Clostridioides difficile infection in a long-term convalescence hospital: A real tale of pitfalls and outdated therapy

Objective. The aim of the study was to know the char-acteristics and risk factors of Clostridioides difficile infection (CDI) in a long-term hospital is key to improve its manage-ment. Material and methods. Retrospective study with 37 pa-tients, along 43 months. We describe demographic variables, clinical data, time to diagnosis, treatment, and evolution. Results. Analysis of 46 episodes (37 patients, mean age=82.2 years). 77.8% were absolutely dependent, 41.7% had chronic kidney disease, 64.9% had received antibiotics in the previous three months, 40.5% received antibiotics at diagnosis. It was the first episode in 78.4%, and first recurrence in 21.6%. Therapy was started in the first 24 hours after diagnosis in 89.2%, mostly metronidazole. 83.3% recovered, 3 patients died from CDI, diagnosis was registered in the discharge report in 91.1%. Conclusions. Previous antibiotic therapy, high grade of dependency and renal failure were the main risk factors. There is room for improvement in CDI management at our hospital. Objective. The aim of the study was to know the characteristics and risk factors of Clostridioides difficile infection (CDI) in a long-term hospital is key to improve its management. Material and methods. Retrospective study with 37 patients, along 43 months. We describe demographic variables, clinical data, time to diagnosis, treatment, and evolution. Results. Analysis of 46 episodes (37 patients, mean age=82.2 years). 77.8% were absolutely dependent, 41.7% had chronic kidney disease, 64.9% had received antibiotics in the previous three months, 40.5% received antibiotics at diagnosis. It was the first episode in 78.4%, and first recurrence in 21.6%. Therapy was started in the first 24 hours after diagnosis in 89.2%, mostly metronidazole. 83.3% recovered, 3 patients died from CDI, diagnosis was registered in the discharge report in 91.1%. Conclusions. Previous antibiotic therapy, high grade of dependency and renal failure were the main risk factors. There is room for improvement in CDI management at our hospital

Analysis and numerical simulation of an induction–conduction model arising in steel heat treating

The goal of steel heat treating is to create a hard enough part over certain critical surfaces or volumes of the workpiece and at the same time keeping its ductility properties all over the rest of the workpiece. Weconsider a mathematical model for the description of the heating–cooling industrial process of a steel workpiece. This model consists of a nonlinear coupled partial differential system of equations involving the electric potential, the magnetic vector potential, the temperature, together with a system of ordinary differential equations for the steel phase fractions. Due to the different time scales related to the electric potential and the magnetic vector potential versus the temperature, we introduce the harmonic regime, leading to a new system of nonlinear PDEs. Finally, we have carried out some 2D numerical simulations of this heating–cooling industrial process.Ministerio de Educación y Ciencia MTM2010-16401Junta de Andalucía FQM-31

Fibroblast migration in 3D is controlled by haptotaxis in a non-muscle myosin II-dependent manner

Cell migration in 3D is a key process in many physiological and pathological processes. Although valuable knowledge has been accumulated through analysis of various 2D models, some of these insights are not directly applicable to migration in 3D. In this study, we have confined biomimetic hydrogels within microfluidic platforms in the presence of a chemoattractant (platelet-derived growth fac- tor-BB). We have characterized the migratory responses of human fibroblasts within them, particularly focusing on the role of non-muscle myosin II. Our results indicate a prominent role for myosin II in the integration of chemo- tactic and haptotactic migratory responses of fibroblasts in 3D confined environments

Nested shallow geothermal systems

The long-term sustainability of shallow geothermal systems in dense urbanized areas can be potentially compromised by the existence of thermal interfaces. Thermal interferences between systems have to be avoided to prevent the loss of system performance. Nevertheless, in this work we provide evidence of a positive feedback from thermal interferences in certain controlled situations. Two real groundwater heat pump systems were investigated using real exploitation data sets to estimate the thermal energy demand bias and, by extrapolation, to assess the nature of thermal interferences between the systems. To do that, thermal interferences were modelled by means of a calibrated and validated 3D city-scale numerical model reproducing groundwater flow and heat transport. Results obtained showed a 39% (522 MWh·yr-1) energy imbalance towards cooling for one of the systems, which generated a hot thermal plume towards the downgradient and second system investigated. The nested system in the hot thermal plume only used groundwater for heating, thus establishing a positive symbiotic relationship between them. Considering the energy balance of both systems together, a reduced 9% imbalance was found, hence ensuring the long-term sustainability and renewability of the shallow geothermal resource exploited. The nested geothermal systems described illustrate the possibilities of a new management strategy in shallow geothermal energy governance

Multifractal characterization of pore size distributions measured by mercury intrusion porosimetry

The aim of this work was to assess the multifractal characteristics of pore size distributions measured by mercury injection porosimetry (MIP). Two pairs of soil samples were collected in plots with different topographic position and soil use, with each pair differentiated by distinct proportion of fine particles and organic matter contents. Macropore volume was higher on samples with higher clay and organic matter content. Mass exponent function, singularity spectra and generalized dimension spectra showed that multifractal distribution was a suitable model for mercury injection curves. Multifractal parameters extracted from singularity spectra and generalized dimension spectra reflected the main characteristics of the pore size distributions (PSDs). Therefore, it was concluded that multifractal analysis is useful for distinguishing between different patterns of pore size distributions obtained by Hg injection

Immediate Effects of Upper Cervical Translatoric Mobilization on Cervical Mobility and Pressure Pain Threshold in Patients With Cervicogenic Headache: A Randomized Controlled Trial

Objective The purpose of this study was to evaluate the immediate effects of upper cervical translatoric spinal mobilization (UC-TSM) on cervical mobility and pressure pain threshold in subjects with cervicogenic headache (CEH). Methods Eighty-two volunteers (41.54 ± 15.29 years, 20 male and 62 female) with CEH participated in the study and were randomly divided into the control and treatment groups. The treatment group received UC-TSM and the control group remained in the same position for the same time as the UC-TSM group, but received no treatment. Cervical mobility (active cervical mobility and flexion-rotation test), pressure pain thresholds over upper trapezius muscles, C2-3 zygapophyseal joints and suboccipital muscles, and current headache intensity (visual analog scale) were measured before and immediately after the intervention by 2 blinded investigators. Results After the intervention, UC-TSM group exhibited significant increases in total cervical mobility (P =.002, d = 0.16) and the flexion–rotation test (P .05). Nevertheless, there was a significantly lower intensity of headache in the UC-TSM group (P =.039, d = 0.57). Conclusions Upper cervical translatoric spinal mobilization intervention increased upper, and exhibited a tendency to improve general, cervical range of motion and induce immediate headache relief in subjects with CEH

Competing endogenous rna networks as biomarkers in neurodegenerative diseases

Protein aggregation is classically considered the main cause of neuronal death in neurodegenerative diseases (NDDs). However, increasing evidence suggests that alteration of RNA metabolism is a key factor in the etiopathogenesis of these complex disorders. Non-coding RNAs are the major contributor to the human transcriptome and are particularly abundant in the central nervous system, where they have been proposed to be involved in the onset and development of NDDs. Interestingly, some ncRNAs (such as lncRNAs, circRNAs and pseudogenes) share a common functionality in their ability to regulate gene expression by modulating miRNAs in a phenomenon known as the competing endogenous RNA mechanism. Moreover, ncRNAs are found in body fluids where their presence and concentration could serve as potential non-invasive biomarkers of NDDs. In this review, we summarize the ceRNA networks described in Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis and spinocerebellar ataxia type 7, and discuss their potential as biomarkers of these NDDs. Although numerous studies have been carried out, further research is needed to validate these complex interactions between RNAs and the alterations in RNA editing that could provide specific ceRNET profiles for neurodegenerative disorders, paving the way to a better understanding of these diseases

Lung metastases share common immune features regardless of primary tumor origin

BACKGROUND: Only certain disseminated cells are able to grow in secondary organs to create a metastatic tumor. Under the hypothesis that the immune microenvironment of the host tissue may play an important role in this process, we have categorized metastatic samples based on their immune features. METHODS: Gene expression data of metastatic samples (n=374) from four secondary sites (brain, bone, liver and lung) were used to characterize samples based on their immune and stromal infiltration using gene signatures and cell quantification tools. A clustering analysis was done that separated metastatic samples into three different immune categories: high, medium and low. RESULTS: Significant differences were found between the immune profiles of samples metastasizing in distinct organs. Metastases in lung showed a higher immunogenic score than metastases in brain, liver or bone, regardless of their primary site of origin. Also, they preferentially clustered in the high immune group. Samples in this cluster exhibited a clear inflammatory phenotype, higher levels of immune infiltrate, overexpression of programmed death-ligand 1 (PD-L1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA4) pathways and upregulation of genes predicting clinical response to programmed cell death protein 1 (PD-1) blockade (T-cell inflammatory signature). A decision tree algorithm was used to select CD74 as a biomarker that identify samples belonging to this high-immune subtype of metastases, having specificity of 0.96 and sensitivity of 1. CONCLUSIONS: We have found a group of lung-enriched metastases showing an inflammatory phenotype susceptible to be treated with immunotherapy

Active cervical range of motion in babies with positional plagiocephaly: Analytical cross-sectional study

Positional plagiocephaly (PP) is a general term describing cranial distortion from preor postnatal forces on the infant head. Abnormal intrauterine forces, multiple births, primiparous mothers, obstetric interventions, prematurity, male sex, excessive time lying in the supine position, and mobility restrictions of the cervical spine have been considered as the main predisposing factors. The objective was to investigate the association between the severity of PP and the active cervical rotation and to analyze the influence of predisposing factors in babies with PP. An analytical crosssectional study was performed on 74 babies with moderate PP. Clinical and demographic data, cranial vault asymmetry, and active cervical rotation range of motion (ROM) were measured. Associations were analyzed with generalized linear models. The mean age was 16.8 ± 5.0 weeks, and 56.8% were male. A restriction in the ROM of active cervical rotation, especially to the left side, was observed. Our models showed that cranial asymmetry was related with left active cervical rotation ROM (p = 0.034) and with being transported in a pushchair (p < 0.001). Conclusions: An increased severity of PP was related with being transported in a baby pushchair and with a reduced active cervical rotation ROM toward the most restricted side. © 2021 by the authors. Licensee MDPI, Basel, Switzerland