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Cartilage thickness change is a well-documented biomarker of osteoarthritis pathogenesis. However, there is still much to learn about the spatial and temporal patterns of cartilage thickness change in health and disease. In this study, we develop a novel analysis method for elucidating such patterns using a functional connectivity approach. Descriptive statistics are reported for 1186 knees that did not develop osteoarthritis during the 8 years of observation, which we present as a model of cartilage thickness change related to healthy aging. Within the control population, patterns vary greatly between male and female subjects, while body mass index (BMI) has a more moderate impact. Finally, several differences are shown between knees that did and did not develop osteoarthritis. Some but not all significance appears to be accounted for by differences in sex, BMI, and knee alignment. With this work, we present the connectome as a novel tool for studying spatiotemporal dynamics of tissue change.

Introduction and objectives: Brief cognitive tests (BCT) are used in primary care (PC) for the detection of cognitive impairment (CI). Still, there are little data on their diagnostic utility (DU) in a community setting. This work evaluates the DU at the population level of Fototest, T@M, AD8 questionnaire and MMSE. It provides new cut-off points (CoP) validated in a CI early detection program. Material and methods: In the population and validation samples, the evaluation was carried out in two phases, a first of screening and administration of BCT and a second of clinical diagnosis, blinded to the results of the BCT, applying the current NIA-AA criteria. The DU of BCT in the population sample was evaluated with the area under the ROC curve (aROC). Youden index and the CoP with the best specificity that ensured a sensitivity of 80% were used to decide on the most appropriate CoP. The sensitivity, specificity, and predictive values for these CoP were calculated in the validation sample. Results: 260 participants (23.1% with CI) from the population sample and 177 (42.4% with CI) from the validation sample were included. The Fototest has the best UD at the population level (aROC 0.851), which improves with the combination of Fototest and AD8 (aROC 0.875). The proposed CoP are AD8 ≥ 1, Fototest ≤ 35, T@M ≤ 40, and MMSE ≤ 26. Conclusion: BCT are helpful in detecting CI in PC. This work supports the use of more demanding PoC. Resumen: Introducción y objetivos: Los test cognitivos breves (TCB) se utilizan en atención primaria (AP) para la detección de deterioro cognitivo (DC) pero existen pocos datos sobre su utilidad diagnóstica (UD) en el ámbito comunitario.Este trabajo evalúa la UD de Fototest, T@M, cuestionario AD8 y MMSE en una muestra representativa de la población y aporta nuevos puntos de corte (PdC) que se han validado en un grupo de personas que consultan por quejas cognitivas. Material y métodos: Ambas muestras, la poblacional y la de validación, se realizó una evaluación en dos fases; una primera de cribado y administración de los TCB y una segunda de diagnóstico clínico, ciego a los resultados de los TCB, aplicando los criterios NIA-AA actuales.La UD de los TCB en la muestra poblacional se evaluó con el área bajo la curva ROC (aROC). Para elegir los PdC óptimos, se evaluaron dos métodos: el índice de Youden y el PdC con mejor especificidad que asegurase una sensibilidad del 80%. En la muestra de validación se calcularon los parámetros de sensibilidad, especificidad, y valores predictivos para estos PdC. Resultados: Se han incluido 260 participantes (23,1% con DC) de la muestra poblacional y 177 (42,4% con DC) de la de validación. El Fototest tiene la mejor UD a nivel poblacional (aROC 0,851), que mejora con la combinación de Fototest y AD8 (aROC 0,875; p

Resumen: Introducción y objetivos: Los test cognitivos breves (TCB) se utilizan en Atención Primaria (AP) para la detección de deterioro cognitivo (DC) pero existen pocos datos sobre su utilidad diagnóstica (UD) en el ámbito comunitario.Este trabajo evalúa la UD de Fototest, T@M, cuestionario AD8 y MMSE en una muestra representativa de la población y aporta nuevos puntos de corte (PdC) que se han validado en un grupo de personas que consultan por quejas cognitivas. Material y métodos: Ambas muestras, la poblacional y la de validación, se realizó una evaluación en 2 fases; una primera de cribado y administración de los TCB y una segunda de diagnóstico clínico, ciego a los resultados de los TCB, aplicando los criterios NIA-AA actuales.La UD de los TCB en la muestra poblacional se evaluó con el área bajo la curva ROC (aROC). Para elegir los PdC óptimos, se evaluaron 2 métodos: el índice de Youden y el PdC con mejor especificidad que asegurase una sensibilidad del 80%. En la muestra de validación se calcularon los parámetros de sensibilidad y especificidad, y los valores predictivos para estos PdC. Resultados: Se ha incluido a 260 participantes (23,1% con DC) de la muestra poblacional y 177 (42,4% con DC) de la de validación. El Fototest tiene la mejor UD a nivel poblacional (aROC 0,851), que mejora con la combinación de Fototest y AD8 (aROC 0,875; p

OBJECTIVE: Although it is established that structural damage of the meniscus is linked to knee osteoarthritis (OA) progression, the predisposition to future development of OA because of geometric meniscal shapes is plausible and unexplored. This study aims to identify common variations in meniscal shape and determine their relationships to tissue morphology, OA onset, and longitudinal changes in cartilage thickness. METHODS: A total of 4,790 participants from the Osteoarthritis Initiative data set were studied. A statistical shape model was developed for the meniscus, and shape scores were evaluated between a control group and an OA incidence group. Shape features were then associated with cartilage thickness changes over 8 years to localize the relationship between meniscus shape and cartilage degeneration. RESULTS: Seven shape features between the medial and lateral menisci were identified to be different between knees that remain normal and those that develop OA. These include length-width ratios, horn lengths, root attachment angles, and concavity. These at-risk shapes were linked to unique cartilage thickness changes that suggest a relationship between meniscus geometry and decreased tibial coverage and rotational imbalances. Additionally, strong associations were found between meniscal shape and demographic subpopulations, future tibial extrusion, and meniscal and ligamentous tears. CONCLUSION: This automatic method expanded upon known meniscus characteristics that are associated with the onset of OA and discovered novel shape features that have yet to be investigated in the context of OA risk.

Background: The relationship between stressful life events and development of severe mental disorders seems relevant. Method: The objectives were: to determine stressful life events in 166 patients with severe mental disorders; to compare levels of symptoms, internalized stigma, difficulties in emotional regulation and well-being between patients with and without a history of stressful life events; and to study the differential profile of patients according on gender. Results: The 75.3% mentioned a stressful life event that had significantly impacted their lives. Participants with a history of stressful events had poorer perceived health and more suicide attempts. They had less positive affect, greater intensity of psychopathological symptoms and difficulties in emotional regulation. From a gender perspective, bullying was the most reported stressful event among men, while sexual abuse was the most reported among women. Conclusions: It is necessary to assess and conduct long-term follow-up of children and adolescents to prevent theirs impact.

Immune thrombocytopenia (ITP) is a disease characterized by platelet destruction, presenting substantial challenges in clinical practice. The classic first line therapeutic management includes corticosteroids and intravenous immunoglobulins. Although it is less frequent in children than in adults, there is a significant percentage of patients, up to 47% according to the Pediatric and Adult Registry on Chronic ITP, who require second-line or further treatment, due to non-response to the first line treatment or persistence of disease, among other reasons. Several second line approaches for its treatment are currently in use, including increasing platelet production with thrombopoietin receptor agonists. We report the case of a 16-year-old patient with ITP and alopecia areata successfully treated with baricitinib, a reversible and selective JAK 1/2 inhibitor. Baricitinib is currently in use for the treatment of several autoimmune conditions and has been shown to increase platelet counts in these patients. This phenomenon has been linked to increased TPO signaling and reduced platelet destruction. There are promising preliminary results of adult ITP patients treated with baricitinib. This case report is the first reported use of baricitinib in ITP in the pediatric and adolescent setting, potentially leading to its use in this condition.

The manufacturing factory layout planning process is commonly supported by the use of digital tools, enabling creation and testing of potential layouts before being realised in the real world. The process relies on engineers’ experience and inputs from several cross-disciplinary functions, meaning that it is subjective, iterative and prone to errors and delays. To address this issue, new tools and methods are needed to make the planning process more objective, efficient and able to consider multiple objectives simultaneously. This work suggests and demonstrates a simulation-based multi-objective optimisation approach that assists the generation and assessment of factory layout proposals, where objectives and constraints related to safety regulations, workers’ well-being and walking distance are considered simultaneously. The paper illustrates how layout planning for a logistics area can become a cross-disciplinary and transparent activity, while being automated to a higher degree, providing objective results to facilitate informed decision-making.

Los retos tecnológicos de la Industry 4.0 en el ámbito de la fabricación inteligente requieren abordar la creciente complejidad de los sistemas de producción automatizados para optimizar la producción. Con tal fin, en este trabajo se presenta una estrategia de control distribuida y colaborativa basada en agentes industriales. Así, se propone un agente industrial que dota de inteligencia a unidades de control encapsuladas proporcionándoles la capacidad de llevar a cabo la negociación y coordinación tanto con otros agentes, como con otras aplicaciones relacionadas con el control y la supervisión de planta. Estas capacidades se describen mediante su integración en una arquitectura de control distribuida para cumplir los objetivos de producción. Su aplicabilidad se muestra en la prueba de concepto que forma parte de una célula flexible de ensamblaje. Este enfoque de agente industrial permite adoptar una tecnología facilitadora de Industry 4.0 sin costos elevados.

OBJECTIVE: To evaluate whether the deep learning (DL) segmentation methods from the six teams that participated in the IWOAI 2019 Knee Cartilage Segmentation Challenge are appropriate for quantifying cartilage loss in longitudinal clinical trials. DESIGN: We included 556 subjects from the Osteoarthritis Initiative study with manually read cartilage volume scores for the baseline and 1-year visits. The teams used their methods originally trained for the IWOAI 2019 challenge to segment the 1130 knee MRIs. These scans were anonymized and the teams were blinded to any subject or visit identifiers. Two teams also submitted updated methods. The resulting 9,040 segmentations are available online.The segmentations included tibial, femoral, and patellar compartments. In post-processing, we extracted medial and lateral tibial compartments and geometrically defined central medial and lateral femoral sub-compartments. The primary study outcome was the sensitivity to measure cartilage loss as defined by the standardized response mean (SRM). RESULTS: For the tibial compartments, several of the DL segmentation methods had SRMs similar to the gold standard manual method. The highest DL SRM was for the lateral tibial compartment at 0.38 (the gold standard had 0.34). For the femoral compartments, the gold standard had higher SRMs than the automatic methods at 0.31/0.30 for medial/lateral compartments. CONCLUSION: The lower SRMs for the DL methods in the femoral compartments at 0.2 were possibly due to the simple sub-compartment extraction done during post-processing. The study demonstrated that state-of-the-art DL segmentation methods may be used in standardized longitudinal single-scanner clinical trials for well-defined cartilage compartments.

Introduction: Our aim was to determine which foetal or neonatal growth curves discriminate the probability of dying of newborns with low birth weight for their gestational age (small for gestational age, SGA) and sex (weight < 10th percentile) and to establish the curves that are presumably most useful for monitoring growth through age 10 years. Material and methods: The analysis included every neonate (15 122) managed in our hospital (2013–2022) and all neonates born preterm before 32 weeks (6913) registered in the SEN1500 database (2019–2022). We considered most useful those curves with the highest likelihood ratio (LR) for dying with or without a history of SGA in each subgroup of gestational ages. Theoretically, the optimal curves for monitoring growth would be those with a higher R2 in the quantile regression formulas for the 50th percentile. Results: The growth curves exhibiting the strongest association between SGA and hospital mortality are the Intergrowth fetal curves and the Fenton neonatal curves in infants born preterm before 32 weeks. However, the optimal curves for premature babies and neonates overall were those of Olsen and Intergrowth. The most useful curves to monitor anthropometric values alone until age 10 years of age are the longitudinal Intergrowth curves followed by the WHO standards, but if a single reference is desired from birth through age 10 years, the best option is the Fenton curves followed by the WHO standards. Conclusions: The Intergrowth reference provides the most discriminating foetal growth curves. In neonatal clinical practice, the optimal references are the Fenton followed by the WHO charts. Resumen: Introducción: Se pretende determinar qué curvas de crecimiento fetal o neonatal discriminan la probabilidad de fallecer de los recién nacidos de bajo peso para su edad gestacional (BPEG) y sexo (peso inferior al percentil 10) y conocer las curvas teóricamente más útiles para seguir el crecimiento hasta los 10 años. Material y método: Se estudian todos los neonatos (15.122) atendidos en nuestro hospital (2013-2022) y todos los prematuros menores de 32 semanas (6.913) incluidos en la base de datos SEN1500 (2019-2022). Las curvas más útiles serán las que tengan un mayor cociente de probabilidad (LHR=likelihood ratio) de fallecer siendo o no BPEG en cada subgrupo de edades gestacionales. Las curvas más indicadas teóricamente en el seguimiento serán las que tengan una mayor R2 en las fórmulas de regresión de las tendencias del percentil 50. Resultados: Las curvas de crecimiento que mejor relacionan BPEG con mortalidad hospitalaria son las fetales de Intergrowth y las neonatales de Fenton en los prematuros menores de 32 semanas. Sin embargo, en todos los prematuros y neonatos en su conjunto, son las de Olsen e Intergrowth. Las curvas más útiles para seguir sólo la evolución antropométrica hasta los 10 años son las longitudinales de Intergrowth más OMS, pero si se desea una curva única desde el nacimiento hasta los 10 años son las de Fenton más OMS. Conclusiones: Las curvas de crecimiento fetal más discriminante son las de Intergrowth fetales. En la práctica clínica del neonatólogo, las curvas más indicadas son las de Fenton más OMS.

Current industrial robotic manipulators have made their lack of flexibility evident. The systems must know beforehand the piece and its position. To address this issue, contemporary approaches typically employ learning-based techniques, which rely on extensive amounts of data. To obtain vast data, an often sought tool is an extensive grasp dataset. This work introduces our Physics-Based Self-Supervised Grasp Pose Detection (PBSS-GPD) pipeline for model-based grasping point detection, which is useful for generating grasp pose datasets. Given a gripper-object pair, it samples grasping pose candidates using a modified version of GPD (implementing inner-grasps, CAD support…) and quantifies their quality using the MuJoCo physics engine and a grasp quality metric that takes into account the pose of the object over time. The system is optimized to run on CPU in headless-parallelized mode, with the option of running in a graphical interface or headless and storing videos of the process. The system has been validated obtaining grasping poses for a subset of Egad! objects using the Franka Panda two-finger gripper, compared with state-of-the-art grasp generation pipelines and tested in a real scenario. While our system achieves similar accuracy compared to a contemporary approach, 84% on the real-world validation, it has proven to be effective at generating grasps with good centering 18 times faster than the compared system.

IntroductionFanconi anemia (FA) is an inherited disorder characterized by bone marrow failure, congenital malformations, and predisposition to malignancies. Alterations in hematopoietic stem cells (HSC) have been reported, but little is known regarding the bone marrow (BM) stroma. Thus, the characterization of Mesenchymal Stromal Cells (MSC) would help to elucidate their involvement in the BM failure.MethodsWe characterized MSCs of 28 FA patients (FA-MSC) before and after treatment (hematopoietic stem cell transplantation, HSCT; or gene therapy, GT). Phenotypic and functional properties were analyzed and compared with MSCs expanded from 26 healthy donors (HD-MSCs). FA-MSCs were genetically characterized through, mitomycin C-test and chimerism analysis. Furthermore, RNA-seq profiling was used to identify dysregulated metabolic pathways.ResultsOverall, FA-MSC had the same phenotypic and functional characteristics as HD-MSC. Of note, MSC-GT had a lower clonogenic efficiency. These findings were not confirmed in the whole FA patients’ cohort. Transcriptomic profiling identified dysregulation in HSC self-maintenance pathways in FA-MSC (HOX), and was confirmed by real-time quantitative polymerase chain reaction (RT-qPCR).DiscussionOur study provides a comprehensive characterization of FA-MSCs, including for the first time MSC-GT and constitutes the largest series published to date. Interestingly, transcript profiling revealed dysregulation of metabolic pathways related to HSC self-maintenance. Taken together, our results or findings provide new insights into the pathophysiology of the disease, although whether these niche defects are involved in the hematopoietic defects seen of FA deserves further investigation.

PurposeThe composition of the subchondral bone marrow and cartilage endplate (CEP) could affect intervertebral disc health by influencing vertebral perfusion and nutrient diffusion. However, the relative contributions of these factors to disc degeneration in patients with chronic low back pain (cLBP) have not been quantified. The goal of this study was to use compositional biomarkers derived from quantitative MRI to establish how CEP composition (surrogate for permeability) and vertebral bone marrow fat fraction (BMFF, surrogate for perfusion) relate to disc degeneration.MethodsMRI data from 60 patients with cLBP were included in this prospective observational study (28 female, 32 male; age = 40.0 ± 11.9 years, 19-65 [mean ± SD, min-max]). Ultra-short echo-time MRI was used to calculate CEP T2* relaxation times (reflecting biochemical composition), water-fat MRI was used to calculate vertebral BMFF, and T1ρ MRI was used to calculate T1ρ relaxation times in the nucleus pulposus (NP T1ρ, reflecting proteoglycan content and degenerative grade). Univariate linear regression was used to assess the independent effects of CEP T2* and vertebral BMFF on NP T1ρ. Mixed effects multivariable linear regression accounting for age, sex, and BMI was used to assess the combined relationship between variables.ResultsCEP T2* and vertebral BMFF were independently associated with NP T1ρ (p = 0.003 and 0.0001, respectively). After adjusting for age, sex, and BMI, NP T1ρ remained significantly associated with CEP T2* (p = 0.0001) but not vertebral BMFF (p = 0.43).ConclusionPoor CEP composition plays a significant role in disc degeneration severity and can affect disc health both with and without deficits in vertebral perfusion.

La innovación y los retos tecnológicos de la fabricación inteligente han provocado un incremento notable en la complejidad del software de control de los sistemas de producción automatizados (aPS) integrados en un entorno global interconectado. Una herramienta de pruebas muy potente para su validación es emplear plantas virtuales (uno de los pilares de la digitalización en la industria). En este contexto, este artículo contribuye con una metodología de diseño e implementación de gemelos funcionales construidos a partir de componentes funcionales básicos de librería, que no precisa herramientas comerciales de desarrollo de plantas virtuales. Como representación virtual de la funcionalidad de una entidad del sistema de producción, el gemelo funcional se empleará como herramienta de pruebas para probar la reacción del sistema de control tanto en producción normal como ante la inyección de fallos. La metodología se ha aplicado en la construcción de los gemelos funcionales que permiten validar el sistema de control de una célula de ensamblaje.

This article presents a case study on the way of teaching and learning the subject ‘Information Systems’ to ICT (Information and Communication Technology) engineering students, which is based on an active learning strategy implemented through a Project-Based Learning (PjBL) method, a practice that facilitates knowledge acquisition in addition to enhancing diverse learning outcomes such as teamwork, critical thinking, and analysis, or communication skills. This study aims to present the students’ perceptions once they have undertaken the whole subject, to better understand the different positive and negative elements associated with PjBL implementation according to their opinions. Students’ perceptions of PjBL were obtained through a survey utilizing the Bipolar Laddering (BLA) technique, which allows them to identify their experiences in terms of both beneficial and challenging aspects, as well as potential improvements to their experiences. On one hand, the most relevant findings on their PjBL experience assessed as positive are presented as follows: to work by themselves on a real project related to the working world; to be able to apply the theoretical topics explained during the class sessions; to have highly talented instructors; to experience a very dynamic and effective way of learning; to give a final presentation to their classmates and the instructors; and to work in groups. On the other hand, when analyzing the core negative perceptions, the following ones were highlighted by the surveyed students: undertaking just a single project; having an overly theoretical context; and having too much freedom, which could lead to confusion.

Noise-induced hearing loss (NIHL) is responsible for significant adverse effects on cognition, quality of life and work, social relationships, motor skills, and other psychological aspects. The severity of NIHL depends on individual patient characteristics, sound intensity, and mainly the duration of sound exposure. NIHL leads to the production of a reactive oxygen (ROS) inflammatory response and the activation of apoptotic pathways, DNA fragmentation, and cell death. In this situation, antioxidants can interact with free radicals as well as anti-apoptotics or anti-inflammatory substances and stop the reaction before vital molecules are damaged. Therefore, the aim of this study was to analyze the effects of different pharmacological treatments, focusing on exogenous antioxidants, anti-inflammatories, and anti-apoptotics to reduce the cellular damage caused by acoustic trauma in the inner ear. Experimental animal studies using these molecules have shown that they protect hair cells and reduce hearing loss due to acoustic trauma. However, there is a need for more conclusive evidence demonstrating the protective effects of antioxidant/anti-inflammatory or anti-apoptotic drugs’ administration, the timeline in which they exert their pharmacological action, and the dose in which they should be used in order to consider them as therapeutic drugs. Further studies are needed to fully understand the potential of these drugs as they may be a promising option to prevent and treat noise-induced hearing loss.

Voltage-gated ion channels are essential for membrane potential maintenance, homeostasis, electrical signal production and controlling the Ca2+ flow through the membrane. Among all ion channels, the key regulators of neuronal excitability are the voltage-gated potassium channels (KV), the largest family of K+ channels. Due to the ROS high levels in the aging brain, K+ channels might be affected by oxidative agents and be key in aging and neurodegeneration processes. This review provides new insight about channelopathies in the most studied neurodegenerative disorders, such as Alzheimer Disease, Parkinson’s Disease, Huntington Disease or Spinocerebellar Ataxia. The main affected KV channels in these neurodegenerative diseases are the KV1, KV2.1, KV3, KV4 and KV7. Moreover, in order to prevent or repair the development of these neurodegenerative diseases, previous KV channel modulators have been proposed as therapeutic targets.

PurposeTo organize a multi-institute knee MRI segmentation challenge for characterizing the semantic and clinical efficacy of automatic segmentation methods relevant for monitoring osteoarthritis progression.Materials and methodsA dataset partition consisting of three-dimensional knee MRI from 88 retrospective patients at two time points (baseline and 1-year follow-up) with ground truth articular (femoral, tibial, and patellar) cartilage and meniscus segmentations was standardized. Challenge submissions and a majority-vote ensemble were evaluated against ground truth segmentations using Dice score, average symmetric surface distance, volumetric overlap error, and coefficient of variation on a holdout test set. Similarities in automated segmentations were measured using pairwise Dice coefficient correlations. Articular cartilage thickness was computed longitudinally and with scans. Correlation between thickness error and segmentation metrics was measured using the Pearson correlation coefficient. Two empirical upper bounds for ensemble performance were computed using combinations of model outputs that consolidated true positives and true negatives.ResultsSix teams (T 1-T 6) submitted entries for the challenge. No differences were observed across any segmentation metrics for any tissues (P = .99) among the four top-performing networks (T 2, T 3, T 4, T 6). Dice coefficient correlations between network pairs were high (> 0.85). Per-scan thickness errors were negligible among networks T 1-T 4 (P = .99), and longitudinal changes showed minimal bias (< 0.03 mm). Low correlations (ρ < 0.41) were observed between segmentation metrics and thickness error. The majority-vote ensemble was comparable to top-performing networks (P = .99). Empirical upper-bound performances were similar for both combinations (P = .99).ConclusionDiverse networks learned to segment the knee similarly, where high segmentation accuracy did not correlate with cartilage thickness accuracy and voting ensembles did not exceed individual network performance.See also the commentary by Elhalawani and Mak in this issue.Keywords: Cartilage, Knee, MR-Imaging, Segmentation © RSNA, 2020Supplemental material is available for this article.

Coffee fruit cascara, which is the skin and pulp of the coffee cherry, has been authorized as a novel food for commercialization in the European Union. The present research assessed the feasibility of using spray drying to produce a soluble powder called instant cascara (IC), employing sun-dried ripe coffee cherry pulp as a raw material. Although there were no significant differences (p > 0.05) in the overall antioxidant capacity between the freeze-dried and spray-dried samples, after an in vitro simulation of the digestion process, the spray-dried sample was significantly (p < 0.05) more antioxidant. Both samples reduced physiological intracellular ROS and significantly decreased (p < 0.05) the secretion of the pro-inflammatory factor NO. Alkaloids and phenolic compounds were detected in intestinal digests. In conclusion, spray drying is a good technique for producing IC as its use does not affect its properties and causes less environmental impact than freeze drying, as calculated by life cycle assessment. Sensory analysis did not show significant differences between the commercial beverage and the IC beverage in the adult population. IC at 10 mg/mL was significantly less accepted in adolescents than the commercial beverage. Future work will include the reformulation of the IC beverage at 10 mg/mL, which has antioxidant and anti-inflammatory potential, to increase its hedonic acceptance in all consumer segments.

The digital maturity of universities has been a key element in coping with the forced situation brought about by COVID-19 and in subsequent years. This research paper presents a case study of a private Spanish university that aims to analyze the challenges and opportunities that have arisen after the pandemic in terms of resource management and training for teaching innovation and digitization. The nature of this study is qualitative, in which nine interviews were conducted with managers from different faculties and those responsible for Information and Communication Technologies. After analyzing the data with Atlas.ti, four categories were established (technological resources and devices, challenges, opportunities, and others). The study concludes by discussing the commitment to online training, the popularization of videoconferencing tools for teaching sessions, meetings, or synchronous tutorials, and the acceleration of digital transformation, among others.

AbstractIn 2018, Ipas Bolivia launched an abortion self-care (ASC) community intervention with the goal of increasing access to supportive, well-informed abortion support provided by community agents (CAs). Between September 2019 and July 2020, Ipas conducted a mixed-methods evaluation to assess the reach, outcomes, and acceptability of the intervention. We used logbook data maintained by CAs to capture demographic characteristics and ASC outcomes of people supported. We also conducted in-depth interviews with 25 women who had received support and 22 CAs who had provided support. 530 people accessed ASC support through the intervention, most of whom were young, single, educated women accessing abortion in the first trimester. Among the 302 people who self-managed their abortions, 99% reported having a successful abortion. No women reported adverse events. All women interviewed expressed satisfaction with the support provided by the CA and, in particular, with the information, lack of judgement, and respect they felt from CAs. CAs spoke highly about their experience and viewed their participation as a way to increase people’s ability to exercise their reproductive rights. Obstacles included experiences of stigma, fears of legal repercussions, and difficulties dispelling misconceptions around abortion. Legal restrictions and abortion stigma continue to complicate access to safe abortion, and findings from this evaluation highlight important avenues for the effectiveness and expansion of ASC interventions, including legal support to people who have abortions and those who provide abortion support, building capacity of people as informed buyers, and ensuring that interventions reach rural and other often under-served people.

An assessment framework of marine ecosystem services (ES) indicators to quantify the socio-ecological effectiveness of nature-based solutions (NBS) and nature-inclusive harvesting (NIH) under climate-driven changes was developed. It creates a common understanding about the health status of ecosystems, their services (ES), and the impact of implementing NBS&NIH to inform policymakers and the public. The two NBS considered were restoration and conservation which need to be performed considering the sustainable harvesting of marine resources (NIH). The interaction between the biodiversity indicators with the socioeconomic, response and pressure indicators was established using the ES cascade. However, it was also linked to other environmental (e.g., DAPSI(W)R(M)) and economic frameworks such as the Standard National Account (SNA) and the System of Environment Economic Accounting (SEEA). A set of 155 multidisciplinary indicators were identified through a literature review and their effectiveness in measuring ES under changing climate. Biodiversity & environmental as well as Pressure indicators are the most numerous in the list representing 34 % and 23 % of the total respectively, while only 12 % of the used Indicators below to the economic dimension. Socioeconomic indicators considering CC are rarely contemplated, except for a short list redefining output and demand approach indicators to aggregate a carbon footprint valuation. For cultural services economic indicators dominate, whereas sparse for provisioning and regulating. The 70 % of the selected indicators were also empirically verified with 27 European storylines. Storylines have high coverage of biodiversity, environmental indicators, and CC indicators (91 %), lower coverage of economic (71 %) and poorer related to social (31 %) indicators. Harvest, pressure and/or habitats are clearly the groups of indicators majority used when evaluating the ES on marine and coastal ecosystems both in terms of the number of used indicators but also, the frequency of use. Despite the increase of ES research, this study identifies 14 substantial gaps or weaknesses limiting the guidance for NBS&NIH implementation derived from the employment of an unbalanced (between dimensions and key groups) number of quantitative indicators.

Knee pain is the most common and debilitating symptom of knee osteoarthritis (OA). While there is a perceived association between OA imaging biomarkers and pain, there are weak or conflicting findings for this relationship. This study uses Deep Learning (DL) models to elucidate associations between bone shape, cartilage thickness and T2 relaxation times extracted from Magnetic Resonance Images (MRI) and chronic knee pain. Class Activation Maps (Grad-CAM) applied on the trained chronic pain DL models are used to evaluate the locations of features associated with presence and absence of pain. For the cartilage thickness biomarker, the presence of features sensitive for pain presence were generally located in the medial side, while the features specific for pain absence were generally located in the anterior lateral side. This suggests that the association of cartilage thickness and pain varies, requiring a more personalized averaging strategy. We propose a novel DL-guided definition for cartilage thickness spatial averaging based on Grad-CAM weights. We showed a significant improvement modeling chronic knee pain with the inclusion of the novel biomarker definition: likelihood ratio test p-values of 7.01 × 10-33 and 1.93 × 10-14 for DL-guided cartilage thickness averaging for the femur and tibia, respectively, compared to the cartilage thickness compartment averaging.

PurposeTo develop an automated pipeline based on convolutional neural networks to segment lumbar intervertebral discs and characterize their biochemical composition using voxel-based relaxometry, and establish local associations with clinical measures of disability, muscle changes, and other symptoms of lower back pain.MethodsThis work proposes a new methodology using MRI (n = 31, across the spectrum of disc degeneration) that combines deep learning-based segmentation, atlas-based registration, and statistical parametric mapping for voxel-based analysis of T1ρ and T2 relaxation time maps to characterize disc degeneration and its associated disability.ResultsAcross degenerative grades, the segmentation algorithm produced accurate, high-confidence segmentations of the lumbar discs in two independent data sets. Manually and automatically extracted mean disc T1ρ and T2 relaxation times were in high agreement for all discs with minimal bias. On a voxel-by-voxel basis, imaging-based degenerative grades were strongly negatively correlated with T1ρ and T2 , particularly in the nucleus. Stratifying patients by disability grades revealed significant differences in the relaxation maps between minimal/moderate versus severe disability: The average T1ρ relaxation maps from the minimal/moderate disability group showed clear annulus nucleus distinction with a visible midline, whereas the severe disability group had lower average T1ρ values with a homogeneous distribution.ConclusionThis work presented a scalable pipeline for fast, automated assessment of disc relaxation times, and voxel-based relaxometry that overcomes limitations of current region of interest-based analysis methods and may enable greater insights and associations between disc degeneration, disability, and lower back pain.