Detection and diversity of gastrointestinal viruses in wastewater from Caracas, Venezuela, 2021-2022

Gastrointestinal viruses (GIV) are an important cause of childhood morbidity and mortality, particularly in developing countries. Their epidemiological impact in Venezuela during the COVID-19 pandemic remains unclear. GIV can also be detected in domestic sewage. Ninety-one wastewater samples from urban areas of Caracas collected over 12 months and concentrated by polyethylene-glycol-precipitation, were analyzed by multiplex reverse-transcription-PCR for rotavirus/calicivirus/astrovirus and enterovirus/klassevirus/cosavirus, and monoplex-PCR for adenovirus and Aichi virus. The overall frequency of virus detection was 46.2%, fluctuating over months, and peaking in the rainy season. Adenoviruses circulated throughout the year, especially type F41, and predominated (52.7%) over caliciviruses (29.1%) that peaked in the rainy months, rotaviruses (9.1%), cosaviruses (5.5%), astroviruses and enteroviruses (1.8%). Aichi-virus and klassevirus were absent. Rotavirus G9/G12, and P[4]/P[8]/P[14] predominated. The occurrence of GIV in wastewater reflects transmission within the population of Caracas and the persistence of a potential public health risk that needs to be adequately monitored.

Molecular characterization of human adenovirus causing infantile acute gastroenteritis in Venezuela before and after rotavirus vaccine implementation

Human adenoviruses (HAdV) of species F are commonly involved in pediatric acute gastroenteritis (AGE). The real impact on Venezuelan health is unknown. To investigate the prevalence and molecular diversity of HAdV in Venezuela, 630 fecal samples collected from children with AGE in 3 cities, from 2001 to 2013, were tested by PCR. Species F and types F40/41 were identified by REA. HAdV was detected in 123 cases (19.5%), most from outpatient females under 24 months old. A progressive and substantial increase in the detection rate was observed over time, significantly higher in rotavirus vaccinated than unvaccinated children (28.4% vs. 9.5%, P = 0.00019). Phylogenetic analysis of 28 randomly selected genomes showed high similarity among HAdV-F40/41 and those worldwide. HAdV-F of type 41 prevailed (79.8%) and clustered into 2 intratypic major clades. The significant involvement of HAdV-F41 in AGE suggests the importance of actively monitoring viral agents other than rotavirus, especially after vaccine introduction.

Spatial distribution and source identification of phthalates and organochlorine compounds in Galician mussels (NW Spain)

The spatial distribution of five phthalate esters (PAEs) and 17 organochlorine compounds (OCs) in wild and raft mussels from Galician littoral collected in 2020, and its relationship with anthropogenic activities was studied in this work. The Rías de Foz and Muros-Noia were the most polluted by PAEs, while the Rías de Ferrol and Barqueiro by PCBs. The highest levels of all contaminants were present in wild mussel, except DEHP that were predominant in raft mussel. The levels of most PAEs were negatively correlated with levels of the lower chlorinated PCBs and OCPs. The spatial distribution of pollutants confirmed by PCA was affected by the proximity to anthropogenic sources, phthalates by urban wastewater and PCBs by industrial inputs, mainly. The study of human exposure assessment suggests that Risk Quotient values were < 1, so the consumption of Galician raft mussels did not pose a risk to human health.

Hepatocellular carcinoma in Peru: A molecular description of an unconventional clinical presentation

INTRODUCTION AND AIM

Hepatocellular carcinoma (HCC) is the third most frequent cancer of digestive tract tumors in Peru, with a high mortality rate of 17.7 per 100,000 inhabitants. A significant number of HCC cases in Peru do not follow the classic clinical epidemiology of the disease described in other parts of the world. Those patients present with a distinct transcriptome profile and a singular tumor process, suggesting a particular type of hepatocarcinogenesis in a portion of the Peruvian population. Our aim was to understand the clinical and biologic involvement of the epigenetic profile (methylation) and gene expression (transcriptome) of HCC in Peruvian patients.

METHODS

HCC and liver transcriptome and DNA methylation profiles were evaluated in 74 Peruvian patients.

RESULTS

When grouped by age, there was greater DNA methylation in younger patients with HCC but no differences with respect to the transcriptomic profile. A high prevalence of the hepatitis B virus (HBV) (>90%) was also observed in the younger patients with HCC. Enrichment analyses in both molecular profiles pinpointed PRC2 as an important molecular effector of that liver tumor process in Peruvian patients.

CONCLUSION

HCC in Peruvian patients has a unique molecular profile, associated with the presence of HBV, as well as overall DNA hypermethylation related to undifferentiated liver cells or cellular reprogramming.

Optimization of micro-QuEChERS extraction coupled with gas chromatography-mass spectrometry for the fast determination of phthalic acid esters in mussel samples

In this study, a new miniaturized version of the analytical method based on the Quick, Easy, Cheap, Effective, Rugged, and Safe (QuEChERS) technique using Florisil in the cleanup step for extracting six phthalic acid esters (PAEs) in mussel samples was developed by using a design of experiments. For this purpose, 1.5 mL of ultrapure water and later, 1.5 mL of acetonitrile were added to 0.1 g of the lyophilized sample, followed by 0.3 g of a commercial extraction salt packet (magnesium sulfate, sodium chloride, sodium citrate dihydrate, and sodium hydrogencitrate sesquihydrate). The recovered extract was purified using 0.1 g of Florisil. The final extract was evaporated and reconstituted in 1 mL of hexane. The six phthalates were determined by a GC-MS (SIM) system. The whole method was validated at two concentration levels. Recoveries ranged from 79% to 108%. Reproducibility in terms of coefficients of variation was between 4.9% and 12.1%. The limits of quantification of the whole method were between 0.53 and 38.0 μg per kg dry weight. Five mussel samples coming from the Galician Rías were analysed using this method. Except for three of the five samples where DnOP (di-n-octyl phthalate) was below the limit of quantification, all PAEs were found in concentrations that ranged between 1.99 and 372.7 μg per kg dry weight.

Mechanical ventilation in Spain, 1998-2016: changes in the disconnection of mechanical ventilation

PURPOSE

To evaluate changes in the disconnection of mechanical ventilation in Spain from 1998 to 2016.

DESIGN

Post-hoc analysis of four cohort studies.

AMBIT

138 Spanish ICUs.

PATIENTS

2141 patients scheduled extubated.

INTERVENTIONS

None.

VARIABLES OF INTEREST

Demographics, reason for mechanical ventilation, complications, methods for disconnection, failure on the first attempt at disconnection, duration of weaning, reintubation, post-reintubation tracheotomy, ICU stay and mortality.

RESULTS

There was a significant increase (p<0.001) in the use of gradual reduction of support pressure. The adjusted probability of using the gradual reduction in pressure support versus a spontaneous breathing trial has increased over time, both for the first attempt at disconnection (taking the 1998 study as a reference: odds ratio 0.99 in 2004, 0.57 in 2010 and 2.43 in 2016) and for difficult/prolonged disconnection (taking the 1998 study as a reference: odds ratio 2.29 in 2004, 1.23 in 2010 and 2.54 in 2016). The proportion of patients extubated after the first attempt at disconnection has increased over time. There is a decrease in the ventilation time dedicated to weaning (from 45% in 1998 to 36% in 2016). However, the duration in difficult/prolonged weaning has not decreased (median 3 days in all studies, p=0.435).

CONCLUSIONS

There have been significant changes in the mode of disconnection of mechanical ventilation, with a progressive increase in the use of gradual reduction of pressure support. No relevant changes in outcomes have been observed.

HUMAN COSAVIRUS INFECTION IN HIV SUBJECTS WITH DIARRHOEA: PERSISTENT DETECTION ASSOCIATED WITH FATAL OUTCOME

BACKGROUND

Human cosavirus (HCoSV) is a new member of the Picornaviridae family, geographically widespread among humans. It has been suggested as a causative agent of acute gastroenteritis, but its pathogenicity is not currently certain. In HIV-infected subjects, diarrhoea is one of the most frequent gastrointestinal manifestations, whose aetiology remains often unexplained.

OBJECTIVES

To identify the cause of viral diarrhoea among HIV infected patients by molecular assays.

STUDY DESIGN

A total of 143 stool samples from HIV subjects with and without diarrhoea, were screened for conventional enteric viruses (rotavirus, adenovirus, norovirus and astrovirus) by molecular assays. The presence of HCoSV genome was investigated by nested RT-PCR for the 5'UTR region. Positive samples were further characterized by sequencing and phylogenetic analysis.

RESULTS

Enteric viruses were more frequently found in diarrhoea cases (9/82) than controls (0/61) (p=0.007). HCoSV was detected in five (3.5%) of the subjects affected by diarrhoea. Phylogenetic analysis revealed the predominance of the HCoSV species D. One patient suffered a persistent cosavirus infection with a same strain and after eight months he had a fatal outcome. No other pathogens could be detected.

CONCLUSIONS

The results suggest a role of non-conventional enteric viruses, as HCoSV, as a potential opportunistic agent causing persistent infection and deterioration of the clinical conditions in HIV-infected patients. Screening procedures and monitoring including such viruses would be helpful in the clinical management of such patients.

[Smell and taste disorders in Spanish patients with mild COVID-19]

Introduction

Coronavirus disease 2019 (COVID-19) has spread rapidly throughout the world. Smell and/or taste disorders have emerged as a very frequent symptom as the disease has spread in Europe. Spain is one of the European countries with the highest number of infections.

Objective

This study aimed to investigate the clinical progression of smell and taste disorders in Spanish patients with mild COVID-19.

Methods

An online survey was used to conduct a cross-sectional study of patients who presented sudden smell and/or taste disorders during the 2 months of total lockdown due to COVID-19 in Spain.

Results

In our sample, 91.18% of respondents with impaired smell and/or taste and who were able to undergo PCR testing were positive for SARS-CoV-2 infection. Anosmia and ageusia presented in isolation in 6.5% of participants. The remaining 93.5% presented other mild symptoms: headache (51.6%), cough (51.6%), myalgia (45.2%), asthaenia (38.7%), nasal congestion or rhinorrhoea (35.5%), fever (41.9%), low-grade fever (29.0%), odynophagia (25.8%), or diarrhoea (6.5%). The mean duration of anosmia was 8.33 days, with patients subsequently manifesting hyposmia; complete resolution occurred after a mean of 17.79 days. In 22.6% of respondents, olfactory deficits persisted. All participants recovered their sense of taste.

Conclusions

Olfactory and gustatory disorders are prevalent symptoms in mild COVID-19. Most patients do not present associated nasal congestion or rhinorrhoea and a small group of patients present these alterations in isolation.

Smell and taste disorders in Spanish patients with mild COVID-19

Introduction

Coronavirus disease 2019 (COVID-19) has spread rapidly throughout the world. Smell and/or taste disorders have emerged as a very frequent symptom as the disease has spread in Europe. Spain is one of the European countries with the highest number of infections.

Objective

This study aimed to investigate the clinical progression of smell and taste disorders in Spanish patients with mild COVID-19.

Methods

An online survey was used to conduct a cross-sectional study of patients who presented sudden smell and/or taste disorders during the 2 months of total lockdown due to COVID-19 in Spain.

Results

In our sample, 91.18% of respondents with impaired smell and/or taste and who were able to undergo PCR testing were positive for SARS-CoV-2 infection. Anosmia and ageusia presented in isolation in 6.5% of participants. The remaining 93.5% presented other mild symptoms: headache (51.6%), cough (51.6%), myalgia (45.2%), asthaenia (38.7%), nasal congestion or rhinorrhoea (35.5%), fever (41.9%), low-grade fever (29.0%), odynophagia (25.8%), or diarrhoea (6.5%). The mean duration of anosmia was 8.33 days, with patients subsequently manifesting hyposmia; complete resolution occurred after a mean of 17.79 days. In 22.6% of respondents, olfactory deficits persisted. All participants recovered their sense of taste.

Conclusions

Olfactory and gustatory disorders are prevalent symptoms in mild COVID-19. Most patients do not present associated nasal congestion or rhinorrhoea and a small group of patients present these alterations in isolation.

Qualitative disorder measurements from backscattering spectra through an optical fiber

In the processes related to the development of cancer, there are different genetic and epigenetic events involved that result in structural changes of the affected cells. In the early stages of the disease, these changes occur at the nanoscale, remaining undetectable by conventional light microscopy, due to diffraction-limited resolution (∼250 - 550 nm). In this sense, a technique termed partial wave spectroscopy (PWS) allows the detection of these nanostructural changes by measuring a statistical parameter called disorder strength (L _d ). PWS uses a combination of a tunable filter and a camera to acquire the backscattering spectra for each pixel on the image. In this paper, we study and validate the possibility of obtaining a qualitative measurement of the disorder using the spectrum of the averaged spatial information. Instead of using spatial information and measuring sequentially spectral ranges, we measure the backscattered signal gathered by an optical fiber by means of a spectrograph. This will allow this method to be applied in systems where it is not possible to acquire a complete high resolution image for many spectral bands, while significantly enhancing speed.

Mechanical ventilation in Spain, 1998-2016: Epidemiology and outcomes

PURPOSE

To evaluate changes in the epidemiology of mechanical ventilation in Spain from 1998 to 2016.

DESIGN

A post hoc analysis of four cohort studies was carried out.

SETTING

A total of 138 Spanish ICUs.

PATIENTS

A sample of 4293 patients requiring invasive mechanical ventilation for more than 12h or noninvasive ventilation for more than 1h.

INTERVENTIONS

None.

VARIABLES OF INTEREST

Demographic variables, reason for mechanical ventilation, variables related to ventilatory support (ventilation mode, tidal volume, PEEP, airway pressures), complications during mechanical ventilation, duration of mechanical ventilation, ICU stay and ICU mortality.

RESULTS

There was an increase in severity (SAPSII: 43 points in 1998 vs. 47 points in 2016), changes in the reason for mechanical ventilation (decrease in chronic obstructive pulmonary disease and acute respiratory failure secondary to trauma, and increase in neurological disease and post-cardiac arrest). There was an increase in noninvasive mechanical ventilation as the first mode of ventilatory support (p<0.001). Volume control ventilation was the most commonly used mode, with increased support pressure and pressure-regulated volume-controlled ventilation. A decrease in tidal volume was observed (9ml/kg actual b.w. in 1998 and 6.6ml/kg in 2016; p<0.001) as well as an increase in PEEP (3cmH₂O in 1998 and 6cmH₂O in 2016; p<0.001). In-ICU mortality decreased (34% in 1998 and 27% in 2016; p<0.001), without geographical variability (median OR 1.43; p=0.258).

CONCLUSIONS

A significant decrease in mortality was observed in patients ventilated in Spanish ICUs. These changes in mortality could be related to modifications in ventilation strategy to minimize ventilator-induced lung injury.

An incidental finding in newborn screening leading to the diagnosis of a patient with ECHS1 mutations

Short-chain enoyl-CoA hydratase (ECHS1) is a mitochondrial beta-oxidation enzyme involved in the metabolism of acyl-CoA fatty acid esters, as well as in valine metabolism. ECHS1 deficiency has multiple manifestations, including Leigh syndrome early at birth or in childhood with poor prognosis, to cutis laxa, exercise-induced dystonia and congenital lactic acidosis.

Here we describe the case of a newborn with mutations in ECHS1 that caught our attention after the incidental finding of 3-hydroxy-butyryl\3-hydroxy-isobutyryl\malonylcarnitine (C4OH\C3DC) and tiglylcarnitine (C5:1) on blood spot in the newborn screening (NBS) program. Diagnosis was suspected based on the analysis of organic acids on dried urine spot. A moderate increase of 2-methyl-2,3-dihydroxybutyric acid, was detected, which is a known marker of this disease. Exome analysis showed c.404A>G (p.Asn135Ser) mutation in homozygosis in the ECHS1 gene. The child was therefore admitted to the hospital. Initial examination showed little response to auditory stimuli and mild hypertonia of the extremities. Clinical deterioration was evident at 4 months of age, including neurological and cardiac involvement, and the patient died at 5 months of age. This case illustrates how an incidental detection in the NBS Program can lead to the diagnosis ECHS1 deficiency. Although it is a severe disease, with no treatment available, early detection would allow adequate genetic counseling avoiding the odyssey that suffered most of these families.

Placental levels of metals and associated factors in urban and sub-urban areas of Seville (Spain)

Environmental exposure to metals among women, revealed their adverse effects on pregnancy. The fetus is exposed to these toxic elements only via the placenta which are able to accumulate there or cross it, compromising the protective functions of this organ. Numerous studies have shown associations between the prenatal exposition to some metals and an impact on cognitive, motor and intellectual development of the child. Sixty two placental samples were taken at delivery to determine the mineral content (Al, B, Ba, Ca, Cd, Cr, Cu, Fe, K, Li, Mg, Mn, Mo, Na, Ni, Pb, Sr, V, Zn) by ICP-OES. Among these metals, essential ones (B, Ca, Cu, Fe, Mg, Mn, Mo, Na, Zn) can have health beneficial effects at low levels however, in high concentration are potentially toxic. On the other hand, elements such as Al, Cd, Pb, are classified as toxic metals, no matter what its concentration is. The aim of this study is to find the potential relationships between these metals levels, newborn's parameters, pregnancy details and the epidemiologic information obtained using a questionnaire data from the participant pregnant women from Seville (Spain). The main maternal determinant of detectable placenta Cd levels was smoking during pregnancy. Other maternal factors that may affect placenta metal levels were gestational age (Al, B, Ba, and Pb) or dietary supplement (Fe). It has to be stressed that our results have to be interpreted with caution, because of the small study group and the low exposure levels, along with the lack of information on potential sources of exposure to these metals. The use of placenta samples obtained at delivery can be considered strength of this study since the concentration of some metals in placenta can indicate the extent of maternal exposure during gestation.

Holographic waveguides in photopolymers

The possibilities that offer the holographic optical elements for photovoltaic and "see through display" applications open new windows for holographic recording materials. In this sense, some specific characteristics are required for each particular application. Waveguides are one of the key elements for these applications. Photopolymers are one of the most competitive candidates for waveguide fabrication. In this work, we evaluate the performance of one example from each of three families of photopolymer material in fabrication of a 633nm waveguide. Firstly, polyvinyl alcohol acrylamide, PVA/AA, the second one, a nanoparticle-thiol-ene, NPC, and on the last place a penta/hexa-acrylate based polymer with dispersed nematic liquid crystal molecules, PDLC. We study the critical role of the material and in particular, spatial resolution for this application.

Pepsinogen C Expression in Tumors of Extragastric Origin

We have examined by immunohistochemistry the ability of human carcinomas of various origin to produce pepsinogen C, an aspartyl proteinase mainly involved in the digestion of proteins in the stomach and recently found to be associated with breast carcinomas. Of the 268 tumors analyzed 80 (29.8%) showed positive staining for pepsinogen C. These positive tumors included 12 gastric (38.7% of the 31 examined cases), nine pancreatic (42.8%), two renal (20%), 12 prostatic (40%), three bladder (27.3%), 14 endometrial (29.7%) and 18 ovarian (40%) carcinomas. We also detected 10 melanomas (50%) that were positive for pepsinogen C. By contrast, immunohistochemical staining for the proteinase was not detected in colorectal, cervical, lung and basal cell skin carcinomas. These results demonstrate that pepsinogen C, a proteolytic enzyme of highly restricted expression in human tissues, can also be expressed by a wide variety of human carcinomas. In addition, and similar to pepsinogen C expression in breast carcinomas, the production of this enzyme by different human tumors might be related to putative hormonal alterations associated with the development and progression of these tumors.

Expression and Clinical Significance of Pepsinogen C in Resectable Pancreatic Cancer

Pepsinogen C is an aspartyl-proteinase usually involved in the digestion of proteins in the stomach, and an androgen- inducible protein in breast cancer cells. In this study we evaluated its expression and clinical significance in patients with resectable pancreatic cancer. Pepsinogen C expression was examined by immunohistochemical methods in a series of 73 pancreatic carcinomas. The prognostic value of pepsinogen C was retrospectively evaluated by multivariate analysis. A total of 21 (28.8%) pancreatic carcinomas stained positively for pepsinogen C. The percentage of pepsinogen C-positive tumors was significantly higher in well-differentiated tumors (38.3%) than in moderately differentiated (15.8%) and poorly differentiated (0%) tumors (p<0.05). In addition, statistical analysis revealed that pepsinogen C expression was associated with clinical outcome. Thus, patients with pepsinogen C-negative tumors have a poorer overall survival than those with pepsinogen C-positive tumors. Our results led us to consider that the expression of pepsinogen C may represent a useful biological marker in pancreatic cancer. Expression of this protein may be a marker of gastric-type differentiation of the tumors and it might also reflect the existence of a complete hormone receptor pathway in a subset of pancreatic carcinomas.

Human rotavirus strains circulating in Venezuela after vaccine introduction: predominance of G2P[4] and reemergence of G1P[8]

BACKGROUND

Rotavirus (RV) is the most common cause of severe childhood diarrhea worldwide. Despite Venezuela was among the first developing countries to introduce RV vaccines into their national immunization schedules, RV is still contributing to the burden of diarrhea. Concerns exist about the selective pressure that RV vaccines could exert on the predominant types and/or emergence of new strains.

RESULTS

To assess the impact of RV vaccines on the genotype distribution 1 year after the vaccination was implemented, a total of 912 fecal specimens, collected from children with acute gastroenteritis in Caracas from February 2007 to April 2008, were screened, of which 169 (18.5%) were confirmed to be RV positive by PAGE. Rotavirus-associated diarrhea occurred all year-round, although prevailed during the coolest and driest months among unvaccinated children under 24 months old. Of 165 RV strains genotyped for G (VP7) and P (VP4) by seminested multiplex RT-PCR, 77 (46.7%) were G2P[4] and 63 (38.2%) G1P[8]. G9P[8], G3P[8] and G2P[6] were found in a lower proportion (7.3%). Remarkable was also the detection of <5% of uncommon combinations (G8P[14], G8P[4], G1P[4] and G4P[4]) and 3.6% of mixed infections. A changing pattern of G/P-type distribution was observed during the season studied, with complete predominance of G2P[4] from February to June 2007 followed by its gradual decline and the reemergence of G1P[8], predominant since January 2008. Phylogenetic analysis of VP7 and VP4 genes revealed a high similarity among G2P[4] and global strains belonging to G2-II and P[4]-V lineages. The amino acid substitution 96D → N, related with reemergence of the G2 genotype elsewhere, was observed. The G1P[8] strains from Caracas were grouped into the lineages G1-I and P[8]-III, along with geographically remote G1P[8] rotaviruses, but they were rather distant from Rotarix® vaccine and pre-vaccine strains. Unique amino acid substitutions observed on neutralization domains of the VP7 sequence from Venezuelan post-vaccine G1P[8] could have conditioned their re-emergence and a more efficient dissemination into susceptible population.

CONCLUSIONS

The results suggest that natural fluctuations of genotypes in combination with forces driving the genetic evolution could determine the spread of novel strains, whose long-term effect on the efficacy of available vaccines should be determined.

An adverse immune-endocrine profile in patients with tuberculosis and type 2 diabetes

Diabetes is a risk factor for the development of pulmonary tuberculosis (TB) and both diseases present endocrine alterations likely to play a role in certain immuno-endocrine-metabolic associated disorders. Patients with TB, or with TB and type 2 diabetes (TB + T2DM) and healthy controls (HCo) were assessed for plasma levels of cortisol, dehydroepiandrosterone (DHEA), estradiol, testosterone, growth hormone (GH), prolactin, insulin-like growth factor-1 (IGF-1), cytokines (IL-6, IL-10, IFN-γ) and the specific lymphoproliferative capacity of peripheral blood mononuclear cells. All patients had higher levels of cortisol with a reduction in DHEA, thus resulting in an increased cortisol/DHEA ratio (Cort/DHEA). Increased prolactin and particularly GH levels were found in both groups of TB patients. This was not paralleled by increased concentrations of IGF, which remained within the levels of HCo. Estradiol levels were significantly augmented in patients TB, and significantly more in TB + T2DM, whereas testosterone levels were decreased in both groups of patients. IFN- γ and IL-6 concentrations were significantly increased in all TB, even further in TB + T2DM; while IL-10 was equally increased in both groups of TB patients. The in vitro specific proliferative capacity was decreased in both groups of patients as compared to that of HCo. The adverse immune-endocrine profile of TB seems to be slightly more pronounced in patients who also have T2DM.

Diffractive lenses recorded in absorbent photopolymers

Photopolymers can be appealing materials for diffractive optical elements fabrication. In this paper, we present the recording of diffractive lenses in PVA/AA (Polyvinyl alcohol acrylamide) based photopolymers using a liquid crystal device as a master. In addition, we study the viability of using a diffusion model to simulate the lens formation in the material and to study the influence of the different parameters that govern the diffractive formation in photopolymers. Once we control the influence of each parameter, we can fit an optimum recording schedule to record each different diffractive optical element with the optimum focalization power.

Time to culture conversion in smokers with pulmonary tuberculosis

Background and objective. It has been reported that tobacco smoking slows the sterilisation of sputum culture in pulmonary tuberculosis, but the factors that could delay culture conversion in patients who smoke are not known. Our aim is to identify the factors influencing sputum culture conversion in smokers with pulmonary tuberculosis. Methods. Ninety-nine patients with a smoking history and diagnosed with pulmonary tuberculosis were analysed retrospectively. The relationship between sputum culture status at the second month and the following variables: age, gender, pack-years index, comorbid diseases, number acid-fast bacilli (AFB) in sputum smear examination, radiological findings (cavitary, extensive or limited disease), drug susceptibility pattern and initial treatment, was analysed. The Student t-test, chi-square test and logistic regression model with forward stepwise conditional methods were used for statistical analysis. A p value of &lt;0.05 was considered to be statistically significant. Results. Twenty six patients (26.2%): 18 males (22.2%) and 8 females (44%) were sputum culture positive at the end of the second month of treatment. In univariate analysis, culture conversion time was significantly associated with female gender and extensive disease, but in a logistic regression analysis was only correlated with female gender (OR=5.63 95% CI 1.21-20.64-p=0.02). Conclusion. In current smokers with pulmonary tuberculosis, the ‘time to culture’ conversion relates only to the female gender.

Good response to rituximab in a patient with granulomatosis with polyangiitis and pulmonary, renal manifestations and ophthalmoplegia

Cyclophosphamide (CYC) is a classical drug for the treatment of severe granulomatosis with polyangiitis (GPA). However, a considerable number of patients are resistant to standard treatment and it can show substantial toxicity. Therefore, alternative agents should be considered in refractory cases. We report the successful use of rituximab (RTX) in a 70-year-old patient diagnosed of GPA who developed ophthalmoplegia, an uncommon complication of GPA. The patient also had upper and lower respiratory tract involvement and kidney manifestations with good prognosis. We review the causes of ophtalmoparesis and the treatment with RTX in GPA.

Two diffusion photopolymer for sharp diffractive optical elements recording

Photopolymers as recording media are widely used in optical applications. In such materials, changes in the phase of the transmittance function are generated during exposure due to refractive index and thickness modulations. These changes arise primarily as a consequence of photopolymerization and mass transport processes. Characterizing polymers' performance, for example, quantifying the value of monomer diffusion, is therefore very important. Applying index matching, the volume and surface optical effect are separated in an acrylamide/polyvinylalcohol (AA/PVA) material. Using a simplified model that includes the effects of the holes produced during polymerization, both hole and monomer diffusion are analyzed. The analysis presented indicates higher material sensitivity than previously estimated. The results also indicate the possibility of recording sharper diffractive optical elements profiles, like blazed gratings, having diffraction efficiencies higher than 80%.

Reproductive ecology of coypu (Myocastor coypus Molina, 1782) in the Middle Delta of the Paraná River, Argentina

The objective of this study was to estimate and compare some important reproductive parameters of Myocastor coypus over time (June 2006-May 2008), in wetlands of the Middle Delta of the Paraná River (MD) Entre Ríos province, R. Argentina. Within the original coypu distribution range, the MD is among the areas of highest habitat suitability for the species. Coypus were captured and the following reproductive parameters were estimated on a monthly, seasonal and annual basis: pregnancy rate (PR), litter size (LS), gross productivity (GP) and annual production (AP). Statistical non-parametric tests were used for comparisons. Additionally, the expected birth date of each embryo and fetus was estimated by assigning it to a developmental stage category and considering the gestation period of the species. All the parameters showed high values and PR and LS differed significantly between the dry (2006) and humid years (2007). Two peaks of birth were detected, one in spring and another one in mid-autumn. The implications of these results for ensuring the sustainable management of this rodent are discussed.

On the prediction of Hodgkin lymphoma treatment response

PURPOSE

The cure rate in Hodgkin lymphoma is high, but the response along with treatment is still unpredictable and highly variable among patients. Detecting those patients who do not respond to treatment at early stages could bring improvements in their treatment. This research tries to identify the main biological prognostic variables currently gathered at diagnosis and design a simple machine learning methodology to help physicians improve the treatment response assessment.

METHODS

We carried out a retrospective analysis of the response to treatment of a cohort of 263 Caucasians who were diagnosed with Hodgkin lymphoma in Asturias (Spain). For that purpose, we used a list of 35 clinical and biological variables that are currently measured at diagnosis before any treatment begins. To establish the list of most discriminatory prognostic variables for treatment response, we designed a machine learning approach based on two different feature selection methods (Fisher's ratio and maximum percentile distance) and backwards recursive feature elimination using a nearest-neighbor classifier (k-NN). The weights of the k-NN classifier were optimized using different terms of the confusion matrix (true- and false-positive rates) to minimize risk in the decisions.

RESULTS AND CONCLUSIONS

We found that the optimum strategy to predict treatment response in Hodgkin lymphoma consists in solving two different binary classification problems, discriminating first if the patient is in progressive disease; if not, then discerning among complete and partial remission. Serum ferritin turned to be the most discriminatory variable in predicting treatment response, followed by alanine aminotransferase and alkaline phosphatase. The importance of these prognostic variables suggests a close relationship between inflammation, iron overload, liver damage and the extension of the disease.

Influence of index matching on AA/PVA photopolymers for low spatial frequency recording

Photopolymers present appealing optical properties for holographic and diffractive applications. They enable modulation of the electrical permittivity and thickness and are self-processing, and layers with a wide range of thicknesses and properties can be fabricated on demand. In order to obtain a complete characterization of the material, low spatial frequency analysis has become a fundamental tool because the motion of the components inside of the material can be measured. We propose to use an index matching component to carry out a complete characterization and to differentiate the "apparent" and the real monomer diffusion. We also have quantified the minimum thickness to obtain the phase modulation of 2π required for the fabrication of many diffractive elements such as lenses, axicons, or blazed gratings. Finally, we have studied the influence of the thermal effects in the thickness variations.

Applicability and accuracy improvement of transient elastography using the M and XL probes by experienced operators

Transient elastography (TE) is the reference method to obtain liver stiffness measurements (LSM), but no results are obtained in 3.1% and unreliable in 15.8%. We assessed the applicability and diagnostic accuracy of TE re-evaluation using M and XL probes. From March 2011 to April 2012 868 LSM were performed with the M probe by trained operators (50-500 studies) (LSM1). Measurements were categorized as inadequate (no values or ratio <60% and/or IQR/LSM >30%) or adequate. Inadequate LSM1 were re-evaluated by experienced operators (>500 explorations) (LSM2) and inadequate LSM2 using XL probe (LSMXL). Inadequate LSM1 were obtained in 187 (21.5%) patients, IQR/LSM >30% in 97 (51%), ratio <60% in 24 (13%) and TE failed to obtain a measurement in 67 (36%). LSM2 achieved adequate registers in 123 (70%) of 175 registers previously considered as inadequate. Independent variables (OR, 95%CI) related to inadequate LSM1 were body mass index (1.11, 1.04-1.18), abdominal circumference (1.03, 1.01-1.06) and age (1.03, 1.01-1.04) and to inadequate LSM2 were skin-capsule distance (1.21, 1.09-1.34) and abdominal circumference (1.05, 1.01-1.10). The diagnostic accuracy (AUROC) to identify significant fibrosis improved from 0.89 (LSM1) to 0.91 (LSM2) (P = 0.046) in 334 patients with liver biopsy or clinically significant portal hypertension. A third evaluation (LSMXL) obtained adequate registers in 41 (93%) of 44 patients with inadequate LSM2. Operator experience increases the applicability and diagnostic accuracy of TE. The XL probe may be recommended for patients with inadequate values obtained by experienced operators using the M probe. http://clinicaltrials.gov (NCT01900808).

Postoperative surgical complications after lung transplantation

This is a review article on the main postoperative complications after lung transplantation: airways complications, vascular complications, pleural complications, surgical wound complications, and abdominal complications. Incidence data, severity, and major management regimens are reported. Postoperative complications after lung transplantation result in a significantly increased morbidity and mortality, with early diagnosis and therapy being extremely important.

Effects of crude protein level in the concentrate and time allotment on pasture on milk yield, urinary nitrogen, and purine derivative excretion in lactating Latxa ewes

This study assessed the influence of reducing the crude protein (CP) content (from 190 to 130 g/kg CP/kg) in the supplementary concentrate and time allotment on pasture (TAP) on the milk yield, bodyweight, and the urinary nitrogen (N) and purine derivatives (PD) in lactating Latxa ewes. Animals were reared in a production system that restricted the amount of time that ewes spent on pasture. In mid-April, at the start of the 42 days experiment, 40 dairy Latxa ewes were assigned to one of four groups on the basis of their initial milk yield, days in lactation (DIL), bodyweight (BW), and condition score; thereafter, each group grazed in its own fenced paddock. The experiment was based on a 2 × 2 factorial design that included two CP levels and two pasture grazing regimes: 4 h continuous grazing (CG) in the morning or 2 h grazing in the morning and 2 h in the afternoon (DG). Individual milk yield was recorded three times a week, and time spent grazing and BW was recorded weekly. In the middle (day 15–17; P1) and at the end (day 36–38; P2) of the experiment, urinary spot samples were collected using a catheter. At the end of the experiment, ewes were confined to metabolic cages and urine was collected. CP level of the concentrate was not correlated with time spent grazing; however, the ewes that were permitted access to pasture twice per day spent more time grazing (223 min/day vs 207 min/day, P < 0.01) and were more efficient with their time (56 min/h grazing vs 52 min/h, P < 0.05) than the ewes that were permitted access to pasture once per day. Concentrate CP levels were not correlated with milk yield or composition, although ewes that received the high protein (HP) lost more weight than did those that received the low protein (LP) concentrate. Concentrate CP level and TAP were not correlated with creatinine (CR) excretion rate (mean = 315 µmol/kg LW0.75 s.e. 0.0161). Urea-N was the largest component of urinary-N (68.7 s.e. 2.33%; P > 0.05), and urea-N waste was higher in HP ewes (202.7 mmol/day) than it was in LP ewes (159.5 mmol/day) (s.d. 27.83; P < 0.01). Ewes subjected to the DG regime had significantly (P < 0.01) higher urinary PD excretion (23.6 vs 21.4 mmol/day s.d. 4.01; P < 0.01), and tended (P < 0.1) to excrete less urea-N (175.1 vs 188.3 mmol, s.d. 27.83) than did the CG ewes. A reduction in the CP in the supplementary concentrate led to a reduction in N waste without having a detrimental effect on performance or milk production.

Lipopolysaccharide-Induced Ionized Hypocalcemia and Acute Kidney Injury in Carotid Chemo/Baro-Denervated Rats

The acute kidney injury (AKI) observed during sepsis is due to an uncontrolled release of inflammatory mediators. Septic patients develop electrolytic disturbances and one of the most important is ionized hypocalcemia. AKI adversely affects the function of other organs and hypocalcemia is associated with cardiovascular and respiratory dysfunctions. Since carotid body chemoreceptors modulate the systemic inflammatory response during sepsis syndromes, we used pentobarbitone-anesthetized male Sprague-Dawley rats in control condition (SHAM surgery) and after bilateral carotid neurotomy (carotid chemo/baro-denervated, BCN). We evaluate serum creatinine (CRE), serum neutrophil gelatinase-associated lipocaline (NGAL), ionized calcium (iCa) and cardiac Troponin I (cTnI) 90 min after the IP administration of 15 mg/kg lipopolysaccharide (LPS) or saline. In the SHAM group, LPS failed to induce significant changes CRE, NGAL, or iCa, and increased cTnI. Conversely, in the BCN group LPS increased CRE and NGAL, decreased iCa, and enhanced the increase of cTnI. Our results suggest that carotid chemo/baro-receptors might contribute to the regulation of both renal function and calcemia during sepsis. In addition, results imply that the carotid chemo-baroreceptors serve as an immunosensory organ.

WITHDRAWN:Postoperative surgical complications after lung transplantation

This article has been withdrawn for editorial reasons because the journal will be published only in English. In order to avoid duplicated records, this article can be found at http://dx.doi.org/10.1016/j.rppnen.2014.09.007. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.

Design and verification of the shielding around the new Neutron Standards Laboratory (LPN) at CIEMAT

The construction of the new Neutron Standards Laboratory at CIEMAT (Laboratorio de Patrones Neutrónicos) has been finalised and is ready to provide service. The facility is an ∼8 m×8 m×8 m irradiation vault, following the International Organization for Standardization 8529 recommendations. It relies on several neutron sources: a 5-GBq (5.8× 10(8) s(-1)) (252)Cf source and two (241)Am-Be neutron sources (185 and 11.1 GBq). The irradiation point is located 4 m over the ground level and in the geometrical centre of the room. Each neutron source can be moved remotely from its storage position inside a water pool to the irradiation point. Prior to this, an important task to design the neutron shielding and to choose the most appropriate materials has been developed by the Radiological Security Unit and the Ionizing Radiations Metrology Laboratory. MCNPX was chosen to simulate the irradiation facility. With this information the walls were built with a thickness of 125 cm. Special attention was put on the weak points (main door, air conditioning system, etc.) so that the ambient dose outside the facility was below the regulatory limits. Finally, the Radiation Protection Unit carried out a set of measurements in specific points around the installation with an LB6411 neutron monitor and a Reuter-Stokes high-pressure ion chamber to verify experimentally the results of the simulation.

Strategies for Cd accumulation in Dittrichia viscosa (L.) Greuter: role of the cell wall, non-protein thiols and organic acids

Dittrichia viscosa (L.) Greuter is plant species commonly found in degraded zones of Asturias (Spain), where it accumulates high levels of Cd, but the mechanisms involved in this response in non-model plants have not been elucidated. In this way, we analysed the fraction of the total Cd bound to the cell walls, the ultrastructural localization of this metal, and non-protein thiol and organic acid concentrations of two clones of D. viscosa: DV-A (from a metal-polluted soil) and DV-W (from a non-polluted area). After 10 days of hydroponic culture with Cd, fractionation and ultrastructural localisation studies showed that most of the Cd accumulated by D. viscosa was kept in the cell wall. The non-protein thiol content rose in D. viscosa with Cd exposure, especially in the non-metallicolous DV-W clone, and in both clones we found with Cd exposure a synthesis de novo of phytochelatins PC2 and PC3 in shoots and roots and also of other phytochelatin-related compounds, particularly in roots. Regarding organic acids, their concentration in both clones decreased in shoots after Cd treatment, but increased in roots, mainly due to changes in the citric acid concentration. Thus, retention of Cd in the cell wall seems to be the first strategy in response to metal entry in D. viscosa and once inside cells non-protein thiols and organic acids might also participate in Cd tolerance.