Executive summary of the consensus document on the management of perioperative anemia in Spain

Perioperative anemia is an independent risk factor for postoperative morbidity and mortality. However, conceptual, logistical and administrative barriers persist that hinder the widespread implementation of protocols for their management. The project coordinator convened a multidisciplinary group of 8 experienced professionals to develop perioperative anemia management algorithms, based on a series of key points (KPs) related to its prevalence, consequences, diagnosis and treatment. These KPs were assessed using a 5-point Likert scale, from "strongly disagree [1]" to "strongly agree [5]". For each KP, consensus was reached when receiving a score of 4 or 5 from at least 7 participants (>75%). Based on the 36 KPs agreed upon, diagnostic-therapeutic algorithms were developed that we believe can facilitate the implementation of programs for early identification and adequate management of perioperative anemia, adapted to the characteristics of the different institutions in our country.

Outbreak of Dermatophyte Infections on the Head and Neck Related to Shave Haircuts: Description of a Multicenter Case Series

INTRODUCTION

Since 2021, an increase in cases of tinea capitis has been detected in adolescents who shave their hair with fade haircut.

PATIENTS AND METHODS

Multicenter retrospective observational study of cases of cephalic pole dermatophytosis with a history of having been acquired after frequent shaving in hairdressing. A call was made to dermatologists from the Spanish Academy of Dermatology and Venereology (AEDV) to provide cases observed between January 2021 and December 2022. Patients with microbiological confirmation by culture or direct examination with KOH were included.

RESULTS

107 cases were collected, 106 of which were male. 78 non-inflammatory forms were observed; compared to 29 inflammatory. The most frequently isolated fungus was Trichophyton tonsurans (75.7 % of cases). The lesions appeared predominantly on the nape of the neck and temporal area.

CONCLUSIONS

the distribution by sex, age and lesional location seems to indicate that a new social trend, in which male adolescents regularly go to hairdressers to shave the occipital and temporal areas, would be the cause of this grouping of cases of ringworm of the scalp. The most frequent microorganism in our study (T. tonsurans) coincides with the most prevalent in our environment. This study shows an accumulation of cases that can be taken into account by competent Public Health agencies, which are responsible for ensuring compliance with the rules of disinfection of the material used for shaving.

Turning an invasive alien species into a valuable biomass: Anaerobic digestion of Rugulopteryx okamurae after thermal and new developed low-cost mechanical pretreatments

The invasive alien seaweed Rugulopteryx okamurae (R.o.) has spread quickly through the Mediterranean Sea causing an unprecedented ecological impact. A solution integrated into a circular economy model is needed in order to curb the negative effects of its presence. Anaerobic digestion (AD) is proposed as a feasible process able to transform biomass into renewable energy. Nevertheless, in order to improve the methane yield and surpass the drawbacks associated with AD processes, this research proposes a thermal pretreatment and a new developed method where the macroalgae is mechanically pretreated with zeolite. Chemical and microstructure characterization of the algal biomass after pretreatments involved scanning electron microscopy (SEM), X-ray powder diffraction (XRD) and Fourier-transform infrared spectroscopy (FTIR). The highest methane yields of 240 (28) and 250 (20) NLCH4 kg-1 VSadded were obtained with the new mechanical pretreatment and the thermal pretreatment at 120 °C for 45 min without zeolite, achieving a 35 % improvement against the non-pretreated algae. A direct relationship between the crystallinity index of the samples and methane production was observed. The experimental data of methane production versus time were found to be in accordance with both first-order kinetic and Transference Function mathematical models.

Mapping of Dietary Interventions Beneficial in the Prevention of Secondary Health Conditions in Spinal Cord Injured Population: A Systematic Review

OBJECTIVES

Individuals with spinal cord injury are at risk of secondary health conditions (SHC) that develop as a consequence of autonomic dysfunction, prolonged oxidative stress and inflammation, and physical inactivity coupled with inadequate energy and nutritional intake. SHC can be debilitating and even life-threatening, and its prevention remains one of the major challenges in the continuum of medical care of aging SCI population. An unhealthy diet is a major driver of inflammation, oxidative stress, and unfavourable metabolic status and may be a practical preventive target to tackle increased SHC risk post-injury.

AIMS

To provide a catalogue of dietary interventions beneficial in prevention of SHC among individuals with SCI by conducting a systematic review of the literature on dietary interventions and dietary supplementation in promoting health and well-being after the injury. In addition, we aimed to provide a summary of observational studies exploring the association between habitual diet (macro- and micronutrients intake and dietary patterns) and health patterns following the injury.

METHOD

This review was registered at PROSPERO (University of York) with registration number CRD42022373773. Four medical databases (EMBASE.com, MEDLINE [Ovid], Cochrane CENTRAL, and Web of Science Core Collection) and Google Scholar were searched from inception until 11th July 2022. Studies were included if they were clinical trials or observational studies conducted in adult individuals with SCI and provided information of interest. Based on strength of the study design and risk of bias assessment (using the NIH tool), we classified studies from Level 1 (most reliable studies) to Level 4 (least reliable studies).

RESULTS

Of 12,313 unique citations, 47 articles (based on 43 original studies) comprising 32 interventional (22 RCTs, 3 NRCT, and 7 pre-post studies) and 11 observational studies (2 cohort studies, 2 case-control, 1 post-intervention follow-up study, and 6 cross-sectional studies) were included in the present systematic review. Twenty studies (46.5%) were classified as Level 1 or 2, indicating high/moderate methodological quality. Based on those studies, dietary strategies including high protein diet, intermittent fasting, balanced diet in combination with physical conditioning and electrical stimulation, and dietary supplementation including alpha-lipoic acid, creatine, vitamin D, and cranberry-derived supplements and probiotics were mapped as the most promising in prevention of SHC among individuals with SCI.

CONCLUSIONS

To develop timely and effective preventive strategies targeting major SHC (e.g., cardiometabolic diseases, urinary tract infections) in SCI, further research is warranted to confirm the effectiveness of dietary strategies/interventions identified through the current systematic review of the literature.

Deep Learning Adapted to Differential Neural Networks Used as Pattern Classification of Electrophysiological Signals

This manuscript presents the design of a deep differential neural network (DDNN) for pattern classification. First, we proposed a DDNN topology with three layers, whose learning laws are derived from a Lyapunov analysis, justifying local asymptotic convergence of the classification error and the weights of the DDNN. Then, an extension to include an arbitrary number of hidden layers in the DDNN is analyzed. The learning laws for this general form of the DDNN offer a contribution to the deep learning framework for signal classification with biological nature and dynamic structures. The DDNN is used to classify electroencephalographic signals from volunteers that perform an identification graphical test. The classification results show exponential growth in the signal classification accuracy from 82 percent with one layer to 100 percent with three hidden layers. Working with DDNN instead of static deep neural networks (SDNN) represents a set of advantages, such as processing time and training period reduction up to almost 100 times, and the increment of the classification accuracy while working with less hidden layers than working with SDNN, which are highly dependent on their topology and the number of neurons in each layer. The DDNN employed fewer neurons due to the induced feedback characteristic.

Worldwide Research Trends on Solar-Driven Water Disinfection

“Ensure access to water for all”, states Goal 6 of the UN’s Sustainable Development Goals. This worldwide challenge requires identifying the best water disinfection method for each scenario. Traditional methods have limitations, which include low effectiveness towards certain pathogens and the formation of disinfection byproducts. Solar-driven methods, such as solar water disinfection (SODIS) or solar photocatalysis, are novel, effective, and financially and environmentally sustainable alternatives. We have conducted a critical study of publications in the field of water disinfection using solar energy and, hereby, present the first bibliometric analysis of scientific literature from Elsevier’s Scopus database within the last 20 years. Results show that in this area of growing interest USA, Spain, and China are the most productive countries in terms of publishing, yet Europe hosts the most highly recognized research groups, i.e., Spain, Switzerland, Ireland, and UK. We have also reviewed the journals in which researchers mostly publish and, using a systematic approach to determine the actual research trends and gaps, we have analyzed the capacity of these publications to answer key research questions, pinpointing six clusters of keywords in relation to the main research challenges, open areas, and new applications that lie ahead. Most publications focused on SODIS and photocatalytic nanomaterials, while a limited number focused on ensuring adequate water disinfection levels, testing regulated microbial indicators and emerging pathogens, and real-world applications, which include complex matrices, large scale processes, and exhaustive cost evaluation.

Retraction notice to "Influence of hypertonic volume replacement on the microcirculation in cardiac surgery" [Br J Anaesth 67 (1991) 595-602]

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the Editor-in-Chief, Professor Hugh Hemmings, based on the recommendations of Justus-Liebig-University Giessen following an internal review of research conducted by Joachim Boldt at the University. This is further described in 'Further Retractions of Articles by Joachim Boldt', https://doi.org/10.1016/j.bja.2020.02.024.

Colorectal cancer guidelines seldom include the patient perspective

OBJECTIVES

This study aimed to describe how colorectal practice guidelines (PGs) incorporate the patient perspective.

STUDY DESIGN AND SETTING

We searched in the Guidelines International Network library, MEDLINE, National Guideline Clearinghouse, NHS Evidence database, and TRIP database. Two authors independently selected the PGs. We considered recommendations rated or worded as weak or conditional or suggesting multiple options, as potentially preference sensitive. Two authors independently evaluated if, in potentially sensitive recommendations, the patient perspective was incorporated.

RESULTS

We included 28 PGs that contained 588 recommendations, being 256 potentially preference sensitive. Ten PGs (36%) included patients in the development process, and 12 (43%) provided information about patients' perspectives. Nine PGs (32%) included recommendations in which the patient perspective was explicitly considered, and 13 (46.4%) that recommended a discussion with the patient. From a total of 588 recommendations, 9.7% (25/256) of potentially preference-sensitive recommendations considered the patient perspective. The inclusion of patients in the development process was associated with a more frequent incorporation of the patient perspective in potentially preference sensitive recommendations (70% vs. 0%; P < 0.001).

CONCLUSIONS

Guideline users should be aware that the incorporation of the patient perspective in colorectal cancer PGs is suboptimal. Guideline developers should make efforts to incorporate the patient perspective, especially in preference-sensitive recommendations.

Evidence mapping based on systematic reviews of therapeutic interventions for soft tissue sarcomas

PURPOSE

Soft tissue sarcomas are a heterogeneous group of rare tumours of mesenchymal origin. Evidence mapping is one of the most didactic and friendly approaches to organise and summarise the range of research activity in broad topic fields. The objective of this evidence mapping is to identify, describe and organise the current available evidence about therapeutic interventions on soft tissues sarcomas.

METHODS

We followed the methodology of global evidence mapping. We performed a search of the PubMed, EMBASE, The Cochrane Library and Epistemonikos to identify systematic reviews (SRs) with or without meta-analyses published between 1990 and March 2016. Two independent literature reviewers assessed eligibility and extracted data. Methodological quality of the included systematic reviews was assessed using AMSTAR. We organised the results according to identified PICO questions and used tables and a bubble plot to display the results.

RESULTS

The map is based on 24 SRs that met eligibility criteria and included 66 individual studies. Three-quarters were either observational or uncontrolled clinical trials. The quality of the included SRs was in general moderate or high. We identified 64 PICO questions from them. The corresponding results mostly favoured the intervention arm.

CONCLUSIONS

This evidence mapping was built on the basis of SRs, which mostly included non-experimental studies and were qualified by the AMSTAR tool as of moderate quality. The evidence mapping created from PICO questions is a useful approach to describe complex and huge clinical topics through graphical media and orientate further research to fulfil the existing gaps. However, it is important to delimitate the steps of the evidence mapping in a pre-established protocol.

Successful lichen translocation on disturbed gypsum areas: A test with adhesives to promote the recovery of biological soil crusts

The loss of biological soil crusts represents a challenge for the restoration of disturbed environments, specifically in particular substrates hosting unique lichen communities. However, the recovery of lichen species affected by mining is rarely addressed in restoration projects. Here, we evaluate the translocation of Diploschistes diacapsis, a representative species of gypsum lichen communities affected by quarrying. We tested how a selection of adhesives could improve thallus attachment to the substrate and affect lichen vitality (as CO₂ exchange and fluorescence) in rainfall-simulation and field experiments. Treatments included: white glue, water, hydroseeding stabiliser, gum arabic, synthetic resin, and a control with no adhesive. Attachment differed only in the field, where white glue and water performed best. Adhesives altered CO₂ exchange and fluorescence yield. Notably, wet spoils allowed thalli to bind to the substrate after drying, revealing as the most suitable option for translocation. The satisfactory results applying water on gypsum spoils are encouraging to test this methodology with other lichen species. Implementing these measures in restoration projects would be relatively easy and cost-effective. It would help not only to recover lichen species in the disturbed areas but also to take advantage of an extremely valuable biological material that otherwise would be lost.

Do plasma catecholamines influence microcirculatory blood flow in cardiac surgery patients?

To investigate whether plasma catecholamines influence blood flow on the microcirculatory level, forehead and forearm skin blood flow was measured by a two-channel laser Doppler blood flux monitor in 50 patients undergoing aortocoronary bypass grafting. Macrohaemodynamics, plasma viscosity, and skin temperatures were additionally monitored. Plasma catecholamines (adrenaline [AD] and noradrenaline [NOR] ) were determined using high-pressure liquid chromatography (HPLC) from arterial blood samples.

In the prebypass period, blood concentrations of both catecholamines increased slightly showing a wide range of values (AD ranging from 3 to 955 pg/ml; NOR ranging from 27 to 5326 pg/ml). In spite of the tremendous increase in plasma catecholamines before and after bypass, laser Doppler flow (LDF) remained almost stable in this period. Neither LDF nor macrocirculatory parameters were correlated to plasma catecholamines. Cardiopulmonary bypass (CPB) resulted in a significant increase in catecholamines (AD ranging from 80 to 2480 pg/ml; NOR ranging from 188 to 9898 pg/ml). Although haematocrit and plasma viscosity were significantly reduced during CPB, LDF decreased in comparison to baseline values (LDF forehead: -25%; LDF forearm: -35%) ( p<0.05).

It is concluded that plasma catecholamine levels were markedly changed during cardiac surgery showing a wide range of concentrations. Microcirculatory flow assessed by laser Doppler remained almost unaffected by these alterations and was not correlated to AD or NOR plasma concentrations. However, during CPB a significant increase in catecholamines can contribute to the risk of microperfusion abnormalities which can be assessed by laser Doppler technique.

Hormonal response to fluid administration in cardiac surgery patients

The effects of three different fluid regimes administered before surgery on stress-related hormones were studied in 36 patients undergoing elective aortocoronary bypass grafting. Low-dose Ringer's solution (10 ml/kg; low-dose crystalloid group [LDC]), high-dose Ringer's solution (20 ml/kg; high-dose crystalloid group [(HDC]). or a combination of Ringer's solution (10 ml/kg) with high-molecular weight hydroxyethylstarch (HES) (10 ml/kg) (crystalloid-HES group [C-HES]) were randomly administered prior to operation. Haemodynamic variables and plasma concentrations of ADH, ACTH, renin, aldosterone, cortisol and catecholamines were studied before volume load, before commencement of cardiopulmonary bypass (CPB), and immediately after weaning from CPB.

Cardiac index and stroke volume index in the C-HES group increased by 20% and 18% respectively, systemic vascular resistance decreased by 25% after volume infusion. This was associated with a decrease in the plasma concentrations of ADH, renin and aldosterone. In contrast to this, in the LDC and HDC groups, haemodynamic parameters remained almost unchanged after volume load. This was associated with an increase in aldosterone (LDC 20%; HDC 58%) and renin (LDC 110%; HDC 44%). In all groups, plasma concentrations of catecholamines increased progressively during the time of surgery and were not influenced by the nature or volume of fluid administered.

We conclude that the administration of a combination of crystalloid and colloid solutions during induction of anaesthesia effectively improves haemodynamics and attenuates the increase of the plasma levels of ADH, renin and aldosterone often associated with surgery.

Enhancing seedling production of native species to restore gypsum habitats

Gypsum habitats are widespread globally and are important for biological conservation. Nevertheless, they are often affected by human disturbances and thus require restoration. Sowing and planting have shown positive results, but these actions are usually limited by the lack of native plant material in commercial nurseries, and very little information is available on the propagation of these species. We address this issue from the hypothesis that gypsum added to a standard nursery growing medium (peat) can improve seedling performance of gypsum species and, therefore, optimise the seedling production for outplanting purposes. We test the effect of gypsum on emergence, survival, and growth of nine native plant species, including gypsophiles (exclusive to gypsum) and gypsovags (non-exclusive to gypsum). We used four treatments according to the proportions, in weight, of gypsum:standard peat (G:S), i.e. high-g (50G:50S), medium-g (25G:75S), low-g (10G:90S), and standard-p (0G:100S). Our results showed that the gypsum treatments especially benefited the emergence stage, gypsophiles as group, and Ononis tridentata as a taxon. In particular, the gypsum treatments enhanced emergence of seven species, survival of three species, and growth of two gypsophiles, while the use of the standard peat favoured only the emergence or growth of three gypsovags. Improving emergence and survival at the nursery can provide a reduction of costs associated with seed harvesting, watering, and space, while enlarging seedlings can favour the establishment of individuals after outplanting. Thus, we suggest adding gypsum to standard peat for propagating seedlings in species from gypsum habitats, thereby potentially cutting the costs of restoring such habitats. Our assessment enables us to provide particular advice by species. In general, we recommend using between 25 and 50% of gypsum to propagate gypsophiles, and between 0 and 10% for gypsovags. The results can benefit not only the production of widely distributed species commonly affected by gypsum quarrying, but also of narrow and threatened endemic species that require particularly efficient use of their seeds. In addition, our study highlights the importance of using appropriate growing media to propagate plants characteristic of special substrates for restoration purposes.

Polymorphism G1359A of the cannabinoid receptor gene (CNR1): allelic frequencies and influence on cardiovascular risk factors in a multicentre study of Castilla-Leon

BACKGROUND

A polymorphism (1359 G/A) of the CNR1 gene was reported as a common polymorphism in Caucasian populations and was related to cardiovascular risk factors. The present study aimed to investigate the allelic distribution of polymorphism (G1359A) of the CB1 receptor gene in a geographical area of Spain (Community of Castilla y Leon) and to evaluate the influence of this polymorphism on obesity anthropometric parameters and cardiovascular risk factors in the fasted state in obese patients.

METHODS

A population of 341 obese subjects was analysed. Tetrapolar electrical bioimpedance measurement, blood pressure measurement, a serial assessment of nutritional intake with 3 days of written food records and a biochemical analysis were all performed.

RESULTS

One hundred and seventy-seven patients (51.9%) had the genotype G1359G (wild-type group) and 164 (48.1%) patients were A carriers: G1359A (136 patients; 39.9%) or A1359A (28 patients; 8.2%) (mutant type group). The Health Area of Palencia had a lower frequency of wild-type genotype and G allelic frequency than all the other Health Areas. Segovia and Burgos Areas had a higher frequency of wild-type genotype and G allelic frequency than the other Health Areas. High-density lipoprotein (HDL) cholesterol was higher in the mutant type group and blood tryglicerides were lower in the same group.

CONCLUSIONS

In conclusion, the novel finding of the present study is the association of the mutant type group G1359A and A1359A with a better lipid profile (triglycerides and HDL cholesterol) than the wild-type group. The frequencies of this polymorphism are different among Health Areas of Castilla y Leon (Spain).

Sugar production from barley straw biomass pretreated by combined alkali and enzymatic extrusion

A pretreatment that combines a thermo-mechanical process (extrusion) with chemical and biological catalysts to produce fermentable sugars from barley straw (BS) biomass was investigated. BS was firstly extruded with alkali and then, the pretreated material (extrudate) was submitted to extrusion with hydrolytic enzymes (bioextrusion). The bioextrudate was found to have 35% (w/w dwb) of total solids in soluble form, partly coming from carbohydrate hydrolysis during bioextrusion. About 48% of soluble solids dry weight is comprised by sugars, mostly glucose and xylose. Further enzymatic hydrolysis of bioextrudate could be successfully carried out at high solid loading level of 30% (w/v), with sugar production yield of 32 g glucose and 18 g xylose/100g bioextrudate at 72 h incubation (equivalent to 96 and 52 g/l concentration, respectively). These results, together with the high level of integration of the process, indicate a great potential of this pretreatment technology for sugar production from lignocellulosic substrates.

Ethanol production from glucose and xylose obtained from steam exploded water-extracted olive tree pruning using phosphoric acid as catalyst

In this work, the effect of phosphoric acid (1% w/w) in steam explosion pretreatment of water extracted olive tree pruning at 175°C and 195°C was evaluated. The objective is to produce ethanol from all sugars (mainly glucose and xylose) contained in the pretreated material. The water insoluble fraction obtained after pretreatment was used as substrate in a simultaneous saccharification and fermentation (SSF) process by a commercial strain of Saccharomyces cerevisiae. The liquid fraction, containing mainly xylose, was detoxified by alkali and ion-exchange resin and then fermented by the xylose fermenting yeast Scheffersomyces stipitis. Ethanol yields reached in a SSF process were close to 80% when using 15% (w/w) substrate consistency and about 70% of theoretical when using prehydrolysates detoxified by ion-exchange resins. Considering sugars recovery and ethanol yields about 160g of ethanol from kg of water extracted olive tree pruning could be obtained.

Salivary cortisol increases after bariatric surgery in women

Cortisol increases have been associated with psychological and physiological stress; however, cortisol dynamics after weight loss (bariatric) surgery have not been defined. Obese participants not using exogenous glucocorticoids were eligible to participate. Female participants (n=24) provided salivary cortisol samples at bedtime, upon awakening the following morning, and 30 min after awakening before, and at 6 or 12 months after bariatric surgery. The Medical Outcomes Study Short Form-12 version 2 questionnaire regarding health-related quality of life was also completed. Preoperatively, mean body mass index was 45.1±8.1 kg/m2. Mean late night (1.8±1.1 nmol/l), awakening (10.7±7.4 nmol/l), and after-awakening (11.5±7.9 nmol/l) salivary cortisol values were within normal ranges. The cortisol awakening response (mean 21.1±79.7%, median 13.7%) was at the low end of normal. Preoperatively, participants had lower mental and physical health-related quality of life scores than US adult norms (p<0.001). Salivary cortisol was not correlated with measures of health-related quality of life. Mean BMI decreased over time (p<0.001) and participants experienced improved physical and mental health-related quality of life (p≤0.011). Postoperative late night salivary cortisol was not different from preoperative values. Awakening and after-awakening cortisol levels were higher than preoperative values (15.3±7.7 nmol/l, p=0.013; 17.5±10.2 nmol/l, p=0.005; respectively), but the cortisol awakening response was not changed (mean 26.7±66.2%; median 7.8%). Morning salivary cortisol increased at long-term follow-up after bariatric surgery. Although self-evaluated mental and physical health improved after surgery, the cortisol awakening response is at the low end of normal, which may indicate continued physiological stress.

Effect of water extraction on sugars recovery from steam exploded olive tree pruning

Biomass of olive tree pruning can be considered a suitable raw material for the production of ethanol due to its high content of potentially fermentable carbohydrates. However its high extractives content could cause condensation reactions between extractives and acid insoluble lignin during pretreatment, hindering the enzymatic hydrolysis of pretreated material. In this work, the effect of extractives removal before steam explosion of olive tree pruning was evaluated. The objectives are to recover as much glucose as possible in the extraction stage and to avoid the condensation reactions. The effect of temperature and time of water extracted material on sugars recovery was studied using a response surface method according to a central composite design. Extractive removal previous to steam explosion resulted in 20% more total sugars recovery in comparison to a material without water extraction stage.

Effect of endoxylanase and α-L-arabinofuranosidase supplementation on the enzymatic hydrolysis of steam exploded wheat straw

The cost and hydrolytic efficiency of enzymes are major factors that restrict the commercialization of the bioethanol production process from lignocellulosic biomass. Hemicellulases and other accessory enzymes are becoming crucial to increase enzymatic hydrolysis (EH) yields at low cellulase dosages. The aim of this work was to evaluate the effect of two recombinant hemicellulolytic enzymes on the EH of steam pretreated wheat straw. Pretreatments at two severity conditions were performed and the whole slurry obtained after steam explosion pretreatment was employed as substrate. An endoxylanase (Xln C) from Aspergillus nidulans and an α-L-arabinofuranosidase (AF) from Aspergillus niger, have been applied in combination with cellulase enzymes. A degree of synergism of 29.5% and increases up to 10% in the EH yields were obtained, showing the potential of accessory activities to improve the EH step and make the whole process more effective.

Analysis of 2735 canine uroliths in Spain and Portugal. A retrospective study: 2004-2006

The objective of the study was to evaluate epidemiological data derived from 2735 canine uroliths received by Hill's Pet Nutrition from Spain and Portugal between January 2004 and December 2006. The results of quantitative analysis from Minnesota Urolith Center (MUC) were compared with that from other countries and interrelations of mineral composition, age, breed, and gender were determined. The most frequent calculus was calcium oxalate (38.1%) followed by struvite (32.9%). Eighty-three breeds plus crossbreeds (25%) were identified. In all of them, but Dalmatians, calcium oxalate and struvite accounted for 71-78%. The mean age of urolith appearance was 7.6 years. There was a significant difference in the frequency of different uroliths composition among the six most common breeds presenting urolithiasis in Spain and Portugal (Yorkshire terrier, Miniature Schnauzer, Cocker Spaniel, Poodle, Shih Tzu and Dalmatian). This is the first report on xanthine urolithiasis found in Spain. Prevalence of cystine calculi was significantly lower (3.2%) than that reported previously in parts of Spain (26%).

Polymorphism Ala54Thr of fatty acid-binding protein 2: Allelic frequencies and influence on cardiovascular risk factors in a multicenter study of Castilla y Leon

BACKGROUND

A transition of guanin to alanin at codon 54 of the fatty acid-binding protein 2 gene (FABP2) results in an amino acid substitution (Ala54 to Thr54). This polymorphism was associated with some cardiovascular risk factors.

OBJECTIVE

The aim of our study was to investigate the influence of the Thr54 polymorphism in the FABP2 gene on obesity anthropometric parameters and cardiovascular risk factors in the fasted state in obese subjects and the allelic distribution of this polymorphism in a geographic area of Spain.

DESIGN

A population of 264 obese subjects was analyzed in a cross-sectional study from all health centers of Castilla y Leon (Spain). A nutritional and biochemical evaluation was performed. The statistical analysis was performed for the combined Ala54/Thr54 and Thr54/Thr54 genotype as a dominant model.

RESULTS

The mean age was 41.1 ± 13.1 years and the mean BMI 36.5 ± 5.9, with 94 males (35.6%) and 170 females (74.4%). One hundred and fifty-three subjects (58%) had the genotype Ala54/Ala54 (wild-type group) and 111 (42%) participants had the genotype Ala54/Thr54 (n = 92, 34.8%) or Thr54/Thr54 (n = 19, 7.2%) (mutant-type group). The health area of Valladolid had a lower frequency of wild-type genotype and Ala54 allelic frequency than all the other health areas of Castilla y Leon. C-reactive protein was higher in the mutant-type than the wild-type group (3.4 ± 5.6 vs. 7.9 ± 10.4 mg/dl; p < 0.05).

CONCLUSION

The finding of this study is the association of the Thr54/Ala54 and Thr54/Thr54 FABP2 phenotypes with higher levels of C-reactive protein without relation to insulin resistance. Frequencies of this polymorphism are different among health areas of Castilla y Leon.

Pretreatment technologies for an efficient bioethanol production process based on enzymatic hydrolysis: A review

Biofuel produced from lignocellulosic materials, so-called second generation bioethanol shows energetic, economic and environmental advantages in comparison to bioethanol from starch or sugar. However, physical and chemical barriers caused by the close association of the main components of lignocellulosic biomass, hinder the hydrolysis of cellulose and hemicellulose to fermentable sugars. The main goal of pretreatment is to increase the enzyme accessibility improving digestibility of cellulose. Each pretreatment has a specific effect on the cellulose, hemicellulose and lignin fraction thus, different pretreatment methods and conditions should be chosen according to the process configuration selected for the subsequent hydrolysis and fermentation steps. This paper reviews the most interesting technologies for ethanol production from lignocellulose and it points out several key properties that should be targeted for low-cost and advanced pretreatment processes.

Polymorphism Trp64Arg of beta 3 adrenoreceptor gene: allelic frequencies and influence on insulin resistance in a multicenter study of Castilla-León

BACKGROUND AND OBJECTIVE

The genetic variant (Trp64Arg) is a missense mutation located within the beta3 adrenoreceptor (Beta3AR). The aim of our study was to investigate the influence of Trp64Arg polymorphism in the Beta3AR gene on insulin resistance in obese patients and the allelic distribution of this polymorphismin a geographic area of Spain.

DESIGN

A population of 264 obese patients was analyzed. A bioimpedance, blood pressure, an assessment of nutritional intake, and biochemical parameters were measured. The beta 3 adrenoreceptor gene polymorphism(Trp64Arg) was genotyped.

RESULTS

Two hundred and twenty six patients (77 males/149 females) (85.6%) had the genotype Trp64/Trp64 (wild type group) with and average age of 41.12 +/- 13.1 years and 38 patients (16 males/22 females) Trp64/Arg64 (14.4%) (mutant type group) with an average age of 40.5 +/- 12.7 years. High frequencies of Arg64 allele were observed in Salamanca and Valladolid. In the mutant type group, HOMA (3.75 +/- 2.77 vs 5.27 +/- 5.4; p < 0.05) was higher than wild type group.

CONCLUSION

The finding of this study is the association of the Trp64/Arg64 Beta3AR with higher levels of HOMA. Frequencies of this polymorphism are different among geographic areas.

Effect of different cellulase dosages on cell viability and ethanol production by Kluyveromyces marxianus in SSF processes

This study was aimed to study the effect of commercial cellulases (Celluclast 1.5 LFG) on Kluyveromyces marxianus CECT 10875 growth and ethanol production in SSF processes. Preliminary tests carried out in glucose (50 g/L) fermentation medium showed that high enzyme amounts (2.5-3.5 FPU/mL) could cause a negative effect on K. marxianus growth rate and viable cells number. However, the maximum ethanol production was not affected and about 86% of the theoretical (22 g/L) was reached in all cases independently of the enzyme dosage. In SSF experiments, cell viability was always affected by enzyme loading. Nevertheless, slight differences observed on cell viability during glucose fermentation processes with the detected concentrations of the additives did not justify the negative effect observed in SSF experiments.

Partial response to anti-CD20 monoclonal antibody treatment of severe immune thrombocytopenic purpura in a patient with common variable immunodeficiency

Immune thrombocytopenic purpura (ITP), alone or in combination with autoimmune hemolytic anemia (Evans syndrome) and/or autoimmune neutropenia, is frequent in patients with common variable immunodeficiency (CVID). A 34-year-old man with CVID had long-standing unresponsive ITP. The patient had a 9-year history of CVID on substitutive therapy with intravenous immunoglobulin (IVIG). The clinical course of CVID was complicated with refractory fistulizing inflammatory bowel disease, nodular regenerative hyperplasia of the liver, splenomegaly, severe portal hypertension, and hypercatabolism of IgG. ITP was refractory to medical therapy, including different combinations of corticosteroids, high-dose IVIG, azathioprine, and vincristine. Splenectomy was not performed because of severe portal hypertension. He received a total five doses of rituximab, a monoclonal antibody directed against CD20 antigen, at a dose of 375 mg/m(2). After an initially slow response, his platelet count increased to more than 50,000/microL by the fourth week of infusion. Therapy was well tolerated, and B lymphocytes were effectively depleted from the peripheral blood. The patient was completely tapered off glucocorticoids and maintained platelets at above 40,000/microL. The patient has not taken immunosuppressive agents for 11 months. Early treatment with rituximab might be an option for patients with CVID and ITP that do not respond to other treatments or for patients for whom a splenectomy is contraindicated.

[Current status of clinical nutrition at the network of public hospitals from Castilla y León]

INTRODUCTION

Clinical nutrition is an activity realized in most of Health Centres of France, Canada, Great Britain and USA. The aim of our work was to determine activity and resources of Nutrition Units of Hospitals in the Community of Castilla y León.

MATERIAL AND METHODS

A questionnaire was send to all Hospitals of Castilla y León (SACYL); Hospital Universitario Rio Hortega, Hospital Clinico Universitario, Hospital Comarcal de Medina del Campo, Hospital General Yagüe-Divino Vallés (Burgos), Complejo Hospitalario de Le6n, Hospital General de Segovia, Hospital Virgen de Sonsoles de Avila, Hospital Virgen de la Concha de Zamora, Hospital Comarcal de Aranda de Duero, Hospital Comarcal de Miranda, Hospital General de Soria, Hospital Clinico Universitario de Salamanca.

RESULTS

Nine Centres responded questionnaire (75%). A total of 5 Hospitals had a Unit of Nutrition (55.6%). The results showed an average of 0.37 +/- 0.55 specialists for each 400 beds, 0.87 +/- 0.63 nurses for each 400 beds and 1.91 +/- 2.3 auxiliaries for each 400 beds, with an average of 0.21 +/- 0.41 specialists for each 100,000 habitants, 0.49 +/- 0.36 nurses for each 100,000 habitants and 1.09 +/- 1.2 auxiliaries for each 100,000 habitants. The activity of these Units is demanded by other Units, with an average of 3.2 +/- 3.4 consultations per day. The main diseases of this activity were 33.3% tumoral pathology, 55.6% surgery and 11.1% neurological pathology. Oral supplements were the first intervention tool. Only 3 Centres had a home artificial nutrition consultation. The main diseases of this activity were post surgical patients (33,3%), tumoral pathology (33,3%), neurological pathology (22%) and inflammatory bowel disease (11%).

CONCLUSION

Resources in Units of Nutrition of Castilla y Leon were limited. However, activity in Hospital an in home is equal than other areas. New actions of Local Administration are necessaries to follow recommendations of Council of Europe.

Application of Fenton's reaction to steam explosion prehydrolysates from poplar biomass

The application of Fenton's reaction to enhance the fermentability of prehydrolysates obtained from steam explosion pretreatment of poplar biomass was studied. Reaction conditions of temperature and H2O2 and Fe(II) concentrations were studied. The fermentability of prehydrolysate treated by Fenton's reaction was tested by using different inoculum sizes of thermotolerant strain Kluyveromyces marxianus CECT 10875. The highest percentages of toxic compound degradation (ranging from 71 to 93% removal) were obtained at the highest H2O2 concentration tested (50 mM). However, a negative effect on fermentability was observed at this H2O2 concentration at the lower inoculum loading. An increase in inoculum size to 0.6 g/L resulted in an enhanced ethanol fermentation yield of 95% relative to control.

Estrogen inhibits GH signaling by suppressing GH-induced JAK2 phosphorylation, an effect mediated by SOCS-2

Oral estrogen administration attenuates the metabolic action of growth hormone (GH) in humans. To investigate the mechanism involved, we studied the effects of estrogen on GH signaling through Janus kinase (JAK)2 and the signal transducers and activators of transcription (STATs) in HEK293 cells stably expressing the GH receptor (293GHR), HuH7 (hepatoma) and T-47D (breast cancer) cells. 293GHR cells were transiently transfected with an estrogen receptor-alpha expression plasmid and luciferase reporters with binding elements for STAT3 and STAT5 or the beta-casein promoter. GH stimulated the reporter activities by four- to sixfold. Cotreatment with 17beta-estradiol (E(2)) resulted in a dose-dependent reduction in the response of all three reporters to GH to a maximum of 49-66% of control at 100 nM (P < 0.05). No reduction was seen when E(2) was added 1-2 h after GH treatment. Similar inhibitory effects were observed in HuH7 and T-47D cells. E(2) suppressed GH-induced JAK2 phosphorylation, an effect attenuated by actinomycin D, suggesting a requirement for gene expression. Next, we investigated the role of the suppressors of cytokine signaling (SOCS) in E(2) inhibition. E(2) increased the mRNA abundance of SOCS-2 but not SOCS-1 and SOCS-3 in HEK293 cells. The inhibitory effect of E(2) was absent in cells lacking SOCS-2 but not in those lacking SOCS-1 and SOCS-3. In conclusion, estrogen inhibits GH signaling, an action mediated by SOCS-2. This paper provides evidence for regulatory interaction between a sex steroid and the GHJAKSTAT pathway, in which SOCS-2 plays a central mechanistic role.

Ethanol production from lignocellulosic byproducts of olive oil extraction

The recent implementation of a new two-step centrifugation process for extracting olive oil in Spain has substantially reduced water consumption, thereby eliminating oil mill wastewater. However, a new high sugar content residue is still generated. In this work the two fractions present in the residue (olive pulp and fragmented stones) were assayed as substrate for ethanol production by the simultaneous saccharification and fermentation (SSF) process. Pretreatment of fragmented olive stones by sulfuric acid-catalyzed steam explosion was the most effective treatment for increasing enzymatic digestibility; however, a pretreatment step was not necessary to bioconvert the olive pulp into ethanol. The olive pulp and fragmented olive stones were tested by the SSF process using a fed-batch procedure. By adding the pulp three times at 24-h intervals, 76% of the theoretical SSF yield was obtained. Experiments with fed-batch pretreated olive stones provided SSF yields significantly lower than those obtained at standard SSF procedure. The preferred SSF conditions to obtain ethanol from olives stones (61% of theoretical yield) were 10% substrate and addition of cellulases at 15 filter paper units/g of substrate.

Psychosocial factors and intervention-associated changes in those factors as correlates of change in fruit and vegetable consumption in the Maryland WIC 5 A Day Promotion Program

This study sought to examine: (a) the relative effects of baseline demographic and psychosocial factors and an intensive nutritional intervention on changes in fruit and vegetable consumption in low-income, ethnically diverse women served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program in Maryland; (b) whether this intervention, designed to modify psychosocial factors associated with fruit and vegetable consumption, was successful in changing these factors; and (c) whether changes in these factors were associated with increased consumption. The same women from 15 WIC program sites were surveyed at baseline and postintervention 8 months later. Women randomized to the intervention group showed significantly greater mean change in self-efficacy, attitudes, social support, and knowledge of national consumption recommendations than control group women. Changes in all psychosocial factors were significantly associated with nutrition session attendance and increased consumption. In a hierarchical model, changes in these factors accounted for most of the intervention effect on increased consumption.

Gamma knife radiosurgery for the treatment of brain metastases

One hundred and ninety-three patients with brain metastases from various primary sites received Gamma Knife radiosurgery (GKR) from July 1992 to August 1997 and were reviewed to evaluate their clinical outcome. Survival follow-up was available on 173 patients. Whole-brain radiation therapy was also administered to 148 of these patients. The median survival was 13.1 months from initial detection of brain metastases, and 7.5 months from GKR. Univariate and multivariate analyses were performed to determine prognostic factors that influenced survival following GKR. Enhanced survival is observed in patients with radiosensitive tumor types, supratentorial tumor, history of brain tumor resection, controlled primary site, and absent extracranial metastases. Local lesion control was obtained in 82% of the patients according to their last follow-up MRI scan. GKR is an effective means of treating patients with brain metastases.

Insulin regulation of human hepatic growth hormone receptors: divergent effects on biosynthesis and surface translocation

Insulin modulates the biological actions of GH, but little is known about its effect on human hepatic GH receptors (GHRs). Using the human hepatoma cell line HuH7 as a model, we investigated insulin regulation of total, intracellular, and cell surface GHRs and receptor biosynthesis and turnover. Insulin up-regulated total and intracellular GHRs in a concentration-dependent manner. It increased surface GHRs in a biphasic manner, with a peak response at 10 nmol/L, and modulated GH-induced Janus kinase-2 phosphorylation in parallel with expression of surface GHRs. The abundance of GHR messenger ribonucleic acid and protein, as assessed by RT-PCR and Western analysis, respectively, markedly increased with insulin treatment. To examine whether insulin regulates GHRs at the posttranslational level, its effects on receptor surface translocation and internalization were investigated. Insulin suppressed surface translocation in a concentration-dependent manner, whereas internalization was unaffected. Moreover, insulin actions on total GHRs and surface translocation were inhibited by PD98059 and wortmannin, respectively. In conclusion, insulin regulates hepatic GHR biosynthesis and surface translocation in a reciprocal manner, with surface receptor availability the net result of the divergent effects. The divergent actions of insulin appear to be mediated by the mitogen-activated protein kinase and phosphatidylinositol 3-kinase pathways, respectively.

Effect of chip size on steam explosion pretreatment of softwood

Although considerable progress has been made in technology for converting lignocellulosic biomass into ethanol, substantial opportunities still exist to reduce production costs. In biomass pretreatment, reducing milling power is a technological improvement that will substantially lower production costs for ethanol. Improving sugar yield from hemicellulose hydrolysis would also reduce ethanol production costs. Thus, it would be desirable to test innovative pretreatment conditions to improve the economics by reducing electrical power of the milling stage and by optimizing pretreatment recovery of hemicellulose, as well as to enhance cellulose hydrolysis. The objective of this study was to evaluate the effect of chip size (2-5, 5-8, and 8-12 mm) on steam-explosion pretreatment (190 and 210 degrees C, 4 and 8 min) of softwood (Pinus pinaster).

Distribution and abundance of messenger ribonucleic acid for growth hormone receptor isoforms in human tissues

Two alternatively spliced exon 9 variants of human GH receptor (GHR) messenger ribonucleic acid (mRNA), GHR-(1-279) and GHR(1-277), were recently identified in liver. They encode receptor proteins lacking most of the intracellular domain and inhibit GH action in a dominant negative manner. Little is known about tissue distribution and abundance of these GHR isoforms. We have developed quantitative RT-PCR assays specific for the full-length and truncated GHRs and investigated their expression in various human tissues and cell lines. The mRNA of full-length GHR and GHR-(1-279) were readily detectable in all tissues investigated, with liver, fat, muscle, and kidney showing high levels of expression. These two receptor isoforms were also detected in a range of human cell lines, with strongest expression in IM9, a lymphoblastoid cell line. In contrast, GHR-(1277) message was expressed at low levels in liver, fat, muscle, kidney, and prostate and in trace amount in IM9 cells. Full-length GHR was the most abundant isoform, accounting for over 90% of total receptor transcripts in liver, fat, and muscle for quantitative RT-PCR. However, liver had 2- to 4-fold more full-length receptor mRNA and 16- to 40-fold more GHR-(1-277) mRNA than fat and muscle, whereas the mRNA levels of GHR-(1-279) were similar in the three tissues. GHR-(1-279) constituted less than 4% in liver and 7-10% in fat and muscle. GHR-(1-277) accounted for 0.5% of total GHR transcripts in liver and less than 0.1% in the other two tissues. These data suggest that the absolute and relative abundance of mRNA of the three GHR isoforms may be tissue specific. The regulation of expression of exon 9 alternatively spliced GHR variants may provide a potential mechanism for modulation of GH sensitivity at the tissue level.

Protein oxidation in response to increased transcriptional or translational errors

In this study, we show a correlation between synthesis of aberrant proteins and their oxidative modification. The level of aberrant proteins was elevated in Escherichia coli cultures by decreasing transcriptional or translational fidelity using specific mutations or drugs. Protein carbonylation, an oxidative modification, increased in parallel to the induction of the heat shock chaperone GroEL. As the protein turnover rates and level of intracellular oxidative stress remained unchanged, it appears that carbonylation results from the increased susceptibility of the misfolded proteins. These studies show that the cellular protein oxidation is not limited only by available reactive oxygen species, but by the levels of aberrant proteins. Thus, protein oxidation seen in aging cells may be the consequence also of reduced transcriptional/translational fidelity, and protein structures appear to have evolved to minimize oxidative damage. In addition, we discuss the possibility that carbonylation, being an unrepairable protein modification, may serve as a tagging system to shunt misfolded proteins between pathways of refolding by chaperones or the proteolytic apparatus.