Effect of the harvest date, calcium and other chemicals on the quality and storability of ‘Golden Smoothie’ apples

Apples cultivated in Mexico generally are smaller and softer than those produced in other geographical latitudes considered as optimal for apple production. The aim of this evaluation was determine the effect of applications with calcium, nitrogen, potassium, magnesium, sulfur and naphthaleneacetic acid (NAA), as well as the harvest date on the quality of apple fruits. ‘Golden Smoothie’ apple trees were treated foliarly with CaCl2 with and without NAA, and with a mixture of N, K, Mg and S or gypsum applied to soil for two years. Apples were harvested at 141 (regular harvest date), 161 (mid-late harvest) and 171 days (late harvest) after full bloom (DAFB) and evaluated for quality at harvest time and during their storage at 0°C for up to 179 days. Foliar applications of CaCl2 significantly increased the calcium content in fruit and leaves, but fruit quality, including firmness, was not influenced. Fertilization of soil with the mixture of nutrients, including CaSO4, did not influence the fruit quality. Lately harvested fruit was 14.9% heavier but 17.1% softer than fruit picked at the commercial harvest date. Delaying of fruit harvest reduced about 43 d the storability of fruit. Based in these results, the relative softness of apples grown in Mexico is not related with its calcium content, hence unlikely to be overcome with the application of this mineral. Even in the control fruits, both seasons, the stored fruits do not show some physiological disorder as bitter pit.  Objective: Apples cultivated in Mexico generally are smaller and softer than those produced in other geographical latitudes considered as optimal for apple production. The aim of this evaluation was determine the effect of applications with calcium, nitrogen, potassium, magnesium, sulfur and naphthaleneacetic acid (NAA), as well as the harvest date on the quality of apple fruits. Methodology ‘Golden Smoothie’ apple trees were treated foliarly with CaCl2 with and without NAA, and with a mixture of N, K, Mg and S or gypsum applied to soil for two years. Apples were harvested at 141 (regular harvest date), 161 (mid-late harvest) and 171 days (late harvest) after full bloom (DAFB) and evaluated for quality at harvest time and during their storage at 0°C for up to 179 days. Results: Foliar applications of CaCl2 significantly increased the calcium content in fruit and leaves, but fruit quality, including firmness, was not influenced. Fertilization of soil with the mixture of nutrients, including CaSO4, did not influence the fruit quality. Lately harvested fruit was 14.9% heavier but 17.1% softer than fruit picked at the commercial harvest date. Delaying of fruit harvest reduced about 43 d the storability of fruit. Based in these results, the relative softness of apples grown in Mexico is not related with its calcium content, hence unlikely to be overcome with the application of this mineral. Conclusions: Even in the control fruits, both seasons, the stored fruits do not show some physiological disorder as bitter pi

D-cycloserine augmentation of exposure-based cognitive behavior therapy for anxiety, obsessive-compulsive, and posttraumatic stress disorders: a systematic review and meta-analysis of individual participant data

Importance: Whether and under which conditions D-cycloserine (DCS) augments the effects of exposure-based cognitive behavior therapy for anxiety, obsessive-compulsive, and posttraumatic stress disorders is unclear. Objective: To clarify whether DCS is superior to placebo in augmenting the effects of cognitive behavior therapy for anxiety, obsessive-compulsive, and posttraumatic stress disorders and to evaluate whether antidepressants interact with DCS and the effect of potential moderating variables. Data Sources: PubMed, EMBASE, and PsycINFO were searched from inception to February 10, 2016. Reference lists of previous reviews and meta-analyses and reports of randomized clinical trials were also checked. Study Selection: Studies were eligible for inclusion if they were (1) double-blind randomized clinical trials of DCS as an augmentation strategy for exposure-based cognitive behavior therapy and (2) conducted in humans diagnosed as having specific phobia, social anxiety disorder, panic disorder with or without agoraphobia, obsessive-compulsive disorder, or posttraumatic stress disorder. Data Extraction and Synthesis: Raw data were obtained from the authors and quality controlled. Data were ranked to ensure a consistent metric across studies (score range, 0-100). We used a 3-level multilevel model nesting repeated measures of outcomes within participants, who were nested within studies. Results: Individual participant data were obtained for 21 of 22 eligible trials, representing 1047 of 1073 eligible participants. When controlling for antidepressant use, participants receiving DCS showed greater improvement from pretreatment to posttreatment (mean difference, -3.62; 95% CI, -0.81 to -6.43; P = .01; d = -0.25) but not from pretreatment to midtreatment (mean difference, -1.66; 95% CI, -4.92 to 1.60; P = .32; d = -0.14) or from pretreatment to follow-up (mean difference, -2.98, 95% CI, -5.99 to 0.03; P = .05; d = -0.19). Additional analyses showed that participants assigned to DCS were associated with lower symptom severity than those assigned to placebo at posttreatment and at follow-up. Antidepressants did not moderate the effects of DCS. None of the prespecified patient-level or study-level moderators was associated with outcomes. Conclusions and Relevance: D-cycloserine is associated with a small augmentation effect on exposure-based therapy. This effect is not moderated by the concurrent use of antidepressants. Further research is needed to identify patient and/or therapy characteristics associated with DCS response.2018-05-0

Oxigenación con membrana extracorpórea en el paciente COVID-19: resultados del Registro Español ECMO-COVID de la Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE)

Background and aim: COVID-19 patients with severe heart or respiratory failure are potential candidates for extracorporeal membrane oxygenation (ECMO). Indications and management of these patients are unclear. Our aim is to describe the results of a prospective registry of COVID-19 patients treated with ECMO. Methods: An anonymous prospective registry of COVID-19 patients treated with veno-arterial (V-A) or veno-venous (V-V) ECMO was created on march 2020. Clinical, analytical and respiratory preimplantation variables, implantation data and post-implantation course data were recorded. The primary endpoint was all cause in-hospital mortality. Secondary events were functional recovery and the combined endpoint of mortality and functional recovery in patients followed at least 3 months after discharge. Results: Three hundred and sixty-six patients from 25 hospitals were analyzed, 347 V-V ECMO and 18 V-A ECMO patients (mean age 52.7 and 49.5 years respectively). Patients with V-V ECMO were more obese, had less frequently organ damage other than respiratory failure and needed less inotropic support; Thirty three percent of V-A ECMO and 34.9% of V-A ECMO were discharged (P = NS). Hospital mortality was non-significantly different, 56.2% versus 50.9% respectively, mainly during ECMO therapy and mostly due to multiorgan failure. Other 51 patients (14%) remained admitted. Mean follow-up was 196 +/- 101.7 days (95%CI: 170.8-221.6). After logistic regression, body weight (OR 0.967, 95%CI: 0.95-0.99, P = 0.004) and ECMO implantation in the own centre (OR 0.48, 95%CI: 0.27-0.88, P = 0.018) were protective for hospital mortality. Age (OR 1.063, 95%CI: 1.005-1.12, P = 0.032), arterial hypertension (3.593, 95%CI: 1.06-12.19, P = 0.04) and global (2.44, 95%CI: 0.27-0.88, P = 0.019), digestive (OR 4,23, 95%CI: 1.27-14.07, P = 0.019) and neurological (OR 4.66, 95%CI: 1.39-15.62, P = 0.013) complications during ECMO therapy were independent predictors of primary endpoint occurrence. Only the post-discharge day at follow-up was independent predictor of both secondary endpoints occurrence. Conclusions: Hospital survival of severely ill COVID-19 patients treated with ECMO is near 50%. Age, arterial hypertension and ECMO complications are predictors of hospital mortality, and body weight and implantation in the own centre are protective. Functional recovery is only predicted by the follow-up time after discharge. A more homogeneous management of these patients is warranted for clinical results and future research optimization. (C) 2022 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U

Risk and protective factors for anxiety and obsessive-compulsive disorders: an umbrella review of systematic reviews and meta-analyses

A multitude of risk/protective factors for anxiety and obsessive-compulsive disorders have been proposed. We conducted an umbrella review to summarize the evidence of the associations between risk/protective factors and each of the following disorders: specific phobia, social anxiety disorder, generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder, and to assess the strength of this evidence whilst controlling for several biases.Publication databases were searched for systematic reviews and meta-analyses examining associations between potential risk/protective factors and each of the disorders investigated. The evidence of the association between each factor and disorder was graded into convincing, highly suggestive, suggestive, weak, or non-significant according to a standardized classification based on: number of cases (>1000), random-effects p-values, 95% prediction intervals, confidence interval of the largest study, heterogeneity between studies, study effects, and excess of significance.Nineteen systematic reviews and meta-analyses were included, corresponding to 216 individual studies covering 427 potential risk/protective factors. Only one factor association (early physical trauma as a risk factor for social anxiety disorder, OR 2.59, 95% CI 2.17-3.1) met all the criteria for convincing evidence. When excluding the requirement for more than 1000 cases, five factor associations met the other criteria for convincing evidence and 22 met the remaining criteria for highly suggestive evidence.Although the amount and quality of the evidence for most risk/protective factors for anxiety and obsessive-compulsive disorders is limited, a number of factors significantly increase the risk for these disorders, may have potential prognostic ability and inform prevention

The Rise and Fall of "Respectable" Spanish Liberalism, 1808-1923: An Explanatory Framework

The article focuses on the reasons behind both the consolidation of what I have termed “respectable” liberalism between the 1830s and the 1840s and its subsequent decline and fall between 1900 and 1923. In understanding both processes I study the links established between “respectable” liberals and propertied elites, the monarchy, and the Church. In the first phase these links served to consolidate the liberal polity. However, they also meant that many tenets of liberal ideology were compromised. Free elections were undermined by the operation of caciquismo, monarchs established a powerful position, and despite the Church hierarchy working with liberalism, the doctrine espoused by much of the Church was still shaped by the Counter-Reformation. Hence, “respectable” liberalism failed to achieve a popular social base. And the liberal order was increasingly denigrated as part of the corrupt “oligarchy” that ruled Spain. Worse still, between 1916 and 1923 the Church, monarch, and the propertied elite increasingly abandoned the liberal Monarchist Restoration. Hence when General Primo de Rivera launched his coup the rug was pulled from under the liberals’ feet and there was no one to cushion the fall

Diseño y validación de un cuestionario para evaluar la satisfacción de los pacientes atendidosen las consultas externas de un hospital de Madrid en 2006.

Fundamento: Para conocer la calidad de la asistencia sanitaria es imprescindible incorporar el punto de vista del paciente realizando estudios de satisfacción. Las encuestas de satisfacción precisan unas propiedades psicométricas que garanticen su fiabilidad y validez. El objetivo de este trabajo es diseñar y validar un cuestionario para conocer la satisfacción de los pacientes con las consultas externas hospitalarias. Métodos: Estudio de validación de un cuestionario autocumplimentado, diseñado por un grupo de expertos, compuesto por 12 preguntas que se aplicó a una muestra de 677 pacientes de las consultas externas del hospital Gregorio Marañón. Se analizó el comportamiento métrico del cuestionario en cuanto a validez de constructo, de criterio y capacidad predictiva y la consistencia interna. Resultados: Se analizó el comportamiento métrico del cuestionario respecto a la validez de constructo identificándose 2 factores ¿calidad clínica¿ y ¿calidad administrativa¿ que explican el 63% de la varianza, validez de criterio concurrente (coeficiente de correlación de Spearman de 0,85 respecto al criterio de referencia ¿satisfacción global con la atención recibida en consultas externas¿, OR 1,19 respecto al criterio de referencia ¿conoce el nombre del médico que le atiende en la consulta¿), capacidad predictiva del cuestionario medida mediante análisis discriminante obteniéndose un 84% de los casos clasificados correctamente y consistencia interna (Alfa de Cronbach 0,90). Conclusiones: El cuestionario reúne suficientes propiedades psicométricas como para que pueda ser considerado una herramienta útil y fiable para medir la satisfacción de los pacientes con las consultas externas hospitalarias

Teoría de la mente en trastornos del neurodesarrollo: más allá del trastorno del espectro autista

Resumen: Introducción: La teoría de la mente (ToM) es la capacidad humana de percibir, interpretar y atribuir los estados mentales de las otras personas y la alteración de esta función cognitiva es un síntoma nuclear del trastorno del espectro autista (TEA). Hay otros trastornos del neurodesarrollo como el trastorno obsesivo-compulsivo de inicio en la infancia (TOC) y el síndrome de Tourette (ST), que pueden presentarse con disfunciones cognitivas, y en los que la ToM ha sido menos estudiada, especialmente en población juvenil. El objetivo de este estudio fue comparar la ToM avanzada entre grupos de jóvenes con diagnóstico de TOC, ST o TEA y un grupo de controles sanos. Métodos: Se entrevistaron clínicamente a varones de entre 11 y 17 años con diagnóstico principal de TOC (n = 19), ST (n = 14), TEA (n = 18), y un grupo control de sujetos sanos (n = 20). Se les administró instrumentos de estimación de cociente intelectual, severidad de los síntomas psiquiátricos y las pruebas para evaluar la ToM: la tarea Historias de la vida cotidiana y el Test de la mirada. Resultados: Los jóvenes con ST presentan dificultades similares para resolver tareas de ToM avanzada al nivel de los pacientes con TEA, a diferencia de los pacientes con TOC de inicio en la infancia que presentan resultados similares a los controles sanos. Conclusiones: La ToM está alterada en otros trastornos del neurodesarrollo más allá del TEA, como en el ST. Abstract: Introduction: Theory of mind (ToM) is the human ability to perceive, interpret, and attribute the mental states of other people, and the alteration of this cognitive function is a core symptom of autistic spectrum disorder (ASD). In such other neurodevelopmental disorders as childhood-onset obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) that can present with cognitive dysfunctions, ToM has been less extensively studied, especially in the young population. The aim of the study was to compare advanced ToM between groups of young people diagnosed with OCD, TS, or ASD and a control group. Methods: Clinical interviews were conducted with male patients aged between 11 and 17 years with a main diagnosis of OCD (n = 19), TS (n = 14), or ASD (n = 18), and a control group (n = 20). We administered instruments for estimating intelligence quotient and severity of psychiatric symptoms, and tasks to evaluate ToM (the “Stories from everyday life” task and the “Reading the mind in the eyes” test). Results: Young people with TS and with ASD present similar difficulties in solving advanced ToM tasks, whereas patients with childhood-onset OCD present similar results to controls. Conclusions: ToM is altered in other neurodevelopmental disorders beyond ASD, such as TS

Theory of mind in neurodevelopmental disorders: beyond autistic spectrum disorder

Introduction: Theory of mind (ToM) is the human ability to perceive, interpret, and attribute the mental states of other people, and the alteration of this cognitive function is a core symptom of autistic spectrum disorder (ASD). In such other neurodevelopmental disorders as childhood-onset obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) that can present with cognitive dysfunctions, ToM has been less extensively studied, especially in the young population. The aim of the study was to compare advanced ToM between groups of young people diagnosed with OCD, TS, or ASD and a control group. Methods: Clinical interviews were conducted with male patients aged between 11 and 17 years with a main diagnosis of OCD (n = 19), TS (n = 14), or ASD (n = 18), and a control group (n = 20). We administered instruments for estimating intelligence quotient and severity of psychiatric symptoms, and tasks to evaluate ToM (the ''Stories from everyday life'' task and the ''Reading the mind in the eyes” test). Results: Young people with TS and with ASD present similar difficulties in solving advanced ToM tasks, whereas patients with childhood-onset OCD present similar results to controls. Conclusions: ToM is altered in other neurodevelopmental disorders beyond ASD, such as TS. Resumen: Introducción: La Teoría de la Mente (ToM) es la capacidad humana de percibir, interpretar y atribuir los estados mentales de las otras personas y la alteración de esta función cognitiva es un síntoma nuclear del Trastorno del Espectro Autista (TEA). Hay otros trastornos del neurodesarrollo como el Trastorno Obsesivo-Compulsivo de inicio en la infancia (TOC) y el Síndrome de Tourette (ST), que pueden presentarse con disfunciones cognitivas, y en los que la ToM ha sido menos estudiada, especialmente en población juvenil. El objetivo de este estudio fue comparar la ToM avanzada entre grupos de jóvenes con diagnóstico de TOC, ST o TEA y un grupo de controles sanos. Métodos: Se entrevistaron clínicamente a varones de entre 11 y 17 años con diagnóstico principal de TOC (n = 19), ST (n = 14), TEA (n = 18), y un grupo control de sujetos sanos (n = 20). Se les administraron instrumentos de estimación de cociente intelectual, severidad de los síntomas psiquiátricos, y las pruebas para evaluar la ToM: la tarea Historias de la Vida Cotidiana y el Test de la Mirada. Resultados: Los jóvenes con ST presentan dificultades similares para resolver tareas de ToM avanzada al nivel de los pacientes con TEA, a diferencia de los pacientes con TOC de inicio en la infancia que presentan resultados similares a los controles sanos. Conclusiones: La ToM está alterada en otros trastornos del neurodesarrollo más allá del TEA, como en el ST