Prognostic significance of infarct size and location: The case of insular stroke

The prognostic relevance of strokes in different locations is debated. For example, insular strokes have been associated with increased mortality, but this association could reflect their greater severity. In two independent cohorts of patients with supratentorial ischemic stroke (n = 90 and 105), we studied the prognostic consequences of lesion size and location using voxel-based lesion-symptom mapping before and after volume control, which better accounts for total lesion volume. Strokes affecting the insula were larger than non-insular strokes (28 vs 2cc and 25 vs 3cc, p < 0.001 in both cohorts). A number of supratentorial areas (mainly in the left hemisphere), including the insula, were associated with poor functional outcome in both cohorts before (4014 voxels) and after volume control (1378 voxels), while the associations with death were greatly reduced after volume control (from 8716 to 325 voxels). Exploratory analyses suggested that the method of lesion volume quantification, the National Institutes of Health Stroke Scale hemispheric bias and patient selection can result in false associations between specific brain lesions and outcomes. In conclusion, death in the first months after stroke is mainly explained by large infarct volumes, whereas lesions of specific supratentorial structures, mostly in the left hemisphere, also contribute to poor functional outcomes

Assessment of Acute-Phase Protein Response Associated with the Different Pathological Forms of Bovine Paratuberculosis

[EN] In this study, the concentrations of two acute-phase proteins (APPs), haptoglobin (Hp) and serum amyloid A (SAA), were quantitatively assessed in serum samples from cattle naturally infected with paratuberculosis (PTB). APP profiles were compared across 190 animals classified according to the different pathological forms associated with infection: uninfected (n = 59), with focal lesions (n = 73), multifocal lesions (n = 19), and diffuse paucibacillary (n = 11) and diffuse multibacillary lesions (n = 28). Our results showed a significant increase in both APPs in infected animals compared to the control group, with differences depending on the type of lesion. Hp and SAA levels were increased significantly in all infected animals, except in cows with diffuse multibacillary lesions that showed similar values to non-infected animals. The expression pattern of both APPs was similar and negatively correlated with the antibody levels against PTB. These results indicate that the release of Hp and SAA is related to the presence of PTB lesions associated with a high cell-mediated immune response and a lower bacterial load, suggesting that the pro-inflammatory cytokines that are associated with these forms are the main stimulus for their synthesis. These molecules could show some potential to be used as putative biomarkers of PTB infection, particularly for the identification of subclinical animals showing pathological forms related to latency or resistance to the development of advanced lesionsSIThis study was funded by grants RTI2018-099496-B-I00 from the Spanish Ministry of Science and Innovation and LE259/P18 from “Junta de Castilla y León

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Neuromodulation-induced prehabilitation to leverage neuroplasticity before brain tumor surgery: a single-cohort feasibility trial protocol

IntroductionNeurosurgery for brain tumors needs to find a complex balance between the effective removal of targeted tissue and the preservation of surrounding brain areas. Neuromodulation-induced cortical prehabilitation (NICP) is a promising strategy that combines temporary inhibition of critical areas (virtual lesion) with intensive behavioral training to foster the activation of alternative brain resources. By progressively reducing the functional relevance of targeted areas, the goal is to facilitate resection with reduced risks of neurological sequelae. However, it is still unclear which modality (invasive vs. non-invasive neuromodulation) and volume of therapy (behavioral training) may be optimal in terms of feasibility and efficacy.Methods and analysisPatients undertake between 10 and 20 daily sessions consisting of neuromodulation coupled with intensive task training, individualized based on the target site and neurological functions at risk of being compromised. The primary outcome of the proposed pilot, single-cohort trial is to investigate the feasibility and potential effectiveness of a non-invasive NICP protocol on neuroplasticity and post-surgical outcomes. Secondary outcomes investigating longitudinal changes (neuroimaging, neurophysiology, and clinical) are measured pre-NICP, post-NICP, and post-surgery.Ethics and disseminationEthics approval was obtained from the Research Ethical Committee of Fundació Unió Catalana d'Hospitals (approval number: CEI 21/65, version 1, 13/07/2021). The results of the study will be submitted to a peer-reviewed journal and presented at scientific congresses.Clinical trial registrationClinicalTrials.gov, identifier NCT05844605

What we know about media communication on antibiotics and antimicrobial resistance. A systematic review of the scientific literature

Objective: Systematically review the literature regarding media communication about antibiotics and anti-microbial resistance (AMR) to synthesise its key characteristics and impact effectiveness, identifying gaps and areas for further research. Methods: A comprehensive systematic review covering five international databases for articles published between 1st September 2008 and 1st September 2018 was performed using the registered protocol (PROSPERO: CRD42018116464). The search using terms related to media communication and antibiotics or AMR yielded 19 eligible studies, which were analysed and qualitatively synthesised. Results: Research on media communication regarding antibiotics or AMR has rapidly increased in the last decade. 74% of studies used a media content analysis method, while the remaining studies collected data via surveys. Print media were examined in 53% (n = 10), with 74% (n = 14) focused on English language media. Conclusion: Currently, knowledge regarding media communication of antibiotics and AMR is very restricted to English-speaking print media. Further research is required to understand communication on this topic from other media (types and geographical regions) as well as how media effects attitude and behaviour change. Practice implications: Better understanding of media communication regarding antibiotics and AMR may be crucial for policymakers and public health experts when planning strategies to tackle this issue

Assessment of Acute-Phase Protein Response Associated with the Different Pathological Forms of Bovine Paratuberculosis

In this study, the concentrations of two acute-phase proteins (APPs), haptoglobin (Hp) and serum amyloid A (SAA), were quantitatively assessed in serum samples from cattle naturally infected with paratuberculosis (PTB). APP profiles were compared across 190 animals classified according to the different pathological forms associated with infection: uninfected (n = 59), with focal lesions (n = 73), multifocal lesions (n = 19), and diffuse paucibacillary (n = 11) and diffuse multibacillary lesions (n = 28). Our results showed a significant increase in both APPs in infected animals compared to the control group, with differences depending on the type of lesion. Hp and SAA levels were increased significantly in all infected animals, except in cows with diffuse multibacillary lesions that showed similar values to non-infected animals. The expression pattern of both APPs was similar and negatively correlated with the antibody levels against PTB. These results indicate that the release of Hp and SAA is related to the presence of PTB lesions associated with a high cell-mediated immune response and a lower bacterial load, suggesting that the pro-inflammatory cytokines that are associated with these forms are the main stimulus for their synthesis. These molecules could show some potential to be used as putative biomarkers of PTB infection, particularly for the identification of subclinical animals showing pathological forms related to latency or resistance to the development of advanced lesions

Radio Zarza : una aventura en el aire

Este proyecto de innovación educativa se presentó en el Congreso Internacional de Innovación en la Educación celebrado en Valladolid los dias 26, 27 y 28 de abril de 2005Realizado en el Instituto 'Giner de los Ríos' de León durante el curso académico 2003-2004. El objetivo general que se plantea es poner en marcha de una emisora escolar capaz de difundir, desde el propio centro y a partir de una efectiva implicación de alumnos y profesores, una programación estable. Para ello se cuenta con el departamento de electrónica, cuyos profesores y alumnos trabajaron en los dos cursos anteriores en el diseño técnico de un estudio radiofónico en las propias dependencias del instituto desarrollando tareas como fueron: instalación de antena radiofónica, cableados, configuración de una pequeña mesa técnica capaz de emitir, configuración de un estudio radiofónico con seis entradas de microfonía además de los micrófonos de ambiente, apertura de una línea telefónica e incluso habilitación de las condiciones necesarias para poder desarrollar en un futuro próximo la emisión de programas de televisión desde el propio estudio. Este proyecto una vez sentadas las bases técnicas necesarias sigue los siguientes pasos:- Constitución de un equipo de profesores y alumnos responsables de la puesta en marcha de la emisora. - Distribución de responsabilidades: Área Técnica, a cargo de profesores de los ciclos de electrónica. Área de dicción y redacción, a cargo de departamentos diversos (Lengua española, Inglés, Ciencias naturales). Área de actividades diversas de archivo, rastreo de información, creación de logotipo de la emisora, labores de hemeroteca, efectos musicales... (Lengua española, Música, expresión Plástica). - Establecimiento de un plan de trabajo trimestral, donde ya se contemplaba el horizonte de la inauguración de la emisora a mediados del segundo trimestre. - Difusión entre los alumnos del centro del proyecto y puesta en marcha de labores de ensayo a fin de diseñar progresivamente una programación idónea con las personas más adecuadas para las distintas tareas (locución, redacción, búsqueda de información..). - Definición del nombre de la emisora y su cobertura radiofónica ( tras numerosos ensayos se decidió que fuese en FM dejando para más adelante el dial de emisión). Los departamentos implicados en el proyecto fueron: Matemáticas, Inglés, Lengua Castellana, Biología, Electrónica, Sanidad (Auxiliar Enfermería, Farmacia y Salud Ambiental) y Música. En cuanto al alumnado, se decidió que estuviese representado por el máximo de niveles educativos posible. Así, desde el comienzo hubo representación de alumnos de primer ciclo y segundo ciclo de enseñanza secundaria, bachilleratos y ciclos de grado medio y superior de las diferentes especialidades del instituto (Electrónica, Mecánica y Sanidad) hasta un total de varias decenas -equilibrados alumnos y alumnas en la medida de lo posible- que fueron repartiéndose conforme a sus preferencias pero también conforme a sus posibilidades. Se propuso partir de una hipotética programación piloto que abarca distintos tipos de programas de acuerdo con un triple eje básico de objetivos: a) Programas de intención informativa y crítica. b) Programas de intención didáctica. c) Programas de intención recreativa. De acuerdo con todo lo anterior, se comenzó a estudiar la naturaleza de los programas, que evidentemente habrían de responder a una parrilla radiofónica convencional, con el añadido peculiar de lo que significa una emisora escolar. Así, se distribuyen inicialmente los programas en las siguientes secciones, concernientes a los temas que respectivamente se detallan:- Didácticos: 1- 'Naturaleza Viva' (Ciencias Naturales). 2- 'Bandas sonoras' (Música y Cine). 3- 'English Everywhere' (Inglés). 4- 'Crónicas Verdes' (salud Ambiental). 5- 'Diga 33' (Familias profesionales de Sanidad) . 6- Informativos y críticos: 'El kiosco radiofónico' (Lengua Castellana) . Presencias en directo (Programas que contaron con la sucesiva presencia de personas de distintos ámbitos en entrevistas, mesas redondas... Fue el caso de políticos, responsables educativos provinciales, asociaciones de carácter civil (Mujeres Maltratadas), especialistas en temas de interés para el alumnado (trastornos de alimentación, profesionales destacados (fotógrafo de 'El Mundo' destacado en Irak) . 'La hora del orientador' (Departamento de Orientación). Programas de información deportiva: 'El chándal' (alumnos de primer ciclo de enseñanza secundaria) y 'La ráfaga deportiva' (alumnos de bachillerato. 7- Recreativos: Programas musicales ('Música de ayer y de hoy', 'Dedicatorias', 'Planet makina'). Concursos: 'Nos vamos a Italia', con los alumnos del viaje escolar de bachillerato, y 'El Trespiés', sobre cuestiones numéricas y verbales. Tras las tareas de aprendizaje del primer trimestre -que incluyeron visitas a otras emisoras como Radio Universidad, Radio Intereconomía o la emisora escolar 'Onda Chachi', de la localidad leonesa de El Burgo Ranero- el segundo trimestre se dedicó a perfilar definitivamente la parrilla radiofónica inicial de Radio Zarza. Paralelamente, se fijó la cobertura de difusión a partir de numerosos estudios de alumnos de electrónica para establecer el alcance del campo así como la frecuencia: 99.6 FM. Desde el primer momento se decidió que la emisión se pudiese escuchar a través de Internet desde la página web del centro: www.ginerdelosrios.org.Junta de Castilla y LeónCastilla y LeónConsejería de Educación. Dirección General de Universidades e Investigación; Monasterio de Nuestra Señora de Prado, Autovía Puente Colgante, s. n.; 47071 Valladolid; Tel. +34983411881; Fax +34983411939ES

Neuromodulation-induced prehabilitation to leverage neuroplasticity before brain tumor surgery: a single-cohort feasibility trial protocol

Introduction: Neurosurgery for brain tumors needs to find a complex balance between the effective removal of targeted tissue and the preservation of surrounding brain areas. Neuromodulation-induced cortical prehabilitation (NICP) is a promising strategy that combines temporary inhibition of critical areas (virtual lesion) with intensive behavioral training to foster the activation of alternative brain resources. By progressively reducing the functional relevance of targeted areas, the goal is to facilitate resection with reduced risks of neurological sequelae. However, it is still unclear which modality (invasive vs. non-invasive neuromodulation) and volume of therapy (behavioral training) may be optimal in terms of feasibility and efficacy.Methods and analysis: Patients undertake between 10 and 20 daily sessions consisting of neuromodulation coupled with intensive task training, individualized based on the target site and neurological functions at risk of being compromised. The primary outcome of the proposed pilot, single-cohort trial is to investigate the feasibility and potential effectiveness of a non-invasive NICP protocol on neuroplasticity and post-surgical outcomes. Secondary outcomes investigating longitudinal changes (neuroimaging, neurophysiology, and clinical) are measured pre-NICP, post-NICP, and post-surgery.Ethics and dissemination: Ethics approval was obtained from the Research Ethical Committee of Fundacio Unio Catalana d'Hospitals (approval number: CEI 21/65, version 1, 13/07/2021). The results of the study will be submitted to a peer-reviewed journal and presented at scientific congresses