patients in a real-world clinical setting. Methods We retrospectively analyzed 30 patients with POEMS syndrome consecutively diagnosed and treated at 8 hospitals in Catalonia, Spain, between 1996 and 2021. Medical records were reviewed for clinical and lab features at diagnosis, first-line treatment, autologous stem-cell transplantation (ASCT) and outcomes including progression-free (PFS) and overall survival (OS). Diagnosis was stablished according to published diagnostic criteria (Dispenzieri A, Am J Hematol 2011). Median follow up of alive patients was 13 years. Results Median age of the series was 65 years (range, 42-86). The median serum M-spike was 5 g/L. The heavy chain isotype was IgG in 43% of patients and IgA in 40%, while the light chain isotype was lambda in 87%. Four patients had more than 10% bone marrow plasma cells. VEGF was available in 18 patients and 16 of them (88%) had increased levels (3 times greater than the superior limit). All patients presented peripheral neuropathy, and other clinical features included organomegaly (22 patients), extravascular volume overload (22), endocrinopathy (20), skin lesions (18), thrombocytosis (18) osteosclerotic lesions (17), polycythemia (7), papilledema (7), pulmonary hypertension (4), portal hypertension (4), and Castleman disease (7). The median time between onset of symptoms and diagnosis was 6.3 months. Treatment information was available in 29 patients. Four patients had an isolated bone lesion and received only local radiation therapy, with hematologic and clinical response in 2 of them and a 10-year OS of 87%. Twenty-three patients underwent an ASCT: 15 after chemotherapy (with or without additional radiation therapy) and 8 upfront. Median age at the time of ASCT was 54 years. Conditioning prior to ASCT consisted in melphalan 200 mg/m2 in 74% of cases and 140 mg/m2 in 26%. Among 20 evaluable patients for hematologic response, 10 achieved a complete response and 10 obtained a partial response (PR). Eleven (55%) of these hematologic responding patients also obtained a significant organ improvement in a median time of 7 months after ASCT (range, 4–11). Nine patients (41.7%) progressed at a median time of 5 years after transplant, 5 of them received a second ASCT and 3 achieved at least a PR. After the second ASCT, only one patient clinically progressed after 38 months. All the remaining patients remained in response at the last follow-up evaluation. Median PFS and OS of the series were 6 and 12 years, respectively. Conclusions In conclusion, in our experience ASCT proved to be highly effective for patients with POEMS syndrome. When progression is confirmed after the first transplant, a second ASCT may be performed with potential clinical benefit.

La infección COVID-19 está obligando a toda la sociedad a adoptar numerosos cambios, al menos hasta que existan un tratamiento o vacuna eficaces. El impacto que está produciendo en nuestro sistema sanitario tiene pocos precedentes similares, al tratarse de una patología nueva y que ha obligado a tomar decisiones complejas a partir de una evidencia escasa. Los servicios de radiología tienen un papel fundamental en el manejo de esta patología, tanto en el diagnóstico como en el manejo posterior de los pacientes. Pero, para ello, se debe entender la infección, de forma que se puedan poner en marcha circuitos seguros para pacientes y trabajadores. En este artículo se resume la fisiopatología de la infección COVID-19 y se presentan las medidas que se deben adoptar en el servicio de radiología.

Background and importance Fractures are the most common injuries seen after a fall. Falls among the older population are associated with a high morbidity and mortality. The aetiology of falls is usually multifactorial and the use of several types of drugs has been associated with an increased fall risk. As drugs are a modifiable risk factor, periodic drug review and eventual withdrawal of drug related falls could be a possible strategy to prevent falls in older people. Aim and objectives The aim of the study was to analyse the proportion of patients who were treated for osteoporosis and were taking, concomitantly, any drug that increased the risk of falls. Material and methods A retrospective observational study was conducted in three primary care centres covering a population of 97 722 people. Study population: patients with a prescription of any drug for osteoporosis. Data collected were age, gender, drugs for osteoporosis treatment and drugs that had a medium or high fall risk. Results A total of 1594 patients were treated with drugs for osteoporosis: 91.5% were women, median age was 72.4 (SD 10.6) years. Drugs for osteoporosis prescribed were: alendronate (62.7%), denosumab (15.5%), alendronic acid+colecalciferol (6.2%), risedronate (6.2%), ibandronate (3.5%), raloxifene (3.0%), teriparatide (1.8%), bazedoxifene (1.0%) and etidronate (0.1%). We found that 69.1% of patients had an active prescription of a drug that increased the risk of falls: 38.5% of patients had one drug concomitantly prescribed; 30.5% two; 17.9% three; 8.7% four; and 4.4% five or more. The most prescribed drugs related to falls were (expressed as per cent of prescriptions): anxiolytics (N05B) (21.2%), antidepressants (N06A) (19.5%), high risk antihypertensives (beta-blockers (C07A) (9.2%) and angiotensin convertor enzyme inhibitors (C09A) (8.9%)), opioid analgesics (N02A) (8.3%), medium risk antihypertensives (calcium antagonists (C08C) (7.4%) and angiotensin II receptor antagonists (C09C) (5.5%)), antihypertensives combined with diuretics (C09C, C09B) (7.3%), hypnotics and sedatives (N05C) (5.4%) and antiepileptics considered as high or medium risk (valproic acid, carbamazepine, clonazepam, phenytoin, phenobarbital and gabapentin) (3.7%). Conclusion and relevance Concomitant prescription of drugs for osteoporosis and drugs that increase the risk of falls is common. Periodic drug review is required to reassess the necessity of continuing drugs that contribute to the risk of falls in patients treated for osteoporosis. References and/or acknowledgements No conflict of interest.

“Manvert Foliplus” is an organic compound that stimulates bud burst, flowering and growth of plants and fruits. It is composed of amino acids, reducing sugars and phytohormones from seaweed extract. BIOVERT and IRTA have jointly conducted a trial over two years (2015 and 2016), to assess the efficacy of this biostimulant in fruit set and production of two hazelnut (Corylus avellana L.) cultivars ‘Negret’ and ‘Tonda di Giffoni’ in both, a comparative trial in IRTA-Mas de Bover field station and in two commercial orchards. The product was applied by foliar spraying in different periods: from the fruit set time to the kernel growth stage (covering a period of 40 days). Different treatments were tested: application at fruit set time, fruit set + 10 days, fruit set + 10 days + 20 days, fruit set + 10 days + 20 days + 40 days and control. Total applied dose was 2 L ha(-1) spray-1. Fallen blank fruits, production and nut quality (nut weight, kernel weight, size >12 mm, and defects) were evaluated for each treatment, in both cultivars. A positive effect of Manvert Foliplus in hazelnut production was observed in the two cultivars in 2015, for some treatments, and only in ‘Tonda di Giffoni’ in 2016. In 2015, a lower number of fallen blank fruits was observed in ‘Tonda di Giffoni’ trees treated with this biostimulant. No significant differences were found in nut quality among treatments for both cultivars, in any of the two years of the trial.

Self-fertility in almond is one of the main aims in the Spanish breeding programs. However, productivity depends not only on the level of self-fertility but also in other factors such as the number of flowers produced, on the percentage of fruit set and on the fruit weight. These yield components are genotype-dependent and are influenced by climatic and management conditions. The almond tree like other fruit trees shows a regulation effect of the productive load that can occur with flower drops and can continue with fruit drops, to be able to reach a good balance between crop load and vegetative growth. In this work, the pattern of the physiological flower and fruit drops in different almond cultivars was evaluated. The work was carried out in a plot in Lleida (Northeastern Spain) set in a randomized blocks trial (4 replicates of each cultivar and 4 trees replicate-1). The number and the evolution of flowers and fruits were assessed every 15 days, from pink bud to nut harvest. The evaluation was carried out in two shoots per replication and using four blocks for each cultivar. The results of one year study (2016) showed two different flower and fruit drop patterns which are modulated according to cultivar and their phenological evolution. The cultivar patterns differ considering the productive organ that drops, the time when the drops occur and the severity of the drops.

Hematopoietic stem cell transplantation (HSCT) from a mismatched unrelated donor, an haploidentical donor or a cord blood unit (CBU) has become a widely aviable approach if patient lacks a matched related or unrelated donor. However, if the patient has anti-HLA antibodies against antigens present in the mismatched donor or CBU (donor-specific antibodies, DSAs) this option should be disregarded due to the high risk of graft failure. Desensitization can be used to reduce levels of DSAs but this technique has limited results. We report the case of a 62-year-old woman with DSAs against two haploidentical familiar donors who failed desensitization of DSAs. Finally she underwent a HSCT from a 5/10 mismatched unrelated donor which has been successful.

The aim of the present study was to explore whether there is enhanced endothelial dysfunction in patients developing acute GvHD (aGvHD) after allogeneic hematopoietic cell transplantation (allo-HCT) and to identify biomarkers with predictive and/or diagnostic value. In in vitro experiments, endothelial cells (ECs) were exposed to serum from patients with (aGvHD, n = 31) and without (NoGvHD, n = 13) aGvHD, to evaluate changes in surface adhesion receptors, the reactivity of the extracellular matrix by measuring the presence of Von Willebrand factor (VWF) and platelet adhesion, and the activation of intracellular signaling proteins. Plasma levels of VWF, ADAMTS-13, TNF receptor 1 (TNFR1), soluble vascular cell adhesion molecule 1 and soluble intercellular adhesion molecule 1 were also measured. In vitro results showed a more marked proinflammatory and prothrombotic phenotype in ECs in association with aGvHD. Regarding circulating biomarkers, levels of VWF and TNFR1 above an optimal cutoff score, taken independently or combined, at day 7 after allo-HCT, would be able to positively predict that around 90% of patients will develop aGvHD. Our results demonstrate that endothelial damage is aggravated in those allo-HCT recipients developing aGvHD, and that VWF and TNFR1 are promising predictive aGvHD biomarkers. These findings could contribute to improve the understanding of the pathophysiology of aGvHD.

Background Frail and multimorbid patients are often prescribed multiple medications.1 Polypharmacy, along with drug-drug interactions and potentially inappropriate medications (PIMs), are known as the iatrogenic triad. Consequently, this population has an increased risk of negative health outcomes. Purpose To review the medication plan of chronic patients in the home care programme by a multidisciplinary team (integrated by doctors, nurses and clinical pharmacists) to adjust and optimize drug therapy and to reduce treatment complexity and polypharmacy. Material and methods This was a prospective interventional study in a primary care centre. Domiciliary patients were visited by the multidisciplinary team. The clinical pharmacist interviewed the patient and/or caregiver to obtain a comprehensive medication history (including over-the-counter drugs) and to assess medication adherence. The review process was conducted by the multidisciplinary team and consisted of four steps: deprescribing strategies according to current clinical evidence; simplification of the dosing regimen; identification of drug-related problems; and replacement of PIMs. The final medication plan was agreed with the patient and/or caregiver. The Medication Regimen Complexity Index (MRCI) before and after medication review was recorded.2 Results Thirty-three patients were included with a median age of 88.1±6.3 (72.7% female). A total of 4.0±1.9 therapy modifications per patient were performed (ranging from 0 to 10). The main modifications (n=132) were: deprescribing (43.2%, in 25 patients), dose or dosage adjustment (25.0%, in 20 patients) and drug substitution (18.9%, in 21 patients). The number of prescribed treatments before and after the review was 11.0±3.8 vs 9.4±3.9, whereas the MRCI was 27.5±11.2 vs 23.6±10.7, respectively. Conclusion Medication review by a multidisciplinary team is an effective strategy for tailoring drug therapies, reducing polypharmacy and treatment complexity in home care patients. References and/or acknowledgements 1. Cullinan S, Raae Hansen C, Byrne S, et al. Challenges of deprescribing in the multimorbid patient. Eur J Hosp Pharm 2017;24:43–6. http://dx.doi.org/10.1136/ejhpharm-2016–000921 2. George J, Phun YT, Bailey MJ, et al. Development and validation of the medication regimen complexity index. Ann Pharmacother 2004;38:1369–76. DOI: 10.1345/aph.1D479 No conflict of interest.

Objectives To assess risk factors for multidrug-resistant Pseudomonas aeruginosa (MDR-PA) infection in neutropenic patients. Methods Single-centre retrospective analysis of consecutive bloodstream infection (BSI) episodes (2004–2017, Barcelona). Two multivariate regression models were used at BSI diagnosis and P. aeruginosa detection. Significant predictors were used to establish rules for stratifying patients according to MDR-PA BSI risk. Results Of 661 Gram-negative BSI episodes, 190 (28.7%) were caused by P. aeruginosa (70 MDR-PA). Independent factors associated with MDR-PA among Gram-negative organisms were haematological malignancy (OR 3.30; 95% CI 1.15–9.50), pulmonary source of infection (OR 7.85; 95% CI 3.32–18.56), nosocomial-acquired BSI (OR 3.52; 95% CI 1.74–7.09), previous antipseudomonal cephalosporin (OR 13.66; 95% CI 6.64–28.10) and piperacillin/tazobactam (OR 2.42; 95% CI 1.04–5.63), and BSI occurring during ceftriaxone (OR 4.27; 95% CI 1.15–15.83). Once P. aeruginosa was identified as the BSI aetiological pathogen, nosocomial acquisition (OR 7.13; 95% CI 2.87–17.67), haematological malignancy (OR 3.44; 95% CI 1.07–10.98), previous antipseudomonal cephalosporin (OR 3.82; 95% CI 1.42–10.22) and quinolones (OR 3.97; 95% CI 1.37–11.48), corticosteroids (OR 2.92; 95% CI 1.15–7.40), and BSI occurring during quinolone (OR 4.88; 95% CI 1.58–15.05) and β-lactam other than ertapenem (OR 4.51; 95% CI 1.45–14.04) were independently associated with MDR-PA. Per regression coefficients, 1 point was assigned to each parameter, except for nosocomial-acquired BSI (3 points). In the second analysis, a score >3 points identified 60 (86.3%) out of 70 individuals with MDR-PA BSI and discarded 100 (84.2%) out of 120 with non-MDR-PA BSI. Conclusions A simple score based on demographic and clinical factors allows stratification of individuals with bacteraemia according to their risk of MDR-PA BSI, and may help facilitate the use of rapid MDR-detection tools and improve early antibiotic appropriateness.

Carob (Ceratonia siliqua L.) is an important evergreen tree of the Mediterranean landscape. Its economic interest is increasing thanks also to the presence, in the seeds, of the locust bean gum (LBG), a galactomannan largely used by the food industry as a stabilizer and thickening agent. Its economic and ecological values make the understanding of carob genetic diversity of great interest both for breeding and conservation purposes. The world’s largest carob germplasm collection was genotyped using both eight carob-specific nuclear short sequence repeat (nSSR) and the sequencing of a chloroplast locus. The collection is composed of 215 accessions introduced from 12 countries of origin spanning from traditional to novel areas of cultivation. To assess the genetic diversity of the collection, several approaches were coupled: structure analysis, principal component analysis (PCA), and graphic clustering either from dissimilarity data and coancestry data. Structure analysis suggested the presence of two distinct genetic pools: one characterizing northeastern Spain and the second spread in other countries and southern Spain. The PCA and discriminant analysis of principal component (DAPC) complemented the structure results allowing a better understanding of the genetic differences between countries while the network-joining analysis provided additional insights on the similarity between individuals. Short sequence repeat (SSR) data coupled with phenotypic data (floral sex and status) were also used to define the first core collection of carobs. Multi-approach analysis of genetic diversity together with the definition of a core collection represent useful tools for the setup of genetic-guided intervention both for conservation and breeding purposes.

Senescence is a state of permanent cell cycle arrest. Cellular senescence can promote tissue remodelling but can negatively affect regenerative capacities of tissues and contribute to inflammation and the progression of cancer and ageing-related diseases. This Review highlights the chemical characteristics of senescence and how we can target senescent cells with small molecules to induce senescence in hyperproliferative tissues. Alternatively, these small molecules can also be administered to inhibit senescence or eliminate senescent cells as the basis of a promising strategy to treat ageing-related diseases. We also describe advances in detecting senescence in in vitro and in vivo models, such that we can evaluate response to treatments intended to induce or eliminate senescent cells.

Sclerodermoid chronic graft-versus-host disease (scGVHD) is a severe complication of allogeneic haema­- topoietic stem cell transplantation. The aim of this study was to investigate the usefulness of high-frequency ultrasound of the skin in assessing the inflammatory patterns and prognosis of patients with scGVHD. A prospective study was carried out with patients who developed scGVHD in the period June 2016 to April 2018. Clinical and ultrasound examinations were performed on the first visit and at 6-month follow-up. A total of 24 patients were included in the study. A 6-month follow-up high-frequency ultrasound of the skin was performed on 20 of the 24 patients. Abnormal B-mode findings in high-frequency ultrasound of the skin consisted of hypoechogenic dermis, hypoechogenicity of septa and hyperechogenicity of lobules in hypodermis. No differences were observed in these basal parameters between treatment progressive/non-responding and inactive/responding scGVHD groups of patients. Basal Doppler showing increased vascular flow with a systolic peak ≥10 cm/s and a vascular resistance index ≥ 0.70 was observed only in those patients who developed progressive/non-responding scGVHD (62.5% vs 0% p = 0.006). In conclusion, Doppler ultrasound is a useful tool to assess the inflammatory activity and outcome of scGVHD. These findings could enhance patient management and help to guide treatment decisions.