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In 2016, the Hepatitis B and C Public Policy Association (HepBCPPA), gathered all the main stakeholders in the field of hepatitis C virus (HCV) to launch the now landmark HCV Elimination Manifesto, calling for the elimination of HCV in the EU by 2030. Since then, many European countries have made progress towards HCV elimination. Multiple programmes—from the municipality level to the EU level—were launched, resulting in an overall decrease in viremic HCV infections and liver-related mortality. However, as of 2021, most countries are not on track to reach the 2030 HCV elimination targets set by the WHO. Moreover, the COVID-19 pandemic has resulted in a decrease in HCV diagnoses and fewer direct-acting antiviral treatment initiations in 2020. Diagnostic and therapeutic tools to easily diagnose and treat chronic HCV infection are now well established. Treating all patients with chronic HCV infection is more cost-saving than treating and caring for patients with liver-related complications, decompensated cirrhosis or hepatocellular carcinoma. It is more important than ever to reinforce and scale-up action towards HCV elimination. Yet, efforts urgently need the dedicated commitment of policymakers at all governmental and policy levels. Therefore, the third EU Policy Summit, held in March 2021, featured EU parliamentarians and other key decision makers to promote dialogue and take strides towards securing wider EU commitment to advance and achieve HCV elimination by 2030. We have summarized the key action points and reported the ‘Call-to-Action’ statement supported by all the major relevant European associations in the field.

Diverse morphological, cellular and physiological changes occur during seed maturation in Bixa orellana when the seed tissues form specialized cell glands that produce reddish latex with high bixin amounts. Transcriptomic profiling during seed development in three B. orellana accessions (P12, N4 and N5) with contrasting morphologic characteristics showed enrichment in pathways of triterpenes, sesquiterpenes, and cuticular wax biosynthesis. WGCNA allows groups of all identified genes in six modules the module turquoise, the largest and highly correlated with the bixin content. The high number of genes in this module suggests a diversification of regulatory mechanisms for bixin accumulation with the genes belonging to isoprene, triterpenes and carotene pathways, being more highly correlated with the bixin content. Analysis of key genes of the mevalonate (MVA) and the 2C-methyl-D-erythritol-4-phosphate (MEP) pathways revealed specific activities of orthologs of BoHMGR, BoFFP, BoDXS, and BoHDR. This suggests that isoprenoid production is necessary for compounds included in the reddish latex of developing seeds. The carotenoid-related genes BoPSY2, BoPDS1 and BoZDS displayed a high correlation with bixin production, consistent with the requirement for carotene precursors for apocarotenoid biosynthesis. The BoCCD gene member (BoCCD4-4) and some BoALDH (ALDH2B7.2 and ALDH3I1) and BoMET (BoSABATH1 and BoSABATH8) gene members were highly correlated to bixin in the final seed development stage. This suggested a contributing role for several genes in apocarotenoid production. The results revealed high genetic complexity in the biosynthesis of reddish latex and bixin in specialized seed cell glands in different accessions of B. orellana suggesting gene expression coordination between both metabolite biosynthesis processes.

La ventilación mecánica invasiva (VMI) es una terapia de soporte vital que no está exenta de complicaciones, como la disfunción diafragmática inducida por la ventilación mecánica, que se caracteriza por atrofia y debilidad de dicho musculo. El interés en esta patología parece estar basado en la asociación encontrada con resultados clínicos negativos. La prevalencia oscila entre 29 y 80%, probablemente debido a la variabilidad entre los diferentes métodos diagnósticos y el momento de la evaluación. El patrón de oro continúa siendo la presión negativa transdiafragmática generada por la estimulación bilateral de los nervios frénicos, aunque por la falta de practicidad, se comenzó a utilizar la ecografía diafragmática. Si bien cuenta con varias modalidades, no todas tienen análisis de correlación con el patrón de oro. Otra problemática surge al momento de analizar la asociación independiente entre la patología y la VMI, ya que los factores confusores no son sencillos de aislar.

Background: Cardiac surgery with extracorporeal circulation (ECC) requires the administration of anticoagulant drugs to maintain ACT ranges 400–600 seconds, which requires exhaustive coagulation monitoring for which various point-of-care devices are available. However, there is variability between them, so we aimed to compare the values in ACT measurement. Methods: Simultaneous ACT measurements were performed with the Hemochron Response®, Hemostasis Management System Plus® (HMS Plus®) and Hemochron Signature® systems. Results: A total of 255 simultaneous measurements were taken, the mean and standard deviation (SD) of each device were: Hemochron Signature® 361.1 seconds (SD: 156.9), HMS Plus® 412.8 seconds (SD: 180.9) and Hemochron Response® 422.8 seconds (SD: 187.9), being these differences statistically significant (Fridman’s test p < 0.01). For comparisons the Bland–Altman method was used, resulting the Hemochron Response® has 61.7 seconds higher mean values than the Hemochron Signature®, the Hemochron Response® 10 seconds higher than the HMS Plus® and the HMS Plus® 51.7 seconds higher than the Hemochron Signature®. Conclusion: The differences found in comparisons are considered to be clinically relevant, which is why it is considered important to make the variability of the different monitoring systems known and to take them into account for optimal control of this parameter and its clinical repercussions.

Carotene cleavage dioxygenases (CCDs) are a large family of Fe2+ dependent enzymes responsible for the production of a wide variety of apocarotenoids, such as bixin. Among the natural apocarotenoids, bixin is second in economic importance. It has a red-orange color and is produced mainly in the seeds of B. orellana. The biosynthesis of bixin aldehyde from the oxidative cleavage of lycopene at 5,6/5′,6′ bonds by a CCD is considered the first step of bixin biosynthesis. Eight BoCCD (BoCCD1-1, BoCCD1-3, BoCCD1-4, CCD4-1, BoCCD4-2, BoCCD4-3 and BoCCD4-4) genes potentially involved in the first step of B. orellana bixin biosynthesis have been identified. However, the cleavage activity upon lycopene to produce bixin aldehyde has only been demonstrated for BoCCD1-1 and BoCCD4-3. Using in vivo (Escherichia coli) and in vitro approaches, we determined that the other identified BoCCDs enzymes (BoCCD1-3, BoCCD1-4, BoCCD4-1, BoCCD4-2, and BoCCD4-4) also participate in the biosynthesis of bixin aldehyde from lycopene. The LC-ESI-QTOF-MS/MS analysis showed a peak corresponding to bixin aldehyde (m/z 349.1) in pACCRT-EIB E. coli cells that express the BoCCD1 and BoCCD4 proteins, which was confirmed by in vitro enzymatic assay. Interestingly, in the in vivo assay of BoCCD1-4, BoCCD4-1, BoCCD4-2, and BoCCD4-4, bixin aldehyde was oxidized to norbixin (m/z 380.2), the second product of the bixin biosynthesis pathway. In silico analysis also showed that BoCCD1 and BoCCD4 proteins encode functional dioxygenases that can use lycopene as substrate. The production of bixin aldehyde and norbixin was corroborated based on their ion fragmentation pattern, as well as by Fourier transform infrared (FTIR) spectroscopy. This work made it possible to clarify at the same time the first and second steps of the bixin biosynthesis pathway that had not been evaluated for a long time.

Aim: The aim of this study is to evaluate long-term durability and effectiveness of the adjustable transobturator male system (ATOMS). Materials and methods: The retrospective multicenter Iberian ATOMS study (n = 215) was updated to evaluate long-term continence status, complications, explants, and secondary treatments. Mean follow-up from surgery to March 2020 was 60.6 ± 18.4 months (range, 39-91). Eleven patients deceased of an unrelated causes. Kaplan-Meier curves were performed to evaluate device durability and incontinence free of recurrence interval. The multivariate analysis defined the population at risk of device explant. Results: A total of 155 patients were dry at the last follow-up visit (72.1%); 99 (46%) used no pads and 56 (26%) used a security pad/day with urine loss less than 10 mL; 96% of dry patients after adjustment remained free of incontinence 1 year later, 93.6% 2 years later, 91.1% 3 years later, 89.2% 5 years later, and 86.7% 8 years later. Complications during follow-up occurred in 43 of 215 (20%). In total, 25 (11.6%) devices were explanted and causes were inefficacy 11 (44%), inefficacy and pain 3 (12%), port erosion 10 (40%), and wound infection 1 (4%). The secondary implant was performed in 11 (5.1%) cases, 6 artificial urinary sphincter and 5 repeated ATOMS. Time to explant was associated to complications (P < .0001), baseline stress urinary incontinence (SUI) severity (P = .01), and former irradiation (P = .03). Multivariate analysis revealed complications (hazard ratio [HR] = 8.71; 3.83-19.82), baseline SUI severity (>5 compared to 1-2 pads/day; HR = 14.9; 1.87-125), and irradiation before ATOMS (HR = 2.26; 1.02-5.18) predicted earlier ATOMS explant. Three cases received radiation after implant without complication. Conclusions: ATOMS device is efficacious and safe in the long term. Determinants for device explant include complications, baseline severity of incontinence, and previous irradiation. Currently, the durability of the device after 5 years is reassuring. Sin financiación 2.696 JCR (2020) Q3, 50/89 Urology & Nephrology 0.918 SJR (2020) Q1, 27/107 Urology No data IDR 2020 UEM

Carotene cleavage dioxygenases (CCDs) are a large family of Fe

Objective To analyze metabolic differences during normothermic regional perfusion (NRP) between the dissimilar types of donation after circulatory death, uncontrolled (uDCD) and controlled (cDCD), and the evolution of the transplanted kidneys. Methods Observational, prospective, cohort study. We included patients from uDCD and cDCD maintained with NRP in 2017. Six consecutive blood gases were collected with determination of pH and lactic acid. Creatinine levels were monitored at 24 hours, 3 months, and 6 months after transplant and the need for renal replacement therapy was evaluated. Descriptive statistical analysis was performed, presenting the qualitative variables as frequencies and percentages, and quantitative as mean ± SD or median (interquartile range [IQR]). We used χ2 testing for bivariate analysis of qualitative variables. Results We collected 18 donors. Fifteen out of 18 (83.3%) were men with a median of 51 years (IQR, 46-60). Eleven out of 18 (61.1%) were cDCD and 7 out of 18 (38.9%) were uDCD. The blood gas results are illustrated in Table 1 . A total of 28 renal transplants were obtained with a median age of 47 years (IQR, 45-57); 83% were male. Ten out of 28 (35.7%) came from uDCD and 18 out of 28 (64.7%) from cDCD. Table 2 shows the monitoring of the creatinine values of the recipients after the transplantation. Conclusions There are more metabolic disorders in our series in uDCD organ donation compared with cDCD. The recovery of the renal function of organs from uDCD is slower than that of cDCD, however; the tendency is toward normality.

BACKGROUND: Laboratory studies suggest applying positive pressure without endotracheal suction during cuff deflation and extubation. Although some studies reported better physiological outcomes (e.g. arterial blood gases) with this technique, the safety of positive pressure extubation technique has not been well studied. The aim of this study was to determine the safety of the positive-pressure extubation technique compared with the traditional extubation technique in terms of incidence of complications. METHODS: Adult subjects who were critically ill and on invasive mechanical ventilation who met extubation criteria were included. The subjects were randomly assigned to positive-pressure extubation (n = 120) or to traditional extubation (n = 120). Sequential tests for noninferiority and, when appropriate, for superiority were performed. Positive pressure was considered noninferior if the upper limit of the CI for the absolute risk difference did not exceed a threshold of 15% in favor of the traditional group, both in per protocol and intention-to-treat analyses. A P value of RESULTS: A total of 236 subjects were included in the primary analysis (per protocol) (119 in the positive-pressure group and 117 in the traditional group). The incidence of overall major and minor complications, pneumonia, extubation failure, and reintubation was lower in the positive-pressure group than in the traditional group, with statistical significance for noninferiority both in the per protocol (P CONCLUSIONS: Positive pressure was safe and noninferior to traditional extubation methods. Furthermore, positive pressure has shown to be superior in terms of a lower incidence of major complications. (ClinicalTrials.gov registration NCT03174509.)

Backgrounds Patient-reported outcome measurements are important for urinary incontinence. We analyze self-assessed patient satisfaction and defne the clinical profle of patient with highest satisfaction with the adjustable transobturator male system (ATOMS). Methods Patient perception of results was evaluated in a series of 181 patients after ATOMS adjustment. Baseline incontinence severity was defned in pads-per-day (PPD) as mild (2), moderate (3–5) or severe (≥6), and dryness as use of none or one security PPD. Post-operative pain at discharge was evaluated by 0–10 visual analogue scale and complications by Clavien–Dindo classifcation. Multivariate analysis was performed to anticipate “very much better” than baseline perception on patient global impression of improvement and a predictive nomogram was developed. Results Dryness was achieved in 80.7% (94.9% mild, 80.8% moderate and 65.8% severe groups). Mean pad-test and padcount decrease with respect to baseline was 458±330 ml and 3.2±1.9 PPD, respectively (both p

Background: Migrants in high-income countries may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations, indirect health and social impacts, and to determine key risk factors.; Methods: We did a systematic review following PRISMA guidelines (PROSPERO CRD42020222135). We searched multiple databases to 18/11/2020 for peer-reviewed and grey literature on migrants (foreign-born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts and risk factors using narrative synthesis.; Results: 3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected. Migrants experience risk factors including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement.; Conclusions: Migrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health and policy responses to the pandemic. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups. © 2021 The Author(s). Published by Elsevier Ltd.

RESUMEN Objetivo: Describir los resultados de la implementación de un protocolo de cuidados respiratorios y de ventilación mecánica en el potencial donante de pulmón, que cumplen las condiciones para ser procurados. El objetivo secundario es comparar los resultados con datos históricos. Métodos: Estudio retrospectivo y observacional. Incluye potenciales donantes aptos para procuración de órganos con muerte encefálica internados en las áreas críticas de la Ciudad Autónoma de Buenos Aires, desde abril de 2017 hasta marzo de 2018. Variables principales: número de potencial donante de pulmón que alcanzan el objetivo de procuración, tasa de pulmones procurados y tasa de pulmones implantados. Se consideraron valores significativos p < 0,05. Resultados: Se incluyeron 30 potenciales donantes de pulmón, 23 (88.5%; IC95% 69,8 - 97,6) cumplieron el objetivo de oxigenación. Veinte potenciales donantes de pulmón donaron órganos y de ellos, ocho donaron pulmones, con los cuales se realizaron 4 trasplantes bipulmonares y 8 unipulmonares. Los pulmones procurados e implantados en el periodo pre-protocolo fueron 7, mientras que durante el protocolo fueron 12 (valor p = 0,38). La tasa de implantación fue 58,3% (7/12) en el control histórico y 100% (12/12) (valor p = 0,04) en el periodo de estudio. Conclusión: El protocolo permitió alcanzar el objetivo de oxigenación en la mayoría de los potenciales donantes de pulmón y una mejoría estadísticamente significativa en la tasa de implantación. ABSTRACT Objective: To describe the results from the implementation of a respiratory care and mechanical ventilation protocol on potential lung donors who met the conditions for procurement. The secondary objective is to compare the results with historical data. Methods: This was a retrospective, observational study. It included potential donors suitable for procurement of organs who had brain death and were hospitalized in critical care units of the Autonomous City of Buenos Aires from April 2017 to March 2018. Main variables: number of potential lung donors that reached the objective of procurement, rate of lungs procured, and rate of implanted lungs. Values of p < 0.05 were considered significant. Results: Thirty potential lung donors were included, and 23 (88.5%; 95%CI 69.8 - 97.6) met the oxygenation objective. Twenty potential lung donors donated organs, of whom eight donated lungs, with which four double lung transplants and eight single lung transplants were performed. Seven of 12 lungs were procured and implanted in the preprotocol period, while all 12 were under the protocol (p = 0.38). The implantation rate was 58.3% (7/12) in the historical control period and 100% (12/12) (p = 0.04) in the study period.

Invasive mechanical ventilation (VMI) is a life support therapy that is not free of complications, such as ventilator induced diaphragmatic dysfunction, which is characterized by atrophy and weakness of the muscle. Interest in this pathology seems to be based on the association found with negative clinical results. The prevalence ranges between 29 and 80%, probably due to the variability between the different diagnostic methods and the time of evaluation. The gold standard continues to be the transdiaphragmatic negative pressure generated by the bilateral stimulation of the phrenic nerves, although due to the lack of practicality, diaphragmatic ultrasound began to be used. Although it has several modalities, not all of them have correlation analysis with the gold standard. Another problem arises when analyzing the independent association between pathology and VMI, since confusing factors are not easy to isolate.La ventilación mecánica invasiva (VMI) es una terapia de soporte vital que no está exenta de complicaciones, como la disfunción diafragmática inducida por la ventilación mecánica, que se caracteriza por atrofia y debilidad de dicho musculo. El interés en esta patología parece estar basado en la asociación encontrada con resultados clínicos negativos. La prevalencia oscila entre 29 y 80%, probablemente debido a la variabilidad entre los diferentes métodos diagnósticos y el momento de la evaluación. El patrón de oro continúa siendo la presión negativa transdiafragmática generada por la estimulación bilateral de los nervios frénicos, aunque por la falta de practicidad, se comenzó a utilizar la ecografía diafragmática. Si bien cuenta con varias modalidades, no todas tienen análisis de correlación con el patrón de oro. Otra problemática surge al momento de analizar la asociación independiente entre la patología y la VMI, ya que los factores confusores no son sencillos de aislar.

To describe the results from the implementation of a respiratory care and mechanical ventilation protocol on potential lung donors who met the conditions for procurement. The secondary objective is to compare the results with historical data.This was a retrospective, observational study. It included potential donors suitable for procurement of organs who had brain death and were hospitalized in critical care units of the Autonomous City of Buenos Aires from April 2017 to March 2018. Main variables: number of potential lung donors that reached the objective of procurement, rate of lungs procured, and rate of implanted lungs. Values of p0.05 were considered significant.Thirty potential lung donors were included, and 23 (88.5%; 95%CI 69.8 - 97.6) met the oxygenation objective. Twenty potential lung donors donated organs, of whom eight donated lungs, with which four double lung transplants and eight single lung transplants were performed. Seven of 12 lungs were procured and implanted in the preprotocol period, while all 12 were under the protocol (p = 0.38). The implantation rate was 58.3% (7/12) in the historical control period and 100% (12/12) (p = 0.04) in the study period.Describir los resultados de la implementación de un protocolo de cuidados respiratorios y de ventilación mecánica en el potencial donante de pulmón, que cumplen las condiciones para ser procurados. El objetivo secundario es comparar los resultados con datos históricos.Estudio retrospectivo y observacional. Incluye potenciales donantes aptos para procuración de órganos con muerte encefálica internados en las áreas críticas de la Ciudad Autónoma de Buenos Aires, desde abril de 2017 hasta marzo de 2018. Variables principales: número de potencial donante de pulmón que alcanzan el objetivo de procuración, tasa de pulmones procurados y tasa de pulmones implantados. Se consideraron valores significativos p0,05.Se incluyeron 30 potenciales donantes de pulmón, 23 (88.5%; IC95% 69,8 - 97,6) cumplieron el objetivo de oxigenación. Veinte potenciales donantes de pulmón donaron órganos y de ellos, ocho donaron pulmones, con los cuales se realizaron 4 trasplantes bipulmonares y 8 unipulmonares. Los pulmones procurados e implantados en el periodo pre-protocolo fueron 7, mientras que durante el protocolo fueron 12 (valor p = 0,38). La tasa de implantación fue 58,3% (7/12) en el control histórico y 100% (12/12) (valor p = 0,04) en el periodo de estudio.El protocolo permitió alcanzar el objetivo de oxigenación en la mayoría de los potenciales donantes de pulmón y una mejoría estadísticamente significativa en la tasa de implantación.

Este artículo se escribe dentro del proyecto de I+D: “La recepción de la Filosofía grecorromana en la Filosofía y las Ciencias Humanas en Francia y España desde 1980 hasta la actualidad” (FFI2014-53792-R), Este artículo pretende situar el sorteo en la filosofía política de Jacques Rancière. El sorteo está vinculado con una reflexión de un enorme calado filosófico sobre la igualdad aritmética y la igualdad geométrica. Partiendo de un importante trabajo de Cornelius Castoriadis al respecto, analizaremos a continuación la relación de la filosofía política de Rancière con la igualdad. Por último, nos ocuparemos del sorteo y del lugar que ocupa en su obra. El trabajo de Bernard Manin sobre las democracias antiguas y los sistemas de gobierno representativo nos ayudará a contextualizar las propuestas de Rancière sobre el recurso a la selección aleatoria en política., This paper analyses the place of sortition in the political philosophy of Jacques Rancière. The idea of sortition is linked to a philosophical reflection on arithmetic equality and geometric equality. Thus, starting from an important work of Cornelius Castoriadis in this sense, we will analyze below the relationship of Rancière’s political philosophy with equality. Finally we will analyze the sortition and the place it occupies in his work. Bernard Manin’s work on ancient democracies and systems of representative government will help us contextualize Rancière’s proposals on the use of random selection in politics.

Carotenoid pigments are abundant in plants mainly in flowers and fruits and have diverse roles in photobiology, photochemistry, and medicine. Carotenoids properties, such as reactivity with singlet oxygen and with a range of free radicals, render them essential in dietary recommendations. These compounds have the particularity of acting to attenuate or prevent human chronic diseases (e.g., breast cancer, diabetes mellitus, eye illness, and cardiovascular ailments) and aging. Mechanisms associated with the anti- and prooxidant behavior of carotenoids make them essential elements for human health. Several studies, including cell cultures, animal studies, and epidemiological investigations have indicated the effect of dietary carotenoids in reducing the risk of chronic diseases, such as cancer and coronary heart disease.