A phase I dose escalation and expansion trial of the next-generation oral SERD camizestrant in women with ER-positive, HER2-negative advanced breast cancer: SERENA-1 monotherapy results.

BACKGROUND: SERENA-1 (NCT03616587) is a phase I, multi-part, open-label study of camizestrant in pre- and post-menopausal women with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer. Parts A and B aim to determine the safety and tolerability of camizestrant monotherapy and define doses for clinical evaluation. PATIENTS AND METHODS: Women aged ≥18 years with metastatic or recurrent ER+, HER2- breast cancer, refractory (or intolerant) to therapy, were assigned 25 mg up to 450 mg once daily (QD; escalation) or 75, 150, or 300 mg QD (expansion). Safety and tolerability, antitumor efficacy, pharmacokinetics, and impact on mutations in the estrogen receptor gene (ESR1m) circulating tumor (ct)DNA levels were assessed. RESULTS: By 9 March 2021, 108 patients received camizestrant monotherapy at 25-450 mg doses. Of these, 93 (86.1%) experienced treatment-related adverse events (TRAEs), 82.4% of which were grade 1 or 2. The most common TRAEs were visual effects (56%), (sinus) bradycardia (44%), fatigue (26%), and nausea (15%). There were no TRAEs grade 3 or higher, or treatment-related serious adverse events at doses ≤150 mg. Median tmax was achieved ∼2-4 h post-dose at all doses investigated, with an estimated half-life of 20-23 h. Efficacy was observed at all doses investigated, including in patients with prior cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) and/or fulvestrant treatment, with and without baseline ESR1 mutations, and with visceral disease, including liver metastases. CONCLUSIONS: Camizestrant is a next-generation oral selective ER antagonist and degrader (SERD) and pure ER antagonist with a tolerable safety profile. The pharmacokinetics profile supports once-daily dosing, with evidence of pharmacodynamic and clinical efficacy in heavily pre-treated patients, regardless of ESR1m. This study established 75-, 150-, and 300-mg QD doses for phase II testing (SERENA-2, NCT04214288 and SERENA-3, NCT04588298).

Undetectable circulating tumor DNA confirms the inability of pseudomyxoma peritonei to systemic dissemination.

The study of circulating tumor DNA (ctDNA) plays a pivotal role in advancing precision oncology, providing valuable information for individualized patient care and contributing to the ongoing effort to improve cancer diagnosis, treatment, and management. However, its applicability in pseudomyxoma peritonei (PMP) remains unexplored. In this multicenter retrospective study involving 21 PMP patients, we investigated ctDNA presence in peripheral blood using three distinct methodologies. Despite mucinous tumor tissues exhibiting KRAS and GNAS mutations, ctDNA for these mutations was undetectable in blood samples. In this pilot study, circulating tumor DNA was not detected in blood when the tumor harbored mutations of known significance. In the future, a study with a larger sample size is needed to confirm these findings and to determine whether ctDNA could identify patients at risk for early recurrence and/or systemic metastases.

Could the aroma of spices produce a cross-modal enhancement of food saltiness and contribute to reducing salt intake?

BACKGROUND: As a result of its correlation with cardiovascular diseases, salt intake must be reduced. According to multi-sensory integration, aroma plays an important role in saltiness enhancement; this could enable a food's salt content to be reduced without losing acceptance. We therefore studied the effect of three spices, Curcuma longa, Laurus nobilis L. and Petroselinum crispum L., on saltiness enhancement through sensory tests on consumers. This was followed by olfactometric analysis with the aim of relating the effect to the spices' aromatic composition. RESULTS: According to the odour-induced salty taste enhancement (OISE) mean values, bay leaf and turmeric had the highest effect on saltiness enhancement, at a similar level to dry-cured ham aroma, wherwas parsley had a significantly lower OISE value. Only one odour-active compound (OAC), eugenol, showed a direct correlation with the spices' OISE values. Turmeric primarily had OACs with sweet aroma, whereas bay leaf had more OACs belonging to the spicy-aroma category. CONCLUSION: The three spices, turmeric, bay leaf and parsley, investigated in the present study appear to enhance the salty taste of mashed potato with a low salt content. The results suggest that an interaction effect among OACs with different aromatic ranges may exist. Therefore, when the global OAC modified frequency value, grouped according to aroma range, was considered, the sweet range appears to counteract the effect of the spicy aroma on saltiness. © 2024 Society of Chemical Industry.

Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: Long term oncologic outcomes from the international PSOGI registry.

The laparoscopic approach for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (L-CRS + HIPEC) in highly selected patients was previously reported from the PSOGI registry with a demonstrable reduction in length of stay and post-operative morbidity. This study aims to update this international PSOGI registry with a larger cohort of patients and a longer follow-up period. METHODS: An international registry was designed through a networking database (REDCAP®). All centers performing L-CRS + HIPEC were invited through PSOGI to submit data on their cases. Variables such as demographics, clinical outcomes, and survival were analyzed. RESULTS: A total of 315 L-CRS + HIPEC cases were provided by 14 worldwide centers. A total of 215 patients were included in the L-CRS + HIPEC group. The median peritoneal cancer index (PCI) was 3 (3-5). The median length of stay was 7 days (5-10) and the major morbidity (Clavien-Dindo ≥3) was 6.1% after 30 days. The 5-year disease-free survival (DFS) per tumor origin was: 94% for PMP-LG, 85% for PMP-HG, 100% for benign multicyst peritoneal mesothelioma (MPM), 37.4% for colonic origin, and 54%(at 3 years) for ovarian origin. The 5 years overall survival (OS) per tumor origin was: 100% for PMP-LG, PMP-HG and MPM; 61% for colonic origin, and 74% (at 3 years) for ovarian origin. In addition, a total of 85 patients were analyzed in the laparoscopic risk-reducing HIPEC (L-RR + HIPEC). The median length of stay was 5 days (4-6) and the major morbidity was 6% after 30 days. The 5-year DFS per tumor origin was: 96% for perforated low grade appendiceal mucinous neoplasm (LAMN II) and 68.1% for colon origin. The 5 years OS per tumor origin was: 98% for LAMN II and 83.5% for colonic origin. CONCLUSIONS: Minimally invasive CRS + HIPEC is a safe procedure for selected patients with peritoneal carcinomatosis in specialized centers. It improves perioperative results while providing satisfactory oncologic outcomes. L-RR + HIPEC represents a promising strategy that could be evaluated in patients with high risk of developing peritoneal carcinomatosis into prospective randomized trials.

Establishment of a desirable dose using neutral argon plasma to eradicate miliary peritoneal implants: A phase I/II controlled trial.

INTRODUCTION: Neutral argon plasma (NAP) system could meet the requirements to achieve oncological cytoreduction of peritoneal carcinomatosis with miliary lesions, minimizing the associated morbidity. This phase I/II trial aims to establish the desirable dose that is safe and effective in eliminating tumor cells with lower penetration. METHODS: Patients diagnosed with different origins for peritoneal carcinomatosis and miliary implants were selected for the study. The safe and potentially effective dose (desirability) of NAP was evaluated according to three factors: distance (mm), application time (s) and power (%), to evaluate the response variables such as the presence of tumor cells (Y/N) and the depth of penetration. RESULTS: Ten patients and 120 samples were evaluated and treated with NAP. There was no vascular or organ injury intraoperative using a pre-established dose of 100% (coagulation mode) at a distance of 2-3 cm. The distance was found to be correlated with the presence of the tumor cells in ex-vivo analysis, with an OR of 15.4 (4.0-111.4). The time and energy used were protective factors to eliminate tumor cells with an OR of 0.4 (0.1-0.9) and 0.8 (0.8-0.9), respectively. The safest and most effective desirability results were as follows i) energy 80% during 2-4 s with a distance of 2 cm (0.89), and ii) energy 100% during 2-4 s with a distance of 3 cm (0.90). CONCLUSIONS: The use of NAP during a CRS and HIPEC is safe and effective for eradicating tumor cells on the peritoneal surface at suggested doses of energy, distance and duration. TRIAL IDENTIFICATION: ClinicalTrials.gov Identifier: NCT04904042.

COVID-19 pandemic on coronary artery and cerebrovascular diseases in Southern Spain: interrupted time series analysis.

OBJECTIVE: Healthcare systems have been put under intense pressure by the COVID-19 pandemic, although some studies have shown a decline in hospital admissions for cardiovascular and cerebrovascular diseases during the first and second wave of the pandemic. In addition, studies analyzing gender and procedural differences are scarce. The present study aimed to determine the impact of the pandemic on hospital admissions for acute myocardial infarction (AMI) and cerebrovascular disease (CVD) in Andalusia (Spain) and analyzed differences by gender and by percutaneous coronary interventions performed. PATIENTS AND METHODS: An interrupted time series analysis of AMI and CVD hospital admissions in Andalusia (Spain) was carried out to measure the impact of the COVID-19 outbreak. AMI and CVD cases admitted daily in public hospitals of Andalusia between January 2018 and December 2020 were included. RESULTS: During the pandemic, significant reductions in AMI [-19%; 95% confidence interval (CI): (-29%, -9%), p<0.001] and CVD [-17%; 95% CI: (-26%, -9%); p<0.01] in daily hospital admissions were observed. Differences were also produced according to the diagnosis (ST-Elevation Myocardial Infarction, Non-ST-Elevation Myocardial Infarction, other AMI and stroke), with a greater reduction in females for AMI and in males for CVD. Although there were more percutaneous coronary interventions during the pandemic, no significant reductions were observed. CONCLUSIONS: A decline in AMI and CVD daily hospital admissions during the first and second wave of COVID-19 pandemic was noted. Gender differences were observed, but no clear impact was observed in percutaneous interventions.

Endodontic variables in patients with SARS-CoV-2 infection (COVID-19) in relation to the severity of the disease.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is the cause of the ongoing coronavirus disease 2019 (COVID-19) pandemic. It has been hypothesized oral health may be related to the severity and complications of COVID-19. The aim of this study was to analyze the prevalence of apical periodontitis and the frequency of root canal treatment in a sample of patients with SARS-CoV-2 infection (COVID-19), correlating them with the severity of the disease. MATERIAL AND METHODS: This retrospective study was conducted following the Strengthening Reporting Observational Studies in Epidemiology (STROBE) guidelines. The study examined 280 patients with positive real time PCR COVID-19 test whose treatment was performed in our hospital. Fifty-two patients aged 52.3 ± 17.3 years, including 30 males and 22 females, who had an orthopantomography in their clinical record, performed in the last 2 years, were included. Patients with SARS-CoV-2 infection were grouped as mild or moderate (MM) and severe or critical (SC) illness groups, according to the NIH COVID-19 Treatment Guidelines (Wu & McGoogan 2020). Radiographic records were analyzed and apical periodontitis (AP) was diagnosed as radiolucent periapical lesions (RPLs), using the periapical index score (PAI). Student's t test, χ2 test and multivariate logistic regression were used in the statistical analysis. RESULTS: The number of carious teeth was significantly higher in the SC group (3.4 ± 4.1), which showed more than twice as many teeth with carious lesions than the MM group (1.4 ± 1.8) (p = 0.02). Multivariate regression analysis showed association between the number of carious teeth and the severity of SARS-CoV-2 disease (OR = 1.5; 95% CI = 1.1-2.1; p = 0.017). Endodontic status (OR = 7.12; 95% CI = 1.2-40.9; p = 0.027) also correlated with the disease severity. CONCLUSIONS: The results suggest that the oral health status of COVID-19 patients correlated with the severity of the SARS-CoV-2 virus infection. Significant association has been found between the severity of COVID-19 disease and the presence of a greater number of teeth with caries lesions, as well as with endodontic status.

Influence of the Washing Process and the Time of Fruit Harvesting throughout the Day on Quality and Chemosensory Profile of Organic Extra Virgin Olive Oils.

In recent years, there has been a growing demand for organic extra virgin olive oils (OEVOOs) as quality products with greater added value. The aim of the present work was to determine whether the washing process and time of harvesting (morning or afternoon) plays an important role in the quality of Picual OEVOOs by studying quality parameters (degree of acidity, peroxide value, K232, K270, oxidative stability), and volatile and sensory profiles. Olive fruits were harvested at three maturity stages and within each phase at two times of the day (morning and afternoon). Then, samples were divided into two blocks (washed and unwashed). Volatile profile was obtained by headspace solid-phase microextraction (HS-SPME) coupled to gas chromatography-mass spectrometry (GC-MS). Regarding the physicochemical quality parameters, sensory and volatile profiles, there were no differences between the oils produced under the two treatments applied (washed/non-washed). However, the time of harvesting (morning or afternoon) did influence the volatile and sensory profile, with higher values in the oils obtained from fruits harvested in the morning, being statistically significant for the families of aldehydes, hydrocarbures and lactones. Besides, the olives harvested during the mornings gave rise to oils with higher values in the green and apple fruit attributes.

First Leptophobic Dark Matter Search from the Coherent-CAPTAIN-Mills Liquid Argon Detector.

We report the first results of a search for leptophobic dark matter (DM) from the Coherent-CAPTAIN-Mills (CCM) liquid argon (LAr) detector. An engineering run with 120 photomultiplier tubes (PMTs) and 17.9×10^{20} protons on target (POT) was performed in fall 2019 to study the characteristics of the CCM detector. The operation of this 10-ton detector was strictly light based with a threshold of 50 keV and used coherent elastic scattering off argon nuclei to detect DM. Despite only 1.5 months of accumulated luminosity, contaminated LAr, and nonoptimized shielding, CCM's first engineering run has already achieved sensitivity to previously unexplored parameter space of light dark matter models with a baryonic vector portal. With an expected background of 115 005 events, we observe 115 005+16.5 events which is compatible with background expectations. For a benchmark mediator-to-DM mass ratio of m_{V_{B}}/m_{χ}=2.1, DM masses within the range 9 MeV≲m_{χ}≲50 MeV are excluded at 90% C. L. in the leptophobic model after applying the Feldman-Cousins test statistic. CCM's upgraded run with 200 PMTs, filtered LAr, improved shielding, and 10 times more POT will be able to exclude the remaining thermal relic density parameter space of this model, as well as probe new parameter space of other leptophobic DM models.

Dysregulation of macrophage PEPD in obesity determines adipose tissue fibro-inflammation and insulin resistance.

Resulting from impaired collagen turnover, fibrosis is a hallmark of adipose tissue (AT) dysfunction and obesity-associated insulin resistance (IR). Prolidase, also known as peptidase D (PEPD), plays a vital role in collagen turnover by degrading proline-containing dipeptides but its specific functional relevance in AT is unknown. Here we show that in human and mouse obesity, PEPD expression and activity decrease in AT, and PEPD is released into the systemic circulation, which promotes fibrosis and AT IR. Loss of the enzymatic function of PEPD by genetic ablation or pharmacological inhibition causes AT fibrosis in mice. In addition to its intracellular enzymatic role, secreted extracellular PEPD protein enhances macrophage and adipocyte fibro-inflammatory responses via EGFR signalling, thereby promoting AT fibrosis and IR. We further show that decreased prolidase activity is coupled with increased systemic levels of PEPD that act as a pathogenic trigger of AT fibrosis and IR. Thus, PEPD produced by macrophages might serve as a biomarker of AT fibro-inflammation and could represent a therapeutic target for AT fibrosis and obesity-associated IR and type 2 diabetes.

Influence of the ripening chamber's geographical location on dry-cured Iberian ham's key odorants.

Olfactometric and sensory analyses have been applied to study the possible influence of the ripening chamber's geographical location on the aroma sensory profiles and key odorants of Iberian ham. Dry-cured Iberian ham was obtained from 3 acorn-fed pigs and, for the first time, both of the participating production facilities, located in two different Andalusian municipalities with different altitudes above mean sea level, processed one of the two hind legs from each pig. The descriptive sensory profile of orthonasal and retronasal odours was determined by trained panellists, while odour-active compounds were determined by gas chromatography/mass spectrometry-olfactometry (GC/MS-O). The results obtained showed that, separately, both techniques enable Iberian ham samples to be differentiated by their ripening chamber's geographical location. For sensory analysis, retronasal sensory analysis appeared to be the most suitable for this goal, highlighting the "meat broth odour" and "roasted nuts odour" descriptors which presented significant differences between geographical locations for samples from all pigs. Moreover, ripening chamber's geographical location characteristics and the initial composition of the raw material seemed to influence the content of some odour-active compounds. The odour-active compound identified as octane/acetone and isobutanol were conditioned by the ripening chamber's geographical location, while decanal/2-ethyl-1-hexanol, 1-undecanol, 2-furanmethanol and cis-2-nonenal were also influenced by the individual pig itself. This study showed that slight climatological differences due to the location of the ripening chamber seem to have somewhat of an influence on the aromatic profile.

Vaginal birth after caesarean section before and during COVID-19 pandemic. Factors associated with successful vaginal birth.

BACKGROUND: The ratio of caesarean has been increasing considerably in many countries. Planning a vaginal birth after a previous caesarean is considered an important option for women in a subsequent pregnancy. AIMS: To analyse obstetric and neonatal outcomes in women in labour after caesarean section before and during the COVID-19 pandemic, and to determine factors associated with successful vaginal birth after caesarean (VBAC). METHODS: Observational cohort study of women in labour with history of caesarean section who gave birth between March 2019 and December 2020 in a tertiary hospital in southern Spain. Consecutive sampling was performed using the maternal birth database and a descriptive and inferential analysis of the study variables was carried out. Socio-demographic, obstetric and neonatal variables were compared between the pre-pandemic and pandemic periods. Multiple logistic regression analysis was performed to determine variables associated with VBAC success. FINDINGS: The VBAC success rate was 67.4%. The caesarean section rate was significantly higher during the COVID-19 pandemic period. Factors associated with VBAC success were: birth before the pandemic (OR 0.32) and at night (OR 0.45), use of epidural analgesia (OR 2.14), and having had a previous vaginal birth (OR 1.98). CONCLUSIONS: The success rate of VBAC was lower during the pandemic. Knowledge of the factors related to VBAC success is critical for practitioners when supporting women in decision-making about mode of birth after a previous caesarean section.

A non-destructive sampling method for food authentication using gas chromatography coupled to mass spectrometry or ion mobility spectrometry.

The study of volatile compounds obtained by gas chromatography (GC) coupled to mass spectrometry (MS) or ion mobility spectrometry (IMS) may be very useful to protect food quality, especially when using a non-destructive sampling method. In this work, the authentication of the highly appreciated dry-cured Iberian ham by those techniques was studied and compared. The results obtained show the suitability of a non-destructive sampling method coupled to headspace sampling (HS)-GC-IMS or HS-GC-MS to determine volatile markers in the feeding Iberian pig regime. Although both methods were suitable to differentiate the ham categories, HS-GC-IMS was more sensitive detecting a higher number of compounds than HS-GC-MS, which provided accurate qualitative results. The results of principal component analysis showed that ethanol, 2-propanol and 3-methylbutanol, identified by HS-GC-IMS, and 3-methylbutanal and heptane, identified by HS-GC-MS, could be considered potential markers to identify ham from different feeding regimes.

Developing Electrospun Ethylcellulose Nanofibrous Webs: An Alternative Approach for Structuring Castor Oil.

The development of environment-friendly natural polymer gel-like dispersions in oil media, with functional properties, in terms of formulation design and synthesis protocol, is still a cutting-edge research area for many applications. The aim of this work was to study the manufacture of electrospun ethylcellulose (EC) nanofibrous webs and to examine their usage to thicken vegetable oils as an alternative approach. The role of concentration, molecular weight (Mw), and binary solvent systems on the electrospinnability of EC and subsequently on the rheological properties of EC nanofiber dispersions in castor oil was investigated. It was observed that, for each Mw, defect-free nanofibers were produced above a critical concentration, corresponding to about 2.5 the entanglement concentration (Ce). The average fiber diameter increased with both Mw and EC concentrations. Dielectric constant and dipole moment of binary solvent systems influenced the morphology of the EC nanofiber web. The morphology of the micro- and nanoarchitectures generated played a key role in the physical stabilization and rheological behavior of electrospun EC dispersions. The storage modulus (G') of EC dispersions was correlated with both the spinning solution concentration and average fiber diameter. Furthermore, electrospun EC nanofiber dispersions were compared with EC oleogels obtained by traditional thermogelation from thermorheological and tribological points of view. Overall, this work proposes an efficient and innovative approach to produce bio-based oleogel-like dispersions with great potential in different sectors such as pharmaceuticals, food, or lubricants.

Detection of Xylella fastidiosa in almond orchards by synergic use of an epidemic spread model and remotely sensed plant traits.

The early detection of Xylella fastidiosa (Xf) infections is critical to the management of this dangerous plan pathogen across the world. Recent studies with remote sensing (RS) sensors at different scales have shown that Xf-infected olive trees have distinct spectral features in the visible and infrared regions (VNIR). However, further work is needed to integrate remote sensing in the management of plant disease epidemics. Here, we research how the spectral changes picked up by different sets of RS plant traits (i.e., pigments, structural or leaf protein content), can help capture the spatial dynamics of Xf spread. We coupled a spatial spread model with the probability of Xf-infection predicted by a RS-driven support vector machine (RS-SVM) model. Furthermore, we analyzed which RS plant traits contribute most to the output of the prediction models. For that, in almond orchards affected by Xf (n = 1426 trees), we conducted a field campaign simultaneously with an airborne campaign to collect high-resolution thermal images and hyperspectral images in the visible-near-infrared (VNIR, 400-850 nm) and short-wave infrared regions (SWIR, 950-1700 nm). The best performing RS-SVM model (OA = 75%; kappa = 0.50) included as predictors leaf protein content, nitrogen indices (NIs), fluorescence and a thermal indicator (Tc), alongside pigments and structural parameters. Leaf protein content together with NIs contributed 28% to the explanatory power of the model, followed by chlorophyll (22%), structural parameters (LAI and LIDFa), and chlorophyll indicators of photosynthetic efficiency. Coupling the RS model with an epidemic spread model increased the accuracy (OA = 80%; kappa = 0.48). In the almond trees where the presence of Xf was assayed by qPCR (n = 318 trees), the combined RS-spread model yielded an OA of 71% and kappa = 0.33, which is higher than the RS-only model and visual inspections (both OA = 64-65% and kappa = 0.26-31). Our work demonstrates how combining spatial epidemiological models and remote sensing can lead to highly accurate predictions of plant disease spatial distribution.

Ventilatory therapies and Intensive Care admissions for patients with COVID-19: a systematic review.

OBJECTIVE: The aim of the study was to synthesize and analyze the scientific publications related to ventilatory therapies used in patients with COVID-19 in Intensive Care Units (ICUs), the parameters of invasive mechanical ventilation prescribed for these patients, and the clinical characteristics of patients admitted to the ICU. MATERIALS AND METHODS: A systematic review was carried out through the PubMed, Embase, Web of Science and Cochrane Library databases. Studies published up to 31/05/2020 were included if they made reference to ventilatory therapies used in ICU patients with COVID-19. RESULTS: Qualitative analysis was performed on 30 included studies. A total sample of 48,743 patients was analyzed, of which 17.66% were admitted to ICUs, and 6.4% of these patients died. Of the patients analyzed, 44.4% required some type of respiratory support. Specifically, 12.8% of patients received invasive mechanical ventilation, while 9.7% received non-invasive mechanical ventilation, and 29.7% received high-flow nasal oxygen. CONCLUSIONS: COVID-19 has led to a high number of ICU admissions and a challenge for ICUs is to provide the best ventilatory therapy available to patients admitted. It has been observed that the available figures for ICU admissions and the use of ventilatory therapies are similar across continents. However, the data suggest that geographic areas with higher rates of ICU admission have lower mortality rates. The lack of information in some of the clinical records limits the ability to obtain more conclusive results.

Mortality and critical conditions in COVID-19 patients at private hospitals: weekend effect?

OBJECTIVE: The aim of the study was to find factors associated with the mortality of admission to the intensive care unit (ICU) in patients with COVID-19. MATERIALS AND METHODS: Retrospective observational study with a database of 1987 patients with COVID-19 who had attended the emergency department of a private hospital network between February 2020 and April 2020 were analyzed. Clinical variables and some laboratory parameters were studied. The Charlson and Elixhauser comorbidity indices were calculated. The dependent variables were mortality and admission to the ICU. A descriptive and correlational analysis was performed. Logistic regression models and Kaplan-Meier survival curves were established. RESULTS: Positive correlations were observed between age, creatinine, and D-dimer levels, as well as with the scores obtained with the Charlson and Elixhauser indices. Differences in the levels of these parameters were also observed when analyzing variables such as mortality, sex or admission to the ICU. Mortality was associated with high creatinine and D-dimer levels and advanced age. Survival curves indicated longer survival in patients not admitted to the ICU, admitted to the hospital during the week, and in those with lower creatinine and D-dimer levels. CONCLUSIONS: Mortality in Spanish patients with COVID-19 admitted to private hospitals was associated with high creatinine and D-dimer levels and advanced age. Longer survival was obtained on weekdays. This study provides valuable information on the management and nursing care of these patients in order to optimize resources in pandemic situations.

Sleep, dreams, nightmares, and sex-related differences: a narrative review.

OBJECTIVE: The aim of this study was to review the available findings on sex-related differences for sleep disorders, dreams and nightmares. MATERIALS AND METHODS: We explored the PubMed, EMBASE and Google Scholar electronic databases, with regards to the searching terms 'sleep', 'dreams', and 'nightmares' associated with 'sex' and/or 'gender'. Moreover, other supplementary terms for the searching strategy were 'chronobiology', and 'circadian rhythm'. Due to the relative paucity of studies including separate analysis by sex, and especially to their wide heterogeneity, we decided to proceed with a narrative review, highlighting the sex-related findings of each topic into apposite boxes. RESULTS: On one hand, sleep disorders seem to be more frequent in women. On the other hand, sex-related differences exist for either dreams or nightmares. As for the former, differences make reference to dream content (men: physical aggression, women family themes), self-reported perspective (men dream in third person, women in first person), dream sharing (more frequent in women), lucid dreaming (women more realistic, men more controlled), and daydreaming (young men more frequently have sexual themes). Nightmares are more frequent in women too, and they are often associated with sleep disorders and even with psychiatric disorders, such as depression and/or anxiety. In women, a strong association has been shown between nightmares and evening circadian preference. CONCLUSIONS: For many years, and for many reasons, laboratory experiments have been conducted mainly, if not exclusively, on male animals. Thus, a novel effort towards a new governance of scientific and research activities with a gender-specific perspective has been claimed for all areas of medicine, and more research on sex-differences is strongly needed also on this topic.