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In the management of native Amazonian forests, infrastructure, such as stockyards and skid trails, are costly attributes and are responsible for a large part of the environmental impacts, productivity, costs and performance in forest management operations. The objective of this study was to apply a mathematical optimization model for the allocation of storage yards in native forest. The study was carried out in a native forest, in a sustainable forest management located in the Brazilian Amazon. The analyzed area has 3556.27 ha, which involved 16,425 trees and 311 wood storage yards. The study area was subdivided into three smaller areas by the company, which helped to optimize the number and size of yards. The dimensions of the storage yards were 25 × 25 m, with the maximum skid distance of trees from the felling site to the prioritized storage yard being 250 m. Two models were analyzed using integer linear programming: Model A - without penalties and Model B - with cost penalties (fictional) for opening storage yards through integer linear programming. The cost penalty served to prevent the selection of an excessive number of yards and thus the initial need to open them. Among the models, area 3 had the fewest storage yard exclusions when adding the opening cost penalty and can be considered the one that best managed the distribution in terms of cost and environmental impact of this infrastructure in the exploration. The number of storage yards allocated by model B was reduced by 27.3%, proving to be efficient in reducing impacts (5.3 ha) and in the uniformity of the amount of wood to be stored. The answers found by the models are viable solutions that allow for better results in infrastructure planning, and they can certainly be adopted by companies engaged in sustainable forest management., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

OCCUPATIONAL APPLICATIONSStandard operating procedures (SOPs) in complex industrial settings require a process for change management which can accommodate updates and adapt to changing tasks, roles, and tools. Interviews with users and administrators of SOPs in a large petrochemical company revealed contrasting perceptions of the procedural change process. Administrators (those who write or oversee the procedures, such as at the mid-level management level or "blunt end" of the process) perceived the change process as transparent, accessible, and encouraging for users of procedures at the sharp end, whereas users themselves perceived the process to be opaque and futile. Given the critical role of effective procedures in maintaining a safe workplace, these findings have important implications for ergonomics and human factors practitioners. Considerations for designing SOP change management should include accounting for process change transparency, emphasizing the importance of employee buy-in, and effectively communicating about procedures, policies, and safety in the change management.

Objective: Using eye tracking technology, this study sought to determine if differences in hazard statement (HS) compliance based on design elements are attributable to attention maintenance (AM)., Background: Recent empirical work has demonstrated counter-intuitive findings for HS designs embedded in procedures. Specifically, prevalent HS designs in procedures were associated with lower compliance., Method: The current study utilized eye tracking technology to determine whether participants are attending to HSs differently based on the inclusion or absence of visually distinct HS design elements typically used for consumer products. We used two different designs that previously yielded the largest gap in HS compliance. In a fully-crossed design, 33 participants completed four rounds of tasks using four procedures with embedded HSs. To assess AM, eye tracking was used to measure gaze and fixation duration., Results: The results indicated there are differences in AM between the two designs. The HSs that included elements traditionally considered effective in the consumer products literature elicited lower fixation duration times, and were associated with lower compliance. However, AM did not mediate the design effect on compliance., Conclusions: The study results suggest the design of HSs are impacting individuals as early as the AM stage of the C-HIP model. The absence of HS design-AM-compliance mediation suggests other C-HIP elements more directly explain the HS design-compliance effects., Application: These results provide more evidence that the communication of Health, Environment, and Safety information in procedures may need to be different from those on consumer products, suggesting design efficacy may be task dependent.

Objectives: Changes in placental features, such as maternal and fetal vascular malperfusion, are associated with SARS-CoV-2 infection. The anatomopathologic study of the placenta is crucial for understanding pregnancy and fetal complications. To that end, this study aimed to describe placental features and analyze the association between placental findings and perinatal outcomes in a cohort of pregnant women with severe COVID-19., Methods: This nested study within a prospective cohort study consisted of 121 singleton pregnant women with a diagnosis of severe COVID-19. Placental pathologic findings were described, and the associations between severe COVID-19 and clinical parameters and perinatal outcomes were assessed., Results: The prevalence of maternal vascular malperfusion was 52.1%, followed by fetal vascular malperfusion at 21.5%, ascending intrauterine infections at 11.6%, and inflammatory lesions at 11.6%. Other lesions were observed in 39.7% of the placentas examined. Inflammatory lesions were an independent factor (P = .042) in 5-minute Apgar scores below 7. Ascending infection was associated with fetal death (P = .027)., Conclusions: Maternal vascular malperfusion was the most prevalent placental feature in patients with severe COVID-19. Chorangiosis is associated with poor perinatal outcomes., (© The Author(s) 2024. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Minimal Cut Sets (MCSs) identify sets of reactions which, when removed from a metabolic network, disable certain cellular functions. The traditional search for MCSs within genome-scale metabolic models (GSMMs) targets cellular growth, identifies reaction sets resulting in a lethal phenotype if disrupted, and retrieves a list of corresponding gene, mRNA, or enzyme targets. Using the dual link between MCSs and Elementary Flux Modes (EFMs), our logic programming-based tool aspefm was able to compute MCSs of any size from GSMMs in acceptable run times. The tool demonstrated better performance when computing large-sized MCSs than the mixed-integer linear programming methods. We applied the new MCSs methodology to a medically-relevant consortium model of two cross-feeding bacteria, Staphylococcus aureus and Pseudomonas aeruginosa. aspefm constraints were used to bias the computation of MCSs toward exchanged metabolites that could complement lethal phenotypes in individual species. We found that interspecies metabolite exchanges could play an essential role in rescuing single-species growth, for instance inosine could complement lethal reaction knock-outs in the purine synthesis, glycolysis, and pentose phosphate pathways of both bacteria. Finally, MCSs were used to derive a list of promising enzyme targets for consortium-level therapeutic applications that cannot be circumvented via interspecies metabolite exchange., (© 2024. The Author(s).)

Interaction has been recognised as an essential lens to understand how cognition is formed in a complex adaptive team such as a multidisciplinary crisis management team (CMT). However, little is known about how interactions within and across CMTs give rise to the multi-team system's overall cognitive functioning, which is essential to avoid breakdowns in coordination. To address this gap, we characterise and compare the component CMTs' role-as-intended (RAI) and role-as-observed (RAO) in adapting to the complexity of managing informational needs. To characterise RAI, we conducted semi-structured interviews with subject matter experts and then made a qualitative synthesis using a thematic analysis method. To characterise RAO, we observed multiteam interaction networks in real-time at a simulated training environment and then analysed the component CMTs' relative importance using node centrality measures. The resulting inconsistencies between RAI and RAO imply the need to investigate cognition in multiple CMTs through the lens of interaction. Practitioner summary: When a disaster occurs, multidisciplinary CMTs are expected to serve their roles as described in written or verbal guidelines. However, according to our naturalistic observations of multiteam interaction networks, such descriptions may be (necessary but) insufficient for designing, training, and evaluating CMTs in the complexity of managing informational needs together.

Competing Interests: The authors declare no conflicts of interest.

Competing Interests: The authors declare no conflicts of interest.

Objective: The objective of these studies was to identify hazard statement (HS) design elements in procedures that affected whether both workers and lab participants performed the associated hazard mitigation., Background: Many of the incidents in high-risk industries are the result of issues with procedures (e.g., standard operating procedures; SOPs) workers use to support their performance. HSs in these procedures are meant to communicate potential work hazards and methods of mitigating those hazards. However, there is little empirical research regarding whether current hazard design guidelines for consumer products translate to procedures., Method: Two experimental studies-(1) a laboratory study and (2) a high-fidelity simulation-manipulated the HS design elements present in procedures participants used while performing tasks. Participants' adherence to the mitigation of the hazard was compared for the HS designs., Results: The guidelines for HSs from consumer products did not translate to procedures. Specifically, the presence of an alert icon, a box around the statement, and highlighting the statement did not improve adherence to HSs. Indeed, the only consistent finding was for the Icon, with its presence reliably predicting nonadherence in both studies. Additionally, the total number of design elements did not have a positive effect on adherence., Conclusion: These findings indicate that more fundamental procedure HSs research is needed to identify effective designs as well as to understand the potential attentional mechanisms associated with these findings., Application: The findings from these studies indicate that current regulations and guidelines should be revisited regarding hazard presentation in procedures.

Background: Integrase strand transfer inhibitor-based regimens are recommended for first-line therapy in human immunodeficiency virus type 2 (HIV-2). Nonetheless, dolutegravir (DTG) clinical trial data are lacking., Methods: We conducted a phase 2, single-arm, open-label trial to evaluate the safety and efficacy of a triple therapy regimen that included DTG in persons with HIV-2 (PWHIV-2) in Portugal. Treatment-naive adults receive DTG in combination with 2 nucleoside reverse transcriptase inhibitors (NRTIs). Treatment efficacy was evaluated by the proportion of patients who achieved a plasma viral load (pVL) <40 copies/mL and/or by the change from baseline in CD4+ T-cell count and in CD4/CD8 ratio at week 48., Results: A total of 30 patients were enrolled (22 women; median age, 55 years). At baseline, 17 (56.7%) individuals were viremic (median, pVL 190 copies/mL; interquartile range [IQR], 99-445). The median CD4 count was 438 cells/μL (IQR, 335-605), and the CD4/CD8 ratio was 0.8. Three patients discontinued the study. At week 48, all participants (27) had pVL <40 copies/mL. No virological failures were observed. Mean changes in CD4 count and CD4/CD8 ratio at week 48 were 95.59 cells/µL (95% confidence interval [CI], 28-163) and 0.32 (95% CI, .19 to .46). The most common drug-related adverse events were headache and nausea. One participant discontinued due to central nervous system symptoms. No serious adverse events were reported., Conclusions: DTG plus 2 NRTIs is safe and effective as first-line treatment for PWHIV-2 with a tolerability profile previously known. No virological failures were observed that suggest a high potency of DTG in HIV-2 as occurs in HIV-1., Clinical Trials Registration: M NCT03224338., Competing Interests: Potential conflicts of interest. A. R. S. reports consulting fees from and participation on a data and safety monitoring board (DSMB) or advisory board for MSD; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events; and support for attending meetings and/or travel from ViiV Healthcare, Gilead Sciences, and MSD. F. M. reports consulting fees from ViiV Healthcare, Gilead, Merck Sharp & Dohme, and Astra Zeneca; payment or honoraria for presentations from ViiV Healthcare, Gilead, and MercK Sharp & Dohme; and participation on an advisory board for ViiV Healthcare, Gilead, and MercK Sharp & Dohme. J. B. reports consulting fees from ViiV Healthcare and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Gilead and ViiV Healthcare. K. M. reports payment or honoraria as a conference speaker from Merck Sharp & Dome and ViiV Healthcare and payment for expert testimony for an advisory board from Gilead Sciences and ViiV Healthcare. N. M. reports payment or honoraria for speakers bureaus from Merck Sharpe & Dohme and Gilead Sciences. S. L. reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from ViiV Healthcare, MSD, Pfizer, and Gilead Sciences; support for attending meetings and/or travel from MSD; and participation on a DSMB or advisory board for ViiV Healthcare. D. T. reports payment or honoraria for presentations or educational events from ViiV Healthcare, Gilead, and MSD; support for attending an international meeting, scientific update from MSD; and participation on an advisory board from ViiV Healthcare, Gilead, and MSD. P. P. reports payment or honoraria for presentations from ViiV Healthcare, Gilead, MSD, and Janssen Cilag; support for attending meetings and/or travel from Janssen Cilag; and participation on an advisory board for Gilead Sciences, ViiV Healthcare, and MSD. P. G. reports grants or contracts from Gilead Sciences; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from ViiV Healthcare, Gilead Sciences, MSD, and Janssen; support for attending meetings and/or travel from ViiV Healthcare and MSD; and participation on a DSMB or advisory board from ViiV Healthcare and MSD. J. A. reports honoraria for an education event from ViiV Healthcare; support for attending meetings and/or travel from ViiV Healthcare; and participation on an advisory board from ViiV Healthcare. M. J. L. reports payment for a presentation from ViiV Healthcare. C. F. reports payment or honoraria as a specialist and speaker from ViiV Healthcare Unipessoal LDA and Gilead Sciences LDA and participation on an advisory board for ViiV Healthcare Unipessoal LDA and Gilead Sciences LDA. L. D. reports support for a virtual meeting registration from ViiV Healthcare; participation on an advisory board from Gilead Sciences; and a role as a member and paid collaborator from the GAT—Grupo de Ativistas em Tratamentos. D. P. reports consulting fees from ViiV Healthcare; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from ViiV Healthcare, AbbVie, and Roche; and support for attending meetings and/or travel from ViiV Healthcare and Merck Sharpe & Dohme. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: We investigated whether the socioeconomic status (SES) influenced survival rates in oropharynx cancers (OPC), oral cavity cancers (OCC), and larynx cancers (LC) in Brazilian patients., Methods: This hospital-based cohort study assessed the age-standardized 5-year relative survival (RS) using the Pohar Perme estimator., Results: Overall, we identified 37 191 cases, and 5-year RS were 24.4%, 34.1%, and 44.9% in OPC, OCC, and LC, respectively. In multiple Cox regression, the highest risk of death occurred in the most vulnerable social strata for all subsites-that is, illiterates or patients relying on publicly funded healthcare services. Disparities increased over time by 34.9% in OPC due to the rising of survival rates in the highest SES, whereas they reduced by 10.2% and 29.6% in OCC and LC., Conclusions: The potential inequities were more significant for OPC than for OCC and LC. It is urgent to tackle social disparities to improve prognoses in highly unequal countries., (© 2023 Wiley Periodicals LLC.)

Objective: The goal of this study is to assess machine learning for predicting procedure performance from operator and procedure characteristics., Background: Procedures are vital for the performance and safety of high-risk industries. Current procedure design guidelines are insufficient because they rely on subjective assessments and qualitative analyses that struggle to integrate and quantify the diversity of factors that influence procedure performance., Method: We used data from a 25-participant study with four procedures, conducted on a high-fidelity oil extraction simulation to develop logistic regression (LR), random forest (RF), and decision tree (DT) algorithms that predict procedure step performance from operator, step, readability, and natural language processing-based features. Features were filtered using the Boruta approach. The algorithms were trained and optimized with a repeated 10-fold cross-validation. After training, inference was performed using variable importance and partial dependence plots., Results: The RF, DT, and LR algorithms with all features had an area under the receiver operating characteristic curve (AUC) of 0.78, 0.77, and 0.75, respectively, and significantly outperformed the LR with only operator features (LROP), with an AUC of 0.61. The most important features were experience, familiarity, total words, and character-based metrics. The partial dependence plots showed that steps with fewer words, abbreviations, and characters were correlated with correct step performance., Conclusion: Machine learning algorithms are a promising approach for predicting step-level procedure performance, with acknowledged limitations on interpolating to nonobserved data, and may help guide procedure design after validation with additional data on further tasks., Application: After validation, the inferences from these models can be used to generate procedure design alternatives.

Background: Although often overlooked, patient and public involvement (PPI) is vital when considering the design and delivery of complex and adaptive clinical trial designs for chronic health conditions such as multiple sclerosis (MS)., Methods: We conducted a rapid review to assess current status of PPI in the design and conduct of clinical trials in MS over the last 5 years. We provide a case study describing PPI in the development of a platform clinical trial in progressive MS., Results: We identified only eight unique clinical trials that described PPI as part of articles or protocols; nearly, all were linked with funders who encourage or mandate PPI in health research. The OCTOPUS trial was co-designed with people affected by MS. They were central to every aspect from forming part of a governance group shaping the direction and strategy, to the working groups for treatment selection, trial design and delivery. They led the PPI strategy which enabled a more accessible, acceptable and inclusive design., Conclusion: Active, meaningful PPI in clinical trial design increases the quality and relevance of studies and the likelihood of impact for the patient community. We offer recommendations for enhancing PPI in future MS clinical trials.

Cryopreservation, or the freezing of embryos or sperm, has become a routine part of many research projects involving laboratory mice. In this article, we combine historical and sociological methods to produce a cryopolitical analysis of this less explored aspect of animal research. We provide a longitudinal account of mouse embryo and semen storage and uses in the UK and show that cryopreservation enabled researchers to overcome particular challenges-fears of strain loss, societal disapproval, and genetic drift-in ways which enabled the continued existence of strains and contributed to the scaling up of mouse research since World War II. We use the theoretical lens of cryopolitics to explore three different, yet overlapping, cryopolitical strategies that we identify. All share the ability to ensure the continued maintenance of genetically defined strains without the need for continually breeding colonies of mice. We argue that, in contrast to more common imaginaries of species conservation, the cryopolitical rationale can best be understood as purposefully not letting the strain die without requiring animals to live. The ability to freeze mice, then, had the potential to unsettle who the objects of care are in mouse research, from individual animals to the concept of the strain itself., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Colorectal cancer is one of the most incident types of cancer in the world, with almost 2 million new cases annually. In Brazil, the scenery is the same, around 41 thousand new cases were estimated in the last 3 years. This increase in cases further intensifies the interest and importance of studies related to the topic, especially using new approaches. The use of machine learning algorithms for cancer studies has grown in recent years, and they can provide important information to medicine, in addition to making predictions based on the data. In this study, five different classifications were performed, considering patients' survival. Data were extracted from Hospital Based Cancer Registries of São Paulo, which is coordinated by Fundação Oncocentro de São Paulo, containing patients with colorectal cancer from São Paulo state, Brazil, treated between 2000 and 2021. The machine learning models used provided us the predictions and the most important features for each one of the algorithms of the studies. Using part of the dataset to validate our models, the results of the predictors were around 77% of accuracy, with AUC close to 0.86, and the most important column was the clinical staging in all of them., (© 2023. The Author(s).)

OCCUPATIONAL APPLICATIONSThere are increasing numbers of organizations that are implementing digital procedures (e.g., standard operating procedures). These efforts are often assumed to be a positive development but can be quite costly-both in terms of money and training for a digital rollout. As a result, organizations and practitioners may find themselves at risk for failure when implementing digital procedures. The results of the current study suggest that if workers perceive digital procedures as useful and easy to use, this perception translates into positive attitudes, which subsequently result in fewer deviations. Since acceptance is relatively easy to assess, practitioners can benefit from using these assessments prior to a digital transition/roll-out to both compare competing hardware and software applications, and to initiate and continuously monitor the development of digital procedures. We consider this approach as advantageous to having management develop a system and fully deploying digital procedures without any consideration of worker acceptance.

Introduction: Kidney transplant recipients are a subgroup of patients at higher risk of critical forms of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection and poor outcomes due to immunosuppression treatment. Herein, we present data from a single center cohort of kidney transplant recipients with SARS-CoV-2 infection., Methods: In a prospective study, baseline characteristics, clinical features, antiviral and immunosuppression management were compared between outpatients and hospitalized patients, during a one-year period., Results: Seventy-seven kidney transplant recipients were analyzed, including outpatients and hospitalized patients, with a median age of 57.7 (IQR 49.7-64.9) years. Twenty-eight (36.4%) were managed as outpatients, while 49 (63.6%) patients required hospital admission. Among hospitalized patients, 18.4% were admitted in ICU, 49% had AKI, and 20.4% died. Immunosuppression adjustments were performed in 95.9% of hospitalized patients, with dose of anti-metabolites adjusted in 83.7%, mTOR inhibitors in 14.3%, calcineurin inhibitors in 12.2%, and corticosteroid therapy in 81.6%., Conclusion: Among hospitalized patients, immunosuppression management included reduction or withdrawal of anti-metabolite and increase of corticosteroid dose. AKI occurred in almost half of patients and mortality in hospitalized patients reached 20%, reflecting greater disease severity than the general population.

The global distribution of laboratory mouse strains is valued for ensuring the continuity, validity and accessibility of model organisms. Mouse strains are therefore assumed mobile and able to travel. We draw on the concept of 'animal mobilities' (Hodgetts and Lorimer 2019) to explain how attending to laboratory mice as living animal, commodity and scientific tool is shaping how they are transported through contemporary scientific infrastructures and communities. Our paper is framed around exploring how animal strains travel, rather than animals, as we show that it is only through understanding strain mobility that we can explain how and why live animal movement can be replaced by germinal products. The research is based on qualitative fieldwork in 2018 and 2019 that included 2 weeks ethnography and interviews with key informants involved in the movement of laboratory animals. The empirical analysis discusses practices that relate to managing biosecurity and animal welfare concerns when moving laboratory animal strains. In closing we reflect more broadly on the contemporary 'ethico-onto-epistemological' (Barad, 2014) entanglement that shapes who or what travels to support laboratory science data-making practices, and the intensity of care 'tinkering' practices (Mol and Law 2010) that facilitate the movement. We explain how a laboratory animal strain exceeds its value solely as a mobile and thus exchangeable commodity, illustrated in how values that relate to animal sentience and infection-risk supports its material transformation. Consequently, it is becoming increasingly common for non-sentient germinal products - embryos and gametes - to replace live sentient animals when being moved., (© 2022. The Author(s).)

The application of genome editing to animal research connects to a wide variety of policy concerns and public conversations. We suggest focusing narrowly on public opinion of genome editing is to overlook the range of positions from which people are brought into relationships with animal research through these technologies. In this paper, we explore three key roles that publics are playing in the development of genome editing techniques applied to animals in biomedical research. First, publics are positioned by surveys and focus groups as stakeholders with opinions that matter to the development of research technologies. Learning lessons from controversies over genetically modified food in Europe, these methods are used to identify problems in science-society relations that need to be managed. Second, people are recruited into research projects through participating in biobanks and providing data, where their contributions are encouraged by appeals to the public good and maintained by public confidence. Thirdly, patients are increasingly taking positions within research governance, as lay reviewers on funding panels, where their expertise helps align research priorities and practices with public expectations of research. These plural publics do not easily aggregate into a simple or singular public opinion on genome editing. We conclude by suggesting more attention is needed to the multiple roles that different publics expect - and are expected - to play in the future development of genomic technologies.

Cat scratch disease (CSD) is a zoonosis caused by Bartonella henselae, which is usually transmitted to humans through scratches or bites from infected cats. It is primarily a disease of children and adolescents, although it can affect individuals of any age. In approximately 10% of cases, patients can present atypical manifestations that may involve the musculoskeletal system. Herein, we report a case of a healthy 51-year-old man that developed low-grade fever and regional lymphadenopathy, followed by erythema nodosum and oligoarthritis. He had been scratched and bitten by his cat before the onset of symptoms. The diagnosis was confirmed serologically by the presence of high titers of specific IgG antibodies. Bartonella henselae was also detected in the blood of the owner's cat by PCR and DNA sequencing.

Evaluate the effect of 12 wks of concurrent training (CT) in the extracellular matrix (ECM) of subcutaneous adipose tissue (SAT) in people living with HIV/AIDS (PLWHA). In the non-randomized clinical trial, 19 participants, 11 healthy (HIV-) and 18 PLWHA under the use of highly active antiretroviral therapy (HAART) for at least 1 year (HIV+). All participants engaged in a moderate-intensity CT program for 12 weeks, 3 times a week. Before and after CT, aerobic and strength performance were assessed, as well as anthropometric and biochemical blood profiles. In addition, SAT biopsies were performed for histologic and morphometric analyses. Statistical analysis was carried out with R Studio, using descriptive and inferential analysis, ANOVA test, and mixed-effect model ( P < 0.05). HIV+ showed higher levels of very-low-density lipoproteins and triglycerides and lower levels of high-density lipoproteins at baseline than HIV- ( P < 0.05). All groups showed improved aerobic and strength performances ( P < 0.05). Both groups showed reduced adipocyte sizes after CT ( P < 0.05). Lastly, HIV+ presented smaller adipocytes and higher elastic fiber deposition at baseline and decreased after training only in HIV+, similar to the HIV group. Thus, CT in PLWHA promoted a decrease in the size heterogeneity of adipocytes and elastic fiber deposition, remodeling the ECM, and improving the SAT fibrosis profile. Brazilian Clinical Trials Registry (ensaiosclinicos.gov.br - UTN: U1111-1214-3022). Novelty: Adipose tissue fibrosis is improved by training in people living with HIV. Concurrent training remodels adipose tissue extracellular matrix.

Background: College students are leading an evolution of device use both in the type of device and the frequency of use. They have transitioned from desktop stations to laptops, tablets, and especially smartphones and use them throughout the day and into the night., Methods: Using a 35-min online survey, we sought to understand how technology daily usage patterns, device types, and postures affect pain and discomfort to understand how knowledge of that pain might help students avoid it. Data were analyzed from 515 students (69.5% male) who completed an internet-delivered survey (81.3% response rate)., Results: Participants ranked smartphones as their most frequently used technology (64.0%), followed by laptops and tablets (both 53.2%), and desktop computers (46.4%). Time spent using smartphones averaged over 4.4 h per day. When using their devices, students were more likely to adopt non-traditional workplace postures as they used these devices primarily on the couch or at a chair with no desk., Conclusion: Recent trends in wireless academic access points along with the portability of small handheld devices, have made smartphones the most common link to educational materials despite having the least favorable control and display scenario from an ergonomic perspective. Further, the potential impact of transitions in work environments due to COVID-19 may further exacerbate ergonomic issues among millions highlighting the need for such work to be carried out., (© 2021. The Author(s).)

Undiagnosed HIV-1 patients still account for 25% of worldwide HIV patients. Studying late presenters (LPs) for HIV care may help to identify characteristics of such patients. The present study aims to identify factors associated with late presentation and late presentation with advanced disease based on a population of patients followed in a Portuguese hospital between 1984 and 2017. Sociodemographic and clinical data from infected patients with HIV-1 aged 18 years and older, followed in Egas Moniz Hospital, in Portugal were collected. Of the 907 patients included in this study, 68.7% were males and the median age was 37 years (interquartile range 30-47). Four hundred fifty-nine patients (50.6%) were LP and, of these, 284 patients (61.9%) were LPAD. The LP population mostly originated from Portugal and sub-Saharan Africa (64.4% and 28.8%; p  = .004) and the HIV exposure category, mainly heterosexuals and men have sex with men (57.0% and 24.9%; p  < .001). The stage of disease and viral load at diagnosis were significantly associated with both LP and LPAD ( p  < .001). Factors associated with LP in the logistic regression included age at diagnosis lower than 30 years (adjusted odds ratio [aOR] 0.34; 0.17-0.68; p  = .002) and origin from sub-Saharan Africa (aOR 2.24; 1.44-3.50; p  < .001). Late presentation is a major obstacle to halt the HIV epidemic. In this population, the majority of newly diagnosed HIV-infected individuals were LPs. Our results characterize vulnerable populations that should be frequently tested for HIV.

Background: Patient education is essential in Parkinson's disease (PD). However, it is not known which aspects of patient education are associated with an improvement in quality of life (QoL)., Objective: To identify factors that predicted an improvement in QoL in PD patients that participate in an education program., Methods: EduPark is a community-hospital patient education program. PD Patients that had participated in the program between September 2013 and March 2017 were retrospectively included. QoL was prospectively evaluated (using the PDQ-8 questionnaire) before and after the patient's participation. We used mixed linear models (adjusted for the initial value of the PDQ-8) to determine socio-demographic and clinical variables that predicted the change in the PDQ-8 score., Results: A total of 181 patients were included (mean±standard deviation age: 62.9±8.2 years; disease duration: 9.1±5.3 years). 76.7% of the 103 patients having undergone a cognitive evaluation did not display cognitive impairment. We did not identify any factors that predicted the program's impact on the patient's QoL. Participation in the program was associated with a significant decrease (improvement) in the PDQ-8 score (39.4±17.81 before and 35.6±15.9 afterwards, P<0.001)., Conclusion: We did not identify any factors that were predictive of the patient education program's impact on QoL in patients with PD. Participation in the program was associated with a significant improvement in QoL. Our results suggest that Patient Education Programs should be more widely prescribed and developed in the management of PD., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Introduction: We aimed to compare clinical features of older age group and young and middle-aged patients with COVID-19 and analyze mortality predictors., Methods: Retrospective analysis of ongoing collection of prespecified data, on a single institution, including patients hospitalized consecutively due to COVID-19 infection, from March to June 2020., Results: Of 195 patients, 56.9% were ⩾65 years (older age group). Older age group had multimorbidity ( p  < 0.001). At admission Early Warning Score-2 ( p  < 0.001), C-reactive protein, D-dimer, creatinine, anemia and lymphopenia were higher in older age group, as well as median time of hospitalization (14 vs 10 days, p  = 0.004). Complications were more common in older age group, but there were no significant differences in admission to intensive care. There were 18 deaths, 16 in older age group. Modified Early Warning Score at admission (odds ratio = 1.60, 95% confidence interval = 1.07-1.37, p  = 0.021) and C-reactive protein >5 mg/dL (odds ratio = 2.12, 95% confidence interval = 1.13-26.26, p  = 0.034) were independent predictors of inhospital mortality in older age group but not in young and middle-aged., Conclusion: Older age group was at higher risk for complications and inhospital mortality. Identification of specific scores of severity for this population is essential to ensure that best care is provided., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)

Yarrowia lipolytica is a non-conventional yeast with promising industrial potentials for lipids and citrate production. It is also widely used for studying mitochondrial respiration due to a respiratory chain like those of mammalian cells. In this study we used a genome-scale model (GEM) of Y. lipolytica metabolism and performed a dynamic Flux Balance Analysis (dFBA) algorithm to analyze and identify metabolic levers associated with citrate optimization. Analysis of fluxes at stationary growth phase showed that carbon flux derived from glucose is rewired to citric acid production and lipid accumulation, whereas the oxidative phosphorylation (OxPhos) shifted to the alternative respiration mode through alternative oxidase (AOX) protein. Simulations of optimized citrate secretion flux resulted in a pronounced lipid oxidation along with reactive oxygen species (ROS) generation and AOX flux inhibition. Then, we experimentally challenged AOX inhibition by adding n-Propyl Gallate (nPG), a specific AOX inhibitor, on Y. lipolytica batch cultures at stationary phase. Our results showed a twofold overproduction of citrate (20.5 g/L) when nPG is added compared to 10.9 g/L under control condition (no nPG addition). These results suggest that ROS management, especially through AOX activity, has a pivotal role on citrate/lipid flux balance in Y. lipolytica. All taken together, we thus provide for the first time, a key for the understanding of a predominant metabolic mechanism favoring citrate overproduction in Y. lipolytica at the expense of lipids accumulation.

In many countries, the consumption of still wine is in strong decline. The market for rose wine, however, stands in stark contrast to this trend, seeing worldwide growth of almost 30% over the last 15 years. For most observers/experts, product colour plays an important role in this paradigm shift. For this reason, companies' marketing efforts often focus on this purely visual characteristic. There is, however, no certainty that other emerging consumer demands, related to environmental concerns or how "natural" a wine is (organic wines, natural wines, etc.), do not also play a role in the enthusiasm seen in new wine consumers. This article proposes an assessment of expectations related to colour and the decisions made by rose wine consumers, using two complementary experiments carried out in France. The first experiment is based on an online survey studying only consumers' colour preferences. We will show that, contrary to popular belief, there is no consensus on this criterion, although regional trends can be identified. Typically, the "salmon" shade, which is generally the leader on the global market-and characteristic of Provence wines-does not win unanimous support across all regions. In contrast, an "apricot" shade seems to be preferred by consumers in the Bordeaux region. The second experiment confirms this result within the framework of an experimental market revealing consumers' willingness to pay (WTP). This market also offers consumers the opportunity to taste wines and provides information on organic certification and "naturalness" (symbolised by the absence of added sulphites). We will then demonstrate how the latter criteria, although often popular, play only a small role-compared with colour-in consumer decisions. We will conclude this article with observations on the atypical nature of the rose wine market and on possible avenues for further research related to the emotional role colour plays in wine tasting and its possible specificity in the world of food and drink products.

Animals used in biological research and testing have become integrated into the trajectories of modern biomedicine, generating increased expectations for and connections between human and animal health. Animal research also remains controversial and its acceptability is contingent on a complex network of relations and assurances across science and society, which are both formally constituted through law and informal or assumed. In this paper, we propose these entanglements can be studied through an approach that understands animal research as a nexus spanning the domains of science, health and animal welfare. We introduce this argument through, first, outlining some key challenges in UK debates around animal research, and second, reviewing the way nexus concepts have been used to connect issues in environmental research. Third, we explore how existing social sciences and humanities scholarship on animal research tends to focus on different aspects of the connections between scientific research, human health and animal welfare, which we suggest can be combined in a nexus approach. In the fourth section, we introduce our collaborative research on the animal research nexus, indicating how this approach can be used to study the history, governance and changing sensibilities around UK laboratory animal research. We suggest the attention to complex connections in nexus approaches can be enriched through conversations with the social sciences and medical humanities in ways that deepen appreciation of the importance of path-dependency and contingency, inclusion and exclusion in governance and the affective dimension to research. In conclusion, we reflect on the value of nexus thinking for developing research that is interdisciplinary, interactive and reflexive in understanding how accounts of the histories and current relations of animal research have significant implications for how scientific practices, policy debates and broad social contracts around animal research are being remade today., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)

Alzheimer's disease (AD) and cancer have much in common than previously recognized. These pathologies share common risk factors (inflammation and aging), with similar epidemiological and biochemical features such as impaired mitochondria. Metabolic reprogramming occurs during aging and inflammation. We assume that inflammation is directly responsible of the Warburg effect in cancer cells, with a decreased oxidative phosphorylation and a compensatory highthroughput glycolysis (HTG). Similarly, the Warburg effect in cancer is thought to support an alkaline intracellular pH (pHi), a key component of unrelenting cell growth. In the brain, inflammation results in increased secretion of lactate by astrocytes. The increased uptake of lactic acid by neurons results in the inverse Warburg effect, such as seen in AD. The neuronal activity is dampened by a fall of pHi. Pronounced cytosol acidification results in decreased mitochondrial energy yield as well as apoptotic cell death. The link between AD and cancer is reinforced by the fact that treatment aiming at restoring the mitochondrial activity have been experimentally shown to be effective in both diseases. Low carb diet, lipoic acid, and/or methylene blue could then appear promising in both sets of these clinically diverse diseases.

Muong Nong-type (MN) tektites are a layered type of tektite associated to the Australasian strewn field, the youngest (790 kyr) and largest on Earth. In some MN tektites, coesite is observed in association with relict quartz and silica glass within inclusions surrounded by a froth layer. The formation of coesite-bearing frothy inclusions is here investigated through a 3D textural multiscale analysis of the vesicles contained in a MN tektite sample, combined with compositional and spectroscopic data. The vesicle size distribution testifies to a post-shock decompression that induced melting and extensive vesiculation in the tektite melt. Compared to free vesicles, nucleated homogeneously in the tektite melt, froth vesicles nucleated heterogeneously on relict quartz surfaces at the margins of coesite-bearing inclusions. The rapid detachment of the froth vesicles and prompt reactivation of the nucleation site favoured the packing of vesicles and the formation of the froth structure. Vesicle relaxation time scales suggest that the vesiculation process lasted few seconds. The formation of the froth layer was instrumental for the preservation of coesite, promoting quenching of the inclusion core through the subtraction of heat during froth expansion, thereby physically insulating the inclusion until the final quench of the tektite melt.

Objective: We aimed to identify opportunities for application of human factors knowledge base to mitigate disaster management (DM) challenges associated with the unique characteristics of the COVID-19 pandemic., Background: The role of DM is to minimize and prevent further spread of the contagion over an extended period of time. This requires addressing large-scale logistics, coordination, and specialized training needs. However, DM-related challenges during the pandemic response and recovery are significantly different than with other kinds of disasters., Method: An expert review was conducted to document issues relevant to human factors and ergonomics (HFE) in DM., Results: The response to the COVID-19 crisis has presented complex and unique challenges to DM and public health practitioners. Compared to other disasters and previous pandemics, the COVID-19 outbreak has had an unprecedented scale, magnitude, and propagation rate. The high technical complexity of response and DM coupled with lack of mental model and expertise to respond to such a unique disaster has seriously challenged the response work systems. Recent research has investigated the role of HFE in modeling DM systems' characteristics to improve resilience, accelerating emergency management expertise, developing agile training methods to facilitate dynamically changing response, improving communication and coordination among system elements, mitigating occupational hazards including guidelines for the design of personal protective equipment, and improving procedures to enhance efficiency and effectiveness of response efforts., Conclusion: This short review highlights the potential for the field's contribution to proactive and resilient DM for the ongoing and future pandemics.

In large-scale extreme events, multidisciplinary crisis management teams (CMTs) are required to function together cognitively. Despite theoretical maturity in team cognition and recurrent emphasis on cognition in the crisis management practices, no synthesis of theoretical and practical discourses is currently available, limiting empirical investigations of cognition in CMTs. To address this gap, this paper aims to review the definitions of cognition in CMTs, with a particular focus on examining if and to what extent they are diversified. Through a systematic process to search peer-reviewed journal articles published in English from 1990 to 2019, 59 articles were selected with 62 coded definitions of 11 different constructs. The similarities and variabilities of the definitions were examined in terms of their theoretical and practical emphases and then synthesised into an integrative definition expected to serve as a general guide of reference for future researchers seeking an operational definition of cognition in CMTs. Practitioner summary: Understanding of cognition in CMTs is grounded in various theories and models with varying assumptions. An integrative conceptualisation of such cognition as interaction within and across CMTs to perceive, diagnose, and adapt to the crisis may facilitate the accumulation of knowledge and future operationalisations. Abbreviations: CMT(s): crisis management team(s); SMM: shared mental model; TMM: team mental model; COP: common operating picture; SSA: shared situation awareness; TSA: team situation awareness; DC: distributed cognition; ITC: interactive team cognition; TMS: transitive memory system(s); DSA: distributed situation awareness.

There is a growing need for resilience in dealing with unexpected events during disasters. The purpose of this review was to summarize and synthesize the literature that examined resilience in the context of emergency management (EM). Four groups of findings were synthesized: definitions, key dimensions, technical tools, and research settings employed in the research. First, definitions of resilience, improvisation, and adaptation were summarized and critically evaluated. Second, four key dimensions of EM resilience were identified: collective sensemaking, team decision making, harmonizing work-as-imagined and work-as-done, and interaction and coordination. Third, this review identified five prevalent technical tools used to enhance resilience in EM: mapmaking, event history logging, mobile communication applications, integrated information management system, and decision support tools. Fourth, two major design features of emergency simulations, incident scenarios and participant roles, are evaluated. For each finding, directions for future research efforts to improve resilience in EM are proposed., Competing Interests: Declaration of competing interest We have no conflict of interest to report., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

OCCUPATIONAL APPLICATIONS There has been increasing use of small unmanned aerial systems in disaster and incident response. We evaluated sUAS pilot states during the tactical response to the 2018 Kilauea Volcano Lower East Rift Zone event, using a 3-minute psychomotor vigilance test (PVT) and wrist worn heart rate sensor. The field data, collected over four days, indicated that the sUAS pilots did not recover to baseline vigilance and physiological levels. Some pilots stopped participating over time, owing to logistical constraints of performing the 3-minute PVT test. Additionally, all pilots refrained from rating their perceived workload levels. We summarize the utility of and challenges associated with collecting performance, physiological, and subjective measures of pilot fatigue during real disaster response.

Modern communities face escalating threats from natural disasters. Thus, the resilience of incident management teams (IMTs) during adverse events becomes crucial to protect lives and physical systems. However, prior studies have only partially highlighted factors related to IMT resilience. To provide a holistic understanding of the resilience of the IMTs, this study conducted semi-structured interviews with 10 experienced IMT personnel during Hurricane Harvey. Thematic analysis revealed six characteristics of resilient IMTs during a hurricane event: (i) establishing a common operating picture, (ii) adopting and adapting plans and protocols, (iii) proactive, re-prioritizing, and unconventional decision-making, (iv) enhancing resourcefulness and redundancy, (v) learning for improved anticipation and response readiness, and (vi) inter-organisational relationship to promote IMT functions. As an empirical investigation of the resilience of the IMTs, the findings inform future endeavours for developing incident information technologies and strategies to harmonise pre-established plans with adaptive actions in the field and fostering capabilities to learn from incidents. Practitioner summary: Resilient incident management teams establish a common operating picture; effectively adopt and adapt plans and protocols; make decisions in an unconventional and anticipatory fashion; constantly re-prioritize goals and tasks; enhance resourcefulness and redundancy; continuously learn skills for improved anticipation and response readiness; and exhibit good inter-organisational coordination and planning skills.

Multidisciplinary incident management teams (IMTs) are required to operate in resilient ways as emergency situations unfold unexpectedly. Although resilience in emergency management has been widely studied in many emergency contexts, the development of a new method to investigate actual resilient performance of the IMTs under realistic settings has been limited. To address such gap, this paper first introduces Interaction Episode Analysis (IEA), a novel approach to capture and describe emergent team performance. As an exploratory observation study, we apply the IEA to an information management aspect of the IMTs in two emergency exercises carried out in a high-fidelity environment. As a result, the IEA provides comparable sets of episodes as instances of work-as-done, rendering opportunities to further analyze essential elements of interactions between team members as well as information management activities. Moreover, the IEA enables comparisons between the observations and identification of challenges faced by the team in managing incident information and adaptive behaviors used to address the challenges. By gathering more evidences as well as addressing limitations identified in this study, the IEA is expected to serve as a method that facilitates the analysis of work-as-done of complex team work and the reconciliation between work-as-done and work-as-imagined to promote resilience in emergency management., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

This article presents the results of a qualitative study based on semi-structured in-depth interviews with ten adolescents, aged between 15 and 17 years, who live in a favela in the South Zone of Rio de Janeiro, Brazil, and who had experienced an illegal abortion between the ages of 12 and 17. We sought to examine more effectively the issue of abortion in adolescence and the strategies employed by adolescents in order to have an abortion within an illegal context. We unveiled the methods that were used, the locations where abortions took place and the manner in which the process of having an abortion happened. The abortions took place at clandestine clinics; at the apartment of a partner's friend; and using the medication "Cytotec" (misoprostol). The values paid for the abortion ranged between BRL 500.00 and BRL 2,500.00 and all took place without the knowledge or participation of the adolescents' legal guardians. One adolescent had to seek out a health service due to complications from the abortion. Informants relied on friends and/or partners and almost all were alone when they had their abortions, which should motivate a reflection regarding the risks taken and the solitude experienced by these adolescents in order to undergo an unsafe and illegal act. We conclude that the study of abortion at this life stage makes an important contribution to understanding sexuality and reproduction in adolescence.

Networks of reactions inside the cell are constrained by the laws of mass and energy balance. Constrained-based modelling (CBM) is the most used method to describe the mass balance of metabolic network. The main key concepts in CBM are stoichiometric analysis such as elementary flux mode analysis or flux balance analysis. Some of these methods have focused on adding thermodynamics constraints to eliminate non-physical fluxes or inconsistencies in the metabolic system. Here, we review the main different approaches and how they tackle the different class of problems.

The implications of freezing seeds to conserve genes statically and for the long term are complex and deserve further reflection to appreciate seed banking as an attempt to detach seeds from their life cycle. Here, I use a cryopolitical framework to explore this in the context of the activities of the International Board of Plant Genetic Resources (IBPGR) between 1973 and 1984. I suggest that the emergence of seed banks is a shift toward a cryopower mode of governance, where technoscientific intervention in the biology of seeds was presented as a means to manage the survival of seeds. The project of ex situ conservation is a socio-technical effort by international institutions such as IBPGR and a variety of institutions with seed repositories. In creating a coldscape, they sought to make genetic resources into frozen seeds that were stable and mobile, not only across space but, importantly, over time. Consequently, our interpretations of seed banks as sites of geopolitical significance in the controversies over access to seeds can be complemented by considering their biopolitical importance as interventions that extend the power of IBPGR and other institutions toward plant life, and the future., (© 2019 The Authors. Culture, Agriculture, Food and Environment published by Wiley Periodicals, Inc. on behalf of American Anthropological Association.)

Objectives: The aim of the review was to elucidate the adverse effects of chronic treatment with the main subclasses of highly active antiretroviral therapy (HAART)., Methods: A systematic review was carried out using the methods recommended in the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P). Searches of articles in MEDLINE, SCIELO, Web of Science and LILACS were conducted from January to October 2018 based on the following descriptors and keywords: 'HIV' [AND]; 'AIDS' [OR]; 'HAART' [AND]; 'Highly Active Antiretroviral Therapy' [OR]; 'Adverse Effects' [AND]. All articles selected described the biochemical changes produced by, and the main adverse effects of, using one or more of the following HAART subclasses: nucleoside reverse transcriptase inhibitors (NRTIs), nonnucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs) and other new drugs. The selected articles included patients living with HIV (PLWH) initiating or continuing any type of HAART. The results are presented qualitatively and discussed., Results: Twenty-one articles found in the searches were selected for the review, and they included a total of 5626 participants. Seven of the studies investigated mainly NRTIs, three studies mainly NNRTIs, eight studies predominantly PIs, and three studies other antiretroviral drugs as the main treatment. The most common adverse effects on biochemical parameters were the emergence of anaemia for NRTIs as well as NNRTIs and PIs, and plasma lipid alterations caused by their prolonged use. In general, it was found that biological differences among individuals can cause differences in adverse effects, such as virological and treatment failure., Conclusions: One or more occurrences of adverse effects of the chronic utilization of drugs were found for all subclasses of HAART, and certain combinations of drugs from different subclasses were also found to be associated with adverse events., (© 2019 British HIV Association.)

Background: Microalgae have been proposed as potential platform to produce lipid-derived products, such as biofuels. Knowledge on the intracellular carbon flow distribution may identify key metabolic processes during lipid synthesis thus refining culture/genetic strategies to maximize cell lipid productivity. A kinetic metabolic model simulating cell metabolic behavior and lipid production was first applied in the microalgae platform Chlorella protothecoides under heterotrophic condition. It combines both physiology and flux information in a kinetic approach. Cell nutrition, growth, lipid production and almost 30 metabolic intermediates covering central carbon metabolism were included and simulated., Results: Model simulations were shown to adequately agree with experimental data, which is suggesting that the proposed model copes with Chlorella protothecoides cells' biology. The dynamic metabolic flux analysis using the model showed a reversible starch flux from accumulation to decomposing when glucose reached depletion, while net lipid flux shows a quasi-constant rate. The sensitive flux parameters on starch and lipid metabolism suggested that starch synthesis is the major competing pathway that affects lipid accumulation in C. protothecoides. Flux analysis also demonstrated that high lipid yield under heterotrophic condition is accompanied with high lipid flux and low TCA activity. Meanwhile, the dynamic flux distribution also suggests a relatively constant ratio of glucose distributed to biomass, lipid, starch, nucleotides as well as pentose phosphate pathway., Conclusion: The model described not only experimental data, but also unraveled intracellular carbon flow distribution and identify key metabolic processes during lipid synthesis. Most of the metabolic kinetics also showed statistical significance for metabolic mechanism. Therefore, this study unravels the mechanisms of the glucose impact on the dynamic carbon flux distribution, thus improving our understanding of the links between carbon fluxes and lipid metabolism in C. protothecoides.

Introduction: Non-tuberculous mycobacteria are ubiquitous organisms. Precise determination of infection numbers is difficult, since reporting them to public health departments is frequently not mandatory; furthermore, isolating a non-tuberculous mycobacteria does not necessarily translate into disease. The aims of this study were to ascertain non-tuberculous mycobacteria data of a tertiary hospital, determine the incidence and approach to colonization versus disease, and the incidence of predisposing comorbidities., Material and Methods: Retrospective study in a tertiary hospital, involving patients with positive cultural exam for non-tuberculous mycobacteria in any biological sample, from 2010 to 2017., Results: A total of 125 non-tuberculous mycobacteria isolates was identified, corresponding to 96 patients. Of these, 57.4% were male (n = 54); median age was 65 years (interquartile range = [50 - 82]). From these, 60.7% (n = 57) had some degree of immunosuppression, most frequently due to malignant tumour (49.0%) or HIV infection (39.2%). It was found that 29 patients (31.0%) had structural respiratory tract changes. Colonization was defined in 65.6% of patients (n = 63). While 71.0% of non-tuberculous mycobacteria infections were pulmonary, the remaining 29.0% presented as disseminated. According to available clinical records, 60.6% (n = 20) of the presumably infected patients fulfilled American Thoracic Society diagnostic criteria for non-tuberculous mycobacteria disease., Discussion: Several cases of non-tuberculous mycobacteria infection in this study presented as life-threatening, multi-systemic disease, highlighting the importance of accurate diagnosis and timely treatment. Other cases of presumed infection might instead have corresponded to colonization, possibly resulting in futile therapy., Conclusion: While there are diagnostic criteria for treatment of non-tuberculous mycobacteria infections, no such guidelines exist to assess colonization. One of the most challenging aspects remains the correct differentiation between colonization and early-stage infection.

We performed a study to identify potential causes and risk factors of vertebral fracture cascade. Vertebral fracture cascade is a severe clinical event in patients with bone fragility. Only half of patients have an identified cause of secondary osteoporosis., Introduction: Vertebral fracture (VF) is the most common osteoporotic fracture, and a strong risk factor of subsequent VFs leading to VF cascade (VFC). We prompted a study to identify potential causes and risk factors of VFC., Methods: VFC observations were collected retrospectively between January 2016 and April 2017. VFC was defined as an occurrence of at least three VFs within 1 year., Results: We included in 10 centers a total of 113 patients with VFC (79.6% of women, median age 73, median number of VFs in the cascade, 5). We observed 40.5% and 30.9% of patients with previous major fractures and a previous VF, respectively, and 68.6% with densitometric osteoporosis; 18.9% of patients were currently receiving oral glucocorticoids and 37.1% in the past. VFC was attributed by the physician to postmenopausal osteoporosis in 54% of patients. A secondary osteoporosis associated with the VFC was diagnosed in 52 patients: glucocorticoid-induced osteoporosis (25.7%), non-malignant hemopathies (6.2%), alcoholism (4.4%), use of aromatase inhibitors (3.6%), primary hyperparathyroidism (2.7%), hypercorticism (2.7%), anorexia nervosa (2.7%), and pregnancy and lactation-associated osteoporosis (1.8%). A total of 11.8% of cases were reported following a vertebroplasty procedure. A total of 31.5% patients previously received an anti-osteoporotic treatment. In six patients, VFC occurred early after discontinuation of an anti-osteoporotic treatment, in the year after the last dose effect was depleted: five after denosumab and one after odanacatib., Conclusion: The results of this retrospective study showed that only half of VFC occurred in patients with a secondary cause of osteoporosis. Prospective studies are needed to further explore the determinants of this severe complication of osteoporosis.

In the recent years, cancer research succeeded with sensitive detection methods, targeted drug delivery systems, and the identification of a large set of genes differently expressed. However, although most therapies are still based on antimitotic agents, which are causing wide secondary effects, there is an increasing interest for metabolic therapies that can minimize side effects. In the early 20 th century, Otto Warburg revealed that cancer cells rely on the cytoplasmic fermentation of glucose to lactic acid for energy synthesis (called "Warburg effect"). Our investigations aim to reverse this effect in reprogramming cancer cells' metabolism. In this work, we present a metabolic therapy specifically targeting the activity of specific enzymes of central carbon metabolism, combining the METABLOC bi-therapeutic drugs combination (Alpha Lipoic Acid and Hydroxycitrate) to Metformin and Diclofenac, for treating tumors implanted in mice. Furthermore, a dynamic metabolic model describing central carbon metabolism as well as fluxes targeted by the drugs allowed to simulate tumors progression in both treated and non-treated mice, in addition to draw hypotheses on the effects of the drugs on tumor cells metabolism. Our model predicts metabolic therapies-induced reversed Warburg effect on tumor cells.

Existing risk assessment tools are not effective or sustainable in identifying Oil and Gas Extraction (OGE) workers at high risk of fatigue-related injuries or incidents. We developed a comprehensive Fatigue Risk Assessment and Management in high-risk Environments (FRAME) survey through an industry-academic participatory approach. The FRAME survey was developed through: (1) systematic gathering of existing fatigue scales; (2) refining the inventory using the Delphi Consensus technique; and (3) further refinement through employee/worker focus groups. The participatory approach resulted in a final FRAME survey across four fatigue dimensions-sleep, shiftwork, physical, and mental fatigue, and was composed of 26 items. The FRAME survey was founded on occupational fatigue science and refined and tailored to the OGE industry, through rigorous industry stakeholder input, for safer, effective, practical, and sustainable fatigue assessment and management efforts.

Objective: Evaluation of effects of native language-native (L1) versus nonnative (L2)-on procedure performance., Background: Written procedures are used by global industries to facilitate accurate and safe performance of hazardous tasks. Often companies require that all employees be sufficiently literate in English and to use only English versions., Method: Industrial tasks were tested using a virtual reality industrial environment (Second Life ® ) to explore effects on procedural performance and safety statement adherence. Fifty-four engineering students (27 L2) participated in the study to explore the native language variable. The participants completed the procedures under time pressure and were scored according to procedure performance and hazard comprehension., Results: Analysis of eight procedures showed significant differences between L1 and L2 for procedure performance (specifically for L2 females). There were no language fluency or hazard comprehension differences found between the two groups., Conclusion: The results suggest that (a) the lower procedure performance of L2 readers was not due to English proficiency but more likely to time pressure; (b) implications regarding single language procedures are not fully understood, particularly with regard to gender differences., Application: This research is applicable to high-risk industries providing single language, time critical procedures to multilingual workforces.

This paper discusses the topic of first sexual intercourse in adolescence focusing on the course of ten young girls with experience of induced abortion living in a favela in Rio de Janeiro. The analysis uses the description of the process of entry into sexuality as a strategy to elucidate the context of pregnancy and the first clandestine abortion in the affective-sexual path of girls interviewed. The first sexual intercourse is a realm of sexuality and social life involving socialization, interpretation of rules and meanings, system of attitudes, ways of approximation, control and modeling of affections, emotions and gender relationships. The results showed that the age difference between couples in sexual initiation is significant, clarifying the context in which decisions on contraceptive methods, pregnancy and abortion were held. We noted that adolescents subject to difficult decisions about their sexuality and reproduction at a time of life where they still lack sexual and reproductive experience. The data collected show the importance of strengthening of public policies, discussions on gender and adolescent sexual and reproductive rights in many spheres of society, such as schools, family and other institutions.

Metabolic pathway analysis is a key method to study metabolism and the elementary flux modes (EFMs) is one major concept allowing one to analyze the network in terms of minimal pathways. Their practical use has been hampered by the combinatorial explosion of their number in large systems. The EFMs give the possible pathways at steady state, but the real pathways are limited by biological constraints. In this review, we display three different methods that integrate thermodynamic constraints in terms of Gibbs free energy in the EFMs computation., (© 2018 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.)