Engineering conductive protein films through nanoscale self-assembly and gold nanoparticles doping

Protein-based materials are usually considered as insulators, although conductivity has been recently shown in proteins. This fact opens the door to develop new biocompatible conductive materials. While there are emerging efforts in this area, there is an open challenge related to the limited conductivity of protein-based systems. This work shows a novel approach to tune the charge transport properties of protein-based materials by using electron-dense AuNPs. Two strategies are combined in a unique way to generate the conductive solid films: (1) the controlled self-assembly of a protein building block; (2) the templating of AuNPs by the engineered building block. This bottom-up approach allows controlling the structure of the films and the distribution of the AuNPs within, leading to enhanced conductivity. This work illustrates a promising strategy for the development of effective hybrid protein-based bioelectrical materialsThis work was partially supported by the European Research Council ERC-CoG-648071-ProNANO, ERC-PoC-841063-NIMM, Agencia Estatal de Investigación, Spain (PID2019- 111649RB-I00; and MAT2017-88693-R), and the Basque Government (Elkartek KK-2017/00008), E.L-M thanks the Spanish Ministry of Science and Innovation for the FPI grant (BES-2017-079646). This work was performed under the Maria de Maeztu Units of Excellence Program from the Spanish State Research Agency – Grant No. MDM-2017-0720 (CIC biomaGUNE) and SEV-2016-0686 (IMDEA Nanociencia

Relapse of unusual localization of classic seminoma with post-chemotherapy transformation

Germ cell tumor is the most common cancer among males in the 20–39 year-old age range, representing 21% of invasive cancer diagnose. The vast majority of testicular tumors in this age range are germ cell tumors. There are two types of malignant tumors, the pure seminoma cell and non-seminomatous germinal cell tumors (NGCT). We present the case of a patient who underwent a testicular tumor surgery, classic seminoma stage I, receiving two cycles of adjuvant carboplatin chemotherapy. During the follow up, an elevation on the alpha-fetoprotein level was observed, thus the final diagnosis was adenopatic recurrence of the Yolk Sac tumor.-----------------------------------------------------------------Cite this article as: Urena MD, Legeren M, Galvez F, Villaescusa A, Aparicio J, Jurado JM, Blancas I, Sanchez MJ, Romera AL, Martinez AP, Quiñonez E, Dulcey I, Puche JL. Relapse of unusual localization of classic seminoma with post-chemotherapy transformation. Int J Cancer Ther Oncol 2014; 2(1):02016.DOI: http://dx.doi.org/10.14319/ijcto.0201.

Human–landscape interactions in the Conquezuela–Ambrona Valley (Soria, continental Iberia): From the early Neolithic land use to the origin of the current oak woodland

The sedimentological, geochemical and palynological analyses performed in the Conquezuela palaeolake (41°11′N; 2°33′W; 1124 m a.s.l.) provide a detailed, multiproxy palaeoenvironmental reconstruction in one of the key areas of inner Iberian Neolithic colonization. Combined with archaeobotanical and archaeological data from well-dated settlements along the Conquezuela–Ambrona Valley we investigate how environmental conditions may affect both socio-economic adaptations and livelihood strategies of prehistoric communities. The first evidences of early Neolithic occupation in the valley ca. 7250–6450 cal yr BP (5300–4500 BC) coincided with the onset of a period (7540–6200 cal yr BP, 5590–4250 BC) with higher water availability and warmer climate as alluvial environments were substituted by carbonate-wetland environments in the basin. The Conquezuela record supports an early Neolithic colonization of the inner regions of Iberia favored by warmer and humid climate features and with preferential settlement patterns associated to lakes. The maximum human occupation of the valley occurred during the mid–late Neolithic and Chalcolithic (6200–3200 cal yr BP, 4250–1250 BC) as evidenced by the high number of archaeological sites. Although a number of hydrological oscillations have been detected during this period, the intense landscape transformation at basin-scale, leading to a deforested landscape, was largely a consequence of widespread farming and pastoral practices. Socio-economic activities during Bronze, Iron and Roman times modified this inherited landscape, but the second largest ecosystem transformation only occurred during Mediaeval times when a new agrarian landscape developed with the expansion of stockbreeding transhumance. The current vegetation cover characterized by patches of holm and marcescent oaks and fields reflects an intense human management combining both extensive herding with agrarian activities in order to transform the previous forested landscape into a dehesa-like system.The funding for the present study derives from DINAMO2 (CGL-BOS 2012-33063) and AGRIWESTMED (ERC Grant Agreement #230561) projects, provided by the Spanish Inter-Ministry Commission of Science and Technology (CICYT) and the European Research Council under the European Union's Seventh Framework Programme (FP7/2007–2013). XRF data were obtained at the XRF Core Scanner Laboratory (CRG Marine Geosciences, University of Barcelona). Josu Aranbarri acknowledges the predoctoral funding provided by the Basque Country Government (ref: FI-2010-5). Graciela Gil-Romera hold a post-doctoral contract funded by “Juan de la Cierva” (ref: JCI2009-04345) program. Eduardo García-Prieto and Maria Leunda are supported by predoctoral FPI grants BES-2010-038593 and BES-2013-063753, respectively. We also thank Elena Royo for her help with the lab procedures and the two anonymous referees for their valuable suggestions.Peer reviewe

A multi-dating approach to age-modelling long continental records: The 135 ka El Cañizar de Villarquemado sequence (NE Spain)

Under embargo until: 2021-06-23We present a multidisciplinary dating approach - including radiocarbon, Uranium/Thorium series (U/Th), paleomagnetism, single-grain optically stimulated luminescence (OSL), polymineral fine-grain infrared stimulated luminescence (IRSL) and tephrochronology - used for the development of an age model for the Cañizar de Villarquemado sequence (VIL) for the last ca. 135 ka. We describe the protocols used for each technique and discuss the positive and negative results, as well as their implications for interpreting the VIL sequence and for dating similar terrestrial records. In spite of the negative results of some techniques, particularly due to the absence of adequate sample material or insufficient analytical precision, the multi-technique strategy employed here is essential to maximize the chances of obtaining robust age models in terrestrial sequences. The final Bayesian age model for VIL sequence includes 16 AMS 14C ages, 9 single-grain quartz OSL ages and 5 previously published polymineral fine-grain IRSL ages, and the accuracy and resolution of the model are improved by incorporating information related to changes in accumulation rate, as revealed by detailed sedimentological analyses. The main paleohydrological and vegetation changes in the sequence are coherent with global Marine Isotope Stage (MIS) 6 to 1 transitions since the penultimate Termination, although some regional idiosyncrasies are evident, such as higher moisture variability than expected, an abrupt inception of the last glacial cycle and a resilient response of vegetation in Mediterranean continental Iberia in both Terminations.acceptedVersio

Holocene climate variability, vegetation dynamics and fire regime in the central Pyrenees: the Basa de la Mora sequence (NE Spain)

High resolution multiproxy data (pollen, sedimentology, geochemistry, chironomids and charcoal) from the Basa de la Mora (BSM) lake sequence (42° 32′ N, 0° 19′ E, 1914 m a.s.l.) show marked climate variability in the central southern Pyrenees throughout the Holocene. A robust age model based on 15 AMS radiocarbon dates underpins the first precise reconstruction of rapid climate changes during the Holocene from this area. During the Early Holocene, increased winter snowpack and high snowmelt during summer, as a consequence of high seasonality, led to higher lake levels, a chironomid community dominated by non-lacustrine taxa (Orthocladiinae) related to higher inlet streams, and a forested landscape with intense run-off processes in the watershed. From 9.8 to 8.1 cal ka BP, climate instability is inferred from rapid and intense forest shifts and high fluctuation in surface run-off. Shifts among conifers and mesophytes reveal at least four short-lived dry events at 9.7, 9.3, 8.8 and 8.3 cal ka BP. Between 8.1 and 5.7 cal ka BP a stable climate with higher precipitation favoured highest lake levels and forest expansion, with spread of mesophytes, withdrawal of conifers and intensification of fires, coinciding with the Holocene Climate Optimum. At 5.7 cal ka BP a major change leading to drier conditions contributed to a regional decline in mesophytes, expansion of pines and junipers, and a significant lake level drop. Despite drier conditions, fire activity dropped as consequence of biomass reduction. Two arid intervals occurred between 2.9 and 2.4 cal ka BP and at 1.2–0.7 cal ka BP (800–1300 AD). The latter coincides with the Medieval Climate Anomaly and is one of the most arid phases of the Holocene in BSM sequence. Anthropogenic disturbances were small until 700 AD, when human pressure over landscape intensified, with Olea cultivation in the lowlands and significant deforestation in highlands. Colder and unfavourable weather conditions during the second part of the Little Ice Age caused a temporary cease of high-land management. The most intense anthropogenic disturbances occurred during the second half of 19th century. Last decades are characterized by recovery of the vegetation cover as a result of land abandonment, and lowered lake levels, probably due to higher temperatures

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Diatom and vegetation responses to Late Glacial and Early Holocene climate changes at Lake Estanya (Southern Pyrenees, NE Spain)

We investigate Lake Estanya's diatom and pollen records from the Late Glacial (LG) to the Early Holocene (EH), in order to compare limnological and vegetation responses to common climate forcing. The biotic changes recognized in this study largely agree with the hydrological evolution of the lake described previously for the same period. The diatom record shows high sensitivity to fluctuations in both lake level and salinity concentration as a consequence of climate shifts. In addition vegetation results indicate that the area could have played an important role as regional vegetation refuge. Shallow lake conditions during the Last Glacial Maximum (LGM) were punctuated by relatively deeper freshwaters between 19.3 and 18.6. cal. kyr BP and at 18.0. cal. kyr BP, as recorded by diatom shifts. A subsequent increasing aridity trend, coinciding with the Mystery Interval (MI), affected the diatom accumulation rates, which dropped to its minimum values between 17.2 and 14.7. cal. kyr BP. Particularly dry and cold conditions during the LGM and MI are supported by the largest values of steppic pollen taxa of the whole sequence, which account for up to 40%. However, relatively high values of Betula during the Heinrich Event 1 suggest a plausible regional vegetation refuge. Abrupt cooling and warming episodes within the LG triggered remarkable ecological threshold crossings in the diatom communities, especially during the stadial/interstadial episodes. At this point, the vegetation reflects the onset of warm conditions during the Bølling/Allerød with the partial substitution of Betula by Marcescent and Evergreen Quercus, which probably indicates the arrival of temperate taxa to the area and the likely migration of birch to higher altitudes. The Younger Dryas Stadial shows a complex ecological response. Diatoms are very poorly preserved, but aquatic taxa reach their highest values. An increase in Marcescent Quercus during this cold stage lends further support to the hypothesis that this is a regional vegetation refuge. Low lake levels recorded during the EH affected the development and preservation of diatom communities. A delay in the onset of humid conditions for the EH is also supported by the vegetation composition, characterized by the maximum expansion of Juniperus. © 2013 Elsevier B.V.This research has been funded through the projects LIMNOCLIBER (REN2003-09130-C02-02), IBERLIMNO (CGL2005-20236-E/ CLI), LIMNOCAL (CGL2006-13327-C04-01), PALEODIVERSITAS (CGL2006-02956/BOS), GLOBALKARST (CGL2009-08415), GRACCIE-CONSOLIDER (CSD2007-00067), DINAMO (CGL2009-07992), DINAMO2 (CGL2012-33063); provided by the Spanish Inter-Ministry Commission of Science and Technology (CICYT); and PIRINEOSABRUPT (PM073/2007), provided by the Diputación General de Aragón. Mario Morellón Marteles and Graciela Gil-Romera hold post-doctoral contacts funded by the “JAE-Doc/CSIC” ref.- and “Juan de la Cierva” (grant ref. JCI2009) programs respectively. Ana Pérez-Sanz has been supported by a PhD Fellowship provided by the Aragon Government. We also thank Beatriz Bueno and Aída Adsuar for lab assistance. Finally, we are grateful to Antonia Andrade Olalla for helping in initial pollen analyses and to Joan Gomà for assistance in diatom taxonomic determinations. Two referee's constructive criticism and suggestions helped improved a former version of this paper.Peer Reviewe