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Abstract Aims LMNA‐related dilated cardiomyopathy (DCM) is a rare disease with an incompletely defined phenotype. The phase 3 REALM‐DCM trial evaluated a potential disease‐modifying therapy for LMNA‐related DCM but was terminated due to futility without safety concern. This study utilized pooled data from REALM‐DCM to descriptively characterize the phenotype and progression of LMNA‐related DCM in a contemporary cohort of patients using common heart failure (HF) measures. Methods REALM‐DCM enrolled patients with stable LMNA‐related DCM, an implanted cardioverter defibrillator or cardiac resynchronization therapy defibrillator, and New York Heart Association (NYHA) Class II/III HF symptoms. Results Between 2018 and 2022, 77 patients took part in REALM‐DCM. The median patient age was 53 years (range: 23–72), and 57% were male. Overall, 88% of patients had a pathogenic or likely pathogenic LMNA variant, and 12% had a variant of uncertain significance with a concordant phenotype. Among patients with confirmed sequencing, 55% had a missense variant. Atrial fibrillation was present in 60% of patients; 79% of all patients had NYHA Class II and 21% had NYHA Class III HF symptoms at baseline. Median (range) left ventricular ejection fraction (LVEF), 6 min walk test (6MWT) distance, Kansas City Cardiomyopathy Questionnaire Overall Summary (KCCQ‐OS) score and N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) concentration at baseline were 42% (23–62), 403 m (173–481), 67 (18–97) and 866 pg/mL (57–5248), respectively. LVEF, 6MWT distance and KCCQ‐OS score were numerically lower in patients who had NYHA Class III versus II symptoms at baseline (LVEF: 38% vs. 43%; 6MWT distance: 326 vs. 413 m; and KCCQ‐OS score: 43 vs. 70), whereas NT‐proBNP concentration was higher (1216 vs. 799 pg/mL). Median follow‐up was 73 weeks (range: 0.4–218; 73 in NYHA Class II and 75 in NYHA Class III). Patients displayed variable change from baseline in 6MWT, KCCQ‐OS and NT‐proBNP values during follow‐up. Overall, 25% of patients experienced ventricular tachycardia, and 8% had ventricular fibrillation. Ten (13%) patients met the composite endpoint of worsening HF (adjudicated HF‐related hospitalization or urgent care visit) or all‐cause death; six had NYHA Class II and four had NYHA Class III at baseline. All‐cause mortality occurred in 6 (8%) patients; three had NYHA Class II and three had NYHA Class III symptoms at baseline. Conclusions Findings confirm the significant morbidity and mortality associated with LMNA‐related DCM despite the standard of care management. Typical measures of HF, including 6MWT distance, KCCQ‐OS score and NT‐proBNP concentration, were variable but correlated with NYHA class. An unmet treatment need remains among patients with LMNA‐related DCM. NCT03439514.

Abstract Aims Recognition of transthyretin amyloid cardiomyopathy is increasing due to advances in cardiac imaging and diagnostic strategies, but questions remain regarding disease frequency and characteristics. We examined the prevalence and characteristics of transthyretin amyloid cardiomyopathy in older patients with hypertrophic cardiomyopathy of unascertained aetiology. Methods and results TTRACK was a multicentre, non‐interventional, cross‐sectional epidemiologic study funded by Pfizer and conducted in 20 hospitals and medical centres in 11 countries (NCT03842163). Eligible patients were aged ≥50 years, had hypertrophic cardiomyopathy (maximal end‐diastolic left ventricular wall thickness ≥15 mm on echocardiogram) without an identified genetic or alternative origin at study enrolment, and underwent 99mTechnetium bone scintigraphy, with or without single photon emission computed tomography (SPECT). Cardiac‐versus‐bone uptake on scans was visually scored from 0 to 3 (Perugini scoring). Patients with grades 1–3 underwent monoclonal protein and laboratory testing and transthyretin (TTR) gene sequencing. Of 766 eligible patients, 691 (90.2%) had scintigraphy alone and 75 (9.8%) scintigraphy plus SPECT. Two hundred and eight patients (27.2%) had grade 2 or 3 cardiac uptake on scintigraphy; 144 (18.8%) had grade 2 or 3 cardiac uptake and no evidence of plasma cell dyscrasia and were diagnosed with transthyretin amyloid cardiomyopathy. Of patients with transthyretin amyloid cardiomyopathy, 11 (7.6%) had a pathogenic TTR gene variant and 34 (23.8%), 74 (51.7%), and 35 (24.5%) had New York Heart Association class I, II, and III/IV heart failure (HF) symptoms, respectively. Clinical and laboratory diagnostic characteristics were observed in ≥90% of patients with transthyretin amyloid cardiomyopathy. The characteristics most strongly associated with transthyretin amyloid cardiomyopathy on multivariable analysis were carpal tunnel syndrome (odds ratio [OR] 54.3; P

Abstract Background Sepsis is a leading cause of acute kidney injury requiring continuous kidney replacement therapy (CKRT) and CKRT can alter drug pharmacokinetics (PK). Cefepime is used commonly in critically ill children and is cleared by CKRT, yet data regarding cefepime PK and pharmacodynamic (PD) target attainment in children receiving CKRT are scarce, so we performed Monte Carlo simulations (MCS) of cefepime dosing strategies in children receiving CKRT. Methods We developed a CKRT “module” in the precision dosing software Edsim++. The module was added into a pediatric cefepime PK model. 1000-fold MCS were performed using six dosing strategies in patients aged 2–25 years and ≥ 10 kg with differing residual kidney function (estimated glomerular filtration rate of 5 vs 30 mL/min/1.73 m2), CKRT prescriptions, (standard-dose total effluent flow of 2500 mL/h/1.73 m2 vs high-dose of 8000 mL/h/1.73 m2), and fluid accumulation (0–30%). Probability of target attainment (PTA) was defined by percentage of patients with free concentrations exceeding bacterial minimum inhibitory concentration (MIC) for 100% of the dosing interval (100% fT > 1xMIC) and 4xMIC using an MIC of 8 mg/L for Pseudomonas aeruginosa. Results Assuming standard-dose dialysis and minimal kidney function, > 90% PTA was achieved for 100% fT > 1x MIC with continuous infusions (CI) of 100–150 mg/kg/day (max 4/6 g) and 4-h infusions of 50 mg/kg (max 2 g), but > 90% PTA for 100% fT > 4x MIC was only achieved by 150 mg/kg CI. Decreased PTA was seen with less frequent dosing, shorter infusions, higher-dose CKRT, and higher residual kidney function. Conclusions Our new CKRT-module was successfully added to an existing cefepime PK model for MCS in young patients on CKRT. When targeting 100% fT > 4xMIC or using higher-dose CKRT, CI would allow for higher PTA than intermittent dosing.

Abstract Objective The aim of this study is to describe the pre‐ and post‐operative developmental and intellectual functions in a cohort of patients who underwent surgery for drug‐resistant epilepsy (DRE) before the age of 5 years. Method We retrospectively reviewed the medical records and neurodevelopmental assessments of a cohort of 80 surgically treated pediatric patients with DRE. We included patients if they had at least one pre‐ and one post‐surgical neuropsychological assessments; 27 met the inclusion criteria. We evaluated Developmental Quotient (DQ) and Intelligence Quotient (IQ) before and after surgery. We identified two groups based on psychological evaluation outcome: Group 1, with stable or improved developmental and intellectual functions, and Group 2, experiencing developmental and intellectual loss. Results The mean age at seizure onset was 1.2 ± 1.0 years, and the mean age at surgery was 2.9 ± 1.2 years. At the last follow‐up (mean 4 years, SD ± 2), 19/27 (70%) patients were seizure‐ and drug‐free; 18/27 patients (67%) fit in Group 1, and 9/27 (33%) fit in Group 2. The mean age at surgery was 2.6 years (SD ± 1.1; range 1.2–5.1) in Group 1 and 3.4 years in Group 2 (SD ± 1.1; range 1.6–5.0). Group 1 had a lower pre‐operative DQ/IQ total score than Group 2 (median DQ/IQ respectively 82 vs 108, p = 0.05). Between pre‐ and post‐assessments, we found that in Group 1, Performance scores improved (82.7 vs 102, p = 0.001), while in Group 2, the Total and Verbal scores worsened (respectively 108 vs 75, p = 0.008, and 100 vs 76, p = 0.021). Significance Our study's results emphasize the positive impact of surgery before the age of 5 years on developmental and intellectual outcomes. Despite limitations such as a small sample size, lack of a control group, and diverse etiologies, our findings support the crucial role of early intervention in preserving or enhancing developmental and intellectual functions in young patients with DRE. Plain Language Summary This retrospective study, conducted at the Bambino Gesù Children Hospital in Italy, reports neuropsychological and developmental and/or cognitive data for children undergoing early epilepsy surgery (before the age of 5). It found that children with lower developmental or cognitive profiles gained the highest scores on post‐operative neuropsychological evaluations. This study provides information on the potential benefits of early surgery in shortening the duration of epilepsy, preventing or arresting deterioration, and enhancing plasticity and recovery.

Interpreting and enacting curriculum in any school is a complex undertaking, even more so in special school contexts where teachers must develop and enact appropriate curriculum modifications and accommodations for small groups of students and individual students. In special education contexts, educational modifications are changes teachers make based on a standardised curriculum, in order to be able to support the individual learning of students with intellectual and other profound disabilities, in terms of personalising learning for each student. These modifications are derived from teachers' curriculum (re)interpretations. Conversely, educational accommodations are the adjustments that teachers make in how they deliver the interpreted curriculum through individual learning episodes without changing the existent learning foci. This article presents a theorisation of how some special school educators interpret and reinterpret standardised curriculum to support the individual learning needs of students with moderate to profound disabilities through operationalising a theoretical framework of personalised learning. Operationalising personalised learning in special school contexts is theorised to be a collaged hermeneutical circle, where special education teachers work to (re)interpret curriculum, alongside the individual learning needs evidenced through teacher assessments and observations, and from student individual education plans. Within special school contexts, teachers approach the Australian Curriculum text as collaborative teams and engage in dialogue and planning about the curriculum to be taught and assessed. Thus, they aim to ensure that their students engage with the appropriate curriculum and have opportunities for learning on the same basis as students without their specific needs (i.e. students without disability). Unlike teachers in mainstream schooling contexts, teachers in special schools must (re)interpret curriculum that has not been explicitly developed for the unique learning needs of students with profound disability.

This article reports on the findings of a qualitative case study exploring the auditory skill "deficits" of a twice-exceptional male student who had multiple exceptionalities, including deficits in auditory processing skills, which contributed to learning issues and social connection difficulties in unique ways. Auditory skill deficits are an under-researched area in the field of gifted education, yet these are requisite skills necessary for learning in school. For this case study, auditory deficits were related to phonological processing, auditory sequential memory, lowered auditory recall abilities, and weaknesses in auditory analysis skills. The role that these auditory skill deficits played in the educational experiences of this young person is explored. Findings suggest that the presentation and impact of auditory processing deficits is very individual.

Abstract Black carbon is a refractory form of organic carbon formed from the incomplete combustion of fossil fuels and biomass. Riverine transport is considered the dominant pathway of black carbon to the coastal oceans. However, the provenance and pathways of black carbon to the open ocean remain unknown. Here we use both stable and radiogenic isotopes of carbon to show that sedimentary black carbon across the equatorial Atlantic Ocean is aeolian and primarily derived from biomass burning of C4-plants. Fluxes of surface sedimentary black carbon measured along an equatorial Atlantic Ocean transect using chemothermal oxidation at 375 °C were relatively consistent across the Atlantic, ranging from 0.10–0.35 mg cm−2 kyr−1. Carbon isotope values near Africa suggest the black carbon was mostly young and derived from C4 plants, whereas offshore South America, the black carbon was older and dominated by C3 plants. The black carbon radiocarbon values were similar to the reservoir corrected total organic carbon near Africa, implying little pre-aging on land and increased westwards. These findings highlight the influence of C4-biomass burning in the tropical Atlantic and the importance of aeolian deposition as a black carbon source within the global carbon cycle.

The paper explores valorisation of hotel service quality elements and puts them in the context of guests’ preferences related with luxury accommodation. The focus of the paper is perception of luxury hotel offer and influence of sustainability labels and excellence awards on tourists’ preferences. The purpose of the paper is a better understanding of consumers’ attitudes when choosing luxury hotel accommodation developed and awarded within the sustainability concept. The methodology includes qualitative and quantitative analysis of the defined quality elements, perception of luxury and impact of sustainable awards and certificates on consumers’ preferences. The research was conducted using an online questionnaire in the last quarter of 2021, and it was carried out on a sample of 102 respondents, guests of upscale and luxury hotels. The research results were processed using quantitative statistical methodology, including mean values, percentages, STDEV, VAR and the Chi-square test of probability, while the open-ended question was processed using qualitative methodology, and the results are presented through the new model. Interpersonal communication followed by physical facilities and characteristics of luxury hotels are highlighted as important parameters, as is the valorisation of sustainable labels and certificates. However, by testing of the research questions and expected values, the authors have learnt that guests, consumers of luxury hotel products, predominantly do not valorise sustainable awards and certificates as key factors of perception of luxury. The findings suggest that sustainable initiatives in modern hospitality are entailed; however, the perception of luxury is not conditioned by awards and certificates.The research results, as well as the acquired knowledge, could encourage hoteliers to a more meaningful and effective promotion of certificates and awards in order to present a series of investments, activities and sustainable initiatives that have resulted in a certificate of excellence. The research bridges a scientific and professional gap in understanding of advantages of labels and awards and presents a platform for future research.

Abstract A 26-year-old man with Ehlers-Danlos syndrome, recurrent otitis externa, and chronic otitis media sustained a left lower extremity amputation and open femur fracture with internal hardware fixation after a motor vehicle collision in Arizona. He presented to the emergency department at our institution with severe left leg pain and purulent discharge despite receiving two unidentified antibiotics upon discharge. Evaluations revealed an abscess and malunion of the femur. Initial cultures yielded scant Priestia endophytica, leading to daptomycin treatment. His condition worsened until Gram-positive bacilli identified as Mycobacterium goodii, a rare nosocomial mycobacterial species, were found. Significant improvement occurred with appropriate antibiotics. This case highlights the challenges in diagnosing and managing M. goodii infections in immunocompromised patients with orthopedic complications and notes P. endophytica as a previously unreported, possibly opportunistic human pathogen.

Abstract Objective To assess seizure and developmental outcomes, their predictors, and complications in 160 children who, between 1998 and 2022, underwent surgery for lesional epilepsy with curative intent before the age of 3 years. To compare trends in epilepsy surgery in this age group before and after the year 2014. Methods Retrospective multicenter study. Descriptive and univariate analyses, and multivariable models for all outcomes. Results These 160 patients (76 F; 47.5%) underwent 169 surgeries (age at surgery 20.4 ± 9.4 months). At the last follow‐up (77 ± 57.4 months), 121 patients (75.6%) were in Engel class I, 106 (66.2%) of whom were in Engel class Ia. Antiseizure medications were stopped in 84 patients (52.5%). Complications requiring reoperations were observed in 16 patients (10%; 9.5% of surgeries) and unexpected permanent deficits in 12 (7.5%; 7.1% of surgeries). Postoperative cognitive functions remained unchanged in 56 patients (44.4%), improved in 51 (40.5%), and worsened in 19 (15.1%). Multivariable analyses showed that the probability of achieving Engel class Ia was lower when the duration of epilepsy was longer, patients underwent preoperative video‐EEG, and unexpected postoperative permanent deficits occurred. Cognitive improvement after surgery was associated with lower preoperative seizure frequency, better preoperative developmental level, and a longer postoperative follow‐up. FCDII and tumors were the histopathologies carrying a higher probability of achieving seizure freedom, while polymicrogyria was associated with a lower probability of cognitive improvement. The number of patients operated on after 2014 was higher than before (61.3% vs. 38.7%), with stable outcomes. Significance Epilepsy surgery is effective and safe in infants and toddlers, although the complication rate is higher than seen in older patients. Shorter duration of epilepsy, lower seizure frequency, no need for video‐EEG, tumors, and some malformations of cortical development are robust predictors of seizure and cognitive outcome that may be exploited to increase earlier referral. Plain Language Summary This study analyzed the results of epilepsy surgery in 160 children who had been operated on before the age of 3 years at four Italian centers between 1998 and 2022. At the last follow‐up (77 ± 57.4 months), 121 patients (75.6%) were free from disabling seizures, of which 106 (66.2%) were completely seizure‐free since surgery. Major surgical complications occurred in 28 patients (17.5%), which is higher than observed with epilepsy surgery in general, but similar to hemispheric/multilobar surgery. Postoperative cognitive function remained unchanged in 56 patients (44.4%), improved in 51 (40.5%), and worsened in 19 (15.1%). Epilepsy surgery is effective and safe in infants and toddlers.

This article draws on case study findings of educator leadership in an online gifted education school, which emerged from a larger study exploring online engagement practices used by specialist gifted education teachers to (re)engage gifted learners. The gifted education teachers and their team leader were interviewed about leadership practices for supporting online engagement of gifted primary and high school students. Semi-structured interview data were transcribed, coded, and thematically analysed. Findings related to teachers voicing the importance of a passionate and committed team leader who understood giftedness and who acted as a facilitator in both the continuous development of teaching team skills and facilitation of online engagement practices for gifted students. Findings indicated five key themes related to transformational leadership practices: (1) understanding requirements of online practices for teaching gifted students; (2) supporting digital and online innovation and creativity for engaging gifted students; (3) leveraging the unique skills of the specialist teaching team for teaching gifted students in the online space; (4) actively facilitating and encouraging (re)engagement of gifted students through online participation; (5) follow-through to meet the needs and concerns of the specialist teaching team, gifted students, and their parents and/or carers. These leadership practices are of importance for actively supporting gifted education teachers and their students in online learning environments in order to achieve positive student engagement and learning outcomes commensurate with student potential.

ABSTRACT The decomposition of soil organic carbon within tropical peatlands is influenced by the functional composition of the microbial community. In this study, building upon our previous work, we recovered a total of 28 metagenome-assembled genomes (MAGs) classified as Bathyarchaeia from the tropical peatlands of the Pastaza-Marañón Foreland Basin (PMFB) in the Amazon. Using phylogenomic analyses, we identified nine genus-level clades to have representatives from the PMFB, with four forming a putative novel family (“Candidatus Paludivitaceae”) endemic to peatlands. We focus on the Ca. Paludivitaceae MAGs due to the novelty of this group and the limited understanding of their role within tropical peatlands. Functional analysis of these MAGs reveals that this putative family comprises facultative anaerobes, possessing the genetic potential for oxygen, sulfide, or nitrogen oxidation. This metabolic versatility can be coupled to the fermentation of acetoin, propanol, or proline. The other clades outside Ca. Paludivitaceae are putatively capable of acetogenesis and de novo amino acid biosynthesis and encode a high amount of Fe3+ transporters. Crucially, the Ca. Paludivitaceae are predicted to be carboxydotrophic, capable of utilizing CO for energy generation or biomass production. Through this metabolism, they could detoxify the environment from CO, a byproduct of methanogenesis, or produce methanogenic substrates like CO2 and H2. Overall, our results show the complex metabolism and various lineages of Bathyarchaeia within tropical peatlands pointing to the need to further evaluate their role in these ecosystems.IMPORTANCEWith the expansion of the Candidatus Paludivitaceae family by the assembly of 28 new metagenome assembled genomes, this study provides novel insights into their metabolic diversity and ecological significance in peatland ecosystems. From a comprehensive phylogenic and functional analysis, we have elucidated their putative unique facultative anaerobic capabilities and CO detoxification potential. This research highlights their crucial role in carbon cycling and greenhouse gas regulation. These findings are essential for resolving the microbial processes affecting peat soil stability, offering new perspectives on the ecological roles of previously underexplored and underrepresented archaeal populations.

Background Hypertrophic cardiomyopathy (HCM) is an inherited disorder whose causal variants involve sarcomeric protein genes. One of these is myosin-binding protein C (MYBPC3), being previously associated with a favourable prognosis. Our objective is to describe the clinical characteristics and events of a molecularly homogeneous HCM cohort associated with truncating MYBPC3 variants.Methods and results A cohort of patients and relatives with HCM diagnosis and carrying a truncating MYBPC3 variant were retrospectively recruited. Subjects had an average follow-up of 7.77 years, with an incident HCM phenotype of 10%. They were middle-aged adult patients (47±16.8 years) without significant comorbidities or symptoms. Hypertrophy was discrete with a significative difference between probands and relatives (17.5±4 mm vs 14.6±5 mm; p

Not available.

Los Hermanos Díaz Barraza fueron un dúo de compositores criollos que creó su producción musical entre las décadas de 1950 y 1980. A pesar de contar con un amplio repertorio, sus canciones corren el riesgo de pasar al olvido, ya que solo se conservan en la memoria de sus círculos familiares y amicales. Por ello, uno de los objetivos de este artículo es reconocer y difundir la obra de estos compositores. Para lograrlo, se recopilaron sus canciones y se realizaron entrevistas, transcripciones y análisis musical de tres piezas. Los resultados del análisis comparativo determinaron una evolución en su estilo compositivo, y afirmaron la importancia histórica de la obra musical de los compositores para la música criolla, especialmente para el distrito de Breña, vecindario donde crecieron y vivieron la mayor parte de sus vidas.

The green seaweed Ulva fenestrata is a future food candidate, however, both compositional, e.g. protein content, and sensory qualities depend on cultivation and harvest conditions. The aim was to explore sensory qualities of, and consumer attitudes to, U. fenestrata derived from three different cultivation conditions and three harvest times. U. fenestrata was cultivated at sea and in two different land-based tank settings, one mimicking seawater and one with added process water from fishing industry to increase protein content. The seaweed was subjected to sensory analysis performed by an analytical sensory panel and a focus group consisting of consumers. The former assessed the seaweed as dried whole blades (9 samples) and as emulsions (9 samples). Consumers assessed whole blades and a vegan spread enriched with powdered U. fenstrata. All seaweed samples were intensely green; had tastes of umami, salt, bitter, and sour; odours and flavours of grass and fresh seaweed; and had a crispy texture. Cultivation in tanks resulted in a crispier texture than sea cultivation (p

Background Although genetic variants in MYH7 are the most frequent cause of pediatric genetic dilated cardiomyopathy (DCM), there are no studies available describing this entity. We sought to describe clinical features, analyze variant location, and explore predictors of bad prognosis in pediatric MYH7‐related DCM. Methods and Results We evaluated clinical records from 44 patients (24 men; median age at diagnosis, 0.54 [interquartile range, 0.01–10.8] years) with pathogenic/likely pathogenic variants in MYH7 diagnosed with DCM at pediatric age (

Objetivos: Identificar e avaliar a frequência de doadores que se autoexcluiram, comparar porcentuais de testes sorológicos positivos entre doadores que se autoexcluiram e que não se autoexcluiram. Material e métodos: Coletados dados do sistema informatizado dos Hemonúcleos/Postos de Coleta da COLSAN, da capital (Ermelino Matarazzo, Tatuapé, Campo Limpo e Vergueiro), de outros municípios do interior do estado (Sorocaba e Jundiaí), Santos, e dos postos da região do ABC (Mauá, Santo Andre - H. Mário Covas, São Caetano e São Bernardo do Campo). Foram utilizados para análise, os dados do período de janeiro de 2023 a janeiro de 2024. As análises comparativas foram feitas utilizando-se o teste do qui-quadrado, considerando-se valores menores ou iguais a 0,05 como com significancia estatística. Resultados: Foram computadas 730 autoexclusões de um total de 180.300 doadores. Levando-se em conta os valores totais (todos os postos de coleta) obtidos na pesquisa, foram encontradas positividades sorológicas em 4,38% dentre os doadores que se autoexcluiram (32 de 730) e 1,90% dentre os que não se autoexcluíram (3.426 de 179.570). Dividindo entre postos da cidade de São Paulo (capital) e demais cidades do estudo, no primeiro grupo dos valores totais, a positividade se deu em 5,26% dos doadores que se autoexcluiram (9 de 171) e 2,26% dos que não se autoexcluiram (803 de 35.789); e do segundo grupo, essa positividade se deu em 4,11% nos que se autoexcluiram e 1,83% nos que não se autoexcluiram. Estes valores apresentaram significância estatística (p ≤ 0,05). Considerando avaliação sobre cada sorologia específica, em comparação com os doadores que não se autoexcluiram, encontramos maior porcentagem de positividade sorológica naqueles que se autoexcluiram para sífilis, HIV e Nat HIV com significância estatística (p ≤ 0,05). Na divisão entre cidade de São Paulo e demais cidades, observamos: no primeiro grupo, a relação de sorologias positivas com significância estatística se deu para Sífilis, Chagas, HIV e Nat HIV; e no segundo grupo Sífilis, Nat HIV e anti-HBC. Discussão: O voto de autoexclusão foi implementado no processo de doação de sangue, ao final da entrevista e de modo confidencial, a fim de aumentar a segurança do processo transfusional, em que o doador pode indicar alguma inadequação que faça do seu sangue maior risco de contaminação por infecções que, eventualmente, poderiam passar sem ser identificados por conta da janela imunológica. Observamos que os dados sorológicos coletados neste estudo foram superiores naqueles que se autoexcluiram, tanto em valores totais quanto em diversas sorologias específicas. Isso vai ao encontro com o objetivo da implementação da autoexclusão no processo da coleta de sangue, corroborando para a segurança do processo ao impedir a doação e possível contaminação com agentes infecciosos. Conclusão: A autoexclusão, instituída para aprimoramento da segurança no processo de doação de sangue, mostra-se importante e eficiente.

Background: Serodiagnosis of TORCH infections should be performed in pre-pregnancy and reproductive-age women to prevent vertical transmission. Herein, we conducted a 5-year cross-sectional retrospective study in childbearing age women to provide prevalence data. Also, stratifying the cohort into three age groups, we identified those most susceptible to acute TORCH infections. Methods: Between 2019 and 2023, serum samples from 2286 childbearing age women attending the “R. Dulbecco” University Hospital of Catanzaro were collected. Screening for TORCH pathogens, such as: Toxoplasma gondii (TOX), Cytomegalovirus (CMV), Rubella Virus (RUB), Parvovirus B19 (ParvoB19), Herpes Simplex Virus types 1 and 2 (HSV1, HSV2) and Treponema pallidum was carried out using serological tests. Chemiluminescent immunoassay was performed to detect TOX, CMV and ParvoB19 Immunoglobulin M (IgM) and Immunoglobulin G (IgG) antibodies, while Enzyme Linked Fluorescent Assay was performed to detect RUB IgM and IgG antibodies and CMV and TOX IgG Avidity. Enzyme Linked Immunosorbent Assay was performed to detect HSV1 IgG, HSV2 IgG, HSV1/2 IgM, T. pallidum total antibodies and RUB IgG Avidity. Binomial logistic regression models were developed to compare seroprevalence rates among different age groups. Results: The highest immunological protection was observed for RUB infection (87 %), probably associated with vaccination practice, followed by HSV1 and CMV (82 % and 63 %). The 16–25 year age group results as the most susceptible to acute infections as demonstrated by odds of CMV IgM positivity (primary infection) which decreased with age. Conclusions: The TORCH serological screening program should be implemented in women before pregnancy to formulate strategies for serological screening of childbearing age women and guiding clinicians in making decisions.

Abstract Epilepsy surgery is effective for patients with medication-resistant seizures, however 20–40% of them are not seizure free after surgery. Aim of this study is to evaluate the role of linear and non-linear EEG features to predict post-surgical outcome. We included 123 paediatric patients who underwent epilepsy surgery at Bambino Gesù Children Hospital (January 2009–April 2020). All patients had long term video-EEG monitoring. We analysed 1-min scalp interictal EEG (wakefulness and sleep) and extracted 13 linear and non-linear EEG features (power spectral density (PSD), Hjorth, approximate entropy, permutation entropy, Lyapunov and Hurst value). We used a logistic regression (LR) as feature selection process. To quantify the correlation between EEG features and surgical outcome we used an artificial neural network (ANN) model with 18 architectures. LR revealed a significant correlation between PSD of alpha band (sleep), Mobility index (sleep) and the Hurst value (sleep and awake) with outcome. The fifty-four ANN models gave a range of accuracy (46–65%) in predicting outcome. Within the fifty-four ANN models, we found a higher accuracy (64.8% ± 7.6%) in seizure outcome prediction, using features selected by LR. The combination of PSD of alpha band, mobility and the Hurst value positively correlate with good surgical outcome.

Anatomical votives have largely been considered by scholars in connection with Roman expansion in Central Italy. Within this ‘religious romanization’ frame, scholars have viewed the presence of the anatomical terracottas of the 4th–2nd cc. BC as the material manifestation of Roman presence in the religious sphere of the Italian peninsula. This paper presents the results from recent and ongoing archaeological studies on pre-Roman sanctuaries in Central and Northern Italian and focuses on the presence of bronze body parts among their votive offerings. The data allows for a reconsideration of the influence of Rome on local religious traditions and sheds light on the mechanism of continuity and change after the Roman expansion.

El objetivo de este artículo es examinar las narrativas digitales sobre la inmigración de Venezuela entre los y las usuarias colombianas. Para ello, se analiza el debate político sobre este colectivo en la plataforma X/Twitter en Colombia. La muestra está conformada por los tuits que fueron categorizados según una tipología de encuadres genéricos y específicos diseñada para este análisis de contenido. De un corpus de 160.095 tuits con hashtags sobre esta migración, se filtraron 15.703 tuits originales. Los resultados sugieren la pervivencia de la polarización respecto a los tipos de encuadre utilizados. Los de tipo genérico responden a ejes temáticos; los específicos, a mensajes que encuadran mayoritariamente a los migrantes como víctimas de un conflicto o crisis humanitaria (25 % y 17,3 %). Quienes los sitúan en el frame de la amenaza fiscal o del orden público suman un 26,7 %. Los datos obtenidos apuntan a que es esencial promover un debate público informado y constructivo sobre la migración venezolana en Colombia. Esto implica, no solo abordar la desinformación y los discursos de odio, sino también proporcionar espacios para que las voces de los migrantes y las comunidades receptoras sean escuchadas y tenidas en cuenta en el debate público y en la toma de decisiones políticas.

Background Aficamten, a novel cardiac myosin inhibitor, reversibly reduces cardiac hypercontractility in obstructive hypertrophic cardiomyopathy. We present a prespecified analysis of the pharmacokinetics, pharmacodynamics, and safety of aficamten in SEQUOIA‐HCM (Safety, Efficacy, and Quantitative Understanding of Obstruction Impact of Aficamten in HCM). Methods and Results A total of 282 patients with obstructive hypertrophic cardiomyopathy were randomized 1:1 to daily aficamten (5–20 mg) or placebo between February 1, 2022, and May 15, 2023. Aficamten dosing targeted the lowest effective dose for achieving site‐interpreted Valsalva left ventricular outflow tract gradient

Background: Wild-type transthyretin amyloidosis (ATTRwt amyloidosis) is primarily diagnosed in elderly men but diagnoses in younger patients and women have recently increased. Objectives: The purpose of this study was to examine age- and sex-related differences in patients with ATTRwt amyloidosis enrolled in the THAOS (Transthyretin Amyloidosis Outcomes Survey). Methods: THAOS was a global, longitudinal, observational survey of patients with transthyretin amyloidosis, including both hereditary and wild-type disease, and asymptomatic carriers of pathogenic transthyretin gene variants. Patient characteristics at enrollment were analyzed by age at enrollment and sex (data cutoff date: August 1, 2022). Results: Of 1,251 patients with ATTRwt amyloidosis, 13.7%, 49.1%, 34.5%, and 2.8% were aged

Tissue engineering (TE) offers promising solutions for regenerative medicine through the use of porous scaffolds and cells, providing a favorable environment for the production of functional three-dimensional (3D) tissues. However, TE strategies have faced physiological limitations with static three-dimensional culture alone, and perfusion bioreactors provide a controlled environment that better mimics native tissue. In this study, we present the optimized geometry of an existing custom-made perfusion bioreactor that utilizes an external airlift circulation loop, essentially a specially structured bubble column designed for the simultaneous allocation of multiple seeded scaffolds. By reducing volumes and materials, the optimized system maintains the same level of reliability and functionality. The study employs computational fluid dynamics (CFD) analysis and a mathematical model to gain insights into fluid flow and oxygen transport, respectively. Therefore, in line with the increasingly recognized trend of device miniaturization, scaling down the initial device would enable high-speed analysis of cellular response in perfused cultures, allowing the study of various morphologies, different cell populations, or different drug treatments. Furthermore, the possibility of creating series and parallel connections between multiple devices, while maintaining dimensions suitable for incubator insertion, demonstrates the potential of this system for testing engineered constructs while simultaneously enabling time and cost reduction compared to existing perfusion devices in the field of Tissue Engineering.

Summary: During COVID-19 in the US, social determinants of health (SDH) have driven health disparities. However, the use of SDH in COVID-19 vaccine modeling is unclear. This review aimed to summarize the current landscape of incorporating SDH into COVID-19 vaccine transmission modeling in the US. Medline and Embase were searched up to October 2022. We included studies that used transmission modeling to assess the effects of COVID-19 vaccine strategies in the US. Studies’ characteristics, factors incorporated into models, and approaches to incorporate these factors were extracted. Ninety-two studies were included. Of these, 11 studies incorporated SDH factors (alone or combined with demographic factors). Various sets of SDH factors were integrated, with occupation being the most common (8 studies), followed by geographical location (5 studies). The results show that few studies incorporate SDHs into their models, highlighting the need for research on SDH impact and approaches to incorporating SDH into modeling. Funding: This research was funded by the Centers for Disease Control and Prevention (CDC).