Feeding Behavior Modifies the Circadian Variation in RR and QT intervals by Distinct Mechanisms in Mice.

Rhythmic feeding behavior is critical for regulating phase and amplitude in the ¼24-hour variation of heart rate (RR intervals), ventricular repolarization (QT intervals), and core body temperature in mice. We hypothesized changes in cardiac electrophysiology associated with feeding behavior were secondary to changes in core body temperature. Telemetry was used to record electrocardiograms and core body temperature in mice during ad libitum-fed conditions and after inverting normal feeding behavior by restricting food access to the light cycle. Light cycle-restricted feeding modified the phase and amplitude of 24-hour rhythms in RR and QT intervals, and core body temperature to realign with the new feeding time. Changes in core body temperature alone could not account for changes in phase and amplitude in the ¼24-hour variation of the RR intervals. Heart rate variability analysis and inhibiting ß-adrenergic and muscarinic receptors suggested that changes in the phase and amplitude of 24-hour rhythms in RR intervals were secondary to changes in autonomic signaling. In contrast, changes in QT intervals closely mirrored changes in core body temperature. Studies at thermoneutrality confirmed that the daily variation in QT interval, but not RR interval, primarily reflected daily changes in core body temperature (even in ad libitum-fed conditions). Correcting the QT interval for differences in core body temperature helped unmask QT interval prolongation after starting light cycle-restricted feeding and in a mouse model of long QT syndrome. We conclude feeding behavior alters autonomic signaling and core body temperature to regulate phase and amplitude in RR and QT intervals, respectively.

Partículas en suspensión PM10, NO2 y agudizaciones de enfermedad respiratoria crónica / Particulate matter PM10, NO2 and exacerbations of chronic respiratory diseases

Objetivos Las nuevas directrices de la Organización Mundial de la Salud recomiendan estudios con exposición simultánea a varios contaminantes atmosféricos. El objetivo principal ha sido conocer la fuerza de la asociación entre diferentes concentraciones de PM10 y NO2 y la agudización de enfermedad respiratoria (AER), en concreto del asma y la enfermedad pulmonar obstructiva crónica. Material y métodos Estudio transversal retrospectivo. La población analizada estuvo compuesta por adultos atendidos en un SUAP en determinados días lag+1 de 2019, siendo los días posteriores a las fechas en las que se registran elevaciones de PM10 por encima del valor límite diario. Se han elaborado 3 índices (1: niveles elevados de PM10 y NO2; 2: nivel elevado de PM10 y nivel bajo de NO2, y 3: niveles bajos de PM10 y NO2) y un modelo de regresión logística para cada uno de ellos, con la AER como variable de resultado, y la adición progresiva de variables de ajuste (sexo, edad, tabaco, índice de Charlson, estación, precipitación, viento y temperatura). Resultado Se analizaron 461 personas, 17 con AER. Los modelos 1 y 2 presentaron valores muy similares en la OR ajustada (4,28 [IC95% 1,05-17]), R2 (0,88) y el área bajo la curva ROC (>0,72). En ambos se mantuvo la significación tras incluir las variables de ajuste, mientras que el modelo 3 solo permitió la precipitación. La inclusión del índice de Charlson y el consumo de tabaco en los 3 modelos suponía la pérdida de la significación de la combinación PM10/NO2 respecto a la AER. Conclusiones Los niveles elevados de PM10 presentan relación con la AER y tienen mayor impacto que el NO2, siendo el consumo de tabaco y las comorbilidades los principales precipitantes de las AER (AU)

Objectives The new World Health Organization guidelines recommend studies with simultaneous exposure to multiple air pollutants. The main objective has been to analyze the strength of the association between different concentrations of PM10 and NO2 and the exacerbation of chronic respiratory diseases (ECRD), specifically asthma and chronic obstructive pulmonary disease. Material and methods Retrospective cross-sectional study. The population analyzed were adults treated in an urgent and primary health care center on certain lag+1 days in 2019. Three indices have been developed (1: high levels of PM10 and NO2; 2: high level of PM10 and low level of NO2, and 3: low levels of PM10 and NO2) and a logistic regression model for each of them, with ECRD as the outcome variable, and the progressive addition of adjustment variables (sex, age, tobacco, Charlson index, season, precipitation, wind and temperature). Results Four hundred and sixty-one people were analyzed, 17 with ECRD. Models 1 and 2 presented very similar values in the adjusted OR (4.28 [95% CI 1.05–17]), R2 (0.88) and the area under the ROC curve (>0.72). In both of them the significance was maintained after including the adjustment variables, while model 3 only allowed the addition of precipitation. The inclusion of the Charlson index and the tobacco consumption in the 3 models implied the loss of statistical significance of the PM10/NO2 combination regarding ECRD. Conclusions High levels of PM10 are related to ECRD and have a greater impact than NO2, with tobacco use and comorbidities being the main precipitants of ECRD (AU)

Cell adhesion molecules E-cadherin and CADM1 are differently expressed in canine inflammatory mammary cancer.

Human inflammatory breast cancer (IBC) and canine inflammatory mammary cancer (IMC) are the most aggressive and lethal types of mammary tumors with specific characteristics such as exacerbated angiogenesis, lymphangiogenesis and lymphangiotropism. E-cadherin expression is another specific feature of IBC not previously studied in canine IMC. In this study, the expression of E-cadherin and CADM1 (Cell Adhesion molecule 1) and their possible role as key molecules involved in the pathogenesis of IMC were immunohistochemically analyzed in 19 canine IMC and 15 grade III non-IMC cases. E-cadherin and CADM1 expression was higher in IMC cases (p = 0.002, p = 0.008, respectively). In the IMC group, E-cadherin cytoplasmic immunolabeling was more frequent (p = 0.035) and it was associated to the expression of the angiogenic and lymphangiogenic factors COX-2 (p = 0.009), VEGF-A (p = 0.031) and VEGF-D (p = 0.008). The differential mRNA expression between IMC and non-IMC was studied by microarray analysis in 6 cases. E-cadherin gene (CDH1) was not up-regulated in IMC cases at a transcriptional level; interestingly CADM1 was 7-fold upregulated. The differential expression of E-cadherin protein in IMC suggests a possible role of E-cadherin in the characteristic exacerbated angiogenesis and lymphangiogenesis and further support IMC as a natural model for the study of human IBC. Future studies in IBC and IMC including a broad panel of adhesion molecules are necessary to elucidate their role in the metastatic process and angiogenesis.

[Particulate matter PM10, NO2 and exacerbations of chronic respiratory diseases]. / Partículas en suspensión PM10, NO2 y agudizaciones de enfermedad respiratoria crónica.

OBJECTIVES: The new World Health Organization guidelines recommend studies with simultaneous exposure to multiple air pollutants. The main objective has been to analyze the strength of the association between different concentrations of PM10 and NO2 and the exacerbation of chronic respiratory diseases (ECRD), specifically asthma and chronic obstructive pulmonary disease. MATERIAL AND METHODS: Retrospective cross-sectional study. The population analyzed were adults treated in an urgent and primary health care center on certain lag+1 days in 2019. Three indices have been developed (1: high levels of PM10 and NO2; 2: high level of PM10 and low level of NO2, and 3: low levels of PM10 and NO2) and a logistic regression model for each of them, with ECRD as the outcome variable, and the progressive addition of adjustment variables (sex, age, tobacco, Charlson index, season, precipitation, wind and temperature). RESULTS: Four hundred and sixty-one people were analyzed, 17 with ECRD. Models 1 and 2 presented very similar values in the adjusted OR (4.28 [95% CI 1.05-17]), R2 (0.88) and the area under the ROC curve (>0.72). In both of them the significance was maintained after including the adjustment variables, while model 3 only allowed the addition of precipitation. The inclusion of the Charlson index and the tobacco consumption in the 3 models implied the loss of statistical significance of the PM10/NO2 combination regarding ECRD. CONCLUSIONS: High levels of PM10 are related to ECRD and have a greater impact than NO2, with tobacco use and comorbidities being the main precipitants of ECRD.

Contour-Based Detection and Quantification of Tar Spot Stromata Using Red-Green-Blue (RGB) Imagery.

Quantifying symptoms of tar spot of corn has been conducted through visual-based estimations of the proportion of leaf area covered by the pathogenic structures generated by Phyllachora maydis (stromata). However, this traditional approach is costly in terms of time and labor, as well as prone to human subjectivity. An objective and accurate method, which is also time and labor-efficient, is of an urgent need for tar spot surveillance and high-throughput disease phenotyping. Here, we present the use of contour-based detection of fungal stromata to quantify disease intensity using Red-Green-Blue (RGB) images of tar spot-infected corn leaves. Image blocks (n = 1,130) generated by uniform partitioning the RGB images of leaves, were analyzed for their number of stromata by two independent, experienced human raters using ImageJ (visual estimates) and the experimental stromata contour detection algorithm (SCDA; digital measurements). Stromata count for each image block was then categorized into five classes and tested for the agreement of human raters and SCDA using Cohen's weighted kappa coefficient (κ). Adequate agreements of stromata counts were observed for each of the human raters to SCDA (κ = 0.83) and between the two human raters (κ = 0.95). Moreover, the SCDA was able to recognize "true stromata," but to a lesser extent than human raters (average median recall = 90.5%, precision = 89.7%, and Dice = 88.3%). Furthermore, we tracked tar spot development throughout six time points using SCDA and we obtained high agreement between area under the disease progress curve (AUDPC) shared by visual disease severity and SCDA. Our results indicate the potential utility of SCDA in quantifying stromata using RGB images, complementing the traditional human, visual-based disease severity estimations, and serve as a foundation in building an accurate, high-throughput pipeline for the scoring of tar spot symptoms.

Associations between sinus tachycardia and adverse cardiovascular outcomes and mortality in cancer patients.

BACKGROUND: Sinus tachycardia in cancer reflects a significant multi-system organ stressor and disease, with sparse literature describing its clinical significance. We assessed cardiovascular (CV) and mortality prognostic implications of sinus tachycardia in cancer patients. METHODS: We conducted a case-control study of 622 cancer patients at a U.S. urban medical center from 2008 to 2016. Cases had ECG-confirmed sinus tachycardia [heart rate (HR) ≥100 bpm] in ≥3 different clinic visits within 1 year of cancer diagnosis excluding a history of pulmonary embolism, thyroid dysfunction, left ventricular ejection fraction <50%, atrial fibrillation/flutter, HR >180 bpm. Adverse CV outcomes (ACVO) were heart failure with preserved ejection fraction (HFpEF), HF with reduced EF (HFrEF), hospital admissions for HF exacerbation (AHFE), acute coronary syndrome (ACS). Regression analyses were conducted to examine the effect of sinus tachycardia on overall ACVO and survival. RESULTS: There were 51 cases, age and sex-matched with 571 controls (mean age 70±10, 60.5% women, 76.4% Caucasian). In multivariate analysis over a 10-year follow-up period, sinus tachycardia (HR ≥100 vs. <100 bpm) was an independent predictor of overall ACVO (OR 2.8, 95% CI: 1.4-5.5; P=0.006). There was increased incidence of HFrEF (OR 3.3, 95% CI: 1.6-6.5; P=0.004) and AHFE (OR 6.3, 95% CI: 1.6-28; P=0.023), but not HFpEF or ACS (P>0.05) compared with controls. Sinus tachycardia was a significant predictor of overall mortality after adjusting for significant covariates (HR 2.9, 95% CI 1.8-5; P<0.001). CONCLUSIONS: Independent of typical factors that affect cardiovascular disease, sinus tachycardia around the time of cancer treatment is associated with increased ACVO and mortality in cancer patients at 10 years of follow-up.

Monitoring and Forecasting COVID-19: Heuristic Regression, Susceptible-Infected-Removed Model and, Spatial Stochastic.

The COVID-19 pandemic has had worldwide devastating effects on human lives, highlighting the need for tools to predict its development. The dynamics of such public-health threats can often be efficiently analyzed through simple models that help to make quantitative timely policy decisions. We benchmark a minimal version of a Susceptible-Infected-Removed model for infectious diseases (SIR) coupled with a simple least-squares Statistical Heuristic Regression (SHR) based on a lognormal distribution. We derive the three free parameters for both models in several cases and test them against the amount of data needed to bring accuracy in predictions. The SHR model is ≈ ±2% accurate about 20 days past the second inflexion point in the daily curve of cases, while the SIR model reaches a similar accuracy a fortnight before. All the analyzed cases assert the utility of SHR and SIR approximants as a valuable tool to forecast the disease's evolution. Finally, we have studied simulated stochastic individual-based SIR dynamics, which yields a detailed spatial and temporal view of the disease that cannot be given by SIR or SHR methods.

Zirconia aerogels for thermal management: Review of synthesis, processing, and properties information architecture.

Zirconia aerogels are porous nanomaterials with high specific surface areas and low thermal conductivities that are suitable for a wide range of functions. The applications of zirconia aerogels include numerous uses in thermal management systems that are specifically beneficial in aeronautics and aerospace systems. This review seeks to detail the synthesis, processing, and characterization of these unique materials. However, the many distinctive synthesis pathways and processing conditions of zirconia aerogels can make the optimization of these materials difficult, potentially inhibiting further development. Independent variables in the synthesis process alone include zirconium precursor, rare earth stabilizer, solvent system, gelation agent, and surfactant templating agent. If only two distinct options were available for each synthetic variable, there would be up to 32 different synthetic pathways; if there were three options for each variable, 243 different synthetic pathways would be possible. Apart from the gel synthesis, processing conditions, including drying method, drying temperature, drying solvent, and sintering temperature, as well as various techniques used to characterize aerogels, need to be considered. To mitigate the sheer volume of synthetic parameters, this review uses an architected information structure to contemplate approximately 600 aerogel materials, along with the synthesis and processing conditions that make each material unique. By utilizing this information structure, containing over 10,000 relationships amongst 3,800 nodes, the connection between specific properties of zirconia aerogels and the pathways used to produce them can be more easily visualized, leading to a more effective understanding of the many variables that are used in the synthesis and processing of these materials. This review seeks to utilize data science in a way that can elucidate structure-property relationships in colloidal chemistry, providing a more efficient way to evaluate the synthesis and processing of materials with high experimental dimensionality.

Effects of exogenous α-amylases, glucoamylases, and proteases on ruminal in vitro dry matter and starch digestibility, gas production, and volatile fatty acids of mature dent corn grain.

Two separate experiments were carried out to evaluate the effects of incremental doses of 10 exogenous endo-acting α-amylase and exo-acting glucoamylase; 1LAT (bacterial α-amylase), 2AK, 3AC, 4Cs4, 5Trga, 6Afuga, 7Fvga, and 10Tg (fungal α-amylases, glucoamylases, and α-glucosidase), 8Star and 9Syn (fungal amylase-mixtures; experiment 1) and three exogenous proteases; 11P14L, 12P7L, and 13P30L (bacterial proteases; experiment 2) on in vitro dry matter digestibility (IVDMD) and in vitro starch digestibility (IVSD) of mature dent corn grain using a batch culture system. Incremental doses of the exogenous enzymes (0, 0.25, 0.50, 0.75, and 1.00 mg/g of dried substrate) were applied directly to the substrate (0.5 g of ground corn, 4 mm) in sextuplicate (experiment 1) or quadruplicate (experiment 2) within F57 filter bags, which were incubated at 39 °C in buffered rumen fluid for 7 h. Rumen fluid was collected 2-3 h after the morning feeding from three lactating dairy cows and pooled. Cows were consuming a midlactation total mixed ration (TMR; 1.60 Mcal/kg DM and 15.4%; net energy of lactation and crude protein, respectively). Three independent runs were carried out for each experiment. Data were analyzed as a randomized complete block design using run as the blocking factor. Dose was used as a fixed factor while run was considered a random factor. Linear, quadratic, and cubic orthogonal contrasts were also tested. In experiment 1, enzymes 2AK, 3AC, and 10Tg did not increase (P > 0.10) IVDMD and IVSD, whereas 0.25 mg of enzymes 1LAT, 5Trga, and 8Star increased (P < 0.01) IVDMD by 23%, 47%, and 62% and IVSD by 35%, 41%, and 58%, respectively, compared with the control. Enzymes 4Cs4, 6Afuga, 7Fvga, and 9Syn linearly increased IVDMD and IVSD (P < 0.01). Greatest increases in IVDMD (82.9%) and IVSD (85.9%) resulted with 1 mg of 6Afuga compared to control. In experiment 2, the lowest dose of exogenous proteases 11P14L and 12P7L increased (P < 0.01) IVDMD by 98% and 87% and IVSD by 57% and 64%, respectively, whereas the highest dose of 13P30L increased (P = 0.02) IVDMD by 44.8% and IVSD by 30%, relative to the control. In conclusion, IVSD and IVDMD were increased by one α-amylase, certain glucoamylases, and all proteases tested, with the glucoamylase 6Afuga in experiment 1 and the neutral protease 12P7L in experiment 2, increasing IVDMD and IVSD to the greater extents. Future in vivo studies are required to validate these findings before these enzyme additives can be recommended for improving the digestibility of mature dent corn grain.

I know your face but can't remember your name: Age-related differences in the FNAME-12NL.

OBJECTIVE: The Face-Name Associative Memory test (FNAME) has recently received attention as a test for early diagnosis of Alzheimer's disease. So far, however, there has been no systematic investigation of the effects of aging. Here, we aimed to assess the extent to which the FNAME performance is modulated by normal ageing. METHOD: In a first step, we adapted the FNAME material to the Dutch population. In a second step, younger (n = 29) and older adults (n = 29) were compared on recall and recognition performance. RESULTS: Significant age effects on name recall were observed after the first exposure of new face-name pairs: younger adults remembered eight, whereas older adults remembered a mean of four out of twelve names. Although both age groups increased the number of recalled names with repeated face-name exposure, older adults did not catch up with the performance of the younger adults, and the age-effects remained stable. Despite of that, both age groups maintained their performance after a 30-min delay. Considering recognition, no age differences were demonstrated, and both age groups succeeded in the recognition of previously shown faces and names when presented along with distractors. CONCLUSIONS: This study presents for the first time the results of different age groups regarding cross-modal associative memory performance on the FNAME. The recall age effects support the hypothesis of age-related differences in associative memory. To use the FNAME as an early cognitive biomarker, further subscales are suggested to increase sensitivity and specificity in the clinical context.

Chemical equilibrium in AGB atmospheres: Successes, failures, and prospects for small molecules, clusters, and condensates.

Chemical equilibrium has proven extremely useful for predicting the chemical composition of AGB atmospheres. Here we use a recently developed code and an updated thermochemical database that includes gaseous and condensed species involving 34 elements to compute the chemical equilibrium composition of AGB atmospheres of M-, S-, and C-type stars. We include for the first time Ti x C y clusters, with x = 1-4 and y = 1-4, and selected larger clusters ranging up to Ti13C22, for which thermochemical data are obtained from quantum-chemical calculations. Our main aims are to systematically survey the main reservoirs of each element in AGB atmospheres, review the successes and failures of chemical equilibrium by comparing it with the latest observational data, identify potentially detectable molecules that have not yet been observed, and diagnose the most likely gas-phase precursors of dust and determine which clusters might act as building blocks of dust grains. We find that in general, chemical equilibrium reproduces the observed abundances of parent molecules in circumstellar envelopes of AGB stars well. There are, however, severe discrepancies of several orders of magnitude for some parent molecules that are observed to be anomalously overabundant with respect to the predictions of chemical equilibrium. These are HCN, CS, NH3, and SO2 in M-type stars, H2O and NH3 in S-type stars, and the hydrides H2O, NH3, SiH4, and PH3 in C-type stars. Several molecules have not yet been observed in AGB atmospheres but are predicted with non-negligible abundances and are good candidates for detection with observatories such as ALMA. The most interesting ones are SiC5, SiNH, SiCl, PS, HBO, and the metal-containing molecules MgS, CaS, CaOH, CaCl, CaF, ScO, ZrO, VO, FeS, CoH, and NiS. In agreement with previous studies, the first condensates predicted to appear in C-rich atmospheres are found to be carbon, TiC, and SiC, while Al2O3 is the first major condensate expected in O-rich outflows. According to our chemical equilibrium calculations, the gas-phase precursors of carbon dust are probably acetylene, atomic carbon, and/or C3, while for silicon carbide dust, the most likely precursors are the molecules SiC2 and Si2C. In the case of titanium carbide dust, atomic Ti is the major reservoir of this element in the inner regions of AGB atmospheres, and therefore it is probably the main supplier of titanium during the formation of TiC dust. However, chemical equilibrium predicts that large titanium-carbon clusters such as Ti8C12 and Ti13C22 become the major reservoirs of titanium at the expense of atomic Ti in the region where condensation of TiC is expected to occur. This suggests that the assembly of large Ti x C y clusters might be related to the formation of the first condensation nuclei of TiC. In the case of Al2O3 dust, chemical equilibrium indicates that atomic Al and the carriers of Al-O bonds AlOH, AlO, and Al2O are the most likely gas-phase precursors.

Geology of the InSight landing site on Mars.

The Interior Exploration using Seismic Investigations, Geodesy and Heat Transport (InSight) spacecraft landed successfully on Mars and imaged the surface to characterize the surficial geology. Here we report on the geology and subsurface structure of the landing site to aid in situ geophysical investigations. InSight landed in a degraded impact crater in Elysium Planitia on a smooth sandy, granule- and pebble-rich surface with few rocks. Superposed impact craters are common and eolian bedforms are sparse. During landing, pulsed retrorockets modified the surface to reveal a near surface stratigraphy of surficial dust, over thin unconsolidated sand, underlain by a variable thickness duricrust, with poorly sorted, unconsolidated sand with rocks beneath. Impact, eolian, and mass wasting processes have dominantly modified the surface. Surface observations are consistent with expectations made from remote sensing data prior to landing indicating a surface composed of an impact-fragmented regolith overlying basaltic lava flows.

[Executive function deficits and neurodevelopmental disorders in childhood and adolescence]. / Déficits ejecutivos y trastornos del neurodesarrollo en la infancia y en la adolescencia.

INTRODUCTION: Currently, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has new criteria that include a diagnostic reference to neurodevelopmental disorders. Neurodevelopmental disorders are diverse, and even though they are independent diagnostic entities they share common manifestations in people with brain damage or dysfunction of the prefrontal cortex; that is, neurodevelopmental disorders present different alterations in executive functions. DEVELOPMENT: The aim of the present study was to offer an overview of the recent findings on executive functioning in children, adolescents and young adults with different neurodevelopmental disorders: autistic spectrum disorder, attention-deficit/hyperactivity disorder and specific learning disorder. Hence, with this objective, 27 studies from the literature were reviewed. The results indicate a statistically significant association between the dimension of flexibility and attention deficit/hyperactivity disorder (W of Wilcoxon = 123.0; p = 0.011), and flexibility with autistic spectrum disorder (W of Wilcoxon = 101.5; p = 0.003); and absence of a statistically significant association between the different assessed dimensions and specific learning disorder. CONCLUSIONS: The dimensions of executive functioning are affected to a variable degree in different neurodevelopmental disorders. We can hypothesis that the dimensions that are affected in the different neurodevelopmental disorders can be characterized in terms of the existence of a continuum, and occasionally those dimensions are too complex to establish categorical limits when comparing different neurodevelopmental disorders.

TITLE: Déficits ejecutivos y trastornos del neurodesarrollo en la infancia y en la adolescencia.Introducción. Actualmente, en el Manual diagnóstico y estadístico de los trastornos mentales (DSM-5) se incluye una nueva categoría diagnóstica referida a trastornos del neurodesarrollo. Son diversos los trastornos del neurodesarrollo que, aun siendo entidades diagnósticas independientes, comparten manifestaciones comunes a las que presentan personas con daño cerebral o disfunción en la corteza prefrontal, es decir, presentan diferentes alteraciones de las funciones ejecutivas. Desarrollo. El propósito de este estudio es ofrecer una visión de los hallazgos actuales sobre el funcionamiento ejecutivo en niños y jóvenes con diferentes trastornos del neurodesarrollo: trastorno del espectro autista, trastorno por déficit de atención/hiperactividad y trastorno específico del aprendizaje. Con este objetivo se revisaron 27 artículos. Los resultados de los análisis indican una asociación estadísticamente significativa entre dimensión de flexibilidad y trastorno por déficit de atención/hiperactividad (W de Wilcoxon = 123; p = 0,011) y dimensión de flexibilidad y trastorno del espectro autista (W de Wilcoxon = 101,5; p = 0,003), y ausencia de asociación estadísticamente significativa entre las diferentes dimensiones evaluadas y trastorno específico del aprendizaje. Conclusiones. Las dimensiones ejecutivas se encuentran afectadas en los diferentes trastornos del neurodesarrollo en grado variable. Podemos hipotetizar la existencia de un continuo en las dimensiones que se encuentran afectadas en los diferentes trastornos del neurodesarrollo; en ocasiones, es complejo establecer límites categoriales cuando se comparan distintos trastornos.

GABAB receptors modulate morphine antinociception: Pharmacological and genetic approaches.

Previous studies in our laboratory showed an interaction between the GABAergic and opioid systems involved in the analgesic effect of baclofen (BAC). Furthermore, it is known that sex differences exist regarding various pharmacological responses of morphine (MOR) and they are related to an increased sensitivity to MOR effects in males. The aims of the present study were to evaluate the possible involvement of the GABAB receptors in the antinociceptive responses induced by MOR (1, 3 and 9 mg/kg, s.c.) administration using both pharmacological (BAC 2 mg/kg, i.p.; and 2-OH-saclofen, SAC 0.3 mg/kg, intra cisterna magna) and genetic approaches (GABAB1 knockout mice; GABAB1 KO) in mice of both sexes. In addition, we explored the alterations in c-Fos expression of different brain areas involved in the antinociceptive effect of MOR using both approaches. The pharmacological approach showed a higher dose-dependent antinociceptive effect of MOR in male mice compared to female mice. BAC and SAC pretreatment potentiated and attenuated the antinociceptive effect of MOR, respectively, in both sexes. The genetic approach revealed a dose-dependent antinociceptive effect of MOR in the wild type mice, but not in the GABAB1 KO mice and no sex differences were observed. Additionally, BAC and SAC pretreatment and the lack of GABAB1 subunit of the GABAB receptor prevented the changes observed in c-Fos expression in the cingulate cortex and nucleus accumbens of male mice. Our results suggest that the GABAB receptors are involved in the MOR antinociceptive effect of both male and female mice.

Intrachiasmatic craniopharyngioma: Assessment of visual outcome with optical coherence tomography after complete surgical removal.

BACKGROUND: Optic chiasm invasion by a craniopharyngioma (CP) is exceptional. Surgical treatment of intrachiasmatic CPs associates a high risk of chiasm injury, which should be properly addressed before surgery. CASE DESCRIPTION: We present a 46-year-old woman admitted to the hospital with low visual acuity (0.1 in the right eye and 0.5 in the left) and a severe defect in her visual fields, in addition to headaches, diabetes insipidus, and a long-term depressive disorder. Her visual deficit progressed from a right homonymous temporal inferior quadrantanopia to an almost complete loss of vision in both eyes that only spared the upper nasal quadrants. Brain MRI showed a rounded third ventricle tumor with a potbelly expansion of the optic chiasm, suggesting chiasm invasion by the tumor. Optical coherence tomography (OCT) showed the thinning of the retinal nerve fiber layer (RNFL) in the superior and temporal wedges of the right eye and in the temporal wedge of the left one. The tumor was completely removed by employing a frontotemporal craniotomy and a translamina terminalis approach. Histological analysis showed a squamous-papillary CP. Postoperatively, a significant worsening of the visual defect was evidenced on the perimetry, which was related to a marked RNFL atrophy measured with OCT, as compared to the preoperative study. The poor long-term visual outcome in this patient correlated well with the results of postoperative OCT. CONCLUSIONS: Preoperative analysis of retinal atrophy with optic coherence tomography allows a reliable assessment of the patient's visual outcome in CPs involving the optic chiasm.

Prevalence and Factors Associated With Fatigue in Patients With Inflammatory Bowel Disease: A Multicentre Study.

BACKGROUND AND AIMS: The aims of this study were to determine the prevalence of fatigue in patients with inflammatory bowel disease [IBD], to identify the factors associated with fatigue and its severity, to assess the impact of fatigue on quality of life [QoL], and to evaluate the relationship between fatigue and sleep disorders. METHODS: This was a prospective multicentre study conducted at 22 Spanish centres. Consecutive patients followed at IBD Units were included. Fatigue was evaluated with the Fatigue Severity Scale [FSS] and the Fatigue Impact Scale [FIS]. Quality of life and sleep quality were assessed using the IBD Questionnaire-Short Form [IBDQ-9] and the Pittsburgh Sleep Quality Index [PSQI], respectively. RESULTS: A total of 544 consecutive adult IBD patients were included [50% women, mean age 44 years, 61% Crohn's disease]. The prevalence of fatigue was 41% (95% confidence interval [CI] = 37-45%). The variables associated with an increased risk of fatigue were: anxiety [OR = 2.5, 95% CI = 1.6-3.7], depression [OR = 2.4, 95% CI = 1.4-3.8], presence of extraintestinal manifestations [EIMs] [OR = 1.7, 95% CI = 1.1-2.6], and treatment with systemic steroids [OR = 2.8, 95% CI = 1.4-5.7]. The presence of EIMs [regression coefficient, RC = 8.2, 95% CI = 2.3-14.2], anxiety [RC = 25.8, 95% CI = 20.0-31.5], depression [RC = 30.6, 95% CI = 24.3-37.0], and sleep disturbances [RC = 15.0, 95% CI = 9.3-20.8] were associated with severity of fatigue. Patients with fatigue had a significantly decreased IBDQ-9 score [p < 0.001]. CONCLUSIONS: The prevalence of fatigue in IBD patients is remarkably high and has a negative impact on QoL. Therapy with systemic steroids is associated with an increased risk of fatigue. The severity of fatigue is associated with anxiety, depression, sleep disorders, and the presence of EIMs. Fatigue was not associated with anaemia, disease activity or anti-TNF therapy.

[Model of executive functions based on factorial analyses in child and school populations: a meta-analysis]. / Modelo de funciones ejecutivas basado en analisis factoriales en poblacion infantil y escolar: metaanalisis.

INTRODUCTION: Executive functions are defined as a set of skills that are involved in various activities which are novel to the individual and which require a creative solution. It is not easy or straight forward to conceptualise or identify the factors that make up a population of young children. AIM: To analyse the components of executive function due to the clinical implications in different neurodevelopmental disorders in a population-based sample of young children. DEVELOPMENT: From the body of literature, 35 published papers that used different factor analysis approaches for factor extraction were reviewed. The probability of a study with three factors being undertaken in the stage between 0 to 12 years is 1.44 times higher than studies being undertaken with some focus on another structure. The probability of a study being undertaken that focuses on the Flexibility dimension in the stage between 0 to 12 years is 1.45 times higher than a study being undertaken that focuses on any other dimension. The association between the different structures and dimensions that are analysed with respect to age using the Kendall tau-b indicates a statistically significant association between: studies with three factors and age (tau = 0.29; p = 0.044) and flexibility with age (tau = 0.37; p = 0.012). CONCLUSIONS: The diversity of the obtained results can be attributed to, and is in line with, the plurality of theoretical conceptualisations, tests used and statistical analyzes carried out. It can be concluded that working memory, inhibition and flexibility are the executive processes most commonly found in the factorial models of executive control in young children and adolescents.

TITLE: Modelo de funciones ejecutivas basado en analisis factoriales en poblacion infantil y escolar: metaanalisis.Introduccion. Las funciones ejecutivas se definen como un conjunto de habilidades implicadas en diversas actividades que son novedosas para el individuo y que precisan una solucion creativa. No es facil su conceptualizacion ni la identificacion de los factores que las configuran en la poblacion infantil y escolar. Objetivo. Analizar la estructura y los componentes de la funcion ejecutiva en poblacion preescolar y escolar. Desarrollo. Se revisaron 35 articulos que utilizan diferentes enfoques de analisis factoriales para la extraccion de los factores. La probabilidad de ocurrencia de un estudio con tres factores en la etapa de 0 a 12 años es 1,44 veces superior a la de los estudios que se centran en otra estructura. La probabilidad de ocurrencia de un estudio que se centra en la dimension de flexibilidad en la etapa de 0 a 12 años es 1,45 veces superior a la presencia de un estudio que se centra en cualquier otra dimension. La asociacion entre las diferentes estructuras y dimensiones analizadas con la edad con tau-b de Kendall indica una asociacion estadisticamente significativa entre estudios con tres factores y edad (tau = 0,29; p = 0,044) y flexibilidad con la edad (tau = 0,37; p = 0,012). Conclusiones. La diversidad de resultados obtenidos puede atribuirse y esta en consonancia con la pluralidad de conceptualizaciones teoricas, pruebas empleadas y analisis estadisticos efectuados. Se puede concluir que actualizacion/memoria de trabajo, inhibicion y flexibilidad son los procesos ejecutivos mas comunmente encontrados en los modelos factoriales de control ejecutivo en niños de preescolar y escolar.

[Absenteeism and associated factors in scheduled visits to a Preventive Medicine outpatient clinic]. / Absentismo, y factores asociados, en las citas programadas de una consulta externa de Medicina Preventiva.

BACKGROUND: Patient absenteeism in outpatient clinics represents a significant obstacle to the cost-effectiveness of healthcare. The aim of this study was to assess the frequency of absence of patients and its associated factors in scheduled visits to a Preventive Medicine department. PATIENTS AND METHODS: The cross-sectional study was carried out in the Service of Preventive Medicine of the Lozano Blesa University Clinical Hospital of Zaragoza. It included all the visits scheduled from 3 January to 31 March 2017. For each visit, the date and time were registered, together with the type (first or consecutive appointments), age, gender, town of residence, country of birth, and underlying disease. The Chi-squared test was used to determine the association between the variables and making the visit, with a multiple logistic regression analysis being performed on the variables in which a significant association was found. RESULTS: Of the total of 582 appointments studied, the absenteeism rate was 12.5% (73 out of 582; 13.7% for first appointments and 11.7% for consecutive appointments). Variables that revealed a significant association with patients not attending were: time (9.00-11:15 a. m.; OR=1.84; 95%CI: 1.10-3.08), day of the week (Mondays-Thursdays; OR=3.19; 95%CI: 1.12-9.07), country of birth (outside of Spain; OR=2.09; 95%CI:1.09-3.99), vaccination group (chronic kidney disease during pre-dialysis or dialysis; OR=3.59; 95%CI: 1.57-8.18), and age group (under 52 years old; OR=1.85; 95%CI: 1.08-3.19). CONCLUSIONS: The rate of absenteeism is at an intermediate position compared to the outpatient visits for other departments. The detection of associated factors makes it possible to plan specific measures for improvements that may reduce absences.