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The research aimed to generate bioelectricity using pepper waste and the microalgae Spirulina sp by a double-chamber microbial fuel cell (dcMFC). A dcMFC was constructed with Cu and Zn electrodes, where organic waste and microalgae were placed in the anodic and cathodic chambers, respectively. Also, electrochemical parameters were measured for 35 days. Finally, possible electrogenic microorganisms were isolated and identified. It was possible to generate maximum values of current (6.04414 ± 0.2145 mA) and voltage (0.77328 ± 0.213 V). The maximum conductivity value was 134.1636 ± 7.121 mS/cm, while the internal resistance value was 83.784 ±7.147Ω. The values of power and current density reached were 584.45 ± 19.14 mW/cm 2 and 5.983 A/cm 2, respectively. The optimal operating pH was 4.59 ± 0.14. From the microbial growth on the anode, the yeast Yarrowia phangngaensis (1) and Pseudomonas stutzeri (2) were identified, which may be involved in the transfer of electrons to the electrode. In conclusion, it was possible to generate clean energy in a laboratory-scale dcMFC when pepper waste and Spirulina sp. were used. These results are promising because organic waste can generate sustainable and environmentally friendly energy.

The dumping of organic waste in the areas surrounding food supply centers and the excessive use of fossil fuels for energy generation have generated major pollution problems worldwide. One of the novel solutions is the use of organic waste for electricity generation through the use of microbial fuel cell technology. In this research, low-cost, laboratory-scale, double-chamber microbial fuel cells were fabricated using zinc and copper as electrodes and avocado waste as fuel. Current and voltage values of 3.7326 ± 0.05568 mA and 0.74 ± 0.02121 V were achieved on the seventh day, with an optimum operating pH of 5.98 ± 0.16 and a maximum electrical conductivity of 94.46 ± 5.12 mS/cm. The cells showed a very low operating resistance of 71.480 Ω, indicating the good electrical conductivity of the electrodes. Likewise, a power density of 566.80 ± 13.48 mW/cm2 at a current density of 5.165 A/cm2 was generated. This research provides an eco-friendly solution to farmers and companies dedicated to the export and import of this fruit because it shows the benefits of using their own waste for the generation of electricity, reducing costs.

Summary: Chemically induced dimerization (CID) is a useful tool for artificially inducing protein-protein interactions. Although CID has been used extensively for live-cell microscopy applications in mammalian systems, it is rarely utilized in yeast cell biology studies. Here, we present a step-by-step protocol for the utilization of a CID system in live-cell microscopy experiments of budding yeast endocytosis. While focusing on the study of endocytosis, this protocol framework is adaptable to the study of other cellular processes in Saccharomyces cerevisiae.For complete details on the use and execution of this protocol, please refer to Lamb et al. (2021).

In this study, an alternative method is proposed for producing electricity using microbial fuel cells (MFCs) and fruit waste in case of industries and farmers. Herein, MFCs were manufactured using zinc and copper electrodes and three types of organic waste (R. ulmifolius, H. undatus, and M. citrifolia) as the substrate. The results revealed that the H. undatus waste generated the highest voltage and current values, i.e., 1.17 ± 0.12 V and 25.78 ± 0.89 mA, respectively, in an open circuit. However, all the substrates exhibited acidic pH values. The H. undatus substrate reported the highest voltage, power density (PD), and current density (CD) values at a Vmaxvalue of 1.11 ± 0.25 V, a PDmaxvalue of 0.0719 ± 0.0012 W/cm2, and a CDmaxvalue of 0.051 A/cm2. Conversely, the R. ulmifolius substrate exhibited the lowest values at a Vmaxvalue of 0.96 ± 0.13 V, a PDmaxvalue of 0.0668 ± 0.0013 W/cm2, and a CDmaxvalue of 0.025 A/cm2. The micrographs denote that the Cu anode porosity of H. undatus is higher when compared with those of the remaining two substrates, and the Pichia guilliermondii, Candida boidinii, and Brevibacillus laterosporus microorganisms were observed in its anodic biofilm.

Resumen: Introducción: Cada año se tratan 38 millones de pacientes con lesiones en los servicios de Urgencias, siendo el 90% en forma de lesiones no intencionadas (LNI). Actualmente no existen registros globales de su manejo en España ni de los factores de riesgo que puedan llevar asociados. Nuestro objetivo es describir el manejo de las LNI en los Servicios de Urgencias Pediátricos (SUP) y analizar los factores relacionados con la presencia de lesiones graves. Material y métodos: Subestudio de estudio observacional prospectivo multicéntrico desarrollado durante 12 meses en 11 SUP de hospitales de la Red de Investigación de la Sociedad Española de Urgencias Pediátricas (RiSEUP-SPERG), incluyéndose niños de 0 a 16 años de edad que consultan por una LNI, los días 13 de cada mes. Se registraron datos epidemiológicos, circunstancias de la lesión y datos sobre la atención en el SUP y destino al alta. Resultados: Se registraron 10.175 episodios, de los que 1.941 fueron LNI (19,1%). Se incluyeron 1.673, de los cuales 257 (15,4%) fueron graves. La prueba complementaria realizada más frecuentemente fue la radiografía simple (60,0%) y el procedimiento más frecuente fue la inmovilización de extremidad (38,6%). Se encontró asociación significativa entre presentar una LNI grave y la edad > 5 años (OR 2,24; IC 95%: 1,61-3,16), el antecedente de fractura (OR 2,05; IC 95%: 1,22-3,43) o la actividad deportiva como mecanismo lesional (OR 1,76; IC 95%: 1,29-2,38), entre otros. Conclusión: En España, la mayoría de los casos de LNI no son graves. Las radiografías y la inmovilización de extremidades son las pruebas y procedimientos más frecuentemente realizados. La LNI grave se asoció con factores individuales, como la edad > 5 años o el antecedente de fractura, y con la actividad deportiva como mecanismo asociado a gravedad. Resulta vital implementar medidas para mejorar la prevención de estas lesiones y apoyar la capacitación de los cuidadores mediante programas educacionales. Abstract: Introduction: Thirty-eight million patients with injuries are treated in Emergency Departments every year, 90% of them being in the form of unintentional injuries (UIs). There are currently no global records of its management in Spain, or the risk factors that may be associated with them. The objective of this study is to describe the management of UIs in Spanish paediatric emergency departments, and to analyse factors related to the presence of serious injuries. Material and methods: A sub-study of a prospective multicentre observational study conducted over 12 months in 11 hospitals of the Spanish Paediatric Emergency Research Group (RiSEUP-SPERG), including children from 0 to 16 years of age consulting for UIs. Epidemiological data, circumstances of the injury, and data on emergency care and discharge destination were recorded on the 13th day of each month. Results: A total of 10,175 episodes were recorded, of which 1,941 were UIs (19.1%), including 1,673, of which 257 (15.4%) were severe. The most frequent complementary test was simple radiography (60.0%), and the most frequent procedure was limb immobilisation (38.6%). A significant relationship was found between presenting with a severe UI and age > 5 years (OR 2.24; 95% CI: 1.61-3.16), history of fracture (OR 2.05; 95% CI: 1.22-3.43), or sports activity as a mechanism of injury (OR 1.76; 95% CI: 1.29-2.38), among others. Conclusion: In Spain, most UIs are not serious. X-rays and immobilisation of extremities are the most frequently performed tests and procedures. Severe UIs were associated with individual factors, such as age > 5 years or history of fracture, and with sports activity as a mechanism associated with severity. It is vital to implement measures to improve the prevention of these injuries and to support the training of caregivers through educational programmes.

Abstract: Platelet α-granules play important roles in platelet function. They contain hundreds of proteins that are synthesized by the megakaryocyte or taken up by endocytosis. The trafficking pathways that mediate platelet α-granule biogenesis are incompletely understood, especially with regard to cargo synthesized by the megakaryocyte. Vacuolar-protein sorting 33B (VPS33B) and VPS16B are essential proteins for α-granule biogenesis, but they are largely uncharacterized. Here, we adapted a powerful method to directly map the pathway followed by newly synthesized cargo proteins to reach α-granules. Using this method, we revealed the recycling endosome as a key intermediate compartment in α-granule biogenesis. We then used CRISPR/Cas9 gene editing to knock out VPS33B in pluripotent stem cell–derived immortalized megakaryocyte cells (imMKCLs). Consistent with the observations in platelets from patients with VPS33B mutation, VPS33B-knockout (KO) imMKCLs have drastically reduced levels of α-granule proteins platelet factor 4, von Willebrand factor, and P-selectin. VPS33B and VPS16B form a distinct and small complex in imMKCLs with the same hydrodynamic radius as the recombinant VPS33B-VPS16B heterodimer purified from bacteria. Mechanistically, the VPS33B-VPS16B complex ensures the correct trafficking of α-granule proteins. VPS33B deficiency results in α-granule cargo degradation in lysosomes. VPS16B steady-state levels are significantly lower in VPS33B-KO imMKCLs, suggesting that VPS16B is destabilized in the absence of its partner. Exogenous expression of green fluorescent protein–VPS33B in VPS33B-KO imMKCLs reconstitutes the complex, which localizes to the recycling endosome, further defining this compartment as a key intermediate in α-granule biogenesis. These results advance our understanding of platelet α-granule biogenesis and open new avenues for the study of these organelles.

Ginger is a culinary spice with a millennia-old tradition due to its extensive therapeutic applications, recently validated by scientific studies. In particular [6]-Gingerol, a key active molecule in ginger, exhibits extraordinary capabilities in addressing a wide spectrum of health issues. However, its therapeutic potential is limited by its rather low bioavailability. The incorporation of [6]-Gingerol into membrane systems of liposomes, micelles, or exosomes is a promising strategy to overcome this limitation. In this contribution, we report the hitherto unexplored surface properties of [6]-Gingerol at the air-water interface. Our comprehensive study, which includes a detailed analysis of surface pressure and surface potential vs. area per molecule isotherms, surface compression modulus, and Brewster Angle Microscopy, demonstrates the capability of [6]-Gingerol to form Langmuir films. These films can be transferred onto solid substrates, forming remarkably homogeneous Langmuir-Blodgett films which have been characterized by Quartz Crystal Microbalance and Atomic Force Microscopy. This study may be of interest as it paves the way for future research on introducing [6]-Gingerol into membrane systems and transporting it into living cells.

Introduction SUV measurements from static brain [18F]FDG PET acquisitions are a commonly used tool in preclinical research, providing a simple alternative for kinetic modelling, which requires complex and time-consuming dynamic acquisitions. However, SUV can be severely affected by the animal handling and preconditioning protocols, primarily by those that may induce changes in blood glucose levels (BGL). Here, we aimed at developing and investigating the feasibility of SUV-based approaches for a wide range of BGL far beyond normal values, and consequently, to develop and validate a new model to generate standardized and reproducible SUV measurements for any BGL.Material and methods We performed dynamic and static brain [18F]FDG PET acquisitions in 52 male Sprague-Dawley rats sorted into control (n = 10), non-fasting (n = 14), insulin-induced hypoglycemia (n = 12) and glucagon-induced hyperglycemia (n = 16) groups. Brain [18F]FDG PET images were cropped, aligned and co-registered to a standard template to calculate whole-brain and regional SUV. Cerebral Metabolic Rate of Glucose (CMRglc) was also estimated from 2-Tissue Compartment Model (2TCM) and Patlak plot for validation purposes.Results Our results showed that BGL=100±6 mg/dL can be considered a reproducible reference value for normoglycemia. Furthermore, we successfully established a 2nd-degree polynomial model (C1=0.66E-4, C2=-0.0408 and C3=7.298) relying exclusively on BGL measures at pre-[18F]FDG injection time, that characterizes more precisely the relationship between SUV and BGL for a wide range of BGL values (from 10 to 338 mg/dL). We confirmed the ability of this model to generate corrected SUV estimations that are highly correlated to CMRglc estimations (R2= 0.54 2TCM CMRgluc and R2= 0.49 Patlak CMRgluc). Besides, slight regional differences in SUV were found in animals from extreme BGL groups, showing that [18F]FDG uptake is mostly directed toward central regions of the brain when BGLs are significantly decreased.Conclusion Our study successfully established a non-linear model that relies exclusively on pre-scan BGL measurements to characterize the relationship between [18F]FDG SUV and BGL. The extensive validation confirmed its ability to generate SUV-based surrogates of CMRglu along a wide range of BGL and it holds the potential to be adopted as a standard protocol by the preclinical neuroimaging community using brain [18F]FDG PET imaging.

The HEALthy Brain and Child Development (HBCD) Study, a multi-site prospective longitudinal cohort study, will examine human brain, cognitive, behavioral, social, and emotional development beginning prenatally and planned through early childhood. Electroencephalography (EEG) is one of two brain imaging modalities central to the HBCD Study. EEG records electrical signals from the scalp that reflect electrical brain activity. In addition, the EEG signal can be synchronized to the presentation of discrete stimuli (auditory or visual) to measure specific cognitive processes with excellent temporal precision (e.g., event-related potentials; ERPs). EEG is particularly helpful for the HBCD Study as it can be used with awake, alert infants, and can be acquired continuously across development. The current paper reviews the HBCD Study’s EEG/ERP protocol: (a) the selection and development of the tasks (Video Resting State, Visual Evoked Potential, Auditory Oddball, Face Processing); (b) the implementation of common cross-site acquisition parameters and hardware, site setup, training, and initial piloting; (c) the development of the preprocessing pipelines and creation of derivatives; and (d) the incorporation of equity and inclusion considerations. The paper also provides an overview of the functioning of the EEG Workgroup and the input from members across all steps of protocol development and piloting.

Summary: Background: Surgical care holds significant importance in healthcare, especially in low and middle-income countries, as at least 50% of the 4.2 million deaths within the initial 30 days following surgery take place in these countries. The Lancet Commission on Global Surgery proposed six indicators to enhance surgical care. In Colombia, studies have been made using secondary data. However, strategies to reduce perioperative mortality have not been implemented. This study aims to describe the fourth indicator, perioperative mortality rate (POMR), with primary data in Colombia. Methods: A multicentre prospective cohort study was conducted across 54 centres (hospitals) in Colombia. Each centre selected a 7-day recruitment period between 05/2022 and 01/2023. Inclusion criteria involved patients over 18 years of age undergoing surgical procedures in operating rooms. Data quality was ensured through a verification guideline and statistical analysis using mixed-effects multilevel modelling with a case mix analysis of mortality by procedure-related, patient-related, and hospital-related conditions. Findings: 3807 patients were included with a median age of 48 (IQR 32–64), 80.3% were classified as ASA I or II, and 27% of the procedures had a low-surgical complexity. Leading procedures were Orthopedics (19.2%) and Gynaecology/Obstetrics (17.7%). According to the Clavien–Dindo scale, postoperative complications were distributed in major complications (11.7%, 10.68–12.76) and any complication (31.6%, 30.09–33.07). POMR stood at 1.9% (1.48–2.37), with elective and emergency surgery mortalities at 0.7% (0.40–1.23) and 3% (2.3–3.89) respectively. Interpretation: The POMR was higher than the ratio reported in previous national studies, even when patients had a low–risk profile and low-complexity procedures. The present research represents significant public health progress with valuable insights for national decision-makers to improve the quality of surgical care. Funding: This work was supported by Universidad del Rosario and Fundación Cardioinfantil-Instituto de Cardiología grant number CTO-057-2021, project-ID IV-FGV017.

The genus Distichlis comprises halophytic perennial C4 grasses which grow in very extreme conditions. It is distributed throughout almost the entire American continent. Despite these interesting characteristics, studies on these plants are relatively scarce, and their ecological and productive value deserves to be further explored. In this work, nutritional aspects, and composition of the cell walls of the aerial part (leaves and shoots) of D. laxiflora Hack were studied. Their changes over four samplings in different seasons, in two nearby sites: a halophytic meadow (H), and a mesophytic meadow (M), were analyzed. Photosynthetic efficiency and K/Na ratio were determined as stress indicators. Plants of sites H and M have similar cell wall content except for spring when plants from site H show lower values. Also, the spring samples present a markedly higher in vitro digestibility for site H. In agreement, samples from site H contain lower amounts of glucuronoarabinoxylans and β-glucans. The protein content is lower in site H, except for spring, and with a maximum in summer for site M. This work shows some changes in the cell walls of D. laxiflora in response to salinity, and these changes influence the digestibility of this material. Spring, coinciding with the regrowth cycle of this plant and with the worst stress indicators, is the season when plants of the halophytic site show the highest nutritional quality for grazing cattle.

Summary: Background: All-cause and AIDS-mortality in Europe has been decreasing between 1996 and 2020. However, regional differences as well as their drivers remain unclear. This study investigates mortality differences and their drivers, including usage of and response to antiretroviral therapy (ART) and active tuberculosis (TB), among people with HIV across Europe. Methods: People with HIV enrolled in EuroSIDA were followed from 2001 through 2020. Immunologic-virologic status (IVS) was categorized as poor (CD4-cell count ≤350 cells/mm3 and viral load (VL) > 200 copies/ml), good (CD4 ≥ 500 and VL

Introduction: Recent studies show an increase in the prevalence of Haemophilus influenzae and a decrease in Streptococcus pneumoniae among the bacteria that cause acute otitis media (AOM). The objective of our study was to analyse the distribution of pathogens identified in children aged less than 14 years presenting to the emergency department with AOM and their patterns of antimicrobial resistance. Patients and methods: Single centre retrospective, analytical study in patients aged less than 14 years with a diagnosis of AOM in whom an ear drainage sample was collected for culture in the paediatric emergency department of a tertiary care hospital between 2013 and 2021. Results: During the study period, there were 14 684 documented care episodes corresponding to children with a diagnosis of AOM. An ear drainage culture was performed in 768 of those episodes. The median age of the patients was 2 years, 57% were male and 70% had a previous history of AOM. The most frequently isolated pathogens were: Haemophilus influenzae (n = 188 [24.5%]; 15.5% of them resistant to ampicillin), Streptococcus pyogenes (n = 86 [11.2%]), Staphylococcus aureus (n = 82 [10.7%]), Streptococcus pneumoniae (n = 54 [6.9%]; 9.4% with intermediate resistance to penicillin), Pseudomonas aeruginosa (n = 42 [5.5%]) and Moraxella catarrhalis (n = 11 [1.4%]). No pathogen was isolated in 34.9% of cases. Conclusions: Haemophilus influenzae is the leading cause of AOM in children aged less than 14 years. This, combined with the low frequency of isolation and penicillin resistance of Streptococcus pneumoniae, calls into question the appropriateness of high-dose amoxicillin for empiric treatment of AOM. Resumen: Introducción: Estudios recientes señalan un aumento de la prevalencia de Haemophilus influenzae y una disminución de Streptococcus pneumoniae entre las bacterias causantes de otitis media aguda (OMA). El objetivo del estudio es conocer la distribución de microorganismos patógenos identificados en Urgencias en los menores de 14 años con OMA y su patrón de resistencias. Pacientes y métodos: Estudio retrospectivo, analítico y unicéntrico incluyendo pacientes menores de 14 años diagnosticados de OMA en los que se recogió un cultivo de secreción ótica en el servicio de urgencias pediátricas de un hospital terciario entre 2013 y 2021. Resultados: Durante el periodo de estudio, se registraron 14684 episodios con diagnóstico de OMA, recogiéndose en 768 cultivo de secreción ótica. La mediana de edad fue de 2 años, el 57% varones y el 70% habían presentado al menos una OMA previa. Los patógenos más frecuentemente aislados fueron: Haemophilus influenzae 188 (24,5%; de ellos 15,5% resistentes a ampicilina), Streptococcus pyogenes 86 (11,2%), Staphylococcus aureus 82 (10,7%), Streptococcus pneumoniae 54 (6,9%, de ellos 9,4% con resistencia intermedia a penicilina), Pseudomonas aeruginosa 42 (5,5%) y Moraxella catarrhalis 11 (1,4%). En el 34.9% no se aislaron patógenos. Conclusiones: Haemophilus influenzae es la primera causa de OMA en menores de 14 años. Este hecho, junto a la baja tasa de aislamientos y resistencia a penicilina de Streptococcus pneumoniae, cuestiona la idoneidad de la amoxicilina a dosis elevadas como tratamiento antibiótico empírico de la OMA.

Resumen: Introducción: Estudios recientes señalan un aumento de la prevalencia de Haemophilus influenzae y una disminución de Streptococcus pneumoniae entre las bacterias causantes de otitis media aguda (OMA). El objetivo del estudio es conocer la distribución de microorganismos patógenos identificados en Urgencias en los menores de 14 años con OMA y su patrón de resistencias. Pacientes y métodos: Estudio retrospectivo, analítico y unicéntrico incluyendo pacientes menores de 14 años diagnosticados de OMA en los que se recogió un cultivo de secreción ótica en el servicio de urgencias pediátricas de un hospital terciario entre 2013 y 2021. Resultados: Durante el periodo de estudio se registraron 14.684 episodios con diagnóstico de OMA, recogiéndose en 768 cultivo de secreción ótica. La mediana de edad fue de 2 años, el 57% varones y el 70% habían presentado al menos una OMA previa. Los patógenos más frecuentemente aislados fueron: Haemophilus influenzae, 188 (24,5%; de ellos, 15,5% resistentes a ampicilina); Streptococcus pyogenes, 86 (11,2%); Staphylococcus aureus, 82 (10,7%); Streptococcus pneumoniae, 54 (6,9%; de ellos, 9,4% con resistencia intermedia a penicilina); Pseudomonas aeruginosa, 42 (5,5%) y Moraxella catarrhalis, 11 (1,4%). En el 34,9% no se aislaron patógenos. Conclusiones: Haemophilus influenzae es la primera causa de OMA en menores de 14 años. Este hecho, junto a la baja tasa de aislamientos y resistencia a penicilina de Streptococcus pneumoniae, cuestiona la idoneidad de la amoxicilina a dosis elevadas como tratamiento antibiótico empírico de la OMA. Abstract: Introduction: Recent studies show an increase in the prevalence of Haemophilus influenzae and a decrease in Streptococcus pneumoniae among the bacteria that cause acute otitis media (AOM). The objective of our study was to analyse the distribution of pathogens identified in children aged less than 14 years presenting to the emergency department with AOM and their patterns of antimicrobial resistance. Patients and methods: Single centre retrospective, analytical study in patients aged less than 14 years with a diagnosis of AOM in whom an ear drainage sample was collected for culture in the paediatric emergency department of a tertiary care hospital between 2013 and 2021. Results: During the study period, there were 14,684 documented care episodes corresponding to children with a diagnosis of AOM. An ear drainage culture was performed in 768 of those episodes. The median age of the patients was 2 years, 57% were male and 70% had a previous history of AOM. The most frequently isolated pathogens were: Haemophilus influenzae (n = 188 [24.5%]; 15.5% of them resistant to ampicillin), Streptococcus pyogenes (n = 86 [11.2%]), Staphylococcus aureus (n = 82 [10.7%]), Streptococcus pneumoniae (n = 54 [6.9%]; 9.4% with intermediate resistance to penicillin), Pseudomonas aeruginosa (n = 42 [5.5%]) and Moraxella catarrhalis (n = 11 [1.4%]). No pathogen was isolated in 34.9% of cases. Conclusions: Haemophilus influenzae is the leading cause of AOM in children aged less than 14 years. This, combined with the low frequency of isolation and penicillin resistance of Streptococcus pneumoniae, calls into question the appropriateness of high-dose amoxicillin for empiric treatment of AOM

EEG studies play a crucial role in enhancing our understanding of brain development across the lifespan. The increasing clinical and policy implications of EEG research underscore the importance of utilizing reliable EEG measures and increasing the reproducibility of EEG studies. However, important data characteristics like reliability, effect sizes, and data quality metrics are often underreported in pediatric EEG studies. This gap in reporting could stem from the lack of accessible computational tools for quantifying these metrics for EEG data. To help address the lack of reporting, we developed a toolbox that facilitates the estimation of internal consistency reliability, effect size, and standardized measurement error with user-friendly software that facilitates both computing and interpreting these measures. In addition, our tool provides subsampled reliability and effect size in increasing numbers of trials. These estimates offer insights into the number of trials needed for detecting significant effects and reliable measures, informing the minimum number of trial thresholds for the inclusion of participants in individual difference analyses and the optimal trial number for future study designs. Importantly, our toolbox is integrated into commonly used preprocessing pipelines to increase the estimation and reporting of data quality metrics in developmental neuroscience.

This study explores how reducing lubricant viscosity affects fuel economy in passenger cars through experimental characterization and semi-predictive modelling. Thus, three engine oils (0W-20, 5W-30, and 5W-40) were tested for their rheological and tribological properties. Data were introduced into a detailed GT-Suite model of a turbocharged gasoline SUV. Simulations over six different driving cycles, including European homologation and real-driving conditions, used a fast-running model (FRM) to assess engine friction and wear protection. Results showed that lower viscosity oils, especially 0W-20, significantly reduced frictional losses, enhancing fuel economy. However, lower viscosity also increased contact friction under high power demand, raising durability concerns. A comprehensive evaluation of lubricants performance, offering insights into the trade-offs between fuel economy improvements and potential durability risks.

Fascioliasis, only foodborne trematodiasis of worldwide distribution, is caused by Fasciola hepatica and F. gigantica, liver flukes transmitted by freshwater snails. Southern and southeastern Asia is an emerging hot spot of F. gigantica, despite its hitherto less involvement in human infection. In Vietnam, increasing cases have been reported since 1995, whereas only sixteen throughout 1800–1994. A database was created to include epidemiological data of fascioliasis patients from the 63 Vietnam provinces throughout 1995–2019. Case profiles were based on serology, symptoms, eosinophilia, imaging techniques, stool egg finding, and post-specific-treatment recovery. Radio broadcasting about symptoms and costless diagnosis/treatment led patients to hospitals after symptom onset. Yearly case numbers were modelled and spatio-temporally analyzed. Missing data and confounders were assessed. The countrywide spread has no precedent. It started in the central coast, including 53,109 patients, mostly adults and females. Seasonality, linked to vegetable consumption, peaks in June, although the intensity of this peak differs according to relief/climatic zones. Incidence data and logistic regression curves are obtained for the first time in human fascioliasis. Fasciolid hybrids accompanying the spreading F. gigantica flukes, and climate change assessed by risk index correlations, are both ruled out as outbreak causes. Human-guided movements of livestock from an original area prove to be the way used by fasciolids and lymnaeid vectors to expand geographically. Radix viridis, a highly efficient transmitting and colonizing vector, played a decisive role in the spread. The use of irrigated crop fields, widely inhabited by R. viridis, for livestock grazing facilitated the transmission and spread of the disease. General physician awareness and diagnostic capacity improvement proved the successful impact of such knowledge transfer in facilitating and increasing patient infection detection. Information, education and communication to the public by radio broadcasting demonstrated to be very helpful. Fasciola gigantica is able to cause epidemic and endemic situations similar to F. hepatica. The magnitude of the human outbreak in Vietnam is a health wake-up call for southern and southeastern countries of Asia which present the highest human population densities with increasing food demands, uncontrolled livestock inter-country exchange, foreign import practices, and monsoon's increasing climate change impact.

The study addresses the detection of anxiety symptoms in young people using artificial intelligence models. Questionnaires such as the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder 7-item scale (GAD-7) are used to collect data, with a focus on early detection of anxiety. Three machine learning models are employed: Support Vector Machine (SVM), K Nearest Neighbors (KNN), and Random Forest (RF), with cross-validation to assess their effectiveness. Results show that the RF model is the most efficient, with an accuracy of 91 %, surpassing previous studies. Significant predictors of anxiety are identified, such as parental education level, alcohol consumption, and social security affiliation. A relationship is observed between anxiety and personal and family history of mental illness, as well as with characteristics external to the model, such as family and personal history of depression. The analysis of the results highlights the importance of considering not only clinical but also social and family aspects in mental health interventions. It is suggested that the sample size be expanded in future studies to improve the robustness of the model. In summary, the study demonstrates the usefulness of artificial intelligence in the early detection of anxiety in young people and highlights the relevance of addressing multidimensional factors in the assessment and treatment of this condition.

The theta band is one of the most prominent frequency bands in the electroencephalography (EEG) power spectrum and presents an interesting paradox: while elevated theta power during resting state is linked to lower cognitive abilities in children and adolescents, increased theta power during cognitive tasks is associated with higher cognitive performance. Why does theta power, measured during resting state versus cognitive tasks, show differential correlations with cognitive functioning? This review provides an integrated account of the functional correlates of theta across different contexts. We first present evidence that higher theta power during resting state is correlated with lower executive functioning, attentional abilities, language skills, and IQ. Next, we review research showing that theta power increases during memory, attention, and cognitive control, and that higher theta power during these processes is correlated with better performance. Finally, we discuss potential explanations for the differential correlations between resting/task-related theta and cognitive functioning, and offer suggestions for future research in this area.

Platelets are the critical target for preventing and treating pathological thrombus formation. However, despite current antiplatelet therapy, cardiovascular mortality remains high, and cardiovascular events continue in prescribed patients. In this study, first results were obtained with ortho-carbonyl hydroquinones as antiplatelet agents; we found that linking triphenylphosphonium cation to a bicyclic ortho-carbonyl hydroquinone moiety by a short alkyl chain significantly improved their antiplatelet effect by affecting the mitochondrial functioning. The mechanism of action involves uncoupling OXPHOS, which leads to an increase in mitochondrial ROS production and a decrease in the mitochondrial membrane potential and OCR. This alteration disrupts the energy production by mitochondrial function necessary for the platelet activation process. These effects are responsive to the complete structure of the compounds and not to isolated parts of the compounds tested. The results obtained in this research can be used as the basis for developing new antiplatelet agents that target mitochondria.

Fascioliasis is a snail-borne zoonotic disease with impact on the development of human subjects and communities. It is caused by two liver-infecting fasciolid trematode species, the globally-distributed Fasciola hepatica and the Africa/Asia-restricted but more pathogenic, larger F. gigantica. Fasciola gigantica is the cause of endemicity in livestock throughout the warm lowlands from Pakistan to southeastern Asia since old times. Human fascioliasis is emerging in this region at present, with an increase of patient reports. Complete sequences of rDNA ITS-1 and ITS-2 spacers and mtDNA nad1 and cox1 genes were obtained from fasciolid eggs found in the endoscopic bile aspirate from a patient of Arunachal Pradesh, northeastern India. Egg measurements, pronounced ITS heterozygosity, and pure F. gigantica mtDNA haplotypes demonstrate an infection by a recent F. gigantica-like hybrid. Sequence identities and similarities with the same DNA markers found in livestock from Bangladesh prove the human-infecting fasciolid to present identical ITSs and nad1 haplotypes and only one silent transversion in cox1 when compared to a widely-spread combined haplotype in animals. In northeastern India and Bangladesh, human fascioliasis emergence appears linked to increasing livestock prevalences due to: ruminant importation from other countries because of the increasing demand of rapidly growing human populations; numerous livestock movements, including transborder corridors, due to the uncontrolled small-scale household farming practices; and man-made introduction of F. hepatica with imported livestock into an area originally endemic for F. gigantica leading to frequent hybridization. Sequences, phylogenetic trees, and networks indicate that the origins of intermediate/hybrid fasciolids and factors underlying human infection risk differ in eastern and western South Asia. The emergence scenario in southern China and Vietnam resembles the aforementioned of northeastern India and Bangladesh, whereas in Pakistan it is linked to increasing monsoon rainfall within climate change combined with an impact of an extensive irrigation system. Past human-guided movements of pack animals along the western Grand Trunk Road and the eastern Tea-Horse Road explain the F. gigantica mtDNA results obtained. Physicians should be aware about these emerging scenarios, clinical pictures, diagnostic techniques and treatment. Government authorities must appropriately warn health professionals, ensure drug availability and improve livestock control.

Summary: Background: Understanding and optimising mental health and psychosocial support (MHPSS) interventions in humanitarian crises is crucial, particularly for the most prevalent mental health conditions in conflict settings: anxiety, depression, and post-traumatic stress disorder. However, research on what is the most appropriate length of psychological intervention is lacking in this setting. We aimed to establish which factors are most closely related to improvement and to determine the required number of consultations needed to achieve this improvement. Methods: We retrospectively analysed records from 9028 patients allocated to treatment for anxiety, depression, and post-traumatic symptoms from the MHPSS programme in Borno State, Nigeria, from January 2018 to December 2019. Patient characteristics, severity (Clinical Global Impression of Severity Scale, CGI-S scale), and clinical improvement were assessed by an attending counsellor (CGI-I scale) and by the patient (Mental Health Global State, MHGS scale). Improvement was defined as scores 1, 2, and 3 in the Clinical Global Impression of Improvement (CGI-I) scale, and as a decrease of at least 4 points in the MHGS scale. We investigated the associations between the category of symptoms, the severity of illness, and improvement of symptoms using multivariable logistic regression. We used Kaplan–Meier (KM) curves to assess the number of consultations (i.e., time of treatment) needed to achieve improvement of symptoms, by symptom category and symptom severity. Findings: The patients included were referred to treatment for anxiety (n = 3462), depression (n = 3970), or post-traumatic symptoms (n = 1596). Median age was 31 years (range 16–103), and 84.3% were female. Patients categorised as severe were less likely to present improvement according to the CGI-I scale (OR 0.11, 95% CI 0.05–0.25), while none of the other categories of symptoms showed significant results. Overall, three or more consultations were associated with improvement in both scales (OR 3.55, 95% CI 1.47–8.57 for CGI-I; and OR 3.04, 95% CI 2.36–3.90 for MHGS). KM curves for the category of symptoms showed that around 90% of patients with anxiety, depression, or post-traumatic symptoms, as well as those with mild or moderate severity, presented improvement after three consultations, compared with six consultations for those with severe symptoms. Interpretation: Classification by severity among patients with anxiety, depression, or post-traumatic symptoms could predict the probability of improvement, whereas classification by symptoms could not. Our study highlights the importance of classifying patient severity in MHPSS programmes to plan and implement the appropriate duration of care. A major limitation was the number of patients lost to follow up after the first consultation and excluded from the logistic regression and KM analysis. Funding: The study was funded and staffed entirely by Médicos Sin Fronteras (Médecins Sans Frontières), Spain.

Background: The integration of populations with various types of disabilities into basic life support (BLS) training programs could contribute to a potential increase in trained laypersons with BLS knowledge and, consequently, in survival rates. The objective of this study was to analyze the distinct educational methods which exist today on BLS for people with some type of specific disability, and to evaluate their impact on the quality of BLS maneuvers. Methods: A scoping review in which the different training strategies in BLS for people with distinctive disabilities were analyzed was carried out. Previous studies were sought and researched in MEDLINE, EMBASE, and the Cochrane Library from the beginning up to 4 August 2023. Results: A total of 14 studies were thoroughly analyzed. The BLS training strategies for people with disabilities were classified according to the following criteria: objective (training, content validation or analysis of learning barriers), target population (visual, hearing, physical disabilities or Down syndrome), training resources (training with/without adaptation), contents (BLS and use of the automated external defibrillator) and evaluation instrument (i.e., the simulation test and knowledge questionnaire). The variety of BLS training programs for such population is limited. Likewise, people with different disabilities are able to effectively learn BLS maneuvers, although with mixed results, mainly in those regarding the CPR quality. Conclusion: People with visual, hearing disabilities or Down syndrome are able to effectively learn BLS maneuvers.

Fascioliasis causes high economic losses in livestock and underlies public health problems in rural areas, mainly of low-income countries. The increasing animal infection rates in Bangladesh were assessed, by focusing on host species, different parts of the country, and rDNA sequences. Fasciolid flukes were collected from buffaloes, cattle, goats and sheep from many localities to assess prevalences and intensities of infection. The nuclear rDNA internal transcribed spacer (ITS) region including ITS-1 and ITS-2 spacers was analyzed by direct sequencing and cloning, given the detection of intermediate phenotypic forms in Bangladesh. The 35.4% prevalence in goats and 55.5% in buffaloes are the highest recorded in these animals in Bangladesh. In cattle (29.3%) and sheep (26.8%) prevalences are also high for these species. These prevalences are very high when compared to lowlands at similar latitudes in neighboring India. The high prevalences and intensities appear in western Bangladesh where cross-border importation of animals from India occur. The combined haplotype CH3A of Fasciola gigantica widely found in all livestock species throughout Bangladesh fits its historical connections with the western Grand Trunk Road and the eastern Tea-Horse Road. The “pure” F. hepatica sequences only in clones from specimens showing heterozygotic positions indicate recent hybridization events with local “pure” F. gigantica, since concerted evolution did not yet have sufficient time to homogenize the rDNA operon. The detection of up to six different sequences coexisting in the cloned specimens evidences crossbreeding between hybrid parents, indicating repeated, superimposed and rapidly evolving hybridization events. The high proportion of hybrids highlights an increasing animal infection trend and human infection risk, and the need for control measures, mainly concerning goats in household farming management. ITS-1 and ITS-2 markers prove to be useful for detecting recent hybrid fasciolids. The introduction of a Fasciola species with imported livestock into a highly prevalent area of the other Fasciola species may lead to a high nucleotide variation in the species-differing positions in the extremely conserved fasciolid spacers. Results suggest that, in ancient times, frequent crossbreeding inside the same Fasciola species gave rise to the very peculiar characteristics of the present-day nuclear genome of both fasciolids.

The influenza virus has accompanied humans since time immemorial, in the form of annual epidemics and occasional pandemics. It is a respiratory infection with multiple repercussions on people’s lives at an individual and social level, as well as representing a significant burden on the health system. This Consensus Document arises from the collaboration of various Spanish scientific societies involved in influenza virus infection. The conclusions drawn are based on the highest quality evidence available in the scientific literature and, failing that, on the opinion of the experts convened. The Consensus Document addresses the clinical, microbiological, therapeutic, and preventive aspects (with respect to the prevention of transmission and in relation to vaccination) of influenza, for both adult and pediatric populations. This Consensus Document aims to help facilitate the clinical, microbiological, and preventive approach to influenza virus infection and, consequently, to reduce its important consequences on the morbidity and mortality of the population. Resumen: El virus de la gripe ha acompañado al ser humano desde tiempo inmemorial, en forma de epidemias anuales y pandemias ocasionales. Se trata de una infección respiratoria con múltiples repercusiones sobre la vida de las personas a nivel individual y social, así como una importante sobrecarga para el sistema sanitario. El presente documento de consenso surge de la colaboración de diversas sociedades científicas españolas implicadas en la atención de la infección por virus de la gripe. Las conclusiones extraídas se han fundamentado en las evidencias de mayor calidad disponibles en la literatura científica y, en su defecto, en la opinión de los expertos convocados. En el documento de consenso se abordan los aspectos clínicos, microbiológicos, terapéuticos y preventivos (respecto de la prevención de la transmisión y en relación con la vacunación) de la gripe, tanto para población pediátrica como para adultos. Este documento de consenso pretende ayudar a facilitar el abordaje clínico, microbiológico y preventivo de la infección por virus de la gripe y, consecuentemente, a disminuir sus importantes consecuencias sobre la morbimortalidad de la población.

Study region: Quito, Ecuador Study focus: The study region faces two water-related challenges, which, to date, have only been studied to a minimal extent: extreme precipitation events and water shortage in the dry season. This study investigates the current conditions and future changes in short-duration events, low river discharges and associated uncertainties. Daily precipitation and temperature projections from 19 state-of-the-art global climate models (CMIP6) and four future scenarios (SSP1–2.6, SSP2–4.5, SSP3–7.0 and SSP5–8.5) are downscaled with delta change and more advanced quantile perturbation methodologies. Temporal disaggregation is applied to obtain sub-daily precipitation with five extreme value distributions (EVDs). Three conceptual hydrological models are implemented to quantify the impacts on river flows. Variance decomposition is applied to estimate the uncertainty share of climate models, hydrological models, and EVDs in the results. New hydrological insights: The results indicate an intensification of extreme precipitation events, with short-duration events expected to be more intense by up to 30% in the near future (2021–2050) and up to 60% in the far future (2070–2099). The river peak discharges are projected to increase by 5–20% and 10–50% in the near and far future, respectively. On the contrary, the low river flows are projected to decrease by 0–13% and 0–30% for the respective time horizons. Overall, climate models are the dominant source of uncertainty.

The industrial adoption of microbial electrosynthesis (MES) is hindered by high overpotentials deriving from low electrolyte conductivity and inefficient cell designs. In this study, a mixed microbial consortium originating from an anaerobic digester operated under saline conditions (∼13 g L−1 NaCl) was adapted for acetate production from bicarbonate in galvanostatic (0.25 mA cm−2) H-type cells at 5, 10, 15, or 20 g L−1 NaCl concentration. The acetogenic communities were successfully enriched only at 5 and 10 g L−1 NaCl, revealing an inhibitory threshold of about 6 g L−1 Na+. The enriched planktonic communities were then used as inoculum for 3D printed, three-chamber cells equipped with a gas diffusion biocathode. The cells were fed with CO2 gas and operated galvanostatically (0.25 or 1.00 mA cm−2). The highest production rate of 55.4 g m−2 d−1 (0.89 g L−1 d−1), with 82.4% Coulombic efficiency, was obtained at 5 g L−1 NaCl concentration and 1 mA cm−2 applied current, achieving an average acetate production of 44.7 kg MWh−1. Scanning electron microscopy and 16S rRNA sequencing analysis confirmed the formation of a cathodic biofilm dominated by Acetobacterium sp. Finally, three 3D printed cells were hydraulically connected in series to simulate an MES stack, achieving three-fold production rates than with the single cell at 0.25 mA cm−2. This confirms that three-chamber MES cells are an efficient and scalable technology for CO2 bio-electro recycling to acetate and that moderate saline conditions (5 g L−1 NaCl) can help reduce their power demand while preserving the activity of acetogens.

Summary: Background: While a low CD4/CD8 ratio during HIV treatment correlates with immunosenescence, its value in identifying patients at an increased risk for clinical events remains unclear. Methods: We analyzed data from the CoRIS cohort to determine whether CD4 count, CD8 count, and CD4/CD8 ratio at year two of antiretroviral therapy (ART) could predict the risk of serious non-AIDS events (SNAEs) during the next five years. These included major adverse cardiovascular events, non-AIDS-defining malignancies, and non-accidental deaths. We used pooled logistic regression with inverse probability weighting to estimate the survival curves and cumulative risk of clinical events. Findings: The study included 4625 participants, 83% male, of whom 200 (4.3%) experienced an SNAE during the follow-up period. A CD4/CD8 ratio

Resumen: Introducción: el ideario popular, la diseminación a través de redes sociales o la «costumbre» han propiciado diversos mitos sobre el ahogamiento y los incidentes acuáticos que no están basados en evidencias y pueden tener efectos colaterales o limitan la comprensión de este fenómeno. El objetivo de este trabajo ha sido analizar el origen de los mitos más frecuentes relacionados con los incidentes acuáticos y ofrecer una perspectiva científica para su refutación. Materiales y métodos: doce expertos de las Ciencias de la Salud mediante un grupo nominal realizaron el cribado de conceptos en 3 fases: 1ª revisión literatura científica en PubMed en la que se abordasen conceptos erróneos u obsoletos relacionados a los incidentes en entornos acuáticos, 2ª el grupo elaboró un listado de 16 ítems susceptibles de analizar y 3ª se seleccionaron por consenso los mitos considerados más relevantes. Resultados: mediante consenso de expertos y las evidencias disponibles, 10 ítems fueron identificados como potenciales generadores de conceptos erróneos o mitos: el «corte de digestión», el uso de flotadores para prevenir el ahogamiento, hiperventilar antes de bucear, las implicaciones de la bandera roja en las playas, el proceso de ahogamiento, la principal función de los socorristas, orinar sobre picaduras de medusa, la terminología sobre ahogamiento y la reanimación de ahogados. Conclusión: en el ámbito del ahogamiento se sigue utilizando terminología obsoleta y existen creencias populares erróneas que deberían ser actualizadas y desmitificadas, ya que esto podría contribuir a disminuir la incidencia del ahogamiento y sus secuelas. Abstract: Introduction: Popular ideology, dissemination by social networks or the “custom” have fostered numerous myths about drowning and aquatic incidents that are not based on evidence and may be harmful or limit the understanding of this phenomenon. The aim of this paper is to analyze the origin of the most frequent myths related to aquatic incidents and to offer a scientific perspective for their refutation. Materials and methods: Twelve experts in the health sciences by means of a nominal group carried out the screening of concepts in three phases: 1st review of scientific literature in PUBMED in which erroneous or obsolete concepts related to incidents in aquatic environments were addressed, 2nd phase the nominal group elaborated an initial list of 16 items to be analyzed, 3rd phase the final list was refined to 1 by universal consensus of the nominal group. Results: Through expert consensus and available evidence, ten items were identified as potential generators of misconceptions or myths: the “digestion cut-off”, the use of floats to prevent drowning, hyperventilating before diving, the implications of the red flag on beaches, the drowning process, the main role of lifeguards, urinating on jellyfish stings, drowning terminology, and resuscitation of drowned persons. Conclusion: In the field of drowning, obsolete terminology continues to be used and there are erroneous popular beliefs that should be updated and demystified, as this could contribute to reduce the incidence of drowning and its sequelae.

Introduction: Tracheal intubation is a frequent procedure in paediatric intensive care units (PICUs) that carries a risk of complications that can increase morbidity and mortality. Patients and methods: Prospective, longitudinal, observational study in patients intubated in a level III PICU between January and December 2020. We analysed the risk factors associated with failed intubation and adverse events. Results: The analysis included 48 intubations. The most frequent indication for intubation was hypoxaemic respiratory failure (25%). The first attempt was successful in 60.4% of intubations, without differences between procedures performed by staff physicians and resident physicians (62.5% vs 56.3%; P = .759). Difficulty in bag-mask ventilation was associated with failed intubation in the first attempt (P = .028). Adverse events occurred in 12.5% of intubations, and severe events in 8.3%, including 1 case of cardiac arrest, 2 cases of severe hypotension and 1 of oesophageal intubation with delayed recognition. None of the patients died. Making multiple attempts was significantly associated with adverse events (P < .002). Systematic preparation of the procedure with cognitive aids and role allocation was independently associated with a lower incidence of adverse events. Conclusions: In critically ill children, first-attempt intubation failure is common and associated with difficulty in bag-mask ventilation. A significant percentage of intubations may result in serious adverse events. The implementation of intubation protocols could decrease the incidence of adverse events. Resumen: Introducción: La intubación traqueal es un procedimiento frecuente en las unidades de cuidados intensivos pediátricos con riesgo de complicaciones que pueden aumentar la morbimortalidad. Pacientes y métodos: Estudio descriptivo y analítico de una cohorte prospectiva incluyendo a los pacientes intubados en una UCIP de tercer nivel entre enero y diciembre de 2020, analizando los factores asociados con el fracaso de intubación y los efectos adversos. Resultados: Se analizaron 48 intubaciones. La indicación más frecuente fue el fallo respiratorio hipoxémico (25%). El primer intento de intubación fue exitoso en el 60,4%, sin diferencias entre los médicos adjuntos 62,5% y los residentes 56,3%, p = 0,759. La dificultad en la ventilación con bolsa y mascarilla se asoció con el fracaso del primer intento de intubación (p = 0,028). Se objetivaron eventos adversos en un 12,5% de las intubaciones, siendo graves en un 8,3% de los casos, incluyendo una parada cardiorrespiratoria, dos casos de hipotensión grave y una intubación esofágica detectada de forma tardía. Los intentos múltiples de intubación se asociaron significativamente con la aparición de eventos adversos (p

Resumen: Introducción: La intubación traqueal es un procedimiento frecuente en las unidades de cuidados intensivos pediátricos con riesgo de complicaciones que pueden aumentar la morbimortalidad. Pacientes y métodos: Estudio descriptivo y analítico de una cohorte prospectiva que incluye a los pacientes intubados en una unidad de cuidados intensivos pediátricos de tercer nivel entre enero y diciembre de 2020, analizando los factores asociados con el fracaso de intubación y los efectos adversos. Resultados: Se analizaron 48 intubaciones. La indicación más frecuente fue el fallo respiratorio hipoxémico (25%). El primer intento de intubación fue exitoso en el 60,4%, sin diferencias entre los médicos adjuntos y los residentes (62,5 vs. 56,3%; p = 0,759). La dificultad en la ventilación con bolsa y mascarilla se asoció con el fracaso del primer intento de intubación (p = 0,028). Se objetivaron eventos adversos en un 12,5% de las intubaciones, siendo graves en un 8,3% de los casos, incluyendo una parada cardiorrespiratoria, 2 casos de hipotensión grave y una intubación esofágica detectada de forma tardía. Ninguno de los pacientes falleció. Los intentos múltiples de intubación se asociaron significativamente con la aparición de eventos adversos (p

Study region: Belgium Study focus: We assessed statistical downscaling (21 methods) skill and assumptions for seven extreme rainfall indicators in three Belgian areas. The ensemble consists of (i) perturbation methods with four members, (ii) quantile mapping with ten members, and (iii) machine learning with seven members. The methods were evaluated by a perfect predictor experiment in which the outputs of a high-resolution climate model are considered pseudo-observations. The ALARO-0 model with 4 km spatial resolution was considered the high-resolution climate model. The high-resolution outputs were compared with the downscaled results of three future scenarios of the 50 km resolution ALARO-0 model. New hydrological insights: The methods’ skill depends on the area. The skill is higher for the Belgian coastal area compared to the inland and hilly areas. Methods which are based on stationary assumptions have a good skill for the coastal area but show a lower skill for the other areas where the temporal variability in meteorological conditions is stronger. The higher this temporal variability, the more prone are the stationary assumptions to deteriorate in time under different climate forcing conditions. The quantile-based perturbation methods are overall the most robust. An ensemble approach is advised, where different downscaling methods are applied and the uncertainty in the downscaling taken into account, especially when a pseudo-future evaluation, as done in this study, is not possible.

Aim: To implement small methodological changes in basic life support (BLS) training to reduce unnecessary pauses during automated external defibrillator (AED) use. Methods: One hundred and two university students with no BLS knowledge were randomly allocated into three groups (control and 2 experimental groups). Both experimental groups received a two-hour BLS training. While the contents were identical in both groups, in one of them the reduction of no-flow time was focused on (focused no-flow group). The control group did not receive any training. Finally, all of them were evaluated in the same out-of-hospital cardiac arrest simulated scenario. The primary endpoint was the compression fraction. Results: Results from 78 participants were analysed (control group: 19; traditional group: 30; focused no-flow group: 29). The focused no-flow group achieved higher percentages of compression fraction (median: 56.0, interquartile rank (IQR): 53.5–58.5) than the traditional group (44.0, IQR: 42.0–47.0) and control group (52.0, IQR: 43.0–58.0) in the complete scenario. Participants from the control group performed compression-only cardiopulmonary resuscitation (CPR), while the other groups performed compression-ventilation CPR. CPR fraction was calculated, showing the fraction of time in which the participants were performing resuscitation manoeuvres. In this case, the focused no-flow group reached higher percentages of CPR fraction (77.6, IQR: 74.4–82.4) than the traditional group (61.9, IQR: 59.3–68.1) and the control group (52.0, IQR: 43.0–58.0). Conclusions: Laypeople having automated external defibrillation training focused on acting in anticipation of the AED prompts contributed to a reduction in chest compression pauses during an OHCA simulated scenario.

Objectives: Corneal diseases are among the main causes of blindness, with approximately 4.6 and 23 million patients worldwide suffering from bilateral and unilateral corneal blindness, respectively. The standard treatment for severe corneal diseases is corneal transplantation. However, relevant disadvantages, particularly in high-risk conditions, have focused the attention on the search for alternatives. Methods: We report interim findings of a phase I-II clinical study evaluating the safety and preliminary efficacy of a tissue-engineered corneal substitute composed of a nanostructured fibrin-agarose biocompatible scaffold combined with allogeneic corneal epithelial and stromal cells (NANOULCOR). 5 subjects (5 eyes) suffering from trophic corneal ulcers refractory to conventional treatments, who combined stromal degradation or fibrosis and limbal stem cell deficiency, were included and treated with this allogeneic anterior corneal substitute. Results: The implant completely covered the corneal surface, and ocular surface inflammation decreased following surgery. Only four adverse reactions were registered, and none of them were severe. No detachment, ulcer relapse nor surgical re-interventions were registered after 2 years of follow-up. No signs of graft rejection, local infection or corneal neovascularization were observed either. Efficacy was measured as a significant postoperative improvement in terms of the eye complication grading scales. Anterior segment optical coherence tomography images revealed a more homogeneous and stable ocular surface, with complete scaffold degradation occurring within 3–12 weeks after surgery. Conclusions: Our findings suggest that the surgical application of this allogeneic anterior human corneal substitute is feasible and safe, showing partial efficacy in the restoration of the corneal surface.