Spent brewer's yeast as a selective biosorbent for metal recovery from polymetallic waste streams.

While the amount of electronic waste is increasing worldwide, the heterogeneity of electronic scrap makes the recycling very complicated. Hydrometallurgical methods are currently applied in e-waste recycling which tend to generate complex polymetallic solutions due to dissolution of all metal components. Although biosorption has previously been described as a viable option for metal recovery and removal from low-concentration or single-metal solutions, information about the application of selective metal biosorption from polymetallic solutions is missing. In this study, an environmentally friendly and selective biosorption approach, based on the pH-dependency of metal sorption processes is presented using spent brewer's yeast to efficiently recover metals like aluminum, copper, zinc and nickel out of polymetallic solutions. Therefore, a design of experiment (DoE) approach was used to identify the effects of pH, metal, and biomass concentration, and optimize the biosorption efficiency for each individual metal. After process optimization with single-metal solutions, biosorption experiments with lyophilized waste yeast biomass were performed with synthetic polymetallic solutions where over 50% of aluminum at pH 3.5, over 40% of copper at pH 5.0 and over 70% of zinc at pH 7.5 could be removed. Moreover, more than 50% of copper at pH 3.5 and over 90% of zinc at pH 7.5 were recovered from a real polymetallic waste stream after leaching of printed-circuit boards. The reusability of yeast biomass was confirmed in five consecutive biosorption steps with little loss in metal recovery abilities. This proves that spent brewer's yeast can be sustainably used to selectively recover metals from polymetallic waste streams different to previously reported studies.

25 Years of Research in Human Lactation: From Discovery to Translation.

Researchers have recently called for human lactation research to be conceptualized as a biological framework where maternal and infant factors impacting human milk, in terms of composition, volume and energy content are studied along with relationships to infant growth, development and health. This approach allows for the development of evidence-based interventions that are more likely to support breastfeeding and lactation in pursuit of global breastfeeding goals. Here we summarize the seminal findings of our research programme using a biological systems approach traversing breast anatomy, milk secretion, physiology of milk removal with respect to breastfeeding and expression, milk composition and infant intake, and infant gastric emptying, culminating in the exploration of relationships with infant growth, development of body composition, and health. This approach has allowed the translation of the findings with respect to education, and clinical practice. It also sets a foundation for improved study design for future investigations in human lactation.

Precisión diagnóstica de la determinación de la presión arterial en consulta en el control del hipertenso: Propuesta de nuevos valores de corte / Diagnostic accuracy of blood pressure determination in clinics in control of hypertension: proposal of new cut-off values

OBJETIVO: Determinar los valores de punto de corte óptimos para la determinación de la presión arterial en consulta (PAC) como prueba de seguimiento en la consulta de Atención Primaria (AP). MATERIAL Y MÉTODO: A 153 hipertensos menores de 80años que cumplieran con criterios de inclusión y exclusión se les realizó una monitorización ambulatoria de su presión arterial durante 24h (MAPA), tras lo cual se obtuvieron dos medidas de PAC. Con los registros obtenidos de PAC, y tomándose la MAPA como referencia, se procedió a realizar la curva ROC para elegir el punto de corte óptimo. El acuerdo entre ambas mediciones fue determinado por el coeficiente de correlación intraclase y el método de Bland-Altman, tras lo cual se realizó un estudio de validación con el objetivo de diagnosticar el control o no del hipertenso. RESULTADOS: Los valores óptimos de corte fueron 137mmHg para la PA sistólica (sensibilidad: 89,3%; especificidad: 72,2%) y de 84mmHg para la diastólica (sensibilidad: 79,4%; especificidad: 72,3%). El acuerdo en el diagnóstico de control entre PAC y MAPA fue de 58,9% (kappa: 0,418). CONCLUSIÓN: El valor de corte óptimo de la PA diastólica para el seguimiento es menor a las cifras establecidas en la actualidad

AIM: This study seeks to determine the optimal cut-off values for the determination of the blood pressure in the clinic as a follow-up test in Primary Care practice. DESIGN: A total of 153 hypertensive patients under 80years of age who met inclusion and exclusion criteria for the study, were subjected to ambulatory monitoring of their blood pressure for 24hours (ABPM). After which two clinic-based measurements were obtained. With the results obtained from the clinic, and taking the ABMP as a reference, the ROC curve was calculated choose the optimal cut-off point. The agreement between both measurements was determined by the intraclass correlation coefficient and the Bland-Altman equation. A validation study was then carried out with the objective of diagnosing whether or not the hypertensive patient was in control. RESULTS: The optimal cut-off values were 137mmHg for systolic BP (sensitivity: 89.3%; specificity: 72.2%) and 84mmHg for diastolic blood pressure (sensitivity: 79.4%; specificity: 72.3%). The agreement in the diagnosis of control between clinic-based measurement and ABPM was 58.9% (Kappa: 0.418). CONCLUSION: The optimal cut-off value of the diastolic BP for follow-up is lower than the values currently established

[Diagnostic accuracy of blood pressure determination in clinics in control of hypertension: Proposal of new cut-off values]. / Precisión diagnóstica de la determinación de la presión arterial en consulta en el control del hipertenso: Propuesta de nuevos valores de corte.

AIM: This study seeks to determine the optimal cut-off values for the determination of the blood pressure in the clinic as a follow-up test in Primary Care practice. DESIGN: A total of 153 hypertensive patients under 80years of age who met inclusion and exclusion criteria for the study, were subjected to ambulatory monitoring of their blood pressure for 24hours (ABPM). After which two clinic-based measurements were obtained. With the results obtained from the clinic, and taking the ABMP as a reference, the ROC curve was calculated choose the optimal cut-off point. The agreement between both measurements was determined by the intraclass correlation coefficient and the Bland-Altman equation. A validation study was then carried out with the objective of diagnosing whether or not the hypertensive patient was in control. RESULTS: The optimal cut-off values were 137mmHg for systolic BP (sensitivity: 89.3%; specificity: 72.2%) and 84mmHg for diastolic blood pressure (sensitivity: 79.4%; specificity: 72.3%). The agreement in the diagnosis of control between clinic-based measurement and ABPM was 58.9% (Kappa: 0.418). CONCLUSION: The optimal cut-off value of the diastolic BP for follow-up is lower than the values currently established.

Validity of self blood pressure measurement in the control of the hypertensive patient: factors involved.

BACKGROUND: Improving clinical practice aimed at controlling hypertension is a pending issue in health systems. One of the methods currently used for this purpose is self blood pressure measurement (SBPM) whose use increases every day. The aims of this study are to establish the optimal cut-off point for the 3-day SMBP protocol and to identify factors that could affect the precision of the 3-day SMBP protocol using 24-h ambulatory blood pressure monitoring (ABPM) as a reference. METHOD: This is a cross-sectional descriptive study to validate a diagnostic test performed by a primary care team in Murcia, Spain. A total of 153 hypertensive patients under 80 years of age who met the inclusion criteria were evaluated. ABPM was performed for 24 h. The SBPM protocol consisted of recording 2 measurements in the morning and 2 at night for 3 days. RESULTS: The cut-off point for SBP was set at 135 mmHg (sensitivity: 80.39%, specificity: 74.19%), and for DBP, it was set at 83 mmHg (sensitivity: 76.48%, specificity: 84.89%), which yielded the highest combined sensitivity and specificity. After carrying out the validation study with the new figures, we proceeded to establish which socio-demographic factors prevented a correct classification of patients. These errors were more common in male patients for the assessments of both DBP (OR = 2.4) and SBP (OR = 2.5); hypertensive patients with age < 67,5 years (OR = 1,5); having no work activity (OR = 3,6) and with concomitant chronic kidney disease (CKD) (OR = 5.0). CONCLUSION: Being male, older than 67.5 years, with CKD or with no work activity increases the probability of being misclassified for hypertension during follow-up as assessed by SBPM over 3 days. TRIAL REGISTRATION: This study was approved by the research ethics committee of the University of Murcia under registration number 1018/2015.

Synthesis of C14-Desmethylene Corialactone D and Discovery of Inhibitors of Nerve Growth Factor Mediated Neurite Outgrowth.

An asymmetric synthesis of C14-desmethylene corialactone D is described on the basis of strategic application of a metallacycle-mediated annulative cross-coupling reaction, a Still [2,3]-Wittig rearrangement, and Morken's hydroxyl-directed diboration reaction. While representing a convenient approach to access novel compositions of matter inspired by the sesquiterpenoid natural product class (including classic natural product synthesis targets including the picrotaxanes and dendrobine), these studies have led to the discovery of natural product-inspired agents that inhibit nerve growth factor (NGF)-mediated neurite outgrowth in PC-12 cells.

Eficiencia entre los diferentes patrones de medida de la automonitorización de la presión arterial en el seguimiento del hipertenso en atención primaria / Efficiency between the different measurement patterns of home blood pressure monitoring in the follow-up of hypertensive patients in primary care

Objetivo: Identificar el patrón de medición de la automonitorización de la presión arterial (AMPA) más eficiente para el seguimiento del hipertenso en atención primaria. Diseño: Estudio validación de prueba diagnóstica. Emplazamiento: Equipo de atención primaria en Murcia. Población: Ciento cincuenta y tres hipertensos menores de 80 años que cumplieran con los criterios de inclusión; y con AMPA y monitorización ambulatoria de su presión arterial válidos. Mediciones principales: Realización de monitorización ambulatoria de presión arterial durante 24 h (MAPA). El protocolo de AMPA consistió en registrar 2 mediciones en la mañana y 2 en la noche durante 7 días. Con los registros obtenidos se establecieron los diferentes patrones de AMPA (7, 6, 5, 4, 3 días). Para el análisis utilizamos las curvas COR, el coeficiente de correlación intraclase y el diagrama de Bland-Altman. Resultados: Las mejores áreas bajo la curva para la presión sistólica de los diferentes patrones de la AMPA correspondieron al patrón de 4 días: 0,837 (0,77-0,90); y al de 3 días: 0,834 (0,77-0,90). En cuanto a la diastólica, el patrón de 7 días presentó un área bajo la curva de 0,889 (0,84-0,94); y en segundo lugar, coincidiendo con la misma cifra, los patrones de 3 y 4 días: 0,834 (0,83-0,94). No hubo diferencias significativas entre los coeficientes de correlación intraclase para las presiones arteriales sistólicas y diastólicas. El patrón de 3 días mostró en conjunto una menor dispersión en el diagrama de Bland-Altman. Conclusión: Proponemos el patrón de AMPA de 3 días para el seguimiento del paciente hipertenso, ya que no presenta una eficiencia inferior a los demás patrones

Objective: To identify the most efficient measurement pattern of home blood pressure monitoring (HBPM) for the follow-up of hypertensive patients in primary care. Design: Validation study of a diagnostic test. Setting: Primary care team in Murcia, Spain. Population: One hundred and fifty three hypertensive patients younger than 80 years who met the inclusion criteria, who used HBPM and ambulatory blood pressure monitoring. Main measurements: Performing HBPM for 24hours. The HBPM protocol consisted of recording 2 measurements in the morning and 2 in the evening for 7 days. With the records obtained, the different HBPM patterns were established (7, 6, 5, 4, 3 days). The ROC curves were used for the analysis, together with the correlation coefficients and the Bland-Altman plots. Results: The best areas under the curve for the systolic pressure of the different HBPM patterns corresponded to the 4-day pattern: 0.837 (0.77-0.90); and the 3 day one: 0.834 (0.77-0.90). As for diastolic pressure, the 7-day pattern had an area under the curve of 0.889 (0.84-0.94); followed by the 3 and 4 days patterns, which had the same statistical result both: 0.834 (0.83-0.94). There were no significant differences between correlation coefficients for systolic and diastolic blood pressures. The 3-day pattern showed a lower dispersion in the Bland-Altman plots. Conclusion: The 3 days HBPM pattern is proposed for the follow-up of the hypertensive patient, since it does not have an inferior efficiency to the other patterns

A Complementary Process to Pauson-Khand-Type Annulation Reactions for the Construction of Fully Substituted Cyclopentenones.

A complementary process to the Pauson-Khand annulation is described that is well suited to forging densely substituted/oxygenated cyclopentenone products (including fully substituted variants). The reaction is thought to proceed through a sequence of metallacycle-mediated bond-forming events that engages an internal alkyne and a ß-keto ester in an annulation process that forges two C-C bonds. A variant of this annulation process has also been established that delivers deoxygenated cyclopentenones that lack the allylic tertiary alcohol.

[Efficiency between the different measurement patterns of home blood pressure monitoring in the follow-up of hypertensive patients in primary care]. / Eficiencia entre los diferentes patrones de medida de la automonitorización de la presión arterial en el seguimiento del hipertenso en atención primaria.

OBJECTIVE: To identify the most efficient measurement pattern of home blood pressure monitoring (HBPM) for the follow-up of hypertensive patients in primary care. DESIGN: Validation study of a diagnostic test. SETTING: Primary care team in Murcia, Spain. POPULATION: One hundred and fifty three hypertensive patients younger than 80 years who met the inclusion criteria, who used HBPM and ambulatory blood pressure monitoring. MAIN MEASUREMENTS: Performing HBPM for 24hours. The HBPM protocol consisted of recording 2 measurements in the morning and 2 in the evening for 7 days. With the records obtained, the different HBPM patterns were established (7, 6, 5, 4, 3 days). The ROC curves were used for the analysis, together with the correlation coefficients and the Bland-Altman plots. RESULTS: The best areas under the curve for the systolic pressure of the different HBPM patterns corresponded to the 4-day pattern: 0.837 (0.77-0.90); and the 3 day one: 0.834 (0.77-0.90). As for diastolic pressure, the 7-day pattern had an area under the curve of 0.889 (0.84-0.94); followed by the 3 and 4 days patterns, which had the same statistical result both: 0.834 (0.83-0.94). There were no significant differences between correlation coefficients for systolic and diastolic blood pressures. The 3-day pattern showed a lower dispersion in the Bland-Altman plots. CONCLUSION: The 3 days HBPM pattern is proposed for the follow-up of the hypertensive patient, since it does not have an inferior efficiency to the other patterns.

Combined Skin and Muscle DNA Priming Provides Enhanced Humoral Responses to a Human Immunodeficency Virus Type 1 Clade C Envelope Vaccine.

Intradermal (i.d.) and intramuscular (i.m.) injections when administered with or without electroporation (EP) have the potential to tailor the immune response to DNA vaccination. This Phase I randomized controlled clinical trial in human immunodeficiency virus type 1-negative volunteers investigated whether the site and mode of DNA vaccination influences the quality of induced cellular and humoral immune responses following the DNA priming phase and subsequent protein boost with recombinant clade C CN54 gp140. A strategy of concurrent i.d. and i.m. DNA immunizations administered with or without EP was adopted. Subtle differences were observed in the shaping of vaccine-induced virus-specific CD4+ and CD8+ T cell-mediated immune responses between groups receiving: i.d.EP + i.m., i.d. + i.m.EP, and i.d.EP + i.m.EP regimens. The DNA priming phase induced 100% seroconversion in all of the groups. A single, non-adjuvanted protein boost induced a rapid and profound increase in binding antibodies in all groups, with a trend for higher responses in i.d.EP + i.m.EP. The magnitude of antigen-specific binding immunoglobulin G correlated with neutralization of closely matched clade C 93MW965 virus and Fc-dimer receptor binding (FcγRIIa and FcγRIIIa). These results offer new perspectives on the use of combined skin and muscle DNA immunization in priming humoral and cellular responses to recombinant protein.

Carbohydrate/DBU Cocatalyzed Alkene Diboration: Mechanistic Insight Provides Enhanced Catalytic Efficiency and Substrate Scope.

A mechanistic investigation of the carbohydrate/DBU cocatalyzed enantioselective diboration of alkenes is presented. These studies provide an understanding of the origin of stereoselectivity and also reveal a strategy for enhancing reactivity and broadening the substrate scope.

Synthesis of Highly Oxygenated Carbocycles by Stereoselective Coupling of Alkynes to 1,3- and 1,4-Dicarbonyl Systems.

Densely substituted and highly oxygenated carbocycles are challenging targets for synthesis. In particular, those possessing numerous contiguous, fully substituted carbon atoms (i.e., tertiary alcohols and quaternary centers) are often not accessible in a direct fashion, necessitating the strategic decoupling of ring-formation from the establishment of functionality about the system. Here, we describe an approach to the construction of highly oxygenated mono-, di-, and polycyclic carbocycles from the reaction of disubstituted alkynes with ß- or γ-dicarbonyl systems. These processes embrace a variant of metallacycle-mediated annulation chemistry where initial alkyne-carbonyl coupling is followed by a second, now intramolecular, stereoselective C-C bond-forming event. In addition to revealing the basic reactivity pattern in intermolecular settings, we demonstrate that this class of reactivity is quite powerful in a fully intramolecular context and, when terminated by a stereoselective oxidation process, can be used to generate polycyclic systems containing a fully substituted and highly oxygenated five-membered ring.

Yellow Nail Syndrome and Nail Lichen Planus may be Induced by a Common Culprit. Focus on Dental Restorative Substances.

Different clinical appearances such as Yellow nail syndrome and Lichen planus or lichenoid reactions can originate from close or identical etiologies. They may result from dental restorative materials or metal allergy. Interestingly, the nail sometimes returns to its normal condition, months after the withdrawal of the offending agents.

Hazards in opportunity.

Epidemiology studies have found that immigrants who enter the United States from Mexico have prevalence rates of mental disorder similar to residents of Mexico City. These rates are much lower than rates of mental disorder found in those of Mexican decent who were born in the United States. Prevalence of depression in U.S.-born Mexican-Americans approximates prevalence rates for the general U.S. population and is twice as high as the rates for recent immigrants from Mexico. This paper will discuss hypotheses that might contribute to these findings. These include decrease in family and social support, the need to compete in a more open society, and the inability to satisfy perceived needs and marginal position in society.

Linfedema: a propósito de un caso Hospital Provincial de Cotopaxi / Linfedema: with regard to a case Provincial Hospital of Cotopaxi

Analiza que el diagnóstico y tratamiento del paciente con una masa en la región inguino-genital y acompañado de edema en extremidades constituye un verdadero problema para el médico en general. A ello contribuyen la falta de estudios que hayan valorado una población de individuos con tales características. El linfedema es una condición resultante de un trastorno topográficamente limitado del drenaje linfático o del líquido intersticial secundario a diversas etiologías pudiendo ser: congénito (linfedema primitivo o enfermedad de Milroy) como consecuencia de aplasia de canales linfáticos o secundario (adquirido) cuando es debido a lesión de los linfáticos por infección, invasión maligna, irradiación o resección quirúrgica. La revisión del presente caso intenta actualizar conocimientos en cuanto a diagnbóstico diferencial se refiere...