Depositional sequences and ammonoid assemblages in the upper Cenomanian-lower Santonian of the Iberian Peninsula (Spain and Portugal)

A clear relationship exists between eustatic sea-level rises and falls recorded as cyclical depositional sequences and ammonite faunas during the Cenomanian-Santonian in the Iberian and West Portuguese basins. Most of the faunal turnovers correlate with stratigraphic intervals related to marine transgressions, maximum flooding of the shelf (locally associated to anoxic events), and marine regressions. Specifically, within each depositional sequence, three distinct and identical events of morphological change occur, involving ammonoids belonging to different groups. Transgressive sediments are characterized by moderately ornamented, inflated and evolute morphologies, which are replaced by smooth, involute and compressed oxycones (the most hydrodynamic shells) during maximum flooding (and to a lesser extent at the early highstand) of the sequences. The latter morphologies in turn are replaced by coarsely ornamented and evolute shells during late highstands. We conclude that ammonoid faunal analysis can be used to trace sea-level changes and provides an additional tool for sequence stratigraphy

Synchrotron X-ray microdiffraction to study dental structures in Cretaceous crocodylomorphs

Synchrotron radiation X-ray microdiffraction (SR-μXRD) has been applied for the first time as a fundamental method of analysis to unveil crocodilian teeth growth and development. Teeth from a fossil crocodylomorph from the Upper Cretaceous site of Lo Hueco (Spain) and a modern crocodylian from the living species Crocodylus niloticus have been analysed. Both samples have been studied through Polarized Light Microscopy, Scanning Electron Microscopy coupled with Energy Dispersive X-Ray Spectroscopy, Confocal Raman Spectroscopy, and SR-μXRD. Significant differences have been found in hydroxyapatite (HA) crystallite sizes and texture, and the evolution of these two features along teeth depth. The main differences observed in crystallite size are related to postdepositional processes and/or the environmental and functional pressures of teeth during crocodylomorph life, very different from that of the modern specimen. Regarding the crystalline texture in the tooth enamel, it can be linked to teeth functionality during crocodilian life, causing the directed growth of HA crystallites due to the mechanical stress to which they are subjectedThis work was funded by the projects PGC2018-099405-B-100 (Ministerio de Ciencia, Innovacion y Universidades); HAR2017- 82755-P, HAR2016-78036-P, HAR2016-74846-P, HAR2017-83004-P, CGL2015-66604, CGL2015-68363 and MAT2015-67593-P (Ministerio de Economía y Competitividad, Spain); and 201860E127 (CSIC

Concern and Risk Perception: Effects on Osteoprotective Behaviour

This study aimed to determine the effect that level of concern for osteoporosis, as well as self-perceived risk of osteoporosis and fracture, has on supplementation use, seeking medical advice, bone mineral density (BMD) testing, and antiosteoporosis medication (AOM) use. Study subjects were 1,095 female Australian participants of the Global Longitudinal study of Osteoporosis in Women (GLOW) untreated for osteoporosis at baseline. Study outcomes from self-administered questionnaires included calcium and vitamin D supplementation, self-reported seeking of medical advice regarding osteoporosis, BMD testing, and AOM use in the last 12 months at the late assessment. Logistic regression was used in the analysis. Concern significantly increased the likelihood of seeking medical advice and, however, had no significant impact on screening or treatment. Heightened self-perceived risks of osteoporosis and fracture both significantly increased the likelihood of seeking medical advice and BMD testing while elevated self-perceived risk of fracture increased AOM use. Supplementation use was not significantly associated with concern levels and risk perception. Concern and risk perceptions to osteoporosis and fracture were significantly associated with certain bone-protective behaviours. However, the disconnect between perceived osteoporosis risk and AOM use illustrates the need to emphasize the connection between osteoporosis and fracture in future education programs

Concern and Risk Perception: Effects on Osteoprotective Behaviour

This study aimed to determine the effect that level of concern for osteoporosis, as well as self-perceived risk of osteoporosis and fracture, has on supplementation use, seeking medical advice, bone mineral density (BMD) testing, and antiosteoporosis medication (AOM) use. Study subjects were 1,095 female Australian participants of the Global Longitudinal study of Osteoporosis in Women (GLOW) untreated for osteoporosis at baseline. Study outcomes from self-administered questionnaires included calcium and vitamin D supplementation, self-reported seeking of medical advice regarding osteoporosis, BMD testing, and AOM use in the last 12 months at the late assessment. Logistic regression was used in the analysis. Concern significantly increased the likelihood of seeking medical advice and, however, had no significant impact on screening or treatment. Heightened self-perceived risks of osteoporosis and fracture both significantly increased the likelihood of seeking medical advice and BMD testing while elevated selfperceived risk of fracture increased AOM use. Supplementation use was not significantly associated with concern levels and risk perception. Concern and risk perceptions to osteoporosis and fracture were significantly associated with certain bone-protective behaviours. However, the disconnect between perceived osteoporosis risk and AOM use illustrates the need to emphasize the connection between osteoporosis and fracture in future education programs

A novel class of CoA-transferase involved in short-chain fatty acid metabolism in butyrate-producing human colonic bacteria

Peer reviewedPublisher PD

The Impact of Fracture Incidence on Health Related Quality of Life among Community-Based Postmenopausal Women

This prospective study aimed to examine the impact of fracture incidence on health-related quality of life (HRQOL) among postmenopausal women. Study subjects were Australian female community-dwellers in the Global Longitudinal Study of Osteoporosis in Women (GLOW). Self-administered questionnaires were collected annually from 2007 to 2010. Outcomes were the Medical Outcomes Study Short Form-36 (SF-36 physical function (SF36PFS) and vitality (SF36VS) scores), European Quality of Life (EQ-5D), and self-reported general health (GH) of excellent/good. Questionnaires were divided into prior to, the 1st, the 2nd, and the 3rd year after incident fracture assessments. Generalized linear models with generalised estimating equations (GEE) were employed for the analysis. The 2,872 participants (age: median 65; interquartile range 60-73 years) provided a total of 10,436 assessments including 266, 165 and 76 assessments for the 1st, the 2nd, and the 3rd year after incident fracture, respectively. Multivariate adjustments showed reductions in HRQOL measures peaking at the 1st year for SF36VS (coefficient −3.0; 95% CI: −5.1, −0.8) and EQ-5D (coefficient −0.03; 95% CI: −0.06, −0.00) and at the 2nd year for SF36PFS (coefficient −3.0; 95% CI: −5.6, −0.5) and GH (odds ratio 0.92; 95% CI: 0.70, 1.19). Fracture incidence reduced HRQOL including vitality and physical function among relatively young, healthy postmenopausal women and the reduction in European Quality of Life measure was clinically important

Comparative prebiotic activity of mixtures of cereal grain polysaccharides

The main components of the non-starch polysaccharide (NSP) fraction of wheat flour are arabinoxylan (AX) and β-glucan. These are also present in other cereal grains, but their proportions vary with AX being the major component in wheat and rye and β-glucan in barley and oats. Therefore, it was hypothesised that these NSPs could act synergistically when fermented in vitro at the ratios present in the major foods consumed, resulting in increased prebiotic activity. AX and β-glucan were therefore tested in in vitro fermentation studies to assess their prebiotic activity when used individually and/or in different ratios. Short-chain fatty-acids (SCFAs) produced from in vitro fermentation were measured using HPLC and bacterial populations were measured using flow cytometry with fluorescence in situ hybridisation (Flow-FISH). Fermentation of AX alone resulted in a significant bifidogenic activity and increased concentrations of SCFAs, mainly acetate, after 8-24 h of fermentation, however β-glucan alone did not show prebiotic activity. The greatest prebiotic activity, based on concentration of total SCFAs and increases in total bacteria as well as beneficial Bifidobacterium and Clostridium coccoides/Eubacterium groups, was observed when AX and β-glucan were combined at a 3:1 ratio, which corresponds to their ratios in wheat flour which is major source of cereal fibre in the diet. This indicates that the population of bacteria in the human GI tract may be modulated by the composition of the fibre in the diet, to maximise the prebiotic potential

Consensus recommendations for the improvement of inter- and intra-centre care coordination in the management of hemophilia

Hemofilia A; Equipo multidisciplinar; TelefarmaciaHaemophilia A; Multidisciplinary care team; TelepharmacyHemofilia A; Equip multidisciplinar; TelefarmàciaObjetivo definir las recomendaciones consensuadas para mejorar la coordinación asistencial entre Farmacia Hospitalaria, Hematología y Enfermería, inter e intra-centros, en la atención a los pacientes con hemofilia. Método se identificaron y valoraron las recomendaciones para la mejora de la coordinación asistencial en el abordaje de los pacientes con hemofilia, por parte de un panel multidisciplinar de profesionales con experiencia en este campo (Farmacia Hospitalaria, Hematología y Enfermería) y apoyado en la evidencia científica. La valoración de las recomendaciones identificadas se realizó por metodología de consenso Rand/UCLA (Delphi-adaptado) con base en su adecuación y, posteriormente, a su necesidad. En ambos casos, se empleó la escala ordinal de Likert. Los datos se analizaron estadísticamente a través de diferentes métricas. Resultados se identificaron 53 recomendaciones para la mejora de la coordinación asistencial entre Farmacia Hospitalaria, Hematología y Enfermería en el manejo del paciente con hemofilia, agrupadas en 8 ámbitos de actuación: i) Unidades de Hemofilia, centros de referencia y abordaje multidisciplinar; ii) papel de Hematología, Farmacia Hospitalaria y Enfermería en el recorrido asistencial de los pacientes con hemofilia; iii) telefarmacia y telemedicina; iv) monitorización farmacocinética; v) transición al régimen de paciente adulto; vi) educación sanitaria al paciente; vii) cirugía, urgencias e ingreso hospitalario; y viii) evaluación de los resultados. Todas las recomendaciones fueron valoradas por el panel de expertos externos como adecuadas y necesarias. Conclusiones el recorrido asistencial del paciente con hemofilia es complejo y depende de diversas variables. Además, requiere la implicación de distintos profesionales sanitarios que deben actuar de manera coordinada e integrada en todas las etapas de la vida del paciente, de manera adaptada a sus necesidades individuales. Las recomendaciones identificadas y consensuadas pueden suponer una mejora para la continuidad y calidad asistencial, pues facilitan la integración y coordinación de los profesionales implicados en el abordaje de esta enfermedad, especialmente de Farmacia Hospitalaria, Hematología y Enfermería.Objective Define consensus recommendations to improve care coordination between Hospital Pharmacy, Haematology and Nursing, inter- and intra-center, in the care of haemophilia patients. Method Recommendations for the improvement of care coordination in the management of haemophilia patients were identified and assessed by a multidisciplinary panel of professionals with experience in this field (Hospital Pharmacy, Haematology and Nursing) and supported by scientific evidence. The identified recommendations were assessed by Rand/UCLA consensus methodology (Delphi-adapted) based on their appropriateness and, subsequently, on their necessity. In both cases, it was used ordinal Likert scale. Data were statistically analysed through different metrics. Results Fifty-three recommendations for the improvement of care coordination between Hospital Pharmacy, Haematology and Nursing in the management of haemophilia patients were identified, grouped into eight areas of action: i) Haemophilia units, reference centers and multidisciplinary care; ii) Role of Haematology, Hospital Pharmacy and Nursing in the patient journey of haemophilia patients; iii) Telepharmacy and telemedicine; iv) Pharmacokinetic monitoring; v) Transition to adult patient regimen; vi) Patient health education; vii) Surgery, emergency room and hospital admission; and viii) Outcome evaluation. All recommendations were assessed as appropriate and necessary by the external expert panel. Conclusions Haemophilia patient journey is complex and depends on different variables. It also requires the involvement of different healthcare professionals who must act in a coordinated and integrated manner at all stages of the patient's life, adapted to their individual needs. On this matter, the identified and agreed recommendations may improve continuity and quality of care, as they facilitate the integration and coordination of the professionals involved in the management of this pathology, especially Hospital Pharmacy, Haematology and Nursing.Para la realización de este trabajo se ha contado con el patrocinio de CSL-Behring

Synchrotron X-ray microdiffraction to study dental structures in Cretaceous crocodylomorphs

Synchrotron radiation X-ray microdiffraction (SR-μXRD) has been applied for the first time as a fundamental method of analysis to unveil crocodilian teeth growth and development. Teeth from a fossil crocodylomorph from the Upper Cretaceous site of Lo Hueco (Spain) and a modern crocodylian from the living species Crocodylus niloticus have been analysed. Both samples have been studied through Polarized Light Microscopy, Scanning Electron Microscopy coupled with Energy Dispersive X-Ray Spectroscopy, Confocal Raman Spectroscopy, and SR-μXRD. Significant differences have been found in hydroxyapatite (HA) crystallite sizes and texture, and the evolution of these two features along teeth depth. The main differences observed in crystallite size are related to postdepositional processes and/or the environmental and functional pressures of teeth during crocodylomorph life, very different from that of the modern specimen. Regarding the crystalline texture in the tooth enamel, it can be linked to teeth functionality during crocodilian life, causing the directed growth of HA crystallites due to the mechanical stress to which they are subjected

Hospital-acquired influenza infections detected by a surveillance system over six seasons, from 2010/2011 to 2015/2016

In addition to outbreaks of nosocomial influenza, sporadic nosocomial influenza infections also occur but are generally not reported in the literature. This study aimed to determine the epidemiologic characteristics of cases of nosocomial influenza compared with the remaining severe cases of severe influenza in acute hospitals in Catalonia (Spain) which were identified by surveillance. An observational case-case epidemiological study was carried out in patients aged ≥18 years from Catalan 12 hospitals between 2010 and 2016. For each laboratory-confirmed influenza case (nosocomial or not) we collected demographic, virological and clinical characteristics. We defined patients with nosocomial influenza as those admitted to a hospital for a reason other than acute respiratory infection in whom ILI symptoms developed ≥48 h after admission and influenza virus infection was confirmed using RT-PCR. Mixed-effects regression was used to estimate the crude and adjusted OR. One thousand seven hundred twenty-two hospitalized patients with severe laboratory-confirmed influenza virus infection were included: 96 (5.6%) were classified as nosocomial influenza and more frequently had > 14 days of hospital stay (42.7% vs. 27.7%, P <.001) and higher mortality (18.8% vs. 12.6%, P <.02). The variables associated with nosocomial influenza cases in acute-care hospital settings were chronic renal disease (aOR 2.44 95% CI 1.44-4.15) and immunodeficiency (aOR 1.79 95% CI 1.04-3.06). Nosocomial infections are a recurring problem associated with high rates of chronic diseases and death. These findings underline the need for adherence to infection control guidelines