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Chlorophyll a concentration (Chla) is a well-proven proxy of biocrust development, photosynthetic organisms’ status, and recovery monitoring after environmental disturbances. However, laboratory methods for the analysis of chlorophyll require destructive sampling and are expensive and time consuming. Indirect estimation of chlorophyll a by means of soil surface reflectance analysis has been demonstrated to be an accurate, cheap, and quick alternative for chlorophyll retrieval information, especially in plants. However, its application to biocrusts has yet to be harnessed. In this study we evaluated the potential of soil surface reflectance measurements for non-destructive Chla quantification over a range of biocrust types and soils. Our results revealed that from the different spectral transformation methods and techniques, the first derivative of the reflectance and the continuum removal were the most accurate for Chla retrieval. Normalized difference values in the red-edge region and common broadband indexes (e.g., normalized difference vegetation index (NDVI)) were also sensitive to changes in Chla. However, such approaches should be carefully adapted to each specific biocrust type. On the other hand, the combination of spectral measurements with non-linear random forest (RF) models provided very good fits (R2 > 0.94) with a mean root mean square error (RMSE) of about 6.5 µg/g soil, and alleviated the need for a specific calibration for each crust type, opening a wide range of opportunities to advance our knowledge of biocrust responses to ongoing global change and degradation processes from anthropogenic disturbance.

In arid and semiarid ecosystems, plant interspaces are frequently covered by communities of cyanobacteria, algae, lichens and mosses, known as biocrusts. These crusts often act as runoff sources and are involved in soil stabilization and fertility, as they prevent erosion by water and wind, fix atmospheric C and N and contribute large amounts of C to soil. Their contribution to the C balance as photosynthetically active surfaces in arid and semiarid regions is receiving growing attention. However, very few studies have explicitly evaluated their contribution to organic carbon (OC) lost from runoff and erosion, which is necessary to ascertain the role of biocrusts in the ecosystem C balance. Furthermore, biocrusts are not resilient to physical disturbances, which generally cause the loss of the biocrust and thus, an increase in runoff and erosion, dust emissions, and sediment and nutrient losses. The aim of this study was to find out the influence of biocrusts and their removal on dissolved and sediment organic carbon losses. One-hour extreme rainfall simulations (50 mm h-1) were performed on small plots set up on physical soil crusts and three types of biocrusts, representing a development gradient, and also on plots where these crusts were removed from. Runoff and erosion rates, dissolved organic carbon (DOC) and organic carbon bonded to sediments (SdOC) were measured during the simulated rain. Our results showed different SdOC and DOC for the different biocrusts and also that the presence of biocrusts substantially decreased total organic carbon (TOC) (average 1.80 plus or minus 1.86 g m-2) compared to physical soil crusts (7.83 plus or minus 3.27 g m-2). Within biocrusts, TOC losses decreased as biocrusts developed, and erosion rates were lower. Thus, erosion drove TOC losses while no significant direct relationships were found between TOC losses and runoff. In both physical crusts and biocrusts, DOC and SdOC concentrations were higher during the first minutes after runoff began and decreased over time as nutrient-enriched fine particles were washed away by runoff water. Crust removal caused a strong increase in water erosion and TOC losses. The strongest impacts on TOC losses after crust removal occurred on the lichen plots, due to the increased erosion when they were removed. DOC concentration was higher in biocrust-removed soils than in intact biocrusts, probably because OC is more strongly retained by BSC structures, but easily blown away in soils devoid of them. However, SdOC concentration was higher in intact than removed biocrusts associated with greater OC content in the top crust than in the soil once the crust is scraped off. Consequently, the loss of biocrusts leads to OC impoverishment of nutrient-limited interplant spaces in arid and semiarid areas and the reduction of soil OC heterogeneity, essential for vegetation productivity and functioning of this type of ecosystems.

Arid and semi-arid ecosystems are characterized by patchy vegetation and variable resource availability. The interplant spaces of these ecosystems are very often covered by cyanobacteria-dominated biocrusts, which are the primary colonizers of terrestrial ecosystems and key in facilitating the succession of other biocrust organisms and plants. Cyanobacterial biocrusts regulate the horizontal and vertical fluxes of water, carbon and nutrients into and from the soil and play crucial hydrological, geomorphological and ecological roles in these ecosystems. In this paper, we analyze the influence of cyanobacterial biocrusts on water balance components (infiltration-runoff, evaporation, soil moisture and non-rainfall water inputs (NRWIs)) in representative semiarid ecosystems in southeastern Spain. The influence of cyanobacterial biocrusts, in two stages of their development, on runoff-infiltration was studied by rainfall simulation and in field plots under natural rainfall at different spatial scales. Results showed that cover, exopolysaccharide content, roughness, organic carbon, total nitrogen, available water holding capacity, aggregate stability, and other properties increased with the development of the cyanobacterial biocrust. Due to the effects on these soil properties, runoff generation was lower in well-developed than in incipient-cyanobacterial biocrusts under both simulated and natural rainfall and on different spatial scales. Runoff yield decreased at coarser spatial scales due to re-infiltration along the hillslope, thus decreasing hydrological connectivity. Soil moisture monitoring at 0.03 m depth revealed higher moisture content and slower soil water loss in plots covered by cyanobacterial biocrusts compared to bare soils. Non-rainfall water inputs were also higher under well-developed cyanobacterial biocrusts than in bare soils. Disturbance of cyanobacterial biocrusts seriously affected the water balance by increasing runoff, decreasing soil moisture and accelerating soil water loss, at the same time that led to a very significant increase in sediment yield. The recovery of biocrust cover after disturbance can be relatively fast, but its growth rate is strongly conditioned by microclimate. The results of this paper show the important influence of cyanobacterial biocrust in modulating the different processes supporting the capacity of these ecosystems to provide key services such as water regulation or erosion control, and also the important impacts of their anthropic disturbance.

Diabetic retinopathy (DR) is one of the most common complications of diabetes mellitus (DM) causing vision impairment even at young ages. There are numerous mechanisms involved in its development such as inflammation and cellular degeneration leading to endothelial and neural damage. These mechanisms are interlinked thus worsening the diabetic retinopathy outcome. In this review, we propose oxidative stress as the focus point of this complication onset.

Diabetes mellitus (DM) is a progressive disease induced by a sustained state of chronic hyperglycemia that can lead to several complications targeting highly metabolic cells. Diabetic retinopathy (DR) is a multifactorial microvascular complication of DM, with high prevalence, which can ultimately lead to visual impairment. The genesis of DR involves a complex variety of pathways such as oxidative stress, inflammation, apoptosis, neurodegeneration, angiogenesis, lipid peroxidation, and endoplasmic reticulum (ER) stress, each possessing potential therapeutic biomarkers. A specific treatment has yet to be developed for early stages of DR since no management is given other than glycemic control until the proliferative stage develops, offering a poor visual prognosis to the patient. In this narrative review article, we evaluate different dietary regimens, such as the Mediterranean diet, Dietary Pattern to Stop Hypertension (DASH) and their functional foods, and low-calorie diets (LCDs). Nutraceuticals have also been assessed in DR on account of their antioxidant, anti-inflammatory, and antiangiogenic properties, which may have an important impact on the physiopathology of DR. These nutraceuticals have shown to lower reactive oxygen species (ROS), important inflammatory factors, cytokines, and endothelial damage biomarkers either as monotherapies or combined therapies or concomitantly with established diabetes management or nonconventional adjuvant drugs like topical nonsteroidal anti-inflammatory drugs (NSAIDs).

The biocontrol potential of three native soil cyanobacteria from biological soil crusts (Nostoc commune, Scytonema hyalinum, and Tolypothrix distorta) was tested by means of in vitro mycelial growth inhibition assays for eighteen cyanobacteria-based products against three phytopathogenic soilborne fungi (Phytophthora capsici, Pythium aphanidermatum, and Fusarium oxysporum f. sp. radicis-cucumerinum). Three cyanobacteria-based production factors were considered: (i) cyanobacterium strain, (ii) cyanobacterial culture growth phase, and (iii) different post-harvest treatments: raw cultures, cyanobacterial filtrates, and cyanobacterial extracts. Results showed that any of the factors considered are key points for successfully inhibiting fungal growth. N. commune showed the highest growth inhibition rates for the three phytopathogens; stationary phase treatments produced higher inhibition percentages than logarithmic ones; and all the post-harvest treatments of N. commune at the stationary phase inhibited the growth of P. capsici, up to 77.7%. Thus, N. commune products were tested in planta against P. capsici, but none of the products showed efficacy in delaying the onset nor reducing the damage due to P. capsici, demonstrating the complexity of the in planta assay’s success and encouraging further research to design an appropriate scaling up methodology.

ObjectivesReal-world data regarding rheumatoid arthritis (RA) and its association with interstitial lung disease (ILD) is still scarce. This study aimed to estimate the prevalence of RA and ILD in patients with RA (RAILD) in Spain, and to compare clinical characteristics of patients with RA with and without ILD using natural language processing (NLP) on electronic health records (EHR).MethodsObservational case–control, retrospective and multicentre study based on the secondary use of unstructured clinical data from patients with adult RA and RAILD from nine hospitals between 2014 and 2019. NLP was used to extract unstructured clinical information from EHR and standardise it into a SNOMED-CT terminology. Prevalence of RA and RAILD were calculated, and a descriptive analysis was performed. Characteristics between patients with RAILD and RA patients without ILD (RAnonILD) were compared.ResultsFrom a source population of 3 176 165 patients and 64 241 683 EHRs, 13 958 patients with RA were identified. Of those, 5.1% patients additionally had ILD (RAILD). The overall age-adjusted prevalence of RA and RAILD were 0.53% and 0.02%, respectively. The most common ILD subtype was usual interstitial pneumonia (29.3%). When comparing RAILD versus RAnonILD patients, RAILD patients were older and had more comorbidities, notably concerning infections (33.6% vs 16.5%, p<0.001), malignancies (15.9% vs 8.5%, p<0.001) and cardiovascular disease (25.8% vs 13.9%, p<0.001) than RAnonILD. RAILD patients also had higher inflammatory burden reflected in more pharmacological prescriptions and higher inflammatory parameters and presented a higher in-hospital mortality with a higher risk of death (HR 2.32; 95% CI 1.59 to 2.81, p<0.001).ConclusionsWe found an estimated age-adjusted prevalence of RA and RAILD by analysing real-world data through NLP. RAILD patients were more vulnerable at the time of inclusion with higher comorbidity and inflammatory burden than RAnonILD, which correlated with higher mortality.

The relevance of cognitive performance during adolescence requires further studies that analyze potential associated factors. This study aimed to analyze inductive reasoning, reading comprehension, and mathematical thinking (problem-solving and number and calculation) in relation to sleep and depression in 244 students aged 12–17 years (47.6% boys and 52.4% girls). Daytime sleepiness, sleep quality, dysthymia, and euthymia (state and trait) were assessed by self-reported questionnaires. Moreover, correlations between these variables and cognitive performance, and differences depending on sociodemographic variables (sex, age, or academic year) were analyzed using non-parametric tests. Robust regression models were also conducted to evaluate the predictive role of significant variables on cognitive performance. The results showed significant bidirectional relationships between sleep- and depression-related variables, and between the latter ones and cognitive performance. Depression-trait was more related to cognitive performance than depression-state, and euthymia more than dysthymia, but neither daytime sleepiness nor sleep quality significantly correlated with it. As for sociodemographic variables, girls reported worse sleep and more depressive symptoms than boys did, and younger students reported better sleep but performed worse than the older ones. Although these findings should be further explored in forthcoming studies adding other promising variables, they highlight the importance of promoting euthymia to improve cognitive performance in adolescents.

Cystic echinococcosis (CE) is one of the most widespread helminthic zoonoses and is caused by the tapeworm Echinococcus granulosus complex. CE diagnosis and monitoring primarily rely on imaging techniques, complemented by serology. This is usually approached by the detection of IgG antibodies against hydatid fluid (HF), but the use of this heterogeneous antigenic mixture results in a variable percentage of false positive and negative results, and has shown to be useless for follow-up due to the long persistence of anti-HF antibodies in cured patients. To improve test performances and standardization, a number of recombinant antigens mainly derived from HF have been described, among them the B2t and 2B2t antigens. The performance of these antigens in the diagnosis and follow up of patients with CE has been so far evaluated on a limited number of samples. Here, we evaluated the performances of tests based on B2t and 2B2t recombinant antigens compared to HF in IgG-ELISA and immunochromatography (IC) for the diagnosis and follow-up of patients with CE in a retrospective cohort study. A total of 721 serum samples were collected: 587 from 253 patients with CE diagnosed by ultrasonography (US), 42 from patients with alveolar echinococcosis and 92 from healthy donors from Salamanca (Spain). The highest overall sensitivity was obtained with HF in ELISA (85.5%), followed by IC containing HF and 2B2t-HF (83.0% and 78.2%, respectively). The lowest sensitivity was obtained with B2t and 2B2t in ELISA (51.8%). The highest specificity was obtained with IC containing 2B2t-HF (100%), and the lowest with HF-ELISA (78.0%). The lowest cross-reactivity with sera from patients with alveolar echinococcosis was detected with the recombinant antigens in ELISA (9.5% - 16.7%) and the highest with the HF-IC (64.3%). The results of B2t and 2B2t-ELISA were influenced by cyst stage, as classified by US according to the WHO-Informal Working Group on Echinococcosis (WHO-IWGE), with low sensitivity for inactive (CE4 and CE5) cysts, and by the drug treatment, with higher sensitivity in patients after drug treatment compared with patients not subjected to drug treatment. The two recombinant antigens in ELISA provided promising results for monitoring patients in follow-up, although their use is limited to patients with positive serology against them at the beginning of the follow-up. Potential biological reasons behind the low sensitivity of the recombinant antigens and possible strategies to enhance the performance of CE serology are discussed.

Nursing clinics in rheumatology (NCRs) are organisational care models that provide care centred within the scope of a nurse’s abilities. To analyse the impact of NCR in the rheumatology services, national multicenter observational prospective cohort studied 1-year follow-up, comparing patients attending rheumatology services with and without NCR. NCR was defined by the presence of: (1) office itself; (2) at least one dedicated nurse; and (3) its own appointment schedule. Variables included were (baseline, 6 and 12 months): (a) test to evaluate clinical activity of the disease, research and training, infrastructure of unit and resources of NCR and (b) tests to evaluate socio-demographics, work productivity (WPAI), use of services and treatments and quality of life. A total of 393 rheumatoid arthritis and ankylosing spondylitis patients were included: 181 NCR and 212 not NCR, corresponding to 39 units, 21 with NCR and 18 without NCR (age 53 + 11.8 vs 56 + 13.5 years). Statistically significant differences were found in patients attended in sites without NCR, at some of the visits (baseline, 6 or 12 months), for the following parameters: higher CRP level (5.9 mg/l ± 8.3 vs 4.8 mg/l ± 7.8; p  < 0.005), global disease evaluation by the patient (3.6 ± 2.3 vs 3.1 ± 2.4), physician (2.9 ± 2.1 vs 2.3 ± 2.1; p  < 0.05), use of primary care consultations (2.7 ± 5.4 vs 1.4 ± 2.3; p  < 0.001) and worse work productivity. The presence of NCR in the rheumatology services contributes to improve some clinical outcomes, a lower frequency of primary care consultations and better work productivity of patients with rheumatic diseases.