Anatomic Response to Intravitreal Dexamethasone Implant and Baseline Aqueous Humor Cytokine Levels in Diabetic Macular Edema

Dexamethasone; Cytokine; Macular EdemaDexametasona; Citocina; Edema macularDexametasona; Citosina; Edema macularPURPOSE: To determine whether baseline cytokine aqueous humor (AH) levels are associated with diabetic macular edema (DME) anatomic response to dexamethasone intravitreal implant (DEX) injection. METHODS: This was a prospective cohort study of DME cases receiving DEX treatment. Seventy patients were recruited with center-involving DME with spectral-domain (SD) optical coherence tomography (OCT) detection of central macular thickness (CMT) ≥300 μm on macular cube 518 × 128-μm scan protocol (Cirrus SD-OCT). DEX injection and anterior chamber tap to obtain an AH sample were performed at the same time. Multiplex immunoassay was carried out for interleukin (IL)-1β, IL-3, IL-6, IL-8, IL-10; monocyte chemoattractant protein (MCP)-1; interferon gamma-induced protein (IP)-10; tumor necrosis factor (TNF)-α; and vascular endothelial growth factor (VEGF). A follow-up visit and OCT exam were undertaken 6 to 8 weeks afterward. The association between AH cytokine baseline levels and change in CMT and macular volume (MV) was defined as main outcome measure. RESULTS: Multivariate linear regression analysis showed a higher decrease in MV to be associated (Rs of 0.512) with four baseline items: higher MCP-1 (β = -0.4; P = 0.028), higher CMT (β = -0.003; P = 0.024), decreased visual acuity (β = -0.7; P = 0.040), and a diffuse retinal thickening (DRT) OCT pattern (β = -1.3; P < 0.001). Logistic regression found DRT also to be associated with higher odds of a good MV response (odds ratio, 31.96; 95% confidence interval [CI] 7.11-143.72; P < 0.001). CONCLUSIONS: Even though visual acuity response and anatomic effect are not always correlated in DME, we found that baseline elevated MCP-1 AH levels and DRT pattern were biomarkers that predicted a future favorable anatomic response to DEX

Improving Reading Skills Using a Computerized Phonological Training Program in Early Readers with Reading Difficulties

In the last years, there has been a big effort to identify risk factors for reading difficulties and to develop new methodologies to help struggling readers. It has been shown that early intervention is more successful than late intervention, and that intensive training programs can benefit children with reading difficulties. The aim of our study is to investigate the effectiveness of an intensive computerized phonological training program designed to improve reading performance in a sample of children with reading difficulties at the early stages of their reading learning process. Thirty-two children with reading difficulties were randomly assigned to one of the two intervention groups: RDIR (children with reading difficulties following a computerized intensive remediation strategy) (n = 20) (7.01 +/- 0.69 years), focused on training phonemic awareness, decoding and reading fluency through the computational training; and RDOR (children with reading difficulties following an ordinary remediation strategy) (n = 12) (6.92 +/- 0.82 years), which consisted of a reinforcement of reading with a traditional training approach at school. Normal readers (NR) were assigned to the control group (n = 24) (7.32 +/- 0.66 years). Our results indicate that both the RDIR and RDOR groups showed an increased reading performance after the intervention. However, children in the RDIR group showed a stronger benefit than the children in the RDOR group, whose improvement was weaker. The control group did not show significant changes in reading performance during the same period. In conclusion, results suggest that intensive early intervention based on phonics training is an effective strategy to remediate reading difficulties, and that it can be used at school as the first approach to tackle such difficulties

Tissue Distribution of Oleocanthal and Its Metabolites after Oral Ingestion in Rats

Claims for the potential health benefits of oleocanthal (OLC), a dietary phenolic compound found in olive oil, are based mainly on in vitro studies. Little is known about the tissue availability of OLC, which is rapidly metabolized after ingestion. In this study, the distribution of OLC and its metabolites in rat plasma and tissues (stomach, intestine, liver, kidney, spleen, lungs, heart, brain, thyroid and skin) at 1, 2 and 4.5 h after the acute intake of a refined olive oil containing 0.3 mg/mL of OLC was examined by LC-ESI-LTQ-Orbitrap-MS. OLC was only detected in the stomach and intestine samples. Moreover, at 2 and 4.5 h, the concentration in the stomach decreased by 36% and 74%, respectively, and in the intestine by 16% and 33%, respectively. Ten OLC metabolites arising from phase I and phase II reactions were identified. The metabolites were widely distributed in rat tissues, and the most important metabolizing organs were the small intestine and liver. The two main circulating metabolites were the conjugates OLC + OH + CH3 and OLC + H2O + glucuronic acid, which may significantly contribute to the beneficial health effects associated with the regular consumption of extra virgin olive oil. However, more studies are necessary to determine the concentrations and molecular structures of OLC metabolites in human plasma and tissues when consumed with the presence of other phenolic compunds present in EVOO. Keywords: LC-ESI-LTQ-Orbitrap; bioaccumulation; extra virgin olive oil; metabolism; polyphenols

Schistosomiasis Among Female Migrants in Non-endemic Countries : Neglected Among the Neglected? A Pilot Study

Schistosomiasis among migrant populations in Europe is an underdiagnosed infection, yet delayed treatment may have serious long-term consequences. In this study we aimed to characterize the clinical manifestations of Schistosoma infection among migrant women, and the degree of underdiagnosis. We carried out a prospective cross-sectional study among a migrant population living in the North Metropolitan Barcelona area and coming from schistosomiasis-endemic countries. We obtained clinical, laboratory and socio-demographic data from electronic clinical records, as well as information about years of residence and previous attendance at health services. Blood sample was obtained and schistosomiasis exposure was assessed using a specific ELISA serological test. Four hundred and five patients from schistosomiasis-endemic regions were screened, of whom 51 (12.6%) were female. Seropositivity prevalence was 54.8%, but considering women alone we found a prevalence of 58.8% (30 out of 51). The median age of the 51 women was 41.0 years [IQR (35-48)] and the median period of residence in the European Union was 13 years [IQR (10-16)]. Schistosoma -positive women (N = 30) showed a higher prevalence of gynecological signs and symptoms compared to the seronegative women (96.4 vs. 66.6%, p = 0.005). Among seropositive women, the median number of visits to Sexual and Reproductive Health unit prior to diagnosis of schistosomiasis was 41 [IQR (18-65)]. The high prevalence of signs and symptoms among seropositive women and number of previous visits suggest a high rate of underdiagnosis and/or delayed diagnosis of Schistosoma infection, particularly female genital schistosomiasis, among migrant females

Community structure in mediterranean shallow lentic ecosystems : size-based vs. taxon-based approaches

The main environmental variables determining the community structure and the functioning of Mediterranean shallow lentic ecosystems are described. These ecosystems are characterized by the unpredictability of their water inputs and the high variability in their water level and physical and chemical composition. Variations in flooding, salinity, and water turnover are determinant in species composition and nutrient dynamics. Taxon-based and size-based approaches to the study of the community structure of aquatic organisms that colonise these ecosystems are also compared. The conventional taxonomic approach, based on the determination of species composition, has been used for the identification of patterns in species richness, distribution and temporal dynamics, and for ecological requirements of species and their potential use as ecological indicators. This taxonbased approach has been compared with a size-based approach, where individuals are classified by their size. Size-based approach gives complementary information about community structure and dynamics, especially when communities are dominated by a single species. The use of size diversity combined with species diversity is suggested for a more complete understanding of community structuring in this type of ecosystem. Detailed examples of two Mediterranean shallow lentic ecosystems, the salt marshes of the Empordà wetlands and the Espolla temporary karstic pond, which differ in hydrology and water origin, are used to discuss the suitability of these different approaches.Los ecosistemas leníticos someros mediterráneos se caracterizan por la impredictibilidad en las entradas de agua y por la elevada variabilidad en el nivel del agua y su composición física y química. Se describen aquí las principales variables ambientales que determinan la estructura de la comunidad y el funcionamiento de estos ecosistemas. Variaciones en la inundación, la salinidad y la tasa de renovación del agua son determinantes en la composición de especies y en la dinámica de nutrientes. Se comparan también aproximaciones al estudio de la comunidad basadas en la composición taxonómica con las basadas en la distribución de tamaños. La aproximación taxonómica convencional, basada en la determinación de la composición de especies, es adecuada para la identificación de patrones en la distribución y en la dinámica temporal de la especies, así como para el análisis de los requerimientos ambientales de las diferentes especies y su uso potencial como indicadores ecológicos. Esta aproximación taxonómica se ha comparado con otra aproximación basada en el tamaño corporal, donde los individuos se clasifican por su tamaño. La aproximación basada en el tamaño proporciona información complementaria de la estructura y dinámica de las comunidades, especialmente cuando en estas comunidades hay una especie dominante. Se sugiere el uso combinado de una diversidad de tamaños y una diversidad de especies para una comprensión más completa de la estructuración de las comunidades en este tipo de ecosistemas. Para discutir si estas diferentes aproximaciones son o no adecuadas, se presentan datos de dos ecosistemas mediterráneos leníticos y someros: las marismas de Aiguamolls de l'Empordà y la laguna de Espolla, una surgencia cárstica de inundación temporal

Cognitive stimulation has potential for brain activation in individuals with Rett syndrome

Background: Knowledge regarding neuropsychological training in Rett syndrome (RS) is scarce. The aim of this study was to assess the outcome and the duration of the effect of cognitive stimulation on topographic EEG data in RS. Method: Twenty female children diagnosed with RS were included in the analysis. Girls with RS conducted a cognitive task using an eye-tracker designed to evaluate access and choice skills. EEG data was acquired during the experimental procedure including two 10-minutes baseline stages before and after the task. Topographical changes of several EEG spectral markers including absolute and relative powers, brain symmetry index and entropy were assessed. Results: Topographic significance probability maps suggested statistical decreases on delta activity and increases on beta rhythm associated with the cognitive task. Entropy increased during and after the task, likely related to more complex brain activity. A significant positive interaction was obtained between brain symmetry index (BSI) and age showing that the improvement of interhemispheric symmetry was higher in younger girls (5-10 years). Conclusions: According to our findings, significant alterations of brain rhythms were observed during and after cognitive stimulation, suggesting that cognitive stimulation may have effects on brain activity beyond the stimulation period. Finally, our promising results also showed an increased brain symmetry that was especially relevant for the younger group. This could suggest an interaction of the eye-tracking cognitive task, however, further studies in this field are needed to assess the relation between brain asymmetries and age.We would like to acknowledge specific funding support from the Spanish Patient Associations Mi Princesa Rett and Rettando al Síndrome de Rett. This project has also received funding from Torrons Vicens and the Ministry of Science and Innovation (MICINN), Spain, under contract PID2020-117751RB-I00. CIBER-BBN is an initiative of the Instituto de Salud Carlos III, Spain. A. Bachiller is a Serra Húnter Fellow. A.García-Cazorla is supported by FIS P118/00111 “Instituto de Salud Carlos III (ISCIII)” and “Fondo Europeo de desarrollo regional (FEDER)”. A. Tost has received the predoctoral scholarship FI-AGAUR from the Generalitat de Catalunya.Peer ReviewedPostprint (author's final draft

Crustacean and aquatic insect assemblages in the Mediterranean coastal ecosystems of Empord'a wetlands (NE Iberian peninsula)

Coastal wetlands are characterized by high biodiversity, which is one of the main criteria considered when establishing protection policies or when proposing adequate management actions. In this study, the crustacean and aquatic insect composition of the Empordà wetlands is described. These two faunal groups contribute highly to the total biodiversity in these wetlands but are seldom considered when managing natural areas. A selection (84 sampling points) of all water body types present in the Empord'a wetlands were sampled monthly (surber and dip net with a 250 μm mesh). Sampling was carried out during 3 surveys (1991-92, 1996-97 and 1999-2000). A rich fauna of 125 crustacean and 295 aquatic insect taxa was identified. We characterized each water body type using the most abundant species and the relative species richness of the taxonomic groups. A classification of the water body types, according to similarity between inventories, groups the brackish and hyperhaline systems in one cluster and the various freshwater systems in another one. Among freshwater systems, lotic waters and freshwater wetlands have a high similarity, whereas rice fields and freshwater springs have a low similarity.Los humedales costeros se caracterizan por una alta biodiversidad, que es uno de los principales criterios considerados al establecer políticas de protección o al proponer acciones de gestión adecuada. En este estudio se describe la composición de crustáceos e insectos acuáticos de los aiguamolls del Empordà. Estos dos grupos faunísticos contribuyen de forma importante al total de la biodiversidad en los humedales, pero raramente se tienen en consideración al gestionar las áreas naturales. Se muestreó mensualmente una selección (84 puntos de muestreo) de todas las tipologías de masas de agua presentes en los aiguamolls de l'Empordà mediante redes surber y salabres de poro de malla de 250 μm. El muestreo se llevó a cabo durante atres campañas (1991-92, 1996-97 y 1999-2000). Se identificó una riqueza faunística de 125 taxones de crustáceos y 295 taxones de insectos acuáticos. Cada tipología de masa de agua se caracterizó utilizando las especies más abundantes y la riqueza específica de los grupos faunísticos. La clasificación de las tipologías de masas de agua, según la similaridad entre inventarios faunísticos, agrupó los sistemas salobres y hiperhalinos en un grupo. Entre los sistemas de agua dulce, los sistemas lóticos y los humedales de agua dulce presentaron una alta similaridad, mientras que los arrozales y las surgencias de agua dulce mostraron una baja similaridad

Optical Coherence Tomography Angiography in Type 1 Diabetes Mellitus-Report 2: Diabetic Kidney Disease.

The purpose of this study is to investigate potential associations between optical coherence tomography angiography (OCTA) parameters and diabetic kidney disease (DKD) categories in type 1 diabetes mellitus (T1DM) patients and controls. A complete ocular and systemic examination, including OCTA imaging tests and bloods, was performed. OCTA parameters included vessel density (VD), perfusion density (PD), foveal avascular zone area (FAZa), perimeter (FAZp) and circularity (FAZc) in the superficial vascular plexus, and DKD categories were defined according to glomerular filtration rate (GFR), albumin-creatinine ratio (ACR) and KDIGO prognosis risk classifications. A total of 425 individuals (1 eye/1 patient) were included. Reduced VD and FAZc were associated with greater categories of GFR (p = 0.002, p = 0.04), ACR (p = 0.003, p = 0.005) and KDIGO risk prognosis classifications (p = 0.002, p = 0.005). FAZc was significantly reduced in greater KDIGO prognosis risk categories (low risk vs. moderate risk, 0.65 ± 0.09 vs. 0.60 ± 0.07, p < 0.05). VD and FAZc presented the best diagnostic performance in ROCs. In conclusion, OCTA parameters, such as VD and FAZc, are able to detect different GFR, ACR, and KDIGO categories in T1DM patients and controls in a non-invasive, objective quantitative way. FAZc is able to discriminate within T1DM patients those with greater DKD categories and greater risk of DKD progression

Comparison of a human acellular dermal matrix and a polypropylene mesh for pelvic floor reconstruction : a randomized trial study in a rabbit model

Non-absorbable polypropylene (PP) meshes have been widely used in surgical reconstruction of the pelvic floor disorders. However, they are associated with serious complications. Human acellular dermal matrices (hADM) have demonstrated safety and efficacy in reconstructive medicine, but their suitability and efficacy at vaginal level is not known. This study compares the biological performance of PP mesh and a newly developed hADM. 20 rabbits were randomized to receive the hADM graft or the PP mesh. Grafts were surgically implanted in the abdominal wall and vagina. After 180 days, grafts were explanted and evaluated. The vaginal mesh extrusion rate was higher in the PP group (33% vs. 0%, p = 0.015). Full integration of the vaginal grafts was more frequent in the hADM group, where 35% of the grafts were difficult to recognize. In the PP group, the vaginal mesh was identified in 100% of the animals (p = 0.014). In PP group, the infiltrates had a focal distribution and were mostly located in the internal part of the epithelium, while in the hADM group, the infiltrates had a diffuse distribution. Additionally, the hADM group also presented more B-lymphocytes and less T-lymphocytes. Biomechanical analysis showed that hADM had lower resistance to stress. Moreover, PP mesh stiffness and elasticity were higher. Then, hADM is associated with fewer clinical complications, as well as better tissue integration. However, it shows greater incorporation into the surrounding native tissue, especially in the vaginal location, undergoing a reduction in its biomechanical properties 6 months after implantation

Consistent centennial-scale change in European sub-Arctic peatland vegetation towards Sphagnum dominance – implications for carbon sink capacity

Abstract Climate warming is leading to permafrost thaw in northern peatlands, and current predictions suggest that thawing will drive greater surface wetness and an increase in methane emissions. Hydrology largely drives peatland vegetation composition, which is a key element in peatland functioning and thus in carbon dynamics. These processes are expected to change. Peatland carbon accumulation is determined by the balance between plant production and peat decomposition. But both processes are expected to accelerate in northern peatlands due to warming, leading to uncertainty in future peatland carbon budgets. Here, we compile a dataset of vegetation changes and apparent carbon accumulation data reconstructed from 33 peat cores collected from 16 sub-arctic peatlands in Fennoscandia and European Russia. The data cover the past two millennia that has undergone prominent changes in climate and a notable increase in annual temperatures towards present times. We show a pattern where European sub-Arctic peatland microhabitats have undergone a habitat change where currently drier habitats dominated by Sphagnum mosses replaced wetter sedge-dominated vegetation and these new habitats have remained relatively stable over the recent decades. Our results suggest an alternative future pathway where sub-arctic peatlands may at least partly sustain dry vegetation and enhance the carbon sink capacity of northern peatlands.Peer reviewe