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Abstract Background Hypertension is the most common cardiovascular disease in Peru despite the availability of cost-effective, evidence-based treatment. Here we describe the rationale and study design for a hybrid type 2 randomized controlled trial to test the implementation and effectiveness of a community health worker (CHW)-led hypertension control program within the national primary care system in Puno, Peru. Methods We will recruit 1068 adult participants with hypertension aged ≥ 18 years in Puno, Peru, via facility-based enrollment and community health fairs. Participants will be individually randomized (1:1) to either continue with usual care or participate in a 12-month CHW-led home-based hypertension control program consisting of blood pressure monitoring, medication adherence support, and healthy lifestyle counseling. Outcome development and reporting are guided by the Consolidated Framework for Implementation Research (CFIR), the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, and the Proctor et al. framework. Clinical effectiveness outcomes include mean change in systolic blood pressure (primary outcome), diastolic blood pressure, and HbA1C. Implementation outcomes include fidelity (i.e., CHW protocol adherence and dose), reach, adoption, sustainability, acceptability, and cost-effectiveness. Discussion The ANDES trial is testing the first CHW-led multicomponent strategy for hypertension and type 2 diabetes management in Peru. This type 2 hybrid trial will provide critical insights into the individual, community, and system-level factors necessary for successful implementation and effectiveness. These data can inform the future adaptation and scaling of the ANDES strategy in Peru and other LMICs, as well as influence policies at the system level to support this transition. Furthermore, by addressing both hypertension and diabetes, the ANDES strategy supports integrated care approaches advocated by the WHO HEARTS technical package, ultimately enhancing health outcomes and reducing morbidity and mortality in the region. Trial registration ClinicalTrials.gov, ID: NCT05524987 , Addressing Hypertension and Diabetes through Community-Engaged Systems in Puno, Peru (ANDES study), prospectively registered on September 1, 2021.

Systematic studies on the biodiversity of bryophytes along elevational gradients have been conductuted within the native vegetation of the Azores, using the MOVECLIM framework. The primary objective of this study was to inventory the bryophytes present within preserved areas of native vegetation in Terceira Island (Azores). From 25 to 28 September 2012, an inventory of the bryoflora was carried out along an elevational gradient, starting near Serreta lighthouse (38.76658 Latitude; -27.37539 Longitude; 40 m a.s.l.) and culminating on the top of Santa Bárbara Mountain (38.73064 Latitude; -27.32164 Longitude; 1000 m a.s.l.). The study followed the adapted MOVECLIM standardised protocol, as follows: i) six sites were selected along an elevational transect, each site spaced at 200 m elevation intervals; ii) within each site, two 10 m x 10 m plots were established in close proximity from each other (10-15 m); iii) within these plots, three 2 m x 2 m quadrats were randomly selected and sampled for bryophytes. The following substrates were surveyed in each quadrat: rock, soil, humus, organic matter, tree bark at three different heights and leaves/fronds. For each available and bryophyte-colonised substrate, three replicate microplots of 10 cm x 5 cm were collected, resulting in a maximum of 24 microplots per quadrat.Nearly three-quarters of the maximum expected number of microplots (636 out of 864; eventID) were found across the six sites on Terceira Island, resulting in a total of 3677 records (occurrenceID). A high proportion of the specimens could be identified to the species rank (n = 3661; 99.6%), representing 38 families, 60 genera and 92 species, including 58 species of liverworts (Marchantiophyta) and 34 species of mosses (Bryophyta). The inventory included several endemic species: two liverwort species endemic to the Azores, five species endemic to Macaronesia (three mosses and two liverworts) and 11 European endemic species (three mosses and eight liverworts). The elevations with the highest species richness, the highest number of endemic species and the highest number of conservation concern species, spanned between 600 and 1000 m a.s.l. above sea level, coinciding with the best preserved forest vegetation. Overall, tree-dwelling and ground-dwelling substrates showed similar levels of bryophyte occupation (75% vs. 72%). However, the 636 events were unevenly distributed across substrates: leaves and rocks had the fewest replicates (n = 54; 50.0%), while humus and the lowest tree height had the highest values (n = 106; 98.1% and n = 98; 90.7%, respectively).The study contributed to expanding knowledge about the diversity and distribution of the Azorean Bryoflora, both on a local and a regional scale.

Abstract Background It has been suggested that maternal satisfaction should be included as an additional and appropriate outcome indicator in relation to the breastfeeding process. The aim of this study was to analyze the psychometric properties of various existing versions of the Maternal Breastfeeding Evaluation Scale in a Spanish sample. Methods This was a longitudinal observational study, evaluated at three different time points: in the hospital after delivery, and then at five and 12 months after delivery in a Spanish sample. A total of 690 mother participated in this study. Results Confirmatory factor analysis results indicated an improved fit of the data to the original model (CFI = 0.984; TLI = 0.982; RMSEA = 0.079). All dimensions of the Maternal Breastfeeding Evaluation Scale are positively associated with breastfeeding rates and negatively associated with perceived difficulty in continuing to breastfeed after returning to work at five months postpartum. Moreover, the scale can predict breastfeeding behavior at 12 months postpartum. Conclusions The results of this study indicate that the structure of the original version of the Maternal Breastfeeding Evaluation Scale mean it is a is valid and reliable tool for assessing maternal perceptions of the breastfeeding experience in Spain. This research enhances our understanding of maternal satisfaction with the breastfeeding experience and its potential implications for supporting breastfeeding practices. It is an opportunity for the academic, healthcare, and policy sectors to develop more effective interventions to improve breastfeeding rates and ensure a positive experience for mothers.

A vulnerabilidade social é uma influência notável na saúde, bem-estar e no risco de transgressões aos Direitos Humanos. Este estudo observacional transversal objetiva compreender o perfil socioeconômico e demográfico de indivíduos detidos por tráfico de drogas em Fortaleza-CE, assim como identificar o grau de vulnerabilidade social das regiões onde habitam. Adicionalmente, procura-se verificar se esses aspectos se associam com as decisões judiciais em audiências de custódia. Para isso, foram examinados dados de 728 autos de prisão em flagrante registrados entre março de 2018 e setembro de 2019, utilizando-se estatística descritiva, teste de qui-quadrado e análise de distribuição espacial. A análise revelou que a predominância dos presos consiste em homens jovens, pardos, solteiros, com nível de ensino fundamental e sem filhos. Uma associação estatisticamente significativa foi identificada entre o Índice de Vulnerabilidade Social (IVS) e os resultados das audiências de custódia, indicando que o contexto residencial dos detidos pode influenciar significativamente as decisões de encarceramento.

Objectives: To determine the proportion of online vape shops that offer derived cannabinoid products in a large metropolitan area (San Diego, California), measure their compliance with state hemp regulations, and estimate whether these shops receive more website traffic compared to those that offered nicotine or tobacco. Methods: We obtained vape shops (n = 109) using browser-based (i.e., Google Search) and map-based (i.e., Google Maps and Yelp) searches in San Diego from March to August 2023 and conducted a content analysis of their websites to identify derived cannabinoid products offered for mail-order purchasing. Using website traffic data, we examined the association between derived cannabinoid product availability and monthly website visits. Results: Among the 109 online vape shops in the study sample, 35.8 % offered derived cannabinoid products for mail-order purchase and 26.6 % sold flavored (excluding terpenes) and inhalable cannabinoid products. Compared to vape shops that did not offer derived cannabinoid products (Mean: 23,619; 95 % CI: 23,605–23,634), those offering flavored and inhalable cannabinoid products received 2.5 times more monthly website visits (Mean: 57,950; 95 % CI: 57,913–57,986) and those offering any derived cannabinoid products received 5.5 times more monthly website visits (Mean: 130,694; 95 % CI: 130,607–130,782). Conclusion: The prevalence of flavored and inhalable derived cannabinoid products, despite being prohibited under California’s hemp regulations, highlights the need for additional enforcement measures to ensure retailer compliance. The higher website traffic observed among vape shops offering cannabinoid products may be indicative of greater popularity of retailers selling derived cannabinoid products compared to those selling nicotine or tobacco products alone.

This data article presents a comprehensive buccal dental microwear raw database, accompanied by all corresponding archaeological sample micrographs acquired through a ZEISS Axioscope A1 optical microscopy (OM). The dataset includes teeth specimens from 88 adult individuals, representing eight distinct groups spanning the Middle-Late Neolithic to the Middle Bronze Age from the northeastern Iberian Peninsula. These groups include Cova de l'Avi, Cova de Can Sadurní, Cova de la Guineu, Cova Foradada, Cova del Trader, Roc de les Orenetes, Cova del Gegant, and Cova dels Galls Carboners.The data collection process was based on the use of optical microscopy to obtain dental microwear patterns, with a specific focus on the buccal surface of the teeth. To facilitate future comparative studies, we have also included all the micrographs obtained with the optical microscopy and the processed images with the counted striations. The presentation of this extensive dataset sets a base for future research on dental microwear patterns and dietary variations across various prehistoric periods.

Este estudo discute a utilização de métricas de análise espacial em ambiente de Sistemas de Informação Geográficas (SIG) aplicadas a dados do censo populacional do Instituto Brasileiro de Geografia e Estatística (IBGE) dos anos de 2000 e 2010 para entender a complexa e multifacetada mobilidade espacial em Santa Catarina. Para isso, foram usados dados quantitativos coletados nas diferentes regiões administrativas do estado de SC. O fenômeno, observado em vários países, envolve o adensamento populacional em regiões metropolitanas, motivado pela busca por melhores condições de vida e catalisado pelo êxodo rural devido ao avanço tecnológico na agricultura e ao emprego de mão de obra temporária. Tal movimento, geralmente originado em municípios menores em direção a maiores, tem consequências significativas para a dinâmica econômica, social e ambiental dos locais envolvidos, afetando diretamente a qualidade de vida dos indivíduos. Os municípios de São Pedro de Alcântara, Ituporanga, Campo Alegre e Bom Retiro, neste período de 10 anos, apresentaram êxodo rural considerável, com uma queda da população de -34,48%, -5,24%, -5,29% e -4,03% respetivamente, enquanto o aumento da população urbana ocorreu nas regiões do Norte Catarinense, Vale do Itajaí e Grande Florianópolis, com destaque nos seguintes municípios: Massaranduba, Garopaba, Guabiruba, Tijucas, Florianópolis, Blumenau e Joinville, com 64,31%, 42,88%, 41,65%, 38,97%, 22,01%, 21,84% e 19,97%, respetivamente. Estas informações são de utilidade para gestores públicos na definição de meios para viabilizar recursos, infraestrutura e serviços, dada a demanda de moradia, saneamento, educação, saúde entre outros.

This study explored the interconnections between sociodemographic elements, depression, fatigue, and exercise in patients suffering from incurable neoplasm, particularly emphasizing the mediating influence of exercise on the relationship between depression and fatigue This was a prospective, multicenter, observational study involving 15 hospitals across Spain. After three months of systemic cancer treatment, participants completed the Brief Symptom Inventory (BSI), the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) and the Fatigue Assessment Scale (FAS) to measure levels of depression, fatigue, and exercise, respectively. A total of 616 subjects participated in this study. Activity levels differed markedly according to educational attainment, marital, and work status. There was a negative correlation between physical activity and depression, and a positive correlation between depression and fatigue (β = −0.18, and β = 0.46, respectively). Additionally, physical activity inversely influenced fatigue levels (β = 0.21). Physical activity served as a partial intermediary in the link between depression and fatigue among patients with advanced, unresectable cancer. Healthcare providers are urged to consider both the physical and emotional dimensions of cancer treatment, implementing physical activity programs to enhance overall patient quality of life and mental health.

Intraoral scanners are widely used in a clinical setting for orthodontic treatments and tooth restorations, and are also useful for assessing dental wear and pathology progression. In this study, we assess the utility of using an intraoral scanner and associated software for quantifying dental tissue loss in non-human primates. An upper and lower second molar for 31 captive hamadryas baboons (Papio hamadryas) were assessed for dental tissue loss progression, giving a total sample of 62 teeth. The animals are part of the Southwest National Primate Research Center and were all fed the same monkey-chow diet over their lifetimes. Two molds of each dentition were taken at either two- or three-year intervals, and the associated casts scanned using an intraoral scanner (Medit i700). Tissue loss was calculated in WearCompare by superimposition of the two scans followed by subtraction analysis. Four individuals had dental caries, and were assessed separately. The results demonstrate the reliability of these techniques in capturing tissue loss data, evidenced by the alignment consistency between scans, lack of erroneous tissue gain between scans, and uniformity of tissue loss patterns among individuals (e.g., functional cusps showing the highest degree of wear). The average loss per mm2 per year for all samples combined was 0.05 mm3 (0.04 mm3 for females and 0.08 mm3 for males). There was no significant difference in wear progression between upper and lower molars. Substantial variation in the amount of tissue loss among individuals was found, despite their uniform diet. These findings foster multiple avenues for future research, including the exploration of wear progression across dental crowns and arcades, correlation between different types of tissue loss (e.g., attrition, erosion, fractures, caries), interplay between tissue loss and microwear/topographic analysis, and the genetic underpinnings of tissue loss variation.

Abstract In cancer patients, psychological distress, which encompasses anxiety, depression, and somatization, arises from the complex interplay of emotional and behavioral reactions to the diagnosis and treatment, significantly influencing their functionality and quality of life. The aim was to investigate factors associated with psychological distress in cancer patients. This prospective and multicenter study, conducted by the Spanish Society of Medical Oncology (SEOM), included two cohorts of patients with cancer (localized resected or advanced unresectable). They completed surveys assessing psychological distress (BSI-18) before and after cancer treatment and coping (MINI-MAC) and spirituality (FACIT-sp) prior to therapy. A multivariable logistic regression analysis and a Structural Equation Modeling (SEM) were conducted. Between 2019 and 2022, 1807 patients were evaluated, mostly women (54%), average age 64 years. The most frequent cancers were colorectal (30%), breast (25%) and lung (18%). Men had lower levels of anxiety and depression (OR 0.66, 95% CI 0.52–0.84; OR 0.72, 95% CI 0.56–0.93). Colorectal cancer patients experienced less anxiety (OR 0.63, 95% CI 0.43–0.92), depression (OR 0.55, 95% CI 0.37–0.81), and somatization (OR 0.59, 95% CI 0.42–0.83). Patients with localized cancer and spiritual beliefs had reduced psychological distress, whereas those with anxious preoccupation had higher level. SEM revealed a relationship between psychological distress and coping strategies, emphasizing how baseline anxious preoccupation exacerbates post-treatment distress. This study suggests that age, sex, extension and location of cancer, coping and spirituality influence psychological distress in cancer patients.

This paper presents the development and implementation of an API (Application Programming Interface) ecosystem designed to support the creation of assistive technologies for individuals with cognitive disabilities. Leveraging the principles of microservices and an API-centered approach, this ecosystem enhances collaboration among developers, reduces the cost of creating accessible tools, and provides highly adaptable and customizable applications. The study details architectural decisions, including the use of GraphQL for flexibility, and demonstrates the benefits of a service-based architecture for digital inclusion. Case studies illustrate the practical applications, showing how this approach facilitates the development and promotes more accessible digital solutions. The findings suggest that this ecosystem can significantly reduce the time and resources needed to develop assistive technologies, potentially accelerating their adoption in domains such as education, healthcare, and daily living aids. The modular and flexible nature of the API ecosystem supports the rapid development of personalized assistive tools, fosters collaborative development, and ensures cross-platform compatibility. These features contribute to creating robust solutions that address diverse user needs across various devices. The ongoing evolution of the API ecosystem, including the integration of advanced management frameworks, promises further innovation and collaboration in assistive technologies. Future work will focus on implementing a comprehensive API management infrastructure to enhance scalability, security, and monitoring capabilities, including the integration and validation of the ecosystem with third-party applications, and so demonstrating its versatility and scalability in real-world scenarios.

Abstract Background During the COVID-19 pandemic, the Norwegian government appealed to the term “national dugnad” in the communication of containment measures as a call for collective action to fight the spread of infection. “Dugnad” is traditionally associated with solidarity, social responsibility, and a communal spirit in the form of volunteer work carried out by a local community. Although the word “dugnad” is difficult to translate to other languages, it was used as a rhetorical device by the government to communicate health-related information during the pandemic. This study aims to explore how immigrants understood and related to the term “dugnad” as used in the context of the COVID-19 pandemic in Norway. Methods We conducted 55 semi-structured interviews in 2020 with immigrants from Poland (10), Syria (15), Somalia (10), Sri Lanka (10), and Chile (10). Interviews were conducted in participants’ mother-tongues. We used systematic text condensation following Malterud’s four steps to analyze the data. Results The results are organized into three themes corresponding to: (1) meaning making of the term “dugnad”; (2) attitudes towards the term “dugnad”; and (3) reactions to the use of “dugnad” in a public health context. Overall, participants were familiar with the term “dugnad” and positively associated it with volunteering, unity, and a sense of community. However, we found a variety of reactions towards using this term in a public health context, ranging from agreement to disagreement and irritation. Conclusion Health communication during pandemics is crucial for maximizing compliance and gaining control of disease spread. In multicultural societies, governments and authorities should be aware of the linguistic and cultural barriers to public health communication if they are to effectively reach the entire population. The use of culturally specific concepts in this context, specially as rhetorical devices, may hinder effective health communication and increase health inequalities.

Alfalfa is a forage species widely used in Uruguay in intensive livestock and dairy farming. Supplementary irrigation makes it possible to mitigate the negative effects of climate change, increasing and stabilizing the productivity of pastures. It is necessary to evaluate its joint effect with grazing. Two irrigation thresholds were evaluated, with entry of animals. The treatments were: frequent irrigation (30% depleted), spaced irrigation (65% depleted) and rainfed. The experimental design was complete randomized blocks, and 30 months of evaluation. The average annual yield of irrigated alfalfa was 25,333 and 23,177 kg DM ha-1, first and second year of evaluation, respectively. The accumulated production (30 months) did not show a significant difference between the irrigated treatments, but it did between irrigated and rainfed. In the last summer-autumn, the yield of all treatments fell to 8660 kg DM ha-1 (irrigated) and 1756 kg DM ha-1 (rainfed). Seasonal productivity indicates the convenience of irrigating alfalfa in summer since the yield increased 43% in the second year and 4.3 times more in the last year. Furthermore, after the extreme summer drought, in the following autumn, the irrigated treatments yielded 7 times more than the rainfed. Management with spaced irrigation and irrigation depth that do not return the soil to its field capacity increases the effectiveness of precipitation, saving water and energy allocated to irrigation. The apparent density increased towards the end of the experiment as a result of grazing, however, there was no difference between the evaluated irrigation managements.

Desde la COVID-19, la integración de herramientas y competencias digitales en la enseñanza superior ya es una realidad en todos los países. El objetivo de este estudio es analizar la percepción del profesorado (n = 88) y del alumnado (n = 487) de los Grados en Educación Infantil y Primaria y Máster de formación del profesorado de una universidad pública de Madrid acerca de la evolución de su competencia digital, en general, y de las diferentes áreas competenciales, tanto antes como durante la enseñanza remota de emergencia. Para ello, nos apoyamos en el conocido Marco Común de Competencia Digital Docente del Instituto Nacional de Tecnologías Educativas y de Formación del Profesorado (INTEF). Desde una metodología cuantitativa y un cuestionario ad hoc validado por expertos se ha realizado un análisis descriptivo, correlacional e inferencial de las variables. Los resultados evidencian en los dos perfiles la disposición de recursos digitales suficientes para enfrentarse a esta modalidad, un aumento significativo de la autopercepción de esta competencia, destacando mayor desarrollo en las áreas: Comunicación y Colaboración, Creación de contenidos digitales y Seguridad. También muestran descontento hacia la modalidad virtual por la excesiva carga de trabajo y la formación continua requerida. El estudio ayuda a replantear los planes de estudio del futuro docente y los planes de formación del profesorado universitario sobre la necesaria competencia digital en la actualidad.

This study aims to describe the cultural adaptation of the Mental Illness: Clinicians’ Attitudes Scale (MICA-4) for Brazilian context through the description of the translation and back-translation process, face and content validity assessment and reliability assessment. The method for cultural adaptation occurred through translation of the original instrument, evaluation by the Committee of Judges, back-translation and pre-test. The results of the pre-test demonstrated that the MICA-4 is understandable and applicable, in addition to having good internal consistency, with a Cronbach's alpha of 0.75. The Brazilian version of MICA-4 has been demonstrated to be easily applicable, with language suitable for the Brazilian context, presented in an appropriate format, and displaying sufficient understanding and consistency with the original version. This culturally adapted version of MICA-4 for the Brazilian context is suitable for conducting a study to assess its psychometric properties.

The main objective of the National Project for Research and Incidence of Childhood Leukemias is to reduce early mortality rates for these neoplasms in the vulnerable regions of Mexico. This project was conducted in the states of Oaxaca, Puebla, and Tlaxcala. A key strategy of the project is the implementation of an effective roadmap to ensure that leukemia patients are the target of maximum benefit of interdisciplinary collaboration between researchers, clinicians, surveyors, and laboratories. This strategy guarantees the comprehensive management of diagnosis and follow-up samples of pediatric patients with leukemia, centralizing, managing, and analyzing the information collected. Additionally, it allows for a precise diagnosis and monitoring of the disease through immunophenotype and measurable residual disease (MRD) studies, enhancing research and supporting informed clinical decisions for the first time in these regions through a population-based study. This initiative has significantly improved the diagnostic capacity of leukemia in girls, boys, and adolescents in the regions of Oaxaca, Puebla, and Tlaxcala, providing comprehensive, high-quality care with full coverage in the region. Likewise, it has strengthened collaboration between health institutions, researchers, and professionals in the sector, which contributes to reducing the impact of the disease on the community.

Background & Aims: Effective treatments for acute-on-chronic liver failure (ACLF) are a major unmet need. This proof-of-concept pilot study was aimed at evaluating the effects of plasma exchange (PE) with albumin 5% (PE-A5%) on albumin functional capacity and organ dysfunction in patients with ACLF. Methods: Ten adult patients were enrolled in a single-center phase II, prospective, open-label, non-controlled study. Six PE-A5% sessions were performed in 10 days followed by a 1-month follow-up visit. Albumin functional capacity and circulatory function were assessed, as were renal, cerebral, and liver function, and systemic inflammation. The main safety variable was the percentage of PE sessions associated with at least one procedure-related adverse event (AE). Results: Patients with ACLF showed lower albumin binding capacity, lower antioxidant capacity, and lower levels of albumin with preserved structure compared to healthy donors (n = 19). From baseline to day 11, PE-A5% treatment increased albumin levels and improved albumin binding capacity to Sudlow site II (15.3±1.6 mg/ml to 18.9±1.7 mg/ml; p = 0.003), fatty acid-binding capacity (8.2±1.4 μM to 3.1±1.5 μM; p = 0.013) and antioxidant capacity (human mercaptalbumin 9.5±1.5 mg/ml to 14.6±1.6 mg/ml; p = 0.001). Native albumin levels were increased throughout day 1-11 PE-A5% sessions (6.5±1.0 mg/ml to 10.2±1.4 mg/ml; p = 0.035). PE-A5% improved systemic hemodynamics (mean arterial pressure, heart rate, cardiac index), renal function (creatinine level, blood urea nitrogen), cerebral function (hepatic encephalopathy grade), liver parameters (transaminases, bilirubin) and inflammatory parameters (C-reactive protein, leukocyte count). All patients had at least one of the 78 AEs reported, mostly mild (product/procedure-related: 36%). Sixteen serious AEs were reported in eight patients (procedure/product-related: none). Conclusions: PE-A5% was a safe procedure associated with positive effects on albumin functionality, and circulatory, renal, cerebral, and liver function in patients with ACLF. Impact and implications: Acute-on-chronic liver failure (ACLF) is a clinical condition characterized by severe systemic inflammation, organ failure, and high mortality. Plasma exchange removes patient’s plasma containing pathogenic substances, replacing it with 5% albumin and fresh frozen plasma (PE-A5%). In this study, cirrhotic patients with ACLF were treated with PE-A5%, which was a safe procedure that increased binding and antioxidant capacity of patients’ albumin, while improving circulatory, kidney, brain, and liver functions. These beneficial effects could impact survival in ACLF. ClinicalTrials.gov Identifier: NCT01201720 EudraCT number: 2010-021360-15

The Andean Altiplano, characterized by its extreme climatic conditions and high levels of biodiversity, provides a unique environment for studying ecological and evolutionary adaptations in insect morphology. Butterflies, due their large wing surface compared to body surface, and wide distribution among a geographical area given the flight capabilities provided by their wings, constitute a good biological model to study morphological adaptations following extreme weathers. This study focuses on Phulia nymphula, a butterfly species widely distributed in the Andes, to evaluate wing shape variation across six localities in the Northern Chilean Altiplano. The geometric morphometrics analysis of 77 specimens from six locations from the Chilean Altiplano (Caquena, Sorapata Lake, Chungará, Casiri Macho Lake, Surire Salt Flat, and Visviri) revealed significant differences in wing shape among populations. According to the presented results, variations are likely influenced by local environmental conditions and selective pressures, suggesting specific adaptations to the microhabitats of the Altiplano. The first three principal components represented 60.92% of the total wing shape variation. The detected morphological differences indicate adaptive divergence among populations, reflecting evolutionary responses to the extreme and fragmented conditions of the Altiplano. This study gives insights into the understanding of how high-altitude species can diversify and adapt through morphological variation, providing evidence of ecological and evolutionary processes shaping biodiversity in extreme environments.

This study introduces a novel recommender system that integrates academic performance and socio-demographic variables to provide personalised and contextually relevant recommendations for university degree selection. The system aims to optimise the alignment between students’ profiles and potential academic programmes by utilising advanced machine learning models, including XGBoost, Random Forest, GLMNET, and KNN. The research addresses a critical gap identified in the literature, where most existing systems rely solely on academic data, neglecting the significant impact of socioeconomic factors on educational decision-making. The proposed system demonstrates superior predictive accuracy through rigorous cross-validation and hyperparameter tuning compared to simpler models, such as linear regression. The results show that integrating socio-demographic data enhances the relevance of the recommendations, supporting students in making more informed choices. This approach contributes to educational equity by ensuring that guidance is tailored to each student’s unique circumstances, aligning with the sustainable development goal of quality education. The findings highlight the value of incorporating a comprehensive data-driven approach to improve educational outcomes and support more equitable decision-making processes.

Statistics modules are included in most university degrees, independent of the degree area, and this means that many students face these modules underprepared and struggle because of a lack of statistics knowledge. The Maths Support Centre (MSC) in the University College Dublin (UCD) provides support for various mathematics-related subjects, with statistics students being the second-largest cohort of visitors. The overall goal of this paper is to identify the common statistical issues students face during the transition from secondary education to tertiary education. The main data set for this study is the data from UCD students who have accessed the UCD MSC since 2015/16 for statistics support; the categorization of statistical concepts has been made with the statistics module description for each statistics subject at the Universidad Rey Juan Carlos (URJC). First, we conducted a categorization of statistical concepts taught in university (based on URJC’s catergorization); after that, UCD MSC tutor comments were categorized and validated, and subsequently descriptive analyses and text mining were used on the UCD MSC comments to achieve a deeper understanding of the statistical issues. The statistical issues presented were categorized as descriptive statistics (22.8%), probability (44%), statistical inference (29.2%), and statistical software (4%). Students struggled with material that was introduced at university level rather than material seen at secondary level. Our findings on students’ main statistical issues contribute to the development of a suite of evidence-based educational applications and games to support undergraduate students internationally in first- and second-year statistical modules.

IntroductionDrawing from the principles of EMDR (Eye Movement Desensitization and Reprocessing) therapy and the AIP model, the Professional Intervention Program for Adversity (PIPA) was developed with the objective of amalgamating low-intensity group exercises into a unified framework, as a comprehensive intervention for group therapy. The PIPA Program integrates various aspects of EMDR therapy—such as stabilization, resourcing, desensitization, reprocessing, and forming beliefs about the self and future—into a cohesive program. The program’s structure includes self-regulation exercises, the Pillars of Life, the Flash Technique, and the Quadrants exercise.MethodsThe PIPA Program was administered to more than 220 individuals with a high probability of traumatization by the two-year civil war in Ethiopia (2020-2022).ResultsThe results of this study show a statistically significant improvement in PTSD symptoms on PCL-5 scores (from M = 38.58 to M = 20.59) after completing the entire PIPA Program and statistically significant lower SUDS scores within the program segments of the Flash Technique and the Quadrants exercises.DiscussionFuture studies should explore the long-term effects of the PIPA Program and its broader application across different therapeutic contexts. The findings suggest that the PIPA Program is a promising group-based intervention for trauma treatment that is safe and effective, especially in non-clinical settings and for culturally diverse populations.

The AquaCrop model allows evaluating and designing irrigation strategies that improve the use of irrigation water. The objective of this research was to calibrate and validate the AquaCrop model for maize to the climatic conditions of southern Uruguay, with different irrigation water management. This model was calibrated and validated for corn using experimental data from irrigation trials with different deficit levels in three seasons, 2015-16 and 2016-17 (calibration) and 2014-15 (validation). Three maximum irrigation depths were evaluated: 3, 6 and 9 mm day-1, and rainfed (rainfall only). The crop was parameterized for local conditions and water stress coefficients were adjusted. The calibration simulated the yield, biomass and soil moisture in the irrigated treatments with good performance. All the statistic indexes used to evaluate the adjustment between the observed and simulated data model indicated a good model performance, with the exception of the efficiency coefficient of the Nash-Sutcliffe (EF) model. The model underestimated the yield in the rainfed treatment (EF of -0.52) when root depth was limited to 0.7 m. However, the test soil allowed for greater radical exploration than the initially used. At 0.90 m root depth, the model was good at simulating the yields in the rainfed treatment, mainly in dry years (EF of 0.79). The model predicts the yield with good adjustment in different irrigation and rainfall situations if the stress coefficients are adjusted and the crop is properly parameterized, mainly the root depth.

Hipoadrenocorticismo (HA) ou doença de Addison é uma endocrinopatia incomum em cães, com ocorrência principalmente entre um e seis anos de idade. Pode ser classificado de acordo com sua origem, como primário, secundário ou terciário, sendo a forma primária a mais comum, causada pela destruição idiopática imunomediada do córtex da adrenal, que pode resultar na deficiência de mineralocorticoides e/ou glicocorticoides. As manifestações clínicas são inespecíficas. Desta forma, o paciente pode apresentar desde apenas quadros de gastroenterites intermitentes, até hipotensão, tremores, letargia, anorexia e perda de peso. O diagnóstico é realizado na anamnese, sinais clínicos, exames hematológicos, urinálise e ultrassonografia abdominal. No entanto, para o diagnóstico definitivo deve ser feito o teste de estimulação com ACTH (hormônio adrenocorticotrófico), no qual os cães com HA apresentarão resultados abaixo da referência. O tratamento deve ser realizado com base no estado geral do paciente e com a suplementação hormonal, que deve ser avaliada de acordo com a necessidade de cada cão. O presente estudo tem como objetivo relatar o caso de uma cadela da raça Whippet de um ano de idade que foi admitida no serviço de pronto atendimento de um hospital veterinário 24 horas devido a quadro de êmese e anorexia, que evoluíram para uma crise addisoniana. Após o diagnóstico de HA e iniciado o tratamento com prednisolona e acetato de fludrocortisona, a paciente foi acompanhada por 965 dias. Nesse período, apresentou quadros de êmese em situações de estresse, além de apresentar sódio no limite inferior nos exames hematológicos realizados.

Traditional patient- and provider-level hypertension interventions have proven insufficient to halt hypertension as the leading cause of morbidity and mortality globally. Systems-level interventions are required to address factors challenging hypertension control across a social ecological framework, an under-studied topic particularly salient in low- and middle-income countries (LMICs) such as Peru. To inform such interventions, we sought to identify key health systems barriers to hypertension care in Puno, Peru. A participatory stakeholder workshop (October 2021) and 21 in-depth interviews (October 2021-March 2022) were conducted with 55 healthcare professionals (i.e., doctors, nurses, midwives, dentists, nutritionists), followed by a deductive qualitative analysis of transcripts and notes. Participating healthcare providers indicated that low prioritization and lack of national policies for hypertension care have resulted in limited funding and lack of societal-level prevention efforts. Additionally, limited cultural consideration, both in national guidelines as well as by some providers in Puno, results in inadequate care that may not align with local traditions. Providers highlighted that patient care is also hampered by inadequate distribution and occasional shortages of medications and equipment, as well as a lack of personnel and limited opportunities for training in hypertension. Multiple incompatible health information systems, complicated referral systems, and geographic barriers additionally hinder continuity of care and care seeking. Insights gained from health providers on the healthcare system in Puno provide essential contextual information to inform development of organizational-level strategies necessary to improve provider and patient behaviors to achieve better hypertension care outcomes.

The measurement of computational thinking ability among computer science (CS) university students is of paramount importance. This study introduces UniCTCheck, a novel method designed to assess the main components of computational thinking in CS students. Utilising two key instruments, namely, the web application CTScore and the psychometric scale CTProg, this research aims to precisely evaluate seven core components of computational thinking and six programming concepts skills essential for CS students. The study, conducted at Rey Juan Carlos University and Atlantic Technological University Galway, involved a diverse sample of students from different year levels and programme specialisations. Through a rigorous research design, including sampling strategies and data collection tools, this study seeks to address critical research questions related to the measurement of variations in students’ computational thinking and programming skills by gender, university level, and location. By shedding light on the significance of computational thinking and programming in the educational realm, this research contributes to the existing literature and underscores the essential role of computational skills in the modern era.

In recent years, sensory polymers have evolved significantly, emerging as versatile and cost-effective materials valued for their flexibility and lightweight nature. These polymers have transformed into sophisticated, active systems capable of precise detection and interaction, driving innovation across various domains, including smart materials, biomedical diagnostics, environmental monitoring, and industrial safety. Their unique responsiveness to specific stimuli has sparked considerable interest and exploration in numerous applications. However, along with these advancements, notable challenges need to be addressed. Issues such as wearable technology integration, biocompatibility, selectivity and sensitivity enhancement, stability and reliability improvement, signal processing optimization, IoT integration, and data analysis pose significant hurdles. When considered collectively, these challenges present formidable barriers to the commercial viability of sensory polymer-based technologies. Addressing these challenges requires a multifaceted approach encompassing technological innovation, regulatory compliance, market analysis, and commercialization strategies. Successfully navigating these complexities is essential for unlocking the full potential of sensory polymers and ensuring their widespread adoption and impact across industries, while also providing guidance to the scientific community to focus their research on the challenges of polymeric sensors and to understand the future prospects where research efforts need to be directed.

Urban Air Mobility (UAM) is an emerging industry marked by technological advancements, new operational contexts, and regulatory frameworks. This article examines how to improve safety management in UAM operations by adopting a just culture approach from a system of systems perspective. Acknowledging the critical role of front-line workers, especially in the early stage with piloted vehicles, the ecosystem-level approach comprehends multiple providers, operators, and services. Employing an enterprise architecture methodology, we address the challenge of fostering a learning-oriented environment amidst diverse organizational perspectives and stakeholders’ interests. This study identifies key capabilities, functions, and resource exchanges within and across organizations by strategically leveraging architectural views and systemic visualizations. A unified safety committee is discussed and recommended to facilitate consensus among stakeholders, including regulatory bodies, thus paving the way for industry-wide improvements. Findings contribute to evolving safety protocols in UAM operations and serve as a blueprint for integrating cutting-edge methodologies to drive systemic enhancements.

Mycopathogenic moulds are responsible for the greatest crop losses of cultivated mushrooms, thus having a significant negative economic impact on industry. Pesticides are the most common treatment against mycopathogenic moulds, but ultraviolet-B (UV-B, 280–315 nm) radiation could be a more ecological alternative. Thus, we studied the effect of UV-B (at doses from 8 to 192 kJ m−2) on four common mycopathogenic moulds (Cladobotryum mycophilum, Lecanicillium fungicola, Trichoderma aggressivum, and Mycogone perniciosa) under in vitro conditions, using four different culture media. UV-B was tremendously effective in inactivating mould spores even at the lowest dose, with the exception of those of T. aggresivum. Contrarily, UV-B did not present any effect on the development of the host mycelium (Agaricus bisporus), even at the highest dose, when cultivated on Compost Tea medium (CT). This is the most similar medium to the substrate used for commercial mushroom cultivation. UV-B reduced the mould mycelia development in a dose-response manner, but this reduction depended on the species, with the strongly pigmented T. aggressivum as the most tolerant species. Regarding the culture media, all of them (especially CT) absorbed UV-B intensely, contributing to the protection of the mycelia. Overall, UV-B radiation could constitute an ecologically friendly alternative to chemical treatments against mycopathogenic moulds, due to its capacity to inactivate their spores and (in some cases) their mycelia without affecting their hosts.

Certain naturally occurring volatile organic compounds are able to mitigate food spoilage caused by microbial growth. Their considerable vapor pressure enables them to create an antimicrobial atmosphere within a package, and this property can be used for the development of active food-packaging technologies. The volatility of these molecules, however, makes their stabilization difficult and limits their effectiveness. Whilst much research is being undertaken on the use of natural antimicrobial volatiles for inhibiting microbial growth in food, less attention has been paid to the design of controlled-release mechanisms that permit the efficient application of these compounds. Most studies to date either spray the volatile directly onto the fresh product, immerse it in a solution containing the volatile, or embed the volatile in a paper disc to create a vapor in the headspace of a package. More sophisticated alternatives would be delivery systems for the sustained release of volatiles into the package headspace. Such systems are based on the encapsulation of a volatile in organic or inorganic matrices (cyclodextrins, electrospun non-wovens, polymer films, micelles, molecular frameworks, etc.). However, most of these devices lack an efficient triggering mechanism for the release of the volatile; most are activated by humidity. All of these techniques are revised in the present work, and the most recent and innovative methods for entrapping and releasing volatiles based on reversible covalent bonds are also discussed.

Stable palladium (II) complexes, incorporating a double (N-benzoylthiourea) arrangement bonded to a complex heterocyclic scaffold, are used as precursors of catalytic species able to promote Suzuki–Miyaura, Mizoroki–Heck, Hiyama, Buchwald–Hartwig, Hirao and Sonogashira–Hagihara cross-coupling transformations in water. These sustainable processes are chemoselective and very versatile. The nanoparticles responsible for these catalytic reactions were analyzed and studied. Their usefulness is demonstrated after several tests and analyses. The heterogeneous character of this species in water was also confirmed.

Pedagogic Conversational Agents (PCAs) are interactive systems that engage the student in a dialogue to teach some domain. They can have the roles of a teacher, student, or companion, and adopt several shapes. In our previous work, a significant increase of students’ performance when learning programming was found when using PCAs in the teacher role. However, it is not common to find PCAs used in classrooms. In this paper, it is explored whether pre-service teachers would accept PCAs to teach programming better if they were co-designed with them. Pre-service teachers are chosen because they are still in training, so they can be taught what PCAs are and how this technology could be helpful. Moreover, pre-service teachers can choose whether they integrate PCAs in the teaching activities that they carry out as part of their degree’s course. An experiment with 35 pre-service primary education teachers was carried out during the 2021/2022 academic year to co-design a robotic PCA to teach programming. The experience validates the idea that involving pre-service teachers in the design of a PCA facilitates their involvement to integrate this technology in their classrooms. In total, 97% of the pre-service teachers that stated in a survey that they believed robot PCA could help children to learn programming, and 80% answered that they would like to use them in their classrooms.

Sepsis is a leading cause of death in Intensive Care Units. Despite its prevalence, sepsis remains insufficiently understood, with no substantial qualitative improvements in its treatment in the past decades. Immunomodulatory agents may hold promise, given the significance of TNF-α and IL-1β as sepsis mediators. This study examines the immunomodulatory effects of moxifloxacin, a fluoroquinolone utilized in clinical practice. THP1 cells were treated in vitro with either PBS or moxifloxacin and subsequently challenged with lipopolysaccharide (LPS) or E. coli . C57BL/6 mice received intraperitoneal injections of LPS or underwent cecal ligation and puncture (CLP), followed by treatment with PBS, moxifloxacin, meropenem or epirubicin. Atm -/- mice underwent CLP and were treated with either PBS or moxifloxacin. Cytokine and organ lesion markers were quantified via ELISA, colony-forming units were assessed from mouse blood samples, and DNA damage was evaluated using a comet assay. Moxifloxacin inhibits the secretion of TNF-α and IL-1β in THP1 cells stimulated with LPS or E. coli . Intraperitoneal administration of moxifloxacin significantly increased the survival rate of mice with severe sepsis by 80% ( p < 0.001), significantly reducing the plasma levels of cytokines and organ lesion markers. Notably, moxifloxacin exhibited no DNA damage in the comet assay, and Atm -/- mice were similarly protected following CLP, boasting an overall survival rate of 60% compared to their PBS-treated counterparts ( p = 0.003). Moxifloxacin is an immunomodulatory agent, reducing TNF-α and IL-1β levels in immune cells stimulated with LPS and E. coli . Furthermore, moxifloxacin is also protective in an animal model of sepsis, leading to a significant reduction in cytokines and organ lesion markers. These effects appear unrelated to its antimicrobial activity or induction of DNA damage.