A MEC-2/stomatin condensate liquid-to-solid phase transition controls neuronal mechanotransduction during touch sensing.

A growing body of work suggests that the material properties of biomolecular condensates ensuing from liquid-liquid phase separation change with time. How this aging process is controlled and whether the condensates with distinct material properties can have different biological functions is currently unknown. Using Caenorhabditis elegans as a model, we show that MEC-2/stomatin undergoes a rigidity phase transition from fluid-like to solid-like condensates that facilitate transport and mechanotransduction, respectively. This switch is triggered by the interaction between the SH3 domain of UNC-89 (titin/obscurin) and MEC-2. We suggest that this rigidity phase transition has a physiological role in frequency-dependent force transmission in mechanosensitive neurons during body wall touch. Our data demonstrate a function for the liquid and solid phases of MEC-2/stomatin condensates in facilitating transport or mechanotransduction, and a previously unidentified role for titin homologues in neurons.

Advances and Pitfalls of Specialized Pain Care through Public and Private Health Care Providers in Catalonia and the Balearic Islands: A Physician's Survey.

Optimal diagnosis and treatment of pain require a multidisciplinary approach that demands considerable coordination and forethought. A cross-sectional physician survey based on an online questionnaire was carried out to assess the adoption of multidisciplinary working patterns, compare the public and private models, and provide an update on the resources and organization of specialized pain care in Catalonia and the Balearic Islands. Active pain practitioners identified through the Catalan Health Service and Pain Society databases were sent an invitation in December 2020. Of the 321 physicians contacted, 91 (28.3%) answered and 71 provided complete responses (commonly anesthesiologists, representing 92 different sites; some worked at public and private sites). Up to 78.7% reported working in pain management teams, but only 53.5% were regularly involved in teaching or research activities. Thus, the proportion of multidisciplinary sites lies somewhere in-between. Median wait times were significantly shorter and within the recommended standards in private practices (e.g., 15 vs. 90 days in public practices for noncancer patients). In turn, private practices were slightly less staffed and equipped, albeit the differences did not reach statistical significance. Respondents made a median of 530 regular and 30 emergency visits per year, of which 190 involved interventional procedures. They offered a wide range of pharmacological and interventional therapies, although psychotherapy and the most sophisticated procedures were only available in ≤50% of sites. Pain clinicians and facilities are reasonably available in Catalonia, but barely more than half are truly multidisciplinary. Public and private practices differ in some aspects; the latter seems to be more accessible, but it is restricted to patients who can afford it. Compared to previous reports, this update shows both advances and outstanding issues. Multidisciplinary care could be expanded by incorporating more psychologists and some interventional procedures. The public practices should reduce wait times.

Eco-evolutionary agriculture: Host-pathogen dynamics in crop rotations.

Since its origins, thousands of years ago, agriculture has been challenged by the presence of evolving plant pathogens. Temporal rotations of host and non-host crops have helped farmers to control epidemics among other utilities, but further efforts for strategy assessment are needed. Here, we present a methodology for developing crop rotation strategies optimal for control of pathogens informed by numerical simulations of eco-evolutionary dynamics in one field. This approach can integrate agronomic criteria used in crop rotations-soil quality and cash yield-and the analysis of pathogen evolution in systems where hosts are artificially selected. Our analysis shows which rotation patterns perform better in maximising crop yield when an unspecified infection occurs, with yield being dependent on both soil quality and the strength of the epidemic. Importantly, the use of non-host crops, which both improve soil quality and control the epidemic results in similar rational rotation strategies for diverse agronomic and infection conditions. We test the repeatability of the best rotation patterns over multiple decades, an essential end-user goal. Our results provide sustainable strategies for optimal resource investment for increased food production and lead to further insights into the minimisation of pesticide use in a society demanding ever more efficient agriculture.

Prevalence of central and peripheral neuropathic pain in patients attending pain clinics in Spain: factors related to intensity of pain and quality of life.

BACKGROUND: The objective of the study was to estimate the prevalence of pure central neuropathic pain (CNP) and peripheral neuropathic pain (PNP) among patients attending pain clinics in Spain. The study also aimed to analyze factors associated with pain intensity and quality of life (QoL). METHODS: A cross-sectional study was performed including 53 patients with pure CNP and 281 with pure PNP attending in 104 pain clinics in Spain. The revised grading system proposed in 2008 to determine a definite, probable or possible diagnosis of NP was used. Pain features, psychological variables and QoL were assessed. Descriptive, bivariate and multivariate analyses were performed. RESULTS: The prevalence of pure CNP and PNP amongst neuropathic pain patients was 2.4% (95% CI: 1.7;3.1) and 12.9% (95% CI: 1.5;14.3), respectively. Comorbid anxiety, depression or sleep disorders were high in both groups, but higher in CNP patients (51.1%, 71.4%, respectively). Pain intensity in PNP patients was associated with the presence of depression and sleep disturbances. However, in CNP patients, it was related with pain in the lower limbs. The impairment of QoL was greater in CNP patients than in PNP patients; pain location, presence of depression and sleep disturbance were the factors that most negatively affected QoL. Among PNP patients, women and those with higher pain intensity had worse QoL. CONCLUSION: Pain intensity and QoL are affected by different factors in patients suffering from CNP or PNP. Identifying these factors could serve to guide therapeutic strategies and improve the QoL of patients.

Characteristics and outcomes of chronic pain patients referred to hospital pain clinics: a prospective observational study.

BACKGROUND: Understanding the patient referral patterns and medical profiles of patients attending hospital pain clinics, and the therapies offered to them, can provide a useful starting point for evaluating their effectiveness and identifying areas for improvement. METHODS: A prospective observational study was carried out. Sociodemographic and clinical data were gathered at twelve centres. The diagnoses and pain treatments provided by the referring doctors were compared with the ones provided by pain clinicians. Pain severity and patients' quality of life were measured prospectively. Descriptive statistics were compared. RESULTS: Two-hundred sixty-nine patients referred to 12 outpatient hospital pain clinics in Catalonia were followed for 3 months. Most were referred by orthopaedists (50.0%) or primary care physicians (20.2%). The mean age and time since pain onset were 59.4 and 4.1 years, respectively. Pain clinicians changed the diagnostic labels of 48.5% of the patients. Nearly all patients (89.2%) were receiving pain medications prior to referral. Treatment was modified in 94.8%. Pain clinicians used more interventional and/or alternative therapies (65.1% of patients), opioids (46.8%) and co-adjuvants (38.2%). Three months after referral, the 24-h worst and current pain severity had decreased by 30.9% and 27.8% on average, respectively. The mean (effect size) improvements in a quality of life (the EuroQol 5 Dimensions index) and pain (visual analogue scale) scores were, respectively, 0.16 (0.73) and 6.7 (0.31). CONCLUSIONS: Pain clinicians refined the diagnoses and treatments of patients referred to hospital pain clinics and improved outcomes. Relatively few patients are referred from primary care considering the prevalence of chronic pain in this setting.

Melanoma anal, importancia del diagnóstico diferencial con la enfermedad anal benigna / Anal melanoma, the importance of differential diagnosis with benign anal pathology

El melanoma anorrectal, descrito inicialmente por Moore en 1857, es un tumor infrecuente y agresivo, cuyo pronóstico suele ser infausto, con una supervivencia a los cinco años menor de 20 %. La principal importancia de este tumor radica en que suele presentarse como una tumoración anorrectal o producir sangrado, o rectorragia, por lo que el diagnóstico diferencial con la enfermedad anal benigna resulta crucial, pues el pronóstico estará condicionado por el estadio en el momento del diagnóstico. Se presenta el caso de una mujer de 70 años que consultó por sangrado rectal y cuyo diagnóstico inicial fue de trombosis hemorroidal. Tras el diagnóstico de melanoma anorrectal y el estudio de extensión negativo para metástasis, se practicó una amputación abdóminoperineal según la técnica de Miles. Tras nueve años de seguimiento, la paciente se encuentra libre de enfermedad

Anorectal melanoma was first described by Moore in 1857. Is an uncommon and aggresive tumor, with inauspicious prognosis. Five-year survival rates are less than 20%. The main important feature of this tumor is that it usually manifests as a rectal tumor or rectal bleeding; therefore, a diferential diagnosis with benign anal conditions is of utmost importance. Prognosis is conditioned by tumor stage at diagnosis. We present a 70-year-old woman with rectal bleeding with an initial diagnosis of hemorrhoidal trombosis. With the diagnosis of rectal melanoma without distant metastasis, an abdominoperineal resection (Miles operation) was performed. After 9-years follow-up, she is disease free

Necrosis grasa pericárdica asintomática / Asymptomatic pericardial fat necrosis

La necrosis grasa pericárdica es una entidad poco frecuente, benigna y de causa desconocida. Se suele presentar como un dolor torácico agudo, de características pleuríticas, en personas previamente sanas. Radiológicamente se asocia con un aumento de densidad de localización anterior, a nivel paracardíaco, de contornos bien definidos, en la radiografía de tórax posteroanterior. Con carácter excepcional, constituye un hallazgo incidental. El objetivo de esta nota clínica es presentar un caso de necrosis grasa pericárdica en un varón de 38 años asintomático, hallado intraoperatoriamente durante la resección de un carcinoma pulmonar(AU)

Pericardial fat necrosis is an uncommon benign condition of unknown cause. It presents as acute pleuritic chest pain in previously healthy persons associated with a well-defined anterior paracardiac density on posteroanterior chest radiography. Exceptionally, it constitutes an incidental finding. The objective of this study is to report a clinical case of pericardial fat necrosis in an asymptomatic 38-year-old man, found intraoperatively during a lung carcinoma resection(AU)

Hacia la Bolivia autonómica e intercultural del siglo XXI / Towards autonomic and intercultural Bolivia XXI century

Como universidad pública, la Universidad AutónomaGabriel René Moreno ingresa al debate sobre la cuestión nacional, con una propuesta sobre la necesidad de construir en Bolivia un Estado autonómico e intercultural. Esto es, un debate que permita refundar el Estado conciliando los intereses de lasociedad civil con la sociedad política, mediante la Asamblea Constituyente encargada de redactar la nueva Constitución Política del Estado.

Hacia la Bolivia autonómica e intercultural del siglo XXI / Towards autonomic and intercultural Bolivia XXI century

Como universidad pública, la Universidad AutónomaGabriel René Moreno ingresa al debate sobre la cuestión nacional, con una propuesta sobre la necesidad de construir en Bolivia un Estado autonómico e intercultural. Esto es, un debate que permita refundar el Estado conciliando los intereses de lasociedad civil con la sociedad política, mediante la Asamblea Constituyente encargada de redactar la nueva Constitución Política del Estado.

Psychometric properties of the MOS (Medical Outcomes Study) Sleep Scale in patients with neuropathic pain.

OBJECTIVE: This study assessed the psychometric properties of the MOS Sleep Scale in neuropathic pain (NeP). METHODS: Psychometric properties were tested in patients with neuropathic pain enrolled in a prospective study exploring the effectiveness of gabapentin for 3 months. Participants also completed scales for pain intensity, anxiety, depression, disability, and health-related quality of life. Feasibility, reliability, validity and sensitivity to change were measured in this study. RESULTS: Six-hundred-three patients [58.4+/-14.4 years (65.1% female), mean+/-SD] with pain for 1.2+/-3.3 years were included. The MOS Sleep Scale was acceptable (items with missing data <10% and floor and ceiling effects <50% per item and <15% per domain) and reliable (Cronbach's alpha between 0.64 and 0.87, and test-retest intraclass correlation coefficients between 0.79 and 0.91, p<0.001 for all cases). After adjusting for confounders, the MOS Sleep Scale was able to distinguish between sex, present pain intensity, level of disability and presence of anxiety or depression. Correlations with other scales were moderate; rho-coefficients between -0.21 and 0.57 (p<0.01, all cases). The scale was sensitive to change after treatment with gabapentin; after adjusting, responders (50% reduction in baseline pain) showed a decrease in sleep problems index of -25.6+/-14.3 points vs. -12.1+14.5 points in nonresponders (F=80.5, df=1/398, p<0.0001). Score reduction in summary index and subscales correlated significantly with pain intensity reduction (Pearson r-coefficients between 0.428 and 0.116, p<0.01, all cases). CONCLUSIONS: The MOS Sleep Scale showed good psychometric properties and was sensitive to changes in patients with NeP of broad aetiology.