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Background: Radio-Tartaglia syndrome or RATARS is an unfamiliar disease caused by a heterozygous mutation of the SPEN gen in the 1p36 chromosome. Clinically, it is represented by global developmental delay and intellectual disability; however, it can also be associated with other relevant comorbidities that embark on the cardiovascular, gastrointestinal, musculoskeletal, integumentary as well as endocrinological systems. Case Report: A 3-year-old pediatric male patient from Venezuela is referred to genetic counseling due to neurodevelopmental delay, microcephaly and dysmorphisms. The initial diagnostic impression consisted of Williams syndrome. Further studies revealed mild supravalvular stenosis, but no important changes in brain imaging or laboratory analysis. The patient’s diagnosis was later replaced with RATARS after a complete exome sequencing revealed heterozygous SPEN pathogenic genes. Conclusion: The diagnostic process of RATARS must become a pillar of further investigation given its uncertainty when clinically diagnosed hence the necessity of a clear confirmation through exome sequencing. This case report highlights the importance of genetic testing in patients with neurodevelopmental delay due to a possible but uncommon correlation with rare diseases such as RATARS. [ABSTRACT FROM AUTHOR]

Introduction. Cardiovascular risk factors such as obesity, type 2 diabetes, hypertension, smoking, and dyslipidemia enfold heart disease morbimortality. Diagonal earlobe crease has been proposed as a prognostic marker of extension and severity of illness in patients with acute coronary syndrome. But its usefulness remains unclear in patients with or without coronary disease. Methods. A case‐control study was carried out on a total of 805 patients with and without cardiovascular risk factors or acute coronary syndrome. Univariate and multivariate binary logistic regression analyses were used to determine the probability of having diagonal earlobe crease with the presence of cardiovascular risk factors and acute coronary syndrome. Data were summarized as odds ratio with 95% confidence intervals and P values. Results. An unadjusted (univariate) analysis showed that being male, being older than 55 years, obesity, type 2 diabetes mellitus, arterial hypertension, smoking, and dyslipidemia, as well as having acute coronary syndrome, were associated with the presence of diagonal earlobe crease. The multivariate analysis showed that men (OR 1.6, 95% IC 1.1–2.4, P = 0.007), being over 55 years old (OR 4.8, 95% IC 3.2–7.2, P < 0.001), being obese (OR 2.1, 95% IC 1.4–3.1, P < 0.001), having arterial hypertension (1.5, 95% IC 1.1–2.3, P = 0.025), or suffering from acute coronary syndrome (OR 5.3, 95% IC 2.5–11.1, P < 0.001), were independent factors associated with diagonal earlobe crease. The rest of cardiovascular risk factors were not relevant in the multivariate model. Conclusions. In Mexican adults, having an acute coronary syndrome is not the only factor associated with diagonal earlobe crease but also being a man, older than 55 years, having high blood pressure and obesity. Diagonal earlobe crease may simply be caused by changes in the skin and connective tissues of the ears because of the aging process, obesity, and/or being male. These factors, by themselves, enfold cardiovascular risk due to well‐known pathophysiological causes. [ABSTRACT FROM AUTHOR]

Background: Olfactory disorders (ODs) are reported to be an early non-motor sign before the onset of deterioration in neurodegenerative diseases (NDs) such as Alzheimer's and Parkinson's. This systematic revision aims to review the current literature and the value of subjective olfactometry (SO) in the early diagnosis of cognitive decline and NDs. Methods: A systematic literature review was conducted following the PRISMA framework. Four different authors reviewed six different databases. The main variables analyzed were olfactory function and cognitive status. The quality of results was evaluated using the Oxford Centre of Evidence-based Medicine Levels. Results: Twenty-one cross-sectional and cohort studies and six meta-analyses were included. Most of them found an association between ODs and NDs. A prevalence of ODs greater than 80% was shown in Parkinson's disease, proportional to the severity of symptoms. In Alzheimer's, ODs were associated with early diagnosis and prognosis. All SO tests employed in the literature showed enough predictive value to correlate with early stages of cognitive decline. Conclusions: SO should be considered a pivotal tool when diagnosing NDs due to their association with early symptoms and prognosis. However, in the current literature, no firm consensus exists on the optimal SO tests and protocols that should be applied to the study of NDs, which prevents the interpretability and comparability of results among studies. [ABSTRACT FROM AUTHOR]

(1) Background: Surgical criteria for chronic rhinosinusitis with nasal polyps (CRSwNP) remain unresolved. This study addresses these discrepancies by comparing the clinical outcomes of expanded–functional endoscopic sinus surgeries (E–FESS) with more-limited FESS (L-FESS). (2) Methods: A database was analyzed retrospectively to compare surgical outcomes in CRSwNP patients who underwent E-FESS versus those subjected to L-FESS. Quality of life, endoscopic and radiological outcomes were compared at the baseline and two years after surgery. The clinical status of the responder was defined when a minimal clinically important difference of 12 points in SNOT-22 change was achieved. (3) Results: A total of 274 patients met the inclusion criteria and were analyzed; 111 underwent E-FESS and 163 were subjected to L-FESS. Both groups exhibited significant clinical improvements, although a greater magnitude of change in SNOT-22 (14.8 ± 4.8, p = 0.002) was shown after E-FESS. Higher significant improvements for endoscopic and radiological scores and lower surgical revision rates were also noted in the E-FESS group. (4) Conclusions: E-FESS provides better clinical outcomes and reduced revision surgery rates when compared to L-FESS in CRSwNP patients two years after surgery, irrespective of any comorbidity. Further randomized prospective studies are needed to comprehensively contrast these results. [ABSTRACT FROM AUTHOR]

Purpose: Open innovation is an issue that has aroused great interest in recent years. The need to create an environment that facilitates the creation of ideas is essential for the implementation of a series of changes in organizational practices and routines that lead to the launch of new products. However, due to the more behavioral nature and the lesser externalization of these changes introduced in the company's internal processes, how this process occurs has not been studied in depth. The objective of this study is to analyze the effect of an open innovation climate on both incremental and radical product innovation. Moreover, it specifically analyzes the mediating role played by hidden innovation in this relationship. Design/methodology/approach: The methodology used in this study was based on a survey of 213 Spanish SMEs, subsequently applying the structural equation methodology to contrast the results. Findings: The results indicate that open innovation climate offers significant competitive advantages to SMEs. First, the open innovation climate in SMEs favorably influences product innovation (both incremental and radical). Secondly, it is observed that hidden innovations are essential to obtain product innovations. Finally, evidence of the mediating effect of hidden innovation has been obtained. Research limitations/implications: Although the literature often focuses on visible innovation, materialized in product development, this study demonstrates the importance of other types of innovations that are necessary to launch new products. This is especially relevant for SMEs that, with limited resources, must be creative enough to involve their personnel in introducing changes that will lead to new products. This paper attempts to strengthen the previous literature on hidden innovation by contributing to the understanding of how SMEs improve their innovative processes. However, the study has the limitations derived from using a single informant to obtain data, using subjective-type scales and being a cross-sectional research. Practical implications: Managers of SMEs involved in innovation processes should favor the creation of an open innovation climate and invest in organizational innovation. Governments should promote policies to support hidden and open innovation. Originality/value: The main interest of this work is based on the importance of hidden innovation for the development of innovations. This study shows how organizations must make a series of organizational changes prior to the implementation of more visible innovations materialized in products. For this task, the creation of a favorable climate for the development of new ideas becomes a fundamental task. On the other hand, this study has focused on SMEs, which tend to have fewer means for the development of the right conditions for innovation and are often more neglected by scientific research. [ABSTRACT FROM AUTHOR]

COVID-19 vaccines primarily prevent severe illnesses or hospitalization, but there is limited data on their impact during hospitalization for seriously ill patients. In a Mexican cohort with high COVID-19 mortality, a study assessed vaccination's effects. From 2021 to 2022, 462 patients with 4455 hospital days were analyzed. The generalized multivariate linear mixed model (GENLINMIXED) with binary logistic regression link, survival analysis and ROC curves were used to identify risk factors for death. The results showed that the vaccinated individuals were almost half as likely to die (adRR = 0.54, 95% CI = 0.30–0.97, p = 0.041). When stratifying by vaccine, the Pfizer group (BNT162b2) had a 2.4-times lower risk of death (adRR = 0.41, 95% CI = 0.2–0.8, p = 0.008), while the AstraZeneca group (ChAdOx1-S) group did not significantly differ from the non-vaccinated (adRR = 1.04, 95% CI = 0.5–2.3, p = 0.915). The Pfizer group exhibited a higher survival, the unvaccinated showed increasing mortality, and the AstraZeneca group remained intermediate (p = 0.003, multigroup log-rank test). Additionally, BNT162b2-vaccinated individuals had lower values for markers, such as ferritin and D-dimer. Biochemical and hematological indicators suggested a protective effect of both types of vaccines, possibly linked to higher lymphocyte counts and lower platelet-to-lymphocyte ratio (PLR). It is imperative to highlight that these results reinforce the efficacy of COVID-19 vaccines. However, further studies are warranted for a comprehensive understanding of these findings. [ABSTRACT FROM AUTHOR]

Purpose of Review: The advances in the knowledge of the molecular basis of the inflammatory response in chronic rhinosinusitis with nasal polyps (CRSwNP) have led the management of these patients towards personalized and precision medicine. Surgery has been positioned as a suitable alternative in patients who do not achieve control with appropriate medical treatment, but polypoid recurrences remain a constraint. The emergence of new surgical approaches based on patient phenotyping and the poor disease control associated with type 2 inflammatory phenotype makes it necessary to review the role of personalized and precision surgery in managing the disease. Recent Findings: Surgical approaches based on wide resection of bony sinus structures and the treatment of mucosa lining the sinonasal cavity have been analyzed and compared with other techniques and seem to offer more favorable surgical outcomes and improved quality of life (QoL), in addition to lower relapse rates. The innovations with new complementary surgical techniques, such as reboot surgery adding an extended autologous mucosal graft from the nasal floor (mucoplasty), may benefit endoscopic and QoL outcomes in the most severe CRSwNP patients with type 2 phenotype. Summary: Using bilateral endonasal mucoplasty as a complementary technique to reboot surgery is a suitable technical choice that has improved short- and medium-term QoL and endoscopic outcomes for patients with severe CRSwNP. These results are likely due to a combination of the extension of reboot and the inherent inflammatory and healing properties of mucoplasty. We propose this technique as a valuable surgical resource, although more robust clinical studies are needed to evaluate its long-term benefits comprehensively. [ABSTRACT FROM AUTHOR]

Objective: This retrospective study sought to describe the association between preoperative diagnosis of depression and major adverse events after infrainguinal bypass surgery or peripheral vascular intervention (PVI). Methods: We retrospectively analyzed a consecutive series of all patients undergoing PVI and/or infrainguinal bypass surgery at a single tertiary institution between 2010 and 2019. Propensity matching and Cox regression analysis were conducted to examine the impact of comorbid depression on the incidence of major adverse events (MAEs), defined as re-intervention, major amputation, or death, within 2 years of surgery. Results: Of all patients (n = 512) undergoing intervention at our institution, 166 (32.4%) suffered an MAE and 169 (33.0%) patients had a preoperative diagnosis of depression. After propensity score matching, univariate (HR, 1.7; 95% CI, 1.1–2.7) and multivariable hazard analyses (aHR, 1.50; [1.1–2.2]) demonstrate that there is a statistically significant relationship between the diagnosis of depression and increased MAE. Conclusion: Over one-third of our lower extremity revascularization patients were noted to have a preoperative diagnosis of depression. After intervention, these patients had worse outcomes compared to patients without depression; this finding was more evident in patients who underwent PVI mainly due to high overall mortality rate. Prospective studies are necessary to better understand this association and to ascertain if early intervention can improve post-procedure vascular outcomes. [ABSTRACT FROM AUTHOR]

Purpose of Review: Despite molecular underlying advances, limited and divergent data on monoclonal antibodies (mAb) therapy in chronic rhinosinusitis with nasal polyps (CRSwNP) make further analysis necessary. The objective of this study is to evaluate the effect of omalizumab as an adjunct to endoscopic sinus surgery (ESS) on the treatment of CRSwNP under real-life conditions. Recent Findings: Since the introduction of omalizumab, as the first biologic agent for the treatment of diseases such as severe allergic asthma, different studies have demonstrated an effect of omalizumab on CRSwNP, with significant improvements in sinonasal symptoms and endoscopic scores. The high efficacy derived from mAb therapy and the need for ESS prior to mAb recommended by guidelines, has led to compare both therapeutic alternatives, finding discrepancies in their effect on quality of life (QoL) and complementary tests outcomes. Summary: Patients with moderate-to-severe asthma with clinical criteria for omalizumab indication, and coexistent CRSwNP disease, were selected for a non-randomized interventional retrospective study into four treatment subgroups. Measures were analyzed and compared between groups and over time at the baseline, 16 weeks and 1 and 2 years after treatment. Omalizumab treatment in patients with previous ESS exhibited an earlier and more pronounced improvement in QoL, symptoms scale and endoscopic findings (nasal polyp score and the bilateral modified Lund-Kennedy) as early from week 16, which improvement persisted for 2 years. A greater mean improvement of 33.4 ± 6.5 (95% CI: 20.3–46.4; p < 0.001) points in sinonasal outcome test 22 (SNOT-22) was associated with ESS at week 16, against omalizumab effect (17.8 ± 7.6 [95% CI: 2.6–33.0]; p = 0.023). At year 2, an improvement in SNOT-22 of 62.6 ± 8.9 (95% CI: 48.4–84.1; p < 0.001) points was exclusively associated with omalizumab. Clinical evidence of the effect of omalizumab added to ESS treatment is provided in this study in the short- and long-term. [ABSTRACT FROM AUTHOR]

Background: For aggressive maxillary sinus and pterygopalatine fossa (PPF) tumors, an en‐bloc pterygomaxillectomy may be indicated. Methods: Five head specimens were used to study the feasibility of an en‐bloc pterygomaxillectomy. Eighty‐five non‐pathological CT scans were used to compare the superior edge of the inferior turbinate (IT) and the middle turbinate tail (MT) as landmarks for the pterygoid osteotomy. Results: Through a combined sublabial–subperiosteal incision and transoral route, a mid‐sagittal osteotomy through the hard palate and an axial osteotomy below the infraorbital foramen were performed. For the endoscopic pterygoid osteotomy, an infra‐vidian transpterygoid approach was performed, subsequently removing the pterygomaxillectomy en‐bloc. As landmarks, the osteotomies at the level of the MT tail and IT resected the pterygoid plates completely, but the IT osteotomy was further away from the vidian canal (7.5 vs. 6 mm). Conclusions: The endoscopic‐assisted en‐bloc pterygomaxillectomy is feasible. The IT landmark is safe and ensures complete resection of the pterygoid plates. [ABSTRACT FROM AUTHOR]

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Background: High sensitivity C-reactive protein (hsCRP) is a marker of systemic inflammation that has been associated with persistent depressive symptoms. Depression and anxiety are frequently associated with a chronic inflammatory state, yet the nature of this relationship has not been rigorously examined in diverse Hispanic/Latino populations. We aimed to study the association of anxiety and depressive symptoms as well as comorbid presentations, with circulating high sensitivity C-reactive protein (hsCRP) levels in a large Latino cohort of diverse heritages. We hypothesized a significant positive associations of both anxiety and depressive symptoms and hsCRP levels and potential variations among the heritage groups. Methods: Depressive symptoms and anxiety were measured by the Center for Epidemiological Studies Depression Scale (CES-D) and State-Trait Anxiety Inventory (STAI), respectively. Serum hsCRP (hsCRP) levels of 15,448 participants (age 18 to 75 years; 52.3% women) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were measured and categorized based on the established cardiovascular disease (CVD) risk reference values (< 1mg/L, low; 1–<3 mg/L, intermediate; ≥ 3mg/L, high). Results: Mean CES-D, STAI scores, and hsCRP levels were 7.0 (SD = 5.9), 17.0 (SD = 5.7), and 3.84 (SD = 7.85), respectively. Generalized linear modeling, adjusted for sociodemographic characteristics revealed significant associations between depression (exp(β) = 1.12; p<0.01) and anxiety symptoms (exp(β) = 1.10; p<0.05) with continuous hsCRP levels. For categorical values of hsCRP, one SD increase in CES-D and STAI scores was associated with a 10% and 8% increase in the RRRs of high vs. low hsCRP, respectively. However, these relationships between CES-D or STAI and hsCRP were no longer statistically significant after adjustment for CVD risk factors and medications. Conclusion: We found modest associations between anxiety and depressive symptoms and systemic inflammation measured by hsCRP among diverse Hispanics/Latinos that did not appreciably differ between heritage groups. [ABSTRACT FROM AUTHOR]

The success of a study hinges on its recruitment procedures, however there is a paucity of papers focused on innovative recruitment strategies, especially as it relates to the recruitment and retention of marginalized populations. This paper aims to outline how consent-to-contact databases can be used as an effective tool for recruitment. First, we begin by describing the consent-to-contact databases we used. Then, we offer insight into how a consent-to-contact database was utilized to recruit Latino older adults with HIV participants for an interdisciplinary behavioral and physical health promotion intervention. We outline barriers and challenges to recruitment and research participation with a specific emphasis on the unique hurdles associated with recruiting and retaining racial/ethnic minority older adults with HIV in behavioral health studies. Finally, we provide final recommendations for future researchers interested in how to best employ this type of recruitment tool in their own research. [ABSTRACT FROM AUTHOR]

Orientation control over micropatterned crystalline organic semiconductor film is crucial to achieve high device performance with small variation in organic electronics. Here, using Au patterned SiO2 substrates, a method is reported to realize high‐resolution patterning and orientation control of crystalline organic thin films simultaneously. The vacuum deposited N,N‐dioctyl‐3,4,9,10‐perylene tetracarboxylic diimide (PTCDI‐C8) molecules can selectively diffuse to and nucleate on prepatterned Au stripes, resulting in patterned crystalline films with a preferential orientation distribution. Scanning tunneling microscope and high‐resolution atomic force microscope images reveal that the PTCDI‐C8 molecules first assemble on Au with perylene diimide cores in a laying down configuration, providing nucleation sites at the step edges for directional growth along the a‐axis of the molecule crystal. Subsequent deposition of molecules leads to orientated crystalline films growth due to the π packing of the perylene diimide cores, resulting in orientation control on micropatterned crystalline films. The finding provides a new strategy to grow oriented crystalline films for high device performance uniformity. [ABSTRACT FROM AUTHOR]

Doxycycline (Doxy) is an antibiotic, which has exhibited anti-inflammatory activity and glucose metabolism improvement. The present study was proposed to evaluate its effects on glucose metabolism and other associated processes, such as lipemia and adipogenesis, as well as, to evaluate its effects on the liver, pancreas, and aorta in subjects fed with an occidental high-fat diet (HFD). The trial followed three groups of BALB/c mice for 6 months: (1) Standard diet (SD); (2) HFD-placebo (saline solution); and (3) HFD-Doxy (10 mg/kg/day). Intrahepatic fat accumulation (steatohepatosis) and the epididymal fat pad, as well as the hepatic inflammatory infiltrate and ALT serum levels were higher in both groups with the HFD (with/without doxycycline) in comparison with the SD group. The thickness of the aorta (preclinic atherosclerosis) was significantly elevated in the HFD group with respect to the HFD + Doxy and SD group, these two being similar groups to each other. The HFD-Doxy group had pancreatic morphological parameters very similar to those of the SD group; on the contrary, the HFD group reduced the number of pancreatic islets and the number of β cells per mm2, in addition to losing large islets. The index of β cell function (∆Insulin0–30/∆Glucose0–30 ratio) was significantly higher in the HFD + Doxy group, compared to the rest of the groups. [ABSTRACT FROM AUTHOR]

Background: Older Latinos living with the human immunodeficiency virus (HIV) have been disproportionately affected by the epidemic and experience compounded health disparities that have deepened over time. These health disparities are largely related to lifestyle and are either preventable or amenable to early detection or intervention. Despite existing resources to deliver an intervention to reduce this compounded health disparity, there is little information on the effects of health promotion interventions on indices of cardiometabolic risk in midlife and older Latinos living with HIV. The Happy Older Latinos are Active (HOLA) intervention is an innovative health promotion program that is uniquely tailored to meet the diverse needs and circumstances of older Latinos with HIV. The goal of this manuscript is to describe the protocol of a feasibility study of the HOLA health promotion intervention for older HIV-positive Latino men. Methods/design: HOLA, which is informed by Behavioral Activation and Social Learning theory is a community health worker (CHW)-led, multicomponent, health promotion intervention consisting of: (1) a social and physical activation session; (2) a moderately intense group walk led by a CHW for 45 min, 3×/week for 16 weeks; (3) pleasant events (e.g., going to brunch with friends) scheduling. Eighteen community dwelling Latinos living with HIV aged 50+ will be recruited for this feasibility study adapting the HOLA intervention. Participants will be assessed at three time points (baseline, post-intervention, and 3 months post-intervention) on measures of cardiometabolic risk factors (waist circumference, dyslipidemia, hypertension, and glucose), psychosocial functioning, and health-related quality of life. Conclusions: If HOLA can be delivered successfully by CHWs, then the scalability, accessibility, and potential for dissemination is increased. Additionally, this study will inform feasibility and identify modifications needed in the design of a larger hypothesis testing study. Trial registration: Clinicaltrials.gov Identifier: NCT 03839212. Date of Registration: 8 February, 2019. [ABSTRACT FROM AUTHOR]

Direct current (dc) systems have an increasingly important role in electrical systems, especially photovoltaic (PV) solar power plants and battery storage systems as they are essential for the development of more sustainable, efficient, and reliable electrical systems. PV panels and batteries are generally composed of multiple series-parallel cells. This fact makes their fault diagnosis challenging, especially against ground faults as these systems are generally ungrounded. In this article, a ground fault location method for dc sources with multiple series-parallel cells is proposed. It estimates the faulty branch, the faulty cell location inside this branch and its fault resistance. The method is based on the output current measurement of each branch and on the voltage measurement on a grounding resistor, which is switched between three positions: the positive, the midpoint and the negative terminals of the protected dc system. To validate it, several computer simulations and experimental tests on a battery pack have been carried out. The results obtained proves an excellent performance for faulty cell location and fault resistance estimation, although further investigations are required to better discern the faulty branch. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis is globally present in about 1% of the population. This autoinflammatory disease modifies the connective tissue, causing pain and inflammation of the joints. Over time, it causes the loss of joint cartilage and bone mass, decreasing the patient's quality of life. Treatment options now available either give symptomatic alleviation or alter the disease process. Nonetheless, adherence to chronic treatment is typically limited due to adverse effects. As a result, new therapy approaches, such as systemic administration of neutral electrolyzed saline to improve patients' quality of life, are being investigated. The study is a randomized prospective preclinical trial with a single-blind and a 4-arm parallel group using a collagen-induced mice model to generate rheumatoid arthritis. It was carried out on 36 male BALB/c mice, with the primary outcome measure being a scoring system for histopathologic assessment. When all groups are compared, there are significant differences. In addition, the animal model was validated by the healthy group. The animals treated with neutral electrolyzed saline had much less cartilage degradation, bone erosion, pannus development, and inflammation than the placebo-treated mice. Serum IL-6 levels were evaluated in parallel with disease severity expressed as synovitis grading of the affected joints. Spearman's rank correlation coefficient (Rs) = 0.399 (P = 0.016) between serum IL-6 levels and the synovitis grading suggests a direct correlation between IL-6 production and disease severity. An additional trial of 20 male BALB/c mice (10 treated with placebo and 10 with neutral electrolyzed saline for 30 days) showed no clinical nor histopathological evidence of adverse effects. According to histopathological and blood test results, we conclude that neutral electrolyzed saline minimizes mechanical and inflammatory damage to the joint and may be helpful as an alternative to rheumatoid arthritis therapy. [ABSTRACT FROM AUTHOR]

Background: Declining mortality rates and an aging population have contributed to increasing rates of multimorbidity (MM) in the United States. MM is strongly associated with a decline in physical function. Obesity is an important risk factor for the development of MM, and its prevalence continues to rise. Our study aimed to evaluate the associations between obesity, MM, and rates of functional limitations in older adults. Methods: We analyzed body mass index (BMI) and self‐reported comorbidity data from 7261 individuals aged ≥60 years from the National Health and Nutrition Examination Surveys 2005–2014. Weight status was defined based on standard BMI categories. MM was defined as 2 or more comorbidities, while functional limitations were self‐reported. Adjusted logistic regression quantified the association between standard BMI categories and MM. We also examined the difference in the prevalence of limitations between those with and without MM. Results: The overall proportion of individuals with concomitant MM and obesity was 27.0%. Compared to a normal BMI, older adults with obesity had higher odds of MM (Prevalence odds ratio 1.79, 95% CI 1.49, 2.12). Overall, 67.5% of patients with MM also reported a functional limitation, with rates of functional limitation increasing with increasing BMI. When evaluating functional limitations in those with MM by BMI class, 90% of patients classified as severely obese (BMI ≥40 kg/m2) with MM also had a concomitant functional limitation. Conclusions: Compared to normal weight status, obesity is associated with an increased burden of MM and functional limitation among older adults. Our results underscore the importance of identifying and addressing obesity, MM, and functional limitation patterns and the need for evidence‐based interventions that address all three conditions in this population. [ABSTRACT FROM AUTHOR]

This paper empirically examines the economic effects of COVID-19 vaccine rollouts using a cross-country daily database of vaccinations and high-frequency indicators of economic activity—nitrogen dioxide (NO2) emissions, carbon monoxide (CO) emissions, and Google mobility indices—for a sample of 46 countries over the period December 16, 2020 to June 20, 2021. Using surprises in vaccines administered, we find that an unexpected increase in vaccination per capita is associated with a significant increase in economic activity. We also find evidence for nonlinear effects of vaccines, with the marginal economic benefits being larger when vaccination rates are higher. Country-specific conditions play an important role, with lower economic gains if strict containment measures are in place or if the country is experiencing a severe outbreak. Finally, the results provide evidence of spillovers across borders, highlighting the importance of equitable access to vaccines across nations. [ABSTRACT FROM AUTHOR]

The article examines the legal issues over Idaho's "Fairness in Women's Sports Act of 2020," particularly how it breaches the U.S. Constitution's Fourteenth Amendment and Title IX with respect to the rights of transgender student-athletes. Other topics include the physiological concerns of transgender student-athletes and the legal framework of filing a claim under the Equal Protection Clause.

Germline pathogenic variants in BRCA1 confer a high risk of developing breast and ovarian cancer. The BRCA1 exon 11 (formally exon 10) is one of the largest exons and codes for the nuclear localization signals of the corresponding gene product. This exon can be partially or entirely skipped during pre‐mRNA splicing, leading to three major in‐frame isoforms that are detectable in most cell types and tissue, and in normal and cancer settings. However, it is unclear whether the splicing imbalance of this exon is associated with cancer risk. Here we identify a common genetic variant in intron 10, rs5820483 (NC_000017.11:g.43095106_43095108dup), which is associated with exon 11 isoform expression and alternative splicing, and with the risk of breast cancer, but not ovarian cancer, in BRCA1 pathogenic variant carriers. The identification of this genetic effect was confirmed by analogous observations in mouse cells and tissue in which a loxP sequence was inserted in the syntenic intronic region. The prediction that the rs5820483 minor allele variant would create a binding site for the splicing silencer hnRNP A1 was confirmed by pull‐down assays. Our data suggest that perturbation of BRCA1 exon 11 splicing modifies the breast cancer risk conferred by pathogenic variants of this gene. [ABSTRACT FROM AUTHOR]

Objectives This study aims to assess the health effects on mining workers of exposure to chronic intermittent hypoxia (CIH) at high- and very high-altitude mining compared with similar work at lower altitudes in Chile, and it also aims to constitute the baseline of a 5-year follow-up study. Methods We designed a cross-sectional study to assess health conditions in 483 miners working at 2 levels of altitude exposure: 336 working at a very high or high altitude (HA; 247 above 3900–4400 m, and 89 at 3000–3900 m), and 147 below 2400 m. Subjects were randomly selected in two stages. First, a selection of mines from a census of mines in each altitude stratum was made. Secondly, workers with less than 2 years of employment at each of the selected mines were recruited. The main outcomes measured at the baseline were mountain sickness, sleep alterations, hypertension, body mass index, and neurocognitive functions. Results Prevalence of acute mountain sickness (AMS) was 28.4% in the very high-altitude stratum (P = 0.0001 compared with the low stratum), and 71.7% experienced sleep disturbance (P = 0.02). The adjusted odds ratio for AMS was 9.2 (95% confidence interval: 5.2–16.3) when compared with the very high- and low-altitude groups. Motor processing speed and spatial working memory score were lower for the high-altitude group. Hypertension was lower in the highest-altitude subjects, which may be attributed to preoccupational screening even though this was not statistically significant. Conclusions Despite longer periods of acclimatization to CIH, subjects continue to present AMS and sleep disturbance. Compromise of executive functions was detected, including working memory at HA. Further rigorous research is warranted to understand long-term health impacts of high-altitude mining, and to provide evidence-based policy recommendations. [ABSTRACT FROM AUTHOR]

Every year, IEEE Micro selects some of the most notable articles published in the previous year's computer architecture conferences to highlight in this Special Issue. In early 2021, the selection committee chose 12 articles to appear as "Top Picks" and an additional 12 deserving an "Honorable Mention" from among the 2020 conferences. [ABSTRACT FROM AUTHOR]

Banks are the backbone of the financial sector and catalysts in the economic development of any country. Current changes in their global business ecosystem make knowledge of about the fund-supplying and fund-demanding parties of the society a key resource for the fulfillment of banks’ investment and saving functions. This paper addresses the relationship between the performance and a learning culture that is supported by knowledge processes within the organization. Given the relevance of this subject for organizations from most knowledge-intensive domains, this research has focused on the Spanish banking sector. Using a structural equation model, feedback received from 215 employees from 142 individual branches from a major banking institution in Spain is studied. The results of the data analysis show that in addition to maximizing on what is already known about the customer base, employees’ learning about the potential new stakeholders and also about the internal strategies, tools, and techniques is directly related to the bank's performance, which, in turn, influences the economic recovery and socio-economic development. Results support that an active pursuit of learning within the context of the organization is required for banks to remain competitive in the dynamic, global business ecosystem, where international, national, and local banking sectors operate. [ABSTRACT FROM AUTHOR]

Costs of diagnostic testing including sample collection, sampling frequency and sample size are an important consideration in the evaluation of the economic feasibility of alternative surveillance strategies for detection of infectious diseases in aquatic animals. In Chile, Piscirickettsia salmonis is the primary reason for antibiotic treatments in farmed Atlantic salmon. In 2012, a surveillance and control programme for piscirickettsiosis was established with an overall goal of reducing antibiotic use. The present study estimated the cost‐effectiveness of different sampling frequencies and sample sizes to achieve at least 95% confidence of early detection of P. salmonis at the netpen and farm levels using a validated qPCR test. We developed a stochastic model that incorporated variability in test accuracy, within‐pen prevalence and sampling costs. Our findings indicated that the current piscirickettsiosis surveillance programme based on risk‐based sampling of five moribund or dead fish from 2 to 3 netpens is cost‐effective and gives a high probability of detection of P. salmonis in Atlantic salmon farms in Chile at both the netpen and farm levels. Results from this study should incentivize salmon farmers to establish cost‐effective strategies for early detection of P. salmonis infection and the application of this approach to other highly infectious diseases. [ABSTRACT FROM AUTHOR]

Purpose of review: Modern cancer therapies have resulted in prolonged survival and decreased mortality for many types of cancer. Consequently, cancer patients with concomitant cardiovascular disease (CVD) present prior to diagnosis of cancer, resulting from various forms of cancer therapy, or developing after cancer remission are at higher risk for development of cardiovascular-associated morbidity and mortality. Management of CVD, particularly structural heart disease, in this patient population is challenging and associated with elevated surgical risk. Minimally invasive transcatheter procedures have emerged as lower risk treatment modalities that have been shown to be safe and efficacious. This review will evaluate the current literature on percutaneous management of aortic stenosis (AS), mitral regurgitation (MR), tricuspid regurgitation (TR), and intracardiac thrombus (ICTE) or masses in cancer patients. Recent findings: Multiple cohort- and registry-based studies have demonstrated safe and efficacious implementation of transcatheter interventions for the management of severe AS and MR in cancer patients. The development of transcatheter interventions for severe TR is promising and may also be considered for this high-risk patient population. Interestingly, management of ICTE and cardiac masses has also been achieved with a novel transcatheter approach. Summary: While a multidisciplinary heart team approach is necessary to properly manage cancer patients with structural heart disease and ICTE, more robust registry-based and prospective clinical trials are required to meet the needs of a rapidly growing cardio-oncology patient population. [ABSTRACT FROM AUTHOR]

The bond imaging atomic force microscopy (AFM) technique has become an invaluable tool for studying organic molecules on surfaces. The key feature of this technique is the functionalization of the AFM-tip with a single CO molecule, which improves the lateral resolution and allows us to visualize the chemical structure of adsorbed organic molecules. Such experiments are usually performed at low temperatures in an ultrahigh vacuum environment in the frequency modulation (FM) mode. Here, we use the Q-controlled amplitude modulation (AM) mode for imaging organic molecules with CO-functionalized tips in constant-height mode. By reducing the effective quality factor (Qeff) of the sensor from about 20 000–30 000 to 1500–4000, we are able to image molecules with atomic resolution. Detailed instructions for determining the optimum Qeff and oscillation amplitude are given. To compare the phase and frequency shift images of the Q-controlled AM and the FM mode, we define an effective signal-to-noise ratio (SNR) that relates the observed contrast between the bonds and centers of imaged carbon rings to the noise in the respective image regions. This effective SNR is systematically analyzed in different regions of the imaged molecule for different oscillation amplitudes and average tip-substrate distances. By using appropriate imaging parameters, an increased effective SNR is achieved in the Q-controlled AM mode (on the order of 30–60%). This advantage over the conventional FM mode might, e.g., be used for increasing the experimental throughput. [ABSTRACT FROM AUTHOR]

The aggregation of Latino subgroups in national studies creates an overly simplistic narrative that Latinos are at lower risk of mental illness and that foreign nativity seems protective against mental illness (i.e. immigrant paradox). This broad generalization does not hold up as the Latino population ages. Given that social inequalities for risk appear to widen with age, the social disadvantages of being Latino in the United States increase the risk for mental illness across the life span. This review focuses on the mental health of older Latinos, specifically the 3 subgroups with the longest residential history in the United States—Mexicans, Puerto Ricans, and Cubans. We examine relevant epidemiological and clinical psychopathology studies on aging in these Latino populations and present evidence of the heterogeneity of the older Latino population living in the United States, thus illustrating a limitation in this field—combining Latino subgroups despite their diversity because of small sample sizes. We address the migration experience—how intraethnic differences and age of migration affect mental health—and discuss social support and discrimination as key risk and protective factors. We conclude with a discussion on meeting the mental health needs of older Latinos with a focus on prevention, a promising approach to addressing mental illness in older Latinos, and future directions for mental health research in this population. Success in this endeavor would yield a substantial reduction in the burden of late-life depression and anxiety and a positive public health impact. [ABSTRACT FROM AUTHOR]