Prelacrimal window approach to the maxillary sinus: a systematic review and meta-analysis of the literature.

BACKGROUND: The prelacrimal window approach (PLWA) is a minimally invasive surgical technique that has been proposed as an alternative to the traditional approaches to access the maxillary sinus. METHODOLOGY: A systematic review with meta-analysis was performed following PRISMA guidelines and identified 368 articles for initial review of which 14 (610 participants) met the criteria for meta-analysis. Four databases, including PubMed, Google Scholar, Web of Science and Scopus, were searched to identify relevant articles. Two independent reviewers conducted the eligibility as- sessment for the included studies. Methodology quality and risk of bias were evaluated by New Castle Ottawa scale. The outco- mes assessed were recurrence of the pathology, postoperative morbidity including epiphora, dry nose, facial, gingival numbness, epistaxis or local infection. RESULTS: The present data suggest a significant reduction in the recurrence rate of maxillary sinus pathology following PLWA when compared to conventional surgery (endoscopic medial maxillectomy, endoscopic sinus surgery and the Caldwell-Luc operation). The rates of epiphora, facial or gingival numbness, epistaxis or infection requiring intervention, were not significantly different between the procedures. CONCLUSIONS: Maxillary sinus pathology can be effectively treated using the PLWA technique, as it has been shown to result in a lower recurrence rate compared to conventional surgeries.

Hypoxia-induced immortalization of primary cells depends on Tfcp2L1 expression.

Cellular senescence is a stress response mechanism that induces proliferative arrest. Hypoxia can bypass senescence and extend the lifespan of primary cells, mainly by decreasing oxidative damage. However, how hypoxia promotes these effects prior to malignant transformation is unknown. Here we observed that the lifespan of mouse embryonic fibroblasts (MEFs) is increased when they are cultured in hypoxia by reducing the expression of p16INK4a, p15INK4b and p21Cip1. We found that proliferating MEFs in hypoxia overexpress Tfcp2l1, which is a main regulator of pluripotency and self-renewal in embryonic stem cells, as well as stemness genes including Oct3/4, Sox2 and Nanog. Tfcp2l1 expression is lost during culture in normoxia, and its expression in hypoxia is regulated by Hif1α. Consistently, its overexpression in hypoxic levels increases the lifespan of MEFs and promotes the overexpression of stemness genes. ATAC-seq and Chip-seq experiments showed that Tfcp2l1 regulates genes that control proliferation and stemness such as Sox2, Sox9, Jarid2 and Ezh2. Additionally, Tfcp2l1 can replicate the hypoxic effect of increasing cellular reprogramming. Altogether, our data suggest that the activation of Tfcp2l1 by hypoxia contributes to immortalization prior to malignant transformation, facilitating tumorigenesis and dedifferentiation by regulating Sox2, Sox9, and Jarid2.

Early detection of interstitial lung disease in rheumatic diseases: A joint statement from the Portuguese Pulmonology Society, the Portuguese Rheumatology Society, and the Portuguese Radiology and Nuclear Medicine Society.

INTRODUCTION: Interstitial lung disease (ILD) contributes significantly to morbidity and mortality in connective tissue disease (CTD). Early detection and accurate diagnosis are essential for informing treatment decisions and prognosis in this setting. Clear guidance on CTD-ILD screening, however, is lacking. OBJECTIVE: To establish recommendations for CTD-ILD screening based on the current evidence. METHOD: Following an extensive literature research and evaluation of articles selected for their recency and relevance to the characterization, screening, and management of CTD-ILD, an expert panel formed by six pulmonologists from the Portuguese Society of Pulmonology, six rheumatologists from the Portuguese Society of Rheumatology, and six radiologists from the Portuguese Society of Radiology and Nuclear Medicine participated in a multidisciplinary discussion to produce a joint statement on screening recommendations for ILD in CTD. RESULTS: The expert panel achieved consensus on when and how to screen for ILD in patients with systemic sclerosis, rheumatoid arthritis, mixed connective tissue disease, Sjögren syndrome, idiopathic inflammatory myopathies and systemic lupus erythematous. CONCLUSIONS: Despite the lack of data on screening for CTD-ILD, an expert panel of pulmonologists, rheumatologists and radiologists agreed on a series of screening recommendations to support decision-making and enable early diagnosis of ILD to ultimately improve outcomes and prognosis in patients with CTD.

Guarana propagation strategies: a review.

Guarana [Paullinia cupana var. sorbilis (Mart.) Ducke] is a species of great economic and social important in Brazil, as it is the only commercial guarana producer in the world. The vegetative propagation method indicated for the culture is stem cuttings, which aims at productivity, tolerance, and uniformity of clonal cultivars, because reproduction by seeds has slow germination and high genetic variability, which in traditional varieties is an undesirable factor. Genetic factors can interfere with the rooting capacity of the crop. Studies seek alternatives that can improve this condition and enhance the production system. Use of growth regulators, microorganisms that promote plant growth, variation of substrates and fertilization, have been strategies used. Preliminary tests on the rate of stem rooting and seed germination with the use of exogenous phytohormone did not demonstrate in relation to the non-application of these inducers. The use of rhizobacteria, which presents itself as a promising activity in many cultures, has not yet been demonstrated in the culture of guarana. On the other hand, the influence of different substrates on rooting has already shown consistent results as a function of rooting rate. Fertilizing the mother plants as recommended by the production system for the crop has proven to be an efficient procedure. There are still few studies aimed at improving the spread of guarana, demonstrating that new protocols need to be explored, or that the protocols already used are reviewed from another perspective.

Association between rainfall and Escherichia coli in live bivalve molluscs harvested in Sardinia, Italy.

Rainfall is generally accepted as one of the most important factors associated with an increased level of E. coli in bivalve molluscs. Performing microbiological risk assessment is relevant to official control authorities to determine the sanitary status of harvesting areas and, therefore, develop monitoring strategies and identify management practices that could be used to improve the quality and safety of the final product. The present study aimed to investigate the impact of rainfall on the content of E. coli in bivalve molluscs farmed in Sardinia (Italy). Enumeration of E. coli was performed according to the Most Probable Number (MPN) method (ISO 16649-3) on 1,920 bivalve samples collected from 7 regional counties between 2018 and 2020. Bivalve molluscs samples included 955 mussels (Mytilus galloprovincialis), 500 oysters (Crassostrea gigas), 325 clams (Ruditapes decussatus), 94 warty venus (Venus verrucosa), and 46 lagoon cockles (Cerastoderma glaucum). Rainfall data were obtained by the Department of Meteorology of the ARPA Sardegna. For each sampling site, GPS coordinates were used to identify gauge stations within catchment areas. Cumulative rain (mm) was recorded 1, 3, 5, 7, and 15 days before sampling, among which the 7-day cumulative rain was the strongest predictor of E. coli counts. Several thresholds of 7-day cumulative rain (from <10 mm up to >300 mm) before sampling were used to estimate the chances of a non-compliant sample (E. coli levels above the limit for sanitary class A; 230 MPN/100 g). The 7-day cumulative rain was positively associated with the chances of non-compliance. When the 7-day cumulative rain before sampling was >300 mm, 80.5 % of the samples were non-compliant, and the odds of a non-compliant sample were 23.6 times higher, as compared to samples harvested when the 7-day cumulative rainfall was <10 mm. Precipitation data could be a useful tool for interpreting anomalous results from official control authorities and reduce the costs that originate from closure of production areas.

A semi-automated microscopic image analysis method for scoring Ki-67 nuclear immunostaining.

Nuclear proliferation marker MIB-1 (Ki-67) immunohistochemistry (IHC) is used to examine tumor cell proliferation. However, the diagnostic or prognostic value of the Ki-67 nuclear staining intensity and location, defined as nuclear gradient (NG), has not been assessed. This study examined the potential association between Ki-67 NG and cell cycle phases and its effect on the prognosis of pulmonary typical carcinoid (PTC) tumors. We propose a method for classifying the NG of Ki-67 during the cell cycle and compare the results between PTC, pulmonary adenocarcinoma (PAD), and breast ductal carcinoma (BDC). A literature review and objective analysis of IHC-stained paraffin sections were used to determine the Ki-67 labeling index and composed a stratification of the NG into NG1, NG2, and NG3/4 categories. A semi-automated image analysis protocol was established to determine the Ki-67 NG in PTC, PAD, and BDC. High intraobserver consistency and moderate interobserver agreement were achieved in the determination of Ki-67 NG in tumor specimens. NG1 and NG2 were lower in PTC than in PAD and BDC. Cox multivariate analysis of PTC after adjusting for age and number of metastatic lymph nodes showed that Ki-67 NG1 and NG2 significantly predicted clinical outcomes. The semi-automated method for quantification of Ki-67 nuclear immunostaining proposed in this study could become a valuable diagnostic and prognostic tool in PTC.

Medium-term evaluation of the bond strength and dentin penetration of self-adhesive resin cements to root dentin.

BACKGROUND: Medium-term evaluate the bond strength and tag formation in root dentin using self-adhesive cements Maxcem Elite (MCE), Relyx U200 (RU2), SeT PP (SPP) and Megalink (MGL) compared to conventional cement Relyx ARC (ARC) for glass fibre post cementation. MATERIALS AND METHODS: One hundred bovine incisors roots were endodontically treated and divided into 5 groups (n = 20) according to the cementation system: MCE, RU2, SPP, MGL and ARC. All cementation systems were evaluated at 24 h (1) and 12 months (2) after post cementation. Specimens from the cervical, middle and apical thirds of the root were submitted to push-out bond strength test and confocal laser microscopy to verify the dentin penetration. The adhesive failure mode was classified as adhesive, cohesive and mixed. Data were analysed by one-way ANOVA and Tukey tests (α = 5%). RESULTS: ARC-1 and ARC-12 showed the highest bond strength (P < 0.05). ARC showed the greatest tag extension, regardless of the third (P < 0.05). The most frequent failure mode in the 24-h analysis was cohesive, regardless of the cement used. For the 12-month analysis, mixed failure was the most frequent. CONCLUSION: Conventional cement (ARC) showed the highest bond strength and tag extension, regardless of the evaluation period. In all cementation systems, the bond strength decreased after 12 months. © 2023 Australian Dental Association.

Mechanical osteoarthritis of the hip in a one medicine concept: a narrative review.

Human and veterinary medicine have historically presented many medical areas of potential synergy and convergence. Mechanical osteoarthritis (MOA) is characterized by a gradual complex imbalance between cartilage production, loss, and derangement. Any joint instability that results in an abnormal overload of the joint surface can trigger MOA. As MOA has a prevailing mechanical aetiology, treatment effectiveness can only be accomplished if altered joint mechanics and mechanosensitive pathways are normalized and restored. Otherwise, the inflammatory cascade of osteoarthritis will be initiated, and the changes may become irreversible. The management of the disease using non-steroidal anti-inflammatory drugs, analgesics, physical therapy, diet changes, or nutraceuticals is conservative and less effective. MOA is a determinant factor for the development of hip dysplasia in both humans and dogs. Hip dysplasia is a hereditary disease with a high incidence and, therefore, of great clinical importance due to the associated discomfort and significant functional limitations. Furthermore, on account of analogous human and canine hip dysplasia disease and under the One Medicine concept, unifying veterinary and human research could improve the well-being and health of both species, increasing the acknowledgement of shared diseases. Great success has been accomplished in humans regarding preventive conservative management of hip dysplasia and following One Medicine concept, similar measures would benefit dogs. Moreover, animal models have long been used to better understand the different diseases' mechanisms. Current research in animal models was addressed and the role of rabbit models in pathophysiologic studies and of the dog as a spontaneous animal model were highlighted, denoting the inexistence of rabbit functional models to investigate therapeutic approaches in hip MOA.

Impacto de la realización de resonancia magnética multiparamétrica (RMmp) antes de la braquiterapia en pacientes con cáncer de próstata / Prior MRI-imaging impact of patients submitted to brachytherapy for prostate cancer

Introducción La braquiterapia es una opción terapéutica bien establecida para el cáncer de próstata. El uso de la resonancia magnética multiparamétrica (RMmp) para la estadificación y el diagnóstico del cáncer de próstata ha supuesto un cambio en el paradigma actual. En este estudio pretendemos evaluar el impacto, en términos de la recurrencia bioquímica y el tiempo hasta el nadir, de la realización de RMmp para evaluar la presencia de lesiones extracapsulares antes de la braquiterapia en pacientes con cáncer de próstata. Métodos Revisar los datos de 73 pacientes sometidos a braquiterapia. Se evaluaron los siguientes factores: edad, PSA inicial, resultados de la estadificación local por RMmp, ISUP, nadir, tiempo hasta el nadir, PSA a un año, recurrencia bioquímica y tiempo hasta la recurrencia. Resultados La mediana de edad fue de 68años (51-72) y la mediana de seguimiento, de 53meses (30-72). En cuanto a la modalidad de imagen para el diagnóstico, el 30,1% (n=22) de los pacientes se sometieron a RMmp. En el grupo de RMmp, el 90,9% (n=20) tenían al menos una lesión sospechosa en la RMmp. El tiempo hasta el nadir fue de 27meses (3-64) en los pacientes en los que no se realizó RMmp y de 23,5meses (2-48) en los pacientes sometidos a RMmp (p=0,244). La mediana del nadir fue de 0,42ng/ml (<0,001-2) en los pacientes sometidos a RMmp, frente a 0,28ng/ml (<0,001-4) en los pacientes sin RMmp (p=0,062) La recurrencia según los criterios Phoenix fue del 9% (n=2) en los pacientes con RMmp y del 9,2% (n=5) en pacientes sin RMmp (p=0,456), con una mediana de seguimiento de 43meses (12-72) para el grupo con RMmp y de 58meses (30-78) para el grupo sin RMmp. Ambos grupos fueron estadísticamente similares. Conclusión Nuestros resultados nos permiten concluir que en nuestra serie la RMmp no influyó en la recurrencia bioquímica, el tiempo hasta el nadir o el valor del nadir (AU)

Introduction Brachytherapy for the treatment of prostate cancer is a well-established option. Use of Multiparametric Magnetic Resonance Imaging (mpMRI) for staging and diagnosis of prostate cancer has come to change the current paradigm. In this study we aim to assess the impact of performing mpMRI to evaluate the presence of extracapsular lesions before brachytherapy in patients with prostate cancer concerning biochemical recurrence and time to nadir. Methods Review data from 73 patients submitted to brachytherapy. The following factors were evaluated: age, initial PSA, MRI local staging results, ISUP, nadir, time to nadir, PSA at one-year, biochemical recurrence, and time to recurrence. Results Median age was 68years (51-72) and median follow-up 53months (30-72). Concerning imaging modality 30.1% (n=22) patients performed mpMRI. In the mpMRI group, 90.9% (n=20) had at least one suspect lesion on mpMRI. Time to nadir was 27months (3-64) in patients where mpMRI was not performed and 23.5months (2-48) in patients submitted to mpMRI (P=.244). The median value of nadir was 0.42ng/mL (<0.001-2) in patients submitted to mpMRI and vs 0.28ng/mL (<0.001-4) in patients without MRI (P=.062) Recurrence utilizing Phoenix criteria was 9% (n=2) in patients with MRI and 9.2% (n=5) without mpMRI (P=.456), median follow-up of 43months (12-72) for the MRI group with 58months (30-78) for the non-mpMRI group. Both groups were statistically similar. Conclusion Our results allow us to conclude that in our series MRI did not influence biochemical recurrence, time to nadir, or nadir value (AU)

Aerobic exercise prevents cardiomyocyte damage caused by oxidative stress in early cardiovascular disease by increasing vascularity while L-arginine supplementation prevents it by increasing activation of the enzyme nitric oxide synthase.

L-Arginine and chronic exercise reduce oxidative stress. However, it is unclear how they affect cardiomyocytes during cardiovascular disease (CVD) development. The aim of this research was to investigate the possible effects of L-arginine supplementation and aerobic training on systemic oxidative stress and their consequences on cardiomyocytes during cardiometabolic disease onset caused by excess fructose. Wistar rats were allocated into four groups: control (C), fructose (F, 10% fructose in water), fructose training (FT; moderate running, 50-70% of the maximal velocity), and fructose arginine (FA; 880 mg/kg/day). Fructose was given for two weeks and fructose plus treatments for the subsequent eight weeks. Body composition, blood glucose, insulin, lipid profile, lipid peroxidation, nitrite, metalloproteinase-2 (MMP-2) activity, left ventricle histological changes, microRNA-126, -195, and -146, eNOS, p-eNOS, and TNF-α expressions were analyzed. Higher abdominal fat mass, triacylglycerol level, and insulin level were observed in the F group, and both treatments reversed these alterations. Myocardial vascularization was impaired in fructose-fed groups, except in FT. Cardiomyocyte hypertrophy was observed in all fructose-fed groups. TNF-α levels were higher in fructose-fed groups than in the C group, and p-eNOS levels were higher in the FA than in the C and F groups. Lipid peroxidation was higher in the F group than in the FT and C groups. During CVD onset, moderate aerobic exercise reduced lipid peroxidation, and both training and L-arginine prevented metabolic changes caused by excessive fructose. Myocardial vascularization was impaired by fructose, and cardiomyocyte hypertrophy appeared to be influenced by pro-inflammatory and oxidative environments.

Lower low density lipoprotein cholesterol associates to higher mortality in non-diabetic heart failure patients.

Background: In patients with established heart failure (HF) low total cholesterol levels associate with worse prognosis. Evidence concerning the impact of Low-density lipoprotein cholesterol (LDL-c) in HF is scarce. We aimed to evaluate the prognostic impact of LDL-c in patients with HF, both with and without diabetes mellitus (DM). Methods: We retrospectively analyzed outpatients with chronic HF with systolic dysfunction followed in our HF clinic from January/2012 to May/2018. LDL-c was calculated using the Friedewald's formula. Patients without a complete lipid profile were excluded. The endpoint under analysis was all-cause mortality. Patients were followed until January/2021. A Cox-regression analysis was used to study the prognostic impact of LDL-c. The LDL-c cut-off used was 100 mg/dL (mean value). Analysis was stratified according to the coexistence of DM. Multivariate models were built adjusting for age, sex, coronary artery disease, atherosclerotic non-coronary artery disease, arterial hypertension, smoking status, statin use, severity of systolic dysfunction, creatinine clearance and evidence-based therapy. Results: We studied 522 chronic HF patients, mean age was 70 years, 66.5% males. Severe systolic dysfunction was present in 42.7%, 30.5% had coronary heart disease, 60.5% had arterial hypertension, 41.6% had DM. A total of 92.0% were treated with beta blocker, 87.5% with an ACEi/ARB and 29.1% with a MRA. During a median follow-up of 53 (interquartile range 33-73) months, 235 (45%) patients died. Patients with LDL-c ≤100 mg/dL presented increased multivariate-adjusted risk of all-cause mortality: HR = 1.58 (95% CI: 1.08-2.30), p = 0.02. When patients were stratified according to DM, LDL-c ≤100 mg/dL was independently associated with increased death risk - HR = 1.55 (95% CI:1.05-2.30), p = 0.03 in patients without DM; in patients with DM no association was detected - multivariate-adjusted HR = 1.18 (95% CI: 0.77-1.80), p = 0.44. Conclusion: Non-DM HF patients with LDL-c>100 mg/dL have a 35% reduction in the mortality risk when compared with those with lower values. The "cholesterol paradox" in HF also applies to LDL-c in non-DM patients.

Thoracoscopic pneumonectomy in a 4 year-old-child with destroyed lung following viral pneumonia. / Tiroidectomía transoral endoscópica con abordaje vestibular (TOETVA): una nueva opción para el tratamiento de pacientes pediátricos.

Pediatric pneumonectomies are exceptional nowadays, being reserved for cases with destroyed lungs with frequent exacerbations and reinfections and only two cases of thoracoscopic pneumonectomy have been previously published. We present the case of a 4-year-old patient with no relevant history who developed complete atelectasis of the left lung (LL) after influenza A pneumonia, followed by secondary recurrent infections. A year later a diagnostic bronchoscopy without alterations was performed. A complete loss of volume and hypoperfusion of the LL (right lung perfusion 95%, LL perfusion: 5%) with bronchiectasis and hyperinsufflation and herniation of the right lung into the left hemithorax was observed in a pulmonary perfusion SPECT-CT. After unsuccessful conservative management and recurrent infections a pneumonectomy was indicated. The pneumonectomy was performed through a five-port thoracoscopy. The dissection of the hilum was made using hook electrocautery and sealing device. The left main bronchus was sectioned with an endostapler. There were no intraoperative complications. An endothoracic drain was removed the first postoperative day. The patient was discharged on the fourth postoperative day. The patient has not presented any complications 10 months after surgery. Although pneumonectomy is an exceptional surgery in children, it can be performed by minimally invasive surgery with success and safety in centers with extensive experience in pediatric thoracoscopic surgery.

Hoy en día, las neumonectomías pediátricas son algo excepcional. El procedimiento se reserva para aquellos casos en los que los pulmones están destruidos y presentan exacerbaciones y reinfecciones frecuentes, con tan solo dos casos de neumonectomía toracoscópica publicados hasta la fecha. Presentamos el caso de un paciente de 4 años sin antecedentes de interés que desarrolló atelectasia completa del pulmón izquierdo (PI) tras neumonía por gripe A, seguido de infecciones secundarias recurrentes. Un año después, se le practicó broncoscopia diagnóstica, sin que esta mostrara alteraciones significativas. Tras realizársele un SPECT-CT de perfusión pulmonar, se evidenció pérdida completa de volumen e hipoperfusión del PI (perfusión del pulmón derecho: 95%; perfusión del pulmón izquierdo: 5%), con bronquiectasia e hiperinsuflación y herniación del pulmón derecho hacia el hemitórax izquierdo. Tras fracasar el manejo conservador y registrarse infecciones recurrentes, se estableció la indicación de neumonectomía. La neumonectomía se llevó a cabo mediante toracoscopia por cinco puertos. La disección del hilio se realizó mediante gancho de electrocoagulación y dispositivo de sellado. El bronquio principal izquierdo se seccionó con endograpadora. No se registraron complicaciones intraoperatorias. El drenaje endotorácico se retiró al día siguiente de la intervención, mientras que el paciente fue dado de alta a los cuatro días, sin que haya presentado complicaciones transcurridos 10 meses desde la cirugía. Aunque la neumonectomía es una intervención excepcional en niños, puede llevarse a cabo de manera exitosa y segura por cirugía mínimamente invasiva en centros con amplia experiencia en cirugía toracoscópica pediátrica.

A pro-BMP function exerted by Rhodnius prolixus short gastrulation reveals great diversity in the role of BMP modulators during embryonic patterning.

Dorsal-ventral (DV) patterning is regulated by the bone morphogenetic pathway (BMP) in Bilateria. In insect DV patterning, the Toll pathway also plays a role, in addition to BMPs. Variations in the relative importance of each pathway for DV patterning have been reported using single species of coleopteran, hymenopteran, hemipteran and orthopteran insects. To investigate if the molecular control of DV patterning is conserved inside an insect order, the emergent model hemiptera species Rhodnius prolixus was studied. We found that R. prolixus BMP pathway controls the entire DV axis, with a broader effect respective to Toll, as shown for the hemiptera Oncopeltus fasciatus. Different from O. fasciatus, the unique R. prolixus short gastrulation (sog) and the twisted gastrulation (tsg) orthologues do not antagonize, but rather favour embryonic BMP signalling. Our results reinforce the hypothesis that hemiptera rely preferentially on BMPs for DV patterning but that, surprisingly, in R. prolixus Sog and Tsg proteins exert only a positive role to establish a dorsal-to-ventral BMP gradient. Since sog has been reported to be lost from orthopteran and hymenopteran genomes, our results indicate that Sog's role to modify BMP activity varies greatly in different insect species.

Evaluation of a battery of biotests to improve waste ecotoxicity assessment (HP 14), using incineration bottom ash as a case study.

The assessment of waste ecotoxicity (hazardous property HP14 in the European Union) is fundamental for proper waste classification and safe application/disposal. Biotests are relevant for evaluating waste complex matrices, but their efficiency is crucial to encourage their adoption at the industrial level. This work aims at evaluating possibilities of improving the efficiency of a biotest battery previously suggested in the literature, regarding test selection, duration, and/or laboratory resources optimization. Fresh incineration bottom ash (IBA) was the case study. The test battery analysed included standard aquatic (bacteria, microalgae, macrophytes, daphnids, rotifers, fairy shrimp) and terrestrial (bacteria, plants, earthworms, collembolans) organisms. The assessment followed an Extended Limit Test design (three dilutions of eluate or solid IBA) and the Lowest Ineffective Dilution (LID-approach) for ecotoxicity classification. The results emphasize the importance of testing different species. It was also evidenced that tests with daphnids and earthworms may be shortened to 24 h; the miniaturization of tests is suitable as e.g. differential sensitivity of microalgae and macrophytes was captured with low variability; alternative testing kits can be used when methodological difficulties are found. Microalgae were more sensitive than macrophytes. Similar results were found for the Thamnotoxkit and daphnids test for eluates with natural pH, so the former may be used as an alternative. B. rapa was the most sensitive organism, suggesting that it may be tested as the only terrestrial plant species and that minimum test duration is appropriate. F. candida does not appear to add information to the battery. The differences in sensitivity of A. fischeri and E. fetida compared to the remaining species were not significant enough to exclude them from the battery. Thus, this work suggests a biotest battery to test IBA comprising aquatic tests - Aliivibrio fischeri, Raphidocelis subcapitata (miniaturised test), and Daphnia magna (24 h when clear deleterious effects are observed) or Thamnocephalus platyurus (toxkit) - and terrestrial tests - Arthrobacter globiformis, Brassica rapa (14 d), and Eisenia fetida (24 h). Testing waste with natural pH is also recommended. The Extended Limit Test design considering the LID-approach seems useful in waste testing, particularly for the industry, involving low effort, test material requirements, and few laboratory resources. The LID-approach allowed for differentiating ecotoxic from non-ecotoxic effects and captured different sensitivities between species. Ecotoxicological assessment of other waste may benefit from these recommendations, but caution should be taken given the properties of each waste type.

Neumonectomía toracoscópica en un niño de 4 años con el pulmón destruido tras neumonía vírica / Thoracoscopic pneumonectomy in a 4 year-old-child with destroyed lung following viral pneumonia

Hoy en día, las neumonectomías pediátricas son algo excepcional. Elprocedimiento se reserva para aquellos casos en los que los pulmones estándestruidos y presentan exacerbaciones y reinfecciones frecuentes, con tansolo dos casos de neumonectomía toracoscópica publicados hasta la fecha.Presentamos el caso de un paciente de 4 años sin antecedentes deinterés que desarrolló atelectasia completa del pulmón izquierdo (PI) trasneumonía por gripe A, seguido de infecciones secundarias recurrentes.Un año después, se le practicó broncoscopia diagnóstica, sin que estamostrara alteraciones significativas. Tras realizársele un SPECT-CT deperfusión pulmonar, se evidenció pérdida completa de volumen e hi-poperfusión del PI (perfusión del pulmón derecho: 95%; perfusión delpulmón izquierdo: 5%), con bronquiectasia e hiperinsuflación y hernia-ción del pulmón derecho hacia el hemitórax izquierdo. Tras fracasar elmanejo conservador y registrarse infecciones recurrentes, se establecióla indicación de neumonectomía.La neumonectomía se llevó a cabo mediante toracoscopia por cincopuertos. La disección del hilio se realizó mediante gancho de electro-coagulación y dispositivo de sellado. El bronquio principal izquierdose seccionó con endograpadora. No se registraron complicaciones in-traoperatorias.El drenaje endotorácico se retiró al día siguiente de la intervención,mientras que el paciente fue dado de alta a los cuatro días, sin que hayapresentado complicaciones transcurridos 10 meses desde la cirugía.Aunque la neumonectomía es una intervención excepcional enniños, puede llevarse a cabo de manera exitosa y segura por cirugíamínimamente invasiva en centros con amplia experiencia en cirugíatoracoscópica pediátrica.(AU)

Pediatric pneumonectomies are exceptional nowadays, being re-served for cases with destroyed lungs with frequent exacerbations and einfections and only two cases of thoracoscopic pneumonectomy havebeen previously published.We present the case of a 4-year-old patient with no relevant his-tory who developed complete atelectasis of the left lung (LL) afterinfluenza A pneumonia, followed by secondary recurrent infections.A year later a diagnostic bronchoscopy without alterations was per-formed. A complete loss of volume and hypoperfusion of the LL(right lung perfusion 95%, LL perfusion: 5%) with bronchiectasisand hyperinsufflation and herniation of the right lung into the lefthemithorax was observed in a pulmonary perfusion SPECT-CT. Afterunsuccessful conservative management and recurrent infections apneumonectomy was indicated.The pneumonectomy was performed through a five-port thoracos-copy. The dissection of the hilum was made using hook electrocauteryand sealing device. The left main bronchus was sectioned with an en-dostapler. There were no intraoperative complications.An endothoracic drain was removed the first postoperative day. Thepatient was discharged on the fourth postoperative day. The patient hasnot presented any complications 10 months after surgery.Although pneumonectomy is an exceptional surgery in children,it can be performed by minimally invasive surgery with success andsafety in centers with extensive experience in pediatric thoracoscopicsurgery.(UA)

A method to produce a flexible and customized fuel models dataset.

Simulation of vegetation fires very often resorts to fire-behavior models that need fuel models as input. The lack of fuel models is a common problem for researchers and fire managers because its quality depends on the quality/availability of data. In this study we present a method that combines expert- and research-based knowledge with several sources of data (e.g. satellite and fieldwork) to produce customized fuel models maps. Fuel model classes are assigned to land cover types to produce a basemap, which is then updated using empirical and user-defined rules. This method produces a map of surface fuel models as detailed as possible. It is reproducible, and its flexibility relies on juxtaposing independent spatial datasets, depending on their quality or availability. This method is developed in a ModelBuilder/ArcGis toolbox named FUMOD that integrates ten sub-models. FUMOD has been used to map the Portuguese annual fuel models grids since 2019, supporting regional fire risk assessments and suppression decisions. Datasets, models and supplementary files are available in a repository (https://github.com/anasa30/PT_FuelModels). •FUMOD is a flexible toolbox with ten sub-models included that maps updated Portuguese fuel models.

Brain glucose hypometabolism and hippocampal inflammation in Goto-Kakizaki rats.

Brain glucose hypometabolism and neuroinflammation are early pathogenic manifestations in neurological disorders. Neuroinflammation may also disrupt leptin signaling, an adipokine that centrally regulates appetite and energy balance by acting on the hypothalamus and exerting neuroprotection in the hippocampus. The Goto-Kakizaki (GK) rat is a non-obese type 2 diabetes mellitus (T2DM) animal model used to investigate diabetes-associated molecular mechanisms without obesity jeopardizing effects. Wistar and GK rats received the maintenance adult rodent diet. Also, an additional control group of Wistar rats received a high-fat and high-sugar diet (HFHS) provided by free consumption of condensed milk. All diets and water were provided ad libitum for eight weeks. Brain glucose uptake was evaluated by 2-deoxy-2-[fluorine-18] fluoro-D-glucose under basal (saline administration) or stimulated (CL316,243, a selective ß3-AR agonist) conditions. The animals were fasted for 10-12 h, anesthetized, and euthanized. The brain was quickly dissected, and the hippocampal area was sectioned and stored at -80°C in different tubes for protein and RNA analyses on the same animal. GK rats exhibited attenuated brain glucose uptake compared to Wistar animals and the HFHS group under basal conditions. Also, the hippocampus of GK rats displayed upregulated leptin receptor, IL-1ß, and IL-6 gene expression and IL-1ß and the subunit of the transcription factor NF-κB (p-p65) protein expression. No significant alterations were detected in the hippocampus of HFHS rats. Our data indicated that a genetic predisposition to T2DM has significant brain deteriorating features, including brain glucose hypometabolism, neuroinflammation, and leptin signaling disruption in the hippocampal area.

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For the first time, the (d,^{2}He) reaction was successfully used in inverse kinematics to extract the Gamow-Teller transition strength in the ß^{+} direction from an unstable nucleus. The new technique was made possible by the use of an active-target time-projection chamber and a magnetic spectrometer, and opens a path to addressing a range of scientific challenges, including in astrophysics and neutrino physics. In this Letter, the nucleus studied was ^{14}O, and the Gamow-Teller transition strength to ^{14}N was extracted up to an excitation energy of 22 MeV. The data were compared to shell-model and state-of-the-art coupled-cluster calculations. Shell-model calculations reproduce the measured Gamow-Teller strength distribution up to about 15 MeV reasonably well, after the application of a phenomenological quenching factor. In a significant step forward to better understand this quenching, the coupled-cluster calculation reproduces the full strength distribution well without such quenching, owing to the large model space, the inclusion of strong correlations, and the coupling of the weak interaction to two nucleons through two-body currents.

An integrated characterisation of incineration bottom ashes towards sustainable application: Physicochemical, ecotoxicological, and mechanical properties.

Environmental protection is a central concern regarding municipal solid waste incineration bottom ash (IBA) management, but the assessment of waste Hazardous Property HP14 (ecotoxicity) is still under debate. Civil engineering applications may be a suitable management strategy. This work aimed at evaluating IBA regarding mechanical behaviour and environmental hazardous potential, including a biotest battery for ecotoxicity assessment (comprising miniaturised tests), to explore its potential for safe utilization. Physical, chemical, ecotoxicological (Aliivibrio fischeri, Raphidocelis subcapitata, Lemna minor, Daphnia magna, Lepidium sativum), and mechanical (one-dimensional compressibility, shear strength) analyses were performed. The low leaching for potentially toxic metals and ions complied with European Union (EU) limit values for non-hazardous waste landfills. No relevant ecotoxicological effects were found. The biotest battery seems suitable for ecotoxicological assessment in the aquatic ecosystem, providing wide information on waste impact on different trophic/functional levels and chemical uptake routes, simultaneously involving short-duration tests and reduced amounts of waste. IBA presented more compressibility than sand, but its mixture with sand (30%:70%) was closer to sand compressibility. IBA (lower stresses) and the mixture (higher stresses) showed slightly higher shear strength than sand. Overall, IBA presented the potential for valorisation as loose aggregates from an environmental and mechanical viewpoint in a circular economy framework.