Final Measurement of the

This Letter reports one of the most precise measurements to date of the antineutrino spectrum from a purely ^{235}U-fueled reactor, made with the final dataset from the PROSPECT-I detector at the High Flux Isotope Reactor. By extracting information from previously unused detector segments, this analysis effectively doubles the statistics of the previous PROSPECT measurement. The reconstructed energy spectrum is unfolded into antineutrino energy and compared with both the Huber-Mueller model and a spectrum from a commercial reactor burning multiple fuel isotopes. A local excess over the model is observed in the 5-7 MeV energy region. Comparison of the PROSPECT results with those from commercial reactors provides new constraints on the origin of this excess, disfavoring at 2.0 and 3.7 standard deviations the hypotheses that antineutrinos from ^{235}U are solely responsible and noncontributors to the excess observed at commercial reactors, respectively.

Enantiosensitive growth dynamics of chiral molecules on ferromagnetic substrates and the origin of the CISS effect.

The recent demonstration of the existence of an intimate relationship between the chiral structure of some materials and the spin polarization of electrons transmitted through them, what has been called the chirality-induced spin selectivity (CISS) effect, is sparking interest in many related phenomena. One of the most notorious is the possibility of using magnetic materials to apply enantioselective interactions on chiral molecules and chemical reactions involving them. In this work, x-ray photoelectron spectroscopy has been used to characterize the adsorption and growth kinetics of enantiopure organic molecules on magnetic (Co) and non-magnetic (Cu) substrates. While on these latter, no significant enantiosensitive effects are found, on spin-polarized, in-plane magnetized Co surfaces, the two enantiomers have been found to deposit differently. The observed effects have been interpreted as the result of one of the enantiomers being adsorbed in a transient, weakly bound physisorbed-like state with higher mobility due to limited, spin-selective charge transfer between it and the substrate. The study of these phenomena can provide insight into the fundamental mechanisms responsible for the CISS effect.

Prevalence, risk factors and evolution of diabetes mellitus after treatment in primary aldosteronism. Results from the SPAIN-ALDO registry.

PURPOSE: To evaluate the prevalence, risk factors and evolution of diabetes mellitus (DM) after targeted treatment in patients with primary aldosteronism (PA). METHODS: A retrospective multicenter study of PA patients in follow-up at 27 Spanish tertiary hospitals (SPAIN-ALDO Register). RESULTS: Overall, 646 patients with PA were included. At diagnosis, 21.2% (n = 137) had DM and 67% of them had HbA1c levels < 7%. In multivariate analysis, family history of DM (OR 4.00 [1.68-9.53]), the coexistence of dyslipidemia (OR 3.57 [1.51-8.43]) and advanced age (OR 1.04 per year of increase [1.00-1.09]) were identified as independent predictive factors of DM. Diabetic patients were on beta blockers (46.7% (n = 64) vs. 27.5% (n = 140), P < 0.001) and diuretics (51.1% (n = 70) vs. 33.2% (n = 169), p < 0.001) more frequently than non-diabetics. After a median follow-up of 22 months [IQR 7.5-63.0], 6.9% of patients developed DM, with no difference between those undergoing adrenalectomy and those treated medically (HR 1.07 [0.49-2.36], p = 0.866). There was also no significant difference in the evolution of glycemic control between DM patients who underwent surgery and those medically treated (p > 0.05). CONCLUSION: DM affects about one quarter of patients with PA and the risk factors for its development are common to those of the general population. Medical and surgical treatment provides similar benefit in glycemic control in patients with PA and DM.

Long-term efficacy of percutaneous tibial nerve stimulation for faecal incontinence and a new approach for partial responders.

BACKGROUND: The aim of the present study was to evaluate the long-term efficacy of percutaneous tibial nerve stimulation (PTNS) for patients with faecal incontinence (FI) refractory to conservative treatment. Secondary aims were to identify predictors of response and validate new treatment pathways for partial responders. METHODS: A prospective, interventional study was carried out in a specialist defecatory disorder unit from a university hospital between January 2010 and June 2017 on patients > 18 years old with FI refractory to conservative treatment. Thirty-minute PTNS sessions were performed in three phases (weekly, biweekly and monthly) up to a year, with clinical reassessment at 3, 6, 12 and 36 months. Patients were classified as optimal responders when their pretreatment Wexner score decreased > 50%; partial responders when it decreased 25-50%; and insufficient responders if it decreased < 25%. Only optimal and partial responders progressed into successive phases. RESULTS: Between 2010 and 2017, 139 patients (110 women, median age 63 years [range 22-82 years]) were recruited. After the first phase, 4 patients were optimal responders, 93 were partial responders and 36 were insufficient responders. At 6 and 12 months, 66 and 89 patients respectively were optimal responders, with an optimal response rate of 64% at the end of treatment. A total of 93.3% patients with a partial response initially finally became optimal responders. Furthermore, at 36 months, 71.9% of patients were still optimal responders without supplementary treatment, although their quality of life did not improve significantly. Baseline Wexner scores ≤ 10 and symptom duration < 1 year were identified as predictive factors for positive responses to PTNS. CONCLUSIONS: Patients undergoing PTNS for 1 year following this protocol had optimal long-term responses. PTNS sessions for up to 1 year in patients who were partial responders prevents a high percentage of them from needing more invasive treatments, and maintains long-term continence in patients who were optimal responders.

Joint Determination of Reactor Antineutrino Spectra from

A joint determination of the reactor antineutrino spectra resulting from the fission of ^{235}U and ^{239}Pu has been carried out by the Daya Bay and PROSPECT Collaborations. This Letter reports the level of consistency of ^{235}U spectrum measurements from the two experiments and presents new results from a joint analysis of both data sets. The measurements are found to be consistent. The combined analysis reduces the degeneracy between the dominant ^{235}U and ^{239}Pu isotopes and improves the uncertainty of the ^{235}U spectral shape to about 3%. The ^{235}U and ^{239}Pu antineutrino energy spectra are unfolded from the jointly deconvolved reactor spectra using the Wiener-SVD unfolding method, providing a data-based reference for other reactor antineutrino experiments and other applications. This is the first measurement of the ^{235}U and ^{239}Pu spectra based on the combination of experiments at low- and highly enriched uranium reactors.

Joint Measurement of the

The PROSPECT and STEREO collaborations present a combined measurement of the pure ^{235}U antineutrino spectrum, without site specific corrections or detector-dependent effects. The spectral measurements of the two highest precision experiments at research reactors are found to be compatible with χ^{2}/ndf=24.1/21, allowing a joint unfolding of the prompt energy measurements into antineutrino energy. This ν[over ¯]_{e} energy spectrum is provided to the community, and an excess of events relative to the Huber model is found in the 5-6 MeV region. When a Gaussian bump is fitted to the excess, the data-model χ^{2} value is improved, corresponding to a 2.4σ significance.

Nanosecond-Scale Proton Emission from Strongly Oblate-Deformed

Using the fusion-evaporation reaction ^{96}Ru(^{58}Ni,p4n)^{149}Lu and the MARA vacuum-mode recoil separator, a new proton-emitting isotope ^{149}Lu has been identified. The measured decay Q value of 1920(20) keV is the highest measured for a ground-state proton decay, and it naturally leads to the shortest directly measured half-life of 450_{-100}^{+170} ns for a ground-state proton emitter. The decay rate is consistent with l_{p}=5 emission, suggesting a dominant πh_{11/2} component for the wave function of the proton-emitting state. Through nonadiabatic quasiparticle calculations it was concluded that ^{149}Lu is the most oblate deformed proton emitter observed to date.

Sulfadiazine, sulfamethazine and sulfachloropyridazine removal using three different porous materials: Pine bark, "oak ash" and mussel shell.

This work focuses on studying the efficacy of three different by-products to adsorb three antibiotics (sulfadiazine, SDZ; sulfamethazine, SMT; sulfachloropyridazine, SCP). These antibiotics can be considered pollutants of the environment when they reach water, as well as in cases where they are spread on soils through irrigation or contained in sewage sludge or livestock manure. In this study, batch-type adsorption/desorption experiments were performed for each of the three sulfonamides, adding 7 different concentrations of the antibiotics, going from 1 to 50 µmol L-1, and with contact time of 24 h. The results indicate that pine bark is the most efficient bioadsorbent among those studied, as it adsorbs up to 95% of the antibiotics added, while desorption is always less than 11%. However, for "oak ash" and mussel shell the adsorption is always lower than 45 and 15%, respectively, and desorption is high, reaching up to 49% from "oak ash" and up to 81% from mussel shell. Adsorption data showed good fitting to the Linear and Freundlich models, with R2 values between 0.98 and 1.00 in both cases. Kd and KF adsorption parameters showed similar values for the same sorbent materials but were much higher for pine bark than for the other two bioadsorbents. The Freundlich's n parameter showed values in the range 0.81-1.28. The highest KF values (and therefore the highest adsorption capacities) were obtained for the antibiotic SCP in pine bark. Pine bark showed the highest capacity to adsorb each of the antibiotics, increasing as a function of the concentration added. When the concentration of sulfonamide added was 50 µM, the amounts adsorbed were 780 µmol kg-1 for SDZ, 890 µmol kg-1 for SMT, and 870 µmol kg-1 for SCP. "Oak ash" and mussel shell have low adsorption capacity for all three sulfonamides, showing values always lower than 150 µmol kg-1 (oak ash) and 20 µmol kg-1 (mussel shell) when a concentration of 50 µmol L-1 of antibiotic is added. The results of this study could aid to make an appropriate management of the by-products studied, in order to facilitate their valorization and recycling in the treatment of environmental compartments polluted with sulfonamide antibiotics.

Environmental relevance of adsorption of doxycycline, enrofloxacin, and sulfamethoxypyridazine before and after the removal of organic matter from soils.

In this work batch-type experiments were used to study the adsorption of the antibiotics doxycycline (DC), enrofloxacin (ENR), and sulfamethoxypyridazine (SMP) in cultivation soils, before and after the removal of soil organic matter. Organic matter removal by calcination resulted not only in C and N removal, but also in increased soil pH, exchangeable basic cations and surface area values. The results indicate a very different behavior depending on the type of antibiotic, showing the adsorption sequence DC > ENR > SMP. Specifically, DC adsorption was very high in untreated soil samples (with organic matter), and was still high (although decreased) after the removal of soil organic matter. Furthermore, the adsorption behavior of DC was clearly dependent on the pH of the medium. Regarding ENR, it also showed high adsorption, although to a lesser extent than DC. However, when soil organic matter was removed, ENR adsorption significantly decreased in all soil samples. As regards SMP, it was adsorbed to a much lesser extent, and the removal of soil organic matter caused an additional drastic decrease in adsorption, reaching negligible values in some samples. Desorption followed the reverse sequence of adsorption, specifically in the order DC < ENR < SMP. In the case of DC, desorption was negligible, both in samples with and without organic matter, while for ENR and SMP, desorption clearly increased for soil samples where organic matter was removed. These results may be of relevance as regards environmental quality and public health, especially to facilitate a correct use of soils and organic amendments in areas that receive the application of substances containing the investigated antibiotics.

Insulin resistance in non-diabetes patients with spondyloarthritis.

Objectives: Insulin resistance (IR) constitutes a major underlying abnormality driving cardiovascular disease in the general population and has been linked to inflammatory diseases. In this study, we aimed to determine the prevalence of IR in patients with spondyloarthritis (SpA) and whether IR can be explained by disease-related features in such cases. Method: The study included 577 subjects: 306 patients diagnosed with SpA according to Assessment of SpondyloArthritis international Society criteria and 271 controls. Insulin and C-peptide serum levels, IR and ß-cell function (%B) indices by homoeostatic model assessment (HOMA2), and lipid profiles were assessed in patients and controls. A multivariable regression analysis was performed to evaluate the differences in IR indices between patients and controls and to determine how IR is associated with disease-related characteristics in SpA patients. Results: HOMA2-%B and HOMA2-IR scores, both calculated with insulin or C-peptide, had significantly higher values in SpA patients compared to controls in multivariable analysis adjusted for age, gender, traditional IR-related factors, and glucocorticoid intake. Disease activity, functional status, and metrological SpA indices were positively related to IR, but only in univariable analysis. Disease duration and positivity for human leucocyte antigen-B27 were independently associated with a higher HOMA2-%B after multivariable analysis. Conclusion: Patients with SpA have an increased IR compared to controls. SpA disease-related data are independently associated with ß-cell dysfunction.

Risk of dementia in bipolar disorder and the interplay of lithium: a systematic review and meta-analyses.

OBJECTIVES: To assess whether bipolar disorder (BD) increases the rate of dementia and whether lithium is related to a lower risk of dementia in BD. METHODS: A total of 10 studies (6859 BD; 487 966 controls) were included in the meta-analysis to test whether BD is a risk factor for dementia. In addition, five studies (6483 lithium; 43 496 non-lithium) were included in the meta-analysis about the potential protective effect of lithium in BD. RESULTS: BD increases the risk of dementia (odds ratio (OR): 2.96 [95% CI: 2.09-4.18], P < 0.001), and treatment with lithium decreases the risk of dementia in BD (OR: 0.51 [95% CI: 0.36-0.72], P < 0.0001). In addition, secondary findings from our systematic review showed that the risk of progression to dementia is higher in BD than in major depressive disorder (MDD). Moreover, the number of mood episodes predicted the development of dementia in BD. CONCLUSION: Individuals with BD are at higher risk of dementia than both the general population or those with MDD. Lithium appears to reduce the risk of developing dementia in BD.

Current emerging SARS-CoV-2 pandemic: Potential direct/indirect negative impacts of virus persistence and related therapeutic drugs on the aquatic compartments.

The purpose of the present work is to provide a complete overview of possible direct/indirect implications on the quality of aquatic compartments due to the recent SARS-CoV-2 outbreak. With this aim, the environmental impacts are mainly related to i) the virus persistence in sewage and wastewaters, and ii) possible fate in aquatic compartments of drugs tested and administered to SARS-CoV-2 infected patients. Because SARS-CoV-2 spread is very recent, and there is a lack of specific studies on this strain, the virus persistence in wastewaters, the parameters influencing the persistence, as well as the detection methodologies are referenced to the general coronaviruses group. However, the present detailed report of up-to-date knowledge on this topic can provide a useful source for further studies focusing on more deepened investigations of SARS-CoV-2 behaviour in the environment. Such a perspective is significant not only for the control of virus diffusion but also represents a crucial point for the identification of produced alteration to the environmental quality.

Adsorption-desorption of doxycycline in agricultural soils: Batch and stirred-flow-chamber experiments.

With the aim of obtaining information about the environmental fate and dynamics of the antibiotic doxycycline (DC) when it reaches soil, adsorption and desorption processes were studied for this compound in 20 agricultural soils, by means of batch-type and stirred-flow-chamber experiments. The results indicate that the studied soils adsorbed high amounts of DC, with adsorption percentages >91% in all cases. In addition, adsorption results were satisfactorily modeled, with good fittings to the Langmuir and Freundlich equations, with the values for Langmuir's maximum adsorption capacity (qmax) varying between 14,692 and 26,141 µmol kg-1 (average 17,816), and between 1,906 and 13,120 Ln µmol1-n kg-1 (average 6,969) for the Freundlich affinity coefficient, which are very high. The soil variables most related to the adsorption of the antibiotic were linked to organic matter (specifically, soil organic carbon-SOC- and soil nitrogen -N- contents), and to the clay fraction, as well as to cation exchange capacity, being the soils with a greater content in these variables those that presented a greater adsorption. FTIR results shown that DC adsorption mechanisms were based on interactions such as hydrogen bonds and π-π interactions between the antibiotic and soils. Desorption was very low, reaching values between 1 and 2% in batch experiments, and between 5 and 15% in stirred flow chamber experiments, which indicates a strong hysteresis affecting adsorption and desorption processes. This fact can be considered positively, as these soils could retain DC very strongly, thus reducing risks to human and ecological health.

Estimation of adsorption/desorption Freundlich's affinity coefficients for oxytetracycline and chlortetracycline from soil properties: Experimental data and pedotransfer functions.

Tetracycline antibiotics spread in the environment constitute a real threat, causing risks that should be controlled. Retention/release of these compounds after interacting with soil components are the main process governing their entry into water bodies, plant uptake, and availability for soil microorganisms. In this work, batch-type experiments were performed to study adsorption/desorption of oxytetracycline (OTC) and chlortetracycline (CTC) in 63 crop soils. The Freundlich model satisfactory described adsorption curves, showing strong affinity of both antibiotics to soils, with adsorption coefficient (KF(ads)) values between 1015 and 9733 Ln µmol1-n kg-1 for OTC, and between 1099 and 11344 Ln µmol1-n kg-1 for CTC. Desorption percentages were always lower than 10%, indicating that adsorption is highly irreversible. Furthermore, the desorption coefficient (KF(des)) correlated positive and significantly with KF(ads), showing that those soils characterized by higher adsorption were also those showing less desorption. Soil organic carbon (SOC) was the soil characteristic that most explained the variance of KF, both for adsorption and desorption, which caused that soils with higher SOC scores showed higher adsorption and lower desorption for both antibiotics. Pedotransfer functions were developed for OTC and CTC, and resulted effective to satisfactory predict KF(ads) and KF(des) values. These equations would facilitate an easy identification of soils vulnerable to antibiotics pollution, which would allow to program appropriate management practices to decrease undesirable effects on the environment and on public health.

Influence of mussel shell, oak ash and pine bark on the adsorption and desorption of sulfonamides in agricultural soils.

Taking into account the high mobility and environmental risks due to sulfonamide antibiotics as emerging pollutants, batch-type experiments were performed to study adsorption/desorption of three sulfonamides (sulfadiazine -SDZ-, sulfamethazine -SMT- and sulfachloropyridazine -SCP-) in three agricultural soils. The study was carried out both for un-amended and amended soil samples, using different doses (0, 12, 24 and 48 Mg ha-1) of three different by-products (mussel shell, oak ash and pine bark). Adsorption on un-amended soils was rather low, with percentages between 11 and 45% for SDZ, 20-64% for SMT, and 19-65% for SCP. Both the Linear and Freundlich models fitted well to adsorption curves. In the case of un-amended soils, and regarding the Linear model, the values of the coefficient of distribution (Kd, expressed in L kg-1) were between 0.6 and 1.3 for SDZ, between 0.7 and 1.1 for SMT, and between 0.6 and 2.6 for SCP. As regards the Freundlich model, the values of the adsorption constant (KF, expressed in L1/n µmol1-1/n kg-1), were in the range 0.4-1.9 for SDZ, 0.9-2.9 for SMT, and 1.2-3.8 for SCP. Simultaneously, desorption percentages were high, reaching 13.7-47.7% for SDZ, 12.6-35.1% for SMT, and 13.7-34.3% for SCP, when the highest initial antibiotic concentration (50 µmol L-1) was added, thus indicating low retention and high mobility for these compounds in soils. Mussel shell and oak ash amendments did not increase retention of any of the three sulfonamides. However, the incorporation of pine bark resulted in an increase in the adsorption and decrease in desorption for all three antibiotics. Specifically, for soils amended with pine bark at 48 Mg ha-1, Kd values (expressed in L kg-1) were between 2.1 and 2.9 for SDZ, between 3.4 and 3.6 for SMT, and between 2.5 and 8.2 for SCP. Regarding KF (expressed in L1/n µmol1-1/n kg-1), its values ranged from 5.6 to 6.3 for SDZ, 6.2-8.8 for SMT, and 5.3-7.1 for SCP. These scores were clearly higher than those of un-amended soils, and pine bark amendment also resulted in lower desorption percentages, ranging 8.7-11.4% for SDZ, 4.0-10.7% for SMT, and 6.5-16.9% for SCP. This positive effect on the retention of sulfonamides due to pine bark can be attributed to its high organic carbon content (48.6%), as well as to its acidic pHw (4.0). Therefore, pine bark amendment can be considered an effective alternative to increase the retention of sulfonamides in soils, thus reducing their bioavailability and transport to other environmental compartments, and subsequent risks of negative impacts on human and environmental health.

Use of biomass ash to reduce toxicity affecting soil bacterial community growth due to tetracycline antibiotics.

Tetracycline antibiotics (TA) used in veterinary medicine reach terrestrial ecosystems mostly via the repeated applications of animal manures and slurries on agricultural soils, where they may cause toxic effects on bacterial communities. In the current work, we studied the efficacy of adding doses of 0, 6, 24 and 48 g kg-1 of biomass ash (BA) to four different soils to reduce potential negative effects of tetracycline antibiotics. Specifically, soil samples were polluted with different concentrations of tetracycline, oxytetracycline or chlortetracycline, and the bacterial community growth was estimated using the 3H leucine incorporation technique. Soil amendment with BA increased soil pH (1.3-4.8 units), total carbon (0.7-5.8 g kg-1) and Fe and Al oxides concentrations (0.25-3.98 g kg-1), as well as bacterial activity (1-9 times compared to the control). In addition, BA amendment at high doses (24 or 48 g kg-1) resulted in a similar toxicity decrease for the three antibiotics, but with variations among soils. The reductions in antibiotics toxicity were very variable, ranging between 5% and 100% (total recovery). In view of that, the spreading of BA could be interesting as management practice to reduce risks of soil pollution and subsequent toxicity on bacterial communities due to tetracycline antibiotics.

[Myocardial infarction with non-obstructive coronary artery disease. Diagnostic value of intravascular imaging and cardiac resonance]. / Infarto agudo de miocardio sin enfermedad coronaria ateroesclerótica obstructiva: utilidad de las imágenes intravasculares y resonancia cardíaca en su diagnóstico.

BACKGROUND: Myocardial infarction with non-obstructive coronary artery disease (MINOCA) is common. Cardiac magnetic resonance (CMR) and intravascular imaging (IVI) may be useful for establishing its etiology. AIM: To describe a population with MINOCA and its multi-image assessment using IVI or CMR. MATERIAL AND METHODS: Review of medical records, imaging and functional studies of patients with MINOCA treated in three different clinical centers between 2015 and 2019. RESULTS: Twenty-eight patients with MINOCA and IVI were included. Seventy eight percent were women, 46% had hypertension, 32% smoked and 32% had dyslipidemia. At wall motion assessment, 46% presented apical ballooning pattern. In 36% of patients IVI identified lesions that explained the cause of MINOCA, namely plaque disruption (PD) in 18%, spontaneous coronary dissection in 11% and a thrombus without PD in 7%. Forty-six percent of patients had uncomplicated atherosclerotic plaques, and 36% had no pathological findings. CMR was performed in 50% of patients, identifying in all a diagnostic pattern. In nine cases it was compatible with stress cardiomyopathy, three cases had a myocarditis and two cases had transmural infarctions. PD and transmural late gadolinium enhancement were observed in 23% of patients with apical ballooning. Patients with a pattern of myocarditis did not have acute pathological findings at IVI. After a mean follow-up of 16.4±11.4 months, 3 patients with PD died. CONCLUSIONS: Among patients with MINOCA, there was a predominance of female gender with low cardiovascular risk factor load. The multi-image assessment allowed greater precision for etiological diagnosis of MINOCA. Apical ballooning was not pathognomonic for stress cardiomyopathy. PD was associated with mortality.

Experimental data and model prediction of tetracycline adsorption and desorption in agricultural soils.

In this work, tetracycline (TC) adsorption and desorption were studied, and the soil properties that most influenced the process were identified. Batch experiments were carried out on 63 crop soil samples, which showed a wide range of values in their physicochemical characteristics. Adsorption curves fit well to the Freundlich equation, with KF values varying between 901 and 9202 Ln µmol1-n kg-1. Kd values ranged between 53 and 6899 L kg-1 for an initial concentration (Co) of 400 µM, whereas the adsorption capacity (qa) ranged from 8541 to 14,852 µmol kg-1. TC retention on soils was high, with adsorption values always higher than 58%, and desorption values lower than 9%. Bivariate correlations and multiple linear regressions were performed to identify those soil variables having a greater influence on TC adsorption and desorption. The results indicate that organic carbon, clay, exchangeable aluminum, available phosphorus, effective cation exchange capacity content, and pH are the main characteristics affecting TC adsorption and desorption. The models, developed by means of multiple linear regression, gave satisfactory and robust predictions for TC adsorption and desorption, using easily determinable soil characteristics as input.

[Posterior mediastinum infantile hemangioma in an 11 months infant, an unusual finding. A case report and review of the literature]. / Hemangioma infantil del mediastino posterior en un lactante de 11 meses, un hallazgo inusual. Reporte de un caso y revisión de la literatura.

Mediastinal infantile hemangioma has not been reported so far (as far as we are aware), using accurate diagnostic methods. MRI scans are essential for a correct characterization and assessment of the extension. Moreover, Endothelial cell glucose transporter 1 (GLUT1) isoform protein represents an extremely important diagnostic tool to differentiate Infantile Hemangioma from other vascular neoplasms. With regards to management, surgery appears to be the treatment of choice, although it is important to highlight that it is a rare disease and more studies are needed to establish a proper diagnostic and therapeutic protocol. The prognosis seems to be favorable, with not known cases of recurrence or progression to malignancy.

Los hemangiomas infantiles suponen los tumores más comunes en la época de la infancia. Su localización principal se sitúa en la piel, seguida del hígado. Los hemangiomas mediastínicos no han sido descritos hasta la fecha utilizando los métodos diagnósticos actuales adecuados. La resonancia magnética es esencial para una correcta caracterización y evaluación de la extensión. El estudio es histológico siendo el transportador celular de glucosa tipo 1 (GLUT-1) una importantísima herramienta diagnóstica para diferenciar el hemangioma infantil de otras neoplasias vasculares. En lo que al manejo respecta, la cirugía con excisión completa de la masa parece el tratamiento de elección. Es importante resaltar la rareza de esta enfermedad y la necesidad de realizar más estudios para establecer un adecuado protocolo diagnóstico-terapéutico. El pronóstico parece ser favorable, sin constar casos de recurrencia o progresión hacia la malignidad.

Dissection of DLBCL microenvironment provides a gene expression-based predictor of survival applicable to formalin-fixed paraffin-embedded tissue.

Background: Gene expression profiling (GEP) studies recognized a prognostic role for tumor microenvironment (TME) in diffuse large B-cell lymphoma (DLBCL), but the routinely adoption of prognostic stromal signatures remains limited. Patients and methods: Here, we applied the computational method CIBERSORT to generate a 1028-gene matrix incorporating signatures of 17 immune and stromal cytotypes. Then, we carried out a deconvolution on publicly available GEP data of 482 untreated DLBCLs to reveal associations between clinical outcomes and proportions of putative tumor-infiltrating cell types. Forty-five genes related to peculiar prognostic cytotypes were selected and their expression digitally quantified by NanoString technology on a validation set of 175 formalin-fixed, paraffin-embedded DLBCLs from two randomized trials. Data from an unsupervised clustering analysis were used to build a model of clustering assignment, whose prognostic value was also assessed on an independent cohort of 40 cases. All tissue samples consisted of pretreatment biopsies of advanced-stage DLBCLs treated by comparable R-CHOP/R-CHOP-like regimens. Results: In silico analysis demonstrated that higher proportion of myofibroblasts (MFs), dendritic cells, and CD4+ T cells correlated with better outcomes and the expression of genes in our panel is associated with a risk of overall and progression-free survival. In a multivariate Cox model, the microenvironment genes retained high prognostic performance independently of the cell-of-origin (COO), and integration of the two prognosticators (COO + TME) improved survival prediction in both validation set and independent cohort. Moreover, the major contribution of MF-related genes to the panel and Gene Set Enrichment Analysis suggested a strong influence of extracellular matrix determinants in DLBCL biology. Conclusions: Our study identified new prognostic categories of DLBCL, providing an easy-to-apply gene panel that powerfully predicts patients' survival. Moreover, owing to its relationship with specific stromal and immune components, the panel may acquire a predictive relevance in clinical trials exploring new drugs with known impact on TME.