Identification of volatile organic compounds (VOC) emitted from three European orchid species with different pollination strategies : two deceptive orchids (Himantoglossum robertianum and Ophrys apifera) and a rewarding (Gymnadenia conopsea)

Volatile organic compounds (VOC) emission was evaluated in the inflorescences of three species of the family Orchidaceae: Himantoglossum robertianum, Ophrys apifera and Gymnadenia conopsea, that comprise three different pollination strategies: non-rewarding food deceptive, non-rewarding sexually deceptive and nectar rewarding, respectively. VOC were dynamically sampled in custom packed glass multi-sorbent cartridge tubes (Carbotrap, Carbopack X and Carboxen 569). A modified Tedlar® gas sampling bag was placed in vivo covering the inflorescence of the studied orchid, a design that prevents the dilution of the VOC mixture emitted by the flower. Multi-sorbent bed tubes were analysed through automatic thermal desorption coupled with a capillary gas chromatography/mass spectrometry detector. A total of 106 different VOC were found in the scents emitted by the three different studied orchids. A 54% of these compounds had already been identified in floral scents. Generally, only 3 compounds were highly abundant in each species: α-pinene, β-pinene and limonene in Himantoglossum robertianum; 1-butanol, butyl ether and caryophyllene in Ophrys apifera; and phenethyl acetate, eugenol and benzaldehyde in Gymnadenia conopsea. The employment of the presented methodologyPostprint (published version

Perfiles en hostilidad e impulsividad de una muestra de pacientes con trastorno límite de la personalidad en terapia dialectico-conductual.

Descripción y seguimiento de niveles de hostilidad e impulsividad de una muestra de pacientes en terapia dialéctico-conductual grupal

Psychometric characteristics of the Spanish version of instruments to measure neck pain disability

[EN] Background. The NDI, COM and NPQ are evaluation instruments for disability due to NP. There was no Spanish version of NDI or COM for which psychometric characteristics were known. The objectives of this study were to translate and culturally adapt the Spanish version of the Neck Disability Index Questionnaire (NDI), and the Core Outcome Measure (COM), to validate its use in Spanish speaking patients with non-specific neck pain (NP), and to compare their psychometric characteristics with those of the Spanish version of the Northwick Pain Questionnaire (NPQ). Methods. Translation/re-translation of the English versions of the NDI and the COM was done blindly and independently by a multidisciplinary team. The study was done in 9 primary care Centers and 12 specialty services from 9 regions in Spain, with 221 acute, subacute and chronic patients who visited their physician for NP: 54 in the pilot phase and 167 in the validation phase. Neck pain (VAS), referred pain (VAS), disability (NDI, COM and NPQ), catastrophizing (CSQ) and quality of life (SF-12) were measured on their first visit and 14 days later. Patients' self-assessment was used as the external criterion for pain and disability. In the pilot phase, patients' understanding of each item in the NDI and COM was assessed, and on day 1 test-retest reliability was estimated by giving a second NDI and COM in which the name of the questionnaires and the order of the items had been changed. Results. Comprehensibility of NDI and COM were good. Minutes needed to fill out the questionnaires [median, (P25, P75)]: NDI. 4 (2.2, 10.0), COM: 2.1 (1.0, 4.9). Reliability: [ICC, (95%CI)]: NDI: 0.88 (0.80, 0.93). COM: 0.85 (0.75,0.91). Sensitivity to change: Effect size for patients having worsened, not changed and improved between days 1 and 15, according to the external criterion for disability: NDI: -0.24, 0.15, 0.66; NPQ: -0.14, 0.06, 0.67; COM: 0.05, 0.19, 0.92. Validity: Results of NDI, NPQ and COM were consistent with the external criterion for disability, whereas only those from NDI were consistent with the one for pain. Correlations with VAS, CSQ and SF-12 were similar for NDI and NPQ (absolute values between 0.36 and 0.50 on day 1, between 0.38 and 0.70 on day 15), and slightly lower for COM (between 0.36 and 0.48 on day 1, and between 0.33 and 0.61 on day 15). Correlation between NDI and NPQ: r = 0.84 on day 1, r = 0.91 on day 15. Correlation between COM and NPQ: r = 0.63 on day 1, r = 0.71 on day 15. Conclusion. Although most psychometric characteristics of NDI, NPQ and COM are similar, those from the latter one are worse and its use may lead to patients' evolution seeming more positive than it actually is. NDI seems to be the best instrument for measuring NP-related disability, since its results are the most consistent with patient's assessment of their own clinical status and evolution. It takes two more minutes to answer the NDI than to answer the COM, but it can be reliably filled out by the patient without assistanceS

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Identification of volatile organic compounds (VOC) emitted from three European orchid species with different pollination strategies : two deceptive orchids (Himantoglossum robertianum and Ophrys apifera) and a rewarding (Gymnadenia conopsea)

Volatile organic compounds (VOC) emission was evaluated in the inflorescences of three species of the family Orchidaceae: Himantoglossum robertianum, Ophrys apifera and Gymnadenia conopsea, that comprise three different pollination strategies: non-rewarding food deceptive, non-rewarding sexually deceptive and nectar rewarding, respectively. VOC were dynamically sampled in custom packed glass multi-sorbent cartridge tubes (Carbotrap, Carbopack X and Carboxen 569). A modified Tedlar® gas sampling bag was placed in vivo covering the inflorescence of the studied orchid, a design that prevents the dilution of the VOC mixture emitted by the flower. Multi-sorbent bed tubes were analysed through automatic thermal desorption coupled with a capillary gas chromatography/mass spectrometry detector. A total of 106 different VOC were found in the scents emitted by the three different studied orchids. A 54% of these compounds had already been identified in floral scents. Generally, only 3 compounds were highly abundant in each species: α-pinene, β-pinene and limonene in Himantoglossum robertianum; 1-butanol, butyl ether and caryophyllene in Ophrys apifera; and phenethyl acetate, eugenol and benzaldehyde in Gymnadenia conopsea. The employment of the presented methodolog

Assessing the capacity of European regional seas to supply ecosystem services using marine status assessments

In this paper we describe work that progresses the understanding of socio-ecological systems from the perspective of exploring how the supply of ecosystem services might vary with changes in the state of ecosystem components. We developed and tested a new assessment approach (concept, framework and methodology) to assess the capacity of marine ecosystems to supply services, which could be carried out using available policy-reported assessment information on marine biodiversity and ecosystem status. The starting point was an assessment that drew on an understanding of ecosystem state-service relationships, and that was extended to incorporate operational, policy-relevant ecosystem assessment information at European regional sea scales in response to the requirements of the EU Biodiversity Strategy to 2020. The assessment consists of three key steps: (1) identifying all the instances where a marine ecosystem component can potentially contribute to the supply of a marine ecosystem service; (2) developing a critical pathway analysis to identify the major ecosystem component(s) contributing to the supply of a given service; (3) interpreting available information on the state and trends of these major contributing components with knowledge of the ecosystem state-service relationship, to assess the ecosystem's capacity for service supply and its direction of change. The assessment provides a common approach that can be applied across marine regions, and in data rich or data poor situations. This approach captures the sustainability of ecosystem service supply capacity through retaining the connection with the state of the ecosystem and can help to inform management decisions and track the effectiveness of environmental policies.</p