Comparison of direct and indirect soil organic carbon prediction at farm field scale.

To advance sustainable and resilient agricultural management policies, especially during land use changes, it is imperative to monitor, report, and verify soil organic carbon (SOC) content rigorously to inform its stock. However, conventional methods often entail challenging, time-consuming, and costly direct soil measurements. Integrating data from long-term experiments (LTEs) with freely available remote sensing (RS) techniques presents exciting prospects for assessing SOC temporal and spatial change. The objective of this study was to develop a low-cost, field-based statistical model that could be used as a decision-making aid to understand the temporal and spatial variation of SOC content in temperate farmland under different land use and management. A ten-year dataset from the North Wyke Farm Platform, a 20-field, LTE system established in southwestern England in 2010, was used as a case study in conjunction with an RS dataset. Linear, additive and mixed regression models were compared for predicting SOC content based upon combinations of environmental variables that are freely accessible (termed open) and those that require direct measurement or farmer questionnaires (termed closed). These included an RS-derived Ecosystem Services Provision Index (ESPI), topography (slope, aspect), weather (temperature, precipitation), soil (soil units, total nitrogen [TN], pH), and field management practices. Additive models (specifically Generalised Additive Models (GAMs)) were found to be the most effective at predicting space-time SOC variability. When the combined open and closed factors (excluding TN) were considered, significant predictors of SOC were: management related to ploughing being the most important predictor, soil unit (class), aspect, and temperature (GAM fit with a normalised RMSE = 9.1%, equivalent to 0.4% of SOC content). The relative strength of the best-fitting GAM with open data only, which included ESPI, aspect, and slope (normalised RMSE = 13.0%, equivalent to 0.6% of SOC content), suggested that this more practical and cost-effective model enables sufficiently accurate prediction of SOC.

Plant size, latitude, and phylogeny explain within-population variability in herbivory.

Interactions between plants and herbivores are central in most ecosystems, but their strength is highly variable. The amount of variability within a system is thought to influence most aspects of plant-herbivore biology, from ecological stability to plant defense evolution. Our understanding of what influences variability, however, is limited by sparse data. We collected standardized surveys of herbivory for 503 plant species at 790 sites across 116° of latitude. With these data, we show that within-population variability in herbivory increases with latitude, decreases with plant size, and is phylogenetically structured. Differences in the magnitude of variability are thus central to how plant-herbivore biology varies across macroscale gradients. We argue that increased focus on interaction variability will advance understanding of patterns of life on Earth.

CO2 fluxes from three different temperate grazed pastures using Eddy covariance measurements.

Grasslands cover around 25% of the global ice-free land surface, they are used predominantly for forage and livestock production and are considered to contribute significantly to soil carbon (C) sequestration. Recent investigations into using 'nature-based solutions' to limit warming to <2 °C suggest up to 25% of GHG mitigation might be achieved through changes to grassland management. In this study we evaluate pasture management interventions at the Rothamsted Research North Wyke Farm Platform, under commercial farming conditions, over two years and consider their impacts on net CO2 exchange. We investigate if our permanent pasture system (PP) is, in the short-term, a net sink for CO2 and whether reseeding this with deep-rooting, high-sugar grass (HS) or a mix of high-sugar grass and clover (HSC) might increase the net removal of atmospheric CO2. In general CO2 fluxes were less variable in 2018 than in 2017 while overall we found that net CO2 fluxes for the PP treatment changed from a sink in 2017 (-5.40 t CO2 ha-1 y-1) to a source in 2018 (6.17 t CO2 ha-1 y-1), resulting in an overall small source of 0.76 t CO2 ha-1 over the two years for this treatment. HS showed a similar trend, changing from a net sink in 2017 (-4.82 t CO2 ha-1 y-1) to a net source in 2018 (3.91 t CO2 ha-1 y-1) whilst the HSC field was a net source in both years (3.92 and 4.10 t CO2 ha-1 y-1, respectively). These results suggested that pasture type has an influence in the atmospheric CO2 balance and our regression modelling supported this conclusion, with pasture type and time of the year (and their interaction) being significant factors in predicting fluxes.

Analysis of biomolecules in cochineal dyed archaeological textiles by surface-enhanced Raman spectroscopy.

SERS spectroscopy is successfully employed in this work to reveal different components integrating the cochineal colorant employed for dying archaeological textile samples from the Arica Region in North Chile. This analysis was done by in-situ experiments that does not imply the material (colorant and biomolecules) extraction. The spectroscopic analysis of the archaeological textiles by SERS reveals the presence of bands attributed to carminic acid and nucleobases, mainly adenine and guanine. The identification of these biomolecules was also verified in raw cochineal extract and in cochineal dyed replica wool fibers fabricated by us following ancient receipts. The effect of Al on the complexation of carminic acid and other biomolecules was also tested in order to understand the changes induced by the metal interaction on the colorant structure. This study revealed that Al can also complex biomolecules existing in the cochineal extract. In particular, guanine residue seems to interact strongly with the metal, since SERS bands of this residue are enhanced. Furthermore, a theoretical analysis on the interaction of carminic acid and a silver surface was also performed in order to better understand the interaction mechanism between carminic acid and a metal surface that leads to the final SERS spectrum. The results of the present work will be very useful in the identification of different molecules and metal complexes that may be forming part of the cochineal colorant found in archaeological materials.

Reconnaissance of tumor immune microenvironment spatial heterogeneity in metastatic renal cell carcinoma and correlation with immunotherapy response.

A clearer understanding of the tumor immune microenvironment (TIME) in metastatic clear cell renal cell carcinoma (ccRCC) may help to inform precision treatment strategies. We sought to identify clinically meaningful TIME signatures in ccRCC. We studied tumors from 39 patients with metastatic ccRCC using quantitative multiplexed immunofluorescence and relevant immune marker panels. Cell densities were analyzed in three regions of interest (ROIs): tumor core, tumor-stroma interface and stroma. Patients were stratified into low- and high-marker density groups using median values as thresholds. Log-rank and Cox regression analyses while controlling for clinical variables were used to compare survival outcomes to patterns of immune cell distributions. There were significant associations with increased macrophage (CD68+ CD163+ CD206+ ) density and poor outcomes across multiple ROIs in primary and metastatic tumors. In primary tumors, T-bet+ T helper type 1 (Th1) cell density was highest at the tumor-stromal interface (P = 0·0021), and increased co-expression of CD3 and T-bet was associated with improved overall survival (P = 0·015) and survival after immunotherapy (P = 0·014). In metastatic tumor samples, decreased forkhead box protein 3 (FoxP3)+ T regulatory cell density correlated with improved survival after immunotherapy (P = 0·016). Increased macrophage markers and decreased Th1 T cell markers within the TIME correlated with poor overall survival and treatment outcomes. Immune markers such as FoxP3 showed consistent levels across the TIME, whereas others, such as T-bet, demonstrated significant variance across the distinct ROIs. These findings suggest that TIME profiling outside the tumor core may identify clinically relevant associations for patients with metastatic ccRCC.

Statement of the Spanish Society of Allergology and Clinical Immunology on Provocation Tests With Aspirin/Nonsteroidal Anti-inflammatory Drugs.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used throughout the world. They are frequently involved in hypersensitivity reactions, which range from local or mild reactions to systemic and severe reactions. Consequently, it is necessary to perform an exhaustive study of patients in order to make an accurate diagnosis, search for safe procedures in the case of severe reactions, and identify alternative treatment options. Various guidelines and protocols address the management of hypersensitivity to NSAIDs, although these vary widely from country to country. The Committees of Asthma, Rhinoconjunctivitis, and Drug Allergy of the Spanish Society of Allergy and Clinical Immunology (SEAIC) propose the present position statement on available options for provocation testing with aspirin/NSAIDs. This document is the fruit of an exhaustive review of current evidence and is based on recent publications addressing the diagnosis of patients with hypersensitivity to NSAIDs and on a consensus-oriented discussion among a group of experts from the SEAIC. The main objective was to draft an easy-toread, practical guideline for health care professionals in specialist areas who assess and manage patients with suspected hypersensitivity to NSAIDs. Furthermore, indications, contraindications, and procedures for oral, bronchial, and nasal provocation tests with aspirin/NSAIDs have been updated.

Indications for small bowel capsule endoscopy and its safety and diagnostic yield in Mexican patients. Experience at a tertiary care hospital center. / Indicaciones, rendimiento diagnóstico y seguridad de la cápsula endoscópica de intestino delgado en pacientes mexicanos. Experiencia de un centro de tercer nivel.

INTRODUCTION: Appearing in the year 2000, capsule endoscopy revolutionized the study of the small bowel. It is the gold standard for the study of small bowel bleeding and is considered a safe procedure. OBJECTIVE: The aim of the present study was to identify the indications for, diagnostic yield, and safety of capsule endoscopy in Mexican patients. MATERIALS AND METHODS: A descriptive study was conducted on the first 500 small bowel capsule endoscopies performed at a tertiary care hospital center in Mexico City. Sex, age, type of video camera employed, bowel transit time, referral diagnosis, and capsule endoscopy findings and complications were registered. RESULTS: Mean patient age was 55years (±17.63) and 57.9% of the cases were women. Complete visualization of the small bowel was achieved in 420 capsule endoscopies (84%). Mean bowel transit time was 272.25minutes (±114.86). The most common indications for the procedure were small bowel bleeding (65.2%), search for neoplasia (14.4%), and Crohn's disease (10.2%). The presence of ulcers was the most common finding in small bowel bleeding (24.8%), followed by angioectasias (18.9%). Capsule retention was the only complication and it presented in 11 patients (2.2%). CONCLUSIONS: Capsule endoscopy is a safe and efficacious method for studying the small bowel. The results obtained in Mexican patients were similar to those described in the international literature. The present case series is the largest reported in a Mexican population.

Calidad durante el almacenamiento de huevos de gallinas alimentadas con dietas con aceite de palma / Egg quality during storage of eggs from hens fed diets with crude palm oil

RESUMEN Objetivo. Evaluar el efecto del aceite crudo de palma (ACP) sobre la calidad del huevo almacenado por varios días a diferentes temperaturas. Materiales y métodos. Un total de 240 gallinas de 28 semanas se alimentaron con dietas con 30g/kg de aceite de soya (AS) o ACP. Después de 12 semanas, muestras de huevos se almacenaron durante 0, 4, 8 y 12 días a 4, 12 y 24°C. Las características de calidad del huevo fueron evaluadas. Resultados. El huevo y la albúmina de gallinas en la dieta con ACP fueron más pesados que aquellos en la dieta con AS (p<0.05). La alta temperatura de almacenamiento redujo el peso del huevo, albúmina y yema, unidades Haugh (UH), altura de la albúmina y la yema, pH y color (p<0.05), pero aumentó el ancho de la albúmina y la yema, y la longitud de la albúmina (p<0.05). A medida que aumentaba el tiempo de almacenamiento, el peso del huevo, el peso y la altura de la albúmina, y la altura de la yema, el pH y el color se redujeron (p<0.05). Sin embargo, el peso y el ancho de la yema, el ancho y la longitud de la albúmina aumentaron (p<0.05). La interacción aceite x tiempo de almacenamiento (p<0.05) indico que la altura de la albumina, UH y el color de la yema de los huevos de la dieta con ACP fueron mejores a los 12 días de almacenamiento que en la dieta con AS. Conclusiones. Las gallinas en la dieta con ACP tuvieron huevos y albuminas más pesadas que las de las de la adieta con AS. La calidad del huevo disminuyó conforme el tiempo y temperatura de almacenamiento se incrementó, pero, los huevos de las gallinas suplementadas con ACP tuvieron mejor calidad en algunas características a los 12 días de almacenamiento.

ABSTRACT Objective. Evaluate the effect of crude palm oil (CPO) on quality traits of eggs stored various days at different temperatures. Material and Methods. A total of 240 hens, 28 weeks of age were fed diets with 30 g/kg of soybean oil (SO) or CPO. After 12 weeks, sample of eggs were stored during 0, 4, 8 and 12 days at 4, 12 and 24 °C. Egg quality traits were evaluated. Results. Egg and albumen from hens in CPO diet were heavier than those in SO (p<0.05). High storage temperature reduced egg, albumen and yolk weights, Haugh units (HU), albumen and yolk heights, pH and color (p<0.05), but increased albumen and yolk widths and albumen length (p<0.05). As storage time increased, egg weight, albumen weight and height, and yolk height, pH and colour were reduced (p<0.05). However, yolk weight and width, albumen width and length increased (p<0.05). Oil x storage time interaction (p<0.05) indicated that albumen height, HU and yellowness of yolk from hens in CPO diets were better at 12 days of storage than for hens fed SO. Conclusions. Hens in CPO diet had heavier eggs and albumen than those in SO diet. Egg quality traits decreased as temperature and days of storage increased, but, eggs from hens supplemented CPO had better quality in some traits at 12 days of storage.

PillCam SB3 vs. PillCam SB2: Can technologic advances in capsule endoscopy improve diagnostic yield in patients with small bowel bleeding? / Pillcam SB3 vs. Pillcam SB2: ¿pueden los avances tecnológicos de la cápsula endoscópica mejorar el rendimiento diagnóstico en pacientes con hemorragia de intestino delgado?

INTRODUCTION AND OBJECTIVE: The SB3 capsule endoscopy system has better image resolution and the capacity to increase the number of images from 2 to 6 frames per second. Small bowel bleeding is the most common indication. The aim To determine if the advances in capsule endoscopy technology increase diagnostic yield in cases of small bowel bleeding, according to the Saurin classification. MATERIAL AND METHODS: A retrospective, observational, analytic, cross-sectional study included 100 SB2 capsule endoscopies and 100 SB3 capsule endoscopies in patients that presented with small bowel bleeding. The findings obtained with both systems were evaluated. The lesions identified by the two capsules were categorized using the Saurin classification. The relation between the lesions identified with the SB3 and those found with the SB2 was identified through a logistic regression analysis. RESULTS: In the SB2 capsule endoscopy group, 60% were women, patient age was 59 years (42.2, 73), and intestinal transit time was 271min (182, 353). In the SB3 group, 57% were women, patient age was 60 years (42.5, 73), and intestinal transit time was 277min (182, 352). There were no significant differences in the identification of P0 and P2 lesions between the two systems. The SB3 capsule endoscope identified more P1 lesions (p=0.020, OR: 2.35, 95% CI:1.12-4.90). There was no significant difference in relation to location of the lesions in the small bowel. CONCLUSIONS: A greater number of P1 lesions were detected through the technologic advances made in SB3 capsule endoscopy, but the diagnostic yield for P2 lesions was not modified.

Impact of an antimicrobial stewardship program on urinary tract infections caused by extended-spectrum ß-lactamase-producing Escherichia coli.

OBJECTIVE: To analyze the clinical and economic impact of an antimicrobial stewardship program (ASP) targeting urinary tract infections (UTI) caused by extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli. METHODS: An observational retrospective study that included adults with a diagnosis of UTI caused by ESBL-producing E. coli admitted to a tertiary care hospital in Barcelona, Spain, between January 2014 and December 2015. The impact of the ASP was analyzed in terms of clinical and economic outcomes. RESULTS: A total of 222 patients met the inclusion criteria and an intervention was made by the ASP team in 104 cases (47%). ASP intervention was an independent variable related to clinical cure (p = 0.008). Other variables influencing clinical outcomes were the McCabe Jackson score (p = 0.005) and outpatient status (p < 0.001). The ASP interventions in this study had no economic impact. CONCLUSIONS: Antimicrobial stewardship has a positive clinical impact on UTIs caused by ESBL-producing E. coli. Further prospective studies are needed to assess the economic impact of ASPs on UTI caused by ESBL-producing E. coli.

Rasch analysis of the Mini Mental State Examination (MMSE) in older adults in Antioquia, Colombia / Análisis rasch del mini mental state examination (mmse) en adultos mayores de antioquia, colombia

Resumen Objetivo. Evaluar las evidencias de validez del Mini Mental State Examination que sustentan su interpretación en adultos mayores. Métodos. Estudio de fuente secundaria con la participación de 4034 adultos mayores residentes de Antioquia, Colombia, 2012. Se siguieron los lineamientos de Wolfe y Smith para análisis desde el modelo Rasch. Resultados. Se identificó dependencia local entre los ítems de atención y cálculo. Estos producen una segunda medida que afecta la unidimensionalidad del instrumento. La confiabilidad de los ítems fue de 0,80, la medida explicó el 45,2% de la varianza de las puntuaciones crudas. Conclusión. Los resultados sugieren diferenciar las habilidades de atención y cálculo de los demás procesos cognitivos considerados por el instrumento. El MMSE presenta limitaciones de validez de generalización que potencialmente afectan comparaciones transculturales.

Abstract Objective. To evaluate validity of the Mini-Mental State Examination (MMSE) that supports the interpretability in older adults. Methods. Secondary data study administered in 4.034 older adults in Antioquia, Colombia, 2012. Data were analyzed from Rasch models according to Wolfe and Smith guidelines. Results. Attention and calculation items showed local dependency. They produce a second relevant measure affecting the unidimensional type of the test. The reliability of the items was of 0.80, the measure explained 45.2% of the raw score variance. Conclusion. Results suggest differentiating attention and calculation abilities from the other cognitive processes considered by the test. MMSE shows generalization validity limitations that may affect transcultural comparisons.

Increased regional gray matter atrophy and enhanced functional connectivity in male multiple sclerosis patients.

Evidence suggests that sex/gender is an important factor for understanding multiple sclerosis (MS) and that some of its neuropathological consequences might manifest earlier in males. In the present study, we assessed gray matter (GM) volume and functional connectivity (FC) in a sample of female and male MS patients (MSp) and female and male healthy controls (HCs). As compared to female MSp, male MSp showed decreased GM volume in the bilateral frontal areas and increased FC between different brain regions. Because both sets of changes correlated significantly and no differences in cognitive performance were observed, we suggest that the FC increase observed in male MSp acts as a compensatory mechanism for their more extensive GM loss and that it promotes a functional convergence between male- and female-MSp.

Effect of environmental factor on some litter traits of sows in the tropics Mexican / Efecto de factores ambientales sobre algunas características de la camada de cerdas en el trópico de México

Objective. To determine the effect of environmental factors on litter traits at birth and weaning, and their repeatabilities in four farms in the sub-humid tropics of Mexico. Materials and methods. Data from 46.249 to 50.316 litters for litter size at birth (LSB), number of piglets born alive (NBA), litter weight at birth (LWB), number of piglets weaned (NPW) and litter weight at weaning (LWW) were used. The statistical model for LSB, NBA and LWB included the effects of farm, farrowing year, farrowing season, parity number, simple interactions, random effects of sow and the error term. NPW and LWW were analyzed using the previous model plus the linear and quadratic effects of lactation length (LL). Results. The means for LSB, NBA, LWB, NPW and LWW were 11.7 piglets, 11.0 piglets, 16.1 kg, 10.3 piglets and 61.3 kg, respectively. All effects in the model affected the litter traits. Farrowing year x season interaction was significant for NPW, LWB and LWW. The dry season had the highest LSB, NBA y NPW. First parity sows had higher LSB and NBA means than for second parity sows. Parity increase until parity 4 to decrease thereafter. LL had a quadratic effect on NPW and LWW. Repeatability estimates for LSB, NBA, and LWB were 0.12, 0.12 and 0.14, respectively. Conclusions. All traits studied were influenced by the environmental factors studied. Repeatabilities for LSB, NBA and LWB were low.

Objetivo. Determinar el efecto de factores ambientales sobre características de la camada al nacer y al destete, y sus repetibilidades en cuatro granjas en el trópico sub-húmedo de México. Materiales y métodos. Se utilizaron los datos de 50.316 a 46.249 camadas para el total de lechones nacidos (LSB), lechones nacidos vivos (NBA) y peso de la camada al nacimiento (LWB), lechones destetados (NPW) y peso de la camada al destete (LWW). El modelo estadístico para LSB, NBA y LWB incluyen los efectos de granja, año, época, número de parto, interacciones simples, efecto aleatorio de cerda y error. El modelo para NPW y LWW incluyó los factores anteriores y además, los efectos lineal y cuadrático de largo de lactación (LL). Resultados. Las medias para LSB, NBA, LWB, NPW y LWW fueron 11.7 lechones, 11.0 lechones, 16.1 kg, 10.3 lechones y 61.3 kg, respectivamente. Todos los factores estudiados afectaron las características de la camada. La interacción de año x época fue significativa para NPW, LWB y LWW. La época seca presentó las mayores medias de LSB, NBA y NPW. Las cerdas primer parto obtuvieron medias de LSB y NBA superiores que las cerdas del segundo parto. Las medias por número de parto incrementaron hasta el cuarto, para después disminuir. La LL obtuvo un efecto cuadrático sobre NPW y LWW. Las repetibilidades estimadas para LSB, NBA, y LWW fueron 0.12, 0.12 y 0.14, respectivamente. Conclusiones. Todos los factores ambientales estudiados afectaron las características de la camada al nacer y al destete. Las repetibilidades estimadas fueron bajas.

[Pneumocystis jiroveci pneumonia: Clinical characteristics and mortality risk factors in an Intensive Care Unit]. / Neumonía por Pneumocystis jiroveci: características clínicas y factores de riesgo asociados a mortalidad en una Unidad de Cuidados Intensivos.

OBJECTIVE: To describe the epidemiological characteristics of the population with Pneumocystis jiroveci (P. jiroveci) pneumonia, analyzing risk factors associated with the disease, predisposing factors for admission to an intensive care unit (ICU), and prognostic factors of mortality. DESIGN AND PATIENTS: A retrospective observational study was carried out, involving a cohort of patients consecutively admitted to a hospital in Spain from 1 January 2007 to 31 December 2011, with a final diagnosis of P. jiroveci pneumonia. SETTING: The ICU and hospitalization service of Hospital del Mar, Barcelona (Spain). RESULTS: We included 36 patients with pneumonia due to P. jiroveci. Of these subjects, 16 required ICU admission (44.4%). The average age of the patients was 41.3 ± 12 years, and 23 were men (63.9%). A total of 86.1% had a history of human immunodeficiency virus (HIV) infection, and the remaining 13.9% presented immune-based disease subjected to immunosuppressive therapy. Risk factors associated to hospital mortality were age (51.8 vs. 37.3 years, P=.002), a higher APACHE score upon admission (17 vs. 13 points, P=.009), the need for invasive mechanical ventilation (27.8% vs. 11.1%, P=.000), requirement of vasoactive drugs (25.0% vs. 11.1%, P=.000), fungal coinfection (22.2% vs. 11.1%, P=.001), pneumothorax (16.7% vs. 83.3%, P=.000) and admission to the ICU (27.8% vs. 72.2% P=.000). CONCLUSIONS: The high requirement of mechanical ventilation and vasoactive drugs associated with fungal coinfection and pneumothorax in patients admitted to the ICU remain as risk factors associated with mortality in patients with P. jiroveci pneumonia.

[Uroflowmetric review of pediatric distal urethroplasty]. / Revisión uroflujométrica de pacientes intervenidos de hipospadias distales.

INTRODUCTION: Urethral stricture is the most common complication in hypospadias surgery. The monitoring of operated patients allows rapid detection of this complication and the uroflowmetry is the main diagnostic method. OBJECTIVES: To study of functional results in patients who underwent distal urethroplasty, using uroflowmetry. PATIENTS AND METHODS: A retrospective chart review was conducted of 81 patients who underwent distal hypospadias repair (7 coronal, 51 subcoronal and 23 distal penile shaft) and a postoperatory uroflowmetric study. The patients were divided into two groups, in each type of hypospadias, according to the presence or absence of stenotic complications (0 coronal, 10 subcoronal and 5 distal penile shaft). The functional effects in both groups were studied. RESULTS: All patients with stenotic complications showed maximum flow rates and mean flow rates below 15 and 20 percentiles respectively and a plateauing layout of the urinary flow curve. The treatment of these conditions resulted in the normalization of the maximum flow values ​​(in 100% of the subcoronal and 100% of the distal penile shaft hypospadias), as well as in the mean flow values ​​(in 88% of the subcoronal and 75% of the distal penile shaft hypospadias). The curve also adapted a bell-shaped in 100% of the H. coronal and 50% of the H. distal penile shaft. The uroflowmetry presented a spontaneous improvement in all patients without stenotic complications but with low flows in their first uroflowmetric. CONCLUSIONS: Uroflowmetry is an objective method for the evaluation of hypospadias surgery, being easy to perform, noninvasive and reliable. Obstructed uroflow patterns point to the presence of a stenotic complication.

INTRODUCCION: La estenosis uretral es la complicación más frecuente de la cirugía del hipospadias. El seguimiento de los pacientes intervenidos permite su rápida detección, siendo la uroflujometría su principal método diagnóstico. OBJETIVOS: Estudiar la repercusión funcional, mediante la uroflujometría, en pacientes intervenidos de hipospadias distal. MATERIALES Y METODOS: Se presenta un estudio descriptivo, retrospectivo, en el que se revisaron las historias clínicas de 81 pacientes intervenidos de hipospadias distal (7 balánicos, 51 balanopeneanos y 23 peneanos anteriores) y a los que les realizaron estudios uroflujométricos. En cada tipo de hipospadias, se dividieron los pacientes en dos grupos según la presencia de complicaciones estenóticas (0 balánicos, 10 balanopeneanos y 5 peneanos anteriores) o la ausencia de estas y se estudiaron las repercusiones funcionales en ambos grupos. RESULTADOS: Todos aquellos pacientes con complicaciones estenóticas presentaron flujos máximos y medios por debajo de los percentiles 15 y 20 respectivamente, así como un trazado de la curva anormal. El tratamiento de estas complicaciones estenóticas se tradujeron en una normalización tanto en los valores de flujo máximo (en el 100% de los hipospadias balanopeneanos y en el 100% de los hipospadias peneanos anteriores), como en los valores de flujo medio (en el 88% de los hipospadias balanopeneanos y el 75% de los hipospadias peneanos anteriores). La curva, además, adaptó un trazado en forma de campana en el 100% de los hipospadias balanopeneanos y el 50% de los hipospadias peneanos anteriores. Se detectó una mejoría uroflujométrica espontánea en aquellos pacientes que, sin complicaciones estenóticas, presentaron en su primer control uroflujométrico flujos bajos. CONCLUSIONES: La uroflujometría es un método objetivo para la evaluación de la cirugía del hipospadias, siendo una técnica fácil, reproducible y no invasiva. Los parámetros uroflujométricos bajos indican la presencia de una complicación estenótica.

Neumonía por pneumocystis jiroveci: características clínicas y factores de riesgo asociados a mortalidad en una unidad de cuidados intensivos / Pneumocystis jiroveci pneumonia: clinical characteristics and mortality risk factorsinanintensive care unit

Objetivo. Describir las características epidemiológicas de la población con neumonía por Pneumocystis jiroveci (P. jiroveci), analizando factores de riesgo asociados a la enfermedad, factores predisponentes para ingreso en una unidad de cuidados intensivos (UCI) y factores pronóstico de mortalidad. Diseño y pacientes Estudio observacional y retrospectivo de una cohorte de pacientes ingresados consecutivamente en un hospital de España desde el 1 de enero del 2007 al 31 de diciembre del 2011 cuyo diagnóstico final fue neumonía por P. jiroveci.ÁmbitoUCI y servicio de hospitalización del Hospital del Mar, Barcelona. Resultados. Se incluyeron 36 pacientes con neumonía por P. jiroveci de los que 16 (44,4%) precisaron de ingreso en UCI. La edad media de todos los pacientes fue de 41,3±12 años, de los que 23 (63,9%) eran hombres. El 86,1% tenía antecedente de infección por virus de la inmunodeficiencia humana (VIH) y el resto (el 13,9%) de alguna enfermedad inmunológica con tratamiento inmunosupresor. Los factores de riesgo asociados a mortalidad hospitalaria fueron la edad (51,8 vs. 37,3 años; p=0,002), APACHE mayor al ingreso (17 vs. 13 puntos; p=0,009), la necesidad de ventilación mecánica invasiva (27,8 vs. 11,1%; p=0,000), requerimiento de fármacos vasoactivos (25 vs. 11,1%; p=0,000), coinfección fúngica (22,2 vs. 11,1%; p=0,001), neumotórax (16,7 vs. 83,3%; p=0,000) ingreso en UCI (27,8 vs. 72,2%; p=0,000). Conclusiones. Los altos requerimientos de ventilación mecánica y de fármacos vasoactivos asociado a la coinfección fúngica y presencia de neumotórax en pacientes ingresados en la UCI continúan siendo factores de riesgo asociados a mayor mortalidad en pacientes con neumonía por P. jiroveci.

Thrombin-facilitated efflux of D-[3H]-aspartate from cultured astrocytes and neurons under hyponatremia and chemical ischemia.

Thrombin effect increasing swelling-induced glutamate efflux was examined in cultured cortical astrocytes, cerebellar granule neurons (CGN), hippocampal and cortical neurons. Hypotonic glutamate efflux (monitored by D-[(3)H]aspartate) from cortical astrocytes was increased by thrombin (5 U/mL) to reach 16% of the cell pool in 5 min. Thrombin had lower effects in CGN, and marginal effects in hippocampal and cortical neurons. These differences were related to the magnitude of thrombin-evoked cytosolic calcium rise. The protease-activated receptor 1 is expressed in astrocytes and neurons. In astrocytes exposed to chemical ischemia (sodium iodoacetate plus sodium azide) D-[(3)H]aspartate release showed a first phase (20-40 min) of initial low efflux which progressively increases; and a second phase (40-60 min) of larger efflux coincident with cell swelling. Efflux at the first phase was 52% inhibited by the glutamate transporter blocker DL-threo-ß-benzyloxyaspartic-acid (TBOA) and 11% by the volume-sensitive pathway blocker phloretin. At the second phase, efflux was reduced 52 and 38% respectively, by these blockers. In CGN D-[(3)H]aspartate efflux increased sharply and then decreased. This efflux was 32% reduced by calcium omission, 46% by TBOA and 32% by 4-[(2-butyl-6,7dichloro-2-cyclopentyl-2,3-dihydro-1oxo-1H-inden-5-yl)oxy] butanoic-acid. Thrombin enhanced this release by 32%. Ischemic treatment increased astrocyte mortality from 4% in controls to 39 and 61% in ischemia and ischemia plus thrombin, respectively. Cell death was prevented by phloretin. CGN viability was unaffected by the treatment. These results suggest that coincidence of swelling and thrombin during ischemia elevates extracellular glutamate prominently from astrocyte efflux, which may endanger neurons in vivo.

Evolutionary changes in plant tolerance against herbivory through a resurrection experiment.

Both theoretical and empirical works have highlighted the difference in the evolutionary implications of host resistance and tolerance against their enemies. However, it has been difficult to show evolutionary changes in host defences in natural populations; thus, evaluating theoretical predictions of simultaneous evolution of defences remains a challenge. We studied the evolutionary changes in traits related to resistance and tolerance against herbivory in a natural plant population using seeds from two collections made in a period of 20 years. In a common garden experiment, we compared defensive traits of ancestral (1987) and descendant (2007) subpopulations of the annual plant Datura stramonium that shows genetic variation for tolerance and to which the specialist herbivore Lema daturaphila is locally adapted. We also examined the effects of different plant genotypes on the herbivore for testing the plant genetic variation in resistance. Based on the response to the contemporary herbivore populations, results revealed a nonsignificant response in plant resistance traits (herbivore consumption, foliar trichomes and tropane alkaloids), but a significant one in tolerance. The survival of herbivores in laboratory experiments depended on the plant genotype, which suggests genetic variation in plant resistance. Although we cannot identify the selective agent for the change nor exclude genetic drift, the results are consistent with the expectation that when resistance fails to control herbivory, tolerance should play a more important role in the evolution of the interaction.

Cancer-associated fibroblasts and M2-polarized macrophages synergize during prostate carcinoma progression.

Inflammation is now acknowledged as an hallmark of cancer. Cancer-associated fibroblasts (CAFs) force a malignant cross talk with cancer cells, culminating in their epithelial-mesenchymal transition and achievement of stemness traits. Herein, we demonstrate that stromal tumor-associated cells cooperate to favor malignancy of prostate carcinoma (PCa). Indeed, prostate CAFs are active factors of monocyte recruitment toward tumor cells, mainly acting through stromal-derived growth factor-1 delivery and promote their trans-differentiation toward the M2 macrophage phenotype. The relationship between M2 macrophages and CAFs is reciprocal, as M2 macrophages are able to affect mesenchymal-mesenchymal transition of fibroblasts, leading to their enhanced reactivity. On the other side, PCa cells themselves participate in this cross talk through secretion of monocyte chemotactic protein-1, facilitating monocyte recruitment and again macrophage differentiation and M2 polarization. Finally, this complex interplay among cancer cells, CAFs and M2 macrophages, cooperates in increasing tumor cell motility, ultimately fostering cancer cells escaping from primary tumor and metastatic spread, as well as in activation of endothelial cells and their bone marrow-derived precursors to drive de novo angiogenesis. In keeping with our data obtained in vitro, the analysis of patients affected by prostate cancers at different clinical stages revealed a clear increase in the M2/M1 ratio in correlation with clinical values. These data, coupled with the role of CAFs in carcinoma malignancy to elicit expression of stem-like traits, should focus great interest for innovative strategies aimed at the co-targeting of inflammatory cells and fibroblasts to improve therapeutic efficacy.