The deposition and manipulation of human remains in natural caves are well known for the Neolithic of Southern Iberia. The cultural meaning of these practices is however still largely unclear. Cueva ...de los Marmoles (CM, Priego-Córdoba) is one of the most important cave contexts from Southern Spain, which returned a large number of commingled skeletal remains suggesting its funerary use from the Neolithic to the Late Bronze Age. Here we discuss CM from a chronological and cultural perspective based on new radiocarbon, anthropological, and taphonomic analyses. These include the estimation of the minimum number of individuals, the exploration of fragmentation patterns characterizing different skeletal regions, and the macroscopic and microscopic analysis of modifications to the remains of possible anthropic origin. Radiocarbon data point to a funerary use of CM between the 5
th
-2
nd
millennium cal. BCE. MNI estimates reveal the presence of at least 12 individuals (seven adults and five nonadults). The low representation of elements from hands and feet suggests that individuals were placed in the cave while partially decomposed. Anthropic traces on the remains (e.g. fresh fractures, marrow canal modifications, and scraping marks) hint at their intentional fragmentation, cleaning from residual soft tissues, and in some cases reutilization. These practices are well-exemplified by the recovery of one "skull cup" and of two long bones used as tools. These data align with those from other cave contexts from the same geographic region, suggesting the presence, especially during the Neolithic period, of shared ideologies centered on the human body.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Breast cancer patients under neoadjuvant chemotherapy includes a heterogeneous group of patients who eventually develop distal disease, not detectable by current methods. We propose the use of ...exosomal miRNAs and circulating tumor cells as diagnostic and predictive biomarkers in these patients.
Fifty-three breast cancer women initially diagnosed with localized breast cancer under neoadjuvant chemotherapy were prospectively enrolled in this study. However, six of them were later re-evaluated and diagnosed as metastatic breast cancer patients by PET-CT scan. Additionally, eight healthy donors were included. Circulating tumor cells and serum exosomal miRNAs were isolated from blood samples before and at the middle of neoadjuvant therapy and exosomal miRNA levels analyzed by qPCR.
Before neoadjuvant therapy, exosomal miRNA-21 and 105 expression levels were higher in metastatic versus non-metastatic patients and healthy donors. Likewise, higher levels of miRNA-222 were observed in basal-like (p = 0.037) and in luminal B versus luminal A (p = 0.0145) tumor subtypes. Exosomal miRNA-222 levels correlated with clinical and pathological variables such as progesterone receptor status (p = 0.017) and Ki67 (p = 0.05). During neoadjuvant treatment, exosomal miRNA-21 expression levels directly correlated with tumor size (p = 0.039) and inversely with Ki67 expression (p = 0.031). Finally, higher levels of exosomal miRNA-21, miRNA-222, and miRNA-155 were significantly associated with the presence of circulating tumor cells.
Liquid biopsies based on exosomal miRNAs and circulating tumor cells can be a complementary clinical tool for improving breast cancer diagnosis and prognosis.
•This study has identified the 13 most vulnerable countries in terms of tourism competitiveness.•The most vulnerable are Panama, Georgia, Bahrain, Morocco, Montenegro, Albania, Mexico, Dominican ...Republic, Jordan, Tunisia, Cape Verde, Honduras, and Lebanon.•The keys dimensions that condition the competitiveness have been identified.•These dimensions are related to cultural heritage, protection of natural areas, information and communication technologies, among others.
Business activities within the tourism industry are especially suffering from the consequences of the COVID19 pandemic. Those countries whose economy depends largely on tourism will experience a troublesome situation for years to come. Their return to a normal situation will be conditioned by the competitiveness of their tourism sector. The study begins by pinpointing the countries that have been more hardly stricken by the pandemic and in which tourism accounts for a greater share of the GDP. A comparative analysis of the competitiveness of these countries with that of world-leading countries will be carried out so as to conclude which will face the recovery period in a more vulnerable situation. The measurement of tourism competitiveness will be supported by the creation of a synthetic indicator based on the P2 distance method. A group of 13 countries has been identified as the most vulnerable, and it is advisable to act urgently in the following areas: the promotion of cultural elements and the historical and artistic heritage, the protection of natural areas, the availability of information and communication technologies, the international openness of the destination, and the availability of transportation infrastructures and tourist services.
Introduction
The presence of iron deficiency (ID) in patients with acute heart failure (AHF) is high. There are few studies on the characteristics of these patients and the safety of ferric ...carboxymaltose administration (FCM).
Objective
Study the differences among patients with AHF based on the presence and type of ID as well as the safety of FCM administration in these patients.
Method
The AHF‐ID study is a multicentre, analytical, prospective follow‐up cohort including patients admitted to six Spanish hospitals for AHF. ID was defined as serum ferritin <100 μg/L (group A) or ferritin 100‐299 μg/L with a TSAT <20% (group B). In cases receiving FCM the appearance of adverse events was analysed. Adjusted Cox regression was used to determine the association with 30‐days reattendance for AHF after discharge.
Results
A total of 221 patients were recruited; 191 (86.4%) presented ID, 121 (63.4%) group A and 70 (36.6%) group B. There were scarce differences between the groups analysed. No differences were found in 30‐days reattendance for AHF. FCM was administered to 158 (71.5%) patients, with 8 (5.1%) presenting adverse events, the most frequent being digestive alterations. Treatment was not discontinued in any case.
Conclusions
There are scarce differences between the presence and the type of ID in patients with AHF. The administration of FCM in patients with ID and AHF is safe.
New tourism trends, such as vacation rentals websites and low-cost tourism, have generated a new environment of interactions between tourism and the citizens. To this, we must add the fortuitous ...increase in demand in some touristic destinations. This has derived in situations of rejection in traditionally tourism-dependent environments. In this study, which is focused on the city of Barcelona, we use work-field data to analyze the elements that lie behind the popular aversion to tourism. Assuming a non-forced analysis that takes the Social Exchange Theory as a framework, we have determined that the negative economic effects derived from the increase in the number of accommodations destined for vacation rentals and in the demand lie behind this rejection. The main impacts that are perceived directly from these factors are: the increase in residential rentals prices and a shift from a traditional market to one oriented to the tourist with higher prices. It has also been determined that the most vulnerable population groups are those who manifest a stronger rejection, tenants of apartments in city centers, and citizens with a low/medium income, who perceive rises in the prices and a change in the market focus to a larger extent.
Systemic lupus erythematosus (SLE) is a common systemic autoimmune disease with a complex genetic inheritance. Genome-wide association studies (GWAS) have significantly increased the number of ...significant loci associated with SLE risk. To date, however, established loci account for less than 30% of the disease heritability and additional risk variants have yet to be identified. Here we performed a GWAS followed by a meta-analysis to identify new genome-wide significant loci for SLE.
We genotyped a cohort of 907 patients with SLE (cases) and 1524 healthy controls from Spain and performed imputation using the 1000 Genomes reference data. We tested for association using logistic regression with correction for the principal components of variation. Meta-analysis of the association results was subsequently performed on 7,110,321 variants using genetic data from a large cohort of 4036 patients with SLE and 6959 controls of Northern European ancestry. Genetic association was also tested at the pathway level after removing the effect of known risk loci using PASCAL software.
We identified five new loci associated with SLE at the genome-wide level of significance (p < 5 × 10
): GRB2, SMYD3, ST8SIA4, LAT2 and ARHGAP27. Pathway analysis revealed several biological processes significantly associated with SLE risk: B cell receptor signaling (p = 5.28 × 10
), CTLA4 co-stimulation during T cell activation (p = 3.06 × 10
), interleukin-4 signaling (p = 3.97 × 10
) and cell surface interactions at the vascular wall (p = 4.63 × 10
).
Our results identify five novel loci for SLE susceptibility, and biologic pathways associated via multiple low-effect-size loci.
Cardiotoxicity (CTox) is a major side effect of cancer therapies, but uniform diagnostic criteria to guide clinical and research practices are lacking.
We prospectively studied 865 patients, aged ...54.7 ± 13.9; 16.3% men, scheduled for anticancer therapy related with moderate/high CTox risk. Four groups of progressive myocardial damage/dysfunction were considered according to current guidelines: normal, normal biomarkers (high-sensitivity troponin T and N-terminal natriuretic pro-peptide), and left ventricular (LV) function; mild, abnormal biomarkers, and/or LV dysfunction (LVD) maintaining an LV ejection fraction (LVEF) ≥50%; moderate, LVD with LVEF 40-49%; and severe, LVD with LVEF ≤40% or symptomatic heart failure. Cardiotoxicity was defined as new or worsening of myocardial damage/ventricular function from baseline during follow-up. Patients were followed for a median of 24 months. Cardiotoxicity was identified in 37.5% patients during follow-up 95% confidence interval (CI) 34.22-40.8%, 31.6% with mild, 2.8% moderate, and 3.1% with severe myocardial damage/dysfunction. The mortality rate in the severe CTox group was 22.9 deaths per 100 patients-year vs. 2.3 deaths per 100 patients-year in the rest of groups, hazard ratio of 10.2 (95% CI 5.5-19.2) (P < 0.001).
The majority of patients present objective data of myocardial injury/dysfunction during or after cancer therapy. Nevertheless, severe CTox, with a strong prognostic relationship, was comparatively rare. This should be reflected in protocols for clinical and research practices.
Hormonal Dependence and Cancer in Systemic Lupus Erythematosus Cobo‐Ibáñez, Tatiana; Urruticoechea‐Arana, Ana; Rúa‐Figueroa, Iñigo ...
Arthritis care & research (2010),
February 2020, 2020-Feb, 2020-02-00, 20200201, Letnik:
72, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Objective
To estimate the incidence and analyze any cancer‐associated factors in patients with systemic lupus erythematosus (SLE), differentiating between hormone‐sensitive (HS) and non‐HS cancers.
...Methods
This was a retrospective multicenter study of a patient cohort from the Systemic Lupus Erythematosus Registry of the Spanish Society of Rheumatology. Included were the first cancer post‐SLE diagnosis, clinical and sociodemographic information, cumulative damage, severity, comorbidities, treatments, and refractoriness. Cancers were classified as HS (prostate, breast, endometrium, and ovarian) and non‐HS (the remainder). The standardized incidence ratio (SIR) was calculated and logistic regression models were built.
Results
A total of 3,539 patients (90.4% women) were included, 154 of whom had cancer (91% female), and 44 had HS cancer (100% female). The cancer SIR was 1.37 (95% confidence interval 95% CI 1.15–1.59), with higher values in women age <65 years (SIR 2.38 95% CI 1.84–2.91). The SIR in women with HS versus non‐HS cancer was 1.02 (95% CI 0.13–1.91) and 1.93 (95% CI 0.98–2.89). In HS versus non‐HS cancers, SLE diagnostic age (odds ratio OR 1.04 P = 0.002 versus 1.04 P = 0.019), and period of disease evolution (OR 1.01 P < 0.001 versus 1.00 P = 0.029) were associated with cancer. The Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (OR 1.27 P = 0.022) and angiotensin‐converting enzyme (ACE) inhibitor prescriptions (OR 2.87 P = 0.048) were associated with non‐HS cancers.
Conclusion
Cancer incidence in patients with SLE was higher than in the Spanish population, particularly among young women. This increase might be due to non‐HS cancers, which would be associated with SLE involving greater cumulative damage where more ACE inhibitors are prescribed.
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