Mercury and selenium concentrations in lanugo of free-ranging California sea lions in the southern Gulf of California, Mexico.

Total mercury ([THg]) and selenium ([TSe]) concentrations were determined in California sea lion (Zalophus californianus) lanugo from the Gulf of California in 2021 and 2022. Relationships with sex, morphometrics, and year were evaluated. Following toxicological thresholds of concern for piscivorous mammals, most pups had a [THg] < 10 ppm, one pup (2021) had a [THg] > 20 ppm, no pups had a [THg] > 30 ppm. Females had significantly higher [TSe] than males; sex did not influence [THg]. [THg] and [TSe] in 2022 were significantly higher in the general population and male cohorts compared to 2021. Significant negative correlations were observed between [THg], [TSe], and morphometrics (2021). These results indicate that, compared to other pinniped species, regional California sea lions may have a decreased likelihood of experiencing Hg-related adverse health effects. Year-related changes in element concentrations suggest continued monitoring of this population to assess pinniped, environmental, and potentially, human health.

Differential regulation of MAP2 by phosphorylation events in proline-rich versus C-terminal domains.

MAP2 is a critical cytoskeletal regulator in neurons. The phosphorylation of MAP2 (MAP2-P) is well known to regulate core functions of MAP2, including microtubule (MT)/actin binding and facilitation of tubulin polymerization. However, site-specific studies of MAP2-P function in regions outside of the MT-binding domain (MTBD) are lacking. We previously identified a set of MAP2 phosphopeptides which are differentially expressed and predominantly increased in the cortex of individuals with schizophrenia relative to nonpsychiatric comparison subjects. The phosphopeptides originated not from the MTBD, but from the flanking proline-rich and C-terminal domains of MAP2. We sought to understand the contribution of MAP2-P at these sites on MAP2 function. To this end, we isolated a series of phosphomimetic MAP2C constructs and subjected them to cell-free tubulin polymerization, MT-binding, actin-binding, and actin polymerization assays. A subset of MAP2-P events significantly impaired these functions, with the two domains displaying different patterns of MAP2 regulation: proline-rich domain mutants T293E and T300E impaired MT assembly and actin-binding affinity but did not affect MT-binding, while C-terminal domain mutants S426E and S439D impaired all three functions. S443D also impaired MT assembly with minimal effects on MT- or actin-binding. Using heterologous cells, we also found that S426E but not T293E had a lower capability for process formation than the wild-type protein. These findings demonstrate the functional utility of MAP2-P in the proline-rich and C-terminal domains and point to distinct, domain-dependent regulations of MAP2 function, which can go on to affect cellular morphology.

Safety and efficacy of the patency capsule.

INTRODUCTION AND AIMS: The patency capsule is an effective diagnostic method for preventing video capsule retention in the small bowel during capsule endoscopy. The most frequently associated complication when using the patency capsule is symptomatic retention. The aim of the present study was to evaluate the effectiveness and safety of patency capsules administered to patients at a tertiary care hospital center. MATERIALS AND METHODS: A retrospective observational study was conducted that included all the patients with confirmed Crohn's disease that were administered a patency capsule, within the time frame of January 2019 and December 2020. PC diagnostic yield, sensitivity, specificity, positive predictive value, and negative predictive value were evaluated, in relation to capsule endoscopy and double-balloon endoscopy findings. Complications associated with the patency capsule were also identified. RESULTS: Thirty patients were included, in whom the patency capsule had 83% sensitivity, 100% specificity, 100% positive predictive value, and 96% negative predictive value, with a diagnostic yield of 96.7%. There was one complication (3.3%) and it resolved spontaneously. CONCLUSIONS: The patency capsule is a safe and effective method for reducing video capsule retention during capsule endoscopy in patients with Crohn's disease.

Trends and projections in sexually transmitted infections in people aged 45 years and older in England: analysis of national surveillance data.

AIMS: We describe the epidemiology of sexually transmitted infections (STIs) and HIV in people aged ⩾45 years in England and provide future projections about the burden of STIs in this age group. METHODS: Analysis of national surveillance data in England from 2014 to 2019 for chlamydia, gonorrhoea, herpes, syphilis, anogenital warts and HIV was carried out. Time trends were assessed by the Poisson regression and reported using incidence rate ratios (IRRs). Two scenarios were modelled to predict the number of new STI diagnoses and associated costs in 2040. RESULTS: In 2019, there were 37,692 new STI diagnoses in people ⩾45 years in England. Between 2014 and 2019, there was a significant increase in the rate of new STI diagnoses in men (IRR = 1.05, p = .05) and those aged 45-64 years (IRR = 1.04, p = .05). Absolute numbers of new STI diagnoses in men who have sex with men increased by 76% between 2014 and 2019 (IRR = 1.15, p < .001). In adults aged ⩾50 years, the number of episodes of care for HIV increased over time (age = 50-64 years, IRR = 1.10; age = 65+ years, IRR = 1.13; p <.001). The modelled scenarios predicted an increase in STI diagnoses and costs in older people by 2040. CONCLUSION: STI rates in England are increasing in people aged ⩾45 years. The population is ageing and older people will contribute an increasing burden to STI costs if this trend continues. The reasons for this trend are not fully understood and further longitudinal epidemiological research is needed. Sexual health promotion campaigns and healthcare interventions targeted at older people should be prioritised.

Indicators of oxidative stress in leukocytes isolated from bottlenose dolphins (Tursiops truncatus) in response to a proinflammatory challenge.

Few studies have analyzed the indicators of oxidative stress in marine mammals following exposure to lipopolysaccharides (LPS); sex and maturity-related differences have not been explored. The objective of this study was to compare the indicators of oxidative stress following exposure to LPS for 24 and 48 h in isolated Pacific bottlenose dolphin (Tursiops truncatus; N = 12) leukocytes in relation to sex and maturity stage, using spectrophotometry. Following 48 h under experimental conditions (10 µg LPS mL-1), the leukocytes from males (n = 5) produced significantly more superoxide radical (O2•-; F (1, 8) = 13.965, p = 0.006) and displayed significantly greater activities of catalase (CAT; F (1, 8) = 9.465, p = 0.015) and glutathione S-transferase (GST; p = 0.028) compared to the leukocytes from females (n = 7). Following 48 h under experimental conditions, maturity-stage did not significantly influence the indicators of oxidative stress. Mature bottlenose dolphins (n = 7) had a significantly higher average daily dietary intake compared to immature bottlenose dolphins (n = 5; F (1, 10) = 5.825, p = 0.036). These results suggest that sex-related strategies for coping with a proinflammatory challenge may be present within the leukocytes from bottlenose dolphins, while potential maturity stage-related strategies require further investigation.

Which model of small bowel capsule endoscopy has a better diagnostic yield? A systematic review and meta-analysis.

Background and study aims: Small-bowel capsule endoscopy (SBCE) is a safe and efficient method for diagnosis of small-bowel diseases. Since its development, different models have appeared. The aim of this study was to analyze which of the different models of SBCE has the best diagnostic yield. Patients and methods: Extensive medical literature research was reviewed, using MESH terms, searching studies comparing different SBCE types. We analyzed the diagnostic yield of all the comparisons and when there were 2 or more studies that compared the same model of SBCEs, a meta-analysis was performed. Results: Ten eligible studies including 1065 SBCEs procedures were identified. The main indication was occult gastrointestinal bleeding in 9/10 studies. Two of them included anemia, chronic diarrhea and/or chronic abdominal pain. The indication in one article was celiac disease. In 9 studies, different types of SBCEs (MiroCam, Endocapsule, OMOM and CapsoCam) were compared with PillCam (SB, SB2 and SB3). Three studies compared MiroCam vs PillCam and CapsoCam vs PillCam, while two studies contrast Endocapsule vs PillCam. None of the SBCEs show superiority over PillCam [OR 0.78 (95%CI;0.60-1.01)]. One study compared SBCEs other than Pillcam (MiroCam vs Endocapsule). Nine studies did not find statistical differences between SBCEs, one showed better diagnostic yield of Mirocam compared with PillCam SB3 (p=0.02). The difference between these SBCE was not replayed in the metaanalysis [OR 0.77 (95%CI;0.49-1.21)]. Conclusions: Despite the appearance of new SBCE models, there are no differences in diagnostic yield; therefore, SBCE endoscopist's performance should be based on experience and availability.

Form Factors and Two-Photon Exchange in High-Energy Elastic Electron-Proton Scattering.

We present new precision measurements of the elastic electron-proton scattering cross section for momentum transfer (Q^{2}) up to 15.75 (GeV/c)^{2}. Combined with existing data, these provide an improved extraction of the proton magnetic form factor at high Q^{2} and double the range over which a longitudinal or transverse separation of the cross section can be performed. The difference between our results and polarization data agrees with that observed at lower Q^{2} and attributed to hard two-photon exchange (TPE) effects, extending to 8 (GeV/c)^{2} the range of Q^{2} for which a discrepancy is established at >95% confidence. We use the discrepancy to quantify the size of TPE contributions needed to explain the cross section at high Q^{2}.

Utility of capsule endoscopy in the diagnosis of gastrointestinal graft-versus-host disease.

INTRODUCTION AND AIM: Graft-versus-host disease (GvHD) is a complication of hematopoietic cell transplantation, and the small bowel is one of the main targets in the gastrointestinal tract. Capsule endoscopy is a safe procedure and can be useful in the diagnosis of GvHD. The aim of the present study was to compare the diagnostic yield of capsule endoscopy with the histopathologic findings in GvHD. MATERIALS AND METHODS: A retrospective diagnostic test study included all the patients with suspected GvHD that underwent gastroscopy and colonoscopy, with histopathologic evaluation of the biopsies taken, and capsule endoscopy, within the time frame of July 2015 and July 2019. Capsule endoscopy findings were compared with the histopathologic diagnosis, considered the gold standard. RESULTS: Twenty-one patients with GvHD (7 [33%] women; 37 ± 11.9 years of age) were included, 20 (95%) of whom had acute GvHD. The median gastric transit time of the capsule was 55 minutes (20-113) and the median small bowel transit time was 261 minutes (238-434). The entire small bowel was visualized through capsule endoscopy in 17 cases (80.95%). The histopathologic findings and capsule endoscopy findings resulted in the diagnosis of GvHD in 17 and 16 cases, respectively. There was agreement between the histopathologic and capsule endoscopy findings in 18 cases (15 positive and 3 negative). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic yield of capsule endoscopy were 88%, 75%, 94%, 60%, and 85%, respectively. CONCLUSIONS: Capsule endoscopy is a safe tool for the diagnosis of GvHD, with high sensitivity and positive predictive value, as well as moderate agreement with histopathologic findings.

Emerging applications of clinical ultrasonography.

In this work, we introduce the numerous emerging areas and frontiers in the use of point-of-care ultrasonography. Of these, we review the following three: 1) the use of clinical ultrasonography in infectious and tropical diseases (we address its usefulness in the diagnosis and follow-up of the main syndromes, in tropical diseases, and in areas with scarce resources); 2) the usefulness of clinical ultrasonography in the assessment of response to volume infusion in severely ill patients (we review basic concepts and the main static and dynamic variables used for this evaluation); and 3) the use of clinical ultrasonography in the assessment of muscle mass in elderly patients with primary sarcopenia (we review the main muscles and measurements used for it).

Vía clínica de recuperación intensificada en cirugía cardiaca. Documento de consenso de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SEDAR), la Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE) y la Asociación Española de Perfusionistas (AEP) / Guidelines for enhanced recovery after cardiac surgery. Consensus document of Spanish Societies of Anesthesia (SEDAR), Cardiovascular Surgery (SECCE) and Perfusionists (AEP)

La vía clínica de recuperación intensificada en cirugía cardiaca (RICC) pretende identificar, difundir y favorecer la implementación de las mejores actuaciones basadas en la evidencia científica para disminuir la variabilidad en la práctica clínica. La puesta en marcha de estas prácticas en el proceso clínico global favorecerá la obtención de mejores resultados, acortamiento de estancias hospitalarias y en la Unidad de Cuidados Críticos, lo que permitirá una reducción de costes y una mayor eficiencia. Tras realizar una revisión sistemática en cada uno de los puntos del proceso perioperatorio en cirugía cardiaca, se han redactado recomendaciones basadas en la mejor evidencia científica disponible en la actualidad con el consenso de las sociedades científicas implicadas.(AU)

The ERAS guidelines are intended to identify, disseminate and promote the implementation of the best, scientific evidence-based actions to decrease variability in clinical practice. The implementation of these practices in the global clinical process will promote better outcomes and the shortening of hospital and critical care unit stays, thereby resulting in a reduction in costs and in greater efficiency. After completing a systematic review at each of the points of the perioperative process in cardiac surgery, recommendations have been developed based on the best scientific evidence currently available with the consensus of the scientific societies involved.(AU)

Guidelines for enhanced recovery after cardiac surgery. Consensus document of Spanish Societies of Anesthesia (SEDAR), Cardiovascular Surgery (SECCE) and Perfusionists (AEP). / Vía clínica de recuperación intensificada en cirugía cardiaca. Documento de consenso de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SEDAR), la Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE) y la Asociación Española de Perfusionistas (AEP).

The ERAS guidelines are intended to identify, disseminate and promote the implementation of the best, scientific evidence-based actions to decrease variability in clinical practice. The implementation of these practices in the global clinical process will promote better outcomes and the shortening of hospital and critical care unit stays, thereby resulting in a reduction in costs and in greater efficiency. After completing a systematic review at each of the points of the perioperative process in cardiac surgery, recommendations have been developed based on the best scientific evidence currently available with the consensus of the scientific societies involved.

MAP2 is differentially phosphorylated in schizophrenia, altering its function.

Schizophrenia (Sz) is a highly polygenic disorder, with common, rare, and structural variants each contributing only a small fraction of overall disease risk. Thus, there is a need to identify downstream points of convergence that can be targeted with therapeutics. Reduction of microtubule-associated protein 2 (MAP2) immunoreactivity (MAP2-IR) is present in individuals with Sz, despite no change in MAP2 protein levels. MAP2 is phosphorylated downstream of multiple receptors and kinases identified as Sz risk genes, altering its immunoreactivity and function. Using an unbiased phosphoproteomics approach, we quantified 18 MAP2 phosphopeptides, 9 of which were significantly altered in Sz subjects. Network analysis grouped MAP2 phosphopeptides into three modules, each with a distinct relationship to dendritic spine loss, synaptic protein levels, and clinical function in Sz subjects. We then investigated the most hyperphosphorylated site in Sz, phosphoserine1782 (pS1782). Computational modeling predicted phosphorylation of S1782 reduces binding of MAP2 to microtubules, which was confirmed experimentally. We generated a transgenic mouse containing a phosphomimetic mutation at S1782 (S1782E) and found reductions in basilar dendritic length and complexity along with reduced spine density. Because only a limited number of MAP2 interacting proteins have been previously identified, we combined co-immunoprecipitation with mass spectrometry to characterize the MAP2 interactome in mouse brain. The MAP2 interactome was enriched for proteins involved in protein translation. These associations were shown to be functional as overexpression of wild type and phosphomimetic MAP2 reduced protein synthesis in vitro. Finally, we found that Sz subjects with low MAP2-IR had reductions in the levels of synaptic proteins relative to nonpsychiatric control (NPC) subjects and to Sz subjects with normal and MAP2-IR, and this same pattern was recapitulated in S1782E mice. These findings suggest a new conceptual framework for Sz-that a large proportion of individuals have a "MAP2opathy"-in which MAP function is altered by phosphorylation, leading to impairments of neuronal structure, synaptic protein synthesis, and function.

Aplicaciones emergentes de la ecografía clínica / Emerging applications of clinical ultrasonography

En el documento actual introduciremos las áreas más emergentes y frontera del uso de la ecografía clínica a la cabecera del paciente, que son numerosas. De entre todas ellas se revisarán 3: 1) la ecografía clínica en las enfermedades infecciosas y patología tropical (se abordará su utilidad en el diagnóstico y seguimiento de los principales síndromes, así como los usos para patología tropical y en áreas con escasos recursos); 2) la utilidad de la ecografía clínica para la evaluación de la respuesta a la infusión de volumen en pacientes graves (se revisarán conceptos básicos, así como las principales variables estáticas y dinámicas utilizadas para realizar esta evaluación); y por último, 3) se abordará la utilización de la ecografía clínica para la valoración de la masa muscular en la sarcopenia primaria de las personas ancianas (se repasarán los principales músculos y medidas que se utilizan para ello) (AU)

In this work, we introduce the numerous emerging areas and frontiers in the use of point-of-care ultrasonography. Of these, we review the following three: 1) the use of clinical ultrasonography in infectious and tropical diseases (we address its usefulness in the diagnosis and follow-up of the main syndromes, in tropical diseases, and in areas with scarce resources); 2) the usefulness of clinical ultrasonography in the assessment of response to volume infusion in severely ill patients (we review basic concepts and the main static and dynamic variables used for this evaluation); and 3) the use of clinical ultrasonography in the assessment of muscle mass in elderly patients with primary sarcopenia (we review the main muscles and measurements used for it) (AU)

Efectos del método Pilates en la reducción de caídas, el riesgo y miedo a caer en el adulto mayor: una revisión sistemática / The effects of the Pilates method on falls, risk and fear of falling in older adults: A systematic review

ANTECEDENTES: Las caídas son la segunda causa mundial de muerte por lesiones accidentales. La mayor tasa de mortalidad se produce en los adultos mayores. OBJETIVO: Evaluar si la práctica del método Pilates es efectiva para reducir las caídas y el riesgo de caída en el adulto mayor. MÉTODOS: Revisión sistemática de artículos originales publicados desde el inicio hasta octubre de 2018. Bases de datos consultadas: Medline, PubMed, Google Scholar, Web of Knowledge, OVID y ScienceDirect. Se incluyeron estudios experimentales y cuasi-experimentales en los que los participantes fueron adultos mayores y recibieron una intervención basada en el método Pilates, y en los que se evaluaron los efectos sobre las caídas, el riesgo o el miedo a las caídas. La síntesis fue descriptiva y se evaluó la calidad de los estudios incluidos con las escalas PEDro y Otawa. RESULTADOS: Seis estudios cumplieron los criterios de elegibilidad. Cinco fueron estudios clínicos aleatorizados y el restante un estudio de intervención. Un total de 216 participantes fueron incluidos. Dos estudios evaluaron el efecto sobre las caídas con resultados inconcluyentes. En general los efectos sobre el equilibrio asociado con el riesgo de caídas fueron positivos. El efecto sobre el miedo a la caída, valorado por un estudio, también dedujo resultados positivos derivados de la práctica de Pilates. CONCLUSIONES: La práctica de ejercicio basado en el método Pilates es efectiva para mejorar las habilidades de equilibrio estático y dinámico, así como la fuerza muscular en adultos mayores (predictores de caídas). Existe escasez de estudios orientados a evaluar específicamente la reducción del número de caídas y del miedo a caer. La implementación de ensayos clínicos con poder adecuado queda justificada para resolver el efecto del método Pilates sobre las caídas en el adulto mayor

BACKGROUND: Falls are the second leading cause of death by accidental injury worldwide. The highest death rate is in older adults. OBJECTIVE: To assess whether practicing the Pilates Method is effective in reducing falls and the risk of falling. METHODS: A systematic review of original articles published from inception until October 2018. Databases consulted: Medline, PubMed, Google Scholar, Web of Knowledge, OVID, and ScienceDirect. We included experimental and quasi-experimental studies in which the participants were older adults and had undergone an intervention based on the Pilates Method, and in which the effects on falls, risk, and fear of falling were assessed. The synthesis was descriptive, and the quality of the studies included was assessed with the PEDro and Ottawa scales. RESULTS: Six studies met the eligibility criteria. Five were randomised trials and one was an intervention study. A total of 216 participants were included. Two studies assessed the effect on falls with inconclusive results. Overall, the effects on balance associated with risk of falling were positive. The effect on fear of falling, assessed by one study, also concluded positive results from the practice of Pilates. CONCLUSIONS: Exercising based on the Pilates method is effective in improving static and dynamic balance skills and muscle strength in older adults (predictors of falls). There are few studies that specifically assess reduction in number of falls and fear of falling. The implementation of clinical trials of adequate power is justified to establish the effect of the Pilates method on falls in older adults

Emerging applications of clinical ultrasonography. / Aplicaciones emergentes de la ecografía clínica.

In the current document, we introduce the numerous emerging areas and frontiers in the use of point-of-care clinical ultrasonography. Of these, we review the following 3: 1) the use of clinical ultrasonography in infectious and tropical diseases (we address it's usefulness in the diagnosis and follow-up of the main syndromes, tropical diseases and in areas with scarce resources); 2) the usefulness of clinical ultrasonography in the assessment of response to volume infusion in severely ill patients (we review basic concepts and the main static and dynamic variables employed for this evaluation); and 3) the use of clinical ultrasonography in the assessment of muscle mass in elderly patients with primary sarcopenia (we review the main muscles and measurements employed for them it.

A case of esophageal carcinoma due to esophageal squamous papillomatosis.

INTRODUCTION: Squamous Papilloma is a rare benign tumor of the esophagus. Esophageal squamous papilloma is thought to arise from a chronic inflammatory reaction due to mechanical or chemical irritant. ESP is usually considered to have a benign clinical course; however, some reports highlight the potential development of a malignancy. The development of extensive esophageal squamous papillomas also known as squamous papillomatosis of the esophagus is even less frequent. PRESENTATION OF THE CASE: We present the case of an esophageal papillomatosis that developed into an invasive esophageal squamous cell carcinoma that was only diagnosed in the surgical specimen after minimally invasive Ivor-Lewis esophagectomy and in this case report, we discuss its etiology, diagnosis and treatment. CONCLUSION: Extensive papillomatosis with continuous symptoms, especially persistent dysphagia, should always prompt a thorough analysis into a possible underlying malignancy.

DFTB+, a software package for efficient approximate density functional theory based atomistic simulations.

DFTB+ is a versatile community developed open source software package offering fast and efficient methods for carrying out atomistic quantum mechanical simulations. By implementing various methods approximating density functional theory (DFT), such as the density functional based tight binding (DFTB) and the extended tight binding method, it enables simulations of large systems and long timescales with reasonable accuracy while being considerably faster for typical simulations than the respective ab initio methods. Based on the DFTB framework, it additionally offers approximated versions of various DFT extensions including hybrid functionals, time dependent formalism for treating excited systems, electron transport using non-equilibrium Green's functions, and many more. DFTB+ can be used as a user-friendly standalone application in addition to being embedded into other software packages as a library or acting as a calculation-server accessed by socket communication. We give an overview of the recently developed capabilities of the DFTB+ code, demonstrating with a few use case examples, discuss the strengths and weaknesses of the various features, and also discuss on-going developments and possible future perspectives.