Exercise during pregnancy reduces the rate of cesarean and instrumental deliveries: results of a randomized controlled trial

Objective: In this study, the authors assessed the effects of a structured, moderate-intensity exercise program during the entire length of pregnancy on a woman’s method of delivery. Methods: A randomized controlled trial was conducted with 290 healthy pregnant Caucasian (Spanish) women with a singleton gestation who were randomly assigned to either an exercise (n=138) or a control (n=152) group. Pregnancy outcomes, including the type of delivery, were measured at the end of the pregnancy. Results: The percentage of cesarean and instrumental deliveries in the exercise group were lower than in the control group (15.9%, n=22; 11.6%, n=16 vs. 23%, n=35; 19.1%, n=29, respectively; p=0.03). The overall health status of the newborn as well as other pregnancy outcomes were unaffected. Conclusions: Based on these results, a supervised program of moderate-intensity exercise performed throughout pregnancy was associated with a reduction in the rate of cesarean sections and can be recommended for healthy women in pregnancy

Identification of Promoter Region Markers Associated With Altered Expression of Resistance-Nodulation-Division Antibiotic Efflux Pumps in Acinetobacter baumannii

Genetic alterations leading to the constitutive upregulation of specific efflux pumps contribute to antibacterial resistance in multidrug resistant bacteria. The identification of such resistance markers remains one of the most challenging tasks of genome-level resistance predictors. In this study, 487 non-redundant genetic events were identified in upstream zones of three operons coding for resistance-nodulation-division (RND) efflux pumps of 4,130 Acinetobacter baumannii isolates. These events included insertion sequences, small indels, and single nucleotide polymorphisms. In some cases, alterations explicitly modified the expression motifs described for these operons, such as the promoter boxes, operators, and Shine-Dalgarno sequences. In addition, changes in DNA curvature and mRNA secondary structures, which are structural elements that regulate expression, were also calculated. According to their influence on RND upregulation, the catalog of upstream modifications were associated with "experimentally verified," "presumed," and "probably irrelevant" degrees of certainty. For experimental verification, DNA of upstream sequences independently carrying selected markers, three for each RND operon, were fused to a luciferase reporter plasmid system. Five out of the nine selected markers tested showed significant increases in expression with respect to the wild-type sequence control. In particular, a 25-fold expression increase was observed with the ISAba1 insertion sequence upstream the adeABC pump. Next, overexpression of each of the three multi-specific RND pumps was linked to their respective antibacterial substrates by a deep A. baumannii literature screen. Consequently, a data flow framework was then developed to link genomic upregulatory RND determinants to potential antibiotic resistance. Assignment of potential increases in minimal inhibitory concentrations at the "experimentally verified" level was permitted for 42 isolates to 7-8 unrelated antibacterial agents including tigecycline, which is overlooked by conventional resistome predictors. Thus, our protocol may represent a time-saving filter step prior to laborious confirmation experiments for efflux-driven resistance. Altogether, a computational-experimental pipeline containing all components required for identifying the upstream regulatory resistome is proposed. This schema may provide the foundational stone for the elaboration of tools approaching antibiotic efflux that complement routine resistome predictors for preventing antimicrobial therapy failure against difficult-to-threat bacteria.This research was supported by grants MPY 380/18 and MPY 509/19 from the Instituto de Salud Carlos III (ISCIII). ML-S is the recipient of a Sara Borrell contract by the ISCIII. AM-G is the recipient of a Miguel Servet contract by the ISCIII.S

Role of peptidoglycan recycling enzymes AmpD and AnmK in Acinetobacter baumannii virulence features

Acinetobacter baumannii is an important causative agent of hospital acquired infections. In addition to acquired resistance to many currently-available antibiotics, it is intrinsically resistant to fosfomycin. It has previously been shown that AmpD and AnmK contribute to intrinsic fosfomycin resistance in A. baumannii due to their involvement in the peptidoglycan recycling pathway. However, the role that these two enzymes play in the fitness and virulence of A. baumannii has not been studied. The aim of this study was to characterize several virulence-related phenotypic traits in A. baumannii mutants lacking AmpD and AnmK. Specifically, cell morphology, peptidoglycan thickness, membrane permeability, growth under iron-limiting conditions, fitness, resistance to disinfectants and antimicrobial agents, twitching motility and biofilm formation of the mutant strains A. baumannii ATCC 17978 ΔampD::Kan and ΔanmK::Kan were compared to the wild type strain. Our results demonstrate that bacterial growth and fitness of both mutants were compromised, especially in the ΔampD::Kan mutant. In addition, biofilm formation was decreased by up to 69%, whereas twitching movement was reduced by about 80% in both mutants. These results demonstrate that, in addition to increased susceptibility to fosfomycin, alteration of the peptidoglycan recycling pathway affects multiple aspects related to virulence. Inhibition of these enzymes could be explored as a strategy to develop novel treatments for A. baumannii in the future. Furthermore, this study establishes a link between intrinsic fosfomycin resistance mechanisms and bacterial fitness and virulence traits.ML-S was supported by the Sara Borrell Program of the Instituto de Salud Carlos III (CD17CIII/00017), and AT was supported by the Garantıa Juvenil Program of the Comunidad ́Autónoma de Madrid (PEJ2018-004820-A -MPY 387/19), is currently supported by a FPU grant (FPU20/03261) and PhD student in Biomedical Sciences and Public Health, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain ([email protected]). MM is supported by grants from the Instituto de Salud Carlos III (MP 516/19 and MPY 380/18).S

Assessing Shiny apps through student feedback: recommendations from a qualitative study

This is the accepted version of the following article: Gonzalez, J., Lopez, M., Cobo, E., Cortes, J. Assessing Shiny apps through student feedback: recommendations from a qualitative study. "Computer applications in engineering education", Setembre 2018, vol. 26, núm. 5, p. 1813-1824., which has been published in final form at https://onlinelibrary.wiley.com/doi/abs/10.1002/cae.21932Teaching statistics has benefited from Java applets, the successful technology that appeared in the late 90s and which allowed real interactivity on an Internet browser. Combining dynamic functionality with the web provides an inspirational complement to the contents of many subjects in undergraduate statistics courses, especially for active learning activities. Since Java applets are becoming obsolete, we explore a different technology based on R (currently a popular statistical language) and Shiny, which is a web framework for developing interactive applications inside the R environment. Although the pedagogical value of these tools has been implicitly accepted so far, our aim is to consider the students' perspective while investigating more suitable means to accompany the use of apps in statistics. We conducted a qualitative study in which we tested 10 of our applications and collected student opinions through questionnaires and regular meetings. Our conclusions indicate that the students view these resources positively, although they demand more support, just enough to facilitate both getting started and using the tools effectively. In addition, programming in R is surely more accessible and satisfying for statistics lecturers than other languages and, consequently, implementing instructional activities can be specially tailored by the teacher.Peer ReviewedPostprint (author's final draft

Sustainable Carbon as Efficient Support for Metal-Based Nanocatalyst: Applications in Energy Harvesting and Storage

[EN] Sustainable activated carbon can be obtained from the pyrolysis/activation of biomass wastes coming from different origins. Carbon obtained in this way shows interesting properties, such as high surface area, electrical conductivity, thermal and chemical stability, and porosity. These characteristics among others, such as a tailored pore size distribution and the possibility of functionalization, lead to an increased use of activated carbons in catalysis. The use of activated carbons from biomass origins is a step forward in the development of more sustainable processes enhancing material recycling and reuse in the frame of a circular economy. In this article, a perspective of different heterogeneous catalysts based on sustainable activated carbon from biomass origins will be analyzed focusing on their properties and catalytic performance for determined energy-related applications. In this way, the article aims to give the reader a scope of the potential of these tailor-made sustainable materials as a support in heterogeneous catalysis and future developments needed to improve catalyst performance. The selected applications are those related with H2 energy and the production of biomethane for energy through CO2 methanation.This research was funded by the Centro de Desarrollo Tecnologico Industrial-CDTI (ALMAGRID Project-CER-20191006), by the Instituto Valenciano de Competitividad Empresarial-IVACE-FEDER (BIO3 Project-IMDEEA/2019/44) and by the Agencia Valenciana de Investigacion-AVI (REWACER Project INNEST00/19/050).Buaki-Sogo, M.; Zubizarreta Saenz De Zaitegui, L.; García Pellicer, M.; Quijano-Lopez, A. (2020). Sustainable Carbon as Efficient Support for Metal-Based Nanocatalyst: Applications in Energy Harvesting and Storage. 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Elective Recurrent Inguinal Hernia Repair: Value of an Abdominal Wall Surgery Unit

Inguinal hernia; Abdominal wall surgeryHernia inguinal; Cirugía de la pared abdominalHèrnia inguinal; Cirurgia de la paret abdominalBackground The aim of this study was to analyze the impact of an abdominal wall surgery unit on postoperative complications (within 90 days postoperatively), hernia recurrence and chronic postoperative inguinal pain after elective recurrent inguinal hernia repair. Methods We conducted a retrospective cohort study of all adult patients who underwent elective recurrent inguinal hernia repair between January 2010 and October 2021. Short- and long-term outcomes were compared between the group of patients operated on in the abdominal wall surgery unit and the group of patients operated on by other units not specialized in abdominal wall surgery. A logistic regression model was performed for hernia recurrence. Results A total of 250 patients underwent elective surgery for recurrent inguinal hernia during the study period. The patients in the abdominal wall surgery group were younger (P ≤ 0.001) and had fewer comorbidities (P ≤ 0.001). There were no differences between the groups in terms of complications. The patients in the abdominal wall surgery group presented fewer recurrences (15% vs. 3%; P = 0.001). Surgery performed by the abdominal wall surgery unit was related to fewer recurrences in the multivariate analysis (HR = 0.123; 95% CI = 0.21–0.725; P = 0.021). Conclusions Specialization in abdominal wall surgery seems to have a positive impact in terms of recurrence in recurrent inguinal hernia repair. The influence of comorbidities or type of surgery (i.e., outpatient surgery) require further study.Open Access Funding provided by Universitat Autonoma de Barcelona. This work did not receive external funding from any source other than the authors’ institution

A young girl with severe polyarteritis nodosa successfully treated with tocilizumab: a case report

Child; Polyarteritis nodosa; TocilizumabNena; Poliarteritis nodosa; TocilizumabNiña; Poliarteritis nodosa; TocilizumabBackground Childhood Polyarteritis nodosa (PAN) is a systemic vasculitis with necrotizing inflammation of medium- and small-sized arteries. Disease evolution may be severe and refractory to standard treatment including prednisone, azathioprine and cyclophosphamide. Case presentation We present the case of a young girl with severe PAN resulting in progressive ischemia and necrosis of fingers and toes. Biological work-up revealed increased acute phase reactants and interleukin-6 levels. She was only partially controlled despite high-dose corticosteroids and cyclophosphamide infusions, and eventually achieved rapid improvement and sustained remission on tocilizumab. Further, we review the current evidence of the interleukin-6-inhibitor tocilizumab for the treatment of PAN. Conclusion Tocilizumab may be an efficient therapeutic option in a subset of treatment-refractory children with PAN

Assessment of the Impact of Long Integration Time in Geosynchronous SAR Imagery of Agricultural Fields by Means of GB-SAR Data

Geosynchronous Synthetic Aperture Radar (GeoSAR) missions offer the advantage of near-continuous monitoring of specific regions on Earth, making them essential for applications that require continuous information. However, wind induced motion along the inherent long integration time can result in image defocusing, with potential degradation of retrieved information. This paper aims to investigate the impact of GEOSAR long integration time in Synthetic Aperture Radar (SAR) imaging and derived products (time series of backscatter and coherence) required to extract agriculture relevant soil or crop parameters of interest. The study is based on the extensive HydroSoil data acquisition campaign carried out over barley and corn crops, funded by the European Space Agency (ESA). The collected raw data are used to synthesize equivalent apertures with integration times of up to 4 hours, similar to those acquired with a GeoSAR. These Ultra Slow apertures facilitate the assessment of the impact of agricultural scene decorrelation on the generation of images with extended integration times.This work was funded by the European Space Agency (ESA Contract No. 4000132509/20/NL/FF/ab with UPC), supported by the Spanish MCINN funds Unidad de Excelencia Maria de Maeztu MDM-2016-0600 and under projects PID2020-117303GB-C21/AEI/10.13039/501100011033 and PID2020-117303GB-C22/AEI/10.13039/501100011033

Optimization of a Lambda-RED Recombination Method for Rapid Gene Deletion in Human Cytomegalovirus

Human cytomegalovirus (HCMV) continues to be a major cause of morbidity in transplant patients and newborns. However, the functions of many of the more than 282 genes encoded in the HCMV genome remain unknown. The development of bacterial artificial chromosome (BAC) technology contributes to the genetic manipulation of several organisms including HCMV. The maintenance of the HCMV BAC in E. coli cells permits the rapid generation of recombinant viral genomes that can be used to produce viral progeny in cell cultures for the study of gene function. We optimized the Lambda-Red Recombination system to construct HCMV gene deletion mutants rapidly in the complete set of tested genes. This method constitutes a useful tool that allows for the quick generation of a high number of gene deletion mutants, allowing for the analysis of the whole genome to improve our understanding of HCMV gene function. This may also facilitate the development of novel vaccines and therapeutics.This study was supported by the Spanish Ministry of Science, Innovation and University, Instituto de Salud Carlos III Grant/Award Numbers: PI17CIII-00014 (MPY110/18); PI20CIII-00009 (MPY303/20); DTS18CIII/00006 (MPY127/19). E.G.-R. is supported by the Sara Borrell Program (CD18CIII/00007), M.L.-S. is supported by the Sara Borrell Program (CD17CIIII/00017), Instituto de Salud Carlos III, Ministerio de Ciencia, Innovación y Universidades.S

Flexible and Conductive Bioelectrodes Based on Chitosan-Carbon Black Membranes: Towards the Development of Wearable Bioelectrodes

[EN] Wearable sensors for non-invasive monitoring constitute a growing technology in many industrial fields, such as clinical or sport monitoring. However, one of the main challenges in wearable sensing is the development of bioelectrodes via the use of flexible and stretchable materials capable of maintaining conductive and biocompatible properties simultaneously. In this study, chitosan-carbon black (CH-CB) membranes have been synthesized using a straightforward and versatile strategy and characterized in terms of their composition and their electrical and mechanical properties. In this sense, CH-CB membranes showed good conductivity and mechanical resistance thanks to the presence of carbon black, which decreases the insulating behavior of chitosan, while flexibility and biocompatibility are maintained due to the dual composition of the membrane. Thus, flexible and biocompatible conductive bioelectrodes have been developed by the combined use of CH and CB without the use of toxic reagents, extra energy input, or long reaction times. The membranes were modified using the enzymes Glucose Oxidase and Laccase in order to develop flexible and biocompatible bioelectrodes for enzymatic glucose biofuel cells (BFCs) and glucose detection. A BFC assembled using the flexible bioelectrodes developed was able to deliver 15 mu W cm(-2), using just 1 mM glucose as biofuel, and up to 21.3 mu W center dot cm(-2) with higher glucose concentration. Additionally, the suitability of the CH-CB membranes to be used as a glucose sensor in a linear range from 100 to 600 mu M with a limit of detection (LOD) of 76 mu M has been proven. Such demonstrations for energy harvesting and sensing capabilities of the developed membrane pave the way for their use in wearable sensing and energy harvesting technologies in the clinical field due to their good mechanical, electrical, and biocompatible properties.This work has been supported by the Instituto Valenciano de Competitividad Empresarial (IVACE) in accordance with the IMAMCL/2020/1 agreement and within the framework of the BioSensCell project.Buaki-Sogo, M.; García-Carmona, L.; Gil Agustí, MT.; García Pellicer, M.; Quijano-Lopez, A. (2021). Flexible and Conductive Bioelectrodes Based on Chitosan-Carbon Black Membranes: Towards the Development of Wearable Bioelectrodes. Nanomaterials. 11(8):1-17. https://doi.org/10.3390/nano11082052S11711