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Introduction: Hip range of motion (ROM) across various planes is necessary in sport-related activities. Static stretching was commonly used to improve hip ROM. The Lightback system, a novel compression device, has been developed to enhance hip mobility by applying controlled axial forces on the femur. This study aimed to evaluate the effectiveness of the Lightback system in improving hip ROM and posterior chain flexibility compared to conventional static stretching., Methods: A randomized cross-over trial was carried out in 31 physically active participants (62 lower limbs; n = 31 Lightback group (LBG) and n = 31 stretching group (SG)). Hip rotation at two positions of hip flexion (active and passive external (ER) and internal rotation (IR) at 0-90° hip flexion), total rotation ROM (TRROM), and the flexibility of the posterior chain (active knee extension test (AKE) and active straight leg raise (ASLR)) were measured before and after the stretching session., Results: LBG demonstrated significantly greater improvements in hip ER and IR compared to the SG. Specifically, the LBG showed significant increases in active ER at 0° ( p = 0.002) and 90° ( p < 0.001) of hip flexion, as well as IR at 0° ( p = 0.007) and 90° ( p < 0.001). TRROM in neutral and at 90° of hip flexion also improved significantly in the LBG ( p < 0.001). In passive ROM, the LBG exhibited significant increases in ER at 0° ( p < 0.001), IR at 90° ( p = 0.001), and TRROM at both positions ( p < 0.001), compared to the SG. Regarding posterior chain flexibility, both groups improved in AKE and ASLR ( p < 0.001), but the LBG showed a significantly larger effect in ASLR ( p < 0.001), with no significant difference between groups in AKE., Conclusion: This study demonstrated that both the Lightback system and static gluteal stretching improved passive hip ROM. However, the Lightback system showed greater improvements in active ROM, particularly in external and internal rotation at various degrees of hip flexion, as well as in posterior chain flexibility. Notably, the Lightback system significantly enhanced large improvement in the ASLR test., Competing Interests: The authors declare that they have no competing interests., (© 2025 Cotteret et al.)

Trait-based indicators offer insights into environmental impacts on communities but are often limited by the availability of species traits data, relying on subsets that may omit less studied taxa, leading to bias. To address this, we tested the species selection's influence on trait-based indices using filters based on occurrence, species' distributions, and abundance. Using data from two bottom-trawl surveys, we compiled 15 traits for the 246 most common demersal species in two temperate ecosystems in the North-East Atlantic and Mediterranean Sea. Our analyses revealed that trait data is strongly biased toward abundant and large species, particularly those of commercial importance or conservation concern. While species selection had minimal impact on community traits, excluding invertebrates strongly affected the results, highlighting their key role in community dynamics., 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 © 2025. Published by Elsevier Ltd.)

Introduction: In sports, 80% of all ankle injuries are sprains of the external compartment. Functional bandages are usually used preventively, specially in individuals with a history of lateral ankle injuries. To this day, the actual benefits of such taping remain unknown as important modifications are introduced in the ankle biomechanics., Objective: The aim of the present study is to describe the biomechanical processes underlying these effects, such as modification during stance times, balance, contact surface and maximum and average pressures in the rearfoot, forefoot and midfoot, using a sprain preventive taping for the external ankle compartment., Methods: An observational, analytic, cross-sectional study was designed. Data from static and dynamic plantar pressures with a pressure platform and balance data assessed with the Y Balance Test (YBT) were analysed in 50 participants (age = 21.00 ± 2.34 years, weight = 71.11 ± 13.12 kg, height = 1.75 ± 00.9 m, BMI = 22.94 ± 2.50 kg/m2, foot size = 41.60 ± 3.00) with and without preventive functional taping for lateral ankle sprain (LAS)., Results: A statistically significant decrease in YBT was observed in the taped participants toward anterior ( p  = 0.001) and posterolateral ( p  = 0.005) motion. On the static measures at the pressure platform, an increase in peak pressure at the midfoot ( p  = 0.001), a decrease in the maximum pressure in the forefoot ( p  = 0.003) and a decrease in the contact surface in the rearfoot ( p  = 0.003) were recorded. Dynamic measures at the pressure platform analysis showed a statistically significant decrease in contact surface at the rearfoot ( p  = 0.001), an increase in mean pressure in both the midfoot ( p  = 0.044) and forefoot ( p  = 0.001) and a significant decrease in velocity in the forefoot ( p  = 0.003)., Conclusions: In conclusion, we observed that ankle taping led to increased peak pressures in the midfoot and decreased maximum pressures in the forefoot, indicating a shift in load distribution within the plantar surface. Simultaneously, a significant reduction in the velocity at the forefoot during dynamic tasks suggests that taping may alter natural gait dynamics, potentially affecting movement efficiency and stride characteristics. In addition, the application of ankle taping significantly altered balance, as evidenced by a decrease of YBT scores anterior and posterolateral directions. Prophylactic taping in patients with no prior history of LAS is not recommended., Competing Interests: Carlos Romero Morales is an Academic Editor for PeerJ., (©2025 Bravo-Aguilar et al.)

Background: Newly diagnosed patients with lung cancer experience significant challenges navigating a fragmented health system. Nurse navigators can use clinical expertise and coordination to address barriers to care., Objectives: This quality improvement project aimed to expedite the selection and initiation of first-line treatment for patients with stage III or IV lung cancer. Using a nurse navigator process early on in care, coupled with liquid biopsy, this project focused on reducing the time from tissue biopsy to treatment decision., Methods: The team performed a retrospective chart review 12 months preimplementation and 8 months postimplementation., Findings: Using liquid biopsy, the time to treatment initiation was 21 days compared to 36 days with tissue biopsy only (p = 0.003). Postimplementation, median days to treatment decreased from 34 to 23.5 (p = 0.027), and treatment decisions made during the initial medical oncology visit increased from 38% to 55%.

Primary Care is the first point of contact for most patients after the onset of symptoms of inflammatory bowel disease (IBD). Establishing an initial diagnostic process based on compatible symptoms and agreed criteria and referral pathways, depending on the degree of suspicion and the patient's situation, can reduce diagnostic delays. Once the patient is referred to the Digestive specialist and the diagnosis of IBD is established, a treatment and follow-up plan is structured. The management of the patient must be shared with the participation of the family practitioners in the diagnosis and treatment of concomitant or intercurrent pathologies, the recognition of flare-ups or complications (of IBD or treatments), education tasks or adherence control. With the purpose of developing a comprehensive guide on the management of IBD aimed at Primary Care doctors, we have developed this positioning document collaboratively between the Spanish Society of Primary Care Physicians (SEMERGEN) and the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU)., (Copyright © 2024 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.)

The postacute myocardial infarction electrical storm is a life-threatening entity. Resistance to ischemia in Purkinje fibers may be the origin of short-coupled premature ventricular contractions that trigger severe arrhythmic events. We present a case where the use of emergency catheter ablation, guided by a 3D navigation system and an ultra-high-density mapping catheter, successfully terminated the arrhythmic storm. This case highlights the crucial role of advanced mapping and ablation techniques in managing complex postinfarction arrhythmias and provides valuable insights that may enhance future clinical practice in similar critical situations., Competing Interests: The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2025 The Authors.)

To enhance athletic performance and reduce the risk of injury, load quantification has allowed for a better understanding of the individual characteristics of the physical demands on soccer players during training or competition. In this regard, it appears crucial to summarize scientific evidence to provide useful information and future directions related to the speed and acceleration profiles of male soccer players. This review aims to evaluate the findings reflected in the available literature on both profiles in football, synthesizing and discussing data from scientific articles, while providing insights into quantification methods, employed thresholds, tracking systems, terminology, playing position, and microcycle day. Therefore, it is hoped that this narrative review can support objective decision-making in practice for coaches, sports scientists, and medical teams regarding individualized load management and the appropriate selection of metrics, to explore current trends in soccer player profiles.

Introduction: The Optilume® Paclitaxel-coated urethral dilatation balloon is an alternative to conventional endoscopic treatments that combines mechanical dilatation with local delivery of paclitaxel., Objective: To describe the success rate and analyze the safety of the device in real clinical practice. To evaluate possible predictors of treatment failure., Materials and Methods: Retrospective multicenter study in patients diagnosed with urethral stricture and treated with an Optilume® balloon in routine clinical practice. Data were collected from flowmetry, questionnaires (PROM and IPSS) and cystoscopy before surgery, and 3, 6 and 12 months after the procedure, according to standard practice. Surgical success was defined as the absence of subsequent urethral manipulation and a Qmax >10 ml/s., Results: 238 patients treated with Optilume® in 12 Spanish hospitals between May 2021 and April 2024 were included in the study. Of these, 156 who had a minimum follow-up of 3 months, were analyzed. Median stricture length: 1.5 cm (0.5-5.3), mainly in bulbar urethra (87.7%). Of the total, 12.8% of patients had a history of pelvic radiotherapy, and 81.4% had undergone prior urethral manipulation. Postoperative complications were reported in 14.2% of the total. The treatment success rate was 73.8%, with a median follow-up of 8 months (5-12). No predictors of stricture recurrence were identified. Recurrence rates were higher in strictures located in the posterior versus anterior urethra (42.9% vs. 24.6%, p = 0.126). No significant differences were observed between patients with and without prior urethral manipulation., Conclusion: Treatment with Optilume® has been shown to be safe and effective in short-term routine clinical practice., Competing Interests: Declaration of competing interest None of the authors have any conflict of interest to declare in relation to the content of this article., (Copyright © 2024. Published by Elsevier España, S.L.U.)

Background and Objective: Complicated urinary tract infections (cUTIs) are serious, potentially life-threatening infections that occur in patients with an increased disease progression risk. Antimicrobial resistance represents an important health issue worldwide, contributing to relapses, which can generate further resistances. It is necessary to clarify the role of microbiological eradication as an additional objective in the management of cUTIs. Some publications suggest that relapses relate to insufficient bacterial suppression in the urinary tract. This study focuses on generating a consensus on how patients with cUTIs would benefit from effective antimicrobial agents associated with higher rates of bacterial eradication., Methods: The nominal group technique was followed: systematic literature review, development of a questionnaire, expert panel meeting to discuss results, individual review of draft consensus document, and expert panel meeting to discuss final views and finalise the consensus document., Key Findings and Limitations: Experts identified risk factors for cUTIs (patients with a higher risk of relapse, physiological obstruction of urinary tract, immune suppression, and previous relapse), and patients who would benefit most from a therapeutic strategy combining clinical cure and aim for microbiological eradication. While experts agreed that the scientific evidence discourages repetition of urine cultures after treatment, they proposed recommendations to prioritise antibiotics with higher evidence of microbiological eradication and close follow-up in patients with a higher risk of relapse, considering any symptoms appearing following clinical cure of the cUTI., Conclusions and Clinical Implications: Selection of active antimicrobial agents associated with increased microbiological eradication should be prioritised in patients with cUTIs and a high risk of relapse., Patient Summary: Complicated urinary tract infections (cUTIs) occur in patients with an increased risk of disease progression or are caused by multidrug-resistant uropathogens. Antimicrobial resistance is of concern as it can result in relapses. Antimicrobial therapeutic strategies associated with increased microbiological eradication in cUTI patients with a high risk of relapse are crucial to prevent relapses and development of antibiotic resistance., (© 2024 The Author(s).)

Our study evaluated the efficacy and feasibility of left bundle branch area pacing (LBBAP) compared to right ventricular outflow tract septal pacing (RVOSP). We conducted a prospective, single-center, observational study involving 200 consecutive patients who required pacemaker implantation. The patients were divided into two groups (LBBAP and RVOSP), with 100 patients in each group. We aimed to compare the safety and efficacy, as well as the procedure and fluoroscopy times, between the two groups. Additionally, we aimed to describe the learning curve for the LBBAP group. The success and acute complication rates were similar ( P = .56 vs. P = .65). The procedure time was longer in the LBBAP group compared to the RVOSP group (18 [13-28] vs. 11 [7-17] min; P < .001), while the fluoroscopy time was shorter in the LBBAP group compared to the RVOSP group (2.8 [1.3-3.7] vs. 3.1 [2-5.9] min; P = .02). The paced QRS interval was narrower in the LBBAP group (123.77 ± 10.25 vs. 159.79 ± 17.0 ms; P = .001). There were no significant differences in pacing parameters like R-wave sensing (9.6 ± 5.2 vs. 9.1 ± 4.7 mV; P = .91), bipolar impedance (685.9 ± 151.8 vs. 686.5 ± 158.6 Ω; P = .98), or pacing threshold (0.70 ± 0.29 vs. 0.64 ± 0.26 V @ 0.4 ms; P = .63). In the LBBAP group, both the procedure time (12 [10.5-15] vs. 32 [28.5-38.5] min; P < .001) and the fluoroscopy time (2 [1-4.6] vs. 5.1 [3.4-12] min; P < .01) were shorter in the last quartile (Q4) compared to the first quartile (Q1). The procedure time was similar between LBBAP Q4 and RVOSP (12 [10.5-15] vs. 11 [7-17] min; P = .33). LBBAP is as safe as RVOSP and achieves a narrower paced QRS compared to RVOSP. After a rapid learning curve, a shorter fluoroscopy time and a similar procedure time can be achieved., Competing Interests: Dr. Ramos-Maqueda and M. Cabrera-Ramos have received proctoring honoraria from Medtronic, outside the scope of the submitted work. The remaining authors report no conflicts of interest for the published content. No funding information was provided., (Copyright: © 2024 Innovations in Cardiac Rhythm Management.)

Objectives: The effects of acute physical exercise in patients with resistant hypertension remain largely unexplored compared with hypertensive patients in general. We assessed the short-term effects of acute moderate-intensity (MICE) and high-intensity interval exercise (HIIE) on the clinic (BP) and 24-h ambulatory blood pressure (ABP) of patients with resistant hypertension., Methods: Using a crossover randomized controlled design, 10 participants (56 ± 7 years) with resistant hypertension performed three experimental sessions: MICE, HIIE, and control. MICE consisted of continuous treadmill exercise at an intensity of 3-4 metabolic equivalents of energy (METs) until completing 3 kcal/kg and was energy-matched to HIIE (which included six to eight intervals of 3 min duration at 6-7 METs interspersed with 1.5-min rests at 3 METs). In the control session, participants remained seated for 50 min. Flow-mediated vasodilation, autonomic nervous system balance (heart rate variability), exerkines [interleukin (IL)-6, IL-8, IL-15, vascular endothelial growth factor A, irisin, adiponectin, and angiopoietin] and 71 inflammatory-related proteins were also measured., Results: Compared with baseline, HIIE and MICE reduced clinic SBP immediately ( P  < 0.001 for both) and 90 min ( P  = 0.001 and P  = 0.041, respectively) postexercise. HIIE and MICE also reduced clinic DBP immediately postexercise ( P  = 0.003 and P  = 0.025). By contrast, no changes were found in the control session. On the other hand, no significant effects were noted for 24 h ABP measures or for the rest of variables., Conclusion: Although in patients with resistant hypertension, acute aerobic exercise induces short-term reductions in clinic BP, this stimulus does not suffice to reduce 24 h ABP or to impact on potential biological mechanisms., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Primary dysmenorrhea (PD), a prevalent menstrual condition characterized by pelvic pain during the menstrual cycle, significantly impacts the quality of life of women and produces increased pain sensitivity that can persist throughout the menstrual cycle. However, scientific literature has not studied whether there are implications for alterations in muscle function and endurance in the abdominopelvic region during the non-painful phases of the menstrual cycle. The aim of this study was to compare muscle function and endurance capacity in the abdominopelvic region in women with PD versus women without this condition. An observational, cross-sectional study was designed to analyze muscle activation and endurance capacity using electromyography (EMG) during McGill exercises. Forty-four women were included, 22 with PD and 22 without dysmenorrhea. The results did not indicate significant differences in muscle activation and endurance of the abdominopelvic musculature between the two groups (p > 0.05). However, the analysis suggests that women with primary dysmenorrhea might develop compensatory strategies that allow them to maintain physical function despite their condition. These results suggest that the approach to PD could focus more on pain management rather than physical functionality, and more studies are needed from a comprehensive approach to more accurately evaluate the relationship between PD and muscle function., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Institutional Review Board Statement: The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Commission of Universidad Europea de Madrid (protocol code CIPI/23.146; date of approval: April 20, 2023). Informed consent: Informed consent was obtained from all participants involved in the study., (© 2024. The Author(s).)

Background: We report the first case of findings suggestive of progressive multifocal leukoencephalopathy and immune restitution syndrome (PML-IRIS) in a patient with multiple sclerosis receiving ozanimod preceded by an unexpected increase in the serum neurofilament light-chain (sNfL) levels., Case Report: A 57-year-old-woman treated with ozanimod for the last 8 years presented, during surveillance MRI, with findings compatible with PML-IRIS. Overt clinical symptoms were absent. sNfL levels increased 4 months earlier and peaked at presentation. Lymphocyte count reached nadir of 330/mL at 8 months earlier., Conclusion: The case illustrates the utility of sNfL levels for PML surveillance in patients receiving immunosuppressors., 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., (Copyright © 2024 Quintanilla-Bordás, Gorriz, Cubas-Núñez, Castillo-Villalba, Carreres-Polo, Casanova and Pérez-Miralles.)

Objective: Shoulder pain, primarily due to rotator cuff tendinopathy, significantly impacts function and quality of life, with considerable socioeconomic implications. Physiotherapy myofascial trigger point therapy (MPT) is traditionally used, but therapeutic exercise (TE) has gained attention for its potential administrative and implementation benefits. The aim of this study was to evaluate the efficacy of TE compared with MPT in treating shoulder tendinopathies., Methods: A single-blind randomised controlled trial was conducted comparing TE and MPT. Outcome measures included pain intensity with the Numerical Rating Scale, pressure pain threshold (PPT) and range of motion (ROM), assessed before and after 10 treatment sessions. A total number of 72 participants (TE group n=36 age 49.22±15.29/MTP group n=36 age 49.03±19.12) participated in the study., Interventions: Participants in both groups were evaluated before treatment and after 10 sessions. A total of 10 sessions were conducted over 5 weeks of intervention., Results: Both interventions showed improvements in pain intensity and ROM, with no significant differences between the groups in most measures except PPT, where TE demonstrated a greater decrease in pressure-induced pain., Conclusion: TE could serve as an alternative to manual therapy, offering cost-benefit advantages, especially in administration via telecare and group sessions, highlighting its broader application in physiotherapy., Trial Registration Number: NCT06241404., Competing Interests: None declared., (Copyright © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This study reports on the development and testing of a comprehensive diabetes telemonitoring program tailored to meet the needs of underserved Hispanic/Latino patients with diabetes. Individuals participating in the culturally tailored program had significantly better 6-month outcomes than those receiving comprehensive outpatient management for A1C, blood pressure, and diabetes self-efficacy, with no differences between groups in quality of life, medication adherence, emotional functioning, patient activation, or unscheduled physician visits. These findings suggest that culturally congruent diabetes telemonitoring may be effective for this underserved population., Competing Interests: No potential conflicts of interest relevant to this article were reported., (© 2024 by the American Diabetes Association.)

This study aimed to determine the effects of spray dried plasma (SDP) on growth performance, carcass traits, tibia quality, and hemagglutination inhibition titers in broilers fed two nutritional strategies with high or low nutrient density. In the study, 816 one-day-old Ross 308 male broiler chickens were divided into a 2 × 2 factorial arrangements consisting of four treatment groups with 12 replicates (17 birds/replicate) based on diets with high nutrient density (HND) or low nutrient density (LND) from d 0 to 42 and receiving either control or 1% SDP diets during d 0 to 10. The results showed that feed intake (FI) and body weight gain (BWG) were increased (P < 0.05) and feed conversion ratio (FCR) was significantly reduced (P = 0.003) for broilers fed HND diets from d 0 to 42. The inclusion of SDP increased the BWG (P < 0.001), FI (P < 0.001), and FCR (P < 0.05) during d 0 to 10 of broiler life but not effect of SDP was observed for the whole 0-42 d period. Carcass yield increased with HND (P < 0.001) and dietary SDP (P = 0.002). However, HND feeding significantly decreased liver (P < 0.001), bursa of Fabricius (P = 0.002), abdominal fat (P < 0.001), proventriculus (P < 0.001) and gizzard weight (P < 0.001), but increased heart weight (P = 0.013), although spleen weight remained unaffected (P > 0.05) on d 42. Tibial bone morphometric and mechanical properties improved (P < 0.05) with SDP supplementation, and bone ash, Ca, and P remained unaffected (P > 0.05) on d 14. With the exception at d 28 (P = 0.037), the antibody titer to ND virus was similar among all treatment groups (P > 0.05) at d 0, 14, and 42. In conclusion, HND diets improve performance of broilers during the whole period and SDP supplementation during starter phase improve performance at this period, but also increased carcass yield, and tibial quality. Therefore, inclusion of SDP in the starter diet could be a beneficial nutritional strategy to improve the health and production of broilers provided feeding strategies using various nutrient densities., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Bundur 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.)

The effect of feeding spray dried porcine plasma (SDPP) to male turkeys during the first 4 weeks of life was evaluated at 20 weeks of age. A total of 648 male Hybrid Converter day-old turkeys were divided into two groups of 9 replicate pens of 36 birds each, and fed a commercial-type program of 7 diet phases. In phase 1 birds were fed a corn-soybean meal Control diet for 4 weeks, or a diet with 2% SDPP of similar nutrient density. Thereafter, both groups were fed common diets until the end of the trial at 20 weeks of age. At 4 weeks of age, birds were subjected to heat stress and crowding for a period of 24 hrs to simulate the stress induced commercially when moved from the brooder house into a grow-out building. Poults fed SDPP had greater body weight (BW) and body weight gain at 6 (p<0.05) and at 9 weeks of age (p<0.10). At 20 weeks of age, BW of turkeys fed SDPP vs Control was not different. However, the European Productivity Index (EPI) that incorporates final body weight, feed conversion ratio and livability, tended to be higher (p<0.10) for the SDPP group (EPI = 545 vs 529, respectively) because of the higher livability trend exhibited in SDPP group (96.91 vs 94.75%, respectively). Likewise, birds fed SDPP showed significantly lower frequency of foot pad lesions vs Controls (p<0.05) by the end of the study. In conclusion, SDPP fed early in life can reduce stress, improve performance and reduce incidence of foot pad lesions in turkeys., (© 2024 The Authors. This is an open access article under the CC BY-NC-ND 4.0 license (https://creativecommons.org/licenses/by-nc-nd/4.0/deed.en), which allows re-users to copy and distribute the material in any medium or format in unadapted form and for noncommercial purposes, and only so long as attribution is given to the creator.)

We study driven atomic Josephson junctions realized by coupling two two-dimensional atomic clouds with a tunneling barrier. By moving the barrier at a constant velocity, dc and ac Josephson regimes are characterized by a zero and nonzero atomic density difference across the junction, respectively. Here, we monitor the dynamics resulting in the system when, in addition to the above constant velocity protocol, the position of the barrier is periodically driven. We demonstrate that the time-averaged particle imbalance features a plateau behavior that is the analog of Shapiro steps observed in driven superconducting Josephson junctions. The underlying dynamics reveals an intriguing interplay of the vortex and phonon excitations, where Shapiro steps are induced via suppression of vortex growth. We study the system with a classical-field dynamics method, and benchmark our findings with a driven circuit dynamics.

Combined use of edible films (EF) with nanoencapsulation systems could be an effective alternative for improving the films' physical properties and maintaining bioactive compounds' stability. This research work focuses on the combined use of EF of cellulose-derived biopolymers enriched with liposomes that encapsulate grape seed tannins and on the subsequent evaluation of the physical properties and wettability. Tannin-containing liposomal suspensions (TLS) showed 570.8 ± 6.0 nm particle size and 99% encapsulation efficiency. In vitro studies showed that the release of tannins from liposomes was slower than that of free tannins, reaching a maximum release of catechin of 0.13 ± 0.01%, epicatechin of 0.57 ± 0.01%, and gallic acid of 3.90 ± 0.001% over a 144 h period. Adding liposomes to biopolymer matrices resulted in significant decrease ( p < 0.05) of density, surface tension, tensile strength, elongation percentage, and elastic modulus in comparison to the control, obtaining films with greater flexibility and lower breaking strength. Incorporating TLS into EF formulations resulted in partially wetting the hydrophobic surface, reducing adhesion and cohesion compared to EF without liposomes. Results indicate that the presence of liposomes improves films' physical and wettability properties, causing them to extend and not contract when applied to hydrophobic food surfaces.

Objective: MSB11022 is a biosimilar of adalimumab that has been shown comparable bioequivalence, safety, tolerability, and immunogenicity profiles to the reference adalimumab in healthy volunteers or in patients with psoriasis or rheumatoid arthritis (RA). This is the first study conducted under clinical practice conditions evaluating the switch from reference adalimumab to MSB11022 in patients with RA., Methods: Retrospective and multicenter study with data from the medical records of patients with RA who switched from reference adalimumab or another biosimilar to MSB11022 and maintained this treatment for at least 6 months. Information registered comes from baseline visit, the moment of the switch, and the follow-up visits., Results: Data from 86 patients were evaluated (median age 63.5 years, 75.6% female, 44.2% had erosive RA). Only 3.5% of the patients received biologic therapy prior to adalimumab. At baseline, median DAS28-CRP was 1.77 (80.2% in remission and 96.5% with low disease activity) and median CDAI was 4.00 (44.2% in remission and 90.7% with low disease activity). After a median follow-up of 8 months, median DAS28-CRP was 1.87 (86.0% in remission and 94.2% with low disease activity) and median CDAI was 4.00 (38.5% in remission and 95.3% with low disease activity). Only three patients experienced pain, swelling, and stinging at the injection site or a locally extensive hematoma in the area of administration., Conclusions: Adalimumab biosimilar MSB11022 maintained the efficacy benefits provided by previous adalimumab treatments with a safety profile in line with that already described for other biosimilars.

Background: Elexacaftor/tezacaftor/ivacaftor (ETI) has reduced many symptoms of cystic fibrosis (CF)., Objectives: We sought to identify the impact of ETI on both symptoms and treatment decisions among adults with CF., Design: Participants were enrolled in a cross-sectional study. Surveys were sent via a RedCap link. Semistructured interviews were administered remotely via Microsoft Teams. Interviews were audio recorded and professionally transcribed., Methods: We assessed Cystic Fibrosis Questionnaire-Revised (CFQ-R) subscales for physical, respiratory, emotion, and treatment, and analyzed semistructured interviews covering CF treatment regimens and daily living. Quantitative and qualitative results were analyzed separately and via a mixed-methods convergence coding matrix., Results: Twenty-four adults with CF taking ETI were included. CFQ-R subscale scores (mean scores/standard deviation) were physical (82.1/22.8), respiratory (83.7/11.2), emotion (65.3/14.2), and treatment (57.5/20.1). Three themes about decision-making for non-ETI-treatments emerged: (1) How I'm feeling, (2) Not noticing a difference, and (3) Uncertainty about long-term impact of modifying treatment regimens, and we found participants weighed each of these factors in their treatment decisions. Key findings from mixed-methods analysis show that among individuals experiencing higher CFQ-R scores for physical and respiratory compared to emotion and treatment, there were statements indicating that while those participants were experiencing better physical health, many continued their burdensome treatment regimens., Conclusion: With little long-term data on the impact of reducing non-ETI treatments, participants weighed how they were feeling, treatment efficacy beliefs, and risk tolerance when making treatment decisions., (© The Author(s), 2024.)

Background : This cross-sectional observational study aimed to investigate differences in abdominal musculature thickness, pelvic tilt, and trunk mobility between women with primary dysmenorrhea (PD) and a control group (CG). Methods : Participants included 44 women (22 with PD and 22 controls) aged over 18, nulliparous, and of reproductive age. Ultrasound imaging was used to measure the thickness of the transverse abdominis (TrA), internal oblique (IO), external oblique (EO), and rectus abdominis (RA) muscles at rest and during contraction. Additionally, anterior pelvic tilt was assessed using the Palpation Meter (PALM), and trunk flexion and extension were measured using an accelerometer (activForce2). Results : Significant differences ( p < 0.05) were found in RA and EO muscle thickness, with lower values in the PD group compared to CG. However, there were no significant differences ( p > 0.05) in TrA and IO muscle thickness, anterior pelvic tilt, or trunk mobility between groups. Conclusions : These findings contribute to understanding the musculoskeletal factors potentially involved in dysmenorrhea. Further research is needed to explore associations between PD and structural and alignment parameters.

Streptococcus constellatus pharyngis is a gram-positive commensal bacterium commonly found in the oropharynx, gastrointestinal and urogenital tracts. It might be an aggressive opportunistic pathogen causing invasive pyogenic infections in sterile areas, mostly as peritonsillar and orofacial abscesses. We report the case of a 6-year-old girl, who presented multiple head and neck abscesses and bilateral cavernous sinus thrombosis secondary to Streptococcus constellatus pharyngis . Cavernous sinus thrombosis, consequent to this microorganism, has not been reported to date in the literature. Due to the invasive features of this pathogen, a long-term antibiotherapy (up to 9 months) is required. Additionally, a surgical drainage is indicated in case of head and neck, or brain abscesses, larger than 20 or 25 mm respectively. Anticoagulation should be considered in case of venous thrombosis. The interest of this case is not only based on the rarity and severity of the disease, but also on the success of medical and surgical therapy (including long- term antibiotics, anticoagulation and two surgical procedures). This experience may serve as a guide to treat future cases., Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04511-3., (© The Author(s) 2024.)

Background: Uncontrolled donation after circulatory death (uDCD) increases organ availability for kidney transplantation (KT) at the expense of a higher risk of primary graft nonfunction (PNF). At least half of the cases of PNF are secondary to graft venous thrombosis. The potential benefit from prophylactic anticoagulation in this scenario remains unclear., Methods: In this single-center retrospective study we compared 2 consecutive cohorts of KT from uDCD with increased (≥0.8) renal resistive index (RRI) in the Doppler ultrasound examination performed within the first 24-72 h after transplantation: 36 patients did not receive anticoagulation ("nonanticoagulation group") and 71 patients underwent prophylactic anticoagulation until normalization of RRI in follow-up Doppler examinations ("anticoagulation group")., Results: Anticoagulation was initiated at a median of 2 d (interquartile range, 2-3) after transplantation and maintained for a median of 12 d (interquartile range, 7-18). In 4 patients (5.6%), anticoagulation had to be prematurely stopped because of the development of a hemorrhagic complication. In comparison with the nonanticoagulation group, recipients in the anticoagulation group had a lower 2-wk cumulative incidence of graft venous thrombosis (19.4% versus 0.0%; P  < 0.001) and PNF (19.4% versus 2.8%; P  = 0.006). The competing risk analysis with nonthrombotic causes of PNF as the competitive event confirmed the higher risk of graft thrombosis in the nonanticoagulation group (P  = 0.0001). The anticoagulation group had a higher incidence of macroscopic hematuria (21.1% versus 5.6%; P  = 0.049) and blood transfusion requirements (39.4% versus 19.4%; P  = 0.050) compared with the nonanticoagulation group. No graft losses or deaths were attributable to complications potentially associated with anticoagulation., Conclusions: Early initiation of prophylactic anticoagulation in selected KT recipients from uDCD with an early Doppler ultrasound RRI of ≥0.8 within the first 24-72 h may reduce the incidence of graft venous thrombosis as a cause of PNF., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.)

(1) Background: Urinary tract infections (UTIs) are among the most frequent complications in kidney transplant (KT) recipients. Asymptomatic bacteriuria (ASB) may be a risk factor for UTIs and graft rejection. We aimed to evaluate available evidence regarding the benefit of screening and treatment of ASB within the first year after KT. (2) Evidence acquisition: A systematic literature search was conducted in MEDLINE, the Cochrane Library CENTRAL and Embase. Inclusion criteria were manuscripts in English addressing the management of ASB after KT. The PICO questions concerned Patients (adults receiving a KT), Intervention (screening, diagnosis and treatment of ASB), Control (screening and no antibiotic treatment) and Outcome (UTIs, sepsis, kidney failure and death). (3) Evidence synthesis: The systematic review identified 151 studies, and 16 full-text articles were evaluated. Seven were excluded because they did not evaluate the effect of treatment of ASB. There was no evidence for a higher incidence of lower UTIs, acute pyelonephritis, graft loss, or mortality in patients not treated with antibiotics for ASB. Analysis of comparative non-randomized and observational studies did not provide supplementary evidence to guide clinical recommendations. We believe this lack of evidence is due to confounding risk factors that are not being considered in the stratification of study patients.

In the present study, an enzymatically hydrolyzed porcine plasma (EHPP) was nutritionally and molecularly characterized. EHPP molecular characterization showed, in contrast to spray-dried plasma (SDP), many peptides with relative molecular masses (Mr) below 8,000, constituting 73% of the protein relative abundance. IIAPPER, a well-known bioactive peptide with anti-inflammatory and antioxidant properties, was identified. In vivo functionality of EHPP was tested in C. elegans and two different mouse models of intestinal inflammation. In C. elegans subjected to lipopolysaccharide exposure, EHPP displayed a substantial anti-inflammatory effect, enhancing survival and motility by 40% and 21.5%, respectively. Similarly, in mice challenged with Staphylococcus aureus enterotoxin B or Escherichia coli O42, EHPP and SDP supplementation (8%) increased body weight and average daily gain while reducing the percentage of regulatory Th lymphocytes. Furthermore, both products mitigated the increase of pro-inflammatory cytokines expression associated with these challenged mouse models. In contrast, some significant differences were observed in markers such as Il-6 and Tnf-α, suggesting that the products may present different action mechanisms. In conclusion, EHPP demonstrated similar beneficial health effects to SDP, potentially attributable to the immunomodulatory and antioxidant activity of its characteristic low Mr bioactive peptides., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Solà-Ginés 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.)

Purpose: To provide a descriptive report of mortality and morbidity in the first 30 days of diagnosis of urosepsis. Secondary aim is to identify risk factors of unfavourable outcomes., Methods: Prospective observational multicentre cohort study conducted from September 2014 to November 2018 in European hospitals. Adult patients (≥ 18 years) diagnosed with acute urosepsis according to Sepsis-2 criteria with confirmed microbiological infection were included. Outcomes were classified in one of four health states: death, multiple organ failure, single organ failure, and recovery at day 30 from onset of urosepsis. Descriptive statistics and ordinal logistic regression analysis was performed., Results: Three hundred and fifty four patients were recruited, and 30-day mortality rate was 2.8%, rising to 4.6% for severe sepsis. All patients who died had a SOFA score of ≥ 2 at diagnosis. Upon initial diagnosis, 79% (n = 281) of patients presented with OF. Within 30 days, an additional 5% developed OF, resulting in a total of 84% affected. Charlson score (OR 1.14 CI 1.01-1.28), patients with respiratory failure at baseline (OR 2.35, CI 1.32-4.21), ICU admission within the past 12 months (OR 2.05, CI 1.00-4.19), obstruction causative of urosepsis (OR 1.76, CI 1.02-3.05), urosepsis with multi-drug-resistant(MDR) pathogens (OR 2.01, CI 1.15-3.53), and SOFA baseline score ≥ 2 (OR 2.74, CI 1.49-5.07) are significantly associated with day 30 outcomes (OF and death)., Conclusions: Impact of comorbidities and MDR pathogens on outcomes highlights the existence of a distinct group of patients who are prone to mortality and morbidity. These findings underscore the need for the development of pragmatic classifications to better assess the severity of UTIs and guide management strategies., Study Registration: Clinicaltrials.gov registration number NCT02380170., (© 2024. The Author(s).)

Introduction and Objectives: Transplant renal artery stenosis (TRAS) is a vascular complication after kidney transplantation which estimated incidence is 13%. It could cause refractory arterial hypertension, kidney dysfunction and premature death in transplant recipients., Methods: We carried out a retrospective study including every patient who underwent renal transplantation between 2014 and 2020. They were evaluated with a systematic post-transplant renal Doppler ultrasound. To identify independent risk factors for transplant renal artery stenosis we performed a multivariate analysis., Results: Seven hundred twenty-four kidney transplants were included, 12% ​​were living donors and 88% were deceased donors. The mean age was 54.8 in recipients and 53 in donors. Transplant renal artery stenosis was diagnosed in 70 (10%) recipients, the majority in the first 6 months after surgery. 51% of patients with transplant renal artery stenosis were managed conservatively. The multivariate analysis showed diabetes mellitus, graft rejection, arterial resuture and donor body mass index as independent risk factors for transplant renal artery stenosis. Survival of the grafts with transplant renal artery stenosis was 98% at 6 months and 95% at two years., Conclusions: The systematic performance of Doppler ultrasound in the immediate post-transplant period diagnosed 10% of transplant renal artery stenosis in our cohort. Despite the above risk factors, an adequate monitoring and treatment could avoid the increased risk of graft loss in patients with transplant renal artery stenosis., (Copyright © 2024. Published by Elsevier España, S.L.U.)

In this paper we discuss the details, limitations, and difficulties of the implementation in hardware of a memristor-based random number generator that exhibits monofractal/multifractal behavior. To do so, the components and selection criteria of a reference memristor and one proposed by the authors, the chaotic circuit leveraging them, and the processing that is performed on the chaotic signals to achieve the random discrete sequences are described. After applying the estimation tools, findings indicate that more than 60% of the proposed combinations allow generating random discrete sequences, with long-range dependence, and that both monofractal and multifractal behaviors can also be obtained. Consequently, a hardware system was achieved that can be used as a source of entropy in future synthetic biological signal generators., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Cesar Hernandez reports administrative support and equipment, drugs, or supplies were provided by District University Francisco José de Caldas., (© 2024 The Authors.)

Introduction: Alzheimer's disease (AD) is a neurodegenerative disease and the main cause of dementia in the elderly. AD pathology is characterized by accumulation of microglia around the beta-amyloid (Aβ) plaques which assumes disease-specific transcriptional signatures, as for the disease-associated microglia (DAM). However, the regulators of microglial phagocytosis are still unknown., Methods: We isolated Aβ-laden microglia from the brain of 5xFAD mice for RNA sequencing to characterize the transcriptional signature in phagocytic microglia and to identify the key non-coding RNAs capable of regulating microglial phagocytosis. Through spatial sequencing, we show the transcriptional changes of microglia in the AD mouse brain in relation to Aβ proximity., Results: Finally, we show that phagocytic messenger RNAs are regulated by miR-7a-5p, miR-29a-3p and miR-146a-5p microRNAs and segregate the DAM population into phagocytic and non-phagocytic states., Discussion: Our study pinpoints key regulators of microglial Aβ clearing capacity suggesting new targets for future therapeutic approaches., (© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Introduction: Fungi that produce mycotoxins can grow on certain food products, such as grains and feed, and can cause a variety of health issues if consumed by animals, including chickens. The use of spray-dried plasma (SDP) is one strategy for combating the health problems caused by mycotoxins., Materials and Methods: In the present study, Ross 308 chickens ( n  = 960) were divided into four treatment groups. T1 group was given a control diet (corn-soybean meal), T2 group was given a control diet +2% SDP, T3 group was given a control diet +2% SDP + mixture mycotoxins and T4 group was givena control diet + mycotoxin mixture., Results: The presence of SDP resulted in weight gain and decreased feed efficiency, whereas mycotoxins resulted in weight loss and increased feed efficiency. SDP increased the thymus' relative weight. The presence of mycotoxins increased the heterophile/lymphocyte ratio. The presence of mycotoxins reduced the production of IL-2 and macrophage inflammatory protein-3 Alpha (MIP-3a), whereas the presence of SDP increased the production of macrophage colony-stimulating Factor (M-CSF). SDP resulted in higher IgA concentrations in the intestinal and tracheal washes than mycotoxin. Finally, adding SDP to broiler diets boosts weight gain, feed efficiency, and immune system development., Discussion: Our results provide information supporting that SDP is a promising tool for improving poultry immunity and performance., Competing Interests: JP and LR are employed by APC LLC, Ankeny, IA, United States, a company that manufacture and sell spray-dried plasma. However, they declared that the company did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Authors ensure the objectivity and accuracy in the collection and presentation and interpretation of the results. The remaining 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., (Copyright © 2024 Gómez-Verduzco, Arce-Menocal, López-Coello, Avila-González, Márquez-Mota, Polo and Rangel.)

Introduction: A new technology capable of monitoring local impedance (LI) and contact force (CF) has recently been developed. At the same time, there is growing concern regarding catheter ablation performed under fluoroscopy guidance, due to its harmful effects for both patients and practitioners. The aim of this study was to assess the safety and effectiveness of zero-fluoroscopy cavotricuspid isthmus (CTI) ablation monitoring LI drop and CF as well as to elucidate if these parameters can predict successful radiofrequency (RF) applications in CTI ablation., Methods: We conducted a prospective observational study recruiting 50 consecutive patients who underwent CTI ablation. A zero-fluoroscopy approach guided by the combination of LI drop and CF was performed. In each RF application, CF and LI drop were monitored. A 6-month follow-up visit was scheduled to assess recurrences., Results: A total of 767 first-pass RF applications were evaluated in 50 patients. First-pass effective RF applications were associated with greater LI drops: absolute LI drops (30.05 ± 6.23 Ω vs. 25.01 ± 5.95 Ω), p  = 0.004) and relative LI drops (-23.3 ± 4.9% vs. -18.3 ± 5.6%, p  = 0.0005). RF applications with a CF between 5 and 15 grams achieved a higher LI drop compared to those with a CF below 5 grams (29.4 ± 8.76 Ω vs. 24.8 ± 8.18 Ω, p  < 0.0003). However, there were no significant differences in LI drop between RF applications with a CF between 5 and 15 grams and those with a CF beyond 15 grams (29.4 ± 8.76 Ω vs. 31.2 ± 9.81 Ω, p  = 0.19). CF by itself, without considering LI drop, did not predict effective RF applications (12.3 ± 7.54 g vs. 11.18 ± 5.18 g, p  = 0.545). Successful CTI ablation guided by a zero-fluoroscopy approach was achieved in all patients. Only one patient experienced a recurrence during the 6-month follow-up., Conclusions: LI drop (absolute and relative values) appears to be a good predictor of successful RF applications to achieve CTI conduction block. The optimal CF to achieve a good LI drop is between 5 and 15 g. A zero-fluoroscopy approach guided by LI and CF was feasible, effective, and safe., Competing Interests: JR-M and MC-R have received consulting fees from Boston Scientific outside the submitted work. JA-A, IM-G, and GL-R are Boston Scientific employees. The remaining 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., (© 2024 Melero-Polo, Cabrera-Ramos, Alfonso-Almazán, Marín-García, Montilla-Padilla, Ruiz-Arroyo, López-Rodríguez and Ramos-Maqueda.)

Background: Foley catheters have been subject to limited development in the last few decades. They fulfil their basic function of draining urine from the bladder but cause other associated problems. T-Control is a new silicone Foley catheter with an integrated fluid control valve whose design aims to reduce the risks associated with bladder catheterization by a multifactorial approach. The general purpose of this study is to determine the effectiveness, comfort, and experience of the patient catheterized with T-Control® compared with patients with a conventional Foley catheter., Study Design: This trial is a mixed-method study comprising a two-arm, pilot comparative study with random allocation to T-Control catheter or traditional Foley catheter in patients with long-term catheterization and a study with qualitative methodology, through discussion groups., Endpoints: The comfort and acceptability of the T-Control® device (qualitative) and the quality of life related to self-perceived health (quantitative) will be analysed as primary endpoints. As secondary endpoints, the following will be analysed: magnitude and rate of infections (symptomatic and asymptomatic); days free of infection; indication of associated antibiotic treatments; determination of biofilm; number of catheter-related adverse events; use of each type of catheterization's healthcare resources; and level of satisfaction and workload of health professionals., Patients and Methods: Eligible patients are male and female adults aged ≥18 years, who require a change of long-term bladder catheter. The estimated sample size is 50 patients. Patient follow-up includes both the time of catheter insertion and its removal or change 4 weeks later, plus the time until the discussion groups take place., Competing Interests: This group of authors J. M. P., A. B. S. C., and S. P. G. declare that they have no competing interests. This group of authors Y. R. F., C. V. N., L. P. P., L. G. P., and M. A. G. B. belongs to the Evaluation Unit (SESCS), Canary Island Health Service (SCS) (www.sescs.es), an institution of the Canary Islands Government that is also a member of the Spanish Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS, www.ricapps.es). This article is part of the early dialogues activity carried out by the SESCS as an Evaluation agency and declares that they have no competing interests. M. L. G., M. S. M., C. A. M., and M. M. V. are part of Rethink Medical S.L., which is the Sponsor of this study, owning the rights of T‐Control., (© 2023 Rethink Medical SL and The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.)

Background and Objective: To determine the operational characteristics of salivary gland ultrasound (SGU) in the diagnosis of Sjögren's syndrome (SS) in a population of colombian patients with dry symptoms., Materials and Methods: Study of diagnostic tests in patients with dry symptoms who consecutively attended the rheumatology consultation (2018-2020). Sociodemographic and clinical data were obtained through a survey, paraclinical and ophthalmological tests, minor salivary gland biopsy, unstimulated salivary flow and SGU (score 0-6 based on De Vita) were done. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values (Stata 15®) were calculated. The receiver operating characteristics (ROC) curve was developed., Results: 102 patients were included (34 SS and 68 non-SS), mean age 55.69 (±11.93) years, 94% women. Positive ultrasound (score of 2 or more) was more frequent in the SS group, (70.6% vs. 22.1%, P<0.0001). The sensitivity was the same for grade 2 and 3 (70.59%), with a higher specificity (89.71%) for grade 3 (PPV 77.42% NPV 85.92). The ROC curve from the sum of the glands by means of ultrasound was better than those of the independent glands. The ROC curve of the ultrasound presented a greater area under the curve (0.72 [0.61-0.82]) than that of the histological analysis (focus score) (0.68 [0.59-0.78]), P=0.0252., Conclusion: Salivary gland ultrasound is a useful and reliable method for the classification of SS. Its use could be considered in the future within the SS classification criteria., (Copyright © 2024. Published by Elsevier España, S.L.U.)

Musculoskeletal injuries in elite sports are ones of the most impact issue because their remarkable impact on performance caused by drastic absence of training and competition and a progressive deterioration in physical health, emotional and social athletes' dimensions. Also, the prevalence of epidemiologic research found an incidence of musculoskeletal disorders vary within sports and in elite athletes which is even higher as a consequence of higher demand physical performance. This way, the loss of physical performance due to an sport injury impacts not only the individual economic sphere of the professional but also that ofsports entities, reaching, according to some studies, a loss estimated in the range of 74.7 million pounds. Thus, the purpose of this article is to review and to provide an overview of the most common musculoskeletal injuries in elite sports precipitating factors, clinical presentation, evidence-based diagnostic evaluation, and treatment recommendations with a view to preventing medical conditions or musculoskeletal injuries that may alter performance and general health in the elite athletes., Competing Interests: Declaration of Competing Interest There are no conflicts of interest or Source of Funding., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: In the context of COVID-19, respiratory training is vital for the care and recuperation of individuals. Both exercise-based and instrumental respiratory training have been employed as interventions to enhance respiratory function, providing relief from symptoms in those impacted by the virus. The aim of this study was to evaluate the efficacy of two different respiratory rehabilitation programs., Methods: A total of 200 participants affected with COVID-19 respiratory sequels were recruited, with a block randomization regarding sex to ensure equal and appropriate applicability of the results. An experimental controlled and randomized study was conducted, with participants engaging in a 31 days respiratory rehabilitation program, (a) experimental group, inspiratory training device combined with aerobic exercise and (b) traditional respiratory exercises combined with aerobic exercise., Results: Both groups improved in cardiorespiratory parameters, with a decrease in systolic and diastolic pressure, dyspnea and lower limbs fatigue, and increased oxygen saturation, 6 min walking distance, diaphragmatic thickness, forced vital capacity, forced expiratory volume during the first second, peak expiratory flow rate, forced inspiratory vital capacity and maximal inspiratory pressure. Comparison between groups showed statistically significant differences in all variables except for oxygen saturation, 6 min walking distance and diaphragmatic thickness. The results of this study support the use of specific inspiration training devices for respiratory rehabilitation in COVID-19 sequels., Competing Interests: The authors declare that they have no competing interests., (© 2023 Sánchez-Milá et al.)

Spray-dried animal plasma (SDAP) and wheat gluten (WG) are common binders in wet pet food that provide amino acids and energy, as well as texture and cohesiveness due to their gelling strength, water retention and fat emulsion properties. Binder use is a valuable tool especially in recipes based on ingredients with low technological properties such as fish by-products containing spines and scales and soft texture after cooking. Two basal recipes for chunks in gravy were produced to evaluate experimental treatments. One basal recipe used a mixture of salmon and tuna by-products as the only animal protein sources without binders or with a 20 g/kg inclusion of SDAP or WG. The other basal recipe mimicked a more typical commercial recipe containing meat animal ingredients and a 40 g/kg salmon by-product to develop experimental treatments with and 0, 10, 20, 30 or 40 g/kg inclusions of SDAP. Dry matter, protein, and viscosity were evaluated in raw emulsions. After a 1 h retorting at 121 °C, hardness was measured in emulsions and in cooked chunks, juiciness, and Texture Profile Analysis (TPA) were assessed. Results demonstrated the viability of producing quality chunks in gravy containing only fish by-products including 20 g/kg of SDAP, which significantly increased hardness, elasticity, cohesiveness, and juiciness. There was a positive linear correlation of increased SDAP inclusion rate in the commercial recipe for most of the quality parameters evaluated. Based on these results, the inclusion of SDAP in fish recipes can help manufacturers achieve technological quality control targets for commercial wet pet food and may help producers to successfully formulate new recipes for wet pet food products using fish by-products as the sole animal protein source.

Purpose: This study sought to determine health-related quality of life and self-reported complications associated with clean intermittent catheterization (CIC)., Design: Observational, cross-sectional study., Subjects and Setting: The target population was patients cared for by the urology department at Hospital 12 de Octubre in Madrid, Spain, undergoing CIC for chronic urinary retention of any etiology (neurogenic bladder dysfunction, neobladder, and other). The sample comprised 50 respondents with a mean age of 49 years; a majority (66%, n = 33) were female. Participants performed an average of 4 CICs., Methods: All participants completed the ISC-Q (Intermittent Self-Catheterization Questionnaire) and a questionnaire about CIC-associated complications. Data were collected in February 2019., Results: A vast majority of respondents (98%, n = 49) indicated preparation for catheterization was simple, and 76% (n = 38) indicated the catheter was easy to insert. One in 5 (20%, n = 10) considered carrying catheters and supplies inconvenient, though 58% (n = 29) indicated it was easy to dispose of the catheters outside the home. Most respondents (98%, n = 49) indicated they felt self-conscious about their need to self-catheterize, and 16% (n = 8) felt that CIC created limitations when visiting friends and family. The most frequent complication was symptomatic urinary tract infections (UTIs); participants reported an average of 1.7 UTIs in the last year. Additional complications, such as epididymo-orchitis, urethral stenosis, and urethral bleeding, were reported by less than 5% (n = 2) of participants., Conclusions: Participants managed by CIC for chronic urinary retention of any cause reported acceptable levels of satisfaction with the procedure. The reported incidence of complications was low, except for UTIs., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 by the Wound, Ostomy and Continence Nurses Society.)

African swine fever virus (ASFV) is a dsDNA virus that can cause high mortality in pigs of all ages. Spray-dried porcine plasma (SDPP) is a highly digestible ingredient used in feed because it benefits performance, gut function and immunity. The objectives were to test if the spray-drying (SD) conditions along with post-drying storage of product for 14 days can inactivate ASFV inoculated in liquid plasma. Fresh liquid porcine plasma was inoculated with ASFV (BA71V) to a final concentration of 105.18 ±0.08 TCID50/mL of liquid plasma. Triplicate 2-L samples of spiked plasma were SD in a lab drier set at an outlet temperature of 80°C or 71°C. The final dried samples were stored at 4°C or 20°C for 14 d. Liquid and SD samples were analyzed for ASFV infectivity in two mirror 24-well plaques containing VERO cells monolayers. Wells were inoculated with different dilutions of SDPP dissolved 1:9 in PBS. One plaque was immediately frozen at -80°C and the other was incubated at 37°C for 3 d. Each dilution was replicated 9 times. After incubation both plaques were analyzed for ASFV by qRT-PCR. Results indicated that the SD process inactivated between 3.2 to 4.2 Logs ASFV TCID50/mL and 2.53 to 2.75 Logs TCID50/mL when the outlet temperature were 80°C and 71°C respectively. All SD samples stored at 4°C or 20°C for 14 d were absent of infectious ASFV. The combination of SD and post drying storage at both temperatures for 14 d was able to inactive >5.18 ±0.08 Log10 of ASFV inoculated in liquid porcine plasma, demonstrating that the manufacturing process for SDPP can be considered safe regarding ASFV., Competing Interests: The authors have read the journal’s policy and the authors of this manuscript have the following competing interests: EB, CR, JR and JPolo are employed by APC Europe, S.L.U. Granollers, Spain and JPolo is employed by APC LLC, Ankeny, IA, USA. APC Europe and APC LLC manufactures and sells spray-dried animal plasma; however, the companies did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. This does not alter the authors’ adherence to all PLOS ONE policies on sharing data and materials. JPujols, NN and JS declared no conflict of interest., (Copyright: © 2023 Blázquez 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.)

SARS-CoV-2 infection causes COVID-19. Several clinical reports have linked COVID-19 during pregnancy to negative birth outcomes and placentitis. However, the pathophysiological mechanisms underpinning SARS-CoV-2 infection during placentation and early pregnancy are not clear. Here, to shed light on this, we used induced trophoblast stem cells to generate an in vitro early placenta infection model. We identified that syncytiotrophoblasts could be infected through angiotensin-converting enzyme 2 (ACE2). Using a co-culture model of vertical transmission, we confirmed the ability of the virus to infect syncytiotrophoblasts through a previous endometrial cell infection. We further demonstrated transcriptional changes in infected syncytiotrophoblasts that led to impairment of cellular processes, reduced secretion of HCG hormone and morphological changes vital for syncytiotrophoblast function. Furthermore, different antibody strategies and antiviral drugs restore these impairments. In summary, we have established a scalable and tractable platform to study early placental cell types and highlighted its use in studying strategies to protect the placenta., (© 2023. The Author(s).)

Samples from potato fields with lesions with late blight-like symptoms were collected from eastern North Carolina in 2017 and the causal agent was identified as Phytophthora nicotianae. We have identified P. nicotianae in potato and tomato samples from North Carolina, Virginia, Maryland, Pennsylvania, and New York. Ninety-two field samples were collected from 46 fields and characterized for mefenoxam sensitivity, mating type, and simple sequence repeat genotype using microsatellites. Thirty-two percent of the isolates were the A1 mating type, while 53% were the A2 mating type. In six cases, both A1 and A2 mating types were detected in the same field in the same year. All isolates tested were sensitive to mefenoxam. Two genetic groups were discerned based on STRUCTURE analysis: one included samples from North Carolina and Maryland, and one included samples from all five states. The data suggest two different sources of inoculum from the field sites sampled. Multiple haplotypes within a field and the detection of both mating types in close proximity suggests that P. nicotianae may be reproducing sexually in North Carolina. There was a decrease in the average number of days with weather suitable for late blight, from 2012 to 2016 and 2017 to 2021 in all of the North Carolina counties where P. nicotianae was reported. P. nicotianae is more thermotolerant than P. infestans and grows at higher temperatures (25 to 35°C) than P. infestans (18 to 22°C). Late blight outbreaks have decreased in recent years and first reports of disease are later, suggesting that the thermotolerant P. nicotianae may cause more disease as temperatures rise due to climate change., Competing Interests: The author(s) declare no conflict of interest.

A 49-year old patient (BMI 29.4kg/m 2 and ASA III) with grade III subglottic stenosis (> ventilator in flow controlled ventilation mode, which allowed us to regulate both inspiratory and expiratory flow without compromising gas exchange despite maintaining peak FIO 2 at 0.3 due to the risk of ignition. Before proceeding with endoscopic dilation, the 4.5mm laser endotracheal tube was withdrawn and high flow nasal cannula oxygenation was started in order to prolong apnoeic oxygenation. Total apnoea time was 11min, maintaining SpO 2 >70%) underwent laser resection followed by dilation. During resection he was ventilated by the Evone>ventilator; high flow nasal cannula therapy; apnoeic oxygenation-98% and peak EtCO 2 60mmHg throughout the procedure., (Copyright © 2023 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.)

A total of 216 Cobb 500 broiler breeder hens were randomly distributed across 2 dietary treatments with 0 or 1% spray-dried plasma (SDP) resulting in 27 replications/treatment and 4 birds/replication. In addition, 36 roosters were divided between the same treatments and housed, in individual pens, being each bird considered a replicate. Experimental diets were fed from 26 wk until 65 wk of age. At 29, 45, and 63 wk of age, broiler breeder hens were inseminated, and eggs were incubated. Three progeny studies were performed and hatched birds were allocated in a randomized 2 × 2 factorial design (maternal diet: with or without inclusion of 1% SDP × progeny diet: with or without the inclusion of 2% SDP from 1 to 7 d of age). After 7 d of age, all birds received the same diet until 42 d. In all trials, birds were challenged with coccidiosis vaccine at 7 d of age. Furthermore, in the second experiment, heat stress was also included for 6 h a day during the whole trial. At 42-days posthatch in the first experiment, greater FI, BW, and BWG in chicks hatched from breeders fed 1% dietary SDP was observed. This effect did not extend to the other hatches. In the second trial, a decreased FCR in broilers fed the control diet from breeder hens fed 1 % of SDP was observed, as well as an interaction between the SDP groups, since broilers supplemented with SDP and originated from breeders fed SDP showed higher BW and BWG in comparison to other groups at 42 d. In the third trial, contrary to what was observed in the first study, SDP supplementation did not affect any of the performance indexes. In the 3 studies, no differences were found in carcass characteristics. SDP did not affect hen BW, egg production, fertility, or hatch of fertile. These results suggest that providing dietary SDP to broilers has some beneficial effects on broiler chickens., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Antiphospholipid syndrome is an autoimmune disorder characterized by antiphospholipid antibodies, which can lead to both arterial and venous thrombosis. Neurological manifestations of antiphospholipid syndrome are diverse and can include stroke, seizures, and transient ischemic attacks. We present the case of an elderly patient with right hemisyndrome secondary to underlying antiphospholipid syndrome. This report aims to highlight the importance of recognizing antiphospholipid syndrome as a potential cause of neurologic deficits, precisely right hemisyndrome, and to emphasize the need for early diagnosis and appropriate management., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Raza et al.)

Roux-en-Y gastric bypass (RYGB) is a minimally invasive procedure that usually takes two hours. It is commonly performed in refractory cases to help morbidly obese patients (BMI ≥ 40 kg/m2) lose weight. It is well known that morbid obesity accompanies other comorbid conditions such as atherosclerotic diseases, strokes, cancers, and mental health issues such as anxiety and depression. It is crucial to treat this category of patients to improve their quality of life and minimize the chance of mortality in these patients. Given the importance of treating this group, we explored the long-term outcomes of patients who underwent bariatric surgery for cardiovascular diseases, cancer, and depression compared to those who did not. This systematic review utilized articles identified through PubMed using the following search terms: (morbidly obese OR obesity OR obese) AND (bariatric surgery OR metabolic surgery OR gastric bypass OR gastrectomy) AND (chronic disease OR chronic diseases OR cardiovascular diseases OR heart diseases OR cancer OR neoplasms OR stroke OR depressive disorder OR depression). The filter used was observational studies, which yielded 217 studies. Out of these results, eight citations were included in an observational study that met our eligibility criteria. From our search, the articles showed a clinically significant decrease in the incidence of cardiovascular disease, cancer, and depressive disorders after treatment with bariatric surgery. Furthermore, there was also a correlation between bariatric surgery and remission of type 2 diabetes. The surgery has an apparent protective effect on the development and progression of comorbid conditions accompanying morbid obesity. Overall, the quality of life has improved in patients who have undergone the procedure compared to those who have not. Bariatric surgery must be recommended as a beneficial option in managing morbidly obese patients (BMI ≥ 40 kg/m2) who have responded poorly to first-line management plans., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Raza et al.)

Introduction: Patients with neurogenic lower urinary tract dysfunction (NLUTD) reliant on intermittent self-catheterization for bladder emptying are at an increased risk of recurrent urinary tract infections (rUTI). So far, the most common practice in the prevention of rUTIs is long-term low-dose antibiotic prophylaxis, phytotherapy, and immunomodulation, whereby antibiotic prophylaxis inevitably leads to the emergence of drug-resistant pathogens and difficulty in treating infections. Therefore, non-antibiotic alternatives in the prevention of rUTIs are urgently required. We aim to identify the comparative clinical effectiveness of a non-antibiotic prophylaxis regimen in the prevention of recurrent urinary tract infections in patients with neurogenic bladder dysfunction who practice intermittent self-catheterization., Methods and Analysis: In this multi-centre, prospective longitudinal multi-arm observational study, a total of 785 patients practising intermittent self-catheterisation due to NLUTD will be included. After inclusion, non-antibiotic prophylaxis regimens will be instilled with either UroVaxom ® (OM-89) standard regimen, StroVac ® (bacterial lysate vaccine) standard regimen, Angocin ® , D-mannose (oral dose 2 g), bladder irrigation with saline (once per day). The management protocols will be pre-defined, but the selection of the protocol will be at the clinicians' discretion. Patients will be followed for 12 months from the onset of the prophylaxis protocol. The primary outcome is to identify the incidence of breakthrough infections. The secondary outcomes are adverse events associated with the prophylaxis regimens and the severity of breakthrough infections. Other outcomes include the exploration of change in susceptibility pattern via the optional rectal and perineal swab, as well as health-related quality of life over time (HRQoL), which will be measured in a random subgroup of 30 patients., Ethics and Dissemination: Ethical approval for this study has been granted by the ethical review board of the University Medical Centre Rostock (A 2021-0238 from 28 October 2021). The results will be published in a peer-reviewed journal and presented at relevant meetings., Study Registration Number: German Clinical Trials Register: Number DRKS00029142.

Background: Pulmonary rehabilitation (PR) decreases rehospitalization for people with COPD. However, less than 2% receive PR, partly due to lack of referral and sparsity of PR facilities. This disparity is particularly pronounced in African American and Hispanic persons with COPD. Telehealth-provided PR could increase access and improve health outcomes., Methods: We applied the RE-AIM framework in a post-hoc analysis of our mixed methods RCT comparing referral to Telehealth-delivered PR (TelePR) versus standard PR (SPR) for African American and Hispanic COPD patients hospitalized for COPD exacerbation. Both arms received a referral to PR for 8 weeks, social worker follow-up, and surveys administered at baseline, 8 weeks, 6, and 12 months. PR sessions were conducted twice a week for 90 min each (16 sessions total). Quantitative data were analyzed using 2-sample t tests or nonparametric Wilcoxon tests for continuous data and χ 2 /Fisher exact tests for categorical data. Logistic regression-estimated odds ratios (ORs) were used for the intention-to-treat primary outcome. Qualitative interviews were conducted at the end of the study to assess adherence and satisfaction and were analyzed using inductive and deductive methods. The goal was to understand Reach (whether the target population was able to be enrolled), Effectiveness (primary outcome was a composite of 6-month COPD rehospitalization and death), Adoption (proportion of people willing to initiate the program), Implementation (whether the program was able to be executed as intended, and Maintenance (whether the program was continued)., Results: Two hundred nine people enrolled out of a 276-recruitment goal. Only 85 completed at least one PR session 57/111 (51%) TelePR; 28/98 (28%) SPR. Referral to TelePR compared to SPR did not decrease the composite outcome of 6-month COPD-readmission rate/death (OR1.35;95%CI 0.69,2.66). There was significant reduction in fatigue (PROMIS® scale) from baseline to 8-weeks in TelePR compared to SPR (MD-1.34; ± SD4.22; p = 0.02). Participants who received TelePR experienced improvements from baseline in several outcomes (ie, before and after 8 weeks of PR) in the following: COPD symptoms, knowledge about COPD management, fatigue, and functional capacity. Among the patients who had 1 initial visit, adherence rates were similar (TelePR arm, 59% of sessions; SPR arm, 63%). No intervention-related adverse events occurred. Barriers to PR adoption included difficulty or reluctance to complete medical clearances and beliefs about PR efficacy. Notably, only 9 participants sustained exercise after program completion. Maintenance of the program was not possible due to low insurance reimbursement and sparsity of Respiratory Therapists., Conclusions: TelePR can reach COPD patients with health disparities and can be successfully implemented. The small sample size and large confidence intervals prevent conclusion about the relative effectiveness of participating in TelePR compared to SPR. However, improved outcomes were seen for those in TelePR as well as in SPR. Increasing adoption of PR and TelePR requires consideration of comorbidity burden, and perception of PR utility, and must facilitate medical clearances. Given the sparsity of SPR locations, TelePR can overcome at least the barrier of access. However, given the challenges to the uptake and completion of PR - many of the additional barriers in PR (both in TelePR and SPR) need to be addressed. Awareness of these real-world challenges will not only inform implementation of TelePR for clinicians seeking to adopt this platform but will also inform study designers and reviewers regarding the feasibility of approaches to patient recruitment and retention., (© 2023. The Author(s).)