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This article aims to detect metacognitive components of learning-to-learn competence in the teaching programs of Pedagogy and Telecommunications Engineering degrees in Spain. These components involve such as knowledge of the task and strategies to approach it, planning, organization and time management, self-assessment, control and self-regulation and problem-solving during the learning process itself, key aspects for the professional training of autonomous learners. The methodology consisted of a qualitative documentary review of 1,896 teaching programs. We employed a qualitative content analysis to code the components of the metacognitive dimension proposed by the Theoretical Model of learning-tolearn competence by Gargallo et al. (2020a). The results show that the competencies appear atomized in knowledge and skills, but hardly incorporate attitudes and contextual elements. So, we concluded that it is difficult for the curricular proposal, as it is expressed, to develop the metacognitive dimension of the learning-to-learn competence. [ABSTRACT FROM AUTHOR]

Background Immune control of Epstein-Barr virus (EBV) infection is impaired in individuals with HIV. We explored maternal factors associated with EBV acquisition in HIV-exposed uninfected (HEU) infants and the relationship between EBV infection and serious adverse events (SAEs) during the first year of life. Methods 201 HEU infants from Uganda enrolled in the ANRS 12174 trial were tested for antiviral capsid antigen (anti-VCA) antibodies at week 50. Date of infection was estimated by testing EBV DNA at weeks 1, 6, 14, 26, 38, and 50 postpartum on dried blood spots. Results Eighty-seven (43%) infants tested positive for anti-VCA IgG at week 50. Among the 59 infants positive for EBV DNA, 25% were infected within the first 26 weeks. Almost half (12%) were infected before week 14. Shedding of EBV in breast milk was associated with EBV DNA in maternal plasma (P = .009), HIV RNA detection (P =  .039), and lower CD4 count (P = .001) and correlated with plasma EBV DNA levels (P = .002). EBV infant infection at week 50 was associated with shedding of EBV in breast milk (P = .009) and young maternal age (P = .029). Occurrence of a clinical SAE, including malaria and pneumonia, was associated with higher levels of EBV DNA in infants (P = .010). Conclusions By assessing EBV infection in HEU infants we observed that infection during the first year is determined by HIV and EBV maternal factors and that EBV DNA levels were higher among infants with clinical SAEs. Clinical Trials Registration NCT00640263. [ABSTRACT FROM AUTHOR]

This study investigates the role of divorce and remarriage on cognitive outcomes of children. Using the rich panel data information from the National Longitudinal Survey of Children and Youth (NLSCY), collected biennially since 1994, we investigate the association between children's math and reading performance and divorce and remarriage relative to intact families. We find that children who stay-in or move-to non-intact families have lower reading scores than those who stay in intact families. Although initial findings indicate that family structure has an overall small effect on children's math performance, we find a differential impact of family structure on Math performance across gender and cultural heritage. [ABSTRACT FROM AUTHOR]

Background: A growing body of evidence suggests that early life health and developmental outcomes can be improved through parental support programs. The objective of this project was to test the feasibility, impact, and relative cost-effectiveness of an adapted "Reach Up and Learn" program delivered through home-visiting programs as well as through center-based parenting groups on child health and development in the municipality of Boa Vista, Brazil.Methods: A randomized, stepped-wedge design was used to roll out and evaluate the two parenting platforms in Boa Vista municipality. A total of 39 neighborhoods with a high Neighborhood Vulnerability Index were selected for the study. For the first phase of the program, nine neighborhoods were randomly selected for home visits, and two were randomly selected for the center-based parenting groups. In the second phase of the program, 10 neighborhoods were added to the home-visiting program, and eight were added to the center-based program. In the final phase of the program, the remaining 10 control areas will also be assigned to treatment. Study eligibility will be assessed through a baseline survey completed by all pregnant women in the 39 study areas. Pregnant women will be eligible to participate in the study if they are either classified as poor, were under age 20 years when they became pregnant, or if they indicate to have been exposed to domestic or sexual violence. To assess program impact, an endline survey will be conducted when children reach age 2 years. The primary study outcome is child development at age 2 years as measured by the PRIDI instrument. Secondary outcome will be infant mortality, which will be assessed linking municipal vital registration systems to the program rollout.Discussion: This trial will assess the feasibility and impact of parenting programs rolled out at medium scale. The results from the trial should create evidence urgently needed for guiding Brazil's national Criança Feliz program as well as similar efforts in other countries.Trial Registration: ClinicalTrials.gov, ID: NCT03386747. Registered on 13 December 2017. All items of the World Health Organization Trial Registration Data Set are available in this record. [ABSTRACT FROM AUTHOR]

This review article was prompted by a remarkable growth in the number of scientific publications dealing with the use of nanocellulose (especially nanofibrillated cellulose (NFC), cellulose nanocrystals (CNC), and bacterial cellulose (BC)) to enhance the barrier properties and other performance attributes of new generations of packaging products. Recent research has confirmed and extended what is known about oxygen barrier and water vapor transmission performance, strength properties, and the susceptibility of nanocellulose-based films and coatings to the presence of humidity or moisture. Recent research also points to various promising strategies to prepare ecologically-friendly packaging materials, taking advantage of nanocellulose-based layers, to compete in an arena that has long been dominated by synthetic plastics. Some promising approaches entail usage of multiple layers of different materials or additives such as waxes, high-aspect ratio nano-clays, and surface-active compounds in addition to the nanocellulose material. While various high-end applications may be achieved by chemical derivatization or grafting of the nanocellulose, the current trends in research suggest that high-volume implementation will likely incorporate water-based formulations, which may include water-based dispersions or emulsions, depending on the enduses. [ABSTRACT FROM AUTHOR]

The review aims at reporting on recent developments in nanocellulose-based materials and their applications in packaging with special focus on oxygen and water vapor barrier characteristics. Nanocellulose materials, including cellulose nanocrystals (CNC), nanofibrillated cellulose (NFC), and bacterial nanocellulose (BNC), have unique properties with the potential to dramatically impact many commercial markets including packaging. In addition to being derived from a renewable resource that is both biodegradable and non-toxic, nanocellulose exhibits extremely high surface area and crystallinity and has tunable surface chemistry. These features give nanocellulose materials great potential to sustainably enhance oxygen and water vapor barrier properties when used as coating, fillers in composites and as self-standing thin films. [ABSTRACT FROM AUTHOR]

This paper uses the confidential files of the Canadian Census 1991-2006 to examine the fertility of married immigrant women (the presence of infants and preschool children in the household) around the time of migration. Then it estimates a proportional hazards model of first-birth risks of migrants relative to natives from two years before to five years after arrival to Canada. While immigrants have relatively fewer births during the two years preceding migration, these rise after one year in Canada, consistent with both catchup and with concurrent events such as marriage happening during migration. Consistent with the socialization hypothesis, fertility levels vary across origins. [ABSTRACT FROM AUTHOR]

Soybean hulls were used to isolate cellulosic microfibrils (SMF) and brick-like microparticles (SMP) by combining chemical and mechanical pretreatments. The key physical and chemical features of SMF and SMP were compared with those of micro and nanofibrillated cellulose (MNFC) obtained from fully bleached wood fibers. SMF and SMP chemical composition includes residual polysaccharides and lignin that endow such biologically-derived materials with properties typical of nanocellulosics. Compared to MNFC, SMF and SMP exhibit enhanced crystallinity (∼ > 10% higher) and thermal stability (onset degradation temperature >295 °C and maximum degradation at 361 and 355 °C). Such observations make SMF and SMP suitable for reinforcement in thermoplastic composites. A strong shear thinning behavior was observed for aqueous dispersions of SMF and SMP, revealing that these cellulose microstructures are of interest for rheology modification, coatings and films. Overall, the availability and low cost of biomass from residual soybean hulls constitutes a viable option for their use as a feedstock for the production and development of novel materials from SMF and SMP. [ABSTRACT FROM AUTHOR]

This study is part of an investigation whose purpose is to provide evidence about the perceptions of students with respect to equality and gender violence of two universities (Spanish and Mexican). It is a pluri-methodological research where the aim was to assess the current situation of these dimensions, establishing differences and similarities to understand the phenomenon. Starting from application of focus groups, questionnaires and observations, we have been discovered that at both universities there are still elements that generate inequality, discrimination and even violence. Globally, the results have revealed similar trends in perceptions of students on the issues investigated. [ABSTRACT FROM AUTHOR]

Introduction: In this text statistical results of the relationship between managers with features green talent and implementing practices of green supply chain are presented. Because there research on the importance of vision High direction for the adoption of green practices; yet no realizes the personal characteristics of the management, nor the significant relationship between these characteristics and implementation practices of green supply chain, this is the contribution of this research. The work was developed in manufacturing companies with more than ten workers in the eastern part of the state of Morelos Mexico. The characterization of the term green talent was reported in the article, Green Talent: characterization and research, published in issue 14 of this magazine. Method: The method involves the construction of a survey divided into three categories conviertieron later in variables: practice green supply chain, green talent and institutional pressures. The first two were adapted survey Zhu and Sarkis (2007) and the third emerged from the social representation of green talent, due to a phase of this research. The survey was validated with a group of entrepreneurs from the National Chamber of Industry (CANACINTRA) Chapter Morelos. The validated instrument to 26 executives of manufacturing companies was applied with more than ten workers in the eastern part of Morelos, in order to test the relationship between characteristics of green managers with talent and practical implementation of green supply chain. For this were used as statistical tools Pearson correlation and multiple linear regression. Results: Practice green supply chain of manufacturing companies in the eastern area of the state of Morelos are in the planning stage. Respondents from companies recognize green features of talent in their senior executives. Institutional pressures (market regulation and competition) are important for companies that participated in the study despite the difficulty lies in implementing them. Conclusion: Green talent and practice green supply chain are variables that correlate, i.e., there is a statistically significant relationship between the two variables. Through multiple linear regression method states that institutional pressures: market regulation and competition, are due to the implementation of practices of green supply chain. These institutional pressures and the presence of features green talent in management, combine to implementing practices of green supply chain in manufacturing companies with more than ten workers in the eastern part of the state of Morelos, Mexico. [ABSTRACT FROM AUTHOR]

Understanding enzyme-substrate interactions is critical in designing strategies for bioconversion of lignocellulosic biomass. In this study we monitored molecular events, in situ and in real time, including the adsorption and desorption of cellulolytic enzymes on lignins and cellulose, by using quartz crystal microgravimetry and surface plasmon resonance. The effect of a nonionic surface active molecule was also elucidated. Three lignin substrates relevant to the sugar platform in biorefinery efforts were considered, namely, hardwood autohydrolysis cellulolytic (HWAH), hardwood native cellulolytic (MPCEL), and nonwood native cellulolytic (WSCEL) lignin. In addition, Kraft lignins derived from softwoods (SWK) and hardwoods (HWK) were used as references. The results indicated a high affinity between the lignins with both, monocomponent and multicomponent enzymes. More importantly, the addition of nonionic surfactants at concentrations above their critical micelle concentration reduced remarkably (by over 90%) the nonproductive interactions between the cellulolytic enzymes and the lignins. This effect was hypothesized to be a consequence of the balance of hydrophobic and hydrogen bonding interactions. Moreover, the reduction of surface roughness and increased wettability of lignin surfaces upon surfactant treatment contributed to a lower affinity with the enzymes. Conformational changes of cellulases were observed upon their adsorption on lignin carrying preadsorbed surfactant. Weak electrostatic interactions were determined in aqueous media at pH between 4.8 and 5.5 for the native cellulolytic lignins (MPCEL and WSCEL), whereby a ~20% reduction in the enzyme affinity was observed. This was mainly explained by electrostatic interactions (osmotic pressure effects) between charged lignins and cellulases. Noteworthy, adsorption of nonionic surfactants onto cellulose, in the form cellulose nanofibrils, did not affect its hydrolytic conversion. Overall, our results highlight the benefit of nonionic surfactant pretreatment to reduce nonproductive enzyme binding while maintaining the reactivity of the cellulosic substrate. [ABSTRACT FROM AUTHOR]

Soda-anthraquinone (soda-AQ) pulping of barley straw was used to obtain cellulosic pulps for papermaking purposes. The identified parameters, or variables to be optimized, were operating time, anthraquinone concentration, and PFI refiner revolutions, and the influence of these operating variables on pulp properties was studied. A polynomial model that reproduced the experimental results with errors less than 6% was developed. Operating variables were found (46 min of processing time, 0.4 wt.% of anthraquinone concentration, and 3000 rpm of PFI revolution) that yielded competitive pulp properties (82 °SR beating grade number, 870 mL/g of viscosity, Kappa number of 13, 77 Nm/g of tensile index, and 30% ISO brightness) at reasonable chemical and energy costs. On the other hand, this study highlights the usefulness of this polynomial model as a method to minimize the use of anthraquinone in these pulping processes and to be able to predict what the pulp properties will be. For comparison purposes, new operating conditions were found, and the pulp properties still remain at a very good level for this cereal straw. [ABSTRACT FROM AUTHOR]

Atrial arrhythmias, and specifically atrial fibrillation (AF), induce rapid and irregular activation patterns that appear on the torso surface as abnormal P-waves in electrocardiograms and body surface potential maps (BSPM). In recent years both P-waves and the BSPM have been used to identify the mechanisms underlying AF, such as localizing ectopic foci or high-frequency rotors. However, the relationship between the activation of the different areas of the atria and the characteristics of the BSPM and P-wave signals are still far from being completely understood. In this work we developed a multi-scale framework, which combines a highly-detailed 3D atrial model and a torso model to study the relationship between atrial activation and surface signals in sinus rhythm. Using this multi scale model, it was revealed that the best places for recording P-waves are the frontal upper right and the frontal and rear left quadrants of the torso. Our results also suggest that only nine regions (of the twenty-one structures in which the atrial surface was divided) make a significant contribution to the BSPM and determine the main P-wave characteristics. [ABSTRACT FROM AUTHOR]

Canada's immigration system is currently undergoing significant change driven by several goals that include (1) a desire to improve the economic outcomes of entering immigrants; (2) an attempt to better respond to short-term regional labor market shortages often associated with commodity booms, and (3) a desire to shift immigration away from the three largest cities to other regions of the country. These goals reflect the implementation of new immigration programs in the 2000s. The paper discusses the recent changes to Canadian immigration policy, examines preliminary evaluations of the new programs and discusses potential future issues emanating from the changes. [ABSTRACT FROM AUTHOR]

We compare the returns on education for graduates of postsecondary institutions who delayed their tertiary education for some time and those who proceeded with no delays. Using a unique survey that collects information on a representative cohort of graduates, we are able to estimate the effects of delaying school among successful graduates abstracting from specific macroeconomic conditions at the time of graduation. We show that graduates who delayed their education enjoy a premium relative to graduates who completed their education with no interruptions even after considering other factors such as experience or labour market connections. These estimates are robust to the possibility of selection in the decision to delay school. The results unveil a puzzle about the returns on education that calls for further research to investigate the effect of delay on earnings. [ABSTRACT FROM AUTHOR]

We analysed the fertility of women who migrated to Canada before reaching age 19, using the 20 per cent sample of the Canadian censuses from 1991 to 2006. Fertility increases with age at immigration, and is particularly high for those immigrating in late adolescence. This pattern prevails regardless of the country of origin, and of whether the mother tongue of the migrants was an official language in Canada. The fertility of those for whom it was an official language is always lower on average than of those for whom it was not, but there does not seem to be a critical age at which the fertility of the former and the latter starts to diverge. Formal education has an effect: the fertility of immigrants who arrived in Canada at any age before adulthood and who were or became college graduates is similar to that of their native peers. An appendix to this paper is available at http://dx.doi.org/10.1080/00324728.2013.802007 [ABSTRACT FROM AUTHOR]

Abstract: The influence of temperature (150–190°C), time (0–20min), liquid/solid ratio (6–8) and sulfuric acid concentration (0.1–0.5%), on the hydrolysis of palm empty fruit bunches (EFBs) was studied and the liquid and solid fractions were analyzed. Polynomial models were found to reproduce the experimental results with errors less than 15% in most of the cases (except for xylose concentration). Operating conditions of 190°C for 15min at a liquid/solid ratio of 6 and a sulfuric acid concentration of 0.1% resulted in the production of 3.12, 4.0, 2.35 and 2.28g/L of glucose, xylose, arabinose and acetic acid, respectively, starting with 1000g of EFBs. The yield was 67.96%. Soda-anthraquinone, ethanol and ethanolamine pulping of the solid fraction provided pulps with brightness values (63.24%, 28.78%, 48.76%), but with poor resistance properties (6.57–8.54Nm/g for tensile index, 0.38–0.44kN/g for burst index and 0.96–1.02mNm2/g for tear index). Therefore it is advisable to use the pulps for speciality papers or for bioethanol-production. [Copyright &y& Elsevier]

Abstract: Different cellulose pulps were produced from sulfur-free chemical treatments of Empty Palm Fruit Bunch Fibers (EPFBF), a by-product from palm oil processing. The pulps were microfluidized for deconstruction into nanofibrillated cellulose (NFC) and nanopaper was manufactured by using an overpressure device. The morphological and structural features of the obtained NFCs were characterized via atomic force and scanning electron microscopies. The physical properties as well as the interactions with water of sheets from three different pulps were compared with those of nanopaper obtained from the corresponding NFC. Distinctive chemical and morphological characteristics and ensuing nanopaper properties were generated by the EPFBF fibers. The NFC grades obtained compared favorably with associated materials typically produced from bleached wood fibers. Lower water absorption, higher tensile strengths (107–137MPa) and elastic modulus (12–18GPa) were measured, which opens the possibility for valorization of such widely available bioresource. [Copyright &y& Elsevier]

Empty fruit bunches (EFB) from palm oil were characterized. The holocellulose (66.97%), α-cellulose (47.91%), and lignin (24.45%) are similar to wood materials, and various non-wood materials, but the fiber length is shorter (0.53 mm). The influence of operational variables in the EFB pulping [formic acid (75-95%), hydrochloric acid (0.05-0.15%), and time (30-150 min)], on the yield, kappa number, viscosity, and brightness of the pulps was studied. By using a factorial design, equations that reproduced the experimental results for the dependent variables, errors less than 10% were obtained. These equations could be used to find suitable conditions, so that operating with not too high values of operating variables (with minor costs of capital and of operation), pulps could be obtained with acceptable properties. In this way, a cellulosic pulp with a 42.3% yield, 22.7% brightness, and a 512 mL/g viscosity was obtained under the following conditions: 92.5% of formic acid, 0.075% of hydrochloric acid, and a time of 60 min. A pulp (31.1 kappa number and 606 mL/g viscosity) was bleached by EPabOPoP sequence, achieving a brightness of 69.4%, a loss of viscosity and yield of 34.8% and 13.1%, respectively. The residual liquor from the pulping with formic acid 95%, 0.05% hydrochloric acid and 30 min, provides a liquor with 18.2% residual lignin, 4.1% glucose, 9.8% xylose, and 1.2% arabinose, all on dry weight of original material. [ABSTRACT FROM AUTHOR]

Abstract: Milox pulping of EFB was used to obtain pulps. In the first Milox stage, the influences of operating variables on pulp properties were studied and polynomial and neural fuzzy models that reproduced the experimental results with errors less than 10% were developed. Operating variables were found (93wt.% of formic acid, 3wt.% of hydrogen peroxide, and 165min) that yielded acceptable pulp properties (40.5% yield, 50.3% brightness and 608mL/g viscosity) at reasonable chemical and energy costs. The second stage was studied by subjecting the liquors of the previously optimized first stage to different treatment times. This time should be 30min or less, to avoid a negative effect on viscosity. The residual liquor from the first Milox stage contained virtually no precipitable lignin and only low amounts of sugar (wt.%): glucose 0.71, xylose 4.22, galactose 1.19, mannose 0.22, all on original raw material dry. [Copyright &y& Elsevier]

Mantle cell lymphoma (MCL) is a lymphoid neoplasm derived from mature B cells that represents 5-10% of non-Hodgkin lymphomas. MCL usually has an adverse clinical course characterized by a poor response to chemotherapy and a median overall survival of 3-5 years. Extranodal involvement, including central nervous system (CNS) infiltration, is a well-known feature of this disease. The incidence of CNS involvement in patients with MCL has been reported to range from 4% to 26%, with blastoid histology being one of the most relevant predicting factors for this complication. In most cases, CNS infiltration is a late event in the course of the disease. Treatment of this complication usually includes intrathecal chemotherapy in combination or not with systemic chemotherapy, frequently with high-dose methotrexate (MTX). However, once CNS infiltration is diagnosed, the prognosis is dismal and most patients die in less than 1 year. The relatively high risk of CNS involvement leads to the question of whether or not treatment strategies should take into consideration such a complication in all patients with MCL or only in a subset of them. However, the role of intravenous high-dose MTX as CNS prophylaxis in MCL is doubtful and, on the other hand, CNS infiltration is almost invariably part of disseminated disease, and the cause of death is systemic progression in virtually all patients. Therefore, CNS prophylaxis should be investigated as part of better therapies for this type of lymphoma. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The present study was aimed at sonographically determining the liver size in healthy newborns, infants and children under 7 years of age, correlating results with age, sex, height, body weight and body mass index. MATERIALS AND METHODS: A total of 584 healthy children subdivided into 11 age groups were evaluated with measurements of the left lobe craniocaudal diameter at the midsternal line, and the craniocaudal diameter of the right lobe posterior surface at the midclavicular line. The following tests were utilized for statistical analysis: a) Pearson's correlation coefficient (correlation study); b) non-paired Student's t-test (comparison of measures between sexes); c) nonlinear regression models (nomograms). RESULTS: The liver size presented a progressive growth from the birth up to the age of 7, proportionally lower than the body growth, in correlation with age, height and body weight (r > 0.70). Correlation with the body mass index was not observed (r < 0.11). There was no significant difference in liver size between male and female individuals. CONCLUSION: Liver size was sonographically determined in healthy children under the age of 7 by means of a standardized method, demonstrating a strong correlation with age and anthropometric indicators. Nomograms demonstrate the typical variations of the liver size in the population evaluated with a different growth pattern for each hepatic lobe. [ABSTRACT FROM AUTHOR]

This ecological study was developed to evaluate the patterns in hospital morbidity due respiratory diseases among people over 60 years old residing in the State of Paraná, before and after the implementation of vaccination campaigns against influenza. The data about hospitalizations in the 1995-2005 period were obtained from the Hospital Information System and grouped according to health center macro-regions, month of occurrence, gender and age group. The data was submitted to Analysis of Variance and Tukey statistical tests, and showed a decreasing tendency in hospitalizations in both genders after the vaccinations started, with different levels among age groups, gender, months of the year and health center macro-regions. The risk for hospitalization was higher for males and for older patients, from June to October, and in macro-region number 3, followed by regions 4, 5, 6, 2 and 1. [ABSTRACT FROM AUTHOR]

Abstract: Microperforated films (perforation diameter <200μm) are an option for achieving the appropriate gaseous composition in modified atmosphere packaging, especially for fresh-cut products. In this project, static techniques were used to experimentally measure the oxygen and carbon dioxide transmission rates of microperforated films. Twenty nine microperforations of different dimensions (from 40×30μm to 350×110μm) and thickness (from 29 to 57μm) were tested in the project. A potential equation was found to provide a good prediction of the dependence of the O2 and CO2 transmission rates on the perforation area. The data predicted by the equation was compared with those from five other bibliographic models. The empirical equation agrees, within the experimental range, with the modified Fick’s law (considering the total diffusive pass length of a perforation as the sum of the perforation length and end correction term). The predictions of the proposed equation for thicker films and holes of larger dimensions (equivalent radius >3000μm) correspond to those of the empirical models. [Copyright &y& Elsevier]

The article focuses on a study that analyzed the prevalence and the biologic and clinical significance of leukemic involvement in patients with mantle cell lymphoma (MCL). The researchers applied conventional morphology and flow cytometry (FC) to assess leukemic expression. CONCLUSIONS. The results indicate that leukemic expression at diagnosis detected by FC was highly frequent in the MCL patients.

We use data from Cycles 1 to 3 of the National Longitudinal Survey of Children and Youth to examine whether and how much housing and neighbourhood quality affect child outcomes. Home ownership, housing assistance, the need for major repairs, residential stability, underhousing, and neighbourhood quality are used as explanatory variables in population-averaged panel data and endogenous treatment models to estimate the impact of these variables on child cognitive, behavioural, and emotional outcomes. We find positive impacts of home ownership on reading scores, and positive impacts of housing subsidies on boys' behavioural scores, but negative impacts of subsidies on girls' emotional scores after controlling for other factors. Both girls and boys fare worse in housing requiring major repairs, but boys are negatively affected by housing instability, while girls are negatively affected by poor neighbourhood quality. [ABSTRACT FROM AUTHOR]

Abstract: Physiological maturity of peach at harvest greatly influences the post-harvest quality. Changes in colour during the last ripening stages of a very late and firm peach cultivar [Prunus persica (L.) Batsch cv. Calanda] have been studied to assess the feasibility of using reflectance colour references as non-destructive indices of maturity. The respiratory peak was simultaneous to the ethylene rise, and both induced important changes in the peaches. The physiological changes brought about a rise in polyphenoloxidase and peroxidase enzyme activity. The amount of carotenoids increased as maturity advanced and more markedly at the climacteric rise. Reflectance spectra and CIELAB coordinates reflected changes in skin and pulp colour and a * and h ab evolved nearly in a near linear way. Values of the b * coordinate show changes as well. These findings agree with and extend previous results that reflectance changes can be used as reliable indices to establish the time of physiological maturity in Calanda peaches. [Copyright &y& Elsevier]

Mantle cell lymphoma (MCL) is a mature B-cell proliferation characterized by the presence of translocation t(11;14)(q13;q32), an aggressive clinical course, and poor response to chemotherapy. The majority of drugs currently used in the treatment of lymphoproliferative disorders induce cell death by triggering apoptosis, but few data concerning drug-induced apoptosis in MCL have been reported. We have analysed the mechanisms of drug-induced cell death in four cell lines with the t(11;14) and in primary cells from 10 patients with MCL. Mitoxantrone, a topoisomerase II inhibitor, induced a strong cytotoxic effect in three cell lines (JVM-2, REC-1, and Granta 519), and in primary MCL cells. This cytotoxic effect due to apoptosis induction was observed despite the presence of either p53 or ATM abnormalities. However, no cytotoxic effect was detected after incubation with DNA-damaging agents in the NCEB-1 cell line, carrying p53 and ATM alterations, despite the presence of functional mitochondrial machinery. These results support that mitoxantrone can be effective in the treatment of MCL but that this activity requires the integrity of functional DNA-damage response genes.Oncogene (2004) 23, 8941-8949. doi:10.1038/sj.onc.1208084 Published online 11 October 2004 [ABSTRACT FROM AUTHOR]

Simple Summary: Current recommendations suggest setting two parallel cytogenetic cultures with 12-O-tetradecanoly-phorpol-13-acetate (TPA) and IL2+DSP30 as a mitogen to detect complex karyotypes (CKs) in chronic lymphocytic leukemia (CLL). However, studies comparing CK detection concordance between both methods in the same cohort are lacking. Herein, we evaluated the performance of two parallel cultures in a CLL cohort of 255 patients, specifically comparing CK detection (globally and in each individual patient). The CK detection rates and their prognostic impacts were similar for both mitogens. However, nearly one-third of CKs were only identified in one culture, mainly due to the detection of a normal karyotype or no metaphases in the other. In summary, the assessment of parallel cytogenetic cultures is the best strategy to detect CKs in CLL. Nonetheless, as IL2+DSP30 achieved the best performance, it should be prioritized above TPA if a single analysis is required to optimize cytogenetic assessment in routine practice. Current CLL guidelines recommend a two parallel cultures assessment using TPA and IL2+DSP30 mitogens for complex karyotype (CK) detection. Studies comparing both mitogens for CK identification in the same cohort are lacking. We analyzed the global performance, CK detection, and concordance in the complexity assessment of two cytogenetic cultures from 255 CLL patients. IL2+DSP30 identified more altered karyotypes than TPA (50 vs. 39%, p = 0.031). Moreover, in 71% of those abnormal by both, IL2+DSP30 identified more abnormalities and/or abnormal metaphases. CK detection was similar for TPA and IL2+DSP30 (10% vs. 11%). However, 11/33 CKs (33%) were discordant, mainly due to the detection of a normal karyotype or no metaphases in the other culture. Patients requiring treatment within 12 months after sampling (active CLL) displayed significantly more CKs than those showing a stable disease (55% vs. 12%, p < 0.001). Disease status did not impact cultures' concordance (κ index: 0.735 and 0.754 for stable and active). Although CK was associated with shorter time to first treatment (TTFT) using both methods, IL2+DSP30 displayed better accuracy than TPA for predicting TTFT (C-index: 0.605 vs. 0.580, respectively). In summary, the analysis of two parallel cultures is the best option to detect CKs in CLL. Nonetheless, IL2+DSP30 could be prioritized above TPA to optimize cytogenetic assessment in clinical practice. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discussed the outbreak of acute hepatitis C among HIV-infected men in Madrid, Spain.

Background: Etravirine/raltegravir dual therapy has been shown to be highly effective as a twice-daily (q12h) regimen in suppressed HIV-infected patients enrolled in the ANRS-163 study.Objectives: As a once-daily (q24h) regimen is easier for daily life, we aimed to evaluate the capacity of etravirine/raltegravir (400/800 mg) q24h to maintain viral suppression in patients on etravirine/raltegravir q12h.Methods: Patients on a suppressive etravirine/raltegravir q12h regimen for at least 96 weeks were switched to etravirine/raltegravir q24h in this prospective, multicentre, open-label, single-arm study. Primary outcome was the rate of virological failure (VF: confirmed pVL >50 copies/mL, single pVL >400 copies/mL or single pVL >50 copies/mL with ART change) at Week 48 (W48). Secondary outcomes included treatment strategy success rate (no VF and no treatment discontinuation), regimen tolerability, plasma drug concentrations and resistance profile in the case of VF.Results: A total of 111 patients were enrolled, with a median (IQR) age of 57 years (52-62), CD4 count of 710 cells/mm3 (501-919) and viral suppression for 7.9 years (5.9-10.7). Two patients experienced viral rebound at W24 and W48, leading to a VF rate of 2.0% (95% CI 0.5-7.8) at W48, associated with INSTI resistance in one case. Both had past NNRTI mutations. Ten patients discontinued treatment for adverse events (n = 2), investigator or patient decisions (n = 3), lost to follow-up (n = 3), death (n = 1) or pregnancy (n = 1). Overall, the strategy success rate was 89% (95% CI 81.5-93.6) at W48. In a subgroup of 64 patients, median (IQR) plasma C24h concentrations were 401 ng/mL (280-603) for etravirine and 62 ng/mL (31-140) for raltegravir.Conclusions: Switching patients virally suppressed on etravirine/raltegravir q12h to the same regimen but given q24h was highly effective in maintaining virological suppression in HIV-infected patients. [ABSTRACT FROM AUTHOR]

Objective: Considering the importance of the beginning of the academic trajectory for children to reach their full development, this work aims to evaluate the school readiness of preschool-age children and identify which factors influence these results, in order to contribute to the proposition of strategies that allow improving the teaching-learning process and child development. Methods: This is a cross-sectional, descriptive and analytical study with 443 preschool children belonging to the West Region Cohort (ROC Cohort), from the public school system of the city of São Paulo. School readiness was assessed by the International Development and Early Learning Assessment (IDELA) tool. Nonparametric techniques were used for the correlation analysis between IDELA scores and sociodemographic and socioeconomic conditions: Spearman’s parametric correlation, Mann-Whitney and Kruskal-Wallis tests. Results: The children’s mean age was 69 months (standard deviation — SD=2.8; ranging from 55 to 72 months) and most of them came from families with low socioeconomic level. Most children showed adequate readiness in the overall score (65%) and in most domains, except for emergent literacy, in which most (56.9%) were classified as “emergent”. The highest percentage of insufficiency was identified in executive functions (4.1%), which showed a correlation only with the caregiver’s education. Conclusions: Children had adequate school readiness scores, except for emergent literacy, but the insufficiency in executive functions may compromise the future schooling of these children. Thus, pedagogical proposals should consider these aspects for learning and pediatricians need to reinforce the habit of reading and playing games to stimulate child development. [ABSTRACT FROM AUTHOR]

Objective: The COVID-19 pandemic Increased the risk of impairing the mother-infant bonding. The objectives of this study were to evaluate the early bond established between mother and infant and postpartum depression (PPD) in pregnancies that occurred during the pandemic period, to identify the factors that may have influenced these outcomes and to verify if there was an association between bonding and probable PPD. Methods: This is a cross-sectional study of postpartum women from a public maternity hospital in the city of São Paulo conducted from February to June 2021, involving 127 mother-baby dyads. The initial data were collected in the immediate postpartum period and between 21–45 days after birth, using a semi-structured questionnaire on sociodemographic characteristics, gestational and birth conditions, and baby characteristics; the Edinburgh Postnatal Depression Scale (EPDS) and Postpartum Bonding Questionnaire (PBQ) were used to evaluate PPD and bonding, respectively. Results: The presence of probable PPD and unplanned pregnancies were associated with higher PBQ score and risk to impaired bonding (p = 0.001 and p = 0.004, respectively). EPDS showed a high prevalence of PPD (29.1%) and was not associated with any Studied variable. Probably, this high prevalence of probable PPD was due to the context of insecurity secondary to the pandemic. Conclusions: We observed an increase in the prevalence of probable PPD and unplanned pregnancies during the first 18 months of the pandemic, which were associated with worse scores in mother-infant bonding. The impaired bond can affect the future development of children born during this period. [ABSTRACT FROM AUTHOR]

This paper analyzes the representations of good university teachers prepared by professors at public universities in Mexico, and discusses the implications for management, training, and identity. A literature review allowed us to contrast instructional and student-centered focuses, while defining ethical, pedagogical, and multifunctional dimensions. We employed quantitative methodology based on a representative sample's responses to a Likert scale survey. The resulting representations were inferred by analyzing linear trends and dif erences by age group, type of contract, seniority, gender, and area of knowledge. The findings show that the teachers' shift toward student-centered learning requires explanation and self-criticism of their representations, as well as ethical displacement; also necessary are adequate conditions and coherent institutional discourse. [ABSTRACT FROM AUTHOR]

The assessment of mood disorders and addiction linked to the practice of chemsex is of interest given the psychoactive substances used. The aim of this study was to assess risky sexual and addictive behavior to chemsex and related anxiety/depression symptoms in individuals receiving HIV pre‐exposure prophylaxis (PrEP). In this cross‐sectional study, all adults presenting for PrEP renewal at French sexual health centers were enrolled from January 2018 to March 2019. Participants completed a questionnaire on chemsex (i.e., the use of psychoactive substances before/during sex), including adapted Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) to chemsex addiction (questions of ASSIST were modified to focus on chemsex). Anxiety/depression was assessed with the Hospital Anxiety and Depression Scale. In the last 3 months before enrollment, 39.8% (94/236) of participants reported chemsex. The main psychoactive substances consumed during chemsex were cathinones (74.6%), gamma‐hydroxybutyrate (66.3%), and other psychostimulants (60%). The median score of the chemsex‐focused ASSIST was 8 [IQR25–75: 3–15]; 72.2% of participants had a score justifying at least a brief intervention (>4). In multivariate analyses, anxiety and cathinones consumption were associated with an ASSIST score >4: OR 13.65 (95%CI 1.68–662.7), P = 0.0062, and OR 8.468 (95%CI 2.066–43.059), P = 0.0014, respectively. The level of addiction to the practice of chemsex can be difficult to estimate for the user, and the ASSIST makes it possible to evaluate this addiction and to direct the subjects toward specialized consultations of addictology, sexual health, or PrEP renewals. The implementation of the modified ASSIST in these consultations can allow early systematic screening and counseling. [ABSTRACT FROM AUTHOR]

Interest in sustainability and its relation to performance has grown significantly among practitioners and operations management (OM) scholars. However, there is still a paucity of research on the antecedents and drivers of sustainability, as well as on the relationship between sustainability and performance. Moreover, the literature offers contradictory results on this relationship. Therefore, the goal of this paper is to provide a research synthesis about the overall state of the art of empirical research on the impact of sustainability management practices on performance, encompassing social and environmental dimensions. To achieve this goal, the authors develop a rigorous systematic review of the extant literature on sustainability relationships with firm performance, emphasizing the under-researched area of causal models of sustainability and operational performance. This research is a first attempt to go beyond the highly dispersed work on the subject, aiming to provide more generalizable evidence about theories, methods and findings. The synthesis embraces 231 papers in total and identifies the main variables on causal models depicting the relationships between sustainability and performance, analyses how the studies on the subject are conducted, and investigates the impact and the mechanisms through which sustainability affects operational performance (OP). Overall, there are positive effects of sustainability on performance, such as lower costs, better delivery and product quality, enhanced volume and mix flexibility, although different mechanisms drive the sustainability-performance links and they differ according to contexts. The study outlines implications for practice and future research. [ABSTRACT FROM AUTHOR]

When simulating the macroscopic current flowing through cardiac ion channels, two mathematical formalisms can be adopted: the Hodgkin–Huxley model (HHM) formulation, which describes openings and closings of channel ‘gates’, or the Markov model (MM) formulation, based on channel ‘state’ transitions. The latter was first used in 1995 to simulate the effects of mutations in ionic currents and, since then, its use has been extended to wild-type channels also. While the MMs better describe the actual behavior of ion channels, they are mathematically more complex than HHMs in terms of parameter estimation and identifiability and are computationally much more demanding, which can dramatically increase computational time in large-scale (e.g. whole heart) simulations. We hypothesize that a HHM formulation obtained from classical patch-clamp protocols in wild-type and mutant ion channels can be used to correctly simulate cardiac action potentials and their static and dynamic properties. To validate our hypothesis, we selected two pivotal cardiac ionic currents (the rapid delayed rectifier K + current, I Kr , and the inward Na + current, I Na ) and formulated HHMs for both wild-type and mutant channels (LQT2-linked T474I mutation for I Kr and LQT3-linked ΔKPQ mutation for I Na ). Action potentials were then simulated using the MM and HHM versions of the currents, and the action potential waveforms, biomarkers and action potential duration rate dependence properties were compared in control conditions and in the presence of physiological variability. While small differences between ionic currents were found between the two models (correlation coefficient ρ >0.92), the simulations yielded almost identical action potentials ( ρ >0.99), suggesting that HHMs may also be valid to simulate the effects of mutations affecting I Kr and I Na on the action potential. [ABSTRACT FROM AUTHOR]

Simple Summary: Genome complexity, detected by chromosome banding analysis or chromosomal microarray analysis, is a poor prognostic factor for chronic lymphocytic leukemia (CLL). Herein, we aimed to assess the performance of optical genome mapping (OGM) for the cytogenomic characterization of CLL patients, with a special focus on risk stratification based on genomic complexity. A cohort of 42 patients enriched in complex karyotypes was assessed by OGM, and the results were compared with those obtained from current methods. Moreover, clinical–biological characteristics and time to first treatment were analyzed according to the OGM-defined complexity. Globally, OGM identified 90% of the known alterations and provided novel structural information about these aberrations in 55% of patients. Regarding genomic complexity, OGM allowed us to identify a complex group (≥10 alterations) displaying enrichment of TP53 abnormalities and poorer evolution. Altogether, we confirmed that OGM is a valuable tool for the cytogenomic assessment and prognostic stratification of CLL patients. Novel treatments in chronic lymphocytic leukemia (CLL) have generated interest regarding the clinical impact of genomic complexity, currently assessed by chromosome banding analysis (CBA) and chromosomal microarray analysis (CMA). Optical genome mapping (OGM), a novel technique based on imaging of long DNA molecules labeled at specific sites, allows the identification of multiple cytogenetic abnormalities in a single test. We aimed to determine whether OGM is a suitable alternative to cytogenomic assessment in CLL, especially focused on genomic complexity. Cytogenomic OGM aberrations from 42 patients were compared with CBA, FISH, and CMA information. Clinical–biological characteristics and time to first treatment (TTFT) were analyzed according to the complexity detected by OGM. Globally, OGM identified 90.3% of the known alterations (279/309). Discordances were mainly found in (peri-)centromeric or telomeric regions or subclonal aberrations (<15–20%). OGM underscored additional abnormalities, providing novel structural information on known aberrations in 55% of patients. Regarding genomic complexity, the number of OGM abnormalities had better accuracy in predicting TTFT than current methods (C-index: 0.696, 0.602, 0.661 by OGM, CBA, and CMA, respectively). A cut-off of ≥10 alterations defined a complex OGM group (C-OGM, n = 12), which included 11/14 patients with ≥5 abnormalities by CBA/CMA and one patient with chromothripsis (Kappa index = 0.778; p < 0.001). Moreover, C-OGM displayed enrichment of TP53 abnormalities (58.3% vs. 3.3%, p < 0.001) and a significantly shorter TTFT (median: 2 vs. 43 months, p = 0.014). OGM is a robust technology for implementation in the routine management of CLL patients, although further studies are required to define standard genomic complexity criteria. [ABSTRACT FROM AUTHOR]

The aim of this paper is to reflect on the relationship between mental health and social vulnerability at the intersection of biological psychiatry and the Brazilian psychiatric reform. The concepts of mental health and social vulnerability, as based on diagnostic manuals and epidemiological research, are taken up in the scope of public health policies. We identify the need to overcome the traditional technical and scientific logic to incorporate the singularity and knowledge related to human suffering. [ABSTRACT FROM AUTHOR]

Introduction: Dysregulated NK cell‐mediated immune responses contribute to tumor evasion in chronic lymphocytic leukemia (CLL), although the NK cell compartment in CLL‐like monoclonal B‐cell lymphocytosis (MBL) is poorly understood. In healthy individuals, human cytomegalovirus (HCMV) induces the expansion of NK cells expressing high levels of CD94/NKG2C NK cell receptor (NKR) specific for HLA‐E. Methods: We analyzed the expression of NKG2A, NKG2C, ILT2, KIR, CD161, and CD57 in 24 MBL and 37 CLL. NKG2C was genotyped in these patients and in 81 additional MBL/CLL, while NKG2C gene expression was assessed in 26 cases. In 8 CLL patients with increased lymphocytosis (≥20 × 109/L), tumor HLA‐E and HLA‐G expression was evaluated. Results: NKR distribution did not significantly differ between MBL and CLL patients, although they exhibited reduced NKG2C+ NK cells compared with a non‐CLL group (4.6% vs 12.2%, P =.012). HCMV+ patients showed increased percentages of NKG2C+ NK cells compared with HCMV− (7.3% vs 2.9%, P =.176). Frequencies of NKG2C deletions in MBL/CLL were similar to those of the general population. Low/undetectable NKG2C expression was found among NKG2C+/− (45%) and NKG2C+/+ (12%) patients. CLL cases with increased lymphocytosis displayed especially reduced NKG2C expression (1.8% vs 8.1%, P =.029) and tumor cells with high HLA‐E (>98%) and variable HLA‐G expression (12.4%, range: 0.5‐56.4). CLL patients with low NKG2C expression (<7%) showed shorter time to first treatment (P =.037). Conclusion: Reduced percentages of CD94/NKG2C+ NK cells were observed in CLL and MBL patients independently of HCMV serostatus and NKG2C zygosity, particularly in CLL patients with increased lymphocytosis, which could potentially be related to the exposure to tumor cells. [ABSTRACT FROM AUTHOR]

• An increased inflammatory signature exists in MBL, mediated mainly by monocytes. • This inflammatory signature is reduced in early-stage CLL, especially IGHV-mutated patients. • A similar increase in Th1 and cytotoxic CD4+ T cells is detected in both entities. • Tumor-supporting effects of monocytes are similarly observed in both entities. Several studies in chronic lymphocytic leukemia (CLL) patients have reported impaired immune cell functions, which contribute to tumor evasion and disease progression. However, studies on CLL-like monoclonal B-cell lymphocytosis (MBL) are scarce. In the study described here, we characterized the immune environment in 62 individuals with clinical MBL, 56 patients with early-stage CLL, and 31 healthy controls. Gene expression arrays and quantitative reverse transcription polymerase chain reaction were performed on RNA from CD4+ peripheral blood cells; serum cytokines were measured with immunoassays; and HLA-DR expression on circulating monocytes, as well as the percentages of Th1, cytotoxic, exhausted, and effector CD4+ T cells, were evaluated by flow cytometry. In addition, cell cultures of clonal B cells and CD14-enriched or -depleted cell fractions were performed. Strikingly, MBL and early-stage CLL differed in pro-inflammatory signatures. An increased inflammatory drive orchestrated mainly by monocytes was identified in MBL, which exhibited enhanced phagocytosis, pattern recognition receptors, interleukin-8 (IL8), HMGB1, and acute response signaling pathways and increased pro-inflammatory cytokines (in particular IL8, interferon γ [IFNγ], and tumor necrosis factor α). This inflammatory signature was diminished in early-stage CLL (reduced IL8 and IFNγ levels, IL8 signaling pathway, and monocytic HLA-DR expression compared with MBL), especially in those patients with mutations in IGHV genes. Additionally, CD4+ T cells of MBL and early-stage CLL exhibited a similar upregulation of Th1 and cytotoxic genes and expanded CXCR3+ and perforin+ CD4+ T cells, as well as PD1+ CD4+ T cells, compared with controls. Cell culture assays disclosed tumor-supporting effects of monocytes similarly observed in MBL and early-stage CLL. These novel findings reveal differences in the inflammatory environment between MBL and CLL, highlighting an active role for antigen stimulation in the very early stages of the disease, potentially related to malignant B-cell transformation. Image, graphical abstract [ABSTRACT FROM AUTHOR]

Objective: To assess personal, professional, medical, and scientific educational characteristics and issues reported by pediatricians. Methods: Cross-sectional study based on an online survey including 614 pediatricians who graduated in the last 15 years at a University Pediatric Department in Brazil. Results: The response rate was 331/614(54%). The majority were females (82%), the median age was 33 years (27– 40) and median years of pediatric practice was 5 (1–13). High workload (>60 hours/week) occurred in 25% and 47% earned ≥15 minimum wages/month. The most work-related issues reported were long working hours, poor social life and a sedentary lifestyle (>50%). Pediatricians were further divided into two groups, according to years of pediatric clinical practice: group 1 (≤5 years) and group 2 (>5 years). The median of overall satisfaction with pediatric residency [8(0–10) vs. 9 (4–10); p=0.002] was significantly reduced in group 1. The frequencies of workload >60 hours, work on pediatric ward and pediatric intensive care were significantly higher in the first group (p<0.05). Regarding main issues related to clinical practice in the last year, long working hours (73 vs. 53%; p<0.001), poor social life (75 vs. 62%; p=0.018) and harassment (23 vs. 4%; p=0.003) were significantly higher in the first group. Conclusions: Very early career pediatricians (≤5 years) reported higher workload, lower income, work-related issues and different location of pediatric practice compared to early career pediatricians (>5 years). The overall satisfaction with pediatric residency was good, however, reduced in very early career pediatricians. [ABSTRACT FROM AUTHOR]

Coordinated fog (edge) and cloud computing systems are expected to expedite the evolution of smart farming toward openness and data sharing while making agriculture economically sustainable for smaller farms. We demonstrate a farming system that deploys low-cost technology and uniquely considers animal welfare and quality of life. [ABSTRACT FROM AUTHOR]

A growing body of epigenetic research suggests that in-utero adaptations to environmental changes display important sex-specific variation. We tested this heterogeneous adaptation hypothesis using data from 900 children born at the University Hospital in São Paulo, Brazil, between October 2013 and April 2014. Crude and adjusting linear models were used to quantify the associations between prematurity, being small for gestational age, and children's physical and mental development at 12 months of age. Prematurity was negatively associated with neuropsychological development in final models (z score difference, −0.42, 95% confidence intervals: −0.71, −0.14), but associations did not vary significantly by sex. For being small for gestational age, associations with height-for-age, weight-for-age, and neuropsychological development were also negative, but they were systematically larger for male than for female infants (P < 0.05 for all). These results suggest that male fetuses may be more vulnerable to intrauterine adversity than female fetuses. Further research will be needed to better understand the mechanisms underlying these sex-specific associations. [ABSTRACT FROM AUTHOR]

Time series analysis with explanatory variables encompasses methods to model and predict correlated data taking into account additional information, known as exogenous variables. A thorough search in literature returned a dearth of systematic literature reviews (SLR) on time series models with explanatory variables. The main objective is to fill this gap by applying a rigorous and reproducible SLR and a bibliometric analysis to study the evolution of this area over time. The study resulted in the identification of the main methods of time series that incorporate input variables per knowledge area and methodology. The largest number of papers belongs to environmental sciences, followed by economics and health. Regression model is the method with the highest number of applications, followed by Artificial Neural Networks and Support Vector Machines, which experienced rapid and recent growth. A research agenda in time series analysis with exogenous variables closes the paper. [ABSTRACT FROM AUTHOR]

Mantle cell lymphoma (MCL) is an aggressive B-cell malignancy, but some patients have a very indolent evolution. This heterogeneous course is related, in part, to the different biological characteristics of conventional MCL (cMCL) and the distinct subgroup of leukemic nonnodal MCL (nnMCL). Robust criteria to distinguish these MCL subtypes and additional biological parameters that influence their evolution are not well defined. We describe a novel molecular assay that reliably distinguishes cMCL and nnMCL using blood samples. We trained a 16-gene assay (L-MCL16 assay) on the NanoString platform using 19 purified leukemic samples. The locked assay was applied to an independent cohort of 70 MCL patients with leukemic presentation. The assay assigned 37% of cases to nnMCL and 56% to cMCL. nnMCL and cMCL differed in nodal presentation, lactate dehydrogenase, immunoglobulin heavy chain gene mutational status, management options, genomic complexity, and CDKN2A/ATM deletions, but the proportion with 17p/TP53 aberrations was similar in both subgroups. Sequential samples showed that assay prediction was stable over time. nnMCL had a better overall survival (OS) than cMCL (3-year OS 92% vs 69%; P = .006) from the time of diagnosis and longer time to first treatment. Genomic complexity and TP53/CDKN2A aberrations predicted for shorter OS in the entire series and cMCL, whereas only genomic complexity was associated with shorter time to first treatment and OS in nnMCL. In conclusion, the newly developed assay robustly recognizes the 2 molecular subtypes of MCL in leukemic samples. Its combination with genetic alterations improves the prognostic evaluation and may provide useful biological information for management decisions. [ABSTRACT FROM AUTHOR]

Background: Differential trends in mortality suggest that stillbirths may dominate neonatal mortality in the medium to long run. Brazil has made major efforts to improve data collection on health indicators at granular geographic levels, and provides an ideal environment to test this hypothesis. Our goals were to examine levels and trends in stillbirths and neonatal deaths and the extent to which the mortality burden caused by stillbirths dominates neonatal mortality at the municipality- and state-level. Methods: We used data from the Brazilian Ministry of Health’s repository on births, fetal, and neonatal deaths (2010–2014) to calculate stillbirth and neonatal mortality rates for São Paulo state’s 645 municipalities. Results: At the state level, 7.9 per 1000 pregnancies ended in stillbirth (fetal death >22 weeks gestation or fetal weight >500g), but this varied from 0.0 to 28.4 per 1000 across municipalities. 7.9 per 1000 live births also died within the first 28 days. 42% of municipalities had a higher stillbirth rate than neonatal mortality rate, and in 61% of areas with low neonatal mortality (<8.0 per 1000), stillbirth rates exceeded neonatal mortality rates. Conclusions: This analysis suggests large variability and inequality in mortality outcomes at the sub-national level. The results also imply that stillbirth mortality may exceed neonatal mortality in Brazil and similar settings in the next few decades, which suggests a need for a shift in policy. This work further underscores the importance of continued research into causes and prevention of stillbirth. [ABSTRACT FROM AUTHOR]