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Stable water isotopes are useful tools for the characterization of groundwater recharge and the identification of evaporation and marine intrusion processes. This work compiles the isotopic values determined in rainwater samples and water collected in the river Záncara in the section between Zafra de Záncara and Villaescusa de Haro (Cuenca, Spain) from January 2013 to October 2015. The main purpose of this work is the exploration of the application of environmental isotopes to estimate the nature and magnitude of discharges to river Záncara along the section studied by using the δ2H, δ18O and δ13C values. Groundwater discharges are significant throughout the course of the river, reaching its maximum near Villar de Cañas. Os isótopos estáveis em amostras de água são ferramentas úteis para a caracterização de recarga de águas subterrâneas, identificação de evaporação e processos de intrusão marinha. Este trabalho reúne os valores isotópicos determinados em amostras de águas pluviais e água captada no rio Záncara no trecho entre Zafra de Záncara e Villaescusa de Haro (Cuenca, Espanha) desde janeiro de 2013 até outubro 2015. O principal objetivo deste trabalho é explorar as aplicações de os isótopos ambientais, a fim de estimar a natureza ea magnitude das descargas para o rio Záncara ao longo da seção estudada usando δ2H, δ18O e δ13C. As descargas de águas subterrâneas parecem significativas ao longo do curso do rio, atingindo o seu máximo perto de Villar de Cañas. [ABSTRACT FROM AUTHOR]

Introduction. We assess the attitudes of Spanish doctors towards immigrant patients. Material and method. Design: cross-sectional descriptive study carried out in January-June 2003. Sample and setting. Family doctors and third-year residents of 15 health care centers in Zaragoza, Spain. Instrument: specifically designed interview answered in anonymously and on a voluntary basis. Results. A total of 62.3 % of the sample responded. Nearly 75 % of the doctors had received training on immigration, mainly from a theoretical point of view. Almost 25 % of immigrant consultations are not related to health matters. Doctors think that immigrant patients somatize more than Spanish ones but they do not suffer from more psychiatric illness. They also think immigrants show less treatment compliance and are more demanding. They disagree about possible racial biases in diagnosis or treatment of these patients. Spanish doctors consider that the different ethnic groups present similar management difficulties. The group with the most negative stereotype was the patients from Muslim North African countries. Discussion. These findings are discussed from a psychological and anthropological perspective. [ABSTRACT FROM AUTHOR]

Stem cell therapy is an emerging treatment paradigm for stroke patients with remaining neurological deficits. While allogeneic cell transplants overcome the manufacturing constraints of autologous grafts, they can be rejected by the recipient's immune system, which identifies foreign cells through the human leukocyte antigen (HLA) system. The heterogeneity of HLA molecules in the human population would require a very high number of cell lines, which may still be inadequate for patients with rare genetic HLAs. Here, we outline key progress in genetic HLA engineering in pluripotent stem and derived cells to evade the host's immune system, reducing the number of allogeneic cell lines required, and examine safety measures explored in both preclinical studies and upcoming clinical trials., Competing Interests: Declaration of Interests The authors declare no competing interests, (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Stem cell therapy has been shown to improve stroke outcomes in animal models and is currently advancing towards clinical practice. However, uncertainty remains regarding the optimal route for cell delivery to the injured brain. Local intracerebral injections are effective in precisely delivering cells into the stroke cavity but carry the risk of damaging adjacent healthy tissue. Systemic endovascular injections, meanwhile, are minimally invasive, but most injected cells do not cross CNS barriers and become mechanically trapped in peripheral organs. Although the blood-brain barrier and the blood-CSF barrier tightly limit the entrance of cells and molecules into the brain parenchyma, immune cells can cross these barriers especially under pathological conditions, such as stroke. Deciphering the cell surface signature and the molecular mechanisms underlying this pathophysiological process holds promise for improving the targeted delivery of systemic injected cells to the injured brain. In this review, we describe experimental approaches that have already been developed in which (i) cells are either engineered to express cell surface proteins mimicking infiltrating immune cells; or (ii) cell grafts are preconditioned with hypoxia or incubated with pharmacological agents or cytokines. Modified cell grafts can be complemented with strategies to temporarily increase the permeability of the blood-brain barrier. Although these approaches could significantly enhance homing of stem cells into the injured brain, cell entrapment in off-target organs remains a non-negligible risk. Recent developments in safety-switch systems, which enable the precise elimination of transplanted cells on the administration of a drug, represent a promising strategy for selectively removing stem cells stuck in untargeted organs. In sum, the techniques described in this review hold great potential to substantially improve efficacy and safety of future cell therapies in stroke and may be relevant to other brain diseases., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Guarantors of Brain.)

Pharmacological inhibition of astrocytic enzyme autotaxin rescues the stroke penumbra in mice and improves functional recovery, indicating therapeutic potential.

In this study, polyvinyl alcohol (PVA)-mixed DL-alanine (PVA/DL-alanine) polycrystals are fabricated, and their piezoelectric characteristics in the d 33 mode are investigated. The d 33 piezoelectric coefficients of the PVA/DL-alanine polycrystals are found to increase with an increase in the weight ratio of DL-alanine, and the PVA/DL-alanine polycrystal composed of PVA and DL-alanine in a weight ratio of 1:3 exhibits a d 33 of ∼5 pC/N. The piezoelectric characteristics of the PVA/DL-alanine polycrystals are discussed in terms of the crystal structure by employing scanning electron microscopy and X-ray diffraction analyses. To confirm the piezoelectric performance of the polycrystals, the piezoelectric voltages of a piezoelectric device composed of a single layer of ZnO thin film and heterostructured devices consisting of a layer of PVA/DL-alanine polycrystal and a ZnO thin film layer are measured and compared. This study presents PVA/DL-alanine polycrystals as a potential piezoelectric material for bio-friendly piezoelectric-device applications., Competing Interests: The authors declare no competing interests., (© 2022 The Authors.)

Background/aims: Posthepatectomy liver failure (PHLF) is a major complication that increases mortality in patients with hepatocellular carcinoma after surgical resection. The aim of this retrospective study was to evaluate the utility of magnetic resonance elastography-assessed liver stiffness (MRE-LS) for the prediction of PHLF and to develop an MRE-LS-based risk prediction model., Methods: A total of 160 hepatocellular carcinoma patients who underwent surgical resection with available preoperative MRE-LS data were enrolled. Clinical and laboratory parameters were collected from medical records. Logistic regression analyses were conducted to identify the risk factors for PHLF and develop a risk prediction model., Results: PHLF was present in 24 patients (15%). In the multivariate logistic analysis, high MRE-LS (kPa; odds ratio [OR] 1.49, 95% confidence interval [CI] 1.12 to 1.98, p=0.006), low serum albumin (≤3.8 g/dL; OR 15.89, 95% CI 2.41 to 104.82, p=0.004), major hepatic resection (OR 4.16, 95% CI 1.40 to 12.38, p=0.014), higher albumin-bilirubin score (>-0.55; OR 3.72, 95% CI 1.15 to 12.04, p=0.028), and higher serum α-fetoprotein (>100 ng/mL; OR 3.53, 95% CI 1.20 to 10.40, p=0.022) were identified as independent risk factors for PHLF. A risk prediction model for PHLF was established using the multivariate logistic regression equation. The area under the receiver operating characteristic curve (AUC) of the risk prediction model was 0.877 for predicting PHLF and 0.923 for predicting grade B and C PHLF. In leave-one-out cross-validation, the risk model showed good performance, with AUCs of 0.807 for all-grade PHLF and 0. 871 for grade B and C PHLF., Conclusions: Our novel MRE-LS-based risk model had excellent performance in predicting PHLF, especially grade B and C PHLF.

Several studies have reported changes in body composition in rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Our study showed that body composition measurements obtained by absorptiometry were highly reproducible in patients suffering from these diseases. This study justifies the use of absorptiometry measurements in longitudinal studies in this population., Purpose: Our study aimed to assess the reproducibility of total and regional body composition in patients with rheumatoid arthritis (RA) and with ankylosing spondylitis (AS) and to compare them to healthy subjects., Methods: The study enrolled 80 subjects including 32 healthy subjects, 31 RA patients, and 17 AS patients. Each subject had two scans in one day under the same standard conditions and none ate nor drunk before being repositioned on the table. The reproducibility was assessed through the coefficient of variation (CV), the least significant change (LSC), the intraclass correlation (ICC), and the smallest significant difference (SDD)., Results: Total body composition measurements obtained by dual-energy X-ray absorptiometry (DXA) were highly reproducible, and there was no statistically significant difference between reproducibility in healthy subjects, patients with RA, and patients with AS. For total body fat mass (FM), lean mass (LM), and bone mineral content (BMC) in the total population, CV values were 1.71%, 1.25%, and 1.74%, respectively; ICC values were 0.998, 0.996, and 0.993, respectively; LSC values were 4.88%, 3.7%, and 5.2%, respectively; and SDD values were ± 1.23 Kg, ± 1.47 Kg, and ± 126.0 g, respectively. For regional body FM, LM, and BMC in the total population, CV values in the arms were 8.46%, 4.17%, and 3.79%, respectively; in the legs 6.24%, 3.59%, and 2.04%, respectively, and in the trunk 5.02%, 2.92%, and 5.24%, respectively., Conclusion: Total body tissue mass, FM percentage, FM, LM, and BMC measurements obtained by DXA are highly reproducible in RA and AS.

Muscular sarcoidosis is rarely symptomatic and mainly affects proximal muscles of the lower extremities. However, the distal localization in the upper extremities is rare. We used systematic approach to analyze all relevant literature review and we identified only three cases of muscular sarcoidosis of the upper extremities. We report the case of a 56-year-old woman who presented distal and bilateral swelling of the extensor surface of the forearms revealing muscular sarcoidosis. The laboratory exams associated elevated acute phase reactants with elevated serum angiotensin-converting enzyme levels and normal serum muscle enzymes. Ultrasound and MRI showed a bilateral and symmetrical muscle hypertrophy of the extensors of the fingers. Histological examination of muscle specimen and minor salivary gland biopsy revealed noncaseating epithelioid-cell granulomas. Therefore, the diagnosis of muscular sarcoidosis of the finger extensor muscles was made. Swelling of the forearms disappeared gradually under prednisolone 1 mg/kg/day. We used methotrexate as a steroid-sparing agent. Muscular MRI in sarcoidosis is not specific, but is to make a diagnosis of the lesion to optimize the biopsy which the cornerstone of the diagnosis ofsarcoidosis.

Introduction: We assess the attitudes of Spanish doctors towards immigrant patients., Design: cross-sectional descriptive study carried out in January-June 2003., Sample and Setting: Family doctors and third-year residents of 15 health care centers in Zaragoza, Spain., Instrument: specifically designed interview answered in anonymously and on a voluntary basis., Results: A total of 62.3 % of the sample responded. Nearly 75 % of the doctors had received training on immigration, mainly from a theoretical point of view. Almost 25 % of immigrant consultations are not related to health matters. Doctors think that immigrant patients somatize more than Spanish ones but they do not suffer from more psychiatric illness. They also think immigrants show less treatment compliance and are more demanding. They disagree about possible racial biases in diagnosis or treatment of these patients. Spanish doctors consider that the different ethnic groups present similar management difficulties. The group with the most negative stereotype was the patients from Muslim North African countries., Discussion: These findings are discussed from a psychological and anthropological perspective.