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Colloidal suspensions made of smart core–shell structures are of current interest in many fields. Their properties come from the possibility of varying the core and shell materials for modifying the composite particles' chemical, biological, and optical properties. These particles are formed with a material with a constant refractive index core and a shell with a refractive index decaying until it matches the solvent refractive index. Poly(N-IsoPropyl AcrylaMide) (PNIPAM) is a typical example of materials forming shells. In this report, we present how to apply Mie scattering theory to predict and understand the static light scattering of large nonhomogeneous colloidal particles with spherical symmetry whose size is comparable with or larger than the light wavelength used for developing scattering experiments, where the Rayleigh–Gans–Debye approximation is not valid. Here, the refractive index decay was approximated by a Gaussian RI profile numerically evaluated through a multilayer sphere. We calculated the form factor functions of suspensions of PNIPAM microgels previously reported and core–shell suspensions made of polystyrene/PNIPAM at 20 and 40 °C synthesized by us. In all the cases, our method succeeded in providing the scattering intensity as a function of the angle. The software for using the numerical method is fairly straightforward and is accessible as an open-source code. The results can not only help predict and understand the photonic properties of microgels with large core–shell structures but also for any particle with a refractive index distribution with spherical symmetry, as in the case of microgels with super chaotropic agents, hollow microgels, or microparticles. [ABSTRACT FROM AUTHOR]

CNDOL is an a priori, approximate Fockian for molecular wave functions. In this study, we employ several modes of singly excited configuration interaction (CIS) to model molecular excitation properties by using four combinations of the one electron operator terms. Those options are compared to the experimental and theoretical data for a carefully selected set of molecules. The resulting excitons are represented by CIS wave functions that encompass all valence electrons in the system for each excited state energy. The Coulomb–exchange term associated to the calculated excitation energies is rationalized to evaluate theoretical exciton binding energies. This property is shown to be useful for discriminating the charge donation ability of molecular and supermolecular systems. Multielectronic 3D maps of exciton formal charges are showcased, demonstrating the applicability of these approximate wave functions for modeling properties of large molecules and clusters at nanoscales. This modeling proves useful in designing molecular photovoltaic devices. Our methodology holds potential applications in systematic evaluations of such systems and the development of fundamental artificial intelligence databases for predicting related properties. [ABSTRACT FROM AUTHOR]

Copyright of Revista Latinoamericana de Hipertension is the property of Revista Latinoamericana de Hipertension and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The objective of this study was to investigate which of two short questionnaires, the Asthma Control Test (ACT) or the COPD Assessment Test (CAT), correlates better with severity variables and whether they share similar determinants in patients with asthma–COPD overlap. Method: This observational, cross-sectional, multicentric study included smokers and former smokers of more than 10 pack-years, with non-fully reversible airflow obstruction and either a concomitant diagnosis of asthma or signs of type 2 inflammation, from 15 centres in Spain. Results: A total of 157 patients were included, 109 (69.4%) were men, the mean age was 63.3 (SD: 9) years and the mean FEV1 (%) was 59.7% (SD: 20.5%). The mean CAT score was 14.5 (SD: 8.7), and the mean ACT score was 17.9 (SD: 5.2). Both scores showed good correlations (r = 0.717; p < 0.001). In the multivariate analysis, the Hospital Anxiety and Depression Scale and mMRC dyspnoea scores were independently and significantly associated with both the CAT and ACT scores; however, age was only significantly associated with the CAT, and the EQ-5D scores and the number of exacerbations in the previous year were only significantly associated with the ACT scores. The ACT had a slightly better predictive value for exacerbations than the CAT (AUC = 0.70 (95% CI: 0.62 to 0.79 vs. 0.65 (95% CI: 0.56 to 0.74))). Conclusions: There is a good correlation between ACT and CAT scores in patients with ACO. However, severe patients scored worse on the CAT than the ACT. Anxiety, depression and dyspnoea were significantly associated with both the CAT and ACT scores. The ACT was a slightly better predictor of exacerbations than the CAT in this population. [ABSTRACT FROM AUTHOR]

Background/objectives: Fostamatinib is a spleen tyrosine kinase (SYK) inhibitor approved for the treatment of adult patients with chronic immune thrombocytopenia (ITP). There is little information about dose tapering and sustained remission after discontinuation in ITP. In this retrospective multicenter study, we evaluated efficacy and safety of fostamatinib in adult patients with ITP before, during, and after tapering/discontinuation (T/D). Methods: T/D was performed on subjects who achieved complete platelet response (CR) with progressive, conditional dose reduction every four weeks. Results: Sixty-one patients were included from 14 reference centers between October 2021 and May 2023. In subjects that completed T/D (n = 9), the median time from treatment initiation to response was 21 days (IQR: 7.5–42), median time from treatment initiation to CR was 28 days (IQR: 28–42), median time from treatment initiation to the start of tapering was 116 days (IQR: 42–140), and duration of tapering was 112.5 days (IQR: 94.5–191). The median platelet count was 232 × 109/L (IQR: 152–345 × 109/L) at tapering and 190 × 109/L (IQR: 142.5–316.5 × 109/L) at discontinuation. With a median follow-up since discontinuation of 263 days (IQR: 247–313 days), only two patients have relapsed (at 63 and 73 days). Fostamatinib was restarted, achieving a new CR. Platelet counts higher than 100 × 109/L in week 12 were the only positive predictive factors for successful tapering and discontinuation. Conclusions: Sustained response in patient with ITP treated with fostamatinib could be developed. The prognostic factors and recommended scheme of tapering still have to be evaluated. [ABSTRACT FROM AUTHOR]

In this research, the design and simulation of a heat sink for photovoltaic panels were carried out using aluminum and copper, the most commonly used materials in heat dissipation systems. This heat sink consisted of fins that were tested both perforated and non-perforated to improve heat dissipation efficiency. This research stems from the need to reduce the temperature of photovoltaic panels during operation, as scientific evidence shows that photovoltaic panels experience a decrease in efficiency as the temperature increases, taking as a reference the temperature under standard test conditions. The simulations of photovoltaic panels with aluminum and copper fins, both perforated and non-perforated, followed a rigorous methodology. For validation, the simulation results were compared with field data, yielding a mean absolute percentage error of 1.71%. The findings indicate that copper fins reduced the temperature of the photovoltaic panel by 2.62 K, resulting in a 1.31% increase in efficiency. Similarly, aluminum fins reduced the temperature by 2.10 K, with a 1.05% increase in efficiency. Perforated copper fins achieved a temperature reduction of 3.07 K, increasing efficiency by 1.54%, while perforated aluminum fins reduced the temperature by 2.49 K, contributing to a 1.25% increase in efficiency. [ABSTRACT FROM AUTHOR]

C4F7N [2,3,3,3-tetrafluoro-2-(trifluoromethyl)propanenitrile]/CO2 gas mixtures are being developed as an eco-friendly electrical insulator to replace SF6, the most potent greenhouse industrial gaseous dielectric. However, recent studies have reported complicated and often conflicting decomposition pathways for C4F7N/CO2 gas mixtures, which has raised concerns. In this work, the decomposition characteristics of C4F7N/CO2 gas mixtures were studied comprehensively by both designed computations and experiments. Computations were performed starting from fundamental propositions of C4F7N/CO2 decompositions, which were further experimentally verified by pyrolysis, long-term thermal aging with/without catalytic materials (industrial-grade molecular sieves 4A), and electrical decomposition by spark discharge. The results of both computations and experiments suggest that in an ideal thermal decomposition, C4F7N is likely to decompose into C2F6 and small fluoronitriles first at high temperatures. The generation of C3F6 and C2N2 from C4F7N thermal decomposition at lower temperatures appears because of the catalytic effect of incompatible materials, for example, the industrial-grade molecular sieves 4A that we tested. The electron impact dissociation of C4F7N plays an important role in C4F7N electrical decomposition, leading to additional formation of distinctive small molecules of CF4 and C2N2 of low concentrations. It was pointed out based on a real arcing test in a load disconnector that the decomposition of C4F7N gas mixtures in real applications will be at a much moderate and manageable rate than what was obtained from the highly accelerated laboratory tests presented in this work. The signatures of decomposition products extracted in this study provide invaluable guidance for developing decomposition-based diagnosis and fixation of decomposition byproducts toward SF6-free power grids. [ABSTRACT FROM AUTHOR]

Background: Colibacillosis caused by Escherichia coli causes significant economic losses in the livestock sector worldwide and is one of the calves' leading causes of diarrhea. Aim: This study aimed to identify the most frequent E. coli molecularly pathotypes in calves with diarrhea in six provinces of the Cajamarca region in the northern highlands of Peru. Methods: Twenty-eight herds of dairy cattle under a semi-intensive rearing system were evaluated; 95 samples were isolated from calves with diarrhea up to the first month of life, 62 males and 33 females, during the rainy season. Results: The presence of virulence genes of E. coli strains was more prevalent in males; the astA (89.47%), st (83.15%), and f5 (57.89%) genes were more expressed, and the lt (17.89%) and stx2 (1.05%) genes were less expressed. The eae gene (21.05%) was more present in females. Conclusion: When E. coli strains express virulence genes astA, st, and f5 and their atypical double, triple, and quadruple combination between different observed pathotypes, they give rise to the formation of several pathotypes by the horizontal transfer of virulence genes, which can cause colibacillosis processes in more virulent calves, which is one of the most important causes of diarrhea in calves in the region of Cajamarca, compromising the sanitary viability in the herds. [ABSTRACT FROM AUTHOR]

Background: The effect of an intervention based on Mediterranean diet on reducing recurrence risk or subsyndromal depressive symptoms in recovered depressed patients has not been explored. Methods: The PREDIDEP study was a two-year randomized trial designed to assess the effect of the Mediterranean Diet enriched with extra virgin olive oil on depression recurrence. At baseline and at four, eight, 16, 20, and 24 months of follow-up, depressive symptoms were evaluated through the Beck Depression inventory. Cox regression analysis was fitted to assess the role of dietary intervention on the risk of depression recurrence. Mixed effects linear models were used to assess changes in depressive subsyndromal symptoms according to the intervention. Results: After two years of intervention, the dietary intervention group (n = 103) compared to the control group (n = 93) showed no differences regarding depression recurrence risk as main outcome. As secondary outcomes, an improvement of depressive symptoms was yielded at four (−2.15; 95% CI = −4.00 to −0.29) and eight months (−2.42; 95% CI = −4.17 to −0.67) in the intervention group, with no changes in control group. Moreover, at 20 months, significant differences were found between groups (−3.35; 95% CI = −6.08 to −0.61). Conclusions: An intervention with Mediterranean diet in patients with previous depressive episodes might contribute to the reduction of depressive subsyndromal symptoms. [ABSTRACT FROM AUTHOR]

Aim: Compare two vancomycin dosing strategies in critical patients with methicillin-resistant Staphylococcus aureus (MRSA) infections, considering the heterogeneity of the dosing regimens administered and their implications for toxicity and efficacy. Materials & methods: Longitudinal retrospective observational study in two patient cohorts (standard dosing vs dosing via Bayesian algorithms). Results: The group of Bayesian algorithms received substantially higher and significantly heterogeneous doses, with an absence of nephrotoxicity. The speed of decrease observed in CRP and PCT was greater for the Bayesian strategy (p = 0.045 and 0.0009, respectively). Conclusion: Applying Bayesian algorithms to vancomycin dosage individualization allows for administering much higher doses than with standard regimens, facilitating a quicker clinical response in the absence of nephrotoxicity. Article highlights Critical patients treated with vancomycin present high inter-individual variability in both clearance and half-life, estimated at 65.3 and 99.1%, respectively. Critical patients under vancomycin treatment present intra-individual variability in clearance and half-life, with a magnitude justifying periodic control of concentrations throughout the duration of the treatment. The variability of total daily doses required by critical patients presents up to a 60-fold difference between patients who require lower doses and those who require higher doses, indicating the need to individualize dosage schemes for each particular patient. The dosing strategy guided by Bayesian algorithms, compared with the strategy guided solely by renal function, presented superior clinical effectiveness when considering remission speed for PCR and PCT. The dosing strategy guided by Bayesian algorithms, when compared with the strategy guided entirely by renal functionality, was not related with higher kidney damage rates, despite requiring substantially higher total daily doses. It is essential to remember that the science which makes dosing individualization possible is 'clinical pharmacokinetics', and thus every mathematical-statistical analysis must always be accompanied by an integral clinical vision for the patient, in order to design dosage schemes which can satisfy their needs in a timely way as well as the changes in their clinical evolution across the treatment. Returning to the roots of pharmacokinetics, based upon deep knowledge of the molecule and its behavior in the human body under different physio-pathological conditions, would make it possible to improve the effectiveness/toxicity profile of vancomycin, as well as other antibiotics characterized by high inter- and intra-individual variability. Maintaining standard dosage schemes based on guides or recommendations which only consider body weight or kidney function contributes to under-usage of the frontline pharmacotherapy arsenal, and to mediocre clinical results which could favor the development of drug resistance. [ABSTRACT FROM AUTHOR]

Taking two cacti species as source of bioinspiration and tubular metamaterials are developed and studied under torsion. A flower-like cross section and a void distribution are the two bioinspired characteristics used for the design of tubular metamaterials. The geometrical parameters that define the two bioinspired characteristics are identified. Changes in torsional stiffness due to varying these parameters are studied using finite element simulations. The shape of the tubular metamaterials cross section had a larger influence on their torsional stiffness compared to the void distribution. Results presented could serve as a guide for the design of tubular metamaterials with tuned torsional stiffness. [ABSTRACT FROM AUTHOR]

Monitoring cell secretion in complex microenvironments is crucial for understanding cellular behavior and advancing physiological and pathological research. While traditional cell culture methods, including organoids and spheroids, provide valuable models, real-time monitoring of cell secretion of signaling molecules remains challenging. Integrating advanced monitoring technologies into these systems often disrupts the delicate balance of the microenvironment, making it difficult to achieve sensitivity and specificity. This review explored recent strategies for integrating the monitoring of cell secretion of signaling molecules, crucial for understanding and replicating cell microenvironments, within cell culture platforms, addressing challenges such as non-adherent cell models and the focus on single-cell methodologies. We highlight advancements in biosensors, microfluidics, and three-dimensional culture methods, and discuss their potential to enhance real-time, multiplexed cell monitoring. By examining the advantages, limitations, and future prospects of these technologies, we aim to contribute to the development of integrated systems that facilitate comprehensive cell monitoring, ultimately advancing biological research and pharmaceutical development. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: To infer a reliable SARS-CoV-2 antibody protection level from a serological test, an appropriate quantitative threshold and solid equivalence across serological tests are needed. Additionally, tests should show a solid correlation with neutralising assays and with the protection observed in large population cohorts even against emerging variants. Objectives: We studied convalescent and vaccinated populations using 11 commercial antibody assays. Results were compared to evaluate discrepancies across tests. Neutralisation capacity was measured in a subset of the samples with a lentiviral-based assay. Methods: Serum from convalescent (n = 121) and vaccinated individuals (n = 471, 260 with Comirnaty, 110 with Spikevax, and 96 with Vaxzevria) was assessed using 11 different assays, including two from Abbott, Euroimmun, Liaison, Roche, and Vircell, and one from Siemens. A spike protein-lentiviral vector with a fluorescent reporter was used for neutralisation assay of serum from convalescent (n = 26) and vaccinated (n = 39) individuals. Results: Positivity ranged between 81.3 and 94.3% after infection and 99.4 and 99.7% after vaccination, depending on the assay. Both cohorts showed a high level of qualitative agreement across tests (Fleiss' kappa = 0.598 and 0.719 for convalescent and vaccinated respectively). Spikevax vaccine recipients showed the highest level of antibodies in all tests. Effectiveness of each test predicting SARS-CoV-2 neutralising capacity depended on assay type and target, with CLIA and anti-S being more effective than ELISA and anti-N assays, respectively. Conclusions: High-throughput immunoassays are good predictors of neutralising capacity. Updated targets and better standardisation would be required to find an effective correlate of protection, especially to account for antibodies against new variants. [ABSTRACT FROM AUTHOR]

Introduction: Although sudden death (SD) is a recognized complication of cardiac amyloidosis, there is scarce data about its incidence, mechanisms, and predictors. The aim of this study was to describe incidence of SD and to analyze possible risk factors. Methods: Consecutive patients with ATTR or AL cardiac amyloidosis evaluated at two European centers were identified. SD was defined as unexpected death in clinically stable patients. Cox proportional hazard regression was performed to assess risk factors in univariate analysis. Those statistically significant were then assessed through age-adjusted multivariate analysis. Results: Analysis included 784 patients, 569 with ATTR amyloidosis (mean age 74.1 ± 12.1 years) and 215 with AL amyloidosis (mean age 64.5 ± 10.8 years). After a median follow-up of 1.9 years, SD rate at 2 years was 1.8% in ATTR. Previous pacemaker implantation (PPM) was associated with increased risk after age-adjusted analysis (HR 4.97; 95%CI: 1.39–17.7; p = 0.01). SD rate in AL amyloidosis patients at 2 years was 8.0% after a median follow-up of 1.2 years. Betablockers and NYHA III-IV were independently associated with an increased risk after age-adjusted multivariate analysis (HR 7.06 95%CI (2.31–21.5) p = 0.001) and (HR 4.56 95%CI (1.51–13.8) p = 0.007) respectively. Conclusions: SD is more frequent in AL than in ATTR cardiac amyloidosis. SD is associated with different risk factors in both entities. [ABSTRACT FROM AUTHOR]

This study contributes to the literature on linear algebra instruction by designing and researching a teaching sequence based on APOS Theory to introduce engineering students to vector spaces. The sequence offers students multiple opportunities to understand the concept. Another contribution is the evidence that introducing prerequisite concepts—such as equality, sets, and binary operations—before tackling vector space was crucial for grasping the role of proof in determining whether a set is a vector space. The findings confirm that, as other studies have shown, vector space is challenging for students. However, the results demonstrate that students were able to face this challenge. All students showed evidence of developing an understanding of the concept, with nine achieving a clear grasp of vector space and the role of proof by the end of the experience. Additionally, the progress observed—from having difficulties with symbols to successfully proving statements involving unconventional operations—underscores the effectiveness of the teaching approach. [ABSTRACT FROM AUTHOR]

Objective: While there is increasing information regarding the occupational risks to pregnant physicians, there is inconsistent and limited subspecialty data. Physicians may be at increased risk for pregnancy complications due to occupational exposure, long work hours, nightshifts, and physical/mental demands. Additionally, little is known regarding the education physicians receive pertaining to pregnancy risks respective to their specialties as well as departmental/institutional support for pregnancy loss or complication. Therefore, a survey was developed and distributed across multiple academic sites to ascertain if there is an inherent occupation-associated risk of pregnancy complication(s) and/or pregnancy loss for anesthesiologists (ANES) when compared to obstetrician/gynecologists (OB/GYN). Methods: A specialty-specific survey was distributed electronically to attending ANES and OB/GYN, via departmental listservs at six participating academic medical centers. Responses were collected from March to October 2022 and included demographic information, practice characteristics, education about pregnancy risks and details of pregnancy complications and loss. The primary comparison between specialty groups was the occurrence of at least one pregnancy complication and/or loss. Logistic regression was used to evaluate specialty outcome associations. Additionally, complication rates and types between specialties were compared using univariate and multivariable models. Results: The survey was distributed to 556 anesthesiology and 662 obstetrics–gynecology faculty members with 224 ANES and 168 OB/GYN respondents, yielding an overall 32.2% response rate. Of the survey respondents, 103 ANES and 116 OB/GYN reported at least one pregnancy. Demographics were similar between the two cohorts. ANES had higher gravidity and parity relative to OB/GYN and tended to be earlier in their career at first pregnancy (p =.008, <.001, and.043, respectively). The rate of any pregnancy complication, including loss, was similar between specialties (65.1% (67/103) vs. 65.5% (76/116), p =.942). Of the respondents reporting at least one pregnancy, 56.7% of ANES and 53.9% of OB/GYN experienced a complication while at work. Obstetrician–gynecologists had higher use of reproductive assistance (28% (47/116) vs. 11% (20/103), p <.001). There were no notable differences between cohorts for complications, prematurity, and neonatal intensive care admission. Forty-one percent (161/392) of total respondents recalled learning about occupational risks to pregnancy, and ANES were more likely than OB/GYN to have recalled learning about these risks (121/224 (54%) and 40/168 (23.8%), respectively, p <.001). Conclusions: ANES and OB/GYN had similar risks for pregnancy complications and loss. Anesthesiologists were more likely to recall receiving education regarding occupational risk to pregnancy, though fewer than half of all survey respondents recalled learning about these risks. Our survey results are similar to the previously identified higher rate of pregnancy complications and loss in female physicians while uncovering areas of potential knowledge gaps for which institutions and practices could strive to improve upon. More research is needed to examine the relationship between occupation and pregnancy risk pertaining to female physicians with the goal being to identify modifiable risk factors. [ABSTRACT FROM AUTHOR]

Introduction: Severe recurrent aphthous stomatitis (RAS) represents a therapeutic challenge because of its impact on the patient's quality of life. Additionally, no approved systemic therapies are available. Roflumilast, a phosphodiesterase‐4 inhibitor, has shown promise in other inflammatory dermatological conditions. This study aimed to assess the characteristics, effectiveness, and safety of roflumilast in treating RAS in routine clinical practice. Methods: This is a single cohort ambispective observational study conducted in five Spanish centers. Twenty‐two patients with RAS treated with roflumilast participated. Data collection included demographic, clinical, and outcome variables. Statistical analysis compared the outcomes of 12 weeks of roflumilast treatment with a similar prior period without treatment. Results: During treatment with roflumilast, a significant reduction in flare‐ups (88%) and oral ulcers (94%) was observed compared to the untreated period. A reduction in pain (66%) and ulcer duration (63%) was observed. Adverse effects (AEs) occurred in 13 patients, predominantly headache and gastrointestinal disturbances. Most of these were self‐limiting or manageable with dose adjustment. Treatment was withdrawn in three cases, mainly because of AEs. Conclusions: This study suggests that roflumilast may effectively treat RAS by reducing the number of flare‐ups and ulcers, their duration, and the symptomatology produced by the ulcers. In addition, roflumilast has a good safety profile, is well tolerated at low doses, and does not require close monitoring. These characteristics and its favorable economic profile make roflumilast a promising therapeutic option in this pathology. [ABSTRACT FROM AUTHOR]

Shared intentionality is key for understanding human cooperation and cognition. This paper proposes a new way of looking at shared intentionality as a set of interconnected threshold traits, highlighting the role of developmental niche construction in its evolution. This perspective suggests that shared intentionality may have arisen from environmental changes and interactions influencing existing traits, rather than genetic variation for novel cognitive machinery. [ABSTRACT FROM AUTHOR]

This study uses authentic cariño to explore a care and connect model in a case study of a single district in Teachers Educating All Multilingual Students (TEAMS), funded by a National Professional Development (NPD) grant. Along with ESOL/dual language licensure coursework, teachers in five districts engage in family–school–community partnerships to develop multilingual family engagement. COVID‐19 required urgent shifts in how teachers and districts reached families and offered services. Accordingly, the research question is as follows: How did TEAMS teachers' conceptions of caring and connecting to support multilingual family engagement shift in response to the COVID‐19 pandemic? Data included three teacher focus groups per district, interviews with facilitators and administrators, and individual teacher interviews. Case study was used across districts, but focusing particularly on one district with high percentages of teachers of color and low‐income multilingual families, the population hardest hit and dehumanized during COVID‐19. Analysis employed critical authentic cariño to explore teachers' authentic and aesthetic care that shifted over time—from focus on technologies and translators, pity, depersonalized objectives, and academic goals to warmer relationships, personalismo, relaxing together, reaching out, persistence, and advocacy. Results suggest ways to transform structures to better meet the needs of multilingual families by organizing around authentic care with families. [ABSTRACT FROM AUTHOR]

Introduction: Invasive meningococcal disease (IMD) has a low incidence but is a life-threatening illness with a 10–15% mortality rate. Even with timely treatment, survivors may experience acute and long-term health complications. While meningococcal vaccines are recommended for adolescents and young adults in the USA, vaccination coverage remains uneven across serotypes. This study investigated the physical, social, psychological, and economic burden of IMD on survivors and their caregivers in the USA during the acute phase (Part 1, presented in this manuscript) and the long-term phase (Part 2, presented in a separate manuscript) of IMD. Methods: This study implemented a non-interventional, mixed-methods approach using a bespoke survey and qualitative interviews (designed on the basis of a preliminary conceptual model of IMD) with US survivors and their caregivers. Results: A total of 11 survivors (1 adolescent, 10 adults) and 3 caregivers participated in the study. Survivors contracted IMD during infancy (n = 2), childhood (n = 3), or adulthood (n = 6), and often described leading healthy lives pre-IMD. At IMD onset, interactions with the healthcare system impacted participants' experiences; confusion and care delays were common, and procedures were often invasive (e.g., amputations). Survivors commonly experienced symptoms including skin rash (7/11), fever (6/11), and unconsciousness (6/11), consistent with caregivers' reports. Survivors able to report on the short-term impacts of IMD (n = 9) described functional limitations (9/9), emotional impacts (6/9) such as fear and trauma, and school (6/9), work (4/9), and financial (5/9) challenges. Caregivers also experienced emotional impacts (3/3) and family (2/3), work (3/3), and financial (3/3) impacts during the acute phase. Conclusions: IMD places a significant humanistic burden on survivors and their caregivers during the acute phase. Results from Part 1 of this study indicate a need for increased disease awareness and healthcare provider education, expeditious diagnosis, and improved access to prevention methods such as available meningococcal vaccines. A video abstract is available with this article. 7CedpUhoy_P6EE5C2Mz6-e Video abstract (MP4 1,24,432 kb) Plain Language Summary: Invasive meningococcal disease (IMD) is an uncommon but serious infection. Even with treatment, IMD is deadly for up to 10–15% of people who get sick, and survivors may experience short-term and long-term health problems. While IMD can be prevented through vaccination, many people are not vaccinated. We asked 11 survivors and 3 of their caregivers in the USA about their experiences with IMD during the time of their infection and initial recovery (the "short term"). We were particularly interested in the symptoms that survivors experienced, their diagnosis and treatment experiences, and the impact on survivors' and caregivers' quality of life. Most survivors described leading healthy lives before getting sick. Severe skin rash, fever, and unconsciousness were common symptoms when survivors got the infection. Most participants were admitted to the hospital when symptoms started (many through the emergency room). However, not everyone was diagnosed quickly or accurately, and many experienced delays in receiving care. Treatments could be drastic, such as immediate surgery to remove arms or legs. Survivors and caregivers described feeling scared and traumatized, and many experienced challenges with day-to-day activities. Healthcare-related expenses and the inability to attend school or work led to financial challenges for some. The burden of IMD infection and initial recovery is significant. There is a need for increased public disease awareness, targeted education for healthcare providers, and improved access to prevention measures such as vaccination. The long-term effects of IMD infection were also explored in this study, and are presented in another paper [1]. [ABSTRACT FROM AUTHOR]

Introduction: Invasive meningococcal disease (IMD) has a low incidence but is a life-threatening illness that is preventable via vaccination. Even with treatment, up to 10–15% of cases are fatal, and many survivors may experience severe long-term sequelae. Building upon the acute-phase findings presented in the Part 1 manuscript for this study, we describe the long-term physical, social, psychological, and economic burden of IMD on US survivors and their caregivers in this Part 2 manuscript. Methods: This was a novel, non-interventional, mixed-methods study among US survivors and their caregivers using a bespoke survey and qualitative interviews. Results: Ten adult survivors, one adolescent survivor, and three caregivers participated in this study. Survivors described extensive physical, neurological, and systemic sequelae, including difficulty walking (11/11), repeat secondary infections (9/11), and numbness (6/11), among others, which were echoed by caregivers. Survivors shared that IMD had negatively impacted their long-term quality of life, citing long-term impacts including emotional impacts (11/11), social impacts (10/11), memory (7/11) and attention (5/11) problems, and difficulty with functional (10/11), self-care (7/11), and physical (6/11) activities. Caregivers were also impacted, describing emotional trauma (3/3), sleep problems (2/3), and day-to-day challenges (2/3). Long-term financial challenges related to healthcare resource utilization were substantial, with specialized care and rehabilitation therapy expenses (11/11), insurance challenges (8/11), and high out-of-pocket costs (6/11) for survivors. Productivity losses were also commonly described by survivors (9/11); sequelae hindered ability to attend school (9/11) or work full time (8/11). Caregivers (2/3) described taking leave from their employment, affecting family income. Conclusions: The humanistic burden of IMD on survivors and their caregivers is substantial and persistent. A comprehensive approach, including preventative measures (e.g., vaccination) and long-term medical, psychological, and financial support for those affected, is needed to mitigate the burden of IMD. A video abstract is available with this article. -99uXpJYNLEniKmRRZ2d4e Video abstract (MP4 1,17,430 kb) Plain Language Summary: Invasive meningococcal disease (IMD) is an uncommon but life-threatening disease that can lead to serious long-term health problems and impacts on quality of life. We conducted this study to understand the experiences of survivors of IMD and their caregivers in the USA. In a previous paper, we described the experiences of 11 survivors and 3 caregivers during the time of IMD infection and initial recovery (the "short-term") [1]. Here, we continue to follow the journeys of those survivors and caregivers, and explore the health complications and impacts of IMD that persist long after initial recovery. Survivors experienced long-term physical, neurological, and systemic health problems due to IMD, such as difficulty walking, repeat infections, and numbness. Many shared that their quality of life had been negatively affected by IMD, describing memory and attention problems, social challenges, emotional trauma, and difficulty with daily activities. Caregivers were also impacted, experiencing sleep problems, distress, and day-to-day challenges. Even with insurance, specialized medical care and therapies were expensive and led to long-term financial challenges. Many survivors also found it difficult to attend school or work full-time because of their health limitations. Caregivers' ability to work was also limited because of caregiving needs, affecting ability to earn income. IMD places a heavy, long-term burden on survivors and their caregivers, and understanding the lived experiences of those affected is crucial. In addition to prevention (such as through vaccination), comprehensive, long-term medical, psychological, and financial support is needed to reduce the burden of this disease. [ABSTRACT FROM AUTHOR]

Background: We aim to describe the management and outcomes of patients with persistent lymphadenopathy (LAD) after primary chemoradiation for head and neck squamous cell carcinoma (HNSCC) based on post‐treatment PET/CT results. Methods: Retrospective chart review was conducted of all patients who underwent primary concurrent chemoradiation for HNSCC at a tertiary care center from 2010 to 2022 and had persistent post‐treatment LAD. Results: Nearly 62% of patients were managed conservatively, and 27.0% underwent neck dissection. PET‐positive patients were more likely to undergo neck dissection than PET‐negative patients (p = 0.042). Positive predictive value (PPV) and negative predictive values (NPV) of PET/CT in detecting residual disease in the neck were 48.0% and 73.7%, respectively. Conclusions: PPV and NPV of PET/CT for detecting residual neck disease in patients with post‐treatment LAD was lower than those of HNSCC patients with and without persistent LAD reported in other studies. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the scoping review is to develop understandings around the high demand for in-home healthcare for the aged and how to find ways to better support declining numbers of in-home care workers and healthcare professionals. The scoping review highlights the role of human resource management (HRM) in this sector. Design/methodology/approach: This scoping review of literature takes a systematic approach to identify themes on the aged care sector and levels of support for in-home care. We map the literature from specific databases to find themes. Findings: It is important for HRM of aged care service providers to understand the key issues around homecare workers and healthcare professionals. There are key issues for stakeholders, such as clients' health needs, organizations struggling to recruit and retain healthcare workers, and it is critical to know how such issues impact on clients and the healthcare workforce. Originality/value: There is a dearth of literature on in-home care for the aged, and therefore, we contribute to understandings about the competing pressures surrounding the demand for in-home care versus the declining number of homecare workers and professional healthcare workers in this sector. We highlight the lack of HRM support from aged care providers and the impact on homecare workers. [ABSTRACT FROM AUTHOR]

Purpose: Pre-pandemic research demonstrated the challenges of the nursing workforce and the provision of quality of patient care. Such challenges have been significantly intensified during the COVID-19 pandemic, not least in the workplace and fear of staff catching and transmitting COVID-19. We draw on conservation of resources (COR) theory to examine the impact of the fear of COVID-19 on nurses and the role of well-being-HRM (WBHRM) in negating the fear of COVID-19 and its impact on job stress and perceived quality of patient care. Design/methodology/approach: We collected data from 260 nurses (treating COVID-19 patients) employed in US hospitals across two-waves. Data were analyzed using mediated regression and moderated mediation. Findings: The results indicated that when nurses report higher levels of fear of COVID-19, this translates into higher levels of nursing job stress. This, in turn, reduces nurses' perceptions of quality of patient care they can provide. As previous research has found, decreased perceptions of quality of patient care is a significant factor driving intentions to leave the profession. The results demonstrated that WBHRM practices buffer the negative impact of fear of COVID-19 on job stress, and in turn, the perceived quality of patient care. Originality/value: Our paper contributes to new knowledge for healthcare managers on WBHRM bundles and their efficacy in buffering the effects of fear on job stress and quality of patient care. We contribute new knowledge on fear at work and how to manage employees' fear through WBHRM practices. [ABSTRACT FROM AUTHOR]

BACKGROUND: Isometric maximal voluntary force (IMVF) is essential for individuals' health and physical performance. Therefore, there is a need for valid and reliable devices to assess IMVF. OBJECTIVE: To determine the validity and reliability of the Valkyria Trainer Balance® portable force platform in its isometric mode. METHODS: Fifty-eight physically healthy individuals (30 men and 28 women) participated in the study. A repeated measures design was used to compare the inter-day test-retest reliability of peak force. The validity of the Valkyria Trainer Balance® force platform was determined by comparing the peak force with the ArtOficio® force platform. The analysis consisted of the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and coefficient of variation (CV). A CV ⩽ 10% and ICC ⩾ 0.80 were considered acceptable reliability, while a ⩽ 5% and ICC ⩾ 0.90 were regarded as high reliability. RESULTS: CV the peak force showed high test-retest inter-day reliability (CV = 4.3% and ICC = 0.99). When comparing both force platforms, there was a 1.1% difference between the two devices. CONCLUSIONS: The results of this study demonstrate that the Valkyria Trainer Balance® force platform is valid and reliable for assessing IMVF in physically healthy individuals. [ABSTRACT FROM AUTHOR]

This work presents an evaluation of CNN models and data augmentation to carry out the hierarchical localization of a mobile robot by using omnidirectional images. In this sense, an ablation study of different state-of-the-art CNN models used as backbone is presented and a variety of data augmentation visual effects are proposed for addressing the visual localization of the robot. The proposed method is based on the adaption and re-training of a CNN with a dual purpose: (1) to perform a rough localization step in which the model is used to predict the room from which an image was captured, and (2) to address the fine localization step, which consists in retrieving the most similar image of the visual map among those contained in the previously predicted room by means of a pairwise comparison between descriptors obtained from an intermediate layer of the CNN. In this sense, we evaluate the impact of different state-of-the-art CNN models such as ConvNeXt for addressing the proposed localization. Finally, a variety of data augmentation visual effects are separately employed for training the model and their impact is assessed. The performance of the resulting CNNs is evaluated under real operation conditions, including changes in the lighting conditions. Our code is publicly available on the project website https://github.com/juanjo-cabrera/IndoorLocalizationSingleCNN.git. [ABSTRACT FROM AUTHOR]

Background: Knowledge, attitudes, and practices related to oral health among parents play a crucial role in shaping oral hygiene and preventing early childhood caries. This study was intended to determine the effect of a neuroeducational strategy in improving knowledge, attitudes, and practices related to early childhood caries among mothers or caregivers of children. Methods: A quasi-experimental study was conducted, implementing an educational strategy involving 33 mothers or female caregivers of children who met specific selection criteria. The strategy consisted of three key elements derived from neuroeducation: (1) experiment, (2) surprise and play, and (3) learn. Based on the participants' attendance at the sessions, they were categorized into two groups: those who underwent in-person intervention (G1) and those who received a combined in-person and virtual intervention (G2). The impact of the strategy was evaluated by comparing the participants' knowledge and attitudes, as well as their children's plaque index, before and after the intervention (immediate and 6-month impact). Results: The participants exhibited a favorable and statistically significant effect on the median number of correct answers related to knowledge (G1 immediate effect (IE): p = 0.03, 6-month effect (ME): p = 0.002; G2 IE p = 0.002, ME: p = 0.001), and in the children's plaque index (G1 IE: p = 0.003, ME: p = 0.003; G2 IE: p = 0.033, ME: p = 0.003). Furthermore, there was an increase in the number of participants with a high level of knowledge (G1 IE: 41.5%; ME: 75%; G2 IE: 45.5%, ME: 42.9%), and of children with a good level of oral hygiene (G1 IE: 50%; ME: 73.0%; G2 IE: 27.3%, ME: 84.6%). Finally, qualitative interviews revealed a lasting clarity in concepts and sustained knowledge and attitudes at the six-month mark. However, a slightly diminished understanding of the relationship between bacteria, sugar, and caries was observed in G2 group, and some loss of association in the G1 group, at six months. Conclusion: The implementation of this strategy resulted in significant and lasting impacts on knowledge, attitudes, and practices, especially in the G1 group. Nevertheless, there is a need for further reinforcement of the association between bacteria, sugar, and caries. [ABSTRACT FROM AUTHOR]

Background: Rett syndrome (RTT), a developmental disorder primarily affecting girls and linked to methyl‐CpG binding protein‐2 (MECP2) gene mutations, presents musculoskeletal abnormalities with varying prevalence across studies and age groups. Our aim was to delineate the prevalence of orthopaedic conditions in individuals with RTT. Method: Three databases were searched and independently screened by two reviewers to retrieve observational studies published after 2000 that recruited 10 or more patients diagnosed with RTT and reported the prevalence of any orthopaedic conditions (scoliosis, hip displacement, knee problems or foot deformities). A random‐effects meta‐analysis was performed to determine the pooled prevalence based on study weight. Results: Of 867 screened studies, 21 studies involving 9997 girls with RTT (mean age 14.1 years; range, 3–38.5) met the inclusion criteria. The pooled prevalence of scoliosis was 64.5% [95% confidence interval (CI) 55.4–73.6%; I2 = 99%; P < 0.01], of hip displacement was 29.6% (95% CI 8.9–50.2%; I2 = 97%; P < 0.01) and of foot deformities was 53% (95% CI 17.5–89.2%; I2 = 98%; P < 0.01). Knee problems were reported in only one study. Scoliosis prevalence increased in studies with a high percentage of genetic testing and MECP2 positivity [69.1% (95% CI 58.9–79.2%; I2 = 99%; P < 0.01)], those with a mean age over 13 years [73% (95% CI 59.1–87%; I2 = 100%; P < 0.01)], and studies combining both variables [80.13% (95% CI 70.8–89.4%; I2 = 81%; P < 0.01)]. Conclusions: This meta‐analysis found that approximately two in three girls with RTT develop scoliosis, one in two exhibit foot deformities and one in three experience hip displacement. These findings enhance our understanding of the prevalence of orthopaedic conditions in RTT, which can guide the establishment of surveillance protocols, clinical guidelines and management strategies tailored to the needs of RTT patients. [ABSTRACT FROM AUTHOR]

A reconfigurable intelligent surface (RIS), a leading‐edge technology, represents a new paradigm for adaptive control of electromagnetic waves between a source and a user. While RIS technology has proven effective in manipulating radio frequency waves using passive elements such as diodes and MEMS, its application in the optical domain is challenging. The main difficulty lies in meeting key performance indicators, with the most critical being accurate and self‐adjusting positioning. This work presents an alternative RIS design methodology driven by an all‐silicon structure and fluid infiltration, to achieve real‐time control of focal length toward a designated user, thereby enabling secure data transmission. To validate the concept, both numerical simulations and experimental investigations of the RIS design methodology are conducted to demonstrate the performance of fluid‐infiltrated metalens‐driven RIS for this application. When combined with different fluids, the resulting ultra‐compact RIS exhibits exceptional varifocal abilities, ranging from 0.4 to 0.5 mm, thereby confirming the adaptive tuning capabilities of the design. This may significantly enhance the modulation of optical waves and promote the development of RIS‐based applications in wireless communications and secure data‐transmission integrated photonic devices. [ABSTRACT FROM AUTHOR]

This study explores the impact of artificial intelligence (AI) on brand communication within corporate social networks, analyzing its benefits, ethical and technical challenges, and proposing responsible implementation strategies enriched with new theoretical contributions. To achieve this, a systematic literature review (SLR) was conducted based on the SPAR-4-SLR methodology by Paul et al. (2021), using 57 studies from Scopus and Web of Science over the past six years. This approach was complemented with recommendations from Kitchenham and Charters (2007) to ensure rigor and thoroughness in the analysis. The study reveals that artificial intelligence transforms interactions within corporate social networks by enabling effective personalization, optimizing customer experience, and enhancing satisfaction. Benefits include precise segmentation, predictive analytics, and customer service optimization through chatbots. However, significant ethical challenges also emerge, such as data privacy, algorithmic bias, and a lack of transparency in AI models. The necessity for responsible practices and regulations that foster user trust and mitigate risks associated with the implementation of AI in digital communication strategies is emphasized. [ABSTRACT FROM AUTHOR]

The document provides a comprehensive overview of the diagnosis, monitoring, and treatment of anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) with renal involvement, focusing on granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). It outlines the definitions, clinical presentation, histopathological classification, monitoring strategies, induction and maintenance treatments, as well as special considerations for relapsing, refractory, and frail patients with renal AAV. The document was prepared by the Catalan Group for the Study of Glomerular Diseases (GLOMCAT), which comprises nephrologists with extensive experience in the diagnosis and treatment of AAV patients. Several virtual and face-to-face meetings were held for coordination, section assignments, and content discussion. An exhaustive and systematic search of the literature was carried out, which included, among others, the following databases: PubMed, EMBASE, Cochrane Library, Google Scholar, and ClinicalTrials.gov, as well as the abstract books of national and international congresses. Overall, the document provides a comprehensive guide for clinicians managing patients with renal AAV, offering evidence-based recommendations for diagnosis, monitoring, and treatment across various clinical scenarios. [ABSTRACT FROM AUTHOR]

Objectives: Persistent Postural-Perceptual Dizziness (PPPD) is a frequent diagnosis in patients with chronic dizziness, ineffective postural control, visual dependence, and emotional symptoms. Methods: 53 patients with PPPD (25–84 years old) and 53 adults (29–84 years old) with no vestibular disease agreed to participate in this study. Assessments included: vestibular function tests (sinusoidal yaw rotation and vestibular-evoked myogenic potentials); accuracy and precision of Subjective Visual Vertical (SVV) estimation while static and during on-axis yaw rotation; static posturography with open/closed eyes and 30° neck extension, while standing on hard/soft surface; questionnaires on symptoms of unsteadiness, spatial anxiety, dizziness-related handicap, anxiety/depression, depersonalization/derealization, and perceived stress. After preliminary bivariate analyses, analysis of covariance was performed on the measurements of postural sway, spatial anxiety, and dizziness-related handicap (p < 0.05). Results: Higher intraindividual variability (reduced precision) on SVV estimations was evident in patients with PPPD compared to adults with no vestibular disease, which was related to the length of postural sway, to velocity displacement in the sagittal plane, as well as to spatial anxiety and common mental symptoms (including depersonalization/derealization symptoms). Covariance analysis showed contribution of these factors to the dizziness-related handicap reported by the patients. Conclusions: Unprecise graviception could be a contributing factor to the postural instability and mental symptoms reported by patients with PPPD, which in turn contribute to their dizziness-related handicap. [ABSTRACT FROM AUTHOR]

Featured Application: Microencapsulated pomegranate juice can be used as a preventive and palliative treatment of metabolic syndrome. Pomegranate juice possesses therapeutic properties against metabolic syndrome. Microencapsulation of pomegranate juice (MPJ) may extend its shelf life; however, further research is necessary to ascertain its comparative efficacy with fresh juice. This work evaluated the effect of MPJ in an animal model with induced metabolic syndrome (MetS). MetS was induced in Male Wistar rats by administering 30% sucrose orally for 22 weeks. Once MetS was verified in the animals, seven groups were formed as follows: control (Ctrl); MetS; MetS + Placebo; Ctrl + MPJ; MetS + MPJ1 600; MetS + MPJ2 1800; and MetS + MPJ3 2900 mg/kg. Systolic and diastolic blood pressure, glucose, triglycerides, and total HDL-c levels in the MetS + MPJ groups improved significantly (p < 0.05) vs. the MetS group at the end of the study. Microencapsulation maintained the anti-metabolic-syndrome properties of pomegranate juice and could be used to control metabolic syndrome. [ABSTRACT FROM AUTHOR]

Resistance to systemic therapies in sarcomas poses a significant challenge to improving clinical outcomes. Recent research has concentrated on the tumor microenvironment's role in sarcoma progression and treatment resistance. This microenvironment comprises a variety of cell types and signaling molecules that influence tumor behavior, including proliferation, metastasis, and resistance to therapy. Adenosine, abundant in the tumor microenvironment, has been implicated in promoting immunosuppression and chemoresistance. Targeting adenosine receptors and associated pathways offers a novel approach to enhancing immune responses against tumors, potentially improving immunotherapy outcomes in cancers, including sarcomas. Manipulating adenosine signaling also shows promise in overcoming chemotherapy resistance in these tumors. Clinical trials investigating adenosine receptor antagonists in sarcomas have fueled interest in this pathway for sarcoma treatment. Ultimately, a comprehensive understanding of the tumor and vascular microenvironments, as well as the adenosine pathway, may open new avenues for improving treatment outcomes and overcoming resistance in sarcoma. Further studies and clinical trials are crucial to validate these findings and optimize therapeutic strategies, particularly for osteosarcoma. This study provides a literature review exploring the potential role of the adenosine pathway in sarcomas. [ABSTRACT FROM AUTHOR]

Blood pressure (BP) is one of the most prominent indicators of potential cardiovascular disorders. Traditionally, BP measurement relies on inflatable cuffs, which is inconvenient and limit the acquisition of such important health-related information in general population. Based on large amounts of well-collected and annotated data, deep-learning approaches present a generalization potential that arose as an alternative to enable more pervasive approaches. However, most existing work in this area currently uses datasets with limitations, such as lack of subject identification and severe data imbalance that can result in data leakage and algorithm bias. Thus, to offer a more properly curated source of information, we propose a derivative dataset composed of 380 hours of the most common biomedical signals, including arterial blood pressure, photoplethysmography, and electrocardiogram for 1,524 anonymized subjects, each having 30 segments of 30 seconds of those signals. We also validated the proposed dataset through experiments using state-of-the-art deep-learning methods, as we highlight the importance of standardized benchmarks for calibration-free blood pressure estimation scenarios. [ABSTRACT FROM AUTHOR]

Education on the selection of low-sugar ultra-processed foods (UPF) plays a crucial role in promoting good oral health. This study aimed to assess the impact of a virtual educational strategy, developed in the field of dentistry, on improve Knowledge, Attitudes, and Practices (KAPs) related to oral health and the appropriate selection of sweet-tasting UPF. A quasi-experimental study with a pre-test and post-test design was conducted, involving parents and caregivers of children and pre-adolescents. Thirteen virtual learning objects (VLO) were delivered via Facebook. To measure the impact of the strategy, a validated instrument was used before the intervention, immediately after, and again six months later to assess Knowledge, Attitudes, and Practices (KAPs) on the subject. The median scores before and after the intervention were compared using the Friedman test for related samples, followed by multiple comparisons with Dunn's test. Participants' KAP levels were analyzed using Pearson's Chi-square test and multiple comparisons of column proportions with Bonferroni correction. Finally, a satisfaction and applicability survey was conducted. A significant improvement (p < 0.01) was observed in the participants' median KAP scores both immediately after the intervention and six months later. A greater number of participants reached the highest level in knowledge (Before (B): 43.8%, Immediately After (IA): 86%, After six months (A6): 81.3%), attitudes (B: 34.2%, IA: 69.4%, A6: 65.2%), and practices (B: 22.5%, IA: 53.7%, A6: 47.3%). Most participants described the course as consistently dynamic, well-organized, and appropriate timing. They also expressed their intention to apply the knowledge in their daily lives. The implemented strategy improved participants' KAPs concerning oral health and the appropriate selection of sweet-tasting UPF. It also resulted in participants' children consuming fewer sweet bakery products, candies, and flavored milk. Additionally, more participants reported consistently reading food labels after the intervention, although this behavior was not adopted by the majority. [ABSTRACT FROM AUTHOR]

To date, there is no licensed vaccine against the protozoan parasite Trypanosoma cruzi (T. cruzi) , the etiological agent of Chagas Disease. T. cruzi has evolved numerous mechanisms to evade and manipulate the host immune system. Among the subversive strategies employed by the parasite, marked increases in CD11b+ Gr-1+ myeloid-derived suppressor cells (MDSCs) in several organs have been described. We have reported that CD11b+ Gr-1+ cells are involved not only during infection but also after immunization with a trans-sialidase fragment (TSf) adjuvanted with a cage-like particle adjuvant (ISPA). Thus, the aim of this work was to gain control over the involvement of MDSCs during immunization to potentiate a vaccine candidate with protective capacity in multiple mouse models of T. cruzi infection. Here, we show that the Gr-1+ cells that increase during TSf-ISPA immunization have suppressive capacity over bone marrow-derived dendritic cells and CD4+ lymphocytes. Protocols using one or two doses of 5-fluorouracil (5FU) were employed to deplete and control MDSC dynamics during immunization. The protocol based on two doses of 5FU (double 5FU TSf-ISPA) was more successful in controlling MDSCs during immunization and triggered a higher immune effector response, as evidenced by increased numbers of CD4+, CD4+CD44+, CD8+, CD8+CD44+, CD11c+, and CD11c+CD8α+ cells in the spleen and lymph nodes of double 5FU TSf-ISPA mice as compared to 5FU-TSf-ISPA mice. In line with these results, the protective capacity of the double 5FU TSf-ISPA protocol was higher compared to the 5FU-TSf-ISPA protocol against high lethal doses of intraperitoneal infection with the Tulahuen T. cruzi strain. When cross-protective capacity was analyzed, the optimized protocol based on double 5FU TSf-ISPA conferred protection in several preclinical models using different discrete typing units (DTU VI and DTU I), different mouse strains (BALB/c and C57BL/6), different parasite doses (1000 to 20000), and routes of administration (intraperitoneal and intradermal). Developing vaccines that are currently lacking may require new strategies to further potentiate vaccine candidates. Results reported herein provide evidence that rational control of cells from the regulatory arm of the immune system could enhance a vaccine candidate with cross-protective capacity in multiple mouse models of T. cruzi infection. [ABSTRACT FROM AUTHOR]

Background: Depression and anxiety are prevalent in older adults with cancer but are often undertreated. Older adults are also at increased risk of chemotherapy toxicity (CT). This study evaluated the impact of depression and anxiety symptoms on severe CT risk in older adults with cancer. Methods: This is a secondary analysis of a randomized trial (2:1) evaluating geriatric assessment–driven intervention (GAIN) versus standard of care (SOC) to reduce grade 3+ CT in older adults with cancer. Mental health was assessed via the Mental Health Inventory 13. CT was graded by National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. Results: A total of 605 patients enrolled (402 GAIN; 203 SOC). Overall, 35% were depressed and 47% were anxious. Patients with depression had increased CT in the SOC arm (70.7% vs. 54.3%; p =.02) but not in the GAIN arm (54.3% vs. 48.5%; p =.27). CT was more likely in SOC patients with depression (odds ratio [OR], 2.03; 95% CI, 1.10–3.72). This association persisted after adjusting for Cancer and Aging Research Group toxicity score (OR, 1.98; 95% CI, 1.07–3.65) and for demographic, disease, and treatment factors (OR, 2.00; 95% CI, 1.03–3.85). Depression and CT were not associated in the GAIN arm (OR, 1.26; 95% CI, 0.84–1.91). Anxiety and CT were not associated in either arm. Conclusions: Elevated depression symptoms are associated with increased risk of severe CT in older adults with cancer, which was mitigated with GAIN. This suggests that treating depression symptoms may lower toxicity risk. Future studies are needed to confirm and investigate the impact of depression‐specific interventions on outcomes. Depression symptoms are associated with increased risk of severe chemotherapy toxicities in older adults with cancer. This risk is mitigated in those who receive geriatric assessment–driven interventions. [ABSTRACT FROM AUTHOR]

Background: Podoconiosis is an underreported lymphoedema whose distribution is uncertain at global level and within endemic countries. Previous work has identified countries with historical evidence of podoconiosis, but which do not currently report cases. Podoconiosis may persist in these countries or have been eliminated due to socioeconomic development. Here we describe two different approaches used to clarify podoconiosis endemicity status in Guatemala and in Idukki District (Kerala State, India). Methods: Two different epidemiological approaches were used by different research teams, determined by the available resources and contextual factors in the two settings. In Guatemala, where lymphoedema cases are routinely recorded in the health information system, 102 municipalities with suspected cases, historical evidence of podoconiosis, high poverty rates, or environmental suitability for the disease were visited. Active case searches were conducted from July 2016 to October 2018, and suspected cases were clinically examined to confirm or rule out podoconiosis. In Idukki, where lymphoedema cases were not routinely recorded, a population-based prevalence survey for lymphoedema was conducted from September to December 2022, covering 13,664 individuals aged 15 years and older. Results: Both approaches were effective at clarifying podoconiosis endemicity. In Guatemala, 20 cases with lower limb swelling were investigated. Podoconiosis was ruled out in all cases, and filarial lymphoedema was suspected in three. In Idukki District, 105 cases of lower limb swelling were identified. None was confirmed to have podoconiosis, with post-surgical lymphoedema and hypertension being the most common diagnoses. Active filarial infection was identified in two cases in Idukki District. Conclusions: These investigations provide evidence that podoconiosis is currently non-endemic in Guatemala and in Idukki District in India. They also demonstrate that population-based surveys and targeted case searches both provide effective ways to explore disease endemicity in areas where this is uncertain. The most appropriate approach depends on a combination of contextual and research-based factors, including evidence for endemicity, resources available, and geographical, population, and health system factors. [ABSTRACT FROM AUTHOR]

Introduction: Endometriosis is a chronic gynecological disease associated with chronic debilitating pain, poor mental health and quality of life. The objective of this paper is to evaluate the effectiveness of psychological interventions aimed at improving the pain, quality of life and mental health of women with endometriosis. Methods: A systematic review (SR) of the literature with meta-analysis (MA) was carried out. MEDLINE, Embase, PsycINFO and CENTRAL were searched to locate Randomized Controlled Trials (RCTs). The risk of bias assessment of each study was conducted using the Cochrane Collaboration's RoB 2.0 tool. Results: Seven RCTs were included (N = 757). The data obtained suggest that psychological interventions reduce dyspareunia [standardized mean difference (SMD): -0.54, 95% CI: −0.86, −0.22] and dyschezia [mean difference (MD): -2.90, 95% CI: −4.55, −1.26] and increase mental health levels (SMD: 0.70, 95% CI: 0. 42, 0.99); they also point to a large reduction in levels of trait anxiety (MD: -6.63, 95% CI: −8.27, −4.99) and depression (MD: -2.49, 95% CI: −3.20, −1.79), and a likely reduction in state anxiety (MD: -9.72, 95% CI: −13.11, −6.33) experienced by women with endometriosis. It was also identified that psychological interventions probably slightly reduce pelvic pain and may increase physical health. However, most of the included studies have a high overall risk of bias or have certain concerns, which limit conclusions about the certainty of the evidence. Discussion: The available evidence indicates that psychological interventions are effective in improving the pain, quality of life and mental health variables of women with endometriosis. Systematic review registration: https://www.crd.york.ac.uk/prospero/, CRD42024516100. [ABSTRACT FROM AUTHOR]