[Impact of COVID-19s alarm states in the care of pediatric patients in Primary Care in a health area in northern Spain]. / Impacto de los estados de alarma por COVID-19 en la atención a pacientes pediátricos en Atención Primaria de un área sanitaria del norte de España.

AIM: The SARS-CoV-2 pandemic has meant a global change in the healthcare model, enhancing telematic assistance, specially at the Health Primary Care (PC). There are few studies that relate the attendance of children at the PC to the pandemic of COVID-19. The aim of our study is to describe the impact of the two Spanish states of alarm on the care of children at de PC level. MATERIAL AND METHODS: Retrospective observational study. The PC visits corresponding to pediatric patients (<14 years) from a health area in northern Spain during the first and second states of alarm were analyzed, and compared with their equivalent periods in 2019. RESULTS: During the first state of alarm, home lockdown and school closure were established, and a large decrease in pediatric visits to the health centres was observed (758 vs. 1381 in 2019) at the expense of health check-ups and infectious diseases. This decrease was not observed in the second state of alarm (1375 vs. 1233 in 2019). In both states of alarm, the percentage of telephone assistance increased significantly. CONCLUSIONS: The implementation of alarm states has meant a decrease on the demand of medical care, especially during the first state of alarm, may be owing to the fear of the families of going to the health center and the decrease in the transmissibility of viruses due to home lockdown. The increase of the telematic assistance has been on account of the need of reorganization of health care, wich has proven to be effective.

Lambs' live weight estimation using 3D images.

The sheep sector has not suffered the technification that other livestock sectors have. The lack of technological knowledge of the farmers and the economic limitations of the sector have made this technification difficult. One of the most widely used technologies is Precision Livestock Farming (PLF). PLF has already been used in other livestock sectors to improve farming efficiency. In the light of the problem that sheep farmers have in weighing lambs and their low precision, this paper proposes a system for estimating weight by means of 3D image capture. Thus, zenithal images of 272 lambs have been recorded. They have been processed using the capture of the upper area and the average depth of the pixels of the lamb. This estimates the weight of the animal with an error of less than 6%. This technology has a low economic cost and is easy to operate, helping farmers to be more willing to use it. This method manages to reduce the duration of the process, the stress of the animal and to improve the overall accuracy in weight estimation. Thus, it will help to have a greater control of the weight of the animal and to improve the economic profitability that the farmer obtains for the lambs.

Outcomes After Vascular Surgery Procedures in Patients with COVID-19 Infection: A National Multicenter Cohort Study (COVID-VAS).

OBJECTIVES: To analyze the outcome of vascular procedures performed in patients with COVID-19 infection during the 2020 pandemic. METHODS: This is a multicenter, prospective observational cohort study. We analyzed data from 75 patients with COVID-19 infection undergoing vascular surgery procedures in 17 hospitals across Spain and Andorra between March and May 2020. The primary end point was 30-day mortality. Clinical Trials registry number NCT04333693. RESULTS: The mean age was 70.9 (45-94) and 58 (77.0%) patients were male. Around 70.7% had postoperative complications, 36.0% of patients experienced respiratory failure, 22.7% acute renal failure, and 22.7% acute respiratory distress syndrome (ARDS). All-cause 30-days mortality rate was 37.3%. Multivariate analysis identified age >65 years (P = 0.009), American Society of Anesthesiologists (ASA) classification IV (P = 0.004), preoperative lymphocyte count <0.6 (×109/L) (P = 0.001) and lactate dehydrogenase (LDH) >500 (UI/L) (P = 0.004), need for invasive ventilation (P = 0.043), postoperative acute renal failure (P = 0.001), ARDS (P = 0.003) and major amputation (P = 0.009) as independent variables associated with mortality. Preoperative coma (P = 0.001), quick Sepsis Related Organ Failure Assessment (qSOFA) score ≥2 (P = 0.043), lymphocytes <0.6 (×109/L) (P = 0.019) leucocytes >11.5 (×109/L) (P = 0.007) and serum ferritin >1800 mg/dL (P = 0.004), bilateral lung infiltrates on thorax computed tomography (P = 0.025), and postoperative acute renal failure (P = 0.009) increased the risk of postoperative ARDS. qSOFA score ≥2 was the only risk factor associated with postoperative sepsis (P = 0.041). CONCLUSIONS: Patients with COVID-19 infection undergoing vascular surgery procedures showed poor 30-days survival. Age >65 years, preoperative lymphocytes <0.6 (x109/L) and LDH >500 (UI/L), and postoperative acute renal failure, ARDS and need for major amputation were identified as prognostic factors of 30-days mortality.

On the rapid in situ oxidation of two-dimensional V2CTz MXene in culture cell media and their cytotoxicity.

The plethora of emerging two-dimensional (2D) materials exhibit wide potential application in novel technologies and advanced devices. However, their stability in environmental conditions could be an issue, affecting their application possibilities and posing health risks. Moreover, their decomposed leftovers can also induce a negative influence on human health. In particular, transition metal carbides commonly referred to as MXenes are susceptible to environmental oxidation being decomposed toward transition metal oxides and carbide-derived carbon. In this study we focused on the oxidation-state-related in vitro cytotoxicity of delaminated V2CTz onto immortalized keratinocytes (HaCaT) and malignant melanoma (A375) human cell lines. Due to the fact, that the V2CTx MXenes are least stable from all known obtained MXenes up to date, the vanadium ones were a practical choice to visualize the oxidation-cytotoxic correlation keeping the standards of 24-48 h of cell culturing. We found that the oxidation of V2CTz highly increases their cytotoxicity toward human cells, which is also time and dose dependent. The identified mode of action relates to the cell cycle as well as cellular membrane disintegration through direct physicochemical interactions.

Constitutional risk factors for focal neuropathies in patients referred for electromyography.

BACKGROUND AND PURPOSE: It is well established that patient-related constitutional features predispose to focal peripheral neuropathies. Some of these risk factors were investigated in common focal neuropathies encountered in patients referred for electromyography. METHODS: Gender, age, height and body mass index (BMI) were analysed retrospectively as risk factors for 11 focal neuropathies. In all, 9686 patients (age range 18-96 years; 58% women) were included from three different centres, with identical methods and equipment. RESULTS: High BMI was related to carpal tunnel syndrome (CTS), ulnar neuropathy at the elbow (UNE), combined CTS and UNE, meralgia paraesthetica and lumbar radiculopathy. In women, CTS and Morton's metatarsalgia were more common, whilst long thoracic neuropathies, suprascapular neuropathies and UNE were more common in men. Older age increased the risk for CTS, UNE, Morton's metatarsalgia and radiculopathies. CONCLUSIONS: Age, gender and BMI are important risk factors for many common focal neuropathies.

Asistencia a población infantil en una unidad de pediatría de atención primaria durante el estado de alarma por COVID-19. Eficacia de la asistencia telefónica y los circuitos específicos / Assistance to children in a Primary Care Pediatric Unit during the COVID-19 state of alarm. Effectiveness of telephone assistance and specific circuits

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Dentin Priming with Amphipathic Antimicrobial Peptides.

The evolution of bonded restorations has undergone great progress over several decades. Nonetheless, life spans of bonded restorations are limited mainly because of the eventual incidence of recurrent caries. Over time, water and waterborne agents (acids, enzymes) degrade the components of the dentin/restoration interface, allowing bacterial colonization and dentin reinfection at the margins of the restoration. We developed a 2-tier protective technology consisting of priming/coating dentin with amphipathic and antimicrobial peptides (AAMPs) to obtain hydrophobic/water-repellent and antibiofilm dentin-resisting recurrent caries around bonded restorations. We tested a series of AAMPs to assess their structure-function relationships as well as the effects of different dentin-conditioning methods on the structural features of AAMP-coated dentin. We found relation between the secondary structure of AAMPs (high portion of ß-sheet), the antimicrobial potency of AAMPs, and the AAMPs' ability to form hydrophobic coatings on dentin. We also determined that AAMPs had preferential adsorption on the mineral phase of dentin, which suggested that peptides arrange their cationic and hydrophilic motifs in direct contact with the negatively charged minerals in the hydrophilic dentin. These results led us to explore different dentin-conditioning methods that would increase the mineral/collagen ratio and their effect on AAMP immobilization. We innovatively imaged the spatial distribution of the AAMPs in relation to the dentinal tubules and collagen network using a minimally invasive multimodal imaging technique: multiphoton-second harmonic generation. Using multiphoton-second harmonic generation imaging, we determined that partial deproteinization of dentin increased the amount of immobilized AAMPs as compared with the total etched dentin at the dentin surface and extended deeply around dentinal tubules. Last, we analyzed the release rate of AAMPs from dentin coatings in artificial saliva to predict their stability in the clinical setting. In conclusion, priming dentin with AAMPs is a versatile new approach with potential to fortify the otherwise vulnerable adhesive-based interfaces.

[Effects of lameness at the time of drying off on the lactation and fertility performance of the following lactation]. / Auswirkungen von Lahmheiten zum Zeitpunkt des Trockenstellens auf die Milch- und Fruchtbarkeitsleistungen der folgenden Laktation.

INTRODUCTION: The aim of the study was to clarify how lameness and its severity in dairy cows at the time of drying off will affect the milk performance and fertility in the following lactation when treated appropriately at the time of drying off. The lameness scoring and a gait assessment took place during drying off, in the 1st week after calving, as well as 2 months after calving. Each lame cow was compared with a non-lame control cow from the same farm. The milk and fertility data of the following lactation were compared with those of the previous lactation. Most of the lameness occurred in the hind limbs and was most frequently due to digital dermatitis (Mortellaro), limax, and Rusterholz sole ulcer. The mean lameness duration after treatment was 26 days (median 16 days) and was significantly longer in case of horn lesions than in skin lesions. Recurrences most often occured in the interdigital cleft region. Lameness- free control animals were often affected by heel horn erosion and digital dermatitis. In the present study, a lameness treated at the time of dry off did not have a negative effect on fertility, but on milk yield and milk fat. Treatment could not eliminate these negative effects. However, it can be hypothesized that the negative effects on these and other parameters would have been even greater than without adequate treatment.

INTRODUCTION: Le but de cette étude était de savoir dans quelle mesure les boiteries des vaches laitières au moment du tarissement influaient sur la production laitière et la fécondité lors de la lactation suivante si elles étaient traitées au moment du tarissement. Le scoring des boiteries et une estimation de la marche avaient lieu lors du tarissement, dans la première semaine après le vêlage ainsi que deux mois plus tard. On a mis en comparaison lors de l'examen initial une vache non boiteuse de l'exploitation par rapport à chaque vache boiteuse. Par contre, on a utilisé pour la comparaison des résultats de la production laitière et la fertilité les données de la lactation précédente. Les boiteries survenaient principalement aux membres postérieurs et étaient le plus souvent causées pas une dermatite digitée, une limace ou un ulcère de Rusterholz. La durée moyenne de la boiterie après traitement était de 26 jours (médiane 16 jour) et était significativement plus élevée lors de lésions de la corne que lors de lésions cutanées. On constatait principalement des récidives lors d'affection dans l'espace interdigité. Les animaux de contrôle non-boiteux étaient souvent atteints de pourriture de la corne en talons et de dermatite digitée. Pour la première fois, on a suivi le scoring de boiterie, les affections des onglons et leur traitement chez des vaches durant la période de tarissement sur une longue durée. Une boiterie présente au moment du tarissement avait un effet négatif sur la production laitière et sur le taux de matières grasses dans la lactation qui suivait. Un traitement ne permettait pas de supprimer ces effets négatifs mais on peut admettre que ceux-ci se serait encore aggravés sans traitement de même que d'autre paramètres tel que la période de service ou le délai de mise à la reproduction.

[Correlation of a lameness scoring system and claw lesion]. / Korrelation eines Lahmheit-Scoring- Systems und Klauenläsionen.

INTRODUCTION: The aim of this study was to investigate the relationship between lameness scoring and clinical findings. The lameness scoring and a gait assessment took place during drying off, the first week after calving and two months after calving in 29 lame and 27 free of lameness cows. In between the farmer scored the lamness. Most of the lameness occurred in the hind limbs and were most frequently caused by dermatitis digitalis, Mortellaro, Limax, and Rusterholz sole ulcer. The mean duration of lameness after treatment was 26 days (median 16 days) and was significantly longer in case of horn lesions than in skin lesions (including interdigital dermatitis). Lameness- free control animals were often affected by heel horn erosion and digital dermatitis. It was shown that the sensitivity of lameness (lameness is caused by a certain aetiology) for a certain cause of lameness (dermatitis interdigitalis, doble sole, purulent hollow wall, Limax, digital dermatitis, Rusterholz sole ulcer and sole contusion) increases along with the threshold (degree of lameness) but that the specificity (no lameness is not related to a certain aetiology) remained constant at the same time. The highest sensitivity was achieved in injuries, followed by interdigital hyperplasia. The receiver operating curve (ROC) showed that lameness was the best selecting symptom in white line lesions followed by claw injury. The positive predictive values varied between 38.8% in white line lesions and 0% in Rusterholz's sole ulcer. The negative predictive values varied between 99.1% in interdigital dermatitis and 82.3% in interdigital dermatitis. The ROC analysis shows which lameness is more related to a certain claw disease. The results demonstrate, that a lameness score cannot be linked to a certain claw disease.

INTRODUCTION: Le but de la présente étude était de voir dans quelle mesure il existe une relation entre un système de scoring des boiteries et les constatations cliniques. On a utilisé un scoring de boiterie simple et une estimation de la marche chez 29 animaux boiteux et 27 animaux sains au moment du tarissement, dans la première semaine après le vêlage ainsi que deux mois après celui-ci. Entre ces examens, les boiteries ont été enregistrées par les agriculteurs. La plupart des boiteries affectaient les postérieurs et étaient le plus souvent causées pas une dermatite digitée, une limace ou un ulcère de Rusterholz. La durée moyenne de la boiterie après traitement était de 26 jours (médiane 16 jours) et était nettement plus importante lors de lésions de la corne que lors de lésions de la peau. Les animaux non-boiteux étaient souvent atteints de pourriture de la corne en talons et de dermatite digitée. On a constaté que la sensitivité de la boiterie (la boiterie parle pour une cause donnée) augmentait avec l'augmentation de la valeur limite (intensité de la boiterie) pour une cause de boiterie donnée (dermatite interdigitée, double sole, fourmilière purulente, limace, dermatite digitée, ulcère de Rusterholz, contusion de sole) et que, simultanément, la spécificité (l'absence de boiterie parle contre une certaine cause) restait constante. La sensitivité la plus élevée était observée en cas de blessures, suivies par les limaces. La surface sous la courbe ROC (receiver operating curve) montrait que la discrimination était la meilleure en cas de fourmilière purulente, suivie par les blessures d'onglon. Les valeurs prédictives positives variaient entre 38.8% pour la fourmilière purulente et 0% pour l'ulcère de Rusterholz. Les valeurs prédictives négatives variaient entre 99.1% pour la dermatite interdigitée et 82.3% pour la dermatite digitée. L'analyse ROC montre quelles boiteries sont associées le plus souvent avec certaines affections des onglons. Les résultats montrent qu'on ne peut pas, sur la base de la boiterie, déduire l'affection des onglons.

[Influence of depression on the initial diagnosis and the evolution of cognitive impairment]. / Influencia de la depresion en el diagnostico inicial y evolutivo del deterioro cognitivo.

INTRODUCTION: Depression and cognitive impairment maintain a close and complex relationship, which could be modified by pharmacological treatment. AIM: To analyze the influence of depression and antidepressive medication on the initial diagnosis and the evolution of cognitive impairment. PATIENTS AND METHODS: All the patients derived to a Neurology clinic due to complaints or suspicion of cognitive impairment, during a period of nine years, were studied. The influence of demographic and depression-related variables on initial cognitive diagnosis, cognitive-functional situation and 1-year evolution were analyzed. RESULTS: A total of 582 patients were included (mean age: 77.6 ± 7.0; 64.9% women). Frequency of current and past depression were, respectively, 25.4% and 17.2%. In addition, 20.6% of the patients were taking antidepressant medication and 31.2% were on anxiolytic/hypnotic treatment. One-year follow-up visit was available in 320 (59.8%) of patients. In the adjusted analysis, anxiolytic/hypnotic treatment was associated with a worse cognitive-functional situation in the initial visit, while past depression and presence of dystimia were associated with a favorable evolution (p < 0.05). CONCLUSIONS: Past or current depression are not associated with bad prognosis in patients derived to neurologist due to possible cognitive impairment.

TITLE: Influencia de la depresion en el diagnostico inicial y evolutivo del deterioro cognitivo.Introduccion. La depresion y el deterioro cognitivo mantienen una estrecha y compleja relacion, que podria verse alterada por el tratamiento antidepresivo. Objetivo. Analizar la influencia de la depresion y del tratamiento antidepresivo en el diagnostico cognitivo inicial y evolutivo de los pacientes remitidos a neurologia por quejas o sospecha de deterioro cognitivo. Pacientes y metodos. Se estudio a todos los pacientes remitidos a una consulta de neurologia por quejas o sospecha de deterioro cognitivo durante un periodo de nueve años. Se analizo la influencia de las variables demograficas y de las variables relacionadas con la depresion en el diagnostico cognitivo y en la situacion cognitivo-funcional inicial y tras un año de seguimiento. Resultados. Se incluyo a 582 pacientes (edad media: 77,6 ± 7 años; mujeres, 64,9%). La frecuencia de depresion actual o en el pasado era, respectivamente, del 25,4% y 17,2%. El 20,6% de los pacientes recibia tratamiento con farmacos antidepresivos y el 31,2% tomaba ansioliticos/hipnoticos. Se dispuso de seguimiento al cabo de un año en 320 pacientes (59,8%). En el analisis ajustado, el tratamiento ansiolitico/hipnotico se asocio a una peor situacion cognitiva y funcional inicial, mientras que la depresion en el pasado y la presencia de distimia en la visita inicial se asociaron a una evolucion favorable (p < 0,05). Conclusiones. La depresion pasada o actual no es un factor de mal pronostico en los pacientes remitidos al neurologo por posible deterioro cognitivo.

In vivo osseointegration of dental implants with an antimicrobial peptide coating.

This study aimed to evaluate the in vivo osseointegration of implants with hydrophobic antimicrobial GL13K-peptide coating in rabbit femoral condyles by micro-CT and histological analysis. Six male Japanese Rabbits (4 months old and weighing 2.5 kg each) were included in this study. Twelve implants (3.75 mm wide, 7 mm long) were randomly distributed in two groups, with six implants in the experimental group coated with GL13K peptide and six implants in the control group without surface coating. Each implant in the test and the control group was randomly implanted in the left or right side of femoral condyles. On one side randomly-selected of the femur, each rabbit received a drill that was left without implant as control for the natural healing of bone. After 3 weeks of healing radiographic evaluation of the implant sites was taken. After 6 weeks of healing, rabbits were sacrificed for evaluation of the short-term osseointegration of the dental implants using digital radiography, micro-CT and histology analysis. To perform evaluation of osseointegration, implant location and group was double blinded for surgeon and histology/radiology researcher. Two rabbits died of wound infection in sites with non-coated implants 2 weeks after surgery. Thus, at least four rabbits per group survived after 6 weeks of healing. The wounds healed without suppuration and inflammation. No implant was loose after 6 weeks of healing. Radiography observations showed good osseointegration after 3 and 6 weeks postoperatively, which proved that the tissues followed a natural healing process. Micro-CT reconstruction and analysis showed that there was no statistically significant difference (P > 0.05) in volume of bone around the implant between implants coated with GL13K peptide and implants without coating. Histomorphometric analysis also showed that the mineralized bone area was no statistically different (P > 0.05) between implants coated with GL13K peptide and implants without coating. This study demonstrates that titanium dental implants with an antimicrobial GL13K coating enables in vivo implant osseointegration at similar bone growth rates than gold-standard non-coated dental implants up to 6 weeks of implantation in rabbit femurs.

ETP-46321, a dual p110α/δ class IA phosphoinositide 3-kinase inhibitor modulates T lymphocyte activation and collagen-induced arthritis.

Class IA phosphoinositide 3-kinases (PI3Ks) are essential to function of normal and tumor cells, and to modulate immune responses. T lymphocytes express high levels of p110α and p110δ class IA PI3K. Whereas the functioning of PI3K p110δ in immune and autoimmune reactions is well established, the role of p110α is less well understood. Here, a novel dual p110α/δ inhibitor (ETP-46321) and highly specific p110α (A66) or p110δ (IC87114) inhibitors have been compared concerning T cell activation in vitro, as well as the effect on responses to protein antigen and collagen-induced arthritis in vivo. In vitro activation of naive CD4(+) T lymphocytes by anti-CD3 and anti-CD28 was inhibited more effectively by the p110δ inhibitor than by the p110α inhibitor as measured by cytokine secretion (IL-2, IL-10, and IFN-γ), T-bet expression and NFAT activation. In activated CD4(+) T cells re-stimulated through CD3 and ICOS, IC87114 inhibited Akt and Erk activation, and the secretion of IL-2, IL-4, IL-17A, and IFN-γ better than A66. The p110α/δ inhibitor ETP-46321, or p110α plus p110δ inhibitors also inhibited IL-21 secretion by differentiated CD4(+) T follicular (Tfh) or IL-17-producing (Th17) helper cells. In vivo, therapeutic administration of ETP-46321 significantly inhibited responses to protein antigen as well as collagen-induced arthritis, as measured by antigen-specific antibody responses, secretion of IL-10, IL-17A or IFN-γ, or clinical symptoms. Hence, p110α as well as p110δ Class IA PI3Ks are important to immune regulation; inhibition of both subunits may be an effective therapeutic approach in inflammatory autoimmune diseases like rheumatoid arthritis.

Assessment of coinfection of sexually transmitted pathogen microbes by use of the anyplex II STI-7 molecular kit.

Anyplex STI-7 is a new molecular kit that detects seven sexually transmitted pathogens. Among 202 subjects screened for genital infection, 143 (70.4%) were diagnosed with at least one pathogen, in concordance with reference methods. In addition, the Anyplex STI-7 demonstrated coinfections, such as that with Ureaplasma parvum and Chlamydia trachomatis, in young women.

[Socio-demographic characteristics and health status of patients at a free-of-charge outpatient clinic in Paris]. / Analyse du profil socio-démographique et médical des patients de 5 permanences d'accès aux soins de santé (PASS) parisiennes.

PURPOSE: In the context of the French National Health Service, a free access to healthcare facilities (the PASS: "permanence d'accès aux soins de santé") has been implanted in 2000 for patients without health insurance or those dealing with financial hardship. There is few data about socio-demographic characteristics of the patients using these services. The objective of this study was to provide descriptive data about socio-demographic characteristics and motivation of those patients who use these clinics. METHODS: This descriptive cross-sectional study was conducted between April an May 2008, in 5 PASS clinics from academic tertiary hospitals in Paris. Descriptive data on patient were collected by general practitioners at the end of their consultations. RESULTS: This study included 581 patients. The mean age was 42 years, and 65% of patients were males. Only 50.9% declared a salary income and 38.5% had a health insurance. Half of the patients were homeless, and 80% were migrants. The main reasons to visit these health facilities were direct access (no appointment needed), being in financial difficulty and having a medical record in the same hospital. Half of the patients had one chronic disease at least, while only a third of them saw regularly a physician. A total of 834 diseases were found among the 581 patients, including 411 chronic diseases, and 17% of the patients had a psychologic or a psychiatric disorder. Prognosis was divided in three grades: good, low and poor. Almost a half of the patients were considered by the doctor as having a low or a poor prognosis if they would not receive a therapy. CONCLUSIONS: The findings of this study suggest that the PASS carry out their mission: most of the patients frequenting these facilities live under poor conditions and are in poor health status compared to the patients having access to conventional outpatient services.

Human BRS-3 receptor: functions/role in cell signaling pathways and glucose metabolism in obese or diabetic myocytes.

Several studies showed that the orphan Bombesin Receptor Subtype-3 (BRS-3) - member of the bombesin receptor family - has an important role in glucose homeostasis (v.g.: BRS-3-KO mice developed mild obesity, and decreased levels of BRS-3 mRNA/protein have been described in muscle from obese (OB) and type 2 diabetic (T2D) patients). In this work, to gain insight into BRS-3 receptor cell signaling pathways, and its implication on glucose metabolism, primary cultured myocytes from normal subjects, OB or T2D patients were tested using high affinity ligand - [d-Tyr(6),ß-Ala(11),Phe(13),Nle(14)]bombesin6-14. In muscle cells from all metabolic conditions, the compound significantly increased not only MAPKs, p90RSK1, PKB and p70s6K phosphorylation levels, but also PI3K activity; moreover, it produced a dose-response stimulation of glycogen synthase a activity and glycogen synthesis. Myocytes from OB and T2D patients were more sensitive to the ligand than normal, and T2D cells even more than obese myocytes. These results widen the knowledge of human BRS-3 cell signaling pathways induced by a BRS-3 agonist, described its insulin-mimetic effects on glucose metabolism, showed the role of BRS-3 receptor in glucose homeostasis, and also propose the employing of BRS-3/ligand system, as participant in the obese and diabetic therapies.

Degradation in the dentin-composite interface subjected to multi-species biofilm challenges.

Oral biofilms can degrade the components in dental resin-based composite restorations, thus compromising marginal integrity and leading to secondary caries. This study investigates the mechanical integrity of the dentin-composite interface challenged with multi-species oral biofilms. While most studies used single-species biofilms, the present study used a more realistic, diverse biofilm model produced directly from plaques collected from donors with a history of early childhood caries. Dentin-composite disks were made using bovine incisor roots filled with Z100(TM) or Filtek(TM) LS (3M ESPE). The disks were incubated for 72 h in paired CDC biofilm reactors, using a previously published protocol. One reactor was pulsed with sucrose, and the other was not. A sterile saliva-only control group was run with sucrose pulsing. The disks were fractured under diametral compression to evaluate their interfacial bond strength. The surface deformation of the disks was mapped using digital image correlation to ascertain the fracture origin. Fracture surfaces were examined using scanning electron microscopy/energy-dispersive X-ray spectroscopy to assess demineralization and interfacial degradation. Dentin demineralization was greater under sucrose-pulsed biofilms, as the pH dropped <5.5 during pulsing, with LS and Z100 specimens suffering similar degrees of surface mineral loss. Biofilm growth with sucrose pulsing also caused preferential degradation of the composite-dentin interface, depending on the composite/adhesive system used. Specifically, Z100 specimens showed greater bond strength reduction and more frequent cohesive failure in the adhesive layer. This was attributed to the inferior dentin coverage by Z100 adhesive, which possibly led to a higher level of chemical and enzymatic degradation. The results suggested that factors other than dentin demineralization were also responsible for interfacial degradation. A clinically relevant in vitro biofilm model was therefore developed, which would effectively allow assessment of the degradation of the dentin-composite interface subjected to multi-species biofilm challenge.

Antimicrobial properties and dentin bonding strength of magnesium phosphate cements.

The main objective of this work was to assess the antimicrobial properties and the dentin-bonding strength of novel magnesium phosphate cements (MPC). Three formulations of MPC, consisting of magnesium oxide and a phosphate salt, NH4H2PO4, NaH2PO4 or a mixture of both, were evaluated. As a result of the setting reaction, MPC transformed into either struvite (MgNH4PO4·6H2O) when NH4H2PO4 was used or an amorphous magnesium sodium phosphate when NaH2PO4 was used. The MPC had appropriate setting times for hard tissue applications, high early compressive strengths and higher strength of bonding to dentin than commercial mineral trioxide aggregate cement. Bacteriological studies were performed with fresh and aged cements against three bacterial strains, Escherichia coli, Pseudomonas aeruginosa (planktonic and in biofilm) and Aggregatibacter actinomycetemcomitans. These bacteria have been associated with infected implants, as well as other frequent hard tissue related infections. Extracts of different compositions of MPC had bactericidal or bacteriostatic properties against the three bacterial strains tested. This was associated mainly with a synergistic effect between the high osmolarity and alkaline pH of the MPC. These intrinsic antimicrobial properties make MPC preferential candidates for applications in dentistry, such as root fillers, pulp capping agents and cavity liners.

Evaluación de la utilidad diagnóstica de la versión española del cuestionario al informador «AD8» / Assessing the diagnostic accuracy (DA) of the spanish version of the informant-based AD8 questionnaire

Introducción: El AD8 es un cuestionario al informador breve que puede ser autoaplicado y facilita la identificación de deterioro cognitivo (DC); nuestro objetivo es evaluar la utilidad diagnóstica (UD) de una versión espa˜nola. Material y métodos: Estudio transversal en una muestra clínica de díadas paciente/ informador, 330 sujetos con sospecha de DC o demencia (DEM) y 71 controles. Se ha evaluado la consistencia interna ( de Cronbach) y la validez (correlaciones parciales con estadio GDS, Fototest e índice funcional [IF]). La UD se ha evaluado para no DC vs DC (GDS 3-4) por medio del área bajo la curva ROC (aROC) y se ha considerado mejor punto de corte aquel que hacía máximo el índice de Youden. Resultados: En la muestra, 105 no tenían DC, 99 tenían DC sin DEM y 203 DEM. La consistencia interna es alta ( 0,90, IC del 95%, 0,89-0,92), al igual que las correlaciones con GDS (r = 0,72, p < 0,001), Fototest (r = —0,61, p < 0,001) e IF (r = 0,59, p < 0,001). El aROC del AD8 es 0,90 (IC del 95%, 0,86-0,93), sin diferencia significativa con la del Fototest (aROC 0,93, IC del 95%, 0,89-0,96); el mejor punto de corte es 3/4 con sensibilidad de 0,93 (IC del 95%, 0,88-0,96), especificidad de 0,81 (IC del 95%, 0,72-0,88) y el 88,8% de las clasificaciones correctas. El uso conjunto de AD8 y Fototest mejora de forma significativa la UD de ambos (aROC 0,96, IC del 95%, 0,93-0,98, p < 0,05). Conclusiones: La versión espa˜nola del AD8 conserva las cualidades psicométricas y la UD de la versión original; su uso combinado con el Fototest mejora de forma significativa la UD de ambos (AU)

Introduction: The AD8 is a brief informant-based questionnaire that may also be selfadministered, and which aids in identifying cognitive impairment (CI). Our goal is to assess the diagnostic accuracy (DA) of a Spanish version of that questionnaire. Material and methods: Cross-sectional study of a clinical sample of patient/informant dyads including 330 subjects with suspected CI or dementia (DEM) and 71 controls. We evaluated internal consistency (Cronbach’s alpha) and validity (partial correlations with GDS stage, Fototest results and functional index measure [FIM]). We assessed DA for CI vs no CI (GDS stage 3-4) using the area under the ROC curve (AUC), and the cut-off with the highest Youden index was determined to be optimal. Results: In the sample, 105 subjects had no CI, 99 had CI without DEM and 203 had DEM. Internal consistency was high ( 0.90, 95% confidence interval: 0.89-0.92), as were correlations with the GDS score (r=0.72, P<.001), Fototest results (r=−0.61, P<.001) and FIM (r=0.59, P<.001). The AUC for AD8 was 0.90 (95% confidence interval: 0.86-0.93), which was not significantly different from that of the Fototest (AUC 0.93, 95% confidence interval: 0.89-0.96). The optimal cut-off point was 3/4 with a sensitivity of 0.93 (95% confidence interval: 0.88-0.96) and a specificity of 0.81 (95% confidence interval: 0.72-0.88); 88.8% of the classifications were correct. Combined use of AD8 and the Fototest significantly improved the DA of both (AUC 0.96, 95% confidence interval: 0.93-0.98, P<.05). Conclusions: The Spanish version of the AD8 questionnaire preserves the psychometric qualities and DA of the original. Using this test in combination with the Fototest significantly increases the DA of both tests (AU)

Assessing the diagnostic accuracy (DA) of the Spanish version of the informant-based AD8 questionnaire.

INTRODUCTION: The AD8 is a brief informant-based questionnaire that may also be self-administered, and which aids in identifying cognitive impairment (CI). Our goal is to assess the diagnostic accuracy (DA) of a Spanish version of that questionnaire. MATERIAL AND METHODS: Cross-sectional study of a clinical sample of patient/informant dyads including 330 subjects with suspected CI or dementia (DEM) and 71 controls. We evaluated internal consistency (Cronbach's alpha) and validity (partial correlations with GDS stage, Fototest results and functional index measure [FIM]). We assessed DA for CI vs no CI (GDS stage 3-4) using the area under the ROC curve (AUC), and the cut-off with the highest Youden index was determined to be optimal. RESULTS: In the sample, 105 subjects had no CI, 99 had CI without DEM and 203 had DEM. Internal consistency was high (α 0.90, 95% confidence interval: 0.89-0.92), as were correlations with the GDS score (r=0.72, P<.001), Fototest results (r=-0.61, P<.001) and FIM (r=0.59, P<.001). The AUC for AD8 was 0.90 (95% confidence interval: 0.86-0.93), which was not significantly different from that of the Fototest (AUC 0.93, 95% confidence interval: 0.89-0.96). The optimal cut-off point was 3/4 with a sensitivity of 0.93 (95% confidence interval: 0.88-0.96) and a specificity of 0.81 (95% confidence interval: 0.72-0.88); 88.8% of the classifications were correct. Combined use of AD8 and the Fototest significantly improved the DA of both (AUC 0.96, 95% confidence interval: 0.93-0.98, P<.05). CONCLUSIONS: The Spanish version of the AD8 questionnaire preserves the psychometric qualities and DA of the original. Using this test in combination with the Fototest significantly increases the DA of both tests.