Search

Cerebral salt wasting syndrome is described as a hyponatremic condition in the context of a central nervous system injury. It is caused by a renal loss of sodium, and the primary distinguishing factor among similar conditions, such as the syndrome of inappropriate antidiuretic hormone secretion, is a reduction in the extracellular fluid volume. We describe here the case of a young adult who suffered brain injuries as a result of a gunshot and developed cerebral salt wasting syndrome during his in-hospital stay. Any type of cerebral attack can lead to hyponatraemic syndrome, but the most common are subarachnoid hemorrhages and neurological and meningeal tuberculosis infections. Treatment of the cerebral salt wasting syndrome leads to both hypovolemia and hyponatremia correction. The first line of management included hydric reposition with saline solution, either isotonic or hypertonic, depending on the severity of the symptoms.

Abstract Excessive gestational weight gain may be associated with unfavorable pregnancy outcomes. We explored the impact of excessive weight gain on components of HDL metabolism in maternal plasma: sterol composition of HDL particles, distribution of HDL subclasses and SCARB1, ABCA1 and ABCG1 genes expressions and their associations with newborns’ characteristics. The study included 124 pregnant women, 58 with recommended and 66 with excessive weight gain. Concentrations of cholesterol synthesis marker, desmosterol, within HDL increased during pregnancy in both groups of participants. In women with excessive weight gain, levels of cholesterol absorption marker, campesterol, within HDL were significantly lower in the 3rd trimester compared to the 1st and 2nd trimesters. Relative proportions of large HDL 2b subclasses increased during pregnancy in women with recommended weight gain. Women with high pre-pregnancy BMI and excessive gestational weight gain had the lowest levels of β-sitosterol within HDL and the highest relative proportions of HDL 3a and HDL 3b subclasses in the 2nd trimester. Large HDL 2b particles were in positive correlation, while smaller HDL 3 subclasses and SCARB1 gene expressions were in negative correlation with APGAR scores. In conclusion, excessive weight gain could contribute to altered metabolism of HDL, and subsequently to poorer neonatal outcomes.

Objetivo: Describir y sintetizar la literatura científica publicada entre 2017 y 2023 sobre las repercusiones psicológicas de la angustia moral y la sensibilidad ética en profesionales sanitarios de Unidades de Cuidados Intensivos. Metodología: se diseñó una Revisión de alcance realizando búsquedas en las siguientes bases de datos: Medline,Scopus,Sciencedirect,Dialnet,Scielo. Se utilizaron ecuaciones de búsqueda como: “Effects of moral distress AND health personnel”, “effects of ethical sensitivity AND healthcare personnel”. Se extrajo información sobre variables relacionadas con angustia moral y sensibilidad ética, se diseñó una base de datos para clasificar la información, sintetizarla y realizar un análisis hermenéutico. Resultados: se identificaron factores internos y externos relacionados con angustia moral y sensibilidad ética. Los factores internos fueron frustración, impotencia y enojo; los factores externos estuvieron relacionados con las políticas del hospital, la jerarquía en la UCI y la falta de comunicación. Al sufrir angustia moral y disminuir la sensibilidad ética se identificó falta de empatía y fatiga mental. Sin embargo, hay mayor desarrollo de la sensibilidad ética cuando se realizan actividades grupales para búsqueda de nuevos conocimientos y estrategias de comunicación asertiva. Conclusión: los profesionales sanitarios que trabajan en UCI están expuestos a sufrir angustia moral y su sensibilidad ética se pone a prueba diariamente. A raíz de la pandemia por COVID-19 los desafíos éticos experimentados se hacen más evidentes, esto ha aumentado síntomas de angustia moral como sentimientos de culpa, preocupación y pérdida de confianza. La sensibilidad ética es importante en las UCI para reconocer y comprender los problemas del personal sanitario.

Abstract The COVID-19 pandemic had a profound global impact, characterized by a high fatality rate and the emergence of enduring consequences known as Long COVID. Our study sought to gauge the prevalence of Long COVID syndrome in northeastern Mexico, correlating it with patients' comorbidities and vaccination records. We carried out an observational cross-sectional approach, by administering a comprehensive questionnaire covering patients’ medical history, demographics, vaccination status, COVID-related symptoms, their duration, and any treatment received. Our participant cohort included 804 patients, averaging 41.5 (SD 13.6) years in age, with 59.3% being women. Notably, 168 individuals (20.9%) met Long COVID criteria. Our analysis of COVID-19 long lasting compared vaccination schemes, unveiling a significant difference between vaccinated and unvaccinated groups (p =

Abstract Background Multimodal rehabilitation has shown good results in adults with temporomandibular disorder (TMD), but there is still doubt regarding the protocol’s ideal format (face-to-face or online), and its effectiveness among adolescents. The purpose of this study is to describe a randomized clinical trial protocol of face-to-face and online multimodal rehabilitation, in adolescents with TMD, and to determine its effects on pain, peripheral oxygenation of the masseter muscle, and mandibular range of motion, kinesiophobia and parafunction. Methods A randomized, controlled clinical trial, blinded to statistical analyses, will be carried out, involving 26 adolescents, diagnosed with TMD. After randomization, the participants will be allocated into two groups: (1) telerehabilitation and (2) face-to-face treatment groups. Each group will undergo an initial assessment, followed by three treatment sessions, reassessment, and follow-up. Appointments and reassessments will be face-to-face, with instruments validated and adapted for adolescent age groups. The intervention protocol also aims at practicality, ease of execution, and strategies for the patient to easily self-manage and perform independently, adapted for face-to-face or online formats. The Diagnostic Criteria for Temporomandibular Disorders, physical and psychosocial aspects, algometry, near-infrared spectroscopy, and the Tampa scale for kinesiophobia will be used to assess the outcomes. Discussion It is expected that this study will contribute to online and face-to-face assessments and demonstrate the differences in the practice of rehabilitation of adolescents with TMD. Data will be published after the study is completed, and if the benefits are proven, care modalities may be implemented. Trial registration REBEC—RBR-5scd5tm, UTN code: U1111-1288–4495 . Registered on 19 May 2023.

Abstract Background The COVID-19 pandemic has resulted in a critical shortage of respiratory ventilators, highlighting the urgent need to explore alternative treatment options for patients with acute respiratory distress syndrome (ARDS) caused by respiratory viruses, as an alternative to invasive mechanical ventilation (IMV) in future pandemics. Objectives The objective of this study was to assess the effectiveness of alternative noninvasive oxygenation and ventilation strategies in comparison to invasive mechanical ventilation (IMV) in patients with virus-induced acute respiratory failure (ARF). The primary outcome was the all-cause ICU mortality rate. Methods A systematic review was conducted following the Cochrane guidelines and PRISMA reporting guidelines. The search encompassed databases such as Medline, Cochrane CENTRAL, and Embase to identify relevant indexed literature. Additionally, gray literature was included by consulting regulatory agencies. The included studies compared various oxygenation and ventilatory alternatives, such as high-flow nasal cannula (HFNC), continuous positive airway pressure (CPAP), or noninvasive mechanical ventilation (NIMV) with IMV. An exploratory meta-analysis was performed by calculating the risk ratio (RR) by random effects and meta-regression to explore possible sources of heterogeneity and to compare ventilatory alternatives against IMV to reduce mortality, length of stay (LOS) days in ICU, nosocomial infection, and barotrauma. Results A total of forty-seven studies were included in this systematic review. NIMV had an RR of 0.70 (0.58–0.85), HFNC had an RR of 0.54 (0.42–0.71), and CPAP had an RR of 0.80 (0.71–0.90), with meta-regression models that reduced heterogeneity to 0%. For LOS days in ICU, NIMV had 0.38 (− 0.69: − 0.08) lower days and HFNC 0.29 (− 0.64: 0.06) lower days with meta-regression models that reduction heterogeneity to 0% for HFNC and 50% for NIMV. Not enough studies reported nosocomial infection or barotrauma to evaluate them in a meta-analysis. The overall quality of evidence, as assessed by GRADE evaluation, was determined to be from very low to medium certainty depending on the ventilatory strategy and outcome. Conclusions The findings of this systematic review support the use of alternative noninvasive oxygenation and ventilation strategies as viable alternatives to conventional respiratory ventilation for managing viral-induced ARF. Although it is essential to interpret these findings with caution given the overall low to medium certainty of the evidence, the integration of these modalities as part of the management strategies of these patients could help reduce the utilization of ICU beds, invasive ventilators, and costs in both developed and developing countries.

Polysarcosine emerges as a promising alternative to polyethylene glycol (PEG) in biomedical applications, boasting advantages in biocompatibility and degradability. While the self-assembly behavior of block copolymers containing polysarcosine-containing polymers has been reported, their potential for shape transformation remains largely untapped, limiting their versatility across various applications. In this study, we present a comprehensive methodology for synthesizing, self-assembling, and transforming polysarcosine-poly(benzyl glutamate) block copolymers, resulting in the formation of bowl-shaped vesicles, disks, and stomatocytes. Under ambient conditions, the shape transformation is restricted to bowl-shaped vesicles due to the membrane's flexibility and permeability. However, dehydration of the polysarcosine broadens the possibilities for shape transformation. These novel structures exhibit asymmetry and possess the capability to encapsulate smaller structures, thereby broadening their potential applications in drug delivery and nanotechnology. Our findings shed light on the unique capabilities of polysarcosine-based polymers, paving the way for further exploration and harnessing of their distinctive properties in biomedical research.

Abstract Nutrition plays a crucial role in human and planetary health, as prevailing nutritional patterns significantly contribute to the global non-communicable disease pandemic. Moreover, the global food system is inextricably linked to planetary health deterioration. The relevance of nutrition for individual and planetary health is insufficiently addressed in German medical schools. Here, we present a two-week course for medical students in the 8th semester at Charité - Universitätsmedizin Berlin on nutrition and fasting in the context of human and planetary health. The course was developed iteratively along the Kern cycle for medical curricula and underwent evaluation through a mixed-methods design spanning across two consecutive semesters. Assessment involved quantitative questionnaires and qualitative interviews. The main exploratory outcome was the overall module rating. Further outcomes encompassed in-depth evaluations of specific aspects, including content, teaching methods, instructor performance, and subjective experiential aspects. The conceptualisation resulted in a highly participative two-week course of 37.5 h. The main learning objectives aimed at the acquisition of technical competences and personal competencies in four areas: (1) the role of nutrition in health and disease; (2) the exploration of global food systems; (3) communication on subjects of nutrition; (4) culinary medicine. Various interactive didactic methodologies were used. 77.8% (n = 27) of the participants rated the course as very good or good. The conviction that nutrition influences health and disease increased over the course (Wilcoxon signed rank test, z = -2.82, p = 0.005, r = 0.57). In the qualitative interviews (n = 8) the course content, its didactical diversity and the positive group experience were appreciated. Our results indicate that it could be worthwhile to further incorporate nutrition curricula in medical education.

Abstract Background Human milk electrolytes are known biomarkers of stages of lactation in the first weeks after birth. However, methods for measuring milk electrolytes are available only in laboratory or expert settings. A small handheld milk sensing device (Mylee) capable of determining on-site individual secretory activation progress from sensing the conductivity of a tiny milk specimen was developed. Here we evaluate the validity of a novel milk-sensing device (Mylee) for measuring the progress of milk maturation and secretory activation status. Methods Retrospective data analysis of laboratory records generated using the Mylee device. Device conductivity measurements were assessed for accuracy, reliability and stability in rigorous laboratory tests with standard materials. A set of human milk specimens (n = 167) was used to analyze the agreement between the milk maturation score and laboratory measurements of the secretory activation biomarker milk sodium [Na+]. Results The Mylee device was demonstrated to have excellent reproducibility (CV95% 0.90). With regression analysis, we revealed excellent agreement between Mylee milk maturation (MM%) output or its raw conductivity signal and laboratory measurements of conductivity and sodium [Na+] in a dataset of milk specimens (n = 167; R2 > 0.9). The Mylee MM% score showed good predictive ability for secretary activation status, as determined by sodium threshold (18 mmol/L) in human milk specimens. Conclusions In this study, we demonstrated the reliability and validity of the Mylee device and its ability to detect on-site milk secretory activation in a manner comparable to that of electrolyte-based methods. The novel MyLee device offers the potential to generate real-time information about the lactation stage, measured by mothers at the commodity of their home.

Abstract Introduction Certain aspects of indigenous communities, such as cultural practices and access to care, have been discussed as potential determinants of oral health. However, research on this topic remains limited. Understanding the factors influencing oral health and their perceptions is crucial for developing culturally appropriate interventions. This study aims to evaluate the determinants and self-perception of oral health through a mixed study within a specific indigenous community in the north of Chile. Furthermore, this is the first study to examine oral health in the Quechua and Aymara communities of Chile. Methods This exploratory study was conducted in in two phases: a quantitative phase, involving clinical examination and administration of questionnaires; and qualitative phase, consisting of interviews with subset of participants from the quantitative phase. A descriptive statistic of the quantitative data was performed. Results While no significant differences were found between indigenous and non-indigenous population in this city of Chile, differences were observed between the two main indigenous communities (Aymaras and Quechuas). Historical factors appeared to influence these differences. Belonging to the Aymara community emerges as a significant determinant of oral health, characterized by a greater need for oral rehabilitation, barriers to accessing dental care, lower self-perception of the quality of oral health. Educational level and rurality were identified as factors potentially affecting the oral health status of this community. Conclusion Ethnicity can influence in oral health, primarily in relation to rurality and educational level. This study found no significant overall differences in oral health between Indigenous and non-Indigenous participants. However, Quechuas exhibited better oral health than Aymaras. Participants demonstrated good oral health knowledge and a positive attitude towards prevention, despite recalling limited education in their youth. We emphasize the need for implementing strategies for oral health promotion and prevention that consider cultural, linguistic and specific needs of these communities.

IntroductionProlactin (PRL) is a pleiotropic hormone implicated in various physiological processes; however, its contribution to neurodevelopment, particularly early corticogenesis, remains insufficiently characterized. In this study, we investigate PRL’s regulatory influence on the initial stages of cortical development, with an emphasis on its effects on neuronal and astrocytic differentiation.MethodsWe employed a standardized in vitro differentiation protocol to generate cortical neurons from mouse embryonic stem cells (mESCs). Prolactin receptor (PRLr) expression was evaluated in pluripotent stem cells, neural stem cells (NSCs), immature neurons, and mature neurons using both PCR and immunofluorescence. These analyses revealed dynamic changes in PRLr expression throughout the differentiation process. Additionally, cells were treated with varying concentrations of PRL during early and late differentiation phases, enabling assessment of its impact on neuronal phenotypic distribution and morphological complexity.ResultsEarly PRL administration significantly enhanced the population of β-tubulin III + immature neurons, promoting neuronal survival without altering NSC proliferation. Furthermore, PRL treatment increased the abundance of Tbr1 + and NeuN + neurons, augmented dendritic complexity, and accelerated neuronal maturation. In contrast, PRL exposure at later stages of neural differentiation did not yield comparable effects. Notably, PRL delayed the maturation of protoplasmic astrocytes, although the total astrocyte population was not affected.DiscussionThese findings highlight PRL’s pivotal role as a regulator of early corticogenesis by modulating neuronal survival, dendritic development, and astrocyte maturation. PRL thus emerges as a potential key factor in neurodevelopment, underscoring its importance in the hormonal regulation of neural differentiation and maturation. These insights may have broader implications for understanding the molecular and cellular mechanisms underlying normal and pathological neurodevelopment.

Introduction: This scoping review aimed to analyze the literature on the relationship between heatwaves or above-average temperature and interpersonal violence. Because of the nature of third-party violent behavior and our focus on the most direct effects of abnormal temperature on it, we excluded self-directed and collective violence, such as social conflicts. Methods: This review was conducted in accordance with the JBI methods outlined for scoping reviews and in line with the Preferred Reporting Items for Systematic Reviews (PRISMA-ScR). The publication period under consideration was 2012-2024 and was conducted on Scopus, PubMed, Web of Science, and PsycINFO databases. Results: Of the original number of 5,146 studies, 15 were included in the scoping review. Works including historical and longitudinal data were considered. Overall, the results of the studies included in the review highlighted a relationship between heatwaves and above-average temperature and interpersonal violence, and highest temperatures are presented as a predictor of interpersonal violence. Discussion: The literature analysis underlines how climate change may affect people’s well-being, mental health, and behavior. However, it is essential to point out that most authors acknowledge their study’s limitations and that the results should be cautiously viewed. Future research is needed to better understand the relationship between heatwaves or above-average temperature and human health. Policymakers should implement programs to prevent violent behavior in terms of increased temperature adaptation and mitigation (e.g., promoting green spaces and reducing pollution) and at the level of individual city institutions, which can monitor the phenomenon and take action, such as increasing the presence of security personnel in anticipation of periods of highest temperatures.

The Special Rapporteur on the promotion and protection of human rights in the context of climate change, Elisa Morgera, prepared a Report on access to information on climate change and its impact on human rights in July 2024. The report was presented at the 79th session of the UN General Assembly. The report highlights the challenges and good practices related to access to information on climate change and human rights and clarifies the international obligations of states, recommending the strengthening of international cooperation which can increase public awareness and participation. By ensuring access to credible and transparent information, the states should give the opportunity to every citizen to adapt and manage extreme situations in a timely manner. The responsibility of the business environment in preventing negative effects that some development projects could have on the climate and human rights is also highlighted. The report aims to inform on the interpretation and implementation of the Paris Agreement on climate change. It is stressed that Member States must take on their climate change obligations, as well as the Glasgow Climate Action Work Programme. Last but not least, it recalls the importance of achieving at global level Sustainable Development Goals 13 (climate action) and 14 (life below water) of the 2030 Agenda to which Member States adhered in 2015.

Este artículo describe la economía criminal del grupo delincuencial organizado “Los Pachelly”, así como su relación con el narcotráfico en el municipio de Bello, Antioquia (2009-2020). Más que una comprensión cuantitativa de la capacidad económica de este actor se busca describir, catalogar y analizar las dinámicas que ejecuta para su persistencia en el tiempo. Metodológicamente, la investigación hace uso del estudio de caso y la técnica de rastreo de prensa, identificando las dinámicas delictivas, de coerción y coacción, en las cuales este actor basa su accionar para obtener recursos financieros. Los registros noticiosos fueron contrastados con documentos oficiales e informes de organizaciones no gubernamentales, entre otras fuentes. Esta investigación aporta a la comprensión del fenómeno de las economías criminales y su incidencia en los territorios, particularmente en uno poco explorado en relación con dichas temáticas.

Virginia Woolf's personal life has sparked an incredible amount of controversy throughout the years. Numerous speculations have been developed about her personal struggle with mental illness and the effect it had on her writing. This article argues that in Woolf’s case, writing took the form of “scriptotherapy”, which is regarded as an effective means of dealing with trauma. From another angle, the article aims to shed more light on yet another manifestation of Woolf’s genius: an intuitive but accurate description of a war veteran’s torment and subsequent suicide, as a consequence of dealing with untreated Post-Traumatic Stress Disorder. When examining Septimus’ trauma, we identify similarities between his story and Woolf’s personal experience with the male-dominated psychiatric elite of her times (documented by her biographers). The study also investigates Virginia Woolf’s feminist perspective on trauma, through analysing societal norms’ profound influence on human suffering.

Abstract Knowledge about seafloor depth, or bathymetry, is crucial for various marine activities, including scientific research, offshore industry, safety of navigation, and ocean exploration. Mapping the central Arctic Ocean is challenging due to the presence of perennial sea ice, which limits data collection to icebreakers, submarines, and drifting ice stations. The International Bathymetric Chart of the Arctic Ocean (IBCAO) was initiated in 1997 with the goal of updating the Arctic Ocean bathymetric portrayal. The project team has since released four versions, each improving resolution and accuracy. Here, we present IBCAO Version 5.0, which offers a resolution four times as high as Version 4.0, with 100 × 100 m grid cells compared to 200 × 200 m. Over 25% of the Arctic Ocean is now mapped with individual depth soundings, based on a criterion that considers water depth. Version 5.0 also represents significant advancements in data compilation and computing techniques. Despite these improvements, challenges such as sea-ice cover and political dynamics still hinder comprehensive mapping.

Abstract Background Local recurrence of rectal cancer (LRRC) previously treated with radiotherapy is associated with a poor prognosis. Historically, the integration of radiotherapy (RT) with surgery has improved the likelihood of complete resections (R0) and, consequently, enhanced survival. Unfortunately, many LRRC cases are not amenable to surgical intervention. The inclusion of chemotherapy (CHT) alongside advanced RT techniques including proton and carbon ion RT (CIRT) and stereotactic body radiation therapy (SBRT), has generated new treatment options. Therefore, there is a need for improved stratification of LRRC patients to enhance treatment outcomes. The RETRY is an integrated trial with the primary aim to explore if combining CHT with RT in all available modalities can enhance local control (LC) in LRRC patients, consequently improving survival. Methods Experts from Italian centers specializing in rectal cancer and LRRC management collaborated to design a prospective multicenter observational study within the AIRO group for gastrointestinal malignancies. Eligible participants are adult LRRC patients who previously had pelvic RT, meet specific criteria, and are affiliated with the participating Italian centers. Specific criteria must be met for CIRT referral. A total of 88 patients will be enrolled over three years. The primary objective is to determine the 3-year LC rate. Secondary outcomes include assessing survival, quality of life, and R0 resection rates in surgery cases. A minimum dose of 40 Gy, conventional fractionation with concomitant fluoropyrimidine—with/without oxaliplatin-based CHT (CRT) is prescribed in neoadjuvant setting. Alternatively, the dose will vary from 35 to 40 Gy in 5 fractions based on clinical judgment, by SBRT. Both proton and photon therapies will be evaluated in these approaches. Surgery will be considered if deemed operable. In inoperable cases, CIRT with a dose of 40–60 Gy relative biological effectiveness (RBE) will be administered with a daily dose fraction ranging between 3 and 4.8 Gy RBE. Discussion The RETRY trial aims to investigate the combined effects of RT and CHT and when feasible the addition of surgery, to determine whether this comprehensive approach can result in improved survival and quality of life for LRRC patients. Trial registration number ClinicalTrials.gov (No. NCT05984576).

The development of anticancer diagnostic and therapeutic strategies is of crucial importance to improve efficacy and therapeutic specificity. Here, we describe the synthesis and characterization of fluorescent self-assembling nanomicelles (NMs) based on a biocompatible polysaccharide (cellulose, CE) functionalized with a tetraphenyl ethylene derivative (TPEHy) and loaded with Doxorubicin (DOX) with aggregation-induced emission (AIE) properties and pH-dependent drug release. We obtained CE-TPEHy-NMs with an average diameter of 60 ± 17 nm for unloaded NMs and 86 ± 25 nm for NMs loaded with DOX, respectively. Upon testing different conditions, we obtained an encapsulation efficiency of 86% and a loading capacity of 90%. A controlled dialysis experiment showed that the release of DOX after 48 h is minimal at pH 7.4 (11%), increasing at pH 6.5 (50%) and at its maximum at pH 4.5 (80%). The cytotoxicity of blank and loaded CE-TPEHy-NMs at increasing concentrations and different pH conditions was tested on a MG-63 human osteosarcoma cell line. Based on viability assays at pH 7.4, neither unloaded nor loaded CE-TPEHy-NMs exerted any inhibition on cell proliferation. At pH 6.5, proliferation inhibition significantly increased, confirming the pH-dependent release. We characterized and studied the performance of CE-based amphiphilic, biocompatible NMs for controlled drug release in acidic conditions, such as tumor microenvironments. Further studies are required to optimize their synthesis process and to validate their antitumoral properties in vivo.

This paper proposes an integrated approach to define the best consignment strategy for storing containers in an export yard of a maritime terminal. The storage strategy identifies the rules for grouping homogeneous containers, which are defined simultaneously with the assignment of each group of containers to the available blocks (bay-locations) in the yard. Unlike recent literature, this study focuses specifically on weight classes and their respective limits when establishing the consignment strategy. Another novel aspect of this work is the integration of a data-driven algorithm and operations research. The integrated approach is based on unsupervised learning and optimization models and allows us to solve large instances within a few seconds. Results obtained by spectral clustering are treated as input datasets for the optimization models. Two different formulations are described and compared: the main difference lies in how containers are assigned to bay-locations, shifting from a time-consuming individual container assignment to the assignment of groups of containers, which offers significant advantages in computational efficiency. Experimental tests are organized into three campaigns to evaluate the following: (i) The computational time and solution quality (i.e., space utilization) of the proposed models; (ii) The performance of these models against a benchmark model; (iii) The practical effectiveness of the proposed solution approach.

Abstract Background There is an increasing range of mind–body medicine (MBM) courses in Germany to support university students in dealing with stress. The evaluation of these varies and often only has a small number of participants due to the limited group size of the courses. The aim of this project was the development of a quantitative basic evaluation that can be used across all sites that conduct MBM courses. Methods In a consensus-based and systematic decision-making process, the learning objectives and various questionnaires for the evaluation of MBM courses were discussed and evaluated by experts according to defined criteria. The process was iterative, in which the reflection and definition of the learning objectives and the questionnaires were conditional and adapted if necessary. The recommendations for the basic evaluation of students’ MBM courses were developed by consensus among the experts. Results For the experts, the most important learning objectives of the MBM courses were stress reduction and self-experience with the exercises. A total of 21 questionnaires were evaluated from nine topics: mindfulness, empathy, self-reflection, self-efficacy, resilience, stress, sense of coherence, quality of life, and well-being. Finally, eight questionnaires were recommended by the expert group for use in a basic evaluation: stress (PSS-10), quality of life (WHOQOL-Bref), mindfulness (MAAS), self-efficacy (GSE), self-compassion (SCS), empathy (SPF), self-reflection (GRAS) and sense of coherence (SOC-13). Further questionnaires were recommended as "optional". An additional qualitative evaluation is recommended for a broader and deeper understanding of the quantitative results. Conclusions The proposed basic evaluation is the central result of the iterative consensus-based decision-making process, which reflects the learning objectives of the underlying MBM courses. We hope that the basic evaluation will be integrated into other MBM courses so that results of various courses can be pooled and compared across sites in the future. This could increase the informative value of the evaluations. Furthermore, researchers could consider the use of the basic evaluation in clinically controlled trials on MBM. Trial registration The project was not registered in a clinical trial registry because no results from health care interventions on human participants have been analyzed or reported.

Abstract In epithelia, apicobasal cell polarization is closely linked to cell-cell contact formation, both controlled by the conserved Crumbs (CRB) complex, which includes the transmembrane protein Crumbs (CRB3a) and adapter proteins PALS1, PATJ, and LIN7c. In MDCK II cells, a model for cell polarization, depletion of PALS1 - which binds to all CRB components - leads to defective cell polarization and improper distribution of tight junction proteins, resulting in severe epithelial barrier defects in 3D cyst models. This study investigated whether this phenotype is associated with transcriptional changes by analyzing wildtype (WT) and PALS1 knockout (KO) MDCK II cell lines grown under non-confluent conditions and in 3D cyst cultures. Our results indicate that the transition from non-confluent cells to 3D cysts involves numerous differentially expressed genes (DEGs) in both WT and KO cells. Importantly, the analyses revealed significant overlaps between WT and KO cells in their maturation processes, suggesting that most identified DEGs are linked to differentiation from non-confluent to polarized MDCK cells and likely not a result of PALS1 deficiency. Gene Ontology (GO) enrichment and over-representation analyses using REACTOME and KEGG databases confirmed these similarities. In contrast, the direct comparison of WT and KO cells at the two stages showed fewer DEGs and overlaps in associated biological processes and signaling pathways. DEGs associated with the 3D stage, in which the phenotype manifests, contain DEGs and pathways that were predominantly linked to cell cycle linked processes, centromere assembly, or DNA replication. Furthermore, the transcription of genes encoding key junction proteins, additional polarity proteins, and cell-substrate interaction proteins is less affected by the loss of PALS1, indicating that PALS1 influences the transcriptional profiles in epithelial cells as a modulating factor.

Introduction: Workplace bullying (WB), encompassing work-related bullying (WRB) and personal bullying (PB), significantly impacts workers and organizational culture. This study explores the broader implications of WB, focusing on its perception when associated with job functions versus when targeted at individuals. Methods: This cross-sectional study was carried out in a healthcare facility in northwestern Italy, involving 311 workers who responded to a questionnaire designed to assess the nature of bullying experienced. The survey explored various dimensions of WB, including psychosocial climate, leadership behavior, job satisfaction, and mental health outcomes. Results: Our findings indicated that WRB had a more detrimental impact than PB. Employees exposed to WRB reported lower job satisfaction (F(2, 295) = 59.048, p < .001), higher stress levels, and increased burnout (Emotional Exhaustion F(2, 294) = 40.346, p < .001). WRB was associated with negative perceptions of organizational fairness (F(2, 295) = 38.637, p < .001) and dynamism. PB also showed significant effects, particularly on team dynamics (MDOQ_team F(2, 294) = 52.514, p < .001) and communication (MDOQ_communic F(2, 294) = 15.038, p < .001). Discussion and Conclusions: WB profoundly deteriorates inter- and intra-group processes and undermines organizational culture, potentially affecting its legitimacy and reputation. The study underscores the need for organizational strategies that mitigate WB by promoting positive workplace environments and enhancing managerial practices to prevent bullying.

Abstract The RNA binding protein Human Antigen R (HuR) has been identified as a main regulator of the innate immune response and its inhibition can lead to beneficial anti-inflammatory effects. To this aim, we previously synthesized a novel class of small molecules named Tanshinone Mimics (TMs) able to interfere with HuR-RNA binding, and that dampen the LPS-induced immune response. Herein, we present a novel series of TMs, encompassing thiophene 3/TM9 and 4/TM10, furan 5/TM11 and 6/TM12, pyrrole 7b/TM13, and pyrazole 8. The furan-containing 5(TM11) showed the greatest inhibitory effect of the series on HuR-RNA complex formation, as suggested by RNA Electromobility Shift Assay and Time-Resolved FRET. Molecular Dynamics Calculation of HuR − 5/TM11 interaction, quantum mechanics approaches and Surface Plasmon Resonance data, all indicates that, within the novel heteroaryl substituents, the furan ring better recapitulates the chemical features of the RNA bound to HuR. Compound 5/TM11 also showed improved aqueous solubility compared to previously reported TMs. Real-time monitoring of cell growth and flow cytometry analyses showed that 5/TM11 preferentially reduced cell proliferation rather than apoptosis in murine macrophages at immunomodulatory doses. We observed its effects on the innate immune response triggered by lipopolysaccharide (LPS) in macrophages, showing that 5/TM11 significantly reduced the expression of proinflammatory cytokines as Cxcl10 and Il1b.

Abstract Background Human papillomavirus (HPV) infection is a leading cause of oropharyngeal squamous cell cancer (OPSCC). This study aimed to carry out a Knowledge, Attitude and Perception survey on HPV infection, HPV+ OPSCC, and HPV vaccination among Italian dental students. Methods Through an online self-administered questionnaire consisting of 82 questions, data on dental students’ sociodemographic characteristics, knowledge, attitudes and perceptions concerning HPV+ OPSCC, infection and vaccination were acquired. A statistical analysis, based on their year of attendance (early career, from 1st to 3rd year vs. late career, from 4th to 6th year) was also conducted. Results A total of 412 dental students completed the questionnaire. Knowledge of HPV+ OPSCC was reported by 61% of early-career students and 73% of late-career students, with high awareness of the HPV-OPSCC correlation in both groups (85% vs. 89%, respectively). The percentage of correct responses regarding HPV infection knowledge was 61% for early-career and 73% for late-career students, while vaccine knowledge was 70% and 78%, respectively. Over 90% of students acknowledged the dentist’s role in educating patients about HPV and OPSCC, and attitudes toward discussing HPV and vaccination were positive. However, only about half would recommend the vaccine to either gender. Statistically significant differences were found between early- and late-career groups across all knowledge sections (p

Importance: Orthognathic surgery is utilized to rectify facial deformities, but it can lead to neurosensory alterations. Electroacupuncture has been shown to enhance sensitivity and motor functions in patients post-surgery. However, its application in traumatic facial injuries remains inadequately researched. Objective: To investigate the effects of electroacupuncture on sensitivity and orofacial function in patients undergoing orthognathic surgery.Design, Setting, and Population: A randomized clinical trial involving patients undergoing bimaxillary orthognathic surgery and genioplasty who are randomly allocated to either a physiotherapy (PT) or physiotherapy plus electroacupuncture group (PTEA). Exposures: Participants will be allocated to their respective therapies for a duration of six weeks. The PT group will receive a 50-minute physical therapy session along with 30 minutes of simulated procedure. The PTEA group will receive 50 minutes of physical therapy followed by 30 minutes of electroacupuncture. Main Outcomes and Measures: Before treatment, sensitivity will be assessed using the SMILE Sensitivity Test-BAURU kit, edema will be evaluated using the MD Anderson Cancer Center Head and Neck Lymphedema protocol, range of motion will be measured using a digital caliper, and muscle pain and fatigue will be gauged using numerical scales. The chewing function will be evaluated using the Chewing Quality Assessment Questionnaire. Results: All assessments will be repeated at three and six months following the initiation of treatment. Conclusions and Relevance: This study may provide reliable and high-quality clinical evidence regarding the impact of electroacupuncture on restoring altered sensation and motor function in patients undergoing orthognathic surgery.

Durante la escolaridad intermedia, los estudiantes comienzan a emplear recursos gramaticales que les permiten una mayor precisión conceptual. Los sintagmas nominales (SN) son un recurso sintáctico utilizado para especificar las entidades introducidas en el discurso, otorgando mayor densidad léxica y exactitud disciplinar. Aunque se ha investigado sobre la extensión y complejidad de los SN en géneros analíticos no disciplinares, se ha explorado mínimamente su contribución a la calidad de géneros disciplinares. Este estudio analizó los SN empleados en 243 explicaciones científicas escritas por 66 estudiantes de 4° básico en cuatro momentos de una secuencia de aprendizaje sobre explicaciones científicas. Asimismo, se determinó la contribución de los SN a la calidad de estas explicaciones. Se identificaron y clasificaron los SN según su composición estructural y se calculó su longitud y la diversidad de SN en cada explicación. Los resultados muestran diferencias significativas en todos los SN para todos los momentos con efectos más grandes entre los momentos 1 y 4. Los modelos de regresión evidenciaron que en la primera unidad la diversidad de SN y el uso de SN simples fueron predictores de la calidad de las explicaciones (R2 = 0,40); mientras que para la segunda unidad, la diversidad de SN y el uso de SN nominal complejo extenso contribuyeron a la calidad (R2 = 0,27), aunque este último con un coeficiente negativo. Estos resultados enfatizan las conexiones entre sintaxis, género y trayectorias micro-evolutivas del lenguaje importantes de considerar en propuestas instruccionales para estudiantes que comienzan la literacidad disciplinar.

Liposarcoma is a malignant mesenchymal tumor defined as a rare cancer due to its low incidence rate. The most common location of liposarcoma is in the extremities, followed by retroperitoneum, with the bone and trunk being the less frequent presentations. The most common histological subtype is well-differentiated liposarcoma, which has the highest local recurrence, is slow-growing, and is insensitive to chemo and radiotherapy. We present the case of a 62-year-old male patient with a 10-year-growth mass in the dorsal region. A computed tomography scan showed a huge mass in the right dorsal space with a malignant lipomatous appearance, which required surgical removal of a mass of 2,800 g.

The congenital extrahepatic portosystemic shunt is a rare anomaly characterized by aplasia or hypoplasia of intrahepatic portal venous branches that generate complete or partial extrahepatic shunting of portal venous intra-systemic veins. The clinical presentation is variable, including nausea, abdominal pain, anorexia, and jaundice. This entity has been associated with other congenital anomalies, and the most common are the cardiovascular anomalies. Imaging studies are essential to confirm the diagnosis, establish pre-operative planning, and determine the surgical procedure to be performed. We presented the case of a 15-year-old adolescent who had abdominal symptoms and was found to have a portal venous vascular abnormality.

Resumen: Introducción: actualmente, la biomedicina se ha convertido en una herramienta indispensable para las ciencias de la salud. Sin embargo, se carece de propuestas educativas enfocadas en la enseñanza de este campo para estudiantes de carreras de Medicina. En este artículo se presenta el diseño de una propuesta metodológica para la enseñanza de la biomedicina orientada a herramientas de diagnóstico molecular de enfermedades infecciosas, desde el contexto de la carrera de Medicina en la Universidad Internacional SEK de Ecuador. Métodos: la propuesta fue estructurada con base en requisitos de materias de ciencias básicas que los estudiantes necesitan cursar para comprender el tema de diagnóstico molecular. Se propone la metodología de aprendizaje basado en problemas híbrido, aplicada en clases de teoría y práctica. Los recursos necesarios están asociados a artículos científicos, reactivos y equipamiento para ejecutar las pruebas moleculares, muestras biológicas y la infraestructura para las prácticas. Resultados: la propuesta inicia con un problema fundamentado en signos y síntomas de una enfermedad, la necesidad de pruebas sensibles y específicas, y la incorporación de los conceptos de One Health, microbioma y disbiosis. El flujo de trabajo en las clases se desarrolla con la participación activa del estudiante mediante lecturas, discusiones, exposiciones y laboratorios, junto con componentes de enseñanza tradicional, así como evaluaciones tanto orales como escritas. Conclusiones: la propuesta aquí presentada se fundamenta en una estrategia de enseñanza flexible y apoyada en varios recursos que buscan el aprendizaje significativo, sustentado en el trabajo autónomo del estudiante y en la guía del docente. Abstract: Background: Currently, biomedicine has become an indispensable tool for health sciences. However, there is a lack of formal educational proposals focused on teaching this field to medical students. This article presents the design of a methodological proposal for teaching biomedicine oriented to diagnostic tools for infectious diseases, within the context of the medical program at the Universidad Internacional SEK in Ecuador. Methods: The proposed structure is based on the requirements of basic science subjects that students must complete to understand molecular diagnostics. A hybrid problem-based learning methodology is proposed, applied in theory and practice classes. The necessary resources are associated with scientific articles, reagents and equipment for performing molecular tests, biological samples, and the infrastructure for conducting laboratory practices. Results: The proposal begins with a problem based on signs and symptoms of a disease, the need for sensitive and specific tests, and the incorporation of the concepts of One Health, microbiome and dysbiosis. The workflow in the classes is developed with the active participation of the student, through readings, discussions, presentations and laboratories, along with traditional teaching components, as well as oral and written assessments. Conclusions: The proposal presented here is based on a flexible teaching strategy supported by various resources, which seek significant learning, sustained by the student's autonomous work and guidance from the teacher.

Exposure to cross-cultural medical education is essential for professionals aiming to work in global health or serve diverse communities. However, traditional in-person exchange programs can be complex, costly, and restricted, particularly during times when travel is limited, such as during the COVID-19 pandemic. These challenges prompted us to explore novel approaches to support cross-cultural exchange programs. We designed, piloted, and evaluated a cross-cultural virtual exchange experience using case-based learning (CBL). Our study involved 14 bilingual medical students from the United States and Colombia who participated in four virtual CBL sessions. Following each session, participants engaged in guided discussions to reflect on their attitudes toward the experience, and content analysis was framed by sociocultural learning theory (SCLT). This study provides justification and operational guidance for implementing and improving upon cross-cultural virtual exchange experiences among medical trainees, with potential applicability to other contexts.

Este trabalho, oriundo de pesquisa de doutorado, teve como objetivo analisar se as cotas raciais contribuem para a construção da identidade de graduandos/as cotistas de universidade pública. As cotas raciais foram importantes para a democratização do acesso ao ensino superior, bem como, espaço de visibilidade e transformação do grupo beneficiado e as resistências engendradas pelas diversas frentes negras tem parte importante nessas conquistas. A proposta deste artigo é apresentar os resultados obtidos na referida pesquisa no que tange aos benefícios líquidos que a política social reverbera em cada sujeito beneficiário, no seu meio social, na universidade e na sociedade.

Este estudo objetivou estimar a prevalência de clusters de fatores comportamentais de risco para Doenças Crônicas Não Transmissíveis (DCNT), bem como os fatores associados em Agentes Comunitários de Saúde (ACS). Trata-se de um estudo censitário, transversal analítico, derivado de um projeto de pesquisa intitulado Condições de trabalho e saúde de ACS do norte de Minas Gerais: estudo longitudinal, realizado na cidade de Montes Claros, MG. A variável dependente foi a presença simultânea, ou clusters, de três ou mais fatores comportamentais de risco para DCNT. A definição de variáveis associadas foi realizada após análise de regressão múltipla de Poisson com variância robusta. Participaram do estudo 675 ACS. Desses, 57.6% (n=389) apresentaram pelo menos três fatores de risco simultâneos para DCNT, sendo os mais prevalentes baixo consumo de frutas, inatividade física e consumo abusivo de refrigerantes. As variáveis que se mostraram associadas ao cluster de fatores comportamentais foram idade maior ou igual a 37 anos (RP=0.87; IC95%=0.81-0.94; p=0.001), percepção do estado de saúde ruim (RP=1.08; IC95%=1.00-1.16; p=0.037) e presença de hipertensão (RP=1.17; IC95%=1.06-1.30; p=0.001). Conclui-se que a prevalência de três ou mais fatores de risco para DCNT nos ACS foi elevada, e que fatores sociodemográficos e clínicos estão associados ao desfecho investigado. Considerando os resultados registrados, os serviços de saúde devem propiciar políticas de atenção diferenciadas aos ACS, buscando prevenir os fatores comportamentais que podem elevar a morbimortalidade por DCNT.

Introduction The treatment of patients with cardiogenic shock (CS) has been focused historically on single interventions (medical treatments, percutaneous and surgical interventions and, more recently, various temporary mechanical circulatory supports). However, none of these interventions has significantly changed the short-term prognosis of CS. Moreover, considerable interest in interventions applied in the acute setting has not been matched with comprehensive assessment of patients’ long-term follow-up, not only for survival and rehospitalisation but also for quality of life and functional status, recovery from critical illness and its destructive sequelae, and a global evaluation of the overall sustainability of pathways of care. To fill this knowledge gap, the ENIGMA study will be conducted.Methods and analysis This is a prospective and retrospective multicentre registry conducted under the scientific coordination of the IRCCS Fondazione Don Gnocchi and funded by the Italian Ministry of Health (PNRR-MCNT2-2023-12377767). Data referring to 2000 patients included in the Altshock registry, the largest multicentre CS registry in Italy, will be analysed. A standardised protocol of high-intensity cardiac rehabilitation has been defined and will be followed by the involved institutions after the inclusion of the first 1000 patients. Where feasible, this new pathway will be implemented in every institution. All the patients enrolled will be evaluated according to the Long-Term Conditions Questionnaire, the Kansas City Cardiomyopathy Questionnaire and a questionnaire on the patient experience at 6-month follow-up, to evaluate real-life comparative effects on patient outcomes and experiences. In conclusion, a health technology assessment (HTA) analysis, grounded in the EUnetHTA Core Model, will be conducted to define the potential multidimensional benefits and effects with regard to the overall economic, organisational and social sustainability of the innovative dedicated pathway. Various data sources will be used to conduct the HTA: (1) literature evidence, to define the evidence-based comparative indicators considering both surgical approaches; (2) real-world anonymised data from the hospitals included in the study, to enable costing of the rehabilitative pathways; and (3) healthcare professionals’ perceptions, defining the perceived added value of the innovative pathway versus the historical one, based on an evaluation scale ranging from −3 to +3.Ethics and dissemination The study was approved by the ethical committee (EC) of Lombardy Region (CET 44/24), on 28 May 2024, and is under evaluation by the EC of three other centres. The study protocol will be evaluated for ethics by 10 more centres in January 2025. Study results will be published in peer-reviewed publications and disseminated through conference presentations. The Associazione Nazionale Scompensati Cardiaci (AISC; ‘National Association of Patients with Heart Failure’), the Progetto Vita initiative and the non-profit organisation ‘Heart Helps Heart’ have endorsed the project and will be involved in disseminating information about the project and its outcomes to the general public.Clinical trial registration number The ENIGMA-shock study has been registered at ClincialTrials.gov: NCT06572826.

RESUMO: Nos últimos anos, a democracia universitária entrou na agenda dos debates nacionais, em vista das sucessivas intervenções nos sistemas eleitorais das Instituições Federais de Ensino Superior. Estima-se que 45% das universidades federais sofreram algum tipo de ingerência na escolha dos reitores, além de modificações legais em seus processos decisórios. Nesse cenário, marcado pelo enfraquecimento de princípios democráticos, o presente artigo teve por objetivo analisar os impactos das ingerências federais nas práticas de gestão democráticas das universidades federais, entre os anos de 2018 e 2022. Enquanto recorte metodológico, recorreu-se à unidade de análise de 11 universidades mineiras, acompanhadas de pesquisas documentais e questionários com 167 membros de conselhos universitários. Os resultados apontaram que as intervenções, via medidas provisórias e notas técnicas, revogaram práticas democráticas institucionalizadas, como a paridades nas votações internas em universidades. Por outro lado, ainda que a maioria dos conselheiros universitários refutassem a discricionariedade federal para a escolha dos reitores, os discursos da supremacia docente emergiram quando da concordância com as mudanças que reduziram a participação dos discentes e servidores técnico-administrativos nos processos eleitorais. As conclusões apontam para a necessidade de se debater os limites das interferências recentes como também as contradições internas que atravessam historicamente as práticas das universidades, na busca por caminhos mais democráticos.

PurposeApproximately 10–20% of couples in Germany are unable to conceive. About 50% of this subfertility can be attributed to the male partner. Preclinical studies suggest that fasting could potentially influence central mechanisms of spermatogenesis. This study aimed at investigating feasibility and effects of a Fasting Mimicking Diet (FMD) in the context of male subfertility.Materials and methodsIn this two-arm, randomized, controlled, exploratory mixed methods study men with impaired sperm quality were randomized into a fasting and a waiting-list control group. The fasting group followed an FMD (500 kcal/d for 5 days) thrice within 4 months, while the control group was instructed to maintain their lifestyle and diet. We assessed sperm quality according to WHO criteria (total and progressive sperm motility, concentration, total sperm count, ejaculation volume and sperm morphology) from baseline to 6 months later. Semi-structured interviews were conducted in a subgroup and evaluated by structured content analysis.ResultsRecruitment proved difficult, with 18 out of only 22 recruited participants completing all visits. There were no marked group differences between fasters (n = 10, 36.9 ± 5.17 years) and controls (n = 8, 36.1 ± 2.8 years) regarding sperm parameters. Effect sizes suggest slight positive trends regarding between group changes in the ANCOVA for total sperm motility (eta2 = 0.030) progressive sperm motility (eta2 = 0.059), total sperm count (eta2 = 0.001), concentration (eta2 = 0.050), normal sperm morphology (eta2 = 0.019) and the percentage of round cells (eta2 = 0.462) in the fasting group and a general decrease of sperm quality in the control group. This decrease of sperm quality concerned all parameters but the ejaculation volume, which increased in the CG but decreased in the FG (eta2 = 0.254). The decline of sperm quality in the CG is not explicable by the study setting. We also saw positive trends concerning the intragroup changes (e.g., within group change for progressive sperm motility: d = 0.36), Qualitative analysis (10 interviews) showed FMD feasibility, and its compatibility with full-time work. Motivation toward a healthier lifestyle after the FMD and a feeling of self-empowerment concerning one’s fertility were reported.ConclusionThis limited exploratory study showed FMD feasibility but found no notable differences between groups regarding all parameters. Yet, we saw positive trends regarding the between and within group changes in favour of the fasting group. Possible beneficial effects of the FMD on sperm quality should be investigated in larger studies. Interview results suggest that fasting could be a useful supportive intervention in male subfertility regarding self-efficacy and positive lifestyle changes.

IntroductionNutrition plays a crucial role in current German public health strategies. While sociodemographic differences in nutrition have been extensively studied, recent data specific to Germany remains limited.MethodsAn online-representative cross-sectional survey was conducted in 2022 among German-speaking adults aged 18–75 using a Computer Assisted Web Interview (CAWI) format. The survey addressed personal eating habits, the importance of nutrition, motivations behind food choices, and openness to dietary changes. Data analysis included both descriptive and inferential statistics, incorporating CHAID decision tree analysis and nonparametric methods for inductive statistical evaluation.ResultsAmong the 4,065 participants, 62.3% regarded healthy nutrition as important, with women, individuals with higher education, and those aged under 26 or over 70 demonstrating greater emphasis on nutrition. CHAID analysis identified education as the most significant predictor of attitudes toward healthy nutrition, followed by sex and income. Participants with a positive attitude toward healthy nutrition reported higher HRQoL scores (EQ-Index = 0.862) compared to neutral or negative attitudes (EQ-Index = 0.835)0.10.5% of participants reported not to eat meat, 28.6% were self-reported flexitarians and 54.1% of participants considered themselves omnivorous. Gender-specific dietary preferences were observed, with plant-based diets being much more popular among females. Participants identified taste preference as the primary factor influencing food choices (77.2%) when asked about the main reasons for their eating habits. Approximately 18% of participants predominantly or exclusively bought organic foods. Interestingly, one third of participants indicated a willingness to adopt a more plant-based diet if recommended by physicians or scientists.ConclusionThis online representative survey revealed significant associations between nutrition and sociodemographic aspects. Understanding this complex interplay might be useful for public health nutrition strategies that promote healthier national eating patterns.

Understanding the habitat selection and movement patterns of carnivores in arid landscapes requires an assessment of the spatiotemporal patterns of ephemeral resource-rich and climatically suitable sites. One example is the South American grey fox (Lycalopex griseus), a mesocarnivore that inhabits north-central Chile, an arid region under increasing human presence and where coastal fog is an important but variable source of moisture. Here, we hypothesized that space use decisions of foxes are influenced by spatiotemporal variation in plant productivity, human settlements, and microclimate conditions. Home ranges and Resource Selection Functions were fitted to the GPS data of seven foxes tracked year-round and related to ecological landscape and site-level attributes derived from remote sensing. Home ranges increased with incident radiation, elevation, topographic diversity, normalized difference water index (ndwi), and distance to roads, but decreased with proximity to the coastline. Foxes avoided using sites distant from the coast, located at the highest altitudes, and with higher surface temperatures, while being more likely to move to sites with high ndwi. Our results show that South American grey foxes living in arid landscapes adjust their home ranges, and habitat use decisions within home ranges, to topography but also to environmental conditions that vary intra annually. Extreme microclimate conditions can directly shape the habitat use patterns but also indirectly through seasonally modifying plant productivity, while terrain morphology (topography and elevation) acts as a regulator of extreme climate. We also noted that road network influences the behavioral response of foxes and its expansion is expected to exert pressure on the conservation of fox populations.

Abstract Background Despite the growth in the older population, there is a noticeable research gap regarding integrative health systems for older people and their impact on longevity in nonagenarians. This study aimed to evaluate the effect of an integrative health system consisting of medical services, recreational facilities, and housing on longevity in a population of nonagenarians in Northern Mexico. Methods This was a cross-sectional, retrospective, descriptive-analytical study in which we measured and analyzed medical history such as number of hospitalizations, visits to geriatric consultation, hypertension, history of chronic pain, polypharmacy, dementia, rheumatic disease, diabetes mellitus, insomnia, depression, ischemic cardiomyopathy, among others. We also measured social engagement and number of caregivers. A logistic regression was performed to evaluate the predictors of mortality in this population. Results We included one hundred and ninety-five nonagenarians with a mean (SD) age of 94 (4.2) years and of which 112 (55.7%) were female. The findings from logistic regression analysis indicated that a higher frequency of hospitalizations was associated with an elevated mortality risk (OR = 1.272, p = 0.049). Conversely, increased visits to geriatric consultation services as primary care were linked to a reduced mortality risk (OR = 0.953, p = 0.002). Additionally, social engagement displayed a protective effect (OR = 0.336, p = 0.05). Conclusions This study highlighted the role of systemic health approaches in extending life through insights into nonagenarian patients’ involvement in primary care, as measured by consultation frequency, and participation in social activities, mitigating mortality risks. Meanwhile, it emphasized the potential consequences of higher hospitalization rates on increased mortality risk.

Abstract Regulatory T cells (Tregs) are crucial immune cells for tissue repair and regeneration. However, their potential as a cell-based regenerative therapy is not yet fully understood. Here, we show that local delivery of exogenous Tregs into injured mouse bone, muscle, and skin greatly enhances tissue healing. Mechanistically, exogenous Tregs rapidly adopt an injury-specific phenotype in response to the damaged tissue microenvironment, upregulating genes involved in immunomodulation and tissue healing. We demonstrate that exogenous Tregs exert their regenerative effect by directly and indirectly modulating monocytes/macrophages (Mo/MΦ) in injured tissues, promoting their switch to an anti-inflammatory and pro-healing state via factors such as interleukin (IL)-10. Validating the key role of IL-10 in exogenous Treg-mediated repair and regeneration, the pro-healing capacity of these cells is lost when Il10 is knocked out. Additionally, exogenous Tregs reduce neutrophil and cytotoxic T cell accumulation and IFN-γ production in damaged tissues, further dampening the pro-inflammatory Mo/MΦ phenotype. Highlighting the potential of this approach, we demonstrate that allogeneic and human Tregs also promote tissue healing. Together, this study establishes exogenous Tregs as a possible universal cell-based therapy for regenerative medicine and provides key mechanistic insights that could be harnessed to develop immune cell-based therapies to enhance tissue healing.

Resumen: Introducción: La inteligencia artificial (IA), a través de herramientas como ChatGPT, está transformando la educación superior con cada vez más estudiantes y docentes que incorporan IA en práctica diaria. En esta línea, nuevos desafíos emergen en el ámbito educativo, donde la necesidad de un equilibrio entre eficiencia y originalidad, y un análisis profundo con un enfoque en la integridad académica es requerido. Objetivo: El presente artículo discute la relación entre la IA e integridad académica en educación superior, y describe el proceso de desarrollo de una declaración de integridad académica adaptada al uso de IA. Metodología: Incluye análisis de herramientas de IA relevantes y evaluaciones por expertos, se propone un marco para la adopción ética y responsable de la IA. Resultados: muestran una integración efectiva de la declaración en trabajos académicos, fomentando la transparencia y la honestidad. Discusión y Conclusión: resalta la variabilidad en la adopción de la declaración según los niveles académicos, sugiriendo la necesidad de un enfoque más personalizado. En conclusión, se debería enfatizar el rol de la declaración en la promoción de prácticas éticas y en la preparación de futuros desafíos en la intersección de tecnología y educación. Abstract: Introduction: Artificial intelligence (AI), through tools like ChatGPT, is transforming higher education with more and more students and teachers incorporating AI into daily practice. Along these lines, new challenges emerge in the educational field, where the need for a balance between efficiency and originality, and a deep analysis with a focus on academic integrity is required. Aims: This article discusses the relationship between AI and academic integrity in higher education and describes the process of developing an academic integrity statement adapted to the use of AI. Methodology: Using a methodology that includes analysis of relevant AI tools and expert evaluations, a framework for the ethical and responsible adoption of AI is proposed. Results: The results show an effective integration of the statement in academic works, promoting transparency and honesty. Discussion and Conclusions: The discussion highlights the variability in adoption of the statement across academic levels, suggesting the need for a more personalized approach. In conclusion, the role of the declaration in promoting ethical practices and preparing for future challenges at the intersection of technology and education should be emphasized.

Resumen: Introducción: La educación interprofesional (EIP) es crucial para la formación de futuros profesionales de la salud, fomentando la colaboración y el trabajo en equipo entre disciplinas. Este estudio analiza las percepciones sobre la EIP de estudiantes y docentes en asignaturas de primer año en carreras de Ciencias de la Salud, utilizando una metodología de Aprendizaje-Servicio (A-S) desarrollada en línea durante la pandemia de COVID-19. Metodología: Se implementó un enfoque de metodología mixta secuencial que involucró a 88 estudiantes y 12 docentes de las carreras de Terapia Ocupacional, Kinesiología, Nutrición y Dietética y Fonoaudiología. Resultados: Los resultados revelaron diferencias significativas en la disposición hacia la educación interprofesional después de la intervención, especialmente en estudiantes de Nutrición y Dietética. Además, el análisis cualitativo destacó la favorable percepción de estudiantes y docentes hacia la EIP en modalidad virtual. Las habilidades clave, como interacción, comunicación, compromiso, respeto y empatía, fueron resaltadas. La triangulación de datos cualitativos y cuantitativos mostró convergencia en las categorías de “trabajo en equipo” y “centrado en el paciente”. Conclusión: Este estudio respalda la importancia de la EIP en la formación de pregrado de profesionales de la salud, incluso en entornos virtuales. Los estudiantes demostraron una excelente disposición y enfoque centrado en el paciente. Estos hallazgos subrayan la necesidad de continuar desarrollando programas de EIP en el pregrado, equipando a los estudiantes con habilidades y competencias esenciales para su futuro profesional. Abstract: Introduction: Interprofessional education (IPE) is crucial for the training of future health professionals, promoting collaboration and teamwork between disciplines. This study analyzes the perceptions about IPE of students and teachers in first year health sciences courses, using a Service Learning (S-L) methodology, which was conducted online during the COVID-19 pandemic. Methodology: A sequential mixed-method approach was implemented involving 88 students and 12 faculty members from Occupational Therapy, Physiotherapy, Nutrition and Dietetics, and Speech Therapy. Results: The findings revealed significant differences in the disposition towards interprofessional learning and interprofessional education after the intervention, especially in Nutrition and Dietetics students. Furthermore, the qualitative analysis highlighted the favorable perception of students and teachers towards IPE in virtual mode. Key skills such as interaction, communication, commitment, respect, and empathy were highlighted. The triangulation of qualitative and quantitative data showed convergence in “teamwork” and “patient-centeredness”. Conclusion: This study supports the importance of IPE in the undergraduate training of health professionals, even in virtual environments like the present. Students demonstrated an excellent disposition and patient-centered approach. These findings underscore the need to continue developing undergraduate IPE programs, equipping students with skills and competencies for their future professional careers.

Resumen: Introducción: La comunicación es clave en Terapia Ocupacional y su efectividad afecta hasta un 20% en los resultados terapéuticos. Se debe desarrollar a lo largo de la formación y carrera profesional, constituyendo las prácticas profesionales un periodo crítico. Este estudio explora opiniones y percepciones sobre la importancia y desempeño de la competencia de comunicación en estudiantes de Terapia Ocupacional durante sus prácticas profesionales. Metodología: Diseño mixto secuencial explicativo, transversal, de alcance descriptivo, en el que participaron 32 docentes a través de una encuesta online y entrevistas individuales. Resultados: Los elementos más relevantes con relación a la competencia de comunicación son: acuerdo sobre planes y problemas, información, perspectiva del paciente y empatía. Además, los docentes encontraron que el desempeño de la competencia en los estudiantes mejora al finalizar la práctica profesional. Discusiones: La importancia de la comunicación es ampliamente reconocida por los participantes, sin embargo, existen diferencias en su valoración. Factores personales, curriculares y habilidades docentes pueden influir en el desempeño. Se sugiere incorporarla en el currículum desde el inicio de la formación. Conclusiones: Las habilidades comunicativas son fundamentales para los terapeutas ocupacionales, especialmente durante sus prácticas profesionales. Se debe fomentar su desarrollo de manera continua para que los estudiantes adquieran habilidades comunicativas claras y efectivas que favorezcan el éxito terapéutico. Abstract: Introduction: Communication is key in Occupational Therapy and its effectiveness affects up to 20% of therapeutic results. It must be developed throughout the occupational therapists training and professional career, with internships being a critical period for the acquisition of these skills. This study explores opinions and perceptions about the importance and performance of communication competencies in Occupational Therapy students during their professional internships. Methodology: Mixed sequential explanatory cross-sectional design, with a descriptive scope, in which 32 teachers participated through an online survey and individual interviews. Results: The most relevant elements in relation to communication competence are: agreement on plans and problems, information, patient perspective and empathy. In addition, teachers found that the performance of communication competence in students improves at the end of professional internship. Discussions: Communication competence is important, but there are differences in its assessment. Personal, curricular factors and teaching skills can influence performance. It is suggested to incorporate it into the curriculum from the beginning of training. Conclusions: Communication competence is essential for occupational therapists, especially during their professional internships. Its continuous development should be encouraged so that students acquire clear and effective communication skills that promote therapeutic success.

La mayoría de los productores de pepino en invernaderos de baja tecnología no presta atención al efecto de la humedad del aire sobre sus cultivos. La humedad relativa (HR) afecta la transpiración de las plantas y la traslocación de nutrimentos hacia la parte aérea, teniendo como resultado un efecto en el estado nutrimental. En este estudio se planteó determinar si la concentración de la solución nutritiva, en términos de conductividad eléctrica (CE) (1.7, 2.2 y 2.7 dS m-1), afecta el crecimiento, rendimiento y calidad de frutos en pepino creciendo bajo diferente HR (35%, 50%, 65%). Comparado con las plantas de HR a 35%, el rendimiento aumentó en 14 y 17% cuando la humedad fue de 50 y 65%, respectivamente. Sin embargo, este aumento fue más marcado al suministrar soluciones nutritivas de baja concentración (1.7 dS m-1). En condiciones de alta HR (65%), disminuyó la concentración de NO3– (-21%), K+ (-16%), y Ca++ (-14%) en el extracto de la savia del peciolo, mientras que en los frutos ocurrieron tendencias similares con el NO3– (-26%) y el K+ (-13%). En contraste, el Ca++ aumentó hasta 24%. La HR modificó el balance entre el NO3–, K+ y Ca++, siendo el óptimo de 19.3 para el K+/Ca++ en frutos y de 8.7 para el NO3–/Ca++ en el peciolo. Se concluye que el pepino produce mayor rendimiento y calidad de fruto cuando la HR del invernadero se mantiene en 65% en combinación con una baja concentración de la solución nutritiva (1.7 dS m-1).

Abstract Regulatory T cells (Tregs) are key immune regulators that have shown promise in enhancing cardiac repair post-MI, although the mechanisms remain elusive. Here, we show that rapidly increasing Treg number in the circulation post-MI via systemic administration of exogenous Tregs improves cardiac function in male mice, by limiting cardiomyocyte death and reducing fibrosis. Mechanistically, exogenous Tregs quickly home to the infarcted heart and adopt an injury-specific transcriptome that mediates repair by modulating monocytes/macrophages. Specially, Tregs lead to a reduction in pro-inflammatory Ly6CHi CCR2+ monocytes/macrophages accompanied by a rapid shift of macrophages towards a pro-repair phenotype. Additionally, exogenous Treg-derived factors, including nidogen-1 and IL-10, along with a decrease in cardiac CD8+ T cell number, mediate the reduction of the pro-inflammatory monocyte/macrophage subset in the heart. Supporting the pivotal role of IL-10, exogenous Tregs knocked out for IL-10 lose their pro-repair capabilities. Together, this study highlights the beneficial use of a Treg-based therapeutic approach for cardiac repair with important mechanistic insights that could facilitate the development of novel immunotherapies for MI.

Abstract Astrocytes display context-specific diversity in their functions and respond to noxious stimuli between brain regions. Astrocytic mitochondria have emerged as key players in governing astrocytic functional heterogeneity, given their ability to dynamically adapt their morphology to regional demands on ATP generation and Ca2+ buffering functions. Although there is reciprocal regulation between mitochondrial dynamics and mitochondrial Ca2+ signaling in astrocytes, the extent of this regulation in astrocytes from different brain regions remains unexplored. Brain-wide, experimentally induced mitochondrial DNA (mtDNA) loss in astrocytes showed that mtDNA integrity is critical for astrocyte function, however, possible diverse responses to this noxious stimulus between brain areas were not reported in these experiments. To selectively damage mtDNA in astrocytes in a brain-region-specific manner, we developed a novel adeno-associated virus (AAV)-based tool, Mito-PstI expressing the restriction enzyme PstI, specifically in astrocytic mitochondria. Here, we applied Mito-PstI to two brain regions, the dorsolateral striatum and dentate gyrus, and we show that Mito-PstI induces astrocytic mtDNA loss in vivo, but with remarkable brain-region-dependent differences on mitochondrial dynamics, Ca2+ fluxes, and astrocytic and microglial reactivity. Thus, AAV-Mito-PstI is a novel tool to explore the relationship between astrocytic mitochondrial network dynamics and astrocytic mitochondrial Ca2+ signaling in a brain-region-selective manner.

Abstract Cellular senescence is characterized by a permanent growth arrest and is associated with tissue aging and cancer. Senescent cells secrete a number of different cytokines referred to as the senescence-associated secretory phenotype (SASP), which impacts the surrounding tissue and immune response. Here, we find that senescent cells exhibit higher rates of protein synthesis compared to proliferating cells and identify eIF5A as a crucial regulator of this process. Polyamine metabolism and hypusination of eIF5A play a pivotal role in sustaining elevated levels of protein synthesis in senescent cells. Mechanistically, we identify a p53-dependent program in senescent cells that maintains hypusination levels of eIF5A. Finally, we demonstrate that functional eIF5A is required for synthesizing mitochondrial ribosomal proteins and monitoring the immune clearance of premalignant senescent cells in vivo. Our findings establish an important role of protein synthesis during cellular senescence and suggest a link between eIF5A, polyamine metabolism, and senescence immune surveillance.

Históricamente, las mujeres han encontrado diversas maneras para redefinir y revalorizar los entornos naturales. Propuestas que han estado caracterizadas por la representación, recalificación o resignificación de la naturaleza, trascendiendo a la cuestión de forma, belleza o al puro aprovechamiento visual para enfocarse en una comprensión real y compleja: la necesaria interacción y dependencia que tenemos los seres humanos como especie, con otras especies, y con el ecosistema. Conceptos como la simbología, el bien común, la memoria, la participación, los espacios propios para la creación y el entendimiento, y también para el desarrollo personal y colectivo, hilvanan la primera parte del presente artículo a través de distintas formas de aproximación a la naturaleza, la mayoría de ellas no reconocidas en absoluto por la historiografía de la arquitectura y el paisajismo, que las ha relegado de sus discursos hegemónicos y, por tanto, a una condición periférica. Se trata, sin embargo, de una selección histórica de posiciones políticas a través del paisaje: proyectos pensados desde la experiencia y desde la práctica de mujeres paisajistas, arquitectas, artistas o activistas motivadas por valores integrales y de fondo para un uso igualitario de los espacios naturales. Se propone un segundo apartado que arriba en el caso concreto del diseño del paisaje realizado por mujeres en Cataluña. Una breve antología, con el propósito de reivindicar actuaciones y protagonistas para ser analizadas desde claves comunes con los relatos históricos de la primera parte. La arquitectura del paisaje en Cataluña es actualmente un ámbito consolidado y reconocido profesional y académicamente. Existen estructuras y mecanismos al servicio de su especialización, así como ofertas educativas, observatorios institucionales y organismos internacionales enfocados en el ámbito del paisaje y los retos futuros. De la denominada Escuela de Barcelona y su posterior contexto sociopolítico y académico, surgieron relatos y expresiones arquitectónicas de mujeres egresadas o influenciadas por dicha Escuela que son origen y legado de la práctica y la teoría sobre el paisaje.