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Pretend play is crucial for developing communication and cognitive skills in preschool children. Targeted coaching during pretend play can effectively support family-centered practices and home-based assistance. This study employed a detailed collective case study to explore how eCoaching can aid family-centered practices during at-home pretend play for children with speech-language and developmental delays. Two mother-child pairs, each involving a preschool child with an Individual Education Plan (IEP), participated in at-home eCoaching sessions while engaging in pretend play. Implementing eCoaching helped mothers acquire play-based knowledge and better facilitate pretend play tailored to their child's developmental needs. Throughout the eCoaching process, improvements were noted in the children's quality of pretend play and language behaviors. After the eCoaching sessions concluded, both mothers and children experienced benefits from the process. The mothers had positive perceptions of their eCoaching sessions, found them easy to implement, and considered eCoaching beneficial for themselves and their children. This indicates that eCoaching is a socially valid family-centered practice. Future research should investigate how individual variables associated with the eCoaching influence child and family outcomes.

El objetivo de este estudio fue analizar las barreras y facilitadores que los estudiantes con discapacidad manifiestan en Educación Física y en el deporte en Chile, Colombia, España y Perú. Se diseñó un estudio de tipo exploratorio, correlacional y de alcance transversal donde participaron 362 niñas, niños y adolescentes con discapacidad de Chile (41.1 %), Colombia (14.6 %), España (11.6 %) y Perú (32.5 %), a quienes se les aplicó el cuestionario “Barriers and facilitators of sports in children with physical disabilities” (BaFSCH) en su versión traducida al español. Respecto a los resultados, el 72.7 % practica actividad física en la escuela, con una mayor tendencia en Colombia (88.7 % χ² = 11.17, p = .02), donde el 72.0 % lo hace en clase de Educación Física mientras que el 38 %, en talleres de actividad física y deporte. Los principales facilitadores de inclusión son los padres y tutores, junto a sus amistades en el espacio escolar, y las barreras se asocian a algún accidente o caída, y/o su discapacidad y/o deficiencia. A su vez, el sexo biológico (OR = 1.893, IC = 1.19-3.00, p = .007) se asocia a un facilitador para la práctica de la actividad física, mientras que ser estudiante con discapacidad intelectual (OR = .437, IC = .20 – .94, p = .03) y discapacidad física (OR = .298, IC = .15-.58, p = .0002) se asocia a una barrera para la inclusión. Con esta investigación se reveló que la clase de Educación Física es fundamental en la práctica de la actividad física en el espacio educativo para niñas, niños y adolescentes con discapacidad, al igual que el entorno, que se transforma en factor protector a nivel ambiental.

Abstract Opsins are G protein-coupled receptors (GPCRs) that have evolved to detect light stimuli and initiate intracellular signaling cascades. Their role as signal transducers is critical to light perception across the animal kingdom. Opsins covalently bind to the chromophore 11-cis retinal, which isomerizes to the all-trans isomer upon photon absorption, causing conformational changes that result in receptor activation. Monostable opsins, responsible for vision in vertebrates, release the chromophore after activation and must bind another retinal molecule to remain functional. In contrast, bistable opsins, responsible for non-visual light perception in vertebrates and for vision in invertebrates, absorb a second photon in the active state to return the chromophore and protein to the inactive state. Structures of bistable opsins in the activated state have proven elusive, limiting our understanding of how they function as bidirectional photoswitches. Here we present active state structures of a bistable opsin, jumping spider rhodopsin isoform-1 (JSR1), in complex with its downstream signaling partners, the Gi and Gq heterotrimers. These structures elucidate key differences in the activation mechanisms between monostable and bistable opsins, offering essential insights for the rational engineering of bistable opsins into diverse optogenetic tools to control G protein signaling pathways.

Abstract Partially autonomous vehicles can help minimize human errors. However, being free from some driving subtasks can result in a low vigilance state, which can affect the driver’s attention towards the road. The present study first tested whether drivers of partially autonomous vehicles would benefit from the addition of auditory versions of the messages presented in variable message signs (VMS), particularly, when they find themselves in a monotonous driving situation. A second aim was to test whether the addition of auditory messages would also produce an indirect effect on the driver’s vigilance, improving performance on other driving subtasks not related to the message processing. Forty-three volunteers participated in a driving simulator study. They completed two tasks: (a) a VMS task, where they had to regain manual control of the car if the VMS message was critical, and (b) a car-following task, where they had to pay attention to the preceding car to respond to occasional brake events. Behavioral and EEG data were registered. Overall, results indicated that the addition of audio messages helped drivers process VMS information more effectively and maintain a higher level of vigilance throughout the driving time. These findings would provide useful information for the development of partially automated vehicles, as their design must guarantee that the driver remains attentive enough to assume control when necessary.

Introduction: severe obesity results in high cardiovascular risk, increasing morbidity and mortality. New and improved methods are needed to detect cardiovascular diseases rapidly in severe obesity. microRNAs (miRNAs) has shown promise as diagnostic tools. This study aimed to identify plasma miRNAs useful as biomarkers of cardiovascular risk (CVR) in people with severe obesity. Methods: The study included 66 people with severe obesity classified in groups with atheroma (n = 32) and free of plaques (n = 34). Plasma samples were collected 1 month before bariatric surgery and at 6 and 12 months of follow-up. Participants were screened for the levels of 188 miRNAs, and 24 promising candidates were individually validated by quantitative polymerase chain reaction. Results: After validation, 5 of the 24 miRNAs showed significant differences over time in both groups: miR-375 increased after bariatric surgery, whereas miR-144-5p, miR-20a-3p, miR-145-5p and miR-21-3p exhibited decreased expression after bariatric surgery. The expression of 3 of the 24 miRNAs also differed between patients with and without atheroma: subjects with plaque had lower miR-126 but higher miR-21-3p and miR-133a-3p. Only miR-133a-3p exhibited exceptional discriminatory ability between subjects with and without plaque (area under the curve, 0.90; 95% confidence interval, 0.81–0.99). Conclusion: A specific signature of c-miRNA comprising miR-375, miR-144-5p, miR-20a-3p, miR-145-5p and miR-21-3p may facilitate CVR monitoring after bariatric surgery. Furthermore, miR-21-3p, miR-126-3p and miR-133a-3p show potential as specific biomarkers for subclinical atherosclerosis, with miR-133a-3p potentially able to diagnose subclinical atherosclerosis early in severe obesity.

Abstract Background Oral microbiota comprises polymicrobial communities shaped by mutualistic coevolution with the host, contributing to homeostasis and regulating immune function. Nevertheless, dysbiosis of oral bacterial communities is associated with a number of clinical symptoms that ranges from infections to oral cancer. Peri-implant diseases are biofilm-associated inflammatory conditions affecting the soft and hard tissues around dental implants. Characterization and identification of the biofilm community are essential for the understanding of the pathophysiology of such diseases. For that sampling methods should be representative of the biofilm communities Therefore, there is a need to know the effect of different sampling strategies on the biofilm characterization by next generation sequencing. Methods With the aim of selecting an appropriate microbiome sampling procedure for periimplant biofilms, next generation sequencing was used for characterizing the bacterial communities obtained by three different sampling strategies two months after transepithelial abutment placement: adjacent periodontal crevicular fluid (ToCF), crevicular fluid from transepithelial abutment (TACF) and transepithelial abutment (TA). Results Significant differences in multiple alpha diversity indices were detected at both the OTU and the genus level between different sampling procedures. Differentially abundant taxa were detected between sample collection strategies, including peri-implant health and disease related taxa. At the community level significant differences were also detected between TACF and TA and also between TA and ToCF. Moreover, differential network properties and association patterns were identified. Conclusions The selection of sample collection strategy can significantly affect the community composition and structure. Trial registration This research is part of a randomized clinical trial that was designed to assess the effect of transepithelial abutment surface on the biofilm formation. The trial was registered at Trial Registration ClinicalTrials.gov under the number NCT03554876.

RESUMEN La tomografía computarizada es una técnica no invasiva, de gran resolución espacial, con excelente definición del calcio y del espacio intravascular al emplear medios de contraste, que brinda la posibilidad de realizar tanto mediciones como simulaciones virtuales de intervencionismo coronario y estructural. Se ha establecido como la técnica de referencia en la selección de pacientes y la planificación de procedimientos de intervencionismo transcatéter coronario y estructural en diferentes escenarios (implante percutáneo de válvula aórtica, cierre percutáneo de orejuela izquierda, reemplazo de válvula mitral transcatéter y reemplazo de válvula tricúspide transcatéter). El presente trabajo revisa el papel de la tomografía computarizada en el intervencionismo cardiaco coronario y estructural.

ABSTRACT Computed tomography is a noninvasive imaging technique with high spatial resolution, providing excellent definition of calcium and intravascular space through the use of contrast media. This imaging modality allows both highly accurate measurements and virtual simulations for preprocedural planning in coronary and structural heart disease interventions. Computed tomography is currently the gold standard technique for patient selection and preprocedural planning in numerous scenarios, such as transcatheter aortic valve implantation, left atrial appendage occlusion, transcatheter mitral valve repair, and transcatheter tricuspid valve repair. This article reviews the role of computed tomography in transcatheter coronary and structural heart disease interventions.

Abstract Background Little information exists about vitamin D status in bitches with mammary tumors. Objectives To determine whether low plasma vitamin D concentrations are found in bitches with mammary tumors. Animals Eighty‐five client‐owned bitches with mammary tumors (n = 21 benign, n = 64 malignant) and 39 age‐matched healthy bitches. Methods Case‐control study. Plasma ionized and total calcium, phosphorus, magnesium, urea, creatinine, albumin, total proteins, alanine aminotransferase, alkaline phosphatase, parathyroid hormone (PTH), calcitriol (1,25‐dihydroxyvitamin D), and 25‐hydroxyvitamin D concentrations were measured in all bitches at the time of clinical diagnosis and before any treatments. Statistical analysis was performed to compare variables among groups (control, benign, and malignant). Results No significant differences were found when plasma 25‐hydroxyvitamin D concentrations in bitches with malignant (148.9 [59.9] ng/mL) and benign mammary tumors (150.1 [122.3] ng/mL) were compared with control group (129.9 [54.5] ng/mL). Parathyroid hormone was significantly higher in bitches with malignant (19.9 [20.5] pg/mL), and benign mammary tumors (14.6 [14.9] pg/mL) compared with control group (7.5 [7.5] pg/mL; P

Families play a critical role in supporting their children with autism spectrum disorder (ASD) and in advocating for their health and educational needs. However, many families around the world experience social, emotional, and financial difficulties, as well as challenges navigating various systems in search for the services and supports their children require. Colombia has made some recent strides in supporting the needs of families of children with ASD, but there is still concern among families that their children are not receiving adequate services. Thus, we were interested in learning more about what it was like to parent a child with ASD in Colombia. In particular, we focused on investigating the families' perceptions, experiences, and aspirations for their child with ASD by conducting focus group interviews. Four primary themes emerged from these interviews with Colombian parents, which included the impact of the disability diagnosis on the family, the systemic and societal challenges they faced, the strengths they saw in their child, and their future aspirations and expectations for their child. Implications for developing culturally responsive parent education programs are discussed.

Background The benefit of patent foramen ovale closure (PFOC) ≤9 months after a cryptogenic stroke has been demonstrated in several randomised clinical trials. There is, however, insufficient data to support PFOC in non-recent cryptogenic strokes.Aims The objective of the study was to evaluate the effectiveness of PFOC in relation to the time since the patient’s most recent cryptogenic cerebrovascular event (CVE) or systemic embolism (SE).Methods We conducted a multicentre, retrospective cohort study with international participation, to assess the results of an early closure (EC,

The progress in industrial and corporate blockchain technology, particularly the pioneering fintech financing methods rooted in blockchain like Initial Coin Offerings (ICOs) and Security Token Offerings (STOs), has the potential to disrupt across industries. These innovations offer creative solutions to address longstanding challenges. However, the novelty of these concepts has given rise to issues related to information asymmetry among investors, exacerbated by the opinions shared on social media platforms. To comprehensively analyse the trends of these technologies and their societal impact, as well as their influence on the contemporary business landscape, we conducted a study in the social platforms X (formerly known as Twitter) analysing 59,453 tweets using natural language processing (NLP). Through this research, we have identified key topics such as investment security or corporate challenges that provide valuable insights and structured information essential for industry stakeholders. In summary, this study explores the dynamic interplay between blockchain technology, ICOs, STOs and social media in the industry. It sheds light on the sentiment and implications of the use of this technology and these emerging financial models, offering a nuanced understanding of their impact on the market. Thus, the idea that user opinions play a crucial role in influencing decisions is supported, and their impact can fluctuate depending on the changing dynamics of the market.

Diego José Montero-Tejero,1 Nerea Jiménez-Picón,2 Juan Gómez-Salgado,3,4,* Elena Vidal-Tejero,5 Javier Fagundo-Rivera6,* 1Department of Emergency, Hospital Universitario Lucus Augusti, Galician Health Service, Lugo, Galicia, Spain; 2Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Andalusia, Spain; 3Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Andalusia, Spain; 4Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador; 5Department of Cardiology, Hospital Universitario Virgen Del Rocío, Andalusian Health Service, Sevilla, Andalusia, Spain; 6Centro Universitario de Enfermería Cruz Roja, University of Seville, Sevilla, Andalusia, Spain*These authors contributed equally to this workCorrespondence: Juan Gómez-Salgado, Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Avda. Tres de Marzo, S/N, Huelva, 21007, Spain, Tel +34 959219700, Email salgado@uhu.es Javier Fagundo-Rivera, Centro Universitario de Enfermería Cruz Roja, Sevilla, Spain, Avda, de la Cruz Roja, 1, duplicado, Sevilla, 41009, Spain, Tel +34 954350997, Email javier.fagundo@cruzroja.esObjective: To assess personal and work-related factors influencing the stress levels of nurses during prehospital care. Specifically, to identify associations between the level of perceived stress, the degree of professional experience, and the level of knowledge. Secondly, to examine the relationship between stress levels and violence in the work environment. And third, to investigate the main protective factors against work-related stress during prehospital care.Methods: Systematic review in PubMed, WOS, Enfispo, Cochrane, and LILACS databases following the PRISMA methodology (last search 08/Aug/2023). Following the PECO framework, studies on occupational stress factors in ambulance emergency nurses were investigated. Studies in English or Spanish, from 2013 to 2023, and only research articles were admitted, thus excluding reviews, dissertations, and grey literature. Possible bias and level evidence were assessed using critical appraisal tools and GRADE. This protocol was registered in PROSPERO with code CRD42023446080.Results: Fourteen articles were selected, and n=855 prehospital nurses were identified. One study was a clinical trial, and the others were observational and qualitative. The level of evidence was very low (n=7), low (n=6), and moderate (n=1); any study was excluded due to methodological bias. Five categories of stressors were extracted: the management of the health service (ie, workload organisation, and resources), patient care (mainly paediatric care), interpersonal stressors (relationship with peers), environmental factors (exposure to injuries), and personal factors (training, experience, and coping strategies). Violence at work is frequent for prehospital nurses, implying both verbal and physical aggressions. Support from peers was associated with positive results against stress.Conclusion: Managing workload and improving resources in the work environment are essential to reduce fatigue and allow emotional processes to be addressed. Providing workers with coping skills also imposes on them the responsibility to cope with stress. Collective awareness is the main element in reducing the incidence of stress.Keywords: ambulance, prehospital, emergency care, nurses, stress, occupational health, management

Abstract Glioblastoma (GBM) is the most common primary malignant cancer of the central nervous system. Insufficient oxygenation (hypoxia) has been linked to GBM invasion and aggression, leading to poor patient outcomes. Hypoxia induces gene expression for cellular adaptations. However, GBM is characterized by high intertumoral (molecular subtypes) and intratumoral heterogeneity (cell states), and it is not well understood to what extent hypoxia triggers patient-specific gene responses and cellular diversity in GBM. Here, we surveyed eight patient-derived GBM stem cell lines for invasion phenotypes in 3D culture, which identified two GBM lines showing increased invasiveness in response to hypoxia. RNA-seq analysis of the two patient GBM lines revealed a set of shared hypoxia response genes concerning glucose metabolism, angiogenesis, and autophagy, but also a large set of patient-specific hypoxia-induced genes featuring cell migration and anti-inflammation, highlighting intertumoral diversity of hypoxia responses in GBM. We further applied the Shared GBM Hypoxia gene signature to single cell RNA-seq datasets of glioma patients, which showed that hypoxic cells displayed a shift towards mesenchymal-like (MES) and astrocyte-like (AC) states. Interestingly, in response to hypoxia, tumor cells in IDH-mutant gliomas displayed a strong shift to the AC state, whereas tumor cells in IDH-wildtype gliomas mainly shifted to the MES state. This distinct hypoxia response of IDH-mutant gliomas may contribute to its more favorable prognosis. Our transcriptomic studies provide a basis for future approaches to better understand the diversity of hypoxic niches in gliomas.

Cellular processes require precise and specific gene regulation, in which continuous mRNA degradation is a major element. The mRNA degradation mechanisms should be able to degrade a wide range of different RNA substrates with high efficiency, but should at the same time be limited, to avoid killing the cell by elimination of all cellular RNA. RNase Y is a major endoribonuclease found in most Firmicutes, including Bacillus subtilis and Staphylococcus aureus. However, the molecular interactions that direct RNase Y to cleave the correct RNA molecules at the correct position remain unknown. In this work we have identified transcripts that are homologs in S. aureus and B. subtilis, and are RNase Y targets in both bacteria. Two such transcript pairs were used as models to show a functional overlap between the S. aureus and the B. subtilis RNase Y, which highlighted the importance of the nucleotide sequence of the RNA molecule itself in the RNase Y targeting process. Cleavage efficiency is driven by the primary nucleotide sequence immediately downstream of the cleavage site and base-pairing in a secondary structure a few nucleotides downstream. Cleavage positioning is roughly localised by the downstream secondary structure and fine-tuned by the nucleotide immediately upstream of the cleavage. The identified elements were sufficient for RNase Y-dependent cleavage, since the sequence elements from one of the model transcripts were able to convert an exogenous non-target transcript into a target for RNase Y.

Searching for positive selection signals across genomes has identified functional genetic variants responding to environmental change. In Native Americans of Mexico, we used the fixation index (Fst) and population branch statistic (PBS) to identify SNPs suggesting positive selection. The 103 most differentiated SNPs were tested for associations with metabolic traits, the most significant association was FADS2/rs174616 with body mass index (BMI). This variant lies within a linkage disequilibrium (LD) block independent of previously reported FADS selection signals and has not been clearly associated with metabolic phenotypes. We tested this variant in two independent cohorts with cardiometabolic data. In the Genetics of Atherosclerotic Disease (GEA) cohort, the derived allele (T) was associated with increased BMI, lower LDL-C levels and a decreased risk of subclinical atherosclerosis in women. Significant gene-diet interactions affected lipid, apolipoprotein and adiponectin levels with differences according to sex, involving mainly total and complex dietary carbohydrate%. In the Genotype-related Effects of PUFA trial, the derived allele was associated with lower Δ-6 desaturase activity and erythrocyte membrane dihomo-gamma-linolenic acid (DGLA) levels, and with increased Δ-5 desaturase activity and eicosapentaenoic acid levels. This variant interacted with dietary carbohydrate% affecting Δ-6 desaturase activity. Notably, the relationship of DGLA and other erythrocyte membrane LC-PUFA indices with HOMA-IR differed according to rs174616 genotype, which has implications regarding how these indices should be interpreted. In conclusion, this observational study identified rs174616 as a signal suggesting selection in an independent linkage disequilibrium block, was associated with cardiometabolic and erythrocyte measurements of LC-PUFA in two independent Mexican cohorts and showed significant gene-diet interactions.

El presente artículo examina la situación de la lengua española en las enseñanzas de idiomas de régimen especial. Para ello, a través de un estudio cuantitativo con carácter descriptivo, se ha realizado una encuesta a 44 Escuelas Oficiales de Idiomas (EOI) de las 71 que ofrece la posibilidad de estudiar español como lengua extranjera (62%). Los resultados indican resultados pioneros sobre la temática de estudio, por ejemplo, que la enseñanza de español representa alrededor del 8% de la oferta total que existe en las EOI. A pesar de los desafíos y las limitaciones, el estudio destaca el potencial de las EOI como institución única en el marco europeo para promover la lengua española. Por tanto, se aboga por futuras investigaciones en este campo con el objeto de mejorar la calidad de las enseñanzas especializadas en general, y de la lengua española en particular.

El embarazo, especialmente el tercer trimestre, incrementa notablemente el riesgo de rotura de los aneurismas esplénicos. Cuando esto ocurre, se desencadena un cuadro clínico grave manifestado principalmente como un dolor abdominal agudo acompañado de inestabilidad hemodinámica. A pesar de la gran morbimortalidad tanto materna como fetal que esto conlleva, no existe hoy en día consenso sobre su manejo óptimo. Se presenta el caso de una secundigesta a la que se diagnostica de manera incidental un aneurisma en la arteria esplénica durante el segundo trimestre de gestación. Tras confirmarse dicho diagnóstico mediante resonancia magnética, se decide realizar una esplenectomía programada vía laparotómica en semana 24+2. La evolución maternofetal posterior fue favorable hasta la semana 40 en la que se produjo un parto eutócico. Los aneurismas esplénicos deben tratarse en todas las gestantes, independientemente de su tamaño o sintomatología, pues el beneficio supera los riesgos que supone una cirugía programada.

ABSTRACT: Objectives: Information is scarce on clinical experiences with non-neutropenic patients with invasive fungal infection (IFI) receiving isavuconazole. We aimed to report the safety and effectiveness of this drug as a first-line treatment or rescue in real life. Methods: A retrospective, observational multicentric study of non-neutropenic patients who received isavuconazole as an IFI treatment at 12 different university hospitals (January 2018-2022). All patients met criteria for proven, probable or possible IFI according to EORTC-MSG. Results: A total of 238 IFIs were treated with isavuconazole during the study period. Combination therapy was administered in 27.7% of cases. The primary IFI was aspergillosis (217, 91.2%). Other IFIs treated with isavuconazole were candidemia (n = 10), mucormycosis (n = 8), histoplasmosis (n = 2), cryptococcosis (n = 2), and others (n = 4). Median time of isavuconazole treatment was 29 days. Only 5.9% (n = 14) of cases developed toxicity, mainly hepatic-related (10 patients, 4.2%). Nine patients (3.8%) had treatment withdrawn. Successful clinical response at 12 weeks was documented in 50.5% of patients. Conclusion: Isavuconazole is an adequate treatment for non-neutropenic patients with IFIs. Toxicity rates were low and its effectiveness was comparable to other antifungal therapies previously reported.

Antler is one of the primary animal raw materials exploited for technical purposes by the hunter-gatherer groups of the Eurasian Upper Palaeolithic (UP) all over the ecological range of deers, and beyond. It was exhaustively employed to produce one of the most critical tools for the survival of the UP societies: hunting weapons. However, antler implements can be made from diverse deer taxa, with different ecological requirements and ethological behaviours. Identifying the antler's origin at a taxonomic level is thus essential in improving our knowledge of humans' functional, practical and symbolic choices, as well as the human-animal interface during Prehistoric times. Nevertheless, palaeogenetics analyses have focused mainly on bone and teeth, with genetic studies of antler generally focused on modern deer conservation. Here we present the results of the first whole mitochondrial genome ancient DNA (aDNA) analysis by means of in-solution hybridisation capture of antlers from pre-Holocene archaeological contexts. We analysed a set of 50 Palaeolithic and Neolithic (c. 34-8ka) antler and osseous objects from South-Western Europe, Central Europe, South-Western Asia and the Caucasus. We successfully obtained aDNA, allowing us to identify the exploited taxa and demonstrate the archaeological relevance of those finds. Moreover, as most of the antlers were sampled using a minimally-invasive method, further analyses (morphometric, technical, genetic, radiometric and more) remain possible on these objects.