Scorecard Approach to Eliminate Onchocerciasis in Venezuela.

In the Americas, onchocerciasis has been eliminated in 11 of 13 endemic foci by mass administration of ivermectin. The remaining at-risk population resides in a contiguous cross-border transmission zone located in the Amazon jungle in northwest Brazil and southern Venezuela, known as the Yanomami Focus Area. Here, we describe the development and implementation of a data-driven tool, called the Scorecard Approach (SCA), for the 393 communities that comprise the Venezuela South Focus. The SCA was first applied in 2018 and is reassessed on an annual basis. This operational strategy seeks to prioritize communities with low ivermectin coverage while taking into account the nature and variation of other epidemiological and logistical variables. Numeric scores are assigned for each factor and added together to yield a composite score for each community that is categorized as high, medium, or low priority. In this way, the SCA serves as a valuable and comprehensive strategy for planning, monitoring, and maximizing programmatic efficiency. In addition, it has allowed the country to face the main challenges of this endemic area: its remoteness, its large areas of territory to cover, the semi-nomadic nature of the Yanomami people, and their continuous cross-border movements. For 2022, the SCA categorized 54 (13.7%), 108 (27.5%), and 231 (58.8%) communities as high, medium, and low priority, respectively. The results presented here show that prioritizing communities at risk and with greatest needs increases the feasibility of interrupting the transmission of onchocerciasis by 2025 in the last endemic focus in the Americas.

The DNA Methyltransferase DMAP1 is Required for Tissue Maintenance and Planarian Regeneration.

The precise regulation of transcription is required for embryonic development, adult tissue turnover, and regeneration. Epigenetic modifications play a crucial role in orchestrating and regulating the transcription of genes. These modifications are important in the transition of pluripotent stem cells and their progeny. Methylation, a key epigenetic modification, influences gene expression through changes in histone tails and direct DNA methylation. Work in different organisms has shown that the DNA methyltransferase-1-associated protein (DMAP1) may associate with other molecules to repress transcription through DNA methylation. Thus, DMAP1 is a versatile protein implicated in a myriad of events, including pluripotency maintenance, DNA damage repair, and tumor suppression. While DMAP1 has been extensively studied in vitro, its complex regulation in the context of the adult organism remains unclear. To gain insights into the possible roles of DMAP1 at the organismal level, we used planarian flatworms that possess remarkable regenerative capabilities driven by pluripotent stem cells called neoblast. Our findings demonstrate the evolutionary conservation of DMAP1 in the planarian Schmidtea mediterranea. Functional disruption of DMAP1 through RNA interference revealed its critical role in tissue maintenance, neoblast differentiation, and regeneration in S. mediterranea. Moreover, our analysis unveiled a novel function for DMAP1 in regulating cell death in response to DNA damage and influencing the expression of axial polarity markers. Our findings provide a simplified paradigm for studying DMAP1's epigenetic regulation in adult tissues.

Does Exerting Grasps Involve a Finite Set of Muscle Patterns? A Study of Intra- and Intersubject Variability of Forearm sEMG Signals in Seven Grasp Types.

Surface Electromyography (sEMG) signals are widely used as input to control robotic devices, prosthetic limbs, exoskeletons, among other devices, and provide information about someone's intention to perform a particular movement. However, the redundant action of 32 muscles in the forearm and hand means that the neuromotor system can select different combinations of muscular activities to perform the same grasp, and these combinations could differ among subjects, and even among the trials done by the same subject. In this work, 22 healthy subjects performed seven representative grasp types (the most commonly used). sEMG signals were recorded from seven representative forearm spots identified in a previous work. Intra- and intersubject variability are presented by using four sEMG characteristics: muscle activity, zero crossing, enhanced wavelength and enhanced mean absolute value. The results confirmed the presence of both intra- and intersubject variability, which evidences the existence of distinct, yet limited, muscle patterns while executing the same grasp. This work underscores the importance of utilizing diverse combinations of sEMG features or characteristics of various natures, such as time-domain or frequency-domain, and it is the first work to observe the effect of considering different muscular patterns during grasps execution. This approach is applicable for fine-tuning the control settings of current sEMG devices.

Ti-Modified Imogolite Nanotubes as Promising Photocatalyst 1D Nanostructures for H2 Production.

Imogolite nanotubes (INTs) are predicted as a unique 1D material with spatial separation of conduction and valence band edges but their large band gaps have inhibited their use as photocatalysts. The first step toward using these NTs in photocatalysis and exploiting the polarization-promoted charge separation across their walls is to reduce their band gap. Here, the modification of double-walled aluminogermanate INTs by incorporation of titanium into the NT walls is explored. The precursor ratio x = [Ti]/([Ge]+[Ti]) is modulated between 0 and 1. Structural and optical properties are determined at different scales and the photocatalytic performance is evaluated for H2 production. Although the incorporation of Ti atoms into the structure remains limited, the optimal condition is found around x = 0.4 for which the resulting NTs reveal a remarkable hydrogen production of ≈1500 µmol g-1 after 5 h for a noble metal-free photocatalyst, a 65-fold increase relative to a commercial TiO2 -P25. This is correlated to a lowering of the recombination rate of photogenerated charge carriers for the most active structures. These results confirm the theoretical predictions regarding the potential of modified INTs as photoactive nanoreactors and pave the way for investigating and exploiting their polarization properties for energy applications.

Impacto de la pandemia por COVID-19 en la formación de los cirujanos torácicos en España / Impact of the COVID-19 pandemic on thoracic surgery training in Spain

Tras más de dos años desde su aparición, la pandemia por SARS-CoV-2 ha generado importantes cambios en la sanidad y su organización. El presente trabajo trata de dilucidar las implicaciones de estos en la formación especializada de la cirugía torácica y sus repercusiones en los profesionales. Para ello, desde la Sociedad Española de Cirugía Torácica (SECT) se distribuye una encuesta entre los residentes en activo y aquellos que han terminado su formación en los últimos tres años. Esta consta de 24 preguntas cerradas de respuesta múltiple sobre el impacto de la pandemia en sus servicios, su formación y su vivencia. La tasa de respuesta (TR) de la encuesta fue de 42% (52 de una población objetivo de 120). El efecto de la pandemia en el funcionamiento de los servicios de cirugía torácica fue considerado alto o extremo según 78,8% de los participantes. Las actividades académicas fueron completamente suspendidas en 42,3% de los casos, mientras que 57,7% de los participantes tuvieron que prestar atención asistencial a pacientes ingresados por COVID, de los cuales 25% fue a tiempo parcial y 32,7% a tiempo completo. De los encuestados, 80% consideró que los cambios sufridos durante la pandemia afectaron su formación como residente y 36,5% opinó que debería ofrecerse una prolongación del periodo de formación para quienes se hayan visto afectados. Así pues, observamos cómo la pandemia ha afectado profundamente de forma negativa la formación especializada en cirugía torácica en España. (AU)

In the more than 2 years since its emergence, the SARS-CoV-2 pandemic has prompted important changes in healthcare systems and their organization. The aim of this study is to determine the implications in specialized thoracic surgery training as well as the repercussions on thoracic surgery residents. With this objective, the Spanish Society of Thoracic Surgery has conducted a survey among all its trainees and those who had finished their residency during the last 3 years. It consisted of 24 multiple-answer closed questions about the impact of the pandemic on their services, their training, and their personal experience. The response rate was 42% (52 out of a target population of 120). The effect of the pandemic on thoracic surgery services was high or extreme according to 78.8% of the participants. Academic activities were completely cancelled in 42.3% of the cases, and 57.7% of the respondents were required to treat hospitalized COVID patients (25% part-time, and 32.7% full-time). More than 80% of the survey participants believed that changes during the pandemic negatively affected their training, and 36.5% would prefer to extend their training period. In sum, we observe how the pandemic has had deep negative effects on specialized training in thoracic surgery in Spain. (AU)

Electromyography and kinematics data of the hand in activities of daily living with special interest for ergonomics.

This work presents a dataset of human hand kinematics and forearm muscle activation collected during the performance of a wide variety of activities of daily living (ADLs), with tagged characteristics of products and tasks. A total of 26 participants performed 161 ADLs selected to be representative of common elementary tasks, grasp types, product orientations and performance heights. 105 products were used, being varied regarding shape, dimensions, weight and type (common products and assistive devices). The data were recorded using CyberGlove instrumented gloves on both hands measuring 18 degrees of freedom on each and seven surface EMG sensors per arm recording muscle activity. Data of more than 4100 ADLs is presented in this dataset as MATLAB structures with full continuous recordings, which may be used in applications such as machine learning or to characterize healthy human hand behaviour. The dataset is accompanied with a custom data visualization application (ERGOMOVMUS) as a tool for ergonomics applications, allowing visualization and calculation of aggregated data from specific task, product and/or participants' characteristics.

Postoperative morbidity after anatomical lung resections by VATS vs thoracotomy: Treatment and intention-to-treat analysis of the Spanish Video-Assisted Thoracic Surgery Group / Morbilidad postoperatoria después de una resección pulmonar anatómica mediante cirugía toracoscópica frente a cirugía abierta: análisis por tratamiento y por intención de tratar del Grupo Español de Cirugía Torácica Videoasistida

Objectives In recent years, video-assisted thoracoscopic lung resections (VATS) have been associated with lower morbidity than open surgery. The aim of our study is to compare postoperative morbidity among patients from the national database of the Spanish Group of Video-Assisted Thoracic Surgery (GE-VATS) after open and video-assisted anatomic lung resections using a propensity score analysis.MethodsFrom December 2016 to March 2018, a total of 3533 patients underwent anatomical lung resection at 33 centers. Pneumonectomies and extended resections were excluded. A propensity score analysis was performed to compare the morbidity of the thoracotomy group (TG) vs the VATS group (VATSG). Treatment and intention-to-treat (ITT) analyses were conducted.ResultsIn total, 2981 patients were finally included in the study: 1092 (37%) in the TG and 1889 (63%) in the VATSG for the treatment analysis; and 816 (27.4%) in the TG and 2165 patients (72.6%) in the VATSG for the ITT analysis. After propensity score matching, in the treatment analysis, the VATSG was significantly associated with fewer overall complications than the TG OR 0.680 [95%CI 0.616, 0.750]), fewer respiratory (OR 0.571 [0.529, 0.616]) cardiovascular (OR 0.529 [0.478, 0.609]) and surgical (OR 0.875 [0.802, 0.955]) complications, lower readmission rate (OR 0.669 [0.578, 0.775]) and a reduction of hospital length of stay (−1.741 ([−2.073, −1.410]). Intention-to-treat analysis showed only statistically significant differences in overall complications (OR 0.76 [0.54–0.99]) in favor of the VATSG.ConclusionIn this multicenter population, VATS anatomical lung resections have been associated with lower morbidity than those performed by thoracotomy. However, when an intention-to-treat analysis was performed, the benefits of the VATS approach were less prominent. (AU)

Introducción El objetivo de nuestro estudio es comparar la morbilidad postoperatoria entre los pacientes de la base de datos nacional del Grupo Español de Cirugia Torácica Videoasistida (GE-VATS) después de resecciones pulmonares anatómicas abiertas y videoasistidas mediante un análisis de emparejamiento por índice de propensión.MétodosDesde Diciembre de 2016 hasta Marzo de 2018, un total 3533 pacientes fueron intervenidos de resección pulmonar anatómica en 33 centros. Se excluyeron las neumonectomías y las resecciones extendidas. Se realizó un análisis de índice de propensión para comparar la morbilidad de cirugía abierta (TG) frente a VATS (VATSG). Se realizó un análisis por tratamiento y por intención de tratar (ITT).ResultadosEn el estudio se incluyeron finalmente 2981 pacientes: 1092 (37%) en TG y 1889 (63%) en VATSG. En el análisis por tratamiento, la VATS se asoció significativamente con menor tasa de complicaciones que la cirugía abierta (OR 0.680 [95%CI 0.616, 0.750]), de complicaciones respiratorias (OR 0.571 [0.529, 0.616]), cardiovasculares (OR 0.529 [0.478, 0.609]) y quirúrgicas (OR 0.875 [0.802, 0.955]), menor tasa de reingresos (OR 0.669 [0.578, 0.775]) y menor estancia (−1.741 ([−2.073, −1.410]). En el de intención de tratar, se observaron diferencias estadísticamente significativas a favor de la VATS solo en las complicaciones en general (OR 0.76 [0.54–0.99]).ConclusionesEn esta población multicéntrica, las lobectomías y segmentectomias anatómicas por VATS se han asociado con menor tasa de complicaciones que las realizadas por toracotomía. Sin embargo, en el análisis por intención de tratar, los beneficios de la VATS no fueron tan evidentes. (AU)

Characterization of polyphenols compounds extracted from stressed apple peel and their interaction with ß-lactoglobulin.

This paper proposes to apply a postharvest environmental stress to red apples, Malus domestica, variety Red Delicious in order to increase the polyphenols compounds (PP) content in their peels. The possibility of enhancing extractable PP provides a useful alternative for the use of discarded crops in the food industry. A great increase in PP was observed in response to light damage produced by the environmental stress applied in this work. Flavonols > anthocyanins > flavanols > dihydrochalcones > phenolic acids is the order in PP content. The interaction of the extracted PP from unstressed and stressed apple peels with beta-lactoglobulin (ß-LG) was characterized. A PP/ß-LG complex which was formed with one single binding site in the protein was determined. The interaction was spontaneous and enthalpy driven. PP extracted from unstressed samples had greater affinity for the protein than PP extracted from stressed samples, possibly due to the polar characteristic of anthocyanins. The results of this last study could provide a better understanding of the interaction between PP and ß-LG to incorporate them into functional foods.

Salubrízate, un proyecto de armonía con las personas y el entorno / Salubrízate: a project in harmony with the people and the environment

Introducción. Salubrízate es un grupo de procesos y activos comunitarios que realiza intervenciones de educación y promoción de la salud para el bienestar colectivo, en Ourense y alrededores desde el año 2018. Objetivo. El objetivo principal es conocer y responder a las inquietudes de salud de la ciudadanía. Métodos. Esta experiencia se basa en un modelo abierto a la participación, intersectorial y multidisciplinar, que tiene la capacidad de adaptarse a diversas circunstancias sanitarias o sociales, como la COVID. Se trabaja en cuatro áreas: hábitos saludables, bienestar emocional y social, entornos saludables y seguridad ciudadana. Tiene como recursos principales a las personas, los medios de comunicación colectiva como la radio y las redes sociales y diversas instituciones tanto sanitarias como sociales. Resultados. La repercusión de Salubrízate se está midiendo a través del alcance de cada uno de los proyectos llevados a cabo por el grupo, analizando también las debilidades que limitan el proyecto y sus fortalezas. (AU)

Introduction. Salubrízate is a group of community processes and assets that has been implementing health education and promotion interventions for collective well-being in Ourense and its surroundings since 2018.Aim. The main purpose is to be aware of the health concerns of citizens and respond to them.Methods. This experience is based on an intersectoral and multidisciplinary model open to participation, which can adapt to various health or social circumstances, such as COVID-19. The programme works on four areas: healthy habits, emotional and social well-being, healthy environments and citizen safety. Its key resources are people, mass media such as radio and social media and various health and social institutions.Results. The impact, strengths and limiting weaknesses of Salubrízate are being analysed by means of the scope of each project conducted by the group.

Impact of hand osteoarthritis in women on maximal forces in six different grasp types.

This work aims to: (1) Provide maximal hand force data on six different grasp types for healthy subjects; (2) detect grasp types with maximal force significantly affected by hand osteoarthritis (HOA) in women; (3) look for predictors to detect HOA from the maximal forces using discriminant analyses. Thirty-three healthy subjects (37 ± 17 years, 17 women, 16 men) and 30 HOA patients (72 ± 9 years, all women) participated in the experiment. Participants were asked to exert their maximal force while performing six different grasp types 3 times. Two MANOVAs were conducted to detect if force depended on gender in healthy participants and if force significantly diminished in women with HOA. Finally, a linear discriminant analysis for detecting HOA was performed using forces of the grasp types that were significantly affected by HOA. Gender-disaggregated statistics are provided for healthy participants. Significant differences are obtained for all grasp types per gender. The women with HOA exerted significantly lower force values (p < 0.001) for all the grasp types than healthy ones. The discriminant analysis revealed that oblique grasp was the most significant one for detecting HOA. A discrimination equation was obtained with a specificity of 88.2% and a sensitivity of 83.3%. This work provides grip force data on six grasp types for healthy participants and for women with HOA. HOA women present reduced strength in all grasps due to pathology. Three of these grasps are a novelty. Oblique grasp strength may suffice to discriminate a patient with HOA, which might help non-invasive HOA detection.

The BE-UJI hand function activity set: a reduced set of activities for the evaluation of the healthy and pathological hand.

BACKGROUND: Hand kinematics during hand function tests based on the performance of activities of daily living (ADLs) can provide objective data to determine patients' functional loss. However, they are rarely used during clinical assessments because of their long duration. Starting with the 20 Sollerman Hand Function Test (SHFT) tasks, we propose identifying a reduced set of ADLs that provides similar kinematic information to the original full set in terms of synergies, ranges of motion and velocities. METHODS: We followed an iterative method with the kinematics of 16 hand joints while performing the 20 ADLs of the SHFT. For each subject, ADLs were ordered according to their influence on the synergies obtained by means of a principal component analysis, the minimum number of ADLs that represented the original kinematic synergies (maximum angle of 30° between synergies), and the maintained ranges of joint movements (85% of the original ones) were selected for each subject. The set of the most frequently selected ADLs was verified to be representative of the SHFT ADLs in terms of motion strategies, ranges of motion and joint velocities when considering healthy subjects and Hand Osteoarthritis patients. RESULTS: A set of 10 tasks, the BE-UJI activity set, was identified by ensuring a certain (minimum) similarity in synergy (maximum mean angle between synergies of 25.5°), functional joint ranges (maximum differences of 10°) and joint velocities (maximum differences of 15°/s). The obtained tasks were: pick up coins from purses, lift wooden cubes, pick up nuts and turn them, write with a pen, cut with a knife, lift a telephone, unscrew jar lids and pour water from a cup, a jar and a Pure-Pak. These activities guarantee using the seven commonest handgrips in ADLs. CONCLUSION: The BE-UJI activity set for the hand function assessment can be used to obtain quantitative data in clinics as an alternative to the SHFT. It reduces the test time and allows clinicians to obtain objective kinematic data of the motor strategies, ranges of motion and joint velocities used by patients.

Postoperative morbidity after anatomical lung resections by VATS vs thoracotomy: Treatment and intention-to-treat analysis of the Spanish Video-Assisted Thoracic Surgery Group.

OBJECTIVES: In recent years, video-assisted thoracoscopic lung resections (VATS) have been associated with lower morbidity than open surgery. The aim of our study is to compare postoperative morbidity among patients from the national database of the Spanish Group of Video-Assisted Thoracic Surgery (GE-VATS) after open and video-assisted anatomic lung resections using a propensity score analysis. METHODS: From December 2016 to March 2018, a total of 3533 patients underwent anatomical lung resection at 33 centers. Pneumonectomies and extended resections were excluded. A propensity score analysis was performed to compare the morbidity of the thoracotomy group (TG) vs the VATS group (VATSG). Treatment and intention-to-treat (ITT) analyses were conducted. RESULTS: In total, 2981 patients were finally included in the study: 1092 (37%) in the TG and 1889 (63%) in the VATSG for the treatment analysis; and 816 (27.4%) in the TG and 2165 patients (72.6%) in the VATSG for the ITT analysis. After propensity score matching, in the treatment analysis, the VATSG was significantly associated with fewer overall complications than the TG OR 0.680 [95%CI 0.616, 0.750]), fewer respiratory (OR 0.571 [0.529, 0.616]) cardiovascular (OR 0.529 [0.478, 0.609]) and surgical (OR 0.875 [0.802, 0.955]) complications, lower readmission rate (OR 0.669 [0.578, 0.775]) and a reduction of hospital length of stay (-1.741 ([-2.073, -1.410]). Intention-to-treat analysis showed only statistically significant differences in overall complications (OR 0.76 [0.54-0.99]) in favor of the VATSG. CONCLUSION: In this multicenter population, VATS anatomical lung resections have been associated with lower morbidity than those performed by thoracotomy. However, when an intention-to-treat analysis was performed, the benefits of the VATS approach were less prominent.

A Planarian Model System to Study Host-Pathogen Interactions.

This protocol is focused on using the recently established planarian infection model system to study host-pathogen interactions during fungal infection. Here, we describe in detail the infection of the planarian Schmidtea mediterranea with the human fungal pathogen Candida albicans. This simple and reproducible model system allows for rapid visualization of tissue damage throughout different infection timepoints. We note that this model system has been optimized for use with C. albicans, but should also be applicable for use with other pathogens of interest.

Impact of COVID-19 pandemic in thoracic surgery training in Spain.

In the more than 2 years since its emergence, the SARS-CoV-2 pandemic has prompted important changes in healthcare systems and their organization. The aim of this study is to determine the implications in specialized thoracic surgery training as well as the repercussions on thoracic surgery residents. With this objective, the Spanish Society of Thoracic Surgery has conducted a survey among all its trainees and those who had finished their residency during the last 3 years. It consisted of 24 multiple-answer closed questions about the impact of the pandemic on their services, their training, and their personal experience. The response rate was 42% (52 out of a target population of 120). The effect of the pandemic on thoracic surgery services was high or extreme according to 78.8% of the participants. Academic activities were completely cancelled in 42.3% of the cases, and 57.7% of the respondents were required to treat hospitalized COVID patients (25% part-time, and 32.7% full-time). More than 80% of the survey participants believed that changes during the pandemic negatively affected their training, and 36.5% would prefer to extend their training period. In sum, we observe how the pandemic has had deep negative effects on specialized training in thoracic surgery in Spain.

Low-Dose Gamma Radiation Sterilization for Decellularized Tracheal Grafts.

One of the main key aspects in ensuring that a transplant evolves correctly is the sterility of the medium. Decellularized tracheal transplantation involves implanting an organ that was originally in contact with the environment, thus not being sterile from the outset. While the decellularization protocol (through detergent exposition [2% sodium dodecyl sulfate], continuous stirring, and osmotic shocks) is conducted in line with aseptic measures, it does not provide sterilization. Therefore, one of the main challenges is ensuring sterility prior to in vivo implantation. Although there are established gamma radiation sterilization protocols for inorganic materials, there are no such measures for organic materials. Additionally, the protocols in place for inorganic materials cannot be applied to organic materials, as the established radiation dose (25 kGy) would completely destroy the implant. This paper studies the effect of an escalated radiation dose in a decellularized rabbit trachea. We maintained the dose range (kGy) and tested escalated doses until finding the minimal dose at which sterilization is achieved. After determining the dose, we studied effects of it on the organ, both histologically and biomechanically. We determined that while 0.5 kGy did not achieve sterility, doses of both 1 kGy and 2 kGy did, with 1 kGy, therefore, being the minimal dose necessary to achieve sterilization. Microscopic studies showed no relevant changes compared to non-sterilized organs. Axial biomechanical characteristics were not altered at all, and only a slight reduction in the force per unit of length that the organ can radially tolerate was observed. We can therefore conclude that 1 kGy achieves complete sterilization of decellularized rabbit trachea with a minimal, if any, effects on the organ.

Toward Early and Objective Hand Osteoarthritis Detection by Using EMG during Grasps.

The early and objective detection of hand pathologies is a field that still requires more research. One of the main signs of hand osteoarthritis (HOA) is joint degeneration, which causes loss of strength, among other symptoms. HOA is usually diagnosed with imaging and radiography, but the disease is in an advanced stage when HOA is observable by these methods. Some authors suggest that muscle tissue changes seem to occur before joint degeneration. We propose recording muscular activity to look for indicators of these changes that might help in early diagnosis. Muscular activity is often measured using electromyography (EMG), which consists of recording electrical muscle activity. The aim of this study is to study whether different EMG characteristics (zero crossing, wavelength, mean absolute value, muscle activity) via collection of forearm and hand EMG signals are feasible alternatives to the existing methods of detecting HOA patients' hand function. We used surface EMG to measure the electrical activity of the dominant hand's forearm muscles with 22 healthy subjects and 20 HOA patients performing maximum force during six representative grasp types (the most commonly used in ADLs). The EMG characteristics were used to identify discriminant functions to detect HOA. The results show that forearm muscles are significantly affected by HOA in EMG terms, with very high success rates (between 93.3% and 100%) in the discriminant analyses, which suggest that EMG can be used as a preliminary step towards confirmation with current HOA diagnostic techniques. Digit flexors during cylindrical grasp, thumb muscles during oblique palmar grasp, and wrist extensors and radial deviators during the intermediate power-precision grasp are good candidates to help detect HOA.

Solar water splitting Pt-nanoparticle photosystem I thylakoid systems: Catalyst identification, location and oligomeric structure.

Photosynthetic conversion of light energy into chemical energy occurs in sheet-like membrane-bound compartments called thylakoids and is mediated by large integral membrane protein-pigment complexes called reaction centers (RCs). Oxygenic photosynthesis of higher plants, cyanobacteria and algae requires the symbiotic linking of two RCs, photosystem II (PSII) and photosystem I (PSI), to split water and assimilate carbon dioxide. Worldwide there is a large research investment in developing RC-based hybrids that utilize the highly evolved solar energy conversion capabilities of RCs to power catalytic reactions for solar fuel generation. Of particular interest is the solar-powered production of H2, a clean and renewable energy source that can replace carbon-based fossil fuels and help provide for ever-increasing global energy demands. Recently, we developed thylakoid membrane hybrids with abiotic catalysts and demonstrated that photosynthetic Z-scheme electron flow from the light-driven water oxidation at PSII can drive H2 production from PSI. One of these hybrid systems was created by self-assembling Pt-nanoparticles (PtNPs) with the stromal subunits of PSI that extend beyond the membrane plane in both spinach and cyanobacterial thylakoids. Using PtNPs as site-specific probe molecules, we report the electron microscopic (EM) imaging of oligomeric structure, location and organization of PSI in thylakoid membranes and provide the first direct visualization of photosynthetic Z-scheme solar water-splitting biohybrids for clean H2 production.

Results in mediastinal lymph node staging of surgical lung cancer: Data from the prospective cohort of the Spanish Video-Assisted Thoracic Surgery Group.

OBJECTIVES: The objective of this study was to assess the diagnostic performance of combined computerised tomography (CT) and positron emission tomography (PET) in mediastinal staging of surgical lung cancer based on data obtained from the prospective cohort of the Spanish Group for Video-Assisted Thoracic Surgery (GEVATS). METHODS: A total of 2782 patients underwent surgery for primary lung carcinoma. We analysed diagnostic success in mediastinal lymph node staging (cN2) using CT and PET. Bivariate and multivariate analyses were performed of the factors involved in this success. The risk of unexpected pN2 disease was analysed for cases in which an invasive testing is recommended: cN1, the tumour centrally located or the tumour diameter >3 cm. RESULTS: The overall success of CT together with PET was 82.9% with a positive predictive value of 0.21 and negative predictive value of 0.93. If the tumour was larger than 3 cm and for each unit increase in mediastinal SUVmax, the probability of success was lower with OR 0.59 (0.44-0.79) and 0.71 (0.66-0.75), respectively. In the video-assisted thoracic surgery (VATS) approach, the probability of success was higher with OR 2.04 (1.52-2.73). The risk of unexpected pN2 increased with the risk factors cN1, the tumour centrally located or the tumour diameter >3 cm: from 4.5% (0 factors) to 18.8% (3 factors) but did not differ significantly as a function of whether invasive testing was performed. CONCLUSIONS: CT and PET together have a high negative predictive value. The overall success of the staging is lower in the case of tumours >3 cm and high mediastinal SUVmax, and it is higher when VATS is performed. The risk of unexpected pN2 is higher if the disease is cN1, the tumour centrally located or the tumour diameter >3 cm but does not vary significantly as a function of whether patients have undergone invasive testing.