Notes

Physical reactions and health risks of edible amaranth underneath multiple challenges associated with direct through soils along with ambiance.
The view of cancer as a tumor cell-centric disease is now replaced by our understanding of the interconnection and dependency of tumor stroma. Cancer-associated fibroblasts (CAFs), the most abundant stromal cells in the tumor microenvironment (TME), are involved in anticancer therapeutic resistance. As we unearth more solid evidence on the link between CAFs and tumor progression, we gain insight into the role of CAFs in establishing resistance to cancer therapies. Herein, we review the origin, heterogeneity, and function of CAFs, with a focus on how CAF subsets can be used as biomarkers and can contribute to therapeutic resistance in cancer. We also depict current breakthroughs in targeting CAFs to overcome anticancer therapeutic resistance and discuss emerging CAF-targeting modalities.Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Guidelines on Cardiovascular Disease Prevention. We present the Spanish adaptation of the 2021 European Guidelines on Cardiovascular Disease (CVD) prevention in clinical practice. The current guidelines besides the individual approach greatly emphasize on the importance of population level approaches to the prevention of cardiovascular diseases. Systematic global CVD risk assessment is recommended in individuals with any major vascular risk factor. Regarding LDL-Cholesterol, blood pressure, and glycemic control in patients with diabetes mellitus, goals and targets remain as recommended in previous guidelines. However, it is proposed a new, stepwise approach (Step 1 and 2) to treatment intensification as a tool to help physicians and patients pursue these targets in a way that fits patient profile. After Step 1, considering proceeding to the intensified goals of Step 2 is mandatory, and this intensification will bere, diabetes and chronic renal failure are included.
To describe the long-term anatomical and functional restoration observed in patients operated on for a large macular hole (MH) using different macular interposition techniques.

Retrospective analysis of the results obtained in a series of 9 patients undergoing large MH surgery (≥450μm) performing 4 different macular interposition techniques inverted internal limiting membrane flap in 4 cases, autotransplantation of internal limiting membrane in 2, amniotic membrane graft in 2, and autologous anterior capsule graft in one. The mean follow-up time was 11 months. Anatomically, the outcome measures explored were the restoration of the outer layers of the retina and the pattern of MH closure. The final visual acuity and visual quality were functionally assessed.

The restoration of the outer layers was partial in 6 cases. The macular closure rate was 100%, showing an incomplete pattern in 4 cases. Visual acuity improved in 7 patients, remaining stable in 2. Three cases showed an eccentric fixation pattern and/or metamorphopsia.

The development of new surgical techniques has increased the rate of macular closure in large MHs. However, the anatomical and functional restoration remains unpredictable. In this work, macular closure was achieved in all patients and a higher rate of complete closure using inverted internal limiting membrane flap. The restoration of the outer layers was more favorable in the groups in which internal limiting membrane had been used. Functional recovery was independent of the technique used.
The development of new surgical techniques has increased the rate of macular closure in large MHs. However, the anatomical and functional restoration remains unpredictable. In this work, macular closure was achieved in all patients and a higher rate of complete closure using inverted internal limiting membrane flap. The restoration of the outer layers was more favorable in the groups in which internal limiting membrane had been used. Functional recovery was independent of the technique used.
To explore the knowledge, experiences, and perceptions of childbirth educators about providing childbirth education to women with physical disability.

Qualitative descriptive design.

Telephone interviews.

Seventeen childbirth educators.

We used a semistructured interview guide to explore participants' knowledge, experiences, and perceptions of providing childbirth education to women with physical disability. We audio recorded, transcribed, and analyzed the interviews using content analysis.

We identified four themes Importance of Childbirth Education for All Women, Inadequate Knowledge About Physical Disability, Willingness to Learn About Physical Disability, and Misconceptions and Assumptions About Women With Physical Disability.

Participants reported little knowledge about the needs of pregnant women with physical disability and limited experience with them in childbirth education classes. They reported eagerness to learn about disability and its effect on pregnancy to help provide meaningful education to women with physical disability. Childbirth educators need to develop and implement innovative approaches to reach women with physical disability, provide information relevant to their needs, and address the misconceptions and assumptions they may have about women with physical disability and pregnancy.
Participants reported little knowledge about the needs of pregnant women with physical disability and limited experience with them in childbirth education classes. They reported eagerness to learn about disability and its effect on pregnancy to help provide meaningful education to women with physical disability. Protein Tyrosine Kinase inhibitor Childbirth educators need to develop and implement innovative approaches to reach women with physical disability, provide information relevant to their needs, and address the misconceptions and assumptions they may have about women with physical disability and pregnancy.
To synthesize the findings on the effect of technology-mediated education intervention in the first year after birth on maternal health outcomes and to evaluate interventions for participant perspectives and health equity.

We conducted a systematic review of the literature using the electronic databases PubMed, Embase, and CINAHL for articles published between 2010 and 2020. The search strategy was developed by a health sciences librarian.

We included articles if the following criteria were met they reported studies conducted in the United States or a resource-similar nation on the evaluation of a technology-mediated education intervention within the first year after birth and they included the assessment of at least one maternal health outcome.

The lead author extracted data from the full-text articles and entered them into Microsoft Excel. We assessed the quality and risk of bias using the Cochrane Collaboration's tool for examining the potential risk of bias.

We identified 21 articles that met tht from more attention to health equity and design in collaboration with women to gain a better understanding of the information needs and desired technology features.
Newly qualified midwives in the Netherlands perceive the adaptation to new responsibilities as difficult due to the autonomous nature of- and required accountability for the work they face in practice.

All Dutch newly qualified midwives are accountable for their work from the moment of registration while usually working solistically.

This paper explores the perceptions of experienced midwives regarding (1) the performance- and transition into practice of newly qualified midwives, and (2) their supporting role in this transition.

The design of this study is qualitative with focus groups. Experienced midwives' perceptions were explored by means of seven semi-structured focus groups (N=46 participants) with two meetings for each focus group.

Community-based and hospital-based midwives perceived newly qualified midwives as colleagues who did not oversee all their tasks and responsibilities. They perceived newly qualified midwives as less committed to the practice organisation. Support in community-basedmidwives prioritised their work with pregnant individuals and the organisation of their practice above supporting newly qualified midwives.
The first wave of the SARS-CoV-2 pandemic exerted enormous stress on the healthcare system. Community of Madrid hospitals responded by restructuring and scaling their capacity to adapt to the high demand for care.

This was a retrospective observational study conducted between 18 March and 21 June 2020 with data from public and private hospitals in CoM, Spain. Absolute and relative frequencies were calculated for inpatients with and without COVID-19, available and occupied beds in intensive care unit (ICU) and non-ICU wards, daily new admissions (NA), individuals awaiting hospitalisation in the emergency department (ED), and discharges.

Compared to pre-pandemic years, during the maximum care pressure period (18 March-17 April 2020), the average number of total available and occupied beds increased by 27% and 36%, respectively. Also, the average number of available and occupied ICU beds increased by 174% and 257% respectively, and average occupancy was 81%. The average daily NAs were 1,503 (90% from the ED) and 949 (63% due to COVID-19), and of these, 61 (6.4%) were admitted to the ICU. On average, at 600p.m., 1112 patients were waiting in the ED to be admitted and 299 (26.8%) patients waited for more than 24h. Discharges due to death for COVID-19 inpatients in the non-ICU and ICU wards were 16% and 36%, respectively.

This study confirmed the critical role of the ICU and ED, especially in the care of patients before being hospitalizated, in pandemic or health crisis scenarios.
This study confirmed the critical role of the ICU and ED, especially in the care of patients before being hospitalizated, in pandemic or health crisis scenarios.
The management of local relapse after prostate cancer radiotherapy is frequently based on androgen deprivation therapy. The aim of the study was to report Gustave Roussy's experience with salvage prostate brachytherapy.

All cases of localized prostate cancer presenting in an irradiated area who received salvage high dose rate (HDR) brachytherapy from 2013 to 2020 were retrospectively reviewed.

A total of 64 patients were included. Median follow up was 30.5 months. Median initial EBRT dose was 70 Gy [Q1-Q3 70 - 74]. Median PSA at brachytherapy was 6.8 ng/mL [Q1-Q3 4.4 - 8.7] with a median interval between first and salvage irradiation of 10 years [Q1-Q3 6.9 - 12.6]. The modality of the first irradiation was an exclusive EBRT in 73% of the cases, mostly with a 3D technique (82%). Dose prescription was two fractions of 12 Gy or 13 Gy associated with androgen deprivation therapy for 63% of the patients. About 23% of the patients were castrate-resistant. Disease free survival at 2 years was 58% in the whole population and 66% in hormone sensitive patients. The only factors associated with disease free survival on multivariate analysis was a high-risk disease at initial diagnosis (HR = 3.59, IC95 [1.75; 7.39], p = 0.0005). Grade 3 urinary and rectal toxicities occurred in 1.5% and 1.5% of the patients, respectively.

HDR salvage brachytherapy seems to be a safe option for patients presenting with an isolated local relapse of prostate cancer.
HDR salvage brachytherapy seems to be a safe option for patients presenting with an isolated local relapse of prostate cancer.
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