Identification of master regulator genes controlling pathogenic CD4+ T cell fate in inflammatory bowel disease through transcriptional network analysis.

Inflammatory bowel diseases (IBD) are a group of chronic inflammatory conditions of the gastrointestinal tract associated with multiple pathogenic factors, including dysregulation of the immune response. Effector CD4+ T cells and regulatory CD4+ T cells (Treg) are central players in maintaining the balance between tolerance and inflammation. Interestingly, genetic modifications in these cells have been implicated in regulating the commitment of specific phenotypes and immune functions. However, the transcriptional program controlling the pathogenic behavior of T helper cells in IBD progression is still unknown. In this study, we aimed to find master transcription regulators controlling the pathogenic behavior of effector CD4+ T cells upon gut inflammation. To achieve this goal, we used an animal model of IBD induced by the transfer of naïve CD4+ T cells into recombination-activating gene 1 (Rag1) deficient mice, which are devoid of lymphocytes. As a control, a group of Rag1-/- mice received the transfer of the whole CD4+ T cells population, which includes both effector T cells and Treg. When gut inflammation progressed, we isolated CD4+ T cells from the colonic lamina propria and spleen tissue, and performed bulk RNA-seq. We identified differentially up- and down-regulated genes by comparing samples from both experimental groups. We found 532 differentially expressed genes (DEGs) in the colon and 30 DEGs in the spleen, mostly related to Th1 response, leukocyte migration, and response to cytokines in lamina propria T-cells. We integrated these data into Gene Regulatory Networks to identify Master Regulators, identifying four up-regulated master gene regulators (Lef1, Dnmt1, Mybl2, and Jup) and only one down-regulated master regulator (Foxo3). The altered expression of master regulators observed in the transcriptomic analysis was confirmed by qRT-PCR analysis and found an up-regulation of Lef1 and Mybl2, but without differences on Dnmt1, Jup, and Foxo3. These two master regulators have been involved in T cells function and cell cycle progression, respectively. We identified two master regulator genes associated with the pathogenic behavior of effector CD4+ T cells in an animal model of IBD. These findings provide two new potential molecular targets for treating IBD.

Multimedia IoT-surveillance optimization model using mobile-edge authentic computing.

Smart technologies are advancing the development of cutting-edge systems by exploring the future network. The Internet of Things (IoT) and many multimedia sensors interact with each other for collecting and transmitting visual data. However, managing enormous amounts of data from numerous network devices is one of the main research challenges. In this context, various IoT systems have been investigated and have provided efficient data retrieval and processing solutions. For multimedia systems, however, controlling inefficient bandwidth utilization and ensuring timely transmission of vital information are key research concerns. Moreover, to transfer multimedia traffic while balancing communication costs for the IoT system, a sustainable solution with intelligence in real-life applications is demanded. Furthermore, trust must be formed for technological advancement to occur; such an approach provides the smart communication paradigm with the incorporation of edge computing. This study proposed a model for optimizing multimedia using a combination of edge computing intelligence and authentic strategies. Mobile edges analyze network states to discover the system's status and minimize communication disruptions. Moreover, direct and indirect authentication determines the reliability of data forwarders and network stability. The proposed authentication approach minimizes the possibility of data compromise and increases trust in multimedia surveillance systems. Using simulation testing, the proposed model outperformed other comparable work in terms of byte delivery, packet overhead, packet delay, and data loss metrics.

Nanomaterial accumulation in boiling brines enhances epithermal bonanzas.

Epithermal bonanza-type ores, characterized by weight-percent contents of e.g., gold and silver in a few mm to cm, are generated by mixtures of magmatic-derived hydrothermal brines and external fluids (e.g., meteoric) that transport a variety of metals to the site of deposition. However, the low solubilities of precious metals in hydrothermal fluids cannot justify the high concentrations necessary to produce such type of hyper-enriched metal ore. Here we show that boiling metal-bearing brines can produce, aggregate, and accumulate metal nanomaterials, ultimately leading to focused gold + silver ± copper over-enrichments. We found direct nano-scale evidence of nanoparticulate gold- and/or silver-bearing ores formed via nonclassical growth (i.e., nanomaterial attachment) during boiling in an intermediate-sulfidation epithermal bonanza. The documented processes may explain the generation of bonanzas in metal-rich brines from a range of mineral deposit types.

Low-Cost Turbidity Sensor to Determine Eutrophication in Water Bodies.

Eutrophication is the excessive growth of algae in water bodies that causes biodiversity loss, reducing water quality and attractiveness to people. This is an important problem in water bodies. In this paper, we propose a low-cost sensor to monitor eutrophication in concentrations between 0 to 200 mg/L and in different mixtures of sediment and algae (0, 20, 40, 60, 80, and 100% algae, the rest are sediment). We use two light sources (infrared and RGB LED) and two photoreceptors at 90° and 180° of the light sources. The system has a microcontroller (M5stacks) that powers the light sources and obtains the signal received by the photoreceptors. In addition, the microcontroller is responsible for sending information and generating alerts. Our results show that the use of infrared light at 90° can determine the turbidity with an error of 7.45% in NTU readings higher than 2.73 NTUs, and the use of infrared light at 180° can measure the solid concentration with an error of 11.40%. According to the determination of the % of algae, the use of a neural network has a precision of 89.3% in the classification, and the determination of the mg/L of algae in water has an error of 17.95%.

Development of a Low-Cost Optical Sensor to Detect Eutrophication in Irrigation Reservoirs.

In irrigation ponds, the excess of nutrients can cause eutrophication, a massive growth of microscopic algae. It might cause different problems in the irrigation infrastructure and should be monitored. In this paper, we present a low-cost sensor based on optical absorption in order to determine the concentration of algae in irrigation ponds. The sensor is composed of 5 LEDs with different wavelengths and light-dependent resistances as photoreceptors. Data are gathered for the calibration of the prototype, including two turbidity sources, sediment and algae, including pure samples and mixed samples. Samples were measured at a different concentration from 15 mg/L to 4000 mg/L. Multiple regression models and artificial neural networks, with a training and validation phase, are compared as two alternative methods to classify the tested samples. Our results indicate that using multiple regression models, it is possible to estimate the concentration of alga with an average absolute error of 32.0 mg/L and an average relative error of 11.0%. On the other hand, it is possible to classify up to 100% of the samples in the validation phase with the artificial neural network. Thus, a novel prototype capable of distinguishing turbidity sources and two classification methodologies, which can be adapted to different node features, are proposed for the operation of the developed prototype.

A Wireless Sensor Network Deployment for Soil Moisture Monitoring in Precision Agriculture.

The use of precision agriculture is becoming more and more necessary to provide food for the world's growing population, as well as to reduce environmental impact and enhance the usage of limited natural resources. One of the main drawbacks that hinder the use of precision agriculture is the cost of technological immersion in the sector. For farmers, it is necessary to provide low-cost and robust systems as well as reliability. Toward this end, this paper presents a wireless sensor network of low-cost sensor nodes for soil moisture that can help farmers optimize the irrigation processes in precision agriculture. Each wireless node is composed of four soil moisture sensors that are able to measure the moisture at different depths. Each sensor is composed of two coils wound onto a plastic pipe. The sensor operation is based on mutual induction between coils that allow monitoring the percentage of water content in the soil. Several prototypes with different features have been tested. The prototype that has offered better results has a winding ratio of 1:2 with 15 and 30 spires working at 93 kHz. We also have developed a specific communication protocol to improve the performance of the whole system. Finally, the wireless network was tested, in a real, cultivated plot of citrus trees, in terms of coverage and received signal strength indicator (RSSI) to check losses due to vegetation.

C-type lectin receptors MR and DC-SIGN are involved in recognition of hemocyanins, shaping their immunostimulatory effects on human dendritic cells.

Hemocyanins are used as immunomodulators in clinical applications because they induce a strong Th1-biased cell-mediated immunity, which has beneficial effects. They are multiligand glycosylated molecules with abundant and complex mannose-rich structures. It remains unclear whether these structures influence hemocyanin-induced immunostimulatory processes in human APCs. We have previously shown that hemocyanin glycans from Concholepas concholepas (CCH), Fissurella latimarginata (FLH), and Megathura crenulata (KLH), participate in their immune recognition and immunogenicity in mice, interacting with murine C-type lectin receptors (CLRs). Here, we studied the interactions of these hemocyanins with two major mannose-binding CLRs on monocyte-derived human DCs: MR (mannose receptor) and DC-SIGN (DC-specific ICAM-3-grabbing nonintegrin). Diverse analyses showed that hemocyanins are internalized by a mannose-sensitive mechanism. This process was calcium dependent. Moreover, hemocyanins colocalized with MR and DC-SIGN, and were partly internalized through clathrin-mediated endocytosis. The hemocyanin-mediated proinflammatory cytokine response was impaired when using deglycosylated FLH and KLH compared to CCH. We further showed that hemocyanins bind to human MR and DC-SIGN in a carbohydrate-dependent manner with affinity constants in the physiological concentration range. Overall, we showed that these three clinically valuable hemocyanins interact with human mannose-sensitive CLRs, initiating an immune response and promoting a Th1 cell-driving potential.

Deployment Strategies of Soil Monitoring WSN for Precision Agriculture Irrigation Scheduling in Rural Areas.

Deploying wireless sensor networks (WSN) in rural environments such as agricultural fields may present some challenges that affect the communication between the nodes due to the vegetation. These challenges must be addressed when implementing precision agriculture (PA) systems that monitor the fields and estimate irrigation requirements with the gathered data. In this paper, different WSN deployment configurations for a soil monitoring PA system are studied to identify the effects of the rural environment on the signal and to identify the key aspects to consider when designing a PA wireless network. The PA system is described, providing the architecture, the node design, and the algorithm that determines the irrigation requirements. The testbed includes different types of vegetation and on-ground, near-ground, and above-ground ESP32 Wi-Fi node placements. The results of the testbed show high variability in densely vegetated areas. These results are analyzed to determine the theoretical maximum coverage for acceptable signal quality for each of the studied configurations. The best coverage was obtained for the near-ground deployment. Lastly, the aspects of the rural environment and the deployment that affect the signal such as node height, crop type, foliage density, or the form of irrigation are discussed.

Adaptation and Validation of the Eudaimonic Well-Being Questionnaire to the Spanish Sport Context.

Studies to date that have focused on the well-being of the athlete have been based on the hedonic point of view. However, there is a second point of view: eudemonia. Therefore, the present study aims to validate and adapt the Eudemonic Well-Being Scale to the sport context. The study involved 2487 from several sport clubs. Several confirmatory factor analyses were carried out and showed that the six-factor questionnaire was the one with the best fit indices. These results show that the scale is in relation to the original scale (from Spain) and to Waterman's theoretical model.

Mechanisms for Pd-Au enrichment in porphyry-epithermal ores of the Elatsite deposit, Bulgaria.

Porphyry Cu can contain significant concentrations of platinum-group elements (PGE: Os, Ir, Ru, Rh, Pt, Pd). In this study, we provide a comprehensive in situ analysis of noble metals (PGE, Au, Ag) for (Cu-Fe)-rich sulfides from the Elatsite, one of the world's PGE-richest porphyry Cu deposits. These data, acquired using laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS), indicate that Pd was concentrated in all the (Cu-Fe)-rich sulfides at ppm-levels, with higher values in pyrite (~6 ppm) formed at the latest epithermal stage (i.e., quartz-galena-sphalerite assemblage) than in bornite and chalcopyrite (<5 ppm) from the hypogene quartz-magnetite-bornite-chalcopyrite ores. Likewise, Au is significantly more concentrated in pyrite (~5 ppm) than in the (Cu-Fe)-rich sulfides (≤0.08 ppm). In contrast, Ag reaches hundreds of ppm in pyrite and bornite (~240 ppm) but is in much lesser amounts in chalcopyrite (<25 ppm). The inspection of the time-resolved spectra collected during LA-IPC-MS analyses indicates that noble metals are present in the sulfides in two forms: (1) structurally bound (i.e., solid solution) in the lattice of sulfides and, (2) as nano- to micron-sized inclusions (Pd-Te and Au). These observations are further confirmed by careful investigations of the PGE-rich (Cu-Fe)-rich sulfides by combining high-spatial resolution of field emission scanning electron microscope (FESEM) and focused ion beam and high-resolution transmission electron microscopy (FIB/HRTEM). A typical Pd-bearing mineral includes the composition PdTe2 close to the ideal merenskyite but with a distinct crystallographic structure, whereas Au is mainly found as native element. Our detailed mineralogical study coupled with previous knowledge on noble-metal inclusions in the studied ores reveals that noble metal enrichment in the Elatsite porphyry ores was mainly precipitated from droplets of Au-Pd-Ag telluride melt (s) entrained in the high-temperature hydrothermal fluid. These telluride melts could separate at the time of fluid unmixing from the silicate magma or already be present in the latter either derived from deep-seated crustal or mantle sources. Significant enrichment in Pd and Au (the latter correlated with As) in low-temperature pyrite is interpreted as remobilization of these noble metals from pre-existing hypogene ores during the epithermal overprinting.

Fluxing of mantle carbon as a physical agent for metallogenic fertilization of the crust.

Magmatic systems play a crucial role in enriching the crust with volatiles and elements that reside primarily within the Earth's mantle, including economically important metals like nickel, copper and platinum-group elements. However, transport of these metals within silicate magmas primarily occurs within dense sulfide liquids, which tend to coalesce, settle and not be efficiently transported in ascending magmas. Here we show textural observations, backed up with carbon and oxygen isotope data, which indicate an intimate association between mantle-derived carbonates and sulfides in some mafic-ultramafic magmatic systems emplaced at the base of the continental crust. We propose that carbon, as a buoyant supercritical CO2 fluid, might be a covert agent aiding and promoting the physical transport of sulfides across the mantle-crust transition. This may be a common but cryptic mechanism that facilitates cycling of volatiles and metals from the mantle to the lower-to-mid continental crust, which leaves little footprint behind by the time magmas reach the Earth's surface.

Short-Term Changes on Body Composition and Bone Mass After One-Anastomosis Gastric Bypass: a Prospective Observational Study.

PURPOSE: Bariatric surgery generates a large weight loss. It is considered a successful surgery when 50% of the excess weight loss is reached. However, this measure does not include some variables that may have a direct impact on a patient's health, such as fat-free mass (FFM) or bone mass. Therefore, the aim of this study is to evaluate body composition and bone mass in patients undergoing one-anastomosis gastric bypass (OAGB). METHODS: A prospective observational study was performed in patients undergoing OAGB. Body composition and bone mass were evaluated by bioelectrical impedance analysis at baseline (1 day prior to surgery), at 6 and 12 months after surgery. RESULTS: A total of 94 patients (67% females and 33% males) were included in the study. The excess BMI loss at 6 and 12 months after surgery was 97.9 ± 20.1% and 110.2 ± 30.5% respectively. The FFM showed a reduction of 6.6 ± 4.8 kg (p < 0.01) 6 months after surgery and of 7.9 ± 4.9 kg (p < 0.01) at 12 months, meaning a decrease of 10.5 ± 7.3% and a 12.9 ± 6.6% respectively. The bone mass decrease was 10.1 ± 6.9% (p < 0.01) and 12.9 ± 6.5% (p < 0.01) at 12 months after OAGB. CONCLUSIONS: OAGB obtains a relevant weight loss in patients with morbid obesity, mainly, due to fat mass reductions. However, this procedure also provokes FFM and bone mass decreases, especially in females, but not significantly greater than other restrictive or mixed procedures.

IoT-Based Smart Irrigation Systems: An Overview on the Recent Trends on Sensors and IoT Systems for Irrigation in Precision Agriculture.

Water management is paramount in countries with water scarcity. This also affects agriculture, as a large amount of water is dedicated to that use. The possible consequences of global warming lead to the consideration of creating water adaptation measures to ensure the availability of water for food production and consumption. Thus, studies aimed at saving water usage in the irrigation process have increased over the years. Typical commercial sensors for agriculture irrigation systems are very expensive, making it impossible for smaller farmers to implement this type of system. However, manufacturers are currently offering low-cost sensors that can be connected to nodes to implement affordable systems for irrigation management and agriculture monitoring. Due to the recent advances in IoT and WSN technologies that can be applied in the development of these systems, we present a survey aimed at summarizing the current state of the art regarding smart irrigation systems. We determine the parameters that are monitored in irrigation systems regarding water quantity and quality, soil characteristics and weather conditions. We provide an overview of the most utilized nodes and wireless technologies. Lastly, we will discuss the challenges and the best practices for the implementation of sensor-based irrigation systems.

Are There Ideal Small Bowel Limb Lengths for One-Anastomosis Gastric Bypass (OAGB) to Obtain Optimal Weight Loss and Remission of Comorbidities with Minimal Nutritional Deficiencies?

BACKGROUND: Ideal jejunal and ileal lengths in bariatric/metabolic procedures to be left in alimentary continuity still remain unclear. We aimed to evaluate different lengths of biliopancreatic limb (BPL) and common limb (CL) performed in a series of patients submitted to OAGB, and correlate them with weight loss and nutritional deficits. PATIENTS AND METHODS: A prospective observational study of 350 consecutive morbidly obese patients undergoing OAGB was performed. BPL and CL lengths were determined intraoperatively; BPL/TBL and CL/TBL ratios were then calculated. Anthropometric variables, remission of comorbidities and specific supplementation needs were recorded at 1, 2 and 5 years after surgery. RESULTS: Three hundred patients were included for final analysis. BPL length and BPL/TBL ratio directly correlated with Units of BMI lost (UBMIL). Conversely, CL length and CL/TBL ratio showed an inverse correlation with UBMIL. Establishing a BMI ≤ 25 kg/m2 as ideal, the most accurate AUC, to predict achieving an ideal BMI at 1, 2 and 5 years after surgery, was obtained for the CL/TBL ratio, followed by the CL length at 1, 2 and 5 years. An ideal range was established between 0.40 and 0.43 for the CL/TBL ratio, and 200 to 220 cm for the CL length. Among these ranges, there were no cases of protein or calorie malnutrition. CONCLUSION: TBL measurement is essential to obtain optimal outcomes after OAGB, both in terms of excellent weight loss and remission/improvement of comorbidities, as well as with a low risk of nutritional deficiencies. The CL/TBL ratio, followed by CL length, are the most accurate parameters to predict a 5-year postoperative BMI ≤ 25 kg/m2.

N-Glycosylation of mollusk hemocyanins contributes to their structural stability and immunomodulatory properties in mammals.

Hemocyanins are widely used as carriers, adjuvants, and nonspecific immunostimulants in cancer because they promote Th1 immunity in mammals. Hemocyanins also interact with glycan-recognizing innate immune receptors on antigen-presenting cells, such as the C-type lectin immune receptors mannose receptor (MR), macrophage galactose lectin (MGL), and the Toll-like receptors (TLRs), stimulating proinflammatory cytokine secretion. However, the role of N-linked oligosaccharides on the structural and immunological properties of hemocyanin is unclear. Mollusk hemocyanins, such as Concholepas concholepas (CCH), Fissurella latimarginata (FLH), and Megathura crenulata (KLH), are oligomeric glycoproteins with complex dodecameric quaternary structures and heterogeneous glycosylation patterns, primarily consisting of mannose-rich N-glycans. Here, we report that enzyme-catalyzed N-deglycosylation of CCH, FLH, and KLH disrupts their quaternary structure and impairs their immunogenic effects. Biochemical analyses revealed that the deglycosylation does not change hemocyanin secondary structure but alters their refolding mechanism and dodecameric structure. Immunochemical analyses indicated decreased binding of N-deglycosylated hemocyanins to the MR and MGL receptors and TLR4 and reduced endocytosis concomitant with an impaired production of tumor necrosis factor α, and interleukins 6 and 12 (IL-6 and IL-12p40, respectively) in macrophages. Evaluating the function of N-deglycosylated hemocyanins in the humoral immune response and their nonspecific antitumor effects in the B16F10 melanoma model, we found that compared with native hemocyanins N-deglycosylated hemocyanins elicited reduced antibody titers, as well as partially diminished antitumor effects and altered carrier activities. In conclusion, the glycan content of hemocyanins is, among other structural characteristics, critically required for their immunological activities and should be considered in biomedical applications.

TLR4, but Neither Dectin-1 nor Dectin-2, Participates in the Mollusk Hemocyanin-Induced Proinflammatory Effects in Antigen-Presenting Cells From Mammals.

Mollusk hemocyanins have biomedical uses as carriers/adjuvants and nonspecific immunostimulants with beneficial clinical outcomes by triggering the production of proinflammatory cytokines in antigen-presenting cells (APCs) and driving immune responses toward type 1 T helper (Th1) polarization. Significant structural features of hemocyanins as a model antigen are their glycosylation patterns. Indeed, hemocyanins have a multivalent nature as highly mannosylated antigens. We have previously shown that hemocyanins are internalized by APCs through receptor-mediated endocytosis with proteins that contain C-type lectin domains, such as mannose receptor (MR). However, the contribution of other innate immune receptors to the proinflammatory signaling pathway triggered by hemocyanins is unknown. Thus, we studied the roles of Dectin-1, Dectin-2, and Toll-like receptor 4 (TLR4) in the hemocyanin activation of murine APCs, both in dendritic cells (DCs) and macrophages, using hemocyanins from Megathura crenulata (KLH), Concholepas concholepas (CCH) and Fissurella latimarginata (FLH). The results showed that these hemocyanins bound to chimeric Dectin-1 and Dectin-2 receptors in vitro; which significantly decreased when the glycoproteins were deglycosylated. However, hemocyanin-induced proinflammatory effects in APCs from Dectin-1 knock-out (KO) and Dectin-2 KO mice were independent of both receptors. Moreover, when wild-type APCs were cultured in the presence of hemocyanins, phosphorylation of Syk kinase was not detected. We further showed that KLH and FLH induced ERK1/2 phosphorylation, a key event involved in the TLR signaling pathway. We confirmed a glycan-dependent binding of hemocyanins to chimeric TLR4 in vitro. Moreover, DCs from mice deficient for MyD88-adapter-like (Mal), a downstream adapter molecule of TLR4, were partially activated by FLH, suggesting a role of the TLR pathway in hemocyanin recognition to activate APCs. The participation of TLR4 was confirmed through a decrease in IL-12p40 and IL-6 secretion induced by FLH when a TLR4 blocking antibody was used; a reduction was also observed in DCs from C3H/HeJ mice, a mouse strain with a nonfunctional mutation for this receptor. Moreover, IL-6 secretion induced by FLH was abolished in macrophages deficient for TLR4. Our data showed the involvement of TLR4 in the hemocyanin-mediated proinflammatory response in APCs, which could cooperate with MR in innate immune recognition of these glycoproteins.

Whipple disease after bariatric surgery: from malabsorption to malnutrition status.

Introduction: Malabsorptive bariatric techniques are associated with nutritional deficiencies. However, when patients do not respond to supplemental intensive treatments they should be closely followed because they can hide other pathological conditions. We present the case of a 47-year-old man with morbid obesity (body mass index [BMI]: 48 kg/m2) who underwent bariatric surgery. In 2016, he presented severe pneumonia and hospitalization at the Intensive Unit Care was required. After this episode, his nutritional state impaired, presenting 6-7 diarrhea/steatorrhea events per-day and requiring several hospitalizations due to the persistence of severe hypoproteinemia. He was given parenteral high-protein associated with low-fat oral diet. He presented a temporary biochemical improvement, but the hypoproteinemia recurred. Finally, tests revealed the presence of Tropheryma whipplei as protein-losing enteropathy. Whipple's disease (WD) is a rare cause of diarrhea and malnutrition, and these symptoms can be confused with the postoperative status of malabsorptive bariatric techniques. WD requires early diagnosis with prolonged antibiotic treatment to avoid severe complications.

Introducción: Las técnicas bariátricas malabsortivas suelen asociarse a deficiencias nutricionales. Sin embargo, cuando los pacientes no responden a tratamientos intensivos suplementarios, deben valorarse otras condiciones patológicas. Presentamos el caso de un hombre de 47 años, obeso mórbido (índice de masa corporal [IMC]: 48 kg/m2) sometido a cirugía bariátrica, que dos años más tarde presentó neumonía severa, por lo que requirió ingreso en la Unidad de Cuidados Intensivos. Posteriormente, el estado nutricional se deterioró, presentando 6-7 episodios de diarrea-esteatorrea/día y requiriendo varias hospitalizaciones por hipoproteinemia severa. Recibió infusión parenteral rica en proteínas asociada con una dieta baja en grasas y presentó mejoría analítica temporal. Finalmente, las pruebas revelaron la presencia de Tropheryma whipplei, una bacteria que genera enteropatía pierde-proteínas. La enfermedad de Whipple (EW) es una causa poco común de diarrea y malnutrición. Estos síntomas pueden confundirse con el posoperatorio de técnicas bariátricas malabsortivas. La EW requiere un diagnóstico precoz con un tratamiento antibiótico prolongado para evitar complicaciones graves.

Whipple disease after bariatric surgery: from malabsorption to malnutrition status / La enfermedad de Whipple después de cirugía bariátrica: de la malabsorción a la malnutrición

Malabsorptive bariatric techniques are associated with nutritional deficiencies. However, when patients do not respond to supplemental intensive treatments they should be closely followed because they can hide other pathological conditions. We present the case of a 47-year-old man with morbid obesity (body mass index [BMI]: 48 kg/m2) who underwent bariatric surgery. In 2016, he presented severe pneumonia and hospitalization at the Intensive Unit Care was required. After this episode, his nutritional state impaired, presenting 6-7 diarrhea/steatorrhea events per-day and requiring several hospitalizations due to the persistence of severe hypoproteinemia. He was given parenteral high-protein associated with low-fat oral diet. He presented a temporary biochemical improvement, but the hypoproteinemia recurred. Finally, tests revealed the presence of Tropheryma whipplei as protein-losing enteropathy. Whipple's disease (WD) is a rare cause of diarrhea and malnutrition, and these symptoms can be confused with the postoperative status of malabsorptive bariatric techniques. WD requires early diagnosis with prolonged antibiotic treatment to avoid severe complications

Las técnicas bariátricas malabsortivas suelen asociarse a deficiencias nutricionales. Sin embargo, cuando los pacientes no responden a tratamientos intensivos suplementarios, deben valorarse otras condiciones patológicas. Presentamos el caso de un hombre de 47 años, obeso mórbido (índice de masa corporal [IMC]: 48 kg/m2) sometido a cirugía bariátrica, que dos años más tarde presentó neumonía severa, por lo que requirió ingreso en la Unidad de Cuidados Intensivos. Posteriormente, el estado nutricional se deterioró, presentando 6-7 episodios de diarrea-esteatorrea/día y requiriendo varias hospitalizaciones por hipoproteinemia severa. Recibió infusión parenteral rica en proteínas asociada con una dieta baja en grasas y presentó mejoría analítica temporal. Finalmente, las pruebas revelaron la presencia de Tropheryma whipplei, una bacteria que genera enteropatía pierde-proteínas. La enfermedad de Whipple (EW) es una causa poco común de diarrea y malnutrición. Estos síntomas pueden confundirse con el posoperatorio de técnicas bariátricas malabsortivas. La EW requiere un diagnóstico precoz con un tratamiento antibiótico prolongado para evitar complicaciones graves

Physical Wellbeing Monitoring Employing Non-Invasive Low-Cost and Low-Energy Sensor Socks.

Determining and improving the wellbeing of people is one of the priorities of the OECD countries. Nowadays many sensors allow monitoring different parameters in regard to the wellbeing of people. These sensors can be deployed in smartphones, clothes or accessories like watches. Many studies have been performed on wearable devices that monitor certain aspects of the health of people, especially for specific diseases. In this paper, we propose a non-invasive low-cost and low-energy physical wellbeing monitoring system that provides a wellness score based on the obtained data. We present the architecture of the system and the disposition of the sensors on the sock. The algorithm of the system is presented as well. The wellness threshold evaluation module allows determining if the monitored parameter is within healthy ranges. The message forwarding module allows decreasing the energy consumption of the system by detecting the presence of alerts or changes in the data. Finally, a simulation was performed in order to determine the energy consumption of the system. Results show that our algorithm allows saving 44.9% of the initial energy in 10,000 min for healthy people.

Author Correction: Evaluation of Weight Loss Indicators and Laparoscopic One-Anastomosis Gastric Bypass Outcomes.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.