Physical condition and perceived fatigue in post-covid patients: An observational descriptive study.

BACKGROUND: Patients with severe coronavirus disease 2019 (COVID-19) often require hospital admission and experience sequelae such as chronic fatigue or low muscle mass. OBJECTIVE: To analyze the functional capacity of a cohort of patients with severe acute respiratory syndrome coronavirus 2 who required hospitalization. DESIGN AND SETTING: An observational descriptive study was conducted on post-COVID-19 patients referred to the Rehabilitation Department of Gregorio Marañón Hospital (Madrid, SPAIN). METHODS: Cardiorespiratory fitness, muscle strength, body composition, and perception of fatigue and dyspnea were analyzed. Furthermore, the existing correlations between clinical variables and physical conditions were analyzed. RESULTS: Forty-two patients who required hospital admission (80 ± 22.45 days) or intensive care unit (ICU) admission (58 ± 10.52 days) were analyzed. They presented with decreased strength, respiratory capacity, and moderate-to-severe perceived fatigue. Additionally, an inverse correlation was found between right-handgrip strength and days in the ICU, as well as the 6-minute walk test for women. Similarly, strength and fitness were negatively associated with perceived fatigue. CONCLUSIONS: Post-COVID-19 patients showed low muscle function and low levels of physical fitness associated with high perceived fatigue.

ANCUT1, a novel thermoalkaline cutinase from Aspergillus nidulans and its application on hydroxycinnamic acids lipophilization.

One of the four cutinases encoded in the Aspergillus nidulans genome, ANCUT1, is described here. Culture conditions were evaluated, and it was found that this enzyme is produced only when cutin is present in the culture medium, unlike the previously described ANCUT2, with which it shares 62% amino acid identity. The differences between them include the fact that ANCUT1 is a smaller enzyme, with experimental molecular weight and pI values of 22 kDa and 6, respectively. It shows maximum activity at pH 9 and 60 °C under assayed conditions and retains more than 60% of activity after incubation for 1 h at 60 °C in a wide range of pH values (6-10) after incubations of 1 or 3 h. It has a higher activity towards medium-chain esters and can modify long-chain length hydroxylated fatty acids constituting cutin. Its substrate specificity properties allow the lipophilization of alkyl coumarates, valuable antioxidants and its thermoalkaline behavior, which competes favorably with other fungal cutinases, suggests it may be useful in many more applications.

Physical condition and perceived fatigue in post-covid patients: An observational descriptive study

ABSTRACT BACKGROUND: Patients with severe coronavirus disease 2019 (COVID-19) often require hospital admission and experience sequelae such as chronic fatigue or low muscle mass. OBJECTIVE: To analyze the functional capacity of a cohort of patients with severe acute respiratory syndrome coronavirus 2 who required hospitalization. DESIGN AND SETTING: An observational descriptive study was conducted on post-COVID-19 patients referred to the Rehabilitation Department of Gregorio Marañón Hospital (Madrid, SPAIN). METHODS: Cardiorespiratory fitness, muscle strength, body composition, and perception of fatigue and dyspnea were analyzed. Furthermore, the existing correlations between clinical variables and physical conditions were analyzed. RESULTS: Forty-two patients who required hospital admission (80 ± 22.45 days) or intensive care unit (ICU) admission (58 ± 10.52 days) were analyzed. They presented with decreased strength, respiratory capacity, and moderate-to-severe perceived fatigue. Additionally, an inverse correlation was found between right-handgrip strength and days in the ICU, as well as the 6-minute walk test for women. Similarly, strength and fitness were negatively associated with perceived fatigue. CONCLUSIONS: Post-COVID-19 patients showed low muscle function and low levels of physical fitness associated with high perceived fatigue.

Integrative review of remote patient monitoring in gynecologic and urologic surgical oncology.

Patients with cancer facing complex and invasive urologic and gynecologic cancer surgery often experience symptoms and rapid declines in functional capacity postoperatively. Remote patient monitoring that leverages patient-generated health data is a potential approach to assess and promote postoperative recovery. This integrative review aims to provide an overview of the current literature and research on remote patient monitoring in gynecologic and urologic surgical oncology.

Nicotianarupicola sp. nov. and Nicotianaknightiana (sect.Paniculatae, Solanaceae), a new endemic and a new record for the flora of Chile.

Nicotianaknightiana is recorded for the first time for the flora of Chile. A new species of Nicotiana, endemic to the coast of the Coquimbo region is described and illustrated. Molecular analysis placed the new species within the N.sect.Paniculatae, as sister to N.cordifolia, an endemic to Juan Fernandez islands. The new species can be considered critically endangered (CR) according to the IUCN categories due to its restricted and fragmented distribution, small population number, and the threat that urbanization and mining activities represent for the conservation of the biodiversity of the area.

The Physiological Effect of a Holoparasite Over a Cactus Along an Environmental Gradient.

Echinopsis chiloensis is an endemic cactus from Chile, distributed in a temperature and rainfall gradient between 30° and 35° South latitude, with mean temperatures increasing and precipitation decreasing toward the north. It is the main host of the mistletoe Tristerix aphyllus, a holoparasite completely dependent on the cactus for water, carbon, and minerals. In this study, we investigated the consequences of parasitism over the fitness and physiology of this cactus throughout its distribution range and how it is affected by the environment. We measured five functional traits in eight populations latitudinally distributed, the first three only for the host: reproductive fitness, stomatal traits (density and size), and photosynthesis (during winter and summer); and the last two for the host and parasite: stable isotopes (∂13C and ∂15N), and nutrients (carbon and nitrogen content). The results showed a negative effect of parasitism over fitness of infected cacti. However, the higher nitrogen concentrations in cactus tissues toward the south improved overall fitness. Regarding photosynthesis, we only observed a negative effect of parasitism during the dry season (summer), which is also negatively affected by the increase in summer temperatures and decrease in winter rainfall toward the north. There were no differences in nutrient concentration or in the isotopic signature of healthy and infected cacti. Conversely, we observed a higher carbon and lower nitrogen concentration in mistletoes than in cacti regardless of latitude. The loss of temperature seasonality toward the north increases the C:N ratio, and the values between the parasite and its host diverge. ∂15N was similar between parasites and hosts while ∂13C of the parasite was enriched when compared to its host. Overall, the infection by T. aphyllus affects Echinopsis chiloensis fitness but showed no strong effects over the cactus physiology, except for the summer photosynthesis. Therefore, our data revealed that E. chiloensis response to T. aphyllus infection is sensitive to environmental changes in a way that could be strongly impacted by the desertification projected for this area due to climate change.

Calceolariaflavida (Calceolariaceae) a new endemic species to central Chile.

A new species of Calceolariasect.Cheiloncos endemic to central Chile is described. A comparison with the morphologically similar species Calceolariaasperula and Calceolariapetioalaris is made, and a key as well as detailed images to differentiate them is provided. The species is only known from the Natural Sanctuary Cerro El Roble, which is part of the coastal mountain range of central Chile and can be considered as Critically Endangered (CR) under the IUCN categories and criteria.

Self-Compatibility Not Associated with Morphological or Genetic Diversity Reduction in Oil-Rewarding Calceolaria Species.

One of the most common evolutionary transitions in angiosperms is the reproductive change from outcrossing to selfing, commonly associated with changes in floral biology and genetic diversity. Here, we aim to test whether self-compatibility leads to a reduction of floral traits and genetic diversity. For this, we experimentally estimate levels of self-compatibility, measure three floral traits and estimate four genetic diversity parameters using nine microsatellites in nine Calceolaria species. Our analysis indicated that four of the study species were self-incompatible. In addition, we found that self-compatible species did not show a reduction in floral traits size, but rather displayed larger corolla and elaiophore areas. Our analyses of genetic diversity identified larger allele number and observed heterozygosity in selfers than in outcrossers, but did not find larger inbreeding in the self-compatible species. Even though our results contradict our expectations, in the case of Calceolaria, their high dependence on only two genera of oil-bees puts the genus in a vulnerable reproductive position, probably facilitating the evolution of reproductive assurance mechanisms in the absence of pollinators. As a result, plants maintain their pollinator attraction traits while evolving the ability to self, possibly in a delayed way.

Divergence in Plant Traits and Increased Modularity Underlie Repeated Transitions Between Low and High Elevations in the Andean Genus Leucheria.

Understanding why some plant lineages move from one climatic region to another is a mayor goal of evolutionary biology. In the southern Andes plant lineages that have migrated along mountain ranges tracking cold-humid climates coexist with lineages that have shifted repeatedly between warm-arid at low elevations and cold habitats at high elevations. Transitions between habitats might be facilitated by the acquisition of common traits favoring a resource-conservative strategy that copes with drought resulting from either low precipitation or extreme cold. Alternatively, transitions might be accompanied by phenotypic divergence and accelerated evolution of plant traits, which in turn may depend on the level of coordination among them. Reduced integration and evolution of traits in modules are expected to increase evolutionary rates of traits, allowing diversification in contrasting climates. To examine these hypotheses, we conducted a comparative study in the herbaceous genus Leucheria. We reconstructed ancestral habitat states using Maximum Likelihood and a previously published phylogeny. We performed a Phylogenetic Principal Components Analysis on traits, and then we tested the relationship between PC axes, habitat and climate using Phylogenetic Generalized Least Squares (PGLS). Finally, we compared the evolutionary rates of traits, and the levels of modularity among the three main Clades of Leucheria. Our results suggest that the genus originated at high elevations and later repeatedly colonized arid-semiarid shrublands and humid-forest at lower elevations. PGLS analysis suggested that transitions between habitats were accompanied by shifts in plant strategies: cold habitats at high elevations favored the evolution of traits related to a conservative-resource strategy (thicker and dissected leaves, with high mass per area, and high biomass allocation to roots), whereas warm-arid habitats at lower elevations favored traits related to an acquisitive-resource strategy. As expected, we detected higher levels of modularity in the clades that switched repeatedly between habitats, but higher modularity was not associated with accelerated rates of trait evolution.

Response of xerophytic plants to glacial cycles in southern South America.

BACKGROUND AND AIM: Quaternary glaciations strongly affected the distribution of species from arid and semi-arid environments, as temperature drops were accompanied by strong fluctuations in rainfall. In this study, we examined the response of xerophytic species to glacial cycles, determining the genetic patterns and climatic niche of Echinopsis chiloensis var. chiloensis, an endemic columnar cactus of arid and semi-arid regions of Chile. METHODS: We analysed 11 polymorphic microsatellites for 130 individuals from 13 populations distributed across the entire distribution of the species. We examined genetic diversity and structure, identified possible patterns of isolation by distance (IBD) and tested two competing population history scenarios using Approximate Bayesian Computation. The first scenario assumes a constant population size while the second includes a bottleneck in the southern population. The latter scenario assumed that the southernmost populations experienced a strong contraction during glaciation, followed by a postglacial expansion; by contrast, the area of the northernmost populations remained as a stable refugium. We also used ecological niche modelling (ENM) to evaluate the location and extension of suitable areas during the Last Glacial Maximum (LGM) and the mid-Holocene. KEY RESULTS: We found a decline in genetic diversity towards high latitudes and a significant IBD pattern that together with ENM predictions suggest that E. chiloensis var. chiloensis experienced range contraction northwards during wet-cold conditions of the LGM, followed by expansion during aridification of the mid-Holocene. In addition to IBD, we detected the presence of a strong barrier to gene flow at 32°30'S, which according to coalescence analysis occurred 44 kyr BP. The resulting genetic clusters differed in realized climatic niche, particularly in the variables related to precipitation. CONCLUSIONS: Our results suggest that the cactus E. chiloensis var. chiloensis experienced range contraction and fragmentation during the wet-cold conditions of the LGM, which may have facilitated ecological differentiation between northern and southern populations, promoting incipient speciation.

Selfing and Drought-Stress Strategies Under Water Deficit for Two Herbaceous Species in the South American Andes.

Angiosperms are highly diverse in their reproductive systems, including predominantly selfing, exclusive outcrossing, and mixed mating systems. Even though selfing can have negative consequences on natural populations, it has been proposed that plants having a predominantly selfing strategy are also associated with fast development strategies through time limitation mechanisms that allow them to complete their life cycle before the onset of severe drought. This relationship might be affected by the challenges imposed by global change, such as a decrease in pollinator availability and the earlier and more severe onset of droughts. In this work, our aim was to investigate whether selfing is correlated with a dehydration avoidance strategy, and how this could affect drought resistance and survival in two species with different types of selfing: pollinator-independent delayed selfing (Schizanthus grahamii) and pollinator-dependent selfing (Schizanthus hookeri), representing a gradient in selfing rates. We hypothesize that delayed selfing species and highly selfing populations will show "fast" plant traits whereas we will find no pattern in more outcrossed populations of the pollinator-dependent species. However, we predicted that high selfing populations would have lower survival rates when exposed to chronic drought early in their development since fast traits imply physiological compromises that will affect their drought survival. To evaluate these hypotheses, we characterized different physiological and morphological traits in response to two contrasting treatments (moist and dry) in a total of six populations of the two species. We found a relationship between the delayed selfing species and a dehydration avoidance strategy and also with low drought survival. Our work offers evidence to support the importance of abiotic factors, such as drought, on the possible variation in selfing rates on natural populations, and the effect that this mating system could have in their ability to face new environmental conditions such as those imposed by climate change.

What explains the lacklustre response to Zika in Brazil? Exploring institutional, economic and health system context.

By early-2016, the international community began to pressure Brazil for a stronger policy response to Zika. In contrast to what was seen in the past, however, these international pressures did not elicit such a response. In this article, we explore why this was the case, reviewing the government's policy response and the broader political and economic context shaping this response. The authors used single case study analysis and qualitative sources, such as books, journal articles, and government policy reports to support their empirical claims. We found that despite increased international pressures from the WHO, domestic political factors and economic recession hampered the government's ability to strengthen its health systems response to Zika. Consequently, those states most afflicted by Zika have seen policy initiatives that lack sufficient funding, administrative and human resource capacity. This study revealed that despite a government's deep foreign policy history of positively responding to international pressures through a stronger policy response to health epidemics, a sudden change in government, rising political instability, and economic recession can motivate governments to abandon this foreign policy tradition and undermine its response to new public health threats.

Floral meristem size and organ number correlation in Eucryphia (Cunoniaceae).

We present a comparative flower ontogenetic study in five species of the genus Eucryphia with the aim of testing whether differences in the organ number observed can be explained by changes in the meristematic size of floral meristem and floral organs. Species native to Oceania, viz. E. milliganii, E. lucida and E. moorei, have the smallest gynoecia with ca. 6 carpels, while the Chilean E. glutinosa and E. cordifolia present more than ten carpels. E. milliganii has the smallest flower with the lowest stamen number (ca. 50), while the other species produce around 200 stamens and more. Standardized measurements of meristematic sectors were taken in 49 developing flowers that were classified into three well-defined ontogenetic stages. Sizes of meristems varied significantly among species within each developmental stage as revealed by ANOVA analyses. Significant regressions between organ number and corresponding meristem size were consistent with the premise that a larger meristem size prior to organ initiation could be determining for a higher organ number. Flower organogenesis in Eucryphia also involves relevant meristem expansion while the organs are initiated, which results in a particular androecium patterning with a chaotic stamen arrangement. Meristem expansion also appears to be slower but more extensive in species with larger initial meristematic size, suggesting that flower phenotype can be determined in ontogeny by this heterochronic interplay of space and time.

The Diverse Iron Distribution in Eudicotyledoneae Seeds: From Arabidopsis to Quinoa.

Seeds accumulate iron during embryo maturation stages of embryogenesis. Using Arabidopsis thaliana as model plant, it has been described that mature embryos accumulate iron within a specific cell layer, the endodermis. This distribution pattern was conserved in most of the analyzed members from Brassicales, with the exception of the basal Vasconcellea pubescens that also showed elevated amounts of iron in cortex cells. To determine whether the V. pubescens iron distribution was indicative of a wider pattern in non-Brassicales Eudicotyledoneae, we studied iron distribution pattern in different embryos belonging to plant species from different Orders from Eudicotyledoneae and one basal from Magnoliidae. The results obtained indicate that iron distribution in A. thaliana embryo is an extreme case of apomorphic character found in Brassicales, not-extensive to the rest of Eudicotyledoneae.

Energy expenditure, body composition, and prevalence of metabolic disorders in patients with Duchenne muscular dystrophy.

INTRODUCTION: Duchenne muscular dystrophy (DMD) is a severe muscular disease characterized by progressive loss of functional muscle mass followed by changes in body composition. AIM: To describe body composition, resting energy expenditure (REE), and metabolic disorders in DMD patients followed-up at a tertiary care center. To analyze the association with type of steroid and ambulatory status, and to compare obese DMD patients with patients with multifactorial obesity. POPULATION AND METHODS: A prospective, observational, cross-sectional study was conducted. Anthropometric measurements were taken, evaluating body composition with bioelectrical impedance analysis (BIA), REE with indirect calorimetry, and biochemical parameters in all DMD patients seen between June 2013 and April 2014. RESULTS: 63 boys between 5.4 and 18.7years of age were evaluated. Diagnosis of obesity ranged from 28% measuring body mass indexZ-score (BMIZ-score) to 70% using percentage of fat mass (%FM). Patients who had lost gait had a significantly higher %FM than those in whom gait was preserved (72% vs 46%, p<0.05). Insulin resistance was present in 29% associated with BMI Z-score and waist circumference and 40% had dyslipidemia associated with %FM, both of which were steroid independent. In obese DMD patients REE was lower than predicted and also lower than controls, and persist when dividing the patients into ambulators and non-ambulators. CONCLUSIONS: A high prevalence of obesity was observed. BMI-Z-score underestimates the degree of FM. No correlation was found between steroid type and body composition or metabolic disorders. No differences were found in REE between ambulators and non-ambulators. Obese DMD patients have a lower REE than controls.

Series de Pediatría Garrahan. El niño con problemas neurológicos / Garrahan Pediatrics Series. The child with neurological problems

Las afecciones neurológicas son uno de los motivos de consulta más frecuentes en la práctica pediátrica ambulatoria y ocupan un alto índice de las camas en la internación. El papel del pediatra en este contexto es muy complejo, ya que es quien recibe a un paciente en la emergencia o en el consultorio y debe estar atento a si un determinado síntoma o signo neurológico puede ser transitorio o el indicio de una enfermedad grave. Así, son fundamentales tanto el conocimiento de las distintas entidades neurológicas y de sus aspectos epidemiológicos y patogénicos como también el examen semiológico y los primeros estudios por realizar para la orientación diagnóstica, el tratamiento inicial, las indicaciones de derivación, la prevención de riesgos y el asesoramiento a los padres. Este nuevo volumen aborda esta temática especial con énfasis en el trabajo interdisciplinario y entre sus características se destacan: El estudio de importantes temas clínicos, como las convulsiones febriles, que se presentan en el 2% al 5% de los niños; la epilepsia infantil, con una prevalencia del 1%; la cefalea, cuya incidencia ha aumentado en los últimos veinte años y es hoy el motivo de consulta más frecuente en los servicios de neurología; las crisis paroxísticas no epilépticas, que aparecen entre el 5% y el 20% de la población infantil; el desafío diagnóstico del lactante hipotónico; las encefalopatías agudas, y los trastornos de la marcha y del movimiento. La inclusión, en todos los capítulos, de casos clínicos con su evolución y desenlace, textos destacados con los principales conceptos, puntos claves para recordar, además de material complementario, como bibliografía adicional, videos y enlaces a sitios web de interés. Una obra sólida y práctica, que transmite las experiencias de los profesionales de una institución del prestigio internacional del Hospital de Pediatría Prof. Dr. Juan P. Garrahan ­a treinta años de su creación- dedicada a todos los pediatras, donde quiera que trabajen al servicio de la salud de los niños.