Intrapartum and perinatal results associated with different degrees of staining of meconium stained amniotic fluid

OBJECTIVE: To determine the intrapartum and perinatal results associated with different degrees of staining of meconium stained amniotic fluid (MSAF). STUDY DESIGN: In a retrospective cohort study of all singleton deliveries over a period of one year (2015) in a tertiary hospital, we compared different degrees of MSAF (yellow, green and thick) to clear amniotic fluids, and analysed in each group maternal, intrapartum and neonatal variables as well as umbilical cord blood gas analysis. RESULTS: Of the 3590 deliveries included, 503 (14%) had MSAF. The incidence of MSAF rises with gestational age at delivery, reaching 20.7% in gestations above 41 weeks compared to 4.3% below 37 weeks. As the amniotic fluid staining progresses we found a higher proportion of intrapartum fevers (p  0.05). We have observed a similar distribution of umbilical artery pH ranges in all groups (p > 0.05). CONCLUSIONS: MSAF was associated with an increase in the rate of pathological fetal heart rate patterns, intrapartum fevers, operative vaginal and cesarean section deliveries, need for neonatal resuscitation, low Apgar scores and higher fetal-neonatal mortality. Moreover, we found that the risks increase as the staining and consistency of the amniotic fluid evolves so it should alert the obstetrician and paediatrician to the potential adverse outcomes

Biomarker-Guided Anti-Egfr Rechallenge Therapy in Metastatic Colorectal Cancer

Anticossos monoclonals anti-EGFR; Càncer colorectal metastàticAnticuerpos monoclonales anti-EGFR; Cáncer colorrectal metastásicoAnti-EGFR monoclonal antibodies; Metastatic colorectal cancerThe prognosis of patients with metastatic colorectal cancer (mCRC) who progressed to the first and the second lines of treatment is poor. Thus, new therapeutic strategies are needed. During the last years, emerging evidence suggests that retreatment with anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (MAbs) in the third line of mCRC patients, that have previously obtained clinical benefit by first-line therapy with anti-EGFR MAbs plus chemotherapy, could lead to prolonged survival. The rationale beyond this “rechallenge” strategy is that, after disease progression to first line EGFR-based therapy, a treatment break from anti-EGFR drugs results in RAS mutant cancer cell decay, restoring the sensitivity of cancer cells to cetuximab and panitumumab. In fact, rechallenge treatment with anti-EGFR drugs has shown promising clinical activity, particularly in patients with plasma RAS and BRAF wild type circulating tumor DNA, as defined by liquid biopsy analysis at baseline treatment. The aim of this review is to analyze the current knowledge on rechallenge and to investigate the role of novel biomarkers that can guide the appropriate selection of patients that could benefit from this therapeutic strategy. Finally, we discuss on-going trials and future perspectives.Regione Campania (I-Cure Research Project, Grant number: Cup 21C17000030007), Gruppo Oncologico dell’Italia Meridionale (GOIM)

Bases fisiológicas del crecimiento diferencial en la fase inicial del desarrollo de dos progenies de Pinus taeda bajo condiciones de campo, en Misiones Argentina

Para contribuir al conocimiento de caracteres ecofisiológicos útiles en la selección de genotipos aptos para ciertas áreas ecológicas, en el contexto de cambio climático, el objetivo del presente trabajo fue evaluar variables morfo-fisiológicas responsables del crecimiento diferencial de plantines de Pinus taeda bajo condiciones ambientales subtropicales. Se evaluaron en medio-hermanos provenientes de una madre de crecimiento rápido (CR) y una de crecimiento lento (CL) las variables: incremento en altura, diámetro a la altura del cuello (DAC), conductancia estomática (gs), potencial hídrico (Ψ) mínimo y máximo, fotosíntesis neta a saturación de radiación fotosintéticamente activa (Asat), conductancia (Kh) y conductividad hidráulica específica (ks) y foliar específica (kl) de ramas, y asignación de biomasa aérea. Los genotipos CR presentaron mayor incremento en altura y DAC y mayor producción de biomasa aérea. Los patrones de gs, Ψ y Asat fueron similares entre genotipos. En contraste, los genotipos CR presentaron mayor eficiencia de conducción de agua por unidad de área foliar en condiciones de alta disponibilidad de agua, aunque su ks fue más afectada bajo condiciones de déficit hídrico que en los CL. Las diferencias observadas en asignación de biomasa aérea, que modifican la arquitectura hidráulica de la planta, serían parcialmente responsables de las tasas diferenciales de crecimiento. Asimismo, la tendencia de menor regulación estomática en los genotipos CR, reflejada en mayor grado de anisohidrismo y mayor caída en ks en períodos secos, sugiere que estos podrían ser más susceptibles al déficit hídrico que los CL, requiriéndose más estudios para poner a prueba esta hipótesis.The aim of this study was to evaluate morpho-physiological variables responsible for differential growth of Pinus taeda seedlings under subtropical natural environmental conditions in order to determine key eco-physiological characters for selection of better adapted genotypes in the context of climate change. The following variables were evaluated in half-sibling individuals from two mothers, a fast-growing (CR) and a slow-growing (CL) genotype: height and basal diameter (BD) increment, stomatal conductance (gs), minimum and maximum daily water potential (Ψ), photosynthesis at light saturation (Asat), branch specific hydraulic conductivity (ks), hydraulic conductance (Kh), leaf specific hydraulic conductivity (kl) and aerial biomass allocation. The CR genotypes had higher height and BD increment and increased biomass production. Daily gs and Ψ patterns and Asat were similar among genotypes. In contrast, CR genotypes presented a higher water conduction efficiency per leaf area unit under conditions of high soil water availability, although their ks was more affected under water deficit conditions than in CL genotypes. The observed differences in biomass allocation within aerial compartments, leading to changes in the whole hydraulic architecture of the plant, would be responsible for differential growth rates. In addition, the observed trend of a lower stomatal regulation in CR, reflected in a higher degree of anisohydrism and higher ks losses in a dry period, suggests that these genotypes could be more vulnerable to water deficits than CL, requiring further studies to test this hypothesis.EEA MontecarloFil: Bulfe, Nardia María. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Montecarlo; ArgentinaFil: Faustino, Laura Inés. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Fisiología Vegetal. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Instituto de Fisiología Vegetal; ArgentinaFil: Pinazo, Martin Alcides. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Montecarlo; ArgentinaFil: Graciano, Corina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Fisiología Vegetal. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Instituto de Fisiología Vegetal; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Agrarias y Forestales; ArgentinaFil: Fernandez, Marí­a Elena. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Grupo de Ecología Forestal; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Epigenetic modifiers as potential therapeutic targets in diabetic kidney disease

Diabetic kidney disease is one of the fastest growing causes of death worldwide. Epigenetic regulators control gene expression and are potential therapeutic targets. There is functional interventional evidence for a role of DNA methylation and the histone post-translational modifications—histone methylation, acetylation and crotonylation—in the pathogenesis of kidney disease, including diabetic kidney disease. Readers of epigenetic marks, such as bromodomain and extra terminal (BET) proteins, are also therapeutic targets. Thus, the BD2 selective BET inhibitor apabetalone was the first epigenetic regulator to undergo phase-3 clinical trials in diabetic kidney disease with an endpoint of kidney function. The direct therapeutic modulation of epigenetic features is possible through pharmacological modulators of the specific enzymes involved and through the therapeutic use of the required substrates. Of further interest is the characterization of potential indirect effects of nephroprotective drugs on epigenetic regulation. Thus, SGLT2 inhibitors increase the circulating and tissue levels of β-hydroxybutyrate, a molecule that generates a specific histone modification, β-hydroxybutyrylation, which has been associated with the beneficial health effects of fasting. To what extent this impact on epigenetic regulation may underlie or contribute to the so-far unclear molecular mechanisms of cardio-and nephroprotection offered by SGLT2 inhibitors merits further in-depth studies.This research was funded by FIS/FEDER funds (PI15/00298, CP14/00133, PI16/01900, PI18/01386, PI18/0133, PI19/00588, PI19/00815, DTS18/00032, ERA-PerMed-JTC2018 (KIDNEY ATTACK AC18/00064 and PERSTIGAN AC18/00071), ISCIII-RETIC REDinREN RD016/0009), Sociedad Española de Nefrología, FRIAT, Comunidad de Madrid en Biomedicina B2017/BMD- 3686 CIFRA2-CM. Salary support: ISCIII Miguel Servet to ABS and MDS-N, ISCIII Sara Borrell to JM-MM, REDinREN RD016/0009 to MF-B, and MICIU to JG-M

Engineering conductive protein films through nanoscale self-assembly and gold nanoparticles doping

Protein-based materials are usually considered as insulators, although conductivity has been recently shown in proteins. This fact opens the door to develop new biocompatible conductive materials. While there are emerging efforts in this area, there is an open challenge related to the limited conductivity of protein-based systems. This work shows a novel approach to tune the charge transport properties of protein-based materials by using electron-dense AuNPs. Two strategies are combined in a unique way to generate the conductive solid films: (1) the controlled self-assembly of a protein building block; (2) the templating of AuNPs by the engineered building block. This bottom-up approach allows controlling the structure of the films and the distribution of the AuNPs within, leading to enhanced conductivity. This work illustrates a promising strategy for the development of effective hybrid protein-based bioelectrical materialsThis work was partially supported by the European Research Council ERC-CoG-648071-ProNANO, ERC-PoC-841063-NIMM, Agencia Estatal de Investigación, Spain (PID2019- 111649RB-I00; and MAT2017-88693-R), and the Basque Government (Elkartek KK-2017/00008), E.L-M thanks the Spanish Ministry of Science and Innovation for the FPI grant (BES-2017-079646). This work was performed under the Maria de Maeztu Units of Excellence Program from the Spanish State Research Agency – Grant No. MDM-2017-0720 (CIC biomaGUNE) and SEV-2016-0686 (IMDEA Nanociencia

Maternal diet-induced obesity during pregnancy alters lipid supply to mouse E18.5 fetuses and changes the cardiac tissue lipidome in a sex- dependent manner

Maternal obesity during pregnancy has immediate and long-term detrimental effects on the offspring heart. In this study, we characterized the cardiac and circulatory lipid profiles in late gestation E18.5 fetuses of diet-induced obese pregnant mice and established the changes in lipid abundance and fetal cardiac transcriptomics. We used untargeted and targeted lipidomics and transcriptomics to define changes in the serum and cardiac lipid composition and fatty acid metabolism in male and female fetuses. From these analyses we observed: (1) maternal obesity affects the maternal and fetal serum lipidome distinctly; (2) female fetal heart lipidomes are more sensitive to maternal obesity than males; (3) changes in lipid supply might contribute to early expression of lipolytic genes in mouse hearts exposed to maternal obesity. These results highlight the existence of sexually dimorphic responses of the fetal heart to the same in utero obesogenic environment and identify lipids species that might mediate programming of cardiovascular health.MRC Metabolic Diseases Unit [MRC_MC_UU_00014/4] Cambridge Home and EU Student Scholarship British Heart Foundation studentship [FS/12/64/30001] II was supported by a British Heart Foundation studentship [FS/18/56/35177

Dynamic Edematous Response of the Human Heart to Myocardial Infarction Implications for Assessing Myocardial Area at Risk and Salvage

BACKGROUND: Clinical protocols aimed to characterize the post-myocardial infarction (MI) heart by cardiac magnetic resonance (CMR) need to be standardized to take account of dynamic biological phenomena evolving early after the index ischemic event. Here, we evaluated the time course of edema reaction in patients with ST-segment-elevation MI by CMR and assessed its implications for myocardium-at-risk (MaR) quantification both in patients and in a large-animal model. METHODS: A total of 16 patients with anterior ST-segment-elevation MI successfully treated by primary angioplasty and 16 matched controls were prospectively recruited. In total, 94 clinical CMR examinations were performed: patients with ST-segment-elevation MI were serially scanned (within the first 3 hours after reperfusion and at 1, 4, 7, and 40 days), and controls were scanned only once. T2 relaxation time in the myocardium (T2 mapping) and the extent of edema on T2-weighted short-tau triple inversion-recovery (ie, CMR-MaR) were evaluated at all time points. In the experimental study, 20 pigs underwent 40-minute ischemia/reperfusion followed by serial CMR examinations at 120 minutes and 1, 4, and 7 days after reperfusion. Reference MaR was assessed by contrast-multidetector computed tomography during the index coronary occlusion. Generalized linear mixed models were used to take account of repeated measurements. RESULTS: In humans, T2 relaxation time in the ischemic myocardium declines significantly from early after reperfusion to 24 hours, and then increases up to day 4, reaching a plateau from which it decreases from day 7. Consequently, edema extent measured by T2-weighted short-tau triple inversion-recovery (CMR-MaR) varied with the timing of the CMR examination. These findings were confirmed in the experimental model by showing that only CMR-MaR values for day 4 and day 7 postreperfusion, coinciding with the deferred edema wave, were similar to values measured by reference contrast-multidetector computed tomography. CONCLUSIONS: Post-MI edema in patients follows a bimodal pattern that affects CMR estimates of MaR. Dynamic changes in post-ST-segment-elevation MI edema highlight the need for standardization of CMR timing to retrospectively delineate MaR and quantify myocardial salvage. According to the present clinical and experimental data, a time window between days 4 and 7 post-MI seems a good compromise solution for standardization. Further studies are needed to study the effect of other factors on these variables.This study was partially supported by a competitive grant from the Spanish Society of Cardiology (Proyectos de Investigacion Traslacional en Cardiologia de la Sociedad Espanola de Cardiologia 2015, for the project Caracterizacion tiSUlar miocaRdica con resonancia magnetica en pacientes tras inFarto agudo de mioCardio con elevacioN de ST sometidos a angloplastia Coronaria primaria. Estudio SURF-CNIC), by a competitive grant from the Carlos III Institute of Health-Fondo de Investigacion Sanitaria- and the European Regional Development Fund (ERDF/FEDER) (PI10/02268 and PI13/01979), the Spanish Ministry of economy, industry, and competitiveness (MEIC) and ERDF/FEDER SAF2013-49663-EXP. Dr Fernandez-Jimenez holds a FICNIC fellowship from the Fundacio Jesus Serra, the Fundacion Interhospitalaria de Investigacion Cardiovascular, and the Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), and Dr Aguero is a FP7-PEOPLE-2013-ITN-Cardionext fellow. This study forms part of a Master Research Agreement between the CNIC and Philips Healthcare, and is part of a bilateral research program between Hospital de Salamanca Cardiology Department and the CNIC. This research program is part of an institutional agreement between FIIS-Fundacion Jimenez Diaz and CNIC. The CNIC is supported by the MEIC and the Pro CNIC Foundation, and is a Severo Ochoa Center of Excellence (MEIC award SEV-2015-0505).S

Ulmus laevis in the Iberian Peninsula: a review of its ecology and conservation

European white elm (Ulmus laevis Pallas) populations are scarce, small and fragmented in the Iberian Peninsula. Due to these characteristics the indigenous status of the species in the region has been questioned, whilst the species? role in Iberian riparian forest ecology has been neglected. Herein we review past studies regarding this species? distribution and ecology in the Iberian Peninsula, with special emphasis on the establishment of conservation priorities. We first present a collection of palaeogeographic, historic and genetic data suggesting that the Iberian Peninsula was a glacial refuge for U. laevis. Secondly, we analyse U. laevis distribution in relation to soil physico- chemical properties and water availability in Spain. Following this, we focus on the reproductive biology of the species, and investigate the effect of masting and empty seed production on predation and regeneration establishment. Finally, based on this knowledge, we propose conservation policies for U. laevis in the Iberian Peninsula