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Climate modelling and analysis are facing new demands to enhance projections and climate information. Here we argue that now is the time to push the frontiers of machine learning beyond state-of-the-art approaches, not only by developing machine-learning-based Earth system models with greater fidelity, but also by providing new capabilities through emulators for extreme event projections with large ensembles, enhanced detection and attribution methods for extreme events, and advanced climate model analysis and benchmarking. Utilizing this potential requires key machine learning challenges to be addressed, in particular generalization, uncertainty quantification, explainable artificial intelligence and causality. This interdisciplinary effort requires bringing together machine learning and climate scientists, while also leveraging the private sector, to accelerate progress towards actionable climate science.

OVERVIEW: The retail grocery sector is not a leader in new product development due to inherent innovation risks and retailers' complex relationships with suppliers. Product co-innovation is an effective way to overcome innovation barriers and is feasible when retailers collaborate with customers and suppliers. We present a case study of Mercadona, a leading retailer in Spain that introduces new products developed using a novel co-innovation approach where customers and suppliers collaborate in innovation hubs from the start of the ideation phase. Other companies can learn from Mercadona's innovation journey over the last 20 years. KEYWORDS: Co-innovation, Customer focus, Retailing, In the consumer retail sector, especially the grocery sector, innovation occurs primarily in infrastructure--shelf positioning, product arrangement, and information technology--and less frequently in new product development. Lack of new product [...]

Background and objectivesAntimicrobial stewardship programmes (ASPs) have resulted in antimicrobial consumption (AMC) reduction and quality of prescription (QOP) improvement. However, evidence of ASP impact in paediatrics is still limited. This study aims to assess a paediatric ASP long-term outcomes.MethodsA quality improvement study assessed by a interrupted time series analysis was conducted in a paediatric tertiary hospital. QOP expressed as proportion of adequate prescriptions, AMC measured by defined daily dose incidence per 1000 occupied bed days, incidence density of bloodstream infections (BSIs) and its related all-cause crude death rate (CDR) were compared between pre (from January 2013 to December 2015) and post (from January 2016 to December 2019) ASP activities intensification, which included a dedicated paediatric infectious diseases physician to actively perform educational interviews with prescribers.ResultsInappropriate prescribing showed a significant downward shift associated to the intervention with a −51.4% (−61.2% to −41.8%) reduction with respect to the expected values. Overall AMC showed no trend change after the intervention. For neonatology a28.8% (−36.8% to −20.9%) reduction was observed. Overall anti-pseudomonal cephalosporin use showed a −51.2% (−57.0% to −45.4%) reduction. Decreasing trends were observed for carbapenem use, with a quarterly per cent change (QPC) of −2.4% (−4.3% to −0.4%) and BSI-related CDR (QPC=−3.6%; −5.4% to −1.7%) through the study period. Healthcare-associated multi-drug-resistant BSI remained stable (QPC=2.1; −0.6 to 4.9).ConclusionsIntensification of counselling educational activities within an ASP suggests to improve QOP and to partially reduce AMC in paediatric patients. The decreasing trends in mortality remained unchanged.

Increased serum urate (SU) and hyperuricemia (HU) are associated with chronic noncommunicable diseases and mortality. SU concentrations are affected by several factors, including diet, and are expected to rise with age. We investigated whether the Dietary Approaches to Stop Hypertension (DASH) diet alter this trend.

Abstract: Background: Total colectomy is the surgery of choice for colonic inertia (CI) when medical treatment has failed. Laparoscopic total colectomy has demonstrated to be a feasible technique. Objective: Present our experience in patients with CI who underwent laparoscopic total colectomy (TC) + ileorectoanastomosis (IRA) and evaluate the functional results and medium-term follow-up after this surgery. Material and methods: All patients with CI were included in a prospective laparoscopic surgical protocol, from 2002 to 2007. These patients had a complete work-up for chronic constipation (clinical records, barium enema, colonic transit time, defecography, anorectal manometry, small bowel follow through). All patients were evaluated with Wexner’s score for constipation pre- and postoperatively, asked if they would recommend surgery to other patients, and if they were satisfied with the procedure (on a scale from 1 to 10). Statistical analysis was carried out using Student’s T-test. Results: In this period 20 patients were operated with diagnosis of CI. All patients were females with an average age of 41.5 years (range 18–52 years). Mean operative time was 248 min (range 170–360 min). One (5%) patient was converted to open surgery. The medium time to flatus per anum and feeding was 2 (range 1–6) and 3 (range 2–6) days, respectively. The medium postoperative stay was 7 days. Seven patients (35%) presented surgical postoperative complications (three postoperative ileus, one portal thrombosis, one rectal hemorrhage, one anastomotic leakage, and one hemoperitoneum). There was no postoperative mortality. The average follow-up was 25 months (range 1–60 months). Preoperative Wexner’s constipation score was 22.3 (range 19–29 months) pre surgery and at the end of follow-up was 1.8 (range 0–6) (p < 0.01). The medium level of satisfaction was 8 (range 2–10) and only one patient would not recommend surgery to other patients. Conclusion: The laparoscopic access is a safe technique with satisfactory functional results after medium-term follow-up.

AbstractEffective science communication for a multilingual population requires more than language translation, it also requires being mindful of cultural communication styles. This study tested the impact that communication style has on feelings of inclusion, learning, and engagement in the Earth sciences for Hispanic and Latinx adults. An online survey with open and closed questions was used to evaluate two science videos (in both Spanish and English) with different communication styles: 1) a traditional, interview-based style, where experts present a science concept, and 2) an informal conversational style, where a scientific message is shared through a casual conversation. Seventy-four participants self-identified as Hispanic and Latinx and were the focus of the data analysis. Both video styles were positively received, with participant feedback emphasizing feelings of inclusion in seeing Latina scientists, easy to understand science concepts, and accessible language. Hispanic and Latinx adults preferred the traditional video, but the conversational video ranked higher in other aspects, which varied based on participants’ primary spoken language at home. For example, the conversational video had a positive impact on the ability to relate information to their own life and increase awareness of Earth science careers for Spanish-language speakers. Findings suggest the use of both video styles could improve feelings of inclusion and engagement for Hispanic and Latinx adults. Additional aspects of culture and demographics may explain some of the language-based results. Future science videos are encouraged to be co-designed by, for, and with Hispanic and Latinx communities to emphasize cultural values while avoiding stereotyping and cultural appropriation.

Metabolic syndrome (MetS) and common mental disorders are prevalent conditions. However, the relationship of MetS and its components with depression, anxiety, and common mental disorders has not been sufficiently addressed in low-/middle-income countries.

Brugada syndrome (BrS) is a cardiac arrhythmia disorder associated with sudden death in young adults. With the exception of SCN5A, encoding the cardiac sodium channel NaV1.5, susceptibility genes remain largely unknown. Here we performed a genome-wide association meta-analysis comprising 2,820 unrelated cases with BrS and 10,001 controls, and identified 21 association signals at 12 loci (10 new). Single nucleotide polymorphism (SNP)-heritability estimates indicate a strong polygenic influence. Polygenic risk score analyses based on the 21 susceptibility variants demonstrate varying cumulative contribution of common risk alleles among different patient subgroups, as well as genetic associations with cardiac electrical traits and disorders in the general population. The predominance of cardiac transcription factor loci indicates that transcriptional regulation is a key feature of BrS pathogenesis. Furthermore, functional studies conducted on MAPRE2, encoding the microtubule plus-end binding protein EB2, point to microtubule-related trafficking effects on NaV1.5 expression as a new underlying molecular mechanism. Taken together, these findings broaden our understanding of the genetic architecture of BrS and provide new insights into its molecular underpinnings.

This study aims to determine the optimal proportion for different chemotherapy schemes in patients with metastatic colorectal cancer who have undergone surgical resection in Colombia.

IMPORTANCE: Truncating variants in the gene encoding filamin C (FLNCtv) are associated with arrhythmogenic and dilated cardiomyopathies with a reportedly high risk of ventricular arrhythmia. OBJECTIVE: To determine the frequency of and risk factors associated with adverse events among FLNCtv carriers compared with individuals carrying TTN truncating variants (TTNtv). DESIGN, SETTING, AND PARTICIPANTS: This cohort study recruited 167 consecutive FLNCtv carriers and a control cohort of 244 patients with TTNtv matched for left ventricular ejection fraction (LVEF) from 19 European cardiomyopathy referral units between 1990 and 2018. Data analyses were conducted between June and October, 2020. MAIN OUTCOMES AND MEASURES: The primary end point was a composite of malignant ventricular arrhythmia (MVA) (sudden cardiac death, aborted sudden cardiac death, appropriate implantable cardioverter-defibrillator shock, and sustained ventricular tachycardia) and end-stage heart failure (heart transplant or mortality associated with end-stage heart failure). The secondary end point comprised MVA events only. RESULTS: In total, 167 patients with FLNCtv were studied (55 probands [33%]; 89 men [53%]; mean [SD] age at baseline evaluation, 43 [18] years). For a median follow-up of 20 months (interquartile range, 7-60 months), 29 patients (17.4%) reached the primary end point (19 patients with MVA and 10 patients with end-stage heart failure). Eight (44%) arrhythmic events occurred among individuals with baseline mild to moderate left ventricular systolic dysfunction (LVSD) (LVEF = 36%-49%). Univariable risk factors associated with the primary end point included proband status, LVEF decrement per 10%, ventricular ectopy (≥500 in 24 hours) and myocardial fibrosis detected on cardiac magnetic resonance imaging. The LVEF decrement (hazard ratio [HR] per 10%, 1.83 [95% CI, 1.30-2.57]; P &lt; .001) and proband status (HR, 3.18 [95% CI, 1.12-9.04]; P = .03) remained independent risk factors on multivariable analysis (excluding myocardial fibrosis and ventricular ectopy owing to case censoring). There was no difference in freedom from MVA between FLNCtv carriers with mild to moderate or severe (LVEF ≤35%) LVSD (HR, 1.29 [95% CI, 0.45-3.72]; P = .64). Carriers of FLNCtv with impaired LVEF at baseline evaluation (n = 69) had reduced freedom from MVA compared with 244 TTNtv carriers with similar baseline LVEF (for mild to moderate LVSD: HR, 16.41 [95% CI, 3.45-78.11]; P &lt; .001; for severe LVSD: HR, 2.47 [95% CI, 1.04-5.87]; P = .03). CONCLUSIONS AND RELEVANCE: The high frequency of MVA among patients with FLNCtv with mild to moderate LVSD suggests that higher LVEF values than those currently recommended should be considered for prophylactic implantable cardioverter-defibrillator therapy in FLNCtv carriers.

•Immune checkpoint inhibitors emerged as a the predominant 2L treatment, leading to a substantial decrease in the utilization of chemotherapies beyond the 1L.•Despite the introduction of immune checkpoint inhibitors, treatment attrition rates remained elevated, with approximately only half of patients undergoing ICIs the post-ICIs era.•When comparing the outcomes of patients treated before and after the introduction of ICIs, we did not observe higher rates of either a 2-year OS or an increase in the number of patients receiving 3L therapies.

Stringent variant interpretation guidelines can lead to high rates of variants of uncertain significance (VUS) for genetically heterogeneous disease like long QT syndrome (LQTS) and Brugada syndrome (BrS). Quantitative and disease-specific customization of American College of Medical Genetics and Genomics/Association for Molecular Pathology (ACMG/AMP) guidelines can address this false negative rate.

At present, no approved pharmacotherapies are available for unclassifiable interstitial lung disease (ILD), which is characterised by progressive fibrosis of the lung. We aimed to assess the efficacy and safety of pirfenidone in patients with progressive fibrosing unclassifiable ILD.

The degree to which weight reduction leads to the remission of hypertension in population studies is not clear. We investigated whether the changes in adiposity measures predicted the remission of hypertension in a racially admixed population over a mean 4-year follow-up. All 4847 hypertensive individuals at baseline (2008–2010) from the multicenter Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were included. Changes in weight, waist circumference (WC), or body mass index (BMI) (reduction or increase ≥5% from baseline values, vs stability) and remission of hypertension (SBP < 140 and DBP < 90 mmHg and no use of antihypertensive medication at follow-up visit, in 2012–2014) were investigated using mixed effects logistic regression models. Proportional attributable benefit was additionally calculated. Analyses were stratified by sex and antihypertensive medication use at baseline. Remission of hypertension was 11.3% (n= 546). Among men, after adjustments, the reduction of weight (OR = 1.52 95% CI 1.10–2.10), WC (OR = 1.56 95% CI 1.04–2.35) or BMI (OR = 1.60 95% CI 1.13–2.27) was associated with the remission of hypertension. Among those not taking antihypertensive medication at baseline, after adjustments, the reduction of weight (OR = 1.64 95% CI 1.18–2.27), WC (OR = 1.76 95% CI 1.18–2.61) or BMI (OR = 1.57 95% CI 1.10–2.25) was associated with the remission of hypertension. Proportional attributable benefit among those with adiposity reduction was about 30%, indicating its potential for prevention. In conclusion, our study reinforces the role of adiposity-reducing strategies (e.g., healthy diet and regular physical activity) for the treatment and prevention of hypertension, which might have potential applications for clinical practice.

Angiotensin peptides have been implicated in idiopathic pulmonary fibrosis (IPF) pathogenesis. Angiotensin modulators are used to treat arterial hypertension, a frequent comorbidity of IPF. This post hoc analysis evaluated associations of antihypertensive treatments with disease-related outcomes in IPF.

A study was carried out to examine the relationship among commitment and use of retailersE information and communication technology (ICT) solutions for retail customers. Finding suggests four segments that differ substantially in commitment.

The electronics era is flourishing and morphing itself into Internet of Everything, IoE. At the same time, questions arise on the issue of electronic materials employed: especially their natural availability and low-cost fabrication, their functional stability in devices, and finally their desired biodegradation at the end of their life cycle. Hydrogen bonded pigments and natural dyes like indigo, anthraquinone and acridone are not only biodegradable and of bio-origin but also have functionality robustness and offer versatility in designing electronics and sensors components. With this Perspective, we intend to coalesce all the scattered reports on the above-mentioned classes of hydrogen bonded semiconductors, spanning across several disciplines and many active research groups. The article will comprise both published and unpublished results, on stability during aging, upon electrical, chemical and thermal stress, and will finish with an outlook section related to biological degradation and biological stability of selected hydrogen bonded molecules employed as semiconductors in organic electronic devices. We demonstrate that when the purity, the long-range order and the strength of chemical bonds, are considered, then the Hydrogen bonded organic semiconductors are the privileged class of materials having the potential to compete with inorganic semiconductors. As an experimental historical study of stability, we fabricated and characterized organic transistors from a material batch synthesized in 1932 and compared the results to a fresh material batch.

Introduction: Treatment of patients with adult congenital heart disease (ACHD) with advanced therapies including heart transplant (HT) is often delayed due to paucity of objective prognostic markers for the severity of heart failure (HF). While the utility of Cardiopulmonary Exercise Testing (CPET) in non-ACHD patients has been well-defined as it relates to prognosis, CPET for this purpose in ACHD is still under investigation.Methods: We performed a retrospective cohort study of 20 consecutive patients with ACHD who underwent HT between March 2010 and February 2016. Only 12 of 20 patients underwent CPET prior to transplantation. Demographics, standard measures of CPET interpretation, and 30-day and 1-year post transplantation outcomes were collected.Results: Patient Characteristics. Twenty patients with ACHD were transplanted at a median of 40 years of age (range: 23-57 years). Of the 12 patients who underwent CPET, 4 had undergone Fontan procedures, 4 had tetralogy of Fallot, 3 had d-transposition of the great arteries, and 1 had Ebstein anomaly. Thirty-day and one-year survival was 100%. All tests included in the analysis had a peak respiratory quotient _1.0. The median peak oxygen consumption per unit time (_VO2) for all diagnoses was 18.2 mL/kg/min (46% predicted), ranging from 12.2 to 22.6.Conclusion: There is a paucity of data to support best practices for patients with ACHD requiring transplantation. While it cannot be proven based on available data, it could be inferred that outcomes would have been worse or perhaps life sustaining options unavailable if providers delayed referral because of the lack of attainment of CPET-specific thresholds.

The fungicide agents are a key component in the fruits and vegetables production. The Iprodione residues are one of the pesticide more frequently found in food products. The available data about the cytotoxicity of iprodione and its metabolites are scarce and do not allow characterization of its genotoxic potential and define the risk assessment.The human larynx epidermoid carcinoma cell line (HEp-2) has been shown to be sensitive to the toxic effects of xenobiotics of different origin and have been often used in citotoxicity and genotoxicity studies. The purpose of this paper is to evaluate the induction of genotoxicity and the role of oxidative stress in HEp-2cell line by exposure to the IP. The MTT test for viability resulted in CL5085.86 (77.05–95.68) μg/mL of Iprodione. On the basis of this result, we proceeded to expose the cells to the sublethal concentrations (below the CL50) during 24 h to analyze the mitotic index and nuclear division index in order to determine the subcytotoxic concentrations of IP which the genotoxicity was evaluated. The subcytotoxic concentrations of 7, 17, and 25 μg/mL IP induced aneugenic effects as micronuclei centromere positive whereas 17 μg/mL was a threshold for centromere negative micronuclei induction in HEp-2 cells. The abnormal mitosis was induced for exposition of Hep-2 cells to the three concentrations. According to the result obtained, citotoxicity and genotoxicity oxidative stress studies were performed in 1.5, 7.0, and 25 μg/mL of IP. The results showed that the GSH intracellular content, the SOD activity and the levels of oxidative damage of the proteins were affected lead to redox imbalance. The decreased in the SOD activity and protein oxidation were in according to the result obtained to genotoxicity, suggesting that different biological targets could be affected.

Duchenne muscular dystrophy is a disorder with variable expression caused by framedisrupting mutations in the dystrophin gene. It is characterized by progressive muscle weakness and dilated cardiomyopathy. In-frame dystrophin mutations cause a clinically moderate disorder named Becker muscular dystrophy. Our aim was to study the clinical and genetic characteristics of a family with inherited cardiomyopathy and Becker muscular dystrophy. The index case was diagnosed with psychomotor retardation at 5 years of age. Asymmetric left ventricular hypertrophy and a long QT interval were evidenced at the age of 12. Mild muscular weakness was developed subsequently. Three genetic variants were identified in the index case: p.Arg891Alafs*160 in the MYBPC3 gene, p.Thr263Met in the KCNJ5 gene, and p.Ser2437_Ile2554delinsPhe in the DMD gene. The latter was expected to generate an in-frame deletion of exons 51 and 52 of the dystrophin gene. A family study revealed that the father and 3 uncles were carriers of the MYBPC3 mutation. The mother and a maternal grandfather were carriers of the other 2 variants. The 80-year-old grandfather, who had the dystrophin mutation, showed no sign of cardiomyopathy or muscular weakness. The deletion of exons 51 and 52 in the DMD gene, which has been proposed as one of the therapeutic strategies for Duchenne, is consistent with a normal life expectancy and the absence of myopathic symptoms in hemizygous males.

The hydrophilic nature of hydrogels allows their swelling in aqueous solutions. In that way, any substance loaded inside the gel is exposed to the aqueous media and could be released if it is soluble in water. However, only substances that are soluble in water can be loaded inside a gel, which can be swelled only in water. In this work, we studied the swelling of poly(N-isopropylacrylamide) (PNIPAM) gels in nonaqueous solvents and their solutions with water. PNIPAM gels swell strongly in highly polar solvents, but they do not swell in slightly polar solvents (e.g., toluene). However, it is possible to swell the gel in mixtures containing toluene. The observed properties of PNIPAM gels allow describing them both as solvogels or amphigels. When the loaded substance is soluble in one solvent (e.g., water) and not in another (e.g., chloroform), the substance is not released but exposed to the new media. As a proof of concept, a colorimetric pH sensor active in CHCl3and a Cu1+sensor in water were built. Moreover, using a ternary solution containing toluene linear polystyrene can be loaded inside the gel, making a semi-interpenetrated network. Because PNIPAM swells in water and solvents immiscible in water, a liquid/liquid interphase can be set inside a gel. A near-infrared absorbing dye (soluble in CHCl3) is loaded in only half of a thermoresponsive PNIPAM gel. Upon near-infrared irradiation, only the region where the dye is loaded heats up driving the phase transition of PNIPAM.

Long‐term trends suggest shifts toward earlier tornado season peaks, and yet fail to examine the role of year‐to‐year climate variability. Here, El Niño–Southern Oscillation phase is demonstrated to influence annual cycle characteristics of United States tornadoes. Observations and favorable environments show substantial modification of the peak spatial distribution and the temporal onset of tornado occurrence. La Niña produces an earlier annual peak probability by 1.5–2 weeks, with a higher overall fraction of events in March and April. In contrast, El Niño leads to a week delay in the maximum probability and enhances a second peak in the fall months. Consequently, this suggests that climate change is not the sole driver of changes to seasonal onset and peak, and climate variability plays an important role in modulating the annual cycle. What drives the onset of tornado season, and can we point to a changing climate as the cause of a trend toward an earlier season start date? In this paper, climate variability driven by equatorial Pacific sea surface temperature variations (El Niño–Southern Oscillation) is shown to modulate the characteristics of when the majority of tornadoes in any given year occur, and the timing of the season peak. La Niña is shown to shift the bulk of tornado season earlier by 1.5–2 weeks relative to years when no Pacific sea surface temperature anomaly exists, while El Niño delays the maximum daily frequency by a week. This result contrasts earlier studies that show long‐term trends of a similar or smaller magnitude, which had previously suggested that climate variability does not modulate the annual cycle. The results here provide the potential for guidance as to season onset in developing seasonal tornado outlooks. El Niño–Southern Oscillation modulates both the timing and magnitude of the annual cycle for tornadoesClimate variability plays a substantial role in the characteristics of the annual cycle of tornadoesSeasonal cycle shifts by El Niño–Southern Oscillation are significant compared to historical tornado record trends

Factors at the level of family/healthcare worker, organization, and system are neglected in medication nonadherence research in heart transplantation (HTx). The 4‐continent, 11‐country cross‐sectional Building Research Initiative Group: Chronic Illness Management and Adherence in Transplantation (BRIGHT) study used multistaged sampling to examine 36 HTx centers, including 36 HTx directors, 100 clinicians, and 1397 patients. Nonadherence to immunosuppressants—defined as any deviation in taking or timing adherence and/or dose reduction—was assessed using the Basel Assessment of Adherence to Immunosuppressive Medications Scale©(BAASIS©) interview. Guided by the Integrative Model of Behavioral Prediction and Bronfenbrenner's ecological model, we analyzed factors at these multiple levels using sequential logistic regression analysis (6 blocks). The nonadherence prevalence was 34.1%. Six multilevel factors were associated independently (either positively or negatively) with nonadherence: patient level: barriers to taking immunosuppressants (odds ratio [OR]: 11.48); smoking (OR: 2.19); family/healthcare provider level: frequency of having someone to help patients read health‐related materials (OR: 0.85); organization level: clinicians reporting nonadherent patients were targeted with adherence interventions (OR: 0.66); pickup of medications at physician's office (OR: 2.31); and policy level: monthly out‐of‐pocket costs for medication (OR: 1.16). Factors associated with nonadherence are evident at multiple levels. Improving medication nonadherence requires addressing not only the patient, but also family/healthcare provider, organization, and policy levels. Multilevel factors, such as relation to the patient, healthcare provider, transplant center, and healthcare system, are associated with immunosuppressive drug nonadherence in heart transplant recipients, indicating a need for multilevel interventions to address nonadherence.

In this review modification of cellulose and alumina membranes are studied. Cellulose membranes are classified by the derivatives used for its modification. General biomedical applications of modified cellulose membranes with organic substrates are studied and their specific applications with organic substrates are also analysed. Review includes preparation of zwitterionic polymers on cellulose membranes and its biocompatibility, antioxidant activity and the fabrication of biosensors and biochips by immobilising biomolecules; the study of drug delivery systems; membranes for anti-contaminant activity, wastewater filtration and finally the modification of regenerated cellulose membranes with lipid nanoparticles and layers. Regarding the alumina membranes modified with organic compounds, specific applications in biomedical field are studied.

Background: In this review, we summarized the relevance of anisotropic morphologies in the synthesis and applications of metal nanoparticles, including Janus nanoparticles. In recent years, the control over the shape of metal particles has successfully achieved. Non-spherical gold nanoparticles such as rods, wires, cubes, triangular prisms, decahedra, or octahedra exhibit unique properties that differ from those of symmetric, spherical gold nanoparticles. Objective: This article provides a general view of current research in the field of anisotropic metal nanoparticles. We begin by explaining the relevance of anisotropic metal nanoparticles in the field of nanotechnology. Then, we distinguish between physical and chemical method frequently performed for the preparation of metallic nanoparticles. In this review we only focus in chemical methods, and the following sections divide the most recently published procedures in two different methods for chemical synthesis: seed-mediated growth and seedless procedures. For each of these routes, we present the fabrication of metal particles in aqueous or organic media. Conclusion: In this review, we also describe numerous procedures for the functionalization of several anisotropic morphologies with silica, poly(N-isopropylacrylamide) (pNIPAM), as well as the fabrication of bimetallic core shell structures. We hope that this review will help the scientists to carry out several general routes for the synthesis of non-spherical particles to exploit their efficacy for wide applications.

Idiopathic pulmonary fibrosis (IPF) is a progressive parenchymal lung disease of complex cause. Gastro-oesophageal reflux (GER) and microaspiration have been proposed as risk factors for the development and progression of IPF, but robust definitive data are few. A recent international guideline conditionally recommended the use of antacid therapy (proton pump inhibitors or histamine-2-receptor antagonists) for patients with IPF, in the absence of oesophageal reflux or symptoms. In this Position Paper, we summarise the literature addressing the association between GER and IPF, and also identify future research priorities that could clarify this issue. We shed light on the process through which the guideline recommendation was achieved and aim to contextualise the recommendation for providers caring for patients with IPF.

Objective: To estimate the association between regular consumption of sweetened soft drinks, natural fruit juice, and coconut water with metabolic syndrome (MetS).Methods: This was a cross-sectional study including men and women aged 35–74 years from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) Study, excluding patients with type 2 diabetes. The main explanatory variables were beverage consumption and the outcome variable was metabolic syndrome (Adult Treatment Panel III).Results: After adjustments, a daily intake of 250 ml of soft drink increased the chance of metabolic syndrome (odds ratio [OR] = 1.95; 95% confidence interval [CI], 1.60–2.38). There was no association between coconut water and MetS. Moderate consumption of fruit juices has low odds of MetS compared to no consumption.Conclusion: Our results add evidence to potential negative effects of sweetened soft drinks on cluster metabolic abnormalities in middle-income countries.

Myofibroblasts are key effector cells in tissue stiffening and fibrosis progression, but the contribution of cells undergoing epithelial–mesenchymal transition (EMT) is unclear. Unlike EMT, myofibroblasts contribute to tissue stiffening through their contractility and expression of fibrillar collagens, which is associated with aberrant FAK (Y397) hyperactivation.

BackgroundRetinitis pigmentosa (RP) is the most common form of inherited retinal dystrophy, with a worldwide prevalence of 1 in 4000 persons. While in most cases of RP, the disease is limited to the eye (non-syndromic), over 40 forms of syndromic RP have been described.ObjectivesTo identify the genetic basis for syndromic RP in three unrelated families from Israel and Spain.MethodsWhole exome sequencing was conducted in one Israeli and two Spanish families segregating autosomal recessive RP with intellectual disability. Complete ophthalmic examination included best-corrected visual acuity, funduscopy, optical coherence tomography, fluorescein angiography, flash visual evoked potentials, and electroretinography. Reverse transcription (RT)-PCR and immunostaining were used to examine the spatial and temporal expression pattern of SCAPER.ResultsIn all patients, biallelic SCAPERmutations were observed. Clinically, patients with SCAPERmutations show signs of typical RP. In addition, they have mild to moderate intellectual disability and attention-deficit/hyperactivity disorder. SCAPERwas found to be ubiquitously expressed in a wide range of human tissues, including retina and brain. Furthermore, RT-PCR analysis revealed that in both mouse eye and brain, Scaperis expressed as early as embryonic day 14. In the mouse retina, SCAPER is located in multiple layers, including the retinal pigment epithelium, photoreceptor outer and inner segments, the inner plexiform layer and the ganglion cell layer.ConclusionsDeleterious SCAPERmutations were identified in four patients from three unrelated families of different ethnic backgrounds, thereby confirming the involvement of this gene in the aetiology of autosomal recessive syndromic RP.

ObjectivesThe purpose of our study is (1) to characterise patients with congenital heart disease undergoing heart transplantation by adult cardiac surgeons in a large academic medical centre and (2) to describe successful outcomes associated with our multidisciplinary approach to the evaluation and treatment of adults with congenital heart disease (ACHD) undergoing orthotopic heart transplantation (OHT).BackgroundHeart failure is the leading cause of death in patients with ACHD leading to increasing referrals for OHT.MethodsThe Penn Congenital Transplant Database comprises a cohort of patients with ACHD who underwent OHT between March 2010 and April 2016. We performed a retrospective cohort study of the 20 consecutive patients. Original cardiac diagnoses include single ventricle palliated with Fontan (n=8), dextro-transposition of the great arteries after atrial switch (n=4), tetralogy of Fallot (n=4), pulmonary atresia (n=1), Ebstein anomaly (n=1), unrepaired ventricular septal defect (n=1) and Noonan syndrome with coarctation of the aorta (n=1).ResultsEight patients required pretransplant inotropes and two required pretransplant mechanical support. Nine patients underwent heart–liver transplant and three underwent heart–lung transplant. Three patients required postoperative mechanical circulatory support. Patients were followed for an average of 38 months as of April 2016, with 100% survival at 30 days and 1 year and 94% overall survival (19/20 patients).ConclusionsACHD–OHT patients require highly specialised, complex and multidisciplinary healthcare. The success of our programme is attributed to using team-based, patient-centred care including our multidisciplinary staff and specialists across programmes and departments.

Insulin resistance is characterized by the failure of target cells to respond to normal levels of circulating insulin, and this condition is related to cardiovascular disease. This study sought to evaluate the prevalence of insulin resistance and its association with markers of metabolic abnormalities and metabolic syndrome in bank employees.

One view of sarcoidosis is that the term covers many different diseases. However, no classification framework exists for the future exploration of pathogenetic pathways, genetic or trigger predilections, patterns of lung function impairment, or treatment separations, or for the development of diagnostic algorithms or relevant outcome measures. We aimed to establish agreement on high-resolution CT (HRCT) phenotypic separations in sarcoidosis to anchor future CT research through a multinational two-round Delphi consensus process. Delphi participants included members of the Fleischner Society and the World Association of Sarcoidosis and other Granulomatous Disorders, as well as members' nominees. 146 individuals (98 chest physicians, 48 thoracic radiologists) from 28 countries took part, 144 of whom completed both Delphi rounds. After rating of 35 Delphi statements on a five-point Likert scale, consensus was achieved for 22 (63%) statements. There was 97% agreement on the existence of distinct HRCT phenotypes, with seven HRCT phenotypes that were categorised by participants as non-fibrotic or likely to be fibrotic. The international consensus reached in this Delphi exercise justifies the formulation of a CT classification as a basis for the possible definition of separate diseases. Further refinement of phenotypes with rapidly achievable CT studies is now needed to underpin the development of a formal classification of sarcoidosis.

Single atom catalysts (SACs) possess unique catalytic properties due to low-coordination and unsaturated active sites. However, the demonstrated performance of SACs is limited by low SAC loading, poor metal–support interactions, and nonstable performance. Herein, we report a macromolecule-assisted SAC synthesis approach that enabled us to demonstrate high-density Co single atoms (10.6 wt % Co SAC) in a pyridinic N-rich graphenic network. The highly porous carbon network (surface area of ∼186 m2g–1) with increased conjugation and vicinal Co site decoration in Co SACs significantly enhanced the electrocatalytic oxygen evolution reaction (OER) in 1 M KOH (η10at 351 mV; mass activity of 2209 mA mgCo–1at 1.65 V) with more than 300 h stability. Operando X-ray absorption near-edge structure demonstrates the formation of electron-deficient Co-O coordination intermediates, accelerating OER kinetics. Density functional theory (DFT) calculations reveal the facile electron transfer from cobalt to oxygen species-accelerated OER.

This study investigates the relationship between recurrent binge eating episodes and nutritional and food profiles and lifestyle in the Brazilian Longitudinal Study of Adult Health (Estudo Longitudinal da Saúde do Adulto – ELSA-Brazil) cohort. Recurrent binge eating episodes were associated with obesity (OR 5.188; confidence interval [CI] 4.051–6.645), overweight (OR 2.534; CI 1.980–3.243), female sex (OR 1.918; CI 1.573–2.338), age between 34 and 54 years old (OR 1.349; CI 1.115–1.631), alcohol ingestion ≥ 5 in two hours (OR 1.397; CI 1.068–1.827), and insufficient physical activity (OR 1.290; CI 1.078–1.544). Being overweight has an important association with recurrent binge eating episodes, as does demographic and lifestyle characteristics, including excessive alcohol consumption.

Extreme precipitation events, including those associated with weather fronts, have wide‐ranging impacts across the world. Here we use a deep learning algorithm to identify weather fronts in high resolution Community Earth System Model (CESM) simulations over the contiguous United States (CONUS), and evaluate the results using observational and reanalysis products. We further compare results between CESM simulations using present‐day and future climate forcing, to study how these features might change with climate change. We find that detected front frequencies in CESM have seasonally varying spatial patterns and responses to climate change and are found to be associated with modeled changes in large scale circulation such as the jet stream. We also associate the detected fronts with precipitation and find that total and extreme frontal precipitation mostly decreases with climate change, with some seasonal and regional differences. Decreases in Northern Hemisphere summer frontal precipitation are largely driven by changes in the frequency of different front types, especially cold and stationary fronts. On the other hand, Northern Hemisphere winter exhibits some regional increases in frontal precipitation that are largely driven by changes in frontal precipitation intensity. While CONUS mean and extreme precipitation generally increase during all seasons in these climate change simulations, the likelihood of frontal extreme precipitation decreases, demonstrating that extreme precipitation has seasonally varying sources and mechanisms that will continue to evolve with climate change. Extreme precipitation can have devastating impacts on communities and ecosystems around the world. One source of extreme precipitation is weather fronts, or the boundaries between different types of air masses which can also give rise to high winds, rain, and thunderstorms. Machine learning can be used to automatically detect weather fronts in observations and model simulations. In this work, we use a machine learning algorithm to detect weather fronts in a climate model, and compare present day fronts with those detected in simulations with future climate change. We also compare detected fronts with total and extreme precipitation, to better understand sources of extreme precipitation and how they are changing with climate change. A deep learning algorithm is applied to detect weather fronts in climate model simulations over the contiguous United StatesDetected fronts have seasonally varying spatial patterns of front frequencies and responses to climate changeTotal and extreme precipitation associated with fronts mostly decreases with climate change, largely driven by changes in fronts A deep learning algorithm is applied to detect weather fronts in climate model simulations over the contiguous United States Detected fronts have seasonally varying spatial patterns of front frequencies and responses to climate change Total and extreme precipitation associated with fronts mostly decreases with climate change, largely driven by changes in fronts

The objective was to investigate a family from Argentina. The proposita was a 51-year-old woman who had a moderate bleeding tendency. Some of her children showed a mild bleeding tendency. Her mother and the husband were asymptomatic. Clotting, immunological and molecular biology techniques were used. Partial thromboplastin, prothrombin, Russell Viper venom-clotting times were moderately prolonged in the proposita, whereas they were slightly prolonged in the children and in her mother. Factor X (FX) activity was about 2–3% of normal in all assay systems. FX antigen was less than 5%. Other clotting factors and plateletwere normal. Genetic analysis showed a compound heterozygosis: combination of a ‘new’ mutation (Gln138Arg) with an already known mutation (Glu350Lys). The children had intermediate FX levels (35–63% of normal) and were carriers of one of the two mutations present in the proposita. This is the first observation of a FX deficiency in Argentina.

A combination of synchrotron radiation photoelectron spectroscopy and near-edge X-ray absorption fine structure (NEXAFS) spectroscopy has been used to study the adsorption of phenylphosphonic acid (PPA) on anatase TiO2(101) single crystal at coverages of 0.15 monolayer (ML) and 0.85 ML. The photoelectron spectroscopy data suggest that at 0.15 ML coverage PPA adsorbs in a bidentate geometry following deprotonation of both phosphonate hydroxyl groups, leaving the PO group unbound. At 0.85 ML there is a shift to a mixed bidentate/monodentate binding mode. The carbon K-edge NEXAFS spectra were recorded at two azimuths. Our calculations show that for PPA on anatase TiO2(101) the phenyl ring is oriented 65 ± 4° away from the surface plane with an azimuthal twist of 57 ± 11° away from the [101] azimuth.