Electrochemical biosensor for aerobic acetate detection.

There is an increasing demand on alternatives methods to animal testing. Numerous health parameters have been already studied using in vitro devices able to mimic the essential functions of the organs, being the real-time monitoring and response to stimuli their main limitations. Regarding the health of the gut, the short chain fatty acids, and particularly acetate, have emerged as key biomarkers to evaluate gut healthiness and disease development, although the number of acetate biosensors is still very low. This article presents a microbial biosensor based on fully biocompatible materials which is able to detect acetate in aerobic conditions in the range between 11 and 50 mM, and without compromising the viability and function of either bacteria (>90% viability) or mammalian cells (>80% viability). The detection mechanism is based on the metabolism of acetate by Escherichia coli bacteria immobilized on the transducer surface. Ferricyanide is used as a redox mediator to transfer electrons from the acetate metabolism in the bacterial cells to the transducer. High bacterial concentrations are immobilized in the transducer surface (109 cfu mL-1) by electrodeposition of conductive alginate hydrogels doped with reduced graphene oxide. The results show successful outcomes to exploit bacteria as a biosensing tool, based on the use of inkjet printed transducers, biocompatible materials and cell entrapment technologies.

Evolution of Guidelines for the Management of Hereditary Angioedema due to C1 Inhibitor Deficiency.

Hereditary angioedema (HAE) is a severe and disabling condition characterized by recurrent episodes of subcutaneous or mucosal swelling in the skin and respiratory and gastrointestinal tracts. HAE due to C1-esterase inhibitor deficiency (C1-INH-HAE) is the most prevalent subtype. The present Iberian study compared C1-INH-HAE treatment guidelines published between 2010 and 2022 to identify the main differences in therapeutic approaches for on-demand treatment and short- and long-term prophylaxis (LTP). HAE guidelines evolved with the availability of new treatments and with a change in the management paradigm towards an individualized, patient-centered approach, where quality of life (QOL) is central. A parallel trend was observed towards increasingly frequent home-based treatment, which potentially facilitates timely interventions, provides greater flexibility and convenience, and is associated with increased QOL, enabling patients to lead more normal lives. Most innovations over the years were made for LTP, together with the advent of new therapies and awareness of patients' needs. Several prophylactic therapies with a high level of evidence became available, although formal head-to-head comparisons are lacking. The treatment goals became more ambitious, ranging from a reduction in the frequency, severity, and duration of attacks to achieving total disease control and normalization of patients' lives. The document also addresses relevant items such as changes in terminology (eg, the introduction of designations as "first-line") and the introduction of patient-reported outcome measures to assess patients' perceptions of their self-experienced QOL and well-being. Unmet needs in the management of C1-INH-HAE are identified.

Evolution of Guidelines for the Management of Hereditary Angioedema due to C1 Inhibitor Deficiency

Hereditary angioedema (HAE) is a severe and disabling condition characterized by recurrent episodes of subcutaneous or mucosal swelling in the skin and respiratory and gastrointestinal tracts. HAE due to C1-esterase inhibitor deficiency (C1-INH-HAE) is the most prevalent subtype. The present Iberian study compared C1-INH-HAE treatment guidelines published between 2010 and 2022 to identify the main differences in therapeutic approaches for on-demand treatment and short- and long-term prophylaxis (LTP). HAE guidelines evolved with the availability of new treatments and with a change in the management paradigm towards an individualized, patient-centered approach, where quality of life (QOL) is central. A parallel trend was observed towards increasingly frequent home-based treatment, which potentially facilitates timely interventions, provides greater flexibility and convenience, and is associated with increased QOL, enabling patients to lead more normal lives. Most innovations over the years were made for LTP, together with the advent of new therapies and awareness of patients’ needs. Several prophylactic therapies with a high level of evidence became available, although formal head-to-head comparisons are lacking. The treatment goals became more ambitious, ranging from a reduction in the frequency, severity, and duration of attacks to achieving total disease control and normalization of patients’ lives. The document also addresses relevant items such as changes in terminology (eg, the introduction of designations as “first-line”) and the introduction of patient-reported outcome measures to assess patients’ perceptions of their self-experienced QOL and well-being. Unmet needs in the management of C1-INH-HAE are identified (AU)

El angioedema hereditario (AEH) es una enfermedad grave e incapacitante, caracterizada por episodios recurrentes de edema subcutáneo en la piel o en las mucosas de los tractos respiratorio y gastrointestinal. El AEH por déficit del C1-inhibidor (AEH-C1-INH) es el subtipo más prevalente. En el presente estudio ibérico se han comparado las guías/recomendaciones de tratamiento del AEH-INH-C1, publicadas entre 2010 y 2022 para identificar las principales diferencias en cuanto a los enfoques terapéuticos para el tratamiento a demanda y la profilaxis a corto y largo plazo (PLP). A nivel mundial, las directrices sobre el AEH evolucionaron con la disponibilidad de nuevos tratamientos y con un cambio en el paradigma de gestión hacia un enfoque individualizado y centrado en el paciente en el que la calidad de vida (CdV) es fundamental. En consonancia con ello, se observó una tendencia creciente hacia el tratamiento domiciliario, ya que facilita potencialmente las intervenciones precoces, proporciona mayor flexibilidad y comodidad, y se asocia a una mayor calidad de vida, permitiendo a los pacientes llevar una vida normal. La PLP es el indicador que más innovaciones ha experimentado a lo largo de los años, paralelamente a la disponibilidad de nuevas terapias y a la toma de conciencia de las necesidades de los pacientes. Se dispone de varias terapias profilácticas con un alto nivel de evidencia, aunque faltan estudios específicos de comparaciones directas entre ellas. Los objetivos del tratamiento se han ido haciendo más ambiciosos, desde la reducción de la frecuencia, gravedad y duración de los ataques, hasta lograr el control total de la enfermedad y la normalización de la vida de los pacientes en la actualidad (AU)

Frailty among older Hispanics living in the United States: A scoping review.

A scoping review was conducted to identify the available evidence about frailty among older Hispanics living in the U.S. using the Integral Model of Frailty. A not time-limited search was conducted in five peer-reviewed databases. Identified factors associated with frailty among older Hispanics are presented in four categories: (1) Characteristics and prevalence of frailty, (2) Life course determinants of frailty, (3) Comorbidities associated with frailty, and (4) Adverse outcomes of frailty. A total of 1030 articles were identified, and 37 articles were included in the scoping review. Most studies measured frailty based on the Fried Frailty Phenotype (59.5%, n= 22) and had a longitudinal design (64.9%, n= 24). The overall prevalence of frailty among Hispanics ranged from 4.3% to 37.1% (n= 20 studies). Further research is needed that targets Hispanics from different backgrounds in the U.S., particularly those that are high in number (i.e., Mexicans, Puerto Ricans, and Central Americans).

Trends and Evolution in Women's Health Workforce in the First Quarter of the 21st Century.

Medicine in general, and particularly women's health, is rapidly evolving. This brief communication exposes some of the changes in Obstetrics and Gynecology but are relevant to all areas of medicine. As medical knowledge grows exponentially, there may be a greater sub-specialization of physicians, residency education must adapt, physician burnout remains an issue and clinician-scientists are becoming a dying breed. In addition, healthcare delivery systems and technological innovations, such as intelligent-EMRs, promise to support physician and prevent medical errors.

Longer summer seasons after fire induce permanent drought legacy effects on Mediterranean plant communities dominated by obligate seeders.

The ecological stability of Mediterranean ecosystems is being threatened by climate change. One of the impacts that is expected to be aggravated is the effect of summer drought prolongation toward previous or subsequent seasons by becoming more frequent. This, along with wildfires, could trigger synergistic negative effects on ecosystem regeneration capacity. Here we assessed how extending summer drought in two different ways (to autumn, AutExcl treatment, or bringing it forward to the following spring, SprExcl treatment) would affect plant recovery after an experimental fire carried out in summer in a Mediterranean seeder community. By installing rainout shelters, we assessed differences in seedling emergence, survival and establishment in the main families (Cistaceae, Labiatae, Leguminosae), and the effect on species richness and community composition. We observed that these post-fire dry season extensions reduced the total number of established seedlings and species richness. The most impacting drought treatment was AutExcl. However, the regeneration response was variable depending on the studied family. SprExcl was also determinant for Labiate survival rates. These results suggest that drought events which prolong the usual summer season may have a permanent drought legacy effect on seeder communities as practically all the seeder species populations were established in the first post-fire year. This fact is relevant for Mediterranean ecosystems dominated by seeder species as severer and longer droughts are increasingly recorded and are expected to become more frequent in forthcoming decades.

Thinning and plantation of resprouting species redirect overstocked pine stands towards more functional communities in the Mediterranean basin.

Post-fire regeneration in Pinus halepensis' forests, one of the most abundant vegetation types in the Mediterranean basin, often generates overstocked and vulnerable stands. They accumulate a high fuel load, increasing the risk of further fires, and present high levels of vulnerability due to their reduced seed production. In addition, these dense stands substantially reduce the availability of light and nutrients, which may hinder the recruitment of other species, often generating mono-specific and homogeneous stands, which potentially supply fewer ecosystem services than mixed forests with more heterogeneous structures. In these dense pine stands, management is of high priority to reduce fire hazards and promote their functionality. In overstocked pine stands (>75,000 trees·ha-1), we assessed the long-term effects (10 years) of two thinning levels (600 and 1200 trees·ha-1), in combination with the plantation of Quercus faginea (a resprouter species typical of advanced successional stages in our study area) on 28 above and belowground ecosystem attributes, including fire hazard. After ten years, thinning and plantation interacted to enhance ecosystem attributes associated with disturbance regulation and biodiversity conservation (up to 200%) and food production (up to 90%), while no effects were observed on those attributes related to carbon sequestration and supporting services. These effects were mainly driven by aboveground attributes, as they responded more strongly to our treatments than those belowground. Our results are relevant for the restoration of Mediterranean degraded ecosystems, and show that tree thinning in overstocked pine stands, combined with the plantation of resprouter species, may not only reduce fire risks and accelerate post-fire succession but also enhance the supply of multiple ecosystem services in the long run.

La relación entre inteligencia emocional y personalidad en estudiantes universitarios españoles / The relationship between emotional intelligence with the Big Five in Spanish undergraduates

El objetivo de esta investigación es analizar la relación entre la inteligencia emocional y el modelo de personali-dad de los Cinco Grandes. Una muestra de 430 estudiantes universitarios con edades comprendidas entre los 18 y los 69 años (M = 21’41; DT = 4’99) completaron el Trait Meta Mood Scale (TMMS-24; Salovey, Mayer, Goldman et al., 1995) y el Ten Item Personality Inventory (TIPI; Gosling, Rentfrow y Swann, 2003). El análisis de correlación realizado muestra cierto solapamiento entre las dimensiones de la inteligencia emocional y los factores de los Cinco Grandes. Los resultados de los análisis de regresión están en línea con el modelo de inteligencia emocional rasgo y apoyan la asociación entre determinados factores de los Cinco Grandes (particularmente extraversión y estabilidad emocional) y las dimensiones de la inteligencia emocional. El presente estudio contribuye a expandir la literatura sobre las relaciones entre la inteligencia emocional y la personalidad (AU)

The goal of this research is to analyze the relationship between emotional intelligence with the Big Five personality model. A sample of 300 undergraduate students between the ages of 18 and 69 (M = 21.41; SD = 4.99) filled the Trait Meta Mood Scale (TMMS-24, Salovey, Mayer, Goldman et al., 1995) and the Ten Item Personality Inventory (TIPI; Gosling, Rentfrow, & Swann, 2003). The correlation analysis performed shows some overlap between the dimensions of emotional intelligence and the Big Five factors. The results of the regression analyses are in line with trait emotional intelligence model and support the association between certain factors of the Big Five (particularly with extraversion and emotional stability) and the dimensions of emotional intelligence. The present study contributes to expanding the literature on the relationships between emotional intelligence and personality (AU)

Modified Gaussian models applied to the description and deconvolution of peaks in chiral liquid chromatography.

The description of the profiles of chromatographic peaks has been studied extensively, with a large number of proposed mathematical functions. Among them, the accuracy achieved with modified Gaussian models that describe the deviation of an ideal Gaussian peak as a change in the peak variance or standard deviation over time, has been highlighted. These models are, in fact, a family of functions of different complexity with great flexibility to adjust chromatographic peaks over a wide range of asymmetries and shapes. However, an uncontrolled behaviour of the signal may occur outside the region being fitted, forcing the use of different strategies to overcome this problem. In this work, the performance of the LMG (Linear Modified Gaussian), PVMG (Parabolic Variance Modified Gaussian), and PLMG (Parabolic-Lorentzian Modified Gaussian) models is compared with variants obtained by combination of the modified Gaussian models with an equation that adds an exponential tail and with other functions that limit the growth of the independent variable. The behaviour of the approaches is checked through the simultaneous fitting of enantiomeric peaks showing a wide range of characteristics, obtained in the separation of drugs with chiral activity by liquid chromatography using enantioselective columns. The study is also carried out with the purpose of performing the deconvolution of the peaks of the enantiomers, when these are not completely resolved, in order to evaluate the enantiomeric fraction.

Validation of self-reported adherence in chronic patients visiting pharmacies and factors associated with the overestimation and underestimation of good adherence.

BACKGROUND: Studies validating indirect methods to identify nonadherence in chronic patients who visit pharmacies are lacking. The aim of this study was to validate self-reported adherence and assess the variables associated with both overestimation and underestimation of good adherence when using this method. MATERIALS AND METHODS: An observational, cross-sectional study was undertaken to validate self-reported adherence in 132 community pharmacies throughout Spain in 6237 chronic patients. The Morisky-Green test was used as the validation method and through a 2 × 2 table, the validity indicators, predictive values, and likelihood ratios were calculated. To assess the variables associated with both overestimation and underestimation of good adherence, multivariate logistic regression analysis and calculation of the area under the ROC curve were used to evaluate discriminatory capacity. RESULTS: Sensitivity was 27.8% (95% CI: 26.2-29.4) and specificity was 93.9% (95% CI: 93.1-94.7). Discrepancy analysis obtained a significant overestimation of good adherence (p < 0.001). The factors associated with overestimating good adherence were performing a mnemonic trick (p < 0.001), not self-medicating (p < 0.001), a high level of physical activity (p < 0.001), and an older age (p = 0.014). Factors associated with underestimation were self-medication (p < 0.001), desiring more information (p < 0.001), smoking (p = 0.014), not engaging in physical activity in the low (p = 0.006) or high (p < 0.001) categories, having a younger mean age (p = 0.007), and taking two to three (p = 0.029) or four or more (p < 0.001) chronic treatments. CONCLUSION: Self-reported adherence has good specificity but poor sensitivity. The associated profiles of the discrepancies were obtained to identify both good and poor adherence.

Prevalencia de las intoxicaciones agudas asistidas en 3 hospitales del sureste español / Prevalence of acute poisoning treated in 3 hospitals in Southeast Spain

OBJETIVO: Evaluar las características de las intoxicaciones agudas atendidas en urgencias hospitalarias durante 5 años. MÉTODO: Estudio retrospectivo de las intoxicaciones agudas asistidas en 3 hospitales entre 2013 y 2017, y análisis de las características demográficas, tipos de intoxicación, variaciones estacionales, asistencia recibida y reincidencia. RESULTADOS: El 0,51% de los casos atendidos en los 3 hospitales correspondieron a intoxicaciones agudas. Los porcentajes varían según la localización del hospital (0,91% urbano, 0,37% en zona de costa y 0,22% rural). Las intoxicaciones alcohólicas presentan cierto carácter estacional, aumentando en época estival en la costa (p < 0,05). A partir de los 31 años de edad existen diferencias en cuanto al tipo de intoxicación (p < 0,05) en los 3 hospitales. El alcohol siempre representa el mayor número de casos a partir de los 31 años, excepto en la zona rural donde la mayoría de los casos son intoxicaciones voluntarias con fines autolíticos. Los hombres muestran mayor prevalencia que las mujeres (55,77 vs. 44,23%) para el conjunto de los casos. Las intoxicaciones alcohólicas ocurren en primer lugar en hombres de 30 a 75 años y las voluntarias con fines autolíticos en mujeres, excepto en las de 30 a 46 años en las que también es por alcohol. El mayor número de casos reincidentes se producen por el alcohol en hombres (791 casos) y por benzodiacepinas en mujeres (528 casos). CONCLUSIONES: El número y el tipo de intoxicación varía en función de la ubicación del hospital, la época del año, el sexo y la edad de los pacientes

OBJECTIVE: To assess the characteristics of acute poisoning cases treated in hospital emergency departments over 5 years. METHODS: Retrospective study of acute poisoning cases treated in 3 hospitals between 2013 and 2017 and an analysis of the demographic characteristics, types of poisoning, seasonal variations, care received and recurrence. RESULTS: Some 0.51% of all cases treated in the 3 hospitals corresponded to acute poisoning. The percentages varied by hospital location (0.91% urban, 0.37% coastal and 0.22% rural). Cases of alcohol poisoning had a seasonal character, increasing during the summer on the coast (P<.05). There were differences in the type of poisoning ( P<.05) for patients 31 years of age and older in the 3 hospitals. Alcohol represented the largest number of cases in patients 31 years of age and older, except in the rural area where most cases were due to voluntary poisoning in attempted suicide. Men had a higher prevalence of poisoning than women (55.77% vs. 44.23%) for all cases. Alcohol poisoning was in first place for men 30-75 years, and voluntary poisoning for attempted suicide was first for women, except for those 30-46 years of age for whom alcohol was also number one. The large number of cases of recurrence were due to alcohol in men (791 cases) and to benzodiazepines in women (528 cases). CONCLUSIONS: The number of cases and the type of poisoning varied according to hospital location, season, patient sex and patient age

Prevalence of acute poisoning treated in 3 hospitals in Southeast Spain. / Prevalencia de las intoxicaciones agudas asistidas en 3 hospitales del sureste español.

OBJECTIVE: To assess the characteristics of acute poisoning cases treated in hospital emergency departments over 5 years. METHODS: Retrospective study of acute poisoning cases treated in 3 hospitals between 2013 and 2017 and an analysis of the demographic characteristics, types of poisoning, seasonal variations, care received and recurrence. RESULTS: Some 0.51% of all cases treated in the 3 hospitals corresponded to acute poisoning. The percentages varied by hospital location (0.91% urban, 0.37% coastal and 0.22% rural). Cases of alcohol poisoning had a seasonal character, increasing during the summer on the coast (P<.05). There were differences in the type of poisoning ( P<.05) for patients 31 years of age and older in the 3 hospitals. Alcohol represented the largest number of cases in patients 31 years of age and older, except in the rural area where most cases were due to voluntary poisoning in attempted suicide. Men had a higher prevalence of poisoning than women (55.77% vs. 44.23%) for all cases. Alcohol poisoning was in first place for men 30-75 years, and voluntary poisoning for attempted suicide was first for women, except for those 30-46 years of age for whom alcohol was also number one. The large number of cases of recurrence were due to alcohol in men (791 cases) and to benzodiazepines in women (528 cases). CONCLUSIONS: The number of cases and the type of poisoning varied according to hospital location, season, patient sex and patient age.

Increased aridity drives post-fire recovery of Mediterranean forests towards open shrublands.

Recent observations suggest that repeated fires could drive Mediterranean forests to shrublands, hosting flammable vegetation that regrows quickly after fire. This feedback supposedly favours shrubland persistence and may be strengthened in the future by predicted increased aridity. An assessment was made of how fires and aridity in combination modulated the dynamics of Mediterranean ecosystems and whether the feedback could be strong enough to maintain shrubland as an alternative stable state to forest. A model was developed for vegetation dynamics, including stochastic fires and different plant fire-responses. Parameters were calibrated using observational data from a period up to 100 yr ago, from 77 sites with and without fires in Southeast Spain and Southern France. The forest state was resilient to the separate impact of fires and increased aridity. However, water stress could convert forests into open shrublands by hampering post-fire recovery, with a possible tipping point at intermediate aridity. Projected increases in aridity may reduce the resilience of Mediterranean forests against fires and drive post-fire ecosystem dynamics toward open shrubland. The main effect of increased aridity is the limitation of post-fire recovery. Including plant fire-responses is thus fundamental when modelling the fate of Mediterranean-type vegetation under climate-change scenarios.

Acute care for elderly patients in a functional impairment prevention unit. / Atención aguda a pacientes ancianos en una unidad de prevención del deterioro funcional.

AIM: To determine whether the care of patients with moderate dependency who were hospitalised in a functional impairment prevention unit (FIPU) was superior to that of a conventional unit (CU) in terms of functional impairment and mean stay. METHODS: We conducted a single-centre, retrospective, controlled intervention study that compared acute treatment in an FIPU and in conventional wards. The study included 466 elderly patients with moderate dependence (Barthel index, 30-70) and older than 75 years. Of these, 280 were included in the intervention group and 186 in the control group. The primary outcomes were loss of functionality attributable to the hospitalisation (measured by the loss of ambulation and urinary continence) and differences in the length of stay. RESULTS: The patients hospitalised in the FIPU showed less functional impairment as determined by the loss of urinary continence (2.1% of the FIPU patients vs. 9.7% of the CU patients; p<.01) and the loss of walking ability (2.1% vs. 25.3%; p<.01). The patients hospitalised in the FIPU had a shorter mean stay (7.4 vs. 8.5 days; p<.05), with 1 day less of stay than the CU patients. CONCLUSION: The acute care of elderly patients with moderate dependency in an FIPU was independently associated with less functional decline and shorter stays.

Redirecting fire-prone Mediterranean ecosystems toward more resilient and less flammable communities.

The extensive abandonment of agricultural lands in the Mediterranean basin has led to large landscapes being dominated by early-successional species, characterized by high flammability and an increasing fire risk. This fact promotes fire occurrence and places ecosystems in a state of arrested succession. In this work, we assessed the effectiveness of several restoration actions in redirecting these ecosystems toward more resilient communities dominated by resprouting species. These actions included the mechanical clearing of early-successional species, the plantation of resprouting species, and the combination of both treatments. For 13 years, we assessed shifts in the successional trajectory and ecosystem flammability by changes in: species composition, species richness, ecosystem evenness, the natural colonization of resprouting species, total biomass and proportion of dead biomass. We observed that the plantation and clearing combination was a suitable strategy to promote resilience. Species richness increased as well as the presence of the resprouting species introduced by planting. The natural colonization of the resprouting species was also enhanced. These changes in the successional trajectory were accompanied by a possible reduction of fire risk by reducing dead fuel proportion. These findings are relevant for the management of Mediterranean basin areas, but also suggest new tools for redirecting systems in fire-prone areas worldwide.

Chiral magnetic-nanobiofluids for rapid electrochemical screening of enantiomers at a magneto nanocomposite graphene-paste electrode.

The development of highly sensitive and selective enantiomeric platforms towards the rapid screening of active pharmaceutical ingredients (APIs) is nowadays a crucial challenge in several fields related to pharmacology, biomedicine, biotechnology and (bio)sensors. Herein, it is presented a novel, facile and generic methodology focused on exploiting the synergistically and electrocatalytic properties of chiral magnetic-nanobiofluids (mNBFs) with electrochemical enantiobiosensing at a magneto nanocomposite graphene paste electrode (mNC-GPE). The feasibility of this approach has been validated by chirally recognizing tryptophan (TRP) enantiomers as a proof-of-concept. For this aim, a specific chiral mNBF based on an aqueous dispersion of cobalt ferrite loaded with gold nanoparticles carrying a thiolated ß-cyclodextrin (ß-CD-SH/Au/CoFe2O4-NPs) has been synthesized and used towards the supramolecular discrimination of TRP enantiomers at an advanced graphene-paste transducer via cyclic voltammetry. This strategy, which is the first demonstration of applicability of chiral mNBFs for electrochemical enantiorecognition, opens up new approaches into enantio(bio)sensing.