The Impact of Service-Learning on the Prosocial and Professional Competencies in Undergraduate Physical Education Students and Its Effect on Fitness in Recipients.

Education is a key component of the student's transformation towards the creation of a more sustainable future. Among the methodological adaptations in teaching-learning processes, Service-Learning (SL) stands out as a meaningful academic experience to respond to social needs by developing committed citizens to transform society. The aim of the present study was to analyze the impact of this SL program on prosocial competence and satisfaction levels in university students, enhance physical fitness and analyze the reflections of the recipients. Moreover, the reflections on SL of the students and the migrants were analyzed. A mixed-methods design was performed. Forty-five students of Physical Activity and Sport Sciences provided a service to a migrant group that consisted of physical fitness training. The instruments implemented were the Prosocial and Civic Competence, the Impact of Service-Learning During Initial Training of Physical Activity and Sports and the reflective diary. The recipients participated in a physical fitness assessment and in a group discussion. The results show that SL in PAH contributes to pedagogical, communication, wellbeing and intercultural competences and also improves their prosocial and civic attitudes. Moreover, the recipients could enhance their physical fitness and their social interaction.

Clean H2 Production by Lignin-Assisted Electrolysis in a Polymer Electrolyte Membrane Flow Reactor.

Biomass-derived products, such as lignin, are interesting resources for energetic purposes. Lignin is a natural polymer that, when added to the anode of an alkaline exchange membrane water electrolyser, enhances H2 production rates and efficiencies due to the substitution of the oxygen evolution reaction. Higher efficiencies are reported when different catalytic materials are employed for constructing the lignin anolyte, demonstrating that lower catalytic loadings for the anode improves the H2 production when compared to higher loadings. Furthermore, when a potential of -1.8 V is applied, higher gains are obtained than when -2.3 V is applied. An increase of 200% of H2 flow rates with respect to water electrolysis is reported when commercial lignin is used coupled with Pt-Ru at 0.09 mg cm-2 and E = -1.8 V is applied at the cathode. This article provides deep information about the oxidation process, as well as an optimisation of the method of the lignin electro-oxidation in a flow-reactor as a pre-step for an industrial implementation.

A meta-analysis indicates that the regulation of cell motility is a non-intrinsic function of chemoattractant receptors that is governed independently of directional sensing.

Chemoattraction, defined as the migration of a cell toward a source of a chemical gradient, is controlled by chemoattractant receptors. Chemoattraction involves two basic activities, namely, directional sensing, a molecular mechanism that detects the direction of a source of chemoattractant, and actin-based motility, which allows the migration of a cell towards it. Current models assume first, that chemoattractant receptors govern both directional sensing and motility (most commonly inducing an increase in the migratory speed of the cells, i.e. chemokinesis), and, second, that the signaling pathways controlling both activities are intertwined. We performed a meta-analysis to reassess these two points. From this study emerge two main findings. First, although many chemoattractant receptors govern directional sensing, there are also receptors that do not regulate cell motility, suggesting that is the ability to control directional sensing, not motility, that best defines a chemoattractant receptor. Second, multiple experimental data suggest that receptor-controlled directional sensing and motility can be controlled independently. We hypothesize that this independence may be based on the existence of separated signalling modules that selectively govern directional sensing and motility in chemotactic cells. Together, the information gathered can be useful to update current models representing the signalling from chemoattractant receptors. The new models may facilitate the development of strategies for a more effective pharmacological modulation of chemoattractant receptor-controlled chemoattraction in health and disease.

Analysis of the implementation of an innovative IT solution to improve waiting times, communication with primary care and efficiency in Rheumatology.

OBJECTIVE: To describe in detail an innovative program based on telemedicine for semi-automated prioritization of referrals from Primary Care (PC) to Rheumatology, for reproducibility purposes, and to present the results of the implementation study. METHODS: The context and situation were carefully analyzed, paying attention to all processes in place, referral numbers, waiting times, and number of complementary tests prior to discharge from Rheumatology. The composition of the team, aims, users, scope, and implementation phases were defined. Eight process indicators were established and measured before and 32 months after the program implementation. RESULTS: The program, which includes IT circuits, algorithms based on response to specific guideline-based checklists, e-consultation, and appointments based on priority, was fully implemented in our health area after a pilot study in two PC centers. After implementation, 6185 rheumatology referrals showed an e-consultation response delay of 8.95 days, and to first face-to-face visit (after e-consultation) of 12.6 (previous delay before program implementation was 83.1 days). Resolution by e-consultation reached 20% (1195 patients did not need seeing the rheumatologist to have the problem solved), and 1369 patients (32%) were discharged after the first visit. The overall resolution rate was 44.0% (2564 discharges/5830 e-consultations). From a random sample of 100 visits, only 10% of patients needed additional complementary tests to make a diagnosis and decision by Rheumatology (20.9% decrease from previous period). CONCLUSION: A careful analysis of the situation and processes, with implementation of simple IT circuits, allows for the improvement of the efficiency and resolution of problems in Rheumatology.

Bullying e habilidades sociais de estudantes em transição escolar / Bullying and social skills of students in school transition / Bullying y habilidades sociales de estudiantes en transición escolar

Nos períodos de transição escolar ocorre mais bullying. Um dos fatores associados pode ser a existência de déficits nas habilidades sociais dos estudantes. Assim, o objetivo deste estudo foi verificar possíveis diferenças nas habilidades sociais de estudantes envolvidos e não envolvidos em situações de bullying no período de transição escolar. Participaram 408 estudantes do sexto ano do Ensino Fundamental, com média de idade de 11,3 anos (DP = 0,62). Os dados foram coletados mediante uma escala e um questionário, e avaliados estatisticamente por análises de variância (ANOVA). As vítimas-agressoras apresentaram as menores médias nas habilidades sociais e diferenciaram-se significativamente das vítimas, agressores e não envolvidos no bullying em relação às habilidades de empatia/civilidade, autocontrole e participação. Já os estudantes não envolvidos apresentaram as maiores médias nas habilidades sociais. Conclui-se que a melhoria das habilidades sociais dos estudantes em transição escolar pode ajudar a prevenir e/ou reduzir o bullying (AU).

Bullying tends to occur more often during periods of school transition. One of the associate factors may be a deficit in students' social skills. Thus, this study's objective was to verify potential differences between the social skills of students involved and not involved in bullying during school transition. A total of 408 sixth-grade students, with a mean age of 11.3 years old (SD = 0.62), participated in this study. Data were collected using a scale and a questionnaire and statistically analyzed by Analysis of Variance (ANOVA). Victim-offenders had the lowest mean scores in social skills and differed significantly from victims, bullies, and those not involved in bullying concerning empathy/civility, self-control, and participation skills. On the other hand, students not involved in bullying showed the highest mean scores in social skills. We concluded that improving the students' social skills in school transition might help prevent and/or reduce bullying (AU).

Em los períodos de transición escolar se produce más bullying. Uno de los factores asociados puede ser la existencia de déficits em las habilidades sociales de los estudiantes. Por lo tanto, el objetivo de este estudio fue verificar las posibles diferencias em las habilidades sociales de los estudiantes involucrados y no involucrados em situaciones de bullying em el período de transición escolar. Participaron 408 estudiantes del sexto año de la Educación Primaria, em em media de edad de 11,3 años (DS = 0,62). Los datos se recogieron mediante em escala y em cuestionario, y se analizaron por análisis de varianza (ANOVA). Las víctimas-agresoras presentaron las puntuaciones medias más bajas em las habilidades sociales y se diferenciaron significativamente de las víctimas, agresores y no involucrados em el bullying em relación a las habilidades de empatía/civilidad, autocontrol y participación. Por em lado, los estudiantes no involucrados mostraron las medias más altas em habilidades sociales. Se concluye que la mejora de las habilidades sociales de los estudiantes durante la transición escolar puede ayudar a prevenir y/o reducir el bullying (AU).

Macrosomía fetal y factores de riesgo asociados en la provincia Camagüey

Introducción: La macrosomía fetal, de manera tradicional, ha sido definida por un peso arbitrario al nacer; la misma, ya sea definida por un límite de peso o grande para la edad gestacional, se asocia con numerosas complicaciones perinatales y maternas. Objetivo: Describir los factores de riesgo asociados a la macrosomía fetal en los partos del Hospital Universitario Ginecobstétrico Provincial Ana Betancourt de Mora durante el año 2019. Métodos: Se realizó un estudio observacional descriptivo de corte transversal. El universo quedó constituido por la totalidad de gestantes que tuvieron recién nacidos con peso al nacimiento mayor o igual a 4 000 gramos, el cual ascendió a 526 gestantes. Se utilizó estadística descriptiva. Se calculó media y desviación estándar a las variables cuantitativas. Resultados: Las gestantes estudiadas tenían una media de edad de 27,86 años y un IMC a la captación como promedio de 26,77 con un valor medio de ganancia de peso de 13,68 Kg. Entre los 26 y 35 años hubo 290 gestantes con recién nacidos macrosómicos, respecto a la paridad las que paren sin experiencia de este reunió a 222 grávidas. En las embarazadas catalogadas de sobrepeso con ganancia de 10 a 15 kg se reúnen 104 de los recién nacidos macrosómicos. Respecto al tipo de parto la cesárea representó el 61,4 %. Se observó en 40 gestantes la presencia de diabetes gestacional o pregestacional y preeclampsia respectivamente. Conclusiones: La ganancia excesiva de peso en gestantes con evaluación nutricional de sobrepeso u obesas tuvo la mayor incidencia en la génesis de la macrosomía en los recién nacidos.

Introduction: Fetal macrosomia has traditionally been defined by an arbitrary birth weight. Fetal macrosomia, whether defined by borderline weight or large for gestational age, is associated with numerous perinatal and maternal complications. Objective: To describe the risk factors associated with fetal macrosomia in deliveries at Ana Betancourt de Mora Provincial Gyneco-Obstetric University Hospital during 2019. Methods: A cross-sectional descriptive observational study was carried out. The study universe was made up of all pregnant women who had newborns with a birth weight greater than or equal to 4 000 grams, which amounted to 526 pregnant women. Descriptive statistics were used. Average and standard deviation were calculated for the quantitative variables. Results: The studied pregnant women had an average age of 27.86 years and an average BMI at uptake of 26.77 with an average value of weight gain of 13.68 Kg. Between 26 and 35 years there were 290 pregnant women with newborn macrosomic births, with respect to parity those who give birth without experience of this brought together 222 gravid women. In pregnant women classified as overweight with a gain of 10 to 15 kg, 104 of the macrosomic newborns are gathered. Regarding the type of delivery, cesarean section represented 61.4%. The presence of gestational or pregestational diabetes and preeclampsia, respectively, was observed in 40 pregnant women. Conclusions: The excessive weight gain in pregnant women with nutritional evaluation of overweight or obese were those that had the highest incidence in the genesis of macrosomia in newborns.

The Actin Cytoskeleton at the Immunological Synapse of Dendritic Cells.

Dendritic cells (DCs) are considered the most potent antigen-presenting cells. DCs control the activation of T cells (TCs) in the lymph nodes. This process involves forming a specialized superstructure at the DC-TC contact zone called the immunological synapse (IS). For the sake of clarity, we call IS(DC) and IS(TC) the DC and TC sides of the IS, respectively. The IS(DC) and IS(TC) seem to organize as multicentric signaling hubs consisting of surface proteins, including adhesion and costimulatory molecules, associated with cytoplasmic components, which comprise cytoskeletal proteins and signaling molecules. Most of the studies on the IS have focused on the IS(TC), and the information on the IS(DC) is still sparse. However, the data available suggest that both IS sides are involved in the control of TC activation. The IS(DC) may govern activities of DCs that confer them the ability to activate the TCs. One key component of the IS(DC) is the actin cytoskeleton. Herein, we discuss experimental data that support the concept that actin polarized at the IS(DC) is essential to maintaining IS stability necessary to induce TC activation.

WLTC and real-driving emissions for an autochthonous biofuel from wine-industry waste.

Residues from the wine industry constitute an abundant feedstock for biodiesel production in wine-producing countries. The use of grapeseed oil, together with bioethanol obtained from distillation of wine surplus or grape skins and stalks and wine lees, as reagents in the transesterification reaction, results in a mixture of fatty acid ethyl esters (FAEE), which is a fully renewable, autochthonous, and waste-derived biofuel. In this work, a blend of FAEE produced from grape seed oil with diesel fuel was selected based on a study of fuel properties, and the optimal blend, with 30% v/v of FAEE, was tested in a Euro 6 engine following the Worldwide harmonized Light-duty Test Cycle (WLTC) and a Real Driving Emissions Cycle (RDE), as required in the new certification procedures. Engine performance and emissions from this blend and a commercial diesel fuel were compared. The FAEE blend showed a significant potential to reduce particle emissions, both in mass and number (from 23% in number to 46.5% in mass for WLTC, and from 56% in number to 61% in mass for RDE), and CO (25.5% for WLTC and 39% for RDE) but penalized NOx (32% higher in WLTC and 26.4% higher in RDE).

Intra-Rater (Live vs. Video Assessment) and Inter-Rater (Expert vs. Novice) Reliability of the Test of Gross Motor Development-Third Edition.

The Test of Gross Motor Development (TGMD) is one of the most common tools for assessing the fundamental movement skills (FMS) in children between 3 and 10 years. This study aimed to examine the intra-rater and inter-rater reliability of the TGMD-3rd Edition (TGMD-3) between expert and novice raters using live and video assessment. Five raters [2 experts and 3 novices (one of them BSc in Physical Education and Sport Science)] assessed and scored the performance of the TGMD-3 of 25 healthy children [Female: 60%; mean (standard deviation) age 9.16 (1.31)]. Schoolchildren were attending at one public elementary school during the academic year 2019-2020 from Santiago de Compostela (Spain). Raters scored each children performance through two viewing moods (live and slow-motion). The ICC (Intraclass Correlation Coefficient) was used to determine the agreement between raters. Our results showed moderate-to-excellent intra-rater reliability for overall score and locomotor and ball skills subscales; moderate-to-good inter-rater reliability for overall and ball skills; and poor-to-good for locomotor subscale. Higher intra-rater reliability was achieved by the expert raters and novice rater with physical education background compared to novice raters. However, the inter-rater reliability was more variable in all the raters regardless of their experience or background. No significant differences in reliability were found when comparing live and video assessments. For clinical practice, it would be recommended that raters reach an agreement before the assessment to avoid subjective interpretations that might distort the results.

Relative Age Effect on Motor Competence in Children Aged 4-5 Years.

The purpose of this study was to evaluate whether a Relative Age Effect (RAE) exists in motor competence of preschool children. The hypothesis was that motor competence, assessed by the Movement Assessment Battery for Children-2 (MABC-2), would be higher in preschool children born in the first quarter of the year compared to those who were born in the last quarter of the same year. A total of 360 preschool children were evaluated of whom 208 (57.8%) were boys and 152 (42.8%) were girls, with a mean age of 4.52 years old (± 0.50). The distribution of the participants was 172 children aged 4 years old and 188 aged 5 years old. The data showed a main effect on the age factor in the total score of aiming and catching (p < 0.001) and in the total test score (p < 0.001), in the quarter of birth factor in all the dimensions studied (i.e., total score of manual dexterity (p < 0.001); total score of aiming and catching (p = 0.001); total score of balance (p < 0.001); total test score (p < 0.001)) and in the interaction between both factors (i.e., total score of manual dexterity (p = 0.005); total score of aiming and catching (p = 0.002); total score of balance (p < 0.001); total test score (p < 0.001)). Age and quarter of birth produce a RAE in 4 and 5-year-old preschool children's motor competence.

Economic evaluation of complete revascularization versus stress echocardiography-guided revascularization in the STEACS with multivessel disease.

INTRODUCTION AND OBJECTIVES: Economic studies may help decision making in the management of multivessel disease in the setting of myocardial infarction. We sought to perform an economic evaluation of CROSS-AMI (Complete Revascularization or Stress Echocardiography in Patients With Multivessel Disease and ST-Segment Elevation Acute Myocardial Infarction) randomized clinical trial. METHODS: We performed a cost minimization analysis for the strategies (complete angiographic revascularization [ComR] and selective stress echocardiography-guided revascularization [SelR]) compared in the CROSS-AMI clinical trial (N=306), attributable the initial hospitalization and readmissions during the first year of follow-up, using current rates for health services provided by our health system. RESULTS: The index hospitalization costs were higher in the ComR group than in SelR arm (19 657.9±6236.8 € vs 14 038.7±4958.5 €; P <.001). There were no differences in the costs of the first year of follow-up rehospitalizations between both groups for (ComR 2423.5±4568.0 vs SelR 2653.9±5709.1; P=.697). Total cost was 22 081.3±7505.6 for the ComR arm and 16 692.6±7669.9 for the SelR group (P <.001). CONCLUSIONS: In the CROSS-AMI trial, the initial extra economic costs of the ComR versus SelR were not offset by significant savings during follow-up. SelR seems to be more efficient than ComR in patients with ST-segment elevation acute coronary syndrome and multivessel disease treated by emergent angioplasty. Study registred at ClinicalTrial.gov (Identifier: NCT01179126).

The Chemokine Receptor CCR7 Uses Distinct Signaling Modules With Biased Functionality to Regulate Dendritic Cells.

Chemotaxis is a molecular mechanism that confers leukocytes the ability to detect gradients of chemoattractants. Chemokine receptors are well-known regulators of chemotaxis in leukocytes; however, they can regulate several other activities in these cells. This information has been often neglected, probably due to the paramount role of chemotaxis in the immune system and in biology. Therefore, the experimental data available on the mechanisms used by chemokine receptors to regulate other functions of leukocytes is sparse. The results obtained in the study of the chemokine receptor CCR7 in dendritic cells (DCs) provide interesting information on this issue. CCR7 guides the DCs from the peripheral tissues to the lymph nodes, where these cells control T cell activation. CCR7 can regulate DC chemotaxis, survival, migratory speed, cytoarchitecture, and endocytosis. Biochemical and functional analyses show: first, that CCR7 uses in DCs the PI3K/Akt pathway to control survival, the MAPK pathway to control chemotaxis, and the RhoA pathways to regulate actin dynamics, which in turn controls migratory speed, cytoarchitecture, and endocytosis; second, that these three signaling pathways behave as modules with a high degree of independence; and third, that although each one of these routes can regulate several functions in different settings, CCR7 promotes in DCs a functional bias in each pathway. The data uncover an interesting mechanism used by CCR7 to regulate the DCs, entailing multifunctional signaling pathways organized in modules with biased functionality. A similar mechanism could be used by other chemoattractant receptors to regulate the functions of leukocytes.

Physical Activity Habits and Determinants, Sedentary Behaviour and Lifestyle in University Students.

University students, as a result of their lifestyles, represent a section of the population that is most likely to adopt sedentary behaviours. The aim of the present study was to analyse the determining factors dictating the performance of physical activity as well as sedentary behaviour among university students. A total of 608 students (64.6% women) from the University of Santiago de Compostela (Spain) were selected by stratified random sampling to take part in the study, which involved completing a questionnaire on lifestyle and physical activity. Of the participating students, 69.6% indicated that they performed physical activity; the main reasons given were to maintain fitness and for health, while a lack of time and laziness were the principal reasons given for abandoning or not taking up physical exercise. Significant associations were established between not doing physical activity and the time exposed to screens, time studying, feeling low and smoking; on the other hand, associations could be seen between doing physical activity and the participation of relatives (parents, mothers, partners, older siblings and friends) in physical activity, as well as a positive sense of satisfaction relating to physical education taught in schools. In conclusion, most of the university students did some physical activity, which was associated with less sedentary behaviour, while the influence of school physical education and of the habits of relatives played an important role.

Risk, Diagnostic and Predictor Factors for Classical Hodgkin Lymphoma in HIV-1-Infected Individuals: Role of Plasma Exosome-Derived miR-20a and miR-21.

The incidence of classical Hodgkin lymphoma (cHL) in the HIV-1 setting has increased 5-25-fold compared to that observed in the general population. This study aimed to determine whether selected micro RNAs (miRs) and other soluble biomarkers and cellular subsets are dysregulated in cHL and could be used as biomarkers. This was a retrospective and longitudinal matched case-control study of 111 Caucasian, HIV-1-infected adult individuals, including 37 individuals with cHL and 74 with no type of cancer. Immunovirological data, plasma exosome-derived miR-16, miR-20a, miR-21, miR-221, miR-223, miR-106a, miR-185, miR-23, miR-30d, miR-222, miR-146a and miR-324, plasma IL-6, sCD14, sCD27, sCD30, sIL-2R, TNFR1, and cell phenotyping of T and B lymphocytes and natural killer (NK) cells were analyzed. Before cHL diagnosis, miR-20a, miR-21, and sCD30 were higher in cHL (p = 0.008, p = 0.009 and p = 0.042, respectively), while miR-16 was down-regulated (p = 0.040). miR-20a and miR-21 were independently associated with cHL (p = 0.049 and p = 0.035, respectively). The combination of miR-20a and miR-21 showed a good AUC value of 0.832 with a moderate likelihood ratio positive (LR+) value of 5.6 and a slight likelihood ratio negative (LR-) value of 0.23. At cHL diagnosis, miR-20a, miR-21 and miR-324 were overexpressed in cHL (p = 0.005, p = 0.024, and p = 0.001, respectively), while miR-223, miR-16, miR-185 and miR-106a were down regulated (p = 0.042, p = 0.007, p = 0.006, and p = 0.002, respectively). In addition, sCD14, sCD27, sCD30 and IL2R levels were higher in these individuals (p = 0.038, p = 0.010, p = 0.030, p = 0.006, respectively). miR-20a was independently associated with cHL (p = 0.011). The diagnostic value of miR-20a showed good AUC value of 0.754 (p = 0.074) with a slight LR+ value of 2 and a slight LR- of 0.25. After chemotherapy, miR-20a was higher in those individuals who had an adverse outcome (p < 0.001), while sCD14 and sCD30 were higher (p < 0.001). A specific signature of miRs and cytokines associated with a subsequent cHL diagnosis was found in this study, especially miR-20a and miR-21. Also, another biomarker signature was found at cHL diagnosis, with a relevant discriminant disease value for miR-20a. Of note, miR-20a expression was higher in those individuals who had an adverse clinical outcome after chemotherapy.

The Game of Skittles on the Northern Route of the Camino de Santiago.

The main purpose of this study was to analyze the presence and current situation of the game of skittles throughout the northern route of the Camino de Santiago. Thus, we considered its current practice, modalities, where it is played, and its different manifestations as an informal and formal game (sport), comparing it with other traditional games on this pilgrimage route. To do this, a mixed qualitative-quantitative study was designed with 89 participants (municipal professionals, politicians, players, club managers, and teachers), constituting an informant for each municipality through which the Northern Way passes. An ad hoc questionnaire was used for the data collection, which was processed through content analysis by expert judges (qualitative section) and by using the IBM-SPSS statistical package (version 25). The results of the study show notable skittles activity on the Northern Camino (58.32% of the municipalities), reflected in the number of skittles alleys (n = 291), the number of clubs, associations, and peñas participating in federated leagues (n = 162), and the wide range of varieties of skittles currently active on the Camino (n = 20). The relationship between skittles and local culture, both symbols of identity in these northern Spanish regions, made it possible to preserve the traditional heritage in these places, keeping it alive today, despite the push toward new and more attractive leisure and sport trends.

Fully endoscopic transoral resection of high cervical osteophyte. How I do it?

BACKGROUND: Fully endoscopic transoral approaches (FETOA) constitute a reasonable option for the treatment of middling compressive pathology that involve the craniocervical junction and higher cervical levels. METHODS: We describe, step by step, the FETOA for the treatment of upper cervical lesions. More specifically, the ones that are located between C1 and C3. A giant anterior C1-C2 osteophyte resection will be used as an illustration of these approaches. CONCLUSIONS: This technique represents a minimally invasive treatment option for these kinds of high cervical lesions. It offers optimal visualization, maximizing the resection of these lesions and decreasing the morbidity and mortality.

Angiographically Guided Complete Revascularization Versus Selective Stress Echocardiography-Guided Revascularization in Patients With ST-Segment-Elevation Myocardial Infarction and Multivessel Disease: The CROSS-AMI Randomized Clinical Trial.

BACKGROUND: Recent trials suggest that complete revascularization in patients with acute ST-segment-elevation myocardial infarction and multivessel disease is associated with better outcomes than infarct-related artery (IRA)-only revascularization. There are different methods to select non-IRA lesions for revascularization procedures. We assessed the clinical outcomes of complete angiographically guided revascularization versus stress echocardiography-guided revascularization in patients with ST-segment-elevation myocardial infarction. METHODS: We performed a randomized clinical trial in patients with multivessel disease who underwent a successful percutaneous coronary intervention of the IRA to test differences in prognosis (composite end point included cardiovascular mortality, nonfatal reinfarction, coronary revascularization, and readmission for heart failure after 12 months of follow-up) between complete angiographically guided revascularization (n=154) or stress echocardiography-guided revascularization (n=152) of the non-IRA lesions in an elective procedure before hospital discharge. RESULTS: The trial was prematurely stopped after the inclusion of 77% of the planned study population. As many as 152 (99%) patients in the complete revascularization group and 44 (29%) patients in the selective revascularization group required a percutaneous coronary intervention procedure of a non-IRA lesion before discharge. The primary end point occurred in 21 (14%) patients of the stress echocardiography-guided revascularization group and 22 (14%) patients of the complete angiographically guided revascularization group (hazard ratio, 0.95; 95% CI, 0.52-1.72; P=0.85). CONCLUSIONS: In patients with ST-segment-elevation myocardial infarction and multivessel disease, stress echocardiography-guided revascularization may not be significantly different to complete angiographically guided revascularization, thereby reducing the need for elective revascularization before hospital discharge. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01179126.

Immunological Synapse Formation Induces Mitochondrial Clustering and Mitophagy in Dendritic Cells.

The immunological synapse (IS) is a superstructure formed during T cell activation at the zone of contact between T cells and dendritic cells (DCs). The IS includes specific molecular components in the T cell and DCs sides that may result in different functionality. Most of the studies on the IS have focused on the T cell side of this structure and, in contrast, the information available on the IS of DCs is sparse. Autophagy is a cellular process involved in the clearance of damaged proteins and organelles via lysosomal degradation. Mitophagy is the selective autophagy of damaged mitochondria. In this study, it is shown that IS formation induces clustering of mitochondria in the IS of DCs and partial depolarization of these organelles. At the IS of the DCs also accumulate autophagy and mitophagy markers, even when the kinase complex mTORC1, an inhibitor of the autophagy, is active. Together the results presented indicate that IS formation induces local clustering of mitochondria and mitophagy, which could be a homeostatic mechanism to control the quality of mitochondria in this region. The data underline the complexity of the regulatory mechanisms operating in the IS of DCs.