Search

Sex inequities in liver transplantation (LT) have been documented in several, mostly US-based, studies. Our aim was to describe sex-related differences in access to LT in a system with short waiting times. All adult patients registered in the RETH-Spanish Liver Transplant Registry (2000–2022) for LT were included. Baseline demographics, presence of hepatocellular carcinoma, cause and severity of liver disease, time on the waiting list (WL), access to transplantation, and reasons for removal from the WL were assessed. 14,385 patients were analysed (77% men, 56.2 ± 8.7 years). Model for end-stage liver disease (MELD) score was reported for 5,475 patients (mean value: 16.6 ± 5.7). Women were less likely to receive a transplant than men (OR 0.78, 95% CI 0.63, 0.97) with a trend to a higher risk of exclusion for deterioration (HR 1.17, 95% CI 0.99, 1.38), despite similar disease severity. Women waited longer on the WL (198.6 ± 338.9 vs. 173.3 ± 285.5 days, p < 0.001). Recently, women’s risk of dropout has reduced, concomitantly with shorter WL times. Even in countries with short waiting times, women are disadvantaged in LT. Policies directed at optimizing the whole LT network should be encouraged to guarantee a fair and equal access of all patients to this life saving resource.

The bloom of pelagic Sargassum in the Atlantic Ocean has become increasingly problematic, especially when the algae have beached. A build-up of decaying beached material has damaging effects on coastal ecosystems and tourism industries. While remote sensing offers an effective tool to assess the spatial and temporal patterns of Sargassum over large spatial extents, its use so far has been limited to a broad discrimination of Sargassum species from other macroalgae and floating vegetation. Knowledge on the spatial distribution of decayed material will help to support management strategies and inform targeted removal. In this study, we aim to characterise the spectral response of fresh and decayed Sargassum and identify regions of the spectra that offer the greatest separability for the detection and classification of decayed material. We assessed the spectral response of fresh and decayed Sargassum (1) in situ on the beach and (2) in mesocosm experiments where Sargassum samples were allowed to decay over time. We found a decrease in the magnitude of reflectance, noticeably in the visible region (400–700 nm), for decayed, in contrast to fresh, Sargassum. Separability analyses also showed that most spectral bands with a wavelength > ~540 nm will be capable of discriminating between fresh and decayed material, although the near-infrared region offers the greatest degree of separability. We demonstrate, for the first time, that there are clear differences in the spectral reflectance of fresh and decayed Sargassum with potential application for remote sensing approaches.

Background and Aims: Prognosis after liver transplantation differs between hepatocellular carcinoma (HCC) arising in cirrhotic and non-cirrhotic livers and aetiology is poorly understood. The aim was to investigate differences in mortality after liver transplantation between these patients. Methods: We included patients from the European Liver Transplant Registry transplanted due to HCC from 1990 to November 2016 and compared cirrhotic and non-cirrhotic patients using propensity score (PS) calibration of Cox regression estimates to adjust for unmeasured confounding. Results: We included 22,787 patients, of whom 96.5% had cirrhosis. In the unadjusted analysis, non-cirrhotic patients had an increased risk of overall mortality with a hazard ratio (HR) of 1.37 (95% confidence interval [CI] 1.23–1.52). However, the HR approached unity with increasing adjustment and was 1.11 (95% CI 0.99–1.25) when adjusted for unmeasured confounding. Unadjusted, non-cirrhotic patients had an increased risk of HCC-specific mortality (HR 2.62, 95% CI 2.21–3.12). After adjustment for unmeasured confounding, the risk remained significantly increased (HR 1.62, 95% CI 1.31–2.00). Conclusions: Using PS calibration, we showed that HCC in non-cirrhotic liver has similar overall mortality, but higher HCC-specific mortality. This may be a result of a more aggressive cancer form in the non-cirrhotic liver as higher mortality could not be explained by tumour characteristics or other prognostic variables.

The main purpose of this study was to analyze retrospectively the memories of a group of adults with low skills and the relationships between their memories and their physical education teachers during their school time. Ten adults (7 women and three men) participated in this study, aged between 25 and 56 years that declared to be low skilled during their school days. In order to carry out this study, a semi-strutured interview was conducted focusing the attention on obtaining memories of participants in their PE classes during their schoolage, and mainly their perceptions and feelings about their Primary and Secondary PE teachers. Results showed that the memories of behaviors and personality of their PE teachers were more important for participants than the learning from activities that their PE teachers taught. The feelings and emotions about his/her PE teachers were mostly negative, characterized by humiliation, abandonment, lack of help or indifference towards them. For these participants, their PE teachers did not live up to their needs. Knowing these memories had permitted the researchers to know a hidden part of the PE subject that is referred to a sector of the school population that shows low motor competence.

Due to the worldwide negative impact on sport of the COVID-19 pandemic declared by the WHO in 2020, the first aim of this study was to analyze the influence of COVID-19 on performance indicators as a natural experiment, according to the moment in time: pre-COVID, COVID and post-COVID. The second aim was to analyze and ascertain the persistence of the performance indicators (PIs) over the analyzed seasons. To this end, 5320 teams’ match data corresponding to the 2014/2015 to 2020/2021 seasons of the LaLiga (first division of Spanish men’s soccer) were analyzed. All the seasons developed normally except the 2019/2020 season in which there was a three-month hiatus because of the COVID-19 pandemic, representing a natural experiment without spectators. Statistical tests including ANOVA, general multivariate linear analysis with three independent variables (covidtime, venue and result) and an autocorrelation were performed. The results obtained showed that there were significant differences in the PIs regarding the moment in time, the result, the venue, and the pairwise interactions among them. The evolution of the PIs has changed over the years, showing a decrease in the means of most of them, leading to a more passive game with tighter results; differences which could be generated by the change in the rules (from 3 to 5 substitutions), the total or partial absence of spectators, three months of confinement and inactivity, or the accumulation of matches and minutes played by the individual players. The teams’ technical staffs should bear all of these types of situations in mind as the seasons evolve to adapt as quickly as possible to a more effective game style in order to achieve objectives.

In this study, a designed ad hoc questionnaire was constructed and validated to investigate the opinion of coaches about the concept of unfavorable critical moment in futsal, and the coincident use of goalkeeper as an outfield player strategy (5vs4) with that critical moment, which is a decisive step towards theoretical and methodological convergences. A total of 129 coaches belonging to teams of divisions 1st, 2nd and 2nd B participated in the questionnaire, which was validated by the judgment of experts thru calculating the content validity through the Aiken's V coefficient (Aiken, 1980, 1985). The results of the qualitative study revealed the importance that futsal coaches give to the maximum difference of 2 goals, and to the last 8 min of the game as maximum exponents of criticality, also to the importance of the 5th accumulated foul as a precipitant factor of an unfavorable critical moment in maximum equality matches. In addition, coaches manifested that interactive effects of score-line, remaining time and accumulated fouls could be the trigger of unfavorable critical moments, and using the goalkeeper as an outfield player strategy is a common practice to solve these situations. The values obtained in 19 of the 20 items (V> 0.90) attest that the content of the questionnaire is valid to show that the sample of futsal coaches understands the concept of criticality. The implications of the study contribute to a more specific knowledge of the futsal game and at the practical level the possibility of using this information to establish training objectives related to different stress conditions. Resumen A través de la construcción y validación de un cuestionario diseñado ad hoc se trató de investigar el pensamiento del entrenador relacionado con el concepto de momento crítico desfavorable en futsal, y la utilización del portero-jugador (5vs4) coincidente con el momento crítico, como un paso decisivo hacia convergencias teóricas y metodológicas. Un total de 129 entrenadores pertenecientes a equipos de 1ª, 2ª y 2ª B participaron en el cuestionario, que fue validado mediante el juicio de expertos calculando el índice de validez de contenido a través del coeficiente Aiken's V (Aiken,1980, 1985). Los resultados del estudio cualitativo revelan la importancia que otorgan los entrenadores de futsal a la diferencia máxima de 2 goles y a los últimos 8 minutos del partido como máximos exponentes de la criticidad, y a la importancia de la 5ª falta como factor precipitante de un momento crítico desfavorable en partidos de máxima igualdad. Además, muestran acuerdo en que los efectos interactivos de marcador, tiempo y faltas pueden ser el desencadenante de los momentos críticos desfavorables, y que es una práctica común el decidir afrontarlos con la utilización del procedimiento portero como jugador de campo (5vs4). Los valores obtenidos en 19 de los 20 ítems (V> 0.90) atestiguan que el contenido del cuestionario es válido para demostrar que la muestra de entrenadores de futsal entiende el concepto de criticidad. Las implicaciones del estudio aportan la contribución esencial del entrenador para un conocimiento más específico del juego, y a nivel práctico la posibilidad de utilizar esta información para establecer objetivos de entrenamiento relacionados con las diferentes condiciones de estrés.

Abstract Sexual imprinting is the learning of a mate preference by direct observation of the phenotype of another member of the population. Sexual imprinting can be paternal, maternal, or oblique if individuals learn to prefer the phenotypes of their fathers, mothers, or other members of the population, respectively. Which phenotypes are learned can affect trait evolution and speciation rates. “Good genes” models of polygynous systems predict that females should evolve to imprint on their fathers, because paternal imprinting helps females to choose mates that will produce offspring that are both viable and sexy. Sexual imprinting by males has been observed in nature, but a theory for the evolution of sexual imprinting by males does not exist. We developed a good genes model to study the conditions under which sexual imprinting by males or by both sexes can evolve and to ask which sexual imprinting strategies maximize the fitness of the choosy sex. We found that when only males imprint, maternal imprinting is the most advantageous strategy. When both sexes imprint, it is most advantageous for both sexes to use paternal imprinting. Previous theory suggests that, in a given population, either males or females but not both will evolve choosiness in mating. We show how environmental change can lead to the evolution of sexual imprinting behavior by both sexes in the same population.

Performance analysis in sport is considered a research area that has grown rapidly in the last two decades (O’Donoghue, 2014). One of the most important reasons of this fact is the interest of sport stakeholders (i.e., coaches, players, managers, fans and performance analysist) regarding to improve the training processes and the management and control of competition (O’Donoghue, 2014; O’Donoghue, Holmes, & Robinson, 2017). Accordingly, performance analysis has evolved including different topics and issues to be studied such as: critical moments and perturbations in sport, coaches’ behaviours, performance indicators in sport, injuries incidence and physical analysis, movement analysis during competitions, reliability and validity of sport behaviours, analysis of technique and tactics in sport, normative profilings, analysis of effectiveness of performance analysis or the analysis of referees’ performance (O’Donoghue, 2014).

Resumen El objetivo del presente estudio es analizar la opinión de los entrenadores y expertos sobre la modificación del reglamento en categoría infantil. Para ello se administró el cuestionario de Modificación Reglamentaria de la Competición a un total de 101 entrenadores, y a 14 expertos. Los resultados más significativos señala que: a) el 85.7% de los entrenadores y el 78.6% de los expertos cambiarían alguna regla; b) los entrenadores prohibirían la posibilidad de defender en zona; c) los expertos modificarían la altura de la canasta, disminuirían el tamaño del balón, acercarían la línea de tres puntos, modificarían el sistema de victorias, eliminarían la defensa en zona, y eliminarían el K.O. Todos estos datos, deben servir para realizar una profunda reflexión y futuros estudios, sobre el estado actual del reglamento en la competición infantil, con el objetivo de adaptarlo al joven deportista, y que no sea los niños los que tengan que adaptarse al deporte.AbstractThe aim of this study is to analyze the opinion of the coaches and experts on rule modification in basketball under-14. For this questionnaire was administered to Modify Competition to a total of 101 coaches, and 14 experts. The most significant results indicates that: a) the 85.7% of the coaches and 78.6% of the experts a rule change, b) prohibit coaches the opportunity to defend in zone c) the experts would change the height of the basket, decrease the size of the ball, come close the three point line, victories would change the system, eliminate the zone defense, and eliminate the KO. All these data should be used to make a deep reflection and future studies on the current state of competition regulation in children, with the aim of adapting to the young sport, and not the children who have to adapt to the sport.http://dx.doi.org/10.5232/ricyde2012.02803

La clonación y expresión heteróloga de antígenos de agentes patógenos que afectan humanos y animales, ha demostrado ser una buena alternativa para la obtención de vacunas subunitarias. En este estudio se analiza la expresión estable del gen E que codifica la glicoproteína de envoltura del virus del Oeste del Nilo (VON) en callos embriogénicos de maíz, que fueron transformados mediante biobalística empleando el promotor constitutivo CAMV35S. La expresión del transgen fue determinada mediante RT-PCR en los callos embriogénicos de maíz transformados con la secuencia codificante de la glicoproteína E del VON. Para verificar la expresión de la proteína se realizó un Western blot con extractos de la proteína soluble total (PST) de los callos transformados. De esta manera se identificó una proteína de 68 kDa. Empleando este sistema de expresión se pudo obtener un 0.86 % de PST. En este estudio por primera vez se analiza la expresión de la glicoproteína E del virus del Oeste del Nilo en callos embriogénicos de maíz. Siendo la glicoproteína E del VON la responsable de la inducción de la inmunidad en contra de este virus, esta investigación representa un avance importante en el diseño de un inmunógeno experimental, que permitiría iniciar estudios en animales de laboratorio, con la finalidad de obtener una vacuna prototipo para la prevención y el control de la infección por el VON.

Se sintetizó un catalizador sólido de carácter ácido. El catalizador, que consta de óxido de zirconio y un compuesto de ion sulfato, se preparó variando la temperatura de calcinación, la temperatura de precipitación y la concentración de la fuente de ion sulfato. Las muestras se caracterizaron mediante TGA. XRD, SEM, EDX, FTIR y la acidez se determinó mediante adsorción-desorción con piridina. Los resultados del análisis de TGA muestran la buena resistencia térmica del material. La prueba de XRD establece la existencia de la fase tetragonal y monoclínica y su dependencia con el contenido de ion sulfato sobre la superficie catalítica. Las pruebas de EDX muestran la distribución de los componentes en el catalizador. La acidez determinada fue de 5,46 meq/g. Se especifica y discute la importancia del catalizador; la naturaleza de las especies activas y la relación de las variables involucradas en el tnétodo de preparación. Departamento

This paper presents a study about students’ representations of matter properties. It shows how in order to explain matter discontinuity and intrinsic motion of particles the students frequently use alternative conceptions instead of scientific theories. These conceptions give local consistency centered on the macroscopic perception of matter, while scientific theories give global consistency.

La discusión permite, en un grupo social, examinar un problema pendiente, un conflicto que amenaza su convivencia y desarrollar de sus actividades, para así intentar formular y avanzar colectivamente hacia una solución. Como práctica social reglada, las sociedades democráticas contemporáneas han difundido ampliamente, en particular en los medios de comunicación, uno de sus géneros: la confrontación de opiniones con la perspectiva y el ánimo de enfrentar los conflictos y encontrarles salidas o soluciones.

Machine learning models are increasingly used in the medical domain to study the association between risk factors and diseases to support practitioners in understanding health outcomes. In this paper, we showcase the use of machine-learned staged tree models for investigating complex asymmetric dependence structures in health data. Staged trees are a specific class of generative, probabilistic graphical models that formally model asymmetric conditional independence and non-regular sample spaces. An investigation of the risk factors in invasive fungal infections demonstrates the insights staged trees provide to support medical decision-making.

The bloom of pelagic Sargassum in the Atlantic Ocean has become increasingly problematic, especially when the algae have beached. A build-up of decaying beached material has damaging effects on coastal ecosystems and tourism industries. While remote sensing offers an effective tool to assess the spatial and temporal patterns of Sargassum over large spatial extents, its use so far has been limited to a broad discrimination of Sargassum species from other macroalgae and floating vegetation. Knowledge on the spatial distribution of decayed material will help to support management strategies and inform targeted removal. In this study, we aim to characterise the spectral response of fresh and decayed Sargassum and identify regions of the spectra that offer the greatest separability for the detection and classification of decayed material. We assessed the spectral response of fresh and decayed Sargassum (1) in situ on the beach and (2) in mesocosm experiments where Sargassum samples were allowed to decay over time. We found a decrease in the magnitude of reflectance, noticeably in the visible region (400–700 nm), for decayed, in contrast to fresh, Sargassum. Separability analyses also showed that most spectral bands with a wavelength > ~540 nm will be capable of discriminating between fresh and decayed material, although the near-infrared region offers the greatest degree of separability. We demonstrate, for the first time, that there are clear differences in the spectral reflectance of fresh and decayed Sargassum with potential application for remote sensing approaches. [ABSTRACT FROM AUTHOR]

This work describes the genetic transformation of a strain of Aspergillus niger with five different constructs containing 16 different heterologous genes, coding for four oxidoreductases, two cellobiohydrolases, one endoglucanase, one β‐glucosidase, six enzymes involved in xylose metabolism, and two enzymes involved in fermentation. The aim was to try and engineer a consolidated bioprocessing in A. niger. The fungus already contains most of these enzymes and we only enhanced endogenous activities. We recovered nine transformants containing all genes, as indicated by polymerase chain reaction (PCR). To confirm that the products of the genes were functional, we measured the activity of five different enzymes in all the strains, and they all showed enhanced activity over the wild‐type (wt) strain. The strains were grown on carboxymethyl cellulose (CMC) and xylan as substrates, and they produced considerably more ethanol than the wt. The levels of ethanol production were comparable to those reported in the literature. [ABSTRACT FROM AUTHOR]

The current manuscript aims to verify if the team ability and the players' age influence the distance covered at various speeds and the technical-tactical performance in elite soccer. Physical and technical performance data from all matches in the Spanish LaLiga during the 2018–2019 season were analysed using a computerised tracking system (TRACAB, Chyronhego, New York, USA). Players were categorized into five positional roles: Central Defenders (CD; match observations = 1,179), fullbacks (FB; match observations = 980), Central Midfielders (CM; match observations = 1,000), External Midfielders (EM; match observations = 440), and forwards (F; match observations = 412). The following variables were considered: total distance covered (TD) covered by players, distance covered at high intensity (HIR; >24.0 km · h−1), number of efforts made at high-intensity running (N of HIR), Average Speed (AvSpeed, km · h−1), Offensive Volume (Off Vol): sum of passes, shots, and dribbles executed by the player; Defensive Volume (Def Vol): sum of recoveries, clearances, opponent attack interruptions, and blocked shots executed by the player; and (iii) Game Volume (Game Vol): sum of offensive actions and defensive actions. The variable team quality was established by running an automatic clustering model (two-step) that identified 4 groups of teams: Best teams (ranked from 1st to 6th position), intermediate-higher ranked (from 7th to 11th position), intermediate-lower ranked (from 12th to 15th position), and lower ranked teams (from 16th to 20th position). Generalized linear models were used to analyse differences in players’ match performance according to the team quality, age, and playing position. The main results revealed that: (i) Overall, the team quality affected the performance in all variables (all p

Abstract Uncontrolled bleeding during surgery is associated with high mortality and prolonged hospital stay, necessitating the use of hemostatic agents. Fibrin sealant patches offer an efficient solution to achieve hemostasis and improve patient outcomes in liver resection surgery. We have previously demonstrated the efficacy of a nanostructured fibrin-agarose hydrogel (NFAH). However, for the widespread distribution and commercialization of the product, it is necessary to develop an optimal preservation method that allows for prolonged stability and facilitates storage and distribution. We investigated cryopreservation as a potential method for preserving NFAH using trehalose. Structural changes in cryopreserved NFAH (Cryo-NFAH) were investigated and comparative in vitro and in vivo efficacy and safety studies were performed with freshly prepared NFAH. We also examined the long-term safety of Cryo-NFAH versus TachoSil in a rat partial hepatectomy model, including time to hemostasis, intra-abdominal adhesion, hepatic hematoma, inflammatory factors, histopathological variables, temperature and body weight, hemocompatibility and cytotoxicity. Structural analyses demonstrated that Cryo-NFAH retained most of its macro- and microscopic properties after cryopreservation. Likewise, hemostatic efficacy assays showed no significant differences with fresh NFAH. Safety evaluations indicated that Cryo-NFAH had a similar overall profile to TachoSil up to 40 days post-surgery in rats. In addition, Cryo-NFAH demonstrated superior hemostatic efficacy compared with TachoSil while also demonstrating lower levels of erythrolysis and cytotoxicity than both TachoSil and other commercially available hemostatic agents. These results indicate that Cryo-NFAH is highly effective hemostatic patch with a favorable safety and tolerability profile, supporting its potential for clinical use.

This study explored the impact of the meteorological factors air temperature, relative humidity, and wind speed on teams’ technical performance during the Union of European Football Associations Champions League (UCL). Technical match statistics were collected for five seasons (2016/2017–2020/2021). Thirty-one technical actions and events were categorized into three groups (goal scoring, offense, and defence). Meteorological data were collected from the official UEFA website (air temperature (°C): 11.59 ± 6.87, relative humidity (%): 71.40 ± 17.82, wind speed (km/h): 11.52 ± 7.02). LASSO regression analysis was employed to identify important indicators that affect match outcomes, while separate Poisson regression models were used in generalized linear modelling to determine the effects of meteorological factors on key technical performance indicators. The results revealed that offensive variables were instrumental in distinguishing match outcomes (winning, drawing, and losing), with meteorological factors significantly influencing these variables. Notably, “shot from counter attack” was the most significantly affected variable, being exclusively influenced by air temperature (OR = 0.55, 95% CI: 0.30 to 0.98). Two technical indicators, “dribbles won” and “shots from the 6-yard box,” were both significantly influenced by two meteorological factors. “Cards per foul,” an understudied variable, displayed a close association with all the three meteorological factors. These findings offer valuable insights for coaches and analysts in comprehending the influence of meteorological conditions on crucial technical variables during the performance evaluation of teams. Moreover, they provide valuable information to help coaches devise appropriate tactics for players before or during a match, considering the potential changes in meteorological conditions.

Abstract This study aimed to investigate the impact of tactical formations on the physical and technical performance of professional football players in the Chinese Super League (CSL). A sample of 800 games from the 2015–2021 CSL was analyzed, and players' physical (total distance covered, distance covered while ball in play, number of sprints, sprint distance, and high/middle/low-speed running) and technical (gain/loss of possession, ball retention percentage, challenges, challenge success percentage, passes, and pass success percentage) performance was assessed across six team formations: 3-5-2 (n = 137), 4-3-3 (n = 77), 4-2-3-1 (n = 391), 4-4-2 (n = 257), 3-4-3 (n = 41), and 4-1-4-1 (n = 107). Linear mixed models were used to assess variations in performance indicators across positions and formations. The results demonstrated that central defenders traveled significantly more total and low-speed running distances in the 3-5-2 formation than in the 4-2-3-1 formation (ES range: 0.33–0.34, p

In this contribution, the design and manufacturing of an all-metal coaxial-line X-band bandpass filter is discussed. The device is 3D-printed as a self-supported structure without any dielectric inside the coaxial. The mechanical support between the inner and outer coaxial-line conductors is provided by means of $\lambda /4$ short-circuited stubs, which are also used in the bandpass filter design. The real transmission zeros (TZs) produced by the short-circuited stubs are responsible for a high filter selectivity. In order to enhance the filter performance, a second stage consisting in a coaxial-line stepped-impedance low-pass filter is integrated in the design to provide the rejection level required for the out-of-band behaviour. Following our design method, the bandpass and low-pass filters are designed separately, and a final matching step is performed to connect both and to achieve the aimed frequency specifications. In this way, a monoblock coaxial filter with very good in-band and out-of-band performance can by obtained by using an additive manufacturing (AM) procedure. Only the input/output (I/O) coaxial connectors will need to be assembled to the filter to perform the frequency measurements. The filters in this work can be seen as a first proposal towards more complex multi-functional monoblock structures using additively-manufactured coaxial technology, for highly-integrated RF chains. Other expected benefits beyond the compactness or lightweight are an increased RF shielding, electrostatic discharge risk reduction, and Passive Intermodulation (PIM) protection. In the paper, a prototype with a passband between 8 and 12 GHz is designed and manufactured, using a bandpass filter with three stubs and an integrated 15th-order low-pass filter, providing rejection for spurious frequencies up to 30 GHz. The filter is manufactured using Selective Laser Melting (SLM) and measurements show an excellent agreement with the simulations.

The synergistic effect of antineoplastic drug co-encapsulation systems has made them highly regarded due to their improved pharmacological efficacy. Biopolymer-coated liposomes were evaluated for paclitaxel and doxorubicin co-encapsulation in MCF-7 and MDA-MB-231 breast cancer cell lines. These nanosystems are characterized by dynamic light scattering, transmission electron microscopy, and UV–VIS spectroscopy. The conventional and hybrid liposomal systems presented sizes of 150 to 230 nm and %EE greater than 80% for the encapsulated active ingredients. These drug-laden liposomal systems significantly decreased cell viability in both breast cancer cell lines compared with liposome-free drugs. The delivery of antineoplastic drugs in breast cancer therapy could potentially benefit from new hybrids for drug co-encapsulation.

Birds can be impacted by pollution but are seldom used as bioindicators. One exception involves the Dippers Cinclus spp., a genus of five passerines adapted uniquely to swim and dive in rivers on five continents to feed on aquatic invertebrates and small fishes. Here, we review the effectiveness of Dippers as pollution indicators while identifying further opportunities, caveats and uncertainties that are transferable to other indicator organisms.Dippers have been used as biodindicators i) through relationships linking their distribution, breeding performance and behaviour to river pollution through effects on prey quality and quantity; ii) where contaminants occur in their eggs, tissues, faeces or regurgitates, notably metals (Hg, Se), persistent pollutants (e.g. PCBs, PBDEs, DDE, HEOD) and microplastics. Most data are from C. cinclus in Europe and C. mexicanus in North America.While some pollution effects on Dipper distribution or fitness are well-evidenced, particularly acidification, the resulting impairments are not sufficient to diagnose the source of impact without additional data on water quality or prey abundance. Dippers in these cases provide a general rather than definitive indication of pollution.For contaminants, Dippers have revealed the distribution of specific pollutants at scales ranging from point-sources and regions to different continents. Influences of land use, trophic pathways, diet-shifts, contaminant transport, intergenerational transfer and trends through time have all been identified and supported by detailed knowledge of prey use, territoriality, dispersal, migration, life history, isotopic signatures and energetics.We suggest opportunities to expand the role of Dippers as bioindicators into other locations (Asia and South America), other influences on water quality (e.g. agriculture, wastewater), other contaminants (e.g. PFAs, pharmaceuticals) and through developments in modern biology such as ‘omics. Initial data also show that Dippers could integrate the effects on rivers of habitat modification, flow modification and climate change by indicating effects both directly and through interactions with other multiple stressors. This group of birds illustrates how fundamental ecological information aids the development of bioindicators but reveals the importance of using complementary environmental data when diagnosing bioindicator response. We suggest these are important lessons for ecological indicators more generally.

BackgroundEffective nutrition management is fundamental in the comprehensive treatment of individuals with type 2 diabetes. Various strategies have been explored in this regard, demonstrating their potential usefulness in improving clinical outcomes. This systematic review aims to assess the impact of meals frequency on the well-being of these patients.Methods and findingsIn accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar databases were searched until July 10th, 2023. We included studies from the last 10 years in people with type 2 diabetes that had an intervention regarding their meal frequency. The risk of bias was evaluated based on the Cochrane tool according to the type of study. Of 77 retrieval articles, 13 studies matched our inclusion criteria. The primary focus of each study was to evaluate glycemic control as the major outcome. Studies suggest that meal frequency, time-restricted feeding, breakfast skipping, bedtime snacking, and chrononutrition practices all play roles in type 2 diabetes management and risk.ConclusionsRestricting feeding to 2 to 3 meals per day and practicing time restricted feeding with less than 10 hours of daily food intake promotes weight loss and glycemic control in patients with type 2 diabetes. Aligning food consumption with the body's natural rhythm is beneficial, whereas skipping breakfast disrupts this rhythm. Snacking after evening or waiting 3-4 hours after meal helps control glucose levels, but consuming pre-bedtime snacks do not provide the same benefits.Prospero registration numberCRD42023431785.

Abstract Inhaled nitric oxide (iNO) is a potent and selective pulmonary vasodilator with a safety concern due to rebound pulmonary hypertension (PH) associated with its withdrawal. We report short‐term pulsed iNO in patients with severe pulmonary arterial hypertension (PAH) and nonoperable chronic thromboembolic PH (nCTEPH). This is a retrospective analysis of 33 patients: 22 with PAH and 11 with nCTEPH. We assessed hemodynamic, echocardiographic, and other noninvasive variables to evaluate safety and efficacy of iNO. We performed an iNO withdrawal test during right heart catheterization and after 3 days of iNO treatment. iNO significantly improved all variables examined in 22 patients with PAH and 11 with nCTEPH. Two patterns of response were observed after sudden iNO withdrawal. Twenty‐nine patients (88%) showed minimal hemodynamic, oxygenation and clinical changes. Four patients (12%) had a reduction in cardiac index ≥20% and PaO2 ≥ 5%, three patients did not show clinical deterioration, and one patient developed hemodynamic collapse that needed iNO administration. This retrospective study suggests that short‐term iNO improves hemodynamics and clinical conditions in some patients with PAH an nCTPEH. However, pulsed iNO withdrawal PH rebound could be a serious concern in these patients. Given the lack of evidence, we do not recommend the use of pulsed iNO in the treatment of patients with chronic PH.

Background and Aims: Prognosis after liver transplantation differs between hepatocellular carcinoma (HCC) arising in cirrhotic and non-cirrhotic livers and aetiology is poorly understood. The aim was to investigate differences in mortality after liver transplantation between these patients. Methods: We included patients from the European Liver Transplant Registry transplanted due to HCC from 1990 to November 2016 and compared cirrhotic and non-cirrhotic patients using propensity score (PS) calibration of Cox regression estimates to adjust for unmeasured confounding. Results: We included 22,787 patients, of whom 96.5% had cirrhosis. In the unadjusted analysis, non-cirrhotic patients had an increased risk of overall mortality with a hazard ratio (HR) of 1.37 (95% confidence interval [CI] 1.23–1.52). However, the HR approached unity with increasing adjustment and was 1.11 (95% CI 0.99–1.25) when adjusted for unmeasured confounding. Unadjusted, non-cirrhotic patients had an increased risk of HCC-specific mortality (HR 2.62, 95% CI 2.21–3.12). After adjustment for unmeasured confounding, the risk remained significantly increased (HR 1.62, 95% CI 1.31–2.00). Conclusions: Using PS calibration, we showed that HCC in non-cirrhotic liver has similar overall mortality, but higher HCC-specific mortality. This may be a result of a more aggressive cancer form in the non-cirrhotic liver as higher mortality could not be explained by tumour characteristics or other prognostic variables. [ABSTRACT FROM AUTHOR]

BackgroundSurgical hemostasis has become one of the key principles in the advancement of surgery. Hemostatic agents are commonly administered in many surgical specialties, although the lack of consensus on the definition of intraoperative bleeding or of a standardized system for its classification means that often the most suitable agent is not selected. The recommendations of international organizations highlight the need for a bleeding severity scale, validated in clinical studies, that would allow the selection of the best hemostatic agent in each case. The primary objective of this study is to evaluate the VIBe scale (Validated Intraoperative Bleeding Scale) in humans. Secondary objectives are to evaluate the scale's usefulness in liver surgery; to determine the relationship between the extent of bleeding and the hemostatic agent used; and to assess the relationship between the grade of bleeding and postoperative complications.MethodsProspective multicenter observational study including 259 liver resections that meet the inclusion criteria: patients scheduled for liver surgery at one of 10 medium-high volume Spanish HPB centers using an open or minimally invasive approach (robotic/laparoscopic/hybrid), regardless of diagnosis, ASA score

Acetyl chloride hydrolysis is a highly sensitive exothermic reaction that has presented several industrial safety issues. In the present study, a multiparameter mathematical model, previously developed and applied to simulate the oscillatory thermal behavior of an experimental continuous stirred tank reactor, was used to determine the static/dynamic bifurcation behavior of this reactive system. The values predicted by the model showed good agreement with the experimental data reported in the literature. Full topological classification of its fixed points and iterative maps was obtained: unique solutions (stable and unstable), multiple solutions, cyclic envelope, and bifurcation objects of codimension 1 (e.g., fold and Hopf’s points) and codimension 2 (e.g., cusp and generalized Hopf and Bogdanov-Takens points) have been uncovered. The emphasis of the analysis is to determine safe operating conditions through understanding these topological features and manipulating the reactor design and operating parameters.