Position statement: asthma in Latin America. IS short-acting beta-2 agonist helping or compromising asthma management?

In Latin-America, with 603 million inhabitants, the average prevalence of asthma is estimated at 17%, but with wide fluctuations, ranging from 5% in some cities (Mexico) to 30% in Costa Rica. The risk of severe exacerbations seems to be higher in Latin America compared with other regions. A majority of patients uses daily quick-relief medication, with the belief that it is the most important treatment because of its rapid onset of action; without treating the underlying inflammation. Overuse of short-acting beta2 agonists (SABAs) is associated with increased risk of asthma deaths in a dose-response manner. Beta2 agonists increase the severity of asthma through enhanced bronchial hyperresponsiveness and reduced lung function. Also, it has been shown that overreliance on SABA delays recognition of a potentially life-threatening asthma attack. We believe that overreliance on SABA in asthma is also an important public health issue. The fact that SABA use in GINA is not supported by a randomized trial but by an anonymous paper; makes us guess that we use SABA just because we are used to do so. In 2019 GINA strategy introduces one of the most important changes in the management of Asthma in the past 30 years, highlighting anti-inflammatory reliever therapy. A combination of low dose ICS/fast action bronchodilator will not only treat symptoms, but more importantly the underlying inflammation, protecting patients from preventable asthma attacks. After 50 years of a SABA centric approach in asthma management, it is time to leave behind a treatment based just on the bronchodilation and tackle the inflammation.

Mapping tree density at a global scale.

The global extent and distribution of forest trees is central to our understanding of the terrestrial biosphere. We provide the first spatially continuous map of forest tree density at a global scale. This map reveals that the global number of trees is approximately 3.04 trillion, an order of magnitude higher than the previous estimate. Of these trees, approximately 1.39 trillion exist in tropical and subtropical forests, with 0.74 trillion in boreal regions and 0.61 trillion in temperate regions. Biome-level trends in tree density demonstrate the importance of climate and topography in controlling local tree densities at finer scales, as well as the overwhelming effect of humans across most of the world. Based on our projected tree densities, we estimate that over 15 billion trees are cut down each year, and the global number of trees has fallen by approximately 46% since the start of human civilization.

Cognitive and psychiatric symptoms in genetically determined Parkinson's disease: a systematic review.

The aim was to review the existing reports on cognitive and behavioural symptoms in monogenic forms of Parkinson's disease (PD) and to identify recurring patterns of clinical manifestations in those with specific mutations. A systematic literature search was conducted to retrieve observational studies of monogenic PD. Data pertaining to cognitive and psychiatric manifestations were extracted using standardized templates. The PRISMA guidelines were followed. Of the 1889 citations retrieved, 95 studies on PD-related gene mutations were included: 35 in SNCA, 35 in LRRK2, four in VPS35, 10 in Parkin, three in DJ1 and eight in PINK1. Nineteen studies (20%) provided adequate data from comprehensive cognitive assessment and 31 studies (32.6%) outlined psychiatric manifestations through the use of neuropsychiatric scales. Cognitive impairment was reported in all monogenic PD forms with variable rates (58.8% PINK1, 53.9% SNCA, 50% DJ1, 29.2% VPS35, 15.7% LRRK2 and 7.4% Parkin). In this regard, executive functions and attention were the domains most affected. With respect to psychiatric symptoms, depression was the most frequent symptom, occurring in 37.5% of PINK1 cases and 41.7% of VPS35 and LRRK2 cases. Co-occurrence of cognitive decline with visual hallucinations was evidenced. Widespread accumulation of Lewy bodies, distinctive of SNCA, PINK1 and DJ1 mutations, results in higher rates of cognitive impairment. Similarly, a higher degree of visual hallucinations is observed in SNCA mutations, probably owing to the more widespread accumulation. The lower rates of α-synuclein pathology in LRRK2 and Parkin may underpin the more benign disease course in these patients.

Laparoscopic Liver Resection: A South American Experience with 2887 Cases.

BACKGROUND: Laparoscopic liver resections (LLR) have been increasingly performed in recent years. Most of the available evidence, however, comes from specialized centers in Asia, Europe and USA. Data from South America are limited and based on single-center experiences. To date, no multicenter studies evaluated the results of LLR in South America. The aim of this study was to evaluate the experience and results with LLR in South American centers. METHODS: From February to November 2019, a survey about LLR was conducted in 61 hepatobiliary centers in South America, composed by 20 questions concerning demographic characteristics, surgical data, and perioperative results. RESULTS: Fifty-one (83.6%) centers from seven different countries answered the survey. A total of 2887 LLR were performed, as follows: Argentina (928), Brazil (1326), Chile (322), Colombia (210), Paraguay (9), Peru (75), and Uruguay (8). The first program began in 1997; however, the majority (60.7%) started after 2010. The percentage of LLR over open resections was 28.4% (4.4-84%). Of the total, 76.5% were minor hepatectomies and 23.5% major, including 266 right hepatectomies and 343 left hepatectomies. The conversion rate was 9.7%, overall morbidity 13%, and mortality 0.7%. CONCLUSIONS: This is the largest study assessing the dissemination and results of LLR in South America. It showed an increasing number of centers performing LLR with the promising perioperative results, aligned with other worldwide excellence centers.

Incidental findings on brain MRI in a cohort of diabetic patients.

OBJECTIVE: To study the frequency and management of incidental findings in nonenhanced brain MRI of a middle-aged population of type 2 diabetic patients. METHODS: We retrospectively analyzed the results of 289 brain MRI obtained from subjects between 40-75 years recruited from a previous study. Incidental findings were classified into three categories: (1) Vascular findings; (2) neoplastic findings; and (3) others. On the other side, we made a classification of referral findings. To compare our results, we reviewed the prevalence and evidence about management of both incidental and referral findings in other series. RESULTS: We found an overall prevalence of incidental findings of 10.4% (30/289). Incidental findings raised according to age. The most common incidental findings were: 7 vascular (2.4%), 6 calcifications (2.1%), 6 cystic (2.1%) and 5 neoplastic (1.7%) lesions. A percentage of 1.7% (5/289) were referral findings which required further clinical work-up. CONCLUSION: Incidental findings are relatively common in patients with type 2 diabetes. The most frequent are vascular findings, accordance with previous studies. Referral findings are uncommon. Clinical evidence about how to best manage the majority of incidental findings is lacking.

Octopus maya parasites off the Yucatán Peninsula, Mexico. II. Salivary gland damage by cestodes.

The red octopus Octopus maya Voss et Solís-Ramírez, 1966 is an endemic species and one of the most important fishery resources of the Yucatán Peninsula, Mexico. Due to its economic importance and the fact that in recent years interest in farming this species has increased, several initiatives have been implemented to study its biology and requirements for cultivation. Parasites represent an important component of the biology of the red octopus, as they can have an impact on both wild and cultivated populations. A total of 44 O. maya specimens were sampled from the fishing ports of Ría Lagartos and Dzilam de Bravo, Yucatán; specimens were measured and subsequently subjected to histological analysis of the buccal masses where cestode larvae (Prochristianella sp.) were found in the anterior salivary glands. Results of a chi-squared test showed that specimen size class and infestation levels (parasite abundance) were significantly correlated, with parasite damage levels more pronounced in larger animals. The damage caused to the anterior salivary glands by this parasite could have serious implications for feeding and reproductive success of O. maya.

Goldfish hippocampal pallium is essential to associate temporally discontiguous events.

There is general agreement that the hippocampus of vertebrates, from fish to mammals, is involved in map-like spatial memory. However, in mammals the role of the hippocampus goes beyond the spatial domain as it is also involved in binding the temporally separate events that compose episodic memories. In this regard, the hippocampus of mammals is essential for trace classical conditioning, in which a stimulus-free time gap separates the conditioned stimulus (CS) and the unconditioned stimulus (US), but not for delay conditioning, in which both stimuli coincide in time. Although the involvement of the hippocampus in encoding relational memories based on a temporal frame-work has been extensively studied in mammals, there is scarce evidence about the possible contribution of the hippocampus of non-mammalian vertebrates to the temporal, non-spatial dimension of relational memories. The present work was aimed to determine if the ventral part of the lateral division of the area dorsalis telencephali (Dlv) of goldfish, proposed as homologous to the hippocampus of mammals, is also involved in trace classical conditioning. With this purpose, goldfish with lesions in Dlv, complete telencephalon ablation and sham operation, were trained in delay and trace heart rate classical conditioning. Dlv lesions severely impaired the acquisition of the conditioned response when a stimulus-free time gap was elapsed between the CS and the US (trace conditioning), but not when both stimuli overlapped in time (delay conditioning), revealing that this region, like the hippocampus of mammals, is essential to form the temporal associative memories required by trace conditioning. Present data suggest that the presence of a hippocampal pallium involved in relational, episodic-like memory that preserves both the spatial and the temporal dimensions of past events, could be a primitive feature of the vertebrate brain that has been conserved through evolution.

Lysine partitioning in broiler breeders is not affected by energy or protein intake when fed at current industry levels.

A study was conducted to determine the effects of dietary energy and protein intake on the partitioning of lysine in broiler breeder hens. One hundred twenty-six broiler breeders were randomly assigned to 1 of 6 dietary treatments in a 2 (390, 450 kcal/d) × 3 (22, 24, 26 g of CP/d) fashion. Thirty-six hens were administered a daily oral dose of 15 mg of (15)N-Lys for a period of 2 wk or until first egg. After the 2-wk enrichment period, no isotopes were given for 2 d. After 2 d, a daily oral dose of 15 mg of (2)D4-Lys was administered until the 2nd, 3rd, and 4th egg (saved) after the initial (2)D4-Lys was given, at which point pectoralis muscle was sampled. Weeks 25, 29, and 45 were assessed. Isotopic enrichment of pectoralis muscle, egg yolk, and albumen was determined via gas chromatography-mass spectrometry. The (15)N-Lys was intended to represent endogenous lysine, whereas the (2)D4-Lys was intended to represent dietary lysine. Greater than 78% of all labeled lysine ((15)N and (2)D4-Lys) was found in breast muscle. Endogenous muscle was the main source of lysine for yolk formation at wk 25 and 45. Diet was the main source of lysine for albumen formation at wk 25 and 29. A consistent decrease in the (15)N-Lys in breast muscle from the 2nd to the 3rd egg was observed, while also seeing an increase in the (15)N-Lys in the egg from the 3rd to the 4th egg. No difference in the partitioning of lysine was determined by energy or protein intake at levels typical for the current poultry industry. Rather, age, and possibly rate of production, appear to be the main drivers of lysine partitioning in the broiler breeder hen.

Molluscs generate preferred crystallographic orientation of biominerals by organic templates, the texture and microstructure of Caudofoveata (Aplacophora) shells.

Caudofoveata are molluscs that protect their vermiform body with a scleritome, a mosaic of unconnected blade/lanceolate-shaped aragonite sclerites. For the species Falcidens gutturosus and Scutopus ventrolineatus we studied the crystallographic constitution and crystal orientation texture of the sclerites and the scleritome with electron-backscatter-diffraction (EBSD), laser-confocal-microscopy (LCM) and field-emission electron microscopy (FE-SEM) imaging. Each sclerite is an aragonite single crystal that is completely enveloped by an organic sheath. Adjacent sclerites overlap laterally and vertically are, however, not connected to each other. Sclerites are thickened in their central portion, relative to their periphery. Thickening increases also from sclerite tip towards its base. Accordingly, cross-sections through a sclerite are straight at its tip, curved and bent towards the sclerite base. Irrespective of curved sclerite morphologies, the aragonite lattice within the sclerite is coherent. Sclerite aragonite is not twinned. For each sclerite the crystallographic c-axis is parallel to the morphological long axis of the sclerite, the a-axis is perpendicular to its width and the b-axis is within the width of the sclerite. The single-crystalinity of the sclerites and their mode of organization in the scleritome is outstanding. Sclerite and aragonite arrangement in the scleritome is not given by a specific crystal growth mode, it is inherent to the secreting cells. We discuss that morphological characteristics of the sclerites and crystallographic preferred orientation (texture) of sclerite aragonite is not the result of competitive growth selection. It is generated by the templating effect of the organic substance of the secreting cells and associated extracellular biopolymers.

Biomineral crystallographic preferred orientation in Solenogastres molluscs (Aplacophora) is controlled by organic templating.

Aplacophoran molluscs are shell-less and have a worm-like body which is covered by biomineralized sclerites. We investigated sclerite crystallography and the sclerite mosaic of the Solenogastres species Dorymenia sarsii, Anamenia gorgonophila, and Simrothiella margaritacea with electron-backscattered-diffraction (EBSD), laser-confocal-microscopy and FE-SEM imaging. The soft tissue of the molluscs is covered by spicule-shaped, aragonitic sclerites. These are sub-parallel to the soft body of the organism. We find, for all three species, that individual sclerites are untwinned aragonite single crystals. For individual sclerites, aragonite c-axis is parallel to the morphological, long axis of the sclerite. Aragonite a- and b-axes are perpendicular to sclerite aragonite c-axis. For the scleritomes of the investigated species we find different sclerite and aragonite crystal arrangement patterns. For the A. gorgonophila scleritome, sclerite assembly is disordered such that sclerites with their morphological, long axis (always the aragonite c-axis) are pointing in many different directions, being, more or less, tangential to cuticle surface. For D. sarsii, the sclerite axes (equal to aragonite c-axes) show a stronger tendency to parallel arrangement, while for S. margaritacea, sclerite and aragonite organization is strongly structured into sequential rows of orthogonally alternating sclerite directions. The different arrangements are well reflected in the structured orientational distributions of aragonite a-, b-, c-axes across the EBSD-mapped parts of the scleritomes. We discuss that morphological and crystallographic preferred orientation (texture) is not generated by competitive growth selection (the crystals are not in contact), but is determined by templating on organic matter of the sclerite-secreting epithelial cells and associated papillae.

SPATIAL VARIATION IN HELMINTH PARASITE COMMUNITIES OF THE FRENCH GRUNT, HAEMULON FLAVOLINEATUM (TELEOSTEI: HAEMULIDAE), FROM THE YUCATAN PENINSULA.

The French grunt, Haemulon flavolineatum, is an abundant fish and a good model for studying parasite communities. Specimens were collected at 4 localities between the Campeche Bank (within the Gulf of Mexico) and the Mexican Caribbean Sea to describe and compare the differences and similarities between localities and regions in the communities of parasitic helminths. Thus, we calculated the Hill numbers associated with species richness (q = 0) and the dominance estimator (q = 2) using rarefaction and extrapolation curves to provide asymptotic estimators of diversity. A 2-way PERMANOVA was used to determine whether there was a significant difference in parasite assemblage structure between localities or regions. A total of 11 helminth taxa (species level) were recorded in 104 individuals of H. flavolineatum, consisting of 8 digenean trematodes species, 2 acanthocephalan species, and 1 nematode species. Our findings include new reports of 7 parasite taxa and new geographical records for some parasites in H. flavolineatum. The highest dissimilarities in parasite composition were observed between the most distant locations (Banco Chinchorro vs. Cayo Arcas) that were each located in different regions. Species richness was similar between regions, although the most dominant helminths were Postmonorchis orthopristis and Dollfustrema sp. in the Mexican Caribbean and Campeche Bank regions, respectively. Future studies should explore how patterns in parasite community structure are affected by currents running south to north by the Yucatan Current through the Yucatan Channel and easterly to Campeche Bank.

Clinical utility of a personalized and long-term monitoring device for Parkinson's disease in a real clinical practice setting: An expert opinion survey on STAT-ON™.

BACKGROUND: STAT-ON™ is an objective tool that registers ON-OFF fluctuations making possible to know the state of the patient at every moment of the day in normal life. Our aim was to analyze the opinion of different Parkinson's disease experts about the STAT-ON™ tool after using the device in a real clinical practice setting (RCPS). METHODS: STAT-ON™ was provided by the Company Sense4Care to Spanish neurologists for using it in a RCPS. Each neurologist had the device for at least three months and could use it in PD patients at his/her own discretion. In February 2020, a survey with 30 questions was sent to all participants. RESULTS: Two thirds of neurologists (53.8% females; mean age 44.9±9 years old) worked in a Movement Disorders Unit, the average experience in PD was 16±6.9 years, and 40.7% of them had previously used other devices. A total of 119 evaluations were performed in 114 patients (range 2-9 by neurologist; mean 4.5±2.3). STAT-ON™ was considered "quite" to "very useful" by 74% of the neurologists with an overall opinion of 6.9±1.7 (0, worst; 10, best). STAT-ON™ was considered better than diaries by 70.3% of neurologists and a useful tool for the identification of patients with advanced PD by 81.5%. Proper identification of freezing of gait episodes and falls were frequent limitations reported. CONCLUSION: STAT-ON™ could be a useful device for using in PD patients in clinical practice.

High prevalence of upper urinary tract involvement detected by 111indium-oxine leukocyte scintigraphy in patients with candiduria.

The purpose of this investigation was to assess the prevalence of upper urinary tract involvement in patients with candiduria by means of (111)indium-oxine-labeled leukocyte scintigraphy. An observational cohort study of patients with confirmed candiduria was conducted in an acute-care teaching hospital in Spain from March 2006 through February 2009. An (111)In-labeled leukocyte scan was performed in order to assess the upper urinary tract involvement. A series of non-matched patients without candiduria nor bacteriuria undergoing scintigraphy to exclude infections in other sites than the urinary tract was also studied. Demographics, baseline illness, and clinical data were recorded. Candiduria was detected in 428 patients, and scintigraphy was performed in 35 of these patients. Twenty-nine patients without candiduria nor bacteriuria were also studied. Positive renal scintigraphy was documented in 24 (68%) patients with confirmed candiduria and in 3 (10%) patients without candiduria (p < 0.005). Renal uptake was not associated with a higher mortality nor with re-admissions. Subclinical pyelonephritis could be more frequent in patients with candiduria than it has been previously considered.

The effects of pullet body weight, dietary nonpyhtate phosphorus intake, and breeder feeding regimen on production performance, chick quality, and bone remodeling in broiler breeders.

A 3 × 2 × 2 factorial experiment, consisting of 52 hens per treatment, was conducted to determine the effects of pullet BW, dietary nonphytate phosphorus (NPP), and feeding regimen on performance, progeny quality, and bone remodeling. Cobb 500 broiler breeder pullets were reared to 3 different growth curves: 20% under, Cobb standard, and 20% over. Body weights were recorded weekly and feed adjustments made accordingly. At 21 wk, 624 hens were fed one of 2 breeder diets differing only in the amount of dietary NPP: 0.15 or 0.40%. A normal feeding regimen was appropriate for the particular growth curve; an alternative regimen considered the 3 growth curves together as a flock. At 24, 26, and 29 wk, blood was collected from 5 hens per treatment every 4 h over a 24-h period. Plasma samples were analyzed for total alkaline phosphatase, tartrate-resistant acid phosphatase, parathyroid hormone-related peptide, Ca, and inorganic P. Eggs per hen housed were diminished in hens fed the low dietary NPP and by low pullet target weight. Hens fed low dietary NPP also had lower egg weights but better eggshell quality. Mortality was significantly higher in hens fed low dietary NPP. Breeder tibia relative strength and ash were also significantly lower in hens fed low dietary NPP, regardless of the quantitative amount. Progeny tibia ash was not affected by any treatment. Total alkaline phosphatase responded to pullet BW, however by wk 29, total alkaline phosphatase also became sensitive to dietary NPP. The NPP by pullet BW interaction for tartrate-resistant acid phosphatase levels became significant by 29 wk, and pullet BW was significant at wk 24. The NPP by pullet growth curve interaction was also critical for plasma inorganic P levels throughout the sampling period. In summary, both 0.15% dietary NPP and reared pullets 20% under standard BW negatively affect egg production but do not impair progeny productivity. Body composition appears to be a main contributor in bone remodeling mechanisms, especially during the transition into egg production.

Trace classical conditioning impairment after lesion of the lateral part of the goldfish telencephalic pallium suggests a long ancestry of the episodic memory function of the vertebrate hippocampus.

There is an ongoing debate on the evolutionary origin of the episodic memory function of the hippocampus. A widely accepted hypothesis claims that the hippocampus first evolved as a dedicated system for spatial navigation in ancestral vertebrates, being transformed later in phylogeny to support a broader role in episodic memory with the emergence of mammals. On the contrary, an alternative hypothesis holds that the hippocampus of ancestral vertebrates originally encoded both the spatial and temporal dimensions of relational memories since its evolutionary appearance, thus suggesting that the episodic-like memory function of the hippocampus could be the primitive condition in vertebrate forebrain evolution. The present experiment was aimed at scrutinizing these opposing hypotheses by investigating whether the hippocampal pallium of teleost fish, a vertebrate group that shares with mammals a common ancestor that lived about 400 Mya, is, like the hippocampus of mammals, essential to associate time-discontiguous events. Thus, goldfish with lesions in the ventral part of the dorsolateral pallium (Dlv), a telencephalic region considered homologous to the hippocampal pallium of land vertebrates, were trained in trace versus delay eyeblink-like classical conditioning, two learning procedures that differ only in the temporal relationships between the stimuli to be associated in memory. The results showed that hippocampal pallium lesion in goldfish severely impairs trace conditioning, but spares delay conditioning. This finding challenges the idea that navigation preceded relational memory in evolutionary appearance and suggests the possibility that a relational memory function that associates the experienced events in both the spatial and temporal dimensions could be a primitive feature of the hippocampus that pre-existed in the common ancestor of vertebrates.

Development of 3D-QSAR and pharmacophoric models to design new anti-Trypanosoma cruzi agents based on 2-aryloxynaphthoquinone scaffold.

In this work we have collected a set of 30 trypanosomicidal naphthoquinones and developed pharmacophoric and 3D-QSAR models as tools for the design of new potential anti-Chagasic compounds. Firstly, qualitative information was obtained from SAR and pharmacophoric models identifying some fragments around the 2-aryloxynaphthoquinone scaffold important for the antiparasitic activity. Then, 3D-QSAR CoMFA and CoMSIA models were developed. The models showed adequate statistical parameters where the steric, electrostatic, and hydrophobic features explain the trypanosomicidal effect. Therefore, to validate our models, we carried out the design, synthesis, and biological evaluation on T. cruzi epimastigotes of five new compounds (33a-e). According to CoMFA model, three out of five compounds showed pIC50 values within one logarithmic unit of deviation. The two compounds that did not fit the predictions were those with high lipophilicity, which agreed with the SAR and pharmacophore models. Docking and molecular dynamic studies were performed on T. cruzi trypanothione reductase, in a proposed binding site for this type of naphthoquinone. Interestingly, 33a-e showed the same interaction pattern as a naphthoquinone inhibitor (2). Finally, predicted drug-likeness properties indicated that 33a-e have optimal oral bioavailability. Thus, this study provides new in silico models for obtaining novel trypanosomicidal compounds.

Promoting secure attachment: evaluation of the effectiveness of an early intervention pilot programme with mother-infant dyads in Santiago, Chile.

BACKGROUND: Research indicates that the early attachment patterns of babies could influence their socio-emotional development and prevent the emergence of problematic behaviours in the child later in life. Many studies in the field of early attachment interventions have promoted a secure attachment bond between mother and infant. The purpose of this study was to evaluate the effectiveness of an early pilot intervention programme designed to promote a secure attachment bond in mother-infant dyads belonging to a population seeking regular treatment at urban health centres in Santiago, Chile. METHODS: Primipara mothers were randomly assigned to two intervention conditions: a secure attachment promotion programme (experimental group = 43) or an educational talk (control group = 29). The Strange Situation Assessment was used to collect data on the attachment patterns of babies. RESULTS: The results show that after the intervention, there were more babies with secure attachment in the experimental group than in the control group. CONCLUSIONS: These findings represent a preliminary step towards evaluating interventions aimed at promoting secure attachment in Chilean mother-child dyads. While the effect of the intervention is not significant, the effect size obtained is respectable and consistent with other meta-analytic findings.

Factory neovessels: engineered human blood vessels secreting therapeutic proteins as a new drug delivery system.

Several works have shown the feasibility of engineering functional blood vessels in vivo using human endothelial cells (ECs). Going further, we explored the therapeutic potential of neovessels after gene-modifying the ECs for the secretion of a therapeutic protein. Given that these vessels are connected with the host vascular bed, we hypothesized that systemic release of the expressed protein is immediate. As a proof of principle, we used primary human ECs transduced with a lentiviral vector for the expression of a recombinant bispecific alphaCEA/alphaCD3 antibody. These ECs, along with mesenchymal stem cells as a source of mural cells, were embedded in Matrigel and subcutaneously implanted in nude mice. High antibody levels were detected in plasma for 1 month. Furthermore, the antibody exerted a therapeutic effect in mice bearing distant carcinoembryonic-antigen (CEA)-positive tumors after inoculation of human T cells. In summary, we show for the first time the therapeutic effect of a protein locally secreted by engineered human neovessels.