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Manuel Torres-Gutiérrez,1 Nicolás Lozano-Suárez,2 Viviana A Burgos-Camacho,1 Jessica Caamaño-Jaraba,1 Julia Andrea Gómez-Montero,2 Andrea García-López,2 Fernando Girón-Luque2,3 1Department of Mental Health, Colombiana de Trasplantes, Bogotá, Colombia; 2Department of Transplant Research, Colombiana de Trasplantes, Bogotá, Colombia; 3Department of Transplant Surgery, Colombiana de Trasplantes, Bogotá, ColombiaCorrespondence: Andrea García-López, Transplant Research, Colombiana de Trasplantes, Av Carrera, 30 No. 47 A-74, Bogota, 111311, Colombia, Email aegarcia@colombianadetrasplantes.comIntroduction: Non-adherence in kidney transplants is diversely defined. Immunosuppression non-adherence (INA) is the most used definition and has been associated with graft loss and acute rejection. But INA assesses only one fraction of adherence. Therefore, we analyzed the association of a holistic non-adherence definition with transplant outcomes and compared its prediction performance with other definitions.Methods: We retrospectively included 739 kidney recipients between 2019 and 2021. We evaluated holistic non-adherence (HNA), suboptimal-immunosuppressor levels (SIL), appointment non-adherence (ANA), procedure non-adherence (PNA) and INA. The main outcomes were graft loss, graft rejection, and mortality. A backward logistic regression was performed estimating adjusted and un-adjusted odds ratio (OR) for each outcome. Finally, we compared the non-adherence definitions’ prediction for the main outcomes using the area under the curve.Results: HNA was present in 28.7% of patients. Non-adherent patients had an adjusted OR of 2.66 (1.37– 5.15) for mortality, 6.44 for graft loss (2.71– 16.6), and 2.28 (1.15– 4.47) for graft rejection. INA and PNA presented a moderate discrimination for graft loss and HNA and ANA mild-to-moderate discrimination for graft loss and death.Conclusion: Holistic non-adherence was associated with worst outcomes in kidney recipients and had a significant prediction performance for graft loss and mortality.Keywords: kidney transplantation, patient adherence, mortality, graft survival, patient outcome assessment

Manuel Torres-Gutiérrez,1 Viviana Burgos-Camacho,1 Jessica Paola Caamaño-Jaraba,1 Nicolás Lozano-Suárez,2 Andrea García-López,2 Fernando Girón-Luque2,3 1Department of Mental Health, Colombiana de Trasplantes, Bogotá, Colombia; 2Department of Transplant Research, Colombiana de Trasplantes, Bogotá, Colombia; 3Department of Transplant Surgery, Colombiana de Trasplantes, Bogotá, ColombiaCorrespondence: Andrea García-López, Transplant Research, Colombiana de Trasplantes, Av Carrera, 30 No. 47 A-74, Bogota, 111311, Colombia, Email aegarcia@colombianadetrasplantes.comIntroduction: In renal transplant recipients, compliance with medical therapy is vital. Non-adherence is considered a risk factor for worst outcomes in kidney recipients, with attributed outcomes of 64% for graft loss and 80% for late acute rejection. Most literature defines adherence as self-based immunosuppression compliance but does not consider other relevant factors such as consult and procedure compliance. Therefore, this study aims to describe adherence prevalence in kidney transplant recipients and the factors related to non-adherence.Methods: This cross-sectional study included 1030 renal transplant patients followed by Colombiana de Trasplantes between January 2019 and July 2021. Sociodemographic and clinical variables were obtained based on clinical records. The mental-health group diagnosed holistic adherence in a semi-structured interview. The diagnosis considered medication intake failure, frequency and number of failures to medical controls or other procedures, suspicious non-adherence behaviors, and serum levels of immunosuppressants. A bivariate followed a descriptive analysis, and a forward logistic regression was performed for non-adherence.Results: Patients had a median of 47 years, and 58.1% were male. Non-adherence was presented in 30.7% of patients. The non-adherence patients were younger, with a higher prevalence of males, single, divided transplant care, had a longer time after transplantation, psychopathological diagnosis, and more reinforcement education by only nursing. Older age and multidisciplinary reinforcement education were protective factors. On the other hand, poor social support, psychopathology diagnosis, and longer time after transplant presented as non-adherence risk factors.Conclusion: Holistic non-adherence was diagnosed in approximately one-third of renal transplant recipients. Its definition included more than just medication non-compliance and could identify more non-adherent patients. Notably, there is a need to consider the related factors in the health follow-up and encourage future research in modifiable factor interventions aiming to increase adherence and achieve better outcomes for renal transplant patients.Keywords: treatment adherence and compliance, kidney transplantation, patient compliance, social support, patient education, mental health, psychopathology

Glycosylphosphatidylinositols (GPIs) are highly conserved anchors for eukaryotic cell surface proteins. The apicomplexan parasite, Toxoplasma gondii, is a widespread intracellular parasite of warm-blooded animals whose plasma membrane is covered with GPI-anchored proteins, and free GPIs called GIPLs. While the glycan portion is conserved, species differ in sidechains added to the triple mannose core. The functional significance of the Glcα1,4GalNAcβ1- sidechain reported in Toxoplasma gondii has remained largely unknown without understanding its biosynthesis. Here we identify and disrupt two glycosyltransferase genes and confirm their respective roles by serology and mass spectrometry. Parasites lacking the sidechain on account of deletion of the first glycosyltransferase, PIGJ, exhibit increased virulence during primary and secondary infections, suggesting it is an important pathogenesis factor. Cytokine responses, antibody recognition of GPI-anchored SAGs, and complement binding to PIGJ mutants are intact. By contrast, the scavenger receptor CD36 shows enhanced binding to PIGJ mutants, potentially explaining a subtle tropism for macrophages detected early in infection. Galectin-3, which binds GIPLs, exhibits an enhancement of binding to PIGJ mutants, and the protection of galectin-3 knockout mice from lethality suggests that Δpigj parasite virulence in this context is sidechain dependent. Parasite numbers are not affected by Δpigj early in the infection in wild-type mice, suggesting a breakdown of tolerance. However, increased tissue cysts in the brains of mice infected with Δpigj parasites indicate an advantage over wild-type strains. Thus, the GPI sidechain of T. gondii plays a crucial and diverse role in regulating disease outcomes in the infected host.IMPORTANCEThe functional significance of sidechain modifications to the glycosylphosphatidylinositol (GPI) anchor in parasites has yet to be determined because the glycosyltransferases responsible for these modifications have not been identified. Here we present identification and characterization of both Toxoplasmsa gondii GPI sidechain-modifying glycosyltransferases. Removal of the glycosyltransferase that adds the first GalNAc to the sidechain results in parasites without a sidechain on the GPI, and increased host susceptibility to infection. Loss of the second glycosyltransferase results in a sidechain with GalNAc alone, and no glucose added, and has negligible effect on disease outcomes. This indicates GPI sidechains are fundamental to host-parasite interactions.

The mathematical-related affect research agenda demands studies on the affect-cognition relationship, as well as interventions aimed at improving affective aspects of mathematical learning. The potential of technological environments for promoting cognitive changes in students has been widely informed and there is evidence of their influence in students´ attitudes towards mathematics, such as interest and enjoyment. Research on the so-called mathematical attitudes, more related to mental habits and closely tied to cognitive processes is much scarcer. In this study, we report the transformation of three such mathematical attitudes in the students: perseverance, precision-rigor, and autonomy, when introducing GeoGebra in two secondary classes. Quantitative and qualitative analyses performed on data from various sources, with the total number of students and with a representative sample, show how it is possible to capitalize on initial positive attitudes towards mathematics with technology to bring about a significant improvement in the three above-mentioned attitudes, deemed as genuine elements of mathematical work. GeoGebra affordances constructivity, navigability and interactivity made it possible for new forms of behaviour to emerge in the classroom. Namely, flexible and fluent perseverance on problem solving; increasing inclination for accuracy and realization of its importance for proper reasoning; and willingness to collaborate with peers, helping each other, as well as sharing insights and ideas, thus, gaining independence from the teacher to face non-routine tasks.

Abstract Rotaxanes equipped with actuators hold great potential for developing highly functional molecular machines. Such systems could significantly enhance our ability to study and manipulate biological and artificial membranes. Here, we introduce a rotaxane with a ring featuring two azobenzene photoswitches, which retain their photoreversibility and can be stochastically shuttled along the axle in solution. Studies in model bilayers, supported by molecular dynamics simulations, show how azobenzene photoswitching alters the interaction of rotaxanes with surrounding lipids, leading to changes in lipid packing. Such changes in the lipid bilayer were leveraged to induce the light-triggered release of sulforhodamine B from large unilamellar vesicles. Additionally, light activation of the rotaxanes is shown to induce reversible contraction and expansion of giant unilamellar vesicles. The results provide novel insights into the interactions and operation of rotaxanes in lipid bilayers and their impact on membrane properties. This will aid in developing systems for precise membrane manipulation for applications in biomedicine and bioengineering.

Abstract Background Escherichia coli (E. coli) is one of the main bacteria associated with preterm premature rupture of membranes by increasing pro-matrix metalloproteinase 9 (proMMP-9) and degradation of type IV collagen in human feto-maternal interface (HFMi). proMMP-9 is regulated by progesterone (P4) but it is unclear whether P4 inhibits proMMP in human maternal decidual (MDec). This study aimed to determine a role of P4 on proMMP-2 and − 9 and type IV collagen induced by E. coli infection in MDec. Methods Nine HFMi were mounted in a Transwell system. MDec was stimulated with P4 or E. coli for 3-, 6-, or 24-hours. proMMP-2, -9 and type IV collagen were assessed. Results Gelatin zymography revealed an increase in proMMP-9 after 3, 6, and 24 h of stimulating MDec with E. coli. Using immunofluorescence, it was confirmed the increase in the HFMi tissue and a reduction on the amount of type IV collagen leading to the separation of fetal amniochorion and MDEc. The degradative activity of proMMP-9 was reduced by 20% by coincubation with P4. Conclusions P4 modulates the activity of proMMP-9 induced by E. coli stimulation but it was unable to completely reverse the degradation of type IV collagen in human MDec tissue.

Abstract Background Parkinson´s disease (PD), the second most common neurodegenerative disease in the world, is characterized by the death or impairment of dopaminergic neurons (DAn) in the substantia nigra pars compacta and dopamine depletion in the striatum. Currently, there is no cure for PD, and treatments only help to reduce the symptoms of the disease, and do not repair or replace the DAn damaged or lost in PD. Cell replacement therapy (CRT) seeks to relieve both pathological and symptomatic PD manifestations and has been shown to have beneficial effects in experimental PD models as well as in PD patients, but an apt cell line to be used in the treatment of PD has yet to be established. The purpose of this study was to examine the effects of the transplantation of hVM1 clone 32 cells, a bankable line of human neural stem cells (hNSCs), in a PD mouse model at four months post-transplant. Methods Adult (five month-old) C57BL/6JRccHsd male mice were injected with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and subsequently transplanted with hVM1 clone 32 cells, or buffer, in the left striatum. Four months post-transplant, behavioral effects were explored using the open field and paw print tests, and histological analyses were performed. Results Transplantation of hVM1 clone 32 cells rescued dopaminergic nigrostriatal populations in adult Parkinsonian mice. Motor and neurological deterioration were observed in buffer-treated mice, the latter of which had a tendency to improve in hNSC-transplanted mice. Detection of mast cell migration to the superficial cervical lymph nodes in cell-transplanted mice denoted a peripheral effect. Transplantation of hNSCs also rescued neuroblast neurogenesis in the subgranular zone, which was correlated with dopaminergic recovery and is indicative of local recovery mechanisms. Conclusions In this proof-of-concept study, the transplantation of hVM1 clone 32 cells provided neuroprotection in adult Parkinsonian mice by restoring the dopaminergic nigrostriatal pathway and hippocampal neurogenesis, demonstrating the efficacy of cell replacement therapy as a treatment for PD.

Abstract The COVID-19 pandemic sped up the digitalization process and revolutionized the world of the digital employee. And today, advances in artificial intelligence are having a major impact on the field of Digital HR. In that context, further literature review work is needed on the term Digital HR to complement previous studies and lay the foundation for more pioneering literature on this topic. Then, the aim of this paper is to provide a framework for organizing the main themes discussed in the pioneering literature on digital HR by answering the following research question: What is the knowledge structure of the research in the field of digital human resources? An adaptation of the PRISMA model is used to structure the research design. Applying a mixed methodology, this paper uses a bibliometric technique to identify the main topics studied in Digital HR. Subsequently, in-depth analysis and logical reasoning are applied and a model is proposed based on four questions (how, what, where, who) in order to understand and develop research on digital HR. The RQ4 Digital-HR model constitutes a useful tool in academic, practical, professional, and social contexts. It is worth highlighting the importance of the inclusion of artificial intelligence in the daily processes of a company, and therefore in the progress of the proposed research topic.

Abstract Background From March 7 to April 7, 2020, the Community of Madrid (CoM), Spain, issued interventions in response to the COVID-19 epidemic, including hospital referral triage protocols for long-term care facility (LTCF) residents (March 18–25). Those with moderate to severe physical disability and cognitive impairment were excluded from hospital referral. This research assesses changes in the association between daily hospital referrals and the deaths of LTCF residents attributable to the triage protocols. Methods Daily hospital referrals and all-cause mortality from January to June 2020 among LTCF residents and the CoM population aged 65 + were obtained. Significant changes in LTCF resident daily hospital referrals time series, and in-LTCF and in-hospital daily deaths, were examined with tests for breaks and regimes in time series. Multivariate time series analyses were conducted to test changes in the associations between LTCF resident hospital referrals with daily deaths in-hospital and in-LTCF, and in the CoM population aged 65 + when the triage protocols were implemented. Results Among LTCF residents, hospital referrals declined sharply from March 6 to March 23, 2020. Increases in LTCF residents' daily deaths occurred from March 7 to April 1, followed by a decrease reaching pre-epidemic levels after April 28. The daily ratio of in-hospital deaths to in-LTCF deaths reached its lowest values from March 9 to April 19, 2020. The four versions of the triage protocol, published from March 18 to March 25 had no impact on further changes in the association of hospital referrals with daily deaths of LTCF residents in-hospital or in-LTCF. Conclusions While LTCF residents’ deaths increased, hospital referrals of LTCF residents decreased with the introduction of the CoM governmental interventions on March 7. They were implemented before the enactment of the triage protocols, protecting hospitals from collapse while overlooking the need for standards of care within LTCFs. The CoM triage protocols sanctioned the existing restrictions on hospital referrals of LTCF residents.

Abstract Background Plant long non-coding RNAs (lncRNAs) have important regulatory roles in responses to various biotic and abiotic stresses, including light quality. However, no lncRNAs have been specifically linked to the Shade Avoidance Response (SAS). Results To better understand the involvement of lncRNAs in shade avoidance, we examined RNA-seq libraries for lncRNAs with the potential to function in the neighbor proximity phenomenon in Arabidopsis thaliana (A. thaliana). Using transcriptomes generated from seedlings exposed to high and low red/far-red (R/FR) light conditions, we identified 13 lncRNA genes differentially expressed in cotyledons and 138 in hypocotyls. To infer possible functions for these lncRNAs, we used a ‘guilt-by-association’ approach to identify genes co-expressed with lncRNAs in a weighted gene co-expression network. Of 34 co-expression modules, 10 showed biological functions related to differential growth. We identified three potential lncRNAs co-regulated with genes related to SAS. T-DNA insertions in two of these lncRNAs were correlated with morphological differences in seedling responses to increased FR light, supporting our strategy for computational identification of lncRNAs involved in SAS. Conclusions Using a computational approach, we identified multiple lncRNAs in Arabidopsis involved in SAS. T-DNA insertions caused altered phenotypes under low R/FR light, suggesting functional roles in shade avoidance. Further experiments are needed to determine the specific mechanisms of these lncRNAs in SAS.

Purpose: The aim of this study was to examine whether, drawing on the perception of their coaches, the application of the pedagogical model of sport education could be associated with satisfying the basic psychological needs of children from socially vulnerable backgrounds. Method: A 36-session sport education season was implemented within a community program for youths from disadvantaged environments. Three coaches, one researcher, and 31 children aged 9-11 years (17 boys and 14 girls) of diverse ethnicities participated. Qualitative data were obtained through four focus groups conducted during the program in addition to the research diary of the researcher, who played the role of participant observer. Results: The coaches observed a progressive evolution in the satisfaction of the basic psychological needs of competence, autonomy, relatedness, and the need referred to as novelty. Discussion/Conclusion: We may conclude that sport education can be a valuable tool to improve the satisfaction of these needs in children from socially vulnerable backgrounds.

The purpose of this review was to (1) analyze the effectiveness of immersive virtual reality (iVR) and augmented reality (AR) as teaching/learning resources (collectively called XR-technologies) for gaining anatomy knowledge compared to traditional approaches and (2) gauge students' perceptions of the usefulness of these technologies as learning tools. This meta-analysis, previously registered in PROSPERO (CRD42023423017), followed PRISMA guidelines. A systematic bibliographical search, without time parameters, was conducted through four databases until June 2023. A meta-analytic approach investigated knowledge gains and XR's usefulness for learning. Pooled effect sizes were estimated using Cohen's standardized mean difference (SMD) and 95% confidence intervals (95% CI). A single-group proportional meta-analysis was conducted to quantify the percentage of students who considered XR devices useful for their learning. Twenty-seven experimental studies, reporting data from 2199 health sciences students, were included for analysis. XR-technologies yielded higher knowledge gains than traditional approaches (SMD = 0.40; 95% CI = 0.22 to 0.60), especially when used as supplemental/complementary learning resources (SMD = 0.52; 95% CI = 0.40 to 0.63). Specifically, knowledge performance using XR devices outperformed textbooks and atlases (SMD = 0.32; 95% CI = 0.10 to 0.54) and didactic lectures (SMD = 1.00; 95% CI = 0.57 to 1.42), especially among undergraduate students (SMD = 0.41; 95% CI = 0.20 to 0.62). XR devices were perceived to be more useful for learning than traditional approaches (SMD = 0.54; 95% CI = 0.04 to 1), and 80% of all students who used XR devices reported these devices as useful for learning anatomy. Learners using XR technologies demonstrated increased anatomy knowledge gains and considered these technologies useful for learning anatomy.

Access to clean drinking water remains a challenge in many developing countries, emphasizing the critical need for affordable, scalable and sustainable water treatment technologies. This study employs an electrochemical flow cell incorporating a 3D-printed biomimetic flow field for efficient in situ electrochlorination, avoiding water recirculation or external chloride dosing. The impact of varied ionic compositions of groundwater on electrochlorination efficiency is examined using synthetic groundwater samples, reflecting diverse hydrogeological conditions within a region in a developing country. Employing a Multilevel Factorial Design (MFD), the study highlights the significant influence of water ionic composition, flow rate, and applied current on free chlorine production. The results affirm the capability of the reactor to generate free chlorine species in a range of 0.32–6.13 mg·L−1. The specific energy consumptions oscillate between 0.49 and 19.67 Wh·mg−1 for chloride concentration in the samples ranging from 24 to 146 mg·L−1. This confirms the potential of the suggested electrochemical cell design for broad use in the studied region, and possibly in similar settings worldwide.