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Background: The Movement Disorder Society‐sponsored Non‐motor Rating Scale (MDS‐NMS) assess the severity and disability caused by non‐motor symptoms (NMS) in Parkinson's disease (PD). Objective: This article encapsulates the formal process for completing this program and the data on the first officially approved non‐English version of the MDS‐NMS (Spanish). Methods: The MDS‐NMS translation program involves four steps: translation and back‐translation; cognitive pre‐testing to ensure that raters and patients understand the scale and are comfortable with its content; field testing of the finalized version; analysis of the factor structure of the tested version against the original English language version for the nine domains that could be analyzed in a confirmatory factor analysis. To be designated an "Official MDS translation," the confirmatory factor analysis Comparative Fit Index had to be ≥0.90. Results: The Spanish MDS‐NMS was tested in 364 native‐Spanish‐speaking patients with PD from seven countries. For all subjects with fully computable data with all domains of the MDS‐NMS (n = 349), the Comparative Fit Index was ≥0.90 for the nine eligible domains. Missing data were negligible and moderate floor effect (42.90%) was found for the Non‐Motor Fluctuations subscale. Item homogeneity coefficient was adequate, and the correlation of the MDS‐NMS domains with other measures for related constructs was acceptable (rs ≥ 0.50). Conclusions: The Spanish version of the MDS‐NMS followed the IPMDS Translation Program protocol, reached the criterion to be designated as an Official Translation, and is now available on the MDS website. [ABSTRACT FROM AUTHOR]

Algae have an indisputable role in coastal ecosystems, but their accumulation and uncontrolled proliferation cause severe damage for the local municipalities. Fertilization with seaweed has been shown to increase soil fertility and crop production reducing ultimately the need for inorganic fertilizers. However, contradictory results of the compost effect have been reported. In the present work, we aimed at testing the suitability of three composted algae materials obtained in a previous study as soil amendments for vines. The composted materials consisted of pruning waste (P) and seaweed (S) mixed (henceforth, P2S1, P1S1 and P1S2, referring the number to the ratio of P to S). Overall, we observed an increase in soil organic matter, phosphorus (P) and potassium (K) in the soil treated in comparison with soils with inorganic fertilization. A moderate N soil enrichment (ca. 20%) was also detected. The leaf analysis reflected generally the greatest concentrations of NPK for the organic treatments, but this was remarkable only during the first year after seaweed application. A noticeable improvement in grape production was detected especially with the P1S1 compost without compromising grape quality although a decrease in sucrose content was noted with the compost with higher productivity (e.g. P2S1 and P1S1). This slight sucrose drop could be attributable to a greater water availability mediated by the compost or to a dilution factor of the sucrose content caused by a greater number of berries in those vines. These findings suggest that although monitoring of the long‐term effects is needed, the use of seaweed amendments for agriculture could offer a cost‐effective method for coastal municipalities to reduce excessive algae debris while also minimizing the impacts of inorganic fertilization. [ABSTRACT FROM AUTHOR]

The objective of this cross‐sectional descriptive study is to analyse the degree of compliance with the preventive measures for pressure injuries reported by an International Study Group in a cohort of adult critically ill patients. The level of risk of developing pressure injuries was determined using the Conscious level, Mobility, Hemodynamics, Oxygenation and Nutrition (COMHON) index. According to the level of risk, the preventive measures applied to each patient and scores on the different components of the index were recorded. Number, location and degree of pressure injuries were registered. Seventy‐three patients (male: 68%) with an acute physiology and chronic health evaluation (APACHE) II: 12,1 ± 6,2 and 56,1% of them with invasive mechanical ventilation. The prevalence of pressure injuries was 21,9%, with 43,7% of sacral location and 75% of grade II. The level of risk using the COMHON index was distributed between low 30,1%, intermediate 23,3% and high 46,6%. The compliance range from 0% (offloading heel devices) to the use of active mattress and incontinence pads (100%). Regarding repositioning the degree of compliance varies (from 20% to 80%) according if patients with contraindications (4 points in subscale of Mobility) or those with the capacity to mobilise themselves (2 points in subscale of Mobility) are included in the denominator. We have found that in our ICU there is a wide range of compliance with the use of the preventive measures recommended by the International Study Group. Some of them are related not by the general score of the COMHON scale, but to that obtained in its subscale components. [ABSTRACT FROM AUTHOR]

Background: Men with spinal cord injury (SCI) show a high proportion of sperm DNA damage in their ejaculate but the underlying pathology remains elusive. Objective: To investigate the relative incidence of single (SSBs) and double‐strand DNA breaks (DSBs) and DNase activity in men with SCI. Materials and methods: This study included ejaculates of 20 men with SCI and 27 normozoospermic (sperm donors). A TwoTails comet assay (TTComet) allowed visualization of three categories of sperm DNA damage corresponding to SSBs, DSBs and those with a combination of SSBs and DSBs, facilitating accurate calculation of the total proportion of SSBs and DSBs. A subset of 15 individuals (sperm donors and SCI patients) was used to test for DNase activity in the seminal plasma. Results: While the proportion of DSBs in men with SCI (median‐57.5%) was higher (P = 0.000) than normozoospermic samples (median‐4.6%), the proportion of SSBs was higher (P = 0.022) in the normozoospermic ejaculates (median‐6.0%) compared to men with SCI (median‐2.5%). The relative proportion of the total DSBs with respect to the total SSBs was 3.3× in men with SCI but 0.9× in normozoospermic samples. We further confirmed the high DNase activity in the seminal plasma of men with SCI. Discussion: The TTComet assay provided new insights to the pathology of sperm DNA in men with SCI and may have diagnostic value in developing sperm selection methodologies to reduce DSBs prior to ART. Conclusion: Men with SCI are characterized by a high proportion of sperm with DSBs and high levels of DNase activity in the seminal plasma compared to normozoospermic men. [ABSTRACT FROM AUTHOR]

Sixteen glazes on medieval (14th–16th century AD) pottery fragments from Vega pottery workshop (Burgos, Spain) were characterized to investigate the production technology. To this end, Raman spectroscopy and scanning electron microscopy coupled with energy dispersive X‐ray spectroscopy (SEM‐EDX) were used. The studied glaze samples correspond to fragments of high‐quality glazed ware used by the wealthiest society in the city of Burgos. The most representative types of glazes, corresponding to honey‐marble, honey‐yellow, bright light green, and dark green types, were analysed. Raman spectroscopy shows lead was used as a fluxing agent in glaze production. SEM‐EDX analysis confirms the use of lead oxide and evidences that most of the samples underwent at least two firing processes. No Raman signals of crystalline phases were detected on either glaze surfaces or glaze thin‐sections. The exception is the single firing of dark green glazes, which show pseudobrookite and rutile at the clay body/glaze interface measured in thin section. No colouring crystalline phases were identified by Raman spectroscopy either. However, SEM‐EDX shows iron was the most‐used colouring agent whereas copper was used for bright light green glazes. The polymerization index (Ip) values were used to estimate the firing temperatures. The polymerization index values are typically low for lead glazes and indicate firing temperatures below 700°C. [ABSTRACT FROM AUTHOR]

Mycorrhizal fungi are key components of whole‐plant adaptive strategies to cope with different abiotic and biotic constraints. Although they are particularly sensitive to different global change drivers, there are still many gaps on the mechanisms underpinning shifts in mycorrhizal associations under different climatic and management scenarios. We carried out a field manipulative experiment of rainfall exclusion and increased temperature aimed to evaluate the impact of forecasted warming and drying on mycorrhizal associations of savanna plant communities subjected to different grazing history. Additionally, we compiled detailed information on the abiotic and biotic environment with the final aim of disentangling the direct and indirect effects of climate change on this widespread mycorrhizal symbiosis. Our results suggest that climate change could induce relevant changes in mycorrhizal associations, primarily promoted by warming, which decreased the abundance of mycorrhizae but induced higher activity of nutrient exchange between the host–plant and the mycosymbiont. Temperature did not only affect this symbiosis in a direct way, but also exerted relevant indirect effects via changes in soil functioning and other root‐colonizing microorganisms such as dark septate endophytes. Grazing history influenced the allocation of fungal structures inside the host‐root, but its effect differed as a function of the climatic treatment. Results from this study suggest that mycorrhizal fungi might become less prevalent in plant communities inhabiting savanna ecosystems under future scenarios of increasing aridity. In agreement with this finding, higher temperatures also promoted the predominance of plants with root traits that favour efficient resource acquisition by themselves without the help of a mycorrhizal partner. Our results provide new insights into the interactive effects of the two main threats facing Mediterranean savanna ecosystems, as well as potentially useful information to be applied in ecologically‐based management strategies aimed at attenuating the potential impact of global change on mycorrhizal fungi. [ABSTRACT FROM AUTHOR]

Objectives: Adoptive cell therapy (ACT) with mature T cells modified with a chimeric antigen receptor has demonstrated improved outcome for B‐cell malignancies. However, its application for others such as Hodgkin lymphoma remains a clinical challenge. CD30 antigen, expressed in Hodgkin lymphoma cells, is absent in most healthy tissues, representing an ideal target of ACT for this disease. Despite that, efficacy of CD30‐chimeric antigen receptor (CAR) T cells for Hodgkin lymphoma remains modest. Here, we have developed and tested a novel CD30‐CAR T to improve efficacy of CD30‐CAR therapy, using a targeting epitope within the non‐cleavable part of CD30 receptor, and memory stem T cells (TSCM) to improve engraftment, persistence and antitumor activity. Methods: TSCM‐like cultures were generated and expanded ex vivo and transduced at day 1 or 2 with a lentiviral vector encoding the CD30‐CAR. Therapeutic in vivo experiments were performed using NSG mice injected with L540 (sc) or L428 (iv) and treated with CD30‐CAR T cells when the tumor was established. Results: CD30‐CAR TSCM‐like cells generated and expanded ex vivo, despite CD30 expression and fratricide killing of CD30+ CAR T cells, were not impaired by soluble CD30 and completely eradicated Hodgkin lymphoma in vivo, showing high persistence and long‐lasting immunity. In addition, highly enriched CD30‐CAR TSCM‐like products confer a survival advantage in vivo, in contrast to more differentiated CAR T cells, with higher tumor infiltration and enhanced antitumor effect. Conclusion: This study supports the use of a refined CD30‐CAR T cells with highly enriched TSCM‐like products to improve clinical efficacy of CAR T for Hodgkin lymphoma. [ABSTRACT FROM AUTHOR]

This article discusses the surgical management of inflammatory bowel disease, specifically ulcerative colitis, using a robotic approach. The da Vinci X surgical system is used to perform a multi-quadrant total proctocolectomy with ileoanal pouch. The article provides a step-by-step description of the procedure, which involves making a J-pouch through the ileostomy site and performing ileoanal anastomosis intracorporeally and mechanically. The authors emphasize that the robotic approach is technically demanding but can be performed safely with training and standardization of the technique. [Extracted from the article]

The microencapsulation of spermatozoa offers potential benefits for maintaining sperm survival in vitro. The technique has also resulted in the production of offspring in several domestic animal species, but as yet, it has not been successfully applied in human reproductive medicine. This study examined the effect of alginic acid microencapsulation on human sperm membrane integrity (viability) and sperm DNA fragmentation (SDF) following storage for 24 hr at 37°C. The cumulative sperm viability (Log‐rank, Mantel–Cox; Chi‐square = 114.95, p =.000) and cumulative sperm DNA fragmentation (Log‐rank, Mantel–Cox; Chi‐square = 187.86, p =.000) of encapsulated spermatozoa were substantially improved when compared to control spermatozoa. Significant differences in the dynamic behaviour of different individuals were only apparent for sperm viability in microencapsulated samples (p =.021) while no significant differences were observed in control spermatozoa (p =.245); the equivalent comparison for SDF showed no differences (control p =.320; microencapsulated p =.432). We present potential scenarios for the use of microencapsulated human spermatozoa in reproductive medicine. [ABSTRACT FROM AUTHOR]

Aims: Identifying DNA variants associated with trough serum anti‐tumour necrosis factor (TNF) levels could predict response to treatment in inflammatory bowel disease (IBD). To date, no specific studies have been performed in children. The aim of this study was to identify genetic variants associated with trough serum anti‐TNF levels and whether these variants are differential markers for infliximab and adalimumab. Methods: We included 154 children (age < 18 years) from 17 hospitals who had been diagnosed with IBD and actively treated with infliximab or adalimumab. Twenty‐one polymorphisms were genotyped using real‐time PCR. Trough serum anti‐TNF levels were measured using enzyme‐linked immunosorbent assay (ELISA). The association between DNA polymorphisms and the therapeutic range or the absolute values of anti‐TNF drugs was analysed by Fisher exact test, student's t‐test and logistic regression. Results: The variants rs5030728 (TLR4) and rs11465996 (LY96) were associated with subtherapeutic infliximab levels. rs1816702 (TLR2) was associated with supratherapeutic levels and rs3397 (TNFRSF1B) with subtherapeutic levels of adalimumab (P <.05). In addition, rs1816702 (TLR2) and rs2569190 (CD14) were associated with absolute values of trough serum adalimumab, and rs2569190 (CD14) was associated with absolute values of trough serum adalimumab and infliximab (P <.05). Conclusion: Genotyping of these DNA variants before starting treatment may help to select the best anti‐TNF drug in paediatric patients. The SNP rs1816702 is the most promising marker for tailoring the anti‐TNF regimen in children with IBD. For the first time, DNA variants are associated with trough serum anti‐TNF levels. [ABSTRACT FROM AUTHOR]

Aim: The aim was to develop and operationally define 'performance metrics' that characterize a reference approach to robotic‐assisted low anterior resection (RA‐LAR) and to obtain face and content validity through a consensus meeting. Method: Three senior colorectal surgeons with robotic experience and a senior behavioural scientist formed the Metrics Group. We used published guidelines, training materials, manufacturers' instructions and unedited videos of RA‐LAR to deconstruct the operation into defined, measurable components – performance metrics (i.e. procedure phases, steps, errors and critical errors). The performance metrics were then subjected to detailed critique by 18 expert colorectal surgeons in a modified Delphi process. Results: Performance metrics for RA‐LAR had 15 procedure phases, 128 steps, 89 errors and 117 critical errors in women, 88 errors and 118 critical errors in men. After the modified Delphi process the final performance metrics consisted of 14 procedure phases, 129 steps, 88 errors and 115 critical errors in women, 87 errors and 116 critical errors in men. After discussion by the Delphi panel, all procedure phases received unanimous consensus apart from phase I (patient positioning and preparation, 83%) and phase IV (docking, 94%). Conclusion: A robotic rectal operation can be broken down into procedure phases, steps, with errors and critical errors, known as performance metrics. The face and content of these metrics have been validated by a large group of expert robotic colorectal surgeons from Europe. We consider the metrics essential for the development of a structured training curriculum and standardized procedural assessment for RA‐LAR. [ABSTRACT FROM AUTHOR]

Minimally invasive surgery has demonstrated many benefits in general surgery, particularly in colon and rectal procedures. On the other hand, it has some limitations that must be taken into account, especially technical drawback. Robotic surgery has incorporated many improvements to overcome this disadvantage, such as 3D visualization, articulating instruments assisting complex and precise movements. As a result, robotic colorectal surgery shows less intraoperative blood loss, shorter time to oral tolerance and initial flatus (particularly associated with "Enhanced Recovery After Surgery" protocol), less conversion rate to open surgery, shortened hospital stay, and longer distal margins compared to laparoscopic and open surgery. This approach also shows a shorter learning curve. Some studies suggest that it could decrease perioperatively or 30 days after the intervention's mortality, raise overall survival, reduce wound infection, and improve functional results, while others show no significant difference. However, it lengthens surgical time. Otherwise, the studies included do not show statistically significant changes in the number of resected lymph nodes and anastomotic leaks. Economic costs remain one of the major concerns, although to date there are no large‐scale studies that have evaluated this aspect from a global point of view. Robotic surgery represents a qualitative leap in surgical instruments and, although there is no strong evidence in favor of the use of robotic surgery over laparoscopic or open surgery, there is enough evidence to support its use in colorectal surgery, with potential advantages for patients. [ABSTRACT FROM AUTHOR]

Robotic total mesorectal excision with rectal stump transabdominal purse string and single-stapled anastomosis technique - a video vignette Robotic total mesorectal excision with rectal stump transabdominal purse string and single-stapled anastomosis technique could be a combination that achieves optimal oncological and postoperative outcomes. The treatment of rectal cancer remains a challenge and the main intra-operative goal is to achieve a nerve sparing total mesorectal excision with free margins and watertight anastomosis. [Extracted from the article]

Neurofibromatosis type I (NF1) is one of the most common genetic disorders in humans. NF1, a tumor predisposition syndrome, is caused by heterozygous pathogenic variants in the NF1 gene. Molecular genetic testing of NF1 is complex, especially because of the presence of a high number of partial pseudogenes, some of them with a high percentage of sequence identity. In this study, we have analyzed the largest cohort of NF1 Spanish patients (150 unrelated individuals suspected of having NF1 and 53 relatives, making a total of 203 individuals). Mutation analysis of the entire coding region was performed in all unrelated index patients. Additionally, the Multiplex Ligation‐dependent Probe Amplification (MLPA) test of the NF1 gene and SPRED1 gene analysis (sequencing and MLPA test) was performed in some of the negative patients for NF1 point mutations. When fulfilling the National Institutes of Health (NIH) criterion for the clinical diagnosis of NF1, the detection rate was 79%. Among the 80 genetically confirmed NF1 probands, we detected 69 different pathogenic variants. Two mutations (3%) were gross deletions of the whole gene, the remaining 78 mutations (97%) were small changes spread among all NF1 exons. Among these 69 different mutations detected, 42 mutations were described elsewhere, and 27 mutations were novel mutations. When segregation was studied, 67% of mutations resulted de novo variants. No genetic mosaicism was detected on patients' parents. [ABSTRACT FROM AUTHOR]

Abstract: This article consists of four brief responses to Lucretia B. Yaghjian's “Pedagogical challenges in teaching ESOL/Multilingual writers in theological education,” published in this issue of the journal. [ABSTRACT FROM AUTHOR]

Livedo reticularis‐like eruptions have been described in different viral infections. In patients with COVID‐19, livedo reticularis‐like rashes are usually mild, typically present in a symmetric distribution and mostly involve the lower limbs. A case of livedo reticularis located exclusively on the breasts of a girl with mild systemic symptoms of COVID‐19 is presented. Coagulation studies were normal and findings disappeared within 1 week. [ABSTRACT FROM AUTHOR]

To characterize mitochondrial/apoptotic parameters in chronically human immunodeficiency virus ( HIV-1)-infected promonocytic and lymphoid cells which could be further used as therapeutic targets to test pro-mitochondrial or anti-apoptotic strategies as in vitro cell platforms to deal with HIV-infection. Mitochondrial/apoptotic parameters of U1 promonocytic and ACH2 lymphoid cell lines were compared to those of their uninfected U937 and CEM counterparts. Mitochondrial DNA (mt DNA) was quantified by rt- PCR while mitochondrial complex IV (CIV) function was measured by spectrophotometry. Mitochondrial-nuclear encoded subunits II-IV of cytochrome-c-oxidase (COXII-COXIV), respectively, as well as mitochondrial apoptotic events [voltage-dependent-anion-channel-1( VDAC-1)-content and caspase-9 levels] were quantified by western blot, with mitochondrial mass being assessed by spectrophotometry (citrate synthase) and flow cytometry (mitotracker green assay). Mitochondrial membrane potential ( JC1-assay) and advanced apoptotic/necrotic events (AnexinV/propidium iodide) were measured by flow cytometry. Significant mt DNA depletion spanning 57.67% ( P < 0.01) was found in the U1 promonocytic cells further reflected by a significant 77.43% decrease of mitochondrial CIV activity ( P < 0.01). These changes were not significant for the ACH2 lymphoid cell line. COXII and COXIV subunits as well as VDAC-1 and caspase-9 content were sharply decreased in both chronic HIV-1-infected promonocytic and lymphoid cell lines (<0.005 in most cases). In addition, U1 and ACH2 cells showed a trend (moderate in case of ACH2), albeit not significant, to lower levels of depolarized mitochondrial membranes. The present in vitro lymphoid and especially promonocytic HIV model show marked mitochondrial lesion but apoptotic resistance phenotype that has been only partially demonstrated in patients. This model may provide a platform for the characterization of HIV-chronicity, to test novel therapeutic options or to study HIV reservoirs. [ABSTRACT FROM AUTHOR]

Questions How are ectomycorrhizal ( ECM) and arbuscular mycorrhizal ( AM) traits related to other plant traits at the community level? Which abiotic factors drive the variability of these ECM and AM traits? What is the relative importance of plant species turnover and plant intraspecific differences on mycorrhizal trait variability among communities? Location Nine Mediterranean woody communities, Sierra Morena Mountains, Córdoba, south Spain. Methods Mycorrhizal and plant traits were weighted by the abundance of constitutive plant species to calculate community-weighted means ( CWM). Maximum likelihood techniques were used to analyse how variation in these functional community traits was driven by soil abiotic factors. Results The degree of ECM colonization was positively related to the abundance of evergreen species and to tissue dry matter content (in leaves and roots), but negatively to specific root length and specific leaf area. The best abiotic predictor of ECM colonization was soil moisture, with higher ECM colonization in drier sites. However, AM colonization was not related to any of the plant traits studied, and was positively related to soil Cu and other physico-chemical soil properties. Changes in community mycorrhization of both types were primarily due to plant species turnover (mainly species occurrence), with a remarkable importance of plant intraspecific variability in the case of AM colonization (especially in the percentage of vesicles). Conclusions The degrees of colonization by ECM and AM at the community level exhibited different patterns, influenced by both biotic factors (plant functional structure) and abiotic conditions (soil moisture and chemical composition). The proposed mycorrhizal trait-based approach can help to better understand the role of these symbioses on plant community functioning. [ABSTRACT FROM AUTHOR]

Understanding which factors and rules govern the process of assembly in communities constitutes one of the main challenges of plant community ecology. The presence of certain functional strategies along broad environmental gradients can help to understand the patterns observed in community assembly and the filtering mechanisms that take place. We used a trait-based approach, quantifying variations in aboveground (leaf and stem) and belowground (root) functional traits along environmental gradients in Mediterranean forest communities (south Spain). We proposed a new practical method to quantify the relative importance of species turnover (distinguishing between species occurrence and abundance) versus intraspecific variation, which allowed us to better understand the assemblage rules of these plant communities along environmental gradients. Our results showed that the functional structure of the studied plant communities was highly determined by soil environment. Results from our modelling approach based on maximum likelihood estimators showed a predominant influence of soil water storage on most of the community functional traits. We found that changes in community functional structure along environmental gradients were mainly promoted by species turnover rather than by intraspecific variability. Specifically, our new method of variance decomposition demonstrated that between-site trait variation was the result of changes in species occurrence rather than in the abundance of certain dominant species. In conclusion, this study showed that water availability promoted the predominance of specific trait values (both in above and belowground fractions) associated to a resource acquisition or conservation strategy. In addition, we provided evidence that changes on community functional structure along the environmental gradient were mainly promoted by a process of species replacement, which represent a crucial step towards a more general understanding of the relative importance of intraspecific versus interspecific trait variation in these woody Mediterranean communities. [ABSTRACT FROM AUTHOR]

PREMISE OF THE STUDY: Coflowering plants are at risk for receiving pollen from heterospecifics as well as conspecifics, yet evidence shows wide variation in the degree that heterospecific pollen transfer occurs. Evaluation of patterns and correlates of among- and within-species variation in heterospecific pollen (HP) receipt is key to understanding its importance for floral evolution and species coexistence; however, the rarity of deeply sampled multispecies comparisons has precluded such an evaluation. METHODS: We evaluated patterns of among- and within-species variation in HP load size and diversity in 19 species across three distinct plant communities. We assessed the importance of phenotypic specialization (floral phenotype), ecological specialization (contemporary visitor assemblage), and conspecific flower density as determinants of among-species variation. We present hypotheses for different accrual patterns of HP within species based on the evenness and quality of floral visitors and evaluated these by characterizing the relationship between conspecific pollen (CP) and HP receipt. KEY r e s u lt s : We found that within-species variation in HP receipt was greater than among-species and among-communities variation. Among species, ecological generalization emerged as the strongest driver of variation in HP receipt irrespective of phenotypic specialization. Within-species variation in HP load size and diversity was predicted most often from two CP-HP relationships (linear or exponentially decreasing), suggesting that two distinct types of plant-pollinator interactions prevail. CONCLUSIONS: Our results give important insights into the potential drivers of among- and within-species variation in HP receipt. They also highlight the value of explorations of patterns at the intraspecific level, which can ultimately shed light on plant-pollinator-mediated selection in diverse plant communities. [ABSTRACT FROM AUTHOR]

Questions: Is there any evidence of coordination among leaf, stem and root traits, and thereby of the existence of a plant economics spectrum at the species and community level in Mediterranean forests? Are these traits related to plant size and seedmass? Location: Mediterranean forests and shrublands, Sierra Morena mountains, Córdoba, southern Spain. Methods:We selected nine woody plant communities along a natural local gradient of soil water and nutrient availability. We measured key leaf, stem, root and whole-plant traits for 38 dominant woody plant species. The variation across species of 15 functional traits (of the leaf, stem and root) was analysed and coordination among them was tested. We explored the relationships between these traits (hereafter 'resource-use traits' due to their close association with the acquisition-conservation trade-off) and plant height and seed mass. Finally, we compared results at species level with those calculated at community level, considering community-weightedmeans (CWMs). Results:We found a significant coordination between traits belonging to different plant organs, and propose the existence of a plant economics spectrum in Mediterranean forests along the environmental gradient. However, weaker relationships were found within groups of species under similar environmental conditions. We did not find the expected orthogonal relationships between plant height, seed mass and resource-use traits. Relationships among functional traits were stronger at the community level than at the species level. Conclusions: This study reveals a high degree of functional coordination between traits belonging to different plant organs at both species and community level, and suggests the existence of a plant economics spectrum across 38 Mediterranean woody plant species. However, this general trend of functional coordination between organs became weaker or disappeared when considering restricted groups of species belonging to environmentally similar sites (e.g. dry vs wet sites), suggesting that the diversification of strategies within communities is not related to the economics spectrum at a lower spatial scale. Interestingly, the high degree of coordination between resource-use traits and seed mass at the community level seems to support the tolerance-fecundity model, which predicts an inverse relationship between fecundity and stress tolerance. [ABSTRACT FROM AUTHOR]

Klotho protein has been associated with beneficial effects that contribute to the maintenance of cardiovascular health. Diverse studies suggest that alterations in the levels of this molecule may be associated with pathophysiological abnormalities that result in increased cardiovascular risk. The primary aim of this proof-of-concept study was to analyse the existence of a potential link between Klotho gene polymorphisms and the expression level of this gene in the vascular wall, and additionally with the incidence of cardiovascular disease and cardiovascular risk factors. Our results indicate that the variant G-395A, located in the promoter region, influences Klotho gene vascular expression and is associated with the incidence of diabetes. Similarly, the exonic variant KL-VS was associated with the incidence of atherosclerotic vascular disease and coronary artery disease. Moreover, vascular expression levels of Klotho were related with the incidence of diabetes mellitus and coronary artery disease. These findings, which need to be confirmed in larger studies, suggest a potential role of Klotho in the pathogenesis of vascular damage. [ABSTRACT FROM AUTHOR]

ABSTRACT From its construction in the early 1970s, Cancun has gone through a rapid demographic change accompanied by a transformation in the tourism industry, from having 117 inhabitants in 1969 to over 734,000 in 2014, being visited by more than 3.3 million tourists per year. As a result, Cancun has had to offer up something other than its original Caribbean advertising of 'sun, sand, and sex,' now it is offering its Maya heritage. This paper analyzes the origin, development, and evolution of the 'Mayanization' of Cancun-the use of Maya imagery and iconography in advertisements, architecture and souvenirs-and the promotion of a 'Maya imaginary' through the laborers who fuel the tourism industry, turning cultural, archaeological, and historical patrimony into a commodity. [ABSTRACT FROM AUTHOR]

Diabetic kidney disease (DKD) defines the functional, structural and clinical abnormalities of the kidneys that are caused by diabetes. This complication has become the single most frequent cause of end-stage renal disease. The pathophysiology of DKD comprises the interaction of both genetic and environmental determinants that trigger a complex network of pathophysiological events, which leads to the damage of the glomerular filtration barrier, a highly specialized structure formed by the fenestrated endothelium, the glomerular basement membrane and the epithelial podocytes, that permits a highly selective ultrafiltration of the blood plasma. DKD evolves gradually over years through five progressive stages. Briefly they are: reversible glomerular hyperfiltration, normal glomerular filtration and normoalbuminuria, normal glomerular filtration and microalbuminuria, macroalbuminuria, and renal failure. Approximately 20-40% of diabetic patients develop microalbuminuria within 10-15 years of the diagnosis of diabetes, and about 80-90% of those with microalbuminuria progress to more advanced stages. Thus, after 15-20 years, macroalbuminuria occurs approximately in 20-40% of patients, and around half of them will present renal insufficiency within 5 years. The screening and early diagnosis of DKD is based on the measurement of urinary albumin excretion and the detection of microalbuminuria, the first clinical sign of DKD. The management of DKD is based on the general recommendations in the treatment of patients with diabetes, including optimal glycaemic and blood pressure control, adequate lipid management and abolishing smoking, in addition to the lowering of albuminuria. [ABSTRACT FROM AUTHOR]

Inflammation is a strong predictor of increased morbidity and mortality in hemodialysis (HD) patients. Paricalcitol, a selective vitamin D receptor activator used for prevention and treatment of secondary hyperparathyroidism, has shown anti-inflammatory properties in experimental studies, although clinical data are scarce. In an open-label, prospective, single center, pilot study, 25 stable HD patients, previously receiving calcitriol, completed 12 weeks of therapy with oral paricalcitol. Serum and peripheral blood mononuclear cell (PBMC) expression profiles of inflammatory cytokines were analyzed. Serum interleukin (IL)-1, IL-10, and IL-18 did not change, unlike high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and IL-6, which experienced a significant mean percent decrease of 14.3%, 4.7%, and 5%, respectively. There was a significant reduction in the TNF-α/IL-10 and the IL-6/IL-10 ratios ( P < .05). Serum intact parathyroid hormone concentration experienced a mild but significant reduction. In addition, expression levels of TNF-α and IL-6 decreased by 19.1% ( P < .01) and 17.5% ( P < .001), respectively, whereas expression of IL-10 increased by 17.7% ( P < .01) after treatment. In conclusion, paricalcitol administration to HD patients is associated with a beneficial effect on the inflammatory cytokine serum and gene expression profile of PBMC. This effect may contribute to the survival benefits of paricalcitol observed in clinical studies. [ABSTRACT FROM AUTHOR]

Magnesium (Mg) is the fourth most abundant cation in the body, mainly located within bone and skeletal muscle. The normal total plasma Mg concentration varies in a narrow range, with approximately 60% present as free Mg ions, the biologically active form. The kidney plays a principal role in Mg balance. Approximately 70–80% of plasma Mg is ultrafilterable, and under normal circumstances, 95% of the filtered load of Mg is reabsorbed. As chronic renal failure (CRF) progresses, urinary Mg excretion may be insufficient to balance intestinal Mg absorption and dietary Mg intake becomes a major determinant of serum and total body Mg levels. Until severe reductions in glomerular filtration rate (<30 ml/min), serum Mg levels are usually normal; with lower rates of renal function, serum Mg is increased. Concerning dialysis patients, dialysate Mg plays a critical role in maintaining Mg homeostasis, with serum Mg being largely dependent on the concentration of the ion in the dialysis solution. Magnesium has been implicated in diverse consequences, both beneficial and deleterious, in patients with CRF and dialysis. Potential harmful effects of elevated Mg include altered nerve conduction velocity, increased pruritus, and alterations to osseous metabolism and parathyroid gland function (mineralization defects, contribution to osteomalacic renal osteodystrophy, and adynamic bone disease). Hypermagnesemia also may retard vascular calcification. Low Mg levels have been associated with impairment of myocardial contractility, intradialytic hemodynamic instability, and hypotension. In addition, low Mg has been also linked to carotid intima-media thickness, a marker of atherosclerotic vascular disease and a predictor of vascular events. [ABSTRACT FROM AUTHOR]

Constitutive alkali-labile sites (ALSs) have been investigated using a protocol of DNA breakage detection–fluorescence in situ hybridization (DBD–FISH) in sperm cells from Sus domesticus (pig), Ovis gmelini musimon (mouflon) and Ovis aries (sheep). The results were compared with those obtained using leucocytes from the same species. Whole comparative genomic hybridization (W-CGH) showed that most of the constitutive ALSs in somatic and germ line cells in all species examined were constrained to particular repetitive satellite DNA sequences located in the pericentromeric constitutive heterochromatin of each chromosome. However, their relative abundance was different among cells of the same organism (leucocytes/sperm cells), and this trend was not maintained when the different species were compared. Thus, in mouflon, the density of ALSs in leucocytes when compared with that observed in sperm cells indicated abundance of the order of eight times less. In sheep, both leucocytes and sperm cells exhibited a large quantity of ALSs, being of the order of four times more abundant in sperm cells. In the pig genome, leucocytes showed a high abundance of ALSs (of the order of 12 times more that in sperm cells) but only involved the metacentric chromosomes of the karyotype. ALSs were not present in the acrocentric chromosomes. Contrary to mouflon and sheep, ALSs were relatively scarce in sperm cells from pig. These results suggest that ALSs are a transient structural feature in the cells of any organisms and point to a non-universal model of chromatin organization in sperm cells among mammals. [ABSTRACT FROM AUTHOR]

Interleukin (IL)-12p40, a subunit of IL-12p70 and IL-23, has previously been shown to inhibit IL-12p70 activity and interferon-γ (IFN-γ) production. However, recent evidence has suggested that the role of IL-12p40 is more complex. To study the contribution of IL-12p40 to immune responses against mycobacterial infections, we have used transgenic (tg) mice overexpressing IL-12p40 under the control of a major histocompatibility complex-II promoter. The IL-12p40 transgene was expressed during steady state at concentrations of 129 ± 25 ng/ml of serum and 75 ± 13 ng per spleen, while endogenous IL-12p40 was hardly detectable in control littermates. Bacille Calmette–Guérin (BCG) infection strongly induced the expression of IL-12p40 transgene in infected organs, and IL-12p40 monomeric and dimeric forms were identified in spleen of IL-12p40 tg mice. Excessive production of IL-12p40 resulted in a 14-fold increase in IL-12p70 serum levels in tg mice versus non-transgenic mice. IL-23 was also strongly elevated in the serum and spleens of IL-12p40 tg mice through BCG infection. While IFN-γ and tumour necrosis factor protein levels were similar in IL-12p40 tg and non-transgenic mice, Th2 type immune responses were reduced in IL-12p40 tg mice. The number of BCG granulomas and macrophage expressing inducible nitric oxide synthase were similar in IL-12p40 tg and non-transgenic mice. IL-12p40 tg mice were as resistant as non-transgenic mice to BCG and Mycobacterium tuberculosis infections as they could efficiently control bacillary growth. These data show that high amounts of IL-12p40 promotes IL-12p70 and IL-23 formation, but that does not affect T helper 1 type immune responses and granuloma function, thus leading to normal mycobacterial clearance in infected organs. [ABSTRACT FROM AUTHOR]

Deficiencies in immune responses against polysaccharides can have direct consequences for patients, and therefore, a better undestanding of these immune reactions is crucial We have studied the immune response against the polysaccharide dextran B512 (Dx). Administration of immunogenic doses of thymus-independent (TI) Dx reduces the immunoglobulin G1 response to later challenges with a thymus-dependent (TD) form of Dx. We investigated if this suppression is a general phenomenon caused not only by Dx but also by other TI antigens, and examined possible mechanisms contributing to this unresponsiveness. We show that clonal exhaustion is not involved in modulating subsequent responses, nor is signalling via FcγRIIB or other antibody mediated pathways. The reduced TD response is not an exclusive Dx phenomenon; it is also induced by TI antigen oxazolone (Ox). However, responses against the hapten dinitrophenyl (DNP) are not affected, indicating that the TI priming negative effect is not a general process. This may be explained by the restricted immune response to both Dx and Ox, in contrast to the unrestricted DNP response. Our conclusion from these experiments is that the underlying mechanism for the TI-induced reduction of latter TD responses is a property of the TI activation itself. [ABSTRACT FROM AUTHOR]

In recent years, research on tropical forest conservation has increasingly focused on traditional management systems as a means of achieving a balance between conservation and development. Styrax paralleloneurum , a forest-canopy tree species that produces benzoin, an aromatic resin, is cultivated in such a system. This study is an attempt to determine the impact of benzoin garden management on forest structure, species composition, and diversity. Forty-five gardens were chosen for study in two Northern Sumatra villages, where data on management practices and ecological structure were gathered. Ecological information was also collected from abandoned benzoin gardens and primary forest areas for purposes of comparison. Although benzoin management requires that competing vegetation be thinned, these activities are not intensive, allowing species that coppice to remain in the garden and thereby reducing the effects of competitive exclusion mechanisms on species composition. Tree species diversity in abandoned gardens was similar to that in primary forest, but endemic species and species characteristic of mature habitats were less common. Traditional benzoin garden management represents only a low-intensity disturbance and maintains an ecological structure that allows effective accumulation of forest species over the long term. [ABSTRACT FROM AUTHOR]

I Dear Sir i , Oncological surgery for colon cancer involves resection of the tumour along with the adjacent mesentery and a lymphadenectomy appropriate to the location and stage of the tumour. Since Stages II and III cannot be accurately differentiated preoperatively in colon cancer, resection of the mesentery adjacent to the terminal ileum is important to achieve adequate complete excision of the mesentery [3]. A complete lymphadenectomy following the ileal branch of the superior mesenteric vein in the direction of the ileum can be safely performed, resecting an ileal length of between 10 and 15 cm, because most of peri-ileal lymph node metastases will be found in this area [4]. [Extracted from the article]

Key Clinical Message Although involuntary movements of stumps are less frequent than phantom sensation or other neurological sequelae of limb amputation, they represent a phenomenon that has been known for many years. The pathophysiology remains unknown, but it seems to be related to damage to the peripheral nervous system. Treatment is not standardized, but antimyoclonic drugs seem to be useful. [ABSTRACT FROM AUTHOR]

Background Aims Study Design Results Conclusions Relevance for Clinical Practice Multiple risk assessment scales are available for predicting the development of pressure injuries (PIs) in patients in the intensive care unit (ICU). Most PI risk assessment tools have been validated at the time of admission; however, another time point during treatment could better reflect clinical changes and therefore, the risk of PIs.The study aimed to examine the predictive validity of PI risk assessment scale designed for ICU patients, the conscious level, mobility, haemodynamic, oxygenation and nutrition (COMHON) index, at several time points or intervals during ICU stay.This was an observational prospective study undertaken over a period of 1 year (July 2021–June 2022). Patients admitted to ICU for >3 days were included. The number, location and degree of the PIs were recorded. The level of risk for developing PIs during the stay was determined by calculating the COMHON scores at admission, and 72 h, as well as the highest and mean score. Predictive validity was studied using accuracy parameters and areas under the receiver operating characteristic curve (AUC). The best cutoff point was also determined and used to compare risk between categories.Of the 286 patients included in the study, 160 (59%) were male. The level of severity evaluated using the APACHE II scale was 18.4 ± 5.8 points. Invasive mechanical ventilation was used in 32.1% (n = 92) of the patients and 20.6% (n = 59) received high flow oxygen therapy. The incidence of PI was 15.4% (n = 44), with sacral location in 47.7% (n = 21) and grade II in 75% (n = 33) of the patients. The AUC was 0.907 (0.872–0.942); 0.881 (0.842–0.920); 0.877 (0.835–0.920) and 0.749 (0.667–0.831) at the mean, the highest, 72 h and ICU admission scores, respectively. The best cutoff point was 13 in all patients. The risk of developing a PI was 6.4 times higher in the high‐risk group (>13 points).The best predictive capacity for the COMHON index risk assessment was the mean and highest scores. The predictive accuracy was higher on the third day of the patient's stay than on admission, and this was attributed to the clinical changes observed in some patients over the course of their critical illness.Patients in ICU are at high risk of developing PIs, therefore, preventive measures should be maximized. Risk assessment should be carried out sequentially owing to the changes that patients present throughout their ICU stay and preventive measures should be used according to the risk level. [ABSTRACT FROM AUTHOR]