Radiotolerance of N-cycle bacteria and their transcriptomic response to low-dose space-analogue ionizing irradiation.

The advancement of regenerative life support systems (RLSS) is crucial to allow long-distance space travel. Within the Micro-Ecological Life Support System Alternative (MELiSSA), efficient nitrogen recovery from urine and other waste streams is vital to produce liquid fertilizer to feed food and oxygen production in subsequent photoautotrophic processes. This study explores the effects of ionizing radiation on nitrogen cycle bacteria that transform urea to nitrate. In particular, we assess the radiotolerance of Comamonas testosteroni, Nitrosomonas europaea, and Nitrobacter winogradskyi after exposure to acute γ-irradiation. Moreover, a comprehensive whole transcriptome analysis elucidates the effects of spaceflight-analogue low-dose ionizing radiation on the individual axenic strains and on their synthetic community o. This research sheds light on how the spaceflight environment could affect ureolysis and nitrification processes from a transcriptomic perspective.

Thermonuclear explosions on neutron stars reveal the speed of their jets.

Relativistic jets are observed from accreting and cataclysmic transients throughout the Universe, and have a profound impact on their surroundings1,2. Despite their importance, their launch mechanism is not known. For accreting neutron stars, the speed of their compact jets can reveal whether the jets are powered by magnetic fields anchored in the accretion flow3 or in the star itself4,5, but so far no such measurements exist. These objects can show bright explosions on their surface due to unstable thermonuclear burning of recently accreted material, called type-I X-ray bursts6, during which the mass-accretion rate increases7-9. Here, we report on bright flares in the jet emission for a few minutes after each X-ray burst, attributed to the increased accretion rate. With these flares, we measure the speed of a neutron star compact jet to be v = 0.38 - 0.08 + 0.11 c , much slower than those from black holes at similar luminosities. This discovery provides a powerful new tool in which we can determine the role that individual system properties have on the jet speed, revealing the dominant jet launching mechanism.

Whole transcriptome analysis highlights nutrient limitation of nitrogen cycle bacteria in simulated microgravity.

Regenerative life support systems (RLSS) will play a vital role in achieving self-sufficiency during long-distance space travel. Urine conversion into a liquid nitrate-based fertilizer is a key process in most RLSS. This study describes the effects of simulated microgravity (SMG) on Comamonas testosteroni, Nitrosomonas europaea, Nitrobacter winogradskyi and a tripartite culture of the three, in the context of nitrogen recovery for the Micro-Ecological Life Support System Alternative (MELiSSA). Rotary cell culture systems (RCCS) and random positioning machines (RPM) were used as SMG analogues. The transcriptional responses of the cultures were elucidated. For CO2-producing C. testosteroni and the tripartite culture, a PermaLifeTM PL-70 cell culture bag mounted on an in-house 3D-printed holder was applied to eliminate air bubble formation during SMG cultivation. Gene expression changes indicated that the fluid dynamics in SMG caused nutrient and O2 limitation. Genes involved in urea hydrolysis and nitrification were minimally affected, while denitrification-related gene expression was increased. The findings highlight potential challenges for nitrogen recovery in space.

Microbiological Quality and Safety of Fresh Quail Meat at the Retail Level.

The objective of this study was to evaluate the microbiological quality and safety of 37 fresh quail meats. Mesophiles, Pseudomonas spp., Enterobacteriaceae, and staphylococci counts were 5.25 ± 1.14, 3.92 ± 1.17, 3.09 ± 1.02, and 2.80 ± 0.64 log CFU/g, respectively. Listeria monocytogenes was detected in seven samples (18.92%). Campylobacter jejuni was detected in one sample (2.70%). Clostridium perfringens was not detected in any sample. The dominant bacteria were Pseudomonas spp. (30.46%), Micrococcaceae (19.87%), lactic acid bacteria (14.57%), and Enterobacteriaceae (11.92%). Brochotrix thermosphacta and enterococci were isolated to a lesser extent, 7.28% and 1.99%, respectively. The dominant Enterobacteriaceae found were Escherichia coli (42.53%). ESBL-producing E. coli was detected in one sample (2.70%), showing resistance to 16 antibiotics. Sixteen different Staphylococcus spp. and three Mammaliicoccus spp. were identified, the most common being S. cohnii (19.86%) and M. sciuri (17.02%). S. aureus and S. epidermidis were also found in one and four samples, respectively. Methicillin-resistant M. sciuri and S. warneri were found in 13.51% and 10.81% of quail samples, respectively. These bacteria showed an average of 6.20 and 18.50 resistances per strain, respectively. The high resistance observed in ESBL-producing E. coli and methicillin-resistant S. warneri is of special concern. Measures should be adopted to reduce the contamination of quail meat.

A novel molecular class that recruits HDAC/MECP2 complexes to PU.1 motifs reduces neuroinflammation.

Pervasive neuroinflammation occurs in many neurodegenerative diseases, including Alzheimer's disease (AD). SPI1/PU.1 is a transcription factor located at a genome-wide significant AD-risk locus and its reduced expression is associated with delayed onset of AD. We analyzed single-cell transcriptomic datasets from microglia of human AD patients and found an enrichment of PU.1-binding motifs in the differentially expressed genes. In hippocampal tissues from transgenic mice with neurodegeneration, we found vastly increased genomic PU.1 binding. We then screened for PU.1 inhibitors using a PU.1 reporter cell line and discovered A11, a molecule with anti-inflammatory efficacy and nanomolar potency. A11 regulated genes putatively by recruiting a repressive complex containing MECP2, HDAC1, SIN3A, and DNMT3A to PU.1 motifs, thus representing a novel mechanism and class of molecules. In mouse models of AD, A11 ameliorated neuroinflammation, loss of neuronal integrity, AD pathology, and improved cognitive performance. This study uncovers a novel class of anti-inflammatory molecules with therapeutic potential for neurodegenerative disorders.

Microbiological Quality and Safety of Fresh Turkey Meat at Retail Level, Including the Presence of ESBL-Producing Enterobacteriaceae and Methicillin-Resistant S. aureus.

The aim of this work was to study the microbiological safety and quality of marketed fresh turkey meat, with special emphasis on methicillin-resistant S. aureus, ESBL-producing E. coli, and K. pneumoniae. A total of 51 fresh turkey meat samples were collected at retail level in Spain. Mesophile, Pseudomonas spp., enterococci, Enterobacteriaceae, and staphylococci counts were 5.10 ± 1.36, 3.17 ± 0.87, 2.03 ± 0.58, 3.18 ± 1.00, and 2.52 ± 0.96 log CFU/g, respectively. Neither Campylobacter spp. nor Clostridium perfringens was detected in any sample. ESBL-producing K. pneumoniae and E. coli were detected in 22 (43.14%), and three (5.88%) samples, respectively, all of which were multi-resistant. Resistance to antimicrobials of category A (monobactams, and glycilcyclines) and category B (cephalosporins of third or fourth generation, polymixins, and quinolones), according to the European Medicine Agency classification, was found among the Enterobacteriaceae isolates. S. aureus and methicillin-resistant S. aureus were detected in nine (17.65%) and four samples (7.84%), respectively. Resistance to antimicrobials of category A (mupirocin, linezolid, rifampicin, and vancomycin) and category B (cephalosporins of third- or fourth generation) was found among S. aureus, coagulase-negative staphylococci, and M. caseolyticus isolates.

Frecuencia de conocimientos sobre métodos de higiene oral en adultos en la parroquia "Cumbe" Cuenca, 2021 / Frequency of knowledge about oral hygiene methods in adults in the parish "Cumbe" Cuenca, 2021

Contexto:El nivel de conocimiento de los métodos de higiene oral es un factor clave en el cuidado de la salud oral de la población de cualquier país. Objetivos:Determinar la frecuencia de conocimientos sobre métodos de higiene oral en adultos en la parroquia "Cumbe" Cuenca, 2021. Métodos:Se realizó un estudio descriptivo, con enfoque cualitativo, de tipo documental, comunicacional y transversal actual, mediante la realización de encuestas, en la parroquia Cumbe, con una población de 5.546 habitantes, de los cuales, mediante criterios de inclusión y exclusión, además del uso de la fórmula de cálculo de muestra para población finita, se estableció finalmente una muestra de 400 individuos. Resultados:El nivel de conocimiento alto presentó una frecuencia del 18,25%, el nivel medio obtuvo la frecuencia más alta correspondiente al 52,25% y el nivel bajo fue de 29,5%. Conclusiones:La mayor frecuencia se encontró en el nivel de conocimiento medio sobre los hábitos de higiene oral en adultos en la parroquia "Cumbe" Cuenca, 2021

Introduction:The level of knowledge regarding oral hygiene methods is a key factor in the oral health care of the population of any country. Objectives: To determine the level of knowledge on oral hygiene methods in adults in the "Cumbe" Parish, Cuenca, 2021. Materials and methods:A descriptive study was conducted, with a qualitative, documentary, communicational, and current cross-sectional approach, through surveys, in the Parish, with a population of 5,546 inhabitants, of which through inclusion and exclusion criteria, in addition to the use of the sample calculation formula for a finite population, a sample of 400 individuals was finally established. Results:The high level of knowledge presented a frequency of 18.25%, the medium level obtained the highest frequency corresponding to 52.25% and the low level was 29.5%. Conclusions:The highest frequency was found in the medium level of knowledge about oral hygiene habits in adults in the "Cumbe" Parish, Cuenca, 2021

DUbbing Language-therapy CINEma-based in Aphasia post-Stroke (DULCINEA): study protocol for a randomized crossover pilot trial.

BACKGROUND: Communication is one of the most important predictors of social reintegration after stroke. Approximately 15-42% of stroke survivors experience post-stroke aphasia. Helping people recover from aphasia is one of the research priorities after a stroke. Our aim is to develop and validate a new therapy integrating dubbing techniques to improve functional communication. METHODS: The research project is structured as three work packages (WP). WP1: development of the dubbed language cinema-based therapy: Two research assistants (a speech therapist and a dubbing actor) will select the clips, mute specific words/sentences in progressive speech difficulty, and guide patients to dub them across sessions. Words to be dubbed will be those considered to be functionally meaningful by a representative sample of aphasic patients and relatives through an online survey. WP2: a randomized, crossover, interventional pilot study with the inclusion of 54 patients with post-stroke non-fluent aphasia. Patients will be treated individually in 40-min sessions twice per week for 8 weeks. Primary outcomes will be significant pre/post differences in scores in the Communicative Activity Log (CAL) questionnaire and Boston Diagnostic Aphasia Examination (BDAE) administered by a psychologist blinded to the patients' clinical characteristics. SECONDARY OUTCOMES: General Health Questionnaire (GHQ)-12, Stroke Aphasia Quality of Life Scale (SAQOL-39), Western Aphasia Battery Revised (WAB-R), and the Stroke Aphasic Depression Questionnaire (SADQ10). WP3: educational activities and dissemination of results. WP3 includes educational activities to improve public knowledge of aphasia and dissemination of the results, with the participation of the Spanish patients' association Afasia Activa. DISCUSSION: This pilot clinical trial will explore the efficacy of a new therapeutic tool based on dubbing techniques and computer technology to improve functional communication of patients suffering from post-stroke aphasia with the use of standardized test assessment. TRIAL REGISTRATION: ClinicalTrials.gov NCT04289493 . Registered on 28 February 2020.

Practical protocol of the food allergy committee of the seicap on open oral food challenges to nuts.

Food allergy is rising rapidly among children, and allergy to nuts is one of the most prevalent allergies among them. The category "nuts and seeds" include several plant foods from different botanical families, very different from each other. It is not uncommon to detect co-sensitization to different nuts. However, true co-allergy is less frequent. Up to 80% of patients with positive skin prick tests or specific IgE without true history of reaction who avoid certain nuts, might tolerate them in an Oral Food Challenge (OFC). Although molecular diagnostic techniques help to improve nut allergy diagnosis, OFC still remains the gold standard. For this reason, after reviewing the current bibliography and the recommendations of different allergy societies on standardization of open OFC, the Food Allergy Committee of the Spanish Society of Pediatric Allergy, Asthma and Clinical Immunology (SEICAP) food allergy working group proposed a unified protocol to undertake these OFC, which include preliminary recommendations, unification of total dose, number of doses and interval between doses. Additionally, this group offers an interactive table to facilitate calculation of doses specific to each nut under study.

Perfil lipídico materno como predictor de diabetes gestacional / Maternal lipid profile as predictor of gestational diabetes

RESUMEN Fundamento: evidencias indican que las anormalidades del perfil lipídico contribuyen a la insulinorresistencia. Objetivo: determinar la relación entre los valores del perfil lipídico materno y la aparición de diabetes gestacional. Métodos: se realizó un estudio analítico, transversal con una muestra de 180 gestantes. Se les realizó colesterol total, triglicéridos, LDLc, HDLc y los índices LDLc/HDLc, triglicéridos/HDLc a todas las grávidas en dos momentos del embarazo: a la captación (≤ 12 semanas) y durante el tercer trimestre; así como PTG con 75 g de glucosa anhidra entre las 24-26 semanas de gestación, según el resultado de esta prueba el universo de estudio quedó dividido en dos grupos (con y sin diabetes gestacional). Se empleó estadística descriptiva e inferencial. Resultados: las medias de colesterol total y de triglicéridos se elevaron de manera significativa del primero al tercer trimestre del embarazo independientemente del estado de salud de las gestantes. En el análisis univariado las gestantes con diabetes mellitus gestacional tuvieron un incremento significativo de las concentraciones séricas de todos los componentes del perfil lipídico. El riesgo relativo de aparición de diabetes mellitus gestacional está estratificado según la evaluación nutricional de la gestante a la captación del embarazo donde es 1,46 veces mayor en la gestante obesa con cifras más altas de colesterol al inicio del embarazo y de 1,55 veces mayor en la que tiene valores mayores de triglicéridos. Conclusiones: aquellas embarazadas con mayores valores de triglicéridos, LDLc/HDLc o triglicéridos/HDLc a la captación tuvieron mayor riesgo de desarrollar diabetes gestacional.

ABSTRACT Background: searchers had shown that abnormalities on maternal lipid profile due to resistance to insulin. ` Objective: to evaluate the relationship between maternal lipid profile and the development of gestational diabetes mellitus. Methods: an analytic, cross-sectional, study was carried out with a sample of 180 pregnant women. Total cholesterol, triglycerides, LDLc, HDLc, LDLc/HDLc and triglycerides/HDLc were done to all pregnant women in two moments: at the begin of the pregnancy (less than 12 weeks) and during the third trimester; glucose tolerance test with 75 grams of anhydrate glucose between 24-26 weeks was done too, according to its results the sample was divided in two groups: healthy pregnant women and pregnant women with gestational diabetes mellitus. Inferential and descriptive statistics were used. Results: main values of total cholesterol and triglycerides increases the first trimester to third trimester, regardless the health state of the pregnant women. Pregnant women who suffer from gestational diabetes mellitus had increases of all parameters on lipid profile. Odds Ratio for the development of gestational diabetes mellitus was 1.46 times higher on obese pregnant women with high cholesterol and 1.55 times higher on obese pregnant women with high triglycerides. Conclusions: pregnant women who had high levels of triglycerides, LDLc/HDLc or triglycerides/HDLc at the beginning of pregnancy had more risk of developing gestational diabetes.

Specific and direct modulation of the interaction between adhesion GPCR GPR56/ADGRG1 and tissue transglutaminase 2 using synthetic ligands.

Blocking the interaction between cell-surface receptors and their ligands is a proven therapeutic strategy. Adhesion G protein-coupled receptors (aGPCRs) are key cell-surface receptors that regulate numerous pathophysiological processes, and their large extracellular regions (ECRs) mediate ligand binding and function. The aGPCR GPR56/ADGRG1 regulates central nervous system myelination and melanoma progression by interacting with its ligand, tissue transglutaminase 2 (TG2), but the molecular basis for this interaction is largely undefined. Here, we show that the C-terminal portion of TG2 directly interacted with the GPR56 ECR with high-nanomolar affinity, and used site-directed mutagenesis to identify a patch of conserved residues on the pentraxin/laminin-neurexin-sex-hormone-binding-globulin-like (PLL) domain of GPR56 as the TG2 binding site. Importantly, we also show that the GPR56-TG2 interaction was blocked by previously-reported synthetic proteins, termed monobodies, that bind the GPR56 ECR in a domain- and species-specific manner. This work provides unique tools to modulate aGPCR-ligand binding and establishes a foundation for the development of aGPCR-targeted therapeutics.

Dual Leucine Zipper Kinase Is Constitutively Active in the Adult Mouse Brain and Has Both Stress-Induced and Homeostatic Functions.

Dual leucine zipper kinase (DLK, Map3k12) is an axonal protein that governs the balance between degeneration and regeneration through its downstream effectors c-jun N-terminal kinase (JNK) and phosphorylated c-jun (p-c-Jun). In peripheral nerves DLK is generally inactive until induced by injury, after which it transmits signals to the nucleus via retrograde transport. Here we report that in contrast to this mode of regulation, in the uninjured adult mouse cerebellum, DLK constitutively drives nuclear p-c-Jun in cerebellar granule neurons, whereas in the forebrain, DLK is similarly expressed and active, but nuclear p-c-Jun is undetectable. When neurodegeneration results from mutant human tau in the rTg4510 mouse model, p-c-Jun then accumulates in neuronal nuclei in a DLK-dependent manner, and the extent of p-c-Jun correlates with markers of synaptic loss and gliosis. This regional difference in DLK-dependent nuclear p-c-Jun accumulation could relate to differing levels of JNK scaffolding proteins, as the cerebellum preferentially expresses JNK-interacting protein-1 (JIP-1), whereas the forebrain contains more JIP-3 and plenty of SH3 (POSH). To characterize the functional differences between constitutive- versus injury-induced DLK signaling, RNA sequencing was performed after DLK inhibition in the cerebellum and in the non-transgenic and rTg4510 forebrain. In all contexts, DLK inhibition reduced a core set of transcripts that are associated with the JNK pathway. Non-transgenic forebrain showed almost no other transcriptional changes in response to DLK inhibition, whereas the rTg4510 forebrain and the cerebellum exhibited distinct differentially expressed gene signatures. In the cerebellum, but not the rTg4510 forebrain, pathway analysis indicated that DLK regulates insulin growth factor-1 (IGF1) signaling through the transcriptional induction of IGF1 binding protein-5 (IGFBP5), which was confirmed and found to be functionally relevant by measuring signaling through the IGF1 receptor. Together these data illuminate the complex multi-functional nature of DLK signaling in the central nervous system (CNS) and demonstrate its role in homeostasis as well as tau-mediated neurodegeneration.

Análisis de la percepción del estudiante universitario sobre el contexto sociotecnológico a través de la innovación didáctica / Analysis of the university student's perception of the sociotechnological context through didactic innovation / Análise da percepção do estudante universitário sobre o contexto sociotecnológico através da inovação didática

Resumen Introducción. En el presente artículo se presenta un estudio diacrónico en el que se analizan 405 concepciones de estudiantes universitarios sobre la Sociedad de la Información implementadas a través de un software social (Word Clouds). Objetivo. El objetivo principal consiste en analizar la funcionalidad didáctica de herramientas de creación y difusión de contenido digital para el desarrollo de contenidos de asignaturas universitarias. Materiales y métodos. La muestra participante está compuesta por estudiantes de dos titulaciones: Doble Grado en Trabajo Social y Educación Social correspondientes a los cursos académicos 2010/11 a 2016/17 y Grado de Educación Social (2013/2017) de la Universidad Pablo de Olavide de Sevilla (España). A través de una metodología descriptiva y cualitativa se realiza la codificación y análisis de frecuencias temáticas de las nubes de palabras creadas por los estudiantes correspondiente al curso académico 2011-12 del doble Grado de Trabajo Social y Educación Social (T.S/E.S) y se comparan con los restantes cursos académicos. Resultados. Los resultados muestran que los términos más representativos para los estudiantes son: Globalización (61,86%), Comunicación (43,85%), Tecnología (43,85%), Tecnologías de la Información y Comunicación (TIC) (41,73%), Información (38,98%), e Internet- Red de redes (25,21%). Por último, cabe resaltar que dieciséis nuevos términos aparecen, dependiendo del año académico, siendo los más mencionados: Desigualdad (19,91%), Crisis (13,13%) y Consumo (8,47%). Conclusión. Esta experiencia universitaria permite mostrar que la utilización educativa de creación de nubes de palabras digitales puede ser un recurso didáctico muy interesante como vehículo para el sedimento reflexivo y repositorio de experiencias de aprendizaje del alumnado universitario.

Abstract Introduction. In the present article a diachronic study is presented in which 405 conceptions of university students about the Information Society are analyzed through a social software resource (Word Clouds). Objective. The main objective is to analyze the didactic functionality of tools for creating and disseminating digital content for the development of content for university subjects. Materials and methods. The participating sample is composed of students of two degrees: Double Degree in Social Work and Social Education corresponding to the academic courses 2010/11 to 2016/17 and Degree in Social Education (2013/2017) of the University of Pablo de Olavide / Seville (Spain). Through a descriptive and qualitative methodology, we code and analyse the thematic frequencies of the word clouds created by the students corresponding to the academic year 2011-12 of the double Degree of Social Work and Social Education (TS / ES). Thus, we compare them with the remaining academic courses. Results. The results show that the most representative terms for students are: Globalization (61.86%), Communication (43.85%), Technology (43.85%), Information and Communication Technologies (ICT) (41.73 %), Information (38.98%), and Internet- Network of networks (25.21%). Finally, it should be noted that sixteen new terms appear, depending on the academic year, being the most mentioned: Inequality (19.91%), Crisis (13.13%) and Consumption (8.47%). Conclusion. This university experience shows that the educational use of creating digital content with word clouds resources can be a very interesting didactic resource as a vehicle for reflection and a repository of learning experiences for university students.

Resumo Introdução. No presente artigo, é apresentado um estudo diacrônico em que 405 concepções de estudantes universitários sobre a Sociedade da Informação são analisadas por meio de um recurso de software social (Word Clouds). Objetivo. O objetivo principal é analizar a funcionalidade didática de ferramentas para criação e disseminação de conteúdo digital para o desenvolvimento de conteúdo para disciplinas universitárias. Materiais e métodos. A amostra participante é composta por estudantes de dois graus: Licenciatura Dupla em Serviço Social e Educação Social correspondente aos cursos acadêmicos 2010/11 a 2016/17 e Licenciatura em Educação Social (2013/2017) da Universidade de Pablo de Olavide / Sevilha (Espanha). Por meio de metodologia descritiva e qualitativa, codificamos e analizamos as frequências temáticas das nuvens de palavras criadas pelos alunos correspondentes ao ano acadêmico 2011-12 do duplo Grau de Serviço Social e Educação Social (TS / ES). Assim, comparamos com os demais cursos acadêmicos. Resultados. Os resultados mostram que os termos mais representativos para os alunos são: Globalização (61,86%), Comunicação (43,85%), Tecnologia (43,85%), Tecnologias de Informação e Comunicação (TIC) (41,73%), Informação (38,98%) e Internet-Rede de redes (25,21%). Por fim, cabe destacar que dezesseis novos termos aparecem, dependendo do ano acadêmico, sendo os mais mencionados: Desigualdade (19,91%), Crise (13,13%) e Consumo (8,47%). Conclusão. Essa experiência universitária mostra que o uso educacional da criação de conteúdo digital com recursos de nuvens de palavras pode ser um recurso didático muito interessante como veículo de reflexão e repositório de experiências de aprendizagem para estudantes universitários.

Cetoacidosis diabética normoglucémica en mujeres con diabetes gestacional / Euglycaemic diabetes ketoacidosis in women who suffer from gestational diabetes

RESUMEN Fundamento: la mayoría de los casos de cetoacidosis diabética se presentan con hiperglucemia, en ocasiones puede ser diagnostica con valores normales de la misma, por lo general en la mujer embarazada. Objetivo: presentar el caso de dos gestantes sin diagnóstico previo de diabetes gestacional que desarrollan durante el embarazo una cetoacidosis diabética normoglucémica. Presentación de casos: se trata de dos gestantes sin diagnóstico previo de diabetes gestacional que en el segundo y tercer trimestre del embarazo reciben tratamiento con glucocorticoides endovenosos por diferentes cuestiones (inducción de la madurez pulmonar fetal y crisis materna de asma bronquial) lo cual desencadena cuadros clínicos y bioquímicos compatibles con cetoacidosis diabética normoglucémica. Conclusiones: la cetoacidosis diabética durante el embarazo ocurre con mayor frecuencia en mujeres con diabetes pregestacional sin diagnóstico previo del trastorno, solo en raros casos ocurre en gestantes con diabetes gestacional, las cuales en un pequeño porcentaje se presenta como una cetoacidosis diabética normoglucémica después de la presentación de factores de riesgo gatillantes.

ABSTRACT Background: although the majority cases who suffer from diabetic ketoacidosis show with hyperglycemia, occasionally it can be diagnosed with normal values of glycemia especially on pregnant women. Objective: to show two pregnant women without diagnosis of gestational diabetes previously who developed a normoglyacemic diabetic ketoacidosis during pregnancy. Cases report: two pregnant women without diagnosis of gestational diabetes previously who are treated with glucocorticoids to induce fetal pulmonary develop and to resolve an acute crisis of asthma respectively and they later developed a normoglyacemic diabetic ketoacidosis. Conclusions: diabetic ketoacidosis during pregnancy happen more frequent on pregnant women without previously diagnosis of pre-gestational diabetes, on few cases it happen on pregnant women who suffer from gestational diabetes in which it shows as a normoglyacemic diabetic ketoacidosis in a low percent.

Universo emocional de mujeres afectadas por hepatitis C: una aproximación hermenéutica / The emotional universe of women affected by hepatitis C: A hermeneutic approach

Objetivos: Comprender el universo emocional de mujeres cordobesas afectadas por hepatitis C. Método: Estudio cualitativo hermenéutico. Las participantes cumplían los criterios de inclusión de ser mujer mayor de edad, diagnosticada en la actualidad de hepatitis C y pertenecer a la Plataforma de Afectad@s por la Hepatitis C de Córdoba. El muestreo intencional fue de intensidad y nominado. La recogida de datos se realizó a través de entrevistas en profundidad. El análisis siguió 3niveles: explicación, comprensión superficial y comprensión en profundidad. En el segundo nivel, se incorporó la metáfora «universo de emociones», una taxonomía que organiza las emociones en conjuntos de galaxias para facilitar la comprensión de los fenómenos afectivos. Resultados: Se incluyó a 4 participantes. Los 7 temas resultado recorren las distintas galaxias del universo emocional de las mujeres. «Enfermedad maldita» explora su asco, tristeza y vergüenza. «Afectos íntimos» se detiene tanto en la felicidad y el amor como en la tristeza. «Plataforma amistad» profundiza en la comprensión, bienestar y afecto. «Médicos» se ocupa de la desconfianza y decepción con respecto al nuevo tratamiento; «cura», de la tristeza, miedo, ansiedad y esperanza. «Estado de malestar» se ocupa de la ansiedad. Y «acceso universal ya» explora su ira. Conclusiones: A pesar de la presencia del amor, en el complejo universo emocional de las mujeres con hepatitis C destacan la ira, tristeza y ansiedad. Una hermenéutica de sus emociones facilita la humanización tanto de los cuidados de enfermería que reciben como de la investigación de la que son objeto

Objectives: Understanding the emotional universe of women from Cordoba affected by hepatitis C. Method: Hermeneutic qualitative study. Participants met the criteria of being adult women with a current diagnosis of hepatitis C and belonging to the Plataforma de Afectad@s por la Hepatitis C of Cordoba. The intentional sampling was nominated and followed a criterion of intensity. Data collection was conducted through in-depth interviews. The analysis took place in 3levels: Explanation, naïve understanding and in-depth understanding. In the second level, the metaphor universe of emotions was incorporated, which is a taxonomy that organizes emotions into clusters of galaxies to facilitate understanding of affective phenomena. Results: Four participants were included. Seven themes roam the galaxies in the emotional universe of women. «Damned disease» explores their disgust, sadness and shame. «Intimate affections» focuses on happiness and love as well as sadness. «Friendship-platform» focuses on understanding, welfare and affection. «Physicians» deal with distrust and disappointment regarding new treatment, and with «curing» sadness, fear, anxiety and hope. «State of ill-being» focuses on anxiety. And «universal access now» explores anger. Conclusions: Despite the presence of love in the complex emotional universe of women with hepatitis C, anger, sadness and anxiety are highlighted. Hermeneutics of their emotions facilitates nursing care and nursing research humanization

La enfermera de práctica avanzada en la adecuación de los tratamientos de las heridas crónicas complejas / The advanced practice nurse in the adequacy of chronic, complex wound care

Objetivo: Determinar el impacto de las enfermeras de práctica avanzada en heridas crónicas complejas (EPA-HCC) en la adecuación de los tratamientos de los pacientes con heridas crónicas y el consumo de apósitos en los distritos donde están implantadas. Método: Estudio de tipo cuasiexperimental de tipo pre-post sin grupo control con 3mediciones: preimplantación en 2015, al año de implantación en 2016 y a los 2 años postimplantación en 2017, en los distritos sanitarios donde se estaba pilotando la EPA-HCC en Andalucía. Las variables principales son: número de profesionales formados, número de consultorías, prevalencia de heridas crónicas, adecuación de los tratamientos y coste económico en materiales para cura de los DS participantes. Resultados: Se ha conseguido la formación de un total de 2.717 profesionales sanitarios con un total de 95.095 h lectivas; además, se han realizado un total de 3.871 consultorías y asesorías. La prevalencia de pacientes con lesiones en programa de atención domiciliaria y en residencias ha disminuido a la mitad. La adecuación de los tratamientos ha aumentado hasta el 90% y se ha conseguido un ahorro de más de 250.000 Euros en apósitos, en un período de 2años. Conclusión: La prevalencia de heridas crónicas durante los 2 años de implantación ha disminuido a la mitad, se ha conseguido una correcta adecuación del plan de formación y consultoría, consiguiendo racionalizar el gasto sanitario y una eficiente atención a las personas con heridas crónicas

Aim: To determine the impact of advanced practice nurses in chronic wound care in the adequacy of treatments for patients with chronic wounds and the consumption of dressings in the districts where they have been implemented. Method: A quasi-experimental pre-poststudy without a control group with 3 measurements: pre-implementation in 2015, one year after implementation in 2016, and 2 years post-implementation in 2017, in the health districts (HD) where the role of the advanced practice nurse in chronic wound care was piloted in Andalusia. The main variables were trained professionals, consultancies, prevalence of chronic wounds, adequacy of treatments and economic cost in materials for the participating HD. Results: The training of a total of 2,717 health teams with a total of 95,095 teaching hours was achieved. In addition, a total of 3,871 consultancies were performed. The prevalence of patients with injuries in the home care (HC) programme and in care homes diminished significantly, to almost half. The adequacy of the treatments increased to 90% and savings of more than 250,000 Euros in dressings were achieved in just 2 years. Conclusion: The prevalence of chronic wounds during the 2years of implementation decreased by almost half. Adequacy of training and consultancy was achieved, rationalising health expenditure and ensuring efficient care for patients with chronic wounds

The advanced practice nurse in the adequacy of chronic, complex wound care. / La enfermera de práctica avanzada en la adecuación de los tratamientos de las heridas crónicas complejas.

AIM: To determine the impact of advanced practice nurses in chronic wound care in the adequacy of treatments for patients with chronic wounds and the consumption of dressings in the districts where they have been implemented. METHOD: A quasi-experimental pre-poststudy without a control group with 3measurements: pre-implementation in 2015, one year after implementation in 2016, and 2years post-implementation in 2017, in the health districts (HD) where the role of the advanced practice nurse in chronic wound care was piloted in Andalusia. The main variables were trained professionals, consultancies, prevalence of chronic wounds, adequacy of treatments and economic cost in materials for the participating HD. RESULTS: The training of a total of 2,717 health teams with a total of 95,095 teaching hours was achieved. In addition, a total of 3,871 consultancies were performed. The prevalence of patients with injuries in the home care (HC) programme and in care homes diminished significantly, to almost half. The adequacy of the treatments increased to 90% and savings of more than 250,000€ in dressings were achieved in just 2years. CONCLUSION: The prevalence of chronic wounds during the 2years of implementation decreased by almost half. Adequacy of training and consultancy was achieved, rationalising health expenditure and ensuring efficient care for patients with chronic wounds.

Alergia a las proteínas de leche de vaca no mediada por IgE: documento de consenso de la Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP), la Asociación Española de Pediatría de Atención Primaria (AEPAP), la Sociedad Española de Pediatría Extrahospitalaria y Atención Primaria (SEPEAP) y la Sociedad Española de Inmunología Clínica, Alergología y Asma Pediátrica (SEICAP) / Non-IgE-mediated cow's milk allergy: Consensus document of the Spanish Society of Paediatric Gastroenterology, Hepatology, and Nutrition (SEGHNP), the Spanish Association of Paediatric Primary Care (AEPAP), the Spanish Society of Extra-hospital Paediatrics and Primary Health Care (SEPEAP), and the Spanish Society of Paediatric ClinicaL Immunology, Allergy, and Asthma (SEICAP)

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The Role of APOE4 in Disrupting the Homeostatic Functions of Astrocytes and Microglia in Aging and Alzheimer's Disease.

APOE4 is the greatest genetic risk factor for late-onset Alzheimer's disease (AD), increasing the risk of developing the disease by 3-fold in the 14% of the population that are carriers. Despite 25 years of research, the exact mechanisms underlying how APOE4 contributes to AD pathogenesis remain incompletely defined. APOE in the brain is primarily expressed by astrocytes and microglia, cell types that are now widely appreciated to play key roles in the pathogenesis of AD; thus, a picture is emerging wherein APOE4 disrupts normal glial cell biology, intersecting with changes that occur during normal aging to ultimately cause neurodegeneration and cognitive dysfunction. This review article will summarize how APOE4 alters specific pathways in astrocytes and microglia in the context of AD and the aging brain. APOE itself, as a secreted lipoprotein without enzymatic activity, may prove challenging to directly target therapeutically in the classical sense. Therefore, a deeper understanding of the underlying pathways responsible for APOE4 toxicity is needed so that more tractable pathways and drug targets can be identified to reduce APOE4-mediated disease risk.