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In this work, symmetry groups are used to determine symmetry reductions of a (2 + 1)-dimensional Keller–Segel system depending on two arbitrary functions. We show that the point symmetries of the considered Keller–Segel system comprise an infinite-dimensional Lie algebra which involves three arbitrary functions. By way of example, we have used these point symmetries to reduce straightaway the given system of second-order partial differential equations to a system of second-order ordinary differential equations. Moreover, we are allowed to substitute one of the dependent variables from one of the equations into the other, leading to an equivalent fourth-order nonlinear ordinary differential equation. This equation is reduced through the use of solvable symmetry subalgebras, and some exact solutions are obtained for a particular case.

Objective The study aimed to describe the cases of neurological disease related to the outbreak of enterovirus (EV) in three regions in Northern Spain during 2016. Materials and Methods Multicenter retrospective observational study. Clinical, radiological, and microbiological data were analyzed from patients younger than 15 years with confirmed EV-associated neurological disease admitted to 10 hospitals of Asturias, Cantabria, and Castile and Leon between January 1 and December 31, 2016. Results Fifty-five patients were included. Median age was 24 months (interquartile range = 18.5 months). Fifteen patients were classified as aseptic meningitis (27.3%). In total, 37 cases presented brainstem encephalitis (67.3%), 25 of them due to EV-A71 with excellent prognosis (84.6% asymptomatic 2 months following the onset). Three cases of acute flaccid myelitis (5.5%) by EV-D68 were reported and presented persistent paresis 2 months following the onset. Microbiological diagnosis by reverse transcriptase polymerase chain reaction was performed in all cases, finding EV in cerebrospinal fluid in meningitis, but not in brainstem encephalitis and acute flaccid myelitis, where EV was found in respiratory or rectal samples. Step therapy was administrated with intravenous immunoglobulin (IVIG; 32.7%), methylprednisolone (10%), and plasmapheresis (3.6%). Four patients received fluoxetine (7.3%). Twenty patients needed to be admitted to pediatric intensive care unit (36.4%). Conclusion Clinical, microbiological, and radiological diagnosis is essential in outbreaks of EV neurological disease, taking into account that it can be difficult to identify EV-A71 and EV-D68 in CSF, requiring throat or rectal samples. There is not specific treatment to these conditions and the efficacy and understanding of the mechanism of action of immune-modulatory treatment (IVIG, corticosteroids, and plasmapheresis) is limited.

Cutaneous melanoma (CM) is an aggressive malignant tumor of epidermal melanocytes for which treatment options and survival chances decrease dramatically when metastatic. To date, immunotherapy is becoming a new standard treatment for CM although less than 30% of the patients´ response positively. Therefore, there is a strong interest to identify response predictors and molecular pathways that might lead to therapy failure. Two novel biomarker sources are LncRNA and CircRNA which can function as natural sponges of miRNA as competitive endogenous RNAs (ceRNA) or can associate to RNA-Binding Proteins (RBP) to regulate gene expression. Moreover, several studies have revealed that ceRNA networks are implicated in tumorigenic processes. Considering this, we set to interrogate the role of the ceRNA in the prediction of response to CM immunotherapy. In this pilot study, differential expression was quantified by RNA-seq in 16 FFPE pre-treatment metastatic samples from CM patients treated with Nivolumab. Total RNA isolation was performed from 10 µm slides (4) with RNAeasy FFPE kit. Total RNAseq was done with Truseq Stranded RNA gold kit, and libraries were sequenced on Illumina Nextseq 550. LncRNA were obtained by STARs alignment and explored on LncATLAS. To assess the presence of high confident cirRNA we used 5 different pipelines with a minimum filtering cut-off of 2 junction reads in at least 2 samples and with at least 3 software. Deseq2 pipeline of total mapped reads was used to perform differential expression. We identified 23 circRNA and 74 lncRNA differentially expressed (DE) with a fold change of 1.5 and a p value < 0,01. Ingenuity pathway analysis was carried out to generate DE ceRNA-mRNA networks and associated RBP networks. Interestingly, in the DE ceRNA-mRNA networks, most of the 47 significant canonical pathways comprised immunological pathways such the antigen presentation pathway, Th1 and Th2 activation pathways and PD1-PDL1 cancer immunotherapy pathways. Regarding the DE ceRNA associated RBP networks, HOTAIR regulatory pathway and senescence as well as G1/S cell cycle checkpoint regulator pathways were enriched. Furthermore, we were able to predict the interaction of the DE ceRNA with the activation of key promoters of the immune response such as IL27 (Interleukin 27), EIB3 (Epstein-Barr Virus Induced 3), IL2 (Interleukin 2) and IFNA2 (Interferon Alpha2), as well as the inhibition of negative immune regulators such as SAFB2 (Distal-Less Homeobox 2) and FOXD1 (Forkhead Box D1). In conclusion, we have evidenced for the first time the potential utility of ceRNA as immunotherapy predictors. We have generated a response signature of ceRNA expression and used network analysis to associate them with specific key modulators of the immune response. This study opens a new venue for the investigation of the role of these regulatory ncRNA in the resistance to immunotherapy in cancer. Citation Format: Javier Oliver, Juan Luis Onieva, Maria Garrido-Barros, Alicia Garrido-Aranda, Vanessa De Luque, Martina Alvarez, Alfonso Sanchez, Elisabeth Perez, Patricia Chaves, Maria Jose Lozano, Miguel Berciano, Manolo Cobo, Emilio Alba, Antonio Rueda, Isabel Barragan. Association of ceRNA dysregulation with clinical Response to Immunotherapy in cutaneous melanoma (CM) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1538.

Lung cancer has the second highest incidence and leads cancer mortality worldwide, being Non-Small Cell Lung Cancer (NSCLC) the most prevalent subtype. Immunotherapy with checkpoint blockers has shown outstanding benefits in a subset of NSCLC patients, which are not accurately identified due to the lack of robust biomarkers of response. We hypothesize that specific molecular alterations of NSCLC tumor cells impact the immune microenvironment. Defining this association could improve the prediction of response to immunotherapy. This work aims to identify a multiparametric biomarker signature. We studied 178 tumor samples from a cohort of early stage NSCLC with complete clinical annotation. We analyzed their molecular aberrations, calculated their Tumor Mutational Burden and described their immune landscape by immunohistochemistry and a dedicated RNAseq panel. We defined novel subgroups of NSCLC tumors with specific immune, molecular and clinical features, showing an association between their molecular genotype and immune phenotype. Based on these data, subgroups were proposed as pro-immunogenic, pro-tumorigenic or mixed. Adenocarcinomas clustered in 4 groups. The pro-tumorigenic group had a significant higher proportion of alterations in ARID1A, FGF10, ROS1, TP53. One pro-immunogenic group had a significant higher proportion of MET alterations and lower proportion of EGFR alterations. An immune mixed group significantly accrued never smokers and had no alterations in FGF10. Squamous cell carcinomas clustered in 4 groups. The pro-tumorigenic group had a significant higher proportion of alterations in CCND1, FGF3, FGF10, FGF19, NOTCH1, PIK3CA, PIK3CB, TFRC. A pro-immunogenic group had a significant higher infiltration of T CD4+, T CD8+ and B cells and a higher overall survival. Another pro-immunogenic group had a significant absence of MYCN and NF1 alterations. Taken together we identified a set of candidate predictive biomarkers of response to immunotherapy in NSCLC. Genes overexpressed in pro-immunogenic tumors are related to adaptive immune response stimulation (CD28, FCRLA, JCHAIN, LY9, MS4A1, SLAMF7, TNFRSF9, TNFRSF17), antigen presentation (CD1C, CD1D, HLA-A), apoptosis (FAS), immune chemotaxis (CCL20, CCR4, CCR6), and immune regulation (CD53, PDCD1, SH2D1A, ZAP70). On the other hand, genes upregulated in pro-tumorigenic tumors are involved in angiogenesis (VEGFA), cell cycle regulation (BUB1, CCNB2, FOXM1, MAD2L1, TOP2A), cell growth/survival (IGF1R), DNA replication/repair (KIAA0101) and iron metabolism (HMBS, TFRC). These findings are being validated by Digital Spatial Profiling in a cohort of patients with advanced stage NSCLC that were treated with checkpoint blockers. If confirmed, these results could remarkably improve patient selection and the benefit upon immunotherapy. Citation Format: Javier Ramos-Paradas, David Gomez-Sanchez, Aranzazu Rosado, Alvaro Conrado Ucero, Nuria Carrizo, Ana Belen Enguita, Maria Teresa Muñoz, Esther Conde, Luis Paz-Ares, Eva Maria Garrido-Martin. Comprehensive analysis of non-small cell lung cancer identifies molecular genotype-immunophenotype associations and candidate biomarkers predictive of response to immunotherapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1245.

Highlights • Cel8Pa is an extracellular, halotolerant, broad substrate endoglucanase. • Bg1Pa is an intracellular β-glucosidase, with activity on cello oligosaccharides and high resistance to ethanol. • The concerted action of Cel8Pa and Bg1Pa has a synergistic effect on saccharification of β-glucans. • Cel8Pa and Bg1Pa are cold-stable and candidates for SSF ethanol 2 G processes., In the efficient bioconversion of polysaccharides from lignocellulosic biomass, endoglucanases and β-glucosidases are key enzymes for the deconstruction of β-glucans. In this work, we focused on a GH8 endoglucanase (Cel8Pa) and a GH1 β-glucosidase (Bg1Pa) from Paenibacillus xylanivorans A59. Cel8Pa was active on a broad range of substrates, such as β-glucan from barley (24.5 IU/mg), lichenan (17.9 IU/mg), phosphoric acid swollen cellulose (PASC) (9.7 IU/mg), carboxi-methylcellulose (CMC) (7.3 IU/mg), chitosan (1.4 IU/mg) and xylan (0.4 IU/mg). Bg1Pa was active on cellobiose (C2) and cello-oligosaccharides up to C6, releasing glucose as the main product. When both enzymes were used jointly, there was a synergic effect in the conversion rate of polysaccharides to glucose. Cel8Pa and Bg1Pa presented important properties for simultaneous saccharification and fermentation (SSF) processes in second generation bioethanol production, such as tolerance to high concentration of glucose and ethanol.

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No. of bitstreams: 1 souza_tmg_me_bauru.pdf: 4051105 bytes, checksum: 49d7b732402b19ee26bf397ac7307a00 (MD5) Previous issue date: 2020-02-28 Approved for entry into archive by Lucilene Cordeiro da Silva Messias null (lubiblio@bauru.unesp.br) on 2020-05-27T15:39:33Z (GMT) No. of bitstreams: 1 souza_tmg_me_bauru.pdf: 4051105 bytes, checksum: 49d7b732402b19ee26bf397ac7307a00 (MD5) Made available in DSpace on 2020-05-27T15:39:34Z (GMT). No. of bitstreams: 1 souza_tmg_me_bauru.pdf: 4051105 bytes, checksum: 49d7b732402b19ee26bf397ac7307a00 (MD5) Previous issue date: 2020-02-28 Approved for entry into archive by Lucilene Cordeiro da Silva Messias null (lubiblio@bauru.unesp.br) on 2020-05-27T15:39:33Z (GMT) No. of bitstreams: 1 souza_tmg_me_bauru.pdf: 4051105 bytes, checksum: 49d7b732402b19ee26bf397ac7307a00 (MD5) Made available in DSpace on 2020-05-27T15:39:34Z (GMT). No. of bitstreams: 1 souza_tmg_me_bauru.pdf: 4051105 bytes, checksum: 49d7b732402b19ee26bf397ac7307a00 (MD5) Previous issue date: 2020-02-28 Made available in DSpace on 2020-05-27T15:39:34Z (GMT). No. of bitstreams: 1 souza_tmg_me_bauru.pdf: 4051105 bytes, checksum: 49d7b732402b19ee26bf397ac7307a00 (MD5) Previous issue date: 2020-02-28 A presente pesquisa tem por objetivo elaborar um objeto virtual de aprendizagem em formato de um sinalário ilustrado interativo para o ensino da Libras para os alunos surdos e ouvintes dos anos iniciais do ensino fundamental, com apresentação do léxico do espaço físico e dos objetos que compõem o cenário das dependências do ambiente escolar. Tem por objetivos específicos: 1) mapear e nomear os ambientes escolares dos anos iniciais do ensino fundamental de um município de pequeno porte do interior paulista; 2) levantar a demanda de alunos surdos matriculados nas escolas municipais; 3) mapear e analisar a percepção dos alunos surdos sobre a concepção e nomeação dos ambientes escolares em Libras e; 4) desenvolver o sinalário virtual de aprendizagem. Trata-se de uma pesquisa de abordagem qualitativa, organizada em dois estudos, sendo que o Estudo 1 se refere ao mapeamento do espaço escolar e levantamento da compreensão dos alunos surdos e o Estudo 2 se refere ao planejamento e elaboração do objeto de aprendizagem, tendo por foco alunos surdos que ingressaram na Educação Infantil e nos anos iniciais do Ensino Fundamental. Os participantes para a coleta de dados foram 4 alunos surdos que ingressaram na rede municipal de ensino fundamental, que não dominam ou têm pouco conhecimento da comunicação em língua de sinais. A pesquisa foi desenvolvida no ambiente de 3 escolas de um município de pequeno porte do interior paulista. Como instrumento para registro da coleta de dados, foi elaborado um protocolo de visitas às escolas, onde foram observados e registrados todos os ambientes e os objetos que o compõem. Para os alunos surdos foi elaborada uma entrevista semiestruturada com protocolo de registro do conhecimento prévio de todo o contexto educacional. Os resultados do Estudo 1 apontaram que os alunos não conheciam os sinais em Libras, mas faziam uso de alguns classificadores para identificar alguns objetos apontados. O resultado do Estudo 2 foi o desenvolvimento do Sinalário Ilustrado Interativo com base no protocolo de registro dos ambientes escolares. This research aims to develop a virtual learning object in the form of an interactive illustrated sign for teaching Libras for deaf and hearing students in the early years of elementary school, with the presentation of the lexicon of the physical space and the objects it comprises the scenario of dependencies, the school environment. Its specific objectives are: 1) to map and name the school environments of the early years of elementary school in a small municipality in the interior of São Paulo; 2) raise the demand for deaf students enrolled in municipal schools; 3) map and analyze the perception of deaf students about the design and naming of school environments in Libras and; 4) develop the virtual learning signal. It is a qualitative research, organized in two studies, with Study 1 referring to the mapping of the school space and survey of the understanding of deaf students and Study 2 refers to the planning and elaboration of the learning object, having focus on deaf students who started early childhood and elementary education. Participants for data collection were 4 deaf students who entered the municipal elementary school system, who do not master or have little knowledge of sign language communication. The research was carried out in the environment of 3 schools in a small municipality in the interior of São Paulo. As a tool for recording data collection, a protocol for visits to schools was elaborated, where all environments and objects that compose it were observed and recorded. For deaf students, a semi-structured interview was developed with a protocol for recording prior knowledge of the entire educational context. The results of Study 1 showed that students did not know the signs in Libras but used some classifiers to identify some pointed objects. The result of Study 2 was the development of the Interactive Illustrated Signal based on the prototype protocol for registering school environments

Purpose of Review This review presents an in-depth overview of the sleep–wake phenotype of patients with cirrhosis, together with available pharmacological and non-pharmacological treatment strategies. A set of simple, practical recommendations is also provided. Recent Findings The understanding of the pathophysiology of sleep disorders in this patient population has improved over the past decade, especially in relation to the interplay between homeostatic and circadian sleep regulation. In addition, new tools have been utilised for both screening and in-depth investigation of the sleep–wake profile of these patients. Finally, a number of studies have evaluated the efficacy of novel treatment strategies, often with encouraging results. Summary Since sleep disturbances are common in patients with cirrhosis, more so than in patients with other chronic diseases of similar severity, their assessment should become routine hepatological practice, along with the initiation of adequate treatment.

Treatment of congenital cytomegalovirus infection is mandatory in cases with severe systemic and/or neurological involvement. However, some patients are paucisymptomatic, with very subtle systemic manifestations and/or minimal brain alterations. Current international guidelines do not clearly state whether these children should be treated, and this decision is not straightforward for clinicians. Of a small series of six infants with congenital cytomegalovirus infection admitted to our neonatal unit between 2015 and 2019, half showed paucisymptomatic neurological manifestations. In these cases, the determination of s2-microglobulin in cerebrospinal fluid and magnetic resonance imaging aided in the decision-making concerning the therapeutic approach to follow.

The Poincaré plot is a geometrical technique used to visualize and quantify the correlation between two consecutive data points in a time-series. Since the dynamics of fluctuations in physiological rhythms exhibit long-term correlation and memory, this study aimed to extend the Poincaré plot by calculating the correlation between sequential data points in a time-series, rather than between two consecutive points. By incorporating this so-called lag, we hope to integrate a temporal aspect into quantifying the correlation, to depict whether a physiological system holds prolonged association between events separated by time. In doing so, it attempts to instantaneously characterize the intrinsic behavior of a complex system. We tested this hypothesis on three different physiological time-series: heart rate variability in patients with liver cirrhosis, respiratory rhythm in asthma and body temperature fluctuation in patients with cirrhosis, to evaluate the potential application of the extended Poincaré method in clinical practice. When studying the cardiac inter-beat intervals, the extended Poincaré plot revealed a stronger autocorrelation for patients with decompensated liver cirrhosis compared to less severe cases using Pearson’s correlation coefficient. In addition, long-term variability (known as SD2 in the extended Poincaré plot) appeared as an independent prognostic variable. This holds significance by acting as a non-invasive tool to evaluate patients with chronic liver disease and potentially facilitate transplant selection as an adjuvant to traditional criteria. For asthmatics, employing the extended Poincaré plot allowed for a non-invasive tool to differentially diagnose various classifications of respiratory disease. In the respiratory inter-breath interval analysis, the receiver operating characteristic (ROC) curve provided evidence that the extension of the Poincaré plot holds a greater advantage in the classification of asthmatic patients, over the traditional Poincaré plot. Lastly, the analysis of body temperature from patients using the extended Poincaré plot helped identify inpatients from outpatients with cirrhosis. Through these analyses, the extended Poincaré plot provided unique and additional information which could potentially make a difference in clinical practice. Conclusively, the potential use of our work lies in its possible application of predicting mortality for the organ allocation procedure in patients with cirrhosis and non-invasively distinguish between atopic and non-atopic asthma.

The Poincaré plot is a geometrical technique used to visualize and quantify the correlation between two consecutive data points in a time-series. Since the dynamics of fluctuations in physiological rhythms exhibit long-term correlation and memory, this study aimed to extend the Poincaré plot by calculating the correlation between sequential data points in a time-series, rather than between two consecutive points. By incorporating this so-called lag, we hope to integrate a temporal aspect into quantifying the correlation, to depict whether a physiological system holds prolonged association between events separated by time. In doing so, it attempts to instantaneously characterize the intrinsic behavior of a complex system. We tested this hypothesis on three different physiological time-series: heart rate variability in patients with liver cirrhosis, respiratory rhythm in asthma and body temperature fluctuation in patients with cirrhosis, to evaluate the potential application of the extended Poincaré method in clinical practice. When studying the cardiac inter-beat intervals, the extended Poincaré plot revealed a stronger autocorrelation for patients with decompensated liver cirrhosis compared to less severe cases using Pearson’s correlation coefficient. In addition, long-term variability (known as SD2 in the extended Poincaré plot) appeared as an independent prognostic variable. This holds significance by acting as a non-invasive tool to evaluate patients with chronic liver disease and potentially facilitate transplant selection as an adjuvant to traditional criteria. For asthmatics, employing the extended Poincaré plot allowed for a non-invasive tool to differentially diagnose various classifications of respiratory disease. In the respiratory inter-breath interval analysis, the receiver operating characteristic (ROC) curve provided evidence that the extension of the Poincaré plot holds a greater advantage in the classification of asthmatic patients, over the traditional Poincaré plot. Lastly, the analysis of body temperature from patients using the extended Poincaré plot helped identify inpatients from outpatients with cirrhosis. Through these analyses, the extended Poincaré plot provided unique and additional information which could potentially make a difference in clinical practice. Conclusively, the potential use of our work lies in its possible application of predicting mortality for the organ allocation procedure in patients with cirrhosis and non-invasively distinguish between atopic and non-atopic asthma.

Xylanases are key enzymes for agricultural biomass saccharification for the production of cellulosic ethanol. Success in enzymatic lignocellulose bioconversion is restricted by enzyme production costs, activity and stability under harsh reaction conditions, and their performance when interacting into cellulolytic cocktails. In this work, we present the heterologous expression and enzymatic characterization of a novel endo-β-1,4 xylanase of glycoside hydrolase family 10 (GH10ps) from the white-rot basidiomycete Pycnoporus sanguineus BAFC 2126. Recombinant expression of GH10ps in Pichia pastoris showed that it is a robust enzyme active at a wide range of pHs and temperatures, and with a half-life of 3 h at 70 °C and a stability higher than 48 h at 60 °C. Recombinant GH10ps was also capable of releasing xylooligosaccharides and xylose from pretreated agricultural waste biomass and also complemented commercial cellulases in lignocellulose bioconversion to fermentable sugars. Fil: Niderhaus, Cecilia. Universidad de Buenos Aires; Argentina Fil: Garrido, Mercedes María. Universidad de Buenos Aires; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Insani, Ester Marina. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Buenos Aires; Argentina Fil: Campos, Eleonora. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Buenos Aires; Argentina Fil: Wirth, Sonia Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Buenos Aires; Argentina

Chronic leg ulcers can have a major impact on the quality of life of patients. These wounds can be complex and hard to heal, as several factors may affect the outcome. Underlying conditions, bacterial growth and excess moisture may prevent wounds from healing. We describe the case of a patient with known chronic venous disease, who was admitted to our hospital for several complex, irregular and infected chronic venous ulcers in his lower legs. The management was frustrating for several months, until we began to use methacrylate powder dressing for his hard-to-heal wounds.

A new and generalized statistical model, called Málaga or simply ℳ distribution, has been derived recently to characterize the irradiance fluctuations of an unbounded optical wavefront propagating through a turbulent medium under all irradiance fluctuation conditions. The aforementioned model extends and unifies in a simple analytical closed-form expression most of the proposed statistical models for free-space optical (FSO) communications widely employed until now in the scientific literature. Based on that ℳ model, we have studied some important features associated to its fade statistics and expressed in terms of the expected number of fades per second. The derived expressions become relevant for many aspects in a FSO system, especially those ones related to determine the optimum threshold in a receiver based on a direct detection scheme employing a fixed detection threshold.

Dihydroceramide desaturase 1 (Des1) catalyzes the last step of ceramide synthesis de novo, thus regulating the physiologically relevant balance between dihydrosphingolipids and sphingolipids. Here we report on the configurational preference of Des1 towards isomeric Δ

On January 25th 2011, Egyptians revolted, thereby making history. Before the date, roads to political activism were being incrementally built towards their eventual converging on Tahrir Square. This chapter argues that “nodes of convergence,” defined as shared political and economic grievances, as well as shared virtual and physical spaces, had to be created first before mass mobilization for a collective action of millions on the street could ensue. Providing in-depth examination of events leading to January 25th, this chapter offers a case study for mobilization, from which generalized theory is extrapolated about online communities' convergence, networking, and coalition building. Two main Facebook pages were studied: April 6th Youth Movement and We Are All Khaled Said-- both in Arabic. The conceptualization is built on anthropological fieldwork trips in Egypt since March 2011. This covered ethnographic participant-observations and interviewing. For evidence triangulation purposes of the “convergence effect”, the authors conducted qualitative content analysis of significant posts.

A popular method to estimate proximal/distal temperature (TPROX and TDIST) consists in calculating a weighted average of nine wireless sensors placed on pre-defined skin locations. Specifically, TPROX is derived from five sensors placed on the infra-clavicular and mid-thigh area (left and right) and abdomen, and TDIST from four sensors located on the hands and feet. In clinical practice, the loss/removal of one or more sensors is a common occurrence, but limited information is available on how this affects the accuracy of temperature estimates. The aim of this study was to determine the accuracy of temperature estimates in relation to number/position of sensors removed. Thirteen healthy subjects wore all nine sensors for 24 hours and reference TPROX and TDIST time-courses were calculated using all sensors. Then, all possible combinations of reduced subsets of sensors were simulated and suitable weights for each sensor calculated. The accuracy of TPROX and TDIST estimates resulting from the reduced subsets of sensors, compared to reference values, was assessed by the mean squared error, the mean absolute error (MAE), the cross-validation error and the 25th and 75th percentiles of the reconstruction error. Tables of the accuracy and sensor weights for all possible combinations of sensors are provided. For instance, in relation to TPROX, a subset of three sensors placed in any combination of three non-homologous areas (abdominal, right or left infra-clavicular, right or left mid-thigh) produced an error of 0.13°C MAE, while the loss/removal of the abdominal sensor resulted in an error of 0.25°C MAE, with the greater impact on the quality of the reconstruction. This information may help researchers/clinicians: i) evaluate the expected goodness of their TPROX and TDIST estimates based on the number of available sensors; ii) select the most appropriate subset of sensors, depending on goals and operational constraints.

BACKGROUND & AIMS: Sleep preparation/onset are associated with peripheral vasodilatation and a decrease in body temperature. The hyperdynamic syndrome exhibited by patients with cirrhosis may impinge on sleep preparation, thus contributing to their difficulties falling asleep. The aim of this study was the assessment of skin temperature, in relation to sleep-wake patterns, in patients with cirrhosis. METHODS: Fifty three subjects were initially recruited, and 46 completed the study. Of the final 46, twelve were outpatients with cirrhosis, 13 inpatients with cirrhosis, 11 inpatients without cirrhosis and 10 healthy volunteers. All underwent baseline sleep-wake evaluation and blood sampling for inflammatory markers and morning melatonin levels. Proximal/distal skin temperature and their gradient (DPG) were recorded for 24 hours by a wireless device. Over this period subjects kept a sleep-wake diary. RESULTS: Inpatients with cirrhosis slept significantly less well than the other groups. Inpatients and outpatients with cirrhosis had higher proximal temperature and blunted rhythmicity compared to the other groups. Inpatients with/without cirrhosis had higher distal temperature values and blunted rhythmicity compared to the other groups. Inpatients and outpatients with cirrhosis had significantly lower DPG values compared to the other groups, and DPG reached near-zero values several hours later. Significant correlations were observed between temperature and sleep-wake variables and inflammatory markers. CONCLUSIONS: Alterations of distal/proximal skin temperature, their gradient and their time-course were observed in patients with cirrhosis, which may contribute to their sleep disturbances. This article is protected by copyright. All rights reserved.

Digital and social inclusion intermediaries play a crucial role in providing digital literacy to excluded groups and in using Information and Communication Technologies (ICTs) to support social inclusion. However, information on the main characteristics of these actors is lacking. This paper presents the preliminary results of part of the MIREIA research conducted by the Institute for Prospective Technological Studies of the European Commission's Joint Research Centre, which aimed to characterise eInclusion intermediary actors in Europe and measure their socio-economic impact. This article explores the role of third sector organisations in the broader landscape of eInclusion intermediary actors. It first presents a conceptualization of the role and impacts of eInclusion intermediary actors, based on the results of a literature review and detailed 'locality mappings' conducted in three areas in Europe, in order to provide a definition of these actors. It then presents the methodology and main findings of an online survey designed to provide a 'map' of the eInclusion actors operating in Europe, answering the following questions: What are eInclusion actors? How can they be classified? Which services do they provide, to which targets groups?, and finally How do they operate and innovate? Findings show that the vast majority of eInclusion actors in the third sector are small organizations, in terms of staff numbers and budget, providing ICT services mainly to senior citizens, young adults and unemployed people. The results are consistent with the theoretical framework proposed and thus confirm that the configuration of the main characteristics of eInclusion intermediary actors is influenced by several factors including these actors' own intrinsic characteristics (mission, human and financial resources, etc.) and the external conditions (institutional environment, needs of the population where they operate, etc.). At the same time, these external factors and the different features of the intermediaries are linked and interrelated. These preliminary conclusions point to the fact that, despite the limitations inherent in the approach used, the findings presented in this paper can be considered relevant because: 1) they are the results of the first attempt in Europe to collect primary data from eInclusion intermediary actors and aim to create at least a baseline for future research; 2) the link between this activity and policy-making at EU level and the direct involvement of pan-European stakeholders and practitioners from the field will form the basis for further research and policy actions, informed by the results of the investigation; 3) the findings of the analysis provide useful insights and help shed light on the diversity and role of eInclusion intermediary actors and the contributions of their programmes to advancing social and economic inclusion in Europe. Further research is, however, required to systematise the findings and confirm the preliminary results with more in-depth investigation and analysis.

BACKGROUND: Clamping and cutting of the umbilical cord is the most prevalent of all operations, but the optimal timing of cord clamping is controversial, with different timings offering advantages and disadvantages. This study, for the first time, compares the influence of early and late cord clamping in correlation with oxidative stress and inflammation signaling, Because cord clamping timing may have a significant influence on placenta-to-infant blood transfer, thereby modifying oxygenation of maternal and fetal tissues, and on the transfer of inflammatory mediators throughout the placenta. METHODS: Sixty-four pregnant subjects were selected at the Gynecology and Obstetrics Services Department of the Clinico San Cecilio Hospital, Granada, Spain, based on disease-free women who experienced a normal course of pregnancy and a spontaneous, vaginal, single delivery. Half of the subjects had deliveries with early-clamped newborn infants (at 10 s), and the other half had late-clamped deliveries (at 2 min). RESULTS: Erythrocyte catalase activity was significantly greater in the late-clamped group than in the early-clamped group (P < .01 for the umbilical vein and P < .001 for the artery). The values for superoxide dismutase, total antioxidant status, and soluble tumor necrosis factor receptor II were all significantly higher in the late-clamped group compared with the early-clamped group (P < .01, P < .001, and P < .001, respectively). CONCLUSIONS: The results suggest a beneficial effect of late cord clamping, produced by an increase in antioxidant capacity and moderation of the inflammatory-mediated effects induced during delivery of term neonates.

Glycoside hydrolase family 8 (GH8) includes endoglucanases, lichenases, chitosanases and xylanases, which are essential for polysaccharides breakdown. In this work, we studied a thermally stable GH8 from the cellulose synthase complex of Enterobacter sp. R1, for deconstruction of β-glucans. The biochemical characterization of the recombinant GH8ErCel showed high specificity towards barley β-glucan and lichenan and lower activity on carboxymethylcellulose and swollen cellulose, yielding different length oligosaccharides. By molecular modeling, six conserved subsites for glucose binding and some possible determinants for its lack of xylanase and chitosanase activity were identified. GH8ErCel was active at a broad range of pH and temperature and presented remarkable stability at 60 °C. Additionally, it hydrolyzed β-glucan from oat and wheat brans mainly to tri- and tetraoligosaccharides. Therefore, GH8ErCel may be a good candidate for enzymatic deconstruction of β-glucans at high temperature in food and feed industries, including the production of prebiotics and functional foods.

Little is known about the pathogenesis of cerebral sinovenous thrombosis (CSVT) in the neonate. Although thrombophilia has been described as increasing the risk of CSVT in adults, it remains controversial in pediatric patients, and prospective case–control studies regarding neonatal CSVT are lacking. From 2008 to 2017, all 26 consecutive newborn infants ≥35 weeks of gestation diagnosed with neonatal CSVT, and their mothers, were tested for factor V Leiden (FV) G1691A, FII G20210A, and methylenetetrahydrofolate reductase C677T (MTHFR C677T) mutations. Eighty-five mother–infant pairs were recruited as controls. All infants except 1 with CSVT were suspected due to clinical symptoms, mainly seizures (22/25). Magnetic resonance imaging was performed in 24/26 infants. Heterozygous FV G1691A, FII G20210A, and homozygous MTHFR C677T mutations were present in 1/26, 3/26, and 3/20 infants with CSVT, respectively. FII (odds ratio: 10.96; 95% confidence interval [CI]: 1.09-110.35) and male sex (3.93; 95% CI: 1.43-10.76) were associated with CSVT. When FII G20210A analysis was adjusted for sex, the OR for FII G20210A was 6.70 (95% CI: 0.65-69.22). No differences were found for FV G1691A or homozygous MTHFR mutations between neonates with CSVT and their mothers, compared to controls.

Mestrado em Bioquímica O sobreiro (Quercus suber) é uma árvore de grande longevidade, sendo a espécie dominante do montado de sobro, que se localiza predominantemente na bacia do mediterrânio. A cortiça é a camada mais externa que reveste o tronco e ramos de Q. suber e tem funções de proteção e isolamento. Quimicamente, é composta por suberina, lenhina, polissacarídeos e extratáveis, sendo a suberina o constituinte maioritário e o principal responsável pelas suas propriedades, e que permitem a sua aplicação em diversas áreas para além da produção de rolhas. A aplicação da cortiça tem sido cada vez mais diversificada e a cortiça é já utilizada em indústrias como a construção civil, aeroespacial, e aeronáutica. A maioria da cortiça utilizada pela indústria torna-se subproduto, e estes subprodutos são triturados e aproveitados para a produção de aglomerados de cortiça, onde os grânulos resultantes da trituração são misturados com aglutinantes. Os aglutinantes mais utlizados na produção de aglomerados de cortiça são os poliuretanos (PU), especialmente PU aromáticos como o toluenodiisocianato (TDI) e o difenilmetilenodiisocianato (MDI). Os aglomerados de cortiça estendem atualmente a aplicação deste material a áreas como a moda e o design. A aplicação de aglomerados de cortiça em produtos para contacto com alimentos na Europa obriga ao cumprimento de regulamentações estabelecidas pela Comissão Europeia. A certificação para o contacto com alimentos para materiais aglomerados de cortiça rege-se pelas diretivas para plásticos uma vez que não existem diretivas específicas para cortiça. O processo de certificação inclui análises de migração global do material, sendo que o limite máximo de substâncias migrantes é de 10 mg/dm2, análises de migração específica aos isocianatos (TDI e MDI) e aminas aromáticas primárias (AAP) com limites máximos permitidos de 1 mg/kg e 0,01 mg/kg respetivamente. As AAP originam-se da reação dos isocianatos com a água e, tal como estes, são também perigosas para a saúde do consumidor e por isso são alvo de restrições. Os materiais têm ainda de ser sujeitos a análises sensoriais e metais pesados. Os dois materiais que foram testados para o contacto com alimentos passaram nos testes de certificação, embora por vezes com algumas limitações. Foi ainda testado um material revestido com parafina com os quais não se conseguiram resultados tão promissores devido às propriedades do revestimento, que se perde e contacto com alguns simuladores utilizados. The cork oak (Quercus suber) is a long life tree and the most abundant species of cork oak forests and spreads in the countries of the Mediterranean basin. Cork is the outer bark of Q. suber trunk and branches and has functions like protection and insolation. Chemically, cork is composed by suberin, lignin, polysaccharides and extractives. Suberin is the most abundant compound of cork and the one responsible for its properties which allows its application in different areas beyond cork stoppers production. Thus, cork has been used in different industries like building, aerospace and aeronautics. Most of the cork from cork industry is byproduct and only a little amount is used for natural cork stoppers production. These byproducts are mashed and mixed together with a binder for cork agglomerates production. Binders commonly used in the production of cork agglomerates are polyurethane (PU) based, especially toluene diisocyanate (TDI) and diphenylmethane diisocyanate (MDI). Cork agglomerates intended for food contact materials require the compliance with European Commission regulations. Since there is no certification standards for cork based material intended for food contact this process is based on plastics directives. The certification process comprises overall migration tests (with the limit of 10 mg/dm2) and specific migration of isocianates (TDI and MDI) and primary aromatic amines (AAP) (with limits of 1 mg/kg and 0,01 mg/kg). AAP comes from reaction between isocianates and water and are considered as dangerous and for the consumer health. Moreover, the materials have to be tested for sensory analysis and heavy metals. Both materials tested in this work for food contact application passed the certification tests even with some restrictions. Another material coated with paraffin was also tested but the results were not so promising because of the properties of the coating that is lost with some simulants.

Gender is a crucial determinant of life span, but little is known about gender differences in free radical homeostasis and inflammatory signaling. The aim of the study was to determine gender-related differences concerning oxidative stress and inflammatory signaling of healthy neonates and mothers. Fifty-six mothers with normal gestational course and spontaneous delivery were selected. Blood samples were collected from the mother (at the beginning of delivery and start of expulsive period) and from neonate (from umbilical cord vein and artery). The mothers of girls featured a higher total antioxidant status and lower plasma hydroperoxides than the mother of boys. Regarding the neonates, the girls featured a higher total antioxidant status and lower plasma membrane hydroperoxides in umbilical cord artery together with higher catalase, glutathione peroxidase, and superoxide dismutase activities. Lower levels of interleukin 6, tumor necrosis factor alpha, and prostaglandin E2 were observed in the mothers of girls and higher level of soluble tumor necrosis factor receptor II. In the neonates, lower levels of interleukin 6 and tumor necrosis factor alpha were observed in umbilical artery and higher soluble tumor necrosis factor receptor II in umbilical cord vein and artery of girls. An association between gender, oxidative stress, and inflammation signaling exists, leading to a renewed interest in the neonate’s sex as a potential risk factor to several alterations.

Human papilloma virus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) has a better prognosis than it's HPV negative (HPV(-)) counterpart. This may be due to the higher numbers of tumor-infiltrating lymphocytes (TILs) in HPV positive (HPV(+)) tumors. RNA-Sequencing (RNA-Seq) was used to evaluate whether the differences in clinical behaviour simply reflect a numerical difference in TILs or whether there is a fundamental behavioural difference between TILs in these two settings. Thirty-nine HNSCC tumors were scored for TIL density by immunohistochemistry. After the removal of 16 TILlow tumors, RNA-Seq analysis was performed on 23 TILhigh/med tumors (HPV(+) n=10 and HPV(-) n=13). Using EdgeR, differentially expressed genes (DEG) were identified. Immune subset analysis was performed using Functional Analysis of Individual RNA-Seq/ Microarray Expression (FAIME) and immune gene RNA transcript count analysis. In total, 1,634 DEGs were identified, with a dominant immune signature observed in HPV(+) tumors. After normalizing the expression profiles to account for differences in B- and T-cell number, 437 significantly DEGs remained. A B-cell associated signature distinguished HPV(+) from HPV(-) tumors, and included the DEGs CD200, GGA2, ADAM28, STAG3, SPIB, VCAM1, BCL2 and ICOSLG; the immune signal relative to T-cells was qualitatively similar between TILs of both tumor cohorts. Our findings were validated and confirmed in two independent cohorts using TCGA data and tumor-infiltrating B-cells from additional HPV(+) HNSCC patients. A B-cell associated signal segregated tumors relative to HPV status. Our data suggests that the role of B-cells in the adaptive immune response to HPV(+) HNSCC requires re-assessment.

UNLABELLED Hyperammonaemia/mild hepatic encephalopathy (HE) can be simulated by the oral administration of a so-called amino acid challenge (AAC). This study sought to assess the effects of the AAC alone and in combination with either ammonia-lowering [L-ornithine-L-aspartate (LOLA)] or vigilance-enhancing medication (caffeine). Six patients with cirrhosis (5 males; 61.3 ± 9.2 years; 5 Child A, 1 Child B) and six healthy volunteers (5 males; 49.8 ± 10.6 years) were studied between 08:00 and 19:00 on Monday of three consecutive weeks. The following indices were obtained: hourly capillary ammonia, hourly subjective sleepiness, paper & pencil/computerized psychometry and wake electroencephalography (EEG) at 12:00, i.e. at the time of the maximum expected effect of the AAC. RESULTS On average, patients had worse neuropsychological performance and slower EEG than healthy volunteers in all conditions but differences did not reach significance. In healthy volunteers, the post-AAC increase in capillary ammonia levels was contained by both the administration of LOLA and of caffeine (significant differences between 10:00 and 14:00 h). The administration of caffeine also resulted in a reduction in subjective sleepiness and in the amplitude of the EEG on several frontal/temporal-occipital sites (p

The article Assessment and Management of Sleep Disturbance in Cirrhosis, written by Chiara Formentin, Maria Garrido, and Sara Montagnese, was originally published electronically on the publisher’s internet portal (currently SpringerLink) on 13 February 2018 without open access.

Background Providing structured information for the understanding of hepatic encephalopathy (HE) might be relevant to the prevention and management of the syndrome. The aim of our study was to design a brief, structured educational intervention and evaluate its usefulness in preventing HE-related hospitalisation over time. Methods Thirty-nine cirrhotic outpatients with a history of HE were enrolled and randomly assigned to an intervention (group A; n=20) or control group (group B; n=19). All of them underwent evaluation of HE (clinical and quantitative neuropsychiatric assessment) and completed the Questionnaire on the Awareness of Encephalopathy. A 15 min educational session was then provided to patients in group A, including basic information on the pathophysiology, hygienic and medical management of HE. Results No demographic/clinical differences were observed at baseline between the two groups. Similarly, there were no significant differences in HE-related information available at baseline between the two groups; knowledge of HE was limited in both. The intervention was highly effective in increasing patients’ understanding of treatment of the condition (from 5% to 80%). The educational intervention also reduced the risk of developing an episode of HE over a period of 12 months. Conclusion The educational intervention confirmed the poor knowledge of patients with previous HE about their condition, served as a tool to increase patients’ awareness, and minimised HE-related readmission rates over a period of 1 year.

Introduction Macrophages play a major role as effector cells of the innate immune system and are vital for intestinal tissue homeostasis. An altered function of intestinal macrophages may contribute to the development and propagation of intestinal inflammation in IBD. However, all data available come from mouse models, human whole tissue or in vitro derived macrophages from blood monocytes. We have isolated intestinal macrophages from patients and healthy subjects and analysed their transcriptome in order to study the intrinsic role that macrophages play in the pathogenesis of IBD. Method Fresh colonic mucosal tissue biopsies from 10 CD patients, 10 UC patients and 10 healthy controls were disaggregated to cell suspensions and sorted using fluorescence-activated cell sorting. RNA from intestinal macrophages, identified as CD163+CD14+CD3- population, was extracted and subjected to RNA sequencing. Differential Gene Expression analysis and pathway analysis were performed between the groups. Results The transcriptomic analysis revealed that the gene expression profile of the intestinal macrophages from IBD is dramatically reprogrammed. Differential Gene Expression analysis revealed 1287 DEGs between macrophages from UC patients and healthy controls; 840 DEGs between macrophages from CD patients and healthy controls and 20 DEGs between macrophages from UC and CD patients (1.5 fold change and FDR Conclusion This is the first study to describe the transcriptome of intestinal macrophages from active lesions of patients with IBD by high throughput RNAseq. We show that the transcriptome of these macrophages is profoundly different from those taken from healthy subjects. These results suggest that macrophages play an important role in the propagation of inflammation and we have identified a number of molecules that should be investigated as potential therapeutic targets. Disclosure of Interest None Declared

Este estudo objetiva descrever uma experiência de formação para marisqueiras, conduzida junto à comunidade pesqueira de Ilha do Paty, São Francisco do Conde, em um contexto de ações para promoção da saúde e da segurança alimentar. Estudo de intervenção, com planejamento de atividades por equipe multidisciplinar. As atividades foram desenvolvidas em cinco etapas: sondagem de temas; sensibilização; rotina de trabalho das marisqueiras; curso de boas práticas no beneficiamento de mariscos; e roda de conversa. As metodologias incluíram exposição dialogada, dinâmica de grupos, oficinas, teatro, uso de imagens, atividades dirigidas e distribuição de materiais didáticos. Ao final, solicitou-se a avaliação dos participantes quanto a distintos itens. Em geral, registrou-se satisfação do público-alvo, para a maioria dos indicadores, o que pode relacionar-se tanto à utilização de recursos audiovisuais e estratégias que permitiram troca de experiências, quanto ao reconhecimento da importância da formação. A experiência demonstra o potencial de desenvolvimento de atividades educativas junto a comunidades pesqueiras, com resultados que contribuem para o fortalecimento de cadeias produtivas locais, com promoção da segurança alimentar e da saúde do trabalhador. This study describes an experience in the training of female shellfish gatherers in the fishing community in Ilha do Paty, São Francisco do Conde, within the context of actions to promote health and food safety. This is an intervention study with planning of activities by a multidisciplinary team. The activities were developed in five stages: survey of topics of interest; awareness; female shellfish gatherers' work routine; teaching of best practices in the processing of shellfish; and group conversation. The methodologies included exposure through dialogue, group dynamics, workshops, theater, work with images, directed activities and the distribution of educational materials. At the end, an evaluation by the participants regarding the different aspects was conducted. Overall there was satisfaction among the audience for most indicators, which may relate to both the use of audiovisual resources and strategies that permitted the exchange of experiences regarding the recognition of the importance of training by the target audience. The experiment demonstrates the potential of developing educational activities with the fishing communities, with results that contribute to the bolstering of the local supply chain, with the promotion of food safety and occupational health.

O grupo PET-Saúde da Universidade Estadual de Londrina que atua na Unidade Básica de Saúde Cambé II do município de Cambé-PR realizou pesquisa no período de maio a setembro de 2013 para verificar o acesso das gestantes que realizavam o pré-natal na UBS ao programa odontológico e também para verificar o conhecimento, comprometimento e o referenciamento das gestantes para atenção odontológica pela equipe de saúde. A coleta de dados foi realizada por meio de questionários estruturados. Foram entrevistadas 26 gestantes de um total de 51 que realizavam pré-natal na UBS e 29 funcionários da UBS. Verificou-se que 69,23% das gestantes conheciam o programa odontológico para gestantes; destas 77,77% receberam orientações na primeira consulta do pré-natal e agendaram a primeira consulta ao dentista. 94.44% das gestantes receberam informações de forma verbal, por meio do médico obstetra, equipes de enfermagem e odontologia. Nenhuma agente comunitária de saúde transmitiu estas informações às gestantes. Quanto aos funcionários, 100% dos entrevistados afirmaram conhecer o programa odontológico para gestantes e ter conhecimento de que a equipe do PSF deve orientar as gestantes as gestantes para a atenção odontológica. Concluiu-se que a criação de instrumentos ou de estratégias padronizadas para a disseminação da informação, normatização e envolvimento de toda a equipe pode melhorar a logística e a adesão ao programa.

The effects of intradentate colchicine injections on the performance of tasks requiring spatial working and reference memory are controversial. Multiple-site colchicine injections (7 microg/microl; via a drawn micropipette) throughout the dentate gyrus (DG) of rats (nine sites in each hemisphere, 0.06 microl at each site) selectively destroy about 90% of the DG granule cells, as revealed by quantitative stereological estimates; stereology also revealed minor neuronal losses in the CA4 (33%) and CA1 (23%) subfields, but lack of damage to the CA3 hippocampal subfield. Spatial reference and working memory were assessed in Morris' water maze; in the reference memory task, the rats were required to learn a single, fixed location for the platform over several days of training; in the working memory task, animals were required to learn a new platform location every day, in a matching-to-place procedure. Compared to sham-operated controls, lesioned rats showed significant disruption in acquisition of the reference memory water maze task; however, the data reveal that these rats did acquire relevant information about the task, probably based on guidance and orientation strategies. In a subsequent probe test, with the platform removed, lesioned rats showed disruption in precise indexes of spatial memory (e.g., driving search towards the surroundings of the former platform location), but not in less precise indexes of spatial location. Finally, the lesioned rats showed no improvement in the match-to-place procedure, suggesting that their working memory for places was disrupted. Thus, although capable of acquiring relevant information about the task, possibly through guidance and/or orientation strategies, DG-lesioned rats exhibit a marked difficulty in place strategies. This is particularly evident when these rats are required to deal with one-trial place learning in a familiar environment, such as in the working memory version of the water maze task, which requires flexibility in the use of previously acquired information.

To assess the impact of massage versus ear acupuncture on behavior and participation in occupational therapy of dementia patients.We performed a controlled, randomized longitudinal trial approved by the Bioethics Commission of the University of Extremadura. One hundred twenty elderly subjects with dementia institutionalized in residential homes in Extremadura (Spain) received treatment based on massage and ear acupuncture over three months. Behavior alterations, sleep disturbance, and participation in rehabilitation and eating were assessed every month during the three months of intervention, and at one and two months of follow-up after the end of treatment. The assessment was performed through a structured questionnaire with closed format questions done by an occupational therapist not involved in the study.There was a statistically significant positive effect of massage and ear acupuncture (P0.001) on measured variables in the third month of intervention, which were maintained at two months after completing the treatment (P0.021), when compared to the control group.Massage therapy and ear acupuncture can improve behavior and sleep disturbances, and increase the participation in eating and rehabilitation organized in residential homes, in dementia patients.