Plasma-Based Scaffold Containing Bone-Marrow Mononuclear Cells Promotes Wound Healing in a Mouse Model of Pressure Injury.

Pressure injuries, or pressure ulcers, are a common problem that may lead to infections and major complications, besides being a social and economic burden due to the costs of treatment and hospitalization. While surgery is sometimes necessary, this also has complications such as recurrence or wound dehiscence. Among the newer methods of pressure injury treatment, advanced therapies are an interesting option. This study examines the healing properties of bone marrow mononuclear cells (BM-MNCs) embedded in a plasma-based scaffold in a mouse model. Pressure ulcers were created on the backs of mice (2 per mouse) using magnets and assigned to a group of ulcers that were left untreated (Control, n = 15), treated with plasma scaffold (Plasma, n = 15), or treated with plasma scaffold containing BM-MNC (Plasma + BM-MNC, n = 15). Each group was examined at three time points (3, 7, and 14 days) after the onset of treatment. At each time point, animals were subjected to biometric assessment, bioluminescence imaging, and tomography. Once treatment had finished, skin biopsies were processed for histological and wound healing reverse transcription polymerase chain reaction (RT-PCR) array studies. While wound closure percentages were higher in the Plasma and Plasma + BM-MNC groups, differences were not significant, and thus descriptive data are provided. In all individuals, the presence of donor cells was revealed by immunohistochemistry on posttreatment onset Days 3, 7, and 14. In the Plasma + BM-MNC group, less inflammation was observed by positron emission tomography-computed tomography (PET/CT) imaging of the mice at 7 days, and a complete morphometabolic response was produced at 14 days, in accordance with histological results. A much more pronounced inflammatory process was observed in controls than in the other two groups, and this persisted until Day 14 after treatment onset. RT-PCR array gene expression patterns were also found to vary significantly, with the greatest difference noted between both treatments at 14 days when 11 genes were differentially expressed.

Leader-follower formation control based on non-inertial frames for non-holonomic mobile robots.

A chain formation strategy based on mobile frames for a set of n differential drive mobile robots is presented. Considering two consecutive robots in the formation, robots Ri and Ri+1. It is intended that robot Ri+1 follows the delayed trajectory, τ units of time, of the leader robot Ri. In this way, the follower robot Ri+1 becomes the leader robot for robot Ri+ 2 in the formation and so on. With this formation policy, the trailing distance between two consecutive robots varies accordingly to the velocity of the Ri leader robot. Mobile frames are located on the body of the vehicles, in such a way that the position of robot Ri is determined with respect to the frame located on Ri+1 robot. The strategy relies on the fact that the general leader robot R1 describes any trajectory generated by bounded linear v1(t) and angular ω1(t) velocities. For the remaining vehicles in the string, the strategy considers a desired trajectory for the follower robot Ri+1 obtained by an estimation of the delayed trajectory of the leader robot Ri. This desired estimated trajectory is obtained under the knowledge of the actual and past input velocities of the Ri robot. To formally prove the convergence of the formation strategy, the equations describing the time variation of the relative posture between any pair of consecutive vehicles in the formation are obtained, and a feedback law based on local measurements is proposed to get the convergence of robot Ri+1 to the delayed trajectory, τ units of time, of the trajectory previously described by robot Ri. Lyapunov techniques are considered for this fact. The effectiveness of the chain formation solution is evaluated by means of numerical simulations and real time experiments showing an adequate convergence.

Selection/control concurrent optimization of BLDC motors for industrial robots.

This paper aims to concurrently select and control off-the-shelf BLDC motors of industrial robots by using a synergistic model-based approach. The BLDC motors are considered with trapezoidal back-emf, where the three-phase (a,b,c) dynamics of motors are modeled in a mechatronic powertrain model of the robot for the selection and control problem, defining it as a multi-objective dynamic optimization problem with static and dynamic constraints. Since the mechanical and electrical actuators' parameters modify the robot's performance, the selection process considers the actuators' parameters, their control input, operational limits, and the mechanical output to the transmission of the robot joints. Then, three objective functions are to be minimized, the motor's energy consumption, the tracking error, and the total weight of installed motors on the robot mechanism. The control parameterization approach via a cascade controller with PI controllers for actuators' voltage and a PID controller for actuators' torque is used to solve the multi-objective dynamic optimization problem. Based on simulations of the closed-loop system, a Pareto front is obtained to examine trade-offs among the objective functions before implementing any actuators in the existing robotic system. The proposed method is tested on an experimental platform to verify its effectiveness. The performance of an industrial robot with the actuators originally installed is compared with the results obtained by the synergic approach. The results of this comparison show that 10.85% of electrical power can be saved, and the trajectory tracking error improved up to 57.41% using the proposed methodology.

Gender identity and sexual orientation of people with autism spectrum disorder: a systematic review / Identidad de género y orientación sexual de las personas con Trastorno del Espectro del Autismo: una revisión sistemática

There has been growing interest about gender identity and sexual orientation in people with autism spectrum disorder. This systematic review analyses 18 studies conducted since 2016 that met the inclusion criteria. The aim was to gather evidence of gender identity, gender dysphoria, and sexual orientation in the ASD population. The results indicate an increased prevalence of non-conforming gender identity and gender dysphoria in people with ASD. There was also evidence of greater prevalence of non-heterosexual orientation in people with ASD than people without ASD. These results were particularly found in women with ASD. However, more studies are needed, especially about women, children and adolescents, to ensure that there are suitable support and resources to meet the needs of this population. (AU)

En los últimos años ha surgido un creciente interés en relación con la identidad de género y la orientación sexual de las personas con trastorno del espectro del autismo (TEA). La presente revisión sistemática analiza un total de 18 estudios, publicados a partir de 2016, con la finalidad de obtener evidencias acerca de la identidad y disforia de género, y la orientación sexual en la población con TEA. Los resultados indicaron que existe una mayor prevalencia de identidad de género no conforme y de disforia de género en la población con TEA. Se encontró una mayor prevalencia de orientación no heterosexual en las personas con TEA en comparación con la población sin TEA. Estos resultados se encuentran preferentemente en las mujeres con TEA. No obstante, es necesario disponer de más y mejores evidencias sobre esta temática, especialmente en mujeres, y en las etapas de la niñez y la adolescencia, con el fin de implementar apoyos y recursos adecuados para dar respuesta a las necesidades de estas personas. (AU)

Bio-Inspired Autonomous Navigation and Formation Controller for Differential Mobile Robots.

This article proposes a decentralized controller for differential mobile robots, providing autonomous navigation and obstacle avoidance by enforcing a formation toward trajectory tracking. The control system relies on dynamic modeling, which integrates evasion forces from obstacles, formation forces, and path-following forces. The resulting control loop can be seen as a dynamic extension of the kinematic model for the differential mobile robot, producing linear and angular velocities fed to the mobile robot's kinematic model and thus passed to the low-level wheel controller. Using the Lyapunov method, the closed-loop stability is proven for the non-collision case. Experimental and simulated results that support the stability analysis and the performance of the proposed controller are shown.

Philadelphia-negative chronic myeloproliferative neoplasm follow-up: when the phone rings. Changes during the COVID-19 pandemic and patient satisfaction. Experience in 30 health centers in Spain.

The SARS-CoV-2 pandemic has favored the expansion of telemedicine. Philadelphia-negative chronic myeloproliferative neoplasms (Ph-MPN) might be good candidates for virtual follow-up. In this study, we aimed to analyze the follow-up of patients with Ph-MPN in Spain during COVID-19, its effectiveness, and acceptance among patients. We present a multicenter retrospective study from 30 centers. Five hundred forty-one patients were included with a median age of 67 years (yr). With a median follow-up of 19 months, 4410 appointments were recorded. The median of visits per patient was 7 and median periodicity was 2.7 months; significantly more visits and a higher frequency of them were registered in myelofibrosis (MF) patients. 60.1% of visits were in-person, 39.5% were by telephone, and 0.3% were videocall visits, with a predominance of telephone visits for essential thrombocythemia (ET) and polycythemia vera (PV) patients over MF, as well as for younger patients (< 50 yr). The proportion of phone visits significantly decreased after the first semester of the pandemic. Pharmacological modifications were performed only in 25.7% of the visits, and, considering overall management, ET patients needed fewer global treatment changes. Telephone contact effectiveness reached 90% and only 5.4% required a complementary in-person appointment. Although 56.2% of the cohort preferred in-person visits, 90.5% of our patients claimed to be satisfied with follow-up during the pandemic, with an 83% of positive comments. In view of our results, telemedicine has proven effective and efficient, and might continue to play a complementary role in Ph-MPN patients' follow-up.

Stem cell and tissue engineering approaches in pressure ulcer treatment.

CONTEXT: Pressure ulcers or injuries, arise from ischemic damage to soft tissues induced by unrelieved pressure over a bony prominence. They are usually difficult to treat with standard medical therapy and often they recur. In the search for better treatment options, promising alternative forms of treatment are today emerging. Within the field of regenerative medicine, ongoing research on advanced therapies seeks to develop medicinal products based on gene therapy, somatic cell therapy, tissue-engineering and combinations of these. OBJECTIVE: The main objective is to perform an overview of experimental and clinical developments in somatic cell therapy and tissue engineering targeting the treatment of pressure injuries. METHODS: Searching terms as "PRESSURE ULCER", "STEM CELL THERAPY", "TISSUE ENGINEERING" or "WOUND HEALING" were used in combination or alone, including publications refered to basic and clinical research and focusing on articles showing results obtained in a clinical context. A total of 80 references are cited, including 23 references published in the 3 last years. RESULTS: The results suggest that this form of treatment could be an interesting option in patients with difficult-to-treat ulcers as spinal cord injury patients. CONCLUSION: This field of regenerative medicine is very broad and further research is warranted.

Fine Scale Microevolutionary and Demographic Processes Shaping a Wild Metapopulation Dynamics of the South American Fruit Fly Anastrepha fraterculus.

Anastrepha fraterculus (Wiedmann) is an important American pest species. Knowledge of its population dynamics is of particular interest for ecology, evolutionary biology, and management programs. In the present study, phenotypic, genotypic, and spatial data were combined, within the frame of landscape genetics, to uncover the spatial population genetic structure (SGS) and demographic processes of an Argentinian local population from the Yungas ecoregion. Eight simple sequence repeats (SSR) loci and six morphometric traits were analysed considering the hierarchical levels: tree/fruit/individual. Genetic variability estimates were high (HE = 0.72, RA = 4.39). Multivariate analyses of phenotypic data showed that in average 52.81% of variance is explained by the tree level, followed by between individuals 28.37%. Spatial analysis of morphological traits revealed a negative autocorrelation in all cases. SGS analysis and isolation by distance based on SSR showed no significant autocorrelation for molecular coancestry. The comparison between phenotypic (PST) and molecular (FST) differentiation identified positive selection in different fruits for all traits. Bayesian analysis revealed a cryptic structure within the population, with three clusters spatially separated. The results of this study showed a metapopulation dynamics. The genetic background of the components of this metapopulation is expected to change through time due to seasonality, repopulation activities, and high gene flow, with an estimated dispersal ability of at least 10 km. Effective population size (Ne) of the metapopulation was estimated in around 800 flies, and within subpopulations (clusters) Ne was associated with the levels of genetic drift experienced by the founding lineages.

Resilience and associated factors in women survivors of Intimate Partner Violence: a systematic review

Gran parte de los estudios sobre Violencia de Género en la Pareja (VGP) presentan a las mujeres como víctimas pasivas, pero en los últimos años el número de investigaciones centradas en fortalezas está aumentando. El objetivo del presente estudio es revisar la literatura empírica sobre resiliencia en mujeres supervivientes de VGP para: (a) analizar el consenso en la definición y evaluación de resiliencia; (b) estudiar los correlatos del constructo; y (c) reflexionar sobre la aplicabilidad de este conocimiento en las políticas y la práctica profesional. Siguiendo las guías PRISMA, se realizó una revisión sistemática en las bases de datos Scopus, WoS y PsycINFO, encontrando 42 artículos publicados en inglés o español sin restricción temporal. Los resultados muestran que los estudios adoptan definiciones de resiliencia tanto orientadas al proceso como al rasgo y a los resultados, y que el método de evaluación difiere entre investigaciones. Entre los correlatos de resiliencia se encontraron factores individuales, relacionales y contextuales. Se necesita un consenso teórico y profundizar en los mecanismos por los cuales los factores de vulnerabilidad o protección afectan a grupos con riesgos específicos. Por último, los gobiernos e instituciones deberían emprender acciones de prevención y de apoyo a las mujeres e hijos/as.(AU)

Most researchonIntimate PartnerViolenceagainstwomen(IPV)hastended topresentwomenaspassivevictims,butinrecentyears,therehasbeenan increaseinstudiesadoptinga strengths-based approach. The aim of the present study is to review the empirical literatureabout re-silience in women survivors of IPV to (a) analyze the consensus on the definition andassessment of resilience; (b) study the correlates of resilience; and (c) reflect on theapplicability of such knowledge in policies and pro-fessional practice. Following PRISMAguidelines, a systematic search was carried out in the Scopus, WoS and PsycINFO databases.The search yield-ed 42 articles published in English or Spanish over an unlimited timeframe.Results showed that process-oriented, trait-oriented, and outcomes-oriented definitions ofresilience were all adopted in the research and that assessment methods also differed acrossstudies.Individual,relational,and contextualfactorswerefoundasresiliencecorrelates.There is a need for a theoretical consensus and for research on the mecha-nisms throughwhich vulnerability or protective factors exert their influ-ence on groups with specific riskconditions.Finally,governmentsand in-stitutionsshouldtakeactionstosupportwomenandchildrenandtopre-ventfutureIPV.(AU)

Prevalencia y factores asociados de fragilidad en adultos mayores de 70 años en la comunidad / Prevalence and associated factors of frailty in adults over 70 years in the community

Objetivo: Estimar la prevalencia y analizar los factores asociados al síndrome de fragilidad en adultos ≥70 años, pertenecientes a un centro de salud de Asturias. Diseño: Estudio observacional transversal. Emplazamiento: Centro de Salud El Llano, Asturias. Participantes: Adultos ≥70 años. Mediciones principales: La fragilidad se definió por la presencia de ≥3 criterios del fenotipo de fragilidad de Fried. Variables secundarias: características sociodemográficas, estado de salud, estado funcional, estado cognitivo-afectivo y riesgo social. Se realizó un análisis bivariante y regresión logística. Resultados: Se incluyeron 408 participantes con una edad media de 79,8 (DE 6,6) años, el 59,1% eran mujeres. La prevalencia de fragilidad fue del 27,7% y del 44,9% para la prefragilidad. El perfil sociodemográfico es de una mujer (77%), de elevada edad (>84 años) (50,4%), sin estudios (65,5%), viuda (48,7%), con bajo nivel económico (47,8%) y en riesgo social (OR: 3,3; IC 95%: 2,5-4). Los factores que se asociaron estadísticamente con el síndrome de fragilidad fueron: comorbilidad alta (OR: 2,7; IC 95%: 1,5-5), polimedicación (OR: 1,9; IC 95%: 1,3-3), percepción de la calidad de vida con la salud (OR: 0,95; IC 95%: 0,93-0,97); deambulación alterada (OR: 17,9; IC 95%: 7,1-45,3), apoyo para la marcha (OR: 10,5; IC 95%: 4,7-23,4), alto riesgo de caídas (OR: 6,4; IC 95%: 3,8-10,8), dependencia para las ABVD (OR: 4; IC 95%: 2,4-6,6), AIVD (OR: 9,7; IC 95%: 4,7-20), discapacidad (OR: 37,7; IC 95%: 52,2-274,5), deterioro cognitivo (OR: 4,1; IC 95%: 1,8-9,3) y depresión (OR: 4,8; IC 95%: 2,7-8,7). Conclusiones: La fragilidad es un síndrome multifactorial de elevada prevalencia en los mayores de 70 años, en el que además de los criterios de fragilidad de Fried deben de ser analizados aspectos del estado de salud, funcionales, cognitivos-afectivos y sociales.(AU)

Objective: To estimate the prevalence and analyze the factors associated with frailty syndrome, in adults ≥70 years old, belonging to a health center in Asturias. Design: Observational cross-sectional study. Participants: Adults ≥70 years of age. Site: Health Centre of Llano (Asturias). Main measurements: Frailty was defined by the presence of ≥3 criteria of Fried's frailty phenotype. Secondary variables: sociodemographic characteristics, health status, functional status, cognitive-affective status and social risk. A bivariate analysis and logistic regression were performed. Results: Four hundred eight participants were included, with a mean age of 79.8 (SD 6.6), 59.1% female. The prevalence of frailty was 27.7% and 44.9% for pre-frailty. The sociodemographic profile is that of a woman (77%), of high age (>84 years) (50.4%), without studies (65.5%), widow (48.7%) with low economic status (47.8%) and at social risk (OR: 3.3; 95% CI: 2.5-4). Factors that were statistically associated with frailty syndrome were: high comorbidity (OR: 2.7; 95% CI: 1.5-5), polypharmacy (OR: 1.9; 95% CI: 1.3-3), perception of quality of life with health (OR: 0.95; 95% CI: 0.93-0.97), impaired ambulation (OR: 17.9; 95% CI: 7.1-45.3), support for walking (OR: 10.5; 95% CI: 4.7-23.4), high risk of falls (OR: 6.4; 95% CI: 3.8-10.8), ABVD (OR: 4; 95% CI: 2.4-6.6), AIVD (OR: 9.7; 95% CI: 4.7-20), disability (OR: 37.7; 95% CI: 52.2-274.5), cognitive impairment (OR: 4.1; 95% CI: 1.8-9.3) and depression (OR: 4.8; 95% CI: 2.7-8.7). Conclusions: Frailty is a multifactorial syndrome, with a high prevalence in those over 70 years of age, in which, in addition to Fried's criteria of frailty, aspects of health, functional, cognitive-affective and social status must be analyzed.(AU)

[Actinomyces sp. brain abscess: a rare infection in children. A case report]. / Absceso cerebral por Actinomyces sp.: una infección infrecuente en niños. A propósito de un caso.

Despite advances in diagnostic and treatment techniques, intracranial infections remain serious diseases with an estimated incidence of between 0.3 and 1.3 cases/100,000 inhabitants. We present a previously healthy patient with an intraoperative diagnostic of brain abscess, in whom although the culture showed polymicrobial development, Actinomyces sp was presumptively identified in the pathological anatomy. Given this finding, prolonged combined antibiotic therapy was performed with good evolution. Absceso cerebral por Actinomyces sp.: una infección infrecuente en niños. A propósito de un caso Actinomyces sp. brain abscess: a rare infection in children. A case report The presentation of this suppurative process was nonspecific and the contribution of the anatomopathology in the etiological diagnosis was relevant. The identification of an unusual microorganism defined the need to deepen the identification of predisposing factors.

A pesar de los avances en las técnicas de diagnóstico y tratamiento, las infecciones intracraneanas son aún enfermedades graves con una incidencia estimada entre 0,3 y 1,3 casos por cada 100 000 habitantes. Se presenta un paciente previamente sano con un absceso cerebral de diagnóstico intraoperatorio en quien, si bien el cultivo evidenció desarrollo polimicrobiano, se identificó presuntivamente Actinomyces sp. en la anatomía patológica. Dado este hallazgo, se realizó antibioticoterapia combinada prolongada con buena evolución. La presentación de este proceso supurado fue inespecífica y la contribución de la anatomía patológica en el diagnóstico etiológico fue relevante. La identificación de un microorganismo inhabitual definió la necesidad de profundizar en la determinación de factores predisponentes.

[Prevalence and associated factors of frailty in adults over 70 years in the community]. / Prevalencia y factores asociados de fragilidad en adultos mayores de 70 años en la comunidad.

OBJECTIVE: To estimate the prevalence and analyze the factors associated with frailty syndrome, in adults ≥70 years old, belonging to a health center in Asturias. DESIGN: Observational cross-sectional study. PARTICIPANTS: Adults ≥70 years of age. SITE: Health Centre of Llano (Asturias). MAIN MEASUREMENTS: Frailty was defined by the presence of ≥3 criteria of Fried's frailty phenotype. Secondary variables: sociodemographic characteristics, health status, functional status, cognitive-affective status and social risk. A bivariate analysis and logistic regression were performed. RESULTS: Four hundred eight participants were included, with a mean age of 79.8 (SD 6.6), 59.1% female. The prevalence of frailty was 27.7% and 44.9% for pre-frailty. The sociodemographic profile is that of a woman (77%), of high age (>84 years) (50.4%), without studies (65.5%), widow (48.7%) with low economic status (47.8%) and at social risk (OR: 3.3; 95% CI: 2.5-4). Factors that were statistically associated with frailty syndrome were: high comorbidity (OR: 2.7; 95% CI: 1.5-5), polypharmacy (OR: 1.9; 95% CI: 1.3-3), perception of quality of life with health (OR: 0.95; 95% CI: 0.93-0.97), impaired ambulation (OR: 17.9; 95% CI: 7.1-45.3), support for walking (OR: 10.5; 95% CI: 4.7-23.4), high risk of falls (OR: 6.4; 95% CI: 3.8-10.8), ABVD (OR: 4; 95% CI: 2.4-6.6), AIVD (OR: 9.7; 95% CI: 4.7-20), disability (OR: 37.7; 95% CI: 52.2-274.5), cognitive impairment (OR: 4.1; 95% CI: 1.8-9.3) and depression (OR: 4.8; 95% CI: 2.7-8.7). CONCLUSIONS: Frailty is a multifactorial syndrome, with a high prevalence in those over 70 years of age, in which, in addition to Fried's criteria of frailty, aspects of health, functional, cognitive-affective and social status must be analyzed.

Observer-Based Time-Variant Spacing Policy for a Platoon of Non-Holonomic Mobile Robots.

This paper presents a navigation strategy for a platoon of n non-holonomic mobile robots with a time-varying spacing policy between each pair of successive robots at the platoon, such that a safe trailing distance is maintained at any speed, avoiding the robots getting too close to each other. It is intended that all the vehicles in the formation follow the trajectory described by the leader robot, which is generated by bounded input velocities. To establish a chain formation among the vehicles, it is required that, for each pair of successive vehicles, the (i+1)-th one follows the trajectory executed by the former i-th one, with a delay of τ(t) units of time. An observer is proposed to estimate the trajectory, velocities, and positions of the i-th vehicle, delayed τ(t) units of time, consequently generating the desired path for the (i+1)-th vehicle, avoiding numerical approximations of the velocities, rendering robustness against noise and corrupted or missing data as well as to external disturbances. Besides the time-varying gap, a constant-time gap is used to get a secure trailing distance between each two successive robots. The presented platoon formation strategy is analyzed and proven by using Lyapunov theory, concluding asymptotic convergence for the posture tracking between the (i+1)-th robot and the virtual reference provided by the observer that corresponds to the i-th robot. The strategy is evaluated by numerical simulations and real-time experiments.

Caso clínico: tumor sólido pseudopapilar de páncreas / Solid-pseudopapillary tumour of the pancreas, clinical case / Tumor sólido pseudopapilar de pâncreas, relato de caso

Resumen: Introducción: el tumor sólido pseudopapilar de páncreas (TSP) es un tumor poco frecuente de bajo potencial de malignidad que afecta principalmente a mujeres jóvenes. Objetivo: reportar una adolescente en quien se documentó un TSP. Caso clínico: paciente de 12 años de sexo femenino, en la cual se confirmó un TSP luego de presentar episodio de dolor abdominal intenso a nivel de hipocondrio izquierdo y vómitos. En su historial destacó la ausencia de antecedentes patológicos y un examen físico sin alteraciones. La resonancia nuclear magnética (RNM) identificó a nivel del sector caudal del páncreas una tumoración mixta sólido quística; por sus características se planteó que podría corresponder a un TSP. Se realizó su resección completa. La anatomía patológica confirmó el planteo diagnóstico. Conclusiones: debe ser considerado su diagnóstico en adolescentes de sexo femenino que presentan una tumoración pancreática e imagen compatible. La resección quirúrgica es el Gold Standard del manejo terapéutico.

Summary: Introduction: solid pseudopapillary tumor (SPT) of the pancreas is a rare low-level malignant tumor which mainly affects young women. Objective: report the case of an adolescent with a SPT. Clinical case: twelve-year old female adolescent diagnosed with a SPT after an episode of severe abdominal pain on the left hypochondriac region and vomiting. Her medical record did not show a pathological history nor were there findings in the physical examination. The MRI showed a mixed cystic and solid tumor in the caudal portion of the head of the pancreas, which was initially thought to be a SPT. A total surgical resection was performed and the anatomical pathology confirmed the diagnosis. Conclusions: SPT diagnosis should be considered in female adolescents who show a pancreatic tumor and compatible image. A total surgical resection is the Gold Standard regarding the SPT's therapeutic management.

Resumo: Introdução: o tumor sólido pseudopapilar do pâncreas (TSPP) é um tumor raro com baixo potencial de malignidade que afeta principalmente mulheres jovens. Objetivo: relatar o caso de uma adolescente diagnosticada com um TSPP. Caso clínico: paciente do sexo feminino, 12 anos de idade, confirmada com TSPP após apresentar episódio de dor abdominal intensa em quadrante superior esquerdo e vômitos. Em seu prontuário, destacou-se a ausência de antecedentes patológicos e um exame físico sem alterações. A ressonância magnética (RM) identificou um tumor cístico sólido misto no setor caudal do pâncreas que, por suas características, sugeriu-se que pudesse corresponder a um TSPP. Realizou-se sua ressecção completa. A anatomia patológica confirmou a abordagem diagnóstica. Conclusões: deve se considerar o diagnóstico de TSPP em adolescentes do sexo feminino que apresentam tumor pancreático e imagem compatível. A ressecção cirúrgica é o padrão ouro para o manejo terapêutico.

Life cycle assessment of autochthonous varieties of wheat and artisanal bread production in Galicia, Spain.

For millennia, bread and wheat have been one of the most important sources of nutrients in many civilizations. Today, mechanization and evolution in agriculture and food processing have intensified yields and modified the biological and nutritional aspects of multiple crops and foods. The Galician bread is a reference value of food heritage in Spain, which is made from common wheat grain and is a mixture of indigenous Galician wheat and conventional Spanish wheat. In the pursuit of product excellence, it is interesting to identify the environmental profile as support criteria in decision-making, not only to analyse product environmental sustainability, but also as a marketing element to improve consumer awareness. The paper has a twofold perspective to analyse the environmental burdens of wheat cultivation and the bread sector, using life cycle assessment approach: 1) the comparison of the different types of agricultural systems, i.e. the cultivation of Galician wheat following a strategy of monoculture and crop rotation, certified Galician seed production and its comparison with conventional wheat cultivation and 2) the environmental profile of Galician bread. The functional units chosen were 1 kg of wheat grain transported to the milling facility and 1 kg of Galician bread. The results show that wheat cultivation presents the main environmental impacts of bread production, mainly due to the use of agrochemicals and field emissions. The best cultivation scenario corresponds to a crop rotation system, since chemical fertilisation is not applied. In comparative terms with many staple foods produced in Europe, Galician bread has a low environmental impact. The overall environmental results of bread production draw attention to the dependence of bread and flour manufacturers on the agricultural sector, highlighting the need to share responsibilities across the supply chain. In addition, this study contributes to the stakeholder debate on environmental impacts related to food heritage.

Measuring Explicit Prejudice and Transphobia in Nursing Students and Professionals.

Trans* people frequently report attitudes of prejudice/transphobia in health professionals. Conversely, health professionals indicate the lack of adequate training to care for these people and its impact on the quality of care provided. OBJECTIVE: Our objective was to evaluate the explicit prejudices/transphobia of health students and professionals and compare them with the general population in Tenerife. METHODS: A descriptive cross-sectional study was carried out with the Genderism and Transphobia Scale (GTS) and the Negative Attitude towards Trans* people Scale (EANT) with a total of 602 participants. RESULTS: We found a low mean level of explicit prejudice/transphobia, with little/no differences between occupation groups. Explicit transphobia was correlated with being a man, less educated, and heterosexual, and not personally knowing a trans* person. Men and women were less transphobic about trans* people whose identities coincided with their own. CONCLUSION: All participants showed a low mean level of explicit transphobia. This result is not incompatible with unconscious prejudice, which may translate to discriminatory behaviors. Interventions to change negative attitudes are still needed, since even a small percentage of transphobic health professionals could exert a considerable negative impact on health care. In professionals without transphobic attitudes, the barriers identified by trans* people might be a problem due to the lack of specific training.

Use of eltrombopag for patients 65 years old or older with immune thrombocytopenia.

BACKGROUND: Eltrombopag is useful for immune thrombocytopenia (ITP). However, results of clinical trials may not accurately mirror clinical practice reality. Here we evaluated eltrombopag for primary and secondary ITP in our ≥65-year-old population. METHODS: A total of 106 primary ITP patients (16 with newly diagnosed ITP, 16 with persistent ITP, and 74 with chronic ITP) and 39 secondary ITP patients (20 with ITP secondary to immune disorders, 7 with ITP secondary to infectious diseases, and 12 with ITP secondary to lymphoproliferative disorders [LPD]) were retrospectively evaluated. RESULTS: Median age of our cohort was 76 (interquartile range, IQR, 70-81) years. 75.9% of patients yielded a platelet response including 66.2% complete responders. Median time to platelet response was 14 (IQR, 8-21) days. Median time on response was 320 (IQR, 147-526) days. Sixty-three adverse events (AEs), mainly grade 1-2, occurred. The most common were hepatobiliary laboratory abnormalities (HBLAs) and headaches. One transient ischemic attack in a newly diagnosed ITP and two self-limited pulmonary embolisms in secondary ITP were the only thrombotic events observed. CONCLUSION: Eltrombopag showed efficacy and safety in ITP patients aged ≥65 years with primary and secondary ITP. However, efficacy results in LPD-ITP were poor. A relatively high number of deaths were observed.

Impact of a Formative Program on Transgender Healthcare for Nursing Students and Health Professionals. Quasi-Experimental Intervention Study.

BACKGROUND: The field of specific healthcare for transgender people has not been included in the official curriculum of professionals. This causes a lack of knowledge that can be presumed to become a barrier to healthcare. Currently, different methodologies are emerging to achieve meaningful learning for students and professionals. The objective of this study was to evaluate the increase in the level of knowledge of final-year nursing students, applying methodological strategies such as problem-based learning (PBL) and film-forum. METHODS: 59 nursing students were randomly assigned to two intervention groups (G1 = 31 and G2 = 28), and another 57 were assigned to the control group (without specific classes or workshops on the subject of the study). The intervention consisted of a specific training course on transgender issues (TGSC&W, TransGender Specific Course and Workshop), where the type of meaningful learning strategy used depended on the group (G1 = film-forum and G2 = PBL). The study was carried out at the Faculty of Nursing Nuestra Señora de Candelaria of the Canary Islands Health Service. The randomization was done by blindly choosing a computer-generated code. RESULTS: The main outcome was based on 116 participants, comparing their level of knowledge before and after the workshop. The comparison by pairs shows that there were statistically significant differences (p = 0.000) between those undergoing the methodological interventions and the control group. Statistical significance between film-forum and PBL was not obtained (p = 1.000): Both methodologies increased the level of knowledge, but there was no significant difference between them. The means for satisfaction with the learning methodology used did not show statistically significant differences. CONCLUSION: The workshop carried out was highly effective and significant in terms of increasing knowledge. No significant differences were observed in the level of knowledge, or in the degree of satisfaction, between the two methodologies used (PBL and film-forum).

Sensory evaluation of low-fat yoghurt produced with microbial transglutaminase and comparison with physicochemical evaluation.

BACKGROUND: Low-fat or non-fat yoghurts are popular nowadays. However, their texture is not good and they show considerable syneresis with time. The aim of this research was to evaluate the effect of the application of transglutaminase (TG) to low-fat yoghurt to determine if similar sensory properties to those of full-fat yoghurt can be obtained. Methods of adding TG (prior or simultaneous with fermentation), dose, and TG origin were evaluated. Correlations between sensory and physicochemical parameters were assessed. RESULTS: The results showed no significant differences between TG addition methods in terms of the quantitative and qualitative sensory attributes studied. Simultaneous addition of TG was preferred to speed up the process. A dose of 1 U g-1 was selected as optimal. Few differences were detected due to the origin of the TG. They were not significant although some differences were observed in terms of density, bitterness, and syneresis compared with low and full-fat yoghurts. CONCLUSION: The results showed that sensory parameters cannot be associated with only one physicochemical parameter in yoghurt evaluation. Transglutaminase can be used as a substitute for stabilizers in the production of low-fat yoghurt, maintaining good sensory properties and avoiding initial syneresis. © 2018 Society of Chemical Industry.

Molecular autopsy in a cohort of infants died suddenly at rest.

Sudden infant death syndrome is the leading cause of death during the first year of life. A large part of cases remains without a conclusive cause of death after complete autopsy. In these situations, cardiac arrhythmia of genetic origin is suspected as the most plausible cause of death. Our aim was to ascertain whether genetic variants associated with sudden cardiac death might be the cause of death in a cohort of infants died suddenly. We analyzed 108 genes associated with sudden cardiac death in 44 post-mortem samples of infants less than 1 year old of age who died at rest. Definite cause of death was not conclusive in any case after a complete autopsy. Genetic analysis identified at least one rare variant in 90.90% of samples. A total of 121 rare genetic variants were identified. Of them, 33.05% were novel and 39.66% were located in genes encoding ion channels or associated proteins. A comprehensive genetic analysis in infants who died suddenly enables the unraveling of potentially causative cardiac variants in 2045% of cases. Molecular autopsy should be included in forensic protocols when no conclusive cause of death is identified. Large part genetic variants remain of uncertain significance, reinforcing the crucial role of genetic interpretation before clinical translation but also in early identification of relatives at risk.