Build-Up of a 3D Organogel Network within the Bilayer Shell of Nanoliposomes. A Novel Delivery System for Vitamin D3: Preparation, Characterization, and Physicochemical Stability

The inherent thermodynamic instability of liposomes during production and storage has limited their widespread applications. Therefore, a novel structure of food-grade nanoliposomes stabilized by a 3D organogel network within the bilayer shell was developed through the extrusion process and successfully applied to encapsulate vitamin D₃. A huge flocculation and a significant reduction of zeta potential (-17 mV) were observed in control nanoliposomes (without the organogel shell) after 2 months of storage at 4 °C, while the sample with a gelled bilayer showed excellent stability with a particle diameter of 105 nm and a high negative zeta potential (-63.4 mV), even after 3 months. The development of spherical vesicles was confirmed by TEM. Interestingly, the gelled bilayer shell led to improved stability against osmotically active divalent salt ions. Electron paramagnetic resonance confirmed the higher rigidity of the shell bilayer upon gelation. The novel liposome offered a dramatic increase in encapsulation efficiency and loading of vitamin D₃ compared to those of control.

Toward Complete, Candid, and Unbiased International Consensus Statements on Concussion in Sport

Five international consensus statements on concussion in sports have been published. This commentary argues that there is a strong need for a new approach to them that foregrounds public health expertise and patient-centered guidance. Doing so will help players, parents and practitioners keep perspective about these potentially life-altering injuries especially when they recur.

Understanding Multimodal User Gesture and Speech Behavior for Object Manipulation in Augmented Reality Using Elicitation

The primary objective of this research is to understand how users manipulate virtual objects in augmented reality using multimodal interaction (gesture and speech) and unimodal interaction (gesture). Through this understanding, natural-feeling interactions can be designed for this technology. These findings are derived from an elicitation study employing Wizard of Oz design aimed at developing user-defined multimodal interaction sets for building tasks in 3D environments using optical see-through augmented reality headsets. The modalities tested are gesture and speech combined, gesture only, and speech only. The study was conducted with 24 participants. The canonical referents for translation, rotation, and scale were used along with some abstract referents (create, destroy, and select). A consensus set of gestures for interactions is provided. Findings include the types of gestures performed, the timing between co-occurring gestures and speech (130 milliseconds), perceived workload by modality (using NASA TLX), and design guidelines arising from this study. Multimodal interaction, in particular gesture and speech interactions for augmented reality headsets, are essential as this technology becomes the future of interactive computing. It is possible that in the near future, augmented reality glasses will become pervasive.

MicroRNA Profile of Cardiovascular Risk in Patients with Obstructive Sleep Apnea

BACKGROUND

Obstructive sleep apnea (OSA) is a common disease caused by repeated episodes of collapse of the upper airway during sleep and is associated with the development of cardiovascular disease (CVD). However, there is high heterogeneity in the impact of OSA on patients. Until now, the profile of OSA patients at risk of developing CVD has not been defined, including the measurable variables that could be used to predict the CVD risk of a patient with OSA.

OBJECTIVE

The aim of this study was to identify the microRNA (mi-RNA) profile associated with CVD in patients with OSA.

METHOD

This is an observational, cross-sectional study that included 132 male patients. Three groups were defined as OSA patients, OSA patients with hypertension, and OSA patients who developed a major cardiovascular event. Polysomnography and ambulatory blood pressure measurements were performed. The expression profiling of 188 miRNAs in plasma was performed in 21 subjects (matched by BMI and age) by the TaqMan low density array (TLDA). miRNAs differentially expressed in the different subgroups of patients and miRNAs that correlated with the cardiovascular risk SCORE were selected for validation by RT-qPCR in the 111 remaining patients.

RESULTS

From the TLDA analysis, 7 miRNAs were selected for validation. Differential expression was not confirmed in any of the miRNAs. miR-143 was associated with nocturnal systolic blood pressure. miR-107 correlated with 24-h blood pressure parameters and with nocturnal hypertension. miR-486 was associated with the cardiovascular risk SCORE.

CONCLUSIONS

The circulating profile of miRNAs does not seem to be different in any of the subgroups of patients with OSA and different cardiovascular risk factors. Nevertheless, miR-107 and miR-143 are associated with specific blood pressure parameters in patients with OSA and miR-486 is associated with the cardiovascular risk SCORE.

Behavior of the water/vapor interface of chitosan solutions with an anionic surfactant: effect of polymer-surfactant interactions

The adsorption of mixtures formed by chitosan and sodium lauryl ether sulfate (SLES) at the water/vapor interface has been studied on the basis of their impact on the equilibrium surface tension of the interface, and the response of such an interface to mechanical deformations. The analysis of the surfactant binding to the chitosan chains evidenced that the chitosan-SLES solutions were mixtures of polyelectrolyte-surfactant complexes and a non-negligible amount of free surfactant molecules. The interfacial properties showed two well-differentiated regions for interfacial adsorption as a function of the SLES concentration: (i) at a low surfactant concentration, co-adsorption of chitosan and SLES occurs, and (ii) at high concentrations, the surface is mostly occupied by SLES molecules. This behavior may be interpreted in terms of a complex equilibration mechanism of the interfacial layers, where different coupled dynamic processes may be involved. Furthermore, the use of the time-concentration superposition principle has confirmed the different dynamic behaviors of the chitosan-SLES adsorption as a function of the SLES concentration. This work sheds light on some of the most fundamental bases governing the physico-chemical behavior of mixtures formed by a biopolymer and a surfactant, where their complex behavior is governed by an intricate balance of bulk and interfacial interactions.

Prediction Equations for Maximal Aerobic Capacity on Cycle Ergometer for the Spanish Adult Population

BACKGROUND

Frequently used reference values for clinical exercise testing have been derived from non-random samples and some with poorly defined maximal criteria. Our objective was to obtain population based reference values for peak oxygen uptake (V˙O2) and work rate (WR) for cardiopulmonary exercise testing in a representative sample of Caucasian Spanish men and women.

METHODS

182 men and women, 20-85 years old, were included and exercised on cycle-ergometer to exhaustion. (V˙O2) and WR were measured. The equations obtained from this sample were validated in an independent cohort of 69 individuals, randomly sampled form the same population. Then a final equation merging the two cohorts (=251) was produced.

RESULTS

Height, sex and age resulted predictive of both V˙O2 peak and WR. Weight and physical activity added very little to the accuracy to the equations. The formulas V˙O2peak=0.017⋅height(cm)-0.023⋅age(years)+0.864⋅sex(female=0/male=1)±179lmin-1, and peak WR=1.345 · height (cm) - 2.074 · age (years)+76.54 · sex (female=0/male=1)±21.2W were the best compromise between accuracy and parsimony.

CONCLUSIONS

This study provides new and accurate V˙O2 peak and WR rate reference values for individuals of European Spanish descent.

Using Augmented Reality with Older Adults in the Community to Select Design Features for an Age-Friendly Park: A Pilot Study

Sedentary behavior is prevalent in older adults. Older adults often underutilize public parks for exercising because the parks do not support their needs and preferences. Engaging older adults on the redesign of parks may help promote active lifestyles. The objectives of this pilot study were to evaluate (1) the effects of wearing augmented reality (AR) and virtual reality (VR) glasses on balance; (2) the effects of different virtual walls separating the walking trail from the roadway on older adults' gait, and (3) the preferences of the participants regarding wall design and other features. The participants were ten older adults (68 ± 5 years) who lived within two miles from the park. Balance and gait were assessed using a force plate and an instrumented mat. It was feasible to use AR with older adults in the park to evaluate features for redesign. Motion sickness was not an issue when using AR glasses, but balance was affected when wearing VR goggles. The area of postural sway increased approximately 25% when wearing AR glasses, and it increased by close to 70% when wearing VR goggles compared to no glasses. This difference is clinically relevant; however, we did not have enough power to identify the differences as statistically significant because of the small sample size and large variability. Different walls did not significantly affect the participants' gait either because they did not alter the way they walked or because the holograms were insufficiently realistic to cause changes. The participants preferred a transparent wall rather than tall or short solid walls to separate the park from the roadway.

Permanent cystathionine-β-Synthase gene knockdown promotes inflammation and oxidative stress in immortalized human adipose-derived mesenchymal stem cells, enhancing their adipogenic capacity

In the present study, we aimed to investigate the impact of permanent cystathionine-β-Synthase (CBS) gene knockdown in human telomerase reverse transcriptase (hTERT) immortalized human adipose-derived mesenchymal stem cells (ASC52telo) and in their capacity to differentiate into adipocytes. CBS gene KD in ASC52telo cells led to increased cellular inflammation (IL6, CXCL8, TNF) and oxidative stress markers (increased intracellular reactive oxygen species and decreased reduced glutathione levels) in parallel to decreased H₂S production and rejuvenation (LC3 and SIRT1)-related gene expression. In addition, CBS gene KD in ASC52telo cells resulted in altered mitochondrial respiratory function, characterised by decreased basal respiration (specifically proton leak) and spare respiratory capacity, without significant effects on cell viability and proliferation. In this context, shCBS-ASC52telo cells displayed enhanced adipogenic (FABP4, ADIPOQ, SLC2A4, CEBPA, PPARG)-, lipogenic (FASN, DGAT1)- and adipocyte (LEP, LBP)-related gene expression markers, decreased expression of proinflammatory cytokines, and increased intracellular lipid accumulation during adipocyte differentiation compared to control ASC52telo cells. Otherwise, the increased adipogenic potential of shCBS-ASC52telo cells was detrimental to the ability to differentiate into osteogenic linage. In conclusion, this study demonstrated that permanent CBS gene KD in ASC52telo cells promotes a cellular senescence phenotype with a very increased adipogenic potential, promoting a non-physiological enhanced adipocyte differentiation with excessive lipid storage.

A closer physico-chemical look to the Layer-by-Layer electrostatic self-assembly of polyelectrolyte multilayers

The fabrication of polyelectrolyte multilayer films (PEMs) using the Layer-by-Layer (LbL) method is one of the most versatile approaches for manufacturing functional surfaces. This is the result of the possibility to control the assembly process of the LbL films almost at will, by changing the nature of the assembled materials (building blocks), the assembly conditions (pH, ionic strength, temperature, etc.) or even by changing some other operational parameters which may impact in the structure and physico-chemical properties of the obtained multi-layered films. Therefore, the understanding of the impact of the above mentioned parameters on the assembly process of LbL materials plays a critical role in the potential use of the LbL method for the fabrication of new functional materials with technological interest. This review tries to provide a broad physico-chemical perspective to the study of the fabrication process of PEMs by the LbL method, which allows one to take advantage of the many possibilities offered for this approach on the fabrication of new functional nanomaterials.

Impact of the bulk aggregation on the adsorption of oppositely charged polyelectrolyte-surfactant mixtures onto solid surfaces

The understanding of the deposition of oppositely charged polyelectrolytes-surfactant mixtures onto solid surfaces presents a high interest in current days due to the recognized impact of the obtained layers on different industrial sectors and the performance of several consumer products (e.g. formulations of shampoos and hair conditioners). This results from the broad range of structures and properties that can present the mixed layers, which in most of the cases mirror the association process occurring between the polyelectrolyte chains and the oppositely charged surfactants in the bulk. Therefore, the understanding of the adsorption processes and characteristics of the adsorbed layers can be only attained from a careful examination of the self-assembly processes occurring in the solution. This review aims to contribute to the understanding of the interaction of polyelectrolyte-surfactant mixtures with solid surfaces, which is probably one of the most underexplored aspects of these type of systems. For this purpose, a comprehensive discussion on the correlations between the aggregates formed in the solutions and the deposition of the obtained complexes upon such association onto solid surfaces will be presented. This makes it necessary to take a closer look to the most important forces driving such processes.

Telerehabilitation Programme as a Maintenance Strategy for COPD Patients: A 12-Month Randomized Clinical Trial

BACKGROUND

There is uncertainty regarding efficacy of telehealth-based approaches in COPD patients for sustaining benefits achieved with intensive pulmonary rehabilitation (PR).

RESEARCH QUESTION

To determine whether a maintenance pulmonary telerehabilitation (TelePR) programme, after intensive initial PR, is superior to usual care in sustaining over time benefits achieved by intensive PR.

STUDY DESIGN AND METHODS

A multicentre open-label pragmatic parallel-group randomized clinical trial was conducted. Two groups were created at completion of an 8-week intensive outpatient hospital PR programme. Intervention group (IG) patients were given appropriate training equipment and instructed to perform three weekly training sessions and send performance data through an app to a web-based platform. Patients in the control group (CG) were advised to exercise regularly (usual care).

RESULTS

Ninety-four patients (46 IG, 48 CG) were randomized. The analysis of covariance showed non-significant improvements in 6-min walk distance [19.9m (95% CI -4.1/+43.8)] and Chronic Respiratory Disease Questionnaire - Emotion score [0.4 points (0-0.8)] in the IG. Secondary linear mixed models showed improvements in the IG in Short Form-36 mental component summary [9.7, (4.0-15.4)] and Chronic Respiratory Disease Questionnaire - Emotion [0.5, (0.2-0.9)] scores, but there was no association between compliance and outcomes. Acute exacerbations were associated with a marginally significant decrease in 6-minute walk distance of 15.8m (-32.3/0.8) in linear models.

CONCLUSIONS

The TelePR maintenance strategy was both feasible and safe but failed to show superiority over usual care, despite improvements in some HRQoL domains. Acute exacerbations may have an important negative influence on long-term physical function. CLINICALTRIALS.

GOV IDENTIFIER

NCT03247933.

Rubio R, Coviella C, Santo Orihuela PL, Vassena CV, Lucia A. Surfactantless Emulsions Containing Eugenol for Imidacloprid Solubilization: Physicochemical Characterization and Toxicity against Insecticide-Resistant Cimex lectularius

Synthetic insecticides have been used for a long time as one of the most effective tools for insect pest control. However, the re-emergence of insect pests and their fast development of resistance, as has occurred for pyrethroid-resistant bed bugs Cimex lectularius L., make it necessary to develop new and safe strategies for effective pest control. This has fostered the research on new eco-sustainable formulations based on essential oils, which allows reducing the impact associated with the intensive use of synthetic insecticides on the environment and their effects on human health. This research explores the stability of water/eugenol/ethanol surfactantless emulsions loaded with imidacloprid (0.003 wt%), and their toxicity against a resistant bed bug strain. The results have shown that these emulsions enable the solubilization of a poorly water-soluble drug, such as the imidacloprid, without any significant modification of their stability. Furthermore, the application of the obtained formulations against the pyrethroid-resistant bed bug results in mortality in the 50-85% range upon topical and spray applications, with the increase of the eugenol content enhancing the effectiveness of the formulations. It may be expected that the ternary water/eugenol/ethanol mixtures could be further developed in the preparation of ready to use formulations, enabling the dispersion of insecticides for pest control.

High browsing skeletal adaptations in Spinophorosaurus reveal an evolutionary innovation in sauropod dinosaurs

Sauropods were among the most diverse lineages of dinosaurs, with an ample geographic distribution throughout the Mesozoic. This evolutionary success is largely attributed to neck elongation and its impact on feeding efficiency. However, how neck elongation influenced exactly on feeding strategies is subject of debate. The process of mounting a nearly complete virtual skeleton of Spinophorosaurus nigerensis, from the Middle (?) Jurassic of Niger, has revealed several previously unknown osteological adaptations in this taxon. Wedged sacral and posterior dorsal vertebrae cause the presacral column to deflect antero-dorsally. This, together with elongated scapulae and humeri make the anterior region of the skeleton vertically lengthened. Also, elongated prezygapophyseal facets on the cervical vertebrae and a specialized first dorsal vertebra greatly increase the vertical range of motion of the neck. These characters support this early eusauropod as a more capable high browser than more basally branching sauropods. While limb proportions and zygapophyseal facets vary among Eusauropoda, the sacrum retained more than 10° of wedging in all Eusauropoda. This implied a functional constraint for sauropod species which evolved lower browsing feeding strategies: the antero-dorsal sloping caused by the sacrum had to be counteracted with further skeletal modifications, e.g. a ventrally curved mid to anterior presacral spine to hinder the dorsal slope of the whole presacral series caused by the wedged sacrum. This suggests that at least the last common ancestor of Eusauropoda developed high browsing capabilities, partially due to the modified wedged sacrum, likely a potential synapomorphy of the clade and key in the evolutionary history of the group.

Challenges for implementing a global mental health agenda in Brazil: The "silencing" of culture

Since its emergence in 2007, Global Mental Health has been a growing and polemic area of study, research and practice in mental health worldwide. Despite having a significant endogenous academic production and innovative policy experiences, the Brazilian mental health field and its actors make few references to, and scarcely dialogue with, the Global Mental Health agenda. This article explores an aspect of this divergence between Global Mental Health initiatives and public mental health care in Brazil regarding the role of culture within mental health policies and practices. Our hypothesis is that part of this difficulty can be attributed to the low relevance of the cultural dimension for the Brazilian mental health field, here referred to as the "silencing of culture." We examine the possible historical roots of this process with reference to theories of "anthropophagy" and "cultural uniformity" in the context of Brazilian cultural matrices. We then describe two recent experiences in public mental health care that incorporate cultural competence through the work of community health workers and the example of community therapy. We argue that the development of cultural competence can be decisive in enabling an improved dialogue between research and practice in Brazilian mental health and global mental health initiatives.

Ontogenetic similarities between giraffe and sauropod neck osteological mobility

The functional morphology of sauropod dinosaur long necks has been studied extensively, with virtual approaches yielding results that are difficult to obtain with actual fossils, due to their extreme fragility and size. However, analyses on virtual fossils have been questioned on several of their premises, such as the ability to accurately reconstruct intervertebral tissue with only skeletal data; or whether zygapophyseal overlap can be used to determine the limits of range of motion, since some extreme neck poses in extant giraffes have been claimed not to retain any zygapophyseal overlap. We compared articulation and range of motion in extant giraffes with the exceptionally well-preserved and complete basally branching eusauropod Spinophorosaurus nigerensis from the Middle (?) Jurassic of Niger, under the same virtual paleontology protocols. We examined the articulation and range of motion on grown and young specimens of both Spinophorosaurus and giraffes in order to record any potential changes during ontogeny. Also, the postures of virtual giraffes were compared with previously published data from living animals in the wild. Our analyses show that: (i) articulation of virtual bones in osteologically neutral pose (ONP) does enable accurate prediction of the amount of inter-vertebral space in giraffes and, roughly, in Spinophorosaurus; (ii) even the most extreme neck postures attained by living giraffes in the wild do not require to disarticulate cervical vertebrae; (iii) both living giraffes and Spinophorosaurus have large intervertebral spaces between their cervical centra in early ontogenetical stages, which decrease as ontogeny advances; and (iv) that grown specimens have a greater osteological range of motion in living giraffes and Spinophorosaurus.

Global Mental Health and Pharmacology: The Case of Attention Deficit and Hyperactivity Disorders in Brazil

Global Mental Health (GMH) is the field of study, research, and intervention, which aims at improving access to mental health worldwide. It is based on the global burden of disease research program and on the existence of a large "treatment gap" between the need and availability of mental health services, displaying individual and social costs of undiagnosed and untreated mental disorders, especially in low- and middle-income countries (LMIC). Few academic publications in Brazil dialogue directly with the field of GMH, although several issues drawn from its agenda have been the subject of mental health policies in the country. Brazil can be classified as a middle-income country with a well-structured national health system. This system is oriented toward primary health care, which integrates both community mental health services and the broader health care network. The debate between GMH advocates and critics has unearthed old controversies in psychiatry such as universality or cultural specificity of mental disorders, their expressions, and their relationship with social and economic factors. We intend to examine how these controversies reverberate in the Brazilian mental health scenario, taking as an illustration the debates around Attention Deficit Hyperactivity Disorder (ADHD) in the country. ADHD discussions oppose those who argue that the condition is underdiagnosed and undertreated, and those who claim that there is overdiagnosis and overtreatment and thus, medicalization of childhood. This article presents the current status of the Brazilian mental health literature on ADHD, with emphasis on tensions around diagnosis, prevalence and interventions. Our aim is to highlight how the differential in discourse shapes the debate on ADHD in Brazil and how this may contribute to the GMH agenda. This goal will be undertaken in three steps. First, we will briefly examine studies around GMH and ADHD. Secondly, we address Brazilian studies on this theme, considering the specificities regarding the constitution of the mental health field. Finally, we will examine the debate of treatment gap vs. medicalization in the country in order to underscore the potentials and limitations of each perspective.

DOES WEARING AUGMENTED-REALITY GOGGLES AFFECT OLDER ADULTS’ KINEMATICS DURING GAIT?

Virtual-reality (VR) testing can cause motion sickness and impair safety, especially for older adults, but augmented-reality (AR) may allow the testing of holograms embedded into a mixed-reality environment without the VR impediments. However, wearing AR googles may affect the way people walk, but this possibility has not being tested. The objective of this study was to evaluate if wearing AR googles during gait would affect the kinematics of older adults. Ten older adults (68±5 years), who could walk without assistive devices, participated in this study. The participants walked outdoors in a public park with and without the AR googles. The participants were instrumented inertial movement units to track their kinematics (MTw Awinda trackers, Xsens Technologies B.V., Enschede, the Netherlands). The goal of the study was to assess if simply wearing the googles would affect gait, therefore no holograms were displayed. Ten gait cycles were analyzed and the mean of each subject was used to compare the joint kinematics between the conditions (with vs without googles) using T-tests in SPSS 18. The foot, ankle, knee and hip angles were not different between the conditions (p>0.05), but there were significantly less trunk flexion at 44% of the gait cycle (p=0.035) and less forward head flexion throughout the gait cycle (p=0.023) when the participants were wearing the googles vs. when they were not. The findings indicate that wearing AR goggles changed the trunk and head posture cycle, but did not affect the lower limb kinematics during gait.

Effect of molecular structure of eco-friendly glycolipid biosurfactants on the adsorption of hair-care conditioning polymers

Pseudo-binary mixtures of different glycolipids, four different rhamnolipids (RL) and an alkyl polyglucoside (APG), with poly(diallyl-dimethylammonium chloride) (PDADMAC) have been studied in relation to their adsorption onto negatively charged surfaces to shed light on the impact of the molecular structure of surfactants from natural sources (instead of synthetic surfactant, such as sodium laureth sulfate) on the adsorption of hair-conditioning polymers. For this purpose, the self-assembly of such mixtures in aqueous solution and their adsorption onto negatively charged surfaces mimicking the negative charge of damaged hair fibres have been studied combining experiments and self-consistent field (SCF) calculations. The results show that the specific physico-chemical properties of the surfactants (charge, number of sugar rings present in surfactant structure and length of the hydrocarbon length) play a main role in the control of the adsorption process, with the adsorption efficiency and hydration being improved in relation to conventional sulfate-based systems for mixtures of PDADMAC and glycolipids with the shortest alkyl chains. SCF calculations and Energy Dispersive X-Ray Spectroscopy (EDS) analysis on real hair confirmed such observations. The results allow one to assume that the characteristic of the surfactants, especially rhamnolipids, conditions positively the adsorption potential of polyelectrolytes in these model systems. This study provides important insights on the mechanisms underlying the performance of more complex but eco-friendly washing formulations.

P4460microRNA-17-5p and microRNA-20a-5p downregulation by atorvastatin in Hepg2 cells: a new mechanism involved in the lipid-lowering therapy

Background

Hypercholesterolemia increases the risk of coronary artery disease and its pharmacological treatment has demonstrated, besides reducing cholesterol levels, a decrease in the incidence and mortality from coronary events. The treatment of hypercholesterolemia is mainly driven by using statins. However, the response to pharmacological therapy shows high inter-individual variability, resulting in a variable effect in both lipid lowering and risk reduction. Thus, a better understanding of lipid-lowering mechanism and response variability at molecular level is required. Previously, we demonstrated a deregulation of microRNA (miR) profile in HepG2 cells after atorvastatin treatment, including the downregulation of miR-17-5p and miR-20a-5p which potentially targets the LDL receptor gene (LDLR), suggesting that it might be involved in allowing the LDLR overexpression on the surface of hepatic cells to subsequently capture circulating LDL and to reach the expected lipid-lowering effect.

Purpose

To determine the role of miR-17-5p and miR-20a-5p on the regulation of LDLR gene expression in HepG2 cells.

Methods

Cells HepG2 were treated with atorvastatin 10μM for 24 hours. RNA extraction and enrichment of smallRNAs were performed. The gene expression of miR-17-5p, miR-20a-5p, miR-24-3p, miR-93-5p, miR-106a-5p and LDLR were evaluated. To evaluate the effect of miR-17-5p and miR-20a-5p on LDLR gene expression, both miRs were overexpressed or repressed by transfection of mimics or inhibitors respectively into HepG2 cells for 24, 48 and 72 Hours. The gene expression of LDLR was quantified by real time PCR using RPL27 gene as reference gene. The protein expression of LDLR and beta actin were evaluated using western blot and quantified using the ImageJ software.

Results

Our data showed that atorvastatin significantly repressed the expression of miR-17-5p (P<0.0001) and miR-20a-5p (P=0.0456) in HepG2 cells. In silico studies showed that miR-17-5p interact with the 3'-UTR region of the LDLR. Consistently, when miR-17-5p or miR-20a-5p were overexpressed by using mimics, we observed that gene and protein expression of LDLR decreased significantly (P<0.0001 and P<0.05 respectively). Consistently, when miR-17-5p or miR-20a-5p were repressed by the use inhibitors, we observed that the gene and protein expression of LDLR increases significantly (P<0.005).

Conclusions

In conclusion, we demonstrate that atorvastatin induces a significant down-regulation of the miR-17-5p and miR-20a-5p in HepG2 cells. The overexpression or repression regulate the gene and protein expression of LDLR.

Acknowledgement/Funding

FONDECYT N°3160567, FONDECYT N°1171765 and DIUFRO DI19-0094

Surfactant-Like Behavior for the Adsorption of Mixtures of a Polycation and Two Different Zwitterionic Surfactants at the Water/Vapor Interface

The bulk and interfacial properties of solutions formed by a polycation (i.e., poly(diallyl-dimethylammonium chloride), PDADMAC) and two different zwitterionic surfactants (i.e., coco-betaine (CB) and cocoamidopropyl-betaine (CAPB)) have been studied. The bulk aggregation of the polyelectrolyte and the two surfactants was analyzed by turbidity and electrophoretic mobility measurements, and the adsorption of the solutions at the fluid interface was studied by surface tension and interfacial dilational rheology measurements. Evidence of polymer-surfactant complex formation in bulk was only found when the number of surfactant molecules was closer to the number of charged monomers in solutions, which suggests that the electrostatic repulsion associated with the presence of a positively charged group in the surfactant hinders the association between PDADMAC and the zwitterionic surfactant for concentrations in which there are no micelles in solution. This lack of interaction in bulk is reflected in the absence of an influence of the polyelectrolyte in the interfacial properties of the mixtures, with the behavior being controlled by the presence of surfactant. This work has evidenced the significant importance of the different interactions involved in the system for controlling the interaction and complexation mechanisms of in polyelectrolyte-surfactant mixtures.

Circulating microRNA profile as a potential biomarker for obstructive sleep apnea diagnosis

Evaluation of microRNAs (miRNAs) could allow characterization of the obstructive sleep apnea (OSA) and help diagnose it more accurately. We aimed to examine circulating miRNA profiles to establish the differences between non-OSA and OSA patients. Additionally, we aimed to analyse the effect of continuous positive airway pressure (CPAP) treatment on the miRNA profile. This observational, longitudinal study included 230 subjects referred to the Sleep Unit due to suspected OSA. Expression profiling of 188 miRNAs in plasma was performed in 27 subjects by TaqMan-Low-Density-Array. OSA-related miRNAs were selected for validation by RT-qPCR in 203 patients. Prediction models were built to discriminate between non-OSA and OSA: 1) NoSAS-score, 2) differentially expressed miRNAs, and 3) combination of NoSAS-score plus miRNAs. The differentially expressed miRNAs were measured after 6 months of follow-up. From the 14 miRNAs selected for validation, 6 were confirmed to be differentially expressed. The areas under the curve were 0.73 for the NoSAS-score, 0.81 for the miRNAs and 0.86 for the combination. After 6 months of CPAP treatment, miRNA levels in the OSA group seem to approximate to non-OSA levels. A cluster of miRNAs was identified to differentiate between non-OSA and OSA patients. CPAP treatment was associated with changes in the circulating miRNA profile.

Novel phase I trial design to evaluate the addition of cediranib or selumetinib to preoperative chemoradiotherapy for locally advanced rectal cancer: the DREAMtherapy trial

BACKGROUND

The DREAMtherapy (Dual REctal Angiogenesis MEK inhibition radiotherapy) trial is a novel intertwined design whereby two tyrosine kinase inhibitors (cediranib and selumetinib) were independently evaluated with rectal chemoradiotherapy (CRT) in an efficient manner to limit the extended follow-up period often required for radiotherapy studies.

PATIENTS AND METHODS

Cediranib or selumetinib was commenced 10 days before and then continued with RT (45 Gy/25#/5 wks) and capecitabine (825 mg/m2 twice a day (BID)). When three patients in the cediranib 15-mg once daily (OD) cohort were in the surveillance period, recruitment to the selumetinib cohort commenced. This alternating schedule was followed throughout. Three cediranib (15, 20 and 30 mg OD) and two selumetinib cohorts (50 and 75 mg BID) were planned. Circulating and imaging biomarkers of inflammation/angiogenesis were evaluated.

RESULTS

In case of cediranib, dose-limiting diarrhoea, fatigue and skin reactions were seen in the 30-mg OD cohort, and therefore, 20 mg OD was defined as the maximum tolerated dose. Forty-one percent patients achieved a clinical or pathological complete response (7/17), and 53% (9/17) had an excellent clinical or pathological response (ECPR). Significantly lower level of pre-treatment plasma tumour necrosis factor alpha (TNFα) was found in patients who had an ECPR. In case of selumetinib, the 50-mg BID cohort was poorly tolerated (fatigue and diarrhoea); a reduced dose cohort of 75-mg OD was opened which was also poorly tolerated, and further recruitment was abandoned. Of the 12 patients treated, two attained an ECPR (17%).

CONCLUSIONS

This novel intertwined trial design is an effective way to independently investigate multiple agents with radiotherapy. The combination of cediranib with CRT was well tolerated with encouraging efficacy. TNFα emerged as a potential predictive biomarker of response and warrants further evaluation.

Spatiotemporal palaeodiversity patterns of modern crocodiles (Crocodyliformes: Eusuchia)

Eusuchia is a crocodyliform clade with a rich and diverse fossil record dating back to the Mesozoic. There are several recent studies that analyse crocodyliform palaeodiversity over time, but none of them focuses exclusively on eusuchians. Thus, we estimated subsampled eusuchian palaeodiversity species dynamics over time not only at a global scale, but also by continents and main crocodylian lineages (Alligatoroidea, Crocodyloidea and Gavialoidea). These estimates reveal complex spatiotemporal palaeodiversity patterns, in which two maxima can be detected: the first during the Palaeocene and the second, which is also the biggest, in the middle-late Miocene. The Palaeocene shift is related to a North American alligatoroid diversification, whereas the middle–late Miocene maximum is related to a diversification of the three main Crocodylia lineages in Gondwanan land masses, but especially in South America. Additionally, a model-based study using generalized least squares was carried out to analyse the relationships between different abiotic and sampling proxies and eusuchian palaeodiversity. The results show that palaeotemperature is the most important factor amongst the analysed proxies, in accordance with previous studies. However, the results suggest that, along with palaeotemperature, other abiotic and/or biotic factors might also be driving eusuchian palaeodiversity dynamics.

New highly pachyostotic nothosauroid interpreted as a filter-feeding Triassic marine reptile

Two well-preserved specimens of a new eosauropterygian from the Upper Triassic of Central Spain are attributed to a new taxon, Paludidraco multidentatus gen. et sp. nov. It is a member of Simosauridae that presents several exclusive characters suggesting a highly specialized trophic adaptation. This discovery increases the already high ecological disparity of the Triassic marine reptiles.

New diagnosis for Allodaposuchus precedens, the type species of the European Upper Cretaceous clade Allodaposuchidae

Allodaposuchus precedens is a basal member of Eusuchia, which was established almost a century ago on a set of cranial and postcranial fragmentary remains from the lower Maastrichtian of Vălioara, Romania. It was the first described member and type species of Allodaposuchidae, a recently described European clade representing one of the nearest outgroups to Crocodylia. Although our understanding of the group has expanded in recent years through the description of new forms, a review of Al. precedens is needed. The detailed revision of the classical material from Vălioara, including cranial and postcranial remains, and a comparison with the nearly complete skull from the Romanian synchronous locality of Oarda de Jos, allows us to emend the diagnosis for Al. precedens.

Re-imagining global health through social medicine

The conceptual and practical work done by social medicine and global health have often overlapped. In this paper, we argue that new efforts to apprehend 'the social' in social medicine offer important insights to global health along five lines of critical analysis: (1) reconfigurations of the state and new forms of political activism, (2) philanthrocapitalism and the economisation of life, (3) The economy of attention, (4) anthropogenic climate change, and (5) the geopolitics of North and South.

[Deterioration of vital signs as predictors of major medical emergencies in hospitalized patients]

BACKGROUND

Medical emergencies (ME) in hospitalized patients (cardiac and respiratory arrest, suffocation, asphyxia, seizures, unconsciousness) are associated with high morbidity and mortality. Most of these patients have signs of physiological deterioration prior to the appearance of the emergency. Early detection of warning signs by rapid response teams (RRT) may provide an opportunity for the prevention of major adverse events.

AIM

To identify clinical signs predicting death, need for mechanical ventilation, or transfer to a more complex unit during the 72 hours prior to the activation of the ME code. To evaluate the association of each trigger with specific major adverse events.

PATIENTS AND METHODS

Medical records of 184 hospitalized adult patients in whom the ME code was activated between 2009 and 2014 were reviewed.

RESULTS

Seventy five percent patients who experienced a ME had predictive signs of poor clinical outcome. Polypnea and airway involvement were associated to mechanical ventilation. Hypotension and hypoxemia were associated with mortality.

CONCLUSIONS

In the absence of RRT, special attention should be given to patients with polypnea, airway involvement, hypotension and desaturation, since these are associated with poor clinical outcomes.

Neuregulin 4 Is a Novel Marker of Beige Adipocyte Precursor Cells in Human Adipose Tissue

Background: Nrg4 expression has been linked to brown adipose tissue activity and browning of white adipocytes in mice. Here, we aimed to investigate whether these observations could be translated to humans by investigating NRG4 mRNA and markers of brown/beige adipocytes in human visceral (VAT) and subcutaneous adipose tissue (SAT). We also studied the possible association of NRG4 with insulin action.

Methods: SAT and VAT NRG4 and markers of brown/beige (UCP1, UCP3, and TMEM26)-related gene expression were analyzed in two independent cohorts (n = 331 and n = 59). Insulin resistance/sensitivity was measured using HOMA_IR and glucose infusion rate during euglycemic hyperinsulinemic clamp.

Results: In both cohort 1 and cohort 2, NRG4 and thermogenic/beige-related gene expression were significantly increased in VAT compared to SAT. Adipogenic-related genes followed an opposite pattern. In cohort 1, VAT NRG4 gene expression was positively correlated with BMI and expression of UCP1, UCP3, TMEM26, and negatively with adipogenic (FASN, PPARG, and SLC2A4)- and inflammatory (IL6 and IL8)-related genes. In SAT, NRG4 gene expression was negatively correlated with HOMA_IR and positively with UCP1 and TMEM26 gene expression. Multiple linear regression analysis revealed that expression of TMEM26 gene was the best predictor of NRG4 gene expression in both VAT and SAT. Specifically, NRG4 and TMEM26 gene expression was significantly increased in VAT, but not in SAT stromal vascular fraction cells (p < 0.001). In cohort 2, the significant association between NRG4 and TMEM26 gene expression in both VAT and SAT was confirmed, and SAT NRG4 gene expression also was positively correlated with insulin action and the expression of UCP1.

Conclusion: Current findings suggest NRG4 gene expression as a novel marker of beige adipocytes in human adipose tissue.

Parallels between research in mental health in Brazil and in the field of Global Mental Health: an integrative literature review

Global Mental Health is a field of teaching, research, and practice whose goal is to improve access to mental health and reduce inequalities in mental health outcomes for all people worldwide, especially proposing action in low- and middle-income countries like Brazil. Given this global scenario and Brazil's progress in health and psychiatric reforms, it is important to investigate the current status of the Brazilian mental health literature and its relationship to Global Mental Health, describing how Brazilian research deals with key topics in the Global Mental Health field. The authors performed an integrative literature review using a qualitative and descriptive approach. The article search was performed for the years 2014 and 2015 in Portuguese and English, using the terms "mental health" and "Brazil", combined with key words corresponding to the principal themes addressed by authors in Global Mental Health. The search yielded 88 articles, which were analyzed according to authorship, periodicals and regions, and the analytical categories of access, primary care, community mental health services, social determinants of health, human rights, and equity. Brazil's mental health research revealed a rich and diverse body of studies, showing parallels with the literature on global mental health, but with limited systematization. Although the review revealed efforts to generate knowledge in this field within Brazil, some barriers may be limiting Brazil's participation in the international debate on Global Mental Health.

Adipose TSHB in Humans and Serum TSH in Hypothyroid Rats Inform About Cellular Senescence

BACKGROUND/AIMS

Thyroid hormones have been recently linked to senescence and longevity. Given the recent description of TSHB mRNA in human adipose tissue (AT), we aimed to investigate the relationship between local AT TSH and adipose tissue senescence.

METHODS

TSHB mRNA (measured by real-time PCR) and markers of adipose tissue senescence [BAX, DBC1, TP53, TNF (real-time PCR), telomere length (Telo TAGGG Telomere Length Assay) and lipidomics (liquid chromatography mass spectrometry)] were analysed in subcutaneous (SAT) and visceral (VAT) AT from euthyroid subjects. The chronic effects of TSH were also investigated in AT from hypothyroid rats and after recombinant human TSH (rhTSH) administration in human adipocytes.

RESULTS

Both VAT and SAT TSHB gene expression negatively correlated with markers of AT cellular senescence (BAX, DBC1, TP53, TNF gene expression and specific glucosylceramides) and positively associated with telomere length. Supporting these observations, both rhTSH administration in human adipocytes and increased TSH in hypothyroid rats resulted in decreased markers of cellular senescence (Bax and Tp53 mRNA) in both gonadal and subcutaneous white adipose tissue.

CONCLUSION

These data point to a possible role of TSH in AT cellular senescence.

Magnetic Biohybrid Vesicles Transported by an Internal Propulsion Mechanism

Some biological microorganisms can crawl or swim due to coordinated motions of their cytoskeleton or the flagella located inside their bodies, which push the cells forward through intracellular forces. To date, there is no demonstration of synthetic systems propelling at low Reynolds number via the precise actuation of the material confined within an enclosing lipid membrane. Here, we report lipid vesicles and other more complex self-assembled biohybrid structures able to propel due to the advection flows generated by the actuated rotation of the superparamagnetic particles they contain. The proposed swimming and release strategies, based on cooperative hydrodynamic mechanisms and near-infrared laser pulse-triggered destabilization of the phospholipid membranes, open new possibilities for the on-command transport of minute quantities of drugs, fluid or nano-objects. The lipid membranes protect the confined substances from the outside environment during transportation, thus enabling them to work in physiological conditions.

Grip strength cutpoints for youth based on a clinically relevant bone health outcome

The National Academy of Medicine recommends the handgrip for school-based surveillance of muscle strength for bone health. We established grip strength cutpoints that are linked to bone health in both US and European youth. These cutpoints could serve as a potential set of standards for surveillance and clinical applications.

PURPOSE

The U.S. National Academy of Medicine and experts in Europe recommend the use of grip strength as a valuable and accessible musculoskeletal fitness measure due to its association with bone health. This is the first study to facilitate this recommendation by developing bone health-related grip strength cutpoints for youth based on empirical associations with the well accepted marker of bone development, i.e., height-adjusted total body less head bone mineral content (TBLH_BMC).

METHODS

A purposive sample of healthy youth from Midwest USA (n = 433 youth; 14.1 ± 2.3 years; 1998-2004) and a random sample of healthy adolescents from Zaragoza, Spain (n = 355 youth; 14.9 ± 1.2 years; 2006-2007) were used to develop and test cut-points. Participants' grip strength was measured using a hand-held dynamometer while height-adjusted TBLH_BMC was determined using dual-energy x-ray absorptiometry. Grip strength scores were linked to TBLH_BMC using receiver operator characteristic curves, and grip strength cutpoints were tested based on the area under the curve (AUC), sensitivity (Se), specificity (Sp), and predictive odds ratios. All analyses were conducted in 2016.

RESULTS

The AUC approximated or exceeded 0.80 for grip strength cutpoints, and the associated Se and Sp indices ranged from 53.6 to 92.5%. Sensitivity and Sp remained similar in the validation sample and those not meeting the grip strength cutpoints were five to eight times more likely to have insufficient TBLH_BMC, depending on their sex and cutpoint being considered.

CONCLUSIONS

Grip strength is strongly related to TBLH_BMC, and the proposed cutpoints demonstrated acceptable classification accuracy for screening healthy youth and tracking healthy bone development in community settings. The utility of the cutpoints should be further examined in more diverse populations of youth.

Management of Hemophilia in Spain

Results are presented of a nation-wide inquiry into the management of hemophilia in Spain. It is calculated that there are 1,172 hemophilic patients in the country. A survey has been made of the therapeutic materials (prepared commercially or by hospitals) used in 1974 and their availability in the various hospitals of the Social Security Service. It is estimated that an average of 10,708 units of deficient factor were used per patient in this year. The number of patients on home therapy is 1.2% of the total. All cost of hemophilia treatment is covered by the Social Security. Comments are made on progress during the last five years.

Equilibration of a Polycation-Anionic Surfactant Mixture at the Water/Vapor Interface

The adsorption of concentrated poly(diallyldimethylammonium chloride) (PDADMAC)-sodium lauryl ether sulfate (SLES) mixtures at the water/vapor interface has been studied by different surface tension techniques and dilational viscoelasticity measurements. This work tries to shed light on the way in which the formation of polyelectrolyte-surfactant complexes in the bulk affects the interfacial properties of mixtures formed by a polycation and an oppositely charged surfactant. The results are discussed in terms of a two-step adsorption-equilibration of PDADMAC-SLES complexes at the interface, with the initial stages involving the diffusion of kinetically trapped aggregates formed in the bulk to the interface followed by the dissociation and spreading of such aggregates at the interface. This latter process becomes the main contribution to the surface tension decrease. This work aids our understanding of the most fundamental basis of the physicochemical behavior of concentrated polyelectrolyte-surfactant mixtures which present complex bulk and interfacial interactions with interest in both basic and applied sciences.

A diminutive perinate European Enantiornithes reveals an asynchronous ossification pattern in early birds

Fossils of juvenile Mesozoic birds provide insight into the early evolution of avian development, however such fossils are rare. The analysis of the ossification sequence in these early-branching birds has the potential to address important questions about their comparative developmental biology and to help understand their morphological evolution and ecological differentiation. Here we report on an early juvenile enantiornithine specimen from the Early Cretaceous of Europe, which sheds new light on the osteogenesis in this most species-rich clade of Mesozoic birds. Consisting of a nearly complete skeleton, it is amongst the smallest known Mesozoic avian fossils representing post-hatching stages of development. Comparisons between this new specimen and other known early juvenile enantiornithines support a clade-wide asynchronous pattern of osteogenesis in the sternum and the vertebral column, and strongly indicate that the hatchlings of these phylogenetically basal birds varied greatly in size and tempo of skeletal maturation.

Fossil juvenile Mesozoic birds are exceedingly rare and can provide important insight into the early evolution of avian development. Here, Knoll et al. describe one of the smallest known Mesozoic avians, which indicates a clade-wide asynchronous pattern of osteogenesis and great variation in basal bird hatchling size and skeletal maturation tempo.