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The objective is to evaluate the structural and bromatological modifications of hawthorn yam starch modified chemically with 2‐octenyl‐succinic anhydrous (OSA) and enzymatically with amyloglucosidase (AMG). Methodologically, the bromatological composition, amylose, amylopectin and starch contents, degree of crystallinity, particle size distribution and Fourier transform infrared spectroscopy (FTIR) of native starch, OSA, and AMG from Colombian hawthorn yam were determined. The results indicated higher protein (0.99 ± 0.24%) and fiber (2.00 ± 0.02%) content for the native; higher ash (0.78 ± 0.05%), reducing sugars (66.89 ± 9.10%), sodium (126.31 ± 0.32 mg 100 g−1), iron (1.29 ± 0.01 mg 100 g−1), calcium (72.56 ± 0.35 mg 100 g−1), and copper (3.46 ± 0.02 mg 100 g−1) for OSA. AMG presented the highest manganese content (4.49 ± 0.04 mg 100 g−1). OSA reduced amylose content. AMG presented a larger particle size. In OSA, peaks were identified between 1558 and 1720 cm−1, corresponding to new carbonyl groups (CO) of the octenyl‐succinyl radical. The results indicate that modification with OSA leads to structural alterations that can promote yam starch as an additive to formulate emulsions or colloidal systems during the development of microencapsulated products for the pharmaceutical or food industry. [ABSTRACT FROM AUTHOR]

This paper presents a novel implementation of the Coral Reef Optimization with Substrate Layers (CRO‐SL) algorithm. Our approach, which we call TensorCRO, takes advantage of the TensorFlow framework to represent CRO‐SL as a series of tensor operations, allowing it to run on GPU and search for solutions in a faster and more efficient way. We evaluate the performance of the proposed implementation across a wide range of benchmark functions commonly used in optimization research (such as the Rastrigin, Rosenbrock, Ackley, and Griewank functions), and we show that GPU execution leads to considerable speedups when compared to its CPU counterpart. Then, when comparing TensorCRO to other state‐of‐the‐art optimization algorithms (such as the Genetic Algorithm, Simulated Annealing, and Particle Swarm Optimization), the results show that TensorCRO can achieve better convergence rates and solutions than other algorithms within a fixed execution time, given that the fitness functions are also implemented on TensorFlow. Furthermore, we also evaluate the proposed approach in a real‐world problem of optimizing power production in wind farms by selecting the locations of turbines; in every evaluated scenario, TensorCRO outperformed the other meta‐heuristics and achieved solutions close to the best known in the literature. Overall, our implementation of the CRO‐SL algorithm in TensorFlow GPU provides a new, fast, and efficient approach to solving optimization problems, and we believe that the proposed implementation has significant potential to be applied in various domains, such as engineering, finance, and machine learning, where optimization is often used to solve complex problems. Furthermore, we propose that this implementation can be used to optimize models that cannot propagate an error gradient, which is an excellent choice for non‐gradient‐based optimizers. [ABSTRACT FROM AUTHOR]

Paraganglioma of the middle mediastinum has a prevalence of 1%–2% of paragangliomas and less than 1% of mediastinal masses. It is generally asymptomatic and can easily be confused with other pathologies. The following is the case of a 50‐year‐old patient who, as an incidental finding, documented an injury between the aorta and the pulmonary artery, hypervascularized, which was embolized prior to surgery, which facilitated the complete resection of the lesion by sternotomy. With favorable evolution of the patient and discharge on the fourth postoperative day. A thorough review of the literature on the diagnostic and treatment approach to this pathology has been also carried out. [ABSTRACT FROM AUTHOR]

Background: There are over 42 million dogs in Mexico, with a significant population living on the streets, especially in the State of Mexico. These dogs can act as carriers of zoonotic pathogens, placing children and individuals with chronic diseases or immunodeficiencies at risk. Objectives: To evaluate the prevalence of zoonotic parasites in feral and domestic dogs in the urban area of the eastern State of Mexico and assess their potential impact on public health. Methods: The study was conducted from July 2022 to March 2023 in the urban area located in the eastern region of the State of Mexico. A total of 134 samples of dog faces were collected through convenience sampling, from both domiciled and non‐domiciled dogs. Results: Fifty‐one dogs were identified with Ancylostomatidae family (38.1%, 95% CI: 27.0%–52.1%), 10 with Toxocara spp. (7.5%, 95% CI: 3.6%–13.3%), 7 with Dipylidium caninum (5.5%, 95% CI: 2.1%–10.5%), 8 with Cystoisospora spp. (6.0%, 95% CI: 2.6%–11.4%), 6 with Giardia spp. (4.5%, 95% CI: 1.7‐9.5%) and 2 positive cases for Hymenolepis spp. (1.5%, 95% CI: 0.2%–5.3%) were identified. Conclusions: This study highlights a public health concern related to non‐domiciled dogs, which can serve as carriers of zoonotic parasites. Interactions among non‐domiciled dogs, domiciled dogs and humans heighten the risk of transmission. Implementing prevention, control and awareness strategies is crucial to reduce the spread of these parasites. [ABSTRACT FROM AUTHOR]

This paper presents a novel hybrid approach for the probabilistic reconstruction of meteorological fields based on the combined use of the analogue method (AM) and deep autoencoders (AEs). The AE–AM algorithm trains a deep AE in the predictor fields, which the encoder filters towards a compressed space of reduced dimensionality. The AM is then applied in this latent space to find similar situations (analogues) in the historical record, from which the target field can be reconstructed. The AE–AM is compared to the classical AM, in which flow analogues are explicitly searched in the fully resolved field of the predictor, which may contain useless information for the reconstruction. We evaluate the performance of these two approaches in reconstructing the daily maximum temperature (target) from sea‐level pressure fields (predictor) recorded during eight major European heat waves of the 1950–2010 period. We show that the proposed AE–AM approach outperforms the standard AM algorithm in reconstructing the magnitude and spatial pattern of the considered heat wave events. The improvement ranges from 7% to 22% in skill score, depending on the heat wave analyzed, demonstrating the potential added value of the hybrid method. [ABSTRACT FROM AUTHOR]

Arctic clouds play a key role in Arctic climate variability and change; however, contemporary climate models struggle to simulate cloud properties accurately. Model‐simulated cloud properties are determined by the physical parameterizations and their interactions within the model configuration. Quantifying effects of individual parameterization changes on model‐simulated clouds informs efforts to improve models and provides insights on climate system behavior. This study quantities the influence of parameterization scheme changes on Arctic low cloud properties within the Hadley Center Global Environmental Model 3 atmospheric model using a suite of experiments where individual parameterization packages are changed between the two configurations. The results indicate, surprisingly, that single parameterization changes explain most of the cloud property changes, whereas multiple parameterizations, including non‐cloud schemes, contribute to cloud radiative effect differences. Non‐cloud parameterizations are those not used to compute time step cloud properties. We employ a three‐term decomposition to quantify contributions from (a) regime independent, (b) regime dependent, and (c) the regime frequency of occurrence changes. Decomposition results indicate that cloud property changes vary by meteorological regime, each term contributes differently to each cloud property change, and non‐cloud parameterization changes make substantial contributions to the LW and SW cloud radiative effects by affecting clear‐sky fluxes. The analysis provides insights on the role of non‐cloud parameterizations for setting cloud radiative effects, a pathway for cloud‐atmosphere circulation interactions, raises questions on the importance of infrequently occurring regimes to climate simulations, and on useful observational approaches for improving models. Plain Language Summary: Arctic clouds play a key role in Arctic climate variability and change; however, state‐of‐the‐art climate models struggle to accurately simulate clouds. Errors in model‐simulated clouds have known and unknown influences on the simulated climate and climate change projections. Model cloud properties are determined by the physical parameterizations and their interactions within the model. Thus, to improve model‐simulated clouds, we need to understand the effects of parameterization changes. We use a series of Hadley Center Global Environmental Model 3 atmospheric model simulations where individual parameterizations are changed one‐at‐a‐time. This approach allows us to isolate the influence of individual cloud parameterizations on model‐simulated cloud properties to inform model development and the observations needed to improve models. The results show that individual parameterizations are most important for specific cloud variables and that multiple parameterizations are important to determining the model‐simulated influence of clouds on the energy budget. We also find that changes in model‐simulated cloud properties respond differently under different weather conditions. The analysis provides insights on the role of non‐cloud parameterizations, defined as those that are not used to directly compute cloud properties, for setting cloud radiative effects, the ways that clouds and the atmosphere interact, raises questions on the importance of infrequently occurring weather conditions to climate simulations, and on useful observational approaches for improving models. Key Points: Individual parameterization changes explain cloud property changes while multiple parameterizations explain cloud radiative effect changesThe large‐scale cloud scheme accounts for most of the changes in Arctic meteorological regime frequencyNon‐cloud parameterizations must be considered to understand the full influence of parameterization changes on cloud radiative effects [ABSTRACT FROM AUTHOR]

Background: The use of livers with significant steatosis is associated with worse transplantation outcomes. Brain death donor liver acceptance is mostly based on subjective surgeon assessment of liver appearance, since steatotic livers acquire a yellowish tone. The aim of this study was to develop a rapid, robust, accurate, and cost‐effective method to assess liver steatosis. Methods: From June 1, 2018, to November 30, 2023, photographs and tru‐cut needle biopsies were taken from adult brain death donor livers at a single university hospital for the study. All the liver photographs were taken by smartphones then color calibrated, segmented, and divided into patches. Color and texture features were then extracted and used as input, and the machine learning method was applied. This is a collaborative project between Vall d'Hebron University Hospital and Barcelona MedTech, Pompeu Fabra University, and is referred to as LiverColor. Results: A total of 192 livers (362 photographs and 7240 patches) were included. When setting a macrosteatosis threshold of 30%, the best results were obtained using the random forest classifier, achieving an AUROC = 0.74, with 85% accuracy. Conclusion: Machine learning coupled with liver texture and color analysis of photographs taken with smartphones provides excellent accuracy for determining liver steatosis. [ABSTRACT FROM AUTHOR]

Density functional theory (DFT) calculations explore the stability of a single platinum atom on various flat, stepped, and defective ceria surfaces, in the context of single‐atom catalysts (SACs) for the water–gas shift (WGS) reaction. The adsorption properties and diffusion kinetics of the metal strongly depend on the support termination with large stability on metastable and stepped CeO2(100) and (210) surfaces where the diffusion of the platinum atom is hindered. At the opposite, the more stable CeO2(111) and (110) terminations weakly bind the platinum atom and can promote the growth of metallic clusters thanks to fast diffusion kinetics. The adsorption of carbon monoxide on the single platinum atom supported on the various ceria terminations is also sensitive to the surface structure. Carbon monoxide weakly binds to the single platinum atom supported on reduced CeO2(111) and (211) terminations. The desorption of the CO2 formed during the WGS reaction is thus facilitated on the latter terminations. A vibrational analysis underlines the significant changes in the calculated scaled anharmonic CO stretching frequency on these catalysts. [ABSTRACT FROM AUTHOR]

Background and Aims: Small series suggest that rituximab could be effective as treatment for autoimmune hepatitis (AIH), although data are scarce. We aimed to evaluate the efficacy and safety of rituximab in different cohorts of patients with AIH. Methods: Multicentre retrospective analysis of the 35 patients with AIH and its variant forms treated with rituximab and included in the ColHai registry between 2015 and 2023. Results: Most patients were female (83%), 10 (29%) had cirrhosis and four (11.4%) variant forms of AIH. Indication for rituximab were as follows: 14(40%) refractory AIH, 19(54%) concomitant autoimmune or haematological disorder, 2(6%) intolerance to prior treatments. In three (9%) subjects with a concomitant disorder, rituximab was the first therapy for AIH. Overall, 31 (89%) patients achieved or maintained complete biochemical response (CBR), including the three in first‐line therapy. No difference in CBR was observed according to rituximab indication (refractory AIH 86% vs. concomitant disorders 90%, p =.824) or cirrhosis (80% vs. 92%, p =.319). Rituximab was associated with a significant reduction in corticosteroids (median dose: prior 20 vs. post 5 mg, p <.001) and the discontinuation of ≥1 immunosuppressant in 47% of patients. Flare‐free rate at 1st, 2nd and 3rd year was 86%, 73% and 62% respectively. Flares were not associated with the development of liver failure and were successfully managed with repeated doses of rituximab and/or increased corticosteroids. Three (9%) patients experienced infusion‐related adverse events (1 anaphylaxis and 2 flu‐like symptoms) and five (14%) infections. Conclusion: Rituximab is safe and effective in patients with refractory AIH and those treated due to concomitant autoimmune or haematological disorders. [ABSTRACT FROM AUTHOR]

Portland cements (PCs) and cement blends are multiphase materials of different fineness, and quantitatively analysing their hydration pathways is very challenging. The dissolution (hydration) of the initial crystalline and amorphous phases must be determined, as well as the formation of labile (such as ettringite), reactive (such as portlandite) and amorphous (such as calcium silicate hydrate gel) components. The microstructural changes with hydration time must also be mapped out. To address this robustly and accurately, an innovative approach is being developed based on in situ measurements of pastes without any sample conditioning. Data are sequentially acquired by Mo Kα1 laboratory X‐ray powder diffraction (LXRPD) and microtomography (µCT), where the same volume is scanned with time to reduce variability. Wide capillaries (2 mm in diameter) are key to avoid artefacts, e.g. self‐desiccation, and to have excellent particle averaging. This methodology is tested in three cement paste samples: (i) a commercial PC 52.5 R, (ii) a blend of 80 wt% of this PC and 20 wt% quartz, to simulate an addition of supplementary cementitious materials, and (iii) a blend of 80 wt% PC and 20 wt% limestone, to simulate a limestone Portland cement. LXRPD data are acquired at 3 h and 1, 3, 7 and 28 days, and µCT data are collected at 12 h and 1, 3, 7 and 28 days. Later age data can also be easily acquired. In this methodology, the amounts of the crystalline phases are directly obtained from Rietveld analysis and the amorphous phase contents are obtained from mass‐balance calculations. From the µCT study, and within the attained spatial resolution, three components (porosity, hydrated products and unhydrated cement particles) are determined. The analyses quantitatively demonstrate the filler effect of quartz and limestone in the hydration of alite and the calcium aluminate phases. Further hydration details are discussed. [ABSTRACT FROM AUTHOR]

Objective: Huntington's disease (HD) is a neurodegenerative disorder characterized by progressive motor, cognitive, and psychiatric symptoms. Our aim here was to identify factors that can be modified to slow disease progression even before the first symptoms appear. Methods: We included 2636 presymptomatic individuals (comparison with family controls) drawn from the prospective observational cohort Enroll‐HD, with more than 35 CAG repeats and at least two assessments of disease progression measured with the composite Huntington's disease rating Scale (cUHDRS). The association between sociodemographic factors, health behaviors, health history, and cUHDRS trajectory was assessed with a mixed‐effects random forest using partial dependence plots and Shapley additive explanation method. Results: Participants were followed by an average of 3.4 (SD = 1.97) years. We confirmed the negative impact of age and a high number of CAG repeats. We found that a high level of education, a body mass index (BMI) <23 kg/m2 before the age of 40 and >23 kg/m2 thereafter, alcohol consumption of <15 units per week, current coffee consumption and no smoking were linked to slow disease progression, as did no previous exposure to antidepressants or anxiolytic, no psychiatric history or comorbidities, and being female. Other comorbidities or marital status showed no major association with HD evolution. Interpretation: Reducing modifiable risk factors for HD is one way to support the presymptomatic population. A high level of education, low‐to‐moderate alcohol consumption, no smoking, and BMI control are likely to slow disease progression in this population. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to analyse and compare the microbiome present in root canals and periapical lesions of teeth with post‐treatment infections, and to identify the presence of keystone taxa in both habitats using next‐generation sequencing analysis. Methodology: Apices and periapical lesions of patients with post‐treatment apical periodontitis were surgically extracted. Specimens were cryo‐pulverized, bacterial DNA was extracted, and the V3–V4 hypervariable regions of the 16S rRNA gene were sequenced using the Illumina Miseq platform. Bioinformatic analysis was carried out with Mothur software, whilst diversity indices were obtained using operational taxonomic units (OTUs). The diversity indices were compared with the Kruskal–Wallis test, and community composition differences were explored with Permutational Multivariate Analysis of Variance (PERMANOVA). A bacterial functional study was performed with the Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) analysis. Co‐occurrence network analyses were performed using the Sparse Correlations for Compositional data (SparCC). Eigencentrality, clr‐based abundance and ubiquitousness were applied to infer keystone taxa. P values <.05 were considered statistically significant. Results: Thirty‐two apices and thirty‐nine periapical lesions were sequenced and analysed. A similar alpha‐diversity (p <.05) and community composition (p =.91) was observed for apices and lesion samples. The most abundant OTUs identified amongst all samples included Fusobacterium nucleatum, Prevotella loescheii, Streptococcus intermedius, Porphyromonas gingivalis, Parvimonas micra, Synergistetes bacterium, Tannerella forsythia and Peptostreptococcus stomatis. The metabolic pathways with >0.81% abundances included membrane transport, genetic information processing and metabolic pathways. F. nucleatum was identified as a keystone taxon as it showed ubiquitousness, an eigenvector centrality value of 0.83 and a clr‐based abundance >4. Conclusions: The microbiome in apices and periapical lesions of post‐treatment endodontic infections showed a similar diversity and taxonomic composition. Co‐occurrence network analyses at OTU level identified F. nucleatum as a keystone taxon candidate in these infections. [ABSTRACT FROM AUTHOR]

Aim: To analyse and compare the root canal microbiome present in root‐filled teeth of two different geographical populations, and to study their functional potential using a next‐generation sequencing approach. Methodology: Sequencing data obtained from surgical specimens from previously treated teeth with periapical bone loss from Spain and USA were included in the study. Taxa were classified using SILVA v.138 database. Differences in genera abundances among the 10 most abundant genera were evaluated using a Kruskal–Wallis test. Alpha diversity indices were calculated in mothur. The Shannon and Chao1 indices were used. Analyses of similarity (ANOSIM) to determine differences in community composition were done in mothur, with Bonferroni correction for multiple comparisons. p‐Values <.05 were considered statistically significant. Identification of enriched bacteria function prediction in the study groups (KEGG pathways) was carried out by linear discriminant analysis effect size (LEfSe) via Python 3.7.6. Results: A greater alpha‐diversity (Shannon and Chao1 indices) was observed from samples obtained in Spain (p =.002). Geography showed no significant effects on community composition via an ANOSIM using Bray–Curtis dissimilarities (R = 0.03, p =.21). Bacterial functional analysis prediction obtained by PICRUSt showed that 5.7% KEGG pathways differed between the Spain and US samples. Conclusions: The taxonomic assessment alone does not fully capture the microbiome's differences from two different geographical locations. Carbohydrate and amino acid metabolism were enriched in samples from Spain, while samples from USA had a higher representation of pathways related to nitrogen, propanoate metabolism, and secretion systems. [ABSTRACT FROM AUTHOR]

Glutamate recycling between neurons and astrocytes is essential to maintain neurotransmitter homeostasis. Disturbances in glutamate homeostasis, resulting in excitotoxicity and neuronal death, have been described as a potential mechanism in Alzheimer's disease (AD) pathophysiology. However, glutamate neurotransmitter metabolism in different human brain cells, particularly astrocytes, has been poorly investigated at the early stages of AD. We sought to investigate glucose and glutamate metabolism in AD by employing human induced pluripotent stem cell (hiPSC)-derived astrocytes and neurons carrying mutations in the amyloid precursor protein (APP) or presenilin-1 (PSEN-1) gene as found in familial types of AD (fAD). Methods such as livecell bioenergetics and metabolic mapping using [13C]-enriched substrates were used to examine metabolism in the early stages of AD. Our results revealed greater glycolysis and glucose oxidative metabolism in astrocytes and neurons with APP or PSEN-1 mutations, accompanied by an elevated glutamate synthesis compared to control WT cells. Astrocytes with APP or PSEN-1 mutations exhibited reduced expression of the excitatory amino acid transporter 2 (EAAT2), and glutamine uptake increased in mutated neurons, with enhanced glutamate release specifically in neurons with a PSEN-1 mutation. These results demonstrate a hypermetabolic phenotype in astrocytes with fAD mutations possibly linked to toxic glutamate accumulation. Our findings further identify metabolic imbalances that may occur in the early phases of AD pathophysiology. [ABSTRACT FROM AUTHOR]

General circulation models (GCMs) and their downscaled regional‐scale equivalents have been important tools for climate‐change studies. However, there has been limited assessment of the performance of GCMs and downscaled models in simulating extreme storms in temperate coastal environments. This study assesses the model characterization of extreme storms on the heavily populated coast of south‐east Australia. Twenty‐year average recurrence interval (ARI) storm intensities derived from generalized extreme value (GEV) distributions based on observed and large‐scale atmospheric model data are compared. Changes in extreme storms from past climate to a high‐emission future scenario are also investigated. Simulations of storm minimum surface pressures compared favourably with measured data. Both the GCMs and downscaled models reproduced the observed decrease with increasing latitude along the coast in the 20 year ARI of minimum surface pressure. Both indicated that the minimum storm surface pressure should change negligibly in a high‐emission future. Although the models underestimated the maximum daily precipitation significantly, models are improving significantly with CMIP epoch and downscaling. In the high‐emission future scenario, the GCMs and NARCliM projected the 20 year ARI maximum daily precipitation would increase in the order of 25%. GCMs and the corresponding downscaled products presently do not represent the extreme value distributions of historical wind speed data well, overestimating at smaller values of ARI and significantly underestimating in larger values of ARI. Significant changes in the magnitude of the 20 year ARI maximum daily‐average onshore wind speed are not projected for the high‐emission future. [ABSTRACT FROM AUTHOR]

Introduction: Little is known about very early atrial fibrillation (AF) ablation after first AF detection. Methods: We evaluated patients with AF ablation <4 months from newly diagnosed paroxysmal AF (NEWPaAF) and newly diagnosed persistent AF (NEWPeAF). We compared the two patient populations and compared ablation outcomes to those undergoing later ablation. Results: Ablation was done <4 months from AF diagnosis in 353 patients (135 = paroxysmal, 218 = persistent). Early ablation outcome was best for NEWPaAF versus NEWPeAF for initial (p = 0.030) but not final (p = 0.102) ablation. Despite recent AF diagnosis in both groups, they were clinically quite different. NEWPaAF patients were younger (64.3 ± 13.0 vs. 67.3 ± 10.9, p = 0.0020), failed fewer drugs (0.39 vs. 0.60, p = 0.007), had smaller LA size (4.12 ± 0.58 vs. 4.48 ± 0.59 cm, p < 0.0001), lower BMI (28.8 ± 5.0 vs. 30.3 ± 6.0, p = 0.016), and less CAD (3.7% vs. 11.5%, p = 0.007), cardiomyopathies (2.2% vs. 22.9%, p = 0.0001), hypertension (46.7% vs. 67.4%, p < 0.0001), diabetes (8.1% vs. 17.4%, p = 0.011) and sleep apnea (20.0% vs. 30.3%, p = 0.031). For NEWPaAF, early ablation AF‐free outcome was no better than later ablation (p = 0.314). For NEWPeAF, AF‐free outcomes were better for early ablation than later ablation (p < 0.0001). Delaying ablation allowed more strokes/TIAs in both AF types (paroxysmal p = 0.014, persistent p < 0.0001). Conclusions: Patients presenting for early ablation after newly diagnosed persistent AF have more pre‐existing comorbidities and worse initial ablation outcomes than patients with NEWPaAF. For NEWPaAF, there was no advantage to early ablation, as long as the AF remained paroxysmal. For NEWPeAF, early ablation gave better outcomes than later ablation and they should undergo early ablation. For both AF types, waiting was associated with more neurologic events, suggesting all patients should consider earlier ablation. [ABSTRACT FROM AUTHOR]

Summary: Background: There are few data on corticosteroids (CS)‐sparing strategies for checkpoint inhibitor (ICI)‐induced liver injury (ChILI). Aim: We aimed to assess the performance of a 2‐step algorithm for severe ChILI, based on ICI temporary discontinuation (step‐1) and, if lack of biochemical improvement, CS based on the degree of necroinflammation at biopsy (step‐2). Methods: Prospective study that included all subjects with grade 3/4 ChILI. Peripheral extended immunophenotyping was performed. Indication for CS: severe necroinflammation; mild or moderate necroinflammation with later biochemical worsening. Results: From 111 subjects with increased transaminases (January 2020 to August 2023), 44 were diagnosed with grade 3 (N = 35) or grade 4 (N = 9) ChILI. Main reason for exclusion was alternative diagnosis. Lung cancer (13) and melanoma (12) were the most common malignancies. ICI: 23(52.3%) anti‐PD1, 8(18.2%) anti‐PD‐L1, 3(6.8%) anti‐CTLA‐4, 10(22.7%) combined ICI. Liver injury pattern: hepatocellular (23,52.3%) mixed (12,27.3%) and cholestatic (9,20.5%). 14(32%) presented bilirubin >1.2 mg/dL. Overall, 30(68.2%) patients did not require CS: 22(50.0%) due to ICI discontinuation (step‐1) and 8/22 (36.4%) based on the degree of necroinflammation (step‐2). Biopsy mainly impacted on grade 3 ChILI, sparing CS in 8 out of 15 (53.3%) non‐improvement patients after ICI discontinuation. CD8+ HLA‐DR expression (p = 0.028), central memory (p = 0.046) were lower in CS‐free managed subjects, but effector‐memory cells (p = 0.002) were higher. Time to transaminases normalisation was shorter in those CS‐free managed (overall: p < 0.001, grade 3: p < 0.001). Considering our results, a strategy based on ICI discontinuation and biopsy for grade 3 ChILI is proposed. Conclusions: An algorithm based on temporary immunotherapy discontinuation and biopsy allows CS avoidance in two thirds of cases of severe ChILI. [ABSTRACT FROM AUTHOR]

Numerical association rule mining (NARM) is a popular method under the umbrella of data mining, focused on finding relationships between attributes in transaction databases. Numerical association rules for time series are a new paradigm that extends the applicability of NARM to the domain of time series. Association rule mining algorithms result in numerous rules, the interpretation of which is sometimes not easy for human experts. Therefore, various visualization methods have been developed to improve the explanation results of the rule mining process. This article is a novel contribution to the development of a new visualization method capable of presenting the association rules for time series developed according to the principles of explainable artificial intelligence. The experiments are conducted in the context of smart agriculture (i.e., agricultural time series data), and show the great potential of the proposed visualization method for the future. [ABSTRACT FROM AUTHOR]

Background: The nursing work environment can be compromised due to workload, stress and many other issues. A good nursing work environment is needed to for the health and wellbeing of nurses and therefore measures are developed to improve nursing work environment. Aim: To determine whether measures designed to improve the work environment for nursing professionals are effective. Methodology: Online research in the Medline, Scopus, Web of Science, ERIC, CINHAL, PsycINFO, and American Doctoral Dissertations databases, along with manual search, was carried out. Primary experimental studies made up of intervention and control groups were included, with pre‐/post‐measure evaluation in the nursing team, based on the effects of the interventions. Risk of bias was calculated using the Cochrane tool. Results: A total of 1997 studies were examined; 19 clinical trials met the inclusion criteria. A total of 1427 nurses participated in the selected studies. The fields of application of the interventions were personal and environmental. Out of the fields targeting individuals, three methodologies were identified: cognitive‐behavioral techniques, stress management, channeling anxiety and physical well‐being; and those aimed at environmental fields: aromatization and organization. The most evaluated characteristic was teamwork, and the most analyzed symptom was stress. Most of the interventions concluded with at least one significant improvement. Conclusions: Interventions aimed at enhancing the work environment are effective ways of increasing job satisfaction. The heterogeneity of the data did not allow us to determine which intervention is the most effective. The combination, type, and duration are variables that affect efficacy. Implication for nursing and nursing policy: This systematic review provides resources for improving the work environment that affects nursing staff, other professionals, and patients. Encouraging a healthy atmosphere leads to excellence in care and improved safety. [ABSTRACT FROM AUTHOR]

We are still facing the devastating consequences of COVID‐19. At the beginning of this pandemic, lockdown and non‐pharmaceutical measures were the unique, effective strategy to overcome the ongoing outbreak. After almost a year, an exceptional effort gave the first efficient protective vaccines. Despite these significant advances, new challenges as its mass production and fair distribution emerge. Our work aims to address this balance by formulating an optimal epidemic control problem controlled by lockdown and vaccination but in a synchronized manner. In such a way that the sought‐after solution optimizes the burden and economic implications of COVID‐19 infections and deaths. Thus, we formulate an optimal control problem with a differential equation to describe the spread of COVID‐19. Our formulation measures the efficiency of these controls by a functional cost involving the burden of COVID‐19 quantified in DALYs and the costs regarding vaccination and lockdown. Then we minimize this cost subject to the controlled system and find optimal policies that are constant in time intervals of a given size. To this end, we apply the well‐established heuristic method known as differential evolution. One of the advantages of these policies relies on their practical implementation since the health authority has to make only a finite number of different decisions. Our methodology to find optimal policies allows changes in the dynamics, the cost functional, or how frequently the policymaker changes actions. We show how a well‐synchronized tradeoff between vaccination and lockdown could under‐peak of the outbreak, with a delicate balance to overcome possible economic consequences. [ABSTRACT FROM AUTHOR]

SUMMARY: Cells save their energy during nitrogen starvation by selective autophagy of ribosomes and degradation of RNA to ribonucleotides and nucleosides. Nucleosides are hydrolyzed by nucleoside N‐ribohydrolases (nucleosidases, NRHs). Subclass I of NRHs preferentially hydrolyzes the purine ribosides while subclass II is more active towards uridine and xanthosine. Here, we performed a crystallographic and kinetic study to shed light on nucleoside preferences among plant NRHs followed by in vivo metabolomic and phenotyping analyses to reveal the consequences of enhanced nucleoside breakdown. We report the crystal structure of Zea mays NRH2b (subclass II) and NRH3 (subclass I) in complexes with the substrate analog forodesine. Purine and pyrimidine catabolism are inseparable because nucleobase binding in the active site of ZmNRH is mediated via a water network and is thus unspecific. Dexamethasone‐inducible ZmNRH overexpressor lines of Arabidopsis thaliana, as well as double nrh knockout lines of moss Physcomitrium patents, reveal a fine control of adenosine in contrast to other ribosides. ZmNRH overexpressor lines display an accelerated early vegetative phase including faster root and rosette growth upon nitrogen starvation or osmotic stress. Moreover, the lines enter the bolting and flowering phase much earlier. We observe changes in the pathways related to nitrogen‐containing compounds such as β‐alanine and several polyamines, which allow plants to reprogram their metabolism to escape stress. Taken together, crop plant breeding targeting enhanced NRH‐mediated nitrogen recycling could therefore be a strategy to enhance plant growth tolerance and productivity under adverse growth conditions. [ABSTRACT FROM AUTHOR]

As has been portrayed in the literature, the main proteins extracted from the seeds of Moringa oleifera Lam. have coagulant and clarifying potential in water treatment. However, when using them as coagulant agents, sludge formation occurs, which is an environmental problem. Thus, it was proposed to synthesize hydrogels from the main Moringa seeds proteins and use them as adsorbents. This work aimed to synthesize albumin hydrogels and globulin hydrogels and evaluate their efficiency as adsorbents to remove the reactive black 5 dye. Through FTIR spectrum it was possible to confirm that the synthesis of hydrogels occurred successfully. The kinetic data fit the pseudo‐second order model for both hydrogels. The equilibrium isotherms showed that adsorption occurs in multilayers, due to Freundlich fitting. The maximum adsorption capacity occurred at 298 K and was 1.19 mg g−1 for the albumin hydrogel and 10.06 mg g−1 for the globulin hydrogel. Through the results it is possible to state that globulin hydrogel was more favourable for adsorption since it has a more porous morphology and requires less mass compared to albumin hydrogel. [ABSTRACT FROM AUTHOR]

Bone defects treatment may require the use of biomaterials that behave as a support and promote bone regeneration. Limitations associated with the use of autografts and allografts make it necessary to design new synthetic bone substitutes. Some of the most promising biomaterials currently under investigation are based on nanocarbonate hydroxyapatite (nCHA). In this study, we studied the bone‐inducing capacity of nCHA‐based scaffolds alone (SAG) and enriched with osteostatin (SAGO) or with bone marrow aspirate(SAGB) after implantation for 12 weeks in a 15‐mm long critical defect performed in the radius of New Zealand rabbits. Bone formation obtained was compared with a group with the unfilled defect (CE), as control group, and other with the defect filed with iliac crest autograft (GS), as gold standard. X‐ray follow‐up was performed at 2, 4, 6 and 12 weeks and μCT and histological studies at 12 weeks. The radiological results showed a greater increment in bone formation in the GS group (75%–100%), followed by the SAG and SAGB groups (50%–75%). μCT results showed an increase of bone volume/tissue volume values in GS group followed by SAG and SAGB groups (0.53, 0.40, and 0.31 respectively) compared with CE group (0.26). Histological results showed limited resorption of the nCHA scaffolds and partial osseointegration in the SAG and SAGB groups. However, in the SAGO group, the presence of connective tissue encapsulating the scaffold was detected. In SAG, SAGB, and increase of bone formation were observed compared with CE group, but less than the GS group. Thus, the investigated materials represent a significant advance in the design of synthetic materials for bone grafting, but further studies are needed to bring their in vivo behavior closer to autograft, the gold standard. [ABSTRACT FROM AUTHOR]

This article discusses a study that examines the relationship between clinical severity measures and patient-reported outcomes in individuals with atopic dermatitis (AD). The study used two measures, the Eczema Area and Severity Index (EASI) and the Patient-Oriented Eczema Measure (POEM), to assess clinical severity from both the perspective of the clinician and the patient. The findings indicate that there is a moderate correlation between EASI and POEM, but the correlation between POEM and quality of life (QoL) and psychological measures is consistently higher than that of EASI. The study suggests that patient-reported outcomes provide valuable information that complements clinical severity measures in understanding the impact of AD on patients' lives. [Extracted from the article]

Introduction: The association between motor capacity and the level of disability in patients with fibromyalgia remains underexplored. This study aims to explore the association between physical capacity tests explored in the consultation and the level of disability in women with fibromyalgia. Methods: There were 484 women diagnosed with fibromyalgia who were evaluated with 7 physical capacity tests: 10‐m walk, 2‐minute walk, 5‐repetition getting up from a chair and sitting (G&S), 30‐second chair stand, monopodal balance (right and left), and up‐and‐go. Functional performance was assessed with the Revised Fibromyalgia Impact Questionnaire (FIQR). Evaluation of the association between the physical capacity tests and the FIQR was initially performed using a principal component analysis (PCA). Subsequently, agglomerative hierarchical clustering (AHC) was performed in order to characterize groups of patients. Results: Results show than FIQR and the tests 10‐m walk, 2‐minute walk, 5‐repetition G&S, 30‐second chair stand, and up‐and‐go test were correlated. The results of the AHC determined 3 groups of patients mainly on one motor dimension with significant differences in both the FIQR and the physical capacity tests retained in the PCA (P < 0.001 for all). Conclusion: The application of these physical tests is simple, fast and can be a complement to the FIQR questionnaire when determining the level of disability of patients with fibromyalgia, in addition to providing information on the evolution of the patients when these tests are administered in the clinical consultation. [ABSTRACT FROM AUTHOR]

Studies on third‐party punishment (TPP) have shown it promotes cooperation and prosocial behaviour, albeit at a cost to the punisher. Contrary to the view that such punishment is entirely altruistic, recent research suggests that punishers gain reputational benefits from third‐party punishing in the form of increased trustworthiness. Nevertheless, both how the signal is determined and the honesty of the signalling function of TPP have not been fully examined. Here we present the results of four experiments (n = 1695, prolific.co) in which we examined how TPP signalling varies as a function of its deservedness and severity. Experiments 1A and 1B use incentivized economic game paradigms to show how deservedness, impacts the trustworthiness signalled by the punisher. Experiment 2A expands on traditional dichotomous punishment decisions to show how signalled trustworthiness depends on different levels of TPP severity. Experiment 2B isolates the signalling effectiveness of severity by decoupling it from the corresponding incurred cost to punish and examines its impact on signalled trustworthiness. Overall, we found that punishment signalling is sensitive to deservedness and severity but not independent of other factors such as the cost to punish. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine the feasibility of using readily accessible technology, anterior segment optical coherence tomography (AS‐OCT), to detect and grade meibomian gland dropout and examine its interchangeability with the Oculus Keratograph 5M (K5M). Methods: A total of 30 participants (30 eyes) with a median age of 21 (range = 19–28 years) were recruited. Meibography was performed using two commercially available imaging devices to look at the structure of the meibomian glands and grade them subjectively in real time, and image analysis was used to quantify meibomian gland loss objectively. Gland loss as imaged by the two techniques was graded using the meiboscore grading schema. Test–retest reliability was determined with intraclass correlation coefficients (ICCs). Weighted kappa was used to evaluate agreement between the two imaging devices and four methods of image analysis. Spearman and Pearson correlation coefficients were used to determine the association of structural measurements between each of the techniques. The agreement between the two imaging techniques was determined with the Bland–Altman analysis. Results: Reliability of subjective grading was strong for AS‐OCT (ICC: 0.92, 95% CI: 0.83–0.96, p < 0.001) and K5M (ICC: 0.96, 95% CI: 0.96–0.91, p = 0.001). Image analysis with ImageJ reliability was strong between the imaging devices (ICC: 0.84, 95% CI: 0.55–0.94, p < 0.001). Agreement between each subjective technique was fair, κ = 0.45 (95% CI: 0.17–0.73, p < 0.001) and a positive Spearman correlation was also observed (r = 0.52, p < 0.001). There was no significant difference between the mean meibomian gland loss measured with ImageJ between AS‐OCT and K5M (0.92 ± 6.28, p = 0.26). The 95% limits of agreement were −12.45% to +14.04%. Conclusion: These findings suggest subjective real‐time grading of meibomian gland loss could be performed using readily available AS‐OCT technology and that this method was interchangeable with the K5M. [ABSTRACT FROM AUTHOR]

We compare the radiative feedbacks in an ensemble of global climate models under uniform 4 K warming and cooling of sea surface temperatures. The global‐mean net feedback is less stabilizing under warming in all nine models. This results primarily from less stabilizing water vapor and extra‐tropical shortwave cloud feedbacks, partially offset by more stabilizing tropical cloud feedbacks. The zonal‐mean feedbacks are also robust across the ensemble. In the extra‐tropics, the less stabilizing shortwave cloud feedback under warming is associated with further poleward migration of the mean Southern Hemisphere jet in some models. However, additional experiments with an aquaplanet version of the HadGEM3 model suggest that the asymmetry of the jet shift is not driving the asymmetry in the cloud feedbacks at these latitudes. In the tropics, the stronger water vapor feedback under warming is offset by weaker shortwave cloud feedbacks. The result is that the ensemble spread in the differences between the global feedbacks under warming and cooling is mainly driven by their differences in the tropics. The spatial distribution of the feedbacks largely reflects the zonal‐mean behavior, although there is considerable model spread in the regional cloud feedbacks, particularly in the tropical shortwave cloud feedback. Comparison with CO2‐ and solar‐forced coupled experiments suggests that the global‐mean longwave cloud feedback is nearly invariant to warming and cooling, regardless of the nature of the forcing. The shortwave cloud feedback is generally more positive under warming in the coupled models, consistent with the uniform SST perturbation experiments. Plain Language Summary: A longstanding question in climate science is whether the study of cooler past climates can help us to understand future climate change in response to increasing CO2 and other greenhouse gases. Answering this question is difficult because when the Earth was much colder the climate itself was quite different from today's. This means that we cannot be sure that feedbacks in the climate system operated as they do now, or as they might do in the future. To simplify the problem we have examined climate model experiments in which the surface temperature of the oceans is alternately warmed and cooled by a fixed amount relative to the present day. This provides us with a baseline for understanding the differences between more realistic scenarios of past and future climates. We highlight the role of clouds and atmospheric water vapor in determing these differences and the relative importance of the tropics compared to higher latitudes. Key Points: The global climate feedback is robustly less stabilizing under warming compared to coolingThis is driven by water vapor and extra‐tropical shortwave cloud feedbacks, partially offset by more stabilizing tropical cloud feedbacksSimplified climate model experiments are a valuable tool to help us understand climate feedbacks in colder and warmer climates [ABSTRACT FROM AUTHOR]

Summary: High amounts of raspberries are wasted every year, which are rich source of bioactive compounds. Thus, raspberry waste was used to obtain the essential oil by maceration and the oleoresin by supercritical fluid extraction (SFE). Higher amounts of total phenolics (185 mg GAE g−1) and flavonoids (11.0 mg QE g−1) were obtained in oleoresins than in essential oil (131 mg GAE g−1 and 9.0 mg QE g−1, respectively). DPPH radical scavenging was 1350 μm TE g−1 for oleoresins and 890 μm TE g−1 for essential oil. SFE allowed the extraction of compounds not reported before in red raspberry such as a pinocembrin and farnesol. Oleoresin at 20 μg mL−1 induced a decrease in lipid accumulation during the 3T3‐L1 cell differentiation process, but no after cells were differentiated. Red raspberry waste is an important source of bioactives that can be extracted using green technologies to generate high commercial value by‐products. [ABSTRACT FROM AUTHOR]

Introduction: The exploration of conceptual equivalence within the process of the cross‐cultural adaptation of tools is usually neglected as it generally assumed that the theoretical construct of a tool is conceptualized in the same way in both the original and target culture. This article attempts to throw light on the contribution of the evaluation of conceptual equivalence to the process of adaptation, and for tool development. To illustrate this premise, the example of the cross‐cultural adaptation of the Patients' Perception of Feeling Known by their Nurses (PPFKN) Scale is presented. Design: An adapted version of the Sousa and Rojjanasrirat (Journal of Evaluation in Clinical Practice, 2011, 17(2), 268–274) guidelines was used to translate and culturally adapt the PPFKN Scale to Spanish language and culture. A qualitative descriptive study was added to the traditional process of translation and pilot study to explore the concept in the target culture and recognize conceptual equivalence. Methods: Experts in the tool concept, bilingual translators and the author of the tool participated in the translation of the original tool into Spanish. A pilot study of the Spanish version with a sample of 44 patients and a panel of six experts from different fields evaluated its clarity and relevance. In addition, seven patients participated in a descriptive qualitative study using semi‐structured individual interviews to explore the phenomenon in the new culture. A content analysis following the Miles, Huberman & Saldaña (Qualitative data analysis, a methods sourcebook, 2014) approach was used to analyze qualitative data. Results: The cross‐cultural translation and adaptation of the PPFKN scale into Spanish required a thorough revision. More than half of the items needed discussions to reach consensus regarding the most appropriate Spanish term. In addition, the study confirmed the four attributes of the concept identified in the American context and allowed for new insights within those attributes to appear. Those aspects reflected characteristics of the phenomenon of being known in the Spanish context and were added to the tool in the format of 10 new items. Conclusions: A comprehensive cross‐cultural adaptation of tools should incorporate, together with the study of linguistic and semantic equivalence, the analysis of the conceptual equivalence of the phenomenon in both contexts. The identification, acknowledgment and study of the conceptual differences between two cultures in relation to a phenomenon becomes an opportunity for deeper study of the phenomenon in both cultures, for understanding of their richness and depth, and for the proposal of changes that may enhance the content validity of the tool. Clinical relevance: The evaluation of conceptual equivalence of tools within the process of cross‐cultural adaptation will make it possible for target cultures to rely on tools both theoretically sound and significant. Specifically, the cross‐cultural adaptation of the PPFKN scale has facilitated the design of a Spanish version of the tool that is linguistically, semantically and theoretically congruent with Spanish culture. The PPFKN Scale is a powerful indicator that evidences nursing care contribution to the patient's experience. [ABSTRACT FROM AUTHOR]

Objective: This systematic review provides a comprehensive analysis of the efficacy of autologous cell transplant as a therapeutic approach for stable segmental vitiligo. Vitiligo poses significant challenges for healthcare professionals in terms of treatment selection. Autologous cell transplant has emerged as a promising modality for managing vitiligo, with cultured and noncultured transplants being considered when determining the patient's treatment approach. There is little knowledge and literature on the subject, so we analyze the different studies. Method: Using online medical literature databases and the PRISMA guidelines, six out of 60 articles met the acceptance criteria to be analyzed, emphasizing the lack of current literature on this subject. Results: Autologous cell transplant achieves excellent pigmentation rates for many body parts. We found that cultivated cells had better results than noncultivated ones. Both types of treatments could pigment 80% or more where needed. Conclusion: This review highlights the importance of autologous cell transplant as a new and reliable tool for the treatment of stable segmental vitiligo, cultured transplants being the most effective. By employing autologous cell transplant, the repigmentation rate is notably high and consistently achievable. Although its cost and logistical complexities hinder the current accessibility to this therapy, efforts are being made to enhance its availability, and its scope is expected to expand further. More studies are needed to understand this therapy method in other kinds of vitiligo. [ABSTRACT FROM AUTHOR]

FtpM from Aspergillus fumigatus was the first carboxyl methyltransferase reported to catalyse the dimethylation of dicarboxylic acids. Here the creation of mutant R166M that can catalyse the quantitative conversion of bio‐derived 2,5‐furandicarboxylic acid (FDCA) to its dimethyl ester (FDME), a bioplastics precursor, was reported. Wild type FtpM gave low conversion due to its reduced catalytic efficiency for the second methylation step. An AlphaFold 2 model revealed a highly electropositive active site, due to the presence of 4 arginine residues, postulated to favour the binding of the dicarboxylic acid over the intermediate monoester. The R166M mutation improved both binding and turnover of the monoester to permit near quantitative conversion to the target dimethyl ester product. The mutant also had improved activity for other diacids and a range of monoacids. R166M was incorporated into 2 multienzyme cascades for the synthesis of the bioplastics precursor FDME from bioderived 5‐hydroxymethylfurfural (HMF) as well as from poly(ethylene furanoate) (PEF) plastic, demonstrating the potential to recycle waste plastic. [ABSTRACT FROM AUTHOR]

Background: In order to propose a destination for the bottom ash generated from biomass burning, its morphology, functional groups and mineral phases were studied. Dipyrone has been extensively used as an antipyretic, increased due to cases of COVID‐19, and due to excretion by urine, incorrect disposal and industrial effluents has been destined to wastewater, being harmful to human and animal life. The present study proposes using biomass ash for the adsorption of dipyrone. Results: The characterization of biomass ash shows a sufficient surface area size for adsorption, and a mainly amorphous structure with some peaks of quartz, calcite and other mineral phases. The results show that the kinetic model which best describes the adsorption is the pseudo‐first‐order model. The Langmuir model best fits at 25 °C, and the Freundlich model best describes the adsorption at 35 and 45 °C. The thermodynamic parameters indicated that the process is endothermic with a maximum adsorptive capacity of 65.27 mg g−1. In addition, the adsorption is spontaneous, disordered and chemical. The ionic strength study reveals that the adsorbent is promising for real effluent treatment and there is evidence that electrostatic interaction is not the primary adsorptive mechanism, agreeing with the result obtained from pH testing. The proposed mechanism for dipyrone removal involves hydrogen bonds, π bonds and electron donor–acceptor complex. Conclusions: The results are promising in comparison with recent literature and solve two environmental problems: biomass bottom ash disposal and pharmaceutical removal in aqueous medium. The ash may be regarded as a low‐cost and environmentally friendly adsorbent. © 2023 Society of Chemical Industry (SCI). [ABSTRACT FROM AUTHOR]

Objective: Variants in STAT4 are associated with systemic lupus erythematosus (SLE) and other autoimmune diseases. We undertook this study to investigate how disease‐associated variants affect STAT4 expression, in particular in CD4+ T cells where STAT4 plays an essential role. Methods: We compared Th1 differentiation between naive CD4+ T cells from healthy donors homozygous for the risk (R/R) or nonrisk (NR/NR) alleles. We analyzed epigenetic marks in STAT4 and evaluated the relevance of its third intron, assessed the consequences of Stat4 overexpression in vivo in mice, and analyzed the effects of the STAT4 genotype in patients with lupus nephritis. Results: Naive CD4+ T cells from NR/NR healthy donors down‐regulated STAT4 in response to interleukin‐12 (IL‐12). In contrast, cells from R/R healthy donors maintained high levels. R/R cells exhibited a higher abundance of transcriptionally active STAT4 and increased interferon‐γ production. Accordingly, R/R healthy donors exhibited a stronger induction of local active enhancer marks. Genetic editing confirmed the presence of a negative regulatory region in the STAT4 third intron, where most of the SLE‐associated STAT4 single‐nucleotide polymorphisms (SNPs) are located. In vivo forced expression demonstrated that increases in Stat4 levels in T cells enhanced glomerulonephritis in mice. Accordingly, the R/R genotype was associated with suboptimal response to treatment and with worse clinical outcomes in patients with proliferative lupus nephritis. Conclusion: The SLE‐associated STAT4 haplotype correlates with an abnormal IL‐12–mediated STAT4 transcriptional regulation. Carriers of the risk variant exhibit exaggerated CD4+ proinflammatory capacities that, in the context of SLE, contribute to more severe disease. R/R patients may benefit from blockade of the IL‐12/STAT4 pathway. [ABSTRACT FROM AUTHOR]

Objectives: Fentanyl test strips (FTSs) are increasingly used to address fentanyl contamination of the illicit drug supply by testing a drug for the presence of fentanyl, allowing people who use drugs (PWUD) to engage in overdose prevention. While emergency departments (EDs) have implemented various harm reduction strategies for PWUD, to date distribution of FTSs in EDs is limited and not evaluated. Thus, we sought to explore ED staff experiences distributing FTSs. Methods: Twenty‐one staff serving different roles (e.g., physician, nurse, technician, social worker, certified recovery specialist) within two urban EDs in a major metropolitan area were enrolled in a pilot study to distribute FTS to patients who use drugs. Participants were interviewed about their experience at 3 weeks and again at 3 months. Interviews were recorded, transcribed verbatim, and coded using a conventional content analysis approach. Results: All participants endorsed the utility of FTS distribution in the ED. Across 42 interviews, participants discussed evolving strategies to approach patients about FTS, primarily favorable patient reactions to FTSs, improved dynamics between participants and patients, mixed intervention support from other staff, and named challenges of FTS distribution and recommendations to make FTS distribution in the ED widespread. Recommendations included medical records prompts to offer FTS, offering via different types of staff, and offering FTS during triage. Conclusions: Implementing FTS distribution may improve patient rapport while providing patients with tools to avoid a fentanyl overdose. Participants generally reported positive experiences distributing FTSs within the ED but the barriers they identified limited opportunities to make distribution more integrated into their workflow. EDs considering this intervention should train staff on FTSs and how to identify and train patients and explore mechanisms to routinize distribution in the ED environment. [ABSTRACT FROM AUTHOR]

Heat waves (HWs) can cause large socioeconomic and environmental impacts. The observed increases in their frequency, intensity and duration are projected to continue with global warming. This review synthesizes the state of knowledge and scientific challenges. It discusses different aspects related to the definition, triggering mechanisms, observed changes and future projections of HWs, as well as emerging research lines on subseasonal forecasts and specific types of HWs. We also identify gaps that limit progress and delineate priorities for future research. Overall, the physical drivers of HWs are not well understood, partly due to difficulties in the quantification of their interactions and responses to climate change. Influential factors convey processes at different spatio-temporal scales, from global warming and the large-scale atmospheric circulation to regional and local factors in the affected area and upwind regions. Although some thermodynamic processes have been identified, there is a lack of understanding of dynamical aspects, regional forcings and feedbacks, and their future changes. This hampers the attribution of regional trends and individual events, and reduces the ability to provide accurate forecasts and regional projections. Sustained observational networks, models of diverse complexity, narrative-based methodological approaches and artificial intelligence offer new opportunities toward process-based understanding and interdisciplinary research. Heat waves (HWs) are climate extremes of major societal concern whose frequency, intensity and duration will continue increasing during this century. This review synthesizes the physical understanding and the main scientific challenges. We discuss problems involved in HW definition, including the diversity of HW indicators, and the consideration of adaptive capabilities in a changing climate. We also review observed and projected trends and the associated atmospheric patterns in different areas of the globe, with special attention to the mechanisms and drivers responsible for HW occurrence. These act at different scales, from planetary to local, and include thermodynamic and dynamical processes. There is a limited and fragmentary understanding of the interactions among these processes on regional scales, and their changes under global warming. Process-based understanding will benefit HW forecasts at time horizons longer than weather predictions, attribution of HW trends and events to human activities, and regional climate projections. Improved technological capabilities, models of diverse complexity, or machine-learning techniques will help overcome these challenges. [ABSTRACT FROM AUTHOR]

BACKGROUND: Gluconic acid production by a glucose oxidase (GOx) and catalase (CAT) system has been proposed. However, the bioprocess optimal design and operation are limited by the lack of kinetic models of GOx involving oxygen as substrate. Herein, the GOx‐CAT system is modeled considering a continuous oxygen supply at a bioreactor lab scale. Initially, experiments and modeling for parameter estimations of KLa and the individual enzymes were conducted. Then, experiments and modeling for the GOx‐CAT system were performed for final model tuning. Additionally, the model quality was evaluated, allowing for a deeper understanding of the system phenomenology. RESULTS: From the oxygen transport model tuning, a highly accurate KLa estimation was obtained (R2>0.98 and confidence interval <2%). The highest oxygen transport rate was obtained for the combined system Buffer‐antifoam‐GOx‐CAT that was 2.5 times larger than that obtained for DI water. Kinetic models for the individual enzymes were very accurate and the parameters were fully identifiable. For the integrated system, the gluconic acid evolution was properly predicted and there was a loss of predictive power for the oxygen model. Parameter identifiability analysis showed that kcatCAT and KMHPCAT interpretability was compromised. However, the sensitivity analysis indicated that the model must not be simplified. CONCLUSION: Herein its has been demonstrated that KLa is a complex parameter to be estimated for multi‐enzymatic systems due to its dependency on medium composition, particularly with GOx. Nonetheless, based on the acceptable model predictive power, the calculated parameters could be used for studies on the process design phase. © 2023 The Authors. Journal of Chemical Technology and Biotechnology published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry (SCI). [ABSTRACT FROM AUTHOR]

Aim: To assess and compare the microbiome of paired root apices and periapical lesions from cases with failed endodontic treatment and to associate the microbiome and bacterial metabolic pathways in both sites with asymptomatic apical periodontitis (AAP) and symptomatic apical periodontitis (SAP), using next‐generation sequencing (NGS). Methodology: Matched root apices and periapical lesions of patients with failed root canal treatments were surgically extracted. Specimens were cryopulverized, bacterial DNA was extracted and the V3–V4 hypervariable regions of the 16 S rRNA gene were amplified and sequenced using the Illumina Miseq platform. Diversity and community composition were studied in the paired samples, as well as in AAP and SAP cases. Diversity indices were compared in each case by means of the Wilcoxon matched‐pairs signed rank and Mann–Whitney U tests. Differences in the community composition were explored with multivariate statistical analysis and Linear discriminant analysis Effect Size (LEfSe). Bacterial functional study was performed through the Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) analysis. Results: Twenty‐one paired apices and lesions were successfully sequenced and analysed, identifying a total of 21 phyla and 600 genera. A higher alpha‐diversity was observed in the periapical lesions, although no global differences in the community composition between the two sites were found (p =.87), the most prevalent genera being Fusobacterium, Porphyromonas and Streptococcus. Prevotella, Clostridiales_vadinBB60_group, Bosea, Phreatobacter, Afipia and Xanthobacteriaceae_unclassified were enriched in SAP samples, while Pseudopropionibacterium, Campylobacter and Peptoniphilus were significantly more abundant in AAP cases (p <.05). Metabolic pathways involved in the amino acid metabolism or degradation and flagellum assembly were more abundant in SAP samples, whereas glucose metabolism‐related pathways were associated with AAP. Conclusions: The bacterial community composition was similar in the apices and periapical lesions. The microbiome was different in AAP and SAP samples, gram‐negative bacteria showing higher relative abundances in SAP cases. An association was observed between amino acid degradation and flagellum assembly pathways, and the development of tenderness to percussion or palpation. [ABSTRACT FROM AUTHOR]

This article explores the effects of menopause on the skin and highlights the lack of awareness and information among women and healthcare professionals. Menopause, a natural process that occurs in women in their fifties, is associated with a decrease in estrogen levels, which can lead to changes in the skin such as dryness and increased wrinkles. A survey conducted in France revealed that a majority of menopausal women noticed changes in their skin, but less than 1% used skincare products specifically designed for menopause. The study suggests the need for increased awareness among healthcare professionals, better education for women about menopause, the development of specialized skincare products, and more research on the effects of menopause on the skin. [Extracted from the article]

This article discusses the diagnostic challenges posed by gastric-type mucinous neoplasms of the ovary. These tumors can be difficult to identify as they share characteristics with malignant tumors. The article presents a case study of a 43-year-old patient with a history of endometriosis who underwent surgery for a cystic mass in the right adnexa. The histology revealed a mucinous neoplasm in the ovary and an infiltrating endocervical adenocarcinoma of gastric type. The article emphasizes the importance of identifying atypical cases of recurrent adnexal lesions to prevent misdiagnosis. [Extracted from the article]

Introduction: Vascular access is required for most cardiac electrophysiology procedures. Over the past 2 decades, ultrasound guidance has increased in utilization as the primary method for assisting operators in gaining access to cardiac implantable electronic device (CIED) implantation. Methods: Ultrasound guidance using a technique that includes both short‐axis and long‐axis views combined with a twisting needle motion after maximal tenting provides an extremely safe and reproducible technique for vascular access for all CIED procedures. Results and Conclusions: In this manuscript and accompanying videos, a step‐by‐step guide is explained for optimal ultrasound‐guided visualization and needle maneuver technique to maximize safety and efficiency for vascular access in all CIED procedures. [ABSTRACT FROM AUTHOR]

Aim: Aerosols released from the oral cavity help spread the SARS‐CoV‐2 virus. The use of a mouthwash formulated with an antiviral agent could reduce the viral load in saliva, helping to lower the spread of the virus. The aim of this study was to assess the efficacy of a mouthwash with 0.07% cetylpyridinium chloride (CPC) to reduce the viral load in the saliva of Coronavirus disease 2019 (COVID‐19) patients. Materials and Methods: In this multi‐centre, single‐blind, randomized, parallel group clinical trial, 80 COVID‐19 patients were enrolled and randomized to two groups, namely test (n = 40) and placebo (n = 40). Saliva samples were collected at baseline and 2 h after rinsing. The samples were analysed by reverse transcription‐quantitative polymerase chain reaction (RT‐qPCR) and an enzyme‐linked immunosorbent assay test specific for the nucleocapsid (N) protein of SARS‐CoV‐2. Results: With RT‐qPCR, no significant differences were observed between the placebo group and the test group. However, 2 h after a single rinse, N protein concentration in saliva was significantly higher in the test group, indicating an increase in lysed virus. Conclusions: The use of 0.07% CPC mouthwash induced a significant increase in N protein detection in the saliva of COVID‐19 patients. Lysis of the virus in the mouth could help reduce the transmission of SARS‐CoV‐2. However, more studies are required to prove this. [ABSTRACT FROM AUTHOR]

Aim: To describe the experience of relatives of residents with dementia residing in locked‐down nursing homes during the first outbreak of the COVID‐19 pandemic, concerning their relationships with nurses and the nursing care applied. Methods: A qualitative descriptive study was carried out and purposive sampling was applied. Participants were first‐ and second‐degree relatives of residents with dementia, who lived permanently in a nursing home and who were admitted prior to the COVID‐19 pandemic. Sixteen participants, of which 10 were women (mean age 57.1 years), participated in the study. Data were collected through in‐depth interviews and reflective notes, using a digital platform. An inductive thematic analysis was carried out. This study was approved by the University Research Ethics Committee and followed the COREQ guidelines. The Guba and Lincoln criteria (credibility, transferability, dependability, and confirmability) were applied for quality control. Results: Families' relationships with nurses before the first wave relied on closeness and involvement in care. Families had difficulty maintaining a close relationship with nurses due to turnover and lack of time. The nursing care applied in the first wave resulted in limited family access to the nursing home, limited contact time with residents, and limited close physical contact. Conclusions: The first outbreak has affected the relationships among relatives and nurses in nursing homes. Changes should be made in the organization of care within nursing homes in order to adapt to restrictions due to the pandemic. [ABSTRACT FROM AUTHOR]