Optimizing suction force in mechanical thrombectomy: Priming the aspiration tubing with air versus saline

Objective

We sought to investigate how priming the tube between air versus air mixed with saline ex vivo influenced suction force. We examined how priming the tube influenced peak suction force and time to achieve peak suction force between both modalities.

Methods

Using a Dwyer Instruments (Dwyer Instruments Inc., Michigan City, IN, USA), INC Digitial Pressure Gauge, we were able to connect a .072 inch aspiration catheter to a rotating hemostatic valve and to aspiration tubing. We recorded suction force measured in negative inches of Mercury (inHg) over 10 iterations between having the aspiration tube primed with air alone versus air mixed with saline. A test was used to compare results between both modalities.

Results

Priming the tube with air alone compared to air mixed with saline was found to have an increased average max suction force (-28.60 versus -28.20 in HG, p<0.01). We also identified a logarithmic curve of suction force across time in which time to maximal suction force was more prompt with air compared with air mixed with saline (13.8 seconds versus 21.60 seconds, p<0.01).

Conclusions

Priming the tube with air compared to air mixed with saline suggests that not only is increased maximal suction force achieved, but also the time required to achieve maximal suction force is less. This data suggests against priming the aspiration tubing with saline and suggests that the first pass aspiration primed with air may have the greatest suction force.

Characterizing the frequency, morbidity, and types of traumatic brain injuries after the Mexico-San Diego border wall extension: a retrospective cohort review

OBJECTIVE

The aim of this study was to investigate the impact of the US-Mexico border wall height extension on traumatic brain injuries (TBIs) and related costs.

METHODS

In this retrospective cohort study, patients who presented to the UC San Diego Health Trauma Center for injuries from falling at the border wall between 2016 and 2021 were considered. Patients in the pre-height extension period (January 2016-May 2018) were compared with those in the post-height extension period (January 2020-December 2021). Demographic characteristics, clinical data, and hospital charges were analyzed.

RESULTS

A total of 383 patients were identified: 51 (0 TBIs, 68.6% male) in the pre-height extension cohort and 332 (14 TBIs, 77.1% male) in the post-height extension cohort, with mean ages of 33.5 and 31.5 years, respectively. There was an increase in the average number of TBIs per month (0.0 to 0.34) and operative TBIs per month (0.0 to 0.12). TBIs were associated with increased Injury Severity Score (8.8 vs 24.2, p < 0.001), median (IQR) hospital length of stay (5.0 [2-11] vs 8.5 [4-45] days, p = 0.03), and median (IQR) hospital charges ($163,490 [$86,369-$277,918] vs $243,658 [$136,769-$1,127,920], p = 0.04). TBIs were normalized for changing migration rates on the basis of Customs and Border Protection apprehensions.

CONCLUSIONS

This heightened risk of intracranial injury among vulnerable immigrant populations poses ethical and economic concerns to be addressed regarding border wall infrastructure.

Helical coils augment embolization of the middle meningeal artery for treatment of chronic subdural hematoma: A technical note

Embolization of the middle meningeal artery (MMA) is a safe and effective adjunct in the treatment of chronic subdural hematoma. While prior authors describe the use of coils to assist embolization by preventing reflux through eloquent collaterals, we de- scribe the use of coils to further open the MMA, allowing the administration of greater amounts of embolisate for a more robust embolization. The objective of this study was to demonstrate that helical coils can safely open the MMA following the administration of polyvinyl alcohol (PVA) particles. This allows for more embolisate to be administered into the MMA for more effective treatment. A retrospective review was conducted at our institution including intraoperative images and postoperative clinical and radiographic follow up. Failure rates using MMA embolization with PVA and helical coil augmentation were compared to failure rates in the literature of MMA embolization with PVA or ethylene vinyl-alcohol copolymer alone. A total of 8 cases were reviewed in which this technique was implemented. There were no immediate complications after treatment. All patients that underwent helical coil embolization following the administration of PVA had increased amount of embolisate delivered into the MMA. All patients at follow up had resolution of the subdural hematoma on outpatient imaging. Helical coil embolization allows for more embolisate administration into the MMA and provides a technical advantage for patients that fail traditional techniques of embolization. Case series are taking place to further test this hypothesis and identify the ideal patient population that may gain maximal yield from this novel technique.

Curación de úlceras venosas crónicas inducida con un hidrogel de aloe vera, sorbitol, alantoína y glicerol

Objetivo:

Evaluar la eficacia de un hidrogel compuesto con aloe vera, sorbitol, alantoína y glicerol, y estudiar clínicamente los niveles de interleucina 6 (IL-6) para el tratamiento de úlceras venosas (UV).

Método:

Se realizó un ensayo clínico no aleatorizado de un solo brazo en 10 sujetos. Cada sujeto fue tratado con el hidrogel durante ocho semanas. Tras completar el período de seguimiento, se realizó una evaluación final de las puntuaciones clínicas y moleculares de cada paciente, que se comparó con los datos iniciales.

Resultados:

Los pacientes tratados con el hidrogel presentaron una reducción media del área de la UV de -1,12 cm5 (±2,53), reducción media del volumen de -1,47 cm6 (±3,43) y valor medio de IL-6 perilesional de -1,81 pg/mL (±8,07). También, se encontró una reducción media de la puntuación de la gravedad clínica venosa (VCSSr) de -9,3 (±2,62) y de la puntuación del dolor en la escala visual analógica (VAS) de -5,5 (±2,22).

Conclusión:

La IL-6 es un indicador molecular útil para la vigilancia de la cicatrización de heridas. El tratamiento con un hidrogel a base de aloe vera, sorbitol y alantoína favorece la cicatrización de la herida, mejora la calidad de vida y reduce los niveles de dolor de la UV.

Conflicto de interés:

El investigador principal, Dr Jorge Ulloa, declara recepción de recursos para investigación por parte de Humany Care. Este proyecto fue financiado por Humany Care.

Curación de úlceras venosas crónicas inducida con un hidrogel de aloe vera, sorbitol, alantoína y glicerol

Objetivo:

Evaluar la eficacia de un hidrogel compuesto con aloe vera, sorbitol, alantoína y glicerol, y estudiar clínicamente los niveles de interleucina 6 (IL-6) para el tratamiento de úlceras venosas (UV).

Método:

Se realizó un ensayo clínico no aleatorizado de un solo brazo en 10 sujetos. Cada sujeto fue tratado con el hidrogel durante ocho semanas. Tras completar el período de seguimiento, se realizó una evaluación final de las puntuaciones clínicas y moleculares de cada paciente, que se comparó con los datos iniciales.

Resultados:

Los pacientes tratados con el hidrogel presentaron una reducción media del área de la UV de -1,12 cm5 (±2,53), reducción media del volumen de -1,47 cm6 (±3,43) y valor medio de IL-6 perilesional de -1,81 pg/mL (±8,07). También, se encontró una reducción media de la puntuación de la gravedad clínica venosa (VCSSr) de -9,3 (±2,62) y de la puntuación del dolor en la escala visual analógica (VAS) de -5,5 (±2,22).

Conclusión:

La IL-6 es un indicador molecular útil para la vigilancia de la cicatrización de heridas. El tratamiento con un hidrogel a base de aloe vera, sorbitol y alantoína favorece la cicatrización de la herida, mejora la calidad de vida y reduce los niveles de dolor de la UV.

Conflicto de interés:

El investigador principal, Dr Jorge Ulloa, declara recepción de recursos para investigación por parte de Humany Care. Este proyecto fue financiado por Humany Care.

AB1585-PARE DO PATIENT AND PHYSICIAN ASSESSMENTS OF A HEALTH CARE VISIT MATCH FOR HISPANIC/LATINX PATIENTS WITH RHEUMATOID ARTHRITIS IN THE UNITED STATES AND PUERTO RICO?

Background

Nonlinear associations in rheumatoid arthritis (RA) prevalence and sociodemographic indices suggest social determinants of health affect RA.1 RA screening tools have lower sensitivity and specificity for Hispanic/Latinx individuals compared with white individuals (77% vs 85% sensitivity and 45% vs 87% specificity).2 Hispanic/Latinx people also present to physicians later and with more severe RA.3 There is little research in this population to explain these differences or how they can be addressed. Because it is known the Hispanic/Latinx population has lower English-language proficiency, we hypothesized this is in part because of the lack of validated Spanish-language educational materials and research tools for RA.

Objectives

To validate a Spanish-language patient-provider questionnaire (PPQ) for Hispanic/Latinx patients with RA that had previously been validated as concordant for primary care visits in Sweden.4

To understand if rheumatologist and patient assessments for Hispanic/Latinx people with RA are concordant when using a Spanish-language digital PPQ.

To determine if a Spanish-language rheumatologist-completed PPQ could be a proxy for patient impressions in a prospective clinical study.

Methods

A Spanish-language PPQ for RA was created by translating 9 of 13 questions previously validated in the Swedish study,4 and adding a question about treating to target specific to RA. The survey was made available on tablet devices in 4 rheumatology clinics in the U.S. and Puerto Rico. Clinic staff obtained patient consent and gathered demographic information to generate a unique confidential identifier code for each visit, which was inputted into surveys on tablet devices. After the visit ended the patient and rheumatologist were each given the PPQ coded for that visit to complete independently of one another. The PPQs were submitted electronically to a secure database in which the visit code was the only identifier recorded.

Results

Across 114 clinical visits, 96.75% of possible answers were recorded and were almost invariably positive with scores of 5 (strongly agree; 88%), 4 (agree; 12%), or 3 (neither agree nor disagree; 0.09%). Physicians responded with 4 (agree) more often than patients (18% vs 6% of responses). Responses from both patient and physician were available for (96.64%) of answered questions. Within these paired answers, 80.67% were concordant (same answer from both patient and physician). Physicians answered 4 when patients answered 5 in 76.5% of discordant responses (different ratings from patient and physician). Most physician ratings of 4 came from 1 of the 4 physicians involved and only 12.5% of patients were responsible for 75% of the patient responses of 4.

Conclusion

Hispanic/Latinx patients with RA and their rheumatologist rated their communication, goal setting, and relationships extremely positively, making it difficult to evaluate true concordance and not possible to use rheumatologist-completed PPQs as proxy for patient assessments. Notably, ratings were substantially different from what is typically seen on Likert scales, which normally skew positively but with a normal distribution. This finding may reflect social determinants of health or cultural differences such as a social-desirability bias toward positive statements about physician-patient interactions. Heterogeneity within the participants is also a plausible explanation, considering that a distinct subset of respondents account for almost all responses below the 5 rating. Further research is needed to identify best practices for measuring treatment to target and patient-rheumatologist interactions in the Hispanic/Latinx population with RA.

References

[1]Safiri S, et al. Ann Rheum Dis. 2019;78(11):1463-71. doi:10.1136/annrheumdis-2019-215920

[2]Potter J, et al. J Rheumatol. 2008;35(8):1545-9. PMID: 18597406

[3]Riad M, et al. J Clin Rheumatol. 2019. doi:10.1097/RHU.0000000000001085

[4]Ahlén GC, et al. Fam Pract. 2007;24(5):498503. doi.org/10.1093/fampra/cmm043

Acknowledgements

We wish to acknowledge the important contributions of our HOPE CAPE RA participants, including the patients and providers and Anne Sydor, PhD for her invaluable advice and help throughout the project.

This project was funded by the Bristol Myers Squibb Foundation.

Disclosure of Interests

Daniel Hernandez Grant/research support from: This project is supported by the Bristol Myers Squibb Foundation, Julio Bravo Grant/research support from: This project is supported by the Bristol Myers Squibb Foundation, Juan Jose Maya Grant/research support from: This project is supported by the Bristol Myers Squibb Foundation, Oscar Soto-Raíces Grant/research support from: This project is supported by the Bristol Myers Squibb Foundation, Angel Tapia Grant/research support from: This project is supported by the Bristol Myers Squibb Foundation, Guillermo Valenzuela Grant/research support from: This project is supported by the Bristol Myers Squibb Foundation, W. Benjamin Nowell Grant/research support from: This research was supported by the Bristol Myers Squibb Foundation, Shilpa Venkatachalam Grant/research support from: This project is supported by the Bristol Myers Squibb Foundation

Robotics and Artificial Intelligence in Endovascular Neurosurgery

The use of artificial intelligence (AI) and robotics in endovascular neurosurgery promises to transform neurovascular care. We present a review of the recently published neurosurgical literature on artificial intelligence and robotics in endovascular neurosurgery to provide insights into the current advances and applications of this technology.

The PubMed database was searched for "neurosurgery" OR "endovascular" OR "interventional" AND "robotics" OR "artificial intelligence" between January 2016 and August 2021. A total of 1296 articles were identified, and after applying the inclusion and exclusion criteria, 38 manuscripts were selected for review and analysis. These manuscripts were divided into four categories: 1) robotics and AI for the diagnosis of cerebrovascular pathology, 2) robotics and AI for the treatment of cerebrovascular pathology, 3) robotics and AI for training in neuroendovascular procedures, and 4) robotics and AI for clinical outcome optimization.

The 38 articles presented include 23 articles on AI-based diagnosis of cerebrovascular disease, 10 articles on AI-based treatment of cerebrovascular disease, two articles on AI-based training techniques for neuroendovascular procedures, and three articles reporting AI prediction models of clinical outcomes in vascular disorders of the brain. Innovation with robotics and AI focus on diagnostic efficiency, optimizing treatment and interventional procedures, improving physician procedural performance, and predicting clinical outcomes with the use of artificial intelligence and robotics. Experimental studies with robotic systems have demonstrated safety and efficacy in treating cerebrovascular disorders, and novel microcatheterization techniques may permit access to deeper brain regions. Other studies show that pre-procedural simulations increase overall physician performance. Artificial intelligence also shows superiority over existing statistical tools in predicting clinical outcomes.

The recent advances and current usage of robotics and AI in the endovascular neurosurgery field suggest that the collaboration between physicians and machines has a bright future for the improvement of patient care. The aim of this work is to equip the medical readership, in particular the neurosurgical specialty, with tools to better understand and apply findings from research on artificial intelligence and robotics in endovascular neurosurgery.

Benefits of two twelve-week multimodal programs on reaction time in community dwellings at risk of falling: preliminary results

Background

A slower reaction time (RT) performance is considered a risk factor for falls. Different approaches as a psychomotor intervention (involving neuromotor exercises) or the whole-body vibration (inducing neurophysiological changes) may reduce the risk of falls. Nevertheless, a combined program may promote greater gains. This study aimed to investigate the acceptability and the effect of two multimodal programs on RT in community-dwelling older adults fallers or balance-impaired.

Methods

A total of 37 participants (74.3 ± 5.2 years) were divided into two groups (3x/week): experimental group 1 (psychomotor intervention); experimental group 2 [EG2] (combined program: psychomotor intervention + whole-body vibration). The Deary-Liewald reaction time task assessed RT. Simple and choice reaction time [CRT] (ms) tasks were recorded under single and dual-task (DT) paradigms. DT cost was also computed.

Results

The attendance rate was 86.3%. Wilcoxon test comparisons revealed significant differences between baseline and post-intervention evaluations in the EG2. The improvement was observed in the variable ‘CRT-DT’, in which participants spent less time to perform the task (1026.0 ± 153.4 vs. 960.4 ± 160.9, P = 0.040). The correspondent effect size was medium (r = 0.33). The DT cost was also decreased in CRT-DT by 3.9%. No significant differences between groups were found.

Conclusions

This study demonstrated that both programs were safe and highly attended. The results suggest that a combined intervention (psychomotor intervention + whole-body vibration) should be privileged to improve RT and reduce the risk of falls. Trial Registration: ClinicalTrials.gov Identifier: NCT03446352. Funding: This study was supported by the ESACA Project (Grant ALT20-03-0145-FEDER-000007) and by FCT (SFRH/BD/147398/2019).

Novel approaches to reduce the risk of falling in community dwellings: effects of two multimodal programs in lower-body strength—a pilot study

Background

Muscle weakness is a key risk factor for falls and strength exercises should be included in fall prevention programs. A psychomotor intervention promoting motor stimulation and the whole-body vibration (WBV) providing muscle contractions may reduce the incidence of falls. Our hypothesis relies on the greater benefits of a combined program. This study aimed to evaluate the effectiveness and the feasibility of two 12-week multimodal programs in lower-body strength in community dwellings fallers or with balance impairment.

Methods

Thirty-seven participants (34 women; mean age 74.3 ± 5.2 years) were allocated into: experimental group 1 [EG1] (psychomotor intervention), or experimental group 2 [EG2] (combined program: psychomotor intervention plus WBV), 3x/week. Maximal strength of knee extensors and flexors was assessed by an isokinetic dynamometer at 60°/s. Wilcoxon and Mann-Whitney tests were performed.

Results

The overall adherence rate was high (86.3%), with a level intensity in the rating of perceived exertion of 12.1 ± 0.3 points, in EG1, and 12.5 ± 0.4 points, in EG2. Significant changes between the pre-post intervention were observed exclusively in EG2, in the variables ‘Peak torque extension’ (71.7 ± 28.6 Nm vs. 79.2 ± 23.5 Nm, P = 0.042) and ‘Agonist/Antagonist ratio’ (60.2 ± 13.0 vs. 53.5 ± 8.6, P = 0.013). The effect size (r) in both variables was medium. No significant changes between groups were detected.

Conclusions

This pilot results indicate that both programs were feasible and well-tolerated. The combined program demonstrates larger effectiveness, since the WBV may positively influence the lower-body strength, reducing the risk of falls. Trial Registration: ClinicalTrials.gov Identifier: NCT03446352. Funding: This pilot was granted by the ESACA Project (Grant ALT20-03-0145-FEDER-000007) and by FCT (SFRH/BD/147398/2019).

Vermiproductivity, maturation and microbiological changes derived from the use of liquid anaerobic digestate during the vermicomposting of market waste

Recently, it has been suggested that the liquid fraction of anaerobic digestate, derived from the treatment of wastewater and solid wastes, could be used in vermicomposting as a solution to its disposal, and even for its valorization. Nevertheless, the literature does not provide enough information about its impact on the process of vermicomposting itself and on the final quality of the end-product. In this study, the effect of different doses of digestate in the vermicomposting process treating market waste is assessed measuring earthworm population dynamics, the bacterial community succession present in the vermibeds, as well as maturation and the end-quality of the vermicompost. Our results show that the addition of liquid digestate to the vermibeds increased the earthworms biomass, i.e. 71%, 94% and 168% in control, and vermibeds with 30% and 60% digestate, respectively. Further, the increase in the amount of N in the vermicompost decreased as the digestate addition increased, i.e. 75%, 8%, 3%. The maturity achieved was high in all treatments as shown by the C/N ratio, 7.98, 7.40 and 10.20, and the high seed germination rate, above 90%. Finally, the succession of the microbial community was not disturbed and compositional stabilization was reached after 92 days.

Twelve-week multimodal programs can improve dual-task performance in risk factors for falls in community-dwelling older adults: a pilot study

Introduction Performing a dual-task (DT), mainly while walking and performing another task simultaneously, is seen as determinants factors for falls and injuries in older adults. A psychomotor intervention relying on the prevention of sensorimotor and neurocognitive deterioration may prevent falls. The whole-body vibration (WBV) promotes the increase of agility, reducing the risk of falling. However, an intervention that combines both methods can lead to additional benefits, particularly as regards DT.

Objectives To evaluate the feasibility and the effect of two multimodal programs designed for community-dwelling older adults, fallers or at high risk of falling, on DT performance ability.

Methodology Thirty-seven participants (74.3±5.2 years) were randomly assigned into experimental group 1 [EG1] (psychomotor intervention); or experimental group 2 [EG2] (psychomotor intervention + WBV). DT performance (TUGcog) was assessed by the Timed Up and Go Test (s) performed simultaneously with the counting backward cognitive task.

Results Adherence rate was 86.3%. Wilcoxon test comparisons showed improvements from baseline to post-intervention on EG1 (time (s): 10.1±2.7 vs. 9.0±2.7, p = 0.001; cognitive stops (n): 0.9±1.0 vs. 0.2±0.4, p = 0.012; motor stops (n): 0.3±0.5 vs. 0.0±0.0, p = 0.025), corresponding to an effect size (cohen’s d) ranging from 0.41 (small) to 0.92 (medium) and on EG2 (time (s): 9.9±2.5 vs. 8.5±1.8, p = 0.010; cognitive stops (n): 1.1±0.7 vs. 0.4±0.5, p = 0.004), corresponding to a d ranging from 0.64 (medium) to 1.15 (medium). There were no significant differences between groups.

Conclusion These preliminary results suggested that the multimodal programs were feasible and effective in reducing the risk of falling by improving the determinant risk factor DT performance. Trial Registration: ClinicalTrials.gov Identifier: NCT03446352. Funding: This study was funded by ESACA Project (Grant ALT20-03-0145-FEDER-000007) and by FCT (SFRH/BD/147398/2019).

172 Effect of period of insertion of a progesterone-releasing device and pro-oestrus length on follicular and luteal characteristics and pregnancy rates to fixed-time AI in Bos indicus heifers

An experiment was designed to evaluate the effect of the length of insertion of a progesterone (P4)-releasing device and the length of pro-oestrus on follicular and luteal characteristics and pregnancy rates to AI (P/AI) in Bos indicus heifers treated with oestradiol/P4-based treatments. Bos indicus beef heifers (n=374), 22-26 months of age, with a corpus luteum (CL) or at least one follicle ≥8mm in diameter and with a body condition score between 2.5 and 3.5 (1-to-5 scale) were synchronised using three treatments for fixed-time AI (FTAI). On Day 0, all heifers received 2mg of oestradiol benzoate (Sincrodiol, Ourofino) and an intravaginal device with 1g of P4 (Sincrogest, Ourofino). The P4 device was removed on Day 6 in heifers in the J-Synch 6 group (n=120) and on Day 7 in heifers in the J-Synch 7 group (n=105) and conventional group (n=165). All heifers received 500μg of cloprostenol (Sincrocio, Ourofino) and 300IU of equine chorionic gonadotrophin (SincroeCG 6000UI, Ourofino) at the time of P4 device removal. Furthermore, heifers in the conventional treatment group received 0.5mg of oestradiol cypionate (SincroCP, Ourofino) at the same time. In addition, all heifers were tail-painted for oestrus detection (CeloTest, Biotay). Heifers that had lost ≥50% of the tail paint by 70-74h (J-Synch groups) or 48-52h (conventional group) after device removal were FTAI at that time. Heifers not showing oestrus by 70-74h (J-Synch groups) or 48-52h (conventional group) received 10μg of gonadotrophin-releasing hormone (Sincroforte, Ourofino) at the same time and were FTAI 8h later. All heifers were also examined using ultrasonography (Mindray DP50 Vet) every 12h from the time of device removal to determine the time of ovulation, 6 days after ovulation to determine the diameter of the CL, and 28 days after FTAI for P/AI determination. Data were analysed using the MLGM procedure (InfoStat) for normal data families (follicular dynamics) and binary data family (P/AI). The results are shown in Table 1. The diameter of the dominant preovulatory follicle and the CL did not differ among groups (P&gt;0.12). However, the interval from device removal to ovulation was longer in heifers in the J-Synch groups than in heifers in the conventional group (P&lt;0.05). Furthermore, P/AI was not different among groups. In conclusion, although the J-Synch protocols delayed the interval from P4 device removal to ovulation, the three protocols evaluated in the present study were equally effective in Bos indicus heifers. Table 1.Mean (±s.e.m.) diameter of the preovulatory follicle (P/Foll) and corpus luteum (CL), interval from progesterone (P4) device removal to ovulation, and pregnancy rates to AI (P/AI) in Bos indicus heifers Treatment P/Foll, mm Interval to ovulation, h CL diameter, mm P/AI,% (n) J-Synch 6 10.5±0.7 101.4±2.3a 18.6±1.0 52.0 (62/120) J-Synch 7 10.6±0.7 96.0±2.2a 16.5±0.9 39.0 (41/105) Conventional 9.4±0.7 73.0±1.9b 16.8±0.9 45.0 (74/165) a,bDifferent superscripts denote differences between groups in the interval from P4 device removal to ovulation.

Antifungal activity of the essential oil obtained from Cryptocarya alba against infection in honey bees by Nosema ceranae

The honeybee disease nosemosis type C is a serious problem since its causative agent, microsporidium Nosema ceranae, is widespread among adult honey bees. Some of the feasible alternative treatments that are used to control this disease are plant extracts. The aim of the present work was to evaluate the effects of essential oils of Chilean plant species, such as Cryptocarya alba, which is used against N. ceranae, and to identify and quantify the majority active compounds in the EO as well as their potential use for the control of nosemosis. Essential oils were obtained using the stripping steam technique with Clevenger equipment and were subsequently analyzed by Gas chromatography-mass spectrometry. Mortality was recorded daily over at least 8days as worker honeybees were exposed to a range of doses of EO dispersed in a sucrose solution. C. alba oil appears to be nontoxic to A. mellifera adults at the tested concentration (the same concentration inhibits the growth of N. ceranae), showing that this oil can be used for the treatment of nosemosis. EO effectiveness was demonstrated against N. ceranae by calculating the percentage of decrease in infected bees from untreated infected groups vs infected groups treated with EO or the reference drug fumagillin. It was determined that a dose of 4µg EO/bee was most effective in controlling N. ceranae development. We determined innocuous doses of C. alba essential oil for honeybees. We demonstrated the antifungal activity of C. alba EO at 4μg/bee against N. ceranae and compared it to its major monoterpenes, such as β-phellandrene (20μg/bee), eucalyptol (20μg/bee) and α-terpineol (20μg/bee). The major compounds of C. alba EO, α-terpineol, eucalyptol and β-phellandrene, had significant effects against Apis mellifera infection by N. ceranae, but the antifungal effect of the complete essential oil on N. ceranae was larger than the effect of α-terpineol, eucalyptol or β- phellandrene separately, showing that C. alba oil may be a candidate for the treatment or prevention of nosemosis.

The Behavioral Response Team: building a safer hospital

The increased number of be- havioral health patients in our hospitals whose needs are fre- quently met by caregivers without sufficient behavioral healthcare experience or training, has made it difficult to manage the disruptive be- haviors of seriously ill behav- ioral health patients. How do we meet the need, stay within a reasonable budget, and in- crease safety and confidence in our caregivers? The answer according to the author, is the Behavioral Response team (BRT). In this article, he de- scribes how to develop the team, the roles of its members, and how it responds to a crisis situation.

Differential innate immune response of European seabass (Dicentrarchus labrax) against Streptococcus iniae

Streptococcus iniae is a Gram-positive bacteria that causes invasive infections with severe septicemia and meningitis, producing high economic losses in marine and continental aquaculture. Head kidney leukocytes of European sea bass (Dicentrarchus labrax) were used to measure the differential innate immune response upon infection with S. iniae. The complete inhibition in the production of intracellular superoxide radicals and total peroxidase content was observed in infected cells. This study also elucidates changes in the relative expression of some immune-related genes. Interleukin 1β, tumor necrosis factor-α and interleukin-6 reached a peak of expression at 4-8 h post-infection, subsequently decreasing significantly up to 48 h post-infection. However, interleukin-10 and Mx protein increased over time, reaching the pick of expression at 48 h post-infection, whereas caspase-3 showed down regulation until 48 h post-infection. The in vivo study of immune related genes show the same kinetics of mRNAs expression as in vitro experience. The proinflammatory cytokines mRNA transcription levels peaked at an earlier time in vivo than in vitro system. Our findings indicate that there is a direct relationship between the dissemination of bacteria and the resulting infection-associated inhibition of respiratory burst, apoptosis, and the pro- and anti-inflammatory gene expression profiles.

Immunization of sea bream (Sparus aurata) juveniles against Photobacterium damselae subsp. piscicida by short bath: Effect on some pro-inflammatory molecules and the Mx gene expression

Cytokines are a family of proteins derived from macrophages, lymphocytes, granulocytes, mast cells and epithelial cells and can be divided into interferons (IFNs), Interleukins (ILs) and Tumor Necrosis factors (TNFs) among others. The presence of cytokines in a wide number of fish species has been proved and several molecules types have been already cloned and sequenced. In this work some proinflamatory molecules and Mx gene were detected in the liver of vaccinated sea bream juveniles with an average body weight of 5 g. The method of immunization was by short bath and three different bacterins against the marine pathogen Photobacterium damselae subsp. piscicida were designed and used to immunize fish. Five genes encoding for five different molecules were analyzed by real time PCR: IL-1β, IL Ir-2, Cox-2, Mx and TNFα. Gene expression was quantified along four days after fish immunization and results were compared among groups. Results show that the heat-inactivated vaccine stimulates the up-regulation of IL-1β, IL Ir-2, Cox-2 and TNFα genes whereas the UV-light inactivated vaccine was the unique vaccine which stimulates the expression of Mx gene. The present is a novel study that shows by the first time the effect of the inactivation process of vaccines on the expression levels of genes involved in the defense against Photobacterium damselae subsp piscicida.

Electronic effects of substituents on the stability of the iridanaphthalene compound [Ir[upper bond 1 start]Cp*{=C(OMe)CH=C(o-C6[upper bond 1 end]H4)(Ph)}(PMe3)]PF6

Iridanaphthalene complexes are synthesized from the corresponding methoxy(alkenyl)carbeneiridium compounds. The electronic character of the substituents on the 6-position of the metallanaphthalene ring is crucial from the point of view of the stability of the iridanaphthalene, [Ir[upper bond 1 start]Cp*{=C(OMe)CH=C(o-C[upper bond 1 end]6H4)(Ph)}(PMe3)]PF6, vs. its transformation to the corresponding indanone derivatives. Stability studies of the iridanaphthalene compounds revealed that strong electron donor substituents (-OMe) stabilize the iridanaphthalene, while weak electron donor (-Me) and electron withdrawing (-NO2) groups favor the formation of indanone derivatives. Two possible indanone isomers can be obtained in the conversion of the unstable iridanaphthalene complexes and a mechanism for the formation of these isomers is proposed.

Periodic nanostructures on unpolished substrates and their integration in solar cells

We present a novel fabrication process based on laser interference lithography, lift-off and reactive ion etching, which allows us to fabricate periodic nanostructures on photovoltaic substrates with an average root mean square (RMS) roughness of 750 nm. We fabricate nanostructures on unpolished crystalline silicon substrates, which reduces their reflectance 30% as fabricated. When an additional passivation layer is deposited, the light trapping grows, achieving a reflectance reduction of 60%. In addition, we have successfully integrated the nanostructured substrates in silicon wafer-based solar cells following standard processes, achieving a final efficiency of 15.56%.

Detection of volatile organic compounds using flexible gas sensing devices based on tungsten oxide nanostructures functionalized with Au and Pt nanoparticles

Flexible gas sensor devices are fabricated and optimized by integrating directly, via a single-step vapor-phase deposition method, highly crystalline tungsten oxide nanostructures functionalized with either gold or platinum nanoparticles. Gas tests of these devices show significant improvements with respect to flexible gas sensors based on non-functionalized structures, including greater responses to various volatile organic compounds (ethanol, acetone, methanol and toluene) and better selectivity towards ethanol and methanol, as demonstrate results for the sensors based on platinum-functionalized structures. The method presented here, which includes the fabrication of the whole flexible gas sensing device and the integration of functional nanostructures without the use of transfer methods, provides a simpler, faster and inexpensive method for the fabrication of highly functional flexible microsystems for gas sensing.

The in vitro immunomodulatory effect of extracellular products (ECPs) of Vagococcus fluvialis L21 on European sea bass (Dicentrarchus labrax) leucocytes

The immune associated genes, interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor-α (TNF-α), ciclo-oxigenase-2 (COX-2), and Mx gene were studied by real-time PCR in head-kidney leucocytes of sea bass after incubation with the extracellular products (ECPs) of the probiotic strain Vagococcus fluvialis L21 and polyinosinic:polycytidylic acid (POLY I:C), at different times (T1.5, T6, T12, T24, T48 and T72). In general, we can observe how pro-inflammatory cytokines IL-1β, TNF-α, IL-6 and COX-2 studied displayed a strong peak after stimulation with 1.5 h of ECPs of V. fluvialis L21, significant differences (P < 0.05) exist with other periods and with the POLY I: C at the same time. Similarly to the case of IL-10 also produced a statistically significant (P < 0.05) peak of expression on leukocytes that were stimulated with the ECPs of V. fluvialis L21. In the case of Mx gene expression, we note that in almost all sampling times there is an up-regulation of the Mx gene in leucocytes incubated with ECPs and POLY I:C compared to the control and Mx expression was higher in leucocytes that were stimulated with the ECPs of V. fluvialis for all times, except in T24. With these results we can consider that the ECPs of V. fluvialis L21 have a great power of stimulating the in vitro expression of immune-related genes and may even be useful as adjuvants for vaccine in aquaculture.

Biology-oriented development of novel lipophilic antioxidants with neuroprotective activity

Discovery of hydroxycinnamic acid derivatives with enhanced in lipophilicity, blood brain barrier permeability and neuroprotective potential.

The Crystal Structure of TlBrI2(4-methylpyridine-N-oxide)2

The unit cell of TlBrI2 (4-methylpyridine-N-oxide) 2 is orthorhombic, space group Pnna. with a = 1126.9(3),b = 919.8(2),c = 1210.4(3) pm.and Z = 4. The structure consists of discrete TlBrI2 (4-methyl-pyridine-N-oxide)2 molecules which have a distorted trigonal-bipyramidal geometry. The thallium atom is coordinated to two iodine atoms and a bromine atom in equatorial positions, and by two 4-methyl-pyridine-N-oxide ligands in the axial positions.

Effect of lipopolysaccharides from Vibrio alginolyticus on the Mx gene expression and virus recovery from gilthead sea bream (Sparus aurata L.) experimentally infected with Nodavirus

Infections with nodavirus affect a wild and farmed fish species throughout the world, mostly from the marine environment. The aim of this work was to determine the immune status of gilthead sea bream that comes as a result of a Nodavirus infection, induced by activation of the interferon response pathway by lipopolysaccharides from Vibrio alginolyticus and the expression of interferoninduced Mx protein in liver samples. The enhancement of Mx protein gene expression was detected in liver samples of experimentally nodavirus infected fish and, furthermore, the immunostimulant LPS of V. alginolyticus decreased almost three times the virus titration with respect to no-immunized or infected with nodavirus group of fish.

The in vitro effect of probiotic Vagococcus fluvialis on the innate immune parameters of Sparus aurata and Dicentrarchus labrax

In this study we evaluated the effect of the probiotic Vagococcus fluvialis on the cellular immune unspecific system of two different fish species of great interest in aquaculture such as gilthead sea bream (Sparus aurata) and European sea bass (Dicentrarchus labrax). Leucocytes from head kidney of the two fish species were extracted and concentration adjusted to 10(7) cells ml(-1). Phagocytic and respiratory burst activity and the peroxidase content of leucocytes were observed 30 min after incubation with the probiotic Vagococcus fluvialis alive or inactivated with heat shock or UV-light at different concentrations of 10(7), 10(8), 10(9) cfu ml(-1) (final concentration 10(6), 10(7), 10(8) cfu ml(-1)). V. fluvialis produced dose-dependent increments in respiratory burst in sea bream leucocytes. The respiratory burst activity of sea bream head kidney leucocytes incubated with 10(6) cfu ml(-1) of live and inactivated bacteria was not stimulated. The highest values of peroxidase content were observed in sea bass cells with stimulation indexes higher than 1 in HK leucocytes incubated with 10(8) cfu ml(-1) of live and inactivated bacteria. Statistical analysis revealed that differences being only significant in sea bass leucocytes where 10(8) cfu ml(-1) bacteria denote statistically significant differences (P < 0.05) respect to other concentrations. Highest values of phagocytic activity were obtained in sea bass macrophages incubated with UV-light inactivated bacteria (27.33% ± 1.45), where significantly differences with sea bass HK leucocytes were detected. Our results suggest that the in vitro assays are a useful tool to optimize the effective dose of probiotic bacteria. Although in vivo studies are necessary to confirm the immunomodulatory effect of this strain.

Development and validation of a specific questionnaire for evaluating the impact of gastrointestinal symptoms on the health-related quality of life of transplant patients

BACKGROUND

Transplant patients receiving immunosuppressant treatment suffer gastrointestinal symptoms (GIS) limiting their health-related quality of life (HRQOL) and causing dose redíuctions and discontinuations.

METHODS

This observational, multicenter, cross-sectional study aims to develop and validate a questionnaire for detecting and quantifying the impact of GIS on the HRQOL of patients with functioning organ transplants. We developed a pilot version of the questionnaire SIGIT-QOL (Impact of Gastrointestinal Symptoms on Quality Of Life) and then evaluated the feasibility, validity, and reliability. We consecutively recruited 274 solid organ transplant patients from 20 hospitals. Sociodemographic and clinical data were collected. Patients completed the SIGIT-QOL and Gastrointestinal Quality of Life Index-GIQLI- questionnaires.

RESULTS

Mean age was 52.7 (SD, 7.59) and 181 were male; 43.4% showed an episode of GIS since transplantation (3-12 months before). Of all patients, 95.3% completed the SIGIT-QOL. Mean time of completion was 6.49 minutes. Exploratory factorial analysis identified a 1-dimensional structure (42% of total variance). Internal consistency was high (Cronbach's alpha, 0.889). A significant association was found between the SGITI-QOL and the presence of GIS (P < .01). Finally, correlation coefficients between SIGIT-QOL and GIQLI were moderate-high except for Social Function.

CONCLUSION

The brief SIGIT-QOL questionnaire can detect and quantify the GIS and their impact on the HRQOL of solid organ transplant patients.