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Fusarium oxysporum is a cross-kingdom pathogen that infects humans, animals, and plants. The primary concern regarding this genus revolves around its resistance profile to multiple classes of antifungals, particularly azoles. However, the resistance mechanism employed by Fusarium spp. is not fully understood, thus necessitating further studies to enhance our understanding and to guide future research towards identifying new drug targets. Here, we employed an untargeted proteomic approach to assess the differentially expressed proteins in a soil isolate of Fusarium oxysporum URM7401 cultivated in the presence of amphotericin B and fluconazole. In response to antifungals, URM7401 activated diverse interconnected pathways, such as proteins involved in oxidative stress response, proteolysis, and lipid metabolism. Efflux proteins, antioxidative enzymes and M35 metallopeptidase were highly expressed under amphotericin B exposure. Antioxidant proteins acting on toxic lipids, along with proteins involved in lipid metabolism, were expressed during fluconazole exposure. In summary, this work describes the protein profile of a resistant Fusarium oxysporum soil isolate exposed to medical antifungals, paving the way for further targeted research and discovering new drug targets.

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INTRODUCTION: Spinal muscular atrophy 5q (SMA) is a genetic neurodegenerative disease that affects alpha motor neurons producing progressive weakness. New outcome measures are currently required to accurately characterise the disease progression and the efficacy of new available treatments. The objective of this work is to preliminarily validate a new intelligent keyboard (Neuromyotype) measuring typing strength and speed in patients with SMA. MATERIAL AND METHODS: Twenty two SMA patients older than 15 years, and 26 healthy controls were included. Three measurements were obtained with the keyboard (maximum strength, execution time of a random typing task, execution time of a sequential typing task) together with the time to complete the Nine-Hole Peg Test (9HPT). Patients were also administered motor (Hammersmith Functional Motor Scale Expanded, HFMSE; Revised Upper Limb module, RULM), and functional scales (Egen Klassification, EK2; and the revised version of Amyotrophic Lateral Sclerosis Functional Rating Scale, ALSFRS-R). The viability and construct validity of the Neuromyotype were analysed, measuring the discriminative power between patients and controls (using ROC curves and the Bangdiwala's B statistic), between the different functional types of SMA (walker, sitter and non-sitter) and their correlation with the rest of motor scales. RESULTS: Neuromyotype measurements could be performed in all patients, unlike the rest of the scales. Its administration was quick and easy. The 3 variables on the keyboard discriminated very well between patients and controls, with strength (ROC = 0.963) being the one that best differentiates from the 3, equaling 9HPT (ROC = 0.966). They also showed a good ability to differentiate by functional type (especially non-sitters from sitters and walkers), with sequential time (B = 0.83) being the tool that best discriminates between the three groups above the rest of motor scales. All motor and functional scales showed strong or very strong correlations with each other (rs = 0.71-0.99), with strength correlating better with motor scales and timed variables with functional scales. CONCLUSION: This study shows the feasibility and validity of Neuromyotype for the evaluation of adolescent and adult patients with SMA. Data obtained with this tool could be of great clinical relevance, saving time and resources compared to the rest of the scales.

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We conducted analysis to estimate genetic parameters and to identify genomic regions and candidate genes affecting direct and maternal effects of preweaning calf mortality (PWM) in Nellore cattle. Phenotypic records of 67,196 animals, and 8443 genotypes for 410,936 SNPs were used. Analysis were performed through the weighted single-step GBLUP approach and considering a threshold animal model via Bayesian Inference. Direct and maternal heritability estimates were of 0.2143 ± 0.0348 and 0.0137 ± 0.0066, respectively. The top 10 genomic regions accounted for 13.61 and 14.23% of the direct and maternal additive genetic variances and harbored a total of 63 and 91 positional candidate genes, respectively. Two overlapping regions on BTA2 were identified for both direct and maternal effects. Candidate genes are involved in biological mechanisms i.e. embryogenesis, immune response, feto-maternal communication, circadian rhythm, hormone alterations, myometrium adaptation, and milk secretion, which are critical for the successful calf growth and survival during preweaning period.

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Single and multiple-trait GWAS were conducted to detect genomic regions and candidate genes associated with meat color traits (L*, lightness; a*, redness; b*, yellowness) in Nellore cattle. Phenotypic records of 5000 animals, and 3794 genotypes for 614,274 SNPs were used. The BLUPF90 family programs were used through single step GWAS approach. The top 10 genomic regions from single-trait GWAS explained 13.64%, 15.12% and 13% of genetic variance of L*, a* and b*, which harbored 129, 70, and 84 candidate genes, respectively. Regarding multiple-trait GWAS, the top 10 SNP windows explained 17.46%, 18.98% and 13.74% of genetic variance of L*, a* and b*, and harbored 124, 86, and 82 candidate genes, respectively. Pleiotropic effects were evidenced by the overlapping regions detected on BTA 15 and 26 associated with L* and a* (genetic correlation of -0.53), and on BTA 18 associated with a* and b* (genetic correlation of 0.60). Similar genomic regions located on BTA 2, 5, 6, and 18 were detected through single and multi-trait GWAS. Overlapped regions harbored a total of 30 functional candidate genes involved in mitochondrial activity, structural integrity of muscles, lipid oxidation, anaerobic metabolism, and muscular pH.

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PurposeThe aim of this study was to gain greater insight into the corneal densitometry changes occurring as a result of refractive surgery and to compare these changes across three widely used surgical techniques, namely, photorefractive keratectomy (PRK), laser-assisted in situ keratomileusis with a femtosecond laser (LASIK-FS), or ReLEx small-incision lenticule extraction (ReLEx SMILE).Patients and methodsThree hundred and thirty-six patients (184 male and 152 female patients) participated in this study. They were split into three groups according to the refractive surgery technique they had undergone: LASIK-FS (74 patients), PRK (153 patients), and ReLEx SMILE (109 patients). All participants underwent an exhaustive eye examination both before and after surgery. Pre- and postoperative corneal densitometry was measured using an Oculus Pentacam system.ResultsThe mean postoperative total corneal densitometry values were 16.53±1.94 for the LASIK-FS group, 15.53±1.65 for PRK, and 16.10±1.54 for ReLEx SMILE. When corneal densitometry was analyzed for specific corneal areas, the values corresponding to the 0-2, 2-6, and 6-10 mm annuli were similar across the three surgical techniques. The only region in which differences were found was the peripheral area (P<0.05), but these variations across techniques were not statistically significant.ConclusionsCorneal densitometry can be used as an objective metric to assess corneal response to refractive surgery, and to monitor patients over time. Corneal densitometry was not negatively affected by any of the refractive surgical procedures under evaluation.

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PurposeTo compare measurements taken using a swept-source optical coherence tomography-based optical biometer (IOLmaster 700) and an optical low-coherence reflectometry biometer (Lenstar 900), and to determine the clinical impacts of differences in their measurements on intraocular lens (IOL) power predictions.MethodsEighty eyes of 80 patients scheduled to undergo cataract surgery were examined with both biometers. The measurements made using each device were axial length (AL), central corneal thickness (CCT), aqueous depth (AQD), lens thickness (LT), mean keratometry (MK), white-to-white distance (WTW), and pupil diameter (PD). Holladay 2 and SRK/T formulas were used to calculate IOL power. Differences in measurement between the two biometers were determined using the paired t-test. Agreement was assessed through intraclass correlation coefficients (ICC) and Bland-Altman plots.ResultsMean patient age was 76.3±6.8 years (range 59-89). Using the Lenstar, AL and PD could not be measured in 12.5 and 5.25% of eyes, respectively, while IOLMaster 700 took all measurements in all eyes. The variables CCT, AQD, LT, and MK varied significantly between the two biometers. According to ICCs, correlation between measurements made with both devices was excellent except for WTW and PD. Using the SRK/T formula, IOL power prediction based on the data from the two devices were statistically different, but differences were not clinically significant.ConclusionsNo clinically relevant differences were detected between the biometers in terms of their measurements and IOL power predictions. Using the IOLMaster 700, it was easier to obtain biometric measurements in eyes with less transparent ocular media or longer AL.

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PURPOSE: To determine whether pupil dilation affects biometric measurements and intraocular lens (IOL) power calculation made using the new swept-source optical coherence tomography-based optical biometer (IOLMaster 700©; Carl Zeiss Meditec, Jena, Germany). PROCEDURES: Eighty-one eyes of 81 patients evaluated for cataract surgery were prospectively examined using the IOLMaster 700© before and after pupil dilation with tropicamide 1%. The measurements made were: axial length (AL), central corneal thickness (CCT), aqueous chamber depth (ACD), lens thickness (LT), mean keratometry (MK), white-to-white distance (WTW) and pupil diameter (PD). Holladay II and SRK/T formulas were used to calculate IOL power. Agreement between measurement modes (with and without dilation) was assessed through intraclass correlation coefficients (ICC) and Bland-Altman plots. RESULTS: Mean patient age was 75.17±7.54 years (range: 57-92). Of the variables determined, CCT, ACD, LT and WTW varied significantly according to pupil dilation. Excellent intraobserver correlation was observed between measurements made before and after pupil dilation. Mean IOL power calculation using the Holladay 2 and SRK/T formulas were unmodified by pupil dilation. CONCLUSIONS: The use of pupil dilation produces statistical yet not clinically significant differences in some IOLMaster 700© measurements. However, it does not affect mean IOL power calculation.

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CASO CLÍNICO: Presentamos el caso de una paciente operada previamente de cirugía de glaucoma con dispositivo XEN® sin incidencias, que presenta una ampolla hipertrófica produciendo un ectropión mecánico secundario. Se describe la técnica «Dry Lake» consistente en drenaje de la ampolla, previo bloqueo viscoelástico del dispositivo XEN® vía ab-interno, y el sellado de la ampolla inferior con pegamento tisular. DISCUSIÓN: En el manejo de este tipo de ampollas se han postulado tratamientos médicos, suturas compresoras e incluso la utilización de sangre autóloga. El uso del Tissucol®, ya descrito en la cirugía del glaucoma, puede ser útil en este tipo de casos de ampollas hipertróficas secundarias al dispositivo ab-interno XEN®

CASE REPORT: The case of a patient with previous uncomplicated XEN® drainage glaucoma surgery is described, who presented with hypertrophic bleb and mechanical ectropion. Treatment consisted of the «Dry Lake» procedure to drain the hypertrophic bleb following blockage with viscoelastic of the ab-interno stent and bleb sealing with a tissue adhesive. DISCUSSION: Proposals for the management of this type of bleb include therapeutic strategies, sutures or even autologous blood. The use of Tissucol®, already described in glaucoma surgery, may be appropriate to treat this complication of XEN® placement

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CASE REPORT: The case of a patient with previous uncomplicated XEN(®) drainage glaucoma surgery is described, who presented with hypertrophic bleb and mechanical ectropion. Treatment consisted of the «Dry Lake¼ procedure to drain the hypertrophic bleb following blockage with viscoelastic of the ab-interno stent and bleb sealing with a tissue adhesive. DISCUSSION: Proposals for the management of this type of bleb include therapeutic strategies, sutures or even autologous blood. The use of Tissucol(®), already described in glaucoma surgery, may be appropriate to treat this complication of XEN(®) placement.

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AIM: Nursing leaders from six countries engaged in a year-long discussion on global leadership development. The purpose of these dialogues was to strengthen individual and collective capacity as nursing leaders in a global society. Field experiences in practice and education were shared. Perspectives on global leadership can strengthen nurses' contributions to practice, workplace and policy issues worldwide. BACKGROUND: Transformational leadership empowers nurses' increasing confidence. Mentoring is needed to stimulate leadership development but this is lacking in many settings where nurses practice, teach and influence policy. Organizations with global mission provide opportunity for nurses' professional growth in leadership through international dialogues. PROCEDURES: Dialogues among participants were held monthly by conference calls or videoconferences. Example stories from each participant illustrated nursing leadership in action. From these exemplars, concepts were chosen to create a framework. Emerging perspectives and leadership themes represented all contexts of practice, education, research and policy. The cultural context of each country was reflected in the examples. RESULTS: Themes emerged that crossed global regions and countries. Themes were creativity, change, collaboration, community, context and courage. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Relationships initially formed in professional organizations can be extended to intentionally facilitate global nursing leadership development. Exemplars from the dialogues demonstrated nursing leadership in health policy development within each cultural context. Recommendations are given for infrastructure development in organizations to enhance future collaborations.

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Objetivos. Conocer en nuestro medio los niveles de vitamina D en mujeres durante el climaterio y su diferencia en los casos de osteopenia / osteoporosis confirmados por osteodensitometría. Muestra. Se tomaron 27 pacientes que consultaron por síndrome climaterio a la Clínica de Climaterio del Instituto Materno Infantil (IMI) de Bogotá durante 1999: 3 osteoporóticas, 12 osteopénicas y 12 normales por osteodensitometría de acuerdo a los parámetros establecidos por la Asociación Internacional de Osteoporosis.Metodología. Se utilizó la técnica de radioinmunoanálisis para la determinación cuantitativa de 1,25 (OH)2D2 en plasma humano, utilizando el kit Gamma b1, 25 dihydroxyvitamin de la casa IDS, por medio de inmunoextracción. Sensibilidad - 2 Desviaciones estándar de 10 replicas del calibrador cero (5 pmol/L). Valor de referencia 46- 110 pmol/L. Estos datos se compararon con la Densidad Mineral Osea (DM0) medida por densitometría a nivel de columna lumbar (L4) y fémur, considerando como osteoporosis un T-score de -2.5. Para el cálculo de la muestra se utilizó la prueba de T (22 grados de libertad), asumiendo igualdad de varianzas. Resultados: El promedio para el grupo es 81.7 +18.9 pmol/L. El 68 por ciento de la muestra se encuentra entre 62.7 y 100.6 pmol/L dentro del promedio de lo esperado. El promedio de las mujeres normales es de 100.4 + 13.56 pmol/L y las osteopénicas de 66.96 + 9.5 pmol/L estos valores representan una disminución del 33 por ciento cuando se comparan las mujeres normales frente a las osteopénicas. Existe una diferencia significativa p< 0.001 entre las de DM0 normales y las osteopénicas

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OBJECTIVE: This double-blind, double-dummy, two-way comparative trial evaluated the overall efficacy and tolerability of intramuscular (im) vs oral meloxicam. SUBJECTS: 346 patients with rheumatoid arthritis (RA). TREATMENT AND METHODS: 173 patients in each group were randomised to receive either im meloxicam (15 mg) plus a placebo tablet, or oral meloxicam (15 mg) plus a placebo injection for 7 days. RESULTS: Significant (p < 0.001) improvements in overall pain and disease activity were observed by patients treated with im and oral meloxicam, with no significant difference between treatments. The im formulation was better than the oral tablet in terms of rapidity of action (p=0.012), global efficacy (p=0.030) and duration of morning stiffness (p=0.026). Local tolerability of im meloxicam was very good and comparable with placebo injections. CONCLUSION: Oral and im meloxicam (15 mg) were both effective and well-tolerated for acute exacerbations of RA. The im formulation had some advantages, such as a faster onset of action.

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An isotonic electrolyte solution with a composition similar to equine sweat was compared to an isotonic glucose-glycine-electrolyte solution for oral rehydration therapy in exercising horses. Ten horses were dehydrated by using frusemide and allocated randomly to receive 4 different oral solutions: isotonic sweat-like electrolyte solution, half-strength hypotonic electrolyte solution, isotonic glucose-glycine-electrolyte solution, and plain water. Solutions were given by nasogastric tube using the same volume as the bodyweight lost by each horse. Blood samples were collected before and throughout 6 h of the rehydration period. Results showed that all solutions recovered pre-frusemide values of packed cell volume (PCV) and total plasma protein (TP) in a similar fashion. No changes for Na+ values were observed during the rehydration period when the isotonic sweat-like solution was used. However, a significant hyponatraemia was induced throughout rehydration when the other 3 solutions were given, especially when hypotonic solution and water were used. Osmolality values did not change when both isotonic solutions were administered; but a significant hypotonicity was observed when hypotonic solution and water were given. When the isotonic sweat-like solution was used, plasma Cl-, K+ and creatinine values recovered to premedication values significantly faster than the other 3 solutions. In conclusion, the isotonic sweat-like electrolyte was the best solution because it restored rapidly the fluid and plasma electrolyte imbalances. In contrast, the isotonic glucose-glycine-electrolyte solution impaired the plasma electrolyte imbalances.

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ICN was 90 years old this year and, from all accounts, is still viable and will continue to be meaningful for nurses and nursing well into the year 2000. As it nears its 100th birthday it is only appropriate that we look back in retrospect at accomplishments, take stock of the present situation of nursing worldwide and contemplate future goals. ICN has its longterm plan (page 168), but it is flexible so that it can adapt to changing needs. Below, present and former (one as far back as 1961) members of the ICN team evaluate ICN's worthiness and suggest how it can better serve the nursing profession.

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In the celebration of the 40 years of the World Health Organization's existence, the International Council of Nurses, spokesman for the world's nurses, wants to be present with the enthusiasm of a friend, with the pride to be an associate in providing health care and with due respect of the professionals who recognize the leading role and authority of WHO in the health field.

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