Update on malaria

Despite recent successful efforts to reduce the global malaria burden, this disease remains a significant global health problem. Only in 2018, malaria caused 228 million clinical episodes, 2-4 million of which were severe malaria cases, and 405,000 were fatal. Most of the malaria attributable mortality occurred among children in sub-Saharan Africa. Nowadays, rapid diagnostic tests and artemisinin derivatives are two of the main pillars for the management of malaria. However, considering the current situation, these strategies are not sufficient to maintain a reducing trend in malaria incidence and mortality. New insights into the pathophysiology of malaria have highlighted the importance of the host response to infection. Understanding this response would help to develop new diagnostic and therapeutic tools. Vector and parasite drug resistance are two major challenges for malaria control that require special attention. The most advanced malaria vaccine (RTS,S) is currently being piloted in 3 African countries. (c) 2020 Elsevier Espan similar to a, S.L.U. All rights reserved

Multifocal versus monofocal intraocular lenses after cataract extraction.

BACKGROUND: Good unaided distance visual acuity (VA) is now a realistic expectation following cataract surgery and intraocular lens (IOL) implantation. Near vision, however, still requires additional refractive power, usually in the form of reading glasses. Multiple optic (multifocal) IOLs are available which claim to allow good vision at a range of distances. It is unclear whether this benefit outweighs the optical compromises inherent in multifocal IOLs. OBJECTIVES: To assess the visual effects of multifocal IOLs in comparison with the current standard treatment of monofocal lens implantation. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 5), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to June 2016), Embase (January 1980 to June 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 13 June 2016. SELECTION CRITERIA: All randomised controlled trials comparing a multifocal IOL of any type with a monofocal IOL as control were included. Both unilateral and bilateral implantation trials were included. We also considered trials comparing multifocal IOLs with "monovision" whereby one eye is corrected for distance vision and one eye corrected for near vision. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. We assessed the 'certainty' of the evidence using GRADE. MAIN RESULTS: We found 20 eligible trials that enrolled 2230 people with data available on 2061 people (3194 eyes). These trials were conducted in Europe (13), China (three), USA (one), Middle East (one), India (one) and one multicentre study in Europe and the USA. Most of these trials compared multifocal with monofocal lenses; two trials compared multifocal lenses with monovision. There was considerable variety in the make and model of lenses implanted. Overall we considered the trials at risk of performance and detection bias because it was difficult to mask participants and outcome assessors. It was also difficult to assess the role of reporting bias.There was moderate-certainty evidence that the distance acuity achieved with multifocal lenses was not different to that achieved with monofocal lenses (unaided VA worse than 6/6: pooled RR 0.96, 95% confidence interval (CI) 0.89 to 1.03; eyes = 682; studies = 8). People receiving multifocal lenses may achieve better near vision (RR for unaided near VA worse than J3/J4 was 0.20, 95% CI 0.07 to 0.58; eyes = 782; studies = 8). We judged this to be low-certainty evidence because of risk of bias in the included studies and high heterogeneity (I2 = 93%) although all included studies favoured multifocal lenses with respect to this outcome.People receiving multifocal lenses may be less spectacle dependent (RR 0.63, 95% CI 0.55 to 0.73; eyes = 1000; studies = 10). We judged this to be low-certainty evidence because of risk of bias and evidence of publication bias (skewed funnel plot). There was also high heterogeneity (I2 = 67%) but all studies favoured multifocal lenses. We did not additionally downgrade for this.Adverse subjective visual phenomena were more prevalent and more troublesome in participants with a multifocal IOL compared with monofocals (RR for glare 1.41, 95% CI 1.03 to 1.93; eyes = 544; studies = 7, low-certainty evidence and RR for haloes 3.58, 95% CI 1.99 to 6.46; eyes = 662; studies = 7; moderate-certainty evidence).Two studies compared multifocal lenses with monovision. There was no evidence for any important differences in distance VA between the groups (mean difference (MD) 0.02 logMAR, 95% CI -0.02 to 0.06; eyes = 186; studies = 1), unaided intermediate VA (MD 0.07 logMAR, 95% CI 0.04 to 0.10; eyes = 181; studies = 1) and unaided near VA (MD -0.04, 95% CI -0.08 to 0.00; eyes = 186; studies = 1) compared with people receiving monovision. People receiving multifocal lenses were less likely to be spectacle dependent (RR 0.40, 95% CI 0.30 to 0.53; eyes = 262; studies = 2) but more likely to report problems with glare (RR 1.41, 95% CI 1.14 to 1.73; eyes = 187; studies = 1) compared with people receiving monovision. In one study, the investigators noted that more people in the multifocal group underwent IOL exchange in the first year after surgery (6 participants with multifocal vs 0 participants with monovision). AUTHORS' CONCLUSIONS: Multifocal IOLs are effective at improving near vision relative to monofocal IOLs although there is uncertainty as to the size of the effect. Whether that improvement outweighs the adverse effects of multifocal IOLs, such as glare and haloes, will vary between people. Motivation to achieve spectacle independence is likely to be the deciding factor

Investigating the essential fatty acids in the common cuttlefish Sepia officinalis (Mollusca, Cephalopoda): Molecular cloning and functional characterisation of fatty acyl desaturase and elongase

Some polyunsaturated fatty acids (PUFA) play critical roles in physiology and are essential for normal growth and development of aquatic animals including cephalopods like the common cuttlefish Sepia officinalis. This is particularly true for early life stages when neuronal tissues are rapidly developing and accumulating PUFA. The specific fatty acids (FAs) that can satisfy the essential requirements of any animal species depend upon the enzymatic capability to convert dietary FA into those physiologically important FAs required for normal function. In order to identify the dietary essential FA for the common cuttlefish, we have performed the molecular cloning and functional characterisation of two key enzymes involved in PUFA biosynthesis in this species, namely a fatty acyl desaturase (Fad) and an elongation of very long-chain fatty acid (Elovl) protein. The gene product of the cuttlefish Fad exhibited ∆5-desaturase activity, enabling this species to potentially biosynthesise the physiologically essential FAs eicosapentaenoic (20:5n-3, EPA) and arachidonic (20:4n-3, ARA) acids from 20:4n-3 and 20:3n-6, respectively. However, the cuttlefish Fad did not show ∆6 or ∆8 activity and therefore the biosynthesis of EPA and ARA from C18 PUFA precursors could be limited, suggesting that both may be essential FAs for cuttlefish. Moreover, the cuttlefish Fad also lacked ∆4-desaturase activity suggesting that DHA biosynthesis was not possible and thus DHA is also an essential FA for this species. The cuttlefish ∆5 Fad was able to produce non-methylene-interrupted (NMI) FA, a group of PUFAs typically found in marine invertebrates. The cuttlefish Elovl was able to elongate C18 and C20 PUFA substrates, but showed no activity towards C22 PUFA. Overall the results obtained in the present study allowed the prediction of the biosynthetic pathways of PUFA, including NMI FA, in the common cuttlefish. It was concluded that EPA, ARA and DHA were likely to be essential dietary FA for this species as endogenous production from precursor FA appears to be limited

Short Communication: The potential of portable near infrared spectroscopy for assuring quality and authenticity in the food chain, using Iberian hams as an example

This communication assesses the use of a portable near infrared (NIR) instrument to measure quantitative (fatty acid profile) properties and qualitative (‘Premium’ and ‘Non-premium’) categories of individual Iberian pork carcasses at the slaughterhouse. Acorn-fed Iberian pigs have more unsaturated fats than pigs fed conventional compound feed. Recent advances in miniaturisation have led to a number of handheld NIR devices being developed, allowing processing decisions to be made earlier, significantly reducing time and costs. The most common methods used for assessing quality and authenticity of Iberian hams are analysis of the fatty acid composition of subcutaneous fat using gas chromatography and DNA analysis. In this study, NIR calibrations for fatty acids and classification as premium or non-premium ham, based on carcass fat measured in situ, were developed using a portable NIR spectrometer. The accuracy of the quantitative equations was evaluated through the standard error of cross validation or standard error of prediction of 0.84 for palmitic acid (C16:0), 0.94 for stearic acid (C18:0), 1.47 for oleic acid (C18:1) and 0.58 for linoleic acid (C18:2). Qualitative calibrations provided acceptable results, with up to 98% of samples (n = 234) correctly classified with probabilities ⩾0.9. Results indicated a portable NIR instrument has the potential to be used to measure quality and authenticity of Iberian pork carcasses

Biosynthesis of Polyunsaturated Fatty Acids in Octopus vulgaris: Molecular Cloning and Functional Characterisation of a Stearoyl-CoA Desaturase and an Elongation of Very Long-Chain Fatty Acid 4 Protein

Polyunsaturated fatty acids (PUFAs) have been acknowledged as essential nutrients for cephalopods but the specific PUFAs that satisfy the physiological requirements are unknown. To expand our previous investigations on characterisation of desaturases and elongases involved in the biosynthesis of PUFAs and hence determine the dietary PUFA requirements in cephalopods, this study aimed to investigate the roles that a stearoyl-CoA desaturase (Scd) and an elongation of very long-chain fatty acid 4 (Elovl4) protein play in the biosynthesis of essential fatty acids (FAs). Our results confirmed the Octopus vulgaris Scd is a D9 desaturase with relatively high affinity towards saturated FAs with C18 chain lengths. Scd was unable to desaturate 20:1n-15 (D520:1) suggesting that its role in the biosynthesis of non-methylene interrupted FAs (NMI FAs) is limited to the introduction of the first unsaturation at D9 position. Interestingly, the previously characterised D5 fatty acyl desaturase was indeed able to convert 20:1n-9 (D1120:1) to D5,1120:2, an NMI FA previously detected in octopus nephridium. Additionally, Elovl4 was able to mediate the production of 24:5n-3 and thus can contribute to docosahexaenoic acid (DHA) biosynthesis through the Sprecher pathway. Moreover, the octopus Elovl4 was confirmed to play a key role in the biosynthesis of very long-chain (>C24) PUFAs

Biochemical Diagnosis of Hypertensive Myocardial Fibrosis

A substantial increase in fibrillar collagen has been observed in the left cardiac ventricle of animals and humans with arterial hypertension. Hypertensive myocardial fibrosis is the result of both increased collagen types I and III due to the fact that its synthesis by fibroblasts and myofibroblasts is stimulated and its extracellular collagen degradation unchanged or decreased extracellular collagen degradation. Hemodynamic and non-hemodynamic factors may be involved in the disequilibrium between collagen synthesis and degradation that occurs in hypertension. As shown experimentally and clinically, an exaggerated rise in fibrilar collagen content promotes abnormalities of cardiac function, contributes to the decrease in coronary reserve and facilitates alterations in the electrical activity of the left ventricle. Although microscopic examination of cardiac biopsies is the most reliable method for documenting and measuring myocardial fibrosis, the development of non-invasive methods to indicate the presence of myocardial fibrosis in hypertensive patients would be useful. We have therefore applied a biochemical method based on the measurement of serum peptides derived from the tissue formation when synthesized and degradation of fibrillar collagens to monitor the turnover of these molecules in rats with spontaneous hypertension and patients with essential hypertension

Valentine Allorge (1888-1977). Su contribución a la brioflora española

The VII Bryological Meeting took place on the 5th to the 9th o fApril, 1976 in Mora de Rubielos, its aim being to continue the study of the Iberian System which began in the Sierra de Albarracín. Work done during the Meeting consisted in exploring the sierras of Jabalambre and Gúclar. The result of our gatherings in both these sierras is made known in this article. After a summary study of the vegetation of the area which was the subject of our investigation, the presence of 17 species of Hepaticae and 125 of Mosses is discovered. These resuits form the first contribution for this part of the Iberian System and an important contribution to the knowledge of the Teruel biyodora.La VII Reunión de Briología tuvo lugar los días 5 al 9 de abril de 1976 en Mora de Rubielos, con objeto de continuar el estudio del Sistema Ibérico iniciado con la Sierra de Albarracín. Durante las jornadas de trabajo se exploraron las sierras de Jabalambre y Gúclar. En esta comunicación damos a conocer el resultado de nuestras recolecciones en ambas Sierras. Después de un somero estudio de la vegetación de la zona objeto de nuestro trabajo, se da a conocer la presencia de 17 especies de Hepáticas y 125 de Musgos. Este resultado representa la primera aportación para esta parte del Sistema Ibérico y una notable contribución al conocimiento de la briotlora turolense

Biofortification of UK food crops with selenium

Se is an essential element for animals. In man low dietary Se intakes are associated with health disorders including oxidative stress-related conditions, reduced fertility and immune functions and an increased risk of cancers. Although the reference nutrient intakes for adult females and males in the UK are 60 and 75 μg Se/d respectively, dietary Se intakes in the UK have declined from >60 μg Se/d in the 1970s to 35 μg Se/d in the 1990s, with a concomitant decline in human Se status. This decline in Se intake and status has been attributed primarily to the replacement of milling wheat having high levels of grain Se and grown on high-Se soils in North America with UK-sourced wheat having low levels of grain Se and grown on low-Se soils. An immediate solution to low dietary Se intake and status is to enrich UK-grown food crops using Se fertilisers (agronomic biofortification). Such a strategy has been adopted with success in Finland. It may also be possible to enrich food crops in the longer term by selecting or breeding crop varieties with enhanced Se-accumulation characteristics (genetic biofortification). The present paper will review the potential for biofortification of UK food crops with Se

Gender Differences in Plasma Biomarker Levels in a Cohort of COPD Patients: A Pilot Study

Little is known about gender differences in plasma biomarker levels in patients with chronic obstructive pulmonary disease (COPD). HYPOTHESIS: There are differences in serum biomarker levels between women and men with COPD. OBJECTIVE: Explore gender differences in plasma biomarker levels in patients with COPD and smokers without COPD. METHODS: We measured plasma levels of IL-6, IL-8, IL-16, MCP-1, MMP-9, PARC and VEGF in 80 smokers without COPD (40 males, 40 females) and 152 stable COPD patients (76 males, 76 females) with similar airflow obstruction. We determined anthropometrics, smoking history, lung function, exercise tolerance, body composition, BODE index, co-morbidities and quality of life. We then explored associations between plasma biomarkers levels and the clinical characteristics of the patients and also with the clinical and physiological variables known to predict outcome in COPD. RESULTS: The plasma biomarkers level explored were similar in men and women without COPD. In contrast, in patients with COPD the median value in pg/mL of IL-6 (6.26 vs 8.0, p = 0.03), IL-16 (390 vs 321, p = 0.009) and VEGF (50 vs 87, p = 0.02) differed between women and men. Adjusted for smoking history, gender was independently associated with IL-16, PARC and VEGF levels. There were also gender differences in the associations between IL-6, IL-16 and VEGF and physiologic variables that predict outcomes. CONCLUSIONS: In stable COPD patients with similar airflow obstruction, there are gender differences in plasma biomarker levels and in the association between biomarker levels and important clinical or physiological variables. Further studies should confirm our findings

Inflammatory and Repair Serum Biomarker Pattern. Association to Clinical Outcomes in COPD

Background: The relationship between serum biomarkers and clinical expressions of COPD is limited. We planned to further describe this association using markers of inflammation and injury and repair. Methods: We studied lung function, comorbidities, exercise tolerance, BODE index, and quality of life in 253 COPD patients and recorded mortality over three years. Serum levels of Interleukins 6,8 and16, tumor necrosis factor alpha (TNF α) [inflammatory panel], vascular endothelial growth factor (VEGF), and matrix metalloproteinase 9 (MMP-9) [injury and repair panel] and pulmonary and activation-regulated chemokine (PARC/CCL-18) and monocyte chemotactic protein 1 (MCP-1/CCL2) [chemoattractant panel] were measured. We related the pattern of the biomarker levels to minimal clinically important differences (MCID) using a novel visualization method [ObServed Clinical Association Results (OSCAR) plot]. Results: Levels of the inflammatory markers IL-6, TNF α were higher and those of injury and repair lower (p < 0.01) with more advanced disease (GOLD 1 vs. 4). Using the OSCAR plot, we found that patients in the highest quartile of inflammatory and lowest quartile of injury and repair biomarkers level were more clinically compromised and had higher mortality (p < 0.05). Conclusions: In COPD, serum biomarkers of inflammation and repair are distinctly associated with important clinical parameters and survival