A didactical proposal: The leather processing. Tools, elaboration and divulgation

El presente trabajo pretende ofrecer una propuesta didáctica que posibilite la difusión del conocimiento científico-histórico que tenemos sobre la Prehistoria de una forma adecuada al público al que va dirigido, utilizando para ello la manufactura del cuero como eje vertebradorThis research pretends to offer a didactical proposal to enable the divulgation of our current scientific-historical knowledge about Prehistory. Our overriding objective will be to adapt that knowledge to the public that is going to receive it, using for that leather processing as key backbon

Implementation of methane cycling for deep time, global warming simulations with the DCESS Earth System Model (Version 1.2)

Geological records reveal a number of ancient, large and rapid negative excursions of the carbon-13 isotope. Such excursions can only be explained by massive injections of depleted carbon to the Earth system over a short duration. These injections may have forced strong global warming events, sometimes accompanied by mass extinctions such as the Triassic-Jurassic and end-Permian extinctions 201 and 252 million years ago, respectively. In many cases, evidence points to methane as the dominant form of injected carbon, whether as thermogenic methane formed by magma intrusions through overlying carbon-rich sediment or from warming-induced dissociation of methane hydrate, a solid compound of methane and water found in ocean sediments. As a consequence of the ubiquity and importance of methane in major Earth events, Earth system models for addressing such events should include a comprehensive treatment of methane cycling but such a treatment has often been lacking. Here we implement methane cycling in the Danish Center for Earth System Science (DCESS) model, a simplified but well-tested Earth system model of intermediate complexity. We use a generic methane input function that allows variation in input type, size, timescale and ocean-atmosphere partition. To be able to treat such massive inputs more correctly, we extend the model to deal with ocean suboxic/anoxic conditions and with radiative forcing and methane lifetimes appropriate for high atmospheric methane concentrations. With this new model version, we carried out an extensive set of simulations for methane inputs of various sizes, timescales and ocean-atmosphere partitions to probe model behavior. We find that larger methane inputs over shorter timescales with more methane dissolving in the ocean lead to ever-increasing ocean anoxia with consequences for ocean life and global carbon cycling. Greater methane input directly to the atmosphere leads to more warming and, for example, greater carbon dioxide release from land soils. Analysis of synthetic sediment cores from the simulations provides guidelines for the interpretation of real sediment cores spanning the warming events. With this improved DCESS model version and paleo-reconstructions, we are now better armed to gauge the amounts, types, timescales and locations of methane injections driving specific, observed deep-time, global warming events.FONDECYT (Chile) 1150913 Chilean ICM grant NC12006

Do Elderly Patients with Heart Failure and Reduced Ejection Fraction Benefit from Pharmacological Strategies for Prevention of Arrhythmic Events?

Background Heart failure constitutes one of the leading causes of morbidity and mortality in Western countries, in which it is also the leading cause of hospitalization in elderly patients. The pharmacological therapy of patients with heart failure with reduced ejection fraction (HFrEF) has greatly improved during the last years. Summary The quadruple therapy (sacubitril/valsartan, beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors) is nowadays the cornerstone of medical treatment since it associates lower risk of heart failure hospitalizations and mortality (also of arrhythmic origin). Cardiac arrhythmias, including sudden cardiac death, are common in patients with HFrEF, entailing worse prognosis. Previous studies addressing the role of blocking the renin-angiotensin-aldosterone system and beta-adrenergic receptors in HFrEF have suggested different beneficial effects on arrhythmia mechanisms. Therefore, the lower mortality associated with the use of the four pillars of HFrEF therapy depends, in part, on lower sudden (mostly arrhythmic) cardiac death. Key Messages In this review, we highlight and assess the role of the four pharmacological groups that constitute the central axis of the medical treatment of patients with HFrEF in clinical prognosis and prevention of arrhythmic events, with special focus on the elderly patient, since evidence supports most benefits provided are irrespective of age, but elderly HF patients receive less frequently guideline recommended medical treatment.12 página

Late Chattian platform carbonates with benthic foraminifera and coralline algae from the SE Iberian plate

The carbonate system studied represents an under-investigated sedimentary record formed in the western end of the Tethys during the Chattian relatively warm climate regime. These platform carbonates are examined with respect to rock fabrics, biostratigraphy, biostratinomy, paleoecology, and sequence stratigraphy. Dominant carbonate producers include scleractinian corals and echinoids, but the most prolific were symbiontbearing benthic foraminifera and coralline algae. The presence of Miogypsinoides complanatus and Miogypsinoides formosensis indicates a late Chattian age (Shallow Benthic Zone 23). The depositional profile is consistent with a homoclinal ramp. The absence of a barrier margin and thus, of a lagoon, facilitated the transport and re-working of biogenic components throughout the platform. As a result, facies are rather homogeneous corresponding to a rudstone mainly formed by benthic foraminifera and coralline algae, which passes basinwards to deeper ramp to hemipelagic deposits rich in echinoids and planktonic foraminifera. Within this dominant facies, only subtle and gradual lateral variations on the relative abundance or absence of certain skeletal components or species are recognized, comprising two end members. A proximal biofacies of benthic foraminifera and coralline algae including corals in growth position, fragments of green algae, and seagrass dwellers where Eulepidina, Nummulites, and Operculina are absent, and a distal biofacies where corals, green algae, and seagrass dwellers are not present, but Eulepidina, Nummulites and Operculina are common. Carbonate deposition was controlled by long-term relative sea-level fluctuations including a Rupelian?-late Chattian transgression, a late Chattian regression, which ended in subaerial exposure of proximal ramp carbonates, and a latest Chattian to early Miocene transgression. The Chattian carbonate platform was finally drowned around the Oligocene/Miocene transition

Geology of the Falcón Basin (NW Venezuela)

This paper presents a geological map and cross-section of the Falcón Basin based both on published and unpublished work and on new data collected in the northern and southern basin margins. The geological map covers an area of 4600 km2 at 1:100,000 scale. The cross- section is oriented NNW-SSE, traversing perpendicular to the main structures. In general, the structure of the study area results from the inversion of a graben (Oligocene-early Miocene back-arc basin), that started in the middle Miocene due to the convergence between the Caribbean and South American plates. The map, the cross-section and the observations made in the field have been used to generate a tectonostratigraphic reconstruction of the Falcón Basin. The Oligocene-early Miocene sedimentary succession mapped and described is relevant to the hydrocarbon exploration in the Caribbean and in the Gulf of Venezuela, where new hydrocarbon resources have recently been discovered (i.e. Perla gas field)

Sex differences in the impact of frailty in elderly outpatients with heart failure

Introduction: Frailty is common among patients with heart failure (HF). Our aim was to address the role of frailty in the management and prognosis of elderly men and women with HF. Methods and results: Prospective multicenter registry that included 499 HF outpatients ≥75 years old. Mean age was 81.4 ± 4.3 years, and 193 (38%) were women. Compared with men, women were older (81.9 ± 4.3 vs. 81.0 ± 4.2 years, p = 0.03) and had higher left ventricular ejection fraction (46 vs. 40%, p < 0.001) and less ischemic heart disease (30 vs. 57%, p < 0.001). Women had a higher prevalence of frailty (22 vs. 10% with Clinical Frailty Scale, 34 vs. 15% with FRAIL, and 67% vs. 46% with the mobility visual scale, all p-values < 0.001) and other geriatric conditions (Barthel index ≤90: 14.9 vs. 6.2%, p = 0.003; malnutrition according to Mini Nutritional Assessment Short Formulary ≤11: 55% vs. 42%, p = 0.007; Pfeiffer cognitive test's errors: 1.6 ± 1.7 vs. 1.0 ± 1.6, p < 0.001; depression according to Yesavage test; p < 0.001) and lower comorbidity (Charlson index ≥4: 14.1% vs. 22.1%, p = 0.038). Women also showed worse self-reported quality of life (6.5 ± 2.1 vs. 6.9 ± 1.9, on a scale from 0 to 10, p = 0.012). In the univariate analysis, frailty was an independent predictor of mortality in men [Hazard ratio (HR) 3.18, 95% confidence interval (CI) 1.29-7.83, p = 0.012; HR 4.53, 95% CI 2.08-9.89, p < 0.001; and HR 2.61, 95% CI 1.23-5.43, p = 0.010, according to FRAIL, Clinical Frailty Scale, and visual mobility scale, respectively], but not in women. In the multivariable analysis, frailty identified by the visual mobility scale was an independent predictor of mortality (HR 1.95, 95% CI 1.04-3.67, p = 0.03) and mortality/readmission (HR 2.06, 95% CI 1.05-4.04, p = 0.03) in men. Conclusions: In elderly outpatients with HF frailty is more common in women than in men. However, frailty is only associated with mortality in men

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

Markers of endothelial damage in patients with chronic kidney disease on hemodialysis

Patients with Stage 5 chronic kidney disease who are on hemodialysis (HD) remain in a chronic inflammatory state, characterized by the accumulation of uremic toxins that induce endothelial damage and cardiovascular disease (CVD). Our aim was to examine microvesicles (MVs), monocyte subpopulations, and angiopoietins (Ang) to identify prognostic markers in HD patients with or without diabetes mellitus (DM). A total of 160 prevalent HD patients from 10 centers across Spain were obtained from the Biobank of the Nephrology Renal Network (Madrid, Spain): 80 patients with DM and 80 patients without DM who were matched for clinical and demographic criteria. MVs from plasma and several monocyte subpopulations (CD142+/CD16+, CD14+/CD162+) were analyzed by flow cytometry, and the plasma concentrations of Ang1 and Ang2 were quantified by ELISA. Data on CVD were gathered over the 5.5 yr after these samples were obtained. MV level, monocyte subpopulations (CD14+/CD162+ and CD142+/CD16+), and Ang2-to-Ang1 ratios increased in HD patients with DM compared with non-DM patients. Moreover, MV level above the median (264 MVs/µl) was associated independently with greater mortality. MVs, monocyte subpopulations, and Ang2-to-Ang1 ratio can be used as predictors for CVD. In addition, MV level has a potential predictive value in the prevention of CVD in HD patients. These parameters undergo more extensive changes in patients with DM.Support for this work was provided by Plan Nacional de IDi Proyectos de Investigación en Salud of Instituto de Salud Carlos III (ISCIII)–Subdirección General de Evaluación, Fondos de desarrollo regional (FEDER; PI11/01536, PI12/01489, PI14/00806, PI15/01785); Junta de Andalucía grants (P010-CTS-6337, P11-CTS-7352); and Fundación Nefrológica. P. Buendía, A. Carmona, and C. Luna-Ruiz are fellows from Consejería de Innovacion, Ciencia y Empresa, Junta de Andalucía

Hydroxychloroquine is associated with a lower risk of polyautoimmunity: data from the RELESSER Registry

Objectives. This article estimates the frequency of polyautoimmunity and associated factors in a large retrospective cohort of patients with SLE. Methods. RELESSER (Spanish Society of Rheumatology Lupus Registry) is a nationwide multicentre, hospital-based registry of SLE patients. This is a cross-sectional study. The main variable was polyautoimmunity, which was defined as the co-occurrence of SLE and another autoimmune disease, such as autoimmune thyroiditis, RA, scleroderma, inflammatory myopathy and MCTD. We also recorded the presence of multiple autoimmune syndrome, secondary SS, secondary APS and a family history of autoimmune disease. Multiple logistic regression analysis was performed to investigate possible risk factors for polyautoimmunity. Results. Of the 3679 patients who fulfilled the criteria for SLE, 502 (13.6%) had polyautoimmunity. The most frequent types were autoimmune thyroiditis (7.9%), other systemic autoimmune diseases (6.2%), secondary SS (14.1%) and secondary APS (13.7%). Multiple autoimmune syndrome accounted for 10.2% of all cases of polyautoimmunity. A family history was recorded in 11.8%. According to the multivariate analysis, the factors associated with polyautoimmunity were female sex [odds ratio (95% CI), 1.72 (1.07, 2.72)], RP [1.63 (1.29, 2.05)], interstitial lung disease [3.35 (1.84, 6.01)], Jaccoud arthropathy [1.92 (1.40, 2.63)], anti-Ro/SSA and/or anti-La/SSB autoantibodies [2.03 (1.55, 2.67)], anti-RNP antibodies [1.48 (1.16, 1.90)], MTX [1.67 (1.26, 2.18)] and antimalarial drugs [0.50 (0.38, 0.67)]. Conclusion. Patients with SLE frequently present polyautoimmunity. We observed clinical and analytical characteristics associated with polyautoimmunity. Our finding that antimalarial drugs protected against polyautoimmunity should be verified in future studies

Higher COVID-19 pneumonia risk associated with anti-IFN-α than with anti-IFN-ω auto-Abs in children

We found that 19 (10.4%) of 183 unvaccinated children hospitalized for COVID-19 pneumonia had autoantibodies (auto-Abs) neutralizing type I IFNs (IFN-alpha 2 in 10 patients: IFN-alpha 2 only in three, IFN-alpha 2 plus IFN-omega in five, and IFN-alpha 2, IFN-omega plus IFN-beta in two; IFN-omega only in nine patients). Seven children (3.8%) had Abs neutralizing at least 10 ng/ml of one IFN, whereas the other 12 (6.6%) had Abs neutralizing only 100 pg/ml. The auto-Abs neutralized both unglycosylated and glycosylated IFNs. We also detected auto-Abs neutralizing 100 pg/ml IFN-alpha 2 in 4 of 2,267 uninfected children (0.2%) and auto-Abs neutralizing IFN-omega in 45 children (2%). The odds ratios (ORs) for life-threatening COVID-19 pneumonia were, therefore, higher for auto-Abs neutralizing IFN-alpha 2 only (OR [95% CI] = 67.6 [5.7-9,196.6]) than for auto-Abs neutralizing IFN-. only (OR [95% CI] = 2.6 [1.2-5.3]). ORs were also higher for auto-Abs neutralizing high concentrations (OR [95% CI] = 12.9 [4.6-35.9]) than for those neutralizing low concentrations (OR [95% CI] = 5.5 [3.1-9.6]) of IFN-omega and/or IFN-alpha 2