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IntroductionSystemic lupus erythematosus (SLE) is a chronic autoimmune disease affecting multiple systems and classified under connective tissue disorders. Ocular involvement occurs in up to 30% of SLE cases, with the cornea being particularly susceptible to thinning due to immune-complex deposits and its predominantly type I collagen composition. This corneal thinning is clinically significant in glaucoma, where patients with reduced central corneal thickness (CCT) may have up to a threefold increased risk of developing glaucoma, as well as in refractive surgery. However, existing studies on CCT in SLE are limited and marked by substantial heterogeneity in methodology, technology, criteria, and participant numbers, resulting in conflicting findings. Based in our hypothesis that SLE-related corneal lysis may result in decreased CCT, this study aims to determine and compare the mean CCT values between SLE patients and healthy controls to obtain a more precise understanding of the potential relationship.Methods and analysisA cross-sectional observational study will be conducted, enrolling SLE patients and age-and sex-matched healthy controls recruited from ophthalmology consultations. Exclusion criteria will be applied to rule out other corneal thinning risk factors. A pilot study estimated a minimum sample size of 34 participants per group. CCT measurements will be obtained using Zeiss HD Cirrus 5,000 optical coherence tomography (OCT) on a randomly selected eye, following concordance analysis using the Kappa index. Statistical analysis will include descriptive, bivariate, and multivariate methods. The study protocol was approved by the ethics committee.DiscussionThe cornea’s vulnerability to thinning and lysis in SLE, which impacts CCT, is crucial for the accurate assessment of glaucoma, the leading cause of irreversible blindness worldwide and the second leading cause in Europe. Given that patients with reduced CCT are at a significantly higher risk of developing glaucoma, further research is necessary to understand the association between SLE and CCT. Our study aims to enhance methodological rigor compared to prior research by determining an appropriate sample size and exclusively enrolling SLE patients to increase participant homogeneity. If a significant difference in CCT between groups and an association between CCT and SLE are found, a prospective study will be considered.

Monumento emblemático de la huerta de Valencia, el Palauet Nolla ha tenido una historia compleja. La antigua alquería, que posteriormente fue el símbolo y joya de la prestigiosa fábrica de mosaicos Nolla, ha sin embargo caído en el abandono más completo, e incluso en el olvido. Las patologías que sufría la construcción, y el inminente peligro de pérdida que implicaba, llevó en el año 2010 a iniciar un estudio exhaustivo, que llevaría a redescubrir su valor histórico, arquitectónico y suntuario. Este renacimiento conllevó la realización de varias fases de investigación y de intervención. Cada una de ellas se desarrolló en un contexto específico, con objetivos y condiciones particulares, que requerían una perfecta adecuación de los protocolos, métodos y herramientas, a las características de la misma, con el fin de optimizar los recursos. Levantamiento convencional, escaneado 3D e incluso aplicación del HBIM se han sucedido para conseguir la recuperación de este patrimonio excepcional.

The electrical percolation of alternating current through two-phase polyethylene/graphite composite electrodes with different contents of graphite microparticles immersed in aqueous KCl solutions has been studied. Above the graphite content of the first percolation threshold, the electrochemical impedance response of this electrode is associated with an equivalent circuit of resistance R u in series with a constant phase element (CPE). An insulator material + conducting filler model is proposed in which the electroactive surface is considered as the intersection of the percolation cluster through the solid and the cluster associated with the interfacial region. CPE is analyzed assuming a distribution of microcapacitors of the graphite particles in contact with the dielectric solution and inside the dielectric polymeric phase. [ABSTRACT FROM AUTHOR]

Methylene blue was electropolymerized on the surface of stainless steel 316. The addition of sodium oxalate and working at a pH near 11 allowed us to obtain steel electrodes coated with an electroactive polymer. This polymer shows electrochromic properties like those of the monomer, but also exhibits electroactivity at more positive potentials, which is associated with the active centers in the bridges between monomeric units. A digital video electrochemistry study allowed us to simultaneously quantify, on the one hand, the color changes on the entire surface of the stainless steel and on the other to separate the contribution of the active centers of the phenothiazine ring and of the inter-monomer bonds to the overall polymer response by means of assessing the mean color intensities. A reduction mechanism for the polymer, compatible with the pH variation of the observed electrochemical behavior, was proposed. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation (AF) is the most common arrhythmia to appear in clinical practice. People with AF have 5 times the risk of stroke compared to the general population. Objective: This study aimed to determine the prevalence of AF in people over the age of 50 without known AF, who presented to a community pharmacy to check their cardiovascular risk factors, to identify risk factors associated with AF, and to assess the risk of stroke in people who screened positive for AF. Methods: A multicenter observational descriptive study of a screening program took place from May to December 2016. A blood pressure monitor (Microlife Watch BP Home) was used to screen for AF, and the CHA2DS2-VASc questionnaire was used to assess stroke risk. Results: The study included 452 adults over the age of 50. The CRIFAFARMA study detected a prevalence of AF of 9.1%. Risk factors for AF were: age of 75 years or older ( P = .024), lack of physical activity ( P = .043), diabetes ( P < .001), dyslipidemia ( P = .003), and history of cardiovascular disease ( P = .003). Diabetes (OR 2.79, P = .005) and dyslipidemia (OR 2.16, P = .031) had a combined explanatory capacity in the multivariable logistic regression model adjusted for age. 85% were at high risk of stroke according to the CHA2DS2-VASc scale. Conclusions: AF was detected in more than 9% of the included population. Factors associated with AF were advanced age, lack of physical activity, diabetes, dyslipidemia, and history of cardiovascular disease, with diabetes and dyslipidemia standing out as the factors with independent explanatory capacity.

Purpose: Recognition of clinical inertia is essential to improve the control of chronic diseases. Although it is very intuitive, a better interpretation of the concept of clinical inertia is lacking, likely due to its high complexity. Materials and Methods: After a review of the published articles, we propose a practical vision of inertia, contextualized within the clinical process of hypertension care. Results: This new vision enables the integration of previous terms and definitions of clinical inertia, as well as proposing specific strategies for its reduction. Conclusion: Although some concepts should be considered as ‘justified inertia’ or ‘investigator inertia’, the idea that inertia may be present throughout the continuum of care gives physicians a holistic view of the problem that is easily applicable to their clinical practice. Measures to overcome inertia are complicated because of the intrinsic complexity of the concept.

Background: Community-acquired pneumonia (CAP) is a common cause of morbidity and mortality among adults worldwide. However, the distribution of the etiology of CAP varies from one country to another, with limited data from rural areas. Methods: A prospective hospital-based study on adult CAP was conducted in Leyte, Central Philippines from May 2010 to May 2012. Blood, sputum, and nasopharyngeal samples obtained from patients were used to identify pathogens using standard microbiological culture methods and PCR. Results: Of the 535 patients enrolled, 38% were younger than 50 years old. More than half of the patients had an underlying disease, including pulmonary tuberculosis (22%). The detection rate was higher for bacteria (40%) than viruses (13%). Haemophilus influenzae (12%) was the most commonly detected bacterium and influenza virus (5%) was the most commonly detected virus. The proportion of CAP patients with Mycobacterium tuberculosis infection was higher in the younger age group than in the older age group. Among CAP patients, 14% died during hospitalization, and drowsiness on admission and SpO2

Background Few studies in the scientific literature have analyzed frailty status as an ordinal variable (non-frail, pre-frail and frail) rather than as a binary variable (frail vs non-frail). These studies have found that pre-frailty behaves differently from frailty (no ordinality in the variable). However, although the comparison between pre-frail and frail individuals is clinically relevant to understanding how to treat pre-frailty, this comparison was not performed in previous studies. Materials and Methods A cross-sectional observational study was designed with 621 older individuals aged ≥60 years in Spain in 2017–2018, determining factors associated with a higher frailty stage (non-frail, pre-frail and frail) and undertaking this comparison, in addition to measuring non-frailty. The factors assessed through a multinominal regression model were: age, sex, living alone, recent loss of the partner, income and total comorbidities. Results Of the total participants, 285 were non-frail (45.9%), 210 were pre-frail (33.8%) and 126 were frail (20.3%). Compared to non-frail individuals, pre-frail individuals were older, with more comorbidities and a lower income. Compared to non-frail individuals, frail individuals were more likely to be female, older, with more comorbidities and a lower income. Compared to pre-frail individuals, frail individuals were more likely to be female, older and with more comorbidities. Conclusion Comparison between the pre-frail and frail groups showed that frail persons were more likely to have a lower income, be female, older and have a higher number of comorbidities.

The beta-nerve growth factor (β-NGF) from llama seminal plasma exerts ovulatory and luteotrophic effects following intramuscular or intrauterine infusion in llamas and alpacas. In this study, we investigate the in vitro effect of llama β-NGF on the expression of genes involved in angiogenesis and progesterone synthesis as well as progesterone release in preovulatory llama granulosa cells; we also determine whether these changes are mediated via the ERK1/2 signaling pathway. From adult female llamas, we collected granulosa cells from preovulatory follicles by transvaginal ultrasound-guided follicle aspiration; these cells were pooled and incubated. After 80% confluence, the cultured granulosa cells were treated with β-NGF, β-NGF plus the MAPK inhibitor U0126, or luteinizing hormone, and the abundance of angiogenic and steroidogenic enzyme mRNA transcripts were quantified after 10 and 20 h by RT-qPCR. We also quantified the progesterone concentration in the media after 48 h by radioimmunoassay. We found that application of β-NGF increases the abundance of mRNA transcripts of the vascular endothelial growth factor (VEGFA) and the steroidogenic enzymes cytochrome P450 side-chain cleavage (P450scc/CYP11A1), steroidogenic acute regulatory protein (STAR), and 3β-hydroxysteroid dehydrogenase (HSD3B1) at 10 and 20 h of treatment. Application of the MAPK inhibitor U0126 resulted in downregulation of the genes encoding these enzymes. β-NGF also enhanced progesterone synthesis, which was prevented by the prior application of the MAPK inhibitor U0126. Finally, western blot analysis confirmed that β-NGF activates the ERK1/2 signaling pathway. In conclusion, our results indicate that β-NGF exerts direct luteotropic effects on llama ovarian tissue via the ERK 1/2 pathway.

Abstract No validated screening method currently exists for Chronic Obstructive Pulmonary Disease (COPD) in smokers. Therefore, we constructed a predictive model with simple parameters that can be applied for COPD screening to detect fixed airflow limitation. This observational cross-sectional study included a random sample of 222 smokers with no previous diagnosis of COPD undertaken in a Spanish region in 2014–2016. The main variable was fixed airflow limitation by spirometry. The secondary variables (COPD factors) were: age, gender, smoking (pack-years and Fagerström test), body mass index, educational level, respiratory symptoms and exacerbations. A points system was developed to predict fixed airflow limitation based on secondary variables. The model was validated internally through bootstrapping, determining discrimination and calibration. The system was then integrated into a mobile application for Android. Fifty-seven patients (25.7%) presented fixed airflow limitation. The points system included as predictors: age, pack-years, Fagerström test and presence of respiratory symptoms. Internal validation of the system was very satisfactory, both in discrimination and calibration. In conclusion, a points system has been constructed to predict fixed airflow limitation in smokers with no previous COPD. This system can be integrated as a screening tool, though it should be externally validated in other geographical regions.

It presents a review of the theoretical proposals and plans for development that were made since the middle of the twentieth century and that had as a constant feature the maintenance of private property relations over the means of production, which makes it impossible to achieve real development for the entire population, particularly for the underdeveloped countries. The types of production relations that exist at the same time as the capitalist ones are identified, highlighting the productive economic system characterized by the production relations of social and community participation that are built in different parts of the world that mark differences in the forms of participation in the ownership of the means of production and in the appropriation of the productive benefits. The work is based on research carried out in the parish of Salinas de Tomabela, in the province of Bolivar in Ecuador, with the aim of constructing a conceptual and operational model for local development based on productive relations of community and cooperative participation as agents of socio-economic transformation. With a dialectical materialistic vision, the phenomenon of numerous experiences of solidarity economy that exist throughout Latin America and much of the world was approached, and which opens up perspectives of growth and sustainable development for workers associated with such forms of productive organizations, generating processes of non-capitalist accumulation in previously marginalized localities and inclusive growth to a large majority that leave unemployment and reduce the surplus supply of labor.