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The storage mechanisms of solid-solid supercapacitors based on graphene oxide (rGO/GO/rGO) were explored by Zhang Q et al. (Zhang et al., 2014) [1], using Density Functional Theory (DFT) and Impedance Spectroscopy (EIS) to elucidate the unusual capacitive behavior of GO sandwich films. Their study revealed alternating charged layers without diffusion zones. Analysis of complex impedance (Z*) data, ranging from 10−3 to 3.106 Hz, was conducted using an equivalent circuit, though this was limited to Nyquist plot data.To further investigate charge storage mechanisms, the current study delved deeper into complex impedance (Z*) and conductivity (σ*). A theoretical approach identified relaxation processes in the imaginary parts of (Z″) and (σ'') across frequencies. Extrapolation up to 3.10^9 Hz and deconvolution confirmed three distinct relaxation processes in Z* and σ*, similar to Cole-Cole relaxation, which describes Maxwell-Wagner-Sillars (MWS) relaxation. This reflects local electrical interactions between active sites on molecular chains and counterions, creating induced dipolar moments or diffusion processes.The identified relaxations at low, medium, and high frequencies correspond well with DFT results, attributed to specific regions: graphene oxide (GO), the (rGO/GO) interface, and reduced graphene (rGO). Key parameters extracted from each relaxation, such as relaxation time, ionic strength, and conductivity values at different frequencies, showed good correlation. This approach, based on deep conductivity (σ*) analysis, effectively highlighted the charge conduction and storage mechanisms in rGO/GO/rGO supercapacitor films.

Background: Enabling, supporting and promoting positive health-related behaviours is critical in addressing the major public health challenges of our time, and the multifaceted nature of behaviours requires an evidence-based approach. This statement seeks to suggest how a much-needed enhanced use of behavioural and cultural science and insights for health could be advanced. Study design and methods: and methods: Public health authorities of Europe and Central Asia and international partner organizations in September 2023 met in Copenhagen, Denmark, to discuss the way forward. Drawing on 1) country reporting to WHO, 2) interview study with public health authorities and 3) the meeting deliberations, this meeting statement was developed. Results: The meeting statement presents a joint call for step-change accelerated use of evidence-based approaches for health behaviours. Actionable next steps for public health authorities and international and regional development partners in health are presented. Conclusions: The way forward involves increased resource allocation, integration of behavioural insights into health strategies, advocacy through case and cost-effectiveness examples and capacity building.

Objective: The study compared immunity to the original SARS-CoV-2 virus (Wuhan) and the Omicron variant using neutralizing antibodies (NAbs), that provide a good approximation of protective immunity. The results might help determine immunization strategies. Design and methods: Unlike previous studies, we analyzed NAbs in a random sample of 110 IgG positive sera from individuals who participated in a population-based seroprevalence transversal study, carried out in May 2022 in two Chilean cities, a country with high vaccination coverage. Results: Our findings indicate that 98.2% of individuals had NAbs against Wuhan, 65.5% against Omicron, and 32.7% tested positive for Wuhan but not Omicron. Factors influencing protective immunity included a prior natural infection and the number of vaccines received. NAbs titers against the original virus were high, demonstrating vaccine effectiveness in the population. However, the level of antibodies decreased when measuring NAbs against Omicron, particularly among older individuals, indicating a decline in vaccine protection. Previous COVID-19 episodes acted as a natural booster, increasing NAbs titers against both virus strains. Conclusions: Protective immunity against the original Wuhan SARS-CoV-2 virus is reduced when compared to Omicron variant. Updating vaccine to target emerging variants and continued monitoring of effectiveness at the population level are necessary.

Summary: Obstructive sleep apnea (OSA) induces intermittent hypoxia (IH), an independent risk factor for non-alcoholic fatty liver disease (NAFLD). While the molecular links between IH and NAFLD progression are unclear, immune cell-driven inflammation plays a crucial role in NAFLD pathogenesis. Using lean mice exposed to long-term IH and a cohort of lean OSA patients (n = 71), we conducted comprehensive hepatic transcriptomics, lipidomics, and targeted serum proteomics. Significantly, we demonstrated that long-term IH alone can induce NASH molecular signatures found in human steatohepatitis transcriptomic data. Biomarkers (PPARs, NRFs, arachidonic acid, IL16, IL20, IFNB, TNF-α) associated with early hepatic and systemic inflammation were identified. This molecular link between IH, sleep apnea, and steatohepatitis merits further exploration in clinical trials, advocating for integrating sleep apnea diagnosis in liver disease phenotyping. Our unique signatures offer potential diagnostic and treatment response markers, highlighting therapeutic targets in the comorbidity of NAFLD and OSA.

Ticks are important zoonotic disease vectors for human and animal health worldwide. In Europe they are the principal vector of public health importance, responsible for Lyme disease, the most prevalent and widespread tick-borne disease (TBD). Tick presence and TBD incidence are increasing, questioning the effectiveness of existing surveillance systems. At the European level TBD burden is likely underestimated as surveillance differs amongst and within countries. France created its first national public health policy in 2016 to tackle TBDs, prompted by growing concern from the public, medical professionals and the scientific community for the lack of knowledge on tick-borne pathogen risk on the population. With global changes, France currently faces risk for TBD emergence (e.g. Crimean-Congo hemorrhagic fever) and re-emergence (e.g. tick-borne encephalitis), in addition to increasing Lyme disease cases. We conducted 13 semi-structured interviews with French tick risk surveillance actors to characterize how the national surveillance system functions. Qualitative descriptive analysis was conducted on interview transcripts to create actor maps and identify the barriers and levers for actor interactions. We identified four tick risk surveillance processes: surveillance-oriented research, risk evaluation, policy creation and policy application, to which interdisciplinary, intersectoral and multi-level actor interactions contribute. Actors express a pervasive need to reinforce intersectoral interactions between human, animal and environmental sectors for early risk detection, as well as multi-level interactions to accurately estimate risk and disseminate prevention information. Transdisciplinary, social-ecological system approaches may offer an adaptive framework for locally relevant surveillance activities in diverse social-ecological contexts.

In this study, we designed aptamer-based self-assemblies for the delivery of quinine. Two different architectures were designed by hybridizing quinine binding aptamers and aptamers targeting Plasmodium falciparum lactate dehydrogenase (PfLDH): nanotrains and nanoflowers. Nanotrains consisted in controlled assembly of quinine binding aptamers through base-pairing linkers. Nanoflowers were larger assemblies obtained by Rolling Cycle Amplification of a quinine binding aptamer template. Self-assembly was confirmed by PAGE, AFM and cryoSEM. The nanotrains preserved their affinity for quinine and exhibited a higher drug selectivity than nanoflowers. Both demonstrated serum stability, hemocompatibility, low cytotoxicity or caspase activity but nanotrains were better tolerated than nanoflowers in the presence of quinine. Flanked with locomotive aptamers, the nanotrains maintained their targeting ability to the protein PfLDH as analyzed by EMSA and SPR experiments. To summarize, nanoflowers were large assemblies with high drug loading ability, but their gelating and aggregating properties prevent from precise characterization and impaired the cell viability in the presence of quinine. On the other hand, nanotrains were assembled in a selective way. They retain their affinity and specificity for the drug quinine, and their safety profile as well as their targeting ability hold promise for their use as drug delivery systems.

Ticks are amongst the most important zoonotic disease vectors affecting human and animal health worldwide. Tick-borne diseases (TBDs) are rapidly expanding geographically and in incidence, most notably in temperate regions of Europe where ticks are considered the principal zoonotic vector of Public Health relevance, as well as a major health and economic preoccupation in agriculture and equine industries. Tick-borne pathogen (TBP) transmission is contingent on complex, interlinked vector-pathogen-host dynamics, environmental and ecological conditions and human behavior. Tackling TBD therefore requires a better understanding of the interconnected social and ecological variables (i.e., the social-ecological system) that favor disease (re)-emergence. The One Health paradigm recognizes the interdependence of human, animal and environmental health and proposes an integrated approach to manage TBD. However, One Health interventions are limited by significant gaps in our understanding of the complex, systemic nature of TBD risk, in addition to a lack of effective, universally accepted and environmentally conscious tick control measures. Today individual prevention gestures are the most effective strategy to manage TBDs in humans and animals, making local communities important actors in TBD detection, prevention and management. Yet, how they engage and collaborate within a multi-actor TBD network has not yet been explored. Here, we argue that transdisciplinary collaborations that go beyond research, political and medical stakeholders, and extend to local community actors can aid in identifying relevant social-ecological risk indicators key for informing multi-level TBD detection, prevention and management measures. This article proposes a transdisciplinary social-ecological systems framework, based on participatory research approaches, to better understand the necessary conditions for local actor engagement to improve TBD risk. We conclude with perspectives for implementing this methodological framework in a case study in the south of France (Occitanie region), where multi-actor collaborations are mobilized to stimulate multi-actor collective action and identify relevant social-ecological indicators of TBD risk.

Resumen: Introducción: La alopecia frontal fibrosante (AFF) es una alopecia linfocítica primaria cicatricial, cuya patogenia se desconoce. Se han desarrollado distintos regímenes de tratamientos farmacológicos, siendo el finasteride por sí sólo o en combinación con corticoides, un tratamiento efectivo. Objetivo: Evaluar si en pacientes con AFF la expresión de receptores de andrógenos en las células del folículo piloso es diferente en comparación a los controles sanos. Métodos: Se confeccionaron micromatrices de biopsias de cuero cabelludo de muestras seleccionadas de pacientes con diagnóstico clínico de AFF e histopatológico de AFF/líquen plano pilaris; y muestras de cuero cabelludo sano con características epidemiológicas similares a la de los pacientes seleccionados. Se realizó un estudio inmunohistoquímico para evaluar la expresión de receptores de andrógenos, estrógenos y progesterona en todas las muestras Resultados: Se incluyeron 27 pacientes con AFF diagnosticada clínica e histológicamente, y 26 controles. El 48% de los pacientes con AFF presentaba receptores de andrógenos en cuero cabelludo, en comparación con un 27% de los pacientes sin AFF, diferencias estadísticamente no significativas (valor p >0,05). Los receptores de estrógenos y progesterona fueron negativos en todas las muestras de casos y controles. Conclusión: Existe una tendencia a que los pacientes con AFF presenten una mayor expresión de receptores de andrógenos que pacientes sanos. Se requieren estudios con diseños prospectivos y mayores tamaños muestrales para validar estos resultados, los que además podrían evaluar la correlación entre la presencia de receptores de andrógenos y la respuesta a tratamiento antiandrogénico. Abstract: Introduction: Frontal fibrosing alopecia (FFA) is a lymphocytic primary cicatricial alopecia, which etiology is unknown. Multiple pharmacological therapies have been developed, being finasteride alone or in combination with corticosteroids an effective treatment. Objectives: To evaluate if the expression of androgen, progesterone and estrogen receptors in the hair follicle of patients with FFA differs from healthy controls. Methods: Microarrays were constructed from scalp biopsies taken from patients with a clinical diagnosis of FFA, and histopathological diagnosis of FFA/lichen planopilaris; and from healthy scalp samples from patients with similar demographic characteristics to those of the case group. Immunohistochemical staining was performed to determine the expression of androgen, estrogen and progesterone receptors in all samples. Results: This study included 27 patients with clinical and biopsy-proven FFA and 26 controls. 48% of scalp samples from patients with FFA presented androgen receptors, in contrast to 27% of samples from patients without FFA, although this difference was not statistically significant (p value >0.05). Estrogen and progesterone receptors were negative in all samples. Discussion: There is a tendency for patients with FFA to have a higher concentration of androgen receptors than healthy patients. Studies with prospective designs and larger sample sizes are required to validate these results, which could also evaluate the correlation between the presence of androgen receptors and the response to antiandrogen treatment.

This study aims at estimating which pesticide active substances (ASs) are the best candidates to study potential further degradation of the AS above 120°C. To achieve this, a prioritisation list was built following five consecutive criteria. This first includes substances that are anthropogenic, have a carbon backbone structure, are authorized in the European Union, and have a defined maximum residue limit (MRL). Then, substances were selected according to their physicochemical and structural properties, MRL in main food commodities, standard price and degradation in hydrolysis studies below 120°C. The results showed that out of the initial 1 478 substances reported in the European pesticide database, 24 ASs were selected as the best candidates to test the assumption of degradation above 120°C. This prioritisation list could be useful for future research studies to build their own list and save time in selecting suitable candidates according to their criteria.

Background: The first wave of SARS-CoV-2 infection in Chile occurred during the cold season reaching a peak by the end of June 2020, with 80 % of the cases concentrated in its capital, Santiago. The main objective of this study was to estimate the attack rate during this first wave of SARS-CoV-2 in a large, densely populated city with more than seven million inhabitants. Since the number of confirmed cases provides biased information due to individuals' potential self-selection, mostly related to asymptomatic patients and testing access, we measured antibodies against SARS-CoV-2 to assess infection prevalence during the first wave in the city, as well as estimate asymptomatic cases, and infection fatality ratio. To our knowledge this is one of the few population-based cross-sectional serosurvey during the first wave in a highly affected emerging country. The challenges of pandemic response in urban settings in a capital city like Santiago, with heterogeneous subpopulations and high mobility through public transportation, highlight the necessity of more accurate information regarding the first waves of new emerging diseases. Methods: From April 24 to June 21, 2020, 1326 individuals were sampled from a long-standing panel of household representatives of Santiago. Immunochromatographic assays were used to detect IgM and IgG antibody isotypes. Results: Seroprevalence reached 6.79 % (95 %CI 5.58 %−8.26 %) in the first 107 days of the pandemic, without significant differences among sex and age groups; this figure indicates an attack rate 2.8 times higher than the one calculated with registered cases. It also changes the fatality rate estimates, from a 2.33 % case fatality rate reported by MOH to an estimated crude 1.00 % (CI95 % 0.97–1.03) infection fatality rate (adjusted for test performance 1.66 % [CI95 % 1.61–1.71]). Most seropositive were symptomatic (81,1 %). Conclusions: Despite the high number of cases registered, mortality rates, and the stress produced over the health system, the vast majority of the people remained susceptible to potential new epidemic waves. We contribute to the understanding of the initial spread of emerging epidemic threats. Consequently, our results provide better information to design early strategies that counterattack new health challenges in urban contexts.

Summary: Background: The Omicron variant has challenged the control of the COVID-19 pandemic due to its immuno-evasive properties. The administration of a booster dose of a SARS-CoV-2 vaccine showed positive effects in the immunogenicity against SARS-CoV-2, effect that is even enhanced after the administration of a second booster. Methods: During a phase-3 clinical trial, we evaluated the effect of a second booster of CoronaVac®, an inactivated vaccine administered 6 months after the first booster, in the neutralization of SARS-CoV-2 (n = 87). In parallel, cellular immunity (n = 45) was analyzed in stimulated peripheral mononuclear cells by flow cytometry and ELISPOT. Findings: Although a 2.5-fold increase in neutralization of the ancestral SARS-CoV-2 was observed after the second booster when compared with prior its administration (Geometric mean units p

Objective: Sialidosis is an inborn error of metabolism. There is evidence that the myoclonic movements observed in this disorder have a cortical origin, but this mechanism does not fully explain the bilaterally synchronous myoclonus activity frequently observed in many patients. We present evidence of a subcortical basis for synchronous myoclonic phenomena. Methods: Electromyographic investigations were undertaken in two molecularly and biochemically confirmed patients with sialidosis type-1. Results: The EMG recordings showed clear episodes of bilaterally synchronous myoclonic activity in contralateral homologous muscles. We also observed a high muscular-muscular coherence with near-zero time-lag between these muscles. Conclusion: The absence of coherence phase lag between the right-and-left homologous muscles during synchronous events indicates that a unilateral cortical source cannot fully explain the myoclonic activity. There must exist a subcortical mechanism for bilateral synchronization accounting for this phenomenon. Significance: Understanding this mechanism may illuminate cortical-subcortical relationships in myoclonus.

Objectives: To determine the relative frequency and prognosis value of proteinuria in hantavirus cardiopulmonary syndrome (HCPS) due to Andes virus. Methods: This observational analytical study prospectively obtained data from patients admitted to 12 health centers in nine Chilean cities between 2001 and 2018. Only patients with confirmed Andes virus HCPS and laboratory characterization that included qualitative proteinuria determination at admission were considered. Results: The database involved 175 patients, 95 of them had a measurement of urine protein at the time of hospital admission. They were mainly male (71%) and the median age was 35 [22-47] years. Median duration of the febrile prodromal time was 5 [4-7] days. Hospital length of stay and hospital mortality rate were 10 [7-14] days and 21.1%, respectively. Seventy-three patients (77%) were identified with proteinuria at admission, which was associated with increased mortality rate (26% versus 5%, p=0.036) and the relative risk was 1.3 [1.1-1.6], p=0.002. Conclusions: Proteinuria is a frequent finding in patients with HCPS, which is associated with a higher mortality rate.

Resumen: La respuesta inflamatoria, frecuentemente asociada al parto prematuro extremo, tiene un rol relevante en el pronóstico, ya que la inmadurez propia del sistema inmune en estas condiciones impide la apropiada modulación de estos procesos, promoviendo una inflamación persistente en el tiempo con los consiguientes daños en el corto, mediano y largo plazo. Objetivo: revisar los mecanismos inmunológicos en el prematuro extremo, los efectos en los sistemas de mayor relevancia y nuevas perspectivas terapéuticas. Summary: Inflammatory response, frequently associated with extreme preterm birth, has a relevant role in outcome, since immaturity of immune system, in such conditions, does not allow an appropriate modulation of these processes leading to sustained inflammation, to secondary damage and thus promoting short-medium- and long-term sequelae. Objective: to review immunological mechanisms involved in extreme prematurity, their effects on the most relevant systems and new therapeutical approaches.

Resumen: La respuesta inflamatoria asociada al parto prematuro extremo tiene un rol relevante en el pronóstico del recién nacido. La inmadurez de su sistema inmune no logra modular los mecanismos proinflamatorios y antiinflamatorios, lo que desencadena daños secundarios con secuelas en el corto, mediano y largo plazo. Objetivo: revisar los mecanismos inmunológicos involucrados en el síndrome inflamatorio perinatal persistente, presentando posibles ejes de prevención y tratamiento. Summary: The inflammatory response associated with extreme preterm birth plays a relevant role in the prognosis of the newborn. The immaturity of the immune system fails to modulate the pro-inflammatory and anti-inflammatory mechanisms, triggering secondary damage with short, medium and long term sequelae. Objective: to review the immunological mechanisms involved in the sustained perinatal inflammatory syndrome, presenting possible prevention and treatment targets.

Quality control in semiconductors is a crucial step to produce high quality microchips. During the last years, advances in artificial vision have significantly improved image quality control techniques. In the semiconductor industry, automated visual inspection is fundamental to avoid human intervention and keep the pipeline sanitized. Different types of images are collected during this process, feeding image databases that continually grow and cannot be labelled by humans in an exhaustive manner. Advances in image retrieval search methods are fundamental to develop more efficient techniques that meet user requirements.In this work we propose a dimensionality reduction approach on the feature vectors computed by a classifying deep learning model, while keeping a high retrieval performance. To validate this technique, we evaluate four well-known reduction algorithms on a subset of the full database: Principal Component Analysis (PCA), Sparse Random Projection (SRP), Isomap, Locally Linear Embedding (LLE), in combination with three similarity metrics: Euclidian (L2), cosine and inner product. As the number of components of the vectors is reduced, the performance of the image retrieval is measured by recall, time to search, and memory footprint of the database.PCA offers the best results, allowing a significant reduction in search time and memory usage, while SRP becomes an option only when the cosine distance is used. With PCA, we were able to divide the memory footprint by a factor of 16, the search time by 6, while maintaining an average recall of 0.96.

Resumen: El dolor de cadera en un niño menor de 10 años es un desafío diagnóstico. La causa de este dolor puede ser inflamatoria, infecciosa o propia de un esqueleto en desarrollo. Como en todo paciente pediátrico, la clínica algunas veces no será evidente y requerirá de la experiencia del médico para poder obtener síntomas y signos que guíen el estudio. En esta revisión se presentan las causas más frecuentes de coxalgia en pacientes menores de 10 años. Summary: Hip pain in children under ten years of age is a diagnostic challenge. The origin of the pain can be inflammatory, infectious, or proper to a pediatric growing skeleton. As in every pediatric patient, clinical history may not be evident and the physician experience will be necessary to obtain clinical features to guide the patient study. In this review, the most frequent causes of hip pain in children under ten years of age are displayed.

Aim: The SAMe-TT2R2 score helps identify patients with atrial fibrillation (AF) likely to have poor anticoagulation control during anticoagulation with vitamin K antagonists (VKA) and those with scores >2 might be better managed with a target-specific oral anticoagulant (NOAC). We hypothesized that in clinical practice, VKAs may be prescribed less frequently to patients with AF and SAMe-TT2R2 scores >2 than to patients with lower scores. Methods and results: We analyzed the Phase III dataset of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF), a large, global, prospective global registry of patients with newly diagnosed AF and ≥1 stroke risk factor. We compared baseline clinical characteristics and antithrombotic prescriptions to determine the probability of the VKA prescription among anticoagulated patients with the baseline SAMe-TT2R2 score >2 and ≤ 2. Among 17,465 anticoagulated patients with AF, 4,828 (27.6%) patients were prescribed VKA and 12,637 (72.4%) patients an NOAC: 11,884 (68.0%) patients had SAMe-TT2R2 scores 0-2 and 5,581 (32.0%) patients had scores >2. The proportion of patients prescribed VKA was 28.0% among patients with SAMe-TT2R2 scores >2 and 27.5% in those with scores ≤2. Conclusions: The lack of a clear association between the SAMe-TT2R2 score and anticoagulant selection may be attributed to the relative efficacy and safety profiles between NOACs and VKAs as well as to the absence of trial evidence that an SAMe-TT2R2-guided strategy for the selection of the type of anticoagulation in NVAF patients has an impact on clinical outcomes of efficacy and safety. The latter hypothesis is currently being tested in a randomized controlled trial. Clinical trial registration: URL: https://www.clinicaltrials.gov//Unique identifier: NCT01937377, NCT01468701, and NCT01671007.

Background: Tension band wiring and plates are the most widely used treatments for transverse displaced fractures of olecranon despite high rates of hardware complications, subsequent implant removal, and associated costs. The purpose of this study was to report the outcomes of displaced transverse olecranon fractures treated with intramedullary screw and suture tension band. Methods: We performed an observational, retrospective, consecutive, monocentric, continuous multioperator study. We reviewed 31 Mayo type IIA displaced olecranon fractures treated in our institution with intramedullary 6.5 mm AO cancellous screw and high-strength suture tension band (No. 2 FiberWire®) from 2016 to 2018. Inclusion was limited to functionally independent patients with Mayo type IIA fractures and minimum 24-month follow-up for implant removal. We assessed clinical outcomes including range of motion; QuickDASH score; and Mayo Elbow Performance Score. Categorical data were analyzed with Fisher's exact test when appropriate. Continuous data were analyzed with the Student t-test or Mann-Whitney U test after assessment for normality. Statistical analysis was performed with STATA 16 software. Results: Twenty-seven patients with a mean follow-up period of 38.4 ± 6.2 months (range, 24.1-50 months) were included in the study. The average flexion was 134.5° ± 14.8° (range, 70°-140°) and the mean extension was −5.9° ± 7.0° (range, −20°-0°). Mean pronation and supination were 85.8° ± 11.9° (range, 45°-90°) and 86.9° ± 14.3° (range, 20°-90°), respectively. The mean Mayo Elbow Performance Score was 90.8 ± 9.6 (range, 70-100) with 92.3% good and excellent results. The mean QuickDASH score was 17.1 ± 16 (range, 0-54.5). There were 3 hardware-related removals (11.1%). The overall removal rate was 18.5%. Univariate analysis of the factors associated with implant removal were pain in relation to the implant (60% vs. 11%, P = 0.0482), proximal screw migration (3.7 mm vs. 1.7 mm, P = 0.05), articular angle (22.5° vs. 27.7°, P = 0.0353), and olecranon width (22.2 mm vs. 24.4 mm, P = 0.0166). In total, 26.1% of the cases presented some degree of proximal migration of the implant (2.7 ± 1.8 mm of migration; range, 1.5-6.2 mm). Univariate analysis of the factors associated with implant proximal migration were proximal ulnar dorsal angulation (1.7° vs. 6.4°, P = 0.0179), anteroposterior endomedullary canal (7.3 mm vs. 6.0 mm, P = 0.0369), and lateral endomedullary canal (7.2 mm vs. 5.0 mm, P = 0.0219). Conclusion: The functional outcomes of simple transverse olecranon fractures treated with an intramedullary cancellous screw and a suture tension band are excellent, associated with a low rate of complications and material removal.

Resumen: Antecedentes: La pandemia global de COVID-19 llega al continente americano en marzo del año 2020 y en menos de dos meses reúne a más de la mitad de los casos a nivel global. Objetivo: Caso clínico de una mujer embarazada con una presentación crítica de COVID-19 y embarazo a las 25 semanas de gestación, en el contexto del peak de la pandemia en Chile en el otoño del año 2020. Caso Clínico: El 20 de junio de 2020, una mujer de 34 años, con 25 semanas de embarazo, es trasladada desde Hospital de San Bernardo a Clínica Las Condes en Santiago, Chile, con un cuadro de 10 días de evolución de COVID-19, que evoluciona a una situación crítica con insuficiencia respiratoria severa. Ingresa a unidad de cuidados intensivos para ventilación mecánica. Las imágenes de radiología simple y de tomografía axial computarizada de tórax demuestran una neumopatía bilateral con imágenes características opacidades en vidrio esmerilado, asociado a engrosamiento intersticial, imágenes descritas previamente como características para COVID-19. La paciente permanece en unidad de cuidados intensivos en ventilación mecánica por siete días, con evolución favorable posterior, mejoría del cuadro séptico y alta después de 22 días de hospitalización. El parto ocurre en forma espontánea a las 38 semanas, la madre y el recién nacido evolucionan en buen estado general. El examen histopatológico placentario demuestra compromiso inflamatorio vellositario y los exámenes de anticuerpos en sangre del recién nacido demuestran la presencia de anticuerpos del tipo IgG e IgM. Se trata de uno de los pocos casos demostrados reportados de transmisión transplacentaria vía sanguínea de SARS-CoV-2 de la madre al recién nacido. Summary: Background: The global COVID-19 pandemic reaches the American continent in March 2020 and in less than two months it brings together more than half of the cases globally. Objective: The clinical case of a 25-week pregnant woman with a critical presentation of COVID-19 and pregnancy at 25 weeks of gestation, is presented in the context of the peak of the pandemic in Chile in the fall of 2020. Clinical case: On June 20, 2020, a 34-year-old woman, 25 weeks pregnant, is transferred from Hospital de San Bernardo to Clinica Las Condes in Santiago, Chile, with a ten-day evolution of a COVID-19 that evolves to critical with severe respiratory failure. She is admitted to the intensive care unit for mechanical ventilation. Chest computerized axial tomography images demonstrate bilateral pneumopathy with characteristic images of ground-glass opacities, associated with interstitial thickening, images previously described as characteristics for COVID-19. The patient remains in the intensive care unit on mechanical ventilation for seven days, with subsequent favorable evolution, improvement of the septic condition, and discharge after 22 days of hospitalization. Delivery occurs at 38 weeks, the mother and the newborn evolve in good general condition. The placental histopathological examination demonstrates villous inflammatory involvement, and the newborn's blood tests show the presence of IgG and IgM antibodies. It is one of the few reported cases of transplacental transmission of SARS-CoV-2 from the mother to the newborn.

Introduction: While there is evidence to show the positive effects of automation, the impact on radiation oncology professionals has been poorly considered. This study examined radiation oncology professionals’ perceptions of automation in radiotherapy planning. Method: An online survey link was sent to the chief radiation therapists (RT) of all Australian radiotherapy centres to be forwarded to RTs, medical physicists (MP) and radiation oncologists (RO) within their institution. The survey was open from May-July 2019. Results: Participants were 204 RTs, 84 MPs and 37 ROs (response rates ∼10% of the overall radiation oncology workforce). Respondents felt automation resulted in improvement in consistency in planning (90%), productivity (88%), quality of planning (57%), and staff focus on patient care (49%). When asked about perceived impact of automation, the responses were; will change the primary tasks of certain jobs (66%), will allow staff to do the remaining components of their job more effectively (51%), will eliminate jobs (20%), and will not have an impact on jobs (6%). 27% of respondents believe automation will reduce job satisfaction. 71% of respondents strongly agree/agree that automation will cause a loss of skills, while only 25% strongly agree/agree that the training and education tools in their department are sufficient. Conclusion: Although the effect of automation is perceived positively, there are some concerns on loss of skillsets and the lack of training to maintain this. These results highlight the need for continued education to ensure that skills and knowledge are not lost with automation.

Objectives: In the context of the coronavirus disease 2019 (COVID-19) pandemic, the development and validation of rapid and easy-to-perform diagnostic methods are of high priority. This study was performed to evaluate a novel rapid antigen detection test (RDT) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in respiratory samples. Methods: The fluorescence immunochromatographic SARS-CoV-2 antigen test (Bioeasy Biotechnology Co., Shenzhen, China) was evaluated using universal transport medium with nasopharyngeal (NP) and oropharyngeal (OP) swabs from suspected COVID-19 cases. Diagnostic accuracy was determined in comparison to SARS-CoV-2 real-time (RT)-PCR. Results: A total of 127 samples were included; 82 were RT-PCR-positive. The median patient age was 38 years, 53.5% were male, and 93.7% were from the first week after symptom onset. Overall sensitivity and specificity were 93.9% (95% confidence interval 86.5–97.4%) and 100% (95% confidence interval 92.1–100%), respectively, with a diagnostic accuracy of 96.1% and Kappa coefficient of 0.9. Sensitivity was significantly higher in samples with high viral loads. Conclusions: The RDT evaluated in this study showed a high sensitivity and specificity in samples mainly obtained during the first week of symptoms and with high viral loads, despite the use of a non-validated sample material. The assay has the potential to become an important tool for early diagnosis of SARS-CoV-2, particularly in situations with limited access to molecular methods.

A recent state provision allows quarzitic campo rupestre (QCR) set-asides as in-kind compensation for ironstone campo rupestre (ICR) suppression in the Atlantic Forest, which induces out-of-kind compensation. However, the recently published state provision defines no clear parameters to demonstrate “ecological equivalence” as an in-kind compensation. We evaluated whether there is ecological equivalence between and ICR and QCR in the Brazilian Atlantic Forest. We show marked geological, pedological, floristic, structural, and functional differences between ICR and QCR. There is evidence that the new compensation rules only partially offset loss of biodiversity and ecosystem services hosted by ICR, determining limited effectiveness of the legislation for ICR conservation in the Atlantic Forest. We conclude that the development of clear compensation parameters based on scientific evidence and quantitative indicators is a priority gap for the conservation of ICR under increasing mining pressure.

Background: Neuroimaging technology is being developed to enable non-invasive mapping of the latency distribution of cortical projection pathways in white matter, and correlative clinical neurophysiological techniques would be valuable for mutual verification. Interhemispheric interaction through the corpus callosum can be measured with interhemispheric facilitation and inhibition using transcranial magnetic stimulation. Objective: To develop a method for determining the latency distribution of the transcallosal fibers with transcranial magnetic stimulation. Methods: We measured the precise time courses of interhemispheric facilitation and inhibition with a conditioning-test paired-pulse magnetic stimulation paradigm. The conditioning stimulus was applied to the right primary motor cortex and the test stimulus was applied to the left primary motor cortex. The interstimulus interval was set at 0.1 ms resolution. The proportions of transcallosal fibers with different conduction velocities were calculated by measuring the changes in magnitudes of interhemispheric facilitation and inhibition with interstimulus interval. Results: Both interhemispheric facilitation and inhibition increased with increment in interstimulus interval. The magnitude of interhemispheric facilitation was correlated with that of interhemispheric inhibition. The latency distribution of transcallosal fibers measured with interhemispheric facilitation was also correlated with that measured with interhemispheric inhibition. Conclusions: The data can be interpreted as latency distribution of transcallosal fibers. Interhemispheric interaction measured with transcranial magnetic stimulation is a promising technique to determine the latency distribution of the transcallosal fibers. Similar techniques could be developed for other cortical pathways.

Fifteen years of reported incidents were reviewed to provide insight into the effectiveness of an Incident Learning System (ISL). The actual error rate over the 15 years was 1.3 reported errors per 1000 treatment attendances. Incidents were reviewed using a Mann-Whitney U Test. The average number of incidents per year and the number of incidents per thousand attendances declined over time. Two seven-year periods were considered for analysis and the average for the first period (2005–2011) was 6 reported incidents per 1000 attendances compared to 2 incidents for the later period (2012–2018), p

• Increases in human-wildlife conflicts alongside cultural shifts against lethal control methods are driving the need for alternative wildlife management tools such as fertility control. Contraceptive formulations suitable for oral delivery would permit broader remote application in wildlife species. • This study evaluated the contraceptive effect and immune response to two novel injectable immunocontraceptive formulations targeting the Gonadotropin Releasing Hormone (GnRH): MAF-IMX294 and MAF-IMX294P conjugates, both identified as having potential as oral contraceptives. The study also explored whether in multiparous species immunocontraceptives may either totally prevent reproduction or also affect litter size. • Female rats, chosen as a model species, were given three doses of either MAF-IMX294 or MAF-IMX294P to compare anti-GnRH immune response and reproductive output up to 310 days post-treatment. • Both formulations induced anti-GnRH antibody titres in 100% of rats and significantly impaired fertility compared to control animals. Following treatment with MAF-IMX294 and MAF-IMX294P 0 of 9 and 1 of 10 females respectively produced litters following the first mating challenge 45 days post-treatment, compared to 9 of 9 control animals. • Across the whole 310 day study period 7 of 9 females from the MAF-IMX294 group and 10 of 10 females in the MAF-IMX294P group became fertile, producing at least one litter throughout six mating challenges. • No significant differences were found between the two formulations in antibody titre response or duration of contraceptive effect, with an average time to first pregnancy of 166 days for MAF-IMX294 and 177 days for MAF-IMX294P for all females that became fertile. • Following treatment with MAF-IMX294 and MAF-IMX294P the first litter produced post-infertility in treated females was significantly smaller than in control animals. This indicates treatment with immunocontraceptives may induce an overall suppression of fecundity extending past an initial infertility effect. This increases the potential long-term impact of these immunocontraceptives in multiparous species such as commensal rodents.

Background: Loss-of-function variants in the calcium-sensing receptor (CASR) gene are known to be involved in a clinical spectrum ranging from asymptomatic familial hypocalciuric hypercalcemia (FHH) to neonatal severe hyperparathyroidism (NSHPT). Homozygous or compound heterozygous variants are usually responsible for severe neonatal forms, whereas heterozygous variants cause benign forms. One recurrent pathogenic variant, p.Arg185Gln, has been reported in both forms, in a heterozygous state. This variant can be a de novo occurrence or can be inherited from a father with FHH.NSHPT leads to global hypotonia, failure to thrive, typical X-ray anomalies (diffuse demineralization, fractures, metaphyseal irregularities), and acute respiratory distress which can be fatal. Phosphocalcic markers show severe hypercalcemia, abnormal urinary calcium resorption, and hyperparathyroidism as major signs.Classical treatment involves calcium restriction, hyperhydration, and bisphosphonates. Unfortunately, the disease often leads to parathyroidectomy. Recently, calcimimetics have been used with variable efficacy. Efficacy in NSHPT seems to be particularly dependent on CASR genotype. Case presentation: We describe the antenatal presentation of a male with short ribs, initially suspected having skeletal ciliopathy. At birth, he presented with NSHPT linked to the pathogenic heterozygous CASR variant, Arg185Gln, inherited from his father who had FHH. Postnatal therapy with cinacalcet was successful. Discussion: An exhaustive literature review permits a comparison with all reported cases of Arg185Gln and to hypothesize that cinacalcet efficacy depends on CASR genotype. This confirms the importance of pedigree and parental history in antenatal short rib presentation and questions the feasibility of phosphocalcic exploration during pregnancy or prenatal CASR gene sequencing in the presence of specific clinical signs. It could in fact enable early calcimimetic treatment which might be effective in the CASR variant Arg185Gln.

The chemokine receptors CXCR1/2 play a key role in the aggressiveness of several types of cancers including head and neck squamous cell carcinomas (HNSCCs). In HNSCCs, CXCR1/2 signaling promotes cell proliferation and angiogenesis leading to tumor growth and metastasis. The competitive inhibitor of CXCR1/2, C29, inhibits the growth of experimental HNSCCs in mice. However, a non-invasive tool to monitor treatment response is essential to implement the use of C29 in clinical practices. 18F-FDG PET/CT is a gold-standard tool for the staging and the post-therapy follow-up of HNSCCs patients. Our study aimed to perform the first in vivo monitoring of C29 efficacy by non-invasive 18F-FDG PET/CT imaging. Mice bearing experimental HNSCCs (CAL33) were injected with 18F-FDG (T0) and thereafter treated (n = 7 mice, 9 tumors, 50 mg/kg by gavage) or not (n = 7 mice, 10 tumors) with C29 for 4 consecutive days. Final 18F-FDG-tumor uptake was determined at day 4 (TF). The average relative change (TF-T0) in 18F-FDG tumor uptake was +25.85 ± 10.93 % in the control group vs −5.72 ± 10.07 % in the C29-treated group (p

Objective: The back-average technique is very useful to study the relation between the activity in the cortex and the muscles. It has two main clinical applications, Bereitschaftspotential (BP) recording and myoclonus studies. The BP is a slow wave negativity originating in the supplementary motor cortex and premotor cortex that precedes voluntary movements. This wave also precedes involuntary movements in functional movement disorders (FMD), and it can be used as a helpful diagnostic tool. For the myoclonus studies, the back-average technique is very important to help localizing the source of the myoclonus. The hardware needed to do BP or myoclonus studies is standard and available in any electrophysiology lab, but there are not many software solutions to do the analysis. In this article together with describing the methodology that we use for recording clinical BPs and myoclonus, we present BacAv, an online free application that we developed for the purpose of doing back-average analysis. Methods: BacAv was developed in “R” language using Rstudio, a free integrated development environment. The recommended parameters for the data acquisition for BP recording and myoclonus studies are given in this section. Results: The platform was successfully developed, is able to read txt files, look for muscle bursts, segment the data, and plot the average. The parameters of the algorithm that look for the muscle bursts can be adapted according to the characteristics of the dataset. Conclusion: We have developed software for clinicians who do not have sophisticated equipment to do back-averaging. Significance: This tool will make this useful analysis method more available in a clinical environment.

Objective: The electrophysiological classification of tremors can be a key element in the diagnosis and can facilitate treatment of a patient with tremor; however, the ability to conduct electrophysiological studies of tremor is not widely available. The purpose of this study was to develop and validate a free online platform for tremor analysis. Methods: An online platform for tremor analysis was developed using “R” language; called “Tremoroton”. For validation, we compared the frequency estimation of the tremor obtained with Tremoroton compared with a commercially available software in a cohort of 20 patients (10 with essential tremor and 10 with Parkinson diagnosis), comparing the activity recorded on the accelerometer, extensor carpi radialis and flexor carpi radialis EMG. An intraclass correlation coefficient was used for the comparison. Results: The final version of tremoroton is now online. It allows reading up to 6 channels, and will do time, frequency, time-frequency analysis and calculate coherence. We demonstrated a high correlation in frequency measurements (0.97 (0.945–0.984, 95% IC) for the accelerometers, 0.98 (0.977–0.994, 95% IC) for the extensor carpi radialis EMG, and 0.99 (0.987–0.997, 95% IC) for the flexor carpi radialis EMG) when compared to a commercial software. Conclusion: We were able to develop and validate a free online platform for tremor analysis. Significance: Making this tool available should help expanding tremor analysis techniques from research to the clinical setting.