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Cement is one of the most widely used materials in the global construction industry, serving as an adhesive and binder in projects that require strength and durability. Additionally, cement production indicates a country's development and economic activity, with global production reaching approximately 4 billion tons annually. It is a fine powder composed mainly of lime, silica, iron oxide, and alumina. Portland cement is the most common type, although a wide variety of types of cement differ in their chemical composition, providing them with specific properties for different applications. A set of fifty samples, consisting of eleven primary samples and thirty-nine blends formed by the combination of these eleven samples, was prepared. Additionally, twenty-four samples were randomly selected for error covariance calculation. Subsequently, two analytical techniques, laser-induced breakdown spectroscopy (LIBS) and energy dispersive X-ray fluorescence (ED-XRF) were applied to quantify aluminum (Al), calcium (Ca), iron (Fe), potassium (K), magnesium (Mg), sodium (Na), and sulfur (S). Afterward, the samples were analyzed via ICP OES after acid mineralization with 8 mL aqua regia in a digester block. Multivariate calibration strategies such as principal component regression (PCR), maximum likelihood principal component regression (MLPCR), partial least-squares regression (PLS), and error covariance penalized regression (ECPR) were employed. Finally, figures of merit were calculated to verify the most suitable models. The results revealed robust models with notable sensitivity, ranging from 0.3 to 329 signal a.u (% w w -1 ) -1 ), low limits of detection (LoD) within the range of 0.00-0.1 % w w -1 , and remarkable accuracy ranging from 67.8 % to 140.3 %, particularly for Ca, Fe, Mg, and Na. This research takes an essential step in developing simple analytical methods with low waste generation and less environmental impact, thanks to using novel chemometric techniques to process the data., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Despite Latin America's rich biodiversity, active genetic material conservation programs are scarce. This study investigates potential freezability markers in both sperm and seminal plasma (SP) in Chino Santandereano, a Colombian Creole breed. Thirty ejaculates from ten Chino Santandereano bulls were cryopreserved and subsequently classified as of good (GFE) or poor (PFE) freezability according to their post-thaw total sperm motility (TMOT) and plasma membrane integrity (PMI). Sperm cholesterol and NPC2 protein levels in SP were measured prior to cryopreservation using colorimetric detection, densitometric quantification, and Western blot. Sperm functional competence (SFC), a functional test, was evaluated before and after cryopreservation. Correlation and t-student tests, a binomial regression model and two multiple linear regression models were utilized to evaluate the predictive power of NPC2 protein and sperm related variables. Two bands (14 kDa and 15 kDa) for NPC2 protein were identificated. NPC2 14 kDa is associated with a significant decrease in freezability (P < 0.01). The TMOT in fresh semen highly significant (P < 0.01) for sperm freezability and the interaction between NPC2 14 kDa and cholesterol content in sperm was significant (P < 0.01). Correlation between SFC and TMOT and PMI post-thaw (P < 0.01), along with the significantly different values between PFE and GFE (P < 0.05) were observed. We can conclude that NPC2 protein as a marker for sperm freezability of Chino Santandereano bull, and this depends on sperm content of cholesterol. In addition, our findings support the utility SFC combined tests in providing a precise assessment of sperm freezability., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2025 Elsevier B.V. All rights reserved.)

Background: Aortic regurgitation (AR) is a well-known cause of impaired outcome in patients with centrifugal left ventricular assist devices (cfLVADs). The failure of the aortic valve (AV) to open at least intermittently is associated with cusp remodeling, commissural fusion, and ultimately developing AR. Our aim was to characterize patients in whom AV opening (AVO) was preserved 6 months after implantation and identify determinants related to it., Methods and Results: We conducted standardized echocardiography and collected clinical and laboratory tests at the outpatient clinic 6 months after implantation. We classified patients into those showing intermittently opening of the AV, every 2-3 beats, or in every cycle (AVO) and those whose AV was continuously closed (NAVO). From the 219 cfLVAD implanted in our center between March 2018 and January 2020, 156 subjects were alive and on the device after 6 months. In 2 of the reviewed echocardiograms, we could not evaluate the AV. 99 patients (64%) showed AVO compared to 55 (36%) with NAVO. The first presented higher mean arterial pressure (84 ± 10 vs. 77 ± 13 mm Hg, p = 0.002), larger LV end-diastolic diameter (LVEDD 57.5 ± 12 vs. 52.7 ± 13 mm, p = 0.022), a better TAPSE (15 ± 4 vs. 13 ± 4 mm, p = 0.028), and less frequently significant AR than patients with NAVO (moderate/severe AR in 6% vs. in 20%, p = 0.042). In a multiple logistic regression, a lower NYHA Class, a larger LVEDD, and a better LV ejection fraction appeared as significant predictors of AVO. After a median follow-up of 3.2 years, we found no significant impact on survival stratifying patients by AVO (log-rank p = 0.53)., Conclusion: AVO was associated with better RV function, lower NYHA Class, and a lower rate of significant AR. This could indicate that AVO should be pursued in LVAD patients., (© 2024 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.)

Objectives: The aim of the study is to assess the changes in the pediatric care of patients seen in the Pediatric Emergency Departments (PED) during the bronchiolitis season following the introduction of immunization with a monoclonal antibody against RSV (nirsevimab)., Methods: An observational, retrospective, multicenter study was conducted, analyzing the Bronchiolitis Registry of the Spanish Society of Pediatric Emergency Medicine. This registry, containing data on bronchiolitis cases, was initiated in December 2022. A total of 30 hospitals participated, all of which are members of the Spanish Society of Pediatric Emergency Medicine. Data from a 26-day period in 2 bronchiolitis seasons (2022: preimmunization and 2023: postimmunization) were included. Variables regarding health care burden were recorded for both periods. Quantitative variables were described using mean and SD, and the Student t test was used for comparisons between the 2 periods., Results: Twenty-five hospitals from 11 autonomous communities were included with a mean of 47,811 PED visits/year (SD: 26,675). The number of bronchiolitis cases presenting to the PED and bronchiolitis-related admissions decreased by 41.6%(95% CI: 34.9%-48.2%) and 55.4% (95% CI: 46.6%-64.2%), respectively, while admissions for RSV bronchiolitis decreased by 60.3% (95% CI: 51.9%-68.7%). Admissions to pediatric intensive care units decreased by 81.3% (95% CI: 57.9%-100%). Furthermore, the occupancy rate in the pediatric intensive care units decreased by 30% (95% CI: 22.8%-37.3%), while a reduction of 22.4% (95% CI: 13.2%-31.5%) was observed in the occupancy rate of observation units. The number of bronchiolitis cases transferred to other hospitals decreased by 73.4% (95% CI: 29.0%-100%). Finally, there was a 60.9% (95% CI: 26.5%-95.3%) reduction in the need for high-flow oxygen therapy among bronchiolitis patients., Conclusions: After the introduction of nirsevimab, a large portion of indicators related to the burden of care associated with bronchiolitis during its epidemic season decreased significantly., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Immune checkpoint inhibitors (ICIs) have improved clinical outcomes in patients with non-small cell lung cancer (NSCLC) lacking targetable oncogenic alterations. However, their efficacy in individuals with such genomic alterations remains heterogeneous and poorly understood. In detail, certain oncogenic alterations in TP53, EGFR (uncommon mutations), KRAS (G12C), BRAF (non-V600E), MET (amplifications), FGFR1 and FGFR4, actively modify MAPK, PI3K, and STING signaling, thus remodeling tumoral immune phenotype and are associated with high TMB counts, enriched T lymphocyte tumor infiltration, and high expression of antigen-presenting molecules, supporting their consideration as part of the eligibility criteria for ICIs treatment. Nonetheless, other oncogenic alterations are associated with an immunosuppressive TME, low TMB counts, and downregulation of targetable immune checkpoints, in which novel therapeutic approaches are currently being tested to overcome their intrinsic resistance. In this context, this review discusses the fundamental mechanisms by which frequent driver alterations affect ICIs efficacy in patients with NSCLC, and outlines their prognostic relevance in the era of immunotherapy., Competing Interests: Declarations. Competing interests: Oscar Arrieta reports receiving personal fees from Pfizer, Lilly, Merck, and Bristol-Myers Squibb and grants, as well as personal fees from AstraZeneca, Boehringer Ingelheim, and Roche, but none of these are related to this manuscript. The rest of authors declare no affiliations with, or involvement in, any organization any financial interest in the subject matter or materials discussed in this manuscript., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Probabilistic models in physics often require the evaluation of normalized Boltzmann factors, which in turn implies the computation of the partition function Z . Obtaining the exact value of Z , though, becomes a forbiddingly expensive task as the system size increases. A possible way to tackle this problem is to use the Annealed Importance Sampling (AIS) algorithm, which provides a tool to stochastically estimate the partition function of the system. The nature of AIS allows for an efficient and parallel implementation in Restricted Boltzmann Machines (RBMs). In this work, we evaluate the partition function of magnetic spin and spin-like systems mapped into RBMs using AIS. So far, the standard application of the AIS algorithm starts from the uniform probability distribution and uses a large number of Monte Carlo steps to obtain reliable estimations of Z following an annealing process. We show that both the quality of the estimation and the cost of the computation can be significantly improved by using a properly selected mean-field starting probability distribution. We perform a systematic analysis of AIS in both small- and large-sized problems, and compare the results to exact values in problems where these are known. As a result, we propose two successful strategies that work well in all the problems analyzed. We conclude that these are good starting points to estimate the partition function with AIS with a relatively low computational cost. The procedures presented are not linked to any learning process, and therefore do not require a priori knowledge of a training dataset.

Ice-free areas are habitats for most of Antarctica's terrestrial biodiversity. Although fungal communities are an important element of these habitats, knowledge of their assemblages and ecological functions is still limited. Herein, we investigated the diversity, composition, and ecological functionality of fungal communities inhabiting sediments from ice-free areas across pristine and anthropogenically impacted sites in the Fildes Peninsula on King George Island, Antarctica. Samples were collected from both pristine and disturbed areas. We used the internal transcribed spacer (ITS1) region via Illumina sequencing of 34 sediment samples for fungal identification. The Ascomycota (14.6%) and Chytridiomycota (11.8%) were the most dominant phyla, followed by Basidiomycota (8.1%), Rozellomycota (7.0%), Mucoromycota (4.0%), while 34.9% of the fungal diversity remained unidentified. From a total of 1073 OTUs, 532 OTUs corresponded to 114 fungal taxa at the genus level, and 541 OTUs remained unassigned taxonomically. The highest diversity, with 18 genera, was detected at site A-3. At the genus level, there was no preference for either pristine or disturbed sites. The most widely distributed genera were Betamyces (Chytridiomycota), occurring in 29 of the 34 sites, and Thelebolus (Ascomycota), detected in 8 pristine sites and 7 disturbed sites. The Glomeraceae gen. incertae sedis was more common in disturbed sites. A total of 23 different ecological guilds were recorded, with the most abundant guilds being undefined saprotrophs, plant pathogens, plant saprotrophs, pollen saprotrophs, and endophytes. The fungal communities did not show significant differences between pristine and disturbed sites, suggesting that the anthropogenic impact is either not too intense or prolonged, that the spatial distance between the sampled sites is small, and/or that the environmental factors are similar. Although our study revealed a high fungal diversity with various ecological specializations within these communities, nearly one-third of the diversity could not be assigned to any specific taxonomic category. These findings highlight the need for further taxonomic research on fungal species inhabiting ice-free areas. Without identifying the species present, it is difficult to assess potential biodiversity loss due to environmental changes and/or human activities., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Garnica et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Endoscopy is vital for detecting and diagnosing gastrointestinal diseases. Systematic examination protocols are key to enhancing detection, particularly for the early identification of premalignant conditions. Publicly available endoscopy image databases are crucial for machine learning research, yet challenges persist, particularly in identifying upper gastrointestinal anatomical landmarks to ensure effective and precise endoscopic procedures. However, many existing datasets have inconsistent labeling and limited accessibility, leading to biased models and reduced generalizability. This paper introduces GastroHUN, an open dataset documenting stomach screening procedures based on a systematic protocol. GastroHUN includes 8,834 images from 387 patients and 4,729 labeled video sequences, all annotated by four experts. The dataset covers 22 anatomical landmarks in the stomach and includes an additional category for unqualified images, making it a valuable resource for AI model development. By providing a robust public dataset and baseline deep learning models for image and sequence classification, GastroHUN serves as a benchmark for future research and aids in the development of more effective algorithms., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Introduction: Low back pain is one of the main causes of medical consultation worldwide, with heterogeneous management in the request for complementary methods. This study sought to determine the frequency and clinical and imaging characteristics of patients with low back pain in a tertiary hospital, considering the presence or absence of red flags., Materials and Methods: A retrospective analytical study was carried out at the Private University Hospital of Córdoba. Patients over 18 years of age who consulted for the first time for low back pain between January and June 2021 were included, excluding pregnant and those without complete records., Results: A total of 880 patients were included. Of these, 589 (67%) presented acute low back pain, 112 (13%) subacute and 179 (20%) chronic. Simple low back pain was the most common cause (n=652, 74%), followed by herniated disc (n=179, 20%) and spondylolisthesis (n=33, 4%). Red flags were identified in 190 (22%) patients according to American College of Radiology (ACR) criteria and in 420 (48%) according to the Agency for Health Care Policy and Research (AHCPR). Imaging studies were performed in 314 (75%) patients with AHCPR criteria and 255 (55%) with ACR criteria. Neoplasia/infection and vertebral fracture were diagnosed in 2 (2%) and 5 (9%) patients with red flags, respectively., Discussion: The first consultation for low back pain represented 1.8% of consultations, with acute low back pain being more frequent. Obesity was the most common comorbidity. About half of the patients had red flags according to AHCPR and 21% according to ACR.

The aging of the population is raising the need to make structural changes in the National Health System. First, the need to increase geriatric services in all hospitals. Second, implement and integrate intermediate care (IC), and Third and last, guarantee medical care in long-term care. IC is characterized by a wide range of resources located between acute hospital care and primary care, which include hospitalization devices, both with and without admission or confinement, home and outpatient care, which help to provide continuity and time-limited transition of care. The main objective of IC is an integral (multidimensional) and integrated (interdisciplinary and coordinated between different care levels) care of the older adults, based on the specialized geriatric care. The integration of the IC in the current health system is based on the establishment of two coordinated work dynamics with primary care and acute hospital care, AI becoming key, inside several devices, to prevent hospital admissions (prevent entry -Step Up- focus to give access to primary care to avoid unnecessary hospital admissions) and to facilitate early discharge in acute hospitals (Step Down- focus to promote the best autonomy and functional recovery after a complex acute care). With these objectives in mind, as members of the Intermediate Care Group of the Spanish Society of Geriatrics and Gerontology, the authors propose the following work aiming to revise the current status of available IC resources in Spain, to analyze the context, historical background and its conceptual framework. All these will allow to highlight the undeniable value of IC to healthcare professionals and managers., Competing Interests: Conflicto de intereses Los autores declaran no tener ningún conflicto de intereses., (Copyright © 2024. Publicado por Elsevier España, S.L.U.)

Since their discovery, multicomponent reactions have attracted significant attention due to their versatility and efficiency. This review aims to explore the latest advancements in isocyanate-based multicomponent reactions and the sophisticated chemical opportunities they present for generating molecules of interest. The added value of the methodologies described, supported by mechanism schemes, as well as scopes of application, will be discussed. These developments will be organised as the main accessible chemical functions and sorted according to their type of MCR (3, 4 or 5-MCR)., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Background/Objectives: Current scientific evidence shows both the relationship between good physical condition and a lower incidence of certain chronic diseases (including smoking), as well as the efficacy of cytisinicline. The aim of this protocol is to evaluate the efficacy of the synergistic effect of the combination of targeted physical exercise, together with brief advice and taking the drug cytisinicline, to achieve smoking cessation. Methods : We propose an experimental, multicentre, randomised, controlled study with two parallel arms to be carried out by a multidisciplinary team in the primary care setting of the Andalusian public health system (APHS) in Spain, with a follow-up of 12 months. The population sample will include people who are aged between 18 and 65 years and meet the criteria to be eligible for treatment with cytisinicline financed by the APHS: smokers of 10 or more cigarettes per day who are in the determination/action phase for smoking cessation of the transtheoretical model of Prochaska and Diclemente, willing to start anti-smoking treatment imminently and confirmed, with high dependence to nicotine (Fagerström's test ≥ 7), with a motivation to quit smoking according to the Richmond test (≥6), and who have made a previous smoking cessation attempt in the last year. The study consists of two treatment arms. EXPERIMENTAL ARM: Smokers who are going to be prescribed targeted physical exercise and brief advice to stop smoking while receiving cytisinicline treatment (1.5 mg tablets) according to the care process. CONTROL ARM: Smokers will receive a standard leaflet explaining physical exercise to the general population and brief advice on smoking cessation when starting cytisinicline treatment, according to the care process. The calculated sample size is 75 participants per arm. Results: The primary results will allow us to estimate the efficacy of prescribing physical exercise as an adjuvant therapy to classic multicomponent treatment, incorporating it as an additional element to be considered when it is accepted by the smoker. Conclusions: This protocol (NCT06579846) evaluates the efficacy of combining physical exercise, brief advice, and cytisinicline to support smoking cessation, improve fitness, and reduce smoking-related comorbidities.

Objective: To evaluate the utility of low-cost simulation models to teach surgical techniques for placenta accreta spectrum (PAS), included in a multimodal education workshop for PAS., Methods: This was an observational, survey-based study. Participants were surveyed before and after the use of low-fidelity mannequins to simulate two surgical techniques for PAS (one-step conservative surgery [OSCS] and modified subtotal hysterectomy [MSTH]), within a multimodal educational workshop. The workshops included pre-course preparation, didactics, simulated practice of the techniques using low-cost models, and viewing live surgery., Results: Six OSCS/MSTH training workshops occurred across six countries and a total of 270 participants were surveyed. The responses of 127 certified obstetricians and gynecologists (OB-GYNs) were analyzed. Participants expressed favorable impressions of all components of the simulated session. Perceived anatomical simulator fidelity, scenario realism, educational component effectiveness, and self-assessed performance improvement received ratings of 4-5 (positive end of the Likert scale) from over 90% of respondents. When asked about simulation's role in technique comprehension, comfort level in technique performance, and likelihood of recommending this workshop to others, more than 75% of participants rated these aspects with a score of 4-5 (positively) on the five-point scale., Conclusion: Low-cost simulation, within a multimodal education strategy, is a well-accepted intervention for teaching surgical techniques for PAS., (© 2024 International Federation of Gynecology and Obstetrics.)

Background: Switching to biosimilars is an effective and safe practice in treating inflammatory diseases; however, a nocebo effect may arise as a result of the way in which the switch is communicated to a given patient., Objective: We aimed to design a gaming-based digital educational tool (including a discussion algorithm) to support the training of health care professionals in efficiently communicating the switch to biosimilars, minimizing the generation of a nocebo effect and thus serving as an implementation strategy for the recommended switch., Methods: The tool was developed based on interviews and focus group discussions with key stakeholders, both patients and health care professionals. Messages likely to either generate trust or to trigger a nocebo effect were generated on the basis of the interviews and focus group discussions., Results: A total 7 clinicians and 4 nurses specializing in rheumatology, gastroenterology, and dermatology, with balanced levels of responsibility and experience, as well as balance between geographic regions, participated in the structured direct interviews and provided a list of arguments they commonly used, or saw used, to justify the switching, and objections given by the patients they attended. Patients with immune-mediated inflammatory diseases who were taking biologic drugs with (n=4) and without (n=5) experience in switching attended the focus groups and interviews. Major topics of discussion were the reason for the change, the nature of biosimilars, and their quality, safety, efficacy, and cost. Based on these discussions, a list of objections and of potential arguments was produced. Patients and health care professionals rated the arguments for their potential to evoke trust or a nocebo effect. Two sets of arguments, related to savings and sustainability, showed discrepant ratings between patients and health care professionals. Objections and arguments were organized by categories and incorporated into the tool as algorithms. The educators then developed additional arguments (with inadequate answers) to complement the valid ones worked on in the focus groups. The tool was then developed as a collection of clinical situations or vignettes that appear randomly to the user, who then has to choose an argument to counteract the given objections. After each interaction, the tool provides feedback. The tool was further supported by accredited medical training on biosimilars and switching., Conclusions: We have developed a digital training tool to improve communication on switching to biosimilars in the clinic and prevent a nocebo effect based on broad and in-depth experiences of patients and health care professionals. The validation of this implementation strategy is ongoing., (© Carlos Marras, María Labarga, Daniel Ginard, Jose Manuel Carrascosa, Alejandro Escudero-Contreras, Eduardo Collantes-Estevez, Fernando de Mora, Tamara Robles, Elisa Romero, Rafael Martínez. Originally published in JMIR Formative Research (https://formative.jmir.org).)

In the 2024 PAPPS update, we present preventive activities specific to women's health, except those related to cancer prevention (which are included in another document) and aspects related to differential morbidity of gender, which is a cross-cutting element for all working groups. Contraception is an essential preventive activity; the right to decide both the number of children that they will have and when to have them is considered basic. We must inform about contraceptive methods, guaranteeing in follow-up their safety, efficacy, and effectiveness (tables are included on changing from one method to another to preserve contraceptive protection). We must inform about emergency contraception and propose it in in the event of unprotected intercourse. We will use opportunistic screening to do this, without needing to screen for thrombophilia or dyslipidaemia, but we will screen for hypertension. Pregnancy is a major life experience and general practitioners should not ignore it. We should be competent at both preconception consultation (recommend folic acid intake, avoiding exposure to occupational and environmental hazards, screen for certain pathologies, and assess the intake of medication not indicated during pregnancy) and during follow-up of pregnancy. Whether or not we follow-up the pregnancy, we should not fail to monitor it, taking advantage of this period to promote healthy lifestyles and manage potential intercurrent events. Menopause in general and osteoporosis in particular exemplify the strategy of medicalising life events that has been followed by different bodies and organisations. In our update we address the prevention and treatment of symptoms secondary to oestrogen deprivation. We also propose osteoporosis prevention, including bone density scanning according to the fracture risk in the next 10 years, therefore, bone density screening is not recommended in women under 60 years of age. We recommend the FRAX tool for assessing risk, or better, measuring hip fracture risk with prevalence data from the Community of Madrid. The indication for treatment is linked to the Z-score (bone mineral density compared with women of the same age), since this is a condition associated with aging, and not the T-score, which is used to compare women of 20 years of age., (Copyright © 2024. Publicado por Elsevier España S.L.U.)

Introduction: Introduction: the combination of cesarean section delivery and limited exposure to full breastfeeding (FBF) in the first six months of life may increase the risk of obesity and diabetes mellitus. This study aimed to establish an association between type 2 diabetes mellitus (T2DM) in adulthood, cesarean section delivery and incomplete full breastfeeding (FBF) in individuals from the metropolitan area of Guadalajara, Mexico. Methodology: this analytical cross-sectional study included patients over 18 years of age with T2DM and normal weight, overweight or obesity, regardless of sex. Informed consent was obtained. Variables encompassed T2DM, type of delivery method, first-year diet, family history, demographic, socioeconomic, and educational characteristics, and anthropometric measurements. For statistical analysis, Student's t test, chi-square tests and odds ratios were employed. Results: the study evaluated 218 patients with an average age of 57.8 years (± 12.7) and an average age at T2DM diagnosis of 46.2 years (± 12.5). FBF (65.6 %) and partial breastfeeding (PBF) (23.8 %) prevailed in the first six months. The average age at T2DM diagnosis was 46.7 years (± 12.1) for vaginally born patients and 30.7 years (± 15.5) for cesarean-born patients (p = 0.001). Cesarean delivery increased obesity risk by nine times in patients with T2DM [OR = 8.9 (CI, 1.05, 75.2), p = 0.02]. Conclusion: prioritizing the limitation of nonmedically justified cesarean section deliveries is crucial to mitigate the risk of obesity and T2DM in adulthood. .

WEMAC is a unique open multi-modal dataset that comprises physiological, speech, and self-reported emotional data records of 100 women, targeting Gender-based Violence detection. Emotions were elicited through visualizing a validated video set using an immersive virtual reality headset. The physiological signals captured during the experiment include blood volume pulse, galvanic skin response, and skin temperature. The speech was acquired right after the stimuli visualization to capture the final traces of the perceived emotion. Subjects were asked to annotate among 12 categorical emotions, several dimensional emotions with a modified version of the Self-Assessment Manikin, and liking and familiarity labels. The technical validation proves that all the targeted categorical emotions show a strong statistically significant positive correlation with their corresponding reported ones. That means that the videos elicit the desired emotions in the users in most cases. Specifically, a negative correlation is found when comparing fear and not-fear emotions, indicating that this is a well-portrayed emotional dimension, a specific, though not exclusive, purpose of WEMAC towards detecting gender violence., (© 2024. The Author(s).)

Animals' fitness is determined in a large proportion by the balance in energetic requirements maintained during daily activities, in response to environmental factors. Predation is a major environmental factor influencing the activity patterns of prey, and the deployment of adaptive responses to predation represents a significant cost to prey populations and communities. Experimental removal of predators to study the effect on activity patterns of prey is impractical for vertebrate species. However, islands are often deprived of predators and provide an excellent arena to study prey's responses in the absence of any cue related to predation risk. Here, we investigated whether natural absence of predators in islands has influenced the activity patterns of diurnal agoutis in Panama, by monitoring activity in three sites in each habitat type (predator-free vs predator). We predicted that agoutis in predator-free sites can expand their activity patterns towards the night, which is the period of highest predation risk, in sites with predators. One of our predator-free sites showed relative high activity at night, with no evidence of nocturnality in sites with predators. A clear pattern across our three predator-free sites was that agoutis started their daily activity earlier, before sunrise, which is a period with significant predation risk as well. Our study highlights the role that felids play in regulating agoutis' daily activity patterns and we discuss the implications of our finding. Finally, we also offer a review on agoutis' activity pattern in the Neotropics., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Dumas Galvez reports financial support was provided by SENACYT. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Surgical-related incidents are a common cause of in-hospital adverse events. Surgical patient safety would benefit from evidence-based practices, but a comprehensive collection of patient safety recommendations is still lacking. This study aimed to compile and assess the perioperative patient safety recommendations for adults., Method: A systematic review of clinical practice guidelines was conducted using Medline, Embase, Cochrane, Virtual Health Library Regional Portal, and Trip Database from 2012 to 2022. Eligibility criteria followed a PICAR strategy for patient safety recommendations in the perioperative care continuum. Guidelines were appraised for quality, particularly focusing on the 'rigour of development' domain of the AGREE-II tool for those containing strong recommendations. Descriptive analyses were conducted, emphasizing guideline quality, recommendation strength, and the supporting level of evidence., Results: From the 267 guidelines, 4666 perioperative patient safety recommendations were extracted, of which 44.9% (2095) were strongly recommended. Of these, 322 had the highest level of evidence, but only 18 guidelines met high standards in the AGREE-II 'rigour of development' domain. A subset of 78 recommendations ranked the highest in the strength of recommendation, level of evidence, and rigour of development of their guidelines. A gap was found within pre-admission and post-discharge care recommendations., Discussion: This review highlights the noteworthy variability in the methodological quality of the guidelines, and a discordance between strength of recommendation and evidence level of the available perioperative patient safety recommendations. These findings provide valuable information for advising policy decisions and promoting best practices to enhance global surgical safety., Registration: PROSPERO (CRD42022347449)., (© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.)

There are hereditary mutations that predispose individuals to cancer development, such as pathogenic variants in the germ line of the tumor protein 53 ( TP53 ) suppressor gene. This leads to a rare condition known as Li-Fraumeni syndrome (LFS), characterized by a high risk of developing multiple cancers throughout life by the precancerous niche that promotes the tumor microenvironment. LFS presents a significant challenge due to its limited therapeutic and chemoprophylactic options. Recently, protocols involving metformin as a prophylactic medication have been developed to target precancerous niches. However, this approach is still in the clinical phase, and no established therapeutic regimen is available. Therefore, new alternatives are needed to impact this disease effectively. Novel studies suggest that Sechium extract, rich in polyphenols, exhibits chemoprophylactic, antineoplastic, anti-inflammatory, and antioxidant activities, all involved in the tumor microenvironment of LFS. However, the specific role of Sechium extract in preventing recurrent neoplastic development in LFS remains unclear. We conducted this research through a case report of an LFS-diagnosed patient who has experienced multiple malignancies and cutaneous neoformations. This patient received a chemoprophylactic supplementation based on Sechium H387 07 extract over 11 years without reporting new primary malignancy events or recurrences, as evidenced by laboratory and positron emission tomography/computed tomography (PET/CT) studies. An extensive literature review on the disease, precancerous niche, tumor microenvironment, and potential mechanisms of Sechium H387 07 extract components was conducted to explain cancer absence in LFS. This review promotes the research and use of polyphenols as powerful chemoprophylactic agents to prevent and treat proliferative diseases like LFS.

Introduction: Magnetic resonance imaging (MRI) is crucial for diagnosing and monitoring of multiple sclerosis (MS) as it is used to assess lesions in the brain and spinal cord. However, in real-world clinical settings, MRI scans are often acquired with thick slices, limiting their utility for automated quantitative analyses. This work presents a single-image super-resolution (SR) reconstruction framework that leverages SR convolutional neural networks (CNN) to enhance the through-plane resolution of structural MRI in people with MS (PwMS)., Methods: Our strategy involves the supervised fine-tuning of CNN architectures, guided by a content loss function that promotes perceptual quality, as well as reconstruction accuracy, to recover high-level image features., Results: Extensive evaluation with MRI data of PwMS shows that our SR strategy leads to more accurate MRI reconstructions than competing methods. Furthermore, it improves lesion segmentation on low-resolution MRI, approaching the performance achievable with high-resolution images., Discussion: Results demonstrate the potential of our SR framework to facilitate the use of low-resolution retrospective MRI from real-world clinical settings to investigate quantitative image-based biomarkers of MS., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Giraldo, Khan, Pineda, Liang, Lozano-Castillo, Van Wijmeersch, Woodruff, Lambin, Romero, Peeters and Sijbers.)

The co-occurrence of externalizing and internalizing problems is acknowledged, but gender differences remain unclear. The present study examines gender differences in the longitudinal relationships between conduct and emotional problems throughout childhood. The sample, drawn from the ELISA project, included 2368 children (48.1% girls; ages 3-12). Latent growth curve models were employed to analyze the trajectories of parent-reported conduct problems and emotional symptoms separately, while parallel process latent growth curve models were utilized to compare joint trajectories. The decrease in conduct problems was consistent for girls, but not for boys. High initial emotional symptoms predicted a slower increase in emotional symptoms over time for girls. Parental positivity was a protective factor for conduct problems in girls. Grandiose-deceitful traits were more related to conduct problems in girls, while callous-unemotional traits were related to emotional symptoms in boys. This study highlights the importance of considering gender in childhood conduct and emotional problems., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Stable transgenesis is a transformative tool in model organism biology. Although the sea urchin is one of the oldest animal models in cell and developmental biology, studies in this animal have largely relied on transient manipulation of wild animals, without a strategy for stable transgenesis. Here, we build on recent progress to develop a more genetically tractable sea urchin species, Lytechinus pictus, and establish a robust transgene integration method. Three commonly used transposons (Minos, Tol2 and piggyBac) were tested for non-autonomous transposition, using plasmids containing a polyubiquitin promoter upstream of a H2B-mCerulean nuclear marker. Minos was the only transposable element that resulted in significant expression beyond metamorphosis. F0 animals were raised to sexual maturity, and spawned to determine germline integration and transgene inheritance frequency, and to characterize expression patterns of the transgene in F1 progeny. The results demonstrate transgene transmission through the germline, the first example of a germline transgenic sea urchin and, indeed, of any echinoderm. This milestone paves the way for the generation of diverse transgenic resources that will dramatically enhance the utility, reproducibility and efficiency of sea urchin research., Competing Interests: Competing interests The authors declare no competing or financial interests., (© 2024. Published by The Company of Biologists Ltd.)

Objective: Our study aimed to evaluate the effectiveness of an intervention based on Motivational Interviewing (MI) performed by healthcare professionals in Primary Care (PC) patients with risky alcohol use through a multicenter, two-arm parallel, cluster-randomized, open-label controlled clinical trial., Methods: PC professionals were randomized into two groups: an Experimental Group (EG) and a Control Group (CG). The study was carried out in PC centers of the Andalusian Health Service, located in Cordoba, Spain. An MI-based approach was implemented with patients recruited in the EG, while health advice was provided to those included in the CG. The follow-up period was 12 months, with five visits scheduled. The consumption of standard drinking units per week was quantified, and risky alcohol use was estimated using the Alcohol Use Disorders Identification Test (AUDIT). An intention-to-treat statistical analysis was performed. Relative risk (RR), absolute risk reduction (ARR) and the number of subjects needed to treat (NNT) were used to estimate the intervention effect size., Results: A total of 268 patients were included, 148 in the EG and 120 in the CG. Considering the quantification of risky alcohol use, the ARR at 12 months after baseline visit was 16.46% (95% CI: 5.37-27.99), with an NNT of 6 (95% CI: 4-19). According to the AUDIT, the ARR at 12 months was 13.15% (95% CI: 2.73-24.24%), and the NNT was 8 (95% CI: 4-37)., Conclusions: We concluded that MI is more effective than the usual health advice in decreasing risky alcohol use in patients treated in PC.

The quantum-mechanical nuclear-shell structure determines the stability and limits of the existence of the heaviest nuclides with large proton numbers Z ≳ 100 (refs. 1-3 ). Shell effects also affect the sizes and shapes of atomic nuclei, as shown by laser spectroscopy studies in lighter nuclides 4 . However, experimental information on the charge radii and the nuclear moments of the heavy actinide elements, which link the heaviest naturally abundant nuclides with artificially produced superheavy elements, is sparse 5 . Here we present laser spectroscopy measurements along the fermium (Z = 100) isotopic chain and an extension of data in the nobelium isotopic chain (Z = 102) across a key region. Multiple production schemes and different advanced techniques were applied to determine the isotope shifts in atomic transitions, from which changes in the nuclear mean-square charge radii were extracted. A range of nuclear models based on energy density functionals reproduce well the observed smooth evolution of the nuclear size. Both the remarkable consistency of model prediction and the similarity of predictions for different isotopes suggest a transition to a regime in which shell effects have a diminished effect on the size compared with lighter nuclei., (© 2024. The Author(s).)

Fungi have a unique metabolic plasticity allowing them to produce a wide range of natural products. Since the discovery of penicillin, an antibiotic of fungal origin, substantial efforts have been devoted globally to search for fungal-derived natural bioactive products. Andean region forests represent one of the few undisturbed ecosystems in the world with little human intervention. While these forests display a rich biological diversity, mycological and chemical studies in these environments have been scarce. This review aims to summarise all the efforts regarding the chemical or bioactivity analyses of Agaricomycetes (Basidiomycota) from southern South America environments. Overall, herein we report a total of 147 fungal species, 21 of them showing chemical characterisation and/or biological activity. In terms of chemical cores, furans, chlorinated phenol derivatives, polyenes, lactones, terpenes and himanimides have been reported. These natural products displayed a range of biological activities including antioxidant, antimicrobial, antifungal, neuroprotective and osteoclast-forming suppressing effects.

BackgroundSweden reached the UNAIDS 90-90-90 target in 2015. It is important to reassess the HIV epidemiological situation due to ever-changing migration patterns, the roll-out of PrEP and the impact of the COVID-19 pandemic.AimWe aimed to assess the progress towards the UNAIDS 95-95-95 targets in Sweden by estimating the proportion of undiagnosed people with HIV (PWHIV) and HIV incidence trends.MethodsWe used routine laboratory data to inform a biomarker model of time since infection. When available, we used previous negative test dates, arrival dates for PWHIV from abroad and transmission modes to inform our incidence model. We also used data collected from the Swedish InfCareHIV register on antiretroviral therapy (ART).ResultsThe yearly incidence of HIV in Sweden decreased after 2014. In part, this was because the fraction of undiagnosed PWHIV had decreased almost twofold since 2006. After 2015, three of four PWHIV in Sweden were diagnosed within 1.9 and 3.2 years after infection among men who have sex with men and in heterosexual groups, respectively. While 80% of new PWHIV in Sweden acquired HIV before immigration, they make up 50% of the current PWHIV in Sweden. By 2022, 96% of all PWHIV in Sweden had been diagnosed, and 99% of them were on ART, with 98% virally suppressed.ConclusionsBy 2022, about half of all PWHIV in Sweden acquired HIV abroad. Using our new biomarker model, we assess that Sweden has reached the UNAIDS goal at 96-99-98.

Energetically favorable local interactions can overcome the entropic cost of chain ordering and cause otherwise flexible polymers to adopt regularly repeating backbone conformations. A prominent example is the α helix present in many protein structures, which is stabilized by i , i + 4 hydrogen bonds between backbone peptide units. With the increased chemical diversity offered by unnatural amino acids and backbones, it has been possible to identify regularly repeating structures not present in proteins, but to date, there has been no systematic approach for identifying new polymers likely to have such structures despite their considerable potential for molecular engineering. Here we describe a systematic approach to search through dipeptide combinations of 130 chemically diverse amino acids to identify those predicted to populate unique low-energy states. We characterize ten newly identified dipeptide repeating structures using circular dichroism spectroscopy and comparison with calculated spectra. NMR and X-ray crystallographic structures of two of these dipeptide-repeat polymers are similar to the computational models. Our approach is readily generalizable to identify low-energy repeating structures for a wide variety of polymers, and our ordered dipeptide repeats provide new building blocks for molecular engineering.

The construction sector is presently among the most resource-intensive industries, driving a substantial body of research dedicated to the development of more sustainable materials to address these demands. A particularly promising approach within the framework of the circular economy is the repurposing of waste as a principal raw material for the creation of new construction products. Within this context, the primary aim of this study is to engineer ceramic materials for brick production using 100% waste-derived inputs, specifically aggregate washing sludge and manganese mining by-products. To evaluate the potential of these sustainable ceramic materials, an extensive investigation was conducted, encompassing both physical and mechanical testing, as well as a thorough characterisation of the waste inputs. For this purpose, a series of ceramic specimens were fabricated with varying proportions of mining residues and aggregate washing sludge, adhering to the conventional protocols employed in the manufacture of ceramic bricks. The results demonstrate that these sustainable ceramics exhibit a linear shrinkage reduction of up to 5% compared to traditional clay-based ceramics. Furthermore, they show water absorption levels-whether via capillarity, cold water, or hot water absorption-that are up to twice those observed in conventional clay ceramics, while maintaining comparable density values. This increased absorption, however, correlates with a reduction in mechanical strength at higher concentrations of manganese waste, yet the material continues to meet the minimum strength requirements as specified by industry standards for such products. In conclusion, this research introduces a novel, sustainable ceramic material that not only reduces economic and environmental costs but also adheres to the required performance criteria for construction applications.

Nanomechanical oscillators are an alternative platform for computation in harsh environments. However, external perturbations arising from such environments may hinder information processing by introducing errors into the computing system. Here, we simulate the dynamics of three coupled Duffing oscillators whose multiple equilibrium states can be used for information processing and storage. Our analysis reveals that, within experimentally relevant parameters, error correcting dynamics can emerge, wherein the system's state is robust against random external impulses. We find that oscillators in this configuration have several surprising and attractive features, including dynamic isolation of resonators exposed to extreme impulses and the ability to correct simultaneous errors., (© 2024. The Author(s).)

Purpose: Triple-negative breast cancer (TNBC) is a highly aggressive subtype of breast cancer that lacks effective diagnostic and therapeutic options. Membrane type 1 matrix metalloproteinase (MT1-MMP) is an attractive biomarker for improving patient selection. This study aimed to develop a theranostic tool using a highly tumour-selective anti-MT1-MMP antibody (LEM2/15) radiolabelled with 89 Zr for PET and 177 Lu for therapy in a TNBC murine model., Methods: The LEM2/15 antibody and IgG isotype control were radiolabelled with 89 Zr. PET imaging was performed in a TNBC orthotopic mouse model at 1, 2, 4, and 7 days after administration. Tissue biodistribution and pharmacokinetic parameters were analysed and Patlak linearisation was used to calculate the influx rate of irreversible uptake. The TNBC mice were treated with [ 177 Lu]Lu-DOTA-LEM2/15 (single- or 3-dose regimen) or saline. Efficacy of [ 177 Lu]Lu-DOTA-LEM2/15 was evaluated as tumour growth and DNA damage (γH2AX) in MDA 231-BrM2-831 tumours., Results: At 7 days post-injection, PET uptake in tumour xenografts revealed a 1.6-fold and 2.4-fold higher tumour-to-blood ratio for [ 89 Zr]Zr-Df-LEM2/15 in the non-blocked group compared to the blocked and IgG isotype control groups, respectively. Specific uptake of LEM2/15 in TBNC tumours mediated by MT1-MMP-binding was demonstrated by the Patlak linearisation method, providing insights into the potential efficacy of LEM2/15-based treatments. A similar uptake was found for [ 89 Zr]Zr-Df-LEM2/15 and [ 177 Lu]Lu-DOTA-LEM2/15 in tumours 7 days post-injection (6.80 ± 1.31 vs. 5.61 ± 0.66 %ID/g). Tumour doubling time was longer in the [ 177 Lu]Lu-DOTA-LEM2/15 3-dose regimen treated group compared to the control (50 vs. 17 days, respectively). The percentage of cells with γH2AX-foci was higher in tumours treated with [ 177 Lu]Lu-DOTA-LEM2/15 3-dose regimen compared to tumours non-treated or treated with [ 177 Lu]Lu-DOTA-LEM2/15 single-dose (12 % vs. 4-5 %)., Conclusions: The results showed that the 89 Zr/ 177 Lu-labelled anti-MT1-MMP mAb (LEM2/15) pair facilitated immune-PET imaging and reduced tumour growth in a preclinical TNBC xenograft model., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To assess the feasibility, acceptability, and preliminary impact of Kick Vaping among Latino young adults., Methods: Forty Latino young adults (ages 18 to 25) who were currently vaping received Kick Vaping , a vaping cessation text messaging intervention available in English and Spanish. Feasibility was measured by the eligibility, enrollment, and follow-up rates. Acceptability was measured by overall satisfaction with the intervention. Preliminary impact was measured by self-reported 7-day point prevalence abstinence and changes in self-efficacy., Results: Two hundred three individuals were identified, 61 were assessed for eligibility, and 55 were eligible. Forty individuals consented to participate and were enrolled in Kick Vaping . At baseline, most participants used disposable devices (70%), vaped daily (97.5%), had low (37.5%) or medium (35.0%) e-cigarette dependence, and had attempted to quit in the past year (72.5%). At Month 3, the follow-up rate was 90% (36/40). Treating those lost to follow-up as participants who continued vaping, 75% (30/40) of participants self-reported 7-day point prevalence abstinence. Self-efficacy mean scores significantly increased from 30.65 (SD 8.07) at baseline to 50.11 (SD 10.57) at follow-up ( p  < 0.01). Most participants (88.9%, 32/36) reported being satisfied/extremely satisfied with Kick Vaping ., Conclusion: It is feasible to recruit and retain Latino young adults in a vaping cessation text messaging intervention. Kick Vaping generated high satisfaction among Latino young adults, significantly increased self-efficacy, and resulted in a notable vaping cessation rate at Month 3. Additional testing in a randomized controlled trial is warranted to assess the efficacy of the intervention.

Computed tomography (CT) is used as a valuable tool for device selection for interventional therapy in tricuspid regurgitation (TR). We aimed to evaluate predictors of TR reduction using CT and automated deep learning algorithms. Patients with severe to torrential TR and CTs prior to either percutaneous annuloplasty (PA) or tricuspid transcatheter edge-to-edge repair (T-TEER) were enrolled. CTs were analyzed using automated deep learning algorithms to assess tricuspid valve anatomy, right heart morphology, and function. Outcome parameters comprised post-interventional TR ≤ 1 and all-cause mortality. 84 patients with T-TEER (n = 32) or PA treatment (n = 52) were enrolled. Patients with a post-interventional TR ≤ 1 presented lower tenting heights and smaller tenting angles compared to patients with a TR > 1. Tenting height showed the best accuracy for post-interventional TR > 1 with an AUC of 0.756 (95% CI 0.560-0.951) in the T-TEER and 0.658 (95% CI 0.501-0.815) in the PA group, consistent with a suggested threshold of 6.8 mm and 9.2 mm, respectively. Patients with a post-interventional TR ≤ 1 exhibited a mortality of 4% and those with a TR > 1 of 12% during a follow-up of 331 ± 300 and 370 ± 265 days, respectively (p = 0.124). To conclude, tenting is associated with procedural outcomes and should be considered during screening for interventional TR therapy., (© 2024. The Author(s).)

Introduction: Peripheral arterial disease is a marker of vascular damage that is diagnosed by measuring the ankle-brachial index. The aim of this study was to determine the validity and agreement of the MESI ABPI-MD and Microlife WatchBP® office-ABI oscillometric devices with respect to the gold standard arterial Doppler., Materials and Methods: Observational, cross-sectional, descriptive study of inpatients who underwent ABI measurement with the three devices. Values are considered normal between 1-1.4, indeterminate between 0.91-0.99 and pathological ≤0.9 and >1.4., Results: A total of 187 patients (54.4% male) with a mean age of 66 years were included. The Doppler results were inferior to those of the oscillometric devices (median [IQR] 1.1 [0.2] vs. 1.2 [0.2], P<.05), with no significant differences between the automated devices (P=.29 for the right lower limb and P=.342 for the left lower limb). Both devices had high specificity (96.5-99.2%) and low sensitivity (29.5-45.4%). The correlation of the results was good-moderate for MESI and moderate for Microlife. The agreement between the two was acceptable-moderate., Conclusion: Automated oscillometric devices could be useful in asymptomatic patients as an alternative to arterial Doppler., (Copyright © 2024 Elsevier España, S.L.U. All rights reserved.)

Introduction: Pathogenic or likely pathogenic germline variants (PGVs) in cancer predisposition genes may play a role in lung cancer (LC) susceptibility. However, determining an eligible population for genetic testing remains uncertain. This study aimed to assess the prevalence of PGVs in a selected cohort of individuals with lung adenocarcinoma., Methods: A cross-sectional cohort study was conducted to assess the PGVs rate in lung adenocarcinoma patients with a family history of LC, young-onset presentation, history of never/light smoking, or actionable genomic alterations (AGAs). Sequencing was performed using Sophia Hereditary Cancer Solution panel F, including 144 cancer predisposition genes. Variants classified as pathogenic or likely pathogenic were included for further analysis., Results: Of 201 patients, 43 (21.4 %) exhibited PGVs, among which 64.5 % were DNA damage repair genes, and 86.1 % were clinically actionable. The main PGVs were in ATM (9.3 %), TP53 (6.9 %), BRCA2 (6.9 %), and CHEK2 (6.9 %) genes. PGVs were associated with male sex (adjusted odds ratio [aOR] 2.46, 95 % CI 1.15-5.32, p = 0.021), along with a trend toward association with AGAs (aOR 6.04, 95 % CI 0.77-49.74, p = 0.094)., Conclusions: In this study, a high PGVs prevalence was identified based on our selection criteria, which represents an effective strategy to identify candidates for germline genomic testing, potential screening strategies in close relatives, and personalized therapeutic modalities. Our results warrant further exploration in other populations to confirm them., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Oscar Arrieta reports receiving personal fees from Pfizer, Lilly, Merck, and Bristol-Myers Squibb and grants, as well as personal fees from AstraZeneca, Boehringer Ingelheim, and Roche, but none of these are related to this submitted manuscript. The rest of the authors declare no affiliations with, or involvement in, any organization or any financial interest in the subject matter or materials discussed in this manuscript., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background/objectives: Neck circumference (NC) has been proposed as a simple measurement to identify patients with overweight and obesity. It has been found that adipose tissue at the cervical level is associated with the presence of metabolic alterations. The aim of this study was to estimate the association between NC and indicators of Metabolic Syndrome (MS) to subsequently estimate its capacity to identify the risk of MS compared to waist circumference (WC) and Body Mass Index (BMI)., Methods: A cross-sectional study was carried out with a sample of 286 children 6-9 years old who attended six public primary schools in Jalisco, Mexico. Pearson's correlation coefficients along with sensitivity and specificity tests were performed to analyze the relationship between NC and MS indicators. Odds ratio (OR) and concordance analyses were performed considering the Kappa index., Results: NC showed statistically significant correlations with all MS indicators except for LDL cholesterol and total cholesterol. The cut-off points of NC to identify MS according to sex was >27.4 cm for girls and >29.8 cm for boys. The association of NC with values above the cutoff point and the presence of MS was OR: 21.6 (CI: 7.11-65.74)., Conclusions: NC represents a simple and cost-effective alternative to identify children at risk of MS when compared to BMI and WC.

This brief report describes findings from a single case withdrawal design study which explored the impact of training and emailed video prompts to promote a teacher's implementation of a culturally responsive teaching plan in a therapeutic school. Data collectors gathered implementation data as well as observed students' academic engagement and disruptive behavior. The teacher also provided self-report data regarding student outcomes. Results indicated that, overall, training and emailed video prompts demonstrated improvement in the teacher's implementation of the classroom plan as well as student behavior. However, the improvement in dependent variables was more discernible from the first Phase A to Phase B than the second A to B phase change. To build upon these results, we describe that additional research is needed to generalize findings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Neck circumference (NC) has been proposed as an indicator of upper trunk adiposity and a potential indicator of metabolic risk. The objective was to evaluate NC and its correlation with body fat percentage (BF%) and other indicators of adiposity in children with normal weight, overweight, and obesity., Methods: In a cross-sectional study, 112 children 5 to 10 years of age were included in the outpatient clinic from a public hospital. Measures of weight and height to calculate BMI (kg/m 2 ), NC, mid-upper arm circumference, waist circumference, and tricipital skinfold thickness. Body composition measurements were performed using an electrical bioimpedance device (BIA). The relationship between anthropometric variables and BF% obtained by BIA was determined using Spearman correlation tests. Multivariate models were constructed with BF% as the dependent variable and anthropometric parameters as independent., Results: In the entire group, there was a direct correlation between NC and BF% (r = 0.50, p < 0.001), but lost statistical significance in the case of normal weight. The relationship maintained its significance in subjects from the overweight and obesity groups. In multivariate models, BMI exhibited the highest correlation with BF%, followed by waist circumference and mid-upper arm circumference; for NC, the R 2 value was 0.30 ( p < 0.001)., Conclusions: Neck circumference is useful in the screening of population groups with the advantage of not requiring any specialized instruments for its measurement other than a tape measure. BMI and waist circumference were the best indicators of general and central adiposity, respectively.

Cytomorphology evaluation of bone marrow cell is the initial step to diagnose different hematological diseases. This assessment is still manually performed by trained specialists, who may be a bottleneck within the clinical process. Deep learning algorithms are a promising approach to automate this bone marrow cell evaluation. These artificial intelligence models have focused on limited cell subtypes, mainly associated to a particular disease, and are frequently presented as black boxes. The herein introduced strategy presents an engineered feature representation, the region-attention embedding, which improves the deep learning classification performance of a cytomorphology with 21 bone marrow cell subtypes. This embedding is built upon a specific organization of cytology features within a squared matrix by distributing them after pre-segmented cell regions, i.e., cytoplasm, nucleus, and whole-cell. This novel cell image representation, aimed to preserve spatial/regional relations, is used as input of the network. Combination of region-attention embedding and deep learning networks (Xception and ResNet50) provides local relevance associated to image regions, adding up interpretable information to the prediction. Additionally, this approach is evaluated in a public database with the largest number of cell subtypes (21) by a thorough evaluation scheme with three iterations of a 3-fold cross-validation, performed in 80% of the images ( n  = 89,484), and a testing process in an unseen set of images composed by the remaining 20% of the images ( n  = 22,371). This evaluation process demonstrates the introduced strategy outperforms previously published approaches in an equivalent validation set, with a f1-score of 0.82, and presented competitive results on the unseen data partition with a f1-score of 0.56., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Eduardo Romero reports financial support was provided by Colombia Ministry of Science Technology and Innovation. Jonathan Tarquino reports a relationship with Colombia Ministry of Science Technology and Innovation that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article., (© 2024 The Authors.)

Natural photosystems couple light harvesting to charge separation using a 'special pair' of chlorophyll molecules that accepts excitation energy from the antenna and initiates an electron-transfer cascade. To investigate the photophysics of special pairs independently of the complexities of native photosynthetic proteins, and as a first step toward creating synthetic photosystems for new energy conversion technologies, we designed C 2 -symmetric proteins that hold two chlorophyll molecules in closely juxtaposed arrangements. X-ray crystallography confirmed that one designed protein binds two chlorophylls in the same orientation as native special pairs, whereas a second designed protein positions them in a previously unseen geometry. Spectroscopy revealed that the chlorophylls are excitonically coupled, and fluorescence lifetime imaging demonstrated energy transfer. The cryo-electron microscopy structure of a designed 24-chlorophyll octahedral nanocage with a special pair on each edge closely matched the design model. The results suggest that the de novo design of artificial photosynthetic systems is within reach of current computational methods., (© 2024. The Author(s).)

Colonoscopy is the choice procedure to diagnose, screening, and treat the colon and rectum cancer, from early detection of small precancerous lesions (polyps), to confirmation of malign masses. However, the high variability of the organ appearance and the complex shape of both the colon wall and structures of interest make this exploration difficult. Learned visuospatial and perceptual abilities mitigate technical limitations in clinical practice by proper estimation of the intestinal depth. This work introduces a novel methodology to estimate colon depth maps in single frames from monocular colonoscopy videos. The generated depth map is inferred from the shading variation of the colon wall with respect to the light source, as learned from a realistic synthetic database. Briefly, a classic convolutional neural network architecture is trained from scratch to estimate the depth map, improving sharp depth estimations in haustral folds and polyps by a custom loss function that minimizes the estimation error in edges and curvatures. The network was trained by a custom synthetic colonoscopy database herein constructed and released, composed of 248400 frames (47 videos), with depth annotations at the level of pixels. This collection comprehends 5 subsets of videos with progressively higher levels of visual complexity. Evaluation of the depth estimation with the synthetic database reached a threshold accuracy of 95.65%, and a mean-RMSE of 0.451cm, while a qualitative assessment with a real database showed consistent depth estimations, visually evaluated by the expert gastroenterologist coauthoring this paper. Finally, the method achieved competitive performance with respect to another state-of-the-art method using a public synthetic database and comparable results in a set of images with other five state-of-the-art methods. Additionally, three-dimensional reconstructions demonstrated useful approximations of the gastrointestinal tract geometry. Code for reproducing the reported results and the dataset are available at https://github.com/Cimalab-unal/ColonDepthEstimation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Introduction: Adverse events in health care affect 8% to 12% of patients admitted to hospitals in the European Union (EU), with surgical adverse events being the most common types reported., Aim: SAFEST project aims to enhance perioperative care quality and patient safety by establishing and implementing widely supported evidence-based perioperative patient safety practices to reduce surgical adverse events., Methods: We will conduct a mixed-methods hybrid type III implementation study supporting the development and adoption of evidence-based practices through a Quality Improvement Learning Collaborative (QILC) in co-creation with stakeholders. The project will be conducted in 10 hospitals and related healthcare facilities of 5 European countries. We will assess the level of adherence to the standardised practices, as well as surgical complications incidence, patient-reported outcomes, contextual factors influencing the implementation of the patient safety practices, and sustainability. The project will consist of six components: 1) Development of patient safety standardised practices in perioperative care; 2) Guided self-evaluation of the standardised practices; 3) Identification of priorities and actions plans; 4) Implementation of a QILC strategy; 5) Evaluation of the strategy effectiveness; 6) Patient empowerment for patient safety. Sustainability of the project will be ensured by systematic assessment of sustainability factors and business plans. Towards the end of the project, a call for participation will be launched to allow other hospitals to conduct the self-evaluation of the standardized practices., Discussion: The SAFEST project will promote patient safety standardized practices in the continuum of care for adult patients undergoing surgery. This project will result in a broad implementation of evidence-based practices for perioperative care, spanning from the care provided before hospital admission to post-operative recovery at home or outpatient facilities. Different implementation challenges will be faced in the application of the evidence-based practices, which will be mitigated by developing context-specific implementation strategies. Results will be disseminated in peer-reviewed publications and will be available in an online platform., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Valli et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Suboptimal response to ursodeoxycholic acid occurs in 40% of primary biliary cholangitis (PBC) patients, affecting survival. Achieving a deep response (normalisation of alkaline phosphatase [ALP] and bilirubin ≤0.6 upper limit of normal) improves survival. Yet, the long-term effectiveness of second-line treatments remains uncertain., Aims: To evaluate the long-term effectiveness of obeticholic acid (OCA) ± fibrates. Focusing on biochemical response (ALP ≤1.67 times the upper limit of normal, with a decrease of at least 15% from baseline and normal bilirubin levels), normalisation of ALP, deep response and biochemical remission (deep response plus aminotransferase normalisation)., Methods: We conducted a longitudinal, observational, multicentre study involving ursodeoxyccholic acid non-responsive PBC patients (Paris-II criteria) from Spain and Portugal who received OCA ± fibrates., Results: Of 255 patients, median follow-up was 35.1 months (IQR: 20.2-53). The biochemical response in the whole cohort was 47.2%, 61.4% and 68.6% at 12, 24 and 36 months. GLOBE-PBC and 5-year UK-PBC scores improved (p < 0.001). Triple therapy (ursodeoxycholic acid plus OCA plus fibrates) had significantly higher response rates than dual therapy (p = 0.001), including ALP normalisation, deep response and biochemical remission (p < 0.001). In multivariate analysis, triple therapy remained independently associated with biochemical response (p = 0.024), alkaline phosphatase normalisation, deep response and biochemical remission (p < 0.001). Adverse effects occurred in 41.2% of cases, leading to 18.8% discontinuing OCA. Out of 55 patients with cirrhosis, 12 developed decompensation. All with baseline portal hypertension., Conclusion: Triple therapy was superior in achieving therapeutic goals in UDCA-nonresponsive PBC. Decompensation was linked to pre-existing portal hypertension., (© 2024 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.)

Aims: Layer-specific left ventricular (LV) strain alterations have been suggested as a specific finding in Fabry disease (FD). Our study aimed to assess the diagnostic value of layer-specific radial strain (RS) indices compared to the established LV regional strain pattern in cardiac amyloidosis (CA) and FD, i.e. apical sparing and posterolateral strain deficiency (PLSD)., Methods and Results: We retrospectively analysed the global, subendocardial, subepicardial LV radial strain, the corresponding strain gradient, as well as the regional and global longitudinal strain. The diagnostic accuracy of the diverse LV strain analyses was comparatively assessed using receiver operating characteristic curve and multivariable regression analyses. In 40 FD and 76 CA patients, CA featured more reduced layer strain values [global RS -12.3 (-15.6 to -9.6) in CA vs. -16.7 (-20.0 to -13.6) in FD; P < 0.001; subendocardial RS -22.3 (-27.4 to -15.9) vs. -28.3 (-31.8 to -23.6), P < 0.001; subepicardial RS -6.6 (-8.6 to -4.7) in CA vs. -8.9 (-11.7 to - 6.5) in FD; P < 0.001]. Global radial and longitudinal strain held an area under the curve (AUC) of 0.75 (0.66-0.84) and AUC 0.73 (0.63-0.83). While the apical sparing and PLSD strain pattern showed the highest accuracy as single parameters [AUC 0.87 (0.79-0.95) and 0.81 (0.72-0.89), P < 0.001], the combination of subendocardial RS and the apical sparing pattern featured the highest diagnostic accuracy [AUC 0.92 (0.87-0.97)]., Conclusion: Combining radial strain-derived parameters to the established strain pattern apical sparing and PLSD improve the diagnostic accuracy in the echocardiographic assessment in suspected storage disease., Competing Interests: Conflict of interest: none declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Conduct problems (CP) in childhood and adolescence have a significant impact on the individual, family, and community. To improve treatment for CP, there is a need to improve the understanding of the developmental pathways leading to CP in boys and girls. Prior research has linked the child's fearlessness and callous-unemotional (CU) traits, as well as experiences of parental warmth and punitive parenting, to CP. However, few studies have tested the interplay of these factors in contributing to future CP development. The present study aimed to test the InterFear model, which suggests that fearlessness in early childhood leads to CP through an indirect pathway involving low positive parenting, high negative/punitive parenting, and callous-unemotional (CU) traits. The sample included 2467 Spanish children (48.1% girls; M age = 4.25; SD = 0.91), followed up across a five-year period. Besides a direct association between fearlessness in early childhood and future CP, the results found an indirect pathway whereby fearlessness reduces positive parenting and increases punitive parenting, which contributes to the development of CU traits and sets the stage for CP in later childhood. The specific indirect effect from fearlessness to CP via CU traits accounted for most of the variance, suggesting the existence of a temperamental pathway independent of parental variables. Further, two additional indirect pathways, exclusive of fearlessness, were identified, which started with low parental warmth and positive parenting, leading to CP via CU traits. These findings support the InterFear model, demonstrating multiple pathways to CP with the involvement of fearlessness, parenting practices, and CU traits. This model might play a pivotal role in the development of targeted prevention and intervention strategies for CP.

Objective: To describe the differences according to mental status at admission on the care process and 30-day outcomes in hip fracture patients, mainly regarding the use of rehabilitation resources and anti-osteoporotic medication, by analysing data from the Spanish National Hip Fracture Registry (RNFC, "Registro Nacional de Fracturas de Cadera" in Spanish)., Methods: We analysed prospectively collected data from a cohort of patients admitted participating in the Spanish National Hip Fracture Registry (RNFC) in 76 Spanish hospitals between 2017 and 2019. We classified participants using Short Portable Mental Status Questionnaire (SPMSQ), defining two groups: patients with ≤2 SPMSQ score and patients with >2 SPMSQ score., Results: Of 21,254 patients was recorded SPMSQ in 17,242 patients, 9052 were >2 SPMSQ score (52.6%). These were older (87.7 vs. 85.3 years; p<0.001), had worse mobility (no-independent walking ability 26.0% vs. 4.5%; p<0.001) and were more likely to be living in nursing homes (35.3% vs. 9.6%; p<0.001). They were more likely to be treated nonoperatively (3.8% vs. 1.5%; p>0.001), less early mobilisation (57.5% vs. 68.9%; p<0.001) and suffered higher in-hospital mortality (5.2% vs. 2.7%; p<0.001). At discharge, they received less anti-osteoporotic medication (37.9% vs. 48.9%; p<0.001) and returned home less often (29.8%% vs. 51.2%; p<0.001). One month after fracture, patients with >2 SPMSQ score had poorer mobility (no-independent walking ability 44.4% vs. 24.9%; p<0.001) and were newly institutionalised in a nursing home more (12.6% vs. 12.0%; p<0.001) and were more likely to die by one-month post-fracture (9.5% vs. 4.6%; p<0.001)., Conclusion: RNFC patients with >2 SPMSQ score were more vulnerable and had poorer outcomes than patients with ≤2 SPMSQ score, suggesting that they need specialised care in-hospital and in the recovery phase., (Copyright © 2023 SEGG. All rights reserved.)

Only a few halophilic archaea producing carboxylesterases have been reported. The limited research on biocatalytic characteristics of archaeal esterases is primarily due to their very low production in native organisms. A gene encoding carboxylesterase from Halobacterium salinarum NRC-1 was cloned and successfully expressed in Haloferax volcanii . The recombinant carboxylesterase (rHsEst) was purified by affinity chromatography with a yield of 81%, and its molecular weight was estimated by SDS-PAGE (33 kDa). The best kinetic parameters of rHsEst were achieved using p -nitrophenyl valerate as substrate (K M = 78 µM, k cat = 0.67 s -1 ). rHsEst exhibited great stability to most metal ions tested and some solvents (diethyl ether, n -hexane, n -heptane). Purified rHsEst was effectively immobilized using Celite 545. Esterase activities of rHsEst were confirmed by substrate specificity studies. The presence of a serine residue in rHsEst active site was revealed through inhibition with PMSF. The pH for optimal activity of free rHsEst was 8, while for immobilized rHsEst, maximal activity was at a pH range between 8 to 10. Immobilization of rHsEst increased its thermostability, halophilicity and protection against inhibitors such as EDTA, BME and PMSF. Remarkably, immobilized rHsEst was stable and active in NaCl concentrations as high as 5M. These biochemical characteristics of immobilized rHsEst reveal its potential as a biocatalyst for industrial applications.