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During development and regeneration, proliferation of tissue-specific stem cells is tightly controlled to produce organs of a predetermined size. The molecular determinants of this process remain poorly understood. Here, we investigate the function of Yap1, the transcriptional effector of the Hippo signaling pathway, in skin biology. Using gain- and loss-of-function studies, we show that Yap1 is a critical modulator of epidermal stem cell proliferation and tissue expansion. Yap1 mediates this effect through interaction with TEAD transcription factors. Additionally, our studies reveal that α-catenin, a molecule previously implicated in tumor suppression and cell density sensing in the skin, is an upstream negative regulator of Yap1. α-catenin controls Yap1 activity and phosphorylation by modulating its interaction with 14-3-3 and the PP2A phosphatase. Together, these data identify Yap1 as a determinant of the proliferative capacity of epidermal stem cells and as an important effector of a "crowd control" molecular circuitry in mammalian skin.
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Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Proliferação de Células , Células Epidérmicas , Fosfoproteínas/metabolismo , alfa Catenina/metabolismo , Proteínas 14-3-3/metabolismo , Animais , Proteínas de Ciclo Celular , Linhagem Celular , Epiderme/metabolismo , Camundongos , Proteínas de Sinalização YAPRESUMO
Transcriptome-wide association studies (TWAS) can provide single gene resolution for candidate genes in plants, complementing genome-wide association studies (GWAS) but efforts in plants have been met with, at best, mixed success. We generated expression data from 693 maize genotypes, measured in a common field experiment, sampled over a 2-h period to minimize diurnal and environmental effects, using full-length RNA-seq to maximize the accurate estimation of transcript abundance. TWAS could identify roughly 10 times as many genes likely to play a role in flowering time regulation as GWAS conducted data from the same experiment. TWAS using mature leaf tissue identified known true-positive flowering time genes known to act in the shoot apical meristem, and trait data from a new environment enabled the identification of additional flowering time genes without the need for new expression data. eQTL analysis of TWAS-tagged genes identified at least one additional known maize flowering time gene through trans-eQTL interactions. Collectively these results suggest the gene expression resource described here can link genes to functions across different plant phenotypes expressed in a range of tissues and scored in different experiments.
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Flores , Regulação da Expressão Gênica de Plantas , Estudo de Associação Genômica Ampla , Locos de Características Quantitativas , Transcriptoma , Zea mays , Zea mays/genética , Zea mays/fisiologia , Flores/genética , Flores/fisiologia , Locos de Características Quantitativas/genética , Genótipo , Fenótipo , Genes de Plantas/genética , Folhas de Planta/genética , Folhas de Planta/fisiologia , Folhas de Planta/metabolismo , Perfilação da Expressão GênicaRESUMO
Persistent and unresolved inflammation is a common underlying factor observed in several and seemingly unrelated human diseases, including cardiovascular and neurodegenerative diseases. Particularly, in atopic conditions, acute inflammatory responses such as those triggered by insect venom, food or drug allergies possess also a life-threatening potential. However, respiratory allergies predominantly exhibit late immune responses associated with chronic inflammation, that can eventually progress into a severe phenotype displaying similar features as those observed in other chronic inflammatory diseases, as is the case of uncontrolled severe asthma. This review aims to explore the different facets and systems involved in chronic allergic inflammation, including processes such as tissue remodelling and immune cell dysregulation, as well as genetic, metabolic and microbiota alterations, which are common to other inflammatory conditions. Our goal here was to deepen on the understanding of an entangled disease as is chronic allergic inflammation and expose potential avenues for the development of better diagnostic and intervention strategies.
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Hipersensibilidade , Inflamação , Biologia de Sistemas , Humanos , Inflamação/imunologia , Hipersensibilidade/imunologia , Doença Crônica , AnimaisRESUMO
BACKGROUND: Atherosclerosis, a leading cause of mortality, necessitates effective management of hypercholesterolemia, specifically elevated low-density lipoprotein cholesterol (LDL-C). The emergence of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) has revolutionised lipid-lowering. PCSK9i demonstrates substantial LDL-C reduction and cardiovascular benefits, particularly in statin-intolerant or nonresponsive individuals. However, the potential pleiotropic effects of PCSK9i, especially on arterial stiffness, remain a subject of investigation. This systematic review and meta-analysis seek to provide a nuanced understanding of the potential pleiotropic effects of PCSK9i, specifically on arterial health. The primary objective was to analyse the influence of PCSK9i on arterial stiffness, extending beyond traditional lipid-lowering metrics and contributing to a more comprehensive approach to cardiovascular risk reduction. METHODS: A systematic search was conducted across major databases, clinical trial registries and grey literature. Inclusion criteria comprised adults in prospective cohort studies undergoing PCSK9i augmentation in lipid-lowering therapy, with a focus on arterial stiffness measured by pulse wave velocity (PWv). Random-effects meta-analyses, sensitivity analyses and meta-regression models were employed to assess the pooled effect of adding PCSK9i to lipid-lowering interventions on arterial stiffness. RESULTS: Five studies (158 participants) met the inclusion criteria, demonstrating a significant reduction in PWv (mean difference: -2.61 m/s [95% CI: -3.70, -1.52]; ES: -1.62 [95% CI: -2.53, -.71]) upon adding PCSK9i to lipid-lowering interventions. Subgroup analysis and meta-regression models suggested potential sex-based and baseline PWv-dependent variations, emphasising patient-specific characteristics. CONCLUSION: The meta-analysis provides robust evidence that adding PCSK9i to lipid-lowering interventions significantly improves arterial stiffness, indicating broader vascular benefits beyond LDL-C reduction.
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BACKGROUND: Influenza viruses cause pneumonia in approximately one-third of cases, and pneumonia is an important cause of death. The aim was to identify risk factors associated with severity and those that could predict the development of pneumonia. METHODS: This retrospective, observational study included all adult patients with confirmed influenza virus infection admitted to Son Espases University Hospital during four influenza seasons in Spain (October to May) from to 2012-2016. RESULTS: Overall, 666 patients with laboratory-confirmed influenza were included, 93 (14%) of which were severe; 73 (10.9%) were admitted to Intensive Care Unit (ICU), 39 (5.8%) died, and 185 (27.7%) developed pneumonia. Compared to less severe cases, patients with severe disease: were less vaccinated (40% vs. 28%, p = 0.021); presented with more confusion (26.9% vs. 6.8%), were more hypoxemic (Horowitz index (PaO2/FiO2) 261 vs. 280), had higher C-reactive protein (CRP) (12.3 vs. 4.0), had more coinfections (26.8% vs. 6.3%) and had more pleural effusion (14% vs. 2.6%) (last six all p < 0.001). Risk factors significantly associated with severity were pneumonia [OR (95% CI) = 4.14 (2.4-7.16)], history of heart disease (1.84, 1.03-3.28), and confusion at admission (4.99, 2.55-9.74). Influenza vaccination was protective (0.53, 0.28-0.98). Compared to those without pneumonia, the pneumonia group had higher CRP (11.3 vs. 4.0, p < 0.001), lower oxygen saturation (92% vs. 94%, p < 0.001), were more hypoxic (PaO2/FiO2 266 vs. 281, p < 0.001), and incurred more mechanical ventilation, septic shock, admission to the ICU, and deaths (all four p < 0.001). Higher CRP and lower oxygen saturation were independent variables for predicting the development of pneumonia. CONCLUSIONS: Pneumonia, history of heart disease, confusion and no influenza vaccination were independent variables to present complications in patients admitted with influenza infection.
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Doenças Transmissíveis , Cardiopatias , Influenza Humana , Orthomyxoviridae , Pneumonia Viral , Pneumonia , Adulto , Humanos , Estudos Retrospectivos , Pneumonia/complicações , Doenças Transmissíveis/complicações , Unidades de Terapia Intensiva , Fatores de Risco , Cardiopatias/complicaçõesRESUMO
This study reports on the application of activated carbons from macadamia nut shells as adsorbents for the removal of 2,4-dichlorophenoxyacetic acid, a commonly used pesticide, from water. Different activating agents (FeCl3, ZnCl2, KOH and H3PO4) were used to obtain adsorbents within a wide range of porous texture and surface properties. The characterization of the resulting activated carbons was performed by N2 adsorption-desorption, elemental analysis, TG and pHPZC. The adsorption experiments were conducted in batch at 25, 45 and 65 °C. The adsorption kinetics on activated carbons obtained with FeCl3 H3PO4 or KOH was well described by the pseudo-second order model, whereas for the resulting from ZnCl2 activation the experimental data fit better the pseudo-first order model. The equilibrium studies were performed with the KOH- and ZnCl2-activated carbons, the two showing higher surface area values. In both cases, high adsorption capacities were obtained (c.a. 600 mg g-1) and the experimental data were better described by the Langmuir and Toth models. The thermodynamic study allows concluding the spontaneous and endothermic character of the adsorption process, as well as an increase of randomness at the solid/liquid interface. Breakthrough curves were also obtained and fitted to the logistic model.
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Cloretos , Compostos Férricos , Herbicidas , Poluentes Químicos da Água , Adsorção , Carvão Vegetal , Macadamia , Fenoxiacetatos , Ácido 2,4-Diclorofenoxiacético , Cinética , Poluentes Químicos da Água/análiseRESUMO
PURPOSE: Nutritional ketosis synergistically with body-weight loss induced by a very-low-calorie ketogenic diet (VLCKD) has proven to be effective in improving obesity-related pathophysiology. Recently, growing attention has been focused on the relation between erythropoietin (EPO) and obesity. Thus, this study aims to investigate whether nutritional ketosis and weight loss induced by a VLCKD modify the circulating levels of EPO in patients with obesity in comparison with the effect of low-calorie diet (LCD) or bariatric surgery (BS). METHODS: EPO levels, iron status and body composition parameters were evaluated in 72 patients with overweight or obesity and 27 normal-weight subjects at baseline and after the three different weight-reduction therapies (VLCKD, LCD and BS) in 69 patients with excess body weight. ß-hydroxybutyrate levels were also measured in the VLCKD group. The follow-up was established at 2-3 months and 4-6 months. RESULTS: It was found that EPO levels were higher in morbid obesity and correlated with higher basal weight, fat mass (FM) and fat-free mass (FFM) in the overall sample. High baseline EPO levels were also correlated with higher impact on the course of weight loss and changes in FM and FFM induced by the three weight-loss interventions. Furthermore, the VLCKD induced a decrease in EPO levels coinciding with maximum ketosis, which was maintained over time, while statistically significant changes were not observed after LCD and BS. CONCLUSION: The obesity-related increased EPO levels are restored after VLCKD intervention at the time of maximum ketosis, suggesting a potential role of the nutritional ketosis induced by the VLCKD. Baseline EPO levels could be a biomarker of response to a weight-loss therapy.
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INTRODUCTION: This in-vitro study investigated limitations of intra-oral scanners (IOS) in capturing palatal defects at decreased mouth openings. The trueness and precision of composite 3D-printed models from Cone-Beam Computed Tomography (CBCT) and IOS were measured. METHODS: A partially dentate palatal defect model was scanned with IOS (3M™TrueDefinition) at various simulated mouth openings. Five silicone impressions were poured in gypsum. Scans were taken using 3M™TrueDefinition; Planmeca Planscan®, n=5 each. Model was scanned on two CBCT (PlanmecaProFace®; Accuitomo170®CBCT, n=5 each). Geomagic®Control2014™ was used to create composite-models merging CBCT with IOS. Thirty composite-models were 3D-printed. Trueness and precision were measured. Pearson Correlation Coefficients measured correlation between mouth opening and data capture. Data analysed using Kruskal-Wallis, Wilcoxon rank-sum, and ANOVA. Statistical significance inferred when p⟨0.05. RESULTS: Mouth openings ⟨20mm, IOS didn't capture information of soft tissue. Increased mouth opening positively correlated with increased data capture(r=0.93, p=0.001). AccuitomoCBCT and TrueDefinition IOS composite-models had the highest (trueness) and [precision](median (IQR) 0.172 mm(0.062-0.426)); [mean [SD] 0.080 mm [0.008]]. Casts had the lowest results (median (IQR) 0.289 mm(0.119-1.565));[mean [SD] 0.338 mm [0.089]](p⟨0.001). CONCLUSION: Mouth opening ⟨20mm resulted in insufficient data capture by IOS for clinical applications. Composite digital models showed promising trueness and precision results.
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Desenho Assistido por Computador , Imageamento Tridimensional , Técnica de Moldagem Odontológica , Modelos Dentários , Tomografia Computadorizada de Feixe CônicoRESUMO
AIM: This study aimed to investigate the effects of age, period, and cohort on the incidence of psoriasis in Spain from 1990 through 2019 using the Global Burden of Disease (GBD) database and age-period-cohort (A-P-C) analysis. METHODS: We conducted an ecological trend study to analyze the incidence rates of psoriasis in Spain from 1990 through 2019. Joinpoint Regression Program, Version 5.0.2 - May 2023; Surveillance Research Program, National Cancer Institute and National Cancer Institute A-P-C tools were used to identify trends and assess the effects of age, period, and cohort. RESULTS: From 1990 through 2019, an estimated 2.99 million cases of psoriasis were diagnosed in Spain, with a mean annual increase of 0.49%. Significant decreases in age-standardized incidence rates (ASIR) were reported for both sexes, with women consistently maintaining a slightly higher ASIR. Joinpoint analysis revealed multiple turning points in the downward trend, indicating periods of stabilization. A-P-C analysis demonstrated significant declines in both net (overall trend) and local drift (age-specific trends), indicating a broad decrease in the incidence of psoriasis across most age groups. While the risk of psoriasis increased with age, peaking in the 50-54 age group, it declined thereafter. Furthermore, the analysis revealed a continuous decline in risk from 1990 through 2019 for both sexes, with individuals born in the early 21st century exhibiting a significantly lower risk vs those born in the early 20th century. CONCLUSION: This study observed a slight decline in the reported psoriasis ASIR in Spain, potentially due to reduced exposure to risk factors. However, limitations in data and the complexity of factors influencing the incidence of psoriasis require further research.
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Zebrafish (Danio rerio) is an excellent model to study bacterial infections in fish and their treatment. We used zebrafish as a model of infection for Aeromonas salmonicida subsp. salmonicida (hereinafter A. salmonicida), the causative agent of fish furunculosis. The infection process of A. salmonicida was studied by immersion of zebrafish larvae in 2 different doses of the bacteria and the fish mortality was monitored for three days. The bacterium caused a high mortality (65 %) in zebrafish larvae only when they were exposed to a high bacterial concentration (107 bacterial cells/mL). To evaluate the use of fluorescence microscopy to follow A. salmonicida infection in vivo, two different fluorescent strains generated by labeling an A. salmonicida strain with either, the green fluorescent protein (GFP), or with a previously reported siderophore amonabactin-sulforhodamine B conjugate (AMB-SRB), were used. The distribution of both labeled bacterial strains in the larvae tissues was evaluated by conventional and confocal fluorescence microscopy. The fluorescent signal showed a greater intensity with the GFP-labeled bacteria, so it could be observed using conventional fluorescence microscopy. Since the AMB-SRB labeled bacteria showed a weaker signal, the larvae were imaged using a laser scanning confocal microscope after 48 h of exposure to the bacteria. Both fluorescent signals were mainly observed in the larvae digestive tract, suggesting that this is the main colonization route of zebrafish for waterborne A. salmonicida. This is the first report of the use of a siderophore-fluorophore conjugate to study a bacterial infection in fish. The use of a siderophore-fluorophore conjugate has the advantage that it is a specific marker and that does not require genetic manipulation of the bacteria.
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Aeromonas salmonicida , Doenças dos Peixes , Animais , Sideróforos/metabolismo , Peixe-Zebra , Corantes Fluorescentes/metabolismo , Proteínas de Fluorescência Verde/genética , Proteínas de Fluorescência Verde/metabolismo , Aeromonas salmonicida/genética , Doenças dos Peixes/microbiologiaRESUMO
BACKGROUND: Studies have reported increased incidence of BSI over the past decades and indicate that it is necessary to investigate the causes. The aim of this study was to determine the factors affecting trends in the incidence of bacteraemias and associated mortality. METHODS: We conducted a retrospective cohort study assessing prospectively collected data of all clinically significant bacteraemias between 1991 and 2020 in a 450-bed hospital. We determined the evolution of bacteraemia-associated incidence, adjusted 30-day mortality and performed multivariable logistic regression to compare the evolution of variables associated with mortality between 5-year periods. RESULTS: 6777 episodes were included, 59.7% males, age 66.5 ± 18.2, 39.4% ≥ 75 years. The incidence total increased: 43.8/100,000/year in 1991-1995 to 205 in 2016-2020; community-acquired bacteraemia (24.9 to 139) and hospital-acquired (0.36/1000 inpatients-days to 1.09). Bacteraemia with source in vascular catheter, urinary and biliary tract increased. The 30-day mortality rate of patients was 1179/6777 (17.4%) in the whole series and population-adjusted mortality incidence increased from 11.4/100,000 in 1991-1996 to 28.4 in 2016-2020 (RR 2.49, 95% CI 2.01-3.08). Mortality was higher in men (18.2% vs 16.3%) and those over 74 years (22.2% vs 14.3%). Appropriate empirical antimicrobial treatment improved (66.5% to 73.1%), 30-day mortality of patients decreased from 26.1 to 13.9%. When comparing the evolution of the factors associated with mortality between 1991 and 1996 vs 2016-2020, the frequency of some variables associated with higher mortality increased: male sex (OR 1.38, 95% CI 1.10-1,74), age (OR 1.02, 1.01-10.3), immunosuppressive treatment (OR 3.1, 2.09-4.6), polymicrobial bacteraemia (OR 1.76, 1.12-2.79), and others decreased: severe sepsis/septic shock (OR 0.70, 0.52-0.93), spontaneous bacterial peritonitis in cirrhosis (OR 0.06, 0.02-0.23), endocarditis (OR 0.54, 0.35-0.83); on the other hand, the frequency of factors associated with lower mortality increased: urinary (OR 1.67, 95% CI 1.23-2.27) and bile tract source (OR 1.59, 1.04-2.43), and adequate empirical treatment (OR 1.42, 95% CI 1.10-1.83). CONCLUSIONS: The incidence of bacteraemia increased due to more elderly, co-morbid patients undergoing procedures and more device related bacteraemia. The percentage of mortality decreased because adequate empirical treatment improved, decreased spontaneous bacterial peritonitis in cirrhosis and endocarditis, and increased bacteraemia of urinary and biliary tract source.
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Bacteriemia , Infecção Hospitalar , Sepse , Humanos , Masculino , Idoso , Feminino , Infecção Hospitalar/epidemiologia , Estudos Retrospectivos , Incidência , Bacteriemia/tratamento farmacológico , Bacteriemia/epidemiologia , Bacteriemia/etiologia , Sepse/tratamento farmacológico , Fatores de Risco , Antibacterianos/uso terapêuticoRESUMO
INTRODUCTION: Radiofrequency ablation (RFA) has emerged as a minimally invasive approach to single parathyroid adenoma in primary hyperparathyroidism; however, there is limited evidence on its effectiveness. OBJECTIVE: To evaluate the effectiveness and safety of RFA to treat hyper-functioning parathyroid lesions suggestive of adenomas. MATERIAL AND METHODS: A prospective study was conducted in consecutive patients with primary hyperparathyroidism treated with RFA for single parathyroid lesions in our reference center between November 2017 and June 2021. Pre-treatment (baseline) and follow-up analytical data were gathered on total protein-adjusted calcium, parathyroid hormone [PTH], phosphorus, and 24-h urine calcium. Effectiveness was defined as complete response (normal calcium and PTH), partial response (reduced but not normalized PTH with normal serum calcium), or disease persistence (elevated calcium and PTH). SPSS 15.0 was used for statistical analysis. RESULTS: Four of thirty-three enrolled patients were lost to the follow-up. The final sample comprised 29 patients (22 females) with mean age of 60.93 ± 13.28 years followed up for a mean of 16.29 ± 7.23 months. Complete response was observed in 48.27%, partial response in 37.93%, and hyperparathyroidism persistence in 13.79%. Serum calcium and PTH levels were significantly lower at 1 and 2 years of post-treatment than at baseline. Adverse effects were mild, with two cases of dysphonia (self-limited in one patient) and no cases of hypocalcaemia or hypoparathyroidism. CONCLUSION: RFA may be a safe and effective technique to treat hyper-functioning parathyroid lesions in selected patients.
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Adenoma , Hiperparatireoidismo Primário , Ablação por Radiofrequência , Feminino , Humanos , Pessoa de Meia-Idade , Idoso , Cálcio , Hiperparatireoidismo Primário/diagnóstico , Hiperparatireoidismo Primário/cirurgia , Estudos Prospectivos , Hormônio Paratireóideo , Adenoma/complicações , Adenoma/cirurgiaRESUMO
BACKGROUND AND OBJECTIVE: Previous studies suggest that asthma mortality rates in Spain have been decreasing in recent years. However, this trend is not homogeneous across age groups. Objective: To analyze asthma mortality rates over a 40-year period, focusing on changes associated with the development of new therapeutic approaches. METHODS: Death records and mid-year population data were collected from the National Statistics Institute. Using the direct method, agestandardized mortality rates were calculated for the overall population and for each sex and age group. Significant changes in mortality trends were identified using joinpoint regression analysis. The independent effects of age, period, and cohort and potential years of life lost due to asthma were also analyzed. RESULTS: Age-standardized asthma mortality rates decreased in Spain from 7.38 to 2.03 deaths per 100 000 from the first to the last quinquennium of the study (1980-1984 to 2015-2019) for the whole population. This decrease was more intense among men, where a decrease from 10.37/100 000 to 0.91/100 000 was observed compared with 5.53 to 2.77/100 000 in women. Mortality decreased in all age groups. During the last 3 years, the decrease stabilized in patients aged >64 years but increased in those aged 35-64. Mortality has been decreasing rapidly since the 1990s in patients aged <35 years. CONCLUSION: Asthma mortality rates began to decline in 1980. The decrease was observed among younger cohorts starting in the 1990s, thus confirming earlier trends. Improved diagnosis and development of new therapies for asthma may have played a role in the changes observed. Close monitoring of asthma mortality rates is necessary to confirm these trends.
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Asma , Masculino , Humanos , Feminino , Espanha/epidemiologia , Análise de RegressãoRESUMO
PURPOSE: Rooted in a trans-territorial framework, the present study was designed to provide new evidence regarding the patterns of communication among Hurricane Maria survivors who migrated to the U.S. in the aftermath of the storm. METHODS: A total of 319 Hurricane Maria survivor adults ages 18 and older were recruited into the Adelante Boricua study between August 2020 and October 2021. Most participants had relocated to the U.S. between 2017 and 2018. We used latent profile analysis and multinomial regression to examine the relationship of technology-based communication with depressive symptoms, well-being, cultural connection, and migration stress. RESULTS: We identified a five-class solution, consisting of (1) moderate communication (32%), (2) disengaged (24%), (3) no social media (18%), (4) daily with family in Puerto Rico (6%), and (5) daily trans-territorial (13%) typologies. Participants in the disengaged class were more likely to report elevated depressive symptoms and limited English proficiency, lower prosocial behaviors, lower levels of religiosity, lower attendance at religious services in the U.S., and less engagement in social activities, compared to participants in the Moderate Communication class. CONCLUSION: Roughly one in four individuals in our sample reported very limited technology-based communication with friends/family in their sending and new-receiving communities. As technology and smartphones continue to become integrated into 21st-century life, it is vital that researchers explore how the tremendous potential for connectedness relates to trans-territorial crisis migrants' well-being and adaptation.
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Tempestades Ciclônicas , Migrantes , Adulto , Estados Unidos , Humanos , Porto RicoRESUMO
This study aimed to identify the variables associated with fixation failure in intertrochanteric fractures treated with cephalomedullary nailing (CMN). We retrospectively analyzed 251 consecutive patients who underwent surgery between January 2016 and July 2019. In order to identify predictors of failure (cut-out, cut-through, and/or nonunion), we analyzed: gender, age, fracture stability (according to the AO/OTA Classification), femoral neck angle (FNA), FNA as compared to the contralateral hip, lag screw position, and tip-apex distance (TAD). The failure rate was 9.6%: there were 10 cut-outs (4%), 7 non-unions (2.8%), and 7 cut-throughs (2.8%). Univariate logistic regression analysis showed that the risk factors for fixation failure were: female sex (p= 0.018), FNA <125° (p= 0.003), a difference in FNA of 7.5° as compared to the contralateral hip on the lateral radiograph (p= <0.0001), superior (p= 0.0141) and anterior position (p= <0.0001) of the lag screw, and TAD >25mm (p= 0.016). According to the multivariate analysis, female gender (OR 12.92 ; p 0.0019), the difference in FNA on the lateral view (OR 1.36; p < 0.001), and the anterior position of the screw in the femoral head (OR14.01;p <0.001) were confirmed as independent predictors of failure. In order to avoid failures in intertrochanteric hip fractures treated with CMN, this study confirmed the importance of achieving an accurate reduction on the lateral plane and avoiding the anterior position of the screw on the femoral head.
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Fixação Intramedular de Fraturas , Fraturas do Quadril , Humanos , Feminino , Fixação Intramedular de Fraturas/efeitos adversos , Estudos Retrospectivos , Pinos Ortopédicos , Fraturas do Quadril/cirurgia , Fatores de Risco , Resultado do TratamentoRESUMO
To slow the spread of the COVID-19 virus, some U.S. State governments restricted public activity by implementing lockdowns. The possibility remains that lockdowns may need to be implemented in the future, whether to combat novel strains of COVID-19 or entirely different viruses. The present experiment tested whether thinking about a future lockdown affects people's attitudes toward institutions. We found that conservative participants who thought about a future lockdown reported less intention to adhere to the Centers for Disease Control and Prevention (CDC) guidelines and less trust in the government compared to conservative participants in a control condition. We also found that liberal participants who thought about a future lockdown reported more trust in the government and the CDC, compared to liberal participants in a control condition. These findings suggest that merely considering a future lockdown affects people's intended adherence and institutional trust. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-022-04208-2.
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BACKGROUND AND OBJECTIVE: Surgical excision is the treatment of choice for basal cell carcinoma (BCC). Complete excision with clear margins is important for reducing the risk of recurrence. The aims of this study were to describe the characteristics of BCCs in our health care area, calculate the percentage of positive margins after surgical excision, and determine the risk factors for incomplete excision. MATERIAL AND METHODS: Retrospective observational study of BCCs that were surgically removed at Hospital Universitario Nuestra Señora de Candelaria, in Santa Cruz de Tenerife, Spain, between January 1, 2014 and December 31, 2014. Information was collected on demographic, clinical, and histologic variables, surgical approach, margin status, and the department responsible. RESULTS: In total, 966 BCCs were diagnosed in 776 patients. Nine percent of tumors with complete data were biopsied, 89% were surgically excised, and 2% were removed by shave excision. The median age of patients with excised tumors was 71 years and 52% were men. BCCs were most often located on the face (59.1%). Surgical margins were analyzed in 506 cases, 17% of which had positive margins. Incomplete excision was significantly more common in tumors located on the face (22% vs. 10% for other locations) and in high-risk subtypes according to the World Health Organization classification (25% vs. 15% for low-risk subtypes). CONCLUSIONS: The characteristics of BCCs in our health care area are similar to those described elsewhere. Facial location and histologic subtype are risk factors for incomplete excision. Careful surgical planning is therefore important in the initial management of BCCs with these characteristics.
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Carcinoma Basocelular , Neoplasias Cutâneas , Masculino , Humanos , Idoso , Feminino , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/patologia , Espanha/epidemiologia , Carcinoma Basocelular/epidemiologia , Carcinoma Basocelular/cirurgia , Carcinoma Basocelular/patologia , Biópsia , Margens de ExcisãoRESUMO
Silicon (Si) photonics can have a major impact on the development of mid-IR photonics by leveraging on the reliable and high-volume fabrication technologies already developed for microelectronic integrated circuits. Germanium (Ge), already used in Si photonics, is a prime candidate to extend the operating wavelength of Group IV-based photonic integrated circuits beyond 8 µm, and potentially up to 15 µm. High performance quantum cascade lasers (QCLs) and interband cascade lasers grown on Si have been demonstrated, whereas no QCLs monolithically integrated on Ge have been reported yet. In this work, we present InAs-based QCLs directly grown on Ge by molecular beam epitaxy. The lasers emitting near 14 µm exhibited threshold current densities as low as 0.8-0.85 kA/cm2 at room temperature.
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Bone turnover markers are decreased in GC-treated subjects with DM. Decreased OC levels in GC-treated patients were associated with an increased risk of DM. These results suggest the involvement of OC in glucose homeostasis regulation in DM. INTRODUCTION: Osteocalcin (OC) is involved in the regulation of glucose homeostasis. Glucocorticoid (GC) treatment is associated with impaired osteoblast function, decreased OC levels, and the development and/or worsening of pre-existing diabetes mellitus (DM). Whether decreased OC levels in GC-treated subjects contribute to DM is not well known. The aim of this study was to analyse whether OC levels in GC-treated patients are associated with the presence of DM. METHODS: One hundred twenty-seven patients (aged 61.5 ± 17.9 years) on GC treatment were included. GC dose, treatment duration, presence of DM and bone formation (OC, bone ALP, PINP) and resorption markers (urinary NTX, serum CTX) were analysed. The cut-offs of each bone turnover marker (BTM) for the presence of DM were evaluated and optimised with the Youden index and included in the logistic regression analysis. RESULTS: Among the patients, 17.3% presented DM. No differences were observed in GC dose or duration or the presence of fractures. Diabetics showed lower levels of OC (7.57 ± 1.01 vs. 11.56 ± 1; p < 0.001), PINP (21.48 ± 1.01 vs. 28.39 ± 1; p = 0.0048), NTX (24.91 ± 1.01 vs. 31.7 ± 1; p = 0.036) and CTX (0.2 ± 1.01 vs. 0.3 ± 1; p = 0.0016). The discriminating BTM cut-offs for DM presence were < 9.25 ng/mL for OC, < 24 ng/mL for PINP, < 27.5 nMol/mM for NTX and < 0.25 ng/mL for CTX. In a multivariate logistic regression model adjusted for GC dose, BMI, age and the above four BTMs, only OC remained independently associated with DM presence. Thus, in a model adjusted for GC dose, BMI and age, OC was significantly associated with DM (OR: 6.1; 95%CI 1.87-19.89; p = 0.001). CONCLUSION: Decreased OC levels in GC-treated patients are associated with increased odds of DM, and only OC was independently associated with DM in a model including four BTMs.
Assuntos
Diabetes Mellitus , Glucocorticoides , Adulto , Idoso , Biomarcadores , Remodelação Óssea , Osso e Ossos , Colágeno Tipo I , Glucocorticoides/efeitos adversos , Humanos , Pessoa de Meia-Idade , OsteocalcinaRESUMO
BACKGROUND: Preterm infants are generally fed through nasogastric enteral feeding tubes (NEFTs). The aim of this work was to evaluate the role of NEFTs in the initial colonization of the preterm gut and its evolution within the first 2 weeks after birth. METHODS: For this purpose, fecal and NEFT-derived samples from 30 preterm infants hospitalized in a neonatal intensive care unit (NICU) were collected from birth to the second week of life. Samples were cultivated in ten culture media, including three for the isolation of antibiotic-resistant microorganisms. RESULTS: Isolates (561) were identified by 16S ribosomal RNA gene sequencing. Although the first NEFTs inserted into the neonates after birth were rarely colonized, analysis of NEFTs and fecal samples over time revealed a significant increase in bacterial abundance, diversity, and detection frequency. Results showed a parallel colonization between time-matched NEFTs and fecal samples, suggesting an ongoing bidirectional transfer of bacteria from the neonatal gut to the NEFTs and vice versa. CONCLUSIONS: In short-term hospitalization, length is by far the determinant factor for the early colonization of preterm infants. As NEFT populations reflect the bacterial populations that are colonizing the preterm in a precise moment, their knowledge could be useful to prevent the dissemination of antibiotic-resistant strains. IMPACT: The hospital environment modulates preterm colonization immediately after birth. The colonization of preterm feces and NEFTs occurs in parallel. There is an ongoing bidirectional transfer of microorganisms from the neonatal gut to the NEFTs and vice versa. Bacterial communities inside NEFTs could act as reservoirs of antibiotic resistance genes. NEFT populations reflect the bacteria that are colonizing the preterm at a precise moment.