Quantifying pigment content in crustose coralline algae using hyperspectral imaging: A case study with Tethysphytum antarcticum (Ross Sea, Antarctica).

Crustose coralline algae (CCA) are a highly diverse group of habitat-forming, calcifying red macroalgae (Rhodophyta) with unique adaptations to diverse irradiance regimes. A distinctive CCA phenotype adaptation, which allows them to maximize photosynthetic performance in low light, is their content of a specific group of light-harvesting pigments called phycobilins. In this study, we assessed the potential of noninvasive hyperspectral imaging (HSI) in the visible spectrum (400-800 nm) to describe the phenotypic variability in phycobilin content of an Antarctic coralline, Tethysphytum antarcticum (Hapalidiales), from two distinct locations. We validated our measurements with pigment extractions and spectrophotometry analysis, in addition to DNA barcoding using the psbA marker. Targeted spectral indices were developed and correlated with phycobilin content using linear mixed models (R2 = 0.64-0.7). Once applied to the HSI, the models revealed the distinct phycoerythrin spatial distribution in the two site-specific CCA phenotypes, with thin and thick crusts, respectively. This study advances the capabilities of hyperspectral imaging as a tool to quantitatively study CCA pigmentation in relation to their phenotypic plasticity, which can be applied in laboratory studies and potentially in situ surveys using underwater hyperspectral imaging systems.

Tissue temperature, flux and oxygen of sacral and trochanteric area under pressure of healthy subjects: A quasi-experimental study.

AIM: To evaluate the changes that take place in the perfusion, oxygenation and local temperature of the skin of the sacrum and trochanter when subjected to direct pressure for 2 h. METHODS: Quasi-experimental study in the preclinical phase with healthy subjects acting as their own controls (intrasubject control). The outcome variables were measured with a laser Doppler system (local temperature and oxygenation) and by near-infrared spectroscopy (perfusion). The pressure exerted was measured with a capacitive pressure sensor. No more than one week elapsed between the sacrum and trochanter measurements. RESULTS: The study sample consisted of 18 persons. The comparative analysis of the fluctuations in the parameters measured on the skin of the trochanters and sacrum, according to the time elapsed, revealed a statistically significant increase in temperature and in the pressure exerted. On the other hand, the changes in capillary blood flow and in SaO2 were not statistically significant. CONCLUSION: Our study results show that changes found in terms of temperature and pressure should be taking into account when planning personalised repositioning to patients according to biomechanical and biological situations that vary between anatomical areas. In future research, the changes reported could be evaluated in patients with risk factors for the development of pressure ulcers, thus facilitating the introduction of more personalised planning in the care and prevention of these injuries.

The contribution of network science to the study of food recipes. A review paper.

Recently, scholars have applied network science, which examines interconnected systems, to the study of food recipes. By examining the current literature, this review paper analyses the contribution of network science to recipes, and finds evidence of two main contributions. First, the pioneer studies showed the potential of network science for reducing the complexity of recipes and proposing theories to model ingredient pairings and recipe evolution. The second contribution built upon the previous theories and expanded them to cover different regions of the world as the field moved towards understanding the granularity of human culture with rich and detailed studies that examine different cuisines as more recipe datasets became available. Network science studies of recipes allowed researchers to discover insights in recipes to explain sociocultural aspects of cuisines, and include large numbers of recipes in the analysis, which would be nearly impossible using other techniques.

National Trends and Impact of Regionalization of Radical Cystectomy on Survival Outcomes in Patients with Muscle Invasive Bladder Cancer.

OBJECTIVE: To evaluate national trends and the effect of surgical volume on perioperative mortality and overall survival (OS)in patients undergoing radical cystectomy (RC) for muscle invasive bladder cancer (MIBC). METHODS: We investigated the National Cancer Database to identify patients with localized MIBC (cT2a-T4, M0) who underwent RC from 2004 to 2014. Demographics, 30- and 90-day mortality rates, as well as OS were analyzed. Hospitals were stratified into low-, medium-, and high-volume centers according to median number of RCs performed per year. Multivariate logistic regression models were fitted to identify independent predictors of perioperative mortality. Kaplan-Meier survival curves were generated to evaluate OS. Cox proportional hazard modeling was performed to identify independent predictors of OS. RESULTS: A total of 24,763 patients with localized MIBC who underwent RC from 2004 to 2014 were included in the study. Overall, most (70.85%) RCs occurred at low-volume hospitals, whereas only 15.83% were performed at high-volume hospitals. Thirty-day mortality rates were 2.87%, 2.19%, and 1.83% (P < .01); and 90-day mortality rates were 8.25%, 6.9%, and 5.9% (P < .01) at low-, medium-, and high-volume hospitals, respectively. Multivariate analyses identified RC volume as an independent predictor of 30- and 90-day mortality. RC in high-volume hospitals was associated with a 35% risk reduction in 30-day mortality (odds ratio 0.65, 95% confidence interval [CI] 0.49-0.85; P < .01), and a 26% risk reduction in 90-day mortality (0.74, 95% CI, 0.63-0.87; P < .01). CONCLUSIONS: Treatment at high-volume centers offers improved outcomes and OS benefit. However, in the United States, only 16% of RCs are performed in high-volume hospitals.

Effectiveness of a hydrophobic dressing for microorganisms' colonization of vascular ulcers: Protocol for a randomized controlled trial (CUCO-UV Study).

AIM: To determine the effectiveness of a hydrophobic dressing (Cutimed Sorbact® ) against a silver dressing (Aquacel® Ag Extra) in the level of colonization of chronic venous leg ulcers. The secondary endpoints are health-related quality of life, level of pain, and time to complete healing. DESIGN: Open randomized controlled trial, with blinded endpoint. METHODS: Patients with chronic venous leg ulcers with signs of critical colonization will be randomized in a concealed sequence using computer software to receive one of the alternative dressings. A total of 204 participants recruited in Primary Health Care and nursing homes will be necessary to assure statistical power. Measures will include sociodemographic variables, wound-related variables (area, exudate, and time to healing), level of pain, adverse effects, and health-related quality of life. Smear samples will be collected from the ulcers and will be subject to DNA-typing technique through polymerase chain reaction to obtain the level of colony-forming units. Measures will be collected at baseline, 4, 8, and 12 weeks. DISCUSSION: Elevated levels of microorganisms prevent wound healing and favour its chronification. The main target when colonization is present is to reduce the bacterial load to levels that promote immune system mobilization. Hydrophobic dressings prevent the formation of biofilm in the wound by means of physical effect, so that the possibility of antimicrobial resistance is significantly reduced. IMPACT: Current evidence about the effectiveness of dressings to minimize venous leg ulcers colonization is very limited. Previous studies have important methodological flaws. This study will permit to obtain the effectiveness of hydrophobic dressings against silver dressings with a robust design based on conditions of routine clinical practice in Primary Health Care and nursing homes.

Pressure levels in the trochanter area according to repositioning at different degrees of inclination in healthy subjects.

OBJECTIVES: Patient repositioning is a recommended intervention to prevent or treat pressure ulcers (PUs). One option under consideration is the tailored repositioning according to patient characteristics, but more knowledge is needed on how different repositioning patterns influence on skin pressure. To determine what degree of inclination of the body in bed generates more pressure in the trochanteric region. Additionally, to analyze the influence of factors such as gender, age and anthropometric characteristics in the variations of this pressure. METHODS: Analytical cross-sectional study. Body Mass Index (BMI), lean mass and fat mass were measured in healthy volunteers subject to different inclinations (90°, 60° and 30°) in right lateral decubitus. Pressure was measured with a capacitive surface. RESULTS: In total, 146 subjects were included, of which 45 were men and 101 women. The results showed pressure differences due to the inclination according to gender and anthropometric values, being statistically significant in men at 90° and 60°, and in women at 30°. (hombres 90° p = 0,026, 60° p = 0,049; mujeres 30° p = 0,036) según prueba Brown-Forsythe. CONCLUSIONS: There are differences in the pressures of the trochanteric zone depending on anthropometric factors and by gender, in different body positions. Obese people exerted a higher pressure in the trochanter area at 30° of body inclination than overweight, normal weight and underweight people, respectively. From the clinical point of view, these findings invite to consider a possible differentiation in the repositioning interventions of the patients, according to gender and BMI, as a preventive strategy for PUs.

Enterobacteria in the 21st century: a review focused on taxonomic changes.

INTRODUCTION: Enterobacteria are the main group causing infections in humans. The aim of this review is to present the new genera and the taxonomic changes that the Enterobacteriacea family has experienced in recent years. METHODOLOGY: a systematic search of papers published in databases from January 2000 to July 2018 was done. Additionally, the bibliographic references of each document were reviewed and each paper citing the article was reviewed in search of clinical cases. RESULTS: Nineteen new genera of Enterobacteria have been described since 2000. The genera Yersinia, Morganella and Erwinia do not belong to the family Enterobacteriacea anymore. CONCLUSIONS: for an adequate clinical and epidemiological interpretation, it is advisable to update the libraries of the commercial systems used for the identification of the microorganisms, as well as to train the staff in the taxonomic changes of microorganisms.

Characteristics, consequences and prevention of falls in institutionalised older adults in the province of Malaga (Spain): a prospective, cohort, multicentre study.

OBJECTIVES: Falls are an important adverse event among institutionalised persons. It is in this clinical setting where falls occur more frequently than in any other, despite the measures commonly taken to prevent them. This study aimed to determine the characteristics of a typical institutionalised elderly patient who suffers a fall and to describe the physical harms resulting from this event. We then examined the association between falls and the preventive measures used. METHODS: This was a prospective cohort study in 37 nursing homes in Spain. The participants were all the nursing home residents institutionalised in these centres from May 2014 to July 2016. Participants were followed up for 9 months. During this period, two observations were made to evaluate the preventive measures taken and to record the occurrence of falls. RESULTS: 896 residents were recruited, of whom 647 completed the study. During this period, 411 falls took place, affecting 213 residents. The injuries caused by the falls were mostly minor or moderate. They took place more frequently among women and provoked 22 fractures (5.35%). The most commonly used fall prevention measure was bed rails (53.53% of cases), followed by physical restraint (16.79%). The latter measure was associated with a higher incidence of injuries not requiring stitches (OR=2.06, 95% CI 1.01 to 4.22, P=0.054) and of injuries that did require stitches (OR=3.51, 95% CI 1.36 to 9.01, P=0.014) as a consequence of falls. Bed rails protected against night-time falls. CONCLUSIONS: Falls are a very common adverse event in nursing homes. The prevention of falls is most commonly addressed by methods to restrain movement. The use of physical restraints is associated with a greater occurrence of injuries caused by a fall.

Development of the Andalusian Registry of Patients Receiving Community Case Management, for the follow-up of people with complex chronic diseases.

RATIONALE, AIMS AND OBJECTIVES: Complex chronic diseases are a challenge for the current configuration of health services. Case management is a service frequently provided for people with chronic conditions, and despite its effectiveness in many outcomes, such as mortality or readmissions, uncertainty remains about the most effective form of team organization, structures and the nature of the interventions. Many processes and outcomes of case management for people with complex chronic conditions cannot be addressed with the information provided by electronic clinical records. Registries are frequently used to deal with this weakness. The aim of this study was to generate a registry-based information system of patients receiving case management to identify their clinical characteristics, their context of care, events identified during their follow-up, interventions developed by case managers and services used. METHODS: The study was divided into three phases, covering the detection of information needs, the design and its implementation in the health care system, using literature review and expert consensus methods to select variables that would be included in the registry. RESULTS: A total of 102 variables representing structure, processes and outcomes of case management were selected for their inclusion in the registry after the consensus phase. A web-based registry with modular and layered architecture was designed. The framework follows a pattern based on the model-view-controller approach. In its first 6 months after the implementation, 102 case managers have introduced an average number of 6.49 patients each one. CONCLUSIONS: The registry permits a complete and in-depth analysis of the characteristics of the patients who receive case management, the interventions delivered and some major outcomes as mortality, readmissions or adverse events.

Adaptive horizontal transfer of a bacterial gene to an invasive insect pest of coffee.

Horizontal gene transfer (HGT) involves the nonsexual transmission of genetic material across species boundaries. Although often detected in prokaryotes, examples of HGT involving animals are relatively rare, and any evolutionary advantage conferred to the recipient is typically obscure. We identified a gene (HhMAN1) from the coffee berry borer beetle, Hypothenemus hampei, a devastating pest of coffee, which shows clear evidence of HGT from bacteria. HhMAN1 encodes a mannanase, representing a class of glycosyl hydrolases that has not previously been reported in insects. Recombinant HhMAN1 protein hydrolyzes coffee berry galactomannan, the major storage polysaccharide in this species and the presumed food of H. hampei. HhMAN1 was found to be widespread in a broad biogeographic survey of H. hampei accessions, indicating that the HGT event occurred before radiation of the insect from West Africa to Asia and South America. However, the gene was not detected in the closely related species H. obscurus (the tropical nut borer or "false berry borer"), which does not colonize coffee beans. Thus, HGT of HhMAN1 from bacteria represents a likely adaptation to a specific ecological niche and may have been promoted by intensive agricultural practices.

Design of a case management model for people with chronic disease (Heart Failure and COPD). Phase I: modeling and identification of the main components of the intervention through their actors: patients and professionals (DELTA-icE-PRO Study).

BACKGROUND: Chronic diseases account for nearly 60% of deaths around the world. The extent of this silent epidemic has not met determined responses in governments, policies or professionals in order to transform old Health Care Systems, configured for acute diseases. There is a large list of research about alternative models for people with chronic conditions, many of them with an advanced practice nurse as a key provider, as case management. But some methodological concerns raise, above all, the design of the intervention (intensity, frequency, components, etc). OBJECTIVES: General: To develop the first and second phases (theorization and modeling) for designing a multifaceted case-management intervention in people with chronic conditions (COPD and heart failure) and their caregivers. SPECIFIC AIMS: 1) To identify key events in people living with chronic disease and their relation with the Health Care System, from their point of view. 2) To know the coping mechanisms developed by patients and their caregivers along the story with the disease. 3) To know the information processing and its utilization in their interactions with health care providers. 4) To detect potential unmet needs and the ways deployed by patients and their caregivers to resolve them. 5) To obtain a description from patients and caregivers, about their itineraries along the Health Care System, in terms of continuity, accessibility and comprehensiveness of care. 6) To build up a list of promising case-management interventions in patients with Heart Failure and COPD with this information in order to frame it into theoretical models for its reproducibility and conceptualization. 7) To undergo this list to expert judgment to assess its feasibility and pertinence in the Andalusian Health Care. DESIGN: Qualitative research with two phases: For the first five objectives, a qualitative technique with biographic stories will be developed and, for the remaining objectives, an expert consensus through Delphi technique, on the possible interventions yielded from the first phase. The study will be developed in the provinces of Almería, Málaga and Granada in the Southern Spain, from patients included in the Andalusian Health Care Service database with the diagnosis of COPD or Heart Failure, with the collaboration of case manager nurses and general practitioners for the assessment of their suitability to inclusion criteria. Patients and caregivers will be interviewed in their homes or their Health Centers, with their family or their case manager nurse as mediator. DISCUSSION: First of a series of studies intended to design a case-management service for people with heart failure and COPD, in the Andalusian Health Care System, where case management has been implemented since 2002. Accordingly with the steps of a theoretical model for complex interventions, in this study, theorization and intervention modeling phases will be developed.

Estudio de las aneuploidías del cromosoma 17 y la deleción del gen TP53 en neoplasias hematológicas, por la técnica del FISH-bicolor / Study of chromosome 17 aneuploidy and of TP53 gene deletion in patients with hematological neoplasias by dualcolor fluorescence in situ hybridization (FISH)

Las neoplasias hematológicas se caracterizan por presentar una amplia diversidad de alteraciones genéticas. Se analizaron 15 muestras de pacientes con diferentes tipos de neoplasias hematológicas mediante la técnica FISH, para detectar aneuploidías del cromosoma 17 y la deleción del gen TP53. En 11 de ellas se hicieron análisis cromosómicos por citogenética convencional; 6 de las 11 tenían cariotipo anormal (54,5%): se detectaron 3 translocaciones y 3 mosaicismos. El análisis de las 15 muestras mediante la técnica FISH mostró un 26,7% de aneuploidía del cromosoma 17 y un 33,3% con deleción del gen TP53. De los 6 casos con cariotipo anormal, en 2 se detectaron alteraciones por FISH. En 5 casos se detectaron con esta técnica alteraciones cromosómicas no observadas por citogenética convencional. Solo en 3 (20%) de las 15 muestras analizadas el análisis cromosómico resultó normal por citogenética convencional y FISH. En este trabajo se corrobora que la aneuploidía del cromosoma 17 y la deleción del gen TP53 tienen una baja frecuencia en las neoplasias hematológicas. Sin embargo, el valor pronóstico de estas alteraciones genéticas no está bien definido.

Hematological neoplasias are characterized by a wide spectrum of genetic alterations. We analyzed 15 specimens from patients with various types of hematological malignancies by means of the FISH technique in order to detect aneuploidy of chromosome 17 and deletion of TP53 gene. In 11 of them chromosomal analyses were also carried out using conventional cytogenetic techniques; in 6 of these 11 specimens (54.5%) abnormal karyotypes were detected, namely: 3 translocations and 3 mosaicisms. FISH results revealed that in 26.7% of the 15 specimens there was chromosome 17 aneuploidy, and that 33.3% had TP53 deletion. Out of the 6 cases with abnormal karyotypes, further alterations were detected in two by FISH. In 5 cases chromosomal abnormalities were detected by FISH but not by the conventional cytogenetic procedures. Only in 3 (20%) out of the 15 specimens the results of chromosomal analyses were normal by both the conventional cytogenetics and FISH. These results corroborate the low frequency of chromosome 17 aneuploidy and of TP53 gene deletion in hematological neoplasias. However, the prognostic value of these genetic alterations is still not well defined.

Comportamiento de la leptospirosis en el departamento del Atlántico (Colombia) Enero de 1999 a marzo del 2004 / Behavior of leptospirosis in Atlantic Department (Colombia)January 1999 –March 2004

Objetivos: Describir el comportamiento epidemiológico de la leptospirosis en el departamento delAtlántico (Colombia), de enero de 1999 a marzo del 2004.Metodología: Estudio descriptivo. Se analizaron 970 muestras únicas de pacientes sospechosos deinfecciones con Leptospira en el Laboratorio Departamental del Atlántico mediante AglutinaciónMicroscópica (MAT), usando como antígenos los serovares Icterohemorragiae, Pomona, Canícola,Hardjo, Grippotyphosa y Hardjo-bovis de Leptospira interrogans.

Objective: This study was performed to describe the epidemiological situation of Leptospira in theDepartament of Atlantico (Colombia), from January 1999 to March 2004.Methods: A descriptive study was performed. A total of 970 single serum samples from patients withsuspected Leptospira infections, were analyzed using the microscopic agglutination test (MAT). Theserovars of Icterohaemorrhagiae, Pomona, Canicola, Hardjo, Grippotyphosa and Hardjo-bovis belongingto L. interrogans, were used as antigens. Information about clinical presentation based on epidemiologicalsheets, visits to patients and climatological data were obtained.Results: The 9,7percent samples were IgM positive for Leptospira and the most prevalent was the serovarIcterohaemorrhagiae (62percent), followed by Hardjo (12.8percent). Most of the patients were male (61percent) between 15 and 45 y.o. The most common presenting features in these patients were (91.7percent), myalgia (72 percent), vomit/nausea (70.8 percent), headache (68.1 percent) and icterichia (63.9 percent). 8.6percent of the cases were severe, associated to infections with the serovar Icterohemorragiae and their symptomathology was similar to the Weil ìs syndrome; no fatalities were registered. The highest incidences were recorded during the years 2003 (23),2001(21) and 2002 (18) especially during the rainy season (August-November). Barranquilla reportedthe highest number of cases (46) followed by Soledad (25), Puerto Colombia (6) and Galapa...

Factors influencing gene introgression into the allotetraploid Coffea arabica L. from its diploid relatives.

Factors controlling gene introgression into cultivated arabica coffee (Coffea arabica L.) were investigated. Interspecific triploid hybrid plants between the tetraploid species C. arabica (2n = 44) and a diploid species (2n = 22), either Coffea canephora or Coffea eugenioides, were backcrossed to C. arabica (male parent). Flow cytometric analysis of the nuclear DNA content revealed that most of the BC(1) individuals derived from triploid hybrids involving C. eugenioides were tetraploid or nearly tetraploid. Among the gametes produced by the interspecific triploid hybrids, those possessing approximately 22 chromosomes appeared strongly favored. The amount of introgression in BC(1) individuals (21 and 43 for the BC(1) progenies involving C. canephora and C. eugenioides, respectively) was estimated using species-specific microsatellite markers. A large number of introgressed markers was observed in all BC(1) individuals. Nevertheless, while the frequency of introgressed markers seemed as expected, assuming random chromosome segregation and diploid gamete formation, in the BC(1) derived from triploid hybrids involving C. canephora, this frequency appeared significantly lower in the BC(1) derived from triploid hybrids involving C. eugenioides. Furthermore, the comparison of reciprocal progenies between C. arabica and triploid interspecific hybrids (C. arabica x C. canephora) used as male or female parent revealed a very strong effect of the backcross direction.

Enfermedades de transmisión sanguínea. Riesgo y prevención del equipo quirúrgico / Blood transmission diseases. Risk and prevention among surgical personnel

Se pretende poner al día un tema en plena vigencia, que abarca aspectos médico-legales, éticos, epidemiológicos y técnicos. Se realizará una adecuada valoración de los riesgos reales de infección por accidente laboral para saber cómo conducirnos frente a los mismos. Finalmente se plantean una serie de recomendaciones siguiendo los criterios de bioseguridad a fin de disminuir el número de accidentes y sus consecuencias.

Leucemia linfoide aguda: estudio citogenético en niños atendidos en el Hospital Universitario San Vicente de Paúl de Medellín en el período 1998-2001 / Acute lymphoid leukemia: cytogenetic study in children treated at the San Vicente de Paúl University Hospital in Medellín in the period 1998-2001

Las investigaciones citogenéticas en Leucemia Linfoblástica Aguda (LLA) permiten identificar alteraciones recurrentes específicas en los cromosomas y correlacionarlas con la información biológica. Además, contribuyen a la comprensión de los mecanismos de leucogénesis, como factores pronósticos independientes, y aportan bases para futuras investigaciones terapéuticas.Se analizaron las alteraciones cromosómicas adquiridas en la médula ósea de 44 niños (entre un mes y 14 años) con LLA, diagnosticada clínica e histopatológicamente entre 1998 y 2001 en la Unidad de Hematología Infantil, Hospital San Vicente de Paúl, de Medellín, y cuyas muestras de médula ósea fueron procesadas y analizadas en la Unidad de Genética Médica, de la Facultad de Medicina de la Universidad de Antioquia.El estudio reveló que 17 pacientes (41,5 por ciento) presentaban cariotipo normal y 24 (58,5 por ciento) lo tenían anormal. De estos últimos 18 (75 por ciento) tenían un mosaicismo cromosómico, 4 (16,7 por ciento) exhibían cariotipos hiperdiploides y 2 (8.3 por ciento) presentaban otras alteraciones cromosómicas.No se encontraron asociaciones significativas entre los tipos de leucemia (L1,L2,L3) y el cariotipo.