Thermal tolerance does not explain the altitudinal segregation of lowland and alpine aquatic insects

Elevation gradients provide powerful study systems for examining the influence of environmental filters in shaping species assemblages. High-mountain habitats host specific high-elevation assemblages, often comprising specialist species adapted to endure pronounced abiotic stress, while such harsh conditions prevent lowland species from colonizing or establishing. While thermal tolerance may drive the altitudinal segregation of ectotherms, its role in structuring aquatic insect communities remains poorly explored. This study investigates the role of thermal physiology in shaping the current distribution of high-mountain diving beetles from the Sierra Nevada Iberian mountain range and closely related lowland species. Cold tolerance of five species from each altitudinal zone was measured estimating the supercooling point (SCP), lower lethal temperature (LLT) and tolerance to ice enclosure, while heat tolerance was assessed from the heat coma temperature (HCT). Alpine species exhibited wider fundamental thermal niches than lowland species, likely associated with the broader range of climatic conditions in high-mountain areas. Cold tolerance did not seem to prevent lowland species from colonizing higher elevations, as most studied species were moderately freeze-tolerant. Therefore, fundamental thermal niches seem not to fully explain species segregation along elevation gradients, suggesting that other thermal tolerance traits, environmental factors, and biotic interactions may also play important roles.

Cerebrospinal fluid neopterin as a biomarker of neuroinflammatory diseases

The elevation of neopterin in cerebrospinal fluid (CSF) has been reported in several neuroinflammatory disorders. However, it is not expected that neopterin alone can discriminate among different neuroinflammatory etiologies. We conducted an observational retrospective and case-control study to analyze the CSF biomarkers neopterin, total proteins, and leukocytes in a large cohort of pediatric patients with neuroinflammatory disorders. CSF samples from 277 subjects were included and classified into four groups: Viral meningoencephalitis, bacterial meningitis, acquired immune-mediated disorders, and patients with no-immune diseases (control group). CSF neopterin was analyzed with high-performance liquid chromatography. Microbiological diagnosis included bacterial CSF cultures and several specific real-time polymerase chain reactions. Molecular testing for multiple respiratory pathogens was also included. Antibodies against neuronal and glial proteins were tested. Canonical discriminant analysis of the three biomarkers was conducted to establish the best discriminant functions for the classification of the different clinical groups. Model validation was done by biomarker analyses in a new cohort of 95 pediatric patients. CSF neopterin displayed the highest values in the viral and bacterial infection groups. By applying canonical discriminant analysis, it was possible to classify the patients into the different groups. Validation analyses displayed good results for neuropediatric patients with no-immune diseases and for viral meningitis patients, followed by the other groups. This study provides initial evidence of a more efficient approach to promote the timely classification of patients with viral and bacterial infections and acquired autoimmune disorders. Through canonical equations, we have validated a new tool that aids in the early and differential diagnosis of these neuroinflammatory conditions.

Efficacy of Human Monoclonal Antibody Monotherapy Against Bundibugyo Virus Infection in Nonhuman Primates

Background

The 2013-2016 Ebola virus disease (EVD) epidemics in West Africa highlighted a need for effective therapeutics for treatment of the disease caused by filoviruses. Monoclonal antibodies (mAbs) are promising therapeutic candidates for prophylaxis or treatment of virus infections. Data about efficacy of human mAb monotherapy against filovirus infections in preclinical nonhuman primate models are limited.

Methods

Previously, we described a large panel of human mAbs derived from the circulating memory B cells from Bundibugyo virus (BDBV) infection survivors that bind to the surface glycoprotein (GP) of the virus. We tested one of these neutralizing mAbs that recognized the glycan cap of the GP, designated mAb BDBV289, as monotherapy in rhesus macaques.

Results

We found that recombinant mAb BDBV289-N could confer up to 100% protection to BDBV-infected rhesus macaques when treatment was initiated as late as 8 days after virus challenge. Protection was associated with survival and decreased viremia levels in the blood of treated animals.

Conclusions

These findings define the efficacy of monotherapy of lethal BDBV infection with a glycan cap-specific mAb and identify a candidate mAb therapeutic molecule that could be included in antibody cocktails for prevention or treatment of ebolavirus infections.

A real case study on the physicochemical changes in crude palm oil (

The objective of this study was to evaluate the physicochemical changes in crude palm oil during a real case of deep-frying of akara, cowpea-paste balls, fried and sold in the streets of Brazil. Discontinuous frying over five consecutive days, using 5-h frying a day, was performed according to traditional practices. The formation of polar compounds was evaluated by the IUPAC official method and by quick tests based on measures of physical properties, Testo 270 and Fri-check. In addition, 1H-NMR spectroscopy was applied to evaluate physicochemical changes. The results showed that after 15-h frying the total content of polar compounds (TPC) exceeded the limit of 25% established in most of the recommendations and regulations on heated oils. Such a level was reached quickly due to the high content of hydrolytic compounds present in the fresh oil and to the inappropriate use of blends of fresh and used oil in the oil replenishment. The two quick tests presented significantly lower values for TPC than the official method, probably due to the elevated hydrolysis of the fresh oil. In contrast, 1H-NMR results exhibited changes in the fatty acid composition which were similar to those provided by the common GC analysis. The use of crude palm oils of better initial quality and replenishment with fresh oil only are recommended to improve the quality of the oil absorbed by akara.

Development of a Human Antibody Cocktail that Deploys Multiple Functions to Confer Pan-Ebolavirus Protection

Passive administration of monoclonal antibodies (mAbs) is a promising therapeutic approach for Ebola virus disease (EVD). However, all mAbs and mAb cocktails that have entered clinical development are specific for a single member of the Ebolavirus genus, Ebola virus (EBOV), and ineffective against outbreak-causing Bundibugyo virus (BDBV) and Sudan virus (SUDV). Here, we advance MBP134, a cocktail of two broadly neutralizing human mAbs, ADI-15878 from an EVD survivor and ADI-23774 from the same survivor but specificity-matured for SUDV GP binding affinity, as a candidate pan-ebolavirus therapeutic. MBP134 potently neutralized all ebolaviruses and demonstrated greater protective efficacy than ADI-15878 alone in EBOV-challenged guinea pigs. A second-generation cocktail, MBP134AF, engineered to effectively harness natural killer (NK) cells afforded additional improvement relative to its precursor in protective efficacy against EBOV and SUDV in guinea pigs. MBP134AF is an optimized mAb cocktail suitable for evaluation as a pan-ebolavirus therapeutic in nonhuman primates.

Modeling the two- and three-dimensional displacement field in Lorca, Spain, subsidence and the global implications

Land subsidence associated with overexploitation of aquifers is a hazard that commonly affects large areas worldwide. The Lorca area, located in southeast Spain, has undergone one of the highest subsidence rates in Europe as a direct consequence of long-term aquifer exploitation. Previous studies carried out on the region assumed that the ground deformation retrieved from satellite radar interferometry corresponds only to vertical displacement. Here we report, for the first time, the two- and three-dimensional displacement field over the study area using synthetic aperture radar (SAR) data from Sentinel-1A images and Global Navigation Satellite System (GNSS) observations. By modeling this displacement, we provide new insights on the spatial and temporal evolution of the subsidence processes and on the main governing mechanisms. Additionally, we also demonstrate the importance of knowing both the vertical and horizontal components of the displacement to properly characterize similar hazards. Based on these results, we propose some general guidelines for the sustainable management and monitoring of land subsidence related to anthropogenic activities.

Frying performance of two virgin oils from <em>Cornicabra</em> olives with different ripeness indices

The frying performance of two virgin olive oils (VOO) from Cornicabra olives of different ripeness indices, 2.08 for VOO1 and 4.13 for VOO2, was evaluated. Thermal, oxidative and hydrolytic alterations were determined throughout 40 frying operations with potatoes. The initial oils showed similar fatty acid compositions and oxidative stability indices as determined by Rancimat, but VOO1 presented higher amounts of total polyphenols and tocopherols. The oils showed high and similar frying performance. No significant differences in the levels of polar compounds (PC) were found between the two oils during frying. Therefore, the frying stability of Cornicabra VOOs appears to be unconnected with olive fruit ripeness. The limit of degradation at 25% PC as established in different countries was calculated to occur at 55 frying operations in the two oils. As oil toxicity is related to the levels of compounds formed, the use of Cornicabra VOOs for frying is highly recommended.

Therapeutic treatment of Marburg and Ravn virus infection in nonhuman primates with a human monoclonal antibody

As observed during the 2013-2016 Ebola virus disease epidemic, containment of filovirus outbreaks is challenging and made more difficult by the lack of approved vaccine or therapeutic options. Marburg and Ravn viruses are highly virulent and cause severe and frequently lethal disease in humans. Monoclonal antibodies (mAbs) are a platform technology in wide use for autoimmune and oncology indications. Previously, we described human mAbs that can protect mice from lethal challenge with Marburg virus. We demonstrate that one of these mAbs, MR191-N, can confer a survival benefit of up to 100% to Marburg or Ravn virus-infected rhesus macaques when treatment is initiated up to 5 days post-inoculation. These findings extend the small but growing body of evidence that mAbs can impart therapeutic benefit during advanced stages of disease with highly virulent viruses and could be useful in epidemic settings.

Metabolic and reproductive plasticity of core and marginal populations of the eurythermic saline water bug Sigara selecta (Hemiptera: Corixidae) in a climate change context

Ongoing climate change is driving dramatic range shifts in diverse taxa worldwide, and species responses to global change are likely to be determined largely by population responses at geographical range margins. Here we investigate the metabolic and reproductive plasticity in response to water temperature and salinity variation of two populations of the eurythermic saline water bug Sigara selecta: one population located close to the northern edge of its distribution, in a relatively cold, thermally stable region (SE England - 'marginal'), and one close to the range centre, in a warmer and more thermally variable Mediterranean climate (SE Spain - 'core'). We compared metabolic and oviposition rates and egg size, following exposure to one of four different combinations of temperature (15 and 25°C) and salinity (10 and 35gL^-1). Oviposition rate was significantly higher in the marginal population, although eggs laid were smaller overall. No significant differences in oxygen consumption rates were found between core and marginal populations, although the marginal population showed higher levels of plasticity in both metabolic and reproductive traits. Our results suggest that population-specific responses to environmental change are complex and may be mediated by differences in phenotypic plasticity. In S. selecta, the higher plasticity of the marginal population may facilitate both its persistence in current habitats and northward expansion with future climatic warming. The less plastic core population may be able to buffer current environmental variability with minor changes in metabolism and fecundity, but could be prone to extinction if temperature and salinity changes exceed physiological tolerance limits in the future.

Functional redundancy as a tool for bioassessment: A test using riparian vegetation

There is an urgent need to track how natural systems are responding to global change in order to better guide management efforts. Traditionally, taxonomically based metrics have been used as indicators of ecosystem integrity and conservation status. However, functional approaches offer promising advantages that can improve bioassessment performance. In this study, we aim to test the applicability of functional redundancy (FR), a functional feature related to the stability, resistance and resilience of ecosystems, as a tool for bioassessment, looking at woody riparian communities in particular. We used linear mixed-effect models to investigate the response of FR and other traditional biomonitoring indices to natural (drought duration) and anthropogenic stress gradients (flow regulation and agriculture) in a Mediterranean basin. Such indices include species richness, a taxonomic index, and the Riparian Quality Index, which is an index of ecological status. Then, we explored the ability of FR and the other indices to discriminate between different intensities of human alteration. FR showed higher explanatory capacity in response to multiple stressors, although we found significant negative relationships between all the biological indices (taxonomic, functional and ecological quality) and stress gradients. In addition, FR was the most accurate index to discriminate among different categories of human alteration in both perennial and intermittent river reaches, which allowed us to set threshold values to identify undisturbed (reference condition), moderately disturbed and highly disturbed reaches in the two types of river. Using these thresholds and the best-fitting model, we generated a map of human impact on the functional redundancy of riparian communities for all the stretches of the river network. Our results demonstrate that FR presents clear advantages over traditional methods, which suggests that it should be part of the biomonitoring toolbox used for environmental management so as to obtain better predictions of ecosystem response to environmental changes.

3B11-N, a monoclonal antibody against MERS-CoV, reduces lung pathology in rhesus monkeys following intratracheal inoculation of MERS-CoV Jordan-n3/2012

Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was identified in 2012 as the causative agent of a severe, lethal respiratory disease occurring across several countries in the Middle East. To date there have been over 1600 laboratory confirmed cases of MERS-CoV in 26 countries with a case fatality rate of 36%. Given the endemic region, it is possible that MERS-CoV could spread during the annual Hajj pilgrimage, necessitating countermeasure development. In this report, we describe the clinical and radiographic changes of rhesus monkeys following infection with 5×10⁶ PFU MERS-CoV Jordan-n3/2012. Two groups of NHPs were treated with either a human anti-MERS monoclonal antibody 3B11-N or E410-N, an anti-HIV antibody. MERS-CoV Jordan-n3/2012 infection resulted in quantifiable changes by computed tomography, but limited other clinical signs of disease. 3B11-N treated subjects developed significantly reduced lung pathology when compared to infected, untreated subjects, indicating that this antibody may be a suitable MERS-CoV treatment.

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MERS-CoV Jordan-n3/2012 challenge of rhesus monkeys results in a mild disease.

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CT can be used to monitor disease progression to aid models of human disease.

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Treatment with the human monoclonal antibody 3B11-N resulted in decreased disease.

Multicomponent Quantum Hall Ferromagnetism and Landau Level Crossing in Rhombohedral Trilayer Graphene

Using transport measurements, we investigate multicomponent quantum Hall (QH) ferromagnetism in dual-gated rhombohedral trilayer graphene (r-TLG) in which the real spin, orbital pseudospin, and layer pseudospins of the lowest Landau level form spontaneous ordering. We observe intermediate QH plateaus, indicating a complete lifting of the degeneracy of the zeroth Landau level (LL) in the hole-doped regime. In charge neutral r-TLG, the orbital degeneracy is broken first, and the layer degeneracy is broken last and only in the presence of an interlayer potential U⊥. In the phase space of U⊥ and filling factor ν, we observe an intriguing "hexagon" pattern, which is accounted for by a model based on crossings between symmetry-broken LLs.

Intensive care practices in brain death diagnosis and organ donation

We conducted a multicentre study of 1844 patients from 42 Spanish intensive care units, and analysed the clinical characteristics of brain death, the use of ancillary testing, and the clinical decisions taken after the diagnosis of brain death. The main cause of brain death was intracerebral haemorrhage (769/1844, 42%), followed by traumatic brain injury (343/1844, 19%) and subarachnoid haemorrhage (257/1844, 14%). The diagnosis of brain death was made rapidly (50% in the first 24 h). Of those patients who went on to die, the Glasgow Coma Scale on admission was ≤ 8/15 in 1146/1261 (91%) of patients with intracerebral haemorrhage, traumatic brain injury or anoxic encephalopathy; the Hunt and Hess Scale was 4-5 in 207/251 (83%) of patients following subarachnoid haemorrhage; and the National Institutes of Health Stroke Scale was ≥ 15 in 114/129 (89%) of patients with strokes. Brain death was diagnosed exclusively by clinical examination in 92/1844 (5%) of cases. Electroencephalography was the most frequently used ancillary test (1303/1752, 70.7%), followed by transcranial Doppler (652/1752, 37%). Organ donation took place in 70% of patients (1291/1844), with medical unsuitability (267/553, 48%) and family refusal (244/553, 13%) the main reasons for loss of potential donors. All life-sustaining measures were withdrawn in 413/553 of non-donors (75%).

A tripartite cocktail of chimeric monoclonal antibodies passively protects mice against ricin, staphylococcal enterotoxin B and Clostridium perfringens epsilon toxin

Due to the fast-acting nature of ricin, staphylococcal enterotoxin B (SEB), and Clostridium perfringens epsilon toxin (ETX), it is necessary that therapeutic interventions following a bioterrorism incident by one of these toxins occur as soon as possible after intoxication. Moreover, because the clinical manifestations of intoxication by these agents are likely to be indistinguishable from each other, especially following aerosol exposure, we have developed a cocktail of chimeric monoclonal antibodies that is capable of neutralizing all three toxins. The efficacy of this cocktail was demonstrated in mouse models of lethal dose toxin challenge.

Photocatalytic Activity of ZnO-Biochar Hybrid Composites

<span>Photodegradation of methylene blue (MB) was studied on ZnO in presence of home-made biochars </span><span>prepared by different methods. MB photodegradation was performed under UV-visible irradiation to verify </span><span>the scaling-up of ZnO-AC hybrid materials. It was verified that oxygenated surface groups on carbon were </span><span>photochemically active in the photodegradation of MB and a synergy effect between both solids has been </span><span>estimated from the first-order apparent rate-constants. This effect enhances the photoactivity of ZnO up to </span><span>a factor about 2.5 and the difference in photoactivity in the binary materials was associated to the surface </span><span>properties of AC.</span>

Prevention and treatment of Clostridium perfringens epsilon toxin intoxication in mice with a neutralizing monoclonal antibody (c4D7) produced in Nicotiana benthamiana

Epsilon toxin (ETX), produced by Clostridium perfringens types B and D, is among the most lethal toxins known. ETX is a potential bioterrorism threat that was listed as a Category B agent by the U.S. Centers for Disease Control until 2012 and it still remains a toxin of interest for several government agencies. We produced a monoclonal antibody (MAb) against ETX (ETX MAb c4D7) in Nicotiana benthamiana and characterized its preventive and therapeutic efficacy in mice. The ETX preparation used was highly lethal for mice (LD50 = 1.6 μg/kg) and resulted in a mean time from inoculation to death of 18 and 180 min when administered intravenously or intraperitoneally, respectively. High lethal challenge resulted in dramatic increases of a variety of pro-inflammatory cytokines in serum, while lower, but still lethal doses, did not elicit such responses. ETX MAb c4D7 was highly effective prophylactically (ED50 = 0.3 mg/kg; ED100 = 0.8 mg/kg) and also provided protection when delivered 15-30 min post-ETX intoxication. These data suggest that ETX MAb c4D7 may have use as a pre- and post-exposure treatment for ETX intoxication.

Reversion of advanced Ebola virus disease in nonhuman primates with ZMapp

Without an approved vaccine or treatments, Ebola outbreak management has been limited to palliative care and barrier methods to prevent transmission. These approaches, however, have yet to end the 2014 outbreak of Ebola after its prolonged presence in West Africa. Here we show that a combination of monoclonal antibodies (ZMapp), optimized from two previous antibody cocktails, is able to rescue 100% of rhesus macaques when treatment is initiated up to 5 days post-challenge. High fever, viraemia and abnormalities in blood count and blood chemistry were evident in many animals before ZMapp intervention. Advanced disease, as indicated by elevated liver enzymes, mucosal haemorrhages and generalized petechia could be reversed, leading to full recovery. ELISA and neutralizing antibody assays indicate that ZMapp is cross-reactive with the Guinean variant of Ebola. ZMapp exceeds the efficacy of any other therapeutics described so far, and results warrant further development of this cocktail for clinical use.

Photoinduced doping in heterostructures of graphene and boron nitride

The design of stacks of layered materials in which adjacent layers interact by van der Waals forces has enabled the combination of various two-dimensional crystals with different electrical, optical and mechanical properties as well as the emergence of novel physical phenomena and device functionality. Here, we report photoinduced doping in van der Waals heterostructures consisting of graphene and boron nitride layers. It enables flexible and repeatable writing and erasing of charge doping in graphene with visible light. We demonstrate that this photoinduced doping maintains the high carrier mobility of the graphene/boron nitride heterostructure, thus resembling the modulation doping technique used in semiconductor heterojunctions, and can be used to generate spatially varying doping profiles such as p-n junctions. We show that this photoinduced doping arises from microscopically coupled optical and electrical responses of graphene/boron nitride heterostructures, including optical excitation of defect transitions in boron nitride, electrical transport in graphene, and charge transfer between boron nitride and graphene.

Transport measurement of Landau level gaps in bilayer graphene with layer polarization control

Landau level (LL) gaps are important parameters for understanding electronic interactions and symmetry-broken processes in bilayer graphene (BLG). Here we present transport spectroscopy measurements of LL gaps in double-gated suspended BLG with high mobilities in the quantum Hall regime. By using bias as a spectroscopic tool, we measure the gap Δ for the quantum Hall (QH) state at filling factors ν = ±4 and -2. The single-particle Δ(ν=4) scales linearly with magnetic field B and is independent of the out-of-plane electric field E⊥. For the symmetry-broken ν = -2 state, the measured values of Δ(ν=-2) are ∼1.1 meV/T and 0.17 meV/T for singly gated geometry and dual-gated geometry at E⊥ = 0, respectively. The difference between the two values arises from the E⊥. dependence of Δ(ν=-2), suggesting that the ν = -2 state is layer polarized. Our studies provide the first measurements of the gaps of the broken symmetry QH states in BLG with well-controlled E⊥ and establish a robust method that can be implemented for studying similar states in other layered materials.

Water beetle tolerance to salinity and anionic composition and its relationship to habitat occupancy

Water salinity and ionic composition are among the main environmental variables that constrain the fundamental niches of aquatic species, and accordingly, physiological tolerance to these factors constitutes a crucial part of the evolution, ecology, and biogeography of these organisms. The present study experimentally estimated the fundamental saline and anionic niches of adults of two pairs of congeneric saline beetle species that differ in habitat preference (lotic and lentic) in order to test the habitat constraint hypothesis. Osmotic and anionic realised niches were also estimated based on the field occurrences of adult beetle species using Outlying Mean Index analysis and their relationship with experimental tolerances. In the laboratory, all of the studied species showed a threshold response to increased salinity, displaying high survival times when exposed to low and intermediate conductivity levels. These results suggest that these species are not strictly halophilic, but that they are able to regulate both hyperosmotically and hypoosmotically. Anionic water composition had a significant effect on salinity tolerance at conductivity levels near their upper tolerance limits, with decreased species survival at elevated sulphate concentrations. Species occupying lentic habitats demonstrated higher salinity tolerance than their lotic congeners in agreement with the habitat constraint hypothesis. As expected, realised salinity niches were narrower than fundamental niches and corresponded to conditions near the upper tolerance limits of the species. These species are uncommon on freshwater-low conductivity habitats despite the fact that these conditions might be physiologically suitable for the adult life stage. Other factors, such as biotic interactions, could prevent their establishment at low salinities. Differences in the realised anionic niches of congeneric species could be partially explained by the varying habitat availability in the study area. Combining the experimental estimation of fundamental niches with realised field data niche estimates is a powerful method for understanding the main factors constraining species' distribution at multiple scales, which is a key issue when predicting species' ability to cope with global change.

Prophylactic and therapeutic testing of Nicotiana-derived RSV-neutralizing human monoclonal antibodies in the cotton rat model

Severe lower respiratory tract infection in infants and small children is commonly caused by respiratory syncytial virus (RSV). Palivizumab (Synagis(®)), a humanized IgG1 monoclonal antibody (mAb) approved for RSV immunoprophylaxis in at-risk neonates, is highly effective, but pharmacoeconomic analyses suggest its use may not be cost-effective. Previously described potent RSV neutralizers (human Fab R19 and F2-5; human IgG RF-1 and RF-2) were produced in IgG format in a rapid and inexpensive Nicotiana-based manufacturing system for comparison with palivizumab. Both plant-derived (palivizumab-N) and commercial palivizumab, which is produced in a mouse myeloma cell line, showed protection in prophylactic (p < 0.001 for both mAbs) and therapeutic protocols (p < 0.001 and p < 0.05 respectively). The additional plant-derived human mAbs directed against alternative epitopes displayed neutralizing activity, but conferred less protection in vivo than palivizumab-N or palivizumab. Palivizumab remains one of the most efficacious RSV mAbs described to date. Production in plants may reduce manufacturing costs and improve the pharmacoeconomics of RSV immunoprophylaxis and therapy.

[Quality of care of patients with chronic heart failure in primary care]

INTRODUCTION

The prevalence of Chronic Heart Failure (CHF) in Spain is very high. It is the main cause of many hospital admissions and it is associated with high mortality rates. Its management in Primary Care is not always adequate. Our objective was to evaluate whether an educational intervention in general practitioners would improve the health care of their patients with chronic heart failure.

MATERIAL AND METHODS

Prospective, randomised, and controlled study. A structured formative course was given to the intervention group (IG) of practitioners. A year later changes were compared with a control group (CG). The settings were two Primary Care Centres. One of them was in a rural setting, and the other one with a mixture of rural and urban populations. The study included 185 patients diagnosed with CHF, with a mean age of 79.8 years, and they were assigned to 20 practitioners (Total population: 15, 921) We evaluated the quality of medical history, clinical examination, laboratory tests and treatment.

RESULTS

At the end of the study there were marked differences between both groups. In the IG, the Medical History improved 1.42 points (95% CI: 0.57 to 2.28), P = .001. The Clinical Examination improved 2.37 points (95% CI: 1.10 to 3.65), P > .001 and the Laboratory Tests, 0.75 points (95% CI: -0.15 to 1.66), P = .10; The Overall Difference was 5.44 points (95% Cl: 3.25 to 7.62), P > .001. There were slight improvements in Treatment.

CONCLUSIONS

The intervention promoted from our own work settings achieved a general improvement in the care of patients with heart failure.

Transport spectroscopy of symmetry-broken insulating states in bilayer graphene

Bilayer graphene is an attractive platform for studying new two-dimensional electron physics, because its flat energy bands are sensitive to out-of-plane electric fields and these bands magnify electron-electron interaction effects. Theory predicts a variety of interesting broken symmetry states when the electron density is at the carrier neutrality point, and some of these states are characterized by spontaneous mass gaps, which lead to insulating behaviour. These proposed gaps are analogous to the masses generated by broken symmetries in particle physics, and they give rise to large Berry phase effects accompanied by spontaneous quantum Hall effects. Although recent experiments have provided evidence for strong electronic correlations near the charge neutrality point, the presence of gaps remains controversial. Here, we report transport measurements in ultraclean double-gated bilayer graphene and use source-drain bias as a spectroscopic tool to resolve a gap of ∼2 meV at the charge neutrality point. The gap can be closed by a perpendicular electric field of strength ∼15 mV nm(-1), but it increases monotonically with magnetic field, with an apparent particle-hole asymmetry above the gap. These data represent the first spectroscopic mapping of the ground states in bilayer graphene in the presence of both electric and magnetic fields.

The relationship between fibrogenic TGFβ1 signaling in the joint and cartilage degradation in post-injury osteoarthritis

OBJECTIVE

To review the literature on modulation of chondrocyte activities in the osteoarthritic joint, and to discuss these changes in relation to established hard and soft tissue repair paradigms, with an emphasis on transforming growth factor beta (TGFβ1)-mediated signaling which can promote either a chondrogenic or fibrogenic phenotype.

METHODS

Papers addressing the close relationship between repair in general, and the specific post-injury response of joint tissues are summarized. Different interpretations of the role of TGFβ1 in the emergence of an "osteoarthritic" chondrocyte are compared and the phenotypic plasticity of "reparative" progenitor cells is examined. Lastly, emerging data on a central role for A-Disintegrin-And-Metalloproteinase-with-Thrombospondin-like-Sequences-5 (ADAMTS5) activity in modulating TGFβ1 signaling through activin receptor-like kinase 1 (ALK1) and activin receptor-like kinase 5 (ALK5) pathways is discussed.

RESULTS

The review illustrates how a transition from ALK5-mediated fibrogenic signaling to ALK1-mediated chondrogenic signaling in joint cells represents the critical transition from a non-reparative to a reparative cell phenotype. Data from cell and in vivo studies illustrates the mechanism by which ablation of ADAMTS5 activity allows the transition to reparative chondrogenesis. Multiple large gene expression studies of normal and osteoarthritis (OA) human cartilages (CAs) also support an important role for TGFβ1-mediated pro-fibrogenic activities during disease progression.

CONCLUSIONS

We conclude that progressive articular CA damage in post-injury OA results primarily from biomechanical, cell biologic and mediator changes that promote a fibroblastic phenotype in joint cells. Since ADAMTS5 and TGFβ1 appear to control this process, agents which interfere with their activities may not only enhance endogenous CA repair in vivo, but also improve the properties of tissue-engineered CA for implantation.

Comparison of methods to evaluate the quality of the Mediterranean diet in a large representative sample of young people in Southern Spain

The objective of this study was to compare the usefulness of two methods to evaluate diet quality in young people in Southern Spain: a new Mediterranean Diet Pattern (MDP) and a modification of the Diet Quality Index-International (DQI-I) for the Mediterranean area. The study population was 3190 schoolchildren aged 8-15 yrs. The questionnaires used were first validated (Bland-Altman plot and Wilcoxon tests) in a randomized sample. The DQI gives a more detailed evaluation of food components, whereas the MDS gives global information on food groups but includes foods characteristically consumed in the Mediterranean region. Highly similar results were obtained using the MDP and the adapted DQI-I, which appear to be equally useful to evaluate diet quality in a Mediterranean population. The fact that we selected the same types of food for both indices may explain the similar overall evaluations. According to these results, both methods appear to be equally appropriate for evaluating diet quality in a Mediterranean population.

Persistent microalbuminuria after treatment with renin-angiotensin axis blockers: causes and results of treatment intensification

AIMS

The first phase of this study aimed to determine the causes of persistent microalbuminuria after treatment with renin-angiotensin axis (RAA) blocking drugs. In a second phase we tried to determine if strict control of blood pressure and intensive RAA blockade could induce remission or reduction of microalbuminuria in clinical (primary care) practice.

PATIENTS AND METHODS

The study included both diabetic patients and non-diabetic hypertensive patients treated with RAA drugs in the presence of microalbuminuria. 211 patients were recruited (mean age 66.6±11.3 years, 111 men, 117 were diabetic). In the first phase treatment was optimized at standard doses. In the second phase treatment was increased during a three months period to reach a blood pressure (BP) < 130/80 mmHg by adding other antihypertensive treatment and to obtain maximal RAA blockade using long-acting drugs, increased dosage, or adding further medication at night.

RESULTS

Initial mean BP was 141±16/81±11 mmHg. BP control was unsatisfactory (control of systolic blood pressure [SBP] 19.3%; diastolic blood pressure [DBP] 37.6%). Dosage of RAA blocking drugs was inadequate in 21% of patients. Only 27.4% of patients were taking antihypertensive drugs at night. 30.1% of patients took once daily short acting drugs. During the studymean SBP was reduced to 137±13 mmHg (p < .001) and DBP decreased to 79±10 mmHg (p < .001). Control of SBP improved to 24.5% and DBP control went to 44.4%. Mean microalbuminuria decreased from 64.4±47.0 mg/day to 50.1±53.0 mg/day (p < .001) and the prevalence of microalbuminuria was reduced to 59.1%.

CONCLUSIONS

Persistent microalbuminuria was associated with poor blood pressure control and inadequate drug dosage. Low frequency of administration of drugs at night and inappropriate once-daily pills intake were frequent. Strict control of blood pressure and intensive RAA blockade significantly reduced the prevalence of microalbuminuria.

Production of pharmaceutical-grade recombinant aprotinin and a monoclonal antibody product using plant-based transient expression systems

Plants have been proposed as an attractive alternative for pharmaceutical protein production to current mammalian or microbial cell-based systems. Eukaryotic protein processing coupled with reduced production costs and low risk for mammalian pathogen contamination and other impurities have led many to predict that agricultural systems may offer the next wave for pharmaceutical product production. However, for this to become a reality, the quality of products produced at a relevant scale must equal or exceed the predetermined release criteria of identity, purity, potency and safety as required by pharmaceutical regulatory agencies. In this article, the ability of transient plant virus expression systems to produce a wide range of products at high purity and activity is reviewed. The production of different recombinant proteins is described along with comparisons with established standards, including high purity, specific activity and promising preclinical outcomes. Adaptation of transient plant virus systems to large-scale manufacturing formats required development of virus particle and Agrobacterium inoculation methods. One transient plant system case study illustrates the properties of greenhouse and field-produced recombinant aprotinin compared with an US Food and Drug Administration-approved pharmaceutical product and found them to be highly comparable in all properties evaluated. A second transient plant system case study demonstrates a fully functional monoclonal antibody conforming to release specifications. In conclusion, the production capacity of large quantities of recombinant protein offered by transient plant expression systems, coupled with robust downstream purification approaches, offers a promising solution to recombinant protein production that compares favourably to cell-based systems in scale, cost and quality.

[Study of nutritional menus offered at noon school in Granada]

OBJECTIVE

It has been considered a study of nutritional menus offered at noon School in Granada. Balanced diet in children and youth will enable the prevention of diseases in adulthood. Comparing the menus prepared on school and the services offered by catering.

MATERIAL AND METHODS

The menus are aimed at 5,399 children from Granada, analyzed 354 school menus from 29 centres, public and private schools. Eleven colleges have their own kitchen, while 18 had hired a catering service. The amounts provided in each menu were estimated using standardized photographs of different sizes ration identified by those responsible for the dining room or by weighing Served directly from the ration. Nutritional assessment was determined by software, and the statistical treatment with the program SPSS v. 15.0.

RESULTS

There were statistically significant differences in the intakes of energy and nutrients from the menus developed in the centres and catering services. In the catering firms, the available energy and nutrition is similar, and in the menus prepared at the centres, there are significant differences in relation to some nutrients, depending on whether public school or private.

CONCLUSIONS

The energy, protein and lipid is high and low input from carbohydrates. It is the frequency of excessive consumption of meat and derivatives. To balance the diet of school, it is necessary to complement the menu of midday meals with the rest of the day.