Retinoic acid related orphan receptor α is a genetic modifier that rescues retinal degeneration in a mouse model of Stargardt disease and Dry AMD.

Degeneration of the macula is associated with several overlapping diseases including age-related macular degeneration (AMD) and Stargardt Disease (STGD). Mutations in ATP Binding Cassette Subfamily A Member 4 (ABCA4) are associated with late-onset dry AMD and early-onset STGD. Additionally, both forms of macular degeneration exhibit deposition of subretinal material and photoreceptor degeneration. Retinoic acid related orphan receptor α (RORA) regulates the AMD inflammation pathway that includes ABCA4, CD59, C3 and C5. In this translational study, we examined the efficacy of RORA at attenuating retinal degeneration and improving the inflammatory response in Abca4 knockout (Abca4-/-) mice. AAV5-hRORA-treated mice showed reduced deposits, restored CD59 expression and attenuated amyloid precursor protein (APP) expression compared with untreated eyes. This molecular rescue correlated with statistically significant improvement in photoreceptor function. This is the first study evaluating the impact of RORA modifier gene therapy on rescuing retinal degeneration. Our studies demonstrate efficacy of RORA in improving STGD and dry AMD-like disease.

La enseñanza de la Radiología en otros estudios universitarios / The teaching of Radiology in other university studies

Tras la implantación del Espacio Europeo de Formación Superior, los contenidos del Área de Radiología y Medicina Física que se impartían tradicionalmente en la Licenciatura de Medicina se han incorporado también a los nuevos grados de Odontología, Enfermería, Fisioterapia, Podología y, en menor medida, Farmacia, Terapia Ocupacional, Logopedia, e Ingeniería Biomédica. En su conjunto, los conceptos básicos de radiología y protección radiológica se imparten en Murcia en 5 grados diferentes con un total de 52,5 créditos ECTS, participando en la formación de 1219 alumnos cada curso académico. Esta incorporación en los nuevos grados ha triplicado el número de asignaturas en las que se imparte docencia pregrado, y duplicado tanto el número de créditos ECTS como el número de alumnos de pregrado a los que dirige su labor de formación. Así, ante la posible creación de nuevos grados universitarios en un futuro próximo (Imagen para el Diagnóstico y Técnico en Radioterapia) sería necesaria la implicación de un mayor número de profesionales acreditados, de diferentes especialidades, y que optimicen los recursos docentes (bibliografía, material docente, casos clínicos, etc.) para su utilidad en las diferentes asignaturas que comparten contenidos similares.(AU)

After the implementation of the European Space for Higher Education, the contents of the Radiology and Physical Medicine Area that were taught in the Medicine Degree have also been incorporated into the new degrees of Dentistry, Nursing, Physiotherapy, Podiatry, and, to a lesser extent, Pharmacy, Occupational Therapy, Logopedia, and Biomedical Engineering As a whole, the basic concepts of radiology and radiological protection are taught in Murcia in 5 different degrees with a total of 52.5 ECTS credits, participating in the training of 1,219 students each academic year. This incorporation in the new degrees has tripled the number of subjects in which undergraduate teaching is taught, and doubled both the number of ECTS credits and the number of undergraduate students to whom it directs its training work. Thus, given the possible creation of new university degrees in the near future (Diagnostic Imaging and Radiotherapy Technicians), it would be necessary to involve a greater number of accredited professionals, from different specialties, and to optimize teaching resources (bibliography, material teacher, clinical cases, etc.) for its usefulness in the different subjects that share similar contents.(AU)

The teaching of Radiology in other university studies.

After the implementation of the European Space for Higher Education, the contents of the Radiology and Physical Medicine Area that were taught in the Medicine Degree have also been incorporated into the new degrees of Dentistry, Nursing, Physiotherapy, Podiatry, and, to a lesser extent, Pharmacy, Occupational Therapy, Logopedia, and Biomedical Engineering As a whole, the basic concepts of radiology and radiological protection are taught in Murcia in 5 different degrees with a total of 52.5 ECTS credits, participating in the training of 1219 students each academic year. This incorporation in the new degrees has tripled the number of subjects in which undergraduate teaching is taught, and doubled both the number of ECTS credits and the number of undergraduate students to whom it directs its training work. Thus, given the possible creation of new university degrees in the near future (Diagnostic Imaging and Radiotherapy Technicians), it would be necessary to involve a greater number of accredited professionals, from different specialties, and to optimize teaching resources (bibliography, material teacher, clinical cases, etc.,) for its usefulness in the different subjects that share similar contents.

Occurrence, source estimation, and risk assessment of Polycyclic Aromatic Hydrocarbons in coastal seawaters from the Quintero Industrial Complex (Valparaíso, Chile).

In the 1960s, the Quintero industrial complex was inaugurated in Chile. This began a history of dramatic anthropogenic impacts on the Chilean coast. Among the known, we could mention high atmospheric emissions of chemicals due to combustion processes and frequent oil spills. For this reason, we surveyed the concentrations of fifteen EPAPAHs in the surface coastal waters of the Quintero Bay area in 2015. The levels found are in the range of the highest levels when reviewing the literature (0.97 µg L-1 up to 9.84 µg L-1). The highest levels were found in the vicinity of the industrial complex and decreased in the other two zones. The concentration of individual compounds significantly exceeds the levels recommended by the EPA (Environmental Protection Agency) and the EU water framework directive (WFD). The risk estimations revealed that PAH concentrations represent high-risk for wildlife. Molecular ratios of PAHs were used to identify the possible sources, being these were mainly of pyrogenic origin, agreeing with an origin in the combustion of wood, coal, grass, and fossil fuels. This study contributes to the first data for surface water in a country's highly impacted industrial coastal area.

Does global warming threaten small-scale bivalve fisheries in NW Spain?

Shellfisheries of the intertidal and shallow subtidal infaunal bivalves Ruditapes decussatus, Ruditapes philippinarum, Venerupis corrugata and Cerastoderma edule are of great socio-economic importance (in terms of landings) in Europe, specifically in the Galician Rías Baixas (NW Spain). However, ocean warming may threaten these fisheries by modifying the geographic distribution of the species and thus affecting productive areas. The present study analysed the impact of rising ocean temperature on the geographical distribution of the thermal comfort areas of these bivalves throughout the 21st century. The Delft3D model was used to downscale climate data from CORDEX and CMIP5 and was run for July and August in three future periods (2025-2049, 2050-2074 and 2075-2099) under the RCP8.5 scenario. The areas with optimal temperature conditions for shellfish harvesting located in the middle and outer parts of the rias may increase in the near future for R. decussatus, V. corrugata and C. edule and decrease in the far future for R. philippinarum. Moreover, shellfish beds located in the shallower areas of the inner parts of the Rías Baixas could be affected by increased water temperature, reducing the productive areas of the four species by the end of the century. The projected changes in thermal condition will probably lead to changes in shellfish harvesting modality (on foot or aboard vessels) with further socio-economic consequences.

Global Forum of Cancer Surgeons: Cancer Surgery During the COVID-19 Pandemic: Impact and Lessons Learned.

BACKGROUND: The purpose of this article is to summarize the opinions of the surgical oncology leaders from the Global Forum of Cancer Surgeons (GFCS) about the global impact of COVID-19 pandemic on cancer surgery. METHODS: A panel session (virtual) was held at the annual Society of Surgical Oncology 2021 International Conference on Surgical Cancer Care to address the impact of COVID-19 on cancer surgery globally. Following the virtual meeting, a questionnaire was sent to all the leaders to gather additional opinions. The input obtained from all the leaders was collated and analyzed to understand how cancer surgeons from across the world adapted in real-time to the impact of COVID-19 pandemic. RESULTS: The surgical oncology leaders noted that the COVID-19 pandemic led to severe disruptions in surgical cancer care across all domains of clinical care, education, and research. Several new changes/protocols associated with increased costs were implemented to deliver safe care. Leaders also noted that preexisting disparities in care were exacerbated, and the pandemic had a detrimental effect on well-being and financial status. CONCLUSIONS: The COVID-19 pandemic has led to severe disruptions in surgical cancer care globally. Leaders of the GFCS opined that new strategies need to be implemented to prepare for any future catastrophic events based on the lessons learned from the current events. The GFCS will embark on developing such a roadmap to ensure that surgical cancer care is preserved in the future regardless of any catastrophic global events.

Linking Genes to Traits in Fungi.

Fungi are mediators of the nitrogen and carbon cycles in terrestrial ecosystems. Examining how nitrogen uptake and organic matter decomposition potential differs in fungi can provide insight into the underlying mechanisms driving fungal ecological processes and ecosystem functioning. In this study, we assessed the frequency of genes encoding for specific enzymes that facilitate nitrogen uptake and organic matter decomposition in 879 fungal genomes with fungal taxa grouped into trait-based categories. Our linked gene-trait data approach revealed that gene frequencies vary across and within trait-based groups and that trait-based categories differ in trait space. We present two examples of how this linked gene-trait approach can be used to address ecological questions. First, we show that this type of approach can help us better understand, and potentially predict, how fungi will respond to environmental stress. Specifically, we found that trait-based categories with high nitrogen uptake gene frequency increased in relative abundance when exposed to high soil nitrogen enrichment. Second, by comparing frequencies of nitrogen uptake and organic matter decomposition genes, we found that most ectomycorrhizal fungi in our dataset have similar gene frequencies to brown rot fungi. This demonstrates that gene-trait data approaches can shed light on potential evolutionary trajectories of life history traits in fungi. We present a framework for exploring nitrogen uptake and organic matter decomposition gene frequencies in fungal trait-based groups and provide two concise examples on how to use our framework to address ecological questions from a mechanistic perspective.

[Impact of the use of rings and nail polish on hand hygiene quality in healthcare workers]. / Impacto del uso de anillos y uñas esmaltadas en la calidad de la higiene de manos en el personal de salud.

BACKGROUND: Health-care-associated infections are a frequent problem in hospital environments. Hand hygiene is the most effective measure to prevent outbreaks. The use of certain accessories could decrease its effectiveness, facilitating horizontal transmission of pathogens. OBJECTIVE: Analyze the evidence that assess the impact of the use of rings and nail polish on hand hygiene quality in healthcare workers. METHODS: Non-systematic search in PUBMED/MEDLINE database (1978-2018) of studies in which the quality of hand hygiene or surgical washing is measured, using quantitative cultures or fluorescent stains. RESULTS: Wearing rings: 13 studies met the inclusion criteria. Seven were carried out in general wards. In all of them the use of rings was associated with lower quality of hand hygiene (the majority of low quality). Contrarily, in 3 of 4 primary studies carried out in the operating rooms (of low quality), their use did not affect the quality of surgical washing. Similarly, two systematic reviews obtained similar conclusions. Nail polish: 7 of 54 studies met the inclusion criteria. In four of them there were discordant results (the majority of low quality). One RCT showed a reduction in the quality of surgical washing only when the nail polish was damaged. Gel nail polish was associated with lower quality in two experimental studies. CONCLUSIONS: There is insufficient evidence to associate the use of these accessories with the reduction in the quality of hand hygiene. Its safety was not proven neither. Based on the available evidence (the majority of low quality), a negative impact of the use of rings in clinical units and also of damaged nail polish in operating rooms was observed. Better quality studies are required to address these relevant issues.

Impacto del uso de anillos y uñas esmaltadas en la calidad de la higiene de manos en el personal de salud / Impact of the use of rings and nail polish on hand hygiene quality in healthcare workers

Resumen Introducción: Las infecciones asociadas a la atención de salud son un problema frecuente en el ambiente hospitalario. La higiene de manos es la medida más efectiva para su prevención. El uso de ciertos accesorios en las manos podría disminuir su efectividad y favorecer la transmisión horizontal de agentes infecciosos. Objetivo: Revisar los estudios publicados que evalúan el impacto del uso de anillos y uñas esmaltadas en la calidad de la higiene de manos en trabajadores de la salud. Métodos: Búsqueda no sistemática en base de datos PUBMED/MEDLINE (1978-2018) de estudios en los cuales se mide la calidad de la higiene de manos o lavado quirúrgico, mediante cultivos cuantitativos o tinciones fluorescentes. Resultados: Uso de anillos: Trece de 51 artículos cumplían los criterios de inclusión. Siete fueron realizados en unidades clínicas, y en todos ellos éste se asoció a menor calidad de la higiene de manos (la mayoría de baja calidad). Contrariamente, en tres de cuatro estudios primarios realizados en pabellón (de baja calidad), su uso no impactó en la calidad del lavado quirúrgico. Igualmente, dos revisiones sistemáticas obtuvieron similares conclusiones. Uñas esmaltadas: siete de 54 artículos fueron incluidos. En cuatro hubo resultados discordantes (la mayoría de baja calidad). En un estudio controlado se observó reducción en la calidad del lavado quirúrgico sólo cuando el esmalte estaba dañado. El esmalte gel se asoció a menor calidad de la higiene de manos en dos estudios experimentales. Conclusiones: No existe evidencia de calidad suficiente para asociar el uso de estos accesorios con reducción en la calidad de la higiene de manos. Tampoco queda demostrada su inocuidad. En base a la evidencia disponible (la mayoría de baja calidad), se observó un impacto negativo del uso de anillos en unidades clínicas y también de uñas con esmalte dañado en pabellones quirúrgicos. Se requieren estudios de mejor calidad para abordar estos relevantes tópicos.

Abstract Background: Health-care-associated infections are a frequent problem in hospital environments. Hand hygiene is the most effective measure to prevent outbreaks. The use of certain accessories could decrease its effectiveness, facilitating horizontal transmission of pathogens. Objective: Analyze the evidence that assess the impact of the use of rings and nail polish on hand hygiene quality in healthcare workers. Methods: Non-systematic search in PUBMED/MEDLINE database (1978-2018) of studies in which the quality of hand hygiene or surgical washing is measured, using quantitative cultures or fluorescent stains. Results: Wearing rings: 13 studies met the inclusion criteria. Seven were carried out in general wards. In all of them the use of rings was associated with lower quality of hand hygiene (the majority of low quality). Contrarily, in 3 of 4 primary studies carried out in the operating rooms (of low quality), their use did not affect the quality of surgical washing. Similarly, two systematic reviews obtained similar conclusions. Nail polish: 7 of 54 studies met the inclusion criteria. In four of them there were discordant results (the majority of low quality). One RCT showed a reduction in the quality of surgical washing only when the nail polish was damaged. Gel nail polish was associated with lower quality in two experimental studies. Conclusions: There is insufficient evidence to associate the use of these accessories with the reduction in the quality of hand hygiene. Its safety was not proven neither. Based on the available evidence (the majority of low quality), a negative impact of the use of rings in clinical units and also of damaged nail polish in operating rooms was observed. Better quality studies are required to address these relevant issues.

Effect of triploidy on digestive enzyme activity of early stages of turbot (Scophthalmus maximus).

In the present work, growth and digestive enzyme activities of total acid and alkaline proteases, pepsin, trypsin, lipase, and α-amylase, as well as partial characterization of enzyme activity, were studied in diploid and triploid turbot. Growth was similar between both groups. Acid protease activity increased consistently during the experiment, for both diploid (2n) and triploid (3n) fish. The alkaline protease activity was always higher for triploids throughout the experiment. Proteolytic acid activity (pH 2) was generally higher for diploids, at all temperatures tested. Higher activity was at pH 2 and 3 for 2n and 3n fish, respectively. Regarding temperature, acid and alkaline protease activity was higher at 37 °C and 60 °C, respectively, for both groups. The general increase in pancreatic enzymes (trypsin and amylase) before 35 days after hatching (DAH) and posterior decrease until 60 DAH. There was a marked effect on enzyme activity when changing from live prey to pellets (35 DAH), especially on triploids.

mTORC1 Prevents Epithelial Damage During Inflammation and Inhibits Colitis-Associated Colorectal Cancer Development.

Epithelial cells lining the intestinal mucosa constitute a selective-semipermeable barrier acting as first line of defense in the organism. The number of those cells remains constant during physiological conditions, but disruption of epithelial cell homeostasis has been observed in several pathologies. During colitis, epithelial cell proliferation decreases and cell death augments. The mechanism responsible for these changes remains unknown. Here, we show that the pro-inflammatory cytokine IFNγ contributes to the inhibition of epithelial cell proliferation in intestinal epithelial cells (IECs) by inducing the activation of mTORC1. Activation of mTORC1 in response to IFNγ was detected in IECs present along the crypt axis and in colonic macrophages. mTORC1 inhibition enhances cell proliferation, increases DNA damage in IEC. In macrophages, mTORC1 inhibition strongly reduces the expression of pro-inflammatory markers. As a consequence, mTORC1 inhibition exacerbated disease activity, increased mucosal damage, enhanced ulceration, augmented cell infiltration, decreased survival and stimulated tumor formation in a model of colorectal cancer CRC associated to colitis. Thus, our findings suggest that mTORC1 signaling downstream of IFNγ prevents epithelial DNA damage and cancer development during colitis.

Segmentation Method for Magnetic Resonance-Guided High-Intensity Focused Ultrasound Therapy Planning.

High-intensity focused ultrasound (HIFU) is a minimally invasive therapy modality in which ultrasound beams are concentrated at a focal region, producing a rise of temperature and selective ablation within the focal volume and leaving surrounding tissues intact. HIFU has been proposed for the safe ablation of both malignant and benign tissues and as an agent for drug delivery. Magnetic resonance imaging (MRI) has been proposed as guidance and monitoring method for the therapy. The identification of regions of interest is a crucial procedure in HIFU therapy planning. This procedure is performed in the MR images. The purpose of the present research work is to implement a time-efficient and functional segmentation scheme, based on the watershed segmentation algorithm, for the MR images used for the HIFU therapy planning. The achievement of a segmentation process with functional results is feasible, but preliminary image processing steps are required in order to define the markers for the segmentation algorithm. Moreover, the segmentation scheme is applied in parallel to an MR image data set through the use of a thread pool, achieving a near real-time execution and making a contribution to solve the time-consuming problem of the HIFU therapy planning.

Multimodal Regulation Orchestrates Normal and Complex Disease States in the Retina.

Regulation of biological processes occurs through complex, synergistic mechanisms. In this study, we discovered the synergistic orchestration of multiple mechanisms regulating the normal and diseased state (age related macular degeneration, AMD) in the retina. We uncovered gene networks with overlapping feedback loops that are modulated by nuclear hormone receptors (NHR), miRNAs, and epigenetic factors. We utilized a comprehensive filtering and pathway analysis strategy comparing miRNA and microarray data between three mouse models and human donor eyes (normal and AMD). The mouse models lack key NHRS (Nr2e3, RORA) or epigenetic (Ezh2) factors. Fifty-four total miRNAs were differentially expressed, potentially targeting over 150 genes in 18 major representative networks including angiogenesis, metabolism, and immunity. We identified sixty-eight genes and 5 miRNAS directly regulated by NR2E3 and/or RORA. After a comprehensive analysis, we discovered multimodal regulation by miRNA, NHRs, and epigenetic factors of three miRNAs (miR-466, miR1187, and miR-710) and two genes (Ell2 and Entpd1) that are also associated with AMD. These studies provide insight into the complex, dynamic modulation of gene networks as well as their impact on human disease, and provide novel data for the development of innovative and more effective therapeutics.

¿Conoce cuál es su riesgo de tener diabetes? / Do you know your risk of having diabetes?

La diabetes mellitus tipo 2 (DM2) es una enfermedad silenciosa que afecta hasta el 20% de nuestra población y de ella, hasta el 50% desconoce que la padece. Esta enfermedad se asocia a una alta prevalencia sobre factores de riesgo como el sobrepeso, la obesidad y la inactividad física. Con frecuencia, la DM2 se diagnostica en forma tardía y a veces genera diversas complicaciones asociadas que podrían evitarse

Etiología y perfil de resistencia antimicrobiana en infecciones del pie diabético / Etiology and antimicrobial resistance profile in diabetic foot infections

El pie diabético infectado (PDI) es aquel que presenta infección de piel y partes blandas u óseas por debajo del maléolo; constituye la complicación más frecuente de diabetes que causa hospitalización y amputación. En nuestro hospital los pacientes con pie diabético son asistidos en un consultorio multidisciplinario; el 40% presenta infección leve moderada o grave

Frecuencia de reflujo gastroesofágico ácido en pacientes menores de 2 años con displasia broncopulmonar en el Hospital Infantil de México / Acid gastroesophageal reflux frequency in patients under two years with bronchopulmonary dysplasia at Hospital Infantil de México Federico Gómez

Introducción: La displasia broncopulmonar (DBP) es la enfermedad pulmonar crónica más frecuente que se inicia en la etapa neonatal y afecta a múltiples sistemas. La enfermedad por reflujo gastroesofágico (ERGE) es la patología gastrointestinal más asociada a la DBP. El objetivo del estudio fue establecer la frecuencia de ERGE en lactantes con DBP. Metodología: Estudio observacional, descriptivo y de correlación, con un muestreo no probabilístico. Se incluyeron lactantes con DBP que acudieron a la consulta externa de neumología del Hospital Infantil de México «Federico Gómez». Participaron en el estudio los pacientes que cumplieron con los criterios de selección. Se realizó a los pacientes una pH-metría esofágica, y se registraron los signos y síntomas que presentaron según la hora en que ocurrieron. Resultados: Se incluyeron 20 pacientes, con una mediana de edad de 7,5 meses. El 50% de los pacientes tenía una DBP grave. El síntoma respiratorio sugerente de ERGE más frecuente fue la tos. Se obtuvo una incidencia de ERGE del 40%. Sólo 1 paciente presentó un índice de reflujo patológico, pero el 40% presentó una probabilidad de asociación de síntomas (PAS) para tos mayor del 95%. Todos los pacientes con una puntuación de Euler patológica presentaron una PAS positiva para la tos. No hubo una correlación significativa entre el grado de gravedad de la DBP y el diagnóstico de ERGE (R2= 0,157; p= 0,508). Conclusión: La PAS se debe tener en cuenta como diagnóstico de ERGE en los pacientes con DBP. No hubo correlación entre la gravedad de DBP y ERGE, pero sí una buena correlación entre la positividad de PAS y el índice de Euler en los pacientes con DBP (AU)

Introduction: Bronchopulmonary displasia (BPD) is the most common chronic lung disease that begins in the neonatal period and affects multiple systems. Gastroesophageal reflux disease (GERD) is the gastrointestinal pathology most associated with BPD. The aim of the study was to establish the frequency of GERD in infants with BPD. Material and methods: Observational, descriptive study of correlation, non-probabilistic sampling. Infants with BPD who were attended in the Hospital Infantil de México «Federico Gómez» outpatient pulmonology were included. Those patients who met the selection criteria participated in the study. They underwent to esophageal pH monitoring, registering the signs and symptoms presented by the patient according to the time they occurred. Results: 20 patients were included, with a median age of 7.5 months. 50% of patients had severe BPD. The most common respiratory symptom of GERD suggestive was cough. The incidence of GERD was 40%. Only 1 patient had reflux index (IR) pathological but 40% presented a symptom association probability (SAP) for cough more than 95%. All patients with pathological Euler score showed positive SAP for cough. There was no significant correlation between the severity of DBP and diagnosis of GERD (R2= 0.157; p= 0.508). Conclusion: SAP should be take into account as a diagnosis of GERD in patients with BPD. There was no correlation between the severity of BPD and GERD. There is a good correlation between PAS positivity and Euler index in patients with BPD (AU)

Historia clínica como herramienta para mejora del proceso de atención / Clinical records as a tool for enhancing medical care

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