Identification of Olives Using In-Field Hyperspectral Imaging with Lightweight Models

During the growing season, olives progress through nine different phenological stages, starting with bud development and ending with senescence. During their lifespan, olives undergo changes in their external color and chemical properties. To tackle these properties, we used hyperspectral imaging during the growing season of the olives. The objective of this study was to develop a lightweight model capable of identifying olives in the hyperspectral images using their spectral information. To achieve this goal, we utilized the hyperspectral imaging of olives while they were still on the tree and conducted this process throughout the entire growing season directly in the field without artificial light sources. The images were taken on-site every week from 9:00 to 11:00 a.m. UTC to avoid light saturation and glitters. The data were analyzed using training and testing classifiers, including Decision Tree, Logistic Regression, Random Forest, and Support Vector Machine on labeled datasets. The Logistic Regression model showed the best balance between classification success rate, size, and inference time, achieving a 98% F1-score with less than 1 KB in parameters. A reduction in size was achieved by analyzing the wavelengths that were critical in the decision making, reducing the dimensionality of the hypercube. So, with this novel model, olives in a hyperspectral image can be identified during the season, providing data to enhance a farmer's decision-making process through further automatic applications.

Gluten-sensitive enteropathy in recessive dystrophic epidermolysis bullosa

Recessive dystrophic epidermolysis bullosa (RDEB) is a blistering genodermatosis due to biallelic loss-of-function variants in the type VII collagen (C7) gene (COL7A1). We report the impact of inflammation/autoimmunity on the gut (and other organs) in the nine children with RDEB recruited to an early-phase clinical trial of systemic cell therapy (NCT04153630). This pilot study provides evidence that autoimmunity may play an important role in sustaining chronic inflammation and the coexistence of coeliac disease, which, in turn, could exacerbate anaemia/malnutrition and progression in RDEB. Testing this hypothesis in a larger cohort including children and adults with RDEB and other epidermolysis bullosa (EB) subtypes is warranted so that targeted interventions may improve outcomes.

Data Acquisition for Condition Monitoring in Tactical Vehicles: On-Board Computer Development

This paper outlines the development of an onboard computer prototype for data registration, storage, transformation, and analysis. The system is intended for health and use monitoring systems in military tactical vehicles according to the North Atlantic Treaty Organization Standard Agreement for designing vehicle systems using an open architecture. The processor includes a data processing pipeline with three main modules. The first module captures the data received from sensor sources and vehicle network buses, performs a data fusion, and saves the data in a local database or sends them to a remote system for further analysis and fleet management. The second module provides filtering, translation, and interpretation for fault detection; this module will be completed in the future with a condition analysis module. The third module is a communication module for web serving data and data distribution systems according to the standards for interoperability. This development will allow us to analyze the driving performance for efficiency, which helps us to know the vehicle's condition; the development will also help us deliver information for better tactical decisions in mission systems. This development has been implemented using open software, allowing us to measure the amount of data registered and filter only the relevant data for mission systems, which avoids communication bottlenecks. The on-board pre-analysis will help to conduct condition-based maintenance approaches and fault forecasting using the on-board uploaded fault models, which are trained off-board using the collected data.

Untargeted metabolomic study by liquid chromatography-mass spectrometry in brain tissues on the effects of combined cocaine and ethanol self-administration in male and female young rats

The combined use of ethanol and cocaine is frequent among drug-abuse users and leads to further exacerbation of health consequences compared to individual consumption and this is of special concern during the transition to adulthood. Despite its high prevalence, the effect of combined consumption of cocaine and ethanol has been scarcely studied. In this work, we report the first untargeted metabolomic study in brain tissues to contribute to the advancement in the knowledge of the possible neurobiological effects of this polysubstance dependence. Liquid Chromatography coupled to high resolution Mass Spectrometry was employed to analyze three different brain tissues samples, prefrontal cortex, striatum and hippocampus, from male and female young rats exposed intravenously to a self-administration of these drugs. After optimizing the best sample treatment and selecting the chromatographic and detection conditions to find the maximum number of significant features (possible biomarker metabolites), the high resolution of the Orbitrap analyzer used in this work has made it possible to find up to 761 significant features with assigned molecular formula, of which up to 190 were tentatively identified and 44 unequivocally confirmed. The results demonstrated that the altered metabolic pathways are involved in multiple functions: receptor systems, such as the Glutamine-Glutamic acid-GABA axis or the catecholamine pathway, purinergic and pyrimidine pathways, fatty acids or oxidative stress, among others.

Untargeted metabolomic analysis to explore the impact of soil amendments in a non-conventional wastewater treatment

As non-conventional wastewater treatment, vegetation filters make the most of the natural attenuation processes that occur in soil to remove contaminants, while providing several environmental benefits. However, this practice may introduce contaminants of emerging concern (CECs) and their transformation products (TPs) into the environment. A potential improvement to the system was tested using column experiments containing soil (S) and soil amended with woodchips (SW) or biochar (SB) irrigated with synthetic wastewater that included 11 selected CECs. This study evaluated: i) known CECs attenuation and ii) unknown metabolites formation. Known CECs attenuation was assessed by total mass balance by considering both water and soil media. An untargeted metabolomic strategy was developed to assess the formation of unknown metabolites and to identify them in water samples. The results indicated that SB enhanced CECs attenuation and led to the formation of fewer metabolites. Sorption and biodegradation processes were favored by the bigger surface area of particles in SB column, especially for compounds with negative charges. Incorporating woodchips into soil shortened retention times in the column, which reduced attenuation phenomena and resulted in the formation of significantly more metabolites. Incomplete biodegradation reactions, fostered by shorter retention times in SW column could mainly explain these results.

A General-Purpose Distributed Analytic Platform Based on Edge Computing and Computational Intelligence Applied on Smart Grids

Currently, in many data landscapes, the information is distributed across various sources and presented in diverse formats. This fragmentation can pose a significant challenge to the efficient application of analytical methods. In this sense, distributed data mining is mainly based on clustering or classification techniques, which are easier to implement in distributed environments. However, the solution to some problems is based on the usage of mathematical equations or stochastic models, which are more difficult to implement in distributed environments. Usually, these types of problems need to centralize the required information, and then a modelling technique is applied. In some environments, this centralization may cause an overloading of the communication channels due to massive data transmission and may also cause privacy issues when sending sensitive data. To mitigate this problem, this paper describes a general-purpose distributed analytic platform based on edge computing for distributed networks. Through the distributed analytical engine (DAE), the calculation process of the expressions (that requires data from diverse sources) is decomposed and distributed between the existing nodes, and this allows sending partial results without exchanging the original information. In this way, the master node ultimately obtains the result of the expressions. The proposed solution is examined using three different computational intelligence algorithms, i.e., genetic algorithm, genetic algorithm with evolution control, and particle swarm optimization, to decompose the expression to be calculated and to distribute the calculation tasks between the existing nodes. This engine has been successfully applied in a case study focused on the calculation of key performance indicators of a smart grid, achieving a reduction in the number of communication messages by more than 91% compared to the traditional approach.

Metabolic fingerprinting of chemotherapy-resistant prostate cancer stem cells. An untargeted metabolomic approach by liquid chromatography-mass spectrometry

Chemoresistance is one of the most important challenges in cancer therapy. The presence of cancer stem cells within the tumor may contribute to chemotherapy resistance since these cells express high levels of extrusion pumps and xenobiotic metabolizing enzymes that inactivate the therapeutic drug. Despite the recent advances in cancer cell metabolism adaptations, little is known about the metabolic adaptations of the cancer stem cells resistant to chemotherapy. In this study, we have undertaken an untargeted metabolomic analysis by liquid chromatography–high-resolution spectrometry combined with cytotoxicity assay, western blot, quantitative real-time polymerase chain reaction (qPCR), and fatty acid oxidation in a prostate cancer cell line resistant to the antiandrogen 2-hydroxiflutamide with features of cancer stem cells, compared to its parental androgen-sensitive cell line. Metabolic fingerprinting revealed 106 out of the 850 metabolites in ESI+ and 67 out of 446 in ESI- with significant differences between the sensitive and the resistant cell lines. Pathway analysis performed with the unequivocally identified metabolites, revealed changes in pathways involved in energy metabolism as well as posttranscriptional regulation. Validation by enzyme expression analysis indicated that the chemotherapy-resistant prostate cancer stem cells were metabolically dormant with decreased fatty acid oxidation, methionine metabolism and ADP-ribosylation. Our results shed light on the pathways underlying the entry of cancer cells into dormancy that might contribute to the mechanisms of drug resistance.

El Campus Virtual de Salud Pública de la Organización Panamericana de la Salud como estrategia de cooperación técnica

El Campus Virtual de Salud Pública es la plataforma educativa de la Organización Panamericana de la Salud, concebida como herramienta para la cooperación técnica.

Los objetivos de este artículo son caracterizar la oferta de formación del Campus Virtual de Salud Pública identificando las propuestas de cursos virtuales; caracterizar a los participantes de los cursos; describir los procesos de actualización tecnológica y sus avances en términos de accesibilidad; e identificar su relación con las principales líneas de cooperación de la Organización Panamericana de la Salud.

El Campus Virtual de Salud Pública ha desarrollado 210 cursos con tutoría y 226 de autoaprendizaje desde 2007, relacionados con las políticas de la Organización. Se verificó un uso heterogéneo del campus en las distintas temáticas de la cooperación. La cantidad de cursos autoadministrados realizados durante la pandemia superó la cifra total acumulada en años previos.

Los participantes provienen principalmente de Latinoamérica. Un 67,5% son mujeres, con edades entre 26 y 45 años. Un 57,1% posee educación universitaria, principalmente en enfermería o medicina. La mitad trabaja en hospitales y un 35,8% en el primer nivel.

Más de un 90% de los participantes evaluaron favorablemente los temas abordados, recursos de conocimiento y características del aula virtual. Como dificultades, señalan escasa disponibilidad de tiempo y bajo acceso a internet. Como ventajas, destacan autonomía de horarios y acceso a diversas fuentes de información. Las herramientas de evaluación disponibles no son suficientes para reconocer el impacto de los programas educativos.

Se plantean los desafíos de profundizar en la accesibilidad y calidad de las propuestas educativas, fortalecer la relación con los temas de cooperación y mejorar la evaluación de los cursos y el conocimiento sobre los usuarios.

Mechanistic interrogation of mutation-independent disease modulators of RDEB identifies the small leucine-rich proteoglycan PRELP as a TGF-β antagonist and inhibitor of fibrosis

Recessive dystrophic epidermolysis bullosa (RDEB) is a genetic extracellular matrix disease caused by deficiency in type VII collagen (Col VII). The disease manifests with devastating mucocutaneous fragility leading to progressive fibrosis and metastatic squamous cell carcinomas. Although collagen VII abundance is considered the main predictor of symptom course, previous studies have revealed the existence of mutation-independent mechanisms that control disease progression. Here, to investigate and validate new molecular modifiers of wound healing and fibrosis in a natural human setting, and toward development of disease-modulating treatment of RDEB, we performed gene expression profiling of primary fibroblast from RDEB siblings with marked phenotypic variations, despite having equal COL7A1 genotype. Gene enrichment analysis suggested that severe RDEB was associated with enhanced response to TGF-β stimulus, oxidoreductase activity, and cell contraction. Consistently, we found an increased response to TGF-β, higher levels of basal and induced reactive oxygen species (ROS), and greater contractile ability in collagen lattices in RDEB fibroblasts (RDEBFs) from donors with severe RDEB vs mild RDEB. Treatment with antioxidants allowed a reduction of the pro-fibrotic and contractile phenotype. Importantly, our analyses revealed higher expression and deposition in skin of the relatively uncharacterized small leucine-rich extracellular proteoglycan PRELP/prolargin associated with milder RDEB manifestations. Mechanistic investigations showed that PRELP effectively attenuated fibroblasts' response to TGF-β1 stimulus and cell contractile capacity. Moreover, PRELP overexpression in RDEBFs enhanced RDEB keratinocyte attachment to fibroblast-derived extracellular matrix in the absence of Col VII. Our results highlight the clinical relevance of pro-oxidant status and hyper-responsiveness to TGF-β in RDEB severity and progression. Of note, our study also reveals PRELP as a novel and natural TGF-β antagonist with a likely dermo-epidermal pro-adhesive capacity.

Machine Learning for Shape Memory Graphene Nanoribbons and Applications in Biomedical Engineering

Shape memory materials have been playing an important role in a wide range of bioengineering applications. At the same time, recent developments of graphene-based nanostructures, such as nanoribbons, have demonstrated that, due to the unique properties of graphene, they can manifest superior electronic, thermal, mechanical, and optical characteristics ideally suited for their potential usage for the next generation of diagnostic devices, drug delivery systems, and other biomedical applications. One of the most intriguing parts of these new developments lies in the fact that certain types of such graphene nanoribbons can exhibit shape memory effects. In this paper, we apply machine learning tools to build an interatomic potential from DFT calculations for highly ordered graphene oxide nanoribbons, a material that had demonstrated shape memory effects with a recovery strain up to 14.5% for 2D layers. The graphene oxide layer can shrink to a metastable phase with lower constant lattice through the application of an electric field, and returns to the initial phase through an external mechanical force. The deformation leads to an electronic rearrangement and induces magnetization around the oxygen atoms. DFT calculations show no magnetization for sufficiently narrow nanoribbons, while the machine learning model can predict the suppression of the metastable phase for the same narrower nanoribbons. We can improve the prediction accuracy by analyzing only the evolution of the metastable phase, where no magnetization is found according to DFT calculations. The model developed here allows also us to study the evolution of the phases for wider nanoribbons, that would be computationally inaccessible through a pure DFT approach. Moreover, we extend our analysis to realistic systems that include vacancies and boron or nitrogen impurities at the oxygen atomic positions. Finally, we provide a brief overview of the current and potential applications of the materials exhibiting shape memory effects in bioengineering and biomedical fields, focusing on data-driven approaches with machine learning interatomic potentials.

Decision Support System to Classify and Optimize the Energy Efficiency in Smart Buildings: A Data Analytics Approach

In this paper, an intelligent data analysis method for modeling and optimizing energy efficiency in smart buildings through Data Analytics (DA) is proposed. The objective of this proposal is to provide a Decision Support System (DSS) able to support experts in quantifying and optimizing energy efficiency in smart buildings, as well as reveal insights that support the detection of anomalous behaviors in early stages. Firstly, historical data and Energy Efficiency Indicators (EEIs) of the building are analyzed to extract the knowledge from behavioral patterns of historical data of the building. Then, using this knowledge, a classification method to compare days with different features, seasons and other characteristics is proposed. The resulting clusters are further analyzed, inferring key features to predict and quantify energy efficiency on days with similar features but with potentially different behaviors. Finally, the results reveal some insights able to highlight inefficiencies and correlate anomalous behaviors with EE in the smart building. The approach proposed in this work was tested on the BlueNet building and also integrated with Eugene, a commercial EE tool for optimizing energy consumption in smart buildings.

A retrospective analysis of the impact of the COVID-19 restrictions on energy consumption at a disaggregated level

Since the emergence of the virus that causes COVID-19 (the SARS-CoV-2) in Wuhan in December 2019, societies all around the world have had to change their normal life patterns due to the restrictions and lockdowns imposed by governments. These changes in life patterns have a direct reflection on energy consumption. Thanks to Smart Grid technologies, specifically to the Advance Metering Infrastructure at secondary distribution network, this impact can be evaluated even at the customer level. Thus, this paper analyzes the consumption behavior and the impact that this crisis has had using Smart Meter data. The proposed approach includes the selection and normalization of features, automatic clustering, the obtaining of the estimated consumption without considering the crisis (at short and mid-terms) and the impact evaluation. The proposed approach has been tested on a case with a real Smart Meter infrastructure from Manzanilla (Huelva, Spain). The results of this use case showed that residential customers have increased their consumption around 15% during full lockdown and 7.5% during the reopening period. In contrast, globally, non-residential customers have decreased their consumption 38% during full lockdown and 14.5% during the reopening period. However, referring to non-residential customers, five different consumption profiles were found with different short-term and mid-term behaviors during the COVID crisis. The different behavior found shows customers who have maintained their normal consumption during the lockdown, others who have reduced it (to a greater or lesser extent) and have not recovered it after the removal of the restrictions, and others who have reduced the consumption but then they recovered it when the restrictions were removed. The metadata of the customers in each behavior cluster found are highly correlated to the restrictions imposed to control the spread of the virus. This study shows evidence about the proposed approach usefulness to analyze the behavior and the impact at customer level during the COVID-19 crisis.

Flexibility Services Based on OpenADR Protocol for DSO Level

Nowadays, Distribution System Operators are increasing the digitalization of their smart grids, making it possible to measure and manage their state at any time. However, with the massive eruption of change-distributed generation (e.g., renewable resources, electric vehicles), the grid operation have become more complex, requiring specific technologies to balance it. In this sense, the demand-side management is one of its techniques; the demand response is a promising approach for providing Flexibility Services (FSs) and complying with the regulatory directives of the energy market. As a solution, this paper proposes the use of the OpenADR (Open Automated Demand Response) standard protocol in combination with a Decentralized Permissioned Market Place (DPMP) based on Blockchain. On one hand, OpenADR hierarchical architecture based on distributed nodes provides communication between stakeholders, adding monitoring and management services. Further, this architecture is compatible with an aggregator schema that guarantees the compliance with the strictest regulatory framework (i.e., European market). On the other hand, DPMP is included at different levels of this architecture, providing a global solution to Flexibility Service Providers (FSP) that can be adapted depending on the regulation of a specific country. As a proof of concept, this paper shows the result of a real experimental case, which implements a Capacity Bidding Program where the OpenADR protocol is used as a communication method to control and monitor energy consumption. In parallel, the proposed DPMP based on Blockchain makes it possible to manage the incentives of FSs, enabling the integration of local and global markets.

Impact of Extreme Obesity and Diet-Induced Weight Loss on the Fecal Metabolome and Gut Microbiota

SCOPE

A limited number of human studies have characterized fecal microbiota and metabolome in extreme obesity and after diet-induced weight loss.

METHODS AND RESULTS

Fecal samples from normal-weight and extremely obese adults and from obese participants before and after moderate diet-induced weight loss are evaluated for their interaction with the intestinal adenocarcinoma cell line HT29 using an impedance-based in vitro model, which reveals variations in the interaction between the gut microbiota and host linked to obesity status. Microbiota composition, short chain fatty acids, and other intestinal metabolites are further analyzed to assess the interplay among diet, gut microbiota, and host in extreme obesity. Microbiota profiles are distinct between normal-weight and obese participants and are accompanied by fecal signatures in the metabolism of biliary compounds and catecholamines. Moderate diet-induced weight loss promotes shifts in the gut microbiota, and the primary fecal metabolomics features are associated with diet and the gut-liver and gut-brain axes.

CONCLUSIONS

Analyses of the fecal microbiota and metabolome enable assessment of the impact of diet on gut microbiota composition and activity, supporting the potential use of certain fecal metabolites or members of the gut microbiota as biomarkers for the efficacy of weight loss in extreme obesity.

[Comparative study of the treatment of subtrochanteric fractures in elderly patients: reconstruction nail T2 vs long Gamma nail]

INTRODUCTION

Subtrochanteric fractures are associated with a high rate of complications. Intramedullary nails have proven to be the best choice for treatment, but no implant has been shown to be superior to another. We want to study the differences between treating subtrochanteric fractures in the elderly with two different types of nails: T2 Recon vs Gamma3 long.

MATERIAL AND METHODS

Comparative retrospective study between 2013 and 2015 with 54 patients with subtrochanteric fractures and more than 65 years. The average follow-up is 12 months; 26 patients were treated with T2 Recon, and 28 with Gamma3. The duration of surgery, need for transfusion, evolution and complications of fractures were compared in both groups.

RESULTS

The duration of surgery was significantly longer for T2 Recon (p = 0.035), while the need for transfusion and fracture evolution were similar in both groups. Three cases required another surgery to achieve the final consolidation of the fracture. Two of them due to a failure of the T2 Recon implant, which represents 7.69% of the patients in this group, while the other case belonged to the Gamma3 group and it was sufficient to perform a nail dynamization.

CONCLUSIONS

We found no statistically significant differences, except for a longer surgical time in the T2 Recon group, being a surgeon-dependent variable that is not enough to prove that one nail is better than another.

The Impact of Context on Affective Norms: A Case of Study With Suspense

The emotional response to a stimulus is typically measured in three variables called valence, arousal and dominance. Based on such dimensions, Bradley and Lang (1999) published the Affective Norms for English Words (ANEW), a corpus of affective ratings for 1,034 non-contextualized words. Expanded and adapted to many languages, ANEW provides a corpus to evaluate and to predict human responses to different stimuli, and it has been used in a number of studies involving analysis of emotions. However, ANEW seems not to appropriately predict affective responses to concepts when these are contextualized in certain situational backgrounds, in which words can have different connotations from those in non-contextualized scenarios. These contextualized affective norms have not been sufficiently contrasted yet because the literature does not provide a corpus of the ANEW list in specific contexts. On this basis, this paper reports on the creation of a new corpus of affective norms for the original 1,034 ANEW words in a particular context (a fictional scene of suspense). An extensive quantitative data analysis comparing both corpora was carried out, confirming that the affective ratings are highly influenced by the context. The corpus can be downloaded as Supplementary Material.

Heterogeneous LoRa-Based Wireless Multimedia Sensor Network Multiprocessor Platform for Environmental Monitoring

The acquisition of data in protected natural environments is subordinated to actions that do not stress the life-forms present in that environment. This is why researchers face two conflicting interests: autonomous and robust systems that minimize the physical interaction with sensors once installed, and complex enough ones to capture and process higher volumes of data. On the basis of this situation, this paper analyses the current state-of-the-art of wireless multimedia sensor networks, identifying the limitations and needs of these solutions. In this sense, in order to improve the trade-off between autonomous and computational capabilities, this paper proposes a heterogeneous multiprocessor sensor platform, consisting of an ultra-low power microcontroller and a high-performance processor, which transfers control between processors as needed. This architecture allows the shutdown of idle systems and fail-safe remote reprogramming. The sensor equipment can be adapted to the needs of the project. The deployed equipment incorporates, in addition to environmental meteorological variables, a microphone input and two cameras (visible and thermal) to capture multimedia data. In addition to the hardware description, the paper provides a brief description of how long-range (LoRa) can be used for sending large messages (such as an image or a new firmware), an economic analysis of the platform, and a study on energy consumption of the platform according to different use cases.

Clinically Relevant Correction of Recessive Dystrophic Epidermolysis Bullosa by Dual sgRNA CRISPR/Cas9-Mediated Gene Editing

Gene editing constitutes a novel approach for precisely correcting disease-causing gene mutations. Frameshift mutations in COL7A1 causing recessive dystrophic epidermolysis bullosa are amenable to open reading frame restoration by non-homologous end joining repair-based approaches. Efficient targeted deletion of faulty COL7A1 exons in polyclonal patient keratinocytes would enable the translation of this therapeutic strategy to the clinic. In this study, using a dual single-guide RNA (sgRNA)-guided Cas9 nuclease delivered as a ribonucleoprotein complex through electroporation, we have achieved very efficient targeted deletion of COL7A1 exon 80 in recessive dystrophic epidermolysis bullosa (RDEB) patient keratinocytes carrying a highly prevalent frameshift mutation. This ex vivo non-viral approach rendered a large proportion of corrected cells producing a functional collagen VII variant. The effective targeting of the epidermal stem cell population enabled long-term regeneration of a properly adhesive skin upon grafting onto immunodeficient mice. A safety assessment by next-generation sequencing (NGS) analysis of potential off-target sites did not reveal any unintended nuclease activity. Our strategy could potentially be extended to a large number of COL7A1 mutation-bearing exons within the long collagenous domain of this gene, opening the way to precision medicine for RDEB.

Fibroblast activation and abnormal extracellular matrix remodelling as common hallmarks in three cancer-prone genodermatoses

BACKGROUND

Recessive dystrophic epidermolysis bullosa (RDEB), Kindler syndrome (KS) and xeroderma pigmentosum complementation group C (XPC) are three cancer-prone genodermatoses whose causal genetic mutations cannot fully explain, on their own, the array of associated phenotypic manifestations. Recent evidence highlights the role of the stromal microenvironment in the pathology of these disorders.

OBJECTIVES

To investigate, by means of comparative gene expression analysis, the role played by dermal fibroblasts in the pathogenesis of RDEB, KS and XPC.

METHODS

We conducted RNA-Seq analysis, which included a thorough examination of the differentially expressed genes, a functional enrichment analysis and a description of affected signalling circuits. Transcriptomic data were validated at the protein level in cell cultures, serum samples and skin biopsies.

RESULTS

Interdisease comparisons against control fibroblasts revealed a unifying signature of 186 differentially expressed genes and four signalling pathways in the three genodermatoses. Remarkably, some of the uncovered expression changes suggest a synthetic fibroblast phenotype characterized by the aberrant expression of extracellular matrix (ECM) proteins. Western blot and immunofluorescence in situ analyses validated the RNA-Seq data. In addition, enzyme-linked immunosorbent assay revealed increased circulating levels of periostin in patients with RDEB.

CONCLUSIONS

Our results suggest that the different causal genetic defects converge into common changes in gene expression, possibly due to injury-sensitive events. These, in turn, trigger a cascade of reactions involving abnormal ECM deposition and underexpression of antioxidant enzymes. The elucidated expression signature provides new potential biomarkers and common therapeutic targets in RDEB, XPC and KS. What's already known about this topic? Recessive dystrophic epidermolysis bullosa (RDEB), Kindler syndrome (KS) and xeroderma pigmentosum complementation group C (XPC) are three genodermatoses with high predisposition to cancer development. Although their causal genetic mutations mainly affect epithelia, the dermal microenvironment likely contributes to the physiopathology of these disorders. What does this study add? We disclose a large overlapping transcription profile between XPC, KS and RDEB fibroblasts that points towards an activated phenotype with high matrix-synthetic capacity. This common signature seems to be independent of the primary causal deficiency, but reflects an underlying derangement of the extracellular matrix via transforming growth factor-β signalling activation and oxidative state imbalance. What is the translational message? This study broadens the current knowledge about the pathology of these diseases and highlights new targets and biomarkers for effective therapeutic intervention. It is suggested that high levels of circulating periostin could represent a potential biomarker in RDEB.

Confronting a Paradox: A New Perspective of the Impact of Uncertainty in Suspense

Suspense is a key narrative issue in terms of emotional gratifications. Reactions in response to this type of entertainment are positively related to enjoyment, having a significant impact on the audience's immersion and suspension of disbelief. Related to computational modeling of this feature, some automatic storytelling systems include limited implementations of suspense management system in their core. In this way, the interest of this subject in the area of creativity has resorted to different definitions from fields as narratology and the film industry, as much as several proposals of its constituent features. Among their characteristics, uncertainty is one of the most discussed in terms of impact and need: while many authors affirm that uncertainty is essential to evoke suspense, others limit or reject its influence. Furthermore, the paradox of suspense reflects the problem of including uncertainty as a component required in suspense creation systems. Due to this need to contrast the effects of the uncertainty in order to compute a general model for automatic storytelling systems, we conducted an experiment measuring suspense experienced by a group of subjects that read a story. While a group of them were told the ending of the story in advance, the members of the other group experimented the same story in chronological order. Both the subjects' reported suspense and their physiological responses are gathered and analyzed. Results provide evidence to conclude that uncertainty affects the emotional response of readers, but independently and in a different form than suspense does. It will help to propose a model in which uncertainty is processed separately as management of the amount of knowledge about the outcome available to the spectator, which acts as a control signal to modulate the input features, but not directly in suspense computing.

The role of posttraumatic stress and posttraumatic growth on online information use in breast cancer survivors

OBJECTIVE

Changes perceived as both positive (eg, posttraumatic growth [PTG]) and negative (eg, posttraumatic stress symptoms [PTSS]) have been associated with intensive Internet use among breast cancer survivors. In this multicenter study, we analyzed the role of PTG and PTSS on the amount of time spent looking for online cancer information, its content, and its psychological impact.

METHODS

Posttraumatic stress symptoms and PTG were assessed in 182 breast cancer survivors by using the Post-traumatic Stress Disorder Checklist and Post-traumatic Growth Inventory questionnaires. Subjects also completed a questionnaire about their behavior when looking for online illness-related information (ie, time spent, type of contents, and psychological impact).

RESULTS

Posttraumatic stress symptoms positively correlated with the amount of time spent looking for cancer-related information, including both medical and psychosocial content. By contrast, PTG showed no relationships with the amount of time, but with a predominant search for cancer-related psychosocial information. The psychological impact of online information was associated with participants' levels of PTG and/or PTSS. Whereas PTG was related to a decrease of women's hope, PTSS was linked to the perception of being less conscious or inadequately informed about the illness, thereby increasing feelings of distress.

CONCLUSIONS

Posttraumatic stress symptoms and PTG show relationships with the amount of time spent online, the type of information accessed online, and the psychological impact of Internet use. Health professionals should prescribe online information according to the psychological response to cancer. There is a need for professional-led online resources to provide patients with timely information as well as support sites to facilitate psychological adjustment.

[Dislocation of the proximal hallux interphalangeal joint with interposition of a sesamoid bone: a blibliographic review]

The irreducible dislocation of the hallux interphalangeal joint is an infrequent condition and only a few cases have been described. It presents as dorsal dislocation with interposition of the sesamoid bone, which has the possibility of being radiologically undetectable. We present the case of a 29 year-old patient who, after a sports trauma sustained a hallux interphalangeal dislocation that went unnoticed for eight days. Since, closed reduction was not possible, as occurred in several cases reported in the literature, open reduction was performed through a dorsal incision. Based on a bibliographic review, it is possible to state that there are several treatment options and multiple approaches, and that these lesions usually have a good prognosis.

A consensus statement on the gender perspective in lung cancer

Lung cancer is the most common cancer globally and has the highest mortality. Although this disease is not associated with a particular gender, its incidence is rising among women, who are diagnosed at an increasingly younger age compared with men. One of the main reasons for this rise is women taking up smoking. However, many non-smoking women also develop this disease. Other risk factors implicated in the differential development of lung cancer in women are genetic predisposition, tumour histology and molecular profile. Proportionally more women than men with lung cancer have a mutation in the EGFR gene. This consensus statement reviews the available evidence about the epidemiological, biological, diagnostic, therapeutic, social and psychological aspects of lung cancer in women.

[Reliability of a chronic obstructive pulmonary disease diagnosis register in Primary Care]

INTRODUCTION/OBJECTIVE

One of main limitations in studies of COPD in health databases could be the low quality of the information. Our first aim was evaluate reliability of the registry of COPD diagnosis register in Primary Care. A description and comparison is also presented of the characteristics of the patients according to the diagnostic confirmation.

MATERIAL AND METHODS

A cross-sectional study using healthcare databases of Cantabria. A pre-selected sample of 1,457 patients was obtained in which COPD diagnosis was specifically registered. COPD confirmation was classified into confirmed COPD, not confirmed-not rejected COPD, and diagnostic error (over-diagnosis). Descriptive and clinical characteristics, comorbidities, and treatments were collected in each group.

RESULTS

COPD was confirmed in 766 patients: 52.6% (95%CI: 49.9-55.2). Prevalence of over-diagnosis was 7.2% (95%CI: 5.9-8.6). There were statistically significant gender differences. In the COPD confirmed group age, tobacco consumption and severity according to FEV1 was higher. An average of 1.95 bronchial exacerbations during the last 4years was observed among diagnostic errors. Inhaled corticosteroids were prescribed in 74.9% of COPD confirmed patients, and in 41.9% of over-diagnosed patients.

CONCLUSIONS

The reliability of the COPD register was deficient, with only 52.6% with a confirmed diagnosis. Stable treatment for COPD was prescribed in all groups, highlighting the use of inhaled corticosteroids.

Independent effect of prior exacerbation frequency and disease severity on the risk of future exacerbations of COPD: a retrospective cohort study

Few studies have researched the independent effect of COPD severity on the risk of future exacerbations adjusted by previous exacerbation frequency. We aimed to analyse the independent effect of COPD severity on the risk of exacerbations in the following year, and whether this effect was stronger or not than the effect of a previous history of exacerbations. We conducted a retrospective population-based cohort study including 900 patients with confirmed COPD. Exacerbation frequency was observed for the previous year and for the following year. Patients were defined as ‘Frequent Exacerbator’ (FE) phenotype if they suffered ⩾2 exacerbations in a year, and were categorised according to the severity of COPD (GOLD Grades 1–4). Odds ratios (ORs) were estimated by logistic regression adjusting for age, gender, smoking status, severity of COPD and being FE in the previous year. The main predictor of being FE among all grades of COPD severity was a history of frequent exacerbations in the previous year: adjusted OR 4.97; 95% confidence interval (CI) (3.54–6.97). COPD severity was associated with a higher risk of being FE: Crude OR GOLD Grade 4 3.86; 95% CI (1.50–9.93). However, this association diminished after adjusting for being FE in the previous year: adjusted OR 2.08; 95% CI (0.75–5.82). Our results support that a history of frequent exacerbations in the previous year is the most important independent predictor of exacerbations in the following year, also among the most severe COPD patients. Severity of COPD would be associated with a higher risk of exacerbations, but this effect would be partly determined by the exacerbations suffered in the previous year.

Predictors of Hospitalized Exacerbations and Mortality in Chronic Obstructive Pulmonary Disease

BACKGROUND AND AIM

Exacerbations of chronic obstructive pulmonary disease (COPD) carry significant consequences for patients and are responsible for considerable health-care costs-particularly if hospitalization is required. Despite the importance of hospitalized exacerbations, relatively little is known about their determinants. This study aimed to analyze predictors of hospitalized exacerbations and mortality in COPD patients.

METHODS

This was a retrospective population-based cohort study. We selected 900 patients with confirmed COPD aged ≥35 years by simple random sampling among all COPD patients in Cantabria (northern Spain) on December 31, 2011. We defined moderate exacerbations as events that led a care provider to prescribe antibiotics or corticosteroids and severe exacerbations as exacerbations requiring hospital admission. We observed exacerbation frequency over the previous year (2011) and following year (2012). We categorized patients according to COPD severity based on forced expiratory volume in 1 second (Global Initiative for Chronic Obstructive Lung Disease [GOLD] grades 1-4). We estimated the odds ratios (ORs) by logistic regression, adjusting for age, sex, smoking status, COPD severity, and frequent exacerbator phenotype the previous year.

RESULTS

Of the patients, 16.4% had ≥1 severe exacerbations, varying from 9.3% in mild GOLD grade 1 to 44% in very severe COPD patients. A history of at least two prior severe exacerbations was positively associated with new severe exacerbations (adjusted OR, 6.73; 95% confidence interval [CI], 3.53-12.83) and mortality (adjusted OR, 7.63; 95%CI, 3.41-17.05). Older age and several comorbidities, such as heart failure and diabetes, were similarly associated.

CONCLUSIONS

Hospitalized exacerbations occurred with all grades of airflow limitation. A history of severe exacerbations was associated with new hospitalized exacerbations and mortality.

Evaluation of MPEG-7-Based Audio Descriptors for Animal Voice Recognition over Wireless Acoustic Sensor Networks

Environmental audio monitoring is a huge area of interest for biologists all over the world. This is why some audio monitoring system have been proposed in the literature, which can be classified into two different approaches: acquirement and compression of all audio patterns in order to send them as raw data to a main server; or specific recognition systems based on audio patterns. The first approach presents the drawback of a high amount of information to be stored in a main server. Moreover, this information requires a considerable amount of effort to be analyzed. The second approach has the drawback of its lack of scalability when new patterns need to be detected. To overcome these limitations, this paper proposes an environmental Wireless Acoustic Sensor Network architecture focused on use of generic descriptors based on an MPEG-7 standard. These descriptors demonstrate it to be suitable to be used in the recognition of different patterns, allowing a high scalability. The proposed parameters have been tested to recognize different behaviors of two anuran species that live in Spanish natural parks; the Epidalea calamita and the Alytes obstetricans toads, demonstrating to have a high classification performance.

Prevalence of Influenza Vaccination in Chronic Obstructive Pulmonary Disease Patients and Impact on the Risk of Severe Exacerbations

OBJECTIVE

To determine the prevalence of influenza vaccination in chronic obstructive pulmonary disease (COPD) patients, and the effectiveness of the procedure.

METHODS

Retrospective population-based cohort study. On 31 December 2011, influenza vaccination history was retrieved from 899 patients with confirmed COPD selected by simple random sampling from all COPD patients in Cantabria (northern Spain). Severe exacerbations (hospitalization due to COPD exacerbation) and overall mortality during 2012 were treated as dependent variables. Odds ratios (OR) were estimated by logistic regression, adjusting for age, sex, smoking status, severity of COPD, and frequency of exacerbations during the previous year. Prevented fraction among the exposed (PFe-adjusted) was determined as a measure of impact.

RESULTS

Overall prevalence of influenza vaccination was 62.7%, but this rate fell in patients classified as more severe according to FEV1 (52.0%). Influenza vaccination showed a statistically significant protective effect against severe exacerbations in the following year: Ora: 0.54 (95%CI: 0.35-0.84); FPe-adjusted: 0.46 (95%CI: 0.16-0.65). A non-significant protective effect for overall mortality was observed: Ora: 0.76 (95%CI: 0.41-1.40). When stratified according to COPD severity (FEV1), the protective effect against risk of hospitalization was higher in more severe COPD patients: Ora: 0.23 (95%CI: 0.11-0.48); FPe-adjusted: 0.77 (95%CI: 0.52-0.89).

CONCLUSIONS

We found that influenza vaccination has a protective effect and reduces the risk of hospitalization due to exacerbations in the following year. Despite the evidence for protection, prevalence of vaccination was not optimal, especially in more severe COPD patients.

Mesenteric tumor due to chronic anisakiasis

Intestinal anisakiasis is a rare parasitic disease and difficult to diagnose due to symptoms are not specific, so it is considered an underdiagnosed disease. The clinical suspicion with a correct diagnosis of anisakiasis allows the establishment of a correct treatment; in most cases, the resolution is possible with conservative treatment, avoiding unnecessary surgery to the preoperative differential diagnosis of acute abdomen. We report the case of apatient who required urgent surgery secondary to an exacerbation of chronic anisakiasis.

Signatures of a two-dimensional ferromagnetic electron gas at the La0.7Sr0.3MnO3/SrTiO3 interface arising from orbital reconstruction

The magnetoresistance of La0.7Sr0.3MnO3/SrTiO3 superlattices with magnetic field rotating out-of-plane shows unexpected peaks for in-plane fields. Resistivity calculations with spin-orbit coupling reveal that orbital reconstruction at the manganite interface leads to a 2D ferromagnetic electron gas coupled antiparallel to the manganite "bulk". These orbital and magnetic reconstructions are supported by X-ray linear dichroism and ab initio calculations.

Burden of serious fungal infections in Spain

Estimates of the incidence and prevalence of serious fungal infections, based on epidemiological data, are essential in order to inform public health priorities given the lack of resources dedicated to the diagnosis and treatment of these serious fungal diseases. However, epidemiology of these infections is largely unknown, except for candidaemia and cryptococcosis. The aim of this work is to calculate the burden of serious fungal infections in Spain. All published epidemiology papers reporting fungal infection rates from Spain were identified. Where no data existed, we used specific populations at risk and fungal infection frequencies in those populations to estimate national incidence or prevalence, depending on the condition. Around 8.1 million people suffer a fungal infection every year. Most of them are skin or mucosal infections causing no deaths. Candidaemia is more common than in other European countries and has risen by 1.88-fold in frequency in the last decade (8.1 cases × 100,000). Good estimates of invasive aspergillosis (2.75 cases × 100,000) and mucormycosis (0.04 × 100,000) are available. Fungal infections with a high mortality such as invasive aspergillosis, candidaemia, Pneumocystis pneumonia and mucormycosis are not numerous in Spain, but they affect those with severe underlying diseases and are therefore linked to poor outcomes. Additional studies are required, especially for high burden diseases such as recurrent thrush in women (∼9000 cases × 100,000 women), allergic bronchopulmonary aspergillosis (126 cases × 100,000) and severe asthma with fungal sensitisation (198 cases × 100,000).

Competition between covalent bonding and charge transfer at complex-oxide interfaces

Here we study the electronic properties of cuprate-manganite interfaces. By means of atomic resolution electron microscopy and spectroscopy, we produce a subnanometer scale map of the transition metal oxidation state profile across the interface between the high Tc superconductor YBa2Cu3O7-δ and the colossal magnetoresistance compound (La,Ca)MnO3. A net transfer of electrons from manganite to cuprate with a peculiar nonmonotonic charge profile is observed. Model calculations rationalize the profile in terms of the competition between standard charge transfer tendencies (due to band mismatch), strong chemical bonding effects across the interface, and Cu substitution into the Mn lattice, with different characteristic length scales.

[Intensive care services resources in Spain]

OBJECTIVES

To identify the resources related to the care of critically ill patients in Spain, which are available in the units dependent of the Services of Intensive Care Medicine (ICM) or other services/specialties, analyzing their distribution according to characteristics of the hospitals and by autonomous communities.

DESIGN

Prospective observational study.

SETTING

Spanish hospitals.

PARTICIPANTS

Heads of the Services of ICM.

MAIN OUTCOME VARIABLES

Number of units and beds for critically ill patients and functional dependence.

RESULTS

The total number of registries obtained with at least one Service of ICM was 237, with a total of 100,198 hospital beds. Level iii (43.5%) and level ii (35%) hospitals predominated. A total of 73% were public hospitals and 55.3% were non-university centers. The total number of beds for adult critically ill patients, was 4,738 (10.3/100,000 inhabitants). The services of ICM registered had available 258 intensive are units (ICUs), with 3,363 beds, mainly polyvalent ICUs (81%) and 43 intermediate care units. The number of patients attended in the Services of ICM in 2008 was 174,904, with a percentage of occupation of 79.5% A total of 228 units attending critically ill patients, which are dependent of other services with 2,233 beds, 772 for pediatric patients or neonates, were registered. When these last specialized units are excluded, there was a marked predominance of postsurgical units followed by coronary and cardiac units.

CONCLUSIONS

Seventy one per cent of beds available in the Critical Care Units in Spain are characterized by attending severe adult patients, are dependent of the services of ICM, and most of them are polyvalent.

[Recommendations of the Infectious Diseases Work Group (GTEI) of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) and the Infections in Critically Ill Patients Study Group (GEIPC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) for the diagnosis and treatment of influenza A/H1N1 in seriously ill adults admitted to the Intensive Care Unit]

The diagnosis of influenza A/H1N1 is mainly clinical, particularly during peak or seasonal flu outbreaks. A diagnostic test should be performed in all patients with fever and flu symptoms that require hospitalization. The respiratory sample (nasal or pharyngeal exudate or deeper sample in intubated patients) should be obtained as soon as possible, with the immediate start of empirical antiviral treatment. Molecular methods based on nucleic acid amplification techniques (RT-PCR) are the gold standard for the diagnosis of influenza A/H1N1. Immunochromatographic methods have low sensitivity; a negative result therefore does not rule out active infection. Classical culture is slow and has low sensitivity. Direct immunofluorescence offers a sensitivity of 90%, but requires a sample of high quality. Indirect methods for detecting antibodies are only of epidemiological interest. Patients with A/H1N1 flu may have relative leukopenia and elevated serum levels of LDH, CPK and CRP, but none of these variables are independently associated to the prognosis. However, plasma LDH> 1500 IU/L, and the presence of thrombocytopenia <150 x 10(9)/L, could define a patient population at risk of suffering serious complications. Antiviral administration (oseltamivir) should start early (<48 h from the onset of symptoms), with a dose of 75 mg every 12h, and with a duration of at least 7 days or until clinical improvement is observed. Early antiviral administration is associated to improved survival in critically ill patients. New antiviral drugs, especially those formulated for intravenous administration, may be the best choice in future epidemics. Patients with a high suspicion of influenza A/H1N1 infection must continue with antiviral treatment, regardless of the negative results of initial tests, unless an alternative diagnosis can be established or clinical criteria suggest a low probability of influenza. In patients with influenza A/H1N1 pneumonia, empirical antibiotic therapy should be provided due to the possibility of bacterial coinfection. A beta-lactam plus a macrolide should be administered as soon as possible. The microbiological findings and clinical or laboratory test variables may decide withdrawal or not of antibiotic treatment. Pneumococcal vaccination is recommended as a preventive measure in the population at risk of suffering severe complications. Although the use of moderate- or low-dose corticosteroids has been proposed for the treatment of influenza A/H1N1 pneumonia, the existing scientific evidence is not sufficient to recommend the use of corticosteroids in these patients. The treatment of acute respiratory distress syndrome in patients with influenza A/H1N1 must be based on the use of a protective ventilatory strategy (tidal volume <10 ml / kg and plateau pressure <35 mmHg) and positive end-expiratory pressure set to high patient lung mechanics, combined with the use of prone ventilation, muscle relaxation and recruitment maneuvers. Noninvasive mechanical ventilation cannot be considered a technique of choice in patients with acute respiratory distress syndrome, though it may be useful in experienced centers and in cases of respiratory failure associated with chronic obstructive pulmonary disease exacerbation or heart failure. Extracorporeal membrane oxygenation is a rescue technique in refractory acute respiratory distress syndrome due to influenza A/H1N1 infection. The scientific evidence is weak, however, and extracorporeal membrane oxygenation is not the technique of choice. Extracorporeal membrane oxygenation will be advisable if all other options have failed to improve oxygenation. The centralization of extracorporeal membrane oxygenation in referral hospitals is recommended. Clinical findings show 50-60% survival rates in patients treated with this technique. Cardiovascular complications of influenza A/H1N1 are common. Such problems may appear due to the deterioration of pre-existing cardiomyopathy, myocarditis, ischemic heart disease and right ventricular dysfunction. Early diagnosis and adequate monitoring allow the start of effective treatment, and in severe cases help decide the use of circulatory support systems. Influenza vaccination is recommended for all patients at risk. This indication in turn could be extended to all subjects over 6 months of age, unless contraindicated. Children should receive two doses (one per month). Immunocompromised patients and the population at risk should receive one dose and another dose annually. The frequency of adverse effects of the vaccine against A/H1N1 flu is similar to that of seasonal flu. Chemoprophylaxis must always be considered a supplement to vaccination, and is indicated in people at high risk of complications, as well in healthcare personnel who have been exposed.

Anaerobic monodigestion of poultry manure: determination of operational parameters for CSTR

In this work the anaerobic monodigestion for the treatment of turkey manure was evaluated, without its codigestion with another substrate. The effect of the organic loading rate (OLR) and the substrate concentration (high total solids (TS) concentration) or product concentration (high volatile fatty acids (VFA) and/or ammonia (NH(3)-N) concentrations) was studied. The results show that for a continuous stirred tank reactor (CSTR) operation, a maximum of 40 g/L of TS and 4.0 g/L of ammonium (NH(4)(+)) was required. In addition, the maximum organic loading rate (OLR) will not exceed 1.5 kg VS/m(3)d. Higher TS and NH(4)(+) concentrations and OLR lead to a reduction on the methane productivity and volatile solids (VS) removal. During the CSTR operation, a high alkalinity concentration (above 10 g/L CaCO(3)) was found; this situation allowed maintaining a constant and appropriate pH (close to 7.8), despite the VFA accumulation. In this sense, the alkalinity ratio (α) is a more appropriate control and monitoring parameter of the reactor operation compared to pH. Additionally, with this parameter a VS removal of 80% with a methane productivity of 0.50 m(3)(CH4)/m(3)(R)d is achieved.

Arsenic mobilization by epilithic bacterial communities associated with volcanic rocks from Camarones River, Atacama Desert, northern Chile

The arsenic biogeochemical cycle is greatly dependent on microbial transformations that affect both the distribution and mobility of arsenic species in the environment. In this study, a microbial biofilm from volcanic rocks was characterized on the basis of its bacterial composition and ability to mobilize arsenic under circumneutral pH. Biofilm microstructure was analyzed by scanning electron microscopy (SEM)-energy-dispersive spectroscopy (EDS). Strains were isolated from biofilms and identified by 16S rDNA sequences analysis. Arsenic oxidation and reduction capacity was assayed with high-performance liquid chromatography coupled to gaseous formation performing the detection by atomic absortion in a quartz bucket (HPLC/HG/QAAS), and polymerase chain reaction was used to detect aox and ars genes. Bacterial communities associated with volcanic rocks were studied by denaturing gradient gel electrophoresis (DGGE). The SEM-EDS studies showed the presence of biofilm after 45 days of incubation. The relative closest GenBank matches of the DNA sequences, of isolated arsenic-resistant strains, showed the existence of four different genus: Burkholderia, Pseudomonas, Erwinia, and Pantoea. Four arsenite-resistant strains were isolates, and only three strains were able to oxidize >97% of the As(III) present (500 uM). All arsenate-resistant isolates were able to reduce between 69 and 86% of total As(V) (1000 uM). Analysis of 16S rDNA sequences obtained by DGGE showed the presence of four bacterial groups (∝-proteobacteria, γ-proteobacteria, Firmicutes, and Actinobacteria). Experiments demonstrate that epilithic bacterial communities play a key role in the mobilization of arsenic and metalloids speciation.