Microbial signature profiles of Penaeus vannamei larvae in low-survival hatchery tanks affected by vibriosis.

Vibriosis is caused by some pathogenic Vibrio and produces significant mortality in Pacific white shrimp Penaeus (Litopenaeus) vannamei larvae in commercial hatcheries. Acute hepatopancreatic necrosis disease (AHPND) is an emerging vibriosis affecting shrimp-producing countries worldwide. Zoea 2 syndrome is another type of vibriosis that affects the early stages of P. vannamei larvae. Although the pathogenesis of AHPND and zoea 2 syndrome is well known, there is scarce information about microbial composition and biomarkers of P.vannamei larvae affected by AHPND, and there is no study of the microbiome of larvae affected by zoea 2 syndrome. In this work, we characterized the microbiome of P. vannamei larvae collected from 12 commercial hatchery tanks by high-throughput sequencing. Seven tanks were affected by AHPND, and five tanks were affected by zoea 2 syndrome. Subsequently, all samples were selected for sequencing of the V3-V4 region of the16S rRNA gene. Similarity analysis using the beta diversity index revealed significant differences in the larval bacterial communities between disease conditions, particularly when Vibrio was analyzed. Linear discriminant analysis with effect size determined specific microbial signatures for AHPND and zoea 2 syndrome. Sneathiella, Cyclobacterium, Haliea, Lewinella, among other genera, were abundant in AHPND-affected larvae. Meanwhile, Vibrio, Spongiimonas, Meridianimaribacter, Tenacibaculum, among other genera, were significantly abundant in larvae affected by zoea 2 syndrome. The bacterial network at the phylum level for larvae collected from tanks affected by AHPND showed greater complexity and connectivity than in samples collected from tanks affected by zoea 2 syndrome. The bacterial connections inter Vibrio genera were higher in larvae from tanks affected by zoea 2 syndrome, also presenting other connections between the genera Vibrio and Catenococcus. The identification of specific biomarkers found in this study could be useful for understanding the microbial dynamics during different types of vibriosis.

Safety and Efficacy of Traditional Heart Failure Therapies in Patients With Cardiac Amyloidosis and Heart Failure.

Randomized controlled trials have demonstrated mortality benefits for several medication classes in patients with heart failure (HF), especially with reduced ejection fraction (EF). However, the benefit of these traditional HF therapies in patients with HF from cardiac amyloidosis is unclear. our study aimed to evaluate the safety and efficacy of traditional HF therapies in patients with cardiac amyloidosis and HF with reduced EF or HF with mid-range EF (HFmrEF). We conducted a single-center retrospective study. Patients were included if they were diagnosed with cardiac amyloidosis and HF with reduced EF or HF with mid-range EF between January 2012 and 2022. The primary outcomes of interest were medication use patterns (for ß blockers [BB], angiotensin-converting enzyme inhibitors [ACEI], angiotensin receptor blockers [ARBs], angiotensin receptor neprilysin inhibitors [ARNI], and mineralocorticoid receptor antagonists [MRAs]); potential medication side effects (symptomatic bradycardia, fatigue, hypotension, lightheadedness, and syncope); hospitalization; and death. The associations of BB, ACEI/ARB/ARNI, and MRA use with clinical outcomes were evaluated using Kaplan-Meier and Cox proportional hazards regression. A total of 82 patients met study criteria. At time of cardiac amyloidosis diagnosis, 63.4% were on a BB, 51.2% were on an ACEI/ARB/ARNI, and 43.9% were on an MRA. At last follow-up, 51.2% were on a BB, 35.4% were on an ACEI/ARB/ARNI, and 43.9% were on an MRA. There were no statistically significant differences in rates of potential medication side effects in patients on the medication class compared with those who were not. There was no association with hospitalization or mortality for baseline or follow-up BB, ACEI/ARB/ARNI, or MRA use. In conclusion, BBs, ACEI/ARB/ARNIs, and MRAs may be safely used in this population. However, their use does not appear to improve mortality or hospitalization.

Efecto cicatrizante en incisiones periodontales por extracto hidroalcohólico de Morinda citrifolia / Healing effect on periodontal incisions by hydroalcoholic extract of Morinda citrifolia / Efeito cicatrizante do extrato hidroalcoólico de Morinda citrifolia em incisões periodontais

Los tratamientos periodontales implican cortes y sangrado de la mucosa gingival; la Morinda citrifolia, específicamente sobre los fragmentos encargados de la cicatrización (plaquetas), tiene un efecto más significativo en los procesos curativos de las lesiones. Objetivo. Identificar el potencial cicatrizante de los extractos hidroalcohólicos de Morinda citrifolia (noni peruano) en los procesos regenerativos de las incisiones periodontales al 70% a diversas concentraciones (1%; 5; y 10%) y su efecto coadyuvante acelerador en la vía oral como curación de tejidos. Materiales y Métodos. Se realizó una investigación aplicada, bajo el diseño experimental. Para ello, se llevó a cabo un estudio previo para el análisis farmacognóstico, porcentaje de humedad, pruebas de solubilidad y el análisis fitoquímico cualitativo para garantizar que el análisis farmacológico y la prueba experimental se completaran adecuadamente. Se administraron dosis a cinco ratas albinas macho Holtzman divididas en cuatro grupos a los cuales se les aplicó las concentraciones en cantidades de 0,5 ml dos veces al día en la incisión, la cual se evaluó durante siete días para obtener parámetros específicos, como infección, tono de piel gingival, cierre de heridas, reducción del tamaño de la incisión y porcentaje de curación. Resultados. Indicaron que todos los grupos que se le suministró el extracto hidroalcohólico al 70% en varias concentraciones mejoró su actividad curativa al reducir el tamaño de la incisión en la encía al séptimo día, donde resultó que la mejor concentración fue del 5% en comparación con las otras concentraciones (1% y 10%). Investigación que indica la eficacia de la Morinda citrifolia peruana como acelerador del proceso de curación en la terapia periodontal.

Periodontal treatments involve cuts and bleeding of the gingival mucosa; Morinda citrifolia, specifically on the fragments in charge of healing (platelets), has a more significant effect on the healing processes of the lesions. Objective. To identify the healing potential of hydroalcoholic extracts of Morinda citrifolia (Peruvian noni) in the regenerative processes of periodontal incisions at 70% at various concentrations (1%; 5; and 10%) and its accelerating coadjuvant effect in the oral route as tissue healing. Materials and Methods. An applied research was carried out under an experimental design. For this purpose, a previous study was carried out for pharmacognostic analysis, moisture percentage, solubility tests and qualitative phytochemical analysis to ensure that the pharmacological analysis and experimental test were properly completed. Doses were administered to five male Holtzman albino rats divided into four groups to which the concentrations were applied in 0.5 ml amounts twice daily to the incision, which was evaluated for seven days for specific parameters, such as infection, gingival skin tone, wound closure, incision size reduction and percentage healing. Results. They indicated that all groups that were given the 70% hydroalcoholic extract in various concentrations improved their healing activity by reducing the size of the gingival incision on the seventh day, where it turned out that the best concentration was 5% compared to the other concentrations (1% and 10%). Conclusion. Research indicating the efficacy of Peruvian Morinda citrifolia as an accelerator of the healing process in periodontal therapy.

Os tratamentos periodontais envolvem corte e sangramento da mucosa gengival; a Morinda citrifolia, especificamente sobre os fragmentos responsáveis pela cicatrização (plaquetas), tem um efeito mais significativo nos processos de cicatrização das lesões. Objetivo. Identificar o potencial cicatrizante de extratos hidroalcoólicos de Morinda citrifolia (noni peruano) nos processos regenerativos de incisões periodontais a 70% em diversas concentrações (1%; 5; e 10%) e seu efeito coadjuvante acelerador na via oral como cicatrizante tecidual. Materiais e métodos. Foi realizada uma pesquisa aplicada sob um desenho experimental. Para esse fim, foi realizado um pré-estudo para análise farmacognóstica, porcentagem de umidade, testes de solubilidade e análise fitoquímica qualitativa para garantir que a análise farmacológica e o teste experimental fossem adequadamente concluídos. Cinco ratos albinos Holtzman machos divididos em quatro grupos foram dosados e as concentrações foram aplicadas em quantidades de 0,5 ml duas vezes ao dia na incisão, que foi avaliada por sete dias quanto a parâmetros específicos, como infecção, tônus gengivais da pele, fechamento da ferida, redução do tamanho da incisão e porcentagem de cicatrização. Resultados. Eles indicaram que todos os grupos que receberam extrato hidroalcoólico a 70% em várias concentrações melhoraram sua atividade de cicatrização ao reduzir o tamanho da incisão gengival no sétimo dia, sendo que a melhor concentração foi de 5% em comparação com as outras concentrações (1% e 10%). Conclusão. A pesquisa indica a eficácia da Morinda citrifolia peruana como um acelerador do processo de cicatrização na terapia periodontal.

Aortic Dissection From an Intra-aortic Balloon Pump: A Dangerous Complication to Keep in Mind.

Despite the benefits of the intra-aortic balloon pump (IABP) being a subject of debate, it remains a widely available and easy-to-use mechanical circulatory support device. Nonetheless, its use is not exempt from complications. Aortic dissection from IABP is an infrequent but deathly complication. We describe a case in which early recognition of the condition led to control through an endovascular approach. A 57-year-old male was admitted for acute decompensated heart failure requiring intravenous inotropic agents. While undergoing assessment for a heart transplant, he developed cardiogenic shock requiring initiation of mechanical circulatory support with an IABP. A few hours after device implantation, the patient developed acute tearing chest pain and was found to have an acute dissection in the descending thoracic aorta. Prompt liaison with the endovascular team led to a thoracic endovascular aortic repair to control the extent of the lesion.

Síndrome de Tolosa-Hunt una extraña causa de oftalmoplejía dolorosa: reporte de caso / Tolosa-Hunt syndrome a strange cause of painful ophthalmoplegia: case report

RESUMEN INTRODUCCIÓN: El síndrome de Tolosa-Hunt (STH) se caracteriza por una oftalmoplejía dolorosa, de etiología desconocida. De acuerdo con los hallazgos histopatológicos, se ha descrito la formación de un tejido granulomatoso en los senos cavernosos. PRESENTACIÓN DEL CASO: Una mujer de 22 años con cuadro clínico de 3 semanas de evolución caracterizado por cefalea hemicránea derecha, dolor ocular derecho y diplopía. Su examen físico evidenció la existencia de una oftalmoplejía derecha; la resonancia magnética (RM) de silla turca demostró engrosamiento y realce en la región del seno cavernoso derecho. Se presenta el caso clínico de una causa inusual de oftalmoplejía dolorosa. DISCUSIÓN: La oftalmoplejía dolorosa tiene múltiples diagnósticos diferenciales que incluyen causas neoplá-sicas, vasculares, inflamatorias e infecciosas que pueden afectar el seno cavernoso o la fisura orbitaria superior. El STH, que es una causa rara de oftalmoplejía dolorosa, sigue siendo un diagnóstico de exclusión. Por otra parte, se caracteriza por tener una adecuada respuesta al tratamiento con glucocorticoides. CONCLUSIÓN: La negatividad en las investigaciones de las etiologías de oftalmoplejía, los hallazgos imagenológicos en la RM y la adecuada respuesta cínica con el uso de los corticoides permiten confirmar el diagnóstico. No debería ser necesaria la biopsia del seno cavernoso ante la sospecha de STH con adecuada respuesta al manejo corticoide.

ABSTRACT INTRODUCTION: Tolosa-Hunt syndrome (THS) is characterized by painful ophthalmoplegia of unknown etiology, the formation of a granulomatous tissue in the cavernous sinuses has been described in histopatho-logical findings. CASE PRESENTATION: A 22-year-old woman presenting with 3 weeks of right sided headache, right eye pain and diplopia. Physical examination revealed the existence of a right ophthalmoplegia; magnetic resonance imaging (MRI) of the sella turcica showed thickening and enhancement of the right cavernous sinus. A clinical case of an unusual cause of painful ophthalmoplegia is presented. DISCUSSION: Painful ophthalmoplegia has multiple differential diagnoses that include neoplastic, vascular, inflammatory and infectious causes that can affect the cavernous sinus or the superior orbital fissure. STH is a rare case of painful ophthalmoplegia that continues to be a diagnosis of exclusion characterized by an adequate response to treatment with glucocorticoids. CONCLUSION: The negativity of the investigations for the causes of ophthalmoplegia, the imaging findings in the MRI and the adequate response to corticosteroids allows the diagnosis to be made. Biopsy should not be necessary when THS is suspected and there is an adequate response to corticosteroid management.

Clinical utility of automatic phenotype annotation in unstructured clinical notes: intensive care unit use.

OBJECTIVE: Clinical notes contain information that has not been documented elsewhere, including responses to treatment and clinical findings, which are crucial for predicting key outcomes in patients in acute care. In this study, we propose the automatic annotation of phenotypes from clinical notes as a method to capture essential information to predict outcomes in the intensive care unit (ICU). This information is complementary to typically used vital signs and laboratory test results. METHODS: In this study, we developed a novel phenotype annotation model to extract the phenotypical features of patients, which were then used as input features of predictive models to predict ICU patient outcomes. We demonstrated and validated this approach by conducting experiments on three ICU prediction tasks, including in-hospital mortality, physiological decompensation and length of stay (LOS) for over 24 000 patients using the Medical Information Mart for Intensive Care (MIMIC-III) dataset. RESULTS: The predictive models incorporating phenotypical information achieved 0.845 (area under the curve-receiver operating characteristic (AUC-ROC)) for in-hospital mortality, 0.839 (AUC-ROC) for physiological decompensation and 0.430 (kappa) for LOS, all of which consistently outperformed the baseline models using only vital signs and laboratory test results. Moreover, we conducted a thorough interpretability study showing that phenotypes provide valuable insights at both the patient and cohort levels. CONCLUSION: The proposed approach demonstrates that phenotypical information complements traditionally used vital signs and laboratory test results and significantly improves the accuracy of outcome prediction in the ICU.

Hereditary Transthyretin Amyloidosis Cardiomyopathy: The South Florida Experience.

Numerous studies have examined distinct populations with hereditary transthyretin amyloidosis (hATTR); however, to the best of our knowledge, no studies have focused on the hATTR population of South Florida, a region characterized by its diverse population, with a prominent Black, Afro-Caribbean, and Hispanic presence. We performed a retrospective observational study of patients diagnosed with hATTR cardiomyopathy from 2010 to 2020 at the University of Miami Hospital located in Miami, Florida. Patients with either a positive endomyocardial biopsy or Technetium-99m Pyrophosphate scan were selected and classified into hATTR or wild-type ATTR (ATTRwt), based on genetic testing results. A subsequent electronic medical record review was performed, and baseline characteristics were obtained for both groups. A total of 144 patients were identified to have ATTR and were included in this study. Of these patients, 36% had hATTR (n = 52), and 64% had ATTRwt (n = 92). Baseline age, gender, and race characteristics in the hATTR and ATTRwt groups were consistent with previous observational studies. When comparing our findings with preliminary data from the Transthyretin Amyloidosis Outcome Survey reported in 2016, we observed a higher proportion of Val122Ile (75% vs 44% of all hATTR cases), a lower proportion of hATTR cases (36% vs 52%), and a higher proportion of ATTRwt (64% vs 48%). Preliminary data from the Transthyretin Amyloidosis Outcome Survey did not report specific data about Hispanic patients with hATTR, with only 7% of all cases reported being from non-Caucasian and non-Black patients. Hispanic patients represented 25% of all hATTR cases within our population, with 69% of them being positive for the Val122Ile allele. In conclusion, the large presence of Black and Afro-Caribbean subjects within the South Florida region, in combination with its prominent Hispanic population and the high proportion of adults aged more than 65 years, results in a unique population composition that could help explain the higher-than-expected frequency of Val122Ile and ATTRwt cases observed within our study.

Síndrome de takotsubo atípico o invertido / Atypical or inverted takotsubo syndrome

Resumen El síndrome de takotsubo es una enfermedad cardíaca subregistrada, que inicialmente fue enfocada como una condición benigna. Su presentación clínica típica con abalonamiento apical es la más reconocida; sin embargo, su fenotipo atípico con alteración para la motilidad focal de las paredes miocárdicas con variante ventricular media y escaso compromiso apical se ha demostrado hasta en un 40% de los pacientes con miocardiopatía de takotsubo. Dado que recientemente se ha demostrado que este síndrome puede estar asociado con complicaciones graves, incluida la muerte, y que el pronóstico a largo plazo es similar al de los pacientes con síndromes coronarios, se hace imperativo reconocer sus formas atípicas para mejorar su diagnóstico, tratamiento y pronóstico.

Abstract Takotsubo syndrome is a poorly registered heart disease that was initially approached as a benign condition. Its typical clinical presentation with apical abalonation is the most recognized, however, its atypical phenotype with alteration for focal motility of the myocardial walls with a medium ventricular variant and little apical compromise has been demonstrated in up to 40% of patients with cardiomyopathy of takotsubo. Given that, it has recently been shown that takotsubo syndrome can be associated with severe complications, including death, and that the long-term prognosis is similar to that of patients with coronary syndromes, it is imperative to recognize its atypical forms in order to improve its diagnosis, treatment and prognosis.

Microbiome of Penaeus vannamei Larvae and Potential Biomarkers Associated With High and Low Survival in Shrimp Hatchery Tanks Affected by Acute Hepatopancreatic Necrosis Disease.

Acute hepatopancreatic necrosis disease (AHPND) is an emerging bacterial disease of cultured shrimp caused mainly by Vibrio parahaemolyticus, which harbors the lethal PirAB toxin genes. Although Penaeus vannamei (P. vannamei) postlarvae are susceptible to AHPND, the changes in the bacterial communities through the larval stages affected by the disease are unknown. We characterized, through high-throughput sequencing, the microbiome of P. vannamei larvae infected with AHPND-causing bacteria through the larval stages and compared the microbiome of larvae collected from high- and low-survival tanks. A total of 64 tanks from a commercial hatchery were sampled at mysis 3, postlarvae 4, postlarvae 7, and postlarvae 10 stages. PirAB toxin genes were detected by PCR and confirmed by histopathology analysis in 58 tanks. Seven from the 58 AHPND-positive tanks exhibited a survival rate higher than 60% at harvest, despite the AHPND affectation, being selected for further analysis, whereas 51 tanks exhibited survival rates lower than 60%. A random sample of 7 out of these 51 AHPND-positive tanks was also selected. Samples collected from the selected tanks were processed for the microbiome analysis. The V3-V4 hypervariable regions of the 16S ribosomal RNA (rRNA) gene of the samples collected from both the groups were sequenced. The Shannon diversity index was significantly lower at the low-survival tanks. The microbiomes were significantly different between high- and low-survival tanks at M3, PL4, PL7, but not at PL10. Differential abundance analysis determined that biomarkers associated with high and low survival in shrimp hatchery tanks affected with AHPND. The genera Bacillus, Vibrio, Yangia, Roseobacter, Tenacibaculum, Bdellovibrio, Mameliella, and Cognatishimia, among others, were enriched in the high-survival tanks. On the other hand, Gilvibacter, Marinibacterium, Spongiimonas, Catenococcus, and Sneathiella, among others, were enriched in the low-survival tanks. The results can be used to develop applications to prevent losses in shrimp hatchery tanks affected by AHPND.

Cost-effectiveness of a self-management and comprehensive training intervention in patients with type 2 diabetes up to 5 years of diagnosis in a specialized hospital in Mexico City.

INTRODUCTION: To assess the cost-effectiveness of a multidisciplinary and comprehensive innovative diabetes care program (CAIPaDi) versus usual treatment in public health institutions. RESEARCH DESIGN AND METHODS: Using a cost-effectiveness analysis, we compared the CAIPaDi program versus usual treatment given in Mexican public health institutions. The analysis was based on the IQVIA Core Diabetes Model, a validated simulation model used to estimate long-term clinical outcomes. Data were prospectively obtained from the CAIPaDi program and from public databases and published papers. Health outcomes were expressed in terms of life-years gained and quality-adjusted life years (QALYs). Health and economic outcomes were estimated from a public perspective and discounted at 5% per year over a 20-year horizon. Costs are reported in US dollars (US$) of 2019. A probabilistic sensitivity analysis was performed using life-years gained and QALYs. RESULTS: The CAIPaDi costs on average US$559 (95% CI: -$879 to -$239) less than the usual treatment (95% CI: -$879 to -$239) and produced a difference in mean life-years gained (0.48, 95% CI: 0.45 to 0.52) and mean QALYs (1.43, 95% CI: 1.40 to 1.46). The cost-effectiveness ratio resulted in a saving per life-year gained of -US$1155 (95% CI: -$1962 to -$460). Mean differences in QALYs resulted in a saving per QALY of -US$735 (95% CI: -$1193 to -$305). Probabilistic sensitivity analysis proved the results are robust on both life-years gained and QALYs. CONCLUSIONS: CAIPaDi has a better cost-effectiveness ratio than the usual therapy in Mexican public health institutions.

Fructooligosaccharides production by immobilized Pichia pastoris cells expressing Schedonorus arundinaceus sucrose:sucrose 1-fructosyltransferase.

Fructooligosaccharides (FOSs)-fructose-based oligosaccharides-are typical prebiotics with health-promoting effects in humans and animals. The trisaccharide 1-kestotriose is the most attractive inulin-type FOS. We previously reported a recombinant sucrose:sucrose 1-fructosyltransferase (1-SST, EC 2.4.1.99) from Schedonorus arundinaceus (Sa) that efficiently converts sucrose into 1-kestotriose. In this study, Pichia pastoris PGFT6x-308 constitutively expressing nine copies of the Sa1-SST gene displayed fructosyltransferase activity in undisrupted biomass (49.8 U/ml) and culture supernatant (120.7 U/ml) in fed-batch fermentation (72 hr) with sugarcane molasses. Toluene permeabilization increased 2.3-fold the Sa1-SSTrec activity of whole cells entrapped in calcium-alginate beads. The reaction with refined or raw sugar (600 g/l) yielded 1-kestotriose and 1,1-kestotetraose in a ratio of 8:2 with their sum representing above 55% (wt/wt) of total carbohydrates. The FOSs yield decreased to 45% (wt/wt) when sugarcane syrup and molasses were used as cheaper sucrose sources. The beads retained 80% residual Sa1-SSTrec activity after a 30-day batchwise operation with refined cane sugar at 30°C and pH 5.5. The immobilized biocatalyst is attractive for the continuous production of short-chain FOSs, most particularly 1-kestotriose.

Prospective randomized trial of interventions for vincristine-related neuropathic pain.

BACKGROUND: To evaluate the efficacy of gabapentin at 20 mg/kg per day in the treatment of vincristine-related neuropathic pain. PROCEDURE: Children aged 1-18 years who developed vincristine-induced neuropathy on a St Jude frontline acute lymphoblastic leukemia trial were prospectively enrolled on a randomized, double-blind, placebo-controlled, phase II trial with two treatment arms: gabapentin plus opioid versus placebo plus opioid. Daily evaluations of morphine dose (mg/kg per day) and pain scores were conducted for up to 21 days; the values of the two arms were compared to assess analgesic efficacy. RESULTS: Of 51 study participants, 49 were eligible for analyses. Twenty-five participants were treated with gabapentin, with a mean (SD) dose of 17.97 (2.76) mg/kg per day (median 18.26, range 6.82-21.37). The mean (SD) opioid doses taken, expressed as morphine equivalent daily (mg/kg per day), were 0.26 (0.43) in the gabapentin group (25 patients, 432 days) and 0.15 (0.22) in the placebo group (24 patients, 411 days; P = .15). Only the risk classification of acute lymphoblastic leukemia was significantly associated with the daily morphine dosage (P = .0178): patients in the lower risk arm received higher daily morphine dosages. Multivariate analyses revealed a significant difference between the groups' average daily scores for the previous 24 h and "right now." CONCLUSION: In this population of children with vincristine-related neuropathic pain, opioid consumption and pain scores were higher in the gabapentin group than in the placebo group. Future randomized, double-blind, placebo-controlled studies should test gabapentin given longer or at a higher dose.

Resveratrol Prevents Right Ventricle Remodeling and Dysfunction in Monocrotaline-Induced Pulmonary Arterial Hypertension with a Limited Improvement in the Lung Vasculature.

Pulmonary arterial hypertension (PAH) is a life-threatening disease that is characterized by an increase in pulmonary vascular pressure, leading to ventricular failure and high morbidity and mortality. Resveratrol, a phenolic compound and a sirtuin 1 pathway activator, has known dietary benefits and is used as a treatment for anti-inflammatory and cardiovascular diseases. Its therapeutic effects have been published in the scientific literature; however, its benefits in PAH are yet to be precisely elucidated. Using a murine model of PAH induced by monocrotaline, the macroscopic and microscopic effects of a daily oral dose of resveratrol in rats with PAH were evaluated by determining its impact on the lungs and the right and left ventricular function. While most literature has focused on smooth muscle cell mechanisms and lung pathology, our results highlight the relevance of therapy-mediated improvement of right ventricle and isolated cardiomyocyte physiology in both ventricles. Although significant differences in the pulmonary architecture were not identified either micro- or macroscopically, the effects of resveratrol on right ventricular function and remodeling were observed to be beneficial. The values for the volume, diameter, and contractility of the right ventricular cardiomyocytes returned to those of the control group, suggesting that resveratrol has a protective effect against ventricular dysfunction and pathological remodeling changes in PAH. The effect of resveratrol in the right ventricle delayed the progression of findings associated with right heart failure and had a limited positive effect on the architecture of the lungs. The use of resveratrol could be considered a future potential adjunct therapy, especially when the challenges to making a diagnosis and the current therapy limitations for PAH are taken into consideration.

Phase II clinical trial testing the safety of a humanised monoclonal antibody anti-CD20 in patients with heart failure with reduced ejection fraction, ICFEr-RITU2: study protocol.

INTRODUCTION: Chronic heart failure with reduced ejection fraction (HFrEF) treatment targets neurohormonal inhibition; however, our experimental observations and the recent clinical evidence in myocardial infarction and heart transplant patients support the anti-inflammatory pathway as a potential novel therapeutic target. Therefore, we aimed to assess the safety of human monoclonal antibody-CD20 (rituximab) in patients with HFrEF. METHODS AND ANALYSIS: We designed this protocol according to the Standard Protocol Items: Recommendations for Interventional Trials guidelines as a phase II, single-centred, single group and prospective clinical trial. We hypothesise that the use of a monoclonal antibody, rituximab, could be a potentially safe new agent in HFrEF management. We will include patients with EF≤40%, New York Heart Association functional class III/IV and unresponsive to standard treatment. We will use a dosing regimen (1000 mg) previously applied to post-transplant patients and patients with rheumatoid arthritis with favourable results, aiming to provide supplementary evidence of safety in patients with HFrEF. We designed strategies tailored to preserving the integrity of patient safety. The date of study initiation will be 29th of May 2019. ETHICS AND DISSEMINATION: The following protocol was approved by IRB committees, and as a requirement, all patients need to sign an informed consent form before being subjected to any procedure prior to the initiation of the study. We are aware that the trial will be run in patients who due to their cardiovascular functional class, have reserved prognosis, with no known therapy that leads to improvement. Hence, this trial searches to establish the safety of an alternative strategy in ameliorating prognosis. Regardless of the study outcomes, whether favourable or not, they will be published. If a favourable outcome is evidenced, it will prompt performing a phase III, efficacy-based study. TRIAL REGISTRATION NUMBER: The trial was approved by the IRB (CONBIOÉTICA-19-CEI-011-20161017 and COFEPRIS-17-CI-19-039-003), and registered at Clinicaltrials.gov (NCT03332888; Pre-Results).

Flow, dynamic viscoelastic and creep properties of a biological polymer produced by Sphingomonas sp. as affected by concentration.

In this work, the influence of the concentration on the flow behaviour, dynamic viscoelastic and creep properties of diutan gum in aqueous solution was investigated. Diutan gum is a biopolymer which belongs to the sphingans group. To know its rheological properties and its microstructure as a function of the concentration is directly related to the current and future applications of this biological polymer. Mechanical spectra showed a crossover point between G' and G″ which changed as a function of diutan gum concentration. A master curve for the frequency dependence on the η* was obtained. The creep compliance results made it possible to deduce the yield stress value and they were fitted to Burgers model. A shear-thinning behaviour was exhibited by diutan gum aqueous solutions, which was fitted to the Carreau-Yasuda model. Higher G', G″, τ0 and η0 values and lower ωc, Je0, γ̇c and n values were obtained by increasing the gum concentration, it is being possible to modulate the viscoelasticity, viscosity and shear resistance as a function of concentration. A more complex structure with stronger entanglements between macromolecules of diutan was obtained when the concentration of diutan increases.

Fructooligosaccharides production by Schedonorus arundinaceus sucrose:sucrose 1-fructosyltransferase constitutively expressed to high levels in Pichia pastoris.

The non-saccharolytic yeast Pichia pastoris was engineered to express constitutively the mature region of sucrose:sucrose 1-fructosyltransferase (1-SST, EC 2.4.1.99) from Tall fescue (Schedonorus arundinaceus). The increase of the transgene dosage from one to nine copies enhanced 7.9-fold the recombinant enzyme (Sa1-SSTrec) yield without causing cell toxicity. Secretion driven by the Saccharomyces cerevisiae α-factor signal peptide resulted in periplasmic retention (38%) and extracellular release (62%) of Sa1-SSTrec to an overall activity of 102.1 U/ml when biomass reached (106 g/l, dry weight) in fed-batch fermentation using cane sugar for cell growth. The volumetric productivity of the nine-copy clone PGFT6x-308 at the end of fermentation (72 h) was 1422.2 U/l/h. Sa1-SSTrec purified from the culture supernatant was a monomeric glycoprotein optimally active at pH 5.0-6.0 and 45-50 °C. The removal of N-linked oligosaccharides by Endo Hf treatment decreased the enzyme stability but had no effect on the substrate and product specificities. Sa1-SSTrec converted sucrose (600 g/l) into 1-kestose (GF2) and nystose (GF3) in a ratio 9:1 with their sum representing 55-60% (w/w) of the total carbohydrates in the reaction mixture. Variations in the sucrose (100-800 g/l) or enzyme (1.5-15 units per gram of substrate) concentrations kept unaltered the product profile. Sa1-SSTrec is an attractive candidate enzyme for the industrial production of short-chain fructooligosaccharides, most particularly 1-kestose.

Estudio comparativo del consumo de comida basura en ancianos del ámbito rural frente al ámbito urbano / Comparative study of the fast food consumption in elder people living rural areas versus urban areas

Objetivo: analizar el consumo de comida basura en ancianos del ámbito rural y del ámbito urbano, comprobando si hay diferencias significativas entre ambos grupos. Método: estudio descriptivo transversal en 346 ancianos con una horquilla de edad de 65-95 años, residentes en Porzuna y Madrid. Recogida de datos: encuesta autoadministrada con escala Likert. Análisis de datos: Chi-cuadrado, valor de significación p, intervalos de confianza. Resultados: un 27% de los ancianos rurales (n=46; DE=16,26; IC95%=53,87-61,13) y un 39% de los ancianos urbanitas (n=69) consumen comida basura, existiendo diferencias significativas: X2(1) = 6,1052; X2 crítico = 3,8415; p = 0,014 < 0,05. Si hablamos de las repercusiones en la salud, un 45% de los ancianos rurales (n=42; DE=14,14; IC95%=48,84-55,16) y un 90% de los urbanos (n=62) las percibe como negativas, sin que existan diferencias estadísticamente significativas: X2(1) = 0,067; X2 crítico = 3,8415; p = 0,7957 > 0,05. Discusión: la Escuela de Administración de Empresas ha registrado en España un ascenso del gasto en comida basura por habitante del 49,65% respecto a 2014. Según García y Villalobos su consumo en ancianos se debe a la disminución de poder adquisitivo, la muerte del cónyuge y/o la falta de apoyo social. Conclusiones: existen diferencias estadísticamente significativas en el consumo de comida basura, pero no en la percepción que tienen los ancianos de ambos grupos sobre su estado de salud derivada de su consumo

Objective: to analyze the consumption of junk food in elder people living in rural and urban areas, as well as to verify if there are significant differences between both. Method: cross-sectional descriptive study in 346 elder people in a fork of age 65-95 years, living in Porzuna and Madrid. Data collection: self-administered survey with Likert scale. Data analysis: Chi-square, significance value p, confidence intervals. Results: 27% of rural elder people (n=46, SD=16,26; CI95%=53,87-61,13) and 39% of urban elder people (n=69) consume junk food, with significant differences: X2(1) = 6,1052; X2 crítico = 3,8415; p = 0,014 < 0,05. If we talk about the consequences in elder people's health, 45% of the rural elder people (n=42, SD=14,14; CI95%=48,84-55,16) and 90% of the urban elder people (n=62) perceive them as negative without statistically significant differences: X2(1) = 0,067; X2 crítico = 3,8415; p = 0,7957 > 0,05. Discussion: the Business School has registered in Spain an increase in spending on "junk food" per capita of 49.65% compared to 2014. According to Garcia and Villalobos, their consumption in the elderly is due to the decrease in purchasing power, wife's death and/or the lack of social support. Conclusions: there are statistically significant differences in the consumption of "junk food", but not in the perception that the elderly of both groups have about their state of health derived from their consumption

Estudio comparativo del consumo de comida basura en ancianos del ámbito rural frente al ámbito urbano / Comparative study of the fast food consumption in elder people living rural area versus urban areas

Objetivo: analizar el consumo de comida basura en ancianos del ámbito rural y del ámbito urbano, comprobando si hay diferencias significativas entre ambos grupos. Método: estudio descriptivo transversal en 346 ancianos con una horquilla de edad de 65-95 años, residentes en Porzuna y Madrid. Recogida de datos: encuesta autoadministrada con escala Likert. Análisis de datos: Chi-cuadrado, valor de significación p, intervalos de confianza. Resultados: un 27% de los ancianos rurales (n=46; DE=16,26; IC95%=53,87-61,13) y un 39% de los ancianos urbanitas (n=69) consumen comida basura, existiendo diferencias significativas: X2(1) = 6,1052; X2 crítico = 3,8415; p = 0,014 < 0,05. Si hablamos de las repercusiones en la salud, un 45% de los ancianos rurales (n=42; DE=14,14; IC95%=48,84-55,16) y un 90% de los urbanos (n=62) las percibe como negativas, sin que existan diferencias estadísticamente significativas: X2(1) = 0,067; X2 crítico = 3,8415; p = 0,7957 > 0,05. Discusión: la Escuela de Administración de Empresas ha registrado en España un ascenso del gasto en comida basura por habitante del 49,65% respecto a 2014. Según García y Villalobos su consumo en ancianos se debe a la disminución de poder adquisitivo, la muerte del cónyuge y/o la falta de apoyo social. Conclusiones: existen diferencias estadísticamente significativas en el consumo de comida basura, pero no en la percepción que tienen los ancianos de ambos grupos sobre su estado de salud derivada de su consumo

Objective: to analyze the consumption of junk food in elder people living in rural and urban areas, as well as to verify if there are significant differences between both. Method: cross-sectional descriptive study in 346 elder people in a fork of age 65-95 years, living in Porzuna and Madrid. Data collection: self-administered survey with Likert scale. Data analysis: Chi-square, significance value p, confidence intervals. Results: 27% of rural elder people (n=46, SD=16,26; CI95%=53,87-61,13) and 39% of urban elder people (n=69) consume junk food, with significant differences: X2(1) = 6,1052; X2 crítico = 3,8415; p = 0,014 < 0,05. If we talk about the consequences in elder people's health, 45% of the rural elder people (n=42, SD=14,14; CI95%=48,84-55,16) and 90% of the urban elder people (n=62) perceive them as negative without statistically significant differences: X2(1) = 0,067; X2 crítico = 3,8415; p = 0,7957 > 0,05. an increase in spending on "junk food" per capita of 49.65% compared to 2014. According to Garcia and Villalobos, their consumption in the elderly is due to the decrease in purchasing power, wife's death and/or the lack of social support. Conclusions: there are statistically significant differences in the consumption of "junk food", but not in the perception that the elderly of both groups have about their state of health derived from their consumption

Role of Adaptive Immunity in the Development and Progression of Heart Failure: New Evidence.

Heart failure (HF) is considered the endpoint of a variety of cardiac diseases, which are the leading cause of death in adults and considered a growing pandemic worldwide. Independent of the initial form of cardiac injury, there is evidence linking the involvement of the immune system. In HF there is evidence of the participation of TH1, and TH17 cells, which account for sustained pathological chronic inflammation, cell migration, and the induction of specific pathological phenotypes of mononuclear cells. Of equal or even higher relevance are the B lymphocyte activation mechanisms that include production of pro-inflammatory cytokines, chemokines, and cardiac autoantibodies with or without activation of the complement proteins. Both of these unbalanced T- and B-cell pathways of the adaptive immune system are associated with cardiomyocyte death and tissue remodeling by fibrosis leading to a dysfunctional heart. At this time, therapy with neutralizing antibodies and the use of anti-cytokine immunomodulators to counteract the immune system effects have reached a plateau of mixed results in clinical trials. Nevertheless, recent evidence showed promising results in animal models that suggest that modulation of the adaptive immune system cells more than some of their effector molecules could have benefits in HF patients. This review summarizes the role of the adaptive immunity cells in HF, considering the sustained activation of adaptive immune system as a potential contributor to disease progression in humans and experimental models where its regulation provides a new therapeutic target.

Standoff monitoring of aqueous aerosols using nanosecond laser-induced breakdown spectroscopy: droplet size and matrix effects.

Nanosecond laser-induced breakdown spectroscopy has been examined for the analysis of suspended matter in a free stream of air. The real-time monitoring of this scenario poses major challenges for an accurate categorization due to its changing characteristics such as composition, size, and density of particles. The effects of particle size and matrix in the optical emission responses registered from such scenarios have been evaluated. Distant (10 m) plasmas of saline solutions, containing either NaCl or Na2SO4 at different concentrations, have been induced by nanosecond laser pulses at a wavelength of 1064 nm. The effects of the droplet size and its concentration on differences in the laser-induced breakdown probability, the intensity of the characteristic lines, and the plasma emission continuum have been discussed. The quantification of sodium in distant water droplets has been proved. However, an initial knowledge on the average droplet size is required. The average droplet size could be determined from the slope of H I and O I lines versus the continuum plasma emission, which is only weakly influenced by the salt content in the droplets.