Readability and Comprehension of Anesthesia Informed Consent Forms in a Spanish County Hospital: An Observational Study.

(1) Background: The wording of informed consent forms could hinder their comprehension and hinder patients' autonomous choice. The objective of this study was to analyze the readability and comprehension of anesthesia informed consent forms in a Spanish county hospital. (2) Methods: Descriptive and cross-sectional study carried out on patients who were going to undergo anesthetic techniques. The readability of the forms was analyzed using the INFLESZ tool and their subjective comprehension using an ad hoc questionnaire. (3) Results: The analyzed forms presented a "somewhat difficult" legibility. A total of 44.2% of the patients decided not to read the form, mainly because they had previously undergone surgery with the same anesthetic technique. The language used in the forms was considered inadequate by 49.5% of the patients and 53.3% did not comprehend it in its entirety. A statistically significant negative correlation of age and INFLESZ readability score with the overall questionnaire score was found. A statistically significant association was observed as a function of age and educational level with the different criteria of the questionnaire. (4) Conclusions: The anesthesia informed consent forms presented low readability with limited comprehension. It would be necessary to improve their wording to favor comprehension and to guarantee patients' freedom of choice.

Is central venous catheter in haemodialysis still the main factor of mortality after hospitalization?

BACKGROUND: Haemodialysis is the most frequently prescribed Renal Replacement Therapy modality worldwide. However, patients undergoing this therapy have an unpredictable evolution related to vascular access. OBJECTIVE: To determine the factors associated with the mortality and hospitalization rate in haemodialysis patients at a third-level care Centre in the Dominican Republic. METHODS: This was an observational and prospective study involving a cohort of 192 haemodialysis patients. The patient selection was non-probabilistic for convenience, and a direct source questionnaire was applied. RESULTS: Of the 192 patients in the cohort, 103 (53.6%) were hospitalized and evaluated. The most frequent cause of hospitalization was catheter-related bloodstream infections (53.4%). Almost one-third (28.2%) of the hospitalized patients died, mostly due to infections (12.6%). Of those who died 29 patients (90%) had a Central venous catheter (CVC) with a non-tunnelled catheter (NTCVC) (65.5%); having an NTC CVC makes a patient 85.5 times more likely to be hospitalized than patients with arteriovenous fistulas. CONCLUSION: Vascular access plays a predominant role in the hospitalization and mortality rates in haemodialysis. Patients with an arteriovenous fistula obtained significantly better outcomes than those with central venous catheters.

Nursing Roles in the Quality of Information in Informed Consent Forms of a Spanish County Hospital.

(1) Background: Because of their direct and continuous contact with the patient, nurses play a relevant role in ensuring that informed consent forms are complete and easy to read and comprehend. The objective of this study was to analyze the legibility and formal quality of informed consent forms for non-surgical procedures in a county hospital. (2) Methods: The readability of these forms was analyzed using the INFLESZ scale and the information they provided according to the formal quality criteria established for these forms. (3) Results: Readability was difficult in 78.08% of the forms analyzed. No form fulfilled all the criteria, the most non-compliant being the non-appearance of the verification of delivery of a copy to the patient (100%), the contraindications (94.59%), and the alternatives (83.78%) of the procedure. Statistically significant differences were observed between disciplines with respect to the INFLESZ readability score and the formal quality score, but no statistically significant correlation was found between the two scores. (4) Conclusions: The informed consent forms for non-surgical procedures analyzed presented mostly difficult readability and poor formal quality, making it difficult for patients to have understandable and complete information. Nursing professionals should be actively involved in their improvement to facilitate patient decision making.

Antihéroes que sufren trauma por estrés postraumático y villanos con trastorno de personalidad narcisista: el cisma de los problemas de salud mental en el cine / Antiheroes suffering from post-traumatic stress trauma and villains with narcissistic personality disorder: the schism of mental health problems in cinema

Actualmente existe una tendencia hacia la introducción de problemas de salud mental en los protagonistas de películas, particularmente en los antihéroes. Este hecho contrasta con la tradicional asociación de estas enfermedades con los villanos. Este manuscrito tiene el objetivo de detectar los problemas de salud mental que poseen los villanos y los antihéroes en el cine para averiguar si reciben el mismo tratamiento y si existen enfermedades estigmatizadas y vinculadas a unos y a otros. A partir del análisis cuantitativo y cualitativo de los resultados, se han identificado patrones, tendencias y se han establecido contrastes entre las narrativas de la salud mental entre villanos y antihéroes. Los hallazgos demuestran que el trastorno de estrés postraumático es el más frecuente en antihéroes, mientras que en villanos es el trastorno de personalidad narcisista, lo que evidencia los estigmas existentes en el imaginario cinematográfico.(AU)

Currently there is a trend towards the introduction of mental health problems in the protagonists of films, particularly in antiheroes. This fact contrasts with the traditional association of these diseases with villains. This manuscript has the objective of detecting the mental health problems that villains and antiheroes have in the cinema to find out if they receive the same treatment and if there are stigmatized diseases linked to each other. From the quantitative and qualitative analysis of the results, patterns, trends and contrasts have been identified between the narratives of mental health between villains and antiheroes. The findings show that post-traumatic stress disorder is the most frequent in antiheroes, while in villains it is narcissistic personality disorder, which shows the existing stigmas in the cinematographic imaginary.(AU)

Quadriceps and gluteus medius activity during stable and unstable loading exercises in athletes. A cross-sectional study.

The aim of this study was to evaluate the muscle activation of the vastus medialis, vastus lateralis, and gluteus medius during different strength and stability exercises with a water tank compared with a sandbag. A cross-sectional study was conducted in the Functional Anatomy Laboratory, and the sample consisted of 28 athletes. The main outcome measures were surface electromyography (dependent variable), water tank and sandbag, and exercise type (independent variables): Isometric Single Leg Stance (ISLS), One Leg Deadlift (OLDL), Front Rack Forward Lunge (FRFL), and Lateral Lunge (LL). Repeated measures analysis of variance (ANOVA) revealed a significant Group × Time interaction in gluteus medius root mean square (RMS) (F = 14.198, p < 0.001, ŋ2 = 0.35), vastus lateralis RMS (F = 24.374, p < 0.001, ŋ2 = 0.47), and vastus medialis RMS (F = 27.261, p < 0.001, ŋ2 = 0.50). In the between-group analysis, statistically significant differences were observed in gluteus medius RMS in the ISLS: 28.5 ± 15.8 water tank and 20.8 ± 12.6 sandbag (p < 0.001, ŋ2 = 0.08) and OLDL: 29.7 ± 13.3 water tank and 26.5 ± 13.1 sandbag (p < 0.001, ŋ2 = 0.01). In vastus lateralis in ISLS: 30.4 ± 37.6 water tank and 19.0 ± 26.7 sandbag (p < 0.001, ŋ2 = 0.03). In vastus medialis in ISLS: 14.2 ± 13.0 water tank and 7.0 ± 5.6 sandbag (p < 0.001, ŋ2 = 0.12), OLDL: 21.5 ± 16.9 water tank and 15.5 ± 10.7 sandbag (p = 0.002, ŋ2 = 0.04), and LL: 51.8 ± 29.6 water tank and 54.3 ± 29.3 sandbag (p = 0.017, ŋ2 = 0.00). These results confirm significantly greater activation of the gluteus medius and vastus medialis in the ISLS and OLDL exercises, and of the vastus lateralis in the water tank ISLS exercise. However, the vastus medialis shows greater activation in the LL exercise.

Remote monitoring as a surveillance method in patients on automated peritoneal dialysis for preventing complications and COVID-19 contagion.

BACKGROUND: Due to the health emergency of COVID-19, telemedicine has become more relevant. Remote monitoring conspicuous as a valuable tool for the clinical follow-up of kidney patients, in this case, who are treated with automated peritoneal dialysis. This study aims to describe the use of remote monitoring as a surveillance method in a cohort of patients on automated peritoneal dialysis prevent complications and COVID-19 contagion. METHODS: Study of a cohort of patients who initially participated in a randomized block clinical trial in which the use of Automated Peritoneal Dialysis with Remote Monitoring (APD-RM) was compared with conventional treatment. A descriptive analysis was performed of the rates of infection by COVID-19, the time of incidence until this, mortality, and rates of transfer to hemodialysis. In addition, survival was measured by survival curves. RESULTS: Of the 509 patients, 19 were positive for COVID-19 (incidence rate of 7.0 episodes/100 patient-year), and only six patients recovered from the infection; the death rate was 2.6 % compared to all-cause death of 9.8 %. The most affected group of patients were those over 50 years old, with 71.4 % mortality, in contrast to younger patients infected, with a mortality of 60 %. During the follow-up period, 21 patients were transferred to HD: six due to peritonitis, five due to UF failure, seven due to catheter dysfunction, one due to uremic syndrome, one due to COVID-19, and one by surgical intervention. CONCLUSION: APD-RM patients have a significant advantage over other dialysis therapies because the use of telemedicine not only provides continuity in the patient's clinical treatment but also favors the prevention of COVID-19 infection, the management and prevention of complications inherent to therapy and the preservation of the life of Peritoneal Dialysis patients.

Smartwatch: Looking beyond what you see.

BACKGROUND: The clinical utility of the Apple Inc.® smartwatch in scenarios beyond detecting atrial fibrillation has been debated. Although the device has the capability to record electrocardiograms (ECG) and detect arrhythmias, voltage limitations hinder its accuracy in measuring real voltage when recording precordial leads. This limitation poses challenges for its clinical use in diagnosing ischemia and screening cardiomyopathies. This review aims to analyze the ECG recording capacity of the Apple Watch, investigate the reasons for voltage limitations, and explore alternative approaches for its use in these clinical scenarios. METHODS: A comprehensive literature review was conducted to examine the ECG recording capacity of the Apple Watch and the limitations encountered when recording precordial leads. Data in CSV format files were analyzed to gain insights into the underlying causes of voltage limitations. RESULTS: The Apple Watch demonstrates effectiveness in detecting cardiac arrhythmias such as atrial fibrillation using photoplethysmography and ECG recording. However, voltage limitations during precordial lead recordings impede accurate voltage measurement, thereby limiting its clinical utility. Analysis of the data stored in the CSV files revealed that these voltage limitations are primarily attributed to the presentation format. Exploring alternative approaches for data processing could potentially overcome this challenge. CONCLUSIONS: This review highlights the potential for addressing voltage limitations through alternative data processing approaches. Further research is necessary to identify suitable alternatives that enable the Apple Watch to be effectively utilized in these clinical scenarios.

Type D Adipsia with Severe Hypernatremia: A Unique Presentation of an Extensive Intracranial Germinoma.

Intracranial germ cell tumors are uncommon brain tumors; germinoma is the most common tumor in children and young adults, and the most common regions affected are pineal gland and suprasellar region. Germinomas of the suprasellar region are accompanied by endocrine alterations, with adipsia being a rare presentation. Here, we present the case of a patient with an extensive intracranial germinoma whose initial presentation was adipsia, without any other endocrinological alteration, with development of severe hypernatremia and unusual manifestations derived from it, such as deep vein thrombosis, myopathy with rhabdomyolysis, and neurological axonal damage.

Occupational Exposure to Inhalational Anesthetics and Teratogenic Effects: A Systematic Review.

(1) Background: In the current healthcare environment, there is a large proportion of female staff of childbearing age, so, according to existing conflicting studies, the teratogenic effects that inhalational anesthetics may have on exposed pregnant workers should be assessed. This investigation aims to analyze the teratogenic effects of inhalational anesthetics in conditions of actual use, determining any association with spontaneous abortion or congenital malformations. (2) Methods: A systematic review was carried out according to the PRISMA statement based on PICO (problem of interest-intervention to be considered-intervention compared-outcome) (Do inhalational anesthetics have teratogenic effects in current clinical practice?). The level of evidence of the selected articles was evaluated using the SIGN scale. The databases used were PubMed, Embase, Scopus, Web of Science, Google academic and Opengrey. Primary studies conducted in professionals exposed to inhalational anesthetics that evaluate spontaneous abortions or congenital malformations, conducted in any country and language and published within the last ten years were selected. (3) Results: Of the 541 studies identified, 6 met all inclusion criteria in answering the research question. Since many methodological differences were found in estimating exposure to inhalational anesthetics, a qualitative systematic review was performed. The selected studies have a retrospective cohort design and mostly present a low level of evidence and a low grade of recommendation. Studies with the highest level of evidence do not find an association between the use of inhalational anesthetics and the occurrence of miscarriage or congenital malformations. (4) Conclusions: The administration of inhalational anesthetics, especially with gas extraction systems (scavenging systems) and the adequate ventilation of operating rooms, is not associated with the occurrence of spontaneous abortions or congenital malformations.

Key Stratification of Microbiota Taxa and Metabolites in the Host Metabolic Health-Disease Balance.

Human gut microbiota seems to drive the interaction with host metabolism through microbial metabolites, enzymes, and bioactive compounds. These components determine the host health-disease balance. Recent metabolomics and combined metabolome-microbiome studies have helped to elucidate how these substances could differentially affect the individual host pathophysiology according to several factors and cumulative exposures, such as obesogenic xenobiotics. The present work aims to investigate and interpret newly compiled data from metabolomics and microbiota composition studies, comparing controls with patients suffering from metabolic-related diseases (diabetes, obesity, metabolic syndrome, liver and cardiovascular diseases, etc.). The results showed, first, a differential composition of the most represented genera in healthy individuals compared to patients with metabolic diseases. Second, the analysis of the metabolite counts exhibited a differential composition of bacterial genera in disease compared to health status. Third, qualitative metabolite analysis revealed relevant information about the chemical nature of metabolites related to disease and/or health status. Key microbial genera were commonly considered overrepresented in healthy individuals together with specific metabolites, e.g., Faecalibacterium and phosphatidylethanolamine; and the opposite, Escherichia and Phosphatidic Acid, which is converted into the intermediate Cytidine Diphosphate Diacylglycerol-diacylglycerol (CDP-DAG), were overrepresented in metabolic-related disease patients. However, it was not possible to associate most specific microbiota taxa and metabolites according to their increased and decreased profiles analyzed with health or disease. Interestingly, positive association of essential amino acids with the genera Bacteroides were observed in a cluster related to health, and conversely, benzene derivatives and lipidic metabolites were related to the genera Clostridium, Roseburia, Blautia, and Oscillibacter in a disease cluster. More studies are needed to elucidate the microbiota species and their corresponding metabolites that are key in promoting health or disease status. Moreover, we propose that greater attention should be paid to biliary acids and to microbiota-liver cometabolites and its detoxification enzymes and pathways.

Patient experience in automated peritoneal dialysis with telemedicine monitoring during the COVID-19 pandemic in Mexico: Qualitative study.

AIM: The aim of the study was to understand the experiences of patients on automated peritoneal dialysis (APD) during the period of confinement due to the COVID-19 pandemic. DESIGN: Qualitative exploratory study, phenomenological through semi-structured telephone interview. METHOD: A priori sampling was carried out with patients on APD with remote monitoring and telephone follow-up, in 13 hospitals in Mexico. RESULTS: Twenty-nine informants, mean age 45.41 ± 16.93; 15 women and 14 men. The analysis revealed four categories of analysis: home isolation, clinical follow-up, socioeconomic challenges and infodemic. The experiences of these patients led them to somatize emotions, presenting symptoms such as anxiety, sadness, loneliness, sleep, eating and digestive disorders, situation that sets the tone for future research on telemedicine care models, coping styles, emotional support strategies and socioeconomic impact on patients with chronic home treatments during the pandemic.

Diferentes perspectivas ante las adicciones en la narrativa antiheroica de los personajes de Peaky Blinders / Different perspectives on addictions in the antiheroic narrative of the characters in Peaky Blinders

Introducción: La presente investigación analiza la narrativa y la construcción de los personajes en la serie Peaky Blinders (Knight, BBC, 2013-2022), inspirada en los acontecimientos reales que protagonizó la banda criminal de homónimo nombre a principios del siglo XX en Birmingham. El estudio tiene como objetivo determinar las diferentes perspectivas de sus protagonistas ante las adicciones y el consumo de drogas en el contexto de su época. Método: Mediante un diseño metodológico basado en la integración conceptual (Ruíz de Mendoza, 2009) de las teorías sobre narrativa audiovisual (Canet y Prósper, 2009), la crítica cinematográfica (Orellana, Almacellas y Watt, 2019), la estructura mítica y creación de personajes (Vogler, 2020) y el análisis fílmico y documental (Brisset, 2011), se analizan los personajes de Peaky Blinders, sus tramas, arcos narrativos y su papel en las diferentes temporadas de la serie con el propósito de estudiar el tratamiento de este tipo de adicciones en la ficción y reflexionar acerca de los imaginarios sociales que representan como reflejo del éxito y la decadencia de su tiempo. Resultados y discusión: El resultado de este análisis arroja una interesante reflexión sobre la representación de diferentes tipologías de drogas en la serie. Mientras el opio es tratado como parte de la construcción antiheroica del personaje principal, la cocaína sirve como activador de la violencia y la brutalidad de uno de los personajes secundarios. (AU)

Introduction: This research analyzes the narrative and the construction of the characters in the Peaky Blinders series (Knight, BBC, 2013-2022), inspired by the real events that the criminal gang of the same name starred in at the beginning of the 20th century in Birmingham. The study aims to determine the different perspectives of its protagonists regarding addictions and drug abuse in the context of their time. Method: Through a methodological design based on the conceptual integration (Ruíz de Mendoza, 2009) of the theories on audiovisual narrative (Canet and Prósper, 2009), film criticism (Orellana, Almacellas and Watt, 2019), the mythical structure and creation of characters (Vogler, 2020) and the film and documentary analysis (Brisset, 2011), we analyze the characters of Peaky Blinders, their plots, narrative arcs and their role in the different seasons of the series. This study’s purpose is to examine how drugs are represented in fiction and how they reflect the social imaginaries and the success and fall of characters and their time. Results and discussion: This analysis provides an interesting discussion on the representation of different types of drugs in the series. While opium is treated as part of the anti-heroic construction of the main character, cocaine serves as an activator for the violence and brutality of one of the secondary characters. (AU)

Different perspectives on addictions in the antiheroic narrative of the characters in Peaky Blinders / Diferentes perspectivas ante las adicciones en la narrativa antiheroica de los personajes de Peaky Blinders

Introduction: This research analyzes the narrative and the construction of the characters in the Peaky Blinders series (Knight, BBC, 2013-2022), inspired by the real events that the criminal gang of the same name starred in at the beginning of the 20th century in Birmingham. The study aims to determine the different perspectives of its protagonists regarding addictions and drug abuse in the context of their time. Method: Through a methodological design based on the conceptual integration (Ruíz de Mendoza, 2009) of the theories on audiovisual narrative (Canet and Prósper, 2009), film criticism (Orellana, Almacellas and Watt, 2019), the mythical structure and creation of characters (Vogler, 2020) and the film and documentary analysis (Brisset, 2011), we analyze the characters of Peaky Blinders, their plots, narrative arcs and their role in the different seasons of the series. This study’s purpose is to examine how drugs are represented in fiction and how they reflect the social imaginaries and the success and fall of characters and their time. Results and discussion: This analysis provides an interesting discussion on the representation of different types of drugs in the series. While opium is treated as part of the anti-heroic construction of the main character, cocaine serves as an activator for the violence and brutality of one of the secondary characters. (AU)

Introducción: La presente investigación analiza la narrativa y la construcción de los personajes en la serie Peaky Blinders (Knight, BBC, 2013-2022), inspirada en los acontecimientos reales que protagonizó la banda criminal de homónimo nombre a principios del siglo XX en Birmingham. El estudio tiene como objetivo determinar las diferentes perspectivas de sus protagonistas ante las adicciones y el consumo de drogas en el contexto de su época. Método: Mediante un diseño metodológico basado en la integración conceptual (Ruíz de Mendoza, 2009) de las teorías sobre narrativa audiovisual (Canet y Prósper, 2009), la crítica cinematográfica (Orellana, Almacellas y Watt, 2019), la estructura mítica y creación de personajes (Vogler, 2020) y el análisis fílmico y documental (Brisset, 2011), se analizan los personajes de Peaky Blinders, sus tramas, arcos narrativos y su papel en las diferentes temporadas de la serie con el propósito de estudiar el tratamiento de este tipo de adicciones en la ficción y reflexionar acerca de los imaginarios sociales que representan como reflejo del éxito y la decadencia de su tiempo. Resultados y discusión: El resultado de este análisis arroja una interesante reflexión sobre la representación de diferentes tipologías de drogas en la serie. Mientras el opio es tratado como parte de la construcción antiheroica del personaje principal, la cocaína sirve como activador de la violencia y la brutalidad de uno de los personajes secundarios. (AU)

Exploring Next Generation Probiotics for Metabolic and Microbiota Dysbiosis Linked to Xenobiotic Exposure: Holistic Approach.

Variation of gut microbiota in metabolic diseases seems to be related to dysbiosis induced by exposure to multiple substances called Microbiota Disrupting Chemicals (MDCs), which are present as environmental and dietary contaminants. Some recent studies have focused on elucidating the alterations of gut microbiota taxa and their metabolites as a consequence of xenobiotic exposures to find possible key targets involved in the severity of the host disease triggered. Compilation of data supporting the triad of xenobiotic-microbiota-metabolic diseases would subsequently allow such health misbalances to be prevented or treated by identifying beneficial microbe taxa that could be Next Generation Probiotics (NGPs) with metabolic enzymes for MDC neutralisation and mitigation strategies. In this review, we aim to compile the available information and reports focused on variations of the main gut microbiota taxa in metabolic diseases associated with xenobiotic exposure and related microbial metabolite profiles impacting the host health status. We performed an extensive literature search using SCOPUS, Web of Science, and PubMed databases. The data retrieval and thorough analyses highlight the need for more combined metagenomic and metabolomic studies revealing signatures for xenobiotics and triggered metabolic diseases. Moreover, metabolome and microbiome compositional taxa analyses allow further exploration of how to target beneficial NGP candidates according to their alleged variability abundance and potential therapeutic significance. Furthermore, this holistic approach has identified limitations and the need of future directions to expand and integrate key knowledge to design appropriate clinical and interventional studies with NGPs. Apart from human health, the beneficial microbes and metabolites identified could also be proposed for various applications under One Health, such as probiotics for animals, plants and environmental bioremediation.

Conjunctivitis in an Individual With Monkeypox.

This case report describes a case of monkeypox in a patient with HIV presenting with conjunctivitis.

Metástasis parotídea de carcinoma de células claras renal con presencia simultánea de pseudoaneurisma arterial. Caso clínico y revisión de la literatura / Parotid metastasis of clear cell renal carcinoma with simultaneous presence of arterial pseudoaneurysm. Case report and review of literature

Las metástasis en glándula parótida son muy poco frecuentes. Presentamos el caso de una mujer de 73 años cuyos antecedentes oncológicos principales a destacar son carcinoma ductal infiltrante de mama tratado con mastectomía y linfadenectomía axilar y, posteriormente, carcinoma de células renales de célula clara bilaterales metacrónicos tratados con nefrectomía radical. Desde entonces la mujer se encuentra en diálisis. Presenta tumoración en parótida de 4 cm, que radiológicamente es catalogada como pseudoaneurisma arterial intraparotídeo. Tras la extirpación de la parótida, seis años después de la última nefrectomía, en el estudio anatomopatológico se observa, junto a vasos dilatados, lesión neoplásica compatible morfológica e inmunohistoquímicamente con metástasis de carcinoma de células renales de célula clara. Se ha realizado una profunda revisión de la literatura encontrando menos de 60 casos descritos de metástasis parotídea de carcinoma de células renales de célula clara. Analizándolos observamos metástasis en otros lugares en el 61 % de los mismos, principalmente pulmonares, óseas y en glándulas adrenales, existiendo mayor porcentaje de segundas metástasis (70 %) cuando hay sincronía entre carcinoma renal y metástasis parotídea. En conclusión, presentamos un caso inusual de metástasis tardía de carcinoma renal de célula clara en parótida, y el primero, según nuestro conocimiento, que se diagnostica como hallazgo incidental en la extirpación de un aneurisma intraparotídeo. (AU)

Parotid gland metastases are very rare. We present the case of a 73-year-old woman whose main oncological history to highlight is infiltrating ductal carcinoma of the breast treated with mastectomy and axillary lymphadenectomy and after that. metachronous bilateral clear cell renal cell carcinoma treated with radical nephrectomy. Since then, the woman has been on dialysis. It presents a 4 cm parotid tumor, which is radiologically classified as an intraparotid arterial pseudoaneurysm. After extirpation of the parotid gland, six years after the last nephrectomy, in the pathological study, together with dilated vessels, a neoplastic lesion compatible morphologically and immunohistochemically with metastasis of clear cell renal cell carcinoma is observed. A thorough review of the literature has been carried out, finding less than 60 reported cases of parotid metastasis from clear cell renal cell carcinoma. Analyzing them, we observed metastases in other places in 61 % of them, mainly lung, bone and adrenal glands, with a higher percentage of second metastases (70 %) when there was a synchrony between renal carcinoma and parotid metastasis. In conclusion, we have presented an unusual case of late metastasis of clear cell renal carcinoma in the parotid, and the first –to our knowledge–, which is diagnosed as an incidental finding in the removal of an intraparotid aneurysm. (AU)

Topological and Multivalent Effects in Glycofullerene Oligomers as EBOLA Virus Inhibitors.

The synthesis of new biocompatible antiviral materials to fight against the development of multidrug resistance is being widely explored. Due to their unique globular structure and excellent properties, [60]fullerene-based antivirals are very promising bioconjugates. In this work, fullerene derivatives with different topologies and number of glycofullerene units were synthesized by using a SPAAC copper free strategy. This procedure allowed the synthesis of compounds 1-3, containing from 20 to 40 mannose units, in a very efficient manner and in short reaction times under MW irradiation. The glycoderivatives were studied in an infection assay by a pseudotyped viral particle with Ebola virus GP1. The results obtained show that these glycofullerene oligomers are efficient inhibitors of EBOV infection with IC50s in the nanomolar range. In particular, compound 3, with four glycofullerene moieties, presents an outstanding relative inhibitory potency (RIP). We propose that this high RIP value stems from the appropriate topological features that efficiently interact with DC-SIGN.

Incorporating the Gut Microbiome in the Risk Assessment of Xenobiotics and Identifying Beneficial Components for One Health.

Three areas of relevance to the gut microbiome in the context of One Health were explored; the incorporation of the microbiome in food safety risk assessment of xenobiotics; the identification and application of beneficial microbial components to various areas under One Health, and; specifically, in the context of antimicrobial resistance. Although challenging, focusing on the microbiota resilience, function and active components is critical for advancing the incorporation of microbiome data in the risk assessment of xenobiotics. Moreover, the human microbiota may be a promising source of beneficial components, with the potential to metabolize xenobiotics. These may have possible applications in several areas, e.g., in animals or plants for detoxification or in the environment for biodegradation. This approach would be of particular interest for antimicrobials, with the potential to ameliorate antimicrobial resistance development. Finally, the concept of resistance to xenobiotics in the context of the gut microbiome may deserve further investigation.

Multilevel predictors of climate change beliefs in Africa.

Although Africa is the most vulnerable region to climate change, little research has focused on how climate change is perceived by Africans. Using random forest methodology, we analyze survey and climate data from second-order political boundaries to explore what predicts climate change beliefs in Africa. We include five different dimensions of climate change beliefs: climate change awareness, belief in anthropogenic climate change, risk perception, the need to stop climate change, and self-efficacy. Based on these criteria we identify five key results: (1) climate change in Africa is largely perceived through its negative impacts on agriculture; (2) actual changes in local climate conditions are related to climate change beliefs; (3) authoritarian and intolerant ideologies are associated to less climate change awareness, and a diminished risk perception and belief that it must be stopped; (4) women are less likely to be aware of climate change, and (5) not speaking French, English or Portuguese is linked to a hindered understanding of climate beliefs. Our combined results can help policy makers better understand the need to jointly consider the multilevel complexities of individual beliefs and hydroclimatic data for the development of more accurate adaptation and mitigation strategies to combat the impacts of climate change in Africa.