Clinical practice guideline on the management of vestibular schwannoma.

INTRODUCTION: Vestibular schwannoma (VS) is the most common tumour of the cerebellopontine angle. The greater accessibility to radiological tests has increased its diagnosis. Taking into account the characteristics of the tumour, the symptoms and the age of the patient, three therapeutic strategies have been proposed: observation, surgery or radiotherapy. Choosing the most appropriate for each patient is a frequent source of controversy. MATERIAL AND METHODS: This paper includes an exhaustive literature review of issues related to VS that can serve as a clinical guide in the management of patients with these lesions. The presentation has been oriented in the form of questions that the clinician usually asks himself and the answers have been written and/or reviewed by a panel of national and international experts consulted by the Otology Commission of the SEORL-CCC. RESULTS: A list has been compiled containing the 13 most controversial thematic blocks on the management of VS in the form of 50 questions, and answers to all of them have been sought through a systematic literature review (articles published on PubMed and Cochrane Library between 1992 and 2023 related to each thematic area). Thirty-three experts, led by the Otology Committee of SEORL-CCC, have analyzed and discussed all the answers. In Annex 1, 14 additional questions divided into 4 thematic areas can be found. CONCLUSIONS: This clinical practice guideline on the management of VS offers agreed answers to the most common questions that are asked about this tumour. The absence of sufficient prospective studies means that the levels of evidence on the subject are generally medium or low. This fact increases the interest of this type of clinical practice guidelines prepared by experts.

Polycladomyces zharkentensis sp. nov., a novel thermophilic cellulose- and starch-degrading member of the Bacillota from a geothermal aquifer in Kazakhstan.

A thermophilic, aerobic and heterotrophic filamentous bacterium, designated strain ZKZ2T, was isolated from a pipeline producing hydrothermal water originating from a >2.3 km deep subsurface geothermal source in Zharkent, Almaty region, Kazakhstan. The isolate was Gram-stain-positive, non-motile, heat-resistant and capable of producing a variety of extracellular hydrolases. Growth occurred at temperatures between 55 and 75 °C, with an optimum around 70 °C, and at pH values between 5.5 and 9.0, with an optimum at pH 7.0-7.5 with the formation of aerial mycelia; endospores were produced along the aerial mycelium. The isolate was able to utilize the following substrates for growth: glycerol, l-arabinose, ribose, d-xylose, d-glucose, d-fructose, d-mannose, rhamnose, d-mannitol, methyl-d-glucopyranoside, aesculin, salicin, cellobiose, maltose, melibiose, sucrose, trehalose, melezitose, raffinose, starch, turanose and 5-keto-gluconate. Furthermore, it was able to hydrolyse carboxymethylcellulose, starch, skimmed milk, Tween 60 and Tween 80. The major cellular fatty acids were iso-C15 : 0, iso-C17 : 0, iso-C16 : 0 and C16 : 0. Our 16S rRNA gene sequence analysis placed ZKZ2T within the genus Polycladomyces, family Thermoactinomycetaceae, with the highest similarity to the type species Polycladomyces abyssicola JIR-001T (99.18 % sequence identity). Our draft genome sequence analysis revealed a genome size of 3.3 Mbp with a G+C value of 52.5 mol%. The orthologous average nucleotide identity value as compared to that of its closest relative, P. abyssicola JIR-001T, was 90.23 %, with an in silico DNA-DNA hybridization value of 40.7 %, indicating that ZKZ2T represents a separate genome species. Based on the phenotypic and genome sequence differences from the other two Polycladomyces species, we propose that strain ZKZ2T represents a novel species, for which we propose the name Polycladomyces zharkentensis sp. nov. The type strain is ZKZ2T (=CECT 30708T=KCTC 43421T).

Truncal Plane Blocks for Implantation of Cardiac Resynchronization Devices: A Systematic Review.

Patients undergoing subcutaneous implantable cardioverter-defibrillator (S-ICD) placement can experience significant perioperative pain. General anesthesia is traditionally used for S-ICD placement and is associated with increased risk. Truncal plane blocks (TPBs) and sedation offer an alternative for adequate analgesia while avoiding hemodynamic compromise related to general anesthesia. A comprehensive evidence search utilized PubMed, CINAHL, Google Scholar, EBSCOhost, US National Library of Medicine Clinical Trials, and Medline Complete databases and the evidence examined the efficacy of TPBs in S-ICD placement. The quality of evidence was assessed using the guidelines described in the Johns Hopkins Nursing Evidence-Based Practice Model. Three randomized-controlled trials, four nonrandomized experimental studies, two nonexperimental studies, and three case studies totaling 379 patients were reviewed. Ultrasound-guided TPBs with sedation demonstrated superior analgesic efficacy for S-ICD procedures. Hemodynamics marginally deviated from baseline values and were well tolerated by patients. The evidence suggests that TPBs provide adequate analgesia during intraoperative and postoperative periods. TPBs are effective in reducing pain scores and opioid consumption postoperatively. Although there were no significant changes in hemodynamic values, more research should be conducted to evaluate the effects on intraoperative hemodynamics.

Sphagnum mosses, the impact of disturbances and anthropogenic management actions on their ecological role in CO2 fluxes generated in peatland ecosystems.

Mosses of the genus Sphagnum are the dominant vegetation in most pristine peatlands in temperate and high-latitude regions. They play a crucial role in carbon sequestration, being responsible for ca. 50% of carbon accumulation through their active participation in peat formation. They have a significant influence on the dynamics of CO2 emissions due to an efficient maximum potential photosynthetic rate, lower respiration rates, and the production of a recalcitrant litter whose decomposition is gradual. However, various anthropogenic disturbances and land use management actions that favor its reestablishment have the potential to modify the dynamics of these CO2 emissions. Therefore, the objective of this review is to discuss the role of Sphagnum in CO2 emissions generated in peatland ecosystems, and to understand the impacts of anthropogenic practices favorable and detrimental to Sphagnum on these emissions. Based on our review, increased Sphagnum cover reduces CO2 emissions and fosters C sequestration, but drainage transforms peatlands dominated by Sphagnum into a persistent source of CO2 due to lower gross primary productivity of the moss and increased respiration rates. Sites with moss removal used as donor material for peatland restoration emit twice as much CO2 as adjacent undisturbed natural sites, and those with commercial Sphagnum extraction generate almost neutral CO2 emissions, yet both can recover their sink status in the short term. The reintroduction of fragments and natural recolonization of Sphagnum in transitional peatlands, can reduce emissions, recover, or increase the CO2 sink function in the short and medium term. Furthermore, Sphagnum paludiculture is seen as a sustainable alternative for the use of transitional peatlands, allowing moss production strips to become CO2 sink, however, it is necessary to quantify the emissions of all the components of the field of production (ditches, causeway), and the biomass harvested from the moss to establish a final closing balance of C.

Sustainable Process for Tortilla Production Using Ohmic Heating with Minimal Impact on the Nutritional Value, Protein, and Calcium Performance.

The nixtamalization process used for tortilla production entails extended processing time and generates pollutant effluents. Ohmic heating (OH) is an emerging technology that uses an alternating electric current for rapid and uniform food heating and mitigates effluent concerns. However, gaps exist in nutrient bioavailability studies. In this work, we assessed OH's impact on tortilla nutritional value, protein, and calcium using a rat model. Twenty-five male Wistar rats were fed one of four diets for 21 days: raw corn (RC) as an experimental control, OH-processed tortillas (OHTs), traditionally processed tortillas (TPTs), commercial tortillas (CTs), and a casein diet (CD) as a growth control. Despite similar protein and macronutrient profiles, OH significantly enhanced insoluble fiber content. The weight gain sequence was OHTs > TPTs > CTs > RC. OHTs exhibited superior protein digestibility (88.52%), which was 3% higher than other diets. The serum albumin (2.63-2.73 g/dL) indicated moderate malnutrition due to the tortilla's lower protein content. Nonetheless, the protein efficiency ratio (1.2-1.74) showed no significant difference from TPTs. Bone characteristics and fracture strength resembled the tortilla-fed groups, surpassing RC. X-ray diffraction and scanning electron microscopy confirmed that the OHT and TPT diets improved male rat bone thickness and crystallinity. The findings suggest the potential for OH as an eco-friendly tortilla production method, maintaining nutritional value comparable to traditional methods.

Mechano-electrical interactions and heterogeneities in wild-type and drug-induced long QT syndrome rabbits.

Electromechanical reciprocity - comprising electro-mechanical (EMC) and mechano-electric coupling (MEC) - provides cardiac adaptation to changing physiological demands. Understanding electromechanical reciprocity and its impact on function and heterogeneity in pathological conditions - such as (drug-induced) acquired long QT syndrome (aLQTS) - might lead to novel insights in arrhythmogenesis. Our aim is to investigate how electrical changes impact on mechanical function (EMC) and vice versa (MEC) under physiological conditions and in aLQTS. To measure regional differences in EMC and MEC in vivo, we used tissue phase mapping cardiac MRI and a 24-lead ECG vest in healthy (control) and IKr -blocker E-4031-induced aLQTS rabbit hearts. MEC was studied in vivo by acutely increasing cardiac preload, and ex vivo by using voltage optical mapping (OM) in beating hearts at different preloads. In aLQTS, electrical repolarization (heart rate corrected RT-interval, RTn370) was prolonged compared to control (P < 0.0001) with increased spatial and temporal RT heterogeneity (P < 0.01). Changing electrical function (in aLQTS) resulted in significantly reduced diastolic mechanical function and prolonged contraction duration (EMC), causing increased apico-basal mechanical heterogeneity. Increased preload acutely prolonged RTn370 in both control and aLQTS hearts (MEC). This effect was more pronounced in aLQTS (P < 0.0001). Additionally, regional RT-dispersion increased in aLQTS. Motion-correction allowed us to determine APD-prolongation in beating aLQTS hearts, but limited motion correction accuracy upon preload-changes prevented a clear analysis of MEC ex vivo. Mechano-induced RT-prolongation and increased heterogeneity were more pronounced in aLQTS than in healthy hearts. Acute MEC effects may play an additional role in LQT-related arrhythmogenesis, warranting further mechanistic investigations. KEY POINTS: Electromechanical reciprocity comprising excitation-contraction coupling (EMC) and mechano-electric feedback loops (MEC) is essential for physiological cardiac function. Alterations in electrical and/or mechanical heterogeneity are known to have potentially pro-arrhythmic effects. In this study, we aimed to investigate how electrical changes impact on the mechanical function (EMC) and vice versa (MEC) both under physiological conditions (control) and in acquired long QT syndrome (aLQTS). We show that changing the electrical function (in aLQTS) results in significantly altered mechanical heterogeneity via EMC and, vice versa, that increasing the preload acutely prolongs repolarization duration and increases electrical heterogeneity, particularly in aLQTS as compared to control. Our results substantiate the hypothesis that LQTS is an ?electro-mechanical', rather than a 'purely electrical', disease and suggest that acute MEC effects may play an additional role in LQT-related arrhythmogenesis.

Beamforming Techniques for Passive Radar: An Overview.

Passive radar is an interesting approach in the context of non-cooperative target detection. Because the signal source takes advantage of the so-called illuminator of opportunity (IoO), the deployed system is silent, allowing the operator cheap, portable, and practically undetectable deployments. These systems match perfectly with the use of antenna arrays to take advantage of the additional gains provided by the coherent combination of the signals received at each element. To obtain these benefits, linear processing methods are required to enhance the system's performance. In this work, we summarize the main beamforming methods in the literature to provide a clear picture of the current state of the art. Next, we perform an analysis of the benefits and drawbacks and explore the chance of increasing the number of antenna elements. Finally, we identify the major challenges to be addressed by researchers in the future.

Effect of adding high concentrations of retrograded starch with different amylose content on the physicochemical properties and sensory attributes of Greek-style yogurt.

It is well known that using retrograded starches confers many technological advantages, as well as health benefits when consumed in adequate doses; however, these properties are closely related to the type of starch and/or the treatment applied, therefore, it is of interest to add retrograded starch to popular products such as Greek yogurt. The aim of this work was to investigate the effect of adding two types of retrograded corn starch with different amylose content to a non-strained type of Greek-style yogurt. Retrograded starch from starch containing 27 % (RNS) or 70 % (RHS) amylose was added to yogurt at 0, 10, 12.5, or 15 g/100 g before storage at 4 °C for 14 d. The resistant starch (RS) content, pH, syneresis, flow behavior index, and consistency index, were measured every week. A sensory test was carried out in yogurt added with 12.5 g/100 g of retrograded starches to evaluate acceptance. Adding retrograded starch significantly reduced syneresis while increased the consistency, firmness, and resistant starch content of the yogurt. No significant differences in general acceptance were observed in samples added with RNS when compared to the control. Although a significant difference was observed after adding RHS, the acceptance of the product is still convenient. Adding a high concentration of retrograded starch could help to ensure doses enough for a prebiotic effect of RS with concentrations of 1.74 ± 0.37 to 2.32 ± 0.09 g/100 g and from 3.5 ± 0.08 to 4.21 ± 0.08 g/100 g when RNS or RHS is added respectively, while maintaining the quality characteristics of Greek-style yogurt during storage without compromising the acceptability.

Validation of “TesTactico for F7”: A tool to analyse Declarative Tactical Knowledge based on a Football Competence Observation System / Validación de “TesTactico para F7”: Una herramienta para analizar el Conocimiento Táctico Declarativo basada en un Sistema de Observación de la Competencia Futbolística / Validação do “TesTactico F7”: Um instrumento para analisar o Conhecimento Tático Declarativo baseado em um Sistema de Observação da Competência Futebolística

Este estudio tuvo como objetivo diseñar y validar una prueba de respuesta múltiple con imágenes de situaciones de juego del fútbol para evaluar el conocimiento táctico declarativo (CTD) del jugador. “TesTactico para F7” (fútbol-7) está compuesto por 62 situaciones de juego relacionadas con los criterios (fases, roles, acciones de los subroles adquiridos, principios operacionales y fundamentales/específicos) del Sistema de Observación de la Competencia Futbolística (FOCOS), analizando 67 variables. El coeficiente de validez de contenido (9.63/10) se estimó mediante grupo de expertos (n=13), calculando grado de acuerdo y aceptación. La validez de constructo se calculó mediante la prueba T-Student para muestras independientes. Participaron 155 jóvenes futbolistas organizados según su competencia futbolística (alta=80; baja=75). El cálculo del tamaño de la muestra post-hoc usando G*Power reveló .93 de poder (d=0.5, p=0.5). Se utilizó la corrección de Bonferroni para controlar la tasa de error familiar en cada criterio. Los resultados reflejaron que el grupo de alto nivel fue mejor en las 67 variables, con diferencias significativas (p ≤ .008) en 38 de ellas. También se calculó el tamaño del efecto d-Cohen para evaluar la magnitud de diferencias que fueron grandes (d = 1.38) para el Promedio Total. La fiabilidad de la herramienta se determinó a nivel inter-observador mediante el índice de concordancia kappa de Fleiss (k = .882), y a nivel intra-observador mediante el método test-retest utilizando kappa de Cohen (k = 1.000). La consistencia interna fue estimada a través del coeficiente alfa de Cronbach (α = .925). El análisis de generalizabilidad mostró también una excelente fiabilidad (G =.985) y una representatividad perfecta (r2 = 1.00), evidenciándose que la variabilidad es explicada por las situaciones de juego que componen el test. Se concluye que el instrumento presenta valores óptimos de validez y confiabilidad. (AU)

This study aimed to design and validate a multi-response test with images of football game-play situations to evaluate the player's declarative tactical knowledge (DTK). “TesTactico for F7” (seven-a-side football) is made up of 62 game-play situations related to the criteria (phases, roles, actions of the acquired subroles, operational and core/specific principles) of the Football Competence Observation System (FOCOS), analysing a total of 67 variables. The content validity coefficient (9.63 out of 10) was estimated via expert group (n=13), calculating the averages of the degree of agreement and acceptance of the experts. The construct validity was calculated using Student's T-testfor independent samples. 155 young football players participated according to their football competence (high-level=80; low-level=75). The post-hoc sample size calculation using G*Power revealed .93 of power (d=0.5, p=0.5). Bonferroni correction was used to control the family-wise error rate in each criterion. The results reflected that the high-level group was better in the 67 variables, with significant differences (p ≤ .008) in 38 of them. Cohen’s d-effect size was also calculated to assess the magnitude of the difference between both groups, which were large (d = 1.38) for the Total Average. The reliability of the tool was determined at the inter-observer level using the Fleiss kappa index of concordance (k = .882), and at the intra-observer level through the test-retest method using the Cohen kappa index (k = 1.000). Internal consistency was estimated through Cronbach's alpha coefficient (α = .925). The generalizability analysis also showed excellent reliability (G = .985) and perfect representativeness(r2 = 1.00), showing that the variability is explained by the game-play situations that make up the test. It is concluded that the instrument shows optimal validity and reliability values (AU)

Este estudo teve como objetivo validar um teste de múltipla escolha com imagens de situações de jogo de futebol para avaliar o conhecimento tático declarativo (CTD) do jogador. O "TesTactico F7" (futebol-7) é composto por 62 situações de jogo relacionadas com os critérios do Sistema de Observação da Competência Futebolística (FOCOS), analisando 67 variáveis. O coeficiente de validade de conteúdo (9,63/10) foi estimado por um grupo de especialistas (n=13), calculando o grau de concordância e aceitação. A validade de construto foi calculada usando a T-Student para amostras independentes. Participaram 155 jovens jogadores de futebol, organizados de acordo com sua competência futebolística (alta=80; baixa=75). O cálculo do tamanho da amostra post-hoc usando G*Power revelou poder de 0.93 (d=0.5, p=0.5). A correção de Bonferroni foi usada para controlar a taxa de erro em cada critério. Os resultados mostraram que o grupo de alto nível foi melhor nas 67 variáveis, com diferenças significativas (p ≤ .008) em 38 delas. O tamanho do efeito d-Cohen também foi calculado para avaliar a magnitude das diferenças entre os dois grupos, que foram grandes (d = 1.38) para o Escore Total. A confiabilidade do instrumento foi determinada no nível interobservador pelo índice de concordância Fleiss kappa (k = .882), e no nível intraobservador pelo método teste-reteste usando o kappa de Cohen (k = 1.000). A consistência interna foi estimadapor meio do coeficiente alfa de Cronbach (α = 0,925). A análise de generalização também apresentou excelente confiabilidade (G = .985) e representatividade perfeita (r2 = 1.00), mostrando que a variabilidade é explicada pelas situações de jogo que compõemo teste. Conclui-se que o instrumento apresenta valores ótimos de validade e confiabilidade. (AU)

Draft Genome Sequence of Agrobacterium radiobacter Strain MD22b, Isolated from a Grape Plant in Tajikistan.

Agrobacterium radiobacter strain MD22b was isolated from infected fruit from Vatan Farm, a dekhkan farm in Yangibog (Tursunzade, Tajikistan). The 5.7-Mbp draft genome sequence presented here shares homology with chromosomes 1 and 2, as well as with the Ti plasmid from agrobacteria.

The deep cerebellar nuclei to striatum disynaptic connection contributes to skilled forelimb movement.

Cerebellar-thalamo-striatal synaptic communication has been implicated in a wide range of behaviors, including goal-directed actions, and is altered in cerebellar dystonia. However, its detailed connectivity through the thalamus and its contribution to the execution of forelimb movements is unclear. Here, we use trans-synaptic and retrograde tracing, ex vivo slice recordings, and optogenetic inhibitions during the execution of unidirectional or sequential joystick displacements to demonstrate that the deep cerebellar nuclei (DCN) influence the dorsal striatum with a very high probability. We show that this mainly occurs through the centrolateral (CL), parafascicular (PF), and ventrolateral (VL) nuclei of the thalamus, observing that the DCN→VL and DCN→CL pathways contribute to the execution of unidirectional forelimb displacements while the DCN→PF and DCN→thalamo→striatal pathways contribute to the appropriate execution of forelimb reaching and sequential displacements. These findings highlight specific contributions of the different cerebellar-thalamo-striatal paths to the control of skilled forelimb movement.

Surgical and non-surgical management of thoracic and cervical paraganglioma.

Thoracic and cervical paragangliomas (PGLs) are rare neuroendocrine tumors arising from chromaffin cells of the neural crest progenitors located outside the adrenal gland. We describe our current protocol as a multidisciplinary team for the management of cervical and thoracic PGLs. Surgery is generally considered the treatment of choice as it offers the best chance for cure. For resection of thoracic PGLs, video-assisted thoracoscopic surgery (VATS) is the main surgical approach, while open thoracotomy is preferred in case of tumors > 6cm, lacking confirmation of a plane of separation with adjacent structures, or with technical difficulties during VATS. In cervical PGLs, the surgical approach should be individualized according to location, mainly based on the Glasscock-Jackson and the Fisch-Mattox classifications. Surgery is the treatment of choice for most cervical and thoracic PGLs, but radiotherapy or observation could be more suitable options in unresectable cervical and thoracic PGLs or when resection has been incomplete.

Implications of FRAX® adjusted for recent fracture on the indication of treatment in an FLS.

We analyzed the practical consequences of applying an adjusted FRAX® for recent fractures in a FLS. After analyzing 2777 patients, we concluded that the adjusted FRAX® is irrelevant when calculating FRAX® with DXA and is only useful for fractures of the humerus when DXA is not available. PURPOSE: A FRAX® adjusted to fractures less than 2 years old has been proposed. The objective of this work was to analyze the clinical implications of applying the adjusted FRAX® instead of the classic FRAX® in a fracture liaison service (FLS) unit. METHODS: Adults aged 50 years or older with fragility fractures (hip, spine, humerus, and forearm) that occurred in the 12 months prior to the baseline visit were included. We recorded demographic data, type of fracture, DXA, classic FRAX®, and FRAX® adjusted for recent fractures and indications for anti-osteoporotic medication (AOM) following the guidelines of the Spanish Society of Rheumatology. RESULTS: A total of 2777 patients were included, mean age 73 years, 84% women. The type of fracture was as follows: forearm (n = 958; 34.5%), hip (n = 781; 28.1%), humerus (n = 642; 23.1%), and spine (n = 397, 14.3%). DXA was performed in 2134 cases (76.8%). A total of 2522 patients (90.8%) were candidates for AOM (100% involving the hip and spine, 83% forearm, and 85% humerus). FRAX®-hip ≥ 3% increased from 1601 to 1775 cases (57.6 to 64%). The average FRAX®-hip (SD) increased from 5.7 (6) to 7.5 (9) (4.6 to 8.8 in males and 5.9 to 7.3 in females). The percentage of forearm fracture candidates for AOM, with or without DXA, did not change after FRAX®-hip adjustment, while the number of patients with humerus fractures increased from 59 to 80% in those who did not have DXA. In the entire sample, FRAX®-adjusted led to an indication of AOM for 15 additional patients (0.5% of major fractures): 14 with a humerus fracture and 1 with a forearm fracture. CONCLUSIONS: The adjusted FRAX® for recent fractures in an FLS unit in an adjusted FRAX® is irrelevant when calculating FRAX® with DXA; in fact, it is only useful for fractures of the humerus when DXA is not available.

Uptake-leak balance of SR Ca2+ determines arrhythmogenic potential of RyR2R420Q+/- cardiomyocytes.

Mutations of the RyR2 are channelopathies that can predispose to life threatening catecholaminergic polymorphic ventricular tachycardias (CPVTs) during exercise or stress. However, the cellular and molecular mechanisms that are causal for the arrhythmias downstream of the ß-adrenergic receptor (ß-AR) activation are not defined. They may be specific and different for each particular RyR2 mutation. Obvious possibilities are the phosphorylation of the mutated RyR2s or the stimulation of the SR Ca2+ pump (SERCA), which could increase SR Ca2+ loading. Potentially arrhythmogenic Ca2+ signals, such as Ca2+ waves, were recorded and analyzed from WT and RyR2R420Q+/- mouse cardiomyocytes with confocal microscopy after field stimulation at 1 Hz. In RyR2R420Q+/- cardiomyocytes we found a higher occurrence and frequency of Ca2+ waves, particularly upon ß-AR stimulation with isoproterenol. This was accompanied by a shorter latency to the first spontaneous wave. Wave velocity from raw traces, as well as amplitude and decay time constant (τ) analyzed in de-skewed traces were comparable in both cell types. To obtain further insight into the role of the SERCA we selectively stimulated SERCA in permeabilized myocytes using Fab fragments of a PLB antibody (2D12). Surprisingly, SERCA stimulation alone resulted in considerably higher wave frequencies than when mimicking ß-AR stimulation with cAMP, particularly in RyR2R420Q+/- cardiomyocytes. This may be a consequence of some protective SR Ca2+ unloading resulting from the SR Ca2+ leak via phosphorylated RyR2s in cAMP. Spark-to-spark recovery analysis suggested a remarkably higher Ca2+ release sensitivity in RyR2R420Q+/- cells, both in control and upon ß-AR stimulation. Together these findings suggest that the fine balance between SR Ca2+ loading via SERCA and the Ca2+ leak via mutated and phosphorylated RyR2s is an important determinant for the overall cellular arrhythmogenicity prevailing in the RyR2R420Q+/- myocytes.

Checklist for the evaluation of magnetic resonance imaging in otological pathology.

Otolaryngology specialists must be familiar with radiological studies that allow the diagnosis of different otological pathologies. Magnetic resonance imaging is a complement to computed tomography, which allows a better evaluation of soft tissues and contributes to the differential diagnosis of space-occupying lesions located in the temporal bone and lateral skull base. It is also the technique of choice for the evaluation of the inner ear and the anatomical structures located in the cerebellopontine angle. In this article we present a checklist for magnetic resonance imaging of the ear with different sections that will allow a systematic review of all structures of interest in otological practice, as well as the preferred sequences for each situation.

Lista de verificación para la evaluación de imágenes de resonancia magnética en patología otológica / Checklist for the evaluation of magnetic resonance imaging in otological pathology

Los especialistas en Otorrinolaringología debemos estar familiarizados con los estudios radiológicos que nos permiten el diagnóstico de las distintas patologías otológicas. La resonancia magnética es un complemento a la tomografía computarizada, que permite una mejor evaluación de los tejidos blandos, lo cual contribuye al diagnóstico diferencial de las lesiones ocupantes de espacio localizadas en el hueso temporal y base de cráneo lateral. Es, además, la técnica de elección para la valoración del oído interno y de las estructuras anatómicas situadas en el ángulo pontocerebeloso. En este artículo presentamos una lista de verificación de resonancia magnética del oído con distintos apartados que permitirán hacer una revisión sistemática de todas las estructuras de interés en la práctica otológica, evaluables mediante esta técnica de imagen, así como las secuencias y cortes de elección en cada caso. (AU)

Otolaryngology specialists must be familiar with radiological studies that allow the diagnosis of different otological pathologies. Magnetic resonance imaging is a complement to computed tomography, which allows a better evaluation of soft tissues and contributes to the differential diagnosis of space-occupying lesions located in the temporal bone and lateral skull base. It is also the technique of choice for the evaluation of the inner ear and the anatomical structures located in the cerebellopontine angle. In this article we present a checklist for magnetic resonance imaging of the ear with different sections that will allow a systematic review of all structures of interest in otological practice, as well as the preferred sequences for each situation (AU).

Risk Factors and Clinical Impact of Fibrotic-Like Changes and the Organizing Pneumonia Pattern in Patients With COVID-19- and Non-COVID-19-Induced Acute Respiratory Distress Syndrome / Factores de riesgo e impacto clínico de los cambios fibróticos y el patrón de neumonía organizada en los pacientes con síndrome de distrés respiratorio agudo producido o no por COVID-19

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Debulking SARS-CoV-2 in saliva using angiotensin converting enzyme 2 in chewing gum to decrease oral virus transmission and infection.

To advance a novel concept of debulking virus in the oral cavity, the primary site of viral replication, virus-trapping proteins CTB-ACE2 were expressed in chloroplasts and clinical-grade plant material was developed to meet FDA requirements. Chewing gum (2 g) containing plant cells expressed CTB-ACE2 up to 17.2 mg ACE2/g dry weight (11.7% leaf protein), have physical characteristics and taste/flavor like conventional gums, and no protein was lost during gum compression. CTB-ACE2 gum efficiently (>95%) inhibited entry of lentivirus spike or VSV-spike pseudovirus into Vero/CHO cells when quantified by luciferase or red fluorescence. Incubation of CTB-ACE2 microparticles reduced SARS-CoV-2 virus count in COVID-19 swab/saliva samples by >95% when evaluated by microbubbles (femtomolar concentration) or qPCR, demonstrating both virus trapping and blocking of cellular entry. COVID-19 saliva samples showed low or undetectable ACE2 activity when compared with healthy individuals (2,582 versus 50,126 ΔRFU; 27 versus 225 enzyme units), confirming greater susceptibility of infected patients for viral entry. CTB-ACE2 activity was completely inhibited by pre-incubation with SARS-CoV-2 receptor-binding domain, offering an explanation for reduced saliva ACE2 activity among COVID-19 patients. Chewing gum with virus-trapping proteins offers a general affordable strategy to protect patients from most oral virus re-infections through debulking or minimizing transmission to others.