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Background: Until now, it is uncertain whether lifestyle interventions during pregnancy can prevent gestational diabetes mellites (GDM) in high-risk pregnant women. Objective: This study aims at investigating the effectiveness of dietary interventions and/or exercise interventions during pregnancy for preventing GDM in high-risk pregnant women. Materials and Methods: Eligible randomized controlled trials (RCTs) were selected after a search in CENTRAL, Scopus, and PubMed. Synthesis was performed for the outcome of GDM in women with any identified GDM risk factor. Separate meta-analyses (MA) were performed to assess the efficacy of either nutrition or physical activity (PA) interventions or both combined compared with standard prenatal care for preventing GDM. Subgroup and sensitivity analyses, as well as meta-regressions against OR, were performed to assess potentional heterogeneity. Overall quality, the quality of RCTs, and publication bias were also evaluated. Results: A total of 13,524 participants comprising high-risk pregnant women in 41 eligible RCTs were analyzed for GDM. Women receiving only a nutrition intervention during pregnancy were less likely to experience GDM compared with women following standard prenatal care. Among 3109 high-risk pregnant women undergoing only dietary intervention for preventing GDM, 553 (17.8%) developed GDM; however, the result of the MA was marginally not significant (OR 0.73, 95%CI 0.51, 1.03; p-value 0.07), (Q 21.29, p-value 0.01; I2 58% (95%CI 10, 78%)). Subgroup analyses demonstrated an effect for studies that were conducted in Great Britain (OR 0.65, 95%CI 0.49, 0.81; p-value 0.003), and in Spain (OR 0.50, 95%CI 0.27, 0.94; p-value 0.03), for studies with forms of the Mediterranean diet as the intervention's component (OR 0.61; 95%CI 0.46, 0.81; p-value 0.0005), and for studies including a motivation arm in the intervention (OR 0.71, 95%CI 0.58, 0.87; p-value 0.0008). Among 2742 high-risk pregnant women being analyzed for GDM outcome after receiving only an exercise intervention, 461 (16.8%) were diagnosed with GDM. Women after receiving PA intervention were less likely to develop GDM (OR 0.64, 95%CI 0.51, 0.80; p-value < 0.0001), (Q 11.27, p-value 0.51; I2 0% (95%CI 0, 99%)). Finally, 1308 (17%) cases of GDM were diagnosed among 7673 high-risk pregnant women undergoing both diet and PA intervention. Women in the group of mixed lifestyle intervention had a significant reduction in incidence of GDM (OR 0.70, 95%CI 0.55, 0.90; p-value 0.005), (Q 50.32, p-value < 0.0001, I2 66%, (95% CI 44, 79%)). Conclusions: The results of this study support the efficacy of lifestyle interventions during pregnancy for preventing GDM in high-risk women if an exercise component is included in the intervention arm, either alone, or combined with diet. A combined lifestyle intervention including physical exercise and a Mediterranean diet accompanied by motivation support may be considered the most effective way to prevent GDM among high-risk women during pregnancy. Future research is needed to strengthen these findings. [ABSTRACT FROM AUTHOR]

In recent years, there has been a remarkable development in the technology and legislation related to electric and autonomous vehicles (i.e., EVs/AVs). This technological advancement requires the deployment of the most up-to-date supporting infrastructure to achieve safe operation. Further infrastructure is needed for Level 5 vehicles, namely the introduction of super-fast wireless 5G technology. To achieve harmony between the rapid technological advancement of EVs/AVs and environmental preservation, enacting legislation related to their sustainable use is vital. Thus, this manuscript provides a review of the technological development of EVs/AVs, with a special focus on carbon footprints and the implementation of additive manufacturing using recycled materials. While EVs have a 12.13% increased carbon footprint compared to conventional vehicles, AVs with basic and advanced intelligence features have an increased carbon footprint of 41.43% and 99.65%, respectively. This article emphasizes that the integration of 3D-printed components has the potential to offset this impact with a substantial 60% reduction. As a result, custom-made solutions involving 3D printing are explored, leading to greater speed, customization, and cost-effectiveness for EVs/AVs. This article also lists the advantages and disadvantages of the existing legislation in Spain, the United Kingdom, and the western Balkans, demonstrating various approaches to promoting electric mobility and the development of autonomous vehicles. In Spain, initiatives like the MOVES program incentivize EV adoption, while the UK focuses on expanding the EV market and addressing concerns about EVs' quiet operation. In the western Balkans, the adoption of legislation lags behind, with limited incentives and infrastructure for EVs. To boost sales, legal mechanisms are necessary to reduce costs and improve accessibility, in addition to offering subsidies for the purchase of EVs. To this end, an analysis of the incentive measures proposed for the development and use of renewable power sources for the supply of energy for EVs/AVs is presented. [ABSTRACT FROM AUTHOR]

We conducted an updated meta-analysis to evaluate the 30-day mortality of hip fractures during the COVID-19 pandemic and assess mortality rates by country. We systematically searched Medline, EMBASE, and the Cochrane Library up to November 2022 for studies on the 30-day mortality of hip fractures during the pandemic. Two reviewers used the Newcastle–Ottawa tool to independently assess the methodological quality of the included studies. We conducted a meta-analysis and systematic review including 40 eligible studies with 17,753 patients with hip fractures, including 2280 patients with COVID-19 (12.8%). The overall 30-day mortality rate for hip fractures during the pandemic was 12.6% from published studies. The 30-day mortality of patients with hip fractures who had COVID-19 was significantly higher than those without COVID-19 (OR, 7.10; 95% CI, 5.51–9.15; I2 = 57%). The hip fracture mortality rate increased during the pandemic and varied by country, with the highest rates found in Europe, particularly the United Kingdom (UK) and Spain. COVID-19 may have contributed to the increased 30-day mortality rate in hip fracture patients. The mortality rate of hip fracture in patients without COVID-19 did not change during the pandemic. [ABSTRACT FROM AUTHOR]

The contamination of oats with Fusarium toxins poses a high risk for food safety. Among them, trichothecenes are the most frequently reported in European oats, especially in northern countries. The environmental conditions related to the climate change scenario might favour a distribution shift in Fusarium species and the presence of these toxins in Southern European countries. In this paper, we present an ambitious work to determine the species responsible for trichothecene contamination in Spanish oats and to compare the results in the United Kingdom (UK) using a metataxonomic approach applied to both oat grains and soil samples collected from both countries. Regarding T-2 and HT-2 toxin producers, F. langsethiae was detected in 38% and 25% of the oat samples from the UK and Spain, respectively, and to the best of our knowledge, this is the first report of the detection of this fungus in oats from Spain. The relevant type B trichothecene producer, F. poae, was the most frequently detected Fusarium species in oats from both origins. Other important trichothecene producers, such as the Fusarium tricinctum species complex or Fusarium cerealis, were also frequently detected in oat fields. Many Fusarium toxins, including T-2 and HT-2 toxins, deoxynivalenol, or nivalenol, were detected in oat samples. The results obtained in this work revealed a clear change in the distribution of trichothecene producers and the necessity to establish the potential of these species to colonize oats and their ability to produce mycotoxins. [ABSTRACT FROM AUTHOR]

Simple Summary: Recent studies have mostly focused on the treatment of advanced mycosis fungoides and Sézary syndrome and less on the treatment of relapsed or refractory (R/R) cases of cutaneous T-cell lymphoma (CTCL). There is also a paucity of data on the treatment and outcomes of primary cutaneous anaplastic large cell lymphoma and other rare CTCL subtypes. This European observational study provided real-world data on the current treatments used in the management of CTCL across three lines of therapy. As a result, there was a significant level of heterogeneity in treatment types than expected by European guidelines. These findings highlight the lack of consensus in relapsed CTCL, as well as the urgent unmet treatment needs. The treatment pattern of cutaneous T-cell lymphoma (CTCL) remains diverse and patient-tailored. The objective of this study was to describe the treatment patterns and outcomes in CTCL patients who were refractory or had relapsed (R/R) after a systemic therapy. A retrospective chart review study was conducted at 27 sites in France, Germany, Italy, Spain and the United Kingdom (UK) of patients who received a first course of systemic therapy and relapsed or were refractory. Data were collected longitudinally from diagnosis to first-, second- and third-line therapy. The study included 157 patients, with a median follow-up of 3.2 years. In total, 151 proceeded to second-line and 90 to third-line therapy. In the first line (n = 147), patients were treated with diverse therapies, including single- and multi-agent chemotherapy in 67 (46%), retinoids in 39 (27%), interferon in 31 (21%), ECP in 4 (3%), corticosteroids in 3 (2%) and new biological agents in 3 (2%). In the second line, the use of chemotherapy and retinoids remained similar to the first line, while the use of new biologics increased slightly. In sharp contrast to the first line, combination chemotherapy was extremely diverse. In the third line, the use of chemotherapy remained high and diverse as in the second line. From the time of first R/R, the median PFS was 1.2 years and the median OS was 11.5 years. The presented real-world data on the current treatments used in the management of R/R CTCL in Europe demonstrate the significant heterogeneity of systemic therapies and combination therapies, as expected from the European guidelines. [ABSTRACT FROM AUTHOR]

A new methodology is presented for measuring, classifying and predicting the cycles of uncertainty that occur in temporary decision-making in the tourist accommodation market (apartments and hotels). Special attention is paid to the role of entropy and cycles in the process under the Adaptive Markets Hypothesis. The work scheme analyses random cycles from time to time, and in the frequency domain, the linear and nonlinear causality relationships between variables are studied. The period analysed is from January 2005 to December 2018; the following empirical results stand out: (1) On longer scales, the periodicity of the uncertainty of decision-making is between 6 and 12 months, respectively, for all the nationalities described. (2) The elasticity of demand for tourist apartments is approximately 1% due to changes in demand for tourist hotels. (3) The elasticity of the uncertainty factor is highly correlated with the country of origin of tourists visiting Spain. For example, it has been empirically shown that increases of 1% in uncertainty cause increases in the demand for apartments of 2.12% (worldwide), 3.05% (UK), 1.91% (Germany), 1.78% (France), 7.21% (Ireland), 3.61% (The Netherlands) respectively. This modelling has an explanatory capacity of 99% in all the models analysed. [ABSTRACT FROM AUTHOR]

Numerous varieties of celery are grown in multiple countries to maintain supply, demand and availability for all seasons; thus, there is an expectation for a consistent product in terms of taste, flavour, and overall quality. Differences in climate, agronomy and soil composition will all contribute to inconsistencies. This study investigated the volatile and sensory profile of eight celery genotypes grown in the UK (2018) and Spain (2019). Headspace analysis determined the volatile composition of eight genotypes, followed by assessment of the sensory profile using a trained panel. Significant differences in the volatile composition and sensory profile were observed; genotype and geographical location both exerted influences. Two genotypes exhibited similar aroma composition and sensory profile in both locations, making them good candidates to drive breeding programmes aimed at producing varieties that consistently display these distinctive sensory properties. Celery samples harvested in the UK exhibited a higher proportion of sesquiterpenes and phthalides, whereas samples harvested in Spain expressed a higher aldehyde and ketone content. Studying the relationship between growing environment and genotype will provide information to guide growers in how to consistently produce a high-quality crop. [ABSTRACT FROM AUTHOR]

We describe the outcomes in cancer patients during the initial outbreak of the COVID-19 in Europe from the retrospective, multi-center observational OnCovid study. We identified 204 cancer patients from eight centers in the United Kingdom, Italy, and Spain aged >18 (mean = 69) and diagnosed with COVID-19 between 26 February and 1 April 2020. A total of 127 (62%) were male, 184 (91%) had a diagnosis of solid malignancy, and 103 (51%) had non-metastatic disease. A total of 161 (79%) had >1 co-morbidity. A total of 141 (69%) patients had >1 COVID-19 complication. A total of 36 (19%) were escalated to high-dependency or intensive care. A total of 59 (29%) died, 53 (26%) were discharged, and 92 (45%) were in-hospital survivors. Mortality was higher in patients aged >65 (36% vs. 16%), in those with >2 co-morbidities (40% vs. 18%) and developing >1 complication from COVID-19 (38% vs. 4%, p = 0.004). Multi-variable analyses confirmed age > 65 and >2 co-morbidities to predict for patient mortality independent of tumor stage, active malignancy, or anticancer therapy. During the early outbreak of SARS-CoV-2 infection in Europe co-morbid burden and advancing age predicted for adverse disease course in cancer patients. The ongoing OnCovid study will allow us to compare risks and outcomes in cancer patients between the initial and later stages of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]