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Abstract The characteristics of the host are crucial in the final outcome of COVID-19. Herein, the influence of genetic and clinical variants in COVID-19 severity was investigated in a total of 1350 patients. Twenty-one single nucleotide polymorphisms of genes involved in SARS-CoV-2 sensing as Toll-like-Receptor 7, antiviral immunity as the type I interferon signalling pathway (TYK2, STAT1, STAT4, OAS1, SOCS) and the vasoactive intestinal peptide and its receptors (VIP/VIPR1,2) were studied. To analyse the association between polymorphisms and severity, a model adjusted by age, sex and different comorbidities was generated by ordinal logistic regression. The genotypes rs8108236-AA (OR 0.12 [95% CI 0.02–0.53]; p = 0.007) and rs280519-AG (OR 0.74 [95% CI 0.56–0.99]; p = 0.03) in TYK2, and rs688136-CC (OR 0.7 [95% CI 0.5–0.99]; p = 0.046) in VIP, were associated with lower severity; in contrast, rs3853839-GG in TLR7 (OR 1.44 [95% CI 1.07–1.94]; p = 0.016), rs280500-AG (OR 1.33 [95% CI 0.97–1.82]; p = 0.078) in TYK2 and rs1131454-AA in OAS1 (OR 1.29 [95% CI 0.95–1.75]; p = 0.110) were associated with higher severity. Therefore, these variants could influence the risk of severe COVID-19.

Abstract This study examines the biological effects of palbociclib and ribociclib in hormone receptor-positive breast cancer, pivotal to the HARMONIA prospective phase III clinical trial. We explore the downstream impacts of these CDK4/6 inhibitors, focusing on cell lines and patient-derived tumor samples. We treated HR+ breast cancer cell lines (T47D, MCF7, and BT474) with palbociclib or ribociclib (100 nM or 500 nM), alone or combined with fulvestrant (1 nM), over periods of 24, 72, or 144 h. Our assessments included PAM50 gene expression, RB1 phosphorylation, Lamin-B1 protein levels, and senescence-associated β-galactosidase activity. We further analyzed PAM50 gene signatures from the CORALLEEN and NeoPalAna phase II trials. Both CDK4/6 inhibitors similarly inhibited proliferation across the cell lines. At 100 nM, both drugs partially reduced p-RB1, with further decreases at 500 nM over 144 h. Treatment led to reduced Lamin-B1 expression and increased senescence-associated β-galactosidase activity. Both drugs enhanced Luminal A and reduced Luminal B and proliferation signatures at both doses. However, the HER2-enriched signature significantly diminished only at the higher dose of 500 nM. Corresponding changes were observed in tumor samples from the CORALLEEN and NeoPalAna studies. At 2 weeks of treatment, both drugs significantly reduced the HER2-enriched signature, but at surgery, this reduction was consistent only with ribociclib. Our findings suggest that while both CDK4/6 inhibitors effectively modulate key biological pathways in HR+/HER2- breast cancer, nuances in their impact, particularly on the HER2-enriched signature, are dose-dependent, influenced by the addition of fulvestrant and warrant further investigation.

Abstract Genome-wide association studies have identified thousands of loci associated with common diseases and traits. However, a large fraction of heritability remains unexplained. Epigenetic modifications, such as the observed in DNA methylation have been proposed as a mechanism of intergenerational inheritance. To investigate the potential contribution of DNA methylation to the missing heritability, we analysed the methylomes of four healthy trios (two parents and one offspring) using whole genome bisulphite sequencing. Of the 1.5 million CpGs (19%) with over 20% variability between parents in at least one family and compatible with a Mendelian inheritance pattern, only 3488 CpGs (0.2%) lacked correlation with any SNP in the genome, marking them as potential sites for intergenerational epigenetic inheritance. These markers were distributed genome-wide, with some preference to be located in promoters. They displayed a bimodal distribution, being either fully methylated or unmethylated, and were often found at the boundaries of genomic regions with high/low GC content. This analysis provides a starting point for future investigations into the missing heritability of simple and complex traits.

Abstract The bundle of forest landowners’ rights largely varies from one jurisdiction to another. On a global scale, the diversity of forest management regime and property rights systems is such that finding comprehensive and standardised approaches for governance analysis purposes is a challenging task. This paper explores the use of the Property Rights Index for Forestry (PRIF) as an analytical tool based on five rights domains (access, withdrawal, management, exclusion, and alienation) to assess how regulatory frameworks impact the owners’ forest property rights. We show that PRIF is a reliable index for various governance arrangements, considering its ability to score forest owners’ freedom to decide in case studies that range from the Amazon area (Brazil), Misiones province (Argentina) and Quebec (Canada) to community-managed Nepalese and Mexican forests. PRIF scores obtained in these diverse governance arrangements confirm that the governance of forests held by entities other than the state is driven by two factors: the owner’s ability to exclude the public from the use of his/her own resource and the owner’s freedom to decide on the forest management goals. These factors explained 66.44% of the variance in our sample and should be considered as the main potential drivers while implementing any new international or national policy. Despite having a few limitations, the PRIF is a promising governance indicator and has been proven to perform well for various socioeconomic and legal contexts.

The combined treatment with calcipotriol (Cal) and betamethasone dipropionate (BDP) has emerged as the leading anti-psoriatic topical treatment. Fixed-dose Cal/BDP is available in different formulations, including ointment, gel, foam, and cream. This review examines the mechanism of action of Cal/BDP underlying its therapeutic effect and compiles the evidence regarding its efficacy and safety compared to monotherapy with topical corticosteroids. The dual-action of Cal/BDP targets the inflammatory pathways and abnormal keratinocyte proliferation, both of them fundamental mechanisms of psoriasis pathogenesis. A large number of randomized, double-blind studies support Cal/BDP superiority over topical corticosteroids, demonstrating its broad efficacy across several degrees of psoriasis severity and its capability to provide early significant clinical improvements. This increased efficacy is achieved without negative effects on the safety profile, since the incidence of adverse effects reported with Cal/BDP is usually similar to that of BDP and even lower than that of Cal alone. The combination therapy rapid onset of action, coupled with a simplified dosing regimen, has been identified as crucial for improving long-term adherence and patient outcomes. In conclusion, Cal/BDP is confirmed as a versatile, effective, and convenient option for the patient in psoriasis management.

Background/Objectives: Chronic systemic inflammation is a risk factor that increases the development of atherosclerosis and predisposes to cardiovascular diseases (CVDs). The systemic inflammatory profile of alopecia areata (AA) regarding IFNγ and Th1 cytokine dysregulation has previously been described, suggesting an increased incidence of CVDs in this population. No previous studies investigated the possible relationship between atherosclerosis and AA by cardiovascular imaging techniques. To determine the prevalence, distribution and burden of subclinical atherosclerosis in AA. Methods: We conducted a case–control study in 62 participants, including 31 patients with severe AA (SALT > 75) and 31 healthy controls, matched for age, sex and body mass index (BMI). The participants underwent a detailed history assessment and were subjected to the measurement of weight, height, abdominal circumference and blood pressure. A fasting blood sample was also collected. Subclinical atherosclerosis was evaluated by ultrasonography of the bilateral femoral and carotid arteries. Results: The AA patients had an increased prevalence of subclinical atherosclerosis (54.7%) compared to the healthy controls (22.6%, p = 0.010). The prevalence of atheroma plaques was significantly higher in the carotid arteries (41.90% vs. 12.9%, p = 0.009), while no significant differences were found in femoral plaque prevalence. The AA patients with atherosclerotic plaques were older (p < 0.001) and had a longer time since AA diagnosis (p = 0.11) and increased serum levels of glycated hemoglobin (p = 0.029) and triglycerides (p = 0.009). In a regression analysis, duration of disease and neutrophil/lymphocyte ratio were the main predictors of atherosclerosis. Conclusions: AA patients have an increased prevalence of carotid subclinical atherosclerosis. The duration of AA, systemic inflammation and insulin resistance appear to play a role in the development of subclinical atherosclerosis in this population.

The intricate process of neuronal differentiation integrates multiple signals to induce transcriptional, morphological, and electrophysiological changes that reshape the properties of neural precursor cells during their maturation and migration process. An increasing number of neurotransmitters and biomolecules have been identified as molecular signals that trigger and guide this process. In this sense, taurine, a sulfur-containing, non-essential amino acid widely expressed in the mammal brain, modulates the neuronal differentiation process. In this study, we describe the effect of taurine acting via the ionotropic GABAA receptor and the metabotropic GABAB receptor on the neuronal differentiation and electrophysiological properties of precursor cells derived from the subventricular zone of the mouse brain. Taurine stimulates the number of neurites and favors the dendritic complexity of the neural precursor cells, accompanied by changes in the somatic input resistance and the strength of inward and outward membranal currents. At the pharmacological level, the blockade of GABAA receptors inhibits these effects, whereas the stimulation of GABAB receptors has no positive effects on the taurine-mediated differentiation process. Strikingly, the blockade of the GABAB receptor with CGP533737 stimulates neurite outgrowth, dendritic complexity, and membranal current kinetics of neural precursor cells. The effects of taurine on the differentiation process involve Ca2+ mobilization and the activation of intracellular signaling cascades since chelation of intracellular calcium with BAPTA-AM, and inhibition of the CaMKII, ERK1/2, and Src kinase inhibits the neurite outgrowth of neural precursor cells of the subventricular zone.

Introduction The role of photobiomodulation (PBM) therapy for oral tissue damage induced by cancer treatment is currently unclear, and there is low-quality to moderate-quality evidence supporting the use of this approach for treating xerostomia and/or hyposalivation. Consequently, patients with head and neck cancer increasingly turn to basic oral hygiene to alleviate salivary gland dysfunction, and their adherence can be improved by mobile health (mHealth) education. The primary objective of this study will be to analyse the effects of different doses of PBM therapy (7.5 J/cm2 vs 3 J/cm2) plus mHealth education on quality of life (QoL), oral health, salivary secretion and salivary gland ultrasound assessment at postintervention and at the 6-month follow-up in patients with head and neck cancer after radiotherapy compared with those in control group.Methods and analysis A prospective, three-arm, randomised, placebo-controlled, double-blinded study will be conducted among patients with head and neck cancer suffering from chronic xerostomia. A total of 20 patients per arm will be included and randomly assigned to receive 7.5 J/cm2 of PBM, 3 J/cm2 of PBM or placebo therapy. PBM therapy will be applied during 24 sessions at 22 points extra and intraorally two times per week for 3 months, combined with a mobile application (https://www.laxer.es). The assessments will be recorded at the beginning of the study, at postintervention and at the 6-month follow-up. The primary outcomes will be QoL, oral health, salivary secretion and salivary gland ultrasound. The pain pressure threshold, functional performance, mood and sleep quality will be secondary indicators.Ethics and dissemination This study received ethics approval from the Andalusian Biomedical Research Ethics Portal (2402-N-21 CEIM/CEI Provincial de Granada) according to the Declaration of Helsinki for Biomedical Research. The results of this study will be presented at national and international conferences and published in peer-reviewed journals.Trial registration number ClinicalTrials.gov NCT05106608.

Background Cachichín (Oecopetalum mexicanum Greenm. & C.H. Thomps: Metteniusaceae) is an arboreal species native to the Misantla mountain range, Veracruz, Mexico, whose fruit contains an edible seed with potential nutraceutical properties. Basic biochemical analyses have been performed, though the effects of thermal treatments on the concentration of vital molecules, the seed structure and the histochemistry have yet to be elicited. Herewith we determined the effect of different thermal treatments on the concentrations of total sugars; glucose and fructose; proteins; and amino acids; as well as the impact of such treatments on the anatomy and histochemistry of seeds. Methods Biochemical, anatomical, and histochemical characterizations of the cachichín seed were carried out in raw form (T1) and under three thermal treatments: boiled (T2), commercial toasting (T3), and controlled toasting (T4). The biochemical variables evaluated were total and reducing sugars, total proteins, and total amino acids. Observations of the seed structure were performed by scanning electron microscopy (SEM), while histochemical staining was carried out to identify starch, lipids, tannins, polysaccharides and proteins under compound light microscopy. Results Concentration of total sugars was reduced in boiled (T2) and commercial toasting (T3) seeds as compared to raw (T1) and controlled toasting (T4) seeds; boiled seeds (T3) displayed the lowest concentration of total sugars. An increase in the concentrations of glucose and fructose was observed in T4. As compared to T1, all other treatments did not change protein concentrations in the seed; the only significant difference observed was between T2 and T3, with commercial toasting displaying the highest mean for this variable. Amino acid concentrations decreased in T3 and T4 compared to T1, while in T2 the concentration of these molecules increased. The anatomic analysis of (T1) revealed a well-organized structure, compared to applied thermal treatments, where degradation of anatomical structures was observed. In general, the thermal treatments tested modified the concentrations and distribution of starch, lipids, tannins, polysaccharides and proteins as compared to raw seeds. The raw cachichín seed has a well-defined anatomical and cellular compartmental organization, while the application of the thermal treatments caused a loss of its structural organization and degradation of vital biomolecules. Conclusion The cachichín seed can be considered a good source of proteins and lipids. Thermal treatments can improve its organoleptic properties, though they negatively impact its nutritional value and anatomical structure. Among thermal treatments tested, the controlled toasting can maintain or even improve some nutraceutical properties with a few structural and biochemical modifications.

Cellular senescence and low-grade inflammation favor the acceleration of aging. The liver is an essential metabolic organ because changes related to its function are related to age-related diseases. The objective of this study was to evaluate the effects of maraviroc (MVC) and/or rapamycin (RAPA) on liver tissue in an experimental model of frailty syndrome in mice, since MVC and RAPA are two molecules able to decrease CCR5 expression, which is overexpressed in patients with frailty. Methods: Eighty male homozygous IL10KO mice were randomly assigned to one of 4 groups (n = 20): i) IL10KO group; ii) MVC group, iii) RAPA group, and iv) MVC-RAPA group. Liver samples were analyzed. Gene expression quantification and western blotting were also performed. The proinflammatory cytokines IL-6 and IL-18 were decreased in MVC and MVC/RAPA groups, IL-12 was decreased in RAPA and MVC/RAPA groups and TNF-α was decreased in all therapeutic groups. P21 was decreased in RAPA and MVC/RAPA groups, Galactosidase beta-1, was also significantly reduced in all therapeutic groups, as were NF-kB1, NF-kB2 and STAT3. In all groups, mTOR and CCL5 were significantly reduced. CCR5 expression was decreased in the MVC and MVC/RAPA groups. Conclusion: MVC and RAPA may protect against some factors involved in liver aging. More studies will be necessary to verify their clinical applications.

The occurrence of fungi is cosmopolitan, and while some mushroom species are beneficial to human health, others can be toxic and cause illness problems. This study aimed to analyze the organoleptic, ecological, and morphological characteristics of a group of fungal specimens and identify the most significant features to develop models for fungal toxicity classification using genetic algorithms and LASSO regression. The results of the study indicated that odor, spore print color, and habitat were the most significant characteristics identified by the genetic algorithm GALGO. Meanwhile, odor, gill size, stalk shape, and twelve other features were the relevant characteristics identified by LASSO regression. The importance score of the odor variable was 99.99%, gill size obtained 73.7%, stalk shape scored 39.9%, and the remaining variables did not score higher than 18%. Logistic regression, k-nearest neighbor (KNN), and XG-Boost classification algorithms were used to develop models using the features selected by both GALGO and LASSO. The models were evaluated using sensitivity, specificity, and accuracy metrics. The models with the highest AUC values were XGBoost, with a maximum value of 0.99 using the features selected by LASSO, followed by KNN with a maximum value of 0.99. The GALGO selection resulted in a maximum AUC of 0.98 in KNN and XGBoost. The models developed in this study have the potential to aid in the accurate identification of toxic fungi, which can prevent health problems caused by their consumption.

Abstract Facultative colour change is widespread in the animal kingdom, and has been documented in many distantly related amphibians. However, experimental data testing the extent of facultative colour change, and associated physiological and morphological implications are comparatively scarce. Background matching in the face of spatial and temporal environmental variation is thought to be an important proximate function of colour change in aquatic amphibian larvae. This is particularly relevant for species with long larval periods such as the western spadefoot toad, Pelobates cultripes, whose tadpoles spend up to six months developing in temporary waterbodies with temporally variable vegetation. By rearing tadpoles on different coloured backgrounds, we show that P. cultripes larvae can regulate pigmentation to track fine-grained differences in background brightness, but not hue or saturation. We found that colour change is rapid, reversible, and primarily achieved through changes in the quantity of eumelanin in the skin. We show that this increased eumelanin production and/or maintenance is also correlated with changes in morphology and oxidative stress, with more pigmented tadpoles growing larger tail fins and having an improved redox status.

Abstract We present a Lie algebraic approach to a Hamiltonian class covering driven, parametric quantum harmonic oscillators where the parameter set—mass, frequency, driving strength, and parametric pumping—is time-dependent. Our unitary-transformation-based approach provides a solution to our general quadratic time-dependent quantum harmonic model. As an example, we show an analytic solution to the periodically driven quantum harmonic oscillator without the rotating wave approximation; it works for any given detuning and coupling strength regime. For the sake of validation, we provide an analytic solution to the historical Caldirola–Kanai quantum harmonic oscillator and show that there exists a unitary transformation within our framework that takes a generalized version of it onto the Paul trap Hamiltonian. In addition, we show how our approach provides the dynamics of generalized models whose Schrödinger equation becomes numerically unstable in the laboratory frame.

Objetivo. Contrastar las características del proceso de acreditación de establecimientos de salud en Canadá, Chile, la Comunidad Autónoma de Andalucía, Dinamarca y México, con el fin de identificar elementos comunes y diferencias, y las lecciones aprendidas que puedan ser de utilidad para otros países y regiones. Métodos. Estudio observacional, analítico y retrospectivo en el que se usaron fuentes secundarias de libre acceso sobre acreditación y certificación de establecimientos de salud durante el período 2019-2021 en estos países y regiones. Se describen las características generales del proceso de acreditación y sus respuestas a puntos clave del diseño de estos programas. Además, se generaron categorías de análisis para el avance en su implementación y su nivel de complejidad, y se resumen los resultados favorables y desfavorables informados. Resultados. Los componentes operativos del proceso de acreditación son peculiares de cada país, aunque comparten similitudes. El programa de Canadá es el único que contempla algún tipo de evaluación responsiva. Hay una amplia variación en la cobertura de establecimientos acreditados entre países (desde 1% en México a 34,7% en Dinamarca). Entre las lecciones aprendidas, se destacan la complejidad de aplicación del sistema mixto público-privado (Chile), el riesgo de una excesiva burocratización (Dinamarca) y la necesidad de incentivos claros (México). Conclusiones. Los programas de acreditación operan de forma peculiar en cada país o región, logran alcances diferentes y presentan problemáticas también diversas, de las que podemos aprender. Es necesario considerar los elementos que obstaculizan la implementación y generar adecuaciones para los sistemas de salud en cada país o región.

Summary: Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health.

The Chembio DPP (Dual Path Platform) Syphilis Screen & Confirm kit (https://chembio.com) is a rapid serologic test that can be used to diagnose yaws. We evaluated its capacity to detect patients with ulcers that tested PCR positive for Treponema pallidum subsp. pertenue. DPP detected 84% of ulcers that were positive by PCR.

Abstract Background Several studies have described potential microRNA (miRNA) biomarkers associated with migraine, but studies are scarcely reproducible primarily due to the heterogeneous variability of participants. Increasing evidence shows that disease-related intrinsic factors together with lifestyle (environmental factors), influence epigenetic mechanisms and in turn, diseases. Hence, the main objective of this exploratory study was to find differentially expressed miRNAs (DE miRNA) in peripheral blood mononuclear cells (PBMC) of patients with migraine compared to healthy controls in a well-controlled homogeneous cohort of non-menopausal women. Methods Patients diagnosed with migraine according to the International Classification of Headache Disorders (ICHD-3) and healthy controls without familial history of headache disorders were recruited. All participants completed a very thorough questionnaire and structured-interview in order to control for environmental factors. RNA was extracted from PBMC and a microarray system (GeneChip miRNA 4.1 Array chip, Affymetrix) was used to determine the miRNA profiles between study groups. Principal components analysis and hierarchical clustering analysis were performed to study samples distribution and random forest (RF) algorithms were computed for the classification task. To evaluate the stability of the results and the prediction error rate, a bootstrap (.632 + rule) was run through all the procedure. Finally, a functional enrichment analysis of selected targets was computed through protein–protein interaction networks. Results After RF classification, three DE miRNA distinguished study groups in a very homogeneous female cohort, controlled by factors such as demographics (age and BMI), life-habits (physical activity, caffeine and alcohol consumptions), comorbidities and clinical features associated to the disease: miR-342-3p, miR-532-3p and miR-758-5p. Sixty-eight target genes were predicted which were linked mainly to enriched ion channels and signaling pathways, neurotransmitter and hormone homeostasis, infectious diseases and circadian entrainment. Conclusions A 3-miRNA (miR-342-3p, miR-532-3p and miR-758-5p) novel signature has been found differentially expressed between controls and patients with migraine. Enrichment analysis showed that these pathways are closely associated with known migraine pathophysiology, which could lead to the first reliable epigenetic biomarker set. Further studies should be performed to validate these findings in a larger and more heterogeneous sample.

Chronic exposure to potentially toxic elements (PTEs) such as cadmium (Cd) leads to male reproductive toxicity through the generation of oxidative stress. Spirulina Arthrospira maxima (AM) is a cyanobacterium that has been consumed since ancient times for its high nutritional value, and in recent years for its antiviral, hepatoprotective, hypoglycemic, anticancer, and antioxidant effects, among others. This study aimed to evaluate the effects of AM against the damage to reproductive health induced by Cd. A total of 48 10-week-old sexually experienced male Wistar rats were distributed in five groups (n = 8): control; vehicle (tween-water); cadmium chloride (CdCl2) 5 mg/kg; and three doses of AM (100, 200 and 400 mg/kg) + CdCl2 5 mg/kg. All treatments were orally administered once a day for 36 consecutive days. At the end, sexual behavior was evaluated, and semen, testicle, and blood samples were obtained to analyze sperm quality, enzymatic activity, and testosterone levels, respectively. Rats exposed to Cd showed a decrease in sexual behavior, as well as in the quality of reproductive health, and an increase in oxidative stress; while rats exposed simultaneously to AM + Cd showed an improvement in all this parameters. Based on our results, we believe that the mechanism by which AM exerts its effect could be attributed to the presence of phycobiliproteins. These compounds are responsible for exerting an antioxidant effect and chelating effect on elements such as Cd.

Abstract To describe congenital and acquired heart diseases in a Spanish cohort of adults with Down syndrome (DS), which could inform potential health recommendations for this population. Cross-sectional, observational study of adults with DS evaluated consecutively at a tertiary care, outpatient center between January 1 and December 31, 2019. The study population comprised 937 patients (51.8% men; median [IQR] age, 42 [18] years). An echocardiogram was available in the clinical chart of 420 patients (44.8%). The diagnosis of any form of heart disease was confirmed in 211 patients (22.5%): 101 (10.8%) had congenital heart defects, 80 (8.5%) simultaneous congenital and valvular heart diseases, and 30 (3.2%) isolated valvular heart disease. 111 patients (52.6% of those with congenital or valvular heart disease) had received corrective cardiac surgery. A total of 65 individuals were receiving medical management alone (30.8%), while 35 did not require any treatment because their cardiac disease was mild (16.6%). We found a high overall prevalence of heart disease in patients with DS, higher than previously reported for the pediatric population. Management of cardiovascular disease in adults with DS differs from that of the general population and should include universal echocardiography-based screening.

BackgroundThe high prevalence of overweight and obesity in children from Latin America (LA) have been related to obesogenic food environments. Besides, the negative effects of the Covid-19 pandemic should also be considered. The objective of this research was to describe and compare the perceptions of parents, teachers, and experts in LA of food environments at home and school that favor healthy habits in schoolchildren in pre Covid-19 stage and during the pandemic.MethodsThis study used a survey self-reporting regarding conditions at home and the school favoring healthy habits, for three profiles: parents, primary school teachers, and experts. A fisher exact test was used to establish the difference between the response categories between countries and profiles. Logistic regression models were used to determine the probability of response in the levels of importance adjusted for sex and nationality.ResultsInformation from 954 questionnaires was reported: 48.4% experts, 32.0% teachers, and 19.6% parents. There were differences in the perception of food environments at school between profiles (pConclusionsOur findings showed that parents were less likely to perceive important elements of the school food environment compared to experts and teachers. Interventions are required to improve healthy eating environments that consider children's interpersonal mediators.

Abstract Testing Neanderthal behavioural hypotheses requires a spatial–temporal resolution to the level of a human single occupation episode. Yet, most of the behavioural data on Neanderthals has been obtained from coarsely dated, time-averaged contexts affected by the archaeological palimpsest effect and a diversity of postdepositional processes. This implies that time-resolved Neanderthal behaviour remains largely unknown. In this study, we performed archaeostratigraphic analysis on stratigraphic units ive, ivf, ivg, va, vb and vc from Abric del Pastor (Alcoi, Iberian Peninsula). Further, we isolated the archaeological remains associated with the resulting archaeostratigraphic unit and applied raw material, technological, use-wear, archaeozoological and spatial analyses. Our results show a low-density accumulation of remains from flintknapping, flint tool-use and animal processing around a hearth. These data provide a time-resolved human dimension to previous high-resolution environmental and pyrotechnological data on the same hearth, representing the first comprehensive characterisation of a Neanderthal single occupation episode. Our integrated, multidisciplinary method also contributes to advance our understanding of archaeological record formation processes.

The escalating prevalence of Type 2 Diabetes (T2D) represents a substantial burden on global healthcare systems, especially in regions such as Mexico. Existing diagnostic techniques, although effective, often require invasive procedures and labor-intensive efforts. The promise of artificial intelligence and data science for streamlining and enhancing T2D diagnosis is well-recognized; however, these advancements are frequently constrained by the limited availability of comprehensive patient datasets. To mitigate this challenge, the present study investigated the efficacy of Generative Adversarial Networks (GANs) for augmenting existing T2D patient data, with a focus on a Mexican cohort. The researchers utilized a dataset of 1019 Mexican nationals, divided into 499 non-diabetic controls and 520 diabetic cases. GANs were applied to create synthetic patient profiles, which were subsequently used to train a Random Forest (RF) classification model. The study’s findings revealed a notable improvement in the model’s diagnostic accuracy, validating the utility of GAN-based data augmentation in a clinical context. The results bear significant implications for enhancing the robustness and reliability of Machine Learning tools in T2D diagnosis and management, offering a pathway toward more timely and effective patient care.

Actualmente la generación de residuos por actividades antropogénicas ha generado gran preocupación a nivel mundial principalmente debido a que uno de los desafíos a nivel mundial es garantizar la calidad del agua. Algunos disruptores endocrinos (4-nonilfenol y Bisfenol A) son uno de los compuestos más encontrados en cuerpos de agua representando impactos potenciales a la salud humana y ambiental debido a que su degradación incompleta en plantas tratadoras de agua. El presente trabajo muestra la síntesis de polímeros de impresión molecular (MIPs) con capacidad de retención mayores al 90% para ambos compuestos. Adicionalmente, se demostró la capacidad de los MIPs como coadyuvantes en la degradación de estos contaminantes para minimizar los riesgos potenciales de exposición de dichos compuestos.

Obesity has been linked to cognitive impairment through systemic low-grade inflammation. High fat and sugar diets (HFSDs) also induce systemic inflammation, either by induced Toll-like receptor 4 response, or by causing dysbiosis. This study aimed to evaluate the effect of symbiotics supplementation on spatial and working memory, butyrate concentration, neurogenesis, and electrophysiological recovery of HFSD-fed rats. In a first experiment, Sprague-Dawley male rats were given HFSD for 10 weeks, after which they were randomized into 2 groups ( n = 10 per group): water (control), or Enterococcus faecium + inulin (symbiotic) administration, for 5 weeks. In the fifth week, spatial and working memory was analyzed through the Morris Water Maze (MWM) and Eight-Arm Radial Maze (RAM) tests, respectively, with 1 week apart between tests. At the end of the study, butyrate levels from feces and neurogenesis at hippocampus were determined. In a second experiment with similar characteristics, the hippocampus was extracted to perform electrophysiological studies. Symbiotic-supplemented rats showed a significantly better memory, butyrate concentrations, and neurogenesis. This group also presented an increased firing frequency in hippocampal neurons [and a larger N -methyl- d -aspartate (NMDA)/α-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate (AMPA) current ratio] suggesting an increase in NMDA receptors, which in turn is associated with an enhancement in long-term potentiation and synaptic plasticity. Therefore, our results suggest that symbiotics could restore obesity-related memory impairment and promote synaptic plasticity.

Tuberculosis (TB) of the central nervous system (CNS) is a lethal and incapacitating disease. Several studies have been performed to understand the mechanism of bacterial arrival to CNS, however, it remains unclear. Although the interaction of the host, the pathogen, and the environment trigger the course of the disease, in TB the characteristics of these factors seem to be more relevant in the genesis of the clinical features of each patient. We previously tested three mycobacterial clinical isolates with distinctive genotypes obtained from the cerebrospinal fluid of patients with meningeal TB and showed that these strains disseminated extensively to the brain after intratracheal inoculation and pulmonary infection in BALB/c mice. In this present study, BALB/c mice were infected through the intranasal route. One of these strains reaches the olfactory bulb at the early stage of the infection and infects the brain before the lungs, but the histological study of the nasal mucosa did not show any alteration. This observation suggests that some mycobacteria strains can arrive directly at the brain, apparently toward the olfactory nerve after infecting the nasal mucosa, and guides us to study in more detail during mycobacteria infection the nasal mucosa, the associated connective tissue, and nervous structures of the cribriform plate, which connect the nasal cavity with the olfactory bulb.

Background: Stroke is a highly prevalent disease that can provoke severe disability. We evaluate a predictive model based on the Minimum Basic Data Set (MBDS) compiled by the Spain Health Ministry, obtained for the period 2008–2012 for patients with ischaemic stroke in Spain, to establish the model’s validity and to optimise its calibration. The MBDS is the main clinical-administrative database for hospitalisations recorded in Spain, and to our knowledge, no predictive models for stroke mortality have previously been developed using this resource. The main study aim is to perform an external validation and recalibration of the coefficients of this predictive model with respect to a chronologically later cohort. Material and Methods: External validation (testing the model on a different cohort to assess its performance) and recalibration (validation with optimisation of model coefficients) were performed using the MBDS for patients admitted for ischaemic stroke in the period 2016–2018. A cohort study was designed, in which a recalibrated model was obtained by applying the variables of the original model without their coefficients. The variables from the original model were then applied to the subsequent cohort, together with the coefficients from the initial model. The areas under the curve (AUC) of the recalibration and the external validation procedure were compared. Results: The recalibrated model produced an AUC of 0.743 and was composed of the following variables: age (odds ratio, OR:1.073), female sex (OR:1.143), ischaemic heart disease (OR:1.192), hypertension (OR:0.719), atrial fibrillation (OR:1.414), hyperlipidaemia (OR:0.652), heart failure (OR:2.133) and posterior circulation stroke (OR: 0.755). External validation produced an AUC of 0.726. Conclusions: The recalibrated clinical model thus obtained presented moderate-high discriminant ability and was generalisable to predict death for patients with ischaemic stroke. Rigorous external validation slightly decreased the AUC but confirmed the validity of the baseline model for the chronologically later cohort.

Abstract The soil fauna of the tropics remains one of the least known components of the biosphere. Long-term monitoring of this fauna is hampered by the lack of taxonomic expertise and funding. These obstacles may potentially be lifted with DNA metabarcoding. To validate this approach, we studied the ants, springtails and termites of 100 paired soil samples from Barro Colorado Island, Panama. The fauna was extracted with Berlese-Tullgren funnels and then either sorted with traditional taxonomy and known, individual DNA barcodes (“traditional samples”) or processed with metabarcoding (“metabarcoding samples”). We detected 49 ant, 37 springtail and 34 termite species with 3.46 million reads of the COI gene, at a mean sequence length of 233 bp. Traditional identification yielded 80, 111 and 15 species of ants, springtails and termites, respectively; 98%, 37% and 100% of these species had a Barcode Index Number (BIN) allowing for direct comparison with metabarcoding. Ants were best surveyed through traditional methods, termites were better detected by metabarcoding, and springtails were equally well detected by both techniques. Species richness was underestimated, and faunal composition was different in metabarcoding samples, mostly because 37% of ant species were not detected. The prevalence of species in metabarcoding samples increased with their abundance in traditional samples, and seasonal shifts in species prevalence and faunal composition were similar between traditional and metabarcoding samples. Probable false positive and negative species records were reasonably low (13–18% of common species). We conclude that metabarcoding of samples extracted with Berlese-Tullgren funnels appear suitable for the long-term monitoring of termites and springtails in tropical rainforests. For ants, metabarcoding schemes should be complemented by additional samples of alates from Malaise or light traps.

Abstract Demersal fisheries are one of the top anthropic stressors in marine environments. In the long term, some species are more vulnerable to fishery impacts than others, which can lead to permanent changes on the food web. The trophic relationships between predator and prey constitute the food web and it represents a network of the energy channels in an ecosystem. In turn, the network structure influences ecosystem diversity and stability. The first aim of this study was to describe for the first time the food web of the San Jorge Gulf (Patagonia Argentina) with high resolution, i.e. to the species level when information is available. The San Jorge Gulf was subject to intense fisheries thus our second aim is to analyse the food web structure with and without fishery to evaluate if the bottom-trawl industrial fishery altered the network structure and stability. We used several network metrics like: mean trophic level, omnivory, modularity and quasi-sign stability. We included these metrics because they are related to stability and can be evaluated using predator diets that can weight the links between predators and prey. The network presented 165 species organized in almost five trophic levels. The inclusion of a fishery node adds 69 new trophic links. All weighted and unweighted metrics showed differences between the two networks, reflecting a decrease in stability when fishery was included in the system. Thus, our results suggested a probable change of state of the system. The observed changes in species abundances since the fishery was established, could represent the state change predicted by network analysis. Our results suggests that changes in the stability of food webs can be used to evaluate the impacts of human activity on ecosystems.

Objective To estimate health inequity and vulnerability among Indigenous and non-Indigenous populations with rheumatic and musculoskeletal diseases (RMD) in Latin America using the syndemic approach.Design This is a secondary analysis of a previously published large-scale study on the prevalence of RMD.Setting Studies carried out in five Latin American countries (Argentina, Colombia, Ecuador, Mexico and Venezuela). Health inequity and vulnerability in RMD were identified through a syndemic approach using network and cluster analysis.Participants A total of 44 560 individuals were studied: 29.78% self-identified as Indigenous, 60.92% were female, the mean age was 43.25 years. Twenty clusters were identified in the Indigenous population and 17 in the non-Indigenous population.Results The variables associated with RMD among Indigenous populations were rurality, public health system, high joint biomechanical stress, greater pain, disability and alcoholism; and among non-Indigenous people they were being a woman, urban origin, older age, private health system, joint biomechanical stress, greater pain and disability. We identified different health inequities among patients with RMD (ie, lower educational attainment, more comorbidities), associated with factors such as Indigenous self-identification and rural residence.Conclusions A syndemic approach enables us to identify health inequities in RMD, as shown by higher prevalence of comorbidities, disability and socioeconomic factors like lower educational attainment. These inequities exist for the overall population of patients with RMD, although it is more evident in Indigenous groups with added layers of vulnerability.

The gastrointestinal (GI) tract can be affected by different diseases or lesions such as esophagitis, ulcers, hemorrhoids, and polyps, among others. Some of them can be precursors of cancer such as polyps. Endoscopy is the standard procedure for the detection of these lesions. The main drawback of this procedure is that the diagnosis depends on the expertise of the doctor. This means that some important findings may be missed. In recent years, this problem has been addressed by deep learning (DL) techniques. Endoscopic studies use digital images. The most widely used DL technique for image processing is the convolutional neural network (CNN) due to its high accuracy for modeling complex phenomena. There are different CNNs that are characterized by their architecture. In this article, four architectures are compared: AlexNet, DenseNet-201, Inception-v3, and ResNet-101. To determine which architecture best classifies GI tract lesions, a set of metrics; accuracy, precision, sensitivity, specificity, F1-score, and area under the curve (AUC) were used. These architectures were trained and tested on the HyperKvasir dataset. From this dataset, a total of 6,792 images corresponding to 10 findings were used. A transfer learning approach and a data augmentation technique were applied. The best performing architecture was DenseNet-201, whose results were: 97.11% of accuracy, 96.3% sensitivity, 99.67% specificity, and 95% AUC.

More than 20 global marine extinctions and over 700 local extinctions have reportedly occurred during the past 500 years. However, available methods to determine how many of these species can be confidently declared true disappearances tend to be data-demanding, time-consuming, and not applicable to all taxonomic groups or scales of marine extinctions (global [G] and local [L]). We developed an integrated system to assess marine extinctions (ISAME) that can be applied to any taxonomic group at any geographic scale. We applied the ISAME method to 10 case studies to illustrate the possible ways in which the extinction status of marine species can be categorized as unverified, possibly extinct, or extinct. Of the 10 case studies we assessed, the ISAME method concludes that 6 should be categorized as unverified extinctions due to problems with species' identity and lack of reliable evidence supporting their disappearance (periwinkle-Littoraria flammea [G], houting-Coregonus oxyrinchus [G], long-spined urchin-Diadema antillarum [L], smalltooth sawfish-Pristis pectinata [L], and largetooth sawfish-P. pristis [L]). In contrast, ISAME classified the Guadalupe storm-petrel (Oceanodroma macrodactyla [G]) and the lost shark (Carcharhinus obsolerus [G]) as possibly extinct because the available evidence indicates that their extinction is plausible-while the largetooth sawfish [L] and Steller's sea cow (Hydrodamalis gigas [G]) were confirmed to be extinct. Determining whether a marine population or species is actually extinct or still extant is needed to guide conservation efforts and prevent further biodiversity losses.

Objetivo. Estudiar la factibilidad de utilización de la inteligencia artificial como método sensible y específico para el cribado de COVID-19 en pacientes con afecciones respiratorias empleando imágenes de tórax obtenidas con tomógrafo y una plataforma de telemedicina. Métodos. Entre marzo del 2020 y junio del 2021 se realizó un estudio observacional descriptivo multicéntrico de factibilidad basada en inteligencia artificial (IA) para el cribado de COVID-19 en imágenes de tórax de pacientes con afecciones respiratorias que acudieron a hospitales públicos. El diagnóstico de las imágenes tomográficas de tórax se realizó a través de la plataforma de IA; luego, se comparó con el diagnóstico molecular (RT-PCR) para determinar la concordancia entre ambos y analizar su factibilidad para el cribado de pacientes con sospecha de COVID-19. Las imágenes y los resultados diagnóstico se enviaron a través de una plataforma de telemedicina. Resultados. Se realizó el cribado de 3 514 pacientes con sospecha diagnóstica de COVID-19, en 14 hospitales a nivel nacional. La mayoría de los pacientes tenían entre 27 y 59 años, seguidos por los mayores de 60 años. La edad promedio fue de 48,6 años; el 52,8% eran de sexo masculino. Los hallazgos más frecuentes fueron neumonía grave, neumonía bilateral con derrame pleural, enfisema pulmonar bilateral y opacidad difusa en vidrio esmerilado, entre otros. Se determinó un promedio de 93% de concordancia y 7% de discordancia entre las imágenes analizadas mediante IA y la RT-PCR. La sensibilidad y especificidad del sistema de IA, obtenidas comparando el resultado del cribado obtenido por IA con la RT-PCR, fueron de 93% y 80% respectivamente. Conclusiones. Es viable la utilización de IA sensible y específica para la detección rápida estratificada de COVID-19 en pacientes con afecciones respiratorias utilizando imágenes obtenidas mediante tomografía de tórax y una plataforma de telemedicina en los hospitales públicos de Paraguay.

The aim of this study was to verify the effects of blood flow restriction on movement velocity and muscle activity during the back squat exercise. Methods: Twenty-four university students participated in this study. In two randomized sessions 72 h apart, participants performed a 4-set protocol consisting of 30-15-15-15 repetitions performed at 30% of their one-repetition maximum in the back squat exercise. In both sessions, neuromuscular function was monitored by surface electromyography (EMG) and movement velocity (mean propulsive velocity (MPV), peak concentric velocity (Vmax), and the effort index (EI)). Blood flow restriction (BFR) was applied during exercise in one of the experimental sessions with 80% of full arterial occlusion pressure over lower limbs. Results: The BFR condition showed higher (p < 0.05) EI, peak, and rooted mean square normalized EMG in Set 1 compared to Set 2. Similar MPV and Vmax were observed in each set for both the BFR and control conditions. No significant differences were observed between conditions in any set. Conclusions: BFR did not imply changes in neuromuscular performance during low-intensity resistance training, but it might induce greater intra-series velocity loss and less excitation of the muscles involved.

Introduction: HIV infection is still a public health problem worldwide and co-infections with other infectious agents including intestinal parasites are of particular concern, mainly in developing countries like Colombia. Objective: To conduct a cross-sectional study in patients attending an HIV care program in Antioquia given that there have been few intestinal parasites prevalence studies among the HIV population in the country. Material and methods: We evaluated stool samples from 192 patients by direct wet mount and concentration, modified Ziehl Neelsen staining, and agar plate culture. Univariate and correlation analyses were done to explore the association between socio-demographic and clinical characteristics and parasitological data. Results: The overall prevalence of intestinal parasites in HIV-positive subjects was 29.2% (56/192; 95% CI: 22.8% - 35.6%). Entamoeba histolytica/dispar/moshkosvkii with 13.0% (25/192; 95% CI: 8.2% - 17.8%) and Blastocystis with 12.0% (23/192; 95% CI: 7.4% - 16.6%) were the most frequent. Opportunistic parasites like Cryptosporidium spp. and Cystoisospora belli were less prevalent, each one with 0.5% of positive samples (1/192; 95% CI: 0.1% - 1.5%). Commensal protozoa were also detected with a prevalence of 18.8% (36/192; 95% CI: 13.3% - 24.3%). Most of the individuals in the study had a controlled viral load and an LTCD4 count greater than 200 cel/μL. A small percentage (9.3%) had diarrhea. Bivariate analysis and multivariate logistic regression showed that only age and having pets had a significant association with intestinal parasites in this cohort. Conclusions: Our results confirmed that the evaluated population is at high risk of intestinal parasite infection, which highlights the need for routine screening of gastrointestinal parasites to provide prompt treatment and reduce possible complications.

Abstract Asymmetric Janus transition metal dichalcogenide MoSSe is a promising catalytic material due to the intrinsic in-plane dipole of its opposite faces. The atomic description of the structures observed by experimental techniques is relevant to tuning and optimizing its surface reaction processes. Furthermore, the experimentally observed triangular morphologies in MoSSe suggest that an analysis of the chemical environment of its edges is vital to understand its reactivity. Here we analyze the size-shape stability among different triangular structures-quantum- dots proposed from the ideal S(-1010) and Mo(10-10) terminations. Our stability analysis evidenced that the S–Se termination is more stable than Mo; moreover, as the size of the quantum dot increases, its stability increases as well. Besides, a trend is observed, with the appearance of elongated Mo-S/Se bonds at symmetric positions of the edges. Tersoff–Hamann scanning tunneling microscopy images for both faces of the stablest models are presented. Electrostatic potential isosurfaces denote that the basal plane on the S face of both configurations remains the region with more electron density concentration. These results point toward the differentiated activity over both faces. Finally, our study denotes the exact atomic arrangement on the edges of MoSSe quantum dots corresponding with the formation of S/Se dimers who decorates the edges and their role along with the faces as catalytic sites.

Background Marine species constitute commercially important resources, and knowledge about mechanisms that shape phylogeographic patterns and genetic structure provides valuable information for conservation. The dolphinfish, Coryphaena hippurus, is one of the most important species caught in the Tropical Eastern Pacific (TEP). However, the lack of consensus about the existence of genetically differentiated populations in the area has hindered the adoption of management strategies to ensure its viability. Methods We assessed genetic variation and phylogeographic structure using two mitochondrial genes and 14 nuclear DNA microsatellite loci. Population genetic tools were used to characterize the spatial distribution of genetic variation of C. hippurus in the TEP, evaluate the extent of connectivity between dolphinfish populations, infer potential barriers to gene flow, and test for signals of contemporary and historical demographic expansions. Results Mitochondrial DNA sequences showed genetic homogeneity across locations in the TEP, as well as a strong signal of population expansion dated to the late Pleistocene. In contrast, nuclear microsatellite markers resolved four genetically distinct groups with a remarked genetic differentiation between the most distant locations, at the northern and southern boundaries of the species’ range. High mean genetic diversity was found at all localities (Hs = 0.66–0.81). Notwithstanding, positive FIS and low effective population size (Ne = 77.9–496.4) were also recorded. Conclusions The distribution of genetic variation could be related to expansion-contraction cycles following seasonal temperature changes at transitional areas, promoting population subdivisions. However, we cannot rule out the effect of oceanographic dynamics to the observed patterns. Although this marine species remains highly abundant despite commercial exploitation, the low Ne values are of conservation concern and must be considered in fishery management plans.

Abstract In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the “patient journey”) with perplexing obstacles. High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary. The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded. It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses.

Abstract Granulocyte colony–stimulating factor (G-CSF) has raised much interest because of its role in cocaine addiction in preclinical models. We explored the plasma concentrations of G-CSF in patients diagnosed with substance use disorder (SUD) and highly comorbid psychiatric disorders. In particular, we investigated the association between G-CSF concentrations and comorbid major depressive disorder (MDD) in patients with cocaine and alcohol use disorders (CUD and AUD, respectively). Additionally, patients with MDD but not SUD were included in the study. Three hundred and eleven participants were enrolled in this exploratory study: 136 control subjects, 125 patients with SUD (SUD group) from outpatient treatment programs for cocaine (N = 60, cocaine subgroup) and alcohol (N = 65, alcohol subgroup), and 50 patients with MDD but not SUD (MDD group) from primary-care settings. Participants were assessed based on DSM-IV-TR criteria, and a blood sample was collected to examine the plasma concentrations of G-CSF. G-CSF concentrations were negatively correlated with age in the entire sample (r = − 0.233, p

Abstract COVID-19 has overloaded national health services worldwide. Thus, early identification of patients at risk of poor outcomes is critical. Our objective was to analyse SARS-CoV-2 RNA detection in serum as a severity biomarker in COVID-19. Retrospective observational study including 193 patients admitted for COVID-19. Detection of SARS-CoV-2 RNA in serum (viremia) was performed with samples collected at 48–72 h of admission by two techniques from Roche and Thermo Fischer Scientific (TFS). Main outcome variables were mortality and need for ICU admission during hospitalization for COVID-19. Viremia was detected in 50–60% of patients depending on technique. The correlation of Ct in serum between both techniques was good (intraclass correlation coefficient: 0.612; p

Cystoisospora belli is an intestinal Apicomplexan parasite associated with diarrheal illness and disseminated infections in humans, mainly immunocompromised individuals such as those living with the human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). An irregular administration of highly active antiretroviral therapy (HAART) in HIV patients may increase the risk of opportunistic infections like cystoisosporiasis. We describe here a case of C. belli infection in a Colombian HIV patient with chronic gastrointestinal syndrome and poor adherence to HAART. His clinical and parasitological cure was achieved with trimethoprim-sulfamethoxazole treatment. Although a reduction in the number of C. belli cases has been observed since the use of HAART, this parasite still has to be considered as a differential diagnosis of diarrheal disease in HIV/AIDS patients. Effective interventions enhancing adherence to HAART should be included in HIV patient care programs.

Abstract Rheumatoid arthritis (RA) is a systemic autoimmune disease whose main extra-articular organ affected is the lung, sometimes in the form of diffuse interstitial lung disease (ILD) and conditions the prognosis. A multicenter, observational, descriptive and cross-sectional study of consecutive patients diagnosed with RA-ILD. Demographic, analytical, respiratory functional and evolution characteristics were analyzed to evaluate the predictors of progression and mortality. 106 patients were included. The multivariate analysis showed that the diagnostic delay was an independent predictor of mortality (HR 1.11, CI 1.01–1.23, p = 0.035). Also, age (HR 1.33, 95% CI 1.09–1.62, p = 0.0045), DLCO (%) (HR 0.85, 95% CI 0.73–0.98, p = 0.0246), and final SatO2 (%) in the 6MWT (HR 0.62, 95% CI 0.39–0.99, p = 0.0465) were independent predictor variables of mortality, as well as GAP index (HR 4.65, 95% CI 1.59–13.54, p = 0.0051) and CPI index (HR 1.12, 95% CI 1.03–1.22, p = 0.0092). The withdrawal of MTX or LFN after ILD diagnosis was associated with disease progression in the COX analysis (HR 2.18, 95% CI 1.14–4.18, p = 0.019). This is the first study that highlights the diagnostic delay in RA-ILD is associated with an increased mortality just like happens in IPF.

Among patients affected by the virus COVID-19, physicians have observed ventilation disorders. It is relevant to assess neurological involvement, including the role of diaphragmatic function. Its possible impairment could be related to the systemic inflammatory response and disease progression that both typify COVID-19 infection. We distinguished two groups (severe group (SG) and mild group (MG)) according to the severity of respiratory symptomatology. We performed neurophysiological and sonography studies to evaluate the diaphragmatic function. Regarding the sonography variables, we identified statistically significant differences in the right mean diaphragmatic thickness along with the expiration, showing 1.56 mm (SEM: 0.11) in the SG vs 1.92 mm (SEM: 0.19) in the MG (p = 0.042). The contractibility of both hemidiaphragms was 15% lower in the severe group, though this difference is not statistically significant. In our examination of the neurophysiological variables, in the amplitude responses, we observed a greater difference between responses from both phrenic nerves as follows: the raw differences in amplitude were 0.40 μV (SEM: 0.14) in the SG vs 0.35 μV (SEM: 0.19) in the MG and the percentage difference was 25.92% (SEM: 7.22) in the SG vs 16.28% (SEM: 4.38%) in the MG. Although diaphragmatic dysfunction is difficult to detect, our combined functional and morphological approach with phrenic electroneurograms and chest ultrasounds could improve diagnostic sensitivity. We suggest that diaphragmatic dysfunction could play a relevant role in respiratory disturbance in hospitalised patients with severe COVID-19.

Abstract Munk’s pygmy devil rays (Mobula munkiana) are medium-size, zooplanktivorous filter feeding, elasmobranchs characterized by aggregative behavior, low fecundity and delayed reproduction. These traits make them susceptible to targeted and by-catch fisheries and are listed as Vulnerable on the IUCN Red List. Multiple studies have examined fisheries impacts, but nursery areas or foraging neonate and juvenile concentrations have not been examined. This study describes the first nursery area for M. munkiana at Espiritu Santo Archipelago, Mexico. We examined spatial use of a shallow bay during 22 consecutive months in relation to environmental patterns using traditional tagging (n = 95) and acoustic telemetry (n = 7). Neonates and juveniles comprised 84% of tagged individuals and their residency index was significantly greater inside than outside the bay; spending a maximum of 145 consecutive days within the bay. Observations of near-term pregnant females, mating behavior, and neonates indicate an April to June pupping period. Anecdotal photograph review indicated that the nursery area is used by neonates and juveniles across years. These findings confirm, for the first time, the existence of nursery areas for Munk’s pygmy devil rays and the potential importance of shallow bays during early life stages for the conservation of this species.

Skin secretions of toads are a complex mixture of molecules. The substances secreted comprise more than 80 different compounds that show diverse pharmacological activities. The compounds secreted through skin pores and parotid glands are of particular interest because they help toads to endure in habitats full of pathogenic microbes, i.e., bacteria, fungi, viruses, and protozoa, due to their content of components such as bufadienolides, alkaloids, and antimicrobial peptides. We carried out an extensive literature review of relevant articles published until November 2022 in ACS Publications, Google Scholar, PubMed, and ScienceDirect. It was centered on research addressing the biological characterization of the compounds identified in the species of genera Atelopus, Bufo, Duttaphrynus, Melanophryniscus, Peltopryne, Phrynoidis, Rhaebo, and Rhinella, with antibacterial, antifungal, antiviral, and antiparasitic activities; as well as studies performed with analogous compounds and skin secretions of toads that also showed these activities. This review shows that the compounds in the secretions of toads could be candidates for new drugs to treat infectious diseases or be used to develop new molecules with better properties from existing ones. Some compounds in this review showed activity against microorganisms of medical interest such as Staphylococcus aureus, Escherichia coli, Bacillus subtilis, Coronavirus varieties, HIV, Trypanosoma cruzi, Leishmania chagasi, Plasmodium falciparum, and against different kinds of fungi that affect plants of economic interest.

Major depressive disorder (MDD) is the most recurrent mental illness globally, affecting approximately 5% of adults. Furthermore, according to the National Institute of Mental Health (NIMH) of the U.S., calculating an actual schizophrenia prevalence rate is challenging because of this illness’s underdiagnosis. Still, most current global metrics hover between 0.33% and 0.75%. Machine-learning scientists use data from diverse sources to analyze, classify, or predict to improve the psychiatric attention, diagnosis, and treatment of MDD, schizophrenia, and other psychiatric conditions. Motor activity data are gaining popularity in mental illness diagnosis assistance because they are a cost-effective and noninvasive method. In the knowledge discovery in databases (KDD) framework, a model to classify depressive and schizophrenic patients from healthy controls is constructed using accelerometer data. Taking advantage of the multiple sleep disorders caused by mental disorders, the main objective is to increase the model’s accuracy by employing only data from night-time activity. To compare the classification between the stages of the day and improve the accuracy of the classification, the total activity signal was cut into hourly time lapses and then grouped into subdatasets depending on the phases of the day: morning (06:00–11:59), afternoon (12:00–17:59), evening (18:00–23:59), and night (00:00–05:59). Random forest classifier (RFC) is the algorithm proposed for multiclass classification, and it uses accuracy, recall, precision, the Matthews correlation coefficient, and F1 score to measure its efficiency. The best model was night-featured data and RFC, with 98% accuracy for the classification of three classes. The effectiveness of this experiment leads to less monitoring time for patients, reducing stress and anxiety, producing more efficient models, using wearables, and increasing the amount of data.

Sudden infant death syndrome (SIDS) represents the leading cause of death in under one year of age in developing countries. Even in our century, its etiology is not clear, and there is no biomarker that is discriminative enough to predict the risk of suffering from it. Therefore, in this work, taking a public dataset on the lipidomic profile of babies who died from this syndrome compared to a control group, a univariate analysis was performed using the Mann–Whitney U test, with the aim of identifying the characteristics that enable discriminating between both groups. Those characteristics with a p-value less than or equal to 0.05 were taken; once these characteristics were obtained, classification models were implemented (random forests (RF), logistic regression (LR), support vector machine (SVM) and naive Bayes (NB)). We used seventy percent of the data for model training, subjecting it to a cross-validation (k = 5) and later submitting to validation in a blind test with 30% of the remaining data, which allows simulating the scenario in real life—that is, with an unknown population for the model. The model with the best performance was RF, since in the blind test, it obtained an AUC of 0.9, specificity of 1, and sensitivity of 0.8. The proposed model provides the basis for the construction of a SIDS risk prediction computer tool, which will contribute to prevention, and proposes lines of research to deal with this pathology.

Type 2 diabetes mellitus (T2DM) represents one of the biggest health problems in Mexico, and it is extremely important to early detect this disease and its complications. For a noninvasive detection of T2DM, a machine learning (ML) approach that uses ensemble classification models with dichotomous output that is also fast and effective for early detection and prediction of T2D can be used. In this article, an ensemble technique by hard voting is designed and implemented using generalized linear regression (GLM), support vector machines (SVM) and artificial neural networks (ANN) for the classification of T2DM patients. In the materials and methods as a first step, the data is balanced, standardized, imputed and integrated into the three models to classify the patients in a dichotomous result. For the selection of features, an implementation of LASSO is developed, with a 10-fold cross-validation and for the final validation, the Area Under the Curve (AUC) is used. The results in LASSO showed 12 features, which are used in the implemented models to obtain the best possible scenario in the developed ensemble model. The algorithm with the best performance of the three is SVM, this model obtained an AUC of 92% ± 3%. The ensemble model built with GLM, SVM and ANN obtained an AUC of 90% ± 3%.

Actualmente no existe vacuna disponible ni medicación específica contra la enfermedad por coronavirus 2019 (COVID-19). El tratamiento se basa fundamentalmente en medidas de soporte. En este contexto, se han aprobado múltiples terapias de potencial utilidad para su uso en ensayos clínicos, como la transfusión de plasma convaleciente (TPC). Se realizó una búsqueda en PubMed de estudios sobre plasma convaleciente y COVID- 19, SARS o MERS. Los estudios sobre la eficacia clínica en enfermedades causadas por otros coronavirus (SARS-CoV y MERS-CoV) evidenciaron mejoría clínica, aumento de anticuerpos neutralizantes, disminución de la mortalidad y ausencia de eventos adversos durante y después del tratamiento. En el caso de la COVID-19, se encontraron 13 estudios en pacientes con la COVID-19 grave y crítica. Aunque existen limitaciones en la metodología, en el número de pacientes y en los protocolos para el análisis del plasma convaleciente de los donantes, los pacientes que recibieron TPC evidenciaron mejoría clínica, mejoría de patrones ventilatorios, resolución de lesiones pulmonares, disminución de mortalidad, mejoría de parámetros laboratoriales, aumento de anticuerpos neutralizantes, disminución de carga viral y baja frecuencia de eventos adversos.