The trichome pattern diversity of Cardamine shares genetic mechanisms with Arabidopsis but differs in environmental drivers.

Natural variation in trichome pattern (amount and distribution) is prominent among populations of many angiosperms. However, the degree of parallelism in the genetic mechanisms underlying this diversity and its environmental drivers in different species remain unclear. To address these questions, we analyzed the genomic and environmental bases of leaf trichome pattern diversity in Cardamine hirsuta, a relative of Arabidopsis (Arabidopsis thaliana). We characterized 123 wild accessions for their genomic diversity, leaf trichome patterns at different temperatures, and environmental adjustments. Nucleotide diversities and biogeographical distribution models identified two major genetic lineages with distinct demographic and adaptive histories. Additionally, C. hirsuta showed substantial variation in trichome pattern and plasticity to temperature. Trichome amount in C. hirsuta correlated positively with spring precipitation but negatively with temperature, which is opposite to climatic patterns in A. thaliana. Contrastingly, genetic analysis of C. hirsuta glabrous accessions indicated that, like for A. thaliana, glabrousness is caused by null mutations in ChGLABRA1 (ChGL1). Phenotypic genome-wide association studies (GWAS) further identified a ChGL1 haplogroup associated with low trichome density and ChGL1 expression. Therefore, a ChGL1 series of null and partial loss-of-function alleles accounts for the parallel evolution of leaf trichome pattern in C. hirsuta and A. thaliana. Finally, GWAS also detected other candidate genes (e.g. ChETC3, ChCLE17) that might affect trichome pattern. Accordingly, the evolution of this trait in C. hirsuta and A. thaliana shows partially conserved genetic mechanisms but is likely involved in adaptation to different environments.

Clinical outcomes of anti-reflux mucosal ablation for gastroesophageal reflux disease: An international bi-institutional study.

BACKGROUND AND AIM: Anti-reflux mucosal ablation (ARMA) is an emerging endoscopic treatment aimed at enhancing the gastroesophageal junction flap valve. This study aimed to evaluate its feasibility, effectiveness, and safety. METHODS: Between May 2018 and December 2022, patients with gastroesophageal reflux disease (GERD) symptoms refractory to acid suppression medications or those dependent on such medications were enrolled for ARMA. This retrospective analysis utilized prospectively collected data from an international bi-center study. GERD questionnaire, upper endoscopy, and 24-h pH monitoring were conducted at 2-6 months and 12 months post-ARMA. Clinical success was defined as a > 50% reduction in a validated GERD questionnaire. RESULTS: A total of 68 patients underwent ARMA. Definitive GERD was diagnosed in 44 (64.7%) patients, while 24 (35.3%) exhibited reflux hypersensitivity. Clinical success rates at 2-6 months and 1 year post-ARMA were 60% (39/65) and 70% (21/30), respectively. The median GERD-health-related quality of life score significantly improved from 26 to 11 at 2-6 months (P < 0.001). Among the 51 patients (71.8%) who underwent 24-h pH monitoring, the median acid exposure time decreased from 5.3% to 0.7% (P = 0.003), accompanied by a significant reduction in esophagitis rates (P < 0.001). Multivariate analysis did not identify predictors of short-term success. Nine (13.2%) patients experienced transient stenosis requiring balloon dilation. CONCLUSIONS: ARMA demonstrates both technical feasibility and reproducibility as a safe procedure that effectively ameliorates GERD symptoms in approximately two-thirds of patients during short-term follow up. Both reflux hypersensitivity and confirmed GERD patients, regardless of their response to acid suppression medication, may be suitable candidates.

Determinant factors for first-line treatment choice and effectiveness in pediatric eosinophilic esophagitis: an analysis of the EUREOS EoE CONNECT registry.

This study compared short-term effectiveness of proton pump inhibitors (PPI), swallowed topical corticosteroids (STC), and dietary therapies in reversing clinical and histological features in pediatric patients with eosinophilic esophagitits (EoE). Determinants for treatment choice and PPI therapy effectiveness were also assessed.  A cross-sectional study analysis of patients under 18 years old recruited onto the multicenter EoE CONNECT registry was performed. Clinico-histological response was defined as symptomatic improvement plus a peak eosinophil count below 15 per high-power field after treatment. Effectiveness of first-line options used in monotherapy was compared. Overall, 393 patients (64% adolescents) receiving PPI, STC, or dietary monotherapy to induce EoE remission were identified. PPI was the preferred option (71.5%), despite STC providing the highest clinico-histological response rates (66%) compared to PPI (44%) and diet (42%). Logistic regression identified fibrotic features and recruitment at Italian sites independently associated to first-line STC treatment; age under 12 associated to dietary therapy over other options. Analysis of 262 patients in whom PPI effectiveness was evaluated after median (IQR) 96 (70-145) days showed that this effectiveness was significantly associated with management at pediatric facilities and use of high PPI doses. Among PPI responders, decrease in rings and structures in endoscopy from baseline was documented, with EREFS fibrotic subscore for rings also decreasing among responders (0.27 ± 0.63 vs. 0.05 ± 0.22, p < 0.001). Conclusion: Initial therapy choice for EoE depends on endoscopic phenotype, patient's age, and patients' origin. High PPI doses and treatment in pediatric facilities significantly determined effectiveness, and reversed fibrotic endoscopic features among responders. What is Known: • Proton pump inhibitors are widely used to induce and maintain remission in EoE in real practice, despite other first-line alternative therapies possibly providing higher effectiveness. What is New: • Proton pump inhibitors represent up to two-thirds of first-line monotherapies used to induce EoE remission in pediatric and adolescent patients with EoE. The choice of STC as first-line treatment for EoE was significantly associated with fibrotic features at baseline endoscopy and recruitment in Italian centers; age less than 12 years was associated with dietary therapy. • PPI effectiveness was found to be determined by use of high doses, attendance at pediatric facilities, presenting inflammatory instead of fibrotic or mixed phenotypes, and younger age. Among responders, PPI therapy reversed both inflammatory and fibrotic features of EoE after short-term treatment.

Changes in cardiovascular health and white matter integrity with aerobic exercise, cognitive and combined training in physically inactive healthy late-middle-aged adults: the "Projecte Moviment" randomized controlled trial.

INTRODUCTION: This is a 12-weeks randomized controlled trial examining the effects of aerobic exercise (AE), computerized cognitive training (CCT) and their combination (COMB). We aim to investigate their impact on cardiovascular health and white matter (WM) integrity and how they contribute to the cognitive benefits. METHODS: 109 participants were recruited and 82 (62% female; age = 58.38 ± 5.47) finished the intervention with > 80% adherence. We report changes in cardiovascular risk factors and WM integrity (fractional anisotropy (FA); mean diffusivity (MD)), how they might be related to changes in physical activity, age and sex, and their potential role as mediators in cognitive improvements. RESULTS: A decrease in BMI (SMD = - 0.32, p = 0.039), waist circumference (SMD = - 0.42, p = 0.003) and diastolic blood pressure (DBP) (SMD = - 0.42, p = 0.006) in the AE group and a decrease in BMI (SMD = - 0.34, p = 0.031) and DBP (SMD = - 0.32, p = 0.034) in the COMB group compared to the waitlist control group was observed. We also found decreased global MD in the CCT group (SMD = - 0.34; p = 0.032) and significant intervention-related changes in FA and MD in the frontal and temporal lobes in the COMB group. CONCLUSIONS: We found changes in anthropometric measures that suggest initial benefits on cardiovascular health after only 12 weeks of AE and changes in WM microstructure in the CCT and COMB groups. These results add evidence of the clinical relevance of lifestyle interventions and the potential benefits when combining them. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT031123900.

Preclinical Study of DCD and Normothermic Perfusion for Visceral Transplantation.

Considering recent clinical and experimental evidence, expectations for using DCD-derived intestines have increased considerably. However, more knowledge about DCD procedure and long-term results after intestinal transplantation (ITx) is needed. We aimed to describe in detail a DCD procedure for ITx using normothermic regional perfusion (NRP) in a preclinical model. Small bowel was obtained from pigs donors after 1 h of NRP and transplanted to the recipients. Graft Intestinal samples were obtained during the procedure and after transplantation. Ischemia-reperfusion injury (Park-Chiu score), graft rejection and transplanted intestines absorptive function were evaluated. Seven of 8 DCD procedures with NRP and ITx were successful (87.5%), with a good graft reperfusion and an excellent recovery of the recipient. The architecture of grafts was well conserved during NRP. After an initial damage of Park-chiu score of 4, all grafts recovered from ischemia-reperfusion, with no or very subtle alterations 2 days after ITx. Most recipients (71.5%) did not show signs of rejection. Only two cases demonstrated histologic signs of mild rejection 7 days after ITx. Interestingly intestinal grafts showed good absorptive capacity. The study's results support the viability of intestinal grafts from DCD using NRP, contributing more evidence for the use of DCD for ITx.

Functional outcomes and complications of patients contaminated with Cutibacterium acnes during primary reverse shoulder arthroplasty: study at two- and five-years of follow-up.

PURPOSE: The objective of the study was to compare the functional outcomes and the complication rate of the patients with C. acnes contamination at the end of the primary reverse shoulder arthroplasty (RSA) surgery to those patients without C. acnes contamination. METHOD: A total of 162 patients were included. In all cases, skin and deep tissue cultures were obtained. A molecular typing characterization of the C. acnes strains was performed. Functional outcomes were assessed with the Constant score at the two and five year follow-up and all complications were also recorded. RESULTS: A total of 1380 cultures were obtained from the 162 primary RSA surgeries. Of those, 96 turned out to be positive for C. acnes. There were 25 patients with positive cultures for C. acnes. The overall postoperative Constant score was not significantly different between those patients having C. acnes-positive cultures and those with negative cultures at the two and five year follow-up (59.2 vs. 59.6 at two years, p 0.870, and 59.5 vs. 62.4 at five years, p 0.360). Patients with positive cultures presented a higher complication rate (p 0.001) with two infections, one revision surgery, and one dislocation. CONCLUSION: Patients ending up with C. acnes-positive cultures after primary shoulder arthroplasty surgery do not have worse clinical outcomes when compared to patients having negative cultures, but a greater number of complications were found in those patients with C. acnes-positive cultures.

Influence of blistering lesions on foot functionality in hikers.

BACKGROUND: Friction blisters are formed by abrasion from frictional forces on the upper layer of the epidermis and can make physical activity an uncomfortable experience. To our knowledge, no previous studies have considered how these injuries affect the functionality of the foot. For this reason, the main aim of this study was to evaluate foot function in hikers, with or without blisters. MATERIAL AND METHODS: This case-control study examined 298 hikers who walked the Camino de Santiago long-distance trail (in northern Spain); 207 had one or more blistering foot lesions and 91 had no blisters. Sociodemographic and clinical variables were collected, and the number of blisters and their locations on the foot were recorded. All participants self-completed the Foot Function Index (FFI) questionnaire, in their native language. RESULTS: Pain and disability were significantly greater among the hikers with blisters (pain p=<0.001; disability p = 0.015). However, there were no significant differences in the limitation of physical activity between those with blisters (case group) and the control group (p = 0.144). Neither was there any correlation between the number of blisters and pain, disability or limitation of activity. However, the location of the lesion did influence foot functionality. Blisters on the metatarsal heads were more limiting and caused greater pain (right foot p = 0.009; left foot p = 0.017), greater disability (right foot p = 0.005; left foot p = 0.005), greater limitation of activity (on right foot p = 0.012) and more loss of foot functionality (right foot p = 0.002; left foot p = 0.007). CONCLUSION: The hikers with blisters experienced reduced foot functionality in terms of pain and disability. The number of blisters was not related to foot functionality. Blisters located on the metatarsal heads caused the greatest increase in pain, disability and limitation of activity.

Impact of fibromyalgia and related factors on foot function and quality of life: Cross-sectional study.

BACKGROUND: The aim of study is to examine the factors that may influence pain, disability and the limitation of activity due to the presence of fibromyalgia in the foot. METHODS: 323 patients diagnosed with fibromyalgia were recruited. Each participant completed the Foot Function Index questionnaire (FFI) and the Revised Fibromyalgia Impact Questionnaire (FIQR). A multivariate analysis was performed to determine the factors associated with high scores in each of these questionnaires. RESULTS: In both questionnaires, the subscales presenting the highest scores were foot pain (FFI score: 71.18 ± 20.40) and symptom intensity (FIQR score: 36.23 ± 8.04). According to the multivariate analysis, foot function is influenced by age (p = <0.001), BMI (p = 0.001), lack of physical activity (p = <0.001), the presence of rheumatoid arthritis (p = 0.012), retirement due to disability (p = <0.001) and being unemployed (p < 0.001). CONCLUSION: Fibromyalgia affects foot function, provoking significant pain. Related factors include age, BMI, lack of physical activity, the presence of rheumatoid arthritis, and employment status.

Advanced Nanostructured Conjugated Microporous Polymer Application in a Tandem Photoelectrochemical Cell for Hydrogen Evolution Reaction.

Solar energy conversion through photoelectrochemical cells by organic semiconductors is a hot topic that continues to grow due to the promising optoelectronic properties of this class of materials. In this sense, conjugated polymers have raised the interest of researchers due to their interesting light-harvesting properties. Besides, their extended π-conjugation provides them with an excellent charge conduction along the whole structure. In particular, conjugated porous polymers (CPPs) exhibit an inherent porosity and three-dimensional structure, offering greater surface area, and higher photochemical and mechanical stability than their linear relatives (conjugated polymers, CPs). However, CPP synthesis generally provides large particle powders unsuitable for thin film preparation, limiting its application in optoelectronic devices. Here, a synthetic strategy is presented to prepare nanostructures of a CPP suitable to be used as photoelectrode in a photoelectrochemical (PEC) cell. In this way, electronic and photoelectrochemical properties are measured and, attending to the optoelectronic properties, two hybrid photoelectrodes (photoanode and photocathode) are designed and built to assemble a tandem PEC cell. The final device exhibits photocurrents of 0.5 mA cm-2 at a 0.7 V in the two electrode configuration and the hydrogen evolution reaction is observed and quantified by gas chromatography, achieving 581 µmol of H2 in a one-hour reaction.

Differential environmental and genomic architectures shape the natural diversity for trichome patterning and morphology in different Arabidopsis organs.

Despite the adaptive and taxonomic relevance of the natural diversity for trichome patterning and morphology, the molecular and evolutionary mechanisms underlying these traits remain mostly unknown, particularly in organs other than leaves. In this study, we address the ecological, genetic and molecular bases of the natural variation for trichome patterning and branching in multiple organs of Arabidopsis (Arabidopsis thaliana). To this end, we characterized a collection of 191 accessions and carried out environmental and genome-wide association (GWA) analyses. Trichome amount in different organs correlated negatively with precipitation in distinct seasons, thus suggesting a precise fit between trichome patterning and climate throughout the Arabidopsis life cycle. In addition, GWA analyses showed small overlapping between the genes associated with different organs, indicating partly independent genetic bases for vegetative and reproductive phases. These analyses identified a complex locus on chromosome 2, where two adjacent MYB genes (ETC2 and TCL1) displayed differential effects on trichome patterning in several organs. Furthermore, analyses of transgenic lines carrying different natural alleles demonstrated that TCL1 accounts for the variation for trichome patterning in all organs, and for stem trichome branching. By contrast, two other MYB genes (TRY and GL1), mainly showed effects on trichome patterning or branching, respectively.

Continuous monitoring of cell transfection efficiency with micropatterned substrates.

The effect of cell-cell contact on gene transfection is mainly unknown. Usually, transfection is carried out in batch cell cultures without control over cellular interactions, and efficiency analysis relies on complex and expensive protocols commonly involving flow cytometry as the final analytical step. Novel platforms and cell patterning are being studied to control cellular interactions and improve quantification methods. In this study, we report the use of surface patterning of fibronectin for the generation of two types of mesenchymal stromal cell patterns: single-cell patterns without cell-to-cell contact, and small cell-colony patterns. Both scenarios allowed the integration of the full transfection process and the continuous monitoring of thousands of individualized events by fluorescence microscopy. Our results showed that cell-to-cell contact clearly affected the transfection, as single cells presented a maximum transfection peak 6 h earlier and had a 10% higher transfection efficiency than cells with cell-to-cell contact.

Health-related quality of life in adolescents: individual and combined impact of health-related behaviors (DADOS study).

PURPOSE: To investigate the individual and combined effect of physical activity, adherence to the Mediterranean diet, sleep quality, sleep duration, and screen time on health-related quality of life (HRQoL) in adolescents. METHODS: This is a cross-sectional analysis with 262 adolescents (13.9 ± 0.3 years) from DADOS (Deporte, ADOlescencia y Salud) study. Physical activity was assessed with a wrist-worn GENEActiv triaxial accelerometer. Adherence to the Mediterranean diet was evaluated by the KIDMED questionnaire. Sleep patterns were self-reported through the Spanish version of Pittsburgh Sleep Quality Index questionnaire. Screen time was assessed through the HELENA sedentary behavior questionnaire. HRQoL was measured using the KIDSCREEN-10 questionnaire. Scores were categorized into low and high using a normative cut-off used to identify factors associated with being in a high HRQoL group. A healthy lifestyle index was created including positive scores for each individual behavior, and five categories of achievement were established (0, 1, 2, 3, ≥ 4). RESULTS: Sleep patterns and screen time revealed a significant individual relationship with HRQoL (p < 0.05). Adolescents achieving ≥ 3 positive health-related behaviors showed higher HRQoL levels compared to those fulfilling none (p < 0.05). Logistic regression analysis revealed an increased likelihood of high HRQoL according to the number of positive health-related behaviors achieved (p < 0.05). CONCLUSIONS: Our results reveal higher levels of HRQoL in those adolescents achieving ≥ 3 health-related behaviors compared to their peers achieving none. Moreover, our findings show a cumulative effect of health-related behaviors on HRQoL. These findings underline the key role of promoting a healthy lifestyle in order to improve adolescents' health and well-being.

Fundamental Insights into Photoelectrocatalytic Hydrogen Production with a Hole-Transport Bismuth Metal-Organic Framework.

Solar fuels production is a cornerstone in the development of emerging sustainable energy conversion and storage technologies. Light-induced H2 production from water represents one of the most crucial challenges to produce renewable fuel. Metal-organic frameworks (MOFs) are being investigated in this process, due to the ability to assemble new structures with the use of suitable photoactive building blocks. However, the identification of the reaction intermediates remains elusive, having negative impacts in the design of more efficient materials. Here, we report the synthesis and characterization of a new MOF prepared with the use of bismuth and dithieno[3,2-b:2',3'-d]thiophene-2,6-dicarboxylic acid (DTTDC), an electron-rich linker with hole transport ability. By combining theoretical studies and time-resolved spectroscopies, such as core hole clock and laser flash photolysis measurements, we have completed a comprehensive study at different time scales (fs to ms) to determine the effect of competitive reactions on the overall H2 production. We detect the formation of an intermediate radical anion upon reaction of photogenerated holes with an electron donor, which plays a key role in the photoelectrocatalytic processes. These results shed new light on the use of MOFs for solar fuel production.

Optical Single Cell Resolution Cytotoxicity Biosensor Based on Single Cell Adhesion Dot Arrays.

Low cost, easy to use cell viability tests are needed in the pharmaceutical, biomaterial, and environmental industries to measure adverse cellular effects. We present a new methodology to track cell death with high resolution. Adherent cells commonly detach from the surface when they die, but some toxic compounds promote cell adhesion. A methodology that enables both dynamic detachment monitoring but also rapid detection of toxic effects of compounds that promote cell adhesion would constitute a step forward toward high-throughput cytotoxicity measurements. We achieved dynamic digital quantification of cell viability by simple optical imaging using "single cell adhesion dot arrays" (SCADA), fibronectin (FN) dot arrays designed to accommodate a single cell on each fibronectin dot. For cytotoxicity measurements, cell-filled SCADA substrates were exposed to K2CrO4, HgSO4 salts, and dimethyl sulfoxide (DMSO). The toxic effect of DMSO and K2CrO4 was dynamically monitored by measuring the cell detachment rate during more than 30 h by quantifying the number of occupied dots in the SCADA array. HgSO4 inhibited cellular detachment from the surface, and cytotoxicity was monitored using the trypan blue life/death assay directly on the surface. In all cases, the cytotoxicity effects were easily monitored with single cell resolution, and the results were comparable to previous reports. SCADA enabled dynamic measurements at the highest resolution due to the digital measuring in this method. The integration of SCADA substrates into microfluidic platforms will provide a practical tool that will extend to fundamental research and commercial applications.

Effects of a blue-blocking screen filter on accommodative accuracy and visual discomfort.

INTRODUCTION: The prescription of blue-blocking (B-B) filters for the management of visual symptoms and signs associated with the use of electronic devices is routinely performed by eye care specialists. However, the utility of B-B filters is a matter of debate and discussion by the scientific community due to the lack of evidence supporting their use. Here, we aimed to determine the effects of using B-B filters on the dynamics of the accommodative response and pupil size and perceived levels of visual discomfort, while performing a 30-min reading task at a close distance in subjects who routinely use electronic devices. METHODS: Nineteen healthy young adults (22.0 ± 2.7 years) read two 30-min passages on a computer screen placed at 50 cm, either while using a commercially available B-B filter or without any filter on two different days. The magnitude and variability of both the accommodative response and pupil size were dynamically measured for 60 s using the WAM-5500 open field autorefractometer at 4-5, 9-10, 14-15, 19-20, 24-25, and 29-30 min into the trial. The perceived levels of visual discomfort were also obtained. RESULTS: The lag and variability of accommodation were insensitive to the blue light level (p = 0.34 and 0.62, respectively). There was a time-on-task effect for the variability of accommodation, showing greater instability over time regardless of the blue light level. The use of the B-B filter was associated with improved reading speed (p = 0.02), with an increase of 16.5 words per minute. However, it was not associated with any significant change in pupil dynamics or the perceived levels of visual discomfort (p> 0.05 in both cases). CONCLUSIONS: Our data showed that the use of a B-B filter had no effect on accommodative dynamics or visual symptomatology. Based on these findings, there is no support for the prescription of B-B filters to attenuate the visual symptoms and signs associated with the use of electronic devices in healthy young adults.

Hydroxamate Titanium-Organic Frameworks and the Effect of Siderophore-Type Linkers over Their Photocatalytic Activity.

The chemistry of metal-organic frameworks (MOFs) relies on the controlled linking of organic molecules and inorganic secondary building units to assemble an unlimited number of reticular frameworks. However, the design of porous solids with chemical stability still remains limited to carboxylate or azolate groups. There is a timely opportunity to develop new synthetic platforms that make use of unexplored metal binding groups to produce metal-linker joints with hydrolytic stability. Living organisms use siderophores (iron carriers in Greek) to effectively assimilate iron in soluble form. These compounds make use of hard oxo donors as hydroxamate or catecholate groups to coordinate metal Lewis acids such as iron, aluminum, or titanium to form metal complexes very stable in water. Inspired by the chemistry of these microorganisms, we report the first hydroxamate MOF prepared by direct synthesis. MUV-11 (MUV = materials of Universidad de Valencia) is a crystalline, porous material (close to 800 m2·g-1) that combines photoactivity with good chemical stability in acid conditions. By using a high-throughput approach, we also demonstrate that this new chemistry is compatible with the formation of single-crystalline phases for multiple titanium salts, thus expanding the scope of accessible precursors. Titanium frameworks are regarded as promising materials for photocatalytic applications. Our photoelectrochemical and catalytic tests suggest important differences for MUV-11. Compared to other Ti-MOFs, changes in the photoelectrochemical and photocatalytic activity have been rationalized with computational modeling, revealing how the chemistry of siderophores can introduce changes to the electronic structure of the frontier orbitals, relevant to the photocatalytic activity of these solids.

Community intervention to reduce social isolation in older adults in disadvantaged urban areas: study protocol for a mixed methods multi-approach evaluation.

BACKGROUND: The proportion of older people has dramatically increased in recent decades. Moreover, social and demographic trends show a global increase of older people at risk of loneliness and lack of social relationships. The objective of this study was to evaluate the process, the effectiveness and the cost-effectiveness of a planned 22 weekly group sessions called School of Health for Older People to reduce social isolation. METHODS: This is a mixed methods multi-approach evaluation that includes: 1) A qualitative evaluation among coordinators and participants taking part in the intervention, through in depth-interviews and focus groups, respectively. The main topics covered will be positive and negative aspects of the intervention, suggestions for its improvement, opinions on different aspects of the intervention, and perceived benefits; 2) A quantitative quasi-experimental design, comparing a group of individuals taking part in the intervention with another group with similar characteristics not receiving the intervention. Data will be collected at the beginning and at the end of the intervention. Social support will be measured through questions drawn from the Medical Outcomes Study and the National Social Life, Health, and Aging Project questionnaires. Psychological morbidity will be measured through Goldberg's General Health Questionnaire, and Health-related Quality of Life will be measured through the EuroQoL questionnaire. Information on visits to the primary care center in the years before and after the intervention will be obtained from the electronic records of the primary care centers; 3) A cost-utility analysis, which will be conducted from a health system (primary care) perspective, including direct costs of the program and the primary care health services used. The effects of the intervention will be measured on quality-adjusted life years. DISCUSSION: There is an urgent need for studies assessing the effectiveness and the efficiency of potential interventions to reduce social isolation among older persons. The results of this study will help to fill the knowledge gap in this area and might be especially useful for the development of social and public health policies and programs for older people in disadvantaged neighborhoods in urban areas. TRIAL REGISTRATION: NCT03142048 retrospectively registered (April 11, 2017).

Metastasis of dermatofibrosarcoma diagnosed by capsule endoscopy.

In the study of obscure gastrointestinal bleeding, which includes iron-deficiency anemia, the capsule endoscopy is a valuable diagnostic tool. In the different series the presence of tumors reaches 16% as the cause of it. We present the case of a rare tumor with metastatic extension in the small intestine in which the capsule endoscopy was key to the diagnosis and survival of the patient.

A Facile Synthesis of Blue Luminescent [7]Helicenocarbazoles Based on Gold-Catalyzed Rearrangement-Iodonium Migration and Suzuki-Miyaura Benzannulation Reactions.

New azahelicenes having interesting photophysical properties have been prepared in a four-step sequence. These [7]helicenocarbazoles are efficient blue luminophores, demonstrating the utility of gold catalysis in the preparation of advanced materials.

Fever and Multiple Eschars After an African Safari: Report of Three Cases.

African tick-bite fever (ATBF), a tickborne disease endemic in rural areas of sub-Saharan Africa and the West Indies caused by Rickettsia africae, has been recognized as an emerging health problem in recent years. ATBF has been reported as the second most commonly documented etiology of fever, after malaria, in travelers who return ill from sub-Saharan Africa. Most cases reported in the literature occurred in middle-aged adults, so the incidence of ATBF in children is unclear. We report a cluster of three cases of ATBF that occurred in children ages 7 to 16 years after returning from a game-hunting safari in South Africa.