Exercise Prior to Pregnancy Enhances the Suppressive Function of Tregs in Offspring in a Mouse Model of Asthma

Regulatory T cells (Tregs) are a specialized subset of T cells responsible for peripheral tolerance and the mediation of inappropriate immune responses, such as those seen in asthma and allergy. Our lab is interested in the role that exercise plays in Treg responses. Using a mouse model of asthma, we have shown that exercise increases both the number and suppressive function of Tregs. It has been shown that exposing nursing dams to allergens confers protection against airway hyperresponsiveness and inflammation (trademarks of asthma) in pups exposed to the same allergen. In the present study, we wanted to determine if the exercise-induced increase in number and suppressive function of Tregs would be similarly passed from dams to their pups. Male pups from dams that were exercised prior to pregnancy (E) and pups from sedentary dams (S) were OVA-sensitized and challenged beginning at 4wks of age. Mice were sacrificed and tissues were taken for cell analysis. When co-cultured with CD4+CD25- responder cells, Tregs from E pups enhanced suppression of responder cells between 8.4-10% when compared to Tregs from S pups. While the number of Tregs from the mediastinal lymph node was not significantly different between E and S pups, there was a significant decrease in the number of CD4+ and CD8+ T cells in E pups from S pups (51.24% + 10.2 vs. 33.51% + 3.3 and 21.42% + 7.3 vs. 12.94% + 1.2, respectively), indicating a reduction in cellular infiltration and a muted immune response to allergen. Although not significant, there was a doubling of the number of Tregs in the thymus and bone marrow of E pups compared to S pups. This study indicates that exercise prior to pregnancy may confer some Treg-mediated protection against asthma

Risk and Response-Adapted Treatment in Multiple Myeloma

Myeloma therapeutic strategies have been adapted to patients' age and comorbidities for a long time. However, although cytogenetics and clinical presentations (plasmablastic cytology; extramedullary disease) are major prognostic factors, until recently, all patients received the same treatment whatever their initial risk. No strong evidence allows us to use a personalized treatment according to one cytogenetic abnormality in newly diagnosed myeloma. Retrospective studies showed a benefit of a double autologous transplant in high-risk cytogenetics according to the International Myeloma Working Group definition (t(4;14), t(14;16) or del(17p)). Moreover, this definition has to be updated since other independent abnormalities, namely gain 1q, del(1p32), and trisomies 5 or 21, as well as TP53 mutations, are also prognostic. Another very strong predictive tool is the response to treatment assessed by the evaluation of minimal residual disease (MRD). We are convinced that the time has come to use it to adapt the strategy to a dynamic risk. Many trials are ongoing to answer many questions: when and how should we adapt the therapy, its intensity and duration. Nevertheless, we also have to take into account the clinical outcome for one patient, especially adverse events affecting his or her quality of life and his or her preferences for continuous/fixed duration treatment

El menor como víctima de violencia de género. Un enfoque multidisciplinar

Gender violence is a problematic which affects a large percentage of women throughout the world and its real dimensions are unknown to us in their full extent, for victims tend to hide it perhaps due to feeling shame or to seeing themselves overshadowed. This results in the chronification of a problem the which, mostly because of psychological abuse, is extremely difficult to detect.In this context, children which find themselves inside this dynamic within their homes are a collective specially vulnerable, whether they suffer violence directly or not upon themselves, for the sheer role as witness in this context of continuous violence, affects negatively to the part that families execute as the primary socializing agent, being incapable of bringing to an end the situation which produces such unease and suffering as primary victims, suffering even long term sequels.A legal framework has been enunciated to protect both women and children when facing such situations, but, to which extent do minors see their needs covered? Are they gender violence too? Which effects will have in their lifes have seen these traumatic occurrences?La violencia de género es una problemática que afecta a un gran porcentaje de mujeres en el mundo y cuyas dimensiones reales desconocemos en toda su envergadura pues las mujeres víctimas tienden a la ocultación, ya sea por encontrarse anuladas o por vergüenza, lo cual ayuda a cronificar un problema que, en muchas ocasiones como los malos tratos de tipo psicológico, resulta extremadamente difícil de detectar. En este contexto, los hijos e hijas que se encuentran insertos en estas dinámicas dentro del hogar resultan un colectivo especialmente vulnerable, sufran o no directamente la violencia sobre ellos, pues el mero papel de espectadores en este ambiente de violencia permanente afecta negativamente al papel de la familia como primer agente socializador, son incapaces de ponerle fin por sí mismos a la situación que les genera desazón y sufren como víctimas de primer orden y de procesos de revictimización, con importantes efectos incluso a largo plazo.Se ha articulado un marco legal que ampara a las mujeres y a sus hijos frente a estas situaciones, pero ¿En qué grado ve el menor cubiertas sus necesidades? ¿Es también una víctima de la violencia de género? ¿Qué efectos tendrá en su vida haber presenciado tales acontecimientos traumáticos

SWOT Analysis Applied to Wheat Straw Utilization as a Biofuel in Mexico

Wheat is one of the main crops worldwide with a production of 733 million of tons by 2015. By 2013, the wheat grain production in Mexico was 3,357,307 t. Wheat straw is generated as a biomass waste once the wheat is harvested. However, the agricultural biomass waste has acquired international relevance as a source of bioenergy. The utilization of bioenergy has significant environmental benefits, and also economic benefits because the biomass waste is valorized as biofuel. The use of wheat straw as raw material for any productive process presents diverse factors that must be considered. Among those factors are the low density of biomass, handling and high transportation cost, an attractive heating value, and the physicochemical characterization. Therefore, the aim of this work was to apply the SWOT analysis to wheat straw utilization as a biofuel in Mexico. The main findings highlighted an estimation of 4,612,950.23 t of wheat straw generated. The experimental results of proximate analysis were 64.42% volatile matter, 19.49% fixed carbon and 16.09% ash. The higher heating was 14.86 MJ/kg. An energy potential of 69 PJ per agricultural cycle was calculated, equivalent to 19% of the biomass energy share reported in Mexico’s National Energy Balance, by 2014

Neurotoxicity prevention with a multimodal program (ATENTO) prior to cancer treatment versus throughout cancer treatment in women newly diagnosed for breast cancer: Protocol for a randomized clinical trial

The authors thank the Asociación Española Contra el Cáncer (IDEAS19055CANT), the Spanish Ministry of Education Culture and Sport (MECD) (FPU17/00939, FPU18/03575), the Carlos III Health Institute (FI19/00230), and Carlos III Health Insitute and the European Regional Development Fund (FEDER) (PI18/01840), for funding this study and all participants of the study. IEC is supported by the Spanish Ministry of Economy and Competitiveness. This study was part of a Ph.D thesis conducted in the Clinical Medicine and Public Health Doctoral Studies of the University of Granada, Spain. Trial registration: ClinicalTrials. Gov identifier: NCT04583124.A current challenge in breast cancer (BC) patients is how to reduce the side effects of cancer and cancer treatments and prevent a decrease in quality of life (QoL). Neurotoxic side effects, especially from chemotherapy, are present in up to 75% of women with BC, which implies a large impact on QoL. There is a special interest in the preventive possibilities of therapeutic exercise (TE) for these neurological sequelae, and the benefits of TE could be improved when it is combined with vagal activation techniques (VATs). This superiority randomized controlled trial aims to examine the feasibility and efficacy of an 8-week multimodal intervention (ATENTO) based on moderate-vigorous intensity and individualized TE (aerobic and strength exercises) and VAT (myofascial and breathing exercises), on neurotoxicity prevention in women with BC before starting adjuvant chemotherapy (ATENTO-B) versus throughout adjuvant chemotherapy (ATENTO-T). A sample of 56 women newly diagnosed with BC, as calculated with a power of 85%, will be randomly allocated into these two groups. This study could provide an impetus for the introduction of early multimodal intervention methods to prevent neurotoxicity and consequently avoid the QoL deterioration that BC patients presently suffer throughout their treatments.Fundacion Cientifica Asociacion Espanola Contra el Cancer IDEAS19055CANTSpanish Ministry of Education Culture and Sport FPU17/00939 FPU18/03575Instituto de Salud Carlos III FI19/00230 PI18/01840Fondos Estructurales de la Union Europea (FEDER) PI18/01840Spanish Ministry of Economy and Competitivenes

Stratifying diffuse large B-cell lymphoma patients treated with chemoimmunotherapy: GCB/non-GCB by immunohistochemistry is still a robust and feasible marker

Diffuse large B cell lymphoma (DLBCL) is a heterogeneous group of aggressive lymphomas that can be classified into three molecular subtypes by gene expression profiling (GEP): GCB, ABC and unclassified. Immunohistochemistry-based cell of origin (COO) classification, as a surrogate for GEP, using three available immunohistochemical algorithms was evaluated in TMA-arranged tissue samples from 297 patients with de novo DLBCL treated by chemoimmunotherapy (R-CHOP and R-CHOP-like regimens). Additionally, the prognostic impacts of MYC, BCL2, IRF4 and BCL6 abnormalities detected by FISH, the relationship between the immunohistochemical COO classification and the immunohistochemical expression of MYC, BCL2 and pSTAT3 proteins and clinical data were evaluated. In our series, non-GCB DLBCL patients had significantly worse progression-free survival (PFS) and overall survival (OS), as calculated using the Choi, Visco-Young and Hans algorithms, indicating that any of these algorithms would be appropriate for identifying patients who require alternative therapies to R-CHOP. Whilst MYC abnormalities had no impact on clinical outcome in the non-GCB subtype, those patients with isolated MYC rearrangements and a GCB-DLBCL phenotype had worse PFS and therefore might benefit from novel treatment approaches

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Interpretation of hyperspectral remote-sensing imagery by spectrum matching and look-up tables

A spectrum-matching and look-up-table (LUT) methodology has been developed and evaluated to extract environmental information from remotely sensed hyperspectral imagery. The LUT methodology works as follows. First, a database of remote-sensing reflectance (R[subscript]rs) spectra corresponding to various water depths, bottom reflectance spectra, and water-column inherent optical properties (IOPs) is constructed using a special version of the HydroLight radiative transfer numerical model. Second, the measured Rrs spectrum for a particular image pixel is compared with each spectrum in the database, and the closest match to the image spectrum is found using a least-squares minimization. The environmental conditions in nature are then assumed to be the same as the input conditions that generated the closest matching HydroLight-generated database spectrum. The LUT methodology has been evaluated by application to an Ocean Portable Hyperspectral Imaging Low-Light Spectrometer image acquired near Lee Stocking Island, Bahamas, on 17 May 2000. The LUT-retrieved bottom depths were on average within 5% and 0.5 m of independently obtained acoustic depths. The LUT-retrieved bottom classification was in qualitative agreement with diver and video spot classification of bottom types, and the LUT-retrieved IOPs were consistent with IOPs measured at nearby times and locations.This is the publisher's version of record. The original submission is copyrighted by Optical Society of America and can be found here: http://www.opticsinfobase.org/ao/home.cf

SARS-CoV-2 Infection in Patients With Waldenström's Macroglobulinemia: A Multicenter International Cohort Study

The coronavirus disease 2019 (COVID-19) pandemic has represented a huge challenge for vulnerable patients affected with hematological malignancies.1,2 So far, heterogeneous series on patients with lymphoma and COVID-19 have been published with mortality rates ranging from 25% to 40%,3–8 with only limited information about specific neoplasms.Peer reviewe

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication