Search

Aotearoa New Zealand's aquatic ecosystems are declining despite widespread awareness of mitigation needs. This study employs storytelling to address this issue, testing the role of the messenger in encouraging freshwater restoration in rural catchment communities. We quantified peer-to-peer knowledge exchange on three cognitive processes (retention and extraction of information, motivation to reproduce modelled restoration behaviour, and recall of acquired information), using ArcGIS® ‘StoryMaps’. We created two restoration stories; one told through the voice of a respected catchment group member known for leadership, and one through a collective catchment group voice. We surveyed freshwater community members (N = 82) before and after reading the stories, and one month later, and found that participants reading either catchment restoration story (1) accepted both the catchment collective and the respected individual member as a trusted source, and could therefore relate to either, and (2) thought the story was informative and contained new details, independent of the time span land holders have been actively restoring. While our study found no significant differences between individual or collective storytellers, it confirms the value of trusted messengers as restoration knowledge brokers in rural catchment communities, a critical step in value-led freshwater restoration at large scales.

Abstract Neoadjuvant endocrine therapy (NET) for hormone receptor-positive (HR+) breast cancer might be as effective as chemotherapy, with a better toxicity profile. Blocking a crucial process such as angiogenesis with sunitinib may have a synergistic effect with NET. We aimed to assess the efficacy and safety of neoadjuvant sunitinib plus exemestane in early-stage HR+/HER2-negative breast cancer. In this phase I/II study, postmenopausal women with HR+/HER2− stage II-III breast cancer received neoadjuvant exemestane at conventional dose of 25mg plus sunitinib in a 3 + 3 design at 25mg (3/1weeks scheme) or 37.5mg continuous dose, for 6 months. Coprimary endpoints were the recommended dose of sunitinib combined with exemestane and objective response. Secondary endpoints included safety and biomarkers of early response. For 15 months, 18 patients were enrolled, 15 at sunitinib 25mg and 3 at 37.5mg. Median age was 73, 77% of patients had T2 tumors and 67% node-positive disease. The most common grade 2 toxicity was asthenia (44%), as was hypertension (22%) for grade 3. No grade 4–5 were reported. Twelve patients (66%) achieved an objective response. VEGFR-2 levels significantly decreased after one month of treatment. Differential gene expression analysis showed downregulation of ESR1, PGR and NAT1 in post-treatment samples and upregulation of EGFR, MYC, SFRP1, and FOXC1. PAM50 analysis on 83% of patients showed a prevalence of luminal A subtype, both in pre-treatment (63.6%) and post-treatment tumors (54.5%). Sunitinib plus exemestane was associated with substantial yet reversible toxicities, providing safety, efficacy and biological impact insights of combining an antiangiogenic drug with hormone therapy in early-stage breast cancer. Trial registration: Registered with ClinicalTrials.gov, NCT00931450. 02/07/2009

Abstract Genes of the Sprouty family (Spry1-4) are feedback inhibitors of receptor tyrosine kinases, especially of Ret and the FGF receptors. As such, they play distinct and overlapping roles in embryo morphogenesis and are considered to be tumor suppressors in adult life. Genetic experiments in mice have defined in great detail the role of these genes during embryonic development, however their function in adult mice is less clearly established. Here we generate adult-onset, whole body Spry1/2/4 triple knockout mice. Tumor incidence in triple mutant mice is comparable to that of wild type littermates of up to one year of age, indicating that Sprouty loss per se is not sufficient to initiate tumorigenesis. On the other hand, triple knockout mice do not gain weight as they age, show less visceral fat, and have lower plasma glucose levels than wild type littermates, despite showing similar food intake and slightly reduced motor function. They also show alopecia, eyelid inflammation, and mild hyperthyroidism. Finally, triple knockout mice present phosphaturia and hypophosphatemia, suggesting exacerbated signaling downstream of FGF23. In conclusion, triple knockout mice develop a series of endocrine abnormalities but do not show increased tumor incidence.

Abstract Background Myths of sexual aggression have a negative influence in aggressive behavior against women, in the institutional approaches to sexual violence and in how women cope with it. The objective of this study is to describe acceptance of myths of sexual aggression in young women and men residing in Spain. Method Cross-sectional study carried out online with 2,515 women (50.2%) and men (49.8%) ages 18–35 in Spain in 2020. Information on myths was collected using the Acceptance of Modern Myths About Sexual Aggression Scale (AMMSA). We described the myths most prevalent among women and men. The variables associated with myths were identified using multiple regression. The regression models were adjusted by sociodemographic and sexual orientation variables. Results The average AMMSA values were higher among men [mean: 3.11; standard deviation (sd):1.23] than among women (mean 2.49 sd:1.11). In both sexes, the myths with greater acceptance showed the presence of patriarchal gender roles in sexual contacts. Men were more likely than women to accept myths that question allegations and severity of violence. Having a higher level of educational studies (β -0.350 sd: 0.046) was associated with lower average AMMSA values. Being born in Latin America (β 0.047 sd: 0.063) was associated with higher average AMMSA values. Among heterosexual men, AMMSA values were greater than among gay and bisexual men. Among women, there was no difference in average AMMSA values based on sexual orientation. Conclusions Myths persist during youth that question and trivialize sexual violence against women. It is necessary to implement strategies that reduce these myths, particularly in heterosexual men, in those of foreign-born origin and among those with low levels of education.

Abstract Objective To evaluate the safety of a minimum continuous positive airway pressure of 4 cmH2O (CPAP + 4) during computed tomography (CT)-guided radiofrequency ablation (RFA) for lung malignancies under procedural sedation and analgesia (PSA). Methods This was a prospective, randomised, single-blind, parallel-group, placebo-controlled trial with an open-label medical device conducted at a single tertiary university hospital in Barcelona, Spain. Forty-six patients over 18 years of age scheduled for CT-guided RFA of a malignant pulmonary tumour under PSA were randomised to receive either CPAP + 4 or a modified mask for placebo CPAP (Sham-CPAP). Exclusion criteria included contraindications for RFA, refusal to participate, inability to understand the procedure or tolerate the CPAP test, lung biopsy just prior to RFA, intercurrent diseases, or previous randomisation for additional pulmonary RFA. Primary outcomes were the percentage of patients reporting at least one serious adverse event (SAE), classification for complications from the Cardiovascular and Interventional Radiological Society of Europe (CIRSE), and Clavien-Dindo classifications for complications, hospital stay, and readmissions. Secondary outcomes included adverse events (AEs), respiratory parameters, airway management, and the local radiological efficacy of pulmonary ablation. Results CPAP + 4 prolonged hospital stay (1.5 ± 1.1 vs. 1.0 ± 0 inpatient nights, p = 0.022) and increased the risk of AE post-RFA (odds ratio (95% CI): 4.250 (1.234 to 14.637), p = 0.021 with more pneumothorax cases (n = 5/22, 22.7% vs. n = 0/24, 0%, p = 0.019). Per-protocol analysis revealed more SAEs and CIRSE grade 3 complications in the CPAP + 4 group (23.5% vs. 0%, p = 0.036). No significant differences were found in the effectiveness of oxygenation, ventilation, or pulmonary ablation. Conclusion CPAP is unsafe during CT-guided RFA for lung cancer under PSA even at the lowest pressure setting. Trial registration ClinicalTrials.Gov, ClinicalTrials.gov ID NCT02117908, Registered 11 April 2014, https://www.clinicaltrials.gov/study/NCT02117908 Critical relevance statement This study highlights the hazards of continuous positive airway pressure during radiofrequency ablation of lung cancer, even at minimal pressures, deeming it unsafe under procedural sedation and analgesia in pulmonary interventional procedures. Findings provide crucial insights to prioritise patient safety. Key Points No prior randomised controlled trials on CPAP safety in percutaneous lung thermo-ablation. Standardised outcome measures are crucial for radiology research. CPAP during lung RFA raises hospital stay and the risk of complications. CPAP is unsafe during CT-guided RFA of lung cancer under procedural sedoanalgesia. Graphical Abstract

ABSTRACT The expansion of sugarcane, a tropical high‐yielding feedstock, will likely reshape the Southeastern United States (SE US) bioenergy landscape. However, the sustainability of sugarcane, particularly as it displaces grazed pastures, is highly uncertain. Here, we investigated how pasture conversion to sugarcane in subtropical Florida impacts net ecosystem CO2 exchange (NEE) and net ecosystem carbon (C) balance (NECB). Measurements were made over three full growth cycles (> 3 years) in sugarcane—plant cane, PC; first ratoon cane, FRC; second ratoon cane, SRC—and in improved (IM) and semi‐native (SN) pastures, which make up ca. 37% of agricultural land in the region. Immediately following conversion, PC was a stronger net source of CO2 than pastures, indicating the importance of CO2 losses related to land disturbance. Sugarcane, however, shifted to a strong net sink of CO2 after first regrowth, and overall sugarcane was a stronger net CO2 sink than pastures. Both stand age and low water availability during cane emergence and tillering substantially decreased its potential gross CO2 uptake. Accounting for all C gains and removals (i.e., NECB), greater frequency of burn events and repeated harvest increased removals and overall made sugarcane a stronger C source relative to pastures despite substantial C inputs from the previous land use and a stronger CO2 sink strength. Time since conversion substantially reduced C losses from sugarcane, and the NECB of SRC was similar to that of IM pasture but lower than that of SN pasture, indicating a rapid shift in the NECB of cane. We conclude that the C‐balance implications following conversion will depend on the proportion of IM versus SN pastures converted to sugarcane. Furthermore, our findings suggest that no‐burn harvest management strategies will be critical to the development of a sustainable bioenergy landscape in SE US.

Over the last few years, percutaneous procedures have undergone great advances, thanks to the ultrasound (US) guidance, due to the technical improvements in the US field, combined with the greater availability, good portability, and reduced cost of US devices. The direct target visualization and the real-time imaging performance enabled by US-guidance account for an improved accuracy in needle placement in several rheumatology interventions. So, ultrasound-guided procedures contribute to several diagnostic or therapeutic procedures such as fluid aspiration or treatment instillations of common joints, tendons, and bursas. In clinical practice, this fact is especially important in the case of depth areas like the hip, small anatomical structures as tendon sheaths or nerves in tenosynovitis or nervous blocks, or complex anatomical structures like the spine’s facet joints. The US-guide is an essential tool for performing diagnostic procedures as synovial biopsy. US can also be combined with other imaging techniques, like the establishment portal arthroscopy for instance. Compared to older blind procedures, US-guided injections are more accurate and safer, and they result in better clinical outcomes in terms of joints improvement in function and decreased risk of damages caused by needle misplacement. With the ultrasound guided treatment, we can avoid the instillation of therapeutic products outside the predetermined target, which may be sometimes potentially harmful. The aim of this article is to describe the main generalities of ultrasound-guided procedures in rheumatology, their main advantages and disadvantages, and their particularities in joints where they are most frequently used, such as the shoulder, hip, and knee.

The Pliocene faunas of the northeastern Iberian Peninsula are poorly known due to the scarcity of deposits from this interval. In this context, the site of Sant Nofre-Campredó (Baix Ebre, Catalonia, Spain), comprising two contemporaneous outcrops belonging to geologically correlated sections (Sant Nofre and Campredó-Via Fèrria), makes a significant contribution to the study of Pliocene faunas in this region. The first vertebrate remains were recovered in the late 1970s in clay deposits close to the Sant Nofre Hill. Later, intensive sampling in the 1980s at the Campredó-Via Fèrria outcrop led to the recovery of more than a hundred fossil specimens, including small vertebrates and large mammals. Here, we revise these collections to expand and update the vertebrate list, better constrain the age of the continental deposits, and characterize the environment and climate around the mouth of the Ebro River during the formation of the site. Up to 24 vertebrate species have been identified at Sant Nofre-Campredó, including amphibians, reptiles, and mammals. The presence of the rodents Paraethomys baeticus Piñero & Verzi, 2020, Apocricetus barrierei (Mein & Michaux 1970), and Occitanomys brailloni Michaux, 1969 implies an early Ruscinian age (MN14 unit) for the two outcrops. Biostratigraphic correlations with other well-dated sites in the Iberian Peninsula refine the estimated age of Sant Nofre-Campredó to approximately 4.6 Ma. The ecological affinities of the identified fauna reveal a landscape dominated by woodland habitats in the surroundings of the site during the Early Pliocene, with presence of open humid meadows and water bodies under warm and moist climatic conditions.

Societal Impact Statement Transformative agricultural strategies like agrivoltaics (AV) are essential for addressing the pressing global issues of sustainable energy and food production in a changing climate. Conservation‐agrivoltaics (Conservation‐AV) provides the potential to meet these needs while reinforcing natural resources and protecting the environment. It could enhance the ecological benefits of AV by improving soil health and biodiversity. It could create economic opportunities for farmers and increase the resilience and diversity of food crops under changing climate conditions. Furthermore, it could inform stakeholders about the benefits and challenges of implementing conservation agriculture management practices (CAMP) in AV and encourage further exploration and adoption of this innovative approach. Summary Transformative strategies in agriculture are needed to address urgent global challenges related to energy and food production while reinforcing natural resources and the environment. Agrivoltaics (AV) has emerged in the past decade as one solution to this fundamental challenge of improving energy and food security. AV is defined as the co‐location of solar photovoltaic (PV) panels and crops on the same land to optimize food and energy production simultaneously and sustainably. Here, we propose that AV, together with conservation agriculture management practices (CAMP) strategies can help to intensify food security and energy production while reinforcing natural resources and the environment. Our main assertions in this opinion article are that: (1) AV systems need to overcome several agronomical, environmental, and ecological challenges to intensify food and energy production sustainably; (2) CAMP applied to AV systems can preserve the environment and ensure climate‐resilient food production; (3) implementation of CAMP in AV can lead to long‐term carbon sequestration, lower greenhouse gas emissions, and maintain or increase crop yields while preserving soil health and biodiversity; and (4) adoption of CAMP in AV can bring economic benefits, although challenges need to be overcome. This opinion article proposes a new ecosystem approach to integrate renewable energy and sustainable food production and encourages research on the effects of CAMP on AV systems.

Background: Recurrent urinary tract infection (rUTI) remains a major health burden for women. A randomized, double-blind, placebo-controlled trial (RCT; NCT02543827) reported that female patients with rUTI receiving a sublingual vaccine, MV140, had a reduction in rUTI and increase in UTI-free rate compared with placebo. Objective: To determine the impact of MV140 on the personal burden of disease in women with rUTI using secondary endpoint data from the pivotal RCT evaluating MV140. Design, setting, and participants: In the primary RCT, female patients with rUTI enrolled in Spain and UK (from October 2015 to April 2019) were randomized to placebo (6 mo) or MV140 (3 or 6 mo), and followed for 12 mo. Individuals analyzed in this secondary analysis included those in the placebo and 3-mo (recommended dose) groups. Intervention: A polybacterial sublingual vaccine, MV140 (four inactivated whole-cell bacteria—Escherichia coli, Klebsiella pneumoniae, Proteus vulgaris, and Enterococcus faecalis), or placebo. Outcome measurements and statistical analysis: Symptom severity scoring, antibiotic use, safety, and multiple aspects of quality of life (QoL; Short-Form Questionnaire [SF-36]) were assessed. Results and limitations: Compared with the placebo group (n = 76), the 3-mo vaccinated group (n = 74) experienced fewer overall UTI symptoms (mean symptom score 102.2 ± 222.9 vs 194.2 ± 178.8; p = 0.0002), fewer days on antibiotics (12.4 ± 17.7 vs 28.7 ± 25.2; p = 0.0001), and improved total, general, and physical SF-36 QoL improvement (differences in means for total SF-36 score 15.7; 95% confidence interval [CI] 8.80, 22.64; p

En el artículo se propone una estrategia para la capacitación de los tutores de la práctica pedagógica en el adiestramiento laboral en el Instituto Superior de Ciencias de la Educación (ISCED) en la provincia Huambo-Angola, que responde a las insuficiencias detectadas durante el adiestramiento laboral de los estudiantes de quinto año de la carrera Matemática. A través de la aplicación de métodos empíricos se logró identificar que una de los causales fundamentales que propician estas insuficiencias está dada por la falta de preparación de los profesores que asumen el rol de tutores durante esta etapa para orientar, acompañar y evaluar a los estudiantes en formación. La propuesta fue sometida al criterio de expertos y fue valorada de pertinente y factible, lo que permite a estos estudiantes apropiarse de los conocimientos y las habilidades necesarias para enfrentar esta labor en el nuevo contexto en que se desarrolla la Educación en Angola.

Abstract Interpreting chest X-rays is a complex task, and artificial intelligence algorithms for this purpose are currently being developed. It is important to perform external validations of these algorithms in order to implement them. This study therefore aims to externally validate an AI algorithm’s diagnoses in real clinical practice, comparing them to a radiologist’s diagnoses. The aim is also to identify diagnoses the algorithm may not have been trained for. A prospective observational study for the external validation of the AI algorithm in a region of Catalonia, comparing the AI algorithm’s diagnosis with that of the reference radiologist, considered the gold standard. The external validation was performed with a sample of 278 images and reports, 51.8% of which showed no radiological abnormalities according to the radiologist's report. Analysing the validity of the AI algorithm, the average accuracy was 0.95 (95% CI 0.92; 0.98), the sensitivity was 0.48 (95% CI 0.30; 0.66) and the specificity was 0.98 (95% CI 0.97; 0.99). The conditions where the algorithm was most sensitive were external, upper abdominal and cardiac and/or valvular implants. On the other hand, the conditions where the algorithm was less sensitive were in the mediastinum, vessels and bone. The algorithm has been validated in the primary care setting and has proven to be useful when identifying images with or without conditions. However, in order to be a valuable tool to help and support experts, it requires additional real-world training to enhance its diagnostic capabilities for some of the conditions analysed. Our study emphasizes the need for continuous improvement to ensure the algorithm’s effectiveness in primary care.

Abstract BackgroundOfficial conference hashtags are commonly used to promote tweeting and social media engagement. The reach and impact of introducing a new hashtag during an oncology conference have yet to be studied. The American Society of Clinical Oncology (ASCO) conducts an annual global meeting, which was entirely virtual due to the COVID-19 pandemic in 2020 and 2021. ObjectiveThis study aimed to assess the reach and impact (in the form of vertices and edges generated) and X (formerly Twitter) activity of the new hashtags #goASCO20 and #goASCO21 in the ASCO 2020 and 2021 virtual conferences. MethodsNew hashtags (#goASCO20 and #goASCO21) were created for the ASCO virtual conferences in 2020 and 2021 to help focus gynecologic oncology discussion at the ASCO meetings. Data were retrieved using these hashtags (#goASCO20 for 2020 and #goASCO21 for 2021). A social network analysis was performed using the NodeXL software application. ResultsThe hashtags #goASCO20 and #goASCO21 had similar impacts on the social network. Analysis of the reach and impact of the individual hashtags found #goASCO20 to have 150 vertices and 2519 total edges and #goASCO20 to have 174 vertices and 2062 total edges. Mentions and tweets between 2020 and 2021 were also similar. The circles representing different users were spatially arranged in a more balanced way in 2021. Tweets using the #goASCO21 hashtag received significantly more responses than tweets using #goASCO20 (75 times in 2020 vs 360 times in 2021; zP ConclusionsIntroducing a gynecologic oncology specialty–specific hashtag (#goASCO20 and #goASCO21) that is related but different from the official conference hashtag (#ASCO20 and #ASCO21) helped facilitate discussion on topics of interest to gynecologic oncologists during a virtual pan-oncology meeting. This impact was visible in the social network analysis.

In the complex landscape of energy transition, Cultural Heritage emerges as a fundamental pillar of ‘innovability’, suggesting a lesson from the past. Historically, technical culture has been able to adapt building wisdom to available energy resources, demonstrating surprising resilience and an innate propensity for innovation. The energy adaptation associated with conserving this heritage must preserve the Mediterranean identity this essay aims to address; traditional technologies are still relevant today, while modern energy technologies require harmonious integration. This symbiosis between past and present is of crucial practical and symbolic importance: reconnecting with our cultural roots in moving towards a more sustainable future ensures a painless path to energy efficiency. Article info Received: 05/05/2024; Revised: 12/05/2024; Accepted: 20/05/2024

BackgroundPolymerized allergoids conjugated with mannan represent a novel approach of allergen immunotherapy targeting dendritic cells. In this study, we aimed to determine the optimal dose of mannan-allergoid conjugates derived from grass pollen (Phleum pratense and Dactylis glomerata) administered via either the subcutaneous or sublingual route.MethodsA randomized, double-blind, placebo-controlled trial with a double-dummy design was conducted, involving 162 participants across 12 centers in Spain. Subjects were randomly allocated to one of nine different treatment groups, each receiving either placebo or active treatment at doses of 500, 1,000, 3,000, or 5,000 mTU/mL over four months. Each participant received five subcutaneous (SC) doses of 0.5 mL each, every 30 days, and a daily sublingual (SL) dose of 0.2 mL. Participants who received active treatment through SC, received placebo through SL. Participants who received active treatment through SL, received placebo SC. One Group, as control, received bot SC and SL placebo. The primary efficacy outcome was the improvement in titrated nasal provocation tests (NPT) at the end of the study compared to baseline. Secondary outcomes included specific antibody (IgG4, IgE) and cellular (IL-10 producing and regulatory T cell) responses. All adverse events and side reactions were recorded and assessed.ResultsPost-treatment, the active groups showed improvements in NPT ranging from 33% to 53%, with the highest doses showing the greatest improvements regardless of the administration route. In comparison, the placebo group showed a 12% improvement. Significant differences over placebo were observed at doses of 3,000 mTU/mL (p=0.049 for SL, p=0.015 for SC) and 5,000 mTU/mL (p=0.011 for SL, p=0.015 for SC). A dose-dependent increase in IgG4 was observed following SC administration, and an increase in IL-10 producing cells for both routes of administration. No serious systemic or local adverse reactions were recorded, and no adrenaline was required.ConclusionGrass pollen immunotherapy with mannan-allergoid conjugates was found to be safe and efficacious in achieving the primary outcome, whether administered via the subcutaneous or sublingual routes, at doses of 3,000 and 5,000 mTU/mL.Clinical trial registrationhttps://www.clinicaltrialsregister.eu/ctr-search (EudraCT), identifier 2014–005471–88; https://www.clinicaltrials.gov, identifier NCT02654223.

La Legionella es la bacteria causante de la legionelosis y constituye un notable problema de salud pública. El objetivo de este estudio es establecer la distribución y frecuencia de las diferentes especies y serogrupos de Legionella obtenidos de las muestras analizadas en el Laboratorio de Salud Pública de L’Hospitalet durante el período 2002-2019. Se analizaron 3 935 muestras de agua procedentes de instalaciones con probabilidad de proliferación y dispersión de Legionella mediante el método ISO 11731:1998. Se determinaron número y porcentaje de Legionella spp., L. pneumophila serogrupo Sg 1 y L. pneumophila Sg 2-14 por tipo de instalación y por año. Los resultados indican que las instalaciones con mayor presencia de Legionella son las que incluyen sistemas de agua caliente sanitaria (ACS), (36,4 %). Los sistemas de agua fría sanitaria (AFS) también han de ser considerados lugares propicios para el crecimiento de Legionella (17 %), junto con los sistemas de riego por aspersión (13,5 %). De la totalidad de las muestras positivas halladas en las instalaciones (21,5 %), L. pneumophila es la más aislada en cultivos (70,5 %) y el serogrupo más frecuentemente encontrado es el 2-14 (34,2 %), seguido del Sg 1 (26,4 %). Esto es contrario a lo encontrado en la mayoría de estudios publicados, ya que citan al Sg 1 como el más frecuente en muestras ambientales. Estos aspectos avalarían la necesidad de ampliar el espectro de diagnóstico de la enfermedad en pacientes ya que la mayoría de hospitales utilizan antígeno en orina, cuya principal limitación es que solo detecta L. pneumophila Sg 1.

The objective has been to develop and validate a questionnaire to know patient experience in relation to nursing care during their hospital stay in the Spanish healthcare setting. To know patient experience will improve the quality of care of the healthcare system; therefore, we must count on validated tools so it can be evaluated in an accurate way. Method: a questionnaire containing 29 items alongside socio-demographic questions was developed. It was distributed to 158 patients admitted to a tertiary hospital. The psychometric properties were assessed through principal components analysis and confirmatory factor analysis to evaluate construct validity, employing Cronbach’s alpha to test reliability. Results: The final tool contains 17 items grouped into 5 dimensions: interrelations, nursing care, information during hospital stay, information about patient’s rights, and discharge information. Two additional questions related to pain were added. The questionnaire showed adequate validity and reliability. Conclusions: we describe a new tool validated and adapted to the Spanish healthcare setting with adequate validity and reliability to assess patient experience with nursing professionals during hospital stay. This tool will serve to identify areas for improvement in hospital nursing care and as an instrument in the management and supervision of nursing teams.

Abstract Background Porcine circovirus 2 (PCV-2) poses a significant economic threat for the swine industry, causing a range of diseases collectively referred to as porcine circovirus diseases (PCVDs). Despite PCV-2 vaccine effectiveness, the need for monitoring infectious pressure remains. PCV-2 coinfection with other pathogens like porcine reproductive and respiratory syndrome virus (PRRSV) can exacerbate disease severity and lead to PCV-2-systemic disease cases. Monitoring both PRRSV and PCV-2 in co-infected farms is crucial for an effective management and vaccination programs. The present cross-sectional study aimed to determine PCV-2 antibody levels in piglets at weaning and PCV-2 and PRRSV viremia in pooled serum samples at weaning (vaccination age) and at 6 and 9 weeks of age from a Spanish swine integration system in 2020 (48 farms) and in 2022 (28 out of the 48 analysed previously). Results The frequency of PCV-2 detection in pools of piglet sera was 2.1% (2020) and 7.1% (2022) at vaccination age but increased at the end of the nursery period (10.4% in 2020 and 39.3% in 2022) in both years. Co-infections between PCV-2 and PRRSV were detected in a significant proportion of PRRSV positive farms (15% in 2020, and 60% in 2022). PCV-2 antibody levels (ELISA S/P ratios) at weaning were lower in PCV-2 qPCR positive farms at different sampling time-points (0.361 in 2020 and 0.378 in 2022) compared to PCV-2 qPCR negative ones (0.587 in 2020 and 0.541 in 2022). The 28 farms tested both years were classified in four different epidemiological scenarios depending on their PCV-2 virological status. Those PCV-2 qPCR negative farms in 2020 that turned to be positive in 2022 had a statistically significant increase of PRRSV RT-qPCR detection and a PCV-2 antibody levels reduction, facts that were not observed in the rest of the scenarios. Conclusion This epidemiological study in farms from the same integration system determined the occurrence, in 2020 and in 2022, of PCV-2 and PRRSV infections in piglets during the nursery period by using pooled serum samples.

Con el objetivo de estudiar la composición fenológica y química de 6 variedades de caña de azúcar para ser utilizadas en la alimentación animal se realizó un experimento en áreas del banco de semilla básica ubicado en el batey Espartaco en la provincia de Cienfuegos sobre un suelo Pardo con carbonato (cambisol eutrico), Se utilizó un diseño experimental de bloques al azar, con un modelo de clasificación simple. Cada variedad ocupó un área de 64 m2 (4 surcos de 10 m), en la cepa caña planta, con edades entre 12 y 14 meses de edad, se tomaron tres muestras al azar (réplicas) de cada variedad. Se calcularon los valores de las variables morfológicas peso fresco del tallo, cogollo y hojas secas por la metodología de Molina y Tuero. Para el estudio de la composición química se estudiaron las variables digestibilidad de la materia seca, contenido de fibra ácida detergente, lignina, proteína bruta. Se realizaron análisis de varianza y comparación de medias por la prueba de comparación múltiple de Newman Keuls con las variables fenológicas y químicas. Se confeccionó análisis de conglomerados con las variables, digestibilidad, fibra ácida detergente y lignina. Como resultado se encontraron diferencias significativas en la composición fenológica y química en las variedades estudiadas, el análisis de conglomerados definió 3 grupos lo que permitió recomendar los cultivares C05-307, C05-568, C08-386, para la alimentación animal.

Abstract Sustainable agricultural intensification could improve ecosystem service multifunctionality, yet empirical evidence remains tenuous, especially regarding consequences for spatially coupled ecosystems connected by flows across ecosystem boundaries (i.e., metaecosystems). Here we aim to understand the effects of land-use intensification on multiple ecosystem services of spatially connected grasslands and wetlands, where management practices were applied to grasslands but not directly imposed to wetlands. We synthesize long-term datasets encompassing 53 physical, chemical, and biological indicators, comprising >11,000 field measurements. Our results reveal that intensification promotes high-quality forage and livestock production in both grasslands and wetlands, but at the expense of water quality regulation, methane mitigation, non-native species invasion resistance, and biodiversity. Land-use intensification weakens relationships among ecosystem services. The effects on grasslands cascade to alter multifunctionality of embedded natural wetlands within the metaecosystems to a similar extent. These results highlight the importance of considering spatial flows of resources and organisms when studying land-use intensification effects on metaecosystems as well as when designing grassland and wetland management practices to improve landscape multifunctionality.

The major factors affecting the in vitro immature embryo rescue efficiencies from Prunus persica or P. armeniaca accessions have been identified, along with improving the feasibility. Variations in the woody plant medium (WPM) were used depending on the embryo size. Embryos less than 5 mm long were cultured in WPM supplemented with 1 μM BAP and 1 μM GA3, while embryos bigger than 5 mm long were cultured in hormone-free medium, with or without vermiculite. The environmental in vitro culture conditions consisted of three phases: a (I) stratification at 4 °C during a 3- to 5-month-long period in the dark, followed by (II) growth of germinated embryos at 14 °C for a 4-week-long period, with 12 h light a day, which favors plantlet development, and finally, (III) growth at 24 °C, with 16 h light a day, until the plantlets were acclimatized in the greenhouse. The germination of smaller embryos, at the end of phase I, ranged from 82.2% to 22.1% for apricots and flat peaches, respectively, whereas for bigger embryos, the germination varied from 97.3% to 53.2% for the same species. The embryo germination for peaches and nectarines ranged from 40.1% to 30.3% for smaller embryos, and from 91.9% to 63.0% for bigger embryos. Endo- and epiphytic contamination, affecting from 7.4% to 52.9% of cultured embryos, depending on the fruit type and conservation conditions, and the capacity to acclimate to soil conditions, ranging from 50.4% to 93.2%, were the two most important factors influencing the protocol’s efficiency and feasibility. Considering the overall efficiencies, expressed as hardened plants transferred to field plots over clean uncontaminated embryo, the values ranged from 55.8% for nectarines, 54.0% for peaches, 45.6% for apricots, and 23.3% for flat fruits. The addition of vermiculite to the culture medium significantly improved the plantlet development, avoiding subculture to fresh medium when an extension of phase III was required before acclimatization. Compared to laboratory glassware, the use of food glass containers with air-permeable sealing film, along with vermiculite-containing medium, significantly reduced the costs when handling the large number of embryos required for breeding programs.

Introduction Schizophrenia is associated with a reduced life expectancy, not only because of suicide, but also medical causes such as cancer. Standardized mortality for cancer is higher in patients with schizophrenia, specially for lung, breast and colorectal locations (Ni et al, 2019). Other less frequent tumor locations have not been deeply studied. Thir mortality gap could be related to a delayed diagnosis due to several reasons, such as lower inclusion in screening programs (Solmi et al, 2019). Since cervical cancer has a very efficient screening technique, women with schizophrenia and cervical cancer could have a worse prognosis because of a delayed diagnosis. However, there is a lack of research in this tumor location. Objectives To analyze clinical differences in women with cervical cancer with and without a diagnosis of schizophrenia. Methods We carried out a retrospective cohort analysis with adult patients from the cancer registry of Hospital del Mar diagnosed between 1997 and 2021. The information was crossed with the Minimum Basic Data Set (MBDS) to identify those cancer patients with a diagnosis of schizophrenia using International Classification of Diseases (ICD) 9 codes 295*. The sociodemographic variables were age and sex. The clinical oncological variables included tumor location, place of first conultation, stage, first treatment intention, vital status and place of decease. We used t-student for continuous data and Chi-squared test for categorical variables. We performed a post-hoc analysis using Bonferroni correction for multiple comparisons to identify specifically which categories were significantly different between groups. Results We identified 13 women with schizophrenia and cervical cancer, and 1354 women with cervical cancer without schizophrenia. The proportion of this location was higher in the schizophrenia group (8% of all cancers vs. 4.4%; p=0.03). The proportion of diagnoses through screening programm was significantly lower (7.7% vs 14.6%; p=0.04). There was a trend of fewer diagnoses in situ in patients with schizophrenia (30.8% vs 55.6%) and less radical intention as first treatment option (15.4% vs 3.5%) but without statistical significance in both cases. There was a higher proportion of deceased patients in the group with schizophrenia (46.2% vs 15% p=0.002), and also a higher proportion of deaths outside hospital facilities (30.8% vs 6.6%; p=0.003). Image: Conclusions Women with schizophrenia receive less diagnoses of cervical cancer through screening programs and more in emergency facilities, which could lead to more advanced stages and fewer indication of radical treatments. This ultimately leads to a higher proportion of deaths, and more frequently outside of hospital facilities. Our data supports the idea that the increased mortality for cancer is related to a delayed diagnosis. Women with schizophrenia need special care to ensure their inclusion in early detection programs for cancer. Disclosure of Interest None Declared

Introduction Women experiencing severe perinatal mental health problems require specialized services and care. Perinatal mental disorders are common and can contribute to maternal mortality, affecting neonatal, infant, and child outcomes. Home treatment can prevent hospital admissions and promote strategies within the patient’s support network. Objectives Our aim is to describe a clinical case in perinatal psychiatry managed by a Psychiatric Home Treatment Unit. Methods We present a case of perinatal psychotic depression in a 26-year-old pregnant woman. Results We describe the case of a patient with no prior history of mental health issues. She was 25 weeks pregnant when she first sought psychiatric help in July 2023 and was diagnosed with depressive disorder with psychotic symptoms. She reported symptoms such as low mood, psychomotor inhibition, delusional guilt thoughts, and auditory hallucinations beginning three weeks before her initial visit. Due to her clinical presentation, the patient was admitted to the hospital, where pharmacological treatment was initiated with Olanzapine 5 mg, Sertraline 50 mg, and Lorazepam 1.5 mg. She remained in the hospital for four days, during which she showed gradual improvement but did not achieve full recovery. Considering the improvement observed, home treatment was proposed and accepted by the patient and her relatives. During home treatment, she continued to exhibit persistent depressive and psychotic symptoms, including low mood, inhibition, and delusional thoughts of ruin and catastrophe. Therefore, her treatment was adjusted, with Olanzapine increased to 10 mg, Sertraline raised to 100 mg, and Lorazepam reduced to 0.75 mg. Over time, significant improvement in her clinical symptoms was noted. Throughout the follow-up period, she reported no significant side effects from the pharmacological treatment. After a month of follow-up in our department, she was discharged with outpatient care provided by a specialized community perinatal psychiatric unit. Conclusions We illustrate the possibility of home treatment for perinatal psychiatric disorders. The potential benefits of remaining close to one’s support network and developing coping strategies can be advantageous during the course of illness. Further studies should be conducted to explore these potential benefits. Disclosure of Interest None Declared

Introduction Due to the global humanitarian crisis, there has been a significant increase in global immigration.(1) The migration process typically involves multiple trauma exposures that are sustained over time(2), which may result in an impact on the mental health of these individuals(3), such as posttraumatic stress disorder(3). A recent meta-analysis estimated that 25% of migrants had PTSD(15), which is significantly higher than the 0.2% to 3.8 percent prevalence data found for the general population(4). In addition, a number of meta-analyses indicate an increased risk of psychosis among immigrants(5). Despite this rise, there is a gap in trauma research in non-refugee immigrants, particularly those with psychotic disorders. Objectives To describe and compare PTSD diagnosis between immigrants and locals recruited from mental health services in Barcelona. Methods Patients who have presented, according to DSM-V criteria, one or more non-affective psychotic episodes, were recruited in Acute and Chronic inpatients units at Hospital del Mar (Barcelona) from November 2019 to June 2021, leading to a total sample of 199 patients. Demographic characteristics of patients, clinical data and main pharmacological treatment were recorded through a questionnaire. Database information was completed with electronic medical records. Global Assessment of Posttraumatic Stress Questionnaire (EGEP-5) was used as an instrument to assess PTSD diagnosis, main trauma nature and PTSD symptoms. Comparative analysis was performed with IBM SPSS Statistics (Chicago INC) using Chi-Square Test for qualitative variables and t-Student test for continuous variables. Covariate adjustment with demographic and clinical variables was performed by ANOVA test. Study received local ethics committee approval “CEIC” (No. 2019/8398/I). Results From the total sample of 199 individuals, 98 were immigrants and 98 locals. From the total sample 39 individuals (19.69%) presented PTSD. 32.3% of the immigrants with psychotic disorders presented PTSD compared to 7.1% of the locals with psychotic disorders (F1=19.9, p=0.00). Most traumatic events related to PTSD in immigrants were: “murder of relatives” (33.1%), Physical violence (21.9%) and Terrorism (15.6%) in locals were: “physical violence” (28.6%). Immigrants and locals with psychotic disorders showed similar averages of symptoms, except for avoidance symptoms where locals showed a mean of 5.1 compared to a mean of 3.5 in the immigrant group. Finally, immigrants showed one more functionality affected area by PTSD (5.1) when compared to locals (4) (F7=3.9, p=0.05). Conclusions According to our results there are important differences in PTSD prevalence between immigrants and locals with psychotic disorders. These findings ought to be taken into consideration for programs that are both clinically and sociopolitically tailored to improve assessment and treatment for this population. Disclosure of Interest None Declared

Introduction In recent years, a global debate has emerged regarding the protection of Internet users from exposure to harmful content. Content moderation is defined as the organized practice of filtering user-generated content posted on internet, social networks, and media to determine the appropriateness of the content for a site, locality, or jurisdiction. The growing volume of this content along with the psychological impact of this activity have promoted the application of automated approaches based on artificial intelligence and machine-learning. However, the changing characteristics of content, as well as the cultural differences that influence its appropriateness, mean that human moderation of Internet content currently continues to exist. Psychological effects of this activity such as symptoms of post-traumatic stress disorder (PTSD) could represent an example of secondary trauma. Objectives Our aim is to describe a clinical case of post-traumatic stress disorder presenting with specific traumatic exposure idiosyncrasy that could lead to a better consequence characterization of a recent social phenomena such as internet content moderation. Methods We expose the clinical case of a woman with emotional distress who was reffered to our outpatient psychiatric unit in Barcelona in 2022 after five years working as an internet content moderator. Results We describe the case of a 35-year-old woman without relevant medical, toxicologic or psychiatric record that presents to our out-patient psychiatric clinic with post-traumatic stress disorder after five years of working as an internet content moderator and being exposed to visual traumatic content such as sexual assault and paedophilia. The clinical presentation consisted with one year of recurrent daily panic attacks, intrusive images about the traumatic exposure, intrusive thoughts, insomnia, vivid nightmares, avoidance of exposure to her son, distrust of the environment and intense fear for her son security. The disorder interfered in her capacity to work. The patient received psychological treatment and ISRS (Sertraline) was prescribed, however only partial response was reached with persistence of the majority of symptoms. Conclusions The presented case suggests a temporal and symptom content relationship between the described work exposure and the appearance of emotional distress in a patient without PTSD history. Although previous evidence of secondary trauma in people exposed to indirect traumatic experiences has been reported, for example in healthcare professionals, the exposure to alien trauma through digital exposure as a workactivity is yet to be specifically examined. It is necessary to expand knowledge on the clinical expression of this phenomenon due to the observed recurrence of anxious and depressive symptomatology related to repeated exposure to traumatic content. Disclosure of Interest None Declared

Resumen: Las facultades de medicina son los centros responsables del título de grado que habilita para el ejercicio de la profesión médica, regulada por la normativa europea y nacional. Su número ha pasado de 28 a 50 en los últimos 15 años, decisión que debería depender únicamente de criterios académicos y sanitarios.«Es necesario proporcionar a los futuros médicos la mejor formación científica, profesional y humana posible, para que sean capaces de solucionar los problemas de salud, en un itinerario coordinado y continuado que se inicia con el grado y la formación sanitaria especializada, seguida por un desarrollo profesional continuo» (Declaración de Málaga 2022, Estándares para la educación médica en el grado: pensando en el futuro, avalada por instituciones nacionales e internacionales).Tenemos que seguir trabajando de forma coordinada los responsables universitarios y sanitarios para estabilizar, promocionar y aumentar nuestro profesorado.Afrontamos retos, con deseos de mejorar, gracias a la dedicación de todas las personas que se forman y forman para cuidar la salud de los demás, con nuestro mayor agradecimiento. Abstract: The Schools of Medicine are the responsible centers for the Graduate Degree that qualifies for the practice of the medical profession, regulated by European and national legislation. Their number has increased from 28 to 50 in the last 15 years, a decision that should depend solely on academic and health criteria.“It is necessary to provide future physicians with the best possible scientific, professional and human training, so that they are capable of solving health problems, in a coordinated and continuous itinerary that begins with the degree and specialized health training, followed by continuous professional development” (Declaration of Malaga 2022. Standards for undergraduate medical education: thinking about the future, endorsed by national and international institutions).We need to continue working in a coordinated manner between university and healthcare leaders to stabilize, promote and increase our faculty.We face challenges, with the desire to improve, thanks to the dedication of all the people who are formed and form to care for the health of others, with our greatest gratitude.

Abstract BackgroundThe outbreak of COVID-19 has turned the care model of health systems around the world upside down. The health care crisis has led to opportunities for digital health to deliver quality care, and the system has been redirected toward telemedicine. In Catalonia, Spain, as of March 2020, the pattern of visits in primary care pediatric consultations changed, such that face-to-face visits decreased in favor of non–face-to-face visits. ObjectiveThis study aimed to analyze variations in the types of pediatric visits in primary care centers in Catalonia before and after the onset of COVID-19. MethodsThis was a descriptive observational study based on administrative data. The number and type of visits to primary care pediatric services in Catalonia between January 2019 and December 2022 were studied. ResultsA drop of more than 80% in face-to-face visits and an increase of up to 15 times in remote visits were observed as of March 2020 compared to the previous year. Subsequently, the face-to-face attendance rate began to recover, although it did not reach the same rate as before COVID-19. Non–face-to-face visits were maintained, representing more than 20% of the total after more than 2 years of the pandemic. ConclusionsCOVID-19 has been the trigger for a transition in the types of visits to primary care pediatric services. The COVID-19 pandemic was a clear catalyst for the integration of telemedicine in Catalan pediatric health care. In this context, although face-to-face consultations have recovered in absolute numbers, after the pandemic period, the weight of telemedicine has increased.

Abstract Aim The metabolic and psychological management of paediatric type 1 diabetes mellitus (T1DM) can be challenging over time given that T1DM may cause a negative emotional burden and, consequently, result in poor metabolic control of the disease. The objectives of this study are to translate the Problem Area in Diabetes Survey–Pediatric version (PAID‐Peds) into Spanish, adapt it culturally and validate it. Design Multicenter cross sectional study. Methods 636 patients aged 8–17 years, diagnosed with T1DM, under treatment with insulin and follow‐up at the Miguel Servet University Hospital in Zaragoza (Aragón, Spain), the Ramón y Cajal University Clinical Hospital in Madrid (Spain) and at the Sant Joan de Déu Hospital in Barcelona (Catalonia, Spain) between 1 January 2023 and 31 December 2024 will be included. This study will consist of two phases: (1) Translation and cultural adaptation of the original PAID‐Peds® survey into Spanish following eight steps; (2) Validation of the Spanish version of the PAIS‐Peds® survey. The statistical analysis will be performed using Jamovi® 2.1.23. The reliability or internal consistency will be calculated using Cronbach's alpha index (considering an index higher than 0.8 to be good) and the test–retest will be evaluated using the intraclass correlation coefficient. For validity, confirmatory factor analysis will be calculated. This study has been approved by the ethics and research committees at each centre. Results The translation and validation into Spanish language of the Problem Area in Diabetes Survey‐Pediatric version will be feasible, valid and reliable to detecting the youth‐perceived burden of T1DM. Therapeutic education in diabetes—recommended by the WHO and the Diabetes Education Study Group—has shown encouraging results in glycaemia and psychosocial and behavioural factors in T1DM.

BackgroundMore than half of women with psychosis take care of their children despite the difficulties caused by the disease. Additionally, these kids have a higher risk of developing a mental health disorder. However, no interventions have been developed to meet these needs. Metacognitive Training (MCT) is a psychological intervention that has demonstrated its efficacy in improving cognitive insight, symptom management and social cognition in people with first-episode psychosis (FEP). Additionally, MCT has shown better results in women than men with FEP. This study aims to adapt and evaluate the efficacy of MCT-F in mothers and adolescent children in an online group context with the main purpose of improving family relationships, cognitive awareness and symptoms in women with psychosis and increase their children’s knowledge of the disease and their functioning. As secondary objectives, it also aims to evaluate improvements in metacognition, social cognition, symptoms, protective factors and self-perception of stigma.Materials and methodsA quasi-experimental design with participants acting as their own control will be carried out. Forty-eight mothers with psychosis and their adolescent children (between 12 and 20 years old) recruited from a total of 11 adult mental health care centers will receive MCT-F. Participants will be evaluated 11 weeks before the intervention (T1), at baseline (T2), and post-intervention (T3) with a cognitive insight scale, as a primary outcome. Measures of metacognitive and social cognition, symptoms, cognitive functioning, family and social functioning, protective factors (self-esteem, resilience, and coping strategies) and self-perceived stigma will be addressed as secondary outcomes. Assessment will also address trauma and attachment in mothers and, lastly, the feasibility and acceptability of MCT-F in both participant groups.DiscussionThis will be the first investigation of the efficacy, acceptability, and viability of the implementation of MCT-F. The results of this study may have clinical implications, contributing to improving mothers’ with psychosis and adolescents’ functioning and better understanding of the disease, in addition to the possible protective and preventive effect in adolescents, who are known to be at higher risk of developing severe mental disorders.Clinical trial registration:https://clinicaltrials.gov/, identifier [NCT05358457].

Abstract Background Metabolic control and psychological management of paediatric type 1 diabetes mellitus (T1DM) can be challenging over time. Development of an instrument to assess the youth-reported burden could aid in preventing T1DM-associated diseases. Methods The aim of this study was to translate and validate the Spanish version of the Problem Area in Diabetes Survey–Pediatric version (PAID-Peds). A multicentre, cross-sectional translation and linguistic validation study was performed on a sample of 30 participants aged 8–17 years with a minimum 1-year history of T1DM diagnosed at the Miguel Servet University Hospital in Zaragoza (Aragon, Spain), Ramón y Cajal University Clinical Hospital in Madrid (Spain), and Sant Joan de Déu Hospital in Barcelona (Catalonia, Spain). The qualitative validation consisted of translation into Spanish and back-translation into English of the Paid-Peds survey and subsequent administration to the sample population. Data were gathered on parameters related to sociodemographic characteristics and metabolic control. Validity, feasibility, and test-retest reliability were evaluated. Internal consistency was determined using Cronbach’s alpha coefficient, test-retest reliability by means of interclass correlation, and paired samples using the Wilcoxon W-test. The study was approved by the ethics and research committees at each participating centre. Results The study assessed 30 children (46.7% female) with an average age of 13.33 ± 2.98 years; mean age at onset was 5.70 ± 3.62 years, and the mean disease duration was 7.63 ± 4.36 years. The mean score on the PAID-Peds survey was 42.88 ± 17.85. Cronbach’s alpha coefficient was 0.90. Test-retest reliability measured by interclass correlation coefficient was 0.8 (95% CI: 0.63–0.90). No significant differences in total scores were found between test and retest (Wilcoxon W-test: 289; p = 0.051). Conclusions The Spanish version of the PAID-Peds survey is a feasible, valid, and reliable instrument to assess the youth-perceived burden of T1DM.

Abstract Aotearoa New Zealand’s Northern region is a major gateway for the incursion and establishment of non-indigenous species (NIS) populations due to high numbers of recreational and commercial vessels. This region also holds a unique marine ecosystem, home to many taonga (treasured) species of cultural and economic importance. Regular surveillance, eradication plans and public information sharing are undertaken by local communities and governmental organizations to protect these ecosystems from the impact of NIS. Recently, considerable investments went into environmental DNA (eDNA) research, a promising approach for the early detection of NIS for complementing existing biosecurity systems. We applied eDNA metabarcoding for elucidating bioregional patterns of NIS distributions across a gradient from harbors (NIS hotspots) to open seas (spreading areas). Samples were collected during a research cruise sailing across three Aotearoa New Zealand harbors, Waitematā, Whangārei and Pēwhairangi (Bay of Islands), and their adjacent coastal waters. The small-ribosomal subunit (18S rRNA) and mitochondrial cytochrome c oxidase I (COI) genes were screened using the online Pest Alert Tool for automated detection of putative NIS sequences. Using a probabilistic modelling approach, location-dependent occupancies of NIS were investigated and related to the current information on species distribution from biosecurity surveillance programs. This study was collaboratively designed with Māori partners to initiate a model of co-governance within the existing science system.

When profit-driven renewal is difficult to implement, many historic districts in China become “frozen” under protection. In the recent social context of “building cities for the people”, public value-oriented renewal of urban historic areas has become crucial in city transformation. This study investigates strategies for historic district regeneration in China by integrating spatial form, urban governance, and public value. We propose a novel framework to analyze the regeneration of historic districts, using Taiyuan’s Bell Tower Street as a case study. The framework distinguishes between two dimensions: spatial and economic–social. In the spatial dimension, we focus on the transformation of spatial form to regenerate public value, emphasizing the attribute of “publicness” as central to urban regeneration efforts. This involves a tiered approach to excavating and upgrading historic districts at macro, meso, and micro levels. The economic–social dimension explores urban governance to enhance public value through collaboration between government, market, and societal actors. This study employs a mixed-methods approach, including document reviews, interviews, field observations, and statistical data analysis. The analysis highlights that a public value-oriented approach to heritage regeneration can balance historical preservation with contemporary urban needs, offering a sustainable model for other cities.

The reaction of Mn(II) salts in the air with different R-salicylaldehyde oximes and the sodium or cesium salts of 9-anthracenecarboxylato (9-AC) allows for the isolation of new six polynuclear compounds: [Mn3NaO(salox)3(9-AC)2(EtOH)3H2O]n·2EtOH (1), [Mn3NaO(3-Me-salox)3(9-AC)2(EtOH)3H2O]n·EtOH (2), [Mn6O2(salox)6(9-AC)2(EtOH)2(H2O)2]·3EtOH (3), [Mn3O(3-Me-salox)3(9-AC)(EtOH)3(H2O)]·1.8EtOH·3H2O (4), [Mn6O2(Me-salox)6(9-AC)2(EtOH)4(H2O)2]·0.5H2O (5), and [Mn6O2(Et-salox)6(9-AC)2(EtOH)4(H2O)2]·3EtOH (6). H2salox is a salicylaldehyde oxime, H2(3-Me-salox) is a 3-methyl-salicylaldehyde oxime, H2Me-salox is a 1-(2-hydroxyphenyl)ethan-1-one oxime and a H2-Et-salox is 1-(2-hydroxyphenyl)propan-1-one oxime. Structurally, compounds 1 and 2 consist of chains of trinuclear {MnIII3(μ3-O)(salox)3}+ units connected by Na+ ions. Compounds 3, 5, and 6 are hexanuclear units formed by two parallel trinuclear units {MnIII3(μ3-O)(salox)3}+ or {MnIII3(μ3-O)(Me-salox)3}+ planes related through an inversion center. Compound 4 consists of two isolated [Mn3O(3-Me-salox)3(9-AC)(EtOH)3(H2O)] trinuclear molecules in the unit cell showing crystallographic differences. Magnetic studies reveal a set of antiferromagnetic interactions in compounds 1 and 2 and a combination of antiferromagnetic and ferromagnetic interactions in compounds 3, 5, and 6. In all cases, the magneto-structural correlation between the intramolecular MnIII-N-O-MnIII torsion angle and the magnetic exchange within these units have been confirmed. For compounds 5 and 6, ac magnetic measurements reveal the slow relaxation of magnetization with moderate energy barriers of 19.9 cm−1 and 31.1 cm−1, respectively. Absorbance and fluorescence measurements in solution show the transitions of the 9-anthracenecarboxylate chromophore for all the compounds.

Soft robotic manipulators consisting of serially stacked segments combine actuation and structure in an integrated design. This design can be miniaturised while providing suitable actuation for potential applications that may include endoluminal surgery and inspections in confined environments. The control of these robots, however, remains challenging, due to the difficulty in accurately modelling the robots, in coping with their redundancies, and in solving their full inverse kinematics. In this work, we explore a hybrid approach to control serial soft robotic manipulators that combines machine learning (ML) to estimate the inverse kinematics with closed-loop control to compensate for the remaining errors. For the ML part, we compare various approaches, including both kernel-based learning and more general neural networks. We validate the selected ML model experimentally. For the closed-loop control part, we first explore Jacobian formulations using both synthetic models and numerical approximations from experimental data. We then implement integral control actions using both these Jacobians, and evaluate them experimentally. In an experimental validation, we demonstrate that the hybrid control approach achieves setpoint regulation in a robot with six inputs and four outputs.

El presente trabajo se desarrolló en la finca Punta Las Cuevas del municipio de Cienfuegos, provincia del mismo nombre. En un área de 1914 m2, con la finalidad de evaluar el comportamiento del hongo Mycosphaerella fijiensis Morelet en los clones INIVIT PB-2012 e INIVIT PV 06 30. Para la evaluación se establecieron dos tratamientos, uno para INIVIT PB-2012 y otro para INIVIT PV 06 30 con quince repeticiones, cada uno sembrado a un marco de plantación de 2 m x 2 m. Las variables evaluadas en este trabajo para ambos clones fueron altura de la planta, grosor del tallo, número de hojas activas y número de hojas enfermas. Todas las variables en función de analizar el comportamiento del hongo M. fijiensis en los clones. Los datos fueron procesados estadísticamente a través del software SPSS versión 21. Posteriormente se desarrolló un manejo para el hongo de una forma viable y ecológica. El mismo está enfocado en medidas preventivas y curativas en las que no se aplican fungicidas químicos y la fertilización se realizó con materia orgánica. El experimento mostró que el clon más tolerante y con más posibilidades de adaptabilidad entre los dos fue el INIVIT PB-2012.

Abstract Background Children and young people’s (CYP) mental health is worsening, and an increasing number are seeking psychiatric and mental health care. Whilst many CYPs with low-to-medium levels of psychiatric distress can be treated in outpatient services, CYPs in crisis often require inpatient hospital treatment. Although necessary in many cases, inpatient care can be distressing for CYPs and their families. Amongst other things, inpatient stays often isolate CYPs from their support networks and disrupt their education. In response to such limitations, and in order to effectively support CYPs with complex mental health needs, intensive community-based treatment models, which are known in this paper as intensive community care services (ICCS), have been developed. Although ICCS have been developed in a number of settings, there is, at present, little to no consensus of what ICCS entails. Methods A group of child and adolescent mental health clinicians, researchers and academics convened in London in January 2023. They met to discuss and agree upon the minimum requirements of ICCS. The discussion was semi-structured and used the Dartmouth Assertive Community Treatment Fidelity Scale as a framework. Following the meeting, the agreed features of ICCS, as described in this paper, were written up. Results ICCS was defined as a service which provides treatment primarily outside of hospital in community settings such as the school or home. Alongside this, ICCS should provide at least some out-of-hours support, and a minimum of 90% of CYPs should be supported at least twice per week. The maximum caseload should be approximately 5 clients per full time equivalent (FTE), and the minimum number of staff for an ICCS team should be 4 FTE. The group also confirmed the importance of supporting CYPs engagement with their communities and the need to remain flexible in treatment provision. Finally, the importance of robust evaluation utilising tools including the Children’s Global Assessment Scale were agreed. Conclusions This paper presents the agreed minimum requirements of intensive community-based psychiatric care. Using the parameters laid out herein, clinicians, academics, and related colleagues working in ICCS should seek to further develop the evidence base for this treatment model.

Abstract Bioenergy could help limit global warming to 2°C above pre‐industrial levels while supplying almost a fourth of the world's renewable energy needs by 2050. However, the deployment of bioenergy raises concerns that adoption at meaningful scales may lead to unintended negative environmental consequences. Meanwhile, the full consolidation of a bioenergy industry is currently challenged by a sufficient, resilient, and resource‐efficient biomass supply and an effective conversion process. Here, we provide a comprehensive analysis of how stable isotope approaches have accelerated the development of a robust bioeconomy by advancing knowledge about environmental sustainability, feedstock development, and biological conversion. We show that advances in stable isotope research have generated crucial information to (1) gain mechanistic insight into the potential of bioenergy crops to mitigate climate change as well as their impact on water and nutrient cycling; (2) develop high‐yielding, resilient feedstocks that produce high‐value bioproducts in planta; and (3) engineer microbes to enhance feedstock conversion to bioenergy products. Further, we highlight knowledge gaps that could benefit from future research facilitated by stable isotope approaches. We conclude that advances in mechanistic knowledge and innovations within the field of stable isotopes in cross‐disciplinary research actions will greatly contribute to breaking down the barriers to establishing a robust bioeconomy.

BackgroundFor years, in Catalonia and in the rest of Spain, there has been a deficit and an unequal geographical distribution of health professionals specializing in pediatrics, especially in rural areas. Among the proposals to improve this situation is the promotion of the use of information and communication technologies (ICT) among users and professionals. Moreover, with the outbreak of COVID-19, the use of telehealth has become an essential tool, with an overall increase in non–face-to-face visits, including in primary care pediatrics. In this context, telemedicine, when used in primary care pediatrics, can be an effective means of improving families’ access to medical care. Currently, in Catalonia, telemedicine involving patients and health professionals is used in pediatric primary care through telephone consultation and asynchronous teleconsultation (eConsulta). Video consultation is in practice not used, although it could have different applications. ObjectiveThe aim of this study is to evaluate the feasibility of a video consultation process with physical examination in acute pediatric pathology in rural areas among primary care professionals. In addition, the level of satisfaction with these remote consultations will be assessed from the perspective of both the users and the health care professionals. MethodsWe will conduct a prospective experimental study to analyze the possibility of using video consultation in pediatric acute care in primary care in central Catalonia (Spain). A minimum of 170 children aged between 0 and 14 years attending the primary care center (PCC) for acute illness for a period of 1 year will be included in the study. Initially, the telemetric visit, including a physical examination, will include a nurse at the patient and family’s side and a pediatrician who will participate remotely. Subsequently, the pediatrician will visit the patient in person and the physical examination and diagnosis made during the remote visit will be compared with the physical examination and diagnosis of the face-to-face visit, which is considered the gold standard. ResultsRecruitment was planned to begin in the second half of 2023 and continue for at least 1 year. It is anticipated to be a good resource for a variety of acute pediatric conditions in primary care. The evaluation will focus on the feasibility of performing live remote visits and comparing their diagnostic accuracy with that of face-to-face visits. ConclusionsWe believe that this study could provide evidence on the feasibility and diagnostic accuracy of video consultation in pediatric acute primary care in a rural setting, as well as on satisfaction with video consultations among both users and professionals. If proven useful in addressing the acute needs of children in a variety of situations, it could become a digital health tool that improves the overall pediatric primary care service in rural areas, for both families and professionals. International Registered Report Identifier (IRRID)PRR1-10.2196/52946

Mapping the drivers of change that pose negative pressures or threats to biodiversity can help to identify where biodiversity is most threatened and can be used to determine priority sites to target conservation actions. Overlapping drivers of change maps with distribution maps of sensitive species provides valuable information to identify where and when it would be better to target actions to minimize the risk. The overall aim of this study was to develop a methodology for the integration of risk mapping associated with high human frequentation to guide conservation actions in two case study: the Kentish plover (Charadrius alexandrinus) and Posidonia meadows (Posidonia oceanica), both sensitive to human frequentation. To achieve this, we used two types of geolocated mobile phone information from the STRAVA platform: mapped paths and roads number of visitors at hourly precisions and a sporting activities heatmap representative of a wider period, together with species ecological information and complementary human frequentation data. The final, monthly risk maps identified the areas for Kentish plover with null, low, moderate, high, very high risk attributed to different aspects of the breeding biology of the species, nests, nestlings, and adults. The risk thresholds for nests are lower than for nestlings and adults, thought nestlings were generally less sensitive to human frequentation than adults. Visitors number ranges between 250 and 700 approximately suppose a moderate risk for the three assessed periods, and more than 1200 visitors appeared to prevent the nesting of the species completely. The final risk maps for Posidonia meadows determine the areas with low, moderate, hight and very high risk for human marine activities. Human frequentation values in this case study are scaled between 0 and 1, the results shows that values above 0.1 imply a high risk for the species. Both types of information can be used to target concrete, spatially explicit actions to minimize the risk caused by human frequentation. Furthermore, the first case study would allow to adapt the target actions to the species breeding phenology. The proposed risk assessment workflow is flexible and may be adjusted to match the available information and eventually could be adapted to other conservation objectives arising from different threats. In addition, data gathered from mobile mobility applications show great potential to accurately identify human frequentation, both spatially and temporally.

[This corrects the article DOI: 10.1371/journal.pone.0281197.].

BackgroundThe reasons for mental health consultations are becoming increasingly relevant in primary care. The Catalan health care system is undergoing a process of digital transformation, where eHealth is becoming increasingly relevant in routine clinical practice. ObjectiveThis study aimed to analyze the approach to depressive episodes and the role of eHealth in the Catalan health care system from 2017 to 2022. MethodsA retrospective observational study was conducted on diagnostic codes related to depressive episodes and mood disorders between 2017 and 2022 using data from the Catalan Institute of Health. The sociodemographic evolution and prevalence of depression and mood disorders in Catalonia were analyzed between 2017 and 2022. Sociodemographic variables were analyzed using absolute frequency and percentage. The prevalence of depressive episodes was calculated, highlighting the year-to-year changes. The use of eHealth for related consultations was assessed by comparing the percentages of eHealth and face-to-face consultations. A comparison of sociodemographic variables based on attendance type was conducted. Additionally, a logistic regression model was used to explore factors influencing face-to-face attendance. The analysis used R software (version 4.2.1), with all differences examined using 95% CIs. ResultsFrom 2017 to 2022, there was an 86.6% increase in the prevalence of depression and mood disorders, with women consistently more affected (20,950/31,197, 67.2% in 2017 and 22,078/33,169, 66.6% in 2022). In 2022, a significant rise in depression diagnoses was observed in rural areas (difference 0.71%, 95% CI 0.04%-1.43%), contrasting with a significant decrease in urban settings (difference –0.7%, 95% CI –1.35% to –0.05%). There was a significant increase in antidepressant use in 2022 compared to 2017 (difference 2.4%, 95% CI 1.87%-3.06%) and the proportion of eHealth visits rose from 4.34% (1240/28,561) in 2017 to 26.3% (8501/32,267) in 2022. Logistic regression analysis indicated that men (odds ratio [OR] 1.06, 95% CI 1.04-1.09) and younger individuals had a higher likelihood of eHealth consultations in 2022. Furthermore, individuals using eHealth consultations were more likely to use antidepressants (OR 1.54, 95% CI 1.50-1.57) and anxiolytics (OR 1.06, 95% CI 1.03-1.09). ConclusionsThe prevalence of depression in Catalonia has significantly increased in the last 6 years, likely influenced by the COVID-19 pandemic. Despite ongoing digital transformation since 2011, eHealth usage remained limited as of 2017. During the lockdown period, eHealth accounted for nearly half of all health care consultations, representing a quarter of consultations by 2022. In the immediate aftermath of the COVID-19 pandemic, emerging evidence suggests a significant role of eHealth in managing depression-related consultations, along with an apparent likelihood of patients being prescribed antidepressants and anxiolytics. Further research is needed to understand the long-term impact of eHealth on diagnostic practices and medication use.

Abstract Background The World Health Organization (WHO) has developed the Integrated Care for Older People (ICOPE) strategy to face the challenges of ageing societies. This strategy is focused on person centered care and the assessment intrinsic capacity (IC). Early identification of five domains of IC (cognition, locomotion, vitality, sensory (hearing and vision), and psychological) has been shown to be related with adverse outcomes and can guide actions towards primary prevention and healthy ageing. IC assessment proposed by the WHO ICOPE guidelines is composed by two steps: First, Screening for decreased IC by the ICOPE Screening tool; second, by the reference standard methods. The aim was to assess the performance of diagnostic measures (sensibility, specificity, diagnostic accuracy, and agreement of the ICOPE Screening tool) compared to the reference standard methods in European community-dwelling older adults. Methods Cross-sectional analysis of the baseline of the ongoing VIMCI (Validity of an Instrument to Measure Intrinsic Capacity) cohort study, which was carried out in Primary Care centers and outpatient clinics from 5 rural and urban territories in Catalonia (Spain). Participants were 207community dwelling persons ≥ 70-year-old with Barthel $$\ge$$ ≥ 90, without dementia or advanced chronic conditions who provided their consent to participate. The 5 IC domains were assessed by the ICOPE Screening tool and the reference methods (SPPB, gait speed, MNA, Snellen chart, audiometry, MMSE, GDS5) during patients’ visit. Agreement was assessed with the Gwet AC1 index. Results ICOPE Screening tool sensitivity was higher for cognition (0.889) and ranged between 0.438 and 0.569 for most domains. Specificity ranged from 0.682 to 0.96, diagnostic accuracy from 0.627 to 0.879, Youden index from 0.12 to 0.619, and Gwet AC1 from 0.275 to 0.842. Conclusion The ICOPE screening tool showed fair performance of diagnostic measures; it was helpful to identify those participants with satisfactory IC and showed a modest ability to identify decreased IC in older people with high degree of autonomy. Since low sensitivities were found, a process of external validation would be recommended to reach better discrimination. Further studies about the ICOPE Screening tool and its performance of diagnostic measures in different populations are urgently required.

Due to the diversity of characteristics and the high number of World Heritage sites (49) inscribed by Spain, this country and its ICOMOS National Committee have a long experience in the application of the World Heritage Convention throughout these 50 years. The World Heritage Working Group of the Spanish National Committee of ICOMOS has therefore carried out an analysis of these sites, their history and evolution, typology, and state of conservation with the final goal of assessing their current heritage situation and the contribution of the Convention to the conservation of the Spanish natural and cultural heritage. We also aim to reflect on how Spain has contributed to the World Heritage Convention during these five decades and about the most important challenges that our country needs to confront in order to continue complying with the spirit of the Convention and the principles of its Operational Guidelines. To conduct this analysis, we first deal with the background of the ratification of the Convention in Spain, provide an overview of its application, and describe the evolution of the Spanish Tentative List. Second, we deepen on the Spanish nominations and the typologies of the Spanish properties inscribed on the World Heritage List. Thirdly, we focus on the preservation of the Spanish World Heritage sites basing on the State of Conservation Reports (SOCs) that affect them and the results of the first survey on these properties’ conservation, management and presentation carried out by the Heritage Observatory of ICOMOS Spain. This allows us to share some conclusions about the most positive effects of the Convention for the protection of Spanish cultural heritage and the most important challenges for its future development, many of which can be extended at least to the European context.

Abstract During the second long shutdown period of the CERN accelerator complex (LS2, 2019-2021), several upgrade activities took place at the n_TOF facility. The most important have been the replacement of the spallation target with a next generation nitrogen-cooled lead target. Additionally, a new experimental area, at a very short distance from the target assembly (the NEAR Station) was established. In this paper, the core commissioning actions of the new installations are described. The improvement in the n_TOF infrastructure was accompanied by several detector development projects. All these upgrade actions are discussed, focusing mostly on the future perspectives of the n_TOF facility. Furthermore, some indicative current and future measurements are briefly reported.

Abstract Background Development of precision medicine requires the identification of easily detectable and druggable biomarkers. Despite recent targeted drug approvals, prognosis of acute myeloid leukemia (AML) patients needs to be greatly improved, as relapse and refractory disease are still difficult to manage. Thus, new therapeutic approaches are needed. Based on in silico-generated preliminary data and the literature, the role of the prolactin (PRL)-mediated signaling was interrogated in AML. Methods Protein expression and cell viability were determined by flow cytometry. Repopulation capacity was studied in murine xenotransplantation assays. Gene expression was measured by qPCR and luciferase-reporters. SA-β-Gal staining was used as a senescence marker. Results The prolactin receptor (PRLR) was upregulated in AML cells, as compared to their healthy counterpart. The genetic and molecular inhibition of this receptor reduced the colony-forming potential. Disruption of the PRLR signaling, either using a mutant PRL or a dominant-negative isoform of PRLR, reduced the leukemia burden in vivo, in xenotransplantation assays. The expression levels of PRLR directly correlated with resistance to cytarabine. Indeed, acquired cytarabine resistance was accompanied with the induction of PRLR surface expression. The signaling associated to PRLR in AML was mainly mediated by Stat5, in contrast to the residual function of Stat3. In concordance, Stat5 mRNA was significantly overexpressed at mRNA levels in relapse AML samples. A senescence-like phenotype, measured by SA-β-gal staining, was induced upon enforced expression of PRLR in AML cells, partially dependent on ATR. Similar to the previously described chemoresistance-induced senescence in AML, no cell cycle arrest was observed. Additionally, the therapeutic potential of PRLR in AML was genetically validated. Conclusions These results support the role of PRLR as a therapeutic target for AML and the further development of drug discovery programs searching for specific PRLR inhibitors.

The Toponimia de Ribagorza project, linked to the Onomasticon Cataloniae of Joan Coromines i Vigneaux, is a model of academic collaboration which has produced well-known and fruitful results. However, several localities of Ribagorça were excluded from the aforementioned project, and, as a result, their proper names have remained unpublished. The aim of this paper is to collect the previously unpublished data of Gabasa and Peralta de la Sal.

Abstract Dermatological conditions are a relevant health problem. Machine learning (ML) models are increasingly being applied to dermatology as a diagnostic decision support tool using image analysis, especially for skin cancer detection and disease classification. The objective of this study was to perform a prospective validation of an image analysis ML model, which is capable of screening 44 skin diseases, comparing its diagnostic accuracy with that of General Practitioners (GPs) and teledermatology (TD) dermatologists in a real-life setting. Prospective, diagnostic accuracy study including 100 consecutive patients with a skin problem who visited a participating GP in central Catalonia, Spain, between June 2021 and October 2021. The skin issue was first assessed by the GPs. Then an anonymised skin disease picture was taken and uploaded to the ML application, which returned a list with the Top-5 possible diagnosis in order of probability. The same image was then sent to a dermatologist via TD for diagnosis, as per clinical practice. The GPs Top-3, ML model’s Top-5 and dermatologist’s Top-3 assessments were compared to calculate the accuracy, sensitivity, specificity and diagnostic accuracy of the ML models. The overall Top-1 accuracy of the ML model (39%) was lower than that of GPs (64%) and dermatologists (72%). When the analysis was limited to the diagnoses on which the algorithm had been explicitly trained (n = 82), the balanced Top-1 accuracy of the ML model increased (48%) and in the Top-3 (75%) was comparable to the GPs Top-3 accuracy (76%). The Top-5 accuracy of the ML model (89%) was comparable to the dermatologist Top-3 accuracy (90%). For the different diseases, the sensitivity of the model (Top-3 87% and Top-5 96%) is higher than that of the clinicians (Top-3 GPs 76% and Top-3 dermatologists 84%) only in the benign tumour pathology group, being on the other hand the most prevalent category (n = 53). About the satisfaction of professionals, 92% of the GPs considered it as a useful diagnostic support tool (DST) for the differential diagnosis and in 60% of the cases as an aid in the final diagnosis of the skin lesion. The overall diagnostic accuracy of the model in this study, under real-life conditions, is lower than that of both GPs and dermatologists. This result aligns with the findings of few existing prospective studies conducted under real-life conditions. The outcomes emphasize the significance of involving clinicians in the training of the model and the capability of ML models to assist GPs, particularly in differential diagnosis. Nevertheless, external testing in real-life conditions is crucial for data validation and regulation of these AI diagnostic models before they can be used in primary care.