Use of 3D Printing in Model Manufacturing for Minor Surgery Training of General Practitioners in Primary Care

In order to increase the efficiency of the Spanish health system, minor surgery programs are currently carried out in primary care centers. This organizational change has led to the need to train many general practitioners (GPs) in this discipline on a practical level. Due to the cost of the existing minor surgery training models in the market, pig’s feet or chicken thighs are used to practice the removal of figured lesions and the suture of wounds. In the present work, the use of 3D printing is proposed, to manufacture models that reproduce in a realistic way the most common lesions in minor surgery practice, and that allow doctors to be trained in an adequate way. Four models with the most common dermal lesions have been designed and manufactured, and then evaluated by a panel of experts. Face validity was demonstrated with four items on a five-point Likert scale that was completed anonymously. The models have obtained the following results: aesthetic recreation, 4.6 ± 0.5; realism during anesthesia infiltration, 4.8 ± 0.4; realism during lesion removal, 2.8 ± 0.4; realism during surgical wound closure, 1.2 ± 0.4. The score in this last section could be improved if a more elastic skin-colored filament were found on the market

Whole-system metabolism and CO₂ fluxes in a Mediterranean Bay dominated by seagrass beds (Palma Bay, NW Mediterranean)

The relationship between whole-system metabolism estimates based on planktonic and benthic incubations (bare sediments and seagrass, Posidonia oceanica meadows), and CO2 fluxes across the air-sea interface were examined in the Bay of Palma (Mallorca, Spain) during two cruises in March and June 2002. Moreover, planktonic and benthic incubations were performed at monthly intervals from March 2001 to October 2002 in a seagrass vegetated area of the bay. From the annual study, results showed a contrast between the planktonic compartment, which was heterotrophic during most of the year, except for occasional bloom episodes, and the benthic compartment, which was slightly autotrophic. Whereas the seagrass community was autotrophic, the excess organic carbon production therein could only balance the excess respiration of the planktonic compartment in shallow waters (<10 m) relative to the maximum depth of the bay (55 m). This generated a horizontal gradient from autotrophic or balanced communities in the shallow, seagrass-covered areas of the bay, to strongly heterotrophic communities in deeper areas, consistent with the patterns of CO2 fields and fluxes across the bay observed during the two extensive cruises in 2002. Finally, dissolved inorganic carbon and oxygen budgets provided NEP estimates in fair agreement with those derived from direct metabolic estimates based on incubated samples over the Posidonia oceanica meadow

GaN and InN nanowires grown by MBE: a comparison

Morphological, optical and transport properties of GaN and InN nanowires grown by molecular beam epitaxy (MBE) have been studied. The differences between the two materials in respect to growth parameters and optimization procedure was stressed. The nanowires crystalline quality has been investigated by means of their optical properties. A comparison of the transport characteristics was given. For each material a band schema was shown, which takes into account transport and optical features and is based on Fermi level pinning at the surface.Comment: 5 pages, 5 figure

Idoneidad del uso del MALDI-TOF MS para la identificación de Staphylococcus aureus y miembros del grupo de Staphylococcus intermedius (S.I.G.)

A pesar de que el género Staphylococcus es comúnmente aislado en humanos y animales, su identificación sigue siendo problemática. Este estudio evalúa la idoneidad del MALDI-TOF MS (Biotyper 3) para su identificación, comparando los resultados obtenidos mediante diferentes métodos: fenotípicos, MALDITOF MS (añadiendo o no ácido fórmico) y moleculares. Una colección de 37 cepas fue identificada por técnicas convencionales como S. aureus (n= 7), S. intermedius (n=1) y S. pseudintermedius (n=29). Los aislamientos provenían de perros, tanto sanos como enfermos (n=27), y humanos (n=10), a partir de diferentes muestras biológicas. Todas ellas fueron también identificadas por biología molecular y los cultivos puros fueron procesados en el MALDI-TOF MS. La información fue analizada con DAG_Stat. La sensibilidad, especificidad, eficiencia y el índice kappa se estimaron para cada especie bacteriana con un nivel de confianza del 95%, tomando la biología molecular como gold standard. Se detectaron Estafilococos de 27 perros y de sus dueños. Solamente una cepa de S. intermedius fue aislada, así que los parámetros relacionados con ella tienen que ser considerados con cautela. Todos los S. aureus fueron identificados correctamente. Usando MALDI-TOF MS con ácido fórmico, hubo una concordancia casi perfecta entre pruebas en la identificación de S. aureus y S. pseudintermedius. Cuando no se añadía ácido fórmico, la concordancia fue perfecta para S. aureus, mientras que para S. pseudintermedius fue buena. Este trabajo demuestra la validez, la utilidad y la fiabilidad del MALDI-TOF MS para la identificación de aislamientos bacterianos pertenecientes a Staphylococcus spp

Epigenetic loss of RNA-methyltransferase NSUN5 in glioma targets ribosomes to drive a stress adaptive translational program

Altres ajuts: This work was supported by the Obra Social "La Caixa" (to M. Esteller).Tumors have aberrant proteomes that often do not match their corresponding transcriptome profiles. One possible cause of this discrepancy is the existence of aberrant RNA modification landscapes in the so-called epitranscriptome. Here, we report that human glioma cells undergo DNA methylation-associated epigenetic silencing of NSUN5, a candidate RNA methyltransferase for 5-methylcytosine. In this setting, NSUN5 exhibits tumor-suppressor characteristics in vivo glioma models. We also found that NSUN5 loss generates an unmethylated status at the C3782 position of 28S rRNA that drives an overall depletion of protein synthesis, and leads to the emergence of an adaptive translational program for survival under conditions of cellular stress. Interestingly, NSUN5 epigenetic inactivation also renders these gliomas sensitive to bioactivatable substrates of the stress-related enzyme NQO1. Most importantly, NSUN5 epigenetic inactivation is a hallmark of glioma patients with long-term survival for this otherwise devastating disease

Efficacy and safety of HCV-treatment with direct-acting antiviral agents interferon-free, in patients with severe renal impairment in clinical practice

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Effectiveness of an mHealth intervention combining a smartphone app and smart band on body composition in an overweight and obese population: Randomized controlled trial (EVIDENT 3 study)

Background: Mobile health (mHealth) is currently among the supporting elements that may contribute to an improvement in health markers by helping people adopt healthier lifestyles. mHealth interventions have been widely reported to achieve greater weight loss than other approaches, but their effect on body composition remains unclear. Objective: This study aimed to assess the short-term (3 months) effectiveness of a mobile app and a smart band for losing weight and changing body composition in sedentary Spanish adults who are overweight or obese. Methods: A randomized controlled, multicenter clinical trial was conducted involving the participation of 440 subjects from primary care centers, with 231 subjects in the intervention group (IG; counselling with smartphone app and smart band) and 209 in the control group (CG; counselling only). Both groups were counselled about healthy diet and physical activity. For the 3-month intervention period, the IG was trained to use a smartphone app that involved self-monitoring and tailored feedback, as well as a smart band that recorded daily physical activity (Mi Band 2, Xiaomi). Body composition was measured using the InBody 230 bioimpedance device (InBody Co., Ltd), and physical activity was measured using the International Physical Activity Questionnaire. Results: The mHealth intervention produced a greater loss of body weight (–1.97 kg, 95% CI –2.39 to –1.54) relative to standard counselling at 3 months (–1.13 kg, 95% CI –1.56 to –0.69). Comparing groups, the IG achieved a weight loss of 0.84 kg more than the CG at 3 months. The IG showed a decrease in body fat mass (BFM; –1.84 kg, 95% CI –2.48 to –1.20), percentage of body fat (PBF; –1.22%, 95% CI –1.82% to 0.62%), and BMI (–0.77 kg/m2, 95% CI –0.96 to 0.57). No significant changes were observed in any of these parameters in men; among women, there was a significant decrease in BMI in the IG compared with the CG. When subjects were grouped according to baseline BMI, the overweight group experienced a change in BFM of –1.18 kg (95% CI –2.30 to –0.06) and BMI of –0.47 kg/m2 (95% CI –0.80 to –0.13), whereas the obese group only experienced a change in BMI of –0.53 kg/m2 (95% CI –0.86 to –0.19). When the data were analyzed according to physical activity, the moderate-vigorous physical activity group showed significant changes in BFM of –1.03 kg (95% CI –1.74 to –0.33), PBF of –0.76% (95% CI –1.32% to –0.20%), and BMI of –0.5 kg/m2 (95% CI –0.83 to –0.19). Conclusions: The results from this multicenter, randomized controlled clinical trial study show that compared with standard counselling alone, adding a self-reported app and a smart band obtained beneficial results in terms of weight loss and a reduction in BFM and PBF in female subjects with a BMI less than 30 kg/m2 and a moderate-vigorous physical activity level. Nevertheless, further studies are needed to ensure that this profile benefits more than others from this intervention and to investigate modifications of this intervention to achieve a global effect

Deep-sequencing reveals broad subtype-specific HCV resistance mutations associated with treatment failure

A percentage of hepatitis C virus (HCV)-infected patients fail direct acting antiviral (DAA)-based treatment regimens, often because of drug resistance-associated substitutions (RAS). The aim of this study was to characterize the resistance profile of a large cohort of patients failing DAA-based treatments, and investigate the relationship between HCV subtype and failure, as an aid to optimizing management of these patients. A new, standardized HCV-RAS testing protocol based on deep sequencing was designed and applied to 220 previously subtyped samples from patients failing DAA treatment, collected in 39 Spanish hospitals. The majority had received DAA-based interferon (IFN) a-free regimens; 79% had failed sofosbuvir-containing therapy. Genomic regions encoding the nonstructural protein (NS) 3, NS5A, and NS5B (DAA target regions) were analyzed using subtype-specific primers. Viral subtype distribution was as follows: genotype (G) 1, 62.7%; G3a, 21.4%; G4d, 12.3%; G2, 1.8%; and mixed infections 1.8%. Overall, 88.6% of patients carried at least 1 RAS, and 19% carried RAS at frequencies below 20% in the mutant spectrum. There were no differences in RAS selection between treatments with and without ribavirin. Regardless of the treatment received, each HCV subtype showed specific types of RAS. Of note, no RAS were detected in the target proteins of 18.6% of patients failing treatment, and 30.4% of patients had RAS in proteins that were not targets of the inhibitors they received. HCV patients failing DAA therapy showed a high diversity of RAS. Ribavirin use did not influence the type or number of RAS at failure. The subtype-specific pattern of RAS emergence underscores the importance of accurate HCV subtyping. The frequency of “extra-target” RAS suggests the need for RAS screening in all three DAA target regions

Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems

Cyst-based toxicity tests: 4. The potential of ecotoxicological tests for the prediction of acute toxicity in man as evaluated on the first ten chemicals of the MEIC programme

In the framework of the multicentre evaluation of in vitro cytotoxicity (MEIC) programme, the first ten chemicals of the prescribed list were tested for acute toxicity in four standardized cyst-based aquatic invertebrate tests, consisting of two rotifer species (the estuarine Brachionus plicatilis and the freshwater Brachionus calyciflorus) and two crustacean species (the halophilic anostracan Artemia salina and the freshwater anostracan Streptocephalus proboscideus). Mortality was the test criterion and toxic effects, expressed as 24-hour LC50 values, were correlated with rodent and human acute oral toxicity data. Generally, a good correlation was obtained between any of the invertebrate tests and the rodent data. Likewise, the predictive screening potential of the aquatic invertebrate tests for acute oral toxicity in man was slightly better than the rat test for eight (excluding diazepam and digoxin) and nine (including diazepam, excluding digoxin) of the ten substances. The aquatic test systems however, appear to be more suitable for compounds soluble in water