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Background: The establishment of mycorrhizal relationships between a fungus and a plant typically enhances nutrient and water uptake for the latter while securing a carbon source for the fungus. However, under a particular set of environmental conditions, such as low availability of light and abundant nutrients in the soil, the resources invested in the maintenance of the fungi surpass the benefits obtained by the host. In those cases, facultative mycorrhizal plants are capable of surviving without symbiosis. Facultative mycorrhization in ferns has been overlooked until now. The present study measured the response of Struthiopteris spicant L. Weiss, and its root-associated fungi to different levels of light and nutrient availability in terms of growth, mycorrhizal presence, and leaf nutrient content. This fern species exhibits a great tolerance to variable light, nutrient, and pH conditions, and it has been found with and without mycorrhizae. We conducted a greenhouse experiment with 80 specimens of S. spicant and three factors (Light, Phosphorus, and Nitrogen) resulting in eight treatments., Results: We found a significant influence of the factor light on fungal community composition, plant biomass, and nutrient accumulation. Departing from a lack of colonization at the initial stage, plants showed a remarkable increment of more than 80% in the arbuscular mycorrhizal fungi (AMF) richness and abundance in their roots when grown under high light conditions, compared with the ones in low light. We also observed an upward trend of C:P and C:N ratios and the above- and belowground biomass production when AMF abundance increased. Furthermore, the compositional analysis of the whole fungal communities associated with S. spicant roots revealed clear differences among low-light and high-light treatments., Conclusions: This study is the first to investigate the importance of light and nutrient availability in determining fern-AMF relationships. We confirmed that Struthiopteris spicant is a facultative mycorrhizal plant. The composition and diversity of AMF found in the roots of this fern are strongly influenced by light and less by nutrient conditions. Our study shows that ferns respond very sensitively to changes in environmental factors, leading to shifts in the associated mycorrhizal communities., (© 2024. The Author(s).)

Background: Arteriovenous Malformations (AVMs) are complex vascular anomalies that are usually sporadic and can have a variable clinical course. Treatment of AVMs can lead to severe sequeale and require thorough decision-making. There is a lack of standardized treatment protocols showing a growing need for pharmacological targeted therapies, specially in the most severe cases where surgery may not be feasible. Current knowledge in molecular pathways and genetic diagnosis have shed light in the pathophysiology of AVMs, opening possibilities for personalized treatment strategies., Methods: We performed a retrospective review of patients with head and neck AVMs treated in our department between 2003 and 2021 and performed a complete physical examination and imaging with ultrasound and angio-CT or MRI. Patients underwent genetic testing on AVMs' tissue samples and/or peripheral blood samples. Patients were grouped according to the genetic variant and a correlation between phenotype and genotype was studied., Results: 22 patients with head and neck AVMs were included. We found eight patients with varians in MAP2K1, four patients with pathogenic variants in KRAS, six patients with pathogenic variants in RASA1, one patient with a pathogenic variant in BRAF, one patient with a pathogenic variant in NF1, another patient with a pathogenic variant in CELSR1 and one patient with pathogenic variants in PIK3CA and GNA14. Patients with MAP2K1 variants were the biggest group, with a moderate clinical course. Patients with KRAS mutations showed the most aggressive clinical course and a high rate of recurrence and osteolysis. Patients with RASA1 variants showed a characteristic phenotype with an ipsilateral capillary malformation in the neck., Conclusion: We found a correlation between genotype and phenotype in this group of patients. The genetic diagnosis of AVMs is recommended in order to stablish a personalized treatment strategy. Targeted therapies are currently being investigated with promising results and may be recommended in addition to conventional surgical or embolization procedures, specially in the most complex cases., Level of Evidence: Level IV., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Abstract: Varela-Sanz, A, Sánchez-Otero, T, Tuimil, JL, Boullosa, D, and Iglesias-Soler, E. Influence of recovery mode on the maximum number of intervals until exhaustion during an aerobic interval training session. J Strength Cond Res 37(9): e510-e520, 2023-We analyzed work capacity, cardiometabolic, perceptual, and neuromuscular responses to an aerobic interval training (AIT) running session until exhaustion, with active (AR) vs. passive recovery (PR). Eight well-trained male endurance runners (36.88 ± 7.14 years, 58.22 ± 3.39 ml·kg -1 ·minute -1 ) randomly completed, after familiarizations and the University of Montreal Track Test (UMTT), 2 AIT track running sessions until exhaustion consisting in 2-minute bouts at 100% of maximum aerobic speed (MAS), with 2 minutes of recovery at 80% of the velocity associated to the second ventilatory threshold (vVT 2 ) (i.e., AR), or no exercise (i.e., PR). Oxygen consumption (V̇O 2 ), heart rate (HR), blood lactate [La], rating of perceived exertion (RPE), and countermovement jump (CMJ) were continuously monitored during sessions. The level of statistical significance was set at p ≤ 0.05. PR resulted in longer time to exhaustion during sessions (13.9 vs. 11.6 bouts, p = 0.045), but lower HR ( p < 0.01) when compared with AR. Time spent over 90% of maximum oxygen consumption (V̇O 2max ), blood lactate concentrations, neuromuscular performance, and RPE did not differ between AR and PR ( p > 0.05). Thus, PR allowed runners to perform more work intervals and, therefore, to accumulate a greater volume. On the other hand, when training goals are focused on reaching a higher chronotropic stress (i.e., higher HR) during the training session, athletes would obtain more benefits from AR. This study also demonstrates that the current volume recommendations for AIT are far below (54-64.5%) the maximum training capacity of well-trained runners., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 National Strength and Conditioning Association.)

Premise: Detailed studies of the fungi associated with lycophytes and ferns provide crucial insights into the early evolution of land plants. However, most investigations to date have assessed fern-fungus interactions based only on visual root inspection. In the present research, we establish and evaluate a metabarcoding protocol to analyze the fungal communities associated with fern and lycophyte roots., Methods: We used two primer pairs focused on the ITS rRNA region to screen the general fungal communities, and the 18S rRNA to target Glomeromycota fungi (i.e., arbuscular mycorrhizal fungi). To test these approaches, we collected and processed roots from 12 phylogenetically distant fern and lycophyte species., Results: We found marked compositional differences between the ITS and 18S data sets. While the ITS data set demonstrated the dominance of orders Glomerales (phylum Glomeromycota), Pleosporales, and Helotiales (both in phylum Ascomycota), the 18S data set revealed the greatest diversity of Glomeromycota. Non-metric multidimensional scaling (NMDS) ordination suggested an important geographical effect in sample similarities., Discussion: The ITS-based approach is a reliable and effective method to analyze the fungal communities associated with fern and lycophyte roots. The 18S approach is more appropriate for studies focused on the detailed screening of arbuscular mycorrhizal fungi., (© 2023 The Authors. Applications in Plant Sciences published by Wiley Periodicals LLC on behalf of Botanical Society of America.)

Competing Interests: Disclosure The authors have nothing to disclose.

Background: A sizeable proportion of Brazilian Primary Care (PC) providers suffer from common mental disorders, such as anxiety and depression. In an effort to cope with job-related distress, PC workers are likely to implement maladaptive strategies such as experiential avoidance (EA). The Acceptance and Action Questionnaire (AAQ-II) is a widely used instrument that evaluates EA but has shown questionable internal consistency in specific populations. This study assesses the psychometric properties of the AAQ-II among Brazilian PC providers, evaluates its convergence and divergence with self-criticism and mindfulness skills, and explores its criterion validity on anxiety and depressive symptoms., Methods: A cross-sectional design was conducted in Brazilian PC services, and the sample included 407 PC workers. The measures evaluated EA, self-criticism, mindfulness, depression, and anxiety., Results: The one-factor model of the AAQ-II replicated the original version structure. The AAQ-II presented good internal consistency among Brazilian PC providers. A multiple regression model demonstrated higher relationships with self-criticism than mindfulness skills. The criterion validity of the AAQ-II on anxiety and depression was stronger in the context of more severe symptoms., Conclusions: The AAQ-II is an appropriate questionnaire to measure the lack of psychological flexibility among Brazilian PC workers in the sense of EA.

Background: This study evaluates facial and tongue function in patients undergoing side-to-end hypoglossal-to-facial transfer (HFT) with additional techniques., Methods: Thirty-seven patients underwent a side-to-end HFT. Twelve had additional cross-face grafts, and 9 had an additional masseter-to-facial transfer. Facial was assessed with House-Brackmann (HB), Sunnybrook Facial Grading Scale (SFGS), and eFACE. Martins scale and the Oral-Pharyngeal Disability Index (OPDI) were used to assess tongue function., Results: Ninety-four percent of cases reached HB grades III-IV. Mean total SFGS score improved from 16 ± 15 to 59 ± 11, while total eFACE score from 52 ± 13 to 80 ± 5. Dual nerve transfers were a predictor for a better eFACE total score p = 0.034, β = 2.350 [95% CI, 0.184-4.516]), as well as for a higher SFGS total score (p = 0.036, β = 5.412 [95% CI, 0.375-10.449]). All patients had Martin's grade I. Mean postoperative OPDI scores were 84 ± 17 (local physical), 69 ± 16 (simple and sensory motor components), 82 ± 14 (complex functions), and 73 ± 22 (psychosocial)., Conclusions: The side-to-end HFT offers predictable facial function outcome and preserves tongue function in nearly all cases. Dual nerve transfers appear to improve the final outcome., (© 2022 Wiley Periodicals LLC.)

Purpose: To compare cardio-metabolic, perceptual and neuromuscular responses to an aerobic interval training (AIT) running session, with active (AR) vs. passive recovery (PR)., Methods: Eleven well-trained male distance runners (36.63 ± 6.93 years, 59.26 ± 5.27 mL·kg -1 ·min -1 , ⁓ 35 min in 10 km) completed the University of Montréal Track Test (UMTT) and 2 AIT sessions on track in random order, which consisted of 4 × 2 min at 100% of the maximum aerobic speed (MAS), with 2 min of AR at 80% of the velocity associated to the second ventilatory threshold (vVT 2 ), or no exercise (i.e., PR). During sessions, oxygen consumption (V̇O 2 ), heart rate (HR), blood lactate [La], rating of perceived exertion (RPE), and countermovement jump (CMJ) were continuously monitored., Results: There were no differences in time spent in the "red zone" (i.e. > 90% V̇O 2max ) between sessions (222 ± 73 s AR vs. 230 ± 104 s PR, p = 0.588), although the PR exhibited a greater time spent at peak V̇O 2 close to significance (117 ± 114 vs. 158 ± 109 s, p = 0.056). However, the AR elicited a higher mean V̇O 2 (49.62 ± 5.91 vs. 47.46 ± 4.20 mL·kg -1 ·min -1 , p = 0.021). The AR favored a lower [La] after sessions (6.93 ± 2.22 vs. 6.24 ± 1.93 mmol·L -1 , p = 0.016) and a higher RPE during sessions (15 ± 0.45 vs. 14 ± 0.47, p = 0.045). Meanwhile, the CMJ was significantly potentiated during both sessions., Conclusion: Considering that PR elicited lower perceptual loading for a similar cardiorespiratory response, its use would be preferable, at least, for this type of AIT running sessions., (© 2022. The Author(s).)

The global lockdown to mitigate COVID-19 pandemic health risks has altered human interactions with nature. Here, we report immediate impacts of changes in human activities on wildlife and environmental threats during the early lockdown months of 2020, based on 877 qualitative reports and 332 quantitative assessments from 89 different studies. Hundreds of reports of unusual species observations from around the world suggest that animals quickly responded to the reductions in human presence. However, negative effects of lockdown on conservation also emerged, as confinement resulted in some park officials being unable to perform conservation, restoration and enforcement tasks, resulting in local increases in illegal activities such as hunting. Overall, there is a complex mixture of positive and negative effects of the pandemic lockdown on nature, all of which have the potential to lead to cascading responses which in turn impact wildlife and nature conservation. While the net effect of the lockdown will need to be assessed over years as data becomes available and persistent effects emerge, immediate responses were detected across the world. Thus, initial qualitative and quantitative data arising from this serendipitous global quasi-experimental perturbation highlights the dual role that humans play in threatening and protecting species and ecosystems. Pathways to favorably tilt this delicate balance include reducing impacts and increasing conservation effectiveness., Competing Interests: Authors declare no competing interests., (© 2021 Published by Elsevier Ltd.)

Bilateral facial paralysis is a challenging situation requiring complex management. Surgical treatment can include nerve transfers, mainly masseter-to-facial, or muscle transfers, gracilis free flap, or temporalis transposition. Deciding on the surgical option depends on the duration of the paralysis and the feasibility of facial muscles. We present the case of a 10-year-old child with permanent bilateral facial paralysis after brainstem tumor surgery. The patient was treated with bilateral simultaneous hypoglossal-to-facial transfer followed by bilateral simultaneous masseter-to-facial 12 months later. After 23 months of follow-up and specific physical therapy, she has good and symmetric resting tone, complete eye closure, moderate bilateral smile excursion, mild lip pucker movement, and good oral competence. The combination of these two nerve transfers, when possible, gives the opportunity of restoring movement taking the best of each technique, with acceptable results and no significant clinical deficits in the donor sites., Competing Interests: Disclosure: All the authors have no financial interest in relation to the content of this article., (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

Background: Facial nerve tumors (FNTs) are relatively rare benign lesions that arise from any segment of the facial nerve (FN). About half of all patients present with FN dysfunction, mainly long-standing or progressive facial paralysis. Diagnosis of an FNT is usually based on radiological imaging and confirmed by histological study. Most reported cases of FNTs are schwannomas and hemangiomas., Objectives: The aim of this study was to review 4 cases of lesions with clinical, radiological, and surgical findings that suggested an FNT, the pathology revealing a fibrovascular proliferation with no clear signs of a specific tumor., Method: Medical records of patients who had surgery due to an FN lesion were reviewed. Cases with known tumoral lesions were excluded. Four patients with tumor-like lesions were identified. Their imaging studies were re-evaluated. The pathological study included hematoxylin-eosin, Masson's trichrome, and immunohistochemistry for S100 protein, neurofilaments, CD31, Wilms' tumor 1 (WT1), and D240., Results: The 4 cases revealed tumor-like fibrovascular lesions that could not be classified as typical pathological entities. All cases had a complete facial palsy preoperatively. Computed tomography and magnetic resonance imaging (MRI) suggested schwannoma or hemangioma. A complete excision was achieved, and a facial reconstruction was performed immediately after interruption. Postoperative FN function was improved in all cases. The histological study showed nervous tracts of normal morphology, with fibrous and vascular tissue interspersed in variable proportions. All cases showed areas of fibrosis with Masson's stain. In all cases, nervous tissue and Schwann cells tested positively for neurofilaments and S100, respectively. In vascular areas, endothelial cells stained positively for CD31, and negatively for D240 and WT1., Conclusions: Fibrovascular lesions of the FN may mimic primary FNTs, especially schwannomas and hemangiomas. Surgical excision with grafting or nerve transfer is the procedure of choice if a complete facial paralysis is found. This unusual condition should be considered when counseling patients with FN lesions. The lack of hyperintensity on MRI T2-weighted images may suggest the presence of fibrous tissue., (© 2020 S. Karger AG, Basel.)

: The management of facial paralysis following skull base surgery is complex and requires multidisciplinary intervention. This review shows the experience of a facial nerve (FN) unit in a tertiary university referral center. A multidisciplinary approach has led to the breaking of some old treatment paradigms. An overview of five FN scenarios is presented. For each setting a contemporary approach is proposed in contrast to the established approach. 1) For patients with an anatomically preserved FN with no electrical response at the end of surgery for vestibular schwannoma, watchful waiting is usually advocated. In these cases, reinforcement with an interposed nerve graft is recommended. 2) In cases of epineural FN repair, with or without grafting, and a poor expected prognosis, an additional masseter-to-facial transfer is recommended. 3) FN transfer, mainly hypoglossal-to-facial and masseter-to facial, are usually chosen based on the surgeons' preference. The choice should be based on clinical factors. A combination of techniques improves the outcome in selected patients. 4) FN reconstruction following malignant tumors requires a combination of parotid and temporal bone surgery, involving different specialists. This collaboration is not always consistent. Exposure of the mastoid FN is recommended for lesions involving the stylomastoid foramen, as well as intraoperative FN reconstruction. 5) In patients with incomplete facial paralysis and a skull base tumor requiring additional surgery, consider an alternative reinnervation procedure, "take the FN out of the equation" before tumor resection. In summary, to achieve the best results in complex cases of facial paralysis, a multidisciplinary approach is recommended.

Bell's palsy is the most common diagnosis associated with facial nerve weakness or paralysis. However, not all patients with facial paresis/paralysis have Bell's palsy. Other common causes include treatment of vestibular schwannoma, head and neck tumours, iatrogenic injuries, Herpes zoster, or trauma. The approach to each of these conditions varies widely. The purpose of this guideline is to provide clinicians with guidance on the treatment and monitoring of patients with different causes of facial paralysis. We intend to draft a practical guideline, focusing on operationalised recommendations deemed to be useful in the daily management of patients. This guideline was promoted by the Spanish Society of Otolaryngology and developed by a group of physicians with an interest in facial nerve disorders, including at least one physician from each Autonomous Community. In a question and answer format, it includes 56 relevant topics related to the facial nerve., (Copyright © 2019 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objectives: To analyze the outcome of facial nerve (FN) reconstruction, the impact of technical variations in different conditions and locations, and the importance of additional techniques in case of suboptimal results., Study Design: Retrospective study., Setting: University-based tertiary referral center., Patients: Between 2001 and 2017, reconstruction of the FN was performed on 36 patients with varying underlying diseases., Interventions: FN repair was performed by direct coaptation (n = 3) or graft interposition (n = 33). Microsurgical sutures were used in 17 patients (47%) and fibrin glue was used in all cases. Additional reinnervation techniques (hypoglossal-facial or masseter-facial transfers) were performed in five patients with poor results after initial reconstruction., Main Outcome Measures: FN function was evaluated using the House-Brackmann (HB) and the electronic clinician-graded facial function (eFACE) grading systems. Minimum follow-up was 12 months., Results: FN reconstruction yielded improvement in 83% of patients, 21 patients (58.3%) achieving a HB grade III. The eFACE median composite, static, dynamic and synkinesis scores were 69.1, 78, 53.2, and 88.2 respectively. A tendency towards better outcome with the use of sutures was found, the difference not being significant. All patients undergoing an additional reinnervation procedure achieved a HB grade III, eFACE score being 74.8., Conclusions: FN reconstruction offers acceptable functional results in most cases. No significant differences are expected with technical variations, different locations or conditions. In patients with poor initial results, additional reinnervation techniques should be always considered. The eFACE adds substantial information to the most used HB scale.

Importance: Standardization of outcome measurement using a patient-centered approach in pediatric facial palsy may help aid the advancement of clinical care in this population., Objective: To develop a standardized outcome measurement set for pediatric patients with facial palsy through an international multidisciplinary group of health care professionals, researchers, and patients and patient representatives., Design, Setting, and Participants: A working group of health care experts and patient representatives (n = 21), along with external reviewers, participated in the study. Seven teleconferences were conducted over a 9-month period between December 3, 2016, and September 23, 2017, under the guidance of the International Consortium for Health Outcomes Measurement, each followed with a 2-round Delphi process to develop consensus. This process defined the scope, outcome domains, measurement tools, time points for measurements, and case-mix variables deemed essential to a standardized outcome measurement set. Each teleconference was informed by a comprehensive review of literature and through communication with patient advisory groups. Literature review of PubMed was conducted for research published between January 1, 1981, and November 30, 2016., Main Outcomes and Measures: The study aim was to develop the outcomes and measures relevant to children with facial palsy as opposed to studying the effect of a particular intervention., Results: The 21 members of the working group included pediatric facial palsy experts from 9 countries. The literature review identified 1628 papers, of which 395 (24.3%) were screened and 83 (5.1%) were included for qualitative evaluation. A standard set of outcome measurements was designed by the working group to allow the recording of outcomes after all forms of surgical and nonsurgical facial palsy treatments among pediatric patients of all ages. Unilateral or bilateral, congenital or acquired, permanent or temporary, and single-territory or multiterritory facial palsy can be evaluated using this standard set. Functional, appearance, psychosocial, and administrative outcomes were selected for inclusion. Clinimetric and psychometric outcome measurement tools (clinician-, patient-, and patient proxy-reported) and time points for measuring patient outcomes were established. Eighty-six independent reviews of the standard set were completed, and 34 (85%) of the 40 patients and patient representatives and 44 (96%) of the 46 health care professionals who participated in the reviews agreed that the standard set would capture the outcomes that matter most to children with facial palsy., Conclusions and Relevance: This international collaborative study produced a free standardized set of outcome measures for evaluating the quality of care provided to pediatric patients with facial palsy, allowing benchmarking of clinicians, comparison of treatment pathways, and introduction of value-based reimbursement strategies in the field of pediatric facial palsy., Level of Evidence: NA.

Virtual environments (VEs) have demonstrated promise as a neuropsychological assessment modality and may be well suited for the evaluation of children suspected of having an autism spectrum disorder (ASD). Some recent studies indicate their potential for enhancing reliability, ecologically validity, and sensitivity over traditional neuropsychological evaluation measures. Although research using VEs with ASD is increasing to the degree that several reviews of the literature have been conducted, the reviews to date lack rigor and are not necessarily specific to cognitive or neuropsychological assessment as many focus on intervention. The aim of this project was to comprehensively examine the current literature status of neuropsychological assessment in pediatric ASD using VEs by conducting a systematic review. Specifically, psychometric comparisons of VEs to traditional neuropsychological assessment measures that examined reliability, validity, and/or diagnostic accuracy for pediatric individuals, age 18 and below, with ASD were sought. The search using key words yielded 899 manuscripts, 894 of which were discarded for not meeting inclusion criteria. The remaining five met exclusion criteria. Therefore, the systematic review was modified to a brief report. These findings (or lack thereof) indicate a significant gap in the literature in that psychometric comparisons of these tools for the neuropsychological assessment of pediatric individuals with ASD are lacking. An important future direction of research will be extending the demonstrated incremental validity of VE neuropsychological assessment with other neurodevelopmental (e.g., attention-deficit/hyperactivity disorder) and adult populations to pediatric ASD populations.

Objective: To study the evolution of patients with immediate complete facial paralysis after acoustic neuroma surgery in different scenarios and assess different facial reanimations techniques., Methods: This study included 50 patients with complete facial paralysis immediately after acoustic neuroma surgery. Data were analyzed into 4 groups according to the need and type of reconstruction of the facial nerve, either none, immediate, or on a deferred basis. All patients had intraoperative facial nerve monitoring, and facial nerve function was evaluated according the House-Brackmann (HB) scale., Results: Of all patients with immediate total paralysis, no patients achieved totally normal facial function (grade I), and only 5 (10%) recovered to a grade II. For all groups included, the majority of patients (82%) achieved an acceptable final facial function (grade III HB). In this series, only 2 patients remained with a grade VI facial function., Conclusions: The possibility of recovering near normal facial function after a grade VI facial paralysis is very low. Procedures like the immediate repair of the facial nerve with an interposed donor graft may provide better facial function in patients with partially injured facial nerve. Even in cases of total section, there are other procedures that can improve the results., (© The Author(s) 2015.)

Three bilayer muscles [polypyrrole-paraphenolsulfonic acid/polypyrrole-dodecylbenzensulfonic acid (PPy-HpPS/PPy-DBS) asymmetric bilayer, PPy-HpPS/tape, and PPy-DBS/tape] were characterized during potential cycling in NaPF6 aqueous solutions. In parallel, the angular displacement of the muscle was video-recorded. The dynamo-voltammetric (angle-potential) and coulo-dynamic (charge-potential) results give the reaction-driven ionic exchanges in each PPy film. Electrochemical reactions drive the exchange of anions from the PPy-HpPS layer and cations from the PPy-DBS layer. This means that both layers from the asymmetric bilayer follow complementary volume changes (swelling/shrinking or shrinking/swelling), owing to complementary ionic exchanges (entrance/expulsion) driven by the bilayer oxidation or reduction. The result is a cooperative actuation; the bending amplitude described by the asymmetric bilayer muscle is one order of magnitude larger than those attained from each of the conducting polymer/tape muscles. The cooperative actuation almost eliminates creeping effects. A large dynamical hysteresis persists, which can be attributed to an irreversible reaction of the organic acid components at high overpotentials.

The aim of this study was to compare the effect of two different high-intensity resistance exercise (RE) set configurations on the following: systolic blood pressure (SBP), rate pressure product (RPP), heart rate (HR) variability (HRV), and HR complexity (HRC). Ten well-trained males performed three parallel squat sets until failure (traditional training; TT) with the four repetitions maximum load (4RM), and a rest of 3 min between sets. Thereafter, participants performed a cluster training session (CT) of equated load but with resting time distributed between each repetition. Dependent variables were recorded before, during, and after RE. Mean SBP (25·7 versus 10·9% percentage increase; P = 0·016) and RPP (112·5 versus 69·9%; P = 0·01) were significantly higher in TT. The decrease in HRV after exercise and the drop of HRC during exercise were similar in CT and TT. Change of standard deviation of normal RR intervals after TT correlated with change in SBP (r = 0·803; P = 0·009) while the change of Sample Entropy during exercise correlated with the increment of RPP during CT (ρ = -0·667; P = 0·05). This study suggests that set configuration influences acute cardiovascular responses during RE. When intensity, volume and work-to-rest ratio are equated, CT is less demanding in terms of SBP and RPP. A greater hemodynamic response during exercise would be associated with a faster parasympathetic recovery., (© 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.)

The purpose of this study was to evaluate if a verification test (VT) performed in the field offers more confident results than do traditional criteria in the determination of maximal oxygen uptake ((Equation is included in full-text article.)). Twelve amateur runners (age, 36.6 ± 6.6 years) performed a maximal graded field test and after 15 minutes of passive recovery a supramaximal test to exhaustion at 105% of their velocity associated with (Equation is included in full-text article.)(v(Equation is included in full-text article.)). Traditional criteria and 2 different verification criteria were evaluated. Verification criteria were (a) maximal oxygen uptake achieved in the VT ((Equation is included in full-text article.)) must be ≤5% higher than (Equation is included in full-text article.), and (b) no significant differences of means between tests. All participants met the first verification criterion although significant differences were found between (Equation is included in full-text article.)and (Equation is included in full-text article.)(59.4 ± 5.1 vs. 56.2 ± 4.7 ml·kg·min, p < 0.01). The criteria for the plateau, peak heart rate (HRpeak), maximum respiratory exchange ratio (RERmax), and maximum blood lactate concentration ([La]max) were satisfied by 75, 66, 92, and 66 of the participants, respectively. Kappa coefficients gave a significant and substantial agreement beyond chance between traditional criteria (p < 0.001). Despite the substantial agreement, traditional criteria induced the rejection of participants that might have achieved a true (Equation is included in full-text article.)with HRpeak and [La]max being the more stringent criteria for amateur runners. A verification protocol in the field using the criterion based on individual analysis is recommended.

Purpose: To analyze performance during the execution of a maximum number of repetitions (MNR) in a cluster-set configuration., Method: Nine judokas performed 2 sessions of parallel squats with a load corresponding to 4-repetition maximum (4RM) with a traditional-training (TT) and cluster-training (CT) set configuration. The TT consisted of 3 sets of repetitions leading to failure and 3 min of rest between sets. In the CT the MNR was performed with a rest interval between repetitions (45.44 ± 11.89 s). The work-to-rest ratio was similar for CT and TT., Results: MNR in CT was 45.5 ± 32 repetitions and was 9.33 ± 1.87 times the volume in TT. There was a tendency for the average mean propulsive velocity (MPV) to be higher in CT (0.39 ± 0.04 vs 0.36 ± 0.04 m/s for CT and TT, respectively, P = .054, standardized mean difference [d] = 0.57). The average MPV was higher in CT for a similar number of repetitions (0.44 ± 0.08 vs 0.36 ± 0.04 m/s for CT and TT, respectively, P = .006, d = 1.33). The number of repetitions in TT was correlated with absolute 4RM load (r = -.719, P = .031) but not in CT (r = -.273, P = .477)., Conclusions: A cluster-set configuration allows for a higher number of repetitions and improved sustainability of mechanical performance. CT, unlike TT, was not affected by absolute load, suggesting an improvement of training volume with high absolute loads.

We present the case of a 57-year-old male with left hilar squamous cell carcinoma infiltrating the pulmonary artery and in whom a sleeve bronchoplasty and angioplasty were performed using a bovine pericardial conduit. Three days post-operatively, graft thrombosis was detected; thrombectomy and graft reconstruction were performed with revascularisation of the graft., (Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.)

Aim: To study the subtype prevalence and the phylogenetic relatedness of hepatitis C virus (HCV) sequences obtained from the Argentine general population, a large cohort of individuals was analyzed., Methods: Healthy Argentinian volunteers (n = 6251) from 12 provinces representing all geographical regions of the country were studied. All parents or legal guardians of individuals younger than 18 years provided informed written consent for participation. The corresponding written permission from all municipal authorities was obtained from each city or town where subjects were to be included. HCV RNA reverse transcription-polymerase chain reaction products were sequenced and phylogenetically analyzed. The 5' untranslated region (5'UTR) was used for RNA detection and initial genotype classification. The NS5B polymerase region, encompassing nt 8262-8610, was used for subtyping., Results: An unexpectedly low prevalence of HCV infection in the general population (0.32%) was observed. Our data contrasted with previous studies that reported rates ranging from 1.5% to 2.5%, mainly performed in selected populations of blood donors or vulnerable groups. The latter values are in keeping with the prevalence reported by the 2007 Argentinian HCV Consensus (approximately 2%). HCV subtypes were distributed as follows: 1a (25%), 1b (25%), 2c (25%), 3a (5%), and 2j (5%). Two isolates ascribed either to genotype 1 (5%) or to genotype 3 (5%) by 5'UTR phylogenetic analysis could not be subtyped. Subtype 1a sequences comprised a highly homogeneous population and clustered with United States sequences. Genotype 1b sequences represented a heterogeneous population, suggesting that this genotype might have been introduced from different sources. Most subtype 2c sequences clustered close to the 2c reported from Italy and Southern France., Conclusion: HCV has a low prevalence of 0.32% in the studied general population of Argentina. The pattern of HCV introduction and transmission in Argentina appears to be a consequence of multiple events and different for each subtype.

Background/aims: Splanchnic vasodilation initiates the hyperdynamic syndrome in portal hypertension. We aimed to explore molecular mechanisms involved in the development of mesenteric vasodilation in portal hypertension., Methods: Superior mesenteric artery (SMA) samples from portal vein ligated (PVL) and sham rats were compared in a time course experiment using DNA microarrays. Selected genes were quantified by qRT-PCR in PVL and cirrhotic rats. Inmunohistochemistry of tyrosine hydroxylase (Th) and norepinephrine was assessed in SMA sections of PVL and sham rats. Western blot analysis of Th, dopamine beta-hydroxylase (Dbh) and synaptosome-associated protein (Snap-25) was performed in SMA and jejunum samples from the animal models., Results: Fifty differentially expressed genes implicated in neurotransmission, especially adrenergic, were detected in SMA samples from PVL rats. Sequential analysis showed a profound down-regulation at 14 days in PVL rats. These down-regulated genes were confirmed by RT-PCR in SMA from PVL and cirrhotic rats. Th and NE detection by immunohistochemistry was reduced in PVL compared to sham. Th, Dbh and Snap-25 expression was lower in SMA from 14-day PVL and cirrhotic rats compared to sham and control rats, respectively., Conclusions: Genetic down-regulation of genes related to the adrenergic system might have a role in splanchnic vasodilation of portal hypertension.

An increasing number of new hepatitis C virus NS3-protease inhibitors are being evaluated for the treatment of chronic hepatitis C. Treatment-induced selection of mutants conferring resistance to protease inhibitors has been shown both in vivo and in vitro. A specific mutation, A156T has been shown to confer high-level resistance to several such agents (BILN2061, VX-950, SCH446211 (SCH6) and SCH503034). Here we report the presence of the A156T mutation in close to 1% of NS3 sequences within the liver quasispecies of a chronic hepatitis C patient never treated with anti-NS3-protease inhibitors.

We have investigated two cases of acute hepatitis C that occurred in patients who underwent digestive endoscopy and contrast-enhanced computed tomography (CT) scanning at two different centers. Investigations to identify the sources of infection included an on-site review of diagnostic procedures, interview of the involved healthcare staff, serological testing of the patients who underwent the procedures before and after the index cases and a molecular analysis of viral isolates from the patients and from potential viremic sources. In both cases, the epidemiological investigation identified a chronic hepatitis C virus (HCV) carrier who had been subjected to CT-scanning immediately before the index patient. Genetic distance and molecular phylogenetic analyzes of HCV sequences showed a close relationship between the isolates from these carriers and those from the acute-hepatitis patients, strongly suggesting that patient-to-patient transmission had occurred during CT. This is the first report describing two well documented cases of HCV nosocomial patient-to-patient transmission during contrast-enhanced CT scanning.

Understanding the lipid phase transition of lipid bilayers is of great interest from biophysical, physicochemical, and technological points of view. With the aim of elucidating the structural changes that take place in a DPPC phospholipid bilayer induced by an external isotropic surface pressure, five computer simulations were carried out in a range from 0.1 to 40 mN/m. Molecular dynamics simulations provided insight into the structural changes that took place in the lipid structure. It was seen that low pressures ranging from 0.1 to 1 mN/m had hardly any effect on the structure, electrical properties, or hydration of the lipid bilayer. However, for pressures above 40 mN/m, there was a sharp change in the lipid-lipid interactions, hydrocarbon lipid fluidity, and electrostatic potential, corresponding to the mesomorphic transition from a liquid crystalline state (L(alpha)) to its gel state (P'(beta)). The head lipid orientation remained almost unaltered, parallel to the lipid layer, as the surface pressure was increased, although a noticeable change in its angular distribution function was evident with the phase transition.

The study of asymmetric lipid bilayers is of a crucial importance due to the great number of biological process in which they are involved such as exocytosis, intracellular fusion processes, phospholipid-protein interactions, and signal transduction pathway. In addition, the loss of this asymmetry is a hallmark of the early stages of apoptosis. In this regard, a model of an asymmetric lipid bilayer composed of DPPC and DPPS was simulated by molecular dynamics simulation. Thus, the asymmetric membrane was modeled by 264 lipids, of which 48 corresponded to DPPS- randomly distributed in the same leaflet with 96 DPPC. In the other leaflet, 120 DPPC were placed without DPPS-. Due to the presence of a net charge of -1 for the DPPS- in physiological conditions, 48 Na+ were introduced into the system to balance the charge. To ascertain whether the presence of the DPPS- in only one of the two leaflets perturbs the properties of the DPPC in the other leaflet composed only of DPPC, different properties were studied, such as the atomic density of the different components across the membrane, the electrostatic potential across the membrane, the translational diffusion of DPPC and DPPS, the deuterium order parameters, lipid hydration, and lipid-lipid charge bridges. Thus, we obtained that certain properties such as the surface area lipid molecule, lipid head orientation, order parameter, translational diffusion coefficient, or lipid hydration of DPPC in the leaflet without DPPS remain unperturbed by the presence of DPPS in the other leaflet, compared with a DPPC bilayer. On the other hand, in the leaflet containing DPPS, some of the DPPC properties were strongly affected by the presence of DPPS such as the order parameter or electrostatic potential.

Sexual partners of patients infected with the hepatitis C virus (HCV) often have detectable HCV-specific T-cell responses in the absence of seroconversion, suggesting unapparent, spontaneously resolving infection. To determine whether differences in the evolutionary potential of bottlenecked inoculum may explain the low rate of HCV persistence after sexual exposure, we have investigated changes in the entire HCV nonstructural 3 (NS3) gene over time in a chronic carrier and compared his viral quasispecies with that of the acute-phase isolate of his sexual partner, who developed acute resolving hepatitis C. The overall rate of accumulation of mutations, estimated by regression analysis of six consecutive consensus NS3 sequences over 8 years, was 1.5 x 10(-3) mutations per site per year, with small intersample fluctuations related to changes in environmental conditions. Comparison of quasispecies parameters in one isolate of the chronic carrier with those of the acute-phase isolate of the infected partner revealed a higher heterogeneity and lower proportion of nonsynonymous mutations in the former. All NS3 sequences from the acute-phase isolate clustered with a single sequence from the chronic isolate, despite complete HLA mismatch between the patients, suggesting bottlenecking during transmission. The low risk of viral persistence after sexual exposure to HCV may be related to the selection of a limited number of viral particles carrying a particular combination of mutations which may further limit the potential of a relatively homogeneous quasispecies to rapidly diversify and overcome the immune response of the exposed host.

Polypyrrole/poly(vinyl sulfonate) (PPy/PVS) films in acetonitrile containing 0.1 M LiClO4 were studied by cyclic voltammetry. Consecutive voltammograms pointed to a continuous increase in the charge involved in the process, suggesting a rise in the number of the electroactive participants involved in the redox process. However, voltammograms obtained for the PPy/ClO4 films in analogous conditions pointed to a steady-state behavior from the very early cycles. Theoretical studies based on the Nernst and Butler-Volmer equations indicated that perchlorate ions are involved during the oxidation/reduction process of the PPy/PVS films when the steady state is reached. This result was confirmed by "ex situ" energy-dispersive X-ray analysis of the films. In this regard, the electrochemical behavior of PPy/PVS polymers was similar to that of PPy/ClO4 films when a high number of cycles were carried out. The exchange of ClO4- during the redox reaction of the PPy/PVS films made it necessary to incorporate Li+ cations inside the polymer during the initial voltammetric cycles to compensate for the negative charges of PVS polyanions. Li+ cations are mainly stabilized inside the polymer by the ion pairs formed with the sulfonated groups of the PVS. An increase and shift of the voltammetric cycles indicated a restructuring of the polymeric chains with consecutive scans.

Objective: Although microsurgical bone transplant is still the gold standard, mandibular reconstruction plates (MRP) were for several years considered a fast and safe way to restore mandibular continuity without using a bone graft. New plate designs with locking screws have been recently introduced, and these may overcome some of the complications related to previous designs. We review the results of mandibular reconstruction plates in our institution from 1991 to 1995., Methods: The records of nine cancer patients who underwent lateral mandibular resections (with preservation of both condyle and symphysis) followed by reconstruction with a mandibular reconstruction plate, were retrospectively reviewed. Patients were treated between 1991 and 1995 with regular Synthes and Leibinger plates (without locking screws). Immediately after tumour resection, the bone defect was reconstructed with an MRP without bone grafting. Three cases required soft tissue coverage: two flaps and one buccal fat pad flap., Results: There was immediate orocervical fistula in six cases, one of which required surgical closure; and late complications were common. One patient died due to distant metastasis 13 months after surgery without symptoms related to the plate. The remaining eight patients had their plates removed at between 9 and 52 months after reconstruction, due to screw loosening (four cases), plate exposure (one case), or both (three cases)., Conclusion: Lateral mandibular reconstruction with non-locking screws and regular profile plates is no longer recommended. New plates with improved designs are currently available. Their low profile and locking screws are the usual characteristics of these new plates. More clinical experience is necessary before plate reconstruction can be recommended over microvascular bone transfer.

The movement of an all polymeric triple-layer artificial muscle based on polypyrrole (PPy) that work in aqueous solution was characterised. The magnitude and direction of the experimental current control both rate and direction of the movement. The described angle is a linear function of the consumed charge.

A molecular dynamic simulation of wet polypyrrole film was carried out, in both oxidized and reduced state. The system was modeled by two layers of polypyrrole, water and chloride ions (as counterions required for charge balance in the oxidized state) in atomic detail to provide an insight into some dynamic and steady properties of the system. Our simulations pointed to a swelling of the polymer matrix after oxidation due to electrostatic repulsions between charged sites of the oxidized polypyrrole, followed by penetration of the polypyrrole by counterions to maintain the electroneutrality of the system. Associated with this penetration of counterions toward the core of the oxidized polypyrrole, dehydration of the counterions was observed. This dehydration was compensated (in part) by a strong coordination with the charged sites of the polymer. The remaining hydrophobicity inside the polymer also contributed to the dehydration of these counterions. The translational diffusion coefficient of chloride ions was also calculated at different positions of the polypyrrole/water interface, from bulk water to the inner polymer matrix. A value of 4.1 x 10(-5) cm(2) s(-1) was measured in the bulk water compared to 5 x 10(-7) cm(2) s(-1) inside the polymer, representing a diminution of two orders of magnitude for the translational diffusion coefficient from bulk water to the core of a oxidized polypyrrole matrix. These results were in good agreement with experimental data.

In previous cross-sectional studies, we demonstrated that, in most patients with chronic hepatitis C, the composition and complexity of the circulating hepatitis C virus (HCV) population do not coincide with those of the virus replicating in the liver. In the subgroup of patients with similar complexities in both compartments, the ratio of quasispecies complexity in the liver to that in serum (liver/serum complexity ratio) of paired samples correlated with disease stage. In the present study we investigated the dynamic behavior of viral population parameters in consecutive paired liver and serum samples, obtained 3 to 6 years apart, from four chronic hepatitis C patients with persistently normal transaminases and stable liver histology. We sequenced 359 clones of a genomic fragment encompassing the E2(p7)-NS2 junction, in two consecutive liver-serum sample pairs from the four patients and in four intermediate serum samples from one of the patients. The results show that the liver/serum complexity ratio is not stable but rather fluctuates widely over time. Hence, the liver/serum complexity ratio does not identify a particular group of patients but a particular state of the infecting quasispecies. Phylogenetic analysis and signature mutation patterns showed that virtually all circulating sequences originated from sequences present in the liver specimens. The overall behavior of the circulating viral quasispecies appears to originate from changes in the relative replication kinetics of the large mutant spectrum present in the infected liver.

The quasispecies nature of the hepatitis C virus (HCV) is thought to play a central role in maintaining and modulating viral replication. Several studies have tried to unravel, through the parameters that characterize HCV circulating quasispecies, prognostic markers of the disease. In a previous work we demonstrated that the parameters of circulating viral quasispecies do not always reflect those of the intrahepatic virus. Here, we have analyzed paired serum and liver quasispecies from 39 genotype 1b-infected patients with different degrees of liver damage, ranging from minimal changes to cirrhosis. Viral level was quantified by real-time reverse transcription-PCR, and viral heterogeneity was characterized through the cloning and sequencing of 540 HCV variants of a genomic fragment encompassing the E2-NS2 junction. Although in 95% of patients, serum and liver consensus HCV amino acid sequences were identical, quasispecies complexity varied considerably between the viruses isolated from each compartment. Patients with HCV quasispecies in serum more complex (26%) than, less complex (28%) than, or similarly complex (41%) to those in liver were found. Among the last, a significant correlation between fibrosis and all the parameters that measure the viral amino acid complexity was found. Correlation between fibrosis and serum viral load was found as well (R = 0.7). With regard to the origin of the differences in quasispecies complexity between serum and liver populations, sequence analysis argued against extrahepatic replication as a quantitatively important contributing factor and supported the idea of a differential effect or different selective forces on the virus depending on whether it is circulating in serum or replicating in the liver.

A 69-year-old man was admitted to the Intensive Care Recovery Unit after heart surgery, carrying an intra balloon counterpulsation (IABCP) device inserted percutaneously days before surgery to provide hemodynamic support and which was still required after surgery. Fifteen days after insertion, blood was observed in the safety chamber. Surgical removal of the catheter was required when attempts to remove it manually failed. The balloon was seen to be perforated and clotted blood was found inside. We believe that long-term maintenance of IABCP carries high risk of perforation and entry of blood, which will clot, as well as of catheter entrapment unless removal is prompt.

We present a child with an MCA pattern of sclerocornea, hypertelorism, pterygium colli, upper limb syndactyly, ambiguous genitalia, abnormal ears and nose, umbilical hernia, congenital heart disease, and normal chromosomes (46,XX). Although the defects observed in this case follow the diagnostic criteria for Fraser syndrome proposed by Thomas et al. [1986: Am J Med Genet 25:85-98], we think that this is a different entity.