Marine sediments in the Gulf of Gabes (Tunisia) heavily polluted by phosphogypsum and human microbiota bacteria: phytoremediation by Salicornia europaea as a natural-based solution.

A huge amount of phosphogypsum (PG) wastes generated from the processing phosphate ore in Tunisia Industrial Group Area-Gabes is getting discarded into the sea. Within this framework, the basic objective of this research is to elaborate and discuss a natural-based solution focused on phytoremediation of contaminated (PG) soils and marine sediments with the halophilic plant Salicornia europaea. A significant drop of the organic matter (53.09%), moisture (26.47%), and sediment porosity with (5.88%) was detected in the rhizosphere Salicornia europaea area (RS). Removal of hazardous elements concentrations, such as Pb, Fe, Cu, Cd, and Zn, between contaminated sediment (CS) and RS displayed a significant difference, ranging from 5.33 to 50.02% of hazardous elements removal concentration, which was observed in the rhizosphere zone. The microbiota of both areas (RS and CS) were analyzed by massive sequencing. In both samples, all the sequences belong to only four phyla: Firmicutes and, to a much lower extent, Proteobacteria, Bacteroidetes, and Actinobacteria. The CS sediment seems to be heavily polluted by human activities. Most of the found genera are inhabitants of the intestine of warm-blooded animals (Escherichia, Bacteroides, Prevotella, Faecalibacterium, Ruminococcus, Enterococcus); hence, activities in this area pose a health risk. On the other hand, it may be surprising that 76.4% of the total high-quality sequences retrieved from the RS sample were affiliated to the family Bacillaceae. The salinity of the studied soil exerts a stress on the microbial populations that inhabit it, directing the selection of halotolerant species.

Genome-wide identification of replication fork stalling/pausing sites and the interplay between RNA Pol II transcription and DNA replication progression.

BACKGROUND: DNA replication progression can be affected by the presence of physical barriers like the RNA polymerases, leading to replication stress and DNA damage. Nonetheless, we do not know how transcription influences overall DNA replication progression. RESULTS: To characterize sites where DNA replication forks stall and pause, we establish a genome-wide approach to identify them. This approach uses multiple timepoints during S-phase to identify replication fork/stalling hotspots as replication progresses through the genome. These sites are typically associated with increased DNA damage, overlapped with fragile sites and with breakpoints of rearrangements identified in cancers but do not overlap with replication origins. Overlaying these sites with a genome-wide analysis of RNA polymerase II transcription, we find that replication fork stalling/pausing sites inside genes are directly related to transcription progression and activity. Indeed, we find that slowing down transcription elongation slows down directly replication progression through genes. This indicates that transcription and replication can coexist over the same regions. Importantly, rearrangements found in cancers overlapping transcription-replication collision sites are detected in non-transformed cells and increase following treatment with ATM and ATR inhibitors. At the same time, we find instances where transcription activity favors replication progression because it reduces histone density. CONCLUSIONS: Altogether, our findings highlight how transcription and replication overlap during S-phase, with both positive and negative consequences for replication fork progression and genome stability by the coexistence of these two processes.

Comparison of Circulating Tumor DNA Assays for Molecular Residual Disease Detection in Early-Stage Triple-Negative Breast Cancer.

PURPOSE: Detection of circulating tumor DNA (ctDNA) in patients who have completed treatment for early-stage breast cancer is associated with a high risk of relapse, yet the optimal assay for ctDNA detection is unknown. EXPERIMENTAL DESIGN: The cTRAK-TN clinical trial prospectively used tumor-informed digital PCR (dPCR) assays for ctDNA molecular residual disease (MRD) detection in early-stage triple-negative breast cancer. We compared tumor-informed dPCR assays with tumor-informed personalized multimutation sequencing assays in 141 patients from cTRAK-TN. RESULTS: MRD was first detected by personalized sequencing in 47.9% of patients, 0% first detected by dPCR, and 52.1% with both assays simultaneously (P < 0.001; Fisher exact test). The median lead time from ctDNA detection to relapse was 6.1 months with personalized sequencing and 3.9 months with dPCR (P = 0.004, mixed-effects Cox model). Detection of MRD at the first time point was associated with a shorter time to relapse compared with detection at subsequent time points (median lead time 4.2 vs. 7.1 months; P = 0.02). CONCLUSIONS: Personalized multimutation sequencing assays have potential clinically important improvements in clinical outcome in the early detection of MRD.

Epidemiology and diagnosis of primary aldosteronism. What have we learned from the SPAIN-ALDO registry?

PURPOSE: To summarize the available data on the prevalence, clinical repercussion, and diagnosis of primary aldosteronism (PA) and to discuss the SPAIN-ALDO registry's findings, which is the largest PA patient registry in Spain. METHODS: A comprehensive review of the literature focused on the prevalence, clinical presentation and diagnosis of PA was performed. RESULTS: PA is the most common cause of secondary arterial hypertension. In addition, PA patients have a higher cardio-metabolic risk than patients with essential arterial hypertension matched by age, sex, and blood pressure levels. However, despite its high prevalence and associated metabolic and cardiovascular complications, PA remains largely under-recognized, with less than 2% of people in at-risk populations ever tested. The diagnostic investigation is a multistep process, including screening, confirmatory testing, and subtype differentiation of unilateral from bilateral PA forms. Data from the SPAIN-ALDO registry have shed light on the cardiometabolic impact of PA and about the limitations in the PA diagnosis of these patients in Spain. CONCLUSIONS: The most common cause of secondary hypertension is PA. One of the most challenging aspects of the diagnosis is the differentiation between unilateral and bilateral PA because adrenal venous sampling is a difficult procedure that should be performed in experienced centers. Data from the SPAIN-ALDO registry have provided important information on the nationwide management of this pathology.

Caloric Effect Due to the Aharonov-Bohm Flux in an Antidot.

In this work, we report the caloric effect for an electronic system of the antidot type, modeled by combining a repulsive and attractive potential (parabolic confinement). In this system, we consider the action of a perpendicular external magnetic field and the possibility of having an Aharonov-Bohm flux (AB-flux) generated by a current passing through a solenoid placed inside the forbidden zone for the electron. The energy levels are obtained analytically, and the model is known as the Bogachek and Landman model. We propose to control the caloric response of the system by varying only the AB-flux, finding that, in the absence of an external magnetic field, the maximization of the effect always occurs at the same AB-flux intensity, independently of the temperature, while fixing the external magnetic field at a non-zero value breaks this symmetry and changes the point where the caloric phenomenon is maximized and is different depending on the temperature to which the process is carried. Our calculations indicate that using an effective electron mass of GaAs heterostructures and a trap intensity of the order of 2.896 meV, the modification of the AB-flux achieves a variation in temperature of the order of 1 K. Our analysis suggests that increasing the parabolic confinement twofold increases the effect threefold, while increasing the antidot size generates the reverse effect, i.e., a strong decrease in the caloric phenomenon under study. Due to the great diversity in technological applications that have antidots in electronics, the possibility of controlling their thermal response simply by varying the intensity of the internal current inside the solenoid (i.e., the intensity of AB-flux) can be a platform of interest for experimental studies.

Human Health Risk Assessment of Arsenic and Other Metals in Herbal Products Containing St. John's Wort in the Metropolitan Area of Mexico City.

Consumption of St. John's wort plant is high worldwide due to its various medicinal properties. However, herbal products containing St. John's wort may be contaminated with toxic metals. This is often related to contamination of both water and the atmosphere, lack of proper cultivation methods, and inadequate plant storage conditions, as well as a lack of stricter sanitary supervision. A safety assessment of copper (Cu), lead (Pb), cadmium (Cd) and arsenic (As) content in 23 products containing St. John's wort (pharmaceutical herbal products, food supplements and traditional herbal remedies) sold in the metropolitan area of Mexico City was conducted. The analysis of metals was determined using a graphite-furnace atomic absorption spectrometer. All herbal products were contaminated with Cu, Pb, Cd and As. The pharmaceutical herbal items showed less contamination by metals. The daily human intake (DHI) values for Pb exceeded the permissible limits in the group of traditional herbal remedies. The DHI calculation for As exceeded the permitted intake values for all items in the group of traditional herbal remedies, five food supplements and one pharmaceutical herbal product. The hazard indicator calculation of the non-carcinogenic cumulative risk values for traditional herbal remedies was greater than 1, suggesting a risk to human health.

TRAIP resolves DNA replication-transcription conflicts during the S-phase of unperturbed cells.

Cell division is the basis for the propagation of life and requires accurate duplication of all genetic information. DNA damage created during replication (replication stress) is a major cause of cancer, premature aging and a spectrum of other human disorders. Over the years, TRAIP E3 ubiquitin ligase has been shown to play a role in various cellular processes that govern genome integrity and faultless segregation. TRAIP is essential for cell viability, and mutations in TRAIP ubiquitin ligase activity lead to primordial dwarfism in patients. Here, we have determined the mechanism of inhibition of cell proliferation in TRAIP-depleted cells. We have taken advantage of the auxin induced degron system to rapidly degrade TRAIP within cells and to dissect the importance of various functions of TRAIP in different stages of the cell cycle. We conclude that upon rapid TRAIP degradation, specifically in S-phase, cells cease to proliferate, arrest in G2 stage of the cell cycle and undergo senescence. Our findings reveal that TRAIP works in S-phase to prevent DNA damage at transcription start sites, caused by replication-transcription conflicts.

Características asociadas a la depresión, ansiedad y estrés en estudiantes universitarios / Characteristics associated with depression, anxiety, and stress in university students

Introducción: La presente investigación se enfocó en analizar las características asociadas a la depresión, ansiedad y estrés en estudiantes universitarios en tiempos de pandemia COVID-19. Método: El estudio fue de diseño no experimental, correlacional, prospectivo y de corte transversal. La técnica de recolección de datos fue la encuesta, y su instrumento el cuestionario DASS-21, el cual cuenta con una confiabilidad muy buena de 0.91. Este ha sido aplicado a 385 estudiantes universitarios peruanos, de manera virtual. Resultados: Los resultados indican que de los estudiantes encuestados, un 12% de ellos presentan estrés alto, 7% ansiedad severa y 9% depresión severa. Dentro de los factores que se asociaron al estrés encontramos la edad, la carrera previa, el contar con trabajo, tener enfermedad crónica; la ansiedad tuvo factores asociados como edad, tener una carrera previa, estado laboral y diagnóstico de una enfermedad crónica; la depresión tuvo factores asociados como edad, el tener hijos, con una carrera previa, conexión de internet, tener trabajo, el haber sido diagnosticado con una enfermedad crónica, el tener un familiar o persona cercana con COVID-19 y finalmente el que alguien cercano haya fallecido. Conclusión: Se estimaron 3 modelos de regresión logística con 77.3%, 68.2% y 63.3% de certeza para estrés, ansiedad y depresión respectivamente. (AU)

Introduction: The present research focused on analyzing the characteristics associated with depression, anxiety and stress in university students in times of COVID-19 pandemic. Method: The study had a non-experimental, correlational, prospective, cross-sectional design. The data collection technique was the survey, and its instrument was the DASS-21 questionnaire, which has a very good reliability of 0.91. It has been applied virtually to 385 Peruvian university students. Results: The results show that 12% of the students surveyed presented high stress, 7% severe anxiety and 9% severe depression. Among the factors associated with stress were age, previous major, having a job, having a chronic disease. Anxiety had associated factors such as age, having a previous career, work status and diagnosis of a chronic disease. Depression was associated with factors such as age, having children, having a previous major, internet connection, having a job, having been diagnosed with a chronic disease, having a family member or a close person with COVID-19, and finally having someone close who had passed away. Conclusion: Three logistic regression models were estimated with 77.3%, 68.2% and 63.3% certainty for stress, anxiety and depression, respectively. (AU)

A new semiaquatic worm (Annelida, Oligochaeta) from southeastern Mexican tropical rain forests.

A new Oligochaete worm genus with a single species is described from tropical rain forests of Southern Mexico. Lacandodrilus paludosus Fragoso & Rojas gen. et sp. nov., found in sandy and acid poor swampy soils, presented a characteristic morphology of semiaquatic oligochaetes. The new taxon is holandric, with male pores and ovaries in segment 13, with genital prostatic- like lobular glands in segments 13 and 14 and with long seminal vesicles contained within ovisacs. It is also characterized by exonephric holonephridia covered by a peritoneal granular layer, septal glands and long vascular commissures in former segments. It presents a pair of spermathecae without diverticula in segment 10 and it lacks gizzards, typhlosole or esophagus glands. The new taxon is tentatively placed in family Alluroididae, waiting for additional histological studies that will clarify some characters.

Ecological successions throughout the desiccation of Tirez lagoon (Spain) as an astrobiological time-analog for wet-to-dry transitions on Mars.

Tirez was a small and seasonal endorheic athalassohaline lagoon that was located in central Spain. In recent years, the lagoon has totally dried out, offering for the first time the opportunity to analyze its desiccation process as a "time-analog" to similar events occurred in paleolakes with varying salinity during the wet-to-dry transition on early Mars. On the martian cratered highlands, an early period of water ponding within enclosed basins evolved to a complete desiccation of the lakes, leading to deposition of evaporitic sequences during the Noachian and into the Late Hesperian. As Tirez also underwent a process of desiccation, here we describe (i) the microbial ecology of Tirez when the lagoon was still active 20 years ago, with prokaryotes adapted to extreme saline conditions; (ii) the composition of the microbial community in the dried lake sediments today, in many case groups that thrive in sediments of extreme environments; and (iii) the molecular and isotopic analysis of the lipid biomarkers that can be recovered from the sediments today. We discuss the implications of these results to better understanding the ecology of possible Martian microbial communities during the wet-to-dry transition at the end of the Hesperian, and how they may inform about research strategies to search for possible biomarkers in Mars after all the water was lost.

Gastroparesis in geriatrics population: A United States population study.

BACKGROUND: Older patients with upper gastrointestinal diseases may lack disease-specific symptoms that are required to make the correct diagnosis. This study aimed to compare the gastroparesis demographics, clinical presentation, and surgical management between the older adult and young populations. METHODS: The National Inpatient Sample database was used between the years 2012 and 2014 with the primary diagnosis of gastroparesis. Patients were further divided based on their age into two groups: 70 years or older and younger than 70 years. RESULTS: The older adults were more likely to have early satiety and bloating compared to younger population with an odds ratio (OR) = 3.79; 95% Confidence Interval (95%CI) 2.80- 5.11, p < 0.0001 and OR = 2.80, 95%CI 2.07-3.78, p<0.0001 respectively. Older adults had low odds of having nausea with vomiting (OR = 0.86, 95%CI 0.76-0.95, p = 0.003), or abdominal pain (OR = 0.56, 95%CI 0.50-0.63, p<0.0001). CONCLUSIONS: Older adults had more early satiety and bloating, whereas younger patients had more nausea with vomiting and abdominal pain.

Adrenal incidentalomas, cortisol secretion and cancer: is there a real crosstalk?

Background: Cortisol has immunomodulatory effects that increase the risk and evolution of several diseases. Cancer is characterized by a proinflammatory state in which cells exert impaired function and proliferation. The relation between cortisol secretion and increased risk of malignant neoplasm, or their behavior, has not been fully elucidated. Aim: To determine the relation between cortisol secretion and the prevalence and clinical outcome of malignant neoplasms in patients with adrenal incidentalomas (AIs). Methods: Multicenter retrospective study that included 935 patients with AIs. Cortisol secretion was defined by a cortisol post-dexamethasone suppression test > 1.8 µg/dL, and nonfunctioning AIs (NFAIs) as a value ≤ 1.8 µg/dL. Results: Cortisol secretion was evident in 30.8% of the patients and cancer in 23.6% (especially breast, colorectal, prostate and thyroid cancer). No differences in the cancer prevalence were found between patients with cortisol secretion and NFAIs (63.6% vs. 63.4%, p=0.10). After adjusting by age, cortisol secretion was not associated with the presence of cancer (OR 1.29, CI 0.93-1.78). However, cortisol secretion was significantly associated with stage IV of cancer at diagnosis (OR 2.68, CI 1.19- 6.00) and mortality (OR 3.2, CI 1.28- 7.97). Patients with NFAI and breast cancer required treatment with chemo- and radio-therapy more frequently that patients with cortisol secreting AI (90% vs 10% and 92.9% vs 7.1% respectively, p<0.05), similarly patients with prostate cancer required radiotherapy more frequently (90.9% vs 9.1%, p=0.05); also, patients with colorectal cancer and NFAI, tended to require chemotherapy more frequently(76.5% vs 23.5%, p=0.06). Conclusion: Cortisol secretion does not increase the risk of malignant neoplasm, but it affects its clinical course, treatment requirements and mortality, leading to a worst prognosis and higher mortality when compared with patients with NFAIs.

Análisis no-lineal de la onda gamma del electroencefalograma en una prueba de atención e inhibición / Non-linear analysis of the electroencephalogram gamma wave in an attention and inhibition test

Introducción: Durante las últimas décadas se ha estudiado la señal del electroencefalograma desde una perspectiva de matemática no-lineal. Esto permite entender la actividad eléctrica cerebral como un sistema dinámico complejo. Objetivo: Evaluar los exponentes de Hurst y sus correlaciones en la onda gamma durante una tarea de atención alternante e inhibición de la interferencia en estudiantes universitarios. Métodos: La muestra se constituyó por 14 alumnos de educación física. Para evaluar la actividad eléctrica cerebral se utilizó el dispositivo cerebro-interfaz Emotiv Epoc®. La atención alternante se estimó con el test de símbolos y dígitos, mientras que para la inhibición de la interferencia se empleó la prueba de palabras y colores de Stroop. Resultados: En la prueba de atención alternante, cuatro individuos revelaron mayor propensión al caos en el hemisferio derecho, uno presentó más tendencia en el hemisferio izquierdo y dos no tuvieron una predisposición definida. Por otra parte, durante la prueba de inhibición de la interferencia, cinco presentaron variaciones de las medias de Hurst entre las tres láminas del efecto Stroop, sobre todo de la región temporal. Los exponentes Hurst en ambas pruebas fueron inferiores a 0,5. Conclusiones: Durante la prueba de atención se observó un mayor caos de la actividad eléctrica cerebral, sin existir correlaciones entre las regiones estudiadas. Durante la prueba de inhibición las modificaciones de los exponentes de Hurst no presentaron patrones definidos hacia el orden o caos(AU)

Introduction: During the last decades the electroencephalogram signal has been studied from a nonlinear mathematical perspective. This allows understanding brain electrical activity as a complex dynamical system. Objective: To evaluate Hurst exponents and their correlations in the gamma wave during an alternating attention and interference inhibition task in university students. Methods: The sample consisted of 14 physical education students. The Emotiv Epoc® brain-interface device was used to evaluate brain electrical activity. Alternating attention was estimated with the symbols and digits test, while the Stroop words and colors test was used for interference inhibition. Results: In the alternating attention test, four individuals revealed a greater propensity to chaos in the right hemisphere, one showed a greater tendency in the left hemisphere and two had no defined predisposition. On the other hand, during interference inhibition, variations of Hurst average values between the three Stroop effect slices were determined in five subjects, especially in the temporal region. Hurst exponents in both tests were found to be less than 0.5. Conclusions: During the attention test, a greater chaos of brain electrical activity is observed, with no correlations between the regions studied. During the inhibition test, the modifications of the Hurst exponents do not present defined patterns towards order or chaos(AU)

Historical Aspects of Herbal Use and Comparison of Current Regulations of Herbal Products between Mexico, Canada and the United States of America.

Increased life expectancy and high costs of medicines and medical care have led to the use of herbal products. However, these items may contain toxic compounds that have an impact on public health. We will focus on the regulatory aspects and differences of these products marketed in the North American region (USA-Mexico-Canada) from government websites and selected literature. Mexico has an ancestral tradition of using plants for the treatment, improvement, and maintenance of human health as compared with Canada and the USA Currently, the use of herbal products in this region has a regulatory framework. The legal framework in these three countries is related to their history, idiosyncrasies, socio-economic and cultural aspects. Therefore, there are different public policies for herbal products consumed in the region. Mexico has a more specific classification of these products. In Canada, all herbal products are classified as natural health products and the safety and efficacy must be scientifically proven. In the USA, the development of botanical drugs is very recent. In particular, both herbal products classified as food supplements in Mexico and dietary supplements in the USA may have risks in both safety and efficacy.

Integration of stool microbiota, proteome and amino acid profiles to discriminate patients with adenomas and colorectal cancer.

BACKGROUND: Screening for colorectal cancer (CRC) reduces its mortality but has limited sensitivity and specificity. Aims We aimed to explore potential biomarker panels for CRC and adenoma detection and to gain insight into the interaction between gut microbiota and human metabolism in the presence of these lesions. METHODS: This multicenter case-control cohort was performed between February 2016 and November 2019. Consecutive patients ≥18 years with a scheduled colonoscopy were asked to participate and divided into three age, gender, body-mass index and smoking status-matched subgroups: CRC (n = 12), adenomas (n = 21) and controls (n = 20). Participants collected fecal samples prior to bowel preparation on which proteome (LC-MS/MS), microbiota (16S rRNA profiling) and amino acid (HPLC) composition were assessed. Best predictive markers were combined to create diagnostic biomarker panels. Pearson correlation-based analysis on selected markers was performed to create networks of all platforms. RESULTS: Combining omics platforms provided new panels which outperformed hemoglobin in this cohort, currently used for screening (AUC 0.98, 0.95 and 0.87 for CRC vs controls, adenoma vs controls and CRC vs adenoma, respectively). Integration of data sets revealed markers associated with increased blood excretion, stress- and inflammatory responses and pointed toward downregulation of epithelial integrity. CONCLUSIONS: Integrating fecal microbiota, proteome and amino acids platforms provides for new biomarker panels that may improve noninvasive screening for adenomas and CRC, and may subsequently lead to lower incidence and mortality of colon cancer.

Long-Standing International Cooperation in Parasitology Research: A Summary of 35 Years of Activities in the Bolivian Chaco.

The Bolivian Chaco is a semiarid region with a low population density, situated in the southeast part of the Plurinational State of Bolivia. Here, despite the improvements of the last 15 years, poverty remains high in rural areas, where social vulnerability is widespread. The Guaraní ethnic group often lives in isolated communities with a low standard of hygiene and sanitation. This epidemiological scenario favors the spread of transmissible diseases, including several parasitic infections belonging to the neglected tropical diseases (NTDs) group. In this area, a long-standing research activity, built upon the synergism between local and foreign institutions, has been established since the late 1980s and helps to fill in the knowledge gap about the epidemiology dynamics of soil-transmitted helminths, vector-borne parasites, and other parasitic diseases. A 35-year history of cooperation programs in parasitology research has contributed to informing local health authorities of the NTD burden in the Bolivian Chaco and, ultimately, supports local healthcare providers in the management of parasitic diseases.

Impacto de la pandemia por SARS-CoV-2 en la formación de los alumnos de la Carrera de Médico Especialista en Reumatología / Impact of the SARS-CoV-2 pandemic on a group of Rheumatology trainees of Argentina

Introducción: en 2020, la rápida evolución de la pandemia por SARS-CoV-2 desencadenó una emergencia sanitaria que generó una importante reorganización del sistema de salud, lo que llevó a la discontinuación y posterior adecuación de los sistemas de formación. El objetivo de este estudio fue describir el impacto de la pandemia en un grupo de reumatólogos en formación en la Ciudad Autónoma de Buenos Aires. Materiales y métodos: se envió una encuesta online por correo electrónico a los alumnos de la Carrera de Especialista en Reumatología de la Sociedad Argentina de Reumatología y de la Universidad de Buenos Aires. Incluyó 24 preguntas relacionadas con el impacto de la pandemia en diferentes aspectos de la formación y las nuevas estrategias educativas implementadas. Resultados: de 114 alumnos contactados, respondieron 79 (69,3%). Aproximadamente el 90% indicó que su formación se afectó. Un 46% consideró que la práctica médica y la actividad académica se comprometieron por igual y el 45% solo la práctica médica. Un 50% realizó tareas no relacionadas con su formación. El 57% suspendió temporalmente la asistencia a su centro. También informaron una reducción del 55% (DE 18,6) de las actividades relacionadas con la consulta. Conclusiones: la pandemia por SARS-CoV-2 afectó a los estudiantes de Reumatología al limitar sus actividades prácticas y académicas, y por deber realizar tareas ajenas a su formación en más de la mitad de los casos.

Introduction: in 2020, the rapid evolution of the SARS-CoV-2 pandemic triggered a health emergency, generating an important heath system reorganization which led to the discontinuation and subsequent adaptation of training systems. The objective was to describe the pandemic impact on a group of rheumatology trainees in Buenos Aires, Argentina. Materials and methods: an online survey was sent through e-mail to rheumatology specialist course trainees of Argentine Society of Rheumatology and University of Buenos Aires. It included 24 close-ended questions about the pandemic impact on different aspects of rheumatology training and the new implemented educational response strategies. Results: from 114 trainees contacted, 79 (69.3%) responded. Approximately 90% indicated that their rheumatology training was affected. Forty-six percent thought that medical practice and academic activity were equally affected and 45% that only medical practice was compromised. About 50% reported that they had to perform tasks unrelated to their training. Fifty-seven percent discontinued temporarily the training site attendance. Participants reported a mean reduction of 55% (SD 18.6) of activities related to patient care. Conclusions: the SARS-CoV-2 pandemic affected rheumatology trainees, by limiting their practical and academics activities, and having to perform tasks unrelated to their training in more than a half.

Nefroureterectomía radical lumboscópica con rodete vesical endoscópico, en cáncer urotelial de tracto urinario superior / Lumboscopic radical nephroureterectomy with endoscopic bladder cuff excision in an upper urinary tract urothelial tumor

Los carcinomas uroteliales son el 4to tumor más común. Pueden ubicarse en el tracto urinario inferior (vejiga y uretra) o en el tracto urinario superior (cavidades renales, pelvis renal y uréter). Presentamos una serie de 3 casos, con cuadro de hematuria macroscópica, documentando tumores uroteliales, realizándose en estos casos un abordaje lumboscópico de riñón y una resección endoscópica del rodete vesical. Se realiza nefroureterectomía lumboscópica con resección de rodete vesical endoscópica transuretral. Los 3 pacientes fueron egresados al segundo día posquirúrgico sin complicaciones y en los tres casos el rodete vesical sin evidencia de actividad tumoral, y actualmente en vigilancia con excelente resultados oncológicos. La nefroureterectomía lumboscópica con resección endoscópica del rodete vesical es una técnica reproducible en manos experimentadas, con iguales resultados oncológicos que el abordaje abierto.

Urothelial carcinomas are the 4th most common tumor. They can be located in the lower urinary tract (bladder and urethra) or in the upper urinary tract (renal cavities, renal pelvis, and ureter). We present a series of 3 cases, with a picture of macroscopic hematuria, documenting urothelial tumors, performing in these cases a lumboscopic approach to the kidney and an endoscopic resection of the bladder rim. Lumboscopic nephroureterectomy was performed with transurethral endoscopic bladder rump resection. The 3 patients were discharged on the second postoperative day without complications and in the three cases the bladder rim without evidence of tumor activity, and currently under surveillance with excellent oncological results. Lumboscopic nephroureterectomy with endoscopic resection of the bladder rim is a reproducible technique in experienced hands, with the same oncological results as the open approach.

Electron donor addition for stimulating the microbial degradation of 1,4 dioxane by sequential batch membrane bioreactor: A techno-economic approach.

The presence of 1,4 dioxane in wastewater is associated with severe health and environmental issues. The removal of this toxic contaminant from the industrial effluents prior to final disposal is necessary. The study comprehensively evaluates the performance of sequential batch membrane bioreactor (MBR) for treating wastewater laden with 1,4 dioxane. Acetate was supplemented to the wastewater feed as an electron donor for enhancing and stimulating the microbial growing activities towards the degradation of 1,4 dioxane. The removal efficiency of 1,4 dioxane was maximized to 87.5 ± 6.8% using an acetate to dioxane (A/D) ratio of 4.0, which was substantially dropped to 31.06 ± 3.7% without acetate addition. Ethylene glycol, glyoxylic acid, glycolic acid, and oxalic acid were the main metabolites of 1,4 dioxane biodegradation using mixed culture bacteria. The 1,4 dioxane degrading bacteria, particularly the genus of Acinetobacter, were promoted to 92% at the A/D ratio of 4.0. This condition encouraged as well the increase of the main 1,4 dioxane degraders, i.e., Xanthomonadales (12.5%) and Pseudomonadales (9.1%). However, 50% of the Sphingobacteriales and 82.5% of Planctomycetes were reduced due to the inhibition effect of the 1,4 dioxane contaminate. Similarly, the relative abundance of Firmicutes, Verrucomicrobia, Chlamydiae, Actinobacteria, Chloroflexi, and Nitrospirae was reduced in the MBR at the A/D ratio of 4.0. The results derived from the microbial analysis and metabolites detection at different A/D ratios indicated that acetate supplementation (as an electron donor) maintained an essential role in encouraging the microorganisms to produce the monooxygenase enzymes responsible for the biodegradation process. Economic feasibility of such a MBR system showed that for a designed flow rate of 30 m3∙d-1, the payback period from reusing the treated wastewater would reach 6.6 yr. The results strongly recommend the utilization of mixed culture bacteria growing on acetate for removing 1,4 dioxane from the wastewater industry, achieving dual environmental and economic benefits.