Antibody response in patients admitted to the hospital with suspected SARS-CoV-2 infection: results from a multicenter study across Spain.

AIM: To evaluate the serological response against SARS-CoV-2 in a multicenter study representative of the Spanish COVID pandemic. METHODS: IgG and IgM + IgA responses were measured on 1466 samples from 1236 Spanish COVID-19 patients admitted to the hospital, two commercial ELISA kits (Vircell SL, Spain) based on the detection of antibodies against the viral spike protein and nucleoprotein, were used. RESULTS: Approximately half of the patients presented antibodies (56.8% were IgM + IgA positive and 43.0% were IgG positive) as soon as 2 days after the first positive PCR result. Serological test positivity increased with time from the PCR test, and 10 days after the first PCR result, 91.5% and 88.0% of the patients presented IgM + IgA and IgG antibodies, respectively. CONCLUSION: The high values of sensitivity attained in the present study from a relatively early period of time after hospitalization support the use of the evaluated serological assays as supplementary diagnostic tests for the clinical management of COVID-19.

Synthesis and experimental/computational characterization of sorghum procyanidins-gelatin nanoparticles.

In this research, sorghum procyanidins (PCs) and procyanidin B1 (PB1) were encapsulated in gelatin (Gel) to form nanoparticles as a strategy to maintain their stability and bioactivity and for possible applications as inhibitors of metalloproteinases (MMPs) of the gelatinase type. Encapsulation was carried out by adding either PCs or PB1 to an aqueous solution of A- or B-type Gel (GelA or GelB) at different concentrations and pH. Under this procedure, the nanoparticles PCs-GelA, PCs-GelB, PB1-GelA, and PB1-GelB were synthesized and subsequently characterized by experimental and computational methods. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) revealed that all types of nanoparticles had sizes in the range of 22-138 nm and tended to adopt an approximately spherical morphology with a smooth surface, and they were immersed in a Gel matrix. Spectral analysis indicated that the nanoparticles were synthesized by establishing hydrogen bonds and hydrophobic interactions betweenGel and the PCs or PB1. Study of simulated gastrointestinal digestion suggested that PCs were not released from the Gel nanoparticles, and they maintained their morphology (SEM analysis) and antioxidant activity determined by Trolox-equivalent antioxidant capacity (TEAC) assay. Computational characterization carried out through molecular docking studies of PB1 with Gel or (pro-)metalloproteinase-2 [(pro-)MMP-2], as a model representative of the PCs, showed very favorable binding energies (around -5.0 kcal/mol) provided by hydrogen bonds, van der Waals interactions, and desolvation. Additionally, it was found that PB1 could act as a selective inhibitor of (pro-)MMP-2.

Heart Rate Variability and Gastric Electrical Response to a Cold Pressor Task in Youth with Functional Dyspepsia.

BACKGROUND/AIMS: While stress has been implicated in functional dyspepsia (FD), the mechanisms by which stress results in symptoms are not well defined. The aim of the current study was to assess gastric myoelectric and autonomic changes in response to a physical stressor in youth with FD. METHODS: In a group of healthy controls and pediatric FD subjects, we recorded ECG and EGG signals 30 min before and 60 min after, a cold pressor task (CPT). Gastric EGG and heart rate variability (HRV) parameters were calculated in pre- and post-CPT stages and in short intervals. RESULTS: The pre-CPT percent tachygastria was higher in FD subjects as compared to controls. However, CPT did not induce any EGG changes in either controls or FD subjects and the two groups did not differ from each other post-CPT. The CPT resulted in an increase in HRV and standard deviation of NN intervals in controls; there was no change in any HRV parameter in FD subjects. CONCLUSIONS: Acute physical stress does not appear to induce gastric electrical abnormalities in youth with FD. Youth with FD appear to lack the normal flexible autonomic response to a physical stressor.

Arthroscopic repair of partial-thickness articular surface rotator cuff tears: single-row transtendon technique versus double-row suture bridge (transosseous equivalent) fixation: results from a prospective randomized study.

BACKGROUND: The purpose of this prospective study was to compare the clinical and structural findings following the arthroscopic repair of partial-thickness (exceeding 50%) articular-sided rotator cuff tears using either a single-row or a double-row suture bridge fixation. MATERIALS AND METHODS: Fifty patients were included in this study. The patients were randomly placed into two groups: 25 underwent the single-row (Group I) and 25 a double-row suture bridge fixation (Group II). The clinical outcomes were assessed using ASES and Constant shoulder scores, both preoperatively and at the end of follow-up. The pain level was evaluated using the visual analogue scale (VAS), preoperatively, at 6 months and at the end of follow-up. All patients underwent preoperative MRI to identify the rotator cuff tear, and postoperatively at 12 months to evaluate tendon integrity. RESULTS: The average follow-up was 32.5 months. The mean ASES scores increased from 35.9 to 96.7 in Group I and from 35.3 to 93.4 in Group II; the mean Constant shoulder scores increased from 55.6 to 97.8 in Group I and from 57.5 to 97.3 in Group II. There were no significant differences between the two groups. The average preoperative pain level decreased from 7.4 to 3 at 6 months and to 0.4 at the end of the Group I; and from 7.6 to 3 at 6 months and 0.8 in Group II. There was no significant difference between the two groups. At 12 months, the MRI assessments showed two retears in Group I (8%) and one retear in Group II (4%). CONCLUSION: Arthroscopic repair of partial-thickness articular rotator cuff tears that exceed 50% of tendon thickness with a single-row transtendon repair or double-row suture bridge provides functional improvement and pain relief regardless of the repair technique used. There were no differences in clinical results between both techniques. LEVEL OF EVIDENCE: Level II; prospective comparative study.

[Microbiological diagnosis of medical device-associated infections]. / Diagnóstico microbiológico de las infecciones asociadas a dispositivos biomédicos.

The use of surgically implanted medical devices has increased greatly over the last few years. Despite surgical advances and improvements in the materials and design of devices, infection continues to be a major complication of their use. Device-associated infections are produced mainly during their implantation and, are caused by microorganisms that are part of the skin flora. Biofilm development on device surfaces is the most important factor to explain the pathophysiological aspects of infection. Microbiological diagnosis is difficult and can often only be achieved after removal of the device. Sonication of the removed device may be a useful tool, since this procedure dislodges and disaggregates biofilm bacteria from the device. Molecular techniques, especially PCR, applied to the tissues and material obtained after sonication have shown to have a high sensitivity and specificity for the diagnosis of cardiovascular device infections.

Reproductive pattern of Cuban women living in the municipality of Plaza de la Revolución, Havana, Cuba.

This paper assesses the reproductive and abortion patterns of women living in Plaza de la Revolución, a municipality of Havana, Cuba, by studying the factors influencing birth and abortion rates. Socio-demographic data and female reproductive histories were collected in a survey of 1200 post-menopausal women living in the municipality. Average ages at menarche and at menopause were 12.71 and 48.39 years, respectively, thus yielding a potential long reproductive period of 35.68 years, indicating high fertility. Although the mean pregnancy rate was 3.81 pregnancies per woman, the live birth rate at time of delivery was only 1.89 due to the high rate of abortions: 40% of all pregnancies were voluntarily interrupted. Among the biological and socio-cultural variables that were found to influence the rate of live births were those related marriage pattern, especially age at first union. Demographic variables such as pregnancy order, maternal age and marital status were the main determinants of the abortion pattern, with abortion being used as a method of birth control in order to obtain the desired family size, and most women (75.2%) using contraceptives.

Electrical bioimpedance analysis and comparison in biological tissues through crystalloid solutions implementation.

Electrical bioimpedance is a non-invasive and radiation-free technique that was proposed to be used in different clinical areas, however, its practical use is limited due to its low capacity to discriminate between tissues. In order to overcome this limitation, our research group proposes to incorporate the contrast media into the electrical bioimpedance procedure. The main objective of the present study was to assess the crystalloid solutions as a possible contrast media to discriminate between different tissue types in the bioimpedance technique. Two medical-grade crystalloid solutions (Hartmann and NaCl 0.9%) were injected into three biological ex vivo models: kidney, liver, and brain. BIOPAC system was used to acquire bioimpedance data before and after the injections. The data was adjusted to the Debye electrical model. The analysis of measured values showed substantial bioimpedance disparities in tissues subjected to isotonic solutions. The NaCl solution exhibited more pronounced changes in electrical parameters compared to the Hartmann solution. Similarly, NaCl solution displayed superior discriminatory capabilities among tissues, with variations of 465%, 157%, and 206%. Distinct spectral modifications were identified, with tissues demonstrating unique responses at each frequency of analysis relative to untreated tissue. Variations in bandwidth alterations were discernible among tissues, providing clear distinctions. In conclusion, the research showed that the crystalloid solution exhibited greater sensitivity and superior tissue contrast at specific frequencies. This study's findings underscore the feasibility of implementing crystalloid solutions to enhance tissue discrimination, similar to the effects of contrast agents.

COMPARISON OF LIGAMENT Z-PLASTY AND CONVENTIONAL SURGERY FOR THE TREATMENT OF CARPAL TUNNEL SYNDROME. A RANDOMIZED CLINICAL TRIAL.

BACKGROUND: Conventional surgery performed to treat carpal tunnel syndrome (CTS) is associated with complications such as pillar pain or loss of strength. This study aimed to compare the incidence of pillar pain between two techniques at the 3-week and 6-month follow-up and to determine any differences in the recovery of grip strength (GS), pinch strength (PS), and Boston Carpal Tunnel Questionnaire (BCTQ) scores. METHODS: This randomized clinical trial comprised 109 patients of which 55 underwent ligament Z-plasty and 54 underwent conventional surgery (longitudinal section of the transverse carpal ligament without posterior closure). The GS, PS, presence of pillar pain, and BCTQ scores were assessed preoperatively and after 3 weeks and 6 months. RESULTS: The incidence of pillar pain after 3 weeks was lower in patients undergoing Z-plasty than in those undergoing conventional surgery (25.5% vs. 44.4%, p = 0.04). Moreover, the absolute change in the PS after 3 weeks (p = 0.01) and GS after 6 months (p = 0.05) and the absolute and relative changes in the PS after 6 months (p = 0.008 and p = 0.01, respectively) were significantly higher in the Z-plasty group than in the conventional surgery group. CONCLUSIONS: Z-plasty is a valid surgical procedure for treating CTS. It is associated with a lower incidence of pillar pain and better recovery of postoperative strength compared to the conventional surgical technique, with both techniques showing similar results in CTS recovery.

Anticancer Potential of Flavonoids: An Overview with an Emphasis on Tangeretin.

Natural compounds with pharmacological activity, flavonoids have been the subject of an exponential increase in studies in the field of scientific research focused on therapeutic purposes due to their bioactive properties, such as antioxidant, anti-inflammatory, anti-aging, antibacterial, antiviral, neuroprotective, radioprotective, and antitumor activities. The biological potential of flavonoids, added to their bioavailability, cost-effectiveness, and minimal side effects, direct them as promising cytotoxic anticancer compounds in the optimization of therapies and the search for new drugs in the treatment of cancer, since some extensively antineoplastic therapeutic approaches have become less effective due to tumor resistance to drugs commonly used in chemotherapy. In this review, we emphasize the antitumor properties of tangeretin, a flavonoid found in citrus fruits that has shown activity against some hallmarks of cancer in several types of cancerous cell lines, such as antiproliferative, apoptotic, anti-inflammatory, anti-metastatic, anti-angiogenic, antioxidant, regulatory expression of tumor-suppressor genes, and epigenetic modulation.

Interhospital Spread of blaVIM-1- and blaCTX-M-15-Producing K. pneumoniae ST15 on an IncR Plasmid in Southern Spain.

In 2014-2015, the main CTX-M-15- and OXA-48-producing clone in our region was ST15. Recently, K. pneumoniae ST15 isolates co-producing VIM-1 and CTX-M-15 were detected in several hospitals. The aim was to study the emergence and acquisition of this carbapenemase. Between 2017 and 2019, four hospitals submitted twenty-nine VIM-1- and CTX-M-15-producing K. pneumoniae ST15 isolates to our laboratory. Seven representatives of each XbaI PFGE pulsotype were sequenced using short- and long-read technologies. RAST, CGE databases, and Pathogenwatch were used for resistance determinants and capsule-type analysis. Plasmid comparison was performed with Easyfig2.1. Phylogenetic analysis included other contemporary ST15 isolates from Spain. The 29 isolates were clustered into seven different pulsotypes. The selected genomes, from three hospitals in two different provinces, were clustered together (fewer than 35 alleles) and differed by more than 100 alleles from other ST15 isolates obtained in the region. These seven isolates harbored one IncR plasmid (200-220 kb) with a common backbone and four regions flanked by IS26: one contained blaVIM-1, another contained blaCTX-M-15, the third contained blaOXA-1, and the fourth harbored heavy-metal-tolerance genes. The two initial plasmids, from two different centers, were identical, and rearrangement of four regions was observed in the five subsequent plasmids. Our findings showed the first intercenter dissemination of IncR plasmids carrying blaVIM-1, blaCTX-M-15, and metal-tolerance genes mediated by a new lineage of K. pneumoniae ST15. Two different capture events of the blaVIM-1 gene or different IS26-mediated plasmid rearrangements from a common ancestor may explain plasmid variations.

The CARBA-MAP study: national mapping of carbapenemases in Spain (2014-2018).

Introduction: Infections caused by carbapenem-resistant Enterobacterales (CRE) and carbapenem-resistant Pseudomonas aeruginosa, including isolates producing acquired carbapenemases, constitute a prevalent health problem worldwide. The primary objective of this study was to determine the distribution of the different carbapenemases among carbapenemase-producing Enterobacterales (CPE, specifically Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, and Klebsiella aerogenes) and carbapenemase-producing P. aeruginosa (CPPA) in Spain from January 2014 to December 2018. Methods: A national, retrospective, cross-sectional multicenter study was performed. The study included the first isolate per patient and year obtained from clinical samples and obtained for diagnosis of infection in hospitalized patients. A structured questionnaire was completed by the participating centers using the REDCap platform, and results were analyzed using IBM SPSS Statistics 29.0.0. Results: A total of 2,704 carbapenemase-producing microorganisms were included, for which the type of carbapenemase was determined in 2692 cases: 2280 CPE (84.7%) and 412 CPPA (15.3%), most often using molecular methods and immunochromatographic assays. Globally, the most frequent types of carbapenemase in Enterobacterales and P. aeruginosa were OXA-48-like, alone or in combination with other enzymes (1,523 cases, 66.8%) and VIM (365 cases, 88.6%), respectively. Among Enterobacterales, carbapenemase-producing K. pneumoniae was reported in 1821 cases (79.9%), followed by E. cloacae complex in 334 cases (14.6%). In Enterobacterales, KPC is mainly present in the South and South-East regions of Spain and OXA-48-like in the rest of the country. Regarding P. aeruginosa, VIM is widely distributed all over the country. Globally, an increasing percentage of OXA-48-like enzymes was observed from 2014 to 2017. KPC enzymes were more frequent in 2017-2018 compared to 2014-2016. Discussion: Data from this study help to understand the situation and evolution of the main species of CPE and CPPA in Spain, with practical implications for control and optimal treatment of infections caused by these multi-drug resistant organisms.

Las Alpujarras region (South East Spain) HLA genes study: evidence of a probable success of 17th century repopulation from North Spain.

Conquest of Granada Muslim Kingdom (1492 AD) finished with Muslim occupation; they were mostly North African Berbers who had reached Iberia by 711 AD. A politics of Iberian Christianization followed after this date: Jewish were expelled in 1492 and Moriscos (Spaniards practicing Muslim religion or speaking Arab) were expelled from all Spanish territory on 1609 AD. Las Alpujarras is a southern Spain mountainous secluded region, which underwent a repopulation from North Spain and a specific Muslim (Moriscos)-Christian war took place according to historical records. Both Las Alpujarras repopulation by northern Iberians and Moriscos expulsion success have been debated and are regarded as non-clarified episodes. In this study, we have addressed the question whether the repopulation succeeded by determining HLA genes of present day Las Alpujarras inhabitants and compared with those of other Mediterranean populations HLA frequencies and genealogies. HLA frequencies show ambiguous results because of extant HLA similar gene frequencies there exist in North Africa and Spain. This is reflected by the finding of North and South western Mediterraneans close relatedness of HLA dendrograms and correspondence analyses. However, the genealogical study of extended HLA haplotypes particularly Alpujarran high frequency of HLA-A29-B44-DRB1*0701-DQA1*02-DQB1*02 (not found in Algerians but frequent in North and Central Spain) and Alpujarran low frequency extended haplotype HLA-A3-B7-DRB1*1501-DQA1*0102-DQB1*0602 (frequent in North Europe) reveals that a significant HLA gene flow from North Spain is observed in present day Alpujarrans: both haplotypes are characteristic of North Spain and North Europe, respectively. This may indicate that enforced Alpujarran repopulation from North Spain may have been a success, which was started by Spanish King Philip II in 1571 AD.

Biological fitness and action opportunity of natural selection in an urban population of Cuba: Plaza de la Revolución, Havana.

This paper describes the biological fitness of an urban population of Havana city, Plaza de la Revolución, which has the lowest fertility and the highest demographic ageing in Cuba. The aim is to assess the biological fitness of this community through the indexes of action opportunity of natural selection, to determine its evolutionary pattern and the influence of its socio-cultural peculiarity. Demographic data were obtained from the reproductive histories of 1200 women between the ages of 55 and 64. Data concerning mortality and surviving offspring from the first embryonic stages until age of reproduction were also collected. In order to measure the level of biological fitness two indexes were used: the Crow index of action opportunity of natural selection and the corrected index proposed by Johnston and Kensinger, which takes into account prenatal mortality. This corrected index was calculated including and excluding induced abortions in order to evaluate the contribution of these to biological fitness. When only postnatal mortality was considered, the results showed an evolutionary pattern similar to that of developed countries, based on low mortality and fertility. However, when prenatal mortality was taken into account, biological fitness decreased and the corrected index of natural selection was 4.5 times higher than when miscarriages and fetal deaths were not considered. Moreover, this corrected index was 2.65 times higher when induced miscarriages were considered, indicating the large decrease in biological fitness as a result of the current reproductive behaviour of frequent induced abortion.

Polymorphisms influencing muscle phenotypes in North-African and Spanish populations.

AIM: The purpose of this study was to determine the allelic and genotypic frequency distribution of the C34T mutation in the muscle isoform of the adenosine monophosphate deaminase 1 (AMPD1) gene and of the missense substitution K153R in the myostatin (GDF8) gene in one Spanish and two North African populations. METHOD: One sample of 98 individuals was genotyped from the South of Spain (Alpujarra) and two samples from Morocco (77 Berbers and 78 Arabs). RESULTS: The frequency of the AMPD1 C34T mutation was lower in Berbers (0.071) compared with the Alpujarra cohort (0.153, p = 0.018). The GDF8 K153R substitution showed little variability among the three cohorts. CONCLUSIONS: Studies with larger cohorts and other ethnic groups are needed to corroborate that there does not exist any major variability in the genotype distribution of genes associated with muscle phenotypes in the South-Eastern Mediterranean area.

Scheduling deferrable electric appliances in smart homes: a bi-objective stochastic optimization approach.

In the last decades, cities have increased the number of activities and services that depends on an efficient and reliable electricity service. In particular, households have had a sustained increase of electricity consumption to perform many residential activities. Thus, providing efficient methods to enhance the decision making processes in demand-side management is crucial for achieving a more sustainable usage of the available resources. In this line of work, this article presents an optimization model to schedule deferrable appliances in households, which simultaneously optimize two conflicting objectives: the minimization of the cost of electricity bill and the maximization of users satisfaction with the consumed energy. Since users satisfaction is based on human preferences, it is subjected to a great variability and, thus, stochastic resolution methods have to be applied to solve the proposed model. In turn, a maximum allowable power consumption value is included as constraint, to account for the maximum power contracted for each household or building. Two different algorithms are proposed: a simulation-optimization approach and a greedy heuristic. Both methods are evaluated over problem instances based on real-world data, accounting for different household types. The obtained results show the competitiveness of the proposed approach, which are able to compute different compromising solutions accounting for the trade-off between these two conflicting optimization criteria in reasonable computing times. The simulation-optimization obtains better solutions, outperforming and dominating the greedy heuristic in all considered scenarios.

HLA in Las Alpujarras Mts., South-East Spain: A Renaissance process of population artificial substitution.

Spain was invaded in 711 CE by mostly Berber North Africans carrying Muslim religion to a mostly Christian/Catholic Kingdom. A fight to expel Muslims soon started and were apparently driven out of Iberia (Spain) starting in 1492 CE. However, many of these expelled people were of Iberian old ancestry that had become Muslims at Las Alpujarras Mts. (South-East Spain). Also, Muslim North Africans converted to Christianity either remained there or came back after they more definetively were expelled by 1609 CE. Las Alpujarras region was also repopulated by northern Spaniards mostly from Galicia. Our HLA study of present day Alpujarrans shows that typical North Spain and European Atlantic façade HLA extended haplotypes are very frequent in nowadays Las Alpujarras region, i. e.: HLA-(A*29-B*44)-DRB1*07:01-DQA1*02:01-DQB1*02:01 and (A*02-B*27)-DRB1*15:01-DQA1*01:02-DQB1*06:02. It is concluded that repopulation had a noticeable success even in today Alpujarran population.

Enhancement of the catalytic activity of Mg/Al layered double hydroxide for glycerol oligomers production.

In this study, the impact of rehydration on the catalytic properties of Mg/Al layered double hydroxides (LDH) for glycerol oligomerization was assesed. Although previous works have employed other LDH derived materials in this reaction, little information on recyclability is published. After observing the initial results on how basicity and surface area were related to the catalytic activty, an LDH modification strategy was developed with the addition of acetic acid. Changes on the basic site distribution were noticed and consequently, selectivity to diglycerol was improved. The best catalytic performance (reaction with 4 wt% cat., at 240 °C for 8 hours) led to 64% of glycerol conversion (XGly) and 37% of diglycerol selectivity (Sdi). Aditionally, reciclying of modified LDH was better than the non acid treated material, presenting higher yield of diglycerol. Catalyst deactivation was related to the harsh reaction conditions and to the blockage of active species by impurities. Loss of metallic species by leaching to the reaction products was not oberseved, an advantage in comparison with previous works.