Contamination of Irrigation Well Water by Residual Herbicides

The main residual herbicides applied to citrus in Spain are atrazine, bromacil, diuron, simazine, terbuthylazine, terbumetone, terbutryn and terbacil. Some of the orchards are on continuous non-tillage system, with one or sometimes two treatments a year of the above mentioned products. Water samples from more than fifty irrigation wells located in or near citrus orchards were analysed during the last five years. Many of the water samples do not contain herbicide. There is a close relationship between rainfall episodes and herbicide detection. Concentrations are in the low range of µg/l. Bromacil was the product most commonly found. Some herbicide degradation products also appeared: DCPMU was found more frequently than DCPU; also des-alquil-s-triazines were observed. In two very shallow wells, 1 m depth, located on a sandy soil area, hydroxy-triazines were also detected

Outcomes of abdominal wall reconstruction in patients with the combination of complex midline and lateral incisional hernias.

Background The best treatment for the combined defects of midline and lateral incisional hernia is not known. The aim of our multicenter study was to evaluate the operative and patient-reported outcomes using a modified posterior component separation in patients who present with the combination of midline and lateral incisional hernia. Methods We identified patients from a prospective, multicenter database who underwent operative repairs of a midline and lateral incisional hernia at 4 centers with minimum 2-year follow-up. Hernias were divided into a main hernia based on the larger size and associated abdominal wall hernias. Outcomes reported were short- and long-term complications, including recurrence, pain, and bulging. Quality of life was assessed with the European Registry for Abdominal Wall Hernias Quality of Life score. Results Fifty-eight patients were identified. Almost 70% of patients presented with a midline defect as the main incisional hernia. The operative technique was a transversus abdominis release in 26 patients (45%), a modification of transversus abdominis release 27 (47%), a reverse transversus abdominis release in 3 (5%), and a primary, lateral retromuscular preperitoneal approach in 2 (3%). Surgical site occurrences occurred in 22 patients (38%), with only 8 patients (14%) requiring procedural intervention. During a mean follow-up of 30.1 ± 14.4 months, 2 (3%) cases of recurrence were diagnosed and required reoperation. There were also 4 (7%) patients with asymptomatic but visible bulging. The European Registry for Abdominal Wall Hernias Quality of Life score showed a statistically significant decrease in the 3 domains (pain, restriction, and cosmetic) in the postoperative score compared with the preoperative score. Conclusion The different techniques of posterior component separation in the treatment of combined midline and lateral incisional hernia show acceptable results, despite the associated high complexity. Patient-reported outcomes after measurement of the European Registry for Abdominal Wall Hernias Quality of Life score demonstrated a clinically important improvement in quality of life and pain.post-print2.323 K

Glucose Restriction Promotes Osteocyte Specification by Activating a PGC-1α-Dependent Transcriptional Program.

Osteocytes, the most abundant of bone cells, differentiate while they remain buried within the bonematrix. This encasement limits their access to nutrients and likely affects their differentiation, a pro-cess that remains poorly defined. Here, we show that restriction in glucose supply promotes the oste-ocyte transcriptional program while also being associated with increased mitochondrial DNA levels.Glucose deprivation triggered the activation of the AMPK/PGC-1 pathway. AMPK and SIRT1 activa-tors or PGC-1aoverexpression are sufficient to enhance osteocyte gene expression in IDG-SW3 cells,murine primary osteoblasts, osteocytes, and organotypic/ex vivobone cultures. Conversely, osteo-blasts and osteocytes deficient inPpargc1aandbwere refractory to the effects of glucose restriction.Finally, conditional ablation of both genes in osteoblasts and osteocytes generate osteopenia andreduce osteocytic gene expression in mice. Altogether, we uncovered a role for PGC-1 in the regula-tion of osteocyte gene expression

23 Validation of PD-L1 dynamic expression on extracellular vesicles as a predictor of response to immune-checkpoint inhibitors and survival in non-small cell lung cancer patients

BackgroundImmune-checkpoint inhibitors (ICIs) revolutionized the treatment of advanced non-small cell lung cancer (NSCLC).1–3 To date, tissue PD-L1 immunohistochemistry is one of the leading biomarkers for prediction of ICIs response but has several limitations.4 5Extracellular vesicles (EVs) are cell-derived structures involved in cell communication and represent a potential minimally invasive alternative to predicting ICI response.6–9 Based on this and our preliminary results presented at SITC 2020,10 we hypothesize that EV PD-L1 predicts response to ICIs in NSCLC.MethodsThis study evaluates an exploratory cohort of advanced/metastatic NSCLC patients receiving ICIs (cohort A) and a validation cohort receiving Pembrolizumab+docetaxel or docetaxel alone (PROLUNG Phase 2 randomized trial) (cohort B).11 Plasma samples were collected pre-treatment (T1) and at 3 treatment cycles (T2) (figure 1A). Response was assessed by computed-tomography scan at 3 (cohort A) and 6–8 treatment cycles (cohort B) according to mono- or chemotherapy combination therapy. Patients were classified as responders (partial, stable, or complete response) or non-responders (progressive disease) by RECISTv1.1.12 EVs were isolated by serial ultracentrifugation and characterized following ISEV recommendations.13,14 Tissue PD-L1 expression was measured by standardized immunohistochemistry (SP263, 22C3, or 28–8 clones)5 and EV PD-L1 expression by immunoblot and its ratio was calculated as EV PD-L1 T2/T1. Cut-offs from the exploratory cohort were applied to the validation cohort, being EV PD-L1 ratio <0.85 = Low.ResultsPaired samples from 30 ICIs, 23 pembrolizumab+docetaxel, and 15 docetaxel treated patients were analyzed. In cohort A, non-responders showed higher EV PD-L1 ratio than responders (p=0.012) (figure 1B) with an area-under-the-curve (AUC) of 77.3%, 83.3% sensitivity, and 61.1% specificity, while the tissue PD-L1 was not predictive (AUC=50%). As a validation, pembrolizumab+docetaxel treated non-responders showed higher EV PD-L1 ratio (p=0.036) than responders with an AUC=69.3%, sensitivity=75%, and specificity=63.6%, outperforming the tissue PD-L1 (figure 1C). No statistically significant differences were observed in the docetaxel group (p=0.885). Moreover, ICIs patients with higher EV PD-L1 ratio showed shorter progression-free survival (PFS) (HR=0.30, p=0.066) and overall survival (OS) (HR=0.17, p=0.016) (figure 1D) which was also observed in the pembrolizumab+docetaxel cohort with shorter PFS (HR=0.12, p=0.004) and OS (HR=0.23, p=0.010) (figure 1E). EV PD-L1 ratio did not predict survival in docetaxel-treated patients.Abstract 23 Figure 1(A) Study design and methodology. (B) EV PD-L1 ratio predicts response to ICIs in 30 NSCLC patients from the discovery cohort A and outperforms tissue PD-L1. (C) EV PD-L1 ratio is predictive for response to pembrolizumab+docetaxel in 23 NSCLC patients but not in 15 patients receiving docetaxel alone from cohort B. (D) Higher EV PD-L1 ratio predicts shorter PFS and OS in 30 patients from the discovery cohort A treated with ICIs. (E) Higher EV PD-L1 ratio is associated with shorter PFS and OS in 23 patients treated with pembrolizumab+docetaxel but not in patients treated with docetaxel alone. Abbreviations: CT: Computed tomography, EV: Extracellular vesicle; HR: Hazard Ratio; ICIs: Immune-checkpoint Inhibitors; IHC: Immunohistochemistry; NR: Non-Responders; OS: Overall Survival; p: p-value; PFS: Progression-free survival; R: Responders [Created with BioRender].ConclusionsWe demonstrated that treatment-associated changes in EV PD-L1 levels are predictive of response and survival in advanced NSCLC patients treated with ICIs. This model, if confirmed in a large prospective cohort, could have important clinical implications, guiding treatment decisions and improving the outcome of patients receiving ICIs.AcknowledgementsWe would like to extend our gratitude to the all the patients that participated in the study.ReferencesBorghaei H, Paz-Ares L, Horn L, Spigel DR, Steins M, Ready NE, et al. Nivolumab versus Docetaxel in Advanced Nonsquamous Non–Small-Cell Lung Cancer. N Engl J Med 2015;373:1627–39.Herbst RS, Baas P, Kim DW, Felip E, Pérez-Gracia JL, Han JY, et al. Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010): A randomised controlled trial. Lancet 2016;387:1540–50.Ruiz-Patiño A, Arrieta O, Cardona AF, Martín C, Raez LE, Zatarain-Barrón ZL, et al. Immunotherapy at any line of treatment improves survival in patients with advanced metastatic non-small cell lung cancer (NSCLC) compared with chemotherapy (Quijote-CLICaP). Thorac Cancer 2020;11:353–61.Doroshow DB, Bhalla S, Beasley MB, Sholl LM, Kerr KM, Gnjatic S, et al. PD-L1 as a biomarker of response to immune-checkpoint inhibitors. Nat Rev Clin Oncol 2021;18:345–362.Hirsch FR, McElhinny A, Stanforth D, Ranger-Moore J, Jansson M, Kulangara K, et al. PD-L1 immunohistochemistry assays for lung cancer: results from phase 1 of the blueprint PD-L1 IHC assay comparison project. J Thorac Oncol 2017;12:208–222.Poggio M, Hu T, Pai CC, Chu B, Belair CD, Chang A, et al. Suppression of exosomal PD-L1 induces systemic anti-tumor immunity and memory. Cell 2019;177:414–427.e13.Cordonnier M, Nardin C, Chanteloup G, Derangere V, Algros MP, Arnould L, et al. Tracking the evolution of circulating exosomal-PD-L1 to monitor melanoma patients. J Extracell Vesicles 2020;9:1710899.Del Re M, Cucchiara F, Rofi E, Fontanelli L, Petrini I, Gri N, et al. A multiparametric approach to improve the prediction of response to immunotherapy in patients with metastatic NSCLC. Cancer Immunol Immunother 2020;70:1667–1678.Chen G, Huang AC, Zhang W, Zhang G, Wu M, Xu W, et al. Exosomal PD-L1 contributes to immunosuppression and is associated with anti-PD-1 response. Nature. 2018;560:382–6.10 de Miguel Perez D, Russo A, Gunasekaran M, Cardona A, Lapidus R, Cooper B, et al. 31 Dynamic change of PD-L1 expression on extracellular vesicles predicts response to immune-checkpoint inhibitors in non-small cell lung cancer patients. 2020J Immunother Cancer;8(Suppl 3):A30–A30.Arrieta O, Barrón F, Ramírez-Tirado LA, Zatarain-Barrón ZL, Cardona AF, Díaz-García D, et al. Efficacy and safety of pembrolizumab plus docetaxel vs docetaxel alone in patients with previously treated advanced non–small cell lung cancer: the PROLUNG phase 2 randomized clinical trial. 2020JAMA Oncol;6:856–864.Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). 2009Eur J Cancer;45:228–47.Reclusa P, Verstraelen P, Taverna S, Gunasekaran M, Pucci M, Pintelon I, et al. Improving extracellular vesicles visualization: From static to motion. 2020Sci Rep;10:6494.Théry C, Witwer KW, Aikawa E, Alcaraz MJ, Anderson JD, Andriantsitohaina R, et al. Minimal information for studies of extracellular vesicles 2018 (MISEV2018): a position statement of the International Society for Extracellular Vesicles and update of the MISEV2014 guidelines. 2018J Extracell Vesicles;7:1535750Ethics ApprovalPatients consented to Institutional Review Board–approved protocol, A.O. Pappardo, Messina, Italy for cohort A and Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México in case of the cohort B. Biological material was transferred to the University of Maryland School of Medicine, Baltimore for EV analysis under signed MTA between institutions MTA/2020–13111 & MTA/2020–13113

The OTELO survey: A case study of [O III] lambda 4959,5007 emitters at z=0.83

Context. The OSIRIS Tunable Filter Emission Line Object (OTELO) survey is a very deep, blind exploration of a selected region of the Extended Groth Strip and is designed for finding emission-line sources (ELSs). The survey design, observations, data reduction, astrometry, and photometry, as well as the correlation with ancillary data used to obtain a final catalogue, including photo-z estimates and a preliminary selection of ELS, were described in a previous contribution. Aims. Here, we aim to determine the main properties and luminosity function (LF) of the [O III] ELS sample of OTELO as a scientific demonstration of its capabilities, advantages, and complementarity with respect to other surveys. Methods. The selection and analysis procedures of ELS candidates obtained using tunable filter pseudo-spectra are described. We performed simulations in the parameter space of the survey to obtain emission-line detection probabilities. Relevant characteristics of [O III] emitters and the LF ([O III]), including the main selection biases and uncertainties, are presented. Results. From 541 preliminary emission-line source candidates selected around z = 0.8, a total of 184 sources were confirmed as [O III] emitters. Consistent with simulations, the minimum detectable line flux and equivalent width in this ELS sample are ∼5 × 10−19 erg s−1 cm2 and ∼6 Å, respectively. We are able to constrain the faint-end slope (α = −1.03 ± 0.08) of the observed LF ([O III]) at a mean redshift of z = 0.83. This LF reaches values that are approximately ten times lower than those from other surveys. The vast majority (84%) of the morphologically classified [O III] ELSs are disc-like sources, and 87% of this sample is comprised of galaxies with stellar masses of M⋆ <  1010 M⊙

Guía de Práctica Clínica para el diagnóstico de compromiso orgánico de amiloidosis: Parte 2/3. Año 2020

Métodos: Se generó un listado de preguntas con el formato PICO centradas en la especificidad y sensibilidad de las pruebas diagnósticas en amiloidosis. Se realizó la búsqueda en PubMed durante julio-agosto del 2019, en inglés y español. Los niveles de evidencia y los grados de recomendación se basan en el sistema GRADE (http://www.gradeworkinggroup.org/index.htm). Las recomendaciones se graduaron según su dirección (a favor o en contra) y según fuerza (fuertes y débiles). Las recomendaciones finales fueron evaluadas con la herramienta GLIA para barreras y facilitadores en la implementación de éstas. Interpretación de recomendaciones: Las recomendaciones fuertes indican alta confianza, ya sea a favor o en contra, de una intervención. En esta guía se utiliza el lenguaje “se recomienda” cuando se define una recomendación fuerte. Las recomendaciones débiles indican que los resultados para una intervención, favorable o desfavorable, son dudosos. En este caso, se utiliza el lenguaje “se sugiere”, cuando se define una recomendación débil. Cómo utilizar estas pautas: Las recomendaciones deben ser interpretadas en el contexto de la atención especializada, con estudios diagnósticos validados y realizados por médicos entrenados. Se asume que el médico tratante tiene alto nivel de sospecha de amiloidosis. Asume que los estudios diagnósticos son realizados por médicos entrenados con métodos validados y estandarizados. Esta guía es relevante para los profesionales de la salud y los involucrados en las políticas sanitarias, para ayudar a asegurar que existan los acuerdos necesarios para brindar la atención adecuada. Resumen de recomendaciones En pacientes con sospecha de amiloidosis, se recomienda realizar: ● Un electrocardiograma como evaluación inicial a todo paciente con amiloidosis. ● Ecocardiograma Doppler convencional como imagen inicial de elección para el diagnóstico de amiloidosis cardíaca en pacientes con sospecha de compromiso cardíaco por amiloidosis. ● Ecocardiograma con deformación (strain) para el diagnóstico de amiloidosis cardíaca en pacientes con un ecocardiograma convencional sugestivo o indeterminado de amiloidosis. ● Resonancia magnética cardíaca (RMC) con gadolinio para el diagnóstico de amiloidosis cardíaca en pacientes con estudios previos sugestivos o indeterminados de amiloidosis. ● RMC con técnica de mapeo T1 para el diagnóstico de amiloidosis cardíaca en pacientes con estudios previos sugestivos de amiloidosis y disfunción renal o contraindicación para recibir gadolinio, como alternativa a la RMC con gadolinio. ● RMC con técnica de mapeo T1, medición de volumen extracelular y la cuantificación de la extensión del compromiso cardíaco para el diagnóstico y medición del compromiso cardíaco por amiloidosis en pacientes con estudios previos sugestivos de amiloidosis. Se sugiere realizar: ● RMC con técnica de mapeo T1 y medición del volumen extracelular para el diagnóstico precoz por amiloidosis en pacientes con estudios previos sugestivos de amiloidosis. ● Medición de péptido natriurético tipo B para el rastreo y diagnóstico de amiloidosis cardíaca. ● Centellograma con pirofosfato para el diagnóstico inicial de pacientes con sospecha de amiloidosis cardíaca, diferenciando ATTR (positiva) del resto. Palabras clave: amiloidosis; diagnóstico; amiloidosis de cadenas ligeras de las inmunoglobulinas; amiloidosis familiar.Method: Use the PICO format to generate a series of questions, focusing on the specificity and sensitivity of the amyloidosis diagnostic test. PubMed searches were conducted in English and Spanish from July to August 2019. The level of evidence and recommendation are based on the GRADE system (http://www.gradeworkinggroup.org/index.htm). The recommendations are graded according to their direction (for or against) and strength (strong and weak). Finally, it is recommended to use GLIA tools to evaluate the obstacles and facilitators in implementation. Suggested explanation: A strong suggestion indicates a high degree of trust in support or opposition to the intervention. When defining a strong recommendation, this guide uses the "recommended" language. The weaker recommendations indicate that the outcome of the intervention (favorable or unfavorable) is doubtful. In this case, if a weak recommendation is defined, the "recommendation" language is used. How to use these guidelines: Recommendations must be explained within the scope of special care in validated diagnostic studies conducted by specially trained doctors. Presumably, the attending physician has a high degree of suspicion of amyloidosis. It assumes that diagnostic research is conducted by well-trained doctors using a validated standardized method. This guide is intended for health care professionals and those involved in health care policies to help ensure that the necessary agreements have been reached to provide appropriate care. Summary of recommendations For patients with suspected amyloidosis, it is recommended: ● Electrocardiogram be used as a preliminary assessment for all patients with amyloidosis. ● Doppler echocardiography conventional be used as the initial image of the first choice for cardiac amyloidosis in patients diagnosed with suspected heart involvement due to amyloidosis. ● Echocardiographic strain diagnosis for patients with amyloidosis prompted by conventional echocardiography or uncertain. ● Cardiac magnetic resonance imaging (MRI) be used for the diagnosis of cardiac amyloidosis in patients with previous studies suggesting or uncertain amyloidosis. ● T1 mapping technology for cardiac MRI to diagnose myocardial amyloidosis as an alternative to MRI, for patients with kidney failure or contraindication to other studies ● Cardiac MRI examination with T1 localization technique for patients who have previously studied amyloidosis, and measure the extracellular volume and quantify the degree of cardiac involvement in order to diagnose and measure the cardiac involvement caused by amyloidosis. It is suggested: ● Cardiac MRI with T1 mapping technique and extracellular volume measurement for the early diagnosis of amyloidosis in patients with previous studies suggestive of amyloidosis. ● Measurement of type B-type natriuretic peptide measurement be used for screening and diagnosis of cardiac amyloidosis. ● Pyrophosphate scintigraphy to make a preliminary diagnosis of patients with suspected cardiac amyloidosis, so as to distinguish ATTR (positive) from other patients. Key words: amyloidosis; diagnosis; inmunoglobulin light-chain amyloidosis; amyloidosis, familial.Method: Foi gerada uma lista de questões com o formato PICO focada na especificidade e sensibilidade dos testes diagnósticos em amiloidose. A busca no PubMed foi realizada no período de julho a agosto de 2019, em inglês e espanhol. Os níveis de evidência e graus de recomendação são baseados no sistema GRADE (http://www.gradeworkinggroup.org/index.htm). As recomendações foram graduadas de acordo com sua direção (a favor ou contra) e de acordo com a força (forte e fraca). As recomendações finais foram avaliadas com a ferramenta GLIA para barreiras e facilitadores em sua implementação. Interpretação das recomendações: Recomendações fortes indicam alta confiança, a favor ou contra, de uma intervenção. Este guia usa a linguagem “recomendada” ao definir uma recomendação forte. Recomendações fracas indicam que os resultados para uma intervenção, favorável ou desfavorável, são duvidosos. Nesse caso, a linguagem “é sugerida” é utilizada, quando uma recomendação fraca é definida. Como usar essas diretrizes: As recomendações devem ser explicadas no contexto de cuidados especializados e estudos de diagnóstico validados realizados por médicos treinados. Suponha que o médico assistente suspeite de um alto nível de amiloidose. Ele presumiu que a pesquisa diagnóstica foi conduzida por médicos bem treinados usando métodos padronizados validados. Este guia se aplica a profissionais de saúde e a todos os envolvidos na política de saúde para ajudar a garantir que os arranjos necessários sejam feitos para fornecer cuidados adequados. Resumo das recomendações para diagnóstico Em pacientes com suspeita de amiloidose, é recomendado: ● Um eletrocardiograma como avaliação preliminar. ● Doppler convencional seja usado como primeira escolha para o diagnóstico de amiloidose cardíaca em pacientes com suspeita de amiloidose. ● Ecocardiografia deformada para o diagnóstico de pacientes com amiloidose ou ecocardiografia convencional incerta ● Ressonância magnética cardíaca (RMC) anterior seja usada para o diagnóstico de amiloidose cardíaca em pacientes que realizaram estudos sugestivos ou incertos sobre amiloidose. ● Mapeamento T1 para diagnosticar amiloidose cardíaca com RMC em pacientes com amiloidose e insuficiência renal ou contraindicações de uso. ● Mapamento T1 para pacientes que estudaram previamente a amiloidose para medir o volume extracelular e quantificar o grau de envolvimento cardíaco para diagnosticar e medir o grau de envolvimento cardíaco em pacientes com amiloidose para exame de RMC. Sugere-se: ● Mapamento T1 e medição do volume extracelular para RMC para diagnosticar a amiloidose precocemente. ● Medir o peptídeo natriurético do tipo B para rastrear e diagnosticar a amiloidose cardíaca. ● Cintilografia com pirofosfato para fazer um diagnóstico preliminar de pacientes com suspeita de amiloidose cardíaca, de modo a distinguir ATTR (positivo) de outros pacientes. Palavras chave: amiloidose; diagnóstico; amiloidose de cadeia leve de imunoglobulina; amiloidose familiar.Fil: Posadas Martinez, Maria Lourdes. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Medicina Traslacional e Ingeniería Biomédica - Hospital Italiano. Instituto de Medicina Traslacional e Ingeniería Biomédica.- Instituto Universitario Hospital Italiano de Buenos Aires. Instituto de Medicina Traslacional e Ingeniería Biomédica; ArgentinaFil: Nucifora, Elsa Mercedes. Hospital Italiano. Departamento de Medicina. Servicio de Clínica Médica; ArgentinaFil: Belziti, César. Hospital Italiano. Departamento de Medicina. Servicio de Clínica Médica; ArgentinaFil: Auteri, Miguel Angel. Clínica Giuliani Charata; ArgentinaFil: Aguirre, Maria Adela. Hospital Italiano. Departamento de Medicina. Servicio de Clínica Médica; ArgentinaFil: Pitzus, Ariel Edgardo. Clínica Giuliani Charata; ArgentinaFil: Dragonetti, Laura. Hospital Aleman; ArgentinaFil: Perez de Arenaza, Diego. Hospital Italiano; ArgentinaFil: Peuchot, Verónica. Hospital Italiano. Departamento de Medicina. Servicio de Clínica Médica; Argentin

La vesícula extracelular TGF-β basal es un biomarcador predictivo de la respuesta a los inhibidores del punto de control inmunitario y de la supervivencia en el cáncer de pulmón no microcítico

Antecedentes: Los inhibidores de los puntos de control inmunitarios (ICI) son una estrategia terapéutica eficaz que mejora la supervivencia de los pacientes con cáncer de pulmón en comparación con los tratamientos convencionales. terapéutica eficaz que mejora la supervivencia de los pacientes con cáncer de pulmón en comparación con los tratamientos convencionales. Sin embargo, se necesitan biomarcadores predictivos novedosos para estratificar qué pacientes obtienen un beneficio clínico, ya que el histológico PD-L1, actualmente utilizado y altamente heterogéneo, ha mostrado una baja precisión. La biopsia líquida es el análisis de biomarcadores en fluidos corporales y representa una herramienta mínimamente invasiva que puede utilizarse para monitorizar la evolución del tumor y los efectos del tratamiento, reduciendo potencialmente los sesgos asociados a la heterogeneidad tumoral asociada a las biopsias de tejidos. En este contexto citoquinas, como el factor de crecimiento transformante-β (TGF-β), pueden encontrarse libres en circulación en la sangre y empaquetadas en vesículas extracelulares (VE), que tienen un tropismo de administración específico y pueden afectar a la interacción entre el tumor y el sistema inmunitario. El TGF-β es una citocina inmunosupresora que desempeña un papel crucial en el escape inmunitario de los tumores, la resistencia al tratamiento y la metástasis. Así pues, nuestro objetivo era evaluar el valor predictivo predictivo del TGF-β circulante y EV en pacientes con cáncer de pulmón no microcítico que reciben ICI.Background: Immune‐checkpoint inhibitors (ICIs) are an effective therapeutic strategy, improving the survival of patients with lung cancer compared with conventional treatments. However, novel predictive biomarkers are needed to stratify which patients derive clinical benefit because the currently used and highly heterogenic histological PD‐L1 has shown low accuracy. Liquid biopsy is the analysis of biomarkers in body fluids and represents a minimally invasive tool that can be used to monitor tumor evolution and treatment effects, potentially reducing biases associated with tumor heterogeneity associated with tissue biopsies. In this context, cytokines, such as transforming growth factor‐β (TGF‐β), can be found free in circulation in the blood and packaged into extracellular vesicles (EVs), which have a specific delivery tropism and can affect in tumor/immune system interaction. TGF‐β is an immunosuppressive cytokine that plays a crucial role in tumor immune escape, treatment resistance, and metastasis. Thus, we aimed to evaluate the predictive value of circulating and EV TGF‐β in patients with non–small‐cell lung cancer receiving ICIs

Conservation of the endemic dwarf carnivores of Cozumel Island, Mexico.

Cozumel Island, Mexico, harbours two endemic species of dwarf procyonids: the Pygmy Raccoon Procyon pygmaeus and the Dwarf Coati Nasua nelsoni. Both species are Critically Endangered, and are among the world&rsquo;s most threatened Carnivora. Here we summarise the research we have been conducting on their ecology, evolution, genetics, and conservation. We also summarise the conservation initiatives we have been undertaking and promoting in order to advance the conservation of these unique species and their habitats. This effort illustrates the importance of an interdisciplinary approach in conservation science and action in maximising effectiveness. Nevertheless, the precarious status of the species make it imperative to continue and expand the work we have carried out in Cozumel to prevent two imminent global extinctions.<br /

A genome-wide association study suggests the HLA Class II region as the major susceptibility locus for IgA vasculitis.

The genetic component of Immunoglobulin-A (IgA) vasculitis is still far to be elucidated. To increase the current knowledge on the genetic component of this vasculitis we performed the first genome-wide association study (GWAS) on this condition. 308 IgA vasculitis patients and 1,018 healthy controls from Spain were genotyped by Illumina HumanCore BeadChips. Imputation of GWAS data was performed using the 1000 Genomes Project Phase III dataset as reference panel. After quality control filters and GWAS imputation, 285 patients and 1,006 controls remained in the datasets and were included in further analysis. Additionally, the human leukocyte antigen (HLA) region was comprehensively studied by imputing classical alleles and polymorphic amino acid positions. A linkage disequilibrium block of polymorphisms located in the HLA class II region surpassed the genome-wide level of significance (OR = 0.56, 95% CI = 0.46-0.68). Although no polymorphic amino acid positions were associated at the genome-wide level of significance, P-values of potential relevance were observed for the positions 13 and 11 of HLA-DRB1 (P = 6.67E-05, P = 1.88E-05, respectively). Outside the HLA, potential associations were detected, but none of them were close to the statistical significance. In conclusion, our study suggests that IgA vasculitis is an archetypal HLA class II disease

RBD-specific polyclonal F(ab´)2 fragments of equine antibodies in patients with moderate to severe COVID-19 disease: A randomized, multicenter, double-blind, placebo-controlled, adaptive phase 2/3 clinical trial

Background: passive immunotherapy is a therapeutic alternative for patients with COVID-19. Equine polyclonal antibodies (EpAbs) could represent a source of scalable neutralizing antibodies against SARS-CoV-2. Methods: we conducted a double-blind, randomized, placebo-controlled trial to assess efficacy and safety of EpAbs (INM005) in hospitalized adult patients with moderate and severe COVID-19 pneumonia in 19 hospitals of Argentina. Primary endpoint was improvement in at least two categories in WHO ordinal clinical scale at day 28 or hospital discharge (ClinicalTrials.gov number NCT04494984). Findings: between August 1st and October 26th, 2020, a total of 245 patients were enrolled. Enrolled patients were assigned to receive two blinded doses of INM005 (n = 118) or placebo (n = 123). Median age was 54 years old, 65 1% were male and 61% had moderate disease at baseline. Median time from symptoms onset to study treatment was 6 days (interquartile range 5 to 8). No statistically significant difference was noted between study groups on primary endpoint (risk difference [95% IC]: 5 28% [-3 95; 14 50]; p = 0 15). Rate of improvement in at least two categories was statistically significantly higher for INM005 at days 14 and 21 of follow-up. Time to improvement in two ordinal categories or hospital discharge was 14 2 (§ 0 7) days in the INM005 group and 16 3 (§ 0 7) days in the placebo group, hazard ratio 1 31 (95% CI 1 0 to 1 74). Subgroup analyses showed a beneficial effect of INM005 over severe patients and in those with negative baseline antibodies. Overall mortality was 6 9% the INM005 group and 11 4% in the placebo group (risk difference [95% IC]: 0 57 [0 24 to 1 37]). Adverse events of special interest were mild or moderate; no anaphylaxis was reported. Interpretation: Albeit not having reached the primary endpoint, we found clinical improvement of hospitalized patients with SARS-CoV-2 pneumonia, particularly those with severe disease.Fil: Lopardo, Gustavo. Municipalidad de Vicente Lopez (buenos Aires). Hospital Municipal Doctor Bernardo Houssay.; ArgentinaFil: Belloso, Waldo H.. Hospital Italiano; ArgentinaFil: Nannini, Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Colonna, Mariana. Inmunova; ArgentinaFil: Sanguineti, Santiago. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Inmunova; ArgentinaFil: Zylberman, Vanesa. Inmunova; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Muñoz, Luciana. Inmunova; ArgentinaFil: Dobarro, Martín. Sanatorio Sagrado Corazón; ArgentinaFil: Lebersztein, Gabriel. Sanatorio Sagrado Corazón; ArgentinaFil: Farina, Javier. Gobierno de la Provincia de Buenos Aires. 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No especifíca;Fil: Pereiro, Ana. Fundación Mundo Sano; ArgentinaFil: Sued, Omar. Fundación Huésped; ArgentinaFil: Cahn, Pedro. Fundación Huésped; ArgentinaFil: Spatz, Linus. Inmunova; ArgentinaFil: Goldbaum, Fernando Alberto. Inmunova; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquímicas de Buenos Aires. Fundación Instituto Leloir. Instituto de Investigaciones Bioquímicas de Buenos Aires; Argentina. Universidad Nacional de San Martin. Centro de Rediseño E Ingenieria de Proteinas.; Argentin