Impact of future scenarios of climate change on lignin dynamics in soil: A case study in a Mediterranean savannah.

Lignin is an abundant and recalcitrant biopolymer of major relevance as soil organic matter (SOM) component playing a significant role in its stabilization. In this work, a factorial field experiment was established, where three climatic treatments (W, warming; D, drought; W + D, warming + drought), mimicking future climate change scenarios were installed over five years in a Mediterranean savannah "dehesa", accounting for its landscape diversity (under the tree canopy and in open grassland). A combination of analytical pyrolysis (Py-GC/MS) and the study of biogeochemical proxies based on lignin monomers is used for the direct detection of lignin-derived phenols and to infer possible shifts in lignin dynamics in soil. A total of 27 main lignin-derived methoxyphenols were identified, exhibiting different patterns and proportions, mainly driven by the effect of habitat, hence biomass inputs to SOM. An accelerated decomposition of lignin moieties -(exhibited by higher LG/LS and Al/K + Ac ratios)- is particularly exacerbated by the effect of all climatic treatments. There is also an overall effect on increasing lignin oxidation of side chain in syringyl units, especially under the tree canopy due to the alteration in biomass degradation and potential stimulation of enzyme activities. Conversely, in open grassland these effects are slower since the microbial community is expected to be already adapted to harsher conditions. Our findings suggests that climate change-related temperature and soil moisture deviations impact soil lignin decomposition in dehesas threatening this productive Mediterranean agroecosystem and affecting the mechanism of soil carbon storage.

[Autism spectrum disorder: the impact of an online training strategy on the knowledge of the healthcare staff of a tertiary care hospital]. / Trastorno del espectro autista: impacto de una estrategia de formación en línea en los conocimientos del personal sanitario de un hospital de tercer nivel.

INTRODUCTION: Autism spectrum disorder (ASD) often presents related medical disorders that require specialised healthcare. Professionals in the health sector therefore face difficulties that require specific training in the healthcare needs of this population. AIM: The aim of this study is to quantify paediatric healthcare professionals' knowledge about ASD and to assess the impact of online training. SUBJECTS AND METHODS: It is a quasi-experimental, longitudinal, prospective before-and-after study; study subjects: health professionals; independent variable: online training in ASD; dependent variable: knowledge about ASD. An online training course was held for paediatric professionals to address the core characteristics of diagnosis, as well as the needs they present in the hospital context and the adaptations it is recommended that should be carried out. Fifty-eight healthcare professionals took part. RESULTS: An increase in knowledge about ASD was observed at the end of the intervention (from 73.9% to 85% according to the ASD background knowledge questionnaire), which showed that more than 90% of the participants had the highest level of knowledge about ASD. CONCLUSIONS: Online training courses are a useful and effective way to increase knowledge about ASD and the adaptations that are recommended in the hospital setting. More training in ASD should be made available in these settings.

TITLE: Trastorno del espectro autista: impacto de una estrategia de formación en línea en los conocimientos del personal sanitario de un hospital de tercer nivel.Introducción. El trastorno del espectro autista (TEA) frecuentemente presenta trastornos médicos relacionados que requieren una atención sanitaria especializada. En este sentido, los profesionales del ámbito sanitario se enfrentan a dificultades que precisan una formación específica en las necesidades sanitarias que presenta esta población. Objetivo. Cuantificar los conocimientos sobre el TEA de los profesionales sanitarios del área pediátrica y valorar el impacto de una formación en línea. Sujetos y métodos. Estudio cuasi experimental del antes y después, longitudinal y prospectivo; sujetos a estudio: profesionales sanitarios; variable independiente: formación en línea en TEA; variable dependiente: conocimiento sobre el TEA. Se llevó a cabo una formación en línea para profesionales del área de pediatría en la que se abordaron las características nucleares del diagnóstico, así como las necesidades que presentan en el contexto hospitalario y las adaptaciones que se recomiendan llevar a cabo. Participaron 58 profesionales sanitarios. Resultados. Se observó un aumento en el conocimiento sobre el TEA al finalizar la intervención (del 73,9 al 85% según el cuestionario de conocimientos previos del TEA), que mostró que más del 90% de los participantes tenía el grado máximo de conocimiento sobre el TEA. Conclusiones. Las formaciones en línea son un método para ampliar conocimiento útil y eficaz para aumentar el conocimiento sobre el TEA y las adaptaciones que se recomiendan en el ámbito hospitalario. Se recomienda aumentar la disponibilidad de formación sobre TEA en estos entornos.

Impact of postpartum metritis on the regeneration of endometrial glands in dairy cows.

The postpartum uterus involutes to its pre-pregnant and fully functional state within approximately 60 d after calving. Uterine glands are essential for fertility but little is known about their regeneration postpartum. Likewise, the effect of uterine disease (metritis) on gland regeneration is unknown. We hypothesized that uterine glands would be regenerated early postpartum and that metritis would be associated with slower gland regeneration to affect their numbers later postpartum during the breeding period. Postpartum dairy cows were diagnosed as healthy (n = 17 and 9 for experiment [Exp.] 1 and 2) or metritis (n = 17 and 10 for Exp. 1 and 2, respectively) at 7 to 10 d postpartum. Cows were slaughtered at approximately 1 mo (Exp. 1) or approximately 80 or 165 d (Exp. 2) postpartum for the collection of the uterus. Uterine tissue was sectioned and the number of glandular cross-sections per unit area was counted and cross-sectional area measured. Cellular proliferation within the luminal epithelium (LE) and glandular epithelium (GE) was quantified by MKI67 (marker of cellular proliferation) immunohistochemistry. In early postpartum cows (Exp. 1), the greatest amount of MKI67 staining was found in the deep endometrium (cells closest to the myometrium). Cows with purulent material in the uterine lumen at d 30 slaughter (Exp. 1) had fewer endometrial glands per unit area in the deep and middle endometrium when compared with nonpurulent cows. The MKI67 staining was less in the deep endometrial GE and LE for purulent compared with nonpurulent cows. Estrus cyclicity was associated with a greater number of gland cross-sections in the deep and middle endometrium. Later postpartum (80 and 165 d; Exp. 2), there was greater glandular development compared with Exp. 1 and a tendency for a lesser number of gland cross-sections per unit area in diseased cows without an effect on MKI67 staining in the GE or LE. We conclude that uterine disease slows the development of uterine glands early postpartum (by 1 mo) through a mechanism that involves cellular proliferation within the GE. The impact of the early postpartum disease on glandular development later postpartum (Exp. 2) appeared to be less. Additional time, therefore, may allow recovery of the GE in later postpartum cows.

A pro-BMP function exerted by Rhodnius prolixus short gastrulation reveals great diversity in the role of BMP modulators during embryonic patterning.

Dorsal-ventral (DV) patterning is regulated by the bone morphogenetic pathway (BMP) in Bilateria. In insect DV patterning, the Toll pathway also plays a role, in addition to BMPs. Variations in the relative importance of each pathway for DV patterning have been reported using single species of coleopteran, hymenopteran, hemipteran and orthopteran insects. To investigate if the molecular control of DV patterning is conserved inside an insect order, the emergent model hemiptera species Rhodnius prolixus was studied. We found that R. prolixus BMP pathway controls the entire DV axis, with a broader effect respective to Toll, as shown for the hemiptera Oncopeltus fasciatus. Different from O. fasciatus, the unique R. prolixus short gastrulation (sog) and the twisted gastrulation (tsg) orthologues do not antagonize, but rather favour embryonic BMP signalling. Our results reinforce the hypothesis that hemiptera rely preferentially on BMPs for DV patterning but that, surprisingly, in R. prolixus Sog and Tsg proteins exert only a positive role to establish a dorsal-to-ventral BMP gradient. Since sog has been reported to be lost from orthopteran and hymenopteran genomes, our results indicate that Sog's role to modify BMP activity varies greatly in different insect species.

Radiation protection measures used in Portuguese interventional radiology departments: A national survey.

INTRODUCTION: This study aimed to characterise radiation protection (RP) measures used in interventional radiology (IR) departments in Portugal with respect to European and national recommendations. METHODS: An online national survey was created to characterise the fluoroscopy technology as well as analyse the frequency of body fluoroscopy-guided intervention procedures (FGIP), RP education and training of the staff, and RP measures used daily. RESULTS: In Portugal, most equipment for FGIP are single-sourced and have a flat panel detector (70%). The most commonly FGIP are percutaneous biliary drainage, percutaneous arterial and venous thrombolysis/thrombectomy, arteriovenous malformations embolization, and percutaneous transluminal balloon angioplasty for arteriovenous fistulas. Only a few staff members had received postgraduate education and training in RP (30%), with most nurses having not received RP education and training (40%). Some of the recommended RP measures lacked harmonisation. Additionally, >50% of the IR departments do not consider examination dose values to identify patients eligible for tissue reactions follow-up. CONCLUSION: This is the first study to examine the characteristics of IR departments in Portugal. We observed a lack of RP education and training among staff members; further, there was a need to update some RP measures in some IR departments according to the recommendations. IMPLICATIONS FOR PRACTICE: Our findings will be presented to the participating IR departments in order to update and promote RP best practices. Moreover, our findings will be presented to the national societies of the different professional groups in order to inform strategies for harmonising RP education and training of the staff.

Detección de nefrotóxicos y ajuste de dosis en pacientes con filtrado glomerular bajo realizado en farmacia comunitaria: metodología / Detection of nephrotoxicants and dose adjustment in patients with low glomerular filtration rate performed in community pharmacy: methodology

La enfermedad renal crónica es un problema prevalente y sin tratamiento específico. La detección tem prana es importante, siendo el Filtrado Glomerular estimado (FGe) una prueba muy asequible que puede realizarse en farmacia comunitaria. Si se presenta, es muy importante no dañar más el riñón evitando el uso de medicamentos nefrotóxicos y ajustar las dosis de otros medicamentos de eliminación renal, y la farmacia comunitaria está muy bien posicionada para ello. Objetivo: describir la metodología utilizada para detectar nefrotóxicos y ajustar dosis de otros medica mentos en farmacia comunitaria para su posterior derivación a atención primaria. Método: estudio experimental de seguimiento no controlado multicéntrico realizado en farmacias comunitarias de 4 comunidades autónomas de España. Se incluyen pacientes que cumplen criterios de inclusión y firman el consentimiento informado. Se estudian aquellos con FGe<60 ml/min/1,73m2 y se analiza su medicación utilizando el BOT Plus y otras 4 fuentes de información. Resultado: se incluyen 670 pacientes, 215 de ellos con FGe<60ml/min/1,73m2. De ellos 90 (41,9 %) necesitaron algún tipo de ajuste a juicio del farmacéutico. De estos 90 el 43,3 % (39) tuvieron algún tipo de cambio posteriormente a la intervención del farmacéutico. Conclusión: en pacientes con filtrado glomerular bajo, con la metodología adecuada, el farmacéutico comunitario es capaz de detectar la utilización de medicamentos nefrotóxicos o la utilización de medicamentos a dosis superiores a las recomendadas en función de su estado renal. Detección de nefrotóxicos y ajuste de dosis en pacientes con filtrado glomerular bajo realizado en farmacia comunitaria: metodología (AU)

Chronic kidney disease is a prevalent problem without specific treatment. Early detection is important and estimated glomerular filtration rate (eGFR) is a very affordable test that can be performed in community pharmacies. If present, it is very important not to further damage the kidney by avoiding the use of neph rotoxic drugs and adjusting the doses of other renal elimination drugs and the community pharmacy is very well positioned to do this. Objective: To describe the methodology used to detect nephrotoxic drugs and adjust doses of other drugs in community pharmacies for subsequent referral to primary care. Method: Multicentre experimental multicentre uncontrolled follow-up study carried out in communi ty pharmacies in 4 autonomous communities in Spain. Patients who met the inclusion criteria and signed the informed consent form were included. Those with eGFR <60 ml/min/1.73m2 were studied and their medication was analysed using the BOT Plus and 4 other sources of information. Result: 670 patients were included, 215 of them with eGFR<60ml/min/1.73m2. Of these 90 (41.9%) needed some type of adjustment in the pharmacist’s judgement. Of these 90, 43.3% (39) had some kind of change after the pharmacist’s intervention C onclusion: In patients with low glomerular filtration rate, with the appropriate methodology, the community pharmacist is able to detect the use of nephrotoxic drugs or the use of drugs at doses higher than those recommended according to their renal status (AU)

Telerrehabilitación en tiempos de COVID: una encuesta de satisfacción a cuidadores y pacientes con daño cerebral / Telerehabilitation in the COVID-19 pandemic: A satisfaction survey of caregivers and stroke patients

Objetivo: Determinar el grado de satisfacción de los cuidadores y de los pacientes con ictus que han recibido fisioterapia en formato de telerrehabilitación (TR) durante la primera oleada de la pandemia de SARS-CoV-2. Material y métodos: Se elaboró un estudio descriptivo mediante un cuestionario. El cuestionario incluía preguntas sobre la experiencia general, los problemas encontrados, los resultados subjetivos obtenidos y las sugerencias para futuras ediciones. Resultados: Se seleccionaron 26 sujetos: 16 pacientes (9 hombres y 7 mujeres) con diagnóstico de ictus y 10 cuidadores (3 hombres y 7 mujeres). El 87,6% de los pacientes y el 90% de los cuidadores consideraron que el sistema de conexión era fácil de usar, aunque el 30% dijeron que elegirían otro sistema de conexión en el futuro. Además, el 87,6% de los pacientes estaban de acuerdo o muy de acuerdo en repetir el tratamiento de TR. Conclusión: Los pacientes con ictus y los cuidadores que participan en el programa TR han mostrado un grado de satisfacción aceptable con su participación. (AU)

Aim: To determine the satisfaction degree of caregivers and stroke patients who received physiotherapy in telerehabilitation (TR) format during the first wave of the SARS-CoV-2 pandemic. Material and methods: A descriptive study was developed using a questionnaire. The questionnaire included questions on general experience, problems encountered, subjective results obtained and suggestions for future editions. Results: Twenty-six subjects were selected: 16 patients (9 men and 7 women) with a diagnosis of stroke and 10 caregivers (3 men and 7 women). 87.6% of the patients and 90% of the caregivers found the connection system easy to use, although 30% said they would choose another connection system in the future. In addition, 87.6% of patients agreed or strongly agreed to repeat the TR treatment. Conclusion: Stroke patients and caregivers participating in the TR program showed an acceptable satisfaction degree with their participation. (AU)

[Adaptation and feasibility of the online version of the Fugl Meyer scale for the assessment of patients following cerebrovascular accidents. Reply]. / Comentario al original 'Adaptación y viabilidad de la versión telemática de la escala Fugl Meyer para la evaluación de pacientes tras accidentes cerebrovasculares. Réplica.

TITLE: Comentario al original 'Adaptación y viabilidad de la versión telemática de la escala Fugl Meyer para la evaluación de pacientes tras accidentes cerebrovasculares. Réplica.

Comentario al original ‘Adaptación y viabilidad de la versión telemática de la escala Fugl Meyer para la evaluación de pacientes tras accidentes cerebrovasculares. Réplica / Adaptation and feasibility of the online version of the Fugl Meyer scale for the assessment of patients following cerebrovascular accidents. Reply

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The relationship between the number of weekly physical education classes with morphological, physical, motor and executive functions profiles: a cross-sectional study. Physical Education class morphological, physical, motor and executive functions / Número de sesiones de Educación Física escolar y perfil morfológico, funciones ejecucitivas y aptitud física. Clase de educación físicamorfológicas, físicas, motrices y función ejecutiva

Introducción: La Educación Física Escolar se presenta como un interesante instrumento en la mejora de los dominios de las funciones físicas, motoras y ejecutivas en los niños. Estudios recientes indican la relación positiva de un mayor comportamiento motory aptitud física con ganancias en las capacidades de la función ejecutiva, todas estas capacidades se pueden desarrollar en Educación Física Escolar. Se conoce el beneficio de la Educación Física Escolar en el desarrollo infantil, pero aún es necesario investigar si el número de clases de Educación Física Escolar puede influir en estos aspectos. Objetivo: Verificar el efecto del número de clases de educación física en la escuela sobre indicadores antropométricos, físicos, motores y cognitivos. Métodos: se trata de un estudio descriptivo transversal. Se realizaron tres visitas aleatorias a las instalaciones de la escuela para aplicar los instrumentos de investigación, divididas en tres bloques. 1) Prueba de cancelación de atención y Prueba de carriles A y B (aplicada colectivamente); 2) Prueba de recuperación intermitente -nivel 1 (Yo-Yo IR1); 3) Prueba de anamnesis, composición corporal y Körperkoordination für Kinder (KTK). Resultados: los niños que participaron en dos clases semanales de Educación Física en la escuela lograron valores más bajos de composición corporal y mayores dominios motores y flexibilidad cognitiva en comparación con los niños que asistieron solo a una clase semanal. (AU)

Introduction: School Physical Education presents itself as an interesting instrument in the improvement of physical, motor, and executive functions domains in children. Recent studies indicate the positive relationship of increased motor behavior and physical fitness with gains in executive function capacities, all these capacities can be developed in School Physical Education. It is known about the benefit of School Physical Education in child development, but it is still necessary to investigate whether the number of School Physical Education classes can influence these aspects.Objective: To verify the effect of the number of physical education classes in school on anthropometric, physical, motor and cognitive indicators.Methods: this is a descriptive cross-sectional study. Three random visits were carried out on the school premises to apply the research instruments, divided into three blocks. 1) Attention cancellation test and Test of lanes A and B (collectively applied); 2) Intermittent recovery test -level 1 (Yo-Yo IR1); 3) Anamnesis, body composition and Körperkoordination für Kinder (KTK) test.Results: children who participated in two weekly Physical Education classes at school achieved lower values of body composition and greater motor domains and cognitive flexibility compared to children who attended only one weekly class. (AU)

Introdução:A Educação Física Escolar se apresenta como um instrumento interessante na melhoria dos domínios físico, motores e das funções executivas em crianças. Estudos recentes indicam a relação positiva do aumento do comportamento motor e da aptidão física com ganhos nas capacidades das funções executivas, todas estas capacidades podem ser desenvolvidas na Educação Física Escolar. Sabe-se sobre o benefício da Educação Física Escolar no desenvolvimento infantil, mas, ainda é necessário investigar se o número de aulas de Educação Física Escolar pode influenciar nestes aspectos. Objetivo:Verificar o efeito do número de aulas de educação física escolar nos indicadores antropométricos, físicos, motores e cognitivos. Métodos:trata-se de um estudo transversal descritivo. Foram realizadas três visitas aleatórias nas dependências da escola para aplicação dos instrumentos de pesquisa, divididos em três blocos. 1) Teste de atenção por cancelamento e Teste das faixas A e B (aplicadas coletivamente); 2) Teste de recuperação intermitente -nível 1 (Yo-Yo IR1); 3) Anamnese, composição corporal e teste de Körperkoordination für Kinder (KTK). Resultados:as crianças que participaram de duas aulas semanais de Educação Física na escola alcançaram valores mais baixos de composição corporal e maiores domínios motores e flexibilidade cognitiva em relação às crianças com apenas uma aula semanal. (AU)

Adaptación y viabilidad de la versión telemática de la escala Fugl Meyer para la evaluación de pacientes tras accidentes cerebrovasculares / Adaptation and feasibility of the online version of the Fugl Meyer scale for the assessment of patients following cerebrovascular accidents

Introducción: Los pacientes que han sufrido un accidente cerebrovascular crónico o un ictus necesitan tratamientos de fisioterapia a largo plazo. Sin embargo, la pandemia de COVID-19 ha obligado a detenerlos. Con el objetivo de poder ofrecer una evaluación funcional de forma telemática a estos pacientes, se propuso diseñar una adaptación de la escala de evaluación Fugl Meyer-versión española y comprobar su viabilidad. Pacientes y métodos: Escala telemática adaptada, basada en la escala de evaluación Fugl Meyer. Se mantuvieron los dominios de función motora, equilibrio y dolor, y se eliminaron ítems que requerían ayuda para el paciente. Dicha escala se administró a 14 pacientes con accidente cerebrovascular crónico de la Asociación de Daño Cerebral Adquirido de Salamanca, a través de diferentes plataformas web, siguiendo el mismo procedimiento que la escala original y con una duración de 30 a 45 minutos. Resultados: Todos los pacientes completaron la escala de evaluación Fugl Meyer-versión telemática. La mayor dificultad se encontró para la evaluación de las extremidades inferiores. Los pacientes y los fisioterapeutas destacaron la facilidad de realización de los ítems de la escala. Al comparar las versiones se encontraron correlaciones positivas estadísticamente significativas con la versión original (p < 0,001) y los coeficientes de correlación indicaron una fuerte asociación. La diferencia entre las secciones de la escala equivalentes en cada instrumento no fue mayor que el 5%, excepto en el equilibrio. Conclusión: La escala de evaluación Fugl Meyer-versión telemática, es una escala viable, útil y fácil de aplicar que permite la evaluación del estado funcional de los pacientes con ictus y que puede responder a las necesidades actuales durante la pandemia de COVID-19.(AU)

Introduction: Patients who have suffered a chronic cerebrovascular accident or a stroke need long-term physiotherapy treatments. However, they have had to be stopped due to the COVID-19 pandemic. To be able to offer these patients an online functional assessment, a proposal was put forward to design an adaptation of the Spanish version of the Fugl Meyer assessment scale and to test its viability. Patients and methods: The adapted online scale, based on the Fugl Meyer assessment scale. The motor function, balance and pain domains were kept, and items requiring assistance for the patient were removed. This scale was administered to 13 patients with a chronic cerebrovascular accident from the Salamanca Acquired Brain Injury Association (Asociación de Daño Cerebral Adquirido) via different web platforms. The procedure followed was the same as for the original scale and lasted from 30 to 45 minutes. Results: All the patients completed the Fugl Meyer assessment scale, online version. The greatest difficulty was encountered in the assessment of the lower limbs. Patients and physiotherapists highlighted how easy it was to complete the items in the scale. On comparing the versions, statistically significant positive correlations were found with the original version (p < 0.001) and the correlation coefficients indicated a strong association. The difference between the equivalent sections of the scale in each instrument was no greater than 5%, except for balance. Conclusion: The Fugl Meyer assessment scale, online version, is a feasible, useful and easy to apply scale that allows assessment of the functional status of stroke patients and can help meet the current needs during the COVID-19 pandemic.(AU)

[Adaptation and feasibility of the online version of the Fugl Meyer scale for the assessment of patients following cerebrovascular accidents]. / Adaptación y viabilidad de la versión telemática de la escala Fugl Meyer para la evaluación de pacientes tras accidentes cerebrovasculares.

INTRODUCTION: Patients who have suffered a chronic cerebrovascular accident or a stroke need long-term physiotherapy treatments. However, they have had to be stopped due to the COVID-19 pandemic. To be able to offer these patients an online functional assessment, a proposal was put forward to design an adaptation of the Spanish version of the Fugl Meyer assessment scale and to test its viability. PATIENTS AND METHODS: The adapted online scale, based on the Fugl Meyer assessment scale. The motor function, balance and pain domains were kept, and items requiring assistance for the patient were removed. This scale was administered to 13 patients with a chronic cerebrovascular accident from the Salamanca Acquired Brain Injury Association (Asociacion de Dano Cerebral Adquirido) via different web platforms. The procedure followed was the same as for the original scale and lasted from 30 to 45 minutes. RESULTS: All the patients completed the Fugl Meyer assessment scale, online version. The greatest difficulty was encountered in the assessment of the lower limbs. Patients and physiotherapists highlighted how easy it was to complete the items in the scale. On comparing the versions, statistically significant positive correlations were found with the original version (p < 0.001) and the correlation coefficients indicated a strong association. The difference between the equivalent sections of the scale in each instrument was no greater than 5%, except for balance. CONCLUSION: The Fugl Meyer assessment scale, online version, is a feasible, useful and easy to apply scale that allows assessment of the functional status of stroke patients and can help meet the current needs during the COVID-19 pandemic.

TITLE: Adaptación y viabilidad de la versión telemática de la escala Fugl Meyer para la evaluación de pacientes tras accidentes cerebrovasculares.Introducción. Los pacientes que han sufrido un accidente cerebrovascular crónico o un ictus necesitan tratamientos de fisioterapia a largo plazo. Sin embargo, la pandemia de COVID-19 ha obligado a detenerlos. Con el objetivo de poder ofrecer una evaluación funcional de forma telemática a estos pacientes, se propuso diseñar una adaptación de la escala de evaluación Fugl Meyer-versión española y comprobar su viabilidad. Pacientes y métodos. Escala telemática adaptada, basada en la escala de evaluación Fugl Meyer. Se mantuvieron los dominios de función motora, equilibrio y dolor, y se eliminaron ítems que requerían ayuda para el paciente. Dicha escala se administró a 14 pacientes con accidente cerebrovascular crónico de la Asociación de Daño Cerebral Adquirido de Salamanca, a través de diferentes plataformas web, siguiendo el mismo procedimiento que la escala original y con una duración de 30 a 45 minutos. Resultados. Todos los pacientes completaron la escala de evaluación Fugl Meyer-versión telemática. La mayor dificultad se encontró para la evaluación de las extremidades inferiores. Los pacientes y los fisioterapeutas destacaron la facilidad de realización de los ítems de la escala. Al comparar las versiones se encontraron correlaciones positivas estadísticamente significativas con la versión original (p menor de 0,001) y los coeficientes de correlación indicaron una fuerte asociación. La diferencia entre las secciones de la escala equivalentes en cada instrumento no fue mayor que el 5%, excepto en el equilibrio. Conclusión. La escala de evaluación Fugl Meyer-versión telemática, es una escala viable, útil y fácil de aplicar que permite la evaluación del estado funcional de los pacientes con ictus y que puede responder a las necesidades actuales durante la pandemia de COVID-19.

Videolaryngoscopy vs. direct Macintosh laryngoscopy in tracheal intubation in adults: a ranking systematic review and network meta-analysis.

Videolaryngoscopes are thought to improve glottic view and facilitate tracheal intubation compared with the Macintosh direct laryngoscope. However, we currently do not know which one would be the best choice in most patients undergoing anaesthesia. We designed this systematic review with network meta-analyses to rank the different videolaryngoscopes and the Macintosh direct laryngoscope. We conducted searches in PubMed and a further five databases on 11 January 2021. We included randomised clinical trials with patients aged ≥16 years, comparing different videolaryngoscopes, or videolaryngoscopes with the Macintosh direct laryngoscope for the outcomes: failed intubation; failed first intubation attempt; failed intubation within two attempts; difficult intubation; percentage of glottic opening seen; difficult laryngoscopy; and time needed for intubation. We assessed the quality of evidence according to GRADE recommendations and included 179 studies in the meta-analyses. The C-MAC and C-MAC D-Blade were top ranked for avoiding failed intubation, but we did not find statistically significant differences between any two distinct videolaryngoscopes for this outcome. Further, the C-MAC D-Blade performed significantly better than the C-MAC Macintosh blade for difficult laryngoscopy. We found statistically significant differences between the laryngoscopes for time to intubation, but these differences were not considered clinically relevant. The evidence was judged as of low or very low quality overall. In conclusion, different videolaryngoscopes have differential intubation performance and some may be currently preferred among the available devices. Furthermore, videolaryngoscopes and the Macintosh direct laryngoscope may be considered clinically equivalent for the time taken for tracheal intubation. However, despite the rankings from our analyses, the current available evidence is not sufficient to ensure significant superiority of one device or a small set of them over the others for our intubation-related outcomes.

Predicting lung nodules malignancy.

BACKGROUND: It is critical to developing an accurate method for differentiating between malignant and benign solitary pulmonary nodules. This study aimed was to establish a predicting model of lung nodules malignancy in a real-world setting. METHODS: The authors retrospectively analysed the clinical and computed tomography (CT) data of 121 patients with lung nodules, submitted to percutaneous CT-guided transthoracic biopsy, between 2014 and 2015. Multiple logistic regression was used to screen independent predictors for malignancy and to establish a clinical prediction model to evaluate the probability of malignancy. RESULTS: From a total of 121 patients, 75 (62%) were men and with a mean age of 64.7 years old. Multivariate logistic regression analysis identified six independent predictors of malignancy: age, gender, smoking status, current extra-pulmonary cancer, air bronchogram and nodule size (p<0.05). The area under the curve (AUC) was 0.8573. CONCLUSIONS: The prediction model established in this study can be used to assess the probability of malignancy in the Portuguese population, thereby providing help for the diagnosis of lung nodules and the selection of follow-up interventions.

Colorectal anastomosis during cytoreductive radical surgery in patients with peritoneal surface malignancies. Validation of a new technique (without stoma) to prevent anastomosis leakage in more than 1000 procedures

Objective To describe a novel end-to-end “true” reinforced stapling colorectal anastomosis and to assess surgical outcomes in a large case series of advanced cancer patients undergoing this procedure. Summary background data Anastomotic leakage (AL) remains the main concern following surgery for colorectal cancer. Methods Between September 2006 and May 2018, in the context of the Catalonian Program of Peritoneal Carcinomatosis, 1193 consecutive patients with advanced abdominal and/or pelvic tumors were included in a prospective single-center study. They underwent cytoreductive radical surgery (CRS) in most cases combined with hyperthermic intraperitoneal chemotherapy (HIPEC). Among other surgical procedures, 374 patients underwent rectal resection and colorectal/ileorectal anastomosis, whether alone or associated to other digestive anastomosis. Key aspects of colorectal anastomosis technique were: (1) complete dissection and mobilization of the distal third of the rectum, (2) placement of a stitch that included both ends of the linear stapling of the rectal stump that was knotted on the anvil of the circular stapler, (3) “cleaning” the fatty tissue of the intestinal ends, (4) adjustment of the height of staples to the thickness of the intestinal wall, and (5) a second layer of interrupted nonperforating sutures placed circumferentially to reinforce the stapled anastomoses. A diverting stoma was not performed. Results According to clinical criteria, of the 1193 patients included, 296 cases underwent CRS (group 1) and 897 cases CRS + HIPEC (group 2). In group 1, 332 surgical procedures were performed, with 248 digestive anastomoses, of which 98 (39.5%) were colorectal anastomoses, associated to other digestive anastomosis in 37 cases (AU)

Tandem catalysts for the selective hydrogenation of butadiene with hydrogen generated from the decomposition of formic acid.

We report for the first time the selective hydrogenation of 1,3-butadiene to butene using formic acid as the hydrogen source with 1 wt% Pd/carbon in a continuous flow reactor. The catalytic results show that the selectivity is even higher when formic acid is used compared to gas hydrogen.