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The present article aims to describe the different steps on how to design, develop and conduct quantitative and qualitative Spirituality and Health (S/H) studies from a Brazilian perspective, discussing definitions and instruments, and proposing a "how-to guide" for those interested in this field of research. A narrative review of the literature has been conducted by experts in the field of S/H aiming to develop a "how-to-guide". Spirituality is a very complex concept that has several challenges in the current scientific literature, including the lack of consensus in the definitions, the numerous dimensions assessed, the diverse instruments for measurement, the criticisms from other scholars, the great diversity of religious and cultural traditions and the growing number of "spiritual but not religious" individuals. This review supports that S/H studies may follow the high scientific standards, using consolidated research procedures and solid methods for both qualitative and quantitative research. Some peculiarities of the research methods for this field are discussed. S/H research is still under development, and there are several future directions for S/H studies, aiming to minimize previous criticisms and generating stronger evidence. [ABSTRACT FROM AUTHOR]

Objectives: Currently, there is a growing interest on the benefits of volunteering. Nevertheless, there is scarce evidence for non-volunteering altruistic behaviors. This study aims to investigate the role of both altruism and volunteering on the cognitive performance of older individuals followed for four years. Methods: This was cohort study carried out in 180 Brazilian older adults assessed in three different timepoints (baseline [2015–2016], 2 years of follow-up [2017–2018] and 4 years of follow-up [2019–2020]). Composite cognitive score was calculated based on the Mini-Mental State Examination, Verbal Fluency, Clock-Drawing test, and CERAD Word-List. Altruism was assessed through the Self-reported Altruism Scale and self-reported volunteering status. Mixed ANCOVAS were performed. Results: For altruism, there were significant differences in all time points (Baseline, 2 years and 4 years) favoring higher cognitive scores for higher levels of altruism. However, no differences were observed for volunteering in all time points. Conclusions: Having higher levels of altruism was significantly associated with better cognitive scores Clinical Implications: Altruism, even without volunteering, seem to have positive effects on the cognitive functioning of older adults. Health professionals who take care of older adults might take account of the presence or absence of altruistic behaviors of their patients in their formulations and recommendations. [ABSTRACT FROM AUTHOR]

Mortality resulting from interactions with fishing gears represent an important threat to sensitive species globally. In this study, we address this issue by defining five species groups of marine megafauna (marine mammals, seabirds, demersal and pelagic elasmobranchs, and sea turtles), and conducting a productivitysusceptibility analysis (PSA) within the context of data-limited fisheries in the Mediterranean and Black Sea. Although there are significant differences among species within each group, this approach has been considered much more direct and functional for management purposes. The productivity (P) of each species group was determined by evaluating a set of attributes averaged across representative species within each group. Species groups' susceptibility (S) to bycatch was assessed through a comprehensive review of existing literature and expert judgment, considering a series of semi-quantitative attributes. Our analysis identified areas and fishing gears posing potential risks to the species groups assessed, highlighting that sea turtles and elasmobranchs face the potential risk of incidental captures from various fishing gears operating in both neritic (bottom trawls, set nets and bottomlonglines) and pelagic (drifting longlines) environments. Marine mammals exhibit moderate risk across most fishing gears, with particular concern for the harbour porpoise Phocoena phocoena relicta in the Black Sea, primarily due to the interaction with set nets, which can severely impact entire population even capturing few specimens due the species low productivity. Seabirds face reduced impact with fishing activities, irrespective of the type of gear examined or the specific area under investigation. Overall, our study highlights the specific basins and fishing gears requiring focused management measures, mitigation strategies, and enhanced monitoring activities to mitigate the impacts of bycatch on vulnerable marine megafauna. [ABSTRACT FROM AUTHOR]

In the present study, the microalga Arthrospira platensis DHR 20 was cultivated in vertical flat-plate photobioreactors (FPBRs) to bioremediate anaerobically digested cattle wastewater (ACWW) and used as a growth substrate. The final objective was to evaluate the properties of the oil extracted from this biomass to determine its potential for biodiesel production. The process was divided into five phases, varying the volume of the applied substrate: 1 L (Phase I), 5 L (Phase II), 10 L (Phase III), 15 L (Phase IV), and 20 L (Phase V). Dry biomass reached a maximum of 5.7 g L−1, and productivity peaked at 0.74 g L−1d−1. The highest rate of CO2 biofixation was 1213.5 mg L−1 day−1, showing good potential for purifying the air. The highest specific maximum growth rate (μmax) and the shortest doubling time (Dt) were found during Phase I. The removal of pollutants and nutrients during the experimental phases ranged from 65.8% to 87.1% for chemical oxygen demand (COD), 82.2% to 85.8% for total organic carbon (TOC), 91% to 99% for phosphate (PO43−), 62.5% to 93% for nitrate (NO3−), 90.4% to 99.7% for ammoniacal nitrogen (NH4+), and 86.5% to 98.5% for total nitrogen (TN). The highest lipid production recorded was 0.172 g L−1 day−1. The average cetane number recorded in Phase IV of 51 suggests that the fuel will ignite efficiently and consistently, providing smooth operation and potentially reducing pollutant emissions. The analysis of fatty acids revealed that the produced biodiesel has the potential to be used as an additive for other low-explosive biocombustibles, representing an innovative and sustainable approach that simultaneously offers bioremediation and carbon sequestration. [ABSTRACT FROM AUTHOR]

Mortality resulting from interactions with fishing gears represent an important threat to sensitive species globally. In this study, we address this issue by defining five species groups of marine megafauna (marine mammals, seabirds, demersal and pelagic elasmobranchs, and sea turtles), and conducting a productivity-susceptibility analysis (PSA) within the context of data-limited fisheries in the Mediterranean and Black Sea. Although there are significant differences among species within each group, this approach has been considered much more direct and functional for management purposes. The productivity (P) of each species group was determined by evaluating a set of attributes averaged across representative species within each group. Species groups' susceptibility (S) to bycatch was assessed through a comprehensive review of existing literature and expert judgment, considering a series of semi-quantitative attributes. Our analysis identified areas and fishing gears posing potential risks to the species groups assessed, highlighting that sea turtles and elasmobranchs face the potential risk of incidental captures from various fishing gears operating in both neritic (bottom trawls, set nets and bottom longlines) and pelagic (drifting longlines) environments. Marine mammals exhibit moderate risk across most fishing gears, with particular concern for the harbour porpoise Phocoena phocoena relicta in the Black Sea, primarily due to the interaction with set nets, which can severely impact entire population even capturing few specimens due the species low productivity. Seabirds face reduced impact with fishing activities, irrespective of the type of gear examined or the specific area under investigation. Overall, our study highlights the specific basins and fishing gears requiring focused management measures, mitigation strategies, and enhanced monitoring activities to mitigate the impacts of bycatch on vulnerable marine megafauna. [ABSTRACT FROM AUTHOR]

Prenatal stress may lead to tissue- and sex-specific cardiometabolic disorders in the offspring through imbalances in the insulin signaling pathway. Therefore, we aimed to determine the sex-specific adaptations of prenatal stress on the insulin signaling pathway of cardiac and hepatic tissue of adult offspring Wistar rats. Wistar pregnant rats were divided into control and stress groups. Unpredictable stress protocol was performed from the 14th to the 21st day of pregnancy. After lactation, the dams were euthanized, and blood was collected for corticosterone measurement and the offspring were separated into four groups according to sex and intervention (n = 8/group). At 90 days old, the offspring were submitted to an oral glucose tolerance test (OGTT) and an insulin tolerance test (ITT). After euthanasia, blood collection was used for biochemical analysis and the left ventricle and liver were used for protein expression and histological analysis. Stress increased maternal corticosterone levels. It also increased glucose concentration in both OGTT and ITT and reduced insulin receptor (Irβ) and insulin receptor substrate-1 (IRS1) activation, while reducing the insulin receptor inhibition [protein tyrosine phosphatase 1B (PTP1B)] in the liver of male offspring at 90 days old, without repercussions in cardiac tissue. Moreover, female offspring submitted to prenatal stress exhibited reduced fatty acid uptake, with lower hepatic CD36 expression, reduced high-density lipoprotein cholesterol (cHDL), and increased Castelli risk indexes I and II. Unpredictable prenatal stress evoked reduced insulin sensitivity and liver-specific impairment in insulin signaling activation in male while increasing markers of cardiovascular risk in females. NEW & NOTEWORTHY: Prenatal stress may contribute to tissue-specific programming, especially in the liver. Our results showed that, although there were no repercussions to stress in cardiac tissue at 90 days old, prenatal stress induces a glucose intolerance phenotype with insulin signaling pathway alterations in the liver of male offspring at 90 days old. Furthermore, the prenatal stress altered lipid profile and increased cardiovascular risk in female offspring. [ABSTRACT FROM AUTHOR]

Planning an immediate and multidisciplinary rehabilitation is crucial to reduce the significant physical, cognitive, and psychosocial impact resulting from head trauma. This study highlights the importance of ongoing cognitive rehabilitation in conjunction with other rehabilitation therapies, such as motor, occupational, and speech therapy, for a 19-year-old woman who suffered an acquired traumatic brain injury in a high-energy vehicle accident. When the patient was admitted to the hospital, their cognitive functioning (LCF) was 4 (confused-agitated state), their Barthel index was 0, their Glasgow coma scale (GCS) was 7, and their disability rating scale (DRS) was 7. The patient's cognitive functioning improved to LCF 8 (purposeful-appropriate), numerical rating scale: 0/10, Barthel index: 53, GCS:15, and DRS: 5 at the time of discharge from the neurorehabilitation unit. In conclusion, early cognitive intervention in a multidisciplinary rehabilitation program is essential to maximizing the patient's potential and improving the rehabilitation's outcome. [ABSTRACT FROM AUTHOR]

In this paper, we propose a portmanteau test for misspecification in combination of uniform and binomial (CUB) models for the analysis of ordered rating data. Specifically, the test we build belongs to the class of information matrix (IM) tests that are based on the information matrix equality. Monte Carlo evidence indicates that the test has excellent properties in finite samples in terms of actual size and power versus several alternatives. Differently from other tests of the IM family, finite-sample adjustments based on the bootstrap seem to be unnecessary. An empirical application is also provided to illustrate how the IM test can be used to supplement model validation and selection. [ABSTRACT FROM AUTHOR]

This study compares clinical practice and objections to controversial ethical issues among 836 Brazilian resident physicians according to levels of religiousness/spirituality. Residents with low religiousness/spirituality (s/r) believed less in the influence of spirituality on clinical practice, were less comfortable addressing this issue, tended to listen less carefully and try to change the subject more than other groups. Residents with high spirituality and low religiousness (S/r) inquired more about religious/spiritual issues, while those with high religiousness/spirituality (S/R) were more supportive and reported fewer barriers to addressing these issues. Concerning ethical issues (e.g., physician-assisted suicide, withdrawal of life support, abortion), S/R had more objections than others. [ABSTRACT FROM AUTHOR]

Background: Despite growing evidence on medical students' mental health deterioration, studies have primarily used short follow-up periods and not followed the students throughout their medical training. Objective: To assess mental health (stress, anxiety, and depression) and quality of life changes throughout their medical program, we followed up with the same cohort of students for 6 years. Methods: This longitudinal prospective study followed up with the same group of medical students at a Brazilian public medical school from 2014 to 2020. The study analyzed sociodemographic data, mental health (including depression, anxiety, and stress [DASS-21]), quality of life (WHOQOL-BREF), satisfaction from studying to be a physician, and happiness with life. General linear mixed models were used for the analyses. Results: The cohort included 80 Brazilian medical students (63.7% women; mean age = 19.6 years [ SD = 2.21]). A high prevalence of depressive symptoms, anxiety, and stress was found throughout medical training, with more than 50% of students having significant symptoms. Mental health, happiness, and quality of life levels tended to be better in the first and last semesters, being worse in the middle of the program. However, satisfaction from studying to become a doctor decreased in the second semester, remained low throughout the program, and never returned to baseline levels. Conclusion: Mental health and quality of life levels remained high throughout the medical program, with better levels in the first and last semesters and falling in the middle of the program. These data can help managers and educators understand how psychological distress affects medical students. [ABSTRACT FROM AUTHOR]

Small-scale coastal fisheries in the Mediterranean often employ gillnets, a widely used gear worldwide. The disadvantages of gillnets in this fishery include high bycatch levels of unwanted species and consequent discards. Moreover, spatial conflict with other gears and dolphin depredation often results in considerable economic loss. Alternative fishing methods are being tested. This study investigated whether, in small-scale fisheries in the Adriatic Sea, pots can ensure sustainable harvest of mantis shrimp (Squilla mantis), a major target demersal species in terms of landings, and possibly replace traditional gillnets. We adopted a multidisciplinary approach to investigate the catch efficiency, biological impact, and socio-economic effects of the two fishing methods. We found different species compositions in gillnet and pot catches. Gillnets yielded a greater number of discarded species of no commercial value, whereas pots caught a greater amount of mantis shrimp. Finally, a profit analysis indicated that pot fishery has the potential to increase profits for the commercial fishing industry. This study suggests that pots provide a more sustainable fishing method, both in terms of revenue and environmental impact. [ABSTRACT FROM AUTHOR]

In this paper, we analyse the computational advantages of the spherical parametrisation for correlation matrices in the context of Maximum Likelihood estimation via numerical optimisation. By using the special structure of correlation matrices, it is possible to define a bijective transformation of an n × n correlation matrix R into a vector of n (n - 1) / 2 angles between 0 and π . After discussing the algebraic aspects of the problem, we provide examples of the use of the technique we propose in popular econometric models: the multivariate DCC-GARCH model, widely used in applied finance for large-scale problems, and the multivariate probit model, for which the computation of the likelihood is typically accomplished by simulated Maximum Likelihood. Our analysis reveals the conditions when the spherical parametrisation is advantageous; numerical optimisation algorithms are often more robust and efficient, especially when R is large and near-singular. [ABSTRACT FROM AUTHOR]

We present the state of the art on the study of surfaces and tenuous atmospheres of the icy Galilean satellites Ganymede, Europa and Callisto, from past and ongoing space exploration conducted with several spacecraft to recent telescopic observations, and we show how the ESA JUICE mission plans to explore these surfaces and atmospheres in detail with its scientific payload. The surface geology of the moons is the main evidence of their evolution and reflects the internal heating provided by tidal interactions. Surface composition is the result of endogenous and exogenous processes, with the former providing valuable information about the potential composition of shallow subsurface liquid pockets, possibly connected to deeper oceans. Finally, the icy Galilean moons have tenuous atmospheres that arise from charged particle sputtering affecting their surfaces. In the case of Europa, plumes of water vapour have also been reported, whose phenomenology at present is poorly understood and requires future close exploration. In the three main sections of the article, we discuss these topics, highlighting the key scientific objectives and investigations to be achieved by JUICE. Based on a recent predicted trajectory, we also show potential coverage maps and other examples of reference measurements. The scientific discussion and observation planning presented here are the outcome of the JUICE Working Group 2 (WG2): “Surfaces and Near-surface Exospheres of the Satellites, dust and rings”. [ABSTRACT FROM AUTHOR]

The JUpiter ICy moons Explorer (JUICE) of ESA was launched on 14 April 2023 and will arrive at Jupiter and its moons in July 2031. In this review article, we describe how JUICE will investigate the interior of the three icy Galilean moons, Ganymede, Callisto and Europa, during its Jupiter orbital tour and the final orbital phase around Ganymede. Detailed geophysical observations about the interior of the moons can only be performed from close distances to the moons, and best estimates of signatures of the interior, such as an induced magnetic field, tides and rotation variations, and radar reflections, will be obtained during flybys of the moons with altitudes of about 1000 km or less and during the Ganymede orbital phase at an average altitude of 490 km. The 9-month long orbital phase around Ganymede, the first of its kind around another moon than our Moon, will allow an unprecedented and detailed insight into the moon's interior, from the central regions where a magnetic field is generated to the internal ocean and outer ice shell. Multiple flybys of Callisto will clarify the differences in evolution compared to Ganymede and will provide key constraints on the origin and evolution of the Jupiter system. JUICE will visit Europa only during two close flybys and the geophysical investigations will focus on selected areas of the ice shell. A prime goal of JUICE is the characterisation of the ice shell and ocean of the Galilean moons, and we here specifically emphasise the synergistic aspects of the different geophysical investigations, showing how different instruments will work together to probe the hydrosphere. We also describe how synergies between JUICE instruments will contribute to the assessment of the deep interior of the moons, their internal differentiation, dynamics and evolution. In situ measurements and remote sensing observations will support the geophysical instruments to achieve these goals, but will also, together with subsurface radar sounding, provide information about tectonics, potential plumes, and the composition of the surface, which will help understanding the composition of the interior, the structure of the ice shell, and exchange processes between ocean, ice and surface. Accurate tracking of the JUICE spacecraft all along the mission will strongly improve our knowledge of the changing orbital motions of the moons and will provide additional insight into the dissipative processes in the Jupiter system. Finally, we present an overview of how the geophysical investigations will be performed and describe the operational synergies and challenges. [ABSTRACT FROM AUTHOR]

Objectives: Cranial nerve paralysis is a rare complication of spinal and epidural anesthesia, and some cases of vocal fold paralysis (VFP) have been reported. The aim of this article is to report a case, identify evidence supporting the possibility of VFP being a complication of spinal and epidural anesthesia and to investigate the frequency, the characteristics, and the possible mechanisms of such a complication. Data Sources: CINAHL Complete, Google Scholar, Cochrane Library, Pubmed, and EMBASE. Methods: Case report according to CARE guidelines; scoping review according to PRISMA‐ScR criteria. All types of studies that reported on patients of any age and sex, all types of spinal/epidural anesthesia regardless of the location and of drugs used were included. A data extraction sheet was completed for each study selected for inclusion based on the full‐text screenings. Extracted data included: study characteristics, participant characteristics, intervention characteristics, outcome measures, clinical investigations. The study did not receive external funding. Results: Eight studies met inclusion criteria and a total of 13 events (in 12 patients, including ours) were reported to date. Although there are some hypotheses in regard to the mechanism underlying the phenomena, including mechanical and inflammatory ones, the exact cause is still unclear. Conclusions: Only few cases of VFP after spinal or epidural anesthesia have been reported to date; however, it seems possible that VFP might be a potential underreported complication of such procedures. We believe that more research on the topic is warranted, especially considering the wide population potentially at risk. Level of Evidence: NA Laryngoscope, 134:3477–3484, 2024 [ABSTRACT FROM AUTHOR]

Asteroids smaller than 10 km are thought to be rubble piles formed from the reaccumulation of fragments produced in the catastrophic disruption of parent bodies. Ground-based observations reveal that some of these asteroids are today binary systems, in which a smaller secondary orbits a larger primary asteroid. However, how these asteroids became binary systems remains unclear. Here, we report the analysis of boulders on the surface of the stony asteroid (65803) Didymos and its moonlet, Dimorphos, from data collected by the NASA DART mission. The size-frequency distribution of boulders larger than 5 m on Dimorphos and larger than 22.8 m on Didymos confirms that both asteroids are piles of fragments produced in the catastrophic disruption of their progenitors. Dimorphos boulders smaller than 5 m have size best-fit by a Weibull distribution, which we attribute to a multi-phase fragmentation process either occurring during coalescence or during surface evolution. The density per km2 of Dimorphos boulders ≥1 m is 2.3x with respect to the one obtained for (101955) Bennu, while it is 3.0x with respect to (162173) Ryugu. Such values increase once Dimorphos boulders ≥5 m are compared with Bennu (3.5x), Ryugu (3.9x) and (25143) Itokawa (5.1x). This is of interest in the context of asteroid studies because it means that contrarily to the single bodies visited so far, binary systems might be affected by subsequential fragmentation processes that largely increase their block density per km2. Direct comparison between the surface distribution and shapes of the boulders on Didymos and Dimorphos suggest that the latter inherited its material from the former. This finding supports the hypothesis that some asteroid binary systems form through the spin up and mass shedding of a fraction of the primary asteroid. By comparing boulders' surface distribution and shapes on the binary asteroid system, Didymos, authors show that both bodies are rubble piles produced in their progenitor catastrophic disruption and that the secondary, Dimorphos, likely inherited its material from the primary through spin up and mass shedding. [ABSTRACT FROM AUTHOR]

The bearing capacity - the ability of a surface to support applied loads - is an important parameter for understanding and predicting the response of a surface. Previous work has inferred the bearing capacity and trafficability of specific regions of the Moon using orbital imagery and measurements of the boulder tracks visible on its surface. Here, we estimate the bearing capacity of the surface of an asteroid for the first time using DART/DRACO images of suspected boulder tracks on the surface of asteroid (65803) Didymos. Given the extremely low surface gravity environment, special attention is paid to the underlying assumptions of the geotechnical approach. The detailed analysis of the boulder tracks indicates that the boulders move from high to low gravitational potential, and provides constraints on whether the boulders may have ended their surface motion by entering a ballistic phase. From the 9 tracks identified with sufficient resolution to estimate their dimensions, we find an average boulder track width and length of 8.9 ± 1.5 m and 51.6 ± 13.3 m, respectively. From the track widths, the mean bearing capacity of Didymos is estimated to be 70 N/m2, implying that every 1 m2 of Didymos' surface at the track location can support only ~70 N of force before experiencing general shear failure. This value is at least 3 orders of magnitude less than the bearing capacity of dry sand on Earth, or lunar regolith. Bearing capacity, the ability of a surface to support applied loads, is a critical property in planetary exploration to understand a surface's response to landing or roving. Here, the bearing capacity of the asteroid Didymos is estimated using DART images of suspected boulder tracks on its surface. [ABSTRACT FROM AUTHOR]

Planetary defense efforts rely on estimates of the mechanical properties of asteroids, which are difficult to constrain accurately from Earth. The mechanical properties of asteroid material are also important in the interpretation of the Double Asteroid Redirection Test (DART) impact. Here we perform a detailed morphological analysis of the surface boulders on Dimorphos using images, the primary data set available from the DART mission. We estimate the bulk angle of internal friction of the boulders to be 32.7 ± 2. 5° from our measurements of the roundness of the 34 best-resolved boulders ranging in size from 1.67–6.64 m. The elongated nature of the boulders around the DART impact site implies that they were likely formed through impact processing. Finally, we find striking similarities in the morphology of the boulders on Dimorphos with those on other rubble pile asteroids (Itokawa, Ryugu and Bennu). This leads to very similar internal friction angles across the four bodies and suggests that a common formation mechanism has shaped the boulders. Our results provide key inputs for understanding the DART impact and for improving our knowledge about the physical properties, the formation and the evolution of both near-Earth rubble-pile and binary asteroids. Planetary Defense efforts rely on estimates of asteroids' mechanical properties, which are difficult to obtain accurately from Earth. Here, authors compare images from space missions to the rubble-pile asteroids Dimorphos, Itokawa, Ryugu, and Bennu and study such properties through boulders on their surface. [ABSTRACT FROM AUTHOR]

Images collected during NASA's Double Asteroid Redirection Test (DART) mission provide the first resolved views of the Didymos binary asteroid system. These images reveal that the primary asteroid, Didymos, is flattened and has plausible undulations along its equatorial perimeter. At high elevations, its surface is rough and contains large boulders and craters; at low elevations its surface is smooth and possesses fewer large boulders and craters. Didymos' moon, Dimorphos, possesses an intimate mixture of boulders, several asteroid-wide lineaments, and a handful of craters. The surfaces of both asteroids include boulders that are large relative to their host body, suggesting that both asteroids are rubble piles. Based on these observations, our models indicate that Didymos has a surface cohesion ≤ 1 Pa and an interior cohesion of ∼10 Pa, while Dimorphos has a surface cohesion of <0.9 Pa. Crater size-frequency analyzes indicate the surface age of Didymos is 40–130 times older than Dimorphos, with likely absolute ages of ~ 12.5 Myr and <0.3 Myr, respectively. Solar radiation could have increased Didymos' spin rate leading to internal deformation and surface mass shedding, which likely created Dimorphos. Images collected during NASA's DART mission of the asteroid Didymos and its moon, Dimorphos, are used to explore the origin and evolution of the binary system. Authors analysis indicate that both asteroids are weak rubble piles and that Didymos' surface should be about 40 to 130 times older than Dimorphos. [ABSTRACT FROM AUTHOR]

Spacecraft observations revealed that rocks on carbonaceous asteroids, which constitute the most numerous class by composition, can develop millimeter-to-meter-scale fractures due to thermal stresses. However, signatures of this process on the second-most populous group of asteroids, the S-complex, have been poorly constrained. Here, we report observations of boulders' fractures on Dimorphos, which is the moonlet of the S-complex asteroid (65803) Didymos, the target of NASA's Double Asteroid Redirection Test (DART) planetary defense mission. We show that the size-frequency distribution and orientation of the mapped fractures are consistent with formation through thermal fatigue. The fractures' preferential orientation supports that these have originated in situ on Dimorphos boulders and not on Didymos boulders later transferred to Dimorphos. Based on our model of the fracture propagation, we propose that thermal fatigue on rocks exposed on the surface of S-type asteroids can form shallow, horizontally propagating fractures in much shorter timescales (100 kyr) than in the direction normal to the boulder surface (order of Myrs). The presence of boulder fields affected by thermal fracturing on near-Earth asteroid surfaces may contribute to an enhancement in the ejected mass and momentum from kinetic impactors when deflecting asteroids. Here, authors study boulders' fractures on S-type asteroid, Dimorphos, and show that their size-frequency distribution and orientation are consistent with formation through thermal fatigue. Such fractures seem to propagate horizontally much faster (~kyr) than normal to the boulder's surface (~Myr). [ABSTRACT FROM AUTHOR]

Pots are traditional fishing gear type largely employed in Mediterranean Small Scale Fisheries (SSFs). Their often higher species selectivity and catch quality compared to other gear types such as passive set nets or trawls are appealing characteristics for reducing the impact on benthic communities and diversifying fishing effort in the region. Despite this, in some SSFs, pots are still rarely used as prevalent gear due to low landings and profits. The present study investigated if an experimental pot design of two different colours could improve the catch efficiency for mantis shrimp (Squilla mantis) in the Adriatic coastal SSF, compared to the traditionally used design. The experimental design in white colour increased the catch efficiency for S. mantis compared to the same design in black colour and the traditional pots, while the catch efficiency for black goby (Gobius niger, another commercial species) was higher in the experimental design regardless of the colour. Furthermore, the species composition in catches was not significantly affected with the use of the experimental design, neither in target nor in bycatch species, therefore not causing negative effect on the species community. Finally, the experimental pot design also led to some improvements in gear durability, ensuring a higher resistance to wear, sea currents and marine fouling. The promising results obtained with this new design could broaden the interest towards increased use of pots as alternative and low impact gear in other Mediterranean areas. [ABSTRACT FROM AUTHOR]

Placenta accreta spectrum (PAS) refers to excessive placental invasion into the maternal uterus and it is associated with high risk of obstetric haemorrhage and adverse maternal-neonatal outcomes. Currently, no specific circulating biomarkers of PAS have been identified. Given that in PAS disorders, the depth and the extension of placental invasion into the uterus are expected to be increased, in this study, we analysed plasma levels of syncytiotrophoblast-derived extracellular vesicles (STBEVs) in women with placenta previa (PP), at a high risk of PAS disorders, and pregnant women with normal placentation. Venous blood samples were collected from 35 women with ultrasonographic diagnosis of PP and 35 women with normal placentation, matched for gestational age. Plasma samples were ultracentrifuged at 120.000 g to collect extracellular vesicles (EVs). To identify and quantify plasma placenta–derived EVs (or STBEVs), EVs were analysed by flow cytometry using a monoclonal antibody against placental alkaline phosphatase (PLAP). Plasma levels of STBEVs were significantly higher in PP patients compared to controls. Plasma levels of STBEVs in women with PP and PAS showed a trend to a higher concentration compared to women with PP without PAS, although not reaching a statistical significance. Circulating STBEVs are potential candidates as biological markers to be integrated to ultrasonography in the antenatal screening programme for PAS. More studies are needed to confirm our observation in a larger cohort of patients and to analyse a possible association between high circulating levels of STBEVs and PAS. [ABSTRACT FROM AUTHOR]

Purpose: Altered hemodynamics caused by the presence of an endovascular device may undermine the success of peripheral stenting procedures. Flow-enhanced stent designs are under investigation to recover physiological blood flow patterns in the treated artery and reduce long-term complications. However, flow-enhanced designs require the development of customised manufacturing processes that consider the complex behaviour of Nickel-Titanium (Ni-Ti). While the manufacturing routes of traditional self-expanding Ni–Ti stents are well-established, the process to introduce alternative stent designs is rarely reported in the literature, with much of this information (especially related to shape-setting step) being commercially sensitive and not reaching the public domain, as yet. Methods: A reliable manufacturing method was developed and improved to induce a helical ridge onto laser-cut and wire-braided Nickel–Titanium self-expanding stents. The process consisted of fastening the stent into a custom-built fixture that provided the helical shape, which was followed by a shape-setting in air furnace and rapid quenching in cold water. The parameters employed for the shape-setting in air furnace were thoroughly explored, and their effects assessed in terms of the mechanical performance of the device, material transformation temperatures and surface finishing. Results: Both stents were successfully imparted with a helical ridge and the optimal heat treatment parameters combination was found. The settings of 500 °C/30 min provided mechanical properties comparable with the original design, and transformation temperatures suitable for stenting applications (Af = 23.5 °C). Microscopy analysis confirmed that the manufacturing process did not alter the surface finishing. Deliverability testing showed the helical device could be loaded onto a catheter delivery system and deployed with full recovery of the expanded helical configuration. Conclusion: This demonstrates the feasibility of an additional heat treatment regime to allow for helical shape-setting of laser-cut and wire-braided devices that may be applied to further designs. [ABSTRACT FROM AUTHOR]

Autonomous driving vehicles (ADV), have been in recent years, victims of their own success. Through their use of increasingly sophisticated sensor modalities and deep learning capabilities, ADVs have not only learned how to probe their chaotic environment with higher granularity coupled with smooth trajectory execution but also inherited all the vulnerabilities that were hiding behind these new features. Ensuring the safety of ADVs is crucial since a simple fault along their underlying autopilot software stack can lead to catastrophic accidents with the loss of human lives. Therefore we propose a crash-fault tolerant scheme that can be triggered whenever a crash fault of the safety critical submodules of the autopilot software stack is detected, which executes an emergency trajectory and effectively steers the car into a safe spot where the autopilot can be rejuvenated. We implement and evaluate the efficacy of this recovery scheme in the Apollo ADV software stack in conjunction with the SVL simulator. [ABSTRACT FROM AUTHOR]

The aim of this study was to longitudinally investigate the association between resilience and mental health in older adults and to determine the influence of physical activity on this relationship. A total of 291 older adults were included in a 2-year follow-up study. Adjusted linear regression models evaluated the association between resilience at baseline and mental health after 2 years in sufficiently and insufficiently physically active older adults. A negative correlation was found between resilience at baseline and depression, anxiety, and stress after 2 years for the overall sample. This association changed after stratifying the group. Sufficiently physically active individuals made greater use of the resilience components "Self-Sufficiency" and "Perseverance," whereas insufficiently physically active individuals made greater use of "Meaning of Life" and "Existential Singularity." Physical activity can influence the relationship between resilience and mental health. These results can help guide the devising of more effective interventions for this age group. [ABSTRACT FROM AUTHOR]

The use of new materials in the field of biofuel production has been represented as a step in the development of remarkable catalysts. The use of lipases in the production of biodiesel is often seen as a cost-limiting step, as the operating expenses in recovering such catalysts can lead to unfeasible market expectations. In this study, hydroxyapatite (HAp) particles were evaluated as a support to immobilize commercial lipase, following application in ethyl ester synthesis. First, hydroxyapatite was synthesized through the co-precipitation method at constant pH and selected as a support to be used in enzyme immobilization. The characterization of the biocatalyst support materials produced was carried out using DRX, BET, FTIR, TGA, and SEM analysis. The lipase from Thermomyces lanuginosus was then immobilized in the matrices, and, subsequently, there was transesterification of the vegetable oil deodorization distillate (VODD). The biodiesel samples generated showed that they were within commercial standards, achieving ester conversion greater than 96.5%. Other properties such as density (0.87 g.cm−3) and viscosity (4.36 mm2.s−1) meet the specifications required by ASTM to be used as a biofuel. In the experiment planning technique, the results revealed an experimental trend and a defined behavior: a higher lipase loading in the immobilization and the use of temperatures in the range of 40–50 °C favor high conversions of ethyl esters. Thus, this confirms that the enzymatic chemical catalyst was able to form the main fatty acid esters even using a residual lipid raw material. [ABSTRACT FROM AUTHOR]

Background: The TOPAZ-1 phase III trial reported a survival benefit with the anti-programmed cell death ligand 1 (anti-PD-L1) durvalumab in combination with gemcitabine and cisplatin in patients with advanced biliary tract cancer (BTC). Objective: The present study investigated for the first time the impact on survival of adding durvalumab to cisplatin/gemcitabine compared with cisplatin/gemcitabine in a real-world setting. Patients and Methods: The analyzed population included patients with unresectable, locally advanced, or metastatic BTC treated with durvalumab in combination with cisplatin/gemcitabine or with cisplatin/gemcitabine alone. The impact of adding durvalumab to chemotherapy in terms of overall survival (OS) and progression free survival (PFS) was investigated with univariate and multivariate analysis. Results: Overall, 563 patients were included in the analysis: 213 received cisplatin/gemcitabine alone, 350 received cisplatin/gemcitabine plus durvalumab. At the univariate analysis, the addition of durvalumab was found to have an impact on survival, with a median OS of 14.8 months versus 11.2 months [hazard ratio (HR) 0.63, 95% confidence interval (CI) 0.50–0.80, p = 0.0002] in patients who received cisplatin/gemcitabine plus durvalumab compared to those who received cisplatin/gemcitabine alone. At the univariate analysis for PFS, the addition of durvalumab to cisplatin/gemcitabine demonstrated a survival impact, with a median PFS of 8.3 months and 6.0 months (HR 0.57, 95% CI 0.47–0.70, p < 0.0001) in patients who received cisplatin/gemcitabine plus durvalumab and cisplatin/gemcitabine alone, respectively. The multivariate analysis confirmed that adding durvalumab to cisplatin/gemcitabine is an independent prognostic factor for OS and PFS, with patients > 70 years old and those affected by locally advanced disease experiencing the highest survival benefit. Finally, an exploratory analysis of prognostic factors was performed in the cohort of patients who received durvalumab: neutrophil–lymphocyte ratio (NLR) and disease stage were to be independent prognostic factors in terms of OS. The interaction test highlighted NLR ≤ 3, Eastern Cooperative Oncology Group Performance Status (ECOG PS) = 0, and locally advanced disease as positive predictive factors for OS on cisplatin/gemcitabine plus durvalumab. Conclusion: In line with the results of the TOPAZ-1 trial, adding durvalumab to cisplatin/gemcitabine has been confirmed to confer a survival benefit in terms of OS and PFS in a real-world setting of patients with advanced BTC. [ABSTRACT FROM AUTHOR]

Background: There are few molecular markers driving treatment selection in later lines of treatment for advanced colorectal cancer patients. The vast majority of patients who progress after first- and second-line therapy undergo chemotherapy regardless of molecular data. Objective: We aimed to assess the prognostic and predictive effects of specific RAS mutations on overall survival of patients receiving regorafenib (rego), trifluridine/tipiracil (TFD/TPI), or both. Patients and methods: This was a retrospective observational study based on data from a previous study of our research network, involving nine Italian institutions over a 10-year timeframe (2012–2022). Extended RAS analysis, involving KRAS exon 2–4 and NRAS exon 2–4, and BRAF were the main criteria for inclusion in this retrospective evaluation. Patients with BRAF mutation were excluded. Patients were classified according to treatment (rego- or TFD/TPI-treated) and RAS mutational status (wild-type [WT], KRAS codon 12 mutations, KRAS codon 13 mutations, KRAS rare mutations and NRAS mutations, KRAS G12C mutation and KRAS G12D mutation). Results: Overall, 582 patients were included in the present analysis. Overall survival did not significantly differ in rego-treated patients according to RAS extended analysis, although a trend toward a better median survival in patients carrying G12D mutation (12.0 months), Codon 13 mutation (8.0 months), and Codon 12 mutation (7.0 months) has been observed, when compared with WT patients (6.0 months). Overall survival did not significantly differ in TFD/TPI-treated patients according to RAS extended analysis, although a trend toward a better median survival in WT patients had been observed (9.0 months) in comparison with the entire population (7.0 months). Patients receiving both drugs displayed a longer survival when compared with the population of patients receiving rego alone (p = 0.005) as well as the population receiving TFD/TPI alone (p < 0.001), suggesting a group enriched for favorable prognostic factors. However, when each group was analyzed separately, the addition of TFD/TPI therapy to the rego-treated group improved survival only in all-RAS WT patients (p = 0.003). Differently, the addition of rego therapy to TFD/TPI-treated patients significantly improved OS in the Codon 12 group (p = 0.0004), G12D group (p = 0.003), and the rare mutations group (p = 0.02), in addition to all-RAS WT patients (p = 0.002). The rego-TFD/TPI sequence, compared with the reverse sequence, significantly improved OS only in the KRAS codon 12 group (p = 0.003). Conclusions: Our data demonstrate that RAS mutations do not affect outcome in rego-treated patients as well as TFD/TPI-treated patients. Nevertheless, a trend toward a higher efficacy of rego in RAS-mutated (in particular codon 12, rare RAS mutations, and G12D) patients has been recorded. The rego-TFD/TPI sequence seems to be superior to the reverse sequence in patients carrying an RAS codon 12 mutation, although the impact of other factors as disease burden or performance status cannot be excluded. [ABSTRACT FROM AUTHOR]

This study aims to investigate the current evidence for the use of complementary and alternative medicine (CAM) in fibromyalgia (FM). A systematic review was conducted searching for PubMed, Scopus, CINAHL, PsycInfo, and Web of Science databases. Randomized controlled trials published up to December 2023 in peer-reviewed journals were included. Methodological quality was assessed by the Quality Assessment of Controlled Intervention Studies tool. A total of 216 articles were identified and 15 constituted the final sample. The type of CAM most used was traditional Chinese medicine (60%), and the most common instrument used was the Fibromyalgia Impact Questionnaire (60%). Our review was grouped into four themes based on the origin of the therapies: 1) Traditional Chinese Medicine; 2) Japanese natural harmonization (eg, Reiki); 3) Ayurvedic Medicine; and 4) Other non-drug therapies. Our systematic review showed that there is a wide range of CAMs used to treat FM. Most of the clinical trials have shown significant results for the effectiveness of these interventions in both physical and mental health outcomes of FM as compared to control groups. However, the heterogeneity of the interventions and outcomes warrants further studies on this topic. [ABSTRACT FROM AUTHOR]

Infective endocarditis represents a challenging and life-threatening clinical condition affecting native and prosthetic heart valves, endocardium, and implanted cardiac devices. Right-sided infective endocarditis account for approximately 5–10% of all infective endocarditis and are often associated with intravenous drug use, intracardiac devices, central venous catheters, and congenital heart disease. The tricuspid valve is involved in 90% of right-side infective endocarditis. The primary treatment of tricuspid valve infective endocarditis is based on long-term intravenous antibiotics. When surgery is required, different interventions have been proposed, ranging from valvectomy to various types of valve repair to complete replacement of the valve. Percutaneous removal of vegetations using the AngioVac system has also been proposed in these patients. The aim of this narrative review is to provide an overview of the current surgical options and to discuss the results of the different surgical strategies in patients with tricuspid valve infective endocarditis. [ABSTRACT FROM AUTHOR]

Recent experiments devoted to characterizing the behavior of sessile ferroelectric liquid droplets on ferroelectric solid substrates have shown the existence of a droplet electromechanical Rayleigh-like instability. The instability is induced by the bulk polarization of the ferroelectric fluid, which couples to the polarization of the underlying substrate through its fringing field and solid–fluid interface coupling. With the aim of characterizing this phenomenon, namely the coupling between the polarizations of a fluid and a solid material, we studied the behavior of ferroelectric liquid droplets confined between two solid substrates, arranged in different configurations, realized to generate fringing fields with different profiles. The results show that the features of the droplets instability are indeed affected by the specific fringing field shape in a way dominated by the minimization of the electrostatic energy associated with the bulk polarization of the ferroelectric fluid. [ABSTRACT FROM AUTHOR]

A 10 year-old female spayed German Short-haired Pointer dog weighing 26.8 kg (59 lb) presented with a 2 week history of recurrent ascites. The dog had a 4 year history of idiopathic pericardial effusion causing sporadic episodes of cardiac tamponade and secondary ascites. A subtotal pericardiectomy was performed 3 months prior to presentation. The patient had done well for 2 months following this procedure, at which point the large-volume modified transudate ascites recurred, necessitating abdominocentesis every 10 days. Thoracic and abdominal computed tomography (CT) revealed no abdominal or vascular cause of ascites. Transthoracic echocardiography performed under general anesthesia showed constrictive epicarditis (visceral pericarditis) resulting in diastolic dysfunction and right-sided congestive heart failure. A sternotomy was performed for a pericardial waffle procedure or crosshatch pericardiotomy--scoring of crosshatched incisions into the thickened epicardium. Echocardiographic findings postoperatively were consistent with resolved constrictive epicarditis. At 8 months postoperatively, the dog was clinically normal and had only required one abdominocentesis one month after the waffle procedure. This case report describes the successful treatment of a dog with constrictive epicarditis using a novel surgical technique (waffle procedure) that has not yet been described in veterinary medicine. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effectiveness of spiritual care training on medical students' self-reported competencies. Methods: This is a quasi-experimental (controlled and non-randomized) study including 115 Brazilian medical students. Participants were enrolled into 2 groups: fourth-year students (n  = 64) who received spiritual care training and sixth-year students (n  = 51) who did not receive this training – control group (i.e., usual teaching). Participants answered a self-reported Spiritual Care Competence Scale. Comparisons between groups were performed and effect sizes were reported. Results: Providing a spiritual care training resulted in significantly higher self-reported scores for the dimensions of "Assessment" (d  = 0.99), "Improvement of care" (d  = 0.69), "Counseling (d  = 0.88)," "Referral" (d  = 0.75), and "Total Spiritual Care" (d  = 1.044) as compared to the control group. Likewise, 21 out of 27 items of the Spiritual Care Competence Scale were significantly higher for the intervention group, presenting effect sizes (d) ranging between 0.428 and 1.032. Significance of results: Medical students receiving spiritual care training showed greater self-reported competencies as compared to those in the usual teaching. These results reinforce the importance of promoting spirituality teaching in medical schools. [ABSTRACT FROM AUTHOR]

Driven by growing environmental concerns and regulations, cosmetic companies are seeking reliable methods to promptly assess the possibility of replacing high-impact ingredients with sustainable alternatives. In this work, we exploited rheological and texture analyses to evaluate the possibility of using natural and biodegradable raw materials for reformulating three commercial oil-in-water skin care emulsions from an eco-design perspective. Synthetic texturizers, like nylon-12 and PMMA, were replaced with starch, maltodextrin, and silica, while acrylic rheological modifiers were substituted with polysaccharide associations of sclerotium gum, xanthan gum, diutan gum, and carrageenan. Plant-based emollients and a biodegradable elastomer were used as alternatives to silicone oils. The flow and viscoelastic properties of the samples were characterized using rheological tests under continuous and oscillatory flow conditions. The immersion/de-immersion texture analysis allowed us to measure the mechanical properties of firmness, adhesiveness, and stringiness. A double-blind sensory test assessed the products' application and sensory characteristics. The results revealed that rheology and texture analysis are complementary and correlated techniques, useful for predicting cosmetics' sensory characteristics. While perfect replication of the original formulas might not be achievable, this protocol can aid formulators in selecting new eco-friendly ingredients ensuring the products' desired application and sensory properties without compromising consumer experience. [ABSTRACT FROM AUTHOR]

The Double Asteroid Redirection Test (DART) had an impact with Dimorphos (a satellite of the asteroid Didymos) on 26 September 20221. Ground-based observations showed that the Didymos system brightened by a factor of 8.3 after the impact because of ejecta, returning to the pre-impact brightness 23.7 days afterwards2. Hubble Space Telescope observations made from 15 minutes after impact to 18.5 days after, with a spatial resolution of 2.1 kilometres per pixel, showed a complex evolution of the ejecta3, consistent with other asteroid impact events. The momentum enhancement factor, determined using the measured binary period change4, ranges between 2.2 and 4.9, depending on the assumptions about the mass and density of Dimorphos5. Here we report observations from the LUKE and LEIA instruments on the LICIACube cube satellite, which was deployed 15 days in advance of the impact of DART. Data were taken from 71 seconds before the impact until 320 seconds afterwards. The ejecta plume was a cone with an aperture angle of 140 ± 4 degrees. The inner region of the plume was blue, becoming redder with increasing distance from Dimorphos. The ejecta plume exhibited a complex and inhomogeneous structure, characterized by filaments, dust grains and single or clustered boulders. The ejecta velocities ranged from a few tens of metres per second to about 500 metres per second.Dimorphos ejecta plume properties were revealed by the observations from the LICIACube cube satellite, which was deployed 15 days in advance of the impact of DART. [ABSTRACT FROM AUTHOR]

Background: New indications for existing medicines are increasing over time. In most countries, drug pricing and reimbursement conditions are renegotiated every time a new indication is approved. There is a growing interest in the price negotiation model for new indications, specifically comparing an indication-based versus blended approach. However, little evidence currently exists regarding the complexity of these negotiations and their impact on actual prices. Italy has recently transitioned from an indication-based approach to a blended price model. This study aims to measure the impact of price and reimbursement negotiation of new indications on discounts (i.e. actual prices) and on the negotiation duration, used as a proxy of its complexity. Methods: We considered new indications approved through a European centralized procedure from January 2013 to March 2022 for which the price and reimbursement status was approved in Italy between January 2015 and March 2022, amounting to 52 new indications. Data on the timeframe of the Italian price and reimbursement process and its phases were obtained from publicly available sources. Discounts for the first indication and their subsequent increases for new indications were estimated by comparing ex-factory prices and tendered prices. To calculate p-values, we employed the Mann–Whitney test, and multiple regression models were utilized to examine correlations between negotiation time and the characteristics of the medicines. Results: The mean time to reimbursement was 603 days, in contrast to 583 days for the first launch. Price negotiation took longer for rare diseases, cancer drugs, and in case of therapies with minor added therapeutic value. On average, the additional discount (on top of discounts for prior indications) was 13%, significantly lower than the mean discount for the first indications approved (24.9%). The discounts increment was lower, but negotiation took longer if a Managed Entry Agreement accompanied the final agreement. Additionally, discounts have increased over the years. Conclusion: The negotiation for new indications takes longer than the first one, and provides, on average, an additional discount of 13%. While our findings bear the potential for significant policy implications, they necessitate prudent interpretation due to a limited number of observations. The increasing trend in additional discounts over time applied to all indications in recent negotiations, may suggest a descending trend of value for new indications and a shift from an indication-based pricing approach to a blended model. Otherwise, budget impact considerations might have outweighed a value-based approach in the recent negotiations. If so, two potential options for restoring a value-based approach are returning to an indication-based pricing or giving explicit and higher weight to value within a blended model. [ABSTRACT FROM AUTHOR]

Onopordum tauricum Willd., a species distributed in Eastern Europe, has been the subject of various research endeavors aimed at assessing its suitability for extracting vegetable rennet for use in the production of local cheeses as a substitute for animal-derived rennet. In Italy, the species has an extremely fragmented and localized distribution in six locations scattered across the central-northern Apennines and some areas of southern Italy. In this study, both the morphology and genetic diversity of the six known Italian populations were investigated to detect putative ecotypes. To this end, 33 morphological traits were considered for morphometric measurements, while genetic analysis was conducted on the entire genome using the ddRAD-Seq method. Both analyses revealed significant differences among the Apennine populations (SOL, COL, and VIS) and those from southern Italy (ROT, PES, and LEC). Specifically, the southern Italian populations appear to deviate significantly in some characteristics from the typical form of the species. Therefore, its attribution to O. tauricum is currently uncertain, and further genetic and morphological analyses are underway to ascertain its systematic placement within the genus Onopordum. [ABSTRACT FROM AUTHOR]

Background: The results reported in the TOPAZ-1 phase III trial led to the approval of the combination of cisplatin and gemcitabine with durvalumab as the new first-line standard of care for patients with locally advanced or metastatic cholangiocarcinoma. Objective: We performed a clustering analysis to classify patients into different groups based on their mutation profile, correlating the results of the analysis with clinical outcomes. Methods: We selected 51 patients with cholangiocarcinoma who were treated with the combination of chemotherapy and durvalumab and who were screened using the next-generation sequencing-based FoundationOne gene panel. We conducted mutation-based clustering of tumors and a survival analysis. Results: Three main clusters were identified. Cluster 1 is mostly characterized by mutations in genes belonging to the chromatin modification pathway, altered in 100% of patients. Cluster 2 is characterized by the alteration of several pathways, among which DNA damage control, chromatin modification, RTK/RAS, cell-cycle apoptosis, TP53, and PI3K were the most affected. Finally, most altered pathways in cluster 3 were RTK/RAS and cell-cycle apoptosis. Overall response rate was 4/13 (31%), 12/24 (50%), and 0/10 (0%) in cluster 1, cluster 2, and cluster 3, respectively, and the difference between the three clusters was statistically significant (p = 0.0188). Conclusions: By grouping patients into three clusters with distinct molecular and genomic alterations, our analysis showed that patients included in cluster 2 had higher overall response rates, whereas patients included in cluster 3 had no objective response. Further investigations on larger and external cohorts are needed in order to validate our results. [ABSTRACT FROM AUTHOR]

Background: Alcohol and illicit drug use are prevalent among homeless people. Religiosity and spirituality (RS) have been widely associated with lower consumption of substances. However, evidence of this relationship among homeless people is still scarce. Aims: To evaluate the associations between RS and alcohol and illicit drug consumption among homeless people in a large Brazilian urban center. Method: This cross-sectional study was carried out in São Paulo city, Brazil. Aspects such as spirituality (FACIT-Sp12), religiosity (DUREL), spiritual-religious coping (Brief-RCOPE), and self-report questions concerning the current substance use (alcohol and illicit substances) were evaluated. Adjusted logistic regression models were used to assess the impact of RS beliefs on alcohol and illicit drug consumption. Results: A total of 456 homeless people were included, of an average age of 44.5 (SD = 12.6) years. More than half of the participants consumed alcohol (55.7%) weekly and 34.2% used illicit drugs weekly. Adjusted logistic regression models identified that aspects of RS were associated with lower likelihood factors for alcohol and illicit drug use; conversely, negative spiritual religious coping (SRC) strategies were associated with a higher likelihood to use both. Conclusion: The prevalence of alcohol and illicit drug use among participants was high. RS and positive SRC were important protective factors for lower consumption of these substances. Conversely, negative SRC strategies were associated with risk factors. [ABSTRACT FROM AUTHOR]

Background: Despite studies evaluating the insertion of technology and the use of smartphones in the mental health and learning of medical students, few have investigated these outcomes longitudinally. This study aims to investigate the association between smartphone use and digital addiction with mental health, quality of life, learning, and academic motivation of medical students. Methods: This is a longitudinal study conducted between 2016 and 2018. Socio-demographics, smartphone use, digital dependence (Internet Addiction Test), surface and deep learning approach (Biggs), motivation (Academic Motivation Scale), evaluation of symptoms of depression, anxiety, and stress (DASS- 21) and Quality of Life (WHOQOL-BREF) were assessed. Adjusted regression models were used for data analysis. Results: A total of 269 students were included(51.4% of the total). In the two-year follow-up, despite an increase in the frequency of smartphone use in general and also in the classroom for non-educational activities, no increase in digital dependence was found. In the adjusted models, the frequency of smartphone use and digital dependence were predictors of lower academic motivation and greater surface learning after two years of follow up. However, only digital dependence was a predictor of worse mental health (anxiety, depression, and stress) and worse quality of life. Conclusion: Greater use of smartphones and high addiction scores were associated with worse educational outcomes. Digital dependence was another marker of outcomes in mental health and quality of life. It is important that educators are aware of these negative effects and can guide students on the proper and safe use of these devices. [ABSTRACT FROM AUTHOR]

The ornamental nursery industry is steadily growing in Europe, and a consequent increase in the demand for substrates related to container plant cultivations is expected in the coming years. Currently, substrates consist in part or entirely of peat, a non-renewable resource with concerns about its environmental impact due to extraction, transport, and use. Therefore, it is essential to focus on alternative materials, particularly waste by-products to be recycled as components of substrates to achieve more sustainable cultivations. In this study, substrates obtained by mixing co-composted dredged sediments (S) and green waste (GW) in different ratios (1:3; 1:1; 3:1) were tested for cultivation, and plant growth was compared with a control growing media (peat and pumice in a 1:1 ratio). The cultivation trial lasted for one year and was carried out on two potted ornamental evergreen shrubs (Photinia × fraseri and Viburnum tinus). The results showed that the plant growth parameters of both species, occurring in substrates with co-composted materials, were not significantly affected compared to the control, with the exception of below-ground biomass in V. tinus. Moreover, a Life Cycle Assessment (LCA) analysis was carried out to quantify the greenhouse gas emissions (GHG) deriving from the replacement of peat with the other proposed substrates. The functional unit was 10 L (Ø 24 cm) potted plants and the results were expressed in kg of CO2 equivalent (kg CO2eq). We demonstrated that the replacement of peat-based substrates with the alternative substrates was able to reduce the GHG emission by an average of 11.56 to 23.13%. Higher GHG emissions were related to the cultivation phase (0.9 kg CO2eq/plant), and while comparing substrates, we obtained an average percentage reduction of 28.1% to 59.6%. Thus, our results suggest that co-composted mixtures of dredged sediments with green waste could be used as sustainable techno-soils for pot nursery cultivation of ornamental species with reduced environmental impact. [ABSTRACT FROM AUTHOR]

Prevailing theories of democracy focus on class conflict. In contrast, we study democratic transition when ethnic tensions are more salient than the poor/rich divide, building a model where (i) ethnic groups negotiate about allocating the economic surplus and (ii) military and political mobilizations rest on the unobserved strength of ethnic attachment. Free and fair elections elicit information and restore inter-ethnic bargaining efficiency. Autocrats can rationally choose democratic transition, even if they risk losing power, as elections reduce the opposition's informational rent. The predictions of our framework are consistent with novel country-level and ethnic group-level panel correlational evidence on democratization in the post-decolonization period. [ABSTRACT FROM AUTHOR]

In healthy individuals, the intestinal epithelium forms a tight barrier to prevent gut bacteria from reaching blood circulation. To study the effect of probiotics, dietary compounds and drugs on gut barrier formation and disruption, human gut epithelial and bacterial cells can be cocultured in an in vitro model called the human microbial crosstalk (HuMiX) gut-on-a-chip system. Here, we present the design, fabrication and integration of thin-film electrodes into the HuMiX platform to measure transepithelial electrical resistance (TEER) as a direct readout on barrier tightness in real-time. As various aspects of the HuMiX platform have already been set in their design, such as multiple compressible layers, uneven surfaces and nontransparent materials, a novel fabrication method was developed whereby thin-film metal electrodes were first deposited on flexible substrates and sequentially integrated with the HuMiX system via a transfer-tape approach. Moreover, to measure localized TEER along the cell culture chamber, we integrated multiple electrodes that were connected to an impedance analyzer via a multiplexer. We further developed a dynamic normalization method because the active measurement area depends on the measured TEER levels. The fabrication process and system setup can be applicable to other barrier-on-chip systems. As a proof-of-concept, we measured the barrier formation of a cancerous Caco-2 cell line in real-time, which was mapped at four spatially separated positions along the HuMiX culture area. [ABSTRACT FROM AUTHOR]

(1) Background: Preeclampsia (PE) usually presents with hypertension and proteinuria, related to poor placentation. Reduced maternal–fetal immunological tolerance is a possible trigger of inadequate placentation. Aberrant antigen expression of HLA-DR has been observed in the syncytiotrophoblast of PE patients. In this study, we analyzed plasma levels of Human Leukocyte Antigen (HLA)-DR+ syncytiotrophoblast-derived extracellular vesicles (STEVs) during the three trimesters of pregnancy in relation to PE onset. (2) Methods: Pregnant women underwent venous blood sampling during the three trimesters. STEVs were collected from plasma via ultracentrifugation (120,000 g) and characterized by Western blot, nanotracking analysis and flow cytometry for the expression of Placental Alkaline Phosphatase (PLAP), a placental-derived marker, and HLA-DR. (3) Results: Out of 107 women recruited, 10 developed PE. STEVs were detected in all three trimesters of pregnancy with a zenith in the second trimester. A significant difference was found between the non-PE and PE groups in terms of plasma levels of HLA-DR+ STEVs during all three trimesters of pregnancy. (4) Conclusions: More research is needed to investigate HLA-DR+ as a potential early marker of PE. [ABSTRACT FROM AUTHOR]