Impacto de la identificación de síntomas depresivos en un programa de rehabilitación cardiovascular / Impact of the identification of depressive symptoms in a cardiovascular rehabilitation program

Introducción. La evidencia muestra una relación bidireccional entre la depresión y la enfermedad coronaria. La identificación de síntomas depresivos en la consulta de rehabilitación cardiovascular (RCV) puede ser un indicador valioso. Materiales y métodos. Aquellos pacientes que presentaron síntomas depresivos (autorreportados) fueron remitidos al servicio de Salud Mental (SM), y posteriormente se compararon con un grupo de pacientes sin estos síntomas y se evaluó su impacto en variables cardiovasculares. Resultados. Se evaluaron 60 pacientes. Se observó una adherencia del 86,44% (n=51). 13 pacientes fueron remitidos al área de HM (edad media 67,08 años; DE 6,09). Hemos analizado el impacto que puede representar este trastorno, tanto en la recuperación física como en la percepción de calidad de vida. Conclusiones. Los efectos positivos de la derivación a MH complementan los beneficios de la RCV. La mejora emocional del individuo también favorece la adherencia y el cumplimiento del tratamiento rehabilitador

Introduction. Evidence shows a bidirectional relationship between depression and coronary heart disease. The identification of depressive symptoms in the cardiovascular rehabilitation (CVR) consultation can be a valuable indicator. Materials and methods. Those patients who presented depressive symptoms (self-reported) were referred to the Mental Health (MH) service, and were subsequently compared with a group of patients without these symptoms, and their impact on cardiovascular variables was evaluated. Results. 60 patients were evaluated. An adherence of 86.44% (n=51) was observed. 13 patients were referred to the MH area (mean age 67.08 years; SD 6.09). We have analyzed the impact that this disorder can represent, both on physical recovery and on the perception of quality of life. Conclusions. The positive effects of referral to MH complement the benefits of CVR. The individual's emotional improvement also favors adherence and compliance with rehabilitation treatment

Host space, not energy or symbiont size, constrains feather mite abundance across passerine bird species.

Comprehending symbiont abundance among host species is a major ecological endeavour, and the metabolic theory of ecology has been proposed to understand what constrains symbiont populations. We parameterized metabolic theory equations to investigate how bird species' body size and the body size of their feather mites relate to mite abundance according to four potential energy (uropygial gland size) and space constraints (wing area, total length of barbs and number of feather barbs). Predictions were compared with the empirical scaling of feather mite abundance across 106 passerine bird species (26,604 individual birds sampled), using phylogenetic modelling and quantile regression. Feather mite abundance was strongly constrained by host space (number of feather barbs) but not by energy. Moreover, feather mite species' body size was unrelated to the body size of their host species. We discuss the implications of our results for our understanding of the bird-feather mite system and for symbiont abundance in general.

Ultrasound assisted membrane-assisted solvent extraction for the simultaneous assessment of some drugs involved in drug-facilitated sexual assaults by liquid chromatography-tandem mass spectrometry.

A simple and highly efficient ultrasound assisted membrane-assisted solvent extraction (MASE) pre-treatment method for urine has been developed and validated for the simultaneous determination of twenty-two drugs involved in drug-facilitated sexual assaults (DFSAs) by liquid chromatography-tandem mass spectrometry. MASE was performed with 4.0 mL of urine (pH adjusted at 12), 400 µL of hexane as an organic solvent inside the polypropylene membrane, and ultrasonication (45 kHz, 120 W) for 10 min. A pre-concentration factor of 40 was achieved after evaporation (N2 stream) and re-dissolution in 100 µL of methanol. Analytes were separated using a Zorbax Eclipse Plus C18 column under gradient elution with aqueous 10 mM NH4HCO3 (pH 8.0) and methanol as mobile phases. Matrix-matched calibrations allowed the assessment of DFSA drugs of quite different octanol-water partition coefficients (Ko/w), from 1.32 101 for pregabalin to 2.45 105 for clomipramine (Log P values from 1.12 (pregabalin) to 5.39 (clomipramine)). The limit of detection (LOD) was between 0.0075 to 0.37 µg L-1, with analytical recoveries ranging from 73 to 103%, and relative standard deviations (RSDs) within the 2-20% range. The applicability of the method was demonstrated after analysing urine samples under forensic investigation.

The variability of juvenile dispersal in an opportunistic raptor.

The juvenile dispersal of raptors is a crucial stage that stretches from parental independence to the establishment of the first breeding area. Between 2012 and 2020, 44 juvenile red kites Milvus milvus from the Spanish breeding population were tagged using GPS telemetry to study their dispersal. Juveniles left the parental breeding area at the end of their first summer and performed wandering movements throughout the Iberian Peninsula, returning to the parental breeding area the following year, repeating the same pattern until they settled in their first breeding area. We analyzed the mean distance from the nest, the maximum reached distances, and the traveled distances (daily and hourly) during the first 2 years of dispersal and compared them. Despite the high individual variability, variables describing the dispersal movements of juveniles showed a decreasing trend during the second dispersal year: 80% of individuals reached a shorter maximum distance in the second year, 70% decreased their mean distance to the nest, 65% decreased their hourly traveled distances, and 50% decreased their daily traveled distances. On the other hand, the red kites usually combined wandering movements with the establishment of temporary settlement areas (TSA). The average duration of settlement in the TSAs was 75 ± 40 days (up to 182 days) and was located at 182 ± 168 km from the nest. In those areas, juveniles used 781.0 ± 1895.0 km2 (KDE 95%). Some of the TSAs were used by several individuals, which suggests that these areas might be good targets for conservation in future management plans.

Prognostic Value of Measurable Residual Disease in Patients with AML Undergoing HSCT: A Multicenter Study.

Allogeneic hematopoietic stem cell transplantation (HSCT) represents the best therapeutic option for many patients with acute myeloid leukemia (AML). However, relapse remains the main cause of mortality after transplantation. The detection of measurable residual disease (MRD) by multiparameter flow cytometry (MFC) in AML, before and after HSCT, has been described as a powerful predictor of outcome. Nevertheless, multicenter and standardized studies are lacking. A retrospective analysis was performed, including 295 AML patients undergoing HSCT in 4 centers that worked according to recommendations from the Euroflow consortium. Among patients in complete remission (CR), MRD levels prior to transplantation significantly influenced outcomes, with overall (OS) and leukemia free survival (LFS) at 2 years of 76.7% and 67.6% for MRD-negative patients, 68.5% and 49.7% for MRD-low patients (MRD < 0.1), and 50.5% and 36.6% for MRD-high patients (MRD ≥ 0.1) (p < 0.001), respectively. MRD level did influence the outcome, irrespective of the conditioning regimen. In our patient cohort, positive MRD on day +100 after transplantation was associated with an extremely poor prognosis, with a cumulative incidence of relapse of 93.3%. In conclusion, our multicenter study confirms the prognostic value of MRD performed in accordance with standardized recommendations.

Isolation and quantification of synthetic cannabinoid receptor agonists in human urine using membrane-assisted solvent extraction followed by liquid chromatography-tandem mass spectrometry.

The global market for new psychoactive substances (NPSs) continues to expand, and the range of drugs available on the market has probably never been wider. Synthetic cannabinoids (SCRAs) constitute the largest family of NPSs, and they go unnoticed during illicit drug market control and during routine toxicological-forensic analysis. Membrane-assisted solvent extraction (MASE) has been a novelty proposed for the simultaneous extraction of SCRAs, and urine has been selected as a model forensic-clinical sample. Isolated SCRAs were further determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS). An optimised sample pre-treatment procedure consists of using 400 µL of n-hexane as an extraction phase placed inside a polypropylene (PP) membrane, adjusting the donor phase (urine) at a pH value of 5.9. Extraction was assisted by mechanical (orbital-horizontal) stirring in a temperature-controlled chamber at room temperature for 20 min. n-Hexane extracts were evaporated to dryness and re-suspended in 100 µL of mobile phase, which leads to a pre-concentration factor of 50. Method validation showed analytical recoveries higher than 80% for most SCRAs and repeatability (inter-day and intra-day assays) with RSD values lower than 20%. The proposed method was found to be selective and sensitive and limits of quantification (LOQs) between 0.10 and 1.0 µg L-1 were achieved.

Striking Variability in the Post-Reproductive Movements of Spanish Red Kites (Milvus milvus): Three Strategies, Sex Differences, and Changes over Time.

It was assumed that the Spanish breeding population of the red kite (Milvus milvus) was resident, hence their movements were restricted to their breeding area for their entire lifecycle. However, recent observations indicated that the post-reproductive strategies of the red kite in Spain are more diverse. We tagged 47 breeding adult red kites in Spain and analyzed their movements during the post-reproductive period (July-February). We found three strategies in the population: migration (10%), sedentarism (70%), and sedentarism with post-reproductive movements (20%), based on seasonality and other movement parameters. Sedentarism with post-reproductive movements was a very variable strategy that involved all-direction wandering movements far away from the nest (up to 589 km) after breeding season, and then a returned journey toward the starting point in time for the next breeding season. Our results also suggest that sedentarism with post-reproductive movements is much more common in females than males. Furthermore, 17% of the individuals changed their strategy over the years. This study highlights the great individual variability and plasticity of the red kite and allows for a better understanding of spatial ecology in opportunistic raptors.

Apremilast and biologics: Characteristics of patients treated with apremilast before, during, or after a biological treatment.

Apremilast is an oral small molecule approved for the treatment of psoriasis, psoriatic arthritis and oral ulcers associated with Behçet's disease. This research was conducted to describe the characteristics of patients who received treatment with apremilast for a skin disorder, either before, during, or after a biological treatment, with the aim of analyze the reasons that lead to start this drug in real clinical practice or suspend it for another. A total of 41 patients were enrolled: nine (22.0%) had received biological treatment prior to apremilast, seven (17.0%) both before and after apremilast and 25 (61.0%) after apremilast. One patient received concomitant treatment with adalimumab and apremilast. Most patients (85.4%) received apremilast as treatment for psoriasis. Reasons for starting apremilast were lack of efficacy with previous treatments (85.4%) and adverse effects or contraindication to previous treatments (14.6%), without statistically significant differences between patients who had received a previous biologic and those who had not. Drug survival was not influenced by previous biological treatment, but we found an increased risk of drug discontinuation in patients with chronic kidney disease (log-rank p = 0.028). The main reason of apremilast withdrawal was lack of adequate disease control (60.0%), most of whom required treatment with biologics. Therefore, despite the extensive development of new therapies for psoriasis and other dermatological conditions, apremilast is a widely used drug even in patients who are candidates for biologic treatment. Its initiation is more frequent due to poor disease control than because of other therapies contraindications.

Phenotype Variability Mimicking as a Process for the Test and Optimization of Dynamic Facade Systems.

A genetic algorithm and an artificial neural network are deployed for the design of a dynamic multi-layered façade system that adapts in real-time to different weather and occupants' needs scenarios. The outputs are a set of different performances of the façade insulation cushions, optimized by the previous run of the genetic algorithm. A façade system of ETFE cushions is considered for them to learn from environmental data models. Each façade cushion is set up as an artificial neuron that is linked to the behavior and temperature of the others. The proposed outputs are a set of different performances of the façade system that are optimized through running the genetic algorithm. Façade neurons are configured as genes of the system that is abstractly represented on a digital model. The computational model manages cushion patterns' performances through several phenotypical adaptations, suggesting that the proposed facade system maximizes its thermal efficiency in different scenarios.

Barrier crossings and winds shape daily travel schedules and speeds of a flight generalist.

External factors such as geography and weather strongly affect bird migration influencing daily travel schedules and flight speeds. For strictly thermal-soaring migrants, weather explains most seasonal and regional differences in speed. Flight generalists, which alternate between soaring and flapping flight, are expected to be less dependent on weather, and daily travel schedules are likely to be strongly influenced by geography and internal factors such as sex. We GPS-tracked the migration of 70 lesser kestrels (Falco naumanni) to estimate the relative importance of external factors (wind, geography), internal factors (sex) and season, and the extent to which they explain variation in travel speed, distance, and duration. Our results show that geography and tailwind are important factors in explaining variation in daily travel schedules and speeds. We found that wind explained most of the seasonal differences in travel speed. In both seasons, lesser kestrels sprinted across ecological barriers and frequently migrated during the day and night. Conversely, they travelled at a slower pace and mainly during the day over non-barriers. Our results highlighted that external factors far outweighed internal factors and season in explaining variation in migratory behaviour of a flight generalist, despite its ability to switch between flight modes.

Differential survival throughout the full annual cycle of a migratory bird presents a life-history trade-off.

Long-distance migrations are among the most physically demanding feats animals perform. Understanding the potential costs and benefits of such behaviour is a fundamental question in ecology and evolution. A hypothetical cost of migration should be outweighed by higher productivity and/or higher annual survival, but few studies on migratory species have been able to directly quantify patterns of survival throughout the full annual cycle and across the majority of a species' range. Here, we use telemetry data from 220 migratory Egyptian vultures Neophron percnopterus, tracked for 3,186 bird months and across approximately 70% of the species' global distribution, to test for differences in survival throughout the annual cycle. We estimated monthly survival probability relative to migration and latitude using a multi-event capture-recapture model in a Bayesian framework that accounted for age, origin, subpopulation and the uncertainty of classifying fates from tracking data. We found lower survival during migration compared to stationary periods (ß = -0.816; 95% credible interval: -1.290 to -0.318) and higher survival on non-breeding grounds at southern latitudes (<25°N; ß = 0.664; 0.076-1.319) compared to on breeding grounds. Survival was also higher for individuals originating from Western Europe (ß = 0.664; 0.110-1.330) as compared to further east in Europe and Asia, and improved with age (ß = 0.030; 0.020-0.042). Anthropogenic mortalities accounted for half of the mortalities with a known cause and occurred mainly in northern latitudes. Many juveniles drowned in the Mediterranean Sea on their first autumn migration while there were few confirmed mortalities in the Sahara Desert, indicating that migration barriers are likely species-specific. Our study advances the understanding of important fitness trade-offs associated with long-distance migration. We conclude that there is lower survival associated with migration, but that this may be offset by higher non-breeding survival at lower latitudes. We found more human-caused mortality farther north, and suggest that increasing anthropogenic mortality could disrupt the delicate migration trade-off balance. Research to investigate further potential benefits of migration (e.g. differential productivity across latitudes) could clarify how migration evolved and how migrants may persist in a rapidly changing world.

Evolution of chain migration in an aerial insectivorous bird, the common swift Apus apus.

Spectacular long-distance migration has evolved repeatedly in animals enabling exploration of resources separated in time and space. In birds, these patterns are largely driven by seasonality, cost of migration, and asymmetries in competition leading most often to leapfrog migration, where northern breeding populations winter furthest to the south. Here, we show that the highly aerial common swift Apus apus, spending the nonbreeding period on the wing, instead exhibits a rarely found chain migration pattern, where the most southern breeding populations in Europe migrate to wintering areas furthest to the south in Africa, whereas the northern populations winter to the north. The swifts concentrated in three major areas in sub-Saharan Africa during the nonbreeding period, with substantial overlap of nearby breeding populations. We found that the southern breeding swifts were larger, raised more young, and arrived to the wintering areas with higher seasonal variation in greenness (Normalized Difference Vegetation Index) earlier than the northern breeding swifts. This unusual chain migration pattern in common swifts is largely driven by differential annual timing and we suggest it evolves by prior occupancy and dominance by size in the breeding quarters and by prior occupancy combined with diffuse competition in the winter.

Evo-Devo Strategies for Generative Architecture: Colour-Based Patterns in Polygon Meshes.

Parametric design in architecture is often pigeonholed by its own definition and computational complexity. This article explores the generative capacity to integrate patterns and flows analogous to evolutionary developmental biology (Evo-Devo) strategies to develop emergent proto-architecture. Through the use of coloured patterns (genotype) and the modification of polygonal meshes (phenotype), a methodological proposal is achieved that is flexible to changes and personalization, computationally efficient, and includes a wide range of typologies. Both the process and the result are oriented towards computational lightness for a future and better integration of the workflow in genetic algorithms. Flow-based programming is used to replicate genetic properties such as multifunctionality, repeatability and interchangeability. The results reinforce the biological strategies against other more computationally abstract ones and successfully execute the parallels of universal mechanisms in Evo-Devo that are present in life.

Evo-Devo Algorithms: Gene-Regulation for Digital Architecture.

The majority of current visual-algorithmic architecture is constricted to specific parameters that are gradient related, keeping their parts' relation fixed within the algorithm, far away from a truly parametric modeling with a flexible topology. Recent findings around genetics and certain genes capable of shape conditioning (development) have succeeded in recovering the science of embryology as a valid field that connects and affects the evolutionary ecosystem, showing the existence of universal mechanisms that are present in living species, thus describing powerful strategies for generation and emergence. Therefore, a new dual discipline is justified: Evolutionary developmental biology science. Authors propose the convergence of genetics algorithms and simulated features from evolutionary developmental biology into a single data-flow that will prove itself capable of generating great diversity through a simple and flexible structure of data, commands, and polygonal geometry. For that matter, a case study through visual-algorithmic software deals with the hypothesis that for obtaining a greater emergence and design space, a simpler and more flexible approach might only be required, prioritizing hierarchical levels over complex and detailed operations.

Genetic susceptibility in pharmacodynamic and pharmacokinetic pathways underlying drug induced arrhythmia and sudden unexplained deaths

Abstract Drug-induced arrhythmia is an adverse drug reaction that can be potentially fatal since it is mostly related to drug-induced QT prolongation, a known risk factor for Torsade de Pointes and sudden cardiac death (SCD). Several risk factors have been described in association to these drug-induced events, such as preexistent cardiac disease and genetic variation. Our objective was to study the genetic susceptibility in pharmacodynamic and pharmacokinetic pathways underlying suspected drug-induced arrhythmias and sudden unexplained deaths in 32 patients. The genetic component in the pharmacodynamic pathway was studied by analyzing 96 genes associated with higher risk of SCD through massive parallel sequencing. Pharmacokinetic mediated genetic susceptibility was investigated by studying the genes encoding cytochrome P450 enzymes using medium-throughput genotyping. Pharmacodynamic analysis showed three probably pathogenic variants and 45 variants of uncertain significance in 28 patients, several of them previously described in relation to mild or late onset cardiomyopathies. These results suggest that genetic variants in cardiomyopathy genes, in addition to those related with channelopathies, could be relevant to drug-induced cardiotoxicity and contribute to the arrhythmogenic phenotype. Pharmacokinetic analysis showed three patients that could have an altered metabolism of the drugs they received involving CYP2C19 and/or CYP2D6, probably contributing to the arrhythmogenic phenotype. The study of genetic variants in both pharmacodynamic and pharmacokinetic pathways may be a useful strategy to understand the multifactorial mechanism of drug-induced events in both clinical practice and forensic field. However, it is necessary to comprehensively study and evaluate the contribution of the genetic susceptibility to drug-induced cardiotoxicity. (AU)

Síndrome nefrótico en relación con tratamiento con ustekinumab / Nephrotic syndrome in relation to treatment with ustekinumab

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