Axon development is regulated at genetic and proteomic interfaces between the integrin adhesome and the RPM-1 ubiquitin ligase signaling hub.

Integrin signaling plays important roles in development and disease. An adhesion signaling network called the integrin adhesome has been principally defined using bioinformatics and proteomics. To date, the adhesome has not been studied using integrated proteomic and genetic approaches. Here, proteomic studies in C. elegans identified physical associations between the RPM-1 ubiquitin ligase signaling hub and numerous adhesome components including Talin, Kindlin and beta-integrin. C. elegans RPM-1 is orthologous to human MYCBP2, a prominent player in nervous system development associated with a neurodevelopmental disorder. Using neuron-specific, CRISPR loss-of-function strategies, we show that core adhesome components affect axon development and interact genetically with RPM-1. Mechanistically, Talin opposes RPM-1 in a functional 'tug-of-war' on growth cones that is required for accurate axon termination. Thus, our findings orthogonally validate the adhesome via multi-component genetic and physical interfaces with a key neuronal signaling hub and identify new links between the adhesome and brain disorders.

Exoprotease exploitation and social cheating in a Pseudomonas aeruginosa environmental lysogenic strain with a noncanonical quorum sensing system.

Social cheating is the exploitation of public goods that are costly metabolites, like exoproteases. Exoprotease exploitation in Pseudomonas aeruginosa has been studied in reference strains. Experimental evolution with reference strains during continuous growth in casein has demonstrated that nonexoprotease producers that are lasR mutants are selected while they behave as social cheaters. However, noncanonical quorum-sensing systems exist in P. aeruginosa strains, which are diverse. In this work, the exploitation of exoproteases in the environmental strain ID4365 was evaluated; ID4365 has a nonsense mutation that precludes expression of LasR. ID4365 produces exoproteases under the control of RhlR, and harbors an inducible prophage. As expected, rhlR mutants of ID4365 behave as social cheaters, and exoprotease-deficient individuals accumulate upon continuous growth in casein. Moreover, in all continuous cultures, population collapses occur. However, this also sometimes happens before cheaters dominate. Interestingly, during growth in casein, ID4565's native prophage is induced, suggesting that the metabolic costs imposed by social cheating may increase its induction, promoting population collapses. Accordingly, lysogenization of the PAO1 lasR mutant with this prophage accelerated its collapse. These findings highlight the influence of temperate phages in social cheating.

Fenotipos hipertrigliceridemia e hipertensión-cintura abdominal alterada y su asociación con factores de riesgo cardiovascular en mujeres atendidas en Consulta Provincial de Climaterio

Fundamento: la presencia de fenotipos hipertensión- circunferencia abdominal aumentada se considera un índice pronóstico de deterioro cardiometabólico. Objetivo: determinar la frecuencia de mujeres con fenotipos cintura alterada y establecer la asociación entre estos y los principales factores de riesgo cardiovascular, así como estimar el riesgo cardiovascular global a los 10 años. Métodos estudio descriptivo, correlacional, transversal, que incluyó a 100 mujeres que asistieron a Consulta Provincial de Climaterio, del Hospital Gustavo Aldereguìa, de Cienfuegos, desde marzo 2016 a 2020. Variables analizadas: edad, color de piel, tabaquismo, hipertensión arterial, obesidad, actividad física, diabetes mellitus, índice de masa corporal, circunferencia abdominal, colesterol total, ácido úrico y triglicéridos. Se determinó la razón de prevalencia con un nivel de significación del 95 %. Resultados: la razón de probabilidad demostró mayor riesgo de presentar el fenotipo en mayores de 45 años (1,47), obesas (5,57), hipertensas (3,71) y diabéticas (1,67). Se evidenció asociación significativa entre hábito de fumar y actividad física con razón de probabilidad de 5,80 y 18 respectivamente. Conclusiones: existe una relación significativa entre fenotipos cintura abdominal alterada y los principales factores de riesgo cardiovasculares, como incremento de la edad, riesgo cardiovascular, diabetes mellitus, hipertensión arterial, tabaquismo, inactividad física y obesidad.

Background: the presence of hypertension-increased abdominal circumference phenotypes is considered a cardiometabolic deterioration prognostic index. Objective: to determine the frequency of women with altered waist phenotypes and to establish the association between these and the main cardiovascular risk factors, as well as to estimate the global cardiovascular risk at 10 years. Methods: descriptive, correlational, cross-sectional study, which included 100 women who attended the Provincial Climacteric Consultation, at the Gustavo Aldereguía Lima Cienfuegos Hospital, from March 2016 to 2020. The analyzed variables were: age, skin color, smoking, arterial hypertension, obesity, physical activity, diabetes mellitus, body mass index, abdominal circumference, total cholesterol, uric acid, and triglycerides. The prevalence ratio was determined with a significance level of 95%. Results: the likelihood ratio showed a higher risk of presenting the phenotype in people over 45 years of age (1.47), obese (5.57), hypertensive (3.71) and diabetic (1.67). A significant association was found between smoking and physical activity with a probability ratio of 5.80 and 18, respectively. Conclusions: there is a significant relationship between altered abdominal waist phenotypes and the main cardiovascular risk factors, such as increased age, cardiovascular risk, diabetes mellitus, arterial hypertension, smoking, physical inactivity and obesity.

Identification of Pre-Renal and Intrinsic Acute Kidney Injury by Anamnestic and Biochemical Criteria: Distinct Association with Urinary Injury Biomarkers.

Acute kidney injury (AKI) is a syndrome of sudden renal excretory dysfunction with severe health consequences. AKI etiology influences prognosis, with pre-renal showing a more favorable evolution than intrinsic AKI. Because the international diagnostic criteria (i.e., based on plasma creatinine) provide no etiological distinction, anamnestic and additional biochemical criteria complement AKI diagnosis. Traditional, etiology-defining biochemical parameters, including the fractional excretion of sodium, the urinary-to-plasma creatinine ratio and the renal failure index are individually limited by confounding factors such as diuretics. To minimize distortion, we generated a composite biochemical criterion based on the congruency of at least two of the three biochemical ratios. Patients showing at least two ratios indicative of intrinsic AKI were classified within this category, and those with at least two pre-renal ratios were considered as pre-renal AKI patients. In this study, we demonstrate that the identification of intrinsic AKI by a collection of urinary injury biomarkers reflective of tubular damage, including NGAL and KIM-1, more closely and robustly coincide with the biochemical than with the anamnestic classification. Because there is no gold standard method for the etiological classification of AKI, the mutual reinforcement provided by the biochemical criterion and urinary biomarkers supports an etiological diagnosis based on objective diagnostic parameters.

Benchmarking of stray neutron fields produced by synchrocyclotrons and synchrotrons in compact protontherapy centers (CPTC) using MCNP6 Monte Carlo code.

Proton therapy is an external radiotherapy using proton beams with energies between 70 and 230 MeV to treat some type of tumours with outstanding benefits, due to its energy transfer plot. There is a growing demand of facilities taking up small spaces and Compact Proton Therapy Centers (CPTC), with one or two treatment rooms, supposing the technical response of manufacturers to this request. A large amount of stray radiation is yielded in the interaction of proton beam used in therapy, neutrons mainly, hence, optimal design of shielding and verifications must be carried out in commissioning phases. Currently, almost 50 proton centers are under construction and start up in several countries, including ten in Spain. In the present work the effectiveness of shielding in two CPTC was verified with the Monte Carlo code MCNP6 by calculating the ambient dose equivalent, H*(10) due to secondary neutrons, outside the enclosures and walls of the center. The facilities modelled were the two centers currently operating in Spain, the first, since December 2019, with a superconductor synchrocyclotron, and the second, since March 2020, with a compact synchrotron. The geometry and materials are based on dimensions proposed a priori by the vendors, therefore, the paper is focused on check the suitability of the materials and thickness of the walls of the centers. Several models of the radiation sources were simulated, starting from a conservative assumptions, followed by more realistic scenarios. In all cases, the results reached for the ambient dose equivalent, H*(10), were below 1 mSv/year, which is the legal limit considered for the public in international references. Finally, considering that the recent ICRU Report 95 proposes changes in the operational quantities, the dose outside shieldingt has been evaluated in terms of the new next area surveillance quantity, H*, known as ambient dose, in the process of implementation.

Ferulic acid supplementation for 40 days in hair ewe lambs experiencing seasonal heat stress: short-term effects on physiological responses, growth, metabolism, and hematological profile.

Free ferulic acid (FA) is a natural compound with antioxidant properties which mitigates the negative effects of cold stress in sheep; however, its impact on thermoregulatory responses in heat-stressed sheep has not been defined. The objective was to evaluate the effects of FA supplementation on physiological responses, serum analyte concentrations, and the hematological profile of heat-stressed hair ewe lambs. Twenty-two Dorper × Katahdin ewe lambs (initial body weight = 23.5 ± 2.8 kg and age = 4 months) were housed in individual pens for 40 days and assigned under a randomized complete block design to the following treatments (n = 11): basal diet with 0 (control) or 250 mg of FA/kg of feed. The FA × sampling day interaction only affected serum concentration of some metabolic hormones; particularly on day 20 of the trial, FA increased (P < 0.01) insulins and the insulin to glucose ratio while decreased (P = 0.05) thyroxine. Overall, supplemental FA did not affect rectal temperature, respiratory rate, most body surface temperatures, feedlot performance, and serum concentrations of metabolites, electrolytes, triiodothyronine, and cortisol. In addition, FA only tended to decrease (P ≥ 0.09) erythrocyte count and plaquetocrit and to increase (P = 0.08) mean corpuscular volume. In conclusion, FA supplementation did not improve the growth nor thermoregulatory capacity of heat-stressed hair ewe lambs. Still, it partially modulated the metabolism to reinforce some energetic adaptive mechanisms when the ambient temperature was ≥ 35 °C.

Factores predictores de mortalidad en pacientes con enfermedad coronaria y compromiso del tronco principal izquierdo / Predictors of mortality in patients with coronary artery disease and involvement of the left main artery

Resumen: Introducción: el compromiso del tronco principal izquierdo no protegido (TPInp) en pacientes con enfermedad arterial coronaria (EAC) conlleva alto riesgo de eventos cardiovasculares. La cirugía de revascularización coronaria (CABG) ha sido el estándar de tratamiento; sin embargo, estudios recientes proponen la intervención coronaria percutánea (PCI) como alternativa. Objetivo: evaluar los desenlaces intrahospitalarios y durante el seguimiento del tratamiento de pacientes con compromiso del TPInp. Método: estudio observacional multicéntrico de cohorte retrospectivo, se evaluaron pacientes con EAC y afección del TPI. Muerte de cualquier causa, infarto de miocardio no fatal, accidente cerebrovascular, reintervención y/o readmisión hospitalaria fueron valorados como un desenlace compuesto e individualmente durante la hospitalizacioì n y el tiempo de seguimiento. Resultados: se incluyeron 82 pacientes, con edad promedio 71 ± 9.9 años; 35 recibieron PCI, 31 CABG y 16 manejo meìdico (MM). La mortalidad intrahospitalaria fue del 16%. En el seguimiento medio de 12.3 meses la tasa de mortalidad fue del 20%, la de reinfarto del 6% y la de readmisioìn hospitalaria del 4%. La tasa de incidencia de muerte para MM fue 5.19 por 10.000 personas/diìa, para PCI de 2.3 por 10.000 personas/diìa y para CABG de 1.06 por 10.000 personas/diìa; en el seguimiento la mortalidad fue mayor en el grupo de PCI (HR: 3.6; IC 95% 1.13-11.9; p = 0.02). La frecuencia cardiaca elevada al ingreso se asocioì con mayor mortalidad (0.05). Conclusión: el compromiso del TPI se asocia con alto riesgo de muerte y se presenta con anatomiìa coronaria compleja.

Abstract: Introduction: involvement of the unprotected left main coronary artery (TPInp) in patients with coronary artery disease (CAD) leads to a high risk of cardiovascular events. Coronary artery bypass grafting (CABG) has been the standard of management; however, recent studies propose percutaneous coronary intervention (PCI) as an alternative treatment. Objective: to evaluate the in-hospital and follow-up outcomes of patients with compromised TPInp. Method: retrospective multicenter observational cohort study, we evaluated patients with CAD and TPI involvement. Death from any cause, nonfatal myocardial infarction, stroke, reoperation, and/or hospital readmission were assessed as a composite endpoint and individually during hospitaliza- tion and follow-up time. Results: 82 patients were included, mean age 71 ± 9.9 years; 35 received PCI, 31 CABG, and 16 medical management (MM). In-hospital mortality was 16%. In the mean follow-up of 12.3 months, mortality was 20%, rein- farction 6% and hospital readmission 4%. The incidence rate of death was 5.19 per 10,000 people/day for MM, 2.3 per 10,000 people/day for PCI, and 1.06 per 10,000 people/day for CABG; at follow-up, mortality was higher in the PCI group (HR 3.6; 95%CI 1.13-11.9; p = 0.02). Elevated heart rate on admission was associated with higher mortality (p < 0.05). Conclusion: TPInp involvement is associated with a high risk of death and presents with complex coronary anatomy.

Aplicación de la técnica manual craneosacral en mujeres que laboran en la Educación Superior / Application of the craniosacral manual technique in women working in Higher Education / Aplicação da técnica manual craniossacral em mulheres que trabalham no Ensino Superior

En la actualidad la mayoría de las personas por lo menos una vez en el año presenta una molestia en la estructura del cuello, considerado como cervicalgia o dolor cervical, el mismo que está ocasionando un impacto considerable en la vida de las personas dentro del ámbito familiar, laboral y en la comunidad, provocando efectos negativos en la calidad de vida y en casos severos puede llegar a ocasionar discapacidad y limitación funcional de los movimientos. Por lo que este estudio presentó como objetivo determinar la efectividad de la aplicación de la técnica manual craneosacral en mujeres que laboran en la Universidad Católica de Santiago de Guayaquil. La metodología que se utilizó fue un enfoque cuantitativo- descriptivo con un diseño experimental del tipo pre experimental, con un corte longitudinal, se utilizó como muestra a 31 mujeres que laboran en diversas áreas de la Universidad Católica Santiago de Guayaquil, a su vez, se utilizó como técnica la encuesta, y el instrumento aplicado para la valoración del dolor cervical fue la escala visual analógica del dolor (EVA). Los resultados de esta técnica respecto a la escala visual analógica (EVA) mediante una valoración inicial y final, reflejaron mejoría en el dolor cervical donde el 68% de las pacientes no presentaron dolor, y el 32% reflejan un dolor leve. Se concluyó, que por medio de la técnica manual craneosacral el dolor disminuyo en un gran porcentaje restableciendo los procesos naturales del equilibrio del cuerpo a través de la terapia manual.

Currently, most people at least once a year have a discomfort in the structure of the neck, considered cervicalgia or cervical pain, which is causing a considerable impact on the lives of people within the family, work and in the community, causing negative effects on the quality of life and in severe cases can lead to disability and functional limitation of movements. Therefore, this study presented the objective of determining the effectiveness of the application of the craniosacral manual technique in women who work at the Catholic University of Santiago de Guayaquil. The methodology used was a quantitative-descriptive approach with an experimental design of the pre-experimental type, with a longitudinal cut, 31 women who work in various areas of the Santiago de Guayaquil Catholic University were used as a sample, in turn, used the survey as a technique, and the instrument applied for the assessment of neck pain was the visual analogue pain scale (VAS). The results of this technique with respect to the visual analog scale (VAS) through an initial and final evaluation, reflected improvement in cervical pain where 68% of the patients did not present pain, and 32% reflected mild pain. It was concluded that through the craniosacral manual technique, the pain decreased by a large percentage, restoring the natural processes of the body's balance through manual therapy.

Atualmente, a maioria das pessoas pelo menos uma vez ao ano apresenta um desconforto na estrutura do pescoço, considerado cervicalgia ou dor cervical, que está causando um impacto considerável na vida das pessoas dentro da família, no trabalho e na comunidade, causando efeitos negativos na qualidade de vida e em casos graves pode levar à incapacidade e limitação funcional dos movimentos. Portanto, este estudo apresentou o objetivo de determinar a eficácia da aplicação da técnica manual craniossacral em mulheres que trabalham na Universidade Católica de Santiago de Guayaquil. A metodologia utilizada foi uma abordagem quantitativo-descritiva com um desenho experimental do tipo pré-experimental, com corte longitudinal, 31 mulheres que trabalham em várias áreas da Universidade Católica de Santiago de Guayaquil foram usadas como amostra, por sua vez, utilizaram a pesquisa como técnica, e o instrumento aplicado para avaliação da cervicalgia foi a escala visual analógica de dor (EVA). Os resultados desta técnica com relação à escala visual analógica (EVA) através de uma avaliação inicial e final, refletiram melhora da dor cervical onde 68% dos pacientes não apresentavam dor, e 32% refletiam dor leve. Concluiu-se que através da técnica manual craniossacral, a dor diminuiu em grande porcentagem, restabelecendo os processos naturais de equilíbrio do corpo através da terapia manual.

The role of pre-treatment paraaortic surgical staging for cervical cancer in the EMBRACE criteria.

Background: The State-of-the-Art Treatment for Locally Advanced Cervical Cancer (LACC) is Definite Radio-Chemotherapy based on the Image-guided intensity modulated External beam radiochemotherapy and MRI-based adaptive BRAchytherapy (EMBRACE) trial, according to the FIGO staging. This staging is based on clinical examination and imaging studies; however, there are limitations of imaging techniques which may result in adverse events or death due to insufficient or overtreatment. The aim of the study was to evaluate the feasibility and outcomes of surgical staging in LACC prior to radiotherapy (RT) to personalise target volumes for radiotherapy. Methods: From 2008 to 2018, 138 patients with FIGO 2018 stages IB3-IIIC2 cervical cancer underwent a pretherapeutic laparoscopic staging procedure. The pathological diagnosis was compared with the results of preoperative CT scan. Patients were treated with chemoradiotherapy tailored according to the staging results. Results: The mean patient age was 43 years, the mean body mass index was 27 kg/m2; most lesions were squamous cervical cancer (92%). Staging CT scan had a 77% concordance with the histological findings. Sensitivity was 29%, specificity 85%, positive predictive value 21% and negative predictive value 89%. Surgical staging led to change of stage in 24% of cases. Para -aortic dissection led to change the initially planned radiotherapy fields in 47% of the cases. Major complications included involuntary section of the inferior mesenteric artery (IMA) without clinical repercussion, an infected retroperitoneal haematoma and a symptomatic lymphocele requiring laparoscopic drainage. Conclusion: Laparoscopic staging before primary chemoradiation in patients with LACC was feasible, safe and reproducible, allowing reduction of the radiotherapy treatment volumes of patients.

Hospitalización por Intento de Suicidio en Adolescentes: Mirada retrospectiva de la experiencia y los cambios asociados / Hospitalization for Attempted Suicide in Adolescents: Retrospective look at the experience and associated changes

Resumen: Antecedentes: El principal factor de riesgo para suicidio consumado es el Intento Suicida (IS) previo. La hospitalización psiquiátrica es un recurso terapéutico utilizado en adolescentes para proteger su integridad. Objetivo: Describir y comprender la experiencia de hospitalización psiquiátrica por intento de suicidio y los cambios asociados a ésta, desde la perspectiva de lo/as adolescentes implicados. Método: Estudio cualitativo descriptivo que entrevista a 10 adolescentes que fueron hospitalizados por IS en un centro psiquiátrico. Las entrevistas semiestructuradas fueron codificadas según los criterios de codificación abierta y axial de la Teoría Fundamentada. Resultados: Se presentan dos categorías descriptivas: a) Hospitalización: "lo peor que me ha pasado en la vida… pero tuvo cosas buenas", y b) "Una vez afuera, pienso que me sirvió para cambiar". Luego, se presenta un esquema relacional que articula ambos fenómenos, "de la conmoción a la contención reflexiva". Conclusiones: La experiencia de hospitalización psiquiátrica por IS constituye una experiencia de alto impacto existencial, que brinda posibilidades de movilizar cambios personales y familiares. Sólo post-hospitalización lo/as adolescentes visualizan y desarrollan estos cambios, adhiriendo a los tratamientos indicados y apoyo familiar. Sin embargo, la indicación y gestión de este recurso terapéutico debe ponderarse, para evitar riesgos asociados.

Abstract: Background: Previous suicide attempt (SA) is the main risk factor for completed suicide. Psychiatric hospitalization is a therapeutic resource used in adolescents to protect their integrity. Aim: To describe and understand the experience of psychiatric hospitalization due to SA and the changes associated with it, from the perspective of adolescents involved. Method: Descriptive qualitative study that interviews 10 adolescents who were hospitalized for SA in a psychiatric center. Semi-structured interviews were coded according to Grounded Theory's open and axial coding criteria. Results: Two descriptive categories are presented: a) Hospitalization: "the worst thing that has happened to me in my life… but it had something positive", and b) "Once outside, I think it helped me to change". Then, a relational scheme that articulates both phenomena is presented, "from shock to reflective containment". Conclusions: The experience of psychiatric hospitalization for SA constitutes an experience with a high existential impact, which offers possibilities to mobilize personal and family changes. Only after hospitalization adolescents visualize and develop these changes, adhering to the indicated treatments and family support. However, the indication and management of this therapeutic resource must be considered, to avoid associated risks.

Nesidioblastosis del adulto. Informe de un caso / Adult's Nesidioblastosis. Case report

Resumen La nesidioblastosis del adulto es rara. Se define como cambios en el páncreas endocrino caracterizado por la proliferación anormal de las células de los islotes pancreáticos, que afecta en forma difusa a la glándula, y que causa hipoglucemia hiperinsulinémica persistente en ausencia de un insulinoma. Se presenta el caso de un paciente que ingresa en el servicio de medicina interna del Hospital "Dr. Gustavo Aldereguía Lima" de Cienfuegos con un síndrome hipoglucémico para estudio. Se le realizó prueba de tolerancia a la glucosa oral de 6 h con hipoglucemia (1.9mmol/L) a la hora 5. Prueba de ayuno de 72h: con hipoglucemia a las 2 h con respuesta paradójica de la insulina, glicemia e insulinemia con los síntomas. En la tomografía axial computarizada abdominal multicorte no se evidenció lesión en el páncreas. Se realiza pancreatectomía distal de ± 85% de la glándula con conservación esplénica. La anatomía patología confirmó nesidioblastosis. La nesidioblastosis del adulto es una entidad muy poco frecuente, pero debe ser tenida en cuenta como diagnóstico diferencial de los insulinomas ante la ausencia de lesión evidente en los estudios convencionales de imágenes.

ABSTRACT Adult nesidioblastosis is rare, defined as changes in the endocrine pancreas characterized by abnormal proliferation of pancreatic islet cells, diffusely affecting the gland, and causing persistent hyperinsulinemic hypoglycemia in the absence of an insulinoma. A case of a patient who is admitted to the internal medicine service at the "Dr. Gustavo Aldereguía Lima" Cienfuegos Hospital with a hypoglycemic syndrome for study. A 6-hour oral glucose tolerance test was performed with hypoglycemia (1.9mmol / L) at hour 5. 72-hour fasting test: with hypoglycemia at 2 hours with a paradoxical response to insulin, Glycemia and Insulinemia with the symptom. In the multislice abdominal computerized axial tomography, no lesion in the pancreas was evidenced. A distal pancreatectomy of ± 85% of the gland is performed with splenic preservation. The pathology anatomy confirmed nesidioblastosis. Nesidioblastosis in adults is a very rare entity, but it should be taken into account as a differential diagnosis of insulinomas in the absence of an evident lesion in conventional imaging studies.

[Videourodynamics: Current indications, technique and considerations.] / Videourodinamia: indicaciones actuales, técnicas y consideraciones.

OBJECTIVES: Describe the technique, indications and the correct interpretation given the findings in different clinical entities, and to serve as a guide for urologists, urology residents and even medical students. MATERIAL AND METHODS: A literature search was performed using Pubmed, Cochrane and Scopus database for articles and guidelines published between January 1970 and June 2020. RESULTS: Videourodynamics is a diagnostic procedure that combines the urodynamic study with simultaneous images of the lower urinary tract to assess the anatomy and function during the different phases of micturition.This study provides important information that can modify therapeutic behavior and therefore clinical outcomes of patients. CONCLUSION: The role of videourodynamics becomes more relevant nowadays in the assessment of the pathophysiology of voiding dysfunction, being the gold standard for the workup of neurogenic bladder and voiding dysfunction in young people and women and, possibly in persistent/recurrent incontinence in both men and women.

OBJETIVO: Describir la técnica, las indicaciones y la correcta interpretación dados los hallazgos en diferentes entidades clínicas, y servir como guía para urólogos, residentes de urología e incluso estudiantes de medicina.MATERIAL Y MÉTODO: Se realizó una revisión bibliográfica internacional de artículos o guías en las bases de datos PubMed, Cochrane y Scopus entre enero de 1970 y junio de 2020. RESULTADOS: La videourodinamia es un procedimiento diagnóstico que integra el estudio urodinámico con imágenes simultáneas del tracto urinario inferior para evaluar la anatomía y la función durante las diferentes fases de micción. Este estudio aporta información relevante que puede modificar la conducta terapéutica y por ende los desenlaces clínicos de los pacientes.CONCLUSIÓN: El papel de la videourodinamia cada vez toma más relevancia en la evaluación de la fisiopatología de la disfunción miccional, siendo incluso el patrón de oro para el estudio de disfunción vesical neurogénica y trastornos del vaciado en jóvenes y mujeres y, posiblemente la incontinencia recidivada tanto en hombres como en mujeres.

Videourodinamia: indicaciones actuales, técnicas y consideraciones / Videourodynamics: current indications, techniques and considerations

Objetivo: Describir la técnica, las indicaciones y la correcta interpretación dados los hallazgosen diferentes entidades clínicas, y servir como guía paraurólogos, residentes de urología e incluso estudiantesde medicina.Material y métodos: Se realizó una revisión bibliográfica internacional de artículos o guías en las basesde datos PubMed, Cochrane y Scopus entre enero de1970 y junio de 2020.Resultados: La videourodinamia es un procedimiento diagnóstico que integra el estudio urodinámico conimágenes simultáneas del tracto urinario inferior para evaluar la anatomía y la función durante las diferentesfases de micción. Este estudio aporta información relevante que puede modificar la conducta terapéutica ypor ende los desenlaces clínicos de los pacientes.Conclusion: El papel de la videourodinamia cadavez toma más relevancia en la evaluación de la fisiopatología de la disfunción miccional, siendo incluso elpatrón de oro para el estudio de disfunción vesical neurogénica y trastornos del vaciado en jóvenes y mujeresy, posiblemente la incontinencia recidivada tanto enhombres como en mujeres.(AU)

Objetives: Describe the technique, in-dications and the correct interpretation given the findingsin different clinical entities, and to serve as a guide forurologists, urology residents and even medical students.Material and methods: A literature search was per-formed using Pubmed, Cochrane and Scopus databasefor articles and guidelines published between January1970 and June 2020.Results: Videourodynamics is a diagnostic procedurethat combines the urodynamic study with simultaneousimages of the lower urinary tract to assess the anatomyand function during the different phases of micturition. This study provides important information that can mod-ify therapeutic behavior and therefore clinical outcomesof patients.Conclusion: The role of videourodynamics be-comes more relevant nowadays in the assessment ofthe pathophysiology of voiding dysfunction, being thegold standard for the workup of neurogenic bladder andvoiding dysfunction in young people and women and,possibly in persistent/recurrent incontinence in both menand women:(AU)

Multifocal skeletal tuberculosis with mycobacteremia after kidney transplantation: A case report.

Solid organ transplant recipients have a higher risk of active Mycobacterium tuberculosis infection (TB) compared to the general population. Recognized risk factors are immunosuppressant use, graft dysfunction, diabetes mellitus, liver disease caused by the hepatitis C virus, and co-infections by other opportunists. Most of the active TB cases reported in solid organ transplant recipients occur in kidney transplant patients, especially if they come from M tuberculosis-endemic areas. Extrapulmonary and disseminated TB are among the wide spectrum of clinical presentations found, but the lungs are the most common organ affected. Disseminated disease occurs in up to a third of the affected population, however, multifocal osteoarticular TB with mycobacteremia is unusual. We report the case of a kidney transplant patient with disseminated M tuberculosis infection, who presented with multifocal skeletal TB.

Neutron dosimetry and shielding verification in commissioning of Compact Proton Therapy Centers (CPTC) using MCNP6.2 Monte Carlo code.

Proton therapy (PT) is an external radiotherapy using proton beams with energies between 70 and 230 MeV to treat some type of tumours with outstanding benefits, due to its energy transfer plot. There is a growing demand of facilities taking up small spaces and Compact Proton Therapy Centers (CPTC), with one or two treatment rooms, supposing the technical response of manufacturers to this request. A large amount of stray radiation is produced in the interaction of protons used in therapy, neutrons mainly, hence, optimal design of shielding and verifications must be carried out in commissioning stages. Currently, almost 50 CPTC are under construction and start up in many countries, including several in Spain. In the present work, the effectiveness of shielding in a CPTC was verified with the Monte Carlo code MCNP6 by calculating the ambient dose equivalent, H*(10) due to secondary neutrons, outside the enclosures and walls of the center. The facility modelled was similar to one planned to start operating in 2019 in Spain, a CPTC, made up of a superconducting synchrocyclotron and one treatment room, with a configuration standard, shielding and width of barriers based on dimensions proposed a priori by the vendor. Therefore, the paper is focused in check the suitability of the materials and thickness of the walls of the center and develop the assessment of enclosures. Several models of the radiation sources and type of concrete in walls were simulated, starting from a conservative assumptions, followed by more realistic models. In all cases, the results were below 1 mSv/year, which is the international legal limit considered for the general public. This work is part of the project Contributions to Shielding and Dosimetry of Neutrons in Compact Proton Therapy Centers (CPTC).

Free ferulic acid supplementation of heat-stressed hair ewe lambs: Oxidative status, feedlot performance, carcass traits and meat quality.

Twenty-two Katahdin × Dorper ewe lambs (average weight = 23.5 ± 2.8 kg) were individually housed during a 40-d feeding study and then slaughtered to evaluate effects of free ferulic acid (FA; 0 and 250 mg/kg of feed) on oxidative status, feedlot growth, carcass and non-carcass traits, wholesale cut yields and meat quality under heat stress conditions. Overall feeding FA decreased protein oxidation without affecting oxidative stress index, while growth rate and feed efficiency increased only in the hottest period (i.e., 28 to 45 °C). The FA supplementation increased kidney-pelvic-heart and mesenteric fat deposition, as well as yields of forequarter, shoulder, ribs, loin, and breast and flank, but decreased yields of hindquarter, neck, plain loin and leg. Carcass characteristics and meat quality were unaffected by FA. Overall, FA supplementation of heat-stressed hair ewe lambs enhanced feedlot performance under extreme heat stress and increased internal fat reserves, while changing muscle mass deposition, possibly because it prevented protein oxidation.

Experimental characterization of FANT, a new thermal neutron source.

FANT is the acronym of Enhanced Thermal Neutron Source (Fuente Ampliada de Neutrones Térmicos, in Spanish). This is a parallelepiped box of high-density polyethylene moderator and an isotopic neutron source. The moderator has a cylindrical irradiation chamber where a rather uniform thermal neutron flux is obtained. The FANT design was previously optimized and the neutron spectra were estimated by Monte Carlo calculations with the MCNP6.1 code. To check the characteristics of the FANT thermal neutron field, measurements have been performed at the reference point inside the irradiation chamber with a Bonner sphere spectrometer holding a small 6LiI(Eu) thermal neutron detector. To unfold the neutron spectrum BUNKIUT with UTA4 response matrix and NSDann Ver 4.0 codes were used. Some issues have been found and recommendations are made about the use of large BSS inside narrow spaces, and about the capacity of NSDann code to unfold these kind of spectra. However, the results confirm that the moderation process in FANT is very effective and allows obtaining useful thermal neutron fluence rates.

Removal of As3+, As5+, Sb3+, and Hg2+ ions from aqueous solutions by pure and co-precipitated akaganeite nanoparticles: adsorption kinetics studies.

Adsorption kinetics models have been used to evaluate the adsorption behaviour of pollutants on different materials but there are no reports for the adsorption of As5+, As3+, Sb3+ and Hg2+ on co-precipitated akaganeite nanoparticles which were previously formed in the presence of these ions. In this research, the performance of pure and co-precipitated akaganeite nanoparticles as adsorbents of As3+, As5+, Sb3+ and Hg2+ in aqueous solutions was evaluated using the nonlinear kinetics models of Langmuir, Lagergren, Ho-McKay, Bangham, Elovich and simplified Elovich. In addition, transmission 57Fe Mössbauer spectrometry was used for the first time to compare the physico-chemical properties of akaganeite before and after the adsorption processes. The results showed that co-precipitated akaganeites had much better adsorption capacities than pure akaganeites. On the other hand, the Sb3+ and Hg2+ were the fastest and slowest pollutants respectively adsorbed on all akaganeites. The kinetics models that best described the experimental data for As3+, As5+ and Sb3+ were those of Elovich and simplified Elovich. For Hg2+, the kinetic model that best described the experimental data was that of Bangham. The 300 K and 77 K Mössbauer spectrometry showed only slight variations in some of the hyperfine parameters for the akaganeites after adsorption.

Revisión del impacto del estigma en la salud mental de jóvenes lesbianas, homosexuales, bisexuales y transgénero / Review of the impact of stigma on the mental health of lesbian, gay, bisexual and transgender youth

OBJETIVOS: Revisar la literatura existente respecto del impacto que genera el estigma en la salud mental de los jóvenes lesbianas, gays, bisexuales y transgénero (LGBT). MÉTODOS: Búsqueda bibliográfica en la base de datos Pubmed de los artículos atingentes al tema de los últimos 5 años en población juvenil, complementado con artículos de importancia histórica y algunos pertenecientes a las referencias de los resultados de la búsqueda. RESULTADOS: La evidencia demuestra que los jóvenes LGBT expuestos a estigma tienen una mayor prevalencia de trastornos depresivos, ansiosos, trastornos por uso de sustancias y suicidalidad que la población general. Este fenómeno no corresponde a una característica intrínseca de esta población, sino más bien, responde a factores tanto individuales como interpersonales que se dan en un contexto sociocultural predominante en donde las minorías son estigmatizadas. CONCLUSIONES: Los equipos sanitarios deben orientar sus esfuerzos a la promoción, prevención y pesquisa de patologías de salud mental en los jóvenes LGBT y deben constituirse como agentes activos en la lucha contra la desestigmatización en sus comunidades.

OBJECTIVES: To review the existing literature regarding the impact of stigma on the mental health of sexual minorities such as lesbian, gay, bisexual and transgender (LGBT) youth. METHODS: Bibliographic search in the Pubmed database of the articles relevant to the topic of the last 5 years in the youth population, supplemented with articles of historical importance and some belonging to the references of the search results. RESULTS: Evidence shows that LGBT youth exposed to stigma have a higher prevalence of depression, anxiety, substance use disorders and suicidality than the general population. This phenomenon does not correspond to an intrinsic characteristic of this population, but rather, responds to both individual and interpersonal factors that occur in a predominant sociocultural context where minorities are stigmatized. CONCLUSIONS: The health teams should direct their efforts to the promotion, prevention and detection of mental health pathologies in LGBT youth and should become active agents in the fight against destigmatization in their communities.

Monte Carlo characterization and benchmarking of extended range REM meters for its application in shielding and radiation area monitoring in Compact Proton Therapy Centers (CPTC).

Compact Proton Therapy Centers, CPTC, have a single treatment room, and are technologically more affordable, smaller, advanced and easier to use. From a radiological protection point of view, the leading concern in CPTC are interactions of protons with components of the facility and patients that yield a broad emission of secondary particles, mainly high-energy neutrons, up to 230 MeV, and photons. Optimal design of shielding involves theoretical assumptions in the design phase and, consequently, experimental measurements with extended range neutron detectors must be carried out in the facility during the commissioning period to verify the design, assumptions and building of the enclosures. There are almost 50 CPTC under construction and planning around the world, hence the improvement of methodologies to verify the shielding and to evaluate the dose to workers and general public in CPTC is a trending issue. The aim of this work was to evaluate and compare the response of two commercial extended range REM meters, WENDI-II and LUPIN-II, for their application in shielding verification and radiation area monitoring in CPTC facilities, by estimating the ambient dose equivalent, H*(10), through the Monte Carlo code MCNP6. The results have been compared with previous works. Likewise, the performance evaluation of these devices in continuous energy neutron field have been carried out, using the AmBe/241 neutron source of the Neutronics Hall (NH) of the Neutron Measurements Laboratory of the Energy Engineering Department of Universidad Politecnica de Madrid (LMN-UPM), through Monte Carlo simulation with the MCNP6 code and experimental measurements. The work is framed into the project Contributions to Shielding and Dosimetry of Neutrons in CPTC.