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The development of collaborative nurse prescribing (NP) in Andalusia (Spain) in 2018 gives us the opportunity to measure the impact of this practice. Scientific evidence indicates that prescribing is not more costly when performed by nurses and, in fact, is more economical in some cases. The aim of this study is to determine the effects of NP on the effectiveness, health outcomes and adverse events related to prescribing including in the follow-up of patients treated with antivitamin K oral anticoagulants in primary care (PC) by nurses. The design is a randomized clinical trial. The population comprises 1208 anticoagulated patients in 2019. The sample size calculation considers an alpha error of 0.05, a power of 99% and an effect size of 0.5, resulting in 127 users per group. Therefore, a total sample of 254 participants is needed. However, as the project intends to treat patients it will include the universal sample that meets the criteria in the two health centers participating in the study, with 575 participants in total. Data collection was carried out in the PC District of the Alamillo-San Jerónimo Clinical Management Unit of Sevilla for one year from January 2020. Data analysis is performed using the SPSS Statistics 25 package. We intend to study if nurse collaborative prescription in the follow-up and management of patients taking antivitamin K oral anticoagulants in PC is as effective as the traditional approach to follow-ups carried out by a family physician.

After introducing the stages of male germ cell development, we present the testicular somatic cell types, jointly providing indispensable structural and nutritional support as well as regulatory input during spermatogenesis. We will examine how somatic and germ cells interact to form the germinal epithelium that produces spermatozoa in the cystic mode of spermatogenesis typically found in fish (and amphibia). We discuss how endocrine signals from the pituitary and paracrine signals produced in testis tissue, often in response to endocrine signals, coordinate the cellular and molecular processes that constitute spermatogenesis. In this regard, we first discuss the mitotic phase, when proliferating spermatogonia generate the high number of germ cells required for male fertility. These cells enter meiosis, before completing final differentiation, i.e., the spermiogenesis phase and the acquisition of the spermatozoon fertility potential

Genetic adaptations of organisms living in extreme environments are fundamental to our understanding of where life can evolve. Water is the single limiting parameter in this regard, yet when released in the oceans, the single-celled eggs of marine bony fishes (teleosts) have no means of acquiring it. They are strongly hyposmotic to seawater and lack osmoregulatory systems. Paradoxically, modern teleosts successfully release vast quantities of eggs in the extreme saline environment and recorded the most explosive radiation in vertebrate history. Here, we highlight key genetic adaptations that evolved to solve this paradox by filling the pre-ovulated eggs with water. The degree of water acquisition is uniquely prevalent to marine teleosts, permitting the survival and oceanic dispersal of their eggs

20 years ago, a project that used heroin as a medicine was approved by the Spanish Medicines Agency. A year later, a unique experience began in Granada: the second clinical trial in the world where heroin was used as a medicine, PEPSA. The process was long and tortuous, undoubtedly a great experience and clearly, a great success., Hace 20 años, un proyecto que utilizaba la heroína como medicamento fue aprobado por la Agencia Española del Medicamento. Un año después, empezó en Granada una experiencia única en España: el segundo ensayo clínico en el mundo donde se utilizaba la heroína como medicamento, el PEPSA. El proceso fue largo y tortuoso, sin duda una gran experiencia y claramente, un gran acierto.

Un equipo internacional, con participación del Instituto de Ciencias del Mar del CSIC y liderado por investigadores del IRTA en el Instituto de Biotecnología y Biomedicina de la Universidad Autónoma de Barcelona, identifica los genes que permiten a los peces teleósteos marinos hidratar los huevos para que floten y se dispersen, y logren así sobrevivir. El trabajo aporta nueva luz sobre la evolución de los teleósteos, grupo al que pertenecen casi todos los peces marinos actuales, cuyos antepasados se aventuraron a pasar del agua dulce al dominio salino

The term peroxiporin has been created to define a transmembrane water channel protein (aquaporin) that also conducts hydrogen peroxide (H2O2). Such channels facilitate cell signaling and redox balance. Recent studies have shown that multiple differentially localized aquaporins play important roles in the activation, detoxification, maintenance of motility and swimming performance of piscine spermatozoa. For the first time, the peroxiporin function of one of these channels has been identified as a critical player in the mitochondrial elimination of H2O2, with important implications for sperm competition in fishes. This chapter provides an up-to-date overview of the phylogenetic interrelationships of the gnathostome aquaporin superfamily and the duplicates in teleosts, together with information on which of these channels are expressed in spermatozoa and which retain the biophysical property of H2O2 conductance. We discuss the site-specific functions of the aquaporins for piscine sperm cell physiology and summarize how the signaling pathways governing the intracellular trafficking and function of mitochondrial peroxiporins evolved in their spermatozoa

The dual aquaporin (Aqp1ab1/Aqp1ab2)-mediated hydration of marine teleost eggs, which occurs during oocyte meiosis resumption (maturation), is considered a key adaptation underpinning their evolutionary success in the oceans. However, the endocrine signals controlling this mechanism are almost unknown. Here, we investigated whether the nonapeptides arginine vasopressin (Avp, formerly vasotocin) and oxytocin (Oxt, formerly isotocin) are involved in marine teleost oocyte hydration using the gilthead seabream (Sparus aurata) as a model. We show that concomitant with an increased systemic production of Avp and Oxt, the nonapeptides are also produced and accumulated locally in the ovarian follicles during oocyte maturation and hydration. Functional characterization of representative Avp and Oxt receptor subtypes indicates that Avpr1aa and Oxtrb, expressed in the postvitellogenic oocyte, activate phospholipase C and protein kinase C pathways, while Avpr2aa, which is highly expressed in the oocyte and in the follicular theca and granulosa cells, activates the cAMP-protein kinase A (PKA) cascade. Using ex vivo, in vitro and mutagenesis approaches, we determined that Avpr2aa plays a major role in the PKA-mediated phosphorylation of the aquaporin subdomains driving membrane insertion of Aqp1ab2 in the theca and granulosa cells, and of Aqp1ab1 and Aqp1ab2 in the distal and proximal regions of the oocyte microvilli, respectively. The data further indicate that luteinizing hormone, which surges during oocyte maturation, induces the synthesis of Avp in the granulosa cells via progestin production and the nuclear progestin receptor. Collectively, our data suggest that both the neurohypophysial and paracrine vasopressinergic systems integrate to differentially regulate the trafficking of the Aqp1ab-type paralogs via a common Avp-Avpr2aa-PKA pathway to avoid competitive occupancy of the same plasma membrane space and maximize water influx during oocyte hydration

(A-C) Changes in Pf of X. laevis oocytes injected with water or expressing SaAqp1ab1-WT (A), HhAqp1ab1-WT (B) or SsAqp1ab2-WT (C) alone or in combination with different amounts of the isoforms of each paralog. For SsAqp1ab2-WT and splice forms, oocytes were co-injected with halibut YwhazLb and exposed to FSK. (D) Effect of the inhibition of the oocyte Pf by the different Aqp1ab1 splice forms, at a concentrations that produced approximately half-maximal reduction (as observed in A-C), in SaAqp1ab1 or HhAqp1ab1 expressing oocytes in the presence or absence of YwhazLa, and exposed to FSK. The percentage of Pf inhibition elicited by each isoform under the two conditions is indicated in each plot. In all panels, data are the mean ± SEM (n indicated above each bar) and were statistically analyzed by an unpaired Student’s t-test (*, P < 0.05: **, P < 0.01; ***, P < 0.001; with respect to oocytes injected with the WT form alone).

(A-C) Schematic diagram of the seabream and halibut aqp1ab1 and sole aqp1ab2 genes, and the different emerging transcript variants identified in each species. The numbers represent the exons, and the initiation and stop codons in each mRNA are indicated. (D-F) Integral membrane views (cartoon renders) of the wild type and variant channels. Canonical transmembrane domains are shown in cyan, loops in magenta and the two conserved Asn-Pro-Ala (NPA) motifs in dark blue. Variant regions are shown in red. In sole Aqp1ab2_v2 (C and F), the splicing of the distal region of intron 2 causes out-of-frame readthrough of exon 3 and the spliced exon 4 resulting in a premature stop codon and the truncated protein.

(A-C) Genomic organization of tandemly arranged aqp1ab2 and aqp1ab1 genes in seabream (A) and Atlantic halibut (B), and of the single aqp1ab2 gene in Senegalese sole and Common sole (C). The four exons (1–4) of both genes are represented by blue and red boxes, and the start codons are indicated by upper arrows. Lower arrows indicate the position of the oligonucleotide primers used for RT-PCR. (D-E) Representative RT-PCR analysis of aqp1ab1 and aqp1ab2 expression in different adult tissues from seabream (D) and halibut (E). A single aqp1ab2 mRNA species is expressed in seabream and halibut, whereas two or one splice variants (aqp1ab1_v1 and aqp1ab1_v2) in addition to aqp1ab1 are detected, respectively, as indicated. (F-G) RT-PCR of aqp1ab2 expression in Senegalese sole (F) and Common sole (G) where two splice forms (aqp1ab2_v1 and aqp1ab2 _v2) in addition to aqp1ab2 are amplified in the ovary and testis. In D-G, the sizes (kb) of molecular markers are indicated on the left.

Oligonucleotide primers employed for the RT-PCR screening of splice forms expression of aqp1ab-type genes in teleosts.