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Background and purpose: The aim of this study was to assess the possible pharmacological interactions between safinamide and antidepressants, and in particular the appearance of serotonin syndrome with data from real life. Methods: We conducted a retrospective observational study of patients with Parkinson's disease from our Movement Disorders Unit, who were under treatment with any antidepressant drug and safinamide. Specifically, symptoms suggestive of serotonin syndrome were screened for. Also, we collected time of simultaneous use, doses of levodopa and other antiparkinsonian drugs. Results: Clinical records were reviewed for the study period of September 2018 to September 2019. Seventy-eight PD patients who were treated with safinamide of which 25 (32.05%) had a concomitant treatment with an antidepressant drug, being sertraline and escitalopram the most frequent. Mean age was 80 years ± 8.43 and H&Y stage was 3 [2–4]. Mean dose of levodopa used was 703.75 mg ± 233.15. Median duration of concomitant treatment with safinamide and antidepressant drug was 6 months (IQR 20.5), and over eighteen months in 5 cases. No case of serotonin syndrome was recorded, neither was any of its typical manifestations combined or in isolation. Conclusions: Our real clinical practice study suggests that concomitant use of safinamide with antidepressant drugs in PD patients seemed to be safe and well tolerated, even in the long term. However, caution is warranted, individualizing treatment regimens and monitoring the potential appearance of adverse effects. Resumen: Objetivos: El objetivo de este estudio ha sido evaluar las posibles interacciones farmacológicas entre safinamida y antidepresivos; en particular la aparición del síndrome serotoninérgico mediante datos obtenidos en la vida real. Material y métodos: Realizamos un estudio observacional retrospectivo de pacientes con enfermedad de Parkinson (EP) de nuestra unidad de trastornos del movimiento, que estaban en tratamiento con algún fármaco antidepresivo y safinamida. Específicamente, se examinaron los síntomas sugestivos de síndrome serotoninérgico. Además, se recogieron tiempos de uso simultáneo, dosis de levodopa y otros fármacos antiparkinsonianos concomitantes. Resultados: Se revisaron las historias clínicas correspondientes al período de estudio de septiembre de 2018 a septiembre de 2019. Setenta y ocho pacientes con EP se encontraban en tratamiento con safinamida, de los cuales 25 (32,05%) se encontraban recibiendo además un fármaco antidepresivo, siendo sertralina y escitalopram los más frecuentes. La edad media fue de 80 años ± 8,43 y el estadio H&Y fue de 3 [2-4]. La dosis media de levodopa utilizada fue de 703,75 mg ± 233,15. La mediana de duración del tratamiento concomitante con safinamida y un fármaco antidepresivo fue de 6 meses (IQR: 20,5), y más de 18 meses en 5 casos. No se registró ningún caso de síndrome serotoninérgico, ni tampoco ninguno de sus síntomas de forma aislada. Conclusión: Nuestro estudio de práctica clínica real sugiere que el uso concomitante de safinamida con fármacos antidepresivos en pacientes con EP parece ser seguro y bien tolerado, incluso a largo plazo. Sin embargo, es necesaria precaución, individualizando los regímenes de tratamiento, y controlando la posible aparición de efectos adversos.

Abstract This study analyses body condition and digestive/metabolic parameters of Odontesthesargentinensis from Mar Chiquita Coastal Lagoon (MChCL) during different ovary maturity phases (II: developing; III: spawning capable; IIIas: actively spawning subphase). Silverside individuals in phases II and III maintained their body condition, while it improved in actively spawning subphase. Total weight and Fulton’s condition factor increase in 70% and 50%, respectively. No changes were observed during the ovary maturation phases in hepatosomatic index and intestinal coefficient. Maltase activity in the intestine remained unchanged, while Aminopeptidase-N was higher, about 300%, in the spawning capable phase (III). Alkaline phosphatase in the intestine was unchanged pointing out the maintenance of intestinal homeostasis. Liver glycogen concentration decreased, about 40%, in the actively spawning subphase (IIIas), while muscle glycogen abruptly decreased in phase III and recovered in subphase IIIas. In intestinal fat, triglycerides concentration was lower 70% in subphase IIIas, while no changes occurred in liver and muscle. Muscle protein concentration decreased about 50% in actively spawning subphase. The findings shed light on the remarkable adaptability of this population of O. argentinensis from MChCL to support its gonadal maturation and active spawning maintaining and even improving its physical condition.

The Canary/Iberia region (CIR), part of the Canary Current Upwelling System, is well-known for its coastal productivity and crucial role in enriching the oligotrophic open ocean through the offshore transport of the upwelled coastal waters. Given its significant ecological and socio-economic importance, it is essential to assess the impact of climate change on this area. Therefore, the goal of this study is to analyze the climate change signal over the CIR using a high-resolution regional climate system model driven by the Earth system model MPI-ESM-LR under RCP8.5 scenario. This modelling system presents a regional atmosphere model coupled to a global ocean model with enough horizontal resolution at CIR to examine the role of the upwelling favourable winds and the ocean stratification as key factors in the future changes. CIR exhibits significant latitudinal and seasonal variability in response to climate change under RCP8.5 scenario, where ocean stratification and wind patterns will play both complementary and competitive roles. Ocean stratification will increase from the Strait of Gibraltar to Cape Juby by the end of the century, weakening the coastal upwelling all year long. This increase in stratification is associated with a freshening of the surface layers of the North Atlantic. However, modifications in the wind pattern will play a primary role in upwelling source water depth changes in the southernmost region of the CIR in winter and in the north of the Iberian Peninsula in summer. Wind pattern changes are related to the intensification of the Azores High in winter and to a deepening of the Iberian thermal low in summer months.

Abstract Background 3D printing technology in hospitals facilitates production models such as point-of-care manufacturing. Orthopedic Surgery and Traumatology is the specialty that can most benefit from the advantages of these tools. The purpose of this study is to present the results of the integration of 3D printing technology in a Department of Orthopedic Surgery and Traumatology and to identify the productive model of the point-of-care manufacturing as a paradigm of personalized medicine. Methods Observational, descriptive, retrospective and monocentric study of a total of 623 additive manufacturing processes carried out in a Department of Orthopedic Surgery and Traumatology from November 2015 to March 2020. Variables such as product type, utility, time or materials for manufacture were analyzed. Results The areas of expertise that have performed more processes are Traumatology, Reconstructive and Orthopedic Oncology. Pre-operative planning is their primary use. Working and 3D printing hours, as well as the amount of 3D printing material used, vary according to the type of product or material delivered to perform the process. The most commonly used 3D printing material for manufacturing is polylactic acid, although biocompatible resin has been used to produce surgical guides. In addition, the hospital has worked on the co-design of customized implants with manufacturing companies. Conclusions The integration of 3D printing in a Department of Orthopedic Surgery and Traumatology allows identifying the conceptual evolution from “Do-It-Yourself” to “POC manufacturing”.

Abstract Background The integration of 3D printing technology in hospitals is evolving toward production models such as point-of-care manufacturing. This study aims to present the results of the integration of 3D printing technology in a manufacturing university hospital. Methods Observational, descriptive, retrospective, and monocentric study of 907 instances of 3D printing from November 2015 to March 2020. Variables such as product type, utility, time, or manufacturing materials were analyzed. Results Orthopedic Surgery and Traumatology, Oral and Maxillofacial Surgery, and Gynecology and Obstetrics are the medical specialties that have manufactured the largest number of processes. Working and printing time, as well as the amount of printing material, is different for different types of products and input data. The most common printing material was polylactic acid, although biocompatible resin was introduced to produce surgical guides. In addition, the hospital has worked on the co-design of custom-made implants with manufacturing companies and has also participated in tissue bio-printing projects. Conclusions The integration of 3D printing in a university hospital allows identifying the conceptual evolution to “point-of-care manufacturing.”

Abstract Background 3D printing and distributed manufacturing represent a paradigm shift in the health system that is becoming critical during the COVID-19 pandemic. University hospitals are also taking on the role of manufacturers of custom-made solutions thanks to 3D printing technology. Case Presentation We present a monocentric observational case study regarding the distributed manufacturing of three groups of products during the period of the COVID-19 pandemic from 14 March to 10 May 2020: personal protective equipment, ventilatory support, and diagnostic and consumable products. Networking during this period has enabled the delivery of a total of 17,276 units of products manufactured using 3D printing technology. The most manufactured product was the face shields and ear savers, while the one that achieved the greatest clinical impact was the mechanical ventilation adapters and swabs. The products were manufactured by individuals in 57.3% of the cases, and our hospital acted as the main delivery node in a hub with 10 other hospitals. The main advantage of this production model is the fast response to stock needs, being able to adapt almost in real time. Conclusions The role of 3D printing in the hospital environment allows the reconciliation of in-house and distributed manufacturing with traditional production, providing custom-made adaptation of the specifications, as well as maximum efficiency in the working and availability of resources, which is of special importance at critical times for health systems such as the current COVID-19 pandemic.

Resumen: La impresión 3D (I3D) es una tecnología de fabricación aditiva con un creciente interés en medicina y, sobre todo, en la especialidad de cirugía ortopédica y traumatología. Hay numerosas aplicaciones que aportan un valor añadido al tratamiento personalizado de los pacientes: planificación preoperatoria avanzada, cirugías con herramientas específicas para cada paciente, tratamientos ortésicos a medida, implantes o prótesis personalizadas y un desarrollo innovador en el campo de la ingeniería de tejidos óseos y cartilaginosos.En el presente trabajo se realiza una actualización sobre el papel que el cirujano ortopédico y traumatólogo desempeña como usuario y como médico prescriptor de esta tecnología y se hace un repaso a las etapas necesarias para una correcta integración de la I3D en el flujo asistencial hospitalario, desde los recursos necesarios hasta las recomendaciones legales actuales. Abstract: 3D printing (I3D) is an additive manufacturing technology with a growing interest in medicine and especially in the specialty of orthopaedic surgery and traumatology. There are numerous applications that add value to the personalised treatment of patients: advanced preoperative planning, surgeries with specific tools for each patient, customised orthotic treatments, personalised implants or prostheses and innovative development in the field of bone and cartilage tissue engineering.This paper provides an update on the role that the orthopaedic surgeon and traumatologist plays as a user and prescriber of this technology and a review of the stages required for the correct integration of I3D into the hospital care flow, from the necessary resources to the current legal recommendations.

We analyze the climate change signal in the Mediterranean Sea using the regionally coupled model REMO–OASIS–MPIOM (ROM; abbreviated from the regional atmosphere model, the OASIS3 coupler and the Max Planck Institute Ocean Model). The ROM oceanic component is global with regionally high horizontal resolution in the Mediterranean Sea so that the water exchanges with the adjacent North Atlantic and Black Sea are explicitly simulated. Simulations forced by ERA-Interim show an accurate representation of the present Mediterranean climate. Our analysis of the RCP8.5 (representative concentration pathway) scenario using the Max Planck Institute Earth System Model shows that the Mediterranean waters will be warmer and saltier throughout most of the basin by the end of this century. In the upper ocean layer, temperature is projected to have a mean increase of 2.7 ∘C, while the mean salinity will increase by 0.2 psu, presenting a decreasing trend in the western Mediterranean in contrast to the rest of the basin. The warming initially takes place at the surface and propagates gradually to deeper layers. Hydrographic changes have an impact on intermediate water characteristics, potentially affecting the Mediterranean thermohaline circulation in the future.