Hyper-Reflective Outer Nuclear Layer (HONL) in Vogt-Koyanagi-Harada Disease and Sympathetic Ophthalmia

PURPOSE

To describe the optical coherence tomography (OCT) findings of hyper-reflective outer nuclear layer (HONL) in two cases of stromal choroiditis (Vogt-Koyanagi-Harada disease - VKH, and sympathetic ophthalmia - SO).

METHODS

Case report.

RESULTS

Clinical and imaging findings of two patients (37-year-old female with VKH and 34-year-old male with SO) have been described. Both patients showed typical features of the disease with subretinal fluid accumulation and choroidal thickening on OCT. However, OCT of both patients at the initial visit revealed HONL, which was unusual in these conditions. During follow-up, OCT scans revealed thinning and atrophy of the outer retinal layers, irregular thickening of the retinal pigment epithelium, and irregular autofluorescence pattern on autofluorescence imaging.

CONCLUSIONS

The presence of HONL may serve as a poor prognostic factor in VKH and SO, resulting in thinning and atrophy of the outer retinal layers.

Kanamycin treatment in the pre-symptomatic stage of a Drosophila PD model prevents the onset of non-motor alterations

Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor alterations, which is preceded by a prodromal stage where non-motor symptoms are observed. Over recent years, it has become evident that this disorder involves other organs that communicate with the brain like the gut. Importantly, the microbial community that lives in the gut plays a key role in this communication, the so-called microbiota-gut-brain axis. Alterations in this axis have been associated to several disorders including PD. Here we proposed that the gut microbiota is different in the presymptomatic stage of a Drosophila model for PD, the Pink1^B9 mutant fly, as compared to that observed in control animals. Our results show this is the case: there is basal dysbiosis in mutant animals evidenced by substantial difference in the composition of midgut microbiota in 8-9 days old Pink1^B9 mutant flies as compared with control animals. Further, we fed young adult control and mutant flies kanamycin and analyzed motor and non-motor behavioral parameters in these animals. Data show that kanamycin treatment induces the recovery of some of the non-motor parameters altered in the pre-motor stage of the PD fly model, while there is no substantial change in locomotor parameters recorded at this stage. On the other hand, our results show that feeding young animals the antibiotic, results in a long-lasting improvement of locomotion in control flies. Our data support that manipulations of gut microbiota in young animals could have beneficial effects on PD progression and age-dependent motor impairments.

Systematic mapping of gender equality and social inclusion in WASH interventions: knowledge clusters and gaps

INTRODUCTION

Poor access to water, sanitation and hygiene (WASH) services threatens population health and contributes to gender and social inequalities, especially in low-resource settings. Despite awareness in the WASH sector of the importance of promoting gender equality and social inclusion (GESI) to address these inequalities, evaluations of interventions focus largely on health outcomes, while gender equality and other social outcomes are rarely included. This review aimed to collate and describe available research evidence of GESI outcomes evaluated in WASH intervention studies.

METHODS

We applied a systematic mapping methodology and searched for both academic and grey literature published between 2010 and 2020 in 16 bibliographic databases and 53 specialist websites. Eligibility screening (with consistency checking) was conducted according to predetermined criteria, followed by metadata coding and narrative synthesis.

RESULTS

Our evidence base comprises 463 intervention studies. Only 42% of studies measured transformative GESI outcomes of WASH interventions, referring to those that seek to transform gender relations and power imbalances to promote equality. A majority of studies disaggregated outcome data by sex, but other forms of data disaggregation were limited. Most included studies (78%) lacked a specific GESI mainstreaming component in their intervention design. Of the interventions with GESI mainstreaming, the majority targeted women and girls, with very few focused on other social groups or intersectional considerations.

CONCLUSION

The review points to various areas for future primary and secondary research. Given the potential contribution of WASH to GESI, GESI considerations should be incorporated into the evaluation of WASH interventions. Regular collection of data and monitoring of GESI outcomes is needed as well as developing new and testing existing methods for monitoring and evaluation of such data.

Pembrolizumab in combination with gemcitabine for patients with HER2-negative advanced breast cancer: GEICAM/2015-04 (PANGEA-Breast) study

BACKGROUND

We evaluated a new chemoimmunotherapy combination based on the anti-PD1 monoclonal antibody pembrolizumab and the pyrimidine antimetabolite gemcitabine in HER2- advanced breast cancer (ABC) patients previously treated in the advanced setting, in order to explore a potential synergism that could eventually obtain long term benefit in these patients.

METHODS

HER2-negative ABC patients received 21-day cycles of pembrolizumab 200 mg (day 1) and gemcitabine (days 1 and 8). A run-in-phase (6 + 6 design) was planned with two dose levels (DL) of gemcitabine (1,250 mg/m² [DL0]; 1,000 mg/m² [DL1]) to determine the recommended phase II dose (RP2D). The primary objective was objective response rate (ORR). Tumor infiltrating lymphocytes (TILs) density and PD-L1 expression in tumors and myeloid-derived suppressor cells (MDSCs) levels in peripheral blood were analyzed.

RESULTS

Fourteen patients were treated with DL0, resulting in RP2D. Thirty-six patients were evaluated during the first stage of Simon's design. Recruitment was stopped as statistical assumptions were not met. The median age was 52; 21 (58%) patients had triple-negative disease, 28 (78%) visceral involvement, and 27 (75%) ≥ 2 metastatic locations. Progression disease was observed in 29 patients. ORR was 15% (95% CI, 5-32). Eight patients were treated ≥ 6 months before progression. Fourteen patients reported grade ≥ 3 treatment-related adverse events. Due to the small sample size, we did not find any clear association between immune tumor biomarkers and treatment efficacy that could identify a subgroup with higher probability of response or better survival. However, patients that experienced a clinical benefit showed decreased MDSCs levels in peripheral blood along the treatment.

CONCLUSION

Pembrolizumab 200 mg and gemcitabine 1,250 mg/m² were considered as RP2D. The objective of ORR was not met; however, 22% patients were on treatment for ≥ 6 months. ABC patients that could benefit of chemoimmunotherapy strategies must be carefully selected by robust and validated biomarkers. In our heavily pretreated population, TILs, PD-L1 expression and MDSCs levels could not identify a subgroup of patients for whom the combination of gemcitabine and pembrolizumab would induce long term benefit.

TRIAL REGISTRATION

ClinicalTrials.gov and EudraCT (NCT03025880 and 2016-001,779-54, respectively). Registration dates: 20/01/2017 and 18/11/2016, respectively.

Randomized, direct comparison study of Saccharomyces boulardii CNCM I-745 versus multi-strained Bacillus clausii probiotics for the treatment of pediatric acute gastroenteritis

BACKGROUND

The choice of an appropriate probiotic for pediatric acute gastroenteritis (PAGE) can be confusing. Our aim was to compare the efficacy and safety of 2 probiotics (Saccharomyces boulardii CNCM I-745 vs a 4-strain mixture of Bacillus clausii O/C, SIN, N/R, T) for the treatment of PAGE.

METHODS

A 2-arm parallel, randomized trial recruited children (6 months to 5 years old) with mild-moderate acute diarrhea, from 8 centers in Argentina. A total of 317 children were enrolled and blindly randomized to 5 days of either S boulardii CNCM I-745 (n = 159) or a 4-strain mixture of B clausii (n = 158), then followed for 7 days post-probiotic treatment. A stool sample was collected at inclusion for pathogen identification. The primary outcome was duration of diarrhea defined as the time from enrollment to the last loose stool followed by the first 24-hour period with stool consistency improvement. Secondary outcomes included frequency of loose stools/day, severity of diarrhea, number reporting no diarrhea at Day 6, time-to-first formed stool, recurrence of diarrhea by study end (Day 12) and safety outcomes.

RESULTS

Three hundred twelve (98%) children completed the study. S boulardii CNCM I-745 showed a significant reduction (P = .04) in the mean duration of diarrhea (64.6 hours, 95% confidence interval [CI] 56.5-72.8) compared to those given B clausii (78.0 hours, 95% CI 69.9-86.1). Both probiotics showed improvement in secondary outcomes and were well-tolerated.

CONCLUSION

In this study, S boulardii CNCM I-745 demonstrated better efficacy than B clausii mix for reducing the duration of pediatric acute diarrhea.

The interaction of deep convection with the general circulation in Titan's atmosphere. Part 1: Cloud Resolving Simulations

The deep convective cloud-environment feedback loop is likely important to Titan's global methane, energy, and momentum cycles, just as it is for Earth's global water, energy, and momentum budgets. General circulation models of Titan's atmosphere are unable to explicitly simulate deep convection and must instead parameterize the impact of this important subgrid-scale phenomenon on the model-resolved atmospheric state. The goal of this study is to better quantify through cloud resolving modeling the effects of deep convective methane storms on their environment and to feed that information forward to improve parameterizations in global models. Dozens of atmospheric profiles unstable with respect to deep moist convection are extracted from the global Titan Atmospheric Model (TAM) and used to initialize the cloud-resolving Titan Regional Atmospheric Modeling System (TRAMS). Mean profiles of heating/cooling and moistening/drying of the large-scale environment in TRAMS indicate that Titan's deep convection forces the environment in a manner analogous to Earth: Large-scale subsidence of the environmental air warms and dries the environment, but clouds can also moisten the environment through the detrainment and evaporation of condensate near cloud top. Relative humidity profiles and characteristic convective time scales are derived to guide the tuning of the deep convective parameterization implemented in TAM, as described in a companion paper. The triggering of convection, the dry convective mixing of the planetary boundary layer, and the entrainment of environmental air into rising air parcels are found to be critical to determining whether a deep convective cloud will form. Only profiles with relatively large convective available potential energy (CAPE) and well mixed planetary boundary layers with high relative humidity were found to produce storms. Environments with low level thermal inversions and planetary boundary layers with low relative humidity or rapidly decreasing moisture with height failed to generate deep convection in TRAMS despite positive CAPE.

[Prevalence and incidence of ictus in Europe: systematic review and meta-analysis]

BACKGROUND

Stroke is the second cause of death and the first cause of disability in Europe. The number of stroke patients shows a rapidly increasing due to the increase in the elderly population. The aim of this meta-analysis is to evaluate the prevalence and incidence of stroke in Europe.

METHOD

We conducted a literature search in MEDLINE, SCOPUS, CINAHL Complete and EMBASE, using the keywords "stroke", "cerebrovascular accident", "epidemiology", "prevalence", "incidence" and "Europe". In order to evaluate the quality and risk of bias, we used the Hoy's modified scale for prevalence studies and the Newcastle Ottawa Scale for incidence studies. A random effects model with 95% confidence intervals (95%CI) was used for the meta-analysis. The I2 statistic was applied to assess heterogeneity.

RESULTS

The prevalence of stroke in Europe adjusted for sex was estimated at 9.2% (95%CI: 4.4-14.0). The prevalence was 9.1% (95%CI: 4.7-13.6) in men and 9.2% (95%CI: 4.1-14.4) in women, and increased with age. The incidence of stroke in Europe adjusted for sex was 191.9 per 100,000 person-years (95%CI: 156.4-227.3); it was 195.7 per 100,000 person-years (95%CI: 142.4-249.0) in men and 188.1 per 100,000 person-years (95%CI: 138.6-237.7) in women. Again, these rates increased with age.

CONCLUSION

The prevalence of stroke in Europe is 9.2%. The incidence of stroke in Europe is 191.9 per 100,000 person-years. The prevalence of stroke has increased, whereas the incidence of stroke is stable in comparison with studies conducted at the beginning of the 21st century.

A TLR4 agonist improves immune checkpoint blockade treatment by increasing the ratio of effector to regulatory cells within the tumor microenvironment

Brucella lumazine synthase (BLS) is a homodecameric protein that activates dendritic cells via toll like receptor 4, inducing the secretion of pro-inflammatory cytokines and chemokines. We have previously shown that BLS has a therapeutic effect in B16 melanoma-bearing mice only when administered at early stages of tumor growth. In this work, we study the mechanisms underlying the therapeutic effect of BLS, by analyzing the tumor microenvironment. Administration of BLS at early stages of tumor growth induces high levels of serum IFN-γ, as well as an increment of hematopoietic immune cells within the tumor. Moreover, BLS-treatment increases the ratio of effector to regulatory cells. However, all treated mice eventually succumb to the tumors. Therefore, we combined BLS administration with anti-PD-1 treatment. Combined treatment increases the outcome of both monotherapies. In conclusion, we show that the absence of the therapeutic effect at late stages of tumor growth correlates with low levels of serum IFN-γ and lower infiltration of immune cells in the tumor, both of which are essential to delay tumor growth. Furthermore, the combined treatment of BLS and PD-1 blockade shows that BLS could be exploited as an essential immunomodulator in combination therapy with an immune checkpoint blockade to treat skin cancer.

Wood development regulators involved in apical growth in Pinus canariensis

The shoot apical meristem is responsible of seasonal length increase in plants. In woody plants transition from primary to secondary growth is also produced during seasonal apical growth. These processes are controlled by different families of transcription factors. Levels of transcriptomic activity during apical growth were measured by means of a cDNA microarray designed from sequences related to meristematic activity in Pinus canariensis. The identification of differentially expressed genes was performed using a time-course analysis. A total of 7170 genes were differentially expressed and grouped in six clusters according to their expression profiles. We identified master regulators, such as WUSCHEL-like HOMEOBOX (WOX), to be involved in the first stages of apical development, i.e. growth of primary tissues, while other transcription factors, such as Class III HOMEODOMAIN-LEUCINE ZIPPER (HD-ZIP III) and KNOTTED-like (KNOX) and BEL1-like (BELL) HOMEODOMAIN proteins, were found to be induced during last stages of apical seasonal development, already with secondary growth. Our results reveal the main expression patterns of these genes during apical development and the transition from primary to secondary stem growth. In particular, the regulatory factors identified play key roles in controlling stem architecture and constitute candidate genes for the study of other development processes in conifers.

Prevalence of Spasticity and Postural Patterns in the Upper Extremity Post Stroke

INTRODUCTION

A high number of patients with stroke develop upper extremity spasticity, causing abnormal postures and patterns. These alterations limit the use of arm in functional activities and affect social participation.

AIM

To determine the prevalence of spasticity and postural patterns of the upper extremity post stroke.

MATERIALS AND METHODS

A cross-sectional descriptive design was used with a prospective follow-up. The sample included 136 patients. The study included 3 measuring times; at 10 days (T1), applying a record with sociodemographic-clinical data, the evaluation of muscle tone in the elbow and wrist and the postural patterns of the UE, and at 3 months (T2) and 12 months (T3) post stroke, re-evaluating tone and patterns. Prevalence was calculated through the one-sample chi-squared (χ2) test followed by inspection of the standardized residuals (z) in each cell. The Kappa coefficient evaluated the degree of agreement in elbow and wrist tone.

RESULTS

The prevalence of spasticity in the elbow was 37.5% at T1, 57.4% at T2, and 57.4% at T3. At each time there was a high degree of agreement between elbow and wrist tone. Patients developed increased elbow tone between T1 and T2, with maintained tone between T2 and T3. Postural pattern III was the most prevalent according to Hefter's classification.

CONCLUSION

The prevalence of spasticity in the elbow and wrist increases between 10 days and 3 months post stroke, and is maintained between 3 and 12 months. The onset of spasticity occurs in almost half of patients during the first 10 days post stroke. Postural pattern III according to Hefter's classification presented the greatest prevalence in the spastic UE.

Management of Heart Failure with Reduced Ejection Fraction after ESC 2016 Heart Failure Guidelines: The Linx Registry

Aims

In May 2016, a new version of the European Society of Cardiology (ESC) Guidelines for the management of heart failure (HF) was released. The aim of this study was to describe the management of HF with reduced ejection fraction after the publication of ESC Guidelines.

Methods and results

The Linx registry is a multicentre, observational, cross‐sectional study from 14 Catalan hospitals that enrolled 1056 patients with HF and reduced left ventricular ejection fraction (≤40%) from 1 February to 30 April 2017 in outpatient cardiology clinics. Results were compared between hospitals according to their level of complexity in our own registry and compared with previously published registries similar to ours. Sacubitril/valsartan was prescribed to 23.9% of patients in our population, as a consequence, use of angiotensin‐converting enzyme inhibitor and angiotensin receptor blockers in monotherapy decreased to 48.1% and 16.9%, respectively, and prescription of beta‐blockers (91.8%), mineralocorticoid receptor antagonists (72.7%), and ivabradine (21.4%) remained similar to previous registries. Target doses of beta‐blockers (25.4%), angiotensin‐converting enzyme inhibitors (24.9%), angiotensin receptor blockers (7.7%), sacubitril/valsartan (8.1%), and mineralocorticoid receptor antagonists (19.7%) were accomplished in a low proportion of patients. Our results also suggest that prescription and up‐titration of class I HF drugs were greater in hospitals with higher level of complexity.

Conclusions

The Linx registry shows an appropriate adherence to pharmacological recommendations from ESC HF Guidelines despite a low proportion of patients reached target doses. Almost one‐quarter of patients were under treatment with sacubitril/valsartan a few months after ESC HF Guidelines recommendations.

Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes

OBJECTIVE

There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings.

RESEARCH DESIGN AND METHODS

Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years.

RESULTS

At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects.

CONCLUSIONS

Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.

Equilibria and correlation of systems involving 1-hexyl-3-methylpyridinium trifluoromethanesulfonate

Ionic liquids are being proposed for the improvement of many refinery-related applications where water and oil coexist. However, the lack of relevant thermodynamic data on equilibrium processes involving water, oil and an ionic liquid is a stumbling block. Phase diagrams of these systems are complex, with many different regions, especially when the ionic liquid is solid at room conditions. This greatly complicates modelling, which is usually neglected or carried out only partially. In this work, for the first time, the simultaneous correlation not only of liquid–liquid and liquid–liquid–liquid but also solid–liquid equilibrium data for ternary systems involving ionic liquids has been carried out. To that end, the ionic liquid 1-hexyl-3-methylpyridinium trifluoromethanesulfonate, with an alkyl chain length that favours nano-segregation, was selected. Phase diagrams with water and different representative oils (octane, toluene and cyclohexane) have been determined at various temperatures and atmospheric pressure. The great capacity of the NRTL model, a powerful tool used in all chemical process simulators, was shown by simultaneously correlating data from all the equilibrium regions. However, adequate equilibrium equations and pivotal strategies were required. Low deviations and a good representation of phase diagrams was achieved. A topological analysis based on the Gibbs common tangent criterion and a stability test allowed validation of the proposed correlation parameters.

The NRTL model is a useful tool to carry out the simultaneous correlation of all different equilibrium regions found in a phase diagram.

A Type 1 Diabetes Genetic Risk Score Predicts Progression of Islet Autoimmunity and Development of Type 1 Diabetes in Individuals at Risk

OBJECTIVE

We tested the ability of a type 1 diabetes (T1D) genetic risk score (GRS) to predict progression of islet autoimmunity and T1D in at-risk individuals.

RESEARCH DESIGN AND METHODS

We studied the 1,244 TrialNet Pathway to Prevention study participants (T1D patients' relatives without diabetes and with one or more positive autoantibodies) who were genotyped with Illumina ImmunoChip (median [range] age at initial autoantibody determination 11.1 years [1.2-51.8], 48% male, 80.5% non-Hispanic white, median follow-up 5.4 years). Of 291 participants with a single positive autoantibody at screening, 157 converted to multiple autoantibody positivity and 55 developed diabetes. Of 953 participants with multiple positive autoantibodies at screening, 419 developed diabetes. We calculated the T1D GRS from 30 T1D-associated single nucleotide polymorphisms. We used multivariable Cox regression models, time-dependent receiver operating characteristic curves, and area under the curve (AUC) measures to evaluate prognostic utility of T1D GRS, age, sex, Diabetes Prevention Trial-Type 1 (DPT-1) Risk Score, positive autoantibody number or type, HLA DR3/DR4-DQ8 status, and race/ethnicity. We used recursive partitioning analyses to identify cut points in continuous variables.

RESULTS

Higher T1D GRS significantly increased the rate of progression to T1D adjusting for DPT-1 Risk Score, age, number of positive autoantibodies, sex, and ethnicity (hazard ratio [HR] 1.29 for a 0.05 increase, 95% CI 1.06-1.6; P = 0.011). Progression to T1D was best predicted by a combined model with GRS, number of positive autoantibodies, DPT-1 Risk Score, and age (7-year time-integrated AUC = 0.79, 5-year AUC = 0.73). Higher GRS was significantly associated with increased progression rate from single to multiple positive autoantibodies after adjusting for age, autoantibody type, ethnicity, and sex (HR 2.27 for GRS >0.295, 95% CI 1.47-3.51; P = 0.0002).

CONCLUSIONS

The T1D GRS independently predicts progression to T1D and improves prediction along T1D stages in autoantibody-positive relatives.

Phase II randomized study of PM01183 versus topotecan in patients with platinum-resistant/refractory advanced ovarian cancer

Background

PM01183 is a new compound that blocks active transcription, produces DNA breaks and apoptosis, and affects the inflammatory microenvironment. PM01183 showed strong antitumor activity in preclinical models of cisplatin-resistant epithelial ovarian cancer.

Patients and methods

Patients with platinum-resistant/refractory ovarian cancer were included in a two-stage, controlled, randomized (in a second stage), multicenter, phase II study. Primary endpoint was overall response rate (ORR) by RECIST and/or GCIG criteria. The exploratory first stage (n = 22) confirmed the activity of PM01183 as a single agent at 7.0 mg flat dose every 3 weeks (q3wk). The second stage (n = 59) was randomized and controlled with topotecan on days 1-5 q3wk or weekly (every 4 weeks, q4wk).

Results

ORR was 23% (95% CI, 13%-37%) for 52 PM01183-treated patients. Median duration of response was 4.6 months (95% CI, 2.5-6.9 months), and 23% (95% CI, 0%-51%) of responses lasted 6 months or more. Ten of the 12 confirmed responses were reported for 33 patients with platinum-resistant disease [ORR = 30% (95% CI, 16%-49%)]; for the 29 patients treated with topotecan in the second stage, no responses were found. Median PFS for all PM01183-treated patients was 4.0 months (95% CI, 2.7-5.6 months), and 5.0 months (95% CI, 2.7-6.9 months) for patients with platinum-resistant disease. Grade 3/4 neutropenia in 85% of patients; febrile neutropenia in 21% and fatigue (grade 3 in 35%) were the principal safety findings for PM01183.

Conclusion

PM01183 is an active drug in platinum-resistant/refractory ovarian cancer and warrants further development. The highest activity was observed in platinum-resistant disease. Its safety profile indicates the dose should be adjusted to body surface area (mg/m2).

Trial code

EudraCT 2011-002172-16.

Data Quality and Assessment, Validation Methods and Error Propagation through the Simulation Software: Report from the Round-Table Discussion at the 10th World Congress of Chemical Engineering in Barcelona (October 1-5, 2017)

The issues of data quality and propagation of data uncertainties into process design and plant specifications are of great current interest. Hence, two Working Parties of the European Federation of Chemical Engineers (EFCE) organized a Round Table Discussion on the topic, as part of the World Congress of Chemical Engineering (WCCE10) in Barcelona, in October 2017. The discussion was guided by industrial and academic experts, with the audience as a key part of the discussion, trying to find some answers in three areas: Data acquisition and evaluation of experimental uncertainties, tools for data reconciliation to improve their quality, and impact of data uncertainties on the process at the end. Several concrete stories are presented that demonstrate the importance of considering data quality and all possible contributions to the uncertainty of chemical process design. Difficulties associated with data quality are discussed at various levels: (1) the experimentalists (measurement issues, evaluation of uncertainties, use of consistency analysis tools); (2) model developers (capture of adequate physics, parameter regression strategies, uncertainty propagation), (3) vendors of process simulation software, and (4) process engineers (who are responsible at the end). Paths for improvements were proposed through better and more efficient communication among different participants, as well as through education.

First clinical symptom as a prognostic factor in systemic sclerosis: results of a retrospective nationwide cohort study

The objective of the study is to determine the importance of the mode of onset as prognostic factor in systemic sclerosis (SSc). Data were collected from the Spanish Scleroderma Registry (RESCLE), a nationwide retrospective multicenter database created in 2006. As first symptom, we included Raynaud's phenomenon (RP), cutaneous sclerosis, arthralgia/arthritis, puffy hands, interstitial lung disease (ILD), pulmonary arterial hypertension (PAH), and digestive hypomotility. A total of 1625 patients were recruited. One thousand three hundred forty-two patients (83%) presented with RP as first symptom and 283 patients (17%) did not. Survival from first symptom in those patients with RP mode of onset was higher at any time than those with onset as non-Raynaud's phenomenon: 97 vs. 90% at 5 years, 93 vs. 82% at 10 years, 83 vs. 62% at 20 years, and 71 vs. 50% at 30 years (p < 0.001). In multivariate analysis, factors related to mortality were older age at onset, male gender, dcSSc subset, ILD, PAH, scleroderma renal crisis (SRC), heart involvement, and the mode of onset with non-Raynaud's phenomenon, especially in the form of puffy hands or pulmonary involvement. The mode of onset should be considered an independent prognostic factor in systemic sclerosis and, in particular, patients who initially present with non-Raynaud's phenomenon may be considered of poor prognosis.

Aggregation Patterns, Sampling Plan, and Economic Injury Levels for the New Citrus Pest Delottococcus aberiae (Hemiptera: Pseudococcidae)

Delottococcus aberiae De Lotto (Hemiptera: Pseudococcidae) is the latest exotic mealybug species introduced in citrus in the Mediterranean basin. It causes severe distortion and size reduction on developing fruits. Due to its first interaction with citrus, D. aberiae economic thresholds are still unknown for this crop and the current Integrated Pest Management programs have been disrupted. The objectives of this study were to determine the aggregation patterns of D. aberiae in citrus, develop an efficient sampling plan to assess its population density, and calculate its Economic and Economic Environmental Injury Levels (EIL and EEIL, respectively). Twelve and 19 orchards were sampled in 2014 and 2015, respectively. At each orchard, population densities were monitored fortnightly in leaves, twigs, and fruit, and fruit damage was determined at harvest. Our results showed a clumped aggregation of D. aberiae in all organs with no significant differences between generations on fruit. Fruit damage at harvest was strongly correlated with fruit occupation in spring. Based on these results and using chlorpyrifos as the insecticide of reference, the EIL and EEIL were calculated as 7.1 and 12.1% of occupied fruit in spring, respectively. With all this, we recommend sampling 275 fruits using a binomial sampling method or alternatively, 140 fruits with an enumerative method bimonthly between petal fall and July.

Transcriptomic analysis of wound xylem formation in Pinus canariensis

BACKGROUND

Woody plants, especially trees, usually must face several injuries caused by different agents during their lives. Healing of injuries in stem and branches, affecting the vascular cambium and xylem can take several years. In conifers, healing takes place mainly from the remaining vascular cambium in the margin of the wound. The woundwood formed in conifers during healing usually presents malformed and disordered tracheids as well as abundant traumatic resin ducts. These characteristics affect its functionality as water conductor and its technological properties.

RESULTS

In this work we analyze for the first time the transcriptomic basis of the formation of traumatic wood in conifers, and reveal some differences with normal early- and late-wood. Microarray analysis of the differentiating traumatic wood, confirmed by quantitative RT-PCR, has revealed alterations in the transcription profile of up to 1408 genes during the first period of healing. We have grouped these genes in twelve clusters, according to their transcription profiles, and have distinguished accordingly two main phases during this first healing.

CONCLUSIONS

Wounding induces a complete rearrangement of the transcriptional program in the cambial zone close to the injuries. At the first instance, radial growth is stopped, and a complete set of defensive genes, mostly related to biotic stress, are induced. Later on, cambial activity is restored in the lateral borders of the wound, even at a high rate. During this second stage certain genes related to early-wood formation, including genes involved in cell wall formation and transcription factors, are significantly overexpressed, while certain late-wood related genes are repressed. Additionally, significant alterations in the transcription profile of abundant non annotated genes are reported.

A system for finger tremor quantification in patients with Parkinson's disease

The current diagnosis of Parkinson's disease (PD) is based on a subjective assessment by the specialist. The monitoring of the tremor that presents in the hand index fingers in a patient with Parkinson's is one of the most important parameters to diagnose the evolution of the disease in an objective manner. This research analyze the tremor in the hand index fingers of patients with PD with medication and without medication. A sensor based in a triaxial accelerometer was used to acquire the data produced by the acceleration changes of parkinsonian tremor in the case of three activities: postural tremor, action tremor and rest tremor. Acquired data were processed in Matlab; the data were filtered and the spectral power density (PSD) was estimated with the Burg periodogram. It has been verified that the system presented in this article can accurately detect the parkinsonian tremors of the patients evaluated, additionally has been found that with the medication the tremors do not disappear completely, these remained with the same frequencies of PD but with a very small amplitude.

[Venezuelan consensus guidelines on the use of magnetic resonance in diagnosis and follow up of patients with multiple sclerosis]

INTRODUCTION

The clinical use of magnetic resonance (MR) in patients with multiple sclerosis (MS) has advanced markedly over the past few years. Several groups around the world have developed consensus guidelines about the role of MR in MS at diagnosis and during follow up. However, in some regions is difficult to extrapolate the recommendations.

AIM

To provide recommendations for the implementation of MR in MS patients at diagnosis and follow up in Venezuela.

DEVELOPMENT

A group of experts from Venezuela that included neurologists and radiologists, by using the online surveys methodology as well as face to face meetings developed the intended consensus for the use of MR during the diagnosis and follow up of MS patients in Venezuela. Seventeen recommendations were established based on published evidence and the expert opinion. Recommendations focused on the role of conventional MR techniques and brain atrophy measurement in MS patients both at diagnosis and during follow-up.

CONCLUSIONS

The recommendations of this consensus guidelines attempts to optimize the health care and management of patients with MS in Venezuela.

A system to monitor tremors in patients with Parkinson's disease

In this work the design and development of a system to monitor tremors in patients with Parkinson's disease based on Arduino open-source prototyping platform is presented. For processing data tremors acquired by the sensor device we have developed an Android application which allows an evaluation of the state of PD patients based on three types of tests that are in the Unified Parkinson's Disease Rating Scale recommended by the Movement Disorder Society (MDS-UPDRS); the tests performed in the application are: postural tremor of the hands, kinetic tremors of the hands and resting tremor amplitude. The results of PD Patients showed that despite receiving medication to minimize symptoms of their disease, patients have a considerable tremor amplitude, which affects the normal development of their daily activities. In addition, the spectral analysis of the tremors shows that two of the patients were correctly diagnosed with PD while the third patient showed spectral characteristics which led us to suggest to the treating physician reconsider the diagnosis.

Allele frequencies and other forensic parameters of the HID-Ion AmpliSeq™ Identity Panel markers in Basques using the Ion Torrent PGM™ platform

The HID-Ion AmpliSeq™ Identity Panel amplifies 90 autosomal SNPs and 34 Y- SNPs with massively parallel sequencing (MPS) using the Ion Torrent PGM™ platform. In the present study, 105 Basques were analyzed to assess this panel. All loci were in Hardy-Weinberg equilibrium and no association between them was detected. Forensic parameters were calculated as 5.74×10^-36 for combined match probability and 99.99998% for combined power of exclusion. In conclusion, the HID Identity panel and the use of this new MPS technology are very promising tools for paternity testing and human identification in routine casework in the forensic field.

Flight behaviour and dispersal of Rhynchophorus ferrugineus (Coleoptera: Dryophthoridae) adults using mark-release-recapture method

The flight ability and patterns of an insect influence its spread, and the study of its behaviour can be used to improve the strategies to control the pest. Regarding Rhynchophorus ferrugineus (Olivier) (Coleoptera: Dryophthoridae), one of the worst threats to palm trees worldwide, laboratory experiments have been conducted to analyze their flight potential. However, these data must be complemented with tests that allow us to know its flight behaviour and dispersal patterns under field conditions. Two mark-release-recapture experiments were conducted in areas with R. ferrugineus infestations. In the first, the effects of weevil sex, temperature, solar radiation, and relative humidity, on the take-off and flight mobility of adults were analyzed. The second experiment aimed to determine the maximum flight distance covered by adults in field. The take-off rate for R. ferrugineus males was significantly greater than for females, and was positively influenced by temperature (optimum take-off around 25°C) and solar radiation, both factors being highly correlated. Female weevil recaptures were significantly higher, especially as temperatures increased (optimum recapture around 21°C). Dispersal distances of weevil adults increased when temperatures rose, and while this insect tended to fly short distances (<500 m), it was able to cover up to 7 km. The dispersal of R. ferrugineus adults mainly occurred during the first 7 days after their release, and when relative humidity increased, their dispersal time was reduced. The results obtained will permit a more effective implementation of certain measures used to control R. ferrugineus, such as olfactory trapping or intensive surveillance around pest outbreaks.

Correlation of three-liquid-phase equilibria involving ionic liquids

The difficulty in achieving a good thermodynamic description of phase equilibria is finding a model that can be extended to a large variety of chemical families and conditions. This problem worsens in the case of systems containing more than two phases or involving complex compounds such as ionic liquids. However, there are interesting applications that involve multiphasic systems, and the promising features of ionic liquids suggest that they will play an important role in many future processes. In this work, for the first time, the simultaneous correlation of liquid-liquid and liquid-liquid-liquid equilibrium data for ternary systems involving ionic liquids has been carried out. To that end, the phase diagram of the water + [P6 6 6 14][DCA] + hexane system has been determined at 298.15 K and 323.15 K and atmospheric pressure. The importance of this system lies in the possibility of using the surface active ionic liquid to improve surfactant enhanced oil recovery methods. With those and previous measurements, thirteen sets of equilibrium data for water + ionic liquid + oil ternary systems have been correlated. The isoactivity equilibrium condition, using the NRTL model, and some pivotal strategies are proposed to correlate these complex systems. Good agreement has been found between experimental and calculated data in all the regions (one triphasic and two biphasic) of the diagrams. The geometric aspects related to the Gibbs energy of mixing function obtained using the model, together with the minor common tangent plane equilibrium condition, are valuable tools to check the consistency of the obtained correlation results.

High root temperature affects the tolerance to high light intensity in Spathiphyllum plants

Spathiphyllum wallisii plants were sensitive to temperature stress under high illumination, although the susceptibility of leaves to stress may be modified by root temperature. Leaves showed higher tolerance to high illumination, in both cold and heat conditions, when the roots were cooled, probably because the chloroplast were protected by excess excitation energy dissipation mechanisms such as cyclic electron transport. When the roots were cooled both the activity of electron donation by NADPH and ferredoxin to plastoquinone and the amount of PGR5 polypeptide, an essential component of cyclic electron flow around PSI, increased. However, when the stems were heated or cooled under high illumination, but the roots were heated, the quantum yield of PSII decreased considerably and neither the electron donation activity by NADPH and ferredoxin to plastoquinone nor the amount of PGR5 polypeptide increased. In such conditions, the cyclic electron flow cannot be enhanced by high light and PSII is damaged as a result of insufficient dissipation of excess light energy. Additionally, the damage to PSII induced the increase in both chlororespiratory enzymes, NDH complex and PTOX.

Study of the flying ability of Rhynchophorus ferrugineus (Coleoptera: Dryophthoridae) adults using a computer-monitored flight mill

The red palm weevil, Rhynchophorus ferrugineus (Olivier) (Coleoptera: Dryophthoridae), native to tropical Asian regions, has become a serious threat to palm trees all over the world. Knowledge of its flight potential is vital to improving the preventive and curative measures currently used to manage this pest. As R. ferrugineus is a quarantine pest, it is difficult to study its flight potential in the field. A computer-monitored flight mill was adapted to analyse the flying ability of R. ferrugineus through the study of different flight parameters (number of flights, total distance flown, longest single flight, flight duration, and average and maximum speed) and the influence of the weevil's sex, age, and body size on these flight parameters. Despite significant differences in the adult body size (body weight and length) of males and females, the sex of R. ferrugineus adults did not have an influence on their flight potential. Neither adult body size nor age was found to affect the weevil's flying abilities, although there was a significantly higher percentage of individuals flying that were 8-23 days old than 1-7 days old. Compared to the longest single flight, 54% of the insects were classified as short-distance flyers (covering <100 m) and 36 and 10% were classified as medium- (100-5000 m) and long-distance (>5000 m), respectively. The results are compared with similar studies on different insect species under laboratory and field conditions.

Subjects with impaired fasting glucose: evolution in a period of 6 years

AIM

To study the evolution of impaired fasting glucose (IFG), considering glucose and HbA1c levels and risk factors associated, in a period of 6 years.

METHODS

We studied 94 subjects with impaired fasting glucose (IFG) that were diagnosed in 2005 and followed up to 2012. Glucose and HbA1c levels were determined. A descriptive analysis of contingence charts was performed in order to study the evolution in the development of type-2 diabetes mellitus (T2DM).

RESULTS

Twenty-eight of ninety-four subjects became T2DM; 51/94 remained with IFG; and 20/94 presented normal fasting glucose. From the 28 diabetic subjects, 9 had already developed diabetes and were under treatment with oral hypoglycemic agents; 5 were diagnosed with plasma glucose < 126 mg/dL, but with HbA1c over 6.5%. In those who developed diabetes, 15/28 had a family history of T2DM in first relative degree. Also, diabetic subjects had a BMI significantly higher than nodiabetics (t test: P < 0.01). The individuals that in 2005 had the highest BMI are those who currently have diabetes.

CONCLUSION

The IFG constitutes a condition of high risk of developing T2DM in a few years, especially over 110 mg/dL and in obesity patients.