Tunable Acellular Hyaluronic Acid Hydrogel Systems to Attenuate Left Ventricular Remodeling

Following myocardial infarction (MI), left ventricular (LV) remodeling initiates a series of maladaptive events that may induce heart failure (HF). The use of injectable biomaterials is an attractive approach to attenuate negative remodeling; however, optimal properties for these systems have not been identified. The general hypothesis is that the properties of injectable hydrogels control the magnitude and duration of stabilization in the weakened myocardium and the ability to attenuate LV remodeling. To test this hypothesis, three specific aims were developed. Increased stress due to geometric alterations is thought to exacerbate LV remodeling, causing infarct expansion. Aim 1 utilized methacrylated hyaluronic acid (MeHA) hydrogels to demonstrate ex vivo that macromer modification and oxidation-reduction (redox) initiator concentrations influence the mechanical properties of hydrogel/myocardium composites and their distribution in tissue. Experimental data incorporation into a finite element model of the dilated LV validated previous in vivo geometric outcomes and generally demonstrated the largest stress reduction with higher mechanics and larger volumes. Aims 2 and 3 evaluated the influence of temporal mechanical support on LV remodeling in an in vivo MI model. Hydroxyethyl methacrylate groups were coupled to HA to produce hydrolytically degradable hydrogels (HeMA-HA) polymerized via redox reactions. In Aim 2, hydrogel gelation, mechanics, and degradation properties were varied by altering HeMA modification to yield low and high HeMA-HA with similar gelation and initial mechanics but accelerated degradation kinetics compared to previously studied low and high MeHA. High HeMA-HA was more effective than low HeMA-HA treatment in limiting remodeling; however, high HeMA-HA only limited LV dilation for 2 weeks, while its high MeHA counterpart sustained support up to 8 weeks. In Aim 3, a hydrogel/microsphere composite system was evaluated as an alternative approach to enhance temporal support via collagen bulking through controlled macrophage responses. The composite treatment increased myocardial thickness and decreased chamber volumes compared to hydrogel alone. This work demonstrates the significance of the magnitude and duration of mechanical support in attenuating LV remodeling and provides insight on optimal material properties for injectable biomaterials to develop better therapies to prevent HF

Destination image, satisfaction and destination and loyalty in cruise tourism: the case of Málaga (Spain)

Over the past decades cruise tourism is a sector that has experienced a tremendous growth around the globe. The relations that are established between the different agents that interact in this industry, passengers, crew and residents are crucial for visitor satisfaction and the success of the tourist destination. The study has analyzed the different types of cruise passengers who landed at the port of Malaga and their perception of the city through destination image, satisfaction and destination loyalty. A cluster analysis identified the existence of four different groups of passengers whose opinions can give a specific answer to the consolidation of Malaga as a quality tourist destination. From a practical point of view, recommendations about the adequate management of the destination´s attractions for the cruise industry are discussed in the conclusions.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tec

Las zoonosis reemergentes bajo el enfoque de “Una salud”

In 2004, the World Health Organization (WHO) defined emerging zoonoses as those “newly recognized or newly evolved, or that have occurred previously but show an increase in incidence or expansion in geographical, host or vector range” (1). Approximately 60% of infectious diseases affecting humans are of zoonotic origin (2), and vectors transmit almost 20% of all of them. It emphasizes the connection between human, animal, and environmental health, and the need to study these diseases in their biological, ecological, medical, and economic context to promote and guarantee health globally.La Organización Mundial de la Salud (OMS) definió en 2004 las zoonosis emergentes como aquellas recientemente descubiertas o descritas previamente pero que han evidenciado un incremento de su incidencia, expansión geográfica o variedad de huéspedes o vectores (1). El 60% de las enfermedades infecciosas que afectan al ser humano son de origen zoonótico (2) y casi un 20% de todas ellas son transmitidas por vectores. Esto refuerza la conexión entre la salud animal, humana y ambiental y la importancia del estudio de estas enfermedades en su ámbito biológico, ecológico, médico y económico para promover y garantizar la salud global

Mutation in ROBO3 Gene in Patients with Horizontal Gaze Palsy with Progressive Scoliosis Syndrome: A Systematic Review

Horizontal gaze palsy with progressive scoliosis (HGPPS) is a rare, inherited disorder characterized by a congenital absence of conjugate horizontal eye movements with progressive scoliosis developing in childhood and adolescence. Mutations in the Roundabout (ROBO3) gene located on chromosome 11q23-25 are responsible for the development of horizontal gaze palsy and progressive scoliosis. However, some studies redefined the locus responsible for this pathology to a 9-cM region. This study carried out a systematic review in which 25 documents were analyzed, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. The search was made in the following electronic databases from January 1995 to October 2019: PubMed, Scopus, Web of Science, PEDRO, SPORT Discus, and CINAHL. HGPPS requires a multidisciplinary diagnostic approach, in which magnetic resonance imaging might be the first technique to suggest the diagnosis, which should be verified by an analysis of theROBO3 gene. This is important to allow for adequate ocular follow up, apply supportive therapies to prevent the rapid progression of scoliosis, and lead to appropriate genetic counseling

Sensitization to isothiazolinones in the Spanish Contact Dermatitis Registry (REIDAC): 2019–2021 epidemiological situation

Background: Current frequency and risk factors for sensitization to methylisothiazolinone (MI), methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), benzisothiazolinone (BIT) and octylisothiazolinone (OIT) in Spain are not well known. Objectives: To study the frequency of sensitization, risk factors and simultaneous sensitization between the four isothiazolinones. Materials and Methods: We analysed all 2019-2021 consecutive patients patch-tested with MI (0.2% aq.), MCI/MI (0.02% aq.), BIT (0.1% pet.) and OIT (0.1% pet) within the Spanish Contact Dermatitis Registry (REIDAC). Results: A total of 2511 patients were analysed. Frequencies of sensitization were: any isothiazolinone 15.7%, MI 6.8%, MCI/MI 4.8%, BIT 3.5% and OIT 0.5%. MI and MCI/MI sensitization was associated with being occupationally active, hand dermatitis, detergents and age over 40. BIT sensitization was associated with leg dermatitis and age over 40. About one in nine MI-positive patients were positive to BIT, whereas one in five BIT-positive patients were positive to MI. Conclusions: Sensitization to MI, MCI/MI and BIT is still common in Spain, while sensitization to OIT is rare. Currently, sensitization to MI and MCI/MI seems to be occupationally related. Although its origin is unknown, sensitization to BIT is more frequent in patients aged over 40 years. Simultaneous sensitization between MI and BIT is uncommon.The Spanish Registry of Contact Dermatitis (REIDAC) is promoted by the Fundación Piel Sana (Academia Española de Dermatología y Venereología), which has received financial support from the Spanish Medicines and Health Products Agency (Agencia Española de Medicamentos y Productos Sanitarios. https://www.boe.es/boe/dias/2022/04/11/pdfs/BOE-A-2022-5975.pdf) and Sanofi. The funders were not involved in the design and conduct of the study, collection, management, analysis and interpretation of data, preparation, review, approval of the manuscript, or decision to submit the manuscript for publication

Autoantibody screening in Guillain-Barré syndrome

Background: Guillain?Barré syndrome (GBS) is an acute inflammatory neuropathy with a heterogeneous presentation. Although some evidences support the role of autoantibodies in its pathogenesis, the target antigens remain unknown in a substantial proportion of GBS patients. The objective of this study is to screen for autoantibodies targeting peripheral nerve components in Guillain-Barré syndrome. Methods: Autoantibody screening was performed in serum samples from all GBS patients included in the International GBS Outcome study by 11 different Spanish centres. The screening included testing for anti-ganglioside antibodies, anti-nodo/paranodal antibodies, immunocytochemistry on neuroblastoma-derived human motor neurons and murine dorsal root ganglia (DRG) neurons, and immunohistochemistry on monkey peripheral nerve sections. We analysed the staining patterns of patients and controls. The prognostic value of anti-ganglioside antibodies was also analysed. Results: None of the GBS patients (n = 100) reacted against the nodo/paranodal proteins tested, and 61 (61%) were positive for, at least, one anti-ganglioside antibody. GBS sera reacted strongly against DRG neurons more frequently than controls both with IgG (6% vs 0%; p = 0.03) and IgM (11% vs 2.2%; p = 0.02) immunodetection. No differences were observed in the proportion of patients reacting against neuroblastoma-derived human motor neurons. Reactivity against monkey nerve tissue was frequently detected both in patients and controls, but specific patterns were only detected in GBS patients: IgG from 13 (13%) patients reacted strongly against Schwann cells. Finally, we confirmed that IgG anti-GM1 antibodies are associated with poorer outcomes independently of other known prognostic factor

Autoantibody screening in Guillain-Barré syndrome

Background: Guillain-Barré syndrome (GBS) is an acute inflammatory neuropathy with a heterogeneous presentation. Although some evidences support the role of autoantibodies in its pathogenesis, the target antigens remain unknown in a substantial proportion of GBS patients. The objective of this study is to screen for autoantibodies targeting peripheral nerve components in Guillain-Barré syndrome. Methods: Autoantibody screening was performed in serum samples from all GBS patients included in the International GBS Outcome study by 11 different Spanish centres. The screening included testing for anti-ganglioside antibodies, anti-nodo/paranodal antibodies, immunocytochemistry on neuroblastoma-derived human motor neurons and murine dorsal root ganglia (DRG) neurons, and immunohistochemistry on monkey peripheral nerve sections. We analysed the staining patterns of patients and controls. The prognostic value of anti-ganglioside antibodies was also analysed. Results: None of the GBS patients (n = 100) reacted against the nodo/paranodal proteins tested, and 61 (61%) were positive for, at least, one anti-ganglioside antibody. GBS sera reacted strongly against DRG neurons more frequently than controls both with IgG (6% vs 0%; p = 0.03) and IgM (11% vs 2.2%; p = 0.02) immunodetection. No differences were observed in the proportion of patients reacting against neuroblastoma-derived human motor neurons. Reactivity against monkey nerve tissue was frequently detected both in patients and controls, but specific patterns were only detected in GBS patients: IgG from 13 (13%) patients reacted strongly against Schwann cells. Finally, we confirmed that IgG anti-GM1 antibodies are associated with poorer outcomes independently of other known prognostic factors. Conclusion: Our study confirms that (1) GBS patients display a heterogeneous repertoire of autoantibodies targeting nerve cells and structures; (2) gangliosides are the most frequent antigens in GBS patients and have a prognostic value; (3) further antigen-discovery experiments may elucidate other potential antigens in GBS

Autonomous cortisol secretion in patients with primary aldosteronism: prevalence and implications on cardiometabolic profile and on surgical outcomes

Purpose: The aim of this study was to evaluate the prevalence of autonomous cortisol secretion (ACS) in patients with primary aldosteronism (PA) and its implications on cardiometabolic and surgical outcomes. Methods: This is a retrospective multicenter study of PA patients who underwent 1 mg dexamethasone-suppression test (DST) during diagnostic workup in 21 Spanish tertiary hospitals. ACS was defined as a cortisol post-DST >1.8 μg/dL (confirmed ACS if >5 μg/dL and possible ACS if 1.8–5 μg/dL) in the absence of spe cific clinical features of hypercortisolism. The cardiometabolic profile was compared with a control group with ACS without PA (ACS group) matched for age and DST levels. Results: The prevalence of ACS in the global cohort of patients with PA (n = 176) was 29% (ACS–PA; n = 51). Ten patients had confirmed ACS and 41 possible ACS. The cardiometabolic profile of ACS–PA and PA-only patients was simil ar, except for older age and larger tumor size of the adrenal lesion in the ACS–PA group. When comparing the ACS–PA group (n = 51) and the ACS group (n = 78), the prevalence of hypertension (OR 7.7 (2.64–22.32)) and cardiovascular events (OR 5.0 (2.29–11.07)) was higher in ACS–PA patients than in ACS patients. The coexistence of ACS in patien ts with PA did not affect the surgical outcomes, the proportion of biochemical cure and clinical cure being similar between ACS–PA and PA-only groups. Conclusion: Co-secretion of cortisol and aldosterone affects almost one-thi rd of patients with PA. Its occurrence is more frequent in patients with larger tumors and advanced age. However, the cardiometabolic and surgical outcomes of patients with ACS–PA and PA-only are similar

Destination image, satisfaction and destination loyalty in cruise tourism: the case of Málaga (Spain)

Over the past decades cruise tourism is a sector that has experienced a tremendous growth around the globe. The relations that are establish between the different agents that interact in this industry, passengers, crew and residents are crucial for visitor satisfaction and the success of the tourist destination.The study has analyzed the different types of cruise passengers who landed at the port of Malaga and their perception of the capital through the destination image, satisfaction and destination loyalty in Malaga.A cluster analysis showed the existence of four different groups of passengers whose opinions can give a specific answer to the consolidation of Malaga as a quality tourist destination.From a practical point of view, recommendations about the adequate management of the destination attributes for the cruise industry are discussed in the conclusions.El turismo de cruceros es un sector que ha experimentado un enorme desarrollo en el mundo en las últimas décadas. Las relaciones que se producen entre los diferentes agentes que interactúan en esta industria, pasajeros, tripulación y residentes, son cruciales para la satisfacción de los visitantes y para el éxito del destino turístico. El estudio ha analizado las diferentes tipologías de cruceristas que arriban al puerto de Málaga y su percepción de la ciudad a través de la imagen del destino, la satisfacción y la lealtad al destino. Un análisis cluster demostró la existencia de cuatro grupos de pasajeros claramente diferenciados, cuyas opiniones pueden dar una respuesta específica, para avanzar en la consolidación de Málaga como destino turístico de calidad. Desde un punto de vista práctico, discutiremos en las conclusiones las recomendaciones para la adecuada gestión de las atracciones turísticas dedicadas al sector de los cruceros

User-generated content curation with deep convolutional neural networks

In this paper, we report a work consisting in using deep convolutional neural networks (CNNs) for curating and filtering photos posted by social media users (Instagram and Twitter). The final goal is to facilitate searching and discovering user-generated content (UGC) with potential value for digital marketing tasks. The images are captured in real time and automatically annotated with multiple CNNs. Some of the CNNs perform generic object recognition tasks while others perform what we call visual brand identity recognition. We report experiments with 5 real brands in which more than 1 million real images were analyzed. In order to speed-up the training of custom CNNs we applied a transfer learning strategy.This work is partially supported by the Spanish Ministry of Economy and Competitivity under contract TIN2015-65316-P and by the SGR programme (2014-SGR-1051) of the Catalan Government.Peer Reviewe