Search

The height of the 0 °C isotherm (H0), which commonly signals the freezing level, denotes the lowest altitude within the atmosphere where the air temperature reaches 0 °C. This can be used as an indicator of the transition between rain and snow, making it useful for monitoring and visualizing the height of freezing temperatures in the atmosphere. We study the spatial and temporal variability of H0 across Patagonia (41–54° S) for the 1959–2021 period using reanalysis data from ERA5. Our results indicate that the average isotherm in Patagonia is 1691 m above sea level (m a.s.l.). The spatial distribution of the annual mean field highlights the contrast in the region, with an average maximum of 2658 m a.s.l. in the north and minimum of 913 m a.s.l. in the south. Regarding seasonal variability in the region, H0 ranges from 575 m a.s.l. (winter) to 3346 m a.s.l. (summer). Further, the significant trends calculated over the period show positive values in the whole area. This indicates an upward annual trend in the H0, between 8.8 and 36.5 m per decade from 1959–2021, with the higher value observed in northwestern Patagonia. These upward trends are stronger during summer (8–61 m per decade). Empirical orthogonal function (EOF) analysis was performed on H0 anomalies. The first EOF mode of H0 variability accounts for 84 % of the total variance, depicting a monopole structure centred in the northwestern area. This mode exhibits a strong and significant correlation with the spatial average H0 anomaly field (r=0.85), the Southern Annular Mode (SAM; r= 0.58), temperature at 850 hPa in the Drake Passage (r=0.56), and sea surface temperature off the western coast of Patagonia (r=0.66), underscoring the significant role of these factors in influencing the vertical temperature profile within the region. The spatial distribution of the second (8 %) and third (4.4 %) EOF modes depicts a dipole pattern, offering additional insights into the processes influencing the 0 °C isotherm, especially on the western slope of Patagonia.

The impacts of the accelerated glacier retreat in recent decades on glacier runoff changes are still unknown in most Andean catchments, increasing uncertainties in estimating water availability. This particularly affects the outer tropics and Dry Andes, heavily impacted by prolonged droughts. Current global estimates overlook climatic and morphometric disparities, which significantly influence model parameters, among Andean glaciers. Meanwhile, local studies have used different approaches to estimate glacier runoff in a few catchments. Improving 21st-century glacier runoff projections relies on calibrating and validating models using corrected historical climate inputs and calibrated parameters across diverse glaciological zones. Here, we simulate glacier evolution and related runoff changes between the periods 2000–2009 and 2010–2019 across 786 Andean catchments (11 282 km2 of glacierized area, 11° N to 55° S) using the Open Global Glacier Model (OGGM). TerraClimate atmospheric variables were corrected using in situ data, getting a mean temperature bias by up to 2.1 °C and enhanced monthly precipitation. Glacier mass balance and volume were calibrated, where melt factor and the Glen A parameter exhibited significant alignment with varying environmental conditions. Simulation outcomes were validated against in situ data in three documented catchments (with a glacierized area > 8 %) and monitored glaciers. Our results at the Andes scale reveal an average reduction of 8.3 % in glacier volume and a decrease of 2.2 % in surface area between the periods 2000–2009 and 2010–2019. Comparing these two periods, glacier and climate variations have led to a 12 % increase in mean annual glacier melt (86.5 m3 s−1) and a decrease in rainfall on glaciers of −2 % (−7.6 m3 s−1) across the Andes, with both variables comprising the glacier runoff. We confirmed the utility of our corrected regional simulations of glacier runoff contribution at the catchment scale, where our estimations align with previous studies (e.g., Maipo 34° S, Chile) as well as provide new insights on the seasonal glaciers' largest contribution (e.g., La Paz 16° S, Bolivia) and new estimates of glacier runoff contribution (e.g., Baker 47° S, Chile).

Small specimen testing technology (SSTT) refers to the examination of tiny samples of materials to evaluate their suitability for use in fusion reactors. This includes assessing their thermal, mechanical, and radiation properties, as well as their ability to withstand extreme conditions. SSTT plays a critical role in the development of nuclear fusion technology, which holds the potential to provide a virtually limitless and clean energy source. SSTT is imperative in cases where not much material is available or must be subjected to special conditions that limit it.One of the main challenges in nuclear fusion is the development of materials that can withstand the harsh environment inside a fusion reactor. These materials must be able to withstand high temperatures, intense radiation, and mechanical stress, and be able to maintain their structural integrity for long periods. Small specimen testing allows characterizing and evaluating these properties in a controlled and efficient manner.Small specimen samples, under conditions similar to those in a fusion reactor, will provide crucial information for the design and development of fusion components when irradiated at IFMIF- DONES. The results of SSTT are used to refine materials, optimize production processes, and develop new materials with improved properties.In this work, numerous tensile tests (SSTT) have been carried out on pure copper, a material of interest for fusion with different thicknesses, analyzing the effect of the variation of this variable in the determination of mechanical properties.

Resumen: Introducción: El infarto medular es una entidad infrecuente y con elevada morbilidad. El diagnóstico puede resultar difícil y el tratamiento óptimo sigue siendo controvertido. Existen pocas series de casos publicadas. Métodos: Estudio retrospectivo de infarto medular en un hospital terciario desde 1999 a 2020. Se evaluaron la etiología, las características clínicas, radiológicas, terapéuticas y pronósticas. Resultados: Se incluyeron 41 pacientes (58,5% varones, edad media 61 ±17 años). Treinta y un pacientes (75,6%) presentaban factores de riesgo vascular (FRV). Presentaron déficit motor (39, 95,1%), dolor (20, 48,8%), déficit sensitivo (33, 80,4%) y alteración autonómica (24, 58,5%). Se realizó resonancia magnética (RM) en 37 pacientes (90,2%). En los 12 pacientes con secuencias de difusión, esta estaba alterada en 10. La localización más afectada fue la dorsal (68,2%). Se realizó estudio vascular en 33 pacientes (80,4%). Las etiologías más frecuentes fueron disección aórtica en 6, ateroesclerosis demostrada en estudio vascular en 6, embolia fibrocartilaginosa en 6, posquirúrgico en 5 e hipotensión en 4. El mecanismo etiológico quedó sin filiar en 12 pacientes (29,3%), 9 presentaban FRV. Al final del periodo de seguimiento (mediana 24 meses, rango intercuartílico 3-70), 12 pacientes (29,2%) presentaban deambulación autónoma. La presencia de FRV y la paraparesia se asociaron significativamente a peor pronóstico (p

Introduction: Spinal cord infarction is a rare disease with a high rate of morbidity. Its diagnosis can be challenging and controversy remains regarding the best treatment. Few case series have been published. Methods: We conducted a retrospective review of cases of spinal cord infarction attended in a tertiary hospital from 1999 to 2020. Aetiology and clinical, imaging, and prognostic features were assessed. Results: Forty-one patients (58.5% men, mean [standard deviation] age 61 [17] years) were included in the study. Thirty-one patients (75.6%) presented vascular risk factors. Motor deficits were recorded in 39 (95.1%), pain in 20 (48.8%), sensory deficits in 33 (80.4%), and autonomic dysfunction in 24 (58.5%). MRI was performed in 37 (90.2%) patients. Diffusion-weighted images were available for 12 patients, with 10 showing diffusion restriction. The thoracic region was the most frequently affected (68.2%). Vascular imaging studies were performed in 33 patients (80.4%). The most frequent aetiologies were aortic dissection (6 cases), atherosclerosis demonstrated by vascular imaging (6 cases), fibrocartilaginous embolism (6 cases), surgery (5 cases), and hypotension (4 cases). Aetiology was undetermined in 12 patients (29.3%), although 9 of these presented vascular risk factors. At the end of the follow-up period (median, 24 months; interquartile range, 3–70), 12 patients (29.2%) were able to walk without assistance. Vascular risk factors and paraparesis were significantly associated with poorer prognosis (P

Background and purpose: MAPKs are among the most relevant signalling pathways involved in coordinating cell responses to different stimuli. This group includes p38MAPKs, constituted by 4 different proteins with a high sequence homology: MAPK14 (p38α), MAPK11 (p38β), MAPK12 (p38γ) and MAPK13 (p38δ). Despite their high similarity, each member shows unique expression patterns and even exclusive functions. Thus, analysing protein-specific functions of MAPK members is necessary to unequivocally uncover the roles of this signalling pathway. Here, we investigate the possible role of MAPK11 in the cell response to ionizing radiation (IR). Materials and methods: We developed MAPK11/14 knockdown through shRNA and CRISPR interference gene perturbation approaches and analysed the downstream effects on cell responses to ionizing radiation in A549, HCT-116 and MCF-7 cancer cell lines. Specifically, we assessed IR toxicity by clonogenic assays; DNA damage response activity by immunocytochemistry; apoptosis and cell cycle by flow cytometry (Annexin V and propidium iodide, respectively); DNA repair by comet assay; and senescence induction by both X-Gal staining and gene expression of senescence-associated genes by RT-qPCR. Results: Our findings demonstrate a critical role of MAPK11 in the cellular response to IR by controlling the associated senescent phenotype, and without observable effects on DNA damage response, apoptosis, cell cycle or DNA damage repair. Conclusion: Our results highlight MAPK11 as a novel mediator of the cellular response to ionizing radiation through the control exerted onto IR-associated senescence.

Introduction: The sofosbuvir-velpatasvir (SOF/VEL) combination is a direct-acting antiviral therapy that is authorized and available in Mexico, making the performance of a real-world multicenter study that evaluates the sustained virologic response at 12 weeks post-treatment a relevant undertaking. Methods: A retrospective review of the case records of 241 patients seen at 20 hospitals in Mexico was conducted to assess hepatitis C treatment with the SOF/VEL combination (n = 231) and the sofosbuvir/velpatasvir/ribavirin (SOF/VEL/RBV) combination (n = 10). The primary efficacy endpoint was the percentage of patients that achieved SVR at 12 weeks after the end of treatment. Results: Overall SVR was 98.8% (95% CI 97.35–100%). Only three patients did not achieve SVR, two of whom had cirrhosis and a history of previous treatment with peg-IFN. Of the subgroups analyzed, all the patients with HIV coinfection, three patients with genotype 3, and the patients treated with the SOF/VEL/RBV combination achieved SVR. The subgroups with the lower success rates were patients that were treatment-experienced (96.8%) and patients with F1 fibrosis (95.5%). The most frequent adverse events were fatigue, headache, and insomnia. No serious adverse events were reported. Conclusion: Treatments with SOF/VEL and SOF/VEL/RBV were highly safe and effective, results coinciding with those of other international real-world studies. Resumen: Introducción: La combinación de sofosbuvir-velpatasvir (SOF/VEL) es una terapia antiviral de acción directa que está autorizada y disponible en México. Esto hace que la evaluación de la respuesta virológica sostenida (RVS) 12 semanas después del tratamiento, por medio de la realización de una revisión multicentro en el mundo real, sea una tarea relevante. Métodos: Se efectuó una revisión retrospectiva de los registros de 241 casos de pacientes atendidos en 20 hospitales en México para evaluar el tratamiento contra la hepatitis C con la combinación SOF/VEL (n = 231) y sofosbuvir/velpatasvir/ribavirin (SOF/VEL/RBV) (n = 10). El objetivo de eficacia primario fue el porcentaje de pacientes que lograron la RVS 12 semanas posterior a la finalización del tratamiento. Resultados: En general, la RVS fue de 98.8% (IC 95% 97.35 a 100%). Solo tres pacientes no lograron la RVS, de los cuales dos padecían cirrosis y una tenía historia previa de tratamiento con interferón pegilado (peg-IFN). De los subgrupos analizados, todos los casos con infección de virus de la inmunodeficiencia humana (VIH), tres con genotipo 3 y aquellos tratados con la combinación SOF/VEL/RBV, lograron RVS. Los subgrupos con tasas menores de éxito fueron los pacientes que tenían experiencia con tratamiento (96.8%) y pacientes con fibrosis F1 (95.5%). Los eventos adversos más frecuentes fueron fatiga, cefalea e insomnio. No se reportaron eventos adversos graves. Conclusión: Los tratamientos con SOF/VEL y SOF/VEL/RBV fueron altamente seguros y efectivos y los resultados coinciden con los de otros estudios internacionales realizados en el mundo real.

Resumen: Introducción: La combinación de sofosbuvir-velpatasvir (SOF/VEL) es una terapia antiviral de acción directa que está autorizada y disponible en México. Esto hace que la evaluación de la respuesta virológica sostenida (RVS) 12 semanas después del tratamiento, por medio de la realización de una revisión multicentro en el mundo real, sea una tarea relevante. Métodos: Se efectuó una revisión retrospectiva de los registros de 241 casos de pacientes atendidos en 20 hospitales en México para evaluar el tratamiento contra la hepatitis C con la combinación SOF/VEL (n = 231) y sofosbuvir/velpatasvir/ribavirin (SOF/VEL/RBV) (n = 10). El objetivo de eficacia primario fue el porcentaje de pacientes que lograron la RVS 12 semanas posterior a la finalización del tratamiento. Resultados: En general, la RVS fue de 98.8% (IC 95% 97.35 a 100%). Solo tres pacientes no lograron la RVS, de los cuales dos padecían cirrosis y una tenía historia previa de tratamiento con interferón pegilado (peg-IFN). De los subgrupos analizados, todos los casos con infección de virus de la inmunodeficiencia humana (VIH), tres con genotipo 3 y aquellos tratados con la combinación SOF/VEL/RBV, lograron RVS. Los subgrupos con tasas menores de éxito fueron los pacientes que tenían experiencia con tratamiento (96.8%) y pacientes con fibrosis F1 (95.5%). Los eventos adversos más frecuentes fueron fatiga, cefalea e insomnio. No se reportaron eventos adversos graves. Conclusión: Los tratamientos con SOF/VEL y SOF/VEL/RBV fueron altamente seguros y efectivos y los resultados coinciden con los de otros estudios internacionales realizados en el mundo real. Abstract: Introduction: The sofosbuvir-velpatasvir (SOF/VEL) combination is a direct-acting antiviral therapy that is authorized and available in Mexico, making the performance of a real-world multicenter study that evaluates the sustained virologic response at 12 weeks post-treatment a relevant undertaking. Methods: A retrospective review of the case records of 241 patients seen at 20 hospitals in Mexico was conducted to assess hepatitis C treatment with the SOF/VEL combination (n = 231) and the sofosbuvir/velpatasvir/ribavirin (SOF/VEL/RBV) combination (n = 10). The primary efficacy endpoint was the percentage of patients that achieved SVR at 12 weeks after the end of treatment. Results: Overall SVR was 98.8% (95% CI 97.35-100%). Only three patients did not achieve SVR, two of whom had cirrhosis and a history of previous treatment with peg-IFN. Of the subgroups analyzed, all the patients with HIV coinfection, three patients with genotype 3, and the patients treated with the SOF/VEL/RBV combination achieved SVR. The subgroups with the lower success rates were patients that were treatment-experienced (96.8%) and patients with F1 fibrosis (95.5%). The most frequent adverse events were fatigue, headache, and insomnia. No serious adverse events were reported. Conclusion: Treatments with SOF/VEL and SOF/VEL/RBV were highly safe and effective, results coinciding with those of other international real-world studies.

Modal mass is one of the modal parameters that are required to define the dynamic behavior of a structure when a modal model is used. In experimental modal analysis (EMA), modal masses are the least reliable modal parameter, while in operational modal analysis (OMA), modal masses cannot be estimated because the exciting forces are not measured. In this paper, the concept of cross-length between mode shapes is formulated for continuous and discrete systems, and important properties are derived from this definition. It is demonstrated that the cross-length is zero for all modes in constant mass density systems. For structures consisting of parts with different mass density, equations that relate the partial cross-lengths over the different volumes and the total masses of the different parts can be formulated for each mode, i.e., there is a relationship between the cross-length and the total mass of the parts with different mass density. The equations proposed in the paper have been validated through numerical simulations and experimental testing on two lab-scaled structures. This methodology can also be applied as a correlation technique, specifically to determine how the mass is distributed in the structure, as well as a technique to construct a proportional FRF in constant mass density systems.

Abstract The COVID-19 pandemic has represented a major cause of morbidity/mortality worldwide, overstressing health systems. Multiple myeloma (MM) patients show an increased risk for infections and they are expected to be particularly vulnerable to SARS-CoV-2 infection. Here we have obtained a comprehensive picture of the impact of COVID-19 in MM patients on a local and a global scale using a federated data research network (TriNetX) that provided access to Electronic Medical Records (EMR) from Health Care Organizations (HCO) all over the world. Through propensity score matched analyses we found that the number of new diagnoses of MM was reduced in 2020 compared to 2019 (RR 0.86, 95%CI 0.76–0.96) and the survival of newly diagnosed MM cases decreased similarly (HR 0.61, 0.38–0.81). MM patients showed higher risk of SARS-CoV-2 infection (RR 2.09, 1.58–2.76) and a higher excess mortality in 2020 (difference in excess mortality 9%, 4.4–13.2) than non-MM patients. By interrogating large EMR datasets from HCO in Europe and globally, we confirmed that MM patients have been more severely impacted by COVID-19 pandemic than non-MM patients. This study highlights the necessity of extending preventive measures worlwide to protect vulnerable patients from SARS-CoV-2 infection by promoting social distancing and an intensive vaccination strategies.

Abstract Background Availability of clinically effective and cost-effective treatments for severe asthma would be beneficial to patients and national healthcare systems. The aim of this study was to evaluate clinical outcomes and healthcare expenditure after incorporating benralizumab into the standard treatment of refractory eosinophilic asthma. Methods This was a cross-sectional multicentre study of consecutive patients with refractory eosinophilic asthma who received treatment with benralizumab during at least 12 months. Patient follow-up was performed in specialised severe asthma units. The main effectiveness parameters measured were: the avoidance of one asthma exacerbation, a 3-point increase in the asthma control test (ACT) score, and the difference in utility scores (health-related quality of life) between a 1-year baseline treatment and 1-year benralizumab treatment. The health economic evaluation included direct costs and incremental cost-effectiveness ratios (ICERs). Results After 1 year of treatment with benralizumab, patients with refractory eosinophilic asthma showed an improvement in all the effectiveness parameters analysed: improvement of asthma control and lung function, and decrease in the number of exacerbations, oral corticosteroid (both as corticosteroid courses and maintenance therapy), and inhaled corticosteroid use. The total annual cost per patient for the baseline and benralizumab treatment periods were €11,544 and €14,043, respectively, reflecting an increase in costs due to the price of the biological agent but a decrease in costs for the remaining parameters. The ICER was €602 per avoided exacerbation and €983.86 for every 3-point increase in the ACT score. Conclusions All the pharmacoeconomic parameters analysed show that treatment with benralizumab is a cost-effective option as an add-on therapy in patients with refractory eosinophilic asthma.

Abstract Background Glioblastoma (GBM) is one of the most aggressive and vascularized brain tumors in adults, with a median survival of 20.9 months. In newly diagnosed and recurrent GBM, bevacizumab demonstrated an increase in progression-free survival, but not in overall survival. Methods We conducted an in silico analysis of VEGF expression, in a cohort of 1082 glioma patients. Then, to determine whether appropriate bevacizumab dose adjustment could increase the anti-angiogenic response, we used in vitro and in vivo GBM models. Additionally, we analyzed VEGFA expression in tissue, serum, and plasma in a cohort of GBM patients before and during bevacizumab treatment. Results We identified that 20% of primary GBM did not express VEGFA suggesting that these patients would probably not respond to bevacizumab therapy as we proved in vitro and in vivo. We found that a specific dose of bevacizumab calculated based on VEGFA expression levels increases the response to treatment in cell culture and serum samples from mice bearing GBM tumors. Additionally, in a cohort of GBM patients, we observed a correlation of VEGFA levels in serum, but not in plasma, with bevacizumab treatment performance. Conclusions Our data suggest that bevacizumab dose adjustment could improve clinical outcomes in Glioblastoma treatment.

Purpose: The rational use of antimicrobials is essential and can be achieved through antimicrobial stewardship programs. Although several studies identify the clonal relationships of nosocomial carbapenemase KPC-producing Klebsiella pneumoniae (KPC-Kp) strains, none of them, at our knowledge, investigates at the same time clonal status of colonizing KPC-Kp strains. Our aim was to perform a whole-genome sequencing (WGS) of both, colonizing and infecting KPC-Kp strains, to perform genomic analysis, and identification of acquired antimicrobial resistance genes (ARG). Methods & Materials: A 38 years old woman received a deceased donor kidney transplant in 2013 after 11 years of hemodialysis. The patient developed recurrent urinary tract infections (UTI) with high antibiotic exposition. First sample analyzed was a colonizing strain isolated the first day of hospitalization (HAp39) from a surveillance rectal swab. The second strain was isolated 7 days after hospitalization (HA40) from a urine sample taken in context of UTI suspicion. Both strains showed reduced susceptibility to β-lactams, sulfamethoxazole, trimethoprim, chloramphenicol, tetracycline, and ciprofloxacin according to CLSI, 2020. WGS was carried out using Illumina MiSeq-I, and de novo assembly was performed using SPAdes v.3.11. Genomic analysis was made. Results: Both strains belonged to ST11. They possessed in common a total of 21 transferable ARG, aadA1, aac(6′)-Ib, aph(3′')-Ib, aph(6)-Id, arr-3, blaKPC-2, blaOXA-1, blaOXA-9, blaTEM-1A, catB3, floR, fosA, mph(E), msr(E), oqxA, oqxB, qacEΔ1, qnrB19, sul1, sul2, and tet(A). HAp39 strain also harbored a second carbapenemase blaOXA-163, and a dfrA22-like gene. blaOXA-163 had as flanking sequences IS4(TnpA)-blaOXA-163- HP-Tn3 family (TnpA). Loss of blaOXA-163, and dfrA22-like gene was observed in HA40 strain, though acquisition of blaCTX-M-2, rmtD and a cat-like genes were identified in this strain. The blaKPC-2 gene was located in the same genetic platform (ISKpn27-blaKPC2- ISKpn6-HP-Tn3 (TnpR)) in both strains Conclusion: Colonizing and infecting KPC-Kp strains showed to belong to the same ST11 with a high similarity at DNA level, suggesting they are the same strains. Loss and acquisition of ARG during the hospitalization was observed. Also, a change in epidemiology is being observed displacing KPC-Kp ST258 isolates suggesting that molecular surveillance of ST11 KPC-Kp should be performed in our region to prevent further spread.

Purpose: Rapid spread of multidrug resistant Gram-negative bacilli (MDR-GNB) infection in Coronavirus disease (COVID-19) critically ill patients was observed even in those without underlying diseases and in all age groups. We conducted a prospective cohort study to assess the risk factors for acquisition of MDR-GNB infection in COVID-19 patients and its impact on patients´ outcome. Methods & Materials: We included 43 consecutive patients with COVID-19 from a total of 8874 patients with COVID-19 admitted into the ICU of Aleman Hospital, Argentina, from May 1st 2020 to June 30th 2021. Followed up until death or 30 days after hospital discharge. We divided them into 4 groups: colonized with MDR-GNB (G1), colonized with MDR-GNB and infected with non-carbapenem resistant bacteria (G2), colonized and infected with MDR-GNB (G3), and infected with MDR-GNB without previous colonization (G4). Microbiological sampling was performed according to patient's conditions or epidemiological surveillance. Outcomes considered were length of hospital stay (LOS), mortality and readmission rate. Results: Seven, five, six and twenty five patients were distributed respectively in G1, G2, G3 and G4. Male/female ratio was 2:1 with a median age of 68 years (IQR 62–75). Chronic pulmonary disease (18.6%) was the main comorbidity. Mean LOS was 40.16 days (P=0.79). Prolonged biomedical devices used were observed in 93% of patients (P=0.33). Ventilator associated pneumonia (n:15/36) and catheter-related bloodstream infection (n:16/36) were the most frequent infections (P=0.29, P=0.69). The most common carbapenem-resistant pathogens were Klebsiella pneumoniae (n: 38/60) and Pseudomonas aeruginosa (n:8/60). All patients were exposed to antibiotics before MDR-GNB was diagnosed. The first isolation of MDR-GNB was on average 14 days after hospital admission (P=0,84). Time between MDR-GNB colonization and infection was twice as much between G2 and G3 (8.4 Vs. 4 days, P=0.83). We observed no difference in all-cause mortality rate and readmission rate between the groups (P=0.75, P=0.97). Conclusion: Prolonged ICU hospitalizations in addition to use of invasive devices and antibiotics exposure correlate with a higher risk of developing MDR-GNB colonization and infection in COVID-19 critically ill patients.

Introduction and Objectives: If direct antiviral agents (DAA) are related to the development of HCC is controversial; therefore, exploring risk factors are crucial. We aimed to determine factors related to the development of hepatocellular carcinoma (HCC) in patients with hepatitis c (HCV) and decompensated cirrhosis (DC) treated with DAA. Materials and Methods: A multicenter real-world cohort study including patients with HCV + DC treated with sofosbuvir (SOF) based on regimens free of inhibitors of protease (IPs). Results: 222 patients, 118 (53.2%) were women, mean age 57.2 ±11.5-year-old, 209 (94.1%) achieved sustained virological response (SVR). According to Child-Pugh 44(19.8%) were A with history of any clinical decompensation event, 147(66.2%) B, and 31 (14%) C. After DAA, 134 (60.4%) improve in MELD, 45 (20.3%) had no change, and 43 (19.4%) worse, this worse in MELD was related to non-SVR [SVR 37/209 (17.7%) vs. non-SVR 6/13 (46.2%); OR=2.6, 95%CI:1.4-5.0, p=0.02]. Nineteen (8.6%) developed HCC during the follow-up after therapy with DAA; however, when we compared basal laboratory values between those who developed HCC and those who did not only alfa-fetoprotein (AFP) levels were different (without HCC 14.3 [mean 95%CI: 10.6-18.1] ng/mL vs. HCC 55.7 [mean 95%CI: 28.4-83.0] ng/mL; p 20ng/mL, it is essential to note that patients in this cohort had no any suspicious lesion in ultrasonography (USG) previous to start DAA therapy in their semestral screening as most of the guidelines recommend. AASLD, for example, recommends semestral HCC screening with USG with or without AFP, giving more weight to the imagen study. However, based on our results, we recommend always determining AFP levels as a compliment to USG. Conclusions: In HCV patients with DC treated with DAA and with a negative basal screening USG for suspicious malignant lesions, basal AFP > 20ng/mL are the most critical factor related to the development of HCC and should be determined complementary to the USG study.The authors declare that there is no conflict of interest.

Introduction and Objectives: Clinical trials demonstrated the efficacy and safety of direct antiviral agents (DAA) to treat hepatitis C virus infection (HCV) in patients with decompensated cirrhosis (DC); however, very few real-world studies have been reported in this group. Moreover, predictive factors for non-achieving sustained virological response (SVR) in DC are not entirely understood. Therefore, the aim was to verify the efficacy and safety of DAA and to identify risk factors for failure to achieve SVR in DC. Materials and Methods: A real-world cohort study included HCV patients with DC [Child-Pugh B/C or A but with a history of previous clinical decompensation events like variceal bleeding (VB), hepatic encephalopathy (HE), or ascites]. All patients treated before transplant had MELD ≤ 20 and Child-Pugh ≤ 12 according to AASLD guidelines. Results: 222 patients, 118 (53.2%) were women, mean age 57.2±11.5 year-old, 61 (27.5%) were treated with Sofosbuvir(SOF)/Ledipasvir, 152 (68.5%) with SOF/Velpatasvir, and 9 (4.1%) with SOF/Daclatasvir, 175 (78.8%) used also ribavirin, 209 (94.1%) achieved SVR, despite non-significant difference, Child-Pugh C patients had a suboptimal response (SVR < 95%): A 42/44 (95.5%), B 140/147 (95.2%), C 27/31 (87.0%), p=0.2. Related adverse events were fatigue 60 (27%), nausea 44 (19.8%), headache 43 (19.4%), non-severe peripheral edema 10 (4.5%), anasarca 4 (1.8%), jaundice 6 (2.7%), 3 hemolytic anemia (1.4%), 1 dermatosis (0.4%), congestive cardiac failure 2 (0.9%), need to suspend therapy due to liver-related adverse events 2 (0.9%) they also died. In those who achieved SVR, MELD improved (basal 12.4±3.3 vs. post-SVR 10.9±3.5; p20 and Child-Pugh C >12 are related to non-SVR; however, our study also shows that additional clinical factors have a negative impact on SVR: history of recurrent VB and episodic and persistent HE; therefore, these criteria should also be considered to decide to treat previous or after liver transplantation. In addition, acute decompensation and mortality events are very high in those who do not achieve SVR. Conclusions: SOF based on regimens without PIs are effective and safe in VHC with DC. Additional to classic criteria (MELD >20, Child-Pugh > 12), recurrent VB and HE are predictors of failure to achieve SVR in VHC with DC.The authors declare that there is no conflict of interest.

Using the perceptions of a sample of 231 people from a Spanish region as a case study, this paper aims to respond to the increasing demand for measurement of economic, social and environmental performance of renewables implementation. First, from this information, the paper analyzes the willingness to pay of the rural community for the complete replacement of fossil fuels with clean ones throughout the region. Second, it explores this rural community’s perceptions in order to determine the most outstanding outputs, outcomes and impacts for the whole renewable energy penetration. Keywords: Impact, Output, Outcome, Perception, Renewable, Willingness to pay

Este artículo describe un manipulador móvil, bimanual y con capacidad de manipulación diestra denominado MADAR (de Mobile Anthropomorphic Dual-Arm Robot). Básicamente puede dividirse en dos partes, una base móvil y una estructura superior portando dos brazos en configuración antropomorfa con manos mecánicas diestras equipadas con sensores táctiles. La base, completamente de desarrollo propio, es de forma circular y tiene tres ruedas con un diseño novedoso que permiten una movilidad omnidireccional. La estructura superior integra elementos comerciales, como los brazos, las manos y distintos sensores, que han sido adaptados para su funcionamiento conjunto. El artículo incluye tanto la descripción de los principales elementos del hardware como del software desarrollado para su control y uso.

Introduction: Given that surgical treatment of refractory mesial temporal lobe epilepsy may cause memory impairment, determining which patients are eligible for surgery is essential. However, there is little agreement on which presurgical memory assessment methods are best able to predict memory outcome after surgery and identify those patients with a greater risk of surgery-induced memory decline. Objective: We conducted a systematic literature review to determine which presurgical memory assessment methods best predict memory outcome. Material and methods: The literature search of PubMed gathered articles published between January 2005 and December 2015 addressing pre- and postsurgical memory assessment in mesial temporal lobe epilepsy patients by means of neuropsychological testing, functional MRI, and other neuroimaging techniques. We obtained 178 articles, 31 of which were included in our review. Results: Most of the studies used neuropsychological tests and fMRI; these methods are considered to have the greatest predictive ability for memory impairment. Other less frequently used techniques included the Wada test and FDG-PET. Conclusions: Current evidence supports performing a presurgical assessment of memory function using both neuropsychological tests and functional MRI to predict memory outcome after surgery. Resumen: Introducción: El tratamiento quirúrgico de los pacientes con epilepsia mesial del lóbulo temporal refractaria al tratamiento farmacológico conlleva el riesgo de deterioro de la memoria, siendo así importante una correcta selección de los pacientes. Sin embargo, no existe un consenso claro en cuanto a qué métodos de la evaluación prequirúrgica de la memoria permitirían predecir mejor sus cambios tras la cirugía para identificar a aquellos pacientes con mayor riesgo de deterioro. Objetivos: Identificar qué métodos de evaluación de la memoria podrían ser más útiles en la predicción de sus posibles cambios tras la cirugía, a través de una revisión sistemática de la literatura. Material y métodos: Se realizó una búsqueda de los estudios publicados entre los años 2005 y 2015 en la base de datos Pubmed, incorporando aquellos en los que se evaluaba la memoria, mediante test neuropsicológicos, neuroimagen funcional, y otras, antes y después de la intervención neuroquirúrgica en pacientes con epilepsia mesial del lóbulo temporal, con objeto de predecir sus cambios. Se identificaron 178 artículos, de los cuales 31 fueron finalmente incluidos en la revisión. Resultados: La mayoría de los estudios utilizan test neuropsicológicos y RM funcional, con una amplia variedad de técnicas diferentes, que son los métodos con mayor utilidad predictiva. Otras técnicas, como el test de Wada o el FDG-PET, son menos utilizadas. Conclusiones: La evidencia actual apoya que una evaluación prequirúrgica adecuada de la memoria mediante test neuropsicológicos y RM funcional constituye el mejor modo de predicción de sus cambios tras la cirugía. Keywords: Mesial temporal lobe epilepsy, Hippocampal sclerosis, Memory, Neurosurgery, Functional magnetic resonance imaging, Neuropsychological tests, Palabras clave: Epilepsia mesial temporal, Esclerosis del hipocampo, Memoria, Neurocirugía, Resonancia magnética funcional, Test neuropsicológicos

Resumen: Introducción: El tratamiento quirúrgico de los pacientes con epilepsia mesial del lóbulo temporal refractaria al tratamiento farmacológico conlleva el riesgo de deterioro de la memoria, siendo así importante una correcta selección de los pacientes. Sin embargo, no existe un consenso claro en cuanto a qué métodos de la evaluación prequirúrgica de la memoria permitirían predecir mejor sus cambios tras la cirugía para identificar a aquellos pacientes con mayor riesgo de deterioro. Objetivos: Identificar qué métodos de evaluación de la memoria podrían ser más útiles en la predicción de sus posibles cambios tras la cirugía, a través de una revisión sistemática de la literatura. Material y métodos: Se realizó una búsqueda de los estudios publicados entre los años 2005 y 2015 en la base de datos Pubmed, incorporando aquellos en los que se evaluaba la memoria, mediante test neuropsicológicos, neuroimagen funcional, y otras, antes y después de la intervención neuroquirúrgica en pacientes con epilepsia mesial del lóbulo temporal, con objeto de predecir sus cambios. Se identificaron 178 artículos, de los cuales 31 fueron finalmente incluidos en la revisión. Resultados: La mayoría de los estudios utilizan test neuropsicológicos y RM funcional, con una amplia variedad de técnicas diferentes, que son los métodos con mayor utilidad predictiva. Otras técnicas, como el test de Wada o el FDG-PET, son menos utilizadas. Conclusiones: La evidencia actual apoya que una evaluación prequirúrgica adecuada de la memoria mediante test neuropsicológicos y RM funcional constituye el mejor modo de predicción de sus cambios tras la cirugía. Abstract: Introduction: Given that surgical treatment of refractory mesial temporal lobe epilepsy may cause memory impairment, determining which patients are eligible for surgery is essential. However, there is little agreement on which presurgical memory assessment methods are best able to predict memory outcome after surgery and identify those patients with a greater risk of surgery-induced memory decline. Objective: We conducted a systematic literature review to determine which presurgical memory assessment methods best predict memory outcome. Material and methods: The literature search of PubMed gathered articles published between January 2005 and December 2015 addressing pre- and postsurgical memory assessment in mesial temporal lobe epilepsy patients by means of neuropsychological testing, functional MRI, and other neuroimaging techniques. We obtained 178 articles, 31 of which were included in our review. Results: Most of the studies used neuropsychological tests and fMRI; these methods are considered to have the greatest predictive ability for memory impairment. Other less frequently used techniques included the Wada test and FDG-PET. Conclusions: Current evidence supports performing a presurgical assessment of memory function using both neuropsychological tests and functional MRI to predict memory outcome after surgery. Palabras clave: Epilepsia mesial temporal, Esclerosis del hipocampo, Memoria, Neurocirugía, Resonancia magnética funcional, Test neuropsicológicos, Keywords: Mesial temporal lobe epilepsy, Hippocampal sclerosis, Memory, Neurosurgery, Functional magnetic resonance imaging, Neuropsychological tests

Background: The measurement of core body temperature in the pulmonary artery (Swan-Ganz catheter) is regarded as the reference standard. Nowadays, new non-invasive methods of measuring core temperature have emerged, such as the 3M SpotOn® and the Dräger Tcore® sensor. Methods: A cross-sectional descriptive study was conducted on patients undergoing scheduled cardiac surgery. Both devices, and the Swan-Ganz catheter, were simultaneously evaluated. The correlation of temperature values was measured using the intra-class correlation coefficient and Spearman's rank or Pearson correlation analysis. The repeated-measurements version of the Bland and Altman test were used to determine the level of agreement. Results: A total of 289 measurements were made. Analysis of Spearman rank correlation between the Swan-Ganz catheter and 3M SpotOn® pair yielded a correlation coefficient (r) of 0.82 [95% confidence interval (95% CI); 0.77–0.85, p

Abstract Epidermolysis Bullosa (EB) is a group of rare genetic disorders resulting in skin fragility and other symptoms. Commissioned by DEBRA International and funded by DEBRA Norway, this evidence-bases guideline provides recommendations to optimise psychosocial wellbeing in EB. An international multidisciplinary panel of social and health care professionals (HCP) and people living with EB was formed. A systematic international literature review was conducted by the panel following the Scottish Intercollegiate Guidelines Network (SIGN) methodology. The resulting papers underwent systematic selection and critique processes. Included papers were allocated to 6 different outcome groups to allow data synthesis and exploration: quality of life, coping, family, wellbeing, access to HCP and pain. Based on the evidence in those papers, recommendations were made for individuals living with EB, family and caregivers and HCP working in the field. Few studies have investigated interventions and which factors lead to better outcomes, but general recommendations can be made. EB is a complex disease impacting enormously on every aspect of psychosocial life. People and families living with EB need access to multidisciplinary support, including psychological guidance, in order to improve quality of life and psychosocial wellbeing. Interventions should stimulate social participation to prevent isolation. People with EB and their families should be able to access a supportive network. HCP should be well supported and educated about the complexity of EB. They should work collaboratively with those around the individual with EB (e.g. schools, employers etc.) to provide psychosocial opportunity and care. Attention should be paid to the psychosocial impact of EB as well as physical needs. Directions for research are indicated.

Abstract Background A recent study shows that a multifaceted strategy using an individualised intra-abdominal pressure titration strategy during colorectal laparoscopic surgery results in an acceptable workspace at low intra-abdominal pressure in most patients. The multifaceted strategy, focused on lower to individualised intra-abdominal pressures, includes prestretching the abdominal wall during initial insufflation, deep neuromuscular blockade, low tidal volume ventilation settings and a modified lithotomy position. The study presented here tests the hypothesis that this strategy improves outcomes of patients scheduled for colorectal laparoscopic surgery. Methods The Individualized Pneumoperitoneum Pressure in Colorectal Laparoscopic Surgery versus Standard Therapy (IPPCollapse-II) study is a multicentre, two-arm, parallel-group, single-blinded randomised 1:1 clinical study that runs in four academic hospitals in Spain. Patients scheduled for colorectal laparoscopic surgery with American Society of Anesthesiologists classification I to III who are aged > 18 years and are without cognitive deficits are randomised to an individualised pneumoperitoneum pressure strategy (the intervention group) or to a conventional pneumoperitoneum pressure strategy (the control group). The primary outcome is recovery assessed with the Post-operative Quality of Recovery Scale (PQRS) at postoperative day 1. Secondary outcomes include PQRS score in the post anaesthesia care unit and at postoperative day 3, postoperative complications until postoperative day 28, hospital length of stay and process-related outcomes. Discussion The IPPCollapse-II study will be the first randomised clinical study that assesses the impact of an individualised pneumoperitoneum pressure strategy focused on working with the lowest intra-abdominal pressure during colorectal laparoscopic surgery on relevant patient-centred outcomes. The results of this large study, to be disseminated through conference presentations and publications in international peer-reviewed journals, are of ultimate importance for optimising the care and safety of laparoscopic abdominal surgery. Selection of patient-reported outcomes as the primary outcome of this study facilitates the translation into clinical practice. Access to source data will be made available through anonymised datasets upon request and after agreement of the Steering Committee of the IPPCollapse-II study. Trial registration ClinicalTrials.gov, NCT02773173. Registered on 16 May 2016. EudraCT, 2016-001693-15. Registered on 8 August 2016.

The role of fluvial sedimentary areas as organic carbon sinks remains largely unquantified. Little is known about mechanisms of organic carbon (OC) stabilization in alluvial sediments in semiarid and subhumid catchments where those mechanisms are quite complex because sediments are often redistributed and exposed to a range of environmental conditions in intermittent and perennial fluvial courses within the same catchment. The main goal of this study was to evaluate the contribution of transport and depositional areas as sources or sinks of CO2 at the catchment scale. We used physical and chemical organic matter fractionation techniques and basal respiration rates in samples representative of the three phases of the erosion process within the catchment: (i) detachment, representing the main sediment sources from forests and agricultural upland soils, as well as fluvial lateral banks; (ii) transport, representing suspended load and bedload in the main channel; and (iii) depositional areas along the channel, downstream in alluvial wedges, and in the reservoir at the outlet of the catchment, representative of medium- and long-term residence deposits, respectively. Our results show that most of the sediments transported and deposited downstream come from agricultural upland soils and fluvial lateral bank sources, where the physicochemical protection of OC is much lower than that of the forest soils, which are less sensitive to erosion. The protection of OC in forest soils and alluvial wedges (medium-term depositional areas) was mainly driven by physical protection (OC within aggregates), while chemical protection of OC (OC adhesion to soil mineral particles) was observed in the fluvial lateral banks. However, in the remaining sediment sources, in sediments during transport, and after deposition in the reservoir (long-term deposit), both mechanisms are equally relevant. Mineralization of the most labile OC (the intra-aggregate particulate organic matter (Mpom) was predominant during transport. Aggregate formation and OC accumulation, mainly associated with macroaggregates and occluded microaggregates within macroaggregates, were predominant in the upper layer of depositional areas. However, OC was highly protected and stabilized at the deeper layers, mainly in the long-term deposits (reservoir), being even more protected than the OC from the most eroding sources (agricultural soils and fluvial lateral banks). Altogether our results show that both medium- and long-term depositional areas can play an important role in erosive areas within catchments, compensating for OC losses from the eroded sources and functioning as C sinks.

Abstract Background Extracellular vesicles (EVs) are small membrane-bound vesicles which play an important role in cell-to-cell communication. Their molecular cargo analysis is presented as a new source for biomarker detection, and it might provide an alternative to traditional solid biopsies. However, the most effective approach for EV isolation is not yet well established. Results Here, we study the efficiency of the most common EV isolation methods-ultracentrifugation, Polyethlyene glycol and two commercial kits, Exoquick® and PureExo®. We isolated circulating EVs from the bloodstream of healthy donors, characterized the size and yield of EVs and analyzed their protein profiles and concentration. Moreover, we have used for the first time Digital-PCR to identify and detect specific gDNA sequences, which has several implications for diagnostic and monitoring many types of diseases. Conclusions Our findings present Polyethylene glycol precipitation as the most feasible and less cost-consuming EV isolation technique.

Background: The Global Anticoagulant Registry in the FIELD–Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. Methods and results: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012–2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P

Resumen: Introducción: La asistencia telefónica a demanda (ATAD) es una práctica habitual en las consultas de Neurología; no obstante, los estudios que valoran dicha modalidad de asistencia sanitaria son escasos. Hemos evaluado la ATAD en cuidadores de pacientes con enfermedad de Alzheimer (EA) desde el punto de vista económico y de la satisfacción percibida por el cuidador principal. Pacientes y métodos: Se seleccionó a 97 pacientes con diagnóstico de EA según criterios NINCDS-ADRDA y sus respectivos 97 cuidadores principales. Estudiamos los gastos diferenciales entre las modalidades asistenciales presencial y a demanda a lo largo de 12 meses. A los 12 meses se valoró la satisfacción de los cuidadores principales mediante un cuestionario autoadministrado. Resultados: El ahorro que supuso la ATAD frente la asistencia presencial fue de 80,05 ± 27,07 euros por usuario. Al 73,6% de los cuidadores que usaron la ATAD les parece mejor o mucho mejor esta que la asistencia presencial, mientras que al 2,6% de los cuidadores les parece peor o mucho peor. Conclusiones: La ATAD supone un servicio de salud eficiente en el seguimiento de los usuarios con EA en las consultas de Neurología y la satisfacción de los usuarios fue alta, por lo que consideramos que debería incluirse en la cartera de servicios del sistema sanitario. Abstract: Introduction: Telephone assistance is a common practice in neurology, although there are only a few studies about this type of healthcare. We have evaluated a Telephone Assistance System (TAS) for caregivers of patients with Alzheimer's disease (AD) from 2 points of view: financially and according to the level of satisfaction of the caregiver. Patients and methods: 97 patients with a diagnosis of AD according to NINCDS-ADRDA criteria and their 97 informal caregivers were selected. We studied cost differences between on-site assistance and telephone assistance (TAS) for 12 months. We used a self-administered questionnaire to assess the level of satisfaction of caregivers at the end of the study period. Results: TAS savings amounted to 80.05 ± 27.07 euros per user. 73.6% of the caregivers consider TAS a better or much better system than on-site assistance, while only 2.6% of the caregivers considered TAS a worse or much worse system than on-site assistance. Conclusions: Telephone assistance systems are an efficient healthcare resource for monitoring patients with AD in neurology departments. Furthermore, the level of user satisfaction was high. We therefore consider that telephone assistance service should be offered by healthcare services. Palabras clave: Asistencia telefónica, Cuidados, Unidad de Demencia, Enfermedad de Alzheimer, Cuidador, Satisfacción, Keywords: Telephone assistance, Healthcare, Dementia Unit, Alzheimer's disease, Caregiver, Satisfaction

Introduction: Telephone assistance is a common practice in neurology, although there are only a few studies about this type of healthcare. We have evaluated a Telephone Assistance System (TAS) for caregivers of patients with Alzheimer's disease (AD) from 2 points of view: financially and according to the level of satisfaction of the caregiver. Patients and methods: 97 patients with a diagnosis of AD according to NINCDS-ADRDA criteria and their 97 informal caregivers were selected. We studied cost differences between on-site assistance and telephone assistance (TAS) for 12 months. We used a self-administered questionnaire to assess the level of satisfaction of caregivers at the end of the study period. Results: TAS savings amounted to 80.05 ± 27.07 euros per user. 73.6% of the caregivers consider TAS a better or much better system than on-site assistance, while only 2.6% of the caregivers considered TAS a worse or much worse system than on-site assistance. Conclusions: Telephone assistance systems are an efficient healthcare resource for monitoring patients with AD in neurology departments. Furthermore, the level of user satisfaction was high. We therefore consider that telephone assistance service should be offered by healthcare services. Resumen: Introducción: La asistencia telefónica a demanda (ATAD) es una práctica habitual en las consultas de Neurología; no obstante, los estudios que valoran dicha modalidad de asistencia sanitaria son escasos. Hemos evaluado la ATAD en cuidadores de pacientes con enfermedad de Alzheimer (EA) desde el punto de vista económico y de la satisfacción percibida por el cuidador principal. Pacientes y métodos: Se seleccionó a 97 pacientes con diagnóstico de EA según criterios NINCDS-ADRDA y sus respectivos 97 cuidadores principales. Estudiamos los gastos diferenciales entre las modalidades asistenciales presencial y a demanda a lo largo de 12 meses. A los 12 meses se valoró la satisfacción de los cuidadores principales mediante un cuestionario autoadministrado. Resultados: El ahorro que supuso la ATAD frente la asistencia presencial fue de 80,05 ± 27,07 euros por usuario. Al 73,6% de los cuidadores que usaron la ATAD les parece mejor o mucho mejor esta que la asistencia presencial, mientras que al 2,6% de los cuidadores les parece peor o mucho peor. Conclusiones: La ATAD supone un servicio de salud eficiente en el seguimiento de los usuarios con EA en las consultas de Neurología y la satisfacción de los usuarios fue alta, por lo que consideramos que debería incluirse en la cartera de servicios del sistema sanitario. Keywords: Telephone assistance, Healthcare, Dementia unit, Alzheimer's disease, Caregiver, Satisfaction, Palabras clave: Asistencia telefónica, Cuidados, Unidad de demencia, Enfermedad de Alzheimer, Cuidador, Satisfacción

Resumen: Introducción: Los cuidadores de pacientes con enfermedad de Alzheimer (EA) tienen un deterioro de su calidad de vida relacionada con la salud (CVRS). La CVRS es una medida de resultado centrada en el usuario cada vez más usada. Evaluamos de forma longitudinal la CVRS en cuidadores de pacientes con EA, antes y después, durante un periodo de 12 meses. Métodos: Se incluyó en el estudio a 97 pacientes diagnosticados de EA según criterios NINCDS-ADRDA (Instituto Nacional de Trastornos Neurológicos y de la Comunicación y Accidente Cerebrovascular y Asociación de Enfermedad de Alzheimer y Trastornos relacionados) y sus respectivos 97 cuidadores principales. Se analizaron datos sociodemográficas de ambos, clínicos de los pacientes, y datos en relación con el cuidado en la visita basal. La CVRS se midió con el cuestionario SF-36 en la visita basal y a los 12 meses. Resultados: Las 8 dimensiones de la escala SF-36 en los cuidadores principales empeoraron de forma significativa a los 12 meses, salvo las dimensiones «Función física» y «Función social», que lo hicieron de forma no significativa. Las puntuaciones en la visita basal fueron menores que las correspondientes a la población general. La dimensión que presentó peor puntuación fue «Vitalidad». Conclusiones: La CVRS en cuidadores de pacientes con EA empeora a lo largo de la evolución de esta y es peor que la de la población general, para su edad y género. Abstract: Introduction: Informal caregivers of patients with Alzheimer's disease (AD) have a poor health-related quality of life (HRQOL). HRQOL is an increasingly common user-focused outcome measure. We have evaluated HRQOL longitudinally in caregivers of AD patients at baseline and at 12 months. Methods: Ninety-seven patients diagnosed with AD according to the NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke, and Alzheimer's Disease and Related Disorders Association) and their 97 respective primary caregivers were included in the study. We analysed the following data at the baseline visit: sociodemographic data of both patients and carers, patients’ clinical variables, and data related to the healthcare provided to patients by carers. HRQOL of caregivers was measured with the SF-36 questionnaire at baseline and 12 months later. Results: At 12 months, primary caregivers scored lower in the 8 subscales of the SF-36 questionnaire; differences were statistically significant in all dimensions except for ‘physical function’ and ‘social function’. Baseline scores in our sample were lower than those of the general population. ‘Vitality’ is the dimension that presented the lowest scores. Conclusion: HRQOL in caregivers of patients with Alzheimer's disease deteriorates over time and is poorer than that of the age- and sex-matched general population. Palabras clave: Calidad de vida relacionada con la salud, Cuestionario, Cuidador informal, Enfermedad de Alzheimer, SF-36, Unidad de Demencias, Keywords: Health-related quality of life, Questionnaire, Informal caregiver, Alzheimer's disease, SF-36, Dementia Unit

Introduction: Informal caregivers of patients with Alzheimer disease (AD) have a poor health-related quality of life (HRQOL). HRQOL is an increasingly common user-focused outcome measure. We have evaluated HRQOL longitudinally in caregivers of AD patients at baseline and at 12 months. Methods: Ninety-seven patients diagnosed with AD according to the NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke, and Alzheimer's Disease and Related Disorders Association) and their 97 respective primary caregivers were included in the study. We analysed the following data at the baseline visit: sociodemographic data of both patients and carers, patients’ clinical variables, and data related to the healthcare provided to patients by carers. HRQOL of caregivers was measured with the SF-36 questionnaire at baseline and 12 months later. Results: At 12 months, primary caregivers scored lower in the 8 subscales of the SF-36 questionnaire; differences were statistically significant in all dimensions except for ‘physical function’ and ‘social function’. Baseline scores in our sample were lower than those of the general population. ‘Vitality’ is the dimension that presented the lowest scores. Conclusion: HRQOL in caregivers of patients with AD deteriorates over time and is poorer than that of the age- and sex-matched general population. Resumen: Introducción: Los cuidadores de pacientes con enfermedad de Alzheimer (EA) tienen un deterioro de su calidad de vida relacionada con la salud (CVRS). La CVRS es una medida de resultado centrada en el usuario cada vez más usada. Evaluamos de forma longitudinal la CVRS en cuidadores de pacientes con EA, antes y después, durante un periodo de 12 meses. Métodos: Se incluyó en el estudio a 97 pacientes diagnosticados de EA según criterios NINCDS-ADRDA (Instituto Nacional de Trastornos Neurológicos y de la Comunicación y Accidente Cerebrovascular y Asociación de Enfermedad de Alzheimer y Trastornos relacionados) y sus respectivos 97 cuidadores principales. Se analizaron datos sociodemográficas de ambos, clínicos de los pacientes, y datos en relación con el cuidado en la visita basal. La CVRS se midió con el cuestionario SF-36 en la visita basal y a los 12 meses. Resultados: Las 8 dimensiones de la escala SF-36 en los cuidadores principales empeoraron de forma significativa a los 12 meses, salvo las dimensiones «Función física» y «Función social», que lo hicieron de forma no significativa. Las puntuaciones en la visita basal fueron menores que las correspondientes a la población general. La dimensión que presentó peor puntuación fue «Vitalidad». Conclusiones: La CVRS en cuidadores de pacientes con EA empeora a lo largo de la evolución de esta y es peor que la de la población general, para su edad y género. Keywords: Health-related quality of life, Questionnaire, Informal caregiver, Alzheimer disease, SF-36, Dementia Unit, Palabras clave: Calidad de vida relacionada con la salud, Cuestionario, Cuidador informal, Enfermedad de Alzheimer, SF-36, Unidad de Demencias

Abstract We developed a novel method, PyroTyping, for discrimination of Mycobacterium tuberculosis isolates combining pyrosequencing and IS6110 polymorphism. A total of 100 isolates were analysed with IS6110-restriction fragment length polymorphism (RFLP), spoligotyping, mycobacterial interspersed repetitive units – variable number tandem repeats (MIRU-VNTR), and PyroTyping. PyroTyping results regarding clustering or discrimination of the isolates were highly concordant with the other typing methods performed. PyroTyping is more rapid than RFLP and presents the same discriminatory power, thus, it may be useful for taking timely decisions for tuberculosis control.

After publication of our article [1] the authors have notified us that there are changes in the primary outcome and the statistical analysis plan of the study.

Resumen: Introducción: La prueba de fluidez verbal semántica (FVS) es sensible para detectar deterioro cognoscitivo, es rápida y fácil de utilizar en cualquier contexto cultural, por ello se incluye en la mayoría de los protocolos de evaluación neuropsicológica. El objetivo fue estimar valores normativos de la prueba FVS (animales), en una población de adultos mayores de 65 años. Material y método: Se evaluó a 1233 sujetos sanos, cognitivamente conservados, residentes de 2 áreas (rural y urbana) de México. Se aplicó una batería de exploración neurológica y neuropsicológica, incluyendo la FVS. Resultados: El promedio de edad de la muestra fue de 73 + 6 y escolaridad de 4,0 + 3,9 años, el 59% fueron mujeres. El promedio de palabras generadas en la prueba FVS fue de 14 + 5 y se encontró una correlación de 0,16 de estas puntuaciones con edad, escolaridad y género (p

Introduction: The semantic verbal fluency test (SVF) is sensitive to detecting cognitive decline. It is fast and easy to use in any cultural context; therefore, it is included in most of the neuropsychological assessment protocols. Objective: To estimate normative values for the SVF test (animals), in an elderly population aged 65 years and over. Materials and methods: 1233 subjects who were healthy, cognitively preserved, residents of two areas (rural and urban) of Mexico were assessed. A neurological and neuropsychological exploration battery was applied, including SVF. Results: The age average was 73 + 6 and schooling was 4.0 + 3.9 years, with 59% women. The average of the words generated in the SVF test was 14 + 5, and a correlation of 0.16 of these scores with age, education, and gender was found (P

Resumen: Introducción: El estudio de las redes neuronales implicadas en el procesamiento de la música ha recibido menos atención que la dispensada al lenguaje proposicional. Desde hace dos décadas existe un interés creciente en conocer los mecanismos funcionales del cerebro musical y los trastornos que surgen del daño de las estructuras implicadas en la percepción y producción de la música. Desarrollo: Los déficits congénitos y adquiridos del procesamiento musical en cualquiera de sus componentes (percepción, ejecución, memoria musical) se engloban dentro del término genérico amusia. En este trabajo se presenta una revisión selectiva del «estado-del-arte» de los procesos cognitivos y neurales implicados en la música y los diferentes tipos de amusias. Conclusiones: El procesamiento musical depende de una amplia red neural córtico-subcortical distribuida en ambos hemisferios cerebrales y cerebelo. El análisis de sujetos sanos con neuroimagen funcional y de los déficits selectivos en los componentes musicales (p. ej., tono, ritmo, timbre, contorno melódico) en pacientes con amusia mejorarán nuestro conocimiento acerca de los mecanismos implicados en el procesamiento musical y su relación con otros procesos cognitivos. Abstract: Introduction: The study of the neural networks involved in music processing has received less attention than work researching the brain's language networks. For the last two decades there has been a growing interest in discovering the functional mechanisms of the musical brain and understanding those disorders in which brain regions linked with perception and production of music are damaged. Discussion: Congenital and acquired musical deficits in their various forms (perception, execution, music-memory) are grouped together under the generic term amusia. In this selective review we present the “cutting edge” studies on the cognitive and neural processes implicated in music and the various forms of amusia. Conclusions: Musical processing requires a large cortico-subcortical network which is distributed throughout both cerebral hemispheres and the cerebellum. The analysis of healthy subjects using functional neuroimaging and examination of selective deficits (e.g., tone, rhythm, timbre, melodic contours) in patients will improve our knowledge of the mechanisms involved in musical processing and the latter's relationship with other cognitive processes. Palabras clave: Amusia, Cognición musical, Cerebro y música, Percepción musical, Memoria musical, Neurociencia de la música, Rehabilitación y música, Keywords: Amusia, Music cognition, Brain and music, Musical perception, Musical memory, Musical neuroscience, Musical rehabilitation

Introduction: The study of the neural networks involved in music processing has received less attention than work researching the brain's language networks. For the last two decades there has been a growing interest in discovering the functional mechanisms of the musical brain and understanding those disorders in which brain regions linked with perception and production of music are damaged. Discussion: Congenital and acquired musical deficits in their various forms (perception, execution, music-memory) are grouped together under the generic term amusia. In this selective review we present the “cutting edge” studies on the cognitive and neural processes implicated in music and the various forms of amusia. Conclusions: Musical processing requires a large cortico-subcortical network which is distributed throughout both cerebral hemispheres and the cerebellum. The analysis of healthy subjects using functional neuroimaging and examination of selective deficits (e.g., tone, rhythm, timbre, melodic contours) in patients will improve our knowledge of the mechanisms involved in musical processing and the latter's relationship with other cognitive processes. Resumen: Introducción: El estudio de las redes neuronales implicadas en el procesamiento de la música ha recibido menos atención que la dispensada al lenguaje proposicional. Desde hace dos décadas existe un interés creciente en conocer los mecanismos funcionales del cerebro musical y los trastornos que surgen del daño de las estructuras implicadas en la percepción y producción de la música. Desarrollo: Los déficits congénitos y adquiridos del procesamiento musical en cualquiera de sus componentes (percepción, ejecución, memoria musical) se engloban dentro del término genérico amusia. En este trabajo se presenta una revisión selectiva del «estado-del-arte» de los procesos cognitivos y neurales implicados en la música y los diferentes tipos de amusias. Conclusiones: El procesamiento musical depende de una amplia red neural córtico-subcortical distribuida en ambos hemisferios cerebrales y cerebelo. El análisis de sujetos sanos con neuroimagen funcional y de los déficits selectivos en los componentes musicales (p. ej., tono, ritmo, timbre, contorno melódico) en pacientes con amusia mejorarán nuestro conocimiento acerca de los mecanismos implicados en el procesamiento musical y su relación con otros procesos cognitivos. Keywords: Amusia, Music cognition, Brain and music, Musical perception, Musical memory, Musical neuroscience, Musical rehabilitation, Palabras clave: Amusia, Cognición musical, Cerebro y música, Percepción musical, Memoria musical, Neurociencia de la música, Rehabilitación y música

Muchos gestores basan sus decisiones en su experiencia de campo acumulada, pero no en la bibliografía científica primaria o el consejo por parte de científicos. Es muy infrecuente una gestión basada en la evidencia científica, consistente en el meta-análisis de la bibliografía primaria para dirimir entre opciones de gestión ambiental. Este artículo ilustra esta aproximación con el ejemplo de la gestión de la madera quemada en los bosques Mediterráneos. Tradicionalmente, tras los incendios en muchas partes del mundo, incluido el Mediterráneo, se lleva a cabo la corta y retirada de la madera quemada, usando argumentos económicos, ecológicos y estéticos. Sin embargo, existe una corriente contraria a esta práctica argumentando, entre otras razones, un potencial efecto negativo de la retirada de la madera quemada sobre la regeneración del bosque. Un meta- análisis de la bibliografía pertinente en el Mediterráneo indicó un efecto nulo (densidad y altura de plántulas) o negativo (supervivencia de plántulas) de la retirada de la madera quemada sobre la regeneración del bosque. Aunque un meta-análisis con un tamaño de muestra tan bajo como el posible en el presente estudio no permite conclusiones firmes sobre la gestión de la madera quemada, sí sugiere que: (1) la gestión actual no está en concordancia con la (escasa) evidencia disponible, al menos en lo tocante a la regeneración del bosque quemado y (2) es necesario recabar una evidencia más firme sobre esta práctica de gestión forestal.