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Abstract Immersive virtual environments (VEs) are increasingly used to evaluate human responses to design variables. VEs provide a tremendous capacity to isolate and readily adjust specific features of an architectural or product design. They also allow researchers to safely and effectively measure performance factors and physiological responses. However, the success of this form of design-testing depends on the generalizability of response measurements between VEs and real-world contexts. At the current time, there is very limited research evaluating the consistency of human response data across identical real and virtual environments. Rendering tools were used to precisely replicate a real-world classroom in virtual space. Participants were recruited and asked to complete a series of cognitive tests in the real classroom and in the virtual classroom. Physiological data were collected during these tests, including electroencephalography (EEG), electrocardiography (ECG), electrooculography (EOG), galvanic skin response (GSR), and head acceleration. Participants’ accuracy on the cognitive tests did not significantly differ between the real classroom and the identical VE. However, the participants answered the tests more rapidly in the VE. No significant differences were found in eye blink rate and heart rate between the real and VR settings. Head acceleration and GSR variance were lower in the VE setting. Overall, EEG frequency band-power was not significantly altered between the real-world classroom and the VE. Analysis of EEG event-related potentials likewise indicated strong similarity between the real-world classroom and the VE, with a single exception related to executive functioning in a color-mismatch task.

Zinc (Zn) is an essential trace element that plays a key role in several biological processes, including transcription, signaling, and catalysis. A subcellular network of transporters ensures adequate distribution of Zn to facilitate homeostasis. Among these are a family of importers, the Zrt/Irt-like proteins (ZIP), which consists of 14 members (ZIP1-ZIP14) that mobilize Zn from the extracellular domain and organelles into the cytosol. Expression of these transporters varies among tissues and during developmental stages, and their distribution at various cellular locations is essential for defining the net cellular Zn transport. Normally, the ion is bound to proteins or sequestered in organelles and vesicles. However, though research has focused on Zn internalization in mammalian cells, little is known about Zn mobilization within organelles, including within the nuclei under both normal and pathological conditions. Analyses from stomach and colon tissues isolated from mouse suggested that ZIP11 is the only ZIP transporter localized to the nucleus of mammalian cells, yet no clear cellular role has been attributed to this protein. We hypothesized that ZIP11 is essential to maintaining nuclear Zn homeostasis in mammalian cells. To test this, we utilized HeLa cells, as research in humans correlated elevated expression of ZIP11 with poor prognosis in cervical cancer patients. We stably knocked down ZIP11 in HeLa cancer cells and investigated the effect of Zn dysregulation in vitro. Our data show that ZIP11 knockdown (KD) reduced HeLa cells proliferation due to nuclear accumulation of Zn. RNA-seq analyses revealed that genes related to angiogenesis, apoptosis, mRNA metabolism, and signaling pathways are dysregulated. Although the KD cells undergoing nuclear Zn stress can activate the homeostasis response by MTF1 and MT1, the RNA-seq analyses showed that only ZIP14 (an importer expressed on the plasma membrane and endocytic vesicles) is mildly induced, which may explain the sensitivity to elevated levels of extracellular Zn. Consequently, ZIP11 KD HeLa cells have impaired migration, invasive properties and decreased mitochondrial potential. Furthermore, KD of ZIP11 delayed cell cycle progression and rendered an enhanced senescent state in HeLa cells, pointing to a novel mechanism whereby maintenance of nuclear Zn homeostasis is essential for cancer progression.

Objectives To assess the incidence of hospital admissions for covid-19 disease in pregnant women, severity of covid-19 disease, and medical treatment provided to pregnant women with moderate to severe covid-19 during the first 10 months of the pandemic.Design Individual patient data meta-analysis of population based cohorts in International Obstetric Survey Systems.Setting 10 European countries with national or regional surveillance within the International Obstetric Survey Systems (INOSS) collaboration using aligned definitions and case report forms: Belgium, France (regional), Italy, the Netherlands, Denmark, Finland, Iceland, Norway, Sweden (regional), and the UK. The dominant variant of the SARS-CoV-2 virus was the wild-type variant in all countries during the study period (1 March 2020 to 31 December 2020).Participants The source population was 1.7 million women giving birth (maternities) from 1 March 2020 to 31 December 2020; pregnant women were included if they were admitted to hospital and had a positive polymerase chain reaction test for the SARS-CoV-2 virus ≤7 days before hospital admission, during admission, or up to two days after giving birth. We further categorised the hospital admission in two groups; covid-19 admission (hospital admission due to covid-19 or with reported symptoms of covid-19 disease) or non-covid-19 admission (admission to hospital for obstetric healthcare or no symptoms of covid-19 disease).Main outcome measures Incidence of hospital admissions for covid-19 per 1000 maternities, frequency of moderate to severe covid-19 disease, and number of women who received specific medical treatment for SARS-CoV-2 infection. Moderate to severe covid-19 disease was defined as maternal death, admission to an intensive care unit, or need for respiratory support.Results Among 1.7 million maternities, 9003 women were included in the study: 2350 (26.1%) were admitted to hospital because of covid-19 disease or had symptoms of disease. The pooled incidence of hospital admissions for covid-19 per 1000 maternities was 0.8 (95% confidence interval (CI) 0.5 to 1.2, τ2=0.44), ranging from no hospital admissions in Iceland to 1.7 in France and 1.9 in the UK. 13 women died due to covid-19. Among 2219 women admitted to hospital for covid-19 in countries with complete information on respiratory support, 820 women (39.5%, 95% CI 34.6% to 44.4%, τ2=0.02) had moderate to severe covid-19 disease. At most, 16.8% (95% CI 7.7% to 32.9%, I2=81.8%, τ2=0.7) of women with moderate to severe covid-19 received specific medical treatment for SARS-CoV-2 infection with corticosteroids, although 66.6% (59.4% to 73.2%, I2=50.1, τ2=0.06) were given thromboprophylaxis.Conclusions Population based surveillance in 10 European countries during the first 10 months of the covid-19 pandemic showed variations in the risk of hospital admissions for covid-19 in pregnant women. This finding indicates that national public health policies likely had a substantial and previously unrecognised role in protecting pregnant women. Few pregnant women with moderate to severe covid-19 were given specific medical treatment for SARS-CoV-2 disease, even when there were no or minor safety concerns. Lessons for future pandemics include the importance of rapid, robust surveillance systems for maternal and perinatal health, and of including use for pregnant women early in the development and testing of medicines and vaccines for public health emergencies.

Hate speech is a global issue that is also prevalent among adolescents and requires an educational response. Teachers handle hate speech as part of their professional role. To date, we know little about their beliefs in relation to the early stages of their interventional actions, specifically to their perception of hate speech in school. Thus, this study examined associations between teachers’ social dominance orientation, their pluralist attitude, and their hate speech perception in school. A sample of 471 secondary school teachers from 38 schools (Germany: n = 251; Switzerland: n = 220) participated in a self-report survey from December 2020 to April 2021 (MAge = 42.8 years; 57.7% females; 21.0% with migration status). Data from a total of 3,560 students from grades 7–9 (Germany: n = 1,841; Switzerland: n = 1,719) were matched with teachers’ data to control for students’ hate speech perception in school. Fixed effects multilevel regressions were run, including covariates (teachers’ age, gender, migration status, students’ hate speech perception), teachers’ social dominance orientation, pluralist attitude, and their hate speech perception in school. Teachers perceived a higher frequency of offline hate speech than online hate speech. Contrary to the hypotheses, social dominance orientation was positively associated with offline and online hate speech perception. As predicted, teachers’ pluralist attitude was positively linked to their off- and online hate speech perception. Further research must now clarify how the investigated beliefs and attitudes and teachers’ hate speech perception in school relate to other aspects of their professional competence.

Abstract The frequency of the use of drugs that act on the epidermal growth factor receptor (EGFR) is increasing, with the consequent onset of cutaneous toxicity, specifically acneiform eruption. The authors extensively review the topic, focusing on describing how these drugs can affect the skin and its appendages, that is, the pathophysiology that encompasses the cutaneous toxicity related to the use of EGFR inhibitors. In addition, it was possible to list the risk factors that may be associated with adverse effects of these drugs. Based on this recent knowledge, the authors expect to aid in the management of patients who are more vulnerable to toxicity, reduce morbidities, and improve the quality of life of patients undergoing treatment with EGFR inhibitors. Other issues related to the toxicity of EGFR inhibitors, such as the clinical aspects of the acneiform eruption grades, and other different types of cutaneous and mucosal reactions, are also included in the article.

Positive Energy Districts (PEDs) are a promising approach to urban energy transformation, aiming to optimize local energy systems and deliver environmental, social and economic benefits. However, their effectiveness and justification for investment rely on understanding the additional value they provide (additionality) in comparison to current policies and planning methods. The additionality perspective is not used yet in current evaluations of PED demonstrations and pilots. Therefore, this paper introduces the concept of additionality in the evaluation of PEDs, focusing on the additional benefits they bring and the circumstances under which they are most effective. We discuss the additionality of PEDs in addressing the challenges of climate neutrality and energy system transformation in three European cities that are funded by the European Commission’s H2020 Programme. It should be noted that given the ongoing status of these projects, the assessment is mainly based on preliminary results, as monitoring is still ongoing and quantitative results are not yet available. The paper discusses the drivers and barriers specific to PEDs, and highlights the challenges posed by technical complexities, financing aspects and social and legal restrictions. Conclusions are drawn regarding the concept of additionality and its implications for the wider development of PEDs as a response to the challenges of climate neutrality and energy system transformation in cities. We conclude that the additionality perspective provides valuable insights into the impact and potential of PEDs for societal goals and recommend this approach for use in the final evaluation of R&I projects involving PEDs using actual monitored data on PEDs.

Представлен анализ сюжетов международной жизни, касающихся премьер «Ленинградской симфонии» Д. Д. Шостаковича вне пределов СССР, их подготовки и эффекта, произведенного ими на политический истеблишмент, гуманитарную элиту и простых слушателей в 1942–1943 гг. Конкуренция выдающихся дирижеров – А. Тосканини, Л. Стоковского, Г. Вуда, С. Кусевицкого и др. – за право западной премьеры, переписка с ними самого композитора, формирование общественного мнения и, наконец, эпизод, связанный с несостоявшейся поездкой Шостаковича в США в 1942 г., позволяют существенно дополнить ретроспективную картину «путешествия» Седьмой симфонии по Европе и США. Привлеченные документы акцентируют внимание на общественно-политических итогах эпопеи представления Западу произведения, которое «содействует поддержке непреклонного духа, на котором основаны наши общие надежды на конечную победу», и «выражает мощь России так, как этого никогда не сможет сделать слово», и на роли в ней Наркомата иностранных дел, побуждая к рефлексии о роли искусства в мире, охваченном войной. Они дают возможность проследить хронологию дипломатического «сопровождения» премьер Ленинградской симфонии на Западе в 1942–1943 гг., а также увидеть, кто «дирижировал» воистину победоносным ее звучанием не только в странах-союзницах, но и в нейтральных государствах. В статье использованы документы АВП РФ, касающиеся исполнения «Ленинградской симфонии» вне пределов СССР, впервые вводимые в научный оборот.

Hate speech, or intentional derogatory expressions about people based on assigned group characteristics, has been studied primarily in online contexts. Less is known about the occurrence of this phenomenon in schools. As it has negative consequences for victims, perpetrators, and those who witness it, it is crucial to characterize the occurrence of offline (i.e., in the school) and online hate speech to describe similarities and differences between these two socialization contexts. The present study aimed to investigate the prevalence of hate speech witnessing, victimization, and perpetration, in a sample of 3,620 7–9th graders (51% self-identified as female) from 42 schools in Germany and Switzerland. We found that 67% of the students witnessed hate speech in their school, and 65% witnessed online hate speech at least once in the past 12 months. Approximately 21% of the students self-identified as offline perpetrators and 33% as offline victims, whereas these percentages were lower for online hate speech (13 and 20%, respectively). In both settings, skin color and origin were the most common group references for hate speech (50% offline and 63% online). Offline hate speech mainly came from classmates (88%), unknown sources (e.g., graffiti; 19%), or teachers (12%), whereas online hate speech mostly came from unknown persons (77%). The most frequent forms of offline hate speech were offensive jokes (94%) and the spread of lies and rumors about the members of a specific social group (84%). Significant differences by country, gender, and migration background were observed. Girls reported more offline victimization experiences, less perpetration, and a greater frequency of witnessing hate speech. This difference was larger in magnitude in the online setting. Students in Switzerland reported being exposed to hate speech more often than students in Germany. Students with a migration background reported higher hate speech victimization based on skin color and origin than students without a migration background. The high prevalence of hate speech highlights the need for school-based prevention programs. Our findings are discussed in terms of the practical implications.

2Duf, named after the presence of a transmembrane (TM) Duf421 domain and a small Duf1657 domain in its sequence, is likely located in the inner membrane (IM) of spores in some Bacillus species carrying a transposon with an operon termed spoVA2mob. These spores are known for their extreme resistance to wet heat, and 2Duf is believed to be the primary contributor to this trait. In this study, we found that the absence of YetF or YdfS, both Duf421 domain-containing proteins and found only in wild-type (wt) B. subtilis spores with YetF more abundant, leads to decreased resistance to wet heat and agents that can damage spore core components. The IM phospholipid compositions and core water and calcium-dipicolinic acid levels of YetF-deficient spores are similar to those of wt spores, but the deficiency could be restored by ectopic insertion of yetF, and overexpression of YetF increased wt spore resistance to wet heat. In addition, yetF and ydfS spores have decreased germination rates as individuals and populations with germinant receptor-dependent germinants and increased sensitivity to wet heat during germination, potentially due to damage to IM proteins. These data are consistent with a model in which YetF, YdfS and their homologs modify IM structure to reduce IM permeability and stabilize IM proteins against wet heat damage. Multiple yetF homologs are also present in other spore forming Bacilli and Clostridia, and even some asporogenous Firmicutes, but fewer in asporogenous species. The crystal structure of a YetF tetramer lacking the TM helices has been reported and features two distinct globular subdomains in each monomer. Sequence alignment and structure prediction suggest this fold is likely shared by other Duf421-containing proteins, including 2Duf. We have also identified naturally occurring 2duf homologs in some Bacilli and Clostridia species and in wt Bacillus cereus spores, but not in wt B. subtilis. Notably, the genomic organization around the 2duf gene in most of these species is similar to that in spoVA2mob, suggesting that one of these species was the source of the genes on this operon in the extremely wet heat resistant spore formers.

Living donor kidney transplantation (LDKT) is the best treatment option for end stage renal disease in terms of both patient and graft survival. However, figures on LDKT in Spain that had been continuously growing from 2005 to 2014, have experienced a continuous decrease in the last five years.One possible explanation for this decrease is that the significant increase in the number of deceased donors in Spain during the last years, both brain death and controlled circulatory death donors, might have generated the false idea that we have coped with the transplant needs. Moreover, a greater number of deceased donor kidney transplants have caused a heavy workload for the transplant teams.Furthermore, the transplant teams could have moved on to a more conservative approach to the information and assessment of patients and families considering the potential long-term risks for donors in recent papers. However, there is a significant variability in the LDKT rate among transplant centers and regions in Spain independent of their deceased donor rates. This fact and the fact that LDKT is usually a preemptive option for patients with advanced chronic renal failure, as time on dialysis is a negative independent factor for transplant outcomes, lead us to conclude that the decrease in LDKT depends on other factors.Thus, in the kidney transplant annual meeting held at ONT site in 2018, a working group was created to identify other causes for the decrease of LDKT in Spain and its relationship with the different steps of the process. The group was formed by transplant teams, a representative of the transplant group of the Spanish Society of Nephrology (SENTRA), a representative of the Spanish Society of Transplants (SET) and representatives of the Spanish National Transplant Organization (ONT).A self-evaluation survey that contains requests about the phases of the LDKT processes (information, donor work out, informed consent, surgeries, follow-up and human resources) were developed and sent to 33 LDKT teams. All the centers answered the questionnaire. The analysis of the answers has resulted in the creation of a national analysis of strengths, weaknesses, opportunities, threats (SWOT) of the LDKT program in Spain and the development of recommendations targeted to improve every step of the donation process. The work performed, the conclusions and recommendations provided, have been reflected in the following report: Spanish living donor kidney transplant program assessment: recommendations for optimization. This document has also been reviewed by a panel of experts, representatives of the scientific societies (Spanish Society of Urology (AEU), Spanish Society of Nephrology Nursery (SEDEN), Spanish Society of Immunology (SEI/GETH)) and the patient association ALCER. Finally, the report has been submitted to public consultation, reaching ample consensus. In addition, the transplant competent authorities of the different regions in Spainhave adopted the report at institutional level.The work done and the recommendations to optimize LDKT are summarized in the present manuscript, organized by the different phases of the donation process. Resumen: El trasplante renal de donante vivo (TRDV) es la opción terapéutica con las mejores expectativas de supervivencia para el injerto y para el paciente con insuficiencia renal terminal; sin embargo, este tipo de trasplantes ha experimentado un descenso progresivo en los últimos años en España.Entre las posibles explicaciones del descenso de actividad se encuentra la coincidencia en el tiempo con un aumento en el número de donantes renales fallecidos, tanto por muerte encefálica como por asistolia controlada, que podría haber generado una falsa impresión de ausencia de necesidad del TRDV. Además, la disponibilidad de un mayor número de riñones para trasplante habría supuesto un incremento en la carga de trabajo de los profesionales que pudiera enlentecer los procesos de donación en vida. Otro posible argumento radica en un posible cambio de actitud hacia posturas más conservadoras a la hora de informar a pacientes y a familiares acerca de esta opción terapéutica, a raíz de los artículos publicados respecto al riesgo de la donación a largo plazo. Sin embargo, existe una importantísima variabilidad en la actividad entre centros y comunidades autónomas, no explicada por el volumen de trasplante procedente de otros tipos de donante. Este dato, unido a que la indicación de donación renal en vida se realiza de manera mayoritaria en situación de enfermedad renal crónica avanzada (ERCA) y que el tiempo en diálisis es un factor pronóstico negativo respecto a la supervivencia postrasplante, permite concluir que el descenso depende además de otros factores.Por este motivo, en la reunión anual de equipos de trasplante renal, celebrada en la sede de la Organización Nacional de Trasplantes (ONT) en 2018, se constituyó un grupo de trabajo formado por equipos de trasplante renal, el grupo de trasplantes de la Sociedad Española de Nefrología (SEN) (SENTRA), la Sociedad Española de Trasplantes (SET) y la ONT, con el objetivo de identificar otras causas que condicionaron el descenso de la actividad de este tipo de trasplantes en España y su posible relación con la gestión del proceso de donación de vivo.El grupo de trabajo diseñó un cuestionario de autoevaluación, que fue cumplimentado por las 33 unidades de trasplante renal de donante vivo activas en España. El cuestionario contiene preguntas sobre las diferentes fases del proceso de donación de vivo: información inicial, estudio del donante vivo e información de los riesgos, consentimiento, recursos humanos (RRHH), nefrectomía, trasplante y seguimiento posterior.El análisis de las respuestas ha dado como resultado la creación de un análisis de debilidades, amenazas, fortalezas y oportunidades (DAFO) del programa a nivel nacional y ha permitido elaborar recomendaciones específicas dirigidas a mejorar cada una de las fases del proceso de donación en vida. El documento, denominado Análisis de situación del trasplante renal de donante vivo y hoja de ruta ha sido también revisado por un panel de expertos en TRDV, representantes de varias sociedades científicas implicadas (Asociación Espa˜nola de Urología [AEU], Sociedad Espa˜nola de Enfermería Nefrológica [SEDEN], Sociedad Espa˜nola de Inmunología [SEI/GETH]), el Grupo de Trabajo Enfermedad Renal Crónica Avanzada (ACERCA), la Asociación de Pacientes para la Lucha Contra la Enfermedad Renal (ALCER) y sometido posteriormente a consulta pública. Tras incluir las mejoras sugeridas, el documento final ha sido adoptado institucionalmente en el Consejo Interterritorial de Trasplantes (CIT) del Sistema Nacional de Salud.El trabajo realizado y las recomendaciones para optimizar el TRVD se describen a lo largo del presente artículo, organizados por los diferentes apartados del proceso de donación.

BackgroundIn recent years, there has been increasing interest in studying differences in recipient sex in renal disease treatment, access to renal replacement therapy, and subsequent outcomes. Our aim was to find out whether there are differences in outcomes after renal transplantation between female and male kidney transplant recipients in our series, particularly in adults under 60 years of age during long-term follow-up.MethodsThis was a retrospective study of our kidney transplant series (n = 1,101) to compare graft survival depending on the sex of the recipient in the entire series and patients < 60 years of age (n = 687) during long-term follow-up.ResultsWe observed no association between recipient sex and graft survival throughout the series, regardless of recipient sex. However, adult female recipients under 60 years of age had lower graft survival than male recipients (p = 0.040). Pre-transplant sensitization (HR 2.438, p = 0.002) and donor age (HR: 1.021, p = 0.017) were the independent variables associated with graft failure.ConclusionFemale recipients younger than 60 years of age had lower graft survival than male recipients, although there were no gender differences in graft or patient survival in the overall study population. Recipient sex per se was not related to graft failure, but the greater immunological risk in women and more frequent use of expanded criteria donors in female recipients under 60 years of age were the main factors related to their poorer graft survival. Further studies and new strategies are needed to identify these differences and develop the best approach to address them.

BackgroundThe continued emergence of new COVID-19 variants highlights the importance of vaccination in the effort to reduce disease transmission and burden. The objective of this study is to evaluate the processes and outcomes associated with a novel in-home COVID-19 vaccination program aimed at vaccinating high-risk populations in New York, USA.MethodsTo evaluate program processes, we described the program itself and reflected on some key lessons learned. To evaluate program outcomes, we analyzed data reported by vaccine recipients. These outcomes included the percentage of vaccine recipients that successfully received the full course of vaccinations, and the demographic and health characteristics of vaccine recipients. We additionally assessed demographic differences in motivations for receiving in-home care, using chi-squared tests to assess statistical significance. Data were collected and reported via dynamic online intake forms.ResultsThe median age of vaccine recipients was 79 ± SD 9.0 years. The oldest vaccine recipient was 107 years old. Of those with non-missing data, more than half of vaccine recipients were female (63%), identified as part of a racial/ethnic minority (66%), reported an annual income of < $25,000 (58%), and received a high school degree or less (68%). Most vaccine recipients reported having one or more health conditions associated with increased risk of severe COVID-19 disease (72%). Vaccine recipients were most likely to report receiving in-home vaccination because they were home-bound due to disability. Motivations for receiving in-home vaccination differed by demographic subgroup.ConclusionThe population receiving vaccinations from this in-home care delivery program comprised seniors who were mostly female and non-white, indicated socioeconomic vulnerability, and reported one or more COVID-related health conditions; this signified that the program met its goal of vaccinating those most at risk for severe COVID-19 disease.

Background and objective: The number of patients who start dialysis due to graft failure increases every day. The best dialysis modality for this type of patient is not well defined and most patients are referred to HD. The objective of our study is to evaluate the impact of the dialysis modality on morbidity and mortality in transplant patients who start dialysis after graft failure. Material and methods: A multicentre retrospective observation and cohort study was performed to compare the evolution of patients who started dialysis after graft failure from January 2000 to December 2013. One group started on PD and the other on HD. The patients were followed until the change of dialysis technique, retransplantation or death. Anthropometric data, comorbidity, estimated glomerular filtration rate (eGFR) at start of dialysis, the presence of an optimal access for dialysis, the appearance of graft intolerance and retransplantation were analyzed. We studied the causes for the first 10 hospital admissions after starting dialysis. For the statistical analysis, the presence of competitive events that hindered the observation of the event of interest, death or hospital admission was analyzed. Results: 175 patients were included, 86 in DP and 89 in HD. The patients who started PD were younger, had less comorbidity and started dialysis with lower eGFR than those on HD. The mean follow-up was 34 ± 33 months, with a median of 24 months (IQR 7–50 months), Patients on HD had longer follow-up than patients on PD (35 vs. 18 months, p =

Resumen: Antecedentes y objetivo: El número de personas que inician diálisis por el fracaso del injerto aumenta cada día. La modalidad de diálisis mejor para este tipo de pacientes no está bien definida y la mayoría de ellos son derivados a hemodiálisis (HD). El objetivo de nuestro estudio es evaluar el impacto de la modalidad de diálisis sobre la morbilidad y la mortalidad en individuos trasplantados que inician este procedimiento tras el fracaso del injerto. Material y métodos: Estudio multicéntrico retrospectivo observacional y de cohortes que compara la evolución de los pacientes que inician diálisis tras el fracaso del injerto, desde enero del año 2000 a diciembre del 2013. Un grupo lo hace en diálisis peritoneal (DP) y otro en HD. Se realizó un seguimiento a los pacientes hasta el cambio de técnica de diálisis, retrasplante o fallecimiento. Se analizaron datos antropométicos, comorbilidad, el filtrado glomerular (FG) con el que iniciaban la diálisis, la presencia de un acceso óptimo para esta, la presencia de intolerancia al injerto y el retrasplante. Estudiamos el motivo de los 10 primeros ingresos hospitalarios tras el inicio de la diálisis. Para el análisis estadístico, se tuvo en cuenta la presencia de eventos competitivos que dificultaran la aparición del evento de interés, muerte o ingreso hospitalario. Resultados: Se incluyeron 175 pacientes. En DP 86 y 89 en HD. Los individuos que iniciaron DP eran más jóvenes, tenían menor comorbilidad y lo hacían con FG más bajos que los de HD. El seguimiento medio fue de 34 ± 33 meses, con una mediana de 24 (IQR siete a 50 meses), siendo mayor en los pacientes en HD que en los de DP (35 vs. 18 meses, p = < 0,001). Los factores de riesgo que influyeron en la mortalidad fueron la edad (coeficiente del sub Hazard Ratio [sHR] 1,06 (IC 95%: 1,033 a 1,106, p = 0,000), el uso no óptimo del acceso (sHR 3,00 (IC 95%: 1,507 a 5,982, p = 0,028) y el tipo de diálisis, la DP sHR[DP/HD] 0,36 (IC 95%: 0,148 a 0,890, p = 0,028). Los pacientes en DP tenían menos riesgo de un ingreso hospitalario sHR[DP/HD] 0,52 (IC 95%: 0,369 a 0,743, p = < 0,001) y menos probabilidad de desarrollar una intolerancia al injerto HR 0,307 (IC 95% 0,142 a 0,758, p = 0,009). Conclusiones: Con las limitaciones de un estudio retrospectivo y no randomizado, es la primera vez a nivel nacional que se demuestra que la DP en términos de supervivencia es mejor que la HD cuando fracasa el injerto durante el primer año y medio en diálisis. La presencia de un acceso no óptimo para este procedimiento es un factor de riesgo de mortalidad independiente y modificable. La remisión precoz de los pacientes a las unidades de enfermedad renal crónica avanzada (ERCA) es fundamental para que estos elijan la técnica que más se adapte a sus circunstancias y preparar un acceso óptimo para el inicio de diálisis. Abstract: Background and objective: The number of patients who start dialysis due to graft failure increases every day. The best dialysis modality for this type of patient is not well defined and most patients are referred to HD. The objective of our study is to evaluate the impact of the dialysis modality on morbidity and mortality in transplant patients who start dialysis after graft failure. Material and methods: A multicentre retrospective observation and cohort study was performed to compare the evolution of patients who started dialysis after graft failure from January 2000 to December 2013. One group started on PD and the other on HD. The patients were followed until the change of dialysis technique, retransplantation or death. Anthropometric data, comorbidity, estimated glomerular filtration rate (eGFR) at start of dialysis, the presence of an optimal access for dialysis, the appearance of graft intolerance and retransplantation were analysed. We studied the causes for the first 10 hospital admissions after starting dialysis. For the statistical analysis, the presence of competitive events that hindered the observation of the event of interest, death or hospital admission was analysed. Results: 175 patients were included, 86 in DP and 89 in HD. The patients who started PD were younger, had less comorbidity and started dialysis with lower eGFR than those on HD. The mean follow-up was 34 ± 33 months, with a median of 24 months (IQR 7 - 50 months), Patients on HD had longer follow-up than patients on PD (35 vs. 18 months, p = < 0.001). The mortality risk factors were age sHR 1.06 (95% CI: 1.033 - 1.106, p = 0.000), non-optimal use of access for dialysis sHR 3.00 (95% CI: 1.507 - 5.982, p = 0.028) and the dialysis modality sHR (PD / HD) 0.36 (95% CI: 0.148 - 0.890, p = 0.028). Patients on PD had a lower risk of hospital admission sHR [DP / HD] 0.52 (95% CI: 0.369-0.743, p = < 0.001) and less probability of developing graft intolerance HR 0.307 (95% CI 0.142-0.758, p = 0.009). Conclusions: With the limitations of a retrospective and non-randomized study, it is the first time nationwide that PD shows in terms of survival to be better than HD during the first year and a half after the kidney graft failure. The presence of a non-optimal access for dialysis was an independent and modifiable risk factor for mortality. Early referral of patients to advanced chronic kidney disease units is essential for the patient to choose the technique that best suits their circumstances and to prepare an optimal access for the start of dialysis.

Abstract Patients with psychocutaneous disorders often refuse psychiatric intervention in their first consultations, leaving initial management to the dermatologist. The use of psychotropic agents in dermatological practice, represented by antidepressants, antipsychotics, anxiolytics, and mood stabilizers, should be indicated so that patients receive the most suitable treatment rapidly. It is important for dermatologists to be familiar with the most commonly used drugs for the best management of psychiatric symptoms associated with dermatoses, as well as to manage dermatologic symptoms triggered by psychiatric disorders.

The current energy crisis raised concern about the lack of electricity during the wintertime, especially that consumption should be cut at peak consumption hours. For the building owners, this is visible as rising electricity prices. Availability of near real-time data on energy performance is opening new opportunities to optimize energy flexibility capabilities of buildings. This paper presents a reinforcement learning (RL)-based method to control the heating for minimizing the heating electricity cost and shifting the electricity usage away from peak demand hours. Simulations are carried out with electrically heated single-family houses. The results indicate that with RL, in the case of varying electricity prices, it is possible to save money and keep the indoor thermal comfort at an appropriate level.

Сюжеты Второй мировой войны, безусловно относящиеся к «сложным вопросам истории», до сих пор не отрефлексированы и оттого полны фобий и мифов. Анализируя набор инструментов исторической политики, автор выделяет следующие: политизация истории (следование политической конъюнктуре), манипуляция фактами, героизация (глорификация) истории и ее акторов, демонизация – конструирование образа внутреннего и внешнего врага, идеологическое цензурирование контраверсивных оценок, актуализация социополитической ностальгии. Применение всего этого арсенала идеологического воздействия на массовое сознание можно увидеть в резонансных социополитических эксцессах последнего времени. Различие исторических оценок – это реальность, которую бессмысленно затушевывать. Преодоление исторических травм – «сочетания истории и памяти» – является непреложным условием нормализации, объективизации рефлексии по поводу прошлого. Предметом внимания автора стали внешнеполитические инвективы, ставшие очагами дипломатической напряженности (в частности, Декларация Европарламента о начале Второй мировой войны, принятая в 2019 г.), деятельность правительственных организаций, «отвечающих» за историческую политику (украинский Институт национальной памяти), экспозиции музеев стран Восточной Европы (Музей Второй мировой войны в Гданьске, Музей оккупации в Риге), школьные учебники по истории, судьба памятников, посвященных Второй мировой войне (в частности, Бронзового солдата в Таллине), а также публичные историко-политические акции, переворачивающие историческую реальность (например, шествия в День легионера в Риге), и проявления цензуры изданий с альтернативным взглядом на травмирующие события войны.

Abstract: Good design and construction planning are essential to ensure the quality of the final product. To do this, it is necessary to develop an integrated organizational system for production and work schedule control, just in time material delivery, job site layout planning and real-time task management. The main objective of this work is to propose a method to improve process flow planning of prefabricated concrete panels based on the software application that uses Visilean® to monitor the movement of the parts in the factory. Visilean® model was useful for the visual verification of project, production and installation processes allowing suggestions for improvements to operational procedures. Research’s contribution is to propose a method for integrated planning that favors scenarios creation to anticipate possible problems that usually occur in both production flow and information flow. In practice, the researchers created a simple interface that allows operators to visualize times, production services and their sequence in real-time. Better visualization of the processes and control has a great impact on the final product’s quality, as well as, timely delivery and improved communication between project, production and construction teams. For future research, the inclusion of the Internet of Things for process automation will be an essential complement to the model.

The availability of near-real-time data on energy performance is opening new opportunities to optimize buildings’ energy efficiency and flexibility capabilities and to support the decision-making and planning process of building retrofitting infrastructure investment. Existing tools can support retrofitting design and energy performance contracting. However, there are well-recognized shortcomings of these tools related to their usability, complexity, and ability to perform calculations based on the real-time energy performance of buildings. To address this gap, the advanced retrofitting decision support tool is developed and presented in this study. The strengths of our solution rely on easy usability, accuracy, and transparency of results. The automatic collection of real-time building energy consumption data gathered from the building management systems, combined with data analytics techniques, ensures ease of use and quickness of calculation. These results support step-by-step thinking for retrofitting design and hopefully enable a larger utilization rate for deep building retrofits.

Восприятие и осмысление Второй мировой войны во многом являются стержневыми для исторической самоидентификации представителей нескольких поколений. И полем для политических манипуляций. Так, в частности, в государствах Балтии популярной является идеологема о том, что нацистская оккупация была путем к «освобождению от Советов». Участие в боевых действиях или служба в тыловых подразделениях под знаменами со свастикой трактуются ими как «борьба за независимость». Архивные документы об истинных планах, методах и плодах их реализации руководством Третьего рейха в отношении Прибалтики и населявших ее титульных народов позволяют рассмотреть картину происходившего в этом регионе в 1941–1944 гг. Коллекция материалов оперативного штаба рейхсляйтера Розенберга в Риге, хранящаяся в Латвийском государственном историческом архиве (Latvijas Valsts Vēstures arhīvs), и находящиеся в Центральном архиве ФСБ России документы «Рижского процесса» вкупе с новейшей историографией стали основой предлагаемой статьи. Особое внимание уделено реальным планам руководства рейха в отношении предоставления независимости Латвии, Литве и Эстонии, функционированию «самоуправлений», действиям оккупационных властей, касающимся национальных языков, культуры и образования «неперспективных народов» – литовцев, латышей и эстонцев, создания формирований СС и иных военизированных подразделений из представителей балтийских народов, а также экономическим аспектам нацистской политики на территории «Остланд».

We report a case of phaeohyphomycosis that affected the leg of a 45-year-old Brazilian man, car mechanic and renal transplanted. The direct mycological examination evidenced dematiaceous septated hyphae. The pathogenic fungal species was identified as Exophiala xenobiotica. Antifungal activity in vitro revealed terbinafine as the best antifungal. For treatment, it was chosen surgical excision of the entire lesion and used systemic itraconazole. Phaeohyphomycosis caused by Exophiala xenobiotica is extremely rare and is closely related to transplant patients. Keywords: Exophiala xenobiotica, Phaeohyphomycosis, Immunosuppressed, Renal transplantation

Cystic fibrosis (CF) patients frequently acquire Pseudomonas aeruginosa infections that have been associated with a bad prognosis and an increased rate of pulmonary exacerbations. Respiratory viruses can cause exacerbations in chronic pulmonary diseases including COPD or asthma and have been suggested to contribute to exacerbations also in CF. In this study we investigated a possible link between P. aeruginosa infection and susceptibility to respiratory viruses. We show that P. aeruginosa is able to block the antiviral response of airway epithelial cells thereby promoting virus infection and spread. Mechanistically, P. aeruginosa secretes the protease AprA in a LasR dependent manner, which is able of directly degrading epithelial-derived IFNλ resulting in inhibition of IFN signaling. In addition, we correlate the virus infection status of CF patients with the ability of patients' P. aeruginosa isolates to degrade IFNλ. In line with this, the infection status of CF patients correlated significantly with the amount of respiratory viruses in sputum. Our data suggest that the interplay between P. aeruginosa and respiratory virus infections might partially explain the association of increased rates of pulmonary exacerbations and P. aeruginosa infections in CF patients.

Factors linking inflammation and cancer are of great interest. We now report that the chromatin-targeting E3 ubiquitin ligase RNF20/RNF40, driving histone H2B monoubiquitylation (H2Bub1), modulates inflammation and inflammation-associated cancer in mice and humans. Downregulation of RNF20 and H2Bub1 favors recruitment of p65-containing nuclear factor κB (NF-κB) dimers over repressive p50 homodimers and decreases the heterochromatin mark H3K9me3 on a subset of NF-κB target genes to augment their transcription. Concordantly, RNF20+/− mice are predisposed to acute and chronic colonic inflammation and inflammation-associated colorectal cancer, with excessive myeloid-derived suppressor cells (MDSCs) that may quench antitumoral T cell activity. Notably, colons of human ulcerative colitis patients, as well as colorectal tumors, reveal downregulation of RNF20/RNF40 and H2Bub1 in both epithelium and stroma, supporting the clinical relevance of our tissue culture and mouse model findings.

Incontinentia pigmenti is a rare genodermatosis in which the skin involvement occurs in all patients. Additionally, other ectodermal tissues may be affected, such as the central nervous system, eyes, hair, nails and teeth. The disease has a X-linked dominant inheritance pattern and is usually lethal to male fetuses. The dermatological findings occur in four successive phases, following the lines of Blaschko: First phase - vesicles on an erythematous base; second phase - verrucous hyperkeratotic lesions; third phase - hyperchromic spots and fourth phase - hypochromic atrophic lesions.