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Malignant pleural effusion (MPE) has become an increasingly prevalent complication in oncological patients, negatively impacting their quality of life and casting a shadow over their prognosis. Owing to the pathophysiological mechanisms involved and the heterogeneous nature of the underlying disease, this entity is both a diagnostic and therapeutic challenge. Advances in the understanding of MPE have led to a shift in the treatment paradigm towards a more personalized approach. This article provides a comprehensive review and update on the pathophysiology of MPE and describes the diagnostic tools and the latest advances in the treatment of this complex clinical entity. Resumen: El derrame pleural maligno (DPM) se ha convertido en una complicación cada vez más prevalente en los pacientes oncológicos, empeorando la calidad de vida y ensombreciendo el pronóstico de los mismos. Debido a los mecanismos fisiopatológicos involucrados y a la naturaleza heterogénea de la enfermedad subyacente, esta entidad representa un desafío diagnóstico y terapéutico. Los avances en la comprensión del DPM han originado un cambio en el paradigma del tratamiento hacia un enfoque más personalizado. Este artículo proporciona una revisión exhaustiva y una actualización sobre la fisiopatología del DPM, y describe las herramientas diagnósticas y los últimos avances en el tratamiento de esta compleja entidad clínica.

Abstract Background In recent years, neuroimaging with deep learning (DL) algorithms have made remarkable advances in the diagnosis of neurodegenerative disorders. However, applying DL in different medical domains is usually challenged by lack of labeled data. To address this challenge, transfer learning (TL) has been applied to use state-of-the-art convolution neural networks pre-trained on natural images. Yet, there are differences in characteristics between medical and natural images, also image classification and targeted medical diagnosis tasks. The purpose of this study is to investigate the performance of specialized and TL in the classification of neurodegenerative disorders using 3D volumes of 18F-FDG-PET brain scans. Results Results show that TL models are suboptimal for classification of neurodegenerative disorders, especially when the objective is to separate more than two disorders. Additionally, specialized CNN model provides better interpretations of predicted diagnosis. Conclusions TL can indeed lead to superior performance on binary classification in timely and data efficient manner, yet for detecting more than a single disorder, TL models do not perform well. Additionally, custom 3D model performs comparably to TL models for binary classification, and interestingly perform better for diagnosis of multiple disorders. The results confirm the superiority of the custom 3D-CNN in providing better explainable model compared to TL adopted ones.

Plasma tau phosphorylated at threonine 181 (p-tau181) predicts Alzheimer’s disease (AD) pathology. Here, the authors investigated whether plasma ptau181 could be a potential biomarker of AD in individuals with Down syndrome (DS) and find plasma p-tau181 can detect AD in DS adults.

Abstract Background A single-centre cohort study was performed to identify the independent factors associated with the overall survival (OS) of hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization with drug-eluting beads (DEB-TACE). Methods A total of 216 HCC patients who underwent DEB-TACE from October 2008 to October 2015 at a tertiary hospital were consecutively recruited. The analysis of prognostic factors associated with overall survival after DEB-TACE, stressing the role of post-TACE events, was performed. Results The objective response (OR) rate (Modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria) to the first DEB-TACE (DEB-TACE-1) was 70.3%; the median OS from DEB-TACE-1 was 27 months (95% confidence interval (CI), 24–30). In the multivariate analysis, tumor size, AFP

Abstract Objective To determine the cutoffs that optimized the agreement between 18F‐Florbetapir positron emission tomography (PET) and Aβ1‐42, Aβ1‐40, tTau, pTau and their ratios measured in cerebrospinal fluid (CSF) on the LUMIPULSE G600II instrument, we quantified the levels of these four biomarkers in 94 CSF samples from participants of the Sant Pau Initiative on Neurodegeneration (SPIN cohort) using the Lumipulse G System with available 18F‐Florbetapir imaging. Methods Participants had mild cognitive impairment (n = 35), AD dementia (n = 12), other dementias or neurodegenerative diseases (n = 41), or were cognitively normal controls (n = 6). Levels of Aβ1‐42 were standardized to certified reference material. Amyloid scans were assessed visually and through automated quantification. We determined the cutoffs of CSF biomarkers that optimized their agreement with 18F‐Florbetapir PET and evaluated concordance between markers of the amyloid category. Results Aβ1‐42, tTau and pTau (but not Aβ1‐40) and the ratios with Aβ1‐42 had good diagnostic agreement with 18F‐Florbetapir PET. As a marker of amyloid pathology, the Aβ1‐42/Aβ1‐40 ratio had higher agreement and better correlation with amyloid PET than Aβ1‐42 alone. Interpretation CSF biomarkers measured with the Lumipulse G System show good agreement with amyloid imaging in a clinical setting with heterogeneous presentations of neurological disorders. Combination of Aβ1‐42 with Aβ1‐40 increases the agreement between markers of amyloid pathology.

PMR is a common inflammatory rheumatic disease. Although its clinical characteristics are fully recognized, no specific test for its diagnosis has been established to date. Several studies have described a wide variety of diseases that present with polymyalgic symptoms. A 18FDG-PET/CT scan could help to deal with these differential diagnoses. The goal of our study is to describe the findings of the 18FDG-PET/CT scan in a cohort of PMR patients and to detail how the 18FDG-PET/CT scan improves accuracy when diagnosing other underlying conditions. This cross-sectional study enrolled patients with a diagnosis of PMR who underwent to a 18FDG-PET/CT scan to rule out other diagnosis. The 18FDG-PET/CT scan was performed either following clinical criteria at the onset of clinical symptoms or when the patient became PMR steroid resistant. Patients' demographic, clinical and analytical data at the moment of the 18FDG-PET/CT scan were recorded. The final diagnosis was confirmed according to clinical judgement. A total of 103 patients with PMR were included. In 49.51% of patients, the 18FDG-PET/CT scan was ordered to study resistance to steroid therapy. The final diagnoses of patients were PMR in 70.9% patients, large vessel vasculitis in 15.5%, neoplasms 4.8% and another diagnosis in the rest. The 18FDG-PET/CT scan is a very useful technique for the study of Polymyalgia Rheumatica, not only to help in the diagnostic process, but also due to its role in the identification of a variety of PMR-like patrons.

Introduction: Being labelled as allergic to different drugs results in patients receiving other treatments, which are more toxic, less effective and more expensive. We aimed to analyze different studies of the costs of drug hypersensitivity assessment.Methods: A bibliographic search on studies regarding this issue was performed, including the available scientific evidence up to June 2020. We searched three databases with terms related to costs and allergy testing in drug hypersensitivity reactions.Results: Our search revealed 1,430 publications, of which 20 met the inclusion criteria. In the manuscript, prospective studies evaluating the costs of the evaluation of patients with suspected allergy to beta-lactams or non-steroidal anti-inflammatory drugs are analyzed. Also, comment is made on the costs associated with incorrect labeling as non-steroidal anti-inflammatory drug or penicillin hypersensitivity.Conclusions: Taking all costs into account, the study of drug hypersensitivity is not expensive, particularly considering the economic and clinical consequences of labeling a patient with hypersensitivity to drugs.

Desde hace años, la Unión Europea viene haciendo especial énfasis en la promoción de la capacidad institucional de las administraciones en el marco de los programas de desarrollo local y urbano. Sin embargo, hasta el momento son pocos los trabajos destinados al análisis de la capacidad institucional entre las administraciones locales españolas como producto de estas iniciativas. Este trabajo se destina al estudio de la promoción de dicha capacidad en las ciudades españolas que han implementado programas de desarrollo, en concreto, la iniciativa URBANA 2007-2013. A través de la administración de un cuestionario entre los ayuntamientos españoles y entrevistas en profundidad con actores clave en el diseño e implementación del programa, se trata de analizar la medida en que dicha capacidad se ha desarrollado, así como la relación entre su nivel de desarrollo y otros elementos del contexto local o institucional, como son la experiencia previa acumulada en programas similares y el modelo de gestión en el marco del cual se implementa el programa. Estos elementos se mostrarán como factores clave en el desarrollo de la capacidad institucional.

El estreñimiento en los niños es una de las consultas frecuentes en la farmacia comunitaria. Las precauciones básicas en la alimentación del lactante y el conocimiento de las pautas apropiadas en la introducción de nuevos alimentos se relacionan con la maduración progresiva de los sistemas digestivo y metabólico. El estreñimiento infantil se acompaña de una serie de síntomas cuya trascendencia es necesario reconocer y valorar con el fin de recomendar la consulta al médico o realizar la indicación farmacéutica correspondiente. Las papillas existentes en el mercado español pueden resultar útiles para mejorar el estreñimiento infantil, ya que aportan más fibra, disminuyendo la consistencia de las heces y también ejerciendo un efecto prebiótico (añadiendo FOS e inulina). Otras aportan fibra alimentaria, añadiendo mayor cantidad de pulpas de fruta. La educación dirigida a las madres en cuanto a hábitos alimentarios y una adecuada elección de los productos dietéticos indicados en esta situación permiten, en muchas ocasiones, resolver el problema sin necesidad de recurrir a tratamientos farmacológicos, no siempre convenientes.

OBJETIVOS Conocer las preocupaciones de las usuarias de la farmacia en relación a la menopausia y elaborar una guía de dispensación aplicable en la farmacia comunitaria. MÉTODO Estudio descriptivo, transversal, cuantitativo realizado en 39 mujeres que referían tener preocupaciones sobre problemas asociados a menopausia, utilizando una encuesta personal. Posterior estudio de mercado de las soluciones aplicables a los mismos desde la oficina de farmacia. RESULTADOS Los problemas que más inquietaban fueron los sofocos y sudores nocturnos en un 60% de los casos, en segundo lugar el insomnio e irritabilidad en un 55% de los casos. La atrofia vaginal en un 40%. En nuestro país la legislación vigente permite la comercialización de plantas con fitoestrógenos como medicamento y como suplemento nutricional. Podemos encontrar en el Catálogo de Parafarmacia del Consejo General de Colegios de Farmacéuticos diferentes grupos que tratan síntomas menores de la menopausia a nivel genital. CONCLUSIONES La menopausia es a veces un problema mal entendido y poco consultado por las mujeres que al mismo tiempo demandan soluciones. Las acciones de educación sanitaria en una oficina de farmacia deben ser realizadas centrándose en las demandas de las pacientes.

La sociedad actual se caracteriza por una elevada intolerancia al malestar y una urgencia por solucionar molestias, incluso menores, que conduce a una demanda de utilización de los recursos disponibles, aunque no siempre se precisen, lo que influye en que el uso, entre otros, de antibióticos sea mucho mayor de lo deseable1

The objectives of this work were to estimate the genetic and phenotypic parameters and to predict the genetic and genotypic values of the selection candidates obtained from intraspecific crosses in Panicum maximum as well as the performance of the hybrid progeny of the existing and projected crosses. Seventy-nine intraspecific hybrids obtained from artificial crosses among five apomictic and three sexual autotetraploid individuals were evaluated in a clonal test with two replications and ten plants per plot. Green matter yield, total and leaf dry matter yields and leaf percentage were evaluated in five cuts per year during three years. Genetic parameters were estimated and breeding and genotypic values were predicted using the restricted maximum likelihood/best linear unbiased prediction procedure (REML/BLUP). The dominant genetic variance was estimated by adjusting the effect of full-sib families. Low magnitude individual narrow sense heritabilities (0.02-0.05), individual broad sense heritabilities (0.14-0.20) and repeatability measured on an individual basis (0.15-0.21) were obtained. Dominance effects for all evaluated characteristics indicated that breeding strategies that explore heterosis must be adopted. Less than 5% increase in the parameter repeatability was obtained for a three-year evaluation period and may be the criterion to determine the maximum number of years of evaluation to be adopted, without compromising gain per cycle of selection. The identification of hybrid candidates for future cultivars and of those that can be incorporated into the breeding program was based on the genotypic and breeding values, respectively. The prediction of the performance of the hybrid progeny, based on the breeding values of the progenitors, permitted the identification of the best crosses and indicated the best parents to use in crosses.

O gênero Brachiaria é constituído por cerca de cem espécies, sendo de grande interesse para o melhoramento genético das espécies forrageiras a correta classificação dos acessos envolvidos nos programas de hibridação. Foram analisados 301 acessos, pertencentes a seis diferentes espécies de braquiária, nos quais foram avaliadas características vegetativas, reprodutivas e de pilosidade. Foram realizadas análises discriminantes de Anderson para cada um dos três grupos de caracteres morfológicos, sendo estabelecidas funções para as seis espécies. As taxas de classificação correta para os caracteres vegetativos, reprodutivos e de pilosidade foram, respectivamente, as seguintes: B. brizantha (74,00; 69,33 e 30,67%), B. decumbens (63,04; 89,13 e 65,22%), B. humidicola (52,78; 69,44 e 52,78%), B. jubata (83,87; 77,42 e 64,52%), B. ruziziensis (89,29; 92,86 e 85,71%) e B. dictyoneura (80,00; 70,00 e 70,00%). Os caracteres vegetativos e reprodutivos mostraram ser os mais eficientes, enquanto os de pilosidade foram os menos eficientes na classificação e discriminação das espécies.

Abstract Background Human T-cell leukemia virus (HTLV) -1 and -2 are deltaretroviruses that infect a wide range of cells. Glut1, the major vertebrate glucose transporter, has been shown to be the HTLV Env receptor. While it is well established that the extracellular surface component (SU) of the HTLV envelope glycoprotein (Env) harbors all of the determinants of interaction with the receptor, identification of SU subdomains that are necessary and sufficient for interaction with the receptor, as well as critical amino acids therein, remain to be precisely defined. Although highly divergent in the rest of their genomes, HTLV and murine leukemia virus (MLV) Env appear to be related and based on homologous motifs between the HTLV and MLV SU, we derived chimeric HTLV/MLV Env and soluble HTLV-1 and -2 truncated amino terminal SU subdomains. Results Using these SU constructs, we found that the 183 and 178 amino terminal residues of the HTLV-1 and -2 Env, respectively, were sufficient to efficiently bind target cells of different species. Binding resulted from bona fide interaction with the HTLV receptor as isolated SU subdomains specifically interfered with HTLV Env-mediated binding, cell fusion, and cell-free as well as cell-to-cell infection. Therefore, the HTLV receptor-binding domain (RBD) lies in the amino terminus of the SU, immediately upstream of a central immunodominant proline rich region (Env residues 180 to 205), that we show to be dispensible for receptor-binding and interference. Moreover, we identified a highly conserved tyrosine residue at position 114 of HTLV-1 Env, Tyr114, as critical for receptor-binding and subsequent interference to cell-to-cell fusion and infection. Finally, we observed that residues in the vicinity of Tyr114 have lesser impact on receptor binding and had various efficiency in interference to post-binding events. Conclusions The first 160 residues of the HTLV-1 and -2 mature cleaved SU fold as autonomous domains that contain all the determinants required for binding the HTLV receptor.

The Jambato Harlequin toad ( Atelopus ignescens ), a formerly abundant species in the Andes of Ecuador, faced a dramatic population decline in the 1980s, with its last recorded sighting in 1988. The species was considered Extinct by the IUCN until 2016, when a fortuitous discovery of one Jambato by a local boy reignited hope. In this study, we present findings from an investigation conducted in the Angamarca parish, focusing on distribution, abundance, habitat preferences, ecology, disease susceptibility, and dietary habits of the species. In one year we identified 71 individuals at different stages of development in various habitats, with a significant presence in agricultural mosaic areas and locations near water sources used for crop irrigation, demonstrating the persistence of the species in a complex landscape, with considerable human intervention. The dietary analysis based on fecal samples indicated a diverse prey selection, primarily comprising arthropods such as Acari, Coleoptera, and ants. Amphibian declines have been associated with diseases and climate change; notably, our study confirmed the presence of the pathogen Batrachochytrium dendrobatidis ( Bd ), but, surprisingly, none of the infected Jambatos displayed visible signs of illness. When analyzing climatic patterns, we found that there are climatic differences between historical localities and Angamarca; the temporal analysis also exposes a generalized warming trend. Finally, in collaboration with the local community, we developed a series of management recommendations for terrestrial and aquatic environments occupied by the Jambato., Competing Interests: The authors declare there are no competing interests., (©2024 Vega-Yánez et al.)

Below the Arctic sea ice, under the right conditions, a flux of icy brine flows down into the sea. The icy brine has a much lower fusion point and is denser than normal seawater. As a result, it sinks while freezing everything around it, forming an ice channel called a brinicle (also known as ice stalactite). In this paper, we develop a mathematical model for this phenomenon, assuming cylindrical symmetry. The fluid is considered to be viscous and quasi-stationary. The heat and salt transport are weakly coupled to the fluid motion and are modelled with the corresponding conservation equations, accounting for diffusive and convective effects. Finite-element discretization is employed to solve the coupled system of partial differential equations. We find that the model can capture the general behaviour of the physical system and generate brinicle-like structures while also recovering dendrite composition, which is a physically expected feature aligned with previous experimental results. This represents, to our knowledge, the first complete model proposed that captures the global structure of the physical phenomenon even though it has some discrepancies, such as brine accumulation., Competing Interests: We declare we have no competing interests., (© 2023 The Authors.)

The red-billed tropicbird, Phaethon aethereus , is a species of seabird native to the Galápagos archipelago, and widely distributed across the neotropics. General health, blood chemistry, and haematology parameters have not been published for this species. Blood analyses were performed on samples drawn from 51 clinically healthy red-billed tropicbirds captured from their burrows at Islote Pitt on San Cristóbal Island in July, 2016 (21) and Daphne Major Island in June, 2017 (30). In the field, a point of care blood analyser (iSTAT) was used to obtain results for HCO 3- , pH, pCO 2 , pO 2 , TCO 2 , iCa, Na, K, Cl, Hb, HCT, anion gap, creatinine, glucose and urea nitrogen. Additionally, a portable Lactate Plus TM analyser was used to measure blood lactate, and blood smears were also created in situ . The blood slides were used to estimate leukocyte counts and 100-cell differentials. Alongside these biochemistry and haematology parameters, average heart rate, respiratory rate, body temperature and scaled mass index (calculated from weight and a body measurement) were compared to determine the standard measurements for a healthy individual. The baseline data, and reference intervals reported in this paper are essential to detecting changes in the health of red-billed tropicbirds in the future., Competing Interests: The authors declare there are no competing interests., (©2023 Skehel et al.)

Toxoplasma gondii is a zoonotic intracellular parasite of particular concern in the conservation of wildlife due to its ability to infect all homeotherms and potentially cause acute fatal disease in naive species. In the Galapagos (Ecuador), an archipelago composed of more than a hundred islets and islands, the presence of T. gondii can be attributed to human-introduced domestic cats, but little is known about its transmission in wildlife populations. We compared the prevalence of antibodies against T. gondii in sympatric Galapagos wild bird species that differ in diet and contact with oocyst-contaminated soil to determine the relative importance of trophic habits as an exposure factor. Plasma samples were obtained from 163 land birds inhabiting Santa Cruz, one of the cat-inhabited islands, and from 187 seabirds breeding in cat-free surrounding islands (Daphne Major, North Seymour, and South Plaza). These samples were tested for the presence of T. gondii antibodies using the modified agglutination test (MAT ≥ 1:10). All seven species of land birds and 4/6 species of seabirds presented seropositive results. All great frigatebirds (Fregata minor) (N = 25) and swallow-tailed gulls (Creagrus furcatus) (N = 23) were seronegative. Prevalence ranged from 13% in Nazca boobies (Sula granti) to 100% in Galapagos mockingbirds (Mimus parvulus). It decreased from occasional carnivores (63.43%) to granivores-insectivores (26.22%), and strict piscivores (14.62%). These results indicate that the consumption of tissue cysts poses the highest risk of exposure to T. gondii for Galapagos birds, followed by the ingestion of plants and insects contaminated by oocysts as important transmission pathways., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Mosquera et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Yellowfin tuna, Thunnus albacares, is an important global fishery and of particular importance in the Eastern Pacific Ocean (EPO). According to the 2019 Inter-American Tropical Tuna Commission (IATTC) assessment, yellowfin tuna within the EPO is a single stock, and is being managed as one stock. However, previous studies indicate site fidelity, or limited home ranges, of yellowfin tuna which suggests the potential for multiple yellowfin tuna stocks within the EPO, which was supported by a population genetic study using microsatellites. If numerous stocks are present, management at the wrong spatial scales could cause the loss of minor yellowfin tuna populations in the EPO. In this study we used double digestion RADseq to assess the genetic structure of yellowfin tuna in the EPO. A total of 164 yellowfin tuna from Cabo San Lucas, México, and the Galápagos Islands and Santa Elena, Ecuador, were analysed using 18,011 single nucleotide polymorphisms. Limited genetic differentiation (FST = 0.00058-0.00328) observed among the sampling locations (México, Ecuador, Peru, and within Ecuador) is consistent with presence of a single yellowfin tuna population within the EPO. Our findings are consistent with the IATTC assessment and provide further evidence of the need for transboundary cooperation for the successful management of this important fishery throughout the EPO., Competing Interests: The authors have declared that no competing interests exist.

Recent adaptive radiations are models for investigating mechanisms contributing to the evolution of biodiversity. An unresolved question is the relative importance of new mutations, ancestral variants, and introgressive hybridization for phenotypic evolution and speciation. Here, we address this issue using Darwin's finches and investigate the genomic architecture underlying their phenotypic diversity. Admixture mapping for beak and body size in the small, medium, and large ground finches revealed 28 loci showing strong genetic differentiation. These loci represent ancestral haplotype blocks with origins predating speciation events during the Darwin's finch radiation. Genes expressed in the developing beak are overrepresented in these genomic regions. Ancestral haplotypes constitute genetic modules for selection and act as key determinants of the unusual phenotypic diversity of Darwin's finches. Such ancestral haplotype blocks can be critical for how species adapt to environmental variability and change.

The cnm gene, coding for the glycosylated collagen- and laminin-binding surface adhesin Cnm, is found in the genomes of approximately 20% of Streptococcus mutans clinical isolates and is associated with systemic infections and increased caries risk. Other surface-associated collagen-binding proteins of S. mutans, such as P1 and WapA, have been demonstrated to form an amyloid quaternary structure with functional implications within biofilms. In silico analysis predicted that the β-sheet-rich N-terminal collagen-binding domain (CBD) of Cnm has a propensity for amyloid aggregation, whereas the threonine-rich C-terminal domain was predicted to be disorganized. In this study, thioflavin-T fluorescence and electron microscopy were used to show that Cnm forms amyloids in either its native glycosylated or recombinant nonglycosylated form and that the CBD of Cnm is the main amyloidogenic unit of Cnm. We then performed a series of in vitro , ex vivo , and in vivo assays to characterize the amylogenic properties of Cnm. In addition, Congo red birefringence indicated that Cnm is a major amyloidogenic protein of S. mutans biofilms. Competitive binding assays using collagen-coated microtiter plates and dental roots, a substrate rich in collagen, revealed that Cnm monomers inhibit S. mutans binding to collagenous substrates, whereas Cnm amyloid aggregates lose this property. Thus, while Cnm contributes to recognition and initial binding of S. mutans to collagen-rich surfaces, amyloid formation by Cnm might act as a negative regulatory mechanism to modulate collagen-binding activity within S. mutans biofilms and warrants further investigation. IMPORTANCE Streptococcus mutans is a keystone pathogen that promotes caries by acidifying the dental biofilm milieu. The collagen- and laminin-binding glycoprotein Cnm is a virulence factor of S. mutans. Expression of Cnm by S. mutans is hypothesized to contribute to niche expansion, allowing colonization of multiple sites in the body, including collagen-rich surfaces such as dentin and heart valves. Here, we suggest that Cnm function might be modulated by its aggregation status. As a monomer, its primary function is to promote attachment to collagenous substrates via its collagen-binding domain (CBD). However, in later stages of biofilm maturation, the same CBD of Cnm could self-assemble into amyloid fibrils, losing the ability to bind to collagen and likely becoming a component of the biofilm matrix. Our findings shed light on the role of functional amyloids in S. mutans pathobiology and ecology.

The present study aimed to investigate the acute response of gilthead seabream ( Sparus aurata ) juveniles exposed to temperature, salinity and ammonia stress. Radioimmunoassay was used to evaluate cortisol levels, whereas insulin-like growth factors ( igf1 and igf2 ), myostatin ( mstn ), heat-shock protein 70 ( hsp70 ) and glucocorticoid receptor ( gr ) gene expression was assessed trough Real-Time PCR. The presence and localization of IGF-I and HSP70 were investigated by immunohistochemistry. In all the stress conditions, a significant increase in cortisol levels was observed reaching higher values in the thermic and chemical stress groups. Regarding fish growth markers, igf1 gene expression was significantly higher only in fish subjected to heat shock stress while, at 60 min, igf2 gene expression was significantly lower in all the stressed groups. Temperature and ammonia changes resulted in a higher mstn gene expression. Molecular analyses on stress response evidenced a time dependent increase in hsp70 gene expression, that was significantly higher at 60 min in fish exposed to heat shock and chemical stress. Furthermore, the same experimental groups were characterized by a significantly higher gr gene expression respect to the control one. Immunostaining for IGF-I and HSP70 antibodies was observed in skin, gills, liver, and digestive system of gilthead seabream juveniles.

The swallow-tailed gull, Creagrus furcatus , is a seabird endemic to the Galápagos archipelago. In general health, blood chemistry and haematology, parameters have not been published for this species. Blood analyses were run on samples drawn from 58 clinically healthy swallow-tailed gulls captured at Islote Pitt on San Cristóbal Island in July 2016 (28) and South Plaza Island in June 2017 (30). A point of care blood analyzer (iSTAT) was used in the field to obtain results for HCO 3 - , pH, pCO 2 , pO 2 , TCO 2 , anion gap, chloride, creatinine, glucose, haematocrit, haemoglobin, ionized calcium, potassium, sodium and urea nitrogen. A portable Lactate Plus™ analyzer was used to measure lactate. The baseline data reported is valuable for comparisons amongst different populations in the archipelago and to detect changes in health status of Galápagos swallow-tailed gulls., (© The Author(s) 2020. Published by Oxford University Press and the Society for Experimental Biology.)

The land iguanas, Conolophus pallidus and Conolophus subcristatu are large and charismatic lizards endemic to the Galápagos archipelago, but little information exists on their normal health parameters. The former is restricted to Santa Fe island, while C. subcristatus inhabits the islands of the central and western region of the archipelago. Both species are classified as vulnerable by the IUCN Red List of Threatened Species. As part of a population health assessment authorized by the Galápagos National Park, wild adult iguanas from three islands (North Seymour, South Plazas, and Santa Fe) were captured in July 2018. Data from a single C. subcristatus X Amblyrhynchus cristatus hybrid captured on South Plazas is also included. We analyzed blood samples drawn from 52 healthy wild adult land iguanas captured on three islands. An iSTAT portable blood analyzer was used to obtain values for pH, lactate, pO2, pCO2, HCO3-, sO2%, hematocrit, packed cell volume (PCV), hemoglobin Na, K, iCa, and glucose. Standard laboratory hematology techniques were employed for PCV determination; resulting values were also compared to the hematocrit values generated by the iSTAT. Body temperature, heart rate, respiratory rate, and body measurements were also recorded and compared to previously published data for the marine iguana (Amblyrhynchus cristatus), which shares a common ancestor with the land iguana. The data reported here provide preliminary baseline values that may be useful in comparisons between captive and wild populations, between wild populations, and in detecting changes in health status among Galápagos land iguanas affected by anthropogenic threats, climate change, or natural disturbances., Competing Interests: The authors have declared that no competing interests exist.

Background: One factor many women consider when choosing a medical specialty is the plan to have children and the compatibility of their chosen specialty with motherhood., Objective: We surveyed Hispanic female physicians who are mothers to collect demographic information, specialty choice, childbearing, and professional and personal life characteristics, along with respondents' suggestions for female physicians who want to start a family, and how hospitals and medical institutions could enhance their support of female medical staff members with children., Methods: The questionnaire was fielded on an online forum for Hispanic female physicians who are mothers. We summarized data by frequency and percentages, and means and standard deviations., Results: Common medical specialties of respondents included pediatrics, family medicine, and obstetrics and gynecology, and 19% did not report a medical specialty. Most respondents were married (72%), had 1 or 2 children (89%), and worked at a public hospital 5 days a week (51%). Forty-four percent reported they slept 6 or more hours a night. Differences among specialties included dermatologists, radiologists, and gynecologists reporting working more than other specialties (6 to 7 days a week), psychiatrists reporting greater use of psychiatric medications, and anesthesiologists reporting lower rates of marriage. Female surgeons and emergency medicine physicians reported the highest consumption of alcohol., Conclusions: The results offer initial insights into how medical specialty choice may affect female physicians' work-life balance and can be used to provide guidance to female learners who plan to have a family., Competing Interests: Conflict of interest: The authors declare they have no competing interests.

Since cardiovascular, respiratory, and metabolic systems of reptiles are affected by temperature, accurate measurements are of great importance in both captive husbandry and research. Ectothermic animals generally have core body temperatures close to ambient temperature but can differ from the immediate environment if they are using sunlight to thermoregulate. Many zoological facilities and exotic pet caregivers have begun using infrared temperature guns to assess ambient temperatures of reptile enclosures but there are currently few studies assessing the efficacy of these devices for measuring the body temperatures of reptiles. Conolophus subcristatus , Conolophus pallidus (Galápagos land iguanas), and Amblyrhynchus cristatus X C. subcristatus hybrid are robust land iguanas endemic to the Galápagos archipelago. By comparing the infrared body temperature measurements of land iguanas against virtual simultaneous collection of cloacal temperatures obtained using a thermocouple thermometer, we sought to assess the efficacy of this non-invasive method. We found that internal body temperature can be predicted with a high level of accuracy from three external body temperature sites, providing a good non-invasive method that avoids the capture of animals., Competing Interests: The authors declare that they have no competing interests.

The San Cristóbal lava lizard, Microlophus bivittatus , is one of nine species of lava lizards endemic to the Galápagos Islands of Ecuador. No information presently exists about baseline health parameters for any of these species. We analysed blood samples drawn from 47 lizards (25 males and 22 females) captured at two locations on San Cristóbal Island. A portable blood analyser (iSTAT) was used to obtain near-immediate field results for total CO 2 , lactate, sodium, potassium, ionized calcium, glucose and haemoglobin. Standard laboratory haematology techniques were employed for differential white blood cell counts and haematocrit determination. Body temperature, heart rate and body measurements were also recorded. We found significant differences in haematocrit values between males and females. The values reported in this study provide baseline data that may be useful in detecting changes in health status among lava lizards affected by natural disturbances or anthropogenic threats. Our findings might also be helpful in future efforts to demonstrate associations between specific biochemical or haematological parameters and disease. Because there are several related species on different islands in the Galápagos archipelago, comparisons between populations and species will be of interest. Lay Summary:Haematology and biochemistry values of the San Cristóbal lava lizard Microlophus bivittatus , along with several other health parameters (morphometrics and temperature), are reported for the first time.

The great frigatebird, Fregata minor , is a widely distributed seabird native to the Galápagos archipelago. Haematology and blood chemistry parameters have been published for this species but not from the San Cristóbal and North Seymour great frigatebird breeding colonies. Analyses were run on blood samples drawn from 25 great frigatebirds captured by hand at their nests at Punta Pitt on San Cristóbal Island and 30 birds on North Seymour Island, Galápagos Islands. A portable blood analyser (iSTAT) was used to obtain near immediate field results for pH, pO 2 , pCO 2 , TCO 2 , HCO 3 - , haematocrit (Hct), haemoglobin (Hb), sodium (Na), potassium (K), chloride (Cl), ionized calcium (iCa), creatinine, urea nitrogen, anion gap and glucose. Blood lactate was measured using a portable Lactate Plus™ analyser. Average heart rate, respiratory rate, body weight, body temperature, biochemistry and haematology parameters were comparable to healthy individuals of other Fregatidae. The reported results provide baseline data that can be used for comparisons among populations and in detecting changes in health status among Galápagos great frigatebirds.

A stochastic volatility-in-mean model with correlated errors using the generalized hyperbolic skew Student-t (GHST) distribution provides a robust alternative to the parameter estimation for daily stock returns in the absence of normality. An efficient Markov chain Monte Carlo (MCMC) sampling algorithm is developed for parameter estimation. The deviance information, the Bayesian predictive information and the log-predictive score criterion are used to assess the fit of the proposed model. The proposed method is applied to an analysis of the daily stock return data from the Standard & Poor's 500 index (S&P 500). The empirical results reveal that the stochastic volatility-in-mean model with correlated errors and GH-ST distribution leads to a significant improvement in the goodness-of-fit for the S&P 500 index returns dataset over the usual normal model.

HIV RNA viral load measures are often subjected to some upper and lower detection limits depending on the quantification assays. Hence, the responses are either left or right censored. Linear/nonlinear mixed-effects models, with slight modifications to accommodate censoring, are routinely used to analyze this type of data. Usually, the inference procedures are based on normality (or elliptical distribution) assumptions for the random terms. However, those analyses might not provide robust inference when the distribution assumptions are questionable. In this paper, we discuss a fully Bayesian quantile regression inference using Markov Chain Monte Carlo (MCMC) methods for longitudinal data models with random effects and censored responses. Compared to the conventional mean regression approach, quantile regression can characterize the entire conditional distribution of the outcome variable, and is more robust to outliers and misspecification of the error distribution. Under the assumption that the error term follows an asymmetric Laplace distribution, we develop a hierarchical Bayesian model and obtain the posterior distribution of unknown parameters at the p th level, with the median regression ( p = 0.5) as a special case. The proposed procedures are illustrated with two HIV AIDS studies on viral loads that were initially analyzed using the typical normal (censored) mean regression mixed-effects models, as well as a simulation study.

A Bayesian analysis of stochastic volatility (SV) models using the class of symmetric scale mixtures of normal (SMN) distributions is considered. In the face of non-normality, this provides an appealing robust alternative to the routine use of the normal distribution. Specific distributions examined include the normal, student-t, slash and the variance gamma distributions. Using a Bayesian paradigm, an efficient Markov chain Monte Carlo (MCMC) algorithm is introduced for parameter estimation. Moreover, the mixing parameters obtained as a by-product of the scale mixture representation can be used to identify outliers. The methods developed are applied to analyze daily stock returns data on S&P500 index. Bayesian model selection criteria as well as out-of- sample forecasting results reveal that the SV models based on heavy-tailed SMN distributions provide significant improvement in model fit as well as prediction to the S&P500 index data over the usual normal model.

Several studies have recently been conducted on cultured skin equivalent (SE), prepared using human keratinocytes seeded on various types of dermal equivalents (DE). We previously showed the advantages of our anchorage method in preventing the severe surface reduction of DE due to fibroblast contractile properties in vitro. A new anchored human SE was established in our laboratory in order to obtain a bioengineered tissue that would possess the appropriate histological and biological properties. In order to compare the effects of different collagen origins on the evolution of SE in vitro, human keratinocytes were seeded on three types of anchored DE. A comparative study was carried out between bovine SE (bSE), human SE (hSE), and human skin equivalent containing additional dermal matrix components (hSE+). Immunohistological analysis showed that hSE and hSE+ presented good structural organization, including the deposition of several basement membrane constituents. Higher amounts of transglutaminase, ceramides, and keratin 1 were detected in the epidermal layers of all SE when cultured at the air-liquid interface. However, a 92 kDa gelatinase activity was higher in bovine skin equivalent (bSE) compared to hSE cultures. The use of human collagens comparatively to bovine collagen as SE matricial component delayed the degradation of the dermal layer in culture.

Cultured epidermal sheets are currently used for burn wound treatment but reported results on graft take are variable. This study was designed to evaluate the role and influence of Tisseel, a fibrin glue, in the take of cultured human epidermal sheets in an athymic mouse model. On days 4, 10 and 21 post-grafting, histology, electron microscopy and immunofluorescence staining confirmed the presence of a human epithelium and the development of a basement membrane. Tisseel was detectable on day 4 only, but overall treated and untreated grafts were similar. The use of Tisseel enhanced the mechanical stability of these fragile grafts, increased the percentage of graft take, and its innocuity on the in vivo evolution of cultured epidermal sheets was demonstrated. For these reasons, we think that Tisseel may be advantageous in a clinical setting.

Plastic surgeons are routinely consulted about the care of extended cutaneous necrosis. We present an unusual case of complete bilateral breast necrosis and review of the literature of warfarin-induced necrosis to inform plastic surgeons of new advances in the physiopathology of this entity. Warfarin-induced necrosis seems to be produced by an imbalance between circulating clotting factors and blood anticoagulation factors.

Our laboratory has been involved in finding optimal conditions for producing dermal and skin equivalents. As an original approach, a Box-Behnken experimental design was used to study the effects of the initial collagen and fibroblast concentrations and the initial gel thickness on the contraction of dermal and skin equivalents. The final surface area of dermal equivalent varied significantly with the initial concentration of collagen and fibroblast, whereas the initial thickness of gel had no appreciable effect on the contraction of the dermal equivalent. When keratinocytes were grown on these dermal equivalents they produced a very severe contraction, to an extent that all skin equivalents had a similar final surface area. This severe contraction was independent of collagen and fibroblast concentrations. Models for the prediction of the final percentage contraction of dermal and skin equivalents as a function of the initial concentration of collagen, the logarithm of fibroblast concentration, and the initial gel thickness were obtained and analyzed. Keratinocytes grown at the lowest seeding density did not contract the equivalents. However, histologic analysis has shown an incomplete coverage by these cells of the equivalents. The extensive contraction of the skin equivalent presenting adequate morphology is a major drawback toward its clinical utilization for burn wound coverage.