Diagnostic support in pediatric craniopharyngioma using deep learning

PURPOSE

We studied a pediatric group of patients with sellar-suprasellar tumors, aiming to develop a convolutional deep learning algorithm for radiological assistance to classify them into their respective cohort.

METHODS

T1w and T2w preoperative magnetic resonance images of 226 Chilean patients were collected at the Institute of Neurosurgery Dr. Alfonso Asenjo (INCA), which were divided into three classes: healthy control (68 subjects), craniopharyngioma (58 subjects) and differential sellar/suprasellar tumors (100 subjects).

RESULTS

The PPV among classes was 0.828±0.039, and the NPV was 0.919±0.063. Also explainable artificial intelligence (XAI) was used, finding that structures that are relevant during diagnosis and radiological evaluation highly influence the decision-making process of the machine.

CONCLUSION

This is the first experience of this kind of study in our institution, and it led to promising results on the task of radiological diagnostic support based on explainable artificial intelligence (AI) and deep learning models.

Controlling systemic corruption through group size and salary dispersion of public servants

We investigate an agent-based model for the emergence of corruption in public contracts. There are two types of agents: business people and public servants. Both business people and public servants can adopt two strategies: corrupt or honest behavior. Interactions between business people and public servants take place through defined payoff rules. Either type of agent can switch between corrupt or honest strategies by comparing their payoffs after interacting. We measure the level of corruption in the system by the fractions of corrupt and honest agents for asymptotic times. We study the effects of the group size of the interacting agents, the dispersion with respect to the average salary of the public servants, and a parameter representing the institutional control of corruption. We characterize the fractions of honest and corrupt agents as functions of these variables. We construct phase diagrams for the level of corruption in the system in terms of these variables, where three collective states can be distinguished: i) a phase where corruption dominates; ii) a phase where corruption remains in less than 50% of the agents; and iii) a phase where corruption disappears. Our results indicate that a combination of large group sizes of interacting servants and business people and small dispersion of the salaries of public servants, contributes to the decrease of systemic corruption in public contracts.

Humanitarian missions and visual outcomes in cataract surgery: A literature review

The limited accessibility to ophthalmological services in remote regions of developing countries poses a significant challenge in visual healthcare. Cataracts and refractive errors are prominent causes of visual impairment, and surgery, despite being an efficient option, faces barriers in developing countries due to financial and geographical constraints. Humanitarian missions play a vital role in addressing this issue. The improvement in the accuracy of calculating IOL power through techniques such as keratometry and biometry is a fundamental step towards optimizing surgical outcomes and the quality of life for patients in these underserved regions. In this context, the consideration of keratometry and immersion ultrasound biometry as preoperative assessment standards in cataract surgeries in developing countries is presented as a pertinent and advisable strategy.

Retinal detachment after refractive lens exchange: A narrative review

Refractive lens exchange (RLE) allows to correct ametropias and presbyopia by replacing the crystalline lens with an extended depth of focus or multifocal intraocular lens (IOL). Retinal detachment (RD) is one of the most serious adverse events after RLE. This study aimed to review the evidence related to the risk of RD after RLE and clinical outcomes. A search using PubMed and a snowball search approach was conducted to identify articles and case reports. According to the literature, the risks of RD should be considered in patients <60 years old with axial lengths >23 mm. Only nine articles reported visual acuity (VA) after RD in RLE, and only 25% of eyes had a VA > 20/40. Considering that the decrease in VA might be uniform for all types of IOLs after RD, surgeons should focus on selecting the patient to prevent RD rather than on a particular IOL optical design based on the potential risk of DR.

Tidal modulation of the seismic activity related to the 2021 La Palma volcanic eruption

The volcanic eruption at La Palma started on September 19, 2021. The eruption was preceded by a seismic swarm that began on September 11, although anomalous seismicity has been observed on the island since 2017. During the co-eruptive phase of the seismic activity, hypocenters depth was generally less than 15 km, save for the period between November 10 and November 27, when hypocenters ranged in the depth from 15 to 40 km. The eruption ended on December 13, 2021. We compute tidal stress for each earthquake at the hypocenter depth and find statistically significant correlations between the occurrence times of the earthquakes and the confining tidal stress values and stress rates. The correlation is depth-dependent, and ocean-loading tides have a stronger effect than body tides. We find that tidal stress variations contribute to the eruption onset and that certain explosive events, typical in Strombolian type volcanoes, seem to occur preferentially when the tidal stress rate is high. Our analysis supports the hypothesis that tides may modulate earthquake activity in volcanic areas, specifically during magma migration at shallow depths. A conceptual model is proposed, which could have a general application in the Canary Islands archipelago and other volcanic islands.

Are GES carbapenemases underdiagnosed? An allelic discrimination assay for their accurate detection and differentiation

GES (Guiana Extended Spectrum) carbapenemases belong to "minor class A carbapenemases" and its prevalence could be underestimated due to the lack of specific tests. The aim of this study was to develop an easy PCR method to differentiate between GES β-lactamases with or without carbapenemase activity, based on an allelic discrimination system of SNPs that encode E104K and G170S mutations, without need of sequencing. Two pair of primers and Affinity Plus probes, labeled with different fluorophores; FAM/IBFQ and YAK/IBFQ, were designed for each one of the SNPs. This allelic discrimination assay allows to detect in real time the presence of all type of GES- β-lactamases, being able to differentiate between carbapenemases and extended-spectrum β-lactamase (ESBL), through a quick PCR test that avoid costly sequencing approaches and could help to decrease the current underdiagnosis of minor carbapenemases that scape of phenotypic screenings.

Spectro-temporal behavior of dye-based solid-state random lasers under a picosecond pumping regime: Part III

In two recent works, the authors have investigated the spectro-temporal properties of the random laser emission from solid state dye-doped powders in picosecond pumping regime. Each emission pulse consists, both above and below threshold, in a collection of narrow peaks of a spectro-temporal width at the theoretical limit (ΔωΔt≅1). The distribution of path lengths traveled inside the diffusive active medium by photons that can be amplified by stimulated emission explains this behavior, as demonstrated by a simple theoretical model developed by the authors. The aim of the present work is, first, to develop an implemented model that does not depend on fitting parameters, and which is compatible with the energetic and spectro-temporal properties of the material; and second, to get knowledge about the spatial properties of the emission. The transverse coherence size of each emitted photon packet has been measured; and in addition, we have shown the existence of spatial fluctuations of the emission of these materials, as our model predicts.

Logistics description of a high yield cataract surgery non-profitable expedition

PURPOSE

To describe the logistics and methodology of a high yield surgical non-profitable campaign.

METHODS

A descriptive study based on previous non-profitable campaigns dedicated to cataract surgery.

RESULTS

The method is based on planification, finance acquisition, volunteer support, foreign affairs with the collaborating country where the surgeries are going to be performed, team organization, and overall, summoning all the stated items to materialize a global humanitarian campaign to eradicate cataracts by clinical and surgical procedures.

CONCLUSIONS

Blindness due to cataracts can be over-ruled. We consider that through our planification and methodology, other organizations may acquire some knowledge to improve their methodology and carry out similar volunteering surgical campaigns. Planification, coordination, financial aid, determination, and a strong will power are altogether compulsory for a successful non-profitable surgical campaign.

Shallow magmatic intrusion evolution below La Palma before and during the 2021 eruption

La Palma, Canary Islands, underwent volcanic unrest which culminated in its largest historical eruption. We study this unrest along 2021 using Interferometric Synthetic Aperture Radar (InSAR) and a new improved interpretation methodology, comparing achieved results with the crustal structure. We reproduce the final phase of La Palma volcanic unrest, highligthing a shallow magma accumulation which begins about 3.5 months before the eruption in a crustal volume charactherized by low density and fractured rocks. Our modeling, together with our improved pictures of the crustal structure, allows us to explain the location and characteristics of the eruption and to detect failed eruption paths. These can be used to explain post-eruptive phenomena and hazards to the local population, such as detected gases anomalies in La Bombilla and Puerto Naos. Our results have implications for understanding volcanic activity in the Canaries and volcano monitoring elsewhere, helping to support decision-making and providing significant insights into urban and infrastructure planning in volcanic areas.

Nuevos táxones animales descritos en la península ibérica y Macaronesia desde 1994 (XXII)

Esta nueva lista incluye en 869 táxones nuevos aparecidos en 471 referencias bibliográficas publicadas principalmente entre 2018 y 2021. Comprende 684 especies, 82 géneros o subgéneros, 54 categorías supragenéricas, 47 subespecies y 2 categorías infrasubespecíficas procedentes del área considerada.

Spectro-temporal behavior of dye-based solid-state random lasers under picosecond pumping regime: part II

In a very recent work the spectral and temporal properties of the random laser emission from solid state dye-doped powders have been investigated by the authors in picosecond pumping regime. The emission shows within each pulse, peaks of more intensity than background, and of a spectro-temporal width at the theoretical limit (ΔωΔt≅1), even in conditions well below the threshold. The relationship between the distribution of paths lengths traveled by photons inside the active medium, and the amplification by stimulated emission explains this behavior. The aim of the present work is to propose a simple model that, in addition to explaining these characteristics of the emission, is compatible with the energetic properties of the material. Particularly interesting is the behavior predicted by the model for the emission decay in sub-threshold conditions, as well as its very good fit with the experimental measurements and its comparison with the one found in low dispersive media, that shows the decisive effect of scattering. The set of results is hardly compatible with a mode structure.

Altered Executive Function in Suicide Attempts

Introduction

Executive function organizes and directs behaviour but alterations in this cognitive domain can lead to inaccurate perception, interpretation and response to environmental information, which could be a risk factor for suicide.

Objectives

To explore executive function performance of depressed recent suicide attempters in comparison to depressed past suicide attempters, depressed non-attempters and healthy controls.

Methods

96 participants from the Psychiatry Department of the Araba University Hospital-Santiago were recruited as follows: 20 patients with a recent suicide attempt (<30days) diagnosed with a Major Depressive Disorder (MDD), 33 MDD patients with history of attempted suicide, 23 non-attempter MDD patients and 20 healthy controls. All participants underwent a clinical interview and neuropsychological assessment on executive function with the Wisconsin Sorting Card Test. Backward multiple regressions were performed adjusting for significant confounding variables. For group comparisons ANOVA test and Bonferroni post hoc test were performed with p<0.05 significance level.

Results

Patient groups did not differ regarding severity of depression. All patient groups performed significantly worse than healthy controls on executive function. Adjusted comparisons between patient groups indicated that recent suicide attempters had a poorer performance in this cognitive domain in comparison to both depressed lifetime attempters and depressed non-attempters (B=0.296, p=0.019 and B=0.301, p=0.028 respectively).

Conclusions

Executive function performance is altered in recent suicide attempts. As impaired executive function can be a risk factor for suicide, preventive interventions on suicide should focus on its assessment and rehabilitation.

Disclosure

No significant relationships.

Assessing discards in an illegal small-scale fishery using fisher-led reporting

About a third of all marine fish in the world are caught in Small-Scale Fisheries (SSF). SSF are increasingly recognised as essential for food security and livelihoods for vulnerable and economically fragile communities globally. Although individual SSF vessels are usually perceived as having little impact on the ecosystem, the cumulative impact of gear type and number of vessels may be substantial. Bottom trawling is a common fishing method that can greatly influence the marine ecosystem by damaging the seafloor and generating high levels of discards. However, appropriate sampling coverage using on-board observer programmes to collect these data from SSF are rare, as they are expensive and pose logistical constraints. A mobile App was used to assess whether self-reporting by fishers could provide reliable fine-scale information on fishing effort and discards over time in an illegal shrimp trawling fishery in northern Peru. Maps depicting the spatial distribution of trawling effort and the proportion of discards from observers and fishers were compared using the Similarity in Means (SIM) Index, which ranges from 0 when spatial patterns differ completely to 1 when spatial patterns are very similar. High levels of agreement between spatio-temporal patterns of effort (SIM Index = 0.81) and discards (0.96) were found between fisher and observer maps. Moreover, far greater spatial coverage was accomplished by fishers, suggesting that self-reporting via an App represents a useful approach to collect reliable fisheries data as an initial step for effective monitoring and management of these fisheries.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11160-022-09708-9.

Effect of a Prioritization Score on the Inter-Hospital Transfer Time Management of Severe COVID-19 Patients. A Quasi-Experimental Intervention Study

Background

The overburdening of the healthcare system during the coronavirus disease 19 (COVID-19) pandemic is driving the need to create new tools to improve the management of inter-hospital transport for patients with a severe COVID-19 infection.

Objective

The aim of this study was to analyse the usefulness of the application of a prioritization score (IHTCOVID-19) for inter-hospital transfer of patients with COVID-19 infection.

Methods

The study has a quasi-experimental design and was conducted on the Medical Emergency System, the pre-hospital emergency department of the public company belonging to the Autonomous Government of Catalonia that manages urgent healthcare in the region. Patients with a severe COVID-19 infection requiring inter-hospital transport were consecutively included. The pre-intervention period was from 1 to 31 March 2020, and the intervention period with the IHTCOVID-19 score was from 1 to 30 April 2020 (from 8 am to 8 pm). The prioritization score comprises four priority categories, with Priority 0 being the highest and Priority 3 being the lowest. Inter-hospital transfer (IHT) management times (alert-assignment time, resource management time and total central management time) and their variability were evaluated according to whether or not the IHTCOVID-19 score was applied.

Results

A total of 344 IHTs were included: 189 (54.9%) in the pre-intervention period and 155 (45.1%) in the post-intervention period. The majority of patients were male and the most frequent age range was between 50 and 70 years. According to the IHTCOVID-19 score, 12 (3.5%) transfers were classified as Priority 0, 66 (19.4%) as Priority 1, 247 (71.8%) as Priority 2 and 19 (5.6%) as Priority 3. Overall, with the application of the IHTCOVID-19 score, there was a significant reduction in total central management time [from 112.4 (inter-quartile range (IQR) 281.3) to 89.8 min (IQR 154.9); P = 0.012]. This significant reduction was observed in Priority 0 patients [286.2 (IQR 218.5) to 42.0 min (IQR 58); P = 0.018] and Priority 1 patients [130.3 (IQR 297.3) to 75.4 min (IQR 91.1); P = 0.034]. After applying the IHTCOVID-19 score, the average time of the process decreased by 22.6 min, and variability was reduced from 618.1 to 324.0 min.

Conclusion

The application of the IHTCOVID-19 score in patients with a severe COVID-19 infection reduces IHT management times and variability.

Spectro-temporal behavior of dye-based solid-state random lasers under picosecond pumping regime

In this work, the spectral and temporal properties of the random laser emission from dye-doped solid state powders are investigated in picosecond pumping regime. Ultrafast time-resolved spectroscopy achieved with a streak-camera has been used to perform a detailed study of the temporal evolution of the spectrum of their single pulses. Under conditions of low population inversion density, it is observed that the detected radiation occurs as isolated peaks with a very narrow spectro-temporally spread (ΔωΔt≅1). This behavior remains under conditions of high population inversion density, suggesting that the underlying physical mechanism that produces the emission is the same whatever the pumping conditions. Measurements carried out by varying the numerical aperture of the detection system show that each detected peak within a single pulse is associated with a photon pack emitted in a random direction and wavelength. The relationship between the distribution of paths lengths done by photons inside the active medium, and the gain explains the observed behavior.

Epidemiology and injury trends in the National Basketball Association: Pre- and per-COVID-19 (2017-2021)

Purpose

The aim this study was to provide an epidemiological injury analysis of the National Basketball Association, detailing aspects such as frequency rate, characteristics and impact on performance (missed games), including COVID-19 related and non-related injuries.

Methods

A retrospective study was conducted from the 2017–18 to 2020–2021 season. Publicly available records from the official website of the National Basketball Association were collected, including player’s profiling data, minutes played per game until the injury occurred, unique injuries and injury description [location (body area), diagnosis (or mechanism)], and missed games due to injury.

Results

A total of 625 players and 3543 unique injuries were registered during the period analyzed. There was an increased incidence of missed games and unique injuries ratios, from 2017–18 until 2020–21, even when excluding COVID-19 related cases. The main body areas of injuries corresponded to lower body injuries, specifically knee, ankle and foot. The tendon/ligament group, for both games missed and unique injuries, showed the higher ratios (1.16 and 0.21, respectively), followed by muscle (0.69 and 0.16, respectively) and bones (0.30 and 0.03, respectively). Irrespective of season, the higher percentage of unique injuries occurred in the group of players playing in the 26–35 minutes, followed by the 16–25 minutes played. Guards showed the highest injury ratios compared to other playing positions. Most injuries and missed games due to injury occurred from mid-season to the end of the regular season. The majority of both injuries and missed games were concentrated in the two central experience groups (from 6 to 15 years).

Conclusions

Despite previous efforts to better understand injury risk factors, there has been an increase in unique injuries and missed games. The distribution by body area, type of injury, when they occurred, minutes played and outcomes by play position, age a or years of experience vary between season and franchises.

Diagnosis and Risk Factors of Bovine and Human Fascioliasis in Cattle Farms from a Venezuelan Andean Rural Area

INTRODUCTION

Fascioliasis is caused in Venezuela by the trematode Fasciola hepatica, affecting herbivorous and human. The Venezuelan Andean region is endemic for bovine fascioliasis and its presence in humans is not known. The objective of this work was to detected positive cases of bovine and human fascioliasis by coprological and immunological techniques and determine the possible risk factors, in eight cattle farms of a Venezuelan Andean rural area.

METHODS

We studied 143 samples of feces and sera of bovines, and 34 samples of feces and sera of humans. Feces were examined by several coprologic techniques, while sera were evaluated by ELISA using two antigens: crude extract (CE) and surface proteins (SP) of F. hepatica, which were previously standardized and validated.

RESULTS

The frequency of fascioliasis in bovines was 21% by coprology, and 49.7% by SP-ELISA. The human detection was 0% by coprology, and 29.4% by SP-ELISA. There were statistical significative differences between cattle farms, regarding to the positive results by coprology and by SP-ELISA. About the possible risk factors, statistical association was found only with the presence of snails near or in the farms and consumption of non-channeled water (river, ditch or spring), both for cattle and for humans.

CONCLUSION

The results showed that the studied area is endemic for bovine fascioliasis, the human has been in contact with F. hepatica and there are risk factors for the transmission of the parasite in the studied farms.

Theory of Differential Conductance of Co on Cu(111) Including Co s and d Orbitals, and Surface and Bulk Cu States

We revisit the theory of the Kondo effect observed by a scanning-tunneling microscope (STM) for transition-metal atoms (TMAs) on noble-metal surfaces, including d and s orbitals of the TMA, surface and bulk conduction states of the metal, and their hopping to the tip of the STM. Fitting the experimentally observed STM differential conductance for Co on Cu(111) including both the Kondo feature near the Fermi energy and the resonance below the surface band, we conclude that the STM senses mainly the Co s orbital and that the Kondo antiresonance is due to interference between states with electrons in the s orbital and a localized d orbital mediated by the conduction states.

Acute beetroot juice supplementation improves exercise tolerance and cycling efficiency in adults with obesity

BACKGROUND

Exercise training improves health outcomes in individuals with obesity (IO); however, it remains challenging for IO to adhere to exercise. Thus, it is critical to identify novel strategies that improve exercise tolerance (ET) and adherence in IO. Beetroot juice (BRJ), high in inorganic dietary nitrate, consistently improves exercise performance in athletes, individuals with cardiopulmonary diseases, and nonobese lean individuals. These improvements may be explained by reduced oxygen uptake (VO2 ) during exercise, enhanced blood flow, and greater mitochondrial efficiency. To date, we are aware of no studies that have compared the effects of BRJ, sodium nitrate (NaNO3), and nitrate-depleted BRJ (PLA) for improving ET and cardiometabolic health in IO.

PURPOSE

Determine if BRJ improves ET, exercise efficiency (EE), and cardiometabolic health in IO and identify possible mechanisms of action.

METHODS

Vascular hemodynamic, submaximal- and maximal-exercise VO2 , and time to exhaustion (TTE) were assessed in 16 participants 2.5 hr following consumption of: 1) BRJ, 2) NaNO3 , 3) PLA, or 4) CON.

RESULTS

A significant treatment effect was observed for submaximal exercise VO2 (p = .003), and TTE (p < .001). Post hoc analyses revealed lower VO2 during submaximal exercise in BRJ compared to PLA (p = .009) NaNO3 (p = .042) and CON (0.009), equating to an average improvement of ~ 7% with BRJ. TTE was greater for BRJ compared to other treatment arms, PLA (p = .008), NaNO3 (p = .038), and CON (p=<0.001), equating to ~ 15% improvement with BRJ. No significant changes were observed for other outcomes.

CONCLUSIONS

Consumption of BRJ improved EE during submaximal exercise by 7%, and TTE by 15% compared to other conditions. These results suggest that BRJ may improve EE and exercise tolerance in IO.

FRI0264 EFFECTIVENESS, SAFETY AND PATTERNS OF USE OF RITUXIMAB IN SCLERODERMA, IN CLINICAL PRACTICE: 9 YEARS’ EXPERIENCE IN A TERTIARY HOSPITAL

Background:

Systemic sclerosis (SSc) is a clinically complex and heterogeneous disease. Interstitial lung involvement (ILD) is the main cause of mortality, but progression of skin fibrosis has also been associated with pulmonary dysfunction and mortality. Recently, Rituximab (RTX) has been postulated as a promising therapeutic alternative to cyclophosphamide (CF) or mycophenolate (MFM), but long-term experience is scarce.

Objectives:

Describe the effectiveness, safety and long-term use of RTX, in a series of cases with SSc.

Methods:

Retrospective observational study of patients with SSc (EULAR/ACR 2013 criteria) treated with RTX in a university hospital from 2010 to 2019. Sociodemographic data related to SSc and treatments were collected. The effectiveness of RTX was evaluated at 6-12 months and at the end of follow-up, by means of these main outcomes: Rodnan’s modified cutaneous index (mRSS) for skin fibrosis; CK leves for myopathy, variation >10% in forced vital capacity (FVC) and >15% in lung diffusion capacity of carbon monoxide (DLCO) for ILD. Adverse events (AE) were recorded. Statistical analysis performed with Stata v.14 and statistical significance set for p≤0.05.

Results:

14 women with SSc (mean age 47±13 years, mean evolution 6.2±4.5 years) were treated with RTX for ILD (n=9), skin involvement (n=11) and/or inflammatory myopathy (n=3). The mean±SD of follow-up was 3.36±2.17 years. SSc type: diffuse cutaneous 35.71%, limited cutaneous 21.44%, overlap 35.71% and sine scleroderma 7.14%. Type of antibodies: 50% anti-Scl-70, 14.3% anti-centromere, 21.4% anti-RNA polymerase III and 7.14% anti-Ku. ILD was classified as NINE in 8 patients and NIU in 1. The first cycle of RTX included 2 infusions of 1g and was initiated a mean of 3.36±2.17 years after diagnosis. The retreatments were initially fixed every 6 months and later on demand in 4 patients, and in the rest on demand from the beginning, according to duration of clinical response. A mean of 3.9±2.5 cycles/patient (range: 1-11) were administered. 30% of patients had previously received CF and 21.5% MFM. RTX was administered in association with other DMARDs (MTX 64.29%, hydroxychloroquine [HCQ] 35.71%, MFM 57.14%, others 14.28%), CF (14.29%), intravenous immunoglobulins (7,14%) and prednisone (78.57%). In the final visit, the percentage use of DMARDs (50% MTX, 50% MFM and 28.57% HCQ) and prednisone (62.5% patients, 30% doses) was reduced. mRSS improved significantly. Muscle weakness disappeared in 3/3 with normal CK levels in 2/3 patients with myopathy. The FVC improved or stabilized in 22% and 56% of ILD, respectively, and the DLCO stabilized in 66.70% (not significant). TACAR stabilized in 55.56% of ILD, with some degree of worsening in the rest. Outcomes evolution in the Table:

Functional ParametersBasal (mean±SD)6-12 m (mean±SD)CI 95%PFinal (mean±SD)CI 95%PFVC (n=9)63.2±16.870.3±18.6[-13.3–6.1]0,4071.9±21.1[-14.4–5.9]0.36DLCO (n=9)46.3±18.546.1±20.30,3445.2±22.03[-3.9–12.8]0.24Clinical ParametersBasal (mean±SD)Final (mean±SD)CI 95%PmRSS (n=11)13.1±7.28.8±7.1[0.9–9.4]0.02CK (n=3)1786.7±1483.8134.7±119[-2181.9 –5485.9]0.2

CK: Creatine kinase; SD: Standard deviation; CI: Confidence interval; m: months.

The AE were mostly mild: 13 infusional reactions (6 patients), 1 uncomplicated herpes zoster and 2 serious infections that required admission. There were no exitus.

Conclusion:

Our results, with a limited sample, suggest that the long-term use of RTX in real world clinical practice may be beneficial for the cutaneous, pulmonary and myopathic manifestations of SSc, with an acceptable security profile.

Disclosure of Interests:

Esther Vicente Speakers bureau: BMS, Roche., Javier Fernández: None declared, Irene Llorente Speakers bureau: Gebro, Janssen, Sanofi, Lilly., Lorena Vega: None declared, Santos Castañeda: None declared, Alberto García-Vadillo: None declared, Isidoro González-Álvaro Grant/research support from: Roche Laboratories, Consultant of: Lilly, Sanofi, Paid instructor for: Lilly, Speakers bureau: Abbvie, MSD, Roche, Lilly, Alicia Humbría: None declared, Ana Ortiz: None declared, Esther Patiño: None declared, Eva Tomero Muriel: None declared, Rosario Garcia de Vicuna Grant/research support from: BMS, Lilly, MSD, Novartis, Roche, Consultant of: Abbvie, Biogen, BMS, Celltrion, Gebro, Lilly, Mylan, Pfizer, Sandoz, Sanofi, Paid instructor for: Lilly, Speakers bureau: BMS, Lilly, Pfizer, Sandoz, Sanofi

Applicability and limitations of the radon-deficit technique for the preliminary assessment of sites contaminated with complex mixtures of organic chemicals: A blind field-test

A blind field test with 136 independent measurements of radon (²²²Rn) in soil air retrieved from a depth of 0.8 m in a decommissioned lindane (γ-hexachlorocyclohexane) production plant was undertaken to evaluate the performance of the ²²²Rn-deficit technique as a screening methodology for the location and delineation of subsurface accumulations of complex mixtures of organic contaminants. Maps of ²²²Rn iso-concentrations were drawn and interpreted before direct analytical information regarding concentrations of hexachlorocyclohexanes, chlorobenzenes and BTEX compounds in soil, groundwater and soil air were disclosed to the authors. The location and extension of pollution hot spots inferred from the ²²²Rn campaigns agrees remarkably well with the analytical data obtained from the intrusive sampling campaigns and with the location of contaminant source zones (chemical reactor and waste-storage area) and geological sinks of those contaminants (paleochannel). Two main limitations to the applicability of the ²²²Rn-deficit technique were identified and assessed: The statistically significant variation of ²²²Rn concentrations with diurnal changes of ground-level air temperature and the maximum depth of investigation in the absence of significant advective and co-advective transport of radon. If the influence of those two factors is accounted for and/or minimized (by averaging replicated measurements during the workday and in different days), the ²²²Rn-deficit technique has the potential to be an efficient technique which delivers information in quasi-real time, with a much higher spatial density than that of intrusive techniques, at a much faster rate and at a significantly lower cost. MAIN FINDINGS: The ²²²Rn-deficit technique is an effective tool for real-time site characterization only limited by diffusion length of radon and diurnal temperature variations.

Effect of chloride on the one step electrochemical treatment of an industrial textile wastewater with tin dioxide anodes. The case of trichromy procion HEXL

The resulting solutions from the cotton fabrics dyeing using the trichromy Procion HEXL, with NaCl as electrolyte, were electrochemically treated. These dyes have two azo groups as chromophores and two monochlorotriazinic groups as reactive groups in their structure. The combined oxidation/reduction at 125 mA cm^-2 in a filter-press cell without compartment separation was carried out using an anode of Ti/SnO₂-Sb-Pt and a cathode of stainless steel. This procedure has been effective in previous experiments using sulphate as electrolyte. A significant decrease in total organic carbon (TOC), chemical oxygen demand (COD), and total nitrogen (TN) was obtained. Moreover, the process took place efficiently. The average oxidation state (AOS) and the carbon oxidation state (COS) data confirmed the presence of stable oxidized intermediates in the electrolysed solution. The chromatography and the UV-Visible spectrophotometry assays indicated that full decolourisation is obtained at a loaded charge of around 0.81 Ah L^-1 which is associated with an electrical energy per order (EEO) of 1.20 kWh m^-3.

A diet based on cured acorn-fed ham with oleic acid content promotes anti-inflammatory gut microbiota and prevents ulcerative colitis in an animal model

Background

Diets based on meat products are not recommended in the case of ulcerative colitis (UC). The objective here is to test if some traditional cured meat products, as acorn-fed ham (high levels of oleic acid), may be useful for controlling inflammatory diseases as UC in animal models, which could represent a new dietary complementary intervention in the prevention of this inflammatory disease in humans.

Methods

Two rat cohorts have been used: conventional vegetable rat feed and acorn-fed ham. UC was induced with DSS in drinking water ad libitum for 1 week. Short-chain fatty acids (SCFAs) and 16S rRNA metagenomics from bacterial populations were analyzed in cecum samples. Colon samples were analyzed for histological parameters.

Results

Acorn-fed ham diet induced changes in gut microbiota composition, with pronounced enrichments in anti-inflammatory bacterial genera (Alistipes, Blautia, Dorea, Parabacteroides). The animals with this diet showed a strong reduction in most parameters associated to ulcerative colitis: disease activity index, macroscopic score of colitis, epitelium alteration in colon mucosa, inflammatory cell density in colon, myeloperoxidase titers in colon, proinflammatory cytokines (IL-17, IFN-γ). Also, acorn-fed ham diet animals showed increased total antioxidant activity an oleic acid levels in plasma, as well as higher short-chain fatty acid concentrations in cecum (isobutyric, isovaleric and valeric).

Conclusions

In the acorn-fed ham cohort, as a result of the dietary intake of oleic acid and low intake of omega-6 fatty acids, a strong preventive effect against UC symptoms was observed.

Prospective multicentre study of rectal carriage of multidrug-resistant Enterobacteriaceae among health-care workers in Spain

OBJECTIVES

To investigate the rectal carriage of multidrug-resistant Enterobacteriaceae (colistin-resistant, extended-spectrum β-lactamase (ESBL) -producers and/or carbapenemase-producers) among health-care workers (HCWs) from six Spanish hospitals.

METHODS

Rectal swabs from 258 HCWs, employed in intensive care units, haematology wards and clinical microbiology laboratories from six hospitals in northern Spain were studied. They were cultured in selective media for Gram-negative resistant bacteria. Detection of antimicrobial resistance genes and multilocus sequence typing were performed by PCR and further sequencing. A questionnaire including data related to risk factors of colonization/infection by resistant bacteria (age, gender, chronic diseases, immunosuppressive therapies, invasive procedures or antimicrobial treatments) was given to each participant.

RESULTS

No carbapenemase-producing Enterobacteriaceae were recovered. However, 8/258 HCWs (3.1%) were positive for ESBL-producing isolates. This rate was not higher than the colonization rate previously reported in Spain for healthy people in the community. Five isolates showed high-level resistance to colistin (MICs ranging from 8 to 128 mg/L) but all of them were negative for the mcr genes tested. No statistically significant risk factors for gut colonization by ESBL-producing or colistin-resistant Enterobacteriaceae were identified among the HCWs participating in the study.

CONCLUSIONS

Our data suggest that working in hospitals does not represent a risk for rectal carriage of multidrug-resistant Enterobacteriaceae.

[Convalescent plasma as a therapy for severe COVID-19 pneumonia]

The COVID-19 pandemic presented high mortality from its beginning, without effective treatment for seriously ill patients. Build on the experience in Argentine hemorrhagic fever with convalescent plasma, we incorporated 90 patients with COVID-19, of which 87 were evaluable, into a multicenter study. We collected 397 plasma donations from 278 convalescent donors. Patients received plasma with an IgG concentration of 0.7-0.8 (measured by Abbott chemiluminescence) for every 10 kg of body weight. Survival during the first 28 days was the primary objective; 77% were male, age 54 ± 15.6 y/o (range 27-85), body mass index 29.7 ± 4.4; hypertension 39% and diabetes 20.7%; 19.5% had an immunosuppressive condition, 23% were health workers. Plasma was administered to 55 (63%) on spontaneous breathing with oxygen supplementation (mainly oxygen mask with reservoir bag in 80%), and to 32 patients (37%) on mechanical ventilation. The 28-day survival rate was 80%; 91% in patients infused on spontaneous breathing and 63% in those on mechanical ventilation (p = 0.0002). There was a significant improvement in the WHO pneumonia clinical scale at 7 and 14 days, and in PaO2 / FiO2, ferritin and LDH, in the week post-infusion. We observed an episode of circulatory volume overload and a febrile reaction, both mild. Convalescent plasma infusions are feasible, safe, and potentially effective, especially before requiring mechanical ventilation. They are an attractive clinical option for treating severe forms of COVID-19 until other effective therapies become available.

[Coagulopathy and COVID-19. Recommendations for a changing reality]

The coronavirus disease 2019 (COVID-19) pandemic requires rapid medical responses. The risk of venous and arterial thromboembolism increases in critically ill patients with SARS-CoV-2 infection. There is a hypercoagulable state that includes elevated levels of D-dimer, with an increased risk of organ failure and increased mortality. The abnormalities described in hemostasis should be considered for therapeutic decision making. We analyzed the available scientific evidence for the therapeutic approach of coagulopathy in the course of the disease with the objective of designing realistic therapeutic recommendations aimed at reducing morbidity and mortality in patients with COVID-19.

Vibroequilibria in microgravity: Comparison of experiments and theory

Experiments on vibrated fluids confined in cylindrical and cuboidal containers were performed under the reduced gravity conditions of a parabolic flight. The results constitute a systematic quantitative investigation of the vibroequilibria effect, which refers to the reorientation of vibrated fluids in response to the inhomogeneous oscillatory velocity field and the accompanying dynamic pressure. This effect is amplified in microgravity where the restoring force of gravity is small or absent. Here the vibrations are transmitted via a pair of piezoelectric ceramics and a cantilever beam, excited in a resonant mode. The first and second resonances exhibit different types of motion and lead to different types of vibroequilibria surfaces, one with a dip or crater in the interior and the other flattened compared to the unforced reference experiment. The general tendency for interfaces to orient more perpendicular, on average, to the vibrational axis is confirmed. In the case of water in a cuboidal container, a quantitative comparison is made with vibroequilibria theory and with direct simulations of the Navier-Stokes equations. The good agreement confirms the predictions of vibroequilibria theory and suggests the capacity of this phenomenon to manipulate and position fluids in space environments through the choice of frequency and resonant mode.

Long-term endemic situation caused by a linezolid- and meticillin-resistant clone of Staphylococcus epidermidis in a tertiary hospital

BACKGROUND

Linezolid (LZD)-resistant Staphylococcus epidermidis (LRSE) are increasing, and are mainly associated with outbreaks in hospital wards with high LZD consumption.

AIM

To investigate the frequency of LRSE in a tertiary hospital in the context of LZD use.

METHODS

The frequency of LRSE and the data on LZD usage [expressed as defined daily dose (DDD) per 100 patient-days], from 2011 to 2017, were analysed retrospectively. Selected LRSE were typed by pulsed-field gel electrophoresis (PFGE) and screened for transferable LZD resistance genes. Representative isolates were typed by multi-locus sequence typing, and ribosomal mechanisms of LZD resistance were investigated.

FINDINGS

In total, 435 LRSE were detected, with frequencies ranging from 13.56% to 32.93% in the intensive care unit (ICU) where LZD consumption was high (6.34-8.10 DDDs), and from 2.48 to 6.80% in the remaining wards where LZD use was considerably lower (0.63-2.49 DDDs). The first 44 LRSE isolates recovered (June 2013-June 2014) were closely related according to PFGE patterns, and all except one were resistant to meticillin due to mecA production. Selected isolates belonged to ST2, carried SCCmec III, and had the G2576T mutation in the V domain of each of the six copies of the 23S rRNA gene. Five of the 44 isolates (11.36%) were positive for the cfr gene.

CONCLUSION

An ST2 LZD- and meticillin-resistant clone was found in the ICU and also in wards with low consumption of LZD. This highlights the need to implement and maintain infection control measures as well as antimicrobial stewardship programmes in all hospital units in order to preserve the efficacy of LZD.

Tunable upconversion emission in NaLuF4-glass-ceramic fibers doped with Er3+ and Yb3

Novel glass-ceramic optical fibers containing NaLuF₄ nanocrystals doped with 0.5ErF₃ and 2YbF₃ (mol%) have been prepared by the rod-in-tube method and controlled crystallization. NaLuF₄ nanocrystals with a size around 20 nm are obtained after heat treatment at 600 °C. Intense upconverted green and red emissions due to (²H_11/2, ⁴S_3/2) → ⁴I_15/2 and ⁴F_9/2 → ⁴I_15/2 transitions, respectively, together with a blue emission due to ²H_9/2 → ⁴I_15/2 transition have been observed under excitation at 980 nm. The intensity of the green and red upconversion bands shows a nearly linear dependence on the excitation power which can be explained by saturation effects in the intermediate energy states and proves that a sensitized energy transfer upconversion process is responsible for the population of the emitting levels of Er³⁺ ions. The upconversion emission color changes from yellow to green by increasing the excitation power density which allows to manipulate the color output of the Er³⁺ emission in the glass-ceramic fibers. The tunable emission color is easily detected with the naked eye. This interesting characteristic makes these glass-ceramic fibers promising materials for photonic applications.

Novel glass-ceramic optical fibers containing NaLuF₄ nanocrystals doped with 0.5ErF₃ and 2YbF₃ (mol%) have been prepared by the rod-in-tube method and controlled crystallization.

Quality of life and metabolic control in type 2 diabetes mellitus diagnosed individuals

AIMS

Determine the correlation of quality of life (QoL) and the impact on the metabolic control of patients with type 2 diabetes mellitus (T2DM).

METHODS

An observational study was conducted at the outpatient consulting service in a specialized hospital in Santo Domingo, DR. We used a non-probabilistic, convenience sampling strategy, and the World Health Organization Quality of Life (WHOQOL-BREF) short form questionnaire was applied.

RESULTS

The patients presented lower impact in QoL domains was: pain (x¯=29.07, SD = 3.04) and negative feelings (x¯=28.70, SD = 3.33). We found there is a negative correlation between the psychological domains and the fasting glycemia (r_ho = -0.192, p < 0.05), also between the summary of all domains of QoL and metabolic control, HbA1C (r_ho = -0.205, p < 0.05), and fasting glycaemia (r_ho = -0.214, p < 0.05). There was a significant difference in the physical domains F (1, 131) = 9.73, p = 0.002, η² = 0.069, indicating that men (M = 14.81) have a higher physical QoL than women (M = 13.72).

CONCLUSION

Given the evidence of the impact of metabolic control and the different domains to QoL, it is necessary to consider these aspects in the treatment plan of patients with diabetes, to ensure adequate management and control of future complications.

Input/output energy in solid state dye random lasers

A new approach to the problem of energy in solid state dye random lasers is presented. The measurements performed in terms of absolute energy show that the slope efficiency depends on the measurement conditions. In particular, in lasers with pumping in the picoseconds range, the result is really different if measured by recording the emission in the same time range or in a longer one (nanoseconds range). In the last case, no energy threshold is observed. A previously developed model has been applied to the solid state dye random laser. It is a rate-equations model, based on a distribution of paths with different lengths, which partially share population inversion. The results of the model are satisfactory and show that the dynamic behavior is pretty similar in solid state dye random lasers and in inorganic powders.

Organochlorine pesticides air monitoring near a historical lindane production site in Spain

The landfilling and dumping of persistent organic pollutants (POPs) and other persistent hazardous chemicals, such as hexachlorocyclohexane (HCH) isomers can have significantly adverse environmental consequences and cause contamination in soil, water, and atmosphere systems. Approximately 115,000 t of HCH wastes were generated by INQUINOSA Factory located in Sabiñánigo (Aragón, Spain) from 1975 to 1992, and were mainly dumped at Bailín and Sardas landfills. Under the frame of the project plan approved by the Government of Aragón, remediation and containment measures were implemented at the derelict production facility and landfill sites. To protect and assess the local environment, the concentrations of HCH isomers, pentachlorobenzene (PeCB) and hexachlorobenzene (HCB) in air were periodically monitored in the Sardas landfills and surroundings by passive sampling devices. The influence of meteorological parameters was evaluated, showing positive correlations between temperature and HCH and HCB concentrations. The highest HCH levels were detected in Sardas landfill and INQUINOSA Factory sites. PeCB values were statistically higher in Sardas landfill than in Sabiñánigo urban core, nevertheless, HCB concentrations were similar in both sampling points. Statistically positive correlations were found among HCH isomers in all sampling points, showing a major common source. The chlorobenzenes also correlated positively with each other. The α-/γ-HCH ratios were calculated (1.46 ± 1.25; mean ± S.D.), corroborating that concentrations detected were mainly originated from the historical production, storage and waste disposal of technical HCH.

Extension for Community Healthcare Outcomes Uruguay: A New Strategy to Promote Best Primary Care Practice for Autism

Introduction. In Uruguay, the special care required for children with neurodevelopmental disorders presents difficulties including lack of access to specialists and rehabilitation services. Project ECHO (Extension for Community Healthcare Outcomes) connects primary care clinicians from remote areas to specialists to enable them to treat complex conditions through ongoing education and mentoring. Objective. To share the experience of the ECHO Autism program during the first 2 years of implementation. Methods. Analysis of ECHO Autism clinics from June 2015 to June 2017 including clinical cases presented participants' self-perception of changes in skills and competences. Results. Twenty clinical cases were presented: mean age 4.5 years; 15 were males; and 17 with medical and psychiatric comorbidities. After ECHO Autism implementation, a statistically significant improvement in participants' self-perception of skills and competences was observed. Conclusions. ECHO Autism in Uruguay is a meaningful approach to autism care and offers improved access to best practice care.

Nuevos táxones animales descritos en la península Ibérica y Macaronesia desde 1994 (XXI)

La lista anual incluye en esta ocasión 580 táxones nuevos aparecidos en 309 referencias bibliográficas publicadas principalmente en 2017 y 2018. Comprende 463 especies, 69 géneros o subgéneros, 35 categorías supragenéricas, 12 subespecies y una categoría infrasubespecífica procedentes del área considerada.

Epidemiologic and Histopathologic Characterization of Cutaneous Metastases in Patients Who Visited 2 Hospitals in Santiago de Chile Between 2005 and 2017

BACKGROUND AND OBJECTIVE

Cutaneous metastases (CMs) account for 2% of skin tumors and their incidence varies between 0.7% and 9% in patients with cancer. The objective of this study was to describe and analyze the demographic, clinical, and histopathologic characteristics of CM in patients who visited 2 hospitals in the Santiago de Chile metropolitan region.

MATERIAL AND METHOD

We performed a retrospective, descriptive, analytical, observational, cross-sectional study. We reviewed the pathology reports, patient records, pathology slides, and dates of death for diagnosed cases of CM from the anatomic pathology departments of 2 hospitals in the Santiago de Chile metropolitan region between 2015 and 2017.

RESULTS

Ninety-six patients with CM were included in the study; 60.42% were women and 39.58% were men. The mean (SD) age was 67.95 (13.74) years, with a range of 28 to 96 years. The most common primary tumor was melanoma in 27.08% of cases (n=26), followed by breast cancer (18.75%, n=18), and adenocarcinoma (15.63%, n=15). The median time between diagnosis of the tumor and cutaneous metastasis was 9 months. Patients with CM of melanoma had a higher survival rate than patients with metastasis of other primary tumors (P<.05). A histopathologic study of 91 slides showed that diffuse infiltration of the tissue with tumor cells was the most common pattern and vascular invasion was rare.

CONCLUSIONS

The results are similar to those found worldwide. CM is a rare manifestation of internal tumors. It presents mainly at an advanced age and is equally prevalent in both sexes.