Search

As the interest in natural, sustainable ecosystems arises in many fields, wild plant diversity is reconsidered. The present study is based on extant literature evidence from the journey of John Sibthorp (Professor of Botany, Oxford University) to Peloponnese (Greece) in pre-industrial time. In the year 1795, Peloponnese was a botanically unknown region, very dangerous for travellers and under civil unrest, in conjuncture with a pre-rebellion period. Our study reveals approximately 200 wild plant taxa that were collected from Peloponnese localities in 1795, transported to Oxford University (UK), and quoted in the magnificent edition Flora Graeca Sibthorpiana of the 19th century. Moreover, these plants currently constitute a living collection in Peloponnese, confirmed according to updated data on the vascular Flora of Greece. The presented lists constitute a source of information for plant biologists, linking the past to the present, shedding light on the study of adaptive traits of wild Mediterranean plants and revealing the temporal dimension of natural history. Nowadays, increasing and thorough understanding of the considered plants’ functionality to abiotic and biotic environmental stimuli provides a new framework of sustainability and management options.

Resumen: Introducción: la simulación como herramienta docente está en expansión en la educación de grado. El objetivo de este estudio es describir esta metodología aplicada al paciente pediátrico y descubrir las opiniones de los alumnos. Material y métodos: se realizaron 14 sesiones de simulación clínica avanzada (SCA) de pediatría a 168 alumnos de 6.° curso del grado de Medicina, con los escenarios de bronquiolitis, RCP, taquicardia supraventricular, crisis convulsiva y exploración de centro salud, durante los cursos 2020-2021 y 2021-2022. Tras la SCA tuvieron la oportunidad de responder a una encuesta de satisfacción de 29 preguntas. Resultados: 103/168 (61,3%) alumnos contestaron la encuesta de satisfacción. Las puntuaciones medias ± SD (sobre un máximo de 5) de los ítems principales fueron: aprendizaje de habilidades técnicas 4,58 ± 0,59; comunicación y motivación del alumno en la simulación clínica 4,94 ± 0,24. Sobre la estructura de la sesión de simulación, la puntuación media mejor valorada fue el profesorado 4,95 ± 0,26 y la duración del caso 4,75 ± 0,64. La valoración del alumno sobre el incremento de los conocimientos prácticos en pediatría fue elevada. Conclusiones: la SCA con práctica deliberada que sigue el método de aprendizaje por repetición, es considerada por los alumnos útil y motivadora para su formación. Al terminar la SCA, 87,4% de los participantes consideraron que se sentían capaces de enfrentarse a una urgencia pediátrica; 96% se sentía capaz de identificar a un enfermo inestable aplicando el triángulo de evaluación pediátrica; 94% sabría informar a los padres de forma clara y comprensible. Abstract: Introduction: Simulation as a teaching tool is expanding in healthcare disciplines and is being implemented in pediatric undergraduate education. This study describes this teaching methodology applied to pediatric patient knowledge and considers student opinions in order to tailor it to their educational needs. Methods: Fourteen sessions of advanced clinical simulation (ACS) in Pediatrics were conducted with 168 sixth-year medical students, featuring scenarios of bronchiolitis, CPR, supraventricular tachycardia, seizure, and primary care examination, during the academic years 2020-2021 and 2021-2022. After the ACS, the students were given the opportunity to respond to a satisfaction survey. Results: 103 out of 168 (61,3%) students completed the survey. The average scores ± SD (on a maximum of 5) for the main items were as follows: learning technical skills 4,58 ± 0,59; communication and student motivation in ACS 4,94 ± 0,24. Regarding the structure ACS session, the highest rated average score was for the faculty 4,95 ± 0,26, and the case duration 4,75 ± 0,64. The student assessment of increased practical knowledge in pediatrics was high. Conclusions: ACS with deliberate practice that follows a learning by repetition method is considered useful and motivational learning amongs students. Upon completion of the ACS, 87.4% of the participants felt capable of initially managing a pediatric emergency; 96% felt capable of identifying an unstable patient using the pediatric assessment triangle; and 94% stated that they would be able to provide clear and understandable information to parents.

Introduction: Environmental exposure to tobacco increases the risk of respiratory disease in infants. However, the impact of maternal smoking on the development of acute bronchiolitis has hardly been assessed. The aim of this study was to determine the incidence of acute bronchiolitis and to analyse the effect of prenatal and postnatal maternal smoking on the development of this disease. Patients and methods: A prospective, observational study was performed on healthy newborns from a third level hospital born between October 2015 and February 2016. Questionnaires were completed by the mothers at discharge from maternity and followed-up for two years. These collected information about prenatal and postnatal smoking, lifestyle, family and personal history, and the development of bronchiolitis. A bivariate and multivariate logistic regression analysis was performed. Results: A total of 223 newborns were included, of whom 13.9% were exposed to tobacco smoking during gestation, 21.4% in the postnatal period, and 12.4% in both times. The incidence of bronchiolitis was 28.7% at one year of life, and 34.5% at two years. The multivariate analysis demonstrated that the prenatal and postnatal exposure to tobacco is an independent risk factor for the development of bronchiolitis (OR 4.38; 95% CI; 1.63–11.76), while prolonged breastfeeding is a protective factor (OR 0.13; 95% CI; 0.04–0.48). Other factors that were statistically significant were: atopic dermatitis (OR 2.91; 95% CI; 1.26–6.73), and gestational age (OR 1.42; 95% CI; 1.08–1.88). Conclusions: Children exposed to prenatal and postnatal maternal smoking have a higher risk of suffering bronchiolitis. Reducing the smoking habit in women that intend to become pregnant must be a priority in preventive medicine. Resumen: Introducción: La exposición ambiental al tabaco incrementa el riesgo de patología respiratoria en la infancia. Sin embargo, el impacto del tabaquismo materno en el desarrollo de bronquiolitis aguda ha sido escasamente evaluado. El objetivo del estudio fue determinar la incidencia de bronquiolitis aguda y analizar el efecto del tabaquismo materno prenatal y postnatal en el desarrollo de esta patología. Pacientes y métodos: Estudio observacional, prospectivo, que incluyó recién nacidos sanos de un hospital terciario entre octubre-2015 y febrero-2016. Se realizaron encuestas a las madres al alta de maternidad y seguimiento durante dos años, que recogieron información sobre tabaquismo prenatal y postnatal, estilo de vida, antecedentes familiares y personales, y desarrollo de bronquiolitis. Se realizó análisis de regresión logística bivariante y multivariante. Resultados: Se incluyeron 223 recién nacidos, 13,9% estuvieron expuestos a tabaquismo durante la gestación, 21,4% en período postnatal y 12,4% en ambos momentos. La incidencia de bronquiolitis fue de 28,7% al año de vida y de 34,5% a los dos años. El análisis multivariante demostró que la exposición prenatal y postnatal al tabaco es un factor de riesgo independiente para el desarrollo de bronquiolitis (OR 4,38; IC95% 1,63–11,76), mientras que la lactancia materna prolongada es un factor protector (OR 0,13; IC95% 0,04–0,48). Otros factores que resultaron estadísticamente significativos fueron: dermatitis atópica (OR 2,91; IC95% 1,26–6,73) y edad gestacional (OR 1,42; IC95% 1,08–1,88). Conclusiones: Los niños expuestos a tabaquismo materno prenatal y postnatal presentan un mayor riesgo de padecer bronquiolitis. La disminución del hábito tabáquico en mujeres con intención de embarazo debe ser una prioridad en medicina preventiva.

Background: Enteral nutrition interruptions (ENI) are prevalent in the pediatric intensive care unit (PICU), but there is little evidence of their characteristics. Methods: This is a cross-sectional multicenter study including critically ill children on enteral nutrition. ENIs were classified as PICU procedures, procedures performed outside the PICU (PPOP), feeding intolerance and other criteria. The number and features of ENIs were collected. Results: A total of 75 children were enrolled. There were 41 interruptions affecting 37.3% of the patients with a median duration of 5 ± 9.4 h. The most common reason for ENI was PPOP (41.5%), followed by other criteria. Interruptions were considered preventable in 24.4% of the cases, but only eight were compensated. ENIs were more prevalent among children with cardiac disease (p = 0.047), higher PRISM (p = 0.047) and longer PICU stay (p = 0.035). There was association between PRISM and total interruption time (p = 0.02) and lower caloric intake (p = 0.035). Patients with respiratory illness (p = 0.022) and on noninvasive ventilation (p = 0,028) had fewer ENIs. ENI total time was associated with lower caloric (p = 0.001) and protein (p = 0.02) intake. Conclusions: ENIs are prevalent in PICU, especially in children with higher PRISM, longer PICU stays and cardiac disease, and result in lower caloric and protein intake.

Polarity establishment in many cells is thought to occur via positive feedback that reinforces even tiny asymmetries in polarity protein distribution. Cdc42 and related GTPases are activated and accumulate in a patch of the cortex that defines the front of the cell. Positive feedback enables spontaneous polarization triggered by stochastic fluctuations, but as such fluctuations can occur at multiple locations, how do cells ensure that they make only one front? In polarizing cells of the model yeast Saccharomyces cerevisiae, positive feedback can trigger growth of several Cdc42 clusters at the same time, but this multi-cluster stage rapidly evolves to a single-cluster state, which then promotes bud emergence. By manipulating polarity protein dynamics, we show that resolution of multi-cluster intermediates occurs through a greedy competition between clusters to recruit and retain polarity proteins from a shared intracellular pool.

Based on the traditional fractal theory and on the paper of Stehlík, (2009) the range of fractal dimension of osteoporosis vertebras is analysed. First we give an insight into the field of fractals and the usa­ge of fractals in medicine. After this we show how the analytical tool of Stehlík, (2009) may be applied to the osteoporosis vertebras. It turns out that the used method can be applied very well and that it could help with medical diagnosis. Real data example illustrates the methods discussed.