Sustainable Production of Biofuels and Biochemicals via Electro-Fermentation Technology.

The energy crisis and climate change are two of the most concerning issues for human beings nowadays. For that reason, the scientific community is focused on the search for alternative biofuels to conventional fossil fuels as well as the development of sustainable processes to develop a circular economy. Bioelectrochemical processes have been demonstrated to be useful for producing bioenergy and value-added products from several types of waste. Electro-fermentation has gained great attention in the last few years due to its potential contribution to biofuel and biochemical production, e.g., hydrogen, methane, biopolymers, etc. Conventional fermentation processes pose several limitations in terms of their practical and economic feasibility. The introduction of two electrodes in a bioreactor allows the regulation of redox instabilities that occur in conventional fermentation, boosting the overall process towards a high biomass yield and enhanced product formation. In this regard, key parameters such as the type of culture, the nature of the electrodes as well as the operating conditions are crucial in order to maximize the production of biofuels and biochemicals via electro-fermentation technology. This article comprises a critical overview of the benefits and limitations of this emerging bio-electrochemical technology and its contribution to the circular economy.

DNAJB11 Mutation in ADPKD Patients: Clinical Characteristics in a Monocentric Cohort.

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a late-onset cilia-related disorder, characterized by progressive cystic enlargement of the kidneys. It is genetically heterogeneous with PKD1 and PKD2 pathogenic variants identified in approximately 78% and 15% of families, respectively. More recently, additional ADPKD genes, such as DNAJB11, have been identified and included in the diagnostic routine test for renal cystic diseases. However, despite recent progress in ADPKD molecular approach, approximately ~7% of ADPKD-affected families remain genetically unresolved. We collected a cohort of 4 families from our center, harboring heterozygous variants in the DNAJB11 gene along with clinical and imaging findings consistent with previously reported features in DNAJB11 mutated patients. Mutations were identified as likely pathogenetic (LP) in three families and as variants of uncertain significance (VUS) in the remaining one. One patient underwent to kidney biopsy and showed a prevalence of interstitial fibrosis that could be observed in ~60% of the sample. The presence in the four families from our cohort of ADPKD characteristics together with ADTKD features, such as hyperuricemia, diabetes, and chronic interstitial fibrosis, supports the definition of DNAJB11 phenotype as an overlap disease between these two entities, as originally suggested by the literature.

Frecuencia, actitud y conocimiento sobre el cigarrillo electrónico en estudiantes de medicina / Frequency, attitudeand knowledge about electronic cigarrete in medical students

RESUMEN Introducción. La prevalencia de uso del cigarrillo electrónico (CE) a nivel mundial ha ido en aumento en los últimos años, especialmente en la población joven. Objetivo. Conocer la frecuencia, percepción y el conocimiento sobre el cigarrillo electrónico en estudiantes de medicina de una universidad privada. Metodología. Estudio observacional, descriptivo de corte transversal en el que los datos se recolectaron por medio de una encuesta en formulario de Google. Los estudiantes recibieron vía aplicación de mensajería instantánea un link para responder el cuestionario. Las variables fueron: edad, sexo, uso del cigarrillo electrónico, hábito tabáquico, seguridad, eficacia como método para dejar de fumar, conocimiento sobre la composición del cigarrillo electrónico. Resultados. Respondieron la encuesta 506 estudiantes, de ellos 219 (43,3%) afirmaron utilizar CE. El 54,8% de los usuarios de CE era del sexo masculino y 41,6% tenía entre 22 - 26 años. El 41,0% considera que los CE son seguros, que es un método eficaz para dejar de fumar (57,1%), lo utilizaría para dejar de fumar (68,5%) y que se debería permitir su uso en lugares públicos (57,1%). Un porcentaje importante «desconoce» o considera que «no tienen» en su composición, dietilenglicol/propilenglicol (57,1%), glicerina (57,5%) o nicotina (16%), entre otros compuestos que podrían contener. Conclusión. La frecuencia de uso de CE en estudiantes de medicina de esta universidad es alta, la mayoría apoya su uso y desconoce su composición. Es necesario poner en práctica estrategias de prevención efectivas e informar sobre los riesgos para la salud relacionados con su uso.

ABSTRACT Introduction. The prevalence of electronic cigarette (EC) use worldwide has been increasing in recent years, especially in the young population. Objective. To know the frequency, perception and knowledge about the electronic cigarette in medical students of a private university. Methodology. Observational, descriptive cross-sectional study in which the data was collected through a Google form survey. Students received via instant messaging application a link to answer the questionnaire. The variables were: age, sex, use of the electronic cigarette, smoking habit, safety, efficacy as a method to quit smoking, knowledge about the composition of the electronic cigarette. Results. The survey was answered by 506 students, which 219 (43.3%) stated that they used CE. 54.8% of EC users were male and 41.6% were between 22-26 years old. 41.0% consider that EC is safe, that it is an effective method to quit smoking (57.1%), they would use it to quit smoking (68.5%) and that its use should be allowed in public places (57.1%). A significant percentage «does not know» or considers that they «do not have» in their composition, diethylene glycol/propylene glycol (57.1%), glycerin (57.5%) or nicotine (16%), among other compounds that they could contain. Conclusion. The frequency of EC use in medical students at this university is high, most of them support its use and are unaware of its composition. It is necessary to implement effective prevention strategies and inform about the health risks related to their use.

Validity of a clinical scale in predicting the failure of non-invasive ventilation in hypoxemic patients.

INTRODUCTION: The HACOR scale is a clinical score that can predict early failure of NIV in hypoxemic acute respiratory failure (ARF) The aim of this study is to analyze the validity of the HACOR scale. METHODS: A retrospective study of a cohort of over 2749 episodes on 2711 consecutive patients requiring NIV for hypoxemic ARF in a polyvalent intensive care unit. The scale was measured before starting NIV and at 1, 6, 12, 24 and 48 h after the initiation of NIV. RESULTS: NIV failure occurred in 963 patients (35%). The value of the HACOR scale before NIV did not differ between success and failure. However, at 1, 6, 12, 24 and 48 h of NIV, the scale values clearly differed between the two groups. The HACOR scale at NIV initiation accurately predicts NIV failure in the first hour, with an optimal cut-off value of 8 points. The AUC for predicting NIV failure with HACOR at 1 h is greater than 0.9 in patients with pneumonia and adult respiratory distress syndrome (ARDS). CONCLUSIONS: The HACOR scale measured at 1 h after NIV initiation accurately predicts NIV failure, especially in pneumonia and ARDS.

Chemopreventive effect of pomegranate and cocoa extracts on ultraviolet radiation-induced photocarcinogenesis in SKH-1 mice.

Non-melanoma skin cancer (NMSC) has a high and increasing incidence all over the world. Solar radiation is the main aetiology for humans. Although most research into photocarcinogenesis uses UVB as a source of radiation, UVA is also carcinogenic in long term. Pomegranate (PGE) and cocoa (CE) extracts have been used for medicinal purposes for time immemorial. Recently, it has been claimed that some of their properties may be an effective preventative measure against photocarcinogenesis and photoaging, but to date in vivo models have not been tested using RUVA, the objective of the present work. A lower incidence of lesions was observed in SKH-1 mice treated with PGE (p<0.001), and lower incidence of invasive squamous carcinoma in both treatment groups (p<0.001 for PGE and p<0.05 for CE); the PGE group also showed a lower level of cell proliferation than the control group (p<0.001). Significantly greater p53 alteration was observed in the control group than the treatment groups (p<0.001 for PGE and p = 0.05 for CE). No significant differences were found in relation to TIMP-1 and MMP-9. Taken together, the results suggest that oral feeding of PGE and CE to SKH-1 mice affords substantial protection against the adverse effects of RUVA, especially PGE.

Prevalence of human papillomavirus in the saliva of sexually active women with cervical intraepithelial neoplasias

BACKGROUND: The main objective of this study was to estimate the prevalence of human papillomavirus-DNA (HPV-DNA) in the saliva of sexually active women with HPV-related cervical intraepithelial neoplasias (CIN) and compare the findings with a healthy control group. The secondary objectives were: 1) to determine the concordance between genital and oral HPV types in sexually active women with HPV-related CIN; 2) to analyze whether sexual habits influence the presence of HPV-related CIN; 3) to determine whether sexual habits influence the presence of oral HPV. MATERIAL AND METHODS: Saliva samples were collected from 100 sexually active women, 50 with HPV-related CIN and 50 healthy subjects presenting normal cytology. PCR assay was used to detect HPV-DNA. RESULTS: The prevalence of oral HPV infection in saliva samples was 14% in women with HPV-related CIN, while in the healthy group it was 12%, without statistically significant difference (p = 0.766). As for the concordance between genital and oral HPV types in women with HPV-related CIN, concordance was only observed for HPV-16, whereby among 22 women with genital HPV-16, only one (4.54%) also presented oral HPV-16. Regarding the possible influence of sexual habits on the presence of cervical pathology and presence of oral HPV, it was found that marital status, age at first intercourse, number of lifetime sexual partners, and condom use are related with the presence of cervical pathology (p < 0.001; p = 0.017; p = 0.002; and p < 0.001, respectively); condom use was also found to be related to the presence of oral HPV (p < 0.001). CONCLUSIONS: The prevalence of HPV-DNA in the saliva of sexually active women with HPV-related CIN is similar to healthy women. The concordance between genital and oral HPV types is low. Both the presence of cervical pathology and the presence of oral HPV are related to sexual habits. Wider sample size is required to confirm this results

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Short Femur in the Second Trimester Scan Is Related to Maternal Preeclampsia and Small for Gestational Age Newborns.

OBJECTIVE: To determine the contribution of short femur diaphysis length (FDL) at 19-22 weeks of gestation in the prediction of adverse pregnancy outcomes. METHODS: The study included singleton pregnant women who underwent a routine anomaly scan at 19-22 weeks of gestation at the Virgen de la Arrixaca University Clinical Hospital (Murcia, Spain) between August 2011 and August 2012. Fetal biometry and Doppler ultrasound of uterine arteries were assessed as part of the anomaly scan, and the mean pulsatility index of both uterine arteries was recorded. Maternal obstetric characteristics, such as ethnicity, age, weight, parity, cigarette smoking, and medical history including hypertension and diabetes mellitus were collected from our database system. RESULTS: A total of 6,366 women were included in the study after excluding cases with abnormal karyotype, major fetal abnormalities, or termination of pregnancy. There were 88 cases of preeclampsia (PE) (1.4%). Logistic regression was performed including maternal and fetal characteristics. Short FDL at 19-22 weeks was significantly associated with subsequent development of PE (OR = 0.89, 95% CI: 0.80-0.99, p = 0.025). The best model to predict PE from our sample included gestational age at scan, parity, maternal weight, chronic hypertension, mean pulsatility index in the uterine arteries, and FDL (AUC = 0.78, 95% CI: 0.71-0.84). Regarding small for gestational age (SGA) neonates, there were also significant differences in FDL and FDL <5th centile between the control group and SGA newborns below the 3rd, 5th, and 10th centile. In the groups of preterm births (delivery before 32, 34, and 37 weeks), there were no differences in FDL compared with the control group (term births). DISCUSSION: Our results suggest that FDL at 19-22 weeks of gestation is an independent predictor of PE and SGA newborns.

¿Varía la incidencia de las malformaciones pulmonares congénitas?: 11 años de experiencia / Does the incidence of congenital pulmonary malformations vary? 11 years of experience

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Hidatidosis peritoneal masiva de diagnóstico tardío tras traumatismo abdominal cerrado / Late diagnosis of massive peritoneal hidatidosis after blunt abdominal trauma

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Valoración del patrón de la sexualidad: atención integral de la salud de las personas / Valuation of the pattern of sexuality: comprehensive attention of the people’s health

Antecedentes: La sexualidad es un componente importante de la vida y la salud. Puede ser origen de graves conflictos relacionados con la salud física, psicológica, incluyendo la transmisión de enfermedades, las experiencias negativas, las pautas sexuales, la violencia y los determinantes culturales o religiosos. Sin embargo, la información recogida en los Registros Enfermeros con frecuencia se limita a la reproducción y / o el estado civil de los pacientes. Objetivo: El objetivo de este estudio fue evaluar la calidad de la información sobre aspectos relacionados con la sexualidad, los factores que la determinan y la relevanciaque los datos obtenidos puedan tener sobre la salud de las personas. Métodos: Estudio Observacional realizado en la Unidad de Neumología de un Hospital de referencia provincial en el que se revisaron 250 Valoraciones Iniciales (VI) Historias Clínicas y se entrevistó de forma consecutiva a 292 pacientes ingresados mediante cuestionario. En una primera etapa, se evaluó la información recogida y la naturaleza de los datos obtenidos acerca de la información relacionada con la sexualidad en 250 VI de las Historias Clínicas de pacientes ingresados el año anterior a la realización del estudio. En un segundo paso, se elaboró un cuestionario, basado en los criterios de valoración de los Patrones Funcionales de Gordony centrado en la valoración del Patrón de la sexualidad y se aplicó a292 pacientes hospitalizados. Se investigó la influencialos diferentes aspectos de este patrón mediante el empleo de la prueba de Chi-cuadrado. Resultados:De las 250 VI que se revisaron, se constatóqueen la VIse registraban los datos de reproducción en el 75% de las VI. En la segunda fase, se incluyeron 292 sujetos, 46.,9% hombres y 53,1% mujeres, con edad mediade 57 años, y la tasa de respuesta al cuestionario en los pacientes fue del 100%, siendo el porcentaje de respuesta superior al 95% en todas las preguntas. Se recogió: revisiones por el especialista, utilización de métodos conceptivos, padecimiento de ETS, calidad de relación con la pareja, percepción del sentimiento de su pareja, importancia de las relaciones sexuales en su vida, antecedentes de violencia sexual, relaciones fuera de pareja estable. En el desarrollo del trabajo se identificaron Diagnósticos Enfermeros relevantes para la evolución de la salud integral de las personas en el 70,2% de los casos. Conclusiones: El porcentaje de respuesta a las preguntas del cuestionario fue elevado. Las diferencias en el Patrón de la sexualidad influyeron en la mayoríade las condiciones que requieren la salud integral de las personas. La información recogida tuvo relevancia para la salud integral de las personas en un número elevado de casos. La calidad de la información recogida fue buena, ya que las personas informaron sin reserva y naturalidad, como del resto de los patronesalas preguntas formuladas sobre su sexualidad. Se identifican problemas de prácticas de riesgo y maltrato en un número elevado de personas, que indican la necesidad de su valoración. No preguntar sobre este Patrón o hacerlo solo referido a la reproducción, hace que quede sesgada la información al respecto, en muchas ocasiones con serias repercusiones sobre la salud de las personas. Las enfermeras tienen competencias sobre la salud sexual de las personas y han de ser sus conocimientos científicos las que determinen la idoneidad de la toma de decisiones a este respecto(AU)

Background: Sexuality is an important component of life and health. Also of severe conflicts related to physical or psychological events, including the transmission of diseases, negative experiences, sexual patterns, violence and cultural or religious determinants. Nevertheless, the information collected in the nurse’s files is frequently limited to the reproductive and/or marital status of the patients. Objective: The objective of this study was to evaluate the quality of information on issues related to sexuality, its determinants and the iof the data obtained can have on people's health Methods: Observational study conducted in the respiratory medicine department of a provincial referral hospital where initial assessments (IA) were revised 250 medical charts and interviewed 292 consecutively admitted patients by questionnaire focused. In a first step, the information collected and the nature of the data about the information related to sexuality in 250 IA of medical records of patients admitted in the year before the study. In a second step, a questionnaire was developed, based on the evaluation criteria of functional patterns Gordon and focused on assessing the pattern of sexuality and applied to 292 patients hospitalized. The influence of different aspects of this pattern using the Chi-square test. Results: In the first step of the 250 IA reviewed, it was found that in the IA data were recorded breeding in 75% of the IA. In the second phase, 292 subjects were included, 46.9% men and 53.1% women, mean age 57 years, and the response rate to the questionnaire in patients was 100%, with a higher response rate 95% in all questions. Was collected: reviews by the specialist, use of contraceptives methods, STD condition, quality of relationship with partner, perceived sense of your partner, the importance of sex in his life, a history of sexual violence, stable partner relationships outside. In the development labor Diagnoses were identified relevant to the evolution of the overall health of people in 70.2% of cases. Conclusions: The response rate to the questionnaire was high. The differences in the pattern of sexuality influenced most health conditions requiring full of people. The information collected was relevant to the overall health of people in a large number of cases. Problems are identified risk practices and abuse in a large number of people, indicating the need for assessment. Do not ask about this pattern or do only referred to the reproduction, it is biased for the information, often with serious implications for the health of people. Nurses have expertise on sexual health of people and should be the scientific knowledge to determine the suitability of the decision making in this regard (AU)

Ensayo clínico sobre la compresión radial guiada por la presión arterial media / Clinical trial of radial artery compression guided by mean arterial pressure

Objetivo. Determinar si un método de compresión guiada por la cifra de la presión arterial media del paciente (experimental), es eficaz, seguro y superior a un método de compresión utilizando 15 ml de aire en el dispositivo (estándar) medido en resultados de oclusión de la arteria radial. Método. El estudio fue aleatorizado, unicéntrico e incluía a pacientes a los que se les realizó cateterismo de la arteria radial para diagnóstico o intervencionismo coronario percutáneo, se les retiró el introductor a la finalización del procedimiento y se les comprimió la arteria radial durante 3h, con dispositivo neumático (TR Band™ de Terumo®). Las arterias se valoraron entre las 24 y 72h tras el procedimiento, por curva de pletismografía con test de flujo inverso, y posteriormente con Doppler bidireccional. Resultados. En 351 pacientes estudiados se midió el porcentaje de oclusión arterial, y en el grupo de estudio experimental ocurrió en 2 (1,1%) frente a 21 pacientes (12%) en el grupo estándar (p=0,0001), sin obtener diferencias en el número de complicaciones. Conclusiones. El método de compresión guiado por las cifras de la presión arterial media del paciente, a la finalización del cateterismo de la arteria radial, es eficaz y seguro, y disminuye la oclusión de la arteria frente al método estándar de compresión con el dispositivo neumático(AU)

Objective. To determine whether a compression procedure guided by the patient's mean arterial pressure value (experimental) is safe and effective and superior to a compression procedure using 15 cubic centimeters of air in the device (standard) in patients undergoing radial artery catheterization. Methods. We performed a randomized, single-center study, which included patients undergoing catheterization of the radial artery for diagnosis or percutaneous coronary intervention, in whom the sheath was removed at the end of procedure and the radial artery was compressed for 3h with a pneumatic device (TR Band™ Terumo®). The arteries were evaluated between 24 and 72h after the procedure, using a plethysmography curve with a reverse flow test followed by bidirectional Doppler. Results. The percentage of arterial occlusion was measured in 351 patients. Arterial occlusion was found in two patients (1.1%) in the experimental group compared with 21 patients (12%) in the standard group (p=0.0001). No differences were found in the number of complications. Conclusions. The compression method, guided by the patient's mean arterial pressure value at the end of catheterization of the radial artery, is safe and effective and reduces arterial occlusion compared with the standard compression method using a pneumatic device(AU)

[Clinical trial of radial artery compression guided by mean arterial pressure]. / Ensayo clínico sobre la compresión radial guiada por la presión arterial media.

OBJECTIVE: To determine whether a compression procedure guided by the patient's mean arterial pressure value (experimental) is safe and effective and superior to a compression procedure using 15 cubic centimeters of air in the device (standard) in patients undergoing radial artery catheterization. METHODS: We performed a randomized, single-center study, which included patients undergoing catheterization of the radial artery for diagnosis or percutaneous coronary intervention, in whom the sheath was removed at the end of procedure and the radial artery was compressed for 3 h with a pneumatic device (TR Band Terumo). The arteries were evaluated between 24 and 72 h after the procedure, using a plethysmography curve with a reverse flow test followed by bidirectional Doppler. RESULTS: The percentage of arterial occlusion was measured in 351 patients. Arterial occlusion was found in two patients (1.1%) in the experimental group compared with 21 patients (12%) in the standard group (p = 0.0001). No differences were found in the number of complications. CONCLUSIONS: The compression method, guided by the patient's mean arterial pressure value at the end of catheterization of the radial artery, is safe and effective and reduces arterial occlusion compared with the standard compression method using a pneumatic device.

Low-fluence 1,064-nm laser hair reduction for pseudofolliculitis barbae in skin types IV, V, and VI.

PURPOSE: To evaluate the efficacy of a 1,064-nm neodymium-doped yttrium aluminium garnet (Nd:YAG) laser using lower than traditional fluences (22-40 J/cm(2)) for treatment of pseudofolliculitis barbae (PFB). METHODS: Twenty-two patients with PFB refractory to conservative therapy received five weekly treatments over the anterior neck using a 1,064-nm Nd:YAG laser at 12 J/cm(2). Pulse duration was 20 ms with 10 mm spot size. Topical anesthesia was not used. Treatments were completed 15 minutes after patient arrival. Patients presented for 2- and 4-week follow-up. Ten evaluators used a Global Assessment Scale (GAS) to assess dyspigmentation, papule counts, and cobblestoning by comparing baseline to 4-week follow-up visit photographs. Hair and papule counts were performed on five patients and compared with the GAS. Investigators recorded adverse effects using a visual analog and side effects scale. RESULTS: Eleven patients demonstrated 83% improvement on the GAS (p<.01). There was a mean reduction of 59.5% in dyspigmentation (p<.03), 91.2% in papule count (p<.01), and 75.6% in cobblestoning (p<.02). Patients reported 1 out of 10 on both adverse effects scales. CONCLUSION: Low-fluence 1,064-nm laser treatment achieved significant temporary reduction in PFB. Subjects noted minimal pain without topical anesthesia.

Successful resumption of epoetin alfa after rituximab treatment in a patient with pure red cell aplasia.

An 80-year-old man with chronic renal failure (CRF) had pure red cell aplasia (PRCA) 9 months after starting the subcutaneous administration of recombinant human erythropoietin alfa (rHuEPO-alpha). Owing to the advanced renal failure, conventional immunosuppressive therapies were not practicable. It was decided to administer rituximab (4 cycles of 375 mg/m2/wk). PRCA was treated successfully with rituximab. The administration of rHuEPO-alpha then was resumed via the intravenous route with a satisfactory correction of anemia (12 months after the EPO-alpha rechallenge the patient is still transfusion independent). To the authors' knowledge, this is the first report of (1) a successful treatment with rituximab with CD20 depletion in a CRF patient with PRCA and (2) a successful intravenous resumption of the same rHuEPO-alpha.

Biofeedback in dialysis.

The traditional control of the dialysis session comes about by means of an open-loop system. At the beginning of the session some parameters are set, such as the kind of dialyzer, the blood flow, the ultrafiltration rate, the dialysate conductivity and the dialysate temperature. Generally speaking, these parameters are not modified unless there occur complications in the patient that call for adjustments to be made. The biofeedback concept, which is synonymous with a closed-loop control of biological variables, presupposes, on the other hand: the continuous measurement of a variable thanks to a specific sensor its evaluation by a sort of expert system--the so-called controller and a series of means--the actuators--that allow the behavior of the variable to be directly or indirectly influenced. In clinical practice, different biofeedback systems are emerging, addressed to the control of blood volume, body temperature, and blood pressure. Each one of these systems has been successfully deployed, especially in the management of "difficult" patients unstable from the hemodynamic point of view. However, the future will be an integrated system that sees a complex adaptive, multi-input, multi-output controller which, with a great simplicity of use and low costs, will allow renal replacement therapy to be increasingly physiological and more efficient.