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ObjectivesHealth systems are increasingly accountable for patients and require accurate electronic health record (EHR) vital status. We recently demonstrated that 19% of seriously ill primary care patients in one system were not marked dead in the EHR and 80% of these decedents had an encounter or appointment outstanding after death. Herein we describe the mechanism of identifying decedents whose death is not captured at the level of the EHR, characterize these decedents, and describe medications refilled after death.Materials and methodsDescription of multistep process to identify deceased patients not marked dead in the EHR among a cohort of seriously ill primary care patients including public death file matching, utilization analysis, and chart abstraction. We compared decedents not marked dead in the EHR to known decedents and described pharmacy requests and refills.ResultsNearly 90% of encounters and appointments occurred because the health system EHR did not record the death although 11% of these encounters contained condolences or death notifications. Decedents not marked dead in the EHR were older and lived in more vulnerable areas than those marked dead. Of 146 refill requests after death, 88 medications were authorized.Discussion and conclusionMatching with a limited public death file is an inadequate solution to inaccurate vital status. Better workflows are needed to capture deaths about which clinicians and staff are aware, but will identify only a fraction of the decedents inaccurately listed as alive. Efforts are needed to connect EHRs with more specific sources of linkable decedent information.

ObjectivePatient portals are increasingly used to recruit patients in research studies, but communication response rates remain low without tactics such as financial incentives or manual outreach. We evaluated a new method of study enrollment by embedding a study information sheet and HIPAA authorization form (HAF) into the patient portal preCheck-in (where patients report basic information like allergies).Materials and methodsEligible patients who enrolled received an after-visit patient-reported outcomes survey through the patient portal. No additional recruitment/messaging efforts were made.ResultsA total of 386 of 843 patients completed preCheck-in, 308 of whom signed the HAF and enrolled in the study (37% enrollment rate). Of 93 patients who were eligible to receive the after-visit survey, 45 completed it (48% completion rate).ConclusionEnrollment and survey completion rates were higher than what is typically seen with recruitment by patient portal messaging, suggesting that preCheck-in recruitment can enhance research study recruitment and warrants further investigation.

IntroductionDespite being a bacterial pathogen with devastating consequences, Tenacibaculum maritimum’s pathogenesis is not fully understood. The aim of the present study was to elucidate if different inoculation routes (intraperitoneal - i.p - injection and bath challenge - known to induce mortality) can induce tenacibaculosis (i.e., using the same T. maritimum inoculum), as well as evaluate the short-term immune response of European sea bass (D. labrax). Additionally, the host response against i.p. injection of extracellular products (ECPs) was also studied.MethodsFish were i.p. challenged with 5.5 × 105 CFU mL-1 of T. maritimum cells with or without ECPs (BECPs and BWO, respectively), ECPs alone or marine broth (mock). Another group of fish was bath-challenged with 5.5 × 105 CFU mL-1 to confirm the virulence of the bacterial inoculum. Undisturbed specimens were used as controls. The severity of both challenges was determined by following percentage survival. Blood, liver and head-kidney samples were collected at 0, 3, 6, 24 and 48 h post-challenge for assessing immune parameters, oxidative stress and gene expression. Total and differential peritoneal cell counts were performed. The presence of viable bacteria in the blood and peritoneal cavity was studied.ResultsSymptoms of tenacibaculosis, such as skin/fin abrasions, were only observed in the bath-challenged fish, where 0% survival was recorded, whereas 100% survival was observed after i.p. injection of the same bacterial inoculum. An increase in total leukocyte numbers in the peritoneal cavity was observed 3 h post-injection of BECPs when compared to the other treatments. Blood total leukocytes, lymphocytes, and thrombocyte numbers dropped after the challenge, mainly in fish challenged with BECPs. At 48 h post-challenge, bactericidal activity in the plasma increased in fish injected with bacteria (with and without ECPs). The same tendency was seen for some of the oxidative stress parameters.Discussion/ConclusionsThe increased expression of il1β, il6, il8, and hamp1 in fish challenged with ECPs and BECPs suggests a more exacerbated pro-inflammatory response in the head-kidney against these inocula. The infection trial and the observed immune responses showed that the infection route is a determinant factor regarding T. maritimum-induced pathogenesis in European sea bass.

The paper attempts to investigate the capacity of agroecological cooperative supermarkets in Spain to promote scaling of food products by means of a double perspective. We first employ a vertical scaling approach to analyze the issues affecting the governance and collective organization of the Cooperative Supermarket Network (CSN), set up in May 2022 and comprising eleven Spanish supermarkets. Secondly, we employ a perspective of horizontal scaling to investigate the potential for increased numbers of members, as well as the geographic and sociodemographic variables at play which limit the abovementioned scaling: to this end we use the case study of the cooperative supermarket La Osa, opened in Madrid in December 2020. We adopt a methodology based on participatory action research throughout the years 2022 and 2023, in which the research team was involved in the real processes of creation and development of the CSN or of La Osa. The study confirms the hypothesis that agroecological cooperative supermarkets constitute a formula for efficient retail distribution for scaling sustainable food in Spain. As opposed to the first-generation options for responsible consumption, these supermarkets appear to contribute to generating significant economies of scale and scope. In terms of vertical scaling, joint provision of services, as well as the gaining of political influence in society, constitute the main advantages in relation to the functioning of the CSN. While the recruitment of new members has heretofore been considered a priority in horizontal scaling, particular emphasis should also be placed on loyalty strategies targeting existing members.

Resumen Objetivo: Estimar el grado de alfabetización para la salud (AS) de las técnicas en cuidados auxiliares de enfermería (TCAE) y del personal no sanitario perteneciente a la plantilla laboral de 4 hospitales españoles. Método: Estudio descriptivo-correlacional, siendo la población diana las TCAE a quienes se preguntó, mediante formulario online HLS-EU-Q16 (Health Literacy Survey - European Union), con escala Likert de 4 valores (de 1 muy fácil a 4 muy difícil). Resultados: Respondieron 477 profesionales. Los resultados para la AS global fueron: media 1,95 ± 0,03 y mediana 1,94. El nivel de alfabetización en salud (NAS) demostró AS suficiente en 293 (61,43%) individuos. La mediana sobre la AS de los 3 componentes del cuestionario fue: cuidado sanitario = 2, prevención de enfermedades = 2 y promoción de la salud = 1,75. El ítem sobre sobre la manera de abordar problemas de salud mental es el que presentó mayor dificultad con media de 2,45 ± 0,04 y mediana igual a 2. No hubo diferencias significativas entre TCAE y el personal no sanitario. Conclusiones: El grado de AS de las TCAE resultó ser bueno, tanto a nivel global como en las dimensiones de atención y cuidado sanitario, prevención de enfermedades y promoción de la salud. Asimismo, el nivel de alfabetización en salud que se obtuvo resultó ser suficiente en la mayoría de ellas. No se encontró diferencias con el personal no sanitario perteneciente a la plantilla laboral de 4 hospitales estudiados.

The dynamics of tissue wound healing associated with dental implants placed in fresh extraction sockets or in healed alveolar ridges are not fully understood. Therefore, the aim of this preclinical in vivo investigation was to evaluate soft tissue healing and osseointegration after immediate implant placement, compared with delayed implant placement, using histomorphometric and immunohistochemical analyses. Methods: In 8 dogs, immediate postextraction implants and delayed implants were evaluated. After 2 and 8 weeks of healing, dissected tissue blocks were processed for calcified and decalcified histological analysis. Histometric measurements for soft tissue height and width were performed. Immunohistochemical analysis for the evaluation of bone metabolism, immune response and angiogenesis was performed. Results: At 2 weeks, histometric analysis showed that peri-implant soft tissue height was significantly greater in the immediate implant group (4.47 mm ± 0.78) compared to the delayed implant group (2.92 mm ± 0.51, p = 0.028), primarily due to the connective tissue height. Immunohistochemical analysis indicated significantly higher alkaline phosphatase (ALP) (6.85 ± 5.17 vs. 3.56 ± 2.31, p < 0.05) and matrix metalloproteinase (MMP2) activity (1.59 ± 1.64 vs. 0.58 ± 0.48, p < 0.05) in immediate implants, suggesting increased osteogenic and matrix metalloproteinase activity. At 8 weeks, the peri-implant soft tissue height remained higher in the immediate implant group (3.43 mm ± 0.83) compared to the delayed implant group (2.4 mm ± 0.37, p = 0.088), although the difference was less pronounced. Immunohistochemical differences between groups diminished in late healing stages. Conclusions: Soft tissue dimensions around immediate implants differ from those established around staged implants placed on healed alveolar ridges. Moreover, osseointegration dynamics around immediate implants may occur at a different rate compared with staged implants.

Resumen Introducción: Describir y analizar la percepción existente acerca de la satisfacción laboral (SL) y la calidad de vida (CV) de los/las médicos/as residentes españoles/as en los meses posteriores a la terminación del estado de alarma por la COVID-19 y al año de la misma. Método: Estudio descriptivo-correlacional, siendo la población diana los/las residentes españoles/as a quienes se preguntó, mediante formulario online, en dos cortes (1º de 01/11 al 31/12 de 2020 y 2º entre 01/11 y 31/12 de 2021). Para la SL se utilizó el cuestionario Font-Roja y para la CV el WHOQOL-BREF (ambos mediante escala Likert de 5 valores). Resultados: Respondieron 404 residentes (1er corte) y 411 (2º corte). Los resultados para a SL global mostraron Rho = 0,09; p = 0,081, sin diferencias entre sus medias (-0,07; p = 0,090). La CV global, medida a través del cuestionario, indicó baja correlación entre ambos cortes (Rho = 0,10; p = 0,041), con diferencias entre sus medias (-0,14; p < 0,001). Conclusiones: En relación a la SL no se constató asociación entre los dos periodos estudiados. Respecto a la CV se evidenciaron mejores datos, en el 2º corte, tanto en la CV autopercibida como en el resultado global del cuestionario.

Stepped fishways are the main alternative to allow fish migration in river obstacles. Their design is a multidisciplinary process, where civil engineering meets biology. This can bias the fishway design towards one discipline, which may cause low efficiencies or inadequate solutions. Likewise, it is often challenging to incorporate new discoveries into well-established design principles. To solve these problems, we have developed a novel tool named “Escalas”. Escalas is a multipurpose platform for the assisted design, 1D simulation, assessment, and correction of stepped fishways. Escalas architecture allows fishway assessment during different hydraulic scenarios in the river (i.e., different water levels and discharges in the river), automatic dimensioning considering fish's physical needs, the study of any type of stepped fishway, to test solutions for malfunctioning or to assess fishway retrofitting. This is achieved by a modular variable definition during fishway design or definition, which allows multiple combinations of connections within and/or between cross-walls and independent discharge equation definition. This work aims to introduce Escalas to the research and engineering community, describe its algorithms, and show and validate its performance by its use in real and practical cases. Among others, results demonstrate how the tool can reproduce uniform and non-uniform performances on stepped fishways and allows fishway retrofitting to make hydraulic conditions compatible with fish usage during different river scenarios. Therefore, this work represents a step forward in the fishway engineering discipline by applying methods of engineering informatics and providing a technical and scientific base to make engineering decision-making more reliable and accessible as well as to incorporate new advances in fishway research into the engineering design process.

El excesivo consumo energético es actualmente un gran problema para la sociedad. Parte de la solución a este problema pasa por mejorar la eficiencia de los sistemas de uso extensivo, particularmente los sistemas térmicos. Una forma de abordarlo es mediante la construcción de modelos orientados a la mejora energética. Estos modelos dependen de parámetros, a priori desconocidos, que se deben estimar. En este sentido, la identificabilidad es una propiedad esencial que se debe analizar en cualquier proceso de estimación paramétrica. En este trabajo, presentamos un modelo de parámetros concentrados de un sistema térmico. Después, analizamos su identificabilidad empleando el teorema del isomorfismo local. Finalmente discutimos dos escenarios en función de las variables medidas. En el primero disponemos de medidas del estado completo y demostramos que el modelo es identificable, mientras que en el segundo disponemos de medidas parciales y el modelo resulta ser no identificable. Finalmente, planteamos un análisis adicional en el que determinamos el conjunto mínimo de variables a medir para que el modelo sea identificable.

Chicken meat and its derivatives are easily alterable. They are a nutritionally healthy food, and their consumption has seen a remarkable increase worldwide in recent years. At the same time, consumer demand for the use of natural products to control microbial growth is increasing. In this context, the antimicrobial capacity of a commercial extract of the lemon verbena (Lippia citriodora) plant, (LCE) was tested in binary combination with gallic acid or octyl gallate against two strains of lactic acid bacteria (LAB) of meat origin: Carnobacterium divergens ATCC 35677 and Leuconostoc carnosum ATCC 49367. First, the antimicrobial potential was evaluated by the checkerboard microdilution method at the optimal growth temperature of each and at 4 °C, pH 5.7 and 6.7, in culture medium. Octyl gallate was the most effective antimicrobial against the two bacteria under all study conditions. At 4 °C, the combination of LCE with octyl gallate had a similar antimicrobial effect on the two LAB, being bactericidal at pH 6.7. In chicken breast, this effective combination was tested in normal or modified atmosphere and refrigerated (4–8 °C) for 9 days. LCE + OG in modified atmosphere reduced the different microbial groups studied, including the lactic acid bacteria as the main microorganisms responsible for the spoilage of fresh meat. Further research could pave the way for the development of novel strategies contributing to the technological stability, security, and functional properties of chicken meat.

The search for natural food additives makes propolis an exciting alternative due to its known antimicrobial activity. This work aims to investigate propolis’ behavior as a nitrite substitute ingredient in cooked ham (a ready-to-eat product) when confronted with pathogenic microorganisms of food interest. The microbial evolution of Listeria monocytogenes, Staphylococcus aureus, Bacillus cereus, and Clostridium sporogenes inoculated at known doses was examined in different batches of cooked ham. The design of a challenge test according to their shelf life (45 days), pH values, and water activity allowed the determination of the mesophilic aerobic flora, psychotropic, and acid lactic bacteria viability. The test was completed with an organoleptic analysis of the samples, considering possible alterations in color and texture. The cooked ham formulation containing propolis instead of nitrites limited the potential growth (δ < 0.5 log10) of all the inoculated microorganisms until day 45, except for L. monocytogenes, which in turn exhibited a bacteriostatic effect between day 7 and 30 of the storage time. The sensory analysis revealed the consumer’s acceptance of cooked ham batches including propolis as a natural additive. These findings suggest the functionality of propolis as a promising alternative to artificial preservatives for ensuring food safety and reducing the proliferation risk of foodborne pathogens in ready-to-eat products.

estratigrafía de la Formación Ermita es revisada y subdividida en los miembros Valverde, Baleas y Remedio. Se propone formalmente a este último miembro en el trabajo. La deposición de la Formación Ermita fosiliza una discordancia angular regional en el Fameniense superior. La elevación del bloque Cantábrico parece que estuvo activo desde el Fameniense temprano en coincidencia con la llegada de aportes provenientes del interior de la cordillera Varisca. La elevación y erosión sellada por la discordancia regional tuvo lugar entre el Fameniense medio y el tardío. El intervalo Misisípico posterior de sedimentación condensada en la zona Cantábrica incluye una paraconformidad asociada con una erosión intra-Tournaisiense. La subsidencia baja y el desabastecimiento de aportes hasta el Serpukhoviense tardío fueron contemporáneos con la colisión continental y el relleno por sedimento de los surcos orogénicos generados con la propagación de la deformación en la parte interna de la cordillera Varisca.

BackgroundThis review wants to highlight the importance of computer programs used to control the steps in the management of dangerous drugs. It must be taken into account that there are phases in the process of handling dangerous medicines in pharmacy services that pose a risk to the healthcare personnel who handle them. Objective: To review the scientific literature to determine what computer programs have been used in the field of hospital pharmacy for the management of dangerous drugs (HDs).MethodsThe following electronic databases were searched from inception to July 30, 2021: MEDLINE (via PubMed), Embase, Cochrane Library, Scopus, Web of Science, Latin American and Caribbean Literature in Health Sciences (LILACS) and Medicine in Spanish (MEDES). The following terms were used in the search strategy: “Antineoplastic Agents,” “Cytostatic Agents,” “Hazardous Substances,” “Medical Informatics Applications,” “Mobile Applications,” “Software,” “Software Design,” and “Pharmacy Service, Hospital.”ResultsA total of 104 studies were retrieved form the databases, and 18 additional studies were obtained by manually searching the reference lists of the included studies and by consulting experts. Once the inclusion and exclusion criteria were applied, 26 studies were ultimately included in this review. Most of the applications described in the included studies were used for the management of antineoplastic drugs. The most commonly controlled stage was electronic prescription; 18 studies and 7 interventions carried out in the preparation stage focused on evaluating the accuracy of chemotherapy preparations.ConclusionAntineoplastic electronic prescription software was the most widely implemented software at the hospital level. No software was found to control the entire HD process. Only one of the selected studies measured safety events in workers who handle HDs. Moreover, health personnel were found to be satisfied with the implementation of this type of technology for daily work with these medications. All studies reviewed herein considered patient safety as their final objective. However, none of the studies evaluated the risk of HD exposure among workers.

Film editing has attracted great theoretical and practical interest since the beginnings of cinematography. In recent times, the neural correlates of visual transitions at edit cuts have been at the focus of attention in neurocinematics. Many Event Related Potential (ERP) studies studies have reported the consequences of cuts involving narrative discontinuities, and violations of standard montage rules. However, less is known about edits that are meant to induce continuity. Here, we addressed the neural correlates of continuity editing involving scale, and angle variations across the cut within the same scene, two of the most popular devices used for continuity editing. We recorded the electroencephalographic signal obtained from 20 viewers as they watched four different cinematographic excerpts to extract ERPs at edit points. First, we were able to reproduce the general time and scalp distribution of the typical ERPs to filmic cuts in prior studies. Second, we found significant ERP modulations triggered by scale changes (scale out, scale in, or maintaining the same scale). Edits involving an increase in scale (scale out) led to amplification of the ERP deflection, and scale reduction (scale in) led to decreases, compared to edits that kept scale across the cut. These modulations coincide with the time window of the N300 and N400 components and, according to previous findings, their amplitude has been associated with the likelihood of consciously detecting the edit. Third, we did not detect similar modulations as a function of angle variations across the cut. Based on these findings, we suggest that cuts involving reduction of scale are more likely to go unnoticed, than ones that scale out. This relationship between scale in/out and visibility is documented in film edition manuals. Specifically, in order to achieve fluidity in a scene, the edition is designed from the most opened shots to the most closed ones.

IntroductionElevated pulse pressure (ePP) is an independent marker of cardiovascular risk (CVR) in people older than 60, and a functional marker of subclinical target organ damage (sTOD) which can predict cardiovascular events in patients with hypertension (HTN), regardless of sTOD.ObjectiveTo evaluate the prevalence of ePP in adult population seen in primary care and its association with other vascular risk factors, sTOD and with cardiovascular disease (CVD).Materials and methodsObservational multicentre study conducted in Spain (8,066 patients, 54.5% women) from the prospective cohort study IBERICAN recruited in Primary Care. Pulse pressure (PP) was defined as the difference between the systolic blood pressure (SBP) and the diastolic blood pressure (DBP) ≥60 mmHg. Adjusted (for age and sex) ePP prevalence were determined. Bivariate and multivariate analyses of the possible variables associated with ePP were carried out.ResultsThe mean of PP was 52.35 mmHg, and was significantly higher (p

Introduction: Despite being a bacterial pathogen with devastating consequences, Tenacibaculum maritimum's pathogenesis is not fully understood. The aim of the present study was to elucidate if different inoculation routes (intraperitoneal - i.p - injection and bath challenge - known to induce mortality) can induce tenacibaculosis (i.e., using the same T. maritimum inoculum), as well as evaluate the short-term immune response of European sea bass (D. labrax). Additionally, the host response against i.p. injection of extracellular products (ECPs) was also studied. Methods: Fish were i.p. challenged with 5.5 x 105 CFU mL-1 of T. maritimum cells with or without ECPs (BECPs and BWO, respectively), ECPs alone or marine broth (mock). Another group of fish was bath-challenged with 5.5 x 105 CFU mL-1 to confirm the virulence of the bacterial inoculum. Undisturbed specimens were used as controls. The severity of both challenges was determined by following percentage survival. Blood, liver and head-kidney samples were collected at 0, 3, 6, 24 and 48 h post-challenge for assessing immune parameters, oxidative stress and gene expression. Total and differential peritoneal cell counts were performed. The presence of viable bacteria in the blood and peritoneal cavity was studied. Results: Symptoms of tenacibaculosis, such as skin/fin abrasions, were only observed in the bath-challenged fish, where 0% survival was recorded, whereas 100% survival was observed after i.p. injection of the same bacterial inoculum. An increase in total leukocyte numbers in the peritoneal cavity was observed 3 h post-injection of BECPs when compared to the other treatments. Blood total leukocytes, lymphocytes, and thrombocyte numbers dropped after the challenge, mainly in fish challenged with BECPs. At 48 h post-challenge, bactericidal activity in the plasma increased in fish injected with bacteria (with and without ECPs). The same tendency was seen for some of the oxidative stress parameters. [ABSTRACT FROM AUTHOR]

The antioxidant, anti-inflammatory, and antimicrobial characteristics of propolis, a bioactive compound collected from hives, have prompted its use in the food sector in recent times. This study investigated the physicochemical characteristics, phenolic profile, and antioxidant capacity of 31 propolis extracts collected from Northern Spain. The physicochemical composition (resins, waxes, ashes mineral content, and heavy metals) was within the allowable regulatory limits. The analysis of bioactive compounds enabled the identification of 51 constituents: flavonoids (apigenin, catechin, chrysin, quercetin, and pinocembrin) and phenolic acids (caffeic, ferulic, and coumaric). The mean value of total polyphenols was 42.72 ± 13.19 Pinocembrin–Galangin Equivalents/100 g, whereas a range between 1.64 ± 0.04 and 4.95 ± 0.36 Quercetin Equivalents (QE) g/100 g was found for total flavonoids content. The determination of bioactivities revealed significant antioxidant capacity using DPPH (1114.28 ± 10.39 µM Trolox Equivalents and 3487.61 ± 318.66 µM Vitamin C Equivalents). Resin content in propolis samples was positively and significantly correlated with both polyphenols (rho = 0.365; p = 0.043) and flavonoid composition (rho = 0.615; p = 0.000) as well as the antioxidant capacity TEAC DPPH (rho = 0.415; p = 0.020). A multiple regression analysis modeled the correlation between resin composition, flavonoids, and TEAC DPPH values, yielding a significant regression equation (R2 = 0.618; F (2,28) = 22.629; p < 0.000; d = 2.299). Therefore, evaluating physicochemical parameters and biological activities provides a promising framework for predicting propolis’ quality and antioxidant properties, thus suggesting its potential as a functional and bioactive compound for the food industry.

Resumen Introducción: Revisar la evidencia científica sobre las consecuencias derivadas de la automedicación con benzodiacepinas (BZD) en personas adultas. Método: Revisión exploratoria de los artículos recuperados de las bases de datos MEDLINE (PubMed), Embase, Cochrane Library, Scopus y Web of Science hasta octubre de 2020. La búsqueda se formuló́ mediante los descriptores "Self Medication" y "Benzodiazepines", utilizando los Entry Terms relacionados y los filtros: «Humans» y «Adult: 19+years». La calidad de los artículos se evaluó́ mediante STROBE. Resultados: De las 388 referencias recuperadas, tras aplicar los criterios de inclusión y exclusión, se seleccionaron 14 artículos. Las puntuaciones STROBE oscilaron entre mínimo de 8,7 y máximo de 17,7, con mediana de 14,3. En 8 artículos se estudió la automedicación; en 2 el abuso; en otros 2 la automedicación o el abuso con la finalidad de tratar las emociones, el estrés o, directamente, drogarse. Otros resultados fueron la sobredosificación y el consumo previo y posterior de BZD al ingreso en programa de metadona. Conclusiones: Los artículos revisados reportaron elevada prevalencia de automedicación y auto-manipulación de BZD. Es necesario conocer el patrón de uso en cada grupo poblacional para establecer medidas que garanticen una adecuada prescripción y uso racional. Mejorando la atención farmacéutica en el proceso de dispensación de BZD (alertando sobre las consecuencias de un tratamiento crónico y la exclusividad de las recetas) y la validación farmacéutica (detección de prescripciones inadecuadas), se podría actuar contra la automedicación de las BZD y las consecuencias derivadas.

Abstract Introduction Mitral valve (MV) prolapse (MVP) is a primary valvular abnormality. We hypothesized that additionally there are concomitant abnormalities of the left ventricle (LV) and MV apparatus in this entity even in the absence of significant mitral regurgitation (MR). Objective To characterize MV and LV anatomic and functional features in MVP with preserved LV ejection fraction, with and without significant MR, using cardiovascular magnetic resonance (CMR). Methods Consecutive MVP patients (n = 80, mean 52 years, 37% males) with preserved LV ejection fraction, and 44 controls (46 years, 52% males) by CMR were included, as well as 13 additional patients with “borderline” MVP. From cine images we quantified LV volumes, MV and LV anatomic measurements (including angle between diastolic and systolic annular planes, annular displacement, and basal inferolateral hypertrophy) and, using feature tracking, longitudinal and circumferential peak systolic strains. Results Significant MR was found in 46 (56%) MVP patients. Compared with controls, MVP patients had LV enlargement, basal inferolateral hypertrophy, higher posterior annular excursion, and reduced shortening of the papillary muscles. LV basal strains were significantly increased, particularly in several basal segments. These differences remained significant in patients without significant MR, and many persisted in “borderline” MVP. Conclusions In patients with MVP and preserved LV ejection fraction there is LV dilatation, basal inferolateral hypertrophy, exaggerated posterior annular displacement and increased basal deformation, even in the absence of significant MR or overt MVP. These findings suggest that MVP is a disease not only of the MV but also of the adjacent myocardium.

Está comprobado que el neuromarketing es una herramienta efectiva para perfeccionar ciertas estrategias de venta. A pesar de esa afirmación, existen discusiones sobre cuáles son los límites reales de su efectividad y cómo debe ser la metodología en base a la que se establezcan las mediciones que reflejen los procesos neuronales de los sujetos de estudio. Un área concreta donde las estrategias de neuromarketing resultan más opacas y están menos validadas empíricamente por experimentos publicados en revistas científicas es en el sector cinematográfico. La incidencia potencial comprobada experimentalmente del neuromarketing en la industria cinematográfica contrasta con las informaciones difundidas por canales no científicos en torno a su eficacia controlando los procesos de decisión de los espectadores. En base a estas comunicaciones difundidas, el espectador puede resultar convencido de que el film que va a presenciar se ha servido de estrategias de neuromarketing diseñadas para que le afecten a un nivel biológico, sintiéndose más indefenso ante el film que si no se le hubiese condicionado por esta creencia. Esta predisposición conlleva que el propio anuncio de haber aplicado técnicas de neuromarketing para el diseño del audiovisual funcione a nivel efectivo como marketing que condiciona al espectador.

This study aimed to determine the performance and characteristics of a synthetic barrier membrane of polylactic acid and acetyl butyl citrate (PLAB) for the lateral bone augmentation of peri-implant dehiscence defects (mean height × depth = 3 mm × 1 mm). In eight dogs, three treatment groups were randomly allocated at each chronic peri-implant dehiscence-type defect: (i) a deproteinized bovine bone mineral covered by a synthetic barrier membrane (test group), (ii) a deproteinized bovine bone mineral covered by a natural collagen membrane (positive control), and (iii) a synthetic barrier membrane (negative control). After 4 and 12 weeks of submerged healing, dissected tissue blocks were processed for calcified and decalcified histological analysis. Histometric measurements for tissue and bone width were performed, and bone-to-implant contact and alkaline phosphatase expression where measured. After 4 and 12 weeks of healing, no statistical differences between the groups were observed for the histometric measurements. The expression of alkaline phosphatase was higher in the positive control group after 4 weeks followed by the positive and negative controls (5.25 ± 4.09, 4.46 ± 3.03, and 4.35 ± 2.28%, p > 0.05) and 12 weeks followed by the negative and positive controls (4.3 ± 2.14, 3.21 ± 1.53, and 2.39 ± 1.03%, p > 0.05). Concerning the bone-to-implant contact, after 4 weeks, the test group obtained the highest results (39.54 ± 48.7) vs. (31.24 ± 42.6) and (20.23 ± 36.1), respectively, while after 12 weeks, the positive control group obtained the highest Bone to imaplant contact (BIC) results, followed by the test and negative controls, (35.91 ± 24.9) vs. (18.41 ± 20.5) and (24.3 ± 32.1), respectively; no statistically significant differences were obtained. Within the limitations of the study, new bone formation can be achieved in guided bone regeneration procedures simultaneously with implant placement either with the use of a PLAB membrane or a native collagen membrane, although these differences were not statistically significant.

Background: The risks of osteoporosis and breast cancer are increasing in elderly women. Bisphosphonates and denosumab are recommended for treatment of osteoporosis. They have different and overlapping pharmacodynamics and previous studies have shown conflicting results regarding their risk association with breast cancer. We intend to further look into this issue through a comparative study. Methods: Electronic health records of 91,626 women older than 50 years with no previous history of malignancy and no nonbreast cancer during follow-up were retrieved from southern California and retrospectively analyzed using univariate, bivariate, and log-rank tests. Medication use, breast cancer risk, and associated demographic and clinical history were assessed. Results: Over an average of 3.6 years follow-up, the breast cancer relative risks (RRs) counted after 365 days of latency are 1.12 (95% confidence interval [CI]: 0.64?1.97) for denosumab ever users and 0.37 (95% CI: 0.21?0.66) for bisphosphonates ever users, when covariates are comparable. The significant difference is supported by the Log-rank test (p?=?0.0004). Excluding statins coprescribers, the breast cancer RR is 1.31 (0.71, 2.43) in denosumab group and 0.26 (0.11, 0.62) in bisphosphonates group. There is a reduced RR in statins ever users (0.47, 95% CI: 0.38?0.58), and the breast cancer risk difference is not significant between concomitant denosumab/statins and bisphosphonates/statins ever users with RR 0.65 (0.16, 2.58) versus 0.55 (0.26, 1.16), p?=?0.692. Conclusions: Our data support an association of lower breast cancer risk with bisphosphonates use in elderly women. We did not observe a lower breast cancer risk in denosumab group; however, our data revealed a potential lower breast cancer risk in denosumab users with concurrent statins use and this requires further study.

Despite the extensive literature on Local Agro-food Systems (LAFS), which involves research on local food identity and organisational proximity, the environmental sustainability of these systems has rarely been addressed. This paper develops a new concept called Local Agroecological Food Systems (LAEFS), which focuses the research not only on local food identity, but also on agroecological principles. We aim to conduct a reflexive review of the literature on the conceptual factors attempting to describe the particular characteristics of LAEFS (distinguishing these from LAFS). We explore five axes of analysis: (a) to establish a compromise at the local level between agro-food sectoral specialisation on the one hand and greater cultivated biodiversity and a more diversified economic structure on the other; (b) to geographically and commercially shorten food channels to the fullest extent; (c) to construct new institutional formulae in the fields of logistics, distribution and public procurement for the scaling up of sustainable food; (d) to develop a participatory, bottom-up, multi-stakeholder and multi-level territorial governance; and (e) to reduce the metabolic profile of food systems by reorganising rural-urban linkages. One of the principal objectives of LAEFS should involve redesigning agricultural and food systems at a scale greater than that of the farm (territory or landscape). This requires both a major public policy push and sustainable territorial governance that incorporate an approach based on territory, food systems and agroecology.

The outbreaks of Listeria associated with food consumption are increasing worldwide concurrently with public concern about the need for natural growth inhibitors. In this context, propolis seems to be a promising bioactive product collected by honeybees, due to its antimicrobial activity against different food pathogens. This study aims to evaluate the efficacy of hydroalcoholic propolis extracts for controlling Listeria under several pH conditions. The physicochemical properties (wax, resins, ashes, impurities), the bioactive compounds (phenolic and flavonoid content), and the antimicrobial activity of 31 propolis samples collected from the half North of Spain were determined. Results showed similar trends in the physicochemical composition and bioactive properties, regardless of the harvesting area. Non-limiting pH conditions (7.04, 6.01, 5.01) in 11 Listeria strains (5 from collection and 6 wild strains from meat products) exhibited MICs (Minimum inhibition concentration) and MBCs (Minimum bactericidal concentration) ranging from 39.09 to 625 μg/mL. The antibacterial activity increased under acidic pH conditions, showing a synergistic effect at pH = 5.01 (p < 0.05). These findings suggest the potential of Spanish propolis as a natural antibacterial inhibitor to control Listeria growth in food products.

RESUMEN Objetivo: Conocer y relacionar las tendencias de búsqueda de información sobre Emtricitabina/Tenofovir y las prácticas sexuales de riesgo (chemsex). Método: Estudio ecológico de los volúmenes de búsqueda relativo (VBR) obtenidos de la consulta directa a la herramienta «Google Trends», utilizando los Temas de búsqueda «Emtricitabina/Tenofovir» y «Chemsex», y «Truvada» como Término de Búsqueda. El periodo de búsqueda fue del 1 de enero de 2004 al 31 de diciembre de 2019. Fecha de consulta 16 de enero de 2020. Resultados: El VBR = 100, máximo, se alcanzó en julio de 2012 para «Emtricitabina/Tenofovir», siendo la relación entre los términos de 100/97/10. La asociación entre «Emtricitabina/Tenofovir» y «Truvada» fue muy alta (R = 0,99; p < 0,001). Y las medias de los VBR para «Emtricitabina/Tenofovir» y «Chemsex» de 25,68 y 14,41 respectivamente. La evolución temporal del término «Emtricitabina/Tenofovir» fue lineal (R2 = 0,62; p < 0,001), mientras que para «Chemsex» se obtuvo creciente con ajuste exponencial (R2 = 0,54; p < 0,001). La correlación existente entre los VBR de los dos términos analizados mostró asociación directa significativa (R = 0,69; p < 0,001). Conclusiones: Los hitos observados en el VBR coincidieron con momentos relacionados con eventos destacados. Se probó un crecimiento, a lo largo del tiempo, en la búsqueda de información tanto sobre los Temas Emtricitabina/Tenofovir como sobre “chemsex”. Igualmente, se probó la relación entre ambos Temas. Estas conclusiones podrían estar relacionadas con el aumento de las prácticas sexuales de riesgo.

Introducción: La Web 2.0 ofrece importantes oportunidades cuando se busca información sobre salud. Objetivo: Analizar la tendencia de las búsquedas que se realizan en España a través de Google sobre sífilis y gonorrea y su relación con los datos de enfermedad. Metodología: Los datos se obtuvieron de Google Trends y del Boletín Epidemiológico Semanal. Variables estudiadas: datos de las infecciones de transmisión sexual, volumen de búsqueda relativo (VBR) e hitos. Resultados: Las tendencias de VBR para la sífilis presentaron una progresión ligeramente decreciente (R2=0,05). En la gonorrea la evolución fue ligeramente creciente con ajuste exponencial (R2=0,04). La relación del VBR entre los términos de búsqueda dio baja asociación lineal (R=0,34). La correlación entre los datos de sífilis y el VBR fue no significativa (R=-0,09). La gonorrea presentó baja asociación lineal significativa (R=0,21). Conclusiones: Si bien los datos de enfermedad reflejaron el crecimiento que ya había sido anunciado por diferentes instituciones sanitarias nacionales e internacionales, los datos sobre búsqueda de información no representaron un aumento de la preocupación por estas ITS que influyera en el aumento de la pesquisa online.

Abstract A new early Visean coral assemblage has been recorded from turbidite facies in the southern part of the Azrou-Khenifra Basin, northwest of Khenifra, central Morocco. The newly discovered Ba Moussa West (BMW) coral fauna includes Siphonophyllia khenifrense sp. nov., Sychnoelasma urbanowitschi, Cravenia lamellata, Cravenia tela, Cravenia rhytoides, Turnacipora megastoma and Pleurosiphonella crustosa. The early Visean age of the coral assemblage is supported by foraminiferal and conodont data, with the recognition of the basal Visean MFZ9 Zone. This confirms that the first transgression in the Azrou-Khenifra Basin was during the earliest Visean. The allochthonous coral assemblage was recovered from coarse-grained proximal limestone debris flow and turbidite beds within a fault-bounded unit, lying to the west of a thrust syncline containing upper Visean limestones. No evidence exists of the former early Visean shallow-water platform from which the corals were derived. All other in situ platform carbonate rocks around the southern margin of the Azrou-Khenifra Basin are probably of late Visean (Asbian–Brigantian) age. The early Visean Ba Moussa West coral fauna can be compared with that at Tafilalt in eastern Morocco, as well as in other Saharian basins of Algeria. Many of the genera and species in the Ba Moussa West assemblage are identical to those in NW Europe, with which it must have had marine connections. The new rugose species described, Siphonophyllia khenifrense, is probably endemic to North Africa. Its ecological niche in NW Europe was occupied by S. cylindrica or S. aff. garwoodi.

Resumen Introducción: La neoplasia de próstata es la enfermedad maligna más común de los países desarrollados y la segunda causa de muerte a nivel mundial. Objetivos: Revisar la literatura científica existente sobre la aparición de neoplasias de próstata asociada a la exposición laboral al cadmio y/o sus compuestos. Métodos: Revisión sistemática de la literatura científica recogida en las bases de datos bibliográficas MEDLINE (vía PubMed), The Cochrane Library, Scopus y Web of Science. Los términos utilizados, como descriptores y texto libre en título y resumen, fueron: «Cadmium», «Cadmium Compounds», «Cadmium Radioisotopes», «Cadmium Isotopes», «Cadmium Chloride», «Cadmium Poisoning», «Itai Itai», «Prostatic Neoplasms», «Prostatic Neoplasm», «Prostate Neoplasm», «Prostate Cancer», «Cancer of the Prostate», «Prostatic Cancer», «Cancer of Prostate» y «Occupational Exposure». Se utilizaron los filtros (límites) «humanos» y «adultos» (19+ años). Resultados: Se recuperaron 114 referencias, de las que se pudieron obtener a texto completo 14 artículos tras aplicar los criterios de inclusión y exclusión. En ellos se describe la asociación entre exposición laboral al cadmio y el desarrollo de neoplasia de próstata. Conclusiones: A pesar de obtener unos resultados que evalúan el desarrollo de neoplasia de próstata tras la exposición al cadmio o a sus compuestos, no existe suficiente evidencia que demuestre su efecto carcinogénico en el ámbito laboral, por lo que serían necesarios nuevos estudios que aporten evidencia en relación a este tema.

Summary: Background: Imaging of subclinical atherosclerosis improves cardiovascular risk prediction on top of traditional risk factors. However, cardiovascular imaging is not universally available. This work aims to identify circulating proteins that could predict subclinical atherosclerosis. Methods: Hypothesis-free proteomics was used to analyze plasma from 444 subjects from PESA cohort study (222 with extensive atherosclerosis on imaging, and 222 matched controls) at two timepoints (three years apart) for discovery, and from 350 subjects from AWHS cohort study (175 subjects with extensive atherosclerosis on imaging and 175 matched controls) for external validation. A selected three-protein panel was further validated by immunoturbidimetry in the AWHS population and in 2999 subjects from ILERVAS cohort study. Findings: PIGR, IGHA2, APOA, HPT and HEP2 were associated with subclinical atherosclerosis independently from traditional risk factors at both timepoints in the discovery and validation cohorts. Multivariate analysis rendered a potential three-protein biomarker panel, including IGHA2, APOA and HPT. Immunoturbidimetry confirmed the independent associations of these three proteins with subclinical atherosclerosis in AWHS and ILERVAS. A machine-learning model with these three proteins was able to predict subclinical atherosclerosis in ILERVAS (AUC [95%CI]:0.73 [0.70–0.74], p

Hemophagocytic lymphohistiocytosis (HLH) is a rare potentially life-threatening condition characterized by aberrant inflammation that can be related to genetic or sporadic forms. In both forms, triggering factors may be involved. Early detection of the underlying cause is crucial for therapeutic decision, while early intervention might be associated with better outcomes. The largest descriptions in the literature on HLH refer to pediatric cases. Adolescents and adults may also be affected, but there is scarce evidence regarding their diagnosis and management. We describe here the case of a 68-year-old Swiss woman with HLH, in whom an extensive search for underlying causes was performed, but neither trigger nor pathogenic variant was found. An early intervention first with dexamethasone and later with cyclosporine was performed. The patient showed a favorable response and did not require further hospitalization; however, one year after diagnosis, it was not possible to suspend cyclosporine due to recurrence of laboratory inflammation signs by drug tapering. The occurrence of HLH idiopathic forms represents a challenge; failure to identify the underlying triggering cause generates uncertainty, endless diagnostic investigations, and consequently additional delays in the treatment. This manuscript addresses the difficulties on this issue.