Breeding in bread-making wheat varieties for Mediterranean climate: the need to get resilient varieties.

Introduction: Being one of the "big three" most cultivated cereals in the world, wheat plays a crucial role in ensuring global food/nutrition security, supplying close to 20% of the global needs for calories and proteins. However, the increasingly large fluctuations between years in temperatures and precipitation due to climate change cause important variations in wheat production worldwide. This fact makes wheat breeding programs a tool that, far from going out of fashion, is becoming the most important solution to develop varieties that can provide humanity with the sufficient amount of food it demands without forgetting the objective of quality. Material and methods: The National Institute of Agricultural and Veterinary Research in Portugal has carried out a long-term experiment (9 years) in different locations to test four different bread-making wheat cultivars, each representing important variations in germplasm. Wheat yield and quality traits obtained by official methods were recorded in 18 different environments regarding temperature and precipitation. Results and discussion: According to the ANOVA and PCA, protein content, wet gluten, dough tenacity, and extensibility were found to be highly affected by the environment. Paiva cultivar presented a higher yield in almost all the tested environments, but its quality traits varied enormously. Contrary behavior was recorded for Valbona cultivar. Antequera cultivar, with a production ranging between 4.7 and 9.3 tons/ha and a protein content between 11 and 16.8%, seems to be the most resilient cultivar regarding both productivity and quality of the flour with reference to changes in the main climate traits. The most ancient cultivar, Roxo, released in 1996, showed the worst results in this experiment, supporting the need to continue working in wheat breeding to meet the unavoidable changes in the environment.

Soil and Foliar Zinc Biofortification of Triticale (x Triticosecale) under Mediterranean Conditions: Effects on Forage Yield and Quality.

Zinc (Zn) deficiency represents a significant global concern, affecting both plant and human health, particularly in regions with Zn-depleted soils. Agronomic biofortification strategies, such as the application of Zn fertilizers, offer a cost-effective approach to increase Zn levels in crops. This study aimed to assess the efficacy of soil and foliar Zn biofortification, applied as an aqueous solution of 0.5% zinc sulphate (ZnSO4·7H2O), on triticale (x Triticosecale) grown under Mediterranean conditions. The study was conducted over two growing seasons (2017/18 and 2018/19) in southern Spain, evaluating the effects on biomass yield; forage quality, including crude protein, Van Soest detergent fiber, organic matter digestibility, and relative forage value; and nutrient accumulation. Soil treatment consisted in the application of 50 kg of ZnSO4·7H2O ha-1 solely at the beginning of the first campaign to assess the residual effect on the second year. In contrast, the foliar treatment consisted of two applications of 4 kg of ZnSO4·7H2O ha-1 per campaign, one at the beginning of tillering and the other at the appearance of the first node. The foliar application increased the Zn content of the forage to adequate levels, while the soil application resulted in a 33% increase in biomass production, which is particularly beneficial for farmers. Overall quality was favored by the combined soil + foliar application, and no adverse antagonistic effects on other nutrients were detected. Instead, a synergistic interaction between Se and Zn was observed, which improved the efficacy of this important micronutrient for livestock and human wellbeing.

Serotonin Syndrome: An Emerging Reality in the Emergency Department.

Serotonin syndrome (SS) is an entity caused by interference with the serotonin metabolism and/or by medications that act as serotonin receptor agonists. The signs and symptoms are nonspecific, making the diagnosis challenging. Treatment depends on the severity of the manifestations. In mild to moderate cases, it typically resolves within the first 24 hours after initiating therapy and discontinuation of the serotoninergic medications. A 42-year-old woman with a previous history of depression was admitted to the hospital due to the voluntary ingestion of multiple tablets of escitalopram 10 mg and venlafaxine 75 mg. Physical examination showed a hyperthermic and diaphoretic patient. Tremor, agitation, bilateral ocular clonus, and spontaneous inferior limb clonus were also present. Hunter's criteria were applied, and the diagnosis of SS was assumed. Supportive and symptomatic treatments were initiated. The evolution was benign, with symptomatic remission in the first 24 hours. In the last decades, a large increase in the use of antidepressants was noted, and, as such, defining SS as rare is no longer appropriate. Delaying the treatment can dictate an increase in morbidity and mortality. It is important to highlight that the diagnosis is mainly clinical as diagnostic criteria may miss out on some cases. As such, clinical awareness of SS's multiplicity of presentations is of utmost importance.

Refractory pruritus in primary biliary cirrhosis.

Pruritus is a major symptom of primary biliary cirrhosis, cholestatic autoimmune disease which affects mostly middle-age women. Often, it can be severe and refractory to multiple treatments, and mostly affecting the patient's health-related quality of life. Intense pruritus can be itself an indication to liver transplantation, in extreme cases leading to suicide. Its physiopathology has not yet been fully elucidated, but recent studies added the elevation of autotaxin and lysophosphatidic acid to the group of classic mechanisms already linked to cholestatic pruritus. In this case report we illustrate how ultraviolet B phototherapy appears to successfully control severe pruritus and contribute to the healing of pruritic skin lesions caused by intense scratching. There is limited medical literature concerning this therapeutic approach on cholestatic pruritus, but we hope that further randomised controlled trials will successfully establish it as an effective treatment in the near future.