Therapeutic Management and Long-Term Outcome of Hyperthyroidism in Patients with Antithyroid-Induced Agranulocytosis: A Retrospective, Multicenter Study

BACKGROUND

Antithyroid drug-induced agranulocytosis (AIA) (neutrophils <500/µL) is a rare but serious complication in the treatment of hyperthyroidism.

METHODOLOGY

Adult patients with AIA who were followed up at 12 hospitals in Spain were retrospectively studied. A total of 29 patients were studied. The etiology of hyperthyroidism was distributed as follows: Graves' disease (n = 21), amiodarone-induced thyrotoxicosis (n = 7), and hyperfunctioning multinodular goiter (n = 1). Twenty-one patients were treated with methimazole, as well as six patients with carbimazole and two patients with propylthiouracil.

RESULTS

The median (IQR) time to development of agranulocytosis was 6.0 (4.0-11.5) weeks. The most common presenting sign was fever accompanied by odynophagia. All of the patients required admission, reverse isolation, and broad-spectrum antibiotics; moreover, G-CSF was administered to 26 patients (89.7%). Twenty-one patients received definitive treatment, thirteen patients received surgery, nine patients received radioiodine, and one of the patients required both treatments. Spontaneous normalization of thyroid hormone values occurred in six patients (four patients with amiodarone-induced thyrotoxicosis and two patients with Graves' disease), and two patients died of septic shock secondary to AIA.

CONCLUSIONS

AIA is a potentially lethal complication that usually appears around 6 weeks after the initiation of antithyroid therapy. Multiple drugs are required to control hyperthyroidism before definitive treatment; additionally, in a significant percentage of patients (mainly in those treated with amiodarone), hyperthyroidism resolved spontaneously.

Consumption of health resources in older people with differentiated thyroid carcinoma: a multicenter analysis

OBJECTIVE

There is hardly any information on the consumption of healthcare resources by older people with differentiated thyroid cancer (DTC). We analyzed these consumptions in older patients with DTC and compared patients 75 years and older with subjects aged 60-74 years.

METHODS

A multicenter, retrospective analysis was designed. We recorded three groups of health resources consumption (visits, diagnostic procedures, and therapeutic procedures) and identified a subgroup of patients with high consumption of resources. We compared patients aged between 60-74 years (group 1) with patients aged 75 and over (group 2).

RESULTS

We included 1654 patients (women, 74.4%), of whom 1388 (83.9%) belonged to group 1 and 266 (16.1%) to group 2. In group 2, we found a higher proportion of patients requiring emergency department visits (7.9 vs. 4.3%, P = 0.019) and imaging studies (24.1 vs. 17.3%; P = 0.012) compared to group 1. However, we did not find any significant difference between both groups in the consumption of other visits, diagnostic procedures, or therapeutic procedures. Overall, 340 patients (20.6%) were identified as high consumers of health resources, 270 (19.5%) in group 1 and 70 (26.3%) in group 2 (P = 0.013). Multivariate logistic regression analysis showed that the risk of recurrence and mortality, radioiodine treatment, tumor size, and vascular invasion were significantly related to the high global consumption of resources. However, the age was not significantly related to it.

CONCLUSION

In patients with DTC over 60 years of age, advanced age is not an independent determining factor in the consumption of health resources.

Caregiver training: Evidence of its effectiveness for cognitive and functional improvement in older adults

AIMS AND OBJECTIVES

The objectives of this study were to assess the benefits of a caregiver training programme on the cognitive and functional status of older adults, and to compare the effects of this programme according to type of caregiver (professional vs. family caregiver).

BACKGROUND

Due to demographic changes that have resulted in an aging population, the role of caregiver of an older adult has become very important in recent years.

DESIGN AND METHODS

The sample was composed of 160 older adults: (a) 100 received care from caregivers who had taken the three-month training programme (treatment group), of which 60 were professional caregivers and 40 were family caregivers, and (b) 60 received care from caregivers who had not taken the programme (control group). In order to evaluate programme effects on cognitive and functional status, we used both direct measures answered by the older adults (MMSE, CAPE and EuroQol) and caregiver reports (Barthel and RMPBC). We used a quasi-experimental, pre-post design. We followed SQUIRE 2.0 guidelines for reporting.

RESULTS

The results showed that older adults who were cared for by caregivers that had participated in the training programme showed gains in quality of life and cognitive ability and maintenance of functional ability. Within the treatment group, although everyone significantly improved their scores, the older adults cared for by family caregivers improved in more of the cognitive sub-items than did their peers in the professional caregiver group.

CONCLUSIONS

The data obtained show that a caregiver training programme based on cognitive stimulation produces cognitive, functional and health-related quality-of-life benefits in older adults. Furthermore, the caregivers reported increased satisfaction with their work.

RELEVANCE TO CLINICAL PRACTICE

The improvements obtained in the older adults and in caregivers show the relevance of this type of intervention when working in the clinical field of caregiving.

Generation of Defective Few-Layered Graphene Mesostructures by High-Energy Ball Milling and Their Combination with FeSiCuNbB Microwires for Reinforcing Microwave Absorbing Properties

Defective few-layered graphene mesostructures (DFLGMs) are produced from graphite flakes by high-energy milling processes. We obtain an accurate control of the generated mesostructures, as well as of the amount and classification of the structural defects formed, providing a functional material for microwave absorption purposes. Working under far-field conditions, competitive values of minimum reflection loss coefficient (RL_min) = -21.76 dB and EAB = 4.77 dB are achieved when DFLGMs are immersed in paints at a low volume fraction (1.95%). One step forward is developed by combining them with the excellent absorption behavior that offers amorphous Fe_73.5Si_13.5B₉Cu₁Nb microwires (MWs), varying their filling contents, which are below 3%. We obtain a RL_min improvement of 47% (-53.08 dB) and an EAB enhancement of 137% (4 dB) compared to those obtained by MW-based paints. Furthermore, a f_min tunability is demonstrated, maintaining similar RL_min and EAB values, irrespective of an ideal matching thickness. In this scenario, the Maxwell-Garnet standard model is valid, and dielectric losses mainly come from multiple reflections, interfacial and dielectric polarizations, which greatly boost the microwave attenuation of MWs. The present concept can remarkably enhance not only the MW attenuation but can also apply to other microwave absorption architectures of technological interest by adding low quantities of DFLGMs.

Pseudohypoxia in paraganglioma and pheochromocytoma is associated with an immunosuppressive phenotype

Metastatic pheochromocytoma and paraganglioma (PPGL) have poor prognosis and limited therapeutic options. The recent advent of immunotherapies showing remarkable clinical efficacies against various cancer types offers the possibility of novel opportunities also for metastatic PPGL. Most PPGLs are pathogenically linked to inactivating mutations in genes encoding different succinate dehydrogenase (SDH) subunits. This causes activation of the hypoxia-inducible factor 2 (HIF2)-mediated transcriptional program in the absence of decreased intratumoral oxygen levels, a phenomenon known as pseudohypoxia. Genuine hypoxia in a tumor creates an immunosuppressive tumor microenvironment. However, the impact of pseudohypoxia in the immune landscape of tumors remains largely unexplored. In this study, tumoral expression of programmed death-ligand 1 (PD-L1) and HIF2α and tumor infiltration of CD8 T lymphocytes (CTLs) were examined in PPGL specimens from 102 patients. We assessed associations between PD-L1, CTL infiltration, HIF2α expression, and the mutational status of SDH genes. Our results show that high PD-L1 expression levels in tumor cells and CTL tumor infiltration were more frequent in metastatic than nonmetastatic PPGL. However, this phenotype was negatively associated with SDH mutations and high HIF2α protein expression. These data were validated by analysis of mRNA levels of genes expressing PD-L1, CD8, and HIF2α in PPGL included in The Cancer Genome Atlas database. Further, PD-L1 and CD8 expression was lower in norepinephrine than epinephrine-secreting PPGL. This in silico analysis also revealed the low PD-L1 or CD8 expression levels in tumors with inactivating mutations in VHL or activating mutations in the HIF2α-coding gene, EPAS1, which, together with SDH-mutated tumors, comprise the pseudohypoxic molecular subtype of PPGL. These findings suggest that pseudohypoxic tumor cells induce extrinsic signaling toward the immune cells promoting the development of an immunosuppressive environment. It also provides compelling support to explore the differential response of metastatic PPGL to immune checkpoint inhibitors. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

Tailoring Magnetic Properties of Fe0.65Co0.35 Nanoparticles by Compositing with RE2O3 (RE = La, Nd, and Sm)

Fe-Co alloys are the most important soft magnetic materials, which are successfully used for a wide range of applications. In this work, the magnetic properties of lanthanide-substituted (Fe_0.65Co_0.35)_0.95(RE₂O₃)_0.05 (RE = La, Nd, and Sm) nanoparticles, prepared by mechanical alloying, are reported. Our comprehensive studies (X-ray diffraction, Mössbauer spectroscopy, scanning electron microscopy with X-ray energy dispersive spectrometry, SQUID magnetometry and differential scanning calorimetry) have revealed different properties, depending on the dopant type. The RE₂O₃ addition led to a decrease in the crystallite size and to an increase in the internal microstrain. Moreover, because of the high grain fragmentation tendency of RE₂O₃, the cold welding between Fe-Co ductile particles was minimized, indicating a significant decrease in the average particle size. The parent Fe_0.65Co_0.35 alloy is known for its soft ferromagnetism. For the La-substituted sample, the magnetic energy product was significantly lower (0.450 MG·Oe) than for the parent alloy (0.608 MG·Oe), and much higher for the Sm-substituted compound (0.710 MG·Oe). The processing route presented here, seems to be cost-effective for the large-scale production of soft magnetic materials.

Behavioral intention of mental health practitioners toward the adoption of virtual humans in affect recognition training

This paper explores the key factors influencing mental health professionals' behavioral intention to adopt virtual humans as a means of affect recognition training. Therapies targeting social cognition deficits are in high demand given that these deficits are related to a loss of functioning and quality of life in several neuropsychiatric conditions such as schizophrenia, autism spectrum disorders, affective disorders, and acquired brain injury. Therefore, developing new therapies would greatly improve the quality of life of this large cohort of patients. A questionnaire based on the second revision of the Unified Theory of Acceptance and Use of Technology (UTAUT2) questionnaire was used for this study. One hundred and twenty-four mental health professionals responded to the questionnaire after viewing a video presentation of the system. The results confirmed that mental health professionals showed a positive intention to use virtual reality tools to train affect recognition, as they allow manipulation of social interaction with patients. Further studies should be conducted with therapists from other countries to reach more conclusions.

Epidemiology of mechanical ventilation in Argentina. The EpVAr multicenter observational study

OBJETIVE

To describe mechanical ventilation (MV) practices in Argentina, and to explore factors associated with ICU mortality in this population.

DESIGN

A prospective, multicenter, observational study was carried out.

SETTING

Intensive Care.

PATIENTS

We enrolled patients above 18 years old admitted to any of the participating ICUs requiring invasive MV for at least 12 h since the admission to the healthcare institution, including MV initiation in emergency department, operating room or other hospitals.

INTERVENTIONS

None.

VARIABLES

All variables were classified into three categories: variables related to demographic and clinical factors before the MV, factors related to the first day on MV, and factors related to events happening during the MV (complications and weaning from MV). Mechanical ventilation weaning and mortality were classified according to WIND.

RESULTS

The primary analysis included 950 patients. The main indication for MV was acute respiratory failure (58% of patients). Initial ventilation mode was volume control-continuous mandatory ventilation in 75% of cases. ICU and hospital mortality were 44.6% and 47.9% respectively. The variables identified as independent predictors of mortality in ICU were age (OR 3.48 IC 95% 1.22-11.66; p = 0.028), failure to implement NIV before MV (OR 2.76 IC 95% 1.02-7.10; p = 0.038), diagnosis of sepsis (OR 2.46 IC 95% 1.09-5.47; p = 0.027) and extubation failure (OR 4.50 IC 95% 2.05-9.90; p < 0.001).

CONCLUSIONS

The present study allowed us to describe the characteristics and clinical course of the patients who received mechanical ventilation in Argentina, finding as the main result that mortality was higher than that reported in international studies.

Differentiated thyroid carcinoma in the elderly: influence of age on disease-free and overall survival

PURPOSE

We investigated whether age at diagnosis of differentiated thyroid carcinoma (DTC) may be a risk factor for structural disease and mortality after primary treatment in aging patients.

METHODS

A multicenter, retrospective analysis including patients older than 60 years at DCT diagnosis was designed. All subjects were treated by surgery with or without radioiodine adjuvant therapy and had a minimum follow-up of one year. We compared elderly patients (group 1, 60-74 years) with very old patients (group 2, ≥75 years).

RESULTS

The study involved 1668 patients (74.3% women, median age 67 years, 87.6% papillary thyroid cancer, 73.3% treated with radioiodine), including 1397 in group 1 and 271 in group 2. Patients in group 2 had larger tumor size (1.8 [0.8-3.0] vs 1.5 [0.7-2.8] cm; P = 0.005), higher proportions of tumors with vascular invasion (23.8 vs 16.4%; P = 0.006), and lower proportion of lymphocytic thyroiditis (18.6 vs 24.9%; P = 0.013) than subjects in group 1. Kaplan-Meier survival analysis showed that patients in group 2 had significantly lower structural disease-free survival (DFS) and overall survival (OS) than patients in group 1 (P = 0.035 and <0.001, respectively). In multivariate Cox regression analysis, age was a risk factor significantly associated with OS. However, age was significantly associated with DFS in unadjusted analysis and in analysis adjusted by gender and risk classification variables, but not when pathological and therapy-related variables were introduced in the model. On the other hand, patients who received radioiodine had worse DFS (P < 0.001) compared to those who did not.

CONCLUSION

Although age is a conditioning factor for OS, very old patients do not have a greater risk of developing structural disease throughout the follow-up than elderly patients with DTC.

Large-Area Nanopillar Arrays by Glancing Angle Deposition with Tailored Magnetic Properties

Ferromagnetic films down to thicknesses of tens of nanometers and composed by polycrystalline Fe and Fe₂O₃ nanopillars are grown in large areas by glancing angle deposition with magnetron sputtering (MS-GLAD). The morphological features of these films strongly depend on the growth conditions. Vertical or tilted nanopillars have been fabricated depending on whether the substrate is kept rotating azimuthally during deposition or not, respectively. The magnetic properties of these nanopillars films, such as hysteresis loops squareness, adjustable switching fields, magnetic anisotropy and coercivity, can be tuned with the specific morphology. In particular, the growth performed through a collimator mask mounted onto a not rotating azimuthally substrate produces almost isolated well-defined tilted nanopillars that exhibit a magnetic hardening. The first-order reversal curves diagrams and micromagnetic simulations revealed that a growth-induced uniaxial anisotropy, associated with an anisotropic surface morphology produced by the glancing angle deposition in the direction perpendicular to the atomic flux, plays an important role in the observed magnetic signatures. These results demonstrate the potential of the MS-GLAD method to fabricate nanostructured films in large area with tailored structural and magnetic properties for technological applications.

[Respiratory and physical recovery in cervical spinal cord injury. Seventeen years' experience in a weaning and rehabilitation center: An observational study]

INTRODUCTION AND OBJECTIVES

Spinal cord injury (SCI) is a devastating entity that generates substantial disability. The outcome of respiratory and motor features has an impact in human and social well-being. We analyzed demographic characteristics, motor and respiratory outcomes, and determined equipment needs at discharge in a weaning and rehabilitation center.

MATERIAL AND METHOD

Observational, descriptive and retrospective study of medical records between January 2002 and December 2018. Tracheostomised cervical SCI patients with invasive mechanical ventilation were included. Forced vital capacity (upright and supine), maximal inspiratory and expiratory pressures, ASIA and Spinal Cord Independence MeasureIII (SCIMIII) were obtained.

RESULTS

Of 1603 patients, 3.5% had SCI, and 28 met the inclusion criteria. The most frequent level of injury was C4-C5 (17/28), 21/28 had ASIAA classification, and 19 showed no change in either the ASIA or the SCIM score. In all, 22/28 patients were weaned, while 15/28 were decannulated. Twenty four patients were discharged to home. The most relevant change in SCIMIII was in the 5th component of respiration and sphincter subscale, related to weaning and tracheostomy. At discharge, 23/24 patients needed both respiratory and motor aids.

CONCLUSIONS

The admission rate of SCI patients was low in our weaning and rehabilitation center, with almost all being admitted for traumatic causes. Severity remained unchanged in most ASIAA patients. Respiratory recovery was more clinically significant than recovery of motor function. Upon discharge, most of our patients had to be equipped with both respiratory and motor aids.

Changes in salivary biomarkers of oxidative status in calves at weaning and grouping

BACKGROUND

Saliva is being increasingly used as a sample for measuring biomarkers in several species and shows a high potential of use to detect and monitor stress. The weaning and grouping in dairy calves are a particularly stressful time. Therefore, the objectives of this study were to evaluate a panel of antioxidant and oxidant biomarkers in the saliva of calves on the day of weaning (W0), 2 days after weaning or milk withdrawal (W + 2), and 4 days after grouping (G + 4). In addition, to verify if cortisol and oxytocin concentrations are related to the biomarkers measured.

RESULTS

Salivary cupric reducing antioxidant capacity (CUPRAC), ferric reducing ability of saliva (FRAS), Trolox equivalent antioxidant capacity (TEAC), advanced oxidation protein products (AOPP), and ferrous oxidation-xylenol orange (FOX) were significantly higher (P < 0.02) 4 days after grouping than the day of weaning and 2 days after. The increases were 50 and 54% for CUPRAC, 93 and 116% for FRAS, 117 and 135% for TEAC, 22 and 49% for AOPP and 10 and 5% for FOX in comparison with weaning and 2 days after, respectively. In addition, oxytocin and cortisol showed significant negative and positive correlations (P < 0.05) respectively with the biomarkers of oxidative status.

CONCLUSIONS

Our results showed that calves after grouping show increases in antioxidants and oxidants concentrations, indicating that a balance between these molecules has been tried to maintain during this stressful situation. The dynamic changes of biomarkers of oxidative status should be explored and characterised in other stressful conditions.

Recovery of parathyroid function in patients with thyroid cancer treated by total thyroidectomy: An analysis of 685 patients with hypoparathyroidism at discharge of surgery

OBJECTIVE

We aimed to study the predictive factors for recovery of parathyroid function in hypoparathyroid patients after total thyroidectomy for thyroid cancer.

METHODS

We designed a retrospective, multicentre and nation-wide analysis of patients with total thyroidectomy who were seen in twenty endocrinology departments from January to March 2018. We selected patients with histologically proven thyroid cancer and retrieved information related to surgical procedure and thyroid cancer features. Survival analysis and Cox regression analysis were used to study the relationship between these variables and the recovery of parathyroid function.

RESULTS

From 685 patients with hypoparathyroidism at discharge of surgery, 495 (72.3%) recovered parathyroid function over time. Kaplan-Meier analysis showed that this recovery was significantly related to the presence of specialized surgical team (P<0.001), identification of parathyroid glands at surgery (P<0.001), papillary histopathology (P=0.040), and higher levels of postoperative calcium (Ca) (P<0.001) and parathyroid hormone (PTH) (P<0.001). Subjects with gross extrathyroidal extension (P=0.040), lymph node metastases (P=0.004), and surgical re-intervention after initial surgery (P=0.024) exhibited a significant risk of persistence of hypoparathyroidism. Multivariate Cox regression analysis showed that the significant and independent factors for recovery of parathyroid function were postoperative concentrations of Ca (P=0.038) and PTH (P=0.049). The presence of lymph node metastases was a negative predictor of recuperation of parathyroid function (P=0.042) in this analysis.

CONCLUSION

In patients with thyroid cancer, recovery of parathyroid function after total thyroidectomy was directly related to postoperative Ca and PTH concentrations, and inversely related to lymph node metastases.

[Gastrointestinal manifestations of cystic fibrosis in children]

INTRODUCTION

Cystic fibrosis (CF) is a multisystemic disease, with high morbidity and mortality, and its early diag nosis improves results. Lung conditions are the main cause of morbidity and mortality and are clo sely related to nutritional status and survival. There is little national information about the liver and gastrointestinal characteristics in pediatric patients with CF.

OBJECTIVE

to describe at a gastrointes tinal level, the general, nutritional, and genetic characteristics and the evolution of CF carriers with/ without neonatal screening.

PATIENTS AND METHOD

Retrospective study carried out in 4 public referral hospitals in the Metropolitan Region. The diagnosis of CF confirmed with two positive sweat tests (Gibson and Cooke method) was considered as an inclusion criterion. Those patients with unconfir med neonatal screening tests through Immunoreactive Trypsinogen (IRT) or with only one positive sweat test were excluded. Sex, age, nutritional status, date of diagnosis, clinical presentation at the onset, evolution, and therapies received were recorded as clinical variables, and as laboratory ones, genetic study by means of a diagnostic panel with 36 mutations. The STATA 12 software was used for statistical analysis.

RESULTS

127 patients were included. Respiratory manifestations (recurrent obstructive bronchial syndrome and pneumonia) were present in >60% and gastrointestinal ones (mainly malabsorption and malnutrition syndrome) in >80% of patients. On average, diagnostic confirmation took 4 months. The diagnosis guided by IRT was associated with better nutritional outcomes in the evolution of the patient. In 81.1% of the patients, the genetic study was performed. The most frequent mutations were those associated with DF508 (deletion of phenylalanine 508). 5.8% of the patients presented mutations not included in the gene panel used.

CONCLUSIONS

Gas trointestinal CF appears with pancreatic, intestinal, and hepatic pathology throughout life. Malnutri tion is a frequently present factor, which worsens the prognosis. The management of gastrointestinal manifestations and malnutrition are relevant to improve the morbidity and mortality of CF patients.

Late Recovery of Parathyroid Function After Total Thyroidectomy: A Case-Control Study

The clinical characteristics of patients with postoperative hypoparathyroidism who recover parathyroid function more than 12 months after surgery have not been studied. We aimed to evaluate whether the intensity of replacement therapy with calcium and calcitriol is related to the late recovery of parathyroid function. We compared the demographic, surgical, pathological, and analytical features of two groups of patients: cases, i. e., late recovery patients (those who recover parathyroid function>1 year after thyroidectomy, n=40), and controls, i. e., patients with permanent hypoparathyroidism (n=260). Replacement therapy with calcium and calcitriol was evaluated at discharge of surgery, 3-6 months, 12 months, and last visit. No significant differences were found in clinical, surgical, pathological, or analytical characteristics between cases and controls. The proportion of cases who required treatment with calcium plus calcitriol at 12 months was significantly lower than that found in controls (p<0.001). Furthermore, daily calcium and calcitriol doses in controls were significantly higher than those in cases at 3-6 months (p=0.014 and p=0.004, respectively) and at 12 months (p<0.001 and p=0.043, respectively). In several models of logistic regression analysis therapy with calcium and calcitriol at 12 months was negatively related to late recovery of parathyroid function. Although delayed recuperation of parathyroid function after total thyroidectomy is uncommon (13%), follow-up beyond 12 months is necessary in patients with postoperative hypoparathyroidism, especially in those whose needs of treatment with Ca and calcitriol are reducing over time.

Boosting the Tunable Microwave Scattering Signature of Sensing Array Platforms Consisting of Amorphous Ferromagnetic Fe2.25Co72.75Si10B15 Microwires and Its Amplification by Intercalating Cu Microwires

The following work addresses new configurations of sensing array platforms that are composed of Co-based amorphous ferromagnetic microwires (MWs) to obtain an enhanced modulation of the microwave scattering effects through the application of low strength DC or AC magnetic fields. An amorphous MW is an ultrasoft ferromagnetic material (coercivity ~0.2 Oe) with a circumferential magnetic anisotropy that provides a high surface sensitivity when it is subjected to an external magnetic field. Firstly, microwave scattering experiments are performed as a function of the length and number of MWs placed parallel to each other forming an array. Subsequently, three array configurations are designed, achieving high S₂₁ scattering coefficients up to about −50 dB. The influence of DC and AC magnetic fields on S₂₁ has been analyzed in frequency and time domains representation, respectively. In addition, the MWs sensing array has been overlapped by polymeric surfaces and the variations of their micrometric thicknesses also cause strong changes in the S₂₁ amplitude with displacements in the frequency that are associated to the maximum scattering behavior. Finally, a new concept for amplifying microwave scattering is provided by intercalating Cu MWs into the linear Co-based arrays. The designed mixed system that is composed by Co-based and Cu MWs exhibits a higher S₂₁ coefficient when compared to a single Co-based MW system because of higher electrical conductivity of Cu. However, the ability to modulate the resulting electromagnetic scattering is conferred by the giant magneto-impedance (GMI) effects coming from properties of the ultrasoft amorphous MWs. The mixed array platform covers a wide range of sensor applications, demonstrating the feasibility of tuning the S₂₁ amplitude over a wide scattering range by applying AC or DC magnetic fields and tuning the resonant frequency position according to the polymeric slab thickness.

Oxytocin in bovine saliva: validation of two assays and changes in parturition and at weaning

BACKGROUND

The possible use of oxytocin in saliva as an indicator of positive emotions in bovine species has been poorly investigated. In the present study, two new assays (one using a monoclonal antibody and the other using a polyclonal antibody) for the measurement of oxytocin in bovine saliva were developed and validated. Also, the changes in oxytocin in saliva were explored in two different situations. One was around parturition, and for this purpose, saliva samples from 13 cows were collected at three different times: 7 days before the parturition, the day of parturition and 7 days after the parturition. The second situation was weaning and grouping of calves, and for this purpose, saliva from 25 calves was collected at three different times: 1 day before weaning, 2 days after weaning or milk withdrawal and 4 days after grouping calves.

RESULTS

In cows, oxytocin concentrations showed an increase on the day of parturition with both assays, while in calves, oxytocin concentrations showed a decrease 4 days after the grouping.

CONCLUSIONS

The assays validated in this report could be used for the measurement of oxytocin in bovine saliva and detect changes in this analyte that can occur in different physiological or productive situations such as parturition and weaning.

Oral Meloxicam Administration in Sows at Farrowing and Its Effects on Piglet Immunity Transfer and Growth

Many factors can lead to an inadequate development of piglets during their first days of life, including poor maternal behavior, which can be due to pain caused by farrowing, and reduced colostrum ingestion. This study investigates the action of meloxicam administered orally at farrowing on piglet weight gain and immunity transfer. Thirty-five multiparous sows were divided into two groups and treated with 0.4 mg/kg of oral meloxicam (oral meloxicam group; n = 18) or with a mock administration (control group; n = 17). A total of 382 piglets were individually weighed on the farrowing day (day 0), as well as on days +9 and +20. Immunoglobulin G (IgG) and A (IgA) concentrations in piglet serum and in sow's saliva, colostrum and milk were measured. Additionally, Interleukin-2 (IL-2), Interleukin-4 (IL-4) and Interferon gamma (IFN-⋎) in serum of piglets and in sow's milk or colostrum were studied. All samples were obtained on days +1, +9, and +20. Piglets from sows in the oral meloxicam group tended to grow faster from day +9 to day +20 than did piglets from control sows (p = 0.059), and this difference was also observed in piglets with low body weight (BW) at birth (p = 0.056). The oral meloxicam group sows tended to increase the colostrum levels of IgA and IgG, as compared with control sows on day +1 (p = 0.068 and p = 0.072, respectively). IgA levels in piglet serum from the oral meloxicam group were significantly higher than in the control group on day +1 and +9 (p = 0.019 and p = 0.011 respectively). Furthermore, IL-2 and IL-4 levels in the serum of piglets from sows in the oral meloxicam group tended to be higher than that in the control group on day +9 (p = 0.078 and 0.056, respectively). The administration of meloxicam orally at the beginning of farrowing in multiparous sows increased immunoglobin and cytokine concentrations in colostrum, improving both humoral and cellular immune response of piglets. Pre-weaning growth of piglets born with a low BW improved in the meloxicam-treated group.

KIR2DL2/S2 and KIR2DS5 in alcoholic cirrhotic patients undergoing liver transplantation

INTRODUCTION

The molecular mechanisms underlying alcoholic liver fibrosis and cirrhosis are not completely understood. Hepatic fibrosis involves the interplay of diverse cells and factors, including hepatic stellate cells (HSCs), Kupffer, NK cells, and T-lymphocyte subsets. Killer-cell immunoglobulin-like receptors (KIR) are membrane receptors involved in mediation between NK and activated HSCs, regulating NK cell function through their interaction with HLA-I molecules. The aim of this study was to analyse the genetic association between KIR genes and the susceptibility to or protection from alcoholic cirrhosis (AC) in a cohort of male AC patients undergoing liver transplantation (LT) with and without concomitant viral infections.

MATERIAL AND METHODS

KIR genotyping was performed in nuclear DNA extracted from 281 AC patients and compared with 319 male controls.

RESULTS

Significant differences between total AC patients and healthy controls were only found in the case of KIR2DL2 and KIR2DS5. KIR2DL2 was significantly underrepresented in non-viral AC patients (52.6% vs. 63.3%; p = 0.015), while patients heterozygous for KIR2DL2 were also underrepresented in the non-viral AC group compared with controls (p = 0.034). KIR2DS5 was overrepresented in this group compared with healthy controls (p = 0.002). All these observations were only evident in AC patients older than 54 years old.

CONCLUSIONS

Our data suggest a contrary effect of KIR2DL2 and KIR2DS5 in AC patients older than 54 years, in whom the presence of KIR2DL2 appears to be protective against AC, whereas the presence of KIR2DS5 seems to promote the fibrotic process, particularly in patients with no associated viral infection.

Permanent postoperative hypoparathyroidism: an analysis of prevalence and predictive factors for adequacy of control in a cohort of 260 patients

Background

Recent guidelines for the treatment of hypoparathyroidism emphasize the need for long-term disease control, avoiding symptoms and hypocalcaemia. Our aim has been to analyze the prevalence of poor disease control in a national cohort of patients with hypoparathyroidism, as well as to evaluate predictive variables of inadequate disease control.

Methods

From a nation-wide observational study including a cohort of 1792 patients undergoing total thyroidectomy, we selected 260 subjects [207 women and 53 men, aged (mean ± SD) 47.2±14.8 years] diagnosed with permanent hypoparathyroidism. In every patient demographic data and details on surgical procedure, histopathology, calcium (Ca) metabolism, and therapy with Ca and calcitriol were retrospectively collected. A patient was considered not adequately controlled (NAC) if presented symptoms of hypocalcemia or biochemical data showing low serum Ca levels or high urinary Ca excretion.

Results

Two hundred and twenty-one (85.0%) patients were adequately controlled (AC) and 39 (15.0%) were NAC. Comparison between AC and NAC patients did not show any significant difference in demographic, surgical, and pathological features. Rate of hospitalization during follow-up was significantly higher among NAC patients in comparison with AC patients (35.9% vs. 10.9%, P<0.001). Dose of oral Ca and calcitriol were also significantly higher in NAC subjects. In a subgroup of 129 patients with serum parathyroid hormone (PTH) levels available, we found that NAC patients exhibited significantly lower postoperative PTH concentrations than AC patients [median (interquartile range) 3 (1.9-7.8) vs. 6.9 (3.0-11) pg/mL; P=0.009].

Conclusions

In a nation-wide cohort of 260 subjects with definitive hypoparathyroidism, 15% of them had poor disease control. These patients required higher doses of oral Ca and calcitriol, had higher rate of hospitalization during follow-up and showed lower PTH concentrations in the postoperative period.

Development of a Facial Expression Scale Using Farrowing as a Model of Pain in Sows

Simple Summary

Pain evaluation using non-invasive indicators can be difficult in production animals. Some years ago, a group of scientists realized that it was possible to evaluate pain by just considering animals’ facial expressions. All animals have their own facial expressions, and the animal’s expressiveness affects how difficult it is to find facial zones to evaluate pain. Until today, facial expressions have never been studied in sows. Our group decided to use farrowing (sow parturition) as a pain model to evaluate the sows’ facial expressions. Five different facial expression zones were found in our study: Tension above eyes, Snout angle, Neck tension, Temporal tension and ear position, and Cheek tension. The five zones were studied and evaluated by eight observers after a training session, obtaining good reliability results, especially on Tension above eyes, Snout angle, and Neck tension. These good results suggest that the sow facial expression scale could be a good non-invasive indicator to evaluate pain in sows.

Abstract

Changes in facial expression have been shown to be a useful tool to assess pain severity in humans and animals, but facial scales have not yet been developed for all species. A facial expression scale in sows was developed using farrowing as a pain model. Five potential facial zones were identified: (i) Tension above eyes, (ii) Snout angle, (iii) Neck tension, (iv) Temporal tension and ear position (v), and Cheek tension. Facial zones were examined through 263 images of a total of 21 sows at farrowing, characterizing moments of non-pain (19 days post-farrowing; score 0), moderate pain (time interval between the delivery of two consecutive piglets; score 1) and severe pain (during active piglet delivery; score 2). Images were evaluated by a “Silver Standard” observer with experience in sows’ facial expressions, and by a group of eight animal welfare scientists, without experience in it, but who received a one-hour training session on how to assess pain in sows’ faces. Intra- and inter-observer reliability of the facial expression ranged from moderate to very good for all facial expression zones, with Tension above eyes, Snout angle, and Neck tension showing the highest reliability. In conclusion, monitoring facial expressions seems to be a useful tool to assess pain caused by farrowing.

Effectiveness of Cognitive Interventions in Older Adults: A Review

(1) Introduction: With older adults, cognitive intervention programs are most often used for preventing or reversing a decline in cognitive functions, but it has been recently noted that there are insufficient high-quality research studies that report the effects of cognitive intervention on the cognitive functioning of older adults. (2) Objective: To analyze the available evidence concerning the effect of cognitive interventions for improving or maintaining the general cognitive status of older adults who present different cognitive levels. (3) Method: a review of studies published between 2010 and 2019 using the following databases: PubMed, PsycINFO, Cochrane, Google Scholar, ProQuest and Medline. (4) Results: We selected 13 systematic reviews and/or meta-analyses. The results showed that the cognitive intervention programs improved general cognitive functioning and specific cognitive functions regardless of the initial cognitive level; that cognitive decline was slowed in older persons with dementia; and there was improvement in activities of daily living. Regarding duration of the results, benefits were maintained for periods of 2 months to 5 years. (5) Conclusion: Cognitive interventions have proven effective for maintaining and/or improving cognitive functioning in older adults regardless of their initial cognitive status. Even so, there are few studies that follow up these results to see whether they are maintained in the long term and whether there is transfer to other skills of daily life. However, we were able to observe in the present review how the participants' cognitive level varied according to sociodemographic differences, and to identify which components of cognitive programs make them more effective. Based on the results found, we highlight the importance of designing cognitive intervention programs that meet these effectiveness criteria, in order to maximize the positive effects of such programs when working with a population of older adults.

Control of the Length of Fe73.5Si13.5Nb3Cu1B9 Microwires to Be Used for Magnetic and Microwave Absorbing Purposes

A combination of high-energy ball milling, vacuum filtering, and sedimentation processes has been demonstrated to be a useful approach to reduce, in a controlled way, the length of as-cast Fe_73.5Si_13.5Nb₃Cu₁B₉ amorphous magnetic microwires (MWs) and annealed material at 550 °C in nitrogen conditions. Homogeneous compositional microstructures with fairly narrow size distributions between 1300 and 11.7 μm are achieved, exhibiting tunable response as a soft magnetic material and as a microwave absorber. From the magnetic perspective, the soft magnetic character is increased with smaller length of the MWs, whereas the remanence has the opposite behavior mainly due to the structural defects and the loss of the shape anisotropy. From the microwave absorption perspective, a novel potential applicability is tested in these refined microstructures. This innovation consists of coatings based on commercial paints with a filling percentage of 0.55% of MWs with different lengths deposited on metallic sheets. Large attenuation values around -40 dB are obtained in narrow spectral windows located in the GHz range, and their position can be varied by combining different optimized lengths of MW. As an example of this powerful mechanism for absorbing microwaves at specific frequencies, MW lengths of 2 mm and 50 μm are chosen, where precise tailoring of the minimum reflection loss (R_L) is obtained in a range between 8.85 and 13.25 GHz. To confirm these experimental results, an effective medium standard model proposed for electrical permittivity is used. Experimental and theoretical results are consistent and these novel composites are also proposed as a feasible candidate for designing frequency-selective microwave absorbers on demand, with low filling percentages and high absorption intensity values.

Epigenetic Deregulation of Protocadherin PCDHGC3 in Pheochromocytomas/Paragangliomas Associated With SDHB Mutations

CONTEXT

SDHB mutations are found in an increasing number of neoplasms, most notably in paragangliomas and pheochromocytomas (PPGLs). SDHB-PPGLs are slow-growing tumors, but ∼50% of them may develop metastasis. The molecular basis of metastasis in these tumors is a long-standing and unresolved problem. Thus, a better understanding of the biology of metastasis is needed.

OBJECTIVE

This study aimed to identify gene methylation changes relevant for metastatic SDHB-PPGLs.

DESIGN

We performed genome-wide profiling of DNA methylation in diverse clinical and genetic PPGL subtypes, and validated protocadherin γ-C3 (PCDHGC3) gene promoter methylation in metastatic SDHB-PPGLs.

RESULTS

We define an epigenetic landscape specific for metastatic SDHB-PPGLs. DNA methylation levels were found significantly higher in metastatic SDHB-PPGLs than in SDHB-PPGLs without metastases. One such change included long-range de novo methylation of the PCDHA, PCDHB, and PCDHG gene clusters. High levels of PCDHGC3 promoter methylation were validated in primary metastatic SDHB-PPGLs, it was found amplified in the corresponding metastases, and it was significantly correlated with PCDHGC3 reduced expression. Interestingly, this epigenetic alteration could be detected in primary tumors that developed metastasis several years later. We also show that PCDHGC3 down regulation engages metastasis-initiating capabilities by promoting cell proliferation, migration, and invasion.

CONCLUSIONS

Our data provide a map of the DNA methylome episignature specific to an SDHB-mutated cancer and establish PCDHGC3 as a putative suppressor gene and a potential biomarker to identify patients with SDHB-mutated cancer at high risk of metastasis who might benefit from future targeted therapies.

Prevalence and risk factors for hypoparathyroidism following total thyroidectomy in Spain: a multicentric and nation-wide retrospective analysis

PURPOSE

The prevalence of postoperative hypoparathyroidism has been studied in registries and in surgical series with highly variable and imprecise results. However, the frequency of this hormonal deficiency in the clinical practice of endocrinologists is not known with accuracy. We aimed to assess the prevalence and risk factors of hypoparathyroidism in patients undergoing total thyroidectomy in Spain.

METHODS

We designed a retrospective, multicentre and nation-wide protocol including all patients with total thyroidectomy who were seen in the endocrinology clinic of the participant centers from January to March 2018. Prevalence of hypoparathyroidism was evaluated at discharge of surgery, 3-6 months after surgery, 12 months after surgery and at last visit. Twenty hospitals participated in the study.

RESULTS

Of 1792 patients undergoing total thyroidectomy, 866 (48.3%) developed postoperative hypoparathyroidism at discharge of surgery. Most of them recover parathyroid function over time. Prevalence of hypoparathyroidism at 3-6 months, 12 months and at last visit was 22.9%, 16.7% and 14.5%, respectively. The risk of developing definitive hypoparathyroidism was related to the presence of parathyroid tissue at histology, lymph node dissection, and two-stage thyroidectomy. Patients with thyroid cancer, with higher postoperative calcium levels and treated by expert surgical teams exhibited lower risk of developing permanent hypoparathyroidism.

CONCLUSIONS

Although most patients with postsurgical hypoparathyroidism recover parathyroid function, the prevalence of permanent disease in clinical practice is non negligible (14.5%). Postoperative calcium, extent and timing of surgery, the presence of cancer, expert surgical team, and parathyroid tissue at histology are predictors of permanent hypoparathyroidism.

Correction to: Prevalence and risk factors for hypoparathyroidism following total thyroidectomy in Spain: a multicentric and nation-wide retrospective analysis

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

MEN1-associated primary hyperparathyroidism in the Spanish Registry: clinical characterictics and surgical outcomes

Primary hyperparathyroidism is the most frequent manifestation of multiple endocrine neoplasia type 1 (MEN1) syndrome. Bone and renal complications are common. Surgery is the treatment of choice, but the best timing for surgery is controversial and predictors of persistence and recurrence are not well known. Our study describes the clinical characteristics and the surgical outcomes, after surgery and in the long term, of the patients with MEN1 and primary hyperparathyroidism included in the Spanish Registry of Multiple Endocrine Neoplasia, Pheochromocytomas and Paragangliomas (REGMEN). Eighty-nine patients (49 men and 40 women, 34.2 ± 13 years old) were included. Sixty-four out of the 89 underwent surgery: a total parathyroidectomy was done in 13 patients, a subtotal parathyroidectomy in 34 and a less than subtotal parathyroidectomy in 15. Remission rates were higher after a total or a subtotal parathyroidectomy than after a less than subtotal (3/4 and 20/22 vs 7/12, P < 0.05), without significant differences in permanent hypoparathyroidism (1/5, 9/23 and 0/11, N.S.). After a median follow-up of 111 months, 20 of the 41 operated patients with long-term follow-up had persistent or recurrent hyperparathyroidism. We did not find differences in disease-free survival rates between different techniques, patients with or without permanent hypoparathyroidism and patients with different mutated exons, but a second surgery was more frequent after a less than subtotal parathyroidectomy.

Assessment of cognitive instrumental activities of daily living: a systematic review

PURPOSE

Cognitive instrumental activities of daily living are particularly related to executive functions, such as scheduling appointments, monthly payments, managing the household economy, shopping or taking the bus. The aim of this systematic review was to determine the available tests for the assessment of executive functions with ecological validity to predict individuals' functioning.

MATERIALS AND METHODS

An electronic search was conducted in MEDLINE, Cochrane Central, PsyCInfo and IEEE Xplore until May 2019, in addition to a manual search. The PRISMA criteria and the Covidence platform were used to select articles and extract data.

RESULTS

After applying the search selection criteria, 76 studies were identified. They referred to 110 tools to assess instrumental activities of daily living. Those that have received most attention are related to menu preparation and shopping. Performance-based measures are the most widely used traditional methods. Most tests were aimed at the adult population with acquired brain damage, cognitive impairment or dementia. There was a predominance of tests based on the Multiple Errands Test paradigm.

CONCLUSIONS

In recent years, it has increased the number of tools that assess the instrumental activities of daily living based on technologies such as personal or environmental sensors and serious games.IMPLICATIONS FOR REHABILITATIONAssessment of Instrumental Activities of Daily Living through performance-based measures is especially useful for the early detection of dysfunctions or preclinical disability.Difficulties in performing instrumental activities of daily living are closely associated with deficits in executive functions and prospective memory.Activities of Daily Living can be understood as multitasks.The use of virtual reality-based tests was shown to be sensitive to the detection of cognitive deficits in Activities of Daily Living.An advantage of using virtual reality in assessments is that it can help to predict the level of personal autonomy in patients who are in an institutional environment and could be a first approximation to the real environment.

Strategic reflections of the Spanish Society of Endocrinology and Nutrition on the future of the speciality in the period 2018-2022

Endocrine diseases are experiencing an important increase in their prevalence, due to causes of various kinds, including the epidemic of obesity and malnutrition, the aging of the population, but also the effect of endocrine disruptors, among others. On the other hand, new technologies, both in terms of molecular and genetic analysis, image and new therapeutic devices, require that the endocrine professional community in Spain must be in constant training. The connection with patients through their associations, increasingly active, and with the civil society in general, the professional commitment and demand of various social groups for a modern and equitable care, and to carry out research that facilitates the achievement of advances for patients, forces the specialist in endocrinology and nutrition and the Spanish Society of Endocrinology and Nutrition (SEEN) to position themselves and respond to all these challenges. In this document, the SEEN presents its proposals and its strategy until 2022.

Social cognition remediation interventions: A systematic mapping review

Background

Impairments in social cognition have been described in several psychiatric and neurological disorders. Given the importance of the relationship between social cognition and functioning and quality of life in these disorders, there is a growing interest in social cognition remediation interventions. The aim of this study was to carry out a systematic mapping review to describe the state of the art in social cognition training and remediation interventions.

Methods

Publications from 2006 to 2016 on social cognition interventions were reviewed in four databases: Scopus, PsycINFO, PubMed and Embase. From the initial result set of 3229 publications, a final total of 241 publications were selected.

Results

The study revealed an increasing interest in social cognition remediation interventions, especially in the fields of psychiatry and psychology, with a gradual growth in the number of publications. These were frequently published in high impact factor journals and underpinned by robust scientific evidence. Most studies were conducted on schizophrenia, followed by autism spectrum disorders. Theory of mind and emotional processing were the focus of most interventions, whilst a limited number of studies addressed attributional bias and social perception. Targeted interventions in social cognition were the most frequent practice in the selected papers, followed by non-specific treatment interventions and broad-based interventions.

Conclusions

Research in social cognition remediation interventions is growing. Further studies are needed on attributional bias and social perception remediation programs, while the comparative efficacy of different interventions also remains unclear.

Biomarkers of oxidative stress in saliva in pigs: analytical validation and changes in lactation

Background

Biomarkers of oxidative stress in pigs have been measured in serum/plasma samples. However, blood collection in pigs can be highly stressful to the animals. Saliva is a biological fluid with several advantages in pigs over blood, since it can be easily collected without stress to the animals, being therefore an ideal sample in this species. The objective of this study was the validation of assays for the evaluation of oxidative stress status in saliva of pigs. For this purpose, three assays commonly used to evaluate the total antioxidant capacity (TAC): trolox equivalent antioxidant capacity (TEAC), cupric reducing antioxidant capacity (CUPRAC), and ferric reducing ability of plasma (FRAP)), one individual antioxidant (uric acid) and two assays to evaluate oxidant concentrations (advanced oxidation protein products (AOPP) and hydrogen peroxide (H₂O₂)) were measured and validated in porcine saliva. In addition, the possible changes of these assays in sows’ saliva during lactation were be studied.

Results

The methods had intra- and inter-assays coefficient of variation lower than 15%. They also showed an adequate linearity and recovery, and their detection limits were low enough to detect the analytes in saliva of pigs. Overall the analytical validation tests showed that the assays used in our study are valid and reliable for the evaluation of oxidative stress in porcine saliva. In addition, it was observed that these salivary biomarkers can change in a situation of oxidative stress such as lactation in sows.

Conclusions

All assays for salivary biomarkers of oxidative stress evaluated in this study have demonstrated a high analytical accuracy and low imprecision. In addition, it has been observed that these biomarkers showed significant changes in a situation of oxidative stress such as lactation in sows. Therefore, this study opens a new possibility of using saliva as a non-invasive sample to evaluate oxidative stress in pigs.

Implementing Measurement-Based Care in Behavioral Health: A Review

IMPORTANCE

Measurement-based care (MBC) is the systematic evaluation of patient symptoms before or during an encounter to inform behavioral health treatment. Despite MBC's demonstrated ability to enhance usual care by expediting improvements and rapidly detecting patients whose health would otherwise deteriorate, it is underused, with typically less than 20% of behavioral health practitioners integrating it into their practice. This narrative review addresses definitional issues, offers a concrete and evaluable operationalization of MBC fidelity, and summarizes the evidence base and utility of MBC. It also synthesizes the extant literature's characterization of barriers to and strategies for supporting MBC implementation, sustainment, and scale-up.

OBSERVATIONS

Barriers to implementing MBC occur at multiple levels: patient (eg, concerns about confidentiality breach), practitioner (eg, beliefs that measures are no better than clinical judgment), organization (eg, no resources for training), and system (eg, competing requirements). Implementation science-the study of methods to integrate evidence-based practices such as MBC into routine care-offers strategies to address barriers. These strategies include using measurement feedback systems, leveraging local champions, forming learning collaboratives, training leadership, improving expert consultation with clinical staff, and generating incentives.

CONCLUSIONS AND RELEVANCE

This narrative review, informed by implementation science, offers a 10-point research agenda to improve the integration of MBC into clinical practice: (1) harmonize terminology and specify MBC's core components; (2) develop criterion standard methods for monitoring fidelity and reporting quality of implementation; (3) develop algorithms for MBC to guide psychotherapy; (4) test putative mechanisms of change, particularly for psychotherapy; (5) develop brief and psychometrically strong measures for use in combination; (6) assess the critical timing of administration needed to optimize patient outcomes; (7) streamline measurement feedback systems to include only key ingredients and enhance electronic health record interoperability; (8) identify discrete strategies to support implementation; (9) make evidence-based policy decisions; and (10) align reimbursement structures.

Pharmacological interventions in social cognition deficits: A systematic mapping review

Social cognition is an important research field in psychiatry due to its relevance in the functioning and quality of life of patients. The objective of this work is to conduct a systematic mapping review of pharmacological strategies for improving social cognition deficits. Publications from 2006 to 2016 were reviewed in Scopus, PsycINFO, PubMed, and Embase. From the initial 1059 publications obtained, a final number of 110 were selected. The results show an increasing interest in pharmacological approaches in different medical fields (especially psychiatry, pharmacology, and endocrinology, with schizophrenia and autism as the most studied disorders), as can be observed in the progressive increase in the number of publications, the high degree of scientific evidence, and the high impact factor of publications. However, it is also observed that most studies were conducted with oxytocin, psychostimulants, and antipsychotics (mainly risperidone and olanzapine), with few studies using other drugs. In the different social cognition domains, the majority of publications were focused on emotional processing or theory of mind, with few studies in other domains. Thus, this systematic mapping review shows that, even though there are increasing research activities, there are some important gaps to cover in future investigation.

Cognitive Plasticity in Young-Old Adults and Old-Old Adults and Its Relationship with Successful Aging

The general objective of this study was to analyze cognitive plasticity as a variable related to successful aging in a group of young-old adults and old-old adults using the Auditory Verbal Learning Test—Learning Potential (AVLT-LP). Method: A total of 569 persons, with mean age 76.67 years (379 between the ages of 65 and 80 years, and 190 older than age 80). They were assessed with a socio-health questionnaire, with the AVLT-LP, and with the Spanish version of the Mini Mental State Examination. Results: The results showed significant differences on the test, in favor of the younger group, while the over 80 group gave poorer performance and showed less cognitive plasticity. With relation to gender, slight differences appeared in favor of the women, on the first four test trials, but not on the last two, nor in delayed recall or cognitive plasticity. As for cognitive status, the results showed significantly better task performance levels in healthy elders, as well as greater plasticity. Nonetheless, certain persons with high plasticity were also found among those with cognitive impairment. Conclusions: The data obtained here offers evidence for the importance of cognitive plasticity in elders and its relation to longevity and successful aging. It also provides information about the influence of variables like age, gender and cognitive status on a verbal memory and plasticity assessment task that is in wide use today.

Preliminary results from the use of intraoperative real-time biliary oxygen monitoring in liver transplantation

BACKGROUND AND AIMS

Biliary anastomosis is a frequent area of complications after liver transplantation (LT) and a potential area of "microangiopathy". The concept of a "marginal bile duct" is unexplored. The main aim was to make a preliminary evaluation of the utility of an innovative real-time oxygen microtension (pO2mt) testing device for the assessment of bile duct viability during LT and to correlate these pO2mt values with microvascular tissue quality by histopathology and outcomes.

PATIENTS AND METHODS

Observational prospective cohort study with 23 patients. Oxygen microtension measurements were made placing a micropO2 probe in different areas of recipient and donor's bile duct intraoperative.

RESULTS

Mean pO2mt in the graft bile duct at the level of the anastomosis 103.82 (31-157) mm Hg, being 121.52 (55-174) mm Hg 1.5 cm proximal to the hilar plate (P < 0.001). Mean pO2mt in the recipient's bile duct was 117.87 (62-185) mm Hg, while a value of 137.30 (81-198) mm Hg was observed 1.5 cm distal to the anastomosis (P < 0.001). Cystic duct resection (12 cases) was also related with higher pO2mt values at anastomosis [117.8 (93-157) vs 88.54 (31-124) mm Hg] and distal to anastomosis [135.6 (111-174) vs 106.2 (55-133) mm Hg; P < 0.001]. Patients with 1-, 3-, and 12-month biliary complications had significantly lower pO2mt in the intraoperative measurements.

CONCLUSION

Our preliminary results show that distal borders of donor and recipient bile ducts may be low-vascularized areas. Tissue pO2mt is significantly higher in areas close to the hilar plate and to the duodenum in donor and recipient's sides, respectively. Bile duct injury and biliary complications are associated with worse tissue pO2mt.

Mytilus galloprovincialis fast growing phenotypes under different restrictive feeding conditions: Fast feeders and energy savers

The present study aims to test if the environmental conditions prevailing during the growing period can determine the physiological profiles of specimens differentiated as fast (F) or slow (S) growers in the mussel Mytilus galloprovincialis. We reared mussel spats in the laboratory under two different conditions. In Treatment I (continuous feeding during discontinuous immersion), two mussel groups were submitted to a daily air exposure of 8 h and fed continuously during immersion-time, with either high-quality food dosed below the pseudofaeces threshold (BP group) or low organic content food dosed above the pseudofaeces threshold (AP group). In Treatment II (discontinuous feeding during continuous immersion), mussels were continuously immersed but fed only 1 day per week (RC group). Mussels were reared for 7 and 11 months (time required for size-differentiation) in Treatments I and II, respectively, and the smallest and largest individuals from each group were selected as S and F specimens. A series of feeding experiments (with different food quality, food ration and under continuous food supply) were performed to analyse the physiological performance of selected F and S mussels. In Treatment I, no significant differences were found in the metabolic rates between F and S mussels, and the faster growth rate of F-mussels resulted from their capacity to display higher clearance-ingestion rates and pre-ingestive selections. The physiological basis of growth rate differences between F and S mussels were found to be the same in mussels reared with diets below or above a pseudofaeces threshold (F_BP, F_AP, S_BP and S_AP). In contrast, the mussels from Treatment II had no significant differences in the feeding rates between F_RC and S_RC mussels. However, F individuals were found to have a 33% lower standard metabolic rate, indicating that fast growth under severe feeding restriction stemmed from a higher capacity of F-mussels to save energy during long periods of starvation. Despite the differences in the physiological basis explaining fast growth between the two treatments, F-mussels were found to possess significantly higher gill-surface area in both cases. It is thus concluded that endogenous factors affecting the gill-surface area play a major role in determining inter-individual growth rate differences in the mussel, Mytilus galloprovincialis.

Adaptive, Multisensorial, Physiological and Social: The Next Generation of Telerehabilitation Systems

Some people require special treatments for rehabilitating physical, cognitive or even social capabilities after an accident or degenerative illness. However, the ever-increasing costs of looking after an aging population, many of whom suffer chronic diseases, is straining the finances of healthcare systems around Europe. This situation has given rise to a great deal of attention being paid to the development of telerehabilitation (TR) systems, which have been designed to take rehabilitation beyond hospitals and care centers. In this article, we propose which features should be addressed in the development of TR systems, that is, they should consider adaptive, multisensorial, physiological and social aspects. For this aim, the research project Vi-SMARt is being conducted for evaluating whether and how different technologies, such as virtual reality (VR), multi-sensorial feedback, or telemonitoring, may be exploited for the development of the next generation of TR systems. Beyond traditional aural and visual feedback, the exploitation of haptic sense by using devices such as haptic gloves or wristbands, can provide patients with additional guidance in the rehabilitation process. For telemonitoring, Electroencephalography (EEG) devices show signs of being a promising approach, not only to monitor patients’ emotions, but also to obtain neuro-feedback useful for controlling his/her interaction with the system and thus to provide a better rehabilitation experience.

Assessment of Metal Immission in Urban Environments Using Elemental Concentrations and Zinc Isotope Signatures in Leaves of Nerium oleander

A thorough understanding of spatial and temporal emission and immission patterns of air pollutants in urban areas is challenged by the low number of air-quality monitoring stations available. Plants are promising low-cost biomonitoring tools. However, source identification of the trace metals incorporated in plant tissues (i.e., natural vs anthropogenic) and the identification of the best plant to use remain fundamental challenges. To this end, Nerium oleander L. collected in the city of Zaragoza (NE Spain) has been investigated as a biomonitoring tool for assessing the spatial immission patterns of airborne metals (Pb, Cu, Cr, Ni, Ce, and Zn). N. oleander leaves were sampled at 118 locations across the city, including the city center, industrial hotspots, ring-roads, and outskirts. Metal concentrations were generally higher within a 4 km radius around the city center. Calculated enrichment factors relative to upper continental crust suggest an anthropogenic origin for Cr, Cu, Ni, Pb, and Zn. Zinc isotopes showed significant variability that likely reflects different pollution sources. Plants closer to industrial hotspots showed heavier isotopic compositions (δ⁶⁶Zn_Lyon up to +0.70‰), indicating significant contributions of fly ash particles, while those far away were isotopically light (up to -0.95‰), indicating significant contributions from exhaust emissions and flue gas. We suggest that this information is applied for improving the environmental and human risk assessment related to the exposure to air pollution in urban areas.