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Background Mucocutaneous Behçet disease often presents a therapeutic challenge. Roflumilast has shown promise in the treatment of other inflammatory dermatological conditions. Objectives The objective of this study was to evaluate the characteristics, effectiveness and safety of roflumilast in the treatment of Behçet disease-associated aphthosis in routine clinical practice. Methods We performed a single-cohort ambispective observational study. Eleven patients with Behçet disease treated with roflumilast participated. Data collection included demographic, clinical and outcome variables. Statistical analysis compared 12 weeks of treatment with roflumilast with a previous period without treatment and with a period when the previous treatment was used. Results During treatment with roflumilast, a reduction in flare-ups and oral ulcers was observed compared with the untreated period and the previous treatment period. A reduction in genital ulcers, pain and ulcer duration was observed between the without treatment period and the roflumilast treatment period. Adverse effects occurred in 54% of patients, most of which were self-limiting or manageable with dose adjustment. No patients withdrew treatment. Conclusions Roflumilast appears to be a potential option in the treatment of Behçet disease with favourable effectiveness, safety and tolerability profiles. Although further research is needed, roflumilast offers a promising treatment option for Behçet disease-associated aphthosis, which could improve the patients' quality of life and address unmet therapeutic needs. [ABSTRACT FROM AUTHOR]

This paper deals with minimisation of fuel consumption under real driving conditions using a vehicle speed advisor. The aim is to explore the potential of speed profile optimisation in real driving conditions while assessing the suitability of an application which recommends the driver the optimal vehicle speed sequence that minimises the fuel consumption on a particular route. The speed advisor is based on solving the Optimal Control problem of covering a particular route with minimum fuel consumption with a defined time constraint. The approach presented was applied to and implemented on a real passenger vehicle to obtain a trade-off between fuel consumption and travel time for several trips on the route. Experimental results are presented with and without advisory. With speed advisor, the results approach the pareto front with lesser dispersion. On the other hand, without advisory, the dispersion is higher and largely above the pareto front.

Introduction: This reflection article presents an analysis of innovation with a social and responsible focus from the perspective of higher education. Objective: Likewise, it offers a reflection on the emerging concept of Responsible Social Innovation from the perspective of Higher Education, considering an interdisciplinary approach. Methodology: The research was conducted using a phenomenological design, employing qualitative techniques following an analytical and interdisciplinary approach. A reflection was carried out based on a systematic review of the literature, where theoretical foundations were identified to enable the reflection from the standpoint of Higher Education. Results: The findings show that Responsible Social Innovation is an evolving concept grounded in innovation and social responsibility theories. It also highlights how universities act as change agents, driving such innovations through the creation of startups, business models, and processes with a responsible orientation. Conclusions: The theoretical limitations of Responsible Social Innovation complicate the understanding of this approach. Contributions are needed to promote the generation of models and tools in the design of strategies with this perspective. Universities must design policies that promote innovations with this focus in order to address global issues.

Abstract BackgroundTelomere length (TL) is a marker of cellular health and aging. Physical exercise has been associated with longer telomeres and, therefore, healthier aging. However, results supporting such effects vary across studies. Our aim was to synthesize existing evidence on the effect of different modalities and durations of physical exercise on TL. ObjectiveThe aim of this study was to explore the needs and expectations of individuals with physical disabilities and their interventionists for the use of a virtual reality physical activity platform in a community organization. MethodsWe performed an umbrella review and meta-analysis. Data sources included PubMed, Embase, Web of Science, Cochrane Library, and Scopus. We selected systematic reviews and meta-analyses of randomized and nonrandomized controlled clinical trials evaluating the effect of physical exercise on TL. ResultsOur literature search retrieved 12 eligible systematic reviews, 5 of which included meta-analyses. We identified 22 distinct primary studies to estimate the overall effect size of physical exercise on TL. The overall effect size was 0.28 (95% CI 0.118-0.439), with a heterogeneity test value Q of 43.08 (PIPP ConclusionsOur umbrella review and meta-analysis detected a small-moderate positive effect of physical exercise on TL, which seems to be influenced by the duration and type of physical exercise. High quality studies looking into the impact of standardized, evidence-based physical exercise programs on TL are still warranted.

Abstract BackgroundTechnological advancements have significantly reshaped health care, introducing digital solutions that enhance diagnostics and patient care. Artificial intelligence (AI) stands out, offering unprecedented capabilities in data analysis, diagnostic support, and personalized medicine. However, effectively integrating AI into health care necessitates specialized competencies among professionals, an area still in its infancy in terms of comprehensive literature and formalized training programs. ObjectiveThis systematic review aims to consolidate the essential skills and knowledge health care professionals need to integrate AI into their clinical practice effectively, according to the published literature. MethodsWe conducted a systematic review, across databases PubMed, Scopus, and Web of Science, of peer-reviewed literature that directly explored the required skills for health care professionals to integrate AI into their practice, published in English or Spanish from 2018 onward. Studies that did not refer to specific skills or training in digital health were not included, discarding those that did not directly contribute to understanding the competencies necessary to integrate AI into health care practice. Bias in the examined works was evaluated following Cochrane’s domain-based recommendations. ResultsThe initial database search yielded a total of 2457 articles. After deleting duplicates and screening titles and abstracts, 37 articles were selected for full-text review. Out of these, only 7 met all the inclusion criteria for this systematic review. The review identified a diverse range of skills and competencies, that we categorized into 14 key areas classified based on their frequency of appearance in the selected studies, including AI fundamentals, data analytics and management, and ethical considerations. ConclusionsDespite the broadening of search criteria to capture the evolving nature of AI in health care, the review underscores a significant gap in focused studies on the required competencies. Moreover, the review highlights the critical role of regulatory bodies such as the US Food and Drug Administration in facilitating the adoption of AI technologies by establishing trust and standardizing algorithms. Key areas were identified for developing competencies among health care professionals for the implementation of AI, including: AI fundamentals knowledge (more focused on assessing the accuracy, reliability, and validity of AI algorithms than on more technical abilities such as programming or mathematics), data analysis skills (including data acquisition, cleaning, visualization, management, and governance), and ethical and legal considerations. In an AI-enhanced health care landscape, the ability to humanize patient care through effective communication is paramount. This balance ensures that while AI streamlines tasks and potentially increases patient interaction time, health care professionals maintain a focus on compassionate care, thereby leveraging AI to enhance, rather than detract from, the patient experience.

La producción, distribución y consumo de alimentos elaborados con criterios de sostenibilidad ambiental, económica y social se articula con frecuencia a través de redes ciudadanas territorializadas que propugnan un modelo alimentario basado en la proximidad geográfica. Este artículo analiza la aportación de estas redes alimentarias al desarrollo territorial en las provincias de Salamanca y Zamora, muy afectadas por la despoblación y la dispersión de los centros de producción y consumo. Tras compilar un inventario de casos activos, se ha entrevistado a una muestra de iniciativas representativas de todos los eslabones de la cadena de valor. La información recogida permite profundizar en tres cuestiones. Primera, los valores y objetivos que persiguen sus promotores. Segunda, su arraigo en este frágil territorio, fundamental para evaluar su contribución económica, social, ambiental y de gobernanza. Y tercera, las limitaciones que el entorno territorial y el marco institucional y de gobernanza imponen al fortalecimiento de estas iniciativas. Se concluye que el capital social que subyace en estas redes alimentarias es el recurso fundamental que sostiene su capacidad para aprovechar el capital natural del territorio, a pesar de las limitadas capacidades económicas y del desigual apoyo que reciben por parte de las Administraciones Públicas.

Approximately, 20% of ischemic strokes are attributed to the presence of atherosclerosis. Lipoproteins play a crucial role in the development of atherosclerosis, with LDL promoting atherogenesis and HDL inhibiting it. Therefore, both their concentrations and their biological properties are decisive factors in atherosclerotic processes. In this study, we examined the qualitative properties of lipoproteins in ischemic stroke patients with carotid atherosclerosis. Lipoproteins were isolated from the blood of healthy controls (n = 27) and patients with carotid atherosclerosis (n = 64) at 7 days and 1 year postischemic stroke. Compared to controls, patients’ LDL 7 days poststroke showed increased levels of apoC-III, triacylglycerol, and ceramide, along with decreased cholesterol and phospholipid content. LDL from patients induced more inflammation in macrophages than did LDL from controls. HDL isolated from patients 7 days after stroke showed alterations in the apolipoprotein cargo, with reduced levels of apoA-I and increased levels of apoA-II, and apoC-III compared to controls. Patients’ HDL also showed a higher electronegative charge than that of controls and partially lost its ability to counteract the modification of LDL and the inflammatory effects of modified LDL. One year after stroke onset, the composition of patients’ LDL and HDL resembled those of the controls. In parallel, LDL and HDL gained positive charge, LDL became less prone to oxidation and aggregation, and HDL regained protective properties. In conclusion, LDL and HDL in ischemic stroke patients with carotid atherosclerosis exhibited alterations in composition and function, which were partially reversed 1 year after stroke.

Occult HCV infection (OCI) is defined by the presence of HCV RNA in hepatocytes and/or peripheral blood mononuclear cells (PBMCs) without detectable HCV RNA or anti-HCV antibodies in plasma. OCI is underrecognized and may contribute to HCV transmission. This study estimated OCI prevalence and associated risk factors in adults from Mexico City. Methods : A retrospective cross-sectional study was conducted, analyzing 507 general population volunteers. Demographic data and potential risk factors were collected via questionnaire. Anti-HCV detection was performed using two techniques: immunochromatographic rapid test and chemiluminescent microparticle immunoassay (CMIA). Nested PCR was employed to detect HCV RNA in plasma and PBMCs. Positive samples were genotyped through sequencing and phylogenetic analysis of the Core/E1 region. Results : Of 507 participants, four were anti-HCV positive. HCV RNA was found in PBMCs of 27 individuals, while plasma samples tested negative, indicating a 5.3% OCI prevalence. OCI was significantly associated with blood donation ( p = 0.015), drug use ( p = 0.019), particularly cocaine ( p = 0.001), and endoscopy ( p = 0.043). Genotypes 1b, 1a, 2b, 3a, and 2j were detected in OCI cases. Conclusions : OCI prevalence in Mexico City's general population is notable, with significant links to blood donation, cocaine use, and endoscopy. Enhanced diagnostic strategies are crucial to detect OCI and mitigate HCV transmission.