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IntroductionLiver transplant recipients are at a heightened risk for oropharyngeal dysphagia; identification of those who are at high risk for postoperative dysphagia could reduce hospital costs and length of stay. We sought to identify predictors of dysphagia, in a large cohort of patients who underwent liver transplantation.MethodsElectronic medical records were queried for patients undergoing liver transplantation, who underwent instrumental swallowing evaluations. Demographics, functional outcomes, and interventions were collected. Logistic regression analyses were performed to identify predictors of dysphagia.ResultsSeven hundred and ninety-five patients met inclusionary criteria. Multivariate analyses found ethnic group (p = .0191), MELD Score (p

For patients with end stage organ failure, organ transplant is frequently the only curative option available. However, organs available for transplant are in critically short supply around the world, which has led to lengthy wait times and increased mortality. Increased global life expectancy, coupled with raised age thresholds for recipients, has heightened demand and further compounded the need for alternative strategies. Bioengineering substitutes including organ-on-a-chip and 3D bioprinting technologies have made considerable strides toward whole organ generation. Skin is the organ where the most advances have been made thus far, due to the relatively less complex spatial architecture and industry interest in the development of sophisticated models for pharmaceutical and cosmetics testing. Here, we discuss the challenges of recapitulating the complexity of native skin, including a stratified structure, vascularization, and inclusion of skin appendages, such as hair follicles and sweat glands. We discuss current technological and biological progress in the field of tissue and organ bioengineering as well as highlight future challenges to generate de novo tissue for skin grafting.

Background: Dental and oral health education is conducted with the aim of changing the habits of a person, group of people, or society so they can gain knowledge, attitudes, and habits to behave in a healthy way in the field of dental and oral health. Elementary school age is the right time for teachers to introduce and instill healthy living habits. A dental and oral health education for Little Doctor students is assumed to help improve the dental and oral health of other students, teachers, and other staff of the school, as well as the people around the student outside of school. Purpose: To describe the effect of interactive dental health education on knowledge improvement. Methods: This study’s sample size was 31 Little Doctor students in the third through sixth grades. The activity in general adopted two-way communication; interactive speaking was performed to stimulate the students attentiveness to the topics, allowing students to engage with the speakers. To assess the students’ knowledge level of oral and dental health, a pre-test questionnaire was filled out prior to starting, and the same questionnaire was filled out as a post-test after completing all the agenda. Results: There were significant differences between pre-test and post-test results (P-value < 0.05), with the mean rank of the post-test group (45.56%) being significantly higher than the pre-test group (17.44%). Conclusion: The interactive education method in elementary school was found to be efficacious and more preferable as it matches the level of growth and development in school-age children.

Abstract We investigate the band structure of metal-dielectric photonic crystals comprising stacked organic semiconductor microcavities with silver metal mirrors incorporating crystal defects: individual unit cells with aperiodic dimensionality. Both transfer matrix simulation and experimental verification are performed to investigate the impact on the photonic band structure as a single cavity is varied in size. The resulting mid-gap defect states are shown to hybridize with a photonic band at certain resonant dimensions. The resonance of the defect cavity affects the transmittance of light through the device, disrupting or enhancing the coupling between otherwise resonant cavities. We outline potential applications for defect engineering of these devices through controlled manipulation of the transmission spectrum.

Abstract Building reliable and robust quantitative structure–property relationship (QSPR) models is a challenging task. First, the experimental data needs to be obtained, analyzed and curated. Second, the number of available methods is continuously growing and evaluating different algorithms and methodologies can be arduous. Finally, the last hurdle that researchers face is to ensure the reproducibility of their models and facilitate their transferability into practice. In this work, we introduce QSPRpred, a toolkit for analysis of bioactivity data sets and QSPR modelling, which attempts to address the aforementioned challenges. QSPRpred’s modular Python API enables users to intuitively describe different parts of a modelling workflow using a plethora of pre-implemented components, but also integrates customized implementations in a “plug-and-play” manner. QSPRpred data sets and models are directly serializable, which means they can be readily reproduced and put into operation after training as the models are saved with all required data pre-processing steps to make predictions on new compounds directly from SMILES strings. The general-purpose character of QSPRpred is also demonstrated by inclusion of support for multi-task and proteochemometric modelling. The package is extensively documented and comes with a large collection of tutorials to help new users. In this paper, we describe all of QSPRpred’s functionalities and also conduct a small benchmarking case study to illustrate how different components can be leveraged to compare a diverse set of models. QSPRpred is fully open-source and available at https://github.com/CDDLeiden/QSPRpred . Scientific Contribution QSPRpred aims to provide a complex, but comprehensive Python API to conduct all tasks encountered in QSPR modelling from data preparation and analysis to model creation and model deployment. In contrast to similar packages, QSPRpred offers a wider and more exhaustive range of capabilities and integrations with many popular packages that also go beyond QSPR modelling. A significant contribution of QSPRpred is also in its automated and highly standardized serialization scheme, which significantly improves reproducibility and transferability of models.

La Ciencia es un sistema entre cuyos componentes principales están las teorías, a su vez conjuntos sistémicos de conceptos, juicios y razonamientos, dependientes en gran medida para su fiabilidad y precisión en la representación de la realidad de la exactitud en la definición de los primeros. En este trabajo, partiendo de esta tesis, se afirma que en ciencias de la Educación existe un serio problema con la identificación precisa y única de los conceptos y a modo de botón de muestra de tal situación, se analiza una selección de definiciones del concepto recurso educativo digital, de amplio uso en todas las latitudes del planeta y en los más de los idiomas. Con tal objetivo se presenta un bosquejo somero de las formas correctas de realizar las identificaciones de los conceptos, se analiza sobre esa base una muestra de definiciones del concepto recurso educativo digital y se devela la existencia de una gran gama de definiciones y otras formas de identificación, diferentes entre sí y pobremente fundamentadas en definiciones previas. Se finaliza con algunas recomendaciones para mejorar estas definiciones, a modo de inicio de una cruzada en función de revertir tal situación que afecta a las ciencias de la Educación.

Abstract Background In the central nervous system, type 2 vesicular monoamine transporters (VMAT2) are responsible for the reuptake of monoamines from synaptic junction back to pre-synaptic terminal vesicles. These transporters are functionally crucial as they reflect the integrity of monoamine neurons. D6-[18F]FP-(+)-DTBZ, a novel deuterated VMAT2 radioligand, has shown promise as a potential PET tracer for the diagnosis of Parkinson’s disease (PD). This study evaluates the biodistribution and dosimetry of D6-[18F]FP-(+)-DTBZ and includes a head-to-head comparison with its non-deuterated version, [18F]FP-(+)-DTBZ (AV-133), in healthy individuals and PD patients. Results The automated synthesis of D6-[18F]FP-(+)-DTBZ using the SPE method was accomplished in 35 min, yielding a high radiochemical purity (> 99%) and high radiochemical yields (35 ± 5%). The biodistribution and dosimetry study indicated an effective dose of 37.1 ± 7.2 μSv/MBq, with the liver receiving the highest radiation dose (289.6 ± 42.1 μGy/MBq), followed by pancreas (185.2 ± 29.1 μGy/MBq). Brain imaging with D6-[18F]FP-(+)-DTBZ exhibited a significantly increased uptake in VMAT2-rich regions, particularly the striatum. In a head-to-head comparison between [18F]FP-(+)-DTBZ and D6-[18F]FP-(+)-DTBZ, the latter exhibited approximately 15% higher SUVR in the caudate, putamen, and nucleus accumbens. Preliminary studies in PD patients showed a substantial reduction in VMAT2 uptake in the striatum, with the most pronounced decrease observed in the putamen (a 53% decline). Conclusions D6-[18F]FP-(+)-DTBZ is a safe and improved VMAT2-specific imaging agent, which may be suitable for diagnosing PD by evaluating changes in VMAT2 binding of monoamine neurons in the brain. Trial registration Chinese Clinical Trial Registry, ChiCTR2200057218, Registered 16 August 2021, https://www.chictr.org.cn/bin/project/edit?pid=142725 .

Abstract One of the most captivating properties of polaritons is their capacity to confine light at the nanoscale. This confinement is even more extreme in two-dimensional (2D) materials. 2D polaritons have been investigated by optical measurements using an external photodetector. However, their effective spectrally resolved electrical detection via far-field excitation remains unexplored. This hinders their exploitation in crucial applications such as sensing, hyperspectral imaging, and optical spectrometry, banking on their potential for integration with silicon technologies. Herein, we present the electrical spectroscopy of polaritonic nanoresonators based on a high-quality 2D-material heterostructure, which serves at the same time as the photodetector and the polaritonic platform. Subsequently, we electrically detect these mid-infrared resonators by near-field coupling to a graphene pn-junction. The nanoresonators simultaneously exhibit extreme lateral confinement and high-quality factors. This work opens a venue for investigating this tunable and complex hybrid system and its use in compact sensing and imaging platforms.

Background and Purpose The management of acute ischemic stroke (AIS) due to distal medium vessel occlusion (DMVO) remains uncertain, particularly in comparing the effectiveness of intravenous thrombolysis (IVT) plus mechanical thrombectomy (MT) versus IVT alone. This study aimed to evaluate the safety and efficacy in DMVO patients treated with either MT-IVT or IVT alone. Methods This multinational study analyzed data from 37 centers across North America, Asia, and Europe. Patients with AIS due to DMVO were included, with data collected from September 2017 to July 2023. The primary outcome was functional independence, with secondary outcomes including mortality and safety measures such as types of intracerebral hemorrhage. Results The study involved 1,057 patients before matching, and 640 patients post-matching. Functional outcomes at 90 days showed no significant difference between groups in achieving good functional recovery (modified Rankin Scale 0–1 and 0–2), with adjusted odds ratios (OR) of 1.21 (95% confidence interval [CI] 0.81 to 1.79; P=0.35) and 1.00 (95% CI 0.66 to 1.51; P>0.99), respectively. Mortality rates at 90 days were similar between the two groups (OR 0.75, 95% CI 0.44 to 1.29; P=0.30). The incidence of symptomatic intracerebral hemorrhage was comparable, but any type of intracranial hemorrhage was significantly higher in the MT-IVT group (OR 0.43, 95% CI 0.29 to 0.63; P

Abstract Introduction Uncontrolled non-infectious uveitis affecting the posterior segment (NIU-PS) can lead to vision loss due to repeated bouts of inflammation and consequent tissue damage. Patients with chronic NIU-PS who experience recurrent uveitis after being treated with systemic and short-acting local corticosteroids may benefit from the sustained-release 0.18-mg fluocinolone acetonide implant (FAi). Methods In this case series, 18 eyes with chronic, recurrent NIU-PS and cystoid macular edema (CME) treated with the 0.18-mg FAi were analyzed retrospectively. Data on patient demographics, clinical history, previous and concomitant treatments for uveitis recurrence, time to and number of uveitis recurrences, intraocular pressure (IOP), central subfield thickness (CST), and visual acuity (VA) were collected and summarized. Results A majority of patients (14/15 [93%]) had a history of ocular surgery, largely cataract extraction, and all developed chronic and recurrent NIU-PS and CME. At baseline, patients had a mean age of 72 years (range: 46 to 93), were 53% male, and had a mean duration of NIU-PS of 3 years (range: 1 to 19). Patients were followed for an average of 16.5 months (range: 2 to 42.5 months) post FAi. Eleven of the 18 eyes (61%) had ≥ 5 recurrences of uveitis since diagnosis, with an average time to recurrence of approximately 12 weeks (range: 1 to 27). All eyes treated with the 0.18-mg FAi showed reduced NIU-PS recurrence and visual and anatomical improvement, as measured by VA and CST, respectively. Two eyes had an IOP elevation that was managed with topical therapy, and one eye was treated with topical prednisolone for additional inflammation management. Two eyes required adjunct therapy with short-acting intravitreal corticosteroids at 7 and 16 weeks for NIU-PS recurrence after 0.18-mg FAi insertion. Conclusion After receiving the 0.18-mg FAi, eyes with uncontrolled NIU-PS had sustained resolution of CME and inflammation with limited need for supplementary steroid drops or injections and minimal steroid class-specific adverse effects; none required incisional IOP-lowering surgery.

This paper assessed the phytoplankton structure and its relationship with the physical environment in the coastal region off Mazatlán, Mexico, in two seasons of 2022, a year in which a strong La Niña event took place: (1) the warmer (August) and (2) the transitional period to the cold phase (November), based on hydrographic data and samples collected in two systematic scientific expeditions. The results showed clear differences between both seasons. Regarding total abundance, August reached 125,200 cells L−1, while November amounted to 219,900 cells L−1. Regarding species composition, the diatoms Cylindrotheca closterium and Planktoniella sol were dominant in August, while Thalassionema nitzschioides and Tetramphora decussata dominated the assemblages in November. The dinoflagellate Protoperidinium punctulatum was dominant in both seasons. However, very marked differences in its abundance are reported. The differences observed in the species richness and abundance could be attributed to the physical configuration of the water column, particularly the surface temperature, which showed clear changes between both seasons. The results presented here confirmed the high phytoplankton richness (some of them with the potential to generate harmful algal blooms), abundance, and diversity values of the region, suggesting a strong relationship with the physical environment.

Abstract Background The Calakmul Biosphere Reserve (CBR) is known for its rich animal and plant biodiversity, yet its microbial communities remain largely unknown. The reserve does not possess permanent bodies of water; nevertheless, seasonal depressions associated with fractures create wetlands, known locally as aguadas. Given the recent construction of the Maya train that crosses the CRB, it is essential to assess the biodiversity of its microorganisms and recognize their potential as a valuable source of goods. This evaluation is pivotal in mitigating potential mismanagement of the forest ecosystem. To enhance comprehension of microbial communities, we characterized the microbiota in three different wetlands. Ag-UD1 and Ag-UD2 wetlands are located in a zone without human disturbances, while the third, Ag-SU3, is in a semi-urbanized zone. Sampling was carried out over three years (2017, 2018, and 2019), enabling the monitoring of spatiotemporal variations in bacterial community diversity. The characterization of microbiome composition was conducted using 16S rRNA metabarcoding. Concurrently, the genomic potential of select samples was examined through shotgun metagenomics. Results Statistical analysis of alpha and beta diversity indices showed significant differences among the bacterial communities found in undisturbed sites Ag-UD1 and Ag-UD2 compared to Ag-SU3. However, no significant differences were observed among sites belonging to the undisturbed area. Furthermore, a comparative analysis at the zone level reveals substantial divergence among the communities, indicating that the geographic location of the samples significantly influences these patterns. The bacterial communities in the CBR wetlands predominantly consist of genera from phyla Actinobacteria, Acidobacteria, and Proteobacteria. Conclusion This characterization has identified the composition of microbial communities and provided the initial overview of the metabolic capacities of the microbiomes inhabiting the aguadas across diverse conservation zones. The three sites exhibit distinct microbial compositions, suggesting that variables such as chemical composition, natural and anthropogenic disturbances, vegetation, and fauna may play a pivotal role in determining the microbial structure of the aguadas. This study establishes a foundational baseline for evaluating the impact of climatic factors and human interventions on critical environments such as wetlands.

Abstract The smallest entities in aquatic ecosystems, i.e., femtoplankton, are certainly the largest reservoir of uncharacterized biodiversity. Among them, the discovery of mysterious Aster like nanoparticles has raised many questions about their nature, origin and ecology. Here, we highlight the original nature of this new model, organic and composed of enriched-calcium carbohydrates, with no detection of nucleic acids or proteins. The biosynthesis of these entities seems to be associated with a host in their 11 arms’ form prior to their release into the environment. An intriguing aspect of their mode of development is their ability, once free, to change form and maintain their abundance autonomously without metabolism being detected, resulting in an unexpected polymorphism. Their remarkable capacity for massive in situ development and their links with prokaryotes and other microbes suggest a major role in the functioning of aquatic ecosystems. There’s no doubt that these new entities are a source of new knowledge not only in the sciences of organic nanoparticles, but also in their ecological importance for aquatic ecosystems.

Abstract Background Risk scores facilitate the assessment of mortality risk in patients with community-acquired pneumonia (CAP). Despite their utilities, there is a scarcity of evidence comparing the various RS simultaneously. This study aims to evaluate and compare multiple risk scores reported in the literature for predicting 30-day mortality in adult patients with CAP. Methods A retrospective cohort study on patients diagnosed with CAP was conducted across two hospitals in Colombia. The areas under receiver operating characteristic curves (ROC-curves) were calculated for the outcome of survival or death at 30 days using the scores obtained for each of the analyzed questionnaires. Results A total of 7454 potentially eligible patients were included, with 4350 in the final analysis, of whom 15.2% (662/4350) died within 30 days. The average age was 65.4 years (SD: 21.31), and 59.5% (2563/4350) were male. Chronic kidney disease was 3.7% (9.2% vs. 5.5%; p

Abstract The COVID-19 pandemic brought forth an urgent need for widespread genomic surveillance for rapid detection and monitoring of emerging SARS-CoV-2 variants. It necessitated design, development, and deployment of a nationwide infrastructure designed for sequestration, consolidation, and characterization of patient samples that disseminates de-identified information to public authorities in tight turnaround times. Here, we describe our development of such an infrastructure, which sequenced 594,832 high coverage SARS-CoV-2 genomes from isolates we collected in the United States (U.S.) from March 13th 2020 to July 3rd 2023. Our sequencing protocol (‘Virseq’) utilizes wet and dry lab procedures to generate mutation-resistant sequencing of the entire SARS-CoV-2 genome, capturing all major lineages. We also characterize 379 clinically relevant SARS-CoV-2 multi-strain co-infections and ensure robust detection of emerging lineages via simulation. The modular infrastructure, sequencing, and analysis capabilities we describe support the U.S. Centers for Disease Control and Prevention national surveillance program and serve as a model for rapid response to emerging pandemics at a national scale.

Abstract Background Stereotactic radiotherapy is the preferred treatment for managing patients with fewer than five brain metastases (BMs). However, some lesions recur after irradiation. The purpose of this study was to identify patients who are at a higher risk of failure, which can help in adjusting treatments and preventing recurrence. Methods In this retrospective multicenter study, we analyzed the predictive significance of a set of interpretable morphological features derived from contrast-enhanced (CE) T1-weighted MR images as imaging biomarkers using Kaplan–Meier analysis. The feature sets studied included the total and necrotic volumes, the surface regularity and the CE rim width. Additionally, we evaluated other nonmorphological variables and performed multivariate Cox analysis. Results A total of 183 lesions in 128 patients were included (median age 61 [31–95], 64 men and 64 women) treated with stereotactic radiotherapy (57% single fraction, 43% fractionated radiotherapy). None of the studied variables measured at diagnosis were found to have prognostic value. However, the total and necrotic volumes and the CE rim width measured at the first follow-up after treatment and the change in volume due to irradiation can be used as imaging biomarkers for recurrence. The optimal classification was achieved by combining the changes in tumor volume before and after treatment with the presence or absence of necrosis (p

La transición del III al II milenio cal AC en la cuenca alta del Tajo cuenta con escasas dataciones radiométricas, a pesar de disponer de un notable registro arqueológico. La aportación de nuevas dataciones contribuye a asentar puntos de referencia para contextos con cerámica campaniforme y los primeros atribuibles a la Edad del Bronce, una realidad que se ha vuelto especialmente compleja en las últimas décadas. En esta noticia damos a conocer cuatro nuevas dataciones radiométricas que proceden de un contexto de finales del III milenio cal AC excavado en la cueva de la Noguera (Val de San García, Cifuentes). Este contexto nos sirve para actualizar la información sobre las dinámicas culturales que se observan en el área de Guadalajara. Las nuevas dataciones subrayan la complejidad de la transición entre el III y el II milenio cal AC en la parte central de la Península Ibérica, resaltando la diversidad en las formas de ocupación del paisaje. A su vez, la cueva de la Noguera muestra una modalidad de vida en cuevas que parece consistente con otras ocupaciones en la Meseta. La fauna recuperada y los materiales encontrados en la superficie exterior de la cueva indican un posible uso agroganadero de la ubicación.

This study evaluated the ingestion of microplastics (MP) by copepods in Terminos Lagoon (TL), a RAMSAR-listed site in the southern Gulf of Mexico. The evaluation was carried out in two contrasting seasons of 2022, as follows: the dry (April) and the rainy (October). Copepods were collected using a conical plankton net (mesh size of 200 μm). In the laboratory, a pool of all pelagic adult copepod taxa was picked, and the MP inside the organisms were extracted, classified, and photographed using traditional optical and scanning electron microscopy. A total of 268 MP particles were extracted from the interior of copepods; among them, 149 and 119 corresponded to the dry and rainy seasons, respectively. The ingestion rate in the dry season was 0.14, while in the rainy season, it was 0.11. In addition, fibers, plastic fragments, and microspheres with different colors (blue, red, black, green, transparent, and multicolored), sizes, forms (angular, round, triangular, and twisted), and textures were also detected. Fibers were the most abundant MP found in a proportion of more than 85%. In addition, in some sampling sites, microspheres were observed with high relative abundance values (80%). In some sites, fragments reach 20% of the total abundance. Significant differences were observed between the two seasons. The sites closest to the urban area adjacent to TL observed high diversity and abundance of MP. The higher abundance of MP in the dry season is due to lower river discharge, on the other hand. Thus, MP particles accumulate and become available for consumption by copepods. This is the first study that has revealed that the MP was ingested by the copepods in TL. Furthermore, this study provides a baseline information for future research on the abundance of MP in the Gulf of Mexico region.

Abstract Objectives Rice (Oryza sativa) is the most important food for more than two thirds of the world’s population. Bangladesh is the third largest producer and consumer of rice globally. Recently, several symptoms of Bacterial Panicle Blight (BPB) in rice, including seedling blight, sheath rot, floret sterility, and spotted grains, have been detected in the country. In addition, the presence of the most prevalent and virulent causative agent of BPB, Burkholderia glumae, has been confirmed in rice displaying symptoms of the disease. BPB could become one of the next emerging diseases of rice in Bangladesh, and a complete genome of a B. glumae strain from the country will help clarify its origin and devise proper management systems to continue sustainable rice production. Data description We report the first complete genome sequence of a B. glumae strain (BD_21g) isolated from symptomatic rice grains in Bangladesh (Natore District). The genome contains 2 chromosomes (1 and 2, with 3,417,499 and 3,855,283 bp, respectively) and 4 plasmids (1-4, with 123,248, 46,628, 88,744 and 53,064 bp, respectively).

Abstract Secondary tropical forests are at the forefront of deforestation pressures. They store large amounts of carbon, which, if compensated for to avoid net emissions associated with conversion to non-forest uses, may help advance tropical forest conservation. We measured above- and below-ground carbon stocks down to 1 m soil depth across a secondary forest and in oil palm plantations in Malaysia. We calculated net carbon losses when converting secondary forests to oil palm plantations and estimated payments to avoid net emissions arising from land conversion to a 22-year oil palm rotation, based on land opportunity costs per hectare. We explored how estimates would vary between forests by also extracting carbon stock data for primary forest from the literature. When tree and soil carbon was accounted for, payments of US$18–51 tCO2 –1 for secondary forests and US$14–40 tCO2 –1 for primary forest would equal opportunity costs associated with oil palm plantations per hectare. If detailed assessments of soil carbon were not accounted for, payments to offset opportunity costs would need to be considerably higher for secondary forests (US$28–80 tCO2 –1). These results show that assessment of carbon stocks down to 1 m soil depth in tropical forests can substantially influence the estimated value of avoided-emission payments.

Abstract The gradual progress in aligning financial flows with the adoption of clean technologies reveals a persistent funding gap, signaling a global misallocation of capital. Addressing this challenge necessitates political leadership and robust policies to counteract the insecurities impeding the redirection of financial flows. This study investigates into the impact of energy-related public–private partnership investments (PPPIE) and macro-environmental variables on the attainment of Sustainable Development Goal 7 (SDG7) across Association of Southeast Asian Nations (ASEAN) member countries from 1999 to 2021. Employing the Dynamac command technique, we conduct autoregressive distribution lag analysis and the Bounds Cointegration Test to evaluate ASEAN’s efforts in achieving SDG7. Results indicate that a ten-year exogenous shock to the GDP growth rate initially causes a temporary decline in both GDP and PPPIE, albeit not statistically significant. However, in the long run, the shock becomes statistically significant, correlating with a negative decline in the GDP growth rate. This underscores the negative impact of external factors like the COVID-19 pandemic on the economic growth of ASEAN member countries. Specifically, a percentage increase in PPPIE leads to an 8.3% reduction in the GDP growth rate, revealing a detrimental and unsustainable impact on the economy. This signifies that energy investments in the ASEAN region, are predominantly unsustainable and adversely impact economic growth. Moreover, these energy investments contribute to a significant 52.6% increase in greenhouse gas emissions, indicating a substantial setback in the region’s progress towards meeting SDG7’s clean energy objectives by 2030. This suggests the present state of PPPIE does not align with sustainable clean energy goals of the region. Therefore, recommendations should include diversifying energy sources and investment strategies to enhance sustainable clean energy. Also, policymakers and researchers should reassess the terms and conditions of PPPIE, refining frameworks for private sector involvement to align with long-term economic sustainability goals.

Lesson study (LS) offers a systematic, but flexible, approach for enhancing the quality of teaching and learning in Health Professions Education (HPE). There is increasing global use of LS in primary, secondary and higher education, with studies highlighting its impact on enhancing the quality of both teaching and learning through the professional development of teachers. During LS, teachers collaboratively research their own practice with a variety of stakeholders, including students, subject specialists and education experts. The article describes how LS can be practically adapted and implemented in a variety of both academic and clinical settings across the continuum of HPE.

Optomechanical oscillators stand out as high-performance and versatile candidates for serving as reference clocks in sequential photonic integrated circuits. Indeed, they have the unique capability of simultaneously generating mechanical tones and optical signal modulations at frequencies determined by their geometrical design. In this context, the concept of synchronization introduces a powerful means to precisely coordinate the dynamics of multiple oscillators in a controlled manner, therefore increasing efficiency and preventing errors in signal processing photonic systems or communication interfaces. In this work, we demonstrate the cascaded injection locking of a pair of silicon-based optomechanical crystal cavities acting as optomechanical oscillators to an external reference signal that subtly modulates the laser driving only one of them. In contrast to most previous implementations, both cavities support isolated optical resonances and interact by a weak mechanical interconnection. This configuration allows one cavity to be used for probing the mechanical perturbation generated by the oscillator that receives the external forcing. The combination of the obtained results, supported by a numerical model, with remote optical injection locking schemes discussed in the literature lays the groundwork for the distribution of reference signals within large networks of processing elements in future phonon–photon hybrid circuits.

Este artículo explora las reflexiones y formas de apropiación de un proceso intercultural crítico de acercamiento a las prácticas y saberes de los pueblos afrocolombianos mediante la resignificación virtual, narrativa y física de las zoteas o huertas ancestrales comunitarias de las poblaciones afro del Pacífico, en el contexto escolar bogotano. Se identificó, mediante el registro etnográfico en un diario intensivo y la producción audiovisual estudiantil de contenidos sobre pueblos afrodiaspóricos y originarios, un proceso emergente donde la articulación de las prácticas ancestrales con disciplinas artísticas experimentales, como la performance, visibiliza otros saberes ancestrales performados. Esta intervención tiende puentes que conectan el proceso con expresiones contemporáneas de la cosmovisión afro como “reexistencias”, “vivir sabroso” o “suficiencias íntimas”, y permitió cuestionar y transformar paulatinamente la organización del tiempo, el espacio y los roles en la construcción de saber y sentido en la escuela.

Background. Fluoroscopy is the standard intraoperative imaging in orthopaedic surgery. Real-time visualization of fracture reduction and implant placement is essential, especially during closed reduction and percutaneous pin (CRPP) fixation. In the absence of fluoroscopy, conventional radiographs are used. Objective. This study evaluated the early functional outcomes of CRPP fixation for proximal phalangeal and metacarpal fractures done under conventional radiograph guidance. Methodology. Fifty-four patients with 72 fractures of the metacarpal or proximal phalanx in 70 fingers underwent CRPP fixation at the emergency room. Radiographs were used to assess reduction and fixation. Primary outcome measures were Total Active Motion (TAM), and Disabilities of the Arm, Shoulder, and Hand (DASH) score, while secondary outcome measures included fracture reduction, union rate, and complications. These were all evaluated at a mean of 12 weeks after surgery. Results. An average of 2.9 radiographs were taken for each fracture, with a mean surgical time of 40 minutes. The TAM was “excellent to good” in 47% of fingers (mean = 258°), while the rest had “fair” scores (mean = 235°). Seventy-six percent of patients had a mean DASH score of 4.9. Thirty-five percent of fractures achieved anatomic reduction and maintained until union. Short procedure time did not influence the DASH scores. Complications reported were malunion (2), stiffness (5), and extension lag (7). There was no reported nonunion. Conclusion. Closed reduction with pinning of proximal phalangeal and metacarpal fractures guided by conventional radiograph in the absence of fluoroscopy, remains to be effective and reliable with favorable early outcomes.

Background Flow diversion has revolutionized the management of wide‐necked intracranial aneurysms (IAs). We aimed to assess the effectiveness and safety of the new generation 64‐wire Surpass Evolve for the treatment of unruptured small/medium‐sized IAs. Methods and Results This is a subanalysis from the SEASE (Safety and Effectiveness Assessment of the Surpass Evolve) registry, an observational cohort study including 15 academic institutions in North America and Europe between July 2020 and October 2022. Patients with wide‐necked saccular IAs, measuring

Background Acute ischemic stroke arising from medium vessel occlusions (MeVO) poses substantial challenges in treatment and management. This study aims to elucidate the outcomes and factors contributing to achieving excellent recanalization (modified Thrombolysis in Cerebral Infarction [mTICI] 2c–3) versus successful recanalization (mTICI 2b) in patients with MeVO stroke undergoing mechanical thrombectomy (MT). Methods We conducted a multinational study analyzing data from the MAD‐MT (Multicenter Analysis of Distal Medium Vessel Occlusions: Effect of Mechanical Thrombectomy) registry, encompassing 37 centers across North America, Asia, and Europe, collected between September 2017 and July 2023. The study included acute ischemic stroke patients with MeVO treated with MT, with or without intravenous thrombolysis, who achieved mTICI 2b–3 post‐MT. Results Among 1463 patients with successful recanalization (mTICI 2b–3), 523 achieved mTICI 2b recanalization, and 940 achieved mTICI 2c–3. Distal occlusions exhibited higher odds of excellent recanalization compared with proximal MeVO vessel occlusions (odds ratio, 1.58; 95% CI, 1.17–2.15; P = 0.003). Cardioembolic stroke pathogenesis was associated with a higher likelihood of excellent recanalization (1.67; 95% CI, 1.07–2.59; P = 0.018). Patients achieving mTICI 2c–3 recanalization demonstrated lower initial National Institutes of Health Stroke Scale scores, significant improvements in postprocedural National Institutes of Health Stroke Scale shift, and a higher percentage of favorable 90‐day outcomes compared with those with mTICI 2b. However, no significant difference in 90‐day mortality rates was observed. Conclusion This study underscores that among patients with MeVO stroke with successful recanalization (mTICI 2b–3) there is higher likelihood of achieving excellent recanalization (mTICI 2c–3) in distal occlusions and cardioembolic pathogenesis. mTICI 2c–3 scores post‐MT correlate with improved clinical outcomes compared with mTICI 2b, affirming the superiority of excellent recanalization over successful recanalization in patients with MeVO stroke. Further prospective studies and randomized controlled trials are warranted for validation.

Background The presence of an incorporated branch as well as its anatomical relationship to the intracranial aneurysms (IAs) and the parent artery may affect the occlusion outcome following flow diversion. This study evaluated the safety and effectiveness of the cobalt‐chromium Surpass Evolve (Stryker), a 64‐wire flow diversion device for the treatment of IAs with incorporated branches. Methods This subanalysis uses data from the SEASE (Safety and Effectiveness Assessment of Surpass Evolve) registry to retrieve data related to IAs with incorporated branches. Those IAs were classified by a core lab into 4 categories based on their anatomical relationship to the parent artery and branch: (A) sidewall anatomic, (B) sidewall hemodynamic, (C) neck branch, and (D) dome branch. We compared the outcomes based on their incorporated branch's relation to the dome (A–C versus D). Results This study included 67 patients and IAs. Most IAs were in the posterior communicating artery (46.3%), with a median size of 4.35 mm. Age, sex, comorbidities, baseline functional‐status, and IA features were similar between the 2 groups. Among those, 53 (79.1%) had branches emerging from the dome, and 14 (20.9%) had branches originating from other locations (A = 7, B = 2, and C = 5). At a median imaging follow‐up of 10.5 months, complete occlusion was lower in IAs with a branch from the sac compared with those with the neck (60.8% versus 92.9%; P = 0.026), with an overall occlusion of 67.7%. Thromboembolic and hemorrhagic complications, as well as retreatment, were reported in 1.6% and 3.1% of cases, respectively, with no significant differences between groups. Conclusion Our analysis underscores the influence of branch origin on occlusion rates, with the neck‐originating branch demonstrating higher occlusion rates. These insights emphasize the role of anatomical considerations in treatment strategies, follow‐up timelines, and designing future clinical trials. Further studies are warranted to explore these variations across different flow diversion technologies.

We present a methodology based on the System of Environmental-Economic Accounting-Ecosystems Accounting (SEEA-EA) framework to measure urban ecosystem condition accounts. This methodology allows the condition accounts of urban ecosystems to be spatially and explicitly evaluated at a detailed scale. The reference area is determined using object-based evaluation, where the reference value for each variable is set in a real geographic context rather than individual pixels.This methodology consists of the following steps: 1. Delimitation of the urban categories to be evaluated; 2. Selection of the variables that characterize the abiotic and biotic environment; 3. Establishment of the reference polygon with which to compare the condition values; 4. Calculation of weighted condition indicators; 5. Generation of a single condition index from the aggregation of the indicators.In Madrid, the areas with the highest condition levels are characterised by a significant density of trees and bird species richness. In contrast, areas with the lowest condition levels are defined by high contamination, impervious surfaces, built-up areas and major communication routes.This innovative approach to calculating urban conditions represents an advancement in local-scale urban condition accounting and offers a potentially compatible tool with current urban policy frameworks. Its applications can be various, from identifying urban problems to reviewing the effectiveness of a plan already implemented. Several advantages have been identified over other ecosystem accounting metrics. These advantages include lower operating costs, a more integrative vision, adaptability to different spatial scales, flexibility in modifying its structure, the capacity to incorporate complex urban dynamics, reduced dependence on human judgment and easier interpretation of results.

Background: The Union of European Football Association's (UEFA) Financial Fair Play (FFP) regulations are a topic of ongoing debate. This study aims to evaluate and quantify the FFP's effect on clubs' financial performance and critically review the regulatory changes introduced by the UEFA in 2022 through the new Financial Sustainability Regulations (FSR). Methods: A systematic review and meta-analysis were conducted using the Web of Science and Scopus databases up to December 31, 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Results: This systematic review included 22 articles; a meta-analysis was conducted on 52 financial measures derived from 20 studies of 11 articles. The meta-analysis’ main result—obtained by comparing two different financial measures (profitability versus solvency)—revealed that FFP's effect on profitability measures was significant, with a value of 0.151 (p = 0.050); however, the effect size for solvency measures was not significant, with a value of 0.049 (p = 0.639). Contributions: This systematic review revealed variability in the results of the studies analysed, reflecting contextual factors' influence, which underlines the need for a more adaptive and specific approach to clubs’ financial control policies. The meta-analysis found that the type of financial measure employed (profitability versus solvency) was a notable source of variability among the studies, as its moderating effect was significant. Consequently, the FFP exerted contrasting effects on profitability and solvency. Limitations: A significant level of heterogeneity was observed in the financial measures analysed, predominantly because of the different samples and periods across the included studies. Conclusions: This study corroborates FFP's mixed and limited impact on financial performance, highlighting the need for stricter control in European football, which aligns with the new FSR. Our study underscores aspects that future research should address to deepen knowledge of UEFA regulations' efficiency in enhancing football's financial sustainability.

En este trabajo se presenta el descubrimiento de un nuevo yacimiento del Neolítico antiguo en el interior peninsular (cuenca del Duero), a partir de los resultados preliminares de la campaña de sondeo realizada en septiembre de 2023. El Abrigo de Guachos además de contener un nuevo e interesante registro para analizar el comienzo del Neolítico en el interior peninsular, muestra también evidencias de ocupaciones y actividad humana posterior, en época romana (periodo bajoimperial). Esta nueva secuencia resulta de gran interés para analizar la evolución de la actividad humana en el barranco del río Duratón. En las Hoces del Duratón, a pesar de haber una rica secuencia de arte rupestre que abarca desde el Neolítico hasta la Edad Media, no se han podido localizar aún secuencias arqueológicas que permitan documentar la evolución y características de este amplio poblamiento humano. ABSTRACT: In this paper, the discovery of a new Early Neolithic site in the interior of the Iberian peninsula (Duero basin) is presented, based on the preliminary results of the excavation campaign conducted in September 2023. The Guachos rock shelter is located in the municipality of Sepúlveda (Segovia) within the “Hoces del río Duratón” Natural reserve, approximately 1300 meters downstream from the Talcano Roman bridge. Specifically, it is located on the outer side of a meander on the left bank of the river, which has eroded the Cretaceous dolomites, at UTM coordinates ETRS89 (Zone 30) X. 434.944, Y. 4.571.952, and about 10 meters above the current riverbed. The rock shelter has maximum dimensions of about 50 meters in length and 20 meters in width, with an average height to the overhang of about 13 meters, making it a space of considerable size. In total, an approximate area of 300 square meters for the archaeological deposit has been estimated. The Guachos Rock Shelter, in addition to containing a new and interesting record for analyzing the beginning of the Neolithic in the interior of the Iberian peninsula, also shows evidence of later occupations and human activity during the Roman period (Low Roman Empire). This new sequence is of great interest for studying the evolution of human activity in the Duratón River gorge. In the “Hoces del Duratón”, despite the presence of a rich sequence of rock art spanning from the Neolithic to the Middle Ages, archaeological sequences that would allow for the documentation of the evolution and characteristics of this extensive human settlement have not yet been found.

Las Casas de la Juventud nacen en la segunda mitad del siglo XX como lugares para la libertad y la socialización entre jóvenes españoles. En estos nuevos entornos se programaban actividades con un sentido democrático, vanguardista, y con vocación educativa y social. En este sentido, el objetivo de este artículo es definir las dinámicas internas que han seguido las Casas de la Juventud en España, buscando vínculos con los principios de intervención social básicos, sin perder de vista su contextualización. Para ello hemos utilizado una metodología de corte cualitativo, basado en la revisión histórico-documental, y un método de entrevista. Así, se ha procedido a estudiar las casas más representativas a nivel estatal. Para el análisis de resultados se han definido varias categorías en función de las propuestas e iniciativas, los recursos existentes, las técnicas de intervención y el papel de sus profesionales, y, por último, la gestión ejercida por sus direcciones. Finalmente, y entre las principales conclusiones, destacamos que los factores que más han incidido en el éxito, y caída, de este modelo son de índole política, y de gestión.

El presente artículo aborda la compleja relación de Franz Kafka con su identidad judía, explorando la intersección entre su biografía, escritos y contexto cultural. A través de su literatura personal, Kafka retrató la tensión entre la asimilación y la tradición, rebelándose contra la primera a través de una búsqueda de un ideal del yo judío en múltiples facetas de la judeidad: desde el yidishismo hasta el sionismo. Su búsqueda representó un desafío a la dinámica de la asimilación y fue un intento de emanciparse de la totalizante figura de su padre, Hermann, quien encarna las consecuencias de la asimilación en la autonarración de Kafka. La búsqueda del yo judío llevó a Kafka a enfrentar tensiones inherentes a la experiencia del antisemitismo, pero también al anhelo por una identidad estable que, al igual que muchos de sus contemporáneos, supuso la búsqueda de toda una vida.