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Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The goal of achieving clinical remission in patients with spondyloarthritis does not necessarily include the resolution of entheseal inflammation from a histological perspective. However, enthesis not clinically inflamed, under mechanical stress, may behave differently from healthy subjects considering the physiopathology of SpA. Our goal was to determine whether ultrasound changes in entheses differ between SpA patients in clinical remission and healthy subjects. SpA patients in clinical remission and matched healthy controls were recruited. At baseline, the following variables were measured on the dominant side by ultrasound: thickness of the distal patellar enthesis (hDP), the deep infrapatellar bursa (hDIB), the Achilles enthesis (hA), the preachilleal bursa (hPAB), effusion in the preachileal bursa (hePAB), and the presence of power Doppler signal in both enthesis. All measurements except hDP and hA were collected again after exercise (post-stress ultrasound). 30 patients and 30 controls were enrolled. In all subjects, hDIB, hPAB, and the preachileal bursa occupancy index increased significantly after the exercise. The increase was significantly greater in patients for all variables. At baseline, in patients, hyperemia was detected in one patellar tendon (3.3%) and in two Achilles tendons (6.7%). After exercise, the number of tendons with hyperemia increased to 11/30 (36.7%) and 12/30 (40%), respectively. Among controls, there was no detectable basal hyperemia, but after exercise, it was detected in 1/30 patellar tendons (3.3%) and 2/30 Achilles tendons (6.7%). Exercise triggers a greater effusive and hyperemic synovial response in patients in remission than in healthy controls. These findings suggest that the definition of remission should also include an assessment of the synovial response to mechanical stress. • Patients developed greater bursal distension after exercise than controls. • Some patients, considered to be in clinical remission, developed enthesal hyperemia after physical activity. • The current definition of remission should be reconsidered and include the concept of normalization of the biomechanical stress response. [ABSTRACT FROM AUTHOR]

The Valve Academic Research Consortium (VARC)-3 definition for neurologic events after transcatheter aortic valve replacement (TAVR) lacks clinical validation. This study sought to determine the incidence, predictors, and clinical impact of neurologic events following TAVR as defined by VARC-3 criteria. This was a multicenter study including 2,924 patients with severe aortic stenosis undergoing TAVR. Based on Neurologic Academic Research Consortium (NeuroARC) classification, neurologic events were classified as NeuroARC type 1 (stroke), NeuroARC type 2 (covert central nervous system injury), and NeuroARC type 3 (transient ischemic attack and delirium). Baseline, procedural, and follow-up data were prospectively collected in a dedicated database. After a median follow-up of 13 (7-37) months, neurologic events occurred in 471 patients (16.1%), NeuroARC type 1, 2, and 3 in 37.4%, 4.7%, and 58.0% of cases, respectively, and the majority (58.6%) were periprocedural. Advanced age, chronic kidney disease, atrial fibrillation, major vascular complications, and in-hospital bleeding determined an increased risk of periprocedural events (P < 0.03 for all). Neurologic events occurring during the periprocedural time frame were independently associated with a substantial increase in mortality at 1 year after the intervention (HR: 1.91; 95% CI: 1.23-2.97; P = 0.004). However, although NeuroARC type 1 was associated with an increased mortality risk (IRR: 3.38; 95% CI: 2.30-5.56; P < 0.001 and IRR: 21.7; 95% CI: 9.63-49.1; P < 0.001 for ischemic and hemorrhagic stroke, respectively), the occurrence of NeuroARC type 3 events had no impact on mortality. Neurologic events after TAVR were associated with poorer short- and long-term survival. This correlation was related to the type of NeuroARC event defined by the VARC-3 criteria. Given the negative impact on clinical outcomes, every attempt should be made to reduce the risk of neurologic complications after TAVR. [Display omitted] [ABSTRACT FROM AUTHOR]

Patients treated with left atrial appendage occlusion (LAAO) are at high bleeding risk. Intensive antithrombotic treatment is recommended after the procedure to prevent device-related thrombosis. This study sought to evaluate the incidence, consequences, and predictors of early nonprocedural bleeding after LAAO. This was a multicenter study including 1,649 patients undergoing LAAO in 9 centers. Early nonprocedural bleeding was defined as bleeding unrelated to the procedure occurring within 3 months after device implantation. The severity of bleeding was defined by the Valve Academic Research Consortium-2 classification. A sensitivity analysis was performed at 45 days. A total of 121 (7.3%) patients experienced early nonprocedural bleeding events, and 69 (57.0%) were classified as major bleeding (4.2% of patients). Independent predictors of early nonprocedural bleeding were dual antiplatelet therapy (DAPT) at discharge (adjusted HR [aHR]: 1.61; 95% CI: 1.12-2.33; P = 0.01), prior gastrointestinal bleeding (aHR: 2.15; 95% CI: 1.38-3.35; P < 0.001), and multiple locations of prior bleeding (aHR: 2.33; 95% CI: 1.34-4.05; P < 0.001). DAPT at discharge was predictive of both all and major nonprocedural bleeding at 3 months and 45 days. After a median follow-up of 2.3 years (Q1-Q3: 1.1-4.1 years), early nonprocedural bleeding was independently associated with an increased risk of all-cause death (aHR: 1.53; 95% CI: 1.15-2.06; P < 0.001). This heightened mortality risk was similar at 45 days. Early nonprocedural bleeding after LAAO occurred in ∼7% of patients within 3 months, with more than one-half being classified as major bleeding. Regardless of severity, early nonprocedural bleeding was associated with increased mortality. DAPT at discharge determined an increased risk of early nonprocedural bleeding after LAAO. These results emphasize the importance of bleeding risk for determining antithrombotic strategies after LAAO. [Display omitted] [ABSTRACT FROM AUTHOR]

This study aimed to assess premature mortality due to Diabetes in small areas of Spain between 2016 and 2020, and its relationship with socioeconomic level and the immediate cause of death. As a secondary objective, we evaluated the effect of the Covid 19 pandemic. This was an ecological study of premature mortality due to Diabetes from 2016 to 2020, with a focus on small areas. All deaths in people under 75 years of age due to Diabetes as the underlying cause were included The final sample comprised 7382 premature deaths in 5967 census tracts. Women living in census tracts with an high level of deprivation(RR=2.40) were at a significantly higher risk. Mortality from Diabetes increased with deprivation, especially people aged 0–54(RR=2.40). People with an immediate cause of death related to a circulatory disease, living in census tracts with an high level of deprivation(RR=3.86) was associated with a significantly greater risk of death with underlying Diabetes. When a disease of the circulatory system was recorded as the immediate cause of death, being 65–74 years (RR=71.01) was associated with a significantly higher risk of premature mortality. Living in geographic areas with higher levels of socioeconomic deprivation is associated with a higher risk of premature death from Diabetes in Spain. This relationship has a greater impact on women, people under 54 years, and people at risk of death caused directly by diseases of the circulatory system. Premature mortality due to diabetes saw a modest increase in 2020. • 49,943 died in Spain (2016–2020) from DM; 16.6% (8307) under 75. Study excluded 925 due to unestablished deprivation index. • Deprivation linked to higher DM mortality; women more affected. Most DM deaths (57%) tied to circulatory diseases. • DM mortality increases with deprivation, notably higher when circulatory system is the immediate cause. [ABSTRACT FROM AUTHOR]

This study aimed to assess multicausal mortality due to diabetes from 2016–2018 in Spain. Specific objectives were to quantify the occurrence of diabetes as an underlying cause or as any registered cause on the death certificate. A cross-sectional descriptive study taking a multicausal approach. Diabetes appears as an underlying cause of 2.3% of total deaths in Spain, and as any cause in 6.2%. In patients in whom Diabetes appears as an underlying cause on the death certificates, the 15 most frequent immediate causes are cardiovascular diseases in men(prevalence ratio 1,59)and women (PR1,31). In men, the causes associated with diabetes as any cause were skin diseases(prevalence ratio 1.33), followed by endocrine diseases(prevalence ratio 1.26)and genitourinary diseases (prevalence ratio1.14). In women, the causes associated with the presence of diabetes as any cause were endocrine (prevalence ratio 1.13)and genitourinary (prevalence ratio 1.04)diseases. In patients in whom diabetes appears as an underlying cause on the death certificates, the 15 most frequent immediate causes are cardiovascular diseases. In men, the causes associated with the presence of diabetes as any cause of death are skin, endocrine and genitourinary diseases. In women, the causes associated with diabetes as any cause are endocrine and genitourinary. • This study evaluated multi-causal mortality due to DM between 2016 and 2018 in Spain. • Diabetes Mellitus was the underlying cause of 2.3% of total deaths in Spain. • In 6.2% of cases, Diabetes Mellitus appeared as one of the multiple causes of death [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Stridor is a clinical sign of an underlying disease and a common reason for pediatric emergency department (PED) consultation. Patients presenting with stridor must be evaluated to determine the origin of this abnormality. We present the case of a 7-year-old female patient who presented to our Pediatric Emergency Department with a history of recurrent episodes of stridor with increasing frequency over the previous 4 years, for this reason she was previously admitted to the pediatric intensive care unit. Findings from the otorhinolaryngologic assessment with flexible fiber-optic endoscopy led to a diagnosis of congenital synechia of the vocal cords. The cervical CT scan evidenced critical stenosis of the airway. An initial cordectomy and placement of a silicone device for fixation were performed. Subsequently, the patient required 6 additional interventions for progressive dilation of the glottic space at the level of the vocal cords and injections of mitomycin C injections (an antineoplastic that inhibits collagen proliferation). This case highlights the importance of additional studies (especially examination of the upper airway) when atypical or recurrent findings are revealed by the clinical history, physical examination, or disease course in patients with croup to prioritize cases severe enough to require pediatric intensive care unit admission. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study aimed to develop a 3-dimensional (3D) characterization of the severity of maxillary impacted canines and to test the clinical performance of this characterization as a treatment decision support tool. Cone-beam computed tomography images obtained from 83 patients with 120 impacted maxillary canines were included. Quantitative information on the canine 3D position and qualitative assessment of root damage of adjacent teeth were evaluated. A severity index was constructed on the basis of the quantitative findings. Clinical applicability was tested by comparing clinical diagnosis and treatment planning for conventional records vs the 3D characterization via a 2-part survey. The average quantitative assessments of impacted maxillary canine position were 6.4 ± 3.6 mm from the midsagittal plane, 11.6 ± 3.1 mm in height relative to the occlusal plane, 31.5° ± 18° of roll, and 48.8° ± 14.3° of pitch. The severity index ranged from 0-13 with a mean score of 4.5 ± 2.2. Overlap with adjacent teeth was the greatest contributor (33%) to the index. Bicortically impacted canines caused the most severe root damage. Cone-beam computed tomography was preferred for assessing root damage and overall severity, whereas conventional imaging was sufficient for height and angulation assessment. The 3D report was very important or important for evaluating root damage, canine position, overall severity, and overlap. The 3D report changed most of the decisions relating to biomechanics, patient education, and treatment time estimate. The decision of exposure and traction vs extraction was changed 22% of the time after the presentation of the 3D report. The overlap with adjacent teeth frequently contributes the most to the severity index. The 3D report provided relevant clinical information regarding the canine position, damage to adjacent teeth, and the severity index, with a profound impact on the decisions of the clinicians regarding biomechanics, patient education, and treatment time estimate. • Canine impaction benefits from 3D imaging reports. • Bicortical canine impaction leads to root resorption of adjacent teeth. • Three-dimensional reports change the clinical decisions of orthodontists. [ABSTRACT FROM AUTHOR]

Device-related thrombus (DRT) remains one of the main concerns after left atrial appendage occlusion (LAAO). Several risk factors have been proposed, but most cannot be modulated. A modifiable factor such as device implantation depth is a potential target to adjust the risk for DRT. The aim of this study was to assess the impact of LAAO device implantation depth as a predisposing factor for DRT. The study included patients who underwent successful LAAO at 9 centers in Europe and Canada. Patients were classified into 2 groups: proximal device implantation (covered pulmonary ridge [PR] in the lobe and disc cohort or <5 mm from the PR in the single-lobe cohort) and distal device implantation (uncovered PR in the disc and lobe cohort and ≥5 mm in the single-lobe cohort). A total of 1,317 patients were included. Among these, proximal and distal device implantation was achieved in 732 (55%) and 585 (45%) patients, respectively. No differences in procedural outcomes were observed between the groups. At follow-up, patients with proximal implantation had a lower incidence of DRT (2.3%) than those with distal implantation (12.2%) (P < 0.001). Deeper device implantation and a larger uncovered left atrial appendage area were associated with a higher incidence of DRT (P < 0.001), regardless of device type. In multivariable analysis, distal implant (HR: 5.92; 95% CI: 3.39-10.36) and no or single antiplatelet therapy (HR: 1.62; 95% CI: 0.99-2.62) emerged as independent predictors of DRT. LAAO device implantation depth is an independent risk factor for DRT. Deeper device implantation and larger uncovered left atrial appendage areas were associated with a higher incidence of DRT. [Display omitted] [ABSTRACT FROM AUTHOR]

• Copper surfaces reduce microbial burden compared to control surfaces in health care facilities. • Lack of data remains a problem to connect environmental pollution reduction by copper and reducing HAIs. • Future research should focus on measuring the effectiveness of using copper in contact surfaces and the reduction of HAIs. • Larger sample sizes and longer term studies may be necessary to link copper interventions and HAI's. Hospital-acquired infections (HAIs) are a significant clinical and economic burden on health systems worldwide. Copper alloys have been certified by the US EPA as solid antimicrobial materials, but their effectiveness in reducing HAIs is not well established This systematic review aimed to assess copper surfaces in situ efficacy in reducing health care's microbial burden compared to control surfaces. A literature search was conducted using three electronic databases: Web of Science, PubMed, and Scopus, with the keywords "copper" and "surfaces" and "antimicrobial" and "antibacterial" and "infections." Studies from 2010 to 2022 were included. The quality of the studies was independently screened and assessed using the Newcastle Ottawa Scale. A total of 56 articles were screened, with 8 included in the review and 7, added from references. Two third of the studies report a significant reduction in the microbial burden on copper objects compared to control objects. The 2 studies with the highest scores on NOS evaluation indicated that using copper or copper alloys in healthcare settings can effectively decrease the number of bacterial contaminations on touch surfaces. The results suggest the potential effectiveness of copper as a preventive tool in healthcare facilities, but further studies and longer trials are needed to establish a relationship between copper and reduced nosocomial infections. [ABSTRACT FROM AUTHOR]

There is a significant interest in the development of novel nanomaterials that keep pace with emerging technologies. In this context, soft particles represent an excellent alternative to the conventional inorganic nanomaterials owing to their softness and versatility, rendering them highly useful in various applications. The knowledge of their nanomechanical properties plays a key role in understanding particle behavior under different environments. Advanced measurement techniques have been deployed to accurately quantify mechanical properties of the nanoscopic objects, and AFM stands out as the primary choice. The mechanical behavior of soft particles are determined by numerous parameters such as sample preparation, polymer density, the cononsolvency effect, pH, charge density, temperature, and the integration of nanoparticles. In this chapter, we will introduce the techniques used to investigate the mechanical properties of soft particles and discuss how these parameters play a crucial role in tailoring the nanomechanical performance of soft particles. Additionally, we will present case studies to demonstrate how soft particles are utilized in developing innovative materials across various research fields. [ABSTRACT FROM AUTHOR]

• Out of the National Parks boundaries inhabit forest specialist species without protection. • We identify new priority conservation areas in the Trans-Mexican Volcanic Belt. • Multitaxa and abundance based approach are efficient for declaring protected areas. • Restoration actions are urgent to recover diverse communities in Tlaxcala. The effectiveness of protected areas (PAs) for conservation is under debate because many were decreed without considering biological criteria. Efforts have been made to increase their numbers and to promote ecological connectivity among the existing PAs. In this study, we identify new priority conservation areas (PCAs) through a multi-taxa analysis in a highly fragmented landscape between La Malinche (LMNP) and Iztaccíhuatl − Popocatépetl (IPNP) National Parks in the Trans-Mexican Volcanic Belt. Particularly, we compared the taxonomic diversity of amphibians, reptiles, terrestrial mammals, scarab beetles, myxomycetes, and soil fungal species in six polygons with different land uses and vegetation types. We paid attention to the taxonomic diversity patterns according to the disturbance tolerance of the species, and we described the relationship between biodiversity and environmental variables. Adjacent temperate forests of the IPNP are habitats for the greatest number of species and individuals with low tolerance to disturbance. Polygons located in the central hills of Tlaxcala serve as a reservoir of mainly generalist species but also host exclusive and low tolerance species even though ∼ 63 % of the original vegetation has been transformed. Restoration and conservation through Areas Voluntarily Destined for Conservation and communal protected areas is a challenge that must be addressed to promote biological connectivity between the studied National Parks. Finally, we suggest that multi-taxonomic approaches discriminating species by their level of disturbance tolerance could be an efficient tool to identify new PCAs that ensure ecological processes and maintain diverse communities in highly fragmented landscapes. [ABSTRACT FROM AUTHOR]

Prefabricated dowels do not always provide intraradicular sealing in the root canal dentin, and the lack of sealing predisposes the dowel to adhesive failure and debonding. It is unclear if fiber-reinforced composite resin dowels provide better sealing. The purpose of this in vitro study was to evaluate the intraradicular sealing and morphological fit of prefabricated dowels and fiber-reinforced composite resin dowels in root canal dentin. The thickness of the resin cement layer and push-out bond strength were determined to assess their effects on the sealing of the dowels. A total of 50 permanent maxillary central incisors were endodontically treated and divided into 2 subgroups (n=25). In one group, prefabricated dowels were cemented; in the second group, fiber-reinforced composite resin dowels were placed. The thickness of the resin cement layer was assessed in 3 different locations: coronal, middle, and apical of the root canal dentin with fluorescence confocal laser microscopy. The push-out bond strength was then determined, and intraradicular sealing observed by using scanning electron microscopy. Fiber-reinforced composite resin dowels showed a closer intraradicular fit and seal in the root canal dentin, and the morphology of the apical portion of the fiber-reinforced composite resin dowels showed a sealing area with the gutta percha in the apical portion. The mean thickness of the resin cement layer was significantly reduced for the fiber-reinforced composite resin dowels compared with the prefabricated dowels (P <.05) in the cervical area (197.0 μm versus 311.0 μm) and in the apical portion of the root canal (57.3 μm versus 131.6 μm). The mean push-out strength was higher for the fiber-reinforced composite resin dowels (22.98 N/mm2) than that for the prefabricated dowels (16.49 N/mm2) (P <.05). The morphological fit of fiber-reinforced composite resin dowels provides better intraradicular sealing in the cervical and apical portions, reducing the resin cement thickness. The increased push-out strength can therefore be assumed to result from increased frictional retention compared with prefabricated dowels. [ABSTRACT FROM AUTHOR]

Most severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected individuals are asymptomatic or only exhibit mild disease. In about 10% of cases, the infection leads to hypoxemic pneumonia, although it is much more rare in children. We evaluated 31 young patients aged 0.5 to 19 years who had preexisting inborn errors of immunity (IEI) but lacked a molecular diagnosis and were later diagnosed with coronavirus disease 2019 (COVID-19) complications. Genetic evaluation by whole-exome sequencing was performed in all patients. SARS-CoV-2–specific antibodies, autoantibodies against type I IFN (IFN-I), and inflammatory factors in plasma were measured. We also reviewed COVID-19 disease severity/outcome in reported IEI patients. A potential genetic cause of the IEI was identified in 28 patients (90.3%), including mutations that may affect IFN signaling, T- and B-cell function, the inflammasome, and the complement system. From tested patients 65.5% had detectable virus-specific antibodies, and 6.8% had autoantibodies neutralizing IFN-I. Five patients (16.1%) fulfilled the diagnostic criteria of multisystem inflammatory syndrome in children. Eleven patients (35.4%) died of COVID-19 complications. All together, at least 381 IEI children with COVID-19 have been reported in the literature to date. Although many patients with asymptomatic or mild disease may not have been reported, severe presentation of COVID-19 was observed in 23.6% of the published cases, and the mortality rate was 8.7%. Young patients with preexisting IEI may have higher mortality than children without IEI when infected with SARS-CoV-2. Elucidating the genetic basis of IEI patients with severe/critical COVID-19 may help to develop better strategies for prevention and treatment of severe COVID-19 disease and complications in pediatric patients. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Lactobacillus amylovorus α-amylase is an endoenzyme with a peculiar starch-binding domain containing five identical family 26 carbohydrate-binding modules (CBM26). To investigate the impact of CBMs on catalytic activity, C-terminally truncated derivatives were constructed. The catalytic domain alone shows low affinity for the substrate and a very slow reaction rate, highlighting the importance of CBMs in maintaining the enzyme's optimal conformation and dynamics for efficient catalysis. CBMs enhance enzyme performance, as indicated by improved catalytic efficiency (kcat/Km). Interestingly, the enzyme variant La CD3CBM, with three CBMs, exhibits the best catalytic efficiency on soluble starch, outperforming the wild-type amylase, with five CBMs. In the case of insoluble starch, the catalytic domain alone could not hydrolyze it and even adding a CBM, the release of reducing sugars was very inefficient. However, this efficiency was significantly improved by two orders of magnitude for the three-CBM variant and the wild-type amylase. CBMs also played a crucial role in protein thermostability, contributing to a higher melting temperature of the catalytic domain with just a single CBM. Notably, thermostability did not increase with the number of CBMs. In conclusion, spatial arrangement and interactions between the catalytic domain and CBMs significantly influenced enzymatic efficiency with both soluble and insoluble substrates. These interactions optimize enzymatic activity and improve thermostability. • CBMs play a significant role in the productive adsorption on starch. • Adsorption is influenced by the number of CBMs. • CBMs can modulate the product pattern of amylase. • Presence of CBM improves amylase thermostability. • The most efficient form of the enzyme activity has a catalytic domain with 3CBMs. [ABSTRACT FROM AUTHOR]

Green roofs (GR) are nature-based solutions for climate change adaptation and mitigation in buildings and cities. However, few GR maintenance, installation, and challenge-solving guidelines are available for semiarid climates. We present how three case-study types of GR (urban gardens (UGR), native gardens (NGR), and wetland roofs (WR)) varied in installation costs, irrigation volumes, maintenance times, vegetation cover, survival, biomass and yield, in Ensenada, México, from 2022 to 2023. In UGR, nine edible species were cultivated to yield produce; in NGR, six native plants were planted, and four were grown in WR. UGR installation costs were 31 % and 21 % lower, but maintenance costs were four and 1.5 times higher than NGR and WR, respectively. UGR consumed 17 % more water annually than NGR and 42 % less than WR. Likewise, UGR demanded 94 and 92 % more annual maintenance time than NGR and WR. WR presented the highest survival, height, cover, and biomass values, followed by NGR (except for biomass) and UGR. Our results point to different GR solutions for distinct types of applications and users, demonstrating their versatility in design. All GR categories are suitable to reduce the ecological footprint of buildings; however, we emphasize that each GR design involves different economic, time, and challenge-solving commitments that should be considered before installation and operation. • We studied the economic, labor, and irrigation costs of three extensive green roofs. • We provide maintenance guidelines from a Mediterranean climate case study. • Urban Garden roofs demand more maintenance but can be very productive. • Wetlands and Native Gardens have high installation costs and low maintenance. • Green roofs are highly adaptable for distinct types of applications and users. [ABSTRACT FROM AUTHOR]

Steel honeycomb monoliths have been manufactured by Fused Deposition Modelling-FDM 3D printing technology using 90 % 17–4 PH steel nanoparticles-loaded polymer filament. Pure steel monoliths were obtained after thermal removal of the polymer and steel sintering. NiO-CeO 2 active phase nanoparticles were loaded on powder steel and on the steel monoliths, and the supported catalysts were tested in the hydrogenation of CO 2 to CH 4 , paying special attention to the steel pretreatment before active phase loading. The catalytic experiments confirm that totally functional catalysts have been prepared, showing 100 % selective conversion of CO 2 to CH 4 above 225 ºC and stability in long-term experiments (18 hours at 325 ºC). The catalytic behaviour is improved by H 2 O 2 -pretreatment of the steel honeycomb monoliths before the active phase loading. XPS characterization confirms that the surface of the catalysts is oxidised on the fresh catalysts and gets even more oxidised after the catalytic tests. The H 2 O 2 -pretreatment of the steel support partially avoids the additional oxidation under reaction conditions, keeping chromium and cerium cations less oxidised than on the catalyst prepared with untreated steel. In addition, evidence about the electronic interaction between the steel support and the NiO-CeO 2 (np) active phase are obtained. [Display omitted] • Development of steel honeycomb monoliths by 3D printing using FDM technology. • 3D-printed steel honeycomb monoliths were impregnated with NiO-CeO 2 nanoparticles to test this catalyst in the CO 2 to CH 4 hydrogenation. • Effect of the steel pretreatment before active phase has been studied. • NiO/CeO 2 catalysts in 3D-printed monoliths achieved 100% selectivity for CO 2 to CH 4 conversion above 225ºC, with 18 h stability at 325ºC. [ABSTRACT FROM AUTHOR]

Date seeds are byproducts of date processing and lack value beyond livestock feed. Our work focused on utilizing seed flours (defatted flour, F1, and ethanol-extracted defatted flour, F2) and testing their incorporation into cookies at different wheat flour substitution (10% and 30%). Flours and cookies were analyzed for their proximal and phenolic compositions, and antioxidant activity. Baking behavior, appearance and sensory studies were performed for cookies. Seed flours could be considered as food ingredients for their fiber content (84%), antioxidant properties (631–770 mmol TE/kg), and energy value (22–25 Kcal/100g). F1-Cookies had a higher texture (27–30 N) and phenolic content (0.5–1 g/kg) and a darker color. These characteristics made them less acceptable to the panelists, although their antioxidant activity was high (48–78 mmTE/kg). F2-Cookies were similar in texture (18–19 N) to the control, their color was intermediate between the control and F1, their phenolic content was about half of F1 (0.26–0.49 g/kg), and their antioxidant activity was higher than control (31–50 mmTE/kg). In three out of five parameters evaluated by the panel (odor, taste and texture), there were no significant differences between control and F2-10%. F2 flour would be an interesting product for baked good formulation, as F2-cookies had high fiber content, antioxidant activity, and good consumer acceptability. F1, but only at its lowest dosage (10%), could also be considered a valuable ingredient. This study demonstrated the potential use of date seeds for human consumption, producing healthy and nutritious foods that could promote economic and social development in date producing regions. [ABSTRACT FROM AUTHOR]

Green Infrastructure (GI) is a strategically planned network delivering and enhancing diverse ecosystem services whilst preventing further biodiversity loss. Although not mandatory for EU members to implement GI, it is increasingly advocated as a tool for landscape planning. In 2016, the Swedish Government mandated the County Administrative Boards (CABs) to design regional GI plans using a collaborative process. This study explored the GI collaborative process in the region of Scania in southern Sweden, focusing on forest as an important component of Swedish landscapes. We interviewed 14 different stakeholders who participated in the process, and analysed the preconditions, inner workings and outcomes of collaborative GI planning. Despite remarkably different expectations, the perceived outcomes were consistent. Most stakeholders perceived the process as mainly informational rather than deliberative and, in general, use of the GI plan was limited. Despite successful finalisation of the plan, collaboration as a long-term process has not been achieved, which may limit the realisation of activities that foster GI. Scania's GI planning illustrates the defects of top-down approaches with insufficient resources, failing to address the stakeholders' trust and positioning. A lack of inclusivity and deliberation undermine the legitimacy of collaborative processes, discrediting the very concept of GI in Sweden. Our analysis indicates that a genuine collaborative process and a long-term commitment to implementing GI is unachievable without sustained and substantial governmental funding, capacity development at the lead agency, thorough consideration of prehistory, and targeted measures to increase trust among stakeholders. • Green infrastructure (GI) plans open a new venue for collaborative governance of (forested) landscapes. • Information exchange rather than genuine deliberation dominated the development of GI plan in Scania county. • Stakeholder commitment to the process was too low, GI plan not sufficiently concrete and unsatisfactorily implemented. • Ineffective collaborative process undermines GI planning in the Swedish context. [ABSTRACT FROM AUTHOR]

Hill-Sachs lesions (HSLs) can be present after a primary shoulder dislocation and may go unrecognized; this can alter the necessary bony constraint within the glenohumeral joint. To deal with HSLs, remplissage is a safe procedure with low complication rates, low recurrent instability rates, and good patient outcome scores compared with many of the other alternative techniques. On the other hand, a great number of techniques have been described to treat reverse Hill-Sachs lesions (RHSLs). In this article, we propose a method of treatment for combined simultaneous HSL and RHSL shoulder injuries. However, consensus on a specific treatment is yet to be established. We present an arthroscopic treatment guideline for patients with shoulder instability due to anterior and posterior labral lesions, HSL, and RHSL. [Display omitted] [ABSTRACT FROM AUTHOR]

In-transit metastases (ITM) are defined as metastatic lymph nodes or deposits occurring between the primary tumor and proximal draining lymph node basin. In extremity rhabdomyosarcoma (RMS), they have rarely been reported. This study evaluates the frequency, staging and survival of patients with ITM in distal extremity RMS. Patients with extremity RMS distal to the elbow or knee, enrolled in the EpSSG RMS 2005 trial between 2005 and 2016 were eligible for this study. One hundred and nine distal extremity RMS patients, with a median age of 6.2 years (range 0–21 years) were included. Thirty seven of 109 (34%) had lymph node metastases at diagnosis, 19 of them (51%) had ITM, especially in lower extremity RMS. 18F-FDG-PET/CT detected involved lymph nodes in 47% of patients. In patients not undergoing 18F-FDG-PET/CT lymph node involvement was detected in 22%. The 5-yr EFS of patients with ITM vs proximal lymph nodes vs combined proximal and ITM was 88.9% vs 21.4% vs 20%, respectively (p = 0.01) and 5-yr OS was 100% vs 25.2% vs 15%, respectively (p = 0.003). Our study showed that in-transit metastases constituted more than 50% of all lymph node metastases in distal extremity RMS. 18F-FDG-PET/CT improved nodal staging by detecting more regional and in-transit metastases. Popliteal and epitrochlear nodes should be considered as true (distal) regional nodes, instead of in-transit metastases. Biopsy of these nodes is recommended especially in distal extremity RMS of the lower limb. Patients with proximal (axillary or inguinal) lymph node involvement have a worse prognosis. [ABSTRACT FROM AUTHOR]

Many surgical treatments have been described for massive subcutaneous emphysema (MSE) over the recent years. However, there is no consensus on which is the most recommended and there is great diversity in treatment. With new advances in minimally invasive therapy performed at the bedside, especially in intensive care units, it has been possible to increase therapeutic efficacy. During the COVID-19 pandemic, some therapeutic techniques have been discussed in critically ill patients with SARS-COV-2 respiratory infections, because of the potential overexposure of healthcare personnel to an increased risk of contagion after direct exposure to air trapped in the subcutaneous tissue of infected patients. We present the clinical case of an 82-year-old male patient, SARS COV-2 infected, with MSE after 48 h with invasive mechanical ventilation in critical intensive care. He was treated with negative pressure therapy (NPT) allowing effective resolution of the MSE in a short period (5 days) with a minimally invasive bedside approach, reducing the potential air exposure of health personnel by keeping the viral load retained by the emphysema. Therefore, we present NPT as an effective, minimally invasive and safe therapeutic alternative to be considered in the management of MSE in critically ill patients infected with SARS COV-2. [ABSTRACT FROM AUTHOR]

Surgery plays a key role in the management of Neuroblastic tumours (NB), where the standard approach is open surgery, while minimally invasive surgery (MIS) may be considered an option in selected cases. The indication(s) and morbidity of MIS remain undetermined due to small number of reported studies. The aim of this study was to critically address the contemporary indications, morbidity and overall survival (OS) and propose guidelines exploring the utility of MIS for NB. Materials & Methods: A SIOPEN study where data of patients with NB who underwent MIS between 2005 and 2018, including demographics, tumour features, imaging, complications, follow up and survival, were extracted and then analysed. A total of 222 patients from 16 centres were identified. The majority were adrenal gland origin (54%) compared to abdominal non-adrenal and pelvic (16%) and thoracic (30%). Complete and near complete macroscopic resection (>95%) was achieved in 95%, with 10% of cases having conversion to open surgery. Complications were reported in 10% within 30 days of surgery. The presence of IDRF (30%) and/or tumour volume >75 ml were risk factors for conversion and complications in multivariate analysis. Overall mortality was 8.5%. MIS for NB showed that it is a secure approach allowing more than 95% resection. The presence of IDRFs was not an absolute contraindication for MIS. Conversion to open surgery and overall complication rates were low, however they become significant if tumour volume >75 mL. Based on these data, we propose new MIS guidelines for neuroblastic tumours. [ABSTRACT FROM AUTHOR]

Intraoral distalizers associated with skeletal anchorage provide the major benefit of promoting molar distalization with minimum anchorage loss and patient cooperation. This case report presents the treatment of a 17-year-old female with Class II Division 2 malocclusion, maxillary dentoalveolar protrusion, mild mandibular retrusion, increased overjet, deepbite, and lip incompetence. The treatment plan involved initial maxillary molar distalization with a customized version of the skeletally anchored dual force distalizer (DFD). The customized DFD used smaller mini-implants and included a fixed anterior biteplane. The device applied simultaneous forces from the buccal and palatal sides directly to the molars using nickel-titanium coil springs and allowed orthodontic mechanics in the mandibular teeth. An overcorrected Class I molar relationship was obtained after 6 months. After the distalization phase, retraction mechanics began with retraction loops and using a modified transpalatal bar reinforced with the mini-implants as anchorage. Moreover, the finishing phase was performed with multiloop edgewise archwires and intermaxillary elastics to enable an individualized control of each tooth. Total treatment time comprised 2 years 4 months, and significant improvements regarding the facial and occlusal perspectives were noticed. Similarly, these favorable changes remained stable during the 2-year follow-up period. The customized version of the skeletally anchored DFD followed by fixed appliances showed effectiveness and stability in Class II malocclusion treatment. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The selection of aircraft and engine models poses a significant challenge for Low-Cost Carriers (LCCs) striving for profitability. This decision is compounded by numerous subjective and objective variables and the vast array of available aircraft and engine configurations. Current methodologies, utilizing Multi-Criteria Decision Making (MCDM) and fuzzy logic, often simplify the problem, neglecting the engine consideration and limiting variables and alternatives. In this paper, we propose a novel methodology that circumvents these simplifications, considering engine configurations within the aircraft selection and addressing this problem for 27 parameters and real 51 selection alternatives. Through the consultation of different experts in the aeronautic field, we establish a comprehensive approach to assess the relative and overall performance of multiple variables, as well as their weights and hierarchy in the selection scheme. We apply this methodology to the aircraft selection problem in the medium-haul market, providing a framework and a solution for this currently unexplored literature domain. The results provide valuable insights for validating the devised methodology and providing relevant insights on the characteristics of the medium-haul market for LCCs. • The integration of the engine consideration within the aircraft selection. • The definition of a novel framework of LCC medium-haul aircraft selection parameters. • A new method for systematically defining relative and absolute parameter performance. [ABSTRACT FROM AUTHOR]

To determine whether manual therapy based on joint mobilization techniques applied to recover a limited range of motion (ROM) in older adults could have a beneficial effect on balance. Systematic review from MEDLINE, Embase, Cochrane Library, PEDro, WOS, Scopus, and Scielo, including studies with participants over 60, an experimental intervention based on ankle joint mobilization techniques, oriented to restore ankle ROM and assessing the effects on balance and ROM. A descriptive synthesis and a meta-analysis were conducted to estimate the effect of the interventions on balance and ROM, based on mean differences, with CI set at 95 %. Quality was assessed with PEDro scale and risk of bias with the Cochrane tool. A total of 8 studies were included in the qualitative and 5 in the quantitative synthesis. Manual therapy was shown to be effective, by overall increasing the ankle ROM by 11.3° (95 % CI 6.4 to 15.6). The monopodal stability was improved in 5.8 s (95 % CI 0.1 to 11.4) and the margins of stability in 4.4 cm (95 % CI 0.6 to 8.6). The static balance improved in terms of the center of pressure swayed area with a decrease of 78.4 mm2 (95 % CI 46.1 to 110.6), but not of velocity (95 % CI 24.7 to −36.7). The Timed up and go time decreased by 0.86 s (95 % CI 0.38 to −2.08). Manual therapy based on joint mobilization techniques is an effective approach to increase ankle ROM, with benefits on the stability of older adults. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Ortopédica y Traumatologia (English Edition) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)