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In this Correspondence, P. Pelegrin and colleagues found that the deposition of amyloid in tissues in Cryopyrin-Associated Periodic Syndrome were promoted by the extracellular presence of the inflammasome adaptor protein ASC, opening exciting new directions in clinical practice to obtain a novel therapy towards secondary amyloidosis in inflammasomopathies.

Abstract Background PIEZO1 has emerged as a mechanoreceptor linked with adipogenesis, adipose tissue (AT) inflammation and insulin resistance. We aimed to determine the impact of obesity and obesity-associated type 2 diabetes (T2D) as well as mechanical compression forces on the expression of PIEZO1 in visceral AT (VAT) and its relation with inflammation. Methods Blood and VAT samples were obtained from 100 volunteers. Static compression studies in VAT explants were performed to study the PIEZO1 response. The effect of bariatric surgery on the expression of Piezo1 was assessed in a rat model of diet-induced obesity. Results Obesity and obesity-associated T2D increased (P

Moringa oleifera es una planta tropical cuyo follaje es reconocido como valioso suplemento animal, su cultivo y aprovechamiento crece en las regiones ganaderas de Venezuela, entre ellas, las extensas sabanas del estado Monagas. Con el objetivo de evaluar la producción de biomasa de Moringa, cosechada a cinco edades de corte, en bancos proteicos de las localidades Juanico Sur y San Agustín de La Pica, municipio Maturín, Monagas, Venezuela, se condujeron experimentos bajo el diseño de bloques al azar, en ambas localidades, con cinco edades de corte correspondientes a 30, 45, 60, 75 y 90 días y tres repeticiones por tratamiento. Las variables cuantificadas fueron rendimiento en biomasa fresca y seca -total, hoja y tallo- (kg planta-1), y a partir de estas, se estimó la capacidad de sustentación del cultivo (número de animales ha-1) en cada localidad. Se aplicó comparación por prueba Mann Whitney (Localidades) y por procedimiento ANDEVA (Edades de corte). La producción de biomasa fue estadísticamente diferente entre localidades, siendo Juanico Sur superior, mientras que, entre las edades de corte por localidad no se encontraron diferencias significativas. La biomasa foliar por hectárea en Juanico Sur tendría capacidad de sustentar 20 % de la ración durante 45 días de forma individual a 14 vacas de alta producción; 38 ovinos semiestabulados; 23 cerdos de engorde; 282 conejos o 1 000 gallinas ponedoras; mientras que en San Agustín de La Pica tendría capacidad para soportar aproximadamente solo el 15 % de esa carga animal. Las condiciones edafoclimáticas de San Agustín de La Pica resultaron restrictivas para la producción de biomasa del cultivo de moringa.

Marine-derived actinobacteria isolated from sponge Cliona varians and soft coral Eunicea fusca were screened for antibacterial activity against acne-related bacteria, specifically Staphylococcus epidermidis ATCC 14990, methicillin-resistant Staphylococcus aureus ATCC BAA44, and Cutibacterium acnes ATCC 6919. Cytotoxicity assays were performed on human dermal fibroblast (HDFa) and keratinocyte (HaCaT) cell lines to assess the safety profile of the extracts. Chemical characterization was conducted using high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC–MS/MS). Among the extracts, six derived from Kocuria sp., Rhodococcus sp., Nocardia sp., Micrococcus sp., and Streptomyces sp. demonstrated significant antibacterial activity. Notably, extract Z9.216 from Kocuria sp. exhibited the highest efficacy, inhibiting S. epidermidis by 68%, S. aureus by 93%, and C. acnes by 98.7% at a concentration of 0.003 mg/mL, which was comparable to the standard antibiotics erythromycin and vancomycin, while maintaining over 90% cell viability in both HDFa and HaCaT cell lines. Untargeted metabolomic analysis suggested that antibacterial activity might be associated with compounds from the chemical families of alkaloids, terpenoids, and fatty acids, among others. These findings highlight the therapeutic potential of marine actinobacteria in underexplored environments as a promising strategy for treating acne vulgaris, a chronic inflammatory skin condition.

Presentamos el hallazgo que se produjo en julio de 2023, durante la campaña de excavación arqueológica en la villa romana de Los Villaricos (Mula, Murcia), de un fragmento de bajorrelieve esculpido en piedra arenisca con la representación de un “Despótes Hippôn” o “domador de caballos”. La pieza, cuyas características formales e iconográficas nos ofrecen una cronología plenamente de época ibérica (s. VI-III a. C.) ha aparecido en un contexto tardoantiguo de finales del siglo V e inicios del VI d. C. A lo largo del presente estudio, describiremos la pieza, analizaremos los motivos iconográficos, la simbología de estos y su contexto arqueológico.

Abstract Squamous or epidermoid cancer arises in stratified epithelia but also is frequent in the non-epidermoid epithelium of the lung by unclear mechanisms. A poorly studied mitotic checkpoint drives epithelial cells bearing irreparable genetic damage into epidermoid differentiation. We performed an RNA-sequencing gene search to target unknown regulators of this response and selected the SUMO regulatory protein SENP2. Alterations of SENP2 expression have been associated with some types of cancer. We found the protein to be strongly localised to mitotic spindles of freshly isolated human epidermal cells. Primary cells rapidly differentiated after silencing SENP2 with specific shRNAs. Loss of SENP2 produced in synchronised epithelial cells delays in mitotic entry and exit and defects in chromosomal alignment. The results altogether strongly argue for an essential role of SENP2 in the mitotic spindle and hence in controlling differentiation. In addition, the expression of SENP2 displayed an inverse correlation with the immuno-checkpoint biomarker PD-L1 in a pilot collection of aggressive lung carcinomas. Consistently, metastatic head and neck cancer cells that do not respond to the mitosis-differentiation checkpoint were resistant to depletion of SENP2. Our results identify SENP2 as a novel regulator of the epithelial mitosis-differentiation checkpoint and a potential biomarker in epithelial cancer.

Piperazines and diazepines are examples of nitrogen heterocycles present in many marketed drugs highlighting their importance in the discovery of novel bioactive compounds. However, their synthesis often faces challenges, including complex functionalization and lengthy reaction sequences. Multicomponent reactions, notably the Ugi reaction, have emerged as powerful tools to address these hurdles. Here, we have demonstrated the possibility of using the combination of arylglyoxals and carboxylic acids tethered to nonprotected deactivated amines as a powerful strategy for the synthesis of complex fused heterocycles. The limited nucleophilic character of the amino group of the anthranilic acid, indole-2-carboxylic acid, pyrrole-2-carboxylic acid or N-phenylglycine has allowed the use of these compounds in the Ugi reaction without triggering competitive reactions. The additional functional group present in the resulting Ugi adduct can be leveraged in different post-condensation strategies to easily generate multiple fused nitrogen heterocycles including benzodiazepinone and piperazinone cores.

The genetic basis of severe COVID-19 has been thoroughly studied, and many genetic risk factors shared between populations have been identified. However, reduced sample sizes from non-European groups have limited the discovery of population-specific common risk loci. In this second study nested in the SCOURGE consortium, we conducted a genome-wide association study (GWAS) for COVID-19 hospitalization in admixed Americans, comprising a total of 4702 hospitalized cases recruited by SCOURGE and seven other participating studies in the COVID-19 Host Genetic Initiative. We identified four genome-wide significant associations, two of which constitute novel loci and were first discovered in Latin American populations (BAZ2B and DDIAS). A trans-ethnic meta-analysis revealed another novel cross-population risk locus in CREBBP. Finally, we assessed the performance of a cross-ancestry polygenic risk score in the SCOURGE admixed American cohort. This study constitutes the largest GWAS for COVID-19 hospitalization in admixed Latin Americans conducted to date. This allowed to reveal novel risk loci and emphasize the need of considering the diversity of populations in genomic research.

Background Patients with aortic stenosis may continue to have an increased risk of heart failure, arrhythmias, and death after successful transcatheter aortic valve implantation. Renin‐angiotensin system inhibitors may be beneficial in this setting. We aimed to explore whether ramipril improves the outcomes of patients with aortic stenosis after transcatheter aortic valve implantation. Methods and Results PROBE (Prospective Randomized Open, Blinded Endpoint) was a multicenter trial comparing ramipril with standard care (control) following successful transcatheter aortic valve implantation in patients with left ventricular ejection fraction >40%. The primary end point was the composite of cardiac mortality, heart failure readmission, and stroke at 1‐year follow‐up. Secondary end points included left ventricular remodeling and fibrosis. A total of 186 patients with median age 83 years (range 79–86), 58.1% women, and EuroSCORE‐II 3.75% (range 3.08–4.97) were randomized to receive either ramipril (n=94) or standard treatment (n=92). There were no significant baseline, procedural, or in‐hospital differences. The primary end point occurred in 10.6% in the ramipril group versus 12% in the control group (P=0.776), with no differences in cardiac mortality (ramipril 1.1% versus control group 2.2%, P=0.619) but lower rate of heart failure readmissions in the ramipril group (3.2% versus 10.9%, P=0.040). Cardiac magnetic resonance analysis demonstrated better remodeling in the ramipril compared with the control group, with greater reduction in end‐systolic and end‐diastolic left ventricular volumes, but nonsignificant differences were found in the percentage of myocardial fibrosis. Conclusions Ramipril administration after transcatheter aortic valve implantation in patients with preserved left ventricular function did not meet the primary end point but was associated with a reduction in heart failure re‐admissions at 1‐year follow‐up. Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT03201185.

Mercury pollution is a significant environmental issue, primarily resulting from industrial activities, including gold mining extraction. In this study, 333 microorganisms were tested in increasing mercury concentrations, where 158 bacteria and 14 fungi were able to grow and remain viable at concentrations over 5.0 mg/L of mercuric chloride (II). One of the bacterial strains, Stenotrophomonas sp. INV PRT0231, isolated from the mouth of the San Juan River in the Chocó region in Colombia, showed a high mercury resistance level (MIC90 of 27 ± 9 mg/L), with a removal rate of 86.9%, an absorption rate of 1.2%, and a volatilization rate of 85.7% at pH 6.0 and 30.0 °C. The FTIR analysis showed changes in the functional groups, including fatty acid chains and methyl groups, proteins, and lipopolysaccharides associated with the carboxylate group (COO−), suggesting an important role of these biomolecules and their associated functional groups as mechanisms employed by the bacterium for mercury detoxification. Our study contributes to the understanding of the mechanisms of mercury biotransformation in microbial environmental isolates to help develop bioremediation strategies to mitigate mercury pollution caused by anthropogenic activities.

Abstract Sustainability is an issue of worldwide concern. Twitter is one of the most popular social networks, which makes it particularly interesting for exploring opinions and characteristics related to issues of social preoccupation. This paper aims to gain a better understanding of the activity related to sustainability that takes place on twitter. In addition to building a mathematical model to identify account typologies (bot and human users), different behavioural patterns were detected using clustering analysis mainly in the mechanisms of posting tweets and retweets). The model took as explanatory variables, certain characteristics of the user’s profile and her/his activity. A lexicon-based sentiment analysis in the period from 2006 to 2022 was also carried out in conjunction with a keyword study based on centrality metrics. We found that, in both bot and human users, messages showed mostly a positive sentiment. Bots had a higher percentage of neutral messages than human users. With respect to the used keywords certain commonalities but also slight differences between humans and bots were identified.

Una de las tecnologías mas atractivas y actualmente en auge que se esta desarrollando rápidamente es el Gemelo Digital (Digital Twin en inglés, DT). Es bien conocido como un habilitador para la Industria 4.0. Tanto en la comunidad científica como industrial, el concepto, la tecnología y las aplicaciones asociadas al mismo, van generando controversia. Sigue habiendo una gran variedad de definiciones del mismo concepto. Aparentemente no parece haber una comprensión común de este término en la literatura. Se utiliza de forma diferente en diferentes disciplinas. La simulación basada en modelos ha sido, desde hace mucho tiempo, una herramienta común para el diseño en una fase inicial de planificación, pero no durante el tiempo de trabajo del sistema ya diseñado. En este trabajo se pretende abarcar una revisión histórica de este concepto. Mientras que muchas revisiones bibliográficas existentes se centran principalmente en la industria de manufactura, este artículo hará un enfoque en aplicaciones de los gemelos digitales en el campo de la Automática.

Background: Superficial venous thrombosis (SVT) is a common clinical condition caused by inflammation and the presence of a thrombus inside a superficial vein. It has traditionally been considered a benign and banal disorder, although it can progress or can be associated with thromboembolic disease of deep territories in up to 20%, asymptomatic or symptomatic pulmonary embolism (PE), especially if it affects the main trunk of the internal saphenous vein. The impact of deep vein thrombosis on the quality of life and its sequelae have long been described in the literature; however, they have not been studied in superficial vein thrombosis. Objectives: We aimed to evaluate the risk factors, management, and complications of SVT and its impact on the quality of life of our patients. Methods: Observational, prospective, single-center study to evaluate the management of SVT. The ultrasound (US) was performed initially on symptomatic patients, during treatment with low-molecular-weight heparin (LMWH), at a follow-up, and at the end of 45 days of treatment. A quality-of-life questionnaire was administered to determine the risk factors, management, and complications of SVT at the moment of diagnosis and at the end of treatment. We included patients referred from the emergency department to a monographic consultation for thromboembolic disease, over 18 years of age with a diagnosis of acute SVT symptomatic, without contraindication to initiate anticoagulation. Results: In total, 63 patients were evaluated between October 2020 and April 2022. The mean age was 65.8 years (SD 13.5), of which 35 were women (55.6%), 39 presented cardiovascular risk factors (61.9%), 25 had a history of previous personal venous thromboembolism (VTE) (39.7%), and 10 had obesity (15.9%), 47 had chronic venous insufficiency or varicose veins (74.9%). During follow-up with ultrasound, 39.7% had partial revascularization, and at discharge, 63.5% had permeabilized the thrombosis against 19% who had residual thrombosis or progression of thrombosis. There was a positive correlation between mobility parameters and improvement in the performance of daily activities (rho = 0.35; p = 0.012) and with improvement in pain/discomfort (rho = 0.37; p = 0.007). An improvement in pain parameters was statistically significantly related to a global assessment health perception (rho = 0.48; p < 0.001). Anxiety and depression parameters were related to a global assessment health perception (rho = 0.462; p = 0.001) and to an overall improvement at 12 months (rho = 0.45; p = 0.001). CONCLUSIONS: Superficial venous thrombosis (SVT) is a highly prevalent disease, which is traditionally considered banal and has good evolution, with heterogeneous management in clinical practice and limited information on patient selection for therapies, current treatment routes, and drug use, as well as outcomes. In recent years, the importance of this entity has become evident due to its frequency in clinical practice, its risk of complications, and the impact it has on the quality of life. This study’s results emphasize the importance of the diagnosis, treatment, and follow-up of superficial venous thrombosis.

Introduction: Patient satisfaction with septoturbinoplasty was measured using the subjective visual analogue scale (VAS) and Nasal Obstruction Symptom Evaluation (NOSE) scale. In addition, those factors that impacted satisfaction were confirmed. Materials and Methods: We conducted an observational study of patients who underwent septoturbinoplasty. Age, sex, smoking habit, duration of improvement, postoperative complications, type of packing and surgeon were analysed. The results were compared using the VAS and NOSE scale.Results: The improvement experienced with surgery corresponded to 69.80±26.97 points on the VAS 42.65±22.9 points (p

Abstract Objective To assess how inaccurately the body mass index (BMI) is used to diagnose obesity compared to body fat percentage (BF%) measurement and to compare the cardiometabolic risk in children and adolescents with or without obesity according to BMI but with a similar BF%. Methods A retrospective cross-sectional investigation was conducted including 553 (378 females/175 males) white children and adolescents aged 6–17 years, 197 with normal weight (NW), 144 with overweight (OW) and 212 with obesity (OB) according to BMI. In addition to BMI, BF% measured by air displacement plethysmography, as well as markers of cardiometabolic risk had been determined in the existing cohort. Results We found that 7% of subjects considered as NW and 62% of children and adolescents classified as OW according to BMI presented a BF% within the obesity range. Children and adolescents without obesity by the BMI criterion but with obesity by BF% exhibited higher blood pressure and C-reactive protein (CRP) in boys, and higher blood pressure, glucose, uric acid, CRP and white blood cells count, as well as reduced HDL-cholesterol, in girls, similar to those with obesity by BMI and BF%. Importantly, both groups of subjects with obesity by BF% showed a similarly altered glucose homeostasis after an OGTT as compared to their NW counterparts. Conclusions Results from the present study suggest increased cardiometabolic risk factors in children and adolescents without obesity according to BMI but with obesity based on BF%. Being aware of the difficulty in determining body composition in everyday clinical practice, our data show that its inclusion could yield clinically useful information both for the diagnosis and treatment of overweight and obesity.

Summary: Small nucleolar RNAs (snoRNAs) have been identified dysregulated in several pathologies, and these alterations can be detected in tissues and in circulation. The main aim of this study was to analyze the whole snoRNome in advanced colorectal neoplasms and to identify new potential non-invasive snoRNA-based biomarkers in fecal samples by different analytical approaches. SNORA51, SNORD15B, SNORA54, SNORD12B, SNORD12C, SNORD72, SNORD89, and several members of SNORD115 and SNORD116 clusters were consistently deregulated in both tissue sets. After technical validation, SNORA51 and SNORD15B were detected in FIT+ samples. SNORA51 was significantly upregulated in FIT+ samples from CRC patients compared to healthy controls. This upregulation, together with the fecal hemoglobin concentration, was sufficient to identify, among FIT+ individuals, patients with CRC (AUC = 0.86) and individuals with advanced adenomas (AUC = 0.68). These findings portray snoRNAs as an alternative source of candidates for further studies and SNORA51 appears as a potential non-invasive biomarker for CRC detection.

Esta publicación trata de sintetizar la notable cantidad de estructuras y restos de arquitectura doméstica documentada en la ciudad romana de Carthago Nova. Las diferentes intervenciones de carácter arqueológico que de manera intermitente se han ido desarrollando en la ciudad a lo largo de más de un siglo, así como algunos proyectos de arqueología urbana, han constatado la presencia de restos domésticos púnicos, bizantinos, islámicos y, por supuesto, romanos, siendo nuestro principal objeto de estudio e interés aquellos pertenecientes al periodo tardorrepublicano y altoimperial. La elaboración de esta síntesis pone de manifiesto las notables diferencias existentes entre las viviendas tardorrepublicanas y las pertenecientes al periodo altoimperial, siendo especialmente evidentes en aspectos tales como la técnica constructiva, los programas decorativos y ornamentales, o la planta. De igual manera, se aprecia un claro y marcado contraste entre las viviendas pertenecientes a las élites o a los individuos más acomodados de la ciudad en comparación con aquellos hogares propiedad de las gentes más humildes. Resulta especialmente destacable cómo los individuos más pudientes eligieron principalmente las laderas de las colinas de la ciudad como lugar donde emplazar sus viviendas. Este escrito también muestra varios ejemplos de viviendas pertenecientes al siglo III d. C., producto de la ocupación, reutilización y amortización de un edificio público, siendo ésta una dinámica presente durante este periodo en otras ciudades que se encontraban bajo la égida de Roma. En resumen, esta publicación constituye una versión actualizada que reúne todas las evidencias localizadas en la ciudad durante este periodo, exponiendo, además, sus principales características. Este conjunto de datos nos permite plantear futuras líneas de investigación de gran interés para el conocimiento de la arquitectura romana en Hispania y de su sociedad.

Abstract Displacements within urban spaces have attracted particular interest among researchers. We examine the journeys that happen in the Madrid Community considering 24 travel typologies and 1390 administrative areas. From an origin–destination (OD) matrix, four classes of major flows are characterised through coarse-graining: hotspot–non-hotspots, non-hotspot–hotspots, hotspots–hotspots, non-hotspot–non-hotspot. In order to make comparisons between them with respect to spatial and temporal patterns, several statistical tests are performed. The spatial activity as well as transition probabilities between administrative zones are also analysed. The mobility network’s topology is examined (some parameters such as maximal connected components, average degree, betweenness, and assortativity as well as the k-cores are checked). A model describing the formation of links between zones (existence of at least one trip between them) is constructed based on certain measures of affinity between areas.

The scientific community has shown considerable interest in Industry 4.0 due to its capacity to revolutionise the manufacturing sector through digitalisation and data-driven decision-making. However, the actual implementation of Industry 4.0 within complex industrial settings presents obstacles that are typically beyond the scope of mainstream research articles. In this paper, a comprehensive case-study detailing our collaborative partnership with a leading medical device manufacturer is presented. The study traces its evolution from a state of limited digitalisation to the development of a digital intelligence platform that leverages data and machine learning models to enhance operations across a wide range of critical machines and assets. The main business objective was to enhance the energy efficiency of the manufacturing process, thereby improving its sustainability measures while also saving costs. The project encompasses energy modelling and analytics, Fault Detection and Diagnostics (FDD), renewable energy integration and advanced visualisation tools. Together, these components enable informed decision making in the context of energy efficiency.

In the railway sector, rolling stock and infrastructure must be maintained in perfect condition to ensure reliable and safe operation for passengers. Climate change is affecting the urban and regional infrastructure through sea level rise, water accumulations, river flooding, and other increased-frequency extreme natural situations (heavy rains or snows) which pose a challenge to maintenance. In this paper, the use of artificial intelligence based on predictive maintenance implementation is proposed for the early detection of degraded conditions of a bridge due to extreme climatic conditions. For this prediction, continuous monitoring is proposed, with the aim of establishing alarm thresholds to detect dangerous situations, so restrictions could be determined to mitigate the risk. However, one of the main challenges for railway infrastructure managers nowadays is the high cost of monitoring large infrastructures. In this work, a methodology for monitoring railway infrastructures to define the optimal number of transductors that are economically viable and the thresholds according to which infrastructure managers can make decisions concerning traffic safety is proposed. The methodology consists of three phases that use the application of machine learning (Random Forest) and artificial cognitive systems (LSTM recurrent neural networks).

Más allá de las exposiciones blockbuster y otras actividades puertas adentro, el éxito del Guggenheim Bilbao está asociado a su gran impacto externo, también en términos artísticos. En primer lugar, por su icónico edificio, una envoltura escultórica que domina el skyline urbano. Luego, porque se arraciman en el vecindario obras de arte público, arquitecturas posmodernas y otros establecimientos culturales. Y además porque el efecto salpica a otros distritos de la ciudad, catalizando barrios creativos. Un triple marco de análisis proyectado en este artículo a otros ejemplos en el Golfo de Vizcaya, que ofrecen muchas similitudes, pero también algunas diferencias. Los emuladores cercanos han inspirado en ocasiones alternativas fervientemente asumidas también en Bilbao.

IntroductionWhole-body autopsies may be crucial to understand coronavirus disease 2019 (COVID-19) pathophysiology. We aimed to analyze pathological findings in a large series of full-body autopsies, with a special focus on superinfections.MethodsThis was a prospective multicenter study that included 70 COVID-19 autopsies performed between April 2020 and February 2021. Epidemiological, clinical and pathological information was collected using a standardized case report form.ResultsMedian (IQR) age was 70 (range 63.75–74.25) years and 76% of cases were males. Most patients (90%,) had at least one comorbidity prior to COVID-19 diagnosis, with vascular risk factors being the most frequent. Infectious complications were developed by 65.71% of the patients during their follow-up. Mechanical ventilation was required in most patients (75.71%) and was mainly invasive. In multivariate analyses, length of hospital stay and invasive mechanical ventilation were significantly associated with infections (p = 0.036 and p = 0.013, respectively). Necropsy findings revealed diffuse alveolar damage in the lungs, left ventricular hypertrophy in the heart, liver steatosis and pre-infection arteriosclerosis in the heart and kidneys.ConclusionOur study confirms the main necropsy histopathological findings attributed to COVID-19 in a large patient series, while underlining the importance of both comorbid conditions and superinfections in the pathology.

Resumen: Los pacientes con demencia son de por sí más vulnerables, y se han visto especialmente afectados por el efecto de la pandemia por COVID-19, tanto de manera directa por la propia enfermedad como de manera indirecta por la privación de estimulación cognitiva debido al aislamiento social por el confinamiento.La infección por el virus SARS-CoV-2 ha dado lugar a una gran variedad de síntomas, entre ellos, síntomas neurológicos, siendo uno de los principales el delirium, especialmente en los ancianos con demencia. La afectación del virus sobre el sistema nervioso central ha sido tanto directa, por el neurotropismo del virus, como indirecta, por la inflamación y la hipoxia tisular de origen vascular.Se analizan las diferentes causas que han podido conducir, en las diferentes olas previas a la variante ómicron, al importante aumento de la morbimortalidad en los pacientes con demencia, especialmente en los más mayores. Abstract: Patients with dementia are in themselves more vulnerable, and have been especially affected by the effect of the COVID-19 pandemic, both directly due to the disease itself, and indirectly due to the deprivation of cognitive stimulation due to isolation social due to confinement.SARS-CoV-2 virus infection has given rise to a wide variety of symptoms, including neurological symptoms and especially delirium in the elderly with dementia. The virus has affected the central nervous system, both directly due to the neurotropism of the virus, and indirectly due to inflammation and tissue hypoxia of vascular origin.The different causes that have been able to lead, in the different waves prior to the omicron variant, to the significant increase in morbidity and mortality in patients with dementia, especially the elderly, are analyzed.

El objeto de este análisis es examinar —naturalmente, de un modo introductorio— cuál puede ser la repercusión de los eventuales avances en los objetivos transhumanistas en el terreno de la responsabilidad criminal. A mi juicio, el análisis de las posibles consecuencias del transhumanismo en el dominio del Derecho penal afecta a dos ámbitos distintos: (i) en primer lugar, puede incidir en los factores que, hoy en día, vertebran la imputación de responsabilidad penal; (ii) por otro lado, es preciso abordar la repercusión que el transhumanismo podría tener ya no en el juicio de imputación de responsabilidad penal, sino en la determinación de las consecuencias asignadas a los responsables penales y en su proceso de ejecución. Como más adelante se verá, esta reflexión arroja hoy en día más preguntas que respuestas.

The Structural Health Monitoring (SHM) capabilities of a well-studied self-healing epoxy resin based on disulfide bonds, through the addition of carbon nanotubes (CNTs), are studied. Since these materials demonstrated, in recent works, a high dependency of the dynamic hardener content on the repair performance, this study aimed to analyze the effect of the vitrimeric chemistry on the electromechanical properties by studying different 2-aminophenyl disulfide (2-AFD) hardener and CNT contents. The electrical conductivity increases with both the CNT and AFD contents, in general. Moreover, an excess of AFD close to the stoichiometric ratio with a low CNT content improved the tensile strength by 45%, while higher AFD contents promoted its detriment by 41% due to a reduced crosslinking density. However, no significant difference in the mechanical properties was observed at a higher CNT content, regardless of the AFD ratio. The developed materials demonstrate a robust electromechanical response at quasi-static conditions. The sensitivity significantly increases at higher AFD ratios, from 0.69 to 2.22 for the 0.2 wt.%. CNT system, which is advantageous due to the enhanced repair performance of these vitrimeric materials with a higher hardener content. These results reveal the potential use of self-healing vitrimers as integrated SHM systems capable of detecting damages and self-repairing autonomously.

IntroductionObesity contributes to ectopic fat deposition in non-adipose organs, including the pancreas. Pancreas steatosis associates with inflammation and β-cell dysfunction, contributing to the onset of insulin resistance and type 2 diabetes. An improvement of pancreatic steatosis and indices of insulin resistance is observed following bariatric surgery, but the underlying mechanisms remain unknown. We sought to analyze whether guanylin (GUCA2A) and uroguanylin (GUCA2B), two gut hormones involved in the regulation of satiety, food preference and adiposity, are involved in the amelioration of pancreas fat accumulation after bariatric surgery.MethodsPancreas steatosis, inflammation, islet number and area were measured in male Wistar rats with diet-induced obesity (n=125) subjected to surgical (sham operation and sleeve gastrectomy) or dietary (pair-fed to the amount of food eaten by gastrectomized animals) interventions. The tissue distribution of guanylate cyclase C (GUCY2C) and the expression of the guanylin system were evaluated in rat pancreata by real-time PCR, Western-blot and immunohistochemistry. The effect of guanylin and uroguanylin on factors involved in insulin secretion and lipogenesis was determined in vitro in RIN-m5F β-cells exposed to lipotoxic conditions.ResultsSleeve gastrectomy reduced pancreas steatosis and inflammation and improved insulin sensitivity and synthesis. An upregulation of GUCA2A and GUCY2C, but not GUCA2B, was observed in pancreata from rats with diet-induced obesity one month after sleeve gastrectomy. Interestingly, both guanylin and uroguanylin diminished the lipotoxicity in palmitate-treated RIN-m5F β-cells, evidenced by lower steatosis and downregulated lipogenic factors Srebf1, Mogat2 and Dgat1. Both guanylin peptides reduced insulin synthesis (Ins1 and Ins2) and release from RIN-m5F β-cells, but only guanylin upregulated Wnt4, a factor that controls β-cell proliferation and function.DiscussionTogether, sleeve gastrectomy reduced pancreatic steatosis and improved β-cell function. Several mechanisms, including the modulation of inflammation and lipogenesis as well as the upregulation of GUCA2A in the pancreas, might explain this beneficial effect of bariatric surgery.

Dietary nutrient composition is essential for shaping important fitness traits and behaviours. Many organisms are protein limited, and for Drosophila melanogaster this limitation manifests at the level of the single most limiting essential Amino Acid (AA) in the diet. The identity of this AA and its effects on female fecundity is readily predictable by a procedure called exome matching in which the sum of AAs encoded by a consumer's exome is used to predict the relative proportion of AAs required in its diet. However, the exome matching calculation does not weight AA contributions to the overall profile by protein size or expression. Here, we update the exome matching calculation to include these weightings. Surprisingly, although nearly half of the transcriptome is differentially expressed when comparing male and female flies, we found that creating transcriptome-weighted exome matched diets for each sex did not enhance their fecundity over that supported by exome matching alone. These data indicate that while organisms may require different amounts of dietary protein across conditions, the relative proportion of the constituent AAs remains constant. Interestingly, we also found that exome matched AA profiles are generally conserved across taxa and that the composition of these profiles might be explained by energetic and elemental limitations on microbial AA synthesis. Thus, it appears that ecological constraints amongst autotrophs shape the relative proportion of AAs that are available across trophic levels and that this constrains biomass composition.

Antecedentes: El tratamiento del traumatismo esplénico se basa en medidas conservadoras no quirúrgicas o en el uso de radiología intervencionista. La cirugía conservadora del bazo en el traumatismo esplénico sigue siendo inusual. Objetivo: El análisis de seguridad y eficacia del tratamiento quirurgico conservador en el traumatismo esplénico. Método: Se realizó un estudio retrospectivo durante un período de 16 años con la intención de registrar la actitud diagnóstica y terapéutica en un hospital de segundo nivel, enfocándose en los pacientes que recibieron tratamiento quirúrgico conservador esplénico por traumatismo esplénico, excluyendo esplenectomías y tratamientos no quirúrgicos. Resultados: 110 pacientes presentaron traumatismo esplénico. La cirugía conservadora esplénica se realizó en 15 pacientes. Los grados de lesiones esplénicas fueron: 1 paciente con grado I, 1 paciente con grado II, 7 pacientes con grado III y 6 pacientes con grado IV. El tratamiento quirúrgico fue esplenorrafia en 5 pacientes (33%), agentes hemostáticos y malla de ácido poliglicólico en 4 (26%), esplenectomía parcial con colocación de malla de ácido poliglicólico en 3 (20%), esplenectomía parcial en 2 (13%) y hemostasia con electrocauterio en 1 (6%). Ninguno de los pacientes tratados inicialmente con cirugía conservadora requirió esplenectomía posterior y ningún paciente falleció. Conclusiones: La cirugía conservadora esplénica puede ser útil y segura en traumatismos esplénicos, la cual tendría su lugar en traumatismos de grados II, III y IV en centros hospitalarios en los que no se cuente con radiología intervencionista urgente.

La lesión iatrogénica de vía biliar es una complicación infrecuente, aunque temida por su morbimortalidad. En cirugías urgentes, su incidencia puede duplicarse, por lo que en casos seleccionados debemos valorar la utilización de recursos como el verde de indocianina para minimizar el riesgo de lesiones biliares o arteriales, al permitir una correcta identificación de las estructuras. Presentamos el caso de una paciente de 57 años con colecistitis aguda a la que realizamos colecistectomía laparoscópica. Ante la dificultad en la diferenciación de estructuras en el triángulo de Calot, se decidió utilizar verde de indocianina, que identificó un conducto cístico muy corto, evitando así una lesión iatrogénica de vía biliar.

Drastic measures are required to meet the standards of the Paris Agreement and limit the increase of global average temperatures well below 2°C compared to pre-industrial levels. Mining activities are typically considered as unsustainable but, at the same time, metals such as cobalt and lithium are essential to sustain the energy transition. Several sustainability goals defined by the United Nations (UN) require large quantities of raw materials. Exploration and extractives activities are required in order to contribute to meeting sustainability standards. Future sourcing of metals will need to implement procedures that go well beyond current ecological, economic, and social requirements and practices. In this paper we assess the usual sustainability criteria and how they apply to the extractives sector. Sustainability can only be achieved if one accepts that the natural capital can be substituted by other forms of capital (so called weak concept of sustainability). Sourcing the raw materials increasingly demanded by our societies will need transparent and inclusive stakeholder participation as well as a holistic understanding of the impact of extractives activities to reach this weak sustainability status. Our analysis shows that the sustainability of mining cannot be reached without harmonized political instruments and investment policies that take the three pillars of environmental, economic, and social sustainability as a major priority.

A pesar de algunos antecedentes dispersos y excepciones, existe una manifiesta laguna en la literatura sobre el concepto de cultura científica comunitaria. Con esa expresión nos referimos a situaciones en las cuales unos ciudadanos perciben un problema, se agrupan, organizan, comunican y ponen en común sus recursos para buscar, evaluar y producir conocimiento científico con el fin de encarar dicho problema. En este trabajo realizamos una propuesta de caracterización de la cultura científica comunitaria. Posteriormente, procedemos a aplicarla y contrastarla respecto del caso de los colectivos de afectados por la COVID persistente. La metodología empleada se ha basado en el análisis documental.

In this study, 338 microorganisms, comprising 271 bacteria and 67 fungi, were isolated from sediment samples collected from underexplored Pacific and Caribbean regions of Colombia. Screening trials were conducted on selected strains (n = 276) to assess their tolerance to cadmium (Cd2+), lead (Pb2+), and zinc (Zn2+), leading to the identification of six bacteria capable of withstanding 750 mg·L−1 of each heavy metal ion. Three promising microorganisms, identified as Enterobacter sp. INV PRT213, Pseudomonas sp. INV PRT215, and Stenotrophomonas sp. INV PRT216 were selected for lead removal experiments using LB broth medium supplemented with 400 mg·L−1 Pb2+. Among these, Pseudomonas sp. INV PRT215 exhibited significant potential, removing 49% of initial Pb2+ after 240 min of exposure (16.7 g wet biomass·L−1, pH 5, 30 °C). Infrared spectra of Pb-exposed biomass showed changes in functional groups, including carbonyl groups of amides, carboxylate, phosphate, hydroxyl, and amine groups, compared to the not-exposed control. These changes suggested interactions between the metal and functional groups in the biomass. The findings of this study highlight the potential of microorganisms derived from coastal marine environments as promising candidates for future applications in bioremediation of polluted environments contaminated with heavy metals.

Background: Determining the infiltration of carcinomas is essential for the proper follow-up and treatment of cancer patients. However, it continues to be a diagnostic challenge for pathologists in multiple types of tumors. In previous studies (carried out in surgical specimens), the protein COL11A1 has been postulated as an infiltration marker mainly expressed in the extracellular matrix (ECM). We hypothesized that a differential expression of COL11A1 may exist in the peritumoral stroma of tumors that have acquired infiltrating properties and that it may be detected in the small biopsies usually available in normal clinical practice. Material and methods: In our study, we performed immunohistochemical staining in more than 350 invasive and noninvasive small samples obtained via core needle biopsy (CNB), colonoscopy, or transurethral resection of bladder tumor (TURBT) of breast, colorectal, bladder, and ovarian cancer. Results: Our results revealed that COL11A1 immunostaining had a sensitivity to classify the samples into infiltrative vs. noninfiltrative tumors of 94% (breast), 97% (colorectal), >90% (bladder), and 74% (ovarian); and a specificity of 97% (breast), 100% (colorectal), and >90% (bladder). In ovarian cancer, the negative predictive value (0.59) did not present improvement over the usual histopathological markers. In all samples tested, the cumulative sensitivity was 86% and the specificity 96% (p < 0.0001). Conclusions: COL11A1-positive immunostaining in small biopsies of breast, colon, bladder and ovarian cancer is an accurate predictive marker of tumor infiltration that can be easily implemented in daily clinical practice.

Este estudio investiga la distribución espacial de los casos de Covid-19 en la provincia de Santa Fe, Argentina, en el periodo entre marzo de 2020 y abril de 2021. Identifica patrones de agrupamiento de distritos en periodos de tiempo seleccionados y analiza la relación entre la incidencia de casos y un índice de calidad de vida (ICV). Los datos provienen del Ministerio de Salud de la Provincia de Santa Fe y del censo Nacional de Población de 2010 (INDEC) y de una proyección al año 2020 (IPEC). La autocorrelación espacial se evaluó mediante el Índice de Moran Global. Los resultados mediante el Índice de Moran Local mostraron una autocorrelación espacial positiva de la incidencia de casos de Covid-19 en los distritos santafesinos y notorios contrastes espacio-temporales: con-glomerados con indicador alto en las regiones sur y centro, y conglo-merados con baja incidencia en el norte.

Abstract Biosurfactants are amphiphilic surface-active molecules of microbial origin principally produced by hydrocarbon-degrading bacteria; in addition to the bioremediation properties, they can also present antimicrobial activity. The present study highlights the chemical characterization and the antimicrobial activities of biosurfactants produced by deep-sea marine bacteria from the genera Halomonas, Bacillus, Streptomyces, and Pseudomonas. The biosurfactants were extracted and chemically characterized through Chromatography TLC, FT-IR, LC/ESI–MS/MS, and a metabolic analysis was done through molecular networking. Six biosurfactants were identified by dereplication tools from GNPS and some surfactin isoforms were identified by molecular networking. The half-maximal inhibitory concentration (IC50) of biosurfactant from Halomonas sp. INV PRT125 (7.27 mg L−1) and Halomonas sp. INV PRT124 (8.92 mg L−1) were most effective against the pathogenic yeast Candida albicans ATCC 10231. For Methicillin-resistant Staphylococcus aureus ATCC 43300, the biosurfactant from Bacillus sp. INV FIR48 was the most effective with IC50 values of 25.65 mg L−1 and 21.54 mg L−1 for C. albicans, without hemolytic effect (

Las sernas constituyen uno de los principales espacios comunales altomedievales, pero su definición resulta esquiva. Dada la diversidad de cultivos, la clave debe encontrarse en las formas de organización y gestión. El artículo analiza cuatro casos de estudio situados en diferentes localidades del valle del Duero (Viñayo, Valdesaz de los Oteros y Villasinta de Torío) y en el actual norte de Portugal (Arouca). La evidencia prueba la existencia de un modelo basado en dos niveles de propiedad. Por un lado y en un nivel superior, una autoridad encargada de velar por la salvaguarda y el correcto uso de las sernas, actuando como árbitro en caso de conflicto o como defensor en caso de amenaza. Por otro lado, y en un nivel inferior, se encontrarían los derechos de acceso de las comunidades, los cuales permitían el aprovechamiento familiar de las diferentes unidades de explotación en las que podían estar divididas las sernas, probablemente a cambio de algún tipo de censo. Finalmente se vincula las sernas y su control con la noción de «economía moral» y las formas de legitimación del dominio social.

En México los costos del manejo gubernamental de residuos son excesivos en un marco de gestión sostenible. La literatura reporta que las actividades económicas de adquisición de residuos en las grandes urbes revitalizan la economía local de zonas marginadas. El objetivo del trabajo fue analizar la distribución geoespacial de los centros de acopio privados [CAP] a partir de variables socioeconómicas que caracterizan a los sectores en base de la pirámide social en el municipio de Nezahualcóyotl. Este trabajo exploratorio utilizó la observación sistemática como estrategia de investigación principal: se realizó un análisis documental de variables sociodemográficas en bases de datos oficiales; con instrumentos de observación sistemática y recorridos virtuales se hizo la identificación y caracterización de CAP; se emplearon sistemas de información geográfica para analizar y representar la interacción de los CAP con su entorno social y económico. Los resultados permitieron caracterizar 293 CAP que se establecen en zonas de nivel socioeconómico bajo y con poca intensidad industrial. Los CAP constituyen fuentes de empleo para la base de la pirámide social dinamizando temporalmente la economía local. Los CAP hacen un uso intensivo del espacio público apropiándoselo para abatir los costos de operación lo que los hace insostenibles.

Introduction: The aim of this prospective descriptive study was to analyse the possible variables associated with marginal bone loss in rehabilitated implants (Proclinic S.A.U, Zaragoza, Spain) two years after their prosthetic loading. Materials and Methods: Three clinical centres collaborated for a period of two years after the prosthetic rehabilitation of the implants (Proclinic S.A.U, Zaragoza, Spain), in which marginal bone loss and the possible associated variables were evaluated. The collection form comprised different variables throughout different stages of the implant procedure, from implant insertion to the subsequent prosthetic rehabilitation, over a two-year period. Data of the patients and implant characteristics were studied. Statistical analysis was performed with SPSS for qualitative (univariate logistic regressions, Chi2 test, and Haberman’s corrected standardised residuals) and quantitative variables (Kolmogorov–Smirnov test). Results: The total study sample consisted of 218 implants (Proclinic S.A.U, Zaragoza, Spain). The sample presented a frequency of 99 men (45.4%) and 119 women (54.6%). The mean age of the patients among the reported cases was 58.56 ± 10.12 years. A statistically significant association was found between marginal bone loss 2 years after prosthetic rehabilitation placement and several variables, including age (under 55 years, 0.25 mm ± 0.56; 55–64 years, 0.74 mm ± 0.57; over 65 years, 0.63 mm ± 0.55; p < 0.0001), gender (female, 0.74 mm ± 0.61; male, 0.34 mm ± 0.51; p < 0.0001), bone quality (D1, 0.75 mm ± 0.62; D2, 0.43 mm ± 0.57; D3, 0.65 mm ± 0.60; p < 0.01), implant diameter (up to 4 mm, 0.49 mm ± 0.58; more than 4 mm, 1.21 mm ± 0.30; p < 0.0001), prosthetic connection type (direct to implant, 0.11 mm ± 0.58; transepithelial straight, 0.67 mm ± 0.57; transepithelial angled, 0.33 mm ± 0.25; p < 0001), implant model (internal conical, 0.17 mm ± 0.24; external conical, 0.48 mm ± 0.61; external cylindrical, 1.12 mm ± 0.32; p < 0.0001), prosthetic restoration type (full denture, 0.59 mm ± 0.59; partial denture, 0.50 mm ± 0.85; unitary crown, 0.08 mm ± 0.19; p < 0.05), and insertion torque (>35 N/cm, 0.53 mm ± 0.58; p < 0.01). Conclusions: At 2 years, marginal bone loss following prosthetic rehabilitation was shown to be influenced by multiple factors. Correct implantological planning is of vital importance for successful rehabilitation.

Background and objective: About 25% of patients with IgA nephropathy (IgAN) progress to stage 5 chronic kidney disease (CKD) after years of evolution. Various tools have been developed in recent years designed to predict which of the patients will had poorer outcomes. The value of circulating galactosyl-deficient IgA1 (Gd-IgA1) has been related to a worse evolution of IgAN in several studies. There are also some publications that relate higher APRIL values with a worse evolution. Recently, a new method has been developed that allows measuring the value of circulating Gd-IgA1 in a simpler way than those previously available. The objective of this study is to analyze the influence of circulating Gd-IgA1, measured by this method, on the progression of IgAN. Materials and methods: Forty-nine patients with a diagnosis of IgAN demonstrated by renal biopsy were selected in our center, without having received prior immunosuppressive treatment, for whom frozen serum was available. The median follow-up was 4 years. Gd-IgA1 was measured by lectin-independent ELISA with the monoclonal antibody KM55 (IgA1 kit Cat. No. 30111694. IBL Int., Hamburg, Germany). Likewise, APRIL levels were also measured in these patients. Results: 19 (38.8%) patients reached stage 5 CKD. The fourth quartile of circulating Gd-IgA1 was related to a higher cumulative risk of reaching stage 5 CKD in the Kaplan–Meier analysis (risk at the 5th year 39.4% vs. 24.3%, log rank p = 0.019). The Gd-IgA1 value was related to an increased risk of CKD stage 5 (HR 1.147, 95% CI 1.035–1.270, p = 0.009), regardless of glomerular filtration rate, proteinuria, the percentage of sclerosed glomeruli and the value of segmental sclerosis. We did not find significant differences in the APRIL values. Conclusions: The value of circulating Gd-IgA1 measured by the monoclonal antibody KM55 is related to a worse evolution of patients with IgAN independently of other variables, so it could be included in the study of patients to improve the prediction of the risk of disease progression. Resumen: Antecedentes y objetivo: En torno al 25% de los pacientes con nefropatía IgA (NIgA) progresa hacia el estadio 5 de la enfermedad renal crónica tras años de evolución. En los últimos años se han desarrollado diversas herramientas diseñadas para predecir qué pacientes evolucionan peor. El valor de IgA1 galactosil-deficiente (Gd-IgA1) circulante se ha relacionado con una peor evolución de la NIgA en algunos estudios. También hay varios trabajos que relacionan valores más elevados de APRIL con una peor evolución. Recientemente se ha desarrollado un método que permite medir el valor de Gd-IgA1 circulante de una manera más sencilla que los previamente disponibles. El objetivo de este estudio es analizar la influencia de la Gd-IgA1 circulante, medida por este método, en la progresión de la NIgA. Materiales y métodos: Se seleccionaron 49 pacientes con diagnóstico de NIgA demostrado mediante biopsia renal en nuestro centro, sin haber recibido tratamiento inmunosupresor previo, de los que se dispusiera de suero congelado. La mediana de seguimiento fue de cuatro años. Se midió Gd-IgA1 mediante ELISA independiente de lectina con el anticuerpo monoclonal KM55 (IgA1 kit Cat. No 30111694. IBL Int., Hamburgo, Alemania). Así mismo también se midieron los niveles de APRIL en estos pacientes. Resultados: 19 (38,8%) pacientes alcanzaron ERC estadio 5. El cuarto cuartil de Gd-IgA1 circulante se relacionaba con un mayor riesgo acumulado de llegar a ERC estadio 5 en el análisis de Kaplan–Meier (riesgo al 5 año 39,4% vs. 24,3%; log rank p = 0,019). El valor de Gd-IgA1 se relacionaba con un mayor riesgo de ERC estadio 5 (HR 1,147; IC 95%: 1,035–1,270; p = 0,009), independientemente del filtrado glomerular, la proteinuria, el porcentaje de glomérulos esclerosados y el valor de esclerosis segmentaria. No encontramos diferencias significativas en los valores de APRIL. Conclusiones: El valor de Gd-IgA1 circulante medido mediante el anticuerpo monoclonal KM55 se relaciona con una peor evolución de los pacientes con NIgA independientemente de otras variables, por lo que se podría incluir en el estudio de los pacientes para mejorar la predicción del riesgo de progresión de la enfermedad.

Summary The surge of SARS‐CoV‐2 has challenged health systems worldwide and efficient tests to detect viral particles, as well as antibodies generated against them, are needed. Specificity, sensitivity, promptness or scalability are the main parameters to estimate the final performance, but rarely all of them match in a single test. We have developed SCOVAM, a protein microarray with several viral antigens (spike, nucleocapsid, main protease Nsp5) as capturing probes in a fluorescence immunoassay for COVID‐19 serological testing. SCOVAM depicts IgG and IgM antibody responses against each of these proteins of 22 individuals in a single microscope slide. It detects specific IgM (0.094 μg ml‐1) and IgG (~0.017 μg ml‐1) and is scalable and cost‐effective. We validated SCOVAM by comparing with a widely used chemiluminescent commercial serological test (n = 742). SCOVAM showed twice the sensitivity and allowed following seroconversion in a single assay. By analysing the prevalence 4 months later in a subset of 76 positive sera, we still detected 93.42% of positives, almost doubling the detection of the commercial assay. The higher sensitivity of SCOVAM is especially relevant to screen sera for convalescent plasma‐based treatments, high‐throughput antibody response monitoring after vaccination or evaluation of vaccine efficiency.

Resumen: Antecedentes y objetivo: En torno al 25% de los pacientes con nefropatía IgA (NIgA) progresa hacia el estadio 5 de la enfermedad renal crónica tras años de evolución. En los últimos años se han desarrollado diversas herramientas diseñadas para predecir qué pacientes evolucionan peor. El valor de IgA1 galactosil-deficiente (Gd-IgA1) circulante se ha relacionado con una peor evolución de la NIgA en algunos estudios. También hay varios trabajos que relacionan valores más elevados de APRIL con una peor evolución. Recientemente se ha desarrollado un método que permite medir el valor de Gd-IgA1 circulante de una manera más sencilla que los previamente disponibles. El objetivo de este estudio es analizar la influencia de la Gd-IgA1 circulante, medida por este método, en la progresión de la NIgA. Materiales y métodos: Se seleccionaron 49 pacientes con diagnóstico de NIgA demostrado mediante biopsia renal en nuestro centro, sin haber recibido tratamiento inmunosupresor previo, de los que se dispusiera de suero congelado. La mediana de seguimiento fue de cuatro años. Se midió Gd-IgA1 mediante ELISA independiente de lectina con el anticuerpo monoclonal KM55 (IgA1 kit Cat. No 30111694. IBL Int., Hamburgo, Alemania). Así mismo también se midieron los niveles de APRIL en estos pacientes. Resultados: 19 (38,8%) pacientes alcanzaron ERC estadio 5. El cuarto cuartil de Gd-IgA1 circulante se relacionaba con un mayor riesgo acumulado de llegar a ERC estadio 5 en el análisis de Kaplan-Meier (riesgo al 5 año 39,4% vs. 24,3%; log rank p = 0,019). El valor de Gd-IgA1 se relacionaba con un mayor riesgo de ERC estadio 5 (HR 1,147; IC 95%: 1,035-1,270; p = 0,009), independientemente del filtrado glomerular, la proteinuria, el porcentaje de glomérulos esclerosados y el valor de esclerosis segmentaria. No encontramos diferencias significativas en los valores de APRIL. Conclusiones: El valor de Gd-IgA1 circulante medido mediante el anticuerpo monoclonal KM55 se relaciona con una peor evolución de los pacientes con NIgA independientemente de otras variables, por lo que se podría incluir en el estudio de los pacientes para mejorar la predicción del riesgo de progresión de la enfermedad. Abstract: Background and objective: About 25% of patients with IgA nephropathy (IgAN) progress to stage 5 chronic kidney disease (CKD) after years of evolution. Various tools have been developed in recent years designed to predict which of the patients will had poorer outcomes. The value of circulating galactosyl-deficient IgA1 (Gd-IgA1) has been related to a worse evolution of IgAN in several studies. There are also some publications that relate higher APRIL values with a worse evolution. Recently, a new method has been developed that allows measuring the value of circulating Gd-IgA1 in a simpler way than those previously available. The objective of this study is to analyze the influence of circulating Gd-IgA1, measured by this method, on the progression of IgAN. Materials and methods: Forty-nine patients with a diagnosis of IgAN demonstrated by renal biopsy were selected in our center, without having received prior immunosuppressive treatment, for whom frozen serum was available. The median follow-up was 4 years. Gd-IgA1 was measured by lectin-independent ELISA with the monoclonal antibody KM55 (IgA1 kit Cat. No. 30111694. IBL Int., Hamburg, Germany). Likewise, APRIL levels were also measured in these patients. Results: 19 (38.8%) patients reached stage 5 CKD. The fourth quartile of circulating Gd-IgA1 was related to a higher cumulative risk of reaching stage 5 CKD in the Kaplan–Meier analysis (risk at the 5th year 39.4% vs. 24.3%, log rank p = 0.019). The Gd-IgA1 value was related to an increased risk of CKD stage 5 (HR 1.147, 95% CI 1.035–1.270, p = 0.009), regardless of glomerular filtration rate, proteinuria, the percentage of sclerosed glomeruli and the value of segmental sclerosis. We did not find significant differences in the APRIL values. Conclusions: The value of circulating Gd-IgA1 measured by the monoclonal antibody KM55 is related to a worse evolution of patients with IgAN independently of other variables, so it could be included in the study of patients to improve the prediction of the risk of disease progression.

Resumen: Objetivo: Describir la evolución de la actividad asistencial y de la coordinación de un equipo especializado hospitalario (equipo de Atención Geriátrica Domiciliaria-AGD) en el apoyo a atención primaria (AP) para la atención de pacientes geriátricos. Emplazamiento: Antigua área de Salud-5 de la Comunidad de Madrid. Participantes, intervenciones y mediciones principales: Evaluación de los pacientes atendidos en su domicilio a petición de AP por AGD, en 1997-1999 y 20 años después, en 2017-2019. Se registraron variables sociodemográficas, clínicas, funcionales y mentales. También datos asistenciales como el tiempo hasta la primera visita, la estancia media, la procedencia y destino de los pacientes, el motivo de consulta y el motivo principal de discapacidad. Resultados: Se atendieron 524 pacientes (58% del total) solicitados desde AP en 1997-1999 y 1196 (72,2% del total) en 2017-2019. Actualmente se muestra un paciente de mayor edad, más incapacitado física y mentalmente, con mayor prevalencia de síndromes geriátricos y mayor fragilidad social. Ha aumentado la demencia como motivo principal de incapacidad, observándose un incremento de la Valoración Geriátrica Integral (VGI) y del control clínico como motivos principales de derivación. Conclusiones: En nuestro medio, transcurridos 20 años, AGD continúa siendo un importante apoyo para AP en el complejo abordaje de los pacientes ancianos frágiles recluidos en su domicilio, que son cada vez más vulnerables desde el punto de vista clínico, funcional, cognitivo y social. Contribuye en el manejo de los síndromes geriátricos, la deprescripción, los ingresos directos hospitalarios cuando se necesitan sin pasar por urgencias y la disminución en la institucionalización, facilitando el mantenimiento del paciente en su domicilio. Abstract: Objective: To describe the evolution of the care and coordination activity of a specialized hospital team (Geriatric Home Care-AGD team) in support of Primary Care (PC) for the care of geriatric patients. Location: Health-5 area of the Community of Madrid. Participants, interventions and main measurements: Evaluation of patients attended at home at the request of PC by AGD, in 1997-1999 and twenty years later, in 2017-2019. Sociodemographic, clinical, functional and mental variables were recorded. Also care data such as time to first visit, average length of stay, origin and destination of patients, reason for consultation and main reason for disability. Results: 524 patients (58% of the total) requested from AP in 1997-1999 and 1196 (72.2% of the total) in 2017-2019 were attended. Currently we show an older patient, more physically and mentally disabled, with a higher prevalence of geriatric syndromes and greater social fragility. Dementia has increased as the main reason for incapacity, with an increase in Comprehensive Geriatric Assessment and clinical control as the main reasons for referral. Conclusions: in our setting, after 20 years, AGD continues to be an important support for PC in the complex approach to frail elderly patients confined to their homes, who are increasingly vulnerable from a clinical, functional, cognitive and social point of view. It contributes to the management of geriatric syndromes, deprescription, direct hospital admissions when needed without having to go to the emergency department, and a decrease in institutionalization, facilitating the maintenance of the patient at home.