Bio-synthesized ZnO nanoparticles and sunlight-driven photocatalysis for environmentally-friendly and sustainable route of synthetic petroleum refinery wastewater treatment.

The design of a green photocatalytic system that harnesses renewable and eco-friendly constituents holds the potential to offer valuable insights into alternative strategies for treating toxic multi-components in refinery water effluents. A significant challenge in implementing a practical and viable approach is the utilization of solar energy-an abundant, natural, and cost-effective resource-for photochemical processes within advanced oxidation processes. In this study, we explored the use of zinc oxide nanoparticles (ZnO NPs) as photocatalyst prepared via an environmentally friendly synthesis approach, resulting in the formation of crystalline wurtzite nanoparticles, with an average size of about 14 nm relatively spherical in shape. Notably, the extract derived from Moringa oleifera was employed in this investigation. These nanoparticles were characterized and validated using various characterization techniques, including X-ray diffraction, transmission electron microscopy, field emission scanning electron microscopy, and energy dispersive X-ray spectroscopy. For comparison, conventionally synthesized ZnO NPs were also included in the evaluations. The findings reveal that, under illumination, biosynthesized ZnO nanoparticles (NPs) exhibit photocatalytic performance in effectively breaking down the organic compounds present in synthetic petroleum wastewater. Photochemical analysis further illustrates the degradation efficiency of Green-ZnO, which, within 180 min of irradiation resulted in 51%, 52%, 88%, and 93% of removal for Phenol, O-Cresol. Under optimal loading conditions, NPs produced via the green synthesis approach perform better when compared to chemically synthesized ZnO. This significant improvement in photocatalytic activity underscores the potential of eco-friendly synthesis methods in achieving enhanced water treatment efficiency.

Enterococcus isolated from poultry intestine for potential probiotic use.

Background and Aim: To develop species-specific probiotics for poultry, it is ideal to obtain these probiotic microorganisms directly from the intestinal tract of broiler and egg-laying chicks in production environments to ensure adaptation to actual conditions. This study aimed to isolate lactic acid bacteria (LAB) from the intestinal tract of broiler and egg-laying chicks to determine their probiotic potential. Materials and Methods: Twenty-five Ross-308 broilers and 25 Isa Brown egg-laying chicks were raised until days 42 and 120, respectively; they were housed in an individual poultry building. Lactic acid bacteria were isolated and identified from the small intestine mucus of broiler and layer chicks and then evaluated based on resistance to acidic pH levels, bile salt concentration, and antagonistic activity against wild strains of Escherichia coli and Salmonella spp. selected strains with probiotic potential were identified by polymerase chain reaction and confirmed by rDNA sequencing. Results: One hundred and fifty Gram-positive isolates were obtained; 28% (42) were catalase and oxidase negative and biochemical identification was made by crystal system: 76.2% (32) Enterococcus spp., 16.6% (7) Lactococcus spp., and 7.2% (3) Streptococcus spp.; and evaluated for hemolysin production; tolerance to low pH and bile salts, and antagonistic potential were carried out. Molecular characterization yielded 56% (24) Enterococcus faecium, and 44% (18) Enterococcus faecalis. About 81% (34) of strains were without vancomycin resistance genes criterion. Conclusion: This study isolated and characterized 36 strains of LAB with probiotic qualities, from the intestines of broiler and egg-laying chicks, selecting E. faecium, Enterococcus avium, and Enterococcus casseliflavus, Lactococcus garviae as promising strains for further in vitro and in vivo research.

Metal-insulator crossover in monolayer MoS2.

We report on transport measurements in monolayer MoS2devices, close to the bottom of the conduction band edge. These devices were annealedin situbefore electrical measurements. This allows us to obtain good ohmic contacts at low temperatures, and to measure precisely the conductivity and mobility via four-probe measurements. The measured effective mobility up toµeff= 180 cm2V-1s-1is among the largest obtained in CVD-grown MoS2monolayer devices. These measurements show that electronic transport is of the insulating type forσ≤ 1.4e2/handn≤ 1.7 × 1012cm-2, and a crossover to a metallic regime is observed above those values. In the insulating regime, thermally activated transport dominates at high temperature (T> 120 K). At lower temperatures, conductivity is driven by Efros-Schklovkii variable range hopping in all measured devices, with a universal and constant hopping prefactor, that is a clear indication that hopping is not phonon-mediated. At higher carrier density, and high temperature, the conductivity is well modeled by the Boltzmann equation for a non-interacting Fermi gas, taking into account both phonon and impurity scatterings. Finally, even if this apparent metal-insulator transition can be explained by phonon-related phenomena at high temperature, the possibility of a genuine 2D MIT cannot be ruled out, as we can observe a clear power-law diverging localization length close to the transition, and a one-parameter scaling can be realized.

Fertility prediction in dairy goats from Murciano-Granadina breed: The role of sperm evaluation and female traits.

Fertility is one of the most economically important traits in farm animals, due to the direct and indirect costs associated to low pregnancy rates. Thus, one of the priority goals in animal reproduction is to predict the performance that the semen doses will have in vivo based on the quality values obtained in laboratory assays. Attempts have been made for getting a predictive model of fertility of frozen-thawed sperm in dairy goats, but similar studies have not been conducted for chilled goat buck sperm doses that are mostly used for artificial insemination in many countries including Spain. We study how parameters of in vitro sperm quality and characteristics of Murciano-Granadina dairy goats may affect the in vivo fertility obtained after artificial insemination with semen doses chilled at 4 °C. Moreover, this information was used for obtaining predictive models of the fertility. Sixty-three ejaculates from 13 males were used to prepare chilled doses for the insemination of 495 goats over 13 sessions. Fresh and chilled sperm were evaluated for motility and plasma membrane integrity with a computer-assisted sperm analysis system and flow cytometry, respectively. Fertility was determined at parturition, according to the kidding goats. Overall fertility was 59.6%. Pearson's correlation coefficients between in vivo fertility and quality variables of fresh sperm were not significant and were low (below 0.34 in absolute value) for chilled sperm. Females' characteristics had a low negative impact on fertility (correlation coefficients of -0.19 with age, -0.20 with parturitions and -0.11 with total milk yield obtained in the best lactation). Fixed and mixed logistic regression procedures were used trying to explain the fertility results. None of the models accurately predicted fertility, but the best models included the percentage of total motile sperm or average path velocity from fresh semen, age of the females and the session effect (uncontrolled environmental effects). These analyses showed that primiparous goats were 2.42 times more likely to get pregnant than goats that had kidded four or more times. Our field assay data on fertility in Murciano-Granadina dairy goats highlighted the importance of making quality controls of sperm, of choosing the doses presenting high percentages of motile sperm exhibiting regular trajectories and of selecting the youngest goats for AI, after their first kidding. Efforts should continue to obtain better predictive models for improving fertility in goat dairy herds.

Videolaparoscopic management of arcuate ligament syndrome in pediatric patients. / Resolución por videolaparoscopia del síndrome de ligamento arcuato en pediatría.

Median arcuate ligament syndrome, which is characterized by postprandial pain, occurs as a result of the compression of the celiac trunk by the ligament. It is a rare pathology in pediatric patients. We present the case of a 14-year-old girl with recurrent abdominal pain. Ultrasound examination showed an increase in celiac trunk flow rate with flow reversal, while CT angiography demonstrated compression. It was surgically managed by dividing the arcuate ligament through videolaparoscopy. Symptoms disappeared right after surgery and did not reappear in the 24-month follow-up. The arcuate ligament is a fibrous band located at the level of the diaphragmatic crus. The fact that the celiac trunk originates at the supradiaphragmatic aorta makes the ligament exert compression during expiration, with transitory distal ischemia. Diagnosis is achieved through Doppler ultrasonography of the celiac trunk or CT angiography, among others. Surgical management involves dividing the arcuate ligament. This syndrome should be considered in the presence of recurrent abdominal pain. The laparoscopic route is the treatment approach suggested.

El síndrome de ligamento arcuato medio caracterizado por dolor posprandial se debe a la compresión del tronco celíaco por dicho ligamento. En pediatría su presentación es infrecuente. Niña de 14 años con dolor abdominal recurrente. Se diagnosticó por ecografía un aumento de la velocidad del flujo del tronco celíaco con inversión de flujo. La angiotomografía evidenció la compresión. Su resolución fue quirúrgica mediante la sección del ligamento arcuato por videolaparoscopia. Los síntomas desaparecieron inmediatamente luego de la cirugía y no recurrieron en 24 meses de seguimiento. El ligamento arcuato es una banda fibrosa en la crura diafragmática. El nacimiento del tronco celíaco en la aorta supradiafragmática conlleva que este ligamento comprima durante la espiración con isquemia distal transitoria. El diagnóstico se realiza con ecografía Doppler del tronco celíaco o angiotomografía, entre otros. La resolución quirúrgica consiste en la sección del ligamento arcuato. Este síndrome debe tenerse en cuenta ante un caso de dolor abdominal recurrente. La vía laparoscópica es sugerida para el tratamiento.

Resolución por videolaparoscopia del síndrome de ligamento arcuato en pediatría / Videolaparoscopic management of arcuate ligament syndrome in pediatric patients

El síndrome de ligamento arcuato medio caracterizado por dolor posprandial se debe a la compresión del tronco celíaco por dicho ligamento. En pediatría su presentación es infrecuente. Niña de 14 años con dolor abdominal recurrente. Se diagnosticó por ecografía un aumento de la velocidad del flujo del tronco celíaco con inversión de flujo. La angiotomografía evidenció la compresión. Su resolución fue quirúrgica mediante la sección del ligamento arcuato por videolaparoscopia. Los síntomas desaparecieron inmediatamente luego de la cirugía y no recurrieron en 24 meses de seguimiento. El ligamento arcuato es una banda fibrosa en la crura diafragmática. El nacimiento del tronco celíaco en la aorta supradiafragmática conlleva que este ligamento comprima durante la espiración con isquemia distal transitoria. El diagnóstico se realiza con ecografía Doppler del tronco celíaco o angiotomografía, entre otros. La resolución quirúrgica consiste en la sección del ligamento arcuato. Este síndrome debe tenerse en cuenta ante un caso de dolor abdominal recurrente. La vía laparoscópica es sugerida para el tratamiento

Median arcuate ligament syndrome, which is characterized by post-prandial pain, occurs as a result of the compression of the celiac trunk by the ligament. It is a rare pathology in pediatric patients. We present the case of a 14-year-old girl with recurrent abdominal pain. Ultrasound examination showed an increase in celiac trunk flow rate with flow reversal, while CT angiography demonstrated compression. It was surgically managed by dividing the arcuate ligament through videolaparoscopy. Symptoms disappeared right after surgery and did not reappear in the 24-month follow-up. The arcuate ligament is a fibrous band located at the level of the diaphragmatic crus. The fact that the celiac trunk originates at the supradiaphragmatic aorta makes the ligament exert compression during expiration, with transitory distal ischemia. Diagnosis is achieved through Doppler ultrasonography of the celiac trunk or CT angiography, among others. Surgical management involves dividing the arcuate ligament. This syndrome should be considered in the presence of recurrent abdominal pain. The laparoscopic route is the treatment approach suggested

Reuse and recycle solutions in refineries by ozone-based advanced oxidation processes: A statistical approach.

Fresh water sources are under pressure globally by the increasing population and consequently increasing production, which increases the water demand day by day. Thus, decreasing the industrial fresh water demand and wastewater production became crucial both for the water availability in the future and for its impact to the environment. This study examined the ozone-based treatments as the possible solution to a refinery to treat the effluent already treated by the traditional techniques to reach the final requirements for reuse and recycle purposes. The screening tests performed by fractional factorial design revealed that the significant parameters for the treatment were ozone feed ratio, H2O2 amount and processing time while pH was found insignificant for this case. Based on the box-Behnken response surface methodology for effluent collected after biological treatment, the significant parameters were optimized as the ozone ratio of 0.9 g/h, H2O2 amount of 47 mg/L and 60 min duration. However, in case of increasing the H2O2 amount to 80 mg/L the duration can be minimized to 37.5 min decreasing the energy and reagent consumption costs by a 37%, reaching a final total organic carbon (TOC) under 4 mg/L, that is the target for reuse possibilities.

[Assessment of creative thinking among medical students]. / Determinación de pensamiento creativo en estudiantes de medicina de una universidad chilena.

BACKGROUND: Creativity is a highly valued quality in different fields. Despite this, it is rarely included in the curricula of medical careers. AIM: To assess creative thinking among undergraduate medical students. MATERIAL AND METHODS: Sixty-seven students aged 18 to 31 years (45% women) from the first (16), third (26) and seventh year (25) of medical school answered a sociodemographic questionnaire and the Torrance Test of Creative Thinking (TTCT). RESULTS: Median creativity index according to age was in percentile 52 (range 2-99). Percentiles for fluency, originality, elaboration, abstraction of titles and resistance for premature closure were 31, 32, 79, 53 and 17 respectively. There were no significant differences between students of different levels (p = 0.73). CONCLUSIONS: In this group of students, there is a high performance in elaboration and a low score in Resistance to premature closure.

Características clínicas de los pacientes con apneas obstructivas del sueño: diferencias según género / Clinical features in patients with obstructive sleep apnea syndrome: differences by gender

INTRODUCCIÓN: El síndrome de apnea obstructiva del sueño (SAHOS) es más prevalente en hombres, los estudios poblacionales muestran una relación de 2:1, sin embargo, en los estudios clínicos la frecuencia llega a ser de hasta de 6:1. Estas diferencias en el ambiente clínico puede ser consecuencia de variaciones en el reporte de síntomas en hombres comparados con mujeres. OBJETIVO: Evaluar las diferencias de género en la presentación clínica de apnea obstructiva de sueño. Pacientes: Estudio transversal de pacientes sometidos a una poligrafía respiratoria (PR) con sospecha clínica de SAHOS. Se recolectaron datos demográficos, antropométricos, comorbilidades y las variables de la PR. Se realizó estudio t de student, Mann-Whitney y chi-cuadrado según correspondiera. RESULTADOS: Se incluyeron 1.044 pacientes: edad promedio 53,2 ± 14 años, 76% hombres. Las mujeres con SAHOS poseen mayor IMC (32,2 ± 6,1 vs 30,8 ± 5,0; p=0,002) y edad (61,4 ± 12,2 vs 52,6 ± 13,9; p < 0,001), pero menor circunferencia de cuello (CC) (38,1 ± 3,6 vs 43,2 ± 3,3; p < 0,001), además, presentan menor IA/H y menor duración de las apneas. No hubo diferencias en los síntomas clásicos de apneas presenciada y somnolencia diurna, sin embargo, describen más frecuentemente insomnio, cefalea matinal, depresión y uso de fármacos hipnóticos. CONCLUSIONES: Las mujeres al momento del diagnóstico son de mayor edad y más obesas, aunque presentan una CC menor, presentan una enfermedad más leve, pero refieren más fatiga, cansancio, cefalea e insomnio. Debemos estar alerta en la presentación clínica diferente de las mujeres para mejorar la sospecha diagnóstica.

INTRODUCTION: Obstructive sleep apnea (OSA) is more prevalent in men, population studies show a ratio of 2:1, however in clinical studies the frequency is as high as 6:1. These differences in the clinical setting may be a consequence of variations in the reporting of symptoms in men compared to women. OBJECTIVE: To evaluate gender differences between women and men with recent diagnosis of OSA. Patients: A cross-sectional, study of patients undergoing home sleep apnea testing (HSAT) with clinical suspicion of OSA. Demographic, anthropometric, comorbidities and HSAT variables were collected. We performed t student analysis, Mann-Whitney test or chi square test as appropriate. RESULTS: 1,044 patients were included: mean age 53.2 ± 14 years, 76% men. Women with OSA have a higher BMI (32.2 ± 6.1 vs 30.8 ± 5.0, p = 0.002), were older (61.4 ± 12.2 vs 52.6 ± 13.9, p <0.001), but have a lower neck circumference (NC) (38.1 ± 3.6 vs. 43.2 ± 3.3, p <0.001). The women presented lower AHI and shorter duration of apneas. Although the classic symptoms of apnea and daytime sleepiness showed no differences, women reported more frequently insomnia, morning headache, depression and use of hypnotic drugs. CONCLUSIONS:: Clinical differences between gender are present at time of diagnosis. Woman are older and more obese, although they have a lower NC. They have a milder disease, but they refer to be more tired, headache, insomnia and depression. We must be alert in the different clinical presentation of women to improve the diagnostic suspicion.

Determinación de pensamiento creativo en estudiantes de medicina de una universidad chilena / Assessment of creative thinking among medical students

Background: Creativity is a highly valued quality in different fields. Despite this, it is rarely included in the curricula of medical careers. Aim: To assess creative thinking among undergraduate medical students. Material and Methods: Sixty-seven students aged 18 to 31 years (45% women) from the first (16), third (26) and seventh year (25) of medical school answered a sociodemographic questionnaire and the Torrance Test of Creative Thinking (TTCT). Results: Median creativity index according to age was in percentile 52 (range 2-99). Percentiles for fluency, originality, elaboration, abstraction of titles and resistance for premature closure were 31, 32, 79, 53 and 17 respectively. There were no significant differences between students of different levels (p = 0.73). Conclusions: In this group of students, there is a high performance in elaboration and a low score in Resistance to premature closure.

Shock anafiláctico versus síndrome de Kounis durante el intraoperatorio de cirugía cardiaca: diagnóstico diferencial / Anaphylactic shock versus Kounis syndrome in cardiac surgery: Differential diagnosis

Pese a que fue descrito hace casi 3 décadas, ha sido en los últimos años cuando se ha producido un incremento notable en la comunicación de casos de síndromes coronarios agudos desarrollados en el contexto de reacciones alérgicas, entidad que es conocida como síndrome de Kounis. En este artículo nos planteamos esta posibilidad diagnóstica ante un fracaso biventricular agudo en el transcurso de una reacción anafiláctica durante el intraoperatorio de una cirugía valvular cardiaca

Although Kounis syndrome was described almost 3 decades ago, there has been a notable increase in the reports of cases of acute coronary syndromes developed in the context of allergic reactions, also known as Kounis syndrome. This article discusses the diagnostic possibility in the face of an acute biventricular failure in the course of an anaphylactic reaction during the intra-operative period of a cardiac valve surgery

Anaphylactic shock versus Kounis syndrome in cardiac surgery: Differential diagnosis. / Shock anafiláctico versus síndrome de Kounis durante el intraoperatorio de cirugía cardiaca: diagnóstico diferencial.

Although Kounis syndrome was described almost 3 decades ago, there has been a notable increase in the reports of cases of acute coronary syndromes developed in the context of allergic reactions, also known as Kounis syndrome. This article discusses the diagnostic possibility in the face of an acute biventricular failure in the course of an anaphylactic reaction during the intra-operative period of a cardiac valve surgery.

[Cerebral ptosis. Analysis of six cases]. / Investigación clínica de la ptosis cerebral. Presentación de seis nuevos casos.

BACKGROUND: Cerebral ptosis is understood as the bilateral paralysis of eyelid elevation linked to a stroke or hemorrhage of the middle cerebral artery (MCA). It is a transient condition, independent of the evolution of the lesion. AIM: To analyze six patients with the condition. PATIENTS AND METHODS: Report of five women and one male aged 42 to 72 years. RESULTS: All suffered an infarction or hemorrhage in the territory of the middle cerebral artery of the non-dominant hemisphere and developed a bilateral palpebral ptosis. The recovery started after the fourth day. At the tenth day, eye opening was effortless and did not require frontal help, despite the persistence of hemiplegia. CONCLUSIONS: Cerebral ptosis is a mimetic dysfunction of a specific non-injured area of the cerebral cortex, originated from a nearby parenchymal damage such as the middle cerebral artery of the same hemisphere. Cerebral ptosis expresses the inhibition of the voluntary eyelid elevation center, of prefrontal location in the non-dominant hemisphere.

Investigación clínica de la ptosis cerebral: presentación de seis nuevos casos / Cerebral ptosis: analysis of six cases

Background: Cerebral ptosis is understood as the bilateral paralysis of eyelid elevation linked to a stroke or hemorrhage of the middle cerebral artery (MCA). It is a transient condition, independent of the evolution of the lesion. Aim: To analyze six patients with the condition. Patients and Methods: Report of five women and one male aged 42 to 72 years. Results: All suffered an infarction or hemorrhage in the territory of the middle cerebral artery of the non-dominant hemisphere and developed a bilateral palpebral ptosis. The recovery started after the fourth day. At the tenth day, eye opening was effortless and did not require frontal help, despite the persistence of hemiplegia. Conclusions: Cerebral ptosis is a mimetic dysfunction of a specific non-injured area of the cerebral cortex, originated from a nearby parenchymal damage such as the middle cerebral artery of the same hemisphere. Cerebral ptosis expresses the inhibition of the voluntary eyelid elevation center, of prefrontal location in the non-dominant hemisphere.

State of the art of produced water treatment.

Produced water (PW) is the wastewater generated when water from underground reservoirs is brought to the surface during oil or gas extraction. PW is generated in large amounts and has a complex composition, containing various toxic organic and inorganic compounds. PW is currently treated in conventional trains that include phase separators, decanters, cyclones and coarse filters in order to comply with existing regulation for discharge. These treatment trains do not achieve more restrictive limitations related to the reuse of the effluent (reinjection into extraction wells) or other beneficial uses (e.g., irrigation). Therefore, and to prevent environmental pollution, further polishing processes need to be carried out. Characterization of the PW to determine major constituents is the first step to select the optimum treatment for PW, coupled with environmental factors, economic considerations, and local regulatory framework. This review tries to provide an overview of different treatments that are being applied to polish this type of effluents. These technologies include membranes, physical, biological, thermal or chemical treatments, where special emphasis has been made on advanced oxidation processes due to the advantages offered by these processes. Commercial treatments, based on the combination, modification and improvement of simpler treatments, were also discussed.

Caracterización del perfil clínico y funcional de pacientes con lesión medular en rehabilitación intrahospitalaria / Characterization of the clinical profile and function of patients with spinal cord injury in in-hospital rehabilitation

Spinal cord injury (SCI) is a pathology that generates great personal, family, economic and social impact. There are two main etiologies that are traumatic (T-SCI) and non-traumatic (NTSCI). These patients receive their rehabilitation in specialized hospital services in the acute and sub-acute phase. A retrospective, descriptive, observational study was designed, reviewing the clinical records of patients diagnosed with SCI at discharge, hospitalized in the Physical Medicine and Rehabilitation Service of the Clinical Hospital of the University of Chile. The general profile of admission of patients with SCI was a young men with NT- SCI, with higher education, paid work and incomplete injury (ASIA B, C, D). An improvement was observed for all patients for the severity of the injury, neurological level, motor level, sensory level and functionality. This is the first study conducted nationwide that provides epidemiological data and functional evolution of patients with SCI and are comparable to those found in the international literature. (AU)

Calidad del sueño en pacientes con enfermedad inflamatoria intestinal / Sleep quality in inflammatory bowel disease patients

Although inflammatory bowel disease (IBD) etiology is still unknown, genetic, environmental and immunological factors are implicated. Studies have considered quality of sleep as a risk factor in IBD course. Objective: To determine sleep quality in IBD patients, irritable bowel syndrome (IBS) patients and healthy controls (HC). Methods: Cross sectional study assessing sleep quality in adult patients with IBD, IBS and HC. All patients answered a validated Spanish version of the Pittsburgh Sleep Quality Index (PSQI) questionnaire in order to evaluate sleep quality. A PSQI global score > 5 is indicative of poor sleep quality. Demographic and clinical variables were assessed. Results: The study included 276 patients, 111 with IBD, 85 with IBS and 80 HC. A PSQI score > 5 was observed in 67 percent of IBD and IBS patients and 55 percent of HC. IBD and IBS patients exhibited poorer sleep quality than HC, although results did not reach statistical significance (p = 0.069 and p = 0.076, respectively). In IBD patients, an association between disease activity and sleep quality was observed (p = 0.025). However, when analyzing separately patients with ulcerative colitis (UC) and Crohn ́s Disease (CD), only in UC patients sleep quality was related with disease activity. The use of sleep medications was significantly higher in IBD and IBS patients compared with healthy controls (p = 0.021 and p = 0.009, respectively). Conclusion: Sleep disturbances are frequent in IBD, IBS patients and even healthy controls. Additionally, IBD patients with active disease, particularly those with UC, exhibit worse sleep quality.

Aunque la etiología de la enfermedad inflamatoria intestinal (EII) es aún desconocida, factores genéticos, ambientales e inmunológicos estarían implicados. Estudios han considerado la calidad del sueño como un factor de riesgo en la evolución de la EII. Objetivo: Determinar la calidad del sueño en pacientes con enfermedad inflamatoria intestinal (EII), síndrome intestino irritable (SII) y controles sanos (CS). Métodos:Estudio transversal en pacientes adultos con EII, SII y CS. Se evaluó la calidad del sueño mediante el Índice de Calidad del Sueño de Pittsburgh (ICSP), siendo una puntuación global > 5 indicativa de mala calidad del sueño. Variables demográficas y clínicas fueron evaluadas. Resultados:Se incluyeron 276 pacientes, 111 con EII, 85 SII y 80 CS. ICSP > 5 fue observado en 67 por ciento de los pacientes con EII y SII, y 55 por ciento de los CS. Los pacientes con EII y SII mostraron una peor calidad del sueño comparado con CS sin alcanzar significancia estadística (p: 0,069 y p: 0,076, respectivamente). En los pacientes con EII, se observó una asociación entre actividad de la enfermedad y calidad del sueño (p: 0,025). Sin embargo, al analizar por diagnóstico específico, sólo pacientes con colitis ulcerosa (CU) presentaron esta asociación. El uso de medicamentos para dormir fue significativamente mayor en los pacientes con EII y SII comparado con CS (p: 0,021 y p: 0,009, respectivamente). Conclusión:Los trastornos del sueño son frecuentes en pacientes con EII, SII e incluso CS. Pacientes con EII activa, en particular aquellos con CU, presentaron una peor calidad del sueño.

A progressively wetter climate in southern East Africa over the past 1.3 million years.

African climate is generally considered to have evolved towards progressively drier conditions over the past few million years, with increased variability as glacial-interglacial change intensified worldwide. Palaeoclimate records derived mainly from northern Africa exhibit a 100,000-year (eccentricity) cycle overprinted on a pronounced 20,000-year (precession) beat, driven by orbital forcing of summer insolation, global ice volume and long-lived atmospheric greenhouse gases. Here we present a 1.3-million-year-long climate history from the Lake Malawi basin (10°-14° S in eastern Africa), which displays strong 100,000-year (eccentricity) cycles of temperature and rainfall following the Mid-Pleistocene Transition around 900,000 years ago. Interglacial periods were relatively warm and moist, while ice ages were cool and dry. The Malawi record shows limited evidence for precessional variability, which we attribute to the opposing effects of austral summer insolation and the temporal/spatial pattern of sea surface temperature in the Indian Ocean. The temperature history of the Malawi basin, at least for the past 500,000 years, strongly resembles past changes in atmospheric carbon dioxide and terrigenous dust flux in the tropical Pacific Ocean, but not in global ice volume. Climate in this sector of eastern Africa (unlike northern Africa) evolved from a predominantly arid environment with high-frequency variability to generally wetter conditions with more prolonged wet and dry intervals.

A prognostic index for locoregional recurrence after neoadjuvant chemotherapy.

BACKGROUND: The appropriate selection criteria for breast-conserving surgery (BCS) or mastectomy after neoadjuvant chemotherapy (NAC) are poorly defined. The aim of this study is to analyse the incidence and prognostic factors for locoregional recurrence (LRR) in patients with breast cancer (BC) treated with NAC to develop a prognostic score to help with clinical decision-making. MATERIALS AND METHODS: Using our retrospective maintained BC database, we identified 730 patients treated with NAC (327 patients treated with BCS and 403 patients treated with mastectomy) between 1998 and 2014. To identify variables associated with an increased LRR rate, we performed firstly Kaplan-Meier curves, with comparisons among groups using log-rank test, and then, significant variables were included in a multivariate analysis using Cox proportional hazards. The prognostic index was developed by assigning score 0 (favourable) or score 1 (unfavourable) for each significant variable of multivariate analysis and was created separately for patients with BCS and mastectomy. RESULTS: At a median follow-up of 72 months, the 6-year cumulative incidence of LRR was 7.2% ( ± 3%) for BCS and 7.9% ( ± 3%) for mastectomy. By univariate analysis, variables associated with an increased LRR were for BCS: HER2 positive, grade III, ductal carcinoma in situ (DCIS), No-pCR (ypTis, ypN0), and age < 40 years; and for mastectomy, HER2-positive, DCIS, No-pCR, and LVI. By multivariate analysis, variables associated with an increased LRR were for BCS: HER2 positive (HR: 11.1, p = 0.001), DCIS (HR: 3.1, p = 0.005), and age < 40 years (HR: 2.8, p = 0.02); and for mastectomy: HER2 positive (HR: 9.5, p = 0.03), DCIS (HR: 2.7, p = 0.01), No-pCR (HR: 11.4, p = 0.01), and age < 40 years (HR: 2.8, p = 0.006). The score stratified patients into three subsets with statistically different levels of risk for LRR. For BCS, the six-year LRR rates were 3%, 13%, and 33% for the low (score 0, n = 120), intermediate (score 1, n = 95) and high (score 2-3, n = 27) risk groups, respectively (p = 0.001). For mastectomy, the six-year LRR rates were 0%, 8%, and 27% for the low (score 0, n = 20), intermediate (score 1-2, n 191), and high (score 3-4, n = 30) risk groups, respectively (p = 0.001). Of note, 21 patients that had a LRR event were HER2 positive, all of them had received trastuzumab. CONCLUSIONS: Patients with a score of 0, which made up to 19% of the study population, had very low risk of LRR. The score enabled the identification of a small group (7%) of patients with very high risk of LRR, and who may benefit from alternative treatment.