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Objective: To determine the cost-effectiveness of a new telemedicine optometric-based screening program of diabetic retinopathy (DR) compared with traditional models' assessments in a universal European public health system. Methods: A new teleophthalmology program for DR based on the assessment of retinographies (3-field Joslin Vision Network by a certified optometrist and a reading center [IOBA-RC]) was designed. This program was first conducted in a rural area 40 km from the referral hospital (Medina de Rioseco, Valladolid, Spain). The cost-effectiveness was compared with telemedicine based on evaluations by primary care physicians and general ophthalmologists, and to face-to-face examinations conducted by ophthalmologists. A decision tree model was developed to simulate the cost-effectiveness of both models, considering public and private costs. The effectiveness was measured in terms of quality of life. Results: A total of 261 patients with type 2 diabetes were included (42 had significant DR and required specific surveillance by the RC; 219 were undiagnosed). The sensitivity and specificity of the detection of DR were 100% and 74.1%, respectively. The telemedicine-based DR optometric screening model demonstrated similar utility to models based on physicians and general ophthalmologists and traditional face-to-face evaluations (0.845) at a lower cost/patient (€51.23, €71.65, and €86.46, respectively). Conclusions: The telemedicine-based optometric screening program for DR in a RC demonstrated cost savings even in a developed country with a universal health care system. These results support the expansion of this kind of teleophthalmology program not only for screening but also for the follow-up of diabetic patients.

In recent years, exposures to organophosphate pesticide have been highlighted as a possible cause or aggravating factor of autism spectrum disorder (ASD). The present study examined if Wistar rats prenatally exposed to chlorpyrifos (CPF) at a dose of 1 mg/kg in GD 12.5-15.5 could express similar behaviors to those exposed to valproic acid (VPA, 400 mg/kg) during the same administration window, which is an accepted animal model of autism. The 3-chambered test was employed to evaluate sociability and reaction to social novelty in two experiments, the first in adolescence and the second in adulthood. The results obtained in this study show that animals prenatally treated with CPF or VPA show a similar behavioral phenotype compared to the control group (CNT). In adolescence, the CPF animals showed a negative index in the reaction to social novelty, followed closely by the VPA, while both experimental groups showed a recovery in this aspect during adulthood. This study therefore provides evidence to suggest that prenatal exposure to CPF in rats could have similar effects on certain components of sociability to those seen in autistic models., (© 2024. The Author(s).)

Drylands account for 45% of the Earth's land area, supporting ~40% of the global population. These regions support some of the most extreme environments on Earth, characterized by extreme temperatures, low and variable rainfall, and low soil fertility. In these biomes, microorganisms provide vital ecosystem services and have evolved distinctive adaptation strategies to endure and flourish in the extreme. However, dryland microbiomes and the ecosystem services they provide are under threat due to intensifying desertification and climate change. In this review, we provide a synthesis of our current understanding of microbial life in drylands, emphasizing the remarkable diversity and adaptations of these communities. We then discuss anthropogenic threats, including the influence of climate change on dryland microbiomes and outline current knowledge gaps. Finally, we propose research priorities to address those gaps and safeguard the sustainability of these fragile biomes., (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Society for Microbial Ecology.)

Air pollution has been associated with a wide range of health issues, particularly regarding cardio-respiratory diseases. Increasing evidence suggests a potential link between gestational exposure to environmental pollutants and neurodevelopmental disorders such as autism spectrum disorder. The respiratory pathway is the most commonly used exposure model regarding PM due to valid and logical reasons. However, PM deposition on food (vegetables, fruits, cereals, etc.) and water has been previously described. Although this justifies the need of unforced, oral models of exposure, preclinical studies using oral exposure are uncommon. Specifically, air pollution can modify normal brain development at genetic, cellular, and structural levels. The present work aimed to investigate the effects of oral gestational exposure to particulate matter (PM) on ultrasonic vocalizations (USV). To this end, pregnant rats were exposed to particulate matter during gestation. The body weight of the pups was monitored until the day of recording the USVs. The results revealed that the exposed group emitted more USV calls when compared to the control group. Furthermore, the calls from the exposed group were longer in duration and started earlier than those from the non-exposed group. Gene expression analyses showed that PM exposure down-regulates the expression of Gabrg2 and Maoa genes in the brain, but no effect was detected on glutamate or other neurotransmission systems. These findings suggest that gestational exposure to PM10 may be related to social deficits or other phenomena that can be analyzed with USV. In addition, we were able to detect abnormalities in the expression of genes related to different neurotransmitter systems, such as the GABAergic and monoaminergic systems. Further research is needed to fully understand the possible effects of air pollutant exposure on neurodevelopmental disorders as well as the way in which these effects are linked to differences in neurotransmission systems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Air pollution plays, nowadays, a huge role in human's health and in the personal economy. Moreover, there has been a rise in the prevalence of neurodevelopmental disorders like the Autism Spectrum Disorder (ASD) in recent years. Current scientific studies have established a link between prenatal or perinatal exposure to environmental pollutants and ASD. This systematic review summarizes the current literature available about the relationship between exposure to air pollutants (particulate matter [PM], Second Organic Aerosols [SOA], Diesel Exhaust [DE], and Traffic Related Air Pollution [TRAP]) and neurodevelopmental disorders in preclinical models using rats and mice. The articles were selected and filtered using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, and bias-evaluated using the SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE) tool. Overall, our findings suggest that air pollutants are associated with negative developmental outcomes characterized by ASD-like behaviors, abnormal biochemical patterns, and impaired achievement of developmental milestones in rodents. However, there is not sufficient information in certain domains to establish a clear relationship. Short phrases for indexing terms: Air pollution affects neurodevelopment; PM exposure modifies glutamate system; Prenatal exposure combined with postnatal affect more to behavioral / cognitive domain; Air pollution modifies social behavior in rodents; Cognitive deficits can be detected after gestational exposure to air pollution., Competing Interests: Declaration of Competing Interest All authors have declared that no financial or personal relationships have influenced in writing this article. No author claimed conflict of interest to disclose. No further affiliations with any organization that may have a financial or political interest in the subject matter discussed in this work are present. The present research was conducted solely for academic purposes and have not received any further support from any external sources that may have influenced our findings or conclusions., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Purpose: Chimeric antigen receptor (CAR)-T cells are a viable treatment option for patients with relapsed or refractory (r/r) aggressive B-cell lymphomas. The prognosis of patients who relapse after CAR-T cell treatment is dismal and factors predicting outcomes need to be identified. Our aim was to assess the value of FDG-PET/CT in terms of predicting patient outcomes., Methods: Twenty-two patients with r/r B-cell lymphoma who received CAR-T cell treatment with tisagenlecleucel (n = 17) or axicabtagene ciloleucel (n = 5) underwent quantitative FDG-PET/CT before (PET-0) and 1 month after infusion of CAR-T cells (PET-1). PET-1 was classified as complete metabolic response (CMR, Deauville score 1-3) or non-CMR (Deauville score 4-5)., Results: At the time of PET-1, 12/22 (55%) patients showed CMR, ten (45%) patients non-CMR. 7/12 (58%) CMR patients relapsed after a median of 223 days, three of them (25%) died. 9/10 (90%) non-CMR patients developed relapse or progressive disease after a median of 91 days, eight of them (80%) died. CMR patients demonstrated a significantly lower median total metabolic tumor volume (TMTV) in PET-0 (1 ml) than non-CMR patients (225 ml)., Conclusion: Our results confirm the prognostic value of PET-1. 42% of all CMR patients are still in remission 1 year after CAR T-cell treatment. 90% of the non-CMR patients relapsed, indicating the need for early intervention. Higher TMTV before CAR-T cell infusion was associated with lower chances of CMR., (© 2023. The Author(s).)

We are reporting our engagement with the 'Learning from Excellence' initiative in the neonatal intensive care unit during the covid era, with enhanced professional and personal stresses in the workforce. It highlights the positive experiences around technical management of sick neonates and human factors, like team working, leadership and communication., Competing Interests: There are no conflicts of interests for the manuscript ‘Excellence reporting in a neonatal intensive care unit during covid-19 era’., (Crown Copyright © 2023 Published by Elsevier Ltd on behalf of Neonatal Nurses Association. All rights reserved.)

Iron is an essential micronutrient for most living organisms, including cyanobacteria. These microorganisms have been found in Earth's driest polar and non-polar deserts, including the Atacama Desert, Chile. Iron-containing minerals were identified in colonized rock substrates from the Atacama Desert, however, the interactions between microorganisms and iron minerals remain unclear. In the current study, we determined that colonized gypsum rocks collected from the Atacama Desert contained both magnetite and hematite phases. A cyanobacteria isolate was cultured on substrates consisting of gypsum with embedded magnetite nanoparticles. Transmission electron microscopy imaging revealed a significant reduction in the size of magnetite nanoparticles due to their dissolution, which occurred around the microbial biofilms. Concurrently, hematite was detected, likely from the oxidation of the magnetite nanoparticles. Higher cell counts and production of siderophores were observed in cultures with magnetite nanoparticles suggesting that cyanobacteria were actively acquiring iron from the magnetite nanoparticles. Magnetite dissolution and iron acquisition by the cyanobacteria was further confirmed using large bulk magnetite crystals, uncovering a survival strategy of cyanobacteria in these extreme environments., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors.)

Based on previous reports, exposure to pesticides could be linked to the prevalence increase of autism spectrum disorders (ASD). Gestational exposure to chlorpyrifos (CPF) has been associated with ASD diagnosis in humans and ASD-like behaviors in rodents. However, ASD severity degree results from the complex relationship between genetic background and environmental factors. Thus, animals with a genetic vulnerability and prenatally exposed to CPF could have a more severe ASD-like phenotype. Fragile X syndrome is one of the most common monogenic causes of ASD, characterized by a mutation in the X chromosome which alters the expression of the fragile X mental retardation protein (FMRP). Based on this, some fmr1 knockout (KO) rodent models have been developed to study the physiological and genetic basis of ASD. Both fmr1-KO and wild-type male rats (F2 generation) were used in the present study. F1 pregnant females were randomly exposed to 1 mg/kg/mL/day of CPF (s.c.) from GD12.5-15.5 or vehicle. Different behavioral, developmental, and molecular variables were analyzed in F2 males. KO rats were heavier, emitted altered USVs, were socially inefficient, reacted more to a novel stimulus, were hyperactive when exploring a new context, but hypoactive when exploring anxiety-inducing environments, and had an upregulated hippocampal expression of the grin2c gene. When exposed to low doses of CPF during gestation, these KO rats showed decreased climbing capacity, dysfunctional social interaction, and increased hippocampal expression for kcc1 and 5ht2c genes. Gestational CPF exposure increased the ASD-like phenotype in those animals with a genetic vulnerability, although its effect was less generalized than expected. It is the first time that this additive effect of CPF exposure and the fmr1-KO genetic vulnerability model is explored concerning social traits or any other behavior., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

In hyper-arid deserts, endolithic microbial communities survive in the pore spaces and cracks of rocks, an environment that enhances water retention and filters UV radiation. The rock colonization zone is enriched in far-red light (FRL) and depleted in visible light. This poses a challenge to cyanobacteria, which are the primary producers of endolithic communities. Many species of cyanobacteria are capable of Far-Red-Light Photoacclimation (FaRLiP), a process in which FRL induces the synthesis of specialized chlorophylls and remodeling of the photosynthetic apparatus, providing the ability to grow in FRL. While FaRLiP has been reported in cyanobacteria from various low-light environments, our understanding of light adaptations for endolithic cyanobacteria remains limited. Here, we demonstrated that endolithic Chroococcidiopsis isolates from deserts around the world synthesize chlorophyll f , an FRL-specialized chlorophyll when FRL is the sole light source. The metagenome-assembled genomes of these isolates encoded chlorophyll f synthase and all the genes required to implement the FaRLiP response. We also present evidence of FRL-induced changes to the major light-harvesting complexes of a Chroococcidiopsis isolate. These findings indicate that endolithic cyanobacteria from hyper-arid deserts use FRL photoacclimation as an adaptation to the unique light transmission spectrum of their rocky habitat.

The molecular and behavioral effects of the developmental exposure to low doses of Chlorpyrifos (CPF) have been intensively studied in young (neonates and adolescents), and adult animals. However, no study examined influences of developmental CPF exposure in older adult or geriatric rats. This is relevant as such ages are generally linked to cognitive decline and the onset of specific neurodegenerative disorders, some of them previously associated with CPF exposure in both preclinical and human studies. 1 mg/kg/mL of CPF was orally administered to both male and female Wistar rats from Postnatal day 10 to 15. Animals' spatial memory, learning, compulsivity, motricity, and anxiety were analyzed with Morris Water Maze (15-16 months of age) and the Plus-maze (at 18 months of age). Results showed that postnatal CPF exposure did not alter either spatial memory, compulsive-like behaviors, or anxiety levels in late-adult rats. However, CPF exposed rats were hyposensitive to brief disruptions (Probe stage) following the learning phase and showed a general decrease in locomotor activity in both paradigms. These data are relevant as it is the first time that developmental exposure to CPF has been studied at such a late age, observing important effects in locomotor activity that could be linked to specific pathologies previously associated with CPF effects in people. Future studies should extend these findings to other behaviors and molecular outcomes., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

An 11-year-old boy with a history of atopy and allergic rhinitis under treatment with sublingual immunotherapy was referred following several episodes of food impaction. Diagnosis of eosinophilic oesophagitis, chronic gastritis and gastric mucosa-associated lymphoid tissue (MALT) lymphoma associated to Helicobacter pylori were confirmed. Results of the extension study were negative and the lymphoma was resolved with eradicating treatment for H. pylori No improvement was observed in the oesophagitis after the withdrawal of immunotherapy and treatment with high proton pump inhibitor doses or following the omission of several foods to which subclinical sensitisation was confirmed. Oesophagitis was finally resolved by removing cow's milk protein. After 10 years, neither eosinophilic oesophagitis nor MALT lymphoma was observed.Gastric MALT lymphoma associated to H. pylori is a rare disorder in children. Although coexisting H. pylori infection is common in patients with eosinophilic oesophagitis, the association of gastric MALT lymphoma with eosinophilic oesophagitis has not been reported before., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Alterations in attention and inhibitory control are common features in several neurological disorders. Environmental factors such as exposure to pesticides have been linked to their appearance. Chlorpyrifos (CPF) is one of the most widely used organophosphate compounds in the world. CPF exposure during development seems to be critical for later behavioral and molecular disruptions during adult ages, although this depends on the specific period of development, where the preweaning period is one of the least studied. Despite the abundant empirical work made in the last decades on developmental CPF exposure, the systematic study of this on attention is sparse, and nonexistent concerning inhibitory control, without a single study on preweaning developmental stages. The present research explored the effects of the exposure to low doses of CPF that do not elicit a significant inhibition of the Cholinesterases during this developmental period on rats' behavior in the five-choice serial reaction time task. Behavioral manipulations (inter-trial interval and stimulus duration), pharmacological manipulations (cholinergic and GABAergic drugs) and brain gene expression analyses were also conducted. Exposure to CPF decreased the locomotor activity and enhanced the learning profile of the female rats, increased the impulsive rates, unmasked by a longer inter-trial interval, hypo-sensitized the cholinergic system and down-regulated the mRNA expression levels of the brain-derived neurotrophic factor in the dorsal striatum of the male rats. This happened without significant inhibition of the brain Acetylcholinesterase. All this new information corroborates that the exposure to a common pesticide at low doses during a key, but under-explored developmental period importantly affects different behaviors, neurotransmitter systems, and molecules that are altered in the main neurological disorders observed nowadays., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Autism spectrum disorder (ASD) is a complex neurodevelopmental pathology characterized by altered verbalizations, reduced social interaction behavior, and stereotypies. Environmental factors have been associated with its development. Some researchers have focused on pesticide exposure. Chlorpyrifos (CPF) is the most used Organophosphate. Previous developmental studies with CPF showed decreased, enhanced or no effect on social outcomes eminently in mice. The study of CPF exposure during preweaning stages on social behavior is sparse in mice and non-existent in rats. d stressors could be at the basis of ASD development, and around postnatal day 10 in the rat is equivalent to the human birthday in neurodevelopmental terms. We explored the effects of exposure to low doses (1mg/kg/mL/day) of CPF during this stage regarding: sociability, dominance gut microbiome and plasma metabolomic profile, since alterations in these systems have also been linked to ASD. There was a modest influence of CPF on social behavior in adulthood, with null effects during adolescence. Dominance and hierarchical status were not affected by exposure. Dominance status explained the significant reduction in reaction to social novelty observed on the sociability test. CPF induced a significant gut microbiome dysbiosis and triggered a hyperlipidemic, hypoglycemic/hypogluconeogenesis and a general altered cell energy production in females. These behavioral results in rats extend and complement previous studies with mice and show novel influences on gut metagenomics and plasma lipid profile and metabolomics, but do not stablish a relation between the exposure to CPF and the ASD phenotype. The effects of dominance status on reaction to social novelty have an important methodological meaning for future research on sociability., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Many adolescents use amphetamines which are the second most common abused illegal drugs. Methamphetamine (Meth), as a potent amphetamine affects attentional functions. However, the most significant factor for susceptibility to Meth is the age of exposure, most studies have examined the effects of Meth after early adolescence stage. The present experiment was aimed to investigate some possible short- and long-term effects of Meth at two distinct points of adolescence stage (early versus late) on 1) locomotor activity in adolescent rats and 2) attentional functions in their adulthood. Rats received Meth (5 mg/kg, i.p., for consecutive 10 days) during early adolescence (postnatal days (PND) 30-39) or late adolescence (PND 50-59). Locomotor activity was assessed after the first and tenth injections. Then, in adulthood, rats were trained and tested on the Five-choice serial reaction time task (5-CSRTT) to display possible attentional impairments. The first Meth administration in early exposed adolescent (EEA) group produced the highest level of activity, compared with the first exposure in late exposed adolescent (LEA) group and tenth administrations in both groups. In adulthood, LEA group significantly delayed learning the 5-CSRTT and exhibited attentional impairments, as demonstrated by significant reduced response accuracy and increased omission errors under pharmacological challenge, compared with control group. The susceptibility to Meth depends on the age of exposure and Meth administration during late adolescence stage may cause prolonged attentional deficits in adulthood., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Development is especially sensitive to Chlorpyrifos (CPF) toxicity, associated with several neurodegenerative and neurodevelopmental disorders where motor function dysfunction is a core symptom. Amongst the alternative molecular targets to cholinesterases inhibition, developmental CPF alters different components in the most important neurotransmitter systems, although this depends on the exposure period. Exposure during the late postnatal preweaning stage is the least studied by far. This period includes essential neurodevelopmental processes and has an important translational meaning. The present study analyzed the influence of low doses of CPF on this developmental window on locomotor activity and the state of the different neurotransmitter systems by pharmacological challenges. Brain gene expression and microbiome modulation following CPF were also analyzed. CPF exposure long-term increased spontaneous vertical activity, female's activity following acute stress, hyposensitized the cholinergic system and hypersensitized the GABAergic system, up-regulated both muscarinic 2 receptor and GABA-A-α2 receptor subunit in the dorsal striatum and the frontal cortex, respectively and induced gut microbiota dysbiosis at both genus and species levels. The present study supports alternative molecular targets than the ChEs following late postnatal, preweaning exposure to low doses of CPF, focusing on both cholinergic and GABAergic systems and the gut microbiome as an important factor., (Copyright © 2019 Elsevier Ltd. All rights reserved.)