Search

Background: Cutibacterium acnes is a common commensal of human skin but may also present as an opportunistic pathogen in prosthetic joint and wound infections. Unfortunately, few complete genomes of C. acnes are publicly available, and even fewer are of isolates associated with infection. Here we report the isolation, characterization, and complete genomes of 2 C. acnes isolates from a surgical site infection of an elbow. Methods: We used standard microbiological methods for phenotypic characterization and performed whole genome sequencing on 2 C. acnes isolates using a combination of short-read and long-read sequencing. Results: Antibiotic susceptibility testing showed beta-lactamase negative and low minimal inhibitory concentrations to all antibiotics tested, with the exception of metronidazole. We assembled complete genomes of the 2 isolates, which are approximately 2.5 megabases in length. The isolates belong to the single-locus sequence type (SLST) H1 and the multi-locus sequence type (MLST) IB. Both isolates have similar composition of known virulence genes, and we found no evidence of plasmids but did find phage-associated genes. Notably, the 2 genomes are 99.97% identical but contain a large genomic inversion encompassing approximately half of the genome. Conclusions: This is the first characterization of this large-scale genomic inversion in nearly identical isolates from the same wound. This report adds to the limited numbers of publicly available infection-associated complete genomes of C. acnes.

ABSTRACT Group B Streptococcus (GBS) is a leading cause of invasive neonatal disease. Epidemiological surveillance of GBS is important to determine cumulative incidence, antimicrobial resistance rates, and maternal and neonatal disease prevention. In this study, we present an update on GBS epidemiology in Alberta, Canada, from 2014 to 2020. Over the 7-year period, 1,556 GBS isolates were submitted to the Alberta Public Health Laboratory for capsular polysaccharide (CPS) typing and antimicrobial susceptibility testing. We analyzed the distribution of CPS types in Alberta and found CPS types III (23.6%), Ia (16.0%), Ib (14.8%), II (13.3%), V (12.7%), IV (12.5%), and VI (2.38%) to be the most prevalent. Less than 1% each of CPS types VII, VIII, and IX were identified. In agreement with historical data, the presence of CPS type IV continued to rise across Alberta, particularly in cases of adult infection, where a 2-fold increase was observed. Cumulative incidences of GBS cases per 100,000 population and late-onset disease per 1,000 live births increased from 4.43 to 5.36 and 0.38 to 0.41, respectively, from 2014 to 2020. However, the incidence of early-onset disease decreased during the 7-year period from 0.2 to 0.07, suggestive of successful intrapartum chemoprophylaxis treatment programs. All GBS isolates were susceptible to penicillin and vancomycin. However, nonsusceptibility to erythromycin increased significantly, from 36.85% to 50.8%, from 2014 to 2020. Similarly, nonsusceptibility to clindamycin also increased significantly, from 21.0% to 45.8%. In comparison to historical data, the overall rates of GBS infection and antimicrobial resistance have increased and the predominant CPS types have changed. IMPORTANCE This work describes the epidemiology of invasive infections caused by the bacterium group B Streptococcus (GBS) in Alberta, Canada. We show that rates of invasive GBS disease have increased from 2014 to 2020 for both adult disease and late-onset disease in neonates, whereas the rate of early onset disease in neonates has decreased. We also show that the rate of resistance to erythromycin (an antibiotic used to treat GBS) has also increased in this time.

Coronary artery disease (CAD) is a complex, multifactorial disease caused, in particular, by inflammation and cholesterol metabolism. At the molecular level, the role of tissue-specific signaling pathways leading to CAD is still largely unexplored. This study relied on two main resources: (1) genes with impact on atherosclerosis/CAD, and (2) liver-specific transcriptome analyses from human and mouse studies. The transcription factor activating transcription factor 3 (ATF3) was identified as a key regulator of a liver network relevant to atherosclerosis and linked to inflammation and cholesterol metabolism. ATF3 was predicted to be a direct and indirect (via MAF BZIP Transcription Factor F (MAFF)) regulator of low-density lipoprotein receptor (LDLR). Chromatin immunoprecipitation DNA sequencing (ChIP-seq) data from human liver cells revealed an ATF3 binding motif in the promoter regions of MAFF and LDLR. siRNA knockdown of ATF3 in human Hep3B liver cells significantly upregulated LDLR expression (p < 0.01). Inflammation induced by lipopolysaccharide (LPS) stimulation resulted in significant upregulation of ATF3 (p < 0.01) and subsequent downregulation of LDLR (p < 0.001). Liver-specific expression data from human CAD patients undergoing coronary artery bypass grafting (CABG) surgery (STARNET) and mouse models (HMDP) confirmed the regulatory role of ATF3 in the homeostasis of cholesterol metabolism. This study suggests that ATF3 might be a promising treatment candidate for lowering LDL cholesterol and reducing cardiovascular risk.

Campylobacter jejuni, a major cause of bacterial foodborne illnesses, is considered highly susceptible to environmental stresses. In this study, we extensively investigated the stress tolerance of 121 clinical strains of C. jejuni against 5 stress conditions (aerobic stress, disinfectant exposure, freeze-thaw, heat treatment, and osmotic stress) that this pathogenic bacterium might encounter during foodborne transmission to humans. In contrast to our current perception about high stress sensitivity of C. jejuni, a number of clinical strains of C. jejuni were highly tolerant to multiple stresses. We performed population genetics analysis by using comparative genomic fingerprinting and showed that multistress-tolerant strains of C. jejuni constituted distinct clades. The comparative genomic fingerprinting subtypes belonging to multistress-tolerant clades were more frequently implicated in human infections than those in stress-sensitive clades. We identified unique stress-tolerant C. jejuni clones and showed the role of stress tolerance in human campylobacteriosis.

Despite the effectiveness of thermal inactivation processes, Escherichiacoli biofilms continue to be a persistent source of contamination in food processing environments. E. coli strains possessing the locus of heat resistance are a novel food safety threat and raises the question of whether these strains can also form biofilms. The objectives of this study were to determine biofilm formation in heat resistant E. coli isolates from clinical and environmental origins using an in-house, two-component apparatus and to characterize biofilm formation-associated genes in the isolates using whole genome sequencing. Optimal conditions for biofilm formation in each of the heat resistant isolates were determined by manipulating inoculum size, nutrient concentration, and temperature conditions. Biofilm formation in the heat resistant isolates was detected at temperatures of 24 °C and 37 °C but not at 4 °C. Furthermore, biofilm formation was observed in all environmental isolates but only one clinical isolate despite shared profiles in biofilm formation-associated genes encoded by the isolates from both sources. The circulation of heat resistant E. coli isolates with multi-stress tolerance capabilities in environments related to food processing signify that such strains may be a serious food safety and public health risk.

OBJETIVO: Conocer edad, sexo, desplazamiento, escolaridad, actividad desarrollada, jornada laboral, vivienda en calle y cobertura de seguridad social de un grupo de niños que laboran en las calles de las capitales latinoamericanas. MATERIAL Y MÉTODOS: Estudio de corte transversal. Se aplicó un cuestionario a 972 niños que trabajan en las calles de Bogotá, Ciudad de Guatemala, Ciudad de México, Quito y San Salvador; RESULTADOS: El 63.3% era de sexo masculino; 39% provenía de familias desplazadas; 18% habitaba en la calle; 62% trabajaba más de 40 horas a la semana; 19% tenía seguridad social, y 32% se dedicaba al comercio ambulante. Se encontró que la mayoría de las variables se comportan de forma significativamente diferente para cada ciudad. CONCLUSIÓN: El trabajo infantil ambulante es una actividad peligrosa, de largas jornadas laborales, con exposición a múltiples factores de riesgo, y se comporta de manera significativamente diferente en cada ciudad estudiada. Esto sugiere que las soluciones al problema deben diseñarse caso por caso.OBJECTIVE: To identify the age, sex, mobility, education, work activity, working hours, street dwelling, and social security coverage in a group of children working in the streets in capital cities in Latin America. MATERIAL AND METHODS: Cross sectional study. A questionnaire was applied to 972 children working in the streets of Bogotá, Guatemala City, Mexico City, Quito and San Salvador. RESULTS: A total of 63.3% subjects were boys; 39% were children from displaced families; 18% lived in the streets; 62% worked more than 40 hours per week; 19% were covered by the social security system, and 32% were street vendors. The behavior of variables differed significantly by city. CONCLUSION: Child labor in the streets is a dangerous activity characterized by long working hours and exposure to risk factors. Child work has different characteristics in each of the cities studied, which suggests that the solution to the problem must be designed on a case by case basis.

Resumo Foi testada a hipótese de que em estratos mais expostos de uma árvore, porém em condições mais xéricas, as folhas apresentam estrutura mais xeroescleromorfa. Notou-se, da base para o ápice da árvore, que o número estomático por mm2 aumentou; os mesófilos aumentaram de espessura; as folhas diminuiram de tamanho, características todas estas que tendem a apoiar a hipótese formulada.

Abstract Defining the molecular mechanisms underlying cardiac resilience is crucial to find effective approaches to protect the heart. A physiologic level of ROS is produced in the heart by fatty acid oxidation, but stressful events can boost ROS and cause mitochondrial dysfunction and cardiac functional impairment. Melusin is a muscle specific chaperone required for myocardial compensatory remodeling during stress. Here we report that Melusin localizes in mitochondria where it binds the mitochondrial trifunctional protein, a key enzyme in fatty acid oxidation, and decreases it activity. Studying both mice and human induced pluripotent stem cell-derived cardiomyocytes, we found that Melusin reduces lipid oxidation in the myocardium and limits ROS generation in steady state and during pressure overload and doxorubicin treatment, preventing mitochondrial dysfunction. Accordingly, the treatment with the lipid oxidation inhibitor Trimetazidine concomitantly with stressful stimuli limits ROS accumulation and prevents long-term heart dysfunction. These findings disclose a physiologic mechanism of metabolic regulation in the heart and demonstrate that a timely restriction of lipid metabolism represents a potential therapeutic strategy to improve cardiac resilience to stress.

Abstract Background Tobacco smoking is the leading cause of preventable death and disease worldwide, with over 8 million annual deaths attributed to cigarette smoking. This study investigates the impact of cigarette smoke and heated tobacco products (HTPs) on microglial function, focusing on toxicological profiles, inflammatory responses, and oxidative stress using ISO standard and clinically relevant conditions of exposure. Methods We assessed cell viability, reactive oxygen species (ROS) production, lipid peroxidation, mitochondrial function, unfolded protein response, and inflammation in human microglial cells (HMC3) exposed to cigarette smoke, HTP aerosol or nicotine. Results Our findings show that cigarette smoke significantly reduces microglial viability, increases ROS formation, induces lipid peroxidation, and reduces intracellular glutathione levels. Cigarette smoke also alters the expression of genes involved in mitochondrial dynamics and biogenesis, leading to mitochondrial dysfunction. Additionally, cigarette smoke impairs the unfolded protein response, activates the NF-κB pathway, and induces a pro-inflammatory state characterized by increased TNF and IL-18 expression. Furthermore, cigarette smoke causes DNA damage and decreases the expression of the aging marker Klotho β. In contrast, HTP, exhibited a lesser degree of microglial toxicity, with reduced ROS production, lipid peroxidation, and mitochondrial dysfunction compared to conventional cigarettes. Conclusion These results highlight the differential toxicological profile of cigarette smoke and HTP on microglial cells, suggesting a potential harm reduction strategy for neurodegenerative disease for smokers unwilling or unable to quit.

Abstract Background The term rapidly progressive dementia (RPD) with Lewy bodies (rpDLB) is used for DLB patients who develop a rapidly progressive neurological syndrome and have reduced survival. Here, we characterise the clinical, neuropathological, and molecular characteristics of a large rpDLB neuropathological series. Methods We included all RPD patients with a disease duration

Abstract Cancer predisposition syndromes are recognized in about 10% of pediatric malignancies with several genes specifically involved in a subset of pediatric tumors such as DICER1, in pleuropulmonary blastoma, cystic nephroma, and brain sarcomas. By contrast, the role of BRCA1/2 in pediatric cancer predisposition is still under investigation. We present two cases of young first-degree cousins, both carrying a germline BRCA2 variant and developing tumors characterized by somatic DICER1 mutations. Patient 1 presented with a cystic nephroma harboring a somatic DICER1 variant (p.Asp1810Tyr), while patient 2 had a primary intracranial DICER1-mutated sarcoma showing a distinct somatic DICER1 variant (p.Asp1709Glu) as well as biallelic inactivation of TP53 (p.Val173Leu, VAF 91%) and APC (p.Ile1307Lys, VAF 95%) and a pathogenic variant in KRAS (p.Gln61His). Both patients carried the same germline BRCA2 variant (p.Arg2842Cys) of unknown significance. The same variant was found in the mother of patient 2 and in the father of patient 1, who are siblings. A homologous recombination deficiency signature was not identified in any of the two tumors, possibly suggesting a reduction of BRCA2 activity. The association of BRCA2 and DICER1 variants in our cases hints at a potential cooperative role in cancer pathogenesis. Further studies are warranted to elucidate the interplay between BRCA1/2 and DICER1 variants and their implications for cancer predisposition and treatment in pediatric patients.

Abstract Glioblastoma (GBM) represents an aggressive brain tumor, characterized by intra- and inter-tumoral heterogeneity and therapy resistance, leading to unfavourable prognosis. An increasing number of studies pays attention on the regulation of ferroptosis, an iron-dependent cell death, as a strategy to reverse drug resistance in cancer. However, the debate on whether this strategy may have important implications for the treatment of GBM is still ongoing. In the present study, we used ferric ammonium citrate and erastin to evaluate ferroptosis induction effects on two human GBM cell lines, U-251 MG, with proneural characteristics, and T98-G, with a mesenchymal profile. The response to ferroptosis induction was markedly different between cell lines, indeed T98-G cells showed an enhanced antioxidant defence, with increased glutathione levels, as compared to U-251 MG cells. Moreover, using bioinformatic approaches and analysing publicly available datasets from patients’ biopsies, we found that GBM with a mesenchymal phenotype showed an up-regulation of several genes involved in antioxidant mechanisms as compared to proneural subtype. Thus, our results suggest that GBM subtypes differently respond to ferroptosis induction, emphasizing the significance of further molecular studies on GBM to better discriminate between various tumor subtypes and progressively move towards personalized therapy.

Abstract Background Technology use may be one strategy to promote mental health and wellbeing among young adults in post-secondary education settings experiencing increasing distress and mental health difficulties. The JoyPop™ app is mobile mental health tool with a growing evidence base. The objectives of this research are to (1) evaluate the effectiveness of the JoyPop™ app in improving emotion regulation skills (primary outcome), as well as mental health, wellbeing, and resilience (secondary outcomes); (2) evaluate sustained app use once users are no longer reminded and determine whether sustained use is associated with maintained improvements in primary and secondary outcomes; (3) determine whether those in the intervention condition have lower mental health service usage and associated costs compared to those in the control condition; and (4) assess users’ perspectives on the quality of the JoyPop™ app. Methods A pragmatic, parallel arm randomized controlled trial will be used. Participants will be randomly allocated using stratified block randomization in a 1:1 ratio to the intervention (JoyPop™) or control (no intervention) condition. Participants allocated to the intervention condition will be asked to use the JoyPop™ app at least twice daily for 4 weeks. Participants will complete outcome measures at four assessment time-points (first [baseline], second [after 2 weeks], third [after 4 weeks], fourth [after 8 weeks; follow-up]). Participants in the control condition will be offered access to the app after the fourth assessment time-point. Discussion Results will determine the effectiveness of the JoyPop™ app for promoting mental health and wellbeing among post-secondary students. If effective, this may encourage more widespread adoption of the JoyPop™ app by post-secondary institutions as part of their response to student mental health needs. Trial registration ClinicalTrials.gov NCT06154369 . Registered on November 23, 2023.

El estudio de costos catastróficos que experimentan las personas afectadas por tuberculosis realizado en Colombia durante la pandemia de COVID-19 trajo consigo la oportunidad de implementar encuestas telefónicas como medio para la recopilación de información. Lo anterior se constituye como una innovación metodológica en los estándares establecidos por la Organización Mundial de la Salud (OMS) que, para este tipo de estudios, suelen tener base en el empleo de encuestas cara a cara con los pacientes que acuden a las instalaciones de salud. El diseño del estudio, sus objetivos y metodología fueron adaptados del manual práctico para la realización de encuestas de costos de la tuberculosis de la OMS. Se seleccionaron 1 065 personas afectadas por tuberculosis como participantes del estudio, a quienes se les administró de manera telefónica el cuestionario estándar adaptado al contexto colombiano. Fue posible obtener datos estructurados sobre los costos directos e indirectos que enfrentan los pacientes con tuberculosis y sus familias; de manera general, se observó que todas las variables de recopilación alcanzaron una completitud mayor a 80%, con un tiempo promedio de encuesta de 40 minutos y una tasa de rechazo de 8%. La metodología de encuestas telefónicas desarrollada para determinar la línea base del estudio de costos catastróficos en Colombia resultó innovadora por el formato telefónico, que mantiene los estándares de información requerida para permitir estimaciones comparables a nivel internacional, y es un medio útil en la generación de resultados estandarizados en eventos en los cuales existe limitación para la realización de encuestas cara a cara.

Abstract Background Patients with COVID-19 often experience severe long-term sequelae. This study aimed to assess resilience and Quality of Life (QoL) of patients who underwent mechanical ventilation due to COVID-19, one year after discharge. Methods This cross-sectional study enrolled patients who received mechanical ventilation for severe COVID-19 and were assessed one-year post-discharge. Participants completed a structured questionnaire via telephone comprising the Connor-Davidson Resilience Scale (CD-RISC) and the Post-COVID-19 Functional Status scale (PCFS). To establish the association between QoL and resilience, Spearman correlations were calculated between the PCFS and the CD-RISC. Linear regression models were adjusted to evaluate which factors were associated with QoL, with the total score of PCFS as the dependent variable. Results A total of 225 patients were included in the analysis. The CD-RISC had a median score of 83 (IQR 74–91). The PCFS results showed that 61.3% (n = 138) of the patients were able to resume their daily activities without limitations. Among them, 37.3% (n = 84) were classified as Grade 0 and 24% (n = 54) as Grade 1. Mild and moderate functional limitations were found in 33.7% of the patients, with 24.8% (n = 56) classified as Grade 2 and 8.8% (n = 20) as Grade 3. Severe functional limitations (Grade 4) were observed in 4.8% (n = 11) of the patients. High CD-RISC scores were associated with lower levels of PCFS score (p

Protein–glycan interactions play pivotal roles in numerous biological processes, ranging from cellular recognition to immune response modulation. Understanding the intricate details of these interactions is crucial for deciphering the molecular mechanisms underlying various physiological and pathological conditions. Computational techniques have emerged as powerful tools that can help in drawing, building and visualising complex biomolecules and provide insights into their dynamic behaviour at atomic and molecular levels. This review provides an overview of the main computational tools useful for studying biomolecular systems, particularly glycans, both in free state and in complex with proteins, also with reference to the principles, methodologies, and applications of all-atom molecular dynamics simulations. Herein, we focused on the programs that are generally employed for preparing protein and glycan input files to execute molecular dynamics simulations and analyse the corresponding results. The presented computational toolbox represents a valuable resource for researchers studying protein–glycan interactions and incorporates advanced computational methods for building, visualising and predicting protein/glycan structures, modelling protein–ligand complexes, and analyse MD outcomes. Moreover, selected case studies have been reported to highlight the importance of computational tools in studying protein–glycan systems, revealing the capability of these tools to provide valuable insights into the binding kinetics, energetics, and structural determinants that govern specific molecular interactions.

RESUMO O Rate of Reading Test foi elaborado com controles espaciais e psicolinguísticos para identificar pessoas com estresse visual. Objetivou-se adaptá-lo para o português, provendo evidências psicométricas. Na Etapa 1, verificou-se a concordância de seis juízes independentes quanto ao grau de dificuldade de vocábulos curtos de alta frequência. Na Etapa 2, verificou-se a acurácia dos vocábulos em 80 leitores do 2º ao 5º ano do ensino fundamental. Na Etapa 3, os juízes escolheram os itens para a adaptação do teste a partir dos vocábulos sem erros de acurácia. Houve concordância entre juízes na elaboração do Teste de Taxa de Leitura, composto por quinze vocábulos de alta frequência, substantivos comuns, no singular, regulares, curta extensão e equilibrados por gênero. Na Etapa 4, investigou-se a fidedignidade em 108 alunos do 3º ano, dos quais 90 participaram do reteste. O Teste de Taxa de Leitura apresentou evidências de validade de conteúdo e fidedignidade satisfatórias.

Abstract We investigated the biomarker profile of neurodegeneration, Alzheimer’s and Lewy body pathology in the CSF of 148 polysomnography-confirmed patients with isolated REM sleep behavior disorder (IRBD), a condition that precedes Parkinson’s disease (PD) and dementia with Lewy bodies (DLB). We assessed misfolded α-synuclein (AS) by RT-QuIC assay, amyloid-beta peptides (Aβ42 and Aβ40), phosphorylated tau (p-tau), and total tau (t-tau) by CLEIA and neurofilament light chain (NfL) by ELISA. We detected AS in 75.3% of patients, pathologically decreased Aβ42/Aβ40 ratio in 22.5%, increased p-tau in 15.5%, increased t-tau in 14.9%, and elevated NfL in 14.7%. After a mean follow-up of 2.48 ± 2.75 years, 47 (38.1%) patients developed PD (n = 24) or DLB (n = 23). At CSF collection, AS positivity [HR 4.05 (1.26–12.99), p = 0.019], mild cognitive impairment [3.86 (1.96–7.61), p

Bolile cardiovasculare rămîn o problemă semnificativă și în continuă creștere în Republica Moldova, reprezentând mai mult de jumătate din toate decesele și ducând la o morbiditate semnificativă. Actualmente se recunoaște că povara bolilor cardiovasculare (BCV) poate fi ameliorată printr-o reducere viguroasă a riscului și prevenirea primară, care rămîn o prioritate importantă pentru toți dezvoltatorii politicii de sanatate. Fiind una din țările europene cu risc crescut pentru bolile cardiovasculare, Moldova se confruntă cu dificultăți majore în realizarea măsurilor de prevenție a BCV atât la nivel popu- lațional cît și individual. Prezentul articol rezumă principalele noutăți din ghidurile de prevenire a bolilor cardiovasculare ale Societății Europene de Cardiologie (ESC), publicate recent, examinând aspectele lor pozitive, dar și aplicabilitatea lor la practica clinică de rutină, ținând cont de caracteristicile socioeconomice ale Moldovei. Estimarea riscului cardiovascular este un pas esențial pentru reducerea apariției evenimentelor cardiovasculare adverse. În acest scop, în Europa a fost utilizată metoda grafică a riscului de evaluare sistematică a riscului coronarian (SCORE). Efortul de a preveni BCV aterosclerotic se concentrează pe identificarea pacienților care ar beneficia cel mai mult de tratamentul factorilor de risc BCV.

En Colombia, los estudios de calidad del agua se han basado en su gran mayoría en información fisicoquímica o bacteriológica, y solamente en las últimas décadas se ha comenzado a integrar e implementar la bioindicación. El propósito del estudio fue caracterizar la calidad del agua del río Frío, usando macroinvertebrados bentónicos como indicadores biológicos, junto con parámetros fisicoquímicos. Con esta integración entre los índices bióticos y fisicoquímicos se determinó la calidad del agua de forma más precisa, debido a que se generó un acercamiento más detallado al estado del río Frío. Una vez muestreados e identificados los macroinvertebrados, se calcularon los índices de calidad BMWP/Col, ASTP, IBF, EPT, y los índices de biodiversidad Shannon-Weaver, riqueza específica, diversidad de Margalef y Menhinick. El número total de individuos resultado del estudio en la cuenca correspondió a 687, representados por 12 órdenes, 24 familias y 25 géneros. Adicionalmente, se llevaron a cabo un análisis de varianza y un análisis multivariante, a través de una correlación canónica. Finalmente, se determinó que la calidad del agua del río Frío es moderadamente contaminada; además, presenta una baja biodiversidad en las especies de macroinvertebrados, y se encontró que el resultado de los índices son independientes de las temporadas climáticas.

Objective: We aimed to determine the prevalence of self-reported swallowing difficulty (dysphagia) among older Colombians and to explore the factors associated with this condition. Methods: This study presents a secondary analysis of the SABE-Colombia survey, a cross-sectional study of community-dwelling older adults. The dependent variable was self-reported swallowing difficulty, assessed through the question: “How often do you have difficulty or discomfort swallowing?” Descriptive and bivariate analyses of the sample were performed, followed by multivariate analysis, adjusting for confounding variables. Results: The final sample included 19 004 older Colombians, whose mean age was 69 years (56% women). The overall prevalence of swallowing difficulty was 12.2%. In the multivariate analysis, significant associations were observed between swallowing difficulty and several factors, including male sex (OR 1.14, 95%CI 1.03 – 1.26), age > 80 years (OR 1.26, 95%CI 1.08 – 1.47), dependence in activities of daily living (OR 1.62, 95%CI 1.23 – 2.13), cognitive impairment (OR 1.49, 95%CI 1.30 – 1.70), depressive symptoms (OR 1.38, 95%CI 1.15 – 1.65), sarcopenia (OR 1.32, 95%CI 1.02 – 1.69), malnutrition (OR 1.35, 95%CI 1.23 – 1.49), and osteoarticular disease (OR 1.18, 95%CI 1.07 – 1.38). Conclusion: There was a high prevalence of swallowing difficulty among older community-dwelling Colombians. Our results showed a strong correlation between swallowing difficulty and risk factors such as cognitive impairment, depressive symptoms, osteoarticular disease, and dependence in activities of daily living, but not with malnutrition or sarcopenia.

Abstract Background Sponges (phylum Porifera) constantly interact with microbes. They graze on microbes from the water column by filter-feeding and they harbor symbiotic partners within their bodies. In experimental setups, sponges take up symbionts at lower rates compared with seawater microbes. This suggests that sponges have the capacity to differentiate between microbes and preferentially graze in non-symbiotic microbes, although the underlying mechanisms of discrimination are still poorly understood. Genomic studies showed that, compared to other animal groups, sponges present an extended repertoire of immune receptors, in particular NLRs, SRCRs, and GPCRs, and a handful of experiments showed that sponges regulate the expression of these receptors upon encounter with microbial elicitors. We hypothesize that sponges may rely on differential expression of their diverse repertoire of poriferan immune receptors to sense different microbial consortia while filter-feeding. To test this, we characterized the transcriptomic response of two sponge species, Aplysina aerophoba and Dysidea avara, upon incubation with microbial consortia extracted from A. aerophoba in comparison with incubation with seawater microbes. The sponges were sampled after 1 h, 3 h, and 5 h for RNA-Seq differential gene expression analysis. Results D. avara incubated with A. aerophoba-symbionts regulated the expression of genes related to immunity, ubiquitination, and signaling. Within the set of differentially-expressed immune genes we identified different families of Nucleotide Oligomerization Domain (NOD)-Like Receptors (NLRs). These results represent the first experimental evidence that different types of NLRs are involved in microbial discrimination in a sponge. In contrast, the transcriptomic response of A. aerophoba to its own symbionts involved comparatively fewer genes and lacked genes encoding for immune receptors. Conclusion Our work suggests that: (i) the transcriptomic response of sponges upon microbial exposure may imply “fine-tuning” of baseline gene expression as a result of their interaction with microbes, (ii) the differential response of sponges to microbial encounters varied between the species, probably due to species-specific characteristics or related to host’s traits, and (iii) immune receptors belonging to different families of NLR-like genes played a role in the differential response to microbes, whether symbionts or food bacteria. The regulation of these receptors in sponges provides further evidence of the potential role of NLRs in invertebrate host-microbe interactions. The study of sponge responses to microbes exemplifies how investigating different animal groups broadens our knowledge of the evolution of immune specificity and symbiosis.

The text analyzes the work by Anne Marie Sauzeau Boetti at the turn of the Seventies and Eighties, it is focused on her critical and intellectual activity related to art and feminism. These last, unlike what happened in Carla Lonzi and Lea Vergine, coexisted effectively and stubbornly in the thought of Sauzeau, who traced a third critical path compared to them. In this text are analysed her numerous contributions published on specialized press, like Data magazine, movement magazine and general press, from Il Manifesto to the broadcast for RadioTre. It is examinated also the role she had at the publishing house Edizioni delle donne, that she contributed to found in 1974 (the first issue was “L’occupazione fu bellissima”, 1976). In both those experiences Anne Marie Sauzeau Boetti did a fundamental work. Through a language and writing able to transmitting a deep and manifold thought, infact she was the one who updated the Italian art system about the teorethical debate on feminism, informing and bringing in Italy what was happening on the international scene and she employeed her critical work in support of her contemporary women artists (such as Elisa Montessori, Marisa Merz and Carla Accardi). Until arriving at the beginning of the Eighties, to suggest a possible way to read the works of female artists of the past.

Abstract Background Many health science curricula have integrated behavioral modification techniques in their plans. Motivational Interviewing is one such technique. Educational interventions to promote Motivational Interviewing have had limited success. Integrating simulation-based learning in health science curricula might offer a platform whereby students can train in well controlled environments with increased authenticity, provision of standardized experiences and the capacity for immediate feedback to participants. Using motivational interviewing as an exemplar, the purpose of this study was to assess the impact of a simulation-based reflective e-training program on knowledge, attitudes, and confidence in Motivational Interviewing among healthcare practitioners from diverse healthcare disciplines. A secondary aim was to explore whether self-reflection can promote reflective learning. Methods This was a mixed-method study design. Fifteen participants from different health disciplines were included in the quantitative phase of the study, the simulated interview, and the reflective assignments while five participated in the focus group. Pre and post tests were used to examine the effect of training on knowledge, attitudes, and confidence in Motivational Interviewing. Assessment of Motivational Interviewing Treatment Integrity [MITI] scores in a simulation-based scenario was used. A qualitative content analysis of a focus group provided a more in-depth understanding of the participants experiences. Excerpts from reflective assignments were analyzed using Transformative Learning Theory concepts. Results A Wilcoxon test showed that the training elicited a change in confidence in performing Motivational Interviewing [Z= -2.766, p = 0.006], median scores increased from 29 to 34. A quarter of technical scores and half of the relational scores indicated good competence. Participants reflected content transformation through feelings of empowerment and satisfaction when they were successful in engaging and motivating clients. Process transformation was evident in reflections on how to improve core skills specifically reflective listening. Reflections on Motivational Interviewing spirit related values showed premise transformation, which may indicate attitude changes. Conclusion A simulation-based e-training program on Motivational Interviewing represents an important educational modality for training in the health disciplines. Results of this study provide evidence supporting the integration of reflective simulation-based e-training into the education curricula of health disciplines in MI and beyond.

Abstract Introduction In highly multiracial populations with inadequate newborn screening, knowledge of the various phenotypic presentations of Cystic Fibrosis (CF) can help reach an early diagnosis. This study aims to describe phenotypes and genotypes at the time of CF diagnosis in a state in the Northeast Region of Brazil. Methods Retrospective cross-sectional study. Clinical data were extracted from the medical records of CF patients. Clinical, laboratory, and genotypic characteristics were described for patients admitted to a tertiary referral center between 2007 and 2021. Results Fifty-eight (58) patients were included in the study, 53.5% of whom were diagnosed through clinical suspicion. The median age at diagnosis was 4.7 months (IQR: 1.5–14.8 months). Five patients had false-negative results in the newborn screening. Faltering growth was the most frequent clinical manifestation. Bronchiectasis and a history of pneumonia predominated in those older than ten, while thinness, underweight, and electrolyte imbalances were more frequent in children under two. Sequencing of the CFTR gene identified 27 genotypes, with at least one class I–III variant in all patients, and nine variants that are rare, previously undescribed, or have uncertain significance (619delA, T12991, K162Q, 3195del6, 1678del > T, 124del123bp, 3121–3113 A > T). The most frequent alleles were p.Phe508del, p.Gly542*, p.Arg334Trp, and p.Ser549Arg. Conclusions Malnutrition and electrolyte imbalances were the most frequent phenotypes for children

Indigenous populations have remained resilient in maintaining their unique culture and values, despite facing centuries of colonial oppression. With many discriminatory policies continuing to disempower Indigenous peoples, First Nations communities have been reported to experience a higher level of cardiovascular disease (CVD)-related mortality, compared to that in the general population. Many of the risk factors contributing to the burden of CVD have been attributed to the impact of colonization and the ongoing dismissal of Indigenous knowledge. Despite Indigenous peoples recognizing the value of addressing their mental, physical, spiritual, and emotional well-being in balanced totality, current health services focus predominantly on the promotion of Western biomedicine. To begin to move toward reconciliation, a better understanding of how Indigenous health is defined within different cultural worldviews is needed. The objective of this scoping review was to explore the various Western and/or Indigenous strategies used for the prevention of CVD and the management of heart health and wellness in Indigenous communities in Canada. In this review, a total of 3316 articles were identified, and only 21 articles met the eligibility criteria. Three major themes emerged, as follows: (i) valuing of the emotional domain of health through cultural safety; (ii) community is at the core of empowering health outcomes; and (iii) bridging of cultures through partnership and mutual learning. Most studies recognized the importance of community engagement to develop heart health strategies that integrate traditional languages and cultures. However, to move toward the delivery of culturally safe care, health systems need to rebuild their relationship with Indigenous peoples. Résumé: Les populations autochtones ont toujours fait preuve de résilience dans le maintien de leurs cultures et de leurs valeurs uniques, malgré des siècles d’oppression coloniale. En raison des nombreuses politiques discriminatoires qui continuent de priver les peuples autochtones de certains pouvoirs, on rapporte que les communautés des Premières Nations ont un taux de mortalité liée aux maladies cardiovasculaires (MCV) supérieur à celui observé dans la population générale. De nombreux facteurs de risque qui contribuent au fardeau des MCV ont été attribués aux répercussions de la colonisation et au rejet continu du savoir autochtone. Malgré le fait que les peuples autochtones reconnaissent l’avantage de prendre soin de leur bien-être mental, physique, spirituel et émotionnel dans une intégralité équilibrée, les services de santé actuels sont essentiellement axés sur la promotion de la biomédecine occidentale. Afin de commencer à nous diriger vers la réconciliation, nous devons mieux comprendre la façon dont les peuples autochtones définissent la santé au sein de différentes visions culturelles du monde. L’objectif de cette étude de portée était d’explorer les diverses stratégies occidentales ou autochtones de prévention des MCV et de prise en charge de la santé et du bien-être cardiaques chez les communautés autochtones du Canada. Dans le cadre de cette étude, 3 316 articles ont été recensés, et seulement 21 d’entre eux répondaient aux critères de sélection. Trois principaux thèmes ont été dégagés, soit : (i) la sécurité culturelle permet de mettre en avant l’importance du domaine émotionnel de la santé; (ii) la communauté est au centre de l’autonomie en matière de devenir de la santé; et (iii) le lien entre les cultures doit se faire au moyen de partenariats et d’apprentissages mutuels. La plupart des études reconnaissaient l’importance de l’engagement communautaire pour mettre au point des stratégies relatives à la santé du cœur qui intègrent les langues et les cultures traditionnelles. Toutefois, afin de passer à la prestation de soins respectueux des cultures, les systèmes de santé doivent reconstruire leur relation avec les peuples autochtones.

The detection of Xylella fastidiosa in Portugal occurred through prospection in 2019 in Vila Nova de Gaia, Porto, in plants of Lavandula dentata L. Currently, in Portugal, there are 18 Xylella fastidiosa Demarcated Zones (DZs). The main objective of this study is to gain a comprehensive understanding of this problem within the defined Demarcated Zones in the North Region of Portugal from 2019 to June 2023. This work comprised two phases: the prospection phase (inspecting plants, sampling, and submission of samples to the laboratory) and the research phase (collecting and organizing data and statistical treatment). Our findings provide essential insights, suggesting that the Northern Region of Portugal is highly conducive to Xylella fastidiosa. Portugal has Xf-preferred hosts such as the olive tree, orange tree, Laurus nobilis, Rosa spp., Nerium oleander L., Pelargonium sp., Hedera helix L., and Lavandula dentata L. Portugal’s favorable environmental factors such as temperature and humidity can have an important role in influencing the interaction between bacteria and hosts. Nevertheless, it is crucial to consider variations in the behavior of insect vectors, as these variations can limit the prevalence of the disease. Activities like the transport of infected planting materials from the first Demarcated Zone of the Area Metropolitana do Porto could be associated with the introduction and spread of Xylella fastidiosa, potentially triggering new disease outbreaks in the country. Our findings confirm the alarming spread of Xylella fastidiosa across Portugal. Factors such as the presence of insect vectors, abundance of host plants, and climate suitability play pivotal roles in Xylella fastidiosa dispersal. We recommend that countries identified with relatively high risk, like Portugal, undertake thorough individual risk analyses. The implementation of preventive measures and, if necessary, the enhancement of surveillance systems for early detection of Xylella fastidiosa in plants and insect vectors are crucial steps.

The main objective of this research was to conduct a comparative study between dissolved air flotation (DAF) and conventional sedimentation (SED) for the treatment of a reservoir water (REW) and small stream water (STW) with low turbidity and low alkalinity in Colombia at the bench-scale level. The experiments were conducted at the bench-scale using a jar test apparatus. Aluminum sulfate was used as the coagulant. The experimental results showed that with an optimum coagulant dose of 30 mg/L as alum to treat REW and 10 mg/L as alum to treat STW; the percentage turbidity removal by DAF and SED were 88–85% and 84–86%; apparent color removal were 65–62% and 87%; and UV-254 nm removal as a surrogate measurement for the concentration of NOM were 74–73% and 64–69%, respectively. HIGHLIGHTS Comparison of two clarification processes in treating a reservoir and stream water for turbidity removal.; Comparison in removing natural organic matter by sedimentation and dissolved air flotation (DAF).; Advantages of DAF on sedimentation in treating two different low turbidity waters.; Impact of different flocculation times on DAF for turbidity removal.;

Abstract Introduction Sodium pentobarbital (SP), a short- to intermediate-acting barbiturate, has limited information in the existing literature. The objectives of this study are to describe (a) the effect of intravenous (IV) SP infusion on pain and sensory abnormalities, and (b) its utility in the diagnosis and management of patients with chronic pain. Methods A narrative review of barbiturate applications for chronic pain was followed by a pragmatic study of 176 consecutive patients admitted to an inpatient pain unit (2004–2009). We collected demographic information upon admission, diagnoses retrieved from chart review, and pain ratings and sensory abnormalities at baseline and after blinded infusion of normal saline (NS) followed by SP. Results The study group consisted of 83 men and 93 women (mean age 41 ± 11 years); the mean NS dose was 7.8 ± 2.3 (range 2–10 ml), the SP dose was 223.8 ± 88 mg (range 40–420), and the numeric rating scale (NRS) baseline pain score was 6.0 ± 2. The mean reduction in NRS reached both statistical and clinical significance in 150 responders to either NS/SP or SP only. Collectively, we found (a) an extremely high rate of response to IV SP irrespective of the underlying pathology, (b) greater response for pain than for sensory abnormalities (sensory gains or deficits), (c) greater response for sensory gain than for sensory deficit, and (d) greater response for allodynia than for pinprick hyperalgesia. Illustrative case reports are also presented. Discussion IV SP infusion is a diagnostic tool that assists in elucidating pain generators and the nature of sensory abnormalities (central vs. peripheral), with effects similar to those of IV sodium amytal. The test cannot be viewed as a tell-all diagnostic modality and must be used in conjunction with clinical judgment, investigations, and psychological reports.

La investigación tiene por objetivo confrontar los mecanismos para el fomento de la cultura investigativa en las universidades, utilizando la planificación estratégica como herramienta de gestión. Se trata de una investigación de tipo documental-propositiva, donde el documento considera la relación entre la promoción de investigación y gestión, mostrando inicialmente el estado actual de las universidades –con énfasis en América Latina- para luego presentar las bases conceptuales de la investigación como proceso cultural abierto y, finalmente, presentar los fundamentos de la gestión mediante gerencia estratégica. Los resultados valorados permiten establecer que el fomento de una cultura investigativa, deberá estar sustentada firmemente en la generación de una política, cuyo eje curricular central sea la investigación, donde la participación de los stakeholders internos y externos sea incluyente e intensiva. De acuerdo con lo anterior, las relaciones interdependientes estarán sustentadas por la funcionalidad organizativa, la co-responsabilidad, la calidad en la generación del conocimiento y administración bajo pensamiento estratégico futurista. Estos principios rectores serán soportados por redes virtuales y presenciales de avanzada tecnología, que permitan la participación, comunicación y delegación horizontal y la difusión universal del conocimiento.

Abstract Background Advanced practice nursing has emerged as a result of the evolution of healthcare systems, the changing needs of the population and the academic development of nursing, as well as sociodemographic and epidemiological changes. The aim of this study is to describe the professional experiences of Spanish advanced practice nurses in specific positions within the healthcare system in order to better understand the development and characteristics of this specialised nursing role. Methods A descriptive qualitative study was conducted. Fourteen advanced practice nurses from healthcare centres participated. Semi-structured interviews were carried out. Braun and Clarke’s method for reflexive thematic analysis was followed. The Atlas. Ti version 22 program was used for technological support. The COREQ checklist was used to optimise the reporting of this qualitative study. Results From the analysis of the data collected, three themes and six subthemes were extracted: 1) Advanced practice nursing on the rise: (a) The driving forces in the development of advanced practice nursing, (b) Barriers to the development of advanced practice nursing; 2) Advanced practice nurses as a response to the population’s needs: (a) The development of a new professional nursing role, (b) The patient at the centre of care in advanced practice nursing; 3) Training as the foundation for advanced practice nursing: (a) Expert nurses in a specific context, (b) Differences in the level of training depending on the context. Conclusion Advanced practice nurses have faced countless barriers and difficulties that have impeded them from demonstrating their importance and effectiveness within the healthcare system. A stable regulatory framework for the functions of advanced practice nurses is required to promote care, training and research in the field of advanced practice nursing. Health institutions need to promote the role of advanced practice nurses, facilitate the employment of new professionals, and establish new areas of practice. Trial registration Not applicable.

Cacti are renowned for their resilience in arid environments and have been utilized as a valuable food source in various cultures for centuries. The potential effects of cactus (Cactaceae) consumption on liver health have garnered significant scientific interest in recent years. This review aimed to consolidate and analyze existing research findings regarding the relationship between cactus-derived compounds and their influence on liver function and health. Various cactus species, particularly Opuntia spp., are rich reservoirs of antioxidants, polyphenols, flavonoids, and betalains. In vitro and in vivo studies with animal models have shown that bioactive constituents of cactus exhibit anti-inflammatory, antioxidative, and antifibrotic properties, which potentially mitigate liver damage induced by oxidative stress, inflammation, and hepatotoxic agents. Understanding their mechanisms of action and conducting rigorous clinical studies with administration of cactus will ascertain their role in preventing and treating liver ailments, offering novel avenues in nutrition, hepatology, and natural medicine.

Surgery for lesions of the proximal part of the pancreatic body or neck can be challenging, and when enucleation is not possible, central pancreatectomy is an option. Laparoscopic central pancreatic resection is rarely described worldwide; it is considered a difficult procedure mainly because of the risk of double pancreatic fistula developing at two sites of resection. However, it seems to be an excellent alternative to distal pancreatectomy or pancreaticoduodenectomy, with the advantages of preserving functioning parenchyma and reducing endocrine and exocrine failure. Nevertheless, patients with pancreatic lesions requiring central resection are often managed with the open approach in many hospitals due to the complexity of total laparoscopic central pancreatectomy, which requires advanced laparoscopic skills, expertise and experience. Here, we report a case of a 29-year-old female who underwent total laparoscopic central pancreatic resection with gastro-pancreatic anastomosis for symptomatic serous cystadenoma. We discuss the details of case management and review the relevant literature.

This work focuses on understanding how researchers in Spain perceive the importance of social media in scientific communication and dissemination and deepening their understanding of the influential underlying factors. From the initial identification of 5,314 researchers affiliated with higher education institutions in Spain, who published in journals indexed in Scopus and Web of Sciences from 2016 to 2020, 487 were surveyed, and 20 were interviewed. The results show how despite the potential of non-academic social media for the social dissemination of scientific knowledge, use remains low among the researchers surveyed in this study. Also, data allow us to recognize how the time of use of social media and the perception of the training needed influence the perception of the usefulness of social media by Spanish researchers on education. Use that does not seem to be oriented toward dialogue and citizen participation. Higher education institutions should improve the communication and scientific dissemination led by researchers through training and the design of dissemination policies that guarantee an active and general use of them (not only academics but also generalists like Facebook or Youtube) to transfer scientific knowledge to society better.

Since language teaching in modern-day society is closely linked to cultural instruction, this study employs the model of a cultural learning analysis based on the earlier work of Paige and Lee. Using this model, the authors analysed the cultural content of six B1 and B2-level textbooks for teaching English to adults in Spain, and carried out a comparative study of the results, contrasting the two levels. Findings show that the subjective aspects of culture receive less coverage in textbooks, despite being fundamental to an understanding of the values of a society. Regarding the comparison between B1 and B2 levels, the data indicate that the number of big 'C' Culture occurrences is similar for both levels, although there are differences in other cultural aspects. So, for example, culture in general is dealt with more at the B1 level, whereas small 'c' culture is dealt with more at the B2 level. Keywords: Culture learning, textbook, EFL, big 'C' Culture, small 'c' culture, 1. Introduction Cultural knowledge has always been an integral part of language learning (Howatt & Widdowson 2004). However, the development of behaviours, skills, and abilities did not gain the importance [...]

Introduction ISMiHealth is a clinical decision support system, integrated as a software tool in the electronic health record system of primary care, that aims to improve the screening performance on infectious diseases and female genital mutilation (FGM) in migrants. The aim of this study is to assess the health impact of the tool and to perform a process evaluation of its feasibility and acceptability when implemented in primary care in Catalonia (Spain).Methods and analysis This study is a cluster randomised control trial where 35 primary care centres in Catalonia, Spain will be allocated into one of the two groups: intervention and control. The health professionals in the intervention centres will receive prompts, through the ISMiHealth software, with screening recommendations for infectious diseases and FGM targeting the migrant population based on an individualised risk assessment. Health professionals of the control centres will follow the current routine practice.A difference in differences analysis of the diagnostic rates for all aggregated infections and each individual condition between the intervention and control centres will be performed. Mixed-effects logistic regression models will be carried out to identify associations between the screening coverage and predictor factors. In addition, a process evaluation will be carried out using mixed methodology.Ethics and dissemination The study protocol has been approved by the institutional review boards at Hospital Clínic (16 June 2022, HCB/2022/0363), Clinical Research Ethics Committee of the Primary Care Research Institute IDIAPJGol (22 June 2022, 22/113-P) and the Almería Research Ethics Committee (27 July 2022, EMC/apg). The study will follow the tenets of the Declaration of Helsinki and Good Clinical Practice. All researchers and associates signed a collaboration agreement in which they undertake to abide by good clinical practice standards.Findings will be disseminated in peer-reviewed journals and communications to congresses.Trial registration number NCT05868005.

Herein, the synthesis and characterization of two robust tungsten and rhenium carbonyl complexes integrated into an organic polymer (CPP‐Re, CPP‐W) are reported. These polymers are obtained by a Suzuki coupling reaction between the corresponding dibromo metal‐carbonyl substituted dipyrido[3,2‐a:2′,3′‐c]phenazine complex and 1,3,5‐triphenylbenzene‐4′,4″,4″,4‴‐triboronic acid and integrated catalytic active sites and photosensitizer since they have not only nitrogen sites to coordinate metal active centers as rhenium or tungsten but photoactive units with good charge‐separating ability which can significantly improve the CO2 photoreduction reaction (CO2PRR). These polymers show similar activity in solid–gas CO2PRR in absence of sacrificial agents to produce syn gas (CO + H2) but CPP‐W selectivity to products change regarding CPP‐Re being able to produce also large amount of more demanding electron products such as methane and ethane. Moreover, the single‐site Re‐ or W‐CPP catalysts could prevent the dimerization of complexes that produces its deactivation. This work shows the potential of CPPs as matrices to support single active centers for heterogeneous catalysis.

BACKGROUND: The worldwide increase in the cesarean delivery rate is a major public health concern and cause of significant debate. Although multiple studies have shown that higher cesarean delivery rates may be associated with adverse maternal and perinatal outcomes, the number of cesarean deliveries has been continuously increasing. In the Republic of Moldova, cesarean delivery increased from 15.75% in 2012 to 27.42% in 2022. However, the perinatal mortality remained unchanged at 11.6%. To understand the factors that determine the increasing trend in cesarean delivery and to approach new strategies to reduce unnecessary surgical delivery, a standardized tool is needed to assess and compare cesarean delivery rates. OBJECTIVE: This study aimed to assess the changes in the rates and trends of cesarean delivery and to evaluate the contribution of different obstetrical populations to overall cesarean delivery rates in the Municipal Clinical Hospital using the Robson classification. STUDY DESIGN: This was a cohort study conducted at the Municipal Clinical Hospital in Chisinau. The study included 13,882 women who gave birth in 2017, 2019, and 2022 at the Municipal Clinical Hospital. All births were classified into 10 Robson groups, using 6 basic variables (parity, cesarean delivery in medical history, labor onset, number of fetuses, gestational age, and fetal presentation). Statistical data were collected and analyzed using the Epi Info program (version 7.2.1.0; Centers for Disease Control and Prevention, Atlanta, GA). RESULTS: The overall cesarean delivery rate was 20.02% (2779/13,882), with a significant increase from 18.59% (809/4351) to 21.59% (1134/5252) (P=.0003). Approximately one-third (1099/2279 [39.55%]) of all cesarean deliveries were performed before labor onset. The main contributor in all study years was group 5 (957/2779 [34.44%]). The next valuable group that contributed to the overall cesarean delivery rate was group 2 (393/2779 [14.14%]), followed by group 1 (333/2779 [11.98%]). CONCLUSION: The Robson Ten-Group Classification System provides a clear and detailed record of the trends in cesarean delivery. In addition, because of the Robson Ten-Group Classification System's simplicity and exclusivity, it can be implemented in the Republic of Moldova. The main contributors to the overall cesarean delivery rate were women with a previous cesarean delivery (group 5), followed by nulliparous women of group 2 and group 1.

IntroductionColorectal cancer stands as a predominant cause of cancer-related mortality worldwide. Despite progressive strides in surgical methodologies, the specter of postoperative complications is very large, significantly impacting both morbidity and mortality rates. This review aims to meticulously examine existing scholarly works to gauge the prevalence, severity, and therapeutic approaches to postoperative complications arising from colorectal cancer surgeries.MethodsEmploying a systematic approach, this study reviewed 135 peer-reviewed publications from the period of 2000–2023. The corpus was organized into categories reflective of the postoperative complications discussed: anastomotic leakage, port-site metastases, small bowel adhesions and obstructions, thrombosis, ileus, postoperative infections, urinary dysfunctions, and cardiovascular dysfunctions. Advanced artificial intelligence tools were leveraged for in-depth literature searches and semantic analyses to pinpoint research lacunae.ResultsThe analysis revealed that anastomotic leakage and postoperative infections garnered the majority of academic focus, representing 35% and 25% of the studies, respectively. Conversely, port-site metastases and cardiovascular dysfunctions were less frequently examined, accounting for merely 5% and 3% of the literature. The reviewed studies indicate a disparity in the reported prevalence rates of each complication, oscillating between 3% and 20%. Furthermore, the review identified a dearth of evidence-based management protocols, underscored by a pronounced heterogeneity in treatment guidelines.ConclusionsThe literature is replete with analyses on anastomotic leakage and postoperative infections; however, there exists a glaring scarcity of exhaustive research on other postoperative complications. This review emphasizes the pressing need for uniform treatment guidelines and spotlights areas in dire need of further research, aiming at the comprehensive enhancement of patient outcomes following colorectal cancer surgery.

BackgroundDecisions regarding mode of delivery in the context of a prior cesarean birth is complicated because both trial of labor after cesarean and elective repeat cesarean birth have risks and benefits.PurposeThe objective of this study was to understand the perspective of women and obstetricians in Coatepeque, Guatemala, to guide the development of a decision aid about mode of birth for women with a history of prior cesarean.MethodsWe conducted in-depth semi-structured interviews with obstetricians at Coatepeque Hospital and women at the Center for Human Development in the southwest Trifinio region of Guatemala in February 2020. Using qualitative content analysis, we recorded, transcribed, translated, and analyzed qualitative data for the meaning of themes and concepts exploring the acceptability of counseling with a decision aid regarding mode of delivery.ResultsA total of 30 qualitative interviews were conducted with women and physicians. Three themes emerged from the qualitative interviews: Having a decision aid for women with a prior cesarean birth will be useful and helpful. Content of the decision aid should include benefits and risks for women and babies as well as figures. Women described the need of tailoring the content surrounding family's role in their decisions. They felt that a trusted provider from the healthcare system should facilitate the use of the decision aid for counseling.ConclusionsThese findings emphasize the support and need for innovative approaches to patient education around mode of delivery after a prior cesarean in the southwest region in Guatemala. There is a need to improve the educational information given to women regarding their mode of delivery after a cesarean birth. Finally, an effective decision aid needs to be tailored to not only the women's needs but also the engagement of the family unit for its successful implementation.

Los hongos endófitos [HE] son microorganismos que viven dentro de las plantas sin causar daño aparente, y colaboran en la síntesis de sustancias reguladoras del crecimiento, fijación de nitrógeno, protección contra patógenos, entre otros beneficios para las plantas. En este estudio se determinó la capacidad de producción de ácido indol acético [AIA] y de solubilización de fosfato, en cuatro cepas de HE aislados desde raíces de Araucaria araucana y se evaluó su efecto sobre la promoción del crecimiento en Nicotiana tabacum, utilizada como planta modelo. Los hongos fueron identificados como Phialocephala fortinii (cepa E-1), Penicillium melinii (cepa E-13), Umbelopsis dimorpha (cepa E-14) y Preussia cymatomera (cepa E-36). El AIA fue determinado utilizando el método de Salkowski, usando caldo de papa dextrosa {CPD] suplementado con 10 mg L-1 de L-triptófano, como precursor para la síntesis de AIA, y la producción fue expresada en mg L-1. La solubilización de fosfato fue determinada en medio sólido Pikovskaya, evaluando los halos formados en el medio y calculando el índice de eficiencia relativa de solubilización {ERS]. Finalmente, la estimulación del crecimiento vegetal por los HE en un co-cultivo con las plántulas de N. tabacum, en condiciones in vitro, fue evaluada a través de la producción de biomasa aérea y radicular de las plántulas. Los mayores valores de AIA y ERS fueron obtenidos con U. dimorpha (52,29 y 3,36 mg L-1, respectivamente). Los hongos utilizados promovieron el crecimiento de la biomasa aérea y radicular de las plantas de N. tabacum en condiciones in vitro, obteniéndose la mayor producción de biomasa seca total (aérea y radicular) con U. dimorpha, con 188,5 mg, valor significativamente mayor (p < 0,01) que el de las plantas control (8,85 mg). A través de este estudio se infiere que los HE aislados de A. araucana promueven el crecimiento vegetal y brindan beneficios para las plantas mediante la producción de fitohormonas.

IntroductionMild cognitive impairment (MCI) or “mild neurocognitive disorder” represents an intermediate status between normality and dementia. It is characterized by cognitive decline that does not significantly interfere with normal daily living activities. Virtual reality (VR) is the new frontier of rehabilitation.MethodsWe enrolled 50 MCI patients who underwent a neuropsychological evaluation and participated in 40 sessions of cognitive treatment using the Virtual Environment for a Superior Neuro-Psychiatry, Second Generation (VESPA 2.0) System. This preliminary study highlights the role of VR tools for cognitive rehabilitation (CR) for the recovery of cognitive functions and consequent better management of MCI condition. Our study demonstrated that the VESPA 2.0 System is a valuable tool in a context that closely resembles real-life situations rather than controlled, artificial environments as traditional cognitive training methods.ResultsThe results showed that the patient group had significant improvements between T0 and T1 (assessment), in particular, in the global cognitive profile, visuospatial skills, and executive functions after treatment with the VESPA 2.0 System.DiscussionOur findings contribute with new evidence of understanding the impact of using simulations of the Activities of Daily Living (ADL) scale in the CR.

Este artigo analisa as práticas leitoras dos brasileiros e propõe uma discussão sobre a trajetória do Plano Nacional do Livro e da Leitura (PNLL) com a finalidade de tentar compreender possíveis conexões entre o comportamento dos leitores e as políticas públicas de estímulo à leitura promovidas pelo governo brasileiro. A análise do corpus compreende o exame de dados importantes da 5ª edição da pesquisa “Retratos da leitura no Brasil. Ademais, com o propósito de delinear prováveis analogias, o presente estudo abarca o percurso e as premissas do Plano Nacional de Leitura (PNL) em Portugal. Os laços históricos, culturais e linguísticos que aproximam os dois países são indeléveis e justificam uma investigação sobre as prováveis similitudes e discrepâncias das suas atuais políticas públicas de incentivo à leitura.