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Abstract Ongoing Arctic greening can increase productivity and reindeer pasture quality in the tundra. However, greening may also entail proliferation of unpalatable species, with consequences for pastoral social-ecological systems. Here we show extensive greening across 20 reindeer districts in Norway between 2003 and 2020, which has reduced pasture diversity. The allelopathic, evergreen dwarf-shrub crowberry increased its biomass by 60%, with smaller increases of deciduous shrubs and no increase in forbs and graminoids, the most species rich growth forms. There was no evidence for higher reindeer densities promoting crowberry. The current management decision-making process aims at sustainable pasture management but does not explicitly account for pasture changes and reduced diversity. Large-scale shifts towards evergreening and increased allelopathy may thus undermine the resource base for this key Arctic herbivore and the pastoral social-ecological system. Management that is sensitive to changes in pasture diversity could avoid mismanagement of a social-ecological system in transition.

High-throughput phenotyping (HTP) provides new opportunities for efficiently dissecting the genetic basis of drought-adaptive traits, which is essential in current wheat breeding programs. The combined use of HTP and genome-wide association (GWAS) approaches has been useful in the assessment of complex traits such as yield, under field stress conditions including heat and drought. The aim of this study was to identify molecular markers associated with yield (YLD) in elite durum wheat that could be explained using hyperspectral indices (HSIs) under drought field conditions in Mediterranean environments in Southern Spain. The HSIs were obtained from hyperspectral imagery collected during the pre-anthesis and anthesis crop stages using an airborne platform. A panel of 536 durum wheat lines were genotyped by sequencing (GBS, DArTseq) to determine population structure, revealing a lack of genetic structure in the breeding germplasm. The material was phenotyped for YLD and 19 HSIs for six growing seasons under drought field conditions at two locations in Andalusia, in southern Spain. GWAS analysis identified 740 significant marker-trait associations (MTAs) across all the durum wheat chromosomes, several of which were common for YLD and the HSIs, and can potentially be integrated into breeding programs. Candidate gene (CG) analysis uncovered genes related to important plant processes such as photosynthesis, regulatory biological processes, and plant abiotic stress tolerance. These results are novel in that they combine high-resolution hyperspectral imaging at the field scale with GWAS analysis in wheat. They also support the use of HSIs as useful tools for identifying chromosomal regions related to the heat and drought stress response in wheat, and pave the way for the integration of field HTP in wheat breeding programs.

Since the 1990s the worldwide rate of obesity has escalated significantly. This overflow affects all demographic groups, with a notable impact on older adults and women. Obesity is associated with a variety of serious chronic health conditions. Additionally, it is linked to endocrine disorders such as hypothyroidism and subclinical hypothyroidism. This review analyzes the connection between obesity and micronutrient levels, particularly focusing on vitamin D, and evaluates potential nutritional and supplementation approaches for this population.Micronutrient imbalances in obesity arise from poor dietary intake, increased nutritional needs, altered pharmacokinetics, and absorption difficulties. These imbalances can lead to critical health and metabolic issues. For example, vitamin D deficiency, which is common in individuals with obesity, is associated with decreased calcium absorption and an incremented risk of type 2 diabetes, metabolic syndrome, and various inflammatory conditions such as cancer.Effectively addressing micronutrient deficiencies requires dietary modifications and, when necessary, supplementation. While enhancing nutrition is critical, supplementation often becomes essential to meet the nutritional needs of individuals with obesity, particularly those on restrictive diets or undergoing bariatric surgery. Supplementing micronutrients and vitamin D in patients with obesity can improve health related outcomes. Moreover, dietary patterns like the Mediterranean diet can increase vitamin D levels. This review underlines the crucial role of tailored supplementation strategies and the demand for continued research to ascertain optimal dosing and its implications for health outcomes.

Abstract Objective To describe healthcare resource utilization (HCRU) and costs, in patients with newly diagnosed heart failure (HF) according to ejection fraction (EF) in Spain. Methods Retrospective cohort study that analyzed anonymized, integrated and computerised medical records in Spain. Patients with ≥ 1 new HF diagnosis between January 2013 and September 2019 were included and followed-up during a 4-year period. Rates per 100 person-years of HCRU and costs were estimated. Results Nineteen thousand nine hundred sixty-one patients were included, of whom 43.5%, 26.3%, 5.1% and 25.1% had HF with reduced, preserved, mildly reduced and unknown EF, respectively. From year 1 to 4, HF rates of outpatient visits decreased from 1149.5 (95% CI 1140.8–1159.3) to 765.5 (95% CI 745.9–784.5) and hospitalizations from 61.7 (95% CI 60.9–62.7) to 15.7(14.7–16.7) per 100 person-years. The majority of HF-related healthcare resource costs per patient were due to hospitalizations (year 1–4: 63.3–38.2%), followed by indirect costs (year 1–4: 12.2–29.0%), pharmacy (year 1–4: 11.9–19.9%), and outpatient care (year 1–4: 12.6–12.9%). Mean (SD) per patient HF-related costs decreased from 2509.6 (3518.5) to 1234.6 (1534.1) Euros (50% cost reduction). At baseline, 70.1% were taking beta-blockers, 56.3% renin-angiotensin system inhibitors, 11.8% mineralocorticoid receptor antagonists and 8.9% SGLT2 inhibitors. At 12 months, these numbers were 72.3%, 65.4%, 18.9% and 9.8%, respectively. Conclusions Although the economic burden of HF decreased over time since diagnosis, it is still substantial. This reduction could be partially related to a survival bias (sick patients died early), but also to a better HF management. Despite that, there is still much room for improvement.

ABSTRACTLaboratory automation in microbiology improves productivity and reduces sample turnaround times (TATs). However, its full potential can be unlocked through the optimization of workflows by adopting lean principles. This study aimed to explore the relative impact of laboratory automation and continuous improvement events (CIEs) on productivity and TATs. Laboratory automation took place in November 2020 and consisted of the introduction of WASPLab and VITEK MS systems. CIEs were run in May and September 2021. Before the conversion, the laboratory processed about ~492 samples on weekdays and had 10 full-time equivalent (FTE) staff for a productivity of 49 samples/FTE/day. In March 2021, after laboratory automation, the caseload went up to ~621 while the FTEs decreased to 8.5, accounting for productivity improvement to 73 samples/FTE/day. The hypothetical productivity went up to 110 samples/FTE/day following CIEs, meaning that the laboratory could at that point deal with a caseload increase to ~935 with unchanged FTEs. Laboratory conversion also led to an improvement in TATs for all sample types. For vaginal swabs and urine samples, median TATs decreased from 70.3 h [interquartile range (IQR): 63.5–93.1] and 73.7 h (IQR: 35.6–50.7) to 48.2 h (IQR: 44.8–67.7) and 40.0 h (IQR: 35.6–50.7), respectively. Automation alone was responsible for 37.2% and 75.8% of TAT reduction, respectively, while the remaining reduction of 62.8% and 24.2%, respectively, was achieved due to CIEs. The laboratory reached productivity and TAT goals predefined by the management after CIEs. In conclusion, automation substantially improved productivity and TATs, while the subsequent implementation of lean management further unlocked the potential of laboratory automation.IMPORTANCEIn this study, we combined total laboratory automation with lean management to show that appropriate laboratory work organization enhanced the benefit of the automation and substantially contributed to productivity improvements. Globally, the rapid availability of accurate results in the setting of a clinical microbiology laboratory is part of patient-centered approaches to treat infections and helps the implementation of antibiotic stewardship programs backed by the World Health Organization. Locally, from the point of view of laboratory management, it is important to find ways of maximizing the benefits of the use of technology, as total laboratory automation is an expensive investment.

Introducción: La 25-hidroxivitamina D (25(OH)D) disminuiría la incidencia de infecciones respiratorias virales, por su efecto pleiotrópico en la inmunomodulación. Objetivo: evaluamos la influencia de la deficiencia severa de 25(OH)D con la severidad de la enfermedad COVID-19. Métodos: estudio retrospectivo observacional, que incluyó 164 pacientes con diagnóstico de COVID-19 ingresados a la unidad de cuidados intensivos que tuvieran valores plasmáticos de 25(OH)D las primeras 72 horas de internación. Resultados: exhibieron deficiencia de 25(OH)D (

Individuals infected with the SARS-CoV-2 virus present with a wide variety of symptoms ranging from asymptomatic to severe and even lethal outcomes. Past research has revealed a genetic haplotype on chromosome 3 that entered the human population via introgression from Neanderthals as the strongest genetic risk factor for the severe response to COVID-19. However, the specific variants along this introgressed haplotype that contribute to this risk and the biological mechanisms that are involved remain unclear. Here, we assess the variants present on the risk haplotype for their likelihood of driving the genetic predisposition to severe COVID-19 outcomes. We do this by first exploring their impact on the regulation of genes involved in COVID-19 infection using a variety of population genetics and functional genomics tools. We then perform a locus-specific massively parallel reporter assay to individually assess the regulatory potential of each allele on the haplotype in a multipotent immune-related cell line. We ultimately reduce the set of over 600 linked genetic variants to identify four introgressed alleles that are strong functional candidates for driving the association between this locus and severe COVID-19. Using reporter assays in the presence/absence of SARS-CoV-2, we find evidence that these variants respond to viral infection. These variants likely drive the locus’ impact on severity by modulating the regulation of two critical chemokine receptor genes: CCR1 and CCR5. These alleles are ideal targets for future functional investigations into the interaction between host genomics and COVID-19 outcomes.

El objetivo de este trabajo es presentar las tareas de intervención y conservación de una vasija utilizada como urna funeraria, hallada en una propiedad privada de la localidad de La Población, Departamento San Javier, Provincia de Córdoba, Argentina y con ello visibilizar la importancia de la articulación de nuestros trabajos científicos con los museos y las comunidades locales. La intervención fue solicitada por el Área de Arqueología de la Agencia Córdoba Cultura SE y el Museo Histórico Popular “Carlos Ferreyra” de San JavierYacanto. El hallazgo consiste en una urna cerámica de morfología globular sin decoración que en su interior contenía los restos de un individuo infantil, hallazgo poco frecuente en el área serrana de la provincia de Córdoba. Las tareas consistieron en la limpieza mecánica de la urna y la exhumación de los restos humanos, posteriormente se procedió a la conservación preventiva del conjunto, la estabilización y la construcción de un soporte adecuado para contención y evitar mayores daños. Se realizó el análisis de los restos para estimar el perfil biológico, sexo, edad, patologías entre otros. Se tomaron muestras de sedimentos para análisis de macro y microrrestos vegetales y se iniciaron los procesos con la comunidad local y el museo para la inclusión de la información obtenida en una futura exhibición. La aparición de esta urna funeraria nos motiva a iniciar un trabajo en conjunto con el museo local y los vecinos en relación con la preservación de estos hallazgos tan sensibles para las comunidades y en actividades relacionadas con la conservación del patrimonio, museología, y la arqueología pública.

Rationale: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 pneumonia. We hypothesize that SARS-CoV-2 causes alveolar injury and hypoxemia by damaging mitochondria in airway epithelial cells (AEC) and pulmonary artery smooth muscle cells (PASMC), triggering apoptosis and bioenergetic impairment, and impairing hypoxic pulmonary vasoconstriction (HPV), respectively. Objectives: We examined the effects of: A) human betacoronaviruses, SARS-CoV-2 and HCoV-OC43, and individual SARS-CoV-2 proteins on apoptosis, mitochondrial fission, and bioenergetics in AEC; and B) SARS-CoV-2 proteins and mouse hepatitis virus (MHV-1) infection on HPV. Methods: We used transcriptomic data to identify temporal changes in mitochondrial-relevant gene ontology (GO) pathways post-SARS-CoV-2 infection. We also transduced AECs with SARS-CoV-2 proteins (M, Nsp7 or Nsp9) and determined effects on mitochondrial permeability transition pore (mPTP) activity, relative membrane potential, apoptosis, mitochondrial fission, and oxygen consumption rates (OCR). In human PASMC, we assessed the effects of SARS-CoV-2 proteins on hypoxic increases in cytosolic calcium, an HPV proxy. In MHV-1 pneumonia, we assessed HPV via cardiac catheterization and apoptosis using the TUNEL assay. Results: SARS-CoV-2 regulated mitochondrial apoptosis, mitochondrial membrane permeabilization and electron transport chain (ETC) GO pathways within 2 hours of infection. SARS-CoV-2 downregulated ETC Complex I and ATP synthase genes, and upregulated apoptosis-inducing genes. SARS-CoV-2 and HCoV-OC43 upregulated and activated dynamin-related protein 1 (Drp1) and increased mitochondrial fission. SARS-CoV-2 and transduced SARS-CoV-2 proteins increased apoptosis inducing factor (AIF) expression and activated caspase 7, resulting in apoptosis. Coronaviruses also reduced OCR, decreased ETC Complex I activity and lowered ATP levels in AEC. M protein transduction also increased mPTP opening. In human PASMC, M and Nsp9 proteins inhibited HPV. In MHV-1 pneumonia, infected AEC displayed apoptosis and HPV was suppressed. BAY K8644, a calcium channel agonist, increased HPV and improved SpO2. Conclusions: Coronaviruses, including SARS-CoV-2, cause AEC apoptosis, mitochondrial fission, and bioenergetic impairment. SARS-CoV-2 also suppresses HPV by targeting mitochondria. This mitochondriopathy is replicated by transduction with SARS-CoV-2 proteins, indicating a mechanistic role for viral-host mitochondrial protein interactions. Mitochondriopathy is a conserved feature of coronaviral pneumonia that may exacerbate hypoxemia and constitutes a therapeutic target.

Summary: Bats perform important ecological roles in our ecosystem. However, recent studies have demonstrated that bats are reservoirs of emerging viruses that have spilled over into humans and agricultural animals to cause severe diseases. These viruses include Hendra and Nipah paramyxoviruses, Ebola and Marburg filoviruses, and coronaviruses that are closely related to severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and the recently emerged SARS-CoV-2. Intriguingly, bats that are naturally or experimentally infected with these viruses do not show clinical signs of disease. Here we have reviewed ecological, behavioral, and molecular factors that may influence the ability of bats to harbor viruses. We have summarized known zoonotic potential of bat-borne viruses and stress on the need for further studies to better understand the evolutionary relationship between bats and their viruses, along with discovering the intrinsic and external factors that facilitate the successful spillover of viruses from bats.

En el presente artículo se dan a conocer los resultados de una investigación de tipo cualitativo, realizada en el colegio Fernando Mazuera Villegas I.E.D con estudiantes de grado segundo, y que tuvo como objetivo la identificación de algunas dificultades en la resolución de problemas matemáticos aditivos simples de composición, descomposición, complemento a derecha y excedencia. Los datos se recolectaron teniendo en cuenta los procedimientos que realizan los estudiantes al resolver problemas de estructura aditiva simple a partir de la aplicación de una secuencia didáctica y de las observaciones de dicha secuencia, las cuales se registraron como notas de campo y de entrevistas clínico críticas. A partir del análisis de la información se determinó que las dificultades se manifiestan tanto en los procesos cognitivos del sujeto como al interior de la estructura del problema. Se identificaron nueve dificultades: respuesta coherente con el enunciado, traducción literal del enunciado, estructura del problema, falta de comprensión del enunciado, rango numérico, razonamiento y argumentación, heurísticos en función de las demandas del problema, lectura de números y procedimientos algorítmicos. La finalidad de este artículo es que esta información sirva de referente para la creación de estrategias pedagógicas por parte de los docentes para lograr el desarrollo cognitivo de sus estudiantes.

Abstract Citizen science can facilitate in‐depth learning for pupils and students, contribute to scientific research, and permit civic participation. Here, we describe the development of the transnational school‐based citizen science project Phenology of the North Calotte. Its primary goal is to introduce pupils (age 12–15; grades 7–10) in northern Norway, Russia, and Finland to the local and global challenges of climate change resulting in life cycle changes at different trophic and ecosystem levels in their backyards. Partnerships between regional scientists and staff from NIBIO Svanhovd, State nature reserves, national parks, and teachers and pupils from regional schools aim to engage pupils in project‐based learning. The project uses standardized protocols, translated into the different languages of participating schools. The phenological observations are centered around documenting clearly defined life cycle phases (e.g., first appearance of species, flowering, ripening, leaf yellowing, snow fall, and melt). The observations are collected either on paper and are subsequently submitted manually to an open‐source online database or submitted directly via a newly developed mobile app. In the long term, the database is anticipated to contribute to research studying changes in phenology at different trophic levels. In principle, guided school‐based citizen science projects have the potential to contribute to increased environmental awareness and education and thereby to transformative learning at the societal level while contributing to scientific progress of understudied biomes, like the northern taiga and (sub)arctic tundra. However, differences in school systems and funding insecurity for some schools have been major prohibiting factors for long‐term retention of pupils/schools in the program. Project‐based and multidisciplinary learning, although pedagogically desired, has been partially difficult to implement in participating schools, pointing to the need of structural changes in national school curricula and funding schemes as well as continuous offers for training and networking for teachers.

Summary: Lymphocytes in the mouse small intestine (SI) epithelium are critical to establish effective barrier immunity. Here, we describe a magnetic cell separation protocol that employs anti-epithelial cellular adhesion molecule (EpCAM) antibodies to deplete epithelial cells and to enrich for intraepithelial lymphocytes (IELs) from SI tissues. The resulting IEL preparation was functionally and phenotypically comparable to IELs isolated using conventional density gradient centrifugation protocols. Moreover, the yield and purity of anti-EpCAM-depleted SI IELs were higher than those enriched by conventional isolation.For complete details on the use and execution of this protocol, please refer to Prakhar et al. (2021).

Purpose. This cohort study describes the differences in kidney cancer age-adjusted incidence and mortality rates between American Indians/Alaskan Natives (AI/ANs) and Whites in Oklahoma. Additionally, rates for the U.S. are updated to establish an epidemiological comparison between Oklahoma and the rest of the country. Materials and Methods. Kidney cancer age-adjusted incidence and mortality rates for Oklahoma were gathered using the Oklahoma Central Cancer Registry since 1999. National rates were obtained from the Center for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database between 1997 and 2017. Rate ratios were used to compare incidence and mortality rates for AI/ANs and Whites within Oklahoma as well as the entire country. Joinpoint regression models were created to illustrate trends in kidney cancer incidence and mortality. Results. The age-adjusted incidence rate of kidney cancer in Oklahoma for AI/ANs and Whites was 32.3 and 15.8 per 100,000, respectively, for an incidence rate ratio of 2.04. The national incidence rate ratio was 0.89. The age-adjusted mortality rate in Oklahoma for AI/ANs and Whites was 9.78 and 4.98 per 100,000, respectively, for a mortality rate ratio of 1.98. Oklahomans, irrespective of race, fare worse in terms of kidney cancer mortality compared to the rest of the country. Conclusions. In Oklahoma, AI/ANs are more likely than Whites to have a kidney cancer diagnosis. AI/ANs are twice as likely to die from kidney cancer than Whites in Oklahoma. AI/AN populations in certain states may benefit from kidney cancer early screening initiatives.

Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) antigen (Ag) tests have been widely employed to identify patients for a rapid diagnosis and pandemic control. Rapid lateral-flow techniques are currently the most used, but automated technologies have emerged as another viable alternative to molecular methods. We aimed to evaluate the analytical performance of the DiaSorin Liaison SARS-CoV-2 Ag test in asymptomatic population and close contacts, for its use as a tool in pandemic control efforts.Material and Methods: A retrospective study was conducted. A total of 861 samples were included, 291 (34%) were positive for SARS-CoV-2 with cycle threshold (Ct) 106 extrapolated copies/ml were reached a sensitivity of 100% (95% IC 97.0–100.0%). For intermediate viral loads (>105 extrapolated copies/ml or

Introduction: Residency applicants use multiple resources to guide their application process including the Student Doctor Network (SDN), a publicly available online forum for the discussion of various topics in medical education. In recent years, specialty-specific forums for residency applicants to self-report their own application information have become popular. These forums allow other applicants to review self-reported data from their peers to inform their own application process. The accuracy of this resource is unknown. To determine whether the SDN is an accurate source of information for emergency medicine (EM) applicants, we compared self-reported SDN data to objective data from the National Resident Matching Program (NRMP). Methods: We retrospectively reviewed self-reported SDN data by DO and MD candidates from EM forums for the 2014, 2016, and 2018 residency application cycles. These data were compared to the NRMP charting outcomes for each respective year. Results: A total of 360 EM applicants self-reported data on the SDN during the years reviewed. The majority of these applicants (79%) posted for the 2018 application cycle following transition to a Google Docs spreadsheet. For the first two years of analysis, mean United States Medical Licensing Examination (USMLE) scores were similar to SDN reports. For the most recent year studied, applicants who posted to SDN reported higher mean (USMLE) Step 1 (234, 95% confidence interval [CI], 233–236) and Step 2 scores (250, 95% CI, 248–251) when compared to NRMP data (231 and 241). Reported contiguous residency program ranks were similar to NRMP in all years, and the proportion indicating Alpha Omega Alpha Honor Medical Society membership was similar to NRMP only for the most recent year studied. Conclusion: Self-reporting on SDN showed a slight bias toward higher USMLE step scores in the most recent year when compared to objective NRMP data. Self-reporting on SDN has increased in recent years, but it is unknown whether this increase will lead to more accurate information for EM applicants. Given the self-reported nature of the SDN, applicants should use SDN forums with caution.

Deregulated SRC/FAK signaling leads to enhanced migration and invasion in many types of tumors. In myxoid and round cell liposarcoma (MRCLS), an adipocytic tumor characterized by the expression of the fusion oncogene FUS-CHOP, SRC have been found as one of the most activated kinases. Here we used a cell-of-origin model of MRCLS and an MRCLS cell line to thoroughly characterize the mechanisms of cell invasion induced by FUS-CHOP using in vitro (3D spheroid invasion assays) and in vivo (chicken chorioallantoic membrane model) approaches. FUS-CHOP expression activated SRC-FAK signaling and increased the invasive ability of MRCLS cells. In addition, FAK expression was found to significantly correlate with tumor aggressiveness in sarcoma patient samples. The involvement of SRC/FAK activation in FUS-CHOP–mediated invasion was further confirmed using the SRC inhibitor dasatinib, the specific FAK inhibitor PF-573228, and FAK siRNA. Notably, dasatinib and PF573228 could also efficiently block the invasion of cancer stem cell subpopulations. Downstream of SRC/FAK signaling, we found that FUS-CHOP expression increases the levels of the RHO/ROCK downstream effector phospho-MLC2 (T18/S19) and that this activation was prevented by dasatinib or PF573228. Moreover, the ROCK inhibitor RKI-1447 was able to completely abolish invasion in FUS-CHOP–expressing cells. These data uncover the involvement of SRC/FAK/RHO/ROCK signaling axis in FUS-CHOP–mediated invasion, thus providing a rationale for testing inhibitors of this pathway as potential novel antimetastatic agents for MRCLS treatment.

In this article, we study a fishing community and its relationship with non-human species, including threatened marine mammals and turtles incidentally captured by fishers. We focus on the interaction between this fishing community and a group of conservation experts who seek to protect these vulnerable species by proposing the testing of alternative fishing gear. This conservation practice, however, ignores the fishing community's worldview − which includes its relationship with animal species and the links and negotiations established with other stakeholders. Through an interdisciplinary ethnographic approach, we find that although fishers classify species according to their capacity to be exploited as a resource, they may also be willing to become strategic conservationists by negotiating with conservation experts to protect some of these species. The coexistence of strategic conservation and resource exploitation practices in this fishing community does not preclude the existence of an 'implicit communalism', in which resource exploitation is rooted in daily intimacy with various species. A comprehensive reconstruction of local perspectives and practices is a first step towards a democratic exchange between local and expert knowledge in pursuit of the conservation of biodiversity.

Introducción: La U.de diabetes fue creada como modelo de integración entre los distintos niveles de salud para dar una respuesta integral al paciente diabético La componen los servicios de nefrología, endocrinología, EED, pie diabético y rehabilitación y traumatología, todo ello coordinado por una EGC. Material y métodos: Estudio realizado en las áreas de salud de la comarca de Guipúzcoa. Se crearon circuitos de derivación de interconsultas a través de “osabide global “programa que permite intercambio de archivos además de interconsultas entre distintos niveles de salud, el circuito permite también derivar entre los distintos servicios que componen la unidad. La EGC realiza un cribaje de las interconsultas según algoritmos de gravedad clasificándolas como: ü No presencial (iC contestadas de forma on line sin presencia del paciente a través del programa. ü Presenciales: pacientes que tiene que acudir al centro hospitalario, siempre citadas según criterios de gravedad. Como outcomes de comorbilidad se midieron: Primarios: ü Mejora esperada en HBAC1 ü Disminución o estabilización de la progresión de la nefropatía (albumina , proteinuria, FG) ü Disminución de amputaciones mayores Secundarios: ü Satisfacción percibida por el paciente con el servicio ü Disminución de visitas a urgencias Resultados:Desde su creación se han cribado por la EGC un total de 5269 interconsultas de las cuales han sido derivadas: 1605 pie diabético, 1169 nefrología, 1872 endocrino, 623 enfermera educadora y 43 rehabilitación. El 98% han sido contestadas dentro del periodo de respuesta pactado y el 95% citada en base a los algoritmos establecidos. 529 (10´03%) se han contestado de forma no presencial siendo la mayoría dudas de tratamiento y 4740 han sido presenciales de las cuales 1664 (35´10%) han sido vistas en más de un servicio simultáneamente. Como datos preliminares de comorbilidad han sido analizado una muestra obtenida en el periodo Enero 2015-Diciembre 2017. Amputaciones mayores se realizaron 9/ 250 pacientes en 2015, 20/362 2016 y 17/293 en 2017 Los 629 pacientes analizados en endocrino presentan HGAC1 basal media de 8´7%, 7´5% a los 3 meses 7´7 a los 6 meses y 7´6 a los 12 meses Tras analizar la muestra de los pacientes con nefropatía estos presentan cifras de progresión de la nefropatía similar a la descrita por la bibliografía en los estudios publicados. Las visitas de nuestros pacientes a urgencias se han disminuido ya que se ha creado un circuito de derivación directa a nuestra unidad. La satisfacción de nuestros pacientes medidas por nuestra unidad de calidad muestra unas buenas cifras en las encuestas realizadas. Conclusión: El papel de la EGC mejora la integración entre los distintos niveles de salud dando respuesta de forma eficaz según algoritmos de gravedad a todas la interconsultas que se realizan a través del circuito logrando una atención integral al paciente diabético y parece mejorar outcomes finales de comorbilidades este grupo de pacientes.

Climatic conditions affect the growth, development and final crop production. As wheat is of paramount importance as a staple crop in the human diet, there is a growing need to study its abiotic stress adaptation through the performance of key breeding traits. New and complementary approaches, such as genome-wide association studies (GWAS) and genomic selection (GS), are used for the dissection of different agronomic traits. The present study focused on the dissection of agronomic and quality traits of interest (initial agronomic score, yield, gluten index, sedimentation index, specific weight, whole grain protein and yellow colour) assessed in a panel of 179 durum wheat lines (Triticum durum Desf.), grown under rainfed conditions in different Mediterranean environments in Southern Spain (Andalusia). The findings show a total of 37 marker-trait associations (MTAs) which affect phenotype expression for three quality traits (specific weight, gluten and sedimentation indexes). MTAs could be mapped on the A and B durum wheat subgenomes (on chromosomes 1A, 1B, 2A, 2B and 3A) through the recently available bread wheat reference assembly (IWGSC RefSeqv1). Two of the MTAs found for quality traits (gluten index and SDS) corresponded to the known Glu-B1 and Glu-A1 loci, for which candidate genes corresponding to high molecular weight glutenin subunits could be located. The GS prediction ability values obtained from the breeding materials analyzed showed promising results for traits as grain protein content, sedimentation and gluten indexes, which can be used in plant breeding programs.

Background. Hypertriglyceridemia and hyperglycemia coexist in 30-60% of patients with diabetes. The impact of hypertriglyceridemia regarding HbA1c assay reliability remains uncertain. Therefore, we conducted a prospective in vivo controlled study with the aim of defining the association between triglyceride levels and HbA1c. Methods. A total of 44 patients with an index-hospital admission diagnosis of diabetic ketoacidosis or hypertriglyceridemia-induced pancreatitis, as a model for acute elevation of triglycerides, were recruited. Blood samples were drawn for the measurement of HbA1c, triglycerides, glucose, and hemoglobin at baseline and subsequently 24 and 48 hours after admission. HbA1c analysis was performed with high-performance liquid chromatography Bio-Rad D10 (NGSP approved). Results. All patients completed the study protocol. A difference between mean triglycerides from day 0 (baseline) to day 2 of 1567.2 mg/dL was observed. We found a difference between mean serum HbA1c from days 0 to 2 of 0.09% [1 mmol/mol] (p=0.004). Moreover, a weak correlation between the mean difference of HbA1c and triglycerides from baseline to day 2 was found to be statistically significant (r=0.256, p=0.015). None of these findings, however, are clinically significant. Conclusion. Triglycerides do not impair the interpretation of HbA1c assay. Patients and clinicians can now be confident that hypertriglyceridemia is not an important factor when interpreting HbA1c results.

There is a growing need for developing high-throughput tools for crop phenotyping that would increase the rate of genetic improvement. In most cases, the indicators used for this purpose are related with canopy structure (often acquired with RGB cameras and multispectral sensors allowing the calculation of NDVI), but using approaches related with the crop physiology are rare. High-resolution hyperspectral remote sensing imagery provides optical indices related to physiological condition through the quantification of photosynthetic pigment and chlorophyll fluorescence emission. This study demonstrates the use of narrow-band indicators of stress as a potential tool for phenotyping under rainfed conditions using two airborne datasets acquired over a wheat experiment with 150 plots comprising two species and 50 varieties (bread and durum wheat). The flights were performed at the early stem elongation stage and during the milking stage. Physiological measurements made at the time of flights demonstrated that the second flight was made during the terminal stress, known to largely determine final yield under rainfed conditions. The hyperspectral imagery enabled the extraction of thermal, radiance, and reflectance spectra from 260 spectral bands from each plot for the calculation of indices related to photosynthetic pigment absorption in the visible and red-edge regions, the quantification of chlorophyll fluorescence emission, as well as structural indices related to canopy structure. Under the conditions of this study, the structural indices (i.e., NDVI) did not show a good performance at predicting yield, probably because of the large effects of terminal water stress. Thermal indices, indices related to chlorophyll fluorescence (calculated using the FLD method), and carotenoids pigment indices (PRI and CAR) demonstrated to be better suited for screening complex traits such as crop yield. The study concludes that the indicators derived from high-resolution thermal and hyperspectral airborne imagery are efficient tools for field-based phenotyping providing additional information to standard NDVI imagery currently used.