Elevated pulse pressure (ePP) is an independent marker of cardiovascular risk (CVR) in people older than 60, and a functional marker of subclinical target organ damage (sTOD) which can predict ...cardiovascular events in patients with hypertension (HTN), regardless of sTOD.
To evaluate the prevalence of ePP in adult population seen in primary care and its association with other vascular risk factors, sTOD and with cardiovascular disease (CVD).
Observational multicentre study conducted in Spain (8,066 patients, 54.5% women) from the prospective cohort study IBERICAN recruited in Primary Care. Pulse pressure (PP) was defined as the difference between the systolic blood pressure (SBP) and the diastolic blood pressure (DBP) ≥60 mmHg. Adjusted (for age and sex) ePP prevalence were determined. Bivariate and multivariate analyses of the possible variables associated with ePP were carried out.
The mean of PP was 52.35 mmHg, and was significantly higher (
< 0.001) in patients with HTN (56.58 vs. 48.45 mmHg) The prevalence of ePP adjusted for age and sex was 23.54% (25.40% men vs. 21.75% women;
< 0.0001). The ePP prevalence rates increased linearly with age (
= 0.979) and were significantly more frequent in population aged ≥65 than in population aged <65 (45.47% vs. 20.98%;
< 0.001). HTN, left ventricular hypertrophy, low estimated glomerular filtration rate, alcohol consumption, abdominal obesity, and CVD were independently associated with ePP. 66.27% of patients with ePP had a high or very high CVR, as compared with 36.57% of patients without ePP (OR: 3.41 95% CI 3.08-3.77).
The ePP was present in a quarter of our sample, and it was increased with the age. Also, the ePP was more frequent in men, patients with HTN, other TOD (as left ventricular hypertrophy or low estimated glomerular filtration rate) and CVD; because of this, the ePP was associated a higher cardiovascular risk. In our opinion, the ePP is an importer risk marker and its early identification lets to improve better diagnostic and therapeutic management.
From February 22 to 24, 2020, an intense dust storm affected the Spanish archipelago of the Canary Islands. Here we assess the radiological impact on the Canary Islands population of several natural ...and artificial radionuclides (40K, 137Cs, 210Pb, 7Be), and other radiological parameters (gross alpha and gross beta activity concentrations) measured in atmospheric aerosols before, during and after the dust storm.
Total Suspended Matter highly correlated with PM10 (Pearson's correlation coefficient, ro = 0.98), showed increments ranging from 849% to 1778% against the background average levels, reaching levels of >3000 μg m−3.
40K and 137Cs radionuclides showed activity values over the minimum detection activity from January to March 2020, coupled with dust intrusion episodes during the study. This finding supports the use of these radionuclides as radiotracers for African low altitude dust intrusions occurring particularly during winter months over the Canary Islands.
A high correlation between gross beta and 210Pb activities suggests that the latter is the main source for gross beta emitters in aerosol samples collected in the study region. 210Pb and 7Be showed a moderate positive correlation and did not show any significant change during the storm, suggesting a similar dynamics of alpha and beta emitters in the low atmosphere.
A Principal Component Analysis of these observations showed two components representing a Saharan component (based on 40K, 137Cs, gross alpha, and PM10) and a heterogeneous component representing North Atlantic and Europe air masses (based on 7Be, 210Pb, and gross beta).
In addition, a K-means cluster analysis helped to disentangle the origin of air masses arriving at the archipelago. Three different clusters were identified: a continental cluster (based on gross beta, 210Pb, and 7Be activity concentrations); an oceanic cluster (with low values of PM10 air concentrations, gross beta, gross alpha, and 210Pb, and 7Be and 40K activity concentrations), reflecting the Atlantic air contributions with lower radionuclide activity and microparticulate matter; and a dust intrusion cluster (with high PM10 values and 137Cs, 40K and gross alpha activity concentrations) representing dust intrusion episodes observed in Tenerife Island. These studies allow the detection and monitoring of radioactive elements, estimating the potential radiological risk to the population associated with mineral dust intrusions.
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•On February 2020, an intense dust storm struck the Canary Islands archipelago.•PM10 air concentration reached levels of >3000 μg m−3.•Gross alpha, 137Cs and 40K showed higher values during such a dust storm.•PCA identified two main components that explain 81% of the total variance.•Three clusters are identified with Oceanic, Continental and Saharan origins.
Background
Tumor human leukocyte antigen class I (HLA-I) expression plays an important role in T cell-mediated tumor rejection. Loss of HLA-I is associated with cancer progression and resistance to ...immunotherapy, including antibodies blocking programmed death-1/programmed death-ligand 1 (PD-1/PD-L1) signaling. Our objective was to analyze a correlation between HLA-I, tumor immune infiltration, and PD-L1/PD-1 axis in bladder cancer in association with the clinicopathologic features of patients.
Methods
We analyzed 85 cryopreserved bladder tumors by immunohistochemistry to investigate the expression of HLA-I, PD-L1, PD-1, CD3, CD8, and CXC chemokine receptor 4 (CXCR4). The results were correlated with tumor stage and other clinicopathologic variables of patients.
Results
We found a strong positive correlation between tumor HLA-I expression and infiltration with CD3+ and CD8 + T cells. PD-L1 expression was positive in 15.5% of tumors and heterogeneous in 40.5%, and was linked to a more advanced tumor stage. The majority of HLA-I-positive/heterogeneous tumors also expressed PD-L1 and PD-1, which were significantly correlated with each other and with lymphocyte infiltration. Interestingly, the analysis of the simultaneous expression of both markers revealed that 85.2% of tumors with a positive/heterogeneous HLA-I phenotype and negative for PD-L1 were mostly non-invasive, representing a ‘tumor rejection’ immune phenotype.
Conclusions
High tumor HLA-I expression with absence of PD-L1 provides bladder cancer with an immune rejection mechanism. Evaluation of PD-L1 and HLA-I together should be considered in bladder cancer and may provide a new predictive biomarker of tumor invasiveness and of the response to ‘immune checkpoint’ therapy.
Objective
The objective of this observational, descriptive, cross-sectional, multicentre study was to assess the perceived quality and grade of satisfaction expressed by patients with chronic ...arthropathies regarding the use of musculoskeletal (MSK) ultrasonography by rheumatologists as an integrated clinical care tool.
Methods
All Spanish rheumatology departments with MSK ultrasonography incorporated in their healthcare services were invited to participate in the study. A Spanish-language survey was offered to fill out anonymously to all consecutive patients with chronic arthropathies under follow-up in the rheumatology outpatient clinics who attended their centre for a period of 3 months. The survey consisted of three sections. The first section contained patients’ demographics, disease data, frequency of performing rheumatological ultrasound and information about who performed their ultrasound assessments. The second section consisted of 14 questions about patient’s experience and opinion on different aspects of the management, performance and perceived usefulness of performing ultrasound, to be answered on a Likert scale 1–5. The third section of the survey was addressed to the rheumatologist ultrasonographers.
Results
Nine hundred and four patients from 16 university hospital rheumatology departments completed the survey. All questions reached an overall favourable response ≥ 80%. Patients who reported usual ultrasound examinations in their rheumatology care and those in which it was their attending rheumatologist who performed the ultrasound assessments responded more favourably.
Conclusion
Our encouraging patient-centred results may be useful in facilitating the implementation of rheumatological ultrasound in rheumatology care worldwide.
Key Points
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This is the largest multicentre survey carried out in patients with chronic joint diseases designed to assess their experience and perceived benefits with the use of ultrasonography performed by rheumatologists in daily practice.
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Musculoskeletal ultrasound incorporated into rheumatology care was very well accepted and valued by most patients.
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The patients perceived that ultrasonography helps not only their rheumatologist but also themselves to better understand their condition.
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The patients believed that ultrasonography helps them accept and comply with the proposed treatment.
To assess the incidence of serious infection (SI) and associated factors in a large juvenile-onset systemic lupus erythematosus (jSLE) retrospective cohort.
All patients in the Spanish Rheumatology ...Society Lupus Registry (RELESSER) who meet ≥4 ACR-97 SLE criteria and disease onset <18 years old (jSLE), were retrospectively investigated for SI (defined as either the need for hospitalization with antibacterial therapy for a potentially fatal infection or death caused by the infection). Standardized SI rate was calculated per 100 patient years. Patients with and without SI were compared. Bivariate and multivariate logistic and Cox regression models were built to calculate associated factors to SI and relative risks.
A total of 353 jSLE patients were included: 88.7% female, 14.3 years (± 2.9) of age at diagnosis, 16.0 years (± 9.3) of disease duration and 31.5 years (±10.5) at end of follow-up. A total of 104 (29.5%) patients suffered 205 SI (1, 55.8%; 2-5, 38.4%; and ≥6, 5.8%). Incidence rate was 3.7 (95%CI: 3.2–4.2) SI per 100 patient years. Respiratory location and bacterial infections were the most frequent. Higher number of SLE classification criteria, SLICC/ACR DI score and immunosuppressants use were associated to the presence of SI. Associated factors to shorter time to first infection were higher number of SLE criteria, splenectomy and immunosuppressants use.
The risk of SI in jSLE patients is significant and higher than aSLE. It is associated to higher number of SLE criteria, damage accrual, some immunosuppressants and splenectomy.
Meloidogyne spp. are an important threat to horticulture and cause substantial yield losses. Plant resistance is an alternative control method for chemical nematicides. This study highlights the host ...suitability of the lettuces cultivars Grand Rapids and Salinas 88 and the beans cultivars Aporé, Cornell 49242, Macarrão Atibaia and Ouro Negro to four Meloidogyne incognita and seven M. javanica isolates from Spain in a pot experiment. Moreover, the response of these cultivars to increasing M. incognita densities (Pi) was assessed in a plastic greenhouse. The lettuce cultivar Regina 71 and the bean cultivar Bolinha were included as susceptible standards for comparison. It was found that Grand Rapids and Salinas 88 lettuces were resistant to the most nematode isolates in the pot experiment but were classified as slightly and moderately resistant, respectively, in the plastic greenhouse at increasing Pi. Regarding the beans, Aporé was resistant to the majority of the Meloidogyne isolates whereas Macarrão Atibaia and Ouro Negro were slightly resistant and Cornell 49242 was susceptible in the pot experiment. In the plastic greenhouse, Aporé was the only cultivar able to effectively suppress the nematode reproduction irrespective of Pi, while Ouro Negro became less resistant as Pi increased. These results play an important role in enhancing the effective and ecofriendly Meloidogyne management strategies.
The fluctuations in Meloidogyne densities and fungal egg parasitism were determined from February 2015 to July 2016 in four vegetable production sites conducted under organic production and two sides ...conducted under integrated standards. At each site, the soil nematode densities at transplanting and at the end of the crops, the galling index, the number of eggs in roots, and the percentage of fungal egg parasitism were determined, and the fungal species were identified. In addition, two pot experiments were conducted with soil taken from each site in February 2015 and 2016 to assess the fungal egg parasitism comparing non-sterile and sterile soil from each site. In field conditions, the nematode population densities in the soil decreased along the crop rotations. The maximum number of eggs per plant was recorded in the spring–summer crops. Egg parasitism ranged from 11.2 to 55% in the organic sites and from 0.8 to 16.5% in the integrated production sites. Pochonia chlamydosporia was the only fungal species isolated in five of the six sites. In both pot experiments, the number of eggs per plant was lower in non-sterile than in sterile soils, except for the M10.45 site, where fungal egg parasites were not recovered. P. chlamydosporia was the only fungal species isolated, ranging between 11 and 74%. Therefore, P. chlamidosporia was the most prevalent fungal species related to Meloidogyne suppression.
Pot experiments were carried out to characterize the response of two Cucumis metuliferus accessions (BGV11135 and BGV10762) against Mi1.2 gene (a)virulent Meloidogyne arenaria, M. incognita and M. ...javanica isolates and to determine the compatibility and the effect on physicochemical properties of fruit melons. In addition, histopathological studies were conducted. One week after transplanting, plants were inoculated with one J2 cm−3 of sterilized sand (200 cm3 pots) and maintained in a growth chamber at 25 °C for 40 days. The susceptible cucumber cv. Dasher II or melon cv. Paloma were included for comparison. The number of egg masses and number of eggs per plant were assessed, and the reproduction index (RI) was calculated as the percentage of eggs produced on the C. metuliferus accessions compared to those produced on the susceptible cultivars. The compatibility and fruit quality were assessed by grafting three scions, two of Charentais type and one of type piel de sapo, under commercial greenhouse conditions. The resistance level of both C. metuliferus accessions ranged from highly resistant (RI < 1%) to resistant (1% ≤ RI ≤ 10%) irrespective of Meloidogyne isolates. Melon plants grafted onto C. metuliferus accession BGV11135 grew as self‐grafted plants without negatively impacting fruit quality traits. Giant cells induced by Meloidogyne spp. on C. metuliferus were in general poorly developed compared to those on cucumber. Furthermore, necrotic areas surrounding the nematode were observed. Cucumis metuliferus accession BGV11135 could be a promising melon rootstock to manage Meloidogyne spp., irrespective of their Mi1.2 (a)virulence, without melon fruit quality reduction.
Measuring magnetic fields in the inner corona, the interface between the solar chromosphere and outer corona, is of paramount importance if we aim to understand the energetic transformations taking ...place there, and because it is at the origin of processes that lead to coronal heating, solar wind acceleration, and of most of the phenomena relevant to space weather. However, these measurements are more difficult than mere imaging because polarimetry requires differential photometry. The coronal magnetograph mission (CMAG) has been designed to map the vector magnetic field, line-of-sight velocities, and plane-of-the-sky velocities of the inner corona with unprecedented spatial and temporal resolutions from space. This will be achieved through full vector spectropolarimetric observations using a coronal magnetograph as the sole instrument on board a spacecraft, combined with an external occulter installed on another spacecraft. The two spacecraft will maintain a formation flight distance of 430 m for coronagraphic observations, which requires a 2.5 m occulter disk radius. The mission will be preferentially located at the Lagrangian L5 point, offering a significant advantage for solar physics and space weather research. Existing ground-based instruments face limitations such as atmospheric turbulence, solar scattered light, and long integration times when performing coronal magnetic field measurements. CMAG overcomes these limitations by performing spectropolarimetric measurements from space with an external occulter and high-image stability maintained over time. It achieves the necessary sensitivity and offers a spatial resolution of 2.5″ and a temporal resolution of approximately one minute, in its nominal mode, covering the range from 1.02 solar radii to 2.5 radii. CMAG relies on proven European technologies and can be adapted to enhance any other solar mission, offering potential significant advancements in coronal physics and space weather modeling and monitoring.
Este trabajo aborda el estudio del Proyecto Scipio, aplicación para teléfonos móviles impulsada por la Junta de Andalucía (dentro de su plataforma Espacios Junta) que permite al visitante del ...Conjunto Arqueológico de Itálica (Sevilla) simular un viaje al pasado y conocer cómo eran sus lugares emblemáticos. El objetivo principal de este trabajo es analizar y describir la herramienta tecnológica y su viabilidad en espacios abiertos. La naturaleza metodológica de este trabajo es eminentemente comparativa y descriptiva, al tratarse de una nueva herramienta digital. Los resultados recogen que el software analizado aloja contenidos en realidad virtual y aumentada, así como recreaciones 3D en 360º del Anfiteatro, donde se ha reconstruido virtualmente el interior del coliseo, de tal forma que el visitante puede ver cómo eran las gradas y la arena. El recorrido por la Casa de los Pájaros recrea el vestíbulo, el peristilo y otras estancias. Ambos son dos de los espacios más emblemáticos de la antigua ciudad romana de Itálica. Este tipo de tecnologías logra una mejor interpretación del conjunto, así como el enriquecimiento del visitante. Del mismo modo, constituye una nueva vía para el fomento del turismo cultural basada en vivir la experiencia a través de la tecnología.
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