Modular and Molecular Optimization of a LOV (Light-Oxygen-Voltage)-Based Optogenetic Switch in Yeast.

Optogenetic switches allow light-controlled gene expression with reversible and spatiotemporal resolution. In Saccharomyces cerevisiae, optogenetic tools hold great potential for a variety of metabolic engineering and biotechnology applications. In this work, we report on the modular optimization of the fungal light-oxygen-voltage (FUN-LOV) system, an optogenetic switch based on photoreceptors from the fungus Neurospora crassa. We also describe new switch variants obtained by replacing the Gal4 DNA-binding domain (DBD) of FUN-LOV with nine different DBDs from yeast transcription factors of the zinc cluster family. Among the tested modules, the variant carrying the Hap1p DBD, which we call "HAP-LOV", displayed higher levels of luciferase expression upon induction compared to FUN-LOV. Further, the combination of the Hap1p DBD with either p65 or VP16 activation domains also resulted in higher levels of reporter expression compared to the original switch. Finally, we assessed the effects of the plasmid copy number and promoter strength controlling the expression of the FUN-LOV and HAP-LOV components, and observed that when low-copy plasmids and strong promoters were used, a stronger response was achieved in both systems. Altogether, we describe a new set of blue-light optogenetic switches carrying different protein modules, which expands the available suite of optogenetic tools in yeast and can additionally be applied to other systems.

Segmental Withdrawal During Screening Colonoscopy Does Not Increase Adenoma Detection Rate.

OBJECTIVES: The aim of this study was to compare a standard versus segmental withdrawal during screening colonoscopy and its effect on the adenoma detection rate (ADR). METHODS: We performed a single-center clinical trial of average-risk patients 50 years of age and older undergoing screening colonoscopy. Patients were randomized into four groups: a standard withdrawal of at least 6 or 8 minutes and a segmental withdrawal, in which ≥3 or ≥4 minutes were dedicated to the right side of the colon, with a minimum withdrawal time of at least 6 or 8 minutes, respectively. RESULTS: There were 311 patients in the study. There was no difference in ADR between the standard and segmental groups (relative ratio [RR] 0.91, P = 0.50), even after stratifying for right-sided adenomas. During standard withdrawal, an increased continuous withdrawal time was associated with a higher ADR (RR 1.08, P <0.001) and total adenomas per patient (RR 1.12, P < 0.001). A binary analysis of ≥8 minutes or <8 minutes withdrawal was associated with an increased adenomas per colonoscopy (RR 1.86, P = 0.04). These differences were not observed in the segmental group. CONCLUSIONS: Overall, there was no benefit from a segmental withdrawal protocol on ADR, but this may have been the result of the inherent limitations in the study design. After sensitivity analysis, a segmental withdrawal protocol led to an improvement in the detection of adenomas per colonoscopy and polyps per colonoscopy. A larger sample size is needed to confirm these findings.

Optogenetic switches for light-controlled gene expression in yeast.

Light is increasingly recognized as an efficient means of controlling diverse biological processes with high spatiotemporal resolution. Optogenetic switches are molecular devices for regulating light-controlled gene expression, protein localization, signal transduction and protein-protein interactions. Such molecular components have been mainly developed through the use of photoreceptors, which upon light stimulation undergo conformational changes passing to an active state. The current repertoires of optogenetic switches include red, blue and UV-B light photoreceptors and have been implemented in a broad spectrum of biological platforms. In this review, we revisit different optogenetic switches that have been used in diverse biological platforms, with emphasis on those used for light-controlled gene expression in the budding yeast Saccharomyces cerevisiae. The implementation of these switches overcomes the use of traditional chemical inducers, allowing precise control of gene expression at lower costs, without leaving chemical traces, and positively impacting the production of high-value metabolites and heterologous proteins. Additionally, we highlight the potential of utilizing this technology beyond laboratory strains, by optimizing it for use in yeasts tamed for industrial processes. Finally, we discuss how fungal photoreceptors could serve as a source of biological parts for the development of novel optogenetic switches with improved characteristics. Although optogenetic tools have had a strong impact on basic research, their use in applied sciences is still undervalued. Therefore, the invitation for the future is to utilize this technology in biotechnological and industrial settings.

Influence of the Mediterranean diet on seminal quality-a systematic review.

Currently, there is a growing interest in the study of fertility because fertility-related problems affect up to 15% of the world's population. The aim of this study was to determine the influence of the Mediterranean diet on seminal quality in men of reproductive age. For this purpose, a systematic review of the literature was carried out following the PRISMA method. Electronic searches were carried out in the international databases PubMed, Scopus, the Cochrane Library, and Web of Science. In total, 10 articles with 2032 men were included. As inclusion criteria, articles published between 2012 and 2022 were selected, including those that included men aged between 18 and 55 years. Nutritional status was assessed through weight, height, and BMI. Dietary habits were evaluated through different indexes and food frequency questionnaires, and finally, semen quality was evaluated by measuring sperm concentration and motility (progressive and non-progressive). In six (60%) of the included articles, a positive relationship between adherence to the Mediterranean diet and semen quality was demonstrated; in two (20%) of the articles, no association was found; and finally, in two (20%) of the included articles, the relationship between dietary patterns typical of DM and semen quality was evaluated. Dietary habits influence semen quality. Adherence to the Mediterranean diet can improve male reproductive health, as it is a diet with antioxidant and anti-inflammatory effects. This is the first systematic review about the influence of the Mediterranean diet on semen quality, and the results are positive. These findings may allow us to provide better advice to our patients and to establish interventions with the aim of improving the results of assisted reproduction techniques.

[Influence of adherence to a mediterranean diet and nutritional status on ovarian reserve]. / Influencia de la adherencia a la dieta mediterránea y del estado nutricional en la reserva ovárica.

OBJECTIVE: Currently, esterility affects between 15% and 20% of couples of fertile age. Female reproductive success is mainly determined by age and ovarian reserve (OR). Recent studies highlight the influence of modifiable factors such as dietary habits and nutritional status on OR. In this regard, the Mediterranean Diet (MD) is postulated as a standard of healthy eating. Therefore, the objective of this paper was to analyze the influence of adherence to DM and nutritional status on the OR of infertile women. METHODS: A descriptive cross-sectional study was carried out, lasting one year, between February 2022 and February 2023, in a sample of forty-five female patients who attended the Gynaecology-Esterility consultation at the Marina Salud Hospital in Denia (Spain) due to genital desire older than one year. An exploratory descriptive analysis based on univariate statistics was performed. RESULTS: The mean age of the sample (n=45) was 31.84 (±3.99) years, with an average BMI of 26.27 (±6.08) kg/m2, with 44.4% (n=20) having excess body weight. The RO was measured based on AMH, with an average value of 2.32 (±1.59) ng/ml and RFA, with an average of 19.80 (±14.13) antral follicles. A statistically significant association was found between low adherence to DM and lower anti-Müllerian hormone (AMH; p=0.025) levels. In addition, an association was found between low consumption of vegetables (p=0.044), excessive consumption of red meat (p=0.027) and carbonated beverages (p=0.015) with insufficient AMH levels, indicative of low OR. Low fruit consumption was also found to be associated with low oestradiol levels (p=0.045). Statistically significant associations were also found reflecting the influence of nutritional status on OR. CONCLUSIONS: One of the main factors conditioning the success of ART (assisted reproductive technology) is the woman's OR. The most widely used parameter to assess OR is AMH. Lifestyle and diet are modifiable factors that can influence OR. High adherence to DM and consumption of vegetables is associated with higher levels of AMH; however, high intake of red meat and carbonated beverages is associated with lower levels. Nutritional status, adherence to DM and dietary habits influence the status of OR, so it would be advisable to promote programmes to improve the population's diet in order to improve reproductive health.

OBJECTIVE: Actualmente, la esterilidad afecta a entre el 15% y 20% de las parejas en edad fértil. El éxito reproductivo femenino está determinado fundamentalmente por la edad y la reserva ovárica (RO). Recientes estudios remarcan la influencia de factores modificables como los hábitos dietéticos y el estado nutricional en la RO. A este respecto, la Dieta Mediterránea (DM) se postula como un estándar de alimentación saludable. Por ende, el objetivo de este estudio fue analizar la influencia de la adherencia a la DM y el estado nutricional en la RO de mujeres estériles. METHODS: Se efectuó un estudio descriptivo transversal, de un año de duración, entre los meses de febrero de 2022 y febrero de 2023, en una muestra de cuarenta y cinco pacientes de sexo femenino que acudieron a la consulta de Ginecología-Esterilidad en el Hospital Marina Salud de Denia (España) por deseo genésico mayor a un año. Se realizó un análisis descriptivo de carácter exploratorio basado en una estadística univariable. RESULTS: El estudio incluyó una muestra total de cuarenta y cinco mujeres (n=45) siendo la media de edad de 31,84 (±3,99) años, siendo el IMC medio de 26,27 (±6,08) kg/m2, teniendo el 44,4% (n=20) un IMC por encima de los valores normales. En cuanto a la RO, se midió en base a la AMH, siendo el valor promedio de 2,32 (±1,59) ng/ml, y al RFA, siendo la media de 19,80 (±14,13) folículos antrales. Se encontró una asociación estadísticamente significativa entre la baja adherencia a la DM y menores niveles de hormona antimülleriana (AMH; p=0,025). Además, se determinó una asociación entre el bajo consumo de verduras y hortalizas (p=0,044), el excesivo consumo de carne roja (p=0,027) y de bebidas carbonatadas (p=0,015) con insuficientes niveles de AMH, indicativos de baja RO. También se observó que el bajo consumo de fruta estaba asociado con bajos niveles de estradiol (p=0,045). Asimismo, se encontraron asociaciones estadísticamente significativas que reflejaban la influencia del estado nutricional en la RO. CONCLUSIONS: Uno de los principales factores que condicionan el éxito de una TRA (técnica de reproducción asistida) es la RO de la mujer, siendo la AMH el parámetro más utilizado para su valoración. La RO puede verse influenciada por factores modificables como son el estilo de vida y la alimentación, se observa cómo una alta adherencia a la DM y el consumo de verduras y hortalizas se relaciona con mayores niveles de AMH; por el contrario, la alta ingesta de carne roja y bebidas carbonatadas se asocia niveles más bajos. El estado nutricional, el grado de adherencia a la DM y los hábitos dietéticos influyen en el estado de la RO, de modo que sería conveniente promover programas de mejora en la alimentación de la población con la finalidad de mejorar la salud reproductiva.

[Comment on article "Correlation between ultrasonography and thorax portable radiography in patients with COVID-19"]. / Comentario al artículo "Correlación entre ultrasonografía y radiografía portátil de tórax en pacientes con COVID-19".

Point-of-care ultrasound is an emerging tool in critical care areas. In the study we are discussing, the ultrasonographic findings are compared and contrasted with the radiographic ones in patients with COVID-19.

El ultrasonido en el punto de atención es una herramienta emergente en la atención de las áreas críticas. En el estudio que comentamos, se comparan los hallazgos ultrasonográficos y se contrastan con los radiográficos en pacientes con COVID-19.

Assessment of Nutritional Status and Its Influence on Ovarian Reserve: A Systematic Review.

BACKGROUND: Nowadays, there is a growing interest in the relationship among lifestyle, reproductive health, and fertility. Recent investigations highlight the influence of environmental and lifestyle factors such as stress, diet, and nutritional status on reproductive health. The aim of this review was to determine the influence of nutritional status on ovarian reserve in order to improve the reproductive health of women of childbearing age. METHODS: A systematic literature review was carried out following the PRISMA method. The quality of the studies was assessed using the Cochrane Collaboration Risk of Bias tool. Data were extracted, and the results were summarized into two blocks: according to the technique used to assess ovarian reserve and nutritional status; according to the results found in the relationship between ovarian reserve and nutritional status. RESULTS: A total of 22 articles involving 5929 women were included. In 12 of the included articles (54.5%), a relationship between nutritional status and ovarian reserve was demonstrated. In seven publications (31.8%), the increased body mass index (BMI) led to a decrease in ovarian reserve, two of them (0.9%) in patients with polycystic ovary syndrome, showing a decrease only if BMI > 25. In two articles (0.9%), there was a negative relationship between ovarian reserve and waist-to-hip ratio, and in one (0.45%), a positive relationship was shown between ovarian reserve and testosterone levels, the latter being related to body mass index. In five articles (22.7%), body mass index was used as a confounder and was negatively related to ovarian reserve, and in another four (18%), no correlation was found. CONCLUSIONS: Ovarian reserve appears to be influenced by nutritional status. A high body mass index has a negative impact on the ovary, decreasing antral follicle count and anti-Müllerian hormone. Oocyte quality is compromised, increasing the rate of reproductive problems and the demand for assisted reproductive techniques. Further studies are needed to understand which dietary factors have the greatest effect on ovarian reserve in order to promote reproductive health.

Adherence to the Mediterranean Diet in Pregnancy and Its Benefits on Maternal-Fetal Health: A Systematic Review of the Literature.

Introduction: Pregnancy is a transcendent period for the mother and the fetus, characterized by an increase on energy requirements. Mediterranean diet (MD) is considered a healthy eating pattern that can provide the nutritional requirements of pregnancy and protect from the development of obstetric pathologies. Objective: To know the relationship between adherence to the MD and its maternal-fetal benefits. Methodology: A systematic review was conducted by identifying articles in the PubMed and Cochrane databases. The publication date of the studies was between 2010 and 2020, and the inclusion criteria established were that the articles were written in English and Spanish and were accessible in full text. Studies concerning assisted reproduction, gene modulation, conference abstracts, systematic reviews, and pilot studies were excluded. Results: Finally, a total of 14 studies were included in the review. The association between the MD and the reduction of some pathologies of pregnancy, such as gestational diabetes, overweight or obesity, sleep quality, complications of childbirth, urinary tract infections (UTIs), and alterations in fetal growth was demonstrated, as well as perinatal problems, including birth weight, prematurity, gastroschisis, and other childhood problems. Conclusion: The MD is an optimal diet to consume during pregnancy.

Women's Well-Being and Rural Development in Depopulated Spain.

The threat of depopulation in the rural areas making up what has become to be known as "empty Spain" is currently an extremely urgent national issue. Women are a fundamental pillar of rural sustainability, but the lack of decent living conditions has led to their mass exodus to the country's cities. We analysed the factors undermining their health and well-being, thus leading to their dissatisfaction and their subsequent desire to abandon the countryside for a better life. A mixed methodology was employed, combining qualitative and quantitative data collection techniques. For data collection, an ad hoc questionnaire was developed before being administered to members of the Rural Development Groups of the Celtiberian Highlands, while some of their number were also interviewed. Rural women experience personal dilemmas that prompt them to migrate. These include choosing between living in the place where they were born, close to their families and neighbours, and a decent productive job, the availability of basic services and a broader range of leisure opportunities, among other aspects. It is essential to acknowledge the socio-economic importance of women's work, to identify invisible burdens and their risks and to adopt measures that facilitate the reconciliation of work and family life.

Improvement of the electron transfer rate in Shewanella oneidensis MR-1 using a tailored periplasmic protein composition.

Periplasmic c-type cytochromes are essential for the electron transport between the cytoplasmic membrane bound menquinol oxidase CymA and the terminal ferric iron reductase MtrABC in the outer membrane of Shewanella oneidensis cells. Either STC or FccA are necessary for periplasmic electron transfer. We followed the hypothesis that the elimination of potential competing reactions in the periplasm and the simultaneous overexpression of STC (cctA) could lead to an accelerated electron transfer to the cell surface. The genes nrfA, ccpA, napB and napA were replaced by cctA. This led to a 1.7-fold increased ferric iron reduction rate and a 23% higher current generation in a bioelectrochemical system. Moreover, the quadruple mutant had a higher periplasmic flavin content. Further deletion of fccA and its replacement by cctA resulted in a strain with ferric iron reduction rates similar to the wild type and a lower concentration of periplasmic flavin compared to the quadruple mutant. A transcriptomic analysis revealed that the quadruple mutant had a 3.7-fold higher cctA expression which could not be further increased by the replacement of fccA. This work indicates that a synthetic adaptation of Shewanella towards extracellular respiration holds potential for increased respiratory rates and consequently higher current densities.

Health education training of university students of the early childhood education degree in Spain. / La formación en educación para la salud del alumnado universitario del grado de educación infantil en España.

In Spain, Health Education is included in the Early Childhood Education curriculum, but teachers do not manage to develop it effectively. We intended to verify the opinion of the students of the Early Childhood Education Degree of the universities of Andalusia about their education and the relevance of this subject. The research was conducted on a population of 2,178 students, using the questionnaire as the main instrument. Its validation required measuring its internal consistency with Cronbach's alpha coefficient and exploratory factor analysis. The students consider essential Child Health Education training (87.8%), and affirmed that the one they received in the official curricula had been weak. The subjects offered are mostly focused on the promotion of healthy lifestyles (61.5%) and prevention (38.5%). On the other hand, they consider first aid training very important. We propose the implementation of a complete and appropriate Health Education in the training of teachers.

En España, la Educación para la Salud se encuentra integrada en el currículo de Educación Infantil, pero los docentes no llegan a desarrollarla de manera efectiva. Pretendemos constatar la opinión del alumnado del Grado de Educación Infantil de las universidades de Andalucía sobre su formación e importancia de esta materia. La investigación se ha realizado sobre una población de 2178 estudiantes, utilizando como instrumento principal el cuestionario. Para su validación medimos su consistencia interna con el coeficiente alfa de Cronbach y el análisis factorial exploratorio. El alumnado estima muy necesaria la formación en Educación para la Salud infantil (87,8%), calificando como deficitaria la recibida en los planes de estudio oficiales. Las materias ofertadas se enfocan en su mayoría a la promoción de hábitos de vida saludables (61,5%) y al ámbito de la prevención (38,5%). En cambio, estiman de gran importancia una formación en primeros auxilios. Proponemos se implante con carácter obligatorio una completa y adecuada Educación para la Salud en la formación del profesorado.

Fungal Light-Oxygen-Voltage Domains for Optogenetic Control of Gene Expression and Flocculation in Yeast.

Optogenetic switches permit accurate control of gene expression upon light stimulation. These synthetic switches have become a powerful tool for gene regulation, allowing modulation of customized phenotypes, overcoming the obstacles of chemical inducers, and replacing their use by an inexpensive resource: light. In this work, we implemented FUN-LOV, an optogenetic switch based on the photon-regulated interaction of WC-1 and VVD, two LOV (light-oxygen-voltage) blue-light photoreceptors from the fungus Neurospora crassa When tested in yeast, FUN-LOV yields light-controlled gene expression with exquisite temporal resolution and a broad dynamic range of over 1,300-fold, as measured by a luciferase reporter. We also tested the FUN-LOV switch for heterologous protein expression in Saccharomyces cerevisiae, where Western blot analysis confirmed strong induction upon light stimulation, surpassing by 2.5 times the levels achieved with a classic GAL4/galactose chemical-inducible system. Additionally, we utilized FUN-LOV to control the ability of yeast cells to flocculate. Light-controlled expression of the flocculin-encoding gene FLO1, by the FUN-LOV switch, yielded flocculation in light (FIL), whereas the light-controlled expression of the corepressor TUP1 provided flocculation in darkness (FID). Altogether, the results reveal the potential of the FUN-LOV optogenetic switch to control two biotechnologically relevant phenotypes such as heterologous protein expression and flocculation, paving the road for the engineering of new yeast strains for industrial applications. Importantly, FUN-LOV's ability to accurately manipulate gene expression, with a high temporal dynamic range, can be exploited in the analysis of diverse biological processes in various organisms.IMPORTANCE Optogenetic switches are molecular devices which allow the control of different cellular processes by light, such as gene expression, providing a versatile alternative to chemical inducers. Here, we report a novel optogenetic switch (FUN-LOV) based on the LOV domain interaction of two blue-light photoreceptors (WC-1 and VVD) from the fungus N. crassa In yeast cells, FUN-LOV allowed tight regulation of gene expression, with low background in darkness and a highly dynamic and potent control by light. We used FUN-LOV to optogenetically manipulate, in yeast, two biotechnologically relevant phenotypes, heterologous protein expression and flocculation, resulting in strains with potential industrial applications. Importantly, FUN-LOV can be implemented in diverse biological platforms to orthogonally control a multitude of cellular processes.

GPD1 and ADH3 Natural Variants Underlie Glycerol Yield Differences in Wine Fermentation.

Glycerol is one of the most important by-products of alcohol fermentation, and depending on its concentration it can contribute to wine flavor intensity and aroma volatility. Here, we evaluated the potential of utilizing the natural genetic variation of non-coding regions in budding yeast to identify allelic variants that could modulate glycerol phenotype during wine fermentation. For this we utilized four Saccharomyces cerevisiae strains (WE - Wine/European, SA - Sake, NA - North American, and WA - West African), which were previously profiled for genome-wide Allele Specific Expression (ASE) levels. The glycerol yields under Synthetic Wine Must (SWM) fermentations differed significantly between strains; WA produced the highest glycerol yields while SA produced the lowest yields. Subsequently, from our ASE database, we identified two candidate genes involved in alcoholic fermentation pathways, ADH3 and GPD1, exhibiting significant expression differences between strains. A reciprocal hemizygosity assay demonstrated that hemizygotes expressing GPD1WA , GPD1SA , ADH3WA and ADH3SA alleles had significantly greater glycerol yields compared to GPD1WE and ADH3WE . We further analyzed the gene expression profiles for each GPD1 variant under SWM, demonstrating that the expression of GPD1WE occurred earlier and was greater compared to the other alleles. This result indicates that the level, timing, and condition of expression differ between regulatory regions in the various genetic backgrounds. Furthermore, promoter allele swapping demonstrated that these allele expression patterns were transposable across genetic backgrounds; however, glycerol yields did not differ between wild type and modified strains, suggesting a strong trans effect on GPD1 gene expression. In this line, Gpd1 protein levels in parental strains, particularly Gpd1pWE, did not necessarily correlate with gene expression differences, but rather with glycerol yield where low Gpd1pWE levels were detected. This suggests that GPD1WE is influenced by recessive negative post-transcriptional regulation which is absent in the other genetic backgrounds. This dissection of regulatory mechanisms in GPD1 allelic variants demonstrates the potential to exploit natural alleles to improve glycerol production in wine fermentation and highlights the difficulties of trait improvement due to alternative trans-regulation and gene-gene interactions in the different genetic background.

Estado nutricional población pediátrica y funcionalidad familiar en una unidad educativa ecuatoriana / Pediatric population nutritional status and family functionality in an Ecuadorian educa-tional unit

El estado de la funcionalidad de la familia influye en la calidad nutricional de sus miembros. El objetivo del presente estudio fue describir el estado nutricional de población pediátrica y la funcionalidad familiar en una unidad educativa pública en la provincia Cotopaxi, Ecuador, durante 2020. Se desarrolló una investigación descriptiva transversal, en la que participaron 179 familias de alumnos con edades entre 5 y 19 años, cuyos padres o tutores legales aportaron los datos de interés. La población pediátrica estuvo conformada por 91 niños/as de 5 a 9 años y 88 adolescentes de 10 a 19 años. El 54,7% correspondió al sexo femenino. En este contexto predominó el estado nutricional normal en los menores de edad y las familias funcionales (57%). La funcionalidad familiar se asoció significativamente con el grupo etario y el estado nutricional atendiendo a la talla/edad. Sin embargo, esa variable resultó independiente con respecto al estado nutricional según IMC/edad.

The state of family functionality influences the nutritional quality of its members. This study aimed to describe the nutritional status of the pediatric population and family functionality in a public educational unit in the Cotopaxi province, Ecuador, during 2020. A cross-sectional descriptive research was developed. The population was constituted by 179 families of students aged between 5 and 19 years old, whose parents or legal guardians provided the data of interest. The pediatric population consisted of 91 children from 5 to 9 years old and 88 adolescents from 10 to 19 years old. 54.7% corresponded to the female sex. In this context, normal nutritional status prevailed in minors and functional families (57%). Family functionality was significantly associated with age group and nutritional status according to height/age. However, this variable was independent with respect to nutritional status according to BMI/age

Device-associated infection rates, mortality, length of stay and bacterial resistance in intensive care units in Ecuador: International Nosocomial Infection Control Consortium's findings.

AIM: To report the results of the International Nosocomial Infection Control Consortium (INICC) study conducted in Quito, Ecuador. METHODS: A device-associated healthcare-acquired infection (DA-HAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units (ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN) definitions and INICC methods. RESULTS: We followed 776 ICU patients for 4818 bed-days. The central line-associated bloodstream infection (CLABSI) rate was 6.5 per 1000 central line (CL)-days, the ventilator-associated pneumonia (VAP) rate was 44.3 per 1000 mechanical ventilator (MV)-days, and the catheter-associated urinary tract infection (CAUTI) rate was 5.7 per 1000 urinary catheter (UC)-days. CLABSI and CAUTI rates in our ICUs were similar to INICC rates [4.9 (CLABSI) and 5.3 (CAUTI)] and higher than NHSN rates [0.8 (CLABSI) and 1.3 (CAUTI)] - although device use ratios for CL and UC were higher than INICC and CDC/NSHN's ratios. By contrast, despite the VAP rate was higher than INICC (16.5) and NHSN's rates (1.1), MV DUR was lower in our ICUs. Resistance of A. baumannii to imipenem and meropenem was 75.0%, and of Pseudomonas aeruginosa to ciprofloxacin and piperacillin-tazobactam was higher than 72.7%, all them higher than CDC/NHSN rates. Excess length of stay was 7.4 d for patients with CLABSI, 4.8 for patients with VAP and 9.2 for patients CAUTI. Excess crude mortality in ICUs was 30.9% for CLABSI, 14.5% for VAP and 17.6% for CAUTI. CONCLUSION: DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates.

Hysteroscopic myomectomy outcomes after 3-month treatment with either Ulipristal Acetate or GnRH analogues: a retrospective comparative study.

Ulipristal Acetate (UPA) modifies the endometrium, as well as fibroids, and therefore it might make hysteroscopic surgery more difficult. To confirm that pre-treatment with UPA is as safe and effective an option as pre-treatment with GnRH analogues, considered the gold standard. We present the first series of 26 hysteroscopic myomectomies after 3 months treatment with UPA and we compare the results with a series of 24 cases pretreated with GnRH analogues. This was a retrospective cohort study between July 2013 and May 2015. We analyszed patients with submucous myomas >2.5 in diameter. Hysteroscopic myomectomy was performed after 3 months of treatment with either UPA (5mg daily) or the GnRH agonist (3.75mg/month). Both groups were similar in age, myoma initial size and classification. There were no significant differences between UPA and GnRHa treated groups in terms of percentage of myomas resected (93% vs 98%), duration of surgery (38 vs 37min), fluid deficit (200 vs 350ml) and complications. In the surgeon's subjective opinion, UPA treatment was associated with an easier resection. Based on our experience, previous treatment with UPA does not difficult Hhysteroscopic myomectomy. Endometrial changes have no impact on surgery. Safety and feasibility are comparable to hysteroscopic myomectomies with previous treatment with GnRH analogues. This allows us to take advantage of the reduction in size of fibroids before surgery with less side effects.

La formación en educación para la salud del alumnado universitario del grado de educación infantil en España / Health education training of university students of the early childhood education degree in Spain

Resumen En España, la Educación para la Salud se encuentra integrada en el currículo de Educación Infantil, pero los docentes no llegan a desarrollarla de manera efectiva. Pretendemos constatar la opinión del alumnado del Grado de Educación Infantil de las universidades de Andalucía sobre su formación e importancia de esta materia. La investigación se ha realizado sobre una población de 2178 estudiantes, utilizando como instrumento principal el cuestionario. Para su validación medimos su consistencia interna con el coeficiente alfa de Cronbach y el análisis factorial exploratorio. El alumnado estima muy necesaria la formación en Educación para la Salud infantil (87,8%), calificando como deficitaria la recibida en los planes de estudio oficiales. Las materias ofertadas se enfocan en su mayoría a la promoción de hábitos de vida saludables (61,5%) y al ámbito de la prevención (38,5%). En cambio, estiman de gran importancia una formación en primeros auxilios. Proponemos se implante con carácter obligatorio una completa y adecuada Educación para la Salud en la formación del profesorado.

Abstract In Spain, Health Education is included in the Early Childhood Education curriculum, but teachers do not manage to develop it effectively. We intended to verify the opinion of the students of the Early Childhood Education Degree of the universities of Andalusia about their education and the relevance of this subject. The research was conducted on a population of 2,178 students, using the questionnaire as the main instrument. Its validation required measuring its internal consistency with Cronbach's alpha coefficient and exploratory factor analysis. The students consider essential Child Health Education training (87.8%), and affirmed that the one they received in the official curricula had been weak. The subjects offered are mostly focused on the promotion of healthy lifestyles (61.5%) and prevention (38.5%). On the other hand, they consider first aid training very important. We propose the implementation of a complete and appropriate Health Education in the training of teachers.

Nitrogen and carbon contents and δ(15) N and δ(13) C signatures in six bryophyte species: assessment of long-term deposition changes (1980-2010) in Spanish beech forests.

In this study we used recent (2010) and herbarium material (1980) of six bryophyte species to assess long-term atmospheric deposition in natural forested areas in northern Spain. For this purpose, tissue nitrogen and carbon content, as well as δ(13) C and δ(15) N signatures of samples of Hypnum cupressiforme, Polytrichastrum formosum, Leucobryum juniperoideum, Rhytidiadelphus loreus, Homalothecium lutescens and Diplophyllum albicans were analysed and comparisons made between years and species. In addition, the usefulness of each of the six species was evaluated. The range of values observed was similar to that in other studies carried out in rural areas. Significantly lower values were found in 2010 for N (H. cupressiforme), δ(15) N (R. loreus and D. albicans), C (R. loreus) and δ(13) C (all except L. juniperoideum). Our natural areas are thus now less influenced by atmospheric pollutants than they were, most probably due to changes in some traditional local activities. Differences were observed between species for all the four parameters studied, so different species must not be analysed together. Finally, R. loreus and H. lutescens seem to be good bioindicators, sensitive even with a few samples, although further studies are needed to corroborate their usefulness.

Sífilis congénita en ecuador presente preocupante / Congenital syphilis in Ecuador present worrying

Introducción: La sífilis congénita (CS) se mantiene como un importante problema de salud pública. aún no se consigue satisfacer la atención prenatal, a pesar del aumento de cobertura, las acciones implementadas muestran baja efectividad en su prevención. La Organización Mundial de la Salud (OMS) estima que, globalmente, la mayoría de las infecciones de sífilis materna no se tratan y tienen un título suficientemente elevado (RPR ≥ 1: 8) como para causar una exposición fetal significativa a T. pallidum. Métodos: Es un estudio epidemiológico observacional y retrospectivo sobre la prevalencia, en el que se revisaron datos del Instituto Nacional de Censos y Estadísticas (INEC). Los datos se obtuvieron de los informes anuales de nacimiento, Se utilizó el programa SPSS 17.0 y Excel. Resultados: Se encontraron 2.210 casos de sífilis congénita en los últimos 16 años, con un incremento importante en los años 2003 y 2013 con 192 y 193 casos respectivamente. Discusión: La prevalencia de CS en el Ecuador igual que el resto de América se incrementa posiblemente la falta de control médico el sub diagnóstico y sub registro son factores importantes que impiden el control adecuado y por el contrario aumenten sistemáticamente. Los primeros años de registro (2000 a 2003) muestran casos tan altos como el final de la línea de base (2012 a 2016) este hecho podría deberse a la falta de prevención. Los registros presentados en el año 2008 tienen un pico que debe analizarse teniendo en cuenta la forma de registro. La presencia de falso positivo podría cuestionarse debido a nuevas técnicas de diagnóstico Conclusión: Los esfuerzos por disminuir la incidencia de sífilis congénita no han sido suficientes y según los datos obtenidos no se lograron cumplir las metas propuestas por la OMS y asumidas por el País, El desconocimiento por parte de los médicos que llevan el control prenatal y quienes reciben recién nacidos en los hospitales existiendo un alarmante sub registro y en otros casos un tratamiento poco eficiente y a destiempo. Sigue siendo la Sífilis congénita un problema médico social fácil de tratar si se diagnostica y trata oportunamente.

Introduction: Congenital syphilis (CS) remains an important public health problem. The prenatal care is still not achieved, despite the increase in coverage, the actions implemented show low effectiveness in its prevention. The World Health Organization (WHO) estimates that, overall, the majority of maternal syphilis infections are not treated and have a sufficiently high titer (RPR ≥ 1: 8) to cause significant fetal exposure to T. pallidum. Methods: This is an observational and retrospective epidemiological study on prevalence, in which data from the National Institute of Census and Statistics (INEC) were reviewed. The data was obtained from the annual birth reports. The SPSS 17.0 program and Excel were used. Results: We found 2,210 cases of congenital syphilis in the last 16 years, with a significant increase in the years 2003 and 2013 with 192 and 193 cases respectively. Discussion: The prevalence of CS in Ecuador, like the rest of the Americas, possibly increases the lack of medical control, the sub-diagnosis and sub-registration are important factors that prevent adequate control and, on the contrary, increase systematically. The first years of registration (2000 to 2003) show cases as high as the end of the baseline (2012 to 2016) this fact could be due to the lack of prevention. The records presented in 2008 have a peak that must be analyzed taking into account the registration form. The presence of false positive could be questioned due to new diagnostic techniques Conclusion: Efforts to reduce the incidence of congenital syphilis have not been sufficient and, according to the data obtained, the goals proposed by the WHO and assumed by the country were not achieved. The lack of knowledge on the part of the doctors who carry out prenatal care and they receive newborns in hospitals, there is an alarming sub-registry and in other cases an inefficient and untimely treatment. Congenital syphilis remains a social medical problem easy to treat if diagnosed and treated promptly