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

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This paper analyzes the influence of gravity segregation effects on inflow performance relationship (IPR) curves, with both totally and partially penetrated vertical wells. Using synthetic responses from a finite difference simulator, the effects of different parameters, such as vertical to radial permeability ratio, production mode, position of productive interval oil rate, and mechanical skin, on the shape of IPR curves are documented. It is shown that greater flow potentials are obtained when the ratio of gravity to viscous forces increases. It is shown that for the case of partially penetrated wells, the IPR curve generated at constant bottomhole pressure does not coincide with the IPR generated at constant oil rate. Also, the presence of gravity segregation affects the values of absolute open flow potential obtaining big differences with the corresponding values when gravitational effects are ignored. The values of the exponent n of Fetkovich IPR and the coefficients of the quadratic equation proposed by Jones et al. are functions not only of time but also of production rate, position of productive interval and other parameters. The consequence of the above results is that the interpretation of IPR curves is affected by the presence of gravitational effects and therefore the use of traditional methods, such as those of Vogel, Fetkovich, or Jones et al., is restricted to the specific conditions considered by these authors. [DOI: 10.1115/1.3185355] Keywords: solution gas drive, inflow performance, gravity segregation

Las encefalitis autoinmunes son procesos inflamatorios cerebrales que se clasifican en dos grandes grupos según el mecanismo patogénico subyacente: las mediadas por anticuerpos vs. antígenos intracelulares (paraneoplásicas) y las mediadas por anticuerpos frente a los antígenos extracelulares o de superficie neuronal. Las manifestaciones clínicas son muy variadas y poco específicas. Las pruebas complementarias incluidas en el diagnóstico clínico de la encefalitis autoinmune incluyen, entre otras, la determinación de anticuerpos en suero o en líquido cefalorraquídeo y la resonancia magnética (RM). La RM puede presentar patrones característicos como la afectación mesial del temporal, aunque en determinados casos puede ser normal. La imagen de tomografía por emisión de positrones (PET/TC) con 18F-Fluorodeoxiglucosa (18F-FDG PET/TC) puede ser de gran utilidad en los casos de encefalitis autoinmunes paraneoplásicas para encontrar el tumor primario. En los casos de encefalitis autoinmunes mediadas por anticuerpos frente a los antígenos extracelulares, la 18F-FDG PET/TC presenta unos patrones que pueden ayudar al diagnóstico clínico. Esta colaboración especial pretende presentar de forma clara y de fácil comprensión las características clínicas de la encefalitis autoinmune, las dificultades en el diagnóstico clínico y los patrones observados en la RM y en la 18F-FDG PET/TC. Autoimmune encephalitis are brain inflammatory processes that are classified into two main groups according to the underlying pathogenic mechanism: antibodies to intracellular antigens (paraneoplastic) and antibodies to extracellular or neuronal surface antigens. The clinical manifestations of autoimmune encephalitis are very varied and non-specific. Complementary tests included in its clinical diagnosis include determination of antibodies in serum or cerebrospinal fluid and magnetic resonance imaging (MRI). MRI may show characteristic patterns such as mesial temporal involvement, although in some cases it may be normal or non-specific. 18F-Fluorodeoxyglucose PET/CT (18F-FDG PET/CT) imaging may be helpful in cases of paraneoplastic autoimmune encephalitis to find the primary tumor. In autoimmune encephalitis mediated by antibodies to extracellular antigens, 18F-FDG PET/CT shows distinctive patterns that can aid clinical diagnosis. This special collaboration aims to present in a clear and easy-to-understand way, the clinical features of autoimmune encephalitis, the difficulties in clinical diagnosis and the patterns seen on MRI and 18F-FDG PET/CT. [ABSTRACT FROM AUTHOR]

The latest version of the Philippine National Standards for Drinking-Water (PNSDW) was issued in 2007 by the Department of Health (DOH). Due to several issues and concerns, the DOH decided to make an update which is relevant and necessary to meet the needs of the stakeholders. As an output, the water quality parameters are now categorized into mandatory, primary, and secondary. The ten mandatory parameters are core parameters which all water service providers nationwide are obligated to test. These include thermotolerant coliforms or Escherichia coli, arsenic, cadmium, lead, nitrate, color, turbidity, pH, total dissolved solids, and disinfectant residual. The 55 primary parameters are site-specific and can be adopted as enforceable parameters when developing new water sources or when the existing source is at high risk of contamination. The 11 secondary parameters include operational parameters and those that affect the esthetic quality of drinkingwater. In addition, the updated PNSDW include new sections: (1) reporting and interpretation of results and corrective actions; (2) emergency drinking-water parameters; (3) proposed Sustainable Development Goal parameters; and (4) standards for other drinking-water sources. The lessons learned and insights gained from the updating of standards are likewise incorporated in this paper. [ABSTRACT FROM AUTHOR]

The understanding of runoff generation mechanisms is crucial for the sustainable management of river basins such as the allocation of water resources or the prediction of floods and droughts. However, identifying the mechanisms of runoff generation has been a challenging task, even more so in arid and semi-arid areas where high rainfall and streamflow variability, high evaporation rates, and deep groundwater reservoirs increase the complexity of hydrological process dynamics. Isotope and hydrochemical tracers have proven to be useful in identifying runoff components and their characteristics. Moreover, although widely used in humid-temperate regions, isotope hydrograph separations have not been studied in detail in arid and semi-arid areas. Thus the purpose of this study is to determine if isotope hydrograph separations are suitable for the quantification and characterization of runoff components in a semi-arid catchment considering the hydrological complexities of these regions. Through a hydrochemical characterization of the surface water and groundwater sources of the catchment and two and three component hydrograph separations, runoff components of the Kaap Catchment in South Africa were quantified using both, isotope and hydrochemical tracers. No major disadvantages while using isotope tracers over hydrochemical tracers were found. Hydrograph separation results showed that runoff in the Kaap catchment is mainly generated by groundwater sources. Two-component hydrograph separations revealed groundwater contributions between 64 and 98% of total runoff. By means of three-component hydrograph separations, runoff components were further separated into direct runoff, shallow and deep groundwater components. Direct runoff, defined as the direct precipitation on the stream channel and overland flow, contributed up to 41 % of total runoff during wet catchment conditions. Shallow groundwater defined as the soil water and near-surface water component, contributed up to 45 % of total runoff, and deep groundwater contributed up to 84% of total runoff. A strong correlation for the four studied events was found between the antecedent precipitation conditions and direct runoff. These findings suggest that direct runoff is enhanced by wetter conditions in the catchment which trigger saturation excess overland flow as observed in the hydrograph separations. [ABSTRACT FROM AUTHOR]

This paper analyzes the influence of gravity segregation effects on inflow performance relationship (IPR) curves, with both totally and partially penetrated vertical wells. Using synthetic responses from a finite difference simulator the effects of different parameters, such as vertical to radial permeability ratio, production mode, position of productive interval, oil rate, and mechanical skin, on the shape of IPR curves are documented. It is shown that greater flow potentials are obtained when the ratio of gravity to viscous forces increases. It is shown that for the case of partially penetrated wells, the IPR curve generated at constant bottomhole pressure does not coincide with the IPR generated at constant oil rate. Also, the presence of gravity segregation affects the values of absolute open flow potential, obtaining big differences with the corresponding values when gravitational effects are ignored. The values of the exponent n of Fetkovich IPR and the coefficients of the quadratic equation proposed by Jones et al. are functions not only of time but also of production rate, position of productive interval, and other parameters. The consequence of the above results is that the interpretation of IPR curves is affected by the presence of gravitational effects and therefore the use of traditional methods, such as those of Vogel , Fetkovich, or Jones et al., is restricted to the specific conditions considered by these authors. [ABSTRACT FROM AUTHOR]

The article reports that significant abdominal trauma in children remains uncommon and doesn't need surgery. Focused Assessment with Sonography for Trauma (FAST) has good sensitivity and specificity for hemoperitoneum and intra-abdominal injuries. The Blunt Abdominal Trauma in Children (BATiC) score use Doppler ultrasound, abdominal signs, hemodynamic stability and blood analysis to find the risk of intra-abdominal injury.

Background: Narrowing, trauma, tumors, and systemic diseases can cause esophageal dysfunction. Severe cases resist traditional surgery, leading to long-term gastrostomy or jejunostomy tubes, affecting patients negatively. No established surgery ensures both airway and oral function with proper speech. This article introduces the oral-vestibule-enteral anastomosis (OVEA) technique, targeting patients with compromised epiglottic closure competence and loss of cervical esophagus, where conventional methods fall short., Methods: Technique description study evaluated in 13 patients in a single tertiary referral center in Mexico City treated with OVEA from January 1990 to July 2023., Results: Of the 13 patients (69% male; mean age, 37.14 ± 12.907 years), preoperative conditions included a mean body mass index of 17.78 ± 2.66 kg/m 2 , 46% with previous abdominal surgeries, and 31% with a smoking history. After OVEA, complications affected 46%, primarily pneumonia (23%), abscess formations (15%), intestinal necrosis (8%), and airway fistula (8%). Reoperation was needed in 38%, addressing functionality loss, necrosis, stenosis, and jawbone remodeling. No fatalities occurred within the first 6 months after surgery; 84% had successful gastrostomy tube removal, and 8% retained a tracheostomy tube. Currently 13 patients (92%) use the OVEA as their main enteral route of feeding., Conclusion: The OVEA technique seems promising for cases involving esophageal loss or impaired epiglottic function, enhancing patients' quality of life by enabling oral feeding and restoring regular eating habits. Further research should focus on long-term results and identifying optimal candidates for this innovative surgical method., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2024 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.)

Background: Platelets are essential for hemostasis and thrombosis and play vital roles during metastatic cancer progression and infection. Hallmarks of platelet function are activation, cytoskeletal rearrangements, and the degranulation of their cellular contents upon stimulation. While α-granules and dense granules are the most studied platelet secretory granules, the dense tubular system (DTS) also functions as a secretory system for vascular thiol isomerases. However, how DTS cargo is packaged and transported from megakaryocytes (MKs) to platelets is poorly understood., Objectives: To underpin the mechanisms responsible for DTS cargo transport and leverage those for therapeutic protein packaging into platelets., Methods: A retroviral expression system combined with immunofluorescence confocal microscopy was employed to track protein DTS cargo protein disulfide isomerase fused to enhanced green fluorescent protein (eGFP-PDI) during platelet production. Murine bone marrow transplantation models were used to determine the release of therapeutic proteins from platelets., Results: We demonstrated that the endoplasmic reticulum retrieval motif Lys-Asp-Glu-Leu (KDEL) located at the C-terminus of protein disulfide isomerase was essential for the regular transport of eGFP-PDI-containing granules. eGFP-PDI ΔKDEL , in which the retrieval signal was deleted, was aberrantly packaged, and its expression was upregulated within clathrin-coated endosomes. Finally, we found that ectopic transgenic proteins, such as tissue factor pathway inhibitor and interleukin 2, can be packaged into MKs and proplatelets by adding a KDEL retrieval sequence., Conclusion: Our data corroborate the DTS as a noncanonical secretory system in platelets and demonstrate that in vitro-generated MKs and platelets may be used as a delivery system for transgenic proteins during cellular therapy., Competing Interests: Declaration of competing interests J.E.I. has a financial interest in and is a founder of Stellular Bio, a biotechnology company focused on making donor-independent platelet-like cells at scale, and Spry Bio. Boston Children’s Hospital manages the interests of J.E.I.. R.F. is a founder of and consultant for Platelet Diagnostics. Beth Israel Deaconess Medical Center manages the interests of R.F.. All other authors declare no competing financial interests., (Copyright © 2024 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved.)

Introduction: In Down syndrome (DS), white matter hyperintensities (WMHs) are highly prevalent, yet their topography and association with sociodemographic data and Alzheimer's disease (AD) biomarkers remain largely unexplored., Methods: In 261 DS adults and 131 euploid controls, fluid-attenuated inversion recovery magnetic resonance imaging scans were segmented and WMHs were extracted in concentric white matter layers and lobar regions. We tested associations with AD clinical stages, sociodemographic data, cerebrospinal fluid (CSF) AD biomarkers, and gray matter (GM) volume., Results: In DS, total WMHs arose at age 43 and showed stronger associations with age than in controls. WMH volume increased along the AD continuum, particularly in periventricular regions, and frontal, parietal, and occipital lobes. Associations were found with CSF biomarkers and temporo-parietal GM volumes., Discussion: WMHs increase 10 years before AD symptom onset in DS and are closely linked with AD biomarkers and neurodegeneration. This suggests a direct connection to AD pathophysiology, independent of vascular risks., Highlights: White matter hyperintensities (WMHs) increased 10 years before Alzheimer's disease symptom onset in Down syndrome (DS). WMHs were strongly associated in DS with the neurofilament light chain biomarker. WMHs were more associated in DS with gray matter volume in parieto-temporal areas., (© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)