Development, characterization and sterilisation of Nanocellulose-alginate-(hyaluronic acid)- bioinks and 3D bioprinted scaffolds for tissue engineering.

3D-bioprinting is an emerging technology of high potential in tissue engineering (TE), since it shows effective control over scaffold fabrication and cell distribution. Biopolymers such as alginate (Alg), nanofibrillated cellulose (NC) and hyaluronic acid (HA) offer excellent characteristics for use as bioinks due to their excellent biocompatibility and rheological properties. Cell incorporation into the bioink requires sterilisation assurance, and autoclave, ß-radiation and γ-radiation are widely used sterilisation techniques in biomedicine; however, their use in 3D-bioprinting for bioinks sterilisation is still in their early stages. In this study, different sterilisation procedures were applied on NC-Alg and NC-Alg-HA bioinks and their effect on several parameters was evaluated. Results demonstrated that NC-Alg and NC-Alg-HA bioinks suffered relevant rheological and physicochemical modifications after sterilisation; yet, it can be concluded that the short cycle autoclave is the best option to sterilise both NC-Alg based cell-free bioinks, and that the incorporation of HA to the NC-Alg bioink improves its characteristics. Additionally, 3D scaffolds were bioprinted and specifically characterized as well as the D1 mesenchymal stromal cells (D1-MSCs) embedded for cell viability analysis. Notably, the addition of HA demonstrates better scaffold properties, together with higher biocompatibility and cell viability in comparison with the NC-Alg scaffolds. Thus, the use of MSCs containing NC-Alg based scaffolds may become a feasible tissue engineering approach for regenerative medicine.

Influence of social cognition as a mediator between cognitive reserve and psychosocial functioning in patients with first episode psychosis.

BACKGROUND: Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years. METHODS: The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis. RESULTS: At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (-10.215 to -0.337) and (-4.731 to -0.605) respectively). CONCLUSIONS: Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.

Association of Thyroid Function Test Abnormalities and Thyroid Autoimmunity With Preterm Birth: A Systematic Review and Meta-analysis.

Importance: Maternal hypothyroidism and hyperthyroidism are risk factors for preterm birth. Milder thyroid function test abnormalities and thyroid autoimmunity are more prevalent, but it remains controversial if these are associated with preterm birth. Objective: To study if maternal thyroid function test abnormalities and thyroid autoimmunity are risk factors for preterm birth. Data Sources and Study Selection: Studies were identified through a search of the Ovid MEDLINE, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, and Google Scholar databases from inception to March 18, 2018, and by publishing open invitations in relevant journals. Data sets from published and unpublished prospective cohort studies with data on thyroid function tests (thyrotropin [often referred to as thyroid-stimulating hormone or TSH] and free thyroxine [FT4] concentrations) or thyroid peroxidase (TPO) antibody measurements and gestational age at birth were screened for eligibility by 2 independent reviewers. Studies in which participants received treatment based on abnormal thyroid function tests were excluded. Data Extraction and Synthesis: The primary authors provided individual participant data that were analyzed using mixed-effects models. Main Outcomes and Measures: The primary outcome was preterm birth (<37 weeks' gestational age). Results: From 2526 published reports, 35 cohorts were invited to participate. After the addition of 5 unpublished data sets, a total of 19 cohorts were included. The study population included 47 045 pregnant women (mean age, 29 years; median gestational age at blood sampling, 12.9 weeks), of whom 1234 (3.1%) had subclinical hypothyroidism (increased thyrotropin concentration with normal FT4 concentration), 904 (2.2%) had isolated hypothyroxinemia (decreased FT4 concentration with normal thyrotropin concentration), and 3043 (7.5%) were TPO antibody positive; 2357 (5.0%) had a preterm birth. The risk of preterm birth was higher for women with subclinical hypothyroidism than euthyroid women (6.1% vs 5.0%, respectively; absolute risk difference, 1.4% [95% CI, 0%-3.2%]; odds ratio [OR], 1.29 [95% CI, 1.01-1.64]). Among women with isolated hypothyroxinemia, the risk of preterm birth was 7.1% vs 5.0% in euthyroid women (absolute risk difference, 2.3% [95% CI, 0.6%-4.5%]; OR, 1.46 [95% CI, 1.12-1.90]). In continuous analyses, each 1-SD higher maternal thyrotropin concentration was associated with a higher risk of preterm birth (absolute risk difference, 0.2% [95% CI, 0%-0.4%] per 1 SD; OR, 1.04 [95% CI, 1.00-1.09] per 1 SD). Thyroid peroxidase antibody-positive women had a higher risk of preterm birth vs TPO antibody-negative women (6.6% vs 4.9%, respectively; absolute risk difference, 1.6% [95% CI, 0.7%-2.8%]; OR, 1.33 [95% CI, 1.15-1.56]). Conclusions and Relevance: Among pregnant women without overt thyroid disease, subclinical hypothyroidism, isolated hypothyroxinemia, and TPO antibody positivity were significantly associated with higher risk of preterm birth. These results provide insights toward optimizing clinical decision-making strategies that should consider the potential harms and benefits of screening programs and levothyroxine treatment during pregnancy.

Síndrome del uno y medio de Fisher a causa de un cavernoma bulbo-protuberancial / Fisher one-and-a-half syndrome due to a bulb protuberance cavernoma

El síndrome del uno y medio de Fisher está producido por una lesión unilateral en la parte dorsal e inferior de la protuberancia localizada específicamente en el tegmento pontino, área que contiene el fascículo longitudinal medial (FLM), la formación reticular paramediana pontina (FRPP) y el núcleo del VI par craneal, responsables de los movimientos horizontales de la mirada. Clínicamente se manifiesta con una parálisis conjugada de la mirada con oftalmoplejía internuclear ipsilateral. Se presenta el caso de una paciente de 60 años de edad que, tras presentar diplopía binocular, oftalmoplejía y parálisis de la mirada conjugada a la izquierda se realizaron estudios de imagen observándose un hematoma hemiprotuberancial secundario a un cavernoma. Tras conducta expectante presentó varios episodios de resangrados con empeoramiento clínico: cefalea, diplopía, tetraparesia e hipoestesia en hemicara derecha, por lo que ante tal evolución se planteó exéresis microquirúrgica del cavernoma protuberancial

The one and a half Fisher syndrome is produced by an unilateral lesion in the dorsal and inferior part of the pons located specifically in the pontine tegmentum. This is an area that contains the medial longitudinal fasciculus (LMF), the paramedian pontine reticular formation (PPRF) and the nucleus of the sixth cranial nerve, responsible for the horizontal movements of the gaze. Clinically it manifests with conjugate gaze palsy with internuclear ophthalmoplegia. The case is reported on a 60 year-old patient, who presented with binocular diplopia, ophthalmoplegia and paralysis of the gaze conjugated to the left. Imaging studies were performed that showed a hemi-protuberant haematoma secondary to a cavernoma. As expected, he presented with several episodes of re-bleeding with clinical worsening: headache, diplopia, tetraparesis, and hypoaesthesia in the right side of the face, as such that the microsurgical exeresis of the protuberant cavernoma was considered

Fisher one-and-a-half syndrome due to a bulb protuberance cavernoma. / Síndrome del uno y medio de Fisher a causa de un cavernoma bulbo-protuberancial.

The one and a half Fisher syndrome is produced by an unilateral lesion in the dorsal and inferior part of the pons located specifically in the pontine tegmentum. This is an area that contains the medial longitudinal fasciculus (LMF), the paramedian pontine reticular formation (PPRF) and the nucleus of the sixth cranial nerve, responsible for the horizontal movements of the gaze. Clinically it manifests with conjugate gaze palsy with internuclear ophthalmoplegia. The case is reported on a 60 year-old patient, who presented with binocular diplopia, ophthalmoplegia and paralysis of the gaze conjugated to the left. Imaging studies were performed that showed a hemi-protuberant haematoma secondary to a cavernoma. As expected, he presented with several episodes of re-bleeding with clinical worsening: headache, diplopia, tetraparesis, and hypoaesthesia in the right side of the face, as such that the microsurgical exeresis of the protuberant cavernoma was considered.

Purinergic receptors in multiple sclerosis pathogenesis.

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system, characterized by the presence of focal lesions in white and grey matter with peripheral immune cells infiltration. Purinergic receptors control immune cell function as well as neuronal and oligodendroglial survival, and the activation of astrocytes and microglia, the endogenous brain immune cells. In particular, ionotropic purinergic receptors P2X4 and P2X7 and metabotropic receptor P2Y12 are differently expressed along the disease and their activation or blockage modifies the course of texperimental autoimmune encephalomyelitis (EAE), the dominant animal model of MS. In this review, we will summarize emerging evidence of the role of these three receptor types as potential MS biomarkers and therapeutic targets.

Manganese levels in newborns' hair by maternal sociodemographic, dietary and environmental factors.

Exposure to manganese (Mn) has been associated with neurodevelopmental problems in children. Mn exposure begins in utero, and maternal sociodemographic, dietary and environmental factors may affect Mn levels in newborns' hair. This study aimed to characterize in utero Mn exposure using Mn levels in newborns' hair as a biomarker of prenatal exposure, and to analyze its relationship with sociodemographic, dietary and environmental factors in the Spanish INMA-Gipuzkoa cohort. Overall, 638 pregnant women were recruited in the first trimester of pregnancy and a hair sample was obtained from 473 newborns. Sociodemographic, dietary and environmental data were recorded through two questionnaires administered in the first and third trimesters of pregnancy. The median Mn concentration in newborns´ hair was 0.31 µg/g (P5 = 0.02; P95 = 1.23). Mn levels in newborns´ hair were associated with smoking during pregnancy (ß = 0.222; 95% CI = 0.065-0.379) and with maternal PM2.5 exposure (ß = 0.025; 95% CI = 0.004; 0.047), as well as with cereal and pasta intake in the first trimester of pregnancy (ß = 0.002; 95% CI = 0.0004; 0.003). In conclusion, fetal exposure to Mn was associated with smoking and exposure to atmospheric pollution during pregnancy.

La introducción de los rayos X en España. La ciencia médica y la sanidad naval rumbo al siglo XX / The Introduction of X-rays in Spain. Medical Science and Navy Health Heading to the 20th Century

OBJETIVO: Análisis del método de diagnóstico de los rayos X adoptado por el Cuerpo de Sanidad de la Armada en los últimos años del siglo XIX y de los apoyos científicos, legales e institucionales. MATERIAL Y MÉTODO: Memorias clínicas apuntando la necesidad de creación de gabinetes radiológicos en los hospitales de la marina; documentos rescatados de los fondos del Archivo General de la Marina (Viso del Marqués, Ciudad Real). Reglamentos, legislación y apoyos del gobierno. Estudios científicos con los pros y los contras de la técnica diagnóstica de la radiología naciente. RESULTADOS: Demanda y adopción de esta técnica y su aplicación a la asistencia sanitaria en el ámbito castrense y su extensión a la población civil. Primeros pasos de los rayos X en España. CONCLUSIÓN: Implantación de la radiología como método diagnóstico en los hospitales y en los barcos de la Armada, dentro del contexto de la ciencia en España a finales del siglo XIX y comienzos del XX

OBJECTIVE: Analysis of the X-ray diagnose method adopted by the Navy Health Corps in the last few years of the 19th century and its scientific, legal and institutional support. Material and METHOD: Clinic reports referring the need to create X-ray consulting rooms in Navy hospitals; documents retrieved from the General Navy Archive (Viso del Marqués, Ciudad Real), regulations, legislation and government support. Scientific research evaluating the advantages and disadvantages of the newly- born radio diagnosis technique. RESULTS: Demand and adoption of this technique, its medical use in the military realm, and its subsequent extension to civil population. First steps of X-rays in Spain. CONCLUSION: Implementation of radiology as a diagnosis method in Navy hospitals and ships within the context of Spanish science by the end of the 19th century and the beginning of the 20th

Espondilodiscitis por Clostridium perfringens / Spondylodiscitis due to Clostridium perfringens

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[Attitudes, perceptions and factors associated with influenza vaccination among primary healthcare professionals in Navarre, 2011-2012]. / Actitudes, percepciones y factores asociados a la vacunación antigripal en los profesionales de atención primaria de Navarra, 2011-2012.

BACKGROUND: The influenza vaccine is recommended for all healthcare workers to protect their own health and their patients. We aimed to describe the influenza vaccine coverage in primary healthcare professionals in the 2011-12 season in Navarre and to study the factors associated with this coverage. METHODS: An anonymous web-based survey was sent to primary healthcare professionals in 2012. The survey collected information on the influenza vaccination status for the four previous seasons, the attitudes towards and knowledge of the vaccine, and socio-demographic and professional data. RESULTS: Of 1,083 professionals, 381 (35%) completed the survey: 54.3% nurses, 35.7% general practitioners and 10% paediatricians. In the 2011-12 season, 56.2% had received the influenza vaccine, without significant changes compared to previous seasons. The vaccination in any previous season was the main predictive factor for current vaccination (odds ratio (OR): 20.87; confidence interval (CI) 95%: 8.98-48.48). The vaccine coverage was higher among those living with persons with risk factors for influenza (OR: 1.72; CI 95%: 1.05-2.84), those worried about becoming ill (OR: 4.59; CI 95%: 2.30-9.15), or infecting their patients (OR: 6.29; IC 95%: 3.02-13.13). Participation in training activities on influenza or vaccines was not significantly associated with influenza vaccination. CONCLUSIONS: Influenza vaccination coverage in primary healthcare professionals in Navarre is below desirable levels. A greater involvement of healthcare professionals is necessary in the influenza prevention strategy.

Actitudes, percepciones y factores asociados a la vacunación antigripal en los profesionales de atención primaria de Navarra, 2011-2012 / Attitudes, perceptions and factors associated with influenza vaccination among primary healthcare professionals in Navarre, 2011-2012

Fundamento. La vacuna de la gripe está indicada en los profesionales sanitarios para proteger su salud y la de sus pacientes. El objetivo fue describir la cobertura de vacunación antigripal en los profesionales de atención primaria durante la temporada 2011-12 en Navarra y estudiar los factores asociados a la vacunación. Material y métodos. Se envió una encuesta anónima vía web a los profesionales de atención primaria en 2012. La encuesta recogió información sobre el estado de vacunación antigripal de las últimas temporadas, sobre las actitudes y conocimientos de la vacuna y datos sociodemográficos y profesionales. Resultados. De 1.083 profesionales, 381 (35%) completaron la encuesta: 54,3% profesionales de enfermería, 35,7% médicos de familia y 10% pediatras. En la temporada 2011-12 se habían vacunado el 56,2%, sin cambios significativos con respecto a temporadas previas. El principal predictor de la vacunación fue el haberse vacunado en alguna temporada previa (odds ratio (OR): 20,87; intervalo de confianza (IC) 95%: 8,98-48,48).Se vacunaron más los que tenían personas con factores de riesgo en la familia (OR: 1,72; IC 95%: 1,05-2,84), los que estaban preocupados por enfermar (OR: 4,59; IC 95%: 2,30-9,15) y por contagiar a sus pacientes (OR: 6,29; IC 95%: 3,02-13,13).El haber participado en actividades formativas sobre gripe y vacunas no influyó en la decisión de vacunarse. Conclusiones. La cobertura de vacunación entre los profesionales sanitarios de atención primaria de Navarra está por debajo de los niveles deseables. Se debe mejorar la implicación de los profesionales en la estrategia de prevención de la gripe (AU)

Background. The influenza vaccine is recommended for all healthcare workers to protect their own health and their patients. We aimed to describe the influenza vaccine coverage in primary healthcare professionals in the 2011-12 season in Navarre and to study the factors associated with this coverage. Methods. An anonymous web-based survey was sent to primary healthcare professionals in 2012. The survey collected information on the influenza vaccination status for the four previous seasons, the attitudes towards and knowledge of the vaccine, and socio-demographic and professional data. Results. Of 1,083 professionals, 381 (35%) completed the survey: 54.3% nurses, 35.7% general practitioners and 10%paediatricians. In the 2011-12 season, 56.2% had received the influenza vaccine, without significant changes compared to previous seasons. The vaccination in any previous season was the main predictive factor for current vaccination (odds ratio (OR): 20.87; confidence interval (CI) 95%:8.98-48.48). The vaccine coverage was higher among those living with persons with risk factors for influenza (OR: 1.72; CI 95%: 1.05-2.84), those worried about becoming ill (OR: 4.59; CI 95%: 2.30-9.15), or infecting their patients (OR: 6.29; IC 95%: 3.02-13.13). Participation in training activities on influenza or vaccines was not significantly associated with influenza vaccination. Conclusions. Influenza vaccination coverage in primary healthcare professionals in Navarre is below desirable levels. A greater involvement of healthcare professionals is necessary in the influenza prevention strategy (AU)

An integrated view of data quality in Earth observation.

Data quality is a difficult notion to define precisely, and different communities have different views and understandings of the subject. This causes confusion, a lack of harmonization of data across communities and omission of vital quality information. For some existing data infrastructures, data quality standards cannot address the problem adequately and cannot fulfil all user needs or cover all concepts of data quality. In this study, we discuss some philosophical issues on data quality. We identify actual user needs on data quality, review existing standards and specifications on data quality, and propose an integrated model for data quality in the field of Earth observation (EO). We also propose a practical mechanism for applying the integrated quality information model to a large number of datasets through metadata inheritance. While our data quality management approach is in the domain of EO, we believe that the ideas and methodologies for data quality management can be applied to wider domains and disciplines to facilitate quality-enabled scientific research.

Poliquistosis renal complicada simulando una colecistitis aguda / Complicated polycistyc kidney disesase simulating an acute cholecystitis

La poliquistosis renal dominante del adulto, aunque es la enfermedad hereditaria más frecuente en la población española, presenta una prevalencia muy baja. Los síntomas iniciales son generalmente inespecíficos y difíciles de detectar por el médico. El método de elección para el diagnóstico de la enfermedad, cuando esta es asintomática, es la ecografía. Presentamos un caso clínico poco frecuente, en el cual el diagnóstico de poliquistosis renal complicada se realiza de forma incidental durante el estudio de un cuadro que simulaba una colecistitis aguda. Queremos resaltar la importancia que tienen una anamnesis detallada y metodológica en el diagnóstico precoz de esta enfermedad (AU)

Adult polycystic kidney disease, although it is the most common hereditary disease in the Spanish population, has very low prevalence. Initial symptoms are usually nonspecific and difficult to detect by the physician. The ultrasonography is the method of choice for diagnosing when the disease is asymptomatic. We report a rare clinical case in which complicated polycystic kidney disease was diagnosed by chance during the study of a simulated acute cholecystitis. We emphasize the importance of making a detailed and methodological medical history for the early diagnosis of this disease (AU)

Management of chylous fistula as a complication of neck dissection: a 10-year retrospective review.

Chylous fistula is a serious complication of neck surgery. The aim of this study was to analyse the incidence, treatment and evolution of chylous fistula in neck dissection. We conducted a retrospective study of 304 patients, 295 (97.03%) men and nine (2.97%) women. Ages ranged from 24 to 80 years (mean = 59.28 years, SD = 6.02) and they had all undergone neck dissection. Chylous fistula occurred in four cases (1.31%). Incidence was 1.83% in laryngeal cancer and 2.7% in oral cavity and oropharyngeal cancer. No statistically significant correlation was found between tumoral stage and fistula occurrence. Radiotherapy prior to surgery was a risk factor although the association was not statistically significant. The incidence rates for radical and functional neck dissection were 3.3% and 0.46%, respectively, statistically significant (P = 0.042). The fistulas were located on the left side in all cases. One of the four patients required surgical intervention and another one died. The occurrence of chylous fistula increased significantly the length of hospital stay (P = 0.01). Chylous fistulas appear on the left side, radiotherapy prior to surgery is a risk factor and there is not correlation with tumoral stage. Chylous fistulas are significantly more common in radical than in functional dissections and increase significantly the length of hospital stay.

[Varicella and herpes zoster incidence prior to the introduction of systematic child vaccination in Navarre, 2005-2006]. / Incidencia de la varicela y el herpes zóster antes de la introducción de la vacunación sistemática infantil en Navarra, 2005-2006.

Varicella is an acute and highly contagious disease produced by the varicella-zoster virus, which leaves lasting immunity. Herpes zoster is produced by reactivation of a latent infection of the same virus. The introduction of systematic and free vaccination against varicella in children of 15 months in Navarre from 2007 onwards can be expected to produce important epidemiological changes. For this reason we describe the previous epidemiological situation in the period from 2005 to 2006. We analysed all cases of varicella and herpes zoster registered in the electronic clinical files of primary care, in the database of hospital discharges and in the mortality register. Between 2005 and 2006, 9,908 cases of varicella were diagnosed (8.29 annually per 1,000 inhabitants), with 90% in children under 15 years old. There were 80 hospital admissions (8 for every 1,000 cases), complications in 2.5 out of every 1,000 cases, and there was one death due to this cause (0.1 per 1,000 cases). In the same period, 4,959 cases of herpes zoster were diagnosed (4.15 cases per 1,000 inhabitants), half in people over 55 years old. There were 179 hospital admissions (36 per 1,000 cases), whose average age was 77, and 83 presented complications (16.7 per 1,000 cases). This epidemiological pattern is similar to that found in other places before the introduction of the vaccine.

Neuropsychological functioning in adolescents with first episode psychosis: a two-year follow-up study.

Cognitive deficits are a core feature of psychotic disorders. Both in adult and adolescent populations, studies have shown that patients with psychosis have poorer cognitive functioning than controls. The cognitive domains that seem to be affected are mainly attention, working memory, learning and memory, and executive function. However, with regard to the trajectory of cognitive function throughout the illness, there is still a dearth of prospective data in patients who develop psychosis during adolescence. In this article, neuropsychological functioning was assessed in a sample of 24 first episodes of early onset psychosis (EOP) and 29 healthy adolescents at baseline and after a two-year follow-up. Patients with EOP showed lower scores than controls in overall cognitive functioning and in all specific domains assessed (attention, working memory, executive function, and learning and memory) both at baseline and the two-year follow-up. When changes in cognitive functioning over two years were assessed, patients and controls showed significant improvement in almost all cognitive domains. However, this improvement disappeared in the patient group after controlling for improvement in symptomatology. Our findings support a neurodevelopmental pathological process in this sample of adolescents with psychosis.