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La contratación pública incide de manera relevante en el conjunto de la actividad productiva nacional de bienes y servicios: tanto como estímulo de su actividad, como en el papel elemento de referencia obligada para la futura asignación de recursos, así como en el desarrollo estratégico de las organizaciones y empresas.Como continuación de un estudio publicado con anterioridad y como objetivo de este nuevo estudio, vamos a fijar el concepto de innovación y desarrollo en la normativa contractual europea, su transposición a la legislación nacional y, finalmente, la identificación de posibles indicadores de innovación y desarrollo.

A Dieulafoy’s lesion is a rare cause of massive gastrointestinal (GI) bleeding. It represents an abnormally dilated submucosal artery that erodes the overlying epithelium in the absence of a primary ulcer. These lesions are usually located in the stomach, nevertheless, they have been found in all areas of the GI tract, including the oesophagus, duodenum and colon. Bleeding episodes are often self-limited, although bleeding can be recurrent and profuse. The case describes a 50-year-old woman who developed haemorrhagic shock secondary to a rectal Dieulafoy’s lesion and discusses the diagnostic and therapeutic approaches.

La determinación sexual de restos humanos arqueológicos ha descansado tradicionalmente en los análisis bioantropológicos, asumiéndose la incertidumbre que ello suponía y la imposibilidad de conocer esta importante variable en el caso de los subadultos. Para mitigar tales inconvenientes, se cuenta hoy con las técnicas de ADN antiguo, pero sus requerimientos impiden su generalización. En este trabajo se ensaya una alternativa, el análisis proteómico, esto es, la detección directa en el esmalte dental de péptidos dimórficos de la amelogenina mediante cromatografía líquida acoplada a espectrometría de masas, con un protocolo bien consolidado. Esta primera aproximación se basa en una colección de dientes, diez de ellos de enterramientos de Cogotas I, y otros seis que van del Calcolítico al Bronce Final, todos ellos de la submeseta norte. El análisis proteómico ha permitido la determinación sexual de esos individuos, incluidos los subadultos ‒el grueso del lote‒, obteniéndose así una información fiable que enriquece su valoración cultural y abre el camino para profundizar en el género y sus implicaciones. Este ensayo también ha tenido en cuenta la controversia, candente en muy diversas disciplinas, sobre la relación sexo-género y el carácter no binario de ambos, problemas que gravitan sobre los análisis osteológicos y también arqueométricos ‒tildados incluso de actos performativos‒, por lo que, tras un acercamiento al debate, se justifica la decisión de utilizar la vía analítica.

Approaches to routine vaccine funding and the underlying budget-setting process vary greatly across European countries. The ongoing COVID-19 pandemic has put enormous pressure on healthcare systems, affecting resilience of the overall vaccine ecosystem.This article reviews how vaccine budgets are structured across 8 European countries (England, Finland, France, Germany, Italy, Norway, Romania, and Spain). First a literature review of the landscape was undertaken, followed by expert interviews to review the findings and consider policy principles to secure prioritisation and sustainability of routine vaccination budgets post-COVID.The organisation of budgets and vaccine spending varies greatly across Europe. In 2/8 countries (France and Germany) vaccine spending is subsumed into a wider healthcare budget. In 2/8 countries (Italy and Romania) the budget differentiates public health and prevention spending from other areas of healthcare, though there is no standalone vaccine budget. In 4/8 countries (England, Finland, Norway and Spain) there is a standalone vaccine budget, however this may not cover all elements needed for immunisation delivery and is not always transparent.Ensuring adequate and dynamic country vaccine budgets, with horizon scanning approaches like in England and Finland, or flexible vaccines expenditures like Germany, would greatly help the timely availability of public funding for new vaccines and strengthen vaccines supply security in Europe through a more virtuous European vaccine ecosystem.

The role of the oral and oropharyngeal microbiota is important in the promoting and the development of cancers in the head and neck area, as discussed in detail in this paper. The subject of this work is to collect scientific information on the importance of the gut-respiratory axis in the promotion, development, and treatment outcomes of head and neck cancers (HNSCC). Scientific knowledge on HNSCC-gut microbiota interplay is rudimentary, therefore the use of knowledge-based on other malignant neoplasms was reported.

Assessing flood risks on road infrastructures is critical for the definition of mitigation strategies and adaptation processes. Some efforts have been made to conduct a regional flood risk assessment to support the decision-making process of exposed areas. However, these approaches focus on the physical damage of civil infrastructures without considering indirect impacts resulting from social aspects or traffic delays due to the functionality loss of transportation infrastructures. Moreover, existing methodologies do not include a proper assessment of the uncertainties involved in the risk quantification. This work aims to provide a consistent quantitative flood risk estimation and influence factor modelling for road infrastructures. To this end, a Flood Risk Factor (FRF) is computed as a function of hazard, vulnerability, and infrastructure importance factors. A Bayesian Network (BN) is constructed for considering the interdependencies among the selected input factors, as well as accounting for the uncertainties involved in the modelling process. The proposed approach allows weighting the relevant factors differently to compute the FRF and improves the understanding of the causal relations between them. The suggested method is applied to a case study located in the region of Santarem Portugal, allowing the identification of the sub-basins where the road network has the highest risks and illustrating the potential of Bayesian inference techniques for updating the model when new information becomes available., This work was partly financed by FCT / MCTES through national funds (PIDDAC) under the R&D Unit Institute for Sustainability and Innovation in Engineering Structures (ISISE), under reference UIDB / 04029/2020. The first author would like to thank FCT – Portuguese Scientific Foundation for the research grant 2020.05755.BD. The second author would like to thank FCT – Portuguese Scientific Foundation for the research grant SFRH/BD/144749/2019. This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 769255. This document reflects only the views of the author(s). Neither the Innovation and Networks Executive Agency (INEA) nor the European Commission is in any way responsible for any use that may be made of the information it contains.

The pioneering nature of this work covers the answers to two questions: (1) Is an up-to-date anatomical model of the larynx needed for modern endoscopic diagnostics, and (2) can such a digital segmentation model be utilized for deep learning purposes. The idea presented in this article has never been proposed before, and this is a breakthrough in numerical approaches to aerodigestive videoendoscopy imaging. The approach described in this article assumes defining a process for data acquisition, integration, and segmentation (labeling), for the needs of a new branch of knowledge: digital medicine and digital diagnosis support expert systems. The first and crucial step of such a process is creating a digital model of the larynx, which has to be then validated utilizing multiple clinical, as well as technical metrics. The model will form the basis for further artificial intelligence (AI) requirements, and it may also contribute to the development of translational medicine.

Viral illnesses like SARS-CoV-2 have pathologic effects on nonrespiratory organs in the absence of direct viral infection. We injected mice with cocktails of rodent equivalents of human cytokine storms resulting from SARS-CoV-2/COVID-19 or rhinovirus common cold infection. At low doses, COVID-19 cocktails induced glomerular injury and albuminuria in zinc fingers and homeoboxes 2 (Zhx2) hypomorph and Zhx2(+/+) mice to mimic COVID-19–related proteinuria. Common Cold cocktail induced albuminuria selectively in Zhx2 hypomorph mice to model relapse of minimal change disease, which improved after depletion of TNF-α, soluble IL-4Rα, or IL-6. The Zhx2 hypomorph state increased cell membrane to nuclear migration of podocyte ZHX proteins in vivo (both cocktails) and lowered phosphorylated STAT6 activation (COVID-19 cocktail) in vitro. At higher doses, COVID-19 cocktails induced acute heart injury, myocarditis, pericarditis, acute liver injury, acute kidney injury, and high mortality in Zhx2(+/+) mice, whereas Zhx2 hypomorph mice were relatively protected, due in part to early, asynchronous activation of STAT5 and STAT6 pathways in these organs. Dual depletion of cytokine combinations of TNF-α with IL-2, IL-13, or IL-4 in Zhx2(+/+) mice reduced multiorgan injury and eliminated mortality. Using genome sequencing and CRISPR/Cas9, an insertion upstream of ZHX2 was identified as a cause of the human ZHX2 hypomorph state.

Bridge infrastructure has great economic, social, and cultural value. Nevertheless, many of the infrastructural assets are in poor conservation condition as has been recently evidenced by the collapse of several bridges worldwide. The objective of this systematic review is to collect and synthesize state-of-the-art knowledge and information about how bridge information modeling, finite element modeling, and bridge health monitoring are combined and used in the creation of digital twins (DT) of bridges, and how these models could generate damage scenarios to be used by anomaly detection algorithms for damage detection on bridges, especially in bridges with cultural heritage value. A total of 76 relevant studies from 2017 up to 2022 have been taken into account in this review. The synthesis results show a consensus toward the future adoption of DT for bridge design, management, and operation among the scientific community and bridge practitioners. The main gaps identified are related to the lack of software interoperability, the required improvement of the performance of anomaly-detection algorithms, and the approach definition to be adopted for the integration of DT at the macro scale. Other potential developments are related to the implementation of Industry 5.0 concepts and ideas within DT frameworks.

Fundamental motor skills (FMS) are essential for enjoyable, confident and skillful participation in physical activity across the lifespan. Due to the alarming low level of FMS proficiency in children and adolescents worldwide, the development of motor competency is an urgent issue for physical education. The promotion and implementation of a systematic process of teaching and learning FMS should be a physical education priority. Accordingly, effective assessment tools for evaluating FMS should be adopted or developed. Because FMS assessment for both children and adolescents need further effective solutions, we proposed the Fundamental Motor Skill in Sport test (FUS) to assess FMS proficiency in students across primary and secondary education. The FUS test involves six sport skill-based tasks: hurdling, jumping rope, forward roll, ball bouncing, throwing and catching a ball, and kicking and stopping a ball. This selection of skills represents high transferability to a wide range of sports and life activities. The results of our study provide evidence that the FUS test is valid, reliable, and feasible to administer in school settings. Therefore, this tool test has the potential to support deliberate practice and improve motor competency by providing a standardized and structured approach to measuring FMS among school-aged students.

Additional file 4. Supplementary results.

Additional file 1. Supplementary methods.

Additional file 3: Supplementary Table 1. List of glycan structures corresponding to every individual plasma protein glycan peak. Supplementary Table 2. Plasma protein derived glycan traits calculated out of 39 initial plasma glycan peaks. Supplementary Table 3. Associations between plasma protein N-glycome and triglycerides. Supplementary Table 4. Associations between plasma protein N-glycome and glucose. Supplementary table 5. Associations between plasma protein N-glycome and insulin.

Additional file 2: Supplementary Figure 1. Representative HILIC-UPLC-FLR chromatogram of plasma protein N-glycome. Supplementary Figure 2. Association of plasma glycans with postprandial glucose and insulin levels. Supplementary Figure 3. The variance explained for glycaemic response and insulin response across various prediction models.

The article pertain to a case study research of social assistance processes in a social policy system of G. city. A main method of investigation was opened, unstandardized systematic interviews with social workers, political figures and administrators of the system. Social services in experiences of our respondents we have interpreted as games for uncertainty control. The games in perspectives of social workers and administrators of the system we understand as pedagogical environments for customers which in the processes of these interactional games shape many of the social, adaptive skills. Such skills enable customers institutional identity management and effective winning spheres of freedom from control. Behavioural strategies of social workers in institutional and organizational environment in relation to customers we conceptualize as exchange models of a “gift for power” above customers spheres of uncertainty control. Inefficiency of social assistance comes from incapacity of such aid to effectively exchange gifts for uncertainty control in daily situations for customers. The Institution of social services has many functional substitutes in social, political and economic environments which are much more effective. Second goal of our investigation was a presentation and portrayal of the real pedagogical environment of social workers. Theory of social intervention and social pedagogy suffers from too many abstracts from reality foundations, premises und presumptions. So social pedagogy as practical science needs also careful and diligent investigation of real social practices in institutional and organizational environment of social policy systems.

Aim of the study. The goal of the study was to assess the frequency of malignancies hidden under the diagnosis of “Bell’s palsy”. We aimed to create diagnostic algorithm to avoid failures concerning patients whose only symptom of parotid gland cancer was irreversible FNP. Materials and methods. We analyzed 253 consecutive patients with FNP treated in our department in the last 5 years. All patients with irreversible FNP were reassessed in 6-12 months. We underlined all shortcomings in the diagnostics of those in whom malignancies were found out in MRI of the neck and presented the proposal of diagnostic algorithm to avoid missing such an entity. Results. Bell’s palsy was observed in 157 / 253 patients (62.06%), in 36 / 157 (22.92%) it remained permanent. In 4 / 36 patients (11.11%) with irreversible FNP, which constituted 2.54% of all “Bell’s palsy” cases, parotid gland deep lobe mass was found out in MRI. In one patient infiltration of the skull base was diagnosed. Adenoid cystic carcinoma was confirmed in final histopathology in all cases. Conclusions. Our experience has shown that irreversible FNP can be a revelator of the malignant tumor located in the deep lobe of the parotid gland. Contrast-enhanced MRI covering intra- and extracranial segments of facial nerve should be ordered in all cases of FNP without recovery after 4 months. The main point of our study is to underline that the assessment of the deep lobe of the parotid gland with MRI should be included in the standard diagnostic protocol in all irreversible “Bell’s palsy” cases. Key words: Bell’s palsy, facial nerve palsy, parotid gland cancer

A fast methodology for the determination of monohydroxy polycyclic aromatic hydrocarbons in human urine using a fully automated microextraction by packed sorbent coupled to a gas chromatograph–mass spectrometer is reported. Sample preparation requires simple hydrolysis, centrifugation, filtration, and dilution. The method does not require a derivatization step prior to analysis with gas chromatography and allows the measurement of up to three samples per hour after hydrolysis. Quantitation is carried out by a one-point standard addition allowing the determination of 6 analytes with good limits of detection (10.1–39.6 ng L−1 in water and 0.5–19.4 µg L−1 in urine), accuracy (88–110%) and precision (2.1–23.4% in water and 5.1–19.0% in urine) values. This method has been successfully applied to the analysis of six urine samples (three from smoker and three from non-smoker subjects), finding significant differences between both types of samples. Results were similar to those found in the literature for similar samples, which proves the applicability of the methodology.

La Constitución de 1978 en su Título I, dedicado a los derechos y deberes fundamentales, consagra en el artículo 47 el derecho de todos a «disfrutar de una vivienda digna y adecuada», objetivo que puede alcanzarse introduciendo diferentes medidas en los ordenamientos tributarios estatal, autonómico y local que, como analizaremos, utilizan distintos beneficios fiscales en sus figuras impositivas para este fin. Asimismo, un tratamiento fiscal desincentivador de la vivienda vacía puede potenciar alcanzar este propósito. Title I of the 1978 Constitution, dedicated to fundamental rights and duties, enshrines in article 47 the right of everyone to "enjoy a decent and adequate home", an objective that can be achieved by introducing different measures in the state and regional tax laws. and local that, as we will analyze, use different tax benefits in their tax figures for this purpose. Likewise, a disincentive tax treatment for empty homes can help achieve this end

Performance evaluation and maintenance planning are gaining importance with ageing rail infrastructure and increasing demand on track safety and continuous availability. The discrete/point railway assets (e.g. bridges, level crossings) together with extended track sections constitute the main railway network infrastructure. The former has important implications in train safety, riding comfort and operating expenditures due to local intensified degradation and plays a role in effective network capacity due to their large quantity. The heterogeneity in asset features and operating environment also adds difficulties to efficient maintenance planning of multiple discrete assets. The current review screens the issue to level crossings, as little concern has been engaged to this asset type, and draws together different perspectives related to their maintenance management. The systems thinking approach is integrated and two levels of asset management (i.e. micro- and macro-level) are used to structure the synthesis, which are interdependent and synergistic. Two major approaches, namely, the mechanistic and data-driven modelling are synthesised. Both contribute to the maintenance knowledge and their comparisons are elaborated. Limitations in existing studies are identified and directions for future research are provided, aiming to contribute to a more refined ‘inspection and diagnosis’ process to properly capture the local track issues and move towards system-level maintenance approach for multiple level crossings.

The full analysis of the text of a contract, asiento, between Philip II of Spain and a Genoese merchant–banker details how in this pre-modern composite state, merchant–bankers acted as agents of the Crown who gathered many scattered sources of income to the Crown and transformed them into large and regular cash flows, mesadas, for the army. Because of the uncertain availability of these sources, the contract provided flexibility to both parties and legal assistance to the banker who reported to accountants for audit and, if necessary, the charge of an interest at about 1 percent per month.

The focus of the research was the process of hydrogen production from a mixture of water and ethanol in plasma and plasma-catalytic reactors. Plasma was produced in a dielectric barrier discharge. The catalyst was cobalt supported on ZrO2 (Co/ZrO2). The catalyst was placed in the grooves of the high voltage electrode. The ethanol conversion was similar in both studied reactors and increased from 34 to 55% with increasing discharge power from 20 to 60 W. However, hydrogen production in the plasma-catalytic reactor was up to 2.4 times greater than in the plasma reactor. The highest energy efficiency of hydrogen production in the plasma catalytic reactor was 7.7 mol(H2)·kWh-1. In the plasma reactor, the concentration of products was constant in the tested range of discharge power. In the plasma-catalytic reactor, H2 and CO2 concentrations increased with increasing discharge power, whereas concentrations of CO, CH4, C2H4, and C2H6 were decreased. The maximum H2 concentration was 56%.

The optimal dietary pattern to improve metabolic function remains elusive. In a 21-day randomized controlled inpatient crossover feeding trial of 20 insulin-resistant obese women, we assessed the extent to which two isocaloric dietary interventions—Mediterranean (M) and high protein (HP)—improved metabolic parameters. Obese women were assigned to one of the following dietary sequences: M–HP or HP–M. Cardiometabolic parameters, body weight, glucose monitoring and gut microbiome composition were assessed. Sixteen women completed the study. Compared to the M diet, the HP diet was more effective in (i) reducing insulin resistance (insulin: Beta (95% CI) = −6.98 (−12.30, −1.65) µIU/mL, p = 0.01; HOMA-IR: −1.78 (95% CI: −3.03, −0.52), p = 9 × 10−3); and (ii) improving glycemic variability (−3.13 (−4.60, −1.67) mg/dL, p = 4 × 10−4), a risk factor for T2D development. We then identified a panel of 10 microbial genera predictive of the difference in glycemic variability between the two diets. These include the genera Coprococcus and Lachnoclostridium, previously associated with glucose homeostasis and insulin resistance. Our results suggest that morbidly obese women with insulin resistance can achieve better control of insulin resistance and glycemic variability on a high HP diet compared to an M diet.

Transition zones such as level crossing and bridge approaches are critical links in railway networks due to higher degradation rates and maintenance needs. In this context, parametric optimization has been applied to improve the design in transition zones; however, it requires a more computationally efficient tool to support repetitive function evaluations, since the involved vehicle–track dynamic simulations are becoming more expensive to evaluate. For this purpose, a surrogate-based simulation methodology is proposed to search for an optimal combination of parameters relevant to the geometry and elasticity of track structures. Specifically, the presented methodology integrates finite element (FE)-based modeling with surrogate-assisted optimization: (1) the FE model is developed to characterize the dynamic behavior of a level crossing under a moving vehicle; (2) the optimization problem is formulated upon this mechanical model by extending the expensive FE simulations to an adaptive surrogate modeling scheme. This integration facilitates efficient exploration of the track design space (thereby reducing the computational cost), and a reasonable balance can be achieved between solution quality and computational effort. The methodology is applied to a Dutch railway case. Results show that compared to a reference design, the optimized design significantly improves performance indicators relevant to wheel–rail contact forces and energy dissipation in the ballast layer. The solution brings great potential in achieving a more desirable vehicle–track interaction and improving the connecting performance between level crossings and transitions. The methodology is applicable to other railway structures and may also contribute to improvements in current track design practices.

Summary Background The aim of this study was to evaluate the incidence and histological type of lesions affecting the ovaries and to analyze employed methods of invasive treatment. Materials & Methods Medical records of patients who were treated surgically for ovarian tumors in the years 2015–2019 were reviewed. The study group was comprised of 31 female patients. Results During 5 years time, there were 31 girls in the age from 3 months to 17 years hospitalized in the department. The mean age was 11 years. Histopathological examination was performed in all of these cases. 12 patients were diagnosed with malignant lesion, 19 with benign lesion. The most commonly diagnosed malignant tumors were a dysgerminoma and a mixed germ cell tumor. In the group of benign lesions, the most frequent tumor type was mature teratoma. The first occurring symptom was abdominal pain. Some of the lesions were diagnosed accidentally during ultrasonography. The diagnostics was expanded depending on the size of the tumor, staging and clinical condition of the patient. All the patients were treated surgically, 16 of them underwent laparoscopic surgery. Torsion of the ovary or oviduct was observed in 3 cases. Chemotherapy was introduced in 8 cases as complementary treatment. Conclusions The most commonly diagnosed tumor was mature teratoma. Ultrasonography is the most frequent method of the ovaries’ examination. Ovarian lesions are characterized by non-specific clinical symptoms, which is associated with prevalent incidental detection during ultrasonography.

El objetivo de este trabajo es dar a conocer el proyecto de traducción y edición de la enciclopedia de emblemas e imprese Mundus Symbolicus de Filippo Picinelli que se lleva a cabo en el Centro de Estudios de las Tradiciones de El Colegio de Michoacán. Así, la traducción permitirá al lector moderno y, en especial, a los historiadores del arte descifrar los significados latentes de los símbolos empleados en la producción plástica y literaria, así como en diversos espacios culturales en donde floreció la emblemática.

Vaccines generate high-affinity antibodies by recruiting antigen-specific B cells to germinal centers (GCs), but the mechanisms governing the recruitment to GCs on secondary challenges remain unclear. Here, using preclinical SARS-CoV and HIV mouse models, we demonstrated that the antibodies elicited during primary humoral responses shaped the naive B cell recruitment to GCs during secondary exposures. The antibodies from primary responses could either enhance or, conversely, restrict the GC participation of naive B cells: broad-binding, low-affinity, and low-titer antibodies enhanced recruitment, whereas, by contrast, the high titers of high-affinity, mono-epitope-specific antibodies attenuated cognate naive B cell recruitment. Thus, the directionality and intensity of that effect was determined by antibody concentration, affinity, and epitope specificity. Circulating antibodies can, therefore, be important determinants of antigen immunogenicity. Future vaccines may need to overcome-or could, alternatively, leverage-the effects of circulating primary antibodies on subsequent naive B cell recruitment.

Chemical Submission (CS) is considered a danger to health and a form of violence. There are different forms of proactive CS (involuntary consumption of psychoactive substances) and opportunistic CS (voluntary consumption), with criminal intent, usually theft, submission, or sexual assault. The objective of this work is to describe the characteristics of cases of suspected CS in adults older than 65 years treated in the Emergency Department of the San Carlos Clinical Hospital and the results of the toxicological analysis performed by the INTCF in Madrid (April 1, 2015-2019). There were 12 (8%) cases of suspected CS, with a mean age of 75 (SD 8) years, of which 8 (66.7%) men, with two different profiles, all associated with theft, and in 3 (25%) possible sexual assault. In 9 (75%) cases, benzodiazepines and / or usual drugs were identified. CS is a problem to consider in Emergency Departments and is not exclusive to the young population.

En el presente estudio se analizan las diferentes medidas tributarias recientemente aprobadas como consecuencia de la crisis generada por la pandemia del COVID-19 apuntando, desde un punto de vista crítico, los problemas que generan para los contribuyentes.This study analyzes the different tax measures recently approved as a consequence of the crisis generated by the COVID-19 pandemic, pointing out the problems they generate for taxpayers.

With the central role of nucleic acids there is a need for development of fluorophores that facilitate the visualization of processes involving nucleic acids without perturbing their natural properties and behaviour. Here, we incorporate a new analogue of adenine, 2CNqA, into both DNA and RNA, and evaluate its nucleobase-mimicking and internal fluorophore capacities. We find that 2CNqA displays excellent photophysical properties in both nucleic acids, is highly specific for thymine/uracil, and maintains and slightly stabilises the canonical conformations of DNA and RNA duplexes. Moreover, the 2CNqA fluorophore has a quantum yield in single-stranded and duplex DNA ranging from 10% to 44% and 22% to 32%, respectively, and a slightly lower one (average 12%) inside duplex RNA. In combination with a comparatively strong molar absorptivity for this class of compounds, the resulting brightness of 2CNqA inside double-stranded DNA is the highest reported for a fluorescent base analogue. The high, relatively sequence-independent quantum yield in duplexes makes 2CNqA promising as a nucleic acid label and as an interbase Förster resonance energy transfer (FRET) donor. Finally, we report its excellent spectral overlap with the interbase FRET acceptors qAnitro and tCnitro, and demonstrate that these FRET pairs enable conformation studies of DNA and RNA.

Sedation is necessary in the management of critically ill patients, both to alleviate suffering and to cure patients with diseases that require admission to the intensive care unit. Such sedation should be appropriate to the patient needs at each timepoint during clinical evolution, and neither too low (undersedation) nor too high (oversedation). Adequate sedation influences patient comfort, safety, survival, subsequent quality of life, bed rotation of critical care units and costs. Undersedation is detected and quickly corrected. In contrast, oversedation is silent and difficult to prevent in the absence of management guidelines, collective awareness and teamwork. The Zero Oversedation Project of the Sedation, Analgesia and Delirium Working Group of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units aims to offer a practical teaching and collective awareness tool for ensuring patient comfort, safety and management with a view to optimizing the clinical outcomes and minimizing the deleterious effects of excessive sedation. The tool is based on a package of measures that include monitoring pain, analgesia, agitation, sedation, delirium and neuromuscular block, keeping patients pain-free, performing dynamic sedation according to clinical objectives, agreeing upon the multidisciplinary protocol to be followed, and avoiding deep sedation where not clinically indicated.

The establishment of oak trees is often a slow and difficult process. Hence, it is necessary to determine the characteristics that can lead to improving their regeneration. In this genus, seed size is highly variable both at the interspecific and intraspecific levels, and the effects of intrapopulation variability are not well understood, being even less so for Quercus faginea. In this study, the effects of the age of the mother tree, seed weight and the interaction between these two factors on seed germination, emergence and growth (biomass) were analysed. For this purpose, 16 trees—8 young and 8 old—were selected with the intent to cover the entire range of acorn weights produced in this population. Among the main results, it should be noted that: (1) in older trees, it is easier to find larger acorns; (2) the percentage and the speed of germination of the acorns of young trees is greater than that of old trees; (3) the percentage and the speed of seedling emergence of young trees is greater than that of old trees; and (4) cotyledon weight is the variable that most influences biomass, quite often in a positive way. Therefore, maintaining intrapopulation variability seems to be an approach that most favours the persistence of these populations.

Environmental heat stress creates a detriment to the welfare and performance in broiler chickens. While there are some dietary mineral and vitamin supplements that mitigate this condition, a rapid, plasma-based detection method would improve management response and broaden the scientific understanding of heat stress. A total of 960 broilers were used to determine the effect of heat stress and dietary electrolyte balance on blood biochemistry. Sex sorted chicks were allocated to 48 pens with 20 chicks per pen creating 6 treatments (3 diets x 2 house environments) with eight replicates and fed one of three dietary treatments: a control containing primarily sodium chloride (NaCl), a heat stress formulation containing bicarbonate (NaHCO3), or heat stress fortified with 200 ppm vitamin C and E (NaHCO3 Fortified). Birds were housed in two different temperature-controlled environments either a thermoneutral (Control) or heat stressed (Heat Stress) environment. At day 28, 35 and 42 venous blood was collected and analyzed using rapid detection methods followed by post-mortem veterinary evaluations. Performance was measured at weekly intervals. Mortality was significantly higher in broilers exposed to heat stress as compared to thermoneutral, while broilers that received dietary sodium chloride also had higher mortality than bicarbonate fed birds. Heat stress significantly impacted potassium, hematocrit, uric acid, total protein, globulin, hematocrit, lymphocytes, sodium, and glucose. This study demonstrates that blood biochemistry of broiler chickens is influenced by dietary intervention and changing environmental conditions. This pattern suggests a blood biomarker footprint of sub-optimal nutrition or poor environmental conditions that may provide valuable information into physiological changes in response to dietary electrolytes, vitamins, and heat stress. Furthermore, this footprint may potentiate the development of diagnostic tools, combining biomarkers to determine nutrition and health status of individual broiler flocks, for nutritionists, veterinarians, and live production managers to manage flocks for environmental, humane, and productive purposes.