Groundwater modelling reports fail to comply with guideline recommendations for model reproducibility.

Computer models are routinely used to underpin critical decision-making for projects that impact groundwater systems. Modelling results are communicated through technical reports, which advise regulators and other stakeholders of groundwater impacts, thereby informing approvals, project restrictions and monitoring requirements. Several guidelines and texts are available to instruct groundwater model development and reporting. In seven of the eight guidelines/texts reviewed, it is recommended that modelling reports (or a model archive) contain sufficient information for an external party to rebuild the model. This study examined that expectation (assumed to be "best practice") by reviewing 25 groundwater modelling reports from eight countries and assessing whether the information contained therein was sufficient (or an archive was provided) to rebuild the model on which the report was based. The reports were characterised based on 18 model components (e.g., aquifer properties, boundary conditions, etc.), and the availability of sufficient information in the report to rebuild each one. The "rebuildability" of model components was classified as: (a) reproducible (from the report), (b) reproducible but assumptions needed, and (c) not reproducible. The Analytical Hierarchical Process was employed to rank the reports based on the reproducibility of the models they describe. Only one of the 25 reports provided adequate information to rebuild the model, while one other report was accompanied by a model archive, resulting in two cases of model reproducibility, contrary to guideline recommendations. This outcome reflects problems with reproducibility in the wider scientific community. We conclude that modelling reports need to provide more detailed information to be compliant with best practice or model archives ought to be made available. Addressing this issue will ensure that stakeholders have access to the information needed to properly assess whether future groundwater impacts have been reliably evaluated.

Conservation genomics of an endangered montane amphibian reveals low population structure, low genomic diversity and selection pressure from disease.

Wildlife diseases are a major global threat to biodiversity. Boreal toads (Anaxyrus [Bufo] boreas) are a state-endangered species in the southern Rocky Mountains of Colorado and New Mexico, and a species of concern in Wyoming, largely due to lethal skin infections caused by the amphibian chytrid fungus Batrachochytrium dendrobatidis (Bd). We performed conservation and landscape genomic analyses using single nucleotide polymorphisms from double-digest, restriction site-associated DNA sequencing in combination with the development of the first boreal toad (and first North American toad) reference genome to investigate population structure, genomic diversity, landscape connectivity and adaptive divergence. Genomic diversity (π = 0.00034-0.00040) and effective population sizes (Ne = 8.9-38.4) were low, likely due to post-Pleistocene founder effects and Bd-related population crashes over the last three decades. Population structure was also low, likely due to formerly high connectivity among a higher density of geographically proximate populations. Boreal toad gene flow was facilitated by low precipitation, cold minimum temperatures, less tree canopy, low heat load and less urbanization. We found >8X more putatively adaptive loci related to Bd intensity than to all other environmental factors combined, and evidence for genes under selection related to immune response, heart development and regulation and skin function. These data suggest boreal toads in habitats with Bd have experienced stronger selection pressure from disease than from other, broad-scale environmental variations. These findings can be used by managers to conserve and recover the species through actions including reintroduction and supplementation of populations that have declined due to Bd.

Selection of patients for percutaneous closure in nonlacunar cryptogenic stroke associated with patent foramen ovale. Data from the NORDICTUS cooperative registry.

INTRODUCTION: There is an extending use of percutaneous closure of patent foramen ovale (PFO) as therapy for PFO-associated cryptogenic strokes. The aim of our study was to investigate the clinical practice of percutaneous closure of PFO and to analyse the variables for decision-making on the selection of patients for this procedure. METHOD: A prospective observational multicentric survey was conducted using all the cases of cryptogenic stroke/transient ischaemic attack associated with PFO recorded in the NORDICTUS hospital registry during the period 2018-2021. Clinical data, radiological patterns, echocardiogram data and factors related to PFO-associated stroke (thromboembolic disease and paradoxical embolism criteria) were recorded. The indication for closure was analysed according to age (≤/> 60 years) and the characteristics of the PFO. RESULTS: In the group ≤ 60 years (n = 488), 143 patients (29.3%) underwent PFO closure. The most influential variables for this therapy were detection of a high-risk PFO (OR 4.11; IC 2.6-6.5, P < .001), criteria for paradoxical embolism (OR 2.61; IC 1.28-5.28; P = .008) and previous use of antithrombotics (OR 2.67; IC 1.38-5.18; P = .009). In the > 60 years group (n = 124), 24 patients had PFO closure (19%). The variables related to this option were history of pulmonary thromboembolism, predisposition to thromboembolic disease, paradoxical embolism criteria, and high-risk PFO. CONCLUSIONS: The detection of a high-risk PFO (large shunt, shunt with associated aneurysm) is the main criterion for a percutaneous closure-based therapy. Other conditions to consider in the eligibility of patients are the history of thromboembolic disease, paradoxical embolism criteria or the previous use of antithrombotics.

Evaluation of the clinical value of automatic online dose restoration for adaptive proton therapy of head and neck cancer.

INTRODUCTION: Intensity modulated proton therapy (IMPT) is highly sensitive to anatomical variations which can cause inadequate target coverage during treatment. This study compares not-adapted (NA) robust plans to two adaptive IMPT methods - a fully-offline adaptive (FOA) and a simplified automatic online adaptive strategy (dose restoration (DR)) to determine the benefit of DR, in head and neck cancer (HNC). MATERIAL/METHODS: Robustly optimized clinical IMPT doses in planning-CTs (pCTs) were available for a cohort of 10 HNC patients. During robust re-optimization, DR used isodose contours, generated from the clinical dose on pCTs, and patient specific objectives to reproduce the clinical dose in every repeated-CT(rCT). For each rCT(n = 50), NA, DR and FOA plans were robustly evaluated. RESULTS: An improvement in DVH-metrics and robustness was seen for DR and FOA plans compared to NA plans. For NA plans, 74%(37/50) of rCTs did not fulfill the CTV coverage criteria (D98%>95%Dprescription). DR improved target coverage, target homogeneity and variability on critical risk organs such as the spinal cord. After DR, 52%(26/50) of rCTs met all clinical goals. Because of large anatomical changes and/or inaccurate patient repositioning, 48%(24/50) of rCTs still needed full offline adaptation to ensure an optimal treatment since dose restoration was not able to re-establish the initial plan quality. CONCLUSION: Robust optimization together with fully-automatized DR avoided offline adaptation in 52% of the cases. Implementation of dose restoration in clinical routine could ensure treatment plan optimality while saving valuable human and material resources to radiotherapy departments.

CA 125 elevado en contexto de endometrioma: reporte de caso / Elevated CA 125 in the context of endometrioma: case report

Introducción: Los tumores benignos de ovario corresponden a un 60-95% de las lesiones anexiales, en edad fértil los más frecuentes corresponden a quistes foliculares y endometriomas. Sin embargo, alrededor del 15% son patología maligna de ovario. Por lo que se debe evaluar aspectos como edad, características ecográficas y la presencia de marcadores tumorales específicos como CA 125. Objetivo general: Describir un reporte de caso y caracterizar la evidencia disponible sobre el abordaje de tumores benignos de ovario. Caso Clínico: Se presenta el caso clínico de una paciente en edad fértil de 43 años, cursando con dolor abdominal asociado a masa anexial, donde destaca la elevación del marcador CA 125 en rango de malignidad, por lo que se solicita valoración por oncología y manejo quirúrgico, confirmándose una masa anexial benigna de características quísticas, sugerente de endometrioma, al descartar patología maligna se realiza quistectomía total. Discusión: La patología anexial es una entidad clínica que puede abarcar características tumorales, ya sean benignas como malignas, por ello frente a lesiones ováricas, siempre se deben descartar estas últimas. Las características ecográficas de la paciente hacían sospechar de un endometrioma, el CA 125 elevado en ella hizo que se optara por un manejo quirúrgico oncológico con biopsia rápida para descartar o confirmar malignidad. Conclusión: Ante la presencia de endometriomas, el tratamiento debe discutirse caso a caso, teniendo en cuenta la sintomatología, deseos de fertilidad futura y tamaño de las lesiones.

Introduction: Benign ovarian tumors correspond to 60-95% of adnexal lesions, in childbearing years the most frequent correspond to follicular cysts and endometriomas. However, about 15% are malignant ovarian pathology. Therefore, aspects such as age, ultrasound characteristics and the presence of specific tumor markers such as CA 125 must be evaluated. General objective: Describe a case report and characterize the available evidence on benign ovarian tumors. Case report: A case of a 43 year old female of childbearing age, presents abdominal pain associated with an adnexal mass, where CA 125 elevations are found in the range of malignancy, for which an oncology evaluation and surgical management. A benign adnexal mass with cystic characteristics is confirmed, suggestive of endometrioma, when malignant pathology is ruled out, a total cystectomy is performed. Discussion: Adnexal pathology is a clinical entity that can include tumor characteristicas, whether benign or malignant, therefore, in the face of ovarian lesions, these should always be ruled out. The sonographic characteristics of the patient made one suspect an endometrioma, the elevated CA 125 in it led to an oncological surgical management with rapid biopsy to rule out or confirm malignancy. Conclusions: In the presence of endometriomas, treatmentshould be discussed individually, taking into account the symptoms, wishes for future fertility, and size of the lesions. Keywords: Ca-125 antigen, Endometriosis, Ovarian neoplasms

Gran mioma uterino: manejo prequirúrgico con uso de agonistas de gnrh: reporte de un caso / Large uterine myoma: presurgical management with the use of gnrh agonists: case report

Introducción: Los leiomiomas uterinos son los tumores pélvicos benignos más comunes entre las mujeres. Se estima que 60% de las mujeres llegan a tener miomatosis a lo largo de la vida (1). La necesidad de tratamiento médico y/o quirúrgico es muy importante de evaluar, ya que los fibromas son una fuente importante de morbilidad ginecológica. Objetivos: Describir el caso de un gran mioma uterino con manejo prequirúrgico de análogos de GnRH, analizando los hallazgos obtenidos en el caso según la evidencia actual. Discusión: Se reporta el caso de una mujer de 29 años sin antecedentes mórbidos conocidos, con presencia de una gran masa abdominal, motivo por el cual se realizó una ecotomografía abdominal que evidenció una masa sugerente de un gran mioma uterino subseroso. Se realizó miomectomía vía laparotomía previo tratamiento médico con análogos de GnRH. Actualmente la frecuencia de miomas de gran tamaño es poco frecuente, por lo que se busca discutir el impacto del tratamiento médico previo a la cirugía en mujeres jóvenes. Conclusiones: La experiencia con el uso prequirúrgico de agonistas de GnRH indica una ventaja en el trabajo bien definida y su uso como tratamiento coadyuvante a la cirugía está bien establecido. Sin embargo, se debe tener en cuenta la posibilidad de recurrencia de los miomas

Introduction: Uterine leiomyomas are the most common benign pelvic tumors in women. It is estimated that 60% of women develop myomatosis throughout life (1). The need for medical and / or surgical treatment is very important to assess, since fibroids are an important source of gynecological morbidity. Objectives: To describe the case of a large uterine myoma with presurgical management of GnRH analogues and to summarize updated evidence on their use. Discussion: The case of a 29-year-old woman with no known morbid history is reported, with the presence of a large abdominal mass, which is why an abdominal ultrasound scan was performed, which revealed a mass suggestive of a large subserous uterine myoma. Myomectomy was performed via laparotomy after medical treatment with GnRH analogues. Currently, the frequency of large fibroids is rare, so we seek to discuss the impact of medical treatment prior to surgery in young women. Conclusions: Experience with the presurgical use of GnRH agonists indicates a well-defined treatment advantage and its use as adjunctive treatment to surgery is well established. However, the possibility of recurrence of fibroids should be taken into account

Dermatomiositis paraneoplásica: a propósito de dos casos / Paraneoplastic dermatomyositis: report of two cases

La dermatomiositis es una miopatía inflamatoria con una incidencia de 0.5-1 caso por 100.000 habitantes. Se caracteriza por lesiones cutáneas típicas y debilidad muscular, aunque ocasionalmente podemos encontrar formas amiopáticas. La asociación con malignidad ha sido ampliamente descrita en la literatura, habiéndose detectado tumores hasta en un tercio de los casos. La presencia del anticuerpo anti-TIF-1-gamma presenta tasas más altas de neoplasia comparada con otras formas sin este anticuerpo, lo que obliga a realizar un despistaje tumoral. A continuación, presentamos 2 casos de dermatomiositis asociada a anticuerpo TIF-1-gamma asociadas a malignidad. (AU)

Dermatomyositis is an inflammatory myopathy with an incidence of 0.5-1 case per 100,000 inhabitants. It is characterized by hallmark cutaneus findings and muscle weakness, although we can occasionally find amyopathic forms. The association with malignancy has been widely described in the literature, as tumors have been detected in up to a third of the cases. The presence of the anti-TIF-1-gamma antibody presents higher rates of neoplasia compared to other forms without this antibody, so it is mandatory to do a tumor screening. Next, we present 2 cases of TIF-1-gamma antibody-associated dermatomyositis associated with malignancy. (AU)

Organosolv processing of vine shoots: Fractionation and conversion of hemicellulosic sugars into platform chemicals by microwave irradiation.

Vine shoots were subjected to a mild aqueous extraction (to remove water-soluble extractives), and the extracted solids were reacted in catalyzed media (containing water and 1-butanol) to achieve the one-stage solubilization of lignin and hemicelluloses, yielding a cellulose-rich solid. Operating in a microwave-heated reactor under optimized conditions (190 °C in media containing 2% of catalyst and 52% 1-butanol), 67.8% lignin was dissolved, and solids containing 75% cellulose were obtained. Lignin was recovered from the reaction medium and characterized, whereas the hemicellulose-derived products present in the aqueous phase (obtained under conditions leading to maximum concentrations of 17.7 g pentoses/L) were converted into furfural at 64.6% molar yield by acidic processing in the presence of recycled 1-butanol.

Disección triple y progresiva de las arterias cervicales asociada a infección respiratoria del tracto superior / Progressive triple dissection of the cervical arteries in association with upper respiratory tract infection

No disponible

Estadificación axilar post-neoadyuvancia en pacientes con cáncer de mama con metástasis ganglionares al diagnóstico. Nuestra experiencia preliminar con biopsia selectiva de ganglio centinela y disección axilar dirigida guiada con semilla de iodo-125 / Post-neoadjuvant axillary staging in node-positive breast cancer patients. Preliminary experience with sentinel lymph node biopsy and targeted axillary dissection with iodine-125 seed

La expansión de la quimioterapia neoadyuvante en cáncer de mama ha dado lugar a nuevos dilemas clínicos en el manejo de pacientes con axila metastásica al diagnóstico. La linfadenectomía axilar es el estándar en su estadificación y tratamiento, pese a tasas de respuesta axilar completa de 40-60%. Estudios prospectivos recientes han demostrado una buena precisión de los métodos mínimamente invasivos de estadificación axilar, por lo que su práctica se está extendiendo entre grupos de expertos. Presentamos nuestros primeros resultados en la evaluación axilar postneoadyuvancia de pacientes con metástasis ganglionares al diagnóstico (cN1) mediante biopsia selectiva de ganglio centinela (BSGC) y disección axilar dirigida guiada con semilla de iodo-125

The expansion of neoadjuvant chemotherapy (NACT) in breast cancer has led to new clinical dilemmas in the management of node-positive cancers at diagnosis. Axillary lymphadenectomy is the standard approach for the staging and treatment, despite complete axillary response rates up to 40-60%. Recent prospective studies have shown good accuracy of non-invasive methods for axillary staging in cN1 patients post-NACT, and have led to the spreading of this practice among expert groups. The first results are presented with post-neoadjuvant axillary re-evaluation of cN1 patients using Sentinel Lymph node biopsy (SLNB) and targeted axillary dissection with iodine-125 seed

[Impact of the COVID-19 pandemic on the training of Spanish neurology residents]. / Repercusión de la pandemia por COVID-19 en la formación de los residentes de neurología españoles.

Introduction: The COVID-19 pandemic has transformed medical practice and severely disrupted the training of medical residents worldwide. The Spanish Society of Neurology conducted a study to assess its impact on the training of neurology residents in Spain. Methods: We performed a descriptive, cross-sectional study through a survey distributed by e-mail to all neurology residents belonging to the Society. The survey included questions on demographic variables, care activity, and personal and educational impact of the pandemic, as well as respondents' expectations for the future of their work in the post-pandemic era. Results: Of 422 surveys sent, we received a total of 152 responses (36%); 79 respondents (52%) were women and 73 (48%) were men. By year of residency, 51 respondents (33.6%) were in the fourth year, 45 (29.6%) in the third year, 28 (18.4%) in the second year, and 28 (18.4%) in the first year. A total of 139 respondents (90.8%) reported changes in hospital activity, and 126 (82.8%) considered the situation to have had a negative impact on their training, with 99 (64.7%) having lost non-recoverable rotations. Sixty-six percent of respondents (n=101) expressed a desire to extend their residency period. Conclusions: The pandemic has had an extremely severe impact on all areas of the health system, with trainee physicians being one of the most affected groups. Among neurology residents, the crisis has caused significant shortcomings in their training and clinical activities, through the suspension of specific rotations. A high percentage of respondents wished to extend the residency period.

Hemorragia subaracnoidea de la convexidad asociada a oclusión carotídea ipsilateral / Convexity subarachnoid haemorrhage associated with ipsilateral carotid artery occlusion

No disponible

Composite Sulfonated Polyether-Ether Ketone Membranes with SBA-15 for Electrochemical Energy Systems.

The aim of this work is the evaluation of a Sulfonated Poly Ether-Ether Ketone (S-PEEK) polymer modified by the addition of pure Santa Barbara Amorphous-15 (SBA-15, mesoporous silica) and SBA-15 previously impregnated with phosphotungstic acid (PWA) fillers (PWA/SBA-15) in order to prepare composite membranes as an alternative to conventional Nafion® membranes. This component is intended to be used as an electrolyte in electrochemical energy systems such as hydrogen and methanol Proton Exchange Membrane Fuel Cell (PEMFC) and Electrochemical Hydrogen Pumping (EHP). The common requirements for all the applications are high proton conductivity, thermomechanical stability, and fuel and oxidant impermeability. The morphology of the composite membranes was investigated by Scanning Electron Microscopy- Energy Dispersive X-ray Spectroscopy (SEM-EDS) analysis. Water Uptake (Wup), Ion Exchange Capacity (IEC), proton conductivity, methanol permeability and other physicochemical properties were evaluated. In PEMFC tests, the S-PEEK membrane with a 10 wt.% SBA-15 loading showed the highest performance. For EHP, the inclusion of inorganic materials led to a back-diffusion, limiting the compression capacity. Concerning methanol permeability, the lowest methanol crossover corresponded to the composites containing 5 wt.% and 10 wt.% SBA-15.

Preliminary results of complete delayed primary bladder exstrophy reconstruction in male patients. / Resultados preliminares de la reconstrucción completa primaria diferida de la extrofia vesical en el varón.

INTRODUCTION: The success of primary bladder closure in bladder exstrophy (BE) is the determining factor for future capacity and continence. In recent years, owing to the unsatisfactory results of staged repair, complete delayed primary reconstruction has gained prominence. OBJECTIVE: To analyze short-term results in male patients with BE undergoing delayed primary closure and compare them with early bladder closure as part of staged repair in our healthcare facility. MATERIALS AND METHODS: The success of bladder closure, postoperative management, complications, and hydronephrosis was assessed over a 12-month follow-up period in both groups: early primary closure (group A) and delayed primary closure (group B). RESULTS: In group A (n=13), mean age at closure was 25 hours and mean pubic diastasis was 32 mm. Patients had respiratory support and muscle relaxation for an average of 4 days postoperatively. Closure success was 85%, and 1 patient presented maintained hydronephrosis beyond the first 6 months. In group B (n=6), mean at closure was 58 days, and mean pubic diastasis was 34 mm. Patients had epidural analgesia and no respiratory support postoperatively. Closure success was 100%. 33% had transient hydronephrosis, and 1 patient (17%) presented maintained bilateral hydronephrosis. The same immobilization technique was used in both groups for 3 weeks. CONCLUSIONS: Delayed primary reconstruction is safe as it allows for closure success without increasing complications as compared to staged repair. A long-term follow-up is required to assess urinary continence, esthetic results, and genital functionality.

INTROUCCION: El éxito del cierre primario vesical en la extrofia (EV) es el factor determinante de la capacidad y continencia futuras. En los últimos años, debido a los resultados poco satisfactorios de la reparación por estadios, la reconstrucción primaria completa diferida ha adquirido mayor protagonismo. OBJETIVO: Analizar los resultados a corto plazo en varones con EV sometidos a cierre primario diferido y compararlos con el cierre vesical precoz en la reparación por estadios en nuestro centro. MATERIAL Y METODOS: Evaluamos el éxito del cierre vesical, el manejo postoperatorio, las complicaciones y la presencia de hidronefrosis durante un tiempo de seguimiento de 12 meses en los grupos: cierre primario precoz (grupo A) y diferido (grupo B). RESULTADOS: En el grupo A (n= 13) la edad media al cierre fue de 25 horas y la diástasis púbica media de 32 mm. Permaneció con asistencia respiratoria y relajación muscular una media de 4 días en el postoperatorio. El éxito del cierre fue del 85% y un paciente mantuvo hidronefrosis más allá de los 6 primeros meses. En el grupo B (n= 6), la edad media al cierre fue de 58 días, la diástasis púbica de 34 mm y se mantuvieron en el postoperatorio con analgesia epidural, sin asistencia respiratoria. El éxito del cierre fue del 100%, el 33% presentó hidronefrosis transitoria y un paciente (17%) hidronefrosis bilateral mantenida. En ambos grupos se empleó igual inmovilización durante 3 semanas. CONCLUSIONES: La reconstrucción primaria diferida es segura, permitiendo el éxito del cierre sin aumentar las complicaciones, comparado con la reparación por estadios. Es necesario un seguimiento a largo plazo para evaluar la continencia urinaria, el resultado estético y la funcionalidad genital.

Resultados preliminares de la reconstrucción completa primaria diferida de la extrofia vesical en el varón / Preliminary results of complete delayed primary bladder exstrophy reconstruction in male patients

Introducción: El éxito del cierre primario vesical en la extrofia (EV) es el factor determinante de la capacidad y continencia futuras. En los últimos años, debido a los resultados poco satisfactorios de la reparación por estadios, la reconstrucción primaria completa diferida ha adquirido mayor protagonismo. Objetivo: Analizar los resultados a corto plazo en varones con EV sometidos a cierre primario diferido y compararlos con el cierre vesical precoz en la reparación por estadios en nuestro centro. Material y métodos: Evaluamos el éxito del cierre vesical, el manejo postoperatorio, las complicaciones y la presencia de hidronefrosis durante un tiempo de seguimiento de 12 meses en los grupos: cierre primario precoz (grupo A) y diferido (grupo B). Resultados: En el grupo A (n = 13) la edad media al cierre fue de 25 horas y la diástasis púbica media de 32 mm. Permaneció con asistencia respiratoria y relajación muscular una media de 4 días en el postoperatorio. El éxito del cierre fue del 85% y un paciente mantuvo hidronefrosis más allá de los 6 primeros meses. En el grupo B (n = 6), la edad media al cierre fue de 58 días, la diástasis púbica de 34 mm y se mantuvieron en el postoperatorio con analgesia epidural, sin asistencia respiratoria. El éxito del cierre fue del 100%, el 33% presentó hidronefrosis transitoria y un paciente (17%) hidronefrosis bilateral mantenida. En ambos grupos se empleó igual inmovilización durante 3 semanas. Conclusiones: La reconstrucción primaria diferida es segura, permitiendo el éxito del cierre sin aumentar las complicaciones, comparado con la reparación por estadios. Es necesario un seguimiento a largo plazo para evaluar la continencia urinaria, el resultado estético y la funcionalidad genital

Introduction: The success of primary bladder closure in bladder exstrophy (BE) is the determining factor for future capacity and con-tinence. In recent years, owing to the unsatisfactory results of staged repair, complete delayed primary reconstruction has gained prominence. Objective: To analyze short-term results in male patients with BE undergoing delayed primary closure and compare them with early blad-der closure as part of staged repair in our healthcare facility.Materials and methods. The success of bladder closure, postop-erative management, complications, and hydronephrosis was assessed over a 12-month follow-up period in both groups: early primary closure (group A) and delayed primary closure (group B). Results: In group A (n =13), mean age at closure was 25 hours and mean pubic diastasis was 32 mm. Patients had respiratory support and muscle relaxation for an average of 4 days postoperatively. Closure success was 85%, and 1 patient presented maintained hydronephrosis beyond the first 6 months. In group B (n = 6), mean at closure was 58 days, and mean pubic diastasis was 34 mm. Patients had epidural anal-gesia and no respiratory support postoperatively. Closure success was 100%. 33% had transient hydronephrosis, and 1 patient (17%) presented maintained bilateral hydronephrosis. The same immobilization technique was used in both groups for 3 weeks. Conclusions: Delayed primary reconstruction is safe as it allows for closure success without increasing complications as compared to staged repair. A long-term follow-up is required to assess urinary continence, esthetic results, and genital functionality

[Constraint-induced movement therapy in the rehabilitation of hemineglect after a stroke]. / Terapia del movimiento inducido por restricción en la rehabilitación de la heminegligencia después de un ictus.

INTRODUCTION: Hemineglect produces a lower capacity for recovery after the stroke and so far there are no rehabilitation techniques that have proven to be effective at functional level. AIMS: The main objective of this work was to assess whether the modified constraint-induced movement therapy (mCIMT)for hemineglect produces greater benefits than conventional therapy on functional hemineglect. Secondary objectives were to assess whether mCIMT produces greater benefits on upper and lower limb function as well as on the degree of autonomy and disability of patients with in relation to conventional therapy. PATIENTS AND METHODS: We have recruited 30 patients with ischemic stroke and diagnosis of hemineglect randomly assigned to mCIMT group (n = 15) or conventional therapy group (n = 15). We used the Catherine Bergego Scale (CBS) for assessment hemineglect; Fugl-Meyer tests for the motor function of lower and upper limb, and Barthel index and modified Rankin scale for the rest of objectives. RESULTS: We have found significant differences in favour of mCIMT group in the CBS after treatment and three months later once finished. We have not found differences between groups for the rest of variables. CONCLUSIONS: mCIMT could be a more effective therapy than conventional therapy to improve the symptoms of hemineglect in the acute stroke. However, it may be clinically more recommended in patients with a certain motor function after stroke.

TITLE: Terapia del movimiento inducido por restricción en la rehabilitación de la heminegligencia después de un ictus.Introducción. La heminegligencia produce una menor capacidad de recuperación después del ictus y hasta el momento no existen técnicas de rehabilitación que hayan demostrado ser funcionalmente efectivas. Objetivos. El objetivo principal de este trabajo fue valorar si la terapia de movimiento inducido por restricción modificada (TMIRm) para la heminegligencia produce mayores beneficios que la terapia convencional sobre la heminegligencia funcional. Los objetivos secundarios fueron evaluar si la TMIRm produce mayores beneficios en la función del miembro superior y del miembro inferior, así como sobre el grado de autonomía y discapacidad de los pacientes con respecto a la terapia convencional. Pacientes y métodos. Se seleccionó a 30 pacientes con ictus isquémico y diagnóstico de heminegligencia, que fueron asignados aleatoriamente al grupo de TMIRm (n = 15) o al grupo de terapia convencional (n = 15). Se empleó la Catherine Bergego Scale (CBS) para la valoración de la heminegligencia; las pruebas Fugl-Meyer para la función motora del miembro inferior y del miembro superior, y el índice de Barthel y la escala de Rankin modificada para el resto de los objetivos. Resultados. Se hallaron diferencias significativas en favor del grupo de TMIRm para la CBS en la valoración después del tratamiento y a los tres meses de finalizado. No se encontraron diferencias entre grupos para el resto de las variables. Conclusiones. La TMIRm podría ser una terapia más efectiva que la convencional para mejorar la sintomatología de la heminegligencia en la fase aguda del ictus. Sin embargo, podría ser clínicamente más recomendable en pacientes con una determinada función motora después del ictus.

Efectos de la espasticidad en la recuperación motora posterior a un ACV / Effects of spasticity on motor recovery after a stroke

Resumen Antecedentes: el proceso rehabilitador orientado a la recuperación motora posterior a un Ataque Cerebro Vascular (ACV), es un proceso complejo asociado con la aparición de signos positivos y negativos posterior a un daño de moto neurona superior (MNS). Objetivo: describir cuales son las efectos de la espasticidad en el proceso rehabilitador posterior a un ACV. Material y método: se realizó una revisión narrativa, a través de un plan de búsqueda por parte de tres revisores, explorando la base de datos PubMed, donde se utilizaron los términos MesH: Spasticity AND Motor Recovery AND Stroke, los límites de búsqueda fueron revisiones y ensayos clínicos en humanos y animales, publicados en los últimos 10 años con textos completos en inglés y español. Resultado: 71 artículos que cumplían con los criterios de búsqueda, fueron identificados, se seleccionaron 21 (16 ensayos clínicos y 5 revisiones), los que fueron analizados a través de las guías Caspe y se utilizaron para la confección de esta revisión. Conclusión: si bien existe amplia evidencia científica, esta no es concluyente, planteando que la espasticidad es fuente de compromiso funcional y discapacidad, pero no siempre es perjudicial, ya sus efectos pueden ser beneficiosos y en ocasiones no necesita tratamiento.

Background and Aim: The rehabilitation process oriented to motor recovery after a stroke is a complex process associated with the appearance of positive and negative signs after motor neuron damage. The aim was to describe the effects of spasticity in the rehabilitation process after a stroke. Methods: Three reviewers, exploring the PubMed database, carried out, a narrative review through a search plan, the terms MesH: Spasticity AND Motor Recovery AND Stroke were used; the search limits were reviews and clinical trials in humans and animals, published in the last 10 years with full texts in English and Spanish. Results: Seventy-one articles that met the search criteria were identified, 21 were selected (16 clinical trials and 5 reviews), which were analyzed through the CASPE guide and used for the preparation of this review. Conclusion: Although there is broad scientific evidence, this is not conclusive, stating that spasticity is a source of functional commitment and disability, but it is not always harmful, and its effects can be beneficial and sometimes do not need treatment.

Synthesis and evaluation of HfO2 as a prospective filler in inorganic-organic hybrid membranes based on Nafion for PEM fuel cells.

Hybrid inorganic-organic Nafion membranes modified with metal oxides (typically TiO2, ZrO2, WO3) are a good alternative for fuel cell applications. However, one of their main limitations is associated with their relative low proton conductivity at temperatures above 80 °C. In this work, we overcome this issue using HfO2 as a filler. HfO2 was prepared by a sol-gel method, and it was compared with a recast Nafion membrane (named as recast). Deconvolved XPS spectra confirmed the presence of hafnia, while EDS analysis was used to determine its weight content resulting in a 1.88 wt%. FT-IR ATR experiments indicated that the HfO2 hybrid membrane possess a higher capability to retain water than the recast. Thus, the water uptake, swelling degree, conductivity tests and fuel cell evaluations were performed. The water uptake analysis revealed that the hybrid membrane presented a higher retention percentage at 100 °C (61%) than recast (29%). This improvement enabled a higher ionic conductivity at 80 °C and 100 °C. The hybrid membrane displayed a higher conductivity at 100 °C than the recast membrane (112 versus 82 mS cm-1), increasing the cell performance to 0.36 W cm-2; being this performance almost two-fold higher to that obtained for the recast membrane. In summary, herein we demonstrated that HfO2 can be considered as an excellent substitute to conventional fillers.