Publications by authors named "J Serra"

621 Publications

Fine-scale population structure in five rural populations from the Spanish Eastern Pyrenees using high-coverage whole-genome sequence data.

Eur J Hum Genet 2021 Apr 9. Epub 2021 Apr 9.

CNAG-CRG, Centre for Genomic Regulation, C/ Baldiri i Reixach 4, 08028, Barcelona, Spain.

The area of the Spanish Pyrenees is particularly interesting for studying the demographic dynamics of European rural areas given its orography, the main traditional rural condition of its population and the reported higher patterns of consanguinity of the region. Previous genetic studies suggest a gradient of genetic continuity of the area in the West to East axis. However, it has been shown that micro-population substructure can be detected when considering high-quality NGS data and using spatial explicit methods. In this work, we have analyzed the genome of 30 individuals sequenced at 40× from five different valleys in the Spanish Eastern Pyrenees (SEP) separated by less than 140 km along a west to east axis. Using haplotype-based methods and spatial analyses, we have been able to detect micro-population substructure within SEP not seen in previous studies. Linkage disequilibrium and autozygosity analyses suggest that the SEP populations show diverse demographic histories. In agreement with these results, demographic modeling by means of ABC-DL identify heterogeneity in their effective population sizes despite of their close geographic proximity, and suggests that the population substructure within SEP could have appeared around 2500 years ago. Overall, these results suggest that each rural population of the Pyrenees could represent a unique entity.
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http://dx.doi.org/10.1038/s41431-021-00875-0DOI Listing
April 2021

Comparative Study of Epoxy-CsHPO Composite Electrolytes and Porous Metal Based Electrocatalysts for Solid Acid Electrochemical Cells.

Membranes (Basel) 2021 Mar 11;11(3). Epub 2021 Mar 11.

Instituto de Tecnología Química (Consejo Superior de Investigaciones Científicas-Universitat Politècnica de València), Av. Los Naranjos, s/n, 46022 Valencia, Spain.

Electrochemical cells based on acid salts (CsHPO) have attracted great interest for intermediate temperature, due to the outstanding proton conductivity of acid salts. In this work, electrodes and electrolyte were optimized following different strategies. An epoxy resin was added to the CsHPO material to enhance the mechanical properties of the electrolyte, achieving good conductivity, enhanced stability, and cyclability. The electrodes configuration was modified, and Ni sponge was selected as active support. The infiltration of different oxide nanoparticles was carried out to tailor the electrodes resistance by promoting the electrocatalyst activity of electrodes. The selection of a cell supported on the electrode and the addition of an epoxy resin enables the reduction of the electrolyte thickness without damaging the mechanical stability of the thinner electrolyte.
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http://dx.doi.org/10.3390/membranes11030196DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999483PMC
March 2021

Breaks in peristaltic integrity predict abnormal esophageal bolus clearance better than contraction vigor or residual pressure at the esophagogastric junction.

Neurogastroenterol Motil 2021 Mar 27:e14141. Epub 2021 Mar 27.

Division of Gastroenterology, Washington University School of Medicine, St Louis, MO, USA.

Background: High-resolution impedance manometry (HRIM) evaluates esophageal peristalsis and bolus transit. We used esophageal impedance integral (EII), the ratio between bolus presence before and after an expected peristaltic wave, to evaluate predictors of bolus transit.

Methods: From HRIM studies performed on 61 healthy volunteers (median age 27 years, 48%F), standard metrics were extracted from each of 10 supine water swallows: distal contractile integral (DCI, mmHg cm s), integrated relaxation pressure (IRP, mmHg), and breaks in peristaltic integrity (cm, using 20 mmHg isobaric contour). Pressure and impedance coordinates for each swallow were exported into a dedicated, python-based program for EII calculation (EII ratio ≥ 0.3 = abnormal bolus clearance). Univariate and multivariate analyses were performed to assess predictors of abnormal bolus clearance.

Key Results: Of 591 swallows, 80.9% were intact, 10.5% were weak, and 8.6% failed. Visual analysis overestimated abnormal bolus clearance compared to EII ratio (p ≤ 0.01). Bolus clearance was complete (median EII ratio 0.0, IQR 0-0.12) in 82.0% of intact swallows in contrast to 53.3% of weak swallows (EII ratio 0.29, IQR 0.0-0.57), and 19.6% of failed swallows (EII ratio 0.5, IQR 0.34-0.73, p < 0.001). EII correlated best with break length (ρ = 0.52, p < 0.001), compared to IRP (ρ: -0.17) or DCI (ρ: -0.42). On ROC analysis, breaks predicted abnormal bolus transit better than DCI or IRP (AUC 0.79 vs. 0.25 vs. 0.44, p ≤ 0.03 for each). On logistic regression, breaks remained independently predictive of abnormal bolus transit (p < 0.001).

Conclusions & Inferences: Breaks in peristaltic integrity predict abnormal bolus clearance better than DCI or IRP in healthy asymptomatic subjects.
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http://dx.doi.org/10.1111/nmo.14141DOI Listing
March 2021

Chicago Classification update (v4.0): Technical review of high-resolution manometry metrics for EGJ barrier function.

Neurogastroenterol Motil 2021 Mar 2:e14113. Epub 2021 Mar 2.

Department of Medicine, University of California, San Diego, California, USA.

Esophagogastric junction (EGJ) barrier function is of fundamental importance in the pathophysiology of gastroesophageal reflux disease. Impaired EGJ barrier function leads to excessive distal esophageal acid exposure or, in severe cases, esophagitis. Hence, proposed high-resolution manometry (HRM) metrics assessing EGJ integrity are clinically important and were a focus of the Chicago Classification (CC) working group for inclusion in CC v4.0. However, the EGJ is a complex sphincter comprised of both crural diaphragm (CD) and lower esophageal sphincter (LES) component, each of which is subject to independent physiological control mechanisms and pathophysiology. No single metric can capture all attributes of EGJ barrier function. The working group considered several potential metrics of EGJ integrity including LES-CD separation, the EGJ contractile integral (EGJ-CI), the respiratory inversion point (RIP), and intragastric pressure. Strong recommendations were made regarding LES-CD separation as indicative of hiatus hernia, although the numerical threshold for defining hiatal hernia was not agreed upon. There was no agreement on the significance of the RIP, only that it could localize either above the LES or between the LES and CD in cases of hiatus hernia. There was agreement on how to measure the EGJ-CI and that it should be referenced to gastric pressure in units of mmHg cm, but the numerical threshold indicative of a hypotensive EGJ varied widely among reports and was not agreed upon. Intragastric pressure was endorsed as an important metric worthy of further study but there was no agreement on a numerical threshold indicative of abdominal obesity.
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http://dx.doi.org/10.1111/nmo.14113DOI Listing
March 2021

Small intestinal bacterial overgrowth in spinal cord injury patients.

Gastroenterol Hepatol 2021 Feb 26. Epub 2021 Feb 26.

Unidad de Motilidad y Trastornos Funcionales Digestivos, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas (CIBERehd), Badalona, Barcelona, España.

Aim: Spinal cord injury (SCI) patients may have intestinal dysmotility and digestive symptoms that are associated with small intestinal bacterial overgrowth (SIBO). The aim of this study is to describe the prevalence of SIBO in SCI patients and the risk factors of its development.

Methods: Twenty-nine consecutive SCI patients were studied (10 women/19 men; mean age 47 years), 16 with subacute injuries (<9 months) and 13 with chronic injuries (>1 year). Nine patients were affected by tetraplegia and 15 by paraplegia. Each patient underwent a glucose breath test according to the North American Consensus and the presence of abdominal symptoms was evaluated during the test. The results were compared with 15 non-neurological patients with SIBO.

Results: Six patients tested positive for SIBO (21%), all of them affected by SCI in the subacute phase, 6/16 vs. 0/13 in the chronic phase (P<.05) and the majority with tetraplegia, 5/9 vs. 1/19 with paraplegia (P<.05). No statistically significant relationship was found with other clinical characteristics. All the tests were positive for methane or mixed (methane and hydrogen), while only 67% of the controls had methane-predominant production (P>.05).

Conclusion: SCI patients can develop SIBO, more frequently in the subacute phase and in tetraplegic patients, highlighting a high production of methane. This complication should be considered in neurogenic bowel management.
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http://dx.doi.org/10.1016/j.gastrohep.2021.01.010DOI Listing
February 2021

In-Depth Analysis of the Impact of Different Serum-Free Media on the Production of Clinical Grade Dendritic Cells for Cancer Immunotherapy.

Front Immunol 2020 5;11:593363. Epub 2021 Feb 5.

Department of Medical Sciences and Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal.

Dendritic cell (DC)-based antitumor vaccines have proven to be a safe approach, but often fail to generate robust results between trials. Translation to the clinic has been hindered in part by the lack of standard operation procedures for vaccines production, namely the definition of optimal culture conditions during DC differentiation. Here we sought to compare the ability of three clinical grade serum-free media, DendriMACS, AIM-V, and X-VIVO 15, alongside with fetal bovine serum-supplemented Roswell Park Memorial Institute Medium (RPMI), to support the differentiation of monocyte-derived DCs (Mo-DCs). Under these different culture conditions, phenotype, cell metabolomic profiles, response to maturation stimuli, cytokines production, allogenic T cell stimulatory capacity, as well as priming of antigen-specific CD8 T cells and activation of autologous natural killer (NK) cells were analyzed. Immature Mo-DCs differentiated in AIM-V or X-VIVO 15 presented lower levels of CD1c, CD1a, and higher expression of CD11c, when compared to cells obtained with DendriMACS. Upon stimulation, only AIM-V or X-VIVO 15 DCs acquired a full mature phenotype, which supports their enhanced capacity to polarize T helper cell type 1 subset, to prime antigen-specific CD8 T cells and to activate NK cells. CD8 T cells and NK cells resulting from co-culture with AIM-V or X-VIVO 15 DCs also showed superior cytolytic activity. 1H nuclear magnetic resonance-based metabolomic analysis revealed that superior DC immunostimulatory capacities correlate with an enhanced catabolism of amino acids and glucose. Overall, our data highlight the impact of critically defining the culture medium used in the production of DCs for clinical application in cancer immunotherapy. Moreover, the manipulation of metabolic state during differentiation could be envisaged as a strategy to enhance desired cell characteristics.
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http://dx.doi.org/10.3389/fimmu.2020.593363DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7893095PMC
February 2021

Transitioning from a coronary to a critical cardiovascular care unit: trends over the past three decades.

Eur Heart J Acute Cardiovasc Care 2020 Jul 16. Epub 2020 Jul 16.

Heart Institute, Hospital Universitari Germans Trias i Pujol, Spain.

Background: Coronary care units were established in the 1960s to reduce acute-phase mortality in acute coronary syndrome. In the 21st century, the original coronary care unit concept has evolved into an intensive cardiovascular care unit. The aim of this study was to analyse trend changes in characteristics and mortality of patients admitted to a coronary care unit over the past three decades.

Method: Between February 1989 and December 2017, a total of 18,334 patients was consecutively admitted to the coronary care unit of a university hospital in Barcelona. Data were analysed in five time frames: 1989-1994, 1995-1999, 2000-2004, 2005-2009 and 2010-2017. We analysed demographic profile, diagnoses at admission and trend changes in mortality across periods.

Results: During the periods, the patients' ages and comorbidities increased. Diagnoses at admission have evolved. Acute coronary syndrome cases declined from the first to the last period (72.6% vs. 62.8%) while heart failure (6.0% vs. 8.6%) and malignant arrhythmias (0.8% vs. 4.0%) increased significantly. Overall, coronary care unit mortality decreased 34% from the first to the last period (6.8% vs. 4.5%, P<0.001). Furthermore, the cause of death has changed, those due to acute coronary syndrome declining (66.7% vs. 45.5%), and death from malignant arrhythmias increasing (1.9% vs. 16.2%) from the first to the last period.

Conclusions: Although acute coronary syndrome remained the main diagnosis, heart failure and arrhythmias have increased. Despite the aging and comorbidities, overall mortality in the coronary care unit decreased by 34% in the past three decades. Deaths due to acute coronary syndrome have declined, whereas those due to malignant arrhythmias have increased.
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http://dx.doi.org/10.1177/2048872620936038DOI Listing
July 2020

Development of a groundwater contamination index based on the agricultural hazard and aquifer vulnerability: Application to Portugal.

Sci Total Environ 2021 Jun 2;772:145032. Epub 2021 Feb 2.

Department of Agroecology, Aarhus University, Blichers Allé 20, DK-8830 Tjele, Denmark.

Reducing nitrate leaching may not result in a significant improvement of groundwater quality. The amount of nitrate reaching groundwater depends not only on the hazard related to agricultural activities but also on-site specific groundwater vulnerability. Using national databases and other compiled datasets, the agricultural hazard was calculated as the ratio of (i) the nitrate leached estimated from the N surplus, and (ii) the water surplus, a proxy of the percolating water below the root zone. By combining the hazard with a multi-parameter groundwater vulnerability, a spatially explicit groundwater contamination risk, developed for mainland Portugal, was computed for 1999 and 2009. Results show an increase from 8,800 to 82,679 ha of the territory rated with a very high contamination risk. The priority areas were successfully screened by the Index, coinciding with the current Vulnerable Zones, although additional hotspots were detected in southern Portugal. Percolation, including both irrigation activity and precipitation, was found to be a key driver for the groundwater contamination risk due to its opposite effects in the hazard and in the vulnerability. Reducing nitrogen leaching may be insufficient to reduce the risk of nitrate contamination if there is a relatively larger reduction in precipitation. This index is particularly useful when applied to contrasting situations of vulnerability and hazard, which require distinct mitigation measures to mitigate groundwater contamination.
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http://dx.doi.org/10.1016/j.scitotenv.2021.145032DOI Listing
June 2021

The Spanish version of the esophageal hypervigilance and anxiety score shows strong psychometric properties: Results of a large prospective multicenter study in Spain and Latin America.

Neurogastroenterol Motil 2021 Feb 13:e14102. Epub 2021 Feb 13.

Digestive System Research Unit, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), University Hospital Vall d'Hebron, Barcelona, Spain.

Background: Anxiety is a significant modulator of sensitivity along the GI tract. The recently described Esophageal Hypervigilance and Anxiety Score (EHAS) evaluates esophageal-specific anxiety. The aims of this study were as follows: 1. translate and validate an international Spanish version of EHAS. 2. Evaluate its psychometric properties in a large Hispano-American sample of symptomatic individuals.

Methods: A Spanish EHAS version was developed by a Delphi process and reverse translation. Patients referred for high-resolution manometry (HRM) were recruited prospectively from seven Spanish and Latin American centers. Several scores were used: EHAS, Hospital Anxiety and Depression Scale (HADS), Eckardt score (ES), Gastroesophageal Reflux Questionnaire (GERDQ), and the Brief Esophageal Dysphagia Questionnaire (BEDQ). Standardized psychometric analyses were performed.

Key Results: A total of 443 patients were recruited. Spanish EHAS showed excellent reliability (Cronbach´s alpha = 0.94). Factor analysis confirmed the presence of two factors, corresponding to the visceral anxiety and hypervigilance subscales. Sufficient convergent validity was shown by moderate significant correlations between EHAS and other symptomatic scores. Patients with high EHAS scores had significantly more dysphagia. There was no difference in EHAS scores when compared normal vs abnormal or major manometric diagnosis.

Conclusions And Inferences: A widely usable Spanish EHAS version has been validated. We confirm its excellent psychometric properties in our patients, confirming the appropriateness of its use in different populations. Our findings support the appropriateness of evaluating esophageal anxiety across the whole manometric diagnosis spectrum.
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http://dx.doi.org/10.1111/nmo.14102DOI Listing
February 2021

Dimethyloxalylglycine, a small molecule, synergistically increases the homing and angiogenic properties of human mesenchymal stromal cells when cultured as 3D spheroids.

Biotechnol J 2021 Jan 20:e2000389. Epub 2021 Jan 20.

Department of Bioengineering, iBB-Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal.

Strategies aiming at increasing the survival and paracrine activity of human mesenchymal stromal cells (MSCs) are of utmost importance to achieve the full therapeutic potential of these cells. Herein, we propose both physical and biochemical strategies to enhance the survival, homing, angiogenic, and immunomodulatory properties of MSCs in vitro. To that purpose, we compared the effect of exposing either 2D monolayer or 3D spheroids of MSCs to (i) hypoxia (2% O ) or to (ii) a hypoxic-mimetic small molecule, dimethyloxalylglycine (DMOG), with cells cultured at 21% O . 3D-cultured MSC spheroids evidenced higher survival upon exposure to oxidative stress and expressed higher levels of factors involved in tissue repair processes, namely tumor necrosis factor-stimulated gene-6, matrix metalloproteinase-2, and vascular endothelial growth factor. MSCs cultured as 3D spheroids and further exposed to hypoxia or hypoxic-mimetic conditions provided by DMOG synergistically favored the expression of the cell surface marker C-X-C chemokine receptor type-4, involved in homing processes to injured tissues, and adhesion to extracellular matrix components as fibronectin. These results highlight the role of ex vivo preconditioning approaches, presenting a novel strategy that combine biochemical stimuli with 3D spheroid organization of MSCs to maximize their tissue regeneration potential.
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http://dx.doi.org/10.1002/biot.202000389DOI Listing
January 2021

Circulating leukocyte-platelet complexes as a predictive biomarker for the development of immune-related adverse events in advanced non-small cell lung cancer patients receiving anti-PD-(L)1 blocking agents.

Cancer Immunol Immunother 2021 Jan 2. Epub 2021 Jan 2.

Group of Immunology-Inflammatory Diseases, Biomedical Research Institut Sant Pau (IIB Sant Pau), Barcelona, Spain.

Background: Anti-PD-(L)1 blocking agents can induce immune-related adverse events (irAEs), which can compromise treatment continuation. Since circulating leukocyte-platelet (PLT) complexes contribute to inflammatory and autoimmune diseases, we aimed to analyze the role of these complexes as predictors of irAEs in non-small cell lung cancer (NSCLC) patients receiving anti-PD-(L)1.

Materials And Methods: Twenty-six healthy donors (HD) and 87 consecutive advanced NSCLC patients treated with anti-PD-(L)1 were prospectively included. Percentages of circulating leukocyte-PLT complexes were analyzed by flow cytometry and compared between HD and NSCLC patients. The association of leukocyte-PLT complexes with the presence and severity of irAEs was analyzed.

Results: NSCLC patients had higher percentages of circulating leukocyte-PLT complexes. Higher percentages of monocytes with bound PLT (CD14 + PLT +) were observed in patients who received prior therapies while CD4 + T lymphocytes with bound PLT (CD4 + PLT +) correlated with platelets counts. The CD4 + PLT + high percentage group presented a higher rate of dermatological irAEs while the CD4 + PLT + low percentage group showed a higher rate of non-dermatological irAEs (p < 0.001). A lower frequency of grade ≥ 2 irAEs was observed in the CD4 + PLT + high percentage group (p < 0.05). Patients with CD4 + PLT + low and CD14 + PLT + high percentages presented a higher rate of grade ≥ 3 irAEs and predominantly developed non-dermatological irAEs (p < 0.01).

Conclusions: Our results suggest that circulating leukocyte-PLT complexes and the combination of CD4 + PLT + and CD14 + PLT + percentages can be used as a predictive biomarker of the development and severity of irAEs in advanced NSCLC patients receiving anti-PD-(L)1 agents.
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http://dx.doi.org/10.1007/s00262-020-02793-4DOI Listing
January 2021

Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0.

Neurogastroenterol Motil 2021 01;33(1):e14058

Division of Gastroenterology & Hepatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Chicago Classification v4.0 (CCv4.0) is the updated classification scheme for esophageal motility disorders using metrics from high-resolution manometry (HRM). Fifty-two diverse international experts separated into seven working subgroups utilized formal validated methodologies over two-years to develop CCv4.0. Key updates in CCv.4.0 consist of a more rigorous and expansive HRM protocol that incorporates supine and upright test positions as well as provocative testing, a refined definition of esophagogastric junction (EGJ) outflow obstruction (EGJOO), more stringent diagnostic criteria for ineffective esophageal motility and description of baseline EGJ metrics. Further, the CCv4.0 sought to define motility disorder diagnoses as conclusive and inconclusive based on associated symptoms, and findings on provocative testing as well as supportive testing with barium esophagram with tablet and/or functional lumen imaging probe. These changes attempt to minimize ambiguity in prior iterations of Chicago Classification and provide more standardized and rigorous criteria for patterns of disorders of peristalsis and obstruction at the EGJ.
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http://dx.doi.org/10.1111/nmo.14058DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8034247PMC
January 2021

Characterization and Cytotoxic Effect of Biosurfactants Obtained from Different Sources.

ACS Omega 2020 Dec 24;5(48):31381-31390. Epub 2020 Nov 24.

EQ10 Group, CINTECX, Department Chemical Engineering, Universidade de Vigo-University of Vigo, Campus As Lagoas-Marcosende, 36310 Vigo, Spain.

In this work, five biosurfactant extracts, obtained from different sources, all of them with demonstrated antimicrobial properties, were characterized and subjected to a cytotoxic study using mouse fibroblast cells (NCTC clone 929). Biosurfactant extracts obtained directly from corn steep water (CSW) showed similar surfactant characteristics to those of the extracellular biosurfactant extract produced by isolated from CSW and grown in tryptic soy broth, observing that they are amphoteric, consisting of viscous and yellowish liquid with no foaming capacity. Contrarily, cell-bound biosurfactant extracts produced from or produced by sp isolated from CSW are nonionic, consisting of a white powder with foaming capacity. All the biosurfactants possess a similar fatty acid composition. The cytotoxic test revealed that the extracts under evaluation, at a concentration of 1 g/L, were not cytotoxic for fibroblasts (fibroblast growth > 90%). The biosurfactant extract obtained from CSW with ethyl acetate, at 1 g/L, showed the highest cytotoxic effect but above the cytotoxicity limit established by the UNE-EN-ISO10993-5. It is remarkable that the cell-bound biosurfactant produced by at a concentration of 1 g/L, promoted the growth of the fibroblast up to 113%.
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http://dx.doi.org/10.1021/acsomega.0c04933DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726928PMC
December 2020

Unravelling the crystal structure of NdWO and NdWMoO mixed ionic electronic conductors.

J Appl Crystallogr 2020 Dec 26;53(Pt 6):1471-1483. Epub 2020 Oct 26.

Instituto de Tecnología Química (Universitat Politècnica de València-Consejo Superior de Investigaciones Cientifícas), Avenida Los Naranjos s/n, Valencia 46022, Spain.

Mixed ionic electronic conducting ceramics Nd WO (δ is the oxygen deficiency) provide excellent stability in harsh environments containing strongly reactive gases such as CO, CO, H, HO or HS. Due to this chemical stability, they are promising and cost-efficient candidate materials for gas separation, catalytic membrane reactors and protonic ceramic fuel cell technologies. As in La WO, the ionic/electronic transport mechanism in Nd WO is expected to be largely controlled by the crystal structure, the conclusive determination of which is still lacking. This work presents a crystallographic study of NdWO and molybdenum-substituted NdWMoO prepared by the citrate complexation route. High-resolution synchrotron and neutron powder diffraction data were used in combined Rietveld refinements to unravel the crystal structure of NdWO and NdWMoO. Both investigated samples crystallize in a defect fluorite crystal structure with space group 3 and doubled unit-cell parameter due to cation ordering. Mo replaces W at both Wyckoff sites 4 and 48 and is evenly distributed, in contrast with La WO. X-ray absorption spectroscopy as a function of partial pressure O in the near-edge regions excludes oxidation state changes of Nd (Nd) and W (W) in reducing conditions: the enhanced hydrogen permeation, ambipolar conduction, observed in Mo-substituted Nd WO is therefore explained by the higher Mo reducibility and the creation of additional - disordered - oxygen vacancies.
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http://dx.doi.org/10.1107/S1600576720012698DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7710492PMC
December 2020

Evaluation of sling fibers and two penetrating vessels for guiding extent of the tunnel and myotomy during posterior peroral endoscopic myotomy in a Western cohort.

VideoGIE 2020 Nov 1;5(11):507-509. Epub 2020 Jul 1.

Motility and Functional Gut Disorders Unit, Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.

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http://dx.doi.org/10.1016/j.vgie.2020.05.034DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649978PMC
November 2020

Optimal Recovery of Valuable Biomaterials, Chondroitin Sulfate and Bioapatites, from Central Skeleton Wastes of Blue Shark.

Polymers (Basel) 2020 Nov 6;12(11). Epub 2020 Nov 6.

Group of Recycling and Valorisation of Waste Materials (REVAL), Marine Research Institute (IIM-CSIC), Eduardo Cabello, 6. Vigo, 36208 Galicia, Spain.

The industrial filleting of blue shark () led to the generation of a large number of central skeletons of low interest to fishmeal plants handling such wastes. In this context, the present study describes the optimization of the hydrolysis process (pH 8.35, T 58 °C, 1% () of alcalase and t = 4 h) to produce chondroitin sulfate (CS) together with the recovery of bioapatites. Then, that hydrolysate was chemically treated with an optimal alkaline-hydroalcoholic-saline solution (0.48 M of NaOH, 1.07 volumes of EtOH and 2.5 g/L of NaCl) and finally purified by ultrafiltration-diafiltration (30 kDa) to obtain glycosaminoglycan with a purity of 97% and a productive yield of 2.8% (/ of skeleton). The size of the biopolymer (CS) was of 58 kDa with prevalence of 6S-GalNAc sulfation (4S/6S ratio of 0.25), 12% of GlcA 2S-GalNAc 6S and 6% of non-sulfated disaccharides. Crude bioapatites were purified by pyrolysis and FT-Raman and XRD techniques confirm the presence of hydroxyapatite [Ca(PO)(OH)], with a molar mass of 502.3 g/mol, embedded in the organic matrix of the skeleton. The mineralized tissues of blue shark are promising marine sources for the extraction of high value biomaterials with clinical application in bone and tissue regeneration and are still completely unexplored.
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http://dx.doi.org/10.3390/polym12112613DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694617PMC
November 2020

Validation and psychometric evaluation of the Spanish version of Brief Esophageal Dysphagia Questionnaire (BEDQ): Results of a multicentric study.

Neurogastroenterol Motil 2021 Apr 9;33(4):e14025. Epub 2020 Nov 9.

Motility and Functional Gut Disorders Unit, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), University Hospital Germans Trias i Pujol, Badalona, Spain.

Background: The recently developed Brief Esophageal Dysphagia Questionnaire (BEDQ) evaluates esophageal obstructive symptoms. Its initial evaluation showed strong psychometric properties. The aims of this study were to (a) translate and validate an international Spanish version of BEDQ and (b) evaluate its psychometric properties in a large Hispano-American sample of symptomatic individuals.

Methods: A Spanish BEDQ version was performed by Hispano-American experts using a Delphi process and reverse translation. Patients were prospectively recruited from seven centers in Spain and Latin America among individuals referred for high-resolution manometry (HRM). Patients completed several scores: Hospital Anxiety & Depression Scale (HADS), Eckardt score (ES), Gastroesophageal Reflux Questionnaire (GERDQ), and the BEDQ. Standardized psychometric analyses were performed.

Key Results: A total of 426 patients were recruited. Spanish BEDQ showed excellent reliability (Cronbach's alpha = 0.91). Factor analysis confirmed its unidimensional character. Moderate significant correlations between BEDQ and other symptomatic scores were found, suggesting sufficient convergent validity. Patients with abnormal or obstructive HRM findings scored significantly higher when compared to normal or non-obstructive findings, respectively. Using a cutoff of 10, BEDQ showed a sensitivity of 65.38% and a specificity of 66.21% and an area under the curve of 0.71 for obstructive or major manometric diagnosis.

Conclusions And Inferences: A widely usable Spanish BEDQ version has been validated. We confirm its excellent psychometric properties in our patients, confirming the appropriateness of its use in different populations.
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http://dx.doi.org/10.1111/nmo.14025DOI Listing
April 2021

High-Resolution Manometry Thresholds and Motor Patterns Among Asymptomatic Individuals.

Clin Gastroenterol Hepatol 2020 Nov 2. Epub 2020 Nov 2.

Division of Gastroenterology, Washington University School of Medicine in St Louis, St Louis, Missouri. Electronic address:

Objective: High-resolution manometry (HRM) is the current standard for characterization of esophageal body and esophagogastric junction (EGJ) function. We aimed to examine the prevalence of abnormal esophageal motor patterns in health, and to determine optimal thresholds for software metrics across HRM systems.

Design: Manometry studies from asymptomatic adults were solicited from motility centers worldwide, and were manually analyzed using integrated relaxation pressure (IRP), distal latency (DL), and distal contractile integral (DCI) in standardized fashion. Normative thresholds were assessed using fifth and/or 95th percentile values. Chicago Classification v3.0 criteria were applied to determine motor patterns across HRM systems, study positions (upright vs supine), ages, and genders.

Results: Of 469 unique HRM studies (median age 28.0, range 18-79 years), 3 quarters had a normal HRM pattern; none had achalasia. Ineffective esophageal motility (IEM) was the most frequent motor pattern identified (15.1% overall), followed by EGJ outflow obstruction (5.3%). Proportions with IEM were lower using stringent criteria (10.0%), especially in supine studies (7.1%-8.5%). Other motor patterns were rare (0.2%-4.1% overall) and did not vary by age or gender. DL thresholds were close to current norms across HRM systems, while IRP thresholds varied by HRM system and study position. Both fifth and 95th percentile DCI values were lower than current thresholds, both in upright and supine positions.

Conclusions: Motor abnormalities are infrequent in healthy individuals and consist mainly of IEM, proportions of which are lower when using stringent criteria in the supine position. Thresholds for HRM metrics vary by HRM system and study position.
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http://dx.doi.org/10.1016/j.cgh.2020.10.052DOI Listing
November 2020

Esophagogastric junction morphology and contractile integral on high-resolution manometry in asymptomatic healthy volunteers: An international multicenter study.

Neurogastroenterol Motil 2020 Oct 23:e14009. Epub 2020 Oct 23.

Division of Gastroenterology, Washington University School of Medicine, St Louis, MO, USA.

Background: Esophagogastric junction contractile integral (EGJ-CI) and EGJ morphology are high-resolution manometry (HRM) metrics that assess EGJ barrier function. Normative data standardized across world regions and HRM manufacturers are limited.

Methods: Our aim was to determine normative EGJ metrics in a large international cohort of healthy volunteers undergoing HRM (Medtronic, Laborie, and Diversatek software) acquired from 16 countries in four world regions. EGJ-CI was calculated by the same two investigators using a distal contractile integral-like measurement across the EGJ for three respiratory cycles and corrected for respiration (mm Hg cm), using manufacturer-specific software tools. EGJ morphology was designated according to Chicago Classification v3.0. Median EGJ-CI values were calculated across age, genders, HRM systems, and regions.

Results: Of 484 studies (28.0 years, 56.2% F, 60.7% Medtronic studies, 26.0% Laborie, and 13.2% Diversatek), EGJ morphology was type 1 in 97.1%. Median EGJ-CI was similar between Medtronic (37.0 mm Hg cm, IQR 23.6-53.7 mm Hg cm) and Diversatek (34.9 mm Hg cm, IQR 22.1-56.1 mm Hg cm, P = 0.87), but was significantly higher using Laborie equipment (56.5 mm Hg cm, IQR 35.0-75.3 mm Hg cm, P < 0.001). 5 percentile EGJ-CI values ranged from 6.9 to 12.1 mm Hg cm. EGJ-CI values were consistent across world regions, but different between manufacturers even within the same world region (P ≤ 0.001). Within Medtronic studies, EGJ-CI and basal LESP were similar in younger and older individuals (P ≥ 0.3) but higher in women (P < 0.001).

Conclusions: EGJ morphology is predominantly type 1 in healthy adults. EGJ-CI varies widely in health, with significant gender influence, but is consistent within each HRM system. Manufacturer-specific normative values should be utilized for clinical HRM interpretation.
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http://dx.doi.org/10.1111/nmo.14009DOI Listing
October 2020

Recommendations for use of antigenic tests in the diagnosis of acute SARS-CoV-2 infection in the second pandemic wave: attitude in different clinical settings.

Rev Esp Quimioter 2020 Dec 19;33(6):466-484. Epub 2020 Oct 19.

Dr. Francisco Javier Candel. Enfermedades Infecciosas y Microbiología Clínica. Hospital Clínico San Carlos. Institutos IdISSC e IML. Profesor Asociado. Facultad de Medicina. UCM. Madrid. Spain.

The high transmissibility of SARS-CoV-2 before and shortly after the onset of symptoms suggests that only diagnosing and isolating symptomatic patients may not be sufficient to interrupt the spread of infection; therefore, public health measures such as personal distancing are also necessary. Additionally, it will be important to detect the newly infected individuals who remain asymptomatic, which may account for 50% or more of the cases. Molecular techniques are the "gold standard" for the diagnosis of SARS-CoV-2 infection. However, the massive use of these techniques has generated some problems. On the one hand, the scarcity of resources (analyzers, fungibles and reagents), and on the other the delay in the notification of results. These two facts translate into a lag in the application of isolation measures among cases and contacts, which favors the spread of the infection. Antigen detection tests are also direct diagnostic methods, with the advantage of obtaining the result in a few minutes and at the very "pointof-care". Furthermore, the simplicity and low cost of these tests allow them to be repeated on successive days in certain clinical settings. The sensitivity of antigen tests is generally lower than that of nucleic acid tests, although their specificity is comparable. Antigenic tests have been shown to be more valid in the days around the onset of symptoms, when the viral load in the nasopharynx is higher. Having a rapid and real-time viral detection assay such as the antigen test has been shown to be more useful to control the spread of the infection than more sensitive tests, but with greater cost and response time, such as in case of molecular tests. The main health institutions such as the WHO, the CDC and the Ministry of Health of the Government of Spain propose the use of antigenic tests in a wide variety of strategies to respond to the pandemic. This document aims to support physicians involved in the care of patients with suspected SC2 infection, in the context of a growing incidence in Spain since September 2020, which already represents the second pandemic wave of COVID-19.
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http://dx.doi.org/10.37201/req/120.2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712344PMC
December 2020

Trends in Short- and Long-Term ST-Segment-Elevation Myocardial Infarction Prognosis Over 3 Decades: A Mediterranean Population-Based ST-Segment-Elevation Myocardial Infarction Registry.

J Am Heart Assoc 2020 10 15;9(20):e017159. Epub 2020 Oct 15.

Heart Institute Hospital Universitari Germans Trias i Pujol Badalona Spain.

Background Coronary artery disease remains a major cause of death despite better outcomes of ST-segment-elevation myocardial infarction (STEMI). We aimed to analyze data from the Ruti-STEMI registry of in-hospital, 28-day, and 1-year events in patients with STEMI over the past 3 decades in Catalonia, Spain, to assess trends in STEMI prognosis. Methods and Results Between February 1989 and December 2017, a total of 7589 patients with STEMI were admitted consecutively. Patients were grouped into 5 periods: 1989 to 1994 (period 1), 1995 to 1999 (period 2), 2000 to 2004 (period 3), 2005 to 2009 (period 4), and 2010 to 2017 (period 5). We used Cox regression to compare 28-day and 1-year STEMI mortality and in-hospital complication trends across these periods. Mean patient age was 61.6±12.6 years, and 79.3% were men. The 28-day all-cause mortality declined from period 1 to period 5 (10.4% versus 6.0%; <0.001), with a 40% reduction after multivariable adjustment (hazard ratio [HR], 0.6; 95% CI, 0.46-0.80; <0.001). One-year all-cause mortality declined from period 1 to period 5 (11.7% versus 9.0%; =0.001), with a 24% reduction after multivariable adjustment (HR, 0.76; 95% CI, 0.60-0.98; =0.036). A significant temporal reduction was observed for in-hospital complications including postinfarct angina (-78%), ventricular tachycardia (-57%), right ventricular dysfunction (-48%), atrioventricular block (-45%), pericarditis (-63%), and free wall rupture (-53%). Primary ventricular fibrillation showed no significant downslope trend. Conclusions In-hospital STEMI complications and 28-day and 1-year mortality rates have dropped markedly in the past 30 years. Reducing ischemia-driven primary ventricular fibrillation remains a major challenge.
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http://dx.doi.org/10.1161/JAHA.120.017159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763375PMC
October 2020

The added value of symptom analysis during a rapid drink challenge in high-resolution esophageal manometry.

Neurogastroenterol Motil 2021 Apr 11;33(4):e14008. Epub 2020 Oct 11.

Motility and Functional Gut Disorders Unit, University Hospital Germans Trias i Pujol, Centro de Investigación Biomedica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Autonomous University of Barcelona, Badalona, Spain.

Introduction: Patients with esophageal symptoms often remain with an uncertain diagnosis after high-resolution manometry.

Aim: To determine the added value of concomitant pressure and symptom analysis in response to a rapid drink challenge (RDC).

Methods: In consecutive patients referred for esophageal manometry, a RDC consisting in free drinking of 200 ml of water as quick as possible was performed after the standard single water swallows manometry. Both pressure patterns and usual symptoms induced by the RDC were analyzed.

Results: A total of 1319 patients were included, (64.7% women, mean age 58.2 years, range 11-90). There were significant differences in pressure responses between patients with obstructive disorders, major hypercontractile disorders, esophageal hypomotility disorders and normal motility. The RDC provoked usual symptoms in 388 (29.4%) patients, associated with hyperpressive and obstructive patterns in 14.0% and 16.6%, respectively. Reproduction of dysphagia and regurgitation (not pain) was significantly associated with abnormal pressure responses during the RDC (p < 0.001 and p = 0.002, respectively). The RDC elicited both abnormal pressure patterns and symptoms in 6.2%, 1.6%, and 20.8% of patients with normal motility, ineffective esophageal motility, and esophago-gastric junction outflow obstruction, respectively.

Conclusion: Concomitant evaluation of symptoms and pressure responses to a RDC may increase the specificity of esophageal motor testing in patients with inconclusive diagnosis or normal esophageal motility.
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http://dx.doi.org/10.1111/nmo.14008DOI Listing
April 2021

Immune-Related Adverse Events and Corticosteroid Use for Cancer-Related Symptoms Are Associated With Efficacy in Patients With Non-small Cell Lung Cancer Receiving Anti-PD-(L)1 Blockade Agents.

Front Oncol 2020 7;10:1677. Epub 2020 Sep 7.

Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Immune-related adverse events (irAEs) have been associated with improved efficacy in advanced non-small cell lung cancer (NSCLC) patients receiving anti-PD-(L)1 blockade agents, while the concurrent use of corticosteroids seems to worsen it. We evaluated outcomes in advanced NSCLC patients treated with anti-PD-(L)1 blockade agents in relation to the presence of irAEs and the reasons for using corticosteroids: whether for palliative cancer-related reasons or for the management of irAEs. Clinical outcomes in advanced NSCLC patients treated with anti-PD-(L)1 blockade agents were calculated with regard to the presence of irAEs and the use of corticosteroids. A landmark analysis was performed to avoid immortal time bias due to the time-dependent nature of irAEs. Out of a total of 267 patients, the 56.9% of patients who experienced irAEs had significantly improved outcomes. In the landmark analysis, median progression-free survival (PFS) was 12.4 months for patients with irAEs vs. 4.1 months for patients without irAEs ( < 0.001), while median overall survival (OS) was 28.2 vs. 12.5 months, respectively ( < 0.001). Likewise, objective response and disease control rates were significantly higher in patients experiencing irAEs: 48.6 vs. 22.8% and 77.1 vs. 39.6% ( < 0.001), respectively. Median OS was significantly shorter for patients receiving ≥10 mg of prednisone equivalent daily for cancer-related symptoms than for the rest of patients (<10 mg prednisone equivalent daily or for management of irAEs): 6 vs. 15.9 months ( < 0.001). IrAEs were associated with improved efficacy in advanced NSCLC patients when a landmark analysis was applied. Patients receiving corticosteroids had significantly poorer outcomes when they were used for cancer-related symptoms.
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http://dx.doi.org/10.3389/fonc.2020.01677DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7505083PMC
September 2020

IL-6 serum levels predict severity and response to tocilizumab in COVID-19: An observational study.

J Allergy Clin Immunol 2021 01 30;147(1):72-80.e8. Epub 2020 Sep 30.

Rheumatology Service, Hospital Universitario de la Princesa, Universidad Autónoma Madrid, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain. Electronic address:

Background: Patients with coronavirus disaese 2019 (COVID-19) can develop a cytokine release syndrome that eventually leads to acute respiratory distress syndrome requiring invasive mechanical ventilation (IMV). Because IL-6 is a relevant cytokine in acute respiratory distress syndrome, the blockade of its receptor with tocilizumab (TCZ) could reduce mortality and/or morbidity in severe COVID-19.

Objective: We sought to determine whether baseline IL-6 serum levels can predict the need for IMV and the response to TCZ.

Methods: A retrospective observational study was performed in hospitalized patients diagnosed with COVID-19. Clinical information and laboratory findings, including IL-6 levels, were collected approximately 3 and 9 days after admission to be matched with preadministration and postadministration of TCZ. Multivariable logistic and linear regressions and survival analysis were performed depending on outcomes: need for IMV, evolution of arterial oxygen tension/fraction of inspired oxygen ratio, or mortality.

Results: One hundred forty-six patients were studied, predominantly males (66%); median age was 63 years. Forty-four patients (30%) required IMV, and 58 patients (40%) received treatment with TCZ. IL-6 levels greater than 30 pg/mL was the best predictor for IMV (odds ratio, 7.1; P < .001). Early administration of TCZ was associated with improvement in oxygenation (arterial oxygen tension/fraction of inspired oxygen ratio) in patients with high IL-6 (P = .048). Patients with high IL-6 not treated with TCZ showed high mortality (hazard ratio, 4.6; P = .003), as well as those with low IL-6 treated with TCZ (hazard ratio, 3.6; P = .016). No relevant serious adverse events were observed in TCZ-treated patients.

Conclusions: Baseline IL-6 greater than 30 pg/mL predicts IMV requirement in patients with COVID-19 and contributes to establish an adequate indication for TCZ administration.
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http://dx.doi.org/10.1016/j.jaci.2020.09.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7525244PMC
January 2021

The European Portuguese version of the insomnia severity index.

J Sleep Res 2021 Feb 30;30(1):e13198. Epub 2020 Sep 30.

Faculty of Psychology and Educational Sciences, University of Coimbra (FPCE-UC), Coimbra, Portugal.

Insomnia is the most prevalent sleep complaint, but remains largely an unidentified public health issue. The Insomnia Severity Index (ISI) is a brief self-report questionnaire to assess insomnia, long-established both in clinical and research settings. The present study aimed to analyse the reliability, validity, and accuracy of the ISI European Portuguese version. After the translation protocol, 1,274 participants (65.54% female), with a mean (SD, range) age of 37.52 (16.82, 18-95) years, completed the ISI. This sample included 250 patients with insomnia from a Sleep Medicine Centre, presenting a diagnosis of insomnia disorder (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; International Classification of Sleep Disorders, Third Edition), and 1,024 individuals from the community. A group of 30 patients with obstructive sleep apnea (OSA) was also recruited. Cronbach's α was 0.88 (internal consistency), and corrected item-total correlations ranged from 0.56 to 0.83. An exploratory factor analysis (oblique rotation) revealed a two-factor solution for both clinical and community samples. The ISI total score significantly differentiated insomnia disorder, no insomnia, and OSA subgroups with a large effect size (η  = 0.42). The correlation between ISI and Pittsburgh Sleep Quality Index supported concurrent validity (0.82), and discriminant validity was confirmed by a moderate correlation between ISI and Beck Depression Inventory Second Edition (0.32). The area under the curve was 0.88, and the optimal cut-off to detect clinical insomnia was 14 (82.1% sensitivity, 79.5% specificity). In conclusion, the Portuguese version of the ISI is a reliable and valid measure of insomnia in clinical and non-clinical populations. Our present study also contributes to relevant data for the international literature regarding the cut-off score of the scale for the detection of clinical insomnia.
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http://dx.doi.org/10.1111/jsr.13198DOI Listing
February 2021

Profiling the participants in creative tourism activities: Case studies from small and medium sized cities and rural areas from Continental Portugal.

Tour Manag Perspect 2020 Oct 12;36:100746. Epub 2020 Sep 12.

CES-Centre for Social Studies, University of Coimbra, Portugal.

Although cultural tourists increasingly seek to experience cultural events actively and to directly engage in creative activities, empirical knowledge about the creative tourist remains limited. This study aims to characterize the motivations and profile of creative tourists. The data was collected through a survey of participants in creative tourism activities in Portugal developed by 40 pilot institutions of the CREATOUR project during 2017 and 2018, with 814 usable questionnaires collected and validated. The questionnaire had 30 questions and marked the first time this kind of research was conducted in Portugal. The questionnaire included questions on: the composition of their travel companions, their previous participation in a creative tourism experience, reasons for visiting the destination, their characterization of the creative tourism experience, an evaluation of their creative tourism experience, and their socio-demographic profile. Using a cluster analysis to analyse the data, three clusters were found: Novelty-Seekers, Knowledge and Skills Learners, and Leisure Creative-Seekers.
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http://dx.doi.org/10.1016/j.tmp.2020.100746DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7486628PMC
October 2020

Behavioural and cognitive changes in aged pet dogs: No effects of an enriched diet and lifelong training.

PLoS One 2020 16;15(9):e0238517. Epub 2020 Sep 16.

Clever Dog Lab, Comparative Cognition, Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University of Vienna, University of Vienna, Vienna, Austria.

Dogs demonstrate behavioural changes and cognitive decline during aging. Compared to laboratory dogs, little is known about aging in pet dogs exposed to different environments and nutrition. In this study, we examined the effects of age, an enriched diet and lifelong training on different behavioural and cognitive measures in 119 pet dogs (>6yrs). Dogs were maintained on either an enriched diet or a control diet for one year. Lifelong training was calculated using a questionnaire where owners filled in their dog's training experiences to date. Before commencing the diet and after one year of dietary treatment, they were tested in the Modified Vienna Canine Cognitive Battery (MVCCB) consisting of 11 subtests to examine correlated individual differences in a set of tasks measuring general, social and physical cognition and related behaviours. Fourty two behavioural variables were coded and were subjected to principle component analyses for variable reduction. Twelve subtest level components and two Z-transformed variables were subjected to exploratory factor analysis which resulted in six final factors: Problem solving, Trainability, Sociability, Boldness, Activity-independence and Dependency. Problem solving, Sociability, Boldness, and Dependency showed a linear decline with age, suggesting that the MVCCB can be used as a tool to measure behavioural and cognitive decline in aged pet dogs. An enriched diet and lifelong training had no effect on these factors, calling attention to the fact that the real world impact of nutritional and other interventions in possibly counteracting the effects of aging, should be further investigated in pet dogs living under diverse conditions, in order to understand their ultimate effects.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238517PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7494100PMC
October 2020

High-Temperature Structural and Electrical Properties of BaCoO Positrodes.

Materials (Basel) 2020 Sep 11;13(18). Epub 2020 Sep 11.

Nanotechnology Centre A, Faculty of Applied Physics and Mathematics and Advanced Materials Centre, Gdańsk University of Technology, ul. Narutowicza 11/12, 80-233 Gdańsk, Poland.

The application of double perovskite cobaltites BaCoO ( = lanthanide element) in electrochemical devices for energy conversion requires control of their properties at operating conditions. This work presents a study of a series of BaCoO ( = La, Pr, Nd) with a focus on the evolution of structural and electrical properties with temperature. Symmetry, oxygen non-stoichiometry, and cobalt valence state have been examined by means of Synchrotron Radiation Powder X-ray Diffraction (SR-PXD), thermogravimetry (TG), and X-ray Absorption Spectroscopy (XAS). The results indicate that all three compositions maintain mainly orthorhombic structure from RT to 1000 °C. Chemical expansion from Co reduction and formation of oxygen vacancies is observed and characterized above 350 °C. Following XAS experiments, the high spin of Co was ascertained in the whole range of temperatures for BLC, BPC, and BNC.
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http://dx.doi.org/10.3390/ma13184044DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7558619PMC
September 2020

Responses to the Letter to the Editor by Brusciano et al.

Neurogastroenterol Motil 2020 09;32(9):e13981

Neurogastroenterology Unit, Division of Diabetes, Endocrinology & Gastroenterology, Wythenshawe Hospital, University of Manchester, Manchester, UK.

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http://dx.doi.org/10.1111/nmo.13981DOI Listing
September 2020

QUALITY OF LIFE OF MOTHERS OF CHILDREN WITH CONGENITAL SYNDROME AFFECTED BY ZIKA VIRUS.

Rev Paul Pediatr 2021 21;39:e2019231. Epub 2020 Aug 21.

Universidade Federal do Maranhão, São Luís, MA, Brazil.

Objective: To investigate how mothers of children with congenital syndrome (microcephaly) associated with Zika virus perceive their quality of life.

Methods: This is a qualitative study carried out in two stages: at the Maternal and Child University Hospital and at Casa de Apoio Ninar through semi-structured interviews with mothers of children with congenital syndrome associated with Zika virus. Ten women comprised the sample.

Results: In line with the critical discourse analysis, four categories emerged based on Fairclough's 2008 assumptions: Quality of Life and Health - quality of life perception associated with the broad meaning of the term health; Quality of Life and Health Care Systems - characterized by care instability and fragmentation; Quality of Life and Free Time - lack of free time for activities of daily living and leisure; Quality of Life and Future Perspectives - lack of future perspective, considering that most participants had to stop working and studying to take care of their children.

Conclusions: Mothers of children with congenital syndrome associated with Zika virus are devoted to their children's care. Their lack of prospects was considered a consequence of the lack of time for activities of daily living and leisure.
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http://dx.doi.org/10.1590/1984-0462/2021/39/2019231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7442408PMC
August 2020